Abstract 3360: Depressed Left Atrial Function and its Relation to Left Ventricular Filling Pressure in Systolic Heart Failure Patients.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Erberto Carluccio ◽  
Macello Chinali ◽  
Paolo Biagioli ◽  
Daniela Girfoglio ◽  
Marina De Marco ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Atrial ◽  
Diastolic Pressure ◽  
Nyha Class ◽  
Systolic Heart Failure ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Atrial Function ◽  
Lv Function ◽  
Filling Pattern

Background : In uncomplicated hypertensive patients with preserved left ventricular (LV) function, enhanced left atrial systolic force (LASF) is associated with LV hypertrophy. In contrast, in patients with prevalent cardiovascular disease, reduced LASF has been shown to be associated with incident atrial fibrillation and poor cardiovascular prognosis. To date the relation between LASF and LV filling pressures in patients with systolic heart failure (HF) has not been adequately investigated. Methods : Doppler echocardiographic measurements of LV systolic, diastolic, and Tissue-Doppler longitudinal function, were obtained in 108 patients (66±12 years; 20% women) with systolic HF [NYHA class III; ejection fraction <40% (mean EF%=27.7±7.7%)]. LASF was calculated from mitral orifice area and transmitral peak A velocity. Population study was dichotomized according to the presence or absence of restrictive filling pattern (RF), defined as DT <150 ms. LV end-diastolic pressure (LVEDP) was derived combining transmitral peak E velocity and tissue Doppler E’ (E/E’ ratio). Results : In the overall population, LASF averaged 10.7±5.8 kdynes. LASF was significantly reduced in patients showing RF (n = 43; 39.8% of study population) compared to non-RF patients (8.1±4.8 vs 12.5±5.8 kdynes, p<0.0001). Consistent with this finding, LVEDP was significantly higher in RF patients (p<0.001). In RF patients, LASF was correlated positively with EF% (r=0.23, p<0.05) and TD systolic peak velocity (r=0.39, p<0.0001), and negatively with isovolumic relaxation time (r=0.68, p<0.0001). In additional analysis comparing quartiles of LV end-diastolic pressure, LASF decreased with increasing quartiles of LV end-diastolic pressure (13.7±7 kdynes vs 12±7 kdynes vs 10.6±5 kdynes vs 8±4 kdynes; p for trend <0.01). Conclusions : In systolic HF patients in class NYHA III, left atrial systolic force is reduced in the presence of restrictive filling pattern due in part to increased LV end-diastolic pressure, also associated with reduced LV systolic performance. In CHF patients, increased LVEDP partially blunts LA atrial function, and might be considered as an index of atrial afterload.

Left Atrial Function Predicts Heart Failure Events in Patients With Newly Diagnosed Left Ventricular Systolic Heart Failure During Short-Term Follow-Up

Angiology ◽  
2013 ◽  
Vol 65 (9) ◽  
pp. 817-823 ◽  
Author(s):  
Christina Chrysohoou ◽  
Iason Kotroyiannis ◽  
Christos-Constadinos Antoniou ◽  
Stella Brili ◽  
Sophia Vaina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Atrial ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Newly Diagnosed ◽  
Short Term

scholarly journals Left atrial function index predicts long-term survival in stable outpatients with systolic heart failure

2016 ◽  
Vol 18 (2) ◽  
pp. 119-127 ◽  
Author(s):  
Luis Sargento ◽  
Andre Vicente Simões ◽  
Susana Longo ◽  
Nuno Lousada ◽  
Roberto Palma dos Reis
Keyword(s):  
Heart Failure ◽  
Left Atrial ◽  
Systolic Heart Failure ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Term Survival ◽  
Long Term Survival ◽  
Function Index

Abstract P237: Is Ischemia/Reperfusion an Efficient Method for Producing Heart Failure in Rats?

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Ana Carolina M Omoto ◽  
Fábio N Gava ◽  
Mauro de Oliveira ◽  
Carlos A Silva ◽  
Rubens Fazan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diastolic Pressure ◽  
Histopathological Examination ◽  
Ischemia Reperfusion ◽  
Mitral Annulus ◽  
Mortality Rates ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Coronary Artery Ligation ◽  
Artery Ligation

