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.

scholarly journals Changes in Mitral Annular Ascent with Worsening Echocardiographic Parameters of Left Ventricular Diastolic Function

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Paula M. Hernández Burgos ◽  
Angel López-Candales
Keyword(s):  
Ejection Fraction ◽  
Diastolic Function ◽  
Electromechanical Coupling ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Clinical Indication ◽  
Ventricular Ejection Fraction ◽  
Stage 1 ◽  
Lv Diastolic Function

Background. While the mitral annular plane systolic excursion (MAPSE) has been suggested as a surrogate measurement of left ventricular ejection fraction, less is known about the relative value of mitral annular ascent (MAa).Methods. Our database was queried for complete transthoracic echocardiograms performed for any clinical indication. Baseline echocardiographic measurements were compared to determine any correlation between MAa and traditional Echo-Doppler echocardiographic measures to characterize left ventricular diastolic dysfunction (LVDD).Results. Patients with normal LV diastolic function were younger (41±13years) than patients with LVDD (stage 1:61±13years; stage 2:57±14years; and stage 3:66±17years;p=0.156). LV ejection fraction decreased in patients with stage 2 LVDD (63±17%) and was further reduced in patients with stage 3 LVDD (28±21;p=0.003).Discussion. While a vigorous MAa excursion was seen in patients with stage 1 LVDD, MAa significantly decreased in stage 2 and stage 3 LVDD patients. Our results highlight the importance of atrioventricular coupling, as MAa motion seems to reflect changes in left atrial pressure. Additional studies are now required to better examine atrioventricular interactions and electromechanical coupling that might improve our assessment of LV diastolic function.

scholarly journals Positive effect of dapagliflozin on left ventricular longitudinal function for type 2 diabetic mellitus patients with chronic heart failure

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Tanaka ◽  
F Soga ◽  
K Tatsumi ◽  
Y Mochizuki ◽  
H Sano ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Function ◽  
Myocardial Function ◽  
Sglt2 Inhibitor ◽  
Left Ventricular ◽  
Sglt2 Inhibitors ◽  
Prospective Multicenter Study ◽  
Lv Diastolic Function

Abstract Background Type 2 diabetes mellitus (T2DM) has come to be considered an independent predictor of mortality, and also a contributor to the development of heart failure (HF) with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). Left ventricular (LV) longitudinal myocardial dysfunction as assessed in terms of lower global longitudinal strain (GLS), has been identified even in T2DM patients with preserved LV ejection fraction (LVEF), and should be considered the first marker of a preclinical form of DM-related cardiac dysfunction, leading to HFpEF. Sodium glucose cotransporter type 2 (SGLT2) inhibitors represent a new class of anti-hyperglycemic agents for T2DM, but the effect of SGLT2 inhibitors on LV longitudinal myocardial function in T2DM patients with HF remains uncertain. To examine this effect, as well as the association of LV longitudinal myocardial function with LV diastolic function after administration of SGLT2 inhibitor in T2DM patients with stable HF, we analyzed data from our previous prospective multicenter study, in which we investigated the effect of SGLT2 inhibitor on LV diastolic functional parameters of T2DM patients with stable HF at five institutions in Japan. Methods Our previous trial was a prospective multicenter study of 58 T2DM patients with stable HF at five institutions in Japan. Patients who had been taking at least one antidiabetic drugs other than SGLT2 inhibitors started the administration of 5 mg/day of dapagliflozin. Echocardiography was performed at baseline and 6 months after administration of dapagliflozin. LV diastolic function was defined as the ratio of mitral inflow E to mitral e' annular velocities (E/e'). LV longitudinal myocardial function was assessed as GLS based on the current guidelines. Results E/e' significantly decreased from 9.3 to 8.5 cm/s 6 months after administration of dapagliflozin (p=0.020) as previously described, while GLS showed significant improvement from 15.5±3.5% to 16.9±4.1% (p&lt;0.01) 6 months after administration of dapagliflozin. Furthermore, improvement of GLS in HFpEF patients was more significant from 17.0±1.9% to 18.7±2.0% (p&lt;0.001), compared to that in HFrEF patients from 11.3±3.8% to 11.8±4.6% (p=0.13). It was noteworthy that multiple regression analysis showed that the change in GLS after administration of dapagliflozin was the only independent determinant parameter for the change in E/e' after administration of dapagliflozin. Conclusion Dapagliflozin was found to be associated with improvement of LV longitudinal myocardial function, which led to further improvement of LV diastolic function of T2DM patients with stable HF. GLS-guided management may thus lead to improved management of T2DM patients with stable HF. Representative case Funding Acknowledgement Type of funding source: None

scholarly journals P1508 Left ventricular diastolic function plays a different role on mortality depending on the severity of systolic dysfunction in acute heart failure patients with reduced ejection fraction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Nakamura ◽  
A Yamada ◽  
S Jinno ◽  
M Kato ◽  
A Takahashi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Function ◽  
Acute Heart Failure ◽  
Cardiac Death ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Group Iii ◽  
Group I ◽  
Lv Diastolic Function

