Diastolic heart failure: Difference between revisions
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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.<ref name="pmid9036306">{{cite journal| author=| title=The effect of digoxin on mortality and morbidity in patients with heart failure. The Digitalis Investigation Group. | journal=N Engl J Med | year= 1997 | volume= 336 | issue= 8 | pages= 525-33 | pmid=9036306 | 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.<ref name="pmid9036306">{{cite journal| author=| title=The effect of digoxin on mortality and morbidity in patients with heart failure. The Digitalis Investigation Group. | journal=N Engl J Med | year= 1997 | volume= 336 | issue= 8 | pages= 525-33 | pmid=9036306 | ||
| 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=9036306 }} <!--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=9036306 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | ||
==Prognosis== | |||
Diastolic dysfunction, even in the absence of clinical [[heart failure]], increases mortality.<ref name="pmid12517230">{{cite journal| author=Redfield MM, Jacobsen SJ, Burnett JC, Mahoney DW, Bailey KR, Rodeheffer RJ| title=Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. | journal=JAMA | year= 2003 | volume= 289 | issue= 2 | pages= 194-202 | pmid=12517230 | |||
| 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=12517230 }} [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=12954043 Review in: ACP J Club. 2003 Sep-Oct;139(2):51] <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 11:50, 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]
Prognosis
Diastolic dysfunction, even in the absence of clinical heart failure, increases mortality.[6]
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.
- ↑ Redfield MM, Jacobsen SJ, Burnett JC, Mahoney DW, Bailey KR, Rodeheffer RJ (2003). "Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic.". JAMA 289 (2): 194-202. PMID 12517230. Review in: ACP J Club. 2003 Sep-Oct;139(2):51