We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Diagnosis and Treatment of Heart Failure Due to Left Ventricular Dysfunction

Ila V. Mehra, PharmD; C. Wayne Weart, PharmD
JAMA. 1994;272(17):1324-1325. doi:10.1001/jama.1994.03520170034020.
Text Size: A A A
Published online


To the Editor.  —We would like to commend Dr Gaasch1 for his excellent review on heart failure due to systolic and diastolic dysfunction. However, he recommends that symptomatic diastolic dysfunction be treated with β-adrenergic blockers or calcium channel blockers (CCBs). While we generally agree with this recommendation, we believe that further clarification is warranted. In the article, the statement was made that "negative chronotropic agents that slow the heart rate are the preferred therapeutic agents" and we fully support this recommendation. However, in Table 2 and in the explanation of the table, the blanket statement is made that β-blockers or CCBs should be used to treat symptomatic left ventricular dysfunction with normal ejection fraction (diastolic dysfunction).1In diastolic dysfunction, there is impaired filling and reduced diastolic relaxation of the left ventricle due to increased stiffness.2 Tachycardia can cause increased diastolic wall tension and may worsen diastolic heart


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.