Left Ventricular Diastolic Size in Patients with Normal Ejection Fraction and Elevated Left Filling Pressures


Address for correspondence and reprint requests: Elias B. Hanna, M.D., Cardiology Department, Louisiana State University, New Orleans, 1542 Tulane Avenue, Room 323, New Orleans, LA 70112. Fax: 504-568-2127; E-mail: ehanna10@yahoo.com


Objective: To evaluate the left-ventricular diastolic chamber size in patients with a normal ejection fraction and elevated left-sided filling pressures. Background: The consensus view that patients with normal left ventricular ejection fraction (LVEF) and elevated left-sided filling pressures have a normal left ventricular diastolic size is a point of controversy. Methods: We reviewed the coded database of echocardiographic studies performed at one institution between July 2007 and July 2008. We performed a retrospective descriptive study of 35 patients with normal ejection fraction (≥55%) and elevated left-sided filling pressures. We looked at their left ventricular internal diastolic diameter (LVIDD). Results: Our population had a high prevalence of hypertension (100%), obesity (63%), diabetes (40%), chronic kidney disease (51%), coronary artery disease (25%), anemia (43%), and left ventricular hypertrophy (65%). Clinical diagnosis of heart failure was documented in 63% of the patients. LVIDD was mildly increased in comparison to a normal historical population: 4.85 ± 0.5 cm for females, 5.3 ± 0.5 cm for males, as compared to 4.6 ± 0.3 cm for normal females (P = 0.045) and 5 ± 0.4 cm for normal males (P < 0.001). However, the distribution of the indexed LVIDDs in these patients was comparable to the normal population (2.6 ± 0.4 cm/m2 for the study population, as compared to 2.7± 0.2 cm/m2 for the normal population, P = 0.16). Conclusion: In a population of patients with a normal LVEF and high left ventricular filling pressures, the indexed LV diastolic size is not increased in comparison to a normal population. (Echocardiography 2010;27:501-504)