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At least 865 records · Page 48Linked to original sources
PubMed1996

Fetal heart rate changes and cerebral oxygenation measured by near-infrared spectroscopy during the first stage of labour.

OBJECTIVE: To determine the relationship between contraction related changes in fetal heart rate and cerebral oxygenation measured by near-infrared spectroscopy during labour. STUDY DESIGN: A specially designed optical probe was inserted through the dilated cervix and placed against the fetal head in 30 women during labour. Alterations in fetal heart rate during the final hour of the first stage of labour were compared with changes in the cerebral haemoglobin oxygenation index (delta oxyhaemoglobin concentration - delta deoxyhaemoglobin concentration) measured before, during and after uterine contractions. RESULTS: Uterine contractions which were associated with either no alteration, accelerations or early decelerations of the fetal heart rate showed no significant changes in the haemoglobin oxygenation index. Variable, late and prolonged decelerations all showed significant decreases in the haemoglobin oxygenation index (P < 0.01) either during (variable) or after (variable, late and prolonged) the uterine contraction. CONCLUSION: The association between variable, late and prolonged FHR decelerations and significant falls in cerebral oxygenation during late labour suggests that these fetal heart rate patterns are associated with an increased risk of fetal cerebral hypoxia.

Adult↗
PubMed1996

Fetal heart rate tracings: observers versus computer assessment.

UNLABELLED: Cardiotocography (CTG) is widely used despite the fact that its diagnostic accuracy is far from satisfying. This is due, among other reasons, to the great intra- and interobserver variation in reading the fetal heart rate tracings. Computerized analysis might be a means to overcome the latter problem. OBJECTIVE: the present study was designed to assess the reproducibility of CTG readings among observers and between observers and a computer system. STUDY DESIGN: 63 fetal heart rate tracings were read by 4 clinicians (2 experienced and 2 inexperienced) and by the 2CTG computerized system. The variables considered were: baseline fetal heart rate (FHR), long-term variability (amplitude bandwidth around the baseline), number of large accelerations and number and type of decelerations. RESULTS: the agreement among observers, assessed by means of kappa coefficient, ranges from fair to good. The agreement between each of the observers and the computer readings, ranges from 0.18 to 0.48 for FHR baseline, from 0.16 to 0.74 for variability, from 0.37 to 0.64 for the number of accelerations and from 0.41 to 0.54 for the number of decelerations. The agreement on the type of decelerations is very low (0.01-0.25). CONCLUSION: it is concluded that interobserver variability between experienced observers, inexperienced observers and 2CTG is considerable and that the use of a computer system should overcome this problem.

Cardiotocography↗
PubMed1984

Corrective reactions to stumbling in man: functional significance of spinal and transcortical reflexes.

Stumbling reactions were studied in terms of bilateral leg muscle electromyographic (EMG) responses during locomotion on a treadmill. At random times, but fixed points in the stepping cycle, short impulses were applied to the treadmill, either accelerating or decelerating its progress. It was found that acceleration was compensated for by a strong ipsilateral gastrocnemius and contralateral tibialis anterior activation, and deceleration by a bilateral tibialis anterior activation. In both muscles the responses appeared with a latency of about 70 msec and lasted for about 150 msec. It is concluded that sudden displacements induced by acceleration or deceleration during gait are compensated for by a polysynaptic spinal pathway, with an associated depression of monosynaptic responses.

Acceleration↗
PubMed1989

Characteristic Doppler echocardiographic pattern of mitral inflow velocity in severe aortic regurgitation.

