A method is described for the continuous recording of changes in the length of a segment of left ventricular myocardium, and its advantages and limitations are discussed. The curve depicting the relation between ventricular diastolic pressure and simultaneous changes in the length of a myocardial segment is presented. For a given increment in pressure, the myocardial segment length increases more at low ventricular diastolic pressure than at high pressure. Atrial systole causes a substantial increase in myocardial segment length when the ventricle is on the sensitive part of its pressure-length curve.. ...
TY - JOUR. T1 - A new approach for evaluation of left ventricular diastolic function. T2 - Spatial and temporal analysis of left ventricular filling flow propagation by color M-mode Doppler echocardiography. AU - Takatsuji, Hiroya. AU - Mikami, Taisei. AU - Urasawa, Kazushi. AU - Teranishi, Jun Ichi. AU - Onozuka, Hisao. AU - Takagi, Chika. AU - Makita, Yasuhiro. AU - Matsuo, Hisashi. AU - Kusuoka, Hideo. AU - Kitabatake, Akira. PY - 1996/2. Y1 - 1996/2. N2 - Objectives. To evaluate left ventricular diastolic function and differentiate the pseudonormalized transmitral flow pattern from the normal pattern, the propagation of left ventricular early filling flow was assessed quantitatively using color M-mode Doppler echocardiography. Background. Because the propagation of left ventricular early filling flow is disturbed in the left ventricle with impaired relaxation, quantification of such alterations should provide useful indexes for the evaluation of left ventricular diastolic function Methods. ...
Potassium depletion exacerbates essential hypertension. Contribution of external forces to left ventricular diastolic pressure: implications for the clinical use of the Starling law
To estimate changes in compliance, we evaluated the effects of sepsis on the end-diastolic pressure-volume relationship (EDPVR) in the left ventricle of rats that had undergone an open thorax procedure. Sepsis was induced in male Wistar Hannover rats (n = 7; 240 to 270 g) by intraperitoneal administration of a slurry of cecal contents; control rats (n = 7) were given 5% dextrose only. On the third day after induction of sepsis, left ventricular (LV) pressure and LV dimensions were recorded simultaneously in animals of both groups. Using a micromanometer and ultrasonic crystals, measurements were obtained at baseline and during the increase of afterload. Blood samples were taken for determination of complete blood count, white blood cell differential count, and lactate concentration, and for bacteriologic examination. Septic rats lost weight, and developed changes in body temperature, ascites, and abscesses in the abdominal and thoracic cavities, gram-negative bacteremia, and increase in heart ...
TY - JOUR. T1 - The natural history of isolated left ventricular diastolic dysfunction. AU - Brogan, Walter C.. AU - Hillis, L. David. AU - Flores, Eduardo D.. AU - Lange, Richard A.. PY - 1992. Y1 - 1992. N2 - study objective: To assess the natural history of isolated left ventricular diastolic dysfunction. materials and methods: Follow-up (average duration, 68 months) was obtained in 51 patients with isolated left ventricular diastolic dysfunction at cardiac catheterization, characterized by (1) an elevated left ventricular end-diastolic pressure; (2) normal left ventricular end-diastolic and end-systolic volumes; (3) normal left ventricular ejection fraction; (4) no coronary artery disease; and (5) no valvular disease. results: During follow-up, seven patients died, but only one died of cardiac causes. Of the 44 living subjects, 20 (45%) noted new-onset symptoms of congestive heart failure, with 11 (25%) of these requiring hospitalization, and 12 (27%) required hospitalization for recurrent ...
In this study we sought to assess the clinical significance of peak negative MVG derived from TDI as a noninvasive indicator of LV diastolic function. By comparing peak negative MVG among patients with or without impairment of systolic and diastolic performance, we have demonstrated that peak negative MVG reflected diastolic abnormalities in these patients. We have also found that peak negative MVG was relatively independent of preload alterations because peak negative MVG was unaltered, while the transmitral flow velocity indices were significantly altered, by passive leg lifting maneuver. Finally, we have found that peak negative MVG showed an improvement by volume-reducing therapy in contrast to the transmitral flow velocity indices, which apparently worsened toward an abnormal relaxation pattern. Thus, peak negative MVG may be a noninvasive indicator of LV diastolic function that is relatively independent of preload alterations, and thereby could be used for the follow-up of patients with ...
