Updated Clinical Importance of LV Diastolic Dysfunction and role of modern Echocardiography
![](https://www.texilajournal.com/thumbs/article/Echocardiogrphy.jpg)
Abstract:
In this review, we discussed about updated concept about diastolic dysfunction
of left ventricle and mechanism behind the diastolic heart failure with normal Ejection
fraction of LV using modern and advanced non-invasive technique of 2D Echocardiography.
In actual way, the invasive data
obtained from cardiac catheterization is considered the gold-standard to study LV
filling pressures and LV pressure volume curves. 2D Echocardiography
with advanced technology is useful, affordable and more convenient to the patients
those who have Hypertension, diabetes, thyroid disorders, infiltrative, restrictive
or hypertrophic cardiomyopathy, valvular disorders, pericarditis, severe pulmonary
hypertension and pre and post operative procedures. We can differentiate diastolic
heart failure from systolic heart failure based on parameters such as increased
myocardial stiffness, delayed isovolumic relaxation, increased LV filling pressure
and decreased LV Compliance but preserved LV Ejection fraction or systolic function
when patients present with dyspnoea on exertion or worsen heart failure.
Keywords-2D Echocardiography, diastolic functions, heart failure,
advanced diastology.
References:
Journal Article
[1].
Hyodo E., Arai K., Koczo A. Alteration in subendocardial and subepicardial myocardial
strain in patients with aortic valve stenosis: an early marker of left ventricular
dysfunction?. J Am Soc Echocardiogr. (2012);25:153-159.
[2].
Herrmann S., Störk S., Niemann M., Low-gradient aortic valve stenosis myocardial
fibrosis and its influence on function and outcome. J Am Coll Cardiol.
(2011);58:402-412.
[3].
Zile MR, Gaasch WH, Carroll JD, Heart failure with a normal ejection fraction:
is measurement of diastolic function necessary to make the diagnosis of diastolic
heart failure? Circulation. (2001);
104: 779–782.
[4].
Ingwall JS. Energetics of the normal and failing human heart: focus on the
creatineE kinase reaction. Adv Org Biol.
(1998);
4: 117–141.
[5].
Solaro RJ, Wolska BM, Westfall M. Regulatory proteins and diastolic relaxation.
In: Lorell BH, Grossman W, eds. Diastolic Relaxation of the Heart. Boston, Mass:
Kluwer Academic Publishers; 1988: 43–54.
[6].
Alpert NR, LeWinter M, Mulieri LA, Chemomechanical energy transduction in
the failing heart. Heart Fail Rev.
1999;
4: 281–295.
[7].
Tian R, Nascimben L, Ingwall JS, Failure to maintain a low ADP concentration
impairs diastolic function in hypertrophied rat hearts. Circulation. 1997; 96: 1313–1319.
[8].
Cooper GIV. Cardiocyte cytoskeleton in hypertrophied myocardium. Heart Fail Rev. 2000;
5: 187–201.
[9].
Kostin S, Hein S, Arnon E, The cytoskeleton and related proteins in the human
failing heart. Heart Fail Rev. 2000;
5: 271–280.
[10].
Paulus WJ. Beneficial effects of nitric oxide on cardiac diastolic function:
“the flip side of the coin.” Heart Fail Rev.
2000;
5: 337–344.
[11].
Hart CY, Hahn EL, Meyer DM, et al. Differential effects of natriuretic peptides
and NO on LV function in heart failure and normal dogs. Am J Physiol Heart Circ Physiol. 2001;
281: H146–H154.
[12].
Milano A.D., Faggian G., Dodonov M., Prognostic value of myocardial fibrosis in
patients with severe AVstenosis. J ThoracCardiovas.Surg.(2012);144:830-837.
[13].
Williams L., Howell N., Pagano D, Titin isoform expression in aortic stenosis. Clin
Sci (Lond). (2009);117:237-242.
[14].
Falcão-Pires I., Hamdani N., Borbély A., Diabetes mellitus worsens diastolic left
ventricular dysfunction in aortic stenosis through altered myocardial structure
and cardiomyocyte stiffness. Circulation. (2011);124:1151-1159.
[15].
Casaclang-Verzosa G., Nkomo V.T., Sarano M.E., Malouf J.F., Miller F.A., Oh J.K.;
E/Ea is the major determinant of pulmonary artery pressure in moderate to severe
aortic stenosis. J Am Soc Echocardiogr. (2008);21:824-827.
[16].
Lancellotti P., Magne J., Donal E., Determinants and prognostic significance of
exercise pulmonary hypertension in asymptomatic severe aortic stenosis. Circulation.
2012;126:851-859.
[17].
Nagueh S.F., Appleton C.P., Gillebert T.C., Recommendations for the evaluation of
left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr.
2009;22:107-133.
[18].
Weidemann F., Herrmann S., Störk S., Impact of myocardial fibrosis in patients with
symptomatic severe aortic stenosis. Circulation. 2009;120:577-584.
[19].
Azevedo C.F., Nigri M., Higuchi M.L., Prognostic significance of myocardial fibrosis
quantification by histopathology and magnetic resonance imaging in patients with
severe aortic valve disease. J Am Coll Cardiol. 2010;56:278-287.
[20].
Biner S., Rafique A.M., Goykhman P., Morrissey R.P., Naghi J., Siegel R.J.; Prognostic
value of E/E' ratio in patients with unoperated severe aortic stenosis. J Am
Coll Cardiol Img. 2010;3:899-907.
