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Raisi-Estabragh Z, Szabo L, Schuermans A, Salih AM, Chin CWL, Vágó H, Altmann A, Ng FS, Garg P, Pavanello S, Marwick TH, Petersen SE. Noninvasive Techniques for Tracking Biological Aging of the Cardiovascular System: JACC Family Series. JACC Cardiovasc Imaging 2024:S1936-878X(24)00082-2. [PMID: 38597854 DOI: 10.1016/j.jcmg.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/01/2024] [Accepted: 03/01/2024] [Indexed: 04/11/2024]
Abstract
Population aging is one of the most important demographic transformations of our time. Increasing the "health span"-the proportion of life spent in good health-is a global priority. Biological aging comprises molecular and cellular modifications over many years, which culminate in gradual physiological decline across multiple organ systems and predispose to age-related illnesses. Cardiovascular disease is a major cause of ill health and premature death in older people. The rate at which biological aging occurs varies across individuals of the same age and is influenced by a wide range of genetic and environmental exposures. The authors review the hallmarks of biological cardiovascular aging and their capture using imaging and other noninvasive techniques and examine how this information may be used to understand aging trajectories, with the aim of guiding individual- and population-level interventions to promote healthy aging.
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Affiliation(s)
- Zahra Raisi-Estabragh
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom; Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.
| | - Liliana Szabo
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom; Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom; Semmelweis University, Heart and Vascular Center, Budapest, Hungary
| | - Art Schuermans
- Faculty of Medicine, KU Leuven, Leuven, Belgium; Program in Medical and Population Genetics, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, USA; Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ahmed M Salih
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom; Department of Population Health Sciences, University of Leicester, Leicester UK; Department of Computer Science, Faculty of Science, University of Zakho, Zakho, Kurdistan Region, Iraq
| | - Calvin W L Chin
- Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore; Cardiovascular Academic Clinical Programme, Duke National University of Singapore Medical School, Singapore, Singapore
| | - Hajnalka Vágó
- Semmelweis University, Heart and Vascular Center, Budapest, Hungary
| | - Andre Altmann
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Fu Siong Ng
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Pankaj Garg
- University of East Anglia, Norwich Medical School, Norwich, United Kingdom; Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom
| | - Sofia Pavanello
- Occupational Medicine, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Padua, Italy; Padua Hospital, Occupational Medicine Unit, Padua, Italy; University Center for Space Studies and Activities "Giuseppe Colombo" - CISAS, University of Padua, Padua, Italy
| | | | - Steffen E Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom; Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom; Health Data Research UK, London, United Kingdom
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Abadie BQ, Cremer PC, Vakamudi S, Gillinov AM, Svensson LG, Cho L. Sex-Specific Prognosis of Left Ventricular Size and Function Following Repair of Degenerative Mitral Regurgitation. J Am Coll Cardiol 2024; 83:303-312. [PMID: 38199708 DOI: 10.1016/j.jacc.2023.10.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/29/2023] [Accepted: 10/13/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Prior studies have demonstrated worse long-term outcomes for women after surgery for severe mitral regurgitation (MR). The current Class I indications for surgery for severe degenerative MR use cutoffs of left ventricular end-systolic dimension (LVESD) and left ventricular ejection fraction (EF) that do not account for known sex-related differences. OBJECTIVES The primary objective of this study was to assess long-term mortality following mitral valve repair in women compared with men on the basis of preoperative left ventricular systolic dimensions and EF. METHODS Consecutive patients who underwent isolated mitral valve repair for degenerative MR at a single institution between 1994 and 2016 were screened. Adjusted HRs for all-cause mortality were compared according to baseline LVESD, LVESD indexed to body surface area (LVESDi), and EF for men and women. RESULTS Among 4,589 patients, 1,825 were women (40%), and after a median follow-up period of 7.2 years, 344 patients (7.5%) had died. The risk for mortality for women increased from the baseline hazard at an LVESD of 3.6 cm, whereas an inflection point for increased risk with LVESD was not evident in men. Regarding LVESDi, the risk for women increased at 1.8 cm/m2 compared with 2.1 cm/m2 in men. For EF, women and men had a similar inflection point (58%); however, mortality was higher for women as EF decreased. CONCLUSIONS After mitral valve repair, women have a higher risk for all-cause mortality at lower LVESD and LVESDi and higher EF. These results support consideration of sex-specific thresholds for LVESDi in surgical decision making for patients with severe MR.
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Affiliation(s)
- Bryan Q Abadie
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Paul C Cremer
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sneha Vakamudi
- Ascension Texas Cardiovascular and the University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - A Marc Gillinov
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Lars G Svensson
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Leslie Cho
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
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Sawada N, Nakanishi K, Nakao T, Miyoshi T, Takeuchi M, Asch FM, Lang RM, Daimon M. Normal Values of Echocardiographic Right Ventricular Size and Systolic Function Measurements in a Healthy Japanese Population - Subanalysis of the WASE Study. Circ Rep 2023; 5:424-429. [PMID: 37969234 PMCID: PMC10632071 DOI: 10.1253/circrep.cr-23-0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 11/17/2023] Open
Abstract
Background: Although accurate assessment of right ventricular (RV) morphology and function is clinically important, data regarding reference values for echocardiographic measurements of the right ventricle in the Japanese population are limited. Methods and Results: The World Alliance Society of Echocardiography (WASE) Normal Values Study was conducted to examine normal echocardiographic values in 15 countries. Using the WASE study database, we analyzed 2-dimensional echocardiographic parameters of RV size and systolic function in 192 healthy Japanese individuals and compared them with those obtained from 153 healthy American individuals. In the Japanese population, the absolute values of RV dimensions were smaller for women than men, although the difference disappeared after the data were adjusted for body surface area. RV dimensions, RV length and RV area were smaller in the elderly, but age did not affect RV systolic function. The absolute value, but not the adjusted value, of RV size tended to be smaller in Japanese than American individuals for both sexes. For men, RV systolic function parameters were lower in the Japanese population. This trend was not seen in women. Conclusions: The present study identified normal reference values for RV size and systolic function in a healthy Japanese population. Sex, age, and race had a significant impact on RV size; however, this trend was weak for RV systolic function.
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Affiliation(s)
- Naoko Sawada
- Department of Cardiovascular Medicine, The University of Tokyo Tokyo Japan
- Department of Cardiology, NTT Medical Center Tokyo Tokyo Japan
| | - Koki Nakanishi
- Department of Cardiovascular Medicine, The University of Tokyo Tokyo Japan
| | - Tomoko Nakao
- Department of Cardiovascular Medicine, The University of Tokyo Tokyo Japan
- Department of Clinical Laboratory, The University of Tokyo Tokyo Japan
| | - Tatsuya Miyoshi
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University Osakasayama Japan
- MedStar Health Research Institute Washington, DC USA
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, University of Occupational and Environmental Health, School of Medicine Kitakyushu Japan
| | | | - Roberto M Lang
- Department of Radiology, University of Chicago Chicago, IL USA
| | - Masao Daimon
- Department of Clinical Laboratory, The University of Tokyo Tokyo Japan
- Department of Cardiology, International University of Health and Welfare, Mita Hospital Tokyo Japan
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van Ommen AMLN, Canto ED, Cramer MJ, Rutten FH, Onland-Moret NC, Ruijter HMD. Diastolic dysfunction and sex-specific progression to HFpEF: current gaps in knowledge and future directions. BMC Med 2022; 20:496. [PMID: 36575484 PMCID: PMC9795723 DOI: 10.1186/s12916-022-02650-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/07/2022] [Indexed: 12/28/2022] Open
Abstract
Diastolic dysfunction of the left ventricle (LVDD) is equally common in elderly women and men. LVDD is a condition that can remain latent for a long time but is also held responsible for elevated left ventricular filling pressures and high pulmonary pressures that may result in (exercise-induced) shortness of breath. This symptom is the hallmark of heart failure with preserved ejection fraction (HFpEF) which is predominantly found in women as compared to men within the HF spectrum. Given the mechanistic role of LVDD in the development of HFpEF, we review risk factors and mechanisms that may be responsible for this sex-specific progression of LVDD towards HFpEF from an epidemiological point-of-view and propose future research directions.
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Affiliation(s)
- A M L N van Ommen
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, 3508 GA, Utrecht, The Netherlands
| | - E Dal Canto
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, 3508 GA, Utrecht, The Netherlands
| | - Maarten J Cramer
- Clinical Cardiology Department, University Medical Center Utrecht, Utrecht University, 3508 GA, Utrecht, The Netherlands
| | - F H Rutten
- Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3508 GA, Utrecht, The Netherlands
| | - N C Onland-Moret
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3508 GA, Utrecht, The Netherlands
| | - H M den Ruijter
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, 3508 GA, Utrecht, The Netherlands.
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Egashira K, Sueta D, Komorita T, Yamamoto E, Usuku H, Tokitsu T, Fujisue K, Nishihara T, Oike F, Takae M, Hanatani S, Takashio S, Ito M, Yamanaga K, Araki S, Soejima H, Kaikita K, Matsushita K, Tsujita K. HFA-PEFF scores: prognostic value in heart failure with preserved left ventricular ejection fraction. Korean J Intern Med 2022; 37:96-108. [PMID: 34929994 PMCID: PMC8747922 DOI: 10.3904/kjim.2021.272] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 03/03/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND/AIMS The Heart Failure Association (HFA)-PEFF score is recognized as a simple method to diagnose heart failure (HF) with preserved ejection fraction (HFpEF). This study aimed to evaluate the relationship between HFA-PEFF scores and cardiovascular outcomes in HFpEF patients. METHODS A total of 502 consecutive HFpEF patients were prospectively observed for up to 1,500 days. Cardiovascular outcomes were compared between two groups of patients, defined by their HFA-PEFF scores: those who scored 2-4 (the intermediate-score group) and those who scored 5-6 group (the high-score group). Overall, 236 cardiovascular events were observed during the follow-up period (median, 1,159 days). RESULTS Kaplan-Meier analysis showed that there were significant differences in composite cardiovascular events and HF-related events between the intermediate-score group and the high-score group (p = 0.003 and p < 0.001, respectively). Multivariate Cox proportional hazards analysis showed that the HFA-PEFF scores significantly predicted future HF-related events (hazard ratio, 1.66; 95% confidence interval [CI], 1.11 to 2.50; p = 0.014); receiver operating characteristic analysis confirmed this relationship (area under the curve, 0.633; 95% CI, 0.574 to 0.692; p < 0.001). The cutoff HFA-PEFF score for the identification of HF-related events was 4.5. Decision curve analysis revealed that combining the HFA-PEFF score with conventional prognostic factors improved the prediction of HF-related events. CONCLUSION HFA-PEFF scores may be useful for predicting HF-related events in HFpEF patients.
