Differentiation of Abnormal Relaxation Pattern with Aging from Abnormal Relaxation Pattern with Coronary Artery Disease in Transmitral Flow with the Use of Tissue Doppler Imaging of the Mitral Annulus

Ohte, Nobuyuki; Narita, Hitomi; Hashimoto, Takeshi; Hayano, Junichiro; Akita, Sachie; Kurokawa, Kazuyuki

doi:10.1053/je.1999.v12.a99354

Cited by 31 publications

(19 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been reported that decreased Ew velocity in conjunction with a decreased Em/Am ratio is strongly correlated with the isovolumic LV relaxation constant ( ) 29 and reflects early diastolic recoil dysfunction. 30,31 Decreased preload index and increased ESWS in acute KD have been reported. 3 Although we also used ESWS as an after-load marker for the LV in this study, ESWS did not significantly change at any stage.…”

Section: Diastolic Function In Acute Kdmentioning

confidence: 99%

Abnormal Tissue Doppler Images are Associated With Elevated Plasma Brain Natriuretic Peptide and Increased Oxidative Stress in Acute Kawasaki Disease

Takeuchi

Saji

Takatsuki

et al. 2007

Circ J

View full text Add to dashboard Cite

awasaki disease (KD) is a systemic vasculitis that primarily affects small and medium-sized arteries. 1 Transient myocardial dysfunction in children with acute KD has been reported 2,3 and moreover, myocardial inflammation, including myocarditis and microvascular damage in the myocardium, has been shown to cause aberrations in cardiac function. 4 Several recent studies have discussed the usefulness of tissue Doppler imaging (TDI) to evaluate left ventricular (LV) function. [5][6][7][8][9][10][11][12][13][14] Tissue Doppler measurement of myocardial Doppler velocity can be used to measure long-axis functions, which seem to be both more sensitive to minor disturbances in LV function and relatively preload-independent. 11,[13][14] In the present study we used TDI to evaluate disturbance of myocardial function in acute KD patients. Circulation Journal Vol.71, March 2007The plasma brain natriuretic peptide (BNP) level is associated with cardiac function in adult patients with congestive heart failure. 15,16 Although elevation of BNP has been reported in acute KD patients,17 no relation between BNP and cardiac function has been found.Reports have suggested that increased systemic oxidative stress is associated with progression of cardiovascular disease, including ischemia -reperfusion injury, atherosclerosis, and heart failure. [18][19][20][21][22][23][24] The isoprostanes are a complex family of compounds produced from arachidonic acid via a free radical-catalyzed mechanism. 18,19 The level of 8-isoprostane is used as a pathophysiological marker of lipid peroxidation. We previously reported elevation of urinary 8-isoprostane levels in acute KD patients, 25 and although the exact pathological role of increased oxidative stress in acute KD is uncertain, we believe that it is associated with oxidative injury to systemic vessels. 25 We hypothesize that this combined with disturbance of myocardial microcirculation may contribute to myocardial dysfunction in acute KD. Therefore, the purpose of the present study was to investigate the relationship between abnormal myocardial performance and plasma BNP levels, and to investigate the association between abnormal myocardial performance and enhanced oxidative stress. Background The aims of this study were to evaluate myocardial mechanics using pulsed tissue Doppler imaging (TDI), and to determine the relationship between abnormal myocardial performance and plasma brain natriuretic peptide (BNP) levels and oxidative stress in acute Kawasaki disease (KD). Methods and ResultsConsecutive TDI parameters, including peak systolic velocity (Sw) and early (Ew) and late diastolic excursion of the mitral annuli were obtained in 42 patients with KD (mean age: 2.4±0.4 years) in weeks 1, 2, and 3, and during convalescence. Plasma BNP level and urinary 8-isoprostane were also examined during the acute phase. These data were then compared with TDI profiles from 62 healthy children, plasma BNP levels in 38 controls with other febrile illnesses, and urinary 8-isoprostane levels in 13 healthy chi...

show abstract

Section: Diastolic Function In Acute Kdmentioning

confidence: 99%

Abnormal Tissue Doppler Images are Associated With Elevated Plasma Brain Natriuretic Peptide and Increased Oxidative Stress in Acute Kawasaki Disease

Takeuchi

Saji

Takatsuki

et al. 2007

Circ J

View full text Add to dashboard Cite

show abstract

“…In our prior study, which included patients with reduced LVEF and E/A <1.0, the patients with impaired LV relaxation could be more clearly separated based on a threshold e' value. 29 In contrast, the present study included only patients with preserved LVEF. This constitutes a limitation in the use of e' as a parameter to differentiate patients with impaired LV relaxation from those with preserved LV relaxation, in patients with abnormal relaxation patterns in the TMF velocity waveform.…”

