title: Transition from asymptomatic diastolic dysfunction to heart failure with preserved ejection fraction: roles of systolic function and ventricular distensibility.
abstract: BACKGROUND
  Systolic abnormality, as well as diastolic dysfunction, is observed in patients with heart failure with preserved ejection fraction (HFPEF). However, the role of these 2 conditions in the transition from asymptomatic diastolic dysfunction to symptomatic heart failure remains unclear. We recently demonstrated that diastolic wall strain (DWS) inversely correlates to the myocardial stiffness constant.
  
  
  RESULTS
  This study consisted of 127 subjects: 52 consecutive HFPEF patients (HFPEF group), 50 asymptomatic hypertensive patients with ejection fraction ≥50% whose age, gender and left ventricular (LV) mass index matched those of the HFPEF group (HT group) and 25 normal volunteers (Normal group). The tissue Doppler-derived peak systolic and early diastolic velocities of the mitral annulus were significantly decreased in groups HFPEF and HT than in group Normal, but were not significantly different between groups HFPEF and HT. DWS was significantly lower in group HFPEF than in group HT.
  
  
  CONCLUSIONS
  The transition from asymptomatic diastolic dysfunction stage to HFPEF stage is not attributed to progression of systolic abnormality, and exacerbation of LV distensibility rather than relaxation plays a crucial role in the development of HFPEF.
authors.affiliation: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Aizawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sakata
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Mano
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Takeda
authors.forename: Tomohito
authors.initials: T
authors.lastname: Ohtani
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Tamaki
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Omori
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Tsukamoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
authors.forename: Issei
authors.initials: I
authors.lastname: Komuro
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003971:Diastole / Q000502:physiology*; D018450:Disease Progression; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology*; D013599:Systole / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology