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Mediating function of heart failure in the causal relationship between diastolic blood pressure and hypertensive renal disease with renal failure:a mediated Mendelian randomization study
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作者 Lei Pang Zi-Jun Ding +3 位作者 Hong-Qiang Chai Fei Li Ming Wu Wei-Bing Shuang 《Frontiers of Nursing》 2024年第3期285-294,共10页
Objective:To study the causality relationship between diastolic blood pressure(DBP)and hypertensive renal disease with renal failure(HRDRF)and the mediating role of hear t failure(HF)in the causality relationship by n... Objective:To study the causality relationship between diastolic blood pressure(DBP)and hypertensive renal disease with renal failure(HRDRF)and the mediating role of hear t failure(HF)in the causality relationship by network Mendelian randomization(MR).Methods:Genome-wide analysis of DBP,HRDRF,and HF was downloaded from the public database(Genome-Wide Analysis Study[GWAS])and was used to analyze the results and to conduct mediated MR analysis.Results:Analysis showed that DBP was positively correlated with HRDRF(OR=1.0002,95%CI:1.0001–1.0003,P=1.8076e-05)and DBP was positively correlated with HF(OR=1.0295,95%CI:1.0221–1.0370,P=2.5292e-15).HF and HRDRF had a positive causal effect(OR=1.0001,95%CI:1.0000–1.0001,P=0.0152).Mediation analysis showed that the contribution ratio of HF to the combined effect of DBP and HRDRF was 24.69%.Conclusions:DBP can increase the risk of renal disease with renal failure,and HF may play an impor tant role in mediating this causal relationship. 展开更多
关键词 atherosclerotic heart disease diastolic blood pressure heart arrhythmia heart failure hypertensive renal disease with renal failure Mendelian randomization
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Intrinsic Wave Velocity Propagation:A Novel Parameter for Assessing the Effect of Anthracycline Chemotherapy Agents on Cardiac Diastolic Function in Breast Cancer Patients
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作者 Xiao HUANG Xin-ying FAN +5 位作者 Qiao CHENG Jun ZHANG Jie SUN Qiao-ying TANG You-bin DENG Xiao-jun BI 《Current Medical Science》 SCIE CAS 2023年第6期1229-1237,共9页
Objective Anthracycline chemotherapeutic agents have significant cardiotoxicity.The present study emphasized the effect of anthracycline chemotherapy drugs on left ventricular(LV)myocardial stiffness in breast cancer ... Objective Anthracycline chemotherapeutic agents have significant cardiotoxicity.The present study emphasized the effect of anthracycline chemotherapy drugs on left ventricular(LV)myocardial stiffness in breast cancer patients by measuring the intrinsic wave velocity propagation(IVP),and evaluating the potential clinical value of IVP in detecting early LV diastolic function impairment.Methods A total of 68 newly diagnosed breast cancer patients,who were treated with anthracycline-based chemotherapy,were analyzed.Transthoracic echocardiography was performed at baseline(T0),and after 1,2,3,4 and 8 chemotherapeutic cycles(T1,T2,T3,T4 and T5,respectively).Then,the IVP,LV strain parameters[global longitudinal strain(GLS),longitudinal peak strain rate at systole(LSRs),longitudinal peak strain rate at early diastole(LSRe),longitudinal peak strain rate at late diastole(LSRa),and the E/LSRe ratio],and conventional echocardiographic parameters were obtained and further analyzed.A relative reduction of>15%in GLS was considered a marker of early LV subclinical dysfunction.Results Compared to the T0 stage,IVP significantly increased at the T1 stage.However,there were no significant changes in GLS,LSRs,or LSRe between the T0 and T1 stages.These parameters significantly decreased from the T2 stage.LSRa started to significantly decrease at the T5 stage,and the E/LSRe ratio started to significantly increase at the T3 stage(all P<0.05).At the T0 stage,IVP(AUC=0.752,P<0.001)had a good predictive value for LV subclinical dysfunction after chemotherapy.Conclusions IVP is a potentially sensitive parameter for the early clinical assessment of anthracycline-related cardiac diastolic impairment. 展开更多
关键词 breast cancer anthracycline chemotherapy drugs intrinsic wave velocity propagation myocardial stiffness cardiac diastolic function
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Effect of PTCA and stenting on left ventricular diastolic function in patients with CHD
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作者 傅向华 《介入放射学杂志》 CSCD 2003年第S1期151-,共1页
Objective The aim of this study was to determine the effect of successful coronary revascularisation on left ventricular diastolic function.Methods We consecutively studied the diastolic function by Doppler echocardio... Objective The aim of this study was to determine the effect of successful coronary revascularisation on left ventricular diastolic function.Methods We consecutively studied the diastolic function by Doppler echocardiography in 125 patients with one vessel disease before and 48 hours after selective coronary angioplasty. The following parameters of left ventricular diastolic function were evaluated: peak early (VE, m/s) and peak late diastolic (VA, m/s) flow velocity, E/A ratio, acceleration time (AT, ms), deceleration time (DT, ms) and isovolumetric relaxation time (IVRT, ms). Ejection fraction (EF; %) was determined and used to characterise systolic left ventricular function. Results All of the patients were initially successful treated with coronary angioplasty (residual stenosis <40% ). In 98 patients( 78.4% ) stents were used to improve an inadequate result after coronary angioplasty. Both patient groups (27 patients with coronary angioplasty and 98 patients with combined coronary angioplasty and stent implantation) showed no relevant differences concerning sex, age, atherosclerotic risk factors, exercise capacity and results of exercise electrocardiography. All patients who underwent stent implantation showed an early improvement of left ventricular diastolic function 48 hours after revascularisation. Surprisingly there was no significant short term improvement (48 hours) of diastolic function in patients with initially successful angioplasty.Conclusions We suppose that stent implantation might normalize coronary blood flow faster than that of coronary balloon angioplasty. 展开更多
