scholarly journals Tissue doppler imaging for estimation of left ventricular filling pressure in patients with systolic and diastolic heart failure: a comparative simultaneous doppler catheterization study

2020 ◽  
Vol 7 (2) ◽  
pp. 319
Author(s):  
Manohar J. Suranagi ◽  
K. Subramanyam ◽  
K. S. Subramani ◽  
K. H. Srinivasa
Keyword(s):  
Heart Failure ◽  
Tissue Doppler Imaging ◽  
Diastolic Heart Failure ◽  
Systolic Heart Failure ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Doppler Imaging ◽  
Heart Failure Patients ◽  
Mitral Annular Velocity

Background: Noninvasive assessment of diastolic filling by Doppler echocardiography provides important information about left ventricular (LV) status in selected subsets of patients. This study was designed to assess whether the lateral mitral annular velocity as assessed by tissue Doppler imaging is associated with invasive measures of diastolic LV performance in patients with diastolic and systolic heart failure. Aim of the study was to compare the diagnostic accuracy of lateral mitral annular E/E′ as an estimate of LV filling pressure with invasive LVEDP measurement in subjects with systolic or purely diastolic heart failure.Methods: Total 100 patients were studied, 50 patients with diastolic heart failure and 50 patients with systolic heart failure in patients undergoing diagnostic coronary angiogram. Detailed 2D Echocardiography, Trans mitral Doppler and Tissue Doppler velocities of lateral mitral annulus was obtained. The ratio of peak mitral velocity (E) to lateral mitral annular velocity (E′) by TDI (E/E′) was calculated.Results: The ratio of E/E′ in diastolic group was 13.4±4.9 and in systolic group it was 13.7±5.2. The mean LVEDP in diastolic heart failure patients was 14.3±4.5 and 14.2±4.9 in systolic heart failure patients. The ratio of E/E′ showed a better correlation with LVEDP. E/E′ <8 accurately predicted normal LVEDP, and E/E′ >15 identified increased LVEDP ≥15mmHg.Conclusions: E/E′ is a reliable estimate of LV filling pressures in subjects with systolic and diastolic heart failure. In subjects with diastolic heart failure, E/E′ seems helpful to identify those with truly elevated LV filling pressures. In patients with diastolic heart failure and normal E/E′, a search for other causes of symptoms (pulmonary disease, obesity and so forth) may be warranted.

Abstract 15943: Left Ventricular Regional Longitudinal Displacement Assessed by Tissue Doppler Imaging is a Powerful Predictor of All-cause Mortality in Patients With Systolic Heart Failure

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Morten Sengeløv ◽  
Peter Godsk Jørgensen ◽  
Niels Eske Bruun ◽  
Flemming Javier Olsen ◽  
Thomas Fritz Hansen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Tissue Doppler Imaging ◽  
Systolic Heart Failure ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Longitudinal Displacement ◽  
Predictors Of Mortality ◽  
All Cause Mortality ◽  
Echocardiographic Parameters

Objective: Tissue tracking (TT), obtained by tissue Doppler imaging (TDI), can be utilized to assess the mitral annular longitudinal displacement (LD) during systole. However, the prognostic utility of regional LD in patients with heart failure with reduced ejection fraction (HFrEF) is unknown. Methods: Transthoracic echocardiographic examinations from 911 patients with HFrEF were retrieved from a heart failure clinic’s database. The exams were performed from 2005 to 2013. The echocardiographic images were subsequently analyzed obtaining conventional echocardiographic measurements. Regional LD was obtained from the three apical TDI projections with sampling at six mitral annular sites located at the anterior, lateral, posterior, inferior, septal and anteroseptal myocardial walls. Results: During a median follow-up period of 40 months 150 (16.4 %) patients died. Patients that died had significantly lower LVEF (23.3% vs 28.3%, p<0.001) and lower regional LD in all six mitral annular sites (Figure). Many conventional echocardiographic parameters presented as predictors of mortality (LVEF, LVMI, LAVI, E, E/e’, deceleration time and TAPSE). However, only LD at the septal and inferior annular sites remained independent predictors of mortality in cox proportional-hazards models after adjusting for age, gender, BMI, total cholesterol, heart rate, atrial fibrillation, non-independent diabetes mellitus and the aforementioned conventional echocardiographic predictors (Figure). In addition, the septal and the inferior sites had the highest Harrell’s C-statistic of all the echocardiographic predictors (0.70 and 72, respectively). Conclusion: In patients with severe heart failure, septal and inferior LD are independent predictors of all-cause mortality. Furthermore, septal and inferior LD proved to be superior prognosticators when compared to all the conventional echocardiographic parameters.

Abstract 3402: Improvement of Left Ventricular Regional Function and Reverse Remodeling in Heart Failure Patients Received Cardiac Contractility Modulation Therapy-A Comprehensive Assessment by Real-Time 3D Echocardiogram and Tissue Doppler Imaging

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Yat-sun Chan ◽  
Qing Zhang ◽  
Jeffrey W Fung ◽  
Anna K Chan ◽  
Chun-yan Ma ◽  
...  
Keyword(s):  
Heart Failure ◽  
Real Time ◽  
Cardiac Contractility ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Doppler Imaging ◽  
Reverse Remodeling ◽  
Cardiac Contractility Modulation ◽  
Heart Failure Patients

Introduction: Cardiac Contractility Modulation (CCM) is a new form of device based therapy for advance heart failure patient even with normal QRS width and therefore not a candidate for cardiac resynchronization therapy. Previous studies showed that CCM improved left ventricular (LV) ejection fraction (EF) and clinical parameters of heart failure patients. However data from comprehensive echocardiographic assessment and structural reverse remodeling is lacking. Methods: 18 patients (mean age: 56±9 years, 15 males) with NYHA class III heart failure, QRS <120msec and already on optimal medical therapy received CCM. Real-time 3D echocardiography (RT3DE) (IE33, Philips) and tissue Doppler imaging (TDI) (Vivid 7, GE) were performed at baseline and 3 months after CCM. Results: LV reverse remodeling with reduction in volumes and gain in EF was observed by RT3DE at 3 months. TDI also showed improvement of regional systolic function resulting in an increase in peak systolic velocity by measuring 12 (Mean Sm-12) or 6 basal (Mean Sm-6) LV segments. LV filling pressure estimated by E/E’ was also favorably reduced (Table ). Conclusions: CCM improves both global and regional LV contractility and reduces filling pressure leading to LV reverse remodeling. Table

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