Abstract 2847: High Prevalence of ’Unclassifiable’ Diastolic Dysfunction Using Current Criteria

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Arumugam Narayanan ◽  
Gerard P Aurigemma ◽  
Jeffrey C Hill ◽  
Jennifer Kane ◽  
Allison McNamee ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Classification Scheme ◽  
Tissue Doppler ◽  
Cross Sectional ◽  
High Prevalence ◽  
Doppler Data ◽  
Pulmonary Vein Flow ◽  
Classification Variable ◽  
Deceleration Time

Background: Cross sectional studies have shown that diastolic dysfunction is prevalent and impacts mortality. Classification of diastolic function (DF) requires several Doppler variables. However, in clinical practice, pts may not necessarily have concordant data, leading to confusion about classification. The issue is compounded in hospitalized patients, who are tachycardic and may have limited Doppler data. Objective: The aims of this study were (1) to determine the percentage of pts with measurable DF data, and (2) to determine the percentage of pts with concordant data. Methods: Data from 100 consecutive in- and outpts in sinus rhythm, compiled by a single experienced sonographer were reviewed; transmitral (E/A), deceleration time (DT), pulmonary vein flow - S/D ratio and A reversal duration (PV A dur), and tissue Doppler E’ were attempted in all. DF was classified as normal, or mild, moderate or restrictive dysfunction, based on the validated and widely used scheme of Redfield et al (JAMA 2003). E/A was used as the primary classification variable. Results: E/A, DT and E/E’ were measurable in 3/4 of pts while PV S/D and A dur were measurable in 1/2 and 1/4 of pts, respectively. The most common reason for inability to record E/A was tachycardia (E/A fusion). Of pts with measurable data, only 55% had ≥3 concordant variables and most of those had normal DF. Summary/Conclusions: Applying the validated DF classification scheme to a wider variety of pts demonstrates: (1) 30% pts could not be classified and (2) only 55% pts have ≥3 concordant measurements. These data suggest the need for a weighted classification scheme which, perhaps, incorporates LA and LV structure, and PA pressure.

Characterization of Electroencephalographic Findings at an Electrodiagnostic Unit of a Tertiary Hospital, North-central Nigeria

2021 ◽  
Vol 2 (1) ◽  
pp. 49-55
Author(s):  
E U Iwuozo ◽  
J O Enyikwola ◽  
I O Obekpa ◽  
O O Ijachi ◽  
A A Godwin ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Seizure Disorder ◽  
Cross Sectional ◽  
North Central ◽  
Younger Age ◽  
High Prevalence ◽  
Diagnosis And Classification ◽  
Age Range

Electroencephalography (EEG) remains an important investigative tool in supporting the diagnosis and classification of various seizure types. We sought to examine and characterize the EEG findings from all patients referred for the procedure. This cross-sectional retrospective study was carried out at an EEG unit in Federal Medical Centre, Makurdi, Benue State, North Central Nigeria from May 2016 to December 2020. Relevant patients' information were extracted and analysed using SPSS version 21. A total of 484 patients were seen over the study period with age range of 1-87 years and median age of 23 years. They comprised of 254 (52.5%) male and 230 (47.5%) female. The psychiatrist and the Physicians/Neurologist referred most of them for EEG, 201 (41.5%) and 124 (25.6%) respectively. The most reported indication for EEG was clinical suspicion of seizure disorder 291 (60.1%), whilst some did not have a clear indication 111 (22.9%). About 417 (86.2%) of our patients had abnormal EEG finding out of which 414 (99.3%) were diagnostic of seizure disorder made up of generalized seizure in 255 (61.6%) and focal seizure in 159 (38.4%). About 237 (48.9%) of them were already on antiepileptic drugs (AEDs) at referral of which 190 (80.2%0 were taking carbamazepine. This study showed a high prevalence of abnormal EEG with most of them diagnostic of seizure disorder especially generalized seizure. They were mostly of younger age group with about half of them already on AEDs at referral, majority of who were sent by the Psychiatrist.

