Russian Heart Failure Journal 2009year What we know and what we don’t know about diastolic heart failure in XXI century

To access this material please log in or register

Register Authorize

What we know and what we don’t know about diastolic heart failure in XXI century

Kastanayan A. А., Nelasov N. Y.

Keywords: XXI century, diagnostics, treatment


Heart failure (HF) with normal ejection fraction (HF-NEF) is more than 50 % of all cases of HF. Till now it is not well known if HF-NEF and HF with decreased ejection fraction (HF-DEF) are independent syndomes or different manifestations of one condition. Due to appearance of impulse-wave tissue dopplerography (ITD) and detection of plasma level of natriuretic peptides more accurate diagnostic criteria of HF-NEF appeared in clinical practise. If ITD shows Е / Е’ >8, but <15, then additional non-invasive researches for LV diastolic disfunction (DD) approvement are needd. Analysis of high-amplitude reflected movement signals (HARMS) registered fr om left heart parts with usual impulse-wave dopplerography, is high sensitive method of DD diagnostic. Modern guidelines for HF-NEF treatment are based on certain data about pathogenesis, treatment principles of other cardiovascular diseases and experts opinion. In small trials on HF-NEF treatment authors used different criteria that lim it impartial comparison of results. In futrther clinical trials on HF-NEF not just ECHO-CG is essential, but also quantitative detection of natriuretic peptides.
  1. Owan TE, Hodge DO, Herges RM et al. Trends in Prevalence and Outcome of Heart Failure with Preserved Ejection Fraction. N Engl J Med. 2006; 355 (3):251–259.
  2. Abhayaratna WP, Marwick TH, Smith WT, Becker NG. Characteristics of left ventricular diastolic dysfunction in the community: an echocardio-graphic survey. Heart. 2006; 92 (9):1259–1264.
  3. Cleland JG, Swedberg K, Follath F et al. The EuroHeart Failure survey programme – a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis. Eur Heart J. 2003; 24 (5):442–463.
  4. Bhatia RS, Tu JV, Lee DS et al. Outcome of Heart Failure with Preserved Ejection Fraction in a Population-Based Study. N Engl J Med. 2006; 355 (3):260–269.
  5. Cleland JG, Tendera M, Adamus J et al. The perindopril in elderly people with chronic heart failure (PEP-CHF) study. Eur Heart J. 2006; 27 (19):2338–2345.
  6. Massie BM, Carson PE, McMurray JJ et al. Irbesartan in patients with heart failure and preserved ejection fraction. N Engl J Med. 2008; 359 (23):2456–2467.
  7. Paulus WJ, Tschope C, Sanderson JE et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J. 2007; 28 (20):2539–2550.
  8. Ghio S, Magrini G, Serio A et al. Effects of nebivolol in elderly heart failure patients with or without systolic left ventricular dysfunction: results of the SENIORS echocardiographic substudy. Eur Heart J. 2006; 27 (5):562–568.
  9. van Kraaij DJ, van Pol PE, Ruiters AW et al. Diagnosing diastolic heart failure. Eur J Heart Fail. 2002; 4 (4):419–430.
  10. Овчинников А. Г., Агеев Ф. Т., Мареев В. Ю. Методические аспекты применения Допплер-эхокардиографии в диагностике диастолической дисфункции левого желудочка. Сердечная недостаточность. 2000; 1 (2):66–70.
  11. Otto CM. Textbook of clinical Echocardiography. – St. Louis. W. B. Saunders Company. 2000. – 444 p.
  12. Мазур Н. А. Диастолическая дисфункция миокарда. – М: Российская медицинская академия последипломного образования, 2001. – 72 с.
  13. Митьков В. В., Сандрикова В. А. Клиническое руководство по ультразвуковой диагностике. – М.: Видар, 1998. – Т. 5. – 360 с.
  14. Alehagen U, Lindstedt G, Levin LA, Dahlstrom U. The risk of cardiovascular death in elderly patients with possible heart failure. Results from a 6‑year follow-up of a Swedish primary care population. Int J Cardiol 2005; 100 (1):17–27.
  15. Nishimura RA, Tajik AJ. Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician’s Rosetta Stone. J Am Coll Cardiol. 1997; 30 (1):8–18.
  16. Zile MR, Gaasch WH, Carroll JD et al. Heart failure with a normal ejection fraction: is measurement of diastolic function necessary to make the diagnosis of diastolic heart failure? Circulation. 2001; 104 (7):779–782.
  17. Mandinov L, Eberli FR, Seiler C, Hess OM. Diastolic heart failure. Cardiovasc Res. 2000; 45 (4):813–825.