Section: Discussionmentioning

confidence: 94%

“…13, 14 Generally, older people without overt cardiac disease are expected to have slow LV relaxation compared to young healthy people, but the extent of deterioration in older healthy people may not be as critical as that observed in patients with cardiac disease. 29 Thus, among subjects who have an abnormal relaxation pattern in the TMF velocity waveform, there may be no significant difference in E or E/A between patients with relatively impaired and those with relatively preserved LV relaxation. Accordingly, in the present study, the aim was to clarify the mechanism that produces similar TMF velocity waveforms in patients with apparently different LV relaxation performance.…”

Section: Discussionmentioning

confidence: 99%

“…In this respect, we previously reported that patients with atypical chest pain but without significant coronary artery stenosis or LV wall motion abnormality had relatively shorter LV relaxation time constant τ and relatively faster e', although they had an abnormal relaxation pattern in the TMF velocity waveform. 29 …”

Section: Patient Characteristics Are Listed Inmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Significance of Abnormal Relaxation Pattern of the Transmitral Flow Velocity Waveform in Older Patients With Preserved Left Ventricular Ejection Fraction

Kikuchi

Wakami

Goto

et al. 2013

Circ J

Self Cite

View full text Add to dashboard Cite

Background:The pathophysiology of abnormal relaxation pattern in the transmitral flow (TMF) velocity waveform has not been fully elucidated. Methods and Results:A total of 173 patients who underwent comprehensive Doppler echocardiography and diagnostic cardiac catheterization for coronary artery disease were enrolled in the study. Peak early and late diastolic TMF velocities (E and A, respectively) were measured. Minimum left ventricular (LV) pressure; LV pre-A wave pressure (surrogate of mean left atrial [LA] pressure); time constant (τ) of LV pressure decay; and LV ejection fraction (LVEF) were calculated. Patients with E/A ratio <1.0 and LVEF ≥50% were enrolled. Patients with τ ≥48 ms and those with τ <48 ms were compared. The 2 groups had no significant differences in E or E/A. Minimum LV pressure (6.9±2.2 mmHg vs. 3.6±2.9 mmHg, P<0.0001) and LV pre-A wave pressure (9.5±2.4 mmHg vs. 6.1±3.0 mmHg, P<0.0001) were significantly higher in patients with τ ≥48 ms compared to those with τ <48 ms, but the difference between the LV pre-A and minimum LV pressures was similar between the groups (2.6±1.4 mmHg vs. 2.5±1.5 mmHg, P=0.89). Conclusions:Proportional elevations in minimum LV and pre-A pressures, due to deteriorated LV relaxation, resulted in no changes in the pressure gradient between the LA and LV in early diastole, E, or E/A. (Circ J 2013; 77: 2551 -2557

show abstract

“…This dependence is more prominent in normal physiology but decreases with diastolic dysfunction [99]. E m also enables discrimination between disease-related changes in LV filling, in patients with coronary artery disease and age-related physiological changes [100]. We have demonstrated that mitral annular E m and A m velocities are significantly lower in heart failure patients than in normal controls of similar age.…”

Section: Diastolic Functionmentioning

confidence: 98%

Application of Tissue Doppler Imaging in Cardiology

Nikitin

Witte²

2004

Cardiology

122

View full text Add to dashboard Cite

Tissue Doppler imaging (TDI) is a new echocardiographic technique employing the Doppler principle to measure the velocity of myocardial segments and other cardiac structures. It is well suited for the measurement of long-axis ventricular function. Impairment of longitudinal myocardial fiber motion is a sensitive marker of early myocardial dysfunction and ischaemia, and TDI might therefore become an important tool in routine echocardiography. The technique allows truly quantitative measurement of regional myocardial function both at rest and during stress echocardiography. TDI has great potential in the diagnosis of diastolic left ventricular dysfunction, overcoming the load-dependence of conventional Doppler techniques. Right ventricular function, intracardiac and pulmonary artery pressures, transplant rejection and intraventricular dyssynchrony can also be assessed. This article reviews the current and evolving applications of TDI in cardiology.

show abstract

Differentiation of Abnormal Relaxation Pattern with Aging from Abnormal Relaxation Pattern with Coronary Artery Disease in Transmitral Flow with the Use of Tissue Doppler Imaging of the Mitral Annulus

Cited by 31 publications

References 29 publications

Abnormal Tissue Doppler Images are Associated With Elevated Plasma Brain Natriuretic Peptide and Increased Oxidative Stress in Acute Kawasaki Disease

Abnormal Tissue Doppler Images are Associated With Elevated Plasma Brain Natriuretic Peptide and Increased Oxidative Stress in Acute Kawasaki Disease

Clinical Significance of Abnormal Relaxation Pattern of the Transmitral Flow Velocity Waveform in Older Patients With Preserved Left Ventricular Ejection Fraction

Application of Tissue Doppler Imaging in Cardiology

Contact Info

Product

Resources

About