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decreased compliance (left ventricular hypertrophy, fibrosis, infiltrative cardiomyopathy). Commonly, patients with systolic dysfunction also manifest diastolic dysfunction.

Treatment of patients with systolic dysfunction with ACE inhibitors and beta-blockers increases survival. Patients with diastolic dysfunction will have treatment aimed at their underlying disease (e.g., ACE inhibitors in hypertensive patients) in addition to diuretics (to reduce preload) and drugs that slow the ventricular rate (to increase the diastolic filling period).

Table 1. Comparison of various modalities used in the evaluation of ventricular function

Modality

Strengths

Weaknesses

Contrast angiography/ vesiculography

•Assesses anatomic CAD

•Invasive

•Contrast reactions •Geometric assumptions in calculation of EF

Echocardiography

•Non-invasive •No radiation •Assesses valve structure and function •Assesses pericardial effusion +/- tamponade

•Requires acoustic window

•Not optimal for RV assessment •Geometric assumptions in

•Assesses wall thickening calculation of EF

Gated myocardial perfusion imaging (MPI)

•Non-invasive •Provides assessment of myocardial perfusion •Can assess wall thickening •No geometric assumptions

•Requires regular rhythm

•May have difficulty tracking the myocardial wall with a severe defect

Equilibrium radionuclide angiocardiography (ERNA)

•Non-invasive

•No geometric assumptions

•Good RV assessment

•Requires good RBC labeling Need to modify technique (e.g., list mode) for arrythmias

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Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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