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Sample records for acute left ventricular

  1. Synthetic Marijuana Induced Acute Nonischemic Left Ventricular Dysfunction

    Moustafa Elsheshtawy; Priatharsini Sriganesh; Vasudev Virparia; Falgun Patel; Ashok Khanna

    2016-01-01

    Synthetic marijuana is an uptrending designer drug currently widely spread in the US. We report a case of acute deterioration of nonischemic left ventricular dysfunction after exposure to synthetic marijuana. This case illustrates the importance of history taking in cardiac patients and identifies a negative cardiovascular effect of synthetic marijuana known as K2, not yet well detected by urine toxicology screening tools.

  2. Synthetic Marijuana Induced Acute Nonischemic Left Ventricular Dysfunction

    Moustafa Elsheshtawy

    2016-01-01

    Full Text Available Synthetic marijuana is an uptrending designer drug currently widely spread in the US. We report a case of acute deterioration of nonischemic left ventricular dysfunction after exposure to synthetic marijuana. This case illustrates the importance of history taking in cardiac patients and identifies a negative cardiovascular effect of synthetic marijuana known as K2, not yet well detected by urine toxicology screening tools.

  3. Synthetic Marijuana Induced Acute Nonischemic Left Ventricular Dysfunction.

    Elsheshtawy, Moustafa; Sriganesh, Priatharsini; Virparia, Vasudev; Patel, Falgun; Khanna, Ashok

    2016-01-01

    Synthetic marijuana is an uptrending designer drug currently widely spread in the US. We report a case of acute deterioration of nonischemic left ventricular dysfunction after exposure to synthetic marijuana. This case illustrates the importance of history taking in cardiac patients and identifies a negative cardiovascular effect of synthetic marijuana known as K2, not yet well detected by urine toxicology screening tools. PMID:27119030

  4. Left Ventricular Free Wall Rupture in Acute Myocardial Infarction: A Case Report and Literature Review

    Amir, Offer; Smith, Ronald; Nishikawa, Akaira; Gregoric, Igor D.; Smart, Frank W.

    2005-01-01

    We describe a case of subacute left ventricular free wall rupture during acute myocardial infarction in a 68-year-old man. The diagnosis was confirmed by echocardiography. The patient was supported by an intra-aortic balloon pump until the ruptured wall could be successfully repaired by suturing and gluing a pericardial patch over the defect and bypassing the left anterior descending coronary artery with a vein graft. This case demonstrates that left ventricular free wall rupture is not alway...

  5. Rapid estimation of left ventricular ejection fraction in acute myocardial infarction by echocardiographic wall motion analysis

    Berning, J; Rokkedal Nielsen, J; Launbjerg, J;

    1992-01-01

    Echocardiographic estimates of left ventricular ejection fraction (ECHO-LVEF) in acute myocardial infarction (AMI) were obtained by a new approach, using visual analysis of left ventricular wall motion in a nine-segment model. The method was validated in 41 patients using radionuclide ventriculog......Echocardiographic estimates of left ventricular ejection fraction (ECHO-LVEF) in acute myocardial infarction (AMI) were obtained by a new approach, using visual analysis of left ventricular wall motion in a nine-segment model. The method was validated in 41 patients using radionuclide...... risk groups following AMI. Thus, the results showed that simple, readily available wall motion-derived estimates of LVEF were as closely associated with LVEF measured by standard reference methods as were previously published, more cumbersome, planimetric echocardiographic methods. Reporting on global...

  6. Right ventricular functional recovery after acute myocardial infarction: relation with left ventricular function and interventricular septum motion. GISSI-3 echo substudy

    Popescu, B A; Antonini-Canterin, F; Temporelli, P L; Giannuzzi, P; Bosimini, E; Gentile, F.; Maggioni, A. P.; Tavazzi, L; Piazza, R.; L. Ascione; Stoian, I; Cervesato, E; Popescu, A C; Nicolosi, G L

    2005-01-01

    Objective: To evaluate the pattern of right ventricular (RV) functional recovery and its relation with left ventricular (LV) function and interventricular septal (IVS) motion in low risk patients after acute myocardial infarction (AMI).

  7. Relationship between left ventricular longitudinal deformation and clinical heart failure during admission for acute myocardial infarction

    Ersbøll, Mads; Valeur, Nana; Mogensen, Ulrik Madvig;

    2012-01-01

    Heart failure (HF) complicating acute myocardial infarction (MI) is an ominous prognostic sign frequently caused by left ventricular (LV) systolic dysfunction. However, many patients develop HF despite preserved LV ejection fractions. The aim of this study was to test the hypothesis that LV...

  8. Left ventricular global longitudinal strain in acute myocardial infarction

    Ersbøll, Mads

    Systolic dysfunction, clinical heart failure and elevated levels of neurohormonal peptides are major predictors of adverse outcome after acute myocardial infarction (MI). In the present thesis we evaluated global longitudinal strain (GLS) in patients with acute MI in relation to neurohormonal...

  9. Anaemia is an independent predictor of mortality in patients with left ventricular systolic dysfunction following acute myocardial infarction

    Valeur, Nana; Nielsen, Olav Wendelboe; McMurray, John J V;

    2006-01-01

    BACKGROUND: In patients with chronic heart failure (HF), mortality is inversely related to haemoglobin (hgb) concentration. We investigated the prognostic importance of anaemia in patients with acute myocardial infarction (AMI) and left ventricular systolic dysfunction (LVSD) with and without HF....... METHODS AND RESULTS: We studied 1731 patients with AMI and left ventricular ejection fraction...

  10. [Acute coronary syndrome with impaired left ventricular function in a carbon monoxide poisoning].

    Capilla, E; Pons, F; Poyet, R; Kerebel, S; Jego, C; Louge, P; Cellarier, G-R

    2016-02-01

    Carbon monoxide poisoning is the leading cause of death by poisoning in France. Neuropsychological symptoms are most common. We report on a patient with acute coronary syndrome and transient left ventricular dysfunction in carbon monoxide poisoning. Patient improved under hyperbaric oxygen therapy. Coronary angiography shows no significant lesion leading to myocardial stunning diagnose. Patients exposed to carbon monoxide must have systematic cardiac evaluation with electrocardiogram and dosage of biomarkers. PMID:25261170

  11. Free radical activity and left ventricular function after thrombolysis for acute infarction.

    Davies, S. W.; Ranjadayalan, K; Wickens, D G; Dormandy, T. L.; Umachandran, V.; Timmis, A D

    1993-01-01

    BACKGROUND--Experimental data suggest that reperfusion injury involving free radicals contributes to the impairment of left ventricular function after successful thrombolysis. METHODS--In 72 patients presenting with acute myocardial infarction, markers of free radical activity were measured before streptokinase and two hours later. Thiobarbituric acid reactive material (TBA-RM) reflects lipid peroxidation by free radicals, and the concentration of plasma total thiols (34 patients) reflects ox...

  12. Relation between early mitral regurgitation and left ventricular thrombus formation after acute myocardial infarction: results of the GISSI-3 echo substudy

    L. Ascione; Antonini-Canterin, F; Macor, F; Cervesato, E; Chiarella, F; Giannuzzi, P; Temporelli, P L; Gentile, F.; Lucci, D.; Maggioni, A. P.; Tavazzi, L; Badano, L.; Stoian, I; Piazza, R.; Bosimini, E

    2002-01-01

    Objective: To evaluate the prevalence and correlates of left ventricular thrombosis in patients with acute myocardial infarction, and whether the occurrence of early mitral regurgitation has a protective effect against the formation of left ventricular thrombus.

  13. Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction

    Ersbøll, Mads; Valeur, Nana; Mogensen, Ulrik Madvig;

    2013-01-01

    This study sought to test the hypothesis that semiautomated calculation of left ventricular global longitudinal strain (GLS) can identify high-risk subjects among patients with myocardial infarctions (MIs) with left ventricular ejection fractions (LVEFs) >40%.......This study sought to test the hypothesis that semiautomated calculation of left ventricular global longitudinal strain (GLS) can identify high-risk subjects among patients with myocardial infarctions (MIs) with left ventricular ejection fractions (LVEFs) >40%....

  14. Mortality and morbidity remain high despite captopril and/or valsartan therapy in elderly patients with left ventricular systolic dysfunction, heart failure, or both after acute myocardial infarction - Results from the Valsartan in Acute Myocardial Infarction Trial (VALIANT)

    White, HD; Aylward, PEG; Huang, Z; Dalby, AJ; Weaver, WD; Barvik, S; Marin-Neto, JA; Murin, J; Nordlander, RO; van Gilst, WH; Zannad, F; McMurray, JJV; Califf, RM; Pfeffer, MA

    2005-01-01

    Background - The elderly constitute an increasing proportion of acute myocardial infarction patients and have disproportionately high mortality and morbidity. Those with heart failure or impaired left ventricular left ventricular function after acute myocardial infarction have high complication and

  15. Abnormal glucose metabolism in acute myocardial infarction: influence on left ventricular function and prognosis

    Høfsten, Dan E; Løgstrup, Brian B; Møller, Jacob E;

    2009-01-01

    OBJECTIVES: We studied the influence of abnormal glucose metabolism on left ventricular (LV) function and prognosis in 203 patients with acute myocardial infarction. BACKGROUND: Abnormal glucose metabolism is associated with increased mortality after acute myocardial infarction. This appears to be...... particularly attributable to an increased incidence of post-infarction congestive heart failure. A relationship between glucose metabolism and LV function could potentially explain this excess mortality. METHODS: In patients without known diabetes, glucose metabolism was determined using an oral glucose...... atrial volume index) and by measuring plasma N-terminal pro-B-type natriuretic peptide levels. RESULTS: After adjustment for age and gender, a linear relationship between the degree of abnormal glucose metabolism was observed for each marker of LV dysfunction (p(trend) < 0.05) with the exception of left...

  16. Association between coronary flow reserve, left ventricular systolic function, and myocardial viability in acute myocardial infarction

    Løgstrup, Brian Bridal; Høfsten, Dan E; Christophersen, Thomas B;

    2010-01-01

    AIMS: To investigate the relationships between coronary flow reserve (CFR), left ventricular (LV) systolic function, and myocardial viability in patients with acute myocardial infarction (AMI). METHODS AND RESULTS: In 149 patients with a first AMI, we estimated CFR non-invasively and assessed LV...... patients with CFR 2, P < 0.0001. CONCLUSION: Resting echocardiographic parameters were similar in patient groups. During LDDE, patients with reduced CFR had increased LV size and compromised longitudinal function of LV and were less likely to have evidence of myocardial viability....

  17. Apical ballooning syndrome complicated by acute severe mitral regurgitation with left ventricular outflow obstruction – Case report

    Celermajer David S

    2007-02-01

    Full Text Available Abstract Background Apical ballooning syndrome (or Takotsubo cardiomyopathy is a syndrome of transient left ventricular apical ballooning. Although first described in Japanese patients, it is now well reported in the Caucasian population. The syndrome mimicks an acute myocardial infarction but is characterised by the absence of obstructive coronary disease. We describe a serious and poorly understood complication of Takotsubo cardiomyopathy. Case Presentation We present the case of a 65 year-old lady referred to us from a rural hospital where she was treated with thrombolytic therapy for a presumed acute anterior myocardial infarction. Four hours after thrombolysis she developed acute pulmonary oedema and a new systolic murmur. It was presumed she had acute mitral regurgitation secondary to a ruptured papillary muscle, ischaemic dysfunction or an acute ventricular septal defect. Echocardiogram revealed severe mitral regurgitation, left ventricular apical ballooning, and systolic anterior motion of the mitral valve with significant left ventricular outflow tract gradient (60–70 mmHg. Coronary angiography revealed no obstructive coronary lesions. She had an intra-aortic balloon pump inserted with no improvement in her parlous haemodynamic state. We elected to replace her mitral valve to correct the outflow tract gradient and mitral regurgitation. Intra-operatively the mitral valve was mildly myxomatous but there were no structural abnormalities. She had a mechanical mitral valve replacement with a 29 mm St Jude valve. Post-operatively, her left ventricular outflow obstruction resolved and ventricular function returned to normal over the subsequent 10 days. She recovered well. Conclusion This case represents a serious and poorly understood association of Takotsubo cardiomyopathy with acute pulmonary oedema, severe mitral regurgitaton and systolic anterior motion of the mitral valve with significant left ventricular outflow tract obstruction. The

  18. Effect of Astragalus Injection on Left Ventricular Remodeling in Aged Patients with Acute Early-stage Myocardial Infarction

    ZHANG Jin-guo (张金国); LIU Ya-jie(刘雅洁); GAO Dong-sheng (高东升); YANG Na (杨娜); LIU Li-xin (刘立新); HE Hua (何华); DONG Hai-xin (董海新); LIU Xue-ling (刘雪玲); CHEN Ting (陈廷); WANG Xue-zhong (王学忠)

    2003-01-01

    Objective: To observe the effect of Astragalus Injection (AI) on left ventricular remodeling in aged patients with acute myocardial infarction (AMI).Methods: Patients with AMI were randomly divided into the AI group (46 cases) treated with AI and the control group (46 cases) treated conventionally. Left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), anterior endocardial segmental length (ASL) and posterior endocardial segmental length (PSL) were all assessed by echocardiogram after 1 week and 4 weeks treatment. The cardiac systolic and diastolic functions were detected by nuclide gating cardiac blood pool imaging at the 4th week. Results: After four weeks' treatment, no obvious change of LVEDVI, LVESVI and ASL in the AI group was found, but these indexes increased significantly in the control group, with significant difference shown between the two groups (P<0.05). As compared with the control group, the left ventricular ejection fraction (LVEF), left ventricular peak ejecting rate (LVPER) and left ventricular peak filling rate (LVPFR) were heightened, the time for peak filling rate (LVTPFR) in the left ventricle was shortened in the AI group.Conclusion: AI is one of the effective drugs in reversing left ventricular remodeling in aged patients with AMI.

  19. Does left ventricular function improve with L-carnitine after acute myocardial infarction?

    Iyer R

    1999-04-01

    Full Text Available A double blind randomized placebo controlled clinical trial was carried out to assess the efficacy and safety of L-carnitine in patients suffering from acute anterior wall myocardial infarction with respect to left ventricular function. Sixty patients (34 men, 26 women, mean age 56+11 yr. with acute anterior wall myocardial infarction were randomized to placebo and L-carnitine. All the patients were given intravenous L-carnitine / placebo in the dose of 6gm/day for the first seven days followed by oral L-carnitine / placebo 3 gm/day in three divided doses for a period of three months. Echocardiography was performed for regional wall motion abnormality, left ventricular end systolic volume (ESV, end diastolic volume (EDV and ejection fraction (EF on admission, after seven days and after three months of the infarction. Forty-four patients completed the study. There were three deaths, two in the placebo and one in the L-carnitine group (p>0.05. Thirteen patients were lost to follow up. Echo parameters in both groups were comparable (p>0.05. The duration of chest pain prior to initiation of the I.V. L-carnitine was 7.5 + 5.2 hrs in the L-carnitine group and 7 + 4 hrs in the placebo group (p>0.05. There was no statistical difference in the EF, ESV and EDV on admission, at discharge and after three months in the L-carnitine and the placebo groups (p>0.05. No significant adverse effects were noted. L-carnitine, though a safe drug, does not affect the left ventricular function in patients with myocardial infarction.

  20. Effect of carvedilol on cardiac function and left ventricular remodeling in rats after acute myocardial infarction

    张军; 贾国良; 王海昌

    2003-01-01

    Objective: To observe the effect of carvedilol injection on left ventricular function and collagen remodeling in rat with myocardial infarction. Methods: Sixty rats with a model of myocardial infarction were randomly divided into nine groups. The rats of therapeutical group were treated with carvedilol injection (2 mg/d intraperitoneal injection) and/or captopil (2 g/L drinking water). Acute myocardial infarction (AMI) group did not receive drug treatment. The animals were sacrificed at 4 weeks and 8 weeks after coronary artery ligation. The levels of plasma angiotensin Ⅱ and plasma aldosterone and left ventricle function were determined at different time. The collagen content and the ratio of type I and Ⅲ collagen of noninfarcted area were also assessed. Results: Compared with AMI group, the levels of plasma and myocardium angiotensin Ⅱ and plasma aldosterone in both carvedilol and captopil group decreased at the eighth week (P<0.05). In addition, carvedilol improved systolic and diastolic function (P<0.05). Compared with sham group, both collagen content and the ratio of type Ⅰ/Ⅲ collagen of noninfarcted area increased in AMI4 and AMI8 group (P<0.05). The hydroxyproline levels and the ratio of type Ⅰ/Ⅲ collagen significantly decreased after carvedilol and/or captopil treatment , compared with AMI group at 4 or 8 week (P<0.05). Conclusion: Carvedilol can improve cardiac function after myocardial infarction and has beneficial effect on left ventricular remodeling.

  1. Infuences of Previous Angina Pectoris on Coronary Collateral Circulation and Left Ventricular Function in Patients with Acute Myocardial Infarction

    罗初凡; 杜志民; 胡承恒; 梅卫义; 伍贵富; 李怡; 马虹

    2001-01-01

    Objective To investigate the influences of previous angina pectoris on coronary collateral circulation and left ventricular function in patients with acute myocardial infarction. Methods 307 patients with a first episode acute myocardial infarction underwent selective coronary angiography and left ventriculography. The relation of previous angina pectoris to coronary collateral circulation, peak creatine kinase and left ventricular function were analyzed.Results ① In the 307 patients, there were 192(62.5 % ) with previous angina [PA ( + ) group] and 115 (37.5 % ) without [PA ( - ) group]. ②The peak creatine kinase (CK) and CK- MB were significantly higher in PA (-) group than in PA (+) group ( P < 0.05 for both comparisons) . ③ Collateral circulation to infarct- related artery was more likely to be present in PA (+) group than in PA (-) group ( P < 0.05) . ④ The left ventricular ejection fraction was significantly increased, and the left ventricular wall motion Cortina score decreased, in PA ( + ) group than in PA ( - ) group ( P < 0.01 for both comparisons) .Conclusion In patients with acute myocardial infarction, previous angina pectoris may have beneficial effects on coronary collateral circulation and left ventricular unction.

  2. Recovery of right and left ventricular function after acute pulmonary embolism

    Klok, F.A., E-mail: f.a.klok@lumc.nl [Section of Vascular Medicine, Department of General Internal Medicine-Endocrinology, Leiden University Medical Center, Leiden (Netherlands); Romeih, S. [Department of Cardiology, Leiden University Medical Center, Leiden (Netherlands); Kroft, L.J.M.; Westenberg, J.J.M. [Department of Radiology, Leiden University Medical Center, Leiden (Netherlands); Huisman, M.V. [Section of Vascular Medicine, Department of General Internal Medicine-Endocrinology, Leiden University Medical Center, Leiden (Netherlands); Roos, A. de [Department of Radiology, Leiden University Medical Center, Leiden (Netherlands)

    2011-12-15

    Aim: To evaluate recovery of cardiac function after acute pulmonary embolism (PE). Materials and methods: Routine breath-held computed tomography (CT)-pulmonary angiography was performed in patients with suspected PE to confirm or exclude the diagnosis of PE at initial presentation. Electrocardiogram (ECG)-triggered cardiac CT was performed to assess biventricular function. After 6 months, cardiac magnetic resonance imaging (MRI) was performed. In total, 15 consecutive patients with PE and 10 without were studied. A significant change in ventricular volume was defined as a >15% change in end-diastolic or -systolic volumes (EDV, ESV), and significant ventricular function improvement as a >5% increase in ejection fraction (EF) as based on reported cut-off values. Results: Right and left ventricular (RV and LV) EDV and ESV changed non-significantly (<1.3%) in the patients without PE, indicating good comparability of those values measured by CT and MRI. PE patients with baseline normal RV function (RVEF {>=}47%) revealed a >5% improvement in the RVEF (+5.4 {+-} 3.1%) due to a decrease in the RVESV. Patients with baseline abnormal RV function showed a >5% improvement in the RVEF (+14 {+-} 15%) due to decreases in both the RVESV and RVEDV. Furthermore, the LVEDV increased in this latter patient group. Conclusions: The present study demonstrated an improvement in RV function in the majority of patients with PE, independent of baseline RV function. The degree of RV and LV recovery was dependent on the severity of baseline RV dysfunction.

  3. Viable Myocardium Impact on Left Ventricular Function after Late Revascularization of Infarct-related Artery in Acute Myocardial Infarction

    Ma Likun; Yu Hua; Huang Xiangyang; Feng Kefu; Han Xiaoping; Ye Qi

    2006-01-01

    Objectives The long-term benefit of late reperfusion of infarct-related artery (IRA) after acute myocardial infarction (AMI) is controversial, and the benefit mechanisms remain uncertain. Low dose dobutamine stress echocardiography (LDSE) can identify viable myocardium and predict improvement of wall motion after revascularization. Methods Sixtynine patients with first AMI who did not received early reperfusion therapy were studied by LDSE at 5 to 10 days after AMI. Wall motion abnormality and left ventricular size were measured at the same time.Successful PCI were done in all patients at 10 to 21 days after AMI onset. Patients were divided in two groups based on the presence or absence of viable myocardium. Echocardiography was repeated six months later. Results There were 157 motion abnormality segments. 89 segments (57%) were viable during LDSE. 26 patients (38%) with viability and 43(62%) without. In viable group, left ventricular ejection fraction (LVEF) was increased (P<0.05),and left ventricular end systolic volume index (LVESVI) and wall motion score (WMS) were decreased (P<0.05 and P<0.01) significantly at 6 months compared with baseline. But in patients without viability, LVEF was decreased (P<0.01), and LVESVI and left ventricular end diastolic volume index (LVEDVI) were increased (P<0.05) significantly after 6 months, and the WMS did not changed (P>0.05). LVEF increased (P<0.05) and WMS decreased (P<0.05) on LDSE during acute phase in patients with viability, but they were not changed in the nonviable group. Conclusions Late revascularization of IRA in patients with presence of viable myocardium after AMI is associated with long-term preservation left ventricular function and less ventricular remodeling.Improvement of left ventricular systolic function on LDSE indicates late phase recovery of left ventricular function after late revascularization.

  4. Left ventricular thrombus in patients with acute myocardial infarction: Case report and Caribbean focused update

    CR Potu

    2012-03-01

    Full Text Available Despite the well documented benefit of echocardiography in acute coronary syndromes, its wide-scale use in the Caribbean is limited by access, health literacy and affordability. Because of the limited use of echocardiography in the region, routine complications of acute myocardial infarction (AMI are not fully appreciated and may go unrecognized, further contributing to increased cardiovascular morbidity and mortality. It is therefore necessary to bring focus to this common clinical condition and highlight the clinical utility of echocardiography in facilitating timely and accurate diagnosis. We report here a case of large left ventricular (LV thrombus in a patient with AMI. Coronary angiography showed completely occluded left anterior descending artery (LAD with angiographically normal remaining vessels. Immediate anticoagulation was commenced with heparin and overlapped with warfarin. No Primary Angioplasty (PA was done based on the evidence from occluded artery trial. LV thrombus was completely resolved on echocardiography at three months. No evidence of thrombo-embolism was found during the resolution of LV thrombus.

  5. Acute Effects of Hemodialysis on Left and Right Ventricular Function: A Doppler Tissue Imaging Study

    Tansel Erol

    2012-08-01

    Full Text Available Purpose: Doppler tissue imaging (DTI allows noninvasive assessment of both left ventricular (LV and right ventricular (RV function. The aim of this study was to evaluate the effect of hemodialysis (HD on LV and RV function using DTI. Method: Our study group included 30 patients on chronic HD program (mean age 45 15 years. Myocardial (Sm, Em, Am and annular velocities (Ea, Aa were measured in several cardiac territories before and after HD. Results: After HD, Ea significantly reduced from 10.8 3.4 cm/s to 9.6 2.4 cm/s (p = 0.029. Patients exhibited a lower Em following HD in all measured territories. Em/Am ratio was also reduced for each LV wall investigated after HD in all measured territories. At the RV segments, Sm, Em, and Am decreased significantly in all measured territories. Em of the anterior wall was positively related to ultrafiltration volume (r = 0.25, p = 0.006, whereas the decrease of Sm of RV basal segment correlated with a decrease of diastolic blood pressure (r = 0.23, p < 0.01. Conclusion: Our data indicate that a single HD session is associated with acute changes of systolic and diastolic parameters of LV and RV. [Cukurova Med J 2012; 37(4.000: 215-222

  6. Left Ventricular Function during Acute High-Altitude Exposure in a Large Group of Healthy Young Chinese Men

    Rao, Mingyue; Li, Jiabei; Qin, Jun; Zhang, Jihang; Gao, Xubin; Yu, Shiyong; Yu, Jie; Chen, Guozhu; Xu, Baida; Li, Huijie; Rao, Rongsheng; Huang, Lan; JIN, JUN

    2015-01-01

    Objective The purpose of this study was to observe left ventricular function during acute high-altitude exposure in a large group of healthy young males. Methods A prospective trial was conducted in Szechwan and Tibet from June to August, 2012. By Doppler echocardiography, left ventricular function was examined in 139 healthy young Chinese men at sea level; within 24 hours after arrival in Lhasa, Tibet, at 3700 m; and on day 7 following an ascent to Yangbajing at 4400 m after 7 days of acclim...

  7. To study the correlation between red cell distribution width and left ventricular ejection fraction in patients of acute myocardial infraction

    Ramji Sharma; Akram Mohammed; Mayank Shrivastava; Ajay Mathur

    2016-01-01

    Background: Ischemic heart disease (IHD) is a condition in which there is an inadequate supply of blood and oxygen to a portion of myocardium. The objective of study was to assess the correlation between red cell distribution width and left ventricular ejection fraction in patients presenting with acute myocardial infarction. Methods: Study was conducted on 200 patients admitted at tertiary care centre with acute myocardial infarction satisfying inclusion criteria. Detailed history and cl...

  8. Myocardium-derived conditioned medium improves left ventricular function in rodent acute myocardial infarction

    Yeh Kuo-Ho

    2011-01-01

    Full Text Available Abstract Background We investigated whether myocardium-derived conditioned medium (MDCM is effective in preserving left ventricular (LV function in a rat acute myocardial infarction (AMI model. Methods Adult male Sprague-Dawley (SD rats (n = 36 randomized to receive either left coronary artery ligation (AMI induction or thoracotomy only (sham procedure were grouped as follows (n = 6 per group: Group I, II, and III were sham-controls treated by fresh medium, normal rat MDCM, and infarct-related MDCM, respectively. Group IV, V, and VI were AMI rats treated by fresh medium, normal MDCM, and infarct-related MDCM, respectively. Either 75 μL MDCM or fresh medium was administered into infarct myocardium, followed by intravenous injection (3 mL at postoperative 1, 12, and 24 h. Results In vitro studies showed higher phosphorylated MMP-2 and MMP-9, but lower α-smooth muscle actin and collagen expressions in neonatal cardiac fibroblasts treated with MDCM compared with those in the cardiac fibroblasts treated with fresh medium (all p Conclusion MDCM therapy reduced cardiac fibrosis and oxidative stress, enhanced angiogenesis, and preserved 90-day LV function in a rat AMI model.

  9. Left Ventricular Thrombosis in Ulcerative Colitis

    Tarek Saleh

    2010-07-01

    Full Text Available Left ventricular thrombi usually occur in the setting of an acute myocardial infarction, left ventricular aneurysm, or dilated cardiomyopathy. In the absence of ventricular wall motion abnormalities, they are rare. This report describes a patient with ulcerative colitis in whom two-dimensional echocardiography revealed a left intraventricular mass. Thrombosis in ulcerative colitis is a serious condition and can occur in a very young population. This case also shows that left ventricular thrombi can occur in the active setting of ulcerative colitis.

  10. Giant and thrombosed left ventricular aneurysm

    Jose; Alberto; de; Agustin; Jose; Juan; Gomez; de; Diego; Pedro; Marcos-Alberca; Jose; Luis; Rodrigo; Carlos; Almeria; Patricia; Mahia; Maria; Luaces; Miguel; Angel; Garcia-Fernandez; Carlos; Macaya; Leopoldo; Perez; de; Isla

    2015-01-01

    Left ventricular aneurysms are a frequent complication of acute extensive myocardial infarction and are most commonly located at the ventricular apex. A timely diagnosis is vital due to the serious complications that can occur,including heart failure,thromboembolism,or tachyarrhythmias. We report the case of a 78-yearold male with history of previous anterior myocardial infarction and currently under evaluation by chronic heart failure. Transthoracic echocardiogram revealed a huge thrombosed and calcified anteroapical left ventricular aneurysm. Coronary angiography demonstrated that the left anterior descending artery was chronically occluded,and revealed a big and spherical mass with calcified borders in the left hemithorax. Left ventriculogram confirmed that this spherical mass was a giant calcified left ventricular aneurysm,causing very severe left ventricular systolic dysfunction. The patient underwent cardioverter-defibrillator implantation for primary prevention.

  11. Predicting outcomes over time in patients with heart failure, left ventricular systolic dysfunction, or both following acute myocardial infarction

    Lopes, Renato D.; Pieper, Karen S.; Stevens, Susanna R.; Solomon, Scott D.; McMurray, John J.V.; Pfeffer, Marc A.; Leimberger, Jeffrey D.; Velazquez, Eric J.

    2016-01-01

    Background: Most studies of risk assessment or stratification in patients with myocardial infarction (MI) have been static and fail to account for the evolving nature of clinical events and care processes. We sought to identify predictors of mortality, cardiovascular death or nonfatal MI, and cardiovascular death or nonfatal heart failure (HF) over time in patients with HF, left ventricular systolic dysfunction, or both post‐MI. Methods and Results: Using data from the VALsartan In Acute m...

  12. Apical ballooning syndrome complicated by acute severe mitral regurgitation with left ventricular outflow obstruction – Case report

    Celermajer David S; Chandrasegaram Manju D; Wilson Michael K

    2007-01-01

    Abstract Background Apical ballooning syndrome (or Takotsubo cardiomyopathy) is a syndrome of transient left ventricular apical ballooning. Although first described in Japanese patients, it is now well reported in the Caucasian population. The syndrome mimicks an acute myocardial infarction but is characterised by the absence of obstructive coronary disease. We describe a serious and poorly understood complication of Takotsubo cardiomyopathy. Case Presentation We present the case of a 65 year...

  13. Left anterior descending coronary artery blood flow and left ventricular unloading during extracorporeal membrane oxygenation support in a swine model of acute cardiogenic shock.

    Brehm, Christoph; Schubert, Sarah; Carney, Elizabeth; Ghodsizad, Ali; Koerner, Michael; McCoach, Robert; El-Banayosy, Aly

    2015-02-01

    The impact of extracorporeal membrane oxygenation (ECMO) support on coronary blood flow and left ventricular unloading is still debated. This study aimed to further characterize the influence of ECMO on coronary artery blood flow and its ability to unload the left ventricle in a short-term model of acute cardiogenic shock. Seven anesthetized pigs were intubated and then underwent median sternotomy and cannulation for venoarterial (VA) ECMO. Flow in the left anterior descending (LAD) artery, left atrial pressure (LAP), left ventricular end-diastolic pressure (LVEDP), and mean arterial pressure (MAP) were measured before and after esmolol-induced cardiac dysfunction and after initiating VA-ECMO support. Induction of acute cardiogenic shock was associated with short-term increases in LAP from 8 ± 4 mm Hg to 18 ± 14 mm Hg (P = 0.9) and LVEDP from 5 ± 2 mm Hg to 13 ± 17 mm Hg (P = 0.9), and a decrease in MAP from 63 ± 16 mm Hg to 50 ± 24 mm Hg (P = 0.3). With VA-ECMO support, blood flow in the LAD increased from 28 ± 25 mL/min during acute unsupported cardiogenic shock to 67 ± 50 mL/min (P = 0.003), and LAP and LVEDP decreased to 8 + 5 mm Hg (P = 0.7) and 5 ± 3 mm Hg (P = 0.5), respectively. In this swine model of acute cardiogenic shock, VA-ECMO improved coronary blood flow and provided some degree of left ventricular unloading for the short duration of the study. PMID:24935151

  14. The Prognostic Value of Left Atrial Peak Reservoir Strain in Acute Myocardial Infarction Is Dependent on Left Ventricular Longitudinal Function and Left Atrial Size

    Ersbøll, Mads; Andersen, Mads J; Valeur, Nana; Mogensen, Ulrik Madvig; Waziri, Homa; Møller, Jacob Eifer; Hassager, Christian; Søgaard, Peter; Køber, Lars

    2013-01-01

    Peak atrial longitudinal strain (PALS) during the reservoir phase has been proposed as a measure of left atrium function in a range of cardiac conditions, with the potential for added pathophysiological insight and prognostic value. However, no studies have assessed the interrelation of PALS and...... left ventricular longitudinal strain (global longitudinal strain) in large-scale populations in regard to prognosis....

  15. Respiratory acoustic impedance in left ventricular failure.

    Depeursinge, F B; Feihl, F; Depeursinge, C; Perret, C H

    1989-12-01

    The measurement of respiratory acoustic impedance (Zrs) by forced pseudorandom noise provides a simple means of assessing respiratory mechanics in nonintubated intensive care patients. To characterize the lung mechanical alterations induced by acute vascular congestion of the lung, Zrs was measured in 14 spontaneously breathing patients hospitalized for acute left ventricular failure. The Zrs data in the cardiac patients were compared with those of 48 semirecumbent normal subjects and those of 23 sitting asthmatic patients during allergen-induced bronchospasm. In the patients with acute left ventricular failure, the Zrs abnormalities noted were an excessive frequency dependence of resistance from 10 to 20 Hz and an abnormally low reactance at all frequencies, abnormalities qualitatively similar to those observed in the asthmatic patients but of lesser magnitude. Acute lung vascular congestion modifies the acoustic impedance of the respiratory system. Reflex-induced bronchospasm might be the main mechanism altering respiratory acoustic impedance in acute left ventricular failure. PMID:2582846

  16. Influence of Transplantation of Allogenic Bone Marrow Mononuclear Cells on the Left Ventricular Remodeling of Rat after Acute Myocardial Infarction

    2006-01-01

    To probe into the influence of transplantation of allogenic bone marrow mononuclear cells (BM-MNCs) on the left ventricular remodeling of rat after acute myocardial infarction (AMD,60 male Wistar rats were evenly divided into three groups at random: control group 1, control group 2and transplantation group. In control group 1, chest was opened without ligation of coronary artery;in control group 2 and transplantation group, the left anterior descending branch of coronary artery was ligated to establish AMI model. Prepared culture medium and allogenic BM-MNCs suspension were respectively implanted the surrounding area of infracted cardiac muscle via epicardium of control group 2 and transplantation group. Four weeks after the operation, the osteopontin gene (OPN mRNA, P<0.01), type Ⅰ collagen (P<0.01) and angiotensin Ⅱ (AngⅡ, P<0.01) content in the left ventricular non-infracted myocardium, and the Ang Ⅱ density in blood plasma (P<0.05) of transplantation group and control group 2 were all significantly higher than that of control group 1. In the transplantation group, the myocardial OPN mRNA, type Ⅰ collagen and Ang Ⅱ content of non-infracted zone in left ventricle, and the Ang Ⅱ concentration in blood plasma were all significantly lower than those of control group 2 (P<0.05 for all). It is concluded that allogenic BM-MNCs transplantation may ease left ventricular remodeling after AMI by inhibiting the synthesis of type Ⅰ collagen in the cardiac muscle and down-regulating the expression of Ang Ⅱ and OPN gene.

  17. Effects of ischemic preconditioning on infarct size and left ventricular functions of patients with first acute myocardial infarction

    Purpose: To evaluate the effect of angina pectoris (AP) prior to first acute myocardial infarction (AMI) on infarct size and left ventricular function. Methods: Patients were divided into 2 groups based on presence of AP within 48 hours before AMI onset, non-AP group (n = 22) and AP group (n 29). Incidences of severe cardiac function disturbances and severe arrhythmias, infarct size detected by 99mTc-MIBI SPECT myocardial perfusion imaging and left ventricular function detected by gated cardiac blood-pool imaging between 2 groups were compared. Results: Incidences of severe cardiac function disturbance were 27.3% (n = 6) and 6.9% (n = 2) between non-Ap group and AP group respectively. The difference was significant (P0.05). Peak values of CPK were 1542.7 +- 1086.4 U/L and 984.3 +- 775.0 U/L respectively (P<0.05). Numbers of infarct segment were 5.9 +- 2.8 and 4.5 +- 2.4 respectively (P < 0.001). LVEF was 39.4% +- 11.5% and 51.5% +- 9.8%, PFR 1.91 +- 0.66 EDV/s and 2.24 +- 0.51 EDV/s, PER 1.98 +- 0.66 EDV/s and 2.54 +- 0.59 EDV/s between non-AP group and AP group respectively (P < 0.05 or 0.001). 6 (27.3%) and 2 (6.9%) showed dyskinesis respectively (P < 0.05). Conclusions: Patients with AP within 48 hours before AMI onset can reduce infarct size and preserve left ventricular function. These favorable effects of AP were related to ischemia preconditioning

  18. Heterogeneous fate of perfusion and contraction after anterior wall acute myocardial infarction and effects on left ventricular remodeling.

    Marcassa, C; Galli, M; Bolli, R; Temporelli, P L; Campini, R; Giannuzzi, P

    1998-12-15

    After acute myocardial infarction, patency of infarct vessel and extent of left venticular (LV) dysfunction are major determinants of ventricular remodeling. Spontaneous, delayed reperfusion in the infarct zone occurs in a sizeable number of patients well after the subacute phase. The aim of this study was to determine the relation between the occurrence of this spontaneous, delayed reperfusion and LV remodeling. In 84 patients, resting LV volumes, topography, regional function, and perfusion were quantitatively evaluated by 2-dimensional echocardiography and sestamibi tomography 5 weeks (study 1) and 7 months (study 2) after anterior Q-wave infarction. At study 2, LV end-diastolic volume increased by > 15% in 17 patients (20%, LV remodeling); they had already had at study 1 significantly larger LV volumes, more severe hypoperfusion and wall motion abnormalities, and greater regional dilation than patients with stable LV volumes. Delayed reperfusion occurred in 8 of 17 patients with and in 42 of 67 patients without LV remodeling (47% vs 63%; p=NS). At study 2, LV regional dilation and end-diastolic volumes were stable in patients with, but increased in patients without, spontaneous reperfusion (from 25+/-24% to 29+/-26% at study 2 [p<0.05] and from 65+/-14 to 68+/-18 ml/m2 [p <0.05]). At multivariate analysis, however, regional ventricular dilation at study 1 was the sole predictor of further LV remodeling. Thus, after acute myocardial infarction, spontaneous reperfusion occurring after 5 weeks plays only a minor role in influencing LV remodeling. Benefits from delayed reperfusion seem limited to patients with preserved LV volumes; patients with an enlarged left ventricle 5 weeks after acute infarction are prone to further LV remodeling, irrespective of delayed reperfusion. PMID:9874047

  19. Mitochondria and left ventricular hypertrophy

    Haiyan Zhu; Shiwen Wang

    2008-01-01

    @@ Introduction Left ventricular hypertrophy (LVH) is one of the vicious organ damages of essential hypertension.It contributes a lot to high mortality of essential hypertension due to sudden cardiac death,ventricular arrhythmia and heart failure.Many factors involve in the pathogenesis of hypertension-induced LVH including inherited variants as well as environmental factors.

  20. Risk factors for development of left ventricular thrombus after first acute anterior myocardial infarction-association with anticardiolipin antibodies

    Okuyan Ertuğrul

    2010-09-01

    Full Text Available Abstract Background Left ventricular thrombus(LVT] formation is a frequent complication in patients with acute anterior myocardial infarction(MI. LVT is associated with increased risk of embolism and higher mortality rates after acute MI. Anticardiolipin antibodies (ACA are immunoglobulins that react with phospholipid-binding proteins interfering with the prothrombin activator complex. The effects of phospholipids on pathophysiology of cardiovascular thrombotic events are well known. In this study, we aimed to evaluate the importance of clinical and biochemical parameters including anticardiolipin antibodies on left ventricular thrombus formation after acute anterior MI. Methods and Results Seventy patients with a first anterior AMI were prospectively and consecutively enrolled. Patients with previous MI, autoimmune disease, collagen vascular disease and arterial or venous thrombosis history were excluded from this study. At the time of hospitalization, key demographic and clinical characteristics were collected including age, gender, ethanol intake and presence of traditional risk factors for atherosclerosis (hypertension, diabetes, smoking, hyperlipidemia, positive family history. Patients were evaluated for echocardiographic data, blood chemistry and ACA. Two-dimensional and Doppler echocardiographic examinations were performed in all patients within the first week and at 14 days after MI. LV thrombus was detected in 30 (42.8% patients. ACA IgM levels were significantly higher in the patient group with LV thrombus than in the group without thrombus (12.44 ±4.12 vs. 7.69 ± 4.25 mpl, p = 0,01. ACA IgG levels were also found higher in the group with LV thrombus (24.2 ± 7.5 vs.17.98 ± 6.45 gpl, p = 0.02. Multivariate analyses revealed diabetes mellitus, higher WMSI, lower MDT and higher ACA IgM and higher ACA IgG levels as independent predictors of left ventricular thrombus formation. Conclusions Our data demonstrate that beside the low

  1. Left ventricular thrombus formation after acute myocardial infarction as assessed by cardiovascular magnetic resonance imaging

    Introduction: Left ventricular (LV) thrombus formation is a feared complication of myocardial infarction (MI). We assessed the prevalence of LV thrombus in ST-segment elevated MI patients treated with percutaneous coronary intervention (PCI) and compared the diagnostic accuracy of transthoracic echocardiography (TTE) to cardiovascular magnetic resonance imaging (CMR). Also, we evaluated the course of LV thrombi in the modern era of primary PCI. Methods: 200 patients with primary PCI underwent TTE and CMR, at baseline and at 4 months follow-up. Studies were analyzed by two blinded examiners. Patients were seen at 1, 4, 12, and 24 months for assessment of clinical status and adverse events. Results: On CMR at baseline, a thrombus was found in 17 of 194 (8.8%) patients. LV thrombus resolution occurred in 15 patients. Two patients had persistence of LV thrombus on follow-up CMR. On CMR at four months, a thrombus was found in an additional 12 patients. In multivariate analysis, thrombus formation on baseline CMR was independently associated with, baseline infarct size (g) (B = 0.02, SE = 0.02, p < 0.001). Routine TTE had a sensitivity of 21–24% and a specificity of 95–98% compared to CMR for the detection of LV thrombi. Intra- and interobserver variation for detection of LV thrombus were lower for CMR (κ = 0.91 and κ = 0.96) compared to TTE (κ = 0.74 and κ = 0.53). Conclusion: LV thrombus still occurs in a substantial amount of patients after PCI-treated MI, especially in larger infarct sizes. Routine TTE had a low sensitivity for the detection of LV thrombi and the interobserver variation of TTE was large.

  2. Left ventricular thrombus formation after acute myocardial infarction as assessed by cardiovascular magnetic resonance imaging

    Delewi, Ronak [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Interuniversity Cardiology Institute of the Netherlands (Netherlands); Nijveldt, Robin [Department of Cardiology, VU University Medical Center, Amsterdam (Netherlands); Hirsch, Alexander [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Marcu, Constantin B.; Robbers, Lourens [Department of Cardiology, VU University Medical Center, Amsterdam (Netherlands); Hassell, Marriela E.C.J.; Bruin, Rianne H.A. de; Vleugels, Jim; Laan, Anja M. van der; Bouma, Berto J. [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Tio, René A. [Thorax Center, University Medical Center Groningen, Groningen (Netherlands); Tijssen, Jan G.P. [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Rossum, Albert C. van [Department of Cardiology, VU University Medical Center, Amsterdam (Netherlands); Zijlstra, Felix [Thorax Center, Department of Cardiology, Erasmus University Medical Center, Rotterdam (Netherlands); Piek, Jan J., E-mail: j.j.piek@amc.uva.nl [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands)

    2012-12-15

    Introduction: Left ventricular (LV) thrombus formation is a feared complication of myocardial infarction (MI). We assessed the prevalence of LV thrombus in ST-segment elevated MI patients treated with percutaneous coronary intervention (PCI) and compared the diagnostic accuracy of transthoracic echocardiography (TTE) to cardiovascular magnetic resonance imaging (CMR). Also, we evaluated the course of LV thrombi in the modern era of primary PCI. Methods: 200 patients with primary PCI underwent TTE and CMR, at baseline and at 4 months follow-up. Studies were analyzed by two blinded examiners. Patients were seen at 1, 4, 12, and 24 months for assessment of clinical status and adverse events. Results: On CMR at baseline, a thrombus was found in 17 of 194 (8.8%) patients. LV thrombus resolution occurred in 15 patients. Two patients had persistence of LV thrombus on follow-up CMR. On CMR at four months, a thrombus was found in an additional 12 patients. In multivariate analysis, thrombus formation on baseline CMR was independently associated with, baseline infarct size (g) (B = 0.02, SE = 0.02, p < 0.001). Routine TTE had a sensitivity of 21–24% and a specificity of 95–98% compared to CMR for the detection of LV thrombi. Intra- and interobserver variation for detection of LV thrombus were lower for CMR (κ = 0.91 and κ = 0.96) compared to TTE (κ = 0.74 and κ = 0.53). Conclusion: LV thrombus still occurs in a substantial amount of patients after PCI-treated MI, especially in larger infarct sizes. Routine TTE had a low sensitivity for the detection of LV thrombi and the interobserver variation of TTE was large.

  3. Serum MMP-8: A Novel Indicator of Left Ventricular Remodeling and Cardiac Outcome in Patients after Acute Myocardial Infarction

    Marie Fertin; Gilles Lemesle; Annie Turkieh; Olivia Beseme; Maggy Chwastyniak; Philippe Amouyel; Christophe Bauters; Florence Pinet

    2013-01-01

    OBJECTIVE: Left ventricular (LV) remodeling following myocardial infarction (MI) is characterized by progressive alterations of structure and function, named LV remodeling. Although several risk factors such as infarct size have been identified, LV remodeling remains difficult to predict in clinical practice. Changes within the extracellular matrix, involving matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs), are an integral part of left ventricular (LV) rem...

  4. Is echocardiography a valid tool to screen for left ventricular systolic dysfunction in chronic survivors of acute myocardial infarction? A comparison with radionuclide ventriculography

    Galasko, G I W; S. Basu; Lahiri, A; Senior, R

    2004-01-01

    Objective: To assess the accuracy of echocardiography with Simpson’s apical biplane method in screening for left ventricular systolic dysfunction (LVSD) in patients six months after acute myocardial infarction (AMI) as compared with radionuclide ventriculography by assessing the proportion of clinically significant errors that occur with echocardiography.

  5. Amiodarone use after acute myocardial infarction complicated by heart failure and/or left ventricular dysfunction may be associated with excess mortality

    Thomas, Kevin L; Al-Khatib, Sana M; Lokhnygina, Yuliya;

    2008-01-01

    BACKGROUND: We sought to assess the association of amiodarone use with mortality during consecutive periods in patients with post-acute myocardial infarction with left ventricular systolic dysfunction and/or HF treated with a contemporary medical regimen. METHODS: This study used data from VALIANT...

  6. Myocardial perfusion in type 2 diabetes with left ventricular hypertrophy: normalisation by acute angiotensin-converting enzyme inhibition

    The purpose of this study was to assess whether acute angiotensin-converting enzyme (ACE) inhibition would improve myocardial perfusion and perfusion reserve in a subpopulation of normotensive patients with diabetes and left ventricular hypertrophy (LVH), both independent risk factors of coronary disease. Using positron emission tomography (PET), we investigated the response of regional myocardial perfusion to acute ACE inhibition with i.v. infusion of perindoprilat (vs saline infusion as control, minimum interval 3 days) in 12 diabetic patients with LVH. Myocardial perfusion was quantified with PET using nitrogen-13 ammonia infused at rest and during dipyridamole hyperaemia. Twelve healthy control subjects were included in the study, five of whom were also studied with perindoprilat. Mean blood pressure in normo-albuminuric, asymptomatic patients was 123±7/65±9 mmHg. Compared with controls, maximal perfusion was reduced in patients (1.8±0.6 vs 2.5±1.0 ml min-1 g-1; P-1 g-1, P<0.01). In the five control subjects both resting and hyperaemic perfusion remained unchanged during perindoprilat infusion. It is concluded that acute ACE inhibition with perindoprilat improves maximal achieved myocardial perfusion in non-hypertensive patients with diabetes and LVH. (orig.)

  7. Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients

    Bang, Casper; Gerdts, Eva; Aurigemma, Gerard P;

    2013-01-01

    Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatatio...

  8. LEFT VENTRICULAR REMODELING IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH AND WITHOUT ST SEGMENT ELEVATION

    N. E. Zakirova

    2016-05-01

    Full Text Available Aim. To study the remodeling of the left ventricle (LV in patients with ST segment elevation (STEMI and non-ST segment elevation (non-STEMI myocardial infarction (MI. Materials and methods. Patients (n=99 with acute MI (48 – with STEMI, 51 – with non-STEMI were examined. Diagnosis of MI was set on the basis of the dynamics of myocardial damage markers, data of clinical and electrocardiogram examination. The comparison group consisted of 33 patients with stable angina functional class 2. The control group included 35 healthy men. Structural and functional state of the LV myocardium and types of its remodeling were assessed by echocardiography.Results. It was found that the LV eccentric hypertrophy was the predominated type of LV remodeling in patients with STEMI. Besides, these patients demonstrated disorders of the LV contractile function (LV ejection fraction 40.2±5.49% vs. 61.4±3.91% in control; p<0.05, the LV dilatation (end-systolic volume index 54.1±5.27 vs. 25.2±2.22 ml/m2 in the control; p<0.05, the lowest LV wall thickness (relative wall thickness 0.36±0.01 vs. 0.44±0.01 in control; p<0.05, increase in the LV myocardial stress (168.3±20.17 vs. 108.6±9.82 dynes/cm2 in control; p<0.05, and LV spherification. The majority of patients with non-STEMI revealed combination of concentric and eccentric types of LV remodeling. Their hemodynamic parameters were comparable to those in patients with stable angina, but exceed the control data.Conclusion. In patients with acute MI severity of the LV remodeling correlated with the depth and vastness of myocardial damage. The most significant hemodynamic changes were observed in STEMI.

  9. Serum Iron Concentration, but Not Hemoglobin, Correlates with TIMI Risk Score and 6-Month Left Ventricular Performance after Primary Angioplasty for Acute Myocardial Infarction

    Ching-Hui Huang; Chia-Chu Chang; Chen-Ling Kuo; Ching-Shan Huang; Tzai-Wen Chiu; Chih-Sheng Lin; Chin-San Liu

    2014-01-01

    Objective Anemia is associated with high mortality and poor prognosis after acute coronary syndrome (ACS). Increased red cell distribution width (RDW) is a strong independent predictor for adverse outcomes in ACS. The common underlying mechanism for anemia and increased RDW value is iron deficiency. It is not clear whether serum iron deficiency without anemia affects left ventricular (LV) performance after primary angioplasty for acute myocardial infarction (AMI). We investigated the prognost...

  10. Impact of endothelial dysfunction on left ventricular remodeling after successful primary coronary angioplasty for acute myocardial infarction. Analysis by quantitative ECG-gated SPECT

    We hypothesized that endothelial cell integrity in the risk area would influence left ventricular remodeling after acute myocardial infarction. Twenty patients (61±8 y.o.) with acute myocardial infarction underwent 99mTc-tetrofosmin imaging in the sub-acute phase and three months after successful primary angioplasty due to myocardial infarction. All patients were administered angiotensin-converting enzyme inhibitor after revascularization. Cardiac scintigraphies with quantitative gated SPECT were performed at the sub-acute stage and again 3 months after revascularization to evaluate left ventricular (LV) remodeling. The left ventricular ejection fraction (EF) and end-systolic and end-diastolic volume (ESV, EDV) were determined using a quantitative gated SPECT (QGS) program. Three months after myocardial infarction, all patients underwent cardiac catheterization examination with coronary endothelial function testing. Bradykinin (BK) (0.2, 0.6, 2.0 μg/min) was administered via the left coronary artery in a stepwise manner. Coronary blood flow was evaluated by Doppler flow velocity measurement. Patients were divided into two groups by BK-response: a preserved endothelial function group (n=10) and endothelial dysfunction group (n=10). At baseline, both global function and LV systolic and diastolic volumes were similar in both groups. However, LV ejection fraction was significantly improved in the preserved-endothelial function group, compared with that in the endothelial dysfunction group (42±10% to 48±9%, versus 41±4% to 42±13%, p<0.05). LV volumes progressively increased in the endothelial dysfunction group compared to the preserved-endothelial function group (123±45 ml to 128±43 ml, versus 111±47 ml to 109±49 ml, p<0.05). In re-perfused acute myocardial infarction, endothelial function within the risk area plays an important role with left ventricular remodeling after myocardial infarction. (author)

  11. Left ventricular thrombus in patients with acute myocardial infarction: Case report and Caribbean focused update

    CR Potu; EE Tulloch-Reid; DS Baugh; EC Madu

    2012-01-01

    Despite the well documented benefit of echocardiography in acute coronary syndromes, its wide-scale use in the Caribbean is limited by access, health literacy and affordability. Because of the limited use of echocardiography in the region, routine complications of acute myocardial infarction (AMI) are not fully appreciated and may go unrecognized, further contributing to increased cardiovascular morbidity and mortality. It is therefore necessary to bring focus to this common clinical conditio...

  12. EFFECT OF LEFT VENTRICULAR SYSTOLIC DYSFUNCTION ON CEREBRAL HEMODYNAMICS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION (THE RESULTS OF OBSERVATIONAL STUDIES

    V. E. Kulikov

    2015-12-01

    Full Text Available Aim. To study the effect of left ventricular (LV systolic dysfunction on cerebral hemodynamic in patients with ST segment elevation myocardial infarction (STEMI during acute period. Material and methods. Cerebral hemodynamics ultrasound assessment was performed in the extra-and intracranial vessels in 118 patients with STEMI. Results. Significant changes in cerebral hemodynamics were found in LV systolic dysfunction with ejection fraction (LVEF ≤40% due to hemispheric blood flow asymmetry in the middle cerebral artery (MCA as large as 45.1±6.7% with correlation coefficient r=-0.87. Compensation of cerebral blood flow was manifested in vasoconstriction or vasodilation (resistive index 0.63-0.76 and 0.49-0.43 c.u., respectively. Conclusion. A strong relationship between LV systolic dysfunction and cerebral hemodynamic was found in patients with STEMI. It was manifested in significant contralateral hemispheric blood flow asymmetry in MCA in patients with LVEF ≤40%. Reduction in cerebral blood flow velocity activated autoregulation mechanism in the form of vasoconstriction or vasodilation.

  13. Clinical Characteristics and Risk Factors of Left Ventricular Thrombus after Acute Myocardial Infarction: A Matched Case-control Study

    Yue-Xin Jiang

    2015-01-01

    Conclusions: This study indicated that lower LVEF, extensive anterior myocardial infarction, severe RWMA, and left ventricular aneurysm were independent risk factors of LVT after AMI. It also suggested that further efforts are needed for the LVT diagnosis after AMI in clinical practice.

  14. Catecholaminergic activation in acute myocardial infarction: time course and relation to left ventricular performance

    Petersen, Claus Leth; Nielsen, Jens Rokkedal; Petersen, Bodil Laub;

    2003-01-01

    AIM: The study was designed to assess (1) the time course of catecholaminergic activation in acute myocardial infarction (AMI) as estimated by adrenaline (ADR) and noradrenaline (NOR) concentrations, and (2) to relate activation of these hormones to predict the outcome of cardiac performance...

  15. Clinical characteristics, left and right ventricular ejection fraction, and long-term prognosis in patients with non-insulin-dependent diabetes surviving an acute myocardial infarction

    Melchior, T; Gadsbøll, N; Hildebrandt, P;

    1996-01-01

    Patients with diabetes mellitus have a high morbidity and mortality from acute myocardial infarction, the reason for which is not fully understood. The relationship between congestive heart failure symptoms, left ventricular ejection fraction, and long-term mortality was examined in 578 hospital...... survivors of acute myocardial infarction, 47 of whom had Type 2 (non-insulin-dependent) diabetes mellitus. None of the patients were treated with insulin. The prevalence of congestive heart failure during hospitalization was similar in patients with and without diabetes, although mean diuretic dose was...... excess mortality in patients with non-insulin-dependent diabetes mellitus is not explained by available risk markers after myocardial infarction. Even though left ventricular ejection fraction and serum creatinine did not differ significantly, the apparent higher dose of Frusemide in patients with than...

  16. Predictors of ventricular remodelling in patients with reperfused acute myocardial infarction and left ventricular dysfunction candidates for bone marrow cell therapy: insights from the BONAMI trial

    Few data are available regarding the relation of left ventricular (LV) mechanical dyssynchrony to remodelling after acute myocardial infarction (MI) and stem cell therapy. We evaluated the 1-year time course of both LV mechanical dyssynchrony and remodelling in patients enrolled in the BONAMI trial, a randomized, multicenter controlled trial assessing cell therapy in patients with reperfused MI. Patients with acute MI and ejection fraction (EF) ≤ 45 % were randomized to cell therapy or to control and underwent thallium single-photon emission computed tomography (SPECT), radionuclide angiography, and echocardiography at baseline, 3 months, and 1 year. Eighty-three patients with a comprehensive 1-year follow-up were included. LV dyssynchrony was assessed by the standard deviation (SD) of the LV phase histogram using radionuclide angiography. Remodelling was defined as a 20 % increase in LV end-systolic volume index (LVESVI) at 1 year. At baseline, LVEF, wall motion score index, and perfusion defect size were significantly impaired in the 43 patients (52 %) with LV remodelling (all p < 0.001), without significant increase in LV mechanical dyssynchrony. During follow-up, there was a progressive increase in LV SD (p = 0.01). Baseline independent predictors of LV remodelling were perfusion SPECT defect size (p = 0.001), LVEF (p = 0.01) and a history of hypertension (p = 0.043). Bone marrow cell therapy did not affect the time-course of LV remodelling and dyssynchrony. LV remodelling 1 year after reperfused MI is associated with progressive LV dyssynchrony and is related to baseline infarct size and ejection fraction, without impact of cell therapy on this process. (orig.)

  17. Predictors of ventricular remodelling in patients with reperfused acute myocardial infarction and left ventricular dysfunction candidates for bone marrow cell therapy: insights from the BONAMI trial

    Manrique, Alain [Nuclear Medicine, CHU de Caen, Caen (France); Universite de Caen Normandie, EA 4650, Caen (France); CHU de Caen et GIP Cyceron, Caen cedex 6 (France); Lemarchand, Patricia; Delasalle, Beatrice; Lamirault, Guillaume; Trochu, Jean-Noel; Le Tourneau, Thierry [L' Institut du thorax, INSERM, UMR1087, Nantes (France); CNRS, UMR 6291, Nantes (France); Universite de Nantes, Nantes (France); CHU de Nantes, Nantes (France); Lairez, Olivier; Roncalli, Jerome [Institut CARDIOMET-Toulouse, Cardiac Imaging Center, CIC Biotherapies, CHU de Toulouse, Toulouse (France); Sportouch-Duckan, Catherine; Piot, Christophe [Universite Montpellier, Institut de Genomique Fonctionnelle, INSERM U661, CNRS UMR 5203, Montpellier (France); Clinique du Millenaire, Montpellier (France); Le Corvoisier, Philippe [Hopital Henri Mondor, INSERM, Centre d' Investigation Clinique 1430 et U955 equipe 3, Creteil (France); Neuder, Yannick [CHU de Grenoble, Pole Thorax et Vaisseaux, Grenoble (France); Richardson, Marjorie [CHRU Lille, Service d' Explorations Fonctionnelles Cardiovasculaires, Hopital Cardiologique, Lille (France); Lebon, Alain [CHU de Caen, Service de Cardiologie, Caen (France); Teiger, Emmanuel [Hopital Henri Mondor, AP-HP, Unite de Cardiologie Interventionnelle et Federation de Cardiologie, Creteil (France); Hossein-Foucher, Claude [Hopital Salengro CHRU de Lille, Service de Medecine Nucleaire, Lille (France); Universite de Lille 2, UFR de Medecine, Lille (France)

    2016-04-15

    Few data are available regarding the relation of left ventricular (LV) mechanical dyssynchrony to remodelling after acute myocardial infarction (MI) and stem cell therapy. We evaluated the 1-year time course of both LV mechanical dyssynchrony and remodelling in patients enrolled in the BONAMI trial, a randomized, multicenter controlled trial assessing cell therapy in patients with reperfused MI. Patients with acute MI and ejection fraction (EF) ≤ 45 % were randomized to cell therapy or to control and underwent thallium single-photon emission computed tomography (SPECT), radionuclide angiography, and echocardiography at baseline, 3 months, and 1 year. Eighty-three patients with a comprehensive 1-year follow-up were included. LV dyssynchrony was assessed by the standard deviation (SD) of the LV phase histogram using radionuclide angiography. Remodelling was defined as a 20 % increase in LV end-systolic volume index (LVESVI) at 1 year. At baseline, LVEF, wall motion score index, and perfusion defect size were significantly impaired in the 43 patients (52 %) with LV remodelling (all p < 0.001), without significant increase in LV mechanical dyssynchrony. During follow-up, there was a progressive increase in LV SD (p = 0.01). Baseline independent predictors of LV remodelling were perfusion SPECT defect size (p = 0.001), LVEF (p = 0.01) and a history of hypertension (p = 0.043). Bone marrow cell therapy did not affect the time-course of LV remodelling and dyssynchrony. LV remodelling 1 year after reperfused MI is associated with progressive LV dyssynchrony and is related to baseline infarct size and ejection fraction, without impact of cell therapy on this process. (orig.)

  18. Plasma YKL-40 and recovery of left ventricular function after acute myocardial infarction

    Hedegaard, A.; Ripa, Maria Sejersten; Johansen, J.S.;

    2010-01-01

    Background: Plasma YKL-40 is increased early in patients with ST-elevation myocardial infarction (STEMI). It is not known whether plasma YKL-40 is related to infarct size and recovery of ventricular function after primary percutaneous coronary intervention (PCI) of STEMI and whether granulocyte...... colony-stimulating factor (G-CSF) therapy influence plasma YKL-40 concentration. Materials and methods: A total of 72 patients (age: 56 +/- 9 years (mean +/- SD), 56 men and 16 women) with STEMI treated with PCI were included in a double-blind, randomized, placebo-controlled trial with subcutaneous G...... baseline and after 6 months. Results: Baseline plasma YKL-40 was increased (median 92 mu g/L) compared to healthy subjects(median 34 mu g/L, p <0.001). In the placebo group hs-CRP and YKL-40 correlated at baseline (p = 0.04) and day 3 (p = 0.01), but not at day 7 and 30. Moreover, YKL-40 correlated...

  19. Plasma YKL-40 and recovery of left ventricular function after acute myocardial infarction

    Hedegaard, A.; Ripa, Maria Sejersten; Johansen, J.S.;

    2010-01-01

    Background: Plasma YKL-40 is increased early in patients with ST-elevation myocardial infarction (STEMI). It is not known whether plasma YKL-40 is related to infarct size and recovery of ventricular function after primary percutaneous coronary intervention (PCI) of STEMI and whether granulocyte...... colony-stimulating factor (G-CSF) therapy influence plasma YKL-40 concentration. Materials and methods: A total of 72 patients (age: 56 +/- 9 years (mean +/- SD), 56 men and 16 women) with STEMI treated with PCI were included in a double-blind, randomized, placebo-controlled trial with subcutaneous G...... baseline and after 6 months. Results: Baseline plasma YKL-40 was increased (median 92 mu g/L) compared to healthy subjects (median 34 mu g/L, p <0.001). In the placebo group hs-CRP and YKL-40 correlated at baseline (p = 0.04) and day 3 (p = 0.01), but not at day 7 and 30. Moreover, YKL-40 correlated...

  20. Changes in left ventricular function and wall thickness in heart transplant recipients and their relation to acute rejection: an assessment by digitised M mode echocardiography

    Mannaerts, H F J; Balk, Aggie; Simoons, Maarten; Tijssen, Jan,; Borden, S.G.; Sutherland, G. R.; Roelandt, Jos; Zondervan, Pieter

    1992-01-01

    textabstractOBJECTIVE--Assessment of changes in left ventricular diastolic function and wall thickness after heart transplantation to verify whether these changes predicted acute rejection assessed by endomyocardial biopsy. DESIGN--Follow up according to a predefined protocol of consecutive patients from the first week after transplantation. SETTING--Heart transplantation unit of the Thoraxcentre, University Hospital Rotterdam Dijkzigt, The Netherlands. PATIENTS--All 32 patients undergoing or...

  1. Right ventricular ejection fraction in patients with acute myocardial infarction assessed by 81m-krypton perfusion. Correlations with left ventricular ejection fraction as a function of myocardial infarction localization

    The right ventricular ejection fraction has been measured from right anterior oblique (R.A.O. 300). Immediatly after this measurement, the left ventricular ejection fraction (L.V.E.F.) has been determined from left anterior oblique (L.A.O.) with 99m-technetium labelled red cells. In 16 normal controls, R.V.E.F. averaged 38+-6,7%. In 24 anterior M.I., R.V.E.F. was normal (43,4+-9,5%). In 33 acute inferior M.I., R.V.E.F. was 35+-8,4%. Among 5 of 33 inferior M.I. patients with right ventricular infarction, R.V.E.F. was reduced (14,6+-4,7%; p-3 V.S. normal and V.S. inferior M.I. without right ventricular involvement). In the latter group, R.V.E.F. averaged 38,6+-8,9% (N.S.V.S. normals). To conclude, this study shows: (1) The use of intraveinous 81 m-krypton allows measuring R.V.E.F. from R.A.O.: this angle brings out the best separation between the right atrium and the right ventricular with no intrusion of a superimposed left ventricle, since 81 m-krypton is expelled at the first lung wash out. (2) R.V.E.F. is well preserved except when inferior infarction involves the right ventricle

  2. Effect of the angiotensin-converting enzyme inhibitor trandolapril on mortality and morbidity in diabetic patients with left ventricular dysfunction after acute myocardial infarction. Trace Study Group

    Gustafsson, I; Torp-Pedersen, C; Køber, L;

    1999-01-01

    OBJECTIVES: This study evaluated the efficacy of long-term treatment with the angiotensin-converting enzyme (ACE) inhibitor trandolapril in diabetic patients with left ventricular dysfunction after acute myocardial infarction (AMI). BACKGROUND: Patients with diabetes mellitus have a high mortality...... following AMI, probably due to a high risk of congestive heart failure and reinfarction. Because ACE inhibition effectively reduces progression of heart failure, it could be particularly beneficial in diabetic patients after AMI. METHODS: The study is a retrospective analysis using data from.......21 to 0.67]), and no significant reduction of this end point was found in the nondiabetic group. CONCLUSIONS: The ACE inhibition after myocardial infarction complicated by left ventricular dysfunction appears to be of considerable importance in patients with diabetes mellitus by saving lives...

  3. Short-term pretreatment with atorvastatin attenuates left ventricular dysfunction, reduces infarct size and apoptosis in acute myocardial infarction rats

    Chen, Tie-Long; Zhu, Guang-Li; He, Xiao-Long; Wang, Jian-an; Yu WANG; Qi, Guo-An

    2014-01-01

    Background: Atorvastatin showed a number of cardiovascular benefits, however, the role and underlying molecular mechanisms of short-term atorvastatin-mediated protection remain unclear. Methods: 30 rats were randomly divided into 3 groups: sham group, acute myocardial infarction model group and atorvastatin group. The rats of acute myocardial infarction model were established by ligation of the left anterior descending of coronary arteries. Before surgery, rats in the atorvastatin group recei...

