title: Systolic and diastolic functions in elderly patients with and without heart failure.
abstract: BACKGROUND
  A considerable number of patients with heart failure (HF) have a normal left ventricular ejection fraction (LVEF). In these subjects, HF has usually been related to diastolic heart failure (DHF), still a frequently overlooked clinical entity.
  
  
  METHODS
  This study reports the clinical, instrumental, and conventional echocardiographic evaluation of 159 consecutive, hospitalized elderly patients, 87 admitted with HF and 72 admitted for other reasons without overt HF.
  
  
  RESULTS
  All of the 87 HF patients had signs of diastolic dysfunction (DDYS), yet 44.8% of them had a normal LVEF. Forty-four of the 72 patients admitted without overt HF (61.1%) had mild DDYS and 14 (19.5%) also had a reduced LVEF. There was a clear relationship between LVEF reduction and the severity of DDYS.
  
  
  CONCLUSIONS
  HF is often a combination of diastolic and systolic function abnormalities. DHF may be difficult to detect in HF subjects with normal LVEF because their DDYS is often mild. However, there are signs of DDYS in all HF patients that increase in severity as LVEF decreases. DDYS could be considered a marker for all forms of HF, especially in elderly patients.
authors.affiliation: 1st Internal Medicine Division-St. Agostino-Estense Hospital, Modena, Italy. p.giovanardi@ausl.mo.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Giovanardi
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Donato
authors.forename: Romeo Giulietto
authors.initials: RG
authors.lastname: Zennaro
authors.forename: Marco
authors.initials: M
authors.lastname: Garuti
authors.forename: Franco
authors.initials: F
authors.lastname: Zioni