Heart failure with a normal ejection fraction

doi:10.1136/bmj.b52

Published 27 January 2009, doi:10.1136/bmj.b52
Cite this as: BMJ 2009;338:b52

Editorials

Heart failure with a normal ejection fraction

Is underdiagnosed, has a high mortality, and lacks evidencebased treatment

The first 150 words of the full text of this article appear below.

The typical image of a patient with heart failure is of a breathlessperson with a large flabby heart, which contracts poorly witha reduced left ventricular ejection fraction. However, manypatients, mainly elderly women, have symptoms of heart failurebut their hearts are not enlarged. Echocardiography shows arelatively normal left ventricular ejection fraction but usuallywith some left ventricular hypertrophy. Because systolic functionwas thought to be normal or near normal, the term "diastolicheart failure" was coined for this group of patients. However,we now know that systolic function is not entirely normal, andthe problem is not only caused by diastolic dysfunction; hencethe term "heart failure with a normal ejection fraction" ismore appropriate.

Recent epidemiological studies have shown that heart failurewith a normal ejection fraction is now a more common cause ofhospital admission than systolic heart failure in many partsof the . . . [Full text of this article]

John E Sanderson, professor of clinical cardiology ¹, Gabriel W K Yip, associate professor²

¹ Department of Cardiovascular Medicine, University of Birmingham, Birmingham B15 2TT, ² Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong

j.e.sanderson@bham.ac.uk

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Articles

Assessing heart failure with normal ejection fraction: Chris Danbury and Andrew Kitching
BMJ 2009 338: b960. [Extract] [Full Text]

Heart failure is in need of a diagnosis: Guy Lloyd
BMJ 2009 338: b961. [Extract] [Full Text]

This article has been cited by other articles:

Danbury, C., Kitching, A. (2009). Assessing heart failure with normal ejection fraction. BMJ 338: b960-b960 [Full text]
Lloyd, G. (2009). Heart failure is in need of a diagnosis. BMJ 338: b961-b961 [Full text]

Rapid Responses:

Read all Rapid Responses

Dynamic assessment of heart failure with normal ejection fraction: Chris Danbury, et al.
bmj.com, 16 Feb 2009 [Full text]
Left ventricular hypertrophy and blood viscosity: is there a connection ?: Les O. Simpson
bmj.com, 17 Feb 2009 [Full text]
A prayer for the failing heart: Roger H Redston
bmj.com, 22 Feb 2009 [Full text]
On the need to redefine heart failure.: Richard G Fiddian-Green
bmj.com, 23 Feb 2009 [Full text]
Heart Failure Badly in Need of a Diagnosis: GUY W Ll Lloyd
bmj.com, 24 Feb 2009 [Full text]