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Patient with Heart Failure and Normal Left Ventricular Ejection Fraction Evaluation

Purpose: To evaluate a patient with heart failure and a normal left ventricular ejection fraction using the algorithm of Kliger et al.

Description

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.


 

Parameters:

(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

 

Hypertension

Wall Thickness by TEE vs ECG

Left Ventricular Size

Diagnosis

absent

wall thick by TEE; increased QRS voltage

NA

idiopathic hypertrophic CM

absent

both normal

NA

restrictive CM

absent

wall thick on TEE but decreased QRS voltage

NA

infiltrative CM

present

NA

decreased for age, gender and body size

ventricular-arterial mismatch (increased afterload)

present

NA

increased for age, gender and body size

volume overload (increased preload)

 

where:

• CM = cardiomyopathy

 


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Specialty

Objective

ICD-10