Since the gradient between aortic pressure and left ventricular diastolic pressure is a major determinant of coronary blood flow, a change in left ventricular relaxation by its effect on early diastole could diminish early diastolic coronary flow. Two interventions that resulted in impaired left ventricular relaxation, hypothermia, and reperfusion following a left anterior descending coronary artery occlusion were studied to evaluate whether there were associated changes in coronary blood flow. With both interventions, there was a significant prolongation of left ventricular relaxation (p less than 0.01) accompanied by a significant decrease in early diastolic coronary blood flow (p less than 0.01). Verapamil did not have a significant effect on these hemodynamic changes during hypothermia. However, verapamil significantly blunted the effects of reperfusion following ischemia on ventricular relaxation (p less than 0.002) and early diastolic coronary blood flow (p less than 0.01). Thus, impaired ...
Atrial fibrillation (AF) is the most frequent form of arrhythmia, and the number of patients with AF has increased with the rapid aging of society (1). AF is an important risk factor for heart failure (2), wherein left ventricular (LV) diastolic function is more closely related to the symptoms, exercise tolerance, and prognosis of patients compared with systolic function (3,4). In the clinical setting, LV diastolic function is mainly evaluated by the transmitral flow velocity pattern using Doppler echocardiography. Evaluation of LV diastolic function is also needed in patients with AF which is extremely challenging because of the lack of atrial systolic transmitral flow wave and the irregularity of Doppler parameters caused by irregular R-R intervals (5-7).. As an alternative method for evaluating LV diastolic function, mitral annular velocity waveforms, which can be recorded using tissue Doppler echocardiography, have been used. The ratio of early diastolic transmitral flow velocity (E) to ...
Anaesthetics may impair the diastolic function of the heart, but the importance of this finding for patients has not been sufficiently examined. Specially the effects on diastolic function in patients with diastolic dysfunction has to be determined. The aim of this study is to examine the effect of isoflurane (only part I), sevoflurane and desflurane (part I+II) on the diastolic left ventricular function by doppler echocardiography ...
In a number of patients with EF 60% or more, signs of heart failure are clinically detected. As a rule, such a condition is caused by LV diastolic dysfunction (impaired relaxation processes due to ischemia, cardiosclerosis, hypertrophy of the walls, pericardial effusion, etc.). According to a number of researchers, patients with signs of heart failure caused only by diastolic dysfunction constitute 15-25% of all patients with HF.. Diastolic dysfunction of the LV is estimated according to the results of a study of transmitral diastolic blood flow in a pulsed mode. Determine: 1. the maximum speed of the early peak of the diastolic filling M1, 2. the maximum speed in the atrial systole M2, 3. the integral of speed (area under the curve) of the early diastolic filling (VTI E), 4. the integral of the speed of atrial systole (VTI A), 5 LV isovolumetric relaxation time (IVRT), 6. time to slow the early diastolic filling (DT).. In the early stages of LV diastolic dysfunction with a slight increase in ...
TY - JOUR. T1 - Left Ventricular Diastolic Dysfunction in Peritoneal Dialysis. AU - Wu, Cho Kai. AU - Lee, Jen Kuang. AU - Wu, Yi Fan. AU - Tsai, Chia Ti. AU - Chiang, Fu Tien. AU - Hwang, Juey Jen. AU - Lin, Jiunn Lee. AU - Hung, Kuan Yu. AU - Huang, Jenq Wen. AU - Lin, Jou Wei. PY - 2015/1/1. Y1 - 2015/1/1. N2 - Left ventricular diastolic dysfunction (LVDD) is common among patients undergoing peritoneal dialysis (PD). We examined the relationship between LVDD, major adverse cardiovascular events (MACE), and mortality in PD patients. A total of 149 patients undergoing PD with preserved left ventricular systolic function were included and followed for 3.5 years. LVDD was diagnosed (according to the European Society of Cardiology guidelines) by conventional and tissue Doppler echocardiography. Serum high-sensitivity C-reactive protein (hsCRP) was measured. The location and volume of adipose tissue were assessed by computed tomography (CT) at the level of the fourth lumbar vertebra. Subjects with ...
