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Pulsed Doppler echocardiographic study of left ventricular diastolic function in patients with idiopathic dilated
V K Bahl1, S Chandra, A K Boro
1Department of Cardiology, Cardiothoracic Sciences Center, All India Institute of Medical Sciences, New Delhi-100 029.
Insights
Dilated cardiomyopathy patients with advanced disease show abnormal diastolic function. Pulsed Doppler echocardiography revealed a restrictive filling pattern, indicating impaired relaxation and filling of the left ventricle.
Area of Science:
- Cardiology
- Echocardiography
- Cardiovascular Physiology
Background:
- Dilated cardiomyopathy (DCM) is primarily characterized by left ventricular systolic dysfunction.
- Limited research exists on diastolic function assessment in DCM patients.
- Understanding diastolic dysfunction is crucial for comprehensive DCM evaluation.
Purpose of the Study:
- To evaluate left ventricular (LV) diastolic function in patients with idiopathic dilated cardiomyopathy using pulsed Doppler echocardiography.
- To compare diastolic parameters between DCM patients and healthy controls.
Main Methods:
- Pulsed Doppler echocardiography was used to obtain transmitral spectral tracings.
- 25 patients with idiopathic DCM (NYHA class III-IV) and 20 healthy controls were studied.
- Key diastolic parameters including E/A ratio, deceleration time, isovolumic relaxation time (IVRT), early filling fraction (EFF), and atrial filling fraction (AFF) were measured.
Main Results:
- DCM patients exhibited significantly reduced systolic function (ejection fraction 36.6% vs. 65% in controls).
- Patients showed an increased E/A ratio (1.89 vs. 1.50), shortened deceleration time (57.05 ms vs. 70.20 ms), and shortened IVRT (53.5 ms vs. 72 ms).
- Higher EFF (0.71 vs. 0.66) and lower AFF (0.28 vs. 0.33) were observed in DCM patients compared to controls.
Conclusions:
- Patients with advanced idiopathic dilated cardiomyopathy demonstrate significant abnormalities in LV diastolic function.
- The findings suggest a restrictive filling pattern in DCM patients as evidenced by Doppler echocardiography.
- Diastolic dysfunction is a prominent feature in advanced DCM, impacting ventricular filling and overall cardiac performance.
Abstract:
Dilated cardiomyopathy is basically regarded as a disease of left ventricular systolic dysfunction. There are only a few studies evaluating diastolic function in patients with dilated cardiomyopathy. To assess the LV diastolic function, 25 patients with idiopathic dilated cardiomyopathy and 20 age and sex matched normal subjects were studied with transmitral spectral tracings derived from pulsed Doppler echocardiography. All cardiomyopathy patients were in New York Heart Association class III to IV with dilated left ventricles and reduced systolic function (mean ejection fraction of 36.6 +/- 6.7 Vs 65 +/- 6 in normal subjects, p < 0.001). Patients with cardiomyopathy demonstrated an increased ratio of early to late diastolic velocity (E/A) (1.89 +/- 0.59 Vs 1.50 +/- 0.27 m/sec, p < 0.05), short deceleration time (E-E/2) (57.05 +/- 13.36 Vs 70.20 +/- 16.56 msec, p < 0.01) and short isovolumic relaxation time (IVRT) (53.5 +/- 22.7 Vs 72 +/- 12 msec, p < 0.05) as compared to normal subjects. The early filling fraction (EFF) was higher (0.71 +/- 0.11 Vs 0.66 +/- 0.06, p < 0.05) and atrial filling fraction (AFF) was lower (0.28 +/- 0.11 Vs 0.33 +/- 0.06, p < 0.05) in cardiomyopathy patients than in normal subjects. Our observations in a select group of dilated cardiomyopathy patients with advanced disease demonstrate a restrictive pattern on pulsed Doppler echocardiography.