2008 Volume 6 Issue 1 Pages 9-14
Background. Little is known of the pathophysiologic characteristics of a common disease cohort with congestive heart failure (CHF) and preserved left ventricular (LV) systolic function. The objective of this retrospective study was to determine the differences in the echocardiographic features in patients with or without previous evidence of new-onset CHF in the outpatient setting using a selected common disease cohort.
Methods and Results. We selected 72 consecutive outpatients, including 37 patients with hypertension, 16 with diabetes, 30 with hyperlipidemia, and/or 10 with coronary artery disease with no significant stenosis, having an early diastolic to atrial systolic transmitral flow velocity ratio (E/A) =<1, and an LV ejection fraction =>50%. The patients were divided into 2 groups according to the presence or absence of previous evidence of new-onset CHF: CHF group (n=7) and control group (n=65). Of the 72 patients, previous CHF was certified in 7 patients (9.7%). The LV mass index and maximal left atrial dimension were significantly greater (P < 0.05 and P < 0.005, respectively), and the systolic and early diastolic strain rates of the LV walls were significantly lower (both P < 0.05) in the CHF group than in the control group. There were no significant differences in peak systolic and early diastolic mitral annular motion velocities (Sw and Ew, respectively) and E/Ew between the 2 groups.
Conclusions. Left atrial enlargement, LV hypertrophy, and LV systolic myocardial dysfunction are important in the development of CHF in patients with impaired LV relaxation and preserved LV pump function.