Patients with dilated cardiomyopathy had significantly reduced peak rates of left ventricular filling compared to controls (10.2 ± 3.5 vs. 17.4 ± 4.6 cm/s, p < 0.05).
Observational (n=52)
Are echocardiographic indices of early diastolic filling altered in patients with dilated cardiomyopathy compared to controls?
In dilated cardiomyopathy, peak rates of early diastolic filling are depressed and correlate with the degree of systolic dysfunction, although the percentage of filling in early diastole remains similar to normals.
Absolute Event Rate: 10.2% vs 17.4%
p-value: p=< 0.05
Indices of early diastolic filling of the left ventricle were evaluated in 52 patients with dilated cardiomyopathy using digitized M-mode echocardiography. Peak rates of left ventricular diastolic dimension change and posterior wall thinning were evaluated. The timing of these peak rates of change as well as the rapid filling period were also measured. Compared to controls there were significant (p < 0.05) reductions in peak rates of left ventricular filling (10.2 ± 3.5 vs. 17.4 ± 4.6 cm/s) and posterior wall thinning (6.6 ± 2.4 vs. 11.9 ± 4.0 cm/s). The timing of the peak rates of change were not significantly different from controls. The rapid filling period significantly shortened from 201 ± 37 ms in controls to 174 ± 58 ms in dilated cardiomyopathy (p < 0.05). After correction for variation due to isovolumic relaxation (rapid filling period - isovolumic relaxation period) the rapid filling period remained significantly shortened (118 ± 59 vs. 148 ± 36 ms, p < 0.05). However, the percentage dimension change during rapid filling was not significantly different from controls (68 ± 20% for patients vs. 72 ± 13% for controls). Peak rates of dimension change and posterior wall thinning were correlated with ventricular dimensions, ejection phase measurements of systolic function and hemodynamics. Peak rates of dimension change correlated best with ∆D (change in ventricular dimension), percent fractional shortening and mean velocity of circumferential fiber shortening. There was no significant correlation with any hemodynamic measurements. The effect of a left-sided conduction delay and right ventricular enlargement on ventricular filling was also determined. Right ventricular size had no effect on any index of ventricular filling. A left-sided conduction delay caused a significant prolongation of the rapid filling period (190 ± 15 vs. 159 ± 7 ms, p < 0.05) and a decrease in percent dimension change during rapid filling (63 ± 5 vs. 74 ± 3, p < 0.05) but no other changes. Peak rates of ventricular filling are depressed and the rapid filling period shortened in dilated cardiomyopathy. However, timing of peak rates of change and the percentage of filling in early diastole are no different than normals. These changes in early diastolic filling correlate best with the degree of decrease in systolic function.
Rahko et al. (2017) conducted an observational in Dilated cardiomyopathy (n=52). Dilated cardiomyopathy vs. Controls was evaluated on Peak rates of left ventricular filling (p=< 0.05). Patients with dilated cardiomyopathy had significantly reduced peak rates of left ventricular filling compared to controls (10.2 ± 3.5 vs. 17.4 ± 4.6 cm/s, p < 0.05).