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  1. Radionuclide assessment of left ventricular function following cardiac surgery

    Energy Technology Data Exchange (ETDEWEB)

    Howe, W.R.; Jones, R.H.; Sabiston, D.C. Jr.

    1976-01-01

    Use of a high count-rate gamma scintillation camera permits the noninvasive assessment of left ventricular function by nuclear angiocardiography. Counts recorded from the region of the left ventricle at 50- or 100-msec intervals during the first transit of an intravenously administered bolus of radioisotope produce a high-fidelity indicator-dilution curve. Count fluctuations reflect left ventricular volume changes during the cardiac cycle and permit measurement of dv/dt, ejection fraction, mean transit time, and wall motion of this chamber. The present study evaluates (1) the accuracy of this technique compared to standard biplane cineangiography and (2) its usefulness in evaluating patients after cardiac surgery.

  2. Mitochondria and left ventricular hypertrophy

    Institute of Scientific and Technical Information of China (English)

    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.

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

    DEFF Research Database (Denmark)

    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...

  4. Three-dimensional echocardiography with tissue harmonic imaging shows excellent reproducibility in assessment of left ventricular volumes

    DEFF Research Database (Denmark)

    Kim, Won Yong; Søgaard, Peter; Egeblad, Henrik;

    2001-01-01

    We studied the reproducibility of repeated measurements of left ventricular (LV) volumes by 2-dimensional (biplane method of disks) and 3-dimensional echocardiography (coaxial scanning) with tissue harmonic imaging. Ten healthy subjects underwent estimation of LV volumes by transthoracic echocard......We studied the reproducibility of repeated measurements of left ventricular (LV) volumes by 2-dimensional (biplane method of disks) and 3-dimensional echocardiography (coaxial scanning) with tissue harmonic imaging. Ten healthy subjects underwent estimation of LV volumes by transthoracic...... a powerful tool for noninvasive LV volume estimation....

  5. Image quality influences the assessment of left ventricular function

    DEFF Research Database (Denmark)

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

    2014-01-01

    divided by the total endocardial border. These ratings were used to generate groups of poor (0%-40%), fair (41%-70%), and good (71%-100%) image quality. The ejection fraction (EF), end-diastolic volume, and end-systolic volume were analyzed by the Simpson method of disks (biplane and monoplane), eyeball......Objectives: Transesophageal echocardiography has become a standard tool for eval uating left ventricular function during cardiac surgery. However, the image quality varies widely between patients and examinations. The aim of this study was to investigate the influence of the image quality on 5...... commonly used 2-dimensional methods. Methods: Transesophageal real-time 3-dimensional echocardiography (3DE) served as a reference. Left ventricular function was evaluated in 63 patients with sufficient real-time 3DE image quality. The image quality was rated using the ratio of the visualized border...

  6. Mechanics of left ventricular aneurysm.

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    Radhakrishnan, S; Ghista, D N; Jayaraman, G

    1986-01-01

    When a coronary artery is significantly occluded, the left ventricular myocardial segment, which is perfused by that coronary artery, will become ischaemic and even irreversibly infarcted. An acute infarct has very low stiffness and if it involves the entire wall there is a risk of rupture; however, in the absence of such a critical situation, fibrous tissue is laid into the infarcted myocardial segment. Such an infarcted fibrotic myocardial segment will not be able to contract, and so generate tensile stress. The surrounding intact myocardium will contract and generate wall stress, thereby developing a high intra-chamber systolic pressure; the chronically infarcted and fibrotic segment will have to sustain this high chamber pressure. Its loss of contractility and the resulting reduced systolic stiffness relative to the intact segment, will cause it to deform into a bulge; this is an aneurysm. When a left ventricular chamber with an aneurysm contracts during the systolic phase, some blood also goes into the aneurysm, and this decreases the stroke volume; since the aneurysm wall is passive, stagnant blood flow prevails in the aneurysm itself, which in turn can give rise to the formation of a mural thrombus. These serious consequences provide a justification for the analysis of an infarcted left ventricular chamber, in order to predict the size of the aneurysmic bulge. Such an analysis is presented in this paper. To determine the left ventricular wall deformation, and the stress arising from infarction of a wall segment (which leads to a ventricular aneurysm) the left ventricle is modelled here as a pressurized ellipsoidal shell. Deformations of infarcted wall segments are computed for several damaged wall-thicknesses in left ventricles of different shapes. The analysis involves a derivation of equations for wall-stress equilibrium with the chamber pressure, and myocardial incompressibility before and after infarct formation. The equations are solved by the Newton

  7. Biplane roentgen videometric system for dynamic, 60/sec, studies of the shape and size of circulatory structures, particularly the left ventricle.

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    Ritman, E. L.; Sturm, R. E.; Wood, E. H.

    1973-01-01

    An operator interactive video system for the measurement of roentgen angiographically outlined structures is described. Left ventricular volume and three-dimensional shapes are calculated from up to 200 pairs of diameters measured from ventriculograms at the rate of 60 pairs of biplane images per second. The accuracy and reproducibility of volumes calculated by the system were established by analysis of roentgenograms of inanimate objects of known volume and by comparison of left ventricular stroke volumes calculated by the system with the stroke volumes calculated by an indicator-dilution technique and an aortic root electromagnetic flowmeter. Computer-generated display of the large amounts of data obtained by the videometry system is described.

  8. Left ventricular pseudoaneurysm after reimplantation procedure.

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    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

  9. Left Ventricular Thrombosis in Ulcerative Colitis

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    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

    Institute of Scientific and Technical Information of China (English)

    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. Giant and thrombosed left ventricular aneurysm.

    Science.gov (United States)

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

    2015-07-26

    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-year-old 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.

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

    OpenAIRE

    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.

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

    OpenAIRE

    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 ...

  14. Total Arterial Revascularisation in Left Ventricular Dysfunction

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The feasibility and safety of total arterial coronary revascularization with 2 arterial conduits in patients with impaired left ventricular function was evaluated. Data were prospectively collected on all patients with multiple vessel disease and moderately or severely impaired left ventricular function, who underwent coronary surgery with the intention of total arterial revascularization with 2 conduits between March 1995 and August 2002. One hundred and seventy-nine patients were included in the study. Acute coronary insufficiency was present in 3 patients and 43 had unstable angina. Severe left ventricular impairment was present in 29 patients. There were 17 redo operations including 3 redo-redo procedures. Eighty-two percent of patients had a Y graft configuration from the left internal mammary artery (right internal mammary artery 40. 8 %, radial artery 33.5 %,other 7.8 % ). The perioperative mortality was 2.2 %, myocardial infarction 1.7 % and stroke 0. 6 %.Total arterial revascularization in patients with ischaemic left ventricular dysfunction can be safely performed with 2 arterial conduits. The radial artery provides conduit length greater than the right internal mammary artery and allows full revascularization despite left ventricular dilatation.

  15. Postoperative normalization of left ventricular noncompaction and new echocardiographic signs in aorta to left ventricular tunnel.

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    Malakan Rad, Elaheh; Zeinaloo, Ali Akbar

    2013-04-01

    We report postoperative normalization of left ventricular noncompaction in a neonate undergoing successful neonatal surgery for type II aorta to left ventricular tunnel (ALVT) associated with a large patent ductus arteriosus, floppy and extremely redundant anterior mitral leaflet, right coronary artery arising directly from the tunnel, and severe left ventricular noncompaction. We also described 2 novel echocardiographic findings in ALVT including "triple wavy line sign" on M-mode echocardiography which disappeared 1 month after operation and "abnormally increased left ventricular posterior wall motion" on M-mode of standard parasternal long-axis view on color tissue Doppler imaging (TDI) that also normalized postoperatively. We showed that proper definition of endocardial border is extremely important in strain and strain rate imaging in the context of left ventricular noncompaction. Preoperative longitudinal strain and strain rate were significantly decreased in comparison to radial strain and strain rate. Circumferential strain and strain rate were normal. PMID:23346986

  16. Left Ventricular Noncompaction: A Distinct Genetic Cardiomyopathy?

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    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

  17. Left ventricular outflow obstruction and necrotizing enterocolitis

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    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.

  18. Cerebrovascular complications of left ventricular assist devices

    NARCIS (Netherlands)

    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

  19. Left ventricular hypertrophy : virtuous intentions, malign consequences

    NARCIS (Netherlands)

    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

  20. The Reproducibility and Absolute Values of Echocardiographic Measurements of Left Ventricular Size and Function in Children are Algorithm Dependent

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    Margossian, Renee; Chen, Shan; Sleeper, Lynn A.; Tani, Lloyd Y.; Shirali, Girish; Golding, Fraser; Tierney, Elif Seda Selamet; Altmann, Karen; Campbell, Michael J.; Szwast, Anita; Sharkey, Angela; Radojewski, Elizabeth; Colan, Steven D.

    2015-01-01

    Background Several quantification algorithms for measuring left ventricular (LV) size and function are used in clinical and research settings. We investigated the effect of the measurement algorithm and beat averaging on the reproducibility of measurements of the LV and assessed the magnitude of agreement among the algorithms in children with dilated cardiomyopathy (DCM). Methods Echocardiograms were obtained on 169 children from 8 clinical centers. Inter- and intra-reader reproducibility were assessed on measurements of LV volumes using biplane Simpson, modified Simpson (MS), and 5/6 x area x length (5/6AL) algorithms. Percent error (%error) was calculated as the inter- or intra-reader difference / mean x 100. Single beat measurements and the 3-beat average (3BA) were compared. Intra-class correlation coefficients (ICC) were calculated to assess agreement. Results Single beat inter-reader reproducibility was lowest (%error was highest) using biplane Simpson; 5/6AL and MS were similar but significantly better than biplane Simpson (p 0.95 across measures, although absolute volume and mass values were systematically lower for biplane Simpson compared to MS and to 5/6AL. Conclusions The reproducibility of LV size and function measurements in children with DCM is highest using the 5/6AL algorithm, and can be further improved by using 3BA. However, values derived from different algorithms are not interchangeable. PMID:25728351

  1. Left ventricular hypertrophy in patients treated with regular hemodialyses

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    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...

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

    OpenAIRE

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  4. Congenital left ventricular aneurysm coexisting with left ventricular non-compaction in a newborn.

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    Ootani, Katsuki; Shimada, Jun; Kitagawa, Yosuke; Konno, Yuki; Miura, Fumitake; Takahashi, Toru; Ito, Etsuro; Ichinose, Kouta; Yonesaka, Susumu

    2014-10-01

    Described herein is the case of a rare combination of congenital left ventricular (LV) aneurysm and left ventricular non-compaction (LVNC) in a newborn. The patient developed refractory heart failure soon after birth and died at 5 months of age. The etiology of both congenital LV aneurysm and LVNC seems to be maldevelopment of the ventricular myocardium during early fetal life. Treatment should be individually tailored depending on clinical severity, and treatment options are limited. Given that this combination of congenital LV aneurysm and LVNC is significantly associated with poor prognosis, it appears that patients with congenital LV aneurysm and LVNC are candidates for early, aggressive intervention, including surgical aneurysmectomy and evaluation for transplantation. It is important to be aware of this combination of congenital LV aneurysm and LVNC, and to make earlier decisions on therapeutic strategy.

  5. Right ventricular failure after left ventricular assist devices.

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    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

  6. Echocardiographic left ventricular hypertrophy in Chinese endurance athletes.

    OpenAIRE

    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...

  7. ECG manifestations of left ventricular electrical remodeling.

    Science.gov (United States)

    Estes, E Harvey

    2012-01-01

    Research and thinking about the electrocardiographic manifestations of left ventricular hypertrophy has been constrained by a limited conceptual model of the process: heart disease produces chamber enlargement (increased mass), which in turn produces an altered electrocardiogram. The process is much more complex than can be represented in this simple model. A more robust and intricate model is proposed, in which heart (and vascular) disease causes structural changes, electrical changes, biochemical changes, and others, all of which interact to produce electrical remodeling of ventricular myocardium. This electrical remodeling results in a variety of ECG changes. All of these changes interact, leading to an altered clinical course, and to premature death. It is suggested that research, based on this model, can provide new clues to the processes involved, and improve the prediction of clinical outcomes. New directions in research, in recording equipment, and in organizational activities are suggested to test this new model, and to improve the usefulness of the electrocardiogram as a research and diagnostic tool.

  8. Left ventricular noncompaction: Clinical-echocardiographic study

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    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.

  9. CT of left ventricular assist devices.

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    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

  10. A biplane roentgen videometry system for dynamic /60 per second/ studies of the shape and size of circulatory structures, particularly the left ventricle.

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    Ritman, E. L.; Sturm, E.; Wood, E. H.; Heintzen, P. H.

    1971-01-01

    A roentgen-television digital-computer technique and a display system developed for dynamic circulatory structure studies are described. Details are given for a videoroentgenographic setup which is used for obtaining biplane roentgen silhouettes of a left ventricle. A 60 per sec measurement of the shape and volume of angiographically outlined cardiac chambers can be made by this technique along with simultaneous ECG, pressure, and flow measurements accessible for real-time digital computer processing and analysis.

  11. Left Ventricular Hypertrophy Evaluation in Obese Hypertensive Patients: Effect of Left Ventricular Mass Index Criteria

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    Eduardo Cantoni Rosa

    2002-04-01

    Full Text Available PURPOSE: To evaluate left ventricular mass (LVM index in hypertensive and normotensive obese individuals. METHODS: Using M mode echocardiography, 544 essential hypertensive and 106 normotensive patients were evaluated, and LVM was indexed for body surface area (LVM/BSA and for height² (LVM/h². The 2 indexes were then compared in both populations, in subgroups stratified according to body mass index (BMI: or = 30kg/m². RESULTS: The BSA index does not allow identification of significant differences between BMI subgroups. Indexing by height² provides significantly increased values for high BMI subgroups in normotensive and hypertensive populations. CONCLUSION: Left ventricular hypertrophy (LVH has been underestimated in the obese with the use of LVM/BSA because this index considers obesity as a physiological variable. Indexing by height² allows differences between BMI subgroups to become apparent and seems to be more appropriate for detecting LVH in obese populations.

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

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    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

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

    Science.gov (United States)

    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

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

    OpenAIRE

    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...

  15. Nipro extra-corporeal left ventricular assist device fitting after left ventricular reconstruction with mitral valve plasty.

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    Arakawa, Mamoru; Yamaguchi, Atsushi; Nishimura, Takashi; Itoh, Satoshi; Yuri, Koichi; Kyo, Shunei; Adachi, Hideo

    2015-12-01

    Both left ventricular assist device and left ventricular reconstruction are treatment choices for severe heart failure conditions. Our institution performed a left ventricular assist device installation following a left ventricular reconstruction procedure on a 42-year-old male patient who presented with dilated cardiomyopathy and low cardiac output syndrome. A mitral valve plasty was used to correct the acute mitral valve regurgitation and we performed a Nipro extra-corporeal left ventricular assist device installation on post-operative day 14. Due to the left ventricular reconstruction that the patient had in a previous operation, we needed to attach an apical cuff on posterior apex, insert the inflow cannula with a large curve, and shift the skin insertion site laterally to the left. We assessed the angle between the cardiac longitudinal axis and the inflow cannula using computed tomography. The patient did not complain of any subjective symptoms of heart failure. Although Nipro extra-corporeal left ventricular assist device installation after left ventricular reconstruction has several difficulties historically, we have experienced a successful case.

  16. Left and right ventricular diastolic function in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Rudhani Ibrahim

    2010-01-01

    Full Text Available The aim of this prospective study was the assessment of left ventricular and right ventricular diastolic function in patients on hemodialysis (HD and the correlation of this func-tion with the duration of HD. The study included 42 patients (22 females and 20 males with chro-nic renal failure (CRF, treated with HD, and 40 healthy subjects (24 females and 16 males with no history of cardiovascular disease and with normal renal function, who constituted the control group. The groups were matched for age and sex. All study patients and control subjects under-went detailed history taking and physical examination. They also underwent electrocardiogram, echocardiography and biochemical and hematological blood analyses. Significant differences were noted between the two groups in the two-dimensional and M-mode echocardiography findings concerning aortic root dimension, transverse diameter of the left atrium, thickness of the inter-ventricular septum, thickness of the left ventricular posterior wall, left ventricular diastolic diameter, left ventricular systolic diameter, shortening fraction, ejection fraction as well as findings from the pulse Doppler study, including E wave, A wave, E/A ratio, deceleration time of E wave (DT-E, acceleration time of E wave (AT-E, tricuspid E and A waves (E tr and A tr and E tr /A tr , ratio. There were significant changes in HD patients without arterial hypertension as well in the control group subjects. Our study suggests that the left ventricular and left atrial dimensions as well as the left ventricular wall thickness are augmented in patients with CRF treated with HD compared with the control group. Additionally, the left and right ventricular diastolic function is also reduced in these patients. These differences were also noted in patients with CRF without arterial hypertension. Left ventricular diastolic dysfunction had no correlation with the duration of HD.

  17. Left and right ventricular diastolic function in hemodialysis patients.

    Science.gov (United States)

    Rudhani, Ibrahim Destan; Bajraktari, Gani; Kryziu, Emrush; Zylfiu, Bejtush; Sadiku, Shemsedin; Elezi, Ymer; Rexhepaj, Nehat; Vitia, Arber; Emini, Merita; Abazi, Murat; Berbatovci-Ukimeraj, M; Kryeziu, Kaltrina; Hsanagjekaj, Venera; Korca, Hajrije; Ukimeri, Aferdita

    2010-11-01

    The aim of this prospective study was the assessment of left ventricular and right ventricular diastolic function in patients on hemodialysis (HD) and the correlation of this function with the duration of HD. The study included 42 patients (22 females and 20 males) with chronic renal failure (CRF), treated with HD, and 40 healthy subjects (24 females and 16 males) with no history of cardiovascular disease and with normal renal function, who constituted the control group. The groups were matched for age and sex. All study patients and control subjects underwent detailed history taking and physical examination. They also underwent electrocardiogram, echocardiography and biochemical and hematological blood analyses. Significant differences were noted between the two groups in the two-dimensional and M-mode echocardiography findings concerning aortic root dimension, transverse diameter of the left atrium, thickness of the interventricular septum, thickness of the left ventricular posterior wall, left ventricular diastolic diameter, left ventricular systolic diameter, shortening fraction, ejection fraction as well as findings from the pulse Doppler study, including E wave, A wave, E/A ratio, deceleration time of E wave (DT-E), acceleration time of E wave (AT-E), tricuspid E and A waves (E tr and A tr ) and E tr /A tr , ratio. There were significant changes in HD patients without arterial hypertension as well in the control group subjects. Our study suggests that the left ventricular and left atrial dimensions as well as the left ventricular wall thickness are augmented in patients with CRF treated with HD compared with the control group. Additionally, the left and right ventricular diastolic function is also reduced in these patients. These differences were also noted in patients with CRF without arterial hypertension. Left ventricular diastolic dysfunction had no correlation with the duration of HD.

  18. Arterial baroreflex function and left ventricular hypertrophy

    Institute of Scientific and Technical Information of China (English)

    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.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    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...... systolic force and left ventricular geometry and function have not been investigated in high-risk hypertrophic hypertensive patients. Participants in the Losartan Intervention For Endpoint reduction in hypertension echocardiography substudy without prevalent cardiovascular disease or atrial fibrillation (n......, transmitral peak E velocities and peak A velocities; and lower E/A ratio (all P hypertensive patients with greater left ventricular mass and prevalence of left ventricular hypertrophy, but normal left ventricular chamber systolic function with increased...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    DEFF Research Database (Denmark)

    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...... was seen when the single slice technique was used (r = 0.06, p greater than 0.80). The results indicate that MRI is a reliable method for left ventricular volume determination when the multislice technique is used....

  3. A two phase harmonic model for left ventricular function

    CERN Document Server

    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.

  4. Left Ventricular Function After Prolonged Exercise in Equine Endurance Athletes

    DEFF Research Database (Denmark)

    Flethøj, M.; Schwarzwald, C. C.; Haugaard, M. M.;

    2016-01-01

    Background: Prolonged exercise in human athletes is associated with transient impairment of left ventricular (LV) function, known as cardiac fatigue. Cardiac effects of prolonged exercise in horses remain unknown. Objectives :To investigate the effects of prolonged exercise on LV systolic...

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

    OpenAIRE

    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...

  6. Electrocardiographic Criteria for Left Ventricular Hypertrophy in Children

    OpenAIRE

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

    2008-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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).

  8. Safety Testing of Left Ventricular Vent Valves

    OpenAIRE

    Gavin, Caroline; Coblentz, John; Acsell, Jeffrey R.; Shackelford, Anthony G.; Sistino, Joseph J.

    2015-01-01

    Vent vacuum relief valves (VRVs) are used to limit the negative pressure at the ventricular vent catheter tip as well as prevent reversal of blood flow and prevention of air embolism. The purpose of this study was to evaluate the performance of three commercially available ventricular vent valves. The negative pressure at which the vent valve opened was measured at the valve inlet using high-fidelity pressure transducers. Also, the flow rate at which air entrainment occurred due to valve open...

  9. Left ventricular systolic and diastolic function in hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Validation of real-time three-dimensional echocardiography for quantifying left ventricular volumes in the presence of a left ventricular aneurysm: in vitro and in vivo studies

    Science.gov (United States)

    Qin, J. X.; Jones, M.; Shiota, T.; Greenberg, N. L.; Tsujino, H.; Firstenberg, M. S.; Gupta, P. C.; Zetts, A. D.; Xu, Y.; Ping Sun, J.; Cardon, L. A.; Odabashian, J. A.; Flamm, S. D.; White, R. D.; Panza, J. A.; Thomas, J. D.

    2000-01-01

    OBJECTIVES: To validate the accuracy of real-time three-dimensional echocardiography (RT3DE) for quantifying aneurysmal left ventricular (LV) volumes. BACKGROUND: Conventional two-dimensional echocardiography (2DE) has limitations when applied for quantification of LV volumes in patients with LV aneurysms. METHODS: Seven aneurysmal balloons, 15 sheep (5 with chronic LV aneurysms and 10 without LV aneurysms) during 60 different hemodynamic conditions and 29 patients (13 with chronic LV aneurysms and 16 with normal LV) underwent RT3DE and 2DE. Electromagnetic flow meters and magnetic resonance imaging (MRI) served as reference standards in the animals and in the patients, respectively. Rotated apical six-plane method with multiplanar Simpson's rule and apical biplane Simpson's rule were used to determine LV volumes by RT3DE and 2DE, respectively. RESULTS: Both RT3DE and 2DE correlated well with actual volumes for aneurysmal balloons. However, a significantly smaller mean difference (MD) was found between RT3DE and actual volumes (-7 ml for RT3DE vs. 22 ml for 2DE, p = 0.0002). Excellent correlation and agreement between RT3DE and electromagnetic flow meters for LV stroke volumes for animals with aneurysms were observed, while 2DE showed lesser correlation and agreement (r = 0.97, MD = -1.0 ml vs. r = 0.76, MD = 4.4 ml). In patients with LV aneurysms, better correlation and agreement between RT3DE and MRI for LV volumes were obtained (r = 0.99, MD = -28 ml) than between 2DE and MRI (r = 0.91, MD = -49 ml). CONCLUSIONS: For geometrically asymmetric LVs associated with ventricular aneurysms, RT3DE can accurately quantify LV volumes.

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

    Science.gov (United States)

    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

  13. Radiofrequency ablation therapy of intractable ventricular tachycardia present with a left ventricular assist device

    DEFF Research Database (Denmark)

    Nielsen, Jan Møller; Kristiansen, Steen Buus; Gerdes, Christian;

    2015-01-01

    Ventricular tachycardia (VT) occurs in up to 59% of patients with left ventricular assist devices (LVAD). In some of these patients, the VT cannot be managed medically or by implantable cardioverter-defibrillator. In this case, a 66-year-old male was successfully treated with radiofrequency...

  14. Right ventricular failure after implantation of a continuous-flow left ventricular assist device

    DEFF Research Database (Denmark)

    Cordtz, Johan Joakim; Nilsson, Jens C; Hansen, Peter B;

    2014-01-01

    Right ventricular failure (RVF) is a significant complication after implantation of a left ventricular assist device. We aimed to identify haemodynamic changes in the early postoperative phase that predicted subsequent development of RVF in a cohort of HeartMate II (HMII) implanted patients....

  15. 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

    DEFF Research Database (Denmark)

    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%....

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    DEFF Research Database (Denmark)

    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...... ventricular electrical delay (RV-LV-IED) was measured. Response to CRT was defined as ≥15% decrease in left ventricular end-systolic volume. RESULTS: Eighteen of 20 (90%) patients with non-ischemic dilated cardiomyopathy (DCM) and 18 of 29 (62%) with ischemic heart disease (IHD) responded to CRT, p.... CONCLUSION: Interventricular electrical delay predicts left ventricular remodeling after CRT and new, strict ECG criteria of LBBB are superior in predicting remodeling....

  18. Determination of left ventricular mass through SPECT imaging

    Science.gov (United States)

    Zárate-Morales, A.; Rodríguez-Villafuerte, M.; Martínez-Rodríguez, F.; Arévila-Ceballos, N.

    1998-08-01

    An edge detection algorithm has been applied to estimate left ventricular (LV) mass from single photon emission computed tomography (SPECT) thallium-201 images. The algorithm was validated using SPECT images of a phantom. The algorithm was applied to 20 patient studies from the Hospital de Cardiologia, Centro Médico Nacional Siglo XXI. Left ventricular masses derived from the stress and redistribution studies were highly correlated (r=0.96). The average LV masses obtained were 162±37 g and 169±34 g in the redistribution and stress studies, respectively.

  19. Ebstein's Anomaly, Left Ventricular Noncompaction, and Sudden Cardiac Death

    Science.gov (United States)

    McGee, Michael; Warner, Luke; Collins, Nicholas

    2015-01-01

    Ebstein's anomaly is a congenital disorder characterized by apical displacement of the septal leaflet of the tricuspid valve. Ebstein's anomaly may be seen in association with other cardiac conditions, including patent foramen ovale, atrial septal defect, and left ventricular noncompaction (LVNC). LVNC is characterized by increased trabeculation within the left ventricular apex. Echocardiography is often used to diagnose LVNC; however, magnetic resonance (MR) imaging offers superior characterization of the myocardium. We report a case of sudden cardiac death in a patient with Ebstein's anomaly with unrecognized LVNC noted on post mortem examination with screening documenting the presence of LVNC in one of the patient's twin sons. PMID:26240764

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

    DEFF Research Database (Denmark)

    Kelbaek, H; Svendsen, Jesper Hastrup; Aldershvile, J;

    2011-01-01

    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 less than 0.01). Radionuclide LVEF values also correlated well with cardioangiographic measurements...

  1. Unusual distribution of noncompaction of left ventricular myocardium.

    Science.gov (United States)

    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

  2. Revascularization in severe left ventricular dysfunction.

    Science.gov (United States)

    Velazquez, Eric J; Bonow, Robert O

    2015-02-17

    The highest-risk patients with heart failure with reduced ejection fraction are those with ischemic cardiomyopathy and severe left ventricular systolic dysfunction (ejection fraction≤35%). The cornerstone of treatment is guideline-driven medical therapy for all patients and implantable device therapy for appropriately selected patients. Surgical revascularization offers the potential for improved survival and quality of life, particularly in patients with more extensive multivessel disease and the greatest degree of left ventricular systolic dysfunction and remodeling. These are also the patients at greatest short-term risk of mortality with coronary artery bypass graft surgery. The short-term risks of surgery need to be balanced against the potential for long-term benefit. This review discusses the evolving data on the role of surgical revascularization, surgical ventricular reconstruction, and mitral valve surgery in this high-risk patient population.