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Affiliation(s)
- Koichi Egashira
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Daisuke Sueta
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takashi Komorita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroki Usuku
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takanori Tokitsu
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Koichiro Fujisue
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Taiki Nishihara
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Fumi Oike
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Masafumi Takae
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Shinsuke Hanatani
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Miwa Ito
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenshi Yamanaga
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Satoshi Araki
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hirofumi Soejima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichi Matsushita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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Sugimoto T, Dohi K. Current status and issues regarding reference values for echocardiography: a short review. J Med Ultrason (2001) 2021; 49:17-19. [PMID: 34185191 DOI: 10.1007/s10396-021-01108-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/02/2021] [Indexed: 10/21/2022]
Abstract
In general, the reference values of diagnostic test parameters are specified based on the values of 95% confidence intervals of those parameters measured in healthy subjects. As heart size varies according to sex, there are sex-related differences in the reference values of echocardiographic parameters. There have been attempts to minimize the variability in the reference values of echocardiographic parameters worldwide by correcting for age-related, sex-related, and body size-related differences. This short review describes the current status and issues regarding the reference values of echocardiographic parameters and discusses the findings of research aimed at resolving these issues.
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Affiliation(s)
- Tadafumi Sugimoto
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, 514-8507, Japan.
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, 514-8507, Japan
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Pewowaruk R, Rutkowski D, Johnson C, Wolfinger A, Roldán-Alzate A. Assessment of sex differences in ventricular-vascular coupling of left ventricular and aortic flow derived from 4D flow MRI in healthy, young adults. J Biomech 2021; 117:110276. [PMID: 33545606 PMCID: PMC7920945 DOI: 10.1016/j.jbiomech.2021.110276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 01/16/2021] [Indexed: 10/22/2022]
Abstract
To gain further insight into male-female differences in cardiovascular conditions it is important to understand sex differences in healthy populations. A previous study from our group of 39 healthy young volunteers (20-35 years) paradoxically found that men had greater left ventricular (LV) kinetic energy (KE) but women had greater LV vorticity. We reanalyzed cardiac four-dimensional flow MRI data from 20 of the original subjects (10 male and 10 female) to quantify aortic flow in addition to LV flow. The combination of LV and aortic flow parameters were then used to calculate ventricular vascular coupling of KE and vorticity. The sex difference found in LV flow were not found in aortic flow and the ventricular-vascular coupling of LV-to-aortic flow was similar between men and women. Dimensional analysis to account for differences in cardiac output and ventricular volume explained the differences found in LV flow. The analysis methods and results of this study may be of further use in understanding ventricular vascular coupling of transported flow variables in healthy sex differences, healthy aging, and various cardiovascular conditions.
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Affiliation(s)
- Ryan Pewowaruk
- Biomedical Engineering, University of Wisconsin - Madison, United States
| | | | - Cody Johnson
- Radiology, University of Wisconsin - Madison, United States
| | | | - Alejandro Roldán-Alzate
- Biomedical Engineering, University of Wisconsin - Madison, United States; Radiology, University of Wisconsin - Madison, United States; Mechanical Engineering, University of Wisconsin - Madison, United States.
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Xu B, Daimon M, Kawata T, Nakao T, Hirokawa M, Sawada N, Kimura K, Yamanaka Y, Morita H, Komuro I, Yatomi Y. Relationship Between Mitral Leaflet Size and Coaptation and Their Associated Factors in Patients with Normal Left Ventricular Size and Systolic Function. Int Heart J 2021; 62:95-103. [PMID: 33455980 DOI: 10.1536/ihj.20-148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Enlargement of the mitral valve (MV) has gained attention as a compensatory mechanism for functional mitral regurgitation (FMR). We aimed to determine if MV leaflet area is associated with MV coaptation-zone area and identify the clinical factors associated with MV leaflet size and coaptation-zone area in patients with normal left ventricle (LV) systolic function and size using real-time 3D echocardiography (RT3DE).We performed RT3DE in 135 patients with normal LV size and ejection fraction. MV leaflet and coaptation-zone areas were measured using custom 3D software. The clinical factors associated with MV leaflet and coaptation-zone areas were evaluated using univariate and multivariate linear regression analyses.There was a significant relationship between MV leaflet and coaptation-zone areas (r = 0.499, P < 0.001). MV leaflet area was strongly associated with body surface area (BSA) (r = 0.905, P < 0.001) rather than LV size and age. MV leaflet area/BSA was independently associated with male gender (P = 0.002), lower diastolic blood pressure (P = 0.042), and LV end-diastolic volume (LVEDV) index (P = 0.048); MV coaptation-zone area/BSA was independently associated with lower LVEDV index (P = 0.01).In patients with normal LV systolic function and size, MV leaflet size has a significant impact on competent MV coaptation. MV leaflet area might be intrinsically determined by body size rather than age and LV size, and the MV leaflet area/BSA is relatively constant. On the other hand, some clinical factors might also influence MV leaflet and coaptation-zone area.
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Affiliation(s)
- Boqing Xu
- Department of Clinical Laboratory, The University of Tokyo Hospital
| | - Masao Daimon
- Department of Clinical Laboratory, The University of Tokyo Hospital.,Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Takayuki Kawata
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Tomoko Nakao
- Department of Clinical Laboratory, The University of Tokyo Hospital
| | - Megumi Hirokawa
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Naoko Sawada
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Koichi Kimura
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Yuko Yamanaka
- Department of Cardiovascular Medicine, Jichi Medical University
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Yutaka Yatomi
- Department of Clinical Laboratory, The University of Tokyo Hospital
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Chang SN, Sung KT, Huang WH, Lin JW, Chien SC, Hung TC, Su CH, Hung CL, Tsai CT, Wu YW, Chiang FT, Yeh HI, Hwang JJ. Sex, racial differences and healthy aging in normative reference ranges on diastolic function in Ethnic Asians: 2016 ASE guideline revisited. J Formos Med Assoc 2021; 120:2160-2175. [PMID: 33423900 DOI: 10.1016/j.jfma.2020.12.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 11/08/2020] [Accepted: 12/24/2020] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Diastolic dysfunction (DD) has shown to be a hallmark pathological intermediate in the development of heart failure with preserved ejection fraction (HFpEF). We aim to establish age- and sex-stratified normal reference values of diastolic indices and to explore racial-differences. METHODS We explored age- and sex-related structural/functional alterations from 6023 healthy ethnic Asians (47.1 ± 10.9 years, 61.3% men) according to 2016 American Society of Echocardiography (ASE) diastolic dysfunction (DD) criteria. Racial comparisons were made using data from London Life Sciences Prospective Population (LOLIPOP) study. RESULTS Age- and sex-based normative ranges (including mean, median, 10% and 90% lower and upper reference values) were extracted from our large healthy population. In fully adjusted models, advanced age was independently associated with cardiac structural remodeling and worsened diastolic parameters including larger indexed LA volume (LAVi), lower e', higher E/e', and higher TR velocity; all p < 0.001), which were more prominent in women (P interaction: <0.05). Broadly, markedly lower e', higher E/e' and smaller LAVi were observed in ethnic Asians compared to Whites. DD defined by 2016 ASE criteria, despite at low prevalence (0.42%) in current healthy population, increased drastically with advanced age and performed perfectly in excluding abnormal NT-proBNP (≥125 pg/mL) (Specificity: 99.8%, NPV: 97.6%). CONCLUSION This is to date the largest cohort exploring the normative reference values using guideline-centered diastolic parameters from healthy Asians, with aging played as central role in diastolic dysfunction. Our observed sex and ethnic differences in defining healthy diastolic cut-offs likely impact future clinical definition for DD in Asians.
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Affiliation(s)
- Sheng-Nan Chang
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Dou-Liu City, Taiwan
| | - Kuo-Tzu Sung
- Department of Medicine, Mackay Medical College, Taipei, Taiwan; Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wen-Hung Huang
- Department of Medicine, Mackay Medical College, Taipei, Taiwan; Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Jou-Wei Lin
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Dou-Liu City, Taiwan
| | - Shih-Chieh Chien
- Department of Medicine, Mackay Medical College, Taipei, Taiwan; Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ta-Chuan Hung
- Department of Medicine, Mackay Medical College, Taipei, Taiwan; Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Cheng-Huang Su
- Department of Medicine, Mackay Medical College, Taipei, Taiwan; Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chung-Lieh Hung
- Department of Medicine, Mackay Medical College, Taipei, Taiwan; Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Institute of Biomedical Sciences, Mackay Medical College, New Taipei, Taiwan.
| | - Chia-Ti Tsai
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Wen Wu
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Fu-Tien Chiang
- Division of Cardiology, Department of Internal Medicine, Fu-Jen Catholic University Hospital and Fu-Jen Catholic University, Taipei, Taiwan
| | - Hung-I Yeh
- Department of Medicine, Mackay Medical College, Taipei, Taiwan; Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Juey-Jen Hwang
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Dou-Liu City, Taiwan; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Wakaki T, Ishibashi N, Yamao H. Increased left ventricular end-diastolic pressure after left ventriculography is associated with subsequent congestive heart failure-related hospitalization. INTERNATIONAL JOURNAL OF THE CARDIOVASCULAR ACADEMY 2021. [DOI: 10.4103/ijca.ijca_56_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Boudagh S, Alizadehasl A, Bakhshandeh H, Sadeghipour P, Mohebbi B, Baay M, Alemzadeh-Ansari M, Hosseini Z, Norouzi Z, Maleki M, Noohi F, Khalili Y, Naderi N, Pouraliakbar H, Ghadrdoost B, Arabian M, Khaleghparast S. Normal values of echocardiographic parameters and incidence of valvular heart findings in 2229 iranian peaple: Results from the “HAMRAH survey”. Res Cardiovasc Med 2021. [DOI: 10.4103/rcm.rcm_18_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Abstract
PURPOSE OF THE REVIEW This review summarizes sex-related changes in the heart and vasculature that occur with aging, both in the presence and absence of cardiovascular disease (CVD). RECENT FINDINGS In the presence of CVD risk factors and/or overt CVD, sex-specific changes in the number of cardiomyocytes, extent of the myocardial extracellular matrix, and myocellular hypertrophy promote unique patterns of LV remodeling in men and women. In addition, age- and sex-specific vascular stiffening is also well established, driven by changes in endothelial dysfunction, elastin-collagen content, microvascular dysfunction, and neurohormonal signaling. Together, these changes in LV chamber geometry and morphology, coupled with heightened vascular stiffness, appear to drive both age-related increases in systolic function and declines in diastolic function, particularly in postmenopausal women. Accordingly, estrogen has been implicated as a key mediator, given its direct vasodilating properties, association with nitric oxide excretion, and involvement in myocellular Ca2+ handling, mitochondrial energy production, and oxidative stress. The culmination of the abovementioned sex-specific cardiac and vascular changes across the lifespan provides important insight into heart failure development, particularly of the preserved ejection fraction variety, while offering promise for future preventive strategies and therapeutic approaches.
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Affiliation(s)
- Andrew Oneglia
- Applied Physiology and Advanced Imaging Lab, University of Texas at Arlington, 655 West Mitchell St, Arlington, TX, 76010, USA
| | - Michael D Nelson
- Applied Physiology and Advanced Imaging Lab, University of Texas at Arlington, 655 West Mitchell St, Arlington, TX, 76010, USA
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, AHSP Suite A3206, Los Angeles, CA, 90048, USA
| | - C Noel Bairey Merz
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, AHSP Suite A3206, Los Angeles, CA, 90048, USA.
