scholarly journals AGE, SEX, AND FRAILTY INFLUENCE AGE-DEPENDENT CHANGES IN VENTRICULAR STRUCTURE AND FUNCTION IN C57BL/6 MICE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S88-S88
Author(s):  
Susan E Howlett ◽  
Alice Kane ◽  
Elise Bisset ◽  
Kaitlyn Keller
Keyword(s):  
Cardiovascular Diseases ◽  
Ejection Fraction ◽  
Diastolic Function ◽  
Systolic Function ◽  
Left Ventricular ◽  
Cardiac Aging ◽  
Lv Mass ◽  
Age Dependent ◽  
The Impact ◽  
Fractional Shortening

Abstract The heart undergoes maladaptive changes during aging that set the stage for cardiovascular diseases, but frail older individuals are most likely to develop such diseases. We investigated the impact of frailty on left ventricular (LV) remodeling in male and female mice (aged 9-23 mos). Ventricular function/structure and frailty were assessed with echocardiography (Vevo 2100) and a frailty index (FI) tool. Fractional shortening (systolic function) increased with age (9 vs 23 mos) in males (27.7±2.6 vs 38.4±1.6%; p<0.05) and females (26.9±1.4 vs 32.5±1.8%; p<0.05); similar results were seen with ejection fraction. Conversely, E/A ratios (diastolic function) declined with age in males (1.9±0.1 vs 1.3±0.1; p<0.05) and females (2.1±0.3 vs 1.6±0.1; p<0.05). LV mass and LV internal diameter (diastole) increased with age in females but not in males, while intraventricular septum (diastole) increased in males only. As age-dependent changes were heterogeneous, we stratified the data by FI scores. Interestingly, fractional shortening (r=0.52; p=0.006) and ejection fraction (r=0.52; p<0.0001) were graded by FI score, but only in males. By contrast, LV mass was graded by frailty, but only in females (r=0.55; p<0.0001). Thus, diastolic function declines with age in both sexes while systolic function actually increases. Aging females display increased LV mass and LV dilation whereas older males exhibit septal thickening. These maladaptive changes are graded by frailty, suggesting that cardiac aging is prominent in those with poor overall health. Age, sex and frailty influence cardiac aging, which may predispose frail older men and women to develop different cardiovascular diseases as they age.

The Impact of Uncontrolled Hypertension on the Longitudinal Systolic Function of the Left Ventricle

2021 ◽  
Vol 17 ◽  
Author(s):  
Nabila Soufi Taleb Bendiab ◽  
Salim Benkhedda ◽  
Latifa Henaoui ◽  
Abderrahim Meziane Tani
Keyword(s):  
Strain Rate ◽  
Diastolic Function ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Left Ventricular ◽  
Uncontrolled Hypertension ◽  
Lv Function ◽  
Ultrasound Evaluation ◽  
Lv Mass ◽  
The Impact

Background: The assessment of the longitudinal component of left ventricular (LV) function is of major clinical importance for the early detection of LV contractile impairment. The aim of this study was to determine the impact of uncontrolled hypertension, on LV longitudinal systolic performance. Methods: The study population included 400 hypertensive patients: 271 patients with uncontrolled blood pressure (BP) and 112 without controlled BP, all patients underwent a complete ultrasound evaluation with calculation of the LV mass, evaluation of diastolic function as well as longitudinal systolic function. Results: Conventional echo demonstrated that uncontrolled patients had increased LV mass (P 0.007), LA (left auricular) dimension (P 0.004), left ventricular wall thickness and impairment of diastolic function (E/E’6 ± 2.1 vs 7.4 ±3.0 P=0.001) while no affection of systolic function could be detected. By deformation imaging, there was a reduction in longitudinal strain (apical 4 view -16.2 ±2.9 vs -18.2± 2.6 P 0.02, apical 3 view -17.3 ± 3.3 vs. -18.9 ± 4.1 P 0.01). Similarly systolic strain rate (SRsys) and early diastolic SR (SRe) reduced significantly in longitudinal direction. Conclusion: Although EF was not different between uncontrolled patients and controls, LV longitudinal strain and strain rate by 2D speckle tracking were lower in the uncontrolled group.

