scholarly journals Assessment of diastolic function in patients with aortic valve diseases

2019 ◽  
Vol 7 (11) ◽  
pp. 4261
Author(s):  
Hamid Obaid Khadhim Al Jaaed ◽  
Kareem Mohsin Yousif ◽  
Kareem Mohsin Yousif
Keyword(s):  
Aortic Valve ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Heart Function ◽  
Systolic Dysfunction ◽  
Doppler Study ◽  
Aortic Sclerosis ◽  
Grade Ii ◽  
Male Patients ◽  
Valve Diseases

Background: Valvular heart disease (VHD) are prevalent and impose significant impact on heart function. Diastolic Dysfunction (DD) is less appreciated than Systolic Dysfunction (SD). The aim of this study was to assess the Diastolic Function (DF) in patients with Aortic Valve (AV) diseases as risk factors predisposing to DD.Methods: Cross-section study that involved 34 patients with AV diseases and other 10 controls. All patients are assessed for diastolic dysfunction by transthoracic echo Doppler study. M-mode echocardiography was used to measure cardiac dimensions and wall thickness. LV mass was measured on echocardiogram at rest.Results: Among the 34-patients, 19 (55.8%) of them were male patients and 15(44.2%) of them were female patients. The data showed that there were 12 patients with Aortic Stenosis (AS), eight patients with AORTIC regurgitation (AR), six patients with Aortic Sclerosis (ASCL) and 8 patients with combined AR-AS. Around third of the patients (35.3%) had Grade II DD followed by grade I and Grade III. However, around 14.7 % didn’t have any dysfunction. Overall, there was 77% of the patients with AV diseases.Conclusions: Author concluded that Aortic Valve diseases is significantly related to- the development of diastolic dysfunction and the DD is influenced by severity of AV diseases.

scholarly journals Echocardiographic Patterns of Left Ventricular Diastolic Function in Cardiac Amyloidosis: An Updated Evaluation

2021 ◽  
Vol 10 (21) ◽  
pp. 4888
Author(s):  
Silvia Oghina ◽  
Wulfran Bougouin ◽  
Mounira Kharoubi ◽  
Louis Bonnefous ◽  
Arnault Galat ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Cardiac Amyloidosis ◽  
Clinical Laboratory ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Ventricular Diastolic Function ◽  
Grade Ii

Aims: Multimodal imaging has allowed cardiac amyloidosis (CA) to be increasingly recognised as a treatable cause of heart failure with preserved ejection fraction, but its prognosis remains poor due to late diagnosis. To assess the left ventricular diastolic function (LVDF) patterns in a large contemporary CA cohort according to the current recommendations and to identify their determinants. Methods and Results: We conducted a monocentric, observational study on a cohort of CA patients from a tertiary CA referral centre. Diastolic function was analysed using standard echocardiography and clinical, laboratory and survival parameters were collected. Four hundred and sixty-four patients with one of the three main type of CA were included: 41% had grade III diastolic dysfunction (restrictive mitral pattern), 25% had grade II diastolic dysfunction, and 25% had grade I diastolic dysfunction; 9% were unclassified. No difference was found between the main CA types. After multivariate analyses, grades II and III were independently associated with dyspnoea, elevated NT-proBNP, cardiac infiltration and systolic dysfunction (global longitudinal strain). Grade I patients had a better prognosis. Conclusion: All LVDF patterns can be observed in CA. One quarter of CA patients have grade I LVDF, reflecting the emergence of earlier stage-related phenotypes with a better prognosis.

scholarly journals Assessment of left ventricular systolic and diastolic functions in severely malnourished children

2019 ◽  
Vol 67 (1) ◽  
Author(s):  
Gihan M. Bebars ◽  
Hany T. Askalany
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Control Group ◽  
Nutritional Rehabilitation ◽  
Malnourished Children ◽  
Grade Ii ◽  
Diastolic Functions