  4. Left ventricular pseudoaneurysm after reimplantation procedure.

    Inoue, Takahiro; Hashimoto, Kazuhiro; Sakamoto, Yoshimasa; Yoshitake, Michio; Matsumura, Yoko; Kinami, Hiroo; Takagi, Tomomitsu

    2016-04-01

    Postoperative left ventricular pseudoaneurysm is a rare, but potentially lethal, complication because of the high risk of rupture and high mortality of repair. We report a 64-year-old man with Marfan syndrome who underwent the reimplantation valve-sparing aortic root replacement complicated by a postoperative left ventricular pseudoaneurysm that required urgent repair. Careful handling of the aortic root is required to avoid a left ventricular pseudoaneurysm, particularly in patients with connective tissue disorder. PMID:24917204

  5. A panel of 4 microRNAs facilitates the prediction of left ventricular contractility after acute myocardial infarction.

    Yvan Devaux

    Full Text Available BACKGROUND: Prediction of clinical outcome after acute myocardial infarction (AMI is challenging and would benefit from new biomarkers. We investigated the prognostic value of 4 circulating microRNAs (miRNAs after AMI. METHODS: We enrolled 150 patients after AMI. Blood samples were obtained at discharge for determination of N-terminal pro-brain natriuretic peptide (Nt-proBNP and levels of miR-16, miR-27a, miR-101 and miR-150. Patients were assessed by echocardiography at 6 months follow-up and the wall motion index score (WMIS was used as an indicator of left ventricular (LV contractility. We assessed the added predictive value of miRNAs against a multi-parameter clinical model including Nt-proBNP. RESULTS: Patients with anterior AMI and elevated Nt-proBNP levels at discharge from the hospital were at high risk of subsequent impaired LV contractility (follow-up WMIS>1.2, n = 71. A combination of the 4 miRNAs (miR-16/27a/101/150 improved the prediction of LV contractility based on clinical variables (P = 0.005. Patients with low levels of miR-150 (odds ratio [95% confidence interval] 0.08 [0.01-0.48] or miR-101 (0.19 [0.04-0.97] and elevated levels of miR-16 (15.9 [2.63-95.91] or miR-27a (4.18 [1.36-12.83] were at high risk of impaired LV contractility. The 4 miRNA panel reclassified a significant proportion of patients with a net reclassification improvement of 66% (P = 0.00005 and an integrated discrimination improvement of 0.08 (P = 0.001. CONCLUSION: Our results indicate that panels of miRNAs may aid in prognostication of outcome after AMI.

  6. Successful Medical Management of a Left Ventricular Thrombus and Aneurysm Following Failed Thrombolysis in Myocardial Infarction

    Oyedeji, Adebayo T.; Christopher Lee; Owojori, Olukolade O.; Ajegbomogun, Olabanji J; Adeseye A Akintunde

    2013-01-01

    We report the case of a patient with an extensive anterior myocardial infarction complicated by left ventricular systolic dysfunction, left ventricular apical thrombus and an apical left ventricular aneurysm following failed thrombolysis. We obtained serial two-dimensional echocardiograms at short intervals in the acute phase and also during the months of recovery and follow up. The patient was successfully and exclusively medically managed.

  7. Effect of ACE inhibitor trandolapril on life expectancy of patients with reduced left-ventricular function after acute myocardial infarction. TRACE Study Group. Trandolapril Cardiac Evaluation

    Torp-Pedersen, C; Køber, L

    1999-01-01

    BACKGROUND: The survival benefit from the use of inhibitors of angiotensin-converting enzyme (ACE) in patients with acute myocardial infarction is usually presented in terms of risk ratios and lives saved per 1000 people treated. A more relevant way to present the extent of benefit would......-blind treatment; continued use of trandolapril was recommended at study closure. INTERPRETATION: In patients with severely reduced left-ventricular function, long-term treatment with an ACE inhibitor during the critical period after myocardial infarction is associated with a substantial increase in life...

  8. Importance of congestive heart failure and interaction of congestive heart failure and left ventricular systolic function on prognosis in patients with acute myocardial infarction

    Køber, L; Torp-Pedersen, C; Pedersen, O D;

    1996-01-01

    Left ventricular (LV) systolic function and congestive heart failure (CHF) are important predictors of long-term mortality after acute myocardial infarction. The importance of transient CHF and the interaction of CHF and LV function on prognosis has not been studied in detail previously. In the......-term mortality, separate analyses were performed in patients with different levels of LV function. Risk ratio (95% confidence intervals [CI]) were determined from proportional hazard models subgrouped by wall motion index or CHF adjusted for age and gender. Heart failure was separated into transient or...

  9. Fractal correlation properties of R-R interval dynamics and mortality in patients with depressed left ventricular function after an acute myocardial infarction

    Huikuri, H. V.; Makikallio, T. H.; Peng, C. K.; Goldberger, A. L.; Hintze, U.; Moller, M.

    2000-01-01

    BACKGROUND: Preliminary data suggest that the analysis of R-R interval variability by fractal analysis methods may provide clinically useful information on patients with heart failure. The purpose of this study was to compare the prognostic power of new fractal and traditional measures of R-R interval variability as predictors of death after acute myocardial infarction. METHODS AND RESULTS: Time and frequency domain heart rate (HR) variability measures, along with short- and long-term correlation (fractal) properties of R-R intervals (exponents alpha(1) and alpha(2)) and power-law scaling of the power spectra (exponent beta), were assessed from 24-hour Holter recordings in 446 survivors of acute myocardial infarction with a depressed left ventricular function (ejection fraction acute myocardial infarction.

  10. A rare combination of undiagnosed hypertrophic cardiomyopathy revealed by intraoperative anaphylaxis resulting in acute left ventricular outflow obstruction and cardiac arrest.

    Smith, Bradford B; Nickels, Andrew S; Sviggum, Hans P

    2016-06-01

    A 75-year-old female presented for left total hip reimplantation and suffered pulseless electrical activity arrest upon lateral positioning and administering vancomycin. Resuscitation was achieved according to Advanced Cardiac Life Support protocol. Post-event echocardiography showed hypertrophic cardiomyopathy with asymmetrical septal thickening, an under-filled left ventricle, dynamic left ventricular outflow obstruction, and severe mitral regurgitation related to systolic anterior motion of the mitral valve. Laboratory analysis showed a tryptase level of 209 ng/mL. After multispecialty evaluation, it was concluded that the patient's arrest was due to vancomycin anaphylaxis in the setting of previously undiagnosed hypertrophic cardiomyopathy leading to acute left ventricular outflow tract obstruction. After medical optimization of the patient's cardiomyopathy and an evaluation of potential intraoperative allergic triggers, the patient underwent a successful hip reimplantation without incident. This case presents a novel combination of events leading to intraoperative cardiac arrest. Rapid identification and an understanding of the cause(s) of cardiac arrest in this setting are critical for effective perioperative care. PMID:27185714

  11. The impact of glucose-insulin-potassium infusion in acute myocardial infarction on infarct size and left ventricular ejection fraction [ISRCTN56720616

    Gosselink AT Marcel

    2005-06-01

    Full Text Available Abstract Background Favorable clinical outcomes have been observed with glucose-insulin-potassium infusion (GIK in acute myocardial infarction (MI. The mechanisms of this beneficial effect have not been delineated clearly. GIK has metabolic, anti-inflammatory and profibrinolytic effects and it may preserve the ischemic myocardium. We sought to assess the effect of GIK infusion on infarct size and left ventricular function, as part of a randomized controlled trial. Methods Patients (n = 940 treated for acute MI by primary percutaneous coronary intervention (PCI were randomized to GIK infusion or no infusion. Endpoints were the creatinine kinase MB-fraction (CK-MB and left ventricular ejection fraction (LVEF. CK-MB levels were determined 0, 2, 4, 6, 24, 48, 72 and 96 hours after admission and the LVEF was measured before discharge. Results There were no differences between the two groups in the time course or magnitude of CK-MB release: the peak CK-MB level was 249 ± 228 U/L in the GIK group and 240 ± 200 U/L in the control group (NS. The mean LVEF was 43.7 ± 11.0 % in the GIK group and 42.4 ± 11.7% in the control group (P = 0.12. A LVEF ≤ 30% was observed in 18% in the controls and in 12% of the GIK group (P = 0.01. Conclusion Treatment with GIK has no effect on myocardial function as determined by LVEF and by the pattern or magnitude of enzyme release. However, left ventricular function was preserved in GIK treated patients.

  12. A systematic review: effect of angiotensin converting enzyme inhibition on left ventricular volumes and ejection fraction in patients with a myocardial infarction and in patients with left ventricular dysfunction

    Abdulla, Jawdat; Barlera, Simona; Latini, Roberto;

    2006-01-01

    BACKGROUND AND AIM: To summarize and quantify results of echocardiographic studies examining the effect of angiotensin converting enzyme (ACE) inhibition on left ventricular remodelling in patients with acute myocardial infarction (MI) and in patients with left ventricular systolic dysfunction (L...

  13. Serum MMP-8: a novel indicator of left ventricular remodeling and cardiac outcome in patients after acute myocardial infarction.

    Marie Fertin

    Full Text Available OBJECTIVE: Left ventricular (LV remodeling following myocardial infarction (MI is characterized by progressive alterations of structure and function, named LV remodeling. Although several risk factors such as infarct size have been identified, LV remodeling remains difficult to predict in clinical practice. Changes within the extracellular matrix, involving matrix metalloproteinases (MMPs and tissue inhibitors of metalloproteinases (TIMPs, are an integral part of left ventricular (LV remodeling after myocardial infarction (MI. We investigated the temporal profile of circulating MMPs and TIMPs and their relations with LV remodeling at 1 year and clinical outcome at 3 years in post-MI patients. METHODS: This prospective multicentre study included 246 patients with a first anterior MI. Serial echocardiographic studies were performed at hospital discharge, 3 months, and 1 year after MI, and analysed at a core laboratory. LV remodeling was defined as the percent change in LV end-diastolic volume (EDV from baseline to 1 year. Serum samples were obtained at hospital discharge, 1, 3, and 12 months. Multiplex technology was used for analysis of MMP-1, -2, -3, -8, -9, -13, and TIMP-1, -2, -3, -4 serum levels. RESULTS: Baseline levels of MMP-8 and MMP-9 were positively associated with changes in LVEDV (P = 0.01 and 0.02, respectively. When adjusted for major baseline characteristics, MMP-8 levels remained an independent predictor LV remodeling (P = 0.025. By univariate analysis, there were positive relations between cardiovascular death or hospitalization for heart failure during the 3-year follow-up and the baseline levels of MMP-2 (P = 0.03, MMP-8 (P = 0.002, and MMP-9 (P = 0.03. By multivariate analysis, MMP-8 was the only MMP remaining significantly associated with clinical outcome (P = 0.02. CONCLUSION: Baseline serum MMP-8 is a significant predictor of LV remodeling and cardiovascular outcome after MI and may help to improve

  14. Association of the beta-1 adrenergic receptor carboxyl terminal variants with left ventricular hypertrophy among diabetic and non-diabetic survivors of acute myocardial infarction

    Hakalahti Anna E

    2010-08-01

    Full Text Available Abstract Background The beta-1 adrenergic receptor (β1AR plays a fundamental role in the regulation of cardiovascular functions. It carries a nonsynonymous single nucleotide polymorphism in its carboxyl terminal tail (Arg389Gly, which has been shown to associate with various echocardiographic parameters linked to left ventricular hypertrophy (LVH. Diabetes mellitus (DM, on the other hand, represents a risk factor for LVH. We investigated the possible association between the Arg389Gly polymorphism and LVH among non-diabetic and diabetic acute myocardial infarction (AMI survivors. Methods The study population consisted of 452 AMI survivors, 20.6% of whom had diagnosed DM. Left ventricular parameters were measured with two-dimensional guided M-mode echocardiography 2-7 days after AMI, and the Arg389Gly polymorphism was determined using a polymerase chain reaction-restriction fragment length polymorphism assay. Results The Arg389 homozygotes in the whole study population had a significantly increased left ventricular mass index (LVMI when compared to the Gly389 carriers (either Gly389 homozygotes or Arg389/Gly389 heterozygotes [62.7 vs. 58.4, respectively (p = 0.023]. In particular, the Arg389 homozygotes displayed thicker diastolic interventricular septal (IVSd measures when compared to the Gly389 carriers [13.2 vs. 12.3 mm, respectively (p = 0.004]. When the euglycemic and diabetic patients were analyzed separately, the latter had significantly increased LVMI and diastolic left ventricular posterior wall (LVPWd values compared to the euglycemic patients [LVMI = 69.1 vs. 58.8 (p = 0.001 and LVPWd = 14.2 vs. 12.3 mm (p Conclusions The data suggest an association between the β1AR Arg389Gly polymorphism and LVH, particularly the septal hypertrophy. The Arg389 variant appears to confer a higher risk of developing LVH than the corresponding Gly389 variant among patients who have suffered AMI. This association cannot be considered to be universal

  15. Case series: Congenital left ventricular diverticulum

    Shah Dharita

    2010-01-01

    Full Text Available Congenital left ventricular diverticulum is a rare cardiac malformation characterized by a localized outpouching from the cardiac chamber. The patient is usually asymptomatic. However, complications like embolism, infective endocarditis, arrhythmia and, rarely, rupture can be the initial presentation. Diagnosis can be established by USG, echocardiography, CT angiography, and MRI. We report here two neonates with congenital left ventricular apical diverticulum associated with epigastric hernia.

  16. Left ventricular noncompaction in Duchenne muscular dystrophy

    Statile, Christopher J; Taylor, Michael D.; Mazur, Wojciech; Cripe, Linda H.; KING, EILEEN; Pratt, Jesse; Benson, D. Woodrow; Hor, Kan N

    2013-01-01

    Background Left ventricular noncompaction (LVNC) describes deep trabeculations in the left ventricular (LV) endocardium and a thinned epicardium. LVNC is seen both as a primary cardiomyopathy and as a secondary finding in other syndromes affecting the myocardium such as neuromuscular disorders. The objective of this study is to define the prevalence of LVNC in the Duchenne Muscular Dystrophy (DMD) population and characterize its relationship to global LV function. Methods Cardiac magnetic res...

  17. Left ventricular non-compaction cardiomyopathy and left ventricular assist device: a word of caution

    Kornberger, A.; Stock, U. A.; Risteski, P.; Beiras Fernandez, A.

    2016-01-01

    Background In patients with left ventricular non-compaction (LVNC), implantation of a left ventricular assist device (LVAD) may be performed as a bridge to transplantation. In this respect, the particular characteristics of the left ventricular myocardium may represent a challenge. Case presentation We report a patient with LVNC who required urgent heart transplantation for inflow cannula obstruction nine months after receiving a LVAD. LVAD parameters, echocardiography and examination of the ...

  18. Fractal analysis of heart rate dynamics as a predictor of mortality in patients with depressed left ventricular function after acute myocardial infarction. TRACE Investigators. TRAndolapril Cardiac Evaluation

    Mäkikallio, T H; Høiber, S; Køber, L;

    1999-01-01

    A number of new methods have been recently developed to quantify complex heart rate (HR) dynamics based on nonlinear and fractal analysis, but their value in risk stratification has not been evaluated. This study was designed to determine whether selected new dynamic analysis methods of HR...... variability predict mortality in patients with depressed left ventricular (LV) function after acute myocardial infarction (AMI). Traditional time- and frequency-domain HR variability indexes along with short-term fractal-like correlation properties of RR intervals (exponent alpha) and power-law scaling...... (exponent beta) were studied in 159 patients with depressed LV function (ejection fraction <35%) after an AMI. By the end of 4-year follow-up, 72 patients (45%) had died and 87 (55%) were still alive. Short-term scaling exponent alpha (1.07 +/- 0.26 vs 0.90 +/- 0.26, p <0.001) and power-law slope beta (-1...

  19. Left ventricular assessment in myocardial infarction - The VALIANT registry

    Hernandez, AF; Velazquez, EJ; Solomon, SD; Kilaru, R; Diaz, R; O'Connor, CM; Ertl, G; Maggioni, AP; Rouleau, JL; van Gilst, W; Pfeffer, MA; Califf, RM

    2005-01-01

    Background: How often echocardiography and cardiac catheterization are used to evaluate left ventricular (LV) function in patients with myocardial infarction (MI) and how they are associated with quality of care is unknown. Methods: Patients with MI in the Valsartan in Acute Myocardial Infarction (V

  20. Left ventricular pseudoaneurysm versus aneurysm a diagnosis dilemma

    Bisoyi, Samarjit; Dash, Anjan K.; Nayak, Debashish; Sahoo, Satyajit; Mohapatra, Raghunath

    2016-01-01

    Free wall rupture of the left ventricle (LV) is a rare but life-threatening complication of acute myocardial infaction. Very rarely such rupture may be contained by the adhering pericardium creating a pseudoaneurysm. This condition warrants for an emergency surgery. Left ventricular aneurysm is the discrete thinning of the ventricular wall (Clinically differentiating the two conditions remains a challenge. We report the case of a patient with LV pseudoaneurysm, initially diagnosed as true aneurysm at our institution. We have attempted to review the existing literature and discussed the characteristic findings of each entity. PMID:26750696

  1. Assessment of left ventricular segmental function after autologous bone marrow stem cells transplantation in patients with acute myocardial infarction by tissue tracking and strain imaging

    RUAN Wen; PAN Cui-zhen; HUANG Guo-qian; LI Yan-lin; GE Jun-bo; SHU Xian-hong

    2005-01-01

    Background Emerging evidence suggests that stem cells can be used to improve cardiac function in patients after acute myocardial infarction. In this randomized trial, we aimed to use Doppler tissue tracking and strain imaging to assess left ventricular segmental function after intracoronary transfer of autologous bone-marrow stem cells (BMCs) for 6 months' follow up. Methods Twenty patients with acute myocardial infarction and anterior descending coronary artery occlusion proven by angiography were double-blindedly randomized into intracoronary injection of bone-marrow cell (treated, n=9) or diluted serum (control, n=11) groups. GE vivid 7 and Q-analyze software were used to perform echocardiogram in both groups 1 week, 3 months and 6 months after treatment. Three apical views of tissue Doppler imaging were acquired to measure peak systolic displacement (Ds) and peak systolic strain (εpeak) from 12 segments of LV walls. Left ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume (ESV) were obtained by Simposon's biplane method. Results (1) 3 months later, Ds and εpeak over the infract-related region clearly increased in the BMCs group [Ds: (4.49±2.71) mm vs (7.56±2.95) mm, P0.05; εpeak : (-13.84±6.05)% vs (-15.04±6.75)%, P>0.05]. At the same time, Ds over the normal region also increased, but the Ds enhancement was markedly higher in the BMCs group than that in the control group [(3.21±3.17) mm vs (0.76±1.94) mm, P0.05). (2) LVEF in treated and control groups were almost the same at baseline (1st week after PCI) [(53.37±8.92)% vs (53.51±5.84)%, P>0.05]. But 6 months later, LVEF in the BMCs group were clearly higher than that in the control group [(59.33±12.91)% vs (50.30±8.30)%, P0.05; ESV: (57.12±18.66) ml vs (62.09±17.68) ml, P>0.05]. Three months later, EDV and ESV in the control group were markedly greater than those in the BMCs group [EDV: (154.89±46.34) ml vs (104.85±33.21) ml, P0.05). Conclusions Emergency

  2. Impact of Left Ventricular Hypertrophy on Troponin Release During Acute Myocardial Infarction: New Insights From a Comprehensive Translational Study

    Fernández‐Jiménez, Rodrigo; Silva, Jacobo; Martínez‐Martínez, Sara; López‐Maderuelo, Mª Dolores; Nuno‐Ayala, Mario; García‐Ruiz, José Manuel; García‐Álvarez, Ana; Fernández‐Friera, Leticia; Pizarro, Tech Gonzalo; García‐Prieto, Jaime; Sanz‐Rosa, David; López‐Martin, Gonzalo; Fernández‐Ortiz, Antonio; Macaya, Carlos; Fuster, Valentin; Redondo, Juan Miguel; Ibanez, Borja

    2015-01-01

    Background Biomarkers are frequently used to estimate infarct size (IS) as an endpoint in experimental and clinical studies. Here, we prospectively studied the impact of left ventricular (LV) hypertrophy (LVH) on biomarker release in clinical and experimental myocardial infarction (MI). Methods and Results ST‐segment elevation myocardial infarction (STEMI) patients (n=140) were monitored for total creatine kinase (CK) and cardiac troponin I (cTnI) over 72 hours postinfarction and were examined by cardiac magnetic resonance (CMR) at 1 week and 6 months postinfarction. MI was generated in pigs with induced LVH (n=10) and in sham‐operated pigs (n=8), and serial total CK and cTnI measurements were performed and CMR scans conducted at 7 days postinfarction. Regression analysis was used to study the influence of LVH on total CK and cTnI release and IS estimated by CMR (gold standard). Receiver operating characteristic (ROC) curve analysis was performed to study the discriminatory capacity of the area under the curve (AUC) of cTnI and total CK in predicting LV dysfunction. Cardiomyocyte cTnI expression was quantified in myocardial sections from LVH and sham‐operated pigs. In both the clinical and experimental studies, LVH was associated with significantly higher peak and AUC of cTnI, but not with differences in total CK. ROC curves showed that the discriminatory capacity of AUC of cTnI to predict LV dysfunction was significantly worse for patients with LVH. LVH did not affect the capacity of total CK to estimate IS or LV dysfunction. Immunofluorescence analysis revealed significantly higher cTnI content in hypertrophic cardiomyocytes. Conclusions Peak and AUC of cTnI both significantly overestimate IS in the presence of LVH, owing to the higher troponin content per cardiomyocyte. In the setting of LVH, cTnI release during STEMI poorly predicts postinfarction LV dysfunction. LV mass should be taken into consideration when IS or LV function are estimated by troponin

  3. Right and left ventricular ejection fraction after an acute inferior wall myocardial infarction and the value of V4R to predict the site of obstruction

    Braat, S.H.; Brugada, P.; Den Dulk, K.; Wellens, H.J.J.

    1984-01-01

    This study was undertaken to compare the right (RVEF) and left ventricular ejection fraction (LVEF) after an acute inferior wall myocardial infarction (MI) caused by an obstruction in the right coronary artery (RCA) or circumflex coronary artery (CX) and to evaluate the value of lead V4R to predict the site of stenosis which caused the MI. In 42 consecutive patients (pts) admitted with an acute inferior wall MI a standard ECG and V4R were recorded. A nuclear angiogram was made one week after the acute MI and the RVEF and LVEF were calculated. Ten to 14 days (mean 12.7) after the acute MI a coronary angiogram was performed to determine the site of occlusion, which had caused the acute MI. According to the site of occlusion the pts were divided in three groups: Group A: the stenosis which had caused the MI was located in the RCA above the first branch to the right ventricle (RV); Group B: the stenosis was below the first branch to the RV in the RCA and Group C: the stenosis was located in the CX. The RVEF and LVEF in these groups are given. Nineteen pts had ST-segment elevation greater than or equal to 1 mm in V/sub 4/R and 17 of these pts had an obstruction above the first branch to the RV in the RCA. There is statistically no significant difference between the LVEF in the three different groups while the RVEF is significantly lower in group A. These pts can be identified by recording V4R.

  4. COMPARISON OF THE EFFECTS OF LOSARTAN, ENALAPRIL AND THEIR COMBINATION IN THE PREVENTION OF LEFT VENTRICULAR REMODELING AFTER ACUTE MYOCARDIAL INFARCTION IN THE RAT

    杨跃进; 张沛; 阮英茆; 宋来凤; 徐新林; 李永利; 周燕文; 田毅; 徐义枢; 陈在嘉

    2002-01-01

    Objectives. To compare the effects of losartan, enalapril and their combination in the prevention ofleft ventricular remodeling (LVRM) after acute myocardial infarction (AMI) in the rat. Methods. AMI model was induced in female SD rats by ligating left coronary artery. Forty-eight hours after the procedure, 83 surviving rats were randomized into one of the following 4 groups: 1 ) AMI control group (n =19), 2) losartan group (n= 22, 3 mg @ kg - 1 @ d - 1 ), 3 ) enalapril group (n = 20, 1 mg @ kg - 1 @ d - 1 ), 4) losartan - enalapril combinative group (n = 22, 3 and 1 mg @ kg- 1 @ d - 1 respectively). 5 ) sham-operated group ( n =10) and 6) normal rats group (n = 10) were selected randomly to serve as non-infarction controls. Losartan and enalapril were delivered by direct gastric gavage. After 4 weeks of medical therapy, hemodynamic studies were performed in each group, then the rat hearts were fixed with 10% formalin and pathologic analysis on them was performed. Complete experimental data was obtained in 56 rats, comprising 1 ) AMI controls (n = 11 ), 2) losartan group (n = 10), 3 ) enalapril group (n = 10), 4) the combination of losartan and enalapril group (n = 11 ),5) sham - operated group (n = 6) and 6) normal controls (n=8). Results. There were no significant differences among the 4 AMI groups in MI size (41.7% ~ 43.4%, all P> 0.05). Compared with sham group, the left ventricular (LV) end diastolic pressure (LVEDP), volume (LVV), long and short axis length (L and D), as well as LV absolute and relative weight (LVAW and LVRW)in AMI group were all significantly increased ( P <0.05 ~ 0. 001 ); whereas the maximum left ventricular pressure rising and droping rates ( + dp/dt) and their corrected values by LV systolic pressure ( + dp/dt/LVSP)were significantly reduced (all P <0.001 ), indicating LVRM occurred and LV systolic and diastolic function impaired after AMI. Compared with AMI group , LVEDP, LVV, LVAW and LVRW were all significantly decreased (P

  5. Establishment of a chronic left ventricular aneurysm model in rabbit

    Cang-Song XIAO; Chang-Qing GAO; Li-Bing LI; Yao WANG; Tao ZHAO; Wei-Hua YE; Chong-Lei REN; Zhi-Yong LIU; Yang WU

    2014-01-01

    Objectives To establish a cost-effective and reproducible procedure for induction of chronic left ventricular aneurysm (LVA) in rabbits. Methods Acute myocardial infarction (AMI) was induced in 35 rabbits via concomitant ligation of the left anterior descending (LAD) coronary artery and the circumflex (Cx) branch at the middle portion. Development of AMI was co n-firmed by ST segment elevation and akinesis of the occluded area. Echocardiography, pathological evaluation, and agar i n-tra-chamber casting were utilized to validate the formation of LVA four weeks after the surgery. Left ventricular end systolic pressure (LVESP) and diastolic pressure (LVEDP) were measured before, immediately after and four weeks after ligation. D i-mensions of the ventricular chamber, thickness of the interventricular septum (IVS) and the left ventricular posterior wall (LVPW) left ventricular end diastolic volume (LVEDV) and systolic volume (LVESV), and ejection fraction (EF) were recorded by echo-cardiography. Results Thirty one (88.6%) rabbits survived myocardial infarction and 26 of them developed aneurysm (83.9%). The mean area of aneurysm was 33.4% ± 2.4% of the left ventricle. LVEF markedly decreased after LVA formation, whereas LVEDV, LVESV and the thickness of IVS as well as the dimension of ventricular chamber from apex to mitral valve annulus significantly increased. LVESP immediately dropped after ligation and recovered to a small extent after LVA formation. LVEDP progressively increased after ligation till LVA formation. Areas in the left ventricle (LV) that underwent fibrosis included the apex, anterior wall and lateral wall but not IVS. Agar intra-chamber cast showed that the bulging of LV wall was prominent in the area of aneurysm. Conclusions Ligation of LAD and Cx at the middle portion could induce develo pment of LVA at a mean area ratio of 33.4%±2.4%which involves the apex, anterior wall and lateral wall of the LV.

  6. Echocardiographic predictors of early in-hospital heart failure during first ST-elevation acute myocardial infarction: does myocardial performance index and left atrial volume improve diagnosis over conventional parameters of left ventricular function?

    Machado Cristiano V

    2011-06-01

    Full Text Available Abstract Background Left ventricular ejection fraction (LVEF has been considered a major determinant of early outcome in acute myocardial infarction (AMI. Myocardial performance index (MPI has been associated to early evolution in AMI in a heterogeneous population, including non ST-elevation or previous AMI. Left atrial volume has been related with late evolution after AMI. We evaluated the independent role of clinical and echocardiographic variables including LVEF, MPI and left atrial volume in predicting early in-hospital congestive heart failure (CHF specifically in patients with a first isolated ST-elevation AMI. Methods Echocardiography was performed within 30 hours of chest pain in 95 patients with a first ST-elevation AMI followed during the first week of hospitalization. Several clinical and echocardiographic variables were analyzed. CHF was defined as Killip class ≥ II. Multivariate regression analysis was used to select independent predictor of in-hospital CHF. Results Early in-hospital CHF occurred in 29 (31% of patients. LVEF ≤ 0.45 was the single independent and highly significant predictor of early CHF among other clinical and echocardiographic variables (odds ratio 17.0; [95% CI 4.1 - 70.8]; p Conclusion For patients with first, isolated ST-elevation AMI, LVEF assessed by echocardiography still constitutes a strong and accurate independent predictor of early in-hospital CHF, superior to isolated MPI and left atrial volume in this particular subset of patients.

  7. Left Ventricular Noncompaction: A Distinct Genetic Cardiomyopathy?

    Arbustini, Eloisa; Favalli, Valentina; Narula, Nupoor; Serio, Alessandra; Grasso, Maurizia

    2016-08-30

    Left ventricular noncompaction (LVNC) describes a ventricular wall anatomy characterized by prominent left ventricular (LV) trabeculae, a thin compacted layer, and deep intertrabecular recesses. Individual variability is extreme, and trabeculae represent a sort of individual "cardioprinting." By itself, the diagnosis of LVNC does not coincide with that of a "cardiomyopathy" because it can be observed in healthy subjects with normal LV size and function, and it can be acquired and is reversible. Rarely, LVNC is intrinsically part of a cardiomyopathy; the paradigmatic examples are infantile tafazzinopathies. When associated with LV dilation and dysfunction, hypertrophy, or congenital heart disease, the genetic cause may overlap. The prevalence of LVNC in healthy athletes, its possible reversibility, and increasing diagnosis in healthy subjects suggests cautious use of the term LVNC cardiomyopathy, which describes the morphology but not the functional profile of the cardiomyopathy. PMID:27561770

  8. Cerebrovascular complications of left ventricular assist devices

    Backes, Daan; van den Bergh, Walter M; van Duijn, Abram L; Lahpor, Jaap R; van Dijk, Diederik; Slooter, Arjen J C

    2012-01-01

    Left ventricular assist devices (LVADs) are increasingly being used as a bridge to heart transplantation or destination therapy. It is unclear which antithrombotic regimen should be used to reduce the risk of stroke. We systematically reviewed the literature on all types of antithrombotic regimens a

  9. Left ventricular hypertrophy : virtuous intentions, malign consequences

    Pokharel, S; Sharma, UC; Pinto, YM

    2003-01-01

    Left ventricular hypertrophy (LVH) is currently the focus of intense cardiovascular research, with the resultant rapid evolution of novel concepts relating to its exceedingly complex pathophysiology. In addition to the alterations in signal transduction and disturbances in Ca2+ homeostasis, there ar

  10. Left ventricular outflow obstruction and necrotizing enterocolitis

    Allen, H.A.; Haney, P.J.

    1984-02-01

    Two neonates had unusually rapid development of necrotizing enterocolitis within 24 hours of birth. Both patients had decreased systemic perfusion secondary to aortic atresia. Onset of either clinical or radiographic manifestations of necrotizing enterocolitis in the first day of life should alert one to the possible presence of severe left ventricular outflow obstruction.

  11. Impact of intracoronary injection of mononuclear bone marrow cells in acute myocardial infarction on left ventricular perfusion and function: a 6-month follow-up gated {sup 99m}Tc-MIBI single-photon emission computed tomography study

    Lipiec, Piotr [Medical University of Lodz, 2nd Department of Cardiology, Lodz (Poland); Medical University of Lodz, 2nd Department of Cardiology, Bieganski Hospital, Lodz (Poland); Krzeminska-Pakula, Maria; Plewka, Michal; Kasprzak, Jaroslaw D. [Medical University of Lodz, 2nd Department of Cardiology, Lodz (Poland); Kusmierek, Jacek; Plachcinska, Anna; Szuminski, Remigiusz [Medical University of Lodz, Department of Nuclear Medicine, Lodz (Poland); Robak, Tadeusz; Korycka, Anna [Medical University of Lodz, Department of Hematology, Lodz (Poland)

    2009-04-15

    We investigated the impact of intracoronary injection of autologous mononuclear bone marrow cells (BMC) in patients with acute ST elevation myocardial infarction (STEMI) on left ventricular volumes, global and regional systolic function and myocardial perfusion. The study included 39 patients with first anterior STEMI treated successfully with primary percutaneous coronary intervention. They were randomly assigned to the treatment group or the control group in a 2:1 ratio. The patients underwent baseline gated single-photon emission computed tomography (G-SPECT) 3-10 days after STEMI with quantitative and qualitative analysis of left ventricular perfusion and systolic function. On the following day, patients from the BMC treatment group were subjected to bone marrow aspiration, mononuclear BMC isolation and intracoronary injection. No placebo procedure was performed in the control group. G-SPECT was repeated 6 months after STEMI. Baseline and follow-up G-SPECT studies were available for 36 patients. At 6 months in the BMC group we observed a significantly enhanced improvement in the mean extent of the perfusion defect, the left ventricular perfusion score index, the infarct area perfusion score and the infarct area wall motion score index compared to the control group (p=0.01-0.04). However, the changes in left ventricular volume, ejection fraction and the left ventricular wall motion score index as well as the relative changes in the infarct area wall motion score index did not differ significantly between the groups. Intracoronary injection of autologous mononuclear BMC in patients with STEMI improves myocardial perfusion at 6 months. The benefit in infarct area systolic function is less pronounced and there is no apparent improvement of global left ventricular systolic function. (orig.)

  12. Prognostic implications of left ventricular mass and geometry following myocardial infarction: the VALIANT (VALsartan In Acute myocardial iNfarcTion) Echocardiographic Study

    Verma, Anil; Meris, Alessandra; Skali, Hicham;

    2008-01-01

    , or resuscitation after cardiac arrest was lowest for patients with normal geometry, and increased with concentric remodeling (hazard ratio [HR]: 3.0; 95% confidence interval [CI]: 1.9 to 4.9), eccentric hypertrophy (HR: 3.1; 95% CI: 1.9 to 4.8), and concentric hypertrophy (HR: 5.4; 95% CI: 3.4 to 8.5), after......OBJECTIVES: This study sought to understand prognostic implications of increased baseline left ventricular (LV) mass and geometric patterns in a high risk acute myocardial infarction. BACKGROUND: The LV hypertrophy and alterations in LV geometry are associated with an increased risk of adverse...... proportional hazards models were used to evaluate the relationships among LVMi, RWT, LV geometry, and clinical outcomes. RESULTS: Mean LVMi and RWT were 98.8 +/- 28.4 g/m(2) and 0.38 +/- 0.08. The risk of death or the composite end point of death from cardiovascular causes, reinfarction, heart failure, stroke...

  13. Effect of low dose acetylsalicylic acid on the frequency and hematologic activity of left ventricular thrombus in anterior wall acute myocardial infarction

    Kuepper, A.J.V.; Verheugt, F.W.; Peels, C.H.; Galema, T.W.; den Hollander, W.; Roos, J.P.

    1989-04-15

    In this prospective, randomized, placebo-controlled trial the effect of 100 mg acetylsalicylic acid (ASA) once daily on the incidence, hematologic activity and embolic potential of left ventricular (LV) thrombosis was studied in 100 consecutive patients with a first anterior wall acute myocardial infarction (AMI). Patients were randomized to ASA or placebo less than 12 hours after onset of symptoms. Heparin, 5,000 IU subcutaneously twice daily, was given to all patients during immobilization. Echocardiography was performed less than 24 hours, 48 to 72 hours and 1, 2, and 12 weeks after AMI. LV thrombosis was detected by echocardiography in 30 (33%) of the 92 evaluable patients (15 patients given ASA and 15 given placebo). Indium-111 platelet scintigraphy was done in 17 of the 22 patients with an LV thrombus at the second week echocardiogram. Among 7 ASA-treated patients, 4 had positive images; among 10 placebo patients, 5 had positive images. LV thrombus resolution was noted in 3 of 9 patients with a positive scan and in 5 of 8 patients with a negative platelet scan. In 7 of 10 ASA-treated patients and 5 of 12 placebo-treated patients thrombus resolution was observed (difference not significant). Systemic embolism occurred in 2 patients, both given ASA, during the first week after AMI. Thus, low dose ASA has no effect on the incidence, hematologic activity and embolic potential of LV thrombosis in anterior wall AMI.

  14. Utility of Global Longitudinal Strain by Echocardiography to Detect Left Ventricular Dysfunction in Long-Term Adult Survivors of Childhood Lymphoma and Acute Lymphoblastic Leukemia.

    Christiansen, Jon R; Massey, Richard; Dalen, Håvard; Kanellopoulos, Adriani; Hamre, Hanne; Fosså, Sophie D; Ruud, Ellen; Kiserud, Cecilie E; Aakhus, Svend

    2016-08-01

    Measuring left ventricular (LV) global longitudinal strain (GLS) is recommended in screening of long-term cancer survivors for cardiotoxicity. However, there are limited data on GLS in this setting, in particular in survivors with apparently normal LV function without risk factors of impaired GLS. In the present study, we measured GLS in 191 adult survivors of childhood lymphoma or acute lymphoblastic leukemia, with normal LV ejection fraction and fractional shortening (FS) and without known hypertension, diabetes mellitus, myocardial infarction, or stroke. We compared GLS in the survivors with 180 controls. Mean GLS was -19.0 ± 2.2% in the survivor group and -21.4 ± 2.0% in the controls (p cancer treatment. Survivors treated with mediastinal radiotherapy had an odds ratio of impaired GLS of 5.2 (95% confidence interval 2.2 to 12) compared with other survivors. Survivors treated with cumulative anthracycline doses >300 mg/m(2) had an odds ratio of 4.8 (95% confidence interval 1.7 to 14) of impaired GLS. In conclusion, this study demonstrates a high proportion of LV dysfunction assessed by GLS in apparently healthy adult survivors of childhood cancer. Impaired GLS was associated with previous exposure to mediastinal radiotherapy and high doses of anthracyclines. The prognostic role of measuring GLS in this specific patient population should be examined in prospective studies. PMID:27296561

  15. Echocardiographic assessment of the impact of cardiovascular risk factors on left ventricular systolic function in patients with acute myocardial infarction

    Vijay Kumar Verma

    2014-06-01

    Conclusion: Since the proportion of patients with LV systolic dysfunction in patients with AMI remains relatively high, LV systolic function variables such as LVEF and LVESV should be echocardiographically evaluated in all patients with AMI. Since the post-infarction LV systolic function remains the single most important determinant of survival, treatment of AMI patients should be aimed at limitation of infarct size and prevention of ventricular dilation. Moreover, cardiovascular risk factors such as diabetes mellitus and smoking have a significant impact on the likelihood of impairment of LV systolic function in patients with AMI and hence could influence long-term prognosis. [Int J Res Med Sci 2014; 2(3.000: 1101-1106

  16. Left ventricular remodeling in the first year after acute myocardial infarction and the predictive value of N-terminal pro brain natriuretic peptide

    Nilsson, Jens C; Groenning, Bjoern A; Nielsen, Gitte; Fritz-Hansen, Thomas; Trawinski, Jürgen; Hildebrandt, Per R; Jensen, Gorm B; Larsson, Henrik B W; Sondergaard, Lars

    2002-01-01

    BACKGROUND: Left ventricular (LV) remodeling after myocardial infarction (MI) has received much attention because of its severe impact on morbidity and mortality rates. However, the incidence and extent of LV remodeling in a modern infarct population who were offered antiremodeling treatment in c...

  17. Incidence of atrial fibrillation in patients with either heart failure or acute myocardial infarction and left ventricular dysfunction: a cohort study

    Schmiegelow, Michelle D; Pedersen, Ole D; Køber, Lars; Seibæk, Marie; Abildstrøm, Steen Z; Torp-Pedersen, Christian

    2011-01-01

    We examined the incidence of new-onset atrial fibrillation in patients with left ventricular dysfunction. Patients either had a recent myocardial infarction (with or without clinical heart failure) or symptomatic heart failure (without a recent MI). Patients were with and without treatment with t...

  18. Relation of Left Ventricular Mass and Infarct Size in Anterior Wall ST-Segment Elevation Acute Myocardial Infarction (from the EMBRACE STEMI Clinical Trial).

    Daaboul, Yazan; Korjian, Serge; Weaver, W Douglas; Kloner, Robert A; Giugliano, Robert P; Carr, Jim; Neal, Brandon J; Chi, Gerald; Cochet, Madeleine; Goodell, Laura; Michalak, Nathan; Rusowicz-Orazem, Luke; Alkathery, Turky; Allaham, Haytham; Routray, Sujit; Szlosek, Donald; Jain, Purva; Gibson, C Michael

    2016-09-01

    Biomarker measures of infarct size and myocardial salvage index (MSI) are important surrogate measures of clinical outcomes after a myocardial infarction. However, there is variability in infarct size unaccounted for by conventional adjustment factors. This post hoc analysis of Evaluation of Myocardial Effects of Bendavia for Reducing Reperfusion Injury in Patients With Acute Coronary Events (EMBRACE) ST-Segment Elevation Myocardial Infarction (STEMI) trial evaluates the association between left ventricular (LV) mass and infarct size as assessed by areas under the curve for creatine kinase-MB (CK-MB) and troponin I release over the first 72 hours (CK-MB area under the curve [AUC] and troponin I [TnI] AUC) and the MSI. Patients with first anterior STEMI, occluded left anterior descending artery, and available LV mass measurement in EMBRACE STEMI trial were included (n = 100) (ClinicalTrials.govNCT01572909). MSI, end-diastolic LV mass on day 4 cardiac magnetic resonance, and CK-MB and troponin I concentrations were evaluated by a core laboratory. After saturated multivariate analysis, dominance analysis was performed to estimate the contribution of each independent variable to the predicted variance of each outcome. In multivariate models that included age, gender, body surface area, lesion location, smoking, and ischemia time, LV mass remained independently associated with biomarker measures of infarct size (CK-MB AUC p = 0.02, TnI AUC p = 0.03) and MSI (p = 0.003). Dominance analysis demonstrated that LV mass accounted for 58%, 47%, and 60% of the predicted variances for CK-MB AUC, TnI AUC, and MSI, respectively. In conclusion, LV mass accounts for approximately half of the predicted variance in biomarker measures of infarct size. It should be considered as an adjustment variable in studies evaluating infarct size. PMID:27392509

  19. Impact of acute changes of left ventricular contractility on the transvalvular impedance: validation study by pressure-volume loop analysis in healthy pigs.

    Vincenzo Lionetti

    Full Text Available BACKGROUND: The real-time and continuous assessment of left ventricular (LV myocardial contractility through an implanted device is a clinically relevant goal. Transvalvular impedance (TVI is an impedentiometric signal detected in the right cardiac chambers that changes during stroke volume fluctuations in patients. However, the relationship between TVI signals and LV contractility has not been proven. We investigated whether TVI signals predict changes of LV inotropic state during clinically relevant loading and inotropic conditions in swine normal heart. METHODS: The assessment of RVTVI signals was performed in anesthetized adult healthy anesthetized pigs (n = 6 instrumented for measurement of aortic and LV pressure, dP/dtmax and LV volumes. Myocardial contractility was assessed with the slope (Ees of the LV end systolic pressure-volume relationship. Effective arterial elastance (Ea and stroke work (SW were determined from the LV pressure-volume loops. Pigs were studied at rest (baseline, after transient mechanical preload reduction and afterload increase, after 10-min of low dose dobutamine infusion (LDDS, 10 ug/kg/min, i.v, and esmolol administration (ESMO, bolus of 500 µg and continuous infusion of 100 µg·kg-1·min-1. RESULTS: We detected a significant relationship between ESTVI and dP/dtmax during LDDS and ESMO administration. In addition, the fluctuations of ESTVI were significantly related to changes of the Ees during afterload increase, LDDS and ESMO infusion. CONCLUSIONS: ESTVI signal detected in right cardiac chamber is significantly affected by acute changes in cardiac mechanical activity and is able to predict acute changes of LV inotropic state in normal heart.

  20. Effect of Varying Definitions of Contrast-Induced Acute Kidney Injury and Left Ventricular Ejection Fraction on One-Year Mortality in Patients Having Transcatheter Aortic Valve Implantation.

    Pyxaras, Stylianos A; Zhang, Yuan; Wolf, Alexander; Schmitz, Thomas; Naber, Christoph K

    2015-08-01

    The prognostic relevance of direct contrast toxicity in patients treated with transcatheter aortic valve implantation (TAVI) remains unclear because of the confounding hemodynamic effect of acute left ventricular ejection fraction (LVEF) impairment on kidney function estimation. In addition, different definitions of contrast-induced acute kidney injury (CI-AKI) may have different prognostic stratification potential. In the present study, 240 consecutive patients who underwent TAVI were prospectively enrolled. CI-AKI was defined (1) according to the postprocedural creatinine increase of ≥0.3 mg/dl or (2) according to the postprocedural decrease of the creatinine clearance of at least 25%. Primary end point of the study was 1-year all-cause mortality. At a mean follow-up of 1.7 ± 1.4 years, all-cause mortality was significantly higher in the CI-AKI patient group, using both CI-AKI definitions (for (1) and (2) p = 0.025 and p definition (2) was higher (area under the curve 0.704; p definition (1) (area under the curve 0.602; p = 0.037) for the primary end point of 1-year mortality. In conclusion, in a nonselected patient population who underwent TAVI, CI-AKI was confirmed as an independent predictor of clinical outcome. Only the interaction between LVEF and baseline creatinine values was found to determine CI-AKI. Definition of CI-AKI based to creatinine clearance values had higher prognostic accuracy in comparison with the CI-AKI definition based on creatinine absolute value changes. PMID:26026866

  1. Relationship between infarct size and severity measured by gated SPECT and long-term left ventricular remodelling after acute myocardial infarction

    Berti, Valentina; Sciagra, Roberto; Pupi, Alberto [University of Florence, Nuclear Medicine Unit, Department of Clinical Physiopathology, Florence (Italy); Acampa, Wanda; Ricci, Francesca; Gallicchio, Rosj; Cuocolo, Alberto [University Federico II and Institute of Biostructures and Bioimages of the National Council of Research, Department of Biomorphological and Functional Sciences, Naples (Italy); Cerisano, Giampaolo [Careggi Hospital, Division of Cardiology, Florence (Italy); Vigorito, Carlo [University Federico II, Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Cardiac Rehabilitation Unit, Naples (Italy)

    2011-06-15

    After acute myocardial infarction (AMI), left ventricular (LV) remodelling may occur despite successful reperfusion. This study aimed to investigate by gated single photon emission computed tomography (SPECT) the long-term evolution of myocardial perfusion and LV function after AMI and to identify the predictors of LV remodelling. Sixty-eight AMI patients successfully treated by primary percutaneous coronary intervention underwent {sup 99m}Tc-sestamibi gated SPECT at 1 month (baseline) and over 6-month follow-up after the acute event. LV remodelling was defined as 20% increase in LV end-diastolic volume at follow-up. At baseline, patients with remodelling (n = 14) showed larger (infarct size 29.3 {+-} 7.8%) and more transmural (infarct severity 0.28 {+-} 0.10) infarctions, and reduced LV ejection fraction (35.4 {+-} 5.6%), but similar LV volume indexes, compared to patients without remodelling (n = 54) (infarct size 20.8 {+-} 14.4%, p < 0.05, infarct severity 0.40 {+-} 0.11, p < 0.001, ejection fraction 44.5 {+-} 9.2, p < 0.001). At stepwise multivariate regression analysis, infarct severity showed the best predictive value for predicting LV remodelling (F = 5.54, p < 0.05). Using the thresholds identified by receiver-operating characteristic curve analysis, infarct size and severity detected patients with remodelling with 75% accuracy and 95% negative predictive value. Infarct resorption (defined as the defect size difference between follow-up and baseline) was comparable between patients with (-4.4 {+-} 8.4%) and without remodelling (-6.8 {+-} 9.4%) (p = NS). Perfusion parameters assessed by gated SPECT in the subacute phase after successfully treated AMI correlate with changes in functional parameters at long-term follow-up. Infarct severity is more effective than infarct size, but both are helpful for predicting LV remodelling. (orig.)

  2. High plasma coenzyme Q10 concentration is correlated with good left ventricular performance after primary angioplasty in patients with acute myocardial infarction

    Huang, Ching-Hui; Kuo, Chen-Ling; Huang, Ching-Shan; Tseng, Wan-Min; Lian, Ie Bin; Chang, Chia-Chu; Liu, Chin-San

    2016-01-01

    Abstract Exogenous administration of coenzyme Q10 (CoQ10) has been shown in experimental models to have a protective effect against ischemia–reperfusion injury. However, it is unclear whether follow-up plasma CoQ10 concentration is prognostic of left ventricular (LV) performance after primary balloon angioplasty in patients with acute ST segment elevation myocardial infarction (STEMI). We prospectively recruited 55 patients with STEMI who were treated with primary coronary balloon angioplasty. Plasma CoQ10 concentrations were measured before primary angioplasty (baseline) and 3 days, 7 days, and 1 month after STEMI using high-performance liquid chromatography. Echocardiography was performed at baseline and at 6-month follow-up. The control group comprised 54 healthy age- and sex-matched volunteers. Serial circulating CoQ10 concentrations significantly decreased with time in the STEMI group. The LV ejection fraction at 6-month follow-up positively correlated with the 1-month plasma CoQ10 tertile. Higher plasma CoQ10 concentrations at 1 month were associated with favorable LV remodeling and systolic function 6 months after STEMI. Multiple linear regression analysis showed that changes in CoQ10 concentrations at 1-month follow-up were predictive of LV systolic function 6 months after STEMI. Changes in CoQ10 concentrations correlated negatively with baseline oxidized low-density lipoprotein and fibrinogen concentrations and correlated positively with leukocyte mitochondrial copy number at baseline. Patients with STEMI who had higher plasma CoQ10 concentrations 1 month after primary angioplasty had better LV performance at 6-month follow-up. In addition, higher plasma CoQ10 concentration was associated with lower grade inflammatory and oxidative stress status. Therefore, plasma CoQ10 concentration may serve as a novel prognostic biomarker of LV systolic function after revascularization therapy for acute myocardial infarction. PMID:27495100

  3. Left ventricular hypertrophy in patients treated with regular hemodialyses

    Petrović Dejan; Stojimirović Biljana

    2008-01-01

    Left ventricular hypertrophy is the main risk factor for development of cardiovascular morbidity and mortality in patients on hemodialysis. Left ventricular hypertrophy is found in 75% of the patients treated with hemodialysis. Risk factors for left ventricular hypertrophy in patients on hemodialysis include: blood flow through arterial-venous fistula, anemia, hypertension, increased extracellular fluid volume, oxidative stress, microinflammation, hyperhomocysteinemia, secondary hyperpara- th...

  4. Progress of ultrasound in evaluation on left ventricular remodeling after acute myocardial infarction%超声新技术评价急性心肌梗死后左心室重构的研究进展

    田芳

    2012-01-01

    Left ventricular remodeling after acute myocardial infarction (AMI) affects the prognosis of the patients and the incidence of cardiovascular events. In early stage, testing and evaluating left ventricular remodeling after AMI by ultrasound has important significance to make the plan of clinical treatment for relieving left ventricular remodeling and improving curative effect. The progress in research of evaluating left ventricular remodeling after AMI by ultrasound were reviewed in this article.%急性心肌梗死(AMI)后,左心室重构影响患者预后及心血管事件的发生率.超声可早期检测和评价AMI患者左心室重构情况,对临床制定治疗方案、改善预后有重要意义.本文就超声新技术评价AMI后左心室重构的研究进展进行综述.

  5. Exercise-Induced Right Ventricular Outflow Tract Tachycardia in a Patient with Isolated Left Ventricular Noncompaction

    Mehmet Eren; Erkan İlhan; Ahmet Taha Alper; Tolga Sinan Güvenç

    2011-01-01

    Isolated left ventricular noncompaction is a hereditary cardiomyopathy in which a variety of supraventricular and ventricular arrhythmias could be observed. We report a patient with exercise-induced ventricular tachycardia with left bundle branch block morphology that had characteristics of an idiopathic ventricular tachycardia who was subsequently diagnosed as left ventricular noncompaction. Successful remission of arrhythmia was ensured after the introduction of oral beta-blocker therapy.

  6. Hemodynamic and radionuclide effects of acute captopril therapy for heart failure: changes in left and right ventricular volumes and function at rest and during exercise

    Although the resting hemodynamic effects of captopril in congestive heart failure are known, little information is available about the hemodynamic response to captopril during exercise or about changes in noninvasive measurements of the size and function of both ventricles. In this study, 14 stable New York Heart Association class III patients were given 25 mg of oral captopril. Rest and exercise hemodynamic measurements and blood pool scintigrams were performed simultaneously before and 90 minutes after captopril. The radionuclide studies were analyzed for left and right ventricular end-diastolic volumes, end-systolic volumes, ejection fractions and pulmonary blood volume. The primary beneficial responses at rest were decreases in left and right ventricular end-diastolic volumes from 388 + 81 to 350 + 77 ml (p < 0.01) and from 52 + 26 to 43 + 20 volume units (p < 0.01), respectively, and in their corresponding filling pressures, from 24 + 10 to 17 + 9 mm Hg and 10 + 5 to and + 5 mm Hg (both p < 0.01). Altough stroke volume did not increase significantly, both left and right ventricular ejection fractions increased slightly, from 19 + 6% to 22 + 5% and from 25 + 9% to 29 + 11%, respectively (both p < 0.01). During exercise, similar changes were noted in both hemodynamic and radionuclide indexes. Thus, in patients with moderate symptomatic limitation from chronic heart failure, captopril predominantly reduces ventricular volume and filling pressure, with a less significant effect on cardiac output. These effects persist during exercise, when systemic vascular resistance is already very low. Radionuclide techniques are valuable in assessing the drug effect in these subjects, particularly when ventricular volumes are also measured

  7. Clinical evaluation of serial thallium-201 myocardial scintigraphy in special reference to left ventricular function in patients with acute myocardial infarction

    In 20 patients with acute myocardial infarction (AMI), serial Tl-201 myocardial scintigraphy was performed and scintigraphic infarct size (SIS) was determined 1 (or less), 2 and 8 weeks after AMI. Hemodynamic indices were determined with a Swan-Ganz catheter at a mean of 27.7 hours after AMI. Left ventricular ejection fraction (EF) was determined with Tc-99m HSA cardiac blood pool scintigram at 8 weeks after AMI. Mapping ECG was also observed serially. Of 20 patients, SIS decreased in 12, was unchanged in 2 and increased in 5. No image defect was observed on the initial scintigram in one case. When the patients were classified into two groups, i.e. those with initial SIS more than 25% and those with initial SIS less than 25%, hemodynamic indices were demonstrated to be more markedly impaired in the former than in the latter. However, when all patients were pooled, correlations between the initial SIS and hemodynamic indies (CI, SI, SWI, PADP) were poor. There was a good correlation between SIS and EF both determined 8 weeks after AMI. When the patients were clasified into the improved and unimproved groups according to the per cent change of SIS (CIS), both hemodynamic indices on admission and EF at 8 weeks were better in the improved than in the unimproved group, and especially significant correlation was found between CIS and each of SI and PADP. There was a good correlation between maximum ΣST in mapping ECG and SIS at 1 week after AMI. (author)

  8. Reverse redistribution phenomenon on rest 99mTc-tetrofosmin myocardial single photon emission computed tomography involves impaired left ventricular contraction in patients with acute myocardial infarction

    The purpose of this study was to investigate the clinical significance of the reverse redistribution (RR) phenomenon on technetium-99m (99mTc)-tetrofosmin myocardial single photon emission computed tomography (SPECT) performed at rest. Twenty-five patients underwent myocardial SPECT 3 weeks after the onset of acute myocardial infarction. Myocardial images were acquired at 40 min (early) and 4 h (delayed) after the injection of 740 MBq of 99mTc-tetrofosmin. The regional myocardial uptake of the tracer in 26 segments of the left ventricular (LV) wall was visually scored from 0 (no activity) to 3 (normal activity), and then the RR was defined as a decrease of more than 1 point in the activity score on the delayed image compared with that on the early image. Regions with an activity score of 3 on both the early and delayed images were defined as normal, and those with a score of 0 or 1 on the early image were considered to have a fixed defect. The regional myocardial 99mTc-tetrofosmin uptake and washout rate were also quantitatively assessed in each region. In addition, exercise stress electrocardiograph-gated SPECT with 99mTc-tetrofosmin was performed within 1 week of the rest study, and the percent count increase (%CI) during myocardial contraction in each corresponding region was studied. RR was observed in 18 of the 25 patients. The regional washout rate of 99mTc-tetrofosmin was significantly higher in the RR regions (45.0±3.8%) than in either the normal regions (36.4±4.1%, p99mTc-tetrofosmin SPECT have severely impaired LV wall contraction after exercise. (author)

  9. Changes of Left Ventricular Geometry Shape and Left Ventricular Regional Function in Patients With Dilated Cardiomyopathy

    Liang-yu WANG; Ming-xing XIE; Qing-bo LI; Ping CHEN; Zhi-xiong CAI; Zhi-dan ZHU

    2009-01-01

    Objectives To assess the left ventricle regional systolic and diastolic function, left ventricle geometry and left venti-tie sphericity indexes in patients with dilated cardiomyopathy (DCM) by quantitative tissue velocity imaging (QTVI). Methods Thirty normal subjects and 52 DCM patients underwent QTVI and colour Doppler flow imaging study in or-der to measure the left ventricular regional function along left ventricle apical long-axis view and the left ventricle geom-etry. Peak tissue velocities of left venticle regional muscular tissue during systole (Vs), systolic acceleration (a), ear-ly diastole(Ve) and left atrium contraction(Va) along left venticle apical long axis view were measured. The indexes of left ventdcular regional systolic and diastolic function were mearsured at the same time. The left ventricle geometry shape was reflected from the systolic and diastolic sphericity index (Sis and Sid), the left ventricular ejection fraction (LVEF) and D wave/A wave (PVd/Pva) of pulmonary veins flowing spectrum reflected the global left ventricular systolic and diastolic function. The Vs, Ve, Va, a, PVd/Pva ratio, LVEF, Sis, Sid and their correlations between normal subjects and patients with DCM were compared and analyzed. Results Vs, Ve, Va, a, PVd/Pva, Sis and Sid in patients with DCM were lower than those in normal persons. There were significant relations between Sis and a (r=0.6142, P<0.05), Ve/Va and Sid (r=0.6271, P<0.05). Conclusions QTVI offer a newer method which has a higher sensitivity and accuracy in evaluating the left venticle regional systolic and diastolic function in DCM patients. There was significant relation between regional cardiac function and left venticle sphericity.

  10. Impact of congestive heart failure and left ventricular systolic function on the prognostic significance of atrial fibrillation and atrial flutter following acute myocardial infarction

    Pedersen, Ole Dyg; Bagger, Henning; Køber, Lars;

    2005-01-01

    BACKGROUND: Reports on the prognostic importance of atrial fibrillation following myocardial infarction have provided considerable variation in results. Thus, this study examined the impact of left ventricular systolic function and congestive heart failure on the prognostic importance of atrial...... congestive heart failure were prospectively collected. Mortality was followed for 5 years. RESULTS: In patients with left ventricular ejection fraction<0.25, atrial fibrillation/atrial flutter was associated with an increased in-hospital mortality (OR=1.8 (1.1-3.2); p<0.05) but not an increased 30-day...... mortality. In patients with 0.250.35. In patients with congestive heart failure, atrial fibrillation/atrial flutter was associated with an increased in-hospital mortality (OR=1.5 (1.2-1.9); p<0.001) and increased 30-day mortality (OR=1.4 (1.1-1.7); p<0.001) but not in patients without congestive heart...

  11. One-Year Safety Analysis of the COMPARE-AMI Trial: Comparison of Intracoronary Injection of CD133+ Bone Marrow Stem Cells to Placebo in Patients after Acute Myocardial Infarction and Left Ventricular Dysfunction

    Samer Mansour

    2011-01-01

    Full Text Available Bone marrow stem cell therapy has emerged as a promising approach to improve healing of the infarcted myocardium. Despite initial excitement, recent clinical trials using non-homogenous stem cells preparations showed variable and mixed results. Selected CD133+ hematopoietic stem cells are candidate cells with high potential. Herein, we report the one-year safety analysis on the initial 20 patients enrolled in the COMPARE-AMI trial, the first double-blind randomized controlled trial comparing the safety, efficacy, and functional effect of intracoronary injection of selected CD133+ cells to placebo following acute myocardial infarction with persistent left ventricular dysfunction. At one year, there is no protocol-related complication to report such as death, myocardial infarction, stroke, or sustained ventricular arrhythmia. In addition, the left ventricular ejection fraction significantly improved at four months as compared to baseline and remained significantly higher at one year. These data indicate that in the setting of the COMPARE-AMI trial, the intracoronary injection of selected CD133+ stem cells is secure and feasible in patients with left ventricle dysfunction following acute myocardial infarction.

  12. Antiarrhythmic effect of carvedilol after acute myocardial infarction: results of the Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction (CAPRICORN) trial

    McMurray, John; Køber, Lars; Robertson, Michele;

    2005-01-01

    prognosis. Angiotensin-converting enzyme inhibitors reduce the incidence of both types of arrhythmia. METHODS: The antiarrhythmic effect of carvedilol was examined in a placebo-controlled multicenter trial, the Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction (CAPRICORN) study, which...... enrolled 1,959 patients with reduced left ventricular systolic function after AMI, 98% of whom were treated with an ACE inhibitor. RESULTS: The incidence of atrial fibrillation/flutter was 53 to 984 (5.4%) in the placebo group and 22 to 975 (2.3%) in the carvedilol group, giving a carvedilol/placebo hazard...... ratio (HR) of 0.41 (95% confidence interval [CI] 0.25 to 0.68; p = 0.0003). The corresponding rates of ventricular tachycardia/flutter/fibrillation were 38 to 984 (3.9%) and 9 to 975 (0.9%) (HR 0.24, 95% CI 0.11 to 0.49; p < 0.0001). CONCLUSIONS: Carvedilol has a powerful antiarrhythmic effect after AMI...

  13. Ultrasound-mediated stimulation of microbubbles after acute myocardial infarction and reperfusion ameliorates left-ventricular remodelling in mice via improvement of borderzone vascularization.

    Jonas Dörner

    Full Text Available AIMS: Post-infarction remodelling (PIR determines left-ventricular (LV function and prognosis after myocardial infarction. The aim of this study was to evaluate transthoracic ultrasound-mediated microbubble stimulation (UMS as a novel gene- and cell-free therapeutic option after acute myocardial infarction and reperfusion (AMI/R in mice. METHODS AND RESULTS: For myocardial delivery of UMS, a novel therapeutic ultrasound-system (TIPS, Philips Medical and commercially available microbubbles (BR1, Bracco Suisse SA were utilized in a closed-chest mouse model. UMS was performed as myocardial post-conditioning (PC on day four after 30 minutes of coronary occlusion and reperfusion. LV-morphology, as well as global and regional function were measured repeatedly with reconstructive 3-dimensional echocardiography applying an additional low-dose dobutamine protocol after two weeks. Scar size was quantified by means of histomorphometry. A total of 41 mice were investigated; 17 received PC with UMS. Mean ejection fraction (EF prior UMS was similar in both groups 53%±10 (w/o UMS and 53%±14 (UMS, p = 0.5, reflecting comparable myocardial mass at risk 17%±8 (w/o UMS, 16%±13 (UMS, p = 0.5. Two weeks after AMI/R, mice undergoing UMS demonstrated significantly better global LV-function (EF = 53%±7 as compared to the group without PC (EF = 39%±11, p<0.01. The fraction of akinetic myocardial mass was significantly lower among mice undergoing UMS after AMI/R [27%±10 (w/o UMS, 13%±8 (UMS, p<0.001]. Our experiments showed a fast onset of transient, UMS-induced upregulation of vascular-endothelial and insulin-like growth factor (VEGF-a, IGF-1, as well as caveolin-3 (Cav-3. The mice undergoing PC with UMS after AMI/R showed a significantly lower scar size. In addition, the microvascular density was significantly higher in the borderzone of UMS-treated animals. CONCLUSION: UMS following AMI/R ameliorates PIR in mice via up-regulation of VEGF-a, IGF

  14. Right ventricular failure after left ventricular assist devices.

    Lampert, Brent C; Teuteberg, Jeffrey J

    2015-09-01

    Most patients with advanced systolic dysfunction who are assessed for a left ventricular assist device (LVAD) also have some degree of right ventricular (RV) dysfunction. Hence, RV failure (RVF) remains a common complication of LVAD placement. Severe RVF after LVAD implantation is associated with increased peri-operative mortality and length of stay and can lead to coagulopathy, altered drug metabolism, worsening nutritional status, diuretic resistance, and poor quality of life. However, current medical and surgical treatment options for RVF are limited and often result in significant impairments in quality of life. There has been continuing interest in developing risk models for RVF before LVAD implantation. This report reviews the anatomy and physiology of the RV and how it changes in the setting of LVAD support. We will discuss proposed mechanisms and describe biochemical, echocardiographic, and hemodynamic predictors of RVF in LVAD patients. We will describe management strategies for reducing and managing RVF. Finally, we will discuss the increasingly recognized and difficult to manage entity of chronic RVF after LVAD placement and describe opportunities for future research. PMID:26267741

  15. Left ventricular hypertrophy in patients treated with regular hemodialyses

    Petrović Dejan

    2008-01-01

    Full Text Available Left ventricular hypertrophy is the main risk factor for development of cardiovascular morbidity and mortality in patients on hemodialysis. Left ventricular hypertrophy is found in 75% of the patients treated with hemodialysis. Risk factors for left ventricular hypertrophy in patients on hemodialysis include: blood flow through arterial-venous fistula, anemia, hypertension, increased extracellular fluid volume, oxidative stress, microinflammation, hyperhomocysteinemia, secondary hyperpara- thyroidism, and disturbed calcium and phosphate homeostasis. Left ventricular pressure overload leads to parallel placement of new sarcomeres and development of concentric hypertrophy of left ventricle. Left ventricular hypertrophy advances in two stages. In the stage of adaptation, left ventricular hypertrophy occurs as a response to increased tension stress of the left ventricular wall and its action is protective. When volume and pressure overload the left ventricle chronically and without control, adaptive hypertrophy becomes maladaptive hypertrophy of the left ventricle, where myocytes are lost, systolic function is deranged and heart insufficiency is developed. Left ventricular mass index-LVMi greater than 131 g/m2 in men and greater than 100 g/m2 in women, and relative wall thickness of the left ventricle above 0.45 indicate concentric hypertrophy of the left ventricle. Eccentric hypertrophy of the left ventricle is defined echocardiographically as LVMi above 131 g/m2 in men and greater than 100 g/m2 in women, with RWT ?0.45. Identification of patients with increased risk for development of left ventricular hypertrophy and application of appropriate therapy to attain target values of risk factors lead to regression of left ventricular hypertrophy, reduced cardiovascular morbidity and mortality rates and improved quality of life in patients treated with regular hemodialyses.

  16. Echocardiographic left ventricular hypertrophy in Chinese endurance athletes.

    Lo, Y S; Chin, M K

    1990-01-01

    Most echocardiographic data on the athletic heart syndrome originate from the United States and Western Europe. There are no published data on echocardiographically documented left ventricular hypertrophy in Asian athletes. We investigated the echocardiographic changes which take place with endurance training by studying eight Hong Kong national cyclists. This study confirms that left ventricular hypertrophy and increased left ventricular end-diastolic dimensions are common findings in Chines...

  17. [EFFICACY OF STANDARD TWO-YEAR COMPREHENSIVE THERAPY TO ACHIEVE TARGET BLOOD PRESSURE AND REGRESSION DEGREES OF REMODELING OF THE LEFT VENTRICULAR HYPERTROPHY IN PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION WITH COMORBID HYPERTENSION].

