Cardiologie clinique et expérimentale
Libre accès
ISSN: 2155-9880
ISSN: 2155-9880
Guy Dori*, Razi Even-Dar, David Saraf and Naama Schwartz
Background: In a previous meta-analysis ejection fraction (EF) was greater in heart failure and preserved ejection fraction (HFPEF) patients than it was in healthy controls (HC). In this study differences between indices of end-systolic and diastolic volumes (ESVi and EDVi) in HFPEF compared to HC were studied, in search for an explanation for the difference in EF. In addition, it was hypothesized that changes in ESVi and EDVi may provide understanding of the process of left ventricular remodeling.
Methods: Literature was searched for studies reporting ejection fraction (EF), EDVi and ESVi. Pooled differences were estimated with weighted and standardized mean differences. The normalized mean difference of X, , where X=EDVi or ESVi and is the mean of X, was plotted as a function of the difference between EF in HC, EFHC, and HFPEF, EFHFPEF, for each study included.
Results: Fourteen studies were analyzed; HFPEF patients were 3.6 years older and 3.2 BMI units heavier than HC (P <0.00, for both); EFHFPEF was 1% smaller than EFHC (WMD 95%CI: -1.66, -0.5; p=0.057). EDViHFPEF and ESViHFPEF were not different from their HC counterparts. Graphical analysis revealed that when EFHFPEF >EFHC, both EDViHFPEF and ESViHFPEF were smaller than their HC counterparts (i.e. NMD[ESVi] and NMD[EDVi] >0), and the absolute difference between ESViHC and ESViHFPEF was greater than that observed between EDViHC and EDViHFPEF. When EFHFPEF<=EFHC, both EDViHFPEF and ESViHFPEF were either greater or smaller than their HC counterparts.
Conclusions: Meta-analysis showed agreement between changes in EDVi and ESVi and the value of EF. On average, the changes demonstrated were not characteristic of concentric hypertrophy. Graphic analysis showed that when EFHFPEF>EFHC, changes in EDVi and ESVi supported characteristics of concentric hypertrophy, and when EFHFPEF