  3. Angiographic left ventricular wall motion score to predict arrhythmia recurrence in patients with sustained ventricular tachycardia or fibrillation

    NARCIS (Netherlands)

    Wiesfeld, ACP; Crijns, HJGM; VandenBroek, SAJ; Landsman, MLJ; Hillege, HL; vanGilst, WH; Lie, KI

    1996-01-01

    Methods Sixty-nine patients with sustained ventricular tachyarrhythmias were followed up to evaluate the predictive value of functional capacity (i.e. New York Heart Association class and peak oxygen consumption) and resting left ventricular function (i.e. radionuclide left ventricular ejection frac

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

    NARCIS (Netherlands)

    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

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

    NARCIS (Netherlands)

    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

  6. Laparoscopic repair of diaphragmatic hernia after left ventricular assist device.

    Science.gov (United States)

    Farma, Jeffrey; Leeser, David; Furukawa, Satoshi; Dempsey, Daniel T

    2003-06-01

    This case report describes a patient with a symptomatic diaphragmatic hernia that developed after orthotopic heart transplantation and explantation of a left ventricular assist device. The hernia was repaired laparoscopically, and at 6-month follow-up, she is without evidence of recurrence.

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

    NARCIS (Netherlands)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    NARCIS (Netherlands)

    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

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

    NARCIS (Netherlands)

    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

  11. Electrocardiographic criteria for left ventricular hypertrophy in children

    NARCIS (Netherlands)

    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

  12. Electrocardiographic criteria for left ventricular hypertrophy in children.

    NARCIS (Netherlands)

    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

  13. Left ventricular cardiac myxoma and sudden death in a dog

    NARCIS (Netherlands)

    de Nijs, Maria Irene; Vink, Aryan; Bergmann, Wilhelmina; Szatmári, Viktor

    2016-01-01

    BACKGROUND: Myxoma is a very rare benign cardiac tumor in dogs. This is the first description of a cardiac myxoma originating from the left ventricular outflow tract, presumably causing sudden death. CASE PRESENTATION: A previously healthy 12-year-old male West Highland white terrier was found dead

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

    NARCIS (Netherlands)

    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

  15. Synthetic Marijuana Induced Acute Nonischemic Left Ventricular Dysfunction

    OpenAIRE

    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.

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

    DEFF Research Database (Denmark)

    Brouwers, Corline; Denollet, Johan; de Jonge, Nicolaas;

    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...

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

    Institute of Scientific and Technical Information of China (English)

    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.

  18. Left ventricular assist device implantation via left thoracotomy: alternative to repeat sternotomy.

    Science.gov (United States)

    Pierson, Richard N; Howser, Renee; Donaldson, Terri; Merrill, Walter H; Dignan, Rebecca J; Drinkwater, Davis C; Christian, Karla G; Butler, Javed; Chomsky, Don; Wilson, John R; Clark, Rick; Davis, Stacy F

    2002-03-01

    Repeat sternotomy for left ventricular assist device insertion may result in injury to the right heart or patent coronary grafts, complicating intraoperative and postoperative management. In 4 critically ill patients, left thoracotomy was used as an alternative to repeat sternotomy. Anastomosis of the outflow conduit to the descending thoracic aorta provided satisfactory hemodynamic support.

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

    DEFF Research Database (Denmark)

    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...

  20. A prospective study found impaired left ventricular function predicted job retirement after acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, Finn E; Sørensen, Henrik T; Skagen, Knud

    2004-01-01

    OBJECTIVE: Impaired left ventricular function is associated with poor prognosis after acute myocardial infarction (MI). It might be hypothesized that impaired left ventricular function would also affect work outcome; however, no existing data address this hypothesis. This study examines whether...

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

    DEFF Research Database (Denmark)

    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....

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

    NARCIS (Netherlands)

    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.

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

    OpenAIRE

    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...

  4. Cardiac arrhythmias and left ventricular hypertrophy in systemic hypertension

    International Nuclear Information System (INIS)

    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)

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

    Institute of Scientific and Technical Information of China (English)

    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.

  6. Left ventricular border recognition using a dynamic search algorithm

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    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...

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

    OpenAIRE

    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.

  9. [The design of bionic left ventricular auxiliary pump].

    Science.gov (United States)

    Jin, Henglin; Hu, Xiaobing; Du, Lei

    2015-01-01

    This paper reports a novel design of bionic left ventricular auxiliary pump, and the characteristic is that elastic diaphragm of pump driven by hydraulic, having smooth, reliable blood supply, can prevent blood clots, can use the flow sensor, pressure sensor detection showing the blood pressure and blood volume at the inlet and outlet of the pump. The pump can go with heart rate synchronization or asynchronous auxiliary by the R wave of human body's ECG. The design goal is realization of bionic throb. Through the animal experiment, the blood pressure waveforms are close to expectations, stable flow can stroke according to the set value, which prove that the pump can meet the requirement for heart disease patients for bionic left ventricular assistant.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. LEFT ATRIAL VOLUME INDEX (LAVI IN THE EVALUATION OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION

    Directory of Open Access Journals (Sweden)

    Malladi Srinivasa

    2015-02-01

    Full Text Available Although cardiac performance is traditionally focused on Ejection fraction an index of systolic function , diastolic function has been found to play an important role in morbidity and mortality. Diastolic heart failure constitutes about 20 - 40% admissions of heart failure. Left atrium is directly exposed to LV pressures in diastole. Chronic sustained elevation of elevated diastolic filling pressures result in left atrial remodeling resulting in its enlargement. Traditionally left atrial size is determined from the parasternal long axis vie w at end systole. However the left atrial volume is a better measure of LA size and provides better prognostic value. The influence of body surface area is corrected by dividing LA volume by body surface area to get LA volume index ( LAVI. The normal value for all age groups is 22 ± 6 ml/m . 1 AIM: To measure the left atrial volume and diastolic function in 60 subjects and to study the correlation between left atrial volume and diastolic dysfunction METHODS: 60 subjects ( 40 with diastolic dysfunction and 20 c ontrols referred to the echocardiography were studied. All subjects underwent trans thoracic echocardiography and Doppler imaging Diastolic filling was categorized as normal (grade 0 impaired relaxation (grade 1 , pseudo normal pattern (grade 2 , restric tive filling (grade 3. LA volume is measured by biplane area length method and indexed to BSA ( LAVI Results : Among diastolic dysfunction group , 25(62.5% had Grade 1 diastolic dysfunction , 6(15% have grade 2 and 9(22.5% had grade3 diastolic dysfunction . Progressive increase in LAVI was seen with increasing severity of diastolic dysfunction. Mean LAVI in normal persons was 23.49±4.009 ml/ sqm and in patients with diastolic dysfunction , it was 29.38±4.45 , 39.44±8.19 , 44.33±5.54 ml/sqm in grade 1 , grade2 and grade3 diastolic dysfunctions groups respectively.

  12. Comprehensive characterisation of hypertensive heart disease left ventricular phenotypes

    OpenAIRE

    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...

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

    OpenAIRE

    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...

  14. Regional assessment of left ventricular torsion by CMR tagging

    OpenAIRE

    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 ...

  15. Synthetic Marijuana Induced Acute Nonischemic Left Ventricular Dysfunction

    Directory of Open Access Journals (Sweden)

    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.

  16. Synthetic Marijuana Induced Acute Nonischemic Left Ventricular Dysfunction.

    Science.gov (United States)

    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

  17. Vitamin D levels and left ventricular diastolic function

    OpenAIRE

    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...

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

    Energy Technology Data Exchange (ETDEWEB)

    Aydiner, A.; Oto, A.; Oram, E.; Oram, A.; Ugurlu, S.; Karamehmetoglu, A. (Hacettepe Univ., Ankara (Turkey). Dept. of Cardiology); Aras, T.; Bekdik, C.F. (Hacettepe Univ., Ankara (Turkey). Dept. of Nuclear Medicine); Gedik, O. (Hacettepe Univ., Ankara (Turkey). Dept. of Endocrinology)

    1991-10-01

    Left ventricular function including regional wall motion (RWM) was evaluated by {sup 99m}Tc 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.).

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

    International Nuclear Information System (INIS)

    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.)

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

    International Nuclear Information System (INIS)

    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)

  1. Epicardial and endocardial mapping determine most successful site of ablation for ventricular tachyarrhythmias originating from left ventricular summit.

    Science.gov (United States)

    Iijima, Kenichi; Chinushi, Masaomi; Furushima, Hiroshi; Aizawa, Yoshifusa

    2012-06-01

    A 34-year-old woman presented with idiopathic premature ventricular complex (PVC) and ventricular tachycardia (VT) originating from the area called the left ventricular summit. Radiofrequency (RF) application both through the coronary sinus and to the epicardial surface transiently suppressed the VT/PVC. Radiofrequency with sufficient energy was only applicable from the endocardial site, and the VT/PVC was successfully eliminated.

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

    DEFF Research Database (Denmark)

    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...

  3. Left Ventricular Non-compaction Cardiomyopathy - A Case Report

    Directory of Open Access Journals (Sweden)

    Timea Szakacs Xantus

    2015-06-01

    Full Text Available Background: Left non-compaction cardiomyopathy (LVNC or “spongy myocardium” is a relatively rare primary genetic cardiomyopathy, characterized by prominent wall trabeculations and intertrabecular recesses which communicate with the ventricular cavity. It appears in isolated form or coexists with other congenital heart diseases and/or systemic abnormalities. Material and method: A 28-year-old woman was admitted with exertional dyspnoea, palpitations, non-specific chest pain and progressive fatigue on exertion. In her family history sudden cardiac-related deaths at young age are present. Cardiovascular system examination revealed tachycardia, intermittent extrabeats. The rest EKG showed sinusal tachycardia (105 bpm, negative T-waves in DII, DIII, aVF, V4-V6. Consecutive 24 hours Holter EKG monitoring revealed nonsustained ventricular tachycardia, paroxysmal atrial fibrillation, isolated ventricular extrasystoles. Echocardiography showed left ventricular systolic dysfunction (LVEF:30-35%, slight LV enlargement, normal right ventricle and small left ventricle (LV trabeculae in the apical area. Cardiac MRI demonstrated dilated LV and the presence of the trabeculations of LV walls suggestive for non-compaction cardiomyopathy. A combined treatment for heart failure and cardiac arrhythmias was initiated with good clinical results. Patient was scheduled for an implantable cardioverter defibrillator “life-saving”. Conclusions: The symptoms of heart failure and cardiac arrhythmias should be considered important in apparently healthy young patients. Besides intensive medical treatment is indicated the implantation of an ICD “life-saving” and in advanced cases heart transplantation. Even if the electrocardiographic findings are non specific for noncompaction, a complete diagnostic evaluation is important, including sophisticated imaging techniques, a screening of first-degree relatives, and an extensive clinical, and genetic appreciation by a

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Assessment of Left Ventricular Radial Deformation by Speckle Tracking Imaging

    Institute of Scientific and Technical Information of China (English)

    Min PAN; Hao LUO; Ashraf Muhammad; Schultheis Judy; Xiaokui LI; David J. Sahn

    2009-01-01

    The left ventricular radial strain in the inner and outer layers was evaluated by using two-dimensional speckle tracking imaging (2DS). Twenty-five piglets were studied. The short axis views were acquired. Peak systolic radial strain was measured from 6 circumferential points related to 6 standard segments in the inner and outer layers respectively using 2DS methods. The peak positive first derivative (dp/dt) of left ventricular pressure was compared to the radial strain from 2DS. The inner band showed higher peak radial strain values as compared to the outer band at all of the segments (P<0.0001), but the differences had significance just in anteroseptal, posterior, inferior and septal seg-ments (P<0.05). Good correlation could be found between radial strain of inner and outer layers and peak dp/dt (P<0.001). These preliminary results showed that the degree of local deformation or wall thickening of the ventricular wall in its inner layer was more obvious than its outer layer. It is suggested that the 2DS technique is useful and sensitive for better understanding the regional and global myocar-dial motion and its relationship to the complex architecture of myocardium.

  6. Robust left ventricular myocardium segmentation for multi-protocol MR

    Science.gov (United States)

    Groth, A.; Weese, J.; Lehmann, H.

    2012-02-01

    For a number of cardiac procedures like the treatments of ventricular tachycardia (VT), coronary artery disease (CAD) and heart failure (HF) both anatomical as well as vitality information about the left ventricular myocardium are required. To this end, two images for the anatomical and functional information, respectively, must be acquired and analyzed, e.g. using two different 3D MR protocols. To enable automatic analysis, a workflow has been proposed1 which allows to integrate the vitality information extracted from the functional image data into a patient-specific anatomical model generated from the anatomical image. However, in the proposed workflow the extraction of accurate vitality information from the functional image depends to a large extend on the accuracy of both the anatomical model and the mapping of the model to the functional image. In this paper we propose and evaluate methods for improving these two aspects. More specifically, on one hand we aim to improve the segmentation of the often low-contrast left ventricular epicardium in the anatomical 3D MR images by introducing a patient-specific shape-bias. On the other hand, we introduce a registration approach that facilitates the mapping of the anatomical model to images acquired by different protocols and modalities, such as functional 3D MR. The new methods are evaluated on clinical MR data, for which considerable improvements can be achieved.

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    DEFF Research Database (Denmark)

    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...... valve flow pattern, this was not associated with reduced cardiovascular morbidity and mortality when adjusting for blood pressure, left atrial diameter, LV mass index, and treatment in time-varying Cox analyses. In contrast, lower in-treatment E/A ratios and shorter mitral valve deceleration times were...... associated with less risk for heart failure. Similarly, normal in-treatment transmitral flow pattern was strongly associated with less risk for heart failure (hazard ratio 0.22, 95% confidence interval 0.05 to 0.98, p = 0.048), even when taking in-treatment left atrial diameter and blood pressure...

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

    OpenAIRE

    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...

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

    Science.gov (United States)

    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.

  13. Subacute gastric perforation caused by a left ventricular assist device

    Institute of Scientific and Technical Information of China (English)

    Demetris Yannopoulos

    2007-01-01

    This case report describes a rare complication of a left ventricular assist device (LVAD). A patient with ischemic cardiomyopathy had an LVAD placed due to intractable congestive heart failure following a large anterior myocardial infarction. The patient developed chronic bacteremia and multiple septic episodes. A gastric endoscopy revealed perforation of the anterior wall of the stomach by the LVAD. Gastric acid related erosions were present on the metallic surface suggesting prolonged exposure. This is the second case report of this rare complication and the first case report of a subacute course.

  14. Left Ventricular Non-compaction in Holt-Oram Syndrome.

    Science.gov (United States)

    Kapadia, Renuka; Choudhary, Preeti; Collins, Nicholas; Celermajer, David; Puranik, Rajesh

    2016-06-01

    Holt-Oram Syndrome is an autosomal dominant condition with complete penetrance and which involves upper limb skeletal and cardiac abnormalities. The latter can be structural defects or involve the conduction system. This report details the occurrence of left ventricular non-compaction in multiple family members with Holt-Oram Syndrome. It is recommended that patients with the Holt-Oram Syndrome be considered for comprehensive cardiac evaluation to exclude non-compaction cardiomyopathy as this may have significant prognostic implications. PMID:26874791

  15. Survival after blunt left ventricular rupture with cardiac tamponade

    Institute of Scientific and Technical Information of China (English)

    Yu-Jang Su; Chang-Chih Chen

    2013-01-01

    A34-year-old man was drunk and drove to hit a traffic island.Cold sweating and unconscious status were found on arrival.Vital signs revealedBP42/25, and heart rate121/min.There was massive pericardial effusion with cardiac tamponade found byCT.Immediate surgical intervention and rupture of left ventricular(LV) free wall was found.He was discharged after2 d intensive care unit(ICU) observation and5-day regular ward care.There is high mortality rate in traumatic heart rupture although timely repair, over all mortality is around20%-36% in recent3 years.

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

    Science.gov (United States)

    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

  17. Left ventricular aneurysm repair with use of a bovine pericardial patch.

    Science.gov (United States)

    Henry, Matthew J; Preventza, Ourania; Cooley, Denton A; de la Cruz, Kim I; Coselli, Joseph S

    2014-08-01

    Left ventricular aneurysm, which can impair systolic function, has a reported incidence of 10% to 35% in patients after myocardial infarction. In a 58-year-old woman who had a history of myocardial infarction, we excised a large left ventricular aneurysm and restored left ventricular geometry with use of a bovine pericardial patch. The aneurysm's characteristics and the patient's preoperative left ventricular ejection fraction of 0.25 had indicated surgical intervention. The patient had an uneventful postoperative course, and her left ventricular ejection fraction was 0.50 to 0.55 on the 4th postoperative day. This case illustrates the value of surgical treatment for patients who have a debilitating left ventricular aneurysm.

  18. Improved Left Ventricular Structure and Function After Successful Kidney Transplantation

    Directory of Open Access Journals (Sweden)

    Bernd Hewing

    2016-10-01

    Full Text Available Background/Aims: Cardiac changes observed in chronic kidney disease patients are of multifactorial origin including chronic uremia, hemodynamics or inflammation. Restoration of renal function by kidney transplantation (KTX may reverse cardiac changes. Novel echocardiographic methods such as speckle tracking echocardiography (STE allow early and sensitive detection of subtle changes of cardiac parameters. We evaluated changes of cardiac structure and function after KTX by advanced echocardiographic modalities. Methods: Thirty-one KTX recipients (female n=11 were evaluated by medical examination, laboratory testing and echocardiography before and after KTX (median follow-up 19 months. Left ventricular (LV and right ventricular (RV diameters and function were assessed by echocardiographic standard parameters. Longitudinal 2D strain of the LV (GLPS and left atrium (LA was determined by 2D STE. Results: After KTX, median serum creatinine level was 1.3 mg/dl (IQR, 1.2-1.5. Systolic blood pressure decreased significantly after KTX. Echocardiography showed a significant reduction in LV end-diastolic septal and posterior wall thickness and LV mass index after KTX, which was accompanied by an improvement of GLPS. There were no relevant changes in parameters of LA (reservoir, conduit or contractile function, LV diastolic or RV function after KTX. Conclusion: LV hypertrophy reversed after successful KTX and was accompanied by an improvement in longitudinal LV function as assessed by STE. Diastolic function and STE-derived LA function parameters did not change significantly after KTX.

  19. Left ventricular mass in chronic kidney disease and ESRD.

    Science.gov (United States)

    Glassock, Richard J; Pecoits-Filho, Roberto; Barberato, Silvio H

    2009-12-01

    Chronic kidney disease (CKD) and ESRD, treated with conventional hemo- or peritoneal dialysis are both associated with a high prevalence of an increase in left ventricular mass (left ventricular hypertrophy [LVH]), intermyocardial cell fibrosis, and capillary loss. Cardiac magnetic resonance imaging is the best way to detect and quantify these abnormalities, but M-Mode and 2-D echocardiography can also be used if one recognizes their pitfalls. The mechanisms underlying these abnormalities in CKD and ESRD are diverse but involve afterload (arterial pressure and compliance), preload (intravascular volume and anemia), and a wide variety of afterload/preload independent factors. The hemodynamic, metabolic, cellular, and molecular mediators of myocardial hypertrophy, fibrosis, apoptosis, and capillary degeneration are increasingly well understood. These abnormalities predispose to sudden cardiac death, most likely by promotion of electrical instability and re-entry arrhythmias and congestive heart failure. Current treatment modalities for CKD and ESRD, including thrice weekly conventional hemodialysis and peritoneal dialysis and metabolic and anemia management regimens, do not adequately prevent or correct these abnormalities. A new paradigm of therapy for CKD and ESRD that places prevention and reversal of LVH and cardiac fibrosis as a high priority is needed. This will require novel approaches to management and controlled interventional trials to provide evidence to fuel the transition from old to new treatment strategies. In the meantime, key management principles designed to ameliorate LVH and its complications should become a routine part of the care of the patients with CKD and ESRD. PMID:19996010

  20. Long-term results of complex left ventricular reconstruction surgery: case report.

    Science.gov (United States)

    Letsou, George V; Forrester, Matthew; Frazier, O H

    2011-01-01

    Left ventricular reconstruction is advocated as a surgical option for patients with severe congestive heart failure. Despite initial enthusiasm for this procedure, reports of long-term results are sparse. Herein, we describe a particularly gratifying case of left ventricular reconstruction in a 43-year-old man, who continues to have excellent left ventricular function 10 years postoperatively. This approach may be a reasonable alternative to cardiac transplantation in patients who lack other treatment options.

  1. 24 Hour ST Segment Analysis in Transient Left Ventricular Apical Ballooning

    OpenAIRE

    Frank Bode; Christof Burgdorf; Heribert Schunkert; Volkhard Kurowski

    2013-01-01

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

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

    OpenAIRE

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

    1991-01-01

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

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

    OpenAIRE

    Katholi, Richard E.; Couri, Daniel M.

    2011-01-01

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

  4. New digital measurement methods for left ventricular volume using real-time three-dimensional echocardiography: comparison with electromagnetic flow method and magnetic resonance imaging

    Science.gov (United States)

    Qin, J. J.; Jones, M.; Shiota, T.; Greenberg, N. L.; Firstenberg, M. S.; Tsujino, H.; Zetts, A. D.; Sun, J. P.; Cardon, L. A.; Odabashian, J. A.; Flamm, S. D.; White, R. D.; Panza, J. A.; Thomas, J. D.

    2000-01-01

    AIM: The aim of this study was to investigate the feasibility and accuracy of using symmetrically rotated apical long axis planes for the determination of left ventricular (LV) volumes with real-time three-dimensional echocardiography (3DE). METHODS AND RESULTS: Real-time 3DE was performed in six sheep during 24 haemodynamic conditions with electromagnetic flow measurements (EM), and in 29 patients with magnetic resonance imaging measurements (MRI). LV volumes were calculated by Simpson's rule with five 3DE methods (i.e. apical biplane, four-plane, six-plane, nine-plane (in which the angle between each long axis plane was 90 degrees, 45 degrees, 30 degrees or 20 degrees, respectively) and standard short axis views (SAX)). Real-time 3DE correlated well with EM for LV stroke volumes in animals (r=0.68-0.95) and with MRI for absolute volumes in patients (r-values=0.93-0.98). However, agreement between MRI and apical nine-plane, six-plane, and SAX methods in patients was better than those with apical four-plane and bi-plane methods (mean difference = -15, -18, -13, vs. -31 and -48 ml for end-diastolic volume, respectively, Pmethods of real-time 3DE correlated well with reference standards for calculating LV volumes. Balancing accuracy and required time for these LV volume measurements, the apical six-plane method is recommended for clinical use.

  5. New digital measurement methods for left ventricular volume using real-time three-dimensional echocardiography: comparison with electromagnetic flow method and magnetic resonance imaging

    Science.gov (United States)

    Qin, J. J.; Jones, M.; Shiota, T.; Greenberg, N. L.; Firstenberg, M. S.; Tsujino, H.; Zetts, A. D.; Sun, J. P.; Cardon, L. A.; Odabashian, J. A.; Flamm, S. D.; White, R. D.; Panza, J. A.; Thomas, J. D.

    2000-01-01

    AIM: The aim of this study was to investigate the feasibility and accuracy of using symmetrically rotated apical long axis planes for the determination of left ventricular (LV) volumes with real-time three-dimensional echocardiography (3DE). METHODS AND RESULTS: Real-time 3DE was performed in six sheep during 24 haemodynamic conditions with electromagnetic flow measurements (EM), and in 29 patients with magnetic resonance imaging measurements (MRI). LV volumes were calculated by Simpson's rule with five 3DE methods (i.e. apical biplane, four-plane, six-plane, nine-plane (in which the angle between each long axis plane was 90 degrees, 45 degrees, 30 degrees or 20 degrees, respectively) and standard short axis views (SAX)). Real-time 3DE correlated well with EM for LV stroke volumes in animals (r=0.68-0.95) and with MRI for absolute volumes in patients (r-values=0.93-0.98). However, agreement between MRI and apical nine-plane, six-plane, and SAX methods in patients was better than those with apical four-plane and bi-plane methods (mean difference = -15, -18, -13, vs. -31 and -48 ml for end-diastolic volume, respectively, Pmeasurement methods of real-time 3DE correlated well with reference standards for calculating LV volumes. Balancing accuracy and required time for these LV volume measurements, the apical six-plane method is recommended for clinical use.

  6. Left ventricular thrombus formation after repair of anomalous left coronary artery from the pulmonary artery.

    Science.gov (United States)

    Freud, Lindsay R; Koenig, Peter R; Russell, Hyde M; Patel, Angira

    2014-04-01

    Although thrombus formation following myocardial infarction in adults is well known, intracardiac thrombosis in children is uncommon. We report the case of a large left ventricular thrombus in an infant with ischemic cardiomyopathy secondary to anomalous origin of the left coronary artery from the pulmonary artery. Given its mobility and protrusion across the aortic valve, the patient underwent urgent thrombus removal through a transaortic approach. There were no embolic or neurologic complications. This case highlights that thrombectomy may be performed safely and successfully in critically ill pediatric patients.

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

    International Nuclear Information System (INIS)

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

  8. Increased Left Ventricular Stiffness Impairs Exercise Capacity in Patients with Heart Failure Symptoms Despite Normal Left Ventricular Ejection Fraction

    Directory of Open Access Journals (Sweden)

    David Sinning

    2011-01-01

    Full Text Available Aims. Several mechanisms can be involved in the development of exercise intolerance in patients with heart failure despite normal left ventricular ejection fraction (HFNEF and may include impairment of left ventricular (LV stiffness. We therefore investigated the influence of LV stiffness, determined by pressure-volume loop analysis obtained by conductance catheterization, on exercise capacity in HFNEF. Methods and Results. 27 HFNEF patients who showed LV diastolic dysfunction in pressure-volume (PV loop analysis performed symptom-limited cardiopulmonary exercise testing (CPET and were compared with 12 patients who did not show diastolic dysfunction in PV loop analysis. HFNEF patients revealed a lower peak performance (=.046, breathing reserve (=.006, and ventilation equivalent for carbon dioxide production at rest (=.002. LV stiffness correlated with peak oxygen uptake (=−0.636, <.001, peak oxygen uptake at ventilatory threshold (=−0.500, =.009, and ventilation equivalent for carbon dioxide production at ventilatory threshold (=0.529, =.005. Conclusions. CPET parameters such as peak oxygen uptake, peak oxygen uptake at ventilatory threshold, and ventilation equivalent for carbon dioxide production at ventilatory threshold correlate with LV stiffness. Increased LV stiffness impairs exercise capacity in HFNEF.

  9. The influence of right ventricular apical pacing on left atrial volume in patients with normal left ventricular function

    Directory of Open Access Journals (Sweden)

    AR Moaref1

    2008-03-01

    Full Text Available Background: Right ventricular apical (RVA pacing has been reported to induce several deleterious effects particularly in the presence of structural heart disease but can also involve patients with normal left ventricular (LV function. Left atrial (LA enlargement is one of these effects, but the majority of studies have measured LA dimension rather than volume.Objective: The present prospective study was designed to assess the effect of RVA pacing on LA volume in patients with normal LV function.Patients and Methods: The study comprised 41 consecutive patients with LV ejection fraction ≥ 45% and LV end diastolic dimension ≤ 56 mm who underwent single-or dual- chamber pacemaker implantation in RVA and followed for LA volume measurement and pacemaker analysis at least during the ensuing 4.2 months. Results: In all, 21 patients were excluded from the study due to five spontaneous wide QRS complex (≥120msec, one recent acute coronary syndrome,one significant valvular heart disease, three pacing frequency <90%, eight death or losing follow up in three cases. In remaining 20 patients, LA volume ragned from 21 to 54 mm3 with mean of 37.3±9.7 mm3 prior to pacemaker implantation that increased to 31 to 103 mm3 (54.3±17.0 during follow-up (P<0.001.Conclusion: RVA pacing might lead to an increase in LA volume even in patients with normal LV function.