Myocardium infarction (MI) elicited by coronary artery ligation (CAL) is commonly used to induce chronic heart failure (HF) in rats. However, CAL shows high mortality rates. Given that ischemia-reperfusion (IR) may cause the development of HF, this approach may be useful for obtaining a model of HF with low mortality rates. Therefore, it was compared the model of CAL vs. IR in rats, evaluating the mortality and cardiac morphological and functional aspects. The IR consisted of 30 minutes of cardiac ischemia. Wistar rats were assigned into three groups: CAL: n=18; IR: n=7; SHAM (fictitious IR): n=7. After four weeks of CAL, the subjects were evaluated by echocardiography and ventriculography as well. The statistical analysis consisted of ANOVA combined with Tukey’s posthoc test (p<0.05). There were no deaths in the IR and SHAM groups, whereas in the CAL group the mortality rate was 33.33% (6 out of 18). In the CAL group echocardiography showed increased left ventricular (LV) cavity during systole (8.3 ± 1mm) and diastole (10.5 ± 1mm); decreased LV free wall during systole (1.4 ± 0.5 mm); increased left atrium/aorta (2.3 ± 0.4) ratio. These changes were not significant in IR (4.8 ± 0.5mm, 7.6 ± 0.6mm, 2.6 ± 0.3 mm, 1.6 ± 0.2) and SHAM (4.6 ± 0.6 mm, 7.7 ± 0.8mm, 2.8 ± 0.4mm, 1.5 ± 0.2) groups. There was also the reduction in the ejection fraction in the CAL group (41 ± 12 %) when compared with IR (65 ± 9%) and SHAM (69 ± 7%) groups. The tissue Doppler analysis from the lateral mitral annulus showed reduction in E′ in CAL (-29 ± 8 mm/s) and IR (-31± 9 mm/s) groups when compared with the SHAM (-48 ± 11 mm/s) group. The ventriculography in the CAL group showed smaller maximum dP/dt (6519 ± 1062) and greater end-diastolic pressure (33 ± 8 mmHg) when compared with IR (8716 ± 756 mmHg/s; 9 ± 9 mmHg) and SHAM (7989 ± 1230 mmHg/s; 9 ± 7 mmHg) groups. The CAL group presented transmural infarct size of 40% of the left ventricular wall, measured under histopathological examination. In conclusion, IR for 30 minutes caused only small changes in LV diastolic function, assessed by tissue Doppler; however, the IR was not effective for promoting HF, as observed with CAL. Thus, it is possible that prolonged IR is necessary for promoting significant HF in rats.

Left ventricular Doppler filling pattern in dilated cardiomyopathy: Relation to hemodynamics and left atrial function

1997 ◽  
Vol 10 (5) ◽  
pp. 518-525 ◽  
Author(s):  
Takahide Ito ◽  
Michihiro Suwa ◽  
Yoshiaki Otake ◽  
Ayaka Moriguchi ◽  
Yuzo Hirota ◽  
...  
Keyword(s):  
Dilated Cardiomyopathy ◽  
Left Atrial ◽  
Left Ventricular ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Filling Pattern

Abstract 15172: Murf1 Inhibitor Embl205 is a New Approach for Treatment of Heart Failure With Preserved Ejection Fraction in an Animal Model

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Anett Jannasch ◽  
Antje Schauer ◽  
Virginia Kirchhoff ◽  
Runa Draskowsi ◽  
Claudia Dittfeld ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Pressure ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Skeletal Muscle Atrophy ◽  
Lv Function ◽  
Preserved Ejection Fraction ◽  
The Impact ◽  
Peak Gradient

Background: The novel MuRF1 inhibitor EMBL205 attenuates effectively developing skeletal muscle atrophy and dysfunction in animals with heart failure with preserved ejection fraction (HFpEF, ZSF1 rat model). The impact of EMBL205 on myocardial function in the HFpEF setting is currently unknown and was evaluated in ZSF1 rats. Methods: 20 wks-old female obese ZSF1 rats received EMBL205 (12 wks, conc. of 0.1% in chow; HFpEF-EMBL205). Age-matched untreated lean (con) and obese (HFpEF) ZSF1 rats served as controls. At 32 wks of age left ventricular (LV)-, aortic valve (AV) function and LV end diastolic pressure (LVEDP) was determined by echocardiography and invasive hemodynamic measurements. LV expression of collagen 1A (Col1A) and 3A (Col3A) was assessed by qRT-PCR, MMP2 expression was obtained by zymography and perivascular fibrosis was quantified in histological sections. Results: Development of HFpEF in ZSF1 obese animals is associated with cardiac enlargement and hypertrophy, as evident by increased myocardial weight, an increase in end diastolic volume (EDV) and LV anterior and posterior wall diameters. Diastolic LV-function is disturbed with elevation of E/é, an increased LVEDP and a preserved LV ejection fraction. AV peak velocity and peak gradient are significantly increased and AV opening area (AVA) significantly decreased. Col1A and Col3A expression are increased in HFpEF animals. EMBL205 treatment results in a significant reduction of myocardial weight and a trend towards lower EDV compared to HFpEF group. EMBL205 attenuates the increase in E/é, LVEDP, AV peak gradient and the decrease of AVA. EMBL205 significantly reduces Col3A expression and a trend for Col1A expression is seen. Increased perivascular fibrosis and MMP2 expression in HFpEF is extenuated by EMBL205 treatment (table 1). Conclusions: Application of EMBL205 attenuated the development of pathological myocardial alterations associated with HFpEF in ZSF1rats due to antifibrotic effects.

