| Objective To assess the changes of left ventricular systolic long axis function and their relations to left ventricular diastolic function as well as global left ventricular systolic function in patients with isolated left ventricular diastolic heart failure. Methods Thirty five patients with isolated diastolic dysfunction (DD), 32 patients with left ventricular diastolic heart failure (DHF), 30 patients with left ventricular systolic heart failure (SHF), and 34 healthy volunteers were enrolled. Using tissue Doppler imaging, the peak systolic (SM), early diastolic (EM) and late diastolic (AM) velocities, as well as the systolic (Ds), early diastolic (DE) and late diastolic (DA) amplitude of mitral annulus motion along the left ventricular long axis were measured in septal, lateral, anterior and inferior sides of the mitral annulus in the apical 4-chamber and 2-chamber views. The time interval from the Q wave in ECG to onset of long axis shortening (Q-SM) was also measured. Left ventricular ejection fraction (LVEF) was obtained by the biplane Simpson's method. Results There were significant differences in SM, DS and Q-SM between control, DD, DHF and SHF groups. SM was (7.32 0.65)cm/s, (6.11 0.96)cm/s, (5.09 0.93)cm/s and (3.58 0.72)cm/s, respectively (F=120.5, P<0.001). Ds was(1.36 0.17)cm, (1.21 0.16)cm, (1.09 0.23)cm and (0.72 0.18)cm, respectively (F=119.9, P<0.001). Q-SM was (91 10)ms, (108 9)ms, (116 10)ms and (123 8)ms, respectively(F=36.7, P<0.001). A SM of 6.0cm/s, i.e. the lower limit of the 95% normal range, predicted presence of systolic dysfunction in patients with DD, DHF and SHF was 45.8%, 92.5% and 100%, repectively. with the development of left ventricular diastolic function from normal to relaxation , pseudonormal filling pattern and restrictive filling pattern, SM> Ds were decreased gradually, they were(7.32 0.65)cm/s, (5.34 0.98)cm/s,(4.64 0.76)cm/s,(2.29 0.68)cm/s(F=116.2, P<0.001); (1.36 0.17)cm, (1.09?.13)cm, (0.83 0.18)cm,(0.48 0.15)cm (F=137.6, P<0.001) respectively. Q-SM was(91 10)ms, (106 11)ms, (113 10)ms, (120 9)ms (F=41.5, P<0.001) respectively, increased gradually. Spearman rank correlation analysis showed the correlation between the change of SM and the degrees of left ventricular diastolic dysfunction was excellent(r=-0.82, P<0.001), so and Ds(r=-0.77, P<0.001), Q-SM(r=0.59, P<0.001). There was a positive correlation between SM and EM (r=0.71, P<0.001), as well as DS andDE(r=0.77, P<0.001). There was a logarithmic curvilinear relationship between SM and LVEF (LVEF= -3.8+35.6 In SM, r=0.83, P<0.001), as well as Ds and LVEF (LVEF= 57.0+29.0 In Ds, r=0.86, P<0.001).Conclusions The left ventricular systolic long axis dysfunction existed in most patients with DHF. The so-called isolated DHF is less common. It is probably only one stage in the pathophysiological process of heart failure. The systolic long axis function was decreased gradually with the development of diastolic dysfunction. The long axis systolic function can assess the left ventricular function. Thus, left ventricular systolic long axis function measured by tissue Doppler imaging is of important value in assessing the left ventricular function in patients with heart failure.
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