  10. Epicardial radiofrequency ablation for left ventricular aneurysm related ventricular arrhythmias during off-pump coronary artery bypass surgery

    Institute of Scientific and Technical Information of China (English)

    YU Yang; GAO Ming-xin; LI Hai-tao; ZHANG Fan; GU Cheng-xiong

    2012-01-01

    Background Left ventricular aneurysm (LVA) is one of the serious complications after acute myocardial infarction.We attempted to evaluate the preliminary efficacy of LVA repair combined with epicardial radiofrequency ablation for ventricular arrhythmia during off-pump coronary artery bypass grafting (OPCAB).Methods From June 2009 to April 2011,31 patients with LVA had angina symptoms and ventricular arrhythmia.In all patients,circular and cross-shaped radiofrequency epicardial ablations were performed using unipolar ablation pen along the border between the aneurysm wall and normal cardiac tissue and in the central zone of the aneurysms,followed by a linear placation of ventricular aneurysms on beating heart.Results All the patients showed complete recovery.The average number of grafted vessels was 2.7±1.3.Intraoperative examinations revealed that the ventricular arrhythmia was effectively controlled by radiofrequency ablation.All cases had been followed up for one year.Holter monitoring revealed a significant reduction in ventricular arrhythmias (P <0.05).Echocardiography showed significant increase in left ventricular ejection fraction (P <0.05) and decrease in left ventricular end-diastolic diameter (P <0.05).Conclusions For patients with ventricular aneurysm and preoperative malignant arrhythmia,aneurysm repair plus epicardial radiofrequency ablation in OPCAB was found to be an effective and feasible therapeutic technique.However,medium-to long-term therapeutic efficacy of this method remains to be determined by future studies and observations.

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

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

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

  12. Right ventricular outflow and apical pacing comparably worsen the echocardioghraphic normal left ventricle

    NARCIS (Netherlands)

    T.J.F. ten Cate (Tim); M.G. Scheffer (Michael); G.R. Sutherland (George); J.F. Verzijlbergen (Fred); N.M. van Hemel (Norbert)

    2008-01-01

    textabstractAims: A depressed left ventricular function (LVF) is sometimes observed during right ventricular apical (RVA) pacing, but any prediction of this adverse effect cannot be done. Right ventricular outflow tract (RVOT) pacing is thought to deteriorate LVF less frequently because of a more no

  13. Assessment of left ventricular function by noninvasive methods.

    Science.gov (United States)

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

    1985-01-01

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

  14. Current Trends in Implantable Left Ventricular Assist Devices

    Directory of Open Access Journals (Sweden)

    Jens Garbade

    2011-01-01

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

  15. Left ventricular diastolic filling in patients with systemic hypertension

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2010-01-01

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

  17. Risk factors predictive of right ventricular failure after left ventricular assist device implantation.

    Science.gov (United States)

    Drakos, Stavros G; Janicki, Lindsay; Horne, Benjamin D; Kfoury, Abdallah G; Reid, Bruce B; Clayson, Stephen; Horton, Kenneth; Haddad, Francois; Li, Dean Y; Renlund, Dale G; Fisher, Patrick W

    2010-04-01

    Right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation appears to be associated with increased mortality. However, the determination of which patients are at greater risk of developing postoperative RVF remains controversial and relatively unknown. We sought to determine the preoperative risk factors for the development of RVF after LVAD implantation. The data were obtained for 175 consecutive patients who had received an LVAD. RVF was defined by the need for inhaled nitric oxide for >/=48 hours or intravenous inotropes for >14 days and/or right ventricular assist device implantation. An RVF risk score was developed from the beta coefficients of the independent variables from a multivariate logistic regression model predicting RVF. Destination therapy (DT) was identified as the indication for LVAD implantation in 42% of our patients. RVF after LVAD occurred in 44% of patients (n = 77). The mortality rates for patients with RVF were significantly greater at 30, 180, and 365 days after implantation compared to patients with no RVF. By multivariate logistic regression analysis, 3 preoperative factors were significantly associated with RVF after LVAD implantation: (1) a preoperative need for intra-aortic balloon counterpulsation, (2) increased pulmonary vascular resistance, and (3) DT. The developed RVF risk score effectively stratified the risk of RV failure and death after LVAD implantation. In conclusion, given the progressively growing need for DT, the developed RVF risk score, derived from a population with a large percentage of DT patients, might lead to improved patient selection and help stratify patients who could potentially benefit from early right ventricular assist device implantation. PMID:20346326

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

    Directory of Open Access Journals (Sweden)

    Erling David Kaunang

    2014-09-01

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

  19. Left and right ventricular contributions to the formation of the interventricular septum in the mouse heart

    NARCIS (Netherlands)

    D. Franco; S.M. Meilhac; V.M. Christoffels; A. Kispert; M. Buckingham; R.G. Kelly

    2006-01-01

    Mammalian heart development involves complex morphogenetic events which lead to the formation of fully separated left and right atrial and ventricular chambers from a tubular heart. Separation of left and right ventricular chambers is dependent on a single structure, the interventricular septum (IVS

  20. Implantation of a left ventricular assist device in patients with a complex apical anatomy.

    Science.gov (United States)

    Palmen, Meindert; Verwey, Harriette F; Haeck, Marlieke L A; Holman, Eduard R; Schalij, Martin J; Klautz, Robert J M

    2012-12-01

    Implantation of a left ventricular assist device can be challenging in patients with an altered apical anatomy after cardiac surgery or as the result of the presence of a calcified apical aneurysm. In this paper we present 2 cases with a challenging apical anatomy and introduce a new surgical technique facilitating left ventricular assist device implantation in these patients.

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

    OpenAIRE

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

    2009-01-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    OpenAIRE

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

    2010-01-01

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

  4. The left atrium, atrial fibrillation, and the risk of stroke in hypertensive patients with left ventricular hypertrophy

    DEFF Research Database (Denmark)

    Wachtell, K.; Devereux, R.B.; Lyle, P.A.;

    2008-01-01

    The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study provided extensive data on predisposing factors, consequences, and prevention of atrial fibrillation (AF) in patients with hypertension and left ventricular (LV) hypertrophy. Randomized losartan-based treatment...

  5. Left ventricular pseudoaneurysm caused by coronary spasm, myocardial infarction, and myocardial rupture.

    Science.gov (United States)

    Mahilmaran, Asha; Nayar, Pradeep G; Sheshadri, Mukundan; Sudarsana, Gurijala; Abraham, K A

    2002-01-01

    We report a very rare case of a 47-year-old man who had coronary spasm that resulted in a silent myocardial infarction, a ruptured myocardial wall, and a nonruptured left ventricular pseudoaneurysm. The patient presented with a 6-month history of dyspnea on exertion, without evidence of fixed coronary artery stenosis. Coronary angiography showed severe coronary spasm of the left anterior descending and left circumflex arteries; the spasm was relieved promptly by nitroglycerin. Echocardiography and left ventricular angiography revealed the large left ventricular pseudoaneurysm posterolateral to the left ventricle. We performed surgical resection of the pseudoaneurysm and patch repair of the ruptured left ventricular wall, with excellent results. We present this case because of the highly unusual sequence of events. Early surgical intervention resulted in the patient's recovery.

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

    DEFF Research Database (Denmark)

    Qi, P; Thomsen, C; Ståhlberg, F;

    1993-01-01

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

  7. A method for permanent transvenous left ventricular pacing.

    Science.gov (United States)

    Blanc, J J; Benditt, D G; Gilard, M; Etienne, Y; Mansourati, J; Lurie, K G

    1998-11-01

    LV-based pacing has recently been reported to be of benefit in patients with severe cardiac failure and left bundle branch block. LV permanent pacing has been reported using epicardial leads but the surgical mortality is excessive. A transvenous approach is now favored. In this regard, cannulation of the coronary sinus and of one of its tributaries using only the permanent electrode is feasible but technically challenging. We describe a "long guiding sheath" method using catheterization, and a long radiopaque and peelable sheath. Once the coronary sinus is cannulated with the electrophysiological catheter, the long sheath is advanced to the mid-part of the coronary sinus. The permanent pacing electrode is then placed through the sheath and into a tributary of the coronary sinus. This method has been attempted in 10 patients and was successful in 8, with an average lead insertion time of 21 +/- 5.5 minutes and an average fluoroscopic time of 11 +/- 5.5 minutes. In conclusion, although transvenous left ventricular pacing remains a challenge, the "long guiding sheath" approach appears to facilitate this procedure with both a high success rate and an acceptable procedure time. PMID:9826852

  8. The Role of Obesity in the Development of Left Ventricular Hypertrophy Among Children and Adolescents.

    Science.gov (United States)

    Brady, Tammy M

    2016-01-01

    Both obesity and hypertension have increased substantially among children over the last several decades. At the same time, mounting evidence has pointed to the role of these and other cardiovascular disease risk factors on the development of end organ damage such as left ventricular hypertrophy in children. While traditionally thought to occur in response to an increased afterload as in systemic hypertension, evidence demonstrates that obesity is associated with left ventricular hypertrophy independent of blood pressure. Both hemodynamic and non-hemodynamic factors contribute to the pathogenesis of obesity-related left ventricular remodeling. However, more contemporary research suggests that adiposity and blood pressure have a greater effect on left ventricular geometry when present together than when present alone. Normalization of left ventricular mass in obese hypertensive individuals requires achievement of both normotension and weight loss. Additional strategies are needed to promote the cardiovascular health of children, with greater emphasis placed on obesity prevention.

  9. 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

    DEFF Research Database (Denmark)

    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...

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

    OpenAIRE

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

    2002-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  12. A Rare Cardiac Malformation in a Patient Presenting with Transient Ischemic Attack: Isolated Left Ventricular Diverticulum

    Directory of Open Access Journals (Sweden)

    Haldun Müderrisoğlu1

    2012-12-01

    Full Text Available Left ventricular diverticulum is a rare congenital malformation consisting of a localized protrusion of the endocardium and myocardium from the free wall of the left ventricle (LV. The prevalence of the disease is 0.26% in nonselected patients who underwent cardiac catheterization. It is believed that the etiology is an intrinsic abnormality developing during embryogenesis. It often does not cause any symptoms. We report a case of isolated left ventricular diverticulum with complaints of transient ischemic attack.

  13. Left ventricular hemodynamics in patients with sick sinus syndrome

    International Nuclear Information System (INIS)

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

  14. Effect of positive pleural pressure on left ventricular performance

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Khoubyari R

    2016-06-01

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

  17. Rotary blood pump control strategy for preventing left ventricular suction.

    Science.gov (United States)

    Wang, Yu; Koenig, Steven C; Slaughter, Mark S; Giridharan, Guruprasad A

    2015-01-01

    The risk for left ventricular (LV) suction while maintaining adequate perfusion over a range of physiologic conditions during continuous flow LV assist device (LVAD) support is a significant clinical concern. To address this challenge, we developed a suction prevention and physiologic control (SPPC) algorithm for use with axial and centrifugal LVADs. The SPPC algorithm uses two gain-scheduled, proportional-integral controllers that maintain a differential pump speed (ΔRPM) above a user-defined threshold to prevent LV suction, while maintaining an average reference differential pressure (ΔP) between the LV and aorta to provide physiologic perfusion. Efficacy and robustness of the proposed algorithm were evaluated in silico during simulated rest and exercise test conditions for (1) ΔP/ΔRPM excessive setpoint (ES); (2) rapid eightfold increase in pulmonary vascular resistance (PVR); and (3) ES and PVR. Hemodynamic waveforms (LV pressure and volume; aortic pressure and flow) were simulated and analyzed to identify suction event(s), quantify total flow output (pump + cardiac output), and characterize the performance of the SPPC algorithm. The results demonstrated that the proposed SPPC algorithm prevented LV suction while maintaining physiologic perfusion for all simulated test conditions, and warrants further investigation in vivo. PMID:25248043

  18. MR image analysis: Longitudinal cardiac motion influences left ventricular measurements

    Energy Technology Data Exchange (ETDEWEB)

    Berkovic, Patrick [University Hospital Antwerp, Department of Cardiology (Belgium)], E-mail: pberko17@hotmail.com; Hemmink, Maarten [University Hospital Antwerp, Department of Cardiology (Belgium)], E-mail: maartenhemmink@gmail.com; Parizel, Paul M. [University Hospital Antwerp, Department of Radiology (Belgium)], E-mail: paul.parizel@uza.be; Vrints, Christiaan J. [University Hospital Antwerp, Department of Cardiology (Belgium)], E-mail: chris.vrints@uza.be; Paelinck, Bernard P. [University Hospital Antwerp, Department of Cardiology (Belgium)], E-mail: Bernard.paelinck@uza.be

    2010-02-15

    Background: Software for the analysis of left ventricular (LV) volumes and mass using border detection in short-axis images only, is hampered by through-plane cardiac motion. Therefore we aimed to evaluate software that involves longitudinal cardiac motion. Methods: Twenty-three consecutive patients underwent 1.5-Tesla cine magnetic resonance (MR) imaging of the entire heart in the long-axis and short-axis orientation with breath-hold steady-state free precession imaging. Offline analysis was performed using software that uses short-axis images (Medis MASS) and software that includes two-chamber and four-chamber images to involve longitudinal LV expansion and shortening (CAAS-MRV). Intraobserver and interobserver reproducibility was assessed by using Bland-Altman analysis. Results: Compared with MASS software, CAAS-MRV resulted in significantly smaller end-diastolic (156 {+-} 48 ml versus 167 {+-} 52 ml, p = 0.001) and end-systolic LV volumes (79 {+-} 48 ml versus 94 {+-} 52 ml, p < 0.001). In addition, CAAS-MRV resulted in higher LV ejection fraction (52 {+-} 14% versus 46 {+-} 13%, p < 0.001) and calculated LV mass (154 {+-} 52 g versus 142 {+-} 52 g, p = 0.004). Intraobserver and interobserver limits of agreement were similar for both methods. Conclusion: MR analysis of LV volumes and mass involving long-axis LV motion is a highly reproducible method, resulting in smaller LV volumes, higher ejection fraction and calculated LV mass.

  19. Calculation of cardiac pressures using left ventricular ejection fraction (LVEF) derived from radionuclide angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hommer, E.

    1981-04-01

    An attempt has been made to develop formulas to determine cardiac pressures in an undisturbed flow in patients without valvular or shunt diseases. These are based entirely on the results of left ventricular ejection fraction rates, permitting pressure analysis of several compartments at the same tine. According to BORER et al. they also enable determination of left ventricular 'Functional Reserve' after bycycle exercise as well as left ventricular 'Relaxation Reserve'. They support the views of NYHA in determining the grades of cardiac insufficiency proving the system- and low-pressure participation. A single formula for pulmonary flow can determine the pulmonary arterial pressure. The left ventricular enddiastolic pressure can also be exclusively calculated by values of left ventricular functions, thus both formulas may be used in disorders of the mitral valves. The possibility to calculate pressures of all the compartments of the heart from left ventricular ejection rate shows, that in undisturbed flow global heart function depends on left ventricular function. Therefore the mutual dependence of these formulas presents an intercompartimental pressure regulation of the heart through pulmonary flow and pulmonary vascular pressure, which leaves an aspect of autonomous cardiac regulation open to discussion.

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

    Directory of Open Access Journals (Sweden)

    Liebson Philip R

    2006-11-01

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

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

    International Nuclear Information System (INIS)

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

  2. A STUDY OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN HYPERTENSION

    Directory of Open Access Journals (Sweden)

    Ravi Keerthy

    2015-03-01

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

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

    Directory of Open Access Journals (Sweden)

    MA Babaee Beigi

    2009-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Zahra Alizadeh-Sani

    2011-12-01

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

  5. The left ventricle as a mechanical engine: from Leonardo da Vinci to the echocardiographic assessment of peak power output-to-left ventricular mass.

    Science.gov (United States)

    Dini, Frank L; Guarini, Giacinta; Ballo, Piercarlo; Carluccio, Erberto; Maiello, Maria; Capozza, Paola; Innelli, Pasquale; Rosa, Gian M; Palmiero, Pasquale; Galderisi, Maurizio; Razzolini, Renato; Nodari, Savina

    2013-03-01

    The interpretation of the heart as a mechanical engine dates back to the teachings of Leonardo da Vinci, who was the first to apply the laws of mechanics to the function of the heart. Similar to any mechanical engine, whose performance is proportional to the power generated with respect to weight, the left ventricle can be viewed as a power generator whose performance can be related to left ventricular mass. Stress echocardiography may provide valuable information on the relationship between cardiac performance and recruited left ventricular mass that may be used in distinguishing between adaptive and maladaptive left ventricular remodeling. Peak power output-to-mass, obtained during exercise or pharmacological stress echocardiography, is a measure that reflects the number of watts that are developed by 100 g of left ventricular mass under maximal stimulation. Power output-to-mass may be calculated as left ventricular power output per 100 g of left ventricular mass: 100× left ventricular power output divided by left ventricular mass (W/100 g). A simplified formula to calculate power output-to-mass is as follows: 0.222 × cardiac output (l/min) × mean blood pressure (mmHg)/left ventricular mass (g). When the integrity of myocardial structure is compromised, a mismatch becomes apparent between maximal cardiac power output and left ventricular mass; when this occurs, a reduction of the peak power output-to-mass index is observed.

  6. Predictors of right ventricular failure after left ventricular assist device implantation.

    Science.gov (United States)

    Koprivanac, Marijan; Kelava, Marta; Sirić, Franjo; Cruz, Vincent B; Moazami, Nader; Mihaljević, Tomislav

    2014-12-01

    Number of left ventricular assist device (LVAD) implantations increases every year, particularly LVADs for destination therapy (DT). Right ventricular failure (RVF) has been recognized as a serious complication of LVAD implantation. Reported incidence of RVF after LVAD ranges from 6% to 44%, varying mostly due to differences in RVF definition, different types of LVADs, and differences in patient populations included in studies. RVF complicating LVAD implantation is associated with worse postoperative mortality and morbidity including worse end-organ function, longer hospital length of stay, and lower success of bridge to transplant (BTT) therapy. Importance of RVF and its predictors in a setting of LVAD implantation has been recognized early, as evidenced by abundant number of attempts to identify independent risk factors and develop RVF predictor scores with a common purpose to improve patient selection and outcomes by recognizing potential need for biventricular assist device (BiVAD) at the time of LVAD implantation. The aim of this article is to review and summarize current body of knowledge on risk factors and prediction scores of RVF after LVAD implantation. Despite abundance of studies and proposed risk scores for RVF following LVAD, certain common limitations make their implementation and clinical usefulness questionable. Regardless, value of these studies lies in providing information on potential key predictors for RVF that can be taken into account in clinical decision making. Further investigation of current predictors and existing scores as well as new studies involving larger patient populations and more sophisticated statistical prediction models are necessary. Additionally, a short description of our empirical institutional approach to management of RVF following LVAD implantation is provided. PMID:25559829

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    Francisca Gavilanes

    2014-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-06-01

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

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

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Chiranjivi Potu

    2012-02-01

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

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

    Institute of Scientific and Technical Information of China (English)

    许晓晗

    2013-01-01

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

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

    OpenAIRE

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

    2009-01-01

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

  15. Effects of preemptive enoximone on left ventricular diastolic function after valve replacement for aortic stenosis

    NARCIS (Netherlands)

    van der Maaten, Joost M. A. A.; de Vries, Adrianus J.; Rietman, Gerrit W.; Gallandat Huet, Rolf C. G.; De Hert, Stefan G.

    2007-01-01

    Objective: Left ventricular (LV) hypertrophy is associated with increased diastolic chamber stiffness early after aortic valve replacement for valve stenosis. Enoximone, a phosphodiesterase III inhibitor, has been shown to improve myocardial contractility and relaxation when administered as a single

  16. Predictors and progression of aortic stenosis in patients with preserved left ventricular ejection fraction

    DEFF Research Database (Denmark)

    Ersboll, Mads; Schulte, Phillip J; Al Enezi, Fawaz;

    2015-01-01

    We aimed to characterize the hemodynamic progression of aortic stenosis (AS) in a contemporary unselected cohort of patients with preserved left ventricular ejection fraction. Current guidelines recommend echocardiographic surveillance of hemodynamic progression. However, limited data exist on th...

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2016-05-10

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

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

    DEFF Research Database (Denmark)

    Vogelsang, Thomas Wiis; Jensen, Ruben J; Monrad, Astrid L;

    2007-01-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    OpenAIRE

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

    2009-01-01

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

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

    OpenAIRE

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

    2008-01-01

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

  3. Impact of the endurance exercise training on structure and function of left ventricular myocardium

    OpenAIRE

    Bisikirskas, Valdas

    2006-01-01

    Key-words: echocardiography, cardiac hypertrophy, aerobic capacity. Subject of the study. Endurance athletes' left ventricular morphofunction. Background. Whether left ventricular structure and function depend on the mode of the regularly performed endurance exercise is not conclusive. If it depended indeed, specialists in sports medicine, exercise physiologist, as well as athletic coaches would have a great possibility to design the architecture and predict the function of athletes' an...

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

    OpenAIRE

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

    2011-01-01

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

  5. Vasodilators and regression of left ventricular hypertrophy. Hydralazine versus prazosin in hypertensive humans.

    Science.gov (United States)

    Leenen, F H; Smith, D L; Farkas, R M; Reeves, R A; Marquez-Julio, A

    1987-05-01

    Long-term treatment of hypertensive rats with arterial vasodilators may further increase left ventricular hypertrophy. Since left ventricular hypertrophy may be an important determinant of outcome in hypertension, the long-term effects of arterial vasodilation with hydralazine on left ventricular mass and function were compared with those of an alternative third-line drug, the alpha1 blocker prazosin, in patients still hypertensive despite combined diuretic and beta blocker therapy. A single-blind, randomized, two-group parallel design was employed. Both treatments induced a sustained antihypertensive effect, with hydralazine showing more effect on supine blood pressure, and prazosin having more effect on standing pressure. Heart rate, cardiac output, and volume status showed only minor changes. Plasma norepinephrine showed a sustained increase when measured in both the supine and standing positions, but the increases were similar for the two treatments. Supine and standing plasma renin activity increased only during long-term treatment with hydralazine. Prazosin induced a progressive decrease in left ventricular mass over time (-34 +/- 15 g/m2 at 12 months), but hydralazine did not (-9 +/- 10 g/m2 after 12 months). Stepwise regression indicated that a decrease in systolic blood pressure was associated with a decrease in left ventricular mass with both treatments, but an increase in plasma norepinephrine was associated with an increase in left ventricular mass only with hydralazine, suggesting that increased sympathetic activity may affect left ventricular mass via cardiac alpha1 receptors. Thus, if regression of left ventricular hypertrophy is a worthwhile therapeutic goal, hydralazine and analogous arterial vasodilators are not drugs of choice.

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

    OpenAIRE

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Arif Elvan

    2011-01-01

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

  9. Left ventricular assist device inflow cannula thrombus: characterization with two-dimensional transthoracic echocardiography.

    Science.gov (United States)

    Missov, Emil

    2013-01-01

    Thrombotic complications are inherent to current generation nonpulsatile left ventricular assist devices. The clinical expression of device thrombosis ranges from catastrophic failure to protracted and indolent. We report the case of a 79-year-old patient who received a left ventricular assist device as destination therapy and presented only with vague clinical symptoms. He was found to have a large thrombus in close proximity with the inflow cannula at the left ventricular apex, raising the question of mechanical obstruction. We describe the step-by-step contrast-enhanced two-dimensional transthoracic echocardiographic examination which allowed to obtain diagnostic acoustic tomograms of the inflow cannula and obviated the need for any additional imaging modalities. Transthoracic echocardiography (TTE) is the most common imaging modality used in the clinical follow-up of left ventricular assist device recipients. A frequent clinical indication for TTE is to exclude left ventricular apical thrombus near the inflow cannula. Imaging of the inflow cannula at the left ventricular apex in the traditional apical 4 chamber, apical 2 chamber, and parasternal long axis views is challenging by TTE mainly because of poor acoustic windows, image artifacts, large body habitus, and operator experience. PMID:24172272

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

    To evaluate the efficacy and safety of long-term treatment with arotinolol in patients with idiopathic dilated cardiomyopathy (IDCM).Methods Sixty-three patients with IDCM were evaluated at baseline and after 12-month therapy with arotinolol.The conventional therapy for congestive heart failure was continued throughout the study with arotinolol as the only β-blocker. Left ventricular function was assessed with the New York Heart Association functional class and two-dimensional echocardiography.Results After 12-month arotinolol treatment, there was a significant improvement in left ventricular systolic function. Left ventricular end-systolic dimension significantly decreased from 59. 52 ± 8. 83 mm to 50. 89 ± 8.17 mm (P <0.001). Left ventricular ejection fraction significantly increased from 27.39% ±7.94% to 41.13% ±9.45% (P <0.001). Left ventricular mass index decreased from 150. 47 ± 42. 42 g/m2 to 141.58 ± 34.36 g/m2 ( P<0.01). No adverse events leading to premature discontinuation of study drug occurred.Conclusion In this preliminary study, 12-month arotinolol treatment has a favorable effect on left ventricular function in patients with IDCM, and it is safe and well tolerated.

  11. Effect of Left Ventricular Outflow Tract Obstruction on Left Atrial Mechanics in Hypertrophic Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Lynne K. Williams

    2015-01-01

    Full Text Available Left atrial (LA volumes are known to be increased in hypertrophic cardiomyopathy (HCM and are a predictor of adverse outcome. In addition, LA function is impaired and is presumed to be due to left ventricular (LV diastolic dysfunction as a result of hypertrophy and myocardial fibrosis. In the current study, we assess the incremental effect of outflow tract obstruction (and concomitant mitral regurgitation on LA function as assessed by LA strain. Patients with HCM (50 obstructive, 50 nonobstructive were compared to 50 normal controls. A subset of obstructive patients who had undergone septal myectomy was also studied. Utilising feature-tracking software applied to cardiovascular magnetic resonance images, LA volumes and functional parameters were calculated. LA volumes were significantly elevated and LA ejection fraction and strain were significantly reduced in patients with HCM compared with controls and were significantly more affected in patients with obstruction. LA volumes and function were significantly improved after septal myectomy. LVOT obstruction and mitral regurgitation appear to further impair LA mechanics. Septal myectomy results in a significant reduction in LA volumes, paralleled by an improvement in function.

  12. Repair of left ventricular aneurysm during off-pump coronary artery bypass surgery

    Institute of Scientific and Technical Information of China (English)

    YU Yang; GU Cheng-xiong; WEI Hua; LIU Rui; CHEN Chang-cheng; FANG Ying

    2005-01-01

    Background Acute myocardial infarction can result in left ventricular aneurysm, which may in turn cause congestive heart failure, ventricular arrhythmia and thromboembolic events. This study evaluates results achieved with a modified linear closure of left ventricular aneurysms during off-pump coronary artery bypass surgery.Methods From January 2001 to May 2004, 75 patients were operated on for nonruptured, postinfarctional, left ventricular aneurysm during off-pump coronary artery bypass surgery. Repair was completed on the beating heart to minimize ischaemia and allow assessment of wall function and viability to guide closure. All patients presented with symptoms of angina and congestive heart failure or ventricular arrhythmia. The majority (75%) of the patients were in NYHA functional class Ⅲ or Ⅳ. Preoperative ejection fraction was 26%±9%. The mean left ventricular, end diastolic diameter was (57.5±7.1) mm. The ventricular preoperative and postoperative performances were compared. χ2 test and Student's t test were used to analyse the outcomes. A P value less than 0.05 was considered significant.Results Hospital mortality was 1.3% (1/75). Coronary artery bypass was performed with an average of (3.3±1.2) grafts per patient. At the time of followup, all the patients had no symptoms. The mean NYHA class and ejection fraction increased significantly (P<0.001). The mean left ventricular, end diastolic diameter decreased significantly (P<0.001). Conclusions Surgical closure of left ventricular aneurysm can be performed during off-pump coronary artery bypass. The operation is associated with a low inhospital mortality and morbidity. A postoperative improvement in the early term cardiac functions and symptoms and quality of life was documented, increasing our expectations of an increased long-term survival.

