Diastolic heart failure: Difference between revisions
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imported>Robert Badgett (New page: {{subpages}} In medicine and physiology, '''diastolic heart failure''' or '''diastolic dysfunction''' is "heart failure caused by abnormal myocardial relaxation during diastoli...) |
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In [[medicine]] and [[physiology]], '''diastolic heart failure''' or '''diastolic dysfunction''' is "[[heart failure]] caused by abnormal myocardial relaxation during diastolic leading to defective cardiac filling."<ref>{{MeSH}}</ref> | In [[medicine]] and [[physiology]], '''diastolic heart failure''' or '''diastolic dysfunction''' is "[[heart failure]] caused by abnormal myocardial relaxation during diastolic leading to defective cardiac filling."<ref>{{MeSH}}</ref> | ||
Up to 40% of patients with heart failure may not have evidence of systolic dysfunction.<ref name="pmid1503353">{{cite journal| author=Bonow RO, Udelson JE| title=Left ventricular diastolic dysfunction as a cause of congestive heart failure. Mechanisms and management. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 6 | pages= 502-10 | pmid=1503353 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=1503353 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
==Diagnosis== | ==Diagnosis== | ||
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[[Echocardiography]] may detect diastolic heart failure (see table).<ref name="pmid20152696">{{cite journal| author=Dokainish H, Nguyen JS, Sengupta R, Pillai M, Alam M, Bobek J et al.| title=Do additional echocardiographic variables increase the accuracy of E/e' for predicting left ventricular filling pressure in normal ejection fraction? An echocardiographic and invasive hemodynamic study. | journal=J Am Soc Echocardiogr | year= 2010 | volume= 23 | issue= 2 | pages= 156-61 | pmid=20152696 | [[Echocardiography]] may detect diastolic heart failure (see table).<ref name="pmid20152696">{{cite journal| author=Dokainish H, Nguyen JS, Sengupta R, Pillai M, Alam M, Bobek J et al.| title=Do additional echocardiographic variables increase the accuracy of E/e' for predicting left ventricular filling pressure in normal ejection fraction? An echocardiographic and invasive hemodynamic study. | journal=J Am Soc Echocardiogr | year= 2010 | volume= 23 | issue= 2 | pages= 156-61 | pmid=20152696 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=20152696 | doi=10.1016/j.echo.2009.11.015 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=20152696 | doi=10.1016/j.echo.2009.11.015 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | ||
The the ratio of peak early (E) or passive diastolic filling and peak atria1 (A) velocities (E/A ratio) of <u><</u> 0.6 is less sensitive.<ref name="pmid2705380">{{cite journal| author=Aguirre FV, Pearson AC, Lewen MK, McCluskey M, Labovitz AJ| title=Usefulness of Doppler echocardiography in the diagnosis of congestive heart failure. | journal=Am J Cardiol | year= 1989 | volume= 63 | issue= 15 | pages= 1098-102 | pmid=2705380 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=2705380 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
==Treatment== | ==Treatment== | ||
Revision as of 10:36, 1 March 2010
In medicine and physiology, diastolic heart failure or diastolic dysfunction is "heart failure caused by abnormal myocardial relaxation during diastolic leading to defective cardiac filling."[1]
Up to 40% of patients with heart failure may not have evidence of systolic dysfunction.[2]
Diagnosis
| Finding | Sensitivity | Specificity |
|---|---|---|
| Mitral annular velocity (E/e') > 13 mm Hg | 70% | 93% |
| Left atrial volume index (LAVi) > 31 mL/m2 | 78% | 76% |
| Pulmonary artery systolic pressure (PAP) | 80% | 64% |
| E/e' or LAVi* | 87% | 88% |
| Notes: * E/e' > 13 mm Hg or LAVi > 31 mL/m2 with E/e' > 7 mm Hg | ||
Echocardiography may detect diastolic heart failure (see table).[3]
The the ratio of peak early (E) or passive diastolic filling and peak atria1 (A) velocities (E/A ratio) of < 0.6 is less sensitive.[4]
Treatment
Digoxin may reduce the combined outcome of death or hospitalization due to worsening heart failure according the results of the ancillary trial of patients with preserved ejection fraction in a larger randomized controlled trial of treating patients with heart failure.[5]
References
- ↑ Anonymous (2024), Diastolic heart failure (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Bonow RO, Udelson JE (1992). "Left ventricular diastolic dysfunction as a cause of congestive heart failure. Mechanisms and management.". Ann Intern Med 117 (6): 502-10. PMID 1503353.
- ↑ 3.0 3.1 Dokainish H, Nguyen JS, Sengupta R, Pillai M, Alam M, Bobek J et al. (2010). "Do additional echocardiographic variables increase the accuracy of E/e' for predicting left ventricular filling pressure in normal ejection fraction? An echocardiographic and invasive hemodynamic study.". J Am Soc Echocardiogr 23 (2): 156-61. DOI:10.1016/j.echo.2009.11.015. PMID 20152696. Research Blogging.
- ↑ Aguirre FV, Pearson AC, Lewen MK, McCluskey M, Labovitz AJ (1989). "Usefulness of Doppler echocardiography in the diagnosis of congestive heart failure.". Am J Cardiol 63 (15): 1098-102. PMID 2705380.
- ↑ (1997) "The effect of digoxin on mortality and morbidity in patients with heart failure. The Digitalis Investigation Group.". N Engl J Med 336 (8): 525-33. PMID 9036306.