scholarly journals Improved Left Ventricular Diastolic Function with Exercise Training in Hypertension: A Doppler Imaging Study

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Huan Zheng ◽  
Ming Luo ◽  
Yi Shen ◽  
Hong Fang
Keyword(s):  
Exercise Training ◽  
Diastolic Function ◽  
Anaerobic Threshold ◽  
Interventricular Septum ◽  
Left Atrial Volume ◽  
Exercise Group ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Volume Index ◽  
Hypertensive Patients

Objective.To study the effects of 6 months’ exercise training on ventricular function in hypertensive patients.Methods.Both groups received routine anti-hypertensive pharmacological therapy and one received a 6 months’ exercise program in addition. All patients underwent incremental cardiopulmonary exercise test and echocardiography in baseline and after 6 months.Results.(1) In 6 months’ follow-up, PeakVO2, Powermax(max workload), AT (anaerobic threshold), VO2AT(VO2at anaerobic threshold), tAT(time from beginning to anaerobic threshold) (), were increased in the exercise group. HRrest(Heart rate at rest) was decreased (). LAVI (left atrial volume index), peak mitral filling velocities during early (E) and late (A) diastole E/A ratio, DT(deceleration time of the mitral E wave), IVST(Interventricular septum thickness in diastole), tissue Doppler indice Mean Ea/Aa ratio () were also improved. (2) Correlation analysis: 4 variates had significant effect on change of PeakVO2in the exercise group: age (), change of HRrest(), change of E/A (), change of Mean Ea/Aa (); Through analyzing 2 groups patients’ baseline values, their age (), VO2AT(), HRrest(), LAVI (), E/A () were found to be independent predictors of MeanEa/Aa. -value under .05 was considered statistically significant.Conclusion.6 months’ exercise could enhance hypertensive patients’ aerobic exercise level and diastolic function to a certain extent.

scholarly journals Association of pericardial adipose tissue with left ventricular structure and function: a region‐specific effect?

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Jin-Seok Kim ◽  
Seon Won Kim ◽  
Jong Seok Lee ◽  
Seung Ku Lee ◽  
Robert Abbott ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Specific Effect ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Structure And Function ◽  
Doppler Imaging ◽  
Volume Index ◽  
2D Echocardiography ◽  
Pericardial Adipose Tissue ◽  
And Function

Abstract Background The independent role of pericardial adipose tissue (PAT) as an ectopic fat associated with cardiovascular disease (CVD) remains controversial. This study aimed to determine whether PAT is associated with left ventricular (LV) structure and function independent of other markers of general obesity. Methods We studied 2471 participants (50.9 % women) without known CVD from the Korean Genome Epidemiology Study, who underwent 2D-echocardiography with tissue Doppler imaging (TDI) and computed tomography measurement for PAT. Results Study participants with more PAT were more likely to be men and had higher cardiometabolic indices, including blood pressure, glucose, and cholesterol levels (all P < 0.001). Greater pericardial fat levels across quartiles of PAT were associated with increased LV mass index and left atrial volume index (all P < 0.001) and decreased systolic (P = 0.015) and early diastolic (P < 0.001) TDI velocities, except for LV ejection fraction. These associations remained after a multivariable-adjusted model for traditional CV risk factors and persisted even after additional adjustment for general adiposity measures, such as waist circumference and body mass index. PAT was also the only obesity index independently associated with systolic TDI velocity (P < 0.001). Conclusions PAT was associated with subclinical LV structural and functional deterioration, and these associations were independent of and stronger than with general and abdominal obesity measures.

scholarly journals The effect of spironolactone on diastolic function in haemodialysis patients

2021 ◽  
Author(s):  
T. Hauser ◽  
◽  
V. Dornberger ◽  
U. Malzahn ◽  
S. J. Grebe ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Diastolic Function ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Left Atrial Volume Index ◽  
Maintenance Haemodialysis ◽  
Significant Difference

