THE PREVALENCE OF LEFT-VENTRICULAR DIASTOLIC FILLING ABNORMALITIES INPATIENTS WITH SUSPECTED HEART-FAILURE

Aims It is reported that one third of patients with heart failure have normal left ventricular systolic function, and may or may not have le ft ventricular diastolic dysfunction. We sought to define the prevalen ce of left ventricular diastolic filing abnormalities in a large unsel ected group of patients, unlike the diagnosis by exclusion in the smal l highly selected groups of patients studied previously. Methods and r esults Patients were referred by general practitioners to an open-acce ss echocardiography service for assessment of possible heart failure. Echocardiography included a Doppler study of transmitral flow at the t ips of the mitral leaflets and calculation of an E/A ratio. Of 534 pat ients referred and assessed, 371 patients had normal systolic function and a measurable E/A ratio. These were compared with age-adjusted ref erence ranges to give 9 above the reference range and 19 below. This i s 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 systo lic dysfunction, or 52 amongst the 423 with a measurable E/A ratio. Co nclusion Either left ventricular diastolic filing abnormalities are ve ry much less common than previously supposed or the E/A ratio is almos t useless for their detection.