scholarly journals Left ventricle diastolic dysfunction in idiopathic inflammatory myopathies: A meta-analysis and systematic review

2021 ◽  
Author(s):  
Yiwen Zhang ◽  
Xiaoqian Yang ◽  
Li Qin ◽  
Qiang Luo ◽  
Han Wang
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Flow Velocity ◽  
Meta Analysis ◽  
Inflammatory Myopathy ◽  
Idiopathic Inflammatory Myopathy ◽  
Diastolic Flow ◽  
Diastolic Velocity ◽  
Echocardiographic Parameters

ABSTRACT Objectives Recent studies have confirmed that heart failure is one of the most important causes of death in patients with idiopathic inflammatory myopathy (IIM). Left ventricle diastolic dysfunction (LVDD) is closely associated with heart failure. Our aim is to determine if the prevalence of LVDD is increased in IIM patients. Methods We performed a time- and language-restricted literature search to identify studies conducted to compare the echocardiographic parameters in IIM patients and controls. Mean differences were used to calculate the effect sizes of the echocardiographic parameters. Results A total of 13 studies met the inclusion criteria and comprised a total of 227 juvenile dermatomyositis (JDM) patients, 391 adult IIM patients, and 550 controls. The adult IIM patients had lower mitral annular early diastolic velocity (eʹ) and peak of early diastolic flow velocity/peak of late diastolic flow velocity (E/A) ratio compared to controls. The mean left atrial dimension and E/eʹ ratio was higher in adult IIM patients as compared to controls. Similarly, in JDM patients, the decreased eʹ was also observed. Conclusion Patients with IIM were more likely to have echocardiographic parameters indicative of diastolic dysfunction. The early heart assessments should be performed in IIM patients.

Left Ventricular Diastolic Dysfunction in Patients with Dermatomyositis Without Clinically Evident Cardiovascular Disease

2014 ◽  
Vol 41 (3) ◽  
pp. 495-500 ◽  
Author(s):  
Han Wang ◽  
Han-Xiong Liu ◽  
Yin-Li Wang ◽  
Xiu-Qiong Yu ◽  
Xian-Xiang Chen ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Flow Velocity ◽  
Disease Duration ◽  
Velocity Ratio ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Control Group ◽  
Diastolic Flow ◽  
Diastolic Velocity ◽  
Cv Disease

Objective.To assess left ventricular (LV) diastolic function in patients with dermatomyositis (DM) without clinically evident cardiovascular (CV) disease and to estimate whether there is an association between the duration of DM and LV diastolic dysfunction (LVDD).Methods.The study included 51 patients with DM (43 women and 8 men) who had no clinically evident CV disease and 51 age-matched and sex-matched healthy controls. Echocardiographic and Doppler studies were conducted in all patients and controls. Early diastolic flow velocity/mitral annular early diastolic velocity (E/Em) was considered a marker for diastolic dysfunction.Results.E/Em was elevated in 39 patients (76.5%) versus 27 controls (52.9%; p < 0.05). There were significant differences between patients versus control group in late diastolic flow velocity (A), E/A ratio, Em, Em/Am (mitral annular late diastolic velocity) ratio, E/Em ratio, and deceleration time (DT; p < 0.05). There was a weak correlation with disease duration between A (r = 0.373, p = 0.007), E/A ratio (r = −0.467, p = 0.001), Em (r = −0.474, p < 0.001), Em/Am ratio (r = −0.476, p < 0.001), E/Em ratio (r = 0.320, p = 0.022), and DT (r = 0.474, p < 0.001). Disease duration was associated with E/Em after controlling for age, sex, and other factors (p < 0.05).Conclusion.Our study confirms a high frequency of LVDD in DM patients without evident CV disease. The association between transmitral flow alteration and disease duration may suggest a subclinical myocardial involvement with disease progression.

Estimation of Left Ventricular Wall Stiffness by Analysis of Late Diastolic Pressure Components

2011 ◽  
Author(s):  
Casandra L. Niebel ◽  
Kelley C. Stewart ◽  
Takahiro Ohara ◽  
John J. Charonko ◽  
Pavlos P. Vlachos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Diastolic Pressure ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Ventricular Wall ◽  
Ventricular Relaxation ◽  
Wall Stiffness ◽  
Ventricular Diastolic Dysfunction

Left ventricular diastolic dysfunction (LVDD) is any abnormality in the filling of the left ventricle and is conventionally evaluated by analysis of the relaxation driven phase, or early diastole. LVDD has been shown to be a precursor to heart failure and the diagnosis and treatment for diastolic failure is less understood than for systolic failure. Diastole consists of two filling waves, early and late and is primarily dependent on ventricular relaxation and wall stiffness.

scholarly journals Dilated Cardiomyopathy in Children and Adults: What is New?