Abstract Background Malnourished children endure many changes in body composition and lose heart and skeletal muscle mass. Diastolic dysfunction is one of the major causes of heart failure with preserved ejection fraction. Aim To assess left ventricular systolic and diastolic functions in children with severe acute malnutrition using tissue Doppler imaging technique and to evaluate the effect of nutritional rehabilitation. Patients and Methods A follow-up case-control study conducted on 60 severely malnourished children (WHZ < -3SD) and 120 age and sex-matched healthy children as a control group. Tissue Doppler imaging (TDI) was done for all included malnourished children at admission and for control to measure left ventricular systolic and diastolic functions. Nutritional rehabilitation was done according to WHO protocol and tissue doppler was repeated after rehabilitation when (WHZ > -2SD) to detect any changes in systolic or diastolic functions. Results Systolic function was normal in malnourished children and control. Grade I diastolic dysfunction was detected in 40% and grade II in 30% of severely malnourished children in comparison to 100% normal diastolic function in control group. No correlations between diastolic dysfunction and either anthropometric measurements, electrolyte disturbances or Hb% in malnourished children before nutritional rehabilitation. Mortality from sepsis with associated ventricular dysfunction grade II documented in 3.3% of malnourished children. After nutritional rehabilitation diastolic function improved significantly as 65.6% of children attained normal diastolic function, 31% grade1 and 3.4% grade II. Positive correlations between diastolic function and WAZ, HAZ, WHZ and MUAC after rehabilitation. Conclusion Severe acute malnutrition affects diastolic function in children which is reversible in most of these cases with rehabilitation. TDI is an easy and practical method for detection and follow-up of ventricular function in malnourished children.

Abstract 13910: Importance of Non-invasive Estimates of Left Ventricular Filling Pressures in Critically Ill Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Abdelrahman M Ahmed ◽  
Brandon Wiley ◽  
Jacob C Jentzer ◽  
Nandan S Anavekar ◽  
Allan S Jaffe
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Troponin T ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Icu Mortality ◽  
Lv Diastolic Function

Introduction: The presence of cardiac dysfunction predicts adverse outcomes in the intensive care unit (ICU). We explored the relationship of cardiac injury and left ventricular (LV) systolic and diastolic dysfunction (LVDD) to outcomes in critically ill patients. Methods: This is a retrospective analysis of adult medical ICU admissions from May, 2018 through October 2019. Patients with elevated high-sensitivity troponin T (hs-cTnT) and an echocardiogram performed within 72 hours of admission were included. Patients were classified as having normal LV diastolic function, isolated LVDD, concomitant LV diastolic and systolic dysfunction (LVDDSD) or indeterminate LV diastolic function based on American Society of Echocardiography 2016 guidelines. LV systolic dysfunction was defined as an ejection fraction (EF) < 50%. Results: Overall, 222 patients were included. LVDD was seen in 123 patients (55.4%). Thirty patients (13.5%) were classified with indeterminate diastolic function and 56 normal diastolic function (25.2%). Of those with LVDD , 59.3% had LVDDSD while isolated LVDD was seen in 40.7%.Patients with LVDDSD had a higher median hs-cTnT at baseline compared to patients with isolated LVDD [102ng/L IQR (50-257) vs. 77 ng/L (33.5-166); p=0.047]. Medial e’ velocity and tricuspid valve systolic regurgitant velocity were often associated with LV systolic dysfunction (p=0.0172 and 0.0013, respectively). LVDDSD was associated with a longer length of stay than patients with isolated LVDD [2.9 (1.6-4.0) vs.1.8 (1.1-3.3); p-value 0.03].Twenty-nine patients died during their ICU stay (13%). Patients with LVDDSD had 9.6-fold higher odds of dying in the ICU than patients with isolated LVDD (p=0.0048). Reduced medial e’ velocity (OR 0.63, CI 0.4-1.0, p=0.0285) and increased E/e’ (OR 1.08, CI 1.01-1.15, p=0.0192) were associated with ICU mortality. The association between LVEF<50% and ICU mortality was less pronounced (OR 0.95, CI 0.01-0.98; p=0.0023). Conclusions: Concomitant LV systolic and diastolic dysfunction and measures of increased cardiac filling pressures are strong predictors of mortality.