    Denesiuk, E V

    2015-01-01

    The study involved 23 men after acute myocardial infarction (AMI) with comorbid arterial hypertension (AH). Mean age of patients was 56.7 years. Recurrent myocardial infarction was determined in 38.4%, cardiac failure I-III functional classes--100% of the cases. All patients underwent clinical examination, electrocardiography and echocardiography, blood lipid profile. Standard comprehensive treatment for two years included an perindopril 5-10 mg/day, beta-blocker bisoprolol--5-10 mg/day, antisclerotic drug atorvastatin--20 mg/day and aspirin--75 mg/day. The patients after treatment was determined by a gradual increase towards the target of AT at 3, 6 and 12 to 24 months. Concentric left ventricular hypertrophy (LVH) before treatment was determined in 47.8%, eccentric--in 52.2% of patients. In the study of degrees of LVH I (initial) the extent to treatment was determined by 4.3%, II (moderate)--26.1%, III (large)--at 69.6%, indicating the development of cardiac remodeling. After the treatment was determined by marked reduction III (large) degree and transfer it in the II (moderate) and I (small) degree of left ventricular hypertrophy due to more or less pronounced changes remodeling left ventricular. The obtained data allow a more detailed and adequately assess the structural and functional outcome variables and determine the regression of myocardial hypertrophy in the background to achieve target blood pressure, which is important in practical cardiology. PMID:27491146

  18. Usefulness of heavy isometric exercise echocardiography for assessing left ventricular wall motion patterns late (> or = 6 months) after acute myocardial infarction.

    Fisman, E Z; Ben-Ari, E; Pines, A; Drory, Y; Motro, M; Kellermann, J J

    1992-11-01

    The aim of this prospective study was to determine the effects of heavy isometric exercise on left ventricular (LV) wall motion patterns in patients who have had myocardial infarction, and to compare heavy isometric exercise with dynamic exercise for competence in eliciting LV wall motion abnormalities at equivalent rate-pressure products. Echocardiography was performed in 42 patients during supine bicycle ergometry and during heavy dynamometer stretching at 50% of maximal voluntary contraction. Systemic vascular resistance increased from 1,484 to 1,649 dynes s cm-5 (p pressure products, heavy isometric exercise is far superior in sensitivity to dynamic exercise. PMID:1414932

  19. Significance of left ventricular volume measurement after heart transplantation using radionuclide techniques

    Novitzky, D.; Cooper, D.; Boniaszczuk, J.; Isaacs, S.; Fraser, R.C.; Commerford, P.J.; Uys, C.J.; Rose, A.G.; Smith, J.A.; Barnard, C.N.

    1985-02-01

    Multigated equilibrium blood pool scanning using Technetium 99m labeled red blood cells was used to measure left ventricular volumes in three heterotopic and one orthotopic heart transplant recipient(s). Simultaneously, an endomyocardial biopsy was performed and the degree of acute rejection was assessed by a histological scoring system. The scores were correlated to changes in ejection fraction and heart rate. Technetium 99m scanning data were pooled according to the endomyocardial biopsy score: no rejection; mild rejection; moderate rejection, and severe rejection. In each group, the median of the left ventricular volume parameters was calculated and correlated with the endomyocardial biopsy score, using a non-parametric one-way analysis of variance. A decrease in stroke volume correlated best with the endomyocardial biopsy score during acute rejection. A decrease in end-diastolic left ventricular volumes did not correlate as well. Changes in the end-systolic left ventricular volumes were not statistically significant, but using a simple correlation between end-systolic left ventricular volumes and endomyocardial biopsy the correlation reached significance. Changes in left ventricular volumes measured by Technetium 99m scanning may be useful to confirm the presence or absence of acute rejection in patients with heart grafts.

  20. Significance of left ventricular volume measurement after heart transplantation using radionuclide techniques

    Multigated equilibrium blood pool scanning using Technetium 99m labeled red blood cells was used to measure left ventricular volumes in three heterotopic and one orthotopic heart transplant recipient(s). Simultaneously, an endomyocardial biopsy was performed and the degree of acute rejection was assessed by a histological scoring system. The scores were correlated to changes in ejection fraction and heart rate. Technetium 99m scanning data were pooled according to the endomyocardial biopsy score: no rejection; mild rejection; moderate rejection, and severe rejection. In each group, the median of the left ventricular volume parameters was calculated and correlated with the endomyocardial biopsy score, using a non-parametric one-way analysis of variance. A decrease in stroke volume correlated best with the endomyocardial biopsy score during acute rejection. A decrease in end-diastolic left ventricular volumes did not correlate as well. Changes in the end-systolic left ventricular volumes were not statistically significant, but using a simple correlation between end-systolic left ventricular volumes and endomyocardial biopsy the correlation reached significance. Changes in left ventricular volumes measured by Technetium 99m scanning may be useful to confirm the presence or absence of acute rejection in patients with heart grafts

  1. 无创正压机械通气治疗急性左心衰竭临床研究%Clinical study on the treatment of acute left ventricular failure by non-invasure positive airway pressure mechanical ventilation

    洪波; 刘荣魁

    2008-01-01

    目前,多数急性左心衰竭(acute left ventricular failure,ALVF)患者仍接受传统的强心、利尿、血管活性药物及ALVF氧疗,随着无创正压机械通气(noninvasive positive air—way pressure mechanical ventilation,NIPPV)技术的完善及经验的积累,NIPPV越来越多地应用于ALVF的治疗。本研究对NIPPV与常规治疗进行随机对照研究,评价其疗效。

  2. Left ventricular noncompaction: Clinical-echocardiographic study

    Nikolić Aleksandra

    2012-01-01

    Full Text Available Background/Aim. Left ventricular noncompaction (LVNC is a disorder in endomyocardial morphogenesis, seen either isolated (in the absence of other cardiac anomalies or in association with congenital heart disease and some neuromuscular diseases. Intrauterine arrest of the compaction of myocardial fibers is postulated to be the reason of LVNC. Recognition of this condition is extremely important due to its high mortality and morbidity that lead to progressive heart failure, ventricular arrhythmias and thromboembolic events. The aim of this study was to determine the prevalence and clinical presentation of LVNC among consecutive outpatients according to clinical and echocardiographyic findings. Methode. A total of 3,854 consecutive patients examined at the Institute for Cardiovascular Diseases within a period January 2006 - January 2007 were included in the study. All the patients underwent echocardiographic examination using the same equipment (Vivid 7, GE Medical System. Echocardiographic parameters and clinical presentation in patients with echocardiographic criteria for LVNC were analyzed. Results. Analyzing 3,854 consecutive outpatients, using two-dimensional Color Doppler echocardiography from January 2006 to January 2007, 12 patients met the criteria for LVNC. Seven of them were male. The mean age at diagnosis was 45 ± 15 years. Analyzing clinical manifestation of LVNC it was found that seven patients had signs of heart failure, six had arrhythmias with no embolic events. Conclusion. Our results suggest that the real prevalence of LVNC may be higher than expected. New studies have to be done to solve this problem.

  3. CT of left ventricular assist devices.

    Carr, Carrie M; Jacob, Jaisy; Park, Soon J; Karon, Barry L; Williamson, Eric E; Araoz, Philip A

    2010-03-01

    Left ventricular assist devices (LVADs) have become an increasingly beneficial option for patients with heart failure, especially in light of the insufficient availability of donor hearts. LVADs have been used effectively in end-stage heart failure as a bridge to heart transplantation, as destination therapy for those ineligible for transplantation, or as a bridge to myocardial recovery. Presently, a wide variety of LVADs are being used therapeutically. Four different LVADs have been used at the authors' institution. The records of 42 patients who underwent implantation of 46 total LVADs during a 17-month period were reviewed; in 23 of these patients, computed tomography of the device was performed. Increased use of LVADs necessitates understanding of the normal positioning of a variety of these devices and recognition of potential complications, which include inflow and outflow cannula complications, postoperative hemorrhage, pericardial tamponade, thrombus formation, aortic valve stenosis, aortic valve insufficiency, right-sided heart failure, and infection. PMID:20228327

  4. Left ventricular thrombus associated with arteriovenous extra corporeal membrane oxygenation

    Makdisi, George; Hashmi, Zubair A.; Wozniak, Thomas C.

    2015-01-01

    Extra corporeal membrane oxygenation (ECMO) has remarkably progressed over the recent years. It has become an invaluable tool in the care of adults and pediatric patients with severe cardiogenic shock. At the initiation of ECMO support, the left ventricular contractility is profoundly impaired. Inadequate right ventricular drainage and bronchial circulation can lead to left ventricular distension, with potential deleterious consequences, ranging from inadequate myocardial rest, pulmonary edema, or intracardiac clot formation. Therefore, it is of extreme importance to ensure an adequate left ventricular drainage. Here we present a case of LV thrombus developed while the patient is on central venoarterial (VA) ECMO. PMID:26716054

  5. Left ventricular thrombus associated with arteriovenous extra corporeal membrane oxygenation.

    Makdisi, George; Hashmi, Zubair A; Wozniak, Thomas C; Wang, I-Wen

    2015-11-01

    Extra corporeal membrane oxygenation (ECMO) has remarkably progressed over the recent years. It has become an invaluable tool in the care of adults and pediatric patients with severe cardiogenic shock. At the initiation of ECMO support, the left ventricular contractility is profoundly impaired. Inadequate right ventricular drainage and bronchial circulation can lead to left ventricular distension, with potential deleterious consequences, ranging from inadequate myocardial rest, pulmonary edema, or intracardiac clot formation. Therefore, it is of extreme importance to ensure an adequate left ventricular drainage. Here we present a case of LV thrombus developed while the patient is on central venoarterial (VA) ECMO. PMID:26716054

  6. Sixty-four-slice CT in the assessment of global and regional left ventricular function: Comparison with MRI in a porcine model of acute and subacute myocardial infarction

    The purpose was to assess 64-slice CT in the analysis of global and regional ventricular function, using a model of acute and subacute myocardial infarction in comparison with cine-MRI. Seven pigs underwent standard MSCT and MRI examination a median 1 and 21 days following creation of reperfused myocardial infarction. Endocardial and epicardial contours were manually defined and ventricular volumes calculated according to Simpson's method. Results were compared by Pearson's correlation coefficient and Blant-Altman analysis. Wall motion was assessed on cine-images and evaluated by kappa statistics. MSCT revealed a strong correlation with cine-MRI regarding quantification of end-diastolic volume (EDV; r = 0.97), end-systolic volume (ESV; r = 0.97), stroke volume (SV; r = 0.94), ejection fraction (EF; r = 0.95) or myocardial mass (MM; r =0.94). Minor overestimation was observed for EDV and ESV (bias -1.7 ml; -1.5 ml; P=0.095; 0.025), whilst the mean difference for EF was found to be negligible (bias 0.9%; P = 0.18). Both modalities showed a 96.2% segmental agreement in regional wall motion (weighted-kappa 0.91 for 238 segments). This was true for both acute and subacute infarct phase and MSCT, and thereby enabled accurate intraindividual follow-up of segmental dysfunction. Sixty-four-slice CT allows for reliable analysis of global cardiac function and, moreover, provides accurate evaluation of wall motion in acute and subacute myocardial infarct. (orig.)

  7. Evaluation of left ventricular volumes measured by magnetic resonance imaging

    Møgelvang, J; Thomsen, C; Mehlsen, J;

    1986-01-01

    Left ventricular end-diastolic and end-systolic volumes were determined in 17 patients with different levels of left ventricular function by magnetic resonance imaging (MRI). A 1.5 Tesla Magnet was used obtaining ECG triggered single and multiple slices. Calculated cardiac outputs were compared...

  8. Left ventricular thrombus associated with arteriovenous extra corporeal membrane oxygenation

    Makdisi, George; Hashmi, Zubair A; Wozniak, Thomas C.; Wang, I-Wen

    2015-01-01

    Extra corporeal membrane oxygenation (ECMO) has remarkably progressed over the recent years. It has become an invaluable tool in the care of adults and pediatric patients with severe cardiogenic shock. At the initiation of ECMO support, the left ventricular contractility is profoundly impaired. Inadequate right ventricular drainage and bronchial circulation can lead to left ventricular distension, with potential deleterious consequences, ranging from inadequate myocardial rest, pulmonary edem...

  9. Left atrial appendage dysfunction in a patient with premature ventricular contractions - a risk factor for stroke?

    Patel, Sandeep M; Ackerman, Michael J; Asirvatham, Samuel J

    2013-01-01

    A 16-year-old female with ventricular dysfunction and frequent ventricular arrhythmia presented with a cardioembolic stroke. Prior electrophysiology study and ablation was performed for ventricular tachycardia (VT). For remaining ventricular ectopy, the patient was maintained on carvedilol and mexiletine. After one year on this regimen, she presented with an acute stroke. Transesophageal echocardiography revealed no evidence of an intracardiac or ventricular thrombus but demonstrated markedly decreased left atrial appendage (LAA) flow velocity worsened during frequent premature ventricular contractions (PVC). In the absence of atrial fibrillation (AF), the LAA dysfunction was considered secondary to the frequent PVCs and was thought to be the underlying cause for the stroke. We present this case to highlight a potential under recognized association between LAA dysfunction and ventricular arrhythmia, similar to that observed with atrioventricular dyssynchronous pacing. PMID:24086095

  10. Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure, or both

    Solomon, Scott D; Zelenkofske, Steve; McMurray, John J V; Finn, Peter V; Velazquez, Eric; Ertl, George; Harsanyi, Adam; Rouleau, Jean L; Maggioni, Aldo; Køber, Lars Valeur; White, Harvey; Van de Werf, Frans; Pieper, Karen; Califf, Robert M; Pfeffer, Marc A

    2005-01-01

    BACKGROUND: The risk of sudden death from cardiac causes is increased among survivors of acute myocardial infarction with reduced left ventricular systolic function. We assessed the risk and time course of sudden death in high-risk patients after myocardial infarction. METHODS: We studied 14......,609 patients with left ventricular dysfunction, heart failure, or both after myocardial infarction to assess the incidence and timing of sudden unexpected death or cardiac arrest with resuscitation in relation to the left ventricular ejection fraction. RESULTS: Of 14,609 patients, 1067 (7 percent) had an event...... associated with a 21 percent adjusted increase in the risk of sudden death or cardiac arrest with resuscitation in the first 30 days. CONCLUSIONS: The risk of sudden death is highest in the first 30 days after myocardial infarction among patients with left ventricular dysfunction, heart failure, or both...

  11. Thrombin Receptor and Ventricular Arrhythmias after Acute Myocardial Infarction

    Tang, Lilong; Deng, Chunyu; Long, Ming; Tang, Anli; Wu, Shulin; Dong, Yugang; Saravolatz, Louis D.; Gardin, Julius M.

    2008-01-01

    The mechanism mediating the development of ventricular arrhythmia (VA) after acute myocardial infarction (AMI) is still uncertain. Thrombin receptor (TR) activation has been proven to be arrhythmogenic in many other situations, and we hypothesize that it may participate in the genesis of post-AMI VA. Using a left coronary artery ligation rat model of AMI, we found that a local injection of hirudin into the left ventricle (LV) significantly reduced the ratio of VA durations to infarction sizin...

  12. Arterial baroreflex function and left ventricular hypertrophy

    MIAO Chao-Yu; SU Ding-Feng

    2004-01-01

    It is well known that the arterial baroreflex(ABR)plays a key role in the regulation of heart rate and stabilization of blood pressure.Currently,it appears that ABR dysfunction is involved in the pathophysiology of cardiovascular disease states.Since the mid-1990s,a number of studies have been carried out in our laboratory to explore the pathological significance of ABR function in cardiovascular damage.This minireview summarizes our research work on the topic of ABR and left ventricular hypertrophy(LVH).On the basis of discussion concerning the importance of ABR dysfunction in hypertensive LVH and sinoaortic denervation-induced LVH,we advance a new strategy for reversal of LVH,that is,restoration of impaired ABR function.We tested this hypothesis in animal models with ABR deficiency.It was found that improvement of impaird ABR function with long-term treatment of ketanserin or candesartan was accompanied by reversal of LVH.The preliminary results indicate that it is feasible to target ABR for treatment of LVH.

  13. Left Ventricular Dilatation Increases the Risk of Ventricular Arrhythmias in Patients With Reduced Systolic Function

    Aleong, Ryan G.; Mulvahill, Matthew J; Halder, Indrani; Carlson, Nichole E; Singh, Madhurmeet; Bloom, Heather L.; Dudley, Samuel C.; Ellinor, Patrick T.; Shalaby, Alaa; Weiss, Raul; Gutmann, Rebecca; Sauer, William H.; Narayanan, Kumar; Chugh, Sumeet S.; Saba, Samir

    2015-01-01

    Background Reduced left ventricular (LV) ejection fraction increases the risk of ventricular arrhythmias; however, LV ejection fraction has a low sensitivity to predict ventricular arrhythmias. LV dilatation and mass may be useful to further risk-stratify for ventricular arrhythmias. Methods and Results Patients from the Genetic Risk of Assessment of Defibrillator Events (GRADE) study (N =930), a study of heart failure subjects with defibrillators, were assessed for appropriate implantable ca...

  14. Effect of left ventricular systolic function on left atrial filling

    The effect of left ventricular (LV) systolic function on left atrial (LA) filling was studied using radionuclide angiography (RNA) and echocardiography in 21 normal subjects and in 40 patients with various heart deseases who had no regurgitant or shunt flow. The LV and LA time-activity curves (TAC) and these first-derivative curves were derived from RNA. The peak rate of LA filling during the atrial filling phase was normalized to the LA maximum counts and was defined as the LA peak filling rate (LAf-PFR). In all patients and normal subjects, the LV peak ejection rate (LVs-PER) occurred at a time close to that of LAf-PFR ((132 ± 22 msec (mean ± SD) vs 139 ± 34 msec, NS)). With use of the following equations, the peak rates of the LV emptying or LA filling determined by the RNA were converted from counts/sec to ml/sec by equating the echocardiographically-derived LV end-diastolic volume or LA maximum volume to the LV end-diastolic counts or the LA maximum counts, respectively. LVs-max dV/dt (ml/sec) = (LVs-PER) x (LV end-diastolic volume). LAf-max dV/dt (ml/sec) = (LAf-PFR) x (LA maximum volume). There was a significant positive correlation between the LVs-max dV/dt, an index of LV systolic function, and the LAf-max dV/dt, an index of LA filling function (r = 0.58, p < 0.001) in all patients and normal subjects. This indicates that the LA peak filling rate increases progressively as the LV peak ejection rate. Thus, these results suggest that the LA filling might be affected by the LV systolic function. (author)

  15. Effect of left ventricular systolic function on left atrial filling

    The effect of left ventricular (LV) systolic function on left atrial (LA) filling was studied using radionuclide angiography (RNA) and echocardiography in 17 normal subjects and in 40 patients with various heart disease who had no regurgitant or shunt flow. The LV and LA time-activity curves (TAC) and these first-derivative curves were derived from RNA. The peak rate of LA filling during the atrial filling phase was normalized to the LA maximal counts and was defined as the LA peak filling rate (LAf-PFR). In all patients and normal subjects, the LV peak ejection rate (LVs-PER) occurred at a time close to that of LAf-PFR (131 ± 22 msec (mean ± SD) vs. 140 ± 35 msec, NS). With use of the following equations, the peak rates of the LV emptying or LA filling determined by the RNA were converted from counts/sec to ml/sec by equating the echocardiographically-derived LV end-diastolic volume or LA maximal volume to the LV end-diastolic counts or the LA maximal counts, respectively. LVs-max dV/dt (ml/sec) = LVs-PER x (LV end-diastolic volume). LAf-max dV/dt (ml/sec) = LAf-PFR x (LA maximal volume). There was a significant positive correlation between the LVs-max dV/dt, an index of LV systolic function, and the LAf-max dV/dt, an index of LA filling function (r = 0.57, p < 0.001) in all patients and normal subjects. This indicates that the LA peak filling rate increases progressively as the LV peak ejection rate. Thus, these results suggest that the LA filling might be affected by the LV systolic function. (author)

  16. Comparison of Left Ventricular Electromechanical Mapping and Left Ventricular Angiography: Defining Practical Standards for Analysis of NOGA™ Maps

    Sarmento-Leite, Rogerio; Silva, Guilherme V.; Dohman, Hans F.R.; Rocha, Ricardo Mourilhe; Dohman, Hans J.F.; de Mattos, Nelson Durval S.G.; Carvalho, Luis Antonio; Gottschall, Carlos A.M.; Perin, Emerson C.

    2003-01-01

    We performed this prospective cohort study to correlate the findings of left ventricular angiography (LVA) and NOGA™ left ventricular electromechanical mapping (LVEM) in the evaluation of cardiac wall motion and also to establish standards for wall motion assessment by LVEM. Fifty-five patients (35 men; mean age, 60.4 ± 11.8 years) eligible for elective left cardiac catheterization underwent LVA and LVEM. Wall motion scores, LV ejection fractions (LVEF), and LV volumes derived from LVA versus...

  17. Automatic extraction of left ventricular contours from MRI images

    In the MRI cardiac function analysis, left ventricular volume curves and diagnostic parameters are obtained by extracting the left ventricular cavities as regions of interest (ROI) from the MR cine images. The ROI extractions had to be done by manual operations, so the examination efficiency and data analysis reproducibility were poor in diagnoses on site. In this paper, we outline an automatic extraction method for the left ventricular contours from MR cine images to improve cardiac function diagnosis. With this method, the operator needs to manually indicate only 3 points on the 1st image, and can then get all the contours from the total sequence of images automatically. (author)

  18. A two phase harmonic model for left ventricular function

    Dubi, S; Dubi, Y

    2006-01-01

    A minimal model for mechanical motion of the left ventricle is proposed. The model assumes the left ventricle to be a harmonic oscillator with two distinct phases, simulating the systolic and diastolic phases, at which both the amplitude and the elastic constant of the oscillator are different. Taking into account the pressure within the left ventricle, the model shows qualitative agreement with functional parameters of the left ventricle. The model allows for a natural explanation of heart failure with preserved systolic left ventricular function, also termed diastolic heart failure. Specifically, the rise in left ventricular filling pressures following increased left-ventricular wall stiffness is attributed to a mechanism aimed at preserving heart rate and cardiac output.

  19. Incidence of Atrial Fibrillation in Patients with either Heart Failure or Acute Myocardial Infarction and Left Ventricular Dysfunction: A Cohort Study

    Abildstrøm Steen Z

    2011-05-01

    Full Text Available Abstract Background We examined the incidence of new-onset atrial fibrillation in patients with left ventricular dysfunction. Patients either had a recent myocardial infarction (with or without clinical heart failure or symptomatic heart failure (without a recent MI. Patients were with and without treatment with the class III antiarrhythmic drug dofetilide over 36 months. Methods The Danish Investigations of Arrhythmia and Mortality ON Dofetilide (DIAMOND studies included 2627 patients without atrial fibrillation at baseline, who were randomised to treatment with either dofetilide or placebo. Results The competing risk analyses estimated the cumulative incidences of atrial fibrillation during the 42 months of follow-up to be 9.6% in the placebo-treated heart failure-group, and 2.9% in the placebo-treated myocardial infarction-group. Cox proportional hazard regression found a 42% significant reduction in the incidence of new-onset AF when assigned to dofetilide compared to placebo (hazard ratio 0.58, 95% confidence interval 0.40-0.82 and there was no interaction with study (p = 0.89. In the heart failure-group, the incidence of atrial fibrillation was significantly reduced to 5.6% in the dofetilide-treated patients (hazard ratio 0.57, 95% confidence interval 0.38-0.86. In the myocardial infarction-group the incidence of atrial fibrillation was reduced to 1.7% with the administration of dofetilide. This reduction was however not significant (hazard ratio 0.61, 95% confidence interval 0.30-1.24. Conclusion In patients with left ventricular dysfunction the incidence of AF in 42 months was 9.6% in patients with heart failure and 2.9% in patients with a recent MI. Dofetilide significantly reduced the risk of developing atrial fibrillation compared to placebo in the entire study group and in the subgroup of patients with heart failure. The reduction in the subgroup with recent MI was not statistically significant, but the hazard ratio was similar to

  20. Temporary epicardial left ventricular and biventricular pacing improves cardiac output after cardiopulmonary bypass

    García-Bengochea Jose B

    2012-10-01

    Full Text Available Abstract Background To evaluate, with different pacing modes, acute changes in left ventricular systolic function, obtained by continuous cardiac output thermodilution in various subsets of patients undergoing cardiopulmonary bypass surgery. Increments of mean arterial pressure and cardiac output were considered the end point. Methods Fifty cases electively submitted to cardiac surgery were analyzed. Isolated valve surgery 62%, coronary revascularization 30% and 8% mixed disease. Left ventricular ejection fraction was preserved in 50%,36% had moderate depression,(EF 36%-50% whereas 14% had severe depression (EF  Results Right atrium-right ventricular pacing, decreased significantly mean arterial pressure and cardiac output (2.3% in the overall population and in the subgroups studied. Right atrium-left ventricle, increased mean arterial pressure and cardiac output in 79% of patients and yielded cardiac output increments of 7.5% (0.40 l/m in the low ejection fraction subgroup and 7.3% (0.43 l/m in the left bundle branch block subset. In atrial fibrillation patients, left ventricular and biventricular pacing produced a significant increase in cardiac output 8.5% (0.39 l/min and 11.6% (0.53 l/min respectively. The dP/dt max increased significantly with both modes (p = 0.021,p = 0.028. Conclusion Right atrial-right ventricular pacing generated adverse hemodynamic effects. Right atrium-left ventricular pacing produced significant CO improvement particularly in cases with depressed ventricular function and left bundle branch block. The greatest increments were observed with left ventricular or biventricular pacing in atrial fibrillation with depressed ejection fraction.

  1. Right and left ventricular performance by nuclear stethoscope

    Right and left ventricular performance by Nuclear Stethoscope using Kr-81m and Tc-99m-RBC were performed. And physiological and pharmacological interventions were also investigated for the evaluation of coronary artery diseases (CAD)

  2. Resting thallium-201 myocardial perfusion patterns in patients with severe left ventricular dysfunction: differences between patients with primary cardiomyopathy, chronic coronary artery disease, or acute myocardial infarction

    This study examined the value of resting thallium-201 imaging in differentiating patients with primary cardiomyopathy from those with ischemic cardiomyopathy. There were 15 patients with primary cardiomyopathy (group I); 20 with chronic CAD (group II); and 25 with acute Q wave myocardial infarction (group III). All patients had LVEF less than or equal to 35%. The thallium score was less than 50 (maximum 60) in one patient (7%) in group I, in 17 patients (85%) in group II, and in 25 patients (100%) in group III (p less than 0.0001, I vs II and III). The number of normal segments was 11.4 +/- 4.9 in group I, 6.9 +/- 2.9 in group II, and 7.0 +/- 2.2 in group III (p less than 0.0001, I vs II, III). Reversible defects were present in three patients in group II, three in group III, and none in group I. Abnormal right ventricular thallium uptake was observed in 27% of patients in group I, 25% in group II, and 40% in group III (p = NS). Abnormal lung thallium uptake was observed in 33% in group I, 20% in group II, and 20% in group III (p = NS). Thus, rest thallium imaging is useful in separating patients with primary cardiomyopathy from those with ischemic cardiomyopathy

  3. Observations of super early left ventricular remodeling experimental myocardial infarction

    Purpose: Ventricular remodeling is defined as the changes in the shape and size of the entire left ventricle after acute myocardial infarction (AMI). Many investigators have shown that left ventricular remodeling is related to clinical outcomes, including mortality, that represent the natural history, of the heart failure syndrome. The aim of this study was to demonstrate that it is possible to observe super early left ventricular remodeling by 99mTc-MIBI myocardial imaging in the dog model of acute experimental myocardial infarction. Methods: Experimental subjects: Twenty-three healthy mongrel dogs (14-25 kg) of either sex were studied under general anesthesia (sodium pentobarbital, 30 mg/kg). The left anterior descending (LAD) coronary artery was dissected and ligated between the first and second diagonal branches. Seven dogs died of ventricular fibrillation after the LAD coronary artery ligation. The 16 remaining dogs were divided into two groups: Group A (GA) received 99mTc-MIBI myocardial imaging (n=8): Group B (GB) received 99mTc-MIBI myocardial imaging combined with echocardiography (n=8). 99mTc-MIBI myocardial perfusion imaging :Static 99mTc-MIBI myocardial imaging was taken with ADAC Vertex Dual-head SPECT. 99mTc-MIBI kit was manufactured in Syncor, China. Each dog served as its own control, and was scanned by 99mTc-MIBI myocardial imaging and chocardiography at 48-72 hours before ligation. The mean time of the first acquisition was 21.87 ± 11.03 (14-48) minutes post-operatively in GA, 57.63±22.83 (30-99) minutes for 99mTc-MIBI imaging in GB, 26.00±15.07 (12-50) minutes for echocardiography in GB. Acquisition techniques for Gated SPECT: ECG synchronized data collection: R wave trigger, 8 Frames/Cardiac cycle. Images were gathered by rotating the detectors 180 degrees at 6 degrees per frame. Each frame took 40 seconds. The dog position was supine. The images were acquired and recorded for 6 hours following the LAD coronary artery ligation. After 6 hours

  4. "Mushroom cloud": a giant left ventricular pseudoaneurysm after a myocardial infarction due to myocardial bridging – a case report

    Ferreira Manuel M; Gouveia Raquel A; Lima Sónia; Santos Miguel; Andrade Maria; Gomes Renata; Silva José

    2009-01-01

    Abstract Left ventricular pseudoaneurysm is an uncommon complication after transmural myocardial infarction, occurring when a free wall rupture is contained by adhesions of the overlying pericardium preventing acute tamponade. In this report, an unusual case of a 61 year-old male with a giant apical left ventricular pseudoaneurysm after an unnoticed myocardial infarction is presented. On coronary angiogram myocardial bridging of the distal left anterior descending artery was judged to be the ...

  5. Recombinant human growth hormone secreted from tissue-engineered bioartificial muscle improves left ventricular function in rat with acute myocardial infarction

    RONG Shu-ling; WANG Yong-jin; WANG Xiao-lin; LU Yong-xin; CHANG Chao; WANG Feng-zhi; LIU Qi-yun; LIU Xiang-yang; GAO Yan-zhang; MI Shao-hua

    2009-01-01

    Background Experimental studies and preliminary clinical studies have suggested that growth hormone (GH) treatment may improve cardiovascular parameters in chronic heart failure (CHF). Recombinant human GH (rhGH) has been delivered by a recombinant protein, by plasmid DNA, and by genetically engineered cells with different pharmacokinetic and physiological properties. The present study aimed to examine a new method for delivery of rhGH using genetically modified bioartificial muscles (BAMs), and investigate whether the rhGH delivered by this technique improves left ventricular (LV) function in rats with CHF.Methods Primary skeletal myoblasts were isolated from several Sprague-Dawley (SD) rats, cultured, purified, and retrovirally transduced to synthesize and secrete human rhGH, and tissue-engineered into implantable BAMs. Ligation of the left coronary artery or sham operation was performed. The rats that underwent ligation were randomly assigned to 2 groups: CHF control group (n=6) and CHF treatment group (n=6). The CHF control group received non-rhGH-secreting BAM (GFP-BAMs) transplantation, and the CHF treatment group received rhGH-secreting BAM (GH-BAMs) transplantation. Another group of rats served as the sham operation group, which was also randomly assigned to 2 subgroups: sham control group (n=6) and sham treatment group (n=6). The sham control group underwent GFP-BAM transplantation, and the sham treatment group underwent GH-BAM transplantation. GH-BAMs and GFP-BAMs were implanted subcutaneously into syngeneic rats with ligaUon of the left coronary artery or sham operation was performed. Eight weeks after the treatment,echocardiography was performed, hGH, insulin-like growth factor-1 (IGF-1) and TNF-a levels in rat serum were measured by radioimmunoassay and ELISA, and then the rats were killed and ventricular samples were subjected to immunohistochemistry. Results Primary rat myoblasts were retrovirally transduced to secrete rhGH and tissue-engineered into

  6. Electrocardiographic Criteria for Left Ventricular Hypertrophy in Children

    Rijnbeek, Peter R; van Herpen, Gerard; Kapusta, Livia; ten Harkel, A. Derk Jan; Witsenburg, Maarten; Kors, Jan A.

    2008-01-01

    Previous studies to determine the sensitivity of the electrocardiogram (ECG) for left ventricular hypertrophy (LVH) in children had their imperfections: they were not done on an unselected hospital population, several criteria used in adults were not applied to children, and obsolete limits of normal for the ECG parameters were used. Furthermore, left ventricular mass (LVM) was taken as the reference standard for LVH, with no regard for other clinical evidence. The study population consisted ...

  7. An Updated Concept for Left Ventricular Hypertrophy Risk in Hypertension

    Frohlich, Edward D.

    2009-01-01

    Left ventricular hypertrophy (LVH) was one of the first three “factors of risk” originally identified by the Framingham Heart Study predisposing the patient to premature morbidity and mortality resulting from coronary heart disease. Among the initial approaches toward specific risk reduction were antihypertensive agents that reduce left ventricular (LV) mass with control of arterial pressure. However, the indication to reduce risk from LVH has not been approved by the federal regulatory agenc...

  8. Left ventricular muscle mass regression after aortic valve replacement.

    Lee, J. W.; Choi, K. J.; Lee, S G; Choo, S. J.; Kim, J.O.; Kang, D H; Song, J.K.; Song, M. G.

    1999-01-01

    Implanting a valve that will reduce left ventricular mass is critical in aortic stenosis. Regression of left ventricular hypertrophy in 46 aortic valve replacement (AVR) patients receiving a St. Jude Medical (SJM) valve was assessed by serial electrocardiographic and echocardiographic studies during the preoperative, immediate, and late postoperative periods. The patients were divided into three groups according to valve size; 19 mm group (n=9), 21 mm group (n=20), and 23+mm group (n=17). The...

  9. Silent myocardial ischemia evaluated by ambulatory left ventricular function monitoring

    Imai, Kamon; Yumikura, Sei; Araki, Yasushi; Ando, Tatsuo; Saito, Satoshi; Ozawa, Yukio; Hatano, Michinobu; Kamata, Rikisaburo (Nihon Univ., Tokyo (Japan). School of Medicine)

    1989-12-01

    To determine whether left ventricular function is less disturbed in asymptomatic ischemia than in symptomatic ischemia, exercise-induced left ventricular function was measured in beat-to-beat using an ambulatory left ventricular function monitoring system. The study subjects were 22 patients with coronary artery disease. Supine and sitting ergometer exercise tests were performed. Of 44 exercise tests, 33 showed significant ST depression on electro-cardiograms. Among these 33, 17 were asymptomatic: 16, symptomatic. The left ventricular functions during exercise of these 33 were analyzed and compared with those of five normal controls. The changes in end-diastolic volume were not so significant either in controls or in the asymptomatic and symptomatic groups, but the changes in end-systolic volume were reversed in the diseased group, particularly in the symptomatic group. The changes in ejection fraction (EF), therefore, were significantly negative in the diseased group, particularly in the symptomatic group. The correlation between exercise-induced left ventricular dysfunction and symptoms was evaluated among the 33 patients. Symptoms were present in 35% (6/17) in <10% decrease in EF, 44% (4/9) in 10{approx}15% decrease, and 85% (6/7)in {ge}15% decrease, respectively. Thus, asymptomatic ischemia represents a lesser degree of myocardial ischemia as indicated by mild left ventricular dysfunction, compared with symptomatic ischemia. However, some cases of severe myocardial ischemia did not develop symptoms. We concluded that silent myocardial ischemia is responsible for a lesser degree of myocardial ischemia and decreased pain perception. (author).

  10. Left Ventricular Mass: Correlation with Fatness, Hemodynamics and Renal Morphology

    Left ventricular mass (LVM) is correlated with body composition and central hemodynamics as well as kidney function. Recently, fat-free mass has been considered to be more strongly correlated with LVM in comparison to other descriptors of fatness. We therefore address the question of whether comprehensive descriptors of fatness, central hemodynamics and renal characteristics demonstrate the association with left ventricular mass in healthy non-obese population. 119 healthy non-obese subjects (53 females, 66 males, mean age 50 yrs) were evaluated. Central hemodynamics was measured by Pulse Wave Analysis, left ventricular mass was assessed by echocardiography, fatness was evaluated by anthropometry, bioimpedance, and ultrasound. Left ventricular mass index (LVMI) correlated to the same extent with central and peripheral blood pressure but not with descriptors of wave reflection. Fat-free mass as well as intraabdominal fat correlated to a similar extent with LVMI. Kidney morphological characteristics indexed to body surface area were associated inversely and independently with LVMI. Comprehensive assessment of fatness reinforced the concept that intraabdominal fat compartment is strongly correlated with left ventricular mass. Descriptors of wave reflection are not associated with left ventricular mass. The interrelationsh between kidney morphology and LVMI indicates that such associations may be a biologically plausible phenomenon

  11. Left Ventricular Aneurysm Presenting as a Late Complication of Childhood Chemotherapy

    Braghadheeswar Thyagarajan

    2015-01-01

    a rare and a dangerous complication which is particularly challenging in diagnosis requiring a high index of suspicion and periodic imaging. We present a case of a young Caucasian male with a past medical history of Acute Lymphocytic Leukemia status after chemotherapy during his childhood diagnosed with left ventricular aneurysm several years later.

  12. Evaluation of the optimal driving mode during left ventricular assist with pulsatile catheter pump in calves

    Mihaylov, D; Verkerke, GJ; Blanksma, PK; Elstrodt, J; de Jong, ED; Rakhorst, G

    1999-01-01

    The pulsatile catheter (PUCA) pump, a left ventricular assist device, was tested during acute experiments in calves using asynchronous and EGG-synchronous assist modes. The aim of the study is to compare ECG-synchronous and asynchronous assist and to find the optimal driving mode for the PUCA pump w

  13. Left ventricular systolic and diastolic function in hyperthyroidism

    Friedman, M.J.; Okada, R.D.; Ewy, G.A.; Hellman, D.J.

    1982-12-01

    In order to assess the effect of hyperthyroidism on systolic and diastolic function of the left ventricle, M-mode echocardiograms and systolic time intervals were obtained in 13 patients while they were clinically hyperthyroid and again when they were euthyroid following radioactive iodine therapy. Echocardiographic tracings of the septum and left ventricular posterior wall were digitized and analyzed to provide the maximum velocity of shortening and maximum velocity of lengthening. These velocities were normalized for left ventricular diastolic dimension. The left ventricular minor axis fractional shortening and the normalized maximum velocity of shortening were both increased during the hyperthyroid state. The normalized maximum velocity of lengthening, a measure of diastolic left ventricular function, was also increased during the hyperthyroid state when compared to the euthyroid state. The preejection period index and the preejection period/left ventricular ejection time ratio were lower when the patients were hyperthyroid than when they were euthyroid. These data confirm the increased inotropic state and demonstrated increased diastolic relaxation velocities of the hyperthyroid left ventricle.

  14. Association of arterial stiffness and electrocardiography-determined left ventricular hypertrophy with left ventricular diastolic dysfunction.

    Po-Chao Hsu

    Full Text Available OBJECTIVES: Increased arterial stiffness is associated with left ventricular diastolic dysfunction (LVDD, but this association may be influenced by left ventricular (LV performance. Left ventricular hypertrophy (LVH is not only a significant determinant of LV performance, but is also correlated with LVDD. This study is designed to compare LV diastolic function among patients divided by brachial-ankle pulse wave velocity (baPWV and electrocardiography (ECG-determined LVH and to assess whether increased baPWV and ECG-determined LVH are independently associated with LVDD. METHODS: This cross-sectional study enrolled 270 patients and classified them into four groups according to the median value of baPWV and with/without ECG-determined LVH. The baPWV was measured using an ABI-form device. ECG-determined LVH was defined by Sokolow-Lyon criterion. LVDD was defined as impaired relaxation, pseudonormal, and restrictive mitral inflow patterns. Groups 1, 2, 3, and 4 were patients with lower baPWV and without ECG-determined LVH, lower baPWV but with ECG-determined LVH, higher baPWV but without ECG-determined LVH, and higher baPWV and with ECG-determined LVH respectively. RESULTS: Early diastolic mitral velocity (Ea was gradually decreased from group 1 to group 4 (p≦0.027. Patients in group 4 had the highest prevalence of LVDD (all p<0.001. After multivariate analysis, both baPWV and ECG-determined LVH were independent determinants of Ea (β = -0.02, P<0.001; β = -1.77, P<0.001 respectively and LVDD (odds ratio = 1.02, P = 0.011 and odds ratio = 3.53, P = 0.013 respectively. CONCLUSION: Our study showed the group with higher baPWV and ECG-determined LVH had the lowest Ea and highest prevalence of LVDD. In addition, both baPWV and ECG-determined LVH were independently associated with Ea and LVDD. Hence, assessment of arterial stiffness by baPWV and LVH by ECG may be useful in identifying the high risk group of LVDD.

  15. Left ventricular systolic response to exercise in patients with systemic hypertension without left ventricular hypertrophy.

    Christian, T F; Zinsmeister, A R; Miller, T D; Clements, I P; Gibbons, R J

    1990-05-15

    Supine exercise radionuclide angiography was performed in 367 men to assess left ventricular (LV) systolic response to exercise; 58 had systemic hypertension without LV hypertrophy on a resting electrocardiogram and 309 were normotensive. All patients met the following criteria defining a low pretest likelihood of coronary artery disease: age less than 50 years; normal electrocardiographic response to exercise; absence of typical or atypical chest pain; and exercise heart rate greater than 120 beats/min. Patients taking beta-receptor blockers were excluded. There were no significant differences between hypertensive and normotensive groups in peak exercise heart rate, workload or exercise duration. However, hypertensive patients had significantly higher peak exercise systolic blood pressures and peak exercise rate-pressure products. There were no differences between patients with and without hypertension in resting ejection fraction, peak exercise ejection fraction (hypertensive patients 0.71 +/- 0.01, normotensive patients 0.70 +/- 0.05) or change in ejection fraction at peak exercise (hypertensive patients 0.07 +/- 0.01, normotensive patients 0.07 +/- 0.04). Diastolic and systolic ventricular volumes tended to be smaller in the hypertensive patients, but the difference was not statistically significant. The change in systolic volume with exercise was similar in the 2 groups (hypertensive -10 +/- 3 ml/m2, normotensive -10 +/- 1 ml/m2). In the absence of electrocardiographic evidence of LV hypertrophy, systemic hypertension does not influence LV systolic response to exercise. PMID:2140008

  16. Mild carbon monoxide poisoning impairs left ventricular diastolic function

    Özgür Çiftçi

    2013-01-01

    Full Text Available Rationale: Carbon monoxide (CO poisoning is associated with direct cardiovascular toxicity. In mild CO poisoning in which cardiovascular life support is not required, the effects of CO on left and right ventricular functions are unknown in patients without cardiac failure. Objectives: Echocardiography was used to determine whether or not mild CO poisoning impairs ventricular function. Twenty otherwise healthy patients with CO poisoning and 20 age- and gender-matched controls were studied. Echocardiographic examinations were performed at the time of admission and 1 week after poisoning. Results: The impairment observed in the left and right ventricular diastolic function at the time of admission was greater than the impairment 1 week after poisoning. Mild CO poisoning did not have a significant effect on systolic function. Carboxyhemoglobin levels were positively correlated with left ventricular diastolic dysfunction, whereas the levels were not correlated with right ventricular diastolic function. Conclusions: In CO intoxication, the development of left and right ventricular diastolic dysfunction precedes systolic abnormality. Patients with mild CO poisoning do not manifest cardiovascular symptoms; however, it should be borne in mind that most of these patients have myocardial involvement.

  17. Review of Current Research on Aldosterone and Left Ventricular Remodeling after Acute Myocardial Infarction%醛固酮对急性心肌梗死后左心室重构影响的研究进展

    吴春涛

    2011-01-01

    心力衰竭已经成为影响人们生命和生活质量的主要疾病,心肌梗死后心室重构是其重要原因之一,急性心肌梗死后神经内分泌系统的过度激活对心室重构的影响已成为共识.作为肾素-血管紧张素-醛固酮系统的重要组成部分,醛固酮对于心血管系统的病理生理作用以及醛固酮逃逸现象确定了醛固酮受体拮抗剂在心力衰竭治疗中的决定性地位.现就醛固酮对于急性心肌梗死后左心室重构影响的研究进展作一综述.%Heart failure is a disease that affects people's quality of life, and ventricular remodeling after myocardial infarction is one of the major reasons. There is a consensus on the effect of over-activation of the neuroendocrine system after acute myocardial infarction ( AMI) on ventricular remodeling. Aldosterone acts as an important part of the renin-angiotensin-aldosterone system, and the aldosterone receptor antagonist plays a crucial role in the modern therapeutic regimen for heart failure attributed to aldosterone's pathophysiological effects on the cardiovascular system and aldosterone escape phenomenon. This article reviews the effects of aldosterone on left ventricular remodeling of AMI.

  18. Magnetic Resonance Imaging of Transient Left Ventricular Apical Ballooning Related to Emotional Stress: a Case Report

    Lee, Mu Sook; Choi, Byoung Wook; Choe, Kyu Ok; Chung, Namsik [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2007-02-15

    Transient left ventricular apical ballooning is characterized by transient wall motion abnormalities involving the left ventricular apex and mid-ventricle in the absence of coronary arterial occlusion. A 66-year-old woman presented to the emergency department with chest pain that mimicked acute myocardial infarction. An aortogram showed akinesis from the mid to apical left ventricle with sparing of the basal segments. Four days later, she underwent MRI, which demonstrated characteristic apical contractile dysfunction, the same as the aortogram, without evidence of myocardial infarction on the MRI. Two weeks later, her symptoms were resolved and follow-up echocardiography showed normal ventricular function. We suggest that MRI might be an integrated imaging diagnostic tool for the diagnosis of this syndrome, which demonstrated characteristic apical contractile dysfunction with performing cine MRI, the absence of significant coronary artery stenosis with performing coronary MR angiography and the absence of myocardial infarction with performing contrast enhanced delayed MRI.

  19. Magnetic Resonance Imaging of Transient Left Ventricular Apical Ballooning Related to Emotional Stress: a Case Report

    Transient left ventricular apical ballooning is characterized by transient wall motion abnormalities involving the left ventricular apex and mid-ventricle in the absence of coronary arterial occlusion. A 66-year-old woman presented to the emergency department with chest pain that mimicked acute myocardial infarction. An aortogram showed akinesis from the mid to apical left ventricle with sparing of the basal segments. Four days later, she underwent MRI, which demonstrated characteristic apical contractile dysfunction, the same as the aortogram, without evidence of myocardial infarction on the MRI. Two weeks later, her symptoms were resolved and follow-up echocardiography showed normal ventricular function. We suggest that MRI might be an integrated imaging diagnostic tool for the diagnosis of this syndrome, which demonstrated characteristic apical contractile dysfunction with performing cine MRI, the absence of significant coronary artery stenosis with performing coronary MR angiography and the absence of myocardial infarction with performing contrast enhanced delayed MRI

  20. 5-Fluorouracil cardiotoxicity: reversible left ventricular systolic dysfunction with early detection.

    Iskandar, Muhammad Zaid; Quasem, Wahid; El-Omar, Magdi

    2015-01-01

    A 33-year-old man presented to hospital with acute shortness of breath and evolving ST segment changes on ECG 3 days following a cycle of 5-fluorouracil (5-FU) for colon cancer. Despite no cardiac history, subsequent echocardiogram showed severe left ventricular systolic dysfunction. The patient was initially treated with heart failure medications and his coronary angiogram was normal. Chemotherapy was stopped and he was started on nitrates and calcium channel blockers. A repeat echocardiogram and cardiac MRI a week later showed complete resolution of his left ventricular dysfunction and he was discharged home. This case report summarises 5-FU cardiotoxicity, and emphasises the importance of early recognition and correct treatment, as left ventricular systolic dysfunction in this context is potentially reversible. PMID:25935919

  1. Combination of traumatic thoracic aortic pseudoaneurysm and myocardial contusion leading to left ventricular aneurysm

    The combination of thoracic aortic pseudoaneurysm and left ventricular aneurysm resulting from a single traumatic incident is an exceedingly rare occurrence. We present a case of a 10-year-old girl who sustained significant blunt trauma to the chest after being involved in a rollover motor vehicle accident. The child underwent immediate repair of a transected aortic arch. An inferior wall left ventricular aneurysm developed 3 weeks later, and the patient underwent successful repair of the left ventricular aneurysm and a damaged mitral valve. The use of fast multidetector row CT, cardiac MRI, and echocardiography have improved our ability to diagnose these types of injuries and accurately image their anatomic relationships in the acute and perioperative settings. (orig.)

  2. A CMR study of the effects of tissue edema and necrosis on left ventricular dyssynchrony in acute myocardial infarction: implications for cardiac resynchronization therapy

    Manka Robert

    2012-07-01

    Full Text Available Abstract Background In acute myocardial infarction (AMI, both tissue necrosis and edema are present and both might be implicated in the development of intraventricular dyssynchrony. However, their relative contribution to transient dyssynchrony is not known. Cardiovascular magnetic resonance (CMR can detect necrosis and edema with high spatial resolution and it can quantify dyssynchrony by tagging techniques. Methods Patients with a first AMI underwent percutaneous coronary interventions (PCI of the infarct-related artery within 24 h of onset of chest pain. Within 5–7 days after the event and at 4 months, CMR was performed. The CMR protocol included the evaluation of intraventricular dyssynchrony by applying a novel 3D-tagging sequence to the left ventricle (LV yielding the CURE index (circumferential uniformity ratio estimate; 1 = complete synchrony. On T2-weighted images, edema was measured as high-signal (>2 SD above remote tissue along the LV mid-myocardial circumference on 3 short-axis images (% of circumference corresponding to the area-at-risk. In analogy, on late-gadolinium enhancement (LGE images, necrosis was quantified manually as percentage of LV mid-myocardial circumference on 3 short-axis images. Necrosis was also quantified on LGE images covering the entire LV (expressed as %LV mass. Finally, salvaged myocardium was calculated as the area-at-risk minus necrosis (expressed as % of LV circumference. Results After successful PCI (n = 22, 2 female, mean age: 57 ± 12y, peak troponin T was 20 ± 36ug/l and the LV ejection fraction on CMR was 41 ± 8%. Necrosis mass was 30 ± 10% and CURE was 0.91 ± 0.05. Edema was measured as 58 ± 14% of the LV circumference. In the acute phase, the extent of edema correlated with dyssynchrony (r2 = −0.63, p 2 = −0.19, p = 0.05. PCI resulted in salvaged myocardium of 27 ± 14%. LV dyssynchrony (=CURE decreased at 4 months from 0.91

  3. Tei index in evaluation on left ventricular dysfunction in early phase acute myocardial infarction in rats%Tei指数评价大鼠超急性期心肌梗死左心功能

    林蔚; 白旭东; 刘美佳

    2012-01-01

    目的 探讨Tei指数对评价大鼠超急性期心肌梗死后左心功能的作用.方法 将健康雄性Wistar大鼠23只随机分为两组:13只予垂体后叶素腹腔注射(实验组),10只予等量生理盐水腹腔注射(对照组).建模后分别记录两组大鼠心电图,用超声心动图检测获取左心室射血分数(EF)、等容收缩时间(ICT)、射血时间(ET)及等容舒张时间(IRT),然后取心肌组织行病理检查.结果 实验组ICT、Tei指数较对照组显著增加(P<0.01).Pearson相关分析显示,ICT及Tei指数与心电图ST段抬高程度、EF相关性良好(P<0.01).结论 Tei指数及其相关参数能客观评价大鼠超急性期心肌梗死的左心功能,可作为基础研究中判断该期心功能异常的良好指标.%Objective To observe the value of Tei index in evaluation on left ventricular dysfunction in early stage of acute myocardial infarction (AMI) in rat. Methods A total of 23 healthy male Wistar rats were randomly classified into experimental group (n=13) and control group (n=10) , and intraperitoneal injecting of Pituitrin or saline was performed, respectively. Parameters were measured with electrocardiography, and left ventricular ejection fraction (EF) , isovolumetric contraction time (ICT) , ejection time (ET) and isovolumic relaxation time (IRT) were obtained with echocardiography after modeling. Then pathological examination was performed in myocardium tissue sections. Results Compared with control group, ICT and Tei index of experimental group significantly increased (P<0. 01). Pearson correlation analysis showed ICT and Tei index were well correlated with ST segment elevation and EF (P<0. 01). Conclusion Tei index and the related parameters are efficient enough to evaluate left ventricular function after rat AMI in super early period, which can be used for basic research in evaluation of cardiac function.

  4. The effects of intraventricular gradients on left ventricular ejection dynamics.

    Murgo, J P; Alter, B R; Dorethy, J F; Altobelli, S A; Craig, W E; McGranahan, G M

    1983-11-01

    The generation of abnormal gradients between the apical cavity and the subaortic valvular region of the left ventricle in patients with hypertrophic cardiomyopathy (HCM) has traditionally been equated to a dynamic obstruction to left ventricular outflow. To examine this concept in more detail, left ventricular ejection dynamics were studied during cardiac catheterization in 30 patients with HCM and 29 patients with no evidence of cardiovascular disease. Using multisensor catheterization techniques, ascending aortic flow velocity and micromanometer left ventricular and aortic pressures were simultaneously recorded during rest (n = 47). Dynamic left ventricular emptying was also analyzed with frame-by-frame angiography (n = 46). The temporal distribution of left ventricular outflow was independently derived from both flow velocity and angiographic techniques. The HCM patients were subdivided into three groups: I, intraventricular gradients at rest (n = 9); II, intraventricular gradients only with provocation (n = 12); III, no intraventricular gradients despite provocation (n = 9). Expressed as a precentage of the available systolic ejection period (%SEP), the time required for ejection of the total stroke volume was (mean +/- 1 S.D.): Group I, 69 +/- 17% (flow), 64 +/- 6% (angio); Group II, 63 +/- 14% (flow), 65 +/- 6% (angio); Group III, 61 +/- 16% (flow), 62 +/- 4% (angio); control group, 90 +/- 5% (flow) 86 +/- 10% (angio). No significant difference was observed between any of the three HCM subgroups, but, compared with the control group, ejection was completed much earlier in systole independent of the presence or absence of intraventricular gradients. The presence of coexisting mitral regurgitation in 12 of the HCM patients did not alter these results. This study demonstrates that 'outflow obstruction', as traditionally defined by the presence of an abnormal intraventricular pressure gradient and systolic anterior motion of the mitral valve, does not impede left

  5. Mild carbon monoxide poisoning impairs left ventricular diastolic function

    Özgür Çiftçi; Murat Günday; Mustafa Çaliskan; Hakan Güllü; Rafi Dogan; Aytekin Güven; Haldun Müderrisoglu

    2013-01-01

    Rationale: Carbon monoxide (CO) poisoning is associated with direct cardiovascular toxicity. In mild CO poisoning in which cardiovascular life support is not required, the effects of CO on left and right ventricular functions are unknown in patients without cardiac failure. Objectives: Echocardiography was used to determine whether or not mild CO poisoning impairs ventricular function. Twenty otherwise healthy patients with CO poisoning and 20 age- and gender-matched controls were studied. Ec...

  6. Assessment of the left ventricular function with the nuclear stethoscope

    The evaluation of the left ventricular function with the Nuclear Stethoscope was performed on 27 patients with heart diseases. The reproducibility of the measurements was good. Repetitions of EF, ER and EDV estimations yielded errors of 2.63%, 1.45% and 0.31%. The comparison with the results of camera ventriculography showed a good agreement of EF, contraction velocity parameters and relaxation velocity parameters, with a cor. coeff. of greater or equal to 0.750. A particularly high correlation was found between the NS EF and NS ER (r = 0.968). It was concluded that the Nuclear Stethoscope provides a reliable evaluation of left ventricular function. (orig.)

  7. Assessment of the left ventricular function with the nuclear stethoscope

    Tarkowska, A.; Adam, W.E.; Bitter, F.

    1980-08-01

    The evaluation of the left ventricular function with the Nuclear Stethoscope was performed on 27 patients with heart diseases. The reproducibility of the measurements was good. Repetitions of EF, ER and EDV estimations yielded errors of 2.63%, 1.45% and 0.31%. The comparison with the results of camera ventriculography showed a good agreement of EF, contraction velocity parameters and relaxation velocity parameters, with a cor. coeff. of greater or equal to 0.750. A particularly high correlation was found between the NS EF and NS ER (r = 0.968). It was concluded that the Nuclear Stethoscope provides a reliable evaluation of left ventricular function.

  8. Rationale and design of EXPLORE: a randomized, prospective, multicenter trial investigating the impact of recanalization of a chronic total occlusion on left ventricular function in patients after primary percutaneous coronary intervention for acute ST-elevation myocardial infarction

    Tuseth Vegard

    2010-09-01

    Full Text Available Abstract Background In the setting of primary percutaneous coronary intervention, patients with a chronic total occlusion in a non-infarct related artery were recently identified as a high-risk subgroup. It is unclear whether ST-elevation myocardial infarction patients with a chronic total occlusion in a non-infarct related artery should undergo additional percutaneous coronary intervention of the chronic total occlusion on top of optimal medical therapy shortly after primary percutaneous coronary intervention. Possible beneficial effects include reduction in adverse left ventricular remodeling and preservation of global left ventricular function and improved clinical outcome during future coronary events. Methods/Design The Evaluating Xience V and left ventricular function in Percutaneous coronary intervention on occLusiOns afteR ST-Elevation myocardial infarction (EXPLORE trial is a randomized, prospective, multicenter, two-arm trial with blinded evaluation of endpoints. Three hundred patients after primary percutaneous coronary intervention for ST-elevation myocardial infarction with a chronic total occlusion in a non-infarct related artery are randomized to either elective percutaneous coronary intervention of the chronic total occlusion within seven days or standard medical treatment. When assigned to the invasive arm, an everolimus-eluting coronary stent is used. Primary endpoints are left ventricular ejection fraction and left ventricular end-diastolic volume assessed by cardiac Magnetic Resonance Imaging at four months. Clinical follow-up will continue until five years. Discussion The ongoing EXPLORE trial is the first randomized clinical trial powered to investigate whether recanalization of a chronic total occlusion in a non-infarct related artery after primary percutaneous coronary intervention for ST-elevation myocardial infarction results in a better preserved residual left ventricular ejection fraction, reduced end-diastolic volume

  9. Detection of left ventricular thrombi by echotomography and computed tomography

    Left ventricular (LV) thrombi are rarely recognized during life, though they are not infrequent at the post-mortem examination of patients succumbed to valvular disease, acute myocardial infarction, and cardiomyopathy. We presented five cases in which LV thrombi were detected by cross-sectional echocardiography (CSE) and confirmed by computed tomography. The main purpose of this study was to compare the echocardiographic findings of the LV thrombi with the manifestations of the LV thrombi on the computed tomograms, with a hope to augment the clinical utility of CSE in the detection of LV thrombi. CSE was recorded from the apical and four-chamber views in addition to the conventional approach. A computed tomographic whole-body scanner which utilized a continuously rotating gantry and pulsed anode with X-ray radiation collimated to form a thin fan-shaped beam was used. A complete section scan was performed in 3 seconds. Sustained enhancement was obtained with a rapid intravenous infusion of 30% meglumine iothalanate. Most of the LV thrombi showed an abnormal echo with irregular borders and/or a mobile mass echo at the apex by CSE. Computed tomographic findings suggestive of LV thrombi appeared as a defect, which was apparently different in quality from the surrounding myocardium or valvular apparatus. These findings were quite consistent with those of CSE with respect to the number and the location of the LV thrombi. (author)

  10. Unusual distribution of noncompaction of left ventricular myocardium.

    Bhardwaj, Ravindra; Abro, Masroor; Gharib, Wissam; Warden, Bradford E; Jain, Abnash; Failinger, Conard F

    2015-01-01

    This case report highlights a rare case of isolated septal noncompaction of the left ventricle, a congenital condition, in a previously asymptomatic adult patient who presented with syncope. Management of left ventricular noncompaction (LVNC) includes treatment for heart failure, arrhythmias, and thromboembolic events; but no criteria exist for primary prophylaxis in patients that might be at high risk. To our knowledge this is the first report of isolated septal noncompaction in a previously asymptomatic adult patient. PMID:25665274

  11. [Evaluation of the addition of counterpulsation to the partial left ventricular-femoral bypass for limitation of evolving myocardial infarction].

    Yamaguchi, A; Ide, H; Ino, T; Adachi, H; Mizuhara, A; Kawahito, K; Murata, S

    1994-08-01

    The effect of adding counterpulsation to a partial left ventricular bypass was evaluated in a canine model of acute myocardial ischemia by using a myocardial staining method. To establish a left ventricular bypass, a catheter consisting of bypass tube (90 cm in length and 15 Fr in inner diameter) and an accompanying intraaortic balloon as a single apparatus (Integrated Cardioassist Catheter; ICAC) was introduced into the left ventricle via the abdominal aorta. The left ventricular bypass was adjusted to 1 L/min. with or without counterpulsation with the aid of a centrifugal pump and IABP console. The use of the ICAC that provided pulsatile left ventricular bypass tended to raise the mean aortic pressure and cardiac output. Reduction of the tension time index was noted with the use of the ICAC in contrast to the control. And increment of the DPTI/TTI ratio was observed with the use of the ICAC in contrast to the control and partial left ventricular bypass alone. While the percentages of the region at risk were similar [17.3 +/- 9.5% (control), vs. 16.4 +/- 3.4% (partial left ventricular bypass alone) vs. 16.9 +/- 5.2% (ICAC)], the percentages of infarct sizes were reduced due to the use of counterpulsation. [61.9 +/- 12.2% (control), vs. 57.5 +/- 3.9% (partial left ventricular bypass alone) vs. 16.8 +/- 6.0% (ICAC)]. These results revealed that the addition of counterpulsation alleviates afterload reduction to the partial left ventricular bypass and was more beneficial to the reduction of the infarct size than partial left ventricular bypass alone. PMID:7963829

  12. Continuous monitoring of left ventricular function by VEST

    Using an ambulatory ventricular function monitor (VEST), left ventricular function (LVF) was examined in one healthy volunteer, 3 with ischemic heart disease, and one with dilated myocardiopathy (DMCP) under various conditions, such as treadmill exercise, standing, and sitting. It was also examined when two DCMP patients with associated left ventricular failure were given a nitrite (ISDM) and cardiotonic agent (E 1020). End-diastolic volume (EDV) decreased in the standing position, and increased in exercise, suggesting the involvement of venous blood pool in the legs. Ejection fraction (EF) decreased in the case of widespread ischemia during exercise. Drug tolerance test revealed decrease in EDV and end-systolic volume (ESV), no change in stroke volume (SV), and slight increase in EF on ISDM; and decrease in EDV and ESV, increase in SV, and marked increase in EF on E 1020. For EF, the VEST data were relatively well correlated with gamma camera data. (Namekawa, K.)

  13. Continuous monitoring of left ventricular function by VEST

    Ohtake, Tohru; Watanabe, Toshiaki; Kosaka, Noboru and others

    1988-01-01

    Using an ambulatory ventricular function monitor (VEST), left ventricular function (LVF) was examined in one healthy volunteer, 3 with ischemic heart disease, and one with dilated myocardiopathy (DMCP) under various conditions, such as treadmill exercise, standing, and sitting. It was also examined when two DCMP patients with associated left ventricular failure were given a nitrite (ISDM) and cardiotonic agent (E 1020). End-diastolic volume (EDV) decreased in the standing position, and increased in exercise, suggesting the involvement of venous blood pool in the legs. Ejection fraction (EF) decreased in the case of widespread ischemia during exercise. Drug tolerance test revealed decrease in EDV and end-systolic volume (ESV), no change in stroke volume (SV), and slight increase in EF on ISDM; and decrease in EDV and ESV, increase in SV, and marked increase in EF on E 1020. For EF, the VEST data were relatively well correlated with gamma camera data. (Namekawa, K.).

  14. Left ventricular noncompaction: diagnosis by three-dimensional echocardiography.

    Correia, Emanuel; Santos, Luís Ferreira; Rodrigues, Bruno; Gama, Pedro; Ferreira, Pedro; Nunes, Luis; Pipa, João; Cabral, Costa; Dionísio, Odete; Santos, Oliveira

    2009-11-01

    Left ventricular noncompaction (LVNC) is a rare congenital disease caused by an arrest in normal myocardial embryogenesis, leading to persistence of numerous prominent trabeculations that communicate with the left ventricle. It was first described as a congenital condition affecting children, but several cases have been reported of late presentation. The main clinical manifestations are congestive heart failure, arrhythmias (supraventricular or ventricular) and systemic embolism. We present the case of a 51-year-old patient brought to our emergency department after an episode of symptomatic ventricular flutter requiring electrical cardioversion. Two-dimensional echocardiography with color Doppler suggested the diagnosis and the three-dimensional echocardiogram revealed the deep trabeculations typical of LVNC. PMID:20222350

  15. Four Genetic Loci Influencing Electrocardiographic Indices of Left Ventricular Hypertrophy

    Shah, Sonia; Nelson, Christopher P.; Gaunt, Tom R.; van der Harst, Pim; Barnes, Timothy; Braund, Peter S.; Lawlor, Debbie A.; Casas, Juan-Pablo; Padmanabhan, Sandosh; Drenos, Fotios; Kivimaki, Mika; Talmud, Philippa J.; Humphries, Steve E.; Whittaker, John; Morris, Richard W.; Whincup, Peter H.; Dominiczak, Anna; Munroe, Patricia B.; Johnson, Toby; Goodall, Alison H.; Cambien, Francois; Diemert, Patrick; Hengstenberg, Christian; Ouwehand, Willem H.; Felix, Janine F.; Glazer, Nicole L.; Tomaszewski, Maciej; Burton, Paul R.; Tobin, Martin D.; van Veldhuisen, Dirk J.; de Boer, Rudolf A.; Navis, Gerjan; van Gilst, Wiek H.; Mayosi, Bongani M.; Thompson, John R.; Kumari, Meena; MacFarlane, Peter W.; Day, Ian N. M.; Hingorani, Aroon D.; Samani, Nilesh J.

    2011-01-01

    Background-Presence of left ventricular hypertrophy on an ECG (ECG-LVH) is widely assessed clinically and provides prognostic information in some settings. There is evidence for significant heritability of ECG-LVH. We conducted a large-scale gene-centric association analysis of 4 commonly measured i

  16. Electrocardiographic criteria for left ventricular hypertrophy in children

    P.R. Rijnbeek (Peter); G. van Herpen (Gerard); L. Kapusta (Livia); A.D.J. ten Harkel (Arend); M. Witsenburg (Maarten); J.A. Kors (Jan)

    2008-01-01

    textabstractPrevious studies to determine the sensitivity of the electrocardiogram (ECG) for left ventricular hypertrophy (LVH) in children had their imperfections: they were not done on an unselected hospital population, several criteria used in adults were not applied to children, and obsolete lim

  17. Electrocardiographic criteria for left ventricular hypertrophy in children.

    Rijnbeek, P.R.; Herpen, G van; Kapusta, L.; Harkel, AD Ten; Witsenburg, M.; Kors, J.A.

