Author + information
- Received December 8, 2003
- Revision received July 6, 2004
- Accepted July 12, 2004
- Published online October 19, 2004.
- Mathew S. Maurer, MD*,
- Daniel Spevack, MD†,
- Daniel Burkhoff, MD, PhD* and
- Itzhak Kronzon, MD, FACC†,* ()
- ↵*Reprint requests and correspondence:
Dr. Itzhak Kronzon, New York University School of Medicine, 550 First Avenue, New York, New York 10016
Heart failure with a normal ejection fraction (HFNEF) predominately afflicts older, female individuals and is considered to be a consequence of diastolic dysfunction. Doppler echocardiography has become the standard method for identifying and characterizing diastolic function. However, the important distinction between Doppler measures of filling dynamicsand true indexes of intrinsic ventricular diastolic chamber propertiesis not widely appreciated. Herein, we delineate physiologic measures of intrinsic ventricular diastolic function, as determined by pressure volume analysis, and compare and contrast these measures with those derived from Doppler echocardiography. Doppler-derived indexes of ventricular filling do not provide specific information on intrinsic passive diastolic properties, and thus, abnormal filling dynamics do not necessarily equate with intrinsic myocardial diastolic dysfunction. This raises a fundamental question as to whether delayed relaxation and/or stiffened passive properties are the unifying pathophysiologic mechanisms in all patients who present with HFNEF.
Dr. Maurer is supported by a Career Development Award from the National Institute on Aging (K23-AG00966).
- Received December 8, 2003.
- Revision received July 6, 2004.
- Accepted July 12, 2004.
- American College of Cardiology Foundation