Russian Heart Failure Journal 2011year Balance of collagen in patients with heart failure and normal ejection fraction, depending on the type of left ventricular filling and E / e' ratio


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2011/

Balance of collagen in patients with heart failure and normal ejection fraction, depending on the type of left ventricular filling and E / e' ratio

Ovchinnikov A. G., Svirida O. N., Azizova A. G., Ageev F. T.

Keywords: left ventricle, heart failure, fibrosis, echocardiography

DOI: 10.18087 / rhfj.2011.3.1539

Background. Currently, one of the most accurate method for LV diastolic pressure assessment is to determine the ratio of peak transmitral E wave and diastolic rise of LV basis in early diastole (E / e' ratio). As diagnostic accuracy of E / e' ratio is greater than E / A ratio and DT interval of transmitral blood flow, it is possible that E / e' ratio is more closely associated with myocardial collagen balance, rather than indicators of transmitral blood flow. Objective.To compare disease severity and levels of biochemical markers of collagen balance in patients with heart failure with preserved LV systolic function and diastolic dysfunction of varying severity, estimated with traditional analysis of transmitral flow, as well as calculation of E / e' ratio. Materials and methods. 51 patients with CHF and LV EF>50 % underwent echocardiographic assessment of LV diastolic function and detection of N-terminal pro-brain natriuretic peptide (NT-proBNP) level and biochemical markers of collagen balance. Results. Ranking of patients by type of LV filling (based on traditional Doppler indices of transmitral flow) did not reveal differences in severity of functional limitations, level of NT-proBNP and left ventricular fibrosis (a marker of collagen balance). However, differences were found in ranking patients according to level of LV filling pressure (on the basis of E / e' ratio by Tissue Dopplerography). NT-proBNP was more accurate marker than markers of collagen balance in the ability to detect patients with high LV filling pressure. No other biochemical parameters but NT-proBNP level was associated with E / e' ratio (r= +0.41; p<0.001). Thus, E / e' ratio more accurately reflects the severity of functional limitations and the degree of LV fibrosis in patients with diastolic heart failure in comparison with traditional evaluation of diastolic dysfunction severity by type of LV filling.
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Ovchinnikov A. G., Svirida O. N., Azizova A. G., Ageev F. T. Balance of collagen in patients with heart failure and normal ejection fraction, depending on the type of left ventricular filling and E / e' ratio. Russian Heart Failure Journal. 2011;12(3):127-135

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