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13
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Miyoshi T, Addetia K, Citro R, Daimon M, Desale S, Fajardo PG, Kasliwal RR, Kirkpatrick JN, Monaghan MJ, Muraru D, Ogunyankin KO, Park SW, Ronderos RE, Sadeghpour A, Scalia GM, Takeuchi M, Tsang W, Tucay ES, Tude Rodrigues AC, Vivekanandan A, Zhang Y, Blitz A, Lang RM, Asch FM, Prado AD, Filipini E, Kwon A, Hoschke-Edwards S, Regina Afonso T, Thampinathan B, Sooriyakanthan M, Zhu T, Wang Z, Wang Y, Zhang M, Zhang Y, Yin L, Li S, Alagesan R, Balasubramanian S, Ananth R, Bansal M, Badano LP, Palermo C, Bossone E, Di Vece D, Bellino M, Nakao T, Kawata T, Hirokawa M, Sawada N, Nabeshima Y, Yun HR, Hwang JW, Fasawe D. Left Ventricular Diastolic Function in Healthy Adult Individuals: Results of the World Alliance Societies of Echocardiography Normal Values Study. J Am Soc Echocardiogr 2020; 33:1223-1233. [DOI: 10.1016/j.echo.2020.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/05/2020] [Accepted: 06/05/2020] [Indexed: 01/10/2023]
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Hirokawa M, Daimon M, Kozuma K, Shinozaki T, Kimura K, Nakao T, Nakanishi K, Sawada N, Ishiwata J, Yoshida Y, Kato TS, Mizuno Y, Morita H, Yatomi Y, Komuro I. Are there gender differences in the association between body mass index and left ventricular diastolic function? A clinical observational study in the Japanese general population. Echocardiography 2020; 37:1749-1756. [PMID: 32959402 DOI: 10.1111/echo.14866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/31/2020] [Accepted: 08/31/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Increased body mass index (BMI) is a major risk factor for heart failure with preserved ejection fraction (HFpEF), and HFpEF is more prevalent in elderly females than males. We hypothesized that there may be gender differences in the association between BMI and echocardiographic left ventricular (LV) diastolic parameters. METHODS We enrolled 456 subjects (243 males) without overt cardiac diseases, all of whom underwent a health checkup. Early (E) and late (A) diastolic transmitral flow velocity, early diastolic mitral annular velocity (e'), and left atrial (LA) volume index were measured by echocardiography to assess LV diastolic function. To examine gender differences in the association between BMI and LV diastolic function, we analyzed the interaction effects of gender on the association between BMI and echocardiographic LV diastolic parameters. RESULTS Although there were significant gender differences in the association between BMI and E/A and e' in the crude model (interaction effect 0.037 and 0.173, respectively; P = .006 and .022, respectively), these differences were not statistically significant after adjustment for factors related to LV diastolic function. On the other hand, there were significant associations between BMI and LV diastolic parameters in each gender, even after adjustment. CONCLUSIONS Our findings suggest there is no gender difference in the association between BMI and echocardiographic LV diastolic parameters. However, the association between BMI and LV diastolic parameters was significant in both genders. Controlling body weight might be beneficial for both women and men to prevent progression of LV diastolic dysfunction and development of HFpEF.
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Affiliation(s)
- Megumi Hirokawa
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Masao Daimon
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Kayoko Kozuma
- Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Koichi Kimura
- The Department of General Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Tomoko Nakao
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Koki Nakanishi
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Naoko Sawada
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Jumpei Ishiwata
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuriko Yoshida
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Tomoko S Kato
- Division of Cardiology, Department of Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Yoshiko Mizuno
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
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15
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Ueda Y, Duler LMM, Elliot KJ, Sosa PMD, Roberts JA, Stern JA. Echocardiographic reference intervals with allometric scaling of 823 clinically healthy rhesus macaques (Macaca mulatta). BMC Vet Res 2020; 16:348. [PMID: 32962713 PMCID: PMC7510309 DOI: 10.1186/s12917-020-02578-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 09/17/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Echocardiography is commonly used for assessing cardiac structure and function in various species including non-human primates. A few previous studies reported normal echocardiographic reference intervals of clinically healthy rhesus macaques under sedation. However, these studies were under-powered, and the techniques were not standardized. In addition, body weight, age, and sex matched reference intervals should be established as echocardiographic measurements are commonly influenced by these variables. The purpose of this study was to establish reference intervals for complete echocardiographic parameters based on a large cohort of clinically healthy rhesus macaques with wide ranges of weight and age distributions using allometric scaling. RESULTS A total of 823 rhesus macaques (ages 6 months to 31 years old; body weights 1.4 to 22.6 kg) were enrolled. Of these rhesus macaques, 421 were males and 402 were females. They were assessed with a complete echocardiographic examination including structural and functional evaluation under sedation with ketamine hydrochloride. The reference intervals of the key echocardiographic parameters were indexed to weight, age, and sex by calculating the coefficients of the allometric eq. Y = aMb. On correlation matrix, body weight, age, sex, and heart rate were significantly correlated with various echocardiographic parameters and some of the parameters were strongly correlated with body weight and age. Multiple regression analysis revealed that heart rate and body weight statistically significantly predicted several echocardiographic parameters. Valve regurgitation including tricuspid, aortic, pulmonic, and mitral regurgitations without other cardiac structural and functional abnormalities are common in clinically healthy rhesus macaques under ketamine sedation. CONCLUSIONS In this study, the reference intervals of echocardiographic parameters were established by performing complete echocardiographic examinations on a large number of clinical healthy rhesus macaques. In addition, allometric scaling was performed based on their weight, and further indexed to age and sex. These allometrically scaled reference intervals can be used to accurately evaluate echocardiographic data in rhesus macaques and diagnose structural and functional evidence of cardiac disease.
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Affiliation(s)
- Yu Ueda
- grid.40803.3f0000 0001 2173 6074Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606 USA
| | - Laetitia M. M. Duler
- grid.27860.3b0000 0004 1936 9684Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616-8732 USA
| | - Kami J. Elliot
- grid.27860.3b0000 0004 1936 9684California National Primate Research Center, University of California-Davis, Davis, CA 95616 USA
| | - Paul-Michael D. Sosa
- grid.27860.3b0000 0004 1936 9684California National Primate Research Center, University of California-Davis, Davis, CA 95616 USA
| | - Jeffrey A. Roberts
- grid.27860.3b0000 0004 1936 9684California National Primate Research Center, University of California-Davis, Davis, CA 95616 USA
| | - Joshua A. Stern
- grid.27860.3b0000 0004 1936 9684Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616-8732 USA ,grid.27860.3b0000 0004 1936 9684California National Primate Research Center, University of California-Davis, Davis, CA 95616 USA
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16
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Minami T, Kawano H, Sato D, Yoshimuta T, Maemura K. Evaluation of echocardiographic parameters in Japanese patients aged over 90 years at a single institution. J Med Ultrason (2001) 2020; 47:555-563. [PMID: 32852677 DOI: 10.1007/s10396-020-01036-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/11/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE The number of patients aged over 90 years undergoing transthoracic echocardiography (TTE) has increased. Normal echocardiographic measurement values in healthy Japanese aged 20-79 years have been reported by Daimon et al., and in those aged 10-89 years by Okura et al. To date, no researchers have published normal values in healthy Japanese aged over 90 years. To understand the echocardiographic characteristics and establish the normal range, we evaluated patients aged over 90 years who had preserved left ventricular (LV) ejection fraction without cardiovascular disease. METHOD Enrolled in the study were consecutive patients aged over 90 years who were examined by TTE at the Ultrasound Imaging Center at Nagasaki University Hospital, Japan, between September 2009 and May 2016. We selected patients with LV ejection fraction > 55%, and without cardiac, renal, or aortic disease. RESULTS Among a total of 956 patients, 73 patients (19 males, 54 females) were admitted. Compared with females, males had significantly higher values of aortic diameter at the sinus of Valsalva and LV diastolic diameter and systolic diameter (P < 0.01), significantly lower E wave velocities (P < 0.01) and left ventricle mass (P < 0.01), and lower values of relative wall thickness (P < 0.01). Compared with subjects in their 70s and 80s in the studies by Daimon and Okura, the E and A wave velocities were higher. CONCLUSION We established the normal range of TTE parameters in elderly patients who had LV ejection fraction > 55% without cardiac, renal, or aortic disease. Sex differences were present as well as a tendency towards age-related changes in LV geometry and diastolic function. Most of the patients aged over 90 years had LV hypertrophy and potential diastolic dysfunction.
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Affiliation(s)
- Takako Minami
- Department of Cardiovascular Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Japan.
| | - Hiroaki Kawano
- Department of Cardiovascular Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Japan
| | - Daisuke Sato
- Department of Cardiovascular Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Japan
| | - Tsuyoshi Yoshimuta
- Department of Cardiovascular Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Japan
| | - Koji Maemura
- Department of Cardiovascular Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Japan
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17
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Seo Y, Ishizu T, Ieda M, Ohte N. Elderly Japanese Standard Data of Echocardiography; From J-LONG study. J Echocardiogr 2020; 18:175-182. [PMID: 32306373 DOI: 10.1007/s12574-020-00469-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/26/2020] [Accepted: 04/05/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Age-related changes in cardiac morphology and function have not been unknown in the elderly. The Japanese eLderly data Of Normal echocardioGraphy (J-LONG) study is a prospective multicenter cohort study and aimed to investigate the echocardiographic data in the healthy Japanese elderly. METHODS Thirty domestic facilities participated in this study, and 130 healthy subjects (57 men, 73 women, 79.6 ± 4.7 years, range 75-98 years, interquartile range 76-82 years) were enrolled in this cohort. Echocardiographic and clinical data sets were obtained in each facility, and total analyses were performed in the University of Tsukuba. RESULTS Almost all cardiac morphological data were significantly larger in men than those in women. However, corrected data by body surface area (BSA) were similar or closer between genders. As a gender difference, the negative correlation between BSA and age was observed in women only (r = - 0.46, p < 0.001), showing the independent determinant of women's left ventricular end-diastolic volume (LVEDV) was age (β = - 0.29, p = 0.01), but not BSA. In men, LVEDV was significantly correlated with BSA (β = 0.42, p = 0.001), but not with age (p = 0.10). Also, women had higher LV ejection fraction (70 ± 7.1 vs. 68 ± 4.9%, p = 0.02), lower E/A (0.67 ± 0.16 vs. 0.75 ± 0.21, p = 0.02), and higher E/e' (10 ± 2.7 vs. 8.9 ± 2.5, p = 0.03) as compared to men. CONCLUSIONS The J-LONG study suggested that correction by the physique was needed to interpret echocardiographic data of the elderly. Also, gender differences and age-related changes in cardiac morphology and function were observed, and further studies are needed to confirm the clinical significance.