    2008-01-01

    Previous studies to determine the sensitivity of the electrocardiogram (ECG) for left ventricular hypertrophy (LVH) in children had their imperfections: they were not done on an unselected hospital population, several criteria used in adults were not applied to children, and obsolete limits of norma

  18. THE PUCA PUMP - A LEFT-VENTRICULAR ASSIST DEVICE

    VERKERKE, B; DEMUINCK, ED; RAKHORST, G; BLANKSMA, PK

    1993-01-01

    Left ventricular assist devices (LVADs) that are being used clinically still have specific drawbacks. Therefore, a new concept for mechanical circulatory support was developed, the pulsatile catheter (PUCA) pump. It consists of an extracorporeally placed, pneumatically driven membrane pump that is c

  19. A simple nomogram for determination of echocardiographic left ventricular geometry

    Heesen, WF; Beltman, FW; Smit, AJ; May, JF

    1998-01-01

    Recent data have shown that left ventricular (I.V) geometry provides additional information on the simple dichotomy of presence or absence of LV hypertrophy with regard to cardiovascular risk of hypertensive patients. A "new" class of concentric remodeling was created, identifying a rather large gro

  20. Echocardiographic evaluation of left ventricular function in ischemic heart disease

    Mollema, Sjoerd Adriaan

    2010-01-01

    The presence of a decreased left ventricular (LV) function after myocardial infarction has demonstrated to be of considerable clinical importance. In this thesis, the role of 2D echocardiography to evaluate LV function in ischemic heart disease was investigated. In the first part of the thesis, rece

  1. Giant blood cyst tumor in the left ventricular outflow tract

    ZHANG Chong; HU Jian; NI Yi-ming; JIANG Zhi-nong; XU He-yun

    2007-01-01

    @@ Blood cyst is a rare primary cardiac tumor usually affecting the cardiac valves. Associated with severe occlusion-related complications, it is generally removed surgically. With a brief review of the literature, we present a case of pedunculated tumor in the left ventricular outflow tract identified by echocardiography.

  2. Quantitative assessment of regional left ventricular motion using endocardial landmarks

    C.J. Slager (Cornelis); T.E.H. Hooghoudt (Ton); P.W.J.C. Serruys (Patrick); J.C.H. Schuurbiers (Johan); J.H.C. Reiber (Johan); G.T. Meester (Geert); P.D. Verdouw (Pieter); P.G. Hugenholtz (Paul)

    1986-01-01

    textabstractIn this study the hypothesis is tested that the motion pattern of small anatomic landmarks, recognizable at the left ventricular endocardial border in the contrast angiocardiogram, reflects the motion of the endocardial wall. To verify this, minute metal markers were inserted in the endo

  3. Cardiac Biomarkers and Left Ventricular Hypertrophy in Asymptomatic Hemodialysis Patients

    Reneta Yovcheva Koycheva

    2015-12-01

    Full Text Available BACKGROUND: Cardiac biomarkers are often elevated in dialysis patients showing the presence of left ventricular dysfunction. The aim of the study is to establish the plasma levels of high-sensitivity cardiac troponin T (hs TnT, precursor of B-natriuretic peptide (NT-proBNP and high sensitivity C-reactive protein (hs CRP and their relation to the presence of left ventricular hypertrophy (LVH in patients undergoing hemodialysis without signs of acute coronary syndrome or heart failure. MATERIAL AND METHODS: Were studied 48 patients - 26 men and 22 women. Pre and postdialysis levels of hs cTnT, NT-proBNP and hs CRP were measured at week interim procedure. Patients were divided in two groups according to the presence of echocardiographic evidence of LVH - gr A - 40 patients (with LVH, and gr B - 8 patients (without LVH. RESULTS: In the whole group of patients was found elevated predialysis levels of all three biomarkers with significant increase (p < 0.05 after dialysis with low-flux dialyzers. Predialysis values of NT-proBNP show moderate positive correlation with hs cTnT (r = 0.47 and weaker with hs CRP (r = 0.163. Such dependence is observed in postdialysis values of these biomarkers. There is a strong positive correlation between the pre and postdialysis levels: for hs cTnT (r = 0.966, for NT-proBNP (r = 0.918 and for hs CRP (r = 0.859. It was found a significant difference in the mean values of hs cTnT in gr. A and gr. B (0.07 ± 0.01 versus 0.03 ± 0.01 ng /mL, p < 0.05 and NT-proBNP (15,605.8 ± 2,072.5 versus 2,745.5 ± 533.55 pg /mL, p < 0.05. Not find a significant difference in hs CRP in both groups. CONCLUSIONS: The results indicate the relationship of the studied cardiac biomarkers with LVH in asymptomatic patients undergoing hemodialysis treatment.

  4. Role of left ventricular twist mechanics in cardiomyopathies, dance of the helices

    Floris; Kauer; Marcel; Leonard; Geleijnse; Bastiaan; Martijn; van; Dalen

    2015-01-01

    Left ventricular twist is an essential part of left ventricular function. Nevertheless, knowledge is limited in "the cardiology community" as it comes to twist mechanics. Fortunately the development of speckle tracking echocardiography, allowing accurate, reproducible and rapid bedside assessment of left ventricular twist, has boosted the interest in this important mechanical aspect of left ventricular deformation. Although the fundamental physiological role of left ventricular twist is undisputable, the clinical relevance of assessment of left ventricular twist in cardiomyopathies still needs to be established. The fact remains; analysis of left ventricular twist mechanics has already provided substantial pathophysiological understanding on a comprehensive variety of cardiomyopathies. It has become clear that increased left ventricular twist in for example hypertrophic cardiomyopathy may be an early sign of subendocardial(microvascular) dysfunction. Furthermore, decreased left ventricular twist may be caused by left ventricular dilatation or an extensive myocardial scar. Finally, the detection of left ventricular rigid body rotation in noncompaction cardiomyopathy may provide an indispensible method to objectively confirm this difficult diagnosis. All this endorses the value of left ventricular twist in the field of cardiomyopathies and may further encourage the implementation of left ventricular twist parameters in the "diagnostic toolbox" for cardiomyopathies.

  5. New strict left bundle branch block criteria reflect left ventricular activation differences

    Emerek, Kasper Janus Grønn; Risum, Niels; Hjortshøj, Søren Pihlkjær;

    2015-01-01

    AIMS: Pacing lead electrical delays and strict left bundle branch block (LBBB) criteria were assessed against cardiac resynchronization therapy (CRT) outcome. METHODS: Forty-nine patients with LBBB and QRS duration >130 milliseconds underwent CRT-implantation. Sensed right ventricular to left...

  6. Left ventricular filling patterns in patients with systemic hypertension and left ventricular hypertrophy (the LIFE study). Losartan Intervention For Endpoint

    Wachtell, K; Smith, G; Gerdts, E;

    2000-01-01

    Abnormal left ventricular (LV) filling may exist in early stages of hypertension. Whether this finding is related to LV hypertrophy is currently controversial. This study was undertaken to assess relations between abnormal diastolic LV filling and LV geometry in a large series of hypertensive pat...

  7. Non-invasive measurement of stroke volume and left ventricular ejection fraction. Radionuclide cardiography compared with left ventricular cardioangiography

    Kelbaek, H; Svendsen, Jesper Hastrup; Aldershvile, J; Folke, K; Nielsen, S L

    2011-01-01

    thermodilution and left ventricular cardioangiographic techniques. In a paired comparison the mean difference between the invasive and radionuclide SV was -1 ml (SED 3.1) with a correlation coefficient of 0.83 (p less than 0.01). Radionuclide LVEF values also correlated well with cardioangiographic measurements...

  8. Myocardial infarction in a patient with left ventricular noncompaction: a case report

    Toufan M; Shahvalizadeh R; Khalili M

    2012-01-01

    Mehrnoush Toufan,1 Roya Shahvalizadeh,1 Majid Khalili21Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 2Azerbaijan National Academy of Sciences, Baku, AzerbaijanAbstract: We describe a 73-year-old male patient with left ventricular noncompaction (LVNC) who was diagnosed with acute myocardial infarction (MI), three-vessel coronary artery disease, a fresh intraventricular thrombus, and mitral regurgitation. He was treated with full anticoagulant therapy, cor...

  9. Association of heart failure hospitalizations with combined electrocardiography and echocardiography criteria for left ventricular hypertrophy

    Gerdts, Eva; Okin, Peter M; Boman, Kurt;

    2012-01-01

    The value of performing echocardiography in hypertensive patients with electrocardiographic left ventricular hypertrophy (LVH) is uncertain.......The value of performing echocardiography in hypertensive patients with electrocardiographic left ventricular hypertrophy (LVH) is uncertain....

  10. Insulin resistance syndrome and left ventricular mass in an elderly population (The Rotterdam Study)

    Rheeder, P; Stolk, RP; Mosterd, A; Pols, HAP; Hofman, A; Grobbee, DE

    1999-01-01

    In a study of elderly men and women, age, body mass index, and systolic blood pressure (and in men, also glucose) were significant predictors of left ventricular mass. Postload insulin was not independently associated with left ventricular mass.

  11. Cardiac MR Elastography: Comparison with left ventricular pressure measurement

    Samani Abbas; Hamm Bernd; Schnorr Jörg; Kaufels Nikola; Laule Michael; Elgeti Thomas; Braun Jürgen; Sack Ingolf

    2009-01-01

    Abstract Purpose of study To compare magnetic resonance elastography (MRE) with ventricular pressure changes in an animal model. Methods Three pigs of different cardiac physiology (weight, 25 to 53 kg; heart rate, 61 to 93 bpm; left ventricular [LV] end-diastolic volume, 35 to 70 ml) were subjected to invasive LV pressure measurement by catheter and noninvasive cardiac MRE. Cardiac MRE was performed in a short-axis view of the heart and applying a 48.3-Hz shear-wave stimulus. Relative changes...

  12. Cardiac arrhythmias and left ventricular hypertrophy in systemic hypertension

    Background: Hypertensive left ventricular hypertrophy (LVH) is associated with increased risk of arrhythmias and mortality. Objective was to investigate the prevalence of cardiac arrhythmias and LVH in systemic hypertension. Methods: In all subjects blood pressure was measured, electrocardiography and echocardiography was done. Holter monitoring and exercise test perform in certain cases. There were 500 hypertensive patients, 156 (31.2%) men and 344 (69%) women >30 years of age in the study. Among them 177 (35.4%) were diabetic, 224 (45%) were dyslipidemia, 188 (37.6%) were smokers, and 14 (3%) had homocysteinemia. Mean systolic BP (SBP) was 180 +- 20 mm Hg and diastolic BP (DBP) was 95 +- 12 in male and female patients. Left ventricular mass index (LVMI) was 119.2 +- 30 2 2gm/m in male while 103 +- 22 gm/m in female patients. Palpitation was seen in 126 (25%) male and 299 (59.8%) female patients. Atrial fibrillation was noted in 108 (21.6%) male and 125 (25%) female patients, 30 (6%) male and 82 (16.4%) female patients had atrial flutter. Ventricular tachycardia was noted in 37 (7.4%) male and 59 (11.8%) female patients. Holter monitoring showed significant premature ventricular contractions (PVC'S) in 109 (21.8%) male and 128 (25.69%) female patients while Holter showed atrial arrhythmias (APC'S) in 89 (17.8%) males and 119 (23.8%) females. Angiography findings diagnosed coronary artery disease in 119 (23.8%) with CAD male and 225 (45%) without CAD while 47 (9.4%) females presented with CAD and 109 (21.8%) without CAD. Conclusion: A significant association has been demonstrated between hypertension and arrhythmias. Diastolic dysfunction of the left ventricle, left atrial size and function, as well as LVH have been suggested as the underlying risk factors for supraventricular, ventricular arrhythmias and sudden death in hypertensives with LVH. (author)

  13. Global left ventricular longitudinal strain is closely associated with increased neurohormonal activation after acute myocardial infarction in patients with both reduced and preserved ejection fraction

    Ersbøll, Mads; Valeur, Nana; Mogensen, Ulrik Madvig;

    2012-01-01

    N-terminal pro brain natriuretic peptide (NT-proBNP) is released in response to increased myocardial wall stress and is associated with adverse outcome in acute myocardial infarction. However, little is known about the relationship between longitudinal deformation indices and NT-proBNP....

  14. The Effect and Mechanism of Forsinopril on Ventricular Hypertrophy of SHR and Left Ventricular Pressure overloading Rat

    黄恺; 戴闺柱

    2002-01-01

    The effects and mechanism of long-term angiotensin converting enzyme inhibitor (ACEI)Forsinopril on left ventricular hypertrophy of spontaneous hypertension rat (SHR) and left ventricular pressure overloading rat were studied. The left ventricular index (left ventricle weight/body weight) was used to evaluate left ventricular hypertrophy and the in situ hybridization to investigate the TGF-β1 gene expression in left ventricle. The results showed that Forsinopril significantly decreased the left ventricular index of both SHR and left ventricle pressure overloading rat. Forsinopril reduced the integral photic density of TGF-β1 gene statement from 2. 836± 0. 314 to 1.91 ± 0. 217(P<0.01, n=8 ) of SHR rat and from 3. 071±0. 456 to 2. 37640. 379 (P<0.01, n=8) of left ventricular pressure overloading rat respectively. It was concluded that Forsinopril could prevent the occurrence of left ventricular hypertrophy and reduce the TGF-β1 gene expression in left ventricle of both SHR and left ventricular pressure overloading rat significantly.

  15. Left atrial systolic force in hypertensive patients with left ventricular hypertrophy: the LIFE study

    Chinali, M.; Simone, G. de; Wachtell, K.;

    2008-01-01

    patients (52.3%), who were older and had higher body mass index and heart rate (all P < 0.01) but similar systolic and diastolic blood pressure, in comparison with patients with normal left atrial systolic force. After controlling for confounders, increased left atrial systolic force was associated with......In hypertensive patients without prevalent cardiovascular disease, enhanced left atrial systolic force is associated with left ventricular hypertrophy and increased preload. It also predicts cardiovascular events in a population with high prevalence of obesity. Relations between left atrial...

  16. 双水平气道正压通气对急性左心衰竭患者血浆脑钠素水平的影响%Effects of Bi-level Positive Airway Pressure on the level of B-type natriuretic peptide in patients with acute left ventricular failure

    秦熠; 王丽敏; 宋倩

    2013-01-01

    Objective To observation the effects of Bi-level Positive Airway Pressure (BiPAP) on the levels of plasma B-type natriuretic peptide (BNP) in patients with acute left ventricular failure. Methods 126 consecutive cases admitted with acute left ventricular failure in the ICU of our hospital were included in the study. These cases were randomly divided into BiPAP group (62 cases, conventional treatment + BiPAP) and control group (64 cases, conventional therapy). The changes of the two groups on plasma BNP levels were compared. Results 6h and 24 h after therapy, plasma BNP levels of BiPAP group were significantly lower than that of control group (P<0. 05, P<0. 01). Conclusion BiPAP could decrease the level of plasma BNP in patients with acute left ventricular failure and is an advantageous treatment for patients with acute left ventricular failure.%目的 观察双水平气道正压通气(BiPAP)对急性左心衰竭患者血浆脑钠素(BNP)水平的影响.方法 对入我院急诊ICU的急性左心衰竭患者126例,随机分为BiPAP组(常规治疗+BiPAP) 62例和对照组(常规治疗)64例,比较两组BNP的变化.结果 治疗6h、24h后BiPAP组BNP较对照组显著降低(P<0.05,P<0.01).结论 BiPAP可使急性左心衰竭患者的BNP下降,有利于急性左心衰竭的治疗.

  17. Serum profiles of circulating granulocyte-macrophage colony-stimulating factor in acute myocardial infarction and relation with post-infarction left ventricular function

    MA Yi-tong; FU Zhen-yan

    2005-01-01

    @@ Accumulating evidence indicates that inflammation plays an important role in cardiac repairing and remodeling after acute myocardial infarction (AMI), process of which is mediated by a cytokine reaction cascade.1 Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a cytokine, which belongs to the family of haemopoietic cell colony-stimulating factor and regulates the proliferation and differentiation of myeloid progenitor cells.

  18. Anesthetic experience of patient with isolated left ventricular noncompaction: a case report

    Kim, Doyeon; Kim, Eunhee; Lee, Jong-Hwan; Kim, Chung Su; Lee, Sangmin Maria; Lee, Jung Eun

    2016-01-01

    Isolated left ventricular noncompaction (LVNC) is a rare primary genetic cardiomyopathy characterized by prominent trabeculation of the left ventricular wall and intertrabecular recesses. Perioperative management of the patient with LVNC might be challenging due to the clinical symptoms of heart failure, systemic thromboembolic events, and fatal left ventricular arrhythmias. We conducted real time intraoperative transesophageal echocardiography in a patient with LVNC undergoing general anesth...

  19. Evaluation of left ventricular function by nuclear stethoscope

    The Nuclear Stethoscope (N.S.) is a unique cardiac probe system that provides a precise, rapid, noninvasive method to directly quantify ventricular functions at the bedside or actual beat-to-beat or composite beat basis. The accuracy and validity of N.S. were studied in 42 patients with cardiac diseases in comparison with camera-computer EF. The N.S. EF was well correlated with camera-computer EF (r = 0.82). In this study, clinical application of N.S. was as follows. 1. Beat-to-beat left ventricular volume response for evaluation of arrythmia (atrial fibrillation, premature ventricular conduction, bigemy et al.) 2. exercise study by handgrip and ergometer. EF is an extremely sensitive indicator to discriminate coronary arteries diseases from normal subjects. (author)

  20. Left ventricular border recognition using a dynamic search algorithm

    Initial results obtained with a simple, fully automated algorithm for detection of left ventricular boundaries are presented. The strength of this approach is the use of dynamic programming search techniques, which allow determination of local border points to be influenced by the entire global border location. The relative contributions of mask mode subtraction and the dynamic search technique are evaluated with respect to accurate border definition. These computer-determined ventricular borders are compared with hand-traced borders on subtracted and unsubtracted images. The modular dynamic search algorithm is shown to perform better than previously described algorithms, which generally require operator interaction. It is also shown that for both manual and automated techniques, ventricular borders derived from subtracted images may be significantly different from borders derived from nonsubtracted images

  1. Left ventricular aneurysm and ventricular tachycardia as initial presentation of cardiac sarcoidosis

    Ashraf Jmeian

    2015-01-01

    Full Text Available Context: Cardiac sarcoidosis (CS is a rare, potentially fatal disease. It has a wide range of clinical presentations that range from asymptomatic electrocardiogram changes to sudden cardiac death. Ventricular aneurysms and ventricular tachycardia are seen late in the disease, and are rarely the presenting manifestation of the disease. Diagnosis of CS is challenging and often missed or delayed. Case Report: We report a 35-year-old patient who presented with sustained ventricular tachycardia and ST-elevation on electrocardiogram. Cardiac catheterization showed normal coronaries and left ventricular aneurysm. Subsequent 2D-echocardiography showed an infiltrative disease pattern. Cardiac MRI was done and showed late gadolinium enhancement in the septum, apex and lateral wall. The patient was diagnosed with cardiac sarcoidosis and treated with immune suppression and antiarrhythmic agent. In addition underwent AICD implantation. Conclusion: Our case highlights the importance of suspecting cardiac sarcoidosis in young patients presenting with electrocardiogram changes, and present an atypical presentation of this disease.

  2. Comparison of cardiovascular magnetic resonance feature tracking and tagging for the assessment of left ventricular systolic strain in acute myocardial infarction

    Highlights: • We compared feature tracking (FT) and tagging quantification of myocardial strain in acute MI. • This is the first study assessing FT strain assessment in acute MI. • FT was more robust and had better myocardial tracking than tagging. • FT had better interobserver agreement and FT analysis was quicker. • FT has stronger correlation with global and segmental infarct size, area at risk (oedema), myocardial salvage and infarct transmurality. • FT is feasible in acute MI and is likely to become the preferred quantification method. - Abstract: Aims: To assess the feasibility of feature tracking (FT)-measured systolic strain post acute ST-segment elevation myocardial infarction (STEMI) and compare strain values to those obtained with tagging. Methods: Cardiovascular MRI at 1.5 T was performed in 24 patients, 2.2 days post STEMI. Global and segmental circumferential (Ecc) and longitudinal (Ell) strain were assessed using FT and tagging, and correlated with total and segmental infarct size, area at risk and myocardial salvage. Results: All segments tracked satisfactorily with FT (p < 0.001 vs. tagging). Total analysis time per patient was shorter with FT (38.2 ± 3.8 min vs. 63.7 ± 10.3 min, p < 0.001 vs. tagging). Global Ecc and Ell were higher with FT than with tagging, apart from FT Ecc using the average of endocardial and epicardial contours (−13.45 ± 4.1 [FT] vs. −13.85 ± 3.9 [tagging], p = 0.66). Intraobserver and interobserver agreement for global strain were excellent for FT (ICC 0.906–0.990) but interobserver agreement for tagging was lower (ICC < 0.765). Interobserver and intraobserver agreement for segmental strain was good for both techniques (ICC > 0.7) apart from tagging Ell, which was poor (ICC = 0.15). FT-derived Ecc significantly correlated with total infarct size (r = 0.44, p = 0.03) and segmental infarct extent (r = 0.44, p < 0.01), and best distinguished transmurally infarcted segments (AUC 0.77) and infarcted from

  3. Comparison of cardiovascular magnetic resonance feature tracking and tagging for the assessment of left ventricular systolic strain in acute myocardial infarction

    Khan, Jamal N., E-mail: jk211@le.ac.uk; Singh, Anvesha, E-mail: as707@le.ac.uk; Nazir, Sheraz A., E-mail: sn191@le.ac.uk; Kanagala, Prathap, E-mail: pk214@le.ac.uk; Gershlick, Anthony H., E-mail: agershlick@aol.com; McCann, Gerry P., E-mail: gerry.mccann@uhl-tr.nhs.uk

    2015-05-15

    Highlights: • We compared feature tracking (FT) and tagging quantification of myocardial strain in acute MI. • This is the first study assessing FT strain assessment in acute MI. • FT was more robust and had better myocardial tracking than tagging. • FT had better interobserver agreement and FT analysis was quicker. • FT has stronger correlation with global and segmental infarct size, area at risk (oedema), myocardial salvage and infarct transmurality. • FT is feasible in acute MI and is likely to become the preferred quantification method. - Abstract: Aims: To assess the feasibility of feature tracking (FT)-measured systolic strain post acute ST-segment elevation myocardial infarction (STEMI) and compare strain values to those obtained with tagging. Methods: Cardiovascular MRI at 1.5 T was performed in 24 patients, 2.2 days post STEMI. Global and segmental circumferential (Ecc) and longitudinal (Ell) strain were assessed using FT and tagging, and correlated with total and segmental infarct size, area at risk and myocardial salvage. Results: All segments tracked satisfactorily with FT (p < 0.001 vs. tagging). Total analysis time per patient was shorter with FT (38.2 ± 3.8 min vs. 63.7 ± 10.3 min, p < 0.001 vs. tagging). Global Ecc and Ell were higher with FT than with tagging, apart from FT Ecc using the average of endocardial and epicardial contours (−13.45 ± 4.1 [FT] vs. −13.85 ± 3.9 [tagging], p = 0.66). Intraobserver and interobserver agreement for global strain were excellent for FT (ICC 0.906–0.990) but interobserver agreement for tagging was lower (ICC < 0.765). Interobserver and intraobserver agreement for segmental strain was good for both techniques (ICC > 0.7) apart from tagging Ell, which was poor (ICC = 0.15). FT-derived Ecc significantly correlated with total infarct size (r = 0.44, p = 0.03) and segmental infarct extent (r = 0.44, p < 0.01), and best distinguished transmurally infarcted segments (AUC 0.77) and infarcted from

  4. [Correlation between QT interval, ventricular arrhythmias and left ventricular function in chronic alcoholics].

    Pomini, G; Gribaldo, R; Bellavere, F; Lupia, M; Sale, F; Rugna, A; Costa, L; Molfese, G

    1986-04-01

    Prolonged QT interval and arrhythmias have been reported to occur in chronic alcoholics. To investigate the role of chronic alcohol consumption in the onset of arrhythmias and the development of the preclinical left ventricular dysfunction, in a group of 12 asymptomatic chronic alcoholics with no clinical evidence of heart disease, with histologically proven hepatic damage, after a week of abstinence from alcohol, the following investigations were performed: measurements of the corrected QT interval (QTc), 24-hours Holter monitoring, systolic time intervals, M-mode echocardiograms. The results were compared to those of 10 normal subjects. Our data suggested no difference in QTc interval between chronic alcoholics and normal persons. The distribution of arrhythmias was not statistically different in the two groups, particularly frequent and complicated arrhythmias occurred in only one subject in each group. Preejection period corrected for heart rate (PEPI) was significantly longer in alcoholics (132 +/- 16 vs 119 +/- 11, p less than 0.05). All echocardiographic parameters examined were not significantly different in the two groups. On the basis of our results, our impression is that the arrhythmogenic role of alcohol, not under acute ingestion, is relatively unimportant and further studies are needed to become a definitive conclusion about subclinical alcoholic cardiomyopathy. PMID:3743931

  5. Evaluation of left ventricular function by digital subtraction angiography

    Effects of contrast medium doses on left ventriculographic images using intravenous digital subtraction angiography (IVDSA-LVG) were assessed. The validity of IVDSA-LVG in evaluating ejection fraction (FF) and left ventricular regional wall motion was determined by comparison with conventional left ventriculography using direct injection (direct LVG). The advantages of left ventriculography using intraarterial subtraction angiography (IADSA-LVG) performed by injecting small doses of contrast media directly into the left ventricle were stressed. 1. To assess the effects of doses of contrast media on IVDSA-LVG, 10, 20, and 30 ml Urografin-76 were injected into the superior vena cava in 16 patients, and the resulting images were compared in each patient. With only 10 ml contrast medium, left ventricular opacification was fairly good, and regional wall motion was evaluated in many cases, but 30 ml were needed to calculate ventricular volume and EF. 2. To determine the validity of IVDSA-LVG in evaluating EF and regional wall motion, we compared IVDSA-LVG using 30 ml of contrast medium with direct LVG in 18 patients. There was a good correlation between the two methods in determining EF (r = 0.877), and 90 % of the interpretations of regional wall motion were in agreement by the two methods. IVDSA-LVG was useful and accurate in evaluating EF and regional wall motion of the left ventricle. 3. IADSA-LVG was performed for five patients, and good quality images were obtained in many cases, even with relatively small doses (10 ml) of contrast media. These results suggested that this method may be used in cases with impaired LV function, to avoid hemodynamic derangement induced by conventional direct LVG using large doses of contrast medium. (author)

  6. Current clinical applications of spectral tissue Doppler echocardiography (E/E' ratio as a noninvasive surrogate for left ventricular diastolic pressures in the diagnosis of heart failure with preserved left ventricular systolic function

    Roux Emmanuel

    2007-03-01

    Full Text Available Abstract Congestive heart failure with preserved left ventricular systolic function has emerged as a growing epidemic medical syndrome in developed countries, which is characterized by high morbidity and mortality rates. Rapid and accurate diagnosis of this condition is essential for optimizing the therapeutic management. The diagnosis of congestive heart failure is challenging in patients presenting without obvious left ventricular systolic dysfunction and additional diagnostic information is most commonly required in this setting. Comprehensive Doppler echocardiography is the single most useful diagnostic test recommended by the ESC and ACC/AHA guidelines for assessing left ventricular ejection fraction and cardiac abnormalities in patients with suspected congestive heart failure, and non-invasively determined basal or exercise-induced pulmonary capillary hypertension is likely to become a hallmark of congestive heart failure in symptomatic patients with preserved left ventricular systolic function. The present review will focus on the current clinical applications of spectral tissue Doppler echocardiography used as a reliable noninvasive surrogate for left ventricular diastolic pressures at rest as well as during exercise in the diagnosis of heart failure with preserved left ventricular systolic function. Chronic congestive heart failure, a disease of exercise, and acute heart failure syndromes are characterized by specific pathophysiologic and diagnostic issues, and these two clinical presentations will be discussed separately.

  7. Recurrent orthostatic syncope due to left atrial and left ventricular collapse after a continuous-flow left ventricular assist device implantation.

    Chandra, Avinash; Pradhan, Rajesh; Kim, Francis Y; Frisch, Daniel R; Bogar, Linda J; Bonita, Raphael; Cavarocchi, Nicholas C; Greenspon, Arnold J; Hirose, Hitoshi; Pitcher, Harrison T; Rubin, Sharon; Mather, Paul J

    2013-01-01

    Left ventricular assist devices (LVADs) have become an established treatment for patients with advanced heart failure as a bridge to transplantation or for permanent support as an alternative to heart transplantation. Continuous-flow LVADs have been shown to improve outcomes, including survival, and reduce device failure compared with pulsatile devices. Although LVADs have been shown to be a good option for patients with end-stage heart failure, unanticipated complications may occur. We describe dynamic left atrial and left ventricular chamber collapse related to postural changes in a patient with a recent continuous-flow LVAD implantation. PMID:23260713

  8. "Mushroom cloud": a giant left ventricular pseudoaneurysm after a myocardial infarction due to myocardial bridging – a case report

    Ferreira Manuel M

    2009-07-01

    Full Text Available Abstract Left ventricular pseudoaneurysm is an uncommon complication after transmural myocardial infarction, occurring when a free wall rupture is contained by adhesions of the overlying pericardium preventing acute tamponade. In this report, an unusual case of a 61 year-old male with a giant apical left ventricular pseudoaneurysm after an unnoticed myocardial infarction is presented. On coronary angiogram myocardial bridging of the distal left anterior descending artery was judged to be the infarct related lesion. The echocardiographic diagnosis allowed for a timely surgical intervention which resulted in the patient's full recovery.

  9. Analysis of left ventricular function in patients with idiopathic cardiomyopathy

    Assessment of left ventricular function by cardiac pool scintigraphy and that of the regional wall motion by Fourier analysis were done in 43 cases of idiopathic cardiomyopathy and normal cases at rest and exercise stress. The normal group showed a linear increase of the left ventricular ejection fraction (LVEF) by multistage exercise stress, but showed bo abnormality of the regional wall motion. The congestive cardiomyopathy group showed markedly lower LVEF than those of the normal group at rest and a decreasing tendency by exercise stress. Abnormalities of the regional ventricular wall motion were not provoked by exercise stress. The hypertrophic cardiomyopathy group showed higher LVEF at rest than those of the normal group, but showed no more increases after the LVEF reached a certain plateau by increases of exercise. This group showed no abnormality of the regional ventricular wall motion. The hypertrophic obstructive cardiomyopathy group showed higher LVEF at rest than those of the normal group, but decreased LVEF by multistage exercise stress. (Chiba, N.)

  10. Allowable variance set on left ventricular function parameter

    Purpose: To evaluate the influence of allowable Variance settings on left ventricular function parameter of the arrhythmia patients during gated myocardial perfusion imaging. Method: 42 patients with evident arrhythmia underwent myocardial perfusion SPECT, 3 different allowable variance with 20%, 60%, 100% would be set before acquisition for every patients,and they will be acquired simultaneously. After reconstruction by Astonish, end-diastole volume(EDV) and end-systolic volume (ESV) and left ventricular ejection fraction (LVEF) would be computed with Quantitative Gated SPECT(QGS). Using SPSS software EDV, ESV, EF values of analysis of variance. Result: there is no statistical difference between three groups. Conclusion: arrhythmia patients undergo Gated myocardial perfusion imaging, Allowable Variance settings on EDV, ESV, EF value does not have a statistical meaning. (authors)

  11. The effects of stress on left ventricular ejection fraction

    The left ventricular ejection fraction (EF) was studied in 17 healthy volunteers with a new ambulatory left ventricular function monitor. Heart rate, EF, and blood pressure measurements were made during rest, a psychiatric stress interview, cold exposure, exercise, and eating. An increase in EF was seen during emotional stress (from 0.45±0.09 to 0.51±0.13, P<0.001). This increase was comparable to that observed during exercise (0.52±0.14) and eating (0.52±0.10, P<0.001). In contrast, cold exposure caused a decrease in EF (0.43±0.13, P<0.05). These observations demonstrate the powerful hemodynamic consequences of common behaviors as well as the utility and feasability of studying such behavioral factors in ambulatory subjects. (orig.)

  12. Aortic wave dynamics and its influence on left ventricular workload.

    Niema M Pahlevan

    Full Text Available The pumping mechanism of the heart is pulsatile, so the heart generates pulsatile flow that enters into the compliant aorta in the form of pressure and flow waves. We hypothesized that there exists a specific heart rate at which the external left ventricular (LV power is minimized. To test this hypothesis, we used a computational model to explore the effects of heart rate (HR and aortic rigidity on left ventricular (LV power requirement. While both mean and pulsatile parts of the pressure play an important role in LV power requirement elevation, at higher rigidities the effect of pulsatility becomes more dominant. For any given aortic rigidity, there exists an optimum HR that minimizes the LV power requirement at a given cardiac output. The optimum HR shifts to higher values as the aorta becomes more rigid. To conclude, there is an optimum condition for aortic waves that minimizes the LV pulsatile load and consequently the total LV workload.

  13. Should we screen for asymptomatic left ventricular dysfunction inglaucoma patients?

    The aim of the study was to assess the frequency of asymptomatic leftventricular dysfunction in primary open-angle glaucoma patients.Two-dimensional and pulsed Doppler echocardiography of transmitral flow wasperformed on 31 glaucoma patients and 27 controls. No significant differencewas found in early (E) and late (A) transmitral filling velocity, velocitytime integral E wave (VTIE) and A wave (VTIA), left ventricular end-diastolicpressure, pulmonary capillary wedge pressure, left ventricular ejectionfraction (EF) and fractional shortening (FS). A significant difference wasfound in ratio E/A (P=0.04) and ratio VTIA/VTIE (P=0.05), although allobtained values were within 95% confidence limit for the corresponding age.Our study tends to indicate the possibility of dysfunction of myocardialrelaxation in glaucoma patients which might be partially attributed tosystematic vascular dysregulation. (author)

  14. Beneficial effects of elevating cardiac preload on left-ventricular diastolic function and volume during heat stress

    Brothers, R M; Pecini, Redi; Dalsgaard, Morten;

    2014-01-01

    Volume loading normalizes tolerance to a simulated hemorrhagic challenge in heat-stressed individuals, relative to when these individuals are thermoneutral. The mechanism(s) by which this occurs is unknown. This project tested two unique hypotheses; that is, the elevation of central blood volume...... via volume loading while heat stressed would 1) increase indices of left ventricular diastolic function, and 2) preserve left ventricular end-diastolic volume (LVEDV) during a subsequent simulated hemorrhagic challenge induced by lower-body negative pressure (LBNP). Indices of left ventricular...... diastolic function were evaluated in nine subjects during the following conditions: thermoneutral, heat stress, and heat stress after acute volume loading sufficient to return ventricular filling pressures toward thermoneutral levels. LVEDV was also measured in these subjects during the aforementioned...

  15. Comprehensive characterisation of hypertensive heart disease left ventricular phenotypes

    Rodrigues, Jonathan C. L.; Amadu, Antonio Matteo; Dastidar, Amardeep Ghosh; Szantho, Gergley V; Lyen, Stephen M.; Godsave, Cattleya; Ratcliffe, Laura E K; Burchell, Amy E; Hart, Emma C.; Hamilton, Mark C K; Nightingale, Angus K; Paton, Julian F. R.; Manghat, Nathan E; Bucciarelli-Ducci, Chiara

    2016-01-01

    OBJECTIVE: Myocardial intracellular/extracellular structure and aortic function were assessed among hypertensive left ventricular (LV) phenotypes using cardiovascular magnetic resonance (CMR).METHODS: An observational study from consecutive tertiary hypertension clinic patients referred for CMR (1.5 T) was performed. Four LV phenotypes were defined: (1) normal with normal indexed LV mass (LVM) and LVM to volume ratio (M/V), (2) concentric remodelling with normal LVM but elevated M/V, (3) conc...

  16. Myocardial blood flow and metabolism in left ventricular ischemic dysfunction

    Vanoverschelde, Jean-Louis

    1995-01-01

    Due to its inherent truly quantitative capabilities, its noninvasive nature and its nondestructive characteristics, PET has emerged as a unique investigative tool for the assessment and quantification of myocardial blood flow and metabolism in man. The present thesis reviews some of the insights gained with the use of PET into the pathophysiology of regional left ventricular ischemic dysfunction. Chapters 1 and 2 dealt with definitions and specific issues pertinent to the pathophysiologic...

  17. Regional assessment of left ventricular torsion by CMR tagging

    Marcus J Tim; Kuijer Joost P; Götte Marco J; Rüssel Iris K

    2008-01-01

    Abstract Purpose To introduce a standardized method for calculation of left ventricular torsion by CMR tagging and to determine the accuracy of torsion analysis in regions using an analytical model. Methods Torsion between base and apex, base and mid, and mid and apex levels was calculated using CSPAMM tagging and Harmonic Phase tracking. The accuracy of torsion analysis on a regional basis (circumferential segments and transmural layers) was analyzed using an analytical model of a deforming ...

  18. A case report of left ventricular wall rupture

    Kordovani H; Danesh Pajoh AH

    1994-01-01

    Cardiac rupture, particularly rupture of the left ventricular wall, has a very high mortality rate. In this occasion, even if injured patients being alive when carried to the hospital, many of them will die due to following possible reasons: severe bleeding, cardiac tamponade, wasting time for routine and usual diagnostic procedures or transferring the injured to other hospital equipped for cardiac surgery. The only way to avoid these dangerous hazards is prompt thoracotomy and repair of the ...

  19. Vitamin D levels and left ventricular diastolic function

    Pandit, Anil; Mookadam, Farouk; Boddu, Sailaja; Aryal Pandit, Aashrayata; Tandar, Anwar; Chaliki, Hari; Cha, Stephen; Lee, Howard R.

    2014-01-01

    Objective To determine the association between serum vitamin D level and left ventricular (LV) diastolic dysfunction. Background Vitamin D deficiency has been shown in observational and prospective studies to be associated with cardiovascular diseases including coronary artery disease, LV hypertrophy and systolic heart failure. Even though diastolic LV dysfunction is an early manifestation of cardiac disease, there is no study that examines whether a deficiency of vitamin D is associated with...

  20. Non-gated computed tomography of left ventricular hypertrophy

    Non-ECG gated computed tomography (CT) of the heart was carried out in 19 cases with cardiovascular diseases; 4 with mitral stenosis, 3 with aortic valve disease, 2 with combined valve disease, 8 with hypertrophic cardiomyopathy and one myocardial infarction and one aortic aneurysm. All cardiac diseases were studied by echocardiography and 13 of them further investigated by intracadiac catheterization. The interventricular septum and the apical and posterolateral wall of the left ventricle were segmentally evaluated as to relative wall thickness of myocardium on CT. The wall thickness was directly measured on left ventricular cine angiograms in 13 cases. O-G vector calculated by CT was compatible with the palne of vectorcardiography in evaluating left ventricular hypertorphy. Conclusion were as follows: 1) The degree and site of myocardial hypertrophy were detected by CT with satisfaction. 2) The area of ventricular myocardium increased in aortic valve disease and hypertrophic cardiomyopathy. 3) The direction and magnitude of O-G vector calculated by CT were well correlated to the half area of QRS loop in horizontal plane of vectorcardiography. (author)

  1. Left ventricular dysfunction and blood glycohemoglobin levels in young diabetics

    Left ventricular function including regional wall motion (RWM) was evaluated by 99mTc first-pass and equilibrium gated blood pool ventriculography and glycohemoglobin (HbA1c) blood levels determined by a quantitative column technique in 25 young patients with insulin-dependent diabetes mellitus without clinical evidence of heart diesease, and in healthy controls matched for age and sex. Phase analysis revealed abnormal RWM in 19 of 21 diabetic patients. The mean left ventricular global ejection fraction, the mean regional ejection fraction and the mean 1/3 filling fraction were lower and the time to peak ejection, the time to peak filling and the time to peak ejection/cardiac cycle were longer in diabetics than in controls. We found high HbA1c levels in all diabetics. There was no significant difference between patients with and without retinopathy and with and without peripheral neuropathy in terms of left ventricular function and HbA1c levels. (orig.)

  2. Left ventricular diverticulum with marked hypertrophy of the left ventricular apex revealed by thallium-201 myocardial emission CT

    A case of left ventricular apical diverticulum with marked hypertrophy of the left ventricular apical wall revealed by thallium-201 myocardial emission CT is reported. A 23-year-old woman was admitted to our hospital for evaluation of chest oppression. She was known to have had a heart murmur soon after birth, but she grew uneventfully, partaking in normal exercise. At the age of 21, she began to feel chest oppression during exercise. As the attacks became frequent, she was admitted to our hospital. Physical examination revealed an ejection systolic murmur in the second left intercostal space. Electrocardiography showed ST depression and T inversion in leads III, a VF and V4-6. M-mode echocardiography was normal. Two-dimensional echocardiography showed a small diverticulum at the apex of the left ventricle, which was also recognized by left ventriculography. It was about 8 x 12 mm in size. Thallium-201 myocardial emission CT disclosed marked uptake in the apex of the left ventricle, suggesting apical hypertrophy. Stress thallium-201 myocardial emission CT was negative. Coronary angiography was normal. The cause of chest oppression in this patient is uncertain, but the small diverticulum and hypertrophy of the cardiac apex may play a role in its pathogenesis. (author)

  3. Non-invasive measurement of stroke volume and left ventricular ejection fraction. Radionuclide cardiography compared with left ventricular cardioangiography

    Kelbaek, H.; Svendsen, J.H.; Aldershvile, J.; Folke, K.; Nielsen, S.L.

    The stroke volume (SV) was determined by first passage radionuclide cardiography and the left ventricular ejection fraction (LVEF) by multigated radionuclide cardiography in 20 patients with ischemic heart disease. The results were evaluated against those obtained by the invasive dye dilution or thermodilution and left ventricular cardioangiographic techniques. In a paired comparison the mean difference between the invasive and radionuclide SV was -1 ml (SED 3.1) with a correlation coefficient of 0.83 (p < 0.01). Radionuclide LVEF values also correlated well with cardioangiographic measurements, r = 0.93 (p < 0.001). LVEF determined by multigated radionuclide cardiography was, however, significantly lower than when measured by cardioangiography, the mean difference being 6% (p < 0.001). These findings suggest that radionuclide determinations of SV and LVEF are reliable. The discrepancy between the non-invasive and invasive LVEF values raises the question, whether LVEF is overestimated by cardioangiography or underestimated by radionuclide cardiography.

  4. 无创双水平气道正压通气治疗急性左心衰竭观察%Effect of BiPAP noninvasive ventilation on patients with acute left ventricular failure

    欧云亭; 简明

    2009-01-01

    Objective To observe the effect of Bi-level positive airway pressure(BiPAP) noninvasive ventilation on acute left ventricular failure(LVF). Methods BiPAP group :32 patients with severe LVF from various causes were treated by BiPAP with traditional drugs. Control group:32 patients were treated with traditional drugs alone,and the results were compared with those of BiPAP group. Results Dyspnea was relieved in all patients in BiPAP group,both the respiratory rate and heart rate were slowed,the vital signs were stable,and PaO2 ,SaO2 went up. The total effective rate was 100%, which was only 68. 75% in control group. Conclusion The use of BiPAP noninvasive ventilation therapy is feasible and effective on LVF.%目的 观察BiPAP治疗急性左心衰竭的疗效.方法 对32例各种病因所致严重左心衰竭患者在常规药物治疗基础上采用BiPAP机经面罩双向正压无创通气治疗,同时与32例常规药物治疗组进行对比.结果 BiPAP组机械通气后所有患者呼吸频率减慢,心率下降,呼吸困难缓解,生命体征平稳,PaO2、SaO2明显增高,缺氧程度得到有效改善,治疗总有效率为100%.对照组在相应时间治疗总有效率仅为68.75%.结论 BiPAP是治疗急性左心衰竭的快速有效方法.

  5. Inverted Left Atrial Appendage: A Cause of Left Ventricular Inflow Obstruction

    A Molaei

    2010-09-01

    Full Text Available When a new left atrial mass is discovered by means of echocardiography, the differential diagnosis is usually between thrombus, vegetation, and tumor. In the past decade, however, the physicians were able to document another cause. Our aim is to introduce a case of postoperative inverted left atrial appendage which caused left ventricular inflow obstruction requiring reoperation. We report a 4- year old boy who had inverted left atrial appendage after atrial septal defect repair. He showed signs and symptoms of pulmonary edema postoperatively. We assessed him by echocardiography and discovered a mass in his left atrium necessitating re-operation. The surgeon found and restored inverted left atrial appendage intra-operatively. Because inverted left atrial appendage can cause severe and occasionally life threatening complications, we believe intraoperative transesophageal echocardiography is highly essential to diagnose this pathology and to avoid restorative reoperation.

  6. Left Ventricular Hypertrophy: Major Risk Factor in Patients with Hypertension: Update and Practical Clinical Applications

    Richard E. Katholi

    2011-01-01

    Full Text Available Left ventricular hypertrophy is a maladaptive response to chronic pressure overload and an important risk factor for atrial fibrillation, diastolic heart failure, systolic heart failure, and sudden death in patients with hypertension. Since not all patients with hypertension develop left ventricular hypertrophy, there are clinical findings that should be kept in mind that may alert the physician to the presence of left ventricular hypertrophy so a more definitive evaluation can be performed using an echocardiogram or cardiovascular magnetic resonance. Controlling arterial pressure, sodium restriction, and weight loss independently facilitate the regression of left ventricular hypertrophy. Choice of antihypertensive agents may be important when treating a patient with hypertensive left ventricular hypertrophy. Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers followed by calcium channel antagonists most rapidly facilitate the regression of left ventricular hypertrophy. With the regression of left ventricular hypertrophy, diastolic function and coronary flow reserve usually improve, and cardiovascular risk decreases.

  7. Left ventricular mass formulae and prevalence rates of echocardiographic left ventricular hypertrophy in Nigerians with essential hypertension

    Ajayi Ebenezer Adekunle; Ajayi Iyiade Adeseye; Oyedeji Tolulope Adebayo; Adeoti Adekunle Olatayo; Omotoye Olusola Joseph; Adebayo Rasaaq Ayodele

    2013-01-01

    Background: Left ventricular hypertrophy (LVH) as a marker of cardiac damage in hypertension has important prognostic implications. With high prevalence of hypertension in Nigeria and the untoward effect of LVH, it is essential that the prevalence of LVH be determined. Aims: To determine prevalence of LVH and its severity in clinical practice among hypertensive patients referred for echocardiographic assessment in Nigeria. Materials and Methods: Devereux and Troy formulae were used to calcula...

  8. Prognostic significance of left ventricular diastolic dysfunction in patients with left ventricular hypertrophy and systemic hypertension (the LIFE Study)

    Wachtell, Kristian; Palmieri, Vittorio; Gerdts, Eva;

    2010-01-01

    Patients with hypertension and left ventricular (LV) hypertrophy commonly have impaired diastolic filling. However, it remains unknown whether changes in LV diastolic filling variables are associated with cardiovascular morbidity and mortality. In this study, 778 patients with hypertension with...... account. In conclusion, antihypertensive treatment in patients with hypertension with electrocardiographic LV hypertrophy resulted in significant improvement in transmitral flow patterns; this was not associated with reduced cardiovascular morbidity and mortality. However, normal in-treatment LV filling...

  9. Radionuclide left ventricular absolute volume determination by ejection fraction measurement data and a left posterior oblique blood pool image

    Kinoshita, Shinichiro (Saitama Medical School, Moroyama (Japan))

    1989-09-01

    A new method for the calculation of left ventricular volumes called the 'semi-geometric' method, was reported by Nichols et al in 1984. This method, however, still had certain limitations for practical use. This paper describes a modified semi-geometric method in which the left ventricular volume was obtained from conventional left ventricular ejection fraction measurement data collected from the modified left anterior oblique position with a caudal tilt of 10 degrees or more and a left posterior oblique blood pool image. The left ventricular end-diastolic volumes obtained by this method were compared with those calculated by combining the thermodilution cardiac output and the left ventricular ejection fraction. The correlation coefficient was r=0.93 (n=20). In the phantom experiment, the true volumes and those obtained by this method showed an excellent correlation (r=0.99). This method is considered accurate and practical. (author).

  10. Valsartan in the treatment of heart failure or left ventricular dysfunction after myocardial infarction

    Naylin Bissessor

    2007-09-01

    Full Text Available Naylin Bissessor1, Harvey White21Cardiology Research Fellow, 2Director of Coronary Care and Green Lane, Cardiovascular Research Unit, Green Lane Cardiovascular Research Unit, Auckland City Hospital, Auckland, New ZealandAbstract: The physiological role of the renin angiotensin aldosterone system (RAAS is to maintain the integrity of the cardiovascular system. The effect of angiotensin II is mediated via the angiotensin type I receptor (AT1 resulting in vasoconstriction, sodium retention and myocyte growth changes. This causes myocardial remodeling which eventually leads to left ventricular hypertrophy, dilation and dysfunction. Inhibition of the RAAS with angiotensin converting enzyme (ACE inhibitors after acute myocardial infarction has been shown to reduce cardiovascular morbidity and mortality. Angiotensin receptor blockers (ARBs specifically inhibit the AT1 receptor. It has not been known until the performance of the VALIANT (valsartan in acute myocardial infarction trial whether blockade of the angiotensin receptor with an ARB or combination of an ACE inhibitor and ARB leads to similar outcomes as an ACE inhibitor. The VALIANT trial demonstrated equal efficacy and non-inferiority of the ARB valsartan 160 mg bid compared with captopril 50 mg tds, when administered to high risk patients with left ventricular dysfunction or heart failure in the immediate post myocardial infarction period. The combination therapy showed no incremental benefit over ACE inhibition or an ARB alone and resulted in increased adverse effects. This review examines the role of valsartan in left ventricular dysfunction post myocardial infarction. We also discuss pharmacokinetics, dosing, side effects, and usage in the elderly.Keywords: valsartan, heart failure, left ventricular dysfunction, myocardial infarction

  11. Myocardial edema and compromised left ventricular function attributable to dirofilariasis and cardiopulmonary bypass in dogs.

    Rohn, D A; Davis, K L; Mehlhorn, U; Allen, S J; Laine, G A

    1995-02-01

    We investigated the relation between left ventricular dysfunction and myocardial edema in dogs with heartworm (Dirofilaria immitis) infection that were undergoing cardiopulmonary bypass. Dogs with and without D immitis were anesthetized by continuous thiopental infusion and were mechanically ventilated. Sonomicrometry crystals were placed on the long and short axes of the left ventricle, and a Millar pressure transducer was placed in the left ventricular chamber. Pressure-volume loops were digitized and continuously recorded. Dogs with and without D immitis were placed on standard hypothermic cardiopulmonary bypass, with 1 hour of aortic cross-clamp. Wet-to-dry weight ratio corrected for residual blood volume was used to quantitate the volume of myocardial edema. Preload recruitable stroke work was used as a preload-independent index of systolic function. Tau, the isovolumic relaxation time constant, was determined to assess diastolic relaxation. Dogs with D immitis had increased baseline myocardial wet-to-dry weight ratio. After cardiopulmonary bypass, myocardial edema increased in all dogs. Acute edema attributable to cardiopulmonary bypass decreased preload recruitable stroke work in all dogs of both groups, and dogs with D immitis could not be weaned from cardiopulmonary bypass. Myocardial edema increased diastolic relaxation times (tau) in dogs with and without D immitis. We conclude that cardiopulmonary bypass and heartworm infection induce myocardial edema. This edema compromises left ventricular systolic and diastolic function making D immitis an important confounding factor in weaning dogs from cardiopulmonary bypass. PMID:7717590

  12. An international perspective on heart failure and left ventricular systolic dysfunction complicating myocardial infarction : the VALIANT registry

    Velazquez, EJ; Francis, GS; Armstrong, PW; Aylward, PE; Diaz, R; O'Connor, CM; White, HD; Henis, M; Rittenhouse, LM; Kilaru, R; van Gilst, W; Ertl, G; Maggioni, AP; Spac, J; Weaver, WD; Rouleau, JL; McMurray, JJV; Pfeffer, MA; Califf, RM

    2004-01-01

    Aims We analysed the contemporary incidence, outcomes, and predictors of heart failure (HF) and/or left ventricular systolic dysfunction (LVSD) before discharge in patients with acute myocardial infarction (MI). The baseline presence of HF or LVSD, or its development during hospitalisation, increase

  13. Dynamic three-dimensional tagged imaging of left ventricular contraction

    This paper reports on a method, cardiac tagging with MR imaging, used to assess ventricular deformation during the cardiac cycle. Twenty human volunteers were examined. Six short-axis images of the left ventricle placed to encompass the entire left ventricle were acquired with six radially distributed linear tags generated at the R wave of the electrocardiogram. A series of six images in the long axis of left ventricle with six equidistant tags extending from apex to base parallel to the short axis of the ventricle were also obtained to determine the amount of apex-to-base translation. An inhouse computer program was used to determine automatically the epicardial, endocardial, and tag contours. A three-dimensional wire frame construct was then generated to serve as the data base for a dynamic three-dimensional display of the contracting ventricle as well as to measure the main components of strain

  14. Ultrasonic evaluation of the relationship between left ventricular hypertrophy or left ventricular geometry and endothelial function in patients with essential hypertension

    Jing Dong; Pingyang Zhang; Xuehong Feng; Chong Wang; Pei Wang

    2009-01-01

    Objective: To assess the relationship between left ventricular hypertrophy (LVH) or left ventricular geometry (LVG) and endothelial function in patients with essential hypertension (EH). Methods: Seventy-six patients and 30 normal subjects were first examined by echocardiography. Brachial artery dilatation induced by reactive hyperemia (DIRH) or nitroglycerin (DING) was detected using high-resolution ultrasonography. Results: DIRH was lower in patients with hypertension than in the controls, and the decrease in DIRH was greater in the patients with LVH than that in patients without LVH (4.36±2.54% vs 8.56+1.87 %; P 0.05). While there was no significant difference in DIRH between the patients with normal left ventricular geometry or cardiac remodeling, the patients showing either eccentric or concentric left ventricular hypertrophy had lower DIRH than the patients with normal left ventricular geometry or cardiac remodeling. The DIRH was the lowest in patients with concentric hypertrophy. Although bivariate analysis showed that the left ventricular mass index (LVMI) correlated well with the brachial artery dilatation induced by reactive hyperemia, diastolic blood pressure and mean blood pressure (r=-0.61, P < 0.0001; r=0.27, P < 0.05; r=0.31, P < 0.05, respectively), a multivariate stepwise regression demonstrated that LVMI correlated only with the brachial artery dilatation induced by reactive hyperemia. Conclusion: Left ventricular hypertrophy was related to endothelial dysfunction in essential hypertension. The endothelial dysfunction might be basic and important in the progression of left ventricular hypertrophy.

  15. LEFT VENTRICULAR ROTATION, TWIST AND UNTWIST: PHYSIOLOGICAL ROLE AND CLINICAL RELEVANCE

    E. N. Pavlyukova

    2015-09-01

    Full Text Available The helical ventricular myocardial band of Torrent-Guasp is a new concept, which provides strong grounds for reconciliation of some important aspects in cardiovascular medicine. Oblique fiber orientation provides left ventricular rotation, which in addition to radial thickening and longitudinal shortening, is predicted as an essential component of the effective left ventricular pumping. Left ventricular rotation can be measured in clinical practice noninvasively using echocardiography and this provides new opportunities for the assessment of different aspects of left ventricular mechanical function.

  16. Radionuclide determination of right and left ventricular stroke volumes

    Wei Feng Shen; Roubin, G.S.; Choong, C.Y.P.; Harris, P.J.; Flether, P.J.; Kelly, D.T.; Uren, R.F.; Hutton, B.F.

    1985-03-01

    The relationship between radionuclide and thermodilution measurement of stroke volumes (SV) was investigated in 30 patients without valvular regurgitation or intracardiac shunt (group A) at rest and during exercise. Both attenuated radionuclide right ventricular (RV) and left ventricular (LV) SV measurements correlated well with the SV determined by the thermodilution method (r = 0.87 and r = 0.93, all P < 0.001). The reliability of the radionuclide method to estimate SV was evaluated prospectively in two additional groups of patients. In 11 patients without valvular regurgitation or intracardiac shunt (group B) the radionuclide RVSV and LVSV closely approximated to thermodilution SV at rest and during exercise. In 15 patients with aortic regurgitation (group C) the radionuclide stroke volume ratio correlated well with the angiographic regurgitant fraction. Thus, both RVSV and LVSV and the severity of aortic regurgitation can be reliably measured with gated radionuclide ventriculography.

  17. Left ventricular structure and remodeling in patients with COPD

    Pelà G

    2016-05-01

    Full Text Available Giovanna Pelà,1 Mauro Li Calzi,1 Silvana Pinelli,1 Roberta Andreoli,1 Nicola Sverzellati,2 Giuseppina Bertorelli,1 Matteo Goldoni,1 Alfredo Chetta11Department of Clinical and Experimental Medicine, 2Department of Surgery, University Medical School, University Hospital Parma, Parma, ItalyBackground: Data on cardiac alterations such as left ventricular (LV hypertrophy, diastolic dysfunction, and lower stroke volume in patients with COPD are discordant. In this study, we investigated whether early structural and functional cardiac changes occur in patients with COPD devoid of manifest cardiovascular disease, and we assessed their associations with clinical and functional features.Methods: Forty-nine patients with COPD belonging to all Global Initiative for Chronic Obstructive Lung Disease (GOLD classes were enrolled and compared with 36 controls. All subjects underwent clinical history assessment, lung function testing, blood pressure measurement, electrocardiography, and conventional and Doppler tissue echocardiography. Patients were also subjected to computed tomography to quantify emphysema score.Results: Patients with COPD had lower LV cavity associated with a marked increase in relative wall thickness (RWT, suggesting concentric remodeling without significant changes in LV mass. RWT was significantly associated with ratio of the forced expiratory volume in 1 second to the forced vital capacity and emphysema score and was the only cardiac parameter that – after multivariate analysis – significantly correlated with COPD conditions in all individuals. Receiver operating characteristic curve analysis showed that RWT (with a cutoff point of 0.42 predicted the severity of COPD with 83% specificity and 56% sensitivity (area under the curve =0.69, 95% confidence interval =0.59–0.81. Patients with COPD showed right ventricular to be functional but no structural changes.Conclusion: Patients with COPD without evident cardiovascular disease

  18. Myocardial perfusion in relation with low left ventricular ejection fraction

    Full text: Aim: Assessment of myocardial perfusion in coronary artery disease (CAD) patients with low left ventricular ejection fraction (LVEF). Material and Methods: 27 patients were included in the study. All patients underwent radionuclide ventriculography with Tc99m human serum albuminum and myocardial perfusion scintigraphy (MPS) with Tc99m SESTAMIBI according to standard two days protocol. All examinations were performed on the SPECT E.CAM Siemens. Results: All patients have been divided into two groups according to the LVEF. 1st group consisted of 16 patients with LVEF from 30% to 50% and the second one - 11 patients with LVEF lower than 30%. MPS revealed 68 segments of reversible perfusion defects and 9 segments of fixed defects (ischemic and post myocardial infarction respectively) in the 1st group. The second group of patients had 41 segments of reversible perfusion defects and 7 segments of fixed ones. The quantity of segments with perfusion defects per one patient in both groups were relatively equivalent: 4,36 and 4,66 respectively. However the analysis shows that perfusion defects of anterior wall of left ventricle were found in 10 of 11 patients (90%) in the 2nd group and in 7 of 16 patients (44%) in the first one. Conclusion: Perfusion abnormalities in the area of anterior wall significantly decrease left ventricular ejection fraction and patients with such kind of localization of perfusion defects have bad prognosis for survival and should be the candidates for myocardial revascularisation in the first turn

  19. Determinants of left ventricular mass in obesity; a cardiovascular magnetic resonance study

    Clarke Kieran

    2009-04-01

    Full Text Available Abstract Background Obesity is linked to increased left ventricular mass, an independent predictor of mortality. As a result of this, understanding the determinants of left ventricular mass in the setting of obesity has both therapeutic and prognostic implications. Using cardiovascular magnetic resonance our goal was to elucidate the main predictors of left ventricular mass in severely obese subjects free of additional cardiovascular risk factors. Methods 38 obese (BMI 37.8 ± 6.9 kg/m2 and 16 normal weight controls subjects, (BMI 21.7 ± 1.8 kg/m2, all without cardiovascular risk factors, underwent cardiovascular magnetic resonance imaging to assess left ventricular mass, left ventricular volumes and visceral fat mass. Left ventricular mass was then compared to serum and anthropometric markers of obesity linked to left ventricular mass, i.e. height, age, blood pressure, total fat mass, visceral fat mass, lean mass, serum leptin and fasting insulin level. Results As expected, obesity was associated with significantly increased left ventricular mass (126 ± 27 vs 90 ± 20 g; p 2 = 0.77. Conclusion The left ventricular hypertrophic response to obesity in the absence of additional cardiovascular risk factors is mainly attributable to increases in lean body mass, LV stroke volume and visceral fat mass. In view of the well documented link between obesity, left ventricular hypertrophy and mortality, these findings have potentially important prognostic and therapeutic implications for primary and secondary prevention.

  20. Left ventricular diastolic function in patients with coronary artery disease

    In 302 patients with confirmed coronary disease we determined the left ventricular diastolic function with the Nuclear Stethoscope by the aid of the Peak Filling Rate (PFR) and the Time to Peak Filling Rate (TPFR). Moreover we investigated the ejection fraction (EF). 201 patients had already suffered a myocardial infarction, of these 99 an anterior wall and 102 an inferior wall infarction. The remaining 101 patients had a CAD without a history of myocardial infarction. The PFR was 2.19 ± 0.65 EDV/sec in the 99 patients after anterior wall infarction and 2.62 ± 0.85 EDV/sec in the 102 patients after inferior wall infarction and 2.79 ± 0.85 EDV/sec in 101 patients with coronary artery disease without a history of myocardial infarction. For the PFR there could be found a statistically significant difference between normal patients and patients after anterior wall infarction (p < 0.0001), normal patients and patients after inferior wall infarction (p < 0.0001) and normal patients and patients with coronary artery disease (p < 0.0001). The TPFR was 180 ± 37.5 msec after anterior - and 158 ± 50.7 msec after inferior wall infarction and 156 ± 45.2 msec in the patients with CAD without previous infarction. The left ventricular diastolic function (PFR and/or TPFR) was abnormal in 88% after anterior- and in 82% after inferior wall infarction and in 69% in coronary patients without previous myocardial infarction. In comparison with this the ejection fraction was reduced in 66% in anterior- and in 61% inferior wall infarction at rest. These results indicate that the diastolic function at rest appears to be more informative for evaluation of a left ventricular dysfunction than the systolic function at rest. (orig.)

  1. Left ventricular diastolic function in patients with coronary artery disease

    Brugger, P.T.

    1986-08-01

    In 302 patients with confirmed coronary disease we determined the left ventricular diastolic function with the Nuclear Stethoscope by the aid of the Peak Filling Rate (PFR) and the Time to Peak Filling Rate (TPFR). Moreover we investigated the ejection fraction (EF). 201 patients had already suffered a myocardial infarction, of these 99 an anterior wall and 102 an inferior wall infarction. The remaining 101 patients had a CAD without a history of myocardial infarction. The PFR was 2.19 +- 0.65 EDV/sec in the 99 patients after anterior wall infarction and 2.62 +- 0.85 EDV/sec in the 102 patients after inferior wall infarction and 2.79 +- 0.85 EDV/sec in 101 patients with coronary artery disease without a history of myocardial infarction. For the PFR there could be found a statistically significant difference between normal patients and patients after anterior wall infarction (p < 0.0001), normal patients and patients after inferior wall infarction (p < 0.0001) and normal patients and patients with coronary artery disease (p < 0.0001). The TPFR was 180 +- 37.5 msec after anterior - and 158 +- 50.7 msec after inferior wall infarction and 156 +- 45.2 msec in the patients with CAD without previous infarction. The left ventricular diastolic function (PFR and/or TPFR) was abnormal in 88% after anterior- and in 82% after inferior wall infarction and in 69% in coronary patients without previous myocardial infarction. In comparison with this the ejection fraction was reduced in 66% in anterior- and in 61% inferior wall infarction at rest. These results indicate that the diastolic function at rest appears to be more informative for evaluation of a left ventricular dysfunction than the systolic function at rest.

  2. Laronidase Replacement Therapy and Left Ventricular Function in Mucopolysaccharidosis I

    Harada, Haruhito; Niiyama, Hiroshi; Katoh, Atsushi; Ikeda, Hisao

    2014-01-01

    We assessed the effects of long-term laronidase replacement therapy (LRT) on the left ventricular (LV) function of a 52-year-old adult woman with mucopolysaccharidosis I (MPS I). The urinary uronic acid concentration significantly decreased by 78.7% (from 75 to 16 mg/g creatinine) after LRT; thereafter, estimated LV weight as assessed by two-dimensional (2D) echocardiography significantly decreased by 33.3% (from 189 to 126 g). Although systolic LV function of the ejection fraction as assesse...

  3. Coronary flow and left ventricular function during environmental stress.

    Erickson, H. H.; Adams, J. D.; Stone, H. L.; Sandler, H.

    1972-01-01

    A canine model was used to study the effects of different environmental stresses on the heart and coronary circulation. The heart was surgically instrumented to measure coronary blood flow, left ventricular pressure, and other cardiovascular variables. Coronary flow was recorded by telemetry. Physiologic data were processed and analyzed by analog and digital computers. By these methods the physiologic response to altitude hypoxia, carbon monoxide, hypercapnia, acceleration, exercise, and the interaction of altitude hypoxia and carbon monoxide were described. The effects of some of these stresses on the heart and coronary circulation are discussed.

  4. Patient-reported outcomes in left ventricular assist device therapy

    Brouwers, Corline; Denollet, Johan; de Jonge, Nicolaas; Caliskan, Kadir; Kealy, Jennifer; Pedersen, Susanne S.

    2011-01-01

    Technological advancements of left ventricular assist devices (LVAD) have created today's potential for extending the lives of patients with end-stage heart failure. Few studies have examined the effect of LVAD therapy on patient-reported outcomes (PROs), such as health status, quality of life, and...... anxiety/depression, despite poor PROs predicting mortality and rehospitalization in patients with heart failure. In this systematic review, we provide an overview of available evidence on the impact of LVAD therapy on PROs and discuss recommendations for clinical research and practice....

  5. Modelling fibre orientation of the left ventricular human heart wall

    Siem, Knut Vidar Løvøy

    2007-01-01

    The purpose of this thesis is to obtain and represent the orientation of the muscle fibres in the left ventricular wall of the human heart. The orientation of these fibres vary continuously through the wall. This report features an introduction to the human heart and medical imaging techniques. Attention is gradually drawn to concepts in computer science, and how they can help us get a “clearer picture” of the internals of, perhaps, the most important organ in the human body. A highly detail...

  6. [Pathophysiology of left ventricular hypertrophy in arterial hypertension].

    Vallotton, M B; Braconi-Quintaje, S; Lang, U

    1997-02-11

    The role of left ventricular hypertrophy as an independent risk factor for subsequent cardio-vascular events is well established, therefore the authors, in this brief review, describe the endocrine function of the heart and the role played by various factors, including hormones, in the development of cardiac remodeling during the course of hypertension. They then outline the present state of our knowledge concerning transmembrane signaling in the cardiomyocyte in response to an activation of specific receptors for vasoactive hormones of the renin-angiotensin II-aldosterone system. PMID:9139339

  7. New nuclear medicine method of calculating left ventricular stroke volume

    Gieschke, R.; Luig, H.; Reuter, R.; Figulla, H.R.

    1983-12-01

    A new non-invasive nuclear medicine procedure for determining the left ventricular stroke volume is described. The procedure exhibits the following features: 1. individual calibration of scintigraphic counts in activity by first-pass evaluation; 2. no need for a delta-shaped bolus injection; and 3. determination of different stroke volumes, e.g. during different grades of exercise, by only one injection and by only one blood sample. 36 results obtained at rest and during exercise are compared with corresponding results of the thermodilution method (r = 0.86).

