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- Rydberg, Erik, et al.
(författare)
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Left atrioventricular plane displacement but not left ventricular ejection fraction is influenced by the degree of aortic stenosis.
- 2004
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Ingår i: Heart. - : BMJ. - 1355-6037. ; 90:10, s. 5-1151
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in UndeterminedAims: To examine how left atrioventricular plane displacement ( AVPD), a widely used measure of left ventricular (LV) function, is related to presence and degree of aortic stenosis. Methods and results: Cardiac dimensions, LV filling, left AVPD, LV ejection fraction (LVEF), and valve function were assessed by echocardiography/Doppler in 182 patients with various cardiac diseases (mean (SD) age 69 (12) years, 36% women), 49 consecutive with and 133 consecutive without aortic stenosis. In an analysis of covariance, neither left AVPD nor LVEF was independently correlated with the presence of aortic stenosis. However, looking separately at patients with aortic stenosis, left AVPD (p = 0.03) but not LVEF correlated independently with degree of aortic stenosis in multiple linear regression analysis. In patients with aortic stenosis, an abnormal left AVPD had 94% sensitivity and 90% negative predictive value with regard to severe aortic stenosis, compared with 56% and 62%, respectively, for LVEF. Conclusion: In patients with cardiac disease, neither left AVPD nor LVEF correlated independently with presence of aortic stenosis. However, in patients with aortic stenosis, left AVPD but not LVEF correlated with the degree of aortic valve obstruction and left AVPD but not LVEF had high sensitivity and negative predictive value with regard to severe aortic stenosis. Compared with LVEF, left AVPD is an earlier and more sensitive marker of LV haemodynamic load in patients with aortic stenosis.
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| 2. |
- Rydberg, Erik, et al.
(författare)
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Left atrioventricular plane displacement determined by echocardiography: a clinically useful, independent predictor of mortality in patients with stable coronary artery disease
- 2003
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Ingår i: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 254:5, s. 479-485
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Tidskriftsartikel (refereegranskat)abstract
- Background. Echocardiographically determined left atrioventricular plane displacement (AVPD) is strongly related to prognosis in patients with chronic heart failure and in postmyocardial infarction patients. We aimed at exploring whether AVPD, unlike ejection fraction, is related to mortality in patients with stable coronary artery disease (CAD). Methods and results. Atrioventricular plane displacement was assessed by two dimensionally guided M-mode echocardiography in the four and two chamber views, in 333 consecutive patients with stable CAD and an abnormal coronary angiogram. Patients were followed up for an average of 41 months. AVPD was lower in patients who died (n = 30, 9.0 %) compared with survivors (9.0 +/- 2.2 vs. 11.5 +/- 2.1 mm, P < 0.0001). Amongst patients with prior myocardial infarction (n = 184) AVPD was 8.7 +/- 2.3 mm in those who died (n = 17) and 11.2 +/- 2.3 mm in the survivors (P < 0.0001). In patients without prior myocardial infarction (n = 149), AVPD was 9.4 +/- 2.1 (n = 13) and 11.8 +/- 1.8 mm, respectively (P < 0.0001). Age, AVPD and four other echocardiographical variables correlated significantly with prognosis in univariate logistic regression analysis. In multiple logistic regression analysis only AVPD (P < 0.0001) correlated independently with mortality. Conclusion. Echocardiographically determined AVPDis a clinically useful, independent prognostic tool in patients with stable CAD. The presence of a documented previous myocardial infarction does not influence this observation.
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| 5. |
- Tasevska, Gordana, et al.
(författare)
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Gender aspects on survival among patients admitted to hospital with suspected or diagnosed heart failure.
- 2008
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1651-2006 .- 1401-7431. ; 42, s. 383-391
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Tidskriftsartikel (refereegranskat)abstract
- Objectives and design. There are conflicting data on gender differences in survival among heart failure (HF) patients. We prospectively assessed gender differences in survival among 930 consecutive patients (464 [49.9%] women, mean age 76.1 +/- 10.1 years), admitted to hospital with suspected or diagnosed HF. Results. Overall, women had lower unadjusted mortality hazard ratio (HR) than men: HR 0.827; 95% confidence interval (CI) 0.690-0.992; p = 0.040. Adjusted HR was 0.786; 95% CI 0.601-1.028; p = 0.079. Unadjusted mortality was significantly higher among patients with a discharge HF diagnosis, compared to those without: HR 1.330; 95% CI 1.107-1.597; p = 0.002; adjusted p = 0.289. Women and men with a discharge HF diagnosis had similar survival: unadjusted HR 1.052; 95% CI 0.829-1.336; p = 0.674; adjusted HR 0.875; 95% CI 0.625-1.225; p = 0.437. Women had lower mortality risk among patients without a discharge HF diagnosis: HR 0.630, 95% CI 0.476-0.833, p = 0.001; adjusted HR 0.611, p = 0.036. Conclusion. Prognosis was poor among patients hospitalised with suspected or diagnosed HF. Among all patients, women had better survival, whereas both sexes had similar survival when the HF diagnosis was certified.
