Assessment of diastolic function: what the general cardiologist needs to know

Mottram, P.; Marwick, Thomas H.

doi:10.1136/hrt.2003.029413

Cited by 185 publications

(142 citation statements)

References 24 publications

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“…The change in diastolic function did not differ by race (Pϭ0.3) or sex (Pϭ0.4). Furthermore, 88 patients (8.3%) had a decrease in LVEF to Ͻ55% (mean LVEF, 46% 8 ) on follow-up testing; of those patients, 60 had stable, 19 had worsening, and 9 had improved diastolic function (Pϭ0.3). Patients with a decrease in LVEF to Ͻ55% were more likely to have advanced DD: 14 (5.3%) had normal diastolic function, 56 (8.1%) had mild DD, and 18 (16%) had moderate/severe DD (Pϭ0.002).…”

Section: Diastolic Function At Baseline and Follow-upmentioning

confidence: 99%

Impact of Progression of Diastolic Dysfunction on Mortality in Patients With Normal Ejection Fraction

AlJaroudi¹,

Alraies

Halley³

et al. 2012

Circulation

204

135

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Section: Diastolic Function At Baseline and Follow-upmentioning

confidence: 99%

Impact of Progression of Diastolic Dysfunction on Mortality in Patients With Normal Ejection Fraction

AlJaroudi¹,

Alraies

Halley³

et al. 2012

Circulation

204

135

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“…When the LV wall tension increases, cardiomyocytes release a pre-prohormone B-type natriuretic peptide (BNP) that is cleaved by circulating endoproteases to release active BNP and an inactive aminoterminal fragment of the prohormone (Nt-proBNP) (Braunwald, 2008). These peptides are good markers of diastolic altered relaxation or stiffness (Mottram and Marwick, 2005). In oncologic settings, transient postinfusional elevations of BNP or Nt-proBNP might denote fluid overload and LV stretch rather than cardiac dysfunction; at a distance from chemotherapy infusions, however, high BNP or Nt-proBNP would denote authentic cardiotoxicity (Sandri et al, 2005).…”

Section: Ranolazinementioning

confidence: 99%

Pharmacology at Work for Cardio-Oncology: Ranolazine to Treat Early Cardiotoxicity Induced by Antitumor Drugs

Minotti

2013

J Pharmacol Exp Ther

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Antitumor drugs may cause asymptomatic diastolic dysfunction that introduces a lifetime risk of heart failure or myocardial infarction. Cardio-oncology is the discipline committed to the cardiac surveillance and management of cancer patients and survivors; however, cardio-oncology teams do not always attempt to treat early diastolic dysfunction. Common cardiovascular drugs, such as b blockers or angiotensin-converting enzyme inhibitors or others, would be of uncertain efficacy in diastolic dysfunction. This perspective describes the potential value of ranolazine, an antianginal drug that improves myocardial perfusion by relieving diastolic wall tension and dysfunction. Ranolazine acts by inhibiting the late inward sodium current, and pharmacological reasonings anticipate that antitumor anthracyclines and nonanthracycline chemotherapeutics might well induce anomalous activation of this current. These notions formed the rationale for a clinical study of the efficacy and safety of ranolazine in cancer patients. This study was not designed to demonstrate that ranolazine reduced the lifetime risk of cardiac events; it was designed as a short term proof-of-concept study that probed the following hypotheses: 1) asymptomatic diastolic dysfunction could be detected a few days after patients completed antitumor therapy, and 2) ranolazine was active and safe in relieving echocardiographic and/or biohumoral indices of diastolic dysfunction, measured at 5 weeks or 6 months of ranolazine administration. These facts illustrate the translational value of pharmacology, which goes from identifying therapeutic opportunities to validating hypotheses in clinical settings. Pharmacology is a key to the success of cardio-oncology.

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“…This impaired LV diastolic function leads to elevation of LV filling pressure [6]. LV filling pressure can be assessed by mitral inflow patterns, i.e., E/A ratio and deceleration time (DT).…”

Section: Tissue Doppler Indicesmentioning

confidence: 99%

Evaluation of Subtle Left Ventricular Systolic Abnormalities in Adult Patients with Hypertrophic Cardiomyopathy

Shetty

Samanth

Nayak

et al. 2014

JCDR

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Assessment of diastolic function: what the general cardiologist needs to know

Cited by 185 publications

References 24 publications

Impact of Progression of Diastolic Dysfunction on Mortality in Patients With Normal Ejection Fraction

Impact of Progression of Diastolic Dysfunction on Mortality in Patients With Normal Ejection Fraction

Pharmacology at Work for Cardio-Oncology: Ranolazine to Treat Early Cardiotoxicity Induced by Antitumor Drugs

Evaluation of Subtle Left Ventricular Systolic Abnormalities in Adult Patients with Hypertrophic Cardiomyopathy

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