scholarly journals Prevalence of Subclinical Levt Ventricular Diastolic Dysfunction in Patient with Metabolic Syndrome in West Region of the Republic of Macedonia

2018 ◽  
pp. 1-9
Author(s):  
Jani Y
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Metabolic Syndrome ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Western Region ◽  
Republic Of Macedonia ◽  
West Region ◽  
Ventricular Diastolic Dysfunction ◽  
The Republic

Background: Metabolic Syndrome (MetS) has been associated with subclinical changes in cardiac structure and function, including left ventricular diastolic dysfunction (LVDD) and is strong risk factors for the future development of clinical heart failure, and specifically increases the risk of heart failure with preserved ejection fraction. To date, the evidence on the prevalence of subclinical LVDD in patient with MetS and relation to components of the MetS, in west region of the Republic of Macedonia are scarce. Objective: We sought to determine the prevalence of subclinical LVDD and relation to components of the MetS, in patient with MetS in our region. Methods: We conducted a multicenter observational cross-sectional study. Recruited were 550 consecutive participants,450 with MetS (mean age 50 years,49% women) and 100 controls (no risk factors for MetS; mean 51 years,57% women) , who attended outpatient visits at general cardiology Health Care Clinics in 6 town on western region Republic of Macedonia, during 1 calendar year. Pertcipans underwent echocardiography with tissue Doppler imaging. Results: Participants with MetS, have significantly increased frequency of subclical LVDD grade 1, in comparation with participants without MetS. (39, 7% vs. 6%, p=0.0005). The overall frequency of subclinical LVDD grade 1, in participants with MetS, was 39, 7%; p=0.0005). Subjects with MetS also had worse measures of diastolic function, including: higher Lev Atrial Volum index {(LAVI), (p=0.00), Lower E/A ratio (p=0.00),lower mean e’(p=0.00) and lower E/ e’ ratio(p=0.00), increased Deceleratio time {(DT),(p=0.00)} and Isovolumetric Relaxation time{(IVRT), (p=0.00). Overall, participants with subclinical LVDD, had a worse cardiovascular risk factor profile, including: higher BMI (p=0.001), higher blood pressure{(BP) (p=0.003)}, elevated Weist circumference{(WC)(p=0.001)} and dyslipidemia (p=0.000) in comparation with participants with normal diastolic function. Also, participants with subclinical LVDD,have more risk factors for MetS than participants with normal diastolic function (p=0.002). There was a significant assotiation between subclinical LVDD and: Age (OR=1.108; 95% CI 1.051 -1.168), Females (OR=3.633; 95% CI2.439-5.413), BMI (OR=7.474; 95% CI 4.881-11.443), control of BP (OR=1.763; 95% CI 1.204-2.580) and number of MetS risk factors (OR= 3.609; 95% CI 2.054-6.340). Conclusion: The prevalence of subclinical LVDD in the patients with MetS, in abscence of coronary disease and other well know heart disease, is considerablye high in western region of the Republic of Macedonia and seem to be significantly associated with age, gender, BMI, Levt Ventricular mass index (LVMI) and number of risk factors for MetS.

Nghiên cứu đánh giá chức năng tâm trương thất trái theo khuyến cáo ASE/EACVI 2016 ở bệnh nhân bệnh cơ tim giãn

2021 ◽  
Author(s):  
Quang Tuan Pham
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Ventricular Diastolic Function ◽  
Ventricular Diastolic Dysfunction ◽  
The Mean

