Is ‘diastolic heart failure’ a diagnosis of exclusion? Echocardiographic parameters of diastolic dysfunction in patients with heart failure and normal systolic function

2003 ◽  
Vol 12 (3) ◽  
pp. 127-134 ◽  
Author(s):  
Philip M. Mottram ◽  
Leanne Short ◽  
Terri Baglin ◽  
Thomas H. Marwick
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Normal Systolic Function ◽  
Patients With Heart Failure ◽  
Echocardiographic Parameters

scholarly journals RISK FACTORS OF DIASTOLIC HEART FAILURE

2006 ◽  
Vol 13 (03) ◽  
pp. 410-416
Author(s):  
LIAQAT ALI ◽  
MUHAMMAD AZHAR ◽  
ABDUL REHMAN ABID
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Nyha Class ◽  
Ischemic Heart ◽  
Normal Systolic Function ◽  
Number Of Patients

Background and objective: Isolated diastolicdysfunction /heart failure is the cause of congestive heart failure in 50% of patients with normal systolic function. Severalfactors have been shown to be predisposing conditions associated with the development of diastolic dysfunction anddiastolic heart failure. This study was designed to study the common and important factors leading to diastolicdysfunction of the heart. Study design: This was a descriptive analytic study. Place & Duration: This study wasconducted at Cardiology Department of Mayo Hospital Lahore from January 1998 to September 1998. Material andmethods: One hundred patients of diastolic heart failure who fulfilled our inclusion criteria were studied when theypresented to echo room for echocardiography. Detailed Echocardiography examination of all patients included in thisstudy was done to measure Doppler parameters of diastolic dysfunction like deceleration time, isovolumic relaxationtime, S & D wave measurements on pulmonary vein. Detailed history was taken and physical examination wasperformed to evaluate the risk factor associated with diastolic dysfunction in each patient. Results Mean age of thestudy population was 511 18 years. Majority of patients 50(50%) had age range from 36 to 55 years. There were62(62%) male and 38(38%) female patients. Majority of patients 34(34%) had NYHA class I symptoms and 30(30%)patients were in NYHA class II. Ejection fraction was normal in 54(54%) of patients while it was less than 40% in 24%of patients. Majority of patients, 28(28%) had Ischemic heart disease while 24(24%) patients had hypertension and14(14%) had diabetes mellitus. Hypertension and Ischemic heart disease were present in 14(14%) patients.Conclusion Approximately 40% - 50% of patients with or without overt clinical features of heart failure have isolateddiastolic dysfunction / DHF with normal systolic function. Coronary artery disease, arterial hypertension and diabetesmellitus are the major factors associated with diastolic dysfunction and DHF. Obesity and aging also contributeindependently to the development of diastolic dysfunction in a reasonable number of patients.

scholarly journals Heart failure with preserved ejection fraction – onset

2021 ◽  
Vol 27 (2) ◽  
pp. 17-36
Author(s):  
Branimir Kanazirev
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Rich Variety ◽  
Patients With Heart Failure

During these more than 20 years of evolution in understandings of the mechanisms of heart failure (HF) with preserved fractional ejection, there has been a rich variety of terminology, including „diastolic heart failure“, „heart failure with preserved systolic function“ and „heart failure with preserved fraction“. By defi nition, the latter term “ejection fraction-induced heart failure” proved to be the most appropriate and was accepted as the most correct, as the presence of diastolic dysfunction is not unique only to this group and exists in these patients, albeit subclinically and discrete disturbance in the longitudinal systolic function of the left ventricle against the background of the preserved ejection fraction. The problem, however, is not in the value of the ejection fraction or in the paradox of the combination of a well-functioning left ventricle and classic symptoms of heart failure, but in the non-infl uence of the prognosis of these patients in the way it is in patients with suppressed EF. Unlike patients with heart failure with a reduced ejection fraction, the prognosis and results in patients with HF with preserved EF do not mark the expected results and so far there are not enough effective and promising therapies.

