Difficulties in the heart's ability to fill with blood are common causes of heart failure -- and appear to be as significant in placing a heart patient at risk of death as are deficiencies in the heart's ability to pump blood, new research from
Difficulties in the heart's ability to fill with blood are common causes of heart failure -- and appear to be as significant in placing a heart patient at risk of death as are deficiencies in the heart's ability to pump blood, new research from Mayo Clinic shows.
As a result of these findings, heart failure -- a leading and urgent public health problem in the United States and elsewhere -- can likely be managed more effectively to identify and treat those at highest risk of dying from heart disease, the Mayo Clinic researchers say. Their report appears in the current Journal of the American Medical Association.
Significance of the Mayo Study
The Mayo study is the first large, community-based study to clarify the role of filling deficiencies -- known as diastolic dysfunction -- in heart failure. In the past, literature shows that heart failure is too often conceived as a pumping problem, known as systolic dysfunction. Systolic dysfunction is an inability to effectively move blood out of the heart. But to pump effectively, the heart also has to have a healthy filling phase.
"Our findings help support the growing understanding that heart failure is a disease with several faces -- and that's the first step to improving treatment," explains Mayo Clinic cardiologist Veronique Roger, M.D., M.P.H., the study's lead author. "Specifically, our results highlight the diverse nature of heart failure as a syndrome in which defects in both the pumping and the filling phases need to be considered for optimal patient management. It is not a case of one or the other."
To clarify the role of diastolic dysfunction in heart failure, Dr. Roger and colleagues recruited 556 patients with heart failure in Olmsted County, Minn., from 2003 to 2005. They tested both heart-pumping and heart-filling functions with Doppler echocardiography. This technique is a form of ultrasound based on the Doppler shift variation in sound