Ranolazine improves diastolic function in spontaneously hypertensive rats

2014 ◽  
Vol 306 (6) ◽  
pp. H867-H881 ◽  
Author(s):  
Sarah Williams ◽  
Marc Pourrier ◽  
Donald McAfee ◽  
Shunping Lin ◽  
David Fedida
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Spontaneously Hypertensive Rats ◽  
Heart Function ◽  
Sodium Current ◽  
Left Ventricular ◽  
Hypertensive Rats ◽  
Late Sodium Current ◽  
Spontaneously Hypertensive ◽  
Ventricular Relaxation

Diastolic dysfunction can lead to heart failure with preserved ejection fraction, for which there is no effective therapeutic. Ranolazine has been reported to reduce diastolic dysfunction, but the specific mechanisms of action are unclear. The effect of ranolazine on diastolic function was examined in spontaneously hypertensive rats (SHRs), where left ventricular relaxation is impaired and stiffness increased. The objective of this study was to determine whether ranolazine improves diastolic function in SHRs and identify the mechanism(s) by which improvement is achieved. Specifically, to test the hypothesis that ranolazine, by inhibiting late sodium current, reduces Ca2+ overload and promotes ventricular relaxation and reduction in diastolic stiffness, the effects of ranolazine or vehicle on heart function and the response to dobutamine challenge were evaluated in aged male SHRs and Wistar-Kyoto rats by echocardiography and pressure-volume loop analysis. The effects of ranolazine and the more specific sodium channel inhibitor tetrodotoxin were determined on the late sodium current, sarcomere length, and intracellular calcium in isolated cardiomyocytes. Ranolazine reduced the end-diastolic pressure-volume relationship slope and improved diastolic function during dobutamine challenge in the SHR. Ranolazine and tetrodotoxin also enhanced cardiomyocyte relaxation and reduced myoplasmic free Ca2+ during diastole at high-stimulus rates in the SHR. The density of the late sodium current was elevated in SHRs. In conclusion, ranolazine was effective in reducing diastolic dysfunction in the SHR. Its mechanism of action, at least in part, is consistent with inhibition of the increased late sodium current in the SHR leading to reduced Ca2+ overload.

scholarly journals Peripartum Cardiomyopathy Presenting with Predominant Left Ventricular Diastolic Dysfunction: Efficacy of Bromocriptine

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Piercarlo Ballo ◽  
Irene Betti ◽  
Giuseppe Mangialavori ◽  
Leandro Chiodi ◽  
Gherardo Rapisardi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Lv Function ◽  
Lv Diastolic Dysfunction ◽  
Lv Diastolic Function

Management of patients with peripartum cardiomyopathy (PPCM) is still a major clinical problem, as only half of them or slightly more show complete recovery of left ventricular (LV) function despite conventional evidence-based treatment for heart failure. Recent observations suggested that bromocriptine might favor recovery of LV systolic function in patients with PPCM. However, no evidence exists regarding its effect on LV diastolic dysfunction, which is commonly observed in these patients. Tissue Doppler (TD) is an echocardiographic technique that provides unique information on LV diastolic performance. We report the case of a 37-year-old white woman with heart failure (NYHA class II), moderate LV systolic dysfunction (ejection fraction 35%), and severe LV diastolic dysfunction secondary to PPCM, who showed no improvement after 2 weeks of treatment with ramipril, bisoprolol, and furosemide. At 6-week followup after addition of bromocriptine, despite persistence of LV systolic dysfunction, normalization of LV diastolic function was shown by TD, together with improvement in functional status (NYHA I). At 18-month followup, the improvement in LV diastolic function was maintained, and normalization of systolic function was observed. This paper might support the clinical utility of bromocriptine in patients with PPCM by suggesting a potential benefit on LV diastolic dysfunction.

scholarly journals Cardiovascular manifestations of People Newly Diagnosed HIV/AIDS and their Correlation with CD4 Count: Report from Northern India

2021 ◽  
pp. 17-22
Author(s):  
Ritu Attri ◽  
Arashbir Kaur ◽  
Satish Sachdeva ◽  
Mandip Singh Bhatia
Keyword(s):  
Pericardial Effusion ◽  
Diastolic Dysfunction ◽  
Systolic Dysfunction ◽  
Cd4 Count ◽  
Newly Diagnosed ◽  
Colour Doppler ◽  
Aids Patients ◽  
X Ray ◽  
Doppler Study ◽  
Hiv Aids

