Role of Left Ventricular Stiffness in Heart Failure With Normal Ejection Fraction
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- 22 April 2008
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 117 (16), 2051-2060
- https://doi.org/10.1161/circulationaha.107.716886
Abstract
Background— Increased left ventricular stiffness is a distinct finding in patients who have heart failure with normal ejection fraction (HFNEF). To elucidate how diastolic dysfunction contributes to heart failure symptomatology during exercise, we conducted a study using an invasive pressure-volume loop approach and measured cardiac function at rest and during atrial pacing and handgrip exercise. Methods and Results— Patients with HFNEF (n=70) and patients without heart failure symptoms (n=20) were enrolled. Pressure-volume loops were measured with a conductance catheter during basal conditions, handgrip exercise, and atrial pacing with 120 bpm to analyze diastolic and systolic left ventricular function. During transient preload reduction, the diastolic stiffness constant was measured directly. Diastolic function with increased stiffness was significantly impaired in patients with HFNEF during basal conditions. This was associated with increased end-diastolic pressures during handgrip exercise and with decreased stroke volume and a leftward shift of pressure-volume loops during atrial pacing. Conclusions— Increased left ventricular stiffness contributed to increased end-diastolic pressure during handgrip exercise and decreased stroke volume during atrial pacing in patients with HFNEF. These data suggest that left ventricular stiffness modulates cardiac function in HFNEF patients and suggests that diastolic dysfunction with increased stiffness is a target for treating HFNEF.This publication has 25 references indexed in Scilit:
- Cardiac Structure and Ventricular–Vascular Function in Persons With Heart Failure and Preserved Ejection Fraction From Olmsted County, MinnesotaCirculation, 2007
- Ventricular Structure and Function in Hypertensive Participants With Heart Failure and a Normal Ejection Fraction: The Cardiovascular Health StudyJournal of the American College of Cardiology, 2007
- Left Ventricular End-Diastolic Volume Is Normal in Patients With Heart Failure and a Normal Ejection Fraction: A Renewed Consensus in Diastolic Heart FailureJournal of the American College of Cardiology, 2007
- Force- and relaxation-frequency relations in patients with diastolic heart failureAmerican Heart Journal, 2006
- Impaired Chronotropic and Vasodilator Reserves Limit Exercise Capacity in Patients With Heart Failure and a Preserved Ejection FractionCirculation, 2006
- Hemodynamic Effects of Long-Term Cardiac Resynchronization TherapyCirculation, 2006
- B-Type Natriuretic Peptide Strongly Reflects Diastolic Wall Stress in Patients With Chronic Heart Failure: Comparison Between Systolic and Diastolic Heart FailureJournal of the American College of Cardiology, 2006
- Age- and Gender-Related Ventricular-Vascular StiffeningCirculation, 2005
- Left Ventricular Systolic Performance, Function, and Contractility in Patients With Diastolic Heart FailureCirculation, 2005
- Role of impaired myocardial relaxation in the production of elevated left ventricular filling pressureAmerican Journal of Physiology-Heart and Circulatory Physiology, 2005