  8. Effects of sedation on echocardiographic variables of left atrial and left ventricular function in healthy cats.

    Ward, Jessica L; Schober, Karsten E; Fuentes, Virginia Luis; Bonagura, John D

    2012-10-01

    Although sedation is frequently used to facilitate patient compliance in feline echocardiography, the effects of sedative drugs on echocardiographic variables have been poorly documented. This study investigated the effects of two sedation protocols on echocardiographic indices in healthy cats, with special emphasis on the assessment of left atrial size and function, as well as left ventricular diastolic performance. Seven cats underwent echocardiography (transthoracic two-dimensional, spectral Doppler, color flow Doppler and tissue Doppler imaging) before and after sedation with both acepromazine (0.1 mg/kg IM) and butorphanol (0.25 mg/kg IM), or acepromazine (0.1 mg/kg IM), butorphanol (0.25 mg/kg IM) and ketamine (1.5 mg/kg IV). Heart rate increased significantly following acepromazine/butorphanol/ketamine (mean±SD of increase, 40±26 beats/min) and non-invasive systolic blood pressure decreased significantly following acepromazine/butorphanol (mean±SD of decrease, 12±19 mmHg). The majority of echocardiographic variables were not significantly different after sedation compared with baseline values. Both sedation protocols resulted in mildly decreased left ventricular end-diastolic dimension and mildly increased left ventricular end-diastolic wall thickness. This study therefore failed to demonstrate clinically meaningful effects of these sedation protocols on echocardiographic measurements, suggesting that sedation with acepromazine, butorphanol and/or ketamine can be used to facilitate echocardiography in healthy cats. PMID:22577049

  9. Deterioration of left ventricular function following atrio-ventricular node ablation and right ventricular apical pacing in patients with permanent atrial fibrillation

    Szili-Torok, Tamas; Kimman, Geert-Jan; Poldermans, Don; Jordaens, Luc; Roelandt, Jos; Theuns, Dominic

    2002-01-01

    textabstractAIMS: Transcatheter radiofrequency ablation of the atrio-ventricular (AV) node followed by ventricular pacing has been shown to improve symptoms and quality of life of patients with atrial fibrillation (AF). It is assumed that function improves, but this has been less well demonstrated. The aim of this study was to assess the long-term effect of AV node ablation and ventricular pacing on left ventricular ejection fraction (LVEF) in patients with permanent AF. METHODS AND RESULTS: ...

  10. Fractal dimension as an index of left ventricular ischaemia: a pilot study

    Myocardial perfusion is performed by the left and the right coronary arteries, which deliver blood to the left and right ventricles, respectively. The impairment of arterial flow supply to the cardiac muscle by disease denotes a phenomenon known as ischaemia. Previous studies have demonstrated the ability of fractal dimension (FD) value of a physiological parameter in differentiating healthy/pathological behaviours. The aim of this study consisted in quantifying the loss of ventricular thickness fractal complexity in order to determine if FD is an intrinsic marker of acute coronary ischaemia. Five mongrel dogs weighing 18.8–26.5 kg (24.4 ± 3.3, mean ± SD) were submitted to this studio. A left ventricular pressure transducer and a fluid-filled catheter for later calibration of the pressure transducer were introduced through a stab wound near the apex. Two pairs of ultrasonic microcrystals (5 MHz) for continuous wall thickness measurements were implanted at the anterior and posterior walls of the left ventricle following a previously described technique. During coronary occlusion, the ischemic wall started to thin at the very onset of relaxation (showing abnormal motility), while the normoperfused wall displayed postejective thickening. Concomitantly, posterior ventricular wall thickness and anterior wall ventricular thickness showed a significant decrease in its FD value (P <0.05). In conclusion, loss of time series fractal complexity (waveform fine structure diminution or ‘unwrinkling’) constitutes a marker of the presence of an ischemic process. As a result, a single scalar value is sufficient to characterize the entire behaviour of the time series. This value manifested a similar trend compared to the most well-known clinical indices of myocardial ischaemia. (paper)

  11. [Atrial filling fraction predicts left ventricular systolic function after myocardial infarction: pre-discharge echocardiographic evaluation].

    Galderisi, M; Fakher, A; Petrocelli, A; Alfieri, A; Garofalo, M; de Divitiis, O

    1995-10-01

    Aim of the study was to examine the relation between Doppler-derived indices of left ventricular diastolic and systolic function early after myocardial infarction. Fifty-three patients (31 males, 22 females) recovering from acute myocardial infarction underwent predischarge Doppler echocardiographic examination. Patients with age > 70 years, previous myocardial infarction, more than mild mitral and aortic regurgitation, mitral and aortic stenosis were excluded. Twenty-two healthy subjects (13 males; 9 females) free of coronary risk factors were selected as the control group. Both end-diastolic and end-systolic volumes and ejection fraction were measured by two-dimensional echocardiography. Pulsed Doppler was used to evaluate mitral inflow and left ventricular outflow velocity patterns. The following indices were measured: peak velocity of early (E) and late (A) flows, ratio of E/A peak velocities, ratio of early to late time velocity integrals, atrial filling fraction (time velocity integral A / time velocity integral of flow during total diastole) and deceleration time of E wave for mitral inflow; peak and time-velocity integral for left ventricular outflow. Stroke volume and cardiac output were obtained by pulsed Doppler using the left ventricular outflow method. The two groups were comparable for age, with blood pressure (p volumes were significantly higher (both p volume and cardiac output (both p volumes, atrial filling fraction was an independent predictor of stroke volume, with a direct relation (beta coefficient = 0.53, p volume indicates the importance of atrial contribution to maintain an adequate systolic performance in patients with myocardial infarction. PMID:8819737

  12. Left ventricular volumes determined with equilibrium rdionuclide angiography

    Del Vecchio, G.; Santomauro, M.; Alfano, B.; Pace, L.; Fazio, S.; D' Amico, P.; Salvatore, M.; De Divitiis, O.

    1988-01-01

    Several methods have been proposed to measure left ventricular volumes by Radionuclide Angiography. An automated method for edge detection and volume determination is presented. This procedures is based on an original algorithm which can take in account factors related to system resolution, background level and the presence of other radioactive sources (i.e. right ventricle, left atrium) within the image. Phantom studies were performed to assess either the effect of the object slope and the influence of the distance from the collimator on the edge detection algorithm. The results showed that the method was independent from such factors, and a very good correlation (r = .99) was found between measured and actual volumes. Furthermore, a preliminary group of patient studies was analyzed using the new algorithm, which showed to be reliable in determining cardiac volumes as compared to thermodilution data (r = .883).

  13. Usefulness of verapamil for congestive heart failure associated with abnormal left ventricular diastolic filling and normal left ventricular systolic performance

    Normal left ventricular systolic performance with impaired left ventricular diastolic filling may be present in a substantial number of patients with congestive heart failure (CHF). To evaluate the effect of oral verapamil in this subset, 20 men (mean age 68 +/- 5 years) with CHF, intact left ventricular function (ejection fraction greater than 45%) and abnormal diastolic filling (peak filling rate less than 2.5 end-diastolic volumes per second [edv/s]) were studied in a placebo-controlled, double-blind 5-week crossover trial. All patients underwent echocardiography to rule out significant valvular disease, and thallium-201 stress scintigraphy to exclude major active ischemia. Compared to baseline values, verapamil significantly improved exercise capacity by 33% (13.9 +/- 4.3 vs 10.7 +/- 3.4 minutes at baseline) and peak filling rate by 30% (2.29 +/- 0.54 vs 1.85 +/- 0.45 edv/s at baseline) (all p less than 0.05). Placebo values were 12.3 +/- 4.0 minutes and 2.16 +/- 0.48 edv/s, respectively (difference not significant for both). Improvement from baseline in an objective clinico-radiographic heart failure score (scale 0 to 13) was significantly greater with verapamil compared to placebo (median improvement in score: 3 vs 1, p less than 0.01). Mean ejection fraction and systolic blood pressure were unchanged from baseline; diastolic blood pressure and heart rate decreased to a small degree. Verapamil may have therapeutic efficacy in patients with CHF, preserved systolic function and impaired diastolic filling

  14. Left Atrial Appendage Dysfunction in a Patient with Premature Ventricular Contractions - A Risk Factor for Stroke?

    Patel, Sandeep M; Ackerman, Michael J.; Asirvatham, Samuel J.

    2013-01-01

    A 16-year-old female with ventricular dysfunction and frequent ventricular arrhythmia presented with a cardioembolic stroke. Prior electrophysiology study and ablation was performed for ventricular tachycardia (VT). For remaining ventricular ectopy, the patient was maintained on carvedilol and mexiletine. After one year on this regimen, she presented with an acute stroke. Transesophageal echocardiography revealed no evidence of an intracardiac or ventricular thrombus but demonstrated markedly...

  15. Changes of left ventricular function at exercise after lung resection

    To determine the effect of lung resection on left ventricular function, 29 surgical patients were examined by using a nuclear stethoscope as a non-invasive means for measuring ventricular function at exercise. Pre- and post-operative parameters were obtained at rest and exercise. At rest, postoperative stroke volume (SV), end-diastolic volume (EDV), ejection fraction (EF), and ejection rate (ER) were significantly decreased; heart rate (HR) was significantly increased; and both filling rate (FR) and cardiac output (CO) remained unchanged. At maximum exercise, postoperative EDV, SV, ER and FR were significantly decreased; and there was no significant difference in either HR or EF, resulting in a significantly decreased CO. A ratio of CO and FR at maximum exercise to at rest was significantly decreased after surgery, as compared with that before surgery. According to the number of lobe resection, similar findings for all parameters, except for EF, were observed in the group of two lobe or more resection (n=13); and only two parameters, ER and FR, had the same tendency as those mentioned above in the group of a single lobe resection (n=16). The age group of 60 years or less (n=14) had similar findings for all parameters. In the group of 65 years or more (n=10), resting HR after surgery was not different from that before surgery; and postoperative CO was significantly decreased at rest, but not different from preoperative value at maximum exercise. In conclusion, left ventricular function associated with lung resection is reflected by decreased EDV and SV resulting from reduced pre-load. These changes may be corrected at rest, but not corrected at maximum exercise, resulting in decreased CO. More noticeable decrease in EDV and SV seems to be associated with larger lung resection. In older patients, HR is not corrected well, resulting in a decrease in CO at rest. (N.K.)

  16. The reproducibility and variability of sequential left ventricular ejection fraction measurements by the nuclear stethoscope

    We evaluated the reproducibility and variability of sequential left ventricular ejection fraction (LVEF) measurements by the nuclear stethoscope in 72 patients. The group as a whole demonstrated excellent reproducibility (r = 0.96). However, repeat LVEF measurements by the nuclear stethoscope at 5-minute interval showed around 9 % absolute difference, at 95 % confidence levels, from one measurement to the next. The finding indicates that a change in LVEF greater than 9 % is necessary for determining an acute effect of an intervention in individual cases. (author)

  17. 24 Hour ST Segment Analysis in Transient Left Ventricular Apical Ballooning

    Frank Bode; Christof Burgdorf; Heribert Schunkert; Volkhard Kurowski

    2013-01-01

    OBJECTIVE: The etiologic basis of transient left ventricular apical ballooning, a novel cardiac syndrome, is not clear. Among the proposed pathomechanisms is coronary vasospasm. Long-term ST segment analysis may detect vasospastic episodes but has not been reported. METHODS: 30 consecutive patients with transient left ventricular apical ballooning, left ventricular dysfunction and normal or near-normal coronary arteries were investigated. A 24-hour Holter ECG was obtained after emergency admi...

  18. Echocardiographic partition values and prevalence of left ventricular hypertrophy in hypertensive Nigerians

    Oladapo Olulola O; Adebayo Adedeji K; Aje Akinyemi; Ojji Dike B; Ogah Okechukwu S; Adebiyi Adewole A; Falase Ayodele O

    2006-01-01

    Abstract Background Left ventricular hypertrophy (LVH) is a well known independent risk factor for cardiovascular events. It has been shown that combination of left ventricular mass (LVM) and relative wall thickness (RWT) can be used to identify different forms of left ventricular (LV) geometry. Prospective studies have shown that LV geometric patterns have prognostic implications, with the worst prognosis associated with concentric hypertrophy. The methods for the normalization or indexation...

  19. How reliable is the electrocardiogram in detecting left ventricular hypertrophy in hypertension?

    Vijan, S. G.; Manning, G; Millar-Craig, M W

    1991-01-01

    This paper assesses the sensitivity and specificity of the electrocardiogram in detecting left ventricular hypertrophy in 75 hypertensive patients. Each patient underwent a 12 lead electrocardiogram and echocardiogram. Left ventricular mass index, using echocardiogram, was calculated according to the Penn convention and left ventricular hypertrophy was assessed by standard electrocardiographic criteria. The electrocardiogram was found to be very specific but insensitive in the detection of le...

  20. Left Ventricular Hypertrophy: Major Risk Factor in Patients with Hypertension: Update and Practical Clinical Applications

    Katholi, Richard E.; Couri, Daniel M.

    2011-01-01

    Left ventricular hypertrophy is a maladaptive response to chronic pressure overload and an important risk factor for atrial fibrillation, diastolic heart failure, systolic heart failure, and sudden death in patients with hypertension. Since not all patients with hypertension develop left ventricular hypertrophy, there are clinical findings that should be kept in mind that may alert the physician to the presence of left ventricular hypertrophy so a more definitive evaluation can be performed u...

  1. Echocardiographic Partition Values and Prevalence of Left Ventricular Hypertrophy in Hypertensive Jamaicans

    Chiranjivi Potu; Edwin Tulloch-Reid; Dainia Baugh; Olusegun A Ismail; Ernest C. Madu

    2012-01-01

    Left ventricular hypertrophy (LVH) detected by either electrocardiography or echo- cardiography has been shown to be an extremely strong predictor of morbidity and mortality in patients with essential hypertension and in members of the general population. Alternative to LVH, left ventricular geometrical patterns offer incremental prognostic value beyond that provided by the other cardiovascular risk factors including left ventricular mass (LVM). Combination of LVM and relative wall thickness ...

  2. Left-Ventricular Structure in the Southall And Brent REvisited (SABRE) Study: Explaining Ethnic Differences

    Park, Chloe M.; March, Katherine; Ghosh, Arjun K.; Jones, Siana; Coady, Emma; Tuson, Claire; Francis, Darrel; Mayet, Jamil; Tillin, Therese; Chaturvedi, Nish; Hughes, Alun D.

    2013-01-01

    Cardiometabolic risk is elevated in South Asians and African Caribbeans compared with Europeans, yet whether this is associated with ethnic differences in left-ventricular structure is unclear. Conventional M-mode or 2-dimensional echocardiography may be misleading, because they calculate left-ventricular mass and remodeling using geometric assumptions. Left-ventricular structure was compared in a triethnic population-based cohort using conventional and 3-dimensional echocardiography on 895 i...

  3. Hypertension and left ventricular hypertrophy in liquidators of consequences of the Chernobyl nuclear accident

    Echocardiography was used for the study of prevalence of left ventricular hypertrophy in 839 liquidators of consequences of the Chernobyl accident. Prevalence of left ventricular hypertrophy (left ventricular myocardial mass 134 g/m2) was 10.3, 13.4 and 22.5 % in liquidators with normal blood pressure, borderline hypertension and hypertension, respectively. Liquidators with normal blood pressure had significantly greater left ventricular myocardial mass than normotensive men from general population while liquidators and non liquidators with hypertension had equal values of this parameter

  4. Clinical application of automatic extraction of left ventricular contours. Evaluation of left ventricular volumes by contrast-enhanced breath-hold ultrafast cine MR imaging

    To assess the validity of automatic extraction of left ventricular inner contours based on contrast-enhanced ultrafast cine-MR images, phantom (n=15) and clinical (n=60) studies were performed. In phantom study, left ventricular volumes obtained by biplane modified Simpson's method based on automatic extraction of left ventricular inner contour was significantly correlated to phantom's volumes(r=0.991). Contrast-enhanced breath-hold ultrafast cine MR imaging was shown to provide accurate cardiac images with high success rate (89% in horizontal long axis section and 88% in vertical long axis section) in clinical study. However, the extraction of left ventricular inner contour depends on operator's manual tracing and the time required for data analysis is longer. The automatic extraction time of left ventricular inner contour was 4 second/frame, on the other hand conventional manual tracing time was 60-90 second/frame. Comparison with left ventricular volumes showed a high correlation between contrast-enhanced ultrafast cine MR imaging (monoplane area-length's and biplane modified Simpson's methods based on automatic extraction of left ventricle) and digital subtraction left ventriculography (biplane area-length's method). (author)

  5. Comparison of Arrhythmias among Different Left Ventricular Geometric Patterns in Essential Hypertension

    2001-01-01

    The differences of arrhythmias among distinct left ventricular geometric patterns in the patients with essential hypertension were studied. 179 patients with essential hypertension received 24 h dynamic ECG recording, ambulatory blood pressure monitoring, echocardiography examination, etc. According to the examinations, left ventricular geometric patterns and arrhythmias were identified. The comparison of morbidity of arrhythmias between the left ventricular remodeling group and the normal geometric pattern group was performed. The multiple stepwise regression analysis was carried out to identify the independent determinants of arrhythmias. After these predictors were controlled or adjusted, the severity of arrhythmias among different left ventricular geometric patterns was compared. It was found that the morbidity of atrial arrhythmia, ventricular arrhythmia and complex ventricular arrhythmias in the left ventricular remodeling group was significantly higher than in the normal geometric pattern group respectively. There were many independent factors influencing on arrhythmias in essential hypertension. Of all these factors, some indices of left ventricular anatomic structure, grade of hypertension, left atrial inner dimension, E/A, diastolic blood pressure load value at night and day average heart rate and so on were very important. After the above-mentioned factors were adjusted, the differences of the orders of arrhythmias between partial geometric patterns were reserved, which resulted from the differences of the geometric patterns. Many factors contributed to arrhythmias of essential hypertension, such as grade of hypertension, LVMI, LA, PWT and so on. The severity of arrhythmias was different in different left ventricular geometric patterns.

  6. New scintigraphic method for determining left ventricular volumes

    Nichols, K.; Adatepe, M.H.; Isaacs, G.H.; Powell, O.M.; Pittman, D.E.; Gay, T.C.; Begg, F.R.

    1984-10-01

    A new scintigraphic count-based method for measuring absolute left ventricular volumes is presented. It is a fast and simple technique that allows geometrical assumptions to be avoided and is free of radiation attenuation corrections. This method requires the acquisition of an image of the left ventricle in the right anterior oblique projection and the collection of gated blood pool images in the left anterior oblique projection. To assess the accuracy of the method scintigraphic stroke volumes were compared with those derived from thermodilution measurements during cardiac catheterization in 20 subjects, and to assess its precision the technique was applied to phantom data of known radionuclide volumes. Excellent correlations were found between the scintigraphic and both the thermodilution and phantom data. The reproducibility of results was investigated by repeating data acquisition and analysis for 15 subjects on two different days, and the interobserver variability of the method was studied by having two computer operators calculate volumes for the same patient data for 20 randomly selected studies.

  7. Passive and active ventricular elastances of the left ventricle

    Ng Eddie YK

    2005-02-01

    Full Text Available Abstract Background Description of the heart as a pump has been dominated by models based on elastance and compliance. Here, we are presenting a somewhat new concept of time-varying passive and active elastance. The mathematical basis of time-varying elastance of the ventricle is presented. We have defined elastance in terms of the relationship between ventricular pressure and volume, as: dP = EdV + VdE, where E includes passive (Ep and active (Ea elastance. By incorporating this concept in left ventricular (LV models to simulate filling and systolic phases, we have obtained the time-varying expression for Ea and the LV-volume dependent expression for Ep. Methods and Results Using the patient's catheterization-ventriculogram data, the values of passive and active elastance are computed. Ea is expressed as: ; Epis represented as: . Ea is deemed to represent a measure of LV contractility. Hence, Peak dP/dt and ejection fraction (EF are computed from the monitored data and used as the traditional measures of LV contractility. When our computed peak active elastance (Ea,max is compared against these traditional indices by linear regression, a high degree of correlation is obtained. As regards Ep, it constitutes a volume-dependent stiffness property of the LV, and is deemed to represent resistance-to-filling. Conclusions Passive and active ventricular elastance formulae can be evaluated from a single-beat P-V data by means of a simple-to-apply LV model. The active elastance (Ea can be used to characterize the ventricle's contractile state, while passive elastance (Ep can represent a measure of resistance-to-filling.

  8. Phase quadrature shift between left and right ventricles during a ventricular tachycardia attack

    Philippe, L.; Itti, R.; Cosnay, P.; Fauchier, J.P.

    1984-08-01

    Equilibrium gated nuclear angiography was performed on a patient during an attack of ventricular tachycardia and then after conversion to sinus rhythm. Global and regional wall motion was assessed by means of isocontours. Fourier phase analysis and factor analysis. Ventricular phase histograms showed a 100/sup 0/ difference between ventricles: left ventricular filling time occurred during right ventricular contraction. The earliest phase was located in the septum and the sequence of activation showed a large delay of left ventricular activation. After conversion to sinus rhythm, a right bundle branch block was observed, being almost the inverse of the latter situation.

  9. Phase quadrature shift between left and right ventricles during a ventricular tachycardia attack

    Equilibrium gated nuclear angiography was performed on a patient during an attack of ventricular tachycardia and then after conversion to sinus rhythm. Global and regional wall motion was assessed by means of isocontours. Fourier phase analysis and factor analysis. Ventricular phase histograms showed a 1000 difference between ventricles: left ventricular filling time occurred during right ventricular contraction. The earliest phase was located in the septum and the sequence of activation showed a large delay of left ventricular activation. After conversion to sinus rhythm, a right bundle branch block was observed, being almost the inverse of the latter situation. (orig.)

  10. Imaging Diagnosis for Left Ventricular Thrombosis in Idiopathic Hypereosinophilic Syndrome

    He, Yu-Quan; Zhao, Ya-Nan; Zhu, Jin-Ming; Zhang, Meng-Chao; Liu, Lin; Zeng, Hong; Yang, Ping

    2014-01-01

    Abstract Idiopathic hypereosinophilic syndrome (IHES) is a rare disease that is frequently associated with cardiac thrombosis and endocardial wall thickness. This case report describes 2 patients who had IHES associated with left ventricular (LV) thrombi. The patients’ symptoms are atypical. Peripheral blood and bone marrow tests showed markedly elevated eosinophils. Electrocardiography showed ischemic changes in both patients. Negative computed tomography (CT) angiography excluded coronary artery stenosis. Transthoracic echocardiography (TTE), conventional multislice spiral CT, gemstone spectral CT, and cardiac magnetic resonance imaging were used to identify the LV intraluminal thrombus and endocardial thickening, and the diagnostic values of each imaging method were analyzed and compared. These patients were clinically diagnosed as “IHES, LV thrombosis, NYHA heart function classification I.” Both patients received oral prednisone and warfarin therapy. At 5 month follow-up, TTE rechecks showed that the size of the LV thrombotic lesion was reduced in the first case but substantially increased in the second case. PMID:25275526

  11. Image quality influences the assessment of left ventricular function

    Grossgasteiger, Manuel; Hien, Maximilian D; Graser, Bastian;

    2014-01-01

    divided by the total endocardial border. These ratings were used to generate groups of poor (0%-40%), fair (41%-70%), and good (71%-100%) image quality. The ejection fraction (EF), end-diastolic volume, and end-systolic volume were analyzed by the Simpson method of disks (biplane and monoplane), eyeball......, with the Teichholz EF found to be most accurate with poor (r = 0.928) in contrast to good (r = 0.699) image quality. Conclusions: With good image quality, the Simpson biplane method is the most accurate 2-dimensional method for assessing the left ventricular EF. Short-axis view methods, especially the...... method, Teichholz method, and speckle-tracking method. Furthermore, the fractional area change was determined. Each correlation with real-time 3DE was evaluated. Results: Correlations of the EF and volumes, respectively, as determined by long-axis view methods increased with improving image quality: the...

  12. Assessment of left ventricular function by noninvasive methods.

    Luisada, A A; Singhal, A; Portaluppi, F

    1985-01-01

    The possibility of evaluating left ventricular function by noninvasive methods is discussed in detail. The methods that are considered are electrocardiograph, phonocardiography, apex cardiography, sphygmography, impedance cardiography, electrokymography, and echocardiography. Following a brief section of 'definitions', each method is described in detail including technical problems, difficulties, and results. The systolic time intervals and the stress tests are briefly discussed. Based on modern experimental studies, the stress test should include both an electro- and a phonocardiogram. In the latter, one would measure the amplitude of the first heart sound as an index of contractility. The conclusion is that combined methods give the best results. They are electrocardiography, phonocardiography, impedance cardiography, and echocardiography. An alternative, dictated by technical problems, is to use at first phonocardiography and impedance plus electrocardiography; then echocardiography plus electrocardiography; and then, if indicated, a stress test might complete the study; the latter should include both an electrocardiogram and a phonocardiogram. PMID:4003144

  13. Current Trends in Implantable Left Ventricular Assist Devices

    Jens Garbade

    2011-01-01

    Full Text Available The shortage of appropriate donor organs and the expanding pool of patients waiting for heart transplantation have led to growing interest in alternative strategies, particularly in mechanical circulatory support. Improved results and the increased applicability and durability with left ventricular assist devices (LVADs have enhanced this treatment option available for end-stage heart failure patients. Moreover, outcome with newer pumps have evolved to destination therapy for such patients. Currently, results using nonpulsatile continuous flow pumps document the evolution in outcomes following destination therapy achieved subsequent to the landmark Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure Trial (REMATCH, as well as the outcome of pulsatile designed second-generation LVADs. This review describes the currently available types of LVADs, their clinical use and outcomes, and focuses on the patient selection process.

  14. Measurement of right and left ventricular ejection fraction in dogs

    Brynjolf, I.; Qvist, J.; Mygind, T.; Jordening, H.; Dorph, S.; Munck, O.

    1983-08-01

    Three techniques for measurement of right (RVEF) and two techniques for left (LVEF) ventricular ejection fraction were evaluated in five dogs. RVEF was measured with a first-pass radionuclide technique using erythrocytes labelled in vitro with Technetium-99m methylene disphosphonate (MDP) and compared with RVEF measured with a thermodilution technique. Thermodilution-determined RVEF was compared with RVEF values measured with cine angiocardiography. LVEF was measured with a radionuclide ECG-gated equilibrium technique and compared with cine angiocardiography. Measurements were performed before and during a continuous infusion of dopamine. There was an excellent correlation between RVEF measured with the first-pass and the thermodilution technique. LVEF measured with the ECG-gated equilibrium technique correlated well with cine angiocardiography.

  15. A case report of left ventricular wall rupture

    Kordovani H

    1994-05-01

    Full Text Available Cardiac rupture, particularly rupture of the left ventricular wall, has a very high mortality rate. In this occasion, even if injured patients being alive when carried to the hospital, many of them will die due to following possible reasons: severe bleeding, cardiac tamponade, wasting time for routine and usual diagnostic procedures or transferring the injured to other hospital equipped for cardiac surgery. The only way to avoid these dangerous hazards is prompt thoracotomy and repair of the wound, which must be done in any surgical ward available. We report a case of cardiact rupture due to penetrating injury caused by a slender sharp object, passing through the heart anteroposteriorly. The patient was successfully rescued. This report indicates that in hospital, where no facility for cardiac surgery is available, this kind of emergency surgery for cardiac rupture is very indicative and may save the life of injured patient.

  16. Left ventricular diastolic filling in patients with systemic hypertension

    To study the prevalence and significance of left ventricular (LV) diastolic dysfunction in mild to moderate systemic hypertension (HT), cardiac blood pool imagings with Tc-99 m were obtained in 10 normal subjects and 27 patients with HT. The patients with HT did not show any evidence of coronary heart disease, renal insufficiency, cerebrovascular accident or diabetes mellitus. They were divided into 3 groups; (1) HT-1 (n=10): without evidence of echocardiographic (UCG) and electrocardiographic (ECG) left ventricular hypertrophy (LVH), (2) HT-2 (n=8): with evidence of ECG-LVH without UCG-LVH, (3) HT-3 (n=9): with evidence of UCG-LVH. UCG-LVH was defined when posterior or interventricular septal tall thickness exceeded 13 mm at end-diastole. From UCG findings LV mass was calculated and from UCG findings and auscultating brachial systolic pressure LV peak-systolic wall stress (WS) was obtained. Cardiac blood pool imagings were performed at modified LAO at rest and during exercise stress. Indices of LV systolic function (rest ejection fraction, mean ejection rate during the first third of ejection and exercise ejection fraction response) were essentially similar in normal subjects and all HT groups. In contrast, LV diastolic filling rate during the first third of diastole (1/3 FR mean) decreased significantly in any group of HT, and it was prominent in HT-3. In patients with HT, 1/3 FR mean did not correlate with blood pressure, LV peak-systolic WS, LV systolic functions and LV end-diastolic volume. But it correlated inversely with LV mass (r=-0.84). These results suggest that impairment of early diastolic LV filling can be detected before systolic cardiac impairment and LVH develop, and it is, at least in part, relate to the LV mass. (author)

  17. Accuracy of advanced versus strictly conventional 12-lead ECG for detection and screening of coronary artery disease, left ventricular hypertrophy and left ventricular systolic dysfunction

    Warren Stafford G; Delgado Reynolds; Bauch Terry; Hayat Matthew J; Bungo Michael W; Rahman M; Vrtovec Bojan; Starc Vito; DePalma Jude L; Greco E; Feiveson Alan H; Kulecz Walter B; Schlegel Todd T; Núñez-Medina Tulio; Medina Rubén

    2010-01-01

    Abstract Background Resting conventional 12-lead ECG has low sensitivity for detection of coronary artery disease (CAD) and left ventricular hypertrophy (LVH) and low positive predictive value (PPV) for prediction of left ventricular systolic dysfunction (LVSD). We hypothesized that a ~5-min resting 12-lead advanced ECG test ("A-ECG") that combined results from both the advanced and conventional ECG could more accurately screen for these conditions than strictly conventional ECG. Methods Resu...

  18. Left atrium remodeling after acute myocardial infarction (results of the GISSI-3 Echo Substudy).

    Popescu, Bogdan A; Macor, Franco; Antonini-Canterin, Francesco; Giannuzzi, Pantaleo; Temporelli, Pier L; Bosimini, Enzo; Gentile, Francesco; Maggioni, Aldo P; Tavazzi, Luigi; Piazza, Rita; Ascione, Luigi; Stoian, Ioana; Cervesato, Eugenio; Nicolosi, Gian L

    2004-05-01

    To evaluate the existence, timing, and determinants of post-infarction left atrial remodeling, we studied a subgroup of 514 patients from the Third Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico Echo Substudy who underwent 4 serial 2-dimensional echocardiograms up to 6 months after acute myocardial infarction. This study is the first to demonstrate, in a large series of patients, the existence of early and late left atrial remodeling after low-risk acute myocardial infarction and the relation of left atrial remodeling to left ventricular remodeling. PMID:15110211

  19. Left ventricular mass in male adolescent athletes and non-athletes

    Erling David Kaunang

    2014-09-01

    Full Text Available Background Systematic exercise leads to increased left ventricular mass, which may be misleading in a differential diagnosis of heart disease in athletes (physiologic hypertrophy versus pathologic hypertrophy. The cause of left ventricular hypertrophy is an important risk factor in the morbidity and mortality of cardiovascular diseases. Objective To compare left ventricular mass and left ventricular hypertrophy in male adolescent athletes and non-athletes. Methods We conducted a cross-sectional, analytic study, from September to December 2012 in male adolescents aged 15-18 years. The case group included athletes from the Bina Taruna Football Club Manado, while the control group included non-athlete adolescents. All subjects underwent history-taking, physical examinations and further supporting examinations. Left ventricular mass was measured by cardiovascular echocardio-graphy (Esaote Mylab 4.0 and calculated based on a formula. Left ventricular hypertrophy was defined as left ventricular mass of > 134 g/m2 body surface area. Results Subjects’ mean left ventricular masses were 359.69 (SD 188.4; 95%CI 283.58 to 435.81 grams in the athlete group and 173.04 (SD 50.69; 95%CI 152.56 to 103.51 grams in the non-athlete group, a statistically significant difference (P=0.0001. Ventricular hypertrophy was found 76.9% compared to 11.5% in the non-athlete group (P=0.0001. Conclusion Left ventricular mass in athletes is bigger than in non-athletes. In addition, left ventricular hypertrophy is more common in male adolescent athletes than in non-athletes. [Paediatr Indones. 2014;54:305-8.].

  20. Our experience with implantation of VentrAssist left ventricular assist device

    Hiriyur Shivalingappa Jayanthkumar

    2013-01-01

    Full Text Available Perioperative anaesthetic management of the VentrAssist TM left ventricular assist device (LVAD is a challenge for anaesthesiologists because patients presenting for this operation have long-standing cardiac failure and often have associated hepatic and renal impairment, which may significantly alter the pharmacokinetics of administered drugs and render the patients coagulopathic. The VentrAssist is implanted by midline sternotomy. A brief period of cardiopulmonary bypass (CPB for apical cannulation of left ventricle is needed. The centrifugal pump, which produces non-pulsatile, continuous flow, is positioned in the left sub-diaphragmatic pocket. This LVAD is preload dependent and afterload sensitive. Transoesophageal echocardiography is an essential tool to rule out contraindications and to ensure proper inflow cannula position, and following the implantation of LVAD, to ensure right ventricular (RV function. The anaesthesiologist should be prepared to manage cardiac decompensation and acute desaturation before initiation of CPB, as well as RV failure and severe coagulopathic bleeding after CPB. Three patients had undergone implantation of VentrAssist in our hospital. This pump provides flow of 5 l/min depending on preload, afterload and pump speed. All the patients were discharged after an average of 30 days. There was no perioperative mortality.

  1. Our experience with implantation of VentrAssist left ventricular assist device

    Jayanthkumar, Hiriyur Shivalingappa; Murugesan, Chinnamuthu; Rajkumar, John; Harish, Bandlapally Ramanjaneya Gupta; Muralidhar, Kanchi

    2013-01-01

    Perioperative anaesthetic management of the VentrAssist™ left ventricular assist device (LVAD) is a challenge for anaesthesiologists because patients presenting for this operation have long-standing cardiac failure and often have associated hepatic and renal impairment, which may significantly alter the pharmacokinetics of administered drugs and render the patients coagulopathic. The VentrAssist is implanted by midline sternotomy. A brief period of cardiopulmonary bypass (CPB) for apical cannulation of left ventricle is needed. The centrifugal pump, which produces non-pulsatile, continuous flow, is positioned in the left sub-diaphragmatic pocket. This LVAD is preload dependent and afterload sensitive. Transoesophageal echocardiography is an essential tool to rule out contraindications and to ensure proper inflow cannula position, and following the implantation of LVAD, to ensure right ventricular (RV) function. The anaesthesiologist should be prepared to manage cardiac decompensation and acute desaturation before initiation of CPB, as well as RV failure and severe coagulopathic bleeding after CPB. Three patients had undergone implantation of VentrAssist in our hospital. This pump provides flow of 5 l/min depending on preload, afterload and pump speed. All the patients were discharged after an average of 30 days. There was no perioperative mortality. PMID:23716768

  2. Determinants of Left Ventricular Mass and Hypertrophy in Hemodialysis Patients Assessed by Cardiac Magnetic Resonance Imaging

    Patel, Rajan K.; Oliver, Scott; Patrick B. Mark; Powell, Joanna R.; McQuarrie, Emily P.; Traynor, James P.; Dargie, Henry J; Jardine, Alan G

    2009-01-01

    Background and objectives: Left ventricular hypertrophy (LVH) is an independent risk factor for premature cardiovascular death in hemodialysis (HD) patients and one of the three forms of uremic cardiomyopathy. Cardiovascular magnetic resonance (CMR) is a volume-independent technique to assess cardiac structure. We used CMR to assess the determinants of left ventricular mass (LVM) and LVH in HD patients.

  3. Second statement of the working group on electrocardiographic diagnosis of left ventricular hypertrophy

    Bacharova, Ljuba; Estes, E Harvey; Bang, Lia E;

    2011-01-01

    The Working Group on Electrocardiographic Diagnosis of Left Ventricular Hypertrophy, appointed by the Editor of the Journal of Electrocardiology, presents the alternative conceptual model for the ECG diagnosis of left ventricular hypertrophy (LVH). It is stressed that ECG is a record of electrical...

  4. Gated spect (GASPECT) for analysis of global and regional left ventricular function

    Eilles, C.

    1988-04-01

    GASPECT enables a quantitative analysis of global and regional left ventricular function. Comparisons with the procedures of thermodilution and cineangiography showed excellent correlations in the measurement of absolute left ventricular volumes. The extent of regional contraction abnormalities in patients with myocardial infarction can be quantified by GASPECT and newly developed method for regional wall motion analysis.

  5. Endothelial dysfunction is associated with left ventricular mass (assessed using MRI) in an adult population (MESA)

    Yeboah, J; Crouse, JR; Bluemke, DA; Lima, JAC; Polak, JF; Burke, GL; Herrington, DM

    2010-01-01

    Brachial flow-mediated dilation (FMD) is a measure of endothelial nitric oxide bioavailability. Endothelial nitric oxide controls vascular tone and is likely to modify the ventricular muscle coupling mechanism. The association between left ventricular mass and FMD is not well understood. We assessed the association between left ventricular mass index (LVMI) and FMD in participants of the Multi-Ethnic Study of Atherosclerosis (MESA). MESA is a population-based study of 6814 adults free of clin...

  6. Normal left ventricular wall motion measured with two-dimensional myocardial tagging

    Qi, P; Thomsen, C; Ståhlberg, F; Henriksen, O

    1993-01-01

    Using a myocardial tagging technique, normal left ventricular wall motion was studied in 3 true short axis views and a double oblique 4-chamber view in 14 and 11 volunteers, respectively. Three orthogonal directions of left ventricular motion were observed throughout the systole; a concentric...... contraction towards the center of the left ventricle, a motion of the base of the heart towards the apex, and a rotation of the left ventricle around its long axis. The direction of left ventricular rotation changed from early systole to late systole. The base and middle levels of the left ventricle rotated...... that MR imaging with myocardial tagging is a method that can be used to study normal left ventricular wall motion, and that is promising for future use in patient groups....

  7. Left ventricular structure and remodeling in patients with COPD

    Pelà, Giovanna; Li Calzi, Mauro; Pinelli, Silvana; Andreoli, Roberta; Sverzellati, Nicola; Bertorelli, Giuseppina; Goldoni, Matteo; Chetta, Alfredo

    2016-01-01

    Background Data on cardiac alterations such as left ventricular (LV) hypertrophy, diastolic dysfunction, and lower stroke volume in patients with COPD are discordant. In this study, we investigated whether early structural and functional cardiac changes occur in patients with COPD devoid of manifest cardiovascular disease, and we assessed their associations with clinical and functional features. Methods Forty-nine patients with COPD belonging to all Global Initiative for Chronic Obstructive Lung Disease (GOLD) classes were enrolled and compared with 36 controls. All subjects underwent clinical history assessment, lung function testing, blood pressure measurement, electrocardiography, and conventional and Doppler tissue echocardiography. Patients were also subjected to computed tomography to quantify emphysema score. Results Patients with COPD had lower LV cavity associated with a marked increase in relative wall thickness (RWT), suggesting concentric remodeling without significant changes in LV mass. RWT was significantly associated with ratio of the forced expiratory volume in 1 second to the forced vital capacity and emphysema score and was the only cardiac parameter that – after multivariate analysis – significantly correlated with COPD conditions in all individuals. Receiver operating characteristic curve analysis showed that RWT (with a cutoff point of 0.42) predicted the severity of COPD with 83% specificity and 56% sensitivity (area under the curve =0.69, 95% confidence interval =0.59–0.81). Patients with COPD showed right ventricular to be functional but no structural changes. Conclusion Patients with COPD without evident cardiovascular disease exhibit significant changes in LV geometry, resulting in concentric remodeling. In all individuals, RWT was significantly and independently related to COPD. However, its prognostic role should be determined in future studies. PMID:27257378

  8. Increasing venoarterial extracorporeal membrane oxygenation flow negatively affects left ventricular performance in a porcine model of cardiogenic shock

    Ostadal, Petr; Mlcek, Mikulas; Kruger, Andreas; Hala, Pavel; Lacko, Stanislav; Mates, Martin; Vondrakova, Dagmar; Svoboda, Tomas; Hrachovina, Matej; Janotka, Marek; Psotova, Hana; Strunina, Svitlana; Kittnar, Otomar; Neuzil, Petr

    2015-01-01

    Background The aim of this study was to assess the relationship between extracorporeal blood flow (EBF) and left ventricular (LV) performance during venoarterial extracorporeal membrane oxygenation (VA ECMO) therapy. Methods Five swine (body weight 45 kg) underwent VA ECMO implantation under general anesthesia and artificial ventilation. Subsequently, acute cardiogenic shock with signs of tissue hypoxia was induced. Hemodynamic and cardiac performance parameters were then measured at differen...

  9. Comparison of permanent left ventricular and biventricular pacing in patients with heart failure and chronic atrial fibrillation: prospective haemodynamic study

    Garrigue, S; Bordachar, P.; Reuter, S.; Jaïs, P.; Kobeissi, A; Gaggini, G; Haïssaguerre, M; Clementy, J

    2002-01-01

    Objective: To compare clinical and haemodynamic variables between left ventricular and biventricular pacing in patients with severe heart failure; and to analyse haemodynamic changes during daily life and maximum exercise during chronic left ventricular and biventricular pacing.

  10. Effects of liraglutide on left ventricular function in patients with non-ST-segment elevation myocardial infarction.

    Chen, Wei-Ren; Shen, Xue-Qin; Zhang, Ying; Chen, Yun-Dai; Hu, Shun-Ying; Qian, Geng; Wang, Jing; Yang, Jun-Jie; Wang, Zhi-Feng; Tian, Feng

    2016-06-01

    The influence of glucagon-like peptide-1 has been studied in several studies in patients with acute myocardial infarction, but not in patients with non-ST-segment elevation myocardial infarction (NSTEMI). We planned to evaluate the effects of liraglutide on left ventricular function in patients with NSTEMI. A total of 90 patients were randomized 1:1 to receive either liraglutide (0.6 mg for 2 days, 1.2 mg for 2 days, followed by 1.8 mg for 3 days) or placebo for 7 days. Eighty-three patients completed the trial. Transthoracic echocardiography was used to assess left ventricular function. At 3 months, the primary endpoint, the difference in the change in left ventricular ejection fraction between the two groups was +4.7 % (liraglutide vs. placebo 95 % CI +0.7 to +9.2 % P = 0.009) under intention-to-treat analysis. The difference in decrease in serum glycosylated hemoglobin levels was -0.2 % (liraglutide vs. placebo 95 % CI -0.1 to -0.3 %; P < 0.001). Inflammation and oxidative stress improved significantly in the liraglutide group compared to the placebo group. Liraglutide could improve left ventricular function in patients with NSTEMI, making it a potential adjuvant therapy for NSTEMI. PMID:26573925

  11. Clinical significance of late high-degree atrioventricular block in patients with left ventricular dysfunction after an acute myocardial infarction--a Cardiac Arrhythmias and Risk Stratification After Acute Myocardial Infarction (CARISMA) substudy

    Gang, Uffe Jakob Ortved; Jøns, Christian; Jørgensen, Rikke Mørch; Abildstrøm, Steen Zabell; Messier, Marc D; Haarbo, Jens; Huikuri, Heikki V; Thomsen, Poul Erik Bloch

    2011-01-01

    High-degree atrioventricular block (HAVB) is a frequent complication in the acute stages of a myocardial infarction associated with an increased rate of mortality. However, the incidence and clinical significance of HAVB in late convalescent phases of an AMI is largely unknown. The aim of this st...

  12. Ventricular Recovery and Pump Explantation in Patients Supported by Left Ventricular Assist Devices: A Systematic Review.

    Phan, Kevin; Huo, Ya Ruth; Zhao, Dong Fang; Yan, Tristan D; Tchantchaleishvili, Vakhtang

    2016-01-01

    Several studies have reported that a portion of patients who exhibit cardiac recovery during left ventricular assist device (LVAD) support can have their device explanted with reasonable long-term survival. The aim of this systematic review is to assess the survival and cardiac function in patients with explanted LVADs from the current literature. Electronic search was performed to identify all studies in English literature assessing LVAD explantation. All identified articles were systematically assessed using the inclusion and exclusion criteria. Selected studies were subjected to quantitative assessment. From 5 electronic databases, 11 studies (213 patients) were included. Pooled mean perioperative mortality rate of those explanted was 9.2% (95% CI, 5.0-14.5%; I = 0). Pooled mean late mortality rate was 15% (95% CI, 9.0-22.1%; I = 31%). The pooled 1, 5, and 10 year survival postexplant was 91, 76, and 65.7%, respectively. Pooled postweaning freedom from heart failure (HF) recurrence reached 81.3%. Subset analysis demonstrated that patients explanted from a continuous-flow LVAD versus pulsatile LVAD had a lower rate of HF recurrence (6.6 vs. 28.3%, p = 0.03) and LVAD reimplantation (7.5 vs. 37%, p = 0.001). Before LVAD explantation, overall mean left ventricular ejection fraction (LVEF) was 49%. Weighted pooled early and late postexplantation mean LVEF was 47.3 and 41.2%, respectively. Late postexplantation LVEF was significantly higher in the continuous-flow versus pulsatile LVAD subgroup (41.5 vs. 24%, p = 0.001). This review shows encouraging safety and 10 year survival outcomes after explantation of LVADs in carefully selected patients, with rates better than expected after a heart transplant. Recovery of the native heart is the most desirable clinical outcome in patients supported with LVADs and should be actively sought. PMID:26735559

  13. Quantification of left-ventricular regional dyssynergy by radionuclide angiography

    To determine whether variables obtained from Fourier analysis of gated equilibrium radionuclide angiographic (RNA) images can detect and quantify changes in left-ventricular (LV) regional wall motion induced by transient ischemia, 11 chronically instrumented dogs were simultaneously studied with hemodynamic measurements and RNA during control, left circumflex (LCx) coronary artery occlusion, and postocclusion conditions. The dogs were preinstrumented with aortic and LV catheters, electromagnetic aortic and LCx coronary artery flow probes, high-fidelity LV micromanometers, LCx coronary artery occluders, and 4-mm ultrasonic transverse LV diameter and 2-mm regional LV segment crystal pairs. Radionuclide LV regional phase and amplitude variables were calculated for each condition. The absolute changes in LCx region RNA mean, median, and standard deviation of mean phase correlated with the percent changes in LCx segment crystal fractional shortening (r = -0.71, -0.64, and -0.51, respectively; all p less than or equal to 0.01). Similarly, the absolute changes and percent changes in LCx region RNA mean amplitude per pixel correlated with the percent changes in LCx segment crystal fractional shortening (r = 0.89 and 0.94, respectively; both p less than 0.001). When these LCx region RNA phase variables were subgrouped according to mild or severe depression or augmentation in LCx segment crystal fractional shortening, progressive differences were observed between the average values for these subgroups (p less than 0.05 to p less than 0.001). These data, therefore, suggest that these regional RNA phase variables may be able to detect and quantify alterations in LV contraction patterns due to transient ischemia

  14. Telemetric left ventricular monitoring using wireless telemetry in the rabbit model

    Zavala Diana L

    2011-09-01

    Full Text Available Abstract Background Heart failure is a critical condition that affects many people and often results from left ventricular dysfunction. Numerous studies investigating this condition have been performed using various model systems. To do so, investigators must be able to accurately measure myocardial performance in order to determine the degree of left ventricular function. In this model development study, we employ a wireless telemetry system purchased from Data Sciences International to continuously assess left ventricular function in the rabbit model. Findings We surgically implanted pressure-sensitive catheters fitted to wireless radio-transmitters into the left ventricle of Dutch-belted rabbits. Following recovery of the animals, we continuously recorded indices of cardiac contractility and ventricular relaxation at baseline for a given time period. The telemetry system allowed us to continuously record baseline left ventricular parameters for the entire recording period. During this time, the animals were unrestrained and fully conscious. The values we recorded are similar to those obtained using other reported methods. Conclusions The wireless telemetry system can continuously measure left ventricular pressure, cardiac contractility, and cardiac relaxation in the rabbit model. These results, which were obtained just as baseline levels, substantiate the need for further validation in this model system of left ventricular assessment.

  15. Diabetes, gender, and left ventricular structure in African-Americans: the atherosclerosis risk in communities study

    Liebson Philip R

    2006-11-01

    Full Text Available Abstract Background Cardiovascular risk associated with diabetes may be partially attributed to left ventricular structural abnormalities. However, the relations between left ventricular structure and diabetes have not been extensively studied in African-Americans. Methods We studied 514 male and 965 female African-Americans 51 to 70 years old, in whom echocardiographic left ventricular mass measurements were collected for the ARIC Study. In these, we investigated the independent association of diabetes with left ventricular structural abnormalities. Results Diabetes, hypertension and obesity prevalences were 22%, 57% and 45%, respectively. Unindexed left ventricular mass was higher with diabetes in both men (238.3 ± 79.4 g vs. 213.7 ± 58.6 g; p Conclusion In African-Americans, diabetes is associated with left ventricular hypertrophy and, with different patterns of left ventricular structural abnormalities between genders. Attenuation seen in adjusted associations suggests that the higher frequency of structural abnormalities seen in diabetes may be due to factors other than hyperglycemia.

  16. Diastolic left ventricular function in patients with mild and moderate hypertension - liquidators of the Chernobyl Nuclear Power Station accident

    Diastolic left ventricular function was studied by doppler-echocardiography in 25 healthy persons (control group) and 50 patients with mild and moderate hypertension including 28 liquidators of the Chernobyl accident consequences. Patients with hypertension including liquidators had such manifestations of diastolic left ventricular dysfunction. These manifestations were more pronounced in liquidators who also had greater left ventricular myocardial mass

  17. Left ventricular hemodynamics in patients with sick sinus syndrome

    The left ventricular (LV) systolic and diastolic functions in 31 patients with sick sinus syndrome (types I and II) were analyzed using LV time activity curves obtained by a 99mTc-RBC cardiac pool scintigraphy-forward and backward multiple gated study (FBMG) and compared with those in controls. On A-V sequential pacing (rate, 70 bpm; A-V delay, 150 msec), LV-peak ejection rate (PER) and peak filling rate (PFR) were significantly decreased compared to those in normal controls. As pacing rate was increased, PFR decreased significantly in patients in whom PER was decreased. The etiology of disturbed LV systolic and diastolic functions in patients with sick sinus syndrome remains unknown. No patient had significant organic coronary artery disease or other cardiac disorder. On the other hand, the frequency of vasospastic angina was higher in this group than in the controls. We suspect that sick sinus syndrome and vasospastic angina probably share a common pathophysiology. In patients with sick sinus syndrome, LV systolic and diastolic functions are impaired at rest and during A-V sequential pacing. (author)

  18. Effect of positive pleural pressure on left ventricular performance

    A sudden increase in pleural pressure such as coughing or a valsalva maneuver causes a transient increase in left ventricular stroke volume but the mechanism is not known. To help understand this phenomenon we studied 7 normal volunteers during spontaneous breathing and when breathing under positive pleural pressure. The positive pressure was developed by expiring against a 24cm H/sub 2/O threshold load. Radionuclide ventriculopgraphy using a double gating technique as performed. Image data were acquired during the cardiac cycles occurring during positive pleural pressure by means of a pressure transducer coupled to an EKG gate. They were compared to data acquired by EKG gating alone under quiet respiration as control. Results are shown for end diastolic (EDC), end systolic (ESC) and stroke counts (SC) and are expressed as % change from control for each parameter. The authors conclude that a transient increase in positive pleural pressure comparable to that reached during forceful coughing increases stroke volume and cardiac output through a combination of increased end diastolic volume with a lesser increase in end systolic volume. This effect was seen in the absence of any change in cardiac rhythm or rate

  19. Medical Image of the week: left ventricular non-compaction

    Khoubyari R

    2016-06-01

    Full Text Available No abstract available. Article truncated at 150 words. A 38-year-old woman with history of type 2 diabetes mellitus and hypertension presented to emergency department with worsening exertional dyspnea and orthopnea for the past 2-3 months. She also reported a 14 pound weight gain within the 2 weeks prior to presentation. She denied any prior history of cardiac or pulmonary disease. Also, there was no family history of heart disease. She denies any recent sick contacts, smoking, alcohol drinking, or substance abuse. Physical exam revealed jugular venous pressure of 10 cm H2O and significant bilateral lower extremity pitting edema. Chest x-ray showed an enlarged cardiac silhouette. Brain naturetic peptide (BNP was 2,917 pg/mL. A subsequent echocardiogram revealed a left ventricular (LV ejection fraction of 23% with severe global LV hypokinesia with moderate mitral regurgitation. Thyroid panel as well as iron panel were within normal range. Other laboratories were unremarkable. For the new onset systolic heart failure, a coronary angiography was ...

  20. QT dispersion in elderly athletes with left ventricular hypertrophy.

    Galetta, F; Franzoni, F; Santoro, G; Prattichizzo, F; Femia, F R; Pastine, F; Pentimone, F

    2003-05-01

    The purpose of this study was to examine the QT dispersion in elderly endurance athletes with left ventricular (LV) hypertrophy. Sixteen athletes (males, mean age 67.6 +/- 4.5 years) with mild to moderate LV hypertrophy, were compared with 16 age-matched hypertensive patients with similar degree of LV hypertrophy and 16 age-matched healthy sedentary controls. All the participants underwent echocardiogram and 12-lead electrocardiogram. QT dispersion was defined as the difference between maximum and minimum QT intervals in the different leads. QT dispersion was corrected (QTc) for heart rate according to Bazett's formula. The results showed in athletes and hypertensive patients comparable LV mass (258.2 +/- 14.2 vs. 262.4 +/- 16.8 g, ns), which was significantly higher than that of controls (p < 0.001). Trained subjects had QT dispersion (38.6 +/- 10.2 ms) and QTc dispersion (39.4 +/- 11.3 ms) significantly lower than hypertensive patients (QT dispersion: 68.4 +/- 11.4 ms; QTc dispersion: 72.2 +/- 8.4, p < 0.001) and comparable with controls (QT dispersion: 44.3 +/- 8.4 ms; QTc dispersion: 46.2 +/- 6.2 ms, ns). In conclusion, in elderly athletes training-induced myocardial hypertrophy was characterized by a QT dispersion significantly lower than hypertensive myocardial hypertrophy. This could provide a simple and inexpensive screening method for differentiating physiologic from pathologic myocardial hypertrophy in elderly subjects. PMID:12784163

  1. PERIOPERATIVE PERIOD FOLLOWING HEART TRANSPLANTATION WITH SEVERE LEFT VENTRICULAR HYPERTROPHY

    V. N. Poptsov

    2012-01-01

    Full Text Available Use donor hearts with left ventricular hypertrophy (LVH is controversial. This category of heart recipients has increasing risk of early graft failure. We proposed that heart transplantation (HT with LVH ≥1.5 cm may be successful if performed in selective category patients from alternate transplant list. This study included 10 pati- ents (2 female and 8 male at the age 26–62 (44 ± 3, who needed urgent HT. This study showed that recipients with LVH ≥1.5 cm demanded more high and long inotropic support with adrenalin and dopamine, more fre- quent use of levosimendan infusion (in 40% of cases and intraaortic balloon conterpulsation (in 50% of cases. However we didn’t observed any difference in survival rate (90.0% vs 89.0% and ICU time (4.8 ± 0.6 days vs 4.1 ± 0.4 days between HT recipients with and without LVH. Our study showed that HT from donor with LVH ≥1.5 cm may be performed in patients, demanding urgent HT, with acceptable early posttransplant results. 

  2. Regional left ventricular diastolic function in hypertrophic cardiomyopathy

    To estimate regional left ventricular (LV) diastolic filling patterns in hypertrophic cardiomyopathy (HCM), a computer-assisted method by applying 'sector analysis' to ECG forward and reverse gated radionuclide ventriculography was developed. Fourteen patients with HCM (four with localized septal hypertrophy, seven with apical hypertrophy and three with septal and apical hypertrophy according to echocardiography) were observed at rest. After establishing serial 20 msec imaged frames, the LV region of interest was subdivided into eight sectors radiating from the geometric center. A time-activity curve was generated for each sector and was fitted by third-order harmonics of the Fourier series. From each fitted curve, the regional peak filling rate (rPFR) and the time to rPFR (rTPFR) in the forward gating method and regional atrial contribution to filling (rAC/FV) in the reverse gating method were calculated. The coefficient of variance of rTPFR was used as an index of LV diastolic asynchrony. In HCM, a prominent delay of rTPFR was observed in the hypertrophied regions. The coefficient of variance of rTPFR correlated inversely with global LVPFR (r=-0.62, p<0.05), indicating that diastolic asynchrony is one of the determinants of the LV early filling rate. Regional AC/FV was augmented in the hypertrophied regions, indicating the important role of atrial systolic LV filling for slowed early filling. Thus, this new method provides valuable information concerning regional diastolic LV wall mechanics in HCM. (author)

  3. Exercise body surface mapping in patients with left ventricular hypertrophy

    To evaluate exercise-induced myocardial ischemia in patients with electrocardiographic evidence of left ventricular hypertrophy (LVH), including ST·T changes, body surface maps (QRST area maps) were recorded using 87 lead points before and after exercise. The patterns of the subtraction QRST area maps (S-maps) were compared with the findings of stress thallium (Tl) scans in 31 patients with hypertrophic cardiomyopathy and in five with essential hypertension. All 18 patients whose S-maps revealed changes less than -40 μVS or only an increase over the anterior chest region showed no positive findings on the stress Tl scans. However, there were clearly positive findings on stress Tl scans in eight (89%) of nine patients whose S-maps revealed changes greater than -40 μVS over a wide precordial region or in six (67%) of nine patients whose S-maps revealed increases over the anterior chest region and had accompanying changes greater than -40 μVS somewhere over the precordial region. These results suggested that exercise QRST area maps could differentiate exercise-induced myocardial ischemia from LVH with ST·T changes. (author)

  4. A STUDY OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN HYPERTENSION

    Ravi Keerthy

    2015-03-01

    Full Text Available INTRTODUCTION: Hypertension is one of the major non communica b le disease among the adult population . Hypertension is the leading cause of morbidity and mortality in both developed and developing countries . Hypertension is the leading cause of ischemic heart disease , heart failure and stroke . (1 In spite of having target organ damage , hypertens ion remains asymptomatic in majority of population . Diastolic dysfunction and left ventricular hypertrophy are the early evidence of hypertensive heart disease , both of which may remain silent . (2 Heart failure is a common and often lethal complication of chronic hypertension . Based on extensive research , it has become possible to focus on individual factors that cause or contribute to the syndrome of chronic heart failure . OBJECTIVE: Main objective of the study of to find out the incidence of left ventricu lar diastolic dysfunction . METERIALS AND METHODS: All hypertensive patient with systolic blood pressure of more than 140 and or diastolic blood pressure of more than 90 are included in the study . Data was collected from history , clinical examination , ECG , Echo . Coronary angiogram was done in few patients to rule out ischemic heart disease . LV dime n sions were obtained by M - mode echo from apical and parasternal windows . Diastolic dysfunction was measured by Doppler echo . RESULTS: 85patients were considered fo r the study . 62 patients had diastolic dysfunction , 40 patients had LVH . Of the 62 patients , 28 had isolated diastolic dysfunction and 34 patients had both systolic and diastolic dysfunction . Ejection fraction was ranging from 50 - 77% . Early peak velocity r anged from40cms/secto 120cms/sec with a mean of 71 . 21+/ - 16 . 81cms/sec in patients with diastolicdys function , l ate atrial velocity ranged from 50cms/sec to 150cms/sec with a mean of102 . 66cmd/sec+/ - 19 . 13cms/sec . E/A ratio ranged from 0 . 41 to 1 . 8 with a mean of 0 . 69+/ - 0 . 14 . CONCLUSION: Since

  5. Transplanted human umbilical cord blood mononuclear cells improve left ventricular function through angiogenesis in myocardial infarction

    HU Cheng-heng; WU Gui-fu; WANG Xiao-qing; YANG Yan-hua; DU Zhi-min; HE Xiao-hong; XIANG Peng

    2006-01-01

    Background Human umbilical cord blood contains an abundance of immature stem/progenitor cells, which may participate in the repair of hearts that have been damaged by myocardial infarction (MI). This study aimed to evaluate the effects of human umbilical cord blood mononuclear cells (hUCBC) transplantation on cardiac function and left ventricular remodeling in rat model of MI.Methods Forty-five male Wistar rats were randomized into three groups: MI or control group (n=15), MI plus cell transplantation (n=15), and sham group (n=15). Acute myocardial infarction (AMI) was established by ligating the left anterior descending artery, thereafter, hUCBC were implanted into the marginal area of infarcted myocardium. In MI/control group, DMEM was injected instead of hUCBC following the same protocol. Left ventricular function assessment was carried out by echocardiography and invasive hemodynamic measurements one month post MI. All rats were sacrificed for histological and immunochemical examinations.Results The transplanted hUCBC survived and engaged in the process of myocardial repair in the host heart.Echocardiography demonstrated that left ventricular function improved significantly in the rats that underwent cell transplantation. Hemodynamic studies found a significantly decreased left ventricular end-diastolic pressure (LVEDP) [(21.08±8.10) mmHg vs (30.82±9.59) mmHg, P<0.05], increase in +dp/dtmax [(4.29± 1.27)mmHg/ms vs (3.24±0.75) mmHg/ms, P<0.05), and increase in -dp/dtmax [(3.71 ±0.79) mmHg/ms vs (3.00±0.49) mmHg/ms, P<0.05] among MI group with hUCBC transplantation when compared with MI/control group.Masson's trichrome staining revealed that the collagen density in the left ventricle was significantly lower in rats of transplantation group than that in the MI control groups [(6.33±2.69)% vs (11.10±3.75)%, P< 0.01]. Based on immunostaining of α-actin, the numbers of microvessels were significantly (P<0.01) increased at the boundary of

  6. Cardiac MRI in a Patient with Coincident Left Ventricular Non-Compaction and Hypertrophic Cardiomyopathy

    Zahra Alizadeh-Sani

    2011-12-01

    Full Text Available Left ventricular non-compaction cardiomyopathy is a rare congenital cardiomyopathy that affects both children and adults. Since the clinical manifestations are not sufficient to establish diagnosis, echocardiography is the diagnostic tool that makes it possible to document ventricular non-compaction and establish prognostic factors. We report a 47-year-old woman with a history of dilated cardiomyopathy with unknown etiology. Echocardiography showed mild left ventricular enlargement with severe systolic dysfunction (EF = 20-25%. According to cardiac magnetic resonance imaging findings non-compaction left ventricle with hypertrophic cardiomyopathy was considered, and right ventricular septal biopsy was recommended. Right ventricular endomyocardial biopsy showed moderate hypertrophy of cardiac myocytes with foci of myocytolysis and moderate interstitial fibrosis. No evidence of infiltrative deposition was seen.

  7. Evaluation of Left Ventricular Dyssynchrony after Coronary Artery Bypass Grafting in Patients with Ischemic Left Ventricular Dysfunction

    MA Babaee Beigi

    2009-12-01

    Full Text Available Background: Ischemic left ventricular (LV dysfunction is one of the major causes of LV dyssynchrony. This is indicative of poor prognosis in patients with LV dysfunction and correction of ischemia by Coronary Artery Bypass Grafting (CABG may resynchronize LV contraction. The aim of this study was to evaluate the effect of CABG on LV dyssynchrony, systolic and diastolic function.Patients: The present study comprised 31 patients with ischemic LV dysfunction with Ejection Fraction (EF:25- 50%. Echocardiography with Tissue Doppler Imaging (TDI was performed to assess LV dyssynchrony (calculated by basal LV segment,to evaluate diastolic function by measurement of peak early diastolic mitral annular velocity (Em ,systolic function by measurement of peak early systolic mitral annular velocity (Sm and Ejection Fraction (EF by Simpson method.Results: Mean LV dyssychrony before CABG was 30±16 ms that decreased to 22±14 ms after operation (P=0.04.There was also improved diastolic and systolic function after CABG ( Em 0.04m/s versus 0.05 m/s , P=0.01 and Sm 0.06 m/s versus 0.08 m/s P=0.01.The mean ejection fraction rose from 40±8.6% to 42±8.2% (P=0.01.Conclusion: CABG is associated with improvement of LV dyssynchrony, systolic and diastolic function in patients with ischemic LV dysfunction.

  8. Effect of Neurohormonal Blockade Drug Therapy on Outcomes and Left Ventricular Function and Structure After Left Ventricular Assist Device Implantation.

    Grupper, Avishay; Zhao, Yanjun M; Sajgalik, Pavol; Joyce, Lyle D; Park, Soon J; Pereira, Naveen L; Stulak, John M; Burnett, John C; Edwards, Brooks S; Daly, Richard C; Kushwaha, Sudhir S; Schirger, John A

    2016-06-01

    Neurohormonal blockade drug therapy (NHBDT) is the cornerstone therapy in heart failure (HF) management for promoting reverse cardiac remodeling and improving outcomes. It's utility in left ventricular assist device (LVAD) supported patients remains undefined. Sixty-four patients who received continuous flow LVAD at our institution were retrospectively reviewed and divided into 2 groups: no-NHBDT group (n = 33) received LVAD support only and NHBDT group (n = 31) received concurrent NHBDT based on the clinical judgment of the attending physicians. Cardiac remodeling (echocardiographic parameters and biomarkers) and clinical outcome (functional status, HF-related hospital readmissions, and mortality) data were collected. A statistically significant increase in ejection fraction, decrease in LV end-diastolic diameter index and LV mass index, and a sustained reduction in N-terminal pro B-type natriuretic peptide (NTproBNP) were observed in the NHBDT group at 6 months after LVAD implant (p improvement in New York Heart Association functional classification and 6-minute-walk distance throughout the study. The combined end point of cardiovascular death or HF hospitalization was significantly reduced in patients receiving NHBDT (p = 0.013) associated primarily with a 12.1% absolute reduction in HF-related hospitalizations (p = 0.046). In conclusion, NHBDT in LVAD-supported patients is associated with a significant reversal in adverse cardiac remodeling and a reduction in morbidity and mortality compared with LVAD support alone. PMID:27079215

  9. Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both

    Pfeffer, Marc A; McMurray, John J V; Velazquez, Eric J; Rouleau, Jean-Lucien; Køber, Lars; Maggioni, Aldo P; Solomon, Scott D; Swedberg, Karl; Van de Werf, Frans; White, Harvey; Leimberger, Jeffrey D; Henis, Marc; Edwards, Susan; Zelenkofske, Steven; Sellers, Mary Ann; Califf, Robert M

    2003-01-01

    BACKGROUND: Angiotensin-converting-enzyme (ACE) inhibitors such as captopril reduce mortality and cardiovascular morbidity among patients with myocardial infarction complicated by left ventricular systolic dysfunction, heart failure, or both. In a double-blind trial, we compared the effect of the...... angiotensin-receptor blocker valsartan, the ACE inhibitor captopril, and the combination of the two on mortality in this population of patients. METHODS: Patients receiving conventional therapy were randomly assigned, 0.5 to 10 days after acute myocardial infarction, to additional therapy with valsartan (4909...... (P<0.001). The valsartan-and-captopril group had the most drug-related adverse events. With monotherapy, hypotension and renal dysfunction were more common in the valsartan group, and cough, rash, and taste disturbance were more common in the captopril group. CONCLUSIONS: Valsartan is as effective as...

  10. Nuclear medical determination of left ventricular diastolic function in coronary heart disease

    Brugger, P.; Laesser, W.K.; Kullich, W.; Stoiberer, I.; Klein, G.

    1985-06-01

    In 64 patients with coronary heart disease, the left ventricular diastolic function was determined by means of a new nuclear medical method (nuclear stethoscope). The investigations revealed an abnormal diastolic filling in 85.9% of the cases on the basis of the parameters peak filling rate and time to peak filling rate as manifestation of a disturbed ventricular function.

