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Clinical and echocardiographic characteristics of patients in sinus rhythm, normal left ventricular function, and

Matan Shimron1,2, Lynne Williams3, Yevgeni Hazanov1,2

  • 1Department of Cardiology, B Padeh Medical Center, Poriya, Israel.

Echocardiography (Mount Kisco, N.Y.)
|February 20, 2018
PubMed

Insights

Diastolic dysfunction (DDFx) diagnosis is challenging in heart failure with preserved ejection fraction (HFpEF). Patients with indeterminate DDFx share clinical and echocardiographic traits with those with definite DDFx, suggesting a closer relationship.

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Research

Background:

  • Diastolic dysfunction (DDFx) is a primary cause of heart failure with preserved ejection fraction (HFpEF).
  • Echocardiographic assessment of DDFx in sinus rhythm patients can be indeterminate due to discrepant measures.
  • Accurate diagnosis of DDFx is crucial for effective HFpEF management.

Purpose of the Study:

  • To characterize patients with indeterminate diastolic function (IndtDFx) using echocardiography.
  • To compare clinical and echocardiographic features of IndtDFx with normal (NDFx) and definite DDFx.
  • To identify predictors of heart failure symptoms in patients with varying diastolic function status.

Main Methods:

  • Retrospective analysis of 1674 patients in sinus rhythm with preserved ejection fraction (EF ≥ 45%).
  • Classification into NDFx, DDFx, and IndtDFx based on lateral mitral E/E' ratio and left atrial systolic diameter (LASd).
  • Statistical analysis to compare group characteristics and identify independent predictors of heart failure symptoms.

Main Results:

  • IndtDFx patients (n=207) showed intermediate parameter abnormalities, overlapping significantly with DDFx patients (n=186).
  • LASd and E/E' were similarly associated with indeterminate diastolic function.
  • Age, female gender, renal failure, E/E', and pulmonary pressure independently predicted heart failure symptoms.

Conclusions:

  • Indeterminate diastolic function in echocardiography is clinically and echocardiographically more aligned with definite diastolic dysfunction than normal function.
  • Left atrial diameter, while abnormal in IndtDFx, did not predict heart failure symptoms.
  • Further research into left atrial function, beyond size, may enhance diagnostic capabilities for diastolic dysfunction.
Abstract

Keywords:
cardiac functionechocardiographyheart failure

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