Our study demonstrated an increase in LV relaxation during diastole (inferred from the absolute increase in IVPG) with exercise in both normal subjects and in patients with heart failure. However, this mechanism was significantly impaired in the heart failure group compared with normal subjects. We provided evidence for a strong relationship between the ability to augment the diastolic LV relaxation (represented by the delta IVPG) with exercise and the V̇o2 max. Our study also demonstrated that in patients with heart failure, the decreased ability to augment the diastolic relaxation is responsible for the inability to accommodate the increase in estimated preload during exercise, resulting in higher filling pressures.. Regional diastolic pressure differences have been identified in the left ventricle only recently and their importance in determining diastolic function now becomes evident. Ling and colleagues (25) described the suction effect that develops secondary to a pressure drop between ...
Reliability of updated left ventricular diastolic function recommendations in predicting elevated left ventricular filling pressure and prognosis
Background-While age-associated changes in LV diastolic function are well-recognized, limited data exist characterizing measures of diastolic function in older adults, including both reference ranges reflecting the older adult population and prognostically relevant values for incident HF, as well as their associations with circulating biomarkers of heart failure (HF) risk.. Methods-Among 5,801 elderly participants in the Atherosclerosis Risk in Communities (ARIC) study (age range 67-90, mean age 76 ± 5, 42% male, 21% black), we determined the continuous association of diastolic measures (TDI e, E/e, and left atrial size) with concomitant NT-proBNP and subsequent HF hospitalization or death. We also determined sex-specific 10th and 90th percentile limits for these measures using quantile regression in 401 participants free of prevalent cardiovascular disease and risk factors. Results-Each measure of diastolic function was robustly associated with NT-proBNP and incident HF or death. ARIC-based ...
TY - JOUR. T1 - Pioglitazone improves left ventricular diastolic function in subjects with diabetes. AU - Clarke, Geoffrey D. AU - Solis-Herrera, Carolina. AU - Molina-Wilkins, Marjorie. AU - Martinez, Sandra. AU - Merovci, Aurora. AU - Cersosimo, Eugenio. AU - Chilton, Robert J. AU - Iozzo, Patricia. AU - Gastaldelli, Amalia. AU - Abdul-ghani, Muhammad A. AU - Defronzo, Ralph A. PY - 2017/11/1. Y1 - 2017/11/1. N2 - OBJECTIVE To examine the effect of pioglitazone on myocardial insulin sensitivity and left ventricular (LV) function in patients with type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS Twelve subjectswith T2Dand 12with normal glucose tolerance received a euglycemic insulin clamp. Myocardial glucose uptake (MGU) and myocardial perfusion were measured with [18F]fluoro-2-deoxy-D-glucose and [15O]H2O positron emission tomography before and after 24 weeks of pioglitazone treatment.Myocardial function and transmitral early diastolic relation/atrial contraction (E/A) flow ratio were ...
Electrocardiographic strain pattern and left ventricular diastolic function in hypertensive patients with left ventricular hypertrophy: The LIFE study Academic Article ...
Standard pulsed Doppler indices are inadequate for assessment of LV relaxation in patients with atrial fibrillation (AF). On the other hand, peak diastolic mitral annulus velocities (Ea) and color M-mode Doppler propagation velocity of mitral inflow (Vp) have been reported as reliable determinants of LV relaxation in those patients. There have been few reports on alteration of LV relaxation during paroxysmal AF. Thirty patients with paroxysmal AF were enrolled in this study. Standard 2 dimensional, color flow Doppler, and tissue Doppler echocardiography were performed before, during AF, and after conversion of AF within 24 hours. LV relaxation was compared among three periods. Early diastolic velocity of TMF (E-wave) was increased, and deceleration time was shortened significantly during AF. Furthermore, systolic velocity of pulmonary vein flow was decreased, and diastolic velocity was increased significantly during AF. These parameters returned to the baseline level after conversion of AF. On ...