关键词 Effect of PTCA and stenting on left ventricular diastolic function in patients with CHD PTCA LEFT in on of with
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Left ventricular regional and global diastolic function assessed using Quantitative Tissue velocity Imaging in patients with hypertrophic cardiomyopathy
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作者 王良玉 王新房 +2 位作者 谢明星 蔡志雄 陈纪平 《South China Journal of Cardiology》 CAS 2003年第2期119-124,共6页
Objectives The study was performed to assess the left ventricular (LV) regional and global diastolic function、left ventricular wall motion features in patients with Hypertrophic cardiomyopathy by Quantitative Tissue ... Objectives The study was performed to assess the left ventricular (LV) regional and global diastolic function、left ventricular wall motion features in patients with Hypertrophic cardiomyopathy by Quantitative Tissue Velocity Imaging (QTVI). Methods 42 patients with hypertrophic cardiomyopathy and 36 age-matched normal subjects underwent QTVI study. Off-line LV regional muscular tissue velocity Imaging along LV apical long-axis view were obtained. Regional diastolic function was assessed in using peak tissue velocities of LV regional muscular tissue during early diastole (Ve)and LA contraction (Va), Ve/Va ratio, derived from Tissue Velocity Imaging. Global diastolic function was reflected by isovolumic relaxation time(IRT) and mitral valve peak flow velocity ( E/A ) calculated with pulsed wave doppler. The end-diastolic interventricular septal thickness (ⅣSt) was measured by conventional 2 - dimension echocardiography. Results ① Ve、 Va、 Ve/Va in the segments of hypertrophic interventricular septum (IVS) reduced wlhile E/A ratio significantly reduced and IRT markedly prolonged in HCM patients than in normal subjects。 ② Ve、 Ve/Va were significant reduced in the segments of hypertrophic interventricular septum compared with other LV segments in HCM patients . ③ There was a correlation between Ve/Va and E/A in HCM patients with abnormal E/A ratio (r = 0. 70). ④ There was a negative correlation between Ve/Va and ⅣSt in non -obstruction HCM patients (B group , r = -0.61 ) Conclusions QTVI offers a newer method in clinical practice which has a higher sensibility and accuracy in evaluating the LV regional and global diastolic function in HCM patients . 展开更多
关键词 Quantitative tissue velocity Imaging Hypertrophy cardiomyopathy Left ventricular diastolic function
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Liver cirrhosis and left ventricle diastolic dysfunction: Systematic review 被引量:7
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作者 Ieva Stundiene Julija Sarnelyte +4 位作者 Ausma Norkute Sigita Aidietiene Valentina Liakina Laura Masalaite Jonas Valantinas 《World Journal of Gastroenterology》 SCIE CAS 2019年第32期4779-4795,共17页
BACKGROUND Liver cirrhosis is a chronic hepatic disease which is associated with cardiovascular abnormalities.Hyperdynamic circulation in liver cirrhosis causes functional and structural cardiac alterations.The preval... BACKGROUND Liver cirrhosis is a chronic hepatic disease which is associated with cardiovascular abnormalities.Hyperdynamic circulation in liver cirrhosis causes functional and structural cardiac alterations.The prevalence of left ventricle diastolic dysfunction(LVDD)in cirrhotic patients ranges from 25.7%to as high as 81.4%as reported in different studies.In several studies the severity of diastolic dysfunction(DD)correlated with a degree of liver failure and the rate of dysfunction was higher in patients with decompensated cirrhosis compared with compensated.Future directions of comprehensive assessment of cardiac function in cirrhotic patients might provide a better prognosis for these patients.AIM To clarify the correlation between the severity of liver cirrhosis and left ventricle diastolic dysfunction in the existing literature.METHODS Through January and February of 2019 at Vilnius University we conducted a systematic review of the global existing literature on the prevalence of left ventricle diastolic dysfunction in patients with liver cirrhosis.We searched for articles in PubMed,Medline and Web of science databases.Articles were selected by using adequate inclusion and exclusion criteria.Our interest was the outcome of likely correlation between the severity of cirrhosis[evaluated by Child-Pugh classes,Model For End-Stage Liver Disease(MELD)scores]and left ventricle diastolic dysfunction[classified according to American Society of Echocardiography(ASE)guidelines(2009,2016)],as well as relative risk of dysfunction in cirrhotic patients.Subgroup analyses were performed to evaluate the ratio and grades of left ventricle