  11. Nuclear medical determination of left ventricular diastolic function in coronary heart disease

    In 64 patients with coronary heart disease, the left ventricular diastolic function was determined by means of a new nuclear medical method (nuclear stethoscope). The investigations revealed an abnormal diastolic filling in 85.9% of the cases on the basis of the parameters peak filling rate and time to peak filling rate as manifestation of a disturbed ventricular function

  12. Left ventricular dysfunction in patients with suspected pulmonary arterial hypertension

    Francisca Gavilanes

    2014-12-01

    Full Text Available OBJECTIVE: To evaluate the role of right heart catheterization in the diagnosis of pulmonary arterial hypertension (PAH. METHODS: We evaluated clinical, functional, and hemodynamic data from all patients who underwent right heart catheterization because of diagnostic suspicion of PAH-in the absence of severe left ventricular dysfunction (LVD, significant changes in pulmonary function tests, and ventilation/perfusion lung scintigraphy findings consistent with chronic pulmonary thromboembolism-between 2008 and 2013 at our facility. RESULTS: During the study period, 384 patients underwent diagnostic cardiac catheterization at our facility. Pulmonary hypertension (PH was confirmed in 302 patients (78.6%. The mean age of those patients was 48.7 years. The patients without PH showed better hemodynamic profiles and lower levels of B-type natriuretic peptide. Nevertheless, 13.8% of the patients without PH were categorized as New York Heart Association functional class III or IV. Of the 218 patients who met the inclusion criteria, 40 (18.3% and 178 (81.7% were diagnosed with PH associated with LVD (PH-LVD and with PAH, respectively. The patients in the HP-LVD group were significantly older than were those in the PAH group (p < 0.0001. CONCLUSIONS: The proportional difference between the PAH and PH-LVD groups was quite significant, considering the absence of echocardiographic signs suggestive of severe LVD during the pre-catheterization investigation. Our results highlight the fundamental role of cardiac catheterization in the diagnosis of PAH, especially in older patients, in whom the prevalence of LVD that has gone undiagnosed by non-invasive tests is particularly relevant.

  13. Effect of percutaneous coronary intervention on ventricular systolic synchrony and brain natriuretic peptide in acute myocardial infarction patients with aneurysm

    Objective: To evaluate the reversed effect on the left ventricular aneurysm (LVA) formation and influence on systolic performance and synchrony using percutaneous coronary intervention (PCI) therapy in patients with acute myocardial infarction (AMI) at different time intervals equilibrium radionuclide angiography (ERNA). Methods: A total of 326 patients with primary anterior AMI accompanied LVA diagnosed by left ventricular graphy were enrolled in this study from January 2001 to July 2004. They were divided into 4 groups according to the time accepting PCI. Group A ( 1 week, n=76). The parameters of the paradox volume image of ventricular movement on the dynamic cine of cardiac blood pool, and the paradox volume index (PVI) as well as the parameters of left ventricular systolic function (LVSF), left ventricular diastolic function (LVDF) and left ventricular systolic synchrony (LVSS) were measured by ERNA with the ventricular phase analysis (PA) at 1st week and 6th month after AMI. The plasma brain natriuretic peptide (BNP) was measured in 18th hour, 5th day and 24th week after AMI. During 3-year follow-up, the major adverse cardiac events (MACE) were recorded.Analysis of variance and χ2-test were used. Results: At 6th month post AMI, the left ventricular ejection fraction (LVEF) in group A, B and C was increased than that in group D, hut phase shift (PS) and full width at half maximum (FWHM) were decreased (F=5.90, 6.80, all P 2=10.05, P<0.05). Conclusion: The early, fully and permanently opening of infarction related artery can effectively inhibit the left ventricular remodeling process, improve its function, prevent LVA formation, and finally improve the prognosis. (authors)

  14. Echocardiographic assessment of fetal left ventricular function in hypertensive disorder of pregnancy

    Objective: To investigate fetal left ventricular function in hypertensive disorder of pregnancy (HDP). Methods: Fetuses of hypertensive (84) and normotensive (147) mothers were enrolled in this study. The fetal left ventricular ejection fractions, E/A ratios of mitral valves, left atrial shortening fractions and Tei indexes of the two groups were measured on fetal echocardiography. Results: The left ventricular ejection fractions (P=0.040), E/A ratios of the mitral valves (P=0.042) and the left atrial shortening fractions (P=0.036) in fetuses of HDP were significantly smaller than those of the normal group whereas the Tei indexes (P=0.030) were significantly larger than those of the normal group. Conclusion: The hypertensive disorder of pregnancy may cause decreased systolic, diastolic and global function of the fetal left ventricle. (authors)

  15. Independent effects of both right and left ventricular function on plasma brain natriuretic peptide

    Vogelsang, Thomas Wiis; Jensen, Ruben J; Monrad, Astrid L; Russ, Kaspar; Olesen, Uffe H; Hesse, Birger; Kjaer, Andreas

    2007-01-01

    BACKGROUND: Brain natriuretic peptide (BNP) is increased in heart failure; however, the relative contribution of the right and left ventricles is largely unknown. AIM: To investigate if right ventricular function has an independent influence on plasma BNP concentration. METHODS: Right (RVEF), left......, which is a strong prognostic marker in heart failure, independently depends on both left and right ventricular systolic function. This might, at least in part, explain why BNP holds stronger prognostic value than LVEF alone....... ventricular ejection fraction (LVEF), and left ventricular end-diastolic volume index (LVEDVI) were determined in 105 consecutive patients by first-pass radionuclide ventriculography (FP-RNV) and multiple ECG-gated equilibrium radionuclide ventriculography (ERNV), respectively. BNP was analyzed by immunoassay...

  16. Erythropoietin Therapy and Left Ventricular Mass Index in CKD and ESRD Patients: A Meta-Analysis

    Parfrey, Patrick S.; Lauve, Maria; Latremouille-Viau, Dominick; Lefebvre, Patrick

    2009-01-01

    Background and objectives: The purpose was to evaluate changes in the left ventricular mass index (LVMi) among anemic chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients treated with recombinant human erythropoietin (EPO).

  17. Heart Failure With Normal Left Ventricular Ejection Fraction : What is the Evidence?

    Kindermann, Michael; Reil, Jan-Christian; Pieske, Burkert; van Veldhuisen, Dirk J.; Boehm, Michael

    2008-01-01

    Heart failure with a normal ejection fraction (HFNEF) is a common clinical problem with many unsolved questions regarding pathophysiology, diagnosis, and therapy. Although the term diastolic heart failure has been abandoned, diastolic left ventricular (LV) dysfunction together with combined systolic

  18. Longitudinal strain bull's eye plot patterns in patients with cardiomyopathy and concentric left ventricular hypertrophy.

    Liu, Dan; Hu, Kai; Nordbeck, Peter; Ertl, Georg; Störk, Stefan; Weidemann, Frank

    2016-01-01

    Despite substantial advances in the imaging techniques and pathophysiological understanding over the last decades, identification of the underlying causes of left ventricular hypertrophy by means of echocardiographic examination remains a challenge in current clinical practice. The longitudinal strain bull's eye plot derived from 2D speckle tracking imaging offers an intuitive visual overview of the global and regional left ventricular myocardial function in a single diagram. The bull's eye mapping is clinically feasible and the plot patterns could provide clues to the etiology of cardiomyopathies. The present review summarizes the longitudinal strain, bull's eye plot features in patients with various cardiomyopathies and concentric left ventricular hypertrophy and the bull's eye plot features might serve as one of the cardiac workup steps on evaluating patients with left ventricular hypertrophy. PMID:27165726

  19. Effects of trimetazidine therapy on left ventricular function after percutaneous coronary intervention

    许晓晗

    2013-01-01

    Objective To explore the effects of trimetazidine therapy on left ventricular(LV)function after percutaneous coronary intervention(PCI).Methods A total of 106 patients with unstable angina pectoris undergoing successful

  20. Clustered metabolic abnormalities blunt regression of hypertensive left ventricular hypertrophy: the LIFE study

    de Simone, G; Okin, P M; Gerdts, E;

    2009-01-01

    BACKGROUND AND AIMS: Clusters of metabolic abnormalities resembling phenotypes of metabolic syndrome predicted outcome in the LIFE study, independently of single risk markers, including obesity, diabetes and baseline ECG left ventricular hypertrophy (LVH). We examined whether clusters of two or...

  1. Impact of fasting glucose on electrocardiographic left ventricular hypertrophy in an elderly general population

    Diederichsen, Søren Z; Pareek, Manan; Nielsen, Mette L;

    2015-01-01

    OBJECTIVE: To evaluate relationships between fasting plasma glucose (FPG), other cardiovascular risk markers and left ventricular hypertrophy (LVH) as detected by electrocardiography. METHODS: Subjects were selected randomly from groups defined by FPG. Traditional risk markers were assessed. LVH...

  2. Echocardiographic Partition Values and Prevalence of Left Ventricular Hypertrophy in Hypertensive Jamaicans

    Chiranjivi Potu

    2012-02-01

    Full Text Available Left ventricular hypertrophy (LVH detected by either electrocardiography or echo- cardiography has been shown to be an extremely strong predictor of morbidity and mortality in patients with essential hypertension and in members of the general population. Alternative to LVH, left ventricular geometrical patterns offer incremental prognostic value beyond that provided by the other cardiovascular risk factors including left ventricular mass (LVM. Combination of LVM and relative wall thickness (RWT can be used to identify different left ventricular geometrical patterns. Various indexation methods normalised for LVM have been shown to offer prognostic significance. There was no prior study on the prevalence of LVH and geometric patterns in hypertensive patients in Jamaica using multiple partition values. Our study was designed to estimate the prevalence of LVH and geometrical patterns in a hypertensive Caribbean population in Jamaica using 10 different published cut-off values.

  3. Left Anterolateral Thoracotomy for Simultaneous Correction of Ventricular Septal Defect and Coarctation of the Aorta

    Chu, Shu-Hsun; Chou, Nai-Kuan; Chou, Tsai-Fwu; Wang, Shoei-Shen

    1994-01-01

    Three patients with ventricular septal defect and coarctation of the aorta were treated successfully by simultaneous correction of both anomalies through a single incision via a left transsternal anterolateral thoracotomy. (Texas Heart Institute Journal 1994; 21:158-60)

  4. Left ventricular dysfunction in normotensive Type 1 diabetic patients: the impact of autonomic neuropathy

    Taskiran, M; Rasmussen, Verner; Rasmussen, Bo Valdemar; Fritz-Hansen, T; Larsson, H. B. W.; Jensen, G. B.; Hilsted, J

    Aims The pathophysiological mechanisms responsible for increased cardiovascular mortality in diabetic autonomic neuropathy (AN) are largely unknown. The aim was to determine the relative role of AN in the pathogenesis of cardiac diastolic dysfunction and left ventricular hypertrophy in Type 1...... diabetes. Methods Ten Type 1 diabetic patients with AN, defined by cardiovascular tests (AN+) and 10 age- and sex-matched patients without neuropathy (AN-) as well as 10 healthy subjects (C) participated in the study. Left ventricular diastolic function was assessed by Doppler echocardiography, whilst...... showed a significantly greater left ventricular mass index in AN+ compared with C [103 +/- 4 g/m(2) (AN+) vs. 98 +/- 7 (AN-) and 92 +/- 4 g/m(2) (C), P < 0.05]. Conclusion Autonomic neuropathy is associated with left ventricular hypertrophy and diastolic dysfunction in Type 1 diabetic patients...

  5. Metabolites of MDMA induce oxidative stress and contractile dysfunction in adult rat left ventricular myocytes

    Shenouda, Sylvia K.; Varner, Kurt J.; Carvalho, Felix; Lucchesi, Pamela A.

    2009-01-01

    Repeated administration of MDMA (ecstasy) produces eccentric left ventricular (LV) dilation and diastolic dysfunction. While the mechanism(s) underlying this toxicity are unknown; oxidative stress plays an important role. MDMA is metabolized into redox cycling metabolites that produce superoxide. In this study, we demonstrated that metabolites of MDMA induce oxidative stress and contractile dysfunction in adult rat left ventricular myocytes. Metabolites of MDMA used in this study included: al...

  6. Natriuretic peptide vs. clinical information for diagnosis of left ventricular systolic dysfunction in primary care

    Wachter Rolf; Pouwels Claudia; Kleta Sibylle; Wetzel Dirk; Kochen Michael M; Lüers Claus; Scherer Martin; Koschack Janka; Herrmann-Lingen Christoph; Pieske Burkert; Binder Lutz

    2008-01-01

    Abstract Background Screening of primary care patients at risk for left ventricular systolic dysfunction by a simple blood-test might reduce referral rates for echocardiography. Whether or not natriuretic peptide testing is a useful and cost-effective diagnostic instrument in primary care settings, however, is still a matter of debate. Methods N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, clinical information, and echocardiographic data of left ventricular systolic function wer...

  7. Dynamics of left ventricular ejection in obstructive and nonobstructive hypertrophic cardiomyopathy.

    Murgo, J P; Alter, B R; Dorethy, J F; Altobelli, S A; McGranahan, G M

    1980-01-01

    The purpose of this study was to examine the dynamics of left ventricular ejection in patients with obstructive and nonobstructive hypertrophic cardiomyopathy (HCM). 30 patients with HCM and 29 patients with no evidence of cardiovascular disease were studied during cardiac catheterization. Using a single multisensor catheter, electromagnetically derived ascending aortic flow velocity and high fidelity left ventricular and aortic pressures were recorded during rest (n = 47) and provocative man...

  8. Effect of Percutaneous Coronary Intervention on Left Ventricular Diastolic Function in Patients With Coronary Artery Disease

    Salehi, Nahid; Saidi, Mohammadreza; Rai, Alireza; Najafi, Farid; Javeedannejad, Seedmokhtar; Babanejad, Mehran; Tadbiri, Hooman

    2015-01-01

    Background: There is considerable disagreement over the effects of percutaneous coronary intervention (PCI) on left ventricular diastolic function that has necessitated the investigation of diastolic indices. The present study was conducted to evaluate left ventricular diastolic function and its indices, three months after performing the PCI procedure in patients with coronary artery disease (CAD). Methods: In a quasi-experimental clinical trial study (before and after), 51 patients with CAD ...

  9. Patient-prosthesis mismatch and reduction in left ventricular mass after aortic valve replacement

    Kandler, Kristian; Møller, Christian H; Hassager, Christian;

    2013-01-01

    The presence of patient-prosthesis mismatch (PPM) after aortic valve replacement may influence patient survival. We examined the relationship between PPM and changes in left ventricular mass index at 3 months follow-up and also overall survival.......The presence of patient-prosthesis mismatch (PPM) after aortic valve replacement may influence patient survival. We examined the relationship between PPM and changes in left ventricular mass index at 3 months follow-up and also overall survival....

  10. Haemochromatosis genotype and iron overload: association with hypertension and left ventricular hypertrophy

    Ellervik, C; Tybjaerg-Hansen, A; Appleyard, M;

    2010-01-01

    We hypothesized that there is an association between haemochromatosis genotype C282Y/C282Y and/or iron overload and risk of hypertension and/or left ventricular hypertrophy (LVH).......We hypothesized that there is an association between haemochromatosis genotype C282Y/C282Y and/or iron overload and risk of hypertension and/or left ventricular hypertrophy (LVH)....

  11. Allopurinol Benefits Left Ventricular Mass and Endothelial Dysfunction in Chronic Kidney Disease

    Kao, Michelle P.; Ang, Donald S.; Gandy, Stephen J.; Nadir, M. Adnan; Houston, J. Graeme; Lang, Chim C; Struthers, Allan D

    2011-01-01

    Allopurinol ameliorates endothelial dysfunction and arterial stiffness among patients without chronic kidney disease (CKD), but it is unknown if it has similar effects among patients with CKD. Furthermore, because arterial stiffness increases left ventricular afterload, any allopurinol-induced improvement in arterial compliance might also regress left ventricular hypertrophy (LVH). We conducted a randomized, double-blind, placebo-controlled, parallel-group study in patients with stage 3 CKD a...

  12. Meta analysis on therapeutic effect of bone marrow stem cell transplantation on left ventricular remodeling in patients with acute myocardial infarction%骨髓干细胞移植改善心肌梗死患者左室重构的Meta分析

    费宇行; 裘毅钢; 李晶

    2011-01-01

    Objective To review the influence of bone marrow stem cell transplantation on left ventricular remodeling in the patients with acute myocardial infarction ( AMI ). Methods The full-text literature about the random and controlling studies on influence of bone marrow stem cell transplantation on left ventricular remodeling after AMI ventilated at home and abroad from 1966 to March 2011 were retrieved from Medline, Embase, China Journal Fulltext Database and Cochrane Library according to the inclusion and exclusion criteria. The literature was analyzed by using RevMan 5.0 software. Results There were totally 16 studies included ( 894 cases ). The results of Meta analysis showed that, compared with the control group, auto-transplantation of bone marrow stem cells decreased the left ventricular end-diastolic volume ( WMD = -7. 74; 95% CI: -11.51- -37 ;P < 0.01 ) and left ventricular end-systolic volume( WMD = -8.22;95% CI: -13.62- -4. 81 ;P <0. 01 ). The analysis of subgroup showed the decrease ofleft ventricular remodeling began from the 3rd month and continued to the 6th month and 12th month. Conclusion The transplantation of bone marrow stem cells can ameliorate left ventricular remodeling after AMI.%目的 评价骨髓干细胞移植对心肌梗死患者左室重构的影响.方法 根据纳入标准和剔除标准检索Medline、Embase、中国期刊全文数据库、Cochrane 图书馆等电子数据库,收集国内外1966~2011年3月公开发表的关于急性心肌梗死后骨髓干细胞移植对左室重构的影响的随机对照研究的全文文献,最后纳入的文献用RevMan 5.0进行分析.结果 共纳入16项研究共894例患者.Meta分析结果显示:与对照组相比,自体骨髓干细胞移植显著降低了心肌梗死患者的左室舒张末期容积(WMD=-7.74;95% CI:-11.51~-3.37;P<0.01)和左室收缩末期容积(WMD=-8.22;95% CI:-13.62~-4.81;P<0.01)的变化.在亚组分析中,从3个月起即显示出减少左室重

  13. Pseudoaneurisma de ventrículo esquerdo associado a insuficiência mitral grave complicando infarto agudo do miocárdio ínfero-látero-dorsal Left ventricular pseudoaneurysm associated to severe mitral insufficiency, complicating inferolaterodorsal acute myocardial infarction

    João Luiz de A. A. Falcão

    2005-06-01

    Full Text Available Descrevemos um caso de pseudoaneurisma de ventrículo esquerdo associado a grave regurgitação mitral, complicando um infarto ínfero-látero-dorsal. A lesão foi descoberta em ecocardiograma de rotina durante o seguimento ambulatorial. Destacam-se a estratégia cirúrgica bem sucedida, e a boa evolução clínica da paciente.We described a case of left ventricular pseudoaneurysm associated to a severe mitral regurgitation, complicating a inferolaterodorsal acute myocardial infarction. The lesion was found in a routine echocardiogram during the in-hospital follow-up. The well-succeeded surgical strategy and the good clinical evolution of the patient were distinguished.

  14. An instrument for long term on-line studies of left ventricular function based upon a personal computer and a miniature detector

    Left ventricular ejection fraction (LVEF) is a noninvasive index of left ventricular function and a useful guide to prognosis after myocardial infarction. This paper describes an instrument for recording LVEF which uses a miniature detector, small enough to be fastened to a subject's chest, and a personal computer, programmed to guide the operator's hand in placing the detector over the left ventricle and analyse the time course of the recorded activity. Electronic circuits for two detectors and a bipolar lead ECG, for triggering gated studies, are built into the computer as add-on cards. Long term studies of left ventricular function, including exercise and acute interventions, are possible as well as beat-to-beat studies. The apparatus fits on a small trolley and can easily be used at the bedside. The cost of this equipment is a small fraction of that of a gamma camera and dedicated computer. (author). 4 refs, 5 figs

  15. Abnormal response of left ventricular systolic function to submaximal exercise in post-partial left ventriculotomy patients

    A.H. Herdy

    2007-02-01

    Full Text Available Patients with heart failure who have undergone partial left ventriculotomy improve resting left ventricular systolic function, but have limited functional capacity. We studied systolic and diastolic left ventricular function at rest and during submaximal exercise in patients with previous partial left ventriculotomy and in patients with heart failure who had not been operated, matched for maximal and submaximal exercise capacity. Nine patients with heart failure previously submitted to partial left ventriculotomy were compared with 9 patients with heart failure who had not been operated. All patients performed a cardiopulmonary exercise test with measurement of peak oxygen uptake and anaerobic threshold. Radionuclide left ventriculography was performed to analyze ejection fraction and peak filling rate at rest and during exercise at the intensity corresponding to the anaerobic threshold. Groups presented similar exercise capacity evaluated by peak oxygen uptake and at anaerobic threshold. Maximal heart rate was lower in the partial ventriculotomy group compared to the heart failure group (119 ± 20 vs 149 ± 21 bpm; P 0.05 vs change in partial ventriculotomy group. The abnormal responses demonstrated here may contribute to the limited exercise capacity of patients with partial left ventriculotomy despite the improvement in resting left ventricular systolic function.

  16. Mapping and Surgical Ablation of Focal Epicardial Left Ventricular Tachycardia

    Arif Elvan

    2011-01-01

    Full Text Available We describe a technical challenge in a 17-year-old patient with incessant epicardial focal ventricular arrhythmia and diminished LV function. Failure of ablation at the earliest activated endocardial site during ectopy suggested an epicardial origin, which was supported by specific electrocardiographic criteria. Epicardial ablation was not possible due to the localization of the origin of the ventricular tachycardia adjacent to the phrenic nerve. Minimal invasive surgical multielectrode high-density epicardial mapping was performed to localize the arrhythmia focus. Epicardial surgical RF ablation resulted in the termination of ventricular ectopy. After 2 years, the patient is still free from arrhythmias.

  17. Close association of arterial plaques with left ventricular hypertrophy and ejection fraction in hemodialysis patients

    Mowlaie Morteza

    2014-01-01

    Full Text Available Introduction: In renal failure patients, cardiovascular complications are a major clinical problem. Objectives: This study aimed to test, the possible association of left ventricular hypertrophy and ejection fraction with plaques of carotid and femoral artery hemodialysis. Patients and Methods: Sixty-one patients, who were on regular hemodialysis were selected. For all patients echocardiography and B-mode Ultrsonographic assessment of carotid-femoral arteries for plaque occurrence were conducted. Results: In this study there was a positive correlation between left ventricular hypertrophy with the duration of hemodialysis treatment (p<0.05. Significant positive association between left ventricular hypertrophy and plaque score and also a significant positive association between left ventricular hypertrophy with presence of chest pain was found (p<0.05. Association of diabetes mellitus with the presence of chest pain was positive. Positive correlation between hypertension with plaque score was demonstrated too (p<0.05. Also an inverse association of plaque score with left ventricular ejection fraction was detected too (p<0.05. Furthermore, the correlation of plaque score with the presence of diabetes mellitus was positive. Conclusion: The present investigations, documents parallel cardiac and vascular adaptation in hemodialysis patients and shows the potential contribution of structural and functional large artery alteration to the pathogenesis of left ventricular hypertrophy which needs more attention in patients on hemodialysis.

  18. EFFECT OF AROTINOLOL ON LEFT VENTRICULAR FUNCTION IN PATIENTS WITH IDIOPATHIC DILATED CARDIOMYOPATHY

    Chao-mei Fan; Xiu-qing Du; Na-qiang Lu; Hong Yang; Yi-shi Li; Li Xu; Ke-fei DOU; Jing-lin Zhao; Xian-qi Yuan; Yan-fen Zhao; Rong-fang Shi

    2007-01-01

    To evaluate the efficacy and safety of long-term treatment with arotinolol in patients with idiopathic dilated cardiomyopathy (IDCM).Methods Sixty-three patients with IDCM were evaluated at baseline and after 12-month therapy with arotinolol.The conventional therapy for congestive heart failure was continued throughout the study with arotinolol as the only β-blocker. Left ventricular function was assessed with the New York Heart Association functional class and two-dimensional echocardiography.Results After 12-month arotinolol treatment, there was a significant improvement in left ventricular systolic function. Left ventricular end-systolic dimension significantly decreased from 59. 52 ± 8. 83 mm to 50. 89 ± 8.17 mm (P <0.001). Left ventricular ejection fraction significantly increased from 27.39% ±7.94% to 41.13% ±9.45% (P <0.001). Left ventricular mass index decreased from 150. 47 ± 42. 42 g/m2 to 141.58 ± 34.36 g/m2 ( P<0.01). No adverse events leading to premature discontinuation of study drug occurred.Conclusion In this preliminary study, 12-month arotinolol treatment has a favorable effect on left ventricular function in patients with IDCM, and it is safe and well tolerated.

  19. Left ventricular assist device inflow cannula thrombus: characterization with two-dimensional transthoracic echocardiography.

    Missov, Emil

    2013-01-01

    Thrombotic complications are inherent to current generation nonpulsatile left ventricular assist devices. The clinical expression of device thrombosis ranges from catastrophic failure to protracted and indolent. We report the case of a 79-year-old patient who received a left ventricular assist device as destination therapy and presented only with vague clinical symptoms. He was found to have a large thrombus in close proximity with the inflow cannula at the left ventricular apex, raising the question of mechanical obstruction. We describe the step-by-step contrast-enhanced two-dimensional transthoracic echocardiographic examination which allowed to obtain diagnostic acoustic tomograms of the inflow cannula and obviated the need for any additional imaging modalities. Transthoracic echocardiography (TTE) is the most common imaging modality used in the clinical follow-up of left ventricular assist device recipients. A frequent clinical indication for TTE is to exclude left ventricular apical thrombus near the inflow cannula. Imaging of the inflow cannula at the left ventricular apex in the traditional apical 4 chamber, apical 2 chamber, and parasternal long axis views is challenging by TTE mainly because of poor acoustic windows, image artifacts, large body habitus, and operator experience. PMID:24172272

  20. Effect of Left Ventricular Outflow Tract Obstruction on Left Atrial Mechanics in Hypertrophic Cardiomyopathy

    Lynne K. Williams

    2015-01-01

    Full Text Available Left atrial (LA volumes are known to be increased in hypertrophic cardiomyopathy (HCM and are a predictor of adverse outcome. In addition, LA function is impaired and is presumed to be due to left ventricular (LV diastolic dysfunction as a result of hypertrophy and myocardial fibrosis. In the current study, we assess the incremental effect of outflow tract obstruction (and concomitant mitral regurgitation on LA function as assessed by LA strain. Patients with HCM (50 obstructive, 50 nonobstructive were compared to 50 normal controls. A subset of obstructive patients who had undergone septal myectomy was also studied. Utilising feature-tracking software applied to cardiovascular magnetic resonance images, LA volumes and functional parameters were calculated. LA volumes were significantly elevated and LA ejection fraction and strain were significantly reduced in patients with HCM compared with controls and were significantly more affected in patients with obstruction. LA volumes and function were significantly improved after septal myectomy. LVOT obstruction and mitral regurgitation appear to further impair LA mechanics. Septal myectomy results in a significant reduction in LA volumes, paralleled by an improvement in function.

  1. Reference values for quantitative left ventricular and left atrial measurements in cardiac computed tomography

    To assess reference values for left ventricular (LV) and left atrial (LA) dimensions, global LV function, and LV-myocardial mass for cardiac CT. We examined 120 subjects undergoing a coronary angiography using 64-slice and dual-source CT. All individuals had a low cardiovascular risk, normal ECG, negative biomarkers, and a normal cardiac CT examination. All subjects had a negative medical history of cardiovascular disease both on admission and at clinical 6-month follow-up. The following measurements were obtained: septal wall thickness (SWT), posterior wall thickness (PWT), LV inner diameter (LVID), LA anterior posterior diameter (LADsys), end-systolic volume (ESV), and end-diastolic volume (EDV), LV-myocardial mass (LVMM). We found significant gender-related differences for all LV dimensions (SWTsys, SWTdia,PWTsys,PWTdia,LVIDsys,LVIDdia). LADsys showed no significant difference between males and females. Significant differences were found for global LV functional parameters including ESV, EDV, and SV, whereas no significant differences were found for the EF. LV-myocardial mass parameters showed significant gender-related differences. No significant correlation was found between any of these parameters and age. All data were transferred to percentile ranks. This study provides gender-related reference values and percentiles for LV and LA quantitative measurements for cardiac CT and should assist in interpreting results. (orig.)

  2. Left ventricular hypertrophy in children, adolescents and young adults with sickle cell anemia

    Gustavo Baptista de Almeida Faro

    2015-10-01

    Full Text Available OBJECTIVE: The aims of this study were to estimate the frequency of left ventricular hypertrophy and to identify variables associated with this condition in under 25-year-old patients with sickle cell anemia.METHODS: A cross-sectional study was performed of children, adolescents and young adults with sickle cell anemia submitted to a transthoracic Doppler echocardiography. The mass of the left ventricle was determined by the formula of Devereux et al. with correction for height, and the percentile curves of gender and age were applied. Individuals with rheumatic and congenital heart disease were excluded. The patients were divided into two groups according to the presence or absence of left ventricular hypertrophy and compared according to clinical, echocardiographic and laboratory variables.RESULTS: A total of 37.6% of the patients had left ventricular hypertrophy in this sample. There was no difference between the groups of patients with and without hypertrophy according to pathological history or clinical characteristics, except possibly for the use of hydroxyurea, more often used in the group without left ventricular hypertrophy. Patients with left ventricular hypertrophy presented larger left atria and lower hemoglobin and hematocrit levels, reticulocyte index and a higher albumin:creatinine ratio in urine.CONCLUSION: Left ventricular hypertrophy was observed in more than one-third of the young patients with sickle cell anemia with this finding being inversely correlated to the hemoglobin and hematocrit levels, and reticulocyte index and directly associated to a higher albumin/creatinine ratio. It is possible that hydroxyurea had had a protective effect on the development of left ventricular hypertrophy.

  3. Left-ventricular structure in the Southall And Brent REvisited (SABRE) study: explaining ethnic differences.

    Park, Chloe M; March, Katherine; Ghosh, Arjun K; Jones, Siana; Coady, Emma; Tuson, Claire; Francis, Darrel; Mayet, Jamil; Tillin, Therese; Chaturvedi, Nish; Hughes, Alun D

    2013-05-01

    Cardiometabolic risk is elevated in South Asians and African Caribbeans compared with Europeans, yet whether this is associated with ethnic differences in left-ventricular structure is unclear. Conventional M-mode or 2-dimensional echocardiography may be misleading, because they calculate left-ventricular mass and remodeling using geometric assumptions. Left-ventricular structure was compared in a triethnic population-based cohort using conventional and 3-dimensional echocardiography on 895 individuals (aged 55-85 years; 427 European, 325 South Asian, 143 African Caribbean). Left-ventricular mass was indexed, and left-ventricle remodeling index and relative wall thickness were calculated. Anthropometry, blood pressure, and fasting bloods were measured. Three-dimensional left-ventricular mass index did not differ between Europeans (mean ± SE, 29.8 ± 0.3 g/m(2.7)) and African Caribbeans (29.9 ± 0.5 g/m(2.7); P=0.9), but it was significantly lower in South Asians (28.1 ± 0.4 g/m(2.7); Pleft-ventricle mass index was significantly higher in African Caribbeans (46.4 ± 0.9 g/m(2.7)) than in Europeans (41.9 ± 0.5 g/m(2.7); PLeft-ventricle remodeling index was the highest in African Caribbeans and the lowest in South Asians. Relative wall thickness was also higher in African Caribbeans, but no different in South Asians, compared with Europeans. Differences in left-ventricle remodeling index were attenuated by adjustment for cardiometabolic factors between African Caribbeans and Europeans only. In conclusion, left-ventricular mass is lower in South Asians and equivalent in African Caribbeans compared with Europeans, even when cardiometabolic risk factors are accounted for. Left-ventricular remodeling rather than hypertrophy may explain the increased risk of heart failure in people of African Caribbean origin. PMID:23478098

  4. Alteration of canine left ventricular diastolic function by intravenous anesthetics in vivo. Ketamine and propofol.

    Pagel, P S; Schmeling, W T; Kampine, J P; Warltier, D C

    1992-03-01

    Diastolic function has been shown to influence overall cardiac performance significantly, but the effect of intravenous anesthetics on diastolic function has not been previously characterized in vivo. The effects of ketamine and propofol on two indices of left ventricular diastolic function were examined in chronically instrumented dogs. Because autonomic nervous system function may significantly influence the systemic hemodynamic actions produced by intravenous anesthetics in vivo, experiments were performed in the presence of pharmacologic blockade of the autonomic nervous system. Two groups comprising a total of 14 experiments were performed using 7 dogs instrumented for measurement of aortic and left ventricular pressure, the maximum rate of increase of left ventricular pressure (dP/dt), subendocardial segment length, and cardiac output. Systemic hemodynamics and diastolic function were recorded and evaluated in the conscious state and after a 20-min equilibration at 25-, 50-, and 100-mg.kg-1.h-1 infusion doses of ketamine or propofol. Ventricular relaxation was described using the time constant of isovolumetric relaxation (tau) assuming a nonzero asymptote of ventricular pressure decay. Regional chamber stiffness, an index of passive ventricular filling, was described using an exponential equation relating segment length to ventricular pressure between minimum ventricular pressure and the onset of atrial systole.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1539854

  5. Effects of PDE type 5 inhibitors on Left Ventricular Diastolic Dysfunction in Resistant Hypertension

    Ana Paula Cabral de Faria

    2015-01-01

    Full Text Available Resistant hypertension (RHTN is a multifactorial disease characterized by blood pressure (BP levels above goal (140/90 mmHg in spite of the concurrent use of three or more antihypertensive drugs of different classes. Moreover, it is well known that RHTN subjects have high prevalence of left ventricular diastolic dysfunction (LVDD, which leads to increased risk of heart failure progression. This review gathers data from studies evaluating the effects of phosphodiesterase-5 (PDE-5 inhibitors (administration of acute sildenafil and short-term tadalafil on diastolic function, biochemical and hemodynamic parameters in patients with RHTN. Acute study with sildenafil treatment found that inhibition of PDE-5 improved hemodynamic parameters and diastolic relaxation. In addition, short-term study with the use of tadalafil demonstrated improvement of LVDD, cGMP and BNP-32 levels, regardless of BP reduction. No endothelial function changes were observed in the studies. The findings of acute and short-term studies revealed potential therapeutic effects of IPDE-5 drugs on LVDD in RHTN patients.

  6. Effects of PDE type 5 inhibitors on left ventricular diastolic dysfunction in resistant hypertension.

    Faria, Ana Paula Cabral de; Modolo, Rodrigo; Moreno, Beatriz Vaz Domingues; Moreno, Heitor

    2015-01-01

    Resistant hypertension (RHTN) is a multifactorial disease characterized by blood pressure (BP) levels above goal (140/90 mmHg) in spite of the concurrent use of three or more antihypertensive drugs of different classes. Moreover, it is well known that RHTN subjects have high prevalence of left ventricular diastolic dysfunction (LVDD), which leads to increased risk of heart failure progression. This review gathers data from studies evaluating the effects of phosphodiesterase-5 (PDE-5) inhibitors (administration of acute sildenafil and short-term tadalafil) on diastolic function, biochemical and hemodynamic parameters in patients with RHTN. Acute study with sildenafil treatment found that inhibition of PDE-5 improved hemodynamic parameters and diastolic relaxation. In addition, short-term study with the use of tadalafil demonstrated improvement of LVDD, cGMP and BNP-32 levels, regardless of BP reduction. No endothelial function changes were observed in the studies. The findings of acute and short-term studies revealed potential therapeutic effects of IPDE-5 drugs on LVDD in RHTN patients. PMID:25352458

  7. Applications of magnetic resonance imaging in the assessment of left ventricular dysfunction

    Beacock, David John

    2002-07-01

    This thesis has described the use of Magnetic Resonance Imaging (MRI) in the investigation of left ventricular dimensions and systolic function. This has been performed in conditions of left ventricular dysfunction, in congestive cardiac failure and following anterior myocardial infarction. The reproducibility of measurements of left ventricular dimensions using MRI has been presented. Such measurements were shown to be reproducible between different MRI studies of normal volunteers and patients with congestive heart failure. Furthermore, measurements from different MRI studies obtained from two commercially different systems were reproducible for the same subject groups. Ventricular dimensions and systolic function was evaluated in adult normal volunteers of different ages. Although left ventricular volumes and mass remained unchanged, detailed studies of the systolic images revealed significant differences between the two age groups. Differences in left ventricular cavity volumes and mass between patients with congestive heart failure and age-matched normal volunteers were also investigated. Left ventricular volumes and myocardial mass were assessed in a group of patients following anterior myocardial infarction. End-systolic volume was significantly increased compared to age-matched volunteers, but no changes in end-diastolic volume or myocardial mass was observed. Serial re-evaluation of these patients revealed no other changes over the subsequent six months. All these patients were treated with optimal medical therapy (thrombolysis, aspirin, beta-blockade and angiotensin converting enzyme inhibition). Thus, the use of this therapy may attenuate the process of left ventricular remodelling. Regional wall thickness was measured in the post-infarct patients. Wall thickening was significantly reduced both in the infarcted regions and in myocardium remote to the infarction. In contrast to previous echocardiographic studies, no 'hypercontractility' was

  8. Evaluation of diastolic function of hypertrophic cardiomyopathy using left ventricular volume-time curve

    Objective: To determine the feasibility of using left ventricular volume-time curve in the evaluation of left ventricular diastolic function, and to analyze characteristics of left ventricular volume-time curve changes in hypertrophic cardiomyopathy (HCM). Methods: Seventeen cases of HCM and 12 healthy volunteers received cardiac MRI (CMRI) examination, and left ventricular (LV) 2-chamber long and short axis cine imaging were performed, LV volume-time curves were reconstructed and platform time, different diastolic volume recovery (DVR) time and their corresponding filling velocity were calculated from LV volume-time curve off-line. The DVR time and their corresponding filling velocity were analyzed by using multiple linear regression analysis. Results: Compared with the group of healthy volunteers,ventricular septal HCM group had delayed left ventricular 50%, 70% DVR time [(8.9 ± 1.3) versus (7.7 ± 0.8) phase, F=6.787, P=0.016; (11.3 ±1.6) versus (9.7±1.8) phase, F=4.927, P=0.036] and shortened plateau time [(1.8 ± 1.7) versus (4.1 ± 1.4) phase, t=6.787, P<0.01]. Ventricular septal HCM group had reduced 30%, 50% DVR filling rates [(0.22 ± 0.11) versus (0.40 ± 0.15) ml/ms, F=12.916, P<0.01; (0.20 ± 0.09) versus (0.30 ± 0.10) ml/ms, F=7.121, P=0.014] compared with those in the group of healthy volunteers. But 70%, 80%, 90% DVR filling rates showed no statistically significant different in the two groups. In HCM patients,myocardial fibrosis caused 50%, 70%, 80% DVR time delay [(9.6 ± 1.0) versus (7.9 ± 1.5) phase, F=5.000, P=0.045; (12.3 ± 1.4) versus (9.6 ± 1.8) phase, F=8.039, P=0.015; (13.1 ±1.4) versus (10.9±1.9) phase, F=5.060, P=0.044], but no significant difference of DVR filling rate was found between the two groups. Conclusions: Left ventricular volume curve analysis techniques can be used for detailed evaluation of left ventricular diastolic function. The left ventricular diastolic dysfunction of hypertrophic cardiomyopathy occurs mainly in

  9. Ethical challenges with the left ventricular assist device as a destination therapy

    Rady Mohamed Y

    2008-08-01

    Full Text Available Abstract The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US Food and Drug Administration and the US Centers for Medicare & Medicaid Services approved permanent implantation of the left ventricular assist device as a destination therapy in Medicare beneficiaries who are not candidates for heart transplantation. The use of the left ventricular assist device as a destination therapy raises certain ethical challenges. Left ventricular assist devices can prolong the survival of average recipients compared with optimal medical management of chronic end-stage heart failure. However, the overall quality of life can be adversely affected in some recipients because of serious infections, neurologic complications, and device malfunction. Left ventricular assist devices alter end-of-life trajectories. The caregivers of recipients may experience significant burden (e.g., poor physical health, depression, anxiety, and posttraumatic stress disorder from destination therapy with left ventricular assist devices. There are also social and financial ramifications for recipients and their families. We advocate early utilization of a palliative care approach and outline prerequisite conditions so that consenting for the use of a left ventricular assist device as a destination therapy is a well informed process. These conditions include: (1 direct participation of a multidisciplinary care team, including palliative care specialists, (2 a concise plan of care for anticipated device-related complications, (3 careful surveillance and counseling for caregiver burden, (4 advance-care planning for anticipated end-of-life trajectories and timing of device deactivation, and (5 a plan to address the long-term financial burden on patients, families, and caregivers. Short-term mechanical circulatory devices (e

  10. Effects of mechanical left ventricular unloading by Impella on left ventricular dynamics in high-risk and primary percutaneous coronary intervention patients

    M. Remmelink; K.D. Sjauw; J.P.S. Henriques; R.J. de Winter; M.M. Vis; K.T. Koch; W.J. Paulus; B.A.J.M. de Mol; J.G.P. Tijssen; J.J. Piek; J.,Jr Baan

    2010-01-01

    OBJECTIVES: We studied online left ventricular (LV) dynamic effects of mechanical LV unloading directly after percutaneous coronary intervention (PCI). BACKGROUND: Limited clinical information is available on the direct LV dynamic consequences of LV unloading in patients undergoing high-risk PCI and

  11. Effect of Salvia Miltiorrhiza on Left Ventricular Hypertrophy and Cardiac Aldosterone in Spontaneously Hypertensive Rats

    韩少杰; 郑智; 任大宏

    2002-01-01

    Summary: Chronic treatment with Salvia Miltiorrhiza preventing left ventricular hypertrophy(LVH) and its possible mechanism-inhibiting the action of cardiac aldosterone in spontaneouslyhypertensive rats (SHR) were investigated. Normotensive Wistar-kyoto (WKY) rats and SHRswere used. Part of SHRs was treated with Salvia Miltiorrhiza for 12 weeks. Systolic blood pres-sure (SBP) and left ventricular mass index were measured. Sections of heart tissue were stainedwith HE method and VanGieson method. Collagen volume fraction was determined in the left ven-tricle by automatically quantitative morphometry. Cardiac aldosterone concentration was measuredby radioimmunoassay. The results indicated that compared with WKY rats, SHRs exhibited high-er SBP, left ventricular collagen volume fraction, and aldosterone concentration (all P<0. 05).After the treatment with Salvia Miltiorrhiza, SBP, left ventricular collagen volume fraction, andaldosterone concentration in SHR were decreased as compared with control group (P<0. 05) ex-cept SBP. It was concluded that chronic treatment with Salvia Miltiorrhiza could prevent left ven-tricular hypertrophy in SHR, significantly inhibit collagen compositions in left ventricle. Themechanism was probably related with the inhibition of the cardiac aldosterone action.

  12. Quantitative analysis of left ventricular strain using cardiac computed tomography

    Buss, Sebastian J., E-mail: sebastian.buss@med.uni-heidelberg.de [Department of Cardiology, University of Heidelberg, 69120 Heidelberg (Germany); Schulz, Felix; Mereles, Derliz [Department of Cardiology, University of Heidelberg, 69120 Heidelberg (Germany); Hosch, Waldemar [Department of Diagnostic and Interventional Radiology, University of Heidelberg, 69120 Heidelberg (Germany); Galuschky, Christian; Schummers, Georg; Stapf, Daniel [TomTec Imaging Systems GmbH, Munich (Germany); Hofmann, Nina; Giannitsis, Evangelos; Hardt, Stefan E. [Department of Cardiology, University of Heidelberg, 69120 Heidelberg (Germany); Kauczor, Hans-Ulrich [Department of Diagnostic and Interventional Radiology, University of Heidelberg, 69120 Heidelberg (Germany); Katus, Hugo A.; Korosoglou, Grigorios [Department of Cardiology, University of Heidelberg, 69120 Heidelberg (Germany)

    2014-03-15

    Objectives: To investigate whether cardiac computed tomography (CCT) can determine left ventricular (LV) radial, circumferential and longitudinal myocardial deformation in comparison to two-dimensional echocardiography in patients with congestive heart failure. Background: Echocardiography allows for accurate assessment of strain with high temporal resolution. A reduced strain is associated with a poor prognosis in cardiomyopathies. However, strain imaging is limited in patients with poor echogenic windows, so that, in selected cases, tomographic imaging techniques may be preferable for the evaluation of myocardial deformation. Methods: Consecutive patients (n = 27) with congestive heart failure who underwent a clinically indicated ECG-gated contrast-enhanced 64-slice dual-source CCT for the evaluation of the cardiac veins prior to cardiac resynchronization therapy (CRT) were included. All patients underwent additional echocardiography. LV radial, circumferential and longitudinal strain and strain rates were analyzed in identical midventricular short axis, 4-, 2- and 3-chamber views for both modalities using the same prototype software algorithm (feature tracking). Time for analysis was assessed for both modalities. Results: Close correlations were observed for both techniques regarding global strain (r = 0.93, r = 0.87 and r = 0.84 for radial, circumferential and longitudinal strain, respectively, p < 0.001 for all). Similar trends were observed for regional radial, longitudinal and circumferential strain (r = 0.88, r = 0.84 and r = 0.94, respectively, p < 0.001 for all). The number of non-diagnostic myocardial segments was significantly higher with echocardiography than with CCT (9.6% versus 1.9%, p < 0.001). In addition, the required time for complete quantitative strain analysis was significantly shorter for CCT compared to echocardiography (877 ± 119 s per patient versus 1105 ± 258 s per patient, p < 0.001). Conclusion: Quantitative assessment of LV strain

  13. Left ventricular diastolic filling in elder patients with systemic hypertension

    To study the significance of left ventricular (LV) diastolic filling in elderly patients with hypertension (HT), cardiac blood pool imagings with Tc-99m were obtained at rest in 17 normal subjects and 28 patients with systemic HT. HT patients did not show any evidence of coronary heart disease, renal insufficiency or other diseases. They showed normal LV ejection fraction (LVEF) and normal LV wall motion. They were divided into 4 groups: normal young (<60 years old, n=10), normal old (≥65 years old, n=7), HT young (<60 years old, N=15), and HT old (≥65 years old, n=13). From the LV volume curve and its first differentiation curve, LVEF, mean first third ejection rate (ERm) and peak ejection rate (PER) were obtained as LV systolic function indices; and LV diastolic filling rate during the first third of diastole (FRm) and peak filling rate (PFR) were obtained as LV diastolic function indices. All indices of LV systolic function were similar in all groups. In contrast, LV diastolic indices (FRm and PFR) of older groups were significantly lower than those of young HT and normal groups. LV diastolic indices in HT groups decreased significantly compared with normal groups of the same age. FRm could distinguish HT patients from normal subjects of the same age more accurately than PFR. In normal subjects, FRm correlated with age (r=-0.490) and ERm (r=-0.489). In addition to age ERm, FRm correlated with LV wall thickness measured by M-mode ecocardiography (r=-0.566) in HT patients. In the HT old group, the correlations between FRm and LV wall thickness and between FRm and ERm were more significant than those in the HT young group. The impairment of early diastolic filling of LV was more prominent in older HT patients than younger HT patients. LV diastolic abnormality was influenced more highly by the degree of LV hypertrophy in older HT patients than younger HT patients. These diastolic abnormalities may cause systolic dysfunction in older HT patients. (J.P.N.)

  14. An examination of left ventricular peak filling rate and ventricular relaxation rate by simultaneous acquisition of radionuclide ventriculography and left ventricular pressure

    We investigated whether peak filling rate (PFR) obtained from ECG gated radionuclide ventriculography (RNV) reflects left ventricular (LV) relaxation rate or not. Five patients with angina pectoris, 5 patients with old myocardial infarction and 6 controls were studied by simultaneous acquisition of RNV and LV pressure. RNV was performed in modified left anterior oblique position before and during angiotensin II (A II) infusion to elevate their blood pressure about 25 mmHg (A-1) and 50 mmHg (A-2). The data were acquired in a list mode and LV volume curves were reconstructed by forward and backward gating from the R wave of ECG. Actual PFR and corrected PFR by stroke volume (/SV), by end diastolic volume (/EDV), by instantaneous volume (/IV) were calculated from LV volume curve and its first differential curve. LV pressure was simultaneously measured by the catheter-tip micromanometer, and the time constant (T) of assumed exponential decline in LV pressure was calculated as index of LV relaxation rate. Although there was no correlation between actual PFR and T, corrected PFR (/EDV) and PFR (/IV) correlated with T. PFR (/EDV) decreased and T increased during A-1 and A-2. Decrease of PFR (/EDV) corresponded with increase of T. Thus, corrected PFR (/EDV) obtained from RNV reflects the rate of LV relaxation, and was considered to be an useful index to evaluate LV diastolic function. (author)

  15. Comparison of methods for determining absolute left ventricular volumes from radionuclide ventriculography

    Warren, S.E.; McKay, R.G.; Aroesty, J.M.; Heller, G.V.; Kolodny, G.M.; Royal, H.D.

    1987-01-01

    Several radionuclide techniques have been used in routine clinical nuclear medicine practice as a means of quantitating left ventricular chamber volumes in man. Despite wide use and availability of the different techniques, however, there has not been a thorough comparison of radionuclide and contrast angiographic measurements performed in the same patients in close temporal proximity. Accordingly, in order to validate traditional methods of ventricular volume measurement, we have performed contrast ventriculography followed immediately (upon return of baseline hemodynamics) by gated radionuclide ventriculography in 34 patients undergoing diagnostic cardiac catheterization. Absolute left ventricular end-diastolic volumes were determined from single-plane, right anterior oblique, end-diastolic contrast silhouettes using a standard area-length method. Radionuclide ventriculographic volumes were determined by three methods: planimetry (32 patients), counts-based (19 patients), and thermodilution stroke volume/radionuclide ejection fraction (32 patients). With planimetry, an area-length method was used in which the modified left anterior oblique left ventricular image was assumed to be a prolate ellipsoid whose volume can be determined by measuring surface area and the ventricular long axis. With the counts-based technique, a blood sample was drawn at the midpoint of the radionuclide ventriculogram acquisition and counted with a gamma camera with appropriate attenuation factor correction. With the thermodilution stroke volume/radionuclide ejection fraction technique, the left ventricular stroke volume was determined by dividing thermodilution cardiac output by the heart rate.

  16. Mechanisms of decreased left ventricular preload during continuous positive pressure ventilation in ARDS

    Dhainaut, J.F.; Devaux, J.Y.; Monsallier, J.F.; Brunet, F.; Villemant, D.; Huyghebaert, M.F.

    1986-07-01

    Continuous positive pressure ventilation is associated with a reduction in left ventricular preload and cardiac output, but the mechanisms responsible are controversial. The decrease in left ventricular preload may result exclusively from a decreased systemic venous return due to increased pleural pressure, or from an additional effect such as decreased left ventricular compliance. To determine the mechanisms responsible, we studied the changes in cardiac output induced by continuous positive pressure ventilation in eight patients with the adult respiratory distress syndrome. We measured cardiac output by thermodilution, and biventricular ejection fraction by equilibrium gated blood pool scintigraphy. Biventricular end-diastolic volumes were then calculated by dividing stroke volume by ejection fraction. As positive end-expiratory pressure increased from 0 to 20 cm H/sub 2/O, stroke volume and biventricular end-diastolic volumes fell about 25 percent, and biventricular ejection fraction remained unchanged. At 20 cm H/sub 2/O positive end-expiratory pressure, volume expansion for normalizing cardiac output restored biventricular end-diastolic volumes without markedly changing biventricular end-diastolic transmural pressures. The primary cause of the reduction in left ventricular preload with continuous positive pressure ventilation appears to be a fall in venous return and hence in right ventricular stroke volume, without evidence of change in left ventricular diastolic compliance.

  17. Lung perfusion and ventilation during implantation of left ventricular assist device as a strategy to avoid postoperative pulmonary complications and right ventricular failure

    Macedo, Francisco Igor B.; Anthony L. PANOS; Andreopoulos, Fotios M.; Salerno, Tomas A.; Pham, Si M.

    2013-01-01

    Right ventricular failure is a major contributor to increased morbidity and mortality in patients undergoing left ventricular assist device implantation. Cardiopulmonary bypass is associated with increased pulmonary ischaemia and pulmonary vascular resistance. Continuous pulmonary perfusion and ventilation represents an emerging strategy for pulmonary protection during cardiac surgery. We hypothesize that this technique may have a pivotal role in reducing postoperative right ventricular dysfu...

  18. Beat-to-beat left ventricular performance in atrial fibrillation: radionuclide assessment with the computerized nuclear probe

    There is wide beat-to-beat variability in cycle length and left ventricular performance in patients with atrial fibrillation. In this study, left ventricular ejection fraction and relative left ventricular volumes were evaluated on a beat-to-beat basis with the computerized nuclear probe, an instrument with sufficiently high sensitivity to allow continuous evaluation of the radionuclide time-activity curve. Of 18 patients with atrial fibrillation, 5 had mitral stenosis, 6 had mitral regurgitation, and 7 had coronary artery disease. Fifty consecutive beats were analyzed in each patient. The mean left ventricular ejection fraction ranged from 17 to 51%. There was substantial beat-to-beat variation in cycle length and left ventricular ejection fraction in all patients, including those with marked left ventricular dysfunction. In 14 patients who also underwent multiple gated cardiac blood pool imaging, there was an excellent correlation between mean ejection fraction derived from the nuclear probe and gated ejection fraction obtained by gamma camera imaging (r . 0.90). Based on beat-to-beat analysis, left ventricular function was dependent on relative end-diastolic volume and multiple preceding cycle lengths, but not preceding end-systolic volumes. This study demonstrates that a single value for left ventricular ejection fraction does not adequately characterize left ventricular function in patients with atrial fibrillation. Furthermore, both the mean beat-to-beat and the gated ejection fraction may underestimate left ventricular performance at rest in such patients

  19. Association of Left Atrial Volume With Mortality Among ESRD Patients With Left Ventricular Hypertrophy Referred for Kidney Transplantation

    Patel, Rajan K.; Jardine, Alan G.M.; Patrick B. Mark; Cunningham, Anthony F.; Steedman, Tracey; Powell, Joanna R.; McQuarrie, Emily P.; Stevens, Kathryn K; Dargie, Henry J; Jardine, Alan G

    2010-01-01

    Background Left ventricular hypertrophy (LVH) is common in patients with end-stage renal disease (ESRD) and an independent risk factor for premature cardiovascular death. Left atrial volume (LAV), measured using echocardiography, predicts death in patients with ESRD. Cardiovascular magnetic resonance (CMR) imaging is a volume-independent method of accurately assessing cardiac structure and function in patients with ESRD. Study Design Single-center prospective observational study to assess the...

  20. A Procedure of Combination of Sequential Internal Thoracic Artery Grafting and Cooley's Technique for Complicated Case With Multi-vessel Disease,Left Ventricular Aneurysm and Mitral Regurgitation

    Meng-ya LIANG; Guang-xian CHEN; Zhong-kai WU; Xi ZHANG

    2009-01-01

    @@ INTRODUCTION Left ventricular aneurysm and ischemic mitral regurgitation are two of most common complications of acute myocardial infarction (AMI).Combination of both these two fatal complications is not rare and the management of these complicated cases is always a challenge to cardiac surgeon because of its relatively high mortality[1]. We reported a rare case of AMI in which a singlestage correction of mitral valve replacement with preservation of mitral apparatus, sequential left internal thoracic artery (ITA) grafting and Cooley's technique.

  1. Screening for Fabry Disease in Left Ventricular Hypertrophy: Documentation of a Novel Mutation

    Ana Baptista

    2015-01-01

    Full Text Available Abstract Background: Fabry disease is a lysosomal storage disease caused by enzyme α-galactosidase A deficiency as a result of mutations in the GLA gene. Cardiac involvement is characterized by progressive left ventricular hypertrophy. Objective: To estimate the prevalence of Fabry disease in a population with left ventricular hypertrophy. Methods: The patients were assessed for the presence of left ventricular hypertrophy defined as a left ventricular mass index ≥ 96 g/m2 for women or ≥ 116 g/m2 for men. Severe aortic stenosis and arterial hypertension with mild left ventricular hypertrophy were exclusion criteria. All patients included were assessed for enzyme α-galactosidase A activity using dry spot testing. Genetic study was performed whenever the enzyme activity was decreased. Results: A total of 47 patients with a mean left ventricular mass index of 141.1 g/m2 (± 28.5; 99.2 to 228.5 g/m2] were included. Most of the patients were females (51.1%. Nine (19.1% showed decreased α-galactosidase A activity, but only one positive genetic test − [GLA] c.785G>T; p.W262L (exon 5, a mutation not previously described in the literature. This clinical investigation was able to establish the association between the mutation and the clinical presentation. Conclusion: In a population of patients with left ventricular hypertrophy, we documented a Fabry disease prevalence of 2.1%. This novel case was defined in the sequence of a mutation of unknown meaning in the GLA gene with further pathogenicity study. Thus, this study permitted the definition of a novel causal mutation for Fabry disease - [GLA] c.785G>T; p.W262L (exon 5.

  2. Screening for Fabry Disease in Left Ventricular Hypertrophy: Documentation of a Novel Mutation

    Fabry disease is a lysosomal storage disease caused by enzyme α-galactosidase A deficiency as a result of mutations in the GLA gene. Cardiac involvement is characterized by progressive left ventricular hypertrophy. To estimate the prevalence of Fabry disease in a population with left ventricular hypertrophy. The patients were assessed for the presence of left ventricular hypertrophy defined as a left ventricular mass index ≥ 96 g/m2 for women or ≥ 116 g/m2 for men. Severe aortic stenosis and arterial hypertension with mild left ventricular hypertrophy were exclusion criteria. All patients included were assessed for enzyme α-galactosidase A activity using dry spot testing. Genetic study was performed whenever the enzyme activity was decreased. A total of 47 patients with a mean left ventricular mass index of 141.1 g/m2 (± 28.5; 99.2 to 228.5 g/m2] were included. Most of the patients were females (51.1%). Nine (19.1%) showed decreased α-galactosidase A activity, but only one positive genetic test − [GLA] c.785G>T; p.W262L (exon 5), a mutation not previously described in the literature. This clinical investigation was able to establish the association between the mutation and the clinical presentation. In a population of patients with left ventricular hypertrophy, we documented a Fabry disease prevalence of 2.1%. This novel case was defined in the sequence of a mutation of unknown meaning in the GLA gene with further pathogenicity study. Thus, this study permitted the definition of a novel causal mutation for Fabry disease - [GLA] c.785G>T; p.W262L (exon 5)

  3. Screening for Fabry Disease in Left Ventricular Hypertrophy: Documentation of a Novel Mutation

    Baptista, Ana, E-mail: baptista-ana@hotmail.com; Magalhães, Pedro; Leão, Sílvia; Carvalho, Sofia; Mateus, Pedro; Moreira, Ilídio [Centro Hospitalar de Trás-os-Montes e Alto Douro, Unidade de Vila Real (Portugal)

    2015-08-15

    Fabry disease is a lysosomal storage disease caused by enzyme α-galactosidase A deficiency as a result of mutations in the GLA gene. Cardiac involvement is characterized by progressive left ventricular hypertrophy. To estimate the prevalence of Fabry disease in a population with left ventricular hypertrophy. The patients were assessed for the presence of left ventricular hypertrophy defined as a left ventricular mass index ≥ 96 g/m{sup 2} for women or ≥ 116 g/m{sup 2} for men. Severe aortic stenosis and arterial hypertension with mild left ventricular hypertrophy were exclusion criteria. All patients included were assessed for enzyme α-galactosidase A activity using dry spot testing. Genetic study was performed whenever the enzyme activity was decreased. A total of 47 patients with a mean left ventricular mass index of 141.1 g/m{sup 2} (± 28.5; 99.2 to 228.5 g/m{sup 2}] were included. Most of the patients were females (51.1%). Nine (19.1%) showed decreased α-galactosidase A activity, but only one positive genetic test − [GLA] c.785G>T; p.W262L (exon 5), a mutation not previously described in the literature. This clinical investigation was able to establish the association between the mutation and the clinical presentation. In a population of patients with left ventricular hypertrophy, we documented a Fabry disease prevalence of 2.1%. This novel case was defined in the sequence of a mutation of unknown meaning in the GLA gene with further pathogenicity study. Thus, this study permitted the definition of a novel causal mutation for Fabry disease - [GLA] c.785G>T; p.W262L (exon 5)

  4. Numerical simulation of the influence of a left ventricular assist device on the cardiovascular system

    Verkerke, GJ; Geertsema, AA; Mihaylov, D; Blanksma, PK; Rakhorst, G

    2000-01-01

    The PUCA (pulsatile catheter) pump is a left ventricular assist device (LVAD) capable of unloading the left ventricle (LV) and improving coronary flow by providing a counterpulsation effect. If consists of an extracorporeal located membrane pump, coupled to a transarterial catheter that enters the b

  5. Left ventricular twist is load-dependent as shown in a large animal model with controlled cardiac load

    A’roch Roman

    2012-06-01

    Full Text Available Abstract Background Left ventricular rotation and twist can be assessed noninvasively by speckle tracking echocardiography. We sought to characterize the effects of acute load change and change in inotropic state on rotation parameters as a measure of left ventricular (LV contractility. Methods Seven anesthetised juvenile pigs were studied, using direct measurement of left ventricular pressure and volume and simultaneous transthoracic echocardiography. Transient inflation of an inferior vena cava balloon (IVCB catheter produced controlled load reduction. First and last beats in the sequence of eight were analysed with speckle tracking (STE during the load alteration and analysed for change in rotation/twist during controlled load alteration at same contractile status. Two pharmacological inotropic interventions were also included to examine the same hypothesis in additionally conditions of increased and decreased myocardial contractility in each animal. Paired comparisons were made for different load states using the Wilcoxon’s Signed Rank test. Results The inferior vena cava balloon occlusion (IVCBO load change compared for first to last beat resulted in LV twist increase (11.67° ±2.65° vs. 16.17° ±3.56° respectively, p  Conclusions Peak systolic LV twist and peak early diastolic untwisting rate are load dependent. Differences in LV load should be included in the interpretation when serial measures of twist are compared.

  6. Effect of Hemodialysis on Left and Right Ventricular Volume and Function

    With the improvement of hemodialysis, the course of thc discase in patient with endstage renal disease has been clearly improved. Nevertheless, among several shortcomings to our present mode of renal replacement therapy, cardiovascular complications have been the leading cause of morbidity and mortality. Several factors such as anemia, arteriovenous shunting of blood, intermittent extracorporeal circulation and hypertension may be contributing. But little is known about the quantitative cardiac hemodynamic characteristics occurred during hemodialysis. The purpose of this study is to observe the sequential hemodynamic changes before, during and after the hemodialysis and to investigate: reliable parameters in the detection of ventricular dysfunction. In the present study, equilibrium radionuclide cardiac angiography was performed and left and right ventricular volume indices, ejection phase indices of both ventricular, performance were measured in the 16 stable patients with chronic renal failure treated with maintenance hemodialysis sequentially i.e. before, during (carly and late phase) and after the hemodialysis. The results obtained were as follows; 1) The indices of the left ventricular function were not changed during the hemodialysis but increased after the hemodialysis. 2) The indices of the right ventricular function(EF, SVI) were significantly decreased in the early phase (15, 30 minutes after starting extracorporeal circulation) but recovered after the hemodialysis, 3) The ratio of right ventricular to left ventricular ejection fraction was significantly decreased in the early phase and the lung volume indices were significantly increased at the same phase. As a conclusion, hemodialysis improves left ventricular function maybe du to increased contractility, and effects on the right ventricular function maybe due to the increased lung volume in the early phase of hemodialysis.

  7. BET 2: Diagnosing acute myocardial infarction in the presence of ventricular pacing: can Sgarbossa criteria help?

    Jothieswaran, Arunan; Body, Richard

    2016-09-01

    The Sgarbossa criteria can be used to identify patients who have acute myocardial infarction (AMI) in the presence of left bundle branch block, which obscures the usual changes associated with ST elevation myocardial infarction. Patients with ventricular paced rhythm have ECG changes with similar morphology to left bundle branch block. A short-cut systematic review was carried out to establish whether the Sgarbossa criteria can accurately diagnose AMI in the presence of ventricular paced rhythm. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that. PMID:27539980

  8. Comparison of the accuracy of electron-beam computed tomography and conventional cineangiography in left ventricular volume measurement

    Purpose: To compare the relative accuracy of left ventricular volume measured by electron-beam computed tomography (EBCT) and conventional cineangiography. Materials and methods: Fourteen human left ventricular casts underwent electron-beam computed tomography scanning and conventional biplane cineangiography. The true left ventricular volume was measured by displacement of water. EBCT left ventricular volume was calculated with modified Simpson's method, the cineangiographic left ventricular volume was calculated with biplane area-length method. Results: The actual left ventricular cast volume was 55.57 +- 28.91 ml, EBCT left ventricular volume was 66.50 +- 33.04 ml for long-axis view, and 60.36 +- 29.90 ml for short-axis view, ventricular volume from biplane cineangiography was 82.09 +- 40.40 ml. Left ventricular volume from biplane cineangiography was significantly larger than those from EBCT and the actual volume (P0.98). Conclusion: EBCT is more accurate for left ventricular volume measurement and should become the gold standard

  9. Role of circulating angiotensin converting enzyme 2 in left ventricular remodeling following myocardial infarction: a prospective controlled study.

    José T Ortiz-Pérez

    Full Text Available Angiotensin-converting enzyme 2 (ACE2 cleaves Angiotensin-II to Angiotensin-(1-7, a cardioprotective peptide. Serum soluble ACE2 (sACE2 activity is raised in chronic heart failure, suggesting a compensatory role in left ventricular dysfunction. Our aim was to study the relationship between sACE2 activity, infarct size, left ventricular systolic function and remodeling following ST-elevation myocardial infarction (STEMI. A contrast-enhanced cardiac magnetic resonance study was performed acutely in 95 patients with first STEMI and repeated at 6 months to measure LV end-diastolic volume index, ejection fraction and infarct size. Baseline sACE2 activities, measured by fluorescent enzymatic assay 24 to 48 hours and at 7 days from admission, were compared to that obtained in 22 matched controls. Patients showed higher sACE2 at baseline than controls (104.4 [87.4-134.8] vs 74.9 [62.8-87.5] RFU/µl/hr, p<0.001. At seven days, sACE2 activity significantly increased from baseline (115.5 [92.9-168.6] RFU/µl/hr, p<0.01. An inverse correlation between sACE2 activity with acute and follow-up ejection fraction was observed (r = -0.519, p<0.001; r = -0.453, p = 0.001, respectively. Additionally, sACE2 directly correlated with infarct size (r = 0.373, p<0.001. Both, infarct size (β = -0.470 [95%CI:-0.691:-0.248], p<0.001 and sACE2 at 7 days (β = -0.025 [95%CI:-0.048:-0.002], p = 0.030 were independent predictors of follow-up ejection fraction. Patients with sACE2 in the upper tertile had a 4.4 fold increase in the incidence of adverse left ventricular remodeling (95% confidence interval: 1.3 to 15.2, p = 0.027. In conclusion, serum sACE2 activity rises in relation to infarct size, left ventricular systolic dysfunction and is associated with the occurrence of left ventricular remodeling.

  10. Normal left ventricular wall motion measured with two-dimensional myocardial tagging

    Using a myocardial tagging technique, normal left ventricular wall motion was studied in 3 true short axis views and a double oblique 4-chamber view in 14 and 11 volunteers, respectively. Three orthogonal directions of left ventricular motion were observed throughout the systole; a concentric contraction towards the center of the left ventricle, a motion of the base of the heart towards the apex, and a rotation of the left ventricle around its long axis. The direction of left ventricular rotation changed from early systole to late systole. The base and middle levels of the left ventricle rotated counterclockwise (CCW) at early systole and clockwise (CW) at late systole, whereas the apex of the heart rotated CW at early systole and CCW at late systole. The different directions of the rotation of base and apex resulted in a myocardial twisting that changed direction from early to late systole. We conclude that MR imaging with myocardial tagging is a method that can be used to study normal left ventricular wall motion, and that is promising for future use in patient groups. (orig.)

