LV filling patterns were studied by Doppler and echocardiographic automated border detection (ABD) in 35 congestive heart failure (CHF) pts (aged 19 to 78 years, mean 53). All pts were in sinus rhythm and mild-to-moderate CFH (NYHA functional class II-III). The etiology of CHF was idiopathic dilated cardiomyopathy in 9 pts, ischemic cardiomyopathy in 10, hypertensive heart disease in 13, and congenital heart disease in 3. Medical therapy consisted of digitalis in 18 pts, diuretics in 19, ACE-inhibitors in 18, and calcium channel blockers in 6. 15 normal age-matched subjects (aged 24 to 72 years, mean 49) were selected as controls. Doppler peak filling velocity at early diastole (E) and at atrial contraction (A) and flow velocity integrals were determined. Real time LV volumes by ABD were obtained with the method of discs in the apical 4 chamber view and LV filling ABD parameters were calculated. 23 pts (group 1) resulted to have systolic dysfunction (LVEF ≤ 50%) and 12 pts (group 2) had normal or nearly normal LVEF. Four out of 23 pts in group 1 and five of 12 pts in group 2 had an E/A mitral flow velocity ratio < 1 and the other 19 pts in group 1 and 7 pts in group 2 had pseudonormalized or nondiagnostic Doppler patterns. Group 1 pts were further classified in pts with severly impaired (LVEF < 40%) and mildly impaired (40% ≤ LVEF ≤ 50%) LV systolic function (group 1a e 1b, respectively). E/A ratio was higher and deceleration time and isovolumic relaxation time were shorter in group 1a CHF pts. There was no significant difference in mitral inflow indices between normal controls and groups 1b and 2, respectively. ABD diastolic indices differed significantly from controls in group 1a and 1b pts. A significant difference in ABD indices was also observed between group 2 pts and normal subjects. Thus ABD filling patterns are useful in differentiating systolic from diastolic dysfunction in CHF pts even in the presence of nondiagnostic Doppler indices.
Assessment of left ventricular diastolic dysfunction in congestive heart failure by acoustic quantification / Vitarelli, Antonino; Sciomer, Susanna; Pugliese, M; Dagianti, Alessandra; Salvati, A; Ciucci, F; Caselli, A; Barbuto, D; Giubilei, R; Mochi, G; Clemente, P; Dagianti, Armando. - In: EUROPEAN JOURNAL OF INTERNAL MEDICINE. - ISSN 0953-6205. - STAMPA. - 8:(1997), pp. 223-230.