title: Improved Diastolic Function Is Associated With Higher Cardiac Output in Patients With Heart Failure Irrespective of Left Ventricular Ejection Fraction.
abstract: BACKGROUND
  Little is known regarding the impact of diastolic function on cardiac output (CO) in patients with heart failure, particularly in patients with lower ejection fraction. This study aimed to evaluate the impact of end-diastolic pressure-volume relationship (EDPVR) on CO and end-diastolic pressure (EDP).
  
  
  RESULTS
  We retrospectively analyzed 1840 consecutive patients who underwent heart catheterization. We divided patients into 8 groups according to ejection fraction (EF) (35-45%, 46-55%, 56-65%, and 66-75%) and EDP (>16 or ≤16 mm Hg). We estimated EDPVR from single measurements in the catheterization data set. Then, we replaced EDPVRs of high-EDP groups with those of normal-EDP groups and compared CO before and after EDPVR replacement. Normalized EDPVR significantly increased CO at EDP=10 mm Hg regardless of EF (EF 35-45%, from 4.5±1.6 to 4.9±1.0; EF 46-55%, 4.6±1.3 to 5.1±1.1; EF 56-65%, 4.9±1.5 to 5.2±1.0; EF 66-75%, 4.9±1.5 to 5.2±1.1). Changes in CO were similar across EF groups.
  
  
  CONCLUSIONS
  Diastolic function normalization was associated with higher CO irrespective of EF. Diastolic dysfunction plays an important role in determining CO irrespective of EF in heart failure patients.
authors.affiliation: Department of Cardiology, Aso-Iizuka Hospital, Iizuka Fukuoka, Japan ttobushi@gmail.com.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Tobushi
authors.affiliation: Department of Cardiology, Aso-Iizuka Hospital, Iizuka Fukuoka, Japan.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Nakano
authors.affiliation: Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Hosokawa
authors.affiliation: Department of Health Information Management, Aso-Iizuka Hospital, Fukuoka, Japan.
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Koga
authors.affiliation: Department of Cardiology, Aso-Iizuka Hospital, Iizuka Fukuoka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yamada
mesh_terms: D000368:Aged; D001794:Blood Pressure; D006328:Cardiac Catheterization; D002302:Cardiac Output / Q000502:physiology*; D016534:Cardiac Output, High / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D003971:Diastole; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D009200:Myocardial Contraction / Q000502:physiology; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: cardiac output; diastolic dysfunction; heart failure