Effect of preload reduction by haemodialysis on new indices of diastolic function

2003 ◽  
Vol 105 (4) ◽  
pp. 499-506 ◽  
Author(s):  
Richard J. GRAHAM ◽  
John S. GELMAN ◽  
Lesley DONELAN ◽  
Philip M. MOTTRAM ◽  
Roger E. PEVERILL
Keyword(s):  
Diastolic Function ◽  
Tissue Doppler Imaging ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Doppler Velocity ◽  
Transmitral Flow ◽  
Mitral Annular Velocity ◽  
Diastolic Velocity ◽  
Preload Reduction

Assessment of mitral annular motion diastolic velocities by M-mode or tissue Doppler imaging and the propagation velocity of early diastolic filling (Vp) by colour M-mode have been proposed as preload-independent indices of diastolic function. The aim of the present study was to determine the effects of preload reduction by haemodialysis on these new echocardiographic indices and to assess the relationship between these indices. The study group comprised 17 patients with chronic renal failure in sinus rhythm with normal left ventricular systolic function who underwent echocardiography 30 min prior to and 30 min following haemodialysis. Following dialysis there were significant reductions in weight (P<0.001), left atrial diameter (P=0.001), the peak Doppler velocity of early diastolic transmitral flow (P=0.005) and the ratio of Doppler velocities of early to late diastolic transmitral flow (P=0.02), consistent with a reduction in intravascular volume. There was no change after dialysis in early diastolic mitral annular velocity using M-mode (P=0.19) or tissue Doppler imaging from either the septal or lateral walls (P=0.88 and P=0.15 respectively), but there was a reduction in Vp after dialysis (55 to 49 cm/s; P=0.04). There were only weak correlations between Vp and the early diastolic mitral annular velocities (r<0.6 for all). We conclude that the assessment of diastolic function by the mitral annular early diastolic velocity appears to be preload-independent, that Vp may be affected by preload and that there is only a weak relationship between Vp and the early diastolic mitral annular velocity.

SHORT –TERM RESULT OF STUDY LEFT VENTRICULAR DIASTOLIC FUNCTION IN ADROID OBESITY PATIENTS BY TISSUE DOPPLER IMAGING

2011 ◽  
pp. 85-90
Author(s):  
Cuu Long Nguyen
Keyword(s):  
Waist Circumference ◽  
Diastolic Function ◽  
Tissue Doppler Imaging ◽  
Doppler Echocardiography ◽  
Left Ventricular Diastolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Transmitral Flow ◽  
Ventricular Diastolic Function

Aim of study: To study changes of left ventricular diastolic function and morphology in adroid obesity patients by standard doppler echocardiography and tissue doppler imaging. In that, evaluate the role of Tissue Doppler Imaging(TDI) in studying the left ventricular diastolic function. Patients and methods: We studied 30 obese patients (12 men have waist circumference ≥90cm and 18 women have waist circumference ≥80 cm), mean age 49.33±7.16 years , non hypertension and non diabetic, by conventional doppler echocardiography and tissue doppler imaging. Results: Mean BMI of obese patients: 25,35±2,87kg/m2. Waist circumference: 91,03±6,29cm. Left ventricular end- diastolic diameter: 45,9±4,05mm. Left ventricular mass: 143,47±35,56g. Left ventricular mass index: 85,69±19,55g/m2. Left atrial diameter: 36,34±4,33mm. The early diastolic wave of the transmitral flow velocity(E): 75,2±17,5 cm/s; the atrial systolic wave of the transmitral flow velocity: 76,2±16,5cm/s; the ratio of early diastolic wave to atrial systolic wave of the transmitral flow velocity: 0,99±0,29. The early diastolic wave of mitral annu-lus using pulsed TDI(Em): 12,1±3,3cm/s. The atrial systolic wave of mitral annu-lus using pulsed TDI(Am): 12,7±2,9cm/s. E to Em wave ratio: 6,76±2,19. Conclusion: In adroid obesity patients, the morphology of diastolic left ventricular changes earlier than the one’s function. Key word: Left ventricular function; Obesity; Tissue Doppler Echocardiography

Abstract 2690: Should We Classify Impaired Relaxation Pattern With Elevated E/e’ As Grade 1 Diastolic Dysfunction?

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Un-jung Choi ◽  
Hong-Seok Lim ◽  
Soo-Jin Kang ◽  
Jung-Won Hwang ◽  
Byoung-Joo Choi ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Flow Velocity ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Transmitral Flow ◽  
Venous Flow ◽  
Mitral Annular Velocity ◽  
Echocardiographic Measurement ◽  
Ventricular Filling Pressure

