scholarly journals The modern approaches to diagnostic of diastolic cardiac insufficiency: unresolved problems and perspectives

2016 ◽  
Vol 22 (2) ◽  
pp. 95-98 ◽  
Author(s):  
E. A Perutskaya ◽  
D. N Perutskiy ◽  
Aleksander A. Zarudskiy ◽  
K. I Proschaev
Keyword(s):  
Left Ventricle ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Stress Echocardiography ◽  
Cardiac Insufficiency ◽  
Chronic Cardiac Insufficiency ◽  
Molecular Components ◽  
Doppler Analysis

According the data of study «EPOCHA-O-CHSN», most of Russian patients with chronic cardiac insufficiency have noncompromised ejection fraction of left ventricle. Therefore, the problem of diagnostic of diastolic chronic cardiac insufficiency seems to be extremely actual. The presented review describes pathogenesis of diastolic dysfunction of myocardium of left ventricle including both hemodynamic and molecular components of this process. It is also related about modern approaches to diagnostic of diastolic cardiac insufficiency. The special emphasis is made on results of Doppler analysis of tissue and stress echocardiography.

scholarly journals Rest NT-proBNP but not MR-proANP predicts positive diastolic stress echocardiography test result in patients with preserved left ventricle ejection fraction and heart failure symptoms

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Kubicius ◽  
M Balys ◽  
Z Gasior ◽  
M Haberka
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Transthoracic Echocardiography ◽  
Stress Echocardiography ◽  
Left Ventricle Ejection Fraction ◽  
Public Institution ◽  
Volume Index

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Medical University of Silesia Introduction Diastolic dysfunction and heart failure (HF) with preserved ejection fraction are diagnostic challenges in rest transthoracic echocardiography (TTE) and clinical practice. The aim of our study was to evaluate the clinical value of diastolic stress echocardiography (DSE) and its corelation with NT-proBNP and MR-proANP testing in patients with preserved left ventricle ejection fraction (LVEF) and HF symptoms. Methods: All the consecutive patients with HF symptoms, preserved LVEF and suspected diastolic dysfunction were examined with DSE with the protocol according to the EACVI 2016 recommendations. Patients with cardiomyopahties, significant valve defects or extracardiac diseases causing similar symptoms were excluded. The assessment of diastolic function was obtained at rest transthoracic echocardiography (TTE) and at peak exertion in DSE: left atrium volume index (LAVI), average E/e’ >14, peak tricuspid regurgitation velocity >2,8 m/s, septal e’ velocity <7 cm/s or lateral e’< 10cm/s (>50% positive – diastolic dysfunction). Moreover, blood samples for NT-proBNP and MR-proANP were taken just before and 30 minutes after DSE. Results The study group included 80 patients (age: 69 ± 8.3 years; 24% males) with dyspnea (NYHA IIa – 53pts; IIb – 17pts; III – 10pts) and risk factors: hypertension (77pts), diabetes (33pts), known coronary artery disease (8pts) and chronic kidney disease (21pts). The rest TTE showed preserved systolic function (LVEF 61.6 ± 8.8%) and normal or indeterminate diastolic function in all patients. DSE revealed positive result for diastolic dysfunction in 17 patients (21%). The levels of NT-proBNP :267(160-518) vs 310(172-522) (p = 0.46) and MR-proANP: 16,2(7,8-542) vs 14,7(6,1-646) p = 0,38 did not significantly change before and after DSE. The ROC analysis showed that age (AUC = 0.720; p < 0.001), LAVI rest (AUC = 0.722, p < 0.01), E/e’ rest (AUC 0.790;p < 0.001) and baseline NT-proBNP (AUC 0.770; p = 0.002) predicted positive DSE. Other parameters, including BMI, baseline E/A, DT or e’ and MR-proANP were not predictive for DSE result. There was a positive correlation between stress NTproBNP and stress LAVI (r = 0.3;p < 0.05) and stress E/e’ (r = 0.5; p < 0.05)  There wasn’t such correlation between MRproANP and stress LAVI and stress E/e’. Conclusions Diastolic stress echocardiography revealed diastolic dysfunction in 21% of study patients and improved the diagnostic value of echocardiography. Rest NT-proBNP but not rest MR-proANP predicted positive DSE.

SIGNIFICANCE OF SYSTOLIC AND DIASTOLIC DYSFUNCTION IN CIRRHOSIS OF THE LIVER

2020 ◽  
Vol 2 (1) ◽  
pp. 85-87
Author(s):  
Saodat Yarmukhamedova ◽  
◽  
Khudoyor Gafforov ◽  
Suvon Yarmatov
Keyword(s):  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Systolic Dysfunction ◽  
Cirrhosis Of The Liver ◽  
Cardiac Insufficiency ◽  
Chronic Cardiac Insufficiency ◽  
Myocardial Dystrophy