In symptomatic severe aortic regurgitation, left ventricular diastolic pressure increases rapidly, often exceeding left atrial pressure in late diastole. This characteristic hemodynamic change should be reflected in the Doppler mitral inflow velocity, which is the direct result of the diastolic pressure difference between the left ventricle and left atrium. Mitral inflow velocity was obtained by pulsed wave Doppler echocardiography in 11 patients (6 men, 5 women: mean age 53 years) with severe symptomatic aortic regurgitation and compared with normal values from 11 sex- and age-matched control subjects. The following Doppler variables were determined: velocity of early filling wave (E), velocity of late filling wave due to atrial contraction (A), E to A ratio (E/A), deceleration time and pressure half-time. In severe aortic regurgitation, E and E/A (1.13 m/s and 3.3, respectively) were significantly higher (p less than 0.001) than normal (0.60 m/s and 1.5, respectively). Deceleration time and pressure half-time (117 and 34 ms, respectively) were significantly shorter (p less than 0.001) than normal (203 and 59 ms, respectively). Late filling wave velocity (A) was not statistically different in the two groups, although it tended to be lower in the patient group (0.39 versus 0.50 m/s). Diastolic mitral regurgitation was present in eight patients (73%). M-mode echocardiography of the mitral valve, performed in 10 patients, showed that only 3 (30%) had premature mitral valve closure. In symptomatic severe aortic regurgitation, the Doppler mitral inflow velocity pattern is characteristic, with increased early filling wave velocity (E) and early to late filling wave ratio (E/A) and decreased deceleration time of the E wave.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Comprehensive Doppler assessment of right ventricular diastolic function in cardiac amyloidosis.

To assess right ventricular diastolic function in cardiac amyloidosis, pulsed wave Doppler ultrasound measurements of right ventricular inflow velocities and superior vena cava and hepatic vein flow velocities with respiratory monitoring were performed in 41 patients with primary systemic amyloidosis and two-dimensional echocardiographic features of cardiac involvement. Right ventricular diastolic function was abnormal in 31 (76%) of these patients, the major abnormality being a short deceleration time (less than 150 ms) in 21 (68%), suggesting restriction. In contrast, 7 (23%) of the 31 patients had a decreased ratio of early (E) and late (A) diastolic peak flow velocities and a prolonged deceleration time (greater than 240 ms), suggesting abnormal relaxation. The patients were classified into two groups on the basis of right ventricular free wall thickness: group 1, less than 7 mm and group 2, greater than or equal to 7 mm. Compared with normal values, group 1 showed an increased peak late flow velocity (44 +/- 19 versus 39 +/- 6 cm/s; p less than 0.01) and a decreased E/A velocity ratio (1.1 +/- 0.4 versus 1.5 +/- 0.3; p less than 0.01). Group 2 showed a markedly shortened deceleration time (151 +/- 37 versus 225 +/- 28 ms; p less than 0.01), characteristic of restriction. In the overall group, superior vena cava peak flow velocity was decreased in systole and increased in diastole and flow reversals during inspiration were increased compared with normal values. Hepatic venous flow velocities were similar to those in the superior vena cava except for larger flow reversals in the hepatic vein. Thus, in cardiac amyloidosis, right ventricular diastolic function is abnormal. There is a spectrum of right ventricular filling abnormalities and the restrictive filling pattern is seen only in the advanced stages of the disease.

Amyloidosis↗
PubMed1990

Analysis of the early transmitral Doppler velocity curve: effect of primary physiologic changes and compensatory preload adjustment.

Left ventricular filling (as assessed by Doppler echocardiography) has previously been shown to depend in a complex fashion on ventricular diastolic function (compliance and relaxation) as well as other variables, such as atrial pressure and compliance, ventricular systolic function and mitral valve impedance. To study the effect of isolated physiologic alterations on individual Doppler indexes, a mathematic model of mitral flow was analyzed. By varying one physiologic variable at a time, it was shown that mitral velocity acceleration is affected directly by atrial pressure and inversely by the ventricular relaxation time constant, with relatively little impact of chamber compliance. Deceleration rate was directly influenced by mitral valve area, atrial pressure and ventricular systolic dysfunction and inversely affected by atrial and ventricular compliance relations, with little impact of relaxation unless it was so delayed as to be incomplete during deceleration. Peak velocity was directly affected most strongly by initial left atrial pressure, and lowered somewhat by prolonged relaxation, low atrial and ventricular compliance and systolic dysfunction. Strikingly different filling patterns emerged when the primary physiologic alterations were accompanied by simultaneous compensatory changes in atrial pressure designed to maintain stroke volume constant. Low ventricular compliance with preload compensation produced characteristic E waves with very short acceleration and deceleration times and high peak velocity. Thus, mathematic analysis of ventricular filling helps to explain the physical and physiologic basis for the transmitral velocity curve.

