Prognostic significance of Doppler-derived left ventricular diastolic filling variables in dilated cardiomyopathy

Shen, Wei Feng; Tribouilloy, Christophe; Rey, Jean‐Luc; Baudhuin, Jean-Jacques; Boey, S; Dufosse, H.; Lesbre, J P

doi:10.1016/0002-8703(92)90067-6

Cited by 97 publications

(42 citation statements)

References 28 publications

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“…Doppler-derived transmitral flow parameters have been most frequently used to evaluate LV diastolic function. Several studies have pointed out that the presence of RFP, that is, high E, low A, and short DT, is closely related to a poor prognosis in patients with LV systolic dysfunction and congestive heart failure [6][7][8][9][10]. Consistent with previous reports, a significant relationship between RFP and cardiovascular events was observed by the univariate Cox model analysis in the present study.…”

Section: Discussionsupporting

confidence: 91%

“…However, elevated left atrial pressure counteracts delayed ventricular relaxation to produce a pseudonormal pattern [3][4][5], and further elevation of left atrial pressure is associated with RFP, characterized by an increased E/A ratio and a shortened DT [3]. RFP is usually seen in patients with severely damaged myocardium and is reported to be associated with unfavorable outcomes in patients with congestive heart failure [4][5][6][7][8][9][10]. This filling pattern, however, is not suitable to detect mild impairment of diastolic function.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Significance of Left Ventricular Diastolic Dysfunction Assessed by Color M-mode Doppler Echocardiography in Patients With Chronic Left Ventricular Systolic Dysfunction

et al. 2004

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Background. Color M-mode Doppler echocardiography provides accurate evaluation of LV diastolic function noninvasively and is reportedly preload independent compared with pulsed Doppler transmitral velocity indexes. This study aimed to determine the prognostic significance of left ventricular (LV) diastolic function in patients with different degrees of chronic LV systolic dysfunction using color M-mode Doppler echocardiography. Methods.A total of 98 consecutive subjects (mean age 57 years, 78 males) with LV systolic dysfunction (61 with previous myocardial infarction and 37 with dilated cardiomyopathy) underwent clinical and echocardiographic evaluation to determine functional status. Measurements of LV and left atrial dimensions, LV ejection fraction (EF), the peak of early and late diastolic transmitral velocities (E and A, respectively), the E/A ratio, deceleration time of E velocity and isovolumic relaxation time using conventional echo-Doppler techniques, and LV flow propagation velocity (FPV) and FPV/E using color M-mode Doppler echocardiography were taken.Results. During the mean follow-up period of 37±28 months, 26 patients had cardiovascular events (death in 4, congestive heart failure in 13, ventricular tachycardia in 6, and cerebral infarction in 3). EF was the single independent predictor of cardiovascular events. While, in the subgroup with EF <0.35, the functional class was the single significant predictor of cardiovascular events, FPV/E was the single best predictor of cardiovascular events in the subgroup with EF ≥0.35.Conclusions. The evaluation of LV diastolic function using color M-mode Doppler-derived FPV/E contributes to predicting clinical outcomes of patients with mildly depressed LV systolic function. (J Echocardiogr 2004; 2: 68-77)

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Left Ventricular Diastolic Dysfunction Assessed by Color M-mode Doppler Echocardiography in Patients With Chronic Left Ventricular Systolic Dysfunction

et al. 2004

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“…6,7 LV Circulation Journal Vol.70, June 2006 diastolic dysfunction is regarded as an early sign of myocardial disease and an important determinant of symptoms and clinical outcome in patients with cardiovascular disease. 8 It has been shown recently that impaired LV diastolic filling occurs in OSA patients with no other active pulmonary or cardiac disease. 9 Clearly, it is important to know whether OSA alone constitutes an independent risk factor for the development of LV dysfunction and hypertrophy, and thus for increased cardiovascular morbidity and mortality.…”

