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Ventricular Diastolic Function (ventricular + diastolic_function)
Kinds of Ventricular Diastolic Function Selected AbstractsAortic Upper Wall Tissue Doppler Image Velocity: Relation to Aortic Elasticity and Left Ventricular Diastolic FunctionECHOCARDIOGRAPHY, Issue 9 2009Soon Yong Suh M.D. Background: Aortic stiffening contributes to the left ventricular (LV) afterload, hypertrophy, and substrate for diastolic dysfunction. It is also known that aortic elastic properties could be investigated with color tissue Doppler imaging (TDI) in aortic upper wall. The purpose of this study is to evaluate the relation of aortic upper wall TDI and aortic stiffness and other parameters of LV diastolic function. Methods: We examined aortic upper wall by TDI at the 3 cm above the aortic valves because of patient's chest discomfort or dyspnea. We excluded the patient with arterial hypertension or reduced left ventricular ejection fraction (LVEF) or significant valvular heart disease. So a total of 126 (mean age 53.8 ± 13.9 years, male 49.2%) patients were enrolled in this study and divided normal LV filling group (N = 31) and abnormal LV filling group (N = 95). Results: Aortic upper wall early systolic velocity and late diastolic velocity were not different between the two groups. Only aortic upper wall early diastolic velocity (AWEDV) was related to aortic stiffness index (r =,0.25, P = 0.008), distensibility (r = 0.28, P = 0.003), early diastolic (Em) (r = 0.45, P = 0.001), E/Em (r =,0.26, P = 0.003), and significantly reduced in abnormal LV filling group (6.19 ± 2.50 vs 8.18 ± 2.87, P = 0.001). Conclusions: AWEDV is decreased significantly in abnormal LV filling patients. It is statistically related to aortic stiffness, distensibility and parameters of abnormal LV filling, Em, E/Em. TDI velocity of the aortic upper wall can be a helpful tool for evaluating aortic stiffness, distensibility, and diastolic function. [source] Analysis of Left Atrial Volume Change Rate for Evaluation of Left Ventricular Diastolic FunctionECHOCARDIOGRAPHY, Issue 7 2004F.E.S.C., Ming-Jui Hung M.D. An excellent correlation exists between the change in the left atrial (LA) angiographic area and posterior aortic wall motion. The aim of the study was to define the role of posterior aortic wall motion, indicating LA volume change, during the left ventricular (LV) phase for the assessment of LV diastolic function. A total of 155 patients underwent echocardiography after cardiac catheterization. Study patients were classified into four groups according to the ratio of early-to-late transmitral flow velocity (E/A ratio) and/or LV end-diastolic pressure (EDP): 42 patients with LVEDP < 15 mmHg and E/A ratio >1 (normal filling); 46 patients with E/A < 1 (impaired relaxation); 46 patients with LVEDP , 15 mmHg and E/A > 1 and <2 (pseudonormal filling); 21 patients with E/A > 2, E , 70 cm/s, and E-wave deceleration time ,160 ms (restrictive filling). The slopes of early and late (slopes E and A) diastolic motion of LA wall were derived from M-mode analysis, together with the LV isovolumic time constant Tau from cardiac catheterization. Values of slope E/A decreased in restrictive filling, pseudonormal filling, and impaired relaxation as compared with normal filling (0.41 ± 0.14, 0.69 ± 0.15, and 0.56 ± 0.23 vs 1.25 ± 0.26, P < 0.001, respectively) and correlated inversely with the isovolumic time constant Tau (r = 0.79, P < 0.001). In cases for which a value of slope E/A < 1 was obtained, indicating a relaxation abnormality, the M-mode derived pattern of LA wall motion identified the underlying abnormal LV diastolic function with a sensitivity of 98.3%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 95.2%. Analysis of the slope of LA wall motion, indicating LA volume change rate, during LV diastolic phase is useful in evaluating LV diastolic function. It provides a new noninvasive index that correlates well with invasive index of LV relaxation. [source] Evaluation of Left Ventricular Diastolic Function after Edge-to-Edge Mitral Valve PlastyJOURNAL OF CARDIAC SURGERY, Issue 1 2010Yong-Qiang Lai M.D. This procedure anchors the correspondence leaflets to create a double-orifice mitral valve. The original mitral valve anatomy is changed, and the opening of mitral valve is restricted. Little is known whether