Cregler L L, Georgiou D, Sosa I
Department of Medicine, Bronx VA Medical Center, New York.
J Natl Med Assoc. 1991 Jan;83(1):49-52.
This study reviewed 372 male patients with congestive heart failure. Two hundred and eighty-three (77%) had congestive heart failure due to systolic dysfunction as demonstrated by radionuclide angiography. Eighty-seven (23%) with congestive heart failure were identified who had normal ejection fractions. All patients met the Framingham criteria for congestive heart failure. These 87 individuals had unrecognized diastolic heart failure. It is important to distinguish between systolic and diastolic heart failure because the pathophysiology, treatment, and prognosis differ significantly. The most frequent cause of diastolic heart failure in this study was hypertension. Diastolic dysfunction should be considered in patients with acute heart failure and severe uncontrolled hypertension, or in patients with ischemic heart disease who develop acute pulmonary edema. Patients who do not respond or deteriorate when treated for heart failure using conventional therapy may also have diastolic dysfunction. These patients warrant special recognition and tailored management.
本研究回顾了372例男性充血性心力衰竭患者。其中283例（77%）经放射性核素血管造影证实因收缩功能障碍导致充血性心力衰竭。确定有87例（23%）充血性心力衰竭患者射血分数正常。所有患者均符合弗雷明汉充血性心力衰竭标准。这87例个体存在未被识别的舒张性心力衰竭。区分收缩性和舒张性心力衰竭很重要，因为其病理生理学、治疗方法及预后有显著差异。本研究中舒张性心力衰竭最常见的病因是高血压。对于急性心力衰竭和严重未控制的高血压患者，或发生急性肺水肿的缺血性心脏病患者，应考虑舒张功能障碍。使用传统疗法治疗心力衰竭无反应或病情恶化的患者也可能存在舒张功能障碍。这些患者需要特别关注并进行针对性管理。