Abstract Background It remains to be clarified whether clinical significance of left ventricular (LV) diastolic function differs depending on the severity of LV systolic dysfunction in patients with acute heart failure (AHF). The aim of this study was to examine the prognostic role of LV diastolic function in AHF patients with various systolic dysfunction.Methods: We studied consecutive hospitalized AHF patients with LV ejection fraction (LVEF) &lt;50%. The exclusion criteria were as follows: atrial fibrillation, severe mitral regurgitation, and inadequate echo image quality. They underwent echocardiography on admission. The eligible patients (n = 289, 165 males, 76 ± 10 years) were divided into 4 groups based on LVEF and left atrial pressure (LAP) grade estimated as in the ESC guidelines: Group I (LVEF 40-49% (mildly reduced LVEF)/normal LAP, n = 28), II (mildly reduced EF/increased LAP, n = 38), III (LVEF &lt;40% (severely reduced LVEF)/normal LAP, n = 110), and IV (severely reduced LVEF/increased LAP, n = 113). Cardiac death was examined up to 60 months.Results: In total, 58 patients (20%) died because of cardiac events during the follow-up (mean 20 ± 19 months). In patients with mildly reduced LVEF, Group I showed significantly less cardiac death ratio than II (n = 1 vs 10, Group I vs II, p = 0.03). On the other hand, in patients with severely reduced LVEF, there was no significant difference in cardiac death ratio between Group III and IV (n = 23 vs 24, Group III vs IV, p = 0.80). That is, LAP grade was a prognostic marker when the patients had mild LV systolic dysfunction, whereas it did not contribute to the prediction of cardiac mortality when patients showed severely reduced LV systolic function. Group I showed significantly better prognosis than those with severe LV systolic dysfunction regardless of LAP grade (Group III, IV) (Group I vs III, p = 0.04; Group I vs IV, p = 0.04).Conclusions: LV diastolic function may have a different clinical significance depending on the severity of LV systolic dysfunction in AHF patients.

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.

scholarly journals Association of glycemic variability with left ventricular diastolic function in type 2 diabetes mellitus

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Shun Yokota ◽  
Hidekazu Tanaka ◽  
Yasuhide Mochizuki ◽  
Fumitaka Soga ◽  
Kentaro Yamashita ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Ejection Fraction ◽  
Diastolic Function ◽  
Glycemic Variability ◽  
Left Ventricular ◽  
Lv Diastolic Dysfunction ◽  
Lv Diastolic Function

Abstract Background Type 2 diabetes mellitus (T2DM) is a major cause of heart failure (HF) with preserved ejection fraction (HFpEF), usually presenting as left ventricular (LV) diastolic dysfunction. Thus, LV diastolic function should be considered a crucial marker of a preclinical form of DM-related cardiac dysfunction. However, the impact of glycemic variability (GV) on LV diastolic function in such patients remains unclear. Methods We studied 100 asymptomatic T2DM patients with preserved LV ejection fraction (LVEF) without coronary artery disease (age: 60 ± 14 years, female: 45%). GV was evaluated as standard deviation of blood glucose level using continuous glucose monitoring system for at least 72 consecutive hours. LV diastolic function was defined as mitral inflow E and mitral e’ annular velocities (E/e’), and > 14 was determined as abnormal. Results E/e’ in patients with high GV (≥ 35.9 mg/dL) was significantly higher than that in patients with low GV (11.3 ± 3.9 vs. 9.8 ± 2.8, p = 0.03) despite similar age, gender-distribution, and hemoglobin A1c (HbA1c). Multivariate logistic regression analysis showed that GV ≥ 35.9 mg/dL (odds ratio: 3.67; 95% confidence interval: 1.02–13.22; p < 0.05) was an independently associated factor, as was age, of E/e’ > 14. In sequential logistic models for the associations of LV diastolic dysfunction, one model based on clinical variables including age, gender and hypertension was not improved by addition of HbA1c (p = 0.67) but was improved by addition of high GV (p = 0.04). Conclusion Since HFpEF is a syndrome caused by diverse agents, reducing GV may represent a potential new therapeutic strategy for the prevention of the development of HFpEF in T2DM patients.