this procedure affects the left ventricular diastolic function. Methods: Thirty patients with mitral regurgitation were included in this study. Fifteen with posterior leaflet prolapse received quadrangular resection (group 1), 15 with anterior or bileaflet prolapse underwent edge-to-edge procedure (group 2). Acute hemodynamics was monitored with a Swan-Ganz catheter (Edwards Lifesciences LLC, Irvine, CA, USA). Left ventricular diastolic function was also evaluated with echocardiography in 28 patients with sinus rhythm. The ratio of peak E velocity and A velocity (E/A), the ratio of early diastolic peak flow velocity to early diastolic mitral annular movement velocity (E/Em), and the ratio of early diastolic mitral annular velocity to late diastolic mitral annular velocity (Em/Am) were measured before operation and one week after operation. Results: Mitral valve area and mitral regurgitate grade decreased significantly after operation. There was no significant change in pulmonary artery wedge pressure between two groups and in each group before and after operation. Echocardiography evaluation showed there was no significant difference in E/A, E/Em, and Em/Am before and after operation between two groups and in each group. Conclusion: Edge-to-edge mitral valve plasty procedure has no significant impairment on left ventricular diastolic function. A double-orifice mitral valve has similar hemodynamic behavior with a physiological valve.(J Card Surg 2010;25:5-8) [source] Effects of Left Ventricular Assist Device on Cardiac Function: Experimental Study of Relationship between Pump Flow and Left Ventricular Diastolic FunctionARTIFICIAL ORGANS, Issue 9 2001Akira Saito Abstract: The left ventricular assist device (LVAD) with centrifugal pump has two characteristics. One is a pump flow wave of the centrifugal pump, consisting of the pulsatile flow of the native heart and the nonpulsatile flow of the centrifugal pump. The other is that the centrifugal pump fills from the native heart not only in the systolic phase, but also in the diastolic phase. In the case of the apex outlet LVAD with centrifugal pump, blood flows from the left atrium through the left ventricle to the pump. Pump flow is regulated by preload, and preload is regulated by diastolic hemodynamics. The aim of this study is to analyze the relationship between pump flow and the diastolic hemodynamics of the native heart. Ten anesthetized intact pigs were studied after placement of an LVAD. Data were recorded with the LVAD off (control) and the LVAD on. The assist rate was changed to 25%, 50%, and 75%. The indexes of left ventricular (LV) diastolic function included LV myocardial relaxation (time constant of isovolumic pressure decay [Tau] and maximum negative dP/dt[LV dP/dt min]) and LV filling (peak filling rate [PFR], time to peak filling rate [tPFR], and diastolic filling time [DFT]). Stroke volume decreased significantly in 75% assist. LV end-systolic pressure decreased significantly in 50% and 75% assist. LV end-diastolic volume decreased as assist rate increased, but there were no significant changes. Stroke work decreased significantly in 50% and 75% assist. LV dP/dt min decreased significantly in 50% and 75% assist. Tau prolonged as assist rate increased, but there were no significant changes. DFT shortened significantly in 75% assist. PFR increased significantly in 75% assist. tPFR shortened significantly in 50% and 75% assist. In this study, LV relaxation delayed as an increasing of pump assist rate, but it suggested a result of reduction of cardiac work. Also, it was suggested that LVAD increases the pressure difference between the left atrium and the left ventricle in the diastolic phase. This phenomenon is due to the filling of the left ventricle. In this study it was suggested that as pump assist rate increases, it is more effective to keep cardiac function in the diastolic phase. [source] Hepatopulmonary Syndrome and Right Ventricular Diastolic Functions: An Echocardiographic ExaminationECHOCARDIOGRAPHY, Issue 4 2006Aziz Karabulut M.D. Aim: Liver functions are affected in the course of cardiac diseases, and similarly, liver diseases affect cardiac functions. Many studies in the literature have shown that left ventricular systolic and/or diastolic dysfunction may develop during chronic liver disease. However, there are limited studies investigating