Impairment of relaxation, the early phase of ventricular diastole is the first stage of heart diastolic dysfunction. Left ventricular diastolic function can be determined noninvasively by Echo- Doppler - derived mitral valve flow velocities. The addition of pulmonary venous flow pattern enables more accurate assessment of left ventricle diastolic function. The role of the right ventricle in haemodynamic function of the heart is now emphasized. The right ventricle diastolic function can be assess by recording the Doppler tricuspid valve flow pattern. Impaired LV diastolic function usually precedes systolic dysfunction and may cause clinical signs of congestive heart failure. Cigarette smoking is one of the major risk factors for cardiovascular diseases. The aim of the study was to assess left and right ventricular diastolic function in healthy, young and slim smokers before and after smoking one cigarette.. Echocardiographic examination: before and after smoking one cigarette Echocardiographic ...
Summary Background Heart failure occurs in 6% of hyperthyroid patients. Nonetheless, only half of those with hyperthyroidism-related heart failure have impaired left ventricular (LV) systolic function. Thus, diastolic dysfunction may play an important role in the pathogenesis. Methods and results We performed serial echocardiographic examinations in 70 consecutive patients with hyperthyroidism (39 ± 2 years, 47 women) to determine their diastolic function and repeated the examinations 6 months after achieving a euthyroid state. All patients had normal LV systolic function, but diastolic dysfunction was detected in 22 cases (mild: 3, moderate: 15 and severe: 4). The prevalence of diastolic dysfunction increased with age from 17·9% in patients ,40 years to 100% in those ,60 years. Increasing age was the only independent predictor for diastolic dysfunction in hyperthyroid patients. After achievement of a euthyroid state, most patients (16/22, 72%) had completely normalized diastolic function: ...
Systolic impairment is well reported in critically ill patients but diastolic function has been relatively understudied. The objective of this review was to assess tissue Doppler indices of diastolic function in critically ill patients along with any association with mortality.A systematic review of articles in English using Medline, EMBASE, CINAHL and the Cochrane database of systematic reviews. Search terms included diastolic function, diastolic dysfunction, diastolic abnormal*, diastolic heart failure, diastolic filling, ventricular relaxation, pulmonary artery occlusion pressure, left ventricular filling pressure, cardiac dysfunction, intensive care, critical care, critically ill, critical illness, sepsis and septic shock. Only studies of critically ill adult patients (excluding post-cardiac surgical patients) whose diastolic function was assessed using tissue Doppler imaging were included. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale (NOS).Nineteen studies were
Early ventricular fibrillation is not related to infarct size. After 24 h ischemic myocytes have either undergone necrosis or recovered, and the risk of ventricular fibrillation diminishes. The majority of the other complications occur in transmural infarcts. Cardiogenic shock is directly related to the proportion of the left ventricular muscle mass which has been lost. Large infarcts are more likely to be anterior because the left anterior descending coronary aretery supplies more than 60 per cent of the myocardial mass.. Cardiogenic shock may lead to an extension of the area of necrosis ( Fig, 2). Myocardial perfusion is dependent on the relation between aortic diastolic pressure and left ventricular cavity pressure. If aortic pressure falls and left ventricular diastolic pressure rises, subendocardial perfusion throughout the whole left ventricle falls; a circumferential zone of subendocardial necrosis occurs and the centers of the papillary muscles also undergo necrosis ( Fig,... . . 2). ...
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Conclusion: Our findings indicate that myocardial damage in patients with diabetes affects diastolic function before systolic function.Even young patients with diabetics with normal systolic ventricular function have diastolic dysfunction, which serves as a marker of a diabetic cardiomyopathy. Diastolic impairment seems not to correlate with disease duration. HbA1c% can be a very good indicator of long term prognosis. Strong correlation exist between diastolic dysfunction and HbA1c%.. ...
