Association of left ventricular diastolic function with systolic dyssynchrony: a population study

Kuznetsova, Tatiana; Bogaert, Petronille; Kloch−Badełek, Małgorzata; Thijs, Daisy; Thijs, Lutgarde; Staessen, Jan A.

doi:10.1093/ehjci/jes189

Cited by 11 publications

(11 citation statements)

References 14 publications

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“…This finding is consistent with the findings reported by Kuznetsova et al [29],. who reported that, in a study population with LV diastolic dysfunction, females had greater dyssynchrony compared with males.…”

Section: Discussionsupporting

confidence: 94%

Dynamic cardiac dyssynchrony is strongly associated with 2-year dialysis adequacy in continuous ambulatory peritoneal dialysis patients

Huang

Chang

et al. 2013

BMC Nephrol

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BackgroundLeft ventricular (LV) dyssynchrony is associated with increased risk of all-cause mortality in patients with end-stage renal disease. Our aim was to determine the associations of LV dynamic dyssynchrony with peritoneal solute clearance in continuous ambulatory peritoneal dialysis (CAPD) patients. Our primary objective was to determine the association between dynamic LV dyssynchrony and CAPD clearance at 2 years. Secondary objectives were to identify the factors influencing dynamic dyssynchrony, and to examine the association between dialysis adequacy and echocardiography-assessed LV outcomes.MethodsFifty CAPD patients and 13 healthy volunteers underwent three-dimensional (3D) dobutamine stress echocardiography (DSE). The main endpoint was systolic dyssynchrony index (SDI). Secondary endpoints, including NT-proBNP, troponin I, Kt/V, and biochemical parameters, were measured before stress echocardiography, and Kt/V was measured again 2 years later. All values are expressed as medians and interquartile ranges (IQR).ResultsNT-proBNP (3872 [808–11779] vs. 4.99 [4.99–36.83] pg/mL, P < 0.001), and log NT-proBNP (3.587 [2.896–4.071] vs. 0.698 [0.698–1.540], P < 0.001) levels were significantly higher in the CAPD group than in the control group. Real-time 3D DSE showed that the systolic dyssynchrony index was significantly different between the two groups at the peak dobutamine stage (1.11% [0.76–1.64%] vs. 0.66% [0.50–1.02%], P = 0.004), but not at resting (1.30% [0.89–1.74%] vs. 1.22 % [0.72–1.68%], P = 0.358).The subgroup of patients in the CAPD group with greater improvements in dialysis adequacy had lower baseline dynamic SDI and more favorable echocardiographic findings at 2 years. Dialysis adequacy decreased significantly at 2 year in patients with higher, but not in those with lower dynamic SDI at baseline. In multivariate linear regression analysis, log NT-proBNP and SDI at the peak dobutamine dose were significantly associated with Kt/V and weekly creatinine clearance at 2 years, while log NT-proBNP was significant associated with SDI at the peak dobutamine stage. Female CAPD patients group had more pronounced dynamic LV dyssynchrony compared with male patients.ConclusionsDynamic systolic dyssynchrony was strongly associated with future dialysis adequacy in CAPD patients. Log NT-proBNP was the important predictor of dynamic dyssynchrony. Our study confirmed the concept that cardiac dysfunction has an impact on dialysis adequacy.

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Section: Discussionsupporting

confidence: 94%

Dynamic cardiac dyssynchrony is strongly associated with 2-year dialysis adequacy in continuous ambulatory peritoneal dialysis patients

Huang

Chang

et al. 2013

BMC Nephrol

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“…The prolonged diastolic and systolic dyssynchronies indicate energy wastage resulting from LV dyssynchrony, which may lead to a reduction in cardiac energy reserves 11 . Moreover, a reduction in systolic shortening resulting from deteriorated dyssynchrony has been shown 26 . Despite a more decreased LV longitudinal systolic function, a more prolonged systolic dyssynchrony was observed in HFrEF patients compared to HFpEF patients in the present study.…”

