scholarly journals THE LEFT VENTRICLE DIASTOLIC FUNCTION IN PATIENTS WITH HYPERTENSION UNDER THE USE OF DIFFERENT DRUG GROUPS

2019 ◽  
Vol 9 (4) ◽  
pp. 290-295
Author(s):  
A. V. Budnevskij ◽  
E. S. Ovsjannikov ◽  
L. E. Kulikova
Keyword(s):  
Blood Pressure ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
European Association ◽  
Cardiovascular Imaging ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Target Values

The objective: To assess the prevalence of diastolic dysfunction in patients with hypertension and preserved left ventricular ejection fraction under pharmacological correction (monotherapy) with angiotensin converting enzyme inhibitors, angiotensin II receptor blockers and β-blockers. Materials and methods: 82 patients (58 women and 24 men) with stage 2 hypertension were examined. The diastolic function was assessed via echocardiography in accordance with the European Association of Cardiovascular Imaging guidelines (2017). Echocardiography was performed before the onset of the treatment and 6 months after its onset. The treatment onset was considered to start after a 2-week period of elimination of previously used pharmacological substance and 2 weeks of assessing tolerability, dose and regimen adjustment. Results: For all selected drugs, target values of blood pressure were achieved, and no adverse effects were identified. The average values of the left atrial volume index before and after the treatment course did not show significant differences. In the majority of the examined patients, this parameter did not exceed the threshold value of 34 ml/m2 . Values exceeding the specified threshold were observed in Group 1 in 4 patients, in Group 2 in 3 patients and in Group 3 in 8 patients. According to the Tissue Doppler echocardiography results on the velocity of myocardial motion at the early diastolic filling, which was measured at the level of the lateral segments of mitral valve and the interventricular septum, positive, but unreliable changes were observed in the Groups of bisoprolol and valsartan, and no changes — in the Group of perindopril. According to the traditional criteria, diastolic dysfunction was observed in 80 % of patients, while according to the criteria of the European Association of Cardiovascular Imaging (2017) — in 21 % of patients. Conclusion: The same efficacy of all three drugs is observed in terms of achieving target blood pressure values. The most pronounced effect on the morphometric parameters of the left atrium and intracardiac hemodynamics is shown in the Groups of bisoprolol and valsartan.

scholarly journals Diastolic dysfunction and mortality in 436  360 men and women: the National Echo Database Australia (NEDA)

2020 ◽  
Author(s):  
David Playford ◽  
Geoff Strange ◽  
David S Celermajer ◽  
Geoffrey Evans ◽  
Gregory M Scalia ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Cardiovascular Imaging ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Prognostic Impact ◽  
Ventricular Ejection Fraction ◽  
Increased Risk ◽  
American Society ◽  
Related Mortality

Abstract Aims  To examine the characteristics/prognostic impact of diastolic dysfunction (DD) according to 2016 American Society of Echocardiography (ASE) and European Society of Cardiovascular Imaging (ESCVI) guidelines, and individual parameters of DD. Methods and results  Data were derived from a large multicentre mortality-linked echocardiographic registry comprising 436 360 adults with ≥1 diastolic function measurement linked to 100 597 deaths during 2.2 million person-years follow-up. ASE/European Association of Cardiovascular Imaging (EACVI) algorithms could be applied in 392 009 (89.8%) cases; comprising 11.4% of cases with ‘reduced’ left ventricular ejection fraction (LVEF < 50%) and 88.6% with ‘preserved’ LVEF (≥50%). Diastolic function was indeterminate in 21.5% and 62.2% of ‘preserved’ and ‘reduced’ LVEF cases, respectively. Among preserved LVEF cases, the risk of adjusted 5-year cardiovascular-related mortality was elevated in both DD [odds ratio (OR) 1.31, 95% confidence interval (CI) 1.22–1.42; P < 0.001] and indeterminate status cases (OR 1.11, 95% CI 1.04–1.18; P < 0.001) vs. no DD. Among impaired LVEF cases, the equivalent risk of cardiovascular-related mortality was 1.51 (95% CI 1.15–1.98, P < 0.001) for increased filling pressure vs. 1.25 (95% CI 0.96–1.64, P = 0.06) for indeterminate status. Mitral E velocity, septal e’ velocity, E:e’ ratio, and LAVi all correlated with mortality. On adjusted basis, pivot-points of increased risk for cardiovascular-related mortality occurred at 90 cm/s for E wave velocity, 9 cm/s for septal e’ velocity, an E:e’ ratio of 9, and an LAVi of 32 mL/m2. Conclusion  ASE/EACVI-classified DD is correlated with increased mortality. However, many cases remain ‘indeterminate’. Importantly, when analysed individually, mitral E velocity, septal e’ velocity, E:e’ ratio, and LAVi revealed clear pivot-points of increased risk of cardiovascular-related mortality.

