Baicu CF et al. (2005) Left ventricular systolic performance, function, and contractility in patients with diastolic heart failure. Circulation 111: 2306–2312

Despite the fact that patients with diastolic heart failure usually have a normal ejection fraction, it has been proposed that significant abnormalities in left-ventricular systolic function are an important component of this condition. Baicu and colleagues hypothesized that the systolic properties of the left ventricle are, in fact, normal in these patients; the results of their study have recently been published in Circulation.

The researchers approached the problem by measuring multiple indices of left-ventricular systolic performance, function, and contractility in 75 patients with chronic diastolic heart failure and 75 controls without cardiovascular disease. Left-ventricular systolic performance was assessed by calculation of the stroke work generated by the ventricle. Left-ventricular systolic function, which relates left-ventricular performance to preload, was examined by measurement of preload-recruitable stroke work and ejection fraction. Finally, left-ventricular contractility was assessed by measuring the systolic stress-shortening relationship, end-systolic pressure-volume relationship, and peak positive dP/dt (the first derivative of left-ventricular pressure versus time).

No significant differences in left-ventricular systolic performance, function or contractility were found between patients and controls, and so Baicu et al. conclude that these properties are unlikely to be linked to the pathophysiology of diastolic heart failure. They discuss these findings in the context of other work in the area, some of which has generated conflicting conclusions.