  18. Lele RD, Luthra K, Sawant Y. Assessment of diastolic heart function-experience with 16‑gated myocardial perfusion SPECT. J Assoc Physicians India. 2008; 56:763–768.
  19. Sciagrà R, Leoncini M. Gated single-photon emission computed tomography. The present-day ‘’one-stop-shop’’ for cardiac imaging. Q J Nucl Med Mol Imaging. 2005; 49 (1):19–29.
  20. Rathi VK, Doyle M, Yamrozik J, Williams RB et al. Routine evaluation of left ventricular diastolic function by cardiovascular magnetic resonance: a practical approach. J Cardiovasc Magn Reson. 2008; 10 (1):36–40.
  21. Rathi VK, Biederman RW. Expanding role of cardiovascular magnetic resonance in left and right ventricular diastolic function. Heart Fail Clin. 2009; 5 (3):421–435.
  22. Pedersen F, Raymond I, Madsen LH, Mehlsen J et al. Echocardiographic indices of left ventricular diastolic dysfunction in 647 individuals with preserved left ventricular systolic function. Eur J Heart Fail. 2004; 6 (4):439–447.
  23. Quintana M, Edner M, Kahan T, Hjemdahl P et al. Is left ventricular diastolic function an independent marker of prognosis after acute myocardial infarction? Int J Cardiol. 2004; 96 (2):183–189.
  24. Winter R, Gudmundsson P, Ericsson G, Willenheimer R. Left ventricular early diastolic inflow velocity and atrial ventricular plane downward velocity: useful parameters to test diastolic function in clinical practice? Diastolic parameters tested in a clinical setting. Eur J Echocardiogr. 2004; 2 (2):126–131.
  25. Appleton C, Hatle L, Popp R. Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined hemodynamic and Doppler echocardiographic study. J Am Coll Cardiol. 1988; 12 (2):426–440.
  26. Rakowsky H, Appleton C, Chan K et al. Canadian consensus recommendations for the measurement and reporting diastolic dysfunction by echocardiography. J Am Soc Echocardiogr. 1996; 9 (5):736–760.
  27. Rocca HP, Rickli H, Jost CH, Jenni R. Left ventricular end-diastolic pressure can be estimated by either changes in transmitral inflow pattern during valsalva maneuver or analysis of pulmonary venous flow. J Am Soc Echocardiogr. 2000; 13 (6):599–607.
  28. Paraskevaidis IA, Tsiapras D, Adamopoulos S. Assessment of the functional status of heart failure in non ischemic dilated cardiomyopathy: an echo-dobutamine study. Cardiovascular Research. 1999; 43 (1):58–66.
  29. Ommen S, Nishimura R, Appleton C et al. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of the left ventricular filling pressures: a comparative simultaneous Doppler-catheterization study. Circulation. 2000; 102 (15):1788–1794.
  30. Rivas-Gotz C, Manolios M, Thohan V, Nagueh SF. Impact of left ventricular ejection fraction on estimation of left ventricular filling pressures using tissue Doppler and flow propagation velocity. Am J Cardiol. 2003; 91 (6):780–784.
  31. Diwan A, McCulloch M, Lawrie G et al. Doppler estimation of left ventricular filling pressures in patients with mitral valve disease. Circulation. 2005; 111 (24):3281–3289.
  32. Неласов Н. Ю., Кастанаян А. А. К вопросу о модификации канад­ской классификации диастолической дисфункции левого желудочка. Сердечная недостаточность. 2001; 1 (2):54–55.
  33. Неласов Н. Ю. Высокоамплитудные отраженные сигналы движения: бесполезный ультразвуковой мираж или источник ценной информации? Ультразвуковая и функциональная диагностика. 2005; 5:93–101.
  34. Nelassov N. Reflected high-intensity motion signals: can this ultrasound phenomenon be used for assessment of left ventricular function? Ultraschall Med. 2004; 25 (6):422–427.
  35. Неласов Н. Ю., Кастанаян А. А., Мареев В. Ю., Агеев Ф. Т. Спектральные допплеровские артефакты: можно ли использовать этот ультразвуковой феномен для оценки функции левого желудочка? Журнал Сердечная недостаточность. 2003; 4 (2):81–84.
  36. Pfeffer MA, Swedberg K, Granger CB et al. CHARM Investigators and Committees. Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programme. Lancet. 2003; 362 (9386):759–766.
  37. Zile MR, Brutsaert DL. New concepts in diastolic dysfunction and diastolic heart failure: Part II: causal mechanisms and treatment. Circulation. 2002; 105 (12):1503–1508.
  38. Swedberg K, Cleland J, Dargie H et al. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J. 2005; 26 (11):1115–1140.
  39. Heart Failure Society Of America. Executive summary: HFSA 2006 Comprehensive Heart Failure Practice Guideline. J Card Fail. 2006; 12 (1):10–38.
