scholarly journals Impact of Pulse Wave Velocity and Parameters Reflecting Android Type Fat Distribution on Left Ventricular Diastolic Dysfunction in Patients with Chronic Coronary Syndromes

2020 ◽  
Vol 9 (12) ◽  
pp. 3924
Author(s):  
Marlena Paniczko ◽  
Małgorzata Chlabicz ◽  
Jacek Jamiołkowski ◽  
Paweł Sowa ◽  
Małgorzata Szpakowicz ◽  
...  
Keyword(s):  
Pulse Wave Velocity ◽  
Diastolic Dysfunction ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Fat Distribution ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Diastolic Dysfunction ◽  
Coronary Syndromes

Background: Left ventricular diastolic dysfunction (LVDD) is caused by a decreased left ventricle relaxation and is associated with an increased risk of symptomatic heart failure (HF) and excessive mortality. Aim: To evaluate the frequency and factors related to LVDD in the population with chronic coronary syndromes (CCS). Methods: 200 patients (mean age 63.18 ± 8.12 years, 75.5% male) with CCS were included. LVDD was diagnosed based on the recent echocardiography guidelines. Results: LVDD was diagnosed in 38.5% of CCS population. From the studied factors, after adjustment for age, sex, and N-terminal pro-brain natriuretic peptide (NT-proBNP), LVDD associated positively with android/gynoid (A/G) fat mass ratio, left ventricular mass index (LVMI), and negatively with Z-score and left ventricular ejection fraction (LVEF). In stepwise backward logistic regression analysis, the strongest factors associated with LVDD were pulse wave velocity value, handgrip strength and waist to hip ratio (WHR). Conclusions: LVDD is common among CCS patients and it is associated with parameters reflecting android type fat distribution regardless of NT-proBNP and high-sensitivity troponin T concentrations. Deterioration in diastolic dysfunction is linked with increased aortic stiffness independently of age and sex. Further studies evaluating the effects of increasing physical fitness and lowering abdominal fat accumulations on LVDD in CCS patients should be considered.

scholarly journals Opportunistic screening models for high-risk men and women to detect diastolic dysfunction and heart failure with preserved ejection fraction in the community

2018 ◽  
Vol 26 (6) ◽  
pp. 613-623 ◽  
Author(s):  
Aisha Gohar ◽  
Rogier F Kievit ◽  
Gideon B Valstar ◽  
Arno W Hoes ◽  
Evelien E Van Riet ◽  
...  
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Preserved Ejection Fraction ◽  
Men And Women ◽  
Ventricular Diastolic Dysfunction

Background The prevalence of undetected left ventricular diastolic dysfunction is high, especially in the elderly with comorbidities. Left ventricular diastolic dysfunction is a prognostic indicator of heart failure, in particularly of heart failure with preserved ejection fraction and of future cardiovascular and all-cause mortality. Therefore we aimed to develop sex-specific diagnostic models to enable the early identification of men and women at high-risk of left ventricular diastolic dysfunction with or without symptoms of heart failure who require more aggressive preventative strategies. Design Individual patient data from four primary care heart failure-screening studies were analysed (1371 participants, excluding patients classified as heart failure and left ventricular ejection fraction <50%). Methods Eleven candidate predictors were entered into logistic regression models to be associated with the presence of left ventricular diastolic dysfunction/heart failure with preserved ejection fraction in men and women separately. Internal-external cross-validation was performed to develop and validate the models. Results Increased age and β-blocker therapy remained as predictors in both the models for men and women. The model for men additionally consisted of increased body mass index, moderate to severe shortness of breath, increased pulse pressure and history of ischaemic heart disease. The models performed moderately and similarly well in men (c-statistics range 0.60–0.75) and women (c-statistics range 0.51–0.76) and the performance improved significantly following the addition of N-terminal pro b-type natriuretic peptide (c-statistics range 0.61–0.80 in women and 0.68–0.80 in men). Conclusions We provide an easy-to-use screening tool for use in the community, which can improve the early detection of left ventricular diastolic dysfunction/heart failure with preserved ejection fraction in high-risk men and women and optimise tailoring of preventive interventions.

scholarly journals The Grade of Left Ventricular Diastolic Dysfunction as a Predictive Factor for Permanent Atrial Fibrillation

2015 ◽  
Vol 61 (3) ◽  
pp. 158-160
Author(s):  
Cerghizan Anda ◽  
Keresztesi Arthur Atilla ◽  
Bataga Simona ◽  
Tilea Ioan
Keyword(s):  
Atrial Fibrillation ◽  
Diastolic Dysfunction ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Left Atrial Size ◽  
Ventricular Ejection Fraction ◽  
Permanent Atrial Fibrillation ◽  
Atrial Size ◽  
Ventricular Diastolic Dysfunction

Abstract The objective of this study was to find a link between the grade of left ventricular diastolic dysfunction (LVDD) and the progression to permanent non-valvular atrial fibrillation (AF), in a group of patients with left ventricular diastolic dysfunction and paroxysmal or persistent atrial fibrillation. Methods: A bidirectional study on 57 patients meeting the inclusion criteria was conducted; each patient was admitted in a university-based hospital between January 1st - June, 30, 2013, with a follow up 3 and 6 months later. Permanent atrial fibrillation development was followed. Results: Out of the 57 patients, 23 had paroxysmal AF and 34 were with persistent AF. After six months, 21 patients progressed to permanent AF, representing 36.84% of the total patients. Female patients with age over 65 had more often atrial fibrillation, but more men progressed to a sustained form of AF. No statistically significant difference regarding the grade of diastolic dysfunction, the left atrial size or volume, or the left ventricular ejection fraction was observed between the patients with progression, compared to those without progression. Conclusions: The grade of left ventricular diastolic dysfunction did not prove to be a predictive factor for permanent atrial fibrillation, neither the left atrial size or volume, or the left ventricular ejection fraction.

