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Abnormal left ventricular relaxation and symptoms of heart failure

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Abstract

Objectives

The purpose of our study was to assess the echocardiographic and angiographic parameters in patients with symptomatic heart failure (HF) and mild diastolic dysfunction (grade I).

Background

It remains uncertain why some patients with mild diastolic dysfunction exhibit HF symptoms and others are asymptomatic.

Methods

The study enrolled 80 hospitalized patients with impaired left ventricular (LV) relaxation. Patients were divided into two groups; one group had chronic functional class II to III dyspnea and the other group had no symptoms of HF. After admission, echocardiography and coronary angiography were performed for all patients and LV systolic and diastolic parameters were compared between the two groups.

Results

More patients in the asymptomatic group were hypertensive (p-value: 0.012). However, coronary artery disease was more prevalent in symptomatic patients (p-value: 0.022). The LV ejection fraction (EF) was significantly lower in symptomatic patients [median 54.33 %, 95 % confidence interval (53.76–54.87 %) in asymptomatic patients and median 49.43, 95 % confidence interval (47.23–50.91 %) in symptomatic patients, p-value <0.001]. Furthermore, the systolic LV internal dimension was significantly larger in this group (p-value: 0.037). The results of logistic regression identified that only the absolute level of the LVEF was the negative determinant of the occurrence of HF in patients with impaired LV relaxation.

Conclusion

Our study showed that LV systolic performance has an important role in occurrence of HF symptoms in patients with grade I diastolic dysfunction.

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Acknowledgments

This study was Dr. Safora Salehi’s postgraduate thesis. The authors would like to thank all of the patients who enrolled in this study and the staff at the Fatemeh Zahra Hospital, Sari, Iran. Financial support was obtained from the Research Council of the Mazandaran University of Medical Sciences and granted to Dr. Maryam Nabati, Assistant Professor of Cardiology and Fellowship of Echocardiography.

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Authors and Affiliations

  1. Department of Cardiology, Faculty of Medicine, Fatemeh Zahra Teaching Hospital, Mazandaran University of Medical Sciences, Artesh Boulevard, Sari, Iran

    Maryam Nabati

  2. Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

    Safora Salehi

  3. Department of Cardiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

    Babak Bagheri

  4. Department of Cardiac Surgery, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

    Mahmoud Nouraei

Authors
  1. Maryam Nabati
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  2. Safora Salehi
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  3. Babak Bagheri
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  4. Mahmoud Nouraei
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Corresponding author

Correspondence to Maryam Nabati.

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Nabati, M., Salehi, S., Bagheri, B. et al. Abnormal left ventricular relaxation and symptoms of heart failure. J Echocardiogr 14, 113–119 (2016). https://doi.org/10.1007/s12574-016-0287-3

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  • DOI: https://doi.org/10.1007/s12574-016-0287-3

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