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

    Science.gov (United States)

    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

  14. Left ventricular reconstruction with no-patch technique:early and late clinical outcomes

    Institute of Scientific and Technical Information of China (English)

    HU Sheng-shou; FAN Hong-guang; ZHENG Zhe; FENG Wei; WANG Wei; SONG Yun-hu; WANG Li-qing; YUAN Xin; ZHANG Shi-ju

    2010-01-01

    Background Few studies have evaluated late clinical outcome of no-patch technique in patients with large left ventricular aneurysms. The objectives of this study were to evaluate a no-patch surgical technique to reconstruct the left ventricle in patients with left ventricular aneurysm and to assess early and late clinical outcomes.Methods In 1995, we began using a no-patch technique in patients with dyskinetic left ventricular aneurysms. A total of 145 patients underwent left ventricular reconstruction with this technique and were followed up for (59±29) months (range,1-127 months). Risk factors for early mortality were analyzed by bivariate analyses. Cox's proportional hazards model was used to calculate risk factors for all-cause mortality and hospital readmission. Kaplan-Meier methodology was used to analyze late survival.Results One week after operation, left ventricular end-diastolic diameter had decreased from (61±8) mm to (55±8)mm, and geometry of the left ventricle was restored to a more normal conical shape. Early mortality was 3% and late mortality 11%. Over a 5-year follow-up period, hospital readmission was 28%. One-, 5-, and 10-year survival estimates were 95% (95% confidence interval (CI) 91%-99%), 86% (95% CI 78%-94%), and 74% (95% CI 60%-88%).Readmission-free survival at 1 and 5 years after operation was 87% (95% CI81%-93%) and 60% (95% CI50%-70%),respectively.Conclusion The no-patch technique for left ventricular reconstruction is an effective and simple procedure that can achieve satisfactory early and late clinical outcomes in patients with left ventricular aneurysms.

  15. Left ventricular hypertrophy in children, adolescents and young adults with sickle cell anemia

    Directory of Open Access Journals (Sweden)

    Gustavo Baptista de Almeida Faro

    2015-10-01

    Full Text Available OBJECTIVE: The aims of this study were to estimate the frequency of left ventricular hypertrophy and to identify variables associated with this condition in under 25-year-old patients with sickle cell anemia.METHODS: A cross-sectional study was performed of children, adolescents and young adults with sickle cell anemia submitted to a transthoracic Doppler echocardiography. The mass of the left ventricle was determined by the formula of Devereux et al. with correction for height, and the percentile curves of gender and age were applied. Individuals with rheumatic and congenital heart disease were excluded. The patients were divided into two groups according to the presence or absence of left ventricular hypertrophy and compared according to clinical, echocardiographic and laboratory variables.RESULTS: A total of 37.6% of the patients had left ventricular hypertrophy in this sample. There was no difference between the groups of patients with and without hypertrophy according to pathological history or clinical characteristics, except possibly for the use of hydroxyurea, more often used in the group without left ventricular hypertrophy. Patients with left ventricular hypertrophy presented larger left atria and lower hemoglobin and hematocrit levels, reticulocyte index and a higher albumin:creatinine ratio in urine.CONCLUSION: Left ventricular hypertrophy was observed in more than one-third of the young patients with sickle cell anemia with this finding being inversely correlated to the hemoglobin and hematocrit levels, and reticulocyte index and directly associated to a higher albumin/creatinine ratio. It is possible that hydroxyurea had had a protective effect on the development of left ventricular hypertrophy.

  16. Alteration of canine left ventricular diastolic function by intravenous anesthetics in vivo. Ketamine and propofol.

    Science.gov (United States)

    Pagel, P S; Schmeling, W T; Kampine, J P; Warltier, D C

    1992-03-01

    Diastolic function has been shown to influence overall cardiac performance significantly, but the effect of intravenous anesthetics on diastolic function has not been previously characterized in vivo. The effects of ketamine and propofol on two indices of left ventricular diastolic function were examined in chronically instrumented dogs. Because autonomic nervous system function may significantly influence the systemic hemodynamic actions produced by intravenous anesthetics in vivo, experiments were performed in the presence of pharmacologic blockade of the autonomic nervous system. Two groups comprising a total of 14 experiments were performed using 7 dogs instrumented for measurement of aortic and left ventricular pressure, the maximum rate of increase of left ventricular pressure (dP/dt), subendocardial segment length, and cardiac output. Systemic hemodynamics and diastolic function were recorded and evaluated in the conscious state and after a 20-min equilibration at 25-, 50-, and 100-mg.kg-1.h-1 infusion doses of ketamine or propofol. Ventricular relaxation was described using the time constant of isovolumetric relaxation (tau) assuming a nonzero asymptote of ventricular pressure decay. Regional chamber stiffness, an index of passive ventricular filling, was described using an exponential equation relating segment length to ventricular pressure between minimum ventricular pressure and the onset of atrial systole.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1539854

  17. Applications of magnetic resonance imaging in the assessment of left ventricular dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Beacock, David John

    2002-07-01

    This thesis has described the use of Magnetic Resonance Imaging (MRI) in the investigation of left ventricular dimensions and systolic function. This has been performed in conditions of left ventricular dysfunction, in congestive cardiac failure and following anterior myocardial infarction. The reproducibility of measurements of left ventricular dimensions using MRI has been presented. Such measurements were shown to be reproducible between different MRI studies of normal volunteers and patients with congestive heart failure. Furthermore, measurements from different MRI studies obtained from two commercially different systems were reproducible for the same subject groups. Ventricular dimensions and systolic function was evaluated in adult normal volunteers of different ages. Although left ventricular volumes and mass remained unchanged, detailed studies of the systolic images revealed significant differences between the two age groups. Differences in left ventricular cavity volumes and mass between patients with congestive heart failure and age-matched normal volunteers were also investigated. Left ventricular volumes and myocardial mass were assessed in a group of patients following anterior myocardial infarction. End-systolic volume was significantly increased compared to age-matched volunteers, but no changes in end-diastolic volume or myocardial mass was observed. Serial re-evaluation of these patients revealed no other changes over the subsequent six months. All these patients were treated with optimal medical therapy (thrombolysis, aspirin, beta-blockade and angiotensin converting enzyme inhibition). Thus, the use of this therapy may attenuate the process of left ventricular remodelling. Regional wall thickness was measured in the post-infarct patients. Wall thickening was significantly reduced both in the infarcted regions and in myocardium remote to the infarction. In contrast to previous echocardiographic studies, no 'hypercontractility' was

  18. Left atrial strain: a new parameter for assessment of left ventricular filling pressure.

    Science.gov (United States)

    Cameli, Matteo; Mandoli, Giulia Elena; Loiacono, Ferdinando; Dini, Frank Lloyd; Henein, Michael; Mondillo, Sergio

    2016-01-01

    In order to obtain accurate diagnosis, treatment and prognostication in many cardiac conditions, there is a need for assessment of left ventricular (LV) filling pressure. While systole depends on ejection function of LV, diastole and its disturbances influence filling function and pressures. The commonest condition that represents the latter is heart failure with preserved ejection fraction in which LV ejection is maintained, but diastole is disturbed and hence filling pressures are raised. Significant diastolic dysfunction results in raised LV end-diastolic pressure, mean left atrial (LA) pressure and pulmonary capillary wedge pressure, all referred to as LV filling pressures. Left and right heart catheterization has traditionally been used as the gold standard investigation for assessing these pressures. More recently, Doppler echocardiography has taken over such application because of its noninvasive nature and for being patient friendly. A number of indices are used to achieve accurate assessment of filling pressures including: LV pulsed-wave filling velocities (E/A ratio, E wave deceleration time), pulmonary venous flow (S wave and D wave), tissue Doppler imaging (E' wave and E/E' ratio) and LA volume index. LA longitudinal strain derived from speckle tracking echocardiography (STE) is also sensitive in estimating intracavitary pressures. It is angle-independent, thus overcomes Doppler limitations and provides highly reproducible measures of LA deformation. This review examines the application of various Doppler echocardiographic techniques in assessing LV filling pressures, in particular the emerging role of STE in assessing LA pressures in various conditions, e.g., HF, arterial hypertension and atrial fibrillation.

  19. Effects of mechanical left ventricular unloading by Impella on left ventricular dynamics in high-risk and primary percutaneous coronary intervention patients

    NARCIS (Netherlands)

    M. Remmelink; K.D. Sjauw; J.P.S. Henriques; R.J. de Winter; M.M. Vis; K.T. Koch; W.J. Paulus; B.A.J.M. de Mol; J.G.P. Tijssen; J.J. Piek; J.,Jr Baan

    2010-01-01

    OBJECTIVES: We studied online left ventricular (LV) dynamic effects of mechanical LV unloading directly after percutaneous coronary intervention (PCI). BACKGROUND: Limited clinical information is available on the direct LV dynamic consequences of LV unloading in patients undergoing high-risk PCI and

  20. Ethical challenges with the left ventricular assist device as a destination therapy

    Directory of Open Access Journals (Sweden)

    Rady Mohamed Y

    2008-08-01

    Full Text Available Abstract The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US Food and Drug Administration and the US Centers for Medicare & Medicaid Services approved permanent implantation of the left ventricular assist device as a destination therapy in Medicare beneficiaries who are not candidates for heart transplantation. The use of the left ventricular assist device as a destination therapy raises certain ethical challenges. Left ventricular assist devices can prolong the survival of average recipients compared with optimal medical management of chronic end-stage heart failure. However, the overall quality of life can be adversely affected in some recipients because of serious infections, neurologic complications, and device malfunction. Left ventricular assist devices alter end-of-life trajectories. The caregivers of recipients may experience significant burden (e.g., poor physical health, depression, anxiety, and posttraumatic stress disorder from destination therapy with left ventricular assist devices. There are also social and financial ramifications for recipients and their families. We advocate early utilization of a palliative care approach and outline prerequisite conditions so that consenting for the use of a left ventricular assist device as a destination therapy is a well informed process. These conditions include: (1 direct participation of a multidisciplinary care team, including palliative care specialists, (2 a concise plan of care for anticipated device-related complications, (3 careful surveillance and counseling for caregiver burden, (4 advance-care planning for anticipated end-of-life trajectories and timing of device deactivation, and (5 a plan to address the long-term financial burden on patients, families, and caregivers. Short-term mechanical circulatory devices (e

  1. Effects of glucose-insulin-potassium on baroreflex sensitivity, left ventricular function and ventricular arrhythmia in the subacute phase of myocardial infarction in rats

    Institute of Scientific and Technical Information of China (English)

    LIU Jian-Guo; SHU He; SHEN Fu-Ming; MIAO Chao-Yu; SU Ding-Feng

    2004-01-01

    Objective:Glucose-insulin-potassium(GIK) is clinically used for reducing mortality in acute myocardial infarction(MI). It is known that ventricular arrhythmia, left ventricular dysfunction and impaired baroreflex sensitivity(BRS) are the three major determinants for predicting the mortality after acute MI. The present work was designed to study the effects of GIK on BRS, ventricular arrhythmia, and left ventricular function in rats with coronary artery ligature. Sprague-Dawley rats were used and the myocardial infarction was produced by ligature of the left anterior descending artery. Five weeks after coronary artery ligation, BRS was measured in conscious state with a computerized blood pressure monitoring system and left ventricular function and electrocardiogram were determined in the anaesthetized state in the subacute phase of myocardial infarction. It was found that GIK did not affect the blood pressure and heart period in both conscious and anaesthetized rats. GIK did not enhance BRS, but reduced ventricular arrhythmia and improved left ventricular function by reducing left ventricular end diastolic pressure in anaesthetized rats with MI. It is proposed that reducing ventricular arrhythmia and improving left ventricular function contribute to the effect of GIK on reducing the mortality after MI.

  2. Quantitative analysis of left ventricular strain using cardiac computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Buss, Sebastian J., E-mail: sebastian.buss@med.uni-heidelberg.de [Department of Cardiology, University of Heidelberg, 69120 Heidelberg (Germany); Schulz, Felix; Mereles, Derliz [Department of Cardiology, University of Heidelberg, 69120 Heidelberg (Germany); Hosch, Waldemar [Department of Diagnostic and Interventional Radiology, University of Heidelberg, 69120 Heidelberg (Germany); Galuschky, Christian; Schummers, Georg; Stapf, Daniel [TomTec Imaging Systems GmbH, Munich (Germany); Hofmann, Nina; Giannitsis, Evangelos; Hardt, Stefan E. [Department of Cardiology, University of Heidelberg, 69120 Heidelberg (Germany); Kauczor, Hans-Ulrich [Department of Diagnostic and Interventional Radiology, University of Heidelberg, 69120 Heidelberg (Germany); Katus, Hugo A.; Korosoglou, Grigorios [Department of Cardiology, University of Heidelberg, 69120 Heidelberg (Germany)

    2014-03-15

    Objectives: To investigate whether cardiac computed tomography (CCT) can determine left ventricular (LV) radial, circumferential and longitudinal myocardial deformation in comparison to two-dimensional echocardiography in patients with congestive heart failure. Background: Echocardiography allows for accurate assessment of strain with high temporal resolution. A reduced strain is associated with a poor prognosis in cardiomyopathies. However, strain imaging is limited in patients with poor echogenic windows, so that, in selected cases, tomographic imaging techniques may be preferable for the evaluation of myocardial deformation. Methods: Consecutive patients (n = 27) with congestive heart failure who underwent a clinically indicated ECG-gated contrast-enhanced 64-slice dual-source CCT for the evaluation of the cardiac veins prior to cardiac resynchronization therapy (CRT) were included. All patients underwent additional echocardiography. LV radial, circumferential and longitudinal strain and strain rates were analyzed in identical midventricular short axis, 4-, 2- and 3-chamber views for both modalities using the same prototype software algorithm (feature tracking). Time for analysis was assessed for both modalities. Results: Close correlations were observed for both techniques regarding global strain (r = 0.93, r = 0.87 and r = 0.84 for radial, circumferential and longitudinal strain, respectively, p < 0.001 for all). Similar trends were observed for regional radial, longitudinal and circumferential strain (r = 0.88, r = 0.84 and r = 0.94, respectively, p < 0.001 for all). The number of non-diagnostic myocardial segments was significantly higher with echocardiography than with CCT (9.6% versus 1.9%, p < 0.001). In addition, the required time for complete quantitative strain analysis was significantly shorter for CCT compared to echocardiography (877 ± 119 s per patient versus 1105 ± 258 s per patient, p < 0.001). Conclusion: Quantitative assessment of LV strain

  3. Effect of Salvia Miltiorrhiza on Left Ventricular Hypertrophy and Cardiac Aldosterone in Spontaneously Hypertensive Rats

    Institute of Scientific and Technical Information of China (English)

    韩少杰; 郑智; 任大宏

    2002-01-01

    Summary: Chronic treatment with Salvia Miltiorrhiza preventing left ventricular hypertrophy(LVH) and its possible mechanism-inhibiting the action of cardiac aldosterone in spontaneouslyhypertensive rats (SHR) were investigated. Normotensive Wistar-kyoto (WKY) rats and SHRswere used. Part of SHRs was treated with Salvia Miltiorrhiza for 12 weeks. Systolic blood pres-sure (SBP) and left ventricular mass index were measured. Sections of heart tissue were stainedwith HE method and VanGieson method. Collagen volume fraction was determined in the left ven-tricle by automatically quantitative morphometry. Cardiac aldosterone concentration was measuredby radioimmunoassay. The results indicated that compared with WKY rats, SHRs exhibited high-er SBP, left ventricular collagen volume fraction, and aldosterone concentration (all P<0. 05).After the treatment with Salvia Miltiorrhiza, SBP, left ventricular collagen volume fraction, andaldosterone concentration in SHR were decreased as compared with control group (P<0. 05) ex-cept SBP. It was concluded that chronic treatment with Salvia Miltiorrhiza could prevent left ven-tricular hypertrophy in SHR, significantly inhibit collagen compositions in left ventricle. Themechanism was probably related with the inhibition of the cardiac aldosterone action.

  4. The influence of glycemia on the left ventricular diastolic function in patients with arterial hypertension

    Directory of Open Access Journals (Sweden)

    Milutinović Suzana

    2008-01-01

    Full Text Available Introduction. Arterial hypertension is a disease which has influence on the left ventricular diastolic function. It has been suggested that impairment of the left ventricular diastolic function in patients with diabetes mellitus is due to arterial hypertension and diffuse peripherial and coronary atherosclerosis which appear early in diabetic patients. Now, however, it is thought, that other mechanisms are responsable for the development of diabetic cardiomyopathy. The aim of the study was to investigate the effect of glycemia on the left ventricular diastolic function in patients with arterial hypertension. Methods. The study included 60 patients with arterial hypertension: 30 (50,00% patients with diabetes mellitus and 30 (50,00% with­out diabetes mellitus. The parameters of diastolic function were measured by the pulsed Doppler echocardiographic technique. Isovolumetric relaxation time, deceleration time, maximum velocity of the early stage of ventricular filling, maximum velocity of the late stage of ventricular filling and the early/late stage of ventricular filling ratio were used to assess the diastolic function. Results. The patients with arterial hypertension and diabetes mellitus compared to the patients with arterial hypertension without diabetes mellitus were significantly obese (p 0.001, had significantly higher glycemia (p<0.0001 and left atrial volume (p<0.05. The patients with arterial hypertension and diabetes mellilus compared to the patients with arterial hypertension without diabetes mellitus had significanllly: longer deceleration time (p< 0.05, lower velocity of early stage of ventricular filling (p<0.05 and lower early/late stage oj ventricular filling ratio (p<0.01. Conclusion. Diastolic function parameters of patients with diabetes mellitus are significantly changed: deceleration time is longer, early stage of ventricular filling and early/late ventricular filling ratio are lower.

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

    DEFF Research Database (Denmark)

    Ersbøll, Mads; Andersen, Mads J; Valeur, Nana;

    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....

  6. Orthotopic heart transplant versus left ventricular assist device: A national comparison of cost and survival

    Science.gov (United States)

    Mulloy, Daniel P.; Bhamidipati, Castigliano M.; Stone, Matthew L.; Ailawadi, Gorav; Kron, Irving L.; Kern, John A.

    2012-01-01

    Objectives Orthotopic heart transplantation is the standard of care for end-stage heart disease. Left ventricular assist device implantation offers an alternative treatment approach. Left ventricular assist device practice has changed dramatically since the 2008 Food and Drug Administration approval of the HeartMate II (Thoratec, Pleasanton, Calif), but at what societal cost? The present study examined the cost and efficacy of both treatments over time. Methods All patients who underwent either orthotopic heart transplantation (n = 9369) or placement of an implantable left ventricular assist device (n = 6414) from 2005 to 2009 in the Nationwide Inpatient Sample were selected. The trends in treatment use, mortality, and cost were analyzed. Results The incidence of orthotopic heart transplantation increased marginally within a 5-year period. In contrast, the annual left ventricular assist device implantation rates nearly tripled. In-hospital mortality from left ventricular assist device implantation decreased precipitously, from 42% to 17%. In-hospital mortality for orthotopic heart transplantation remained relatively stable (range, 3.8%–6.5%). The mean cost per patient increased for both orthotopic heart transplantation and left ventricular assist device placement (40% and 17%, respectively). With the observed increase in both device usage and cost per patient, the cumulative Left ventricular assist device cost increased 232% within 5 years (from $143 million to $479 million). By 2009, Medicare and Medicaid were the primary payers for nearly one half of all patients (orthotopic heart transplantation, 45%; left ventricular assist device, 51%). Conclusions Since Food and Drug Administration approval of the HeartMate II, mortality after left ventricular assist device implantation has decreased rapidly, yet has remained greater than that after orthotopic heart transplantation. The left ventricular assist device costs have continued to increase and have been

  7. Effects of Tribuli Saponins on Left Ventricular Remodeling after Acute Myocardial Infarction in Rats with Hyperlipidemia

    Institute of Scientific and Technical Information of China (English)

    GUO Yan; YIN Hui-jun; SHI Da-zhuo; CHEN Ke-ji

    2005-01-01

    Objective: To observe the effect of Tribuli saponins (TS) on left ventricularremodeling after acute myocardial infarction(AMI) in rats with hyperlipemia. Methods: A composite model of myocardial infarction and hyperlipemia was established and treated with TS to observe its effect on cardiac structure and function by echocardiography. Results: (1) Cardiac function: As compared with the model group, the fractional shortening (FS) and ejection fraction (EF) got increased, and the left ventricular end diastolic volume (LVEDV) and systolic volume (LVESV) got lower in the groups treated with high dose TS and simvastatin ( P<0.05 or P<0.01 ), but difference between the two treated groups was insignificant. (2) Cardiac structure: As compared with the model group, the left ventricular dimension end diastole (LVDd) and systole (LVDs) in the groups treated with high dose TS and simvastatin got lower ( P<0.05 or P<0.01 ). No treatment showed any effect on the thickness of ventricular wall. (3)Ventricular weight index: Both high dose TS and simvastatin could decrease the left ventricular weight index (LVWI) ( P<0.05). Conclusion: TS could attenuate the left ventricular remodeling after acute myocardial infarction to certain extent, and improve cardiac function in the early phase after AMI, thus playing an important role in controlling morbidity and mortality of cardiac events and long-term prognosis.

  8. Pre-chemotherapy values for left and right ventricular volumes and ejection fraction by gated tomographic radionuclide angiography using a cadmium-zinc-telluride detector gamma camera

    DEFF Research Database (Denmark)

    Haarmark, Christian; Haase, Christine; Jensen, Maria Maj;

    2016-01-01

    BACKGROUND: Estimation of left ventricular ejection fraction (LVEF) using equilibrium radionuclide angiography is an established method for assessment of left ventricular function. The purpose of this study was to establish normative data on left and right ventricular volumes and ejection fraction...... age and both left and right ventricular volumes in women (r = -0.4, P cancer patients without other known cardiopulmonary...

  9. Lung perfusion and ventilation during implantation of left ventricular assist device as a strategy to avoid postoperative pulmonary complications and right ventricular failure

    OpenAIRE

    Macedo, Francisco Igor B.; Anthony L. PANOS; Andreopoulos, Fotios M.; Salerno, Tomas A.; Pham, Si M.

    2013-01-01

    Right ventricular failure is a major contributor to increased morbidity and mortality in patients undergoing left ventricular assist device implantation. Cardiopulmonary bypass is associated with increased pulmonary ischaemia and pulmonary vascular resistance. Continuous pulmonary perfusion and ventilation represents an emerging strategy for pulmonary protection during cardiac surgery. We hypothesize that this technique may have a pivotal role in reducing postoperative right ventricular dysfu...

  10. Beat-to-beat left ventricular performance in atrial fibrillation: radionuclide assessment with the computerized nuclear probe

    International Nuclear Information System (INIS)

    There is wide beat-to-beat variability in cycle length and left ventricular performance in patients with atrial fibrillation. In this study, left ventricular ejection fraction and relative left ventricular volumes were evaluated on a beat-to-beat basis with the computerized nuclear probe, an instrument with sufficiently high sensitivity to allow continuous evaluation of the radionuclide time-activity curve. Of 18 patients with atrial fibrillation, 5 had mitral stenosis, 6 had mitral regurgitation, and 7 had coronary artery disease. Fifty consecutive beats were analyzed in each patient. The mean left ventricular ejection fraction ranged from 17 to 51%. There was substantial beat-to-beat variation in cycle length and left ventricular ejection fraction in all patients, including those with marked left ventricular dysfunction. In 14 patients who also underwent multiple gated cardiac blood pool imaging, there was an excellent correlation between mean ejection fraction derived from the nuclear probe and gated ejection fraction obtained by gamma camera imaging (r . 0.90). Based on beat-to-beat analysis, left ventricular function was dependent on relative end-diastolic volume and multiple preceding cycle lengths, but not preceding end-systolic volumes. This study demonstrates that a single value for left ventricular ejection fraction does not adequately characterize left ventricular function in patients with atrial fibrillation. Furthermore, both the mean beat-to-beat and the gated ejection fraction may underestimate left ventricular performance at rest in such patients

  11. Association of Left Atrial Volume With Mortality Among ESRD Patients With Left Ventricular Hypertrophy Referred for Kidney Transplantation

    OpenAIRE

    Patel, Rajan K.; Jardine, Alan G.M.; Patrick B. Mark; Cunningham, Anthony F.; Steedman, Tracey; Powell, Joanna R.; McQuarrie, Emily P.; Stevens, Kathryn K; Dargie, Henry J; Jardine, Alan G

    2010-01-01

    Background Left ventricular hypertrophy (LVH) is common in patients with end-stage renal disease (ESRD) and an independent risk factor for premature cardiovascular death. Left atrial volume (LAV), measured using echocardiography, predicts death in patients with ESRD. Cardiovascular magnetic resonance (CMR) imaging is a volume-independent method of accurately assessing cardiac structure and function in patients with ESRD. Study Design Single-center prospective observational study to assess the...

  12. Evaluation of left ventricular scar identification from contrast enhanced magnetic resonance imaging for guidance of ventricular catheter ablation therapy

    Science.gov (United States)

    Rettmann, M. E.; Lehmann, H. I.; Johnson, S. B.; Packer, D. L.

    2016-03-01

    Patients with ventricular arrhythmias typically exhibit myocardial scarring, which is believed to be an important anatomic substrate for reentrant circuits, thereby making these regions a key target in catheter ablation therapy. In ablation therapy, a catheter is guided into the left ventricle and radiofrequency energy is delivered into the tissue to interrupt arrhythmic electrical pathways. Low bipolar voltage regions are typically localized during the procedure through point-by-point construction of an electroanatomic map by sampling the endocardial surface with the ablation catheter and are used as a surrogate for myocardial scar. This process is time consuming, requires significant skill, and has the potential to miss low voltage sites. This has led to efforts to quantify myocardial scar preoperatively using delayed, contrast-enhanced MRI. In this paper, we evaluate the utility of left ventricular scar identification from delayed contrast enhanced magnetic resonance imaging for guidance of catheter ablation of ventricular arrhythmias. Myocardial infarcts were created in three canines followed by a delayed, contrast enhanced MRI scan and electroanatomic mapping. The left ventricle and myocardial scar is segmented from preoperative MRI images and sampled points from the procedural electroanatomical map are registered to the segmented endocardial surface. Sampled points with low bipolar voltage points visually align with the segmented scar regions. This work demonstrates the potential utility of using preoperative delayed, enhanced MRI to identify myocardial scarring for guidance of ventricular catheter ablation therapy.