Link between diabetes and diastolic dysfunction and the diagnostic role of echocardiography

2009 ◽  
Vol 150 (45) ◽  
pp. 2060-2067 ◽  
Author(s):  
András Nagy ◽  
Zsuzsanna Cserép
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Systolic Dysfunction ◽  
Mitral Annulus ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Doppler Study

Diabetes mellitus, a disease that has been reaching epidemic proportions, is an important risk factor to the development of cardiovascular complication. The left ventricular diastolic dysfunction represents the earliest pre-clinical manifestation of diabetic cardiomyopathy, preceding systolic dysfunction and being able to evolve to symptomatic heart failure. In early stages, these changes appear reversible with tight metabolic control, but as pathologic processes become organized, the changes are irreversible and contribute to an excess risk of heart failure among diabetic patients. Doppler echocardiography provides reliable data in the stages of diastolic function, as well as for systolic function. Combination of pulsed tissue Doppler study of mitral annulus with transmitral inflow may be clinically valuable for obtaining information about left ventricular filling pressure and unmasking Doppler inflow pseudonormal pattern, a hinge point for the progression toward advanced heart failure. Subsequently we give an overview about diabetes and its complications, their clinical relevance and the role of echocardiography in detection of diastolic heart failure in diabetes.

Evaluation of Diastolic Dysfunction Using Cardiac Magnetic Resonance Imaging

2010 ◽  
Vol 6 (1) ◽  
pp. 21 ◽  
Author(s):  
Tarun Pandey ◽  
Kedar Jambhekar ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Pulmonary Veins ◽  
Left Ventricular ◽  
Function Evaluation ◽  
Lv Function

Left ventricular (LV) diastolic dysfunction and diastolic heart failure (DHF) account for approximately 40–50% of all patients with congestive heart failure (CHF). Diastolic dysfunction can be evaluated directly by invasive cardiac catheterisation techniques or non-invasively by transthoracic echocardiography (TTE) or cardiac magnetic resonance (CMR) imaging. Due to its high spatial and temporal resolution, CMR is the accepted gold standard for evaluating ventricular systolic function. Using the cine-phase contrast technique, CMR can interrogate inflow through the mitral valve and pulmonary veins towards evaluation of diastolic dysfunction and has shown good correlation with TTE. Additionally, CMR can evaluate direct myocardial diastolic parameters that have no echo correlate, such as diastolic torsion rate. As CMR has the ability to characterise a range of diastolic impairments, it will likely become an important diagnostic test in the future, capable of comprehensive LV function evaluation. In this article, we focus on LV diastology, and review CMR methodology and parameters for the diagnosis of diastolic dysfunction.

scholarly journals Heart failure with Preserved EF: A Bird Eye View

2013 ◽  
Vol 52 (190) ◽  
Author(s):  
Fahad Aziz ◽  
Luqman-Arfath Thazhatauveetil-Kunhahamed ◽  
Chijioke Enweluzo ◽  
Misbah Zaeem
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Early Recognition ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Systolic Dysfunction ◽  
Hypertensive Heart Disease ◽  
Left Ventricular ◽  
Morbidity Rate ◽  
Annual Mortality

The concept of ‘‘diastolic’’ heart failure grew out of the observation that many patients who have the symptoms and signs of heart failure had an apparently normal left ventricular (LV) ejection fraction. Thus it was assumed that since systolic function was ‘‘pre- served’’ the problem must lie in diastole, although it is not clear by whom or when this assumption was made. Diastolic heart failure is associated with a lower annual mortality rate of approximately 8% as compared to annual mortality of 19% in heart failure with systolic dysfunction, however, morbidity rate can be substantial. Thus, diastolic heart failure is an important clinical disorder mainly seen in the elderly patients with hypertensive heart disease. Early recognition and appropriate therapy of diastolic dysfunction is advisable to prevent further progression to diastolic heart failure and death. There is no specific therapy to improve LV diastolic function directly. Medical therapy of diastolic dysfunction is often empirical and lacks clear-cut pathophysiologic concepts. Nevertheless, there is growing evidence that calcium channel blockers, beta-blockers, ACE-inhibitors and ARB as well as nitric oxide donors can be beneficial. Treatment of the underlying disease is currently the most important therapeutic approach.Keywords: diastolic heart failure; doppler echocardiography; treatment.

