Evaluation of diastolic LV function

2015 ◽  
pp. 323-335
Author(s):  
Johan De Sutter ◽  
Jean-Louis J. Vanoverschelde
Keyword(s):  
Diastolic Function ◽  
Daily Practice ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Lv Function ◽  
Prognostic Information ◽  
Heart Failure Patients ◽  
Lv Mass ◽  
Deformation Measurements

The evaluation of diastolic function in patients with reduced (HFREF) or preserved (HFPEF) left ventricular (LV) ejection fraction is important as it carries both diagnostic and prognostic information. In daily practice, this is most frequently done by standard echocardiographic techniques, including the evaluation of LV mass and LA volumes, as well as transmitral and pulmonary venous PW Doppler, CW Doppler for evaluation of the IVRT, and tissue Doppler imaging of the septal and lateral annular velocities. This permits grading the severity of diastolic dysfunction, which is related to outcome and may be used to estimate LV filling pressures. The latter needs further validation, especially in patients with HFPEF. Newer echocardiographic and cardiac magnetic resonance techniques, including myocardial deformation measurements during diastole, LV twist and untwisting, and parameters of left atrial function, are promising and will hopefully in the future help clinicians to make a more precise evaluation of diastolic function and filling pressures in heart failure patients.

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.

Assessment of systolic function

2011 ◽  
Author(s):  
Alexandra Gonçalves ◽  
Pedro Marcos-Alberca ◽  
Peter Sogaard ◽  
José Luis Zamorano
Keyword(s):  
Systolic Function ◽  
Power Doppler ◽  
Daily Practice ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Function Evaluation ◽  
Lv Function ◽  
Dimensional Echocardiography ◽  
Function Assessment

This chapter describes the different modalities for assessment of systolic function by transthoracic echocardiography. Firstly, the basic principles of physiology and the determinants of left ventricular (LV) performance are considered, followed by a systematic appraisal of the methodologies for global LV systolic function assessment. Starting with M-mode echocardiography, passing through the traditional two-dimensional echocardiography evaluation to three-dimensional echocardiography approaches, main strengths and limitations are described. Power Doppler usefulness, regarding stroke volume calculations and dP/dt measurement are summarily explained, taking into consideration the usual pitfalls found in daily practice. There is a section dedicated to regional systolic function evaluation, with the recommendations for standardized LV division and differential characteristics of wall motion abnormalities. Additionally, more recent approaches with tissue Doppler imaging and strain analyses for global and regional LV function assessment are described. Finally, a section is dedicated to right ventricle systolic function which describes all modalities of evaluation.

scholarly journals Right ventricular improvement is associated with left ventricular diastolic function and size enhancement in PAH patients: an echocardiographic study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C Fauvel ◽  
O Raitiere ◽  
N Si-Belkacem ◽  
C Viacroze ◽  
E Artaud-Macari ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Right Ventricular ◽  
Diastolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Lv Function ◽  
Pulmonary Arterial ◽  
Lv Ejection Fraction ◽  
Rv Function

Abstract Background While pulmonary vasodilation therapy improves right ventricular (RV) function in pulmonary arterial hypertension (PAH), data regarding left ventricular (LV) function remain sparse. Purpose We aimed to investigate whether PAH therapy improve LV function in PAH patients. Methods Between 2002 and 2020, all incident PAH patients from one PH referral centers were included, treated and followed-up according to current ESC/ERS guidelines. All patients had comprehensive echocardiography both investigating right and left ventricular function before and after 1-year of vasodilation therapy. In addition to RV echocardiographic evaluation, we focused on LV ejection fraction from Modified Simpson method, LV diameters by M-mode, transmitral pulsed-wave E/A ratio, Flow to tissue Doppler imaging E/e' ratio, and left atrial size. Results 126 patients were included (63% female, 57±17 yo), mainly from connectivite tissue associated and idiopathic PAH (24% and 28% respectively) causes. Compared to baseline, 1-year NYHA functional class (p<0.01), NTproBNP plasma level (p<0.001), invasive mean pulmonary arterial pressure (p<0.01) and cardiac index (p<0.01) significantly improved. While LV ejection fraction (p=0.68), LV end-diastolic diameter (p=0.11) as well as LA area and volume (p=0.09) were not significantly enhanced under vasodilation therapy, LV diastolic function, assessed by mitral E wave (p<0.01), tissue doppler imaging mitral e' wave (p=0.04), and E/A ratio (p=0.045) were significantly improved at 1-year. There was a significant correlation between LV end-diastolic diameter (p<0.001) and RV end-diastolic area (p<0.001) owing to the normalization of right- to left ventricular interdependence, as well as between mitral E wave and TAPSE (p=0.045). Conclusion By improving RV function, PAH vasodilation therapy enhances LV size and diastolic function and normalizes the biventricular interdependence. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Assessment of left ventricular systolic and diastolic functions in severely malnourished children

