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Left ventricular diastolic heart failure with normal left ventricular systolic function in older persons.
J Lab Clin Med. 2001 May; 137(5):316-23.JL

Abstract

Underlying causes and precipitating causes of congestive heart failure (CHF) should be treated when possible. Older persons with CHF and normal left ventricular (LV) ejection fraction should have maintenance of sinus rhythm, treatment of hypertension and myocardial ischemia, slowing of the ventricular rate below 90 beats/minute, and reduction of salt overload. First-line drug treatment in the management of these persons is the use of loop diuretics combined with beta blockers as tolerated. Angiotensin-converting enzyme (ACE) inhibitors should be administered if CHF persists despite diuretics and beta blockers. If persons are unable to tolerate ACE inhibitors because of cough, rash, or altered taste sensation, angiotensin II type 1 receptor antagonists should be given. If CHF persists despite diuretics, beta blockers, and ACE inhibitors or the person is unable to tolerate beta blockers, ACE inhibitors, and angiotensin II type 1 receptor antagonists, isosorbide dinitrate plus hydralazine should be administered. Calcium channel blockers should be used if CHF persists despite administration of diuretics and the person is unable to tolerate beta blockers, ACE inhibitors, angiotensin II type 1 receptor antagonists, and isosorbide dinitrate plus hydralazine. Digoxin, beta blockers, verapamil, and diltiazem may be used to slow a rapid ventricular rate in persons with supraventricular tachyarrhythmias. Digoxin should not be used in persons with CHF in sinus rhythm with normal LV ejection fraction.

Authors+Show Affiliations

Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, NY, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

11329528

Citation

Aronow, W S.. "Left Ventricular Diastolic Heart Failure With Normal Left Ventricular Systolic Function in Older Persons." The Journal of Laboratory and Clinical Medicine, vol. 137, no. 5, 2001, pp. 316-23.
Aronow WS. Left ventricular diastolic heart failure with normal left ventricular systolic function in older persons. J Lab Clin Med. 2001;137(5):316-23.
Aronow, W. S. (2001). Left ventricular diastolic heart failure with normal left ventricular systolic function in older persons. The Journal of Laboratory and Clinical Medicine, 137(5), 316-23.
Aronow WS. Left Ventricular Diastolic Heart Failure With Normal Left Ventricular Systolic Function in Older Persons. J Lab Clin Med. 2001;137(5):316-23. PubMed PMID: 11329528.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Left ventricular diastolic heart failure with normal left ventricular systolic function in older persons. A1 - Aronow,W S, PY - 2001/5/1/pubmed PY - 2001/6/2/medline PY - 2001/5/1/entrez SP - 316 EP - 23 JF - The Journal of laboratory and clinical medicine JO - J. Lab. Clin. Med. VL - 137 IS - 5 N2 - Underlying causes and precipitating causes of congestive heart failure (CHF) should be treated when possible. Older persons with CHF and normal left ventricular (LV) ejection fraction should have maintenance of sinus rhythm, treatment of hypertension and myocardial ischemia, slowing of the ventricular rate below 90 beats/minute, and reduction of salt overload. First-line drug treatment in the management of these persons is the use of loop diuretics combined with beta blockers as tolerated. Angiotensin-converting enzyme (ACE) inhibitors should be administered if CHF persists despite diuretics and beta blockers. If persons are unable to tolerate ACE inhibitors because of cough, rash, or altered taste sensation, angiotensin II type 1 receptor antagonists should be given. If CHF persists despite diuretics, beta blockers, and ACE inhibitors or the person is unable to tolerate beta blockers, ACE inhibitors, and angiotensin II type 1 receptor antagonists, isosorbide dinitrate plus hydralazine should be administered. Calcium channel blockers should be used if CHF persists despite administration of diuretics and the person is unable to tolerate beta blockers, ACE inhibitors, angiotensin II type 1 receptor antagonists, and isosorbide dinitrate plus hydralazine. Digoxin, beta blockers, verapamil, and diltiazem may be used to slow a rapid ventricular rate in persons with supraventricular tachyarrhythmias. Digoxin should not be used in persons with CHF in sinus rhythm with normal LV ejection fraction. SN - 0022-2143 UR - https://www.unboundmedicine.com/medline/citation/11329528/Left_ventricular_diastolic_heart_failure_with_normal_left_ventricular_systolic_function_in_older_persons_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-2143(01)64231-8 DB - PRIME DP - Unbound Medicine ER -