TÓM TẮT Mục tiêu: Khảo sát chức năng tâm trương thất trái theo khuyến cáo ASE/EACVI 2016 ở bệnh nhân bệnh cơ tim giãn bằng siêu âm tim. Tìm hiểu mối liên quan giữa chức năng tâm trương thất trái với tình trạng giãn thất trái, độ suy tim NYHA, phân suất tống máu thất trái, phân suất co cơ thất trái. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang trên 56 bệnh nhân bệnh cơ tim giãn nguyên phát được nhập viện và điều trị tại bệnh viện Trung ương Huế từ tháng 4/2018 đến tháng 8/2020. Kết quả: Đường kính thất trái cuối tâm trương và cuối tâm thu trung bình là 66,11 ± 7,3 mm và 57,7 ± 8,02 mm. Đường kính nhĩ trái trung bình là 40,61 ± 7,65 mm. Phân suất tống máu thất trái trung bình là 24,68 ± 5,97 %. Phân suất co cơ thất trái trung bình là 12,91 ± 4,55 %. Tất cả các bệnh nhân nhóm nghiên cứu đều có rối loạn chức năng tâm trương thất trái. Chiếm tỷ lệ cao nhất là rối loạn chức năng tâm trương độ II (44,6%), tiếp sau là rối loạn chức năng tâm trương độ III (35,8%) và rối loạn chức năng tâm trương độ I là 19,6%. Không có sự liên quan có ý nghĩa thống kê giữa mức độ rối loạn tâm trương thất trái với đường kính thất trái cuối thì tâm thu và tâm trương (p > 0,05). Có mối liên quan giữa rối loạn chức năng tâm trương thất trái với các thông số phân suất tống máu EF và phân suất co cơ FS (p < 0,005). Có sự tương quan thuận mức độ vừa giữa phân độ rối loạn chức năng tâm trương thất trái với phân độ suy tim theo NYHA với r = 0,445, sự tương quan đó có ý nghĩa thống kê (p < 0,001). Kết luận: Tất cả các bệnh nhân bệnh cơ tim giãn trong nhóm nghiên cứu đều có rối loạn chức năng tâm trương thất trái, chủ yếu là rối loạn chức năng tâm trương nặng độ II - III. Sự rối loạn này thể hiện rõ qua sự biến đổi các thông số đánh giá chức năng tâm trương thất trái trên siêu âm tim theo khuyến cáo ASE/ EACVI 2016, một khuyến cáo mới đưa ra nhằm tiếp cận đánh giá chức năng tâm trương một cách thuận tiện và dễ dàng hơn. Từ khóa: Bệnh cơ tim giãn, rối loạn chức năng tâm trương thất trái, khuyến cáo ASE/EACVI 2016 ABSTRACT EVALUATION OF LEFT DYSTOLIC FUNCTION ACCORDING TO THE RECOMMENDATION ASE/EACVI 2016 INPATIENTS WITH DILATED CARDIOMYPAHTIES Background: Dilated cardiomyopathy is a disease of the heart muscle, characterized by dilatation of the heart chamber and a dysfunction of the left or both ventricles. It often leads to progressive heart failure, and is the leading cause of heart transplant among all cardiomyopathy. The annual rate of sudden cardiac death in dilated cardiomyopathy is 2 - 4%, with sudden death accounting for half of all deaths [9]. Echocardiography is an evaluation of a patient with dilated cardiomyopathy. There have been many studies on dilated cardiomyopathy in the world. However, there are still few studies evaluating diastolic function in patients with dilated cardiomyopathy using cardiac Doppler echocardiography. Experts around the world have made many recommendations in assessing left ventricular diastolic function, most recently is the recommendation ASE/EACVI 2016. Comparing with the 2009 EAE/ASE recommendation, the recommendation ASE/EACVI 2016 for assessment of left ventricular diastolic function has fewer parameters, so it is easier to implement and more convenient in clinical practice. Objective: Surveying left ventricular diastolic function according to the recommendation ASE/EACVI 2016 in patients with dilated cardiomyopathy by echocardiography and investigating the relationship between left ventricular diastolic function with left ventricular dilatation, heart failure NYHA, left ventricular ejection fraction, left ventricle fractional shortening. Methods: Research was designed as a cross - sectional descriptive study. Studied on 56 patients with primary dilated cardiomyopathy were hospitalized and treated at Hue Central Hospital. Results: The results showed: The mean end - diastolic and end - systolic left ventricular diameters were 66,11 ± 7,3 mm and 57,7 ± 8,02 mm. The mean left atrial diameter was 40,61 ± 7,65 mm. The mean left ventricular ejection fraction was 24,68 ± 5,97%. The mean fractional shortening of left ventricular contraction was 12,91 ± 4,55%. All patients in the study group had left ventricular diastolic dysfunction. The highest proportion is diastolic dysfunction grade II (44,6%), followed by diastolic dysfunction grade III (35,8%) and diastolic dysfunction grade I is 19,6%. There was no statistically significant relationship between the classification of left ventricular diastolic dysfunction and left ventricular systolic and diastolic diameter (p > 0.05). There is a relationship between left ventricular diastolic dysfunction and parameters of ejection fraction EF and contraction fraction FS (p < 0.005). There is a moderate positive correlation between the classification of left ventricular diastolic dysfunction and the heart failure rating according to NYHA (r = 0,445, p < 0,001). Conclusion: All patients in the study group had left ventricular diastolic dysfunction, mostly grade II and grade III diastolic dysfunction. This disorder is clearly demonstrated by the change in the parameters of the left ventricular diastolic function assessment on echocardiography according to the 2016 ASE/ EACVI recommendations, a new recommendation introduced to approach the assessment of diastolic functionmore convenient and easier way. Key words: Dilated cardiomyopathy, left ventricular diastolic dysfunction, the recommendation ASE / EACVI 2016.

