Diastolic myocardial dysfunction and its relationship with systolic myocardial dysfunction in primary endocardial fibroelastosis

Objective To investigate diastolic myocardial dysfunction and its relationship with systolic myocardial dysfunction in endocardial fibroelastosis(EFE).Methods Cardiac structure,left ventriclar diastolic and systolic function in 44 children with endocardial fibroelastosis and 50 normal subjects were analyzed by echocardiography.Left ventricular end-diastolic dimension(LVEDD),left atrial dimension(LAD),left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),E peak velocity(VE),A peak velocity(VA),isovolumic relaxing time(IVRT) were assessed.Results According to the result of the echocardiography,7 children only had diastolic dysfunction,37 children had both diastolic and systolic dysfunction.Systolic dysfunction was diagnosed according to IVRT.Systolic dysfunction group whose IVRT≥65()ms including 17 children and IVRT 65()ms group including 27 children.In the comparison of the two groups,the former had a higher LVEF,lower LAD,down regulated VE,up regulated VA and E/A ratio.IVRT had significant positive correlation with LVEDD when LVEF was controlled(P0.05),no significant difference was observed between LVEF and E/A or E(P0.05).If IVRT =70()ms was set up as a separation point,the group with a IVRT ≥70()ms had a higher LVEDD than that with a IVRT 70()ms(P0.05),but no significant difference was found in LVEF.Conclusion Diastolic myocardial dysfunction systolic exists in endocardial fibroelastosis.IVRT has a significantly positive correlation with LVEDD,systolic dysfunction reduced dramatically with diastolic heart failure severity.