Russian Heart Failure Journal 2011year Prognostic role of left ventricular diastolic dysfunction in patients with CAD and heart failure

To access this material please log in or register

Register Authorize

Prognostic role of left ventricular diastolic dysfunction in patients with CAD and heart failure

Hamuev Ya. P.
State Budgetary Educational Institution “I. M. Sechenov First Moscow State Medical University” of the RF Ministry of Health Care, Trubetskaya 8, Bld. 2, Moscow 119991

Keywords: left ventricular diastolic dysfunction, coronary artery disease, prognosis

DOI: 10.18087/rhfj.2011.2.1481

Background. Over the last decade the problem of LV diastolic dysfunction (DD) is highly relevant due to its high prevalence in population. 25–30 % of patients over 45 years have DD. Objective. To expand the assessment of prognosis in CAD patients with heart failure, taking into account clinical data, results of one-and two-dimensional echocardiography, pulsed wave and continuous-wave Doppler echocardiography, Doppler tissue imaging (DWT), ultrasound mapping of elastic arteries. To determine the most significant “related symptoms” to evaluate the prognosis in the model, connecting clinical presentation, echocardiographic data, ultrasound of arteries. Materials and methods. The study included 119 patients with CAD and heart failure II–IV FC (NYHA). The control group included patients with CAD without HF (n=162). All patients underwent echocardiographic studies: one-, two-dimensional echocardiography, Doppler echocardiography. Results. The prediction model of fatal outcome in the studied cohort of patients was developed with sensitivity of 81.8 % and specificity of 86.4 %. “Related symptoms” were picked out as the signs of poor prognosis with sensitivity of 92.0 % and specificity of 91.2 %.
  1. European Study Group on Diastolic Heart Failure. How to diagnose diastolic heart failure. Eur Heart J. 1998;19 (7):990–1003.
  2. Echeverria HH, Bilsker MS, Myerburg RJ, Kessler KM. Congestive heart failure: echocardiographic insights. Am J Med. 1983;75 (5):750–755.
  3. Paulus WJ, Tschope C, Sanderson JE et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J. 2007;28 (20):2539–2550.
  4. Owan TE, Hodge DO, Herges RM et al. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006;355 (3):251–259.
  5. Abhayaratna WP, Marwick TH, Smith WT, Becker NG. Characteristics of left ventricular diastolic dysfunction in the community: an echocardio-graphic survey. Heart. 2006;92 (9):1259–1264.
  6. Cho GY, Marwick TH, Kim HS et al. Global 2‑dimensional strain as a new prognosticator in patients with heart failure. J Am Coll Cardiol. 2009 Aug; 54 (7):618–624.
  7. Persson H, Lonn E, Edner M et al. Diastolic Dysfunction in Heart Failure With Preserved Systolic Function: Need for Objective Evidence. Results From the CHARM Echocardiographic Substudy – CHARMES. J Am Coll Cardiol. 2007;49 (6):687–694.
  8. Pritchett AM, Mahoney DW, Jacobsen SJ et al. Diastolic dysfunction and left atrial volume: a population-based study. J Am Coll Cardiol. 2005;45 (1):87–92.
  9. Maurer MS, Spevack D, Burkhoff D, Kronzon I. Diastolic dysfunction: can it be diagnosed by Doppler echocardiography? J Am Coll Cardiol. 2004;44 (8):1543–1549.
  10. Appleton C, Hatle L, Popp R. Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined hemodynamic and Doppler echocardiographic study. J Am Coll Cardiol. 1988;12 (2):426–440.
  11. Lester SJ, Tajik AJ, Nishimura RA et al. Unlocking the mysteries of diastolic function: deciphering the Rosetta Stone 10 years later. J Am Coll Cardiol. 2008;51 (7):679–689.
  12. Kirkpatrick JN, Vannan MA, Narula J, Lang RM. Echocardiography in heart failure: applications, utility, and new horizons. J Am Coll Cardiol. 2007;50 (5):381–396.
  13. Беленков Ю. Н., Мареев В. Ю. Принципы рационального лечения сердечной недостаточности. – М.: Materia Medica, 2000. – 266с.
  14. Васильев А. П., Стрельцова Н. Н., Горбунов Т. Ю. Значение антиоксидантных свойств карведилола при воздействии на процессы ремоделирования сердца у больных ишемической болезнью сердца с начальными проявлениями сердечной недостаточности. Кардиология. 2003;43 (2):69–70.
  15. Ganau A, Devereux RB, Roman MJ et al. Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. J Am Coll Cardiol. 1992;19 (7):1550–1558.