AbstractHeart failure with preserved ejection fraction (HFpEF) is highly prevalent in patients on maintenance haemodialysis (HD) and lacks effective treatment. We investigated the effect of spironolactone on cardiac structure and function with a specific focus on diastolic function parameters. The MiREnDa trial examined the effect of 50 mg spironolactone once daily versus placebo on left ventricular mass index (LVMi) among 97 HD patients during 40 weeks of treatment. In this echocardiographic substudy, diastolic function was assessed using predefined structural and functional parameters including E/e’. Changes in the frequency of HFpEF were analysed using the comprehensive ‘HFA-PEFF score’. Complete echocardiographic assessment was available in 65 individuals (59.5 ± 13.0 years, 21.5% female) with preserved left ventricular ejection fraction (LVEF > 50%). At baseline, mean E/e’ was 15.2 ± 7.8 and 37 (56.9%) patients fulfilled the criteria of HFpEF according to the HFA-PEFF score. There was no significant difference in mean change of E/e’ between the spironolactone group and the placebo group (+ 0.93 ± 5.39 vs. + 1.52 ± 5.94, p = 0.68) or in mean change of left atrial volume index (LAVi) (1.9 ± 12.3 ml/m2 vs. 1.7 ± 14.1 ml/m2, p = 0.89). Furthermore, spironolactone had no significant effect on mean change in LVMi (+ 0.8 ± 14.2 g/m2 vs. + 2.7 ± 15.9 g/m2; p = 0.72) or NT-proBNP (p = 0.96). Treatment with spironolactone did not alter HFA-PEFF score class compared with placebo (p = 0.63). Treatment with 50 mg of spironolactone for 40 weeks had no significant effect on diastolic function parameters in HD patients.The trial has been registered at clinicaltrials.gov (NCT01691053; first posted Sep. 24, 2012).

Abstract 14622: Longitudinal Changes in Left Ventricular Diastolic Function in Late Life: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Li Zhao ◽  
Brian Claggett ◽  
Kunihiro Matsushita ◽  
Dalane W Kitzman ◽  
Aaron R Folsom ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Diastolic Function ◽  
Left Atrial Volume ◽  
Late Life ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Atrial Volume Index ◽  
Longitudinal Changes ◽  
Aric Study

Introduction: Diastolic dysfunction is a potent risk factor for heart failure (HF). However, there is limited data regarding longitudinal changes of diastolic function in the very old, who are at the highest risk for HF. Methods: We studied 2,559 community-based elderly participants in the prospective ARIC study who underwent protocol echocardiography, were in sinus rhythm at study Visits 5 (2011-2013) and 7 (2018-2019), and did not have an interval myocardial infarction. The primary diastolic measures were Tissue Doppler e’, E/e’ ratio, and left atrial volume index (LAVi). Results: Mean age at Visit 5 was 74±4 years, 59% were women, and 25% black. At Visit 5, mean e’ was 5.8±1.4 cm/s, E/e’ 11.8±3.6, and LAVi 24.3±6.7 ml/m 2 . Over a mean of 6.5±3.1 years, e’ decreased by 0.6±1.4 cm/s, E/e’ increased by 3.1±4.5, and LAVi increased by 1.4±7.7 ml/m 2 . Using validated ARIC-based cut-points, there was significant increase in the proportion of participants with abnormal e’ (18% at Visit 5 to 34 % at Visit 7), E/e’ (20% vs 46%), LAVi (17% vs 25%; all p<0.01), and in the number of abnormal diastolic measures ( Figure ). Compared to participants free of cardiovascular (CV) risk factors or CV diseases (n=237), those with CV risk factors or diseases at Visit 5 (n=2,210) demonstrated greater increases in E/e’ (2.3±3.9 vs 3.1±4.5 respectively; p=0.006) and LAVi (0.0±7.0 vs 1.5±7.7 ml/m 2 ; p=0.008) while increases in E/e’ (5.0±5.1; p<0.001) and LAVi (4.6±8.7 ml/m 2 ; p<0.001) were the most prominent in those who developed HF between Visits 5 and 7 (n=60). Conclusions: Diastolic function progressively worsens over 6.5 years in late life, particularly among persons with CV risk factors. Further studies are necessary to determine if risk factor prevention or control will mitigate these changes.

