scholarly journals Left ventricular diastolic dysfunction in patients with metabolic syndrome

2012 ◽  
Vol 65 (1-2) ◽  
pp. 18-22 ◽  
Author(s):  
Davor Penjaskovic ◽  
Dejan Sakac ◽  
Jovanka Dejanovic ◽  
Radovan Zec ◽  
Nada Zec-Petkovic ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Arterial Hypertension ◽  
Diastolic Dysfunction ◽  
Central Obesity ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Positive Correlation ◽  
Medical Disorders ◽  
Cardiovascular Morbidity And Mortality

Metabolic syndrome (MetS), which is a cluster of medical disorders, is common and it is associated with increased cardiovascular morbidity and mortality. The aim of this study was to evaluate the relationship between characteristics of metabolic syndrome and the grade of diastolic dysfunction. The study included 72 patients (29 male and 43 female), who had central obesity and at least two of the other four characteristics of metabolic syndrome according to IDF (International Diabetes Federation) criteria. The exclusion criteria were age above 65, impaired systolic function (left ventricular ejection fraction <55%), atrial fibrillation, valvular and pericardial heart disease. Diastolic function was determined according to the criteria of the American Society of Echocardiography. There was a positive correlation between the number of characteristics of metabolic syndrome and the diastolic dysfunction grade (p<0.0001). The positive correlation was found between the grade of diastolic dysfunction and the waist circumference (p<0.0001), arterial hypertension (p<0.001), pared glucose tolerance/diabetes (P=0.0063), and hypertriglyceridemia (p=0.0262). A low level of high-density lipoprotein did not show a statistically significant correlation. The presence of metabolic syndrome is associated with the presence of diastolic dysfunction. The grade of diastolic dysfunction is dependent on the number of coexisting characteristics of metabolic syndrome. Arterial hypertension, central obesity, hyperglycemia and hypertriglyceridemia showed a significant correlation with the degree of diastolic dysfunction.

Pathophysiology and causes of cardiac failure

2016 ◽  
Author(s):  
Alexandre Mebazaa ◽  
Mervyn Singer
Keyword(s):  
Stroke Volume ◽  
Diastolic Dysfunction ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Stroke Work ◽  
Compensatory Mechanisms ◽  
Ventricular Ejection Fraction

Organ congestion upstream of the dysfunctional left and/or right ventricle, with preserved stroke volume, is the most frequkeywordent feature of myocardial failure.Clinical manifestations do not necessarily correlate with the degree of left ventricular systolic dysfunction (i.e. left ventricular ejection fraction).Systolic and/or diastolic dysfunction may be present, with systolic dysfunction usually predominating.Pulmonary oedema is related to left ventricular diastolic dysfunction. Compensatory mechanisms (within the heart and/or periphery) may prove paradoxically disadvantageous on ventricular stroke work and stroke volume.

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 &lt; 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 &lt; 0.001] and indeterminate status cases (OR 1.11, 95% CI 1.04–1.18; P &lt; 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 &lt; 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.

The clinical and experimental analysis of ventricular rhythm disturbances in the patients with type 2 diabetes mellitus suffering from diastolic cardiac insufficiency

2015 ◽  
Vol 61 (2) ◽  
pp. 21-27
Author(s):  
I P Tatarchenko ◽  
N V Pozdnyakova ◽  
A G Denisova ◽  
O I Morozova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Left Ventricular ◽  
Cardiac Insufficiency ◽  
Left Ventricular Ejection ◽  
Ventricular Extrasystole ◽  
Ventricular Ejection Fraction

The present study was focused on the assessment of electrophysiological, structural, and functional characteristics of the heart associated with ventricular rhythm disturbances in the patients with type 2 diabetes mellitus (DM2) suffering from diastolic cardiac insufficiency. The study involved a total of 128 patients with DM2 and coronary heart disease (CHD) exhibiting signs of functional class I-III chronic cardiac insufficiency and left ventricular ejection fraction over 50%. The patients were divided into three groups. Group 1 (n=55) included patients presenting with left ventricular relaxation. Group 2 (n=44) was comprised of the patients with the pseudo-normal type of diastolic dysfunction. Group 3 (n=29) consisted of the patients with restrictive diastolic dysfunction. The patients of the latter group were characterized by the high frequency of complicated forms of ventricular arrhythmia, such as Grade IV-V ventricular extrasystole (48.3%) and Grade III ventricular extrasystole (34.5%). Restrictive type of diastolic dysfunction was associated with the delayed fragmented activity in the end part of the ventricular complex in 72.4% of the patients. The close correlation between the left ventricular diastolic function and parameters of myocardial electrical remodeling was documented.

scholarly journals Clinical and Echocardiographic Predictors of Arrhythmias Detected With 24-Hour Holter Electrocardiography Among Hypertensive Heart Failure Patients in Nigeria

2017 ◽  
Vol 11 ◽  
pp. 117954681774663
Author(s):  
Tuoyo Omasan Mene-Afejuku ◽  
Michael Olabode Balogun ◽  
Anthony Olubunmi Akintomide ◽  
Rasaaq Ayodele Adebayo ◽  
Olufemi Eyitayo Ajayi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ventricular Arrhythmias ◽  
Nyha Class ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Premature Ventricular Contractions ◽  
Ventricular Ejection Fraction ◽  
Positive Correlation ◽  
Heart Failure Patients ◽  
Elevated Systolic Blood Pressure