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Affiliation(s)
- Yoshihiro Seo
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
| | - Tomoko Ishizu
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Nobuyuki Ohte
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
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18
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Rimbaş RC, Mihăilă-Baldea S, Magda LŞ, Vişoiu SI, Muraru D, Vinereanu D. New Myocardial Deformation by 2D Multi-layer Speckle-Tracking Analysis in Healthy Patients: Normal Reference Values and Their Physiologic Determinants. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:818-827. [PMID: 31918859 DOI: 10.1016/j.ultrasmedbio.2019.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/19/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
There are limited data regarding intrinsic changes of the left (LV) and right ventricular (RV) deformation assessed layer-by-layer. We designed a prospective multi-centric study, using a new multi-layer 2D-speckle-tracking-echo (MSTE). We investigated the impact of different physiologic parameters on layer-specific LV/RV myocardial deformation and synchrony, in a large group of healty subjects. 151 subjects were feasible for MSTE, divided in 4 groups: <40 yrs, 41 to 50 yrs, 51 to 60, and >61 yrs. We found a significant higher LV dyssynchrony index with age. In all groups, an endo-epicardial gradient was present in longitudinal LV/RV and circumferential deformation, with higher values in endocardial layer (p<0.001). There were no differences in deformation with age in all layers. We provided normal reference values for a new index of LV dyssynchrony, and also for RV longitudinal, LV circumferential and longitudinal layer-specific deformation, which can be further used when assessing subclinical dysfunction in myocardial diseases.
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Affiliation(s)
- Roxana Cristina Rimbaş
- Cardiology Department, University and Emergency Hospital, Bucharest, Romania; University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
| | - Sorina Mihăilă-Baldea
- Cardiology Department, University and Emergency Hospital, Bucharest, Romania; University of Medicine and Pharmacy Carol Davila, Bucharest, Romania; Department of Cardiac, Thoracic and Vascular Science, University of Padua, Italy
| | - Lucia Ştefania Magda
- Cardiology Department, University and Emergency Hospital, Bucharest, Romania; University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | | | - Denisa Muraru
- Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neurologic and Metabolic Sciences, S. Luca Hospital, Milan, Italy
| | - Dragoş Vinereanu
- Cardiology Department, University and Emergency Hospital, Bucharest, Romania; University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
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19
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Rutkowski DR, Barton GP, François CJ, Aggarwal N, Roldán-Alzate A. Sex Differences in Cardiac Flow Dynamics of Healthy Volunteers. Radiol Cardiothorac Imaging 2020; 2. [PMID: 32666051 DOI: 10.1148/ryct.2020190058] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Purpose The purpose of this study was to further understand the relationship between cardiac function and flow, on the basis of sex, by quantifying cardiac flow characteristics and relating them to cardiac muscle performance in young adults. Materials and Methods In this cross-sectional study, cardiac four-dimensional flow (4D flow) magnetic resonance imaging (MRI) and two-dimensional cine MRI were performed on 20 male and 19 female volunteers aged 20-35. Velocity-based metrics of flow, kinetic energy, vorticity, and efficiency indices were quantified, as well as cardiac strain metrics. Results* Peak systolic blood kinetic energy (male: 4.76 ± 2.66 mJ; female: 3.36 ± 1.43 mJ; p=0.047) was significantly higher in the male left ventricle (LV) than in the female LV. Peak systolic vorticity index (male: 0.008 ± 0.005 rad-m2/ml-s; female: 0.014 ± 0.007 rad-m2/ml-s; p=0.007), peak diastolic vorticity index (male: 0.007 ± 0.006 rad-m2/ml-s; female: 0.014 ± 0.010 rad-m2/ml-s; p=0.015), and cycle-average vorticity (male: 0.006 ± 0.001 rad-m2/ml-s; female: 0.011 ± 0.002 rad/s; p=0.001) were all significantly higher in the LV of women than they were in the LV of men. Radial, circumferential, and long-axis strain metrics were significantly higher in the female LV than in the male LV (p<0.05). Circumferential systolic and diastolic strain rates displayed moderate correlation to peak systolic (r=-0.38, p=0.022) and diastolic vorticity (r=0.40, p=0.015) values, respectively. *Results are reported as mean ± standard deviation. Conclusion Left ventricular vorticity metrics were observed to be higher in women than in men and displayed moderate correlation to cardiac strain metrics. The methods and results of this study may be used to further understand the sex-based cardiac efficiency relationship between cardiac function and flow.
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Affiliation(s)
- David R Rutkowski
- Departments of Mechanical Engineering (D.R.R., A.R.A.), Radiology (D.R.R., G.P.B., C.J.F., A.R.A.), Medical Physics (G.P.B.), Cardiovascular Medicine (N.A.), and Biomedical Engineering (A.R.A.), University of Wisconsin-Madison, 1111 Highland Ave, Madison, WI 53705
| | - Gregory P Barton
- Departments of Mechanical Engineering (D.R.R., A.R.A.), Radiology (D.R.R., G.P.B., C.J.F., A.R.A.), Medical Physics (G.P.B.), Cardiovascular Medicine (N.A.), and Biomedical Engineering (A.R.A.), University of Wisconsin-Madison, 1111 Highland Ave, Madison, WI 53705
| | - Christopher J François
- Departments of Mechanical Engineering (D.R.R., A.R.A.), Radiology (D.R.R., G.P.B., C.J.F., A.R.A.), Medical Physics (G.P.B.), Cardiovascular Medicine (N.A.), and Biomedical Engineering (A.R.A.), University of Wisconsin-Madison, 1111 Highland Ave, Madison, WI 53705
| | - Niti Aggarwal
- Departments of Mechanical Engineering (D.R.R., A.R.A.), Radiology (D.R.R., G.P.B., C.J.F., A.R.A.), Medical Physics (G.P.B.), Cardiovascular Medicine (N.A.), and Biomedical Engineering (A.R.A.), University of Wisconsin-Madison, 1111 Highland Ave, Madison, WI 53705
| | - Alejandro Roldán-Alzate
- Departments of Mechanical Engineering (D.R.R., A.R.A.), Radiology (D.R.R., G.P.B., C.J.F., A.R.A.), Medical Physics (G.P.B.), Cardiovascular Medicine (N.A.), and Biomedical Engineering (A.R.A.), University of Wisconsin-Madison, 1111 Highland Ave, Madison, WI 53705
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20
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Kimura Y, Kato T, Miyata H, Sasaki I, Minamino-Muta E, Nagasawa Y, Numao S, Nagano T, Higuchi T, Inoko M. Left Ventricular Diastolic Function During the Normal Peripartum Period. Circ J 2019; 83:2265-2270. [PMID: 31548443 DOI: 10.1253/circj.cj-19-0501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Because cardiovascular function and hemodynamics markedly change during pregnancy, our aim was to elucidate left ventricular (LV) diastolic function in pregnant women.Methods and Results:We prospectively collected the data of 397 pregnant women treated between 2012 and 2013. We evaluated their LV systolic and diastolic functions via echocardiography during the 3rd trimester (28-30 weeks' gestation) and within 4 days of delivery. Additionally, we analyzed the cardiac geometry: relative wall thickness and LV mass index (LVMI). Diastolic dysfunction was defined as early diastolic mitral annulus velocity (e') <7 cm/s and peak early filling velocity (E)/e' ratio >15. The pregnant women were 33.7±5.0 years old and the prevalence of hypertensive disorders in pregnancy (HDP) was 4.0%. LV systolic function was preserved in all pregnant women. However, diastolic function significantly decreased after delivery (mean e': 12.6 vs. 11.6 cm/s, P<0.0001; median E/e' ratio: 6.4 vs. 7.3, P<0.0001). Diastolic function after delivery was associated with the prevalence of HDP (P=0.035) and was correlated with age (R=-0.17, P=0.0009) and LVMI (R=-0.30, P<0.0001). However, these changes in diastolic function remained within the normal range and only 1 woman (1/397, 0.3%) had LV diastolic dysfunction after delivery. CONCLUSIONS LV diastolic function decreased after delivery in pregnant women but was within the normal range.
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Affiliation(s)
- Yuki Kimura
- Cardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital
| | - Takao Kato
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Hiromi Miyata
- Department of Obstetrics and Gynecology, Tazuke Kofukai Medical Research Institute, Kitano Hospital
| | - Issei Sasaki
- Department of Health and Sports Sciences, Kyoto Pharmaceutical University
| | - Eri Minamino-Muta
- Cardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital
| | - Yoshinori Nagasawa
- Department of Health and Sports Sciences, Kyoto Pharmaceutical University
| | - Shigeharu Numao
- Department of Health and Sports Sciences, Kyoto Pharmaceutical University
| | - Tadayoshi Nagano
- Department of Obstetrics and Gynecology, Tazuke Kofukai Medical Research Institute, Kitano Hospital
| | - Toshihiro Higuchi
- Department of Obstetrics and Gynecology, Tazuke Kofukai Medical Research Institute, Kitano Hospital
| | - Moriaki Inoko
- Cardiovascular Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital
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21
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Sawada N, Daimon M, Kawata T, Nakao T, Kimura K, Nakanishi K, Kurano M, Hirokawa M, Xu B, Yamanaka Y, Kato TS, Watanabe M, Yatomi Y, Komuro I. The Significance of the Effect of Visceral Adiposity on Left Ventricular Diastolic Function in the General Population. Sci Rep 2019; 9:4435. [PMID: 30872595 PMCID: PMC6418254 DOI: 10.1038/s41598-018-37137-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/27/2018] [Indexed: 02/08/2023] Open
Abstract
We evaluated the association between visceral adiposity and left ventricular (LV) diastolic function in association with plasma adiponectin levels in 213 subjects without overt cardiac diseases. Abdominal visceral fat area was quantified by computed tomography. Excessive visceral fat was significantly associated with impaired diastolic parameters including E/A, E′ and E/E′. Although serum adiponectin levels decreased with increased visceral adiposity, there was no independent association between serum adiponectin levels and diastolic parameters, which suggest that the role of adiponectin in this association might be indirect.
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Affiliation(s)
- Naoko Sawada
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Masao Daimon
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan. .,Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan.
| | - Takayuki Kawata
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Tomoko Nakao
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan.,Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Koichi Kimura
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Koki Nakanishi
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Makoto Kurano
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Megumi Hirokawa
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Boqing Xu
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuko Yamanaka
- Department of Cardiovascular Medicine, Jichi Medical University, Tochigi, Japan
| | - Tomoko S Kato
- Department of Cardiology, The Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Masafumi Watanabe
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
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22
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Ingvarsson A, Werther-Evaldsson A, Smith GJ, Waktare J, Nilsson J, Stagmo M, Roijer A, Rådegran G, Meurling C. Impact of gender on echocardiographic characteristics in heart transplant recipients. Clin Physiol Funct Imaging 2019; 39:246-254. [PMID: 30770630 DOI: 10.1111/cpf.12565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 02/11/2019] [Indexed: 12/01/2022]
Abstract
AIMS Assessment following heart transplantation (HTx) is routinely performed using transthoracic echocardiography. Differences in long-term mortality following HTx related to donor-recipient matching have been reported, but effects of gender on cardiac size and function are not well studied. The aims of this study were to evaluate differences in echocardiographic characteristics of HTx recipients defined by gender. METHODS AND RESULTS The study prospectively enrolled 123 (n = 34 female) HTx recipients of which 23 recipients was donor-recipient gender mismatched. Patients were examined with 2-dimensional echocardiography using Philips iE33 ultrasound system. Data were analysed across strata based on recipient gender and gender mismatch. Male recipients had larger left ventricular (LV) mass, thicker septal wall (P<0·001) and larger absolute LV volumes (P<0·001). Mean LV ejection fraction (EF) was higher in females (P<0·05), but no differences in conventional parameters of right ventricular (RV) function were found. Ventricular strain was higher in females than in males: LV global longitudinal strain (P<0·01), RV global longitudinal strain (P<0·05) and RV lateral free wall (P<0·05). The male group receiving a female donor heart had comparable EF and strain parameters to the female group receiving a gender-matched heart. CONCLUSION We found that female recipient gender was associated with smaller chamber size, higher LV EF and better LV and RV longitudinal strain. Gender-mismatched male recipients appeared to exhibit function parameters similar to gender-matched female recipients. Our results indicate that the gender aspect, analogous to current reference guidelines in general population, should be taken into consideration when examining patients post-HTx.