scholarly journals Pericardial fat and its influence on cardiac diastolic function

2020 ◽  
Author(s):  
Vera de Wit-Verheggen ◽  
Sibel Altintas ◽  
Romy Spee ◽  
Casper Mihl ◽  
Sander van Kuijk ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Linear Regression Analysis ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Pericardial Fat ◽  
Left Atrial Volume Index

Abstract BackgroundPericardial fat (PF) has been suggested to directly act on cardiomyocytes, leading to diastolic dysfunction. The aim of this study was to investigate whether PF volume is associated with diastolic function independently.Methods254 healthy adults (50-70 years, BMI 18-35 kg/m2, normal left ventricular ejection fraction) from the cardiology outpatient department were included in this study. All patients underwent a coronary computed tomographic angiography for the measurement of pericardial fat volume, as well as a transthoracic echocardiography for the assessment of diastolic function parameters. To assess the independent association of PF and diastolic function parameters multivariable linear regression analysis was performed. To maximize differences in PF volume, the group was divided in low (lowest quartile of both sexes) and high (highest quartile of both sexes) PF. Multivariable binary logistic analysis was used to study the associations within the groups between PF and diastolic function, adjusted for age, BMI and sex.ResultsSignificant associations for all four diastolic parameters with the PF volume were found after adjusting for BMI, age, and sex. In addition, subjects with high pericardial fat had a reduced left atrial volume index (p=0.02), lower E/e (p<0.01) and E/A (p=0.01), reduced e’ lateral (p<0.01), reduced e’ septal p=0.03), compared to subjects with low pericardial fat.ConclusionThese findings confirm that pericardial fat, even in healthy subjects with normal cardiac function, is associated with diastolic function. Our results suggest that the mechanical effects of PF may limit the distensibility of the heart and thereby directly contribute to diastolic dysfunction. Trial registration NCT01671930

scholarly journals New expectations for diastolic function assessment in transthoracic echocardiography based on a semi-automated computing of strain–volume loops

2020 ◽  
Vol 21 (12) ◽  
pp. 1366-1371 ◽  
Author(s):  
Arnaud Hubert ◽  
Virginie Le Rolle ◽  
Elena Galli ◽  
Auriane Bidaud ◽  
Alfredo Hernandez ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Automated Method ◽  
Significant Difference ◽  
Function Assessment