Diastolic dysfunction is a key factor in the pathogenesis of heart failure. Around 50% of cases of heart failure, the hemodynamic correlate of which is increased left ventricular filling pressure, are caused by diastolic dysfunction in the setting of apparently normal systolic function. Due to its high prevalence, diastolic dysfunction is often recognized as an incidental finding. Many patients have Doppler echocardiographic evidence of impaired diastolic function but do not have any symptoms of heart failure at rest. In many of these patients, symptoms of diastolic dysfunction occur only during exercise, as left ventricular filling pressure is normal at rest, but increases with exercise. This implies that filling pressures should also be measured during exercise. The diastolic stress test refers to the evaluation of diastolic function, either invasively or noninvasively, during exercise. This review focuses on the clinical need for diastolic stress testing, both invasively and noninvasively. ...
Although the exercise test was performed after diagnostic catheterisation after an interval of more than three days, non-specific effects of catheterisation and contrast medium might modify postexercise diastolic function. However, the interval between the diagnostic catheterisation and exercise test did not differ significantly among the groups (table 1). Thus the postexercise diastolic dysfunction in group 1 could not be attributed to the effect of catheterisation.. We performed echocardiography serially over a seven day period after exercise. Therefore it is possible that postexercise changes in Doppler indices in patients with dilated cardiomyopathy were a result of measurement errors or day to day variability. However, the mitral flow velocity profile was unchanged throughout the study in the normal subjects and in the dilated cardiomyopathy patients in group 2. Thus day to day variability of Doppler measurements were minimal. Bias related to echocardiographic analysis was also excluded, as ...
In this study, we have performed a comprehensive assessment of systolic and diastolic ventricular function with new noninvasive techniques at rest and on exercise in HFNEF patients and have demonstrated a variety of abnormalities of both systolic and diastolic function. These include reduced radial and longitudinal myocardial systolic strain both at rest and on exercise, reduced systolic and diastolic longitudinal functional reserve (mitral annular velocities fail to rise normally), reduced ventricular systolic rotation at rest that fails to increase normally on exercise, delayed ventricular untwisting with further worsening on exercise associated with a reduced LV suction, and a consequent reduced stroke volume rise on exercise. Recent studies (12-14,37) using similar echocardiographic techniques to ours have elegantly demonstrated the close temporal, functional, and tightly coordinated relationships in normal patients between LV twist during systole, with accompanying mitral annular motion ...
The study by Redfield et al lends further support to the concept that diastolic dysfunction is prevalent, causes symptoms of CHF, and is associated with increased mortality. Diastolic dysfunction refers to a pathologically non-compliant left ventricle (LV) in diastole, which is the result of the combination of slowed LV relaxation and increased stiffness caused by hypertension, diabetes, ischaemia, or a combination.1. The study uses a model of diastolic dysfunction that assumes temporal progression of dysfunction from mild to moderate to severe based on left heart filling patterns obtained by state of the art echo Doppler techniques. Some aspects of this approach are problematic. The temporal progression of diastolic dysfunction has not been shown, the use of echo Doppler parameters was obtained at only a single point in time, and the use of these filling patterns to reflect LV properties in a wide range of patients is not the standard of measurement. Although these limitations should be ...
The LV and right ventricular (RV) diastolic function was evaluated in 65 patients with degree II arterial hypertension (AH) (WHO/IAH?, mean age 50.6±1.2 years) using Doppler echoCG at rest and in cold stress. The study demonstrated a possibility for asynchronous development of ventricular diastolic dysfunction with its prevalence of 14.7% for LV and 23.5% for RV. Disorders of both LV and RV diastolic function were revealed in 26.5% of patients. The cold test considerably more frequently induced impairment of RV than LV diastolic function. Both LV and RV diastolic dysfunction can be sufficiently well corrected with lisinopril, nebivolol and amlodipine ...
