[Evaluation of prevalence and correlation between systolic and distolic dysfunction in patients with congestive heart failure during acute pulmonary edema episodes]

ABSTRACT

Congestive heart failure [CHF] is a major public health problem. Several hospitals - based reports have documented that a high proportion of patients with CHF have a normal LV systolic function. Some of the clinical and paraclinical findings during heart failure episodes show presence of a normal left ventricular ejection fraction [LVEF]. We evaluated the utility of these predictions in patients with HF during an acute pulmonary edema [APE] episode. In this descriptive study, done in cardiology emergency ward of Imam Reza Hospital in 2000 - 2001, 117 patients with sign and symptoms of HF presented with APE were selected based on history, physical examination, and laboratory tests. Eligible patients underwent 2D / Doppler echocardiography during the 2[nd] or 3[rd] day of hospitalization. Normal systolic function was diagnosed if LVEF>45%. Using simson method, patients with acut MI and exclusively chronic lung diseases were excluded from the study. Data was analyzed using frequency distribution tables and descriptive statistics. Out of 117 patients, 72 [62%] were male and 45[38%] female. Mean age of patients was 66.6 +/- 1.5 years. Left ventricular systolic function was evaluated on the basis of ejection fraction and LVEF >= 45% was regarded as normal. 51 [43.6%] patients with HF had normal systolic function; systolic dysfunction was observed in 62.5% of males and 46.7% of females. 65% of patients with normal systolic function had late relaxation diastolic dysfunction, and sever restrective type was seen in 6%. In 91% of severe diastolic dysfunction patients, meanwhile, the systolic function was also abnormal. Results of this study shew that in a significant proportion of patients with heart failure, systolic function of LV is preserved. Systolic dysfunction is more common among men. In most patients with heart failure and normal systolic function, delayed relaxation pattern of diastolic dysfunction was present, although in patients with systolic dysfunction more severe type of restrictive pattern was seen