PMID- 11292953
OWN - NLM
STAT- MEDLINE
DCOM- 20011207
LR  - 20071115
IS  - 0026-4725 (Print)
IS  - 0026-4725 (Linking)
VI  - 49
IP  - 2
DP  - 2001 Apr
TI  - Congestive heart failure in hypertensive patients with normal systolic function 
      and dynamic left ventricular outflow obstruction.
PG  - 99-106
AB  - BACKGROUND: Hypertensive patients with left ventricular hypertrophy and normal 
      systolic function can develop congestive heart failure refractory to conventional 
      drug therapy with digoxin, diuretic, and vasodilators. METHODS: We studied 8 
      patients with a history of systemic hypertension (6 females and 2 males, mean age 
      69+/-6 years), affected by New York Heart Association (NYHA) class IV congestive 
      heart failure notwithstanding conventional drug therapy with digoxin, diuretic, 
      and vasodilators. After clinical history and physical examination, blood 
      chemistry including cardiac enzymes, arterial blood gases, chest roentgenogram, 
      standard 12-lead ECG, and complete echocardiographic study were performed in all 
      patients. RESULTS: In all cases, a left ventricle with increased wall thickness, 
      normal cavity size, and normal or supernormal systolic function was shown. All 
      patients had left ventricular systolic dynamic obstruction, with peak gradient 
      between 36 and 130 mmHg (mean 83+/-31). After having stopped treatment with 
      nitrates, digoxin, and diuretics, drug therapy with calcium channel antagonists 
      or beta-blockers was started, and rapid clinical improvement with disappearance 
      of left ventricular outflow obstruction was observed. CONCLUSIONS: Sometimes, a 
      distinction between several forms of heart failure is clinically impossible. 
      However, when conventional therapy is not effective in patients with longstanding 
      history of systemic hypertension and ECG signs of left ventricular hypertrophy, 
      diastolic heart failure and/or dynamic left ventricular obstruction should be 
      suspected. Thus, an early echocardiographic study should be performed.
FAU - Sgreccia, A
AU  - Sgreccia A
AD  - Istituto di I Clinica Medica, Universita La Sapienza, Viale del 
      Policlinico--00161 Rome, Italy.
FAU - Morabito, G
AU  - Morabito G
FAU - Gurgo Di Castelmenardo, A
AU  - Gurgo Di Castelmenardo A
FAU - Bernardo, M L
AU  - Bernardo ML
FAU - Petrilli, A C
AU  - Petrilli AC
FAU - De Leva, R
AU  - De Leva R
FAU - De Marzio, P
AU  - De Marzio P
FAU - Nuccio, F
AU  - Nuccio F
FAU - Morelli, S
AU  - Morelli S
LA  - eng
PT  - Journal Article
PL  - Italy
TA  - Minerva Cardioangiol
JT  - Minerva cardioangiologica
JID - 0400725
SB  - IM
MH  - Aged
MH  - Female
MH  - Heart Failure/*etiology
MH  - Humans
MH  - Hypertension/*complications/physiopathology
MH  - Male
MH  - Systole
MH  - Ventricular Outflow Obstruction/*complications/physiopathology
EDAT- 2001/04/09 10:00
MHDA- 2002/01/05 10:01
CRDT- 2001/04/09 10:00
PHST- 2001/04/09 10:00 [pubmed]
PHST- 2002/01/05 10:01 [medline]
PHST- 2001/04/09 10:00 [entrez]
PST - ppublish
SO  - Minerva Cardioangiol. 2001 Apr;49(2):99-106.