The main finding of the present study is that IR is associated with LVDD independent of overt diabetes. These finding persist after adjustment for CAD, hypertension, age, sex, history of previous myocardial infarction, history of previous coronary angioplasty, EF and glycaemic control. To our knowledge, this is the first study that demonstrated an association in a population of patients without a history of diabetes focusing on the published current guidelines for the diagnosis of LVDD.. Furthermore, our date confirm the observations that T2DM is associated with LVDD [9], which is considered a precursor of diabetic cardiomyopathy. In addition, we were able to extend the findings in previous studies showing the association between LVDD and IGT.. These findings are in line with a limited number of studies that assessed the relationship between prediabetes and LVDD mainly in population based studies [11]. Nevertheless, there are some concerns about methodological issues involving the identification ...
Left ventricular diastolic function plays an important role in cardiac physiology. Lusitropy, the ability of the cardiac myocytes to relax, is affected by both biochemical events within the myocyte and biomechanical events in the left ventricle. β-Adrenergic stimulation alters diastole by enhancing the phosphorylation of phospholamban, a substrate within the myocyte that increases the uptake of calcium ions into the sarcoplasmic reticulum, increasing the rate of relaxation. Troponin I, a regulatory protein involved in the coupling of excitation to contraction, is vital to maintaining the diastolic state; depletion of troponin I can produce diastolic dysfunction. Other biochemical events, such as defects in the voltage-sensitive release mechanism or in inositol triphosphate calcium release channels, have also been implicated in altering diastolic tone. Extracellular collagen determines myocardial stiffness; impaired glucose tolerance can induce an increase in collagen cross-linking and lead to ...
The participants were randomly assigned to receive the usual primary care (control condition; n = 677) or screening with BNP testing (n = 697) and followed up until December 2011 (mean follow-up, 4.2 [SD, 1.2] years). Intervention-group participants, with BNP levels of 50 pg/mL Sirtinol clinical trial or higher, underwent. echocardiography and collaborative care between their primary care physician and specialist cardiovascular service. The primary end point was prevalence of asymptomatic systolic LV dysfunction, with or without newly diagnosed heart failure. Due to the slower than expected recruitment rates, the investigators extended the study period and redefined the primary endpoint to include significant LV diastolic dysfunction as determined by a ratio of mitral peak velocity. of early filling (E) to early diastolic mitral annular velocity (E) greater than 15.It is important to note that this change did not alter the validity of the study design. Secondary end points included emergency ...
This study, conducted in a cohort of never-treated and well-characterized hypertensive patients, showed that the worsening of glucose tolerance was associated with an impairment of left ventricular diastolic function. The main finding of this study is that 1-h postload plasma glucose in NGT subjects is associated with left ventricular diastolic dysfunction. This result persists after adjustment for all significant covariates reported in Table 3. Of interest and clinically relevant, NGT ≥155 subjects had significantly worse diastolic function compared with NGT,155 subjects and similar compared with IGT and T2D patients. To our knowledge, this is the first study that demonstrates this association, confirming the usefulness of early diagnosis in the stratification of overall cardiovascular risk; in addition, it highlights the links between early alterations of glucose tolerance and early alterations in cardiac function.. There is a consistent body of evidences demonstrating the association ...
Abstract Cardiovascular autonomic neuropathy (CAN) is one of the most serious complications of diabetes and has been weakly linked with left ventricular (LV) diastolic dysfunction. Previous studies that explored this association either suffer from inadequate definition of CAN or have mainly used conventional Doppler or nuclear techniques to investigate LV diastolic function. Tissue Doppler imaging (TDI) has evolved as a new quantitative tool for the assessment of cardiac systolic function, diastolic function, and the hemodynamics of LV filling. We sought to investigate conventional and TDI derived indices of LV systolic and diastolic function in type 1 patients with and without CAN, and also in normal control subjects. Our findings suggest that the presence of CAN seems to have an additive effect on LV diastolic dysfunction in type 1 diabetes.. ...