2019 ◽  
Vol 67 (1) ◽  
Author(s):  
Gihan M. Bebars ◽  
Hany T. Askalany
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Control Group ◽  
Nutritional Rehabilitation ◽  
Malnourished Children ◽  
Grade Ii ◽  
Diastolic Functions

Abstract Background Malnourished children endure many changes in body composition and lose heart and skeletal muscle mass. Diastolic dysfunction is one of the major causes of heart failure with preserved ejection fraction. Aim To assess left ventricular systolic and diastolic functions in children with severe acute malnutrition using tissue Doppler imaging technique and to evaluate the effect of nutritional rehabilitation. Patients and Methods A follow-up case-control study conducted on 60 severely malnourished children (WHZ < -3SD) and 120 age and sex-matched healthy children as a control group. Tissue Doppler imaging (TDI) was done for all included malnourished children at admission and for control to measure left ventricular systolic and diastolic functions. Nutritional rehabilitation was done according to WHO protocol and tissue doppler was repeated after rehabilitation when (WHZ > -2SD) to detect any changes in systolic or diastolic functions. Results Systolic function was normal in malnourished children and control. Grade I diastolic dysfunction was detected in 40% and grade II in 30% of severely malnourished children in comparison to 100% normal diastolic function in control group. No correlations between diastolic dysfunction and either anthropometric measurements, electrolyte disturbances or Hb% in malnourished children before nutritional rehabilitation. Mortality from sepsis with associated ventricular dysfunction grade II documented in 3.3% of malnourished children. After nutritional rehabilitation diastolic function improved significantly as 65.6% of children attained normal diastolic function, 31% grade1 and 3.4% grade II. Positive correlations between diastolic function and WAZ, HAZ, WHZ and MUAC after rehabilitation. Conclusion Severe acute malnutrition affects diastolic function in children which is reversible in most of these cases with rehabilitation. TDI is an easy and practical method for detection and follow-up of ventricular function in malnourished children.

scholarly journals 2326 Prognostic value of left ventricular mitral annular longitudinal displacement measured by tissue Doppler imaging in patients with acute coronary syndrome

2018 ◽  
Vol 2 (S1) ◽  
pp. 46-46
Author(s):  
Mats Lassen ◽  
Kristoffer G. Skaarup ◽  
Allan Z. Iversen ◽  
Peter G. Jørgensen ◽  
Flemming J. Olsen ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Primary Source ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Inferior Wall ◽  
Longitudinal Displacement ◽  
Prognostic Information ◽  
Coronary Syndrome ◽  
Multivariate Adjustment

OBJECTIVES/SPECIFIC AIMS: To investigate the prognostic value of left ventricular mitral annular longitudinal displacement (LD) measured with color tissue Doppler imaging (TDI) in a large population suffering from acute coronary syndrome (ACS). METHODS/STUDY POPULATION: In total, 501 ACS patients underwent an echocardiography within 9 days after a percutaneous coronary intervention. Regional LD was obtained from the 6 mitral annular regions with TDI and GLD was calculated as an average. RESULTS/ANTICIPATED RESULTS: During a median follow-up time of 4.4 years 46 ACS patients suffered CVD. Mean value of GLD in the population was 8.11mm (±2.4). GLD and LD obtained from the inferior wall remained significant independent predictors after multivariate adjustment for clinical parameters, GLD (HR: 1.43, 95% CI: 1.12–1.82, p=0.014, per 1mm decrease), inferior LD (HR: 1.38, 95% CI: 1.14–1.66, p=0.001). Furthermore, inferior wall LD was the primary source of prognostic information in GLD since only inferior LD remained significant when both measures were included in the same model: GLD (HR: 0.95, 95% CI: 0.64–1.40, p=0.781); inferior LD (HR: 1.60, 95% CI: 1.15–2.22, p=0.005). Of all walls, only inferior wall LD remained as an independent predictor after multivariate adjustment. DISCUSSION/SIGNIFICANCE OF IMPACT: GLD provides independent prognostic information in ACS patients over and beyond all conventional echocardiographic measures. Regional inferior LD was the primary source of prognostic information gained from GLD. GLD proved to be a better predictor of cardiovascular events than conventional echocardiographic measures. This could lead to better risk stratification in the clinical setting and open up for earlier intervention in high-risk individuals.

