scholarly journals Improved diastolic dysfunction is associated with higher forward flow and better prognosis in chronic heart failure

2021 ◽  
Author(s):  
Frank Lloyd Dini ◽  
Piercarlo Ballo ◽  
Nicola Riccardo Pugliese ◽  
Ibadete Bytyçi ◽  
Andreina D’Agostino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Diastolic Dysfunction ◽  
Forward Flow

142 Utility of BNP in detecting diastolic dysfunction in chronic heart failure patients

2003 ◽  
Vol 2 (1) ◽  
pp. 23-24
Author(s):  
A SCARDOVI ◽  
C COLETTA ◽  
N ASPROMONTE ◽  
A SESTILI ◽  
M RENZI ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Diastolic Dysfunction ◽  
Heart Failure Patients

Abstract 17220: Effects of the Oral Adsorbent of AST-120 in Patients with both Chronic Heart Failure and Chronic Kidney Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Miki Imazu ◽  
Masanori Asakura ◽  
Takuya Hasegawa ◽  
Hiroshi Asanuma ◽  
Shin Ito ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Kidney Disease ◽  
Chronic Heart Failure ◽  
Kidney Disease ◽  
Diastolic Dysfunction ◽  
Uremic Toxins ◽  
Control Group ◽  
Blood Levels ◽  
Uremic Toxin ◽  
Oral Adsorbent

Background: One of uremic toxins, indoxyl sulfate (IS) is related to the progression of chronic kidney disease (CKD) and the worse cardiovascular outcomes. We have previously reported the relationship between IS levels and the severity of chronic heart failure (CHF), but the question arises as to whether the treatment of uremic toxin is beneficial in patients with CHF. This study aimed to elucidate whether the treatment with the oral adsorbent which reduces uremic toxin improved the cardiac function of the patients with CHF. Methods: First of all, we retrospectively enrolled 49 patients with both CHF and stage ≤3 CKD in our institute compared with the healthy subjects without CHF or CKD in the resident cohort study of Arita. Secondly, we retrospectively enrolled 16 CHF outpatients with stage 3-5 CKD. They were treated with and without the oral adsorbent of AST-120 for one year termed as the treatment and control groups, respectively. We underwent both blood test and echocardiography before and after the treatment. Results: First of all, among 49 patients in CHF patients, plasma IS levels increased to 1.38 ± 0.84 μg/ml from the value of 0.08 ± 0.06 μg/ml in Arita-cho as a community-living matched with gender and eGFR of CHF patients. We found both fractional shortening (FS) and E/e’, an index of diastolic function were decreased (25.0 ± 12.7%) and increased (13.7 ± 7.5), respectively in CHF patients compared with the value of FS and E/e’ in Arita-cho (FS: 41.8 ± 8.3%, E/e’: 8.8 ± 2.1). Secondly, in the treatment group, the plasma IS levels and the serum creatinine and brain natriuretic peptide levels decreased (1.40 ± 0.17 to 0.92 ± 0.15 μg/ml; p<0.05, 1.91 ± 0.16 to 1.67 ± 0.12 mg/dl; p<0.05, 352 ± 57 to 244 ± 49 pg/ml; p<0.05, respectively) and both FS and E/e’ were improved following the treatment with AST-120 (28.8 ± 2.8 to 32.9 ± 2.6%; p<0.05, 18.0 ± 2.0 to 11.8 ± 1.0; p<0.05). However, these parameters did not change in the control group. Conclusions: The treatment to decrease the blood levels of uremic toxins improved not only renal dysfunction but cardiac systolic and diastolic dysfunction in patients with chronic heart failure. Oral adsorbents might be a new treatment of heart failure especially with diastolic dysfunction.

scholarly journals 142 Can BNP be a useful tool for predicting severe diastolic dysfunction in patients with chronic heart failure?

2003 ◽  
Vol 4 ◽  
pp. S9
Author(s):  
A SCARDOVI ◽  
C COLETTA ◽  
N ASPROMONTE ◽  
A SESTILI ◽  
T DIGIACOMO ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Diastolic Dysfunction

scholarly journals Pathogenetic treatment of chronic heart failure: the role of torasemide

2015 ◽  
Vol 12 (3) ◽  
pp. 56-62
Author(s):  
N B Perepech
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Diastolic Dysfunction ◽  
Clinical Studies ◽  
Clinical Manifestations ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Ventricular Filling Pressure ◽  
Ventricular Filling

The article discusses the torasemide pharmacokinetic characteristics which are favourably different from furosemide characteristics. We paid attention to the fact that torasemide had anti-aldosteronic and antifibrotic effects; all these characteristics were alien to other diuretics nature. The results of clinical studies showed torasemide ability to prevent the development and reverse myocardial fibrosis. Taking into account modern representations concerning the pathogenesis of chronic heart failure, in particular the role of diastolic dysfunction in developing haemodynamic compromise, we substantiated torasemide application as a part of complex pharmacotherapy of chronic heart failure in patients with elevated left ventricular filling pressure before the appearance of clinical manifestations of stagnation.

