Restrictive left ventricular filling patterns in very old patients with congestive heart failure: clinical correlates and prognostic significance.

Journal Article (Journal Article)

OBJECTIVES: In certain younger patients with congestive heart failure (CHF), Doppler/echocardiography has identified a "restrictive" pattern of early diastolic ventricular filling characterized by very rapid early filling and a steep deceleration slope. We asked whether a similar restrictive pattern can be identified in very old patients with CHF, and if so, what are its clinical correlates and prognostic implications. DESIGN: Retrospective cohort with prospective follow-up. SETTING: Academic long-term care facility. PARTICIPANTS: Thirty-nine residents with clinical CHF (age 89 +/- 5 (SD) years) MEASUREMENTS: Transmitral Doppler flow, clinical characteristics, recurrent CHF episodes, hospitalizations, and mortality were measured. RESULTS: Fifteen (38%) of the subjects had restrictive filling patterns, characterized by a ratio of early to late flow (E/A) > 1.00 and 24 (62%) had nonrestrictive patterns. The restrictive pattern was associated with a longer duration of CHF, more angina, and higher rate of symptomatic recurrences of CHF. CONCLUSION: A restrictive diastolic filling pattern may represent a late stage in the evolution of congestive heart failure when left ventricular filling pressure is markedly increased. The treatment of CHF in older patients may need to account for different patterns of diastolic filling.

Full Text

Duke Authors

Cited Authors

  • Lipsitz, LA; Byrnes, N; Hossain, M; Douglas, P; Waksmonski, CA

Published Date

  • June 1996

Published In

Volume / Issue

  • 44 / 6

Start / End Page

  • 634 - 637

PubMed ID

  • 8642151

International Standard Serial Number (ISSN)

  • 0002-8614

Digital Object Identifier (DOI)

  • 10.1111/j.1532-5415.1996.tb01823.x


  • eng

Conference Location

  • United States