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Affiliation(s)
- Annika Ingvarsson
- Department of Clinical Sciences Lund, Cardiology, Lund University, Lund, Sweden
- The Section for Heart Failure and Valvular Disease, VO Heart and Lung Medicine, Skane University Hospital, Lund, Sweden
| | - Anna Werther-Evaldsson
- Department of Clinical Sciences Lund, Cardiology, Lund University, Lund, Sweden
- The Section for Heart Failure and Valvular Disease, VO Heart and Lung Medicine, Skane University Hospital, Lund, Sweden
| | - Gustav J Smith
- Department of Clinical Sciences Lund, Cardiology, Lund University, Lund, Sweden
- The Section for Heart Failure and Valvular Disease, VO Heart and Lung Medicine, Skane University Hospital, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
- Lund University Diabetes Center, Lund University, Lund, Sweden
| | | | - Johan Nilsson
- Department of Cardiothoracic Surgery, Anesthesia and Intensive Care, Lund University, Skane University Hospital, Lund, Sweden
| | - Martin Stagmo
- Department of Clinical Sciences Lund, Cardiology, Lund University, Lund, Sweden
- The Section for Heart Failure and Valvular Disease, VO Heart and Lung Medicine, Skane University Hospital, Lund, Sweden
| | - Anders Roijer
- Department of Clinical Sciences Lund, Cardiology, Lund University, Lund, Sweden
- The Section for Heart Failure and Valvular Disease, VO Heart and Lung Medicine, Skane University Hospital, Lund, Sweden
| | - Göran Rådegran
- Department of Clinical Sciences Lund, Cardiology, Lund University, Lund, Sweden
- The Section for Heart Failure and Valvular Disease, VO Heart and Lung Medicine, Skane University Hospital, Lund, Sweden
| | - Carl Meurling
- Department of Clinical Sciences Lund, Cardiology, Lund University, Lund, Sweden
- The Section for Heart Failure and Valvular Disease, VO Heart and Lung Medicine, Skane University Hospital, Lund, Sweden
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Li NY, Yu H, Li XL, Wang QY, Zhang XW, Ma RX, Zhao Y, Xu H, Liang W, Bai F, Yu J. Astragalus Membranaceus Improving Asymptomatic Left Ventricular Diastolic Dysfunction in Postmenopausal Hypertensive Women with Metabolic Syndrome: A Prospective, Open-Labeled, Randomized Controlled Trial. Chin Med J (Engl) 2018; 131:516-526. [PMID: 29483384 PMCID: PMC5850666 DOI: 10.4103/0366-6999.226077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Postmenopausal women with metabolic syndrome (MetS) have increased cardiovascular morbidity and left ventricular diastolic dysfunction (LVDD). The various protective effects of astragalus membranaceus (AM) have been described in previous studies. Therefore, this study aimed to evaluate the effects of different doses of AM on diastolic function in postmenopausal hypertensive women with MetS. Methods: This was a prospective, randomized controlled study. The postmenopausal hypertensive patients with MetS were enrolled from Lanzhou University Second Hospital from March 2014 to April 2015. Patients were divided into three groups: control group (received conventional medical treatment), AM Group 1 (received AM capsules at 5 g/d additionally), and AM Group 2 (received AM capsules at 10 g/d additionally). Echocardiographic and clinical characteristics were evaluated before and 12 months after treatment. Quantitative data were analyzed using unpaired t-test, analysis of variance, and multiple linear regression analysis. Results: A total of 154 patients were subjected to final analysis. In the AM Group 2, significant improvements were noted in diastolic function 12 months after treatment than those of the control group, including the early diastolic mitral annular velocity (E’; 0.065 ± 0.007 m/s vs. 0.061 ± 0.008 m/s, P = 0.014), the ratio of the early diastolic mitral peak flow velocity to the late diastolic mitral peak flow velocity (E/A; 0.81 ± 0.05 vs. 0.80 ± 0.06, P = 0.012), the ratio of E’ to the late diastolic mitral annular velocity (E’/A’; 0.56 ± 0.12 vs. 0.51 ± 0.13, P = 0.048), and the ratio of the early diastolic mitral peak flow velocity (E) to E’ (E/E’; 10.70 ± 1.30 vs. 11.37 ± 1.73, P = 0.031). After treatment, E/E’ (10.70 ± 1.30 vs. 11.24 ± 1.56, P = 0.021), deceleration time (DT; 261.49 ± 44.41 ms vs. 268.74 ± 53.87 ms, P = 0.046), and E’/A’ (0.56 ± 0.12 vs. 0.52 ± 0.13, P = 0.019) values improved more significantly than those of AM Group 2 before treatment. Besides, waist circumference was positively correlated with E’ (r = 0.472; P = 0.003) and E’/A’ (r = 0.321; P = 0.047). In addition, the waist-to-hip ratio was a significant predictor of DT (r = 0.276; P = 0.041), E’ (r = −0.590; P < 0.001), E/E’ (r = 0.454; P = 0.004), and E’/A’ (r = −0.377; P = 0.018). Conclusions: Conventional medical plus AM therapy improved diastolic function. Moreover, WC and WHR might be risk factors for LVDD. Chinese Clinical Trial Register: ChiCTR-TRC-11001747. http://www.chictr.org.cn/showprojen.aspx?proj=7798.
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Affiliation(s)
- Ning-Yin Li
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Heng Yu
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Xiu-Li Li
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Qiong-Ying Wang
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Xiao-Wei Zhang
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Rui-Xin Ma
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Yang Zhao
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Han Xu
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Wei Liang
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Feng Bai
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Jing Yu
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
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24
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Kurisu S, Nitta K, Sumimoto Y, Ikenaga H, Ishibashi K, Fukuda Y, Kihara Y. Implications of electrocardiographic frontal QRS axis on left ventricular diastolic parameters derived from electrocardiogram-gated myocardial perfusion single photon emission computed tomography. Ann Nucl Med 2018; 32:404-409. [PMID: 29713999 DOI: 10.1007/s12149-018-1257-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 04/25/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Current electrocardiographic (ECG) machines report various variables including frontal QRS axis automatically. We tested the hypothesis that QRS axis is associated with left ventricular (LV) diastolic parameters derived from ECG-gated myocardial perfusion single photon emission computed tomography (SPECT) independent of myocardial ischemia. METHODS Ninety-three patients with preserved LV ejection fraction and no evidence of myocardial ischemia were enrolled based on ECG-gated SPECT. Peak filling rate (PFR), one-third mean filling rate (1/3 MFR) and time to peak filling (TTPF) were obtained as LV diastolic parameters. RESULTS There were 82 male and 11 female patients with a mean age of 69 ± 9 years. QRS axis ranged from - 40° to 85° (36° ± 31°). QRS axis was correlated with PFR (r = 0.28, p < 0.01), 1/3 MFR (r = 0.25, p = 0.02) and TTPF (r = - 0.21, p = 0.04). QRS axis was also correlated with age (r = - 0.23, p = 0.03), body mass index (BMI) (r = - 0.36, p < 0.01) and LV mass index (LVMI) (r = - 0.27, p < 0.01). Linear regression analysis showed that QRS axis was associated with PFR, 1/3 MFR and TTPF for LV diastolic function, but was not associated with these LV diastolic parameters after adjustment of various confounders. CONCLUSIONS Our data suggest that QRS axis depends on age, BMI or LVMI, and serves as a surrogate marker of LV diastolic function.
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Affiliation(s)
- Satoshi Kurisu
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Kazuhiro Nitta
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yoji Sumimoto
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima, 734-8551, Japan
| | - Hiroki Ikenaga
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima, 734-8551, Japan
| | - Ken Ishibashi
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yukihiro Fukuda
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima, 734-8551, Japan
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Pagel PS, Dye L, Boettcher BT, Freed JK. Advanced Age Attenuates Left Ventricular Filling Efficiency Quantified Using Vortex Formation Time: A Study of Octogenarians With Normal Left Ventricular Systolic Function Undergoing Coronary Artery Surgery. J Cardiothorac Vasc Anesth 2018. [PMID: 29525195 DOI: 10.1053/j.jvca.2018.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Blood flow across the mitral valve during early left ventricular (LV) filling produces a 3-dimensional rotational fluid body, known as a vortex ring, that enhances LV filling efficiency. Diastolic dysfunction is common in elderly patients, but the influence of advanced age on vortex formation is unknown. The authors tested the hypothesis that advanced age is associated with a reduction in LV filling efficiency quantified using vortex formation time (VFT) in octogenarians undergoing coronary artery bypass graft (CABG) surgery. DESIGN Observational study. SETTING Veterans Affairs medical center. PARTICIPANTS After institutional review board approval, octogenarians (n = 7; 82 ± 2 year [mean ± standard deviation]; ejection fraction 56% ± 7%) without valve disease or atrial arrhythmias undergoing CABG were compared with a younger cohort (n = 7; 55 ± 6 year; ejection fraction 57% ± 7%) who were undergoing coronary revascularization. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS All patients were monitored using radial and pulmonary arterial catheters and transesophageal echocardiography. Peak early LV filling (E) and atrial systole (A) blood flow velocities and their corresponding velocity-time integrals were obtained using pulse-wave Doppler echocardiography to determine E/A, atrial filling fraction (β), and E wave deceleration time. Pulse-wave Doppler also was used to measure pulmonary venous blood flow during systole and diastole. Mitral valve diameter (D) was calculated as the average of major and minor axis lengths obtained in the midesophageal LV bicommissural and long-axis transesophageal echocardiography imaging planes, respectively. VFT was calculated as 4 × (1 - β) × SV/(πD3), where SV is the stroke volume measured using thermodilution. Systemic and pulmonary hemodynamics, LV diastolic function, and VFT were determined during steady-state conditions 30 minutes before cardiopulmonary bypass. A delayed relaxation pattern of LV filling (E/A 0.81 ± 0.16 v 1.29 ± 0.19, p = 0.00015; β 0.44 ± 0.05 v 0.35 ± 0.03, p = 0.0008; E wave deceleration time 294 ± 58 v 166 ± 28 ms, p < 0.0001; ratio of peak pulmonary venous systolic and diastolic blood flow velocity 1.42 ± 0.23 v 1.14 ± 0.20, p = 0.0255) was observed in octogenarians compared with younger patients. Mitral valve diameter was similar between groups (2.7 ± 0.2 and 2.6 ± 0.2 cm, respectively, in octogenarians v younger patients, p = 0.299). VFT was reduced in octogenarians compared with younger patients (3.0 ± 0.9 v 4.5 ± 1.2; p = 0.0171). An inverse correlation between age and VFT was shown using linear regression analysis (VFT = -0.0627 × age + 8.24; r2 = 0.408; p = 0.0139). CONCLUSION The results indicate that LV filling efficiency quantified using VFT is reduced in octogenarians compared with younger patients undergoing coronary artery bypass grafting.