In clinical and instrumental examination of 98 patients with cirrhosis of the liver by means of Echo-CG in M-regimen, in 85% of cases damage to the heart was revealed. The basis of damage to the heart was presented by hypertrophy of the left ventricle and myocardial dystrophy that resulted in disturbance of contractive function, diastolic and systolic dysfunction. Damage to the heart in its turn contributed to the development of chronic cardiac insufficiency and increase of portal hypotension degree

scholarly journals The influence of afterload on left ventricular contractility: 2D-strain and dyssynchrony in stress echocardiography

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E Karev ◽  
S Verbilo ◽  
E Malev ◽  
M Prokudina ◽  
A Suvorov
Keyword(s):  
Coronary Artery ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Stress Echocardiography ◽  
Longitudinal Strain ◽  
Wall Motion ◽  
Wall Motion Score Index ◽  
Wall Motion Abnormalities ◽  
Response To Exercise ◽  
Score Index

Abstract Funding Acknowledgements Type of funding sources: None. Background Hypertensive response to exercise (HRE) has negative prognostic value but its impact on the  left ventricle (LV) contractility and on stress echocardiography (SE) results remains controversial. The global longitudinal strain (GLS) and LV dyssynchrony changes in response to afterload increase were shown even in patients with narrow QRS at rest, but not on exertion. Purpose We aimed to analyze the relation between the blood pressure (BP) during SE and LV GLS and dyssynchrony changes. Methods We performed exercise SE on treadmill in 96 patients without coronary artery stenosis (invasive or CT coronary angiography). Patients divided into two groups: HRE (n = 41) and normal response to exercise (NRE) (n = 55). We analyzed GLS and standard deviation of time between the onset of QRS and segmental longitudinal strain peaks (STE-TIME SD) using speckle tracking and 3d-ejection fraction (EF) at rest and on exertion. Results 2D-EF increase was higher in patients with NRE, but 3D-EF did not differ between groups. Wall motion abnormalities (WMA) on peak stress were detected more often in patients with HRE who had higher wall motion score index (WMSI). GLS on exertion and its increment were lower in HRE group (Fig. 1 - "Bull’s eye" diagrams of GLS at rest and on exertion in patient with NRE (upper panel) and HRE (lower panel)). Among dyssynchrony markers we revealed higher values of STE-TIME SD on exertion in HRE group (Table 1). Moreover the analysis showed positive correlations between BP level on exertion and peak GLS (r = 0.56, p < 0.0001), GLS increase (r = 0.54, p < 0.0001) and STE-TIME SD on exertion (r = 0.27, p < 0.02) Conclusions HRE is associated with less increment in GLS and 2D-EF on exertion. Besides LV dyssynchrony signs can appear in response to exaggerated afterload increase even in patients with narrow QRS complexes. Patients with HRE more often show stress-induced WMA and have greater WMSI on exertion in absence of coronary artery lesions, thus HRE can alter the specificity of the test in transient ischemia detection. Table 1 HRE NRE p Δ-2D ejection fraction 5.0 (4.0; 7.0) 10.0 (8.0; 12.5) <0.0000001 Δ-3D ejection fraction 8.25 (4.0; 8.25) 8.24 (8.15; 11.65) 0.09 Wall motion abnormalities on exertion 46.34% 1.8% <0.00001 Wall motion score index 1.0 (1.0; 1.18) 1.0 (1.0; 1.0) 0.00013 GLS on exertion -21.0 (-22.0; -19.0) -24.0 (-26.5; -23.0) <0.0000001 ΔGLS 0.0 (-1.0; 2.0) 4.0 (2.0; 6.0) <0.0000001 STE-TIME SD-IMPOST 42.0 (35.0; 53.0) 35.0 (27.5; 45.0) 0.012 Left ventricle systolic function and dyssynchrony in two groups. Abstract Figure 1.

scholarly journals Dilated Cardiomyopathy in Children and Adults: What is New?

2008 ◽  
Vol 8 ◽  
pp. 762-775 ◽  
Author(s):  
Galal E. Nagib Elkilany ◽  
Mustafa A. AL-Qbandi ◽  
Khaled A. Sayed ◽  
Ibrahim Kabbash
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Diastolic Dysfunction ◽  
Left Ventricular Ejection ◽  
Global Strain ◽  
Independent Risk Factors

Dilated cardiomyopathy (DCM) is the most common form of cardiomyopathy and cause of cardiac transplantation in children and young adults; mortality is high among this patient population. However, mortality, clinical course, and illustrative echocardiographic data of DCM in children and adults are not well established. Our objective was to provide a research article of detailed descriptions of the incidence, causes, outcomes, related risk factors, and new echocardiographic criteria of risk of death from DCM. Our results showed that independent risk factors at DCM diagnosis for subsequent death or transplantation in children cohorts were older age, congestive heart failure, lower left ventricular ejection fraction (EF ≤ 25%), low global strain, significant mitral valve incompetence, pulmonary hypertension, diastolic dysfunction, right ventricular involvement, and cause of DCM (p< 0.001 for all). In adults, low ejection fraction (<30–35%), global peak systolic strain <-7.6%, increased EDV, ESV, LBBB, diastolic dysfunction, and left ventricle dyssynchrony were the main independent risk factors for major cardiac events and need for CRT or transplantation (p< 0.001 for all). Our conclusions were that in children and adults, DCM is a diverse disorder with outcomes that depend largely on cause, age, heart failure status at presentation, and echocardiographic parameters of the heart (systolic and diastolic function of left ventricle, pulmonary artery pressure, global strain, and valvular function of the mitral valve). This study will present new findings in the diagnostic area.

