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Diagnosing diastolic dysfunction and heart failure with preserved ejection fraction in patients with atrial fibrillation: a clinical challenge.
Beladan, Carmen C; Gual-Capllonch, Francisco; Popescu, Andreea C; Popescu, Bogdan A.
Afiliación
  • Beladan CC; University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania.
  • Gual-Capllonch F; Emergency Institute for Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Cardiology Department, Bucharest, Romania.
  • Popescu AC; Cardiology Department, Hospital Universitari Son Espases, Illes Balears, Spain.
  • Popescu BA; University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania.
Eur Heart J Cardiovasc Imaging ; 2024 Jun 28.
Article en En | MEDLINE | ID: mdl-38940621
ABSTRACT
Left ventricular (LV) diastolic dysfunction, atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) share common risk factors and are closely related to each other and to adverse cardiovascular events. Exertional dyspnea in patients with AF should trigger comprehensive LV diastolic function evaluation since AF frequently precedes incident HFpEF. Echocardiographic assessment of LV diastolic function in patients with AF is challenging, mainly because of variability in cycle length, the absence of atrial contraction, and the frequent occurrence of LA enlargement regardless of LV filling pressures (LVFP). The algorithm of the 2016 recommendations for the evaluation of LV diastolic function cannot be directly applied in this setting. This review discusses the modalities available for diastolic function assessment and HFpEF diagnosis in patients with AF. Based on currently available data, a reasonable clinical target of diastolic function evaluation in AF would be to reach a binary

conclusion:

LVFP elevated or not. Recently, a two-step algorithm that combined several echocardiographic parameters plus inclusion of body mass index, has been proposed to differentiate normal from elevated LVFP in patients with AF. The echocardiographic evaluation must be complemented by a thorough clinical evaluation along with natriuretic peptides and cardiac catheterization in selected cases. If a diagnosis of HFpEF cannot be ascertained, a close follow up for timely identification of diastolic dysfunction markers along with monitoring and correction of modifiable risk factors are recommended.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Heart J Cardiovasc Imaging Año: 2024 Tipo del documento: Article País de afiliación: Rumanía Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Heart J Cardiovasc Imaging Año: 2024 Tipo del documento: Article País de afiliación: Rumanía Pais de publicación: Reino Unido