Abstract Aims Early diagnosis of heart failure with preserved ejection fraction (HFpEF) by determination of diastolic dysfunction is challenging. Strain–volume loop (SVL) is a new tool to analyse left ventricular function. We propose a new semi-automated method to calculate SVL area and explore the added value of this index for diastolic function assessment. Method and results Fifty patients (25 amyloidosis, 25 HFpEF) were included in the study and compared with 25 healthy control subjects. Left ventricular ejection fraction was preserved and similar between groups. Classical indices of diastolic function were pathological in HFpEF and amyloidosis groups with greater left atrial volume index, greater mitral average E/e’ ratio, faster tricuspid regurgitation (P &lt; 0.0001 compared with controls). SVL analysis demonstrated a significant difference of the global area between groups, with the smaller area in amyloidosis group, the greater in controls and a mid-range value in HFpEF group (37 vs. 120 vs. 72 mL.%, respectively, P &lt; 0.0001). Applying a linear discriminant analysis (LDA) classifier, results show a mean area under the curve of 0.91 for the comparison between HFpEF and amyloidosis groups. Conclusion SVLs area is efficient to identify patients with a diastolic dysfunction. This new semi-automated tool is very promising for future development of automated diagnosis with machine-learning algorithms.

scholarly journals Pericardial fat and its influence on cardiac diastolic function

2020 ◽  
Author(s):  
Vera de Wit-Verheggen ◽  
Sibel Altintas ◽  
Romy Spee ◽  
Casper Mihl ◽  
Sander van Kuijk ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Healthy Subjects ◽  
Linear Regression Analysis ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Pericardial Fat ◽  
Fat Volume

Abstract Background Pericardial fat (PF) has been suggested to directly act on cardiomyocytes, leading to diastolic dysfunction. The aim of this study was to investigate whether a higher PF volume is associated with a lower diastolic function in healthy subjects.Methods 254 adults (40-70 years, BMI 18-35 kg/m2, normal left ventricular ejection fraction), with (a)typical chest pain (otherwise healthy) from the cardiology outpatient clinic were retrospectively included in this study. All patients underwent a coronary computed tomographic angiography for the measurement of pericardial fat volume, as well as a transthoracic echocardiography for the assessment of diastolic function parameters. To assess the independent association of PF and diastolic function parameters, multivariable linear regression analysis was performed. To maximize differences in PF volume, the group was divided in low (lowest quartile of both sexes) and high (highest quartile of both sexes) PF volume. Multivariable binary logistic analysis was used to study the associations within the groups between PF and diastolic function, adjusted for age, BMI, and sex.Results Significant associations for all four diastolic parameters with the PF volume were found after adjusting for BMI, age, and sex. In addition, subjects with high pericardial fat had a reduced left atrial volume index (p=0.02), lower E/e (p<0.01) and E/A (p=0.01), reduced e’ lateral (p<0.01), reduced e’ septal p=0.03), compared to subjects with low pericardial fat.Conclusion These findings confirm that pericardial fat volume, even in healthy subjects with normal cardiac function, is associated with diastolic function. Our results suggest that the mechanical effects of PF may limit the distensibility of the heart and thereby directly contribute to diastolic dysfunction.Trial registration NCT01671930

scholarly journals New expectations for diastolic function assessment in TTE based on a semi-automated computing of strain-volume loops

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Hubert ◽  
V Le Rolle ◽  
E Galli ◽  
A Bidaut ◽  
A.I Hernandez ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Automated Method ◽  
Significant Difference ◽  
Function Assessment

Abstract Background Early diagnosis of heart failure with preserved ejection fraction (HFpEF) by determination of diastolic dysfunction is challenging. Strain-volume loop (SVL) is a new tool to analyze left ventricular function. Purpose We propose a new semi-automated method to calculate SVL area and explore the added value of this index for diastolic function assessment. Methods 50 patients (25 amyloidosis, 25 HFpEF) were included in the study and compared with 25 healthy control subjects. All patients underwent standard echocardiography. SVL area were also assessed. Results Left ventricular ejection fraction was preserved and similar between groups. Classical indices of diastolic function were pathological in HFpEF and amyloidosis groups with greater left atrial volume index, greater mitral average E/e' ratio, faster tricuspid regurgitation (p&lt;0.0001 compared with controls). SVL analysis demonstrated a significant difference of the global area between groups, with the smaller area in amyloidosis group, the greater in controls and a mid-range value in HFpEF group (37 vs 120 vs 72 ml.%, respectively, p&lt;0.0001) (Table 1). Applying a Linear Discriminant Analysis (LDA) classifier, results show a mean area under the curve (AUC) of 0.89 for the comparison between HFpEF and amyloidosis groups (Figure 1). Conclusion Strain-volume loops area is efficient to identify patients with a diastolic dysfunction. This new semi-automated tool is very promising for future development of automated diagnosis with machine-learning algorithms. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals The effect of spironolactone on diastolic function in haemodialysis patients

