Entendendo a disfunção diastólica assintomática na prática clínica

Mesquita, Evandro Tinoco; Jorge, Antônio José Lagoeiro

doi:10.1590/s0066-782x2013000100015

Cited by 11 publications

(9 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite being an important tool to assess remodeling and, indirectly, LA function, the indexed LA volume has low sensitivity in the early stages. 19 In turn, variations in the E/e' parameter are also linked to chronic conditions, 13,20 which justifies the absence of changes in both parameters in the present study. Timóteo et al 16 showed significant indexed LA volume changes, but not until later -on 12-month echocardiography follow-up.…”

Section: Barroso Et Al Early Diastolic Dysfunction After Chemotherapysupporting

confidence: 71%

Early Diastolic Dysfunction in Breast Cancer Patients Undergoing Chemotherapy

Barroso¹,

Silva²,

Teles³

et al. 2021

Arq Bras Cardiol: Imagem Cardiovasc

View full text Add to dashboard Cite

Background: Chemotherapy for breast cancer is associated with serious cardiovascular complications such as heart failure. The left ventricular ejection fraction is the main parameter used to assess systolic function in these patients. However, the occurrence of diastolic dysfunction may precede that of systolic dysfunction.Objectives: To evaluate left ventricle diastolic and systolic functions in women with breast cancer undergoing chemotherapy using anthracyclines.Methods: This observational, longitudinal, analytical, and prospective study included 62 women with breast cancer aged 21-75 years old who underwent echocardiography at baseline and after three months of treatment. Diastolic function parameters were evaluated, and the patients were classified as diastolic dysfunction type 1, 2, or 3. Systolic dysfunction was defined as a left ventricular ejection fraction ≤ 53%.Results: After three months of treatment, 35 patients (56.4%) had type 1 diastolic dysfunction, while one (1.6%) had type 2. Diastolic dysfunction was identified in 26 patients at baseline and developed in 10 patients during treatment. Diastolic function parameters, E wave velocity, and E/A ratio decreased significantly (p < 0.05) with chemotherapy; however, the others showed no significant variations. Only three patients had systolic dysfunction, but there was a greater reduction in left ventricular ejection fraction in the group that developed diastolic dysfunction during treatment versus the group with diastolic dysfunction at baseline (p = 0.04). Conclusion:Diastolic dysfunction occurs early in women with breast cancer undergoing chemotherapy. Its onset during the course of treatment is associated with a significantly reduced left ventricular ejection fraction.

show abstract

Section: Barroso Et Al Early Diastolic Dysfunction After Chemotherapysupporting

confidence: 71%

Early Diastolic Dysfunction in Breast Cancer Patients Undergoing Chemotherapy

Barroso¹,

Silva²,

Teles³

et al. 2021

Arq Bras Cardiol: Imagem Cardiovasc

View full text Add to dashboard Cite

show abstract

“…Cardiomyopathy is characterized by increased myocardial stiffness and left ventricular mass (cardiac hypertrophy) [ 55 , 56 ]. At the beginning, it is an asymptomatic impairment of left ventricular diastolic function that leads to symptomatic diastolic dysfunction and finally the systolic function becomes impaired too [ 57 , 58 , 59 ]. Diastolic left ventricular (LV) dysfunction (a restrictive phenotype) has been linked to concentric hypertrophy of LV, and eccentric remodeling of LV has been linked to systolic dysfunction (a dilated phenotype).…”

Section: Diabetic Cardiomyopathymentioning

confidence: 99%

Metabolic Effects of Metformin in the Failing Heart

Dziubak

Wójcicka

Wojtak

et al. 2018

IJMS

View full text Add to dashboard Cite

Accumulating evidence shows that metformin is an insulin-sensitizing antidiabetic drug widely used in the treatment of type 2 diabetes mellitus (T2DM), which can exert favorable effects on cardiovascular risk and may be safely used in patients with heart failure (HF), and even able to reduce the incidence of HF and to reduce HF mortality. In failing hearts, metformin improves myocardial energy metabolic status through the activation of AMP (adenosine monophosphate)-activated protein kinase (AMPK) and the regulation of lipid and glucose metabolism. By increasing nitric oxide (NO) bioavailability, limiting interstitial fibrosis, reducing the deposition of advanced glycation end-products (AGEs), and inhibiting myocardial cell apoptosis metformin reduces cardiac remodeling and hypertrophy, and thereby preserves left ventricular systolic and diastolic functions. While a lot of preclinical and clinical studies showed the cardiovascular safety of metformin therapy in diabetic patients and HF, to confirm observed benefits, the specific large-scale trials configured for HF development in diabetic patients as a primary endpoints are necessary.

show abstract

“…Diastolic dysfunction is associated with adverse outcomes and its prevalence among hypertensive, hyperlipidemic and diabetic adults is very high 2 . It has been shown that lowering blood pressure and heart rate, management of impaired lipid profile and blood glucose could improve diastolic dysfunction 2 .…”

mentioning

confidence: 99%

“…It has been shown that lowering blood pressure and heart rate, management of impaired lipid profile and blood glucose could improve diastolic dysfunction 2 . Also, thyroid dysfunction has been associated with the development of diastolic dysfunction even in patients without underlying heart disease 3 .…”

mentioning

confidence: 99%