  13. Screening for Fabry Disease in Left Ventricular Hypertrophy: Documentation of a Novel Mutation

    Energy Technology Data Exchange (ETDEWEB)

    Baptista, Ana, E-mail: baptista-ana@hotmail.com; Magalhães, Pedro; Leão, Sílvia; Carvalho, Sofia; Mateus, Pedro; Moreira, Ilídio [Centro Hospitalar de Trás-os-Montes e Alto Douro, Unidade de Vila Real (Portugal)

    2015-08-15

    Fabry disease is a lysosomal storage disease caused by enzyme α-galactosidase A deficiency as a result of mutations in the GLA gene. Cardiac involvement is characterized by progressive left ventricular hypertrophy. To estimate the prevalence of Fabry disease in a population with left ventricular hypertrophy. The patients were assessed for the presence of left ventricular hypertrophy defined as a left ventricular mass index ≥ 96 g/m{sup 2} for women or ≥ 116 g/m{sup 2} for men. Severe aortic stenosis and arterial hypertension with mild left ventricular hypertrophy were exclusion criteria. All patients included were assessed for enzyme α-galactosidase A activity using dry spot testing. Genetic study was performed whenever the enzyme activity was decreased. A total of 47 patients with a mean left ventricular mass index of 141.1 g/m{sup 2} (± 28.5; 99.2 to 228.5 g/m{sup 2}] were included. Most of the patients were females (51.1%). Nine (19.1%) showed decreased α-galactosidase A activity, but only one positive genetic test − [GLA] c.785G>T; p.W262L (exon 5), a mutation not previously described in the literature. This clinical investigation was able to establish the association between the mutation and the clinical presentation. In a population of patients with left ventricular hypertrophy, we documented a Fabry disease prevalence of 2.1%. This novel case was defined in the sequence of a mutation of unknown meaning in the GLA gene with further pathogenicity study. Thus, this study permitted the definition of a novel causal mutation for Fabry disease - [GLA] c.785G>T; p.W262L (exon 5)

  14. Screening for Fabry Disease in Left Ventricular Hypertrophy: Documentation of a Novel Mutation

    Directory of Open Access Journals (Sweden)

    Ana Baptista

    2015-01-01

    Full Text Available Abstract Background: Fabry disease is a lysosomal storage disease caused by enzyme α-galactosidase A deficiency as a result of mutations in the GLA gene. Cardiac involvement is characterized by progressive left ventricular hypertrophy. Objective: To estimate the prevalence of Fabry disease in a population with left ventricular hypertrophy. Methods: The patients were assessed for the presence of left ventricular hypertrophy defined as a left ventricular mass index ≥ 96 g/m2 for women or ≥ 116 g/m2 for men. Severe aortic stenosis and arterial hypertension with mild left ventricular hypertrophy were exclusion criteria. All patients included were assessed for enzyme α-galactosidase A activity using dry spot testing. Genetic study was performed whenever the enzyme activity was decreased. Results: A total of 47 patients with a mean left ventricular mass index of 141.1 g/m2 (± 28.5; 99.2 to 228.5 g/m2] were included. Most of the patients were females (51.1%. Nine (19.1% showed decreased α-galactosidase A activity, but only one positive genetic test − [GLA] c.785G>T; p.W262L (exon 5, a mutation not previously described in the literature. This clinical investigation was able to establish the association between the mutation and the clinical presentation. Conclusion: In a population of patients with left ventricular hypertrophy, we documented a Fabry disease prevalence of 2.1%. This novel case was defined in the sequence of a mutation of unknown meaning in the GLA gene with further pathogenicity study. Thus, this study permitted the definition of a novel causal mutation for Fabry disease - [GLA] c.785G>T; p.W262L (exon 5.

  15. Numerical simulation of the influence of a left ventricular assist device on the cardiovascular system

    NARCIS (Netherlands)

    Verkerke, GJ; Geertsema, AA; Mihaylov, D; Blanksma, PK; Rakhorst, G

    2000-01-01

    The PUCA (pulsatile catheter) pump is a left ventricular assist device (LVAD) capable of unloading the left ventricle (LV) and improving coronary flow by providing a counterpulsation effect. If consists of an extracorporeal located membrane pump, coupled to a transarterial catheter that enters the b

  16. Surgical treatment of a giant left ventricular aneurysm- A case report

    Directory of Open Access Journals (Sweden)

    Gustavo Alves Schaitza

    2014-12-01

    Full Text Available An aneurysm of the left ventricle is a complication of acute myocardial infarction. We report a case of a giant aneurysm of the left ventricle after myocardial infarction in a 59 year-old male patient. The surgery to correct the aneurysm was performed with the use of cardiopulmonary bypass under normothermia. A bovine pericardial patch was used for the geometric reconstruction of the ventricular wall affected by the aneurysm. After the procedure, echocardiography and magnetic resonance imaging revealed improvement in left ventricular ejection fraction and volume reduction.

  17. Surgical treatment of a giant left ventricular aneurysm- a case report.

    Science.gov (United States)

    Schaitza, Gustavo Alves; Faria Neto, José Rocha; Francisco, Julio Cesar; Baena, Cristiana Pellegrino; Giffhorn, Helcio; Olandoski, Bruna; Meira, Leanderson Franco de; Guarita-Souza, Luiz César

    2014-01-01

    An aneurysm of the left ventricle is a complication of acute myocardial infarction. We report a case of a giant aneurysm of the left ventricle after myocardial infarction in a 59 year-old male patient. The surgery to correct the aneurysm was performed with the use of cardiopulmonary bypass under normothermia. A bovine pericardial patch was used for the geometric reconstruction of the ventricular wall affected by the aneurysm. After the procedure, echocardiography and magnetic resonance imaging revealed improvement in left ventricular ejection fraction and volume reduction.

  18. Effect of Hemodialysis on Left and Right Ventricular Volume and Function

    International Nuclear Information System (INIS)

    With the improvement of hemodialysis, the course of thc discase in patient with endstage renal disease has been clearly improved. Nevertheless, among several shortcomings to our present mode of renal replacement therapy, cardiovascular complications have been the leading cause of morbidity and mortality. Several factors such as anemia, arteriovenous shunting of blood, intermittent extracorporeal circulation and hypertension may be contributing. But little is known about the quantitative cardiac hemodynamic characteristics occurred during hemodialysis. The purpose of this study is to observe the sequential hemodynamic changes before, during and after the hemodialysis and to investigate: reliable parameters in the detection of ventricular dysfunction. In the present study, equilibrium radionuclide cardiac angiography was performed and left and right ventricular volume indices, ejection phase indices of both ventricular, performance were measured in the 16 stable patients with chronic renal failure treated with maintenance hemodialysis sequentially i.e. before, during (carly and late phase) and after the hemodialysis. The results obtained were as follows; 1) The indices of the left ventricular function were not changed during the hemodialysis but increased after the hemodialysis. 2) The indices of the right ventricular function(EF, SVI) were significantly decreased in the early phase (15, 30 minutes after starting extracorporeal circulation) but recovered after the hemodialysis, 3) The ratio of right ventricular to left ventricular ejection fraction was significantly decreased in the early phase and the lung volume indices were significantly increased at the same phase. As a conclusion, hemodialysis improves left ventricular function maybe du to increased contractility, and effects on the right ventricular function maybe due to the increased lung volume in the early phase of hemodialysis.

  19. [Successful surgical management of aortico-left ventricular tunnel using modern noninvasive diagnostic imaging methods].

    Science.gov (United States)

    Hartyánszky, István; Katona, Márta; Kádár, Krisztina; Apor, Asztrid; Varga, Sándor; Simon, Judit; Tóth, Attila; Karácsony, Tünde; Bogáts, Gábor

    2015-07-12

    Aortico-left ventricular tunnel is a rare congenital cardiac defect, which bypasses the aortic valve via the paravalvar connection from the aorta to the left ventricle. The authors present the case of a 14-year-old boy with aortico-left ventricular tunnel in whom the aortic orifice arose from the right aortic sinus and was closed by a pericardial patch. The diagnosis was confirmed by combined two-dimensional and real time three-dimensional echocardiogram and magnetic resonance imaging. This is the first case, in which these complex diagnostic imaging methods have been used in the pre- and postoperative management of this defect. Optimally the new transthoratic three-dimensional echocardiography would be needed to define the anatomy and functional consequences of the aortico-left ventricular tunnel and in the postoperative follow-up.

  20. Clinical value of regression of electrocardiographic left ventricular hypertrophy after aortic valve replacement.

    Science.gov (United States)

    Yamabe, Sayuri; Dohi, Yoshihiro; Higashi, Akifumi; Kinoshita, Hiroki; Sada, Yoshiharu; Hidaka, Takayuki; Kurisu, Satoshi; Shiode, Nobuo; Kihara, Yasuki

    2016-09-01

    Electrocardiographic left ventricular hypertrophy (ECG-LVH) gradually regressed after aortic valve replacement (AVR) in patients with severe aortic stenosis. Sokolow-Lyon voltage (SV1 + RV5/6) is possibly the most widely used criterion for ECG-LVH. The aim of this study was to determine whether decrease in Sokolow-Lyon voltage reflects left ventricular reverse remodeling detected by echocardiography after AVR. Of 129 consecutive patients who underwent AVR for severe aortic stenosis, 38 patients with preoperative ECG-LVH, defined by SV1 + RV5/6 of ≥3.5 mV, were enrolled in this study. Electrocardiography and echocardiography were performed preoperatively and 1 year postoperatively. The patients were divided into ECG-LVH regression group (n = 19) and non-regression group (n = 19) according to the median value of the absolute regression in SV1 + RV5/6. Multivariate logistic regression analysis was performed to assess determinants of ECG-LVH regression among echocardiographic indices. ECG-LVH regression group showed significantly greater decrease in left ventricular mass index and left ventricular dimensions than Non-regression group. ECG-LVH regression was independently determined by decrease in the left ventricular mass index [odds ratio (OR) 1.28, 95 % confidence interval (CI) 1.03-1.69, p = 0.048], left ventricular end-diastolic dimension (OR 1.18, 95 % CI 1.03-1.41, p = 0.014), and left ventricular end-systolic dimension (OR 1.24, 95 % CI 1.06-1.52, p = 0.0047). ECG-LVH regression could be a marker of the effect of AVR on both reducing the left ventricular mass index and left ventricular dimensions. The effect of AVR on reverse remodeling can be estimated, at least in part, by regression of ECG-LVH.

  1. Relation between QT dispersion, left ventricle systolic function and frequency of ventricular arrhythmias in coronary patients

    Directory of Open Access Journals (Sweden)

    Stoičkov Viktor

    2007-01-01

    Full Text Available Introduction QT dispersion (QTd is a measure of non-homogeneous repolarisation of the myocardium and is used as an indicator of arrhythmogenicity. Objective The aim of this study was to assess the relation between QT dispersion, left ventricle systolic function and frequency of ventricular arrhythmias in coronary patients. Method We studied 290 coronary patients, 72 with angina pectoris and 218 after myocardial infarction. Eighty-one coronary patients had frequent and complex ventricular arrhythmias (out of them 19 had ventricular tachycardia and 209 were without arrhythmias or with infrequent ventricular premature contractions (VPC≤10/h. In all patients, QT dispersion, exercise test, 24-hour Holter monitoring and echocardiographic examination were performed. Results Patients with frequent and complex ventricular arrhythmias had significantly higher values of QTd (71.8±25.5 vs 55.6±21.7 ms; p<0.001, corrected QT dispersion (QTdc: 81.3±31.5 vs. 60.3±26.1 ms; p<0.001, left ventricular end-diastolic diameter (LVEDd: 56.2±6.9 vs. 53.4±6.2 mm; p<0.001 and left ventricular end-systolic diameter (LVESd: 39.5±6.2 vs. 36.0±6.3 mm; p<0.001, and significantly lower values of left ventricular ejection fraction (LVEF: 47.7±13.9 vs. 55.9±11.6%; p<0.001 in comparison to those without arrhythmias or with infrequent VPC. Patients with VT had significantly higher values of QTd and QTdc in comparison to other patients with frequent and complex ventricular arrhythmias (83.8±17.1 vs. 69.4±26.2 ms; p<0.02 for QTd; 101.1±23.9:77.6±31.4 ms; p<0.005 for QTdc. There is a significant negative correlation of QTd and QTdc with LVEF, and a significant positive correlation of QTd and QTdc with inside dimensions of the left ventricle, in patients with frequent and complex ventricular arrhythmias. Conclusion The study demonstrated that patients with frequent and complex ventricular arrhythmias had significantly higher values of QTd and QTdc, as well as a higher

  2. Evaluation of left ventricular function with breath-hold MR imaging

    International Nuclear Information System (INIS)

    Objective: To investigate the value of breath-hold cine MR imaging in the evaluation of left ventricular function. Methods: Eighteen healthy volunteers and 36 patients with cardiac diseases were studied with breath-hold cine MR imaging, then left ventricular volumes and masses were measured, and the measurements were compared with those of conventional cine MR imaging and echocardiography. Results: (1) The measurements of end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) with breath-hold cine MR imaging technique were closely correlated with those obtained by conventional cine MR imaging and echocardiography. There was no statistically significant difference among the measurements of the three methods (P > 0.05). The correlation coefficients were 0.52-0.96. (2) The correlation coefficient of left ventricular mass (EDM and ESM) among three methods were lower than those of left ventricular volume, and there was statistically significant difference in ESM between MRI and echocardiography (P < 0.05). Conclusion: Breath-hold cine MR imaging is an useful method for evaluating the left ventricular function because of non-ghosting artifacts and short imaging time

  3. Lung function and left ventricular hypertrophy in morbidly obese candidates for bariatric surgery

    Science.gov (United States)

    Müller, Paulo de Tarso; Domingos, Hamilton; Patusco, Luiz Armando Pereira; Rapello, Gabriel Victor Guimarães

    2015-01-01

    Objective: To look for correlations between lung function and cardiac dimension variables in morbidly obese patients, in order to test the hypothesis that the relative size of the small airways is independently correlated with left ventricular hypertrophy. Methods: This was a retrospective study involving 192 medical records containing a clinical protocol employed in candidates for bariatric surgery between January of 2006 and December of 2010. Results: Of the 192 patients evaluated, 39 (10 males and 29 females) met the inclusion criteria. The mean BMI of the patients was 49.2 ± 7.6 kg/m2, and the mean age was 35.5 ± 7.7 years. The FEF25-75/FVC, % correlated significantly with left ventricular posterior wall thickness and relative left ventricular posterior wall thickness, those correlations remaining statistically significant (r = −0.355 and r = −0.349, respectively) after adjustment for weight, gender, and history of systemic arterial hypertension. Stepwise multivariate linear regression analysis showed that FVC and FEV1 were the major determinants of left ventricular mass (in grams or indexed to body surface area). Conclusions: A reduction in the relative size of the small airways appears to be independently correlated with obesity-related cardiac hypertrophy, regardless of factors affecting respiratory mechanics (BMI and weight), gender, or history of systemic arterial hypertension. However, FEV1 and FVC might be important predictors of left ventricular mass in morbidly obese individuals. PMID:26578134

  4. Echocardiographic assessment of the different left ventricular geometric patterns in hypertensive patients

    Directory of Open Access Journals (Sweden)

    Delma Maria Cunha

    2001-01-01

    Full Text Available OBJECTIVE: To identiy left ventricular geometric patterns in hypertensive patients on echocardiography, and to correlate those patterns with casual blood pressure measurements and with the parameters obtained on a 24-hour ambulatory blood pressure monitoring. METHODS: We studied sixty hypertensive patients, grouped according to the Joint National Committee stages of hypertension.. Using the single- and two-dimensional Doppler Echocardiography, we analyzed the left ventricular mass and the geometric patterns through the correlation of left ventricular mass index and relative wall thickness. On ambulatory blood pressure monitoring we assessed the means and pressure loads in the different geometric patterns detected on echocardiography RESULTS: We identified three left ventricular geometric patterns: 1 concentric hypertrophy, in 25% of the patients; 2 concentric remodeling, in 25%; and 3 normal geometry, in 50%. Casual systolic blood pressure was higher in the group with concentric hypertrophy than in the other groups (p=0.001. Mean systolic pressure in the 24h, daytime and nighttime periods was also higher in patients with concentric hypertrophy, as compared to the other groups (p=0.003, p=0.004 and p=0.007. Daytime systolic load and nighttime diastolic load were higher in patients with concentric hypertrophy ( p=0.004 and p=0.01, respectively. CONCLUSIONS: Left ventricular geometric patterns show significant correlation with casual systolic blood pressure, and with means and pressure loads on ambulatory blood pressure monitoring.

  5. Ventricular assist device

    Science.gov (United States)

    VAD; RVAD; LVAD; BVAD; Right ventricular assist device; Left ventricular assist device; Biventricular assist device; Heart pump; Left ventricular assist system; LVAS; Implantable ventricular assist device

  6. Left ventricular assist for pediatric patients with dilated cardiomyopathy using the Medos VAD cannula and a centrifugal pump.

    Science.gov (United States)

    Huang, Shu-Chien; Chi, Nai-Hsin; Chen, Chun-An; Chen, Yih-Sharng; Chou, Nai-Kuan; Ko, Wen-Je; Wang, Shoei-Shen

    2009-11-01

    Ventricular assist devices for small pediatric patients are expensive and commercially unavailable in Taiwan. We used the Medos ventricular assist device cannula (Medos, Aachen, Germany) and a centrifugal pump to support pediatric patients with dilated cardiomyopathy and decompensated heart failure. From January 2007 to December 2008, three pediatric patients with dilated cardiomyopathy were supported using a centrifugal pump as the left ventricular assist device. The Medos arterial cannula was sutured to the ascending aorta, and the Apex cannula was fixed into the left ventricular apex. When the patient was weaned off of cardiopulmonary bypass, the left ventricular assist device pump was started. The pump flow was gradually titrated according to the filling status of the left ventricle. All the left ventricular assist devices were successfully implanted and functioned well. Two patients on extracorporeal membrane oxygenation had severe lung edema before left ventricular assist device implantation. Both patients required extracorporeal membrane oxygenation for the postoperative period until the pulmonary edema was resolved. Among the three patients, two successfully bridged to heart transplantation after support for 6 and 11 days, respectively. The first patient (10 kg) expired due to systemic emboli 30 days after left ventricular assist device support. In summary, these results suggest that the Medos ventricular assist device cannula and a centrifugal pump is an option for temporary left ventricular assist device support in patients with intractable heart failure and as a bridge to heart transplantation.

  7. Dipyridamole-thallium tests are predictive of severe cardiac arrhythmias in patients with left ventricular hypertrophy

    International Nuclear Information System (INIS)

    In a population of patients with chronic renal failure (CRF) and a high prevalence of left ventricular hypertrophy (LVH) undergoing chronic hemodialysis, the authors investigated the association between the results of dipyridamole-thallium tests (DTTs) and the occurrence of ventricular arrhythmias. They observed a positive significant association between positive DTTs and the occurrence of severe forms of ventricular arrhythmias. A significant association was also observed between the presence of severe LVH and the occurrence of severe ventricular arrhythmias. However, no association was found between the presence of LVH and the positivity of the DTT. As most of their patients with positive DTTs had unimpaired coronary circulations, they conclude that positive DTTs, although falsely indicative of impaired myocardial blood supply, does have an important clinical relevance, indicating increased risk of morbidity (and, possibly, mortality) due to ventricular arrhythmias in a population of CRF patients submitted to chronic renal function replacement program

  8. Factors influencing left ventricular hypertrophy in children and adolescents with or without family history of premature myocardial infarction

    Directory of Open Access Journals (Sweden)

    Seyyed Mohsen Hosseini

    2014-01-01

    Result : The results showed that among the studied variables, gender, age, body mass index, and blood pressure were associated with the left ventricular hypertrophy. Conclusion: Considering the results and previous studies in this field, it was observed that left ventricular hypertrophy exists at early ages, which is very dangerous and can lead to heart diseases at early ages. Factors such as being overweight, having high blood pressure, and being male cause left ventricular hypertrophy and lead to undiagnosable heart diseases.

  9. Effects of Perindopril on Left Ventricular Remodeling and Osteopontin Expression in Rats With Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    To observe the effects of perindopril on left ventricular remodeling and myocardial osteopontin expression in rats with myocardial infarction. Methods In this study male adult SD rats were randomly divided into 3groups: sham-operation group, MI-saline group and MI-perindopril group. Left anterior descending artery was ligated to generate myocardial infarction. Perindopril (2 mg/kg body weight/day) was administered from the next day of MI.Four weeks later, left ventricular diameter (LVEDD and LVESD) and left ventricular ejection fraction was estimated with echocardiography, LVSP, LVEDP and ± dp/dtmax was detected with hemodynamic measurement, cardiomyocyte diameter and interstitial fibrosis infiltration were evaluated with histological methods, and myocardium osteopontin protein expression level was detected with western blot. Results ①Compared with the sham-operation group, all rats with MI developed significant systolic and diastolic dysfunction, as was indicated by decreased LVEF, LVSP and ± dp/dtmax, as well as increased LVEDP. ②Rats with MI showed significantly dilated left ventricles and higher ventricular weight / body weight ratio, significantly increased cardiomyocyte diameter and marked interstitial fibrosis in the non-infarction area. ③Perindopril treatment partly prevented cardiac dysfunction and left ventricular remodeling as indicated by the parameters mentioned above. ④No osteopontin protein was detected in myocardium of sham-operation rats. In rats with MI, high level osteopontin protein expression was significantly inhibited by perindopril treatment. Conclusions In rats with MI, perindopril treatment significantly prevented left ventricular remodeling and myocardium osteopontin protein expression.

  10. Effects of Long-term Right Ventricular Apical Pacing on Left Ventricular Remodeling and Cardiac Function

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Objective: To investigate the impacts of long-term right ventricular apical pacing on the ventricular remodeling and cardiac functions of patients with high-grade and third-degree atrioventricular blockage with normal heart structures and cardiac functions. In addition, we provide many evidences for choosing an optimal electrode implantation site.Methods: Study participants included patients who were admitted for pacemaker replacements and revisited for examinations of implanted pacemakers at outpatient. Pa...

  11. Left ventricular metastasis from a primary lung carcinoma

    Institute of Scientific and Technical Information of China (English)

    CHE Guo-wei; LIU Lun-xu; ZHANG Er-yong; ZHOU Qing-hua

    2007-01-01

    @@ The most common tumors associated with cardiac metastases are lung carcinoma and melanoma.1 Although the cardiac involvement of lung cancer is common(lung cancer usually directly invades into the pericardium and/or left/right atrium),the primary lung cancer accompanied with metastasis to the left ventricle is extremely rare.

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

    International Nuclear Information System (INIS)

    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.)

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

    International Nuclear Information System (INIS)

    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

  14. 5-Fluorouracil cardiotoxicity: reversible left ventricular systolic dysfunction with early detection.

    Science.gov (United States)

    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

  15. Left Ventricular Hypertrophy: An allometric comparative analysis of different ECG markers

    Science.gov (United States)

    Bonomini, M. P.; Ingallina, F.; Barone, V.; Valentinuzzi, M. E.; Arini, P. D.

    2011-12-01

    Allometry, in general biology, measures the relative growth of a part in relation to the whole living organism. Left ventricular hypertrophy (LVH) is the heart adaptation to excessive load (systolic or diastolic). The increase in left ventricular mass leads to an increase in the electrocardiographic voltages. Based on clinical data, we compared the allometric behavior of three different ECG markers of LVH. To do this, the allometric fit AECG = δ + β (VM) relating left ventricular mass (estimated from ecocardiographic data) and ECG amplitudes (expressed as the Cornell-Voltage, Sokolow and the ECG overall voltage indexes) were compared. Besides, sensitivity and specifity for each index were analyzed. The more sensitive the ECG criteria, the better the allometric fit. In conclusion: The allometric paradigm should be regarded as the way to design new and more sensitive ECG-based LVH markers.

  16. Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling

    International Nuclear Information System (INIS)

    Left ventricular (LV) diastolic dysfunction is associated with new-onset atrial fibrillation (AF), and the estimation of elevated LV filling pressures by E/e' ratio is related to worse outcomes in patients with AF. However, it is unknown if restoring sinus rhythm reverses this process. To evaluate the impact of AF ablation on estimated LV filling pressure. A total of 141 patients underwent radiofrequency (RF) ablation to treat drug-refractory AF. Transthoracic echocardiography was performed 30 days before and 12 months after ablation. LV functional parameters, left atrial volume index (LAVind), and transmitral pulsed and mitral annulus tissue Doppler (e' and E/e') were assessed. Paroxysmal AF was present in 18 patients, persistent AF was present in 102 patients, and long-standing persistent AF in 21 patients. Follow-up included electrocardiographic examination and 24-h Holter monitoring at 3, 6, and 12 months after ablation. One hundred seventeen patients (82.9%) were free of AF during the follow-up (average, 18 ± 5 months). LAVind reduced in the successful group (30.2 mL/m2 ± 10.6 mL/m2 to 22.6 mL/m2 ± 1.1 mL/m2, p < 0.001) compared to the non-successful group (37.7 mL/m2 ± 14.3 mL/m2 to 37.5 mL/m2 ± 14.5 mL/m2, p = ns). Improvement of LV filling pressure assessed by a reduction in the E/e' ratio was observed only after successful ablation (11.5 ± 4.5 vs. 7.1 ± 3.7, p < 0.001) but not in patients with recurrent AF (12.7 ± 4.4 vs. 12 ± 3.3, p = ns). The success rate was lower in the long-standing persistent AF patient group (57% vs. 87%, p = 0.001). Successful AF ablation is associated with LA reverse remodeling and an improvement in LV filling pressure

  17. Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling

    Directory of Open Access Journals (Sweden)

    Simone Nascimento dos Santos

    2014-12-01

    Full Text Available Background: Left ventricular (LV diastolic dysfunction is associated with new-onset atrial fibrillation (AF, and the estimation of elevated LV filling pressures by E/e' ratio is related to worse outcomes in patients with AF. However, it is unknown if restoring sinus rhythm reverses this process. Objective: To evaluate the impact of AF ablation on estimated LV filling pressure. Methods: A total of 141 patients underwent radiofrequency (RF ablation to treat drug-refractory AF. Transthoracic echocardiography was performed 30 days before and 12 months after ablation. LV functional parameters, left atrial volume index (LAVind, and transmitral pulsed and mitral annulus tissue Doppler (e' and E/e' were assessed. Paroxysmal AF was present in 18 patients, persistent AF was present in 102 patients, and long-standing persistent AF in 21 patients. Follow-up included electrocardiographic examination and 24-h Holter monitoring at 3, 6, and 12 months after ablation. Results: One hundred seventeen patients (82.9% were free of AF during the follow-up (average, 18 ± 5 months. LAVind reduced in the successful group (30.2 mL/m2 ± 10.6 mL/m2 to 22.6 mL/m2 ± 1.1 mL/m2, p < 0.001 compared to the non-successful group (37.7 mL/m2 ± 14.3 mL/m2 to 37.5 mL/m2 ± 14.5 mL/m2, p = ns. Improvement of LV filling pressure assessed by a reduction in the E/e' ratio was observed only after successful ablation (11.5 ± 4.5 vs. 7.1 ± 3.7, p < 0.001 but not in patients with recurrent AF (12.7 ± 4.4 vs. 12 ± 3.3, p = ns. The success rate was lower in the long-standing persistent AF patient group (57% vs. 87%, p = 0.001. Conclusion: Successful AF ablation is associated with LA reverse remodeling and an improvement in LV filling pressure.