right ventricular functions during chronic liver diseases. Methods: A total of 84 patients who had no systolic and/or diastolic dysfunction in the left ventricle (LV) were evaluated; 46 patients with liver cirrhosis; 10 (21.74%) cirrhotic patients with hepatopulmonary syndrome (HPS) (group 1), 36 (78.26) cirrhotic patients without HPS (group 2), and 38 healthy individuals were treated as control. Results: Right ventricular diastolic dysfunction was determined in all patients of group 1 (100%), 26 of group 2 (72.22 %), and 4 of the controls (10.52%) (P < 0.05). Tricuspid deceleration time (dt) was significantly different between the groups (P < 0.05). In addition, right atrium (RA) diameters, right ventricle (RV) diameters, and RV wall thickness were significantly different between the groups (P < 0.05). Pulmonary artery pressure (P < 0.05) and pulmonary vascular resistance (P < 0.05) were also seen to be higher in group 1 than those in group 2 and control group. Conclusions: Right ventricular diastolic dysfunction rate is high in chronic liver diseases. In the presence of HPS, right ventricular diastolic dysfunction is more remarkable in patients than those without HPS. Right ventricular diastolic dysfunction may result in dilatation and hypertrophy in the right heart. [source] Ten-Year Echo/Doppler Determination of the Benefits of Aerobic Exercise after the Age of 65 YearsECHOCARDIOGRAPHY, Issue 1 2010Alexander J. Muster M.D. As the human lifespan becomes progressively extended, potential health-related effects of intense aerobic exercise after age 65 need evaluation. This study evaluates the cardiovascular (CV), pulmonary, and metabolic effects of competitive distance running on age-related deterioration in men between 69 (±3) and 77 (±2) years (mean ± SD). Twelve elderly competitive distance runners (ER) underwent oxygen consumption and echo/Doppler treadmill stress testing (Balke protocol) for up to 10 years. Twelve age-matched sedentary controls (SC) with no history of CV disease were similarly tested and the results compared for the initial three series of the study. CV data clearly separated the ER from SC. At entry, resting and maximal heart rate, systolic/diastolic blood pressure, peak oxygen consumption (VO2max), and E/A ratio of mitral inflow were better in the ER (P < 0.05 vs. SC). With aging, ER had a less deterioration of multiple health parameters. Exceptions were VO2max and left ventricular diastolic function (E/A, AFF, IVRT) that decreased (P < 0.05, Year 10 vs. Year 1). Health advantages of high-level aerobic exercise were demonstrated in the ER when compared to SC. Importantly, data collected in ER over 10 years confirm the benefit of intensive exercise for slowing several negative effects of aging. However, the normative drop of exercise capacity in the seventh and eighth decades reduces the potential athleticism plays in prevention of CV events. (Echocardiography 2010;27:5-10) [source] Echocardiographic Study of Cardiac Morphological and Functional Changes before and after Parturition in Pregnancy-Induced HypertensionECHOCARDIOGRAPHY, Issue 3 2006Lijun Yuan M.D. Purpose: To investigate the cardiac morphological and functional changes by echocardiography, before and after parturition in patients with pregnancy-induced hypertension (PIH). Methods: The parameters related to cardiac morphology and left ventricular diastolic and systolic functions were compared before and after parturition in 32 patients with PIH and 24 normal pregnant (NP) women. Results: Compared with NP women, the PIH patients had greater diameters of left atrium and left ventricle in end-diastole (LAd: 38.9 ± 4.5 vs 34.6 ± 4.4 mm, P = 0.0015; LVEDd: 51.2 ± 5.8 vs 47.1 ± 4.2 mm, P = 0.036) and lower E/A (1.2 ± 0.2 vs 1.4 ± 0.2, P = 0.009) and greater fractional shortening (FS) (39.8 ± 6.5% vs 37.1 ± 6.9%, P = 0.042) and ejection fraction (EF) (0.72 ± 0.07 vs 0.66 ± 0.08, P = 0.040). Pericardial effusion (PE) occurred in 31.3% and 16.7% of PIH and NP, respectively. The LAd and LVEDd in 70% and 47% patients with PIH resolved and PE disappeared in 80% of PIH patients postpartum. E/A ratio in PIH significantly increased after parturition, while the two patients with cardiac systolic dysfunction did not improve very much. Conclusions: Compared with normal pregnancy, the most significant cardiac morphological changes in PIH are