scholarly journals Effect of different ranges of systolic blood pressure on left ventricular structure and diastolic function in a Chinese population: a cross-sectional population-based Shunyi study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028398
Author(s):  
Liu Yongtai ◽  
Lai Jinzhi ◽  
Zhou Lixin ◽  
Zhai Feifei ◽  
Zhang Dingding ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Function ◽  
Chinese Population ◽  
Reference Group ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Volume Index ◽  
Cross Sectional ◽  
Group 1

ObjectivesTo evaluate the effect of different ranges of systolic blood pressure (SBP) on left ventricular (LV) geometry and diastolic function in Chinese population.DesignCross-sectional study.SettingPeking Union Medical College Hospital in Beijing, China.ParticipantsAll inhabitants aged 35 years or older, living in five villages of Shunyi were invited. Exclusion criteria included individuals who declined participation, presence of moderate to severe valvular heart disease, persistent atrial fibrillation and suboptimal echocardiograms.InterventionsThe baseline data of 1051 participants were analysed. The relationship between SBP and LV geometric and diastolic function assessed by echocardiography was analysed after adjusting for conventional cardiac risk factors.ResultsThe adjusted value of SBP was independently associated with LV hypertrophy (LVH) and LV diastolic dysfunction (LVDDF) (all p<0.01). Setting individuals with SBP <120 mm Hg as the reference group (group 1), those with SBP between 120 mm Hg and 140 mm Hg (group 2) had higher risk odds of LVH and those with SBP ≥140 mm Hg (group 3) had higher risk odds of LVH and LVDDF (all p<0.01). With the increase of SBP, LV mass index (LVMI) and E/e′ stepwise increased and e′ stepwise decreased significantly from group 1 to 3 (all p<0.05). In the whole population, SBP was independently correlated with LVMI, LVEDD, Left Atrial Volume Index, e′, and E/e′ (all p<0.01).ConclusionsSBP was independently related to LVH and LVDDF, SBP between 120 and 140 mm Hg was independently related to worse LV remodelling and diastolic function, these findings indicated the potential benefit of intensive SBP control.

scholarly journals Association of Pericardial Adipose Tissue With Left Ventricular Structure and Function: A Region-specific Effect?

2020 ◽  
Author(s):  
Jin-Seok Kim ◽  
Seon Won Kim ◽  
Jong Seok Lee ◽  
Seung Ku Lee ◽  
Robert Abbott ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Specific Effect ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Structure And Function ◽  
Doppler Imaging ◽  
Volume Index ◽  
Functional Changes ◽  
Pericardial Adipose Tissue ◽  
And Function

Abstract Background: The independent role of pericardial adipose tissue (PAT) as an ectopic fat associated with cardiovascular disease (CVD) remains controversial. This study aimed to determine whether PAT is associated with left ventricular (LV) structure and function independent of other markers of general obesity.Methods: We studied 2,471 participants (50.9% women) without known CVD from the Korean Genome Epidemiology Study, who underwent 2D-echocardiography with tissue Doppler imaging (TDI) and computed tomography measurement for PAT.Results: Study participants with more PAT were more likely to be men and had higher cardiometabolic indices, including blood pressure, glucose, and cholesterol levels (all P <0.001). Greater pericardial fat levels across quartiles of PAT were associated with increased LV mass index and left atrial volume index (all P <0.001) and decreased systolic (P = 0.015) and early diastolic (P <0.001) TDI velocities, except for LV ejection fraction. These associations remained after a multivariable-adjusted model for traditional CV risk factors and persisted after additional adjustment for general adiposity measures, such as waist circumference and body mass index. PAT was the only obesity index independently associated with systolic TDI velocity (P <0.001).Conclusions: PAT was associated with subclinical LV structural and functional changes, and these associations were independent of and stronger than with general and abdominal obesity measures.

