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XXV Congresso Nazionale ANCE Taormina 8-11 Maggio 2015. “ Scompenso Cardiaco a FE conservata ”. non solo disfunzione diastolica. S. Carerj, MD, FESC Cardiologia, Università di Messina. Guidelines ESC 2012. Solo disfunzione diastolica?. Cut-off Sm 4.4 cm/sec. Cut-off EF 50 %.
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XXV Congresso Nazionale ANCE Taormina 8-11 Maggio 2015 “Scompenso Cardiaco a FE conservata” non solo disfunzione diastolica S. Carerj, MD, FESC Cardiologia, Università di Messina
Cut-off Sm 4.4 cm/sec Cut-off EF 50 % Approximately one half of patients with DHF and another one seventh with DD had subnormal mean SM. Yu CM, Circulation 2002
60% of Stroke Volume is related to AVPD, the remaining 40% is determined by radial function Carlsson M Am J Physiol Heart Circ Physiol 2007
Pathophysiology of Heart Failure With a Normal Ejection Fraction Ting Tan Y, JACC 2009
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Pathophysiology of Heart Failure With a Normal Ejection Fraction Ting Tan Y, JACC 2009
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The performance of the cardiovascular system depends on the interaction of its components. The left ventricle pumps is stroke volume into the arterial system, which then delivers the flow to the tissues. Thus, optimal cardiovascular function requires appropriate coupling of the left ventricle and arterial system. J Am Soc Echocardiogr. 2009; 22: 1246-8
Physiologic Properties of The Aorta Cavalcante JL, JACC 2011
Insulting Leading To Structural Changes in The Aorta and Its Functioning Cavalcante JL, JACC 2011
Arterial-Ventricular Coupling: Role of the Stiffness Vlacahopoulos C, Cardiology 2010
Relationship between stiffness and diastolic parameters Zito C, JCM 2014
Diastolic Velocity Time Integral Coronary Index Cusmà Piccione M., JCM 2014
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“MOLECULAR Imaging” • Longitudinal strain and torsion assessed by two-dimensional speckle tracking correlate with the serum level of tissue inhibitor of matrix metalloproteinase-1, a marker of myocardial fibrosis, in patients with hypertension • Kang SJ. J Am Soc Echocardiogr 2008;21:907-911. Twist Longitudinal strain
Pathophysiology of HF with Preserved Ejection Fraction Borlaug BA, Eur Heart J 2011
Strain Longitudinale e Circonferenziale in pazienti con HFpEF Kraigher-Krainer L, JACC 2014
Strain Longitudinale e NT-proBNP Kraigher-Kraimer E, JACC 2014
Myocardial Deformation Echocardiography 2010
Pathophysiology of Heart Failure With a Normal Ejection Fraction Ting Tan Y, JACC 2009
Effect of Exercise in LV Paramters in Patients with HF with Preserved EF Borlaug BA, Eur Heart J 2011
In HFpEFpatients, moderate exerciseleadsto a steepincrease in proximalafterloadthatisunderstimated at rest and isassociatedwithunfavorableventricular-arterialcoupling and exreciseintolerance.
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Volumi Atriali Sin. e Frazione di Svuotamento Atriale nella HFPEF Melenovsky V, JACC 2007
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Algoritmo Diagnostico della HFpEF Todaro MC, JCM 2014