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| 6. |
- Tasevska, Gordana, et al.
(författare)
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Gender differences in variables related to B-natriuretic peptide, left ventricular ejection fraction and mass, and peak oxygen consumption, in patients with heart failure.
- 2011
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; Apr 7, s. 364-371
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Tidskriftsartikel (refereegranskat)abstract
- AIM AND METHODS: We assessed gender differences in variables related to B-natriuretic peptide (BNP), left ventricular ejection fraction (LVEF), peak oxygen consumption (peak-VO2), and LV mass (LVM), among patients recently hospitalized for suspected heart failure (HF). RESULTS: Of 930 consecutive patients, 409 accepted follow-up after discharge, 221 of these had definite HF (90 women, mean age 74.5 [9.8]years). In 141 HF patients (61 women) with BNP data, women had lower BNP than men (43.9 [38.1] versus 76.3 [88.9]pmol/L, P=0.0193). LVEF (all HF patients) was higher in women (49.8 [13.4] versus 42.4 [13.9]%, P=0.0004). Peak-VO2 (147 HF patients, 48 women) was lower in women (13.9 [4.3] versus 16.3 [4.2]mL/kg/min, P=0.0093). LVM index (200 HF patients, 78 women) was lower in women (130.4 [46.5] versus 171.7 [57.6]g/m(2), P<0.0001). Among HF patients, variables independently related to BNP were body mass index (BMI) and peak-VO2 exclusively among men, mitral regurgitation, respiratory disease and angiotensin receptor blocker treatment only among women. Variables independently related to LVEF were resting heart rate, acetylic salicylic acid use and BNP exclusively among men. No variable was exclusive for women. Variables independently related to peak-VO2 were right ventricular size, BNP, resting and peak heart rate solely among men, BMI and stable angina pectoris exclusively among women. Variables independently related to LVM were left atrial diameter only among men, BMI exclusively among women. CONCLUSION: Among elderly HF patients, there were some important gender differences in BNP, LVEF, peak-VO2 and LVM, and in variables independently related to these factors.
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| 7. |
- Willenheimer, Ronnie, et al.
(författare)
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Echocardiographic assessment of left atrioventricular plane displacement as a complement to left ventricular regional wall motion evaluation in the detection of myocardial dysfunction.
- 2002
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Ingår i: International Journal of Cardiovascular Imaging. - 1875-8312. ; 18:3, s. 181-186
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Tidskriftsartikel (refereegranskat)abstract
- AIM: We aimed to find out if abnormal left atrioventricular plane displacement (AVPD) is a sign of myocardial dysfunction, even in patients with normal left ventricular (LV) regional wall motion (RWM). METHODS: We prospectively performed echocardiography in 1350 consecutive patients referred to our echocardiography laboratory. Left AVPD and LV RWM were evaluated in all patients. We prospectively selected all patients with normal LV RWM but impaired left AVPD for further analysis of clinical parameters. RESULTS: Eighty-eight of the 1350 patients had completely normal LV RWM but impaired left AVPD (< or = 10 mm) in at least one region (septal, lateral, posterior, anterior). Of these, 60.2% had prior and/ or acute myocardial infarction, predominantly non-Q-wave, whereas 33.0% had angina without infarction and 2.3% had hypertension. In 49 (55.7%) patients coronary angiography was performed. All were abnormal. In 4.5% (n = 4) of the patients no obvious reason for the AVPD decrease was found, but was not precluded. CONCLUSION: Almost all patients with abnormal left AVPD and completely normal LV RWM had clinical cardiac disease. Thus, decreased AVPD despite normal LV RWM seems to be a true sign of myocardial dysfunction, predominantly indicating subendocardial dysfunction. In screening for patients with myocardial dysfunction assessment of left AVPD may be useful as a complement to LV RWM evaluation. The prognosis in such patients is currently being evaluated.
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| 8. |
- Willenheimer, Ronnie, et al.
(författare)
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No effects on myocardial ischaemia in patients with stable ischaemic heart disease after treatment with ramipril for 6 months
- 2001
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Ingår i: Current Controlled Trials. Cardiovascular Medicine. - : Springer Science and Business Media LLC. - 1468-6694 .- 1468-6708. ; 2:2, s. 99-105
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess the effects of a 6-month angiotensin-converting enzyme (ACE) inhibitor intervention on myocardial ischaemia.Method: We randomized 389 patients with stable coronary artery disease to double-blind treatment with ramipril 5 mg/day (n = 133), ramipril 1.25 mg/day (n = 133), or placebo (n = 123). Forty-eight-hour ambulatory electrocardiography was performed at baseline, and after 1 and 6 months.Results: Relevant baseline variables were similar in all groups. Changes over 6 months in duration of 1 mm ST-segment depression (STD), total ischaemic burden and maximum STD did not differ significantly between the treatment groups. There was no difference in the frequency of adverse events between the groups.ConclusionACE inhibitor treatment has little impact on incidence and severity of myocardial ischaemia in patients with stable ischaemic heart disease.
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