Serum uric acid possibly associated with abnormal left ventricular diastolic function in healthy individuals

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.W Liu ◽  
C.M Tu
Keyword(s):  
Uric Acid ◽  
Diastolic Function ◽  
Serum Uric Acid ◽  
Elevated Serum ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Volume Index ◽  
Funding Source ◽  
Healthy Individuals ◽  
Left Atrial Volume Index

Abstract Background Elevated serum uric acid (SUA) is reportedly associated with the traditional left ventricular diastolic dysfunction (LVDD). Purpose We aimed to investigate the association between SUA and the contemporarily defined LV diastolic function (LVDF). Methods We prospectively enrolled healthy individuals who underwent echocardiography to evaluate electrocardiographic abnormalities at the health exam between 1st Jan 2018 and 31th Dec 2019. The evaluation for LVDF includes four criteria: (1) septal E' velocity &lt;7 cm/s or lateral E' &lt;10 cm/s. (2) average E/e' ≥14, (3) left atrial volume index (LAVI) &gt;34 ml/m2, (4) tricuspid regurgitation (TR) velocity &gt;2.8 m/s. The study interest were the presence of the LVDF criteria for each or combined. Results The study consisted of 275 healthy individuals (89% male) with the mean age of 32.9±7.6 years and SUA of 6.1±1.3 mg/dl. The hyperuricemic (N=77) vs. normouricemic (N=198) groups had greater ratio of septal e' &lt;7 (18.2% vs. 5.6%, P=0.002), lateral e' &lt;10 (26% vs. 10.8%, P=0.003), the composite of septal e' &lt;7 or lateral e' &lt;10 (31.6% vs. 13.3%, P=0.001), and average E/e' &gt;14 (3.9% vs. 0%, P=0.021). SUA remained significantly associated with septal e' &lt;7 cm/s (adjusted HR: 1.704, 95% CI: 1.093–2.655, P=0.019) and the presence of any LVDF criteria (adjusted HR: 1.342, 95% CI: 1.044–1.724, P=0.022); Trends toward significant association were found between SUA and average E/e' &gt;14 (adjusted HR: 1.330, 95% CI: 0.981–1.804, P=0.066) and between SUA and lateral e' &lt;10cm/s (adjusted HR: 1.342, 95% CI: 0.970–1.857, P=0.076). Conclusions Elevated SUA was associated with abnormal LVDF in the healthy individuals with normal kidney function. Maintaining SUA level within a normal limit may prevent from the development of abnormal LVDF and LVH. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Tri-service General Hospital, Songshan branch

Essential hypertension worsens left ventricular contractility in systemic sclerosis

2021 ◽  
pp. jrheum.200873
Author(s):  
Valentina Mercurio ◽  
Alicia M. Hinze ◽  
Laura K. Hummers ◽  
Fredrick M. Wigley ◽  
Ami A. Shah ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Cardiovascular Risk ◽  
Systemic Sclerosis ◽  
Diastolic Function ◽  
Global Longitudinal Strain ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Volume Index ◽  
Control Groups ◽  
Normal Lvef

Objective Primary cardiac involvement in systemic sclerosis (SSc) is prevalent and morbid, however the influence of traditional cardiovascular risk factors such as essential hypertension (HTN) are unclear. In the present study, we sought to understand the effects of HTN on left ventricular (LV) contractility in SSc patients using echocardiographic speckle-derived global longitudinal strain (GLS). Methods 56 SSc patients with HTN (SSc+HTN+) and 82 SSc patients without HTN (SSc+ HTN-) were compared with 40 non-SSc controls with HTN (SSc-HTN+) and 40 non-SSc controls without HTN (SSc-HTN-), matched by age and sex. All HTN patients were on stable antihypertensive therapies. Echocardiographic measures included LV ejection fraction (LVEF), left atrial volume index (LAVi), and LV diastolic function. LV contractility was assessed by GLS, averaged across the 18 LV segments. Results SSc patients had diminished GLS regardless of HTN status when compared to both control groups despite normal LVEF, p<0.001. SSc+HTN+ had the highest prevalence of diastolic dysfunction with significantly higher septal E/e’, a marker of LV filling pressures (p<0.05), as well as the largest reduction in GLS compared to SSc+HTN- and both control groups. Conclusion Speckle-derived strain revealed diminished LV contractility in SSc patients despite normal LVEF. SSc+HTN+ had more prominent reductions in GLS associated with evidence of LV remodeling and worsened diastolic function. Our findings demonstrate the presence of subclinical LV contractile dysfunction in SSc that is further exacerbated by concomitant HTN, thereby identifying HTN as an important modifiable cardiovascular risk factor that should be managed aggressively in this at-risk population.

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