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Abstract

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Authors: R. Treudler, S. Zeynalova, F. Walther, C. Engel, J. C. Simon

Date Published: 2nd Aug 2017

Publication Type: Journal article

Human Diseases: atopic dermatitis

Abstract (Expand)

In the NORRE study (EHJCVI (2014) 15, 680 – 690) normal values determined by echocardiography were published in healthy subjects (n = 734) with mean age of 46+13 years (range: 20 – 78). Left ventricular (LV)-volumes showed good correlations to the participants' (pts') age. LV-volumes were decreased and LV ejection fraction (EF) was increased according to the increase of the pts' age. A significant correlation between age and LV-mass was only found in women. Left atrial (LA)-volumes did not significantly change with age. Parameters of diastolic function showed a strong age-dependency (decrease of E/A-ratio; increase of E/E'-ratio). In the present LIFE-Adult analysis echocardiographic parameters were compared to the NORRE data. In 773 pts (326 males and 447 females; median age: 51 years), standardised transthoracic echocardiography was performed according to the national and international recommendations. The following parameters were analysed: LV- and LA-volume analyses by M-Mode measurements and 2D-LV planimetry, maximum E-and A-velocity, E/A-ratio and E/E'-ratio. The cohort was divided in age related subcohorts between 20 – 40, 41 – 50 and 51 – 60 years. Mean LV-diameter was 54 ± 5 mm (males) and 49 ± 4 mm (females). There was no age-dependency in males, but a tendency of LV-diameter increase in females. Mean LA diameter was 39 ± 4 mm in males and 35 ± 4 mm in females. Mean LA-diameter-index was 20 ± 2 mm/m2 (males) and 20 ± 3 mm/m2 (females) showing Age-dependency of an increasing LA-diameter in males and females. LV mass-index was 100 ± 20 g/m2 (males) and 83 ± 19 g/m2 (females) showing a tendency of increasing LV mass-index with age in males and females. Subsequently, septal and posterior wall thickness slightly increases with age. No differences of LVEF with increase of the pts' age could be observed. E/A-ratio was decreased and E/E'-ratio was increased with increase of the pts' age. The analysis of the echocardiographic parameters of the LIFE-Adult trial showed differences of the age-dependency in comparison to the NORRE data.

Authors: S. Stöbe, A. Hagendorff, S. Zeynalova, S. Tautenhahn, K. Wirkner, G. Farese, D. Jurisch, D. Pfeiffer, M. Loeffler

Date Published: 18th Aug 2016

Publication Type: Journal article

Abstract (Expand)

The E/E'-ratio is used as a surrogate parameter for the estimation of the left ventricular enddiastolic pressure. It is assumed that chronic systolic and diastolic heart failure is associated with E/E'-values of more than 15 or at least with intermediate values between 9 – 5. The aim of the present retrospective analysis of the epidemiological echocardiographic cohort of the LIFE-Adult study (Leipzig Research Centre for Civilization Diseases) was to evaluate the correlation of NT-BNP (N-terminales propeptid BNP) values to the E/E'-ratio by the assessment of left ventricular diastolic function in this cohort. In 773 participants (pts) standardised transthoracic echocardiography was performed and in 748 pts NT-BNP was analysed. The E/E'-ratio was determined according to the international recommendations by measuring the maximum velocity of the early diastolic inflow by pulsed wave Doppler echocardiography and the basal septal maximum myocardial velocity by tissue Doppler echocardiography at early diastole. NT-BNP was determined using commercially available diagnostic tests. Pathological NT-BNP levels were assumed in the range > 222pg/ml. Normal E/E'-ratios as well as normal NT-BNP levels were observed in 91% of all participants. In 1.4% of the pts elevated NT-BNP levels were found in the presence of normal E/E'-ratio. In contrast in 1.1% of the pts elevated E/E'-ratios were found in the presence of normal NT-BNP levels. Most of the pts with heart failure detected by NT-BNP vales > 222pg/ml also showed intermediate E/E'-ratios between 9 and 15 (42pts). In only 0.8% of the pts (5 pts) significantly elevated E/E'-ratios > 15 and pathological NT-BNP levels could be observed (see fig). Only 4 pts with elevated NT-BNP values showed left ventricular systolic dysfunction. E/E'-ratio has to be verified to be suitable for the detection of heart failure patients. The present data show that E/E'-ratio of > 15 is not well correlated to increased NT-BNP levels.

Authors: S. Stöbe, A. Hagendorff, S. Zeynalova, S. Tautenhahn, S. Wirkner, F. Gerardo, D. Jurisch, D. Pfeiffer, M. Loeffler

Date Published: 18th Aug 2016

Publication Type: Journal article

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