Introduction: About 21.17 lakhs people in India and about 0.49 lakh people in Punjab are living with HIV according to National AIDS Control Organization Annual Report (2015-16). Cardiovascular complications of HIV infection tend to occur late in the disease and are therefore becoming more prevalent in our society as therapy and longevity improve. Aims of this Study: To study incidence of cardiovascular morbidity in newly diagnosed HIV/AIDS patients and their correlation with CD4 count. To study the types of cardiovascular morbidities in newly diagnosed HIV /AIDS patients and their correlation with CD4 count. Methods: 100 HIV patients newly diagnosed by ELISA technique were selected for the study. All patients were subjected to cardiovascular investigations like ECG, ECHO using Philips iE33 Ultrasound Machine with X-MATRIX Technology with X5-1, supports 3D,2D colour flow, M-mode, Pulsed Wave/Continuous Wave (PW/CW) Doppler, Tissue Doppler imaging and chest x-ray. Results: Majority of the patients were asymptomatic (84%). Commonest being Chest pain(1%). 7% patients had ECG abnormalities. Commonest being sinus tachycardia (4), one patient had atrial fibrillation and 2 had LVH.Two patients had Cardiomegaly on X ray examination while remaining 98 patients had normal cardiac size. Out of the 100 patients studied, 27% patients had cardiac involvement on Echocardiography / Colour Doppler study. Out of these 27 patients, 22(80.65%) had CD4 count less than 200, 4(12.90%) had CD4 count between 201-350 and 1(6.45%) had CD4 count>350.Diastolic Dysfunction was most common abnormality followed by tricuspid regurgitation and systolic dysfunction and pericardial effusion on echocardiography / colour Doppler study. 20 patients had Diastolic Dysfunction, out of which 19 had Grade 1 diastolic dysfunction and 1 had Grade 2 diastolic dysfunction. Grade 3 and Grade 4 diastolic dysfunction was not seen in any patient. All patients with Diastolic Dysfunction had CD4 counts less than 200.Six patients had Mild Systolic Dysfunction, out of them 4 were males and 2 were females, all the males had an EF=50%, while females had EF of 50% and 52% respectively. 4 patients had CD4 count less than 200, 1 had CD4 count between 201-350 and remaining 1 CD4 count more than 350.Two patients had Pericardial Effusion and their CD4 count was less than 200. Conclusion: The commonest cardiac abnormality being detected diastolic dysfunction and least common being pericardial effusion. Diastolic dysfunction is directly related to CD4 count.

scholarly journals KADAR N TERMINAL-PRO BRAIN NATRIURETIC PEPTIDE PADA PENDERITA PENYAKIT JANTUNG HIPERTENSI

2018 ◽  
Vol 14 (1) ◽  
pp. 42
Author(s):  
Febria Asterina ◽  
B Nasution ◽  
N Akbar
Keyword(s):  
Serum Level ◽  
Left Ventricular Systolic Dysfunction ◽  
Heart Function ◽  
Systolic Dysfunction ◽  
Hypertensive Heart Disease ◽  
Left Ventricular ◽  
Ventricular Systolic Dysfunction ◽  
Doppler Study ◽  
Significant Difference ◽  
Group 3

Patients with hypertension are at high risk for development of Left Ventricle Hypertrophy (LVH) and Left Ventricular Systolic Dysfunction (LVSD). These conditions should be identified earlier to prevent cardiac morbidity and mortality. To measured serumlevel of NT-proBNP in hypertensive and mild symptomatic Hypertensive Heart Disease (HHD) patients (NYHA class I-II), to performechocardiography evaluation to all of the patients and associated with serum level of NT-proBNP. A cross sectional study was done at H.Adam Malik Hospital Medan, participants were recruited from consecutive samples of 15 hypertensive and 16 mild symptomatic HHDpatients whose visited cardiovascular and internal medicine out patient clinics. Of these patients, blood samples were taken and a twodimension echo-Doppler study was performed. The patients divided into three groups based on echocardiography studies respectively:Group 1: 9 hypertensive patients with normal echocardiography finding; group 2: 13 patients with LVH and ejection fraction (EF) ≥60%; and group 3: 9 patients with LVH and EF < 60%. Mean NT-proBNP serum level (in pg/mL) for groups 1-3 respectively, were:56.4 ± 34.5, 245.4 ± 339.2 and 852.0 ± 1218.9. Mean NT-proBNP serum level differed among all three groups (p = 0.050), butthe significant difference found between group 1 and group 3 (p < 0.05) only. There were significant correlation between NT-proBNPserum level and the three stages of echocardiography finding (r = 0.488 and p = 0.005). The result suggests that NT-proBNP serumlevel correlated with deterioration of heart function and structure according echocardiography studies. The Significant rise in NT-proBNPserum level happened only when Left Ventricular Systolic Dysfunction (LVSD) develops in hypertension.

