Left Ventricular Systolic Function Has Strong Independent Genetic Background from Diastolic Function: A Classical Twin Study

Background and Objectives: No data are available on whether the heritability of left ventricle (LV) systolic and diastolic parameters are independent of each other. Therefore, our aim was to assess the magnitude of common and independent genetic and environmental factors defining LV systolic and diastolic function. Materials and Methods: We analyzed 184 asymptomatic twins (65% female, mean age: 56 ± 9 years). Transthoracic echocardiography was performed to measure LV systolic (global longitudinal and circumferential strain; basal and apical rotation) and diastolic (early diastolic velocity of mitral inflow and lateral mitral annulus tissue; deceleration time and early diastolic strain rate) parameters using conventional and speckle-tracking echocardiography. Genetic structural equation models were evaluated to quantify the proportion of common and specific genetic (Ac, As) and environmental factors (Ec, Es) contributing to the phenotypes. Results: LV systolic parameters had no common genetic or environmental heritability (Ac range: 0–0%; Ec range: 0–0%; As range: 57–77%; Es range: 24–43%). Diastolic LV parameters were mainly determined by common genetic and environmental effects (Ac range: 9–40%; Ec range: 11–49%; As range: 0–29%; Es range: 0–51%). Systolic parameters had no common genetic or environmental factors (Ac = 0%; Ec = 0%) with diastolic metrics. Conclusions: Systolic LV parameters have a strong genetic predisposition to any impact. They share no common genetic or environmental factors with each other or with diastolic parameters, indicating that they may deteriorate specifically to given effects. However, diastolic functional parameters are mainly affected by common environmental influences, suggesting that pathological conditions may deteriorate them equally. Estimation of the genetic and environmental influence and interdependence on systolic and diastolic LV function may help the understanding of the pathomechanism of different heart failure classification types.

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P901 Left ventricular diastolic and systolic functions are compromised in patients with hypothyroidism

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.539 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

R Tafarshiku ◽

M Y Henein ◽

V Berisha-Muharremi ◽

I Bytyci ◽

P Ibrahimi ◽

...

Keyword(s):

Diastolic Function ◽

Systolic Function ◽

White Blood Cells ◽

Left Ventricular ◽

Blood Analysis ◽

Lv Function ◽

Anthropometric Parameters ◽

Age And Gender ◽

And Gender ◽

Lv Diastolic Function

Abstract Background and Aim Long standing hypothyroidism may impair myocardial relaxation, but its effect on systolic myocardial function is still controversial. The aim of this study was to investigate left ventricular (LV) systolic and diastolic function in patients with hypothyroidism. Methods This study included 81 (age 42 ± 13 years, 92% female) patients with hypothyroidism, and 22 age and gender matched controls. All subjects underwent a detailed clinical examination followed by a complete biochemical blood analysis including thyroid function assessment and anthropometric parameters measurements. LV function was assessed by 2 dimensional, M-mode and Tissue-Doppler Doppler echocardiographic examination performed in the same day. Results Patients had lower waist/hip ratio (p < 0.001), higher urea level (p = 0.002) and lower white blood cells (p = 0.011), compared to controls. All other clinical, biochemical and anthropometric data did not differ between the two groups. Patients had impaired LV diastolic function (lower E wave [p < 0.001], higher A wave [p = 0.028], lower E/A ratio [p < 0.001], longer E wave deceleration time [p = 0.01], and higher E/e’ ratio [p < 0.001]), compared with controls. Although LV global systolic function did not differ between groups, LV longitudinal systolic function was compromised in patients (lateral mitral annular plane systolic excursion - MAPSE [p = 0.005], as were lateral and septal TDI s’ [p < 0.001 for both]). Conclusion In patients with hypothyroidism, in addition to compromised LV diastolic function, LV longitudinal systolic function is also impaired compared to healthy subjects of the same age and gender. These findings suggest significant subendocardial function impairment, reflecting potentially micro-circulation disease, that requires optimum management.