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Affiliation(s)
- Paul S Pagel
- Anesthesia Service, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI.
| | - Lonnie Dye
- Anesthesia Service, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI
| | - Brent T Boettcher
- Anesthesia Service, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI
| | - Julie K Freed
- Anesthesia Service, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI
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Botek M, Krejčí J, McKune A. Sex Differences in Autonomic Cardiac Control and Oxygen Saturation Response to Short-Term Normobaric Hypoxia and Following Recovery: Effect of Aerobic Fitness. Front Endocrinol (Lausanne) 2018; 9:697. [PMID: 30532736 PMCID: PMC6265316 DOI: 10.3389/fendo.2018.00697] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 11/05/2018] [Indexed: 01/06/2023] Open
Abstract
Introduction: The main aims of this study were to investigate autonomic nervous system (ANS) and arterial oxygen saturation (SpO2) responses to simulated altitude in males and females, and to determine the association between maximal oxygen uptake (VO2max) and these responses. Materials and Methods: Heart rate variability (HRV) and SpO2 were monitored in a resting supine position during Preliminary (6 min normoxia), Hypoxia (10 min, fraction of inspired oxygen (FiO2) of 9.6%, simulated altitude ~6,200 m) and Recovery (6 min normoxia) phases in 28 males (age 23.7 ± 1.7 years, normoxic VO2max 59.0 ± 7.8 ml.kg-1.min-1, body mass index (BMI) 24.2 ± 2.1 kg.m-2) and 30 females (age 23.8 ± 1.8 years, VO2max 45.1 ± 8.7 ml.kg-1.min-1, BMI 21.8 ± 3.0 kg.m-2). Spectral analysis of HRV quantified the ANS activity by means of low frequency (LF, 0.05-0.15 Hz) and high frequency (HF, 0.15-0.50 Hz) power, transformed by natural logarithm (Ln). Time domain analysis incorporated the square root of the mean of the squares of the successive differences (rMSSD). Results: There were no significant differences in SpO2 level during hypoxia between the males (71.9 ± 7.5%) and females (70.8 ± 7.1%). Vagally-related HRV variables (Ln HF and Ln rMSSD) exhibited no significant differences between sexes across each phase. However, while the sexes demonstrated similar Ln LF/HF values during the Preliminary phase, the males (0.5 ± 1.3) had a relatively higher (p = 0.001) sympathetic activity compared to females (-0.6 ± 1.4) during the Hypoxia phase. Oxygen desaturation during resting hypoxia was significantly correlated with VO2max in males (r = -0.45, p = 0.017) but not in females (r = 0.01, p = 0.952) and difference between regression lines were significant (p = 0.024). Conclusions: Despite similar oxygen desaturation levels, males exhibited a relatively higher sympathetic responses to hypoxia exposure compared with females. In addition, the SpO2 response to resting hypoxia exposure was related to maximal aerobic capacity in males but not females.
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Affiliation(s)
- Michal Botek
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Jakub Krejčí
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
- *Correspondence: Jakub Krejčí
| | - Andrew McKune
- Discipline of Sport and Exercise Science, School of Rehabilitation and Exercise Sciences, Research Institute for Sport and Exercise Science, University of Canberra, Canberra, ACT, Australia
- Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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27
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Lee SC, Daimon M, Di Tullio MR, Homma S, Hasegawa T, Chiou SH, Nakao T, Hirokawa M, Mizuno Y, Yatomi Y, Yamazaki T, Komuro I. Beneficial effect of body weight control on left ventricular diastolic function in the general population: an analysis of longitudinal data from a health check-up clinic. Eur Heart J Cardiovasc Imaging 2017; 19:136-142. [PMID: 29237001 DOI: 10.1093/ehjci/jex219] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 08/24/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Seitetz C Lee
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
- Department of Medicine, Columbia University, 630 West 168th Street, New York 10032, NY, USA
| | - Masao Daimon
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
- Department of Clinical Laboratory, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
| | - Marco R Di Tullio
- Department of Medicine, Columbia University, 630 West 168th Street, New York 10032, NY, USA
| | - Shunichi Homma
- Department of Medicine, Columbia University, 630 West 168th Street, New York 10032, NY, USA
| | - Takahiro Hasegawa
- Department of Biostatistics, Shionogi & Co., Ltd, 1-8-3, Doshomachi, Chuo, Osaka 541-0045, Japan
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, 677 Huntington Ave, Boston, MA 02115, USA
| | - Sy Han Chiou
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, 677 Huntington Ave, Boston, MA 02115, USA
| | - Tomoko Nakao
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
- Department of Clinical Laboratory, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
| | - Megumi Hirokawa
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
| | - Yoshiko Mizuno
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
- Department of Clinical Epidemiology and Systems, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
| | - Tsutomu Yamazaki
- Clinical Research Support Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
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Berghaus TM, Kutsch J, Faul C, von Scheidt W, Schwaiblmair M. The association of N-terminal pro-brain-type natriuretic peptide with hemodynamics and functional capacity in therapy-naive precapillary pulmonary hypertension: results from a cohort study. BMC Pulm Med 2017; 17:167. [PMID: 29202745 PMCID: PMC5716236 DOI: 10.1186/s12890-017-0521-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 11/24/2017] [Indexed: 01/03/2023] Open
Abstract
Background N-terminal pro-brain-type natriuretic peptide (NT-proBNP) is currently used as a surrogate marker for disease severity in pulmonary hypertension (PH). However, NT-proBNP tends to have a high variability and may insufficiently correlate with hemodynamics and exercise capacity. Methods To investigate the association of NT-proBNP with hemodynamics and cardio-pulmonary exercise testing (CPET) in 84 therapy-naive patients with precapillary PH. Results NT-proBNP levels were significantly correlated with hemodynamics and CPET parameters except for cardiac index, diffusion capacity, PaO2 at peak exercise, and peak minute ventilation. NT-proBNP correlated best with hemodynamics and CPET in women and patients >65 years. NT-proBNP correlated better with CPET in pulmonary arterial hypertension compared to chronic thromboembolic PH (CTEPH). Conclusion NT-proBNP is associated with disease severity in precapillary PH. The association might be age- and gender-dependent. NT-proBNP may insufficiently correlate with disease severity in CTEPH, possibly due to comorbidity.
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Affiliation(s)
- T M Berghaus
- Department of Cardiology, Respiratory Medicine and Intensive Care, Klinikum Augsburg, Ludwig-Maximilians-University, Munich, Germany. .,Klinikum Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany.
| | - J Kutsch
- Department of Cardiology, Respiratory Medicine and Intensive Care, Klinikum Augsburg, Ludwig-Maximilians-University, Munich, Germany
| | - C Faul
- Department of Cardiology, Respiratory Medicine and Intensive Care, Klinikum Augsburg, Ludwig-Maximilians-University, Munich, Germany
| | - W von Scheidt
- Department of Cardiology, Respiratory Medicine and Intensive Care, Klinikum Augsburg, Ludwig-Maximilians-University, Munich, Germany
| | - M Schwaiblmair
- Department of Cardiology, Respiratory Medicine and Intensive Care, Klinikum Augsburg, Ludwig-Maximilians-University, Munich, Germany
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Cantinotti M, Giordano R, Paterni M, Saura D, Scalese M, Franchi E, Assanta N, Koestenberg M, Dulgheru R, Sugimoto T, Bernard A, Caballero L, Lancellotti P. Adult echocardiographic nomograms: overview, critical review and creation of a software for automatic, fast and easy calculation of normal values. J Thorac Dis 2017; 9:5404-5422. [PMID: 29312752 PMCID: PMC5757044 DOI: 10.21037/jtd.2017.11.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 10/27/2017] [Indexed: 01/15/2023]
Abstract
There is a crescent interest on normal adult echocardiographic values and the introduction of new deformation imaging and 3D parameters pose the issue of normative data. A multitude of nomograms has been recently published, however data are often fragmentary, difficult to find, and their strengths/limitations have been never evaluated. AIMS (I) to provide a review of current echocardiographic nomograms; (II) to generate a tool for easy and fast access to these data. A literature search was conducted accessing the National Library of Medicine using the keywords: 2D/3D echocardiography, strain, left/right ventricle, atrial, mitral/tricuspid valve, aorta, reference values/nomograms/normal values. Adding the following keywords, the results were further refined: range/intervals, myocardial velocity, strain rate and speckle tracking. Forty one published studies were included. Our study reveals that for several of 2D/3D parameters sufficient normative data exist, however, a few limitations still persist. For some basic parameters (i.e., mitral/tricuspid/pulmonary valves, great vessels) and for 3D valves data are scarce. There is a lack of studies evaluating ethnic differences. Data have been generally expressed as mean values normalised for gender and age instead of computing models incorporating different variables (age/gender/body sizes) to calculate z scores. To summarize results a software (Echocardio-Normal Values) who automatically calculate range of normality for a broad range of echocardiographic measurements according to age/gender/weight/height, has been generated. We provide an up-to-date and critical review of strengths/limitation of current adult echocardiographic nomograms. Furthermore we generated a software for automatic, easy and fast access to multiple echocardiographic normative data.
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Affiliation(s)
- Massimiliano Cantinotti
- Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Italy
- Institute of Clinical Physiology, Pisa, Italy
| | - Raffaele Giordano
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Daniel Saura
- Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain
| | | | - Eliana Franchi
- Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Italy
| | - Nadia Assanta
- Fondazione G. Monasterio CNR-Regione Toscana, Massa and Pisa, Italy
| | - Martin Koestenberg
- Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria
| | - Raluca Dulgheru
- University of Liège hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liège, Belgium
| | - Tadafumi Sugimoto
- Department of University Cardiology, University of Milano School of Medicine, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Anne Bernard
- CHU Tours, France et Université de Tours, Tours, France
| | - Luis Caballero
- Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain
| | - Patrizio Lancellotti
- Department of Cardiology, Cardio-Oncology Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium
- Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
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Nio AQX, Stöhr EJ, Shave RE. Age-related differences in left ventricular structure and function between healthy men and women. Climacteric 2017; 20:476-483. [DOI: 10.1080/13697137.2017.1356814] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- A. Q. X. Nio
- Department of Physiology and Health, Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
| | - E. J. Stöhr
- Department of Physiology and Health, Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
| | - R. E. Shave
- Department of Physiology and Health, Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
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Hirose K, Daimon M, Miyazaki S, Chiang SJ, Morimoto-Ichikawa R, Maruyama M, Kawata T, Ohmura H, Daida H. Estrogen variation during the menstrual cycle does not influence left ventricular diastolic function and untwisting rate in premenopausal women. J Cardiol 2017; 69:389-393. [DOI: 10.1016/j.jjcc.2016.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/06/2016] [Accepted: 09/16/2016] [Indexed: 01/31/2023]
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Lee SL, Daimon M, Nakao T, Singer DE, Shinozaki T, Kawata T, Kimura K, Hirokawa M, Kato TS, Mizuno Y, Watanabe M, Yatomi Y, Yamazaki T, Komuro I. Factors influencing left atrial volume in a population with preserved ejection fraction: Left ventricular diastolic dysfunction or clinical factors? J Cardiol 2016; 68:275-81. [DOI: 10.1016/j.jjcc.2016.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 01/16/2016] [Accepted: 02/02/2016] [Indexed: 11/29/2022]
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Rimbaş RC, Mihăilă S, Enescu OA, Vinereanu D. A new comprehensive 12-segment approach to right ventricular systolic and diastolic functions by 2D speckle tracking echocardiography in healthy individuals. Echocardiography 2016; 33:1866-1873. [PMID: 27613371 DOI: 10.1111/echo.13362] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND 2D speckle tracking echocardiography (2DSTE) was proved to be accurate for the assessment of the RV function. However, normal values for RV strain refer mostly to 3- or 6-segment models, excluding the contribution of other RV walls to RV function. We analyze RV function by 2DSTE in a normal population, using parasternal two-(2C) and apical four-chamber (4C) RV views, and creating a new 12-segment model for a potential better definition of RV function. METHODS We prospectively evaluated 100 normals using 2DE and STE. We assessed the RV systolic function from regional strain (basal, mid, and apical), and at the level of each wall: lateral (LS), septal (SS), inferior (IS), and anterior (AS), and also global strain for 4C (4CGS), and 2C (2CGS). Global systolic strain rate (SRs) was measured from 2C and 4C views. Diastolic function was assessed from early (SRe) and late global strain rate (SRl), for both views. RESULTS A total of 70 healthy individuals (48±15 years, 34 men) were suitable for concomitant 4C and 2CRV analysis. Feasibility of the STE analysis was 87.8%. We found significantly lower SS by comparison with LS, AS, and IS (P<.001). All S/SR parameters (GS, SRs, and SRe) were higher in 2C view than in 4C view (P<.001). All systolic S/SR parameters did not change with age. The early diastolic SR decreased, while the late diastolic SR increased with age. CONCLUSION Our 12-segment RV strain model is feasible. Moreover, 2DSTE analysis using 2C and 4C views of the RV does not provide similar information. Rather, they offer complementary data. This might be of particularly clinical interest in diseases with regional RV dysfunction.