scholarly journals Prevalence and Risk Factors of Left Ventricular Diastolic Dysfunction in Patients With Hyperthyroidism

2021 ◽  
Vol 11 ◽  
Author(s):  
Huan Li ◽  
Renli Zeng ◽  
Yunfei Liao ◽  
Mengfei Fu ◽  
Huan Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Thyroid Hormones ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Left Ventricular ◽  
Obese Patients ◽  
Control Subjects ◽  
Lv Diastolic Dysfunction ◽  
Overt Hyperthyroidism

BackgroundLeft ventricular (LV) diastolic dysfunction has been demonstrated to be an independent predictor of the future heart failure. Heart failure is one of the severe complications caused by overt hyperthyroidism. However, the effects of overt hyperthyroidism on diastolic dysfunction are conflicting, and little is known about the prevalence and risk factors of the diastolic dysfunction in patients with overt hyperthyroidism.MethodsA total of 388 patients with overt hyperthyroidism were included and compared with 388 age- and gender- matched euthyroid control subjects. LV diastolic function was evaluated by traditional and tissue-Doppler echocardiography. Routine clinical medical data and echocardiographic parameters were recorded for analysis.ResultsThe prevalence of LV diastolic dysfunction was 35.1% among hyperthyroid patients and significantly higher than control subjects whose prevalence was 25.5% (P = 0.003), and it increased with age and body mass index (BMI) in patients with overt hyperthyroidism. The possible risk factors for LV diastolic dysfunction, such as hypertension, diabetes, decreased estimated glomerular filtration rate (eGFR), and increased level of thyroid hormones weren’t associated with LV diastolic dysfunction. However, overweight or obese were significantly associated with LV diastolic dysfunction (OR = 3.024, 95% CI = 1.517–6.027, P = 0.002) compared with normal BMI. When compared with age &lt;40 years old group, 40-50 years old group, 50-60 years old group and age ≥60 years old group were significantly associated with LV diastolic dysfunction, with ORs of 2.976 (95% CI = 1.744–5.019), 12.424 (95% CI = 4.934–31.283), 24.966 (95% CI = 5.975–104.321), respectively.ConclusionLV diastolic dysfunction was very common, in particular, in older and overweight or obese patients with overt hyperthyroidism. Additionally, age and BMI were independent risk factors for LV diastolic dysfunction, while the level of thyroid hormones was not. Therefore, besides the LV systolic function, we also need focus on the diastolic function in patients with overt hyperthyroidism in clinical work, especially the older and overweight or obese patients.

scholarly journals Significance of Electrocardiographic QTc Interval on Assessment of Left Ventricular Diastolic Dysfunction in Hypertensive Patient: A Simple Screening Tool