2021 ◽  
Author(s):  
T. Hauser ◽  
◽  
V. Dornberger ◽  
U. Malzahn ◽  
S. J. Grebe ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Diastolic Function ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Left Atrial Volume Index ◽  
Maintenance Haemodialysis ◽  
Significant Difference

AbstractHeart failure with preserved ejection fraction (HFpEF) is highly prevalent in patients on maintenance haemodialysis (HD) and lacks effective treatment. We investigated the effect of spironolactone on cardiac structure and function with a specific focus on diastolic function parameters. The MiREnDa trial examined the effect of 50 mg spironolactone once daily versus placebo on left ventricular mass index (LVMi) among 97 HD patients during 40 weeks of treatment. In this echocardiographic substudy, diastolic function was assessed using predefined structural and functional parameters including E/e’. Changes in the frequency of HFpEF were analysed using the comprehensive ‘HFA-PEFF score’. Complete echocardiographic assessment was available in 65 individuals (59.5 ± 13.0 years, 21.5% female) with preserved left ventricular ejection fraction (LVEF > 50%). At baseline, mean E/e’ was 15.2 ± 7.8 and 37 (56.9%) patients fulfilled the criteria of HFpEF according to the HFA-PEFF score. There was no significant difference in mean change of E/e’ between the spironolactone group and the placebo group (+ 0.93 ± 5.39 vs. + 1.52 ± 5.94, p = 0.68) or in mean change of left atrial volume index (LAVi) (1.9 ± 12.3 ml/m2 vs. 1.7 ± 14.1 ml/m2, p = 0.89). Furthermore, spironolactone had no significant effect on mean change in LVMi (+ 0.8 ± 14.2 g/m2 vs. + 2.7 ± 15.9 g/m2; p = 0.72) or NT-proBNP (p = 0.96). Treatment with spironolactone did not alter HFA-PEFF score class compared with placebo (p = 0.63). Treatment with 50 mg of spironolactone for 40 weeks had no significant effect on diastolic function parameters in HD patients.The trial has been registered at clinicaltrials.gov (NCT01691053; first posted Sep. 24, 2012).

Cardiac T2* Magnetic Resonance Imaging (MRI) in Iron Overload and Ventricular Diastolic Function.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2676-2676 ◽  
Author(s):  
Jane Hankins ◽  
Claudia Hillenbrand ◽  
Vijay Joshi ◽  
Ralf Loeffler ◽  
Ruitian Song ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Serum Ferritin ◽  
Myocardial Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Myocardial Iron ◽  
Ventricular Ejection Fraction ◽  
Systolic And Diastolic Function ◽  
Bright Blood

