scholarly journals Atrial conduction times and left atrial mechanical functions and their relation with diastolic function in prediabetic patients

2017 ◽  
Vol 32 (2) ◽  
pp. 286-294 ◽  
Author(s):  
Naile Eris Gudul ◽  
Turgut Karabag ◽  
Muhammet Rasit Sayin ◽  
Taner Bayraktaroglu ◽  
Mustafa Aydin
Keyword(s):  
Diastolic Function ◽  
Left Atrial ◽  
Atrial Conduction Times

PP-335 Atrial Conduction Times and Left Atrial Mechanical Functions in Patients with Active Acromegaly

2014 ◽  
Vol 113 (7) ◽  
pp. S142
Author(s):  
A. İlter ◽  
A. Kırış ◽  
M. Şahin ◽  
N. Civan ◽  
H. Bektaş ◽  
...  
Keyword(s):  
Left Atrial ◽  
Active Acromegaly ◽  
Atrial Conduction Times

Abstract 649: Increased Left Ventricular Filling Pressure is Associated with Left Atrial Thrombus in Patients with Atrial Fibrillation.

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Katsuomi Iwakura ◽  
Hiroshi Ito ◽  
Atsunori Okamura ◽  
Yasushi Koyama ◽  
Motoo Date ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Diastolic Function ◽  
Left Atrial ◽  
Multivariate Logistic Regression Analysis ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Diastolic Filling ◽  
Ventricular Filling Pressure ◽  
Lv Diastolic Dysfunction ◽  
Ventricular Filling

Patients with atrial fibrillation (AF) are frequently associated with reduced left ventricular (LV) diastolic dysfunction. It is still unclear whether reduced diastolic function is associated with the risk of left atrial (LA) thrombus in AF. The ratio of transmitral E velocity to mitral annular velocity (e′) is an echocardiographic estimate of diastolic LV filling pressure even under AF rhythm. We investigated whether reduced LV diastolic function is associated with the risk of LA thrombus in AF patients, using E/e′ ratio as an index. We enrolled consecutive 405 patients with non-valvular, paroxysmal or chronic AF, who underwent both transthoracic- (TTE) and transesophagial echocardiography (TEE) examination within a month. We measured LA and LV dimensions, LV ejection fraction (%EF), wall thickness, E and e′ velocities on TTE, and determined E/e′ ratio. LA appendage thrombus was found in 33 patients (8.1%). Patients with LA thrombus showed lower e′ velocity (5.3±1.8 vs. 7.0±2.2 cm/s, p<.0001) and higher E/e′ ratio (17.2±9.2 vs. 11.5±5.9, p<.0001) than those without it. Using 12.4 as an optimal cutoff point, E/e′ predicted LA thrombus with 70% sensitivity and 70% specificity (AUC=0.72). Odds ratio for LA thrombus in patients in the highest quartile of E/e′ was 6.38 (3.06–13.9). Multivariate logistic regression analysis indicated that the highest quartiles of E/e′ ratio was an independent predictor of LA thrombus among echocardiographic parameters, along with LA dimension and %EF, whereas e′ was not. LA appendage flow velocity was significantly correlated with E/e′ ratio (p<.0001), implying that increased diastolic filling pressure could be associated with impaired blood flow within LA. Increased LV filling pressure increased the risk of LA thrombus in patients with AF, partially through impaired LA hemodynamics. E/e′ ratio on TTE could be useful for detecting high-risk patients for LA thrombus.

scholarly journals Acute Effects of Pimobendan on Cardiac Function in Dogs With Tachycardia Induced Dilated Cardiomyopathy: A Randomized, Placebo-Controlled, Crossover Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Kaitlin Abbott-Johnson ◽  
Kursten V. Pierce ◽  
Steve Roof ◽  
Carlos L. del Rio ◽  
Robert Hamlin
Keyword(s):  
Heart Rate ◽  
Mitral Regurgitation ◽  
Dilated Cardiomyopathy ◽  
Diastolic Function ◽  
Cardiac Disease ◽  
Left Atrial ◽  
Survival Benefit ◽  
Systolic Function ◽  
Blood Draw ◽  
Post Dose