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Affiliation(s)
- Roxana C Rimbaş
- University and Emergency Hospital, Bucharest, Romania.,University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | - Sorina Mihăilă
- University and Emergency Hospital, Bucharest, Romania.,University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | - Oana A Enescu
- University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | - Dragoş Vinereanu
- University and Emergency Hospital, Bucharest, Romania.,University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
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Laszlo R, Baumann T, Konz H, Dallmeier D, Klenk J, Denkinger M, Koenig W, Rothenbacher D, Steinacker JM. Echocardiographic B-mode evaluation of the right heart in older people: The ActiFE Study. Arch Gerontol Geriatr 2016; 67:145-52. [PMID: 27518473 DOI: 10.1016/j.archger.2016.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/29/2016] [Accepted: 07/29/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE Right heart B-mode echocardiography reference values have been predominantly obtained in younger age cohorts (<65years). Aims of the study were to describe and evaluate the feasibility of right heart B-mode echocardiography in a large geriatric cohort and to analyze standard parameters in defined subgroups with or without any evidence for structural cardiac disease. METHODS ActiFE-Ulm study is a population-based cohort study including a sample of people≥65years old living in the region of Ulm, Germany. Echocardiography including right heart parameters was performed within a cardiovascular follow-up of 688 subjects. PRINCIPAL RESULTS Non-obtainability of right heart B-mode data was rather not a consequence of accompanying cardiac diseases or risk factors but of a more obese body composition. Mean values of right heart measurements of our subpopulation of subjects without evidence for structural cardiac disease were continuously higher than those of the guidelines (e.g. mean right ventricular end diastolic area 23.5±5.6cm(2) (males), 20.3±5.0cm(2) (females)). On an individual basis, guideline-suggested abnormality thresholds were also often exceeded, whereas this situation occurred more often in male than in female subjects. MAJOR CONCLUSIONS Methodically, right heart B-mode echocardiography in older subjects is challenging. Our results suggest an ageing-associated right heart enlargement. Utilization of published right heart reference values in older adults seems to be problematic and in clinical practice, they always have to be interpreted within the clinical and functional context and in relation to other right heart echocardiographic parameters.
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Affiliation(s)
- Roman Laszlo
- University of Ulm, Department of Internal Medicine II (cardiology), Division of Sports and Rehabilitation Medicine, Leimgrubenweg 14, 89070 Ulm, Germany.
| | - Tobias Baumann
- University of Ulm, Department of Internal Medicine II (cardiology), Division of Sports and Rehabilitation Medicine, Leimgrubenweg 14, 89070 Ulm, Germany
| | - Hannah Konz
- University of Ulm, Department of Internal Medicine II (cardiology), Division of Sports and Rehabilitation Medicine, Leimgrubenweg 14, 89070 Ulm, Germany
| | - Dhayana Dallmeier
- University of Ulm, AGAPLESION Bethesda Clinic, Geriatric Center Ulm/Alb-Donau, Zollernring 26, 89073 Ulm, Germany
| | - Jochen Klenk
- University of Ulm, Institute of Epidemiology and Medical Biometry, Helmholtzstr. 22, 89081 Ulm, Germany
| | - Michael Denkinger
- University of Ulm, AGAPLESION Bethesda Clinic, Geriatric Center Ulm/Alb-Donau, Zollernring 26, 89073 Ulm, Germany
| | - Wolfgang Koenig
- Klinik für Herz-& Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Lazarettstr. 36, 80636, Munich, Germany
| | - Dietrich Rothenbacher
- University of Ulm, Institute of Epidemiology and Medical Biometry, Helmholtzstr. 22, 89081 Ulm, Germany
| | - Juergen Michael Steinacker
- University of Ulm, Department of Internal Medicine II (cardiology), Division of Sports and Rehabilitation Medicine, Leimgrubenweg 14, 89070 Ulm, Germany
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Ryu DR. Normal Reference Values for Doppler Echocardiography: Influences of Ageing, Gender and Ethnicity. J Cardiovasc Ultrasound 2016; 24:112-4. [PMID: 27358702 PMCID: PMC4925387 DOI: 10.4250/jcu.2016.24.2.112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 05/31/2016] [Accepted: 05/31/2016] [Indexed: 11/22/2022] Open
Affiliation(s)
- Dong Ryeol Ryu
- Division of Cardiology, Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
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36
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The Effects of Sex on Cardiopulmonary Responses to Acute Normobaric Hypoxia. High Alt Med Biol 2016; 17:108-15. [DOI: 10.1089/ham.2015.0114] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Xu B, Daimon M. Cardiac aging phenomenon and its clinical features by echocardiography. J Echocardiogr 2016; 14:139-145. [DOI: 10.1007/s12574-016-0292-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 04/01/2016] [Accepted: 04/24/2016] [Indexed: 01/09/2023]
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Comparison of Tricuspid Annular Plane Systolic Excursion in Patients With Atrial Fibrillation Versus Sinus Rhythm. Am J Cardiol 2016; 117:226-32. [PMID: 26651451 DOI: 10.1016/j.amjcard.2015.10.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 10/22/2015] [Accepted: 10/22/2015] [Indexed: 11/20/2022]
Abstract
Echocardiography now plays a central guiding role in the management of patients with atrial fibrillation (AF). However, the current guidelines mention little about the presence AF during the assessment of echocardiographic variables in the clinical setting. AF itself may impact on tricuspid annular plane systolic excursion (TAPSE) as a right ventricular systolic function compared with sinus rhythm (SR). The aim of this study was to compare and assess the echocardiographic parameters including TAPSE in patients with AF and SR. From January 1, 2013, to September 30, 2014, patients with AF without any cardiovascular disease were retrospectively evaluated using echocardiography. Age-, gender-, and left ventricular ejection fraction-matched patients with SR were selected from our database on the basis of a comprehensive history, physical examination, and echocardiographic findings. During the study period, we identified 239 patients with AF (74 ± 9 years; 65% men) and without any cardiac disease who underwent echocardiography. We also included 281 patients in the SR group (74 ± 8 years; 67% men). In all study subjects, TAPSE in AF was smaller than in SR regardless of age (17 ± 3 vs 20 ± 3 mm, p <0.001). In the stepwise multiple regression model, TAPSE was strongly associated with the presence of AF (standardized β = -0.362, p <0.001) and stroke volume index (standardized β = 0.173, p <0.001) after adjustment for age, gender, heart rate, left ventricular ejection fraction, and tricuspid regurgitant grade. In conclusions, patients with AF had lower TAPSE than those with SR regardless of age. When we assess TAPSE in the clinical setting, we must pay attention to the presence of AF.
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Hirokawa M, Daimon M, Lee SL, Nakao T, Kawata T, Kimura K, Kato TS, Mizuno Y, Watanabe M, Yatomi Y, Yamazaki T, Komuro I. Early menopause does not influence left ventricular diastolic dysfunction: A clinical observational study in healthy subjects. J Cardiol 2016; 68:548-553. [PMID: 26778586 DOI: 10.1016/j.jjcc.2015.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 11/11/2015] [Accepted: 11/24/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND The prevalence of left ventricular diastolic dysfunction (LVDD) sharply increases in women after their 50s and may contribute to the high prevalence of diastolic heart failure in elderly women. A decrease in estrogen levels after menopause is postulated to be one of the mechanisms responsible for this phenomenon. However, there is a paucity of data on the relationship between the timing of menopause and the progression of LVDD in the clinical setting; thus, we investigated this relationship in healthy postmenopausal women. METHODS We enrolled 115 women and divided them into two groups according to median menopause age: 61 who experienced menopause at ≤50 years (early menopause group), and 54 who experienced menopause at >50 years (late menopause group). We compared the echocardiographic and clinical characteristics between the two groups. RESULTS There were no significant differences in LV diastolic parameters (mitral E/A, p=0.561; e', p=0.052; E/e', p=0.081; DCT, p=0.082; prevalence of LVDD class, p=0.801), as well as other echocardiographic parameters and clinical characteristics between the two groups. Multivariate linear regression analysis showed that the independent determinants of LVDD were age and body mass index, but not the timing of menopause. CONCLUSIONS Early menopause did not influence the progression of LVDD in postmenopausal women. The sharp progression of LVDD in elderly women is complex and probably influenced by multiple factors.
