Echocardiographic Evaluation of Left-Ventricular Diastolic Function in Patients with Chronic Pulmonary Hypertension

Moustapha, Ali; Kaushik, Vinod; Díaz, Susana del Prado; Kang, Seung Ho; Barasch, Eddy

doi:10.1159/000047353

Cited by 40 publications

(32 citation statements)

References 24 publications

(35 reference statements)

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“…Several authors have previously noted the high prevalence of LV diastolic dysfunction in patients with PAH. [1][2][3]14 However, most of these studies included patients with chronic thromboembolic disease or a heterogenous group of patients with PAH. In our cohort, which consisted of carefully selected patients with hemodynamic criteria for PAH, 9 we observed that nine out of 10 patients had impaired LV relaxation (grade I diastolic dysfunction) by echocardiographic criteria, with redistribution of the LV fi lling from early to late diastole.…”

Section: Relationship Of LV Diastolic Function With Hemodynamics Paramentioning

confidence: 99%

“…[1][2][3] Little is known, however, about its association with severity of disease and outcomes in patients with idiopathic or heritable PAH, since most of the studies were done on subjects with chronic thromboembolic disease or included a heterogeneous group of patients with PAH.…”

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confidence: 99%

“…Impaired LV relaxation in PAH is commonly attributed to decreased LV compliance as a result of right-to-left interventricular septal displacement 1,2 or reduced LV preload. 4,5 Studies comparing echocardiographic with hemodynamic data have noted an association between the degree of PAH and the presence of LV diastolic dysfunction, 3,6,7 but limited information exists about the prognostic value of param eters that measure LV diastolic function.…”

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confidence: 99%

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Prevalence and Prognostic Value of Left Ventricular Diastolic Dysfunction in Idiopathic and Heritable Pulmonary Arterial Hypertension

Tonelli¹,

Plana

Heresi³

et al. 2012

Chest

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Background:Little is known about the association between left ventricular (LV) diastolic dysfunction and outcomes in patients with idiopathic or heritable pulmonary arterial hypertension (PAH). Our rationale was to investigate the prevalence of LV diastolic dysfunction, and its association with disease severity and outcomes, in patients with idiopathic or heritable PAH. Methods: Using the Cleveland Clinic Pulmonary Hypertension Registry, we identifi ed subjects with heritable or idiopathic PAH who underwent Doppler echocardiography and right-sided heart catheterization. Echocardiographic diastolic parameters were assessed in each patient. Results: A total of 61 patients met the inclusion criteria (idiopathic 85%, heritable 15%). The age at the time of echocardiography was 48.3 Ϯ 18 years, 84% of the subjects were women, and 48% were on PAH-targeted therapies. Normal LV diastolic function, impaired relaxation, and pseudonormalization were seen in 10%, 88%, and 2% of the patients, respectively. Peak early diastolic (peak E) velocity was directly associated with LV end-diastolic volume and cardiac index and inversely associated with the degree of right ventricular dilation, right atrial pressure, and pulmonary vascular resistance. Peak E velocity was associated with mortality adjusted for age and sex (hazard ratio [HR], 1.5; 95% CI, 1.1-2 per 10 cm/s decrease; P 5 .015) and age, sex, 6-min walk distance, and cardiac output (HR, 1.8; 95% CI, 1.2-2.9 per 10 cm/s decrease; P 5 .01). Conclusions: LV diastolic dysfunction of the impaired relaxation type is observed in the majority of patients with advanced idiopathic or heritable PAH. A decrease in transmitral fl ow peak E velocity is associated with worse hemodynamics and outcome. CHEST 2012; 141(6):1457-1465Abbreviations: A 5 late diastolic; D 5 anterograde diastolic; E 5 early diastolic; HR 5 hazard ratio; LA 5 left atrial; LV 5 left ventricular; NYHA 5 New York Heart Association; PAH 5 pulmonary arterial hypertension; PAOP 5 pulmonary artery occlusion pressure; PAP 5 pulmonary artery pressure; PVR 5 pulmonary vascular resistance; RA 5 right atrial; RHC 5 right-sided heart catheterization; RV 5 right ventricular; S 5 systolic

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Section: Relationship Of LV Diastolic Function With Hemodynamics Paramentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Prevalence and Prognostic Value of Left Ventricular Diastolic Dysfunction in Idiopathic and Heritable Pulmonary Arterial Hypertension

Tonelli¹,

Plana

Heresi³

et al. 2012

Chest

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“…(119,120) Tutar et al (121) described the left ventricular diastolic function impairment in COPD patients, and a similar correlation between right ventricular pressure and E/A ratio, and IVRT. Schena et al (5) also demonstrated that the right ventricular pressure correlates with left ventricular eccentricity indexes; the distorted ventricular geometry results in its abnormal filling pattern in turn.…”

Section: Vidiscussionmentioning

confidence: 83%

“…Some investigators, however, suggest the presence of subclinical systolic dysfunction in the COPD patients. (110) Suchon´ et al (105) found that ejection fraction, shortening fraction and lateral mitral annular peak systolic velocity in COPD patients, were in the normal value range and did not differ significantly from control group. Similar results were obtained by other investigators.…”

Section: Vidiscussionmentioning

confidence: 97%

Assessment of Left and Right Ventricular Functions by Myocardial Performance Index in Patients with Chronic Pulmonary Disease.

Najeebsaeed¹

2016

IOSR

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Background:Development of right ventricular hypertrophy and eventual right side heart failure is common in patients with chronic obstructive pulmonary disease (COPD). However, some disturbance in left ventricular (LV) function has been observed among such patients. The co-existence between chronic obstructive pulmonary disease (COPD) and heart failure has been previously described. However, the co-existence between COPD and subclinical LV dysfunction, without the presence of heart failure symptoms, is less well understood. P=0.128), and RVMPI (Beta =1.436, p=0. 3(98.87 ± 8.41ms) 009). LV diastolic function parameters (A, E/A, and deceleration time of E) were impaired for groups 2 and 3 compared with group 1.Mitral early diastolic and late diastolic annular velocities ratio (Em/Am), were significantly lowest in COPD patients with PH(0.77±0.066), and the isovolumetric relaxation time (IVRT) was significantly longer in group 3(105.43±4.21ms) and group 2(102.27±4.45ms) in relation to control group(71.2±5.51ms). RV diastolic function, E/A ratio was higher in the control subjects compared with the patient groups. The tricuspid inflow velocities ratio (E/A) was significantly lowest value in COPD p=atients with PH (0.84 ± 0.04) and the isovolumetric relaxation time (IVRT) was significantly longer in group

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L’ipertensione polmonare

Marra¹

2006

Ecocardiografia Clinica

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Echocardiographic Evaluation of Left-Ventricular Diastolic Function in Patients with Chronic Pulmonary Hypertension

Cited by 40 publications

References 24 publications

Prevalence and Prognostic Value of Left Ventricular Diastolic Dysfunction in Idiopathic and Heritable Pulmonary Arterial Hypertension

Prevalence and Prognostic Value of Left Ventricular Diastolic Dysfunction in Idiopathic and Heritable Pulmonary Arterial Hypertension

Assessment of Left and Right Ventricular Functions by Myocardial Performance Index in Patients with Chronic Pulmonary Disease.

L’ipertensione polmonare

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