diastolic dysfunction with respect to cirrhosis severity.RESULTS A total of 1149 articles and abstracts met the initial search criteria.Sixteen articles which met the predefined eligibility criteria were included in the final analysis.Overall,1067 patients(out of them 723 men)with liver cirrhosis were evaluated for left ventricle diastolic dysfunction.In our systemic analysis we have found that 51.2%of cirrhotic patients had left ventricle diastolic dysfunction diagnosed and the grade 1 was the most prevalent(59.2%,P<0.001)among them,the grade 3 had been rarely diagnosed-only 5.1%.The data about the prevalence of diastolic dysfunction in cirrhotic patients depending on Child-Pugh Classes was available from 5 studies(365 patients overall)and only in 1 research diastolic dysfunction was found being associated with severity of liver cirrhosis(P<0.005).We established that diastolic dysfunction was diagnosed in 44.6%of Child-Pugh A class patients,in 62%of Child B class and in 63.3%of Child C patients(P=0.028).The proportion of patients with higher diastolic dysfunction grades increases in more severe cirrhosis presentation(P<0.001).There was no difference between mean MELD scores in patients with and without diastolic dysfunction and in different diastolic dysfunction groups.In all studies diastolic dysfunction was more frequent in patients with ascites.CONCLUSION This systemic analysis suggests that left ventricle diastolic dysfunction is an attribute of liver cirrhosis which has not received sufficient attention from clinicians so far.Future suggestions of a comprehensive assessment of cardiac function in cirrhotic patients might provide a better prognosis for these patients and give hint for better understanding of the left ventricle diastolic dysfunction pathogenesis in liver cirrhosis. 展开更多
关键词 Liver CIRRHOSIS Left VENTRICLE diastolic DYSFUNCTION Correlation ECHOCARDIOGRAPHY Systematic review
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Assessment and impact of diastolic function by echocardiography in elderly patients 被引量:3
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作者 Clementina Dugo Marzia Rigolli +1 位作者 Andrea Rossi Gillian A Whalley 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2016年第3期252-260,共9页
Doppler echocardiography is the gold standard for assessment of diastolic dysfunction, which is increasingly recognised as a cause of heart failure, especially in the elderly. Using a combination of Doppler echocardio... Doppler echocardiography is the gold standard for assessment of diastolic dysfunction, which is increasingly recognised as a cause of heart failure, especially in the elderly. Using a combination of Doppler echocardiography techniques, it is possible to identify grades of dia- stolic dysftmction, estimate left ventricular filling pressures and establish the chronicity of diastolic dysfunction. These physiologi- cally-derived measures have been widely validated against invasive measurements of left heart pressures and have been shown to be prog- nostically valuable in a wide range of clinical settings. This review explores the mechanisms, and approaches to the assessment of diastolic dysfunction in the elderly. The challenge for clinicians is to identify pathophysiological changes from those associated with normal ageing. When used in combination, and taking age into account, Doppler echocardiographic parameters are helpful in the assessment of dyspnoea in older patients and provide prognostic insights. 展开更多
关键词 diastolic dysfunction DOPPLER ECHOCARDIOGRAPHY
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Plasma N-terminal pro-brain natriuretic peptide levels in elderly patients with isolated diastolic dysfunction 被引量:2
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作者 Yixin SONG Qing LIN Xiaomin SHI Yunyun QI 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2005年第4期211-215,共5页
Objective To investigate plasma N-terminal pro-brain natriuretic peptide (NT-BNP) levels and to assess their clinical significance in elderly patients with isolated diastolic dysfunction. Methods Plasma NT-BNP level w... Objective To investigate plasma N-terminal pro-brain natriuretic peptide (NT-BNP) levels and to assess their clinical significance in elderly patients with isolated diastolic dysfunction. Methods Plasma NT-BNP level were measured by electrochemiluminescence immunoassay in 34 symptomatic patients (Group 1), 34 asymptomatic patients (Group 2) with isolated diastolic dysfunction, and in 16 elderly healthy subjects (control group, Group 3), serving controls. Colored Doppler echocardiography was performed to evaluate the patients' cardiac structures and functions. Results The plasma NT-BNP level in Group 1 was significantly higher than those in Group 2 and Group 3 and increased with the severity of heart failure. There was no significant difference of plasma NT-BNP levels between Group 2 and Group 3 (p>0.05). A NT-BNP value of 102.75 pg/mL showed a sensitivity of 88.2%, a specificity of 87.5%, and an accuracy of 88.1% for diagnosing diastolic dysfunction. Patients with restrictive filling pattern on echocardiography had higher NT-BNP levels than those of impaired relaxation pattern (1961.2±304.9 versus 460.1±92.7pg/mL, p<0.001). Conclusion The elevation of plasma NT-BNP level in elderly patients with isolated diastolic dysfunction correlates with the severity of their diastolic abnormalities. The level of plasma NT-BNP has an important clinical value in the diagnosis of elderly patients with isolated diastolic dysfunction. 展开更多