Right ventricle and pulmonary arterial pressure

2016 ◽  
Author(s):  
Annemien E. van den Bosch ◽  
Luigi P. Badano ◽  
Julia Grapsa
Keyword(s):  
Clinical Decision Making ◽  
Complex Geometry ◽  
Three Dimensional ◽  
Clinical Decision ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Prognostic Information ◽  
Recent Developments ◽  
And Function

Right ventricular (RV) performance plays an important role in the morbidity and mortality of patients with left ventricular dysfunction, congenital heart disease, and pulmonary hypertension. Assessment of RV size, function, and haemodynamics has been challenging because of its complex geometry. Conventional two-dimensional echocardiography is the modality of choice for assessment of RV function in clinical practice. Recent developments in echocardiography have provided several new techniques for assessment of RV dimensions and function, include tissue Doppler imaging, speckle-tracking imaging, and volumetric three-dimensional imaging. However, specific training, expensive dedicated equipment, and extensive clinical validation are still required. Doppler methods interrogating tricuspid inflow and pulmonary artery flow velocities, which are influenced by changes in pre- and afterload conditions, may not provide robust prognostic information for clinical decision-making. This chapter addresses the role of the various echocardiographic modalities used to assess the RV and pulmonary circulation. Special emphasis has been placed on technical considerations, limitations, and pitfalls of image acquisition and analysis.

Percutaneous intracoronary delivery of SERCA gene increases myocardial function: a tissue Doppler imaging echocardiographic study

2006 ◽  
Vol 291 (4) ◽  
pp. H1773-H1779 ◽  
Author(s):  
Damien Logeart ◽  
Laurent Vinet ◽  
Thierry Ragot ◽  
Michèle Heimburger ◽  
Liliane Louedec ◽  
...  
Keyword(s):  
Tissue Doppler Imaging ◽  
Myocardial Function ◽  
Realistic Model ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Strong Increase ◽  
Lv Function ◽  
Maximal Rate ◽  
Circumflex Artery

The aim of this study was to examine the efficiency of adenovirus-mediated overexpression of sarco(endo)plasmic reticulum Ca2+-ATPase (SERCA1a) gene in a realistic model based on percutaneous intracoronary delivery and on noninvasive functional monitoring. Catheter-based selective coronary delivery of saline or adenoviruses (Ad.CMV.SERCA1a or Ad.CMV.lacZ, 1010 plaque-forming units) was performed in the circumflex artery of rabbits. Effects were assessed and compared by using serial Doppler echocardiography, hemodynamics, and measurements of SERCA protein and Ca2+ uptake activity. On day 3, a 21% increase in SERCA proteins and a 37% increase in the maximal rate of Ca2+ uptake were observed in the transfected left ventricular (LV) walls of Ad.CMV.SERCA1a rabbits. Baseline hemodynamics and conventional echographic measurements of global LV function were poorly affected. In contrast, tissue Doppler imaging (TDI) was able to assess a strong increase in the baseline function of transfected LV walls, as assessed with maximal wall velocities (+32% and +43%, respectively) and strain rates (+18% and +30%, respectively). TDI parameters were closely related to the maximal rate of Ca2+ uptake ( r2 = 0.68 for the systolic strain rate). Serial TDI analysis during follow-up showed that the effects lasted for 7 days and were no longer detectable 15 days after adenoviruses injection. In conclusion, LV function can be increased by adenovirus-mediated overexpression of SERCA in a clinically relevant model, and TDI provides an accurate and noninvasive tool for monitoring effects on global as well as regional myocardial function.

scholarly journals Echocardiographic Evaluation of Left Atrial Mechanics: Function, History, Novel Techniques, Advantages, and Pitfalls

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Roman Leischik ◽  
Henning Littwitz ◽  
Birgit Dworrak ◽  
Pankaj Garg ◽  
Meihua Zhu ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Left Atrial ◽  
Left Ventricular Diastolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Current Standard ◽  
Ventricular Diastolic Function ◽  
Strain Rate Imaging ◽  
Strain And Strain Rate

Left atrial (LA) functional analysis has an established role in assessing left ventricular diastolic function. The current standard echocardiographic parameters used to study left ventricular diastolic function include pulsed-wave Doppler mitral inflow analysis, tissue Doppler imaging measurements, and LA dimension estimation. However, the above-mentioned parameters do not directly quantify LA performance. Deformation studies using strain and strain-rate imaging to assess LA function were validated in previous research, but this technique is not currently used in routine clinical practice. This review discusses the history, importance, and pitfalls of strain technology for the analysis of LA mechanics.

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