Effect of heart rate on left ventricular diastolic transmitral flow velocity patterns assessed by Doppler echocardiography in normal subjects

Harrison, Michael R.; Clifton, G. Dennis; Pennell, Andrew T; DeMaria, Anthony N.

doi:10.1016/0002-9149(91)90902-w

Cited by 202 publications

(71 citation statements)

References 26 publications

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“…Age and heart rate are well-known determinants of diastolic function. Diastolic function deterioration has been shown in normal adult hearts with advancing age (24,25), and many studies have revealed a linear relationship between heart rate and LV filling pattern over a wide heart rate range (26,27). We therefore corrected indexes of LV function for age, heart rate, and systolic arterial pressure differences between patients with and without DAN.…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Systolic and Diastolic Function in Normotensive Type 1 Diabetic Patients With or Without Autonomic Neuropathy

Didangelos

Arsos²,

Karamitsos³

et al. 2003

Diabetes Care

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OBJECTIVE -To investigate the relation between diabetic autonomic neuropathy (DAN) and left ventricular (LV) function in type 1 diabetic patients. RESEARCH DESIGN AND METHODS-A total of 57 type 1 diabetic patients free of coronary artery disease and arterial hypertension were studied. Diagnosis of DAN was established by autonomic nervous function (ANF) tests, and LV systolic and diastolic functions were assessed by radionuclide ventriculography at rest.RESULTS -There were 24 patients who had definite DAN, established by the presence of two or more abnormal ANF tests, and 33 subjects were without DAN. DAN patients had impaired LV filling pattern, obvious by a reduced peak filling rate (3.1 Ϯ 1.1 vs. 3.7 Ϯ 0.7 end-diastolic volume [EDV]/s, P ϭ 0.011) and first third filling fraction (35.3 Ϯ 19.5 vs. 50.8 Ϯ 16%, P ϭ 0.002) as well as an increased time to peak filling (159.4 Ϯ 45.1 vs. 134.2 Ϯ 33.4 ms, P ϭ 0.02) after correction for age and heart rate. There were no differences between the two groups with regard to ejection fraction, cardiac output, and cardiac index, whereas the peak emptying rate was greater in DAN patients (4.1 Ϯ 0.8 vs. 3.6 Ϯ 0.8 EDV/s, P ϭ 0.019), suggesting LV hypercontractility. DAN patients had an increased heart rate (83.4 Ϯ 11.9 vs. 72.7 Ϯ 9.3 bpm, P ϭ 0.001) and slightly higher systolic blood pressure. As a result, LV working load at rest was higher in DAN patients (11,109 vs. 9,096 bpm ϫ mmHg, P Ͻ 0.001). Moreover, a correlation was found between abnormal LV systolic and diastolic indexes and the number of abnormal ANF tests.CONCLUSIONS -At rest, DAN patients have impaired LV filling pattern, slightly increased LV systolic function, and a higher LV working load, in comparison to non-DAN type 1 diabetic patients. Diabetes Care 26:1955-1960, 2003C linical and epidemiological studies have confirmed that patients with diabetes appear susceptible to heart failure, which is the leading cause of death in these patients (1). Impairment of left ventricular (LV) function is frequent in patients with type 1 diabetes, even in the absence of ischemic, hypertensive, or valvular heart disease (2). Possible mechanisms for a specific diabetic cardiomyopathy include abnormalities of small intramural coronary vessels, deposition of collagen, and lipids and metabolic derangements that alter actomyosin and myosin adenosine triphosphatase activities (3). Although histopathologic and biochemical evidence for a distinct diabetic cardiomyopathy is available, it remains unclear whether these pathologic processes may cause significant LV systolic or diastolic dysfunction. Numerous studies have reported normal LV systolic function at rest in most type 1 diabetic patients (4), whereas others have suggested increased LV systolic function (5,6). Several investigators have shown abnormal LV diastolic function in the majority of type 1 diabetic patients (7-11), whereas others (12) found no evidence of LV diastolic dysfunction at rest in longterm type 1 diabetic patients. It has been suggested that LV dysfunction in type...