关键词 elderly ISOLATED diastolic DYSFUNCTION N-TERMINAL pro-brain NATRIURETIC peptide ECHOCARDIOGRAPHY
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Effects of exercise training on diastolic and systolic dysfunction in patients with chronic heart failure 被引量:3
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作者 Ioannis Chaveles Ourania Papazachou +5 位作者 Manal al Shamari Dimitrios Delis Argirios Ntalianis Niki Panagopoulou Serafim Nanas Eleftherios Karatzanos 《World Journal of Cardiology》 2021年第9期514-525,共12页
BACKGROUND Chronic heart failure(CHF)is a complex syndrome characterized by a progressive reduction of the left ventricular(LV)contractility,low exercise tolerance,and increased mortality and morbidity.Diastolic dysfu... BACKGROUND Chronic heart failure(CHF)is a complex syndrome characterized by a progressive reduction of the left ventricular(LV)contractility,low exercise tolerance,and increased mortality and morbidity.Diastolic dysfunction(DD)of the LV,is a keystone in the pathophysiology of CHF and plays a major role in the progression of most cardiac diseases.Also,it is well estimated that exercise training induces several beneficial effects on patients with CHF.AIM To evaluate the impact of a cardiac rehabilitation program on the DD and LV ejection fraction(EF)in patients with CHF.METHODS Thirty-two stable patients with CHF(age:56±10 years,EF:32%±8%,88%men)participated in an exercise rehabilitation program.They were randomly assigned to aerobic exercise(AER)or combined aerobic and strength training(COM),based on age and peak oxygen uptake,as stratified randomization criteria.Before and after the program,they underwent a symptom-limited maximal cardiopulmonary exercise testing(CPET)and serial echocardiography evaluation to evaluate peak oxygen uptake(VO2peak),peak workload(Wpeak),DD grade,right ventricular systolic pressure(RVSP),and EF.RESULTS The whole cohort improved VO2peak,and Wpeak,as well as DD grade(P<0.05).Overall,9 patients(28.1%)improved DD grade,while 23(71.9%)remained at the same DD grade;this was a significant difference,considering DD grade at baseline(P<0.05).In addition,the whole cohort improved RVSP and EF(P<0.05).Not any between-group differences were observed in the variables assessed(P>0.05).CONCLUSION Exercise rehabilitation improves indices of diastolic and systolic dysfunction.Exercise protocol was not observed to affect outcomes.These results need to be further investigated in larger samples. 展开更多
关键词 Chronic heart failure Cardiovascular effects Cardiac rehabilitation Aerobic exercise Strength training diastolic dysfunction
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18β-Glycyrrhetinic Acid Improves Cardiac Diastolic Function by Attenuating Intracellular Calcium Overload 被引量:3
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作者 Jun HAN Guan-hua SU +3 位作者 Yu-hui WANG Yong-xin LU Hong-liang ZHAO Xin-xin SHUAI 《Current Medical Science》 SCIE CAS 2020年第4期654-661,共8页
Summary:Ranolazine,a late sodium current inhibitor,has been demonstrated to be effective on heart failure.18B-glycyrrhetinic acid(18β-GA)has the similar inhibitory effect on late sodium currents.However,its effect on... Summary:Ranolazine,a late sodium current inhibitor,has been demonstrated to be effective on heart failure.18B-glycyrrhetinic acid(18β-GA)has the similar inhibitory effect on late sodium currents.However,its effect on diastolic function is still unknown.This study aimed to determine whether 18β-GA can improve the diastolic function and to explore the underlying mechanisms.Eighty male Sprague Dawley(SD)rats of Langendorff model were randomly divided into the following groups:group A,normal cardiac perfusion group;group B,ischemia-reperfusion group;group C,ischemia-reperfusion with anemoniasulcata toxinⅡ(ATX-Ⅱ);group D,ranolazine group;and group E,18β-GA group with four different concentrations.Furthermore,a pressure-overloaded rat model induced by trans-aortic constriction(TAC)was established.Echocardiography and hemodynamics were used to evaluate diastolic function at 14th day after TAC.Changes of free intracellular calcium(Ca27)concentration was indirectly detected by laser scanning confocal microscope to confirm the inhibition of late sodium currents.With the intervention of ATX-Ⅱon ischemia reperfusion injury group,5 umol/L ranolazine,and 5,10,20,40μmol/L 18β-GA could improve ATX-I-induced cardiac diastolic dysfunction.630 mg/kg glycyrrhizin tablets could improve cardiac diastolic function in the pressure-overloaded rats.18B-GA and ranolazine had similar effects on reducing the free calcium in cardiomyocytes.The study demonstrates that 18B-GA and glycyrrhizin could improve diastolic dysfunction induced by ischemia-reperfusion injury in Langendorff-perfused rat hearts and pressure-overloaded rats.The mechanism may be attributed to the inhibition of enhanced late sodium currents. 展开更多
关键词 glycyrrhetinic acid diastolic function calcium overload
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Shortness of breath in clinical practice: A case for left atrial function and exercise stress testing for a comprehensive diastolic heart failure workup 被引量:6
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作者 Pupalan Iyngkaran Nagesh S Anavekar +2 位作者 Christopher Neil Liza Thomas David L Hare 《World Journal of Methodology》 2017年第4期117-128,共12页
