1. non solo disfunzione diastolica S. Carerj, MD, FESC Cardiologia, Università di Messina XXV Congresso Nazionale ANCE Taormina 8-11 Maggio 2015 “Scompenso Cardiaco a FE conservata”

3. Guidelines ESC 2012

5. Solo disfunzione diastolica?

6. 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

7. Carlsson M Am J Physiol Heart Circ Physiol 2007 60% of Stroke Volume is related to AVPD, the remaining 40% is determined by radial function

9. Pathophysiology of Heart Failure With a Normal Ejection Fraction Ting Tan Y, JACC 2009

10. Nagueh SF, Eur J of Echoc- 2009.

11. Assessment of Filling Pressure Tissue Doppler Ratio Ommen SR, Circulation 102: 1788, 2000

12. Pathophysiology of Heart Failure With a Normal Ejection Fraction Ting Tan Y, JACC 2009

13. Arterial-Ventricular Coupling: Role of the Stiffness Vlacahopoulos C, Cardiology 2010

14. J Am Soc Echocardiogr. 2009; 22: 1246-8 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.

15. Physiologic Properties of The Aorta Cavalcante JL, JACC 2011

16. Insulting Leading To Structural Changes in The Aorta and Its Functioning Cavalcante JL, JACC 2011

17. Arterial-Ventricular Coupling: Role of the Stiffness Vlacahopoulos C, Cardiology 2010

19. Relationship between stiffness and diastolic parameters Zito C, JCM 2014

20. JCM 2014

21. Diastolic Velocity Time Integral Coronary Index Cusmà Piccione M., JCM 2014

22. Correlazione fra stiffness carotidea e riempimento coronarico DVTICI Cusmà Piccione M, JCM 2014

23. Pathophysiology of Heart Failure With a Normal Ejection Fraction Ting Tan Y, JACC 2009

24. Sengupta JASE 2007 ANATOMY OF A VORTEX

25. 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. Longitudinal strain Twist “MOLECULAR Imaging”

26. Borlaug BA, Eur Heart J 2011 Pathophysiology of HF with Preserved Ejection Fraction

28. Strain Longitudinale e Circonferenziale in pazienti con HFpEF Kraigher-Krainer L, JACC 2014

29. Strain Longitudinale e NT-proBNP Kraigher-Kraimer E, JACC 2014

31. Myocardial Deformation Echocardiography 2010

32. Pathophysiology of Heart Failure With a Normal Ejection Fraction Ting Tan Y, JACC 2009

34. Effect of Exercise in LV Paramters in Patients with HF with Preserved EF Borlaug BA, Eur Heart J 2011

35. In HFpEF patients, moderate exercise leads to a steep increase in proximal afterload that is understimated at rest and is associated with unfavorable ventricular-arterial coupling and exrecise intolerance.

36. Tartiere Kestri L, JACC 2012 Exercise Test in Patients with HF and Preserved EF

38. Volumi Atriali Sin. e Frazione di Svuotamento Atriale nella HFPEF Melenovsky V, JACC 2007

39. Riserva atriale sinistra in pazienti con HFpEF

41. Algoritmo Diagnostico della HFpEF Todaro MC, JCM 2014

42. Grazie per l’attenzione