scholarly journals Echocardiographic assessment of Diastolic Function in patients with Atrial Fibrillation

2019 ◽  
Vol 16 (2) ◽  
pp. 17-21
Author(s):  
Ajay Adhikaree ◽  
Rabi Malla ◽  
Ram Kishor Sah ◽  
Arun Maskey ◽  
Sujeeb Rajbhandari ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Relaxation Time ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Echocardiographic Assessment ◽  
Deceleration Time

Background and Aims: Echocardiographic assessment of left ventricular diastolic function in patients with atrial fibrillation is a challenge as loss of atrial kick (A wave), beat to beat variability and left atrium enlargement despite normal atrial pressure make usual guideline based estimation difficult and inaccurate. Hence adoption of additional echocardiography parameters are necessary which are tricky and have varied results. Hence the aim of this study was to study various aspects of diastolic function in patients with atrial fibrillation. Methods: It was a hospital based prospective cross-sectional observational study conducted at cardiology unit, National Academy of Medical Sciences, Kathmandu and Shahid Gangalal National Heart Center, Kathmandu from 1st July 2018 to 30th June 2019. Results: Total of 92 patients were studied. About one third (34.8%) had diastolic dysfunction. Ratio of E/e’(14.65 ± 2.21 Vs 7.66 ± 1.18) , E/Vp (1.57 ± 0.14 Vs 1.20 ± 0.11), isovolumetric relaxation time (53.06 ± 13.82ms Vs 89.33 ± 9.88ms) and deceleration time of pulmonary venous diastolic wave (203.09 ± 26.13ms Vs 292.25 ± 36.32ms) were significantly different in patients with diastolic dysfunction compared to patients without diastolic dysfunction with sensitivity of 90.6%, 84.4%, 81.2% and 78.1% respectively. Conclusion: Diastolic dysfunction is a common entity in patients with atrial fibrillation. Echocardiography parameters like E/e’ ratio, isovolumetric relaxation time, E/Vp ratio and deceleration time of diastolic pulmonary wave were highly sensitive in detection of diastolic dysfunction.

scholarly journals Study of diastolic dysfunction in essential hypertension patients in relation to age and duration of treatment

2017 ◽  
Vol 4 (5) ◽  
pp. 1447
Author(s):  
Vijaykumar V. Ingle
Keyword(s):  
Essential Hypertension ◽  
Diastolic Dysfunction ◽  
Hypertensive Heart Disease ◽  
Tissue Doppler ◽  
Duration Of Treatment ◽  
Major Health Problem ◽  
Major Health ◽  
Hypertensive Patients ◽  
Diagnosis Of Hypertension ◽  
Deceleration Time

Background: Hypertension is a major health problem worldwide and its complications have significant socioeconomic impact. The objective of this study was to evaluate diastolic dysfunction (DD) in essential hypertension patients and the influence of age and duration of hypertension on this parameter.Methods: One hundred essential hypertensive patients (HT) underwent Doppler echocardiography to obtain E/A wave ratio (E/A), atrial deceleration time (ADT), isovolumetric relaxation time (IRT) and Tissue Doppler early diastolic mitral annular velocity (E). All patients were grouped according to age at diagnosis of hypertension and duration of the disease.Results: A higher prevalence of DD occurred parallel to age and duration of the disease.Conclusions: DD was prevalent in this hypertensive population, being highly affected by age and DD is observed in incipient stages of hypertensive heart disease, and thus its early detection may help in the risk stratification of hypertensive patients.

scholarly journals Pie de riesgo y su estratificación en diabéticos

2017 ◽  
Vol 1 (2) ◽  
pp. 68
Author(s):  
Bárbara Hidalgo Martínez ◽  
Jennifer Alexandra Cabezas Jama ◽  
Edgar Stefano Velásquez Ochoa ◽  
Rasiel Acosta Pérez
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Descriptive Study ◽  
Predisposing Factors ◽  
Peripheral Vascular ◽  
Cross Sectional ◽  
Palabras Clave ◽  
High Prevalence ◽  
El Sistema