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Peripartum Cardiomyopathy Presenting with Predominant Left Ventricular Diastolic Dysfunction: Efficacy of Bromocriptine

Case Reports in Medicine ◽

10.1155/2012/476903 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 10

Author(s):

Piercarlo Ballo ◽

Irene Betti ◽

Giuseppe Mangialavori ◽

Leandro Chiodi ◽

Gherardo Rapisardi ◽

...

Keyword(s):

Heart Failure ◽

Diastolic Dysfunction ◽

Diastolic Function ◽

Systolic Function ◽

Systolic Dysfunction ◽

Left Ventricular ◽

Peripartum Cardiomyopathy ◽

Lv Function ◽

Lv Diastolic Dysfunction ◽

Lv Diastolic Function

Management of patients with peripartum cardiomyopathy (PPCM) is still a major clinical problem, as only half of them or slightly more show complete recovery of left ventricular (LV) function despite conventional evidence-based treatment for heart failure. Recent observations suggested that bromocriptine might favor recovery of LV systolic function in patients with PPCM. However, no evidence exists regarding its effect on LV diastolic dysfunction, which is commonly observed in these patients. Tissue Doppler (TD) is an echocardiographic technique that provides unique information on LV diastolic performance. We report the case of a 37-year-old white woman with heart failure (NYHA class II), moderate LV systolic dysfunction (ejection fraction 35%), and severe LV diastolic dysfunction secondary to PPCM, who showed no improvement after 2 weeks of treatment with ramipril, bisoprolol, and furosemide. At 6-week followup after addition of bromocriptine, despite persistence of LV systolic dysfunction, normalization of LV diastolic function was shown by TD, together with improvement in functional status (NYHA I). At 18-month followup, the improvement in LV diastolic function was maintained, and normalization of systolic function was observed. This paper might support the clinical utility of bromocriptine in patients with PPCM by suggesting a potential benefit on LV diastolic dysfunction.

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Right and left ventricular adaptation to hypoxia: a tissue Doppler imaging study

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00332.2005 ◽

2005 ◽

Vol 289 (4) ◽

pp. H1391-H1398 ◽

Cited By ~ 60

Author(s):

Sandrine Huez ◽

Kathleen Retailleau ◽

Philippe Unger ◽

Adriana Pavelescu ◽

Jean-Luc Vachiéry ◽

...

Keyword(s):

Diastolic Function ◽

Wave Velocity ◽

Tissue Doppler Imaging ◽

Systolic Function ◽

Tissue Doppler ◽

Left Ventricular ◽

Doppler Imaging ◽

Lv Function ◽

Tricuspid Annulus ◽

Lv Systolic Function

Hypoxia has been reported to alter left ventricular (LV) diastolic function, but associated changes in right ventricular (RV) systolic and diastolic function remain incompletely documented. We used echocardiography and tissue Doppler imaging to investigate the effects on RV and LV function of 90 min of hypoxic breathing (fraction of inspired O2 of 0.12) compared with those of dobutamine to reproduce the same heart rate effects without change in pulmonary vascular tone in 25 healthy volunteers. Hypoxia and dobutamine increased cardiac output and tricuspid regurgitation velocity. Hypoxia and dobutamine increased LV ejection fraction, isovolumic contraction wave velocity (ICV), acceleration (ICA), and systolic ejection wave velocity (S) at the mitral annulus, indicating increased LV systolic function. Dobutamine had similar effects on RV indexes of systolic function. Hypoxia did not change RV area shortening fraction, tricuspid annular plane systolic excursion, ICV, ICA, and S at the tricuspid annulus. Regional longitudinal wall motion analysis revealed that S, systolic strain, and strain rate were not affected by hypoxia and increased by dobutamine on the RV free wall and interventricular septum but increased by both dobutamine and hypoxia on the LV lateral wall. Hypoxia increased the isovolumic relaxation time related to RR interval (IRT/RR) at both annuli, delayed the onset of the E wave at the tricuspid annulus, and decreased the mitral and tricuspid inflow and annuli E/A ratio. We conclude that hypoxia in normal subjects is associated with altered diastolic function of both ventricles, improved LV systolic function, and preserved RV systolic function.

