scholarly journals 1111-225 In the rapid pacing canine model of heart failure, left ventricular stimulation resynchronizes better the left ventricle compared to biventricular or right ventricular stimulation: An echocardiographic-hemodynamic correlation of systolic and diastolic function

2004 ◽  
Vol 43 (5) ◽  
pp. A132
Author(s):  
Bernard Thibault ◽  
Anique Ducharme ◽  
Yan-Fen Shi ◽  
Marc Dubuc ◽  
Peter Guerra ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Right Ventricular ◽  
Diastolic Function ◽  
Canine Model ◽  
Left Ventricular ◽  
Ventricular Stimulation ◽  
Rapid Pacing ◽  
Systolic And Diastolic Function

scholarly journals Predictors of heart failure in patients with major beta-thalassemia

2020 ◽  
Vol 8 ◽  
pp. 670-684
Author(s):  
Ionut Stanca ◽  
Mihaela Rus ◽  
Alice Albu ◽  
Simona Fica
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Right Ventricle ◽  
Diastolic Function ◽  
Systolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Beta Thalassemia ◽  
Myocardial Mass ◽  
Systolic And Diastolic Function

Cardiomyopathy by loading the myocardium with iron is the cause of heart failure in patients with major beta-thalassemia. In these patients, cardiac systolic function remains normal for a long time, but when signs of heart failure appear, death may occur in the first year, so it is necessary to identify parameters to predict the patient's progress and prognosis.Materials and methods. We enrolled 62 patients with beta-thalassemia major (30 men and 32 women), mean age 29.9 ± 7.3 years. 32.2% of patients had disorders of carbohydrate metabolism, 12.9% associated hypothyroidism, and the mean ferritin was 1060.9 ± 856.6 ng / ml. Patients were evaluated echocardiographically, using tissue doppler technique to assess systolic and diastolic function. Myocardial mass was calculated using standard formulas and the type of left ventricular remodeling (LV) was thus obtained. Depending on the ferritin level, choosing the threshold value of 1000ng / ml, a group subanalysis of the ultrasound parameters of cardiac systolic and diastolic function was performed.Results. All patients had LV ejection fraction above 50% (LVEF), but longitudinal LV systolic dysfunction was observed in 19.3% of patients. Also in patients with serum ferritin values ​​above 1000ng / ml, the parameters of longitudinal systolic function of LV are affected, paradoxically the average value of LVEF being higher in these patients. About a quarter of patients had diastolic dysfunction, but 40.3% had elevated LV filling pressures. We noticed that the batch with ferritin over 1000 ng / ml associated increased LV filling pressures. The evaluation of the function of the right ventricle by tissue Doppler (S wave at the level of the free wall VD) was statistically significantly correlated with the hemoglobin value and we obtained pathological values ​​(S VD <11.5 cm / s) especially in the group with ferritin over 1000ng / ml. We noticed the presence of morphological abnormalities of LV, by increasing myocardial mass and the appearance of LV remodeling, 31% of patients showed severe forms, especially eccentric remodeling. It was observed that there is a risk of negative remodeling of the left ventricle in the group of those with ferritin above 1000ng / ml.Conclusions. The study proves that the evaluation of the systolic and diastolic function of the left and right ventricle by tissue Doppler ultrasound is much more accurate in the early detection of myocardial dysfunction. Ferritin levels above 1000ng / ml have been associated with impaired cardiac function parameters. Also, the remodeling of the left ventricle observed in this group of patients may be the first sign of heart failure.

Left atrial systolic and diastolic function after cessation of pacing in tachycardia-induced heart failure

1997 ◽  
Vol 273 (2) ◽  
pp. H921-H927 ◽  
Author(s):  
B. D. Hoit ◽  
Y. Shao ◽  
M. Gabel ◽  
C. Pawloski-Dahm ◽  
R. A. Walsh
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Left Atrial ◽  
Systolic Function ◽  
Left Ventricular ◽  
Rapid Pacing ◽  
Lv Systolic Function ◽  
Systolic And Diastolic Function ◽  
Lv Diastolic Dysfunction

Studies in the rapid-pacing model of heart failure have shown that left ventricular (LV) systolic function normalizes on cessation of pacing and LV diastolic dysfunction persists, but there is no information regarding atrial function under these conditions. To determine the effects of cessation of pacing on left atrial (LA) systolic and diastolic function, ten dogs with rapid pacing-induced heart failure (250 beats/min for 3-4 wk), six dogs with regression of heart failure (4 wk after cessation of rapid pacing), and seven control dogs were instrumented with LA sonomicrometers and micromanometers. At matched LA pressure, LA ejection (10.2 +/- 3.0 vs. 17.4 +/- 5.5%), reservoir volume fractions (19 +/- 8 vs. 35 +/- 11%), and heart rate-corrected mean normalized systolic ejection rate (1.25 +/- 0.33 vs. 1.60 +/- 0.44 EF/s) were significantly less, and the volume-normalized diastolic stiffness constant (4.9 +/- 0.8 vs. 3.2 +/- 1.1) was significantly greater, in regression versus control dogs; these changes were associated with incomplete regression of LA hypertrophy and a persistent 77.4% increase in beta-myosin heavy chain (beta-MHC) in the LA body. LV systolic function and weight were not significantly different, whereas the time constant of LV relaxation was longer (52.5 +/- 4.4 vs. 40.8 +/- 7.6 ms; P < 0.05) and LV end-diastolic pressure was greater (12.2 +/- 1.8 vs. 7.1 +/- 2.0 mmHg; P < 0.05) in regression compared with control dogs. Thus, unlike the normalization of LV systolic function observed with cessation of rapid pacing, LA systolic function is persistently abnormal, owing in part to persistent LV diastolic dysfunction, residual LA hypertrophy, and MHC isoform switches.