  18. Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Simone Nascimento dos, E-mail: simonens@cardiol.br [Instituto Brasília de Arritmia- Universidade de Brasília, DF (Brazil); Faculdade de Medicina (UnB), Brasília, DF (Brazil); Henz, Benhur Davi; Zanatta, André Rodrigues; Barreto, José Roberto; Loureiro, Kelly Bianca; Novakoski, Clarissa; Santos, Marcus Vinícius Nascimento dos; Giuseppin, Fabio F.; Oliveira, Edna Maria; Leite, Luiz Roberto [Instituto Brasília de Arritmia- Universidade de Brasília, DF (Brazil)

    2014-12-15

    Left ventricular (LV) diastolic dysfunction is associated with new-onset atrial fibrillation (AF), and the estimation of elevated LV filling pressures by E/e' ratio is related to worse outcomes in patients with AF. However, it is unknown if restoring sinus rhythm reverses this process. To evaluate the impact of AF ablation on estimated LV filling pressure. A total of 141 patients underwent radiofrequency (RF) ablation to treat drug-refractory AF. Transthoracic echocardiography was performed 30 days before and 12 months after ablation. LV functional parameters, left atrial volume index (LAVind), and transmitral pulsed and mitral annulus tissue Doppler (e' and E/e') were assessed. Paroxysmal AF was present in 18 patients, persistent AF was present in 102 patients, and long-standing persistent AF in 21 patients. Follow-up included electrocardiographic examination and 24-h Holter monitoring at 3, 6, and 12 months after ablation. One hundred seventeen patients (82.9%) were free of AF during the follow-up (average, 18 ± 5 months). LAVind reduced in the successful group (30.2 mL/m{sup 2} ± 10.6 mL/m{sup 2} to 22.6 mL/m{sup 2} ± 1.1 mL/m{sup 2}, p < 0.001) compared to the non-successful group (37.7 mL/m{sup 2} ± 14.3 mL/m{sup 2} to 37.5 mL/m{sup 2} ± 14.5 mL/m{sup 2}, p = ns). Improvement of LV filling pressure assessed by a reduction in the E/e' ratio was observed only after successful ablation (11.5 ± 4.5 vs. 7.1 ± 3.7, p < 0.001) but not in patients with recurrent AF (12.7 ± 4.4 vs. 12 ± 3.3, p = ns). The success rate was lower in the long-standing persistent AF patient group (57% vs. 87%, p = 0.001). Successful AF ablation is associated with LA reverse remodeling and an improvement in LV filling pressure.

  19. Primary left ventricular hydatid cyst in a child: case report

    Energy Technology Data Exchange (ETDEWEB)

    Turkvatan, A. [Turkiye Yuksek Ihtisas Hospital, Dept. of Radiology, Ankara (Turkey); Yelgec, N.S. [Turkiye Yuksek Ihtisas Hospital, Dept. of Cardiology, Ankara (Turkey); Calikoglu, U.; Olcer, T. [Turkiye Yuksek Ihtisas Hospital, Dept. of Radiology, Ankara (Turkey)

    2000-12-01

    The most common cause of echinococcosis in humans is Echinococcus granulosus. Although hydatid cyst is most frequently localized in liver (more than 65% of cases) and lung (25%) by means of portal and systemic circulation, it may involve other tissues and organs. Cardiac hydatid cysts account for only 0.5%-2% of all hydatid cysts, even in endemic areas. Of all cardiac hydatid cysts, the left ventricle accounts for 60%, right ventricle 10%, pericardium 7%, pulmonary artery 6%, left atrial appendage 6%, and interventricular septum 4%. We report the case of a myocardial hydatid cyst of the left ventricle in a 9-year-old boy. (author)

  20. Hemodynamic and glucometabolic factors in the prediction of left ventricular filling pressures

    DEFF Research Database (Denmark)

    Pareek, M; Nielsen, M L; Olesen, T B;

    2015-01-01

    OBJECTIVE: To explore possible hemodynamic and glucometabolic determinants of left ventricular filling pressures as assessed by the non-invasive surrogate marker, averaged E/é, in otherwise healthy, middle-aged male survivors from a random population sample. DESIGN AND METHODS: Prospective.......01). We did not find any significant interactions in the prediction of E/é. CONCLUSION: In a prospective population-based cohort study including apparently healthy, middle-aged male subjects, higher age, BMI, and creatinine, but not SBP or HR, were significantly associated with higher left ventricular...

  1. Left ventricular to right atrial shunt resulting from infective endocarditis.

    Science.gov (United States)

    Ellis, C J; Gray, K E; Ainscow, D A

    1975-02-01

    A unique case is described in which infective endocarditis of the aortic valve led to intractable heart failure and necropsy examination showed that the patient had developed a communication between the left ventricle and right atrium.

  2. Left ventricular synchrony assessed by phase analysis of gated myocardial perfusion SPECT imaging in healthy subjects

    International Nuclear Information System (INIS)

    Objective: To investigate the value of Cedars-Sinai quantitative gated SPECT (QGS) phase analysis for left ventricular synchrony assessment in healthy subjects. Methods: Seventy-four healthy subjects (41 males, 33 females,average age: (60±13) years) underwent both rest and exercise 99Tcm-MIBI G-MPI. QGS software was used to analyze the reconstructed rest gated SPECT images automatically, and then the parameters of left ventricular synchrony including phase bandwidth (BW) and phase standard deviation (SD) were obtained. The influences of gender and age (age<60 years, n=36; age ≥ 60 years, n=38) on left ventricular systolic synchronicity were analyzed. The phase angle for original segmental contraction was measured to determine the onset of the ventricular contraction using 17-segment model. Forty healthy subjects were selected by simple random sampling method to evaluate the intra-observer and interobserver repeatability of QGS phase analysis software. Two-sample t test and linear correlation analysis were used to analyze the data. Results: The BW and SD of left ventricular in healthy subjects were (37.22 ±11.71)°, (11.84±5.39)° respectively. Comparisons between male and female for BW and SD yielded no statistical significance (BW: (36.00±9.70)°, (38.73±13.84)°; SD: (11.88±5.56)°, (11.79±5.26)°; t=0.96 and-0.07, both P>0.05); whereas the older subjects (age≥60 years) had larger BW than the others (age<60 years ; (39.95± 12.65)°, (34.33± 10.00)°; t=-2.11, P<0.05) and no statistical significance was shown for SD between the two age groups ((11.18±4.31)°, (12.54±6.33)°; t=1.08, P>0.05). Of the 74 subjects, the mechanical activation started from the ventricular base to apex in 54 subjects (73%), and from apex to base in only 20 subjects (27%). High repeatability of phase analysis was observed for both intra-observer and inter-observer (r=0.867-0.906, all P<0.001). Conclusions: Good left ventricular segmental synchrony is shown in healthy

  3. Combined left and right ventricular volume determination by radionuclide angiocardiography using double bolus and equilibrium technique

    DEFF Research Database (Denmark)

    Stokholm, K H; Stubgaard, M; Møgelvang, J;

    1990-01-01

    by indicator dilution. The radionuclide technique comprised four steps: (1) a first-pass study of right ventricle; (2) a bolus study of left ventricle; (3) an equilibrium study of left ventricle; (4) determination of the distribution volume of red blood cells. Absolute volumes of left ventricle were determined......Eighteen patients with ischaemic heart disease were studied. Left and right ventricular volumes including cardiac output (forward flow) were determined by radionuclide angiocardiography using a double bolus and equilibrium technique. As reference, cardiac output was simultaneously measured...... from steps 2 + 3 + 4. Absolute volumes of right ventricle were calculated from stroke volume and right ventricular ejection fraction (EF) which in turn was determined from step 1 by creating composite systolic and composite diastolic images. There was an acceptable agreement between stroke volume...

  4. Evaluation of global and regional left ventricular function obtained by quantitative gated SPECT using {sup 99m}Tc-tetrofosmin for left ventricular dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Ban, Kazunobu; Nakajima, Tohru; Iseki, Harukazu; Abe, Sumihisa; Handa, Shunnosuke; Suzuki, Yutaka [Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine

    2000-08-01

    The quantitative gated SPECT (QGS) software is able to calculate LV volumes and visualize LV wall motion and perfusion throughout the cardiac cycle using an automatic edge detection algorithm of the left ventricle. We evaluated the reliability of global and regional LV function assessment derived from QGS by comparing it with the results from left ventriculo-cineangiography (LVG). In 20 patients with left ventricular dysfunction who underwent ECG gated {sup 99m}Tc-tetrofosmin SPECT, the end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (LVEF) were calculated. The QGS-assessed regional wall motion was determined using the cinematic display. QGS-derived EDV, ESV and LVEF correlated well with those by LVG (p<0.001 for each). There was a good correlation between wall motion score (WMS) derived from the QGS and the LVG (r=0.40, p<0.05). In some patients with extensive myocardial infarction, there was a discrepancy in the regional wall motion results between QGS and LVG. The ECG-gated SPECT using QGS is useful to evaluate global and regional LV functions in left ventricular dysfunction. (author)

  5. Cardiac MRI and Transthoracic Echocardiography of Left Ventricular Myocardial Noncompaction in A Patient with Congestive Heart Failure: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Eui Min; Byun, Joo Nam [Chosun University Hospital College of Medicine, Gwangju (Korea, Republic of); Kim, Dong Hun [Soonchunhyang University Hospital Bucheon College of Medicine, Bucheon (Korea, Republic of)

    2010-11-15

    We report a case of a 38-year-old male presenting with new-onset dyspnea, that was diagnosed as left ventricular noncompaction by transthoracic echocardiographic and cardiac MR. The tests revealed left ventricular systolic dysfunction with prominent trabeculations associated with deep intertrabecular recesses and an enddiastolic noncompacted to compacted ratio of 2.5 in the whole apical wall and mid-ventricular anterolateral and inferolateral walls. Delayed gadolinium contrast-enhanced MRI revealed subepicardial mid-wall hyperenhancement of the midventricular anteroseptal and inferoseptal walls, which suggested myocardial fibrosis. We review the pathophysiology, clinical characteristics, and diagnostic approach of the left ventricular noncompaction associated with congestive heart failure

  6. Effects of Everolimus-Eluting Stents on the Left Ventricular Systolic and Diastolic Functions

    OpenAIRE

    MohammadSadegh Parsaee; Maryam Nabati; Naser Saffar; Morteza Taghavi

    2015-01-01

    Background: The drug-eluting stent (DES) decreases the rate of coronary restenosis and re-obstruction. The aim of this study was to assess prospectively the effectiveness of the new generation DES on the left ventricular (LV) systolic and diastolic functions in patients with isolated severe proximal left anterior descending (LAD) coronary artery stenosis.Methods: A prospective study was conducted on 50 patients with isolated severe proximal LAD stenosis. Successful percutaneous coronary inter...

  7. Left Ventricular Hypertrophy in Chronic Kidney Disease Patients: From Pathophysiology to Treatment

    OpenAIRE

    Di Lullo, Luca; Gorini, Antonio; Russo, Domenico; Santoboni, Alberto; Ronco, Claudio

    2015-01-01

    Cardiovascular diseases represent the main causes of morbidity and mortality in patients with chronic kidney disease (CKD). According to a well-established classification, cardiovascular involvement in CKD can be set in the context of cardiorenal syndrome type 4. Left ventricular hypertrophy (LVH) represents a key feature to provide an accurate picture of systolic-diastolic left heart involvement in CKD patients. Cardiovascular involvement is present in about 80% of prevalent hemodialysis pat...

  8. Assessment of left ventricular systolic and diastolic function in subclinical hypothyroidism

    OpenAIRE

    Velkoska Nakova, Valentina; Krstevska, Branka; Kostovska Srbinovska, Elizabeta; Vaskova, Olivija

    2015-01-01

    Objective: Studies investigating systolic and diastolic left ventricle function in subclinical hypothyroidism (ScH) have shown controversial results. As myocardium is a target organ of thyroid hormone action, the aim of the study was to assess the left ventricular systolic and diastolic function in ScH. Methods: Fifty-four patients with newly diagnosed ScH and 30 euthyroid controls, patients of the University Clinic of the Endocrinology, Diabetes, and Metabolic Disorders Clinic...

  9. Hypertrophic cardiomyopathy with apical left ventricular aneurysm: a case report

    Institute of Scientific and Technical Information of China (English)

    江腾勇; 韩智红; 王京; 吕强; 吴学思

    2002-01-01

    @@ Morphological diversity is one characteristic of hypertrophic cardi omyopathy (HCM), but it is not common that HCM is associated with apical left ve ntricular aneurysm (LVA) without evidence of a coronary artery lesion. We repor t on such a case and review the pathogenesis, manifestations and diagnostic meth ods by collecting the few available papers published on this topic.

  10. Percutaneous transfemoral closure of a pseudoaneurysm at the left ventricular apical access site for transcatheter aortic valve implantation.

    Science.gov (United States)

    Karimi, Ashkan; Beaver, Thomas M; Fudge, James C

    2015-02-01

    This case report illustrates a left ventricular pseudoaneurysm that developed at the transapical access site for transcatheter aortic valve implantation and was successfully excluded percutaneously through a femoral approach using an Amplatzer muscular VSD occluder (St. Jude Medical). We also discuss various currently available devices and technical pearls for percutaneous closure of left ventricular pseudoaneurysms. PMID:25661768

  11. Effect of Peritoneal Dialysis Treatment on Left Ventricular Systolic and Diastolic Functions in Patients with End-Stage Renal Disease

    Directory of Open Access Journals (Sweden)

    Feridun KAVUNCUOĞLU

    2014-09-01

    Full Text Available OBJECTIVE: To analyze the effect of peritoneal dialysis (PD treatment on left ventricular systolic and diastolic function in patients with end-stage renal disease (ESRD. MATERIAL and METHODS: The study population consisted of 51 patients with ESRD. Before a PD catheter was inserted, the patients were evaluated by echocardiography and Doppler tissue imaging (DTI. Then, a PD catheter was inserted. After 6 months, the second echocardiographic evaluations were performed. Left ventricular systolic and diastolic function parameters were compared. RESULTS: The mean age was 47 ± 13 years and 38 (74.5% of the patients were male. No significant difference was found in echocardiographic parameters including ejection fraction, fractional shortening, left ventricular mass, left ventricular mass index, left ventricular posterior wall thickness, inter ventricular septal thickness, left atrial diameter, early diastolic filling/late diastolic filling ratio before and after the period of PD. Left ventricular end-systolic diameter and left ventricular end-diastolic diameter values were significantly lower found in the period after PD. CONCLUSION: Our findings appear to reflect somewhat the favourable changes in LV diastolic and systolic functions in PD patients.

  12. Gated blood-pool SPECT automated versus manual left ventricular function calculations

    NARCIS (Netherlands)

    Slart, RHJA; Poot, L; Piers, DA; van Veldhuisen, DJ; Nichols, K; Jager, PL

    2004-01-01

    Planar gated blood-pool imaging (GBPI) is a standard method for non-invasive assessment of left ventricular (LV) function. Gated blood-pool single photon emission computed tomographic (GBPS) data acquisition can be accomplished in the same time as GBPI, with the benefit of enabling visualization of

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

    DEFF Research Database (Denmark)

    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...

  14. Left ventricular twist and circumferential strain in dogs with myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Zois, Nora Elisabeth; Olsen, N. T.; Moesgaard, S. G.;

    2013-01-01

    During the cardiac cycle, the ventricle undergoes a twisting motion because of the oblique orientation of the left ventricular (LV) myofibers. This can be quantified by speckle-tracking echocardiography (STE). In mitral regurgitation (MR) in humans, the short axis deformation has been suggested...

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Prevalence of heart failure and left ventricular dysfunction in the general population; The Rotterdam Study

    NARCIS (Netherlands)

    A. Mosterd (Arend); A.W. Hoes (Arno); M.C. de Bruyne (Martine); D.T. Linker (David); D.E. Grobbee (Diederick); J.W. Deckers (Jaap); A. Hofman (Albert)

    1999-01-01

    textabstractAIMS: To determine the prevalence of heart failure and symptomatic as well as asymptomatic left ventricular systolic dysfunction in the general population. METHODS AND RESULTS: In 5540 participants of the Rotterdam Study (age 68.9+/-8.7 years, 2251 men) aged

  17. Long term improvement in global left ventricular function after early thrombolytic treatment in acute myocardial infarction

    NARCIS (Netherlands)

    M.L. Simoons (Maarten); M.J. van Eenige; F. Vermeer (Frank); F.W.A. Verheugt (Freek); W. Wijns (William); S.H. Braat (Simon); W.J. Remme (Willem); P.W.J.C. Serruys (Patrick); J.P. Roos; J. Res (Jan); E.E. van der Wall (Ernst)

    1986-01-01

    textabstractThe effect of reperfusion achieved by early intracoronary streptokinase in acute myocardial infarction on left ventricular function was studied in 533 patients enrolled in a prospective randomised multicentre study. Two hundred and sixty four patients were allocated to conventional treat

  18. Effects of the NADPH oxidase inhibitor apocynin on the left ventricular dysfunction induced by cocaine administration

    Institute of Scientific and Technical Information of China (English)

    MarcISABELLE; ChristelleMONTEIL; ChristianTHUILLEZ

    2004-01-01

    AIM: In a previous study, we have shown the role of alphaladrenoceptor in the left ventricular (LV) dysfunction after chronic cocaine administration via the induction of NADPH oxidase. In this study we used the NADPH oxidase inhibitor apocynin, to further investigate the real involvement of this prooxidant system in this LV dysfunction. METHODS: Wistar rats were treated

  19. Dosing of ACE inhibitors in left ventricular dysfunction : Does current clinical dosing provide optimal benefit?

    NARCIS (Netherlands)

    Pinto, YM; van Geel, PP; Alkfaji, H; van Veldhuisen, DJ; van Gilst, WH

    1999-01-01

    In the present review, we discuss the role of clinical dosing of angiotensin converting enzyme (ACE) inhibitors in the treatment of left ventricular dysfunction. Although the precise mechanism of action of ACE inhibitors is still unresolved, the clinical efficacy of ACE inhibitors in the treatment o

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

    NARCIS (Netherlands)

    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

  1. Numerical simulation of the pulsating catheter pump : A left ventricular assist device

    NARCIS (Netherlands)

    Verkerke, GJ; Mihaylov, D; Geertsema, AA; Lubbers, J; Rakhorst, G

    1999-01-01

    The pulsating catheter (PUCA) pump, a left ventricular assist device, consists of a hydraulically or pneumatically driven membrane pump, extracorporeally placed and mounted to a valved catheter. The catheter is introduced into an easily accessible artery and positioned with its distal tip in the lef

  2. Role of angiotensin receptor blockers in patients with left ventricular dysfunction : lessons from CHARM and VALIANT

    NARCIS (Netherlands)

    Voors, AA; van Veldhuisen, DJ

    2004-01-01

    The role of angiotensin receptor blockers (ARBs) in patients with left ventricular dysfunction has changed after the VALIANT and CHARM trials. CHARM proved that candesartan is a good alternative for patients with chronic heart failure who cannot tolerate ACE-inhibitors. Moreover, VALIANT demonstrate

  3. Prediction of the left ventricular mass from the electrocardiogram in systemic hypertension

    NARCIS (Netherlands)

    deVries, SO; Heesen, WF; Beltman, FW; Kroese, AH; May, JF; Smit, AJ; Lie, KI

    1996-01-01

    Although echocardiography provides a reliable method to determine left ventricular (LV) mass, it may not be available in all settings. Numerous electrocardiographic (EGG) criteria for the detection of LV hypertrophy have been developed, but few attempts have been made to predict the LV mass itself f

  4. Assessment of left ventricular regional wall motion by color kinesis technique: comparison with angiographic findings.

    Science.gov (United States)

    Vermes, E; Guyon, P; Weingrod, M; Otmani, A; Soussana, C; Halphen, C; Leroy, G; Haïat, R

    2000-08-01

    The analysis of segmental wall motion using two-dimensional (2-D) echocardiography is subjective with high interobserver variability. Color kinesis is a new technique providing a color-encoded map of endocardial motion. We evaluated the accuracy of color kinesis and 2-D for assessment of regional asynergy compared with left ventricular angiography as a reference method. Fifteen patients admitted for myocardial infarction were studied by echocardiography the day before left ventricular angiography. The left ventricle was divided into seven segments. Each segment was classified by two independent observers as normal or abnormal in 2-D and color kinesis. Accuracy of color kinesis and 2-D was evaluated and compared to left ventricular angiography. Color kinesis is significantly superior to 2-D for all seven segments (mean 0.80/0.68, P = 0.05), except for the septum (0.67/0.60, P = NS). Interobserver variability studied by chi-square statistic is lower with color kinesis (0.70) than with 2-D (0.57). We conclude that these data suggest that color kinesis is a useful method for assessing systolic wall motion in all segments, except the septum and for improving the accuracy of segmental ventricular function and interobserver variability.

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

    DEFF Research Database (Denmark)

    Pfeffer, Marc A; McMurray, John J V; Velazquez, Eric J;

    2003-01-01

    BACKGROUND: Angiotensin-converting-enzyme (ACE) inhibitors such as captopril reduce mortality and cardiovascular morbidity among patients with myocardial infarction complicated by left ventricular systolic dysfunction, heart failure, or both. In a double-blind trial, we compared the effect of the...

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

    DEFF Research Database (Denmark)

    Solomon, Scott D; Zelenkofske, Steve; McMurray, John J V;

    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 ...

  7. Uncontrolled hypertension is associated with coronary artery calcification and electrocardiographic left ventricular hypertrophy

    DEFF Research Database (Denmark)

    Nielsen, Mette Lundgren; Pareek, Manan; Gerke, O;

    2015-01-01

    We conducted a 1:2 matched case-control study in order to evaluate whether the prevalence of coronary artery calcium (CAC) and electrocardiographic left ventricular hypertrophy (LVH) or strain was higher in patients with uncontrolled hypertension than in subjects from the general population, and ...

  8. Psoriasis is associated with subsequent atrial fibrillation in hypertensive patients with left ventricular hypertrophy

    DEFF Research Database (Denmark)

    Bang, Casper N; Okin, Peter M; Køber, Lars;

    2014-01-01

    BACKGROUND: Inflammation contributes to the pathogenesis of psoriasis as well as atrial fibrillation. The impact of psoriasis and its association with new-onset atrial fibrillation was assessed in hypertensive patients with left ventricular hypertrophy (LVH). METHODS: The predictive value of base...

  9. Gene Polymorphism and Left Ventricular Geometry and Function in Hypertensive Subjects

    Directory of Open Access Journals (Sweden)

    Rosario Scaglione

    2010-01-01

    Full Text Available The distribution of the T29C TGFβ1 gene polymorphism was analyzed in 198 hypertensives with left ventricular hypertrophy (LVH and in 235 hypertensives without LVH. Circulating TGFβ1 levels, procollagen type III levels, microalbuminuria, and left ventricular geometry and function were evaluated in all the hypertensives with LVH subgrouped according to T29C TGFβ1 gene polymorphism. Circulating TGFβ1 was evaluated by ELISA technique, procollagen type III by a specific radioimmunoassay, microalbuminuria by radioimmunoassay, and left ventricular geometry and function by echocardiography. All groups were comparable for gender, age, and sex. Regarding T29C TGFβ1 gene polymorphism, prevalence of TC or CC genotypes was significantly (P<.05 higher in hypertensives with LVH than hypertensives without LVH TC and CC LVH hypertensives were characterized by a higher prevalence of subjects with microalbuminuria (P<.05 TC and CC versus TT, by increased levels of TGFβ1, procollagen type III, urinary albumin excretion, LVM, LVM/h2.7, and lower values of left ventricular ejection fraction (P<.05 TC and CC versus TT. Our data suggest that T29C TGFβ1 gene polymorphism was associated with clinical characteristics adequate to recognize a subset of LVH hypertensives with a higher severity of hypertension.

  10. Common variation neighbouring micro-RNA 22 is associated with increased left ventricular mass.

    Directory of Open Access Journals (Sweden)

    Andrew R Harper

    Full Text Available AIMS: Previous genome-wide linkage analysis has suggested that chromosomal region 17p13.3 may harbour genes influencing left ventricular mass (LVM in man. To date, the genetic factors accounting for LVM variability remain largely unknown but a non-coding RNA gene within this region, micro-RNA 22 (miR-22, has been implicated in cardiac hypertrophy and heart failure in animal models. We thus investigated the relationship between common genetic polymorphisms surrounding miR-22 and left ventricular mass in a family-based association study. METHODS AND RESULTS: We studied a cohort of 255 families comprising 1,425 individuals ascertained via a hypertensive proband. Ten single nucleotide polymorphisms which together tagged common genetic variation surrounding the miR-22 gene were genotyped. There was evidence of association between the rs7223247 polymorphism, which lies within the 3'UTR of a gene of unknown function, TLCD2, immediately downstream from miR-22, and left ventricular mass determined by Sokolow-Lyon voltage (Bonferroni corrected p-value = 0.038. The T allele at rs7223247 was associated with an 0.272 standard deviation higher Sokolow-Lyon voltage. Genotype was responsible for ~1% of the population variability in LVM. CONCLUSIONS: Genotype at the rs7223247 polymorphism affects left ventricular mass determined by Sokolow-Lyon voltage. The neighbouring genes miR-22 and TLCD2 are strong candidates to account for this observation.

  11. Home blood pressure measurement : reproducibility and relationship with left ventricular mass

    NARCIS (Netherlands)

    Kok, R.H.; Beltman, F.W.; Terpstra, W.F.; Smit, A.J.; May, J.F.; de Graeff, P.A.; Meyboom-de Jong, B.

    1999-01-01

    OBJECTIVE: To evaluate the reproducibility and relationship with left ventricular mass index of home blood pressure in comparison with ambulatory and office blood pressures. METHODS: We measured home, ambulatory and office blood pressures of 84 previously untreated hypertensive patients, aged 60-74

  12. Renal dysfunction, restrictive left ventricular filling pattern and mortality risk in patients admitted with heart failure

    DEFF Research Database (Denmark)

    Schou, Morten; Kjaergaard, Jesper; Torp-Pedersen, Christian;

    2013-01-01

    Renal dysfunction is associated with a variety of cardiac alterations including left ventricular (LV) hypertrophy, LV dilation, and reduction in systolic and diastolic function. It is common and associated with an increased mortality risk in heart failure (HF) patients. This study was designed...... to evaluate whether severe diastolic dysfunction contribute to the increased mortality risk observed in HF patients with renal dysfunction....

  13. Hemodynamic stress echocardiography in patients supported with a continuous-flow left ventricular assist device

    DEFF Research Database (Denmark)

    Andersen, Mads; Gustafsson, Finn; Madsen, Per Lav;

    2010-01-01

    Functional assessment of continuous-flow left ventricular assist devices (LVADs) is usually performed with the patient at rest. This study compared echocardiographic indices of contraction and filling pressure with invasive measures in 12 ambulatory LVAD patients undergoing symptom-limited bicycl...

  14. Left Ventricular Electromechanical Mapping: A Case Study of Functional Assessment in Coronary Intervention

    OpenAIRE

    Perin, Emerson C.; Silva, Guilherme V.; Sarmento-Leite, Rogerio

    2000-01-01

    Electromechanical mapping is a new diagnostic tool that can be used to identify viable myocardium. In the case reported here, the technique was used before intervention to map areas of viable myocardium; post-intervention mapping showed improved mechanical function of the revascularized areas. Electromechanical mapping offers the potential of assessing left ventricular function in the cardiac catheterization laboratory before and after interventional procedures.

  15. [Isolated left ventricular--right atrial shunt after blunt chest trauma (author's transl)].

    Science.gov (United States)

    Kreuzer, E; Beyer, J

    1978-12-01

    A case of left-ventricular-right-atrial septal defect secundary to blunt chest trauma is described. The etiology of this type of septal defect, e. g. congenital, following aortic and mitral valve replacement, endocarditis and trauma, is discussed. Early defect closure is recommended in the presence of significant shunt volume. PMID:751280

  16. Changes in Fetal Left and Right Ventricular Strain Mechanics during Normal Pregnancy.

    NARCIS (Netherlands)

    Kapusta, L.; Mainzer, G.; Weiner, Z.; Deutsch, L.; Khoury, A.; Haddad, S.; Lorber, A.

    2013-01-01

    BACKGROUND: The aim of this study was to detect normal changes in fetal two-dimensional speckle-tracking echocardiography-derived values for global and regional longitudinal left and right ventricular strain, strain rate, and time to peak (T2P) global strain during pregnancy. METHODS: Forty-four hea

  17. Electrocardiographic left ventricular hypertrophy in GUSTO IV ACS: an important risk marker of mortality in women

    DEFF Research Database (Denmark)

    Westerhout, Cynthia M; Lauer, Michael S; Fu, Yuling;

    2007-01-01

    AIM: To examine the association of left ventricular hypertrophy (LVH) on admission electrocardiography with adverse outcomes in acute coronary syndrome (ACS) patients. METHODS AND RESULTS: A total of 7443 non-ST-elevation ACS patients in Global Utilization of STrategies to Open occluded arteries ...

