A STUDY ON THE CORRELATION BETWEEN MORPHOLOGIC ANORMALIES AND LEFT VENTRICULAR DIASTOLIC FUNCTION IN DILATED CARDIO-MYOPATHY

2011 ◽  
pp. 137-144
Author(s):  
Thi Ngoc Ha Hoang ◽  
Anh Vu Nguyen ◽  
Minh Loi Hoang ◽  
Cuu Long Nguyen ◽  
Thi Thuy Hang Nguyen

Purposes: Describe the morphological and diastolic function of left ventricular changes in the patients with dilated cardiomyopathy (DCM) on US, X-ray findings, and Evaluate the correlation between morphology and diastolic function of left ventricular. Materials and method: Cross sectional study from Dec 2009 to Aug 2010, on 39 patients with dilated cardiomyopathy were evaluated at the University Hospital of Hue College of Medical and Pharmaceutical. Results: 1. X-ray and US findings characteristics of DCM is significantly increased in diameter of L, H and mG; LVM, LVMI, LVDd and LAD. 2. The pression of pulmonary artery has been significantly increased with redistribution pulmonary arteries in 61.5% cases and 23.1% have reversed pulmonary artery distribution. 3. DCM have diastolic dysfunction in 100% patients, including severe disorders to 61.5%; the restrictive dysfunction has ratio E/A>2 and E/Em average was 23.89± 17.23. 4.The correlation between the morphology and function in DCM: the diameter of H and L on the X-ray, LAD and ratio LA/AO on US correlated with the level of diastolic dysfunction (p< 0.05). All three radiographic parameters on the radio standard (H, L, the index Cardio/Thoracic) and LVDd on US have negative correlated with EF and FS with p <0.05. Key words: dilated cardiomyopathy, diastolic dysfunction, cardiac tissue Doppler, reversed pulmonary artery distribution