2008 ◽  
Vol 8 ◽  
pp. 762-775 ◽  
Author(s):  
Galal E. Nagib Elkilany ◽  
Mustafa A. AL-Qbandi ◽  
Khaled A. Sayed ◽  
Ibrahim Kabbash
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Diastolic Dysfunction ◽  
Left Ventricular Ejection ◽  
Global Strain ◽  
Independent Risk Factors

Dilated cardiomyopathy (DCM) is the most common form of cardiomyopathy and cause of cardiac transplantation in children and young adults; mortality is high among this patient population. However, mortality, clinical course, and illustrative echocardiographic data of DCM in children and adults are not well established. Our objective was to provide a research article of detailed descriptions of the incidence, causes, outcomes, related risk factors, and new echocardiographic criteria of risk of death from DCM. Our results showed that independent risk factors at DCM diagnosis for subsequent death or transplantation in children cohorts were older age, congestive heart failure, lower left ventricular ejection fraction (EF ≤ 25%), low global strain, significant mitral valve incompetence, pulmonary hypertension, diastolic dysfunction, right ventricular involvement, and cause of DCM (p< 0.001 for all). In adults, low ejection fraction (<30–35%), global peak systolic strain <-7.6%, increased EDV, ESV, LBBB, diastolic dysfunction, and left ventricle dyssynchrony were the main independent risk factors for major cardiac events and need for CRT or transplantation (p< 0.001 for all). Our conclusions were that in children and adults, DCM is a diverse disorder with outcomes that depend largely on cause, age, heart failure status at presentation, and echocardiographic parameters of the heart (systolic and diastolic function of left ventricle, pulmonary artery pressure, global strain, and valvular function of the mitral valve). This study will present new findings in the diagnostic area.

scholarly journals Rapid Progression of Heart Failure in a Patient with Idiopathic Inflammatory Myopathy

2018 ◽  
Vol 6 (8) ◽  
pp. 157-160 ◽  
Author(s):  
Pramod Theetha Kariyanna ◽  
Apoorva Jayarangaiah ◽  
Abdullah Mehmood ◽  
Mitchell Hare ◽  
Nicholas Taklalsingh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Inflammatory Myopathy ◽  
Idiopathic Inflammatory Myopathy ◽  
Rapid Progression

scholarly journals 1028 Early response to a low- dose acubitril/valsartan (ARNI) therapy among stable symptomatic patients with HFrEF

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
W Sacharczuk ◽  
R Dankowski ◽  
A Baszko ◽  
A Sowinska ◽  
S Ozegowski ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Low Dose ◽  
Global Longitudinal Strain ◽  
Early Response ◽  
Lv Function ◽  
Echocardiographic Evaluation ◽  
Heart Failure Questionnaire ◽  
Echocardiographic Parameters ◽  
The Mean

Abstract Funding Acknowledgements no financial support Background Sacubitril/valsartan (S/V) has shown to improve outcomes, that is related to reverse remodeling of the left ventricle (LV) with improved ejection fraction (LVEF) and mitral regurgitation (MR) during long-term therapy. There are limited data on early effects of S/V treatment with respect to the left ventricle function and echocardiographic evaluation of this phenomenon. Aim of the study was to evaluate the early effect of a starting-dose of S/V administered in patients (pts) with stable symptoms of heart failure on clinical symptoms, laboratory tests and echocardiographic parameters using global longitudinal strain (GLS) as a sensitive parameter detecting improvement of LV function. Methods Twenty pts (mean age 60 years, 2 female), with HFrEF (NYHA class II-III) on optimal medical treatment with ICM (75%) or NICM (35%) were included to low-dose S/V treatment (24/26mg) after excluding contraindications. Clinical and echocardiographic evaluation was performed at baseline and after 30 days. The following parameters have been measured: 6-Minutes Walking Test (6MWT) and Minnesota Living with Heart Failure questionnaire, laboratory results and echocardiographic assessment with speckle tracking technique (STE). Results All pts completed 30 days treatment period without complications and no change to medication. During this period the mean values of RR decreased significantly (SBP 129,4mmHg vs 121,25mmHg and DBP 81,6mmHg vs 79,2mmHg respectively). Other clinical parameters did not change. There were no differences NT-pro BNP and TNT levels (respectively 1726 vs 1930 pg/ml and 26 vs 22 ng/ml). After 30days, the mean 6MWT distance increased by 50m (349,5 vs 401,5m p &lt; 0.01), and a positive response was observed in Minnesota Living with Heart Failure Questionnaire (p &lt; 0.001). Echocardiographic parameters revealed positive remodeling of LV and left atrium (LA). There was a significant improvement in LVEDd (67,9mm vs 64,9mm, p &lt; 0.01), LVESd (61,6mm vs 58,8mm, p &lt; 0.01) and stroke volume (40,5 to 45,8ml, p &lt; 0.01). There was no significant increase in LVEF (30% vs 31,5%, p = 0.052). The diastolic parameters of LV function didn’t change during the study. The LA volumes significantly decreased (110 vs 92ml, p &lt; 0.01) during the treatment period as well as the degree of MR (ERO 0.51 vs 0,37 p &lt; 0.01). Out of several LV deformation parameters, only global longitudinal strain has changed significantly (GLS-6,1% vs -7,0%, p = 0,02). The improvement in symptoms and 6MWT correlated only with global systolic radial (RS) and longitudinal (GLS) strain correlated positively after 30 days treatment. Conclusion:Thirty days treatment with low-dose S/V in stable, symptomatic HFrEF patients leads to symptomatic and clinical improvement which correlates with positive remodeling of the left ventricle and reduces the degree of mitral regurgitation. The GLS is a sensitive indicator of LV function improvement after short time S/V treatment and may be used to assess early response.