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Cardiac manifestations of GH deficiency after treatment for acromegaly: a comparison to patients with biochemical remission and controls

Acta Endocrinologica ◽

10.1530/eje-08-0496 ◽

2008 ◽

Vol 159 (6) ◽

pp. 705-712 ◽

Cited By ~ 9

Author(s):

Agatha A van der Klaauw ◽

Jeroen J Bax ◽

Gabe B Bleeker ◽

Eduard R Holman ◽

V Delgado ◽

...

Keyword(s):

Diastolic Function ◽

Gh Deficiency ◽

Systolic Function ◽

Left Ventricular ◽

Doppler Imaging ◽

Healthy Controls ◽

Cross Sectional ◽

Diastolic Velocity ◽

Active Acromegaly ◽

Biochemical Remission

ObjectiveBoth GH excess and GH deficiency (GHD) lead to specific cardiac pathology. The aim of this study was to evaluate cardiac morphology and function in patients with GHD after treatment for acromegaly.DesignCross-sectional study.Patients and methodsCardiac parameters were studied by conventional two-dimensional echocardiography and tissue Doppler imaging in 53 patients with acromegaly (16 patients with GHD, 20 patients with biochemical remission, and 17 patients with active disease). Patients with GHD were also compared with age- and gender-matched controls.ResultsLeft ventricular (LV) dimensions, wall thickness, and mass did not differ between the three groups, or between the patients with GHD and healthy controls. Systolic function, assessed by LV ejection fraction, tended to be lower in patients with GHD compared with patients with biochemical remission (65.9±7.3% vs 72.4±8.5%, P=0.070), but was higher when compared with active acromegaly (58.8±9.3%, P=0.047). No differences were found with healthy controls. Diastolic function, measured with early diastolic velocity (E′), was lower in patients with GHD when compared with both patients with biochemical remission (6.0±2.1 cm/s vs 8.3±1.5 cm/s, P=0.005) and healthy controls (8.1±1.9 cm/s, P=0.006).ConclusionGHD after acromegaly results in a specific decrease in diastolic function compared with patients with biochemical remission of acromegaly and healthy controls. In addition, systolic function tends to be decreased in patients with GHD compared with patients with biochemical remission, but was higher than that in patients with active acromegaly.

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Sex differences in associations of cardio-ankle vascular index with left ventricular function and geometry

Vascular Medicine ◽

10.1177/1358863x17725810 ◽

2017 ◽

Vol 22 (6) ◽

pp. 465-472 ◽

Cited By ~ 3

Author(s):

Zi Ye ◽

Patricia A Pellikka ◽

Iftikhar J Kullo

Keyword(s):

Arterial Stiffness ◽

Systolic Function ◽

Linear Regression Analysis ◽

Structural Heart Disease ◽

Left Ventricular ◽

Lv Function ◽

Atherosclerotic Cardiovascular Disease ◽

Diastolic Velocity ◽

History Of ◽

Lv Systolic Function

The cardio-ankle vascular index (CAVI) is a measure of global arterial stiffness. We hypothesized that CAVI is associated with left ventricular (LV) function and geometry in individuals without structural heart disease. We measured CAVI in 600 participants (mean age 60.3±14.6 years, 54% men) without history of atherosclerotic cardiovascular disease who were referred for transthoracic echocardiography. Linear regression analysis was used to assess the association of CAVI with LV function (peak mitral annular systolic s’ and early diastolic velocity e’) and structure (LV mass index (LVMI) and relative wall thickness (RWT)). Older age, male sex, lower body mass index, history of hypertension, diabetes and chronic kidney disease were each associated with a higher CAVI (adjusted R2 = 0.56, all p < 0.01). A higher CAVI was associated with lower s’ and e’, and greater RWT, independent of age, sex, systolic BP and other conventional cardiovascular risk factors (all p < 0.05); a borderline association of higher CAVI with greater LVMI ( p = 0.05) was present. Associations with e’, s’ and RWT were similar in women and men but the association with LVMI was stronger in women than in men ( p for interaction = 0.02, multivariable-adjusted β = 6.92, p < 0.001 in women; p > 0.1 in men). In conclusion, a higher CAVI, a measure of global arterial stiffness, is associated with worse LV systolic function, worse diastolic relaxation, and greater LV RWT in both men and women, and with LVMI in women.