Blood Flow Velocity↗
PubMed1996

Effect of the insect growth regulators, N-tert-butyl-N, N'-dibenzoylhydrazines, on neural activity of the American cockroach.

N-tert-Butyl-N,N'-dibenzoylhydrazines, agonists of 20-hydroxyecdysone, decelerated the rising and falling phases of an action potential, which had been electrically induced in the cockroach giant axon, at moderately high concentrations. 4-Aminopyridine, a blocker of potassium channels of nerve, selectively decelerated the falling phase of the action potential. This class of compounds caused convulsions in American cockroaches when injected. The convulsive activity seemed to be positively related to the activity to decelerate the falling phase of the action potential.

4-Aminopyridine↗
PubMedDate not supplied

Cerebral dysfunction following infantile dietary chloride deficiency.

Twenty-two children who were chloride-depleted in infancy due to a chloride-deficient diet and who had resultant hypochloremic alkalosis were analyzed in regard to their signs and symptoms, metabolic studies, and growth parameters. Deceleration of weight, linear growth, and head growth occurred in most, and persistent growth failure occurred in some. The majority had cognitive deficits at follow-up. Comparison with growth parameters in a chronically malnourished group of children who had a variety of disorders revealed a similar degree of deceleration of weight (p = 0.50) and height (p = 0.70), but more severe deceleration of head growth (p = 0.01). Comparison with follow-up cognitive deficits reported in the United States medical literature in children with similar severity of nutritional deprivation indicates that the chloride-depleted infants had more frequent and more severe cognitive deficits (p = 0.09). Cognitive deficits have been documented in U. S. children who are nutritionally deprived only when disorders causing concomitant chloride depletion are responsible for the malnutrition.

Alkalosis↗
PubMed2005

The development of an automatic method of safety monitoring at Pelican crossings.

This paper reports on the development of a method for automatic monitoring of safety at Pelican crossings. Historically, safety monitoring has typically been carried out using accident data, though given the rarity of such events it is difficult to quickly detect change in accident risk at a particular site. An alternative indicator sometimes used is traffic conflicts, though this data can be time consuming and expensive to collect. The method developed in this paper uses vehicle speeds and decelerations collected using standard in situ loops and tubes, to determine conflicts using vehicle decelerations and to assess the possibility of automatic safety monitoring at Pelican crossings. Information on signal settings, driver crossing behaviour, pedestrian crossing behaviour and delays, and pedestrian-vehicle conflicts was collected synchronously through a combination of direct observation, video analysis, and analysis of output from tube and loop detectors. Models were developed to predict safety, i.e. pedestrian-vehicle conflicts using vehicle speeds and decelerations.

Accidents, Traffic↗
PubMed2004

Hyperbaric oxygen treatment does not affect left ventricular chamber stiffness after myocardial infarction treated with thrombolysis.

