Clinical Utility of Single-Beat E/e′ Obtained by Simultaneous Recording of Flow and Tissue Doppler Velocities in Atrial Fibrillation With Preserved Systolic Function

Kusunose, Kenya; Yamada, Hirotsugu; Nishio, S.; Tomita, Noriko; Niki, Toshiyuki; Yamaguchi, Koji; Koshiba, Kunihiko; Yagi, Shusuke; Taketani, Yuji; Igarashi, Takashi; Soeki, Takeshi; Wakatsuki, Tetsuzo; Akiyama, Masashi; Sata, Masataka

doi:10.1016/j.jcmg.2009.05.013

Cited by 79 publications

(58 citation statements)

References 32 publications

(35 reference statements)

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“…przerost lewej komory) i/lub umożliwiając ocenę dysfunkcji rozkurczowej. Zmniejszenie wczesnorozkurczowej prędkości ruchu mięśnia sercowego w tkankowej echokardiowww.kardiologiapolska.pl grafii doplerowskiej (e') odzwierciedla zaburzenia relaksacji lewej komory, natomiast stosunek E/e' koreluje z inwazyjnymi pomiarami ciśnienia napełniania lewej komory [230][231][232][233][234]. Oznaczenia stężenia peptydów natriuretycznych są częścią diagnostycznej oceny HFpEF [222], ale stężenie peptydów natriuretycznych u pacjentów z AF również jest zwiększone, a optymalna diagnostyczna wartość progowa pozostaje nieznana [235].…”

Section: Pacjenci Z Migotaniem Przedsionków Oraz Niewydolnością Sercaunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,380

4,206

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Section: Pacjenci Z Migotaniem Przedsionków Oraz Niewydolnością Sercaunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,380

4,206

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“…(Nihon Kohden Corporation ECG 1250K Tokyo, Japan) After informed consent was obtained from the patients, all patients underwent transthoracic (TTE) and transoesophageal echocardiogram (TOE) (6 MHz transducer GE Medical Systems VIVID 7). In TTE if the ratio of mitral early diastolic (E) velocity obtained from mitral valve tips with pulsed wave Doppler using apical four-cavity imaging to Ea velocity measured from lateral mitral annulus with tissue Doppler was over 11 and if in TOE pulmonary systolic/diastolic (S/D) ratio was less than 1, measurements averaged over 5 to 10 cardiac cycles, the subject was considered to have diastolic dysfunction (4 Correlation between TEE parametres and SEC, thrombus However, in Group D, pulmonary vein D level was found to be significanly higher than group N (p=0.006) while, LAA emptying and filling velocity, LAA lateral wall velocity and pulmonary vein S/D levels were significantly lower than Group N (p=0.028, p<0.001, p<0.001, p<0.001) ( Table 2). Thrombus in group D was higher than group N (p=0.03) ( Table 3).…”

Section: Study Protocol and Definitionsmentioning

confidence: 99%

Effect of left ventricular diastolic dysfunction on left atrial appendage function and thrombotic potential in nonvalvular atrial fibrillation

Demirçelik¹,

Çetın²,

Çiçekçioğlu³

et al. 2014

Anadolu Kardiyol Derg

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Objective: We aimed to investigate effects of left ventricular diastolic dysfunction on left atrial appendage functions, spontaneous echo contrast and thrombus formation in patients with nonvalvular atrial fibrillation. Methods: In 58 patients with chronic nonvalvular atrial fibrilation and preserved left ventricular systolic function, left atrial appendage functions, left atrial spontaneous echo contrast grading and left ventricular diastolic functions were evaluated using transthoracic and transoesophageal echocardiogram. Patients divided in two groups: Group D (n=30): Patients with diastolic dysfunction, Group N (n=28): Patients without diastolic dysfunction. Categorical variables in two groups were evaluated with Pearson's chi-square or Fisher's exact test. The significance of the lineer correlation between the degree of spontaneous echo contrast (SEC) and clinical measurements was evaluated with Spearman's correlation analysis. Results: Peak pulmonary vein D velocity of the Group D was significantly higher than the Group N (p=0.006). However, left atrial appendage emptying velocity, left atrial appendage lateral wall velocity, peak pulmonary vein S, pulmonary vein S/D ratio were found to be significantly lower in Group D (p=0.028, p<0.001, p<0.001; p<0.001). Statistically significant negative correlation was found between SEC in left atrium and left atrial appendage emptying, filling, pulmonary vein S/D levels and lateral wall velocities respectively (r=-0.438, r=-0.328, r=-0.233, r=-0.447). Left atrial appendage emptying, filling, pulmonary vein S/D levels and lateral wall velocities were significantly lower in SEC 2-3-4 than SEC 1 (p=0.003, p=0.029, p<0.001, p=0.002). Conclusion: In patients with nonvalvular atrial fibrillation and preserved left ventricular ejection fraction, left atrial appendage functions are decreased in patients with left ventricular diastolic dysfunction. Left ventricular diastolic dysfunction may constitute a potential risk for formation of thrombus and stroke. (Anadolu Kardiyol Derg 2014; 14: 256-60

