Significance of left atrial overload by electrocardiogram in the assessment of left ventricular diastolic dysfunction

Sumita, Yoshiyuki; Nakatani, Satoshi; Murakami, Ichiro; Taniguchi, Mina

doi:10.1007/s12574-019-00458-5

Cited by 11 publications

(10 citation statements)

References 14 publications

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“…The prolonged P-wave in diabetic rats observed in our paper may reflect atrial conduction disturbances. In patients, P wave duration has been suggested as an index for left ventricular diastolic dysfunction [42].…”

Section: Plos Onementioning

confidence: 99%

Early changes in myocyte contractility and cardiac function in streptozotocin-induced type 1 diabetes in rats

et al. 2020

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Diabetes can elicit direct deleterious effects on the myocardium, independent of coronary artery disease or hypertension. These cardiac disturbances are termed diabetic cardiomyopathy showing increased risk of heart failure with or without reduced ejection fraction. Presently, there is no specific treatment for this type of cardiomyopathy and in the case of type I diabetes, it may start in early childhood independent of glycemic control. We hypothesized that alterations in isolated myocyte contractility and cardiac function are present in the early stages of experimental diabetes in rats before overt changes in myocardium structure occur. Diabetes was induced by single-dose injection of streptozotocin (STZ) in rats with data collected from control and diabetic animals 3 weeks after injection. Left ventricle myocyte contractility was measured by single-cell length variation under electrical stimulation. Cardiac function and morphology were studied by high-resolution echocardiography with pulsed-wave tissue Doppler imaging (TDI) measurements and three-lead surface electrocardiogram. Triglycerides, cholesterol and liver enzyme levels were measured from plasma samples obtained from both groups. Myocardial collagen content and perivascular fibrosis of atria and ventricle were studied by histological analysis after picrosirius red staining. Diabetes resulted in altered contractility of isolated cardiac myocytes with increased contraction and relaxation time intervals. Echocardiography showed left atrium dilation, increased enddiastolic LV and posterior wall thickness, with reduced longitudinal systolic peak velocity (S') of the septum mitral annulus at the apical four-chamber view obtained by TDI. Triglycerides, aspartate aminotransferase and alkaline phosphatase were elevated in diabetic animals. Intertitial collagen content was higher in atria of both groups and did not differ among control and diabetic animals. Perivascular intramyocardial arterioles collagen did not differ between groups. These results suggest that alterations in cardiac function are present in the early phase in this model of diabetes type 1 and occur before overt changes in myocardium structure appear as evaluated by intersticial collagen deposition and perivascular fibrosis of intramyocardial arterioles.

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Section: Plos Onementioning

confidence: 99%

Early changes in myocyte contractility and cardiac function in streptozotocin-induced type 1 diabetes in rats

et al. 2020

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“…The AUC for both corrected P-wave duration, and P-wave dispersion was 0.62. In a similar population (prevalence LVDD = 53%), P-wave duration > 110 ms was more sensitive for LVDD (sensitivity 86%, specificity 86%), and a P-wave duration > 120 ms was more specific for LVDD (sensitivity 34% and specificity 100%) (20).…”

Section: P-wave Area Dispersion and Durationmentioning

confidence: 87%

“…Electrocardiographic (ECG) features derived from atrial contraction up to the ventricular depolarization were described in 11 articles (20)(21)(22)(23)(24)(25)(29)(30)(31)(32)(33).…”

Section: Atrial Contraction Related Featuresmentioning

confidence: 99%

“…In 417 individuals considered at risk for heart failure (e.g., history of hypertension, diabetes, obesity, or having received potential cardiotoxic chemotherapy) enrolled through local media advertising, the P-wave terminal force in lead V1 (PTFV1) ≤ −4,000 µV * ms showed a PPV of 67% and a sensitivity of 36% for LVDD (prevalence LVDD = 65%) (21). In another study with individuals undergoing echocardiography as part of routine cardiac care (20), the sensitivity, specificity, PPV, and NPV of a PTFV1 ≥0.04 mm * s were 27, 100, 100, and 38%, respectively, for a diagnosis of LVDD [present in 62 of 117 participants (53%)]. In 8 among the 117 participants (6.8%), the Morris index was present resulting in a sensitivity, specificity, and PPV and NPV for LVDD of 13, 100, 100, and 34%, respectively (20).…”

Section: Ptfv1 and Morris Indexmentioning

confidence: 99%

“…In another study with individuals undergoing echocardiography as part of routine cardiac care (20), the sensitivity, specificity, PPV, and NPV of a PTFV1 ≥0.04 mm * s were 27, 100, 100, and 38%, respectively, for a diagnosis of LVDD [present in 62 of 117 participants (53%)]. In 8 among the 117 participants (6.8%), the Morris index was present resulting in a sensitivity, specificity, and PPV and NPV for LVDD of 13, 100, 100, and 34%, respectively (20).…”

Section: Ptfv1 and Morris Indexmentioning

confidence: 99%

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Electrocardiographic Features of Left Ventricular Diastolic Dysfunction and Heart Failure With Preserved Ejection Fraction: A Systematic Review

Ommen

Kessler

Valstar

et al. 2021

Front. Cardiovasc. Med.

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Background: Electrocardiographic features are well-known for heart failure with reduced ejection fraction (HFrEF), but not for left ventricular diastolic dysfunction (LVDD) and heart failure with preserved ejection fraction (HFpEF). As ECG features could help to identify high-risk individuals in primary care, we systematically reviewed the literature for ECG features diagnosing women and men suspected of LVDD and HFpEF.Methods and Results: Among the 7,127 records identified, only 10 studies reported diagnostic measures, of which 9 studied LVDD. For LVDD, the most promising features were T-end-P/(PQ*age), which is the electrocardiographic equivalent of the passive-to-active filling (AUC: 0.91–0.96), and repolarization times (QTc interval ≥ 350 ms, AUC: 0.85). For HFpEF, the Cornell product ≥ 1,800 mm*ms showed poor sensitivity of 40% (AUC: 0.62). No studies presented results stratified by sex.Conclusion: Electrocardiographic features are not widely evaluated in diagnostic studies for LVDD and HFpEF. Only for LVDD, two ECG features related to the diastolic interval, and repolarization measures showed diagnostic potential. To improve diagnosis and care for women and men suspected of heart failure, reporting of sex-specific data on ECG features is encouraged.

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Energy wavelet signal processed ECG and standard 12 lead ECG: Diagnosis of early diastolic dysfunction

Whitman,

Tilley,

Padayachee

et al. 2024

Journal of Electrocardiology

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Significance of left atrial overload by electrocardiogram in the assessment of left ventricular diastolic dysfunction

Cited by 11 publications

References 14 publications

Early changes in myocyte contractility and cardiac function in streptozotocin-induced type 1 diabetes in rats

Early changes in myocyte contractility and cardiac function in streptozotocin-induced type 1 diabetes in rats

Electrocardiographic Features of Left Ventricular Diastolic Dysfunction and Heart Failure With Preserved Ejection Fraction: A Systematic Review

Energy wavelet signal processed ECG and standard 12 lead ECG: Diagnosis of early diastolic dysfunction

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