Preserved LVEF is frequently associated with both systolic and diastolic dysfunction, challenging the assumption that HFpEF is solely a disease of isolated diastolic dysfunction.
Answers are grounded in this paper and cite their sources.
LV function improves continuously across normal LVEF; challenges isolated diastolic HFpEF model but hypothesis-generating only.
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).
No takes yet. Share an insight, caveat, or question.
Ian P. Clements (2004) studied this question.
Synapse has enriched 10 related papers. Consider them for comparative context: