Reduced First-Phase Ejection Fraction and Sustained Myocardial Wall Stress in Hypertensive Patients With Diastolic Dysfunction

Acute myocardial infarction (AMI) can progress to cardiogenic shock and mechanical complications. When extracorporeal membrane oxygenation (ECMO) is applied to a patient with AMI with cardiogenic shock and mechanical complications, left ventricular (LV) decompression is an important recovery factor because LV dilation increases myocardial wall stress and oxygen consumption. The authors present the case of a 72-year-old man with AMI and LV dilation who developed cardiogenic shock and papillary muscle rupture and who was treated successfully by ECMO with a left atrial venting.

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Paradoxical Higher Myocardial Wall Stress and Increased Cardiac Remodeling Despite Lower Mass in Females

Journal of the American Heart Association ◽

10.1161/jaha.119.014781 ◽

2020 ◽

Vol 9 (4) ◽

Author(s):

Andrew I. H. Phua ◽

Thu‐Thao Le ◽

Su W. Tara ◽

Antonio De Marvao ◽

Jinming Duan ◽

...

Keyword(s):

Cardiac Remodeling ◽

Wall Stress ◽

Lower Mass ◽

Myocardial Wall ◽

Myocardial Wall Stress

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Elevated Ejection-Phase Myocardial Wall Stress in Children With Chronic Kidney Disease

Hypertension ◽

10.1161/hypertensionaha.115.05704 ◽

2015 ◽

Vol 66 (4) ◽

pp. 823-829 ◽

Cited By ~ 4

Author(s):

Haotian Gu ◽

Manish D. Sinha ◽

Ye Li ◽

John Simpson ◽

Phil J. Chowienczyk

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Wall Stress ◽

Myocardial Wall ◽

Myocardial Wall Stress ◽

Ejection Phase

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8.9 REDUCTION IN MYOCARDIAL WALL STRESS AND DELAYED MYOCARDIAL RELAXATION DURING EXERCISE

Artery Research ◽

10.1016/j.artres.2016.10.065 ◽

2016 ◽

Vol 16 (C) ◽

pp. 67

Author(s):

Haotian Gu ◽

Xiaoli Zhang ◽

Benyu Jiang ◽

Sally Brett ◽

Phil Chowienczyk

Keyword(s):

Wall Stress ◽

Myocardial Relaxation ◽

Myocardial Wall ◽

Myocardial Wall Stress

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1.6 AUGMENTATION PRESSURE INDEPENDENTLY ASSOCIATES WITH TIME TO PEAK SYSTOLIC MYOCARDIAL WALL STRESS

Artery Research ◽

10.1016/j.artres.2014.09.055 ◽

2014 ◽

Vol 8 (4) ◽

pp. 123

Author(s):

H. Gu ◽

M. Sinha ◽

J. Simpson ◽

P. Chowienczyk

Keyword(s):

Wall Stress ◽

Time To Peak ◽

Myocardial Wall ◽

Augmentation Pressure ◽

Myocardial Wall Stress

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Assessment of regional myocardial wall stress before and after surgical correction of functional ischaemic mitral regurgitation using multidetector computed tomography and novel software system☆☆☆

European Journal of Cardio-Thoracic Surgery ◽

10.1016/j.ejcts.2010.01.029 ◽

2010 ◽

Vol 38 (2) ◽

pp. 163-170 ◽

Cited By ~ 7

Author(s):

Yasuhiro Shudo ◽

Kazuhiro Taniguchi ◽

Koji Takeda ◽

Taichi Sakaguchi ◽

Hajime Matsue ◽

...

Keyword(s):

Computed Tomography ◽

Mitral Regurgitation ◽

Multidetector Computed Tomography ◽

Wall Stress ◽

Surgical Correction ◽

Software System ◽

Myocardial Wall ◽

Before And After ◽

Myocardial Wall Stress

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Echocardiographic assessment of left ventricular mass index and function in hypertensive patients with preserved ejection fraction

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20212400 ◽

2021 ◽

Vol 8 (7) ◽

pp. 911

Author(s):

Sabapathy K.

Keyword(s):

Risk Factor ◽

Ejection Fraction ◽

Diastolic Dysfunction ◽

Left Ventricular Mass ◽

Left Ventricular Mass Index ◽

Left Ventricular ◽

Hypertensive Patients ◽

Geometrical Pattern ◽

Lv Ejection Fraction ◽

Lv Diastolic Dysfunction

Background: The aim of the present study is to detect left ventricular (LV) mass and to find out sub clinical LV diastolic dysfunction in hypertensive patients with preserved LV ejection fraction (EF) using echocardiographic parameters.Methods: 96 patients with hypertension were randomly selected irrespective of their sex, race and risk factor and enrolled into this study. Left ventricular mass index (LVMI) and geometrical pattern LV structure were measured. Sub clinical diastolic dysfunction was also assessed by tissue Doppler.Results: Out of 96 patients, 24 had ECG evidence of LV hypertrophy (LVH) 66 were having increased LVMI (154±20), rest 30 had normal LVMI (108±12). They were divided by LV geometrical pattern into concentric LVH (40), eccentric LVH (26), concentric remodeling (19) and normal (11). Diastolic dysfunction in these patients were assessed by E/E´ measurement which was abnormally increased in 42 out of 66 patients with increased LVMI (20±3.4) and 16 out of 30 patients with normal LVMI.Conclusions: Echocardiographic examination help us to find out LVH precisely by calculating LVMI. It also reveals structural changes like concentric LVH, eccentric LVH, concentric remodeling. A significant number of patients with hypertension with normal LV ejection fraction has sub clinical LV diastolic dysfunction which was detected by tissue Doppler imaging (E/E′). The increase in LVMI with or without concentric LVH is an independent risk factor and prognostic marker for cardio vascular events that occur in hypertensive patients. In this study we infer that patients with increase in LVMI with concentric LVH pattern with normal ejection fraction needs more aggressive treatment and regular follow up to prevent cardiovascular complications.

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Abstract 19340: Advanced Peripheral Endothelial Dysfunction Correlates with Left Ventricular Diastolic Dysfunction and Heart Failure with Preserved Left Ventricular Ejection Fraction in Hypertensive Patients

Circulation ◽

10.1161/circ.130.suppl_2.19340 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Eiichi Akiyama ◽

Seigo Sugiyama ◽

Yasushi Matsuzawa ◽

Hiroyuki Suzuki ◽

Masaaki Konishi ◽

...

Keyword(s):

Heart Failure ◽

Endothelial Dysfunction ◽

Confidence Interval ◽

Ejection Fraction ◽

Endothelial Function ◽

Diastolic Dysfunction ◽

Odds Ratio ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Hypertensive Patients

Background: Left ventricular (LV) diastolic dysfunction (DD) and vascular functions including peripheral endothelial function play an important role in the pathogenesis of heart failure (HF) with preserved LV ejection fraction (EF) (HFPEF). Hypertension is the most important risk factor in HFPEF and the increased workload caused by hypertension results in LV pathological hypertrophy and LVDD. However, the importance of endothelial function in hypertensive patients with LVDD or HFPEF remains yet undetermined. We investigated the association between peripheral endothelial function, LVDD, and HFPEF in hypertensive patients. Methods and Results: We evaluated cardiac function by echocardiography measuring the ratio of early transmitral flow velocity to tissue Doppler early diastolic mitral annular velocity (E/e’) and LVEF. We also noninvasively assessed peripheral endothelial function by reactive hyperemia-peripheral arterial tonometry (RH-PAT) as the RH-PAT index(RHI) in 405 hypertensive patients with preserved LVEF (LVEF>50%), comprising 180 HFPEF and 225 non-HF patients (LVDD; E/e’>15, non-HF with LVDD; n=98, non-HF without LVDD; n=127). RHI negatively correlated with E/e’ (r=-0.24, P<0.001) and B-type natriuretic peptide (r=-0.19, P<0.001). RHI was significantly lower in hypertensive patients with HFPEF than in non-HF hypertensive patients (0.49±0.17 vs. 0.62±0.20, P<0.001). Furthermore, RHI was significantly lower in non-HF hypertensive patients with LVDD than those without LVDD (0.58±0.19 vs. 0.65±0.21, P=0.01). Multivariate logistic regression analysis identified that lower RHI independently correlated with the presence of HFPEF in hypertensive patients with preserved LVEF (odds ratio: 0.65, 95% confidence interval: 0.55-0.77, P<0.001) and with the presence of LVDD in non-HF hypertensive patients (odds ratio: 0.65, 95% confidence interval: 0.71-0.95, P=0.01). Conclusions: RHI was independently associated with the presence of HFPEF and LVDD in hypertensive patients with preserved LVEF. Endothelial dysfunction in microcirculation could play a crucial role in the pathogenesis of LVDD and HFPEF in hypertensive patients.

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