Diastolic Dysfunction with Normal Heart T2* in Thalassemia Major with Heart Failure. a Single Centre Study

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2457-2457
Author(s):  
Luigi Mancuso ◽  
Angela Vitrano ◽  
Massimiliano Sacco ◽  
Andrea Mancuso ◽  
Antonietta Ledda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Iron Overload ◽  
Diastolic Dysfunction ◽  
Normal Values ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Thalassemia Major ◽  
Doppler Data ◽  
The Right

Abstract Background Heart failure (HF) is the most important cause of death in Thalassemia Major (TM) patients, and results from iron overload which determines progressive systolic dysfunction of the left ventricle. T2* Magnetic Resonance Imaging (CMR) is the only non-invasive tool for detecting and quantifying myocardial iron storage.We had observed that a large number of Thalassemia patients recently observed at our Centre develops a different form of HF, with evidence of diastolic dysfunction and often in absence of systolic dysfunction. Methods We evaluated the clinical, electrocardiographic, echocardiographic and Doppler data of 16 adult Thalassemia patients with HF observed at our Centre between 2008 and 2016, together with the data obtained by means of T2* CMR. All statistical analyses were descriptive. Results are provided as means ± standard deviations, medians with interquartile ranges (IQR), and percentages. Results Table 1 describes demographics, T2* and Echo-Doppler data of 16 TM patients. The 31.2% were females and the mean age was 44.2±5.7 years.One patient presented systolic dysfunction of the left ventricle whereas the others had echocardiographic and Doppler evidence of diastolic dysfunction. Systolic dysfunction of the right ventricle was also found in 81.25% of cases. Furthermore, 30.75% of cases had T2* values consistent with significant risk for heart failure (≤14 ms), whereas the others had normal values. In 68.75% of the cases ECG showed inversion of T wave beyond V2 lead, and low voltages. Conclusions Most of the patients with heart failure recently observed at our Centre had diastolic dysfunction of the left ventricle with normal systolic function, and impairment of systolic function of the right ventricle, and normal values of cardiacT2*. In 68.75% of cases ECG showed inversion of T wave beyond V2 lead and low voltages. Limitations of this study can be summarizes in: a) small number of cases (16 pts); b) Evidence of normal values of T2* values in most patients does not exclude an iron overload in precedent years. However patients with HF due to systolic dysfunction usually show low or very low values; c) a possible bias of this study may be linked to the Centre where this study has been performed. Our Centre is the Reference Centre of Sicilian Region for Thalassemia patients. This implies the possibility of a very strict surveillance of chelation therapy with frequent evaluations of the data of T2* in order to improve at best the treatment with chelation therapy. It is possible that this, at least in part, might prevent the onset of the classical form of systolic dysfunction of the left ventricle due to iron overload, and that in these patients, differently than in patients followed up in other centres, different forms of HF noit linked to cardiac iron overload may occur: that is heart failure preserved ejection fraction (HFpEF), with prevalent left ventricular diastolic dysfunction. Table 1. Demographics, Echo-Doppler and T2* data Table 1. Demographics, Echo-Doppler and T2* data Disclosures No relevant conflicts of interest to declare.

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