scholarly journals Incremental prognostic and diagnostic value of exercise echocardiography in patients with indeterminate or abnormal diastolic function

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J.C Peteiro Vazquez ◽  
A Bouzas-Mosquera ◽  
E Martin-Alvarez ◽  
C Barbeito-Caamano ◽  
J.M Vazquez-Rodriguez
Keyword(s):  
Diastolic Function ◽  
Systolic Function ◽  
Diagnostic Value ◽  
Tissue Doppler ◽  
Peak Exercise ◽  
Systolic Pulmonary Artery Pressure ◽  
Exercise Echocardiography ◽  
Lv Systolic Function ◽  
Systolic And Diastolic Function ◽  
Restrictive Pattern

Abstract Background Exercise echocardiography (ExE) may assess LV systolic and diastolic function (DF). We aimed to assess the diagnostic and prognostic value of diastolic parameters at exercise (ratio of early LV inflow velocity to early tissue Doppler septal annulus velocity [E/e'] and systolic pulmonary artery pressure [sPAP]) in patients with indeterminate or abnormal resting DF referred for a clinically indicated ExE. Methods Data from 299 patients (72±9 years, 50% women) with LV-DF evaluated according to EACVI-Guidelines 2016, and LVEF ≥50 were extracted from our database. LV systolic and DF and mitral regurgitation (MR) were evaluated at rest. At peak exercise we assessed regional/global LV systolic function, MR, E/e', and sPAP. Abnormal ExE was defined as ischemia or fixed wall motion abnormalities, elevated E/e'values as >15 at rest and at exercise. Considered events were overall mortality, myocardial infarction, admission for unstable angina or cardiac failure, revascularization, pulmonary thromboembolism, and stroke. Results Abnormal resting DF was present in 221 patients (29%), indeterminate in 78 (10%). Exercise E/e' >15 was found in 37% of patients with abnormal DF, and in 21% with indeterminate DF; exercise E/e >15 plus sPAP>51 mmHg in 13% with abnormal DF, and in 9% with indeterminate DF. Based on exercise E/e' >15 (n=16), change from altered relaxation to restrictive pattern with exercise (n=8), or maintenance of a restrictive pattern for >65 years (n=4), indeterminate DF was reclassified to abnormal DF in 28/78 patients (36%). Among the other 50 patients with indeterminate DF and exercise E/e' ≤15, sPAP>51 mmHg was found in 21, having these subjects altered relaxation at rest and at exercise (n=19) or atrial fibrillation (n=2). Abnormal ExE was seen in 18% of patients with indeterminate resting DF, in 30% with abnormal resting DF, and in 40% with raised exercise E/e'. During median follow-up of 1 year (25th-75th percentiles 0.4–1.7) there were 53 events including 12 deaths, 6 myocardial infarctions, and 18 cardiac failures. Independent predictors were history of coronary disease (HR=2.50, 95% CI=1.31–4.75, p=0.005), ACEI/ARAII (HR=0.43, 95% CI=0.23–0.81, p=0.008), positive clinical or exercise ECG testing (HR=2.42, 95% CI=1.33–4.40, p=0.004), peak LVEF (HR=0.94, 95% CI=0.92–0.96, p<0.001), significant exercise MR (HR=3.96, 95% CI=1.58–9.97, p=0.004) and peak E/e'(HR= 1.06, 95% CI=1.02–1.10, p=0.004). Annualized event rates were 59% in patients with (+) ExE plus raised exercise E/e', 24% in those with (+) ExE and normal exercise E/e', 14% in (−) ExE and raised exercise E/e', and 5.4% with both variables normal (Figure). Conclusions ExE reclassified 21 to 36% of patients with indeterminate DF to abnormal DF, and was able to detect non-cardiac exercise-induced pulmonary hypertension. E/e'at postexercise further predicted outcome on top of ExE results in patients with indeterminate or abnormal resting DF. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Additive prognostic value of exercise echocardiography in symptomatic patients with normal or abnormal left ventricular diastolic function

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J.C Peteiro Vazquez ◽  
A Bouzas-Mosquera ◽  
E Martin-Alvarez ◽  
C Barbeito-Caamano ◽  
J Vazquez-Rodriguez
Keyword(s):  
Diastolic Function ◽  
Systolic Function ◽  
Coronary Revascularization ◽  
Left Ventricular Diastolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Peak Exercise ◽  
Exercise Echocardiography ◽  
Lv Systolic Function ◽  
Systolic And Diastolic Function

