Left Ventricular Diastolic Dysfunction in Patients with Dermatomyositis Without Clinically Evident Cardiovascular Disease

2014 ◽  
Vol 41 (3) ◽  
pp. 495-500 ◽  
Author(s):  
Han Wang ◽  
Han-Xiong Liu ◽  
Yin-Li Wang ◽  
Xiu-Qiong Yu ◽  
Xian-Xiang Chen ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Flow Velocity ◽  
Disease Duration ◽  
Velocity Ratio ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Control Group ◽  
Diastolic Flow ◽  
Diastolic Velocity ◽  
Cv Disease

Objective.To assess left ventricular (LV) diastolic function in patients with dermatomyositis (DM) without clinically evident cardiovascular (CV) disease and to estimate whether there is an association between the duration of DM and LV diastolic dysfunction (LVDD).Methods.The study included 51 patients with DM (43 women and 8 men) who had no clinically evident CV disease and 51 age-matched and sex-matched healthy controls. Echocardiographic and Doppler studies were conducted in all patients and controls. Early diastolic flow velocity/mitral annular early diastolic velocity (E/Em) was considered a marker for diastolic dysfunction.Results.E/Em was elevated in 39 patients (76.5%) versus 27 controls (52.9%; p < 0.05). There were significant differences between patients versus control group in late diastolic flow velocity (A), E/A ratio, Em, Em/Am (mitral annular late diastolic velocity) ratio, E/Em ratio, and deceleration time (DT; p < 0.05). There was a weak correlation with disease duration between A (r = 0.373, p = 0.007), E/A ratio (r = −0.467, p = 0.001), Em (r = −0.474, p < 0.001), Em/Am ratio (r = −0.476, p < 0.001), E/Em ratio (r = 0.320, p = 0.022), and DT (r = 0.474, p < 0.001). Disease duration was associated with E/Em after controlling for age, sex, and other factors (p < 0.05).Conclusion.Our study confirms a high frequency of LVDD in DM patients without evident CV disease. The association between transmitral flow alteration and disease duration may suggest a subclinical myocardial involvement with disease progression.

scholarly journals Echocardiographic evaluation of diastolic dysfunction in young and healthy patients with psoriasis: A case-control study

2018 ◽  
Vol 88 (3) ◽  
Author(s):  
Elio Gorga ◽  
Marta Scodro ◽  
Francesca Valentini ◽  
Renzo D'Ortona ◽  
Mariachiara Arisi ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Diastolic Dysfunction ◽  
Early Recognition ◽  
Systolic Function ◽  
Group Versus ◽  
Tissue Doppler ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Control Group ◽  
Systemic Inflammatory Disease

Psoriasis is a systemic inflammatory disease with a great prevalence in general population. The inappropriate activation of the cellular immune system has been hypothesized to be an independent cardiovascular risk factor, given the higher incidence of cardiovascular disorders in psoriatic patients. Echocardiographic abnormalities have been demonstrated too: the aim of our study was to evaluate the presence of preclinical cardiac dysfunction in a cohort of psoriatic patients without cardiovascular risk factors. We enrolled 52 patients with the diagnosis of chronic plaque psoriasis, compared with a control group not affected by any relevant systemic diseases and inflammatory disorders. In all patients and control group, echocardiographic conventional and tissue Doppler (TDI) studies were conducted. The analysis of echocardiographic parameters revealed normal dimension, mass and systolic function of the left ventricle. Left ventricular diastolic dysfunction was found in 36.5% patients in the psoriasis group versus 0% in control group, and significant reduction of the E/A ratio was found also for the right ventricle. A significant increase of mitral regurgitation has been found in psoriatic patients (p=0.005). The early recognition of cardiovascular pre-clinic disease in psoriatic patients may guide a strict follow up and an early treatment, potentially improving cardiovascular prognosis.

scholarly journals Cardiac dysfunction in acromegaly: evidence by pulsed wave tissue Doppler imaging

