The universal of diastolic heart fa...

The universal of diastolic heart failure has generated a fair amount of suit at law with some authorities questioning whether specific evidence of diastolic dysfunction has been build in patients diagnosed with this condition. Zile and colleagues described findings from diagnostic studies performed forward a series of patients diagnosed with diastolic heart failure.

The application of mind authors enrolled 47 patients scheduled for diagnostic cardiac catheterizations who had heart failure and normal left ventricular ejection fractions. These patients were compared with 10 have the direction of patients who had no evidence of heart failure nevertheless underwent catheterization for the evaluation of chest pain and were originate to have normal coronary arteries and systolic function. During cardiac catheterization, a micromanometer was inserted into the left ventricle to measure precisely left ventricular squeezings during diastole. Echocardiography was performed forward all patients, measuring left ventricular bulks at the beginning and finis of diastole. Analysis of urgency and volume values during diastole was used to determine active relaxation and passive stiffness of the left ventricular wall, which are [i]clavis[/i] indicators of diastolic function.

All 47 patients with diastolic heart failure had evidence of abnormal active relaxation, with the minimum diastolic influence in the left ventricle occurring before the time of entire wall relaxation. All 10 rule patients reached minimum diastolic crushing after complete relaxation had occurr Left ventricular passive stiffness was calculated from measures of hurry and volume at the finis of diastole. Increased end-diastolic urgency and decreased end-diastolic volume, which are evidence of abnormally increased passive stiffness, were noted in patients with diastolic heart failure.

The authors deduce that patients diagnosed with diastolic heart failure have consistently demonstrable abnormalities of diastolic function. They argue that "diastolic heart failure" is an appropriate clinical expression to describe heart failure in patients with normal ejection fractions and elevated diastolic pressures

Zile MR et al. Diastolic heart failure--abnormalities in active relaxation and passive stiffness of the left ventricle. N Engl J M May 6 2004;350:1953-9

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