Ventricular systolic dysfunction with and without altered myocardial contractility: Clinical value of echocardiography for diagnosis and therapeutic decision-making

Benefits of transvenous mitral annuloplasty in heart failure with lower degrees of functional mitral regurgitation. Letter regarding the article ‘Treating symptoms and reversing remodelling: clinical and echocardiographic 1‐year outcomes with percutaneous mitral annuloplasty for mild to moderate secondary mitral regurgitation’

“…It is known that MR adversely affects the reliability of LVEF as an index of systolic function because the difference between end-diastolic and end-systolic volume (EDV − ESV) will be not be any more solely the forward (effective) stroke volume (SV f ), but will become the sum of SV f and regurgitant volume (R eg V). 2,3 Thus, with aggravation of MR, the regurgitant fraction increases to the detriment of SV f which explains the possible reduction of LVEF after mitral valve repair or replacement despite an increase in SV f . [2][3][4] In the study by Witte et al, 1 the improved only slightly (not significantly) during the first year after mitral annuloplasty.…”

“…2,3 Thus, with aggravation of MR, the regurgitant fraction increases to the detriment of SV f which explains the possible reduction of LVEF after mitral valve repair or replacement despite an increase in SV f . [2][3][4] In the study by Witte et al, 1 the improved only slightly (not significantly) during the first year after mitral annuloplasty. However, considering the significant reduction of the R eg V, this suggests a possibly significant increase in the SV f , which in turn explains the significantly improved clinical status after annuloplasty.…”

“…(EDV -ESV)/EDV] can overestimate LV systolic function because EDV − ESV will become the sum of SV f + R eg V instead of SV f alone. [3][4][5] Overestimation of LV systolic function can be avoided by calculation of the effective (forward) EF using the formula EF(%) = (SV f /EDV) × 100 which can improve clinical decision-making and also increase the predictive value of EF for patient outcome with LV systolic dysfunction associated with MR. [2][3][4] In the study by Witte et al, 1 the comparison of LVEF before and after annuloplasty revealed no significant differences, but taking into account that the R eg V was significantly higher before annuloplasty, the effective LVEF at baseline was overestimated. It seems therefore very likely that the comparison of the effective LVEF before and after annuloplasty could also reveal significant differences, which would in turn encourage the earlier use of percutaneous mitral annuloplasty.…”

Prognostic implication of a novel right ventricular injury score in septic patients

“…Echocardiography has been recognized as the first-line approach to assess RV function in the critical care setting, as it can identify RV dilatation with the ratio of RV end-diastolic area and LV end-diastolic area (R/LVEDA), identify RVSD with tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC) and peak systolic velocity of lateral tricuspid annulus (S′), and identify RV-pulmonary arterial (PA) decoupling by the TAPSE/pulmonary arterial systolic pressure (PASP) ratio. 2,5 A recent meta-analysis reported that RV dysfunction is associated with short-and long-term prognosis in sepsis and septic shock patients. 6 However, a knowledge gap remains regarding accurate RV function evaluation.…”

Diastolic Dysfunction Prediction with Symptoms Using Machine Learning Approach

“…[2]. Heart disease can be predicted through many dysfunctions, like Systolic Dysfunction and Diastolic Dysfunction [3]. Systolic and diastolic function and dysfunction, derived from the echocardiography test and Doppler test as previously defined in [4].…”