Author(s):  
Quang Tuan Pham

TÓM TẮT Mục tiêu: Khảo sát chức năng tâm trương thất trái theo khuyến cáo ASE/EACVI 2016 ở bệnh nhân bệnh cơ tim giãn bằng siêu âm tim. Tìm hiểu mối liên quan giữa chức năng tâm trương thất trái với tình trạng giãn thất trái, độ suy tim NYHA, phân suất tống máu thất trái, phân suất co cơ thất trái. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang trên 56 bệnh nhân bệnh cơ tim giãn nguyên phát được nhập viện và điều trị tại bệnh viện Trung ương Huế từ tháng 4/2018 đến tháng 8/2020. Kết quả: Đường kính thất trái cuối tâm trương và cuối tâm thu trung bình là 66,11 ± 7,3 mm và 57,7 ± 8,02 mm. Đường kính nhĩ trái trung bình là 40,61 ± 7,65 mm. Phân suất tống máu thất trái trung bình là 24,68 ± 5,97 %. Phân suất co cơ thất trái trung bình là 12,91 ± 4,55 %. Tất cả các bệnh nhân nhóm nghiên cứu đều có rối loạn chức năng tâm trương thất trái. Chiếm tỷ lệ cao nhất là rối loạn chức năng tâm trương độ II (44,6%), tiếp sau là rối loạn chức năng tâm trương độ III (35,8%) và rối loạn chức năng tâm trương độ I là 19,6%. Không có sự liên quan có ý nghĩa thống kê giữa mức độ rối loạn tâm trương thất trái với đường kính thất trái cuối thì tâm thu và tâm trương (p > 0,05). Có mối liên quan giữa rối loạn chức năng tâm trương thất trái với các thông số phân suất tống máu EF và phân suất co cơ FS (p < 0,005). Có sự tương quan thuận mức độ vừa giữa phân độ rối loạn chức năng tâm trương thất trái với phân độ suy tim theo NYHA với r = 0,445, sự tương quan đó có ý nghĩa thống kê (p < 0,001). Kết luận: Tất cả các bệnh nhân bệnh cơ tim giãn trong nhóm nghiên cứu đều có rối loạn chức năng tâm trương thất trái, chủ yếu là rối loạn chức năng tâm trương nặng độ II - III. Sự rối loạn này thể hiện rõ qua sự biến đổi các thông số đánh giá chức năng tâm trương thất trái trên siêu âm tim theo khuyến cáo ASE/ EACVI 2016, một khuyến cáo mới đưa ra nhằm tiếp cận đánh giá chức năng tâm trương một cách thuận tiện và dễ dàng hơn. Từ khóa: Bệnh cơ tim giãn, rối loạn chức năng tâm trương thất trái, khuyến cáo ASE/EACVI 2016 ABSTRACT EVALUATION OF LEFT DYSTOLIC FUNCTION ACCORDING TO THE RECOMMENDATION ASE/EACVI 2016 INPATIENTS WITH DILATED CARDIOMYPAHTIES Background: Dilated cardiomyopathy is a disease of the heart muscle, characterized by dilatation of the heart chamber and a dysfunction of the left or both ventricles. It often leads to progressive heart failure, and is the leading cause of heart transplant among all cardiomyopathy. The annual rate of sudden cardiac death in dilated cardiomyopathy is 2 - 4%, with sudden death accounting for half of all deaths [9]. Echocardiography is an evaluation of a patient with dilated cardiomyopathy. There have been many studies on dilated cardiomyopathy in the world. However, there are still few studies evaluating diastolic function in patients with dilated cardiomyopathy using cardiac Doppler echocardiography. Experts around the world have made many recommendations in assessing left ventricular diastolic function, most recently is the recommendation ASE/EACVI 2016. Comparing with the 2009 EAE/ASE recommendation, the recommendation ASE/EACVI 2016 for assessment of left ventricular diastolic function has fewer parameters, so it is easier to implement and more convenient in clinical practice. Objective: Surveying left ventricular diastolic function according to the recommendation ASE/EACVI 2016 in patients with dilated cardiomyopathy by echocardiography and investigating the relationship between left ventricular diastolic function with left ventricular dilatation, heart failure NYHA, left ventricular ejection fraction, left ventricle fractional shortening. Methods: Research was designed as a cross - sectional descriptive study. Studied on 56 patients with primary dilated cardiomyopathy were hospitalized and treated at Hue Central Hospital. Results: The results showed: The mean end - diastolic and end - systolic left ventricular diameters were 66,11 ± 7,3 mm and 57,7 ± 8,02 mm. The mean left atrial diameter was 40,61 ± 7,65 mm. The mean left ventricular ejection fraction was 24,68 ± 5,97%. The mean fractional shortening of left ventricular contraction was 12,91 ± 4,55%. All patients in the study group had left ventricular diastolic dysfunction. The highest proportion is diastolic dysfunction grade II (44,6%), followed by diastolic dysfunction grade III (35,8%) and diastolic dysfunction grade I is 19,6%. There was no statistically significant relationship between the classification of left ventricular diastolic dysfunction and left ventricular systolic and diastolic diameter (p > 0.05). There is a relationship between left ventricular diastolic dysfunction and parameters of ejection fraction EF and contraction fraction FS (p < 0.005). There is a moderate positive correlation between the classification of left ventricular diastolic dysfunction and the heart failure rating according to NYHA (r = 0,445, p < 0,001). Conclusion: All patients in the study group had left ventricular diastolic dysfunction, mostly grade II and grade III diastolic dysfunction. This disorder is clearly demonstrated by the change in the parameters of the left ventricular diastolic function assessment on echocardiography according to the 2016 ASE/ EACVI recommendations, a new recommendation introduced to approach the assessment of diastolic functionmore convenient and easier way. Key words: Dilated cardiomyopathy, left ventricular diastolic dysfunction, the recommendation ASE / EACVI 2016.


2019 ◽  
Vol 16 (2) ◽  
pp. 17-21
Author(s):  
Ajay Adhikaree ◽  
Rabi Malla ◽  
Ram Kishor Sah ◽  
Arun Maskey ◽  
Sujeeb Rajbhandari ◽  
...  