BACKGROUND: It has been shown that transient increase in left ventricular stiffness, assessed by Doppler-derived early filling deceleration time, occurs during the first 24 to 48 hours after myocardial infarction but returns to normal within several days. It has been reported that hyperbaric oxygen treatment has a favorable effect on left ventricular systolic function in patients with acute myocardial infarction treated with thrombolysis. However, there are no data on the effects of hyperbaric oxygen on diastolic function after myocardial infarction. METHODS: To assess acute and short-term effects of hyperbaric oxygen on left ventricular chamber stiffness, we studied 74 consecutive patients with first acute myocardial infarction who were randomly assigned to treatment with hyperbaric oxygen combined with streptokinase or streptokinase alone. After thrombolysis, patients in the hyperbaric oxygen group received 100% oxygen at 2 atm for 60 minutes in a hyperbaric chamber. All patients underwent 2-dimensional and Doppler echocardiography 1 (after thrombolysis), 2, 3, 7, 21, and 42 days after myocardial infarction. RESULTS: Patient characteristics, including age, sex, risk factors, adjunctive postinfarction therapy, infarct location, and baseline left ventricular volumes and ejection fraction, were similar between groups (P >.05 for all). For both groups, deceleration time decreased nonsignificantly from day 1 to day 3 and increased on day 7 (P <.001, for both groups), increasing nonsignificantly subsequently. The E/A ratio increased in the entire study group throughout the time of study (P <.001, for both groups). The pattern of changes of deceleration time was similar in both groups (P >.05 by analysis of variance), as was in subgroups determined by early reperfusion success. CONCLUSIONS: These data in a small clinical trial do not support a benefit of hyperbaric oxygen on left ventricular diastolic filling in patients with acute myocardial infarction treated with thrombolysis.

Aged↗
PubMed2005

Comparison of usefulness of left ventricular diastolic versus systolic function as a predictor of outcome following primary percutaneous coronary angioplasty for acute myocardial infarction.

Left ventricular (LV) diastolic function is an important predictor of morbidity and mortality after acute myocardial infarction (AMI). We evaluated the role of diastolic function in predicting in-hospital events and LV ejection fraction (EF) 6 months after a first AMI that was treated with primary percutaneous coronary intervention (PCI). We prospectively enrolled 59 consecutive patients who were 60 +/- 15 years of age (48 men), presented at our institution with their first AMI, and were treated with primary PCI. Patients underwent 2-dimensional and Doppler echocardiography, including tissue Doppler imaging of 6 basal mitral annular regions within 24 hours after primary PCI and were followed until discharge. Clinical and echocardiographic variables at index AMI were compared with a combined end point of cardiac death, ventricular tachycardia, congestive heart failure, or emergency in-hospital surgical revascularization. Follow-up echocardiographic assessment was performed at 6 months in 24 patients. During hospitalization, 3 patients died, 7 developed congestive heart failure, 4 had ventricular tachycardia, and 1 required emergency surgical revascularization. Stepwise logistic regression analysis showed the ratio of early mitral inflow diastolic filling wave (E) to peak early diastolic velocity of non-infarct-related mitral annulus (p < 0.01) (E') and mitral inflow E-wave deceleration time (p < 0.02) to be independent predictors of in-hospital cardiac events (generalized R2 = 0.66). In a stepwise multiple linear regression model, independent predictors of follow-up LVEF were mitral inflow deceleration time (R2 = 0.39, p = 0.002), baseline LVEF (R2 = 0.54, p < 0.02), and mitral inflow peak early velocity/mitral annular peak early velocity (or E/E') of infarct annulus (R2 = 0.66, p = 0.02). In conclusion, in patients who are treated with primary PCI for a first AMI, E/E' velocity ratio and mitral inflow E-wave deceleration time are strong predictors of in-hospital cardiac events and of LVEF at 6-month follow-up.

Aged↗
PubMed2005

The influence of gender on knee kinematics, kinetics and muscle activation patterns during side-step cutting.

