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LV Diastolic Dysfunction (lv + diastolic_dysfunction)
Selected AbstractsDiagnostic utility of brain-natriuretic peptide for left ventricular diastolic dysfunction in asymptomatic type 2 diabetic patientsDIABETES OBESITY & METABOLISM, Issue 3 2007M. Shimabukuro Aim:, Left ventricular (LV) diastolic dysfunction has been reported to be prevalent in diabetic subjects, but this recognition could often be missed. We evaluated prevalence of LV diastolic dysfunction and diagnostic utility of brain-natriuretic peptide (BNP) in asymptomatic patients with type 2 diabetes mellitus. Research design and methods:, Plasma BNP levels and LV geometry and diastolic filling indices, including the ratio of peak early transmitral Doppler flow (E) over flow propagation velocity (Vp) measured by colour M-mode Doppler echocardiography, were analysed in 98 consecutive asymptomatic patients with type 2 diabetes mellitus and 51 age-matched controls. Results:, The LV mass index and relative wall thickness were higher in diabetic groups than controls without any differences in LV systolic function. The frequency of diastolic dysfunction defined as E/Vp , 1.5 were 31% in diabetic groups and 15% in controls (,2 = 4.364, p = 0.037). By receiver-operating characteristic (ROC) curve analysis, a BNP cutoff value of 19.2 pg/ml in controls had a 53.1% positive predictive value (53.1%) and a high negative predictive value (94.4%) for E/Vp , 1.5, whereas a BNP cutoff value of 18.1 pg/ml in diabetic groups had a 61.8% positive and 97.3% negative predictive values. Conclusions:, The frequency of E/Vp , 1.5 was higher in asymptomatic diabetic patients, suggesting that LV diastolic dysfunction was prevalent. The plasma concentration of BNP could be used to depict LV diastolic dysfunction in such population. [source] Left ventricular diastolic dysfunction in patients with chronic renal failure: impact of diabetes mellitusDIABETIC MEDICINE, Issue 6 2005J. Miyazato Abstract Aims Left ventricular (LV) hypertrophy and LV diastolic dysfunction are cardiac changes commonly observed in patients with chronic renal failure (CRF) as well as hypertension. Although the impairment of LV diastolic function in patients with diabetes mellitus has been shown, little is known about the specific effect of diabetes on LV diastolic function in patients with CRF. The present study was designed to investigate the impact of diabetic nephropathy on LV diastolic dysfunction, independent of LV hypertrophy, in CRF patients. Methods In 67 patients with non-dialysis CRF as a result of chronic glomerulonephritis (n = 33) or diabetic nephropathy (n = 34), and 134 hypertensive patients with normal renal function, two-dimensional and Doppler echocardiographic examinations were performed, and LV dimension, mass, systolic function, and diastolic function were evaluated. Results LV mass was increased and LV diastolic dysfunction was advanced in subjects with CRF compared with hypertensive controls. In the comparison of echocardiographic parameters between the two groups of CRF patients, i.e. chronic glomerulonephritis and diabetic nephropathy groups, all indices of LV diastolic function were more deteriorated in the diabetic nephropathy group than in the chronic glomerulonephritis group, although LV structure including hypertrophy and systolic function did not differ between the groups. In a multiple regression analysis, the presence of diabetes (i.e. diabetic nephropathy group) was a significant predictor of LV diastolic dysfunction in CRF subjects, independent of other influencing factors such as age, blood pressure, renal function, anaemia and LV hypertrophy. Conclusion The present findings suggest that LV diastolic dysfunction, independent of LV hypertrophy, is specifically and markedly progressed in patients with CRF as a result of diabetic nephropathy. [source] The Influence of Left Ventricle Diastolic Function on Natriuretic Peptides Levels in Patients with Atrial FibrillationPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 6 2009DAWID BAKOWSKI M.D., Ph.D. Background:The diagnosis of the impaired left ventricle (LV) diastolic function during atrial fibrillation (AF) using traditional methods is very difficult. Natriuretic peptides seem to be useful for assessment