  18. Negative inotropic effects of recombinant interleukin 2 in patients without left ventricular dysfunction

    NARCIS (Netherlands)

    Tio, RA; Nieken, J; de Vries, EGE; Pfeiffer, C; de Jongste, MJL; Pieper, E; Moshage, H; Limburg, PC; Mulder, NH

    2000-01-01

    Experimental data have shown that rIL2 has negative inotropic properties. This has not been investigated in humans with normal left ventricular function. Seventeen consecutive renal cell carcinoma patients who received rIL2 therapy because of dissemination were analyzed before and after treatment wi

  19. Relationship between left ventricular dysfunction and depression following myocardial infarction : data from the MIND-IT

    NARCIS (Netherlands)

    van Melle, JP; de Jonge, P; Ormel, J; Crijns, HJGM; van Veldhuisen, DJ; Honig, A; Schene, AH; van den Berg, MP

    2005-01-01

    Aims Depression in patients following myocardial infarction (MI) is associated with an increased risk of mortality, but this association may be confounded by cardiac disease severity. We explored the relationship between left ventricular ejection fraction (LVEF) and depression in MI patients. Method

  20. Magnetic resonance imaging derived left ventricular global and region function parameters in healthy adults

    Institute of Scientific and Technical Information of China (English)

    穆莉莎

    2014-01-01

    Objective To establish cardiac magnetic resonance imaging(MRI)derived left ventricular(LV)global and region function parameters in normal adults.Methods Twenty normal adults were examined with fast imaging employing steady-state(Fiesta)acquisition sequence of cardiac MRI,LV global function and LV region function were measured at basal,middle,apical level and at 16

  1. Left ventricular dyssynchrony in patients with heart failure and preserved ejection fraction

    NARCIS (Netherlands)

    Santos, Angela B. S.; Kraigher-Krainer, Elisabeth; Bello, Natalie; Claggett, Brian; Zile, Michael R.; Pieske, Burkert; Voors, Adriaan A.; McMurray, John J. V.; Packer, Milton; Bransford, Toni; Lefkowitz, Marty; Shah, Amil M.; Solomon, Scott D.

    2014-01-01

    Aims Mechanical dyssynchrony has been postulated to play a pathophysiologic role in heart failure with preserved ejection fraction (HFpEF). Methods and results We quantified left ventricular (LV) systolic dyssynchrony in 130 HFpEF patients with NYHA class II-IV symptoms, ejection fraction (EF) 45, a

  2. Left ventricular dysfunction in normotensive type II diabetic patients in Port Harcourt, Nigeria

    Directory of Open Access Journals (Sweden)

    Dodiyi-Manuel ST

    2013-09-01

    Full Text Available Sotonye T Dodiyi-Manuel,1 Maclean R Akpa,2 Osaretin J Odia2 1Department of Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria; 2Department of Medicine, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Nigeria Background: Diabetes mellitus (DM is on the increase globally. Cardiovascular complications, such as left ventricular dysfunction is a major cause of death in patients with type II DM. Prior to the development of symptomatic heart failure, subclinical left ventricular dysfunction (systolic and diastolic may exist for some time. Aim: The aim of the study was to determine the prevalence of left ventricular dysfunction in non-hypertensive type II DM patients. Methods: A cross sectional study of left ventricular function in 90 normotensive type II diabetes mellitus patients using echocardiography was carried out. Healthy normotensive controls matched for age, sex, and body mass index were selected for comparison. Patients and controls who had hypertension (blood pressure of >140/90 mmHg, history of smoking, significant alcohol history, pregnancy, features of thyroid disease, or valvular heart disease were excluded. Left ventricular diastolic and systolic functions were assessed. Results: Ninety patients, (39 males and 51 females and 90 healthy controls (39 males and 51 females were enrolled. Mean age of patients was 50.76 ± 9.13 years and 51.33 ± 7.84 years for controls. Mean body mass index was 26.88 ± 4.73 kg/m2 in patients and 27.09 ± 4.04 kg/m2 in controls. Mean ejection fraction was 62.4% ± 8.47% and 68.52% ± 7.94% in patients and controls, respectively (P 99 kg/m2 in females and >115 kg/m2 in males was considered abnormal. The left ventricular mass index was also higher in patients than in controls (95.17 ± 25.67 g/m2 versus 85.40 ± 18.0 g/m2; P = 0.004. Conclusion: Normotensive diabetic patients have a high prevalence of left ventricular dysfunction even in the absence of

  3. Remission of chronic anthracycline-induced heart failure with support from a continuous-flow left ventricular assist device.

    Science.gov (United States)

    Khan, Nadeem; Husain, Syed Arman; Husain, Syed Iman; Khalaf, Natalia; George, Joggy; Raissi, Farshad; Segura, Ana Maria; Kar, Biswajit; Bogaev, Roberta C; Frazier, O H

    2012-01-01

    We report the case of a patient who had chronic anthracycline-induced cardiomyopathy that was reversed after treatment with a left ventricular assist device. A 29-year-old woman had undergone anthracycline-based chemotherapy as a teenager in 1991 and 1992 and received a diagnosis of dilated cardiomyopathy 10 years later. Optimal medical therapy had initially controlled the symptoms of heart failure. However, in June 2006, the symptoms worsened to New York Heart Association functional class IV status. We implanted a continuous-flow left ventricular assist device as a bridge to cardiac transplantation; of note, a left ventricular core biopsy at that time showed no replacement fibrosis. The patient's clinical status improved thereafter, enabling left ventricular assist device ex-plantation after 17 months. To our knowledge, this is the first report of the use of left ventricular assist device support to reverse chronic anthracycline-induced heart failure.

  4. Evaluation of global and regional left ventricular systolic function in patients with frequent isolated premature ventricular complexes from the right ventricular outflow tract

    Institute of Scientific and Technical Information of China (English)

    YAO Jing; XU Jing; YONG Yong-hong; CAO Ke-jiang; CHEN Shao-liang; XU Di

    2012-01-01

    Background Frequent premature ventricular complexes from the right ventricular outflow tract (RVOT-PVCs) are associated with left ventricular dysfunction.This study adopted two-dimensional speckle tracking imaging to evaluate global and regional left ventricular myocardial function in patients with frequent RVOT-PVCs.Methods This study included 30 patients with frequent RVOT-PVCs and 30 healthy subjects.Aortic systolic velocity-time integral (AoVTI) and myocardium strain in circumferential (CS),radial (RS) and longitudinal (LS) directions were evaluated by conventional echocardiography and speckle tracking imaging.All values of patients with RVOT-PVCs were recorded during sinus (PVC-S) and PVC beats (PVC-V).Results Significant differences were demonstrated in global CS,RS and LS between the control subjects and the PVC-V (CS:(17.46±2.48)% vs.(11.52±3.28)%,RS:(48.26±10.20)% vs.(20.92±9.78)%,LS:(19.89±2.62)% vs.(11.79±3.66)%,P <0.01),and in segmental RS and LS of nearly all the left ventricular segments.Statistical differences in segmental CS between the PVC-V and the control subjects were only observed in anterior,anteroseptal and septal segments (only seen in anteroseptal and septal segments at apex).Furthermore,V/S AoVTI (AoVTI during the PVC beat divided by AoVTI during the sinus beat,then multiplied by 100%) correlated with coupling interval (r=0.67,P <0.001) and global strain (CS:r=0.48,P=0.007; RS:r=0.65,P <0.001; LS:r=0.65,P <0.001).Conclusions Frequent RVOT-PVCs can induce global and regional left ventricular systolic dysfunction.The reduction of hemodynamic parameters relates to the coupling interval and the global systolic function.

  5. 24 hour ST segment analysis in transient left ventricular apical ballooning.

    Directory of Open Access Journals (Sweden)

    Frank Bode

    Full Text Available OBJECTIVE: The etiologic basis of transient left ventricular apical ballooning, a novel cardiac syndrome, is not clear. Among the proposed pathomechanisms is coronary vasospasm. Long-term ST segment analysis may detect vasospastic episodes but has not been reported. METHODS: 30 consecutive patients with transient left ventricular apical ballooning, left ventricular dysfunction and normal or near-normal coronary arteries were investigated. A 24-hour Holter ECG was obtained after emergency admission. ST segment analysis was performed automatically in 2 leads and confirmed by visual inspection. Criteria for an ischemic event were: 1. ST elevation or 2. horizontal or down-sloping ST segments ≥1 min duration and ≥100 µV J+80 point deviation corrected for baseline ST-deviation. RESULTS: Patients presented with ST segment elevation (n = 19 and/or T wave inversion (n = 20 on admission ECG. Ejection fraction was 50±12%. No transient ST elevations were observed during Holter ECG analysis. In 3 patients, 8 transient episodes of ST depression were recorded. Durations of episodes varied between 75 s and 790 s (mean 229 s. Maximal ST deviation averaged -191±71 µV. Ischemic burden was -1 to -22 mVs (mean -8 mVs. 27 patients showed no ischemic events. CONCLUSIONS: ST segment analysis of 24 h Holter recordings revealed minor ischemic events in only 10% of patients with transient left ventricular apical ballooning. Overall, ST segment changes were not indicative of recurrent coronary spasm playing a major role in the genesis of transient left ventricular apical ballooning.

  6. Left Ventricular Function and Physiological Performance in Female Ironman Athletes and Female Police Officers.

    Science.gov (United States)

    Leischik, Roman; Foshag, Peter; Strauss, Markus; Spelsberg, Norman

    2016-06-01

    Data about physiological performance of female ironman triathletes are rare. However, some studies have reported this endurance sport may cause damage to the right or left ventricles, even in females. The goal of this study was to assess prospectively the right/left ventricular function and physiological performance in female athletes (middle- and long ironman distance) and to compare the findings to female federal police officers. A total of 33 female triathletes and 37 female police officers were examined using spiro-ergometry and echocardiography. Female triathletes achieved VO2max 52.8 ± 5.7 ml/kg(-1)·min(-1), and police officers 35.3 ± 6.5 ml/kg(-1)·min(-1) In athletes, left ventricular end-diastolic diameter was 4.4 ± 0.3 cm and in police officers 4.5 ± 0.4 cm, and the left ventricular muscle mass index was 85.8 g/m(2 )± 18.7 in athletes and in police officers 72.0 g/m(2 )± 9.1. Right ventricular area change among athletes was 49.4 ± 8.5%, and in police officers 46.0 ± 6.9%. The performance date of female triathletes can be used as training prescription for leisure female triathletes, when middle or long distances in triathlon competitions are planned. No right or left ventricular dysfunction was found despite long training and finishing of long distance competitions: non-elite athletes, 5.4 ± 2.8 years of triathlon competitions; elite athletes, 7.6 ± 5.8 years. PMID:27207600

  7. Left ventricular rupture postmitral valve replacement: Surviving a catastrophe

    Directory of Open Access Journals (Sweden)

    Samarjit Bisoyi

    2015-01-01

    Full Text Available One of the dreaded mechanical complications of mitral valve replacement (MVR is rupture of the left ventricle (LV. This report describes the early diagnosis and successful repair of rupture of posterior wall of LV in an elderly patient who underwent MVR. We have discussed the risk factors and perioperative issues implicated in such complication. The anesthesiologist as an intra-operative echocardiographer can aid in identifying the patient at risk. Though important surgical steps are necessary to prevent the complication; nonetheless, the anesthesiologist needs to take key measures in the perioperative period.

  8. [Left ventricular kinetics studied by the color kinesis method. Comparison of bidimensional echographic and angiographic data].

    Science.gov (United States)

    Vermes, E; Guyon, P; Weingrod, M; Otmani, A; Soussana, C; Halphen, C; Leroy, G; Haïat, R

    1998-10-01

    The object of this study was to assess the value of CK in the evaluation of left ventricular wall motion. Fifteen coronary patients aged 56 +/- 12 years were included: 8 patients were examined after acute myocardial infarction and 7 after unstable angina with a history of myocardial information. The left ventricle was divided into 7 segments after a modified Heger model, excluding the basal septal and basal lateral segments not seen on angiography. The left ventricular wall motion was assessed in two-dimensional echocardiography (2DE) and colour kinesis (CK) by two observers and compared with the results of left ventriculography, considered the reference method. Over all the 105 segments studied (7 segments for each of the 15 patients), CK was significantly better than 2DE (80% of segments correctly evaluated by CK vs 68% by 2DE, p kinesis significantly improved the study of all segments except the interventricular septum (67% vs 60%, p = NS). The inter-observer variability in 2DE and CK evaluated over 135 segments (9 per patient) by the kappa was improved by colour kinesis (0.57 in 2DE, 0.7 in CK). The authors conclude that CK enables evaluation of left ventricular wall motion with greater precision and less inter-observer variability.

  9. The study of left ventricular diastolic function by Doppler echocardiography: the essential for the clinician

    Directory of Open Access Journals (Sweden)

    Livio Dei Cas

    2007-06-01

    Full Text Available An abnormal diastolic function of left ventricle represents the main pathophysiological mechanism responsible for different clinical states such as restrictive cardiomyopathy, infiltrative myocardial disease and, specially, diastolic heart failure (also called heart failure with preserved systolic function, which is present in a large number of patients with a clinical picture of pulmonary congestion. Although the invasive approach, through cardiac catheterization allowing the direct measurement of left ventricular filling pressure, myocardial relaxation and compliance, is considered the gold standard for the identification of diastolic dysfunction, several noninvasive methods have been proposed for the study of left ventricular diastolic function. Doppler echocardiography represents an excellent noninvasive technique to fully characterize the diastolic function in health and disease. (Heart International 2007; 3: 42-50

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

    Institute of Scientific and Technical Information of China (English)

    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.

  11. Percutaneous septal ablation for left mid-ventricular obstructive hypertrophic cardiomyopathy: a case report

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    Alioglu Emin

    2006-04-01

    Full Text Available Abstract Background Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHC is a rare type of cardiomyopathy. The diagnosis is based on the hourglass appearance on the left ventriculogram and the presence of pressure gradient between apical and basal chamber of the ventriculum on the hemodynamic assessment. Case presentation The present case represents successful percutaneous treatment with septal ablation to patient with MVOHC associated with systolic anterior motion of the mitral valve and obstruction at both the mid-ventricular and outflow levels. Conclusion Alcohol septal ablation has been proposed as less invasive alternatives to surgery in patients with MVOHC.

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

    Science.gov (United States)

    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

  13. Outcome of Prolonged Ventricular Fibrillation and CPR in a Rat Model of Chronic Ischemic Left Ventricular Dysfunction

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    Xiangshao Fang

    2013-01-01

    Full Text Available Patients with chronic left ventricular (LV dysfunction are assumed to have a lower chance of successful CPR and lower likelihood of ultimate survival. However, these assumptions have rarely been documented. Therefore, we investigated the outcome of prolonged ventricular fibrillation (VF and CPR in a rat model of chronic LV dysfunction. Sprague-Dawley rats were randomized to (1 chronic LV dysfunction: animals underwent left coronary artery ligation; and (2 sham control. Echocardiography was used to measure cardiac performance before surgery and 4 weeks after surgery. Four weeks after surgical intervention, 8 min of VF was induced and defibrillation was delivered after 8 min of CPR. LV dilation and low ejection fraction were observed 4 weeks after coronary ligation. With optimal chest compressions, coronary perfusion pressure values during CPR were well maintained and indistinguishable between groups. There were no differences in resuscitability and numbers of shock required for successful resuscitation between groups. Despite the significantly decreased cardiac index in LV dysfunction animals before induction of VF, no differences in cardiac index were observed between groups following resuscitation, which was associated with the insignificant difference in postresuscitation survival. In conclusion, the outcomes of CPR were not compromised by the preexisting chronic LV dysfunction.

  14. Geometrical models of left ventricular contraction from MRI of the normal and spontaneously hypertensive rat heart

    International Nuclear Information System (INIS)

    This study develops a quantitative analysis and model for the differences in left ventricular dynamics in normal and spontaneously hypertensive rats, as determined using non-invasive magnetic resonance imaging (MRI). We emerge with a characterization of the geometrical changes in the left ventricle resulting from hypertension. In addition, the techniques we have adopted are potentially applicable to the study of other disease models for important human cardiac pathologies. A gradient-echo multislice imaging sequence (echo time 4.3 ms) achieved complete image coverage of the heart at high time resolution (13 ms) through the cardiac cycle. Cardiac anatomy in two age-matched groups of young adult (8 and 12 weeks old) normal Wistar-Kyoto (WKY, n=8) and spontaneously hypertensive rats (SHR, n=8) was imaged in synchrony with the electrocardiographic R wave in defined planes both parallel and perpendicular to the principal cardiac axis. The transverse left ventricular image sections were circularly symmetrical; this permitted application of different analytical models for the three-dimensional geometry of the epi- and endocardial borders. An ellipsoidal figure of revolution offered an effective description of the three-dimensional left ventricular geometry throughout the cardiac cycle in both normal WKY and SHR animals. The model successfully characterized both the changes in the shape of the left ventricle through the cardiac cycle and the pathological alterations resulting from spontaneous hypertension. The elliptical model also formed the basis of a simple stress distribution analysis. Such parametric descriptions thus provided a useful alternative to more complex finite element analyses of cardiac function. The eccentricity of the ventricle was characterized by an ellipticity factor a, where a=1 for a sphere and a<1 for a prolate ellipsoid. At end systole, the endocardial surface of the left ventricle gave a=0.43±0.02 and 0.49±0.02 for the WKY and SHR animals

  15. RARE ANOMALY OF THE CORONARY VESSELS: CORONARY AND LEFT VENTRICULAR FISTULAS

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    L. V. Salamatina

    2014-01-01

    Full Text Available Study objective: description of the case of diagnostics of rare anomaly of the coronary vessels: coronary and left ventricular fistulas.Materials and methods. Patient L., 45 y.o. (height 168 cm, weight 55 kg, male, complained of periodical burning pain behind the breastbone without connection with physical activity, often disturbing at night, stopped with intake of nitrates. The following examination of the patient was performed: clinical and biochemical blood tests, electrocardiography (ECG, Holter ECG monitoring, bicycle ergometry, echocardiography, coronary angiography, computerized tomography.Results. The following clinical diagnosis was set on the basis of complaints. data of objective and instrumental examination: congenital heart disease. Abnormal end of the coronary arteries: multiple coronary and left ventricular fistulas, steal syndrome. Hypoplasia of the right coronary artery (Q 24.5 in accordance with the International Classification of Diseases, revision 10. Coronary angiography has become the main diagnostic method that allowed diagnosis verification: left type of coronary blood circulation. The trunk of the left coronary artery, the anterior interventricular branch,  he diagonal branch, the envelope branch, the obtuse marginal branch, the right coronary artery, the posterior interventricular branch have with irregular contours. Direct abnormal connection (dense grid of fistulas is observed in the medium and lower third of the anterior interventricular branch with the left ventricle cavity. The contrast agent practically completely comes into the left ventricular cavity. The parenchymal phase is very well expressed; the venous phase is not visualized. Conclusion. Congenital heart disease: multiple coronary and left ventricular fistulas. No angiographic evidence of hemodynamically significant stenotic coronary lesions.Conclusion. The practical interest of this observation is due to rarity of disease, analysis of modern

  16. RARE ANOMALY OF THE CORONARY VESSELS: CORONARY AND LEFT VENTRICULAR FISTULAS

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    L. V. Salamatina

    2015-01-01

    Full Text Available Study objective: description of the case of diagnostics of rare anomaly of the coronary vessels: coronary and left ventricular fistulas.Materials and methods. Patient L., 45 y.o. (height 168 cm, weight 55 kg, male, complained of periodical burning pain behind the breastbone without connection with physical activity, often disturbing at night, stopped with intake of nitrates. The following examination of the patient was performed: clinical and biochemical blood tests, electrocardiography (ECG, Holter ECG monitoring, bicycle ergometry, echocardiography, coronary angiography, computerized tomography.Results. The following clinical diagnosis was set on the basis of complaints. data of objective and instrumental examination: congenital heart disease. Abnormal end of the coronary arteries: multiple coronary and left ventricular fistulas, steal syndrome. Hypoplasia of the right coronary artery (Q 24.5 in accordance with the International Classification of Diseases, revision 10. Coronary angiography has become the main diagnostic method that allowed diagnosis verification: left type of coronary blood circulation. The trunk of the left coronary artery, the anterior interventricular branch,  he diagonal branch, the envelope branch, the obtuse marginal branch, the right coronary artery, the posterior interventricular branch have with irregular contours. Direct abnormal connection (dense grid of fistulas is observed in the medium and lower third of the anterior interventricular branch with the left ventricle cavity. The contrast agent practically completely comes into the left ventricular cavity. The parenchymal phase is very well expressed; the venous phase is not visualized. Conclusion. Congenital heart disease: multiple coronary and left ventricular fistulas. No angiographic evidence of hemodynamically significant stenotic coronary lesions.Conclusion. The practical interest of this observation is due to rarity of disease, analysis of modern

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

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    Wachter Rolf

    2008-02-01

    Full Text Available Abstract Background Screening of primary care patients at risk for left ventricular systolic dysfunction by a simple blood-test might reduce referral rates for echocardiography. Whether or not natriuretic peptide testing is a useful and cost-effective diagnostic instrument in primary care settings, however, is still a matter of debate. Methods N-terminal pro-brain natriuretic peptide (NT-proBNP levels, clinical information, and echocardiographic data of left ventricular systolic function were collected in 542 family practice patients with at least one cardiovascular risk factor. We determined the diagnostic power of the NT-proBNP assessment in ruling out left ventricular systolic dysfunction and compared it to a risk score derived from a logistic regression model of easily acquired clinical information. Results 23 of 542 patients showed left ventricular systolic dysfunction. Both NT-proBNP and the clinical risk score consisting of dyspnea at exertion and ankle swelling, coronary artery disease and diuretic treatment showed excellent diagnostic power for ruling out left ventricular systolic dysfunction. AUC of NT-proBNP was 0.83 (95% CI, 0.75 to 0.92 with a sensitivity of 0.91 (95% CI, 0.71 to 0.98 and a specificity of 0.46 (95% CI, 0.41 to 0.50. AUC of the clinical risk score was 0.85 (95% CI, 0.79 to 0.91 with a sensitivity of 0.91 (95% CI, 0.71 to 0.98 and a specificity of 0.64 (95% CI, 0.59 to 0.67. 148 misclassifications using NT-proBNP and 55 using the clinical risk score revealed a significant difference (McNemar test; p Conclusion The evaluation of clinical information is at least as effective as NT-proBNP testing in ruling out left ventricular systolic dysfunction in family practice patients at risk. If these results are confirmed in larger cohorts and in different samples, family physicians should be encouraged to rely on the diagnostic power of the clinical information from their patients.

  18. Left ventricular diastolic dysfunction and N-terminal probrain sodium-uretic peptid level in patients with atrial fibrillation

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    Dzyak G.V.

    2013-06-01

    Full Text Available In our study 100 consecutive non-valvular permanent atrial fibrillation patients with NYHA I – III heart failure, 43 - 86 years old (65 men and 35 women were examined. Control group consisted of 30 patients with arterial hypertension and coronary artery disease matched by age, sex with basic group. Relationship of NT-proBNP with echocardiographic parameters of left heart were studied. Transthoracic echocardiography with tissue doppler measurements were performed on echocardiograph “SONOS 7500”. For left ventricular filling pressure assessment ratio Em/Ea was used due to its diagnostic value in atrial fibrillation (regardless of left ventricular ejection fraction. Mean left ventricular filling pressure was increased in patients with heart failure: in atrial fibrillation group and controls as well. In comparison with controls atrial fibrillation group was more likely to have higher both systolic and diastolic left atrial square and volume. According to Em/Ea in 95% of patients with non-valvular atrial fibrillation high left ventricular filling pressure was observed, this testifies to diastolic dysfunction. This parameter correlated well with left atrial square and volume during systole and diastole. Correlation between NT pro-BNP level and NYHA class of heart failure, left ventricular filling pressure was determined in patients with atrial fibrillation. Tissue doppler echocardiography makes it possible to diagnose left ventricular diastolic dysfunction in atrial fibrillation patients.

  19. [Dynamic obstruction to left ventricular outflow during dobutamine stress echocardiography: the probable mechanisms and clinical implications].

    Science.gov (United States)

    Scandura, S; Arcidiacono, S; Felis, S; Barbagallo, G; Deste, W; Drago, A; Calvi, V; Giuffrida, G

    1998-11-01

    We observed the development of left ventricular outflow tract dynamic obstruction in some patients during dobutamine stress echocardiography. The purpose of this study was to identify the possible mechanisms and to consider the clinical implications. From 11/04/94 to 01/09/97 we studied 547 patients; 42 patients developed dynamic obstruction, defined as a late peak Doppler velocity profile that exceeded baseline outflow velocity by at least 1 m/s. The encountered mechanisms were: increased myocardial contractility; systolic anterior motion of the mitral valve; decreased venous return to the left ventricle, and peculiar characteristics of the left ventricular geometry. The results of this study show that the dynamic obstruction is mainly due to the first mechanism and secondarily to some characteristics of the left ventricular geometry. The hypotension observed in a few cases is not related to the dynamic obstruction but to beta 2 receptor hypersensibility to dobutamine. The symptoms, like dyspnea and chest pain, experienced by these patients are related to the dynamic obstruction rather than to the presence of coronary artery disease. In conclusion, we think that patients who develop dynamic obstruction, without wall motion abnormalities, during dobutamine stress echocardiography, may behave pathophysiologically as patients with obstructive hypertrophic cardiomyopathy, in whom diastolic dysfunction and outflow tract obstruction are responsible for symptoms. Therefore, these patients require a pharmacological treatment with beta blockers and/or non-dihydropyridine calcium channel blockers. PMID:9922586

  20. Traumatic left ventricular aneurysm revealed by systemic embolism. Interest of Indium 111 labelled platelets scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Vahanian, A.; Villemant, D.; Grimberg, F.; Farah, E.; Acar, J.; Drouet, L.

    1984-01-01

    A case of traumatic left ventricular aneurysm, presenting with recurrent cerebral embolism, 36 years after a thoraco-brachial bullet wound was reported. The 58 year old man had no symptoms of angina or particular cardiovascular risk factors. The ECG showed changes of chronic anterior wall infarction, observed 10 years previously on a routine preoperative recording. There was a calcified circular para-apical shadow on chest X-Ray. The antero-apical region showed hypofixation on myocardial scintigraphy, and hypokinesia on isotopic angiography. The coronary arteries were normal. Indium 111 platelet marking revealed a focus of hyperfixation within the left ventricle. At surgery, a true calcific para-apical left ventricular aneurysm was discovered, containing a fresh thrombus. This lesion was resected. Peroperative Indium 111 platelet test confirmed that the thrombus was the site of high uptake. The surgical result was good at 6 months follow-up. This case illustrates: the value of the Indium test which would appear to be a very specific and sensitive method of detecting intraventricular thrombi. This test, which appreciates the thrombolic activy of intracardiac masses is a useful complement to other non-invasive methods such as 2D echocardiography; the special characteristics of post-trauma left ventricular aneurysms which are rare, often diagnosed late, at the time of complications such as systemic embolism, commonly pose medico-legal problems, and for which surgical treatment seems to be indicated in symptomatic patients.