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Direct cardiac versus systemic effects of inorganic nitrite on human left ventricular function

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00081.2021 ◽

2021 ◽

Author(s):

Kevin O'Gallagher ◽

Ana R Cabaco ◽

Matthew Ryan ◽

Ali Roomi ◽

Haotian Gu ◽

...

Keyword(s):

Diastolic Function ◽

Sodium Nitrite ◽

Diastolic Pressure ◽

Contractile Function ◽

Systolic Function ◽

Left Ventricular ◽

Lv Function ◽

Cardiac Contractile Function ◽

Lv Systolic Function ◽

Lv Diastolic Function

Background Inorganic nitrite generates nitric oxide (NO) in vivo and is considered a potential therapy in settings where endogenous NO bioactivity is reduced and left ventricular (LV) function impaired. However, the effects of nitrite on human cardiac contractile function, and the extent to which these are direct or indirect, are unclear. Methods and Results We studied 40 patients undergoing diagnostic cardiac catheterisation who had normal LV systolic function and were not found to have obstructive coronary disease. They received either an intracoronary sodium nitrite infusion (8.7-26 mmol/min, n=20) or an intravenous sodium nitrite infusion (50 mg/kg/min, n=20). LV pressure-volume relations were recorded. The primary end point was LV end-diastolic pressure (LVEDP) while secondary end points included indices of LV systolic and diastolic function. Intracoronary nitrite infusion induced a significant reduction in LVEDP, LV end-diastolic pressure-volume relationship (EDPVR) and the time to LV end-systole (LVEST) but had no significant effect on measures of LV systolic function or systemic haemodynamics. Intravenous nitrite infusion induced greater effects, with significant decreases in LVEDP, EDPVR, LVEST, LV dP/dtmin, tau, and mean arterial pressure. Conclusions These results indicate that inorganic nitrite has modest direct effects on human LV diastolic function, independent of LV loading conditions and without affecting LV systolic properties. The systemic administration of nitrite has larger effects on LV diastolic function which are related to reduction in both preload and afterload. These effects of inorganic nitrite indicate a favourable profile for conditions characterized by LV diastolic dysfunction, e.g. heart failure with preserved ejection fraction.

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Influence of cardiac shape on left ventricular twist

Journal of Applied Physiology ◽

10.1152/japplphysiol.00419.2009 ◽

2010 ◽

Vol 108 (1) ◽

pp. 146-151 ◽

Cited By ~ 60

Author(s):

Bas M. van Dalen ◽

Floris Kauer ◽

Wim B. Vletter ◽

Osama I. I. Soliman ◽

Heleen B. van der Zwaan ◽

...

Keyword(s):

