We aimed to determine the prevalence of echocardiographic abnormalities and their relation to clinical characteristics and cardiac symptoms in a large, contemporary cohort of patients with type 2 diabetes.
A total of 1030 patients with type 2 diabetes participated. Echocardiographic abnormalities were present in 513 (49.8%) patients, mainly driven by a high prevalence of diastolic dysfunction 178 (19.4%), left ventricular hypertrophy 213 (21.0%) and left atrial enlargement, 200 (19.6%). The prevalence increased markedly with age from 31.1% in the youngest group (75?years) (p?
Acute administration of a single dose of valsartan improves left ventricular functions: a pilot study to assess the role of tissue velocity echocardiography in patients with systemic arterial hypertension in the TVE-valsartan study I.
BACKGROUND: The advent of colour-coded tissue velocity echocardiography (TVE) has now made it possible to quantify left ventricular (LV) functions in patients with systemic arterial hypertension (HTN). Hypothesis In this project, we have studied the cardiac effects of a single dose of orally administered valsartan in patients with known HTN. METHODS: Fifty-five patients with HTN with a mean age of 56 +/- 10 years were given an early morning dose of 80 mg valsartan withholding regular antihypertensive medications on the day of investigation. TVE images, acquired on VIVID systems were digitized for postprocessing of longitudinal and radial peak systolic velocities, strain rate, and systolic and diastolic time intervals before (pre) and 5 h after (post) administration of the drug. RESULTS: Blood pressure (mmHg) pre and post, respectively, were 147 +/- 15 versus 137 +/- 14 systolic and 90 +/- 7 versus 86 +/- 7 diastolic (all P
Cigarettes and Swedish snuff contain nicotine, which influence the cardiovascular system. Cigarette smoke has been shown to give an acute impairment in diastolic heart parameters. The systolic and diastolic heart function in snuff users is not thoroughly enough investigated. The aim of this study was to investigate if Swedish snuff will give an acute decrease in systolic and diastolic heart parameters in the left and right ventricles in healthy Swedish snuffers.
Thirty healthy volunteers were examined with echocardiography. The study involved recordings from four different times: before snuff intake, 5 and 30 min after intake and finally 30 min after snuff withdrawal. The systolic and diastolic heart parameters were collected with conventional echocardiographic methods. In addition, the heart frequency and blood pressure response were measured. The pulse and blood pressure response were significantly altered (P
To assess lung function, gas exchange, exercise capacity, and right-sided heart hemodynamics, including pulmonary artery pressure, in patients long term after pneumonectomy.
Among 523 consecutive patients who underwent pneumonectomy for lung cancer between January 1992 and September 2001, 117 were alive in 2006 and 100 were included in the study. During a 1-day period, each patient had complete medical history, chest radiographs, pulmonary function studies, resting arterial blood gas analysis, 6-minute walk test, and Doppler echocardiography.
Most patients (N = 73) had no or only minimal dyspnea. On the basis of predicted values, functional losses in forced expiratory volume in 1 second and forced vital capacity were 38% ± 18% and 31% ± 24%, respectively, and carbon monoxide diffusing capacity decreased by 31% ± 18%. There was a significant correlation between preoperative and postoperative forced expiratory volume in 1 second (P
To study the effect of aerobic interval training (AIT) on myocardial function in sedentary seniors compared to master athletes (MA) and young controls.
Sixteen seniors (72 ± 1 years, 10 men) performed AIT (4 × 4 minutes) at ˜ 90% of maximal heart rate three times per week for 12 weeks. Results were compared with 11 male MA (74 ± 2 years) and 10 young males (23 ± 2 years).
Seniors had an impaired diastolic function compared to the young at rest. AIT improved resting diastolic parameters, increased E/A ratio (44%, p
To assess left ventricular systolic and diastolic function, M-mode (n = 675) and transmitral Doppler echocardiography (n = 358) were performed in patients with stable angina pectoris and compared with 50 matched healthy controls. Left ventricular fractional shortening (FS) was significantly lower in male than in female patients (32 +/- 7 vs. 35 +/- 7%, p
Peak left ventricular (LV) relaxation normally precedes peak filling (E), which supports the hypothesis that LV suction contributes to early-diastolic filling. The significance of similar temporal discordance in late diastole has previously not been studied. We describe the time relationships between mitral annular motion and LV filling in early and late diastole and examine the effect of normal ageing on these time intervals.