of diastolic function in patients with AF. Aim:To evaluate the influence of LV diastolic dysfunction on natriuretic peptides concentrations and to assess the diagnostic value of atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in patients with AF and impaired LV diastolic function. Methods:The study included 42 patients (23 males, 19 females), aged 58.6 ± 8.2 years with nonvalvular persistent AF with preserved LV systolic function who were converted into sinus rhythm by DC cardioversion (CV) and maintained sinus rhythm for at least 30 days. Echocardiography (ECG), ANP, and BNP level measurements were taken at baseline 24 hours before CV and 24 hours and 30 days after CV. On the 30th day following CV in patients with sinus rhythm, Doppler ECG was performed to assess LV diastolic function. Results:Thirty days after CV, normal LV diastolic function in 15 patients and impaired diastolic function in 27 patients was diagnosed: 20 with impaired LV relaxation and seven with impaired LV compliance. During AF and 24 hours, and 30 days after sinus rhythm restoration, significantly higher ANP and BNP levels were observed in patients with LV diastolic dysfunction as compared to the subgroup with normal LV diastolic function. The average values of ANP during AF in patients with normal and impaired diastolic function were 167.3 ± 70.1 pg/mL and 298.7 ± 83.6 pg/mL, respectively (P < 0.001), and the average values of BNP in the above mentioned subgroups were 49.5 ± 14.7 pg/mL and 145.6 ± 49.6 pg/mL respectively (P < 0.001). While comparing the diagnostic value of both natriuretic peptides it was noted that BNP was a more specific and sensitive marker of impaired LV diastolic function. ANP value >220.7 pg/mL measured during AF identified patients with impaired LV diastolic function with 85% sensitivity and 90% specificity. BNP value >74.7 pg/mL proved 95% sensitive and 100% specific in the diagnosing of such a group. Conclusions:The increase of ANP/BNP concentration in patients with AF results not only from the presence of AF, but also reflects the impaired LV diastolic function. Natriuretic peptides, especially BNP, may be useful in diagnosing LV diastolic dysfunction in patients with AF. [source] Cardiac dysfunction during exercise in patients with primary hyperparathyroidismBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 9 2000I.-L. Nilsson Background ,Non-traditional' manifestations of primary hyperparathyroidism (HPT) are controversial, and include morbidity, mortality and risk factors for cardiovascular diseases with some prospects of normalization by parathyroidectomy (PTX). This study evaluated previously unexplored data on cardiac function during exercise in HPT. Methods Thirty patients with HPT (mean(s.d.) serum calcium 2·96(0·24) mmol l,1) and 30 normocalcaemic controls (selected randomly from the background population, and matched for age and sex) underwent exercise testing, echocardiography and 24-h ambulatory blood pressure recordings before and a mean of 13 months after PTX. Results HPT was associated with higher systolic blood pressure during exercise (mean(s.d.) 223(28) versus 203(33) mmHg; P = 0·02), which correlated to the left ventricular (LV) mass and serum PTH (P = 0·014, P = 0·004); higher LV mass in men (mean(s.d.) 142(20) versus 113(28) g m,2), which might relate to the hypertrophic effect of PTH; and increased LV isovolumic relaxation times (mean(s.d.) 102(19) versus 91(15) ms; P = 0·018), indicating LV diastolic dysfunction. ST depression during exercise decreased significantly (mean(s.d.) , 1·0(0·9) versus 0·7(0·5) mm; P = 0·028) and LV mass declined in proportion with the time after PTX (P = 0·04 in men). PTX also affected systolic functions, as fractional shortening, atrioventricular plane displacement and systolic index decreased in men (P = 0·05, P = 0·04, P = 0·04). Twenty-four-hour blood pressures were higher in HPT (P = 0·008), when subjects on ,-blockers (seven patients, five controls) were excluded, and were unaltered by PTX. Conclusion LV systolic and diastolic dysfunction occurs in HPT. The diastolic dysfunction seems to diminish with time after PTX, while the positive inotropic effect of calcium in itself may alleviate the systolic dysfunction. © 2000 British Journal of Surgery Society Ltd [source] | ||||||||||