El pie diabético es una complicación de la diabetes mellitus (DM) que puede controlarse con el manejo del pie de riesgo (PR). Con el objetivo de determinar la prevalencia de los factores predis- ponentes de esta patología y su estratificación en el paciente diabético, se realizó un estudio des- criptivo transversal, con 824 pacientes que asistieron a la consulta externa de endocrinología del Hospital Humberto Pozo, de febrero a julio de 2016. Para la estratificación, se utilizó el Sistema de Clasificación de Riesgos del Consenso Internacional del pie diabético. Se encontró que el 58,3% de los pacientes, presentó PR, el 30,7% en Grado 1 y 22,4% en Grado 2. Los factores predispo- nentes más frecuentes son la neuropatía (36,7%), la enfermedad vascular periférica (32,1%) y las deformidades ortopédicas (15,7%). Se identificó una elevada prevalencia de PR que permite con un correcto manejo de los factores predisponentes, prevenir lesiones y amputaciones. Palabras clave: Pie de riesgo, pie diabético, amputación, prevención de pie diabético. Abstract Diabetic foot is a complication of diabetes mellitus that can be controlled with the management of the risk foot. In order to determine the prevalence of the predisposing factors of the risk foot and its stratification in the diabetic patient, a cross-sectional descriptive study was conducted with 824 dia- betic patients attending the outpatient clinic of endocrinology Humberto Pozo Hospital in the period from February to July 2016. For the stratification, the International Classification of Risks of the Dia- betic Foot Consensus was used. The most frequent predisposing factors were neuropathy (36.7%), peripheral vascular disease (32.1%) and orthopedic deformities (15.7%). A high prevalence of risk foot was identified that allows, with a correct management of the predisposing factors, to prevent injuries and amputations. Key words: risk foot, diabetic foot, amputation, prevention of diabetic foot.  

scholarly journals Relationship between right-to-left shunt and migraine in patients with epilepsy: a single-centre, cross-sectional study in China

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e024144 ◽  
Author(s):  
Lin Zhang ◽  
Xi Zhu ◽  
Xiangmiao Qiu ◽  
Yajiao Li ◽  
Yucheng Chen ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Single Centre ◽  
Cross Sectional ◽  
High Prevalence ◽  
The Right ◽  
Patients With Epilepsy

ObjectivesTo investigate the relationship between right-to-left shunt and migraine to account for the unexplained high prevalence of migraine in patients with epilepsy.DesignThis is a cross-sectional study. The diagnosis and interview process of patients with migraine was based on the International Classification of Headache Disorders-3 beta in patients with epilepsy. Participants underwent transthoracic echocardiography (TTE) with contrast medium to identify right-to-left shunt. The highest number of microbubbles were recorded in the left atrium before the complete microbubble outflow of the right atrium. A moderate-to-large shunt was defined as the presence of 10 or more microbubbles.SettingA single-centre, cross-sectional study in China, 2015–2017.ParticipantsPatients with epilepsy.Primary and secondary outcome measuresThe primary outcome measures were the prevalence of migraine, the prevalence of right-to-left shunt in patients with migraine and those without migraine, and the prevalence of migraine in different degrees of shunting.ResultsThree hundred thirty-nine participants with epilepsy who completed TTE were included in the analysis. The overall prevalence of migraine was 23.0%. One-third of the migraineurs had mild right-to-left shunt and one-fifth of the migraineurs had moderate-to-large right-to-left shunt. Patients with mild shunt did not have a higher prevalence of migraine than those without shunt (26.3% vs 18.1%, p=0.102); however, a higher prevalence of migraine was found in patients with moderate-to-large shunt (39.0% vs 18.1%, OR=2.90, 95% CI=1.41 to 5.98, p=0.003). Patients with migraine and patients without migraine had similar prevalence of mild shunt; however, patients with migraine had more moderate-to-large shunt (20.5% vs 9.6%, p=0.002). Right-to-left shunt and female were factors predicting migraine prevalence.ConclusionsOne-fifth of migraineurs were correlated with moderate-to-large right-to-left shunt which could be an underlying cause of migraine in epilepsy.