  16. Грачев А. В., Аляви А. Л., Ниязова Г. У., Мостовщиков С. Б. Масса миокарда левого желудочка, его функциональное состояние и диастоличе­ская функция сердца у больных артериальной гипертонией при различных эхокардиографических типах геометрии левого желудочка сердца. Кардиология. 2000;40 (3):31–38.
  17. Ommen SR, Nishimura RA. A clinical approach to the assessment of left ventricular diastolic function by Doppler echocardiography: update 2003. Heart. 2003;89 (Suppl 3):iii18–23.
  18. Bruch C, Grude M, Müller J уе al. Usefulness of tissue Doppler imaging for estimation of left ventricular filling pressures in patients with systolic and diastolic heart failure. Am J Cardiol. 2005;95 (7):892–895.
  19. Maeder MT, Kaye DM. Heart failure with normal left ventricular ejection fraction. J Am Coll Cardiol. 2009;53 (11):905–918.
  20. Redfield MM, Rodeheffer RJ, Jacobsen SJ et al. Plasma brain natriuretic peptide to detect preclinical ventricular systolic or diastolic dysfunction: a community-based study. Circulation. 2004;109 (25):3176–3181.
  21. Dokainish H, Zoghbi WA, Lakkis NM et al. Optimal noninvasive assessment of left ventricular filling pressures: a comparison of tissue Doppler echocardiography and B-type natriuretic peptide in patients with pulmonary artery catheters. Circulation. 2004 May; 109 (20):2432–2439.
  22. Tretjak M, Verovnik F, Benko D, Kozelj M. Tissue Doppler velocities of mitral annulus and NT-proBNP in patients with heart failure. Eur J Heart Fail. 2005;7 (4):520–524.
  23. Capomolla S, Ceresa M, Pinna G et al. Echo-Doppler and clinical evaluations to define hemodynamic profile in patients with chronic heart failure: accuracy and influence on therapeutic management. Eur J Heart Fail. 2005;7 (4):624–630.
  24. Lehmann ED. Terminology for the definition of arterial elastic properties. Pathol Biol (Paris). 1999;47 (6):656–664.
  25. Гаман С. А. Оценка распространенности и степени тяжести мультифокального атеросклероза с использованием методов электронно-лучевой компьютерной томографии и ультразвукового дуплексного сканирования у больных ишемической болезнью сердца. Автореф. Дис. к. м. н. Научно-исследовательский институт кардиологии им. А. Л. Мясникова РКНПК МЗ РФ. – М., 2004 –28с.
  26. Arroyo-Espliguero R, Mollichelli N, Avanzas P et al. Chronic inflammation and increased arterial stiffness in patients with cardiac syndrome X. Eur Heart J. 2003 Nov; 24 (22):2006–11.
  27. Lafitte S. Do we need new echocardiographic prognosticators for the management of heart failure patients? J Am Coll Cardiol. 2009;54 (7):625–627.
  28. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991;325 (5):293–302.
  29. Yu CM, Sanderson JE, Marwick TH, Oh JK. Tissue Doppler imaging a new prognosticator for cardiovascular diseases. J Am Coll Cardiol. 2007 May 15;49 (19):1903–1914.
  30. Notomi Y, Thomas JD. Presto untwisting and legato filling. JACC Cardiovasc Imaging. 2009;2 (6):717–719.
  31. Zile MR, Gaasch WH, Carroll JD et al. Heart failure with a normal ejection fraction: is measurement of diastolic function necessary to make the diagnosis of diastolic heart failure? Circulation. 2001;104 (7):779–782.
  32. Burns AT, La Gerche A, Prior DL, Macisaac AI. I. Left ventricular untwisting is an important determinant of early diastolic function. JACC Cardiovasc Imaging. 2009;2 (6):709–716.
  33. Shaw LJ, Bugiardini R, Merz CN. Women and ischemic heart di­sease. Evolving knowledge. J Am Coll Cardiol. 2009 Oct 20;54 (17):1561–1575.
  34. Nishimura RA, Jaber W. Understanding «diastolic heart failure»: the tip of the iceberg. J Am Coll Cardiol. 2007;49 (6):695–697.
  35. Mann T, Goldberg S, Mudge GH Jr, Grossman W. Factors contribu­ting to altered left ventricular diastolic properties during angina pectoris. Circulation. 1979;59 (1):14–20.
  36. Ahmed A, Zile MR, Rich MW et al. Hospitalizations due to unstable angina pectoris in diastolic and systolic heart failure. Am J Cardiol. 2007;99 (4):460–464.
  37. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55 (13):1318–1327.
  38. Elefteriades JA, Farkas EA. Thoracic aortic aneurysm clinically pertinent controversies and uncertainties. J Am Coll Cardiol. 2010;55 (9):841–857.
  39. Borlaug BA, Kass DA. Ventricular-vascular interaction in heart failure. Heart Fail Clin. 2008;4 (1):23–36.
Hamuev Ya. P. Prognostic role of left ventricular diastolic dysfunction in patients with CAD and heart failure. Russian Heart Failure Journal. 2011;12(2):102-107.

To access this material please log in or register

Register Authorize
Ru En