Background (LVDD) either remains latent or manifests as heart failure with preserved ejection fraction (HFpEF). Little is known about echocardiographic parameters associated with symptomatic phenotype. Objective To investigate echocardiographic parameters associated with symptomatic state in LVDD. Methods Three hundred and thirty patients with definite diagnosis of LVDD (according to ASE/EACVI recommendations 2016) were included and divided into asymptomatic LVDD and HFpEF groups according to presence of dyspnea and brain natriuretic peptide levels. We excluded patients with left ventricular ejection fraction <50%, significant valvular heart disease, chronic lung disease, or renal dysfunction. Results Mean age was 61.2 ± 8.3 years; 71% were females. Both groups were matched regarding age, gender, comorbidities, and drug history. HFpEF group showed significantly larger BMI (P = .04), significantly higher IVS thickness (P < .001), LA diameter (P < .001), LA volume index (P = .004), E velocity (P = .001), TR jet velocity (P = .03), and average E/e' ratio (P < .001).On the contrary, lateral e' velocity was significantly lower in HFpEF group (P < .001). By regression analysis, lateral e' velocity was the best independent predictor of symptomatic state. Area under ROC curve of lateral e' velocity was 0.789 (0.667‐0.911, P < .001) to predict symptomatic state in LVDD with the best cutoff value of ≤8.2 cm/s (76% sensitivity and 79% specificity). Moreover, lateral e' velocity was significantly negatively correlated with NYHA class in HFpEF group. Conclusion Reduced lateral e' velocity was associated with symptomatic state in LVDD. Moreover, it was significantly negatively correlated with NYHA class in HFpEF.

BACKGROUND Diastolic function has been reported to be impaired in many patients with coronary slow flow phenomenon (CSFP). CSFP has broad spectrum of clinical presentations, including non-ST elevation myocardial infarction (NSTEMI). We sought to study the short-term evolution of diastolic function in CSFP patients presenting with NSTEMI. METHODS This study included 92 patients with CSFP and acute NSTEMI. Conventional echocardiography Doppler imaging and tissue Doppler echocardiography imaging were used to evaluate diastolic function during index NSTEMI and after 3 months. RESULTS Mean age of study patients was 45.7 ± 6.8 years. The prevalence of diastolic dysfunction (DD) at baseline was 69 patients (75%) and 28 patients (30.4%) at 3 months, p < 0.001. Various diastolic function indices showed significant improvement from baseline to 3 months follow-up. E/Em was 17.32 ± 3.41 at baseline compared to 12.41 ± 5.58 at 3 months, p = 0.039. Septal e′ velocity was 5.67 ± 4.56 cm/s at baseline compared to 7.78 ± 3.22 cm/s at 3 months, p = 0.023. Medications used were not significantly different between those with improved versus unimproved DD. CONCLUSIONS Diastolic function seems to improve over short-term follow-up in patients with CSFP presenting with NSTEMI. This could reflect a transient worsening during acute NSTEMI.

Restrictive filling pattern of diastolic dysfunction on baseline echo Doppler study may predict lack of contractile reserve in patients with LF/LG severe AS.

No abstract

No abstract