Abstract Accumulation of iron in the heart leads to myocardial dysfunction and in severe cases heart failure. Myocardial hemosiderosis occurs in many hematological diseases treated with blood transfusions, including sickle cell anemia (SCA) and beta thalassemia (β-thal). MRI T2* can quantify myocardial iron non-invasively and can be compared to functional studies (e.g., echocardiography). Multiple MRI readers can introduce variation in the measurement. We investigated the relationship of myocardial MRI T2* with echo measurements of both systolic and diastolic function, and the variability introduced by different MRI reviewers. Patients were selected if they received ≥ 18 transfusions, or had a serum ferritin ≥ 1000 ng/mL. Study participants underwent 1.5 Tesla MRI T2* and echocardiography testing within 30 days. Echo measurements included left ventricular ejection fraction (LVEF), mitral annular tissue Doppler (TDV) e’ velocity (a measure of LV diastolic function), left ventricular myocardial performance index (a measure of both systolic and diastolic function - LVMPI), and left ventricular mass index (LVMI). Regions of interest (ROI) were drawn in a homogeneous area of the intraventricular septum. Three independent reviewers, blinded to the patients’ clinical status and the other 2 reviewers’ results, performed the ROI analysis. Agreement among the 3 raters was assessed using interclass correlation coefficient (ICC). Echo findings were associated with heart T2* both as continuous and categorical (normal vs abnormal) variables. Forty-seven patients, median age 14 years (range 7 – 37), participated; 24 (51.1%) were female. Thirty-five (74.5%) had SCA, 8 (17%) had β-thal (major or intermedia), and 4 (8.5%) had bone marrow failure syndromes. Mean (±1SD) echo results were LVEF (±5.8) %, LVMI 86 (±20.4) g/m2, LVMPI 0.3 (±0.1), and TDV e’ velocity 16.2 (±3.4) cm/sec. Only one patient had low LVEF, but 8 (17%) had high LVMPI and 20 (42%) had low TDV e’ velocity. All patients had normal LVMI. The mean myocardium T2* ranged among the 3 reviewers from 27 to 33 (±6.9 to 8.7) msec. Agreement among the 3 raters had an ICC = 0.64. Median T2* values were significantly lower among patients with lower LVMI (32 versus 42 msec, p= 0.019). No other comparisons among echo and T2* results were significant. Median echo findings were compared with T2* values above and below 20 msec: lower LVMI (71 vs 89 g/m2, p=0.04), and higher LVMPI (0.48 versus 0.28, p=0.015) were found among patients with T2* &lt; 20 msec. Mean serum ferritin was 2917 (±2239) ng/mL. Serum ferritin was significantly negatively associated with T2* values (ρ=−0.33, p=0.031). We conclude: Most patients had normal LV systolic function, but 42% had signs of diastolic dysfunction, LVMPI was associated with myocardial iron loading (T2*&gt;20msec), suggesting diastolic dysfunction to be an early sign of myocardial dysfunction in cardiac hemosiderosis, Heart T2* was weakly associated with serum ferritin, The agreement among reviewers of the heart T2* technique was acceptable, but not high, likely reflecting technical difficulties of accurate myocardial ROI determination on “bright blood” T2* maps drawn on thin intraventricular septa. Dark blood techniques should therefore be investigated to reduce blood artifacts, potentially improving accuracy by eliminating artifacts from bright blood signals and thus reducing inter-rater variability in the ROI analysis of myocardial iron.

scholarly journals Validation of the 2016 ASE/EACVI Guideline for Diastolic Dysfunction in Patients With Unexplained Dyspnea and a Preserved Left Ventricular Ejection Fraction

2021 ◽  
Author(s):  
Arno A. van de Bovenkamp ◽  
Vidya Enait ◽  
Frances S. de Man ◽  
Frank T. P. Oosterveer ◽  
Harm Jan Bogaard ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Diagnostic Performance ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Preserved Ejection Fraction ◽  
Ventricular Ejection Fraction