Healthy Volunteers ◽

Systolic Function ◽

Left Ventricular ◽

Lv Function ◽

Total Study Population ◽

Internal Dimension ◽

Apical Rotation ◽

Sphericity Index ◽

And Gender ◽

Lv Systolic Function

The dynamic interaction between subendocardial and subepicardial fibre helices in the left ventricle (LV) leads to a twisting deformation, which has an important role in LV function. This study sought to assess the influence of cardiac shape on LV twist in the normal and dilated human heart. The study comprised 45 dilated cardiomyopathy (DCM) patients and 60 for age- and gender-matched healthy volunteers. Speckle tracking echocardiography was used to determine basal and apical LV peak systolic rotation (Rotmax) and instantaneous LV peak systolic twist (Twistmax). LV sphericity index was calculated by dividing the LV maximal long-axis internal dimension by the maximal short-axis internal dimension at end-diastole. A parabolic relation between the sphericity index and apical Rotmaxor Twistmaxwas identified in the total study population ( R2= 0.56 and R2= 0.54, respectively; both P < 0.001) and healthy volunteers ( R2= 0.39 and R2= 0.25, respectively; both P < 0.001), whereas these relations were linear in DCM patients ( R2= 0.40 and R2= 0.43, respectively; both P < 0.001). In a multivariate analysis, LV sphericity index was the strongest independent predictor of apical Rotmaxand Twistmax. In conclusion, LV apical rotation and twist are significantly influenced by LV configuration. Taking the important function of LV twist into account, this finding highlights the vital influence of cardiac shape on LV systolic function.

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Left Ventricular Diastolic and Systolic Functions in Patients with Hypothyroidism

Medicina ◽

10.3390/medicina56100524 ◽

2020 ◽

Vol 56 (10) ◽

pp. 524

Author(s):

Rina Tafarshiku ◽

Michael Y. Henein ◽

Venera Berisha-Muharremi ◽

Ibadete Bytyçi ◽

Pranvera Ibrahimi ◽

...

Keyword(s):

Diastolic Function ◽

Systolic Function ◽

White Blood Cells ◽

Left Ventricular ◽

Blood Analysis ◽

Lv Function ◽

Anthropometric Parameters ◽

Age And Gender ◽

And Gender ◽

Lv Diastolic Function

Background and objectives: Long standing hypothyroidism may impair myocardial relaxation, but its effect on systolic myocardial function is still controversial. The aim of this study was to investigate left ventricular (LV) systolic and diastolic function in patients with hypothyroidism. Materials and Methods: This study included 81 (age 42 ± 13 years, 92% female) patients with hypothyroidism, and 22 age and gender matched controls. All subjects underwent a detailed clinical examination followed by a complete biochemical blood analysis including thyroid function assessment and anthropometric parameters measurements. LV function was assessed by 2-dimensional, M-mode and Tissue-Doppler Doppler echocardiographic examination performed in the same day. Results: Patients had lower waist/hip ratio (p< 0.001), higher urea level (p = 0.002), and lower white blood cells (p = 0.011), compared with controls. All other clinical, biochemical, and anthropometric data did not differ between the two groups. Patients had impaired LV diastolic function (lower E wave [p< 0.001], higher A wave [p = 0.028], lower E/A ratio [p< 0.001], longer E wave deceleration time [p = 0.01], and higher E/e’ ratio [p< 0.001]), compared with controls. Although LV global systolic function did not differ between groups, LV longitudinal systolic function was compromised in patients (lateral mitral annular plane systolic excursion—MAPSE [p = 0.005], as were lateral and septal s’ [p< 0.001 for both]). Conclusions: In patients with hypothyroidism, in addition to compromised LV diastolic function, LV longitudinal systolic function is also impaired compared to healthy subjects of the same age and gender. These findings suggest significant subendocardial function impairment, reflecting potentially micro-circulation disease that requires optimum management.

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Differences in Left Ventricular Function at Rest and during Isometric Handgrip Exercise in Elite Swimmers, Water Polo Players, and Artistic Swimmers

10.31236/osf.io/pyvts ◽

2021 ◽

Author(s):

Alexandra M Coates ◽

Christian P Cheung ◽

Katharine D Currie ◽

Trevor James King ◽

Margo L Mountjoy ◽

...

