Peak Apical Recoil Rate is a Simplified Index of Left Ventricular Untwist: Validation and Application for Assessment of Diastolic Function in Children

2021 ◽  
Author(s):  
putri yubbu ◽  
Hunter Kauffman ◽  
Renzo Calderon-Anyosa ◽  
Andrea E. Monteroa ◽  
Tomoyuki Sato ◽  
...  
Keyword(s):  
Heart Rate ◽  
Healthy Subjects ◽  
Validation Cohort ◽  
Intraclass Correlation ◽  
Left Ventricular ◽  
Isovolumic Relaxation Time ◽  
Incremental Value ◽  
Pulmonary Capillary ◽  
Straight Leg Raising ◽  
Isovolumic Relaxation

Abstract AimsTo simplify measurement of untwist by measuring the recoil rate of LV apex only, to validate and apply peak apical recoil rate (PARR) as an index of diastolic dysfunction (DD) in pediatric subjects during increased and decreased lusitropic states. Methods and ResultsWe recruited 153 healthy subjects (mean age 13.8+2.9 years), of whom 48 performed straight leg raising exercise and an additional 46 patients (mean 8.4+5.6 years) with documented pulmonary capillary wedge pressures (PCWP) (validation cohort). In addition, we studied 16 dilated cardiomyopathy patients (mean age 9.5+6.3years) (application cohort). PARR and isovolumic relaxation time (IVRT) were compared to PCWP. Both PARR and PARR normalized by heart rate (nPARR) were excellent in detecting patient with PCWP >12 mmHg and greatly superior to IVRT in this respect (AUC: 0.98, 95% CI [0.96, 1.0] vs. AUC: 0.7 95%CI [0.54,0.86]). In DCM patients, PARR and nPARR were greatly decreased compared to controls (-38.58+18.59º/s vs -63.07+16.35º /s, p< 0.001) and (-0.43+0.20 º/ s/min vs -0.83+0.28º/s/min, p<0.0001) but increased with straight leg raising exercise (-59.4+19.4º/s vs -97.82+39.0 º/s, p<0.01) and -0.85+0.36 vs -1.4+0.62 º/s/min (p< 0.0001). The intra-observer and inter-observer intraclass correlation (ICC) coefficients were 0.95 and 0.88, respectively.ConclusionPARR successfully detected increased and decreased lusitropic states and was not affected by age when normalized with heart rate. Both PARR and nPARR are superior to IVRT in their correlation with PCWP and offer incremental value over traditional indices of DD. This highly reproducible parameter may potentially serve as a useful index of elevated PCWP in children.

Influence of heart rate on left ventricular isovolumic relaxation time: a Doppler study in healthy newborns

2004 ◽  
Vol 17 (4) ◽  
pp. 330-331 ◽  
Author(s):  
Antonio De Merulis ◽  
Giulio Calcagni ◽  
Paolo Versacci ◽  
Renato Lucchini ◽  
Flavia Ventriglia ◽  
...  
Keyword(s):  
Heart Rate ◽  
Relaxation Time ◽  
Left Ventricular ◽  
Isovolumic Relaxation Time ◽  
Doppler Study ◽  
Isovolumic Relaxation

Adverse Effects of Hypoxaemia on Diastolic Filling in Humans

1995 ◽  
Vol 89 (2) ◽  
pp. 165-169 ◽  
Author(s):  
Robert I. Cargill ◽  
David G. Kiely ◽  
Brian J. Lipworth
Keyword(s):  
Heart Rate ◽  
Relaxation Time ◽  
Confidence Interval ◽  
Left Ventricular ◽  
Mean Difference ◽  
Oxygen Mixture ◽  
Diastolic Filling ◽  
Isovolumic Relaxation Time ◽  
Isovolumic Relaxation ◽  
Deceleration Time

1. Abnormalities of myocardial relaxation may occur as a consequence of myocyte hypoxia. We have therefore examined the effects of hypoxaemia on right and left ventricular diastolic function in 10 healthy male subjects. 2. After resting to reach baseline haemodynamics, subjects were rendered hypoxaemic by breathing a variable nitrogen/oxygen mixture. Oxygen saturation (SaO2) was maintained at 85–90% for 20 min and then at 75–80% for a further 20 min. Haemodynamic and diastolic filling parameters were measured non-invasively at baseline and at the end of each period of hypoxaemia. 3. Diastolic filling of both ventricles was significantly impaired by hypoxaemia. In comparison with baseline, left ventricular isovolumic relaxation time and transmitral E-wave deceleration time corrected for heart rate were significantly prolonged at SaO2 75–80%: mean difference in corrected relaxation time, 9.8 ms (95% confidence interval 1–19); mean difference in corrected deceleration time, 34 ms (95% confidence interval 11–56). Similarly, right ventricular isovolumic relaxation time and transtricuspid E-wave deceleration time were significantly prolonged at SaO2 values of 75–80% compared with baseline: mean difference in relaxation time, 20.3 ms (95% confidence interval 3–38); mean difference in deceleration time, 33 ms (95% confidence interval 11–55). 4. During hypoxaemia there were dose-related increases in heart rate, cardiac output and mean pulmonary artery pressure, but no effects on mean arterial pressure. 5. Hypoxaemia significantly impairs relaxation of left and right ventricles in normal humans. These changes may reflect impairment of intracellular calcium transport secondary to the effects of myocyte hypoxia.

scholarly journals Childhood and adult exposure to secondhand tobacco smoke and cardiac structure and function: results from Echo-SOL

