Low Cardiac Index in Asymptomatic Hypertensive Patients with a Normal Ejection Fraction: A Pre-heart Failure Syndrome?

摘要

Reduced ejection fraction along with pertinent symptoms and signs is patho-gnomic of heart failure. However, it is estimated that almost 50% of heart failure patients have normal ejection fractions. These patients are treatment resistant and have similar clinical outcomes as those with reduced ejection fraction heart failure. Many hypertensive patients with no clinical signs and symptoms of heart failure and with preserved ejection fractions present with reduced cardiac index on impedance cardiography. These patients may represent a population that will progress to clinical heart failure with normal ejection fraction in the future. Therapeutic strategies in the latter patients remain understudied and presently uncertain. Early recognition of these patients may allow better understanding of the underlying pathophysiology and may help stem the progression to clinical heart failure. This should help arrest and even reverse the dismal morbidity and mortality seen in these patients.