Abstract Background Exercise echocardiography (ExE) may assess left ventricular (LV) systolic and diastolic function. We aimed to assess the value of diastolic parameters at exercise (early LV inflow velocity to early tissue Doppler annulus velocity [E/e']) in patients with normal or abnormal resting diastolic function (DF) referred for a clinically indicated ExE. Methods LV systolic and DF according to EACVI Guidelines-2016, and mitral regurgitation (MR) were evaluated at rest in 773 patients (age 67±12 years) with preserved LVEF (≥50). At peak exercise we assessed regional/global LV systolic function, MR and E/e'. Abnormal ExE was defined as ischemia or fixed wall motion abnormalities and raised E/e'values as >15 at rest and at exercise (e' at the septal level). Patients were grouped as complaining or not of dyspnea. Events were overall mortality, myocardial infarction, admission for unstable angina or cardiac failure, coronary revascularization, pulmonary thromboembolism, and stroke. Results Abnormal resting DF was present in 221 patients (29%), indeterminate in 78 (10%). Percentages were similar among the 431 patients with dyspnea (27%/11%) and the 342 without (31%/ 9%), as they were E/e values >15 at rest and at exercise (16% and 18% with dyspnea; 16% and 21% without). Exercise E/e' >15 was found in 37% of patients with abnormal DF, 21% with undeterminate DF, and 6% with normal DF (p<0.001). Patients with abnormal resting DF had more frequently abnormal ExE (30%) in comparison with indeterminate (18%) or normal DF (17%, p<0.001). Patients with abnormal ExE had more frequently abnormal resting DF than patients with normal ExE (42% vs 25%, p<0.001) and similar indeterminate DF (9% vs 10%). Also, they had raised E/e' values at rest in 29% and at exercise in 25%, in comparison with normal ExE (16% at rest, 13% at exercise, both p<0.001). During median follow-up of 0.9 years (25–75th percentiles 0.4–1.7) there were 109 events. Independent predictors were age (HR=1.03, 95% CI=1.01–1.06, p=0.001), male gender (HR=2.00, 95% CI=1.31–3.07, p=0.001), history of coronary disease (HR=1.63; 95% CI=1.05–2.51, p=0.03), positive clinical or exercise ECG testing (HR=1.92, 95% CI=1.31–2.81, p=0.001), peak exercise LVEF (HR=0.93, 95% CI=0.91–0.94, p<0.001), and exercise E/e'(HR= 1.05, 95% CI=1.01–1.08, p=0.009). Neither resting E/e' values nor resting abnormal DF by EACVI Guidelines-2016 were independent predictors. Annualized event-rates were 38% in patients with (+) ExE plus (+) exercise E/e', 21% in those with (+) ExE and (−) exercise E/e', 11.5% in (−) ExE and (+) exercise E/e', and 3.7% with both variables normal (Figure). Conclusions Diastolic dysfunction results at rest and at exercise were similar between patients with or without dyspnea referred for ExE, but they were associated to abnormal ExE. Exercise E/e' reclassified 21% of patients with indeterminate DF and further predicted outcome on top of ExE results. FUNDunding Acknowledgement Type of funding sources: None.

Value of a comprehensive exercise echocardiography assessment for patients with hypertrophic cardiomyopathy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.C Peteiro Vazquez ◽  
J Peteiro ◽  
R Barriales-Villa ◽  
J Larranaga-Moreira ◽  
C Martinez-Veira ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Diastolic Function ◽  
Wall Thickness ◽  
Systolic Function ◽  
Beta Blockers ◽  
Left Ventricular ◽  
Exercise Echocardiography ◽  
Metabolic Equivalents ◽  
Lv Systolic Function ◽  
Systolic And Diastolic Function

