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European Heart Journal 1997 18(6):981-984;
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European society of Cardiology

The prevalence of left ventricular diastolic filling abnormalities in patients with suspected heart failure

A. P. Davie*,, C. M. Francis{dagger}, L. Caruana{ddagger}, G. R. Sutherland and J. J. V. McMurray*

Department of Cardiology, Western General Hospital Edinburgh, U.K.
*Clinical Research Initiative, University of Glasgow Glasgow, U.K.
{dagger}Victoria Hospital Kirkcaldy, U.K.
{ddagger}Department of Cardiology, Western Infirmary Glasgow, U.K.

revised 10 December 1996; accepted 12 December 1996.

Correspondence: Dr Andrew P. Davie, MRC Clinical Research Initiative in Heart Failure, University of Glasgow. G12 8QQ, Scotland, U.K.

Abstract

AIMS: It is reported that one third of patients with heart failure have normal left ventricular systolic function, and may or may not have left ventricular diastolic dysfunction. We sought to define the prevalence of left ventricular diastolic filling abnormalities in a large unselected group of patients, unlike the diagnosis by exclusion in the small highly selected groups of patients studied previously.

METHODS AND RESULT: Patients were referred by general practitioners to an open-access echocardiography service for assessment of possible heart failure. Echocardiography included a Doppler study of transmitral flow at the tips of the mitral leaflets and calculation of an E/A ratio. Of 534 patients referred and assessed, 371 patients had normal systolic function and a measurable E/A ratio. These were compared with age-adjusted reference ranges to give 9 above the reference range and 19 below. This is only 10 more than would be expected if our patients were normal. In the same group of patients we found 96 cases of left ventricular systolic dysfunction, or 52 amongst the 423 with a measurable E/A ratio.

CONCLUSIONS: Either left ventricular diastolic filling abnormalities are very much less common than previously supposed or the E/A ratio is almost useless for their detection.

Key Words: Heart failure • echocardiography • diastolic filling abnormalities


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