2000 ◽  
pp. 363-369 ◽  
Author(s):  
G Mercuro ◽  
S Zoncu ◽  
P Colonna ◽  
P Cherchi ◽  
S Mariotti ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Tissue Doppler Imaging ◽  
Systolic Function ◽  
Lateral Wall ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Control Group ◽  
Diastolic Velocity ◽  
Acromegalic Cardiomyopathy

OBJECTIVE: To verify whether the accuracy of data on myocardial function provided by pulsed-wave tissue Doppler imaging (PWTDI), a new echocardiographic application that allows quantitative measurements of myocardial wall velocities, could help towards a better understanding of the natural history of acromegalic cardiomyopathy. DESIGN: Eighteen patients with active acromegaly (ten men and eight women; mean age 48.0+/-15.0 years) with no other detectable cause of heart disease underwent PWTDI. Thirteen healthy individuals matched for age and body mass index acted as a control group. METHODS: Ejection fraction (EF), transmitral early/late diastolic velocity (E/A) ratio and isovolumic relaxation time (IVRT) were measured by conventional echocardiography; systolic peak (Sv) and early (Ev) and late (Av) diastolic peak velocities, Ev/Av ratio and regional IVRT (IVRTs) were obtained by PWTDI. RESULTS: All patients showed appreciably abnormal left ventricular global diastolic function represented by prolongation of the IVRT (P<0.001). Using PWTDI we found a prolongation of IVRTs and inversion of the Ev/Av ratio. In addition, the Ev/Av ratio proved to be significantly negatively correlated with IVRT; this correlation was not present in the case of the E/A ratio. Furthermore, a decrease in Sv was detected in the basal segment of the lateral wall (P<0.01), which had the greatest degree of diastolic dysfunction. CONCLUSIONS: PWTDI confirmed the acknowledged diastolic dysfunction that accompanies acromegalic cardiomyopathy and highlighted the greater sensitivity of regional PWTDI with respect to global Doppler diastolic indexes. Furthermore, by revealing an impairment of regional systolic function in presence of a normal EF, the findings with PWTDI contradicted the largely accepted theory that systolic function remains normal for several years in patients affected by acromegalic cardiomyopathy.

scholarly journals Relationship of left ventricular and atrial dimensions with moderate to severe left ventricular diastolic dysfunction (grade II and above)

2020 ◽  
Vol 20 (4) ◽  
pp. 1749-53
Author(s):  
Muhammad Hamza ◽  
Mishal Fatima ◽  
Muhammad Masood ◽  
Hafiz Umar Masood ◽  
Ghazal Tasleem ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Posterior Wall ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Control Group ◽  
Septal Thickness ◽  
Posterior Wall Thickness ◽  
Ventricular Diastolic Dysfunction ◽  
Significant Performance ◽  
Grade Ii

Introduction: Left ventricular diastolic dysfunction (DD) is an entity in which the ventricle fails to fill up properly due to impaired ventricular relaxation and/or decreased compliance. The diagnosis of diastolic dysfunction is based on a variety of parameters in doppler echocardiograpy. However, some parameters like interventricular septal thickness in diastole (IVSd), posterior wall thickness in diastole (PWd), left ventricular internal end diastolic and systolic diameters (LVIDD and LVISD) along with left atrial diameters (LAD) have yet to be evaluated for the diagnostic workup of DD. Methods: A case control study was done in the cardiology department from patient records from 2016 to 2018. Patients were diagnosed as diastolic dysfunction grade II and above by doppler echocardiography. IVSd, PWd, LVIDD, LAD, LVISD were obtained through 2-D echocardiography. Results: Patients with DD had greater LAD, IVSd and PWd and decreased LVIDD and LVISD as compared to control group. Overall, IVSD was the most significant predictor (OR 1.52 95%CI 1.35-1.71) of DD followed by PWd and LAD. Similarly, LAD, IVSd and PWd had higher sensitivity and specificity than LVIDD and LVIDS. Conclusion: IVSd, LAD and PWd showed significant performance in the diagnosis of diastolic dysfunction and hence can be used as a screening and diagnostic tool in diastolic dysfunction of grade ll and above. Keywords: Heart failure; diastolic; echocardiography; left ventricle.