Abstract 18506: Relief of Myocardial Edema in Advanced Decompensated Heart Failure is Associated with Improved Left Ventricular Systolic and Diastolic Function

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Frederik H Verbrugge ◽  
Endry Willems ◽  
Philippe B Bertrand ◽  
Ellen Gielen ◽  
Wilfried Mullens ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Index ◽  
Diastolic Function ◽  
T2 Mapping ◽  
Myocardial Edema ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Volume Index ◽  
Systolic And Diastolic Function ◽  
Cmr Imaging

Introduction: Cardiac magnetic resonance (CMR) imaging with quantitative T2-mapping allows identi[[Unable to Display Character: &#64257;]]cation of myocardial edema, improving risk-stratification in acute coronary syndromes and myocarditis. Hypothesis: Global myocardial edema contributes to left ventricular (LV) dysfunction in advanced decompensated heart failure (ADHF). Methods: CMR with quantitative T2-mapping was performed in consecutive ADHF patients (n=17) undergoing right heart catheterization for worsening dyspnea and volume overload. Patients received vasodilators and diuretics to achieve pulmonary capillary wedge pressure (PCWP) ≤18 mmHg and central venous pressure (CVP) ≤10 mmHg, while maintaining mean arterial pressure ≥65 mmHg. After reaching hemodynamic targets, the pulmonary arterial catheter was removed and CMR imaging repeated. Changes in LV T2-values, hemodynamics, and CMR volumetric measurements were compared. Results: Study patients (64±11 years, male 88%, LV ejection fraction 23±8%, ischemic cardiomyopathy 50%) received decongestive treatment during 5±2 days. PCWP and CVP decreased from 25±7 to 17±4 mmHg and 13±6 to 7±3 mmHg, respectively (p<0.001 for both), while cardiac index increased from 2.14±0.60 to 2.58±0.49 L/min/m 2 (p=0.012). LV T2-values dropped consistently from 59.6±4.9 ms to 56.3±5.2 ms after decongestion (p=0.002; Figure). Decreasing LV T2-values correlated well to both decreasing PCWP (r=0.75; p=0.001) and increasing cardiac index (r=0.58; p=0.023). Although LV end-diastolic volume index (142±31 to 135±34 mL/m 2 ; p=0.033) and end-systolic volume index (110±29 to 99±33 mL/m 2 ; p=0.001) both decreased significantly, the extent of these changes were not correlated to changing T2-values (r=0 and 0.11, respectively; p=ns). Conclusions: Global LV myocardial edema is observed in ADHF and reversible with successful decongestive therapy. Relief of myocardial edema strongly correlates with improvements in systolic and diastolic function.

scholarly journals 586 Effect of sacubitril/valsartan combination in an experimental model of heart failure

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Antonella De Angelis ◽  
Donato Cappetta ◽  
Marialucia Telesca ◽  
Gabriella Bellocchio ◽  
Konrad Urbanek ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Angiotensin Ii ◽  
Left Ventricle ◽  
Diastolic Function ◽  
Cardiac Tissue ◽  
Function Analysis ◽  
Social Burden ◽  
Systolic And Diastolic Function ◽  
Tail Cuff

Abstract Aims The majority of elderly patients with heart failure has a preserved ejection fraction (HFpEF) that constitutes a syndrome characterized by frequent hospitalizations and high mortality. Despite the growing social burden of HFpEF, the comprehension of its pathophysiology is incomplete, and treatment remains largely undefined. Ageing itself may contribute independently to deterioration of diastolic function. Methods and results An 18-month-old female Fischer 344 rats were treated with oral administration of either sacubitril/valsartan (60 mg/kg/die, 1:1 ratio) or valsartan alone (30 mg/kg/die) for 12 weeks. Tail-cuff method was used to monitor blood pressure weekly. Echocardiography and left ventricle catheterization were employed to assess systolic and diastolic function, at baseline, and before sacrifice. Cardiac tissue was used for molecular biology and histochemistry assays. Tail-cuff analysis indicated a comparable decrease in blood pressure between treatments. Hypertrophy also showed a significant reduction with both treatments. On the contrary, myocardial function analysis demonstrated that no treatment was efficacy on diastolic dysfunction. The lack of improvement of cardiac function could be attributed to the inability of the treatments to counteract the accumulation of fibrotic tissue in the left ventricle, which, in turn, is attributable to the failure to reduce the inflammatory process and oxidative stress, and to the inability to modulate angiotensin II pathway. Conclusions Our results evidenced that both sacubitril/valsartan or valsartan treatment was able to improve diastolic function and pro-fibrotic remodelling, partly due to a lack of effect on classical and non-classical pathways of angiotensin II.

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