Background: Patients with coronary microvascular dysfunction (CMD) often have diastolic dysfunction, representing an important therapeutic target. Ranolazine-a late sodium current inhibitor-improves diastolic function in animal models and subjects with obstructive coronary artery disease (CAD). Hypothesis: We hypothesized that ranolazine would beneficially alter diastolic function in CMD. Methods: To test this hypothesis, we performed retrospective tissue tracking analysis to evaluate systolic/diastolic strain, using cardiac magnetic resonance imaging cine images acquired in a recently completed, randomized, double-blind, placebo-controlled, crossover trial of short-term ranolazine in subjects with CMD and from 43 healthy reference controls. Results: Diastolic strain rate was impaired in CMD vs controls (circumferential diastolic strain rate: 99.9% ± 2.5%/s vs 120.1% ± 4.0%/s, P = 0.0003; radial diastolic strain rate: −199.5% ± 5.5%/s vs −243.1% ± 9.6%/s, P = 0.0008, case vs control). ...
Table 1 illustrates associations between risk factors with diastolic LV function. End diastolic volume (EDV) modified the relationship of gender and PFR. Mean PFR was therefore analyzed across quintiles of EDV and was found to be higher in females 386.35, [95%CI 382.53 to 390.17] compared to males 359.11 ml/s [95%CI 355.05 to 363.17] (Fig 1). Comapred to non-smokers smokers had lower peak filling rates. Compared to Whites, Hispanics were at a higher risk for diastolic dysfunction, Chinese ethnicity showed a relative protective effect after adjusting for all other risk factors. ...
The division of diastolic dysfunction into three classes implies progression from one class to the next. However, to our knowledge, no previous studies have shown such progression to occur and the factors that influence this progression. In the current study, over 3.6 years, diastolic function remained stable in approximately half of the study population. Of the remainder, diastolic function deteriorated in 27% and improved in 21%. This suggests that in about half of these patients, diastolic function does not progress with time and the division into stages or classes of severity may erroneously suggest that progression naturally occurs from one stage to the next. From the multivariate model of the predictors of all-cause mortality, progression of diastolic dysfunction, age, clinical evidence of heart failure at the time of echocardiogram, the presence of a major co-morbidity, transmitral flow and diuretic use were each independently associated with outcome. Importantly, the subgroup of patients ...
2010 (English)In: Journal of the American Society of Echocardiography, ISSN 0894-7317, E-ISSN 1097-6795, Vol. 23, no 2, 162-163 p.Article in journal (Other academic) Published ...
[Dyspnea and normal systolic function].: 30-50% of patients presenting with symptoms of congestive heart failure exhibit a near normal left ventricular systolic
To our knowledge, this is the first study comparing the contractile function in SHR with its normotensive control WKY using PV methodology. In addition, we assessed diastolic function in these animals by using this technique and two others. PV analysis is a useful approach for examining the intact chamber function independently of load.. Diastolic dysfunction was expected in the SHR, based on the increased wall thickness and fibrosis and the impaired relaxation and augmented chamber stiffness reported by others using this model.1,4,29 These alterations were detected in vivo in our study, based on the increased EDPVR, the restrictive pattern of the Doppler E/A ratio, and the leftward shift in the PV relation observed in the ex vivo experiments. Impaired relaxation was also detected in our hypertensive animals, as reflected by the prolonged τ and the fact that for a given maximal velocity of contraction (+dP/dt), maximal velocity of relaxation (−dP/dt) was decreased. Relaxation, an active ...
