Certain Heart Patients Erroneously Diagnosed

Researchers at the University of Hull in the UK have found that many heart patients who are diagnosed as having “diastolic heart failure” (DHF) are wrongly diagnosed so. In their opinion, such patients might just be showing effects of ageing or other conditions that are not directly connected to their heart.

DHF is a condition marked by a reduction in the ability of the heart to relax and allow blood to fill in. Systolic heart failure or SHF is another condition of the heart in which the muscle loses its ability to contract. While patient outlooks remain similar, studies have found DHF to be a more common occurrence compared to SHF.

Led by Dr. Andres L. Clark, the research team looked at 568 patients with SHF, 104 with DHF and 400 healthy patients matched to the DHF patients as controls. The researchers found that while both DHF and SHF patients reported a similar degree of breathlessness, body mass index (BMI) was significantly higher in the former.

“Some patients with symptoms suggestive of chronic heart failure have normal heart pumping function, but have hearts that apparently don’t relax to allow filling as well as usual,” Dr. Clark said. “The symptoms are often attributed to the heart abnormalities and such patients are labelled as having DHF.”

However, “our findings suggest that the symptoms of patients with DHF are out of proportion to the objective measurement of any cardiac (disease). There may be an alternative explanation for their symptoms,” Dr. Clark added.

Reporting their study in the journal Heart, Dr. Clark and colleagues noted that DHF patients in their study “were more likely to be female, older and have a higher body mass index, which may explain to some degree why their perception of symptoms is out of proportion to their cardiac (findings).”

At the same time, the researchers found that blood levels of a substance called NT-proBNP were at the same levels in the DHF and control patients but significantly higher in SHF patients. NT-proBNP is considered to be an accurate measure of heart function.

The researchers note that “a requirement for raised BNP does not form part of the case definition for DHF in the latest guidelines.” In their opinion, if it were to be so, “Those patients with breathlessness and ‘abnormal diastolic function’ on echocardiography would be spared a heart failure diagnosis.”

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