scholarly journals Arrest of atherosclerosis progression after interruption of GH replacement in adults with congenital isolated GH deficiency

2012 ◽  
Vol 166 (6) ◽  
pp. 977-982 ◽  
Author(s):  
Vanessa P Araujo ◽  
Manuel H Aguiar-Oliveira ◽  
Joselina L M Oliveira ◽  
Hertaline M N Rocha ◽  
Carla R P Oliveira ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Diastolic Function ◽  
Gh Deficiency ◽  
Systolic Function ◽  
Receptor Gene ◽  
Intima Media Thickness ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Carotid Imt ◽  
Gh Replacement

ObjectiveGH replacement therapy (GHRT) in adult-onset GH deficiency (AOGHD) reduces carotid intima-media thickness (IMT) and increases myocardial mass, with improvement of systolic and diastolic function. These observations have reinforced the use of GHRT on AOGHD. Conversely, we have previously reported that in adults with lifetime congenital and severe isolated GH deficiency (IGHD) due to a mutation in GHRH receptor gene (GHRHR), a 6-month treatment with depot GH increased carotid IMT, caused the development of atherosclerotic plaques, and an increase in left ventricular mass index (LVMI), posterior wall, and septal thickness and ejection fraction. Such effects persisted 12 months after treatment (12-month washout – 12mo).MethodsWe have studied the cardiovascular status (by echocardiography and carotid ultrasonography) of these subjects 60 months after completion of therapy (60-month washout – 60mo).ResultsCarotid IMT reduced significantly from 12 to 60mo, returning to baseline (pre-therapy) value. The number of individuals with plaques was similar at 12 and 60mo, remaining higher than pre-therapy. LVMI, relative posterior wall thickness, and septum thickness did not change between 12 and 60mo, but absolute posterior wall increased from 12 to 60mo. Systolic function, evaluated by ejection fraction and shortening fraction, was reduced at 60mo in comparison with 12mo returning to baseline levels. The E/A wave ratio (expression of diastolic function) decreased at 60mo compared with both 12mo and baseline.ConclusionsIn adults with lifetime congenital IGHD, the increase in carotid IMT elicited by GHRT was transitory and returned to baseline 5 years after therapy discontinuation. Despite this, the number of subjects with plaques remained stable at 60mo and higher than at baseline.

Abstract 4197: Does Relative Wall Thickness or Left Ventricular Mass Index Best Predict Mortality Risk in Patients With Preserved Systolic Function?

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Dharmendrakumar A Patel ◽  
Carl J Lavie ◽  
Sangeeta Shah ◽  
Yvonne Gilliland ◽  
Richard V Milani
Keyword(s):  
Wall Thickness ◽  
Systolic Function ◽  
Age Groups ◽  
Left Ventricular ◽  
Relative Wall Thickness ◽  
Prognostic Impact ◽  
Geometric Patterns ◽  
Lv Mass ◽  
Mortality Table ◽  
The Impact

Background: Several studies have indicated that left ventricular (LV) geometric patterns predict cardiovascular events. However, little data is available that compares the relative prognostic impact of LV mass index (LVMI) and relative wall thickness (RWT) on mortality in a large cohort of patients with preserved systolic function. Methods: The impact of LVMI and RWT on mortality during an average follow-up of 1.7±1.0 years was examined in a sample of 47,701 patients (mean age: 61.6 ± 15.4; females=54.6 %) with preserved ejection fraction(EF), as well as in age groups of <50 yrs(n=10,864; mean age=39.9 ± 8.1; females=58.4 %), 50 –70 yrs (n=20,181; mean age=59.9 ± 5.7; females=52.2 %) and >= 70 yrs (n=16,836; mean age=77.7 ± 5.5; females=55.1 %). Results: With increasing age (<50, 50 –70, >=70 yrs), both LVMI (78.5 ± 23.4, 84.3 ± 25.4, 90.3 ± 27.6; p<0.0001) and RWT (0.37 ± 0.08, 0.41 ± 0.08, 0.43 ± 0.09; p<0.0001) as well as mortality (2.2%, 5.0%, 14.2%; p<0.0001) showed significant linear trends and were independent predictors of mortality (Table , Figure ). Conclusion: Although, both LVMI and RWT were independently associated with increased mortality in all groups, RWT was by far the strongest independent predictor of all-cause mortality, especially in younger patients.

