In diastolic heart failure, the left ventricular (LV) ejection fraction (EF) is normal and there is increased passive stiffness with impaired relaxation of the ventricle, resulting in disturbances in the pattern of filling and elevated diastolic pressure.1–3 The mechanism underlying such failure has been thought to be principally diastolic because LV diastolic function is universally abnormal a...

Aging is often associated with increased systolic blood pressure and decreased diastolic blood pressure. Isolated systolic hypertension or an elevated systolic blood pressure without an elevated diastolic blood pressure is a known risk factor for incident heart failure in older adults. In the current study, we examined whether isolated diastolic hypotension, defined as a diastolic blood pressur...

OBJECTIVES To investigate precipitating factors for systolic and diastolic heart failure. DESIGN Prospective study. PATIENTS AND METHODS The study population consisted of 192 patients with heart failure treated for 536 episodes of acute decompensation of heart failure from 1998 to 2002. The patients were classified as having systolic or diastolic heart failure, and grouped according to aeti...

In diastolic heart failure, the left ventricular (LV) ejection fraction (EF) is normal and there is increased passive stiffness with impaired relaxation of the ventricle, resulting in disturbances in the pattern of filling and elevated diastolic pressure.1–3 The mechanism underlying such failure has been thought to be principally diastolic because LV diastolic function is universally abnormal a...

OBJECTIVES To assess the prevalence, clinical profile and medium-term prognosis in patients with heart failure and preserved systolic ventricular function compared to those with systolic dysfunction. PATIENTS AND METHOD 153 patients were included, 62 with preserved systolic ventricular function (left ventricular ejection fraction > or = 45%) and 91 with impaired systolic ventricular function ...

BACKGROUND Human urotensin II (UTN) has potent vasoactive and cardiostimulatory effects, acting on the G protein-linked receptor GPR14. Myocardial UTN expression is upregulated in heart failure, and UTN stimulates myocardial expression of the natriuretic peptides. We investigated plasma UTN levels in heart failure (HF; left ventricular systolic dysfunction) in comparison with plasma N-terminal ...

Urocortin (UCN), a member of the corticotrophin-releasing factor family, is expressed in heart, brain and gut. UCN has potent cardiostimulatory, cardioprotective, vasodilator and diuretic/natriuretic effects, and cardiac UCN expression is increased in heart failure (HF). In the present study, we investigated plasma levels of UCN in 119 patients with HF and 212 age- and gender-matched controls t...

Many patients with acute heart failure have marked hypertension and preserved left ventricular ejection fraction. In these patients, the heart failure usually does not result from transient systolic dysfunction or valvular abnormalities but rather results from diastolic dysfunction. Treatment of this condition includes control of hypertension, cautious diuresis, and, if necessary, ventilatory s...

Systolic heart failure is characterized by ventricular dilation and reduced ejection fraction, and this syndrome may be either chronic or acute. Left ventricular remodeling is the principal cause of progression of systolic heart failure. Acute heart failure resulting from cardiomyopathy has similar functional and morphologic abnormalities. This review discusses remodeling, initial therapy based...