scholarly journals Complementary supportive therapy for symptomatic patients with left ventricular dilatation and reduced ejection fraction

2021 ◽  
Vol 16 (1-2) ◽  
pp. 23-23
Author(s):  
Mila Jakovljević
Keyword(s):  
Ejection Fraction ◽  
Supportive Therapy ◽  
Left Ventricular ◽  
Ventricular Dilatation ◽  
Reduced Ejection Fraction ◽  
Left Ventricular Dilatation

Early Preload Adaptation in Septic Shock?

2001 ◽  
Vol 94 (3) ◽  
pp. 400-406 ◽  
Author(s):  
Antoine Vieillard-Baron ◽  
Jean-Marie Schmitt ◽  
Alain Beauchet ◽  
Roch Augarde ◽  
Sebastien Prin ◽  
...  
Keyword(s):  
Septic Shock ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Transesophageal Echocardiography ◽  
Left Ventricular ◽  
Ventricular Dilatation ◽  
Stroke Index ◽  
Short Axis ◽  
Fractional Area ◽  
Left Ventricular Dilatation

Background An accepted concept in septic shock is that preload adaptation by acute left ventricular dilatation, when occurring spontaneously or with the aid of volume loading, permits maintenance of an adequate cardiac output, leading to final recovery. From a physiologic point of view, this concept appears debatable because a normal pericardium exerts a restraining action on a normal heart. Methods During a 26-month period, the authors investigated, by transesophageal echocardiography, 40 patients hospitalized in their unit for an episode of septic shock. Transesophageal echocardiography was performed in the first hours after admission, proceeded by correction of any hypovolemia, and stabilization of arterial pressure by vasoactive agent infusion if necessary. Left ventricular dimensions were obtained in long- and short-axis views, permitting calculation of left ventricular ejection fraction (long axis) and fractional area contraction (short axis). Stroke index was simultaneously measured by the Doppler technique. Results Stroke index was strongly correlated with both echocardiographic left ventricle ejection fraction (r = 0.75; P < 0.0001) and left ventricle fractional area contraction (r = 0.76; P < 0.0001), whereas it was independent of echocardiographic left ventricle diastolic dimensions. Conclusions The transesophageal echocardiography study was unable to confirm the reality of the concept of early preload adaptation by left ventricular dilatation in septic shock. Conversely, because left ventricular volume always remained in a normal range after correcting hypovolemia, systolic function was the unique determinant of stroke index in septic shock.

Heart Failure with Preserved Ejection Fraction – A Review

2012 ◽  
Vol 9 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Otto A Smiseth ◽  
Anders Opdahl ◽  
Espen Boe ◽  
Helge Skulstad
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Heart Failure ◽  
The Elderly ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Objective Evidence

Heart failure with preserved left ventricular ejection fraction (HF-PEF), sometimes named diastolic heart failure, is a common condition most frequently seen in the elderly and is associated with arterial hypertension and left ventricular (LV) hypertrophy. Symptoms are attributed to a stiff left ventricle with compensatory elevation of filling pressure and reduced ability to increase stroke volume by the Frank-Starling mechanism. LV interaction with stiff arteries aggravates these problems. Prognosis is almost as severe as for heart failure with reduced ejection fraction (HF-REF), in part reflecting co-morbidities. Before the diagnosis of HF-PEF is made, non-cardiac etiologies must be excluded. Due to the non-specific nature of heart failure symptoms, it is essential to search for objective evidence of diastolic dysfunction which, in the absence of invasive data, is done by echocardiography and demonstration of signs of elevated LV filling pressure, impaired LV relaxation, or increased LV diastolic stiffness. Antihypertensive treatment can effectively prevent HF-PEF. Treatment of HF-PEF is symptomatic, with similar drugs as in HF-REF.

Autologous skeletal myoblast transplantation attenuates left ventricular dilatation without improving cardiac function

2003 ◽  
Vol 9 (5) ◽  
pp. S1
Author(s):  
Patrick I. McConnell ◽  
Louis Astra ◽  
E.William Schneeberger ◽  
Doug Jacoby ◽  
Jonathan Dinsmore ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Left Ventricular ◽  
Ventricular Dilatation ◽  
Skeletal Myoblast ◽  
Left Ventricular Dilatation ◽  
Myoblast Transplantation
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