Link between diabetes and diastolic dysfunction and the diagnostic role of echocardiography

2009 ◽  
Vol 150 (45) ◽  
pp. 2060-2067 ◽  
Author(s):  
András Nagy ◽  
Zsuzsanna Cserép
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Systolic Dysfunction ◽  
Mitral Annulus ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Doppler Study

Diabetes mellitus, a disease that has been reaching epidemic proportions, is an important risk factor to the development of cardiovascular complication. The left ventricular diastolic dysfunction represents the earliest pre-clinical manifestation of diabetic cardiomyopathy, preceding systolic dysfunction and being able to evolve to symptomatic heart failure. In early stages, these changes appear reversible with tight metabolic control, but as pathologic processes become organized, the changes are irreversible and contribute to an excess risk of heart failure among diabetic patients. Doppler echocardiography provides reliable data in the stages of diastolic function, as well as for systolic function. Combination of pulsed tissue Doppler study of mitral annulus with transmitral inflow may be clinically valuable for obtaining information about left ventricular filling pressure and unmasking Doppler inflow pseudonormal pattern, a hinge point for the progression toward advanced heart failure. Subsequently we give an overview about diabetes and its complications, their clinical relevance and the role of echocardiography in detection of diastolic heart failure in diabetes.

scholarly journals P1446 Correlation of B-Type natriuretic peptide with LV and RV function assessed by echocardiography in adults congenital heart diseases patients

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Kavouras ◽  
K Dimopoulos ◽  
A La Leggia ◽  
R Barracano ◽  
M Brida ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Natriuretic Peptide ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Systolic Dysfunction ◽  
Systolic Pressure ◽  
Diastolic Velocity ◽  
Systolic And Diastolic Function ◽  
Rv Function

Abstract Introduction Brain natriuretic peptide (BNP) is a well-established marker for heart failure in the general population however limited data are available on the value of BNP as a diagnostic and prognostic marker in adults with congenital heart disease (ACHD). The purpose of our study is to evaluate the relation between BNP levels and biventricular systolic and diastolic function in patients with ACHD. Methods We evaluated clinically stable ACHD patients who underwent echocardiography from May 2015 until January 2018. We studied the correlation of BNP with the degree of systolic and diastolic dysfunction of the left ventricle. Moreover we also investigate the relation of BNP with the right tricuspid annular plane systolic excursion (TAPSE), the fractional area change (FAC) and the pulmonary arterial systolic pressure (PASP). Results In total, 385 patients were included in our study (median age, 43 ±12 years; 61% male). Of the 385 patients, 193 (50%) had tetralogy of Fallot, 94 (24%) had systemic RV, including patients with transposition of the great arteries (TGA) after atrial switch operation (Mustard or Senning) and congenitally corrected TGA -ccTGA , 43 (11%) had univentricular hearts and Fontan physiology, 55 (14%) had other lesions. BNP levels were 66 ± 26 pg/mL and 93, ±31pg/mL, for patients with EF &gt; 50% and 50%&gt; EF &gt;35% respectively (p = 0.003). BNP levels correlate with parameters reflecting LV filling pressure, including transmitral early diastolic velocity (E) 81 ± 29pg/mL and its ratio to early diastolic annular myocardial tissue velocity (E/Ea) 77 ± 17pg/mL. (r=-0.607, p = 0.003 r=-0.598, p = 0.005, respectively) BNP levels were also significantly higher in patients with impaired tricuspid annular plane systolic excursion 87 ± 21 pg/mL (TAPSE &lt; 14mm; p = 0.002) and decreased RV FAC 81 ± 18 pg/mL (FAC &lt;35% P= 0.004) and in patients with PASP≥35 mmHg (p = 0.003). The ROC curve and logistic regression analysis spotted the role of BNP in identifying systolic and diastolic dysfunction patterns in ACHD patients. Conclusion: In clinical stable ACHD patiens BNP levels correlate well with LV systolic dysfunction as well as with impaired diastolic function. Furthermore patients with impaired RV function and increased PASP have raised BNP levels. Therefore monitoring BNP levels plays an important role in management of clinical stable ACHD patients

Sign in / Sign up

Export Citation Format

Share Document