Evaluation of left ventricular diastolic function based on flow energetic parameters in chronic kidney disease with diastolic dysfunction

Wang, Wei; Wang, Yueheng; Chen, Xiaoxue; Yuan, Lijun; Bai, Hui

doi:10.1111/echo.14264

Cited by 13 publications

(19 citation statements)

References 36 publications

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“…Three peaks were observed in EL in the LV cavity of elderly outpatients in the present study. This pattern is consistent with previous findings 12‐14,16 . In the present study, ED‐EL and LD‐EL were higher than Sys‐EL, while LD‐EL was higher than ED‐EL.…”

Section: Discussionsupporting

confidence: 94%

“…Previous studies evaluated these EL in the LV of healthy adults (29.5 ± 4.8 years old) 12 and children 13 using VFM. Recent study also showed the assessment of EL could be considered as an important supplementary tool to quantitatively evaluate the impaired blood flow efficiency and LV diastolic function in patients with various diastolic dysfunction 14 . Other studies showed that the energetic efficiency assessed by VFM provided prognostic information in valvular diseases 15,16 .…”

Section: Introductionmentioning

confidence: 99%

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Factors contributing to energy loss in left ventricle during diastolic and systolic phases in elderly patients

et al. 2020

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Background The change of left ventricular function deteriorated with age because of gradual increases of blood pressure may result in increased energy loss (EL) in left ventricle (LV). The present study investigated EL in LV among hypertensive elderly patients and examined factors contributing to EL. Methods A single‐center retrospective study was performed on elderly hypertensive outpatients (≥65 years) who underwent echocardiography (N = 105). EL in the LV was measured using a vector flow mapping system, and factors affecting peak EL during the early‐diastolic phase (ED‐EL), late‐diastolic phase (LD‐EL), and systolic phase (Sys‐EL) were evaluated. Result Mean age was 79.9 ± 6.4 years (male 43%). Mean ED‐EL, LD‐EL, and Sys‐EL were 42.1 ± 46.7, 75.6 ± 60.2, and 40.4 ± 40.2 mJ/N/s. In a stepwise regression analysis, the E/e’(lateral) (unstandardized B = 0.005, 95%CI −0.03 to 0.007, standardized β = 0.434, P < .001) was identified as factors affecting ED‐EL. The factors affecting LD‐EL were E/A ratio (B = −0.122, 95%CI −0.176 to −0.068, β = −0.470, P < .001) and time velocity integral (TVI) in LVOT (unstandardized B = 0.002, 95%CI 0.000 to 0.004, β = 0.247, P = .021). The factors influencing Sys‐EL were TVI in LVOT (B = 0.002, 95%CI 0.001 to 0.004, β = 0.390, P < .001), E/A ratio (B = −0.054, 95%CI −0.093 to −0.015, β = −0.258, P = .008), left ventricular outflow tract (LVOT) diameter (B = −0.006, 95%CI −0.010 to −0.002, β = −0.307, P = .006), and left ventricular mass index (B = 0.000, 95%CI 0.000 to 0.001, β = 0.208, P = .039). Conclusion Peak EL in the LV was higher during diastolic phase than systolic phase among elderly hypertensive patients. Peak EL both during late‐diastolic phase and systolic phase was affected by systolic blood flow in LVOT and LV transmitral flow pattern.

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Factors contributing to energy loss in left ventricle during diastolic and systolic phases in elderly patients

et al. 2020

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“…Furthermore, we found that EL during late diastole showed similar results as total diastole. But EL during early diastole had no significant difference between the patients with early CKD and control participants, which may be attribute to the fluctuation of EL during early diastole with different degrees of diastolic dysfunction in patients [30].…”

Section: Discussionmentioning

confidence: 77%

Assessment of left ventricular energy loss using vector flow mapping in patients with stages 1–3 chronic kidney disease