scholarly journals Assessment of diastolic dysfunction in hypertensive patients and its association with left ventricular mass index

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Tahir Siddique ◽  
Sulehria S B ◽  
Fauzia Javed ◽  
Irshad Hussain Qureshi ◽  
Muhammad Kashif Riaz
Keyword(s):  
Diastolic Dysfunction ◽  
Ventricular Hypertrophy ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Chi Square ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Wave Velocities ◽  
Isovolumic Relaxation ◽  
Deceleration Time

Objective: Early detection of diastolic dysfunction in hypertensive patients to reduce complications and improve outcome. Place of Study: East Medical and Cardiology wards of Mayo Hospital Lahore. Study Design: A descriptive cross-sectional study. Patients and Methods: 51 hypertensive patients between 50 - 80 years of either sex enrolled through out patient department of Mayo Hospital Lahore underwent Doppler Echocardigraphy and data was analyzed by using Chi-square and Students `t` tests. Results: The percentage of left ventricular hypertrophy (LVH) was 66.66%. On comparing hypertensive patients with and without LVH, E and A wave velocities, E:A ratio, deceleration time and isovolumic relaxation time were similar. Conclusion: 33.33% of patients had no LVH in the presence of diastolic dysfunction so LVH was not an independent factor associated with abnormal flow patterns in hypertensive patients with normal systolic contractility. Impaired relaxation was the predominant pattern of diastolic dysfunction an d increased further with age.

scholarly journals Migraine headache in patients with idiopathic intracranial hypertension

2017 ◽  
Vol 9 (3) ◽  
Author(s):  
Farzad Sina ◽  
Saeed Razmeh ◽  
Neda Habibzadeh ◽  
Arefeh Zavari ◽  
Mona Nabovvati
Keyword(s):  
Intracranial Hypertension ◽  
Diagnostic Criteria ◽  
Idiopathic Intracranial Hypertension ◽  
Migraine Headache ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
High Prevalence

Migraine is a neurological disorder that afflicts many people in the world and can cause severe disability during the attacks. The pathophysiology of migraine is complex and not fully understood. It seems that migraine is common in idiopathic intracranial hypertension (IIH). However, the association between migraine headache and IIH is still unclear. The present study was conducted to assess the prevalence of migraine headache and associated factors in IIH patients. In this cross-sectional study, a total of 68 patients diagnosed with IIH underwent a medical history interview and a neurological examination. The diagnosis of migraine was based on the four diagnostic criteria of the International Classification of Headache Disorders 3rd edition. Forty-five patients (63.2%) met the diagnostic criteria of migraine headache. There was no significant difference between patients with and without migraine headache in respect of their age, gender, body mass. This study revealed high prevalence of migraine headache in IIH patients; appropriate treatment can reduce their headache and prevent unnecessary treatments for IIH.

scholarly journals High Prevalence of Left Ventricle Diastolic Dysfunction in Severe COPD Associated with A Low Exercise Capacity: A Cross-Sectional Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (6) ◽  
pp. e68034 ◽  
Author(s):  
Marta López-Sánchez ◽  
Mariana Muñoz-Esquerre ◽  
Daniel Huertas ◽  
José Gonzalez-Costello ◽  
Jesús Ribas ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Exercise Capacity ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
High Prevalence ◽  
Severe Copd

scholarly journals Pie de riesgo y su estratificación en diabéticos

2017 ◽  
Vol 1 (2) ◽  
pp. 68
Author(s):  
Bárbara Hidalgo Martínez ◽  
Jennifer Alexandra Cabezas Jama ◽  
Edgar Stefano Velásquez Ochoa ◽  
Rasiel Acosta Pérez
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Descriptive Study ◽  
Predisposing Factors ◽  
Peripheral Vascular ◽  
Cross Sectional ◽  
Palabras Clave ◽  
High Prevalence ◽  
El Sistema

