According to researchers at Johns Hopkins University in the U.S. a dramatic change is needed in the way hundreds of thousands of Americans with a form of heart failure should be treated.
The cardiologists say they have found evidence that patients with non-systolic heart failure may benefit more from pacemakers to speed up the heartbeat than from continual, long-term use of beta blockers, drugs that actually slow down the heartbeat.
Figures suggest that almost half of the 550,000 Americans newly diagnosed each year with heart failure, have the non-systolic form.
Senior study investigator David Kass, M.D., a professor at the Johns Hopkins University School of Medicine and its Heart Institute, says cardiologists are being forced to rethink heart failure because one size does not fit all and care is needed in diagnosing and approaching its treatment.
Professor Kass also says that greater numbers of older adults who have heart failure, mostly women over age 50, have hearts which appear to pump normally and all facets and manifestations of the disease must be understood.
Such cases says Kass are clearly different from traditional, systolic heart failure, where pumping function is depressed but almost all of the research over the last three decades has applied only to those with systolic heart failure.
Non-systolic heart failure is characterized by fairly normal function of the heart’s pumping action, or so-called ejection fraction, when a person is at rest.
This action falters, however, once daily physical activity begins, and the heart becomes increasingly unable to squeeze out sufficient blood flow to energy-starved muscles.
Even small tasks, such as getting dressed in the morning, can leave people exhausted and short of breath.
Kass says until now researchers had thought the problem was that these hearts could simply not relax properly, a so-called failure of their diastolic function.