PMID- 12161228
OWN - NLM
STAT- MEDLINE
DCOM- 20020923
LR  - 20190623
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 90
IP  - 4
DP  - 2002 Aug 15
TI  - Comparison of left ventricular systolic and diastolic function in patients with 
      idiopathic dilated cardiomyopathy and mild heart failure versus those with severe 
      heart failure.
PG  - 390-4
AB  - The pathogenesis of acute pulmonary edema in idiopathic dilated cardiomyopathy 
      (IDC) is not completely understood. Because pulse-wave tissue Doppler imaging 
      (TDI) allows a direct comparison between systolic as well as diastolic wall 
      motion velocities, we tested the hypothesis that acute pulmonary edema is caused 
      by both systolic and diastolic failure. We prospectively studied 65 patients. 
      Forty patients had IDC (group 1), 15 of whom had recent-onset pulmonary 
      congestion (group 1a, New York Heart Association [NYHA] functional classes III 
      and IV) and 25 of whom were in clinically stable condition without signs of 
      pulmonary congestion (group 1b, NYHA I and II). All of these patients were 
      restudied after 3, 7, and 45 days. Groups 1a and 1b were compared with 25 
      subjects without evidence of heart disease (group 2). Peak systolic wall motion 
      velocity (Vs), peak wall motion velocity of the early (Ve), and late (Va) filling 
      waves were measured by TDI; mitral inflow pattern was determined by pulse-wave 
      Doppler and left ventricular (LV) ejection fraction (EF) by 2-dimensional 
      echocardiography. In those patients without pulmonary edema (controls and group 
      1b, n = 50), we found a positive correlation between LVEF and Vs (r = 0.72, p 
      <0.001) and between LVEF and Ve (r = 0.79, p <0.001). Early diastolic wall motion 
      velocity always exceeded peak systolic wall motion velocity (Ve/Vs ratio >1). In 
      patients with IDC with recent-onset pulmonary congestion (group 1a), Ve was 
      significantly lower compared with group 1b (3.5 +/- 0.2 vs 4.9 +/- 0.4 cm/s, p 
      <0.01, Ve/Vs ratio <1). Clinical improvement was paralled by a gradual increase 
      in Ve (3.5 +/- 0.2 to 6.8 +/- 0.3 cm/s, p <0.01) but not in Vs or LVEF. Thus, in 
      patients with IDC acute pulmonary edema is exclusively caused by diastolic rather 
      than systolic failure.
FAU - Richartz, Barbara M
AU  - Richartz BM
AD  - Department of Internal Medicine III, Division of Cardiology, 
      Friedrich-Schiller-University Jena, Jena, Germany. richatz@ed.uni-jena.de
FAU - Werner, Gerald S
AU  - Werner GS
FAU - Ferrari, Markus
AU  - Ferrari M
FAU - Figulla, Hans R
AU  - Figulla HR
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Controlled Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Analysis of Variance
MH  - Cardiomyopathy, Dilated/*complications/diagnostic imaging/physiopathology
MH  - Diastole
MH  - Echocardiography, Doppler
MH  - Female
MH  - Heart Failure/complications/diagnostic imaging/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Pulmonary Edema/*etiology
MH  - Regression Analysis
MH  - Systole
MH  - Ventricular Dysfunction, Left/complications/diagnostic imaging/physiopathology
EDAT- 2002/08/06 10:00
MHDA- 2002/09/24 06:00
CRDT- 2002/08/06 10:00
PHST- 2002/08/06 10:00 [pubmed]
PHST- 2002/09/24 06:00 [medline]
PHST- 2002/08/06 10:00 [entrez]
AID - S0002914902024955 [pii]
AID - 10.1016/s0002-9149(02)02495-5 [doi]
PST - ppublish
SO  - Am J Cardiol. 2002 Aug 15;90(4):390-4. doi: 10.1016/s0002-9149(02)02495-5.