Age dependency in the timing of mitral annular motion in relation to ventricular filling in healthy subjects: Umea General Population Heart Study

Bukachi, Frederick; Waldenström, Anders; Mörner, Stellan; Lindqvist, Per; Henein, Michael Y.; Kazzam, Elsadig

doi:10.1093/ejechocard/jen124

Cited by 9 publications

(7 citation statements)

References 21 publications

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“…However, interestingly, we found that in group 5, EDTD decreased substantially compared to other groups. These findings were in partial agreement with previous studies 4,8,23 . The substantial decrease in EDTD in group 5 might be caused by reduced LV relaxation (i.e.…”

Section: Early Diastolic Phasesupporting

confidence: 93%

Left Ventricular Diastolic Function Assessment Using the Timing of Mitral Annular and Transmitral Flow Velocities

Huang

Zhong

Zhang

et al. 2013

Proceedings of Singapore Healthcare

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Background and aims:Evaluation of left ventricular (LV) diastolic function plays an important role in clinical echocardiography. The relationship between mitral annular velocities from tissue Doppler imaging (TDI) (E' and A') and mitral inflow velocities (E and A) from Doppler echocardiography (DE) provide additional information about LV filling and diastolic function. The aims of this study are to i) assess the time differences between peak E and peak E' , peak A and peak A' , peak Ar and peak A, and ii) examine the effects of age and gender on these time intervals parameters in normal subjects.

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Section: Early Diastolic Phasesupporting

confidence: 93%

Left Ventricular Diastolic Function Assessment Using the Timing of Mitral Annular and Transmitral Flow Velocities

Huang

Zhong

Zhang

et al. 2013

Proceedings of Singapore Healthcare

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“…The a’ velocity is a fast and accurate marker of atrial systolic function and correlates with other measures of LA function [ 20 , 21 , 22 , 31 ]. Preclinical atrial dysfunction is characterized by reduced reservoir and conduit function, while atrial contractile function remains normal.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, the lack of invasive assessment may hinder the evaluation of the accuracy of our findings regarding LAVi/a’ versus cardiac catheterization. However, the inverse correlation of TDI-a’ with LVFP has been previously demonstrated, as well as its relationship with worse DD grades [ 5 , 20 , 21 , 22 ]. Thus, though future invasive studies focused on the relationship between LAVi/a’ and LVFP would be welcome, we do not think their absence may flaw our data or their interpretation.…”

Section: Discussionmentioning

confidence: 99%

“…A relative decrease of 50% or an absolute decrease of 0.5 in the E/A ratio, based on each classification, were used as a highly specific feature for raised LV filling pressures. In addition, we decided to explore the potential role TDI a’, alone [ 20 , 21 , 22 ] or in combination with LAVi (LAVi/a’) [ 13 , 14 , 15 ] in re-classifying patients in the undetermined group.…”

Section: Methodsmentioning

confidence: 99%

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Discrepancies in Assessing Diastolic Function in Pre-Clinical Heart Failure Using Different Algorithms—A Primary Care Study

et al. 2020

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Background: Current guidelines on diastolic function (DF) by the American Society of Echocardiography and the European Association of Cardiovascular Imaging (ASE/EACVI) have been disputed and two alternative algorithms have been proposed by Johansen et al. and Oh et al. We sought (a) to assess the concordance of ASE/EACVI guidelines on DF using these proposed alternative approaches and (b) to evaluate the prevalence of indeterminate diastolic dysfunction (DD) by each method, exploring means for reducing their number. Methods: We retrospectively analyzed the echocardiographic reports of 1158 outpatients including subjects at risk of heart failure without (n = 644) or with (n = 241) structural heart disease, and 273 healthy individuals. Concordance was calculated using the k coefficient and overall proportion of DD reclassification rate. The effectiveness of pulmonary vein flow (PVF), Valsalva maneuver, and left atrial volume index/late diastolic a’-ratio (LAVi/a’) over indeterminate grading was assessed. Results: The DD reclassification rate was 30.1% (k = 0.35) for ASE/EACVI and OH, 36.5% (k = 0.27) for ASE/EACVI and JOHANSEN and 31.1% (k = 0.37) for OH and JOHANSEN (p < 0.0001 for all comparisons). DF could not be graded only by ASE/EACVI and OH in 9% and 11% patients, respectively. The majority of patients could be reclassified using PVF or Valsalva maneuver or LAVi/a’, with the latter being the single most effective parameter. Conclusion: Inconsistencies between updated guidelines and independent approaches to assess and grade DF impede their interchangeable clinical use. The inconclusive diagnoses can be reconciled by conventional echocardiography in most patients, and LAVi/a’ emerges as a simple and effective approach to this aim.

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“…If such patients develop atrial fibrillation, the isolated late diastolic filling component will be shifted to early diastole but at the expense of raising the left atrial pressure and reducing the stroke volume. 4,5 patients with Q wave infarction. 7 Left ventricular filling pattern could also be affected by other electric abnormalities.…”

Section: Age and Diastolic Functionmentioning

confidence: 99%

Assessment Of Left Ventricular Diastolic Function By Doppler Echocardiography

Henein

Lindqvist

2015

Cardiac Failure Review

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Diastole is an essential part of the cardiac cycle, during which significant changes in myocardial function, ion and energy transfer, as well as coronary flow, occur. In contrast to systole, diastole consists of four phases, each of which has its distinguishing function and events. However, the four phases are inter-related with events in early diastole correlating with those in late diastole and those occurring during the isovolumic relaxation time predicting both. The complexity of diastolic phases is reflected in the ways by which diastolic function is assessed. While intra-cardiac flow velocities, into and out of the atria, are measured by pulsed-wave Doppler, those of wall motion are assessed by M-mode, myocardial Doppler velocities or, recently, speckle tracking technique. Optimum integration of various aspects of diastolic function should always be considered in order to obtain an accurate comprehensive assessment, bearing in mind factors that normally affect it, for example age.

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Age dependency in the timing of mitral annular motion in relation to ventricular filling in healthy subjects: Umea General Population Heart Study

Abstract: Sequential prolongation of IVRT with ageing reduces LDTD, thus converging the peaks of A(m), A, and Ar (atrial mechanical alignment)-a potential novel method to identify subjects at increased dependency on atrial contraction for late-diastolic filling.

Cited by 9 publications

References 21 publications

Left Ventricular Diastolic Function Assessment Using the Timing of Mitral Annular and Transmitral Flow Velocities

Left Ventricular Diastolic Function Assessment Using the Timing of Mitral Annular and Transmitral Flow Velocities

Discrepancies in Assessing Diastolic Function in Pre-Clinical Heart Failure Using Different Algorithms—A Primary Care Study

Assessment Of Left Ventricular Diastolic Function By Doppler Echocardiography

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