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J Am Coll Cardiol, 2004; 43:317-327, doi:10.1016/j.jacc.2003.07.046
© 2004 by the American College of Cardiology Foundation
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STATE-OF-THE-ART PAPER

Heart failure with preserved left ventricular systolic function

epidemiology, clinical characteristics, and prognosis

Karen Hogg, BSC, MBChB, MRCP*, Karl Swedberg, MD, PhD{dagger} and John McMurray, MD, FRCP, FESC, FACC*,*

* Department of Cardiology, Western Infirmary, Glasgow, Scotland, United Kingdom
{dagger} Department of Medicine, Sahlgrenska University Hospital/Ostra, Göteborg, Sweden

Manuscript received April 1, 2003; revised manuscript received June 26, 2003, accepted July 21, 2003.

* Reprint requests and correspondence: Prof. John J. V. McMurray, Department of Cardiology, Western Infirmary, Glasgow, G12 8QQ, United Kingdom.
j.mcmurray{at}bio.gla.ac.uk

Recent cross-sectional, population-based echocardiographic studies show that about half of all patients with heart failure have preserved left ventricular systolic function (HF-PSF). Cohort studies of hospitalized patients show a smaller proportion of HF-PSF. Compared to those with reduced systolic function, patients with HF-PSF are more often female, older, less likely to have coronary artery disease, and more likely to have hypertension. Patients with HF-PSF are less symptomatic and receive different pharmacologic therapy than patients with reduced systolic function. Morbidity and mortality rates in patients with HF-PSF are high but not quite as high as in patients with reduced systolic function. Though much has recently been learned about the syndrome of HF-PSF, many questions remain to be answered, not least how it should be treated.

Abbreviations and Acronyms
  AF = atrial fibrillation
  CHF = chronic heart failure
  CHD = coronary heart disease
  DD = diastolic dysfunction
  ECG = electrocardiogram/electrocardiographic
  FS = fractional shortening
  IVRT = isovolumic relaxation time
  LV = left ventricle/ventricular
  LVEF = left ventricular ejection fraction
  PSF = preserved systolic function




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