Postoperative Diastolic Heart Failure

2020 ◽  
pp. 323-332
Author(s):  
Éimhín Dunne ◽  
Niall Fanning
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Disease Process ◽  
Left Ventricular Systolic Function ◽  
Ventricular Rate ◽  
Diastolic Filling ◽  
Management Scenario

This chapter explores acute diastolic heart failure, which presents a difficult management scenario in the early post–cardiac surgery period. Initial diagnosis is assisted by knowledge of the patient's medical history and intraoperative course. It is made using both clinical and echocardiographic parameters. Diastolic dysfunction often remains asymptomatic until late in the disease process. When it presents clinically, it can be associated with an abnormal ejection fraction or, more commonly, with preserved ejection fraction. The diagnosis of diastolic dysfunction requires 3 conditions: the presence of signs and/or symptoms, normal left ventricular systolic function, and increased diastolic filling pressures. Treatment for diastolic heart failure includes fluid therapy, diuretics, vasoactive medicines, control of ventricular rate in atrial fibrillation, and amiodarone.

scholarly journals Inhibition of late Na+ current, a novel target to improve diastolic function and electrical abnormalities in Dahl salt-sensitive rats

2016 ◽  
Vol 310 (10) ◽  
pp. H1313-H1320 ◽  
Author(s):  
Liguo Chi ◽  
Luiz Belardinelli ◽  
Aliya Zeng ◽  
Ryoko Hirakawa ◽  
Sridharan Rajamani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Chronic Treatment ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Mitral Annulus ◽  
Left Ventricular ◽  
Mitral Annulus Velocity ◽  
Lv Mass ◽  
Lv Systolic Function

Late Na+ current ( INaL) is enhanced in myocytes of animals with chronic heart failure and patients with hypertrophic cardiomyopathy. To define the role of INaL in diastolic heart failure, the effects of GS-458967 (GS-967), a potent INaL inhibitor on mechanical and electrical abnormalities, were determined in an animal model of diastolic dysfunction. Dahl salt-sensitive (DSS) rats fed a high-salt (HS) diet for 8 wk, compared with a normal salt (NS) diet, had increased left ventricular (LV) mass (1,257 ± 96 vs. 891 ± 34 mg) and diastolic dysfunction [isovolumic relaxation time (IVRT): 26.8 ± 0.5 vs. 18.9 ± 0.2 ms; early transmitral flow velocity/early mitral annulus velocity (E/E') ratio: 25.5 ± 1.9 vs. 14.9 ± 0.9]. INaL in LV myocytes from HS rats was significantly increased to 0.41 ± 0.02 from 0.14 ± 0.02 pA/pF in NS rats. The action potential duration (APD) was prolonged to 136 ± 12 from 68 ± 9 ms in NS rats. QTc intervals were longer in HS vs. NS rats (267 ± 8 vs. 212 ± 2 ms). Acute and chronic treatment with GS-967 decreased the enhanced INaL to 0.24 ± 0.01 and 0.17 ± 0.02 pA/pF, respectively, vs. 0.41 ± 0.02 pA/pF in the HS group. Chronic treatment with GS-967 dose-dependently reduced LV mass, the increases in E/E' ratio, and the prolongation of IVRT by 27, 27, and 20%, respectively, at the 1.0 mg·kg−1·day−1 dose without affecting blood pressure or LV systolic function. The prolonged APDs in myocytes and QTc of HS rats were significantly reduced with GS-967 treatment. These results indicate that INaL is a significant contributor to the LV diastolic dysfunction, hypertrophy, and repolarization abnormalities and thus, inhibition of this current is a promising therapeutic target for diastolic heart failure.

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