  11. Evaluation of left ventricular function with breath-hold MR imaging

    Objective: To investigate the value of breath-hold cine MR imaging in the evaluation of left ventricular function. Methods: Eighteen healthy volunteers and 36 patients with cardiac diseases were studied with breath-hold cine MR imaging, then left ventricular volumes and masses were measured, and the measurements were compared with those of conventional cine MR imaging and echocardiography. Results: (1) The measurements of end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) with breath-hold cine MR imaging technique were closely correlated with those obtained by conventional cine MR imaging and echocardiography. There was no statistically significant difference among the measurements of the three methods (P > 0.05). The correlation coefficients were 0.52-0.96. (2) The correlation coefficient of left ventricular mass (EDM and ESM) among three methods were lower than those of left ventricular volume, and there was statistically significant difference in ESM between MRI and echocardiography (P < 0.05). Conclusion: Breath-hold cine MR imaging is an useful method for evaluating the left ventricular function because of non-ghosting artifacts and short imaging time

  12. Echocardiographic assessment of the different left ventricular geometric patterns in hypertensive patients

    Delma Maria Cunha

    2001-01-01

    Full Text Available OBJECTIVE: To identiy left ventricular geometric patterns in hypertensive patients on echocardiography, and to correlate those patterns with casual blood pressure measurements and with the parameters obtained on a 24-hour ambulatory blood pressure monitoring. METHODS: We studied sixty hypertensive patients, grouped according to the Joint National Committee stages of hypertension.. Using the single- and two-dimensional Doppler Echocardiography, we analyzed the left ventricular mass and the geometric patterns through the correlation of left ventricular mass index and relative wall thickness. On ambulatory blood pressure monitoring we assessed the means and pressure loads in the different geometric patterns detected on echocardiography RESULTS: We identified three left ventricular geometric patterns: 1 concentric hypertrophy, in 25% of the patients; 2 concentric remodeling, in 25%; and 3 normal geometry, in 50%. Casual systolic blood pressure was higher in the group with concentric hypertrophy than in the other groups (p=0.001. Mean systolic pressure in the 24h, daytime and nighttime periods was also higher in patients with concentric hypertrophy, as compared to the other groups (p=0.003, p=0.004 and p=0.007. Daytime systolic load and nighttime diastolic load were higher in patients with concentric hypertrophy ( p=0.004 and p=0.01, respectively. CONCLUSIONS: Left ventricular geometric patterns show significant correlation with casual systolic blood pressure, and with means and pressure loads on ambulatory blood pressure monitoring.

  13. Fluoroscopy-Guided Resolution of Ingested Thrombus Leading to Functional Disturbance of a Continuous-Flow Left Ventricular Assist Device

    Jens Garbade

    2012-01-01

    Full Text Available The third generation of left ventricular assist devices (LVADs has been shown to improve outcome and quality of life in patients suffering from acute and chronic heart failure. However, VAD-associated complications are still a challenge in the clinical practice. Here we report the resolution of a mobile thrombus formation in the proximity of the inflow cannula of a third generation of LVADs (HVAD Pump, HeartWare, Inc. in a patient with chronic heart failure 4 months after implantation.

  14. Dipyridamole-thallium tests are predictive of severe cardiac arrhythmias in patients with left ventricular hypertrophy

    In a population of patients with chronic renal failure (CRF) and a high prevalence of left ventricular hypertrophy (LVH) undergoing chronic hemodialysis, the authors investigated the association between the results of dipyridamole-thallium tests (DTTs) and the occurrence of ventricular arrhythmias. They observed a positive significant association between positive DTTs and the occurrence of severe forms of ventricular arrhythmias. A significant association was also observed between the presence of severe LVH and the occurrence of severe ventricular arrhythmias. However, no association was found between the presence of LVH and the positivity of the DTT. As most of their patients with positive DTTs had unimpaired coronary circulations, they conclude that positive DTTs, although falsely indicative of impaired myocardial blood supply, does have an important clinical relevance, indicating increased risk of morbidity (and, possibly, mortality) due to ventricular arrhythmias in a population of CRF patients submitted to chronic renal function replacement program

  15. Prolonged left ventricular dysfunction occurs in patients with coronary artery disease after both dobutamine and exercise induced myocardial ischaemia

    BARNES, E; Baker, C; Dutka, D.; Rimoldi, O; Rinaldi, C.; Nihoyannopoulos, P; Camici, P; Hall, R

    2000-01-01

    OBJECTIVE—To determine whether pharmacological stress leads to prolonged but reversible left ventricular dysfunction in patients with coronary artery disease, similar to that seen after exercise.
DESIGN—A randomised crossover study of recovery time of systolic and diastolic left ventricular function after exercise and dobutamine induced ischaemia.
SUBJECTS—10 patients with stable angina, angiographically proven coronary artery disease, and normal left ventricular function.
INTERVENTIONS—Tread...

  16. Factors influencing left ventricular hypertrophy in children and adolescents with or without family history of premature myocardial infarction

    Seyyed Mohsen Hosseini

    2014-01-01

    Result : The results showed that among the studied variables, gender, age, body mass index, and blood pressure were associated with the left ventricular hypertrophy. Conclusion: Considering the results and previous studies in this field, it was observed that left ventricular hypertrophy exists at early ages, which is very dangerous and can lead to heart diseases at early ages. Factors such as being overweight, having high blood pressure, and being male cause left ventricular hypertrophy and lead to undiagnosable heart diseases.

  17. The comparison of effect on left ventricular remodeling and heart function between primary and delayed PCI in patients with acute myocardial infarction%直接与延迟PCI对急性心肌梗死后左室重构及心功能的影响与比较

    刘胜强; 娄闯; 袁博; 任晖

    2015-01-01

    Objective :To investigate and compare the effect between primary and delayed PCI on left ven‐tricular remodeling and heart function in patients with acute myocardial infarction (AMI) .Methods :one hundred and fifteen patients with AMI were divided into primary PCI group (n=40) and delayed PCI group(n=37) and control group without receiving any coronary artery reperfusion (n=38) .Left ventricular end‐diastolic volume index (LV‐EDVI) ,left ventricular end‐systolic volume index (LVESVI)and left ventricular ejection fraction (LVEF) were measured at an average of 7 days and 6 months after AMI and Heart failure events in each group were followed up . Results :There were significant differences in receiving PCI group and control group for LVEDVI and LVESVI and LVEF ,PCI group were better than control group and primary PCI group were more significant than delayed PCI group .The heart failure events in PCI group were less than control group(13 .2% vs 1 .3% ) .Conclusions :Both pri‐mary and delayed PCI therapy can effectively prevent left ventricular remodeling and improve heart function in pa‐tients with AMI and primary PCI is more significant .%目的:探讨比较直接与延迟经皮冠脉介入术(PCI)对急性心肌梗死(AMI)后左室重构及心功能的影响。方法:收集资料完整的 AMI患者115例,其中行直接 PCI治疗40例,行延迟PCI治疗37例,未行任何冠脉再灌注治疗(包括静脉溶栓或PCI术)38例(对照组)。观察所有患者急性心梗后1周、6个月随访时的心脏超声资料及半年内因心衰住院事件,比较分析三组患者左室舒张末容积指数(LVEDVI)、左室收缩末容积指数(LVESVI)及左室射血分数(LVEF)及半年内的心衰再住院率。结果:AMI后行PCI治疗组LVEDVI、LVESVI及LVEF明显好于未行任何冠脉再灌注治疗的对照组患者,并且行直接PCI治疗组LVEDVI、LVESVI及LVEF好于行延迟PCI治疗组患者

  18. Effects of Perindopril on Left Ventricular Remodeling and Osteopontin Expression in Rats With Myocardial Infarction

    2007-01-01

    To observe the effects of perindopril on left ventricular remodeling and myocardial osteopontin expression in rats with myocardial infarction. Methods In this study male adult SD rats were randomly divided into 3groups: sham-operation group, MI-saline group and MI-perindopril group. Left anterior descending artery was ligated to generate myocardial infarction. Perindopril (2 mg/kg body weight/day) was administered from the next day of MI.Four weeks later, left ventricular diameter (LVEDD and LVESD) and left ventricular ejection fraction was estimated with echocardiography, LVSP, LVEDP and ± dp/dtmax was detected with hemodynamic measurement, cardiomyocyte diameter and interstitial fibrosis infiltration were evaluated with histological methods, and myocardium osteopontin protein expression level was detected with western blot. Results ①Compared with the sham-operation group, all rats with MI developed significant systolic and diastolic dysfunction, as was indicated by decreased LVEF, LVSP and ± dp/dtmax, as well as increased LVEDP. ②Rats with MI showed significantly dilated left ventricles and higher ventricular weight / body weight ratio, significantly increased cardiomyocyte diameter and marked interstitial fibrosis in the non-infarction area. ③Perindopril treatment partly prevented cardiac dysfunction and left ventricular remodeling as indicated by the parameters mentioned above. ④No osteopontin protein was detected in myocardium of sham-operation rats. In rats with MI, high level osteopontin protein expression was significantly inhibited by perindopril treatment. Conclusions In rats with MI, perindopril treatment significantly prevented left ventricular remodeling and myocardium osteopontin protein expression.

  19. Myocardial perfusion SPECT for assessment of left ventricular function and volume- comparison with echocardiography

    Objective: The purpose of this study was to evaluate left ventricular volume and function by gated SPECT and comparison of the results with echocardiography. Methods: 65 Consecutive patients (49 male, 16 female; mean age 61+11 years) who underwent both gated 99mTc-MIBI myocardial perfusion SPECT and echocardiography within a 15 days period were included in the study. Exclusion criteria were any change in clinical status between acquisition of the gated SPECT and echocardiography studies, acute myocardial infarction occurring less than 7 days before study, and surgical procedures occurring within 30 days of the study. The clinical diagnosis of each patient was not considered, as this was not relevant to the purpose of the study. The diagnoses were as follows: coronary artery disease (n=46), hypertensive heart disease (n=8), old myocardial infarction (n=5), myocarditis (n=2), and routine medical examination(n=4). A dose of 740 MBq of 99Tcm-sestamibi was administered in resting condition. Gated SPECT images were obtained with ADAC Vertex MCD-AC SPECT system. The raw projection images were reconstructed with filtered back-projection (ramp filter), without attenuation correction. The data, including left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), end-systolic volume (ESV) were obtained using AUTOQUANT software (ADAC corporation). The echocardiography study used its standard techniques. Two nuclear medicine physicians processed the raw images respectively to evaluate internal reproducibility of gated SPECT. In order to compare the results of gated SPECT with echocardiography on different left ventricular volumes, all patients were divided into two groups (EDV90 ml, n=34) based by EDV measurements in echocardiography. Results: The correlation coefficient of LVEF, EDV, ESV between SPECT and echocardiography were 0.77, 0.86 and 0.90 respectively. P0.07). The reproducibility of gated SPECT was excellent. There were no significant differences in LVEF(59

  20. Successful management of a postinfarction left ventricular rupture using a sutureless technique with concomitant myocardial revascularization.

    Kalangos, A; Panos, A; Chatelain, P; Vala, D; Fromage, P; Faidutti, B

    1997-01-01

    We present a case of left ventricular (LV) rupture that occurred on the second day after inferolateral myocardial infarction (MI). An aggressive diagnostic approach with rapid coronary angiography prior to surgical repair provides a benefit characterized postoperatively by complete recovery of myocardial contractility in the akinetic infarcted area. We believe that coronary artery disease associated with subacute ventricular rupture may, in fact, be better investigated and simultaneously treated under a protocol of early surgical repair. PMID:9591179

  1. Impaired left ventricular diastolic filling in patients with familial amyloid polyneuropathy: a pulsed Doppler echocardiographic study.

    Kinoshita, O; Hongo, M; Yamada, H.; Misawa, T.; Kono, J.; Okubo, S.; Ikeda, S

    1989-01-01

    To assess left ventricular diastolic filling in patients with amyloid heart disease 12 patients with familial amyloid polyneuropathy and 15 normal subjects were studied by pulsed Doppler echocardiography. None of the patients had clinical evidence of overt heart disease or restrictive cardiomyopathy and only two of them showed ventricular wall thickening. The peak flow velocity of rapid diastolic filling and the acceleration rate of early diastolic inflow were significantly lower in patients ...

  2. Left ventricular metastasis from a primary lung carcinoma

    CHE Guo-wei; LIU Lun-xu; ZHANG Er-yong; ZHOU Qing-hua

    2007-01-01

    @@ The most common tumors associated with cardiac metastases are lung carcinoma and melanoma.1 Although the cardiac involvement of lung cancer is common(lung cancer usually directly invades into the pericardium and/or left/right atrium),the primary lung cancer accompanied with metastasis to the left ventricle is extremely rare.

  3. Comparison of high temporal resolution left ventricular volume curves before and after mitral valve replacement

    A patient with severe mitral insufficiency was studied preoperatively by conventional cardiac catheterization, including left ventricular contrast angiography, and also by ECG-gated scintigraphic angiocardiography. Following mitral valve replacement the patient was again studied both by cardiac catheterization and by the scintigraphic procedure. A comparison of preoperative left ventricular volume curves derived from a frame-by-frame analysis of the contrast angiogram, and from the scintigraphic procedure, showed good agreement. A major feature of both preoperative volume curves was a large, early diastolic filling rate. The postoperative scintigraphic volume curve exhibited a marked reduction in early filling rate and a much reduced end-diastolic volume. This study suggests that the scintigraphic procedure is capable of closely following diastolic and systolic changes in left ventricular volume

  4. Factor analysis of multigated cardiac blood pool scintigram for the measurement of left ventricular ejection fraction

    Left ventricular ejection fraction (EF) was measured by factor analysis (FA) of multigated cardiac blood pool scintigram in 38 consecutive patients, and compared with that measured by the variable ROI method (EFVROI) with automated left ventricular contour detection. FA was automatically performed without operator intervention with a success rate of 100%. The correlation of EF with EFVROI was significant in the group of 22 patients with normal wall motion (r=0.65, p<0.001), and the entire group of patients (r=0.70, p<0.001), but not significant (p=0.19) in the group of 16 patients with abnormal wall motion. In conclusion, left ventricular ejection fraction can be estimated by factor analysis of MUGA in patients with normal wall motion. (author)

  5. Left Ventricular Hypertrophy: An allometric comparative analysis of different ECG markers

    Bonomini, M. P.; Ingallina, F.; Barone, V.; Valentinuzzi, M. E.; Arini, P. D.

    2011-12-01

    Allometry, in general biology, measures the relative growth of a part in relation to the whole living organism. Left ventricular hypertrophy (LVH) is the heart adaptation to excessive load (systolic or diastolic). The increase in left ventricular mass leads to an increase in the electrocardiographic voltages. Based on clinical data, we compared the allometric behavior of three different ECG markers of LVH. To do this, the allometric fit AECG = δ + β (VM) relating left ventricular mass (estimated from ecocardiographic data) and ECG amplitudes (expressed as the Cornell-Voltage, Sokolow and the ECG overall voltage indexes) were compared. Besides, sensitivity and specifity for each index were analyzed. The more sensitive the ECG criteria, the better the allometric fit. In conclusion: The allometric paradigm should be regarded as the way to design new and more sensitive ECG-based LVH markers.

  6. Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling

    Simone Nascimento dos Santos

    2014-12-01

    Full Text Available Background: Left ventricular (LV diastolic dysfunction is associated with new-onset atrial fibrillation (AF, and the estimation of elevated LV filling pressures by E/e' ratio is related to worse outcomes in patients with AF. However, it is unknown if restoring sinus rhythm reverses this process. Objective: To evaluate the impact of AF ablation on estimated LV filling pressure. Methods: A total of 141 patients underwent radiofrequency (RF ablation to treat drug-refractory AF. Transthoracic echocardiography was performed 30 days before and 12 months after ablation. LV functional parameters, left atrial volume index (LAVind, and transmitral pulsed and mitral annulus tissue Doppler (e' and E/e' were assessed. Paroxysmal AF was present in 18 patients, persistent AF was present in 102 patients, and long-standing persistent AF in 21 patients. Follow-up included electrocardiographic examination and 24-h Holter monitoring at 3, 6, and 12 months after ablation. Results: One hundred seventeen patients (82.9% were free of AF during the follow-up (average, 18 ± 5 months. LAVind reduced in the successful group (30.2 mL/m2 ± 10.6 mL/m2 to 22.6 mL/m2 ± 1.1 mL/m2, p < 0.001 compared to the non-successful group (37.7 mL/m2 ± 14.3 mL/m2 to 37.5 mL/m2 ± 14.5 mL/m2, p = ns. Improvement of LV filling pressure assessed by a reduction in the E/e' ratio was observed only after successful ablation (11.5 ± 4.5 vs. 7.1 ± 3.7, p < 0.001 but not in patients with recurrent AF (12.7 ± 4.4 vs. 12 ± 3.3, p = ns. The success rate was lower in the long-standing persistent AF patient group (57% vs. 87%, p = 0.001. Conclusion: Successful AF ablation is associated with LA reverse remodeling and an improvement in LV filling pressure.

  7. Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling

    Santos, Simone Nascimento dos, E-mail: simonens@cardiol.br [Instituto Brasília de Arritmia- Universidade de Brasília, DF (Brazil); Faculdade de Medicina (UnB), Brasília, DF (Brazil); Henz, Benhur Davi; Zanatta, André Rodrigues; Barreto, José Roberto; Loureiro, Kelly Bianca; Novakoski, Clarissa; Santos, Marcus Vinícius Nascimento dos; Giuseppin, Fabio F.; Oliveira, Edna Maria; Leite, Luiz Roberto [Instituto Brasília de Arritmia- Universidade de Brasília, DF (Brazil)

    2014-12-15

    Left ventricular (LV) diastolic dysfunction is associated with new-onset atrial fibrillation (AF), and the estimation of elevated LV filling pressures by E/e' ratio is related to worse outcomes in patients with AF. However, it is unknown if restoring sinus rhythm reverses this process. To evaluate the impact of AF ablation on estimated LV filling pressure. A total of 141 patients underwent radiofrequency (RF) ablation to treat drug-refractory AF. Transthoracic echocardiography was performed 30 days before and 12 months after ablation. LV functional parameters, left atrial volume index (LAVind), and transmitral pulsed and mitral annulus tissue Doppler (e' and E/e') were assessed. Paroxysmal AF was present in 18 patients, persistent AF was present in 102 patients, and long-standing persistent AF in 21 patients. Follow-up included electrocardiographic examination and 24-h Holter monitoring at 3, 6, and 12 months after ablation. One hundred seventeen patients (82.9%) were free of AF during the follow-up (average, 18 ± 5 months). LAVind reduced in the successful group (30.2 mL/m{sup 2} ± 10.6 mL/m{sup 2} to 22.6 mL/m{sup 2} ± 1.1 mL/m{sup 2}, p < 0.001) compared to the non-successful group (37.7 mL/m{sup 2} ± 14.3 mL/m{sup 2} to 37.5 mL/m{sup 2} ± 14.5 mL/m{sup 2}, p = ns). Improvement of LV filling pressure assessed by a reduction in the E/e' ratio was observed only after successful ablation (11.5 ± 4.5 vs. 7.1 ± 3.7, p < 0.001) but not in patients with recurrent AF (12.7 ± 4.4 vs. 12 ± 3.3, p = ns). The success rate was lower in the long-standing persistent AF patient group (57% vs. 87%, p = 0.001). Successful AF ablation is associated with LA reverse remodeling and an improvement in LV filling pressure.

  8. Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling

    Left ventricular (LV) diastolic dysfunction is associated with new-onset atrial fibrillation (AF), and the estimation of elevated LV filling pressures by E/e' ratio is related to worse outcomes in patients with AF. However, it is unknown if restoring sinus rhythm reverses this process. To evaluate the impact of AF ablation on estimated LV filling pressure. A total of 141 patients underwent radiofrequency (RF) ablation to treat drug-refractory AF. Transthoracic echocardiography was performed 30 days before and 12 months after ablation. LV functional parameters, left atrial volume index (LAVind), and transmitral pulsed and mitral annulus tissue Doppler (e' and E/e') were assessed. Paroxysmal AF was present in 18 patients, persistent AF was present in 102 patients, and long-standing persistent AF in 21 patients. Follow-up included electrocardiographic examination and 24-h Holter monitoring at 3, 6, and 12 months after ablation. One hundred seventeen patients (82.9%) were free of AF during the follow-up (average, 18 ± 5 months). LAVind reduced in the successful group (30.2 mL/m2 ± 10.6 mL/m2 to 22.6 mL/m2 ± 1.1 mL/m2, p < 0.001) compared to the non-successful group (37.7 mL/m2 ± 14.3 mL/m2 to 37.5 mL/m2 ± 14.5 mL/m2, p = ns). Improvement of LV filling pressure assessed by a reduction in the E/e' ratio was observed only after successful ablation (11.5 ± 4.5 vs. 7.1 ± 3.7, p < 0.001) but not in patients with recurrent AF (12.7 ± 4.4 vs. 12 ± 3.3, p = ns). The success rate was lower in the long-standing persistent AF patient group (57% vs. 87%, p = 0.001). Successful AF ablation is associated with LA reverse remodeling and an improvement in LV filling pressure

  9. Dynamics of left ventricular ejection in obstructive and nonobstructive hypertrophic cardiomyopathy.

    Murgo, J P; Alter, B R; Dorethy, J F; Altobelli, S A; McGranahan, G M

    1980-12-01

    The purpose of this study was to examine the dynamics of left ventricular ejection in patients with obstructive and nonobstructive hypertrophic cardiomyopathy (HCM). 30 patients with HCM and 29 patients with no evidence of cardiovascular disease were studied during cardiac catheterization. Using a single multisensor catheter, electromagnetically derived ascending aortic flow velocity and high fidelity left ventricular and aortic pressures were recorded during rest (n = 47) and provocative maneuvers (n = 23). Dynamic ventricular emptying during rest was also analyzed with frame-by-frame angiography (n = 46). Left ventricular outflow was independently derived from both flow velocity and angiographic techniques. The HCM patients were subdivided into three groups: (I) intraventricular gradients at rest (n = 9), (II) intraventricular gradients only with provocation (n = 12), and (III) no intraventricular gradients despite provocation (n = 9). During rest, the percentage of the total systolic ejection period during which forward aortic flow existed was as follows (mean +/- 1 SD): group I, 69 +/- 17% (flow), 64 +/- 6% (angio); group II, 63 +/- 14% (flow), 65 +/- 6% (angio); group III, 61 +/- 16% (flow), 62 +/- 4% (angio); control group, 90 +/- 5% (flow), 86 +/- 9% (angio). No significant difference was observed between any of the HCM subgroups, but compared with the control group, ejection was completed much earlier in systole independent of the presence or absence of intraventricular gradients. These results suggest that "outflow obstruction," as traditionally defined by the presence of an abnormal intraventricular pressure gradient and systolic anterior motion of the mitral valve, does not impede left ventricular outflow in HCM. PMID:6449522

  10. EXPERIMENTAL STUDY OF RIGHT VENTRICULAR ASSIST IN ACUTE RIGHT VENTRICULAR FAILING

    刘明辉; 苏鸿熙; 李功宋; 王加利; 董超; 童健

    1996-01-01

    The efficacy of right atrial-pulmonary artery (RA-PA)bypass during acute right ventricular failure(RVF)produced by pulmonary artery constriction in dogs was examined in this study Control group (n=7)was supported with conventional volume loading and inotropic therapy.In the experimental animals (n=8),RA-PA bypass was initiated 5 min.after the onset of severe RVF.Three control animals died from refractory ventricular fibrillation within one hour of RVF.No animals in the experimental group died within two hours of RA-PA bypass,but the histological study of the lungs in these animals demonstrated peribronchial,preivascular and intraalveolar hemorrhage.Lighr microscopic and electron microscopic examination of the myocardial specimens of the right ventricular free wall displayed the myocardial structures and ultrastructues were maintained effectively with RA-PA bypass wile irreversible myocardial injuries occurred in the control animasls after two hours of RVF with conventional therapy.During the 2hours of RA-PA bypass,the hemodynamic indices were also maintained better when compared to the control animals.It may be concluded,a roller pump right ventricular assist device effectively unloads the acute faijing right ventricle,maintains systemic cardisc output,and significatly reverses the myocardial ischemia during right venrricular failure,but RA-PA bypass may induce pulmonary hypertension due to increased pulmonary vascular resistance secondary to pulmonary edeme and interstitial hemorrhage.

  11. Noninvasive low-frequency electromagnetic stimulation of the left stellate ganglion reduces myocardial infarction-induced ventricular arrhythmia

    Wang, Songyun; Zhou, Xiaoya; Huang, Bing; Wang, Zhuo; Zhou, Liping; Wang, Menglong; Yu, Lilei; Jiang, Hong

    2016-01-01

    Noninvasive magnetic stimulation has been widely used in autonomic disorders in the past few decades, but few studies has been done in cardiac diseases. Recently, studies showed that low-frequency electromagnetic field (LF-EMF) might suppress atrial fibrillation by mediating the cardiac autonomic nervous system. In the present study, the effect of LF-EMF stimulation of left stellate ganglion (LSG) on LSG neural activity and ventricular arrhythmia has been studied in an acute myocardium infarction canine model. It is shown that LF-EMF stimulation leads to a reduction both in the neural activity of LSG and in the incidence of ventricular arrhythmia. The obtained results suggested that inhibition of the LSG neural activity might be the causal of the reduction of ventricular arrhythmia since previous studies have shown that LSG hyperactivity may facilitate the incidence of ventricular arrhythmia. LF-EMF stimulation might be a novel noninvasive substitute for the existing implant device-based electrical stimulation or sympathectomy in the treatment of cardiac disorders. PMID:27470078

  12. Primary left ventricular hydatid cyst in a child: case report

    The most common cause of echinococcosis in humans is Echinococcus granulosus. Although hydatid cyst is most frequently localized in liver (more than 65% of cases) and lung (25%) by means of portal and systemic circulation, it may involve other tissues and organs. Cardiac hydatid cysts account for only 0.5%-2% of all hydatid cysts, even in endemic areas. Of all cardiac hydatid cysts, the left ventricle accounts for 60%, right ventricle 10%, pericardium 7%, pulmonary artery 6%, left atrial appendage 6%, and interventricular septum 4%. We report the case of a myocardial hydatid cyst of the left ventricle in a 9-year-old boy. (author)

  13. Left ventricular diastolic function in valvular aortic stenosis after aortic valve replacement

    Ristić-Anđelkov Anđelka

    2002-01-01

    Full Text Available In adults with significant sympthomatic aortic valve stenosis, aortic valve replacement is therapy of choice. Replacement of the diseased aortic valve with a prosthetic valve yields relief of left ventricular outflow obstruction. Myocardial remodeling with regression of mass transpires as the heart adapts to the new level of after load. In patients with moderate left ventricular hypertrophy improvement in diastolic function during the first year after aortic valve replacement is visible, while in patients with extreme myocardial hypertrophic changes it was slower.

  14. Left ventricular volume unloading with axial and centrifugal rotary blood pumps.

    Giridharan, Guruprasad A; Koenig, Steven C; Soucy, Kevin G; Choi, Young; Pirbodaghi, Tohid; Bartoli, Carlo R; Monreal, Gretel; Sobieski, Michael A; Schumer, Erin; Cheng, Allen; Slaughter, Mark S

    2015-01-01

    Axial (AX) and centrifugal (CFG) rotary blood pumps have gained clinical acceptance for the treatment of advanced heart failure. Differences between AX and CFG designs and mechanism of blood flow delivery may offer clinical advantages. In this study, pump characteristics, and acute physiologic responses during support with AX (HeartMate II) and CFG (HVAD) left ventricular assist devices (LVAD) were investigated in mock loop and chronic ischemic heart failure bovine models. In the mock loop model, pump performance was characterized over a range of pump speeds (HeartMate II: 7,000-11,000 rpm, HVAD: 2,000-3,600 rpm) and fluid viscosities (2.7 cP, 3.2 cP, 3.7 cP). In the ischemic heart failure bovine model, hemodynamics, echocardiography, and end-organ perfusion were investigated. CFG LVAD had a flatter HQ curve, required less power, and had a more linear flow estimation relation than AX LVAD. The flow estimation error for the AX LVAD (±0.9 L/min at 2.7 cP, ±0.7 L/min at 3.2 cP, ±0.8 L/min at 3.7 cP) was higher than the CFG LVAD (±0.5 L/min at 2.7 cP, ±0.2 L/min at 3.2 cP, ±0.5 L/min at 3.7 cP). No differences in acute hemodynamics, echocardiography, or end-organ perfusion between AX and CFG LVAD over a wide range of support were statistically discernible. These findings suggest no pronounced acute differences in LV volume unloading between AX and CFG LVAD. PMID:25635936

  15. Parallel left ventricular assistance tests on the hybrid circulatory model.

    Kozarski, Maciej; Ferrari, Gianfranco; Zielinski, Krzysztof; Gorczynska, Krystyna; Palko, Krzysztof Jakub; Darowski, Marek

    2009-01-01

    Objectives: Evaluation of new control and measurement methods worked out for heart assist devices and artificial hearts need new laboratory tools making experiments more accurate, repeatable, easier and less time consuming. The proper answer to this demand seems to be a hybrid hydro-numerical model HHNM of the circulatory system. Its performance illustrates the exemplary laboratory application when the physical left ventricle assist device is connected in parallel to the numerical left ventri...

  16. Left ventricular synchrony assessed by phase analysis of gated myocardial perfusion SPECT imaging in healthy subjects

    Objective: To investigate the value of Cedars-Sinai quantitative gated SPECT (QGS) phase analysis for left ventricular synchrony assessment in healthy subjects. Methods: Seventy-four healthy subjects (41 males, 33 females,average age: (60±13) years) underwent both rest and exercise 99Tcm-MIBI G-MPI. QGS software was used to analyze the reconstructed rest gated SPECT images automatically, and then the parameters of left ventricular synchrony including phase bandwidth (BW) and phase standard deviation (SD) were obtained. The influences of gender and age (age<60 years, n=36; age ≥ 60 years, n=38) on left ventricular systolic synchronicity were analyzed. The phase angle for original segmental contraction was measured to determine the onset of the ventricular contraction using 17-segment model. Forty healthy subjects were selected by simple random sampling method to evaluate the intra-observer and interobserver repeatability of QGS phase analysis software. Two-sample t test and linear correlation analysis were used to analyze the data. Results: The BW and SD of left ventricular in healthy subjects were (37.22 ±11.71)°, (11.84±5.39)° respectively. Comparisons between male and female for BW and SD yielded no statistical significance (BW: (36.00±9.70)°, (38.73±13.84)°; SD: (11.88±5.56)°, (11.79±5.26)°; t=0.96 and-0.07, both P>0.05); whereas the older subjects (age≥60 years) had larger BW than the others (age<60 years ; (39.95± 12.65)°, (34.33± 10.00)°; t=-2.11, P<0.05) and no statistical significance was shown for SD between the two age groups ((11.18±4.31)°, (12.54±6.33)°; t=1.08, P>0.05). Of the 74 subjects, the mechanical activation started from the ventricular base to apex in 54 subjects (73%), and from apex to base in only 20 subjects (27%). High repeatability of phase analysis was observed for both intra-observer and inter-observer (r=0.867-0.906, all P<0.001). Conclusions: Good left ventricular segmental synchrony is shown in healthy

  17. Evaluation of left ventricular hypertrophy using thallium-201 myocardial scintigraphy, echocardiography and vectorcardiography

    Thallium-201 (201Tl) myocardial scintigraphy was performed in 40 patients with left ventricular hypertrophy(LVH). Twelve out of 40 patients had pressure overloading (Aortic stenosis: 5, Hypertension: 7), 14 patients had volume overloading (Aortic regurgitation: 9, Mitral regurgitation: 5) and 14 had idiopathic cardiomyopathy (Hypertrophic type (HCM): 8, Congestive type (CCM): 6), respectively. LV area, LV uptake index and Wall uptake ratio were calculated from left anterior oblique view of 201Tl myocardial images. These three indices of both pressure overloading and volume overloading were significantly higher than those of controls. The degree of LVH was indicated by both LV area and LV uptake index. LV area was significantly larger in volume overloading than in pressure overloading. In idiopathic cardiomyopathy, these three indices of HCM and LV area and LV uptake index of CCM were significantly increased compared with those of controls. LV area of CCM was significantly larger than that of HCM, while Wall uptake ratio of HCM was significantly higher than that of CCM. LV uptake index and Wall uptake ratio of HCM became higher according as left ventricular cavity became smaller. LV area of CCM became larger in proportion as left ventricular cavity became larger and as left ventricular wall thickness became thinner. (author)

  18. Improved determination of left ventricular volume with myocardial tagging

    Cine MR imaging can be used to determine ventricular volume and ejection fraction. However, definition of the endocardial surface can be difficult, leading some investigators to suggest that black-blood studies are preferable. Grid tagging with use of spatial modulation of magnetization has been used to improve assessments of wall motion. The purpose of this paper, is to determine if grid tagging would also facilitate definition of the endocardial border for volume and ejection fraction calculations. Grid tagging based on spatial modulation of magnetization was implemented on a Toshiba 0.5-T MR imaging device. Standard RAO images were obtained in 10 normal volunteers with use of standard cine MR imaging sequences (33/22) with and without grid tagging. Images were analyzed to determine ventricular volume, cardiac output and wall motion. Images obtained without tagging generally showed good contrast at end diastole, but definition of the endocardial border was frequently more difficult in middle to late systole. Images with tagging provided significantly better definition of endocardial borders, particularly during systole

  19. Coronary collaterals provide a constant scaffold effect on the left ventricle and limit ischemic left ventricular dysfunction in humans

    Hoole, Stephen P.; White, Paul A.; Read, Philip A.; Heck, Patrick M; West, Nick E.; O'Sullivan, Michael; Dutka, David P

    2012-01-01

    Coronary collaterals preserve left ventricular (LV) function during coronary occlusion by reducing myocardial ischemia and may directly influence LV compliance. We aimed to re-evaluate the relationship between coronary collaterals, measured quantitatively with a pressure wire, and simultaneously recorded LV contractility from conductance catheter data during percutaneous coronary intervention (PCI) in humans. Twenty-five patients with normal LV function awaiting PCI were recruited. Pressure-d...

  20. Anastomose cavo-pulmonar associada ao suporte circulatório esquerdo comparada à assistência biventricular na falência cardíaca aguda Cavo-pulmonary anastomosis associated with left ventricular in comparison with biventricular circulatory support in acute heart failure

    Luis Alberto Saraiva Santos

    2012-12-01

    Full Text Available OBJETIVO: Este estudo avaliou o desempenho hemodinâmico e as alterações miocárdicas decorrentes do emprego de dispositivos de assistência ventricular esquerda (DAVE, associado ou não à descompressão do ventrículo direito por meio de derivação cavo-pulmonar, sendo esses achados comparados ao emprego de assistência circulatória biventricular. MÉTODOS: Vinte e um suínos foram submetidos à indução de insuficiência cardíaca através de fibrilação ventricular, sendo a atividade circulatória mantida por DAVE durante 180 minutos. No grupo controle, foi apenas implantado o DAVE. No grupo derivação, além do DAVE foi realizada cirurgia de derivação cavo-pulmonar. No grupo biventricular, foi instituída assistência biventricular. Foram monitoradas as pressões intracavitárias por 3 horas de assistência e amostras do endocárdio dos dois ventrículos foram coletadas e analisadas à microscopia óptica e eletrônica. RESULTADOS: O lactato sérico foi significativamente menor no grupo biventricular (P=0,014. A diferença observada entre o fluxo do DAVE nos grupos derivação e controle (+55±14 ml/kg/min, P=0,072 não foi significativa, enquanto que o fluxo no grupo biventricular foi significativamente maior (+93±17 ml/kg/min, P=0,012 e se manteve estável durante o experimento. A pressão arterial média (PAM se manteve constante apenas no grupo biventricular (POBJECTIVE: Right ventricular (RV failure during left ventricular assist device (LVAD support can result in severe hemodynamic compromise with high mortality. This study investigated the acute effects of cavo-pulmonary anastomosis on LVAD performance and RV myocardial compromise in comparison with biventricular circulatory support, in a model of biventricular failure. METHODS: LVAD support was performed by centrifugal pump in 21 pigs with severe biventricular failure obtained by FV induction. Animals were randomized to be submitted to cavo-pulmonary anastomosis, to

  1. [Echocardiographic study of left ventricular function in 2 different procedures].

    Cini, G; Camici, M; Palla, R; Pentimone, F

    1981-01-01

    Four patients on regular dialysis were studied by echocardiographic method during ultrafiltration sequential dialysis performed according to two different protocols: procedure 1: ultrafiltration alone (1 hour) followed by diffusive dialysis (3 hours); procedure 2: dialysis (3 hours) followed by ultrafiltration alone (1 hour). Blood pressure, heart rate, cardiac output, stroke volume, systolic and diastolic dimension of the left ventricle, systolic and diastolic volumes of the left ventricle, ejection fraction, shortening fraction and total peripheral vascular resistance index were measured. During ultrafiltration there is an increase of the total peripheral vascular resistance index. Myocardial contractility improves only during dialysis. Physiographic and therapeutic implications are discussed. PMID:7286519

  2. Evaluation of global and regional left ventricular function obtained by quantitative gated SPECT using {sup 99m}Tc-tetrofosmin for left ventricular dysfunction

    Ban, Kazunobu; Nakajima, Tohru; Iseki, Harukazu; Abe, Sumihisa; Handa, Shunnosuke; Suzuki, Yutaka [Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine

    2000-08-01

    The quantitative gated SPECT (QGS) software is able to calculate LV volumes and visualize LV wall motion and perfusion throughout the cardiac cycle using an automatic edge detection algorithm of the left ventricle. We evaluated the reliability of global and regional LV function assessment derived from QGS by comparing it with the results from left ventriculo-cineangiography (LVG). In 20 patients with left ventricular dysfunction who underwent ECG gated {sup 99m}Tc-tetrofosmin SPECT, the end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (LVEF) were calculated. The QGS-assessed regional wall motion was determined using the cinematic display. QGS-derived EDV, ESV and LVEF correlated well with those by LVG (p<0.001 for each). There was a good correlation between wall motion score (WMS) derived from the QGS and the LVG (r=0.40, p<0.05). In some patients with extensive myocardial infarction, there was a discrepancy in the regional wall motion results between QGS and LVG. The ECG-gated SPECT using QGS is useful to evaluate global and regional LV functions in left ventricular dysfunction. (author)

  3. Cardiac MRI and Transthoracic Echocardiography of Left Ventricular Myocardial Noncompaction in A Patient with Congestive Heart Failure: A Case Report

    Cho, Eui Min; Byun, Joo Nam [Chosun University Hospital College of Medicine, Gwangju (Korea, Republic of); Kim, Dong Hun [Soonchunhyang University Hospital Bucheon College of Medicine, Bucheon (Korea, Republic of)

    2010-11-15

    We report a case of a 38-year-old male presenting with new-onset dyspnea, that was diagnosed as left ventricular noncompaction by transthoracic echocardiographic and cardiac MR. The tests revealed left ventricular systolic dysfunction with prominent trabeculations associated with deep intertrabecular recesses and an enddiastolic noncompacted to compacted ratio of 2.5 in the whole apical wall and mid-ventricular anterolateral and inferolateral walls. Delayed gadolinium contrast-enhanced MRI revealed subepicardial mid-wall hyperenhancement of the midventricular anteroseptal and inferoseptal walls, which suggested myocardial fibrosis. We review the pathophysiology, clinical characteristics, and diagnostic approach of the left ventricular noncompaction associated with congestive heart failure

  4. Cardiac MRI and Transthoracic Echocardiography of Left Ventricular Myocardial Noncompaction in A Patient with Congestive Heart Failure: A Case Report

    We report a case of a 38-year-old male presenting with new-onset dyspnea, that was diagnosed as left ventricular noncompaction by transthoracic echocardiographic and cardiac MR. The tests revealed left ventricular systolic dysfunction with prominent trabeculations associated with deep intertrabecular recesses and an enddiastolic noncompacted to compacted ratio of 2.5 in the whole apical wall and mid-ventricular anterolateral and inferolateral walls. Delayed gadolinium contrast-enhanced MRI revealed subepicardial mid-wall hyperenhancement of the midventricular anteroseptal and inferoseptal walls, which suggested myocardial fibrosis. We review the pathophysiology, clinical characteristics, and diagnostic approach of the left ventricular noncompaction associated with congestive heart failure

  5. Successful left ventricular assist device re-implantation with omental covering for MDRP device infection.

    Inafuku, Hitoshi; Kuniyoshi, Yukio; Yamashiro, Satoshi; Totsuka, Yuichi; Ono, Minoru

    2016-06-01

    We present a case of paracorporeal left ventricular assist device (p-LVAD)-related infection, caused by multi-drug resistant Pseudomonas aeruginosae (MDRP), and successfully treated by p-LVAD re-implantation with omental covering. A 59-year-old man underwent p-LVAD implantation and coronary artery bypass grafting after percutaneous cardiopulmonary support and intra-aortic balloon pumping for cardiogenic shock due to acute myocardial infarction. Then, he was registered for heart transplantation. He suffered from blood stream infection causative organism of Pseudomonas aeruginosa, 2 months after that operation. He underwent re-median sternotomy and open drainage, 15 months after the p-LVAD implantation. However, he suffered from septic shock due to MDRP. He underwent p-LVAD re-implantation under hypothermic circulatory arrest and iodine gauze packing, followed by omental covering of the all artificial materials in his body 10 days after that operation. Soon after that, the infection was well controlled and the intravenous antibiotics could be discontinued 2 months after that operation. He successfully underwent heart transplantation, 17 months after that procedure. We concluded that p-LVAD re-implantation with omental covering is seemed to be useful in the treatment of massive device infection. This procedure might be a novel treatment for severe VAD-related infection until heart transplantation. PMID:26740211

  6. Improvement of left ventricular filling by ivabradine during chronic hypertension: involvement of contraction-relaxation coupling.

    Melka, Jonathan; Rienzo, Mario; Bizé, Alain; Jozwiak, Mathieu; Sambin, Lucien; Hittinger, Luc; Su, Jin Bo; Berdeaux, Alain; Ghaleh, Bijan

    2016-05-01

    Chronic hypertension is associated with left ventricular (LV) hypertrophy and LV diastolic dysfunction with impaired isovolumic relaxation and abnormal LV filling. Increased heart rate (HR) worsens these alterations. We investigated whether the I f channel blocker ivabradine exerts beneficial effects on LV filling dynamic. In this setting, we also evaluated the relationship between LV filling and isovolumic contraction as a consequence of contraction-relaxation coupling. Therefore, hypertension was induced by a continuous infusion of angiotensin II during 28 days in 10 chronically instrumented pigs. LV function was investigated after stopping angiotensin II infusion to offset the changes in loading conditions. In the normal heart, LV relaxation filling, LV early filling, LV peak early filling rate were positively correlated to HR. In contrast, these parameters were significantly reduced at day 28 vs. day 0 (18, 42, and 26 %, respectively) despite the increase in HR (108 ± 6 beats/min vs. 73 ± 2 beats/min, respectively). These abnormalities were corrected by acute administration of ivabradine (1 mg/kg, iv). Ivabradine still exerted these effects when HR was controlled at 150 beats/min by atrial pacing. Interestingly, LV relaxation filling, LV early filling and LV peak early filling were strongly correlated with both isovolumic contraction and relaxation. In conclusion, ivabradine improves LV filling during chronic hypertension. The mechanism involves LV contraction-relaxation coupling through normalization of isovolumic contraction and relaxation as well as HR-independent mechanisms. PMID:27040115

  7. Cardiac morphology in left ventricular hypertrophy using thallium-201 myocardial scintigraphy

    To evaluate cardiac morphology in the patients with various cases of hypertrophy, we measured left ventricular (LV) size using thallium-201 myocardial scintigraphy in 29 normal subjects and in 90 patients. Cardiac shape and dimension were assessed by measuring the wall thickness and external length in the short and long axis of LV image in LAO projection. In aortic stenosis and hypertensive heart disease the shape was spherical and the wall was thickened. In both mitral (MR) and aortic (AR) regurgitations, LV dilatation were shown; spherical shape in chronic MR but ellipsoid shape in acute MR and AR. Decreased LV size but normal shape was observed in mitral stenosis and cor pulmonale. In hypertrophic cardiomyopathy the LV wall was asymmetrically hypertrophied, while in congestive cardiomyopathy the wall is thin with marked LV dilatation and the shape was spherical. We concluded that the heart had characteristic configuration which might reflect cardiac performance or compensate for the load to the heart, and that thallium-201 myocardial scintigraphy is useful in the evaluation of cardiac morphology as well as in diagnosis of myocardial ischemia. (author)

  8. The left atrium, atrial fibrillation, and the risk of stroke in hypertensive patients with left ventricular hypertrophy

    Wachtell, K.; Devereux, R.B.; Lyle, P.A.;

    2008-01-01

    The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study provided extensive data on predisposing factors, consequences, and prevention of atrial fibrillation (AF) in patients with hypertension and left ventricular (LV) hypertrophy. Randomized losartan-based treatment was...... superior to atenolol-based treatment for reducing new-onset AF and complications, especially stroke, associated with new-onset or pre-existing AF. Potential mechanisms of AF prevention by angiotensin receptor blockade supported by LIFE results include greater reduction in left atrial size and LV...... hypertrophy. Differential effects of antihypertensive treatment on the left atrium and left ventricle may help prevent AF and reduce risk of stroke associated with hypertensive heart disease Udgivelsesdato: 2008/12...

  9. Effects of Everolimus-Eluting Stents on the Left Ventricular Systolic and Diastolic Functions

    MohammadSadegh Parsaee; Maryam Nabati; Naser Saffar; Morteza Taghavi

    2015-01-01

    Background: The drug-eluting stent (DES) decreases the rate of coronary restenosis and re-obstruction. The aim of this study was to assess prospectively the effectiveness of the new generation DES on the left ventricular (LV) systolic and diastolic functions in patients with isolated severe proximal left anterior descending (LAD) coronary artery stenosis.Methods: A prospective study was conducted on 50 patients with isolated severe proximal LAD stenosis. Successful percutaneous coronary inter...

  10. A variant technique for the surgical treatment of left ventricular aneurysms

    Paulo Roberto Barbosa Evora; Paulo Victor Alves Tubino; Luis Gustavo Gali; Lafaiete Alves Junior; Cesar Augusto Ferreira; Solange Bassetto; Antônio Carlos Menardi; Alfredo José Rodrigues; Walter Vilella de Andrade Vicente

    2014-01-01

    Objective: To present a surgical variant technique to repair left ventricular aneurysms. Methods: After anesthesia, cardiopulmonary bypass, and myocardial protection with hyperkalemic tepic blood cardioplegia: 1) The left ventricle is opened through the infarct and an endocardial encircling suture is placed at the transitional zone between the scarred and normal tissue; 2) Next, the scar tissue is circumferentially plicated with deep stitches using the same suture thread, taking care to elimi...

  11. Assessment of left ventricular systolic and diastolic function in subclinical hypothyroidism

    Velkoska Nakova, Valentina; Krstevska, Branka; Kostovska Srbinovska, Elizabeta; Vaskova, Olivija

    2015-01-01

    Objective: Studies investigating systolic and diastolic left ventricle function in subclinical hypothyroidism (ScH) have shown controversial results. As myocardium is a target organ of thyroid hormone action, the aim of the study was to assess the left ventricular systolic and diastolic function in ScH. Methods: Fifty-four patients with newly diagnosed ScH and 30 euthyroid controls, patients of the University Clinic of the Endocrinology, Diabetes, and Metabolic Disorders Clinic...

  12. Left Ventricular Hypertrophy in Chronic Kidney Disease Patients: From Pathophysiology to Treatment

    Di Lullo, Luca; Gorini, Antonio; Russo, Domenico; Santoboni, Alberto; Ronco, Claudio

    2015-01-01

    Cardiovascular diseases represent the main causes of morbidity and mortality in patients with chronic kidney disease (CKD). According to a well-established classification, cardiovascular involvement in CKD can be set in the context of cardiorenal syndrome type 4. Left ventricular hypertrophy (LVH) represents a key feature to provide an accurate picture of systolic-diastolic left heart involvement in CKD patients. Cardiovascular involvement is present in about 80% of prevalent hemodialysis pat...

  13. Hypertrophic cardiomyopathy with apical left ventricular aneurysm: a case report

    江腾勇; 韩智红; 王京; 吕强; 吴学思

    2002-01-01

    @@ Morphological diversity is one characteristic of hypertrophic cardi omyopathy (HCM), but it is not common that HCM is associated with apical left ve ntricular aneurysm (LVA) without evidence of a coronary artery lesion. We repor t on such a case and review the pathogenesis, manifestations and diagnostic meth ods by collecting the few available papers published on this topic.

  14. Left ventricular stroke volume determinations from radionuclide ventriculograms: the effects of photon attenuation

    Schwaiger, M.; Ratib, O.; Henze, E.; Grossman, R.; Dracup, K.; Tillisch, J.H.; Bae, J.H.; Schelbert, H.R.

    1984-10-01

    To improve the accuracy of scintigraphic ventricular volume determination, which is limited by photon attenuation between the heart and the gamma camera, a method was developed for directly measuring the photon attenuation of radioactivity delivered as a bolus through a Swan-Ganz catheter into the right atrium. Comparison of the count rate recovered from this bolus with the total ex vivo measured activity determined by imaging an aliquot of the administered activity allowed calculation of the attenuation factor. Left ventricular stroke volumes determined scintigraphically by the count method in gated blood pool studies and then corrected with this attention factor correlated well with stroke volumes determined from thermodilution cardiac output and heart rate. The results indicate that correction for photon attenuation is needed for accurage measurement of left ventricular volumes.

  15. Percutaneous transfemoral closure of a pseudoaneurysm at the left ventricular apical access site for transcatheter aortic valve implantation.

    Karimi, Ashkan; Beaver, Thomas M; Fudge, James C

    2015-02-01

    This case report illustrates a left ventricular pseudoaneurysm that developed at the transapical access site for transcatheter aortic valve implantation and was successfully excluded percutaneously through a femoral approach using an Amplatzer muscular VSD occluder (St. Jude Medical). We also discuss various currently available devices and technical pearls for percutaneous closure of left ventricular pseudoaneurysms. PMID:25661768

  16. Effect of Peritoneal Dialysis Treatment on Left Ventricular Systolic and Diastolic Functions in Patients with End-Stage Renal Disease

    Feridun KAVUNCUOĞLU

    2014-09-01

    Full Text Available OBJECTIVE: To analyze the effect of peritoneal dialysis (PD treatment on left ventricular systolic and diastolic function in patients with end-stage renal disease (ESRD. MATERIAL and METHODS: The study population consisted of 51 patients with ESRD. Before a PD catheter was inserted, the patients were evaluated by echocardiography and Doppler tissue imaging (DTI. Then, a PD catheter was inserted. After 6 months, the second echocardiographic evaluations were performed. Left ventricular systolic and diastolic function parameters were compared. RESULTS: The mean age was 47 ± 13 years and 38 (74.5% of the patients were male. No significant difference was found in echocardiographic parameters including ejection fraction, fractional shortening, left ventricular mass, left ventricular mass index, left ventricular posterior wall thickness, inter ventricular septal thickness, left atrial diameter, early diastolic filling/late diastolic filling ratio before and after the period of PD. Left ventricular end-systolic diameter and left ventricular end-diastolic diameter values were significantly lower found in the period after PD. CONCLUSION: Our findings appear to reflect somewhat the favourable changes in LV diastolic and systolic functions in PD patients.

  17. Beneficial aspects of real time flow measurements for the management of acute right ventricular heart failure following continuous flow ventricular assist device implantation

    Spiliopoulos Sotirios

    2012-11-01

    Full Text Available Abstract Background Optimal management of acute right heart failure following the implantation of a left ventricular assist device requires a reliable estimation of left ventricular preload and contractility. This is possible by real-time pump blood flow measurements. Clinical case We performed implantation of a continuous flow left ventricular assist device in a 66 years old female patient with an end-stage heart failure on the grounds of a dilated cardiomyopathy. Real-time pump blood flow was directly measured by an ultrasonic flow probe placed around the outflow graft. Diagnosis The progressive decline of real time flow and the loss of pulsatility were associated with an increase of central venous pressure, inotropic therapy and progressive renal failure suggesting the presence of an acute right heart failure. Diagnosis was validated by echocardiography and thermodilution measurements. Treatment Temporary mechanical circulatory support of the right ventricle was successfully performed. Real time flow measurement proved to be a useful tool for the diagnosis and ultimately for the management of right heart failure including the weaning from extracorporeal membrane oxygenation.

  18. Left Ventricular Electromechanical Mapping: A Case Study of Functional Assessment in Coronary Intervention

    Perin, Emerson C.; Silva, Guilherme V.; Sarmento-Leite, Rogerio

    2000-01-01

    Electromechanical mapping is a new diagnostic tool that can be used to identify viable myocardium. In the case reported here, the technique was used before intervention to map areas of viable myocardium; post-intervention mapping showed improved mechanical function of the revascularized areas. Electromechanical mapping offers the potential of assessing left ventricular function in the cardiac catheterization laboratory before and after interventional procedures.

  19. Dosing of ACE inhibitors in left ventricular dysfunction : Does current clinical dosing provide optimal benefit?

    Pinto, YM; van Geel, PP; Alkfaji, H; van Veldhuisen, DJ; van Gilst, WH

    1999-01-01

    In the present review, we discuss the role of clinical dosing of angiotensin converting enzyme (ACE) inhibitors in the treatment of left ventricular dysfunction. Although the precise mechanism of action of ACE inhibitors is still unresolved, the clinical efficacy of ACE inhibitors in the treatment o

  20. Numerical simulation of the pulsating catheter pump : A left ventricular assist device

    Verkerke, GJ; Mihaylov, D; Geertsema, AA; Lubbers, J; Rakhorst, G

    1999-01-01

    The pulsating catheter (PUCA) pump, a left ventricular assist device, consists of a hydraulically or pneumatically driven membrane pump, extracorporeally placed and mounted to a valved catheter. The catheter is introduced into an easily accessible artery and positioned with its distal tip in the lef

  1. [Isolated left ventricular--right atrial shunt after blunt chest trauma (author's transl)].

    Kreuzer, E; Beyer, J

    1978-12-01

    A case of left-ventricular-right-atrial septal defect secundary to blunt chest trauma is described. The etiology of this type of septal defect, e. g. congenital, following aortic and mitral valve replacement, endocarditis and trauma, is discussed. Early defect closure is recommended in the presence of significant shunt volume. PMID:751280

  2. Decreased mitochondrial oxidative phosphorylation capacity in the human heart with left ventricular systolic dysfunction

    Stride, Nis; Larsen, Steen; Hey-Mogensen, Martin; Sander, Kåre; Lund, Jens T; Gustafsson, Finn; Køber, Lars; Dela, Flemming

    2013-01-01

    Heart failure (HF) with left ventricular systolic dysfunction (LVSD) is associated with a shift in substrate utilization and a compromised energetic state. Whether these changes are connected with mitochondrial dysfunction is not known. We hypothesized that the cardiac phenotype in LVSD could be...

  3. Trimetazidine protects against smoking-induced left ventricular remodeling via attenuating oxidative stress, apoptosis, and inflammation.

    Xiang Zhou

    Full Text Available Trimetazidine, a piperazine derivative used as an anti-anginal agent, improves myocardial glucose utilization through inhibition of fatty acid metabolism. The present study was designed to investigate whether trimetazidine has the protective effects against smoking-induced left ventricular remodeling in rats. In this study, Wistar rats were randomly divided into 3 groups: smoking group (exposed to cigarette smoke, trimetazidine group (exposed to cigarette smoke and treated with trimetazidine, and control group. The echocardiographic and morphometric data indicated that trimetazidine has protective effects against smoking-induced left ventricular remodeling. Oxidative stress was evaluated by detecting malondialdehyde, superoxide dismutase, and glutathione peroxidase in the supernatant of left ventricular tissue. Cardiomyocyte apoptotic rate was determined by flow cytometry with Annexin V/PI staining. Gene expression and serum levels of inflammatory markers, including interleukin-1β, interleukin-6, and tumor necrosis factor-α, were deteced by quantitative real-time PCR and enzyme-linked immunosorbent assay. Our results suggested that trimetazidine could significantly reduce smoking-induced oxidative stress, apoptosis, and inflammation. In conclusion, our study demonstrates that trimetazidine protects against smoking-induced left ventricular remodeling via attenuating oxidative stress, apoptosis, and inflammation.

  4. Role of angiotensin receptor blockers in patients with left ventricular dysfunction : lessons from CHARM and VALIANT

    Voors, AA; van Veldhuisen, DJ

    2004-01-01

    The role of angiotensin receptor blockers (ARBs) in patients with left ventricular dysfunction has changed after the VALIANT and CHARM trials. CHARM proved that candesartan is a good alternative for patients with chronic heart failure who cannot tolerate ACE-inhibitors. Moreover, VALIANT demonstrate

  5. Hemodynamic stress echocardiography in patients supported with a continuous-flow left ventricular assist device

    Andersen, Mads; Gustafsson, Finn; Madsen, Per Lav;

    2010-01-01

    Functional assessment of continuous-flow left ventricular assist devices (LVADs) is usually performed with the patient at rest. This study compared echocardiographic indices of contraction and filling pressure with invasive measures in 12 ambulatory LVAD patients undergoing symptom-limited bicycl...

  6. Quantification of left ventricular size on exercise thallium-201 single-photon emission tomography

    The purposes of this study were to determine whether quantification of the left ventricular size on exercise thallium-201 single-photon emission tomography (SPET) correlates with echocardiographic measurements, whether the quantification reflects the severity of coronary artery disease, and whether it can provide supplementary information regarding the severity of coronary artery disease. In 42 control subjects and 110 patients who underwent coronary angiography, we performed exercise 201Tl SPET and quantified six non-regional markers: Lung 201Tl uptake on an initial planar image (Lung/Heart), left ventricular width on a tomogram (Width), change in the Width from the initial to delayed tomograms (ΔWidth), count ratio of the left ventricular cavity to the myocardium (C/M), count ratio of the lung to the myocardium (L/M), and count ratio of the lung to the left ventricular cavity (L/C). In 76 patients, furthermore, the Width was compared with echocardiographic measurements. The Width correlated with echocardiographic measurements (P201Tl SPET correlated with echocardiogrpahic measurements and reflected the severity of coronary artery disease, but may be replaced with quantitation of the lung 201Tl uptake. (orig.)

  7. Prediction of the left ventricular mass from the electrocardiogram in systemic hypertension

    deVries, SO; Heesen, WF; Beltman, FW; Kroese, AH; May, JF; Smit, AJ; Lie, KI

    1996-01-01

    Although echocardiography provides a reliable method to determine left ventricular (LV) mass, it may not be available in all settings. Numerous electrocardiographic (EGG) criteria for the detection of LV hypertrophy have been developed, but few attempts have been made to predict the LV mass itself f

  8. Home blood pressure measurement : reproducibility and relationship with left ventricular mass

    Kok, R.H.; Beltman, F.W.; Terpstra, W.F.; Smit, A.J.; May, J.F.; de Graeff, P.A.; Meyboom-de Jong, B.

    1999-01-01

    OBJECTIVE: To evaluate the reproducibility and relationship with left ventricular mass index of home blood pressure in comparison with ambulatory and office blood pressures. METHODS: We measured home, ambulatory and office blood pressures of 84 previously untreated hypertensive patients, aged 60-74

  9. Magnetic resonance imaging derived left ventricular global and region function parameters in healthy adults

    穆莉莎

    2014-01-01

    Objective To establish cardiac magnetic resonance imaging(MRI)derived left ventricular(LV)global and region function parameters in normal adults.Methods Twenty normal adults were examined with fast imaging employing steady-state(Fiesta)acquisition sequence of cardiac MRI,LV global function and LV region function were measured at basal,middle,apical level and at 16

  10. Relationship between left ventricular dysfunction and depression following myocardial infarction : data from the MIND-IT

    van Melle, JP; de Jonge, P; Ormel, J; Crijns, HJGM; van Veldhuisen, DJ; Honig, A; Schene, AH; van den Berg, MP

    2005-01-01

    Aims Depression in patients following myocardial infarction (MI) is associated with an increased risk of mortality, but this association may be confounded by cardiac disease severity. We explored the relationship between left ventricular ejection fraction (LVEF) and depression in MI patients. Method

  11. Renal dysfunction, restrictive left ventricular filling pattern and mortality risk in patients admitted with heart failure

    Schou, Morten; Kjaergaard, Jesper; Torp-Pedersen, Christian;

    2013-01-01

    Renal dysfunction is associated with a variety of cardiac alterations including left ventricular (LV) hypertrophy, LV dilation, and reduction in systolic and diastolic function. It is common and associated with an increased mortality risk in heart failure (HF) patients. This study was designed to...... evaluate whether severe diastolic dysfunction contribute to the increased mortality risk observed in HF patients with renal dysfunction....

  12. Negative inotropic effects of recombinant interleukin 2 in patients without left ventricular dysfunction

    Tio, RA; Nieken, J; de Vries, EGE; Pfeiffer, C; de Jongste, MJL; Pieper, E; Moshage, H; Limburg, PC; Mulder, NH

    2000-01-01

    Experimental data have shown that rIL2 has negative inotropic properties. This has not been investigated in humans with normal left ventricular function. Seventeen consecutive renal cell carcinoma patients who received rIL2 therapy because of dissemination were analyzed before and after treatment wi

  13. Exercise in heart failure patients supported with a left ventricular assist device

    Jung, Mette Holme; Gustafsson, Finn

    2015-01-01

    After implantation of a continuous-flow left ventricular assist device (CF-LVAD), exercise capacity in heart failure patients remains reduced with peak oxygen uptake (peak VO2) values averaging from 11 to 20 ml/kg/min. Total cardiac output in CF-LVAD patients during exercise is predominantly...

  14. Changes in Fetal Left and Right Ventricular Strain Mechanics during Normal Pregnancy.

    Kapusta, L.; Mainzer, G.; Weiner, Z.; Deutsch, L.; Khoury, A.; Haddad, S.; Lorber, A.

    2013-01-01

    BACKGROUND: The aim of this study was to detect normal changes in fetal two-dimensional speckle-tracking echocardiography-derived values for global and regional longitudinal left and right ventricular strain, strain rate, and time to peak (T2P) global strain during pregnancy. METHODS: Forty-four hea

  15. Common variation neighbouring micro-RNA 22 is associated with increased left ventricular mass.

    Andrew R Harper

    Full Text Available AIMS: Previous genome-wide linkage analysis has suggested that chromosomal region 17p13.3 may harbour genes influencing left ventricular mass (LVM in man. To date, the genetic factors accounting for LVM variability remain largely unknown but a non-coding RNA gene within this region, micro-RNA 22 (miR-22, has been implicated in cardiac hypertrophy and heart failure in animal models. We thus investigated the relationship between common genetic polymorphisms surrounding miR-22 and left ventricular mass in a family-based association study. METHODS AND RESULTS: We studied a cohort of 255 families comprising 1,425 individuals ascertained via a hypertensive proband. Ten single nucleotide polymorphisms which together tagged common genetic variation surrounding the miR-22 gene were genotyped. There was evidence of association between the rs7223247 polymorphism, which lies within the 3'UTR of a gene of unknown function, TLCD2, immediately downstream from miR-22, and left ventricular mass determined by Sokolow-Lyon voltage (Bonferroni corrected p-value = 0.038. The T allele at rs7223247 was associated with an 0.272 standard deviation higher Sokolow-Lyon voltage. Genotype was responsible for ~1% of the population variability in LVM. CONCLUSIONS: Genotype at the rs7223247 polymorphism affects left ventricular mass determined by Sokolow-Lyon voltage. The neighbouring genes miR-22 and TLCD2 are strong candidates to account for this observation.

  16. Evaluation of left ventricular contractility in anterior old myocardial infarction using MRI

    Currently, interventional therapy is often performed for coronary artery disease. Therefore accurate diagnosis of myocardial viability is indispensable. One diagnostic method is measurement of systolic myocardial wall thickening. In the present study, we evaluated myocardial viability in terms of segmental wall thickening using MRI. We performed spin-echo MRI and cine MRI using the double oblique method in 20 patients with anterior old myocardial infarction to obtain the left ventricular long-axis view and four-chamber view. We found a good correlation (r=0.84) between the left ventricular long-axis view and four-chamber view. We found a good correlation (r=0.84) between the left ventricular ejection fraction and the mean percentage wall thickening. Wall thickening of the infarcted myocardium was classified into three patterns (hypokinesis, akinesis and dyskinesis). Akinetic segments were further divided into two classes: one where the wall was unchanged throughout systole and diastole, and the other where thickening was delayed after systole. The segments with delayed contraction showed accumulation of fluorine-18-labeled fluorodeoxyglucose (FDG) by positron emission tomography (PET) or normalized wall motion after PTCA. Therefore, we considered that the segment showing delayed contraction was visible, even if a constant defect was evident on the 201Tl scintigram. In conclusion, analysis of wall thickening using MRI is very useful for evaluating left ventricular contractility and viability. (author)

  17. Left ventricular dysfunction in normotensive type II diabetic patients in Port Harcourt, Nigeria

    Dodiyi-Manuel ST

    2013-09-01

    Full Text Available Sotonye T Dodiyi-Manuel,1 Maclean R Akpa,2 Osaretin J Odia2 1Department of Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria; 2Department of Medicine, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Nigeria Background: Diabetes mellitus (DM is on the increase globally. Cardiovascular complications, such as left ventricular dysfunction is a major cause of death in patients with type II DM. Prior to the development of symptomatic heart failure, subclinical left ventricular dysfunction (systolic and diastolic may exist for some time. Aim: The aim of the study was to determine the prevalence of left ventricular dysfunction in non-hypertensive type II DM patients. Methods: A cross sectional study of left ventricular function in 90 normotensive type II diabetes mellitus patients using echocardiography was carried out. Healthy normotensive controls matched for age, sex, and body mass index were selected for comparison. Patients and controls who had hypertension (blood pressure of >140/90 mmHg, history of smoking, significant alcohol history, pregnancy, features of thyroid disease, or valvular heart disease were excluded. Left ventricular diastolic and systolic functions were assessed. Results: Ninety patients, (39 males and 51 females and 90 healthy controls (39 males and 51 females were enrolled. Mean age of patients was 50.76 ± 9.13 years and 51.33 ± 7.84 years for controls. Mean body mass index was 26.88 ± 4.73 kg/m2 in patients and 27.09 ± 4.04 kg/m2 in controls. Mean ejection fraction was 62.4% ± 8.47% and 68.52% ± 7.94% in patients and controls, respectively (P 99 kg/m2 in females and >115 kg/m2 in males was considered abnormal. The left ventricular mass index was also higher in patients than in controls (95.17 ± 25.67 g/m2 versus 85.40 ± 18.0 g/m2; P = 0.004. Conclusion: Normotensive diabetic patients have a high prevalence of left ventricular dysfunction even in the absence of

  18. Subacute left ventricle free wall rupture after acute myocardial infarction: awareness of the clinical signs and early use of echocardiography may be life-saving

    Canada Manuel; Abecasis Miguel; Couto Rute; Aguiar Carlos; Ferreira Jorge; Andrade Maria; Raposo Luís; Jalles-Tavares Nuno; da Silva José

    2006-01-01

    Abstract Left ventricular free wall rupture (LVFWR) is a fearful complication of acute myocardial infarction in which a swift diagnosis and emergency surgery can be crucial for successful treatment. Because a significant number of cases occur subacutely, clinicians should be aware of the risk factors, clinical features and diagnostic criteria of this complication. We report the case of a 69 year-old man in whom a subacute left ventricular free wall rupture (LVFWR) was diagnosed 7 days after a...

  19. 24 hour ST segment analysis in transient left ventricular apical ballooning.

