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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. 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...

  11. [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

  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. 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...

  12. 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...

  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 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.

  10. 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

  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. 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

  13. 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...

  14. 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.

  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. 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

  1. 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

  2. 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.)

  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. 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)

  8. 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)

  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 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

  9. 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...

  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. 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

  2. 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)

  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. 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...

  7. 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 ...

  8. 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...

  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. 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.)

  1. 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

  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. 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

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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.

  1. 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

  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. 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...

  7. 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...

  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. 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

  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. 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.

  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. 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)

  13. 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.

  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. 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 ...

  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. 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...

  18. 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 ...

  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. 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...

  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. 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.

  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. 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).

  3. 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...

  4. [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

  5. 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...

  6. 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.

  7. 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....

  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. [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