The symptom cluster of shortness of breath(SOB) contributes significantly to the outpatient workload of cardiology services. The workup of these patients includes blood chemistry and biomarkers, imaging and functional... The symptom cluster of shortness of breath(SOB) contributes significantly to the outpatient workload of cardiology services. The workup of these patients includes blood chemistry and biomarkers, imaging and functional testing of the heart and lungs. A diagnosis of diastolic heart failure is inferred through the exclusion of systolic abnormalities, a normal pulmonary function test and normal hemoglobin, coupled with diastolic abnormalities on echocardiography. Differentiating confounders such as obesity or deconditioning in a patient with diastolic abnormalities is difficult. While the most recent guidelines provide more avenues for diagnosis, such as incorporating the left atrial size, little emphasis is given to understanding left atrial function, which contributes to at least 25% of diastolic left ventricular filling; additionally, exercise stress testing to elicit symptoms and test the dynamics of diastolic parameters, especially when access to the "gold standard" invasive tests is lacking, presents clinical translational gaps. It is thus important in diastolic heart failure work up to understand left atrial mechanics and the role of exercise testing to build a comprehensive argument for the diagnosis of diastolic heart failure in a patient presenting with SOB. 展开更多
关键词 diastolic heart failure Exercise stress test Left atrium Shortness of breath Work-up
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Effect of amlodipine combined with telmisartan or compound amiloride on plasma ET-1 concentration and left ventricular diastolic function of essential hypertension patients with left ventricular hypertrophy 被引量:2
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作者 YIN Yanrong WANG Xin +2 位作者 WANG Yaping ZHANG Yong TIAN Gang 《Journal of Medical Colleges of PLA(China)》 CAS 2013年第6期345-354,共10页
Objective: To observe the effect of different combination antihypertensive therapies on plasma endothelin-1 (ET-1) concentration and left ventricular diastolic function of essential hypertension patients with left ... Objective: To observe the effect of different combination antihypertensive therapies on plasma endothelin-1 (ET-1) concentration and left ventricular diastolic function of essential hypertension patients with left ventricular hypertrophy (LVH) Methods: A total of 111 patients with essential hypertension were selected, including 60 cases (34 males, 26 females) aged (60.7±5.6) years with simple hypertension, and 51 cases (28 males, 23 females) aged (61.8±7.0) years with essential hypertension complicated with LVH. Essential hypertension patients with LVH were randomly divided into the group of amlodipine (2.5 mg/d) combined with telmisartan (40 mg/d, n=26) and the group of amlodipine (2.5 mg/d) combined with amiloride (half tablet/d, n=25),and the treatment lasted for 1 year. Echocardiography was performed before and after the treatment. Left ventricular mass index (LVMI), left ventricular isovolumic relaxation time (IVRT) and other indicators were detected, and plasma ET-1 concentrations were measured for comparative analysis. And 56 patients (31 males, 25 females) aged (59.3±6.7) years with normal blood pressure in the same period in our hospital were selected as the normal control group. Results: The general clinical characteristics were similar between hypertensive LVH group, simple hypertensive group and normal healthy control group. Plasma ET-1 concentrations, LVMI and IVRT of hypertensive LVH group were significantly higher than those of normal control group and simple hypertension group, and the difference was statistically significant. The patients' baseline blood pressure, ET-1, LVMI, interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular end-diastolic diameter (LVEDd) and other clinical parameters showed no significant difference (P〉0.05) between the group of amlodipine combined with telmisartan and the group of amlodipine combined with amiloride. It was found that compared with that before treatment, blood pressure could be effectively controlled (P〈0.05), and LVMI, IVST, LVPWT and IVRT (P〈0.05) were all lowered, and ET-1 (P〈0.01) was significantly reduced after 1 year of antihypertensive therapy in both the group of amlodipine combined with telmisartan and the group of amlodipine combined with amiloride. The group of amlodipine combined with telmisartan was better in lowering blood pressure and reducing LVMI, IVST, LVPWT, IVRT and ET-1 than the group of amlodipine combined with amiloride (P〈0.05). Conelus|on: Amlodipine-based combination antthypertensive therapy could reverse LVH and improve left ventricular diastolic function partly by lowering blood pressure and ET-1, and the effect of amlodipine combined with telmisartan was superior to that ofamlodipine combined with amiloride 展开更多
关键词 HYPERTENSION Left ventricular hypertrophy ENDOTHELIN-1 Left ventricular diastolic function
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ASSESSMENT OF DIASTOLIC FUNCTION IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY BY DOPPLER TISSUE IMAGING 被引量:2
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作者 JingLi Yan-lingLiu HaoWang Xiu-zhangLü Hong-changYang Fu-jianDuan Zhen-huiZhu 《Chinese Medical Sciences Journal》 CAS CSCD 2004年第3期203-206,共4页