    Frank Bode

    Full Text Available OBJECTIVE: The etiologic basis of transient left ventricular apical ballooning, a novel cardiac syndrome, is not clear. Among the proposed pathomechanisms is coronary vasospasm. Long-term ST segment analysis may detect vasospastic episodes but has not been reported. METHODS: 30 consecutive patients with transient left ventricular apical ballooning, left ventricular dysfunction and normal or near-normal coronary arteries were investigated. A 24-hour Holter ECG was obtained after emergency admission. ST segment analysis was performed automatically in 2 leads and confirmed by visual inspection. Criteria for an ischemic event were: 1. ST elevation or 2. horizontal or down-sloping ST segments ≥1 min duration and ≥100 µV J+80 point deviation corrected for baseline ST-deviation. RESULTS: Patients presented with ST segment elevation (n = 19 and/or T wave inversion (n = 20 on admission ECG. Ejection fraction was 50±12%. No transient ST elevations were observed during Holter ECG analysis. In 3 patients, 8 transient episodes of ST depression were recorded. Durations of episodes varied between 75 s and 790 s (mean 229 s. Maximal ST deviation averaged -191±71 µV. Ischemic burden was -1 to -22 mVs (mean -8 mVs. 27 patients showed no ischemic events. CONCLUSIONS: ST segment analysis of 24 h Holter recordings revealed minor ischemic events in only 10% of patients with transient left ventricular apical ballooning. Overall, ST segment changes were not indicative of recurrent coronary spasm playing a major role in the genesis of transient left ventricular apical ballooning.

  20. Left Ventricular Function and Physiological Performance in Female Ironman Athletes and Female Police Officers.

    Leischik, Roman; Foshag, Peter; Strauss, Markus; Spelsberg, Norman

    2016-06-01

    Data about physiological performance of female ironman triathletes are rare. However, some studies have reported this endurance sport may cause damage to the right or left ventricles, even in females. The goal of this study was to assess prospectively the right/left ventricular function and physiological performance in female athletes (middle- and long ironman distance) and to compare the findings to female federal police officers. A total of 33 female triathletes and 37 female police officers were examined using spiro-ergometry and echocardiography. Female triathletes achieved VO2max 52.8 ± 5.7 ml/kg(-1)·min(-1), and police officers 35.3 ± 6.5 ml/kg(-1)·min(-1) In athletes, left ventricular end-diastolic diameter was 4.4 ± 0.3 cm and in police officers 4.5 ± 0.4 cm, and the left ventricular muscle mass index was 85.8 g/m(2 )± 18.7 in athletes and in police officers 72.0 g/m(2 )± 9.1. Right ventricular area change among athletes was 49.4 ± 8.5%, and in police officers 46.0 ± 6.9%. The performance date of female triathletes can be used as training prescription for leisure female triathletes, when middle or long distances in triathlon competitions are planned. No right or left ventricular dysfunction was found despite long training and finishing of long distance competitions: non-elite athletes, 5.4 ± 2.8 years of triathlon competitions; elite athletes, 7.6 ± 5.8 years. PMID:27207600

  1. Implications of abnormal right ventricular thallium uptake in acute myocardial infarction

    The correlates of abnormal right ventricular (RV) thallium uptake were examined in 116 patients with documented acute myocardial infarction (AMI) who underwent predischarge thallium-201 scintigraphy at rest, radionuclide angiography and 24-hour ambulatory electrocardiography. The patients were separated into 2 groups: patients group 1 (n = 31) had increased RV thallium uptake and those in group 2 (n = 85) had no such uptake. The 2 groups were comparable in age, type and site of AMI, peak creatine kinase level, systolic blood pressure and heart rate. However, compared with group 2, group 1 had a lower mean left ventricular (LV) ejection fraction (33 +/- 15% vs 39 +/- 14%, p less than 0.05), higher prevalence of increased lung thallium uptake (45% vs 22%, p less than 0.02), more extensive LV perfusion defects (4.4 +/- 2.9 vs 3.0 +/- 3.0 segments, p less than 0.03) and more complex ventricular arrhythmias (55% vs 35%, p less than 0.05). At a mean follow-up of 6 months, 17 patients (8 in group 1 and 9 in group 2) died from cardiac causes. Actuarial life-table analysis showed that the survival rate was better in group 2 than in group 1 (Mantel-Cox statistics = 4.62, p = 0.03). Thus, patients with AMI and abnormal RV thallium uptake have worse LV function, more complex ventricular arrhythmias and worse prognosis

  2. Left ventricular wall motion abnormalities evaluated by factor analysis as compared with Fourier analysis

    Factor analysis was applied to multigated cardiac pool scintigraphy to evaluate its ability to detect left ventricular wall motion abnormalities in 35 patients with old myocardial infarction (MI), and in 12 control cases with normal left ventriculography. All cases were also evaluated by conventional Fourier analysis. In most cases with normal left ventriculography, the ventricular and atrial factors were extracted by factor analysis. In cases with MI, the third factor was obtained in the left ventricle corresponding to wall motion abnormality. Each case was scored according to the coincidence of findings of ventriculography and those of factor analysis or Fourier analysis. Scores were recorded for three items; the existence, location, and degree of asynergy. In cases of MI, the detection rate of asynergy was 94 % by factor analysis, 83 % by Fourier analysis, and the agreement in respect to location was 71 % and 66 %, respectively. Factor analysis had higher scores than Fourier analysis, but this was not significant. The interobserver error of factor analysis was less than that of Fourier analysis. Factor analysis can display locations and dynamic motion curves of asynergy, and it is regarded as a useful method for detecting and evaluating left ventricular wall motion abnormalities. (author)

  3. Evaluation of left ventricular remodeling and function by quantitative real-time three-dimensional echocardiography in patients with acute myocardial infarction%实时三维超声定量评价急性心肌梗死左室重构及功能

    郑丽; 黄国倩; 王成

    2011-01-01

    目的 运用实时三维超声心动图(RT-3DE)定量评价急性心肌梗死(AMI)患者左室重构及功能.方法 根据冠脉造影结果将35例AMI患者分为3个亚组:A组(n=9)为左前降支未受累,B组(n=9)为左前降支病变,C组(n=17)为包含左前降支在内的2支以上血管病变;正常对照组29例.分别应用二维超声心动图(2DE)双平面Simpson's法和RT-3DE对左室容积及功能进行分析评价.结果 RT-3DE与Simpson's法在正常对照组中所得结果差异无统计学意义(P>0.05);在AMI组中,Simpson's法的测量值左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)偏低,左室整体射血分数(EF)偏高(P0.05),而C组经Simpson's法测量的LVEDV、LVESV明显偏低,EF明显偏高(P<0.01).AMI各组间RT-3DE测量值比较结果显示,C组的LVEDV、LVESV明显高于A、B组,EF明显低于A、B组(P<0.01).结论 RT-3DE能够无创、简便、较准确地定量评价AMI患者左室重构和心功能改变,对于包含左前降支的多支冠脉病变及程度较重的患者具有一定的临床意义.%Objective To investigate the application of quantitive real-time three-dimensional echocardiography ( RT-3 DE) in evaluation of left ventricular remodeling and function in patients with acute myocardial infarction (AMI). Methods Thirty-five patients with AMI ( AMI group) were divided into 3 subgroups according to the results of coronary angiography.In subgroup A ( n = 9), left anterior descending artery was not involved; in subgroup B (n = 9), only left anterior descending artery was involved; and in subgroup C ( n = 17), left anterior descending artery was involved in multi-vessel disease. Besides, 29 healthy subjects were served as normal controls. Left ventricular volume and left ventricular function were measured by two-dimensional echocardiography (2DE) biplane Simpson's method and RT-3DE. Results There was no significant difference between the findings of RT-3DE and those of Simpson's methods in normal

  4. The study of left ventricular diastolic function by Doppler echocardiography: the essential for the clinician

    Livio Dei Cas

    2007-06-01

    Full Text Available An abnormal diastolic function of left ventricle represents the main pathophysiological mechanism responsible for different clinical states such as restrictive cardiomyopathy, infiltrative myocardial disease and, specially, diastolic heart failure (also called heart failure with preserved systolic function, which is present in a large number of patients with a clinical picture of pulmonary congestion. Although the invasive approach, through cardiac catheterization allowing the direct measurement of left ventricular filling pressure, myocardial relaxation and compliance, is considered the gold standard for the identification of diastolic dysfunction, several noninvasive methods have been proposed for the study of left ventricular diastolic function. Doppler echocardiography represents an excellent noninvasive technique to fully characterize the diastolic function in health and disease. (Heart International 2007; 3: 42-50

  5. Quantitation of left ventricular dimensions and function by digital video subtraction angiography

    Higgins, C.B.; Norris, S.L.; Gerber, K.H.; Slutsky, R.A.; Ashburn, W.L.; Baily, N.

    1982-08-01

    Digital video subtraction angiography (DVSA) after central intravenous administration of contrast media was used in experimental animals and in patients with suspected coronary artery disease to quantitate left ventricular dimensions and regional and global contractile function. In animals, measurements of left ventricular (LV) volumes, wall thickness, ejection fraction, segmental contraction, and cardiac output correlated closely with sonocardiometry or thermodilution measurements. In patients, volumes and ejection fractions calculated from mask mode digital images correlated closely with direct left ventriculography. Global and segmental contractile function was displayed in patients by ejection shell images, stroke volume images, and time interval difference images. Central cardiovascular function was also quantitated by measurement of pulmonary transit time and calculation of pulmonary blood volume from digital fluoroscopic images. DVSA was shown to be useful and accurate in the quantitation of central cardiovascular physiology.

  6. Contemporary management of acute right ventricular failure: a statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology.

    Harjola, Veli-Pekka; Mebazaa, Alexandre; Čelutkienė, Jelena; Bettex, Dominique; Bueno, Hector; Chioncel, Ovidiu; Crespo-Leiro, Maria G; Falk, Volkmar; Filippatos, Gerasimos; Gibbs, Simon; Leite-Moreira, Adelino; Lassus, Johan; Masip, Josep; Mueller, Christian; Mullens, Wilfried; Naeije, Robert; Nordegraaf, Anton Vonk; Parissis, John; Riley, Jillian P; Ristic, Arsen; Rosano, Giuseppe; Rudiger, Alain; Ruschitzka, Frank; Seferovic, Petar; Sztrymf, Benjamin; Vieillard-Baron, Antoine; Yilmaz, Mehmet Birhan; Konstantinides, Stavros

    2016-03-01

    Acute right ventricular (RV) failure is a complex clinical syndrome that results from many causes. Research efforts have disproportionately focused on the failing left ventricle, but recently the need has been recognized to achieve a more comprehensive understanding of RV anatomy, physiology, and pathophysiology, and of management approaches. Right ventricular mechanics and function are altered in the setting of either pressure overload or volume overload. Failure may also result from a primary reduction of myocardial contractility owing to ischaemia, cardiomyopathy, or arrhythmia. Dysfunction leads to impaired RV filling and increased right atrial pressures. As dysfunction progresses to overt RV failure, the RV chamber becomes more spherical and tricuspid regurgitation is aggravated, a cascade leading to increasing venous congestion. Ventricular interdependence results in impaired left ventricular filling, a decrease in left ventricular stroke volume, and ultimately low cardiac output and cardiogenic shock. Identification and treatment of the underlying cause of RV failure, such as acute pulmonary embolism, acute respiratory distress syndrome, acute decompensation of chronic pulmonary hypertension, RV infarction, or arrhythmia, is the primary management strategy. Judicious fluid management, use of inotropes and vasopressors, assist devices, and a strategy focusing on RV protection for mechanical ventilation if required all play a role in the clinical care of these patients. Future research should aim to address the remaining areas of uncertainty which result from the complexity of RV haemodynamics and lack of conclusive evidence regarding RV-specific treatment approaches. PMID:26995592

  7. C-reactive protein, renal function, and cardiovascular outcome in patients with symptomatic peripheral artery disease and preserved left ventricular systolic function

    Vrsalović, Mislav; Vučur, Ksenija; Car, Boris; Krčmar, Tomislav; Vrsalović Presečki, Ana

    2015-01-01

    Aim To investigate the prognostic role of C-reactive protein (CRP) and renal function for the occurrence of major adverse cardiovascular events (MACE) in patients with symptomatic peripheral artery disease (PAD) and preserved left ventricular ejection fraction (LVEF). Methods The occurrence of MACE, defined as composite endpoint of acute myocardial infarction, urgent coronary revascularization, stroke, and death was assessed in 319 consecutive PAD patients admitted to the University Hospital ...

  8. Percutaneous septal ablation for left mid-ventricular obstructive hypertrophic cardiomyopathy: a case report

    Alioglu Emin

    2006-04-01

    Full Text Available Abstract Background Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHC is a rare type of cardiomyopathy. The diagnosis is based on the hourglass appearance on the left ventriculogram and the presence of pressure gradient between apical and basal chamber of the ventriculum on the hemodynamic assessment. Case presentation The present case represents successful percutaneous treatment with septal ablation to patient with MVOHC associated with systolic anterior motion of the mitral valve and obstruction at both the mid-ventricular and outflow levels. Conclusion Alcohol septal ablation has been proposed as less invasive alternatives to surgery in patients with MVOHC.

  9. Assessment of vasodilator therapy in patients with severe congestive heart failure: limitations of measurements of left ventricular ejection fraction and volumes

    Although noninvasive techniques are often used to assess the effect of vasodilator therapy in patients with congestive heart failure, it is unknown whether changes in noninvasively determined left ventricular ejection fraction, volume, or dimension reliably reflect alterations in intracardiac pressure and flow. Accordingly, we compared the acute effect of sodium nitroprusside on left ventricular volume and ejection fraction (determined scintigraphically) with its effect on intracardiac pressure and forward cardiac index (determined by thermodilution) in 12 patients with severe, chronic congestive heart failure and a markedly dilated left ventricle. Nitroprusside (infused at 1.3 +/- 1.1 [mean +/- standard deviation] microgram/kg/min) caused a decrease in mean systemic arterial, mean pulmonary arterial, and mean pulmonary capillary wedge pressure as well as a concomitant increase in forward cardiac index. Simultaneously, left ventricular end-diastolic and end-systolic volume indexes decreased, but the scintigraphically determined cardiac index did not change significantly. Left ventricular ejection fraction averaged 0.19 +/- 0.05 before nitroprusside administration and increased by less than 0.05 units in response to nitroprusside in 11 of 12 patients. The only significant correlation between scintigraphically and invasively determined variables was that between the percent change in end-diastolic volume index and the percent change in pulmonary capillary wedge pressure (r . 0.68, p . 0.01). Although nitroprusside produced changes in scintigraphically determined left ventricular ejection fraction, end-systolic volume index, and cardiac index, these alterations bore no predictable relation to changes in intracardiac pressure, forward cardiac index, or vascular resistance. Furthermore, nitroprusside produced a considerably greater percent change in the invasively measured variables than in the scintigraphically determined ones

  10. Assessment of vasodilator therapy in patients with severe congestive heart failure: limitations of measurements of left ventricular ejection fraction and volumes

    Firth, B.G.; Dehmer, G.J.; Markham, R.V. Jr.; Willerson, J.T.; Hillis, L.D.

    1982-11-01

    Although noninvasive techniques are often used to assess the effect of vasodilator therapy in patients with congestive heart failure, it is unknown whether changes in noninvasively determined left ventricular ejection fraction, volume, or dimension reliably reflect alterations in intracardiac pressure and flow. Accordingly, we compared the acute effect of sodium nitroprusside on left ventricular volume and ejection fraction (determined scintigraphically) with its effect on intracardiac pressure and forward cardiac index (determined by thermodilution) in 12 patients with severe, chronic congestive heart failure and a markedly dilated left ventricle. Nitroprusside (infused at 1.3 +/- 1.1 (mean +/- standard deviation) microgram/kg/min) caused a decrease in mean systemic arterial, mean pulmonary arterial, and mean pulmonary capillary wedge pressure as well as a concomitant increase in forward cardiac index. Simultaneously, left ventricular end-diastolic and end-systolic volume indexes decreased, but the scintigraphically determined cardiac index did not change significantly. Left ventricular ejection fraction averaged 0.19 +/- 0.05 before nitroprusside administration and increased by less than 0.05 units in response to nitroprusside in 11 of 12 patients. The only significant correlation between scintigraphically and invasively determined variables was that between the percent change in end-diastolic volume index and the percent change in pulmonary capillary wedge pressure (r . 0.68, p . 0.01). Although nitroprusside produced changes in scintigraphically determined left ventricular ejection fraction, end-systolic volume index, and cardiac index, these alterations bore no predictable relation to changes in intracardiac pressure, forward cardiac index, or vascular resistance. Furthermore, nitroprusside produced a considerably greater percent change in the invasively measured variables than in the scintigraphically determined ones.

  11. Application of quantitative radioisotope angiocardiography (QRA) with transesophageal left atrium pacing for the assessment of the effect of sustained-release verapamil on left ventricular function

    The aim of the study was a comparative analysis of global and regional left ventricular function indices in patients with chronic coronary artery disease without myocardial infarction before and after one-month-long treatment with sustained-release verapamil (SR verapamil). The studies were performed in 20 patients with significant changes in coronarography. Left ventricular function was assessed by means of quantitative radioisotope angiocardiography (QRA) at rest, during, and directly after fast transoesophageal left atrium pacing. Before administration of the drug the left ventricular function parameters at rest were normal. At the peak and directly after the pacing the mean values decreased significantly of the global indices of ejection phase. SR verapamil at rest improved significantly the parameters of left ventricular filling phase but deteriorated the parameters of ejection phase. In conditions of transient myocardial ischaemia (during and directly after pacing) the drug decreased significantly the extent of reversible ischaemic left ventricular dysfunction. However, the regional indices of both cardiac cycle phases were not decreased during all stages of left ventricular function study in the patients before and after the treatment with SR verapamil

  12. Geometrical models of left ventricular contraction from MRI of the normal and spontaneously hypertensive rat heart

    This study develops a quantitative analysis and model for the differences in left ventricular dynamics in normal and spontaneously hypertensive rats, as determined using non-invasive magnetic resonance imaging (MRI). We emerge with a characterization of the geometrical changes in the left ventricle resulting from hypertension. In addition, the techniques we have adopted are potentially applicable to the study of other disease models for important human cardiac pathologies. A gradient-echo multislice imaging sequence (echo time 4.3 ms) achieved complete image coverage of the heart at high time resolution (13 ms) through the cardiac cycle. Cardiac anatomy in two age-matched groups of young adult (8 and 12 weeks old) normal Wistar-Kyoto (WKY, n=8) and spontaneously hypertensive rats (SHR, n=8) was imaged in synchrony with the electrocardiographic R wave in defined planes both parallel and perpendicular to the principal cardiac axis. The transverse left ventricular image sections were circularly symmetrical; this permitted application of different analytical models for the three-dimensional geometry of the epi- and endocardial borders. An ellipsoidal figure of revolution offered an effective description of the three-dimensional left ventricular geometry throughout the cardiac cycle in both normal WKY and SHR animals. The model successfully characterized both the changes in the shape of the left ventricle through the cardiac cycle and the pathological alterations resulting from spontaneous hypertension. The elliptical model also formed the basis of a simple stress distribution analysis. Such parametric descriptions thus provided a useful alternative to more complex finite element analyses of cardiac function. The eccentricity of the ventricle was characterized by an ellipticity factor a, where a=1 for a sphere and a<1 for a prolate ellipsoid. At end systole, the endocardial surface of the left ventricle gave a=0.43±0.02 and 0.49±0.02 for the WKY and SHR animals

  13. RARE ANOMALY OF THE CORONARY VESSELS: CORONARY AND LEFT VENTRICULAR FISTULAS

    L. V. Salamatina

    2015-01-01

    Full Text Available Study objective: description of the case of diagnostics of rare anomaly of the coronary vessels: coronary and left ventricular fistulas.Materials and methods. Patient L., 45 y.o. (height 168 cm, weight 55 kg, male, complained of periodical burning pain behind the breastbone without connection with physical activity, often disturbing at night, stopped with intake of nitrates. The following examination of the patient was performed: clinical and biochemical blood tests, electrocardiography (ECG, Holter ECG monitoring, bicycle ergometry, echocardiography, coronary angiography, computerized tomography.Results. The following clinical diagnosis was set on the basis of complaints. data of objective and instrumental examination: congenital heart disease. Abnormal end of the coronary arteries: multiple coronary and left ventricular fistulas, steal syndrome. Hypoplasia of the right coronary artery (Q 24.5 in accordance with the International Classification of Diseases, revision 10. Coronary angiography has become the main diagnostic method that allowed diagnosis verification: left type of coronary blood circulation. The trunk of the left coronary artery, the anterior interventricular branch,  he diagonal branch, the envelope branch, the obtuse marginal branch, the right coronary artery, the posterior interventricular branch have with irregular contours. Direct abnormal connection (dense grid of fistulas is observed in the medium and lower third of the anterior interventricular branch with the left ventricle cavity. The contrast agent practically completely comes into the left ventricular cavity. The parenchymal phase is very well expressed; the venous phase is not visualized. Conclusion. Congenital heart disease: multiple coronary and left ventricular fistulas. No angiographic evidence of hemodynamically significant stenotic coronary lesions.Conclusion. The practical interest of this observation is due to rarity of disease, analysis of modern

  14. RARE ANOMALY OF THE CORONARY VESSELS: CORONARY AND LEFT VENTRICULAR FISTULAS

    L. V. Salamatina

    2014-01-01

    Full Text Available Study objective: description of the case of diagnostics of rare anomaly of the coronary vessels: coronary and left ventricular fistulas.Materials and methods. Patient L., 45 y.o. (height 168 cm, weight 55 kg, male, complained of periodical burning pain behind the breastbone without connection with physical activity, often disturbing at night, stopped with intake of nitrates. The following examination of the patient was performed: clinical and biochemical blood tests, electrocardiography (ECG, Holter ECG monitoring, bicycle ergometry, echocardiography, coronary angiography, computerized tomography.Results. The following clinical diagnosis was set on the basis of complaints. data of objective and instrumental examination: congenital heart disease. Abnormal end of the coronary arteries: multiple coronary and left ventricular fistulas, steal syndrome. Hypoplasia of the right coronary artery (Q 24.5 in accordance with the International Classification of Diseases, revision 10. Coronary angiography has become the main diagnostic method that allowed diagnosis verification: left type of coronary blood circulation. The trunk of the left coronary artery, the anterior interventricular branch,  he diagonal branch, the envelope branch, the obtuse marginal branch, the right coronary artery, the posterior interventricular branch have with irregular contours. Direct abnormal connection (dense grid of fistulas is observed in the medium and lower third of the anterior interventricular branch with the left ventricle cavity. The contrast agent practically completely comes into the left ventricular cavity. The parenchymal phase is very well expressed; the venous phase is not visualized. Conclusion. Congenital heart disease: multiple coronary and left ventricular fistulas. No angiographic evidence of hemodynamically significant stenotic coronary lesions.Conclusion. The practical interest of this observation is due to rarity of disease, analysis of modern

  15. Factor analysis in left ventricular first-pass radionuclide angiography: value of the ventricular factor to measure ejection fraction

    Factor analysis theoretically generates the time-activity curves of the various physiological compartments, or factors, which are superimposed in a dynamic series of scintigraphic frames. An image of the spatial distribution of each of these factors is also displayed. We tested the ability of one of these, the ventricular factor, to measure the left ventricular ejection fraction (LVEF) in first-pass radionuclide angiography (FPRA). Forty-nine patients divided into three groups were studied. In a group of 32 patients, factor analysis was compared to a conventional scintigraphic method and to contrast angiography. The coefficient of correlation was similar for both techniques (r = 0.83). To test reproducibility, another group of 10 patients received two successive injections of Au-195m, three minutes apart. The reproducibility of LVEF was r = 0.78 with factor analysis and r = 0.81 with the conventional method. In a third group of seven patients, three successive injections of Au-195m were performed in the right and in the left anterior oblique projections. The reproducibility of LVEF was r = 0.71 with factor analysis. However, LVEF was significantly lower in LAO than in RAO, 50 +/- 11% vs 58 +/- 17% respectively. It is concluded that factor analysis does not offer a more reliable means of calculating LVEF than a conventional method

  16. Outcome of Prolonged Ventricular Fibrillation and CPR in a Rat Model of Chronic Ischemic Left Ventricular Dysfunction

    Xiangshao Fang

    2013-01-01

    Full Text Available Patients with chronic left ventricular (LV dysfunction are assumed to have a lower chance of successful CPR and lower likelihood of ultimate survival. However, these assumptions have rarely been documented. Therefore, we investigated the outcome of prolonged ventricular fibrillation (VF and CPR in a rat model of chronic LV dysfunction. Sprague-Dawley rats were randomized to (1 chronic LV dysfunction: animals underwent left coronary artery ligation; and (2 sham control. Echocardiography was used to measure cardiac performance before surgery and 4 weeks after surgery. Four weeks after surgical intervention, 8 min of VF was induced and defibrillation was delivered after 8 min of CPR. LV dilation and low ejection fraction were observed 4 weeks after coronary ligation. With optimal chest compressions, coronary perfusion pressure values during CPR were well maintained and indistinguishable between groups. There were no differences in resuscitability and numbers of shock required for successful resuscitation between groups. Despite the significantly decreased cardiac index in LV dysfunction animals before induction of VF, no differences in cardiac index were observed between groups following resuscitation, which was associated with the insignificant difference in postresuscitation survival. In conclusion, the outcomes of CPR were not compromised by the preexisting chronic LV dysfunction.

  17. Natriuretic peptide vs. clinical information for diagnosis of left ventricular systolic dysfunction in primary care

    Wachter Rolf

    2008-02-01

    Full Text Available Abstract Background Screening of primary care patients at risk for left ventricular systolic dysfunction by a simple blood-test might reduce referral rates for echocardiography. Whether or not natriuretic peptide testing is a useful and cost-effective diagnostic instrument in primary care settings, however, is still a matter of debate. Methods N-terminal pro-brain natriuretic peptide (NT-proBNP levels, clinical information, and echocardiographic data of left ventricular systolic function were collected in 542 family practice patients with at least one cardiovascular risk factor. We determined the diagnostic power of the NT-proBNP assessment in ruling out left ventricular systolic dysfunction and compared it to a risk score derived from a logistic regression model of easily acquired clinical information. Results 23 of 542 patients showed left ventricular systolic dysfunction. Both NT-proBNP and the clinical risk score consisting of dyspnea at exertion and ankle swelling, coronary artery disease and diuretic treatment showed excellent diagnostic power for ruling out left ventricular systolic dysfunction. AUC of NT-proBNP was 0.83 (95% CI, 0.75 to 0.92 with a sensitivity of 0.91 (95% CI, 0.71 to 0.98 and a specificity of 0.46 (95% CI, 0.41 to 0.50. AUC of the clinical risk score was 0.85 (95% CI, 0.79 to 0.91 with a sensitivity of 0.91 (95% CI, 0.71 to 0.98 and a specificity of 0.64 (95% CI, 0.59 to 0.67. 148 misclassifications using NT-proBNP and 55 using the clinical risk score revealed a significant difference (McNemar test; p Conclusion The evaluation of clinical information is at least as effective as NT-proBNP testing in ruling out left ventricular systolic dysfunction in family practice patients at risk. If these results are confirmed in larger cohorts and in different samples, family physicians should be encouraged to rely on the diagnostic power of the clinical information from their patients.

  18. Left ventricular diastolic dysfunction and N-terminal probrain sodium-uretic peptid level in patients with atrial fibrillation

    Dzyak G.V.

    2013-06-01

    Full Text Available In our study 100 consecutive non-valvular permanent atrial fibrillation patients with NYHA I – III heart failure, 43 - 86 years old (65 men and 35 women were examined. Control group consisted of 30 patients with arterial hypertension and coronary artery disease matched by age, sex with basic group. Relationship of NT-proBNP with echocardiographic parameters of left heart were studied. Transthoracic echocardiography with tissue doppler measurements were performed on echocardiograph “SONOS 7500”. For left ventricular filling pressure assessment ratio Em/Ea was used due to its diagnostic value in atrial fibrillation (regardless of left ventricular ejection fraction. Mean left ventricular filling pressure was increased in patients with heart failure: in atrial fibrillation group and controls as well. In comparison with controls atrial fibrillation group was more likely to have higher both systolic and diastolic left atrial square and volume. According to Em/Ea in 95% of patients with non-valvular atrial fibrillation high left ventricular filling pressure was observed, this testifies to diastolic dysfunction. This parameter correlated well with left atrial square and volume during systole and diastole. Correlation between NT pro-BNP level and NYHA class of heart failure, left ventricular filling pressure was determined in patients with atrial fibrillation. Tissue doppler echocardiography makes it possible to diagnose left ventricular diastolic dysfunction in atrial fibrillation patients.

  19. Takotsubo cardiomyopathy recurrence with left ventricular apical ballooning following isolated right ventricular involvement: A case report

    JOE, BYUNG-HYUN; HWANG, HUI-JEONG; PARK, CHANG-BUM; JIN, EUN-SUN; SOHN, IL-SUK; CHO, JIN-MAN; KIM, CHONG-JIN

    2013-01-01

    We report a case of Takotsubo cardiomyopathy, which involved the right ventricle at first presentation and demonstrated involvement of the left ventricle during recurrence. The patient was admitted to Kyung Hee University Hospital due to a left hip fracture, which was considered a result of physical stress. Complete recovery was confirmed by echocardiography prior to recurrence. The cause of the second event was surgery for the left hip fracture. Recurrence of Takotsubo cardiomyopathy at various cardiac locations provides evidence against the existing hypotheses that variants of Takotsubo cardiomyopathy are associated with anatomically different distributions of cardiac adrenergic receptors, the degree of stimulation by sympathetic activity and different susceptibilities to such sympathetic stimulation. PMID:23935757

  20. Remodeling after acute myocardial infarction: mapping ventricular dilatation using three dimensional CMR image registration

    O’Regan Declan P

    2012-06-01

    Full Text Available Abstract Background Progressive heart failure due to remodeling is a major cause of morbidity and mortality following myocardial infarction. Conventional clinical imaging measures global volume changes, and currently there is no means of assessing regional myocardial dilatation in relation to ischemic burden. Here we use 3D co-registration of Cardiovascular Magnetic Resonance (CMR images to assess the long-term effects of ischemia-reperfusion injury on left ventricular structure after acute ST-elevation myocardial infarction (STEMI. Methods Forty six patients (age range 33–77 years underwent CMR imaging within 7 days following primary percutaneous coronary intervention (PPCI for acute STEMI with follow-up at one year. Functional cine imaging and Late Gadolinium Enhancement (LGE were segmented and co-registered. Local left ventricular wall dilatation was assessed by using intensity-based similarities to track the structural changes in the heart between baseline and follow-up. Results are expressed as means, standard errors and 95% confidence interval (CI of the difference. Results Local left ventricular remodeling within infarcted myocardium was greater than in non-infarcted myocardium (1.6% ± 1.0 vs 0.3% ± 0.9, 95% CI: -2.4% – -0.2%, P = 0.02. One-way ANOVA revealed that transmural infarct thickness had a significant effect on the degree of local remodeling at one year (P 20% (4.8% ± 1.4 vs −0.15% ± 1.2, 95% CI: -8.9% – -0.9%, P = 0.017. Conclusions The severity of ischemic injury has a significant effect on local ventricular wall remodeling with only modest dilatation observed within non-ischemic myocardium. Limitation of chronic remodeling may therefore depend on therapies directed at modulating ischemia-reperfusion injury. CMR co-registration has potential for assessing dynamic changes in ventricular structure in relation to therapeutic interventions.

  1. A microcomputerized system of nuclear probe for left ventricular function evaluation

    In this work, it is presented the development of a system, consisting in a nuclear probe and a 16 bits microcomputer, for left ventricular function (LVF) monitoring and analysis. Previously used in renal and thyroid studies, the nuclear probe, 2''x2''NaI(Tl) crystal, was adapted for its new application. The alterations include the design and construction of appropriate colimators and unterfacing to a strip-chart register and a magnetic tape recorder. After a single injection of Tc-99m labelling red blood cells, the probe is placed over the patient's chest on a convenient left anterior oblique position and a left ventricle time activity curve is obtained. This curve and the patient's eletrocardiogram (ECG) are recorded for posterior processing. The software, in PASCAL language, transfers the data from the magnetic tape to the microcomputer and provides the LVF and ECG curves to be displayed on beat-to-beat mode or as mean curves. From these curves one can extract ventricular parameter such as: ejection fraction, ejection rate, systolic and diastolic intervals and heart rate, by manually positioning three cursors on the points of interest. A critical evaluation of this method is performed and its advantages as well as its limitations are discussed. This approach provides an easy to operate and a low cost device that can be useful in many clinical situations, for example, the continuous monitoring in ICUs, the screening in out-patient departments. The assessment of drugs effects on left ventricular function is also possible. (author)

  2. Traumatic left ventricular aneurysm revealed by systemic embolism. Interest of Indium 111 labelled platelets scintigraphy

    Vahanian, A.; Villemant, D.; Grimberg, F.; Farah, E.; Acar, J.; Drouet, L.

    1984-01-01

    A case of traumatic left ventricular aneurysm, presenting with recurrent cerebral embolism, 36 years after a thoraco-brachial bullet wound was reported. The 58 year old man had no symptoms of angina or particular cardiovascular risk factors. The ECG showed changes of chronic anterior wall infarction, observed 10 years previously on a routine preoperative recording. There was a calcified circular para-apical shadow on chest X-Ray. The antero-apical region showed hypofixation on myocardial scintigraphy, and hypokinesia on isotopic angiography. The coronary arteries were normal. Indium 111 platelet marking revealed a focus of hyperfixation within the left ventricle. At surgery, a true calcific para-apical left ventricular aneurysm was discovered, containing a fresh thrombus. This lesion was resected. Peroperative Indium 111 platelet test confirmed that the thrombus was the site of high uptake. The surgical result was good at 6 months follow-up. This case illustrates: the value of the Indium test which would appear to be a very specific and sensitive method of detecting intraventricular thrombi. This test, which appreciates the thrombolic activy of intracardiac masses is a useful complement to other non-invasive methods such as 2D echocardiography; the special characteristics of post-trauma left ventricular aneurysms which are rare, often diagnosed late, at the time of complications such as systemic embolism, commonly pose medico-legal problems, and for which surgical treatment seems to be indicated in symptomatic patients.

  3. Forgetting heart break: a fascinating case of transient left ventricular apical ballooning syndrome associated with dissociative amnesia.

    Toussi, Amir; Bryk, Jodie; Alam, Abdulkader

    2014-01-01

    Transient left ventricular apical ballooning syndrome (TLVABS), also known as takotsubo cardiomyopathy, is characterized by transient left ventricular dysfunction, electrocardiographic changes, and release of myocardial enzymes that mimic acute myocardial infarction in patients without angiographic evidence of coronary artery disease. Most patients are post-menopausal women and an emotional or physiologic stressor frequently precedes the presentation. Psychogenic or dissociative amnesia is a memory disorder characterized by sudden retrograde memory loss with inability to recall personal information said to occur for a period of time ranging from hours to years after a stressful event. Interestingly, the mechanism of both disorders has been linked to plasma elevation in catecholamines. Here we present the case of a 66-year-old female diagnosed with both TLVABS and dissociative amnesia following the sudden unexpected death of her sister. To our knowledge, this is surprisingly the first report of the co-occurrence of TLVABS and dissociative amnesia, two processes with a potential shared underlying etiology. PMID:24238814

  4. Relation of left ventricular function, mass, and volume to NT-proBNP in type 1 diabetic patients

    Astrup, Anne Sofie; Kim, Won Yong; Tarnow, Lise;

    2008-01-01

    OBJECTIVES-To measure left ventricular mass (LVM), left ventricular volumes, and left ventricular function (LVF) in a cohort of type 1 diabetic patients and to correlate measures of imaging to NH2-terminal pro-brain natriuretic peptide (NT-proBNP). RESEARCH DESIGN AND METHODS-In a cross-sectional......OBJECTIVES-To measure left ventricular mass (LVM), left ventricular volumes, and left ventricular function (LVF) in a cohort of type 1 diabetic patients and to correlate measures of imaging to NH2-terminal pro-brain natriuretic peptide (NT-proBNP). RESEARCH DESIGN AND METHODS-In a cross...... with patients with persistent normoalbuminuria. Patients with nephropathy had smaller left ventricular volumes and increased levels of NT-proBNP. Linear regression analysis in patients with diabetic nephropathy showed that NT-proBNP and creatinine were associated with LVM. CONCLUSIONS-Increased LVM...... is identified in asymptomatic type 1 diabetic patients with nephropathy compared with normoalbuminuric patients. Elevated levels of NT-proBNP were associated with increased LVM, which are both markers of increased cardiovascular risk....

  5. Impact on Left Ventricular Function and Remodeling and on 1-Year Outcome in Patients With Left Bundle Branch Block After Transcatheter Aortic Valve Implantation.

    Carrabba, Nazario; Valenti, Renato; Migliorini, Angela; Marrani, Marco; Cantini, Giulia; Parodi, Guido; Dovellini, Emilio Vincenzo; Antoniucci, David

    2015-07-01

    Conflicting results have been reported about the prognostic impact of left bundle branch block (LBBB) after transcatheter aortic valve implantation (TAVI). The aim of this study was to evaluate the impact of LBBB after TAVI on left ventricular (LV) function and remodeling and on 1-year outcomes. Of 101 TAVI patients, 9 were excluded. All complications were evaluated according to the Valve Academic Research Consortium 2 definition. Of 92 patients, 34 developed LBBB without more advanced myocardial damage or inflammation biomarkers in comparison with patients without LBBB. The only predictor of new LBBB was larger baseline LV end-diastolic volume. LBBB plus advanced atrioventricular block was strongly correlated with permanent pacemaker implantation (p reverse remodeling at 1 year. The development of acute kidney injury and the logistic European System for Cardiac Operative Risk Evaluation score were associated with poor outcomes (all-cause mortality and heart failure) (hazard ratio 6.86, 95% confidence interval 2.51 to 18.74, p <0.0001, and hazard ratio 1.04, 95% confidence interval 1.01 to 1.08, p = 0.021, respectively), but not LBBB. In conclusion, after TAVI, 37% of patients developed new LBBB without more advanced myocardial damage or inflammation biomarkers. LBBB was associated with a higher rate of permanent pacemaker implantation, which negatively affected the recovery of LV systolic function. The development of acute kidney injury, rather than LBBB, increases the 1-year risk for mortality and hospitalization for heart failure. PMID:25937352

  6. Left ventricular T2 distribution in Duchenne Muscular Dystrophy

    Hagenbuch Sean

    2010-03-01

    Full Text Available Abstract Background Although previous studies have helped define the natural history of Duchenne Muscular Dystrophy (DMD-associated cardiomyopathy, the myocardial pathobiology associated with functional impairment in DMD is not yet known. The objective of this study was to assess the distribution of transverse relaxation time (T2 in the left ventricle (LV of DMD patients, and to determine the association of myocardial T2 heterogeneity to the severity of cardiac dysfunction. DMD patients (n = 26 and normal control subjects (n = 13 were studied by Cardiovascular Magnetic Resonance (CMR. DMD subject data was stratified based on subject age and LV Ejection Fraction (EF into the following groups: A (12 years, n = 5. LV mid-slice circumferential myocardial strain (εcc was calculated using tagged CMR imaging. T2 maps of the LV were generated for all subjects using a black blood dual spin echo method at two echo times. The Full Width at Half Maximum (FWHM was calculated from a histogram of LV T2 distribution constructed for each subject. Results In DMD subject groups, FWHM of the T2 histogram rose progressively with age and decreasing EF (Group A FWHM= 25.3 ± 3.8 ms; Group B FWHM= 30.9 ± 5.3 ms; Group C FWHM= 33.0 ± 6.4 ms. Further, FWHM was significantly higher in those with reduced circumferential strain (|εcc| ≤ 12% (Group B, and C than those with |εcc| > 12% (Group A. Group A FWHM was not different from the two normal groups (N1 FWHM = 25.3 ± 3.5 ms; N2 FWHM= 24.0 ± 7.3 ms. Conclusion Reduced EF and εcc correlates well with increased T2 heterogeneity quantified by FWHM, indicating that subclinical functional impairments could be associated with pre-existing abnormalities in tissue structure in young DMD patients.

  7. Left ventricular function during lethal and sublethal endotoxemia in swine

    Previous studies suggested that after a median lethal dose (LD50) of endotoxin, cardiac contractility was depressed in nonsurviving dogs. The canine cardiovascular system is unlike humans in that dogs have a hepatic vein sphincter that is susceptible to adrenergic stimulation capable of raising hepatic and splanchnic venous pressures. The authors retested the hypothesis that lethality after endotoxin administration is associated with cardiac contractile depression in pigs, because of the hepatic circulation in this species is similar to that of humans. They compared cardiac mechanical function of pigs administered a high dose (250 μg/kg) or a low dose (100 μg/kg) endotoxin by use of the slope of the end-systolic pressure-diameter relationship (ESPDR) as well as other measurements of cardiac performance. In all the pigs administered a high dose, ESPDR demonstrated a marked, time-dependent depression whereas we observed no significant ESPDR changes after low endotoxin doses. The other cardiodynamic variables were uninterpretable, due to the significant changes in heart rate, end-diastolic diameter (preload), and aortic diastolic pressure (afterload). Plasma myocardia depressant factor activity accumulated in all endotoxin-administered animals, tending to be greater in the high-dose group. In this group, both subendocardial blood flow and global function were depressed, whereas pigs administered the low dose endotoxin demonstrated slight, but nonsignificant, increases in flow and function. These observations indicate that myocardial contractile depression is associated with a lethal outcome to high doses of endotoxin. Myocardial perfusion was measured using radiolabeled microspheres infused into the left atria

  8. [Doppler echocardiography for the assessment of left ventricular diastolic function: methodology, clinical and prognostic value].

    Galderisi, Maurizio; Dini, Frank Lloyd; Temporelli, Pier Luigi; Colonna, Paolo; de Simone, Giovanni

    2004-02-01

    To date, left ventricular diastolic function can be clinically assessed by Doppler echocardiography. The Doppler recording of mitral inflow and pulmonary venous flow provides main information about ventricular diastolic properties. At the level of the mitral inflow we can measure the early diastolic peak velocity (E), atrial peak velocity and derive their ratio, the E velocity deceleration time and isovolumic relaxation time, and calculate atrial filling fraction. At the level of the pulmonary veins, the peak systolic velocity (S), the peak diastolic velocity (D), the S/D ratio, the peak of reverse atrial velocity and its duration, above all in terms of difference with the mitral A duration, characterize the different patterns of diastolic function. Also the new ultrasound technologies are clinically useful to define ventricular diastolic properties. The myocardial early diastolic velocity (Em) detectable by pulsed tissue Doppler at the level of the mitral annulus, and the flow propagation velocity (Vp) recordable by color M-mode of left ventricular inflow, both relatively preload-independent, are measurements related to tau, the reference hemodynamic variable. The E/Em and E/Vp ratios provide accurate estimation of the changes in left ventricular end-diastolic pressure. They allow us to distinguish the pseudonormal and restrictive patterns from the normal pattern and are, therefore, alternative tools to Valsalva maneuver of mitral inflow and pulmonary venous flow. The predictive value of the pattern of abnormal relaxation (grade I of diastolic dysfunction) and both the reversible and irreversible restrictive patterns (grade III and IV respectively) is now demonstrated and permits important prognostic stratification and appropriate therapeutic management. PMID:15080528

  9. Instantaneous Decrease in Left Ventricular Afterload during Transcatheter Aortic Valve Implantation Results in Immediate Changes in Left Ventricular Strain.

    Swan, Amy; Prakash, Roshan; Chew, Derek P; Perry, Rebecca; Sinhal, Ajay; Selvanayagam, Joseph B; Joseph, Majo X

    2016-05-01

    Severe aortic stenosis causes chronic increased afterload on the left ventricle (LV) resulting in myocardial hypertrophy and ultimately dysfunction if left untreated. Transcatheter aortic valve implantation (TAVI) immediately decreases the afterload on the LV by reducing the pressure gradient through the aortic valve. In our study, we aim to evaluate immediate changes in LV mechanics using intra-procedural transesophageal echocardiography (TEE) to assess circumferential and radial strain via speckle tracking. Intra-operative TEE was performed during TAVI for 53 patients (mean age 84 ± 8 years). Two-dimensional images in the transgastric view were acquired at the level of the papillary muscle. Circumferential and radial strain was calculated using speckle tracking with Philips Qlab software. Global LV afterload was measured by calculating valvulo-arterial impedance (Zva). Immediately post-TAVI, there was a change in both radial strain rate (Pre: 0.73 ± 0.04 vs. Post: 0.88 ± 0.04 per second, P < 0.001) and circumferential strain rate (-0.53 ± 0.04 (pre) vs. -0.74 ± 0.04 (post) per second, P < 0.001). There was also an immediate improvement in circumferential global strain parameters (-14.5 ± 5% (pre) vs. -16.0 ± 4.7% (post), P < 0.05), whereas there was no significant change seen in global radial strain (15.6 ± 0.8% (pre) vs. 15.2 ± 0.9% (post), P = 0.69). No significant change was seen in LV ejection fraction (51.5 ± 14.2% (pre) vs. 52.1 ± 14.0% (post), P = 0.77). Speckle tracking using TEE images is feasible and identifies significant improvements in LV strain and strain rate immediately following TAVI that is not detected by conventional measure of LV function. PMID:26676176

  10. Depressed left ventricular performance. Response to volume infusion in patients with sepsis and septic shock

    Volume infusion, to increase preload and to enhance ventricular performance, is accepted as initial management of septic shock. Recent evidence has demonstrated depressed myocardial function in human septic shock. We analyzed left ventricular performance during volume infusion using serial data from simultaneously obtained pulmonary artery catheter hemodynamic measurements and radionuclide cineangiography. Critically ill control subjects (n = 14), patients with sepsis but without shock (n = 21), and patients with septic shock (n = 21) had prevolume infusion hemodynamic measurements determined and received statistically similar volumes of fluid resulting in similar increases in pulmonary capillary wedge pressure. There was a strong trend (p = 0.004) toward less of a change in left ventricular stroke work index (LVSWI) after volume infusion in patients with sepsis and septic shock compared with control subjects. The LVSWI response after volume infusion was significantly less in patients with septic shock when compared with critically ill control subjects (p less than 0.05). These data demonstrate significantly altered ventricular performance, as measured by LVSWI, in response to volume infusion in patients with septic shock

  11. Correlation Study of PtfV1 with Heart-Qi Deficiency Syndrome in Patients with Hypertensive Left Ventricular Hypertrophy

    杨传华; 陆峰

    2002-01-01

    @@ It is generally believed that the change of p-wave terminal force in lead V1 (PtfV1) is associated with the inner diameter of left atrium, left ventricular compliance,and ventricular diastolic function. The increase of negative value of PtfV1 in essential hypertensive (EH) patients with left ventricular hypertrophy (LVH) indicates the cardiac function may be damaged. In order to explore the relationship between Heart-Qi Deficiency Syndrome (HQDS) of TCM and PtfV1 level in hypertensive LVH patients, correlation analysis of scores of Heart-Qi Deficiency Syndrome and negative value of PtfV1 was made by the authors.

  12. Noninvasive diagnosis of a false left ventricular aneurysm with radioisotope gated cardiac blood pool imaging. Differentiation from true aneurysm

    Unlike the true left ventricular aneurysm, false aneurysms have recently been shown to be subject to late rupture. Rarely diagnosed before surgery or autopsy, the false aneurysm has never been identified by noninvasive techniques. We report the first such noninvasive diagnosis employing radioisotope gated cardiac blood pool imaging. Due to the unique and possibly life-threatening clinical course and potential for surgical cure of false left ventricular aneurysm, early noninvasive diagnosis by imaging techniques may be critical. The methods shown here are generally applicable, becoming widely available and may help in evaluation of false left ventricular aneurysm as a cause of sudden death

  13. Usefulness of Palliative Care to Complement the Management of Patients on Left Ventricular Assist Devices.

    Luo, Nancy; Rogers, Joseph G; Dodson, Gwen C; Patel, Chetan B; Galanos, Anthony N; Milano, Carmelo A; O'Connor, Christopher M; Mentz, Robert J

    2016-09-01

    Within the last decade, advancements in left ventricular assist device therapy have allowed patients with end-stage heart failure (HF) to live longer and with better quality of life. Like other life-saving interventions, however, there remains the risk of complications including infections, bleeding episodes, and stroke. The candidate for left ventricular assist device therapy faces complex challenges going forward, both physical and psychological, many of which may benefit from the application of palliative care principles by trained specialists. Despite these advantages, palliative care remains underused in many advanced HF programs. Here, we describe the benefits of palliative care, barriers to use within HF, and specific applications to the integrated care of patients on mechanical circulatory support. PMID:27474339

  14. Ebstein’s Anomaly, Left Ventricular Noncompaction, and Sudden Cardiac Death

    Michael McGee

    2015-01-01

    Full Text Available Ebstein’s anomaly is a congenital disorder characterized by apical displacement of the septal leaflet of the tricuspid valve. Ebstein’s anomaly may be seen in association with other cardiac conditions, including patent foramen ovale, atrial septal defect, and left ventricular noncompaction (LVNC. LVNC is characterized by increased trabeculation within the left ventricular apex. Echocardiography is often used to diagnose LVNC; however, magnetic resonance (MR imaging offers superior characterization of the myocardium. We report a case of sudden cardiac death in a patient with Ebstein’s anomaly with unrecognized LVNC noted on post mortem examination with screening documenting the presence of LVNC in one of the patient’s twin sons.

  15. Cardiovascular effects of contrast materials on left ventricular angiography in rabbits

    The precise pathologic anatomy in complex congenital heart disease requires multiple injections of iodinated contrast materials into the cardiac chambers and/or great vessels. In the presence of intracardial shunts, more large volumes of contrast material is often required. In neonates and infants the total volume of contrast material during single angiographic procedure is limited up to 3-4ml/kg. This limitation results from the deleterious effects of systemic hyperosmolarity caused by the contrast materials and may be intensified in the neonate because of the relative immaturity of infants kidneys and delayed excretion of contrast materials. We therefore tried to compare the EKG and left ventricular pressure change with those of high osmolar and low osmolar contrast agent in experimental model. The purpose of the study is to determine and compare the effects of contrast materials on left ventricular hemodynamics

  16. Aneurysm of the left aortic sinus causing acute myocardial infarction

    Jan-Peter Smedema; Vernon Freeman; Johan Brink

    2011-01-01

    This report describes the findings and management of a young male who presented with an acute ST-segment elevation myocardial infarction due to compression of the circumflex coronary artery by a large aneurysm of left sinus of Valsalva.

  17. Aneurysm of the left aortic sinus causing acute myocardial infarction

    This report describes the findings and management of a young male who presented with an acute ST-segment elevation myocardial infarction due to compression of the circumflex coronary artery by a large aneurysm of left sinus of Valsalva

  18. Influence of obesity on left ventricular adaptation, grading and outcome in aortic valve stenosis

    Rogge, Barbara

    2014-01-01

    Background/Aim: Obesity is associated with hemodynamic changes characterized by volume overload adding to the progressive pressure overload induced by aortic valve stenosis (AS). This thesis investigated whether concomitant obesity in patients with AS independently impacts left ventricular (LV) adaptation, grading and outcome during progression of the valve stenosis.Methods: The project was a planned substudy of the Simvastin Ezetimibe in Aortic Stenosis study (SEAS), a prospec...

  19. Focused Review on Transthoracic Echocardiographic Assessment of Patients with Continuous Axial Left Ventricular Assist Devices

    Park, Soon J.; Michel Carrier; Atchison, Fawn W.; Simon Maltais; Louis P. Perrault; Oh, Jae K; Yan Topilsky

    2011-01-01

    Left ventricular assist devices (LVADs) are systems for mechanical support for patients with end-stage heart failure. Preoperative, postoperative and comprehensive followup with transthoracic echocardiography has a major role in LVAD patient management. In this paper, we will present briefly the hemodynamics of axial-flow LVAD, the rationale, and available data for a complete and organized echocardiographic assessment in these patients including preoperative assessment, postoperative and long...

  20. Evaluation of right and left ventricular function in hard metal workers.

    Horowitz, S F; Fischbein, A; Matza, D; Rizzo, J N; Stern, A.; J. Machac; S. J. Solomon

    1988-01-01

    Ingested cobalt has previously been associated with the development of a congestive cardiomyopathy. Despite occasional reports of cardiomyopathy after industrial exposure to cobalt, this association remains controversial. In a study of 30 cemented tungsten carbide workers with a mean duration of exposure to cobalt of 9.9 +/- 5.3 years radionuclide ventriculography was performed to study right and left ventricular ejection fractions at rest and exercise. For the entire group, rest and exercise...

  1. Minimally invasive is the future of left ventricular assist device implantation

    Makdisi, George; Wang, I-Wen

    2015-01-01

    There have been many factors that have allowed for progressive improvement in outcomes and lower complication rates. These include the improvement in left ventricular assist device (LVAD) technologies, combined with better understanding of patient management, all these. Nowadays the numbers of LVAD implantations exceed the number of annual heart transplants worldwide. Minimally invasive procedures are shown to improve the surgical outcome in both LVAD insertion and replacement. These minimall...

  2. Doppler tissue imaging for assessing left ventricular diastolic dysfunction in heart transplant rejection

    Stengel, S; Allemann, Y; Zimmerli, M.; Lipp, E; Kucher, N; Mohacsi, P; Seiler, C.

    2001-01-01

    OBJECTIVE—To test the hypothesis that diastolic mitral annular motion velocity, as determined by Doppler tissue imaging and left ventricular diastolic flow propagation velocity, is related to the histological degree of heart transplant rejection according to the International Society of Heart and Lung Transplantation (ISHLT).
METHODS—In 41 heart transplant recipients undergoing 151 myocardial biopsies, the following Doppler echocardiographic measurements were performed within one hour of biop...

  3. RARE ANOMALY OF THE CORONARY VESSELS: CORONARY AND LEFT VENTRICULAR FISTULAS

    L. V. Salamatina; Ye. Yu. Levchenko; A. A. Seitov; O. M. Zolotenkova; A. A. Burym

    2014-01-01

    Study objective: description of the case of diagnostics of rare anomaly of the coronary vessels: coronary and left ventricular fistulas.Materials and methods. Patient L., 45 y.o. (height 168 cm, weight 55 kg), male, complained of periodical burning pain behind the breastbone without connection with physical activity, often disturbing at night, stopped with intake of nitrates. The following examination of the patient was performed: clinical and biochemical blood tests, electrocardiography (ECG...

  4. Urinary proteome analysis in hypertensive patients with left ventricular diastolic dysfunction

    T. Kuznetsova; Mischak, H.; Mullen, W; J.A. Staessen

    2012-01-01

    Aims Despite the significant heart failure (HF) burden on society, easily applicable screening techniques, particularly for the early detection of asymptomatic left ventricular (LV) dysfunction, are lacking. The present study aimed to identify and test a set of urinary polypeptides that may indicate early LV diastolic dysfunction as defined by echocardiography in hypertensive patients in a cross-sectional case-control study nested within the FLEMish study on ENvironment, Genes and Health Outc...

  5. Intraoperative transesophageal echocardiographic assessment of left ventricular Tei index in congenital heart disease

    Shanthi Sivanandam; Andrew Wey; James St. Louis

    2015-01-01

    Background: Use of the Tei index has not been described to assess myocardial function before or after surgery in pediatric patients. This study was designed to evaluate the left ventricular (LV) function using the Tei index pre- and post-cardiopulmonary bypass in patients with lesion that result in a volume loaded right ventricle (RV). Methods: Retrospective data on 55 patients who underwent repair of a cardiac defect were analyzed. Patients with volume overload RV (n = 15) were compared to p...

  6. Pharmacist intervention in primary care to improve outcomes in patients with left ventricular systolic dysfunction

    Lowrie, R.; Mair, F S; Greenlaw, N.; Forsyth, P.; Jhund, P.S.; McConnachie, A.; Rae, B.; McMurray, J.J.V.

    2012-01-01

    Background Meta-analysis of small trials suggests that pharmacist-led collaborative review and revision of medical treatment may improve outcomes in heart failure. Methods and results We studied patients with left ventricular systolic dysfunction in a cluster-randomized controlled, event driven, trial in primary care. We allocated 87 practices (1090 patients) to pharmacist intervention and 87 practices (1074 patients) to usual care. The intervention was delivered by non-specialist pharmac...

  7. Anemia treatment and left ventricular hypertrophy in non-dialysis chronic kidney disease

    Robert N. Foley; Peter A. McCullough

    2005-01-01

    @@ To this day, the target hemoglobin level that minimizes cardiovascular risk in chronic kidney disease (CKD) patients remains unclear. When one examines the many randomized trials of epoetin therapy in aggregate, enhanced quality of life provides the most cogent argument for hemoglobin levels above 110 g/L. It remains unclear whether treatment of anemia improves longevity, or even a surrogate marker (such as left ventricular [LV] mass index), especially when applied at earlier phases of CKD.

  8. Trimetazidine Protects against Smoking-Induced Left Ventricular Remodeling via Attenuating Oxidative Stress, Apoptosis, and Inflammation

    Zhou, Xiang; Li, Chao; Xu, Weiting; CHEN, JIANCHANG

    2012-01-01

    Trimetazidine, a piperazine derivative used as an anti-anginal agent, improves myocardial glucose utilization through inhibition of fatty acid metabolism. The present study was designed to investigate whether trimetazidine has the protective effects against smoking-induced left ventricular remodeling in rats. In this study, Wistar rats were randomly divided into 3 groups: smoking group (exposed to cigarette smoke), trimetazidine group (exposed to cigarette smoke and treated with trimetazidine...

  9. Quality of Life and Influential Factors in Patients Implanted With a Left Ventricular Assist Device

    Kato, Naoko P; Okada, Ikuko; Imamura, Teruhiko; Kagami, Yukie; Endo, Miyoko; Nitta, Daisuke; Fujino, Takeo; Muraoka, Hironori; Minatsuki, Shun; Maki, Hisataka; Inaba, Toshiro; Kinoshita, Osamu; Nawata, Kan; Hatano, Masaru; Yao, Atsushi

    2015-01-01

    Background: Improving quality of life (QOL) has become an important goal in left ventricular assist device (LVAD) therapy. We aimed (1) to assess the effect of an implantable LVAD on patients QOL, (2) to compare LVAD patients QOL to that of patients in different stages of heart failure (HF), and (3) to identify factors associated with patients QOL. Methods and Results: The QOL of 33 Japanese implantable LVAD patients was assessed using the Minnesota Living with Heart Failure Questionnaire (ML...

  10. Left ventricular geometric patterns in newly presenting nigerian hypertensives: An echocardiographic study

    Ogah Okechukwu S

    2006-01-01

    Full Text Available Abstract Background Hypertension is a global problem and it is prevalent in Nigeria. Left ventricular hypertrophy is a major complication of hypertension with risk of sudden death and arrhythmias among others. Abnormal left ventricular geometric patterns also increase the burden of morbidity and mortality. It is therefore important to know the different left ventricular geometric patterns in Nigerian hypertensives because of their prognostic significance. Methods One hundred (100 newly presenting hypertensives (53 males and 47 females and 100 controls (53 males and 47 females were recruited for the study. All were subjected to clinical evaluation and full echocardiographic examination was performed according to the ASE recommendation. The relative wall thickness and the presence or absence of echocardiographic left ventricular hypertrophy were used to determine the various geometric patterns Results The mean age of the hypertensive subjects was 56.06 (± 7.68 years while that of the control subjects was 56.10 (± 7.68 years. There was no significant difference in the mean ages of the two groups. In the hypertensive subjects 28% had normal geometry, 26% had concentric remodeling, 28% had concentric hypertrophy and 18% had eccentric hypertrophy. In the control group, 86% had normal geometry, 11% had concentric remodeling, 3% had eccentric hypertrophy and none had concentric hypertrophy. There was statistical significance when the geometric patterns of the hypertensive and controls were compared (χ2 = 74.30, p value Conclusion The study showed that only 28% of the hypertensive subjects had normal LV geometric pattern while 86% of the normal subjects had normal geometry. There is need for longitudinal studies in order to prognosticate the various geometric patterns.

  11. Hemorrhagic Cardioembolic Stroke Secondary to a Left Ventricular Thrombus: a Therapeutic Dilemma

    Khalil Al-Farsi; Siddiqui, Aftab A.; Yasser W. Sharef; Al-Belushi, Ali K.; Hakeem Al-Hashim; Mohammed Al-Ghailani; William J Johnsto

    2013-01-01

    Cardiogenic embolism is a major cause of stroke and often leads to significant morbidity and mortality. Despite the recent advances in our understanding of the pathophysiology of stroke and its risk factors, diagnosis and therapy; some case scenarios still present a real challenge for the treating physicians. We report a case of a 50 year old male patient presenting with multi-territory cerebral infarctions due to a left ventricular mobile thrombus complicated with hemorrhagic transformation ...

  12. Left ventricular twisting mechanics and exercise in healthy individuals: a systematic review

    Warburton, Darren

    2012-01-01

    C Taylor Drury,1,2 Shannon SD Bredin,3 Aaron A Phillips,1,2 Darren ER Warburton1,21Cardiovascular Physiology and Rehabilitation Laboratory, University of British Columbia; 2Experimental Medicine Program, Faculty of Medicine, University of British Columbia; 3Cognitive and Functional Learning Laboratory, University of British Columbia, Vancouver, BC, CanadaAbstract: The aim of this study was to review systematically the effects of exercise on left ventricular (LV) twisting mechanics in healthy ...

  13. Left ventricular outflow tract false aneurysm late after aortic valve replacement.

    Bizzarri, Federico; Braconi, Lucio; Rossi, Alessandra; Sorbara, Carlo; Stefano, Pier Luigi

    2005-01-01

    We describe an unusual case of left ventricular outflow tract (LVOT) pseudoaneurysm late after aortic valve replacement. A 77-year-old man, who had undergone aortic valve replacement with mechanical prosthesis 7 years ago, presented, asymptomatic, with a transesophageal echocardiography (TTE) diagnosis of a large cavitary mass arising behind the aortic wall. The orifice of the pseudoaneurysm was successfully surgically closed and the aortic root reconstructed with cryopreserved homograft. PMID:15870043

  14. Increased left ventricular stiffness impairs filling in dogs with pulmonary emphysema in respiratory failure.

    Gomez, A; Mink, S

    1986-01-01

    In a chronic canine model of pulmonary emphysema, we studied the interaction between left ventricular (LV) mechanics and pulmonary disease during severe hypoxemia. The hypoxemia was similar to that which may occur during a severe exacerbation of chronic obstructive lung disease. In six dogs with papain-induced emphysema and in seven dogs without emphysema, LV mechanics were examined when a hypoxic gas mixture was inspired to reduce PO2 to about 35 mmHg (hypoxic study) and during nonhypoxic co...

  15. Prevalence and Determinants of Left Ventricular Hypertrophy in Hypertensive Patients at a Primary Care Clinic

    2012-01-01

    Left ventricular hypertrophy (LVH) has prognostic significance on cardiovascular mortality and morbidity. However, echocardiography screening for LVH is not routinely done for hypertensive patients in a primary care setting. Thus, this quantitative study aims to determine the prevalence and factors associated with LVH in hypertensive patients at a primary care setting. This was a cross-sectional study of 359 consecutive patients with uncomplicated essential hypertension attending a hospital-b...

  16. Relationship between aetiology and left ventricular systolic dysfunction in hypertrophic cardiomyopathy

    Rosmini, Stefania

    2015-01-01

    Background: Hypertrophic cardiomyopathy (HCM) is a common cardiac disease caused by a range of genetic and acquired disorders. The most common cause is genetic variation in sarcomeric proteins genes. Current ESC guidelines suggest that particular clinical features (‘red flags’) assist in differential diagnosis. Aims: To test the hypothesis that left ventricular (LV) systolic dysfunction in the presence of increased wall thickness is an age-specific ‘red flag’ for aetiological diagnosis an...

  17. Left ventricular beat to beat performance in atrial fibrillation: dependence on contractility, preload, and afterload

    Muntinga, H; Gosselink, A; Blanksma, P; De Kam, P J; van der Wall, E; Crijns, H.

    1999-01-01

    OBJECTIVE—To assess independent determinants of beat to beat variation in left ventricular performance during atrial fibrillation.
DESIGN—Prospective study.
SETTING—University hospital.
PATIENTS—Seven patients with chronic non-valvar atrial fibrillation.
INTERVENTIONS—Invasive and non-invasive haemodynamic variables were assessed using a non-imaging computerised nuclear probe, a balloon tipped flow directed catheter, and a non-invasive fingertip blood pressure measurement system linked to a p...

  18. The association of growth differentiation factor-15 with left ventricular hypertrophy in hypertensive patients.

    Hao Xue

    Full Text Available Growth differentiation factor-15 (GDF-15 has been identified as an endogenous anti-hypertrophy effect. However, the association of plasma GDF-15 levels with left ventricular hypertrophy (LVH in hypertension is poorly understood. We investigate the effect of plasma GDF-15 levels on left ventricular hypertrophy (LVH in hypertension. We measured the plasma levels of GDF-15 in 299 untreated hypertensive patients which consisted of 99 with LVH and 200 without LVH using immunoradiometric assay. All subjects were examined by the ultrasonic cardiograph to determine Left ventricular (LV internal diameters, septal thickness, and posterior wall thickness. The associations of GDF-15 with left ventricular mass index (LVMI, LV end-systolic and -diastolic diameters, LV wall thickness, and LV ejection fraction were evaluated. We found that plasma GDF-15 levels in hypertensive patients with LVH [median 1101, 25th-75th percentiles (879-1344 ng/L] were higher than that in hypertensive patients without LVH [median 516, 25th-75th percentiles (344-640 ng/L] (P<0.001. After adjustment for traditional covariates, plasma GDF-15 levels were independently related to LVMI (R(2 = 0.53; β = 0.624, P<0.001, LV interventricular septal thickness (R(2 = 0.23; β = 0.087, P<0.01 and LV posterior wall thickness (R(2 = 0.26; β = 0.103, P<0.05. Our cross-sectional data on a hospital-based sample indicate that plasma GDF-15 levels are associated with LVH in hypertensive patients.

  19. Beneficial effect of isradipine on the development of left ventricular hypertrophy in mild hypertension

    Mehlsen, J; Fornitz, Gitte Gleerup; Haedersdal, C;

    1993-01-01

    The objective of this study was to analyze the long-term hemodynamic effects of the calcium antagonist isradipine in mild hypertension compared with those of the beta 1-selective adrenoceptor antagonist atenolol, focusing in particular on the development of cardiac hypertrophy. Ten male patients...... isradipine (254 +/- 55 g). The results indicate that antihypertensive treatment with isradipine as monotherapy may prevent the development of left ventricular hypertrophy whereas treatment with atenolol as monotherapy does not appear to offer this possibility....

  20. LEFT VENTRICULAR SYSTOLIC FUNCTION DURING TREADMILL WALKING WITH LOAD CARRIAGE IN ADOLESCENTS

    Moran Sagiv

    2006-06-01

    Full Text Available Backpack carriage occurs in day-to-day tasks and has applications in school, physical training, recreational activities and sports. Using metabolic cart and echocardiograph, this study determined and examined the effects of two different load carriages on left ventricular function during 30 min. of treadmill walking in healthy adolescent male subjects. Seventeen males (13.1 ± 0.5 yrs. walked on a treadmill at a speed of 4 km·h-1, each carrying a load relative to his body mass at 333 gr·kg-1 body weight during one session and without weight during the other session. Significant (p < 0.05 differences were noted between the 333 gr·kg-1 body weight and the no weights with regard to: VO2 13.6 ± 1.3 and 10.5 ± 1.1 ml·kg-1·min-1; heart rate: 133.2 ± 7.1 and 121.4 ± 5.6 beats·min-1; mean arterial blood pressure; 95. 4 ± 4.3 and 87.5 ± 3.8 mmHg and systolic blood pressure 147.7 ± 7.0 and 129.8 ± 7.1 mmHg respectively. No significant differences were noted between the two exercises with regard to left ventricular function variables. This study suggests that in adolescents as in adults, the vasodilatation mechanism dominates during combined dynamic and isometric exercises. Thus, the opposing force to the left ventricular ejection is reduced which in turn does not change the left ventricular global function. In addition, the vasodilatation mechanism enables oxygen supply to the contracting muscles via aerobic energy pathways