Purpose : Impaired relaxation pattern (grade 1 diastolic dysfunction) by Doppler echocardiography is known to reflect preserved left ventricular filling pressure (LVFP), while increased ratio of early diastolic transmitral flow velocity to mitral annular velocity (E/E’) indicated elevated LVFP. We evaluated the characteristics of impaired relaxation pattern with elevated E/E’ ratio. Methods : Eighty-eight patients (mean age 63 ± 11, 59 males) who had coronary artery disease with impaired relaxation pattern (E/A < 1) were enrolled. Echocardiography including tissue Doppler imaging (TDI) was performed. All patients underwent cardiac catheterization to investigate LV pre-A pressure (LVP pre-A ) within 6 hours after echocardiographic measurement. Patients were divided into subjects with E/E’ < 10 (n = 71) and E/E’ ≥ 10 (n = 17). Results : LVP pre-A was well correlated with echocardiographic Doppler and hemodynamic parameters (E/E’, r = 0.536, p < 0.001; LA volume, r = 0.295, p = 0.008; EF, r = -0.234, p = 0.028). Forty (45% of total) patients had high LVFP, defined as LVP pre-A ≥15 mmHg. Patients with E/E’ ≥10 had a significantly higher incidence of high LVFP, when compared to patients with E/E’ < 10 (88% vs 35%, p < 0.001). LA volume and LVP pre-A were significantly increased and EF was decreased in patients with E/E’ ≥ 10 (table 1 ). However, there were no significant differences of parameters derived from transmitral inflow and transpulmonary venous flow between two groups. Conclusions : In patients with impaired relaxation pattern, elevated E/E’ has related to elevation of LVFP, regardless of transmitral inflow and transpulmonary indices. Therefore, impaired relaxation pattern with elevated ratio of early diastolic transmitral flow velocity to mitral annular velocity (E/E’) may have been considered as another grade of diastolic dysfunction. Table 1

scholarly journals Right and left ventricular adaptation to hypoxia: a tissue Doppler imaging study

2005 ◽  
Vol 289 (4) ◽  
pp. H1391-H1398 ◽  
Author(s):  
Sandrine Huez ◽  
Kathleen Retailleau ◽  
Philippe Unger ◽  
Adriana Pavelescu ◽  
Jean-Luc Vachiéry ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Wave Velocity ◽  
Tissue Doppler Imaging ◽  
Systolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Lv Function ◽  
Tricuspid Annulus ◽  
Lv Systolic Function

Hypoxia has been reported to alter left ventricular (LV) diastolic function, but associated changes in right ventricular (RV) systolic and diastolic function remain incompletely documented. We used echocardiography and tissue Doppler imaging to investigate the effects on RV and LV function of 90 min of hypoxic breathing (fraction of inspired O2 of 0.12) compared with those of dobutamine to reproduce the same heart rate effects without change in pulmonary vascular tone in 25 healthy volunteers. Hypoxia and dobutamine increased cardiac output and tricuspid regurgitation velocity. Hypoxia and dobutamine increased LV ejection fraction, isovolumic contraction wave velocity (ICV), acceleration (ICA), and systolic ejection wave velocity (S) at the mitral annulus, indicating increased LV systolic function. Dobutamine had similar effects on RV indexes of systolic function. Hypoxia did not change RV area shortening fraction, tricuspid annular plane systolic excursion, ICV, ICA, and S at the tricuspid annulus. Regional longitudinal wall motion analysis revealed that S, systolic strain, and strain rate were not affected by hypoxia and increased by dobutamine on the RV free wall and interventricular septum but increased by both dobutamine and hypoxia on the LV lateral wall. Hypoxia increased the isovolumic relaxation time related to RR interval (IRT/RR) at both annuli, delayed the onset of the E wave at the tricuspid annulus, and decreased the mitral and tricuspid inflow and annuli E/A ratio. We conclude that hypoxia in normal subjects is associated with altered diastolic function of both ventricles, improved LV systolic function, and preserved RV systolic function.

scholarly journals Cardiac dysfunction in acromegaly: evidence by pulsed wave tissue Doppler imaging

2000 ◽  
pp. 363-369 ◽  
Author(s):  
G Mercuro ◽  
S Zoncu ◽  
P Colonna ◽  
P Cherchi ◽  
S Mariotti ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Tissue Doppler Imaging ◽  
Systolic Function ◽  
Lateral Wall ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Control Group ◽  
Diastolic Velocity ◽  
Acromegalic Cardiomyopathy

OBJECTIVE: To verify whether the accuracy of data on myocardial function provided by pulsed-wave tissue Doppler imaging (PWTDI), a new echocardiographic application that allows quantitative measurements of myocardial wall velocities, could help towards a better understanding of the natural history of acromegalic cardiomyopathy. DESIGN: Eighteen patients with active acromegaly (ten men and eight women; mean age 48.0+/-15.0 years) with no other detectable cause of heart disease underwent PWTDI. Thirteen healthy individuals matched for age and body mass index acted as a control group. METHODS: Ejection fraction (EF), transmitral early/late diastolic velocity (E/A) ratio and isovolumic relaxation time (IVRT) were measured by conventional echocardiography; systolic peak (Sv) and early (Ev) and late (Av) diastolic peak velocities, Ev/Av ratio and regional IVRT (IVRTs) were obtained by PWTDI. RESULTS: All patients showed appreciably abnormal left ventricular global diastolic function represented by prolongation of the IVRT (P<0.001). Using PWTDI we found a prolongation of IVRTs and inversion of the Ev/Av ratio. In addition, the Ev/Av ratio proved to be significantly negatively correlated with IVRT; this correlation was not present in the case of the E/A ratio. Furthermore, a decrease in Sv was detected in the basal segment of the lateral wall (P<0.01), which had the greatest degree of diastolic dysfunction. CONCLUSIONS: PWTDI confirmed the acknowledged diastolic dysfunction that accompanies acromegalic cardiomyopathy and highlighted the greater sensitivity of regional PWTDI with respect to global Doppler diastolic indexes. Furthermore, by revealing an impairment of regional systolic function in presence of a normal EF, the findings with PWTDI contradicted the largely accepted theory that systolic function remains normal for several years in patients affected by acromegalic cardiomyopathy.

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