To determine the clinical application of pulsed Doppler tissue imaging in assessing the left ventricular diasto-lic function and in discriminating between normal subjects and patients with hypertrophic cardiomyopathy ... To determine the clinical application of pulsed Doppler tissue imaging in assessing the left ventricular diasto-lic function and in discriminating between normal subjects and patients with hypertrophic cardiomyopathy with various stages of diastolic dysfunction. Methods We measured the peak diastolic velocities of mitral annulus in 81 patients with hypertrophic cardiomyopathy with various stages of diastolic dysfunction and 50 normal volunteers by Doppler tissue imaging using the apical window at 2-ch-amber and long apical views, respectively. The myocardial velocities were determined with use of variance F statistical analysis. Results Early diastolic myocardial velocities of mitral annulus were higher in normal subjects than in patients with hy-pertrophic cardiomyopathy with either delayed relaxation, pseudonormal filling, or restrictive filling. However, peak myocar-dial velocities of mitral annulus during atrial contraction were similar in normal subjects and patients with hypertrophic cardiomyopathy. Conclusion Doppler tissue imaging can directly reflect upon left diastolic ventricular function. Early phase of diastole was the best discriminator between control subjects and patients with hypertrophic cardiomyopathy. 展开更多
关键词 Doppler tissue imaging left ventricular diastolic function hypertrophic cardiomyopathy
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Advances in diastolic heart failure 被引量:1
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作者 Xing Sheng Yang Jing Ping Sun 《World Journal of Cardiology》 CAS 2010年第3期58-63,共6页
More than 50% of people living with congestive heart failure have diastolic heart failure(DHF).Most of them are older than 70 years,and female.The prevalence of DHF has increased with time.DHF is caused by left ventri... More than 50% of people living with congestive heart failure have diastolic heart failure(DHF).Most of them are older than 70 years,and female.The prevalence of DHF has increased with time.DHF is caused by left ventricular(LV) diastolic dysfunction(DD) which is induced by diastolic dyssynchrony.Cardiac and extracardiac factors play important roles in the development of heart failure(HF) symptoms.The diagnosis of DHF is generally based on typical symptoms and signs of HF,preserved or normal LV ejection fraction,DD and no valvular abnormalities on examination,using noninvasive and invasive methodologies.The outcomes with pharmacological therapy in patients with DHF are frequently neutral in clinical trials,and prognosis still remains poor with a 5-year mortality of 42.3% after hospitalization for HF.Further trials are necessary. 展开更多
关键词 B-type NATRIURETIC peptide diastolic dysfunction diastolic DYSSYNCHRONY normal EJECTION fraction diastolic HEART FAILURE Echocardiography HEART FAILURE
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Diastolic heart failure in the elderly 被引量:1
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作者 Jeffrey H.Barsuk William G.Cotts 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2006年第4期210-221,共12页
Heart failure with preserved left ventricular function is a common problem among elderly patients. Given that diastolic heart failure (DHF) occurs in up to 50% of all heart failure admissions, and that incidence incre... Heart failure with preserved left ventricular function is a common problem among elderly patients. Given that diastolic heart failure (DHF) occurs in up to 50% of all heart failure admissions, and that incidence increases with age, knowledge of current recommendations for its diagnosis and treatment are extremely important for the elderly population. Causes of DHF include the aging process itself, hypertension, left ventricular hypertrophy, aortic stenosis, and hypertrophic obstructive cardiomyopathy. The patient with DHF may present with signs and symptoms similar to those observed in systolic heart failure. Treatment goals for the patient with DHF include achieving normal volume status, improving relaxation of the left ventricle, regression of hypertrophy if possible, and management of any co-morbidities that may aggravate the clinical status of patients with DHF. Hopefully, in the future, further data from randomized clinical trials will allow a more defined approach to care in these patients. 展开更多
关键词 diastolic DYSFUNCTION elderly heart failure LEFT VENTRICULAR HYPERTROPHY aging
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NONLINEAR DYNAMICS MODFLING OF MECHANICAL PERIODICITY OF END DIASTOLIC VOLUME OF LEFT VENTRICLE 被引量:1
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作者 XU Shi-xiong(许世雄) +1 位作者 MAO Xiao-chun(毛晓春) 《Applied Mathematics and Mechanics(English Edition)》 SCIE EI 2001年第10期1183-1191,共9页
The cardiovascular system with a lumped parameter model is treated, in which the Starling model is used to simulate left ventricle and the four-element Burattini & Gnudi model is used in the description of... The cardiovascular system with a lumped parameter model is treated, in which the Starling model is used to simulate left ventricle and the four-element Burattini & Gnudi model is used in the description of arterial system. Moreover, the feedback action of arterial pressure on cardiac cycle is taken into account. The phenomenon of mechanical periodicity (MP) of end diastolic volume (EDV) of left ventricle is successfully simulated by solving a series of one-dimensional discrete nonlinear dynamical equations. The effects of cardiovascular parameters on MP is also discussed. 展开更多