Background and Aims: Echocardiographic assessment of left ventricular diastolic function in patients with atrial fibrillation is a challenge as loss of atrial kick (A wave), beat to beat variability and left atrium enlargement despite normal atrial pressure make usual guideline based estimation difficult and inaccurate. Hence adoption of additional echocardiography parameters are necessary which are tricky and have varied results. Hence the aim of this study was to study various aspects of diastolic function in patients with atrial fibrillation. Methods: It was a hospital based prospective cross-sectional observational study conducted at cardiology unit, National Academy of Medical Sciences, Kathmandu and Shahid Gangalal National Heart Center, Kathmandu from 1st July 2018 to 30th June 2019. Results: Total of 92 patients were studied. About one third (34.8%) had diastolic dysfunction. Ratio of E/e’(14.65 ± 2.21 Vs 7.66 ± 1.18) , E/Vp (1.57 ± 0.14 Vs 1.20 ± 0.11), isovolumetric relaxation time (53.06 ± 13.82ms Vs 89.33 ± 9.88ms) and deceleration time of pulmonary venous diastolic wave (203.09 ± 26.13ms Vs 292.25 ± 36.32ms) were significantly different in patients with diastolic dysfunction compared to patients without diastolic dysfunction with sensitivity of 90.6%, 84.4%, 81.2% and 78.1% respectively. Conclusion: Diastolic dysfunction is a common entity in patients with atrial fibrillation. Echocardiography parameters like E/e’ ratio, isovolumetric relaxation time, E/Vp ratio and deceleration time of diastolic pulmonary wave were highly sensitive in detection of diastolic dysfunction.


2019 ◽  
Vol 59 (3) ◽  
pp. 139-43
Author(s):  
Ni Made Ayu Agustini ◽  
Eka Gunawijaya ◽  
Ni Putu Venny Kartika Yantie ◽  
Ketut Dewi Kumara Wati ◽  
Komang Ayu Witarini ◽  
...  

Background In the past, cardiovascular involvement did not seem to be a common complication of HIV, but in recent years it has been described more frequently. With the advent of highly active antiretroviral therapy (HAART), the symptoms of cardiac disease has changed, as the number of HIV-infected patients with abnormal diastolic parameters has increased significantly, often presenting as symptomatic rather than asymptomatic. Objective To analyze for a possible correlation between HAART duration and left ventricular diastolic function in HIV-infected children. Methods This cross-sectional study was conducted from December 2016 to December 2017 at the Cardiology and Allergy-Immunology Division/Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali. Subjects with HAART were collected using a consecutive sampling method. The following data were recorded for each subject: age, sex, current stage of HIV, CD4+ level, as well as HAART regimen and duration of use. Transthoracic echocardiography was performed for tissue doppler imaging (TDI) of diastolic function. Spearman’s test was used to analyze the strength of correlation based on normality test results. Results This study involved 53 subjects, 21 of whom had impaired diastolic function. There was no correlation between HAART duration and diastolic function in children with HIV infection (r= -0.03; P=0.82). Conclusion Diastolic dysfunction is found in children under HAART treatment, but there is no correlation between HAART treatment duration and diastolic dysfunction.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Mouadili ◽  
M Sebani ◽  
C Mbauchy ◽  
M El Hattaoui ◽  
S El Karimi

Abstract The involvement of diabetes in the occurrence of an alteration of the diastolic function of LV is well established. The objective of our study was to evaluate the prevalence of diastolic dysfunction in Type II diabetic patients in light of the latest 2016 recommendations of the American Society of Echocardiography and to identify its associated factors. It was a cross-sectional observational study with a descriptive and analytic focus spread over a 6-month period from July to December 2017.The study included 66 asymptomatic type II diabetic patients, with a normal ECG and a negative stress test ischemia. All hypertensive subjects with an ejection fraction &lt;50%, or those with myocardial, valvular or rhythm disorder, were excluded. The mean age of our patients, was 42 years ± 9 years with extremes ranging from 39 to 84 years, we noted a female predominance (68%) with a sex ratio of 2.14. The prevalence of diastolic dysfunction was 27%. Factors associated with this change in diastolic function were advanced age (p &lt;0.0001), age of diabetes&gt; 10 years (p &lt;0.0001), glycemic imbalance with HbA1c&gt; 7% (p &lt;0) , 0001) and elevated fasting glucose levels (p = 0.039), obesity (p &lt;0.0001), dyslipidemia (p &lt;0.0001) and menopause (p = 0.002). Diastolic dysfunction affects a significant percentage of patients with type II diabetes. Therefore, we propose strict glycemic control in these patients, an early cardiographic echo screening in at-risk subjects, in order to improve their management, and to limit their progression to more serious complications.


