Open AccessImproved Diastolic Function Is Associated With Higher Cardiac Output in Patients With Heart Failure Irrespective of Left Ventricular Ejection Fraction
Author(s) -
Tobushi Tomoyuki,
Nakano Masatsugu,
Hosokawa Kazuya,
Koga Hidenobu,
Yamada Akira
Publication year - 2017
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.116.003389
Subject(s) - medicine , ejection fraction , cardiology , diastole , heart failure , diastolic function , cardiac catheterization , cardiac function curve , stroke volume , blood pressure
Background Little is known regarding the impact of diastolic function on cardiac output ( CO ) in patients with heart failure, particularly in patients with lower ejection fraction. This study aimed to evaluate the impact of end‐diastolic pressure–volume relationship ( EDPVR ) on CO and end‐diastolic pressure ( EDP ). Methods and Results We retrospectively analyzed 1840 consecutive patients who underwent heart catheterization. We divided patients into 8 groups according to ejection fraction ( EF ) (35–45%, 46–55%, 56–65%, and 66–75%) and EDP (>16 or ≤16 mm Hg). We estimated EDPVR from single measurements in the catheterization data set. Then, we replaced EDPVR s of high‐ EDP groups with those of normal‐ EDP groups and compared CO before and after EDPVR replacement. Normalized EDPVR significantly increased CO at EDP =10 mm Hg regardless of EF ( EF 35–45%, from 4.5±1.6 to 4.9±1.0; EF 46–55%, 4.6±1.3 to 5.1±1.1; EF 56–65%, 4.9±1.5 to 5.2±1.0; EF 66–75%, 4.9±1.5 to 5.2±1.1). Changes in CO were similar across EF groups. Conclusions Diastolic function normalization was associated with higher CO irrespective of EF . Diastolic dysfunction plays an important role in determining CO irrespective of EF in heart failure patients.