We investigated the independent variables correlating with the multigated radionuclide peak filling rate (PFR) at rest and during supine bicycle exercise in 20 normal individuals. Independent variables were systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), ejection fraction (LVEF), time to PFR (TPFR), peak ejection rate (PER) and time to PER (TPER). Fifteen subjects completed at least five stages of exercise at 25 watts each. Correlating independent variables were selected by a forward-backward stepwise multiple linear regression (BMDP2R). A partial correlation statistical program was also used to allow control of critical independent variables. The final regression equations were: a) resting state, PFR = -2.5 + 0.03HR + 0.05LVEF + 0.02SBP-0.02DBP, and b) exercise state, PFR = -3.8 + 0.04HR + 0.08LVEF. All independent variables mentioned above correlated with PFR (simple correlations designated as zero partials). However, when LVEF and HR were held constant (second order
McMurray, J. J. , Adamopoulos, S. , Anker, S. D. , Auricchio, A. , Bohm, M. , Dickstein, K. , Falk, V. , Filippatos, G. , Fonseca, C. , Gomez-Sanchez, M. A. , Jaarsma, T. , Kober, L. , Lip, G. Y. , Maggioni, A. P. , Parkhomenko, A. , Pieske, B. M. , Popescu, B. A. , Ronnevik, P. K. , Rutten, F. H. , Schwitter, J. , Seferovic, P. , Stepinska, J. , Trindade, P. T. , Voors, A. A. , Zannad, F. , Zeiher, A. , Bax, J. J. , Baumgartner, H. , Ceconi, C. , Dean, V. , Deaton, C. , Fagard, R. , Funck-Brentano, C. , Hasdai, D. , Hoes, A. , Kirchhof, P. , Knuuti, J. , Kolh, P. , McDonagh, T. , Moulin, C. , Reiner, Z. , Sechtem, U. , Sirnes, P. A. , Tendera, M. , Torbicki, A. , Vahanian, A. , Windecker, S. , Bonet, L. A. , Avraamides, P. , Ben Lamin, H. A. , Brignole, M. , Coca, A. , Cowburn, P. , Dargie, H. , Elliott, P. , Flachskampf, F. A. , Guida, G. F. , Hardman, S. , Iung, B. , Merkely, B. , Mueller, C. , Nanas, J. N. , Nielsen, O. W. , Orn, S. , Parissis, J. T. , and Ponikowski, P. , 2012, " ESC ...
Synonyms for systole and diastole at Thesaurus.com with free online thesaurus, antonyms, and definitions. Dictionary and Word of the Day.
Question - TMT shows exercise nduced ischaemic heart disease, ECHO with grade 1 diastolic dysfunction. Angiogram required?. Ask a Doctor about diagnosis, treatment and medication for Diastolic dysfunction, Ask a Cardiologist
...   Diastole (pronounced di-as´to-le, rhymes with potentially) is the period of time when the heart relaxes after contraction. Ventricular
The book addresses the meaning of the systolic function and diastolic function, how these can best be measured and interpreted, both now and in the future. It also covers topics such as: cardiac mechanics, flow dynamics, vascular properties, neural c...
Answers from specialists on diastolic dysfunction. First: it depends on the causes -- for example, obesity and elevated BP can be treated, but heart attack and heart muscle disease are irreversible
Answer The tie is between B and D We know in hypertensive hearts LV primarily fails in diastole . Lungs get congested due to raised LVEDP .Here is a catch . . . if diastole is terribly dysfunctional how can be systole be near normal ? (After all . . . systole is not…
Rearrange the sentences A to H to show the sequence of blood flow during cardiac cycle A:Atria receive blood from veins and store it prior to each heart beat B:Ventricular diastole C:Pressure... ...
Figure 3.1 illustrates the geometric relationships between the LFT (Marker#29), APT (Marker#31), SH (Marker#22), RFT (Marker#24), and PPT (Marker#33) for diastole (left panel) and systole (right panel).. ...
Fig. 21. The varying severity of restriction to diastolic ventricular filling is shown with lines to indicate the ventricular diastolic pressure elevations and their timing in diastole. In mild form, the pressure increase is during atrial contraction (AC) at end diastole (line #1). As restriction gets worse, the pre-a wave pressure starts to rise gradually and earlier and earlier in diastole. This progression is shown as four successive lines (lines #2). When severe, it may be total during mid and late diastole, restricting flow into the RV beginning with the slow filling phase (SF). There will be very rapid inflow only during early diastole or the rapid filling phase (RF) followed by a rapid rise in pressure with no further flow producing the classic dip and plateau or the square root pattern (line #3). This is typical for chronic constrictive pericarditis. If the restriction is severe and involves also the RF phase, the pressures rise quickly in the RV in early diastole limiting inflow ...