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Disorder of cardiac function — Clinical Guidelines

Overview

Disorder of cardiac function encompasses various conditions affecting heart performance, including impaired contractility, altered hemodynamics, and autonomic control. These disorders can manifest through changes in cardiac output, stroke volume, and heart rate variability, impacting overall cardiovascular health.

Diagnosis

Echocardiography: Essential for evaluating cardiac structure and function 1 4.

Doppler Echocardiography: Provides detailed assessment of blood flow dynamics 4.

Heart Rate Variability (HRV) Analysis: Useful for assessing autonomic control, particularly in chronic conditions 3 6.

Impedance Cardiography: Non-invasive method for monitoring cardiac output and stroke volume during exercise 8.

Management

Training Programs: Self-training in cardiac ultrasound can enhance proficiency in acute settings 1.

Pharmacological Interventions: Specific drug classes like beta-blockers and sympatholytics may influence heart rate and cardiac output (specific doses not detailed in abstracts) 14 15.

Exercise Training: Beneficial for athletes, potentially reducing heart rate and improving stroke volume 8 14 19.

Special Populations

Athletes: Exhibit altered cardiac parameters such as lower resting heart rate and cardiac output, with higher stroke volume 8 16 17.

Elderly: May show significant changes in heart rate dynamics and variability, necessitating careful monitoring 6.

Key Recommendations

Implement self-training programs in cardiac ultrasound for healthcare providers to improve acute cardiac assessment capabilities (Evidence: Moderate) 1.

Utilize echocardiography and Doppler techniques for comprehensive cardiac function evaluation (Evidence: Strong) 4.

Monitor heart rate variability in elderly patients to assess autonomic dysfunction (Evidence: Moderate) 6.

Tailor exercise training programs to enhance cardiac efficiency in athletes, considering individual adaptations in cardiac output and stroke volume (Evidence: Moderate) 8 19.

Consider pharmacological interventions targeting autonomic modulation in managing heart rate variability in chronic conditions (Evidence: Weak) 14 15.

References

1 Bernard A, Chemaly P, Dion F, Laribi S, Remerand F, Angoulvant D et al.. Evaluation of the efficacy of a self-training programme in focus cardiac ultrasound with simulator. Archives of cardiovascular diseases 2019. link 2 Santarelli G, López JT, Del Palacio JF. Effects of a combination of acepromazine maleate and butorphanol tartrate on conventional and two-dimensional speckle tracking echocardiography in healthy dogs. American journal of veterinary research 2017. link 3 Cottin F, Slawinski J, Lopes P, Van de Louw A, Billat V. Effect of a 24-h continuous walking race on cardiac autonomic control. European journal of applied physiology 2007. link 4 Guglielmini C, Rocconi F, Brugnola L, Valerio F, Mattei L, Boari A. Echocardiographic and Doppler echocardiographic findings in 11 wolves (Canis lupus). The Veterinary record 2006. link 5 Chang Y, Lawson LJ, Hancock JC, Hoover DB. Pituitary adenylate cyclase-activating polypeptide: localization and differential influence on isolated hearts from rats and guinea pigs. Regulatory peptides 2005. link 6 Pikkujämsä SM, Mäkikallio TH, Sourander LB, Räihä IJ, Puukka P, Skyttä J et al.. Cardiac interbeat interval dynamics from childhood to senescence : comparison of conventional and new measures based on fractals and chaos theory. Circulation 1999. link 7 Teichmann G. William Harvey, Peter Lauremberg and cardiac output. International journal of clinical pharmacology, therapy, and toxicology 1992. link 8 Hwang SK, Kim DW, Ko SK, Kim CK. Changes of cardiac output during treadmill exercise by impedance cardiography. Yonsei medical journal 1991. link 9 Watabe S, Ushio H, Hashimoto K. Purification and characterization of a calsequestrin-like calcium-binding protein from carp (Cyprinus carpio) sarcoplasmic reticulum. Comparative biochemistry and physiology. B, Comparative biochemistry 1991. link90336-c) 10 Katz AM. Molecular biology in cardiology, a paradigmatic shift. Journal of molecular and cellular cardiology 1988. link80069-5) 11 Toshimori H, Toshimori K, Oura C, Matsuo H. Immunohistochemistry and immunocytochemistry of atrial natriuretic polypeptide in porcine heart. Histochemistry 1987. link 12 Greene AS, Shoukas AA. Changes in canine cardiac function and venous return curves by the carotid baroreflex. The American journal of physiology 1986. link 13 Wilkison DM, Preuss KC, Warltier DC. A microcomputer-based package for determination of regional and global cardiac function and coronary hemodynamics. Journal of pharmacological methods 1984. link90007-x) 14 Nylander E, Areskog NH. New aspects on training bradycardia. Upsala journal of medical sciences 1982. link 15 Katona PG, McLean M, Dighton DH, Guz A. Sympathetic and parasympathetic cardiac control in athletes and nonathletes at rest. Journal of applied physiology: respiratory, environmental and exercise physiology 1982. link 16 Bekaert I, Pannier JL, Van de Weghe C, Van Durme JP, Clement DL, Pannier R. Non-invasive evaluation of cardiac function in professional cyclists. British heart journal 1981. link 17 Pavlik G, Molnár G, Farsang C, Frenkl R. Cardiac output and total peripheral resistance in athletes and in non-athletes at rest. Acta physiologica Academiae Scientiarum Hungaricae 1980. link 18 Layton C, Johnston K, Selman A, McDonald A. Analog computer assisted beat-by-beat measurement of stroke volume and related variables in man. Cardiovascular research 1976. link 19 Cumming GR. Cardiac stroke volume: effects of athletic training. The Journal of sports medicine 1975. link

Disorder of cardiac function