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J Am Coll Cardiol, 2007; 49:88-96, doi:10.1016/j.jacc.2006.10.023 (Published online 31 October 2006).
© 2006 by the American College of Cardiology Foundation
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Systolic and Diastolic Dyssynchrony in Patients With Diastolic Heart Failure and the Effect of Medical Therapy

Jianwen Wang, MD, PhD, Karla M. Kurrelmeyer, MD, Guillermo Torre-Amione, MD, PhD and Sherif F. Nagueh, MD*

Department of Cardiology and Methodist DeBakey Heart Center, The Methodist Hospital, Houston, Texas


Figure 1
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  		Figure 1 Relationship Between Left Ventricular End-Diastolic Volume (EDV) and Stroke Work

The relationship in the control group is shown by the solid line and solid circles (r2 = 0.93; p < 0.001). The relationship in patients with diastolic heart failure (DHF) and systolic dyssynchrony (r2 = 0.94; p < 0.001) is shown by the dotted line and open circles. The relationship in patients with DHF but without systolic dyssynchrony (r2 = 0.9; p < 0.001) is shown by the dashed line and solid squares. The DHF patients without systolic dyssynchrony and the control group had similar linear relationships. This relationship was shifted downward in patients with DHF and systolic dyssynchrony.

 

Figure 2
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  		Figure 2 Relationship Between Mid-Wall Fractional Shortening and Circumferential Wall Stress

Patients with diastolic heart failure (DHF) and systolic dyssynchrony are shown by open circles, whereas patients with DHF but without dyssynchrony are shown by solid circles. The data points for patients with DHF and systolic dyssnchrony were outside the lower 95% prediction interval for the control group.

 

Figure 3
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  		Figure 3 Relation Between LV Diastolic Intraventricular Time Delay and LV Relaxation and Mean Wedge Pressure

Relationship between maximum diastolic time delay and relaxation time constant {tau} (left) and mean wedge pressure (right) in patients with diastolic heart failure. PCWP = pulmonary capillary wedge pressure.

 

Figure 4
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  		Figure 4 Relationship Between Left Ventricular (LV) Mass Index and LV Diastolic Intraventricular Time Delay

Relationship between maximum diastolic time delay and left ventricular (LV) mass index in patients with diastolic heart failure.

 

Figure 5
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  		Figure 5 Relation Between the Change in LV Disatolic Dyssynchrony Index and LV Relaxation With Medical Therapy

Relationship between the percentage change in diastolic time delay and the corresponding percentage change in relaxation time constant {tau} after medical therapy for diastolic heart failure.

 




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