Ventricular volume and length in hypertensive diastolic heart failure

Background. Patients with diastolic heart failure are thought to have a normal or small ventricle with impaired ventricular filling that requires increased filling pressure to maintain normal stroke volume. In this study we test the hypothesis that patients with hypertensive diastolic heart failure have increased left ventricular volumes compared with age-, sex-, and body size-matched control subjects. Method. Left ventricular chordal dimensions from 2-dimensional echocardiography and volumes from 3-dimensional echocardiography were obtained in control subjects (n = 96) and patients with hypertensive diastolic heart failure (n = 28) and compared before and after controlling for age, sex, and body size. Results: Volumes by 3-dimensional echocardiography were significantly larger in the heart failure group than in the control group (P < .05). After matching for age, sex, and body size, volumes remained significantly larger in the patients with heart failure (P < .05). Chordal dimensions were not significantly different between the two groups. Stroke volume and centerline length of the ventricle were significantly increased in the heart failure group compared with matched control subjects (P < .05). Conclusions: Our group of patients with hypertensive diastolic heart failure had significantly increased left ventricular volumes and stroke volume compared with control subjects, compatible with volume overload heart failure. Two-dimensional echocardiographic measurement of the ventricular chordal dimension failed to detect this enlargement. Ventricular length appeared to be preferentially increased in the patients with hypertensive diastolic heart failure.