Assessment of left ventricular diastolic function from mitral annulus motion, a comparison with pulsed Doppler measurements in patients with heart failure

Blomstrand, Peter; Kongstad, Ole; Broqvist, Mats; Dahlström, Ulf; Wranne, Bengt

doi:10.1111/j.1475-097x.1996.tb01014.x

Cited by 30 publications

(20 citation statements)

References 16 publications

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“…The atrial contribution to the total motion33 34 and the maximum diastolic longitudinal relaxation velocity, represented by the maximum inclination on the curve,35 have been suggested as means to assess left ventricular diastolic function.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic assessment of ejection fraction in left ventricular hypertrophy

Wandt

Bojö

Tolagen

et al. 1999

Heart

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Section: Discussionmentioning

confidence: 99%

Echocardiographic assessment of ejection fraction in left ventricular hypertrophy

Wandt

Bojö

Tolagen

et al. 1999

Heart

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“…Both longitudinal M-mode and Doppler tissue imaging (DTI) of the mitral annulus have demonstrated this. [1][2][3][4][5][6][7] Thus the velocities increase from zero at the apex to a maximum at the base of the ventricle for all phases, 8 with a longitudinal velocity gradient as shown in Figure 1. It can be shown that the longitudinal velocity gradient is a measure of the rate of longitudinal deformation, or strain rate.…”

Section: Introductionmentioning

confidence: 91%

Strain rate imaging in normal and reduced diastolic function: Comparison with pulsed doppler tissue imaging of the mitral annulus

Støylen

Slørdahl

Skjelvan

et al. 2001

Journal of the American Society of Echocardiography

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Objectives:The pixel velocity values obtained by color Doppler tissue imaging (DTI) can be processed to velocity gradients as a measure of longitudinal strain rate with a technique termed strain rate imaging (SRI). Color mapping of strain rate does show the spatial-temporal relations of the diastolic phases. The phases of early filling and late filling during atrial systole can be seen to consist of a stretch wave in the myocardium, propagating from the base to the apex. Diastolic function is characterized by both peak strain rate and propagation velocity of this wave. The goals of this study were to establish normal values for these measurements and to study the changes with minimal diastolic dysfunction. Methods: Twenty-eight healthy control subjects and 26 patients with hypertension and normal systolic function were studied. The patients had normal blood pressure on treatment, normal ejection fraction, minimal hypertrophy, and moderately prolonged deceleration and isovolumic relaxation times. Realtime SRI color cineloops, ordinary echocardiography and Doppler recordings, and pulsed wave DTI from the mitral ring were acquired and processed. Results: Patients showed a reduction of systolic and early diastolic tissue velocities and strain rates and no significant increase in late diastolic tissue velocity and strain rate. Propagation velocity of diastolic strain during both early and late filling phases was reduced in the patients. The combination of changes in peak strain rate and propagation velocity of strain rate corresponded with changes in DTI. Conclusion: Diastolic deformation of the ventricle can be shown as a complex series of events, with temporal sequences in the ventricle. The peak strain rate and the propagation velocities of strain rate can describe the two main diastolic events: early and late filling. In reduced diastolic function, both are reduced during early filling. The velocities of the mitral ring are the result of this combination. This adds information about the physiology and pathophysiology of diastole. (J Am Soc Echocardiogr 2001; 14:264-74.)

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“…However, their clinical relevance remains to be demonstrated [29]. Additional information may be gained from newer techniques such as magnetic resonance myocardial tagging, which allows the labeling of specific myocardial regions [30].…”

Section: Diagnosis Of Diastolic Heart Failurementioning

confidence: 99%

Diastolic Heart Failure: A Concise Review

Aziz¹

2013

J Clin Med Res

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The concept of “diastolic” heart failure grew out of the observation that many patients who have the symptoms and signs of heart failure had an apparently normal left ventricular (LV) ejection fraction. Thus it was assumed that since systolic function was “preserved” the problem must lie in diastole, although it is not clear by whom or when this assumption was made. Nevertheless, many guidelines followed on how to diagnose “diastolic” heart failure backed up by indicators of diastolic dysfunction derived from Doppler echoardiography. Diastolic heart failure is associated with a lower annual mortality rate of approximately 8% as compared to annual mortality of 19% in heart failure with systolic dysfunction, however, morbidity rate can be substantial. Thus, diastolic heart failure is an important clinical disorder mainly seen in the elderly patients with hypertensive heart disease. Early recognition and appropriate therapy of diastolic dysfunction is advisable to prevent further progression to diastolic heart failure and death. There is no specific therapy to improve LV diastolic function directly. Medical therapy of diastolic dysfunction is often empirical and lacks clear-cut pathophysiologic concepts. Nevertheless, there is growing evidence that calcium channel blockers, beta-blockers, ACE-inhibitors and ARB as well as nitric oxide donors can be beneficial. Treatment of the underlying disease is currently the most important therapeutic approach.

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Assessment of left ventricular diastolic function from mitral annulus motion, a comparison with pulsed Doppler measurements in patients with heart failure

Cited by 30 publications

References 16 publications

Echocardiographic assessment of ejection fraction in left ventricular hypertrophy

Echocardiographic assessment of ejection fraction in left ventricular hypertrophy

Strain rate imaging in normal and reduced diastolic function: Comparison with pulsed doppler tissue imaging of the mitral annulus

Diastolic Heart Failure: A Concise Review

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