Predisposing Risk Factors Affecting Reversibility of Left Ventricular Diastolic Filling Pattern in Patients with
Dong-Gil Kim1,2, Sungsoo Cho3, Seongjin Park1
1Division of Cardiology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
Yonsei Medical Journal
|January 1, 2025
Summary
Paroxysmal atrial fibrillation (PAF) independently predicts unimproved left ventricular diastolic filling patterns in patients with preserved ejection fraction. Early detection and management of PAF are crucial for preventing adverse cardiovascular events in these patients.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Research
Background:
- Left ventricular diastolic dysfunction (DD) improvement is a positive prognostic indicator in heart failure with reduced ejection fraction.
- Understanding factors influencing diastolic filling pattern (DFP) reversibility in preserved ejection fraction (PEF) is critical for patient management.
Purpose of the Study:
- To investigate predisposing risk factors for the reversibility of left ventricular diastolic filling patterns (LVDFP) in patients with preserved ejection fraction.
- To identify specific clinical factors associated with the progression or improvement of LVDFP in this population.
Main Methods:
- A cohort of 600 patients with pseudonormal LVDFP and preserved EF underwent serial echocardiography between 2011 and 2020.
- Comparative analysis of baseline and follow-up echocardiographic findings to determine factors influencing LVDFP changes.
Main Results:
- 63% of patients showed improvement in LVDFP, while 37% remained unimproved or worsened.
- Paroxysmal atrial fibrillation (PAF) was significantly more prevalent in the unimproved group (9.5% vs. 4.7%).
- PAF was identified as an independent risk factor for unimproved LVDFP (OR: 2.10, p=0.033), with poorer diastolic parameter improvements observed in patients with PAF.
Conclusions:
- Paroxysmal atrial fibrillation is an independent risk factor for unimproved LVDFP in patients with pseudonormal LVDFP and preserved EF.
- Early identification and management of PAF are recommended for patients with left ventricular diastolic dysfunction and preserved EF to mitigate cardiovascular risks.
Related Concept Videos
01:26Imbalances in Cardiac Output
1.3K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.3K
01:17Pathophysiology of Heart Failure
1.5K
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...
1.5K
01:22Heart Failure Drugs: Diuretics
338
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...
338
01:27Regulation of Stroke Volume
3.1K
The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
3.1K