Related Experiment Video

Updated: Jan 28, 2026

A Rat Model of Pressure Overload Induced Moderate Remodeling and Systolic Dysfunction as Opposed to Overt Systolic Heart Failure
07:13

A Rat Model of Pressure Overload Induced Moderate Remodeling and Systolic Dysfunction as Opposed to Overt Systolic Heart Failure

Published on: April 30, 2020

6.9K

Interactive role of diastolic dysfunction and ventricular remodeling in asymptomatic subjects at increased risk of

Iacopo Fabiani1, Nicola Riccardo Pugliese2, Salvatore La Carrubba3

  • 1Dipartimento di Patologia Medica, Chirurgica, Molecolare e dell'Area Critica, Università di Pisa, Via Paradisa, 2 - Ospedale Cisanello, Pisa, 56100, Italy.

The International Journal of Cardiovascular Imaging
|March 1, 2019
PubMed

Insights

Diastolic dysfunction and left ventricular remodeling predict heart failure risk. Combining complex remodeling classification and Nagueh 2016 diastolic function assessment improves risk prediction in asymptomatic patients with preserved ejection fraction.

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Research

Background:

  • Diastolic dysfunction (DD) and left ventricular remodeling (LVR) are key indicators for heart failure (HF) risk.
  • Asymptomatic individuals with preserved ejection fraction (EF) and cardiovascular risk factors require accurate prognostic assessment.
  • Existing methods for evaluating DD and LVR may vary in their prognostic utility.

Purpose of the Study:

  • To evaluate the prognostic impact of different diastolic function algorithms and a complex LVR classification (CRC) in asymptomatic patients at risk for HF.
  • To determine if combining structural (LVR) and functional (DD) assessments improves risk stratification.
  • To identify the most effective algorithms for predicting cardiac events in this population.

Main Methods:

  • Analysis of 1923 asymptomatic patients with at least one cardiovascular risk factor and preserved EF (> >50%).
  • Assessment of LV diastolic function using three distinct algorithms (Paulus et al., Nagueh et al. 2009, Nagueh et al. 2016).
  • Classification of LVR using both classic and complex remodeling classification (CRC) methods.
  • Composite endpoint of cardiac death and HF hospitalization, analyzed via Cox-regression.

Main Results:

  • The Nagueh 2016 algorithm identified the lowest prevalence of DD (3.2%).
  • CRC classified a significant portion of patients with various remodeling patterns, including 15.5% with concentric remodeling and 15.3% unclassifiable.
  • Cox-regression identified CRC (p=0.01) and Nagueh 2016 (p<0.001) as independent predictors of the composite endpoint.
  • The combination of adverse LVR by CRC and DD by Nagueh 2016 was associated with the poorest prognosis.

Conclusions:

  • A concurrent structural (CRC) and functional (Nagueh 2016) analysis significantly enhances prognostic stratification.
  • The Nagueh 2016 algorithm and CRC are valuable tools for identifying high-risk asymptomatic patients.
  • Integrating advanced echocardiographic assessments improves the prediction of adverse cardiac events in patients at risk for HF with preserved EF.

Keywords:
Cardiac remodelingDiastolic dysfunctionHeart failurePreserved ejection fractionPrognosis

More Related Videos

Author Spotlight: Investigating HR-Dependent Cardiac Function in Mouse Models Through a Novel Atrial-Pacing Approach07:49

Author Spotlight: Investigating HR-Dependent Cardiac Function in Mouse Models Through a Novel Atrial-Pacing Approach

Published on: July 21, 2023

1.9K
Induction of Right Ventricular Failure by Pulmonary Artery Constriction and Evaluation of Right Ventricular Function in Mice09:40

Induction of Right Ventricular Failure by Pulmonary Artery Constriction and Evaluation of Right Ventricular Function in Mice

Published on: May 13, 2019

11.1K

Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
872
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
3.5K
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
847
Nucleosome Remodeling02:54

Nucleosome Remodeling

Nucleosomes are the basic units of chromatin compaction. Each nucleosome consists of the DNA bound tightly around a histone core, which makes the DNA inaccessible to DNA binding proteins such as DNA polymerase and RNA polymerase. Hence, the fundamental problem is to ensure access to DNA when appropriate, despite the compact and protective chromatin structure.
Nucleosome remodeling complex
Eukaryotic cells have specialized enzymes called ATP-dependent nucleosome remodeling enzymes. These enzymes...
11.1K
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
314
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
948