BACKGROUND: It has been suggested that gender differences in the performance of athletic maneuvers is a contributory factor with respect to the disproportionate incidence of non-contact anterior cruciate ligament injury in female athletes. The purpose of this study was to evaluate gender differences in knee joint kinematics, kinetics and muscle activation during a side-step cutting. METHODS: Three-dimensional kinematics, ground reaction forces (2400 Hz) and electromyographic activity (surface electrodes) were recorded during the early deceleration phase of side-step cutting in 30 healthy collegiate soccer players (15 male, 15 female). Gender differences in knee joint kinematics, peak moments, net joint moment impulse and average muscle EMG intensity were evaluated with one-tailed t-tests. FINDINGS: No differences in kinematics were found. However, when compared to males, females demonstrated a smaller peak knee flexor moment (1.4 (0.8) vs. 2.1 (0.8) Nm/kg, P = 0.05) and a greater knee adductor moment (0.43 (0.5) vs. 0.01 (0.3) Nm/kg, P < 0.01) during early deceleration. In addition, females displayed greater average quadriceps EMG intensity than males (191% vs. 151% maximum voluntary isometric contraction, P = 0.02). INTERPRETATION: In general, females experienced increased frontal plane moments and decreased sagittal plane moments during early deceleration. These differences are suggestive of an "at risk" pattern in that frontal plane support of the knee is afforded primarily by passive structures (including the anterior cruciate ligament). Furthermore, increased quadriceps activity and smaller net flexor moments may suggest less sagittal plane protection (i.e., increased tendency towards anterior tibial translation).

Biomechanical Phenomena↗
PubMed2004

Impaired left ventricular diastolic function in newborn infants of mothers with pregestational or gestational diabetes with good glycemic control.

THE AIM OF THE STUDY: We assessed by echocardiography the left ventricular systolic and diastolic function in newborn infants of mothers with well-controlled pregestational type 1 or gestational diabetes (IDM) in comparison to normal term neonates. SUBJECTS AND METHODS: Two-dimensional/M-mode and Doppler transmitral flow velocity measurements were performed in 18 IDM and 26 control infants of non-diabetic mothers (gestational ages 36-40 and 36-41 weeks, respectively) between days 2 and 5 after birth. In the IDM, there were nine mothers with pregestational (White class C or D) and nine mothers with gestational diabetes (White class A or A/B). Peak early and atrial filling velocity, early deceleration time, early acceleration time, early, atrial and total time velocity integrals were used to examine the left ventricular diastolic performance. We also calculated the early/atrial velocity ratio, early/atrial integral ratio and early/total integral ratio. The fractional shortening, fractional shortening area, midwall fractional shortening (mFS), left ventricular mass and indexed left ventricular mass for body surface area (BSA) and birth weight were used in assessment of left ventricular systolic performance. RESULTS: The early deceleration time was longer, resulting in higher early integral and early filling fraction (EFF) in the IDM than in the control infants (p<0.01). In the IDM, the fractional shortening was somewhat greater and the left ventricular mass/body surface area ratio was higher than in the control group (p<0.05), although the measures of systolic performance were within the normal range. There were no significant differences in the systolic or diastolic function parameters between the gestational and pregestational groups. CONCLUSION: In the infants of mothers with well-controlled pregestational or gestational diabetes, we found prolonged deceleration time of early left ventricular diastolic filling, probably reflecting an impaired left ventricular relaxation rather than compliance. The mechanism for the findings may be maternal hyperglycemia during the third trimester and subsequent fetal hyperinsulinaemia leading to neonatal cardiac hypertrophy.

Adult↗
PubMed2004

Genesis of the restrictive filling pattern: pericardial constraint or myocardial restraint.