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“…Obtaining simultaneous E and eЈ in atrial fibrillation or any other irregular rhythm 40 Early diastolic strain rate Similar hemodynamic determinant as mitral annulus eЈ 41 and myocardial viability 36 Global diastolic strain rate during IVR Preload independent and good correlation with tau 42 ; detection of viability and prognosis Torsion Detection of mild diastolic dysfunction and loading conditions as well as prognosis 43,44 Regional diastolic strain during stress echocardiography…”

Section: Assessment Of LV Global Diastolic Functionmentioning

confidence: 99%

Established and Novel Clinical Applications of Diastolic Function Assessment by Echocardiography

Park

Nagueh

2011

Circ: Cardiovascular Imaging

142

120

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A cardiac cycle consists of systolic (contraction) and diastolic (relaxation and filling) phases that are linked closely together for optimal function of the heart. Normal diastolic function allows adequate filling of the heart without an excessive increase in diastolic filling pressure both in the resting state and with stress or exertion. 1 The diastolic phase is remarkably well designed to ensure that the ventricle is optimally filled for a given clinical condition. 2 Basically, at the end of systole, left ventricular (LV) relaxation begins as an initial diastolic process, and LV pressure falls rapidly as the LV expands. This relaxation phase is accompanied by active movement of the mitral annulus away from the apex. The velocity of LV dilatation and mitral annular movement during early diastole correlates well with how fast the LV fills and relaxes, respectively. 3,4 Myocardial relaxation continues during early diastole to reach the minimal LV diastolic pressure, which helps with "sucking" or "pulling" the blood actively into the LV (Figure 1, online-only Data Supplement Video 1A). The minimal LV diastolic pressure or completion of relaxation normally occurs by 3.5 times the value of tau-the time constant of relaxation (normal Ͻ45 ms)-after the mitral opening. 5 LV pressure then rises to be equilibrated with left atrial (LA) pressure, at which time the early diastolic filling decelerates to close the mitral valve until the time of atrial contraction when LA pressure increases to initiate the late filling to complete diastole ( Figure 1, online-only Data Supplement Video 1B).In the healthy young heart, early diastole is responsible for the majority of ventricular filling, providing a good diastolic reserve. As myocardial relaxation becomes less active with aging or abnormally delayed due to a disease process, the rate of LV pressure decline during the early diastole is reduced, and it takes a longer time to reach the minimal LV diastolic pressure. The rate of LV dilatation during early diastole is reduced, and both elongation of the LV and mitral annular motion are reduced (Figure 1), resulting in reduced diastolic filling and a longer time to reach equilibration of LV-LA pressure. Under this circumstance, atrial contraction is responsible for a substantial proportion of diastolic filling. As long as all the necessary filling can be completed through this mechanism with intact atrial contraction and an adequate diastolic filling period, the mean LA pressure remains normal, although it may be increased at the end of diastole if LA compliance is decreased.A major problem with delayed relaxation, however, is a reduced diastolic reserve. Healthy individuals with normal relaxation are able to increase the rate of myocardial relaxation when there is a need for increased diastolic filling. Faster relaxation allows the achievement of a lower minimal LV diastolic pressure at a shorter time interval than in the resting state. Hence, increased LV filling can occur even with a shortened diastolic filling time. When myoca...

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Clinical Utility of Single-Beat E/e′ Obtained by Simultaneous Recording of Flow and Tissue Doppler Velocities in Atrial Fibrillation With Preserved Systolic Function

Cited by 79 publications

References 32 publications

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Effect of left ventricular diastolic dysfunction on left atrial appendage function and thrombotic potential in nonvalvular atrial fibrillation

Established and Novel Clinical Applications of Diastolic Function Assessment by Echocardiography

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