Pseudonormal mitral filling pattern predicts hospital re-admission in patients with congestive heart failure

Whalley, Gillian A.; Doughty, Robert N.; Gamble, Greg; Wright, Samson; Walsh, Helen; Muncaster, Stephanie A.; Sharpe, Norman

doi:10.1016/s0735-1097(02)01868-5

Cited by 89 publications

(53 citation statements)

References 41 publications

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“…This result remains to be confirmed in a large prospective study. However, the results are in accordance with studies of patients with heart failure of predominantly ischemic origin, 66 patients undergoing coronary artery bypass grafting, 67 and a recent population-based study. 68 In contrast to the restrictive and pseudonormal patterns, there is little evidence that mild diastolic dysfunction is an independent risk factor after AMI.…”

Section: Relation Between LV Filling Pattern/la Size and Prognosis Afsupporting

confidence: 89%

Prognostic Importance of Diastolic Function and Filling Pressure in Patients With Acute Myocardial Infarction

et al. 2006

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A cute myocardial infarction (AMI) is characterized by regional myocardial damage that may lead to systolic and diastolic dysfunction with a subsequent risk of left ventricular (LV) remodeling, local and systemic neurohormonal activation, and vascular dysfunction. The pathophysiology and prognosis of LV systolic dysfunction after AMI have been the focus of research for several decades. Insights from these studies have led to several therapeutic interventions that improve outcome. In addition to depressed systolic function, clinical or radiographic evidence of heart failure is a consistent and powerful predictor of outcome in patients after AMI. 1 Pulmonary congestion after infarction reflects raised LV filling pressures but is frequently seen after what appears to be only minor myocardial damage. 2 The pathophysiological mechanism for this is incompletely understood but may involve impaired active relaxation of the myocardium and increased LV chamber stiffness and hence abnormalities in diastolic function. If these are to be determined directly, cardiac catheterization with assessment of pressurevolume relationships with the use of high-fidelity micromanometer catheters is required. This highly specialized approach is not suitable for daily clinical practice. Likewise, although direct measurements of right heart or LV end-diastolic pressure are important predictors of adverse outcome after AMI in selected populations, 3,4 the risk of complications precludes routine use of indwelling catheters in all patients. There has therefore been considerable interest in using noninvasive estimates of diastolic function, particularly Doppler echocardiographic assessment of LV filling dynamics and, more recently, the volume of the left atrium (LA), to predict outcome in patients with AMI.The objective of this review is to summarize the current understanding of abnormal LV filling in the early phase after AMI with focus on the complementary prognostic information that may be gained by assessment of LV filling dynamics and LA volume with the use of 2-dimensional and Doppler echocardiography. Doppler Echocardiographic Assessment of Diastolic FunctionAfter an AMI, myocardial ischemia, cell necrosis, microvascular dysfunction, and regional wall motion abnormalities will influence the rate of active relaxation. In addition, interstitial edema, fibrocellular infiltration, and scar formation will directly affect LV chamber stiffness. Thus, abnormalities in LV filling are common in this setting. Spectral Pulsed-Wave Doppler EchocardiographyThe pulsed-wave Doppler technique allows assessment of flow velocities (Ͻ2 m/s) at a distinct spatial position, making the technique suitable for assessment of changes in inflow velocities across the mitral valve during diastole. With mitral valve opening, the early inflow velocity will be determined largely by ventricular suction and the pressure gradient between the LA and LV. [5][6][7] This is followed by a steady decrease in inflow velocity, with a normal duration of 140 to 240 ms (early mitral ...

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Section: Relation Between LV Filling Pattern/la Size and Prognosis Afsupporting

confidence: 89%

Prognostic Importance of Diastolic Function and Filling Pressure in Patients With Acute Myocardial Infarction

et al. 2006

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“…31, 32 In the present study, elevated LVEDP was significantly related to increased CVF. Therefore, accumulation of myocardial interstitial fibrillar collagen may have caused ventricular diastolic dysfunction in the HFREF group with a resultant poor prognosis.…”

Section: Morphometric Variables and Cardiac Function As Prognostic Insupporting

confidence: 57%

Prognostic Impact of Myocardial Interstitial Fibrosis in Non-Ischemic Heart Failure - Comparison Between Preserved and Reduced Ejection Fraction Heart Failure -

Aoki

Fukumoto

Sugimura

et al. 2011

Circ J

155

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“…Unfortunately, the group size of those with pseudonormal or restrictive filling pattern are too small to allow further analysis, but it seems that this could be a more diseased group compared to those with an isolated relaxations abnormality (Table 5), in accordance with earlier published reports [26].…”

Section: Echocardiographic Parameters As Prognostic Indicators For Casupporting

confidence: 85%

Can NT-proBNP predict risk of cardiovascular mortality within 10 years? Results from an epidemiological study of elderly patients with symptoms of heart failure

Alehagen

Dahlström

2009

International Journal of Cardiology

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Pseudonormal mitral filling pattern predicts hospital re-admission in patients with congestive heart failure

Cited by 89 publications

References 41 publications

Prognostic Importance of Diastolic Function and Filling Pressure in Patients With Acute Myocardial Infarction

Prognostic Importance of Diastolic Function and Filling Pressure in Patients With Acute Myocardial Infarction

Prognostic Impact of Myocardial Interstitial Fibrosis in Non-Ischemic Heart Failure - Comparison Between Preserved and Reduced Ejection Fraction Heart Failure -

Can NT-proBNP predict risk of cardiovascular mortality within 10 years? Results from an epidemiological study of elderly patients with symptoms of heart failure

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