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Dinçer, İrem; Kumbasar, Deniz; Nergisoglu, G.; Atmaca, Yusuf; Kutlay, Sim; Akyürek, Ömer; Sayin, Tamer; Erol, Çetin; Oral, Derviş

doi:10.1023/a:1014697208218

Cited by 46 publications

(11 citation statements)

References 18 publications

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“…Tissue Doppler echocardiography (TDE) was found to be a new method to evaluate LV systolic and diastolic dysfunction [21]. Parameters derived from TDE were considered relatively preload-independent [22,23,24]. Some have reported that mitral annular velocity was preload-dependent especially in the early diastolic phase [25,26,27].…”

Section: Introductionmentioning

confidence: 99%

Tissue Doppler Velocity Is Not Totally Preload-Independent: A Study in a Uremic Population after Hemodialysis

Lee¹,

Kang²,

Hsiao³

et al. 2007

Cardiology

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Objectives: The aim of this study was to investigate the changes of regional tissue Doppler velocity after volume removal following regular hemodialysis (HD) in uremic patients. Is tissue Doppler velocity really preload-independent? Background: Diastolic dysfunction was divided into four stages: normal pattern, abnormal relaxation pattern, pseudonormalization pattern, and restrictive pattern. Pulse wave Doppler and color Doppler echocardiography were important diagnostic tools for these forms of diastolic dysfunction. However, they were preload-dependent and sometimes there was confusion between the normal pattern and the pseudonormalization pattern. Tissue Doppler echocardiography was promising for problems in diastolic dysfunction and appeared to be preload-independent. However, there are still some disputes over this point. Methods: Ninety-three uremic patients receiving regular HD were included in the study. There were 45 males and 48 females aged 59 ± 14 years. The mean volume removed after HD was 2.3 ± 0.9 kg. The mean heart rates before and after HD were 77 ± 11 and 76 ± 12 beats per minute, respectively (p = 0.73). All patients received complete transthoracic echocardiography examinations before and after HD. The studies included cardiac chamber size, left ventricular systolic performance, pulse wave Doppler echocardiographic data of mitral inflow and the right upper pulmonary vein including peak velocity of early diastolic E wave, E wave time velocity integral (TVI-E), peak velocity of late diastolic A wave, A wave TVI, systolic phase of pulmonary vein (S wave TVI), early diastolic phase of pulmonary vein (D wave TVI) and atrial contraction phase of pulmonary vein (Ar wave TVI). Pulsed tissue Doppler echocardiography (TDE) was performed and a 4-mm sample volume was placed at the 6 corners of the mitral annulus including septal, lateral, anterior, inferior, anteroseptal and posterior corners. Five to ten cardiac cycles were recorded and the data were averaged. Measurements performed included peak velocity of systolic phase (Sa), early diastolic phase (Ea), late diastolic phase (Aa), Ea/Aa ratio and time from the beginning of electrocardiogram Q wave to the beginning of Sa (Q-Sa time). The same measurements were repeated after HD. Results: After HD, left atrium diameter and left ventricular internal dimensions at end diastole became smaller. There were significant reductions for mitral peak E wave velocity, TVI-E, peak A wave velocity and E/A ratio. As for the pulmonary vein, systolic phase of pulmonary vein and early diastolic phase of pulmonary vein decreased significantly. Peak Ar wave did not change significantly. For TDE, Sa and Aa did not change but Ea did decrease. Conclusion: After HD, there is a significant reduction of intravascular effective volume. No significant change is found for myocardial peak systolic velocity and peak late diastolic velocity. However, there is a significant reduction of myocardial early diastolic phase peak velocity. This suggests that TDE is not completely preload-indep...

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Section: Introductionmentioning

confidence: 99%

Tissue Doppler Velocity Is Not Totally Preload-Independent: A Study in a Uremic Population after Hemodialysis

Lee¹,

Kang²,

Hsiao³

et al. 2007

Cardiology

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“…The time constant of relaxation τ is the gold standard parameter for the assessment of LV diastolic function, but it is not frequently used due to its invasive nature [3,4,5]. Echocardiography became the standard clinical tool for the noninvasive evaluation of LV diastolic function by measuring transmitral flow velocities obtained by the MPD technique [6,7,8].…”

Section: Discussionmentioning

confidence: 99%

“…However, for many instances, information obtained from MPD indices is inconclusive or contradictory. Furthermore, measurements obtained by MPD are load dependent, so patients with an abnormal relaxation and high left atrial pressure may have a normal MPD pattern called pseudonormalization [5,9,10,11, 18]. MPD is correlated with τ except when there is a pseudonormal filling pattern [12].…”

Section: Discussionmentioning

confidence: 99%

“…Routine use of cardiac catheterization, the gold standard for demonstrating left ventricular (LV) diastolic dysfunction by the time constant of relaxation τ, is not feasible [3,4,5]. Echocardiography with mitral pulsed Doppler (MPD) became the standard clinical technique for the noninvasive assessment of LV function [6,7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Echocardiography with mitral pulsed Doppler (MPD) became the standard clinical technique for the noninvasive assessment of LV function [6,7,8]. However, measurements obtained by MPD are load dependent, so patients with relaxation abnormality and high left atrial pressure may present a normal MPD pattern called pseudonormalization [5,9,10,11]. MPD was found to be correlated with τ except when there was a pseudonormal filling pattern [12].…”

Section: Introductionmentioning

confidence: 99%

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Left Ventricular Diastolic Function in Hemodialysis Patients: Role of Preload Increase Maneuver on Tissue Doppler Imaging Evaluation

2006

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Objective: Tissue Doppler imaging (TDI) has recently been proposed as a relatively preload-independent method to evaluate left ventricular diastolic function. We sought to investigate the higher-accuracy of TDI to assess diastolic function in end-stage renal disease (ESRD) patients on hemodialysis (HD) associated with a preload increase maneuver. Methods: Thirty-two consecutiveESRD patients (16 female, ages 48.8 ± 17.5 years, 14 ≤45 and 18 >45 years old) were evaluated. Measurements of E, A velocities and the E/A ratio from transmitral inflow pulsed wave Doppler, and E’, A’ velocities and the E’/A’ ratio from TDI were obtained 1 h before and 1 h after HD at baseline and with a preload increase maneuver. Results: The E/A ratio changed significantly in all patients aged >45 before and after HD with the preload increase maneuver. The E’/A’ ratio increased in all subjects with the preload increase maneuver before HD but did not change with the maneuver after HD in the euvolemic state in all patients. Conclusion: In ESRD patients on routine HD, TDI evaluation associated with a preload increase maneuver proved to be a more accurate method to identify diastolic dysfunction when the evaluation is performed in euvolemic patients after HD.

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Vortex Formation in the Heart

Kheradvar

Pedrizzetti

2011

Vortex Formation in the Cardiovascular System

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Cited by 46 publications

References 18 publications

Tissue Doppler Velocity Is Not Totally Preload-Independent: A Study in a Uremic Population after Hemodialysis

Tissue Doppler Velocity Is Not Totally Preload-Independent: A Study in a Uremic Population after Hemodialysis

Left Ventricular Diastolic Function in Hemodialysis Patients: Role of Preload Increase Maneuver on Tissue Doppler Imaging Evaluation

Vortex Formation in the Heart

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