2019 ◽  
Vol 5 (1) ◽  
pp. 44
Author(s):  
Sheila Dhiene Putri ◽  
Harris Hasan ◽  
Refli Hasan ◽  
A. Afif Siregar ◽  
Nizam Akbar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Screening Tool ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Qtc Interval ◽  
Strong Negative Correlation ◽  
Ventricular Diastolic Dysfunction

Background: Diastolic dysfunction as part of heart failure with preserved ejection fraction (HFpEF) has gain interests, due to the increasing prevalence rate and poor prognosis. Besides the mechanism is not fully understood, there are some difficulties in detecting the presence of diastolic dysfunction. Previous studies have shown correlation between some electrocardiographic parameters and diastolic function. Furthermore, the aim of this study is to assess the diagnostic value of the QTc interval in detecting left ventricular diastolic dysfunction.Methods: A cross sectional study was conducted on patients with clinical suspicion of heart failure. Electrocardiographic examination was performed to obtain QTc interval (msec) using the Bazett formula. Left ventricular diastolic function was assessed using Tissue Doppler Imaging by echocardiography. Using correlation test and ROC method, the relationships between QTc interval and LV diastolic function were investigated.Results: Of 82 patients analyzed, there were 62 patients (75.9%) known to have diastolic dysfunction. The QTc interval was found to be longer in the group with diastolic dysfunction compared to the normal group (442.9±27 vs. 402.1±18.2, p <0.001). There was a strong negative correlation between the QTc interval and diastolic function (r = -0.619; p <0.001). Using ROC analysis, the cut off point for QTc interval was 410 ms with 91% sensitivity, 70% specificity, and 90% positive predictive value.Conclusion: The QTc interval is an accurate, simple and highly feasible electrocardiographic parameter as a screening tool to determine the presence of left ventricular diastolic dysfunction.

scholarly journals Metformin improves diastolic dysfunction of non-diabetic patients with metabolic syndrome: the MET-DIME randomized trial

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
D Santos-Ferreira ◽  
R Ladeiras-Lopes ◽  
F Sampaio ◽  
S Leite ◽  
E Vilela ◽  
...  
Keyword(s):  
Heart Failure ◽  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Primary Endpoint ◽  
Diabetic Patients ◽  
Lifestyle Counseling ◽  
Sf 36 ◽  
Change In Mean

Abstract Background Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors, including abdominal obesity, dyslipidaemia, arterial hypertension and abnormal glucose homeostasis, which occur together more frequently than by chance. Diastolic dysfunction (DD) is one of the most frequent manifestations of subclinical cardiac involvement of MetS, ultimately leading to heart failure with preserved ejection fraction. Metformin's new potential therapeutic actions include prevention of cardiac remodeling and fibrosis. Purpose We aimed to evaluate if metformin improves diastolic function (DF) in non-diabetic patients with MetS. Methods A prospective, randomized, open-label, blinded-endpoint trial was conducted over 24 months. Fifty-four non-diabetic adults with MetS and DD (defined as mean e'&lt;10.2cm/s or &lt;7.2cm/s for individuals 40–59 and 60–65 years old, respectively) were randomized to lifestyle counseling (control arm) or lifestyle counseling plus metformin (intervention arm) on a target dose of 1000 mg bid (figure 1). The primary endpoint was the change in mean e' velocity, assessed at 6, 12 and 24 months. Secondary endpoints included improvements in insulin resistance (HOMA-IR), functional capacity (peak oxygen uptake – VO2) and QoL (SF-36 score). Linear mixed effects modelling was used for longitudinal data analysis based on modified intention-to-treat (mITT) and per-protocol (PP) approaches. Results Forty-nine patients (mean age=51.8±6.4; 55% males) were included in the mITT analysis. Metformin use, on top of lifestyle counseling, led to an increase in mean e' velocity during follow-up (figure 2), with results at 24 months of +0.67±1.90cm/s (vs. −0.33±1.50cm/s in the control group, p=0.056), which reached statistical significance in PP analysis (+0.80±1.99cm/s vs. −0.37±1.52cm/s, p=0.039). In a random intercept linear mixed model adjusting for age, gender, treatment with drugs targeting the renin-angiotensin-aldosterone axis, presence of heart failure and baseline degree of DD, both mITT and PP analysis showed a statistically significant improvement of DF with metformin over time (β-coefficient=0.28, standard error (SE)=0.13, p=0.034, and β-coefficient=0.35, SE=0.14, p=0.011, respectively). This effect was independent of the observed reduction in insulin resistance. There were no differences regarding peak VO2 nor SF-36 score. Conclusions Treatment with metformin of non-diabetic MetS patients with DD, on top of lifestyle counseling, was associated with improved diastolic function. FUNDunding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Merck Study algorithm Primary endpoint results