scholarly journals Association Between Cortisol and Left Ventricular Diastolic Dysfunction in Patients With Diabetes Mellitus: A Case Control Study

2021 ◽  
Author(s):  
RIKAKO SAGARA ◽  
Tomoaki Inoue ◽  
Noriyuki Sonoda ◽  
Chieko Yano ◽  
Misato Motoya ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Linear Regression Analysis ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
University Hospital ◽  
Multivariate Linear Regression Analysis ◽  
Diastolic Velocity ◽  
Ventricular Diastolic Dysfunction ◽  
Patients With Diabetes

Abstract Introduction: Diabetes mellitus (DM) is a major risk factor for the development of cardiovascular diseases. Heart failure with preserved ejection fraction is characterized by left ventricular diastolic dysfunction (LVDD). It has been reported that excess cortisol found in patients with Cushing’s syndrome was associated with the development of LVDD. However, the relationship between cortisol concentration and LVDD in patients with DM has not been addressed. Research Design and Methods: We enrolled 109 patients with DM and 104 patients without DM who had undergone echocardiographic examination at Kyushu University Hospital, Japan, between November 2016 and March 2019. Left ventricular function was evaluated and the ratio of early diastolic velocity from transmitral inflow to early diastolic velocity (E/eʹ) was used as an index of diastolic function. Plasma cortisol concentrations, glycemic control, lipid profiles, treatment with anti-diabetic drugs, and other clinical characteristics were evaluated, and their associations with E/eʹ were determined using univariate and multivariate analyses. Results Multivariate linear regression analysis showed that log E/eʹ was positively correlated with age (p = 0.017), log systolic blood pressure (p = 0.004), and cortisol (p = 0.037) and negatively correlated with eGFR (p = 0.016) and the usage of SGLT2 inhibitors (p = 0.042) in patients with DM. Multivariate analysis showed that cortisol was positively correlated with age (p = 0.016) and HbA1c (p = 0.011). There was no association between E/eʹ and cortisol in patients without DM. Conclusions Increased cortisol levels may increase the risk of developing LVDD in DM patients.

Abstract 2488: Correlation Between The Severity Of Diastolic Dysfunction And Cardiac Torsion

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Sung-Ji Park ◽  
Chinami Miyazaki ◽  
Charles J Bruce ◽  
Diego Bellavia ◽  
Fletcher A Miller ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Early Stage ◽  
Mitral Annulus ◽  
Left Ventricular ◽  
Control Group ◽  
Compensatory Mechanism ◽  
Diastolic Velocity ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Backgrounds: Left ventricular torsion (LVtor) is an integral part of systole and untwisting plays an important role in diastole. The aim of this study was to characterize LVtor and untwisting in different grades of diastolic dysfunction. Methods: We studied 135 patients with normal LV EF with various grades of diastolic dysfunction (40 group1:mild,42 group 2:moderate,and 22 group 3:severe dysfunction) and 31 controls with normal diastolic function. Apical and basal short axis rotations were measured by 2D STE. LVtor was defined as net difference between apical and basal rotation. Results: Age, gender, and EF were similar in 3 groups and control. Mitral annulus early diastolic velocity was reduced in all 3 groups (see table ). Peak LVtor was significantly greater in group 1 compared with control, group 2 and group 3. The time from peak LVtor to Mitral valve opening, and to peak early diastolic velocity were significantly delayed in group 1 compared to control (p=0.0030 and 0.0409, respectively). The twisting rate and untwisting rate were found to be highest in group 1. Conclusions: Systolic torsion and diastolic untwisting are significantly increased in patients with mild diastolic dysfunction. In patients with advanced diastolic dysfunction with increased filling pressure, torsion and untwisting are normalized. Hence, vigorous LV torsion appears to be a compensatory mechanism during an early stage of diastolic dysfunction to maintain normal filling in the setting of reduced longitudinal myocardial motion.