Chen

Wang

et al. 2020

BMC Cardiovasc Disord

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Background: Patients with chronic kidney disease (CKD) experience abnormality of intracardiac blood flow status during early-stages of disease. Left ventricular energy loss (EL) derived from vector flow mapping (VFM) represents fluid energy lost as heat in left ventricle and had been used to detect intracardiac blood flow efficiency. We aimed to evaluate the left ventricular EL in stage 1-3 CKD patients, and explored whether hypertension, a main cardiovascular risk, deteriorate the abnormality of intracardiac blood flow status. Methods: Transthoracic echocardiography was performed in 41 controls and 48 patients with stages 1-3 CKD. CKD patients consisted a subgroup with no hypertension, a subgroup with well-controlled hypertension and a subgroup with poorly controlled hypertension. The EL were calculated in the left ventricle using VFM analysis from the apical 3-chamber view. Furthermore, the correlation and stepwise multiple regression analysis were used to explore the potential independent predictors of left ventricular EL. Results: Compared with controls, stage 1-3 CKD patients showed increased left ventricular EL during total diastole, late diastole, total systole, isovolumic contraction and ejection. CKD patients with poorly controlled hypertension had higher left ventricular EL compared to the other CKD subgroups. Additionally, the ratio of mitral early filling wave peak velocity and early mitral annular peak velocity on septal side, mitral early filling wave peak velocity, and left ventricular mass index were independent predictors of the diastolic EL; whereas systolic blood pressure and left ventricular mass index were independent predictors of the systolic EL. Conclusions: Left ventricular EL was a useful echocardiographic parameter to evaluate the impaired intracardiac blood flow efficiency in patients with stages 1-3 CKD. Hypertension was a crucial contributor for intracardiac blood flow abnormality. This study might provide valuable clinical data to discern cardiac dysfunction and reduce the cardiovascular risk in early-stage CKD.

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“…The proportion of patients with HF and preserved EF (HFpEF) is high in the elderly (16) (14,19). HFpEF often necessitates the evaluation of LV diastolic function.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies evaluated EL in the LV of healthy adults (29.5 ± 4.8 years old) (12) and children (13) using VFM. Recent study also showed VFM could be considered as an important supplementary tool to quantitatively evaluate the impaired blood flow efficiency and LV diastolic function in patients with various diastolic dysfunction (14).…”

Section: Introductionmentioning

confidence: 99%

Factors Contributing to Energy Loss in Left Ventricle during Diastolic and Systolic Phases in Elderly Patients.

Futami

Ishikawa

Maeda

et al. 2020

Preprint

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Background: The change of left ventricular function deteriorated with age because of gradual increases of blood pressure may result in increased energy loss (EL) in left ventricle (LV). The present study investigated EL in LV among hypertensive elderly patients and examined factors contributing to EL. Methods: A single-center retrospective study was performed on elderly hypertensive outpatients (?65 years) who underwent echocardiography (N=105). EL in the LV was measured using an vector flow mapping system, and factors affecting peak EL during the early diastolic phase (ED-EL), late diastolic phase (LD-EL), and systolic phase (Sys-EL) were evaluated. Result: Mean age was 79.9±6.4 years (male 43%). Mean ED-EL, LD-EL, and Sys-EL were 42.1±46.7, 75.6±60.2, and 40.4±40.2 mJ/N/s. In a stepwise regression analysis, the E wave peak velocity of transmitral flow (unstandardized B=0.002, 95%CI 0.001 to 0.002, standardized β=0.547, p<0.001) and stroke volume in the LV outflow tract (LVOT) (B=0.001, 95%CI 0.000 to 0.001, β=0.190, p=0.034) were identified as factors affecting ED-EL. The factors affecting LD-EL were the E/A ratio (B=-0.122, 95%CI-0.180 to-0.064, β=-0.451, p<0.001) and peak velocity in LVOT (unstandardized B=0.001, 95%CI 0.0001 to 0.001, β=0.339, p=0.003). The factors influencing Sys-EL were peak velocity in LVOT (B=0.001, 95%CI 0.001 to 0.001, β=0.619, p<0.001) and the E/A ratio (B=-0.050, 95%CI-0.087 to-0.013, β=-0.241, p=0.008). Conclusion: Peak EL in the LV was higher during diastolic phase than systolic phase among elderly hypertensive patients. Peak EL during each phase was affected by systolic blood flow in LVOT and LV transmitral flow.

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Evaluation of left ventricular diastolic function based on flow energetic parameters in chronic kidney disease with diastolic dysfunction

Cited by 13 publications

References 36 publications

Factors contributing to energy loss in left ventricle during diastolic and systolic phases in elderly patients

Factors contributing to energy loss in left ventricle during diastolic and systolic phases in elderly patients

Assessment of left ventricular energy loss using vector flow mapping in patients with stages 1–3 chronic kidney disease

Factors Contributing to Energy Loss in Left Ventricle during Diastolic and Systolic Phases in Elderly Patients.

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