Left Ventricular Mass Influences Relationship Between Filling Pressure and Early-Diastolic Ratio of Inflow Velocity to Mitral Annular Velocity (E/e′)

Nakabachi, Masahiro; Yamada, Satoshi; Iwano, Hiroyuki; Hayashi, Taichi; Okada, Kazunori; Kusunose, Kenya; Watanabe, Kiyotaka; Ishizu, Tomoko; Wakami, Kazuaki; Yamada, Hirotsugu; Dohi, Kaoru; Seo, Yoshihiro; Ohte, Nobuyuki; Shimizu, Chisato; Mikami, Taisei

doi:10.1253/circj.cj-17-1019

Cited by 4 publications

(6 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, we did not find influence of LV hypertrophy on the association between E/e′ and PAWP in multivariable analysis (Table 2). Although degree of LVH was also reported to alter their relationship, 9 it is conceivable that its influence might be weaker than coincidence of MAC in AS patients.…”

Section: Discussionmentioning

confidence: 99%

“…Taken together with the shared upstream such as aging and atherosclerotic risk factors between AS and MAC, E/e′ might not to be recommended 2). Although degree of LVH was also reported to alter their relationship, 9 it is conceivable that its influence might be weaker than coincidence of MAC in AS patients.…”

Section: Non-invasive Estimation Of LV Fp In As Patientsmentioning

confidence: 99%

“…6 Its clinical utility is widely recognized, at the same time, several clinical conditions where the individual parameters cannot be applied are also pointed. 6,7 Since the AS frequently coincident with conditions such as significant mitral annular calcification (MAC) and a certain left ventricular hypertrophy (LVH), both of which were reported to weaken the associations of E/e′ and LV FP, 8,9 the diagnostic utility of the algorithm might be impaired in AS patients. Nevertheless, the algorithm has not been validated in the population of AS yet.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Non‐invasive assessment of left ventricular filling pressure in aortic stenosis

Aoyagi,

Iwano,

Tamaki

et al. 2024

Echocardiography

Self Cite

View full text Add to dashboard Cite

BackgroundThe assessment of left ventricular (LV) filling pressure (FP) is important for the management of aortic stenosis (AS) patients. Although, it is often restricted for predict LV FP in AS because of mitral annular calcification and a certain left ventricular hypertrophy. Thus, we tested the predictive ability of the algorithm for elevated LV FP in AS patients and also applied a recently‐proposed echocardiographic scoring system of LV FP, visually assessed time difference between the mitral valve and tricuspid valve opening (VMT) score.MethodsWe enrolled consecutive 116 patients with at least moderate AS in sinus rhythm who underwent right heart catheterization and echocardiography within 7 days. Mean pulmonary artery wedge pressure (PAWP) was measured as invasive parameter of LV FP. LV diastolic dysfunction (DD) was graded according to the ASE/EACVI guidelines. The VMT score was defined as follows: time sequence of opening of mitral and tricuspid valves was scored to 0–2 (0: tricuspid valve first, 1: simultaneous, 2: mitral valve first). When the inferior vena cava was dilated, one point was added and VMT score was finally calculated as 0–3.ResultsOf the 116 patients, 29 patients showed elevated PAWP. Ninety patients (93%) and 67 patients (63%) showed increased values for left atrium volume index (LAVI) and E/e′, respectively when the cut‐off values recommended by the guidelines were applied and thus the algorism predicted elevated PAWP with a low specificity and positive predictive value (PPV). VMT ≥ 2 predicted elevated PAWP with a sensitivity of 59%, specificity of 90%, PPV of 59%, and negative predictive value of 89%. An alternative algorithm that applied tricuspid regurgitation velocity and VMT scores was tested, and its predictive ability was markedly improved.ConclusionVMT score was applicable for AS patients. Alternative use of VMT score improved diagnostic accuracy of guideline‐recommended algorism.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Non-invasive Estimation Of LV Fp In As Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Non‐invasive assessment of left ventricular filling pressure in aortic stenosis

Aoyagi,

Iwano,

Tamaki

et al. 2024

Echocardiography

Self Cite

View full text Add to dashboard Cite

show abstract

“…On multiple linear regression, decreased LAS reservoir and elevated SPAP were significantly associated with the degree of pulmonary edema. The 2016 guidelines for assessment of left ventricular diastolic function mention E/e′ as an important and easily-obtained evaluation parameter; however, it is a less accurate parameter for estimating the LV filling pressure compared to invasive catheters (15)(16)(17). Clinical conditions, such as LV hypertrophy and dilatation, severe reduction of LV systolic function, and mitral annular calcification are liable to affect the accuracy of the filling pressure estimated from E/e′ (15,18).…”

Section: Discussionmentioning

confidence: 99%

Correlation of left atrial function and pulmonary edema in patients with left heart failure on cardiopulmonary ultrasonography

