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Diastolic Dysfunction in Heart Failure
Written by Jeanne Bohm, Ph.D.   

From the NetDoc medical news feed

A new study in the November 8 issue of JAMA shows that diastolic dysfunction, whether coupled with poor ejection fraction or with preserved ejection fraction, is more prevalent than previously thought.

Heart failure (HF) has various causes, including poor ejection fraction (EF: the volume of blood pumped out of the ventricle) and diastolic dysfunction (ventricles do not relax properly).

There is disagreement, however, on the prevalence and outcomes of heart failure patients with diastolic dysfunction but preserved EF.

Francesca Bursi, M.D., M.Sc., formerly of Mayo Clinic, and colleagues studied the prevalence of diastolic dysfunction and preserved orreduced EF among heart failure patients in Olmsted County, Minn. The study (September 2003 to October 2005) included 556 participants assessed EF and diastolic function by echocardiography and brain natriuretic peptide levels (BNP). BNP levels increase with worsening heart failure.

The researchers found that 55 percent of participants had preserved EF. Patients with preserved EF were older, more likely to be women, non-smokers, and with no history of heart attack. Diastolic dysfunction was present in 80 percent of patients while combined systolic and diastolic dysfunction or isolated diastolic dysfunction was present in less than half of the patients.

Patients with reduced EF had a greater association with moderate or severe diastolic dysfunction than patients with preserved EF. Both reduced EF and diastolic dysfunction were independently related to higher BNP levels. At 6 months, the number of deaths was approximately 4 times greater than expected for patients with both diastolic dysfunction and either preserved and reduced EF.

Researchers concluded that diastolic dysfunction is common in HF patients even with preserved EF. The authors also noted a high prevalence of moderate and severe diastolic dysfunction in HF patients with reduced EF.

The findings of the study indicate the importance of diastolic dysfunction in both forms of HF.

Researchers believe that characterization of EF and diastolic function is an important assessment in HF patients due to the high mortality rate associated with these two factors.



Systolic and Diastolic Heart Failure in the Community. JAMA. 2006;296:2209-2216.

About the Author

Jeanne Bohm, Ph.D. is a cancer biologist by training, a medical writer and an experienced science educator.

The author has no financial relationship to any of the companies listed in the article.





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