Kenneth M. Kessler, MD
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To the Editor: The editorial by Drs. Jaeschke and Guyatt (1) on the medical therapy for chronic congestive heart failure was concise, timely, and well focused; however, the treatment subgroup was assumed and not defined. Currently, there are four studies (2-4) demonstrating that approximately 30% of patients with congestive heart failure have normal left ventricular ejection fractions. Such patients cannot be clinically discerned from those with abnormal ejection fractions, rarely have marked hypertrophy or hypertrophic cardiomyopathy, but frequently have hypertensive or ischemic heart disease with accompanying diastolic left ventricular dysfunction. Pertinent to medical therapy, patients with normal ejection fractions do
Kessler KM. Medical Therapy for Chronic Congestive Heart Failure. Ann Intern Med. ;111:768–769. doi: 10.7326/0003-4819-111-9-768
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Published: Ann Intern Med. 1989;111(9):768-769.
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