the greater diameters of left atrium and left ventricle, thicker inter-ventricular septum (IVS), more PE, impaired left ventricular diastolic function, and increased systolic function. The PE could disappear in PIH and about half of other abnormalities could recover to be the level of normal pregnancy postpartum within 2 months. [source] Evaluation of Left Ventricular Systolic and Diastolic Global Function: Peak Positive and Negative Myocardial Velocity Gradients in M-Mode Doppler Tissue ImagingECHOCARDIOGRAPHY, Issue 1 2002Yoshiki Ueno M.D. Objectives: To evaluate a new indicator of left ventricular global function: Myocardial velocity gradient (MVG) M-mode Doppler tissue imaging (DTI). Background: MVG is a new indicator of regional left ventricular function and global left ventricular diastolic function. However, it is unclear whether MVG also is an indicator of left ventricular global function in comparison with invasive indices. Methods: We performed conventional imaging and M-mode DTI in 85 subjects and calculated MVG at the posterior wall. We obtained satisfactory images in 65 subjects, who we divided into three groups: Noninvasive study group, invasive study group, and hemodialysis group. The noninvasive study group was divided into three subgroups (a younger normal subgroup, an older normal subgroup, and a cardiomyopathy subgroup), and MVG was compared with indices of conventional imaging. In the invasive study group, we compared MVG and indices of conventional imaging with hemodynamic data (peak positive and negative dp/dt, and the time constant T) using a high fidelity micromanometer-tipped catheter. In the hemodialysis group, we compared indices before hemodialysis with those after hemodialysis. Results: Peak positive MVG correlated well with peak positive dp/dt (r = 0.79), and this did not change with hemodialysis (P = 0.87). Peak negative MVG also correlated well with peak positive dp/dt and the time constant T (r = 0.88 and r = 0.80), and this did not change with hemodialysis (P = 0.97). Conclusions: Peak positive and negative MVG are sensitive and load-insensitive indicators of left ventricular function. [source] Heritability of left atrial size in the Tecumseh populationEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 7 2002P. Palatini Abstract Background ,Little is known about the determinants of atrial size, and no study has analyzed whether genetic factors are involved in the pathogenesis of LA enlargement. Materials and methods We studied the heritability of echocardiographic left atrial size in 290 parents from the Tecumseh Blood Pressure Study and 251 children from the Tecumseh Offspring Study. All data from the parents and children were obtained at the same field office in Tecumseh, USA. Left atrial dimension was determined echocardiographically in accordance with American Society of Echocardiography guidelines with the use of leading-edge-to-leading-edge measurements of the maximal distance between the posterior aortic root wall and the posterior left atrial wall at end systole. Results For correlation between the left atrial dimensions of the parents and their offspring, several models were generated to adjust the atrial dimensions in both groups for an increasing number of clinical variables. After removing the effect of age, gender, height, weight, skinfold thickness, and systolic blood pressure, parent,child correlation for left atrial size was 0·19 (P = 0·007). Further adjustment for left ventricular mass and for measuring left ventricular diastolic function increased the correlation to 0·25 (P = 0·001). Conclusions ,The present data indicate that heredity can explain a small but definite proportion of the variance in left atrial dimension. [source] Neostigmine and pilocarpine attenuated tumour necrosis factor , expression and cardiac hypertrophy in the heart with pressure overloadEXPERIMENTAL PHYSIOLOGY, Issue 1 2008Jessica Freeling The inflammatory cytokine tumour necrosis factor , (TNF,) is known to be a major factor contributing to cardiac remodelling and dysfunction. Parasympathetic nervous system cholinergic function can inhibit TNF, expression during systemic infection. In the present study, we tested the effects of a cholinesterase inhibitor, neostigmine, and a muscarinic cholinergic agonist, pilocarpine, on cardiac hypertrophy and TNF, levels during pressure