scholarly journals SCORING SCALE FOR ASSESSING THE RISK OF DETECTING RIGHT VENTRICLE DIASTOLIC DYSFUNCTION OF TYPE II IN CHRONIC HEART FAILURE

2021 ◽  
Vol 20 (2) ◽  
pp. 77-87
Author(s):  
O.M. Zherko ◽  
◽  
E.I. Shkrebneva ◽  
P.D. Novikov ◽  
A.S. Babenka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Right Ventricle ◽  
Diastolic Dysfunction ◽  
Left Ventricular ◽  
Cardiac Remodelling ◽  
Left Ventricular Ejection ◽  
Lateral Part ◽  
Type Ii ◽  
Ventricular Ejection Fraction

Odjectives. To develop a scoring scale for assessing the risk of detecting right ventricle (RV) diastolic dysfunction (DD) of type II in chronic heart failure (CHF). Material and methods. In 2017-2018, a clinical and instrumental examination of 247 patients aged 40-86 years was performed on the basis of Health Care Institution «The 1st City Clinical Hospital» in Minsk, in 2019-2020, 129 patients at the age of 39-84 years were examined in the State Institution «Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology». Study inclusion criteria: sinus rhythm, essential arterial hypertension (AH), chronic ischemic heart disease (IHD), CHF, informed voluntary consent of the patient to participate in the study. Exclusion criteria: primary mitral regurgitation, mitral stenosis, mitral valve repair or replacement, congenital heart defects, acute and chronic diseases of the lungs and kidneys. Results. The sum of points>52 obtained using a scoring scale that includes scientifically based ultrasound criteria for global cardiac remodelling: RV early diastolic filling index E/eʹ >4.08 (sensitivity (S) 81.1%, specificity (Sp) 56.9%) - 15 points, the amplitude of the systolic displacement of the lateral part of the tricuspid annulus in systole to the apex (TAPSE) ≤20 mm (S 74.1%, Sp 83.3%) - 49 points, pulmonary artery systolic pressure ˃32.6 mm Hg (S 85.2%, Sp 79.5%) - 31 points, indicates a high risk of detecting RV DD of type II in CHF (AUC 0.99, S 93.9%, Sp 100.0%). The reproducibility of the results is shown in an independent examination sample of patients with CHF with preserved left ventricular ejection fraction. (AUC 0.99, S 90.0%, Sp 100%, +PV 100.0%, - PV 34.5% with a cut-off threshold >52). Conclusions.When using the scale, the score is > 52, it is recommended to perform a comprehensive targeted assessment of global cardiac remodelling to determine RV DD of type II in a patient with CHF, complicating essential AH, chronic IHD.

scholarly journals Early changes of energy metabolism, isoformic content and level of titin phosphorylation at diastolic dysfunction

Kardiologiia ◽  
2020 ◽  
Vol 60 (2) ◽  
pp. 4-9
Author(s):  
V. L. Lakomkin ◽  
A. A. Abramov ◽  
I. M. Studneva ◽  
A. D. Ulanova ◽  
I. M. Vikhlyantsev ◽  
...  
Keyword(s):  
Heart Failure ◽  
Energy Metabolism ◽  
Chronic Heart Failure ◽  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Anaerobic Metabolism ◽  
Normal Values ◽  
Adenine Nucleotides ◽  
Lactate Levels ◽  
Myofibril Protein

Relevance. Diastolic dysfunction occurring at hypertension, obesity, diabetes, or treatment with doxorubicin tends to prevail in all patterns of chronic heart failure. Lack of effective therapy forces to look more into the metabolic processes in cardiomyocytes.Objective. Assess energy metabolism in cardiomyocytes and changes in titin, a giant myofibril protein that responsible for their elasticity.Material and Methods. The study model was cardiomyopathy occurring after the 4-week administration of doxorubicin (2 mg/kg weekly). Diastolic dysfunction was identified by echocardiography and catheterization with the simultaneous measurement of pressure and volume of the left ventricle (LV).Results. The levels of adenine nucleotides and phosphocreatine in the heart of animals treated with doxorubicin differed little from the normal values, but lactate levels were increased manifold. A 50% increase in the level of titin phosphorylation was detected, which correlated (r = 0,94) with a nearly twofold increase in the share of a more elastic N2BA-isoform of this protein.Conclusion. This form of diastolic dysfunction involves the activation of anaerobic metabolism and increased stretching of myofibrils facilitating LV filling.

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