Ventricular remodeling during development and recovery from modified tachycardia-induced cardiomyopathy model

1996 ◽  
Vol 271 (6) ◽  
pp. R1529-R1534 ◽  
Author(s):  
K. Yamamoto ◽  
J. C. Burnett ◽  
L. M. Meyer ◽  
L. Sinclair ◽  
T. L. Stevens ◽  
...  
Keyword(s):  
Blood Flow ◽  
Body Weight ◽  
Ejection Fraction ◽  
Diastolic Function ◽  
Coronary Blood Flow ◽  
Left Ventricular ◽  
Lv Mass ◽  
Cardiac Filling ◽  
Tachycardia Induced Cardiomyopathy ◽  
Lv Diastolic Function

his study was designed to characterize left ventricular (LV) function and mass in a modified cardiomyopathy model in the dog in which right ventricular pacing rates are gradually increased throughout 38 days. On the last day of the pacing protocol, ejection fraction was reduced (25 +/- 3 vs. 60 +/- 1%) and LV end-diastolic diameter index (a ratio of LV end-diastolic diameter to body weight, 2.09 +/- 0.02 vs. 1.79 +/- 0.08 mm/kg) and LV mass index (a ratio of LV mass to body weight, 5.2 +/- 0.3 vs. 4.3 +/- 0.2 g/kg) were greater than in the normal dogs (P < 0.05, respectively). Cardiac filling pressures increased, and LV diastolic function and coronary blood flow were impaired. After 4 wk of recovery from the progressive pacing protocol, LV end-diastolic diameter index (2.12 +/- 0.06 mm/kg) and LV mass index (5.6 +/- 0.2 g/kg) remained increased. Ejection fraction was improved (38 +/- 4%) but still depressed. LV diastolic function, coronary blood flow, and cardiac filling pressures returned to levels seen in the normal dogs. This modified cardiomyopathy model associated with LV hypertrophy complements the conventional tachycardia-induced cardiomyopathy model without LV hypertrophy.

The impact of endurance exercise training on left ventricular systolic mechanics

2008 ◽  
Vol 295 (3) ◽  
pp. H1109-H1116 ◽  
Author(s):  
Aaron L. Baggish ◽  
Kibar Yared ◽  
Francis Wang ◽  
Rory B. Weiner ◽  
Adolph M. Hutter ◽  
...  
Keyword(s):  
Exercise Training ◽  
Ejection Fraction ◽  
Endurance Exercise ◽  
Systolic Function ◽  
Radial Strain ◽  
Left Ventricular ◽  
Functional Changes ◽  
Endurance Exercise Training ◽  
Lv Systolic Function ◽  
The Impact

Although exercise training-induced changes in left ventricular (LV) structure are well characterized, adaptive functional changes are incompletely understood. Detailed echocardiographic assessment of LV systolic function was performed on 20 competitive rowers (10 males and 10 females) before and after endurance exercise training (EET; 90 days, 10.7 ± 1.1 h/wk). Structural changes included LV dilation (end-diastolic volume = 128 ± 25 vs. 144 ± 28 ml, P < 0.001), right ventricular (RV) dilation (end-diastolic area = 2,850 ± 550 vs. 3,260 ± 530 mm2, P < 0.001), and LV hypertrophy (mass = 227 ± 51 vs. 256 ± 56 g, P < 0.001). Although LV ejection fraction was unchanged (62 ± 3% vs. 60 ± 3%, P = not significant), all direct measures of LV systolic function were altered. Peak systolic tissue velocities increased significantly (basal lateral S′Δ = 0.9 ± 0.6 cm/s, P = 0.004; and basal septal S′Δ = 0.8 ± 0.4 cm/s, P = 0.008). Radial strain increased similarly in all segments, whereas longitudinal strain increased with a base-to-apex gradient. In contrast, circumferential strain (CS) increased in the LV free wall but decreased in regions adjacent to the RV. Reductions in septal CS correlated strongly with changes in RV structure (ΔRV end-diastolic area vs. ΔLV septal CS; r2 = 0.898, P < 0.001) and function (Δpeak RV systolic velocity vs. ΔLV septal CS, r2 = 0.697, P < 0.001). EET leads to significant changes in LV systolic function with regional heterogeneity that may be secondary to concomitant RV adaptation. These changes are not detected by conventional measurements such as ejection fraction.