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Section: Discussionmentioning

confidence: 99%

Left Ventricular Systolic and Diastolic Function in Normotensive Type 1 Diabetic Patients With or Without Autonomic Neuropathy

Didangelos

Arsos²,

Karamitsos³

et al. 2003

Diabetes Care

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“…Tables II and III. The influence of heart rate on indices of transmitral flow found in this study are in agreement with those of others. 8,23,24 The positive influence of volume load (as measured by functional preload index or SVI) is noted on E wave, E TVI, A wave, and A TVI. This is in agreement with the findings of Stoddard et al 6 and Choong et al 20 Furthermore, contractility (measured as SVI) had a positive effect on E-wave amplitude, as expected from its tight association with excitation-contraction coupling.…”

Section: Present Studymentioning

confidence: 99%

“…In contrast to hypertrophy due to pathologic conditions, no alteration in diastolic function has been seen in athletes with physiologic hypertrophy [25][26][27][28] which could not be explained by changes in loading conditions, body size, LV mass, and heart rate. 23,29 With longer periods of strenuous exercise, independent alterations due to hypertrophy were noted with a reduced rate of early filling, prolongation of IVRT, and reduced rate of filling. 30 The lack of influence of LV end-diastolic dimension, 5,31 mass, 31 and fractional shortening 31 on E/A ratio has been found by others in the normal heart.…”

Section: Present Studymentioning

confidence: 99%

Adaptive mechanisms of left ventricular diastolic function to the physiologic load of pregnancy

Moran

Colan

Mauer

et al. 2002

Clinical Cardiology

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SummaryBackground: Pregnancy is associated with marked alteration in cardiovascular hemodynamics. Recent reports have characterized the effects on cardiac systolic function. Little has been written on the influences of loading conditions on Doppler measures of diastolic function during pregnancy.Hypothesis: Stage of pregnancy has an impact on Doppler indices of diastolic function independent of loading conditions, systolic function, and heart rate.Method: Thirty healthy women were prospectively evaluated by serial echocardiography and Doppler examinations at six time periods: 10-12, 18-20, 28-30, 36-38 weeks gestation, 2-4 and 12-14 weeks postpartum. The related effects on indices of diastolic function and its interaction with load, heart rate, mass, and systolic function were determined.Results: Compared with the nonpregnant state, early (E) velocity increased (0.7 ± 0.1-0.9 ± 0.1 m/s, p = 0.0001), peaking at 18 weeks and returning to normal levels during late pregnancy. Atrial phase (A) velocity peaked at 18 weeks (0.48 ± 0.12-0.60 ± 0.13 m/s, p = 0.0001), remaining high throughout the rest of pregnancy. Consequently, the E/A ratio fell significantly during late pregnancy, from 1.9 ± 0.4 to 1.4 ± 0.3 (p = 0.02). In addition, mean acceleration was significantly increased in early pregnancy with a peak at 18 weeks (7.4 ± 1.3 m/s 2 ), returning to nonpregnant level at term (5.7 ± 1.4 m/s 2 , p = 0.0001). Generalized estimating equation using multivariate regression analysis demonstrated that rising heart rate and stroke volume index had an independent effect on A velocity, and that contractility and preload had an independent effect

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“…However, we have found a study ascribing to PYR an improvement in LV relaxation in hypertensive patients 51 . Harrison et al 52 have shown an inverse correlation between HR and E/A ratio in healthy subjects. One may, therefore, conclude that HR reduction with PYR has been responsible for the increase in the E/A ratio.…”

Section: Discussionmentioning

confidence: 93%

Cholinergic stimulation with pyridostigmine, hemodynamic and echocardiographic analysis in healthy subjects

Pontes

Bastos

et al. 1999

Arq. Bras. Cardiol.

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Effect of heart rate on left ventricular diastolic transmitral flow velocity patterns assessed by Doppler echocardiography in normal subjects

Cited by 202 publications

References 26 publications

Left Ventricular Systolic and Diastolic Function in Normotensive Type 1 Diabetic Patients With or Without Autonomic Neuropathy

Left Ventricular Systolic and Diastolic Function in Normotensive Type 1 Diabetic Patients With or Without Autonomic Neuropathy

Adaptive mechanisms of left ventricular diastolic function to the physiologic load of pregnancy

Cholinergic stimulation with pyridostigmine, hemodynamic and echocardiographic analysis in healthy subjects

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