overload. Rats with transverse aortic constriction exhibited elevated TNF, protein levels in the heart, increased heart weight to body weight ratios (an index of cardiac hypertrophy) and decreased left ventricular diastolic function. Two weeks of infusion with neostigmine (6 ,g kg,1 day,1) or pilocarpine (0.3 mg kg,1 day,1) significantly reduced cardiac hypertrophy, reduced TNF, levels and elevated interleukin-10 levels in heart tissues, and improved ventricular function in rats with transverse aortic constriction. Neither of these treatments significantly changed ventricular pressure load. Furthermore, in primary cultured neonatal cardiac cells, treatment with pilocarpine attenuated adrenergic agonist phenylephrine-induced increased TNF, expression and [3H]leucine (a marker of protein synthesis) incorporation in the cells. Collectively, both cholinergic agents decreased TNF, levels and attenuated cardiac hypertrophy. Since both agents potentially enhanced cholinergic function, the anti-inflammatory action may be involved in the cardioprotective effect of the treatments with these agents. [source] Response to Low serum bilirubin concentrations are associated with impaired aortic elastic properties, but not impaired left ventricular diastolic functionINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 7 2007K. I. Paraskevas No abstract is available for this article. [source] Response to Low serum bilirubin concentrations are associated with impaired aortic elastic properties, but not impaired left ventricular diastolic functionINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 7 2007D. Erdogan No abstract is available for this article. [source] Low serum bilirubin concentrations are associated with impaired aortic elastic properties, but not impaired left ventricular diastolic functionINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2007M. Caliskan Summary Elevated serum bilirubin concentrations protect from atherosclerotic diseases; however, it is not clear whether higher serum bilirubin concentrations in physiological ranges do the same. To investigate the association of high and low serum bilirubin concentrations with left ventricular diastolic function and aortic elastic properties. We evaluated left ventricular diastolic function and aortic elastic properties of 42 healthy subjects with hypobilirubinemia (total bilirubin 0.40 ± 0.08 mg/dl; mean age 37.0 ± 3.9) and 40 healthy subjects with hyperbilirubinemia (total bilirubin 1.56 ± 0.49 mg/dl; mean age 36.2 ± 6.0) using transthoracic second harmonic Doppler echocardiography. Age, gender, body mass index and coronary risk factors were similar between the groups, except high-sensitivity C-reactive protein (hsCRP). Left ventricular diastolic parameters were similar between the two groups. Aortic distensibility (AoD) was found to be significantly lower (11.1 ± 3.9 vs. 13.2 ± 4.9, p = 0.03) and aortic stiffness index (AoSI) (1.99 ± 0.30 vs. 1.85 ± 0.26, p = 0.02) and elastic modulus (AoEM) (2.06 ± 0.83 vs. 1.73 ± 0.68, p = 0.03; the low and high bilirubin groups, respectively) higher in the low bilirubin group. Serum total bilirubin concentration correlated with hsCRP levels, AoD, AoSI and AoEM. In conclusion, left ventricular systolic and diastolic functions were similar between hypo- and hyperbilirubinemic subjects, but aortic elastic properties were impaired in subjects with lower serum bilirubin concentrations. [source] Evaluation of Left Ventricular Diastolic Function after Edge-to-Edge Mitral Valve PlastyJOURNAL OF CARDIAC SURGERY, Issue 1 2010Yong-Qiang Lai M.D. This procedure anchors the correspondence leaflets to create a double-orifice mitral valve. The original mitral valve anatomy is changed, and the opening of mitral valve is restricted. Little is known whether this procedure affects the left ventricular diastolic function. Methods: Thirty patients with mitral regurgitation were included in this study. Fifteen with posterior leaflet prolapse received quadrangular resection (group 1), 15 with anterior or bileaflet prolapse underwent edge-to-edge procedure (group 2). Acute hemodynamics was monitored with a Swan-Ganz catheter (Edwards Lifesciences LLC, Irvine, CA, USA). Left ventricular diastolic function was also evaluated with echocardiography in 28 patients with sinus rhythm. The ratio of peak E velocity and A velocity (E/A), the ratio of