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confidence: 99%

Effect of Obstructive Sleep Apnea on Aortic Elastic Parameters

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et al. 2006

Circ J

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This is an obvious violation of the following "Instructions to Authors": Submission of a manuscript to the Circulation Journal implies that the article is original and that no portion (including figures or tables) is under consideration elsewhere or has been previously published in any form other than as an abstract. Previous publication includes publishing as a component of symposia, proceedings, transactions, books (or chapters), articles published by invitations or reports of any kind, as well as in electronic data bases of a public nature.Therefore, we have decided to retract the paper from Circulation Journal.As Editor-in-Chief, I regret the time that peer reviewers and others spent evaluating this paper.I sincerely hope and trust that there will be no repetition of this kind in the future. Hiroaki Shimokawa, MD, PhDEditor-in-Chief Circulation Journal (Released online August 3, 2010) R E T R A C T I O Nbstructive sleep apnea (OSA) is characterized by periodic complete or partial upper airway obstruction during sleep, causing intermittent cessation of breathing (apnea) or reduction in airflow (hypopnea) despite ongoing respiratory effort. This disorder has been described for decades, but its recognition has remained a problem. OSA appears to be an independent cardiovascular risk factor; several epidemiologic studies have identified OSA syndrome as an independent risk for systemic hypertension, coronary artery disease, stroke, and cardiac arrhythmias. [1][2][3][4] There are conflicting data in the literature on the association between OSA and left ventricular (LV) hypertrophy. Although some investigators have reported that patients with OSA develop LV hypertrophy independently of hypertension, 5 others have found no difference between patients with OSA and control subjects in LV mass (LVM). 6,7 LV Circulation Journal Vol.70, June 2006 diastolic dysfunction is regarded as an early sign of myocardial disease and an important determinant of symptoms and clinical outcome in patients with cardiovascular disease. 8 It has been shown recently that impaired LV diastolic filling occurs in OSA patients with no other active pulmonary or cardiac disease. 9 Clearly, it is important to know whether OSA alone constitutes an independent risk factor for the development of LV dysfunction and hypertrophy, and thus for increased cardiovascular morbidity and mortality.Aortic elastic properties are important determinants of blood pressure (BP) and LV function. The aorta functions not only as a conduit delivering blood to the tissues but also as an important modulator of the entire cardiovascular system, buffering the intermittent pulsatile output from the heart to provide steady flow to the capillary beds. By virtue of its elastic properties, the aorta influences LV function, structure and coronary blood flow. 10 Consequently, we hypothesized that OSA affects the functional and structural properties of large arteries, contributing to impaired LV function and changes in the LV geometry.

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“…Deceleration time o150 ms was regarded as short, 31 and over 250 ms was considered prolonged. 32 Abnormal diastolic filling patterns were classified by a modification of the approach of Appleton et al; 33 abnormal relaxation was identified by prolonged IVRT (4105 ms) and deceleration time (4250 ms) as well as reduced mitral annulus E/A ratio (o0.6); restrictive pattern was identified by short or normal IVRT (o105 ms), reduced deceleration time (o150 ms), and E/A ratio 41.5; ''pseudonormal'' pattern was recognized by the combination of prolonged IVRT (4105 ms) with normal deceleration time and E/A ratio; and LV filling was considered normal when IVRT was o105 ms, deceleration time between 150 and 250 ms, and E/A ratio between 0.6 and 1.5.…”

Section: 30mentioning

confidence: 99%

Impact of valvular regurgitation on left ventricular geometry and function in hypertensive patients with left ventricular hypertrophy: the LIFE study

et al. 2004

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Mild-to-moderate aortic and mitral regurgitation are frequently detected by echocardiogram in asymptomatic hypertensive patients. Our goal was to assess the prevalence and impact of mild-to-moderate mitral and/ or aortic regurgitation on left ventricular (LV) structure and function in patients with hypertension and LV hypertrophy (LVH). Hypertensive patients with ECG LVH enrolled in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiography substudy were evaluated. Among 939 patients with needed LV measurements and Doppler data, 242 had mild (1 þ ) valvular regurgitation, and 51 patients had moderate (2 þ or 3 þ ) regurgitation of one or both valves. In analyses adjusting for gender, patients with mild mitral and/or aortic regurgitation had larger LV internal dimensions (5.25 vs 5.33 cm, Po0.05), higher LV mass indexed for body surface area (122 vs 125 g/m 2 , Po0.05) or height 2.7 (55.4 vs 57.3, Po0.05), and larger left atrial diameter. Patients with moderate regurgitation of one or both valves had larger LV chambers (5.25 vs 5.9 cm, Po0.001), greater mean LV mass (232 vs 248 g, Po0.001) and LV mass indexed for body surface area or height 2.7 , and higher Doppler stroke volume. Patients with moderate valvular regurgitation also had a higher prevalence of LVH due to an increased prevalence of eccentric LVH. There were no differences among groups defined by the presence and severity of valvular regurgitation in cardiac output, total peripheral resistance, or pulse pressure/stroke volume, indicating that the observed inter-group differences in LV geometry were not due to differences in the haemodynamic severity of hypertension. Hypertensive patients with mild-to-moderate mitral or aortic valvular insufficiency have additional LV structural and functional changes that may affect prognosis.

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Prognostic significance of Doppler-derived left ventricular diastolic filling variables in dilated cardiomyopathy

Cited by 97 publications

References 28 publications

Prognostic Significance of Left Ventricular Diastolic Dysfunction Assessed by Color M-mode Doppler Echocardiography in Patients With Chronic Left Ventricular Systolic Dysfunction

Prognostic Significance of Left Ventricular Diastolic Dysfunction Assessed by Color M-mode Doppler Echocardiography in Patients With Chronic Left Ventricular Systolic Dysfunction

Effect of Obstructive Sleep Apnea on Aortic Elastic Parameters

Impact of valvular regurgitation on left ventricular geometry and function in hypertensive patients with left ventricular hypertrophy: the LIFE study

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