Document Detail


Diastolic stiffness as assessed by diastolic wall strain is associated with adverse remodelling and poor outcomes in heart failure with preserved ejection fraction.
MedLine Citation:
PMID:  22645191     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: The pathophysiology of heart failure with preserved ejection fraction (HFpEF) is complex but increased left ventricular (LV) diastolic stiffness plays a key role. A load-independent, non-invasive, direct measure of diastolic stiffness is lacking. The diastolic wall strain (DWS) index is based on the linear elastic theory, which predicts that impaired diastolic wall thinning reflects resistance to deformation in diastole and thus, increased diastolic myocardial stiffness. The objectives of this community-based study were to determine the distribution of this novel index in consecutive HFpEF patients and healthy controls, define the relationship between DWS and cardiac structure and function and determine whether increased diastolic stiffness as assessed by DWS is predictive of the outcome in HFpEF.
METHODS AND RESULTS: Consecutive HFpEF patients (n = 327, EF ≥ 50%) and controls (n = 528) from the same community were studied. Diastolic wall strain was lower in HFpEF (0.33 ± 0.08) than in controls (0.40 ± 0.07, P < 0.001). Within HFpEF, those with DWS ≤ median (0.33) had higher LV mass index, relative wall thickness, E/e', Doppler-estimated LV end-diastolic pressure to LV end-diastolic volume ratio, left atrial volume index, and brain natriuretic peptide (BNP) levels than those with DWS > median. Heart failure with preserved ejection fraction patients with DWS ≤ median had higher rate of death or HF hospitalization than those with DWS > median (P = 0.003) even after the adjustment for age, gender, log BNP, LV geometry, or log E/e' (P < 0.01).
CONCLUSION: These data suggest that DWS, a simple index, is useful in assessing diastolic stiffness and that more advanced diastolic stiffness is associated with worse outcomes in HFpEF.
Authors:
Tomohito Ohtani; Selma F Mohammed; Kazuhiro Yamamoto; Shannon M Dunlay; Susan A Weston; Yasushi Sakata; Richard J Rodeheffer; Veronique L Roger; Margaret M Redfield
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-05-29
Journal Detail:
Title:  European heart journal     Volume:  33     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-16     Completed Date:  2012-10-09     Revised Date:  2013-12-05    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1742-9     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Case-Control Studies
Elasticity / physiology
Female
Heart Failure, Diastolic / physiopathology*
Humans
Male
Middle Aged
Prognosis
Stress, Physiological / physiology
Vascular Stiffness / physiology*
Ventricular Dysfunction, Left / physiopathology*
Ventricular Remodeling / physiology*
Grant Support
ID/Acronym/Agency:
HL 55502/HL/NHLBI NIH HHS; HL 63281/HL/NHLBI NIH HHS; HL 72435/HL/NHLBI NIH HHS; HL 84907/HL/NHLBI NIH HHS; R01 HL055502/HL/NHLBI NIH HHS; R01 HL063281/HL/NHLBI NIH HHS; R01 HL072435/HL/NHLBI NIH HHS; U01 HL084907/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Eur Heart J. 2012 Jul;33(14):1716-7   [PMID:  22730487 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Serum glucose levels for predicting death in patients admitted to hospital for community acquired pn...
Next Document:  Reduced serum levels of vasostatin-2, an anti-inflammatory peptide derived from chromogranin A, are ...