Liaqat Ali, Abdul Rehman Abid, Saqib Shafi Sheikh, Muhammad Azhar.
Clinical functional class correlation with systolic and diastolic dysfunction in heart failure.
Ann Pak Inst Med Sci Jan ;2(4):251-5.

Objective: To correlate the clinical functional class with systolic and diastolic dysfunction assessed by echocardiography. Material and Methods: This descriptive analytic study was conducted from January 1998 to September 1998 at the Cardiology Department of Mayo Hospital Lahore. A total of 60 patients with sinus rhythm and having symptoms of heart failure were included in the study. Results: Group I (functional class I & II) comprised of 42 patients (70%). Group II (functional class Ill and IV) consisted of 18 patients (30%). Hypertension was present in 14(23.3%) patients. History of ischemic heart disease was documented in 17 (28.3%) patients. Diabetes mellitus was present in 9(15%) patients. 19 (31.6%) patients were smoker. Dyslipidemia was present in 29(48.3%) patients. Mean ejection fraction in Group I was 46.3% while it was 34.2% in Group II (p<0.0003). Mean fraction shortening was 24.6% in Group I and 18.1% in Group II (p<0.0001). Mean E wave velocity was 63.2±3.9 cm/sec in Group I and 74.3±4.9 cm/sec in Group II. Mean A wave velocity was 67.1±4.8 cm/sec in Group I and 53.2±5.2 cm/sec. Mean S wave velocity was 56.1±3.9 cm/sec in Group I and 44.8±4.2 in Group II (p<0.02). Mean D wave velocity was 38±3.2 cm/sec in Group I and 43 ±2.6 in Group II (p<0.11). Equal EIA ratio occurred in 6(14.3%) patients in Group I and 2 (11.1%) patients in Group II. Conclusion: There is a correlation between NYHA functional class and systolic and diastolic function as deterioration in systolic function is manifested by advanced functional class which is also accompanied by worsening in left ventricular diastolic pattern.

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