BACKGROUND: Restrictive filling pattern has been predictive of heart failure in patients with cardiomyopathy and after myocardial infarction, and is similar to the filling pattern in constrictive pericarditis and amyloid heart disease. The purpose of this study was to determine the role of both myocardial restraint and pericardial constraint in a chronic left ventricular dysfunction model with restrictive filling. METHODS: After instrumentation, a flat balloon containing a high-fidelity pressure catheter was inserted through a pericardial incision in 12 dogs with chronic left ventricular dysfunction. Intracardiac volume (ICV) was manipulated by inferior venal caval balloon occlusion and volume loading while hemodynamics, echo-assessed chamber size, and transmitral Doppler were obtained at the same atrial paced rate with an intact pericardium and after pericardiectomy. RESULTS: With an intact pericardium, deceleration time increased with reduced ICV (130 +/- 35 vs 153 +/- 47 milliseconds, P <.05) and shortened with increased ICV (107 +/- 45 milliseconds, P <.05). The filling fraction at one-third of diastole decreased with reduced ICV (45.6 +/- 29.3 vs 24.2 +/- 15.8%, P <.01) and increased with increased ICV (60.1 +/- 14.8%, P <.05). Deceleration time could be predicted from intrapericardial pressure, the transmural left ventricular chamber stiffness constant, and filling fraction at one-third of diastole. After pericardiectomy, deceleration time also shortened with increased ICV (141 +/- 26 vs 112 +/- 38 milliseconds, P <.01). However, filling fraction at one-third of diastole was markedly reduced at paced baseline (19.9 +/- 14.4%, P <.01) and with increased ICV (15.5 +/- 11.8%, P <.001) as compared with an intact pericardium. CONCLUSIONS: Pericardial constraint and myocardial restraint play a role in restrictive filling pattern. Pericardial constraint becomes evident with redistribution of diastolic filling to later in diastole after pericardiectomy.

Animals↗
PubMed2005

Transthoracic Doppler echocardiographic assessment of coronary flow velocity pattern in patient with acute myocardial infarction implies progression of myocardial damage.

BACKGROUND: Coronary flow velocity (CFV) pattern with a rapid deceleration time of diastolic flow velocity and small average systolic peak velocity immediately after reperfusion implies poor wall-motion recovery in patients with acute myocardial infarction. Microvascular injury has been demonstrated to progress after coronary reperfusion. The purpose of this study was to assess whether CFV 1 day after reperfusion (day 1) may reflect accurately the degree of myocardial damage. METHODS: In the left anterior descending coronary artery in 29 patients with anterior acute myocardial infarction, CFV was measured immediately and 1 day after recanalization using transthoracic Doppler echocardiography, respectively. Regional wall motion was estimated as anterior wall-motion score index (AWMSI) by echocardiography before recanalization and 1 month after the onset of acute myocardial infarction. RESULTS: Although significant correlation was observed among deceleration time of diastolic flow velocity, average systolic peak velocity, and average peak velocity immediately after reperfusion and 1-month AWMSI (r = -0.62, P < .001; r = -0.61, P < .001; and r = -0.55, P < .01, respectively), much better correlation was demonstrated between those at day 1 and 1-month AWMSI (r = -0.72, P < .0001; r = -0.68, P < .0001; and r = -0.60, P < .001, respectively). Deceleration time of diastolic flow velocity, average systolic peak velocity, and average peak velocity in poor wall-motion recovery group (1-month AWMSI > 2.0, n = 14) were significantly smaller (P < .01, P < .05, and P < .05, respectively) at day 1 compared with those immediately after reperfusion. CONCLUSIONS: CFV pattern assessed by transthoracic Doppler echocardiography at day 1 provides the degree of myocardial damage much more accurately than that immediately after reperfusion. These results may suggest that myocardial damage progresses after reperfusion.

Blood Flow Velocity↗
PubMed2005

Plasma triglyceride level is an independent predictor of altered left ventricular relaxation.

BACKGROUND: Diastolic dysfunction, manifested by impaired left ventricular (LV) relaxation, is prevalent among individuals with metabolic disorders. The objective of this study was to evaluate the extent to which plasma triglyceride (TG) levels are related to LV diastolic function. METHODS: A total of 424 subjects (age 49 +/- 12 years) had fasting plasma TG levels measured and underwent echocardiography for assessment of LV structure and function: LV ejection fraction and LV mass indexed to height (LVM/Ht(2.7)); transmitral inflow early diastolic peak velocity (E wave) and late diastolic peak velocity (A wave), and E wave to A wave ratio (E/A); deceleration time; and Doppler tissue imaging early diastolic myocardial velocity (EM), an index of LV relaxation. RESULTS: All subjects had normal LV ejection fraction, 48% had hypertension, 16% had increased LVM/Ht(2.7), 11% had type 2 diabetes mellitus, 37% were obese, and 27% had hypertriglyceridemia (TG > 150 mg/dL). Univariate analysis showed significant relationships between TG level and E/A, deceleration time, and Em (P < or = .001 for all). After adjustment for potential confounders in multivariate models (eg, age, systolic blood pressure, and LVM/Ht(2.7)), TG levels remained predictive of E/A, deceleration time, and Em (P < or = .05, <.001, and < or =.0001, respectively). Stepwise multivariate analysis showed that after age and body mass index, the TG level was the next most predictive variable of Em. CONCLUSIONS: Plasma TG levels show a strong relationship with impaired LV relaxation, an early marker of diastolic dysfunction in human beings. These findings support a hypothesis whereby elevated TG levels favor myocyte intracellular lipid accumulation, possibly leading to lipotoxic diastolic dysfunction.

