Objectives: In certain younger patients with congestive heart failure (CHF), Doppler/echocardiography has identified a "restrictive" pattern of early diastolic ventricular filling characterized by very rapid early filling and a steep deceleration slope. We asked whether a similar restrictive pattern can be identified in very old patients with CHF, and if so, what are its clinical correlates and prognostic implications.
Design: Retrospective cohort with prospective follow-up.
Setting: Academic long-term care facility.
Participants: Thirty-nine residents with clinical CHF (age 89 +/- 5 (SD) years)
Measurements: Transmitral Doppler flow, clinical characteristics, recurrent CHF episodes, hospitalizations, and mortality were measured.
Results: Fifteen (38%) of the subjects had restrictive filling patterns, characterized by a ratio of early to late flow (E/A) > 1.00 and 24 (62%) had nonrestrictive patterns. The restrictive pattern was associated with a longer duration of CHF, more angina, and higher rate of symptomatic recurrences of CHF.
Conclusion: A restrictive diastolic filling pattern may represent a late stage in the evolution of congestive heart failure when left ventricular filling pressure is markedly increased. The treatment of CHF in older patients may need to account for different patterns of diastolic filling.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1532-5415.1996.tb01823.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Computational modeling of cardiac hemodynamics including chordae tendineae, papillaries, and valves dynamics.
Comput Biol Med
January 2025
LaBS, Dipartimento di Chimica, Materiali e Ingegneria Chimica "Giulio Natta", Politecnico di Milano, Piazza Leonardo da Vinci 32, Milan, 20133, Italy. Electronic address:
In the context of dynamic image-based computational fluid dynamics (DIB-CFD) modeling of cardiac system, the role of sub-valvular apparatus (chordae tendineae and papillary muscles) and the effects of different mitral valve (MV) opening/closure dynamics, have not been systemically determined. To provide a partial filling of this gap, in this study we performed DIB-CFD numerical experiments in the left ventricle, left atrium and aortic root, with the aim of highlighting the influence on the numerical results of two specific modeling scenarios: (i) the presence of the sub-valvular apparatus, consisting of chordae tendineae and papillary muscles; (ii) different MV dynamics models accounting for different use of leaflet reconstruction from imaging. This is performed for one healthy subject and one patient with mitral valve regurgitation.
View Article and Find Full Text PDFThe Role of Advanced Cardiac Imaging in Monitoring Cardiovascular Complications in Patients with Extracardiac Tumors: A Descriptive Review.
J Cardiovasc Dev Dis
December 2024
Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy.
Cardiac involvement in cancer is increasingly important in the diagnosis and follow-up of patients. A thorough cardiovascular evaluation using multimodal imaging is crucial to assess any direct cardiac involvement from oncological disease progression and to determine the cardiovascular risk of patients undergoing oncological therapies. Early detection of cardiac dysfunction, particularly due to cardiotoxicity from chemotherapy or radiotherapy, is essential to establish the disease's overall prognostic impact.
View Article and Find Full Text PDFState of precision medicine for heart failure with preserved ejection fraction in a new therapeutic age.
ESC Heart Fail
January 2025
Faculty of Medicine, Royal Brisbane and Women's Hospital, University of Queensland, Herston, Queensland, Australia.
Heart failure with preserved ejection fraction (HFpEF) is defined by heart failure (HF) with a left ventricular ejection fraction (LVEF) of at least 50%. HFpEF has a complex and heterogeneous pathophysiology with multiple co-morbidities contributing to its presentation. Establishing the diagnosis of HFpEF can be challenging.
View Article and Find Full Text PDFAn interactive simulator to deepen the understanding of Guyton's venous return curve.
J Physiol Sci
January 2025
Department of Hematology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-Ku, 252-0374, Sagamihara, Kanagawa, Japan.
Mean circulatory filling pressure, venous return curve, and Guyton's graphical analysis are basic concepts in cardiovascular physiology. However, some medical students may not know how to view and interpret or understand them adequately. To deepen students' understanding of the graphical analysis, in place of having to perform live animal experiments, we developed an interactive cardiovascular simulator, as a self-learning tool, as a web application.
View Article and Find Full Text PDFQuantitative assessment of early changes in myocardial extracellular volume during postoperative adjuvant chemotherapy in patients with breast cancer via dual-layer spectral detector computed tomography: a cohort study.
Quant Imaging Med Surg
January 2025
Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China.
Background: The major of anticancer therapies induce a wide spectrum of cardiotoxic effects. Early identification of anticancer treatment-associated cardiotoxicity is critical to informing decisions on subsequent interventions. Myocardial extracellular volume (ECV) has been proposed as a useful parameter for quantifying the early cardiotoxicity of cancer-related treatment.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!