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Article: Left ventricular long axis function in diastolic heart failure is reduced in both diastole and systole: Time for a redefinition?

TitleLeft ventricular long axis function in diastolic heart failure is reduced in both diastole and systole: Time for a redefinition?
Authors
Issue Date2002
PublisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/
Citation
Heart, 2002, v. 87 n. 2, p. 121-125 How to Cite?
AbstractObjective: To test the hypothesis that, when measured in the long axis, left ventricular systolic function is abnormal in patients with diastolic heart failure. Design: A case-control study. Setting: University teaching hospital (tertiary referral centre). Patients: 68 patients with heart failure, 29 with a left ventricular ejection fraction (LVEF) of > 0.45 and diastolic dysfunction (diastolic heart failure), 39 with an LVEF of ≤ 0.45 (systolic heart failure), and 105 normal subjects, including 33 age matched controls. Methods: LVEF was measured by cross sectional Simpson's method, and mitral annular amplitudes and velocities by M mode and tissue Doppler echocardiography, respectively, along with mitral Doppler inflow velocities. Results were compared between the three groups. Main outcome measures: Peak systolic mitral annular velocity and amplitude between the different groups. Results: The mitral annular peak mean velocity and amplitude in systole were lower in the patients with diastolic heart failure (mean (SEM), 4.8 (0.2) cm/s) than in the age matched normal controls (6.1 (0.14) cm/s), but higher than those with systolic heart failure (2.8 (0.13) cm/s) (all p < 0.001). Similar changes were seen the mitral annular amplitude during systole. Peak early diastolic velocity and amplitude were also significantly reduced in the group with diastolic heart failure. Left ventricular hypertrophy was evident in over 95% patients in both diastolic and systolic heart failure groups, with a comparable left ventricular mass index. Conclusions: In patients with diastolic heart failure and evidence of left ventricular hypertrophy, there is systolic left ventricular impairment as measured by myocardial Doppler imaging of the longitudinal axis. Thus subtle abnormalities of systolic function are present in patients with heart failure and a normal left ventricular ejection fraction, and there appears to be a continuum of systolic function between those with truly normal, mildly impaired (labelled diastolic heart failure), and obviously abnormal left ventricular systolic function. Isolated diastolic dysfunction is uncommon.
Persistent Identifierhttp://hdl.handle.net/10722/162582
ISSN
2015 Impact Factor: 5.693
2015 SCImago Journal Rankings: 2.647
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYip, Gen_US
dc.contributor.authorWang, Men_US
dc.contributor.authorZhang, Yen_US
dc.contributor.authorFung, JWHen_US
dc.contributor.authorHo, PYen_US
dc.contributor.authorSanderson, JEen_US
dc.date.accessioned2012-09-05T05:21:24Z-
dc.date.available2012-09-05T05:21:24Z-
dc.date.issued2002en_US
dc.identifier.citationHeart, 2002, v. 87 n. 2, p. 121-125en_US
dc.identifier.issn1355-6037en_US
dc.identifier.urihttp://hdl.handle.net/10722/162582-
dc.description.abstractObjective: To test the hypothesis that, when measured in the long axis, left ventricular systolic function is abnormal in patients with diastolic heart failure. Design: A case-control study. Setting: University teaching hospital (tertiary referral centre). Patients: 68 patients with heart failure, 29 with a left ventricular ejection fraction (LVEF) of > 0.45 and diastolic dysfunction (diastolic heart failure), 39 with an LVEF of ≤ 0.45 (systolic heart failure), and 105 normal subjects, including 33 age matched controls. Methods: LVEF was measured by cross sectional Simpson's method, and mitral annular amplitudes and velocities by M mode and tissue Doppler echocardiography, respectively, along with mitral Doppler inflow velocities. Results were compared between the three groups. Main outcome measures: Peak systolic mitral annular velocity and amplitude between the different groups. Results: The mitral annular peak mean velocity and amplitude in systole were lower in the patients with diastolic heart failure (mean (SEM), 4.8 (0.2) cm/s) than in the age matched normal controls (6.1 (0.14) cm/s), but higher than those with systolic heart failure (2.8 (0.13) cm/s) (all p < 0.001). Similar changes were seen the mitral annular amplitude during systole. Peak early diastolic velocity and amplitude were also significantly reduced in the group with diastolic heart failure. Left ventricular hypertrophy was evident in over 95% patients in both diastolic and systolic heart failure groups, with a comparable left ventricular mass index. Conclusions: In patients with diastolic heart failure and evidence of left ventricular hypertrophy, there is systolic left ventricular impairment as measured by myocardial Doppler imaging of the longitudinal axis. Thus subtle abnormalities of systolic function are present in patients with heart failure and a normal left ventricular ejection fraction, and there appears to be a continuum of systolic function between those with truly normal, mildly impaired (labelled diastolic heart failure), and obviously abnormal left ventricular systolic function. Isolated diastolic dysfunction is uncommon.en_US
dc.languageengen_US
dc.publisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/en_US
dc.relation.ispartofHearten_US
dc.titleLeft ventricular long axis function in diastolic heart failure is reduced in both diastole and systole: Time for a redefinition?en_US
dc.typeArticleen_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1136/heart.87.2.121-
dc.identifier.pmid11796546-
dc.identifier.scopuseid_2-s2.0-0036153340en_US
dc.identifier.volume87en_US
dc.identifier.issue2en_US
dc.identifier.spage121en_US
dc.identifier.epage125en_US
dc.identifier.isiWOS:000173450000010-
dc.publisher.placeUnited Kingdomen_US

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