An effect of left ventricular hypertrophy on mild-to-moderate left ventricular diastolic dysfunction

Objectives: Left ventricular diastolic dysfunction (LVDD) is associated with a variety of medical conditions. Left ventricular hypertrophy (LVH) is one of the most common abnormalities that induce LVDD. However, it is unclear whether LVH is a predictor of future LVDD deterioration that leads to dias...

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Main Authors: Sharma Kattel, MD, Salim Memon, MBBS, Keiko Saito, MD, Jagat Narula, MD, PhD, Yuji Saito, MD, PhD
Format: Article
Language:English
Published: Elsevier 2016-03-01
Series:Hellenic Journal of Cardiology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1109966616300045
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spelling doaj-97ac785a9d2d41b1b7c1a462c0769ade2020-11-24T23:15:27ZengElsevierHellenic Journal of Cardiology1109-96662016-03-01572929810.1016/j.hjc.2016.03.004An effect of left ventricular hypertrophy on mild-to-moderate left ventricular diastolic dysfunctionSharma Kattel, MD0Salim Memon, MBBS1Keiko Saito, MD2Jagat Narula, MD, PhD3Yuji Saito, MD, PhD4Department of Medicine, Sisters of Charity Hospital, University at Buffalo, Buffalo, NY, USADepartment of Medicine, Sisters of Charity Hospital, University at Buffalo, Buffalo, NY, USADepartment of Medicine, Sisters of Charity Hospital, University at Buffalo, Buffalo, NY, USADivision of Cardiology, Mount Sinai School of Medicine, New York, NY, USADepartment of Medicine, Sisters of Charity Hospital, University at Buffalo, Buffalo, NY, USAObjectives: Left ventricular diastolic dysfunction (LVDD) is associated with a variety of medical conditions. Left ventricular hypertrophy (LVH) is one of the most common abnormalities that induce LVDD. However, it is unclear whether LVH is a predictor of future LVDD deterioration that leads to diastolic heart failure in patients who already have mild-to-moderate LVDD. In this study, we investigated the effect of LVH on LV diastolic function in mild-to-moderate LVDD patients. Methods: Of the patients with mild-to-moderate LVDD (Grade I and II) with preserved left ventricular ejection fraction (EF), 225 with LVH (LVH group) and 225 without LVH (non-LVH group) were consecutively selected. LVDD was defined by the abnormal patterns of Doppler mitral inflow and tissue Doppler. Left ventricular filling pressure (FP) was estimated by the following formula: 1.9 +1.24× [early mitral inflow velocity (E)/early mitral annular velocity (e')]. The Tei index was implemented to assess global (both systolic and diastolic) left ventricular function. Echocardiographic parameters for LVDD, such as isovolumic relaxation time (IVRT), were compared between the two groups. Results: FP and Tei index were significantly higher in the LVH group compared to the non-LVH group [15.68 mmHg vs. 14.07 mmHg, P < 0.0001, and 0.58 vs. 0.53, P < 0.003, respectively]. IVRT was significantly longer in the LVH group than in the non-LVH group [103.93 ± 23.93 vs. 95.94 ± 20.16, P < 0.0001]. Conclusions: In mild-to-moderate LVDD patients, both FP and the Tei index were significantly higher when LVH was present. This may suggest LVH as a possible predictor for the future development of severe LVDD and diastolic heart failure.http://www.sciencedirect.com/science/article/pii/S1109966616300045Left ventricular hypertrophyLeft ventricular diastolic dysfunctionLeft ventricular filling pressureTei index
collection DOAJ
language English
format Article
sources DOAJ
author Sharma Kattel, MD
Salim Memon, MBBS
Keiko Saito, MD
Jagat Narula, MD, PhD
Yuji Saito, MD, PhD
spellingShingle Sharma Kattel, MD
Salim Memon, MBBS
Keiko Saito, MD
Jagat Narula, MD, PhD
Yuji Saito, MD, PhD
An effect of left ventricular hypertrophy on mild-to-moderate left ventricular diastolic dysfunction
Hellenic Journal of Cardiology
Left ventricular hypertrophy
Left ventricular diastolic dysfunction
Left ventricular filling pressure
Tei index
author_facet Sharma Kattel, MD
Salim Memon, MBBS
Keiko Saito, MD
Jagat Narula, MD, PhD
Yuji Saito, MD, PhD
author_sort Sharma Kattel, MD
title An effect of left ventricular hypertrophy on mild-to-moderate left ventricular diastolic dysfunction
title_short An effect of left ventricular hypertrophy on mild-to-moderate left ventricular diastolic dysfunction
title_full An effect of left ventricular hypertrophy on mild-to-moderate left ventricular diastolic dysfunction
title_fullStr An effect of left ventricular hypertrophy on mild-to-moderate left ventricular diastolic dysfunction
title_full_unstemmed An effect of left ventricular hypertrophy on mild-to-moderate left ventricular diastolic dysfunction
title_sort effect of left ventricular hypertrophy on mild-to-moderate left ventricular diastolic dysfunction
publisher Elsevier
series Hellenic Journal of Cardiology
issn 1109-9666
publishDate 2016-03-01
description Objectives: Left ventricular diastolic dysfunction (LVDD) is associated with a variety of medical conditions. Left ventricular hypertrophy (LVH) is one of the most common abnormalities that induce LVDD. However, it is unclear whether LVH is a predictor of future LVDD deterioration that leads to diastolic heart failure in patients who already have mild-to-moderate LVDD. In this study, we investigated the effect of LVH on LV diastolic function in mild-to-moderate LVDD patients. Methods: Of the patients with mild-to-moderate LVDD (Grade I and II) with preserved left ventricular ejection fraction (EF), 225 with LVH (LVH group) and 225 without LVH (non-LVH group) were consecutively selected. LVDD was defined by the abnormal patterns of Doppler mitral inflow and tissue Doppler. Left ventricular filling pressure (FP) was estimated by the following formula: 1.9 +1.24× [early mitral inflow velocity (E)/early mitral annular velocity (e')]. The Tei index was implemented to assess global (both systolic and diastolic) left ventricular function. Echocardiographic parameters for LVDD, such as isovolumic relaxation time (IVRT), were compared between the two groups. Results: FP and Tei index were significantly higher in the LVH group compared to the non-LVH group [15.68 mmHg vs. 14.07 mmHg, P < 0.0001, and 0.58 vs. 0.53, P < 0.003, respectively]. IVRT was significantly longer in the LVH group than in the non-LVH group [103.93 ± 23.93 vs. 95.94 ± 20.16, P < 0.0001]. Conclusions: In mild-to-moderate LVDD patients, both FP and the Tei index were significantly higher when LVH was present. This may suggest LVH as a possible predictor for the future development of severe LVDD and diastolic heart failure.
topic Left ventricular hypertrophy
Left ventricular diastolic dysfunction
Left ventricular filling pressure
Tei index
url http://www.sciencedirect.com/science/article/pii/S1109966616300045
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