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Characteristic Features on Morphologic and Topographic Findings of Pulmonary Vein Orifices in Transition From Diastolic Dysfunction to Heart Failure: A Computerized Tomography Study.
J Card Fail ; 22(4): 316-20, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26724573


Diastolic dysfunction (DD), a precursor to clinical heart failure (HF), has traditionally been evaluated by means of echocardiography. Data regarding morphologic descriptions of pulmonary vein (PV) orifices in transition from DD to HF have been lacking.


We retrospectively studied 124 subjects with computerized tomography (CT)-derived PV parameters and echocardiography-derived diastolic indices. We categorized our subjects as 1) non-DD, 2) DD, or 3) heart failure with preserved ejection fraction (HFpEF) and observed a graded enlargement for 4 PV orifice areas across these groups. Positive linear relationship between the 4 PV orifice areas, echocardiography-derived mean pulmonary capillary wedge pressure (PCWP), and velocity of propagation (VP) were observed. Finally, maximum areas of left superior pulmonary vein (LSPV) and left inferior pulmonary vein (LIPV) significantly increased clinical diagnosis of HFpEF (likelihood-ratio χ(2): from 42.92 to 50.75 and 54.67 for LSPV and LIPV, respectively) when superimposed on left ventricular mass index, PCWP, and left atrial volume.


PV size measurements with the use of CT are feasible and further aid in diseases discrimination between preclinical DD and those progressed into HF, even with preserved global pumping. Our data suggest that CT-based PV measures may help to identify subjects at risk for HF.





Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Veias Pulmonares / Tomografia Computadorizada por Raios X / Disfunção Ventricular Esquerda / Progressão da Doença / Insuficiência Cardíaca Tipo de estudo: Estudo de coorte Aspecto clínico: Etiologia Limite: Adulto / Idoso / Feminino / Humanos / Masculino / Meia-Idade Idioma: Inglês Revista: J Card Fail Assunto da revista: Cardiologia Ano de publicação: 2016 Tipo de documento: Artigo País de afiliação: Taiwan