scholarly journals 114 Impact of left ventricular ejection fraction on procedural and long-term outcomes of bifurcation percutaneous coronary intervention

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Guglielmo Gallone ◽  
Francesc Bruno ◽  
Ovidio De Filippo ◽  
Enrico Cerrato ◽  
Saverio Muscoli ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Systolic Function ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
All Cause Mortality ◽  
The Impact

Abstract Aims Longitudinal systolic function may integrate information on aortic stenosis (AS) natural history and cardiac comorbidities with potential prognostic implications. We explored the impact of tissue Doppler imaging (TDI)-derived longitudinal systolic function defined by the peak systolic average of lateral and septal mitral annular velocities (average S’) among symptomatic patients with severe AS undergoing transcatheter aortic valve implantation (TAVI). Methods and results 297 unselected patients with severe AS undergoing TAVI from January 2017 to December 2018 at three European centres, with available average S′ at preprocedural echocardiography were retrospectively included. The primary endpoint was the Kaplan Meier estimate of all-cause mortality. After a median 18 months (IQR 12–18) follow-up, 36 (12.1%) patients died. Average S′ was associated with all-cause mortality (per 1 cm/s decrease: HR: 1.29, 95% CI: 1.03–1.60, P = 0.025), with a best cut-off of 6.5 cm/s. Patients with average S′ &lt;6.5 cm/s (55.2% of the study population) presented characteristics of more advanced left ventricular remodelling and functional impairment along with higher burden of cardiac comorbidities, and experienced higher all-cause mortality (17.6% vs. 7.5%, P = 0.007) also when adjusted for in-study outcome predictors (adj-HR: 3.33, 95% CI: 1.25–8.90, P = 0.016). Results were consistent among patients with preserved ejection fraction, normal-flow AS, high-gradient AS and in those without left ventricular hypertrophy. Conclusions Longitudinal systolic function assessed by average S’ is independently associated with long-term all-cause mortality among unselected patients with symptomatic severe AS undergoing TAVI. In this population, an average S′ below 6.5 cm/s best defines clinically meaningful reduced longitudinal systolic function and may aid clinical risk stratification.

scholarly journals P291 Additional value of myocardial work in detecting subclinical systolic dysfunction in patients with bicuspid aortic valve and left ventricular hypertrophy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M E Canonico ◽  
C Santoro ◽  
M Prastaro ◽  
R Sorrentino ◽  
F Luciano ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Ejection Fraction ◽  
Bicuspid Aortic Valve ◽  
Pulse Pressure ◽  
Speckle Tracking ◽  
Left Ventricular ◽  
Lv Mass ◽  
Significant Difference ◽  
Global Work ◽  
The Impact