Diastolic Dysfunction of myocardium In patients wiht chronic cardiac Insufficiency of different genesis

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
O.S. Marinina ◽  
◽  
O.A. Efremova ◽  
L.A. Kamyshnikova ◽  
S.I. Logvinenko ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Cardiac Insufficiency ◽  
Chronic Cardiac Insufficiency

Abstract MP228: The Role Of Gut Microbiome Secreted Short Chain Fatty Acids In The Development Of Heart Failure With Preserved Ejection Fraction HFpEF

2021 ◽  
Vol 129 (Suppl_1) ◽  
Author(s):  
Jomana Hatahet ◽  
Raiza Bonomo ◽  
Tyler Cook ◽  
Chelsea R White ◽  
Chaitanya Gavini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Fatty Acids ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Gut Microbiome ◽  
Cardiac Dysfunction ◽  
Longitudinal Strain ◽  
Preserved Ejection Fraction ◽  
Fecal Matter

More than 50% of patients with heart failure are diagnosed with heart failure with preserved ejection fraction (HFpEF), and 80% of them are obese. It is a prominent disease with no available treatments. It is characterized by diastolic dysfunction that involves increase in left ventricle stiffness and decrease in its relaxation during diastole. To better understand the pathogenesis of obesity associated HFpEF, our studies focus on the early asymptomatic changes in cardiac mechanics that occurs before the increases in intracardiac pressure. Therefore, we have developed an obesity associated mouse model that we called pre-HFpEF where mice were fed either Normal Chow or Western Diet for 14 weeks. Our echocardiography measurements indicated the presence of early cardiac dysfunction consistent with obesity associated pre-HFpEF phenotype. Mice on WD had decrease in Global Longitudinal Strain (%GLS) and Longitudinal strain rate reverse (LSRr) indicating early signs of systolic and diastolic dysfunction, as well as increase in left ventricle anterior and posterior wall thickness during diastole (LVAWd, LVPWd). Obesity is also known to cause microbiome imbalance, which plays a significant role in the development of cardiovascular diseases through changes in short chains fatty acids, which are products of dietary fiber fermentation by the gut bacteria. In order to study the association between gut microbiome imbalance and HFpEF development, we treated our obese pre-HFpEF mice with fecal matter transplantation (FMT) from either lean or obese mice, and we found that FMT from lean mice led to significant improvements in systolic and diastolic dysfunction by increasing %GLS and LSRr and preventing hypertrophy by decreasing LVAWd and LVPWd. In addition, WD reduced butyrate producing bacteria, however circulating levels of butyrate were significantly increased with lean FMT treatment. Using an in-vitro approach to mimic WD we found butyrate treatment to inhibit the activation of NLRP3 inflammasome and NF-KB. Therefore, since FMT treatment improved cardiac dysfunction in obesity associated pre-HFpEF mice, and that butyrate is increased after FMT and can play a role in metabolic homeostasis, we predict that butyrate could be an important player in FMT improvements through cardiac metabolic regulation and cardiac inflammation suppression

Serum Concentration of hsCRP - Possible Marker for Therapy Evaluation in Left Ventricular Dysfunction with Preserved Ejection Fraction

2018 ◽  
Vol 69 (10) ◽  
pp. 2885-2888 ◽  
Author(s):  
Bogdan Ioan Coculescu ◽  
Gabi Valeriu Dinca ◽  
Gheorghe Manole ◽  
Victor Lorin Purcarea ◽  
Ana Maria Oproiu ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Serum Concentration ◽  
Diastolic Dysfunction ◽  
Diagnostic Marker ◽  
Left Ventricular ◽  
Cardiac Insufficiency ◽  
Stable Form ◽  
Preserved Ejection Fraction ◽  
Number Of Patients ◽  
Hs Crp

The study on a subset of 208 patients with diastolic dysfunction with the ejection fraction preserved discusses the possibility of circulating CRP levels to be accepted as a diagnostic marker. In order to carry out a comparative analysis of the significance of hsCRP serum values, the study also included a subgroup labeled as control, consisting of the same number of patients, but diagnosed only with painful chronic ischemic cardiopathy - a stable form of angina pectoris. The conclusion of the study is that the circulating level of hs-CRP can be accepted as a diagnostic marker for both ischemic cardiopathy and diastolic dysfunction with preserved ejection fraction. The result, corroborated with data from other studies that recognize the serum concentration of hs-CRP as a predictor marker in cardiovascular disease, supports its usefulness as a marker for cardiac insufficiency with a history of ischemic cardiopathy, without being a marker for assessing the degree of myocardial contractility deficiency.

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