A total of 128 healthy subjects aged 25-88 years were studied. Transmitral and pulmonary venous flow reversals (Ar) were recorded by Doppler echocardiography. Mitral annular diastolic displacement-early (E(m)) and late (A(m))-were recorded by Doppler tissue imaging. With reference to electrocardiographic R and P-waves, the following measurements were made: R to peak E-wave (R-E) and E(m) (R-E(m)); onset P to peak A-wave (P-pA), A(m) (P-pA(m)), and Ar (P-pAr). The differences between [(R-E) and (R-E(m))] for early-diastolic temporal discordance (EDTD) and [(P-A) and (P-A(m))] for late-diastolic temporal discordance (LDTD) were calculated. Isovolumic relaxation time (IVRT) was also measured. Early-diastolic temporal discordance was approximately 26 ms in all age groups. Late-diastolic temporal discordance, however, was inversely related to age (r = -0.35, P
Ambulatory blood pressure (ABP) has been shown to have an association with left ventricular diastolic dysfunction (LVDD) in cross-sectional assessments. We evaluated the association between ABP measurement (ABPM) and the development of LVDD during over 20 years of follow up in 414 middle-aged subjects from OPERA cohort.
ABPM, clinical, and anthropometric measurements were performed in baseline. Echocardiographic measurements were performed at baseline and during follow-up and E/E' =15 was considered indicating significant LVDD.
Several baseline clinical characteristics (age, female gender, short stature, body mass index, prevalence of diabetes, in-office systolic BP (SBP), in-office pulse pressure (PP), N-terminal pro-atrial natriuretic peptide, and the use of antihypertensive therapy) were associated with the development of LVDD. Baseline 24-hour mean, daytime mean or nighttime mean SBP or diastolic BP were not associated with the development of LVDD, neither were different circadian BP profiles. Instead 24-hour mean, daytime mean and nighttime mean PP showed significant association with the development of LVDD (P from
[An outpatient study by stress echocardiography with dobutamine of myocardial function in patients with congestive heart failure (the first trial in Russia of the use of the dobutamine-echocardiography test)].
Dobutamin stress-echocardiography has been tried outpatiently in the diagnostic center for feasible use in functional assessment of the myocardium in patients with congestive heart failure class 3-4 by classification of New York Heart Association. Eleven outpatients (a mean age 56 +/- 8 years) with left ventricular dilatation and a reduction in the ejection fraction received an increasing dose of dobutamin (5-40 micrograms) min/kg in intravenous infusion in the course of which central hemodynamics and left ventricular segmental contractility were measured with two-dimensional and Doppler echocardiography. By the hemodynamic response to dobutamin infusion reflecting difference in the myocardial reserve, two groups of patients were identified. The authors suggest dobutamin Doppler echocardiography for use in outpatient setting as a safe and effective procedure for assessing contractile myocardial reserve and prognosis of congestive heart failure.
Transcatheter aortic valve implantation (TAVI) is established as an attractive treatment option for high-risk patients with aortic valve stenosis. One concern is the high risk of prosthetic valve regurgitation. This study aimed to examine for potential preoperative risk factors for postprocedural transcatheter heart valve regurgitation and to quantify the risk, degree, and consequences of postprocedural regurgitation.
100 consecutive patients who underwent femoral (n = 22) or transapical (n = 78) TAVI were retrospectively reviewed. Echocardiographic valve regurgitation and clinical parameters were analyzed over the first year after TAVI.
Seventy-five percent of all patients had prosthetic valve regurgitation. It was, however, only mild or absent in 64% of patients and did not require re-intervention in any of the patients in the series. The severity of the regurgitation appeared unchanged over the one-year follow-up period. Moderate to severe regurgitation was associated with significant yet stable dilatation of the left ventricle over one year and lesser NYHA class improvement three months after TAVI. Asymmetrical native valve calcification increased the risk of paravalvular regurgitation non-significantly.
Transcatheter heart valve regurgitation seems to be mild in the majority of cases and unchanged over a 12 months follow-up period. While affecting left ventricular dimensions in moderate or severe cases, we observed no obvious undesirable consequences of the prosthetic valve regurgitation within the first year.