Adverse Cardiac Events and the Impaired Relaxation Left Ventricular Filling Pattern

Lavine, Steven J.; Balbissi, Kais Al

doi:10.1016/j.echo.2016.02.008

Cited by 8 publications

(7 citation statements)

References 28 publications

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“…Prior studies have suggested that further characterization is imperative in assessing the presence and different aspects of left ventricular dysfunction in these patients. 1,6 Our study of patients with an impaired relaxation filling pattern and preserved left ventricular ejection fraction suggests significant heterogeneity in different markers of systolic and diastolic dysfunction.…”

Section: Reproducibilitymentioning

confidence: 85%

The presence of diastolic and systolic dysfunction in patients with impaired relaxation filling pattern

2017

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Section: Reproducibilitymentioning

confidence: 85%

The presence of diastolic and systolic dysfunction in patients with impaired relaxation filling pattern

2017

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“…In the recently published guideline, four parameters have been recommended to establish the presence of LV diastolic dysfunction, that is, e′ of septal and LV lateral wall, average E/e′ ratio, LAVi, and peak TR velocity, when E/A ratio is used to grade the severity. Particularly, average E/e′ has been considered as the most reliable echocardiographic parameter to reflect LV filling pressure . However, the Doppler parameters have been shown to be less sensitive to detect alteration of diastolic performance .…”

Section: Discussionmentioning

confidence: 99%

“…Particularly, average E/e′ has been considered as the most reliable echocardiographic parameter to reflect LV filling pressure. [13][14][15] However, the Doppler parameters have been shown to be less sensitive to detect alteration of diastolic performance. 16,17 E/e′ is subject to angle-dependence and is restricted in the presence of moderate to severe mitral pathologies, besides extrapolation of global diastolic function by regional measurements also seems problematic, especially in patients with regional wall motion abnormality.…”

Section: Discussionmentioning

confidence: 99%

Left ventricular end‐diastolic strain rate recovered in hypothyroidism following levothyroxine replacement therapy: A strain rate imaging study

et al. 2019

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Background This study aimed to explore the impact of overt hypothyroidism on diastolic left ventricular (LV) deformation and the effect of levothyroxine therapy using 2‐dimensional speckle‐tracking echocardiography (STE) strain rate (SR) imaging. Methods Forty‐seven newly diagnosed hypothyroidic patients and 51 controls were prospectively enrolled. All participants underwent comprehensive 2‐dimensional echocardiography. Besides the recently recommended parameters of LV diastolic function, strain imaging for LV systolic global longitudinal strain (GLS), and diastolic SR imaging at isovolumic relaxation period (SRivr), early (SRe) and late (SRa) diastole were assessed. Repeated echocardiography in hypothyroidic patients was made 6 months after the euthyroidic state was achieved. Results Hypothyroidic patients had a lower ejection fraction (EF) than the controls (68.6 ± 5.2% vs 71.5 ± 4.0%, P = 0.002) but all within normal range (57%–80% and 64%–79%, respectively). No difference in the ratio of early mitral flow (E) to early diastolic septal or lateral myocardial motion velocity (e′) was found (both P > 0.05), but significant difference was identified for SRa (0.85 ± 0.17 [/s] vs 1.00 ± 0.17 [/s], P = 0.000) and GLS (−20.8 ± 3.2% vs −23.6 ± 2.3%, P = 0.000). Upon follow‐up, LV SRa (1.01 ± 0.20 [/s], P = 0.99 vs control) normalized when GLS (−21.6 ± 3.1%, P = 0.004 vs control) remained worse than the controls. Conclusion This study demonstrates subtle LV diastolic impairment in untreated hypothyroidic patients using SR imaging, which normalizes with short‐term therapy and predates GLS.

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“…Часто сердечная недостаточность обусловлена систоличес-кой дисфункцией миокарда на фоне сниженной фрак-ции выброса (ФВ) [7]. Сердечная недостаточность с сохраненной фракцией выброса (диастолическая дисфункция) встречается у 22-73% госпитализирован-ных пациентов в зависимости от возраста и критериев диагностики [7], что также отражается на летальности [8]. При этом ценность отдельных эхокардиографи-ческих параметров в прогнозировании исходов оста-ется неизученной.…”

Section: Introductionunclassified

Predictors of complications when transferring postoperative cardiac patients from the intensive care unit

Paromov¹,

Kirov²

2017

PKiK

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Aim. Emphasis in the study was placed on the evaluation of predictors of complications when transferring postoperative cardiac patients from the intensive care unit (ICU). Methods. 60 patients after cardiac surgery were included into this prospective observational study, with 41 of them undergoing off-pump coronary artery bypass grafting (CABG). Before the transfer from ICU, echocardiographical criteria of their systolic and diastolic dysfunction, parameters of oxygenation, hemodynamic and metabolism status, as well as postoperative complications and duration of hospitalization were evaluated. Results. Preoperatively, the patients had a moderate degree of heart failure and preserved ejection fraction. Those patients who had undergone valvular and combined procedures using cardiopulmonary bypass had higher Euroscore II values, more severe heart failure, prolonged duration of surgery, respiratory support and hospitalization in ICU and in hospital. The echocardiographical criteria of diastolic dysfunction before transfer from ICU were recorded in 14-77% patients. Despite a normal range of blood pressure, the systolic function of the left ventricle and preload (left atrial pressure), oxygenation and metabolic status, venous to arterial carbon dioxide difference (Pv-aCO2) and left ventricle performance index (Tei) exceeded the normal values before transfer from ICU. The correlation analysis revealed a relationship between duration of ICU and hospital stay and the criteria of heart failure severity (left atrial pressure [rho = 0.27, 95% CI 0.02–0.48, p = 0.04]) and left ventricle dysfunction (e’ [rho = 0.41, 95% CI 0.17–0.59, p<0.01]) before the transfer. The increase in fluid balance during ICU stay after off-pump coronary artery bypass surgery tended to result in a complicated postoperative period (AUC = 0.73, p = 0.02) and a higher risk of atrial fibrillation. Conclusion. The impairment of the left ventricle diastolic function before transferring from ICU correlates with the duration of hospitalization. A positive fluid balance during ICU period after off-pump surgery might bring about postoperative complications and atrial fibrillation, thus predicting their onset.Received 5 April 2017. Revised 10 August 2017. Accepted 15 August 2017.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.Acknowledgement The authors express their gratitude for patience and support during the study to the staff of Cardiac Surgery Department and Resuscitation Department.

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Adverse Cardiac Events and the Impaired Relaxation Left Ventricular Filling Pattern

Cited by 8 publications

References 28 publications

The presence of diastolic and systolic dysfunction in patients with impaired relaxation filling pattern

The presence of diastolic and systolic dysfunction in patients with impaired relaxation filling pattern

Left ventricular end‐diastolic strain rate recovered in hypothyroidism following levothyroxine replacement therapy: A strain rate imaging study

Predictors of complications when transferring postoperative cardiac patients from the intensive care unit

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