scholarly journals Cortisol Levels Is Associated With Left Ventricular Diastolic Dysfunction in Diabetic Patients

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A81-A81
Author(s):  
Rikako Sagara ◽  
Tomoaki Inoue ◽  
Noriyuki Sonoda ◽  
Chieko Yano ◽  
Misato Motoya ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Plasma Cortisol ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Cortisol Concentration ◽  
Multivariate Linear Regression Analysis ◽  
Plasma Cortisol Concentration ◽  
Diastolic Velocity ◽  
Ventricular Diastolic Dysfunction

Abstract Introduction: Diabetes mellitus (DM) is a major cause of cardiovascular disease including heart failure with preserved ejection fraction (HFpEF), which is characterized by left ventricular diastolic dysfunction (LVDD). It is reported that Cushing’s syndrome is also associated with LVDD. The relationship between plasma cortisol concentration and LVDD, however, has not been investigated in patients with DM. Methods: In this study, 109 patients with DM and 104 patients with non-DM without overt heart failure were enrolled. Left ventricular function were assessed using echocardiography. The ratio of early diastolic velocity (E) from transmitral inflow to early diastolic velocity (e’) of tissue Doppler at mitral annulus (E/e’) was used as an index of diastolic function. Parameters of plasma cortisol concentration, glycemic control, lipid profile, treatment with anti-diabetic drugs and other clinical characteristics were evaluated, and their association with E/e’ determined. Patients taking steroids, undergoing dialysis treatment and with overt heart failure were excluded. Results: Univariate analysis showed that E/e’ was significantly correlated with age (p&lt;0.001), duration of diabetes (p=0.039), systolic blood pressure (SBP) (p&lt;0.001), eGFR (p=0.002), sodium glucose cotransporter 2 (SGLT2) inhibitor use (p&lt;0.001) and cortisol (p=0.009) in patients with DM. Multivariate linear regression analysis showed that log E/e’ was positively correlated with age (p=0.018), log SBP (p= 0.005), eGFR (p=0.015), cortisol (p=0.028) and that log E/e’ was inversely with inhibitor use (p=0.018). There was no association between E/e’ and cortisol in patients with non-DM. Conclusions: Cortisol may be important in the development of LVDD in patients with DM.

scholarly journals Left ventricle diastolic dysfunction in idiopathic inflammatory myopathies: A meta-analysis and systematic review

2021 ◽  
Author(s):  
Yiwen Zhang ◽  
Xiaoqian Yang ◽  
Li Qin ◽  
Qiang Luo ◽  
Han Wang
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Flow Velocity ◽  
Meta Analysis ◽  
Inflammatory Myopathy ◽  
Idiopathic Inflammatory Myopathy ◽  
Diastolic Flow ◽  
Diastolic Velocity ◽  
Echocardiographic Parameters

ABSTRACT Objectives Recent studies have confirmed that heart failure is one of the most important causes of death in patients with idiopathic inflammatory myopathy (IIM). Left ventricle diastolic dysfunction (LVDD) is closely associated with heart failure. Our aim is to determine if the prevalence of LVDD is increased in IIM patients. Methods We performed a time- and language-restricted literature search to identify studies conducted to compare the echocardiographic parameters in IIM patients and controls. Mean differences were used to calculate the effect sizes of the echocardiographic parameters. Results A total of 13 studies met the inclusion criteria and comprised a total of 227 juvenile dermatomyositis (JDM) patients, 391 adult IIM patients, and 550 controls. The adult IIM patients had lower mitral annular early diastolic velocity (eʹ) and peak of early diastolic flow velocity/peak of late diastolic flow velocity (E/A) ratio compared to controls. The mean left atrial dimension and E/eʹ ratio was higher in adult IIM patients as compared to controls. Similarly, in JDM patients, the decreased eʹ was also observed. Conclusion Patients with IIM were more likely to have echocardiographic parameters indicative of diastolic dysfunction. The early heart assessments should be performed in IIM patients.

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