2016 ◽  
Vol 23 (11) ◽  
pp. 1373-1376
Author(s):  
Liaqat Ali ◽  
Naeem Asghar ◽  
Imran Khan

Background: Diabetes mellitus (DM) is not only a significant independent riskfactor for developing of atherosclerotic ischemic heart disease or ventricular hypertrophy but itis also able to trigger a diabetic cardiomyopathy due to dysmetabolic processes resulting heartfailure. Cardiovascular complications are known to be the main cause of death and morbidity indiabetic patients. Objectives: How frequent is the diastolic dysfunction in asymptomatic diabetic?Study Design: Descriptive cross sectional. Setting: Echocardiography department FaisalabadInstitute of Cardiology Faisalabad. Patients were recruited from outpatient department ofFaisalabad institute of cardiology Faisalabad. Duration of Study: Six months from: 28-06-2015to 28-12-2015. Methodology: 200 patients were included in the study. Patient’s bio data wasrecorded and informed consent was taken. All echocardiographic studies were performed withVIVID-07 echo machine by the same operator. Detailed assessment of left ventricular systolicand diastolic function by using standard 2-dimensional, color flow Doppler and tissue Dopplerimaging (TDI) was done. Images were obtained in all patients. Each patient underwent leftventricular (LV) diastolic function assessment by conventional Doppler, tissue Doppler imaging(TDI). LV ejection fraction was calculated using conventional method. Blood flow velocities atmitral valve leaflets and pulmonary veins were recorded with averaged from 3 end-expiratorycycles at a sweep of 100 mm/s. This information was collected through a specially designedproforma by the author. Results: In our study, out of 200 cases, 52%(n=104) were between 50-55 years of age while 48%(n=96) were between 56-60 years of age, mean+sd was calculatedas 55.54+2.59 years, 49%(n=98) were male while 51%(n=102) were females, frequency ofdiastolic dysfunction in asymptomatic, normotensive patients with diabetes mellitus wasrecorded as 45.5%(n=91) while 54.5%(n=109) had no findings of the morbidity. Conclusion:We conclude that the frequency of diastolic dysfunction is quite high (45.5%) in asymptomaticdiabetics.


2018 ◽  
Vol 5 (5) ◽  
pp. 1093
Author(s):  
Tarun Rao ◽  
Mohit Karwa ◽  
Anil Wanjari

Background: There is a significant worldwide burden of CKD; which is likely to increase further. Cardiovascular diseases constitute major cause of morbidity and mortality in CKD. LV dysfunction may be present despite the asymptomatic phase during the early stages of CKD. Thus, early detection of LV dysfunction and targeted interventions can improve prognosis in CKD.Methods: This cross-sectional study was conducted among 250 CKD admitted patients. Echocardiographic examination was done to determine the systolic and diastolic function of LV. For LV systolic function ejection fraction and % fractional shortening were calculated and for LV diastolic function E/A, E/E’, E deceleration time and IVRT were measured.Results: Among 250 study subjects, 112 (47.8%) had systolic dysfunction and 138 (55.2%) had diastolic dysfunction. The prevalence of systolic as well as diastolic dysfunction increased significantly (P<0.05) with deteriorating renal function (39.1% for CKD stage 1 and 67.8% for stage 5 for systolic dysfunction, 34.8% for CKD stage 1 and 77.8% for stage 5 for diastolic dysfunction).Conclusions: LV systolic and diastolic dysfunctions are significantly prevalent among CKD patients which increase with increasing severity of CKD. Hence, it is important to routinely screen these patients for LV dysfunction. The use of echocardiography can detect LV dysfunction at an early stage among the high-risk population of CKD to help plan appropriate strategies to slow the progression of cardiac dysfunction and improve prognosis.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K A Sveen ◽  
E Aagaard ◽  
T Berge ◽  
S Enger ◽  
E Orstad Bjoerkan ◽  
...  