scholarly journals Geographic origin as a determinant of left ventricular mass and diastolic function – the Cardiovascular Risk in Young Finns Study

2018 ◽  
Vol 46 (6) ◽  
pp. 630-637 ◽  
Author(s):  
L. Vähämurto ◽  
M. Juonala ◽  
S. Ruohonen ◽  
N. Hutri-Kähönen ◽  
M. Kähönen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Diastolic Function ◽  
Geographic Origin ◽  
Left Ventricular ◽  
Chd Risk ◽  
Lv Mass ◽  
Chd Risk Factors ◽  
Lv Diastolic Function ◽  
Young Finns Study

Aims: Eastern Finns have higher risk of coronary heart disease (CHD) and carotid intima-media thickness than western Finns although current differences in CHD risk factors are minimal. Left ventricular (LV) mass and diastolic function predict future cardiovascular events but their east–west differences are unknown. We examined the association of eastern/western baseline origin with LV mass and diastolic function. Methods : The study population included 2045 subjects of the Cardiovascular Risk in Young Finns Study with data from the baseline survey (1980) and the latest follow-up (2011) when echocardiography was performed at the age of 34–49 years. Results: Subjects with eastern baseline origin had in 2011 higher LV mass (139±1.0 vs. 135±1.0 g, p=0.006) and E/e′-ratio indicating weaker LV diastolic function (4.86±0.03 vs. 4.74±0.03, p=0.02) than western subjects. Results were independent of age, sex, area of examination and CHD risk factors such as blood pressure and BMI (LV mass indexed with height: p<0.0001; E/e′-ratio: p=0.01). LV end-diastolic volume was higher among subjects with eastern baseline origin (135±0.9 vs. 131±0.9 ml, p=0.0011) but left atrial end-systolic volume, also indicating LV diastolic function, was not different between eastern and western subjects (43.4±0.5 vs. 44.0±0.5 ml, p=0.45). Most of the subjects were well within the normal limits of these echocardiographic measurements. Conclusions: In our healthy middle-aged population, geographic origin in eastern Finland associated with higher LV mass compared to western Finland. Higher E/e′-ratio suggests that subjects with eastern baseline origin might have higher prevalence of diastolic dysfunction in the future than western subjects.

scholarly journals Effect of monomeric adiponectin on cardiac function and perfusion in anesthetized pig

2014 ◽  
Vol 222 (1) ◽  
pp. 137-149 ◽  
Author(s):  
Elena Grossini ◽  
Flavia Prodam ◽  
Gillian Elisabeth Walker ◽  
Lorenzo Sigaudo ◽  
Serena Farruggio ◽  
...  
Keyword(s):  
Blood Flow ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Cardiac Function ◽  
Diastolic Function ◽  
Coronary Blood Flow ◽  
Left Ventricular ◽  
Autonomic Nervous ◽  
Arterial Blood ◽  
No Release

Adiponectin, the most abundant adipokine released by adipose tissue, appears to play an important role in the regulation of vascular endothelial and cardiac function. To date, however, the physiological effects of human monomeric adiponectin on the coronary vasculature and myocardial systo-diastolic function, as well as on parasympathetic/sympathetic involvement and nitric oxide (NO) release, have not yet been investigated. Thus, we planned to determine the primaryin vivoeffects of human monomeric adiponectin on coronary blood flow and cardiac contractility/relaxation and the related role of autonomic nervous system, adiponectin receptors, and NO. In 30 anesthetized pigs, human monomeric adiponectin was infused into the left anterior descending coronary artery at constant heart rate and arterial blood pressure, and the effects on coronary blood flow, left ventricular systo-diastolic function, myocardial oxygen metabolism, and NO release were examined. The mechanisms of the observed hemodynamic responses were also analyzed by repeating the highest dose of human monomeric adiponectin infusion after autonomic nervous system and NO blockade, and after specific adiponectin 1 receptor antagonist administration. Intracoronary human monomeric adiponectin caused dose-related increases of coronary blood flow and cardiac function. Those effects were accompanied by increased coronary NO release and coronary adiponectin levels. Moreover, the vascular effects of the peptide were prevented by blockade of β2-adrenoceptors and NO synthase, whereas all effects of human monomeric adiponectin were prevented by adiponectin 1 receptor inhibitor. In conclusion, human monomeric adiponectin primarily increased coronary blood flow and cardiac systo-diastolic function through the involvement of specific receptors, β2-adrenoceptors, and NO release.