Background: Pimobendan provides a significant survival benefit in dogs with cardiac disease, including degenerative mitral valve disease and dilated cardiomyopathy (DCM). Its positive inotropic effect is well-known, however, it has complex effects and the mechanisms behind the survival benefit are not fully characterized. Secondary hemodynamic effects may decrease mitral regurgitation (MR) in DCM, and the benefits of pimobendan may extend to improved cardiac relaxation and improved atrial function.Hypothesis/Objectives: Our objective was to investigate the acute cardiac effects of pimobendan in dogs with a DCM phenotype. We hypothesized that pimobendan would increase left atrial (LA) contractility, reduce mitral regurgitation, improve diastolic function, and lower circulating NT-ProBNP levels.Animals: Seven purpose-bred Beagles were studied from a research colony with tachycardia induced DCM phenotype.Methods: The effects of pimobendan were studied under a placebo-controlled single-blinded cross-over design. In short, dogs underwent baseline and 3 h post-dose examinations 7 days apart with echocardiography and a blood draw. Dogs were randomized to receive oral placebo or 0.25 mg/kg pimobendan after their baseline exam. Investigators were blinded to treatments until all measurements were compiled.Results: When treated with pimobendan, the dogs had significant increases in systolic function and decreases in MR, compared to when treated with placebo.There were no detectable differences in left atrial measures, including LA size, LA emptying fraction, LA functional index or mitral A wave velocity. Heart rate decreased significantly with pimobendan compared to placebo. There was also a decrease in isovolumetric relaxation time normalized to heart rate. NT-proBNP levels had a high degree of variability.Conclusions: Improved mitral regurgitation severity and improved lusitropic function may contribute to the reported survival benefit for dogs with cardiac disease administered pimobendan. Pimobendan did not overtly improve LA function as assessed by echocardiography, and NT-proBNP was not significantly changed with a single dose of this medication. Further studies are needed to better characterize LA effects with other imaging modalities, to better quantify the total improvement of MR severity, and to assess chronic use of pimobendan on diastolic function in DCM.

scholarly journals P1509 Obesity and diastolic function of the left ventricle by echocardiography in a Mediterranean child population

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Aristizabal Duque ◽  
J Fernandez Cabeza ◽  
I M Blancas Sanchez ◽  
M Ruiz Ortiz ◽  
M Delgado Ortega ◽  
...  
Keyword(s):  
Pressure Gradient ◽  
Diastolic Function ◽  
Wave Velocity ◽  
Left Atrial ◽  
Pediatric Population ◽  
Left Atrial Volume ◽  
Atrial Volume ◽  
Obese Adults ◽  
Rural Town ◽  
The Right

Abstract Background The prevalence of overweight in childhood is 26% and obesity is 12.6% in Spain. Diastolic function assessed with echocardiography shows significant worsening in obese adults compared to non-obese adults. However, few studies describe the association between obesity and diastolic function in the pediatric population. Aim To investigate the relationship between obesity and diastolic function in a Mediterranean pediatric population. Methods A random sample of children and adolescents of primary and secondary education was selected, stratifying by age, gender and educational centers in a rural town of 2864 inhabitants of southern Spain. Children between 6 and 17 years old were included. A transthoracic echocardiogram was performed to evaluate diastolic function. Results A total of 212 children were studied (10.9 ± 3.0 years old and 51.9% males): 163 (76.9%) were not obese and 49 (23.1%) were obese. Age and sex were similar in both groups. Results are shown in the table. Obesity was related to a larger left atrial volume, a higher A-wave velocity, a lower lateral e "wave velocity, a higher average E/e ratio, and a higher pressure gradient between the atrium and the right ventricle. Conclusions Obesity in childhood is associated to worsening of diastolic function parameters commonly measured in echocardiography. Obese Vs non-Obese non-obese obese p Age 10,8 ± 3,0 11,0 ± 2,8 0,63 Male (%) 50,1% 57,1% 0,4 A-wave velocity (cm/s) 58,7 ± 13,1 64,8 ± 13,8 0,005 E/A 1,89 ± 0,45 1,75 ± 0,41 0,05 lateral e" velocity (cm/s) 21,26 ± 4,61 19,58 ± 3,97 0,02 average E/e" 6,4 ± 1,1 7,0 ± 1,2 0,001 left atrial volume (mL) 20,8 ± 6,8 27,9 ± 7,4 &lt;0,0005 pressure gradient (mmHg) 15,5 ± 4,5 18,0 ± 4,9 0,02