Abstract Background An impairment of speckle tracking derived left ventricular (LV) global longitudinal strain (GLS) has been observed in patients with bicuspid aortic valve (BAV) and referred to abnormalities of aortic elasticity properties. The impact of LV mass on myocardial deformation has still not been investigated. This issue can be now better addressed by myocardial work software, which incorporates both deformation and hemodynamic load in the analysis. Aim of the study To analyse the impact of both deformation and strain derived myocardial work in BAV patients with and without LV hypertrophy (LVH). Methods Sixty-five patients with BAV underwent a comprehensive echo exam, including speckle tracking derived calculation of GLS (in absolute value). Parameters of myocardial work such as global work index (GWI), global constructive work (GCW) global wasted work (GWW) and global work efficiency (GWE) were measured according to standardized procedures. Patients with reduced LV ejection fraction and with more than mild aortic stenosis and/or regurgitation were excluded. Other exclusion criteria included coronary artery disease, concomitant valvular heart disease, heart failure, primary cardiomyopathies, permanent and/or persistent atrial fibrillation and inadequate echo images. BAV patients were divided according to presence of LVH: 10 with LVH (LV mass index &gt;47 g/m^2.7 in women and &gt;50 g/m^2.7 in men) and 55 without LVH. Results The two groups were comparable for sex, age and heart rate whereas systolic blood pressure (p = 0.006) and pulse pressure (p = 0.002) were higher in patients with LVH, who also had higher relative diastolic wall thickness (p &lt; 0.02). No significant difference in ejection fraction (p = 0.56), transmitral E/A ratio (p = 0.504) and E/e" (p = 0.311) was found between the two groups. GLS (19.1 ± 2.5 in LVH group and. 20.0 ± 2.4% in patients without LVH, p = 0.290), GWI (p = 0.356) and GCW (p = 0.396) did not differ significantly whereas GWW was higher (119.5 ± 72.9 vs. 72.3 ± 38.7 mmHg%, p = 0.003) and GWE lower (94.4 ± 3.0 vs. 92.2 ± 1.6%, p = 0.007) in BAV patients with LVH (Figure). In the pooled population, LV mass index was related with GWW (r = 0.26, p = 0.03) and GWE (r=-0.30, p &lt; 0.01) but not with GLS (r=-0.22, p = 0.08). The relation between GWE and LV mass index remained significant even after adjusting for pulse pressure (partial r=-0.28, p &lt; 0.02). Conclusion In patients with BAV, LVH plays a detrimental effect on LV systolic function which cannot be identified by ejection fraction and GLS assessment but is unmasked by the application of myocardial work. In presence of LVH, the wasted work of BAV patients is increased and myocardial efficiency is substantially reduced, it being negatively related to LV mass even after adjusting for a raw index of aortic stiffness such as pulse pressure. Abstract P291 Figure. GLS, GWW and GWE according to LVH

Abstract P089: Diabetes Worsens Length Of Stay In Patients With Reduced Ejection Fraction Admitted With Nstemi

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Ebenezer Oni ◽  
Zach Port ◽  
Olayinka Afolabi Brown ◽  
Behnam Bozorgnia ◽  
Aman M Amanullah
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Length Of Stay ◽  
Ejection Fraction ◽  
Systolic Function ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Diabetic Patients ◽  
Ventricular Ejection Fraction ◽  
The Impact

Background: Length of stay is an important quality metric and outcome measure in the management of hospitalized patients. We evaluated the association of diabetes in patients admitted for Non-ST Elevation myocardial infarction (NSTEMI) on their length of stay. Hypothesis: the impact of diabetes on length of stay in patients admitted for STEMI Methods: Our study population included patients admitted for NSTEMI in a single center between 08/01/2016 and 09/30/2012. Diabetes (DM) was defined by a documented diagnosis or use of diabetic medication. A higher length of stay (LOS) was defined as spending more than 5 days in the hospital. Results: A total of 720 patients were included in this analysis. The mean age was 66 ± 0.6 years, 50% (n-269) were diabetics, 59% had left ventricular ejection fraction (EF) < 50% and the median LOS was 5 days. A higher number of diabetic patients had LOS> 5days (55%). In an unadjusted logistic regression, diabetics had increased odds of higher LOS, odd ratio (OR) 1.54 ( CI 1.10-2.16 ), p=0.012. After adjusting for confounding variables, the relationship remained significant. When stratified by left ventricular systolic function on admission, the impact of diabetes on length of stay only remained significant in patients with EF less than 50%. See Table 1. Conclusion: The presence of diabetes was significantly associated LOS in NSTEMI, especially for patients admitted with a reduced left ventricular ejection fraction. This study emphases the impact of diabetes on health comes in cardiovascular disease.