Abstract Funding Acknowledgements Akershus University Hospital and Vestre Viken Hospital Trust OnBehalf ACE 1950 Background Large surveys have previously reported a prevalence of left ventricular diastolic dysfunction (DD) between 20- and 30 % in individuals above 60 years of age. The new DD guidelines from 2016, however, have emphasized the presence of increased left ventricular filling pressure, and may result in a stricter definition of DD. Purpose The aim of the present study was to compare the prevalence of DD using 2009 and 2016 EACVI/ASE criteria and to identify clinical correlates of DD. Methods The present cross-sectional substudy consisted of 3706 indivuduals born in 1950 included in the Akershus Cardiac Examination (ACE1950) 1950 study. Comprehensive baseline cardiovascular examination was performed, including ultrasound imaging utilizing echocardiographic indices for diagnosing DD according to both the 2009 and 2016 criteria. Results Complete echocardiographic data were available in 3464 (93.5%) individuals. Mean age was 63.9 ± 0.7 years, and 49% were women. 11% had diabetes mellitus and 23% were obese (BMI &gt;30). In the total cohort, 19.8% (685/3464) fulfilled the 2009 criteria for diastolic dysfunction. Of these, 7.9% (n = 273) had grade 1; 8.7% (n = 303) grade 2 and 3.1% (n = 109) grade 3 diastolic dysfunction. Only 2.0% (71/3464) of the total cohort were classified with DD according to the 2016 criteria. In individuals with known diabetes the prevalence of DD was 22% and in obese this number was 28.9% using the 2009 criteria. Conclusions Diastolic dysfunction is present in 1 in 5 of 63-65 years old norwegians, and higher in the obese and those with diabetes, according to the 2009 criteria. However, the prevalence was dramatically lower by applying the 2016 criteria. LV filling pressure can be looked upon as dynamic and be normalized by unloading, and therefore possibly mask DD in some individuals.


2021 ◽  
Author(s):  
Dhnanjay Soundappan ◽  
Angus Seen Yeung Fung ◽  
Daniel E Loewenstein ◽  
David Playford ◽  
Geoff Strange ◽  
...  

BACKGROUND: Decreased hydraulic forces during diastole contribute to reduced left ventricular (LV) filling and heart failure with preserved ejection fraction. OBJECTIVES: To determine the association between diastolic hydraulic forces, estimated by atrioventricular area difference (AVAD), and both diastolic function and survival. We hypothesized that decreased diastolic hydraulic forces, estimated as AVAD, would associate with survival independent of conventional diastolic dysfunction measures. METHODS: Patients (n=11,734, median [interquartile range] 3.9 [2.4-5.0] years follow-up, 1,213 events) were selected from the National Echo Database Australia based on the presence of relevant transthoracic echocardiographic measures, LV ejection fraction (LVEF) ≥ 50%, heart rate 50-100 beats/minute, the absence of moderate or severe valvular disease, and no prior cardiac surgery. AVAD was calculated as the cross-sectional area difference between the LV and left atrium. LV diastolic dysfunction was graded according to 2016 guidelines. RESULTS: AVAD was weakly associated with E/e prime, left atrial volume index, and LVEF (multivariable global R2=0.15, p<0.001), and not associated with e prime and peak tricuspid regurgitation velocity. Decreased AVAD was independently associated with poorer survival, and demonstrated improved model discrimination after adjustment for diastolic function grading (C-statistic 0.645 vs 0.607) and E/e prime (C-statistic 0.639 vs 0.621), respectively. CONCLUSIONS: Decreased hydraulic forces, estimated by AVAD, are weakly associated with diastolic dysfunction and provide an incremental prognostic association with survival beyond conventional measures used to grade diastolic dysfunction.


VASA ◽  
2018 ◽  
Vol 47 (5) ◽  
pp. 361-375 ◽  
Author(s):  
Harold Goerne ◽  
Abhishek Chaturvedi ◽  
Sasan Partovi ◽  
Prabhakar Rajiah

Abstract. Although pulmonary embolism is the most common abnormality of the pulmonary artery, there is a broad spectrum of other congenital and acquired pulmonary arterial abnormalities. Multiple imaging modalities are now available to evaluate these abnormalities of the pulmonary arteries. CT and MRI are the most commonly used cross-sectional imaging modalities that provide comprehensive information on several aspects of these abnormalities, including morphology, function, risk-stratification and therapy-monitoring. In this article, we review the role of state-of-the-art pulmonary arterial imaging in the evaluation of non-thromboembolic disorders of pulmonary artery.


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