scholarly journals Normal aging is accompanied by early diastolic filling independent of LV mass, heart rate, contractility and loading conditions

1990 ◽  
Vol 15 (2) ◽  
pp. A187 ◽  
Author(s):  
Dalane W. Kitzman ◽  
Khalid H. Sheikh ◽  
Judy L. Philipa ◽  
Michael B. Higginbotham
Keyword(s):  
Heart Rate ◽  
Normal Aging ◽  
Diastolic Filling ◽  
Loading Conditions ◽  
Lv Mass

scholarly journals P814 Independent association of body mass index and left atrial strain in patients with non valvular atrial fibrillation. The NeAfib-Echo registry

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
L Esposito ◽  
R Sorrentino ◽  
V Capone ◽  
C Santoro ◽  
M Lembo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Heart Rate ◽  
Body Mass ◽  
Left Atrial ◽  
Longitudinal Strain ◽  
Overweight And Obesity ◽  
Volume Index ◽  
The Third ◽  
Lv Mass

Abstract Background Overweight and obesity are related to the risk of new-onset atrial fibrillation (AF). Peak atrial longitudinal strain (PALS) is an advanced echocardiographic parameter of left atrial (LA) function with a recognized diagnostic and prognostic role in both the general population and AF. Purpose To investigate the impact of body mass index (BMI) on LA function by utilizing standard and advanced echocardiography in patients with non-valvular AF. Methods In the NeAfib-Echo registry, 395 consecutive adult patients with non-valvular AF (F/M: 175/220; mean age 70.6 ± 11 years, BMI: 27.8 ± 5.6 kg/m²) were enrolled. 215 patients (54.1%) had permanent/persistent AF (prAF) and 178 (45.9%) had paroxysmal AF (pxAF). Anthropometric parameters and blood pressure (BP) were recorded and CHA2DS2VASc score was calculated. Patients underwent a complete echo-Doppler exam, including determination of PALS and left ventricular (LV) global longitudinal strain (GLS) (both reported in absolute values). The overall population was divided according to BMI tertiles: first tertile <25.3 Kg/m² (n = 127); second tertile 25.3-29 Kg/m² (n = 137); third tertile > 29.3 Kg/m² (n = 130). Results No significant difference of sex prevalence, age, systolic BP and heart rate was found among the three BMI tertiles, whereas diastolic BP was higher in the third tertile (p < 0.001). CHA2DS2VASc score did not significantly differ among tertiles. In the pooled population LV mass index (LVMi) (p = 0.001) progressively increased from the first to the third tertile (p < 0.001), whereas LA volume index, LV ejection fraction (EF), GLS and E/e" ratio were not significantly different among the three groups. PALS was lower in third tertile (14.3 ± 8.2%) versus both the first (19.0 ± 11.5%) and the second tertile (17.7 ± 10.6%) (p < 0.002). In separate sub-analyses according to AF type, PALS was significantly lower in the first than the third tertile in the PxAF group (p < 0.01) but not in patients with PrAF (p = 0.158). In the pooled population PALS was significantly related with BMI (r= -0.17, p < 0.001) (Figure) but also with age, heart rate, LVMi, LV EF, GLS, E/e’ ratio and pulmonary artery systolic pressure (PAPS). By a multilinear regression analysis, after adjusting for CHA2DS2VASc score, LV mass index, LV EF, E/e’ ratio and PAPs, BMI remained independently associated with PALS (standardized β coefficient = -0.127, p < 0.02) (cumulative R² =0.41, SEE = 8.5%, p < 0.0001). Conclusions In patients with non valvular AF, overweight and obesity exert a detrimental effect on LA function as testified by the gradual PALS reduction with the increase of BMI tertiles. BMI is associated with PALS independently of several confounders including CHA2DS2VASc. Besides CHA2DS2VASc score, BMI could be considered as an additional factor for evaluating cardiovascular risk in non valvular AF. Abstract P814 Figure. Relation between BMI and PALS

Heart Rate Is the Major Determinant of Diastolic Filling Pattern During Growth: A Radionuclide Ventriculography Assessment

2002 ◽  
Vol 23 (4) ◽  
pp. 378-387 ◽  
Author(s):  
G. Arsos ◽  
E. Moralidis ◽  
N. Karatzas ◽  
I. Iakovou ◽  
S. Georga ◽  
...  
Keyword(s):  
Heart Rate ◽  
Radionuclide Ventriculography ◽  
Major Determinant ◽  
Diastolic Filling ◽  
Filling Pattern

Lower body negative pressure vs. lower body positive pressure to prevent cardiac atrophy after bed rest and spaceflight. What caused the controversy?

