Dougherty A H, Naccarelli G V, Gray E L, Hicks C H, Goldstein R A
Am J Cardiol. 1984 Oct 1;54(7):778-82. doi: 10.1016/s0002-9149(84)80207-6.
Although there have been isolated reports of congestive heart failure (CHF) with normal systolic function, the prevalence and characteristics of this condition have not previously been described. Accordingly, 188 patients with CHF undergoing radionuclide ventriculography were prospectively evaluated. Sixty-seven (36%) had a normal ejection fraction (EF) of 0.45 or greater, and 121, an abnormal EF of less than 0.45. Of these, 72 (55 with an abnormal EF [group I] and 17 with a normal EF [group II]) were also reviewed for clinical characteristics. There was no demographic difference between groups, except that systemic hypertension appeared to be a contributing factor in 65% of the patients in group II, compared with 23% of the patients in group I (p less than 0.002). Echocardiographic left atrial emptying index, reflecting left ventricular compliance, was determined in 72 patients and 14 normal subjects. Left atrial emptying index in normal control subjects was 0.93 +/- 0.11 (+/- standard deviation), compared with 0.41 +/- 0.18 in group I and 0.44 +/- 0.19 in group II patients (p less than 0.001 vs control in both groups). Thus, normal systolic function is common among patients with CHF. Diastolic dysfunction, consistent with a noncompliant left ventricle, was found in both CHF groups.
尽管已有孤立的报告称存在收缩功能正常的充血性心力衰竭（CHF），但此前尚未描述这种情况的患病率和特征。因此，对188例接受放射性核素心室造影的CHF患者进行了前瞻性评估。67例（36%）射血分数（EF）正常，为0.45或更高，121例EF异常，低于0.45。其中，72例（EF异常组55例[I组]，EF正常组17例[II组]）也接受了临床特征评估。两组之间在人口统计学上没有差异，只是II组65%的患者中系统性高血压似乎是一个促成因素，而I组为23%（p<0.002）。对72例患者和14名正常受试者测定了反映左心室顺应性的超声心动图左心房排空指数。正常对照受试者的左心房排空指数为0.93±0.11（±标准差），I组患者为0.41±0.18，II组患者为0.44±0.19（两组与对照组相比p<0.001）。因此，收缩功能正常在CHF患者中很常见。在两个CHF组中均发现舒张功能障碍，与左心室顺应性差一致。