Evaluation of cardiac function in fetuses of mothers with gestational diabetes

2019 ◽  
Vol 29 (10) ◽  
pp. 1264-1267 ◽  
Author(s):  
Muhammad Mohsin ◽  
Saleem Sadqani ◽  
Kamran Younus ◽  
Zahra Hoodbhoy ◽  
Salima Ashiqali ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Cardiac Function ◽  
Gestational Diabetes Mellitus ◽  
Diastolic Function ◽  
Left Atrial ◽  
Myocardial Hypertrophy ◽  
Control Group ◽  
Diabetes Group ◽  
Diabetic Mothers

AbstractObjective:The purpose of this study was to assess fetal cardiac function in normal fetuses (control group) compared to those who are exposed to gestational diabetes mellitus using different echocardiographic measurements, and to explore the application of left atrial shortening fraction in determination of fetal diastolic function with gestational diabetes mellitus.Methods:A total of 50 women with gestational diabetes and 50 women with a healthy pregnancy were included in the study. Fetal echocardiography was performed and structural as well as functional fetal cardiac parameters were measured. Data were compared between with or without fetal myocardial hypertrophy and the control group.Results:In the study group, out of 50 fetuses of gestational diabetic mothers, 18 had myocardial hypertrophy and 32 had normal septal thickness. Gestational age at time of examination did not differ significantly between the control and gestational diabetes group (p = 0.55). Mitral E/A ratio was lower in gestational diabetes group as compared to the control (p < 0.001). Isovolumetric relaxation and contraction times and myocardial performance index were greater in fetuses of gestational diabetic mothers (p < 0.001). In fetuses of gestational diabetic mothers with myocardial hypertrophy, left atrial shortening fraction was lower as compared to those without myocardial hypertrophy and those of the control group (p < 0.001).Conclusions:The results of this study suggest that fetuses of gestational diabetic mothers have altered cardiac function even in the absence of septal hypertrophy, and that left atrial shortening fraction can be used as a reliable alternate parameter in the assessment of fetal diastolic function.

scholarly journals P934 Left atrial strain association with left ventricular diastolic function

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
I Rodriguez Sanchez ◽  
A Anton ◽  
J J Onaindia ◽  
S Velasco ◽  
J Florido ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Diastolic Function ◽  
Left Atrial ◽  
Normal Function ◽  
Left Ventricular ◽  
P Value ◽  
Peak Strain ◽  
Progressive Decrease ◽  
Significant Group ◽  
Global Peak

Abstract Objectives to evaluate the relationship between left atrial (LA) peak strain and left ventricular (LV) diastolic function and determine whether LA strain could be used to detect elevated filling pressures in a population of patients with preserved LV ejection fraction (LVpEF). Background the assessment of diastolic function is complex and multiparameter. 2016 ASE and EACVI algorithm has simplified this approach, but there are still patients with discrepant values leading to an indeterminate diagnosis, specially in patients with preserved ejection fraction. Methods we prospectively included 129 patients in our cohort. Inclusion criteria were LVEF &gt; 50% and sinus rhythm. Patients with atrial fibrillation, significant mitral valvulopathy or poor quality imaging were excluded. Two-dimensional speckle tracking was used to measure peak LA strain in all LA segments (using apical 4 chamber, 2 chamber and 3 chamber views). We evaluated the association of LA global peak strain and LA 4 chamber peak strain with the different categories of diastolic function according to the 2016 ASE and EACVI algorithm. Results Both LA global peak strain and 4 chamber LA peak strain showed a progressive decrease with worsening diastolic dysfunction (DD) severity (Table 1). A global LA peak strain cutoff value of 28,35% was very accurate to differentiate normal from elevated filling pressures (normal function or grade 1 DD from grades 2 and 3 DD). Diagnostic accuracy: 80.20%; area under the curve: 0,80 (0,72-0,88); A significant group of patients (21,1%) could not be categorized using 2016 algorithm. Conclusions Both LA global peak strain and 4 chamber LA peak strain demonstrated a progressive decrease with worsening DD severity. Global LA peak strain value of 28,35% was an accurate cutoff to differenciate patients with normal vs elevated filling pressures. LA strain values and diastolic function Total LA global peak STRAIN LA 4C STRAIN N (%) p-value p-value Total 129 30.90 %(11.77) 30.43 (12.36) Diastole &lt;0.0001 &lt;0.0001 Normal function 36 (28.13) 39.72% (9.59) 39.98 (10.59) Indeterminate Diastolic Function 23 (17.97) 31.07% (7.97) 30.19 (7.50) Indeterminate DD 4 (3.13) 30.68 % (6.72) 29.75 (7.31) grade 1 DD 22 (17.19) 32.69 % (12.54) 32.98 (14.46) grade 2 DD 36 (28.13) 23.90 % (9.32) 23.53 (9.49) grade 3 DD 7 (5.47) 15.43 % (5.72) 15.85 (7.32)

