Evaluation of Patients with Heart Failure, Preserved Systolic Function and Diastolic Dysfunction

Abstract

Aim: Assessment of the occurrence, severity and progress of the diastolic dysfunction in patients with clinically manifest heart failure with preserved systolic function, by analyzing the ultrasound parameters that define the diastolic ventricular function, recorded dynamically. Material and Methods: The study involved 200 patients suffering from clinically manifest heart failure, admitted in Cardiology Department of Medical no 1, Cluj-Napoca; an echocardiographic study of the systolic and diastolic function was performed, by the same person, for each of them. The echocardiographic study was carried out dynamically, at first within 3 days of the first examination, then, after 9 months. In the present study we selected patients with an ejection fraction> = 50% and diastolic dysfunction. Results: Of the 200 patients initially evaluated, 43 patients were selected based on the inclusion criteria for diastolic dysfunction. The E '/ A' ratios in the lateral regions of the mitral annulus showed a statistically significant improvement when dynamically assessed (0.71 versus 0, 6, p = 0.016). Also, E / E' ratio in the lateral portion of the mitral annulus significantly improved (6.15 vs. 5.44, p = 0.016) and MPI dynamical assessment shows a statistically significant improvement in this parameter (0.52 vs. 0.46 p = 0.014). Conclusions: Diastolic function assessment should be an integral part of the cardiac function assessment due to the increased prevalence of the patients with HF and preserved systolic function. Our study showed that the most reliable parameters used to assess the diastolic dysfunction in patients with preserved systolic function are the following: the E '/ A' ratio at the level of the septum, the E / E' ratio at the level of the lateral wall, as well as the MPI estimate.