2006 ◽  
Vol 100 (3) ◽  
pp. 1090-1090 ◽  
Author(s):  
Marieta V. Pancheva ◽  
Vladimir S. Panchev ◽  
Adelina V. Suvandjieva
Keyword(s):  
Cardiac Muscle ◽  
Bed Rest ◽  
Left Ventricular ◽  
Physiological Adaptation ◽  
Positive Pressure ◽  
Loading Conditions ◽  
Lower Body ◽  
Cardiac Atrophy ◽  
End Diastolic Volume ◽  
Lv Mass

Cardiac muscle adapts well to changes in loading conditions. For example, left ventricular (LV) hypertrophy may be induced physiologically (via exercise training) or pathologically (via hypertension or valvular heart disease). If hypertension is treated, LV hypertrophy regresses, suggesting a sensitivity to LV work. However, whether physical inactivity in nonathletic populations causes adaptive changes in LV mass or even frank atrophy is not clear. We exposed previously sedentary men to 6 ( n = 5) and 12 ( n = 3) wk of horizontal bed rest. LV and right ventricular (RV) mass and end-diastolic volume were measured using cine magnetic resonance imaging (MRI) at 2, 6, and 12 wk of bed rest; five healthy men were also studied before and after at least 6 wk of routine daily activities as controls. In addition, four astronauts were exposed to the complete elimination of hydrostatic gradients during a spaceflight of 10 days. During bed rest, LV mass decreased by 8.0 ± 2.2% ( P = 0.005) after 6 wk with an additional atrophy of 7.6 ± 2.3% in the subjects who remained in bed for 12 wk; there was no change in LV mass for the control subjects (153.0 ± 12.2 vs. 153.4 ± 12.1 g, P = 0.81). Mean wall thickness decreased (4 ± 2.5%, P = 0.01) after 6 wk of bed rest associated with the decrease in LV mass, suggesting a physiological remodeling with respect to altered load. LV end-diastolic volume decreased by 14 ± 1.7% ( P = 0.002) after 2 wk of bed rest and changed minimally thereafter. After 6 wk of bed rest, RV free wall mass decreased by 10 ± 2.7% ( P = 0.06) and RV end-diastolic volume by 16 ± 7.9% ( P = 0.06). After spaceflight, LV mass decreased by 12 ± 6.9% ( P = 0.07). In conclusion, cardiac atrophy occurs during prolonged (6 wk) horizontal bed rest and may also occur after short-term spaceflight. We suggest that cardiac atrophy is due to a physiological adaptation to reduced myocardial load and work in real or simulated microgravity and demonstrates the plasticity of cardiac muscle under different loading conditions.

Adverse Effects of Hypoxaemia on Diastolic Filling in Humans

1995 ◽  
Vol 89 (2) ◽  
pp. 165-169 ◽  
Author(s):  
Robert I. Cargill ◽  
David G. Kiely ◽  
Brian J. Lipworth
Keyword(s):  
Heart Rate ◽  
Relaxation Time ◽  
Confidence Interval ◽  
Left Ventricular ◽  
Mean Difference ◽  
Oxygen Mixture ◽  
Diastolic Filling ◽  
Isovolumic Relaxation Time ◽  
Isovolumic Relaxation ◽  
Deceleration Time

