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Cardiac Chambers and Myocardial Disease
Published in Paul Schoenhagen, Frank Dong, Cardiac CT Made Easy, 2023
Restrictive cardiomyopathies describe a group of disease conditions that are characterized by increased ventricular stiffness. A diagnostic hallmark is diastolic dysfunction, which is best assessed with echocardiography. Ventricular stiffness can be secondary to myocardial infiltration (e.g. cardiac amyloidosis), where advanced disease stages potentially show myocardial prominence and can involve both LV and RV wall (Figures 4.11 and 4.12).41 Restriction can also be caused by endocardial fibrosis (e.g. Loeffler's endocarditis) (Figure 4.13).
Coupling of the Left Ventricle with the Systemic Circulation
Published in Wilmer W Nichols, Michael F O'Rourke, Elazer R Edelman, Charalambos Vlachopoulos, McDonald's Blood Flow in Arteries, 2022
Diastolic dysfunction of the heart is characterized by delay in relaxation during diastole (Le Carpentier et al., 1991; Brutsaert et al., 1993; Federmann and Hess, 1994; Zile and Brutsaert, 2002a, 2002b; Zile et al., 2004; Gaasch and Little, 2007; Paulus et al., 2007; Paulus, 2010; Borlaug et al., 2010; Maeder et al., 2010). Relaxation is an active process, requiring energy, and is slowed in the aged heart with hypertrophy and in ischemic heart disease. In ischemic heart disease, this process may be slowed to such a degree that “postsystolic shortening” may become apparent (Brown et al., 1987; Skulstad et al., 2002) at ventriculography or echocardiography.
Heart failure
Published in Henry J. Woodford, Essential Geriatrics, 2022
Based on ejection fraction measurements obtained from echocardiography, heart failure has been classified into two subtypes. Heart failure with reduced ejection fraction (HFrEF; previously ‘systolic') has an ejection fraction (EF) of 40% or less.4 Heart failure with preserved ejection fraction (HFpEF; previously ‘diastolic') is the term used for the clinical features of heart failure in individuals with an EF of 50% or more plus evidence of left ventricular diastolic dysfunction.5 People with clinical evidence of heart failure but with an EF of 40–49% are something of a grey area. To some degree, both systolic and diastolic dysfunction probably co-exist in many people with heart failure.
Ginsenoside Rc attenuates myocardial ischaemic injury through antioxidative and anti-inflammatory effects
Published in Pharmaceutical Biology, 2022
Lei Shi, Wenwen Fu, Huali Xu, Shihui Li, Xinyu Yang, Wei Yang, Dayun Sui, Quanwei Wang
Myocardial ischaemia is the leading cause of death and disability worldwide. Myocardial ischaemia is caused by an imbalance between myocardial oxygen demand and supply. It results in the myocardial pathological changes ranging from injury to necrosis. Myocardial ischaemia affects the diastolic properties of heart by slowing ventricular relaxation and increasing ventricular stiffness. Thus, it frequently leads to systolic and diastolic dysfunction (Ihara et al. 1994). Myocardial ischaemia also may precipitate heart failure exacerbation. It should be noted that myocardial ischaemia can be either a cause or a consequence of heart failure. Previous study demonstrated that about 70% of heart failure patients have ischaemic heart disease (Pagliaro et al. 2020). Myocardial ischaemia is the most common cause of lethal arrhythmias including ventricular tachycardia and fibrillation. A significant proportion of mortality in myocardial ischaemia patients is due to sudden cardiac death caused by ventricular arrhythmias (Agewall 2017).
Obstructive sleep apnea and cardiovascular events in elderly patients
Published in Expert Review of Respiratory Medicine, 2022
Pablo Catalan Serra, Xavier Soler
In the SHHS, the authors found an independent association between incident cardiovascular disease and OSA [126]. When the patients have diastolic dysfunction and preserved systolic function, the prevalence reaches 55%. In contrast, the risk of heart failure in patients with OSA is more than double the risk in the general population [112]. Patients with OSA show diastolic [127] and systolic [126] left ventricular functional alterations, as well as morphological changes with an increase in left ventricular mass [128]. The increased risk of heart failure is related to both the intensity of the AHI and the intensity of hypoxemia. This relationship is independent of various confounding factors, although it worsens if the patient also suffers from hypertension. From an early age, myocardial damage is not limited only to the left ventricle since there is also dysfunction of the right ventricle [129].
Galectin-3 reflects the echocardiographic quantification of right ventricular failure
Published in Scandinavian Cardiovascular Journal, 2021
Uzair Ansari, Michael Behnes, Julia Hoffmann, Kathrin Weidner, Philip Kuche, Jonas Rusnak, Seung-Hyun Kim, Michele Natale, Nadine Reckord, Siegfried Lang, Ursula Hoffmann, Thomas Bertsch, Marc Fatar, Martin Borggrefe, Ibrahim Akin
Our present study incorporated a population subset of 91 patients derived from a collective who underwent routine echocardiography at between 2014 and 2016. This was determined after ascertaining the inclusion and exclusion criteria for this analysis. The inclusion criteria included all patients at risk of developing cardiovascular disease or already diagnosed with cardiovascular disease. The exclusion criteria encompassed all patients under 18 years of age and/or pregnant; those with mechanical heart valves; those having suffered from a myocardial infarction within the last 3 months and those patients who received an electrical cardioversion within the last 30 days. Patients with heart transplants, acute pulmonary embolism, transient ischemic attacks in the last 30 days, those with acute infections, and/or chronic kidney disease with an eGFR <40 mL/min were also excluded from the study. For this particular sub-study focusing on RVF, only patients with normal left ventricular ejection fraction (LVEF) were included in the study population. Moreover, patients with moderate and severe heart valve disorders, classified as either stenosis or regurgitation were also excluded. Due to difficulties pertaining to accurate diagnosis, patients with varying degrees of diastolic dysfunction could have been included in this study. However, the number of patients with severe degree of diastolic dysfunction is limited.