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Presence and Implication of Temporal Nonuniformity of Early Diastolic Left Ventricular Wall Expansion in Patients With Heart Failure

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Title: Presence and Implication of Temporal Nonuniformity of Early Diastolic Left Ventricular Wall Expansion in Patients With Heart Failure
Authors: Iwano, Hiroyuki Browse this author →KAKEN DB
Kamimura, Daisuke Browse this author
Fox, Ervin R. Browse this author
Hall, Michael E. Browse this author
Vlachos, Pavlos Browse this author
Little, William C. Browse this author
Keywords: Heart failure
Left ventricular diastolic function
Issue Date: Dec-2016
Publisher: Elsevier
Journal Title: Journal of Cardiac Failure
Volume: 22
Issue: 12
Start Page: 945
End Page: 953
Publisher DOI: 10.1016/j.cardfail.2016.04.007
PMID: 27095528
Abstract: Background: Early-diastolic left ventricular (LV) longitudinal expansion is delayed with diastolic dysfunction. We hypothesized that, in patients with heart failure (HF) regardless of LV ejection fraction (EF), there is diastolic temporal non-uniformity with a delay of longitudinal relative to circumferential expansion. Methods and Results: Echocardiography was performed in 143 HF patients: 50 with preserved EF (HFpEF) and 93 with reduced EF (HFrEF) and 31 normal controls. The delay of early-diastolic mitral annular velocity from the mitral Doppler E (TE-e′) was measured as a parameter of the longitudinal-expansion delay. The delay of the longitudinal early-diastolic global strain rate (SRE) relative to circumferential SRE (DelayC-L) was calculated as a parameter of temporal non-uniformity. Intra LV pressure difference (IVPD) was estimated by using color M-mode Doppler data as a parameter of LV diastolic suction. Although normal controls had symmetrical LV expansion in early diastole, TE-e′ and DelayC-L were significantly prolonged in HF regardless of EF (P<0.01 vs controls for all). Multivariate analysis revealed that DelayC-L was the independent determinant of IVPD among the parameters of LV geometry and contraction (β=-0.21, P<0.05). Conclusion: An abnormal temporal non-uniformity of early-diastolic expansion is present in HF regardless of EF, which was associated with reduced LV suction.
Rights: © 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 岩野 弘幸

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