Keyword(s):

Stroke Volume ◽

Diastolic Function ◽

Left Ventricular ◽

Lv Function ◽

Handgrip Exercise ◽

Isometric Handgrip ◽

Training Environment ◽

Water Polo ◽

Apical Rotation ◽

Elite Swimmers

Purpose: Elite swimmers (SW) have reduced diastolic function compared to elite runners, possibly as an adaptation to the aquatic training environment. Water polo players (WP) and artistic swimmers (AS) are exposed to the same hydrostatic pressures as SW, but are subject to different training intensities, postures, and hemodynamic stressors. Our purpose was to compare resting and exercising cardiac function in elite SW, WP, and AS, to characterize the influence of training for aquatic-sport on left ventricular (LV) adaptation.Methods: Ninety athletes (SW:20M/17F; WP:21M/9F; AS:23F) at the 2019 FINA World Championships volunteered for resting and stress (3min 30% maximal isometric handgrip) echocardiographic assessment of LV global function and mechanics. Results: Male SW displayed improved resting systolic and diastolic function compared to WP; however, both groups maintained stroke volume under high-pressure handgrip stress (SW:∆-4±12%; WP:∆-1±13%, P=0.11). There were no differences between female SW and WP resting LV function, but SW demonstrated improved function over AS. During isometric handgrip, all female sport athletes maintained stroke volume (SW:∆3±16%; WP:∆-10±11%; AS:∆-2±14%, P=0.46), but WP had improved apical rotation (∆1.7±4.5°), which was reduced in AS (∆-3.1±4.5°) and maintained in SW (∆-0.5±3.8°, P=0.04). Unlike SW and WP, AS displayed a unique maintenance of early filling velocity during handgrip exercise (SW:∆-3.5±14.7cm/s; WP:∆-15.1±10.8cm/s; AS:∆1.5±15.3cm/s, P=0.02).Conclusion: Among male athletes, SW display primarily volume-based functional adaptations distinct from the mixed volume-pressure adaptations of WP; however, both groups can maintain stroke volume with increased afterload. Female SW and WP do not demonstrate sport-specific differences like males, perhaps owing to sex-differences in adaptation, but have greater volume-based adaptations than AS. Lastly, AS display unique functional adaptations, that may be driven by elevated pressures under low-volume conditions.

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The Impact of Uncontrolled Hypertension on the Longitudinal Systolic Function of the Left Ventricle

Current Hypertension Reviews ◽

10.2174/1573402117666210218105338 ◽

2021 ◽

Vol 17 ◽

Author(s):

Nabila Soufi Taleb Bendiab ◽

Salim Benkhedda ◽

Latifa Henaoui ◽

Abderrahim Meziane Tani

Keyword(s):

Strain Rate ◽

Diastolic Function ◽

Longitudinal Strain ◽

Systolic Function ◽

Left Ventricular ◽

Uncontrolled Hypertension ◽

Lv Function ◽

Ultrasound Evaluation ◽

Lv Mass ◽

The Impact

Background: The assessment of the longitudinal component of left ventricular (LV) function is of major clinical importance for the early detection of LV contractile impairment. The aim of this study was to determine the impact of uncontrolled hypertension, on LV longitudinal systolic performance. Methods: The study population included 400 hypertensive patients: 271 patients with uncontrolled blood pressure (BP) and 112 without controlled BP, all patients underwent a complete ultrasound evaluation with calculation of the LV mass, evaluation of diastolic function as well as longitudinal systolic function. Results: Conventional echo demonstrated that uncontrolled patients had increased LV mass (P 0.007), LA (left auricular) dimension (P 0.004), left ventricular wall thickness and impairment of diastolic function (E/E’6 ± 2.1 vs 7.4 ±3.0 P=0.001) while no affection of systolic function could be detected. By deformation imaging, there was a reduction in longitudinal strain (apical 4 view -16.2 ±2.9 vs -18.2± 2.6 P 0.02, apical 3 view -17.3 ± 3.3 vs. -18.9 ± 4.1 P 0.01). Similarly systolic strain rate (SRsys) and early diastolic SR (SRe) reduced significantly in longitudinal direction. Conclusion: Although EF was not different between uncontrolled patients and controls, LV longitudinal strain and strain rate by 2D speckle tracking were lower in the uncontrolled group.

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