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000831 ◽  
Author(s):  
Melissa Suzanne Burroughs Peña ◽  
Katrina Swett ◽  
Robert C Kaplan ◽  
Krista Perreira ◽  
Martha Daviglus ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Isovolumic Relaxation Time ◽  
Shs Exposure ◽  
Cardiac Structure And Function ◽  
And Function ◽  
Relationship Of ◽  
The Relationship ◽  
Isovolumic Relaxation

ObjectiveTo describe the relationship of household secondhand smoke (SHS) exposure and cardiac structure and function.MethodsParticipants (n=1069; 68 % female; age 45–74 years) without history of tobacco use, coronary artery disease or severe valvular disease were included. Past childhood (starting at age <13 years), adolescent/adult and current exposure to household SHS was assessed. Survey linear regression analyses were used to model the relationship of SHS exposure and echocardiographic measures of cardiac structure and function, adjusting for covariates (age, sex, study site, alcohol use, physical activity and education).ResultsSHS exposure in childhood only was associated with reduced E/A velocity ratio (β=−0.06 (SE 0.02), p=0.008). SHS exposure in adolescence/adult only was associated with increased left ventricular ejection fraction (LVEF) (1.2 (0.6), p=0.04), left atrial volume index (1.7 (0.8), p=0.04) and decreased isovolumic relaxation time (−0.003 (0.002), p=0.03). SHS exposure in childhood and adolescence/adult was associated with worse left ventricular global longitudinal strain (LVGLS) (two-chamber) (0.8 (0.4), p= 0.049). Compared with individuals who do not live with a tobacco smoker, individuals who currently live with at least one tobacco smoker had reduced LVEF (−1.4 (0.6), p=0.02), LVGLS (average) (0.9 (0.40), p=0.03), medial E′ velocity (−0.5 (0.2), p=0.01), E/A ratio (−0.09 (0.03), p=0.003) and right ventricular fractional area change (−0.02 (0.01), p=0.01) with increased isovolumic relaxation time (0.006 (0.003), p=0.04).ConclusionsPast and current household exposure to SHS was associated with abnormalities in cardiac systolic and diastolic function. Reducing household SHS exposure may be an opportunity for cardiac dysfunction prevention to reduce the risk of future clinical heart failure.

Pulsed Doppler assessment of left ventricular diastolic function in normal and cardiomyopathic cats

1999 ◽  
Vol 35 (4) ◽  
pp. 285-291 ◽  
Author(s):  
JM Bright ◽  
ME Herrtage ◽  
JF Schneider
Keyword(s):  
Relaxation Time ◽  
Diastolic Function ◽  
Peak Velocity ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
P Value ◽  
Pulsed Doppler ◽  
Time Data ◽  
Isovolumic Relaxation Time ◽  
Isovolumic Relaxation

Left ventricular (LV) diastolic function was evaluated in 16 cats with primary hypertrophic cardiomyopathy (HCM) using pulsed Doppler (PD) assessment of transmitral flow and isovolumic relaxation time. Data obtained was compared to data from 12 healthy, adult, research cats. Compared to normal cats, the HCM group showed significantly (p value less than 0.05) reduced early LV inflow velocities (mean +/- standard error [SE], peak velocity of 0.70+/-0.04 m/s versus 0.54+/-0.04 m/s and integrated velocity of 0.48+/-0.08 m/s versus 0.37+/-0.03 m/s); a reduced rate of deceleration of early inflow (mean+/-SE, -12.0+/-1.0 m/s2 versus -5.1+/-1.1 m/s2); prolonged isovolumic relaxation time (mean +/- SE, 45.7+/-3.3 ms versus 76.0+/-3.1 ms); and increased atrial systolic flow velocities (mean +/- SE, peak velocity of 0.29+/-0.04 m/s versus 0.48+/-0.04 m/s and integrated velocity of 0.21+/-0.03 m/s versus 0.34+/-0.03 m/s). The results suggest that PD provides a noninvasive method of identifying and quantifying functional diastolic impairment in cats with HCM.

Brain Natriuretic Peptide: Effect on Left Ventricular Filling Patterns in Healthy Subjects

1995 ◽  
Vol 88 (2) ◽  
pp. 159-164 ◽  
Author(s):  
Peter B. M. Clarkson ◽  
Nigel M. Wheeldon ◽  
Catherine MacLeod ◽  
Wendy Coutie ◽  
Thomas M. MacDonald
Keyword(s):  
Relaxation Time ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Plasma Concentrations ◽  
Physiological Role ◽  
Normal Subjects ◽  
Left Ventricular ◽  
Double Blind ◽  
Isovolumic Relaxation Time ◽  
Isovolumic Relaxation

1. Elevated plasma concentrations of brain natriuretic peptide are found in conditions associated with impaired left ventricular diastolic function. The purpose of this study was to determine whether this peptide actually plays a physiological role in improving myocardial performance in diastole. 2. Nine normal subjects received infusions of brain natriuretic peptide or placebo in a randomized, double-blind, crossover study. Brain natriuretic peptide infusion produced a significant reduction in isovolumic relaxation time (means and 95% confidence interval for difference−10.8 ms, −14.5 to −7.0 ms) (P < 0.01) and significantly increased both the peak E/A velocity (0.54, 0.14–0.94) (P < 0.05) and the E/A time velocity integral (1.09, 0.20–1.98) (P < 0.05). 3. These responses were evident at concentrations of brain natriuretic peptide that produced no associated effects on blood pressure, heart rate or stroke distance. 4. Brain natriuretic peptide infusion in normal subjects significantly reduces isovolumic relaxation time and improves transmitral Doppler flow profiles, suggesting that this peptide may be important in the control of left ventricular diastolic relaxation in man.

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