Estimation of Left Ventricular Wall Stiffness by Analysis of Late Diastolic Pressure Components

2011 ◽  
Author(s):  
Casandra L. Niebel ◽  
Kelley C. Stewart ◽  
Takahiro Ohara ◽  
John J. Charonko ◽  
Pavlos P. Vlachos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Diastolic Pressure ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Ventricular Wall ◽  
Ventricular Relaxation ◽  
Wall Stiffness ◽  
Ventricular Diastolic Dysfunction

Left ventricular diastolic dysfunction (LVDD) is any abnormality in the filling of the left ventricle and is conventionally evaluated by analysis of the relaxation driven phase, or early diastole. LVDD has been shown to be a precursor to heart failure and the diagnosis and treatment for diastolic failure is less understood than for systolic failure. Diastole consists of two filling waves, early and late and is primarily dependent on ventricular relaxation and wall stiffness.

scholarly journals Diastolic dysfunction in individuals with and without heart failure with preserved ejection fraction

2021 ◽  
Author(s):  
Jan-Per Wenzel ◽  
Ramona Bei der Kellen ◽  
Christina Magnussen ◽  
Stefan Blankenberg ◽  
Benedikt Schrage ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Risk ◽  
General Population ◽  
Diastolic Dysfunction ◽  
Cardiovascular Risk Factors ◽  
Population Based ◽  
Left Ventricular ◽  
Health Study ◽  
Common Finding

Abstract Aim Left ventricular diastolic dysfunction (DD), a common finding in the general population, is considered to be associated with heart failure with preserved ejection faction (HFpEF). Here we evaluate the prevalence and correlates of DD in subjects with and without HFpEF in a middle-aged sample of the general population. Methods and results From the first 10,000 participants of the population-based Hamburg City Health Study (HCHS), 5913 subjects (mean age 64.4 ± 8.3 years, 51.3% females), qualified for the current analysis. Diastolic dysfunction (DD) was identified in 753 (12.7%) participants. Of those, 11.2% showed DD without HFpEF (ALVDD) while 1.3% suffered from DD with HFpEF (DDwHFpEF). In multivariable regression analysis adjusted for major cardiovascular risk factors, ALVDD was associated with arterial hypertension (OR 2.0, p < 0.001) and HbA1c (OR 1.2, p = 0.007). Associations of both ALVDD and DDwHFpEF were: age (OR 1.7, p < 0.001; OR 2.7, p < 0.001), BMI (OR 1.2, p < 0.001; OR 1.6, p = 0.001), and left ventricular mass index (LVMI). In contrast, female sex (OR 2.5, p = 0.006), atrial fibrillation (OR 2.6, p = 0.024), CAD (OR 7.2, p < 0.001) COPD (OR 3.9, p < 0.001), and QRS duration (OR 1.4, p = 0.005) were strongly associated with DDwHFpEF but not with ALVDD. Conclusion The prevalence of DD in a sample from the first 10,000 participants of the population-based HCHS was 12.7% of whom 1.3% suffered from HFpEF. DD with and without HFpEF showed significant associations with different major cardiovascular risk factors and comorbidities warranting further research for their possible role in the formation of both ALVDD and DDwHFpEF.

Sign in / Sign up

Export Citation Format

Share Document