scholarly journals Cardiotoxicity in breast cancer treatment: What about left ventricular diastolic function and left atrial function?

2019 ◽  
Vol 36 (10) ◽  
pp. 1806-1813 ◽  
Author(s):  
Ana Teresa Timóteo ◽  
Luisa Moura Branco ◽  
Frederico Filipe ◽  
Ana Galrinho ◽  
Pedro Rio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Diastolic Function ◽  
Left Atrial ◽  
Left Ventricular Diastolic Function ◽  
Breast Cancer Treatment ◽  
Left Ventricular ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Ventricular Diastolic Function

A randomized controlled trial of cardiac resynchronization therapy in patients with prolonged atrioventricular interval: the REAL-CRT pilot study

EP Europace ◽  
2019 ◽  
Vol 22 (2) ◽  
pp. 299-305 ◽  
Author(s):  
Giovanni Luca Botto ◽  
Assunta Iuliano ◽  
Eraldo Occhetta ◽  
Giuseppina Belotti ◽  
Giovanni Russo ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Cardiac Resynchronization Therapy ◽  
Diastolic Function ◽  
Lower Risk ◽  
Left Atrial ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Pr Interval ◽  
New Onset

Abstract Aims A prolonged PR interval is known to be associated with increased mortality and a higher risk of developing atrial fibrillation (AF). We tested the hypothesis that cardiac resynchronization therapy (CRT) is superior to conventional dual-chamber pacing with algorithms for right ventricular pacing avoidance (DDD-VPA) in preserving systolic and diastolic function and in preventing new-onset AF in patients with normal systolic function, indication for pacing and prolonged atrioventricular conduction (PR interval ≥220 ms). Methods and results We randomly assigned 82 patients with ejection fraction &gt;35%, indication for pacing and PR interval ≥220 ms to CRT or to DDD-VPA. On 12-month follow-up examination, the study and control arms did not differ in terms of left ventricular end-systolic volume (44 ± 17 mL vs. 47 ± 16 mL, P = 0.511) or ejection fraction (55 ± 6% vs. 57 ± 8%, P = 0.291). The E to A mitral wave amplitude ratio was higher in the CRT arm (1.3 ± 1.3 vs. 0.8 ± 0.4, P = 0.046) and the E wave deceleration time was longer (262 ± 83 ms vs. 205 ± 51 ms, P = 0.027). Left atrial volume was smaller in the CRT arm (64 ± 17 mL vs. 84 ± 25 mL, P = 0.035). Moreover, the functional class was lower in CRT patients (1.4 ± 0.6 vs. 1.8 ± 0.5, P = 0.010). During follow-up, CRT was associated with a lower risk of new-onset AF [hazard ratio = 0.37 (0.13–0.98), P = 0.046]. Conclusion Cardiac resynchronization therapy proved superior to DDD-VPA in terms of better diastolic function, less left atrial enlargement and lower risk of new-onset AF, at 12 months. These data need to be confirmed in a larger trial with longer follow-up. Clinical trial registration URL: http://clinicaltrials.gov/ Identifier: NCT02150538

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