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Congestive heart failure with normal systolic function.

A H Dougherty, G V Naccarelli, E L Gray

    The American Journal of Cardiology
    |October 1, 1984
    PubMed
    Summary
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    Congestive heart failure (CHF) with normal systolic function is common, affecting 36% of patients. This condition is characterized by diastolic dysfunction and a noncompliant left ventricle.

    Area of Science:

    • Cardiology
    • Heart Failure Research

    Background:

    • Isolated reports exist of congestive heart failure (CHF) with preserved systolic function.
    • The prevalence and characteristics of CHF with normal systolic function remain undescribed.

    Purpose of the Study:

    • To prospectively evaluate the prevalence and clinical characteristics of CHF patients with normal systolic function.
    • To investigate the underlying mechanisms, specifically left ventricular compliance, in these patients.

    Main Methods:

    • Prospective evaluation of 188 CHF patients undergoing radionuclide ventriculography.
    • Classification into groups based on ejection fraction (EF): normal (≥0.45) and abnormal (<0.45).
    • Echocardiographic assessment of left atrial emptying index to determine left ventricular compliance.

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    Main Results:

    • 36% (67 of 188) of CHF patients had a normal ejection fraction (≥0.45).
    • Systemic hypertension was a more frequent contributing factor in patients with normal EF (65%) compared to those with abnormal EF (23%).
    • Both CHF groups exhibited significantly reduced left atrial emptying index compared to normal controls, indicating impaired left ventricular compliance.

    Conclusions:

    • Normal systolic function is a common finding in patients diagnosed with congestive heart failure.
    • Diastolic dysfunction, evidenced by reduced left ventricular compliance, is present in CHF patients regardless of systolic function status.
    • This suggests that diastolic dysfunction plays a crucial role in the pathophysiology of CHF, even in the presence of normal systolic function.