Background: Hypertensive heart failure (HHF) is the commonest form of heart failure in Nigeria. There is paucity of data in Nigeria on 24-hour Holter electrocardiography (24-HHECG) and important predictors of arrhythmias among HHF patients. Objectives: To determine the 24-HHECG characteristics among HHF patients. To determine the clinical and echocardiographic predictors of arrhythmias detected using 24-HHECG among HHF patients. Methods: A total of 100 HHF patients as well as 50 age-matched and sex-matched apparently healthy controls were prospectively recruited over a period of 1 year. They all had baseline laboratory tests, echocardiography, and 24-HHECG. Results: Hypertensive heart failure patients had significantly higher counts of premature ventricular contractions (PVCs) than the controls ( P ≤ .001). Ventricular tachycardia (VT) was recorded in 29% of HHF patients as compared with controls who had no VT on 24-HHECG. The standard deviation of all normal to normal sinus RR intervals over 24 hours (SDNN) was abnormally reduced among HHF patients when compared with controls ( P = .046). There was positive correlation between atrial fibrillation (AF) and the following parameters: PVCs ( r = .229, P = .015), New York Heart Association (NYHA) ( r = .196, P = .033), and VT ( r = .223, P = .018). Following multiple linear regression, left ventricular ejection fraction (LVEF) ( P ≤ .001) and serum urea ( P = .037) were predictors of PVCs among HHF patients. Serum creatinine ( P ≤ .001), elevated systolic blood pressure (SBP) ( P = .005), and PVCs ( P ≤ .001) were important predictors of VT among HHF patients. Conclusions: Renal dysfunction and reduced LVEF were important predictors of ventricular arrhythmias. High counts of PVCs and elevated SBP were predictive of the occurrence of VT among HHF patients. The NYHA class and ventricular arrhythmias have a significant positive correlation with AF. The SDNN is reduced in HHF patients.

scholarly journals Effects of Carfilzomib Therapy on Left Ventricular Function in Multiple Myeloma Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Giulia Mingrone ◽  
Anna Astarita ◽  
Lorenzo Airale ◽  
Ilaria Maffei ◽  
Marco Cesareo ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Left Ventricular Function ◽  
Diastolic Dysfunction ◽  
Ventricular Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Lv Function ◽  
Ventricular Ejection Fraction ◽  
Increased Risk ◽  
Cardiovascular Evaluation

Background: Carfilzomib improves the prognosis of multiple myeloma (MM) patients but significantly increases cardiovascular toxicity. The timing and effect of Carfilzomib therapy on the left ventricular function is still under investigation. We sought to assess the echocardiographic systo-diastolic changes, including global longitudinal strain (GLS), in patients treated with Carfilzomib and to identify predictors of increased risk of cardiovascular adverse events (CVAEs) during therapy.Methods: Eighty-eight patients with MM performed a baseline cardiovascular evaluation comprehensive of transthoracic echocardiogram (TTE) before the start of Carfilzomib therapy and after 6 months. All patients were clinically followed up to early identify the occurrence of CVAEs during the whole therapy duration.Results: After Carfilzomib treatment, mean GLS slightly decreased (−22.2% ± 2.6 vs. −21.3% ± 2.5; p &lt; 0.001). Fifty-eight percent of patients experienced CVAEs during therapy: 71% of them had uncontrolled hypertension, and 29% had major CVAEs or CV events not related to arterial hypertension. GLS variation during therapy was not related to an increased risk of CVAEs; however, patients with baseline GLS ≥ −21% and/or left ventricular ejection fraction (LVEF) ≤ 60% had a greater risk of major CVAEs (OR = 6.2, p = 0.004; OR = 3.7, p = 0.04, respectively). Carfilzomib led to a higher risk of diastolic dysfunction (5.6 vs. 13.4%, p = 0.04) and to a rise in E/e′ ratio (8.9 ± 2.7 vs. 9.7 ± 3.7; p = 0.006).Conclusion: Carfilzomib leads to early LV function impairment early demonstrated by GLS changes and diastolic dysfunction. Baseline echocardiographic parameters, especially GLS and LVEF, might improve cardiovascular risk stratification before treatment.

Prevalence and clinical characteristics of patients presenting with phase 4 atrioventricular block

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
S-S Bun ◽  
N Heme ◽  
F Asarisi ◽  
F Squara ◽  
D Scarlatti ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Atrioventricular Block ◽  
Conduction Block ◽  
Premature Ventricular Contraction ◽  
Left Ventricular ◽  
University Hospital ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Conduction Disorders ◽  
High Degree

Abstract Funding Acknowledgements Type of funding sources: None. Background The prevalence of phase 4 atrioventricular block (4AVB) is not known. Objective To assess the exact prevalence of 4AVB in a population of patients with high-degree AVB. Methods All the ECG from patients admitted for high-degree AVB (2 to 1 and complete) were collected at the University Hospital of Nice. The ECG tracings (12-lead surface and telemonitoring during hospitalization) were reviewed by an electrophysiologist. Results From Sept 2019 to Sept 2020, 65 patients were admitted for high-degree AVB. 8 patients (12 %) with 4AVB were identified (3 men; 88 ± 5 years). Arterial hypertension was present in 7/8 (87 %), and a syncopal episode - 4AVB-related - was noticed in 6/8 patients (75 %), mean left ventricular ejection fraction 54 ± 13 %. Baseline QRS width and corrected QT intervals were respectively 131 ± 30 ms and 469 ± 34 ms). 4AVB sequence was induced by a: premature atrial contraction (5/8), premature ventricular contraction (1/8), conduction block in a branch (1/8), sinus rhythm acceleration (1/8). All patients received a dual-chamber pacemaker during hospitalization. Conclusion The exact prevalence of 4AVB is not rare (12 %), and may be underestimated. 4AVB is usually observed in an elderly population, treated for arterial hypertension, and with baseline conduction disorders. Abstract Figure. Phase 4 AVB induced by PAC

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