[21].
Lund O., Flø C., Jensen F.T, Left ventricular systolic and diastolic function in
aortic stenosis. Prognostic value after valve replacement and underlying mechanisms.
Eur Heart J. 1997;18:1977-1987.
[22].
Rasheed R. Zaid, MD; Colin M. Barker, MD; Stephen H. Little,
MD; Sherif F. Nagueh, MD J Am Coll Cardiol.(2013);62(21):1922-1930. doi:10.1016/j.jacc.2013.08.1619
[23].
SHEP Cooperative Research Group. Prevention
of stroke by antihypertensive drug therapy in older persons with isolated systolic
hypertension. final results of the Systolic Hypertension in the Elderly Program
(SHEP). JAMA. 265 1991:3255-3264.
[24].
Staessen J.A., Gasowski J., Wang J.G.;
Risks of untreated and treated isolated systolic hypertension in the elderly. meta-analysis
of outcome trials. Lancet. 355 2000:865-872.
[25].
Franklin S.S., Gustin W., Wong N.D.;
Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart
Study. Circulation. 96 1997:308-315.
[26].
Franklin S.S., Khan S.A., Wong N.D.;
Is pulse pressure useful in predicting risk for coronary heart disease? The Framingham
Heart Study. Circulation. 100 1999:354-360.
[27].
Franklin S.S., Larson M.G., Khan S.A.;
Does the relation of blood pressure to coronary heart disease risk change with aging?
The Framingham Heart Study. Circulation. 103 2001:1245-1249.
[28].
Franklin S.S., Khan S.A., Wong N.D.;
The relation of blood pressure to cardiovascular heart disease risk as a function
of age. the Framingham Heart Study. (abstr). J Am Coll Cardiol. 35 2000:291A
[29].
Safar M.E.; Epidemiological findings
imply that goals for drug therapy of hypertension need to be revised. (editorial).
Circulation. 103 2001:1188-1190.
[30].
Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield
MM (July 2006). "Trends in
prevalence and outcome of heart failure with preserved ejection fraction". N. Engl. J. Med. 355 (3): 251–9. doi:10.1056/NEJMoa 052256. PMID 16855265.
[31].
Bhatia RS, Tu JV, Lee DS, (July 2006). "Outcome of heart failure with preserved ejection
fraction in a population-based study". N. Engl. J.
Med. 355 (3): 260–9.
[32].
Jianwen Wang, PhD, MD; ( Nov. 2007):Left Ventricular Untwisting
Rate by Speckle Tracking Echocardiography, Circulation 2007, 116:2580-2586 .
[33].
Arq
Bras Cardiol. 2013 July; 101(1): 52–58. doi:
10.5935/abc.20130109, Relationship
Between Left Atrial Volume and Diastolic Dysfunction in 500 Brazilian Patients
[34].
European Journal of Echocardiography (2009)
10, 165–193,Recommendations for the Evaluation of Left Ventricular Diastolic Function
by Echocardiography Sherif F. Nagueh, MD, Chair†, Christopher P.
[35].
ejechocard/jep007 165-193 First published online: 6 March 2009, Sherif F. Nagueh, Christopher
P. Appleton, Thierry
C.
“Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography
.”
[36]. J Am Coll Cardiol Img May 2008” 1(3) 366-376 “twist mechanics of the left ventricle, principle
and application”, Partho P Sengupta
[37]. eurheartj/eht179 eht179 (May 2013) “Early diastolic
strain rate in relation to systolic and diastolic function and prognosis in acute
myocardial infarction: a two-dimensional speckle-tracking study”, Mads Ersbøll, J. Andersen, Mogensen.
[38]. euu167, 16 July 2014 Zoltan Bakos, Ellen Ostenfeld ‘A comparison between radial strain evaluation by
speckle-tracking echocardiography and cardiac magnetic resonance imaging, for assessment
of suitable segments for left ventricular lead placement in cardiac resynchronization
therapy.’
[39].
j.echo.2007.05.035 Hideji Tanaka, MD,Yoshifumi
Oishi, MD ‘Contribution of the Pericardium to Left Ventricular Torsion and Regional
Myocardial Function in Patients with Total Absence of the Left Pericardium.’
[40].
ejechocard/jer172 95-103 September 2011 “Torsion analysis in the early detection of anthracycline-mediated
cardiomyopathy”.
[41].
Circulation. 2012, 126-2353-2362. Diastolic Dysfunction and Risk of Atrial
Fibrillation: A Mechanistic Appraisal, Michael
A. Rosenberg
Book Articles
[1].
Eric J. Topol; Robert M. Califf (2007). Textbook of cardiovascular medicine. Lippincott Williams & Wilkins. pp. 420–. ISBN 978-0-7817-7012-5. Retrieved
16 November 2010.
[2].
Crowley, Leonard V. (2013).
An Introduction to Human Disease: Pathology and Pathophysiology Correlations. Jones & Bartlett Publishers. p. 323. ISBN 9781449632403. Retrieved
16 August 2014.
[3].
Germing, A.; Gotzmann, M.; Schikowski, T.; Vierkötter, A.;
Ranft, U.; Krämer, U.; Mügge, A. (2011). "High frequency of diastolic
dysfunction in a population-based cohort of elderly women - but poor association
with the symptom dyspnea". BMC Geriatrics 11:
71. doi:10.1186/1471-2318-11-71. PMC 3219735. PMID 22047619. edit Hurst (2001), p. 709.