[23] To obtain mitral inflow pattern, pulsed-wave Doppler echocardiography recordings were obtained from a sample volume positioned at the tips of the mitral valves parallel to

PF-02341066 chemical structure inflow during diastole at end-expiration. The following parameters were measured: isovolumetric relaxation time (IVRT); peak early filling (E) and its deceleration time (DT); atrial filling peak (A); and the early diastolic mitral inflow velocity/late diastolic (E/A) ratio. E/A ratio was corrected for age. Recordings of mitral inflow with Valsalva maneuver were generally not performed. TDI measurements were sampled at the level of the mitral annulus over the septal wall. Peak early diastolic annular velocity (e′) was measured at the septal and lateral mitral annular sites.[21] Values of e′ measured at both sites were averaged. The combined E/e’ ratio was also calculated. All recordings were performed at a sweep speed of 50-100 mm/sec and averaged over three consecutive cardiac cycles. All echocardiograms

were interpreted by J.N., who had no knowledge of the clinical and laboratory data. LVDD was defined and classified according to ASE guidelines.[21] LVDD included the following categories: grade 1: e’ <8 cm/sec, E/e' ratio <8, E/A ratio <0.8, and DT >200 ms; grade 2: e’ <8 cm/sec, E/e' ratio 9-15, E/A ratio 0.8-1.5, and DT 160-200 ms; and grade 3: e' <8 cm/sec, E/e' ratio >15, E/A ratio >2, and DT <160 ms. Normal ventricular function at rest was defined by an LVEF >50% and without LVDD (e’ ≥8 cm/s, E/e’ ratio selleck chemicals llc <8, and E/A ratio >1). Effective arterial blood volume was assessed by measuring plasma concentration of PRA. The criteria used to define decreased arterial this website blood volume were derived from those used in previous studies as an increase in PRA to a level >4 ng/mL/hour.[20] Results are reported as frequencies or means ± standard deviation (SD) plus 95% confidence

interval (CI) of the mean. The Student t, Mann-Witney’s, or chi-squared tests were used to compare continuous or categorical variables. For comparisons of multiple independent groups, Kruskal-Wallis’ test was used, followed by Mann-Withney’s test. Univariate analyses were used to identify variables associated with development of type 1 HRS as well as with survival. Cox’s proportional hazards method was used to assess the prognostic value of these variables. Accuracy of each independent predictive factor of survival was assessed by receiver operating characteristic curves. Kaplan-Meier’s analysis was used to estimate survival, and probability curves were compared by log-rank test. A P value <0.025 was considered statistically significant for comparisons of multiple groups. All statistical analyses were performed using SPSS 15.0 software (SPSS, Inc., Chicago, IL). The investigation included 80 patients. At rest, all had a normal ejection fraction (>50%). Forty-three patients had normal LV diastolic function, 19 had grade 1 LVDD, and 18 had grade 2 LVDD.