  40. Mulieri LA, Hasenfuss G, Leavitt B et al. Altered myocardial force-frequency relation in human heart failure. Circulation. 1992; 85 (5):1743–1750.
  41. Ahmed A, Rich MW, Fleg JL et al. Effects of digoxin on morbidity and mortality in diastolic heart failure: the ancillary digitalis investigation group trial. Circulation. 2006; 114 (5):397–403.
  42. Busseuil D. Heart rate reduction by ivabradine reduces diastolic dysfunction and atrial fibrosis in hypercholesterolemic rabbits. Eur Heart J. 2009; 30 (Abstract Supplement), 427.
  43. Mulder P. Short-term heart rate reduction induced by ivabradine administered to rats with well-established heart failure improves cardiac function, augments neo-angiogenesis and reduces myocardial hypoxia. Eur Heart J. 2009; 30 (Abstract Supplement), 430.
  44. Thomas JD, Weyman AE. Echocardiographic Doppler evaluation of left ventricular diastolic function: Physics and physiology. Circulation. 1991; 84 (3):977–990.
  45. Appleton CP, Hatle LK. The natural history of left ventricular filling abnormalities: assessment by two dimensional and Doppler echocardiography. Echocardiography. 1992; 9:437–445.
  46. Giannuzzi P, Imparato A. Temporelli PL et al. Doppler-derived mitral deceleration time of early filling as strong predictor of pulmonary capillary wedge pressure in postinfarction patients with left ventricular systolic dysfunction. J Am Coll Cardiol. 1994; 23 (7):1630–1637.
  47. Xie GY, Berk MR, Smith MD et al: Prognostic value of transmitral flow patterns in patients with congestive heart failure. J Am Coll Cardiol. 1994; 24 (1):132–139.
  48. Palazzuoli A, Quatrini I, Vecchiato L et al. Effects of carvedilol on left ventricular diastolic function and chamber volumes in advanced heart failure. Minerva Cardioangiol. 2005; 53 (4):321–328.
  49. Chen HH, Lainchbury JB, Senni M, Redfield MM. Factors influencing survival in patients with diastolic heart failure in Olmsted County, MN, in 1996–97 (abstr). Circulation 2000; 102:II412.
  50. Varadarajan P, Sharma S, Gandhi S et al. «Beneficial Effect of Beta Blockers on Survival in Congestive Heart Failure with Normal Ejection Fraction,» American College of Cardiology 54th Scientific Session, Orlando, Fla. Heart Failure: Therapy, poster session, March 7, 3:30 p. m. – 4:30 p. m., abstract No. 318452.
  51. Wiklund I, Waagstein F, Swedberg K, Hjalmarsson A. Quality of life on treatment with metoprolol in dilated cardiomyopathy: results from the MDC trial. Metoprolol in Dilated Cardiomyopathy trial. Cardiovasc Drugs Ther. 1996; 10 (3):361–368.
  52. Andersson B, Caidahl K, di Lenarda A et al. Changes in early and late diastolic filling patterns induced by long-term adrenergic beta-blockade in patients with idiopathic dilated cardiomyopathy. Circulation. 1996; 94 (4):673–682.
  53. Andersson B, Stromblad SO, Lomsky M, Waagstein F. Heart rate dependency of cardiac performance in heart failure patients treated with metoprolol. Eur Heart J. 1999; 20 (8):575–583.
  54. Glass MG, Reiss I, Cory R et al. Reversal of the negative treppe with β-blockers: role of sarcoplasmic reticulum function and myocardial energetics. Circulation. 1993; 88:I-526.
  55. Hole T, Froland G, Gullestad L et al. Metoprolol CR / XL improves systolic and diastolic left ventricular function in patients with chronic heart failure. Echocardiography. 2004; 21 (3):215–223.
  56. Eichhorn EJ, Heesch CM, Risser RC et al. Pedictors of systolic diastolic improvement in patients with dilated cardiomyopathy treated with metoprolol. J Am Coll Cardiol. 1995; 25 (1):154–162.
  57. Flather M, Shibata M, Coats A et al. Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). Eur Heart J. 2005; 26 (3):215–225.
  58. van Veldhuisen DJ, Cohen-Solal A, Böhm M et al. Beta-blockade with nebivolol in elderly heart failure patients with impaired and preserved left ventricular ejection fraction: data from SENIORS. J Am Coll Cardiol. 2009; 53 (23):2150–2158.
  59. Hernandez AF, Hammill BG, O’Connor CM et al. Clinical effectiveness of beta-blockers in heart failure: findings from the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) Registry. J Am Coll Cardiol. 2009; 53 (2):184–192.

To access this material please log in or register

Register Authorize
Ru En