1. Abnormalities of myocardial relaxation may occur as a consequence of myocyte hypoxia. We have therefore examined the effects of hypoxaemia on right and left ventricular diastolic function in 10 healthy male subjects. 2. After resting to reach baseline haemodynamics, subjects were rendered hypoxaemic by breathing a variable nitrogen/oxygen mixture. Oxygen saturation (SaO2) was maintained at 85–90% for 20 min and then at 75–80% for a further 20 min. Haemodynamic and diastolic filling parameters were measured non-invasively at baseline and at the end of each period of hypoxaemia. 3. Diastolic filling of both ventricles was significantly impaired by hypoxaemia. In comparison with baseline, left ventricular isovolumic relaxation time and transmitral E-wave deceleration time corrected for heart rate were significantly prolonged at SaO2 75–80%: mean difference in corrected relaxation time, 9.8 ms (95% confidence interval 1–19); mean difference in corrected deceleration time, 34 ms (95% confidence interval 11–56). Similarly, right ventricular isovolumic relaxation time and transtricuspid E-wave deceleration time were significantly prolonged at SaO2 values of 75–80% compared with baseline: mean difference in relaxation time, 20.3 ms (95% confidence interval 3–38); mean difference in deceleration time, 33 ms (95% confidence interval 11–55). 4. During hypoxaemia there were dose-related increases in heart rate, cardiac output and mean pulmonary artery pressure, but no effects on mean arterial pressure. 5. Hypoxaemia significantly impairs relaxation of left and right ventricles in normal humans. These changes may reflect impairment of intracellular calcium transport secondary to the effects of myocyte hypoxia.

scholarly journals Left ventricular torsion, energetics, and diastolic function in normal human aging

2012 ◽  
Vol 302 (4) ◽  
pp. H885-H892 ◽  
Author(s):  
Kieren G. Hollingsworth ◽  
Andrew M. Blamire ◽  
Bernard D. Keavney ◽  
Guy A. MacGowan
Keyword(s):  
Ventricular Volume ◽  
Normal Aging ◽  
Left Ventricular ◽  
Diastolic Filling ◽  
Strongly Correlated ◽  
Left Ventricular Torsion ◽  
Tissue Tagging ◽  
Diastolic Left Ventricular Function ◽  
Ventricular Torsion ◽  
Effects Of Aging

This study determined, for the first time, whether the effects of normal aging on systolic and diastolic left ventricular function in subjects without cardiovascular disease are related to underlying energetic defects. Cardiac magnetic resonance imaging with tissue tagging and 31P spectroscopy was used to determine global structure, function, myocardial strains, and the phosphocreatine-to-ATP ratio (PCr/ATP) in 49 healthy subjects aged 20–69 yr. The three major abnormalities that developed with increasing age were the early filling percentage (EFP, the left ventricular volume increase from end systole to mid-diastole divided by stroke volume × 100), which decreased with age, indicating impaired early diastolic filling ( r = −0.72, P < 0.0001), the torsion-to-shortening ratio (TSR, measure of subepicardial torsion exerting mechanical advantage over subendocardial shortening), which increased with age indicating relative subendocardial dysfunction ( r = 0.44, P < 0.02), and the PCr/ATP (decreased with increasing age, r = −0.52, P < 0.003). EFP and TSR were strongly correlated ( r = −0.63, P < 0.0001), although they were not related to PCr/ATP [EFP vs. PCr/ATP: r = 0.34, not significant (NS) and TSR vs. PCr/ATP: r = −0.3, P = NS]. In normal aging, changes in EFP and TSR likely share the same pathophysiology, although it is unlikely that energetics have a major role in the functional effects of aging.

scholarly journals Features of structural and geometric remodeling of the heart and changes in heart diastolic filling in patients with chronic heart failure of ischemic genesis with reduced left ventricular ejection fraction

2021 ◽  
Vol 23 (1) ◽  
pp. 17-23
Author(s):  
V. A. Lysenko
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Left Ventricle ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Diastolic Filling ◽  
Ventricular Ejection Fraction ◽  
Lv Mass