Abstract Background Exercise echocardiography (ExE) may assess left ventricular (LV) systolic and diastolic function, LV outflow tract (LVOT) obstruction and mitral regurgitation (MR). We aimed to assess the feasibility and prognostic value of the assessment of all these issues during exercise in patients with hypertrophic cardiomyopathy (HCM). Methods LV systolic and diastolic function, LVOT gradients, and MR were evaluated during ExE in 285 patients with HCM (age 60±14 years, 168 men) and preserved LVEF (≥50%). Recordings were obtained at rest and peak exercise for regional/global LV systolic function and at rest and within 1.5 min after exercise for the rest of assessments: LVOT gradients, MR and ratio of early LV inflow velocity to early tissue Doppler septal annulus velocity (E/e'). Results Feasibility was 100%, 97%, 98% and 98% for LV systolic function, E/e', LVOT gradients, and MR assessments at exercise, respectively. Thirty-seven patients (13%) had LVOT obstruction at rest, and 76 (27%) developed exercise-induced LVOT obstruction. Mean resting LVEF was 63±3%. New wall motion abnormalities (WMAs) were detected in 38 patients (13%). E/e'>15 was observed in 108 patients at rest (38%) and in 119 at exercise (42%). Corresponding figures for significant MR (moderate or severe) were 20 (7%) and 17 (6%). During follow-up of 3.9±2.5 years, 21 patients had a hard event (cardiac death or transplantation, appropriate discharge of a defibrillator, stroke, myocardial infarction, hospitalization for heart failure), 33 a combined event (hard plus new atrial fibrillation or syncope), and 53 a combined event plus any interventionism. After adjustment, LV wall thickness, resting LVEF, maximal workload in Metabolic Equivalents (METs), and E/e' post-exercise resulted independent predictors of hard events (HR=1.45, 95% CI: 1.21–1.74, p<0.001; HR=0.80, CI: 0.71–0.89, p<0.001; HR=0.73, 95% CI: 0.62–0.86, p<0.001; HR=1.08, 95% CI: 1.02–1.14, p<0.009, respectively). Independent predictors of combined events included also LV wall thickness, resting LVEF, and METs, along with therapy with beta-blockers at the time of ExE (HR=1.29, 95% CI: 1.12–1.50, p=0.001; HR=0.89, CI: 0.81–0.97, p=0.012; HR=0.83, 95% CI: 0.74–0.93, p=0.001; HR=2.51, 95% CI: 1.20–5.25, p=0.015), whereas the model for combined events+any interventionism consisted of beta-blockers, LV wall thickness, LA dimension, METs and new WMAs. (HR=2.15, 95% CI: 1.20–3.86, p=0.01; HR=1.17, 95% CI: 1.03–1.32, p=0.02; HR=1.07, CI: 1.02–1.11, p=0.005; HR=0.90, 95% CI: 0.82–0.98, p=0.01; HR=2.33, 95% CI: 1.17–4.63, p=0.016) Conclusions A comprehensive assessment during ExE is feasible for patients with HCM and provides significant incremental prognostic information Funding Acknowledgement Type of funding source: None

scholarly journals THE DIAGNOSTIC AND PROGNOSTIC VALUE OF RIGHT VENTRICLE SYSTOLIC AND DIASTOLIC FUNCTION IN INFERIOR MYOCARDIAL INFARCTION

Biomedika ◽  
2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Niniek Purwaningtyas
Keyword(s):  
Myocardial Infarction ◽  
Diastolic Function ◽  
Sensitivity And Specificity ◽  
Systolic Function ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Inferior Myocardial Infarction ◽  
St Segment Elevation ◽  
St Segment ◽  
Systolic And Diastolic Function

Right ventricular (RV) involvement increases mortality and morbidity in inferior myocardial infarction (MI). There are sparse data on the usefulness of pulsed tissue Doppler imaging (TDI) in the diagnosis of RV dysfunction in ST segment elevation MI (STEMI). This study evaluate the diagnostic and prognostic significance of RV systolic and diastolic function compared to classical electrocardiographic RVMI diagnostic criteria in this group of patients. Consecutive patients with first, acute, inferior STEMI were prospectively assessed. The RVMI was defined as an ST-segment elevation ≥ 0.1 mV in lead V4R. Echocardiography with TDI was performed within24 h of the onset of symptoms. Out of 31 patients (mean age 56.39 ± 9.02 years), RVMI was found in 18 (37%). Multivariate analysis showed that two variables—RV systolic and diastolic function, were independent predictors of in-hospital prognosis. Sensitivity and specificity the RV systolic function were 94,4% and 69,2%, respectively. While RV diastolic function were 44% and 76,9%, respectively. RV systolic function predict ECG diagnosis of RVMI with relatively high sensitivity and specificity. RV diastolic function predict ECG diagnosis of RVMI with relatively low sensitivity but with high specificity.Keywords: tissue Doppler imaging, RV myocardial infarction, inferior myocardial infarction

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.