early diastolic peak flow velocity to early diastolic mitral annular movement velocity (E/Em), and the ratio of early diastolic mitral annular velocity to late diastolic mitral annular velocity (Em/Am) were measured before operation and one week after operation. Results: Mitral valve area and mitral regurgitate grade decreased significantly after operation. There was no significant change in pulmonary artery wedge pressure between two groups and in each group before and after operation. Echocardiography evaluation showed there was no significant difference in E/A, E/Em, and Em/Am before and after operation between two groups and in each group. Conclusion: Edge-to-edge mitral valve plasty procedure has no significant impairment on left ventricular diastolic function. A double-orifice mitral valve has similar hemodynamic behavior with a physiological valve.(J Card Surg 2010;25:5-8) [source] The effect of low-carbohydrate diet on left ventricular diastolic function in obese childrenPEDIATRICS INTERNATIONAL, Issue 2 2010Cenap Zeybek Abstract Background:, This study was conducted to evaluate left ventricle (LV) functions using conventional and tissue Doppler imaging in childhood obesity and to identify the effects of diet on LV diastolic functions. Methods:, Conventional and tissue Doppler echocardiographic measurements were compared in 34 obese children and 24 age- and gender-matched lean controls. Fasting plasma glucose, insulin and homeostatic model assessment of insulin resistance levels were also obtained. Thirty-one of the obese children were subjected to a low-carbohydrate diet and their follow-up measurements were obtained after 6 months. Results:, Left atrial diameter, LV mass and LV mass index were higher in obese children than in lean controls. Lateral mitral myocardial early diastolic (Em) and peak Em/myocardial late diastolic (Am) were lower, and mitral E/Em and lateral mitral myocardial isovolumetric relaxation time were higher in obese subjects than in lean controls. Insulin and homeostatic model assessment of insulin resistance levels were higher in obese patients and decreased significantly after diet. After diet therapy, lateral mitral Em and peak Em/Am, were increased, mitral E/Em and myocardial isovolumetric relaxation time were decreased. Conclusions:, Obesity predisposes children to increased preload reserve, left ventricular subclinical diastolic dysfunction and deterioration in diastolic filling. Weight reduction with a low-carbohydrate diet seems to be associated with significant improvement in LV diastolic function and a decrease in diastolic filling, as well as causing reversal in insulin resistance seen in obese children. [source] Assessment of right ventricular diastolic filling parameters by Doppler echocardiographyPEDIATRICS INTERNATIONAL, Issue 3 2003Ayten Pamukcu Uyan AbstractBackground: Right ventricular diastolic function has been evaluated in various diseases by the pulsed Doppler technique. Right ventricular diastolic filling parameters show changes with age, heart rate and respiration. Evidences of diastolic left and right ventricular dysfunctions have been reported by echocardiographic studies in asthmatic patients. In the present study, before and after treatment of asthma the right ventricular diastolic filling parameters were compared in children with moderate asthma by Doppler echocardiography (a non-invasive technique). Methods: The study group consisted of 20 children (eight girls, 12 boys) with asthma. During the present study these patients were treated with inhaled steroid and beta-2 agonist daily. Before treatment all patients were evaluated by Doppler echocardiography. At 4,6 weeks after treatment 15 patients that had shown improvement in their symptoms according to the symptom score were also evaluated by Doppler echocardiography. Results: The mean age was 8.6 ± 2.69 years and mean period of symptoms were 56.4 ± 35.8 months. When compared with results of echocardiography before and after treatment, the right ventricular diastolic filling parameters (acceleration time: P < 0.01, deceleration time: P < 0.01 and isovolumetric relaxation time: P < 0.05) were found to be significantly different. Conclusions: We observed significant improvement of right ventricular diastolic filling parameters by Doppler echocardiography after treatment in children with asthma. [source] |