Chronic heart failure (CHF) does not lose its leading position among the problems of cardiovascular disease. Pathological cardiac remodeling combines the processes of hypertrophy and dilatation of cavities and is the main cause of heart failure progression, and consequently results in high cardiac mortality, especially in CHF patients with reduced left ventricular ejection fraction (LV EF). Despite a substantial range of studies on the features of structural and geometric remodeling of the heart, changes in systolic and diastolic function of the ventricles in CHF patients, this issue still presents a challenge and needs to be improved. The aim of the work – to examine changes in structural and geometric parameters and diastolic function of the heart in patients with CHF of ischemic genesis with reduced LV EF. Materials and methods. The study included 79 patients (men – n = 49; women – n = 30) with CHF of ischemic origin with reduced LV EF, sinus rhythm, stage II AB, NYHA II-IV FC (the main group), and 90 patients with coronary heart disease without signs of CHF (men – n = 40, 44.5 %; women – n = 50, 55.5 %), (the comparison group). The patient groups were age-, sex-, height-, weight-, body surface area-matched. Doppler echocardiographic examination was performed on the device Esaote MyLab Eight (Italy). Results. In CHF patients with reduced LV EF, the following indicators prevailed: EDD LV by 18 % (P = 0.001), LV EDV by 45.8 % (P = 0.001), LV EDV index by 44.6 % (P = 0.001), LV ESD by 44.9 % (P = 0.001), PW by 17.7 % (P = 0.001), LV mass index by 66.6 % (P = 0.001) according to the Penn Convention, and by 62.1 % (P = 0.001) according to the ASE; 16.1 % (P = 0.010) increased RV cavity without changes in its wall thickness. In patients with CHF of ischemic origin with reduced LV EF, the main types of LV geometry were: eccentric (70 %) and concentric (24 %) LV hypertrophy. More than half of the CHF patients with reduced LV EF had significant disorders of LV diastolic filling (25 % – “restrictive” and 28 % “pseudonormal”), a 2.3 times increase (P = 0.001) in E/e’ ratio, a 35 % (P = 0.014) increase in the left atrial volume index and 32 % (P = 0.0001) – in pulmonary capillary wedge pressure (PCWP), increased mean and systolic pressure in the pulmonary artery by 1.5 times (P = 0.002) and 1.6 times (P = 0.0001), respectively. Conclusions. Structural and geometric remodeling of the left ventricle in patients with CHF of ischemic origin with reduced LV EF occurs due to an increase in LV myocardial mass via thickening of its walls and cavity dilatation (44.6 % (P = 0.001) increase in the LV EDV index), as well as 66.6 % (P = 0.001) increase in LV mass index with the predominance of eccentric (70 %) and concentric hypertrophy (24 %) over other types of LV geometry. Severe disorders of LV diastolic filling (25 % – “restrictive” and 28 % “pseudonormal”) are attributable to the significant increase in end-diastolic pressure in the left ventricle (2.3 times increase (P = 0.001) in E/e´) with the development of postcapillary pulmonary hypertension (1.5 times increase (P = 0.002) in the mean and 1.6 times (P = 0.0001) – in systolic pressure in the pulmonary artery).

scholarly journals RE-EVALUATION OF THE STRETCH SENSITIVITY HYPOTHESIS OF CRUSTACEAN HEARTS: HYPOXIA, NOT LACK OF STRETCH, CAUSES REDUCTION IN HEART RATE OF ISOLATED HEARTS

1993 ◽  
Vol 176 (1) ◽  
pp. 223-232
Author(s):  
J. L. Wilkens
Keyword(s):  
Heart Rate ◽  
Isolated Heart ◽  
Carcinus Maenas ◽  
Three Dimensional ◽  
Decapod Crustacean ◽  
Diastolic Filling ◽  
Elastic Recoil ◽  
Isolated Hearts

Decapod crustacean hearts are suspended by a three-dimensional array of alary ligaments. These ligaments are stretched during systole; diastolic filling via the ostia occurs as the ventricle is stretched by ligamental elastic recoil. There is no direct venous return to the hearts in these animals. In the present study, an isolated heart preparation with intact ligaments, hereafter called in situ, was used to evaluate the effects of artificially induced stretch on heart rate. Strongly beating in situ neurogenic hearts of the crab Carcinus maenas responded to direct perfusion of the ventricle with oxygenated saline and the attendant augmentation of natural stretch with a small increase in heart rate (fh); however, fh was well maintained for up to 15 min after eliminating stretch by cutting the alary ligaments. In contrast to crabs, high rates of artificial perfusion usually depressed fh in crayfish hearts. Crab heart rate falls during hypoxia and this is readily reversed by even low rates of perfusion with oxygenated saline. It is concluded that the gradual decline in fh of totally isolated in vitro hearts arises from the deepening intraventricular hypoxia experienced by the cardiac ganglion.

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