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&lt;0.05) and females (26.9±1.4 vs 32.5±1.8%; p&lt;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&lt;0.05) and females (2.1±0.3 vs 1.6±0.1; p&lt;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&lt;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&lt;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.

scholarly journals Positive effect of dapagliflozin on left ventricular longitudinal function for type 2 diabetic mellitus patients with chronic heart failure

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Hidekazu Tanaka ◽  
Fumitaka Soga ◽  
Kazuhiro Tatsumi ◽  
Yasuhide Mochizuki ◽  
Hiroyuki Sano ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Function ◽  
Longitudinal Strain ◽  
Myocardial Function ◽  
Global Longitudinal Strain ◽  
Sglt2 Inhibitor ◽  
Left Ventricular ◽  
Lv Diastolic Function

Abstract Background The effect of sodium glucose cotransporter type 2 (SGLT2) inhibitor on left ventricular (LV) longitudinal myocardial function in type 2 diabetes mellitus (T2DM) patients with heart failure (HF) has remained unclear. Methods We analyzed data from our previous prospective multicenter study, in which we investigated the effect of the SGLT2 inhibitor dapagliflozin on LV diastolic functional parameters of T2DM patients with stable HF at five institutions in Japan. Echocardiography was performed at baseline and 6 months after administration of dapagliflozin. LV diastolic function was defined as the ratio of mitral inflow E to mitral e′ annular velocities (E/e′). LV longitudinal myocardial function was assessed as global longitudinal strain (GLS), which in turn was determined as the averaged peak longitudinal strain from standard LV apical views. Results E/e′ significantly decreased from 9.3 to 8.5 cm/s 6 months after administration of dapagliflozin (p = 0.020) as previously described, while GLS showed significant improvement from 15.5 ± 3.5% to 16.9 ± 4.1% (p < 0.01) 6 months after administration of dapagliflozin. Furthermore, improvement of GLS in HF with preserved ejection fraction patients was more significant from 17.0 ± 1.9% to 18.7 ± 2.0% (p < 0.001), compared to that in HF with mid-range ejection fraction and HF with reduced ejection fraction patients from 14.4 ± 2.4% to 15.5 ± 1.8% (p = 0.06) and from 8.1 ± 1.5% to 7.8 ± 2.1% (p = 0.44), respectively. It was noteworthy that multiple regression analysis showed that the change in GLS after administration of dapagliflozin was the only independent determinant parameters for the change in E/e′ after administration of dapagliflozin. Conclusion Dapagliflozin was found to be associated with improvement of LV longitudinal myocardial function, which led to further improvement of LV diastolic function of T2DM patients with stable HF. GLS-guided management may thus lead to improved management of T2DM patients with stable HF.

17β-Estradiol treatment reversed left ventricular dysfunction in castrated male rats: an echocardiographic study

2018 ◽  
Vol 96 (8) ◽  
pp. 850-854 ◽  
Author(s):  
Tomas Baka ◽  
Julius Hodosy ◽  
Kristina Krajcirovicova ◽  
Kristina Repova ◽  
Silvia Aziriova ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Diastolic Function ◽  
Left Ventricular ◽  
Male Rats ◽  
Testosterone Deficiency ◽  
Estradiol Treatment ◽  
17Β Estradiol ◽  
Lv Ejection Fraction ◽  
Lv Diastolic Function ◽  
Fractional Shortening

No data are available on heart function in chronic testosterone deficiency and on the effect of estrogen treatment. Eighteen 4-week-old male Lewis rats were randomly divided into 3 groups (n = 6): 1 group of sham-operated rats and 2 groups of castrated rats. Sixty-six weeks after surgery, 1 castrated group received a dose of 17β-estradiol (10 μg/kg per day) and the remaining 2 groups received a placebo subcutaneously for 14 days. Left ventricular (LV) systolic and diastolic functions were measured by transthoracic echocardiography. Castration decreased LV ejection fraction (9%) and fractional shortening (15%) and deteriorated LV diastolic function (94%). 17β-Estradiol treatment increased LV ejection fraction (15%) and fractional shortening (31%) and improved LV diastolic function (48%). Plasma testosterone concentrations were decreased in both castrated groups. In conclusion, chronic testosterone deficiency induced LV systolic and diastolic dysfunction; these disorders were reversed by short-term treatment with 17β-estradiol.

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