Role of Diastole in Left Ventricular Function, II: Diagnosis and Treatment

2004 ◽  
Vol 13 (6) ◽  
pp. 453-466 ◽  
Author(s):  
Shannan K. Hamlin ◽  
Penelope S. Villars ◽  
Joseph T. Kanusky ◽  
Andrew D. Shaw
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Left Atrial ◽  
Diastolic Heart Failure ◽  
Systolic Heart Failure ◽  
Clinical Signs ◽  
Left Ventricular ◽  
Exercise Intolerance ◽  
Radiographic Findings ◽  
Ventricular Compliance

Left ventricular diastolic dysfunction plays an important role in congestive heart failure. Although once thought to be lower, the mortality of diastolic heart failure may be as high as that of systolic heart failure. Diastolic heart failure is a clinical syndrome characterized by signs and symptoms of heart failure with preserved ejection fraction (0.50) and abnormal diastolic function. One of the earliest indications of diastolic heart failure is exercise intolerance followed by fatigue and, possibly, chest pain. Other clinical signs may include distended neck veins, atrial arrhythmias, and the presence of third and fourth heart sounds. Diastolic dysfunction is difficult to differentiate from systolic dysfunction on the basis of history, physical examination, and electrocardiographic and chest radiographic findings. Therefore, objective diagnostic testing with cardiac catheterization, Doppler echocardiography, and possibly measurement of serum levels of B-type natriuretic peptide is often required. Three stages of diastolic dysfunction are recognized. Stage I is characterized by reduced left ventricular filling in early diastole with normal left ventricular and left atrial pressures and normal compliance. Stage II or pseudonormalization is characterized by a normal Doppler echocardiographic transmitral flow pattern because of an opposing increase in left atrial pressures. This normalization pattern is a concern because marked diastolic dysfunction can easily be missed. Stage III, the final, most severe stage, is characterized by severe restrictive diastolic filling with a marked decrease in left ventricular compliance. Pharmacological therapy is tailored to the cause and type of diastolic dysfunction.

Diastolic dysfunction and abnormal exercise ventilation predict adverse outcome in elderly patients with chronic systolic heart failure

2011 ◽  
Vol 19 (3) ◽  
pp. 396-403 ◽  
Author(s):  
Gabriella Malfatto ◽  
Giovanna Branzi ◽  
Alessia Giglio ◽  
Francesca Ciambellotti ◽  
Alessandra Villani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Elderly Patients ◽  
Diastolic Dysfunction ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Functional Mitral Regurgitation ◽  
Filling Pattern

Background: Heart failure is increasing in the elderly and represents a socioeconomic burden requiring the correct management for which risk stratification is mandatory. Among younger patients, echocardiogram and cardiopulmonary exercise test are useful in prognostic stratification. Few studies have analyzed the utility of these tests in elderly patients. Methods: We report on 90 patients over 70 years old, on whom cardiopulmonary tests and echocardiograms were performed between 1998 and 2006 (67 M, 23 F; 75 ± 3 years; ejection fraction (EF) 30 ± 6%; NYHA 2.1 ± 0.8; 60% ischemic; therapy according to international guidelines). Echocardiographic variables were (1) left ventricular ejection fraction (EF); (2) severity of diastolic dysfunction on multiparametric examination of Doppler and TDI parameters; (3) severity of functional mitral regurgitation. Cardiopulmonary variables were (1) peak VO2; (2) peak O2 pulse; (3) peak respiratory quotient (RQ); (4) VE/VCO2 slope. Endpoint considered was mortality of any cause at three-years follow-up. Results: Mortality was 21%. At univariate analysis, survivors ( n = 71) and deceased ( n = 19) were similar for age, NYHA class, peakVO2 and RQ; they differed for EF, severity of mitral regurgitation, severity of diastolic dysfunction, O2 pulse and VE/VCO2 slope. At multivariate analysis, only VE/VCO2 slope and severe diastolic dysfunction (restrictive filling pattern) discriminated between the two groups. In particular, the association of restrictive filling pattern and VE/VCO2 slope ≥ 45 predicted 3-year mortality with sensitivity of 84% and specificity of 88%. Conclusions: Echocardiographic and cardiopulmonary data can identify high-risk elderly patients with systolic heart failure, who may need aggressive clinical management.

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