关键词 left ventricle end diastolic volume mechanical periodicity nonlinear dynamics
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Severity of Coronary Artery Disease by Coronary CT Angiography in Relation to Left Ventricular Diastolic Function 被引量:2
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作者 Wassam Eldin Hadad Elshafey Walaa Fareed Abdelaziz +1 位作者 Mohamed Seleem Mohamed Osama Mohamed Abdallah Omar 《World Journal of Cardiovascular Diseases》 2020年第4期235-245,共11页
Objectives:?The aim of this study is to evaluate the relationship between severity of CAD by coronary mutlislice computed tomography scan and the degree of diastolic function Methods:?The study consisted of 80 patient... Objectives:?The aim of this study is to evaluate the relationship between severity of CAD by coronary mutlislice computed tomography scan and the degree of diastolic function Methods:?The study consisted of 80 patients who underwent both coronary CTA and TTE within 1 year with no identifiable intervening cardiovascular event in National?Heart?Institute and Menoufia?University?Hospitals. All patients were subjected to detailed medical history, physical examination, full electrocardiography study including tissue Doppler imaging on mitral annulus, MSCT coronary angiography and different laboratory investigation as CBC, creatinine, lipid profile. Results:?From 80 patients who have done both echocardiography examination and MSCT coronary angiography, the CT scan results were 38 patients with non-obstructive coronary artery disease and 42 patients with obstructive CAD, higher number of patients with diastolic dysfunction with higher values of E/E’, medial e’, lateral e’, LAVI (left atrial volume index) and TRV (tricuspid regurge velocity) were found in the group with obstructive coronary artery disease.?Conclusion:?Our study showed that diastolic dysfunction is more prevalent in patients with obstructive coronary artery disease with higher grade of diastolic dysfunction. 展开更多
关键词 CORONARY Artery Disease diastolic DYSFUNCTION MSCT CORONARY ANGIOGRAPHY
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Correlation between ductus venosus spectrum and right ventricular diastolic function in isolated single-umbilical-artery foetus and normal foetus in third trimester 被引量:1
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作者 Tian-Gang Li Fang Nie Xiao-Yan Xu 《World Journal of Clinical Cases》 SCIE 2020年第23期5866-5875,共10页
BACKGROUND Single umbilical artery(SUA)is the most common umbilical cord malformation in prenatal diagnosis.The presence of an SUA can cause blood circulation disorder in the foetus and functional changes of the foeta... BACKGROUND Single umbilical artery(SUA)is the most common umbilical cord malformation in prenatal diagnosis.The presence of an SUA can cause blood circulation disorder in the foetus and functional changes of the foetal heart,affecting foetal circulation.The right ventricular diastolic functions in foetuses with isolated SUA and in normal foetuses in the third trimester were evaluated using the spectral Doppler of blood flow in the foetal ductus venosus(DV).AIM To evaluate the right ventricular diastolic functions in foetuses with isolated SUA and in normal foetuses in the third trimester.METHODS Colour Doppler was used to measure the spectrum of foetal DV and tricuspid orifice in 34 foetuses with isolated SUA aged 28-39 wk and in age-matched healthy controls.The DV flow velocities and velocity ratios were measured.The early passive/late active(E/A)ratio at the tricuspid orifice and tissue Doppler Tei index of the foetal right ventricular in the two groups were also measured.RESULTS During the third trimester,the isolated SUA group showed a lower‘a’-wave peak velocity in the DV than the control group(P<0.05).The correlations between the velocity ratios and E/A ratio at the tricuspid orifice in the two groups were analysed,and the correlation between the ventricular late diastolic velocity/ventricular diastolic peak flow velocity and E/A ratios was the best(R^2of the isolated SUA group:0.520;R2 of the control group:0.358).The correlations between the velocity ratios and tissue Doppler Tei index of foetal right ventricular in the two groups were analysed,and the correlation between the pulsatility index for veins(PIV)and tissue Doppler Tei index ratios was the best(R2 of the isolated SUA group:0.865;R2 of the control group:0.627).CONCLUSION In the isolated SUA group,the atrial systolic peak velocity‘a’decreased,and this finding might be related to the changes in foetal cardiac functions.The ratio of ventricular late diastolic velocity to ventricular diastolic peak flow velocity was closely related to the E/A ratio at the tricuspid valve and can be used to identify changes in the right ventricular diastolic functions of isolated SUA and healthy foetuses.PIV was closely related to the tissue Doppler Tei index of the foetal right ventricular and can be used to identify the right ventricular overall functions of isolated SUA and healthy foetuses. 展开更多
关键词 Isolated single umbilical artery Ductus venosus VELOCITY Right ventricular diastolic function FOETUS
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Reduction of diastolic blood pressure: Should hypertension guidelines include a lower threshold target? 被引量:1
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作者 Steven Tringali Jian Huang 《World Journal of Hypertension》 2017年第1期1-9,共9页
Reduction of diastolic blood pressure to less than 60-80 mm Hg does not improve mortality and may lead to adversecardiovascular events in high risk patient populations. Despite a growing body of evidence supporting th... Reduction of diastolic blood pressure to less than 60-80 mm Hg does not improve mortality and may lead to adversecardiovascular events in high risk patient populations. Despite a growing body of evidence supporting the J-curve phenomenon, no major society guidelines on hypertension include a lower threshold target for diastolic blood pressure. Many major society guidelines for hypertension have been updated in the last 5 years. Some guidelines include goals specific to age and co-morbid conditions. The Sixth Joint Task Force of the European Society of Cardiology and the Canadian Hypertension Education Program are the only guidelines to date that have recommended a lower threshold target, with the Canadian guidelines recommending a caution against diastolic blood pressure less than or equal to 60 mm Hg in patients with coronary artery disease. While systolic blood pressure has been proven to be the overriding risk factor in hypertensive patients over the age of 50 years, diastolic blood pressure is an important predictor of mortality in younger adults. Post hoc data analysis of previous clinical trials regarding safe lower diastolic blood pressure threshold remains inconsistent. Randomized clinical trials designed to determine the appropriate diastolic blood pressure targets among different age groups and populations with different comorbidities are warranted. Hypertension guideline goals should be based on an individual's age, level of risk, and certain co-morbid conditions, especially coronary artery disease, stroke, chronic kidney disease, and diabetes. 展开更多
关键词 Blood PRESSURE GUIDELINE J-CURVE Hypertension diastolic PRESSURE
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Do Continuous Flow LVADS Improve Diastolic Dysfunction? 被引量:1
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作者 Nandini Nair Sudhir Thotakura Enrique Gongora 《Open Journal of Organ Transplant Surgery》 2014年第3期23-28,共6页
Background: Ventricular assist devices are now used as a bridge to recovery/decision/transplant or as destination therapy in end-stage heart failure. Continued improvements in technology and pump design have made impl... Background: Ventricular assist devices are now used as a bridge to recovery/decision/transplant or as destination therapy in end-stage heart failure. Continued improvements in technology and pump design have made implantation an easier process with reduced operative risks and pump-related adverse events. Considering the beneficial effects of these devices in the clinical setting, it seemed logical to address the long-term effect of the continuous flow pumps on diastolic dysfunction. Methods: This study addresses the effect of HeartMate IITM(HMII) support for 284+/-97 days on echocardiographic parameters of diastolic function. Data from fifteen patients was retrospectively studied status post left ventricular assist device (LVAD) implantation. The data at approximately 1-year post implantation was compared with that obtained prior to implantation. Statistical analyses were performed using the Microsoft Excel Program/MSExcel Stats. Echocardiographic measurements were carried out in accordance with the American Society of Echocardiography guidelines. Results: Of all the echocardiographic parameters assessed only E/Ea and calculated left atrial pressure (LAP) showed a statistically significant decrease. Two parameters that showed a trend towards significance are Ea (septal) and global functional index (p = 0.05). Conclusions: Continuous Flow LVAD support appears to improve diastolic dysfunction. This study has limitations in that we used a single type of continuous flow device (HeartMate IITM) and was conducted as a retrospective analysis. Further studies with larger populations and longer support are required to validate this finding. 展开更多
关键词 CONTINUOUS Flow Device diastolic Function HeartMate IITM LEFT VENTRICULAR Assist Devise
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Efficacy of Yiqi Fumai (Freeze-Dried Powder) on Ischemic Diastolic Heart Failure 被引量:1
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作者 Dalin Song Mengfen Hu +3 位作者 Tongliang Han Hua Zhang Yongjun Mao Tao Tian 《Chinese Medicine》 2014年第2期75-86,共12页
Objective: To evaluate the efficacy of Yiqi Fumai freeze-dry powder (YFP) on ischemic diastolic heart failure. Methods: 100 patients diagnosed with unstable angina accompanying ischemic diastolic heart failure (IDHF) ... Objective: To evaluate the efficacy of Yiqi Fumai freeze-dry powder (YFP) on ischemic diastolic heart failure. Methods: 100 patients diagnosed with unstable angina accompanying ischemic diastolic heart failure (IDHF) were selected randomly. 52 patients with TCM syndrome of qi-yin deficiency were divided into Chinese and Western combination therapy group. 48 patients have no TCM syndrome of qi-yin deficiency, and were treated with standard western medicine. After treatment, Seattle Angina Questionnaire Evaluation, ECG, conventional and stress echocardiography (SE) index, NT-proBNP were compared between before and after treatment. Results: The differences of PL, TS, DP between before and after treatment by YFP were statistically significant 展开更多
关键词 Yiqi Fumai (Freeze-Dried Powder) diastolic Heart Failure Seattle ANGINA QUESTIONNAIRE (SAQ) Evaluation Stress ECHOCARDIOGRAPHY
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