Ventricular Structure and Function in Hypertensive Participants With Heart Failure and a Normal Ejection Fraction

Maurer, Mathew S.; Burkhoff, Daniel; Fried, Linda P.; Gottdiener, John S.; King, Donald L.; Kitzman, Dalane W.

doi:10.1016/j.jacc.2006.10.061

Cited by 163 publications

(134 citation statements)

References 43 publications

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“…We excluded three hypertensive patients from the present study because they had reduced EF or LV enlargement suggesting the development of LV systolic dysfunction or LV remodeling. Maurer et al 26 also described an increased LV diastolic diameter in 167 hypertensive patients with heart failure with a normal EF, a finding that is supported by our results. Rame et al 27 reported that 18% of 159 patients with DHF developed reduced EF after a follow-up of B4 years.…”

Section: Global Systolic Functionsupporting

confidence: 90%

Left ventricular global systolic dysfunction has a significant role in the development of diastolic heart failure in patients with systemic hypertension

et al. 2010

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Regional left ventricular (LV) systolic dysfunction has been identified in diastolic heart failure (DHF). However, the relationship between regional or global LV systolic function and heart failure symptoms in DHF has not been evaluated in detail. The present study evaluates such relationships in patients with systemic hypertension (HT) and DHF. We assessed LV systolic and diastolic function in 220 consecutive patients with systemic HT and in 30 normal individuals (Control) using Doppler echocardiography. Patients with HT were assigned to groups with DHF, asymptomatic diastolic dysfunction (ADD) and no diastolic dysfunction (Simple HT). Ejection fraction in DHF was significantly decreased (63 ± 8%) compared with the Control, Simple HT and ADD groups (67±5, 66±7 and 68±8%, respectively). Isovolumetric contraction time in DHF (70±30 msec) was significantly increased compared with those in the ADD, Simple HT and Control groups (31±17, 31±15 and 30±19 msec, respectively). Mitral annular systolic velocities were significantly decreased in the DHF and ADD groups (6.4 ± 1.5 and 7.2 ± 1.3 cm sec À1 , respectively) compared with those in the Simple HT and Control groups (8.5 ± 1.8 and 8.4 ± 3.0 cm sec À1 , respectively), and in the DHF group compared with the ADD group. LV global systolic dysfunction has a significant role in the development of heart failure symptoms associated with DHF in patients with systemic HT.

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Section: Global Systolic Functionsupporting

confidence: 90%

Left ventricular global systolic dysfunction has a significant role in the development of diastolic heart failure in patients with systemic hypertension

et al. 2010

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“…Thus, renal insufficiency may increase the prevalence of DHF partly through the induction of anemia in hypertensive patients without reduced EF. Maurer et al concluded that anemia induced DHF through volume overload because LV end-diastolic dimension was greater in the DHF patients than in hypertensive patients without heart failure (13). However, the LV end-diastolic dimension was small in patients with renal insufficiency and low hemoglobin in this study (Table 4), and thus, anemia was unlikely to induce DHF through volume overload.…”

Section: Renal Insufficiency and Dhfmentioning

confidence: 50%

“…Previous studies have also shown that serum creatinine and the prevalence of anemia were higher in DHF patients than in hypertensive patients without heart failure (13), and anemia exacerbated the prognosis of DHF patients (32,33). Thus, renal insufficiency may increase the prevalence of DHF partly through the induction of anemia in hypertensive patients without reduced EF.…”

Section: Renal Insufficiency and Dhfmentioning

confidence: 92%

“…All of the patients with previous hospitalization were excluded because the reasons for the hospitalization were uncertain in some patients who had been admitted to other hospitals. Following previous clinical studies (12,13), we defined hypertension as systolic (> 140 mmHg) or diastolic (> 90 mmHg) blood pressure based on blood pressure recording at the outpatient clinic and ambulatory blood pressure recording, a reported history of hypertension, or use of antihypertensive medications. Heart failure was diagnosed according to the modified Framingham criteria (11), and the 691 hypertensive patients with preserved EF were divided into groups without (HT, n= 493) and with heart failure (HTHF, n= 198).…”

Section: Patientsmentioning

confidence: 99%

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Difference of Clinical Characteristics between Hypertensive Patients with and without Diastolic Heart Failure: The Roles of Diastolic Dysfunction and Renal Insufficiency

et al. 2008

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Clinical characteristics were compared between hypertensive patients with and without heart failure in the absence of reduced ejection fraction (EF) to gain insights into the effects of renal insufficiency on the prevalence of diastolic heart failure. Study subjects consisted of 691 hypertensive patients with an EF >40%. Patients with serum creatinine >2.5 mg/dL were excluded from the study. The Framingham heart failure criteria were met by 198 patients, and competing risks of the prevalence of heart failure were analyzed. The multiple logistic regression analysis revealed that obesity, female gender, creatinine clearance (CCr), and a ratio of transmitral E velocity to early diastolic mitral annular velocity (E /E ′) >15 were independently associated with the prevalence of heart failure with preserved EF. Patients with 60≤ CCr <90 mL/min represented higher E /E ′ ratio and lower E ′ velocity than the patients with CCr≥90 mL/min, although there was no difference in the prevalence of heart failure between the two groups. These indices were not different between the patients with 60≤ CCr <90 mL/min and CCr <60 mL/min, although the prevalence of heart failure was higher in the patients with CCr <60 mL/min. The hemoglobin concentration was significantly decreased and the brachial-ankle pulse wave velocity was significantly elevated in patients with CCr <60 mL/min. Thus, progressive left ventricular diastolic dysfunction and renal insufficiency are competing risks of the prevalence of diastolic heart failure in hypertensive patients. Renal insufficiency may exert its effects through the modulation of extracardiac factors such as anemia and arterial stiffening rather than through the promotion of

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“…Although clinical classifi cation of patients with HFNEF would appear to be straightforward [6], agreement as to both etiology and pathogenesis has generated ongoing debate, as the prevailing wisdom that diastolic dysfunction explains the disorder has been repeatedly challenged [7][8][9]. The diffi culty of facile, accurate, non-invasive assessment of diastolic function adds to the controversy.…”

Section: Introductionmentioning

confidence: 99%

Systolic Strain Abnormalities To Predict Hospital Readmission in Patients With Heart Failure and Normal Ejection Fraction

Borer¹,

Silverman²,

O’Sullivan³

2010

Journal of Cardiac Failure

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Ventricular Structure and Function in Hypertensive Participants With Heart Failure and a Normal Ejection Fraction

Cited by 163 publications

References 43 publications

Left ventricular global systolic dysfunction has a significant role in the development of diastolic heart failure in patients with systemic hypertension

Left ventricular global systolic dysfunction has a significant role in the development of diastolic heart failure in patients with systemic hypertension

Difference of Clinical Characteristics between Hypertensive Patients with and without Diastolic Heart Failure: The Roles of Diastolic Dysfunction and Renal Insufficiency

Systolic Strain Abnormalities To Predict Hospital Readmission in Patients With Heart Failure and Normal Ejection Fraction

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