Left ventricular ejection time, not heart rate, is an independent correlate of aortic pulse wave velocity

2013 ◽  
Vol 115 (11) ◽  
pp. 1610-1617 ◽  
Author(s):  
Paolo Salvi ◽  
Carlo Palombo ◽  
Giovanni Matteo Salvi ◽  
Carlos Labat ◽  
Gianfranco Parati ◽  
...  
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Heart Period ◽  
Ejection Time ◽  
Left Ventricular Ejection Time ◽  
Ventricular Ejection Time

Several studies showed a positive association between heart rate and pulse wave velocity, a sensitive marker of arterial stiffness. However, no study involving a large population has specifically addressed the dependence of pulse wave velocity on different components of the cardiac cycle. The aim of this study was to explore in subjects of different age the link between pulse wave velocity with heart period (the reciprocal of heart rate) and the temporal components of the cardiac cycle such as left ventricular ejection time and diastolic time. Carotid-femoral pulse wave velocity was assessed in 3,020 untreated subjects (1,107 men). Heart period, left ventricular ejection time, diastolic time, and early-systolic dP/dt were determined by carotid pulse wave analysis with high-fidelity applanation tonometry. An inverse association was found between pulse wave velocity and left ventricular ejection time at all ages (<25 years, r2 = 0.043; 25–44 years, r2 = 0.103; 45–64 years, r2 = 0.079; 65–84 years, r2 = 0.044; ≥85 years, r2 = 0.022; P < 0.0001 for all). A significant ( P < 0.0001) negative but always weaker correlation between pulse wave velocity and heart period was also found, with the exception of the youngest subjects ( P = 0.20). A significant positive correlation was also found between pulse wave velocity and dP/dt ( P < 0.0001). With multiple stepwise regression analysis, left ventricular ejection time and dP/dt remained the only determinant of pulse wave velocity at all ages, whereas the contribution of heart period no longer became significant. Our data demonstrate that pulse wave velocity is more closely related to left ventricular systolic function than to heart period. This may have methodological and pathophysiological implications.

scholarly journals Conventional and optional cardiovascular risk factors in predicting outcome in hemodialysis patients

2020 ◽  
Vol 19 (3) ◽  
pp. 2304
Author(s):  
O. A. Bilevich ◽  
N. V. Ovsyannikov ◽  
E. V. Usacheva ◽  
O. M. Kulikova
Keyword(s):  
Cardiovascular Risk ◽  
General Population ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Hemodialysis Patients ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Decision Tree Method

Aim. To evaluate the frequency and effects on prognosis of conventional and optional cardiovascular risk (CVR) factors in hemodialysis patients.Material and methods. The study included 82 patients receiving hemodialysis. Clinical examination was carried out. We also assesed heart rate variability and pulse wave velocity by photoplethysmography. To identify significant prognostic factors and determine the range of their values, the decision tree method was used.Results. In hemodialysis patients, the prevalence of hypertension and overweight was higher than in the general population — 100% vs 33,8% and 51,2% vs 29,7%, respectively; the smoking prevalence was comparable — 25,6% vs 25,7%; the prevalence of hypercholesterolemia was lower than in the general population — 45,1% vs 57,6%. Optional CVR factors in hemodialysis patients were as follows: level of pulse pressure, duration of hypertension, hemoglobin level, pulse wave velocity, standard deviation normal to normal (SDNN), left ventricular ejection fraction. Based on a combination of significant CVR factors, 5 rules for predicting a favorable or unfavorable outcome in hemodialysis patients were identified.Conclusion. The use of proposed rules allows to develop novel measures and improve current ones aimed at modifying CVR factors and increasing the survival of hemodialysis patients.

scholarly journals Brachial-Ankle Pulse Wave Velocity Is the Only Index of Arterial Stiffness That Correlates with a Mitral Valve Indices of Diastolic Dysfunction, but No Index Correlates with Left Atrial Size

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Bryan Chow ◽  
Simon W. Rabkin
Keyword(s):  
Mitral Valve ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Diastolic Dysfunction ◽  
Wave Velocity ◽  
Left Atrial ◽  
Pulse Wave ◽  
Ankle Brachial Index ◽  
Left Atrial Volume ◽  
Left Ventricular

The objective of this study was to determine the optimal assessment of arterial stiffness that relates to diastolic dysfunction. Forty-one patients had measurements of brachial-ankle pulse wave velocity (baPWV), carotid-femoral pulse wave velocity (cfPWV), ankle brachial index (ABI), pulse pressure (PP), and augmentation index (AIx). Diastolic dysfunction was evaluated by echocardiographic indices of the ratio of the peak early diastolic mitral valve velocity and the peak late diastolic velocity (E/Aratio), left atrial diameter, and left atrial volume indexes. There was a significant (P<0.05) correlation between baPWV andE/Aratio with an inverse relationship indicating that higher arterial stiffness was associated with greater diastolic dysfunction. In contrast, there was no significant correlation betweenE/Aratio and cfPWV, PP, ABI, or AIx. After multivariate analysis, the relationship between baPWV andE/Aratio remained significant (P<0.05), independent of age and systolic blood pressure (BP). There were no correlations between any index of vascular stiffness and left atrial dimension or volume. In summary, baPWV correlates with diastolic dysfunction, independent of a patient’s age and BP and is a better indicator of diastolic dysfunction than other indicators of arterial stiffness. baPWV has the utility of infering the presence of left ventricular diastolic dysfunction.

Sign in / Sign up

Export Citation Format

Share Document