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Assessment of Systolic and Diastolic Cardiac Function beyond Traditional Markers in Hypertensive Patients. Role of Cardiac Reserve
Background: the mechanical performance of the cardiac pump should be evaluated not only at rest but also in relation to its response to peak stimulation, since the earliest consequence of the cardiac pump capacity in the evolution of heart failure is the decrease of the maximal performance. This can be assessed by measuring the cardiac functional reserve, usually by a physical or a pharmacological stress test combined with echocardiography imaging.
Content and comments: in symptomatic heart failure, the main purpose is to objectively identify the point to which the impairment of the pump function is irreversible. Moreover, there is growing evidence that the functional systolic and diastolic reserve is decreased even in the early, subclinical stages of cardiac dysfunction that exists for example in hypertensive disease and that the decrease seems to be related to the number of the associated cardiovascular risk factors.
Conclusion: thus, better preventive and therapeutic strategies could be established by detecting a reduced functional reserve in this category of patients at high risk of heart failure development, with important public-health implications.
Keywords: functional reserve, stress test with dobutamine, subclinical heart failure, beta-blockers, tissue Doppler imaging, speckle tracking