P935 Association of intracellular iron status with left ventricular systolic function response to exercise in heart failure with preserved ejection fraction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Przewlocka-Kosmala ◽  
E Jasic-Szpak ◽  
E A Jankowska ◽  
P Ponikowski ◽  
W Kosmala
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Systolic Function ◽  
Iron Status ◽  
Left Ventricular ◽  
Exercise Intolerance ◽  
Lv Function ◽  
Preserved Ejection Fraction ◽  
Intracellular Iron ◽  
The Impact

Abstract The intracellular iron depletion has been recognized to contribute to the dysregulation of cell energetics. The soluble transferrin receptor (sTfR) is regarded as a marker of cellular iron balance, and its elevated level reflects an insufficient iron delivery to target tissues. Despite the strong pathophysiological link, there is a scarcity of data on the impact of intracellular iron status on myocardial performance. Aim To investigate the association between the intracellular iron status, as assessed by sTfR, and left ventricular (LV) function in a well-characterized population with heart failure and preserved ejection fraction (HFpEF). Methods A complete echocardiogram including evaluation of LV global longitudinal deformation by speckle tracking (GLS) was performed at rest and immediately post-exercise in 83 pts (age 66 ± 8 yrs) with symptomatic HFpEF. Results Pts with the highest sTfR concentrations (from the 3rd sTfR tertile) demonstrated significantly lower exertional GLS than their peers from the other 2 tertiles and lower resting GLS vs. the 2nd tertile (Table). Exercise GLS was inversely correlated with sTfR (r=-0.27, p = 0.01), and this association remained significant after adjustment for age, sex, BMI, LV mass, exercise blood pressure, hemoglobin and serum galectin-3 – a marker of fibrosis (beta=-0.24, p = 0.04). Conclusions In HFpEF, higher sTfR reflecting a decreased global intracellular iron content is independently associated with reduced LV longitudinal contractility response to exertion. This might represent another mechanism of exercise intolerance and should be considered in management strategies in this condition. Abstract P935 Figure.

scholarly journals New antidiabetic therapy and HFpEF: light at the end of tunnel?

2021 ◽  
Author(s):  
Marijana Tadic ◽  
Carla Sala ◽  
Sahrai Saeed ◽  
Guido Grassi ◽  
Giuseppe Mancia ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Diastolic Function ◽  
Negative Impact ◽  
Left Ventricular ◽  
Sglt2 Inhibitors ◽  
Antidiabetic Therapy ◽  
Positive Message ◽  
Increased Risk ◽  
The Impact ◽  
Lv Diastolic Function

AbstractNew antidiabetic therapy that includes sodium-glucose co-transporter 2 (SGLT2) inhibitors, glucagon-like peptide-1 receptor (GLP-1R) agonists, and dipeptidyl peptidase 4 (DPP-4) inhibitors showed significant benefit on cardiovascular outcomes in patients with and without type 2 diabetes mellitus, and this was particularly confirmed for SGLT2 inhibitors in subjects with heart failure (HF) with reduced ejection fraction (HFrEF). Their role on patients with HF with preserved ejection fraction (HFpEF) is still not elucidated, but encouraging results coming from the clinical studies indicate their beneficial role. The role of GLP-1R agonists and particularly DPP-4 inhibitors is less clear and debatable. Findings from the meta-analyses are sending positive message about the use of GLP-1R agonists in HFrEF therapy and revealed the improvement of left ventricular (LV) diastolic function in HFpEF. Nevertheless, the relevant medical societies still consider their effect as neutral or insufficiently investigated in HF patients. The impact of DPP-4 inhibitors in HF is the most controversial due to conflicting data that range from negative impact and increased risk of hospitalization due to HF, throughout neutral effect, to beneficial influence on LV diastolic dysfunction. However, this is a very heterogeneous group of medications and some professional societies made clear discrepancy between saxagliptin that might increase risk of HF hospitalization and those DPP-4 inhibitors that have no effect on hospitalization. The aim of this review is to summarize current clinical evidence about the effect of new antidiabetic medications on LV diastolic function and their potential benefits in HFpEF patients.

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