Section: Discussionmentioning

confidence: 99%

Left ventricular diastolic and systolic dyssynchrony and dysfunction in heart failure with preserved ejection fraction and a narrow QRS complex

et al. 2018

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Aims: Mechanical dyssynchrony has been reported in heart failure with preserved ejection fraction (HFpEF), with a majority of patients having a narrow QRS complex; however, whether any benefit is observed with restoration of dyssynchrony remains unclear. We sought to assess left ventricular (LV) dyssynchrony and function in HFpEF and elucidate the underlying mechanisms that may account for HFpEF.Methods: Seventy-eighty patients with a narrow QRS complex including 47 with HFpEF, 31 with heart failure with reduced ejection fraction (HFrEF) patients, and 29 with asymptomatic left ventricular diastolic dysfunction (LVDD) were recruited. Forty-five normal subjects acted as controls. Systolic LV longitudinal strain (LS), systolic longitudinal strain rate (LSrS), early diastolic longitudinal strain rate (LSrE), and late diastolic longitudinal strain rate (LSrA) were measured using speckle tracking echocardiography. LV diastolic and systolic dyssynchrony (Te-SD and Ts-SD) were calculated.Results: Te-SD and Ts-SD were prolonged in HFpEF and HFrEF patients than in the control group (p<0.05). However, Ts-SD was shorter in HFpEF patients compared to HFrEF patients despite a narrow QRS complex (p<0.05). LV global LS, LSrS, and LSrE were decreased in patients with HFpEF and HFrEF compared to other groups, with HFrEF being even more reduced than HFpEF (p<0.05). Reduced LS, LSrS, and LSrE could effectively differentiate HF from asymptomatic LVDD patients (p<0.05).Conclusion: HFrEF exhibited increased systolic dyssynchrony compared to HFpEF despite a narrow QRS complex in addition to the more reduced diastolic and systolic function. Therefore, targeting to improve diastolic and systolic function instead of managing systolic dyssynchrony might be of great importance in the treatment of HFpEF.

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“…Temporal heterogeneity in systolic function interrupts the normally coordinated relationship between systolic shortening and diastolic lengthening . A reduction in systolic shortening resulting from deteriorated dyssynchrony has been shown to increase LV filling pressure . We also found that LV systolic function was significantly correlated with LV diastolic and systolic dyssynchrony.…”

Section: Discussionmentioning

confidence: 50%

“…30,31 A reduction in systolic shortening resulting from deteriorated dyssynchrony has been shown to increase LV filling pressure. 32 We also found that LV systolic function was significantly correlated with LV diastolic and systolic dyssynchrony. In addition, plasma NT-pro-BNP was correlated with both Te-SD and LV systolic longitudinal strain, suggesting a relationship between systolic and diastolic dysfunction.…”

Section: Ta B L E 3 Comparison Of Left Ventricular Function and Dyssymentioning

confidence: 52%

Left ventricular systolic dysfunction potentially contributes to the symptoms in heart failure with preserved ejection fraction

et al. 2019

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Aims Left ventricular diastolic dysfunction (LVDD) is considered a key factor associated with heart failure (HF) symptoms in patients with preserved ejection fraction (HFpEF). However, LV systolic performance, including LV systolic function and synchrony, has not been well characterized in these patients. The aims of this study were to assess to investigate the underlying relationship and differences between subclinical LVDD and HFpEF. Methods Eighty‐six patients with LVDD were recruited (58 with HFpEF and 28 with subclinical LVDD). Systolic left ventricular (LV) longitudinal strain (LS), systolic longitudinal strain rate (LSrS), early diastolic longitudinal strain rate (LSrE), and late diastolic longitudinal strain rate (LSrA) were measured using speckle tracking echocardiography. LV diastolic and systolic dyssynchrony (Te‐SD and Ts‐SD) were calculated. Forty age‐ and sex‐matched healthy individuals were enrolled as a control group. Results LV global LS and LSrS were decreased in patients with HFpEF than in normal controls and subclinical LVDD patients (P < .05). Te‐SD and Ts‐SD were significantly more prolonged in subclinical LVDD and HFpEF patients than in the control group (P < .05). Reduced LS was associated with HF symptoms in LVDD patients, and a cutoff value of −18% for LS could differentiate HFpEF from subclinical LVDD with 73% sensitivity and 69% specificity. Conclusion LV systolic function and mechanical dyssynchrony were impaired in HFpEF patients. Deteriorated LV longitudinal systolic function was likely correlated with the symptoms of HFpEF.

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Association of left ventricular diastolic function with systolic dyssynchrony: a population study

Abstract: We demonstrated that in unselected subjects LV diastolic dysfunction was associated with mechanical LV dyssynchrony as assessed by echocardiography.

Cited by 11 publications

References 14 publications

Dynamic cardiac dyssynchrony is strongly associated with 2-year dialysis adequacy in continuous ambulatory peritoneal dialysis patients

Dynamic cardiac dyssynchrony is strongly associated with 2-year dialysis adequacy in continuous ambulatory peritoneal dialysis patients

Left ventricular diastolic and systolic dyssynchrony and dysfunction in heart failure with preserved ejection fraction and a narrow QRS complex

Left ventricular systolic dysfunction potentially contributes to the symptoms in heart failure with preserved ejection fraction

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