While there are many ways to categorize heart failure, one of the most commonly used is via ejection fraction. Those with a left ventricular ejection fraction (LVEF) less than 40-50% with signs of hypoperfusion are labeled as systolic heart failure. Think of your heart as the revolving door at the entrance to a fancy building. Low LVEF can be envisioned as a rusty revolving door that allows less traffic flow than compared to when it's oiled & moving appropriately.
Less commonly, some patients have hypoperfusion (inadequate blood flow to end organs) despite normal LVEF (>50-60%). This is labeled as diastolic heart failure or diastolic dysfunction. Think of this as the revolving door now motorized & spinning much too quickly to for anyone to step in & through, therefore, traffic flow is still limited. While we have plenty of evidence as to what improves outcomes in those with the common systolic HF, we really don't have any regarding the less common diastolic HF.
Well, a
prospective, randomized, double-blind, placebo-controlled study was published last week in JAMA in which the authors concluded that
long-term use of spironolactone, an aldosterone antagonist, improved diastolic function but did not improve exercise capacity, symptoms or quality of life. In other words, why do it? Do you really care what your LVEF is as long as you don't have any functional limitation? Give me a study which shows that I can improve your quality of life & keep you healthy for a longer duration of time and then I'll be impressed. In the meantime, I'll keep on doing things because I should, not because I can.
This site complies with the
HONcode standard for trustworthy health information:
verify here.
.jpg)
No comments:
Post a Comment