Hyperdynamic left ventricle on radionuclide myocardial perfusion imaging (RNMPI): A marker of diastolic dysfunction in patients presenting with dyspnea on exertion

Gorantla, Ramakrishna; Ahmed, Saeed; Voruganti, Dinesh; Menzies, Dhananjai J.

doi:10.1016/j.ijcha.2015.01.001

Cited by 8 publications

(6 citation statements)

References 9 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found a very similar exercise response for COPD/ LVDD + patients compared to controls. However, subjects with the COPD/LVFP + association presented a significantly higher baseline NT-proBNP level, frequency of SAH and ejection fraction at rest, all in agreement with previous studies [2,8,13,32,33]. In addition, at peak exercise, these individuals demonstrated a more intense systolic blood pressure response and a similar chronotropic reserve, despite the more intense exercise attained for the LVFP + group.…”

Section: Exercise Responses In the Presence Of Lvddsupporting

confidence: 90%

Left ventricular diastolic dysfunction and exertional ventilatory inefficiency in COPD

Müller

Utida

Augusto

et al. 2018

Respiratory Medicine

View full text Add to dashboard Cite

Background: Left ventricular diastolic dysfunction (LVDD) is highly prevalent in COPD and conflicting results have emerged regarding the consequences on exercise capacity in the 6MWT. We sought to examine the ventilatory efficiency and variability metrics as the primary endpoint and aerobic capacity (V'O 2) as the secondary endpoint. Methods: Forty subjects were included and submitted to comprehensive lung function tests, detailed pulsed-Doppler echocardiography, and cardiopulmonary exercise testing. Four subjects were excluded due to concomitant cardiac disease and two owing to COPD exacerbation. Results: Seventeen COPD/LVDD+ and seventeen COPD/LVDD-individuals were closely matched for baseline characteristics. Throughout the exercise, there was no difference between-groups for primary (V' E /V'CO 2 slope and V' E /V'CO 2 nadir, p > 0.05 for both) or secondary endpoints (V'O 2peak %pred, p > 0.05). Ventilatory variability remained unchanged. However, after very well age-and sex-matched subgroup analysis, five-moderate and three-mild COPD/LVDD + subjects with elevated left ventricular filling pressure (E/e' > 13, n = 8), presented a downward-shifted V' E /V'CO 2 slope (25.7 ± 5.1 vs 33.4 ± 7.1, p = 0.031) and V' E /V'CO 2 nadir reduction (29.7 ± 3.9 vs 36.3 ± 7.2, p = 0.042) besides significantly better V'O 2peak %pred (92.1 ± 21.6% vs 75.8 ± 13.1%, p = 0.045) compared to 8 COPD/LVDD-controls. Ventilatory variability remained once again unchanged. Conclusions: COPD/LVDD overlap is not associated with worse exercise tolerance and/or wasted ventilation in excess compared to controls, even when suspected for elevated left ventricular filling pressure. Further studies are warranted to study specifically if augmented pulmonary blood transit time can allow better gas-exchange, thus preserving exercise capacity under specific conditions in COPD patients without heart failure.

show abstract

Section: Exercise Responses In the Presence Of Lvddsupporting

confidence: 90%

Left ventricular diastolic dysfunction and exertional ventilatory inefficiency in COPD

Müller

Utida

Augusto

et al. 2018

Respiratory Medicine

View full text Add to dashboard Cite

show abstract

“…We confirmed hyperdynamic septal basal tissue quantitatively by the combined analysis of tissue Doppler imaging and dobutamine stress echocardiography in BSH [ 15 ]. However, the determination of hypertension under stress in some symptomatic patients with dyspnea and hyperdynamic function is not recalled during examination and technic analysis [ 16 ]. Therefore, we remarked the importance of investigation for hypertension and technic analysis with ultrasound in symptomatic patients with hyperdynamic LV function [ 17 ].…”

Section: Basal Septal Hypertrophy and Clinic Observationsmentioning

confidence: 99%

Basal Septal Hypertrophy as the Early Imaging Biomarker for Adaptive Phase of Remodeling Prior to Heart Failure

Yalçın

Küçukler

et al. 2021

JCM

View full text Add to dashboard Cite

Hypertension plays a dominant role in the development of left ventricular (LV) remodeling and heart failure, in addition to being the main risk factor for coronary artery disease. In this review, we focus on the focal geometric and functional tissue aspects of the LV septal base, since basal septal hypertrophy (BSH), as the early imaging biomarker of LV remodeling due to hypertensive heart disease, is detected in cross-sectional clinic studies. In addition, the validation of BSH by animal studies using third generation microimaging and relevant clinical observations are also discussed in the report. Finally, an evaluation of both human and animal quantitative imaging studies and the importance of combined cardiac imaging methods and stress-induction in the separation of adaptive and maladaptive phases of the LV remodeling are pointed out. As a result, BSH, as the early imaging biomarker and quantitative follow-up of functional analysis in hypertension, could possibly contribute to early treatment in a timely fashion in the prevention of hypertensive disease progression to heart failure. A variety of stress stimuli in etiopathogenesis and the difficulty of diagnosing pure hemodynamic overload mediated BSH lead to an absence of the certain prevalence of this particular finding in the population.

show abstract

“…More specialised investigations may have diagnostic utility in determining the cause of chronic dyspnoea depending on the results of initial investigations and refined differential diagnoses (Table 4). Imaging modalities that may be utilised include cardiac MRI, lung ventilation/perfusion (V/Q) scans, myocardial perfusion scans, stress echocardiogram or CT coronary angiography (37,39,40). More invasive testing may include cardiac catheterisation for assessment of coronary artery disease or pulmonary pressures, muscle biopsy, bronchoscopy or surgical lung biopsy (31,41,42).…”

Section: Tertiary Investigationsmentioning

confidence: 99%

Diagnostic approach to chronic dyspnoea in adults

et al. 2019

View full text Add to dashboard Cite

Chronic dyspnoea, or breathlessness for more than four weeks duration, is a common symptom in adults presenting to primary and tertiary care. It often presents a diagnostic challenge due to the wide spectrum of underlying disease, which is multifactorial in approximately one third of cases. Challenges in diagnosis include an often non-diagnostic clinical assessment, difficulty in selecting the most appropriate investigations and correct speciality referral for further diagnostic assessment. In patients presenting with chronic dyspnoea, history and physical examination are often non-specific with key findings more useful as negative predictive factors. There is a broad range of simple to specialised investigations that may be utilised in the diagnostic workup. Several diagnostic algorithms incorporating different tiers of investigations have been tested in studies of chronic dyspnoea patients but there is currently very limited data that test a diagnostic algorithm against standard clinical care. In this review we propose a diagnostic pathway with primary, secondary and tertiary level investigations for patients with chronic dyspnoea. This pathway is based on the combination of previously tested diagnostic algorithms in the literature, to assist clinicians in their diagnostic workup of chronic dyspnoea patients. Further research is needed to further evaluate diagnostic algorithms in this setting and to test this diagnostic pathway in clinical practice.

show abstract

Hyperdynamic left ventricle on radionuclide myocardial perfusion imaging (RNMPI): A marker of diastolic dysfunction in patients presenting with dyspnea on exertion

Cited by 8 publications

References 9 publications

Left ventricular diastolic dysfunction and exertional ventilatory inefficiency in COPD

Left ventricular diastolic dysfunction and exertional ventilatory inefficiency in COPD

Basal Septal Hypertrophy as the Early Imaging Biomarker for Adaptive Phase of Remodeling Prior to Heart Failure

Diagnostic approach to chronic dyspnoea in adults

Contact Info

Product

Resources

About