Kliger et al developed an algorithm for classifying a patient with heart failure and a normal left ventricular ejection fraction. The authors are from Columbia University in New York.
(1) arterial hypertension (based on physical examination or clinical history)
(2) left ventricular wall thickness on transesophageal echocardiography (TEE)
(3) QRS voltage on ECG
(4) left ventricular size relative to age, gender and body size
Wall Thickness by TEE vs ECG
Left Ventricular Size
wall thick by TEE; increased QRS voltage
idiopathic hypertrophic CM
wall thick on TEE but decreased QRS voltage
decreased for age, gender and body size
ventricular-arterial mismatch (increased afterload)
increased for age, gender and body size
volume overload (increased preload)
• CM = cardiomyopathy
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Purpose: To evaluate a patient with heart failure and a normal left ventricular ejection fraction using the algorithm of Kliger et al.
Objective: other testing, criteria for diagnosis, severity, prognosis, stage