Journal Article

Combined systolic and diastolic dysfunction in the presence of preserved left ventricular ejection fraction

Ian P. Clements

in European Journal of Heart Failure

Published on behalf of European Society of Cardiology

Volume 7, issue 4, pages 490-497
Published in print June 2005 | ISSN: 1388-9842
Published online June 2005 | e-ISSN: 1879-0844 | DOI: http://dx.doi.org/10.1016/j.ejheart.2004.06.005
Combined systolic and diastolic dysfunction in the presence of preserved left ventricular ejection fraction

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Background

Heart failure with preserved left ventricular ejection fraction (LVEF) suggests isolated diastolic dysfunction.

Aim

The purpose of this study was to determine if systolic and diastolic dysfunction occurred with preserved LVEF.

Methods

Equilibrium resting radionuclide ventriculograms from 439 patients with an LVEF ≥0.50 were used to determine LV peak filling rate (PFR) and peak ejection rate (PER) in end-diastolic volumes per second and LV end-systolic volume (ml). Patients with low-normal (n=147; range, 0.50−0.58; mean±S.D., 0.53±0.02), intermediate-normal (161, 0.59−0.64, 0.61±0.02), and high-normal (131, 0.65−0.94, 0.72±0.06) LVEF were compared.

Results

From low-normal to intermediate-normal to high-normal LVEF, LV end-systolic volume decreased (93±36, 71±33, 43±26, respectively, P<0.0001), PFR increased (2.31±0.74, 2.58±0.74, 3.15±0.94, P<0.0001), PER increased (−2.78±0.50, −3.13±0.47, −3.83±0.84, P<0.0001), the percentages of patients with abnormal PFR decreased (66, 56, 40, P<.0001), and the percentage with abnormal PER decreased (47, 14, 5, P<0.0001). Of 193 patients with preserved LVEF and abnormally low PFR, 65 (34%) had abnormally low PER.

Conclusions

The results indicate that a preserved LVEF was often associated with LV systolic dysfunction (enlarged LV end-systolic volume and low PER) and LV diastolic dysfunction (decreased PFR).

Keywords: Diastole; Radionuclide; Systole; Ventriculography

Journal Article.  4201 words.  Illustrated.

Subjects: Cardiovascular Medicine

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