Left Ventricular end Systolic and Diastolic Volumes and Ejection Fraction in Patients with Heart Failure and Preserved Ejection Fraction Meta and Graphical Analysis

Background: In a previous meta-analysis ejection fraction (EF) was greater in heart failure and preserved ejection fraction (HFPEF) patients than it was in healthy controls (HC). In this study differences between indices of end-systolic and diastolic volumes (ESVi and EDVi) in HFPEF compared to HC were studied, in search for an explanation for the difference in EF. In addition, it was hypothesized that changes in ESVi and EDVi may provide understanding of the process of left ventricular remodeling. Methods: Literature was searched for studies reporting ejection fraction (EF), EDVi and ESVi. Pooled differences were estimated with weighted and standardized mean differences. The normalized mean difference of X, = − N H H H MD[X](XCX?FPEF)/(XC), where X=EDVi or ESVi and X is the mean of X, was plotted as a function of the difference between EF in HC, EFHC, and HFPEF, EFHFPEF, for each study included. Results: Fourteen studies were analyzed; HFPEF patients were 3.6 years older and 3.2 BMI units heavier than HC (P EFHC, both EDViHFPEF and ESViHFPEF were smaller than their HC counterparts (i.e. NMD[ESVi] and NMD[EDVi] >0), and the absolute difference between ESViHC and ESViHFPEF was greater than that observed between EDViHC and EDViHFPEF. When EFHFPEF EFHC, changes in EDVi and ESVi supported characteristics of concentric hypertrophy, and when EFHFPEF