The pathophysiology of heart failure with normal ejection fraction: exercise echocardiography reveals complex abnormalities of both systolic and diastolic ventricular function involving torsion, untwist, and longitudinal motion

Yu Ting Tan, Frauke Wenzelburger, Eveline Lee, Grant Heatlie, Francisco Leyva, Kiran Patel, Michael Frenneaux, John E Sanderson

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403 Citations (Scopus)


The purpose of this study was to test the hypothesis that in heart failure with normal ejection fraction (HFNEF) exercise limitation is due to combined systolic and diastolic abnormalities, particularly involving ventricular twist and deformation (strain) leading to reduced ventricular suction, delayed untwisting, and impaired early diastolic filling.
Original languageEnglish
Pages (from-to)36-46
Number of pages11
JournalJournal of the American College of Cardiology
Issue number1
Publication statusPublished - 30 Jun 2009


  • diastolic
  • heart failure
  • rotation
  • strain
  • untwist
  • socialisation

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