Background Echocardiography is considered the cornerstone of the diagnostic workup of heart failure with preserved ejection fraction. Thus far, validation of the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging (ASE/EACVI) echo‐algorithm for evaluation of diastolic (dys)function in a patient suspected of heart failure with preserved ejection fraction has been limited. Methods and Results The diagnostic performance of the 2016 ASE/EACVI algorithm was assessed in 204 patients evaluated for unexplained dyspnea or pulmonary hypertension with echocardiogram and right heart catheterization. Invasively measured pulmonary capillary wedge pressure (PCWP) was used as the gold standard. In addition, the diagnostic performance of H 2 FPEF score and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) were evaluated. There was a poor correlation between indexed left atrial volume, E/e′ (septal and average) or early mitral inflow (E), and PCWP ( r =0.25–0.30, P values all <0.01). No correlation was found in our cohort between e′ (septal or lateral) or tricuspid valve regurgitation and PCWP. The correlation between diastolic function grades of the ASE/EACVI algorithm and PCWP was poor ( r =0.17, P <0.05). The ASE/EACVI algorithm had a sensitivity and specificity of 35% and 87%, respectively; an accuracy of 67% and an area under the curve of 0.56. Moreover, in 30% of cases the algorithm was not applicable or indeterminate. H 2 FPEF score had a modest correlation with PCWP ( r =0.44, P <0.0001), and accuracy was 73%; NT‐proBNP correlated weakly with PCWP ( r =0.24, P <0.001), and accuracy was 57%. Conclusions The 2016 ASE/EACVI algorithm for the assessment of diastolic function has a limited diagnostic accuracy in patients evaluated for unexplained dyspnea and/or pulmonary hypertension, and especially sensitivity to detect diastolic dysfunction was low.

scholarly journals A. N. Bakoulev Scientific Center for Cardiovascular Surgery

Kardiologiia ◽  
2019 ◽  
Vol 59 (5) ◽  
pp. 26-35
Author(s):  
I. I. Averina ◽  
O. L. Bockeria ◽  
M. Yu. Mironenko ◽  
S. A. Aleksandrova
Keyword(s):  
Heart Failure ◽  
Diastolic Function ◽  
Postoperative Period ◽  
Heart Diseases ◽  
Heart Defects ◽  
Left Ventricular ◽  
Early Postoperative Period ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Objective: to assess dynamics of diastolic function for detection of development of diastolic dysfunction (DD) and it’s causes, to evaluate the effect of DD on prognosis in the postoperative period in patients with acquired heart diseases.Materials and methods. We included in this study 112 patients with aortic and mitral valve diseases (90 men, 22 women, median age 51 [35; 57] years). All patients underwent echocardiography (echo), tissue Doppler, speckle tracking echo prior to surgery, in the early postoperative period (8–14 days) and in 12–36 months after surgery. In 28 patients dynamic contrast-enhanced magnetic resonance imaging was also performed. Patients were divided into groups according to prognosis: group 0 – without complications; group 1 – with postoperative heart failure (HF) and preserved left ventricular ejection fraction (EF); group 2 – with HF and EF <45 %. The following parameters were used for identifying left ventricular (LV) DD: septal velocity es <7 cm / sec, lateral el <10 cm / sec, average E / e ratio >14, left atrial (LA) volume index >34 ml / m2, peak tricuspid regurgitation velocity >2.8 m / sec.Results. Initially diastolicLV function was normal in 34 of 112 patients (30.4 %), in early postoperative period DD emerged in 9 (26.5 %) of these patients. The appearance of LV DD was associated with decrease of septal es immediately after surgery and its subsequent progressive decline in the long-term postoperative period from 8.5±0.71 to 4.6 ±0.53 cm / sec (p=0.005). Worsening of diastolic function and lowering of septal velocity was detected namely in patients with presence of fibrosis. In the group of other patients in whom fibrosis was not studied and the degree of DD increased there was a transient decrease of lateral el (from 10.2±3.1 to 7.5±2.43 cm / sec, p=0.035) and an increase of the E / el (from 10.53±4.07 to 14.5±5.23, p=0.05) in the early period after the operation. There were no correlations between DD and LV EF,LV volumes, and development of arrhythmias. The prognostic model for DD included average longitudinal deformation of LA (global LA longitudinal strain) and E / e ratio on the tricuspid lateral annular velocity.Conclusions. Appearance of DD in postoperative period after correction of acquired heart defects was due to damage of the septal diastolic function which correlated with fibrosis and was indicative of inadequate myocardial protection. The model of development of heart failure with normal EF after operation was designed.

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