  1. A microcomputerized system of nuclear probe for left ventricular function evaluation

    International Nuclear Information System (INIS)

    In this work, it is presented the development of a system, consisting in a nuclear probe and a 16 bits microcomputer, for left ventricular function (LVF) monitoring and analysis. Previously used in renal and thyroid studies, the nuclear probe, 2''x2''NaI(Tl) crystal, was adapted for its new application. The alterations include the design and construction of appropriate colimators and unterfacing to a strip-chart register and a magnetic tape recorder. After a single injection of Tc-99m labelling red blood cells, the probe is placed over the patient's chest on a convenient left anterior oblique position and a left ventricle time activity curve is obtained. This curve and the patient's eletrocardiogram (ECG) are recorded for posterior processing. The software, in PASCAL language, transfers the data from the magnetic tape to the microcomputer and provides the LVF and ECG curves to be displayed on beat-to-beat mode or as mean curves. From these curves one can extract ventricular parameter such as: ejection fraction, ejection rate, systolic and diastolic intervals and heart rate, by manually positioning three cursors on the points of interest. A critical evaluation of this method is performed and its advantages as well as its limitations are discussed. This approach provides an easy to operate and a low cost device that can be useful in many clinical situations, for example, the continuous monitoring in ICUs, the screening in out-patient departments. The assessment of drugs effects on left ventricular function is also possible. (author)

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

    Science.gov (United States)

    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

  3. POST INFARCT LEFT VENTRICULAR ANEURYSMS : 5YEAR SURGICAL EXPERIENCE IN A RURAL CARDIAC CENTRE

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    Ravikrishnan

    2015-08-01

    Full Text Available OBJECTIVES : This is a long term follow up of 54 patients with post infarct left ventricular aneurysm, operated over a period of 5 years, from 2005 to 2010, in a rural cardiac centre. This study aims at assessing efficacy of simple linear closure technique and its long term results. Follow up was done over a period of 2 to 5 years by clinical examination and 2D echocardiography. MATERIALS AND METHODS : 54 patients underwent surgery for left ventricular aneurysm. Age ranged from 50 – 70 years. 50 patients were operated electively and 4 patients within 15 days of acute myocardial infarction. All were approached by median sternotomy incision. Aortic canulat ion was done after heparinisation (3mg/kg. Aorto - bicaval canulation was employed and membrane oxygenators were used in all patients. After cross clamping the aorta, blood cardioplegia was used in all patients. Aortic cross clamp time varied from 40 - 90 min and bypass time varied from 90 - 120 min. Aneurysm was resected and sutured with 2/0 prolene and Teflon felt reinforcement with CABG as concomitant procedure in some. Inotropic support with adrenaline, dopamine or dobutamine was used in all patients. IABP w as employed in 48 patients. All patients were electively ventilated for 24 - 48 hours. 6 required re exploration due to bleeding. 10 patients had mild MR which was left alone. RESULTS : 54 patients were operated for left ventricular aneurysm over a period of 5 years. 4 patients died postoperatively due to low cardiac output and arrhythmias. Follow up was done clinically and with 2D Echocardiography. At the end of 2 years, 22 patients showed no further improvement in LVEF, 32 patients LVEF improved by 10 - 15%. A ll patients required decongestive management. 6 patients died at the end of 2 years. CONCLUSION : Timely and planned surgery with simple techniques, for left ventricular aneurysms can give acceptable mortality and morbidity, in a rural cardiac Centre

  4. Relation of left ventricular function, mass, and volume to NT-proBNP in type 1 diabetic patients

    DEFF Research Database (Denmark)

    Astrup, Anne Sofie; Kim, Won Yong; Tarnow, Lise;

    2008-01-01

    OBJECTIVES-To measure left ventricular mass (LVM), left ventricular volumes, and left ventricular function (LVF) in a cohort of type 1 diabetic patients and to correlate measures of imaging to NH2-terminal pro-brain natriuretic peptide (NT-proBNP). RESEARCH DESIGN AND METHODS-In a cross-sectional......OBJECTIVES-To measure left ventricular mass (LVM), left ventricular volumes, and left ventricular function (LVF) in a cohort of type 1 diabetic patients and to correlate measures of imaging to NH2-terminal pro-brain natriuretic peptide (NT-proBNP). RESEARCH DESIGN AND METHODS-In a cross...... with patients with persistent normoalbuminuria. Patients with nephropathy had smaller left ventricular volumes and increased levels of NT-proBNP. Linear regression analysis in patients with diabetic nephropathy showed that NT-proBNP and creatinine were associated with LVM. CONCLUSIONS-Increased LVM...... is identified in asymptomatic type 1 diabetic patients with nephropathy compared with normoalbuminuric patients. Elevated levels of NT-proBNP were associated with increased LVM, which are both markers of increased cardiovascular risk....

  5. Left ventricular T2 distribution in Duchenne Muscular Dystrophy

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    Hagenbuch Sean

    2010-03-01

    Full Text Available Abstract Background Although previous studies have helped define the natural history of Duchenne Muscular Dystrophy (DMD-associated cardiomyopathy, the myocardial pathobiology associated with functional impairment in DMD is not yet known. The objective of this study was to assess the distribution of transverse relaxation time (T2 in the left ventricle (LV of DMD patients, and to determine the association of myocardial T2 heterogeneity to the severity of cardiac dysfunction. DMD patients (n = 26 and normal control subjects (n = 13 were studied by Cardiovascular Magnetic Resonance (CMR. DMD subject data was stratified based on subject age and LV Ejection Fraction (EF into the following groups: A (12 years, n = 5. LV mid-slice circumferential myocardial strain (εcc was calculated using tagged CMR imaging. T2 maps of the LV were generated for all subjects using a black blood dual spin echo method at two echo times. The Full Width at Half Maximum (FWHM was calculated from a histogram of LV T2 distribution constructed for each subject. Results In DMD subject groups, FWHM of the T2 histogram rose progressively with age and decreasing EF (Group A FWHM= 25.3 ± 3.8 ms; Group B FWHM= 30.9 ± 5.3 ms; Group C FWHM= 33.0 ± 6.4 ms. Further, FWHM was significantly higher in those with reduced circumferential strain (|εcc| ≤ 12% (Group B, and C than those with |εcc| > 12% (Group A. Group A FWHM was not different from the two normal groups (N1 FWHM = 25.3 ± 3.5 ms; N2 FWHM= 24.0 ± 7.3 ms. Conclusion Reduced EF and εcc correlates well with increased T2 heterogeneity quantified by FWHM, indicating that subclinical functional impairments could be associated with pre-existing abnormalities in tissue structure in young DMD patients.

  6. Depressed left ventricular performance. Response to volume infusion in patients with sepsis and septic shock

    International Nuclear Information System (INIS)

    Volume infusion, to increase preload and to enhance ventricular performance, is accepted as initial management of septic shock. Recent evidence has demonstrated depressed myocardial function in human septic shock. We analyzed left ventricular performance during volume infusion using serial data from simultaneously obtained pulmonary artery catheter hemodynamic measurements and radionuclide cineangiography. Critically ill control subjects (n = 14), patients with sepsis but without shock (n = 21), and patients with septic shock (n = 21) had prevolume infusion hemodynamic measurements determined and received statistically similar volumes of fluid resulting in similar increases in pulmonary capillary wedge pressure. There was a strong trend (p = 0.004) toward less of a change in left ventricular stroke work index (LVSWI) after volume infusion in patients with sepsis and septic shock compared with control subjects. The LVSWI response after volume infusion was significantly less in patients with septic shock when compared with critically ill control subjects (p less than 0.05). These data demonstrate significantly altered ventricular performance, as measured by LVSWI, in response to volume infusion in patients with septic shock

  7. Depressed left ventricular performance. Response to volume infusion in patients with sepsis and septic shock

    Energy Technology Data Exchange (ETDEWEB)

    Ognibene, F.P.; Parker, M.M.; Natanson, C.; Shelhamer, J.H.; Parrillo, J.E.

    1988-05-01

    Volume infusion, to increase preload and to enhance ventricular performance, is accepted as initial management of septic shock. Recent evidence has demonstrated depressed myocardial function in human septic shock. We analyzed left ventricular performance during volume infusion using serial data from simultaneously obtained pulmonary artery catheter hemodynamic measurements and radionuclide cineangiography. Critically ill control subjects (n = 14), patients with sepsis but without shock (n = 21), and patients with septic shock (n = 21) had prevolume infusion hemodynamic measurements determined and received statistically similar volumes of fluid resulting in similar increases in pulmonary capillary wedge pressure. There was a strong trend (p = 0.004) toward less of a change in left ventricular stroke work index (LVSWI) after volume infusion in patients with sepsis and septic shock compared with control subjects. The LVSWI response after volume infusion was significantly less in patients with septic shock when compared with critically ill control subjects (p less than 0.05). These data demonstrate significantly altered ventricular performance, as measured by LVSWI, in response to volume infusion in patients with septic shock.

  8. Correlation Study of PtfV1 with Heart-Qi Deficiency Syndrome in Patients with Hypertensive Left Ventricular Hypertrophy

    Institute of Scientific and Technical Information of China (English)

    杨传华; 陆峰

    2002-01-01

    @@ It is generally believed that the change of p-wave terminal force in lead V1 (PtfV1) is associated with the inner diameter of left atrium, left ventricular compliance,and ventricular diastolic function. The increase of negative value of PtfV1 in essential hypertensive (EH) patients with left ventricular hypertrophy (LVH) indicates the cardiac function may be damaged. In order to explore the relationship between Heart-Qi Deficiency Syndrome (HQDS) of TCM and PtfV1 level in hypertensive LVH patients, correlation analysis of scores of Heart-Qi Deficiency Syndrome and negative value of PtfV1 was made by the authors.

  9. Noninvasive diagnosis of a false left ventricular aneurysm with radioisotope gated cardiac blood pool imaging. Differentiation from true aneurysm

    International Nuclear Information System (INIS)

    Unlike the true left ventricular aneurysm, false aneurysms have recently been shown to be subject to late rupture. Rarely diagnosed before surgery or autopsy, the false aneurysm has never been identified by noninvasive techniques. We report the first such noninvasive diagnosis employing radioisotope gated cardiac blood pool imaging. Due to the unique and possibly life-threatening clinical course and potential for surgical cure of false left ventricular aneurysm, early noninvasive diagnosis by imaging techniques may be critical. The methods shown here are generally applicable, becoming widely available and may help in evaluation of false left ventricular aneurysm as a cause of sudden death

  10. MYOCARDIAL REVASCULARIZATION IN PATIENTS WITH LEFT VENTRICULAR SYSTOLIC DYSFUNCTION: PROBLEM STATEMENT

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    A. B. Mironkov

    2013-01-01

    Full Text Available Outcomes of myocardium revascularization in patients with chronic left ventricular systolic dysfunction due to coronary artery disease are still unclear. The identification of dysfunctional myocardial with residual viability that can improve after revascularization are very important for further patient treatment. Hibernating myocardium can be identified by different methods and its presence and extent can predict functional and structural recovery after revascularization. New medical treatments and devices, have improved the prognosis of this patients and their use is supported by a number of clinical trials. The prognostic benefits of coronary revascularization for patients with chronic left ventricular dysfunction on optimal medical therapy and novel devices a randomized trial is still needed. 

  11. Usefulness of Palliative Care to Complement the Management of Patients on Left Ventricular Assist Devices.

    Science.gov (United States)

    Luo, Nancy; Rogers, Joseph G; Dodson, Gwen C; Patel, Chetan B; Galanos, Anthony N; Milano, Carmelo A; O'Connor, Christopher M; Mentz, Robert J

    2016-09-01

    Within the last decade, advancements in left ventricular assist device therapy have allowed patients with end-stage heart failure (HF) to live longer and with better quality of life. Like other life-saving interventions, however, there remains the risk of complications including infections, bleeding episodes, and stroke. The candidate for left ventricular assist device therapy faces complex challenges going forward, both physical and psychological, many of which may benefit from the application of palliative care principles by trained specialists. Despite these advantages, palliative care remains underused in many advanced HF programs. Here, we describe the benefits of palliative care, barriers to use within HF, and specific applications to the integrated care of patients on mechanical circulatory support. PMID:27474339

  12. THE EFFECT OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION ON THE PATHOGENESIS OF ANGINA DECUBITUS

    Institute of Scientific and Technical Information of China (English)

    陈纪林; 高润霖; 姚康宝; 杨跃进; 秦学文; 乔树宾; 姚民

    2000-01-01

    Objective. To investigate the effect of left ventricular diastohc dysfunction on the pathogenesis of angina decubitus (AD). Methods. The study population consisted of three groups: 20 individuals without cardiovascular disease were studied as group Ⅰ . Group Ⅱ included 20 patents with coronary artery disease and without AD. Thirty-one patients with AD and ejection fraction(EF) > 50% were studied as group Ⅲ. Group Ⅱ and Ⅲ were matched for age, EF and extent of coronary artery disease. Results. Left ventriculography (LVG) showed that left ventricular (LV) first 1/3 filling fraction(1/3FF) was significantly lower in group Ⅲ than in group Ⅱ and Ⅰ (both P < 0.001),but LV late 1/3 FF was much higher in group Ⅲ than in group Ⅱ and Ⅰ (P <0.05, P < 0.01). Left ventricular end-diastolic pressure(LVEDP)was markedly increased before and after LVG in group Ⅱ and Ⅲ as compared with group Ⅰ (bothP<0.05, both P< 0.001). The difference of LVEDP caused by left atrial contraction (left atrial contraction pressure difference, LACPD)before and after LVG was much higher in group Ⅲ than in group Ⅰ ( P <0.01, P < 0.001). Howevere,there were significant differences in LVEDP and in LACPD between before and after LVG only in group Ⅲ (both P < 0.01). Conclusion. The patients with AD have LV diastolic dysfunction, which may be closely related to the pathogen esis of angina decubitus.

  13. Lymphoma Presenting as Severe Left Ventricular Systolic Dysfunction: A Case Report

    Directory of Open Access Journals (Sweden)

    Imran Hafeez

    2014-05-01

    Full Text Available Lymphoma involving the heart is rare. This is a case report on non-Hodgkin lymphoma where the patient presented for the first time with heart failure and severe left ventricular systolic dysfunction due to lymphoma infiltrating the heart muscle and had simultaneous bilateral involvement of kidneys. This type of presentation has never been described in world literature and is the first reported case.

  14. Left ventricular twisting mechanics and exercise in healthy individuals: a systematic review

    OpenAIRE

    Warburton, Darren

    2012-01-01

    C Taylor Drury,1,2 Shannon SD Bredin,3 Aaron A Phillips,1,2 Darren ER Warburton1,21Cardiovascular Physiology and Rehabilitation Laboratory, University of British Columbia; 2Experimental Medicine Program, Faculty of Medicine, University of British Columbia; 3Cognitive and Functional Learning Laboratory, University of British Columbia, Vancouver, BC, CanadaAbstract: The aim of this study was to review systematically the effects of exercise on left ventricular (LV) twisting mechanics in healthy ...

  15. Influence of obesity on left ventricular adaptation, grading and outcome in aortic valve stenosis

    OpenAIRE

    Rogge, Barbara

    2014-01-01

    Background/Aim: Obesity is associated with hemodynamic changes characterized by volume overload adding to the progressive pressure overload induced by aortic valve stenosis (AS). This thesis investigated whether concomitant obesity in patients with AS independently impacts left ventricular (LV) adaptation, grading and outcome during progression of the valve stenosis.Methods: The project was a planned substudy of the Simvastin Ezetimibe in Aortic Stenosis study (SEAS), a prospec...

  16. Anemia treatment and left ventricular hypertrophy in non-dialysis chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    Robert N. Foley; Peter A. McCullough

    2005-01-01

    @@ To this day, the target hemoglobin level that minimizes cardiovascular risk in chronic kidney disease (CKD) patients remains unclear. When one examines the many randomized trials of epoetin therapy in aggregate, enhanced quality of life provides the most cogent argument for hemoglobin levels above 110 g/L. It remains unclear whether treatment of anemia improves longevity, or even a surrogate marker (such as left ventricular [LV] mass index), especially when applied at earlier phases of CKD.

  17. ENHANCED EXTERNAL COUNTERPULSATION IMPROVES ENDOTHELIAL FUNCTION AND EXERCISE CAPACITY IN PATIENTS WITH ISCHEMIC LEFT VENTRICULAR DYSFUNCTION

    OpenAIRE

    Beck, DT; Martin, JS; Casey, DP; Avery, JC; Sardina, PD; Braith, RW

    2014-01-01

    Enhanced external counterpulsation (EECP) therapy decreases angina episodes and improves quality of life in patients with left ventricular dysfunction (LVD). However, studies have not elucidated the mechanisms of action and overall effects of EECP in patients with LVD. The purpose of this study was to investigate the effects of EECP on endothelial function in peripheral conduit arteries and exercise capacity (peak VO2) in patients with LVD. Patients with ischemic LVD (EF 34.5±4.2%; n=9), and ...

  18. Validation study of candidate single nucleotide polymorphisms associated with left ventricular hypertrophy in the Korean population

    OpenAIRE

    Park, Jin-Kyu; Kim, Mi Kyung; Choi, Bo Youl; Jung, Yusun; Song, Kyuyoung; Kim, Yu Mi; Shin, Jinho

    2015-01-01

    Background Left ventricular hypertrophy (LVH) is a valid predictor for cardiovascular mortality and morbidity regardless of age, gender, and race. The HyperGEN study conducted a genome-wide association study and identified twelve single nucleotide polymorphisms (SNPs) associated with LVH. The aim of this study was to validate these candidate SNPs in the Korean population. Methods Among 1637 individuals from the Korean Multi-Rural Communities Cohort Study (MRCohort) of the Korean Genome Epidem...

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

    Directory of Open Access Journals (Sweden)

    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

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

    OpenAIRE

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

    2013-01-01

    Perioperative anaesthetic management of the VentrAssist TM left ventricular assist device (LVAD) is a challenge for anaesthesiologists because patients presenting for this operation have long-standing cardiac failure and often have associated hepatic and renal impairment, which may significantly alter the pharmacokinetics of administered drugs and render the patients coagulopathic. The VentrAssist is implanted by midline sternotomy. A brief period of cardiopulmonary bypass (CPB) for apical ca...

  1. A novel left ventricular assist device with impeller pump and brushless motor compacted in one unit

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The impeller pump we developed has assisted the circulation of calves for two months, but further improvements to solve the problems of bearing wear and thrombosis along the bearing are desirable. Thus we have designed a new left ventricular assist device (LVAD) with impeller pump and brushless motor compacted in one unit, for which a ceramic bearing and a purge system through the bearing have been devised. The first experiments indicate that this new device could prospectively work for more than one year.

  2. Aortico-left ventricular tunnel in adulthood: twenty-two year follow up.

    Science.gov (United States)

    Norman, Rose; Kafka, Henryk

    2009-05-01

    Aortico-left ventricular tunnel (ALVT) is a rare congenital cardiac defect that is usually managed by surgical or catheter intervention. This case documents the 22 year follow up of a 44 year old man who has been managed medically through a programme of close clinical and echocardiographic monitoring. This report illustrates that conservative management of Type I ALVT can be undertaken without adverse clinical consequences.

  3. Role of Bradykinin on Left Ventricular Remodeling and Cardiac Function after Myocardial Infarction in Rats

    Institute of Scientific and Technical Information of China (English)

    Hai-zhu ZHANG; Li-quan LEI; Chang-cong CUI; Jian LIU

    2009-01-01

    Objectives To investigate the influences of bradykinin (BK) on hemodynamics, left ventricular hypertrophy and interstitial collagen metabolism after myocardial infarction (MI) in rats and the contribution of BK in angiotensin-con-verting enzyme (ACE) inhibition therapy. Methods By means of hemodynamic measurements, morphometric study of myocyte hypertrophy and SDS-PAGE technique ,the effects of enalapril pressure (500μg·kg-1·day-1) ,enalapril(500μg·kg-1·day-1) with BK B2 receptor antagonist Hoe-140 (500μg·kg-1·day-1),angiotensin Ⅱ (AgII) type 1 (AT1) receptor antagonist losartan(3mg·kg-1·day-1)on mean arterial pressure (MAP) ,left ventricular end-dias-tolic pressure (LVEDP), as well as maximum positive left ventricular pressure change (+ dp/dtmax), Ⅴ(m) n, col-lagen content and the ratio of type Ⅰ to type Ⅲ collagen (Ⅰ / Ⅲ) of noninfarcted area were observed in rats after MI. Treatments were started on the 3rd day after MI and continued for another 28 days. Results Enalapril reduced LV-EDP, Ⅴ(m) n and collagen content as well as collagen Ⅰ/Ⅲ compared with the untreated MI group (P < 0. 05), and all of these effects of enalapril were partly blunted by concomitant treatment with hoe-140 (P < 0. 05). Losartan was less effective than enalapril (P < 0. 05). However, three treatment groups had no significant differences in + dp/dtmax and had similar reductions in MAP compared with untreated MI group. Conclusions BK can improve cardiac function and prevent left ventricular hypertrophy with myocardial fibrosis independent of blood pressure. The mechanisms of ACEI are both blockade of Ang Ⅱ formation and inhibition of BK degradation.

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

    Science.gov (United States)

    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

  5. Intraoperative transesophageal echocardiographic assessment of left ventricular Tei index in congenital heart disease

    OpenAIRE

    Shanthi Sivanandam; Andrew Wey; James St. Louis

    2015-01-01

    Background: Use of the Tei index has not been described to assess myocardial function before or after surgery in pediatric patients. This study was designed to evaluate the left ventricular (LV) function using the Tei index pre- and post-cardiopulmonary bypass in patients with lesion that result in a volume loaded right ventricle (RV). Methods: Retrospective data on 55 patients who underwent repair of a cardiac defect were analyzed. Patients with volume overload RV (n = 15) were compared to p...

  6. Pharmacist intervention in primary care to improve outcomes in patients with left ventricular systolic dysfunction

    OpenAIRE

    Lowrie, R.; Mair, F S; Greenlaw, N.; Forsyth, P.; Jhund, P.S.; McConnachie, A.; Rae, B.; McMurray, J.J.V.

    2012-01-01

    Background Meta-analysis of small trials suggests that pharmacist-led collaborative review and revision of medical treatment may improve outcomes in heart failure. Methods and results We studied patients with left ventricular systolic dysfunction in a cluster-randomized controlled, event driven, trial in primary care. We allocated 87 practices (1090 patients) to pharmacist intervention and 87 practices (1074 patients) to usual care. The intervention was delivered by non-specialist pharmac...

  7. Evaluation of right and left ventricular function in hard metal workers.

    OpenAIRE

    Horowitz, S F; Fischbein, A; Matza, D; Rizzo, J N; Stern, A.; J. Machac; S. J. Solomon

    1988-01-01

    Ingested cobalt has previously been associated with the development of a congestive cardiomyopathy. Despite occasional reports of cardiomyopathy after industrial exposure to cobalt, this association remains controversial. In a study of 30 cemented tungsten carbide workers with a mean duration of exposure to cobalt of 9.9 +/- 5.3 years radionuclide ventriculography was performed to study right and left ventricular ejection fractions at rest and exercise. For the entire group, rest and exercise...

  8. Hemorrhagic Cardioembolic Stroke Secondary to a Left Ventricular Thrombus: a Therapeutic Dilemma

    OpenAIRE

    Khalil Al-Farsi; Siddiqui, Aftab A.; Yasser W. Sharef; Al-Belushi, Ali K.; Hakeem Al-Hashim; Mohammed Al-Ghailani; William J Johnsto

    2013-01-01

    Cardiogenic embolism is a major cause of stroke and often leads to significant morbidity and mortality. Despite the recent advances in our understanding of the pathophysiology of stroke and its risk factors, diagnosis and therapy; some case scenarios still present a real challenge for the treating physicians. We report a case of a 50 year old male patient presenting with multi-territory cerebral infarctions due to a left ventricular mobile thrombus complicated with hemorrhagic transformation ...

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

    OpenAIRE

    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...

  10. Minimally invasive is the future of left ventricular assist device implantation

    OpenAIRE

    Makdisi, George; Wang, I-Wen

    2015-01-01

    There have been many factors that have allowed for progressive improvement in outcomes and lower complication rates. These include the improvement in left ventricular assist device (LVAD) technologies, combined with better understanding of patient management, all these. Nowadays the numbers of LVAD implantations exceed the number of annual heart transplants worldwide. Minimally invasive procedures are shown to improve the surgical outcome in both LVAD insertion and replacement. These minimall...

  11. RARE ANOMALY OF THE CORONARY VESSELS: CORONARY AND LEFT VENTRICULAR FISTULAS

    OpenAIRE

    L. V. Salamatina; Ye. Yu. Levchenko; A. A. Seitov; O. M. Zolotenkova; A. A. Burym

    2014-01-01

    Study objective: description of the case of diagnostics of rare anomaly of the coronary vessels: coronary and left ventricular fistulas.Materials and methods. Patient L., 45 y.o. (height 168 cm, weight 55 kg), male, complained of periodical burning pain behind the breastbone without connection with physical activity, often disturbing at night, stopped with intake of nitrates. The following examination of the patient was performed: clinical and biochemical blood tests, electrocardiography (ECG...

  12. Dynamic left ventricular outflow tract obstruction complicating aortic valve replacement: A hidden malefactor revisited

    Directory of Open Access Journals (Sweden)

    Panduranga Prashanth

    2010-01-01

    Full Text Available It is known that a dynamic left ventricular outflow tract (LVOT obstruction exists in patients, following aortic valve replacement (AVR and is usually considered to be benign. We present a patient with dynamic LVOT obstruction following AVR, who developed refractory cardiogenic shock and expired inspite of various treatment strategies. This phenomenon must be diagnosed early and should be considered as a serious and potentially fatal complication following AVR. The possible mechanisms and treatment options are reviewed.

  13. Increased left ventricular stiffness impairs filling in dogs with pulmonary emphysema in respiratory failure.

    OpenAIRE

    Gomez, A; Mink, S

    1986-01-01

    In a chronic canine model of pulmonary emphysema, we studied the interaction between left ventricular (LV) mechanics and pulmonary disease during severe hypoxemia. The hypoxemia was similar to that which may occur during a severe exacerbation of chronic obstructive lung disease. In six dogs with papain-induced emphysema and in seven dogs without emphysema, LV mechanics were examined when a hypoxic gas mixture was inspired to reduce PO2 to about 35 mmHg (hypoxic study) and during nonhypoxic co...

  14. Relationship between aetiology and left ventricular systolic dysfunction in hypertrophic cardiomyopathy

    OpenAIRE

    Rosmini, Stefania

    2015-01-01

    Background: Hypertrophic cardiomyopathy (HCM) is a common cardiac disease caused by a range of genetic and acquired disorders. The most common cause is genetic variation in sarcomeric proteins genes. Current ESC guidelines suggest that particular clinical features (‘red flags’) assist in differential diagnosis. Aims: To test the hypothesis that left ventricular (LV) systolic dysfunction in the presence of increased wall thickness is an age-specific ‘red flag’ for aetiological diagnosis an...

  15. [Isolated left ventricular muscular diverticulum in an adult. Value of non-invasive examinations].

    Science.gov (United States)

    Holeman, A; Bellorini, M; Lefevre, T; Lévy, M; Loiret, J; Huerta, F; Thébault, B; Funck, F

    1997-10-01

    The authors report a case of ventriculum in a 45 year old women investigated for chest pain. This was a congenital muscular left ventricular diverticulum confirmed by a complete imaging series including echocardiography, magnetic resonance imaging, angio-scintigraphy and conventional angiography. This diverticulum was unusual due to the fact that there was no associated congenital disease and that it was discovered in an adult. The authors review the literature and discuss the value of non-invasive imaging procedures.

  16. The association of growth differentiation factor-15 with left ventricular hypertrophy in hypertensive patients.

    Directory of Open Access Journals (Sweden)

    Hao Xue

    Full Text Available Growth differentiation factor-15 (GDF-15 has been identified as an endogenous anti-hypertrophy effect. However, the association of plasma GDF-15 levels with left ventricular hypertrophy (LVH in hypertension is poorly understood. We investigate the effect of plasma GDF-15 levels on left ventricular hypertrophy (LVH in hypertