Diastolic Dysfunction in Chronic Stable Angina. Intra-Exercise Comparison of Abnormal Impedance Waveform with Change in Ejection Fraction and Diastolic Filling Characteristics

1983 ◽  
Vol 64 (2) ◽  
pp. 31P-31P
Author(s):  
M.J. Bowles ◽  
A. Lahiri ◽  
R. Jones ◽  
W.D. Cooper ◽  
E.B. Raftery
Keyword(s):  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Diastolic Filling ◽  
Filling Characteristics

scholarly journals Hydraulic force is a novel mechanism of diastolic function that may contribute to decreased diastolic filling in HFpEF and facilitate filling in HFrEF

2021 ◽  
Vol 130 (4) ◽  
pp. 993-1000
Author(s):  
Katarina Steding-Ehrenborg ◽  
Erik Hedström ◽  
Marcus Carlsson ◽  
Elira Maksuti ◽  
Michael Broomé ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Physiological Mechanism ◽  
Diastolic Filling ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Hydraulic Force ◽  
Patients With Heart Failure ◽  
Cardiac Filling

It is a previously unrecognized physiological mechanism of the heart that diastolic filling occurs with the help of hydraulics. In patients with heart failure with preserved ejection fraction, atrial dilatation may cause the net hydraulic force to work against cardiac filling, thus further augmenting diastolic dysfunction. In contrast, it may work favorably in patients with dilated ventricles, as in heart failure with reduced ejection fraction.

Postoperative Diastolic Heart Failure

2020 ◽  
pp. 323-332
Author(s):  
Éimhín Dunne ◽  
Niall Fanning
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Diastolic Heart Failure ◽  
Disease Process ◽  
Left Ventricular Systolic Function ◽  
Ventricular Rate ◽  
Diastolic Filling ◽  
Management Scenario

This chapter explores acute diastolic heart failure, which presents a difficult management scenario in the early post–cardiac surgery period. Initial diagnosis is assisted by knowledge of the patient's medical history and intraoperative course. It is made using both clinical and echocardiographic parameters. Diastolic dysfunction often remains asymptomatic until late in the disease process. When it presents clinically, it can be associated with an abnormal ejection fraction or, more commonly, with preserved ejection fraction. The diagnosis of diastolic dysfunction requires 3 conditions: the presence of signs and/or symptoms, normal left ventricular systolic function, and increased diastolic filling pressures. Treatment for diastolic heart failure includes fluid therapy, diuretics, vasoactive medicines, control of ventricular rate in atrial fibrillation, and amiodarone.

scholarly journals Preoperative elevated E/e’ (≥ 15) with preserved ejection fraction is associated with the development of postoperative heart failure in intermediate-risk non-cardiac surgical patients

2020 ◽  
Vol 34 (2) ◽  
pp. 250-256 ◽  
Author(s):  
Midoriko Higashi ◽  
Kenji Shigematsu ◽  
Kenji Tominaga ◽  
Kazuya Murayama ◽  
Daisuke Seo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Clinical Symptoms ◽  
Left Ventricular ◽  
Surgical Patients ◽  
Diastolic Filling ◽  
Intermediate Risk ◽  
Preserved Ejection Fraction ◽  
Diastolic Velocity

Abstract Purpose Left ventricular diastolic dysfunction is an independent risk factor for adverse cardiovascular morbidities and mortalities in cardiovascular and high-risk surgical patients. However, there were only a few investigations among intermediate-risk surgical patients. This study aimed to investigate postoperative heart failure (HF) in intermediate-risk surgical patients who had preoperative diastolic dysfunction with preserved ejection fraction (EF). Methods Consecutive patients underwent intermediate-risk surgery between January 2016 and December 2018 were retrospectively evaluated. Patients with preserved EF were divided into three groups using one of the parameters of diastolic function: the ratio of early diastolic filling velocity to the peak diastolic velocity of mitral medial annulus (E/e’) ≥ 15, E/e’ between 8 and 15, and E/e’ < 8. Postoperative HF was defined as clinical symptoms and radiological evidence and low SpO2 less than 93%. The primary outcome was the incidence of postoperative HF and its relation to preoperative E/e’. Chi-squared test, unpaired t test with Welch’s correction, and multivariate logistic regression were used for analysis. Results In total, 965 patients were included in the final analysis. Postoperative HF developed in 36/965 (3.7%) patients with preserved EF. The incidence of postoperative HF was stratified according to the E/e’, and the rates of HF occurrence in patients with E/e’ < 8, 8–15, and ≥ 15 were 1.8%, 2.7%, and 15%, respectively (P < 0.01). Conclusion Preoperative elevated E/e’ (≥ 15) was associated with the development of postoperative HF in intermediate-risk surgical patients with preserved EF.

scholarly journals Early Impairment of Left Ventricular Function in Hypertensive Patients with Preserved Ejection Fraction using Tissue Doppler Echocardiography

2017 ◽  
Vol 9 (2) ◽  
pp. 147-154
Author(s):  
Rezwana Siddique ◽  
Tuhin Haque ◽  
Md Kabiruzzaman ◽  
Sohel Reza Chowdhury ◽  
Fazila Tun Nesa Malik ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Diastolic Filling ◽  
Preserved Ejection Fraction ◽  
Hypertensive Patients ◽  
Group 2

Background: Hypertension is an emerging risk factor for developing heart failure with preserved ejection fraction (HFpEF). Diastolic dysfunction most frequently associated with a subclinical impairment of systolic function in patients with HFpEF. The aim of this study was to detect early impairment of left ventricular function in hypertensive patients with preserved ejection fraction using Tissue Doppler Imaging (TDI).Methods: This cross-sectional study included a total 105 subjects who were divided into three groups (group-1: 35 healthy control; group-2: 35 hypertensive patients without concentric left ventricular hypertrophy, and group-3: 35 hypertensive patients with concentric left ventricular hypertrophy having left ventricular ejection fraction (LVEF)>50% on 2D echocardiography). They underwent TDI to measure systolic dysfunction by systolic annular velocity during systole (S´) and diastolic dysfunction by diastolic filling pressure (E/E´).Results: The results were obtained in 105 subjects: group-1 (40.63±5.0years; 34.4% male); group-2 (49.57±9.7years; 34.4% male) and group-3 (55.17±8.5years; 31.2% male). LVMI and RWT were significantly higher (p<0.001) in both hypertensive groups. The presence of systolic dysfunction by TDI as evidence by systolic annular velocity (S´) was significantly reduced (p<0.001) in both hypertensive groups compared to controls (0.08±0.11 vs.06±0.01 vs. 0.05±0.01).The presence of diastolic dysfunction by TDI as evidence by diastolic filling pressure (E/E´) were significantly higher (p<0.001) in both groups of hypertensive patients. There was significant correlation between E/E´ and S´(r = -593; p= <0.001).Conclusion: TDI provided a new insight into impaired systolic function by detecting lower values of S´ and impaired diastolic function by detecting higher values of E/E´ in hypertensive patients. This study was a clear reflection of early impairment of LV function in hypertensive patients (with or without C-LVH) and it might be helpful for identifying hypertensive patients who are at high risk for heart failure.Cardiovasc. j. 2017; 9(2): 147-154

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