Echocardiographic assessment of age-associated changes in systolic and diastolic function of the female F344 rat heart

2004 ◽  
Vol 96 (2) ◽  
pp. 822-828 ◽  
Author(s):  
Marvin O. Boluyt ◽  
Kimber Converso ◽  
Hyun Seok Hwang ◽  
Agdas Mikkor ◽  
Mark W. Russell
Keyword(s):  
Diastolic Function ◽  
Rat Heart ◽  
Phased Array ◽  
Systolic Function ◽  
Tissue Doppler ◽  
Lv Function ◽  
F344 Rat ◽  
Array Transducer ◽  
Echocardiographic Assessment ◽  
Systolic And Diastolic Function

Aging is associated with hypertrophy, dilatation, and fibrosis of the left ventricle (LV) of the heart. Advances in echocardiographic assessment have made it possible to follow changes in cardiac function in a serial, noninvasive manner. The purpose was to determine whether there is echocardiographic evidence of age-associated changes in chamber dimensions and systolic and diastolic properties of the female Fischer 344 (F344) rat heart. On the basis of previous invasive studies, it was predicted that echocardiographic assessment would detect age-associated changes in indexes of systolic and diastolic function. Rats were sedated with 1.5% isoflurane and placed in the supine position. Two-dimensional images and two-dimensionally guided M-mode, Doppler M mode, Doppler tissue, and pulsed-wave Doppler recordings were obtained from the parasternal long axis, parasternal short axis, and/or apical four-chamber views as per convention by using a 15-MHz linear array or 8-MHz phased-array transducer or a GE S10-MHz phased-array transducer. Compared with young adult 4-mo-old rats, there is a significant decrement in the resting systolic function of the LV in 30-mo-old female F344 rats as evidenced by declines in LV ejection fraction (80 ± 9 vs. 89 ± 5%; mean ± SD), fractional shortening (43 ± 9 vs. 54 ± 8%) and velocity of circumferential fiber shortening (2.43 ± 0.53 vs. 2.99 ± 0.50 circ/s). Evidence for age-associated differences in diastolic function included an increase in isovolumic relaxation time (25.0 ± 7.6 vs. 17.2 ± 4.4 ms) and decreases in the tissue Doppler peak E waves at the septal annulus and at the lateral annulus of the mitral valve. The modest changes in systolic and diastolic LV function that occur with advancing age in the female F344 rat are likely to reduce the capacity of the heart to respond to hemodynamic challenges.

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.

Abstract 18119: Structural and Functional Right Ventricular Remodelling is Related to Training Intensity in an Experimental Model of Endurance Training

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Maria Sanz ◽  
Cira Rubies ◽  
Marta Sitges ◽  
Montserrat Battle ◽  
Bart Bijnens ◽  
...  
Keyword(s):  
Animal Model ◽  
Diastolic Function ◽  
Exercise Intensity ◽  
Systolic Function ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Dual Response ◽  
Echocardiographic Assessment ◽  
Intensity Of Exercise ◽  
Systolic And Diastolic Function

Background: a deleterious, potentially arrhythmogenic right ventricle (RV) remodelling has been documented in response to regular training in athletes. However, it is unclear how exercise intensity contributes to RV adverse remodelling. Aim: Our aim was to evaluate the relationship between RV functional and structural remodelling,and the intensity of exercise in an animal model. Methods: Thirty-six Wistar rats were conditioned to run daily in a treadmill at a moderate (MOD, 45 min at 30cm/s; estimated 60% VO2max) or vigorous (VIG, 60 min at 60cm/s; estimated 85-90% VO2max) intensity for 16 weeks; Sedentary rats (SED) served as controls. An standard echocardiographic assessment of both ventricles and Tissue Doppler Imaging (TDI) of the RV were performed. Hemodynamics of both ventricles were evaluated with a sensor tip pressure catheter. Results: After MOD training, both ventricles similarly dilated (roughly 15%). RV function improved as shown by increased RV apical function assessed by TDI (Figure).With VIG training, though, RV disproportionately dilated (in comparison to MOD: 10±13% RV dilation vs 1±12% LV dilation, p<0.05), RV systolic function declined, and RV diastolic function worsened (Figure).The hemodynamic experiments confirmed a decreased RV contractility and impaired relaxation with VIG training (Figure) in comparison to MOD. The LV systolic and diastolic function were unchanged in all groups. Conclusion: In this animal model we show that exercise intensity critically determines a dual response of the RV. A favourable adaptation of the RV after MOD training turned into disproportionate RV dilatation, decreased contractility and worse diastolic function in the VIG group. Our findings suggest the existence of an intensity threshold beyond which remodelling of the RV becomes maladaptive. Our work provides valuable data to identify athletes at risk of exercise related complications

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.

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