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Affiliation(s)
- Megumi Hirokawa
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Masao Daimon
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan; Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan.
| | - Seitetsu L Lee
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Tomoko Nakao
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Takayuki Kawata
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Koichi Kimura
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Tomoko S Kato
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan; Department of Cardiovascular Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Yoshiko Mizuno
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Masafumi Watanabe
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Tsutomu Yamazaki
- Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
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Machino-Ohtsuka T, Seo Y, Ishizu T, Sato K, Sugano A, Yamamoto M, Hamada-Harimura Y, Aonuma K. Novel Mechanistic Insights Into Atrial Functional Mitral Regurgitation – 3-Dimensional Echocardiographic Study –. Circ J 2016; 80:2240-8. [DOI: 10.1253/circj.cj-16-0435] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Yoshihiro Seo
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba
| | - Tomoko Ishizu
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba
| | - Kimi Sato
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba
| | - Akinori Sugano
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba
| | | | | | - Kazutaka Aonuma
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba
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Hayashi S, Yamada H, Nishio S, Hotchi J, Bando M, Takagawa Y, Saijo Y, Hirata Y, Sata M. Age- and gender-specific changes of tricuspid annular motion velocities in normal hearts. J Cardiol 2015; 65:397-402. [DOI: 10.1016/j.jjcc.2014.06.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 06/20/2014] [Accepted: 06/25/2014] [Indexed: 01/04/2023]
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Sasaki S, Daimon M, Kawata T, Miyazaki S, Ichikawa R, Maruyama M, Chiang SJ, Mahara K, Watanabe H, Sumiyoshi T, Tomoike H, Daida H. Factors responsible for elevated plasma B-type natriuretic peptide levels in severe aortic stenosis: Comparison between elderly and younger patients. J Cardiol 2014; 64:476-81. [DOI: 10.1016/j.jjcc.2014.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 03/15/2014] [Accepted: 03/22/2014] [Indexed: 11/28/2022]
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Age-specific changes in left ventricular diastolic function: a velocity-encoded magnetic resonance imaging study. Eur Radiol 2014; 25:1077-86. [PMID: 25430004 DOI: 10.1007/s00330-014-3488-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 08/20/2014] [Accepted: 11/03/2014] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Our objectives were to assess the ability of phasecontrast MRI (PC-MRI) to detect sub-clinical age-related variations of left ventricular (LV) diastolic parameters and thus to provide age-related reference ranges currently available for echocardiography but not for MRI-PC, and to identify independent associates of such variations. METHODS We studied 100 healthy volunteers (age = 42 ± 15years, 50 females) who had MRI with simultaneous blood pressure measurements. LV mass and volumes were assessed. Semiautomated analysis of PC-MRI data provided: 1) early transmitral (Ef) and atrial (Af) peak filling flow-rates (ml/s) and filling volume (FV), 2) deceleration time (DT), isovolumic relaxation time (IVRT), and 3) early myocardial longitudinal (E') peak velocity. RESULTS MRI-PC diastolic parameters were reproducible as reflected by low coefficients of variations (ranged between 0.31 to 6.26 %). Peak myocardial velocity E' (r = -0.63, p < 0.0001) and flow-rate parameters were strongly and independently associated to age (Ef/Af:r = -0.63, DT:r = 0.46, IVRT:r = 0.44, Ef/FV:r = -0.55, Af/FV:r = 0.56, p < 0.0001). Furthermore, LV relaxation parameters (E', DT, IVRT), were independently associated to LV remodelling (LV mass/end-diastolic volume) and myocardial wall thickness (p < 0.01). CONCLUSIONS PC-MRI age-related reference ranges of diastolic parameters are provided. Such parameters might be useful for a fast, reproducible and reliable characterization of diastolic function in patients referred for clinical MRI exam KEY POINTS • MRI age-related reference values of left ventricular diastolic parameters are provided. • MRI diastolic parameters can characterise sub-clinical age-related variations in healthy individuals. • Diastolic function would complement cardiac MRI exam with currently neglected data. • Diastolic function would enhance MRI diagnostic value in cardiomyopathy and heartfailure.
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44
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Nio AQX, Stöhr EJ, Shave R. The female human heart at rest and during exercise: A review. Eur J Sport Sci 2014; 15:286-95. [DOI: 10.1080/17461391.2014.936323] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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45
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Ichikawa R, Daimon M, Miyazaki T, Kawata T, Miyazaki S, Maruyama M, Chiang SJ, Suzuki H, Ito C, Sato F, Watada H, Daida H. Influencing factors on cardiac structure and function beyond glycemic control in patients with type 2 diabetes mellitus. Cardiovasc Diabetol 2013; 12:38. [PMID: 23446214 PMCID: PMC3598845 DOI: 10.1186/1475-2840-12-38] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 02/17/2013] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND We hypothesized that clinical factors other than glycemic control may influence abnormal cardiac function in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the independent factors for abnormal cardiac function among clinical factors in T2DM. METHODS We studied 148 asymptomatic patients with T2DM without overt heart disease. Echocardiographic findings were compared between diabetic patients and 68 age-matched healthy subjects. Early (E) and late (A) diastolic mitral flow velocity and early diastolic mitral annular velocity (e') were measured for assessing left ventricular (LV) diastolic function. We evaluated insulin resistance, non-esterified fatty acid, high-sensitive CRP, estimated glomerular filtration rate, waist/hip ratio, abdominal visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and other clinical characteristics in addition to glycemic control. VAT and SAT were quantified by computed tomography. RESULTS In T2DM, E/A and e' were significantly lower, and E/e', left atrial volume and LV mass were significantly greater than in control subjects. In multivariate liner regression analysis, VAT was an independent determinant of left atrial volume (β =0.203, p=0.011), E/A (β =-0.208, p=0.002), e' (β =-0.354, p<0.001) and E/e' (β=0.220, p=0.003). Age was also an independent determinant, whereas fasting plasma glucose and hemoglobin A1c levels were not. In addition to systolic blood pressure, waist-hip ratio (β=0.173, p=0.024) and VAT/SAT ratio (β=0.162, p=0.049) were independent determinants of LV mass. CONCLUSION Excessive visceral fat accompanied by adipocyte dysfunction may play a greater role than glycemic control in the development of diastolic dysfunction and LV hypertrophy in T2DM.
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Affiliation(s)
- Ryoko Ichikawa
- Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo, Japan
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Sundström D, Waldenborg M, Magnuson A, Emilsson K. Chronic nicotine effects on left ventricular function in healthy middle-aged people: an echocardiographic study. Clin Physiol Funct Imaging 2013; 33:317-24. [PMID: 23692623 DOI: 10.1111/cpf.12031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 01/16/2013] [Indexed: 11/28/2022]
Abstract
AIMS Cigarettes and Swedish snuff influence the cardiovascular system in many ways. Cigarette and snuff usage have been linked with an acute impairment in several diastolic cardiac parameters during intake. The aim of this study is to investigate whether long-term usage of Swedish snuff or cigarettes also causes a more permanent impairment of systolic and/or diastolic cardiac parameters in the left ventricle in otherwise healthy middle-aged snuffers and smokers. METHODS AND RESULTS Eighty-seven age-matched volunteers were included and examined with echocardiography. The volunteers were divided into three subgroups; one group with non-tobacco users, one group with long-term smokers and finally one group with long-term snuffers. The smokers and snuffers were instructed not to use these products for at least 5 h before the examination. The systolic and diastolic cardiac parameters were collected at one time. Most of the systolic parameters measured were unaltered between the tobacco subgroups and non-tobacco users, and therefore, no alteration of significance was found in systolic parameters. Also, almost all of the diastolic parameters measured were not significantly impaired in the tobacco subgroups compared with non-tobacco users. However, the deceleration time (DT) was slightly prolonged (P<0·05) and thus statistically significant in the tobacco subgroups. This finding is somewhat difficult to interpret but may be seen as random. CONCLUSIONS This study reveals that most systolic- and diastolic cardiac parameters are not chronically significantly altered in middle-aged long-term tobacco users compared with age-matched non-tobacco users.
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Affiliation(s)
- D Sundström
- Department of Clinical Physiology, Örebro University Hospital, Örebro, Sweden.
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Föll D, Taeger S, Bode C, Jung B, Markl M. Age, gender, blood pressure, and ventricular geometry influence normal 3D blood flow characteristics in the left heart. Eur Heart J Cardiovasc Imaging 2012; 14:366-73. [PMID: 23002214 DOI: 10.1093/ehjci/jes196] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS The aim of this study was to assess the effect of age, gender, physiological, and global cardiac function parameters on differences in normal 3D blood flow in the left ventricle (LV) and atrium (LA) using 4D flow magnetic resonance imaging (MRI). METHODS AND RESULTS Four-dimensional flow MRI was acquired in healthy volunteers of two age and gender groups: <30 years (6 women, n = 12) and >50 years (6 women, n = 12). Systolic and early to mid-diastolic vortex flow (number of vortices, duration, area, peak velocity inside the vortex) in the LA and LV was assessed using intra-cardiac flow visualization based on 3D particle traces and velocity vector fields. A larger number of vortices in the LA were found in young compared with older individuals (number of diastolic vortices: 1.6 ± 0.8 vs. 0.7 ± 0.7, P = 0.01) with higher velocities (54 ± 12 cm/s vs. 41 ± 11 cm/s in systole, 47 ± 13 vs. 31 ± 8 cm/s in diastole, P < 0.05). Vortices in the LV base were smaller in women compared with men (369 ± 133 vs. 543 ± 176 mm(2), P = 0.009), while vortex size was increased in mid-ventricular locations (maximum area: 546 ± 321 vs. 293 ± 174 mm(2), P < 0.05). Correlation analysis revealed significant relationships (P = 0.005-0.048, correlation coefficients = 0.44-0.84) between LA and LV vortex characteristics (number, size, vortex velocities) and blood pressure as well as end-diastolic volume, LV length, and ejection fraction. CONCLUSIONS Flow patterns in the left heart demonstrated differences related to age, gender, blood pressure, and ventricular geometry. The findings constitute a prerequisite for the understanding of the impact of cardiac disease on intra-cardiac haemodynamics.
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Affiliation(s)
- Daniela Föll
- Department of Cardiology and Angiology, University Heart Center Freiburg, Hugstetterstr 55, Freiburg 79106, Germany
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Fukuda S, Watanabe H, Daimon M, Abe Y, Hirashiki A, Hirata K, Ito H, Iwai-Takano M, Iwakura K, Izumi C, Hidaka T, Yuasa T, Murata K, Nakatani S, Negishi K, Nishigami K, Nishikage T, Ota T, Hayashida A, Sakata K, Tanaka N, Yamada S, Yamamoto K, Yoshikawa J. Normal Values of Real-Time 3-Dimensional Echocardiographic Parameters in a Healthy Japanese Population. Circ J 2012; 76:1177-81. [DOI: 10.1253/circj.cj-11-1256] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shota Fukuda
- Department of Medicine, Osaka Ekisaikai Hospital
| | - Hiroyuki Watanabe
- Department of Cardiology, Sakakibara Heart Institute, Japan Research Promotion Society of Cardiovascular Disease
| | - Masao Daimon
- Department of Cardiology, Juntendo University School of Medicine
| | - Yukio Abe
- Department of Cardiology, Osaka City General Hospital
| | | | - Kumiko Hirata
- Department of Cardiology, Wakayama Medical University
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine
| | - Masumi Iwai-Takano
- Department of Infection Control and Laboratory Medicine, Fukushima Medical University
| | | | | | - Takayuki Hidaka
- Department of Cardiovascular Medicine, Hiroshima University Hospital
| | - Toshinori Yuasa
- Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University
| | - Kazuya Murata
- Division of Laboratory, Yamaguchi University Hospital
| | - Satoshi Nakatani
- Department of Health Sciences, Osaka University Graduate School of Medicine
| | - Kazuaki Negishi
- Department of Medicine and Biological Science, Gunma University Graduate School of Medicine
| | | | - Tomoko Nishikage
- Department of Physiological Laboratory, Osaka Seamen's Insurance Hospital
| | | | | | - Konomi Sakata
- Second Department of Internal Medicine, Kyorin University School of Medicine
| | | | - Satoshi Yamada
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
| | - Kazuhiro Yamamoto
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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