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M. JESSUP

Tenth International Symposium HEART FAILURE & Co. CARDIOLOGY SCIENCE UPDATE FEMALE DOCTORS SPEAKING ON FEMALE DISEASES Milano 9 - 10 aprile 2010. M. JESSUP. Heart Failure in Women Diastolic Heart Failure: a Matter of Not Compliant Myocardium. Mariell Jessup MD, FAHA, FACC

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M. JESSUP

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  1. Tenth International Symposium HEART FAILURE & Co. CARDIOLOGY SCIENCE UPDATE FEMALE DOCTORS SPEAKING ON FEMALE DISEASES Milano 9 - 10 aprile 2010 M. JESSUP

  2. Heart Failure in WomenDiastolic Heart Failure: a Matter of Not Compliant Myocardium Mariell Jessup MD, FAHA, FACC Professor of Medicine University of Pennsylvania

  3. OPTIMIZE-HF Fonarow et al. JACC 2007; 50:768

  4. 312 patients, mean age:66 years, LVEF: 50%, 34% women. The median follow-up was 18.7 months. Diastolic dysfunction: 67% of classified patients moderate and severe DD: 44%

  5. CHARM JACC 2007; 49: 687

  6. Serum markers of fibrosis (CITP and PIIINP) are associated with systolic and diastolic HF in community-dwelling elderly individuals. These associations remained significant even after adjustment for demographic and clinical characteristics, bone mineral density and NT-proBNP.

  7. Stress does not commonly induce systolic dysfunction in patients with HFNEF. • It is unlikely that exercise intolerance is due to global regional or long-axis systolic dysfunction or other non-cardiac causes. • Abnormalities in diastolic function are often induced or exacerbated by stress in these patients, • Stress-induced impairment of early diastolic relaxation with consequent rise in the LV end-diastolic pressure is the likely cause of exercise intolerance.

  8. Diastolic Heart Failure: a Matter of Not Compliant Myocardium • Women age their hearts differently than men, setting the stage for less compliant myocardium. • Heart rate response is also not normal in HFpEF. • The abnormal myocardium is not just more fibrotic. • Other aging factors and multiple co-morbidities must play a role.

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