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(Circulation. 2008;118:e505.)
© 2008 American Heart Association, Inc.

Correspondence

Letter by Razzolini and Tarantini Regarding Article, "Restrictive Left Ventricular Filling Pattern Does Not Result From Increased Left Atrial Pressure Alone"

Renato Razzolini, MD; Giuseppe Tarantini, MD

Department of Heart, Chest and Vessels Science, University of Padova, Padova, Italy

To the Editor:

We congratulate Masutani and colleagues¹ on their insightful article distinguishing a restrictive filling pattern due to an overfilled normal left ventricle from one due to a failing enlarged left ventricle. We do not think, however, that the differences they found in diastolic parameters are due to primary diastolic dysfunction, as they claim. In fact, they compared 3 groups of dogs: a control group (C), a volume overloaded group (VOL), and a group with systolic heart failure induced by rapid ventricular pacing (HF). Therefore, the differences in diastolic parameters between VOL and HF groups are obviously due primarily to a systolic, not diastolic, dysfunction. Moreover, the difference in average operative compliance (K_LV) does not mean that the 3 groups belong to 3 different passive pressure-volume curves: the average K_LV in group C could well be the average of the flat portion, whereas K_LV in group HF could be the average of the steep portion and K_LV in group VOL could be the average of both portions of the same pressure-volume curve.

We think that the article is an elegant proof that heart failure with systolic dysfunction can induce a secondary alteration in diastolic parameters but is not proof of a primary diastolic dysfunction.

	Acknowledgments

 
Disclosures

None.

	Reference

Top Reference

 
1. Masutani S, Little WC, Hasegawa H, Cheng H-J, Cheng C-P. Restrictive left ventricular filling pattern does not result from increased left atrial pressure alone. Circulation. 2008; 117: 1550–1554.[Abstract/Free Full Text]

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Razzolini, R. Articles by Tarantini, G. Search for Related Content PubMed PubMed Citation Articles by Razzolini, R. Articles by Tarantini, G. Related Collections Congestive