Female↗
PubMed2006

Diastolic dysfunction and autonomic abnormalities in patients with systolic heart failure.

BACKGROUND: Patients with systolic heart failure (SHF) often have concomitant diastolic dysfunction (DD). SHF is associated with decreased heart rate variability (HRV), but the impact of degree of DD on HRV in SHF is unclear. METHODS AND RESULTS: HRV was measured in 139 patients, aged 64+/-12 years, 74% male, LVEF 30+/-8%. Patients had stable NYHA class II-III CHF on ACE inhibitors or ATII receptor blockers, with LVEF or=200 pg/ml. Subjects underwent 2-D echocardiography with Doppler assessment and 24-h Holters. Patients were categorized as having impaired relaxation (E-deceleration time>2 SD above age-adjusted normal values (AANV), E/A or=1; N=30), pseudonormal (E-deceleration time within 2 SD of AANV, E/A=1-2, systolic/diastolic pulmonary vein flow<1; N=25) or restrictive filling patterns (E-deceleration time>2 SD below AANV or/and E/A ratio>or=2; N=84) Differences were adjusted for clinical covariates using UNIANOVA, p<0.05. HRV was reduced and BNP higher in pseudonormal patients compared to impaired relaxation, but this difference was only significant for restrictive vs. impaired filling. Differences remained significant after adjustment for covariates. CONCLUSION: Significantly more abnormal HRV, reflecting greater cardiac autonomic dysfunction, is associated with restrictive DD compared to impaired relaxation.

Adult↗
PubMed2004

Long-term cocaine use is related to cardiac diastolic dysfunction in an African-American population in Baltimore, Maryland.

BACKGROUND: Only limited studies have been done on the effects of long-term cocaine use on the human heart, and the results remain controversial. In this study, we examined and compared the diastolic function of non-cocaine users and chronic cocaine users to reveal the impact of long-term cocaine use on the human heart. METHODS: Two-dimensional echocardiogram and pulsed Doppler transmitral blood flow pattern were obtained from 138 recruited study participants with different cocaine histories. The indices of cardiac structure and function were measured from the echocardiogram of each participant. Student's t-test was used to compare the average echocardiographic measurements of the non-cocaine user group and the cocaine user group. Multivariate regression analysis was deployed to eliminate the effects of age, gender, blood pressure, and HIV infection on the functional measurements of the two groups. RESULTS: The cocaine user group had a significantly longer average deceleration time than did the non-cocaine user group (208.1 +/- 38.2 vs. 167.5 +/- 39.1 ms, P<0.001). A linear association existed between the deceleration time and the log-transformed duration of cocaine use (beta=0.00351, S.E.=0.00104, P=0.001). Cocaine users in this study were approximately five times more likely to have an elongated deceleration time (>200 ms) than were non-users (OR, 4.799; 95% CI, 1.000-23.044; P=0.05). No significant differences were observed in the other measured diastolic functional parameters, such as isovolumic ventricular relaxation time, E wave, A wave, and E/A ratio. CONCLUSIONS: Long-term cocaine use is linked to decline in diastolic function.

Adult↗