Li,

Hu,

Chen

2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

ObjectivePatients with heart failure with pulmonary edema may have declining left atrial (LA) function. Left atrial strain (LAS) imaging enables quantitative assessment of LA function. The aim of this prospective study was to assess the LA function and pulmonary edema in patients with heart failure evaluated by cardiopulmonary ultrasonography.MethodsTwo-dimensional speckle-tracking echocardiography for LAS was performed in 115 consecutive patients with congestive heart failure. A semiquantitative B-lines score of pleural effusions was derived by pulmonary ultrasound almost at the same time by combined cardiopulmonary ultrasound.ResultsCompared with those who did not have pulmonary edema, patients with pulmonary edema had lower LAS (LASreservoir, 21.5 ± 4.9% vs. 9.2 ± 3.7% [P < 0.001]; LASconduit, 10.7 ± 3.5% vs. 5.1 ± 2.1% [P < 0.001]; LASpump, 11.3 ± 5.4% vs. 4.0 ± 2.7% [P < 0.001]), lower LVEF, TAPSE; and higher SPAP, E/e′, larger LA, LV, RV; more severe MR. However, there were no signiﬁcant between-group differences with respect to sex and body surface area. In patients with pulmonary edema, B-lines score was independently associated with LASreservoir (R = −0.71, P < 0.001); LASpump (R = −0.66, P < 0.001) and LASconduit (R = −0.56, P < 0.001). On multiple linear regression, decreased LASreservoir (beta = −0.61, B = −0.71, P < 0.001) and elevated SPAP (beta = 0.31, B = 0.13, P = 0.01) were significantly associated with B-lines score in heart failure.ConclusionDeclining LA function, especially the reservoir function, assessed by speckle-tracking echocardiography is related to the degree and occurrence of pulmonary edema in patients with left heart failure.

show abstract

“…The tendency toward abnormal perfusion at rest in the hypertrophied heart has been related to arterial remodeling that is out of proportion to the hypertrophied myocardium and the increased extravascular forces acting on intramural arteries [ 21 , 22 ]. Notably, the index of left ventricular mass in diastole could accurately predict the invasively measured left ventricular pressure and E/e’ ratio in cohorts with hypertensive heart disease [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Diastolic Function: Comparison of Slow Coronary Flow Phenomenon and Left Ventricular Hypertrophy in the Absence of Obstructive Coronary Disease

Semerdzhieva¹,

Денчев²,

Господинова³

2022

Cureus

View full text Add to dashboard Cite

Background An interplay of myocardial structural abnormalities and coronary arterial dysfunction underlies the worsening left ventricular compliance. The conventionally used angina drugs have demonstrated a beneficial effect on both angina and coronary flow in cases with microvascular dysfunction and non-obstructive coronary disease. Despite that, vasoactive therapy only partially affects diastolic function in this patient population. Purpose This retrospective study was planned to evaluate the association of myocardial mass, delayed epicardial coronary flow, and vasoactive drugs with parameters of diastolic function in two cohorts with preserved left ventricular function and non-obstructive coronary disease in patients with slow coronary flow phenomenon (SCFP) and patients with the hypertensive disease and left ventricular hypertrophy. Material and methods The epicardial coronary flow was evaluated in 48 patients with unstable angina in the absence of coronary stenosis >50%, by applying the methods of corrected thrombolysis in myocardial infraction frame count (cTFC). The abnormalities in the left ventricular function were assessed by echocardiography using PW-Doppler of the diastolic mitral inflow and tissue Doppler imaging. Twenty-one (43.8%) patients were diagnosed with SCFP, and twelve patients (25%) had slow epicardial coronary flow, hypertensive disease, and ventricular hypertrophy (SF LVH ). The remaining 15 (31.3%) were patients with ventricular hypertrophy, hypertension, and non-delayed epicardial coronary flow (NF LVH ). Results The patients with SF LVH showed reduced peak early diastolic lateral mitral annular velocity (e’ L ) when compared to SCFP (7.1±1.9cm/s vs 8.6±2.1 cm/s, p=0.045) and NF LVH (7.1±1.9 cm/s vs 8.7±1.8 cm/s, p=0.018). A borderline significant difference was observed for the peak early diastolic septal mitral annular velocity (e’S) between the patients with SF LVH and SCFP ( 7.0±1.3 cm/s vs 8.3±2.1 cm/s, p=0.057). The ratio of mitral diastolic inflow velocity to early diastolic velocity of the mitral annulus (E/e’) in the SF LVH group was a tendency higher than E/e’ of the patients with SCFP (9.8±3.1 vs. 8.2±2.1, p=0.084) and NF LVH (9.8±3.1 vs. 7.8±1.5, p=0.051) .In the group with left ventricular hypertrophy, E/e’ >10 was more frequently observed in patients with a marked delay in the epicardial flow (33.1 ± 13.1 frames vs. 25.4 ± 11.8 frames, p=0.011) and higher left ventricular mass (146.9 ± 17.7 g/m2 vs. 126.1 ± 121.5 g/m2, p=0.027). Conclusions Patients with microvascular angina represent a diverse population. The echocardiographic parameters of left ventricular relaxation (e') and end-diastolic pressure (E/e’) are abnormally altered in the population with left ventricular hypertrophy compared...

show abstract

Left Ventricular Mass Influences Relationship Between Filling Pressure and Early-Diastolic Ratio of Inflow Velocity to Mitral Annular Velocity (E/e′)

Cited by 4 publications

References 18 publications

Non‐invasive assessment of left ventricular filling pressure in aortic stenosis

Non‐invasive assessment of left ventricular filling pressure in aortic stenosis

Correlation of left atrial function and pulmonary edema in patients with left heart failure on cardiopulmonary ultrasonography

Left Ventricular Diastolic Function: Comparison of Slow Coronary Flow Phenomenon and Left Ventricular Hypertrophy in the Absence of Obstructive Coronary Disease

Contact Info

Product

Resources

About