El pie diabético es una complicación de la diabetes mellitus (DM) que puede controlarse con el manejo del pie de riesgo (PR). Con el objetivo de determinar la prevalencia de los factores predis- ponentes de esta patología y su estratificación en el paciente diabético, se realizó un estudio des- criptivo transversal, con 824 pacientes que asistieron a la consulta externa de endocrinología del Hospital Humberto Pozo, de febrero a julio de 2016. Para la estratificación, se utilizó el Sistema de Clasificación de Riesgos del Consenso Internacional del pie diabético. Se encontró que el 58,3% de los pacientes, presentó PR, el 30,7% en Grado 1 y 22,4% en Grado 2. Los factores predispo- nentes más frecuentes son la neuropatía (36,7%), la enfermedad vascular periférica (32,1%) y las deformidades ortopédicas (15,7%). Se identificó una elevada prevalencia de PR que permite con un correcto manejo de los factores predisponentes, prevenir lesiones y amputaciones. Palabras clave: Pie de riesgo, pie diabético, amputación, prevención de pie diabético. Abstract Diabetic foot is a complication of diabetes mellitus that can be controlled with the management of the risk foot. In order to determine the prevalence of the predisposing factors of the risk foot and its stratification in the diabetic patient, a cross-sectional descriptive study was conducted with 824 dia- betic patients attending the outpatient clinic of endocrinology Humberto Pozo Hospital in the period from February to July 2016. For the stratification, the International Classification of Risks of the Dia- betic Foot Consensus was used. The most frequent predisposing factors were neuropathy (36.7%), peripheral vascular disease (32.1%) and orthopedic deformities (15.7%). A high prevalence of risk foot was identified that allows, with a correct management of the predisposing factors, to prevent injuries and amputations. Key words: risk foot, diabetic foot, amputation, prevention of diabetic foot.  

scholarly journals ASYMPTOMATIC DIABETICS

2016 ◽  
Vol 23 (11) ◽  
pp. 1373-1376
Author(s):  
Liaqat Ali ◽  
Naeem Asghar ◽  
Imran Khan
Keyword(s):  
Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Pulmonary Veins ◽  
Tissue Doppler ◽  
Cardiovascular Complications ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Cross Sectional ◽  
Color Flow

Background: Diabetes mellitus (DM) is not only a significant independent riskfactor for developing of atherosclerotic ischemic heart disease or ventricular hypertrophy but itis also able to trigger a diabetic cardiomyopathy due to dysmetabolic processes resulting heartfailure. Cardiovascular complications are known to be the main cause of death and morbidity indiabetic patients. Objectives: How frequent is the diastolic dysfunction in asymptomatic diabetic?Study Design: Descriptive cross sectional. Setting: Echocardiography department FaisalabadInstitute of Cardiology Faisalabad. Patients were recruited from outpatient department ofFaisalabad institute of cardiology Faisalabad. Duration of Study: Six months from: 28-06-2015to 28-12-2015. Methodology: 200 patients were included in the study. Patient’s bio data wasrecorded and informed consent was taken. All echocardiographic studies were performed withVIVID-07 echo machine by the same operator. Detailed assessment of left ventricular systolicand diastolic function by using standard 2-dimensional, color flow Doppler and tissue Dopplerimaging (TDI) was done. Images were obtained in all patients. Each patient underwent leftventricular (LV) diastolic function assessment by conventional Doppler, tissue Doppler imaging(TDI). LV ejection fraction was calculated using conventional method. Blood flow velocities atmitral valve leaflets and pulmonary veins were recorded with averaged from 3 end-expiratorycycles at a sweep of 100 mm/s. This information was collected through a specially designedproforma by the author. Results: In our study, out of 200 cases, 52%(n=104) were between 50-55 years of age while 48%(n=96) were between 56-60 years of age, mean+sd was calculatedas 55.54+2.59 years, 49%(n=98) were male while 51%(n=102) were females, frequency ofdiastolic dysfunction in asymptomatic, normotensive patients with diabetes mellitus wasrecorded as 45.5%(n=91) while 54.5%(n=109) had no findings of the morbidity. Conclusion:We conclude that the frequency of diastolic dysfunction is quite high (45.5%) in asymptomaticdiabetics.

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