Soufer R, Wohlgelernter D, Vita N A, Amuchestegui M, Sostman H D, Berger H J, Zaret B L
Am J Cardiol. 1985 Apr 1;55(8):1032-6. doi: 10.1016/0002-9149(85)90741-6.
Clinical congestive heart failure (CHF) is traditionally associated wtih significant left ventricular (LV) systolic dysfunction. Over a 1-year period, 58 patients with CHF and intact systolic function (LV ejection fraction [EF] 62 +/- 11%) were identified. An objective clinical-radiographic CHF score was used to document the clinical impression. Based on radionuclide evaluation of peak filling rate, 38% of these patients were found to have a significant abnormality in diastolic function as measured by peak filling rate (less than 2.50 end-diastolic volume/s). An additional 24% of the patients had probable diastolic dysfunction with borderline abnormal peak filling rate measurements (2.5 to 3.0 end-diastolic volume/s). The disease states most frequently associated with CHF and intact systolic function were coronary artery disease and systemic hypertension. During a 3-month sampling period 42% of patients with clinical diagnosis of CHF referred to the nuclear cardiology laboratory were found to have intact systolic function; thus, intact systolic function is not uncommon in patients with clinical CHF. Abnormal diastolic function is the most frequently encountered mechanism for the occurrence of CHF. Definition of systolic and diastolic function appears relevant for development of optimal therapeutic strategies for the treatment of patients with CHF.
传统上，临床充血性心力衰竭（CHF）与显著的左心室（LV）收缩功能障碍相关。在1年的时间里，确定了58例收缩功能正常（左心室射血分数[EF]为62±11%）的CHF患者。采用客观的临床-影像学CHF评分来记录临床印象。基于放射性核素对峰值充盈率的评估，发现这些患者中有38%的舒张功能存在显著异常，以峰值充盈率衡量（低于2.50舒张末期容积/秒）。另外24%的患者可能存在舒张功能障碍，峰值充盈率测量值处于临界异常范围（2.5至3.0舒张末期容积/秒）。与CHF和收缩功能正常最常相关的疾病状态是冠状动脉疾病和系统性高血压。在一个为期3个月的抽样期间，转诊至核心脏病学实验室且临床诊断为CHF的患者中，42%被发现收缩功能正常；因此，收缩功能正常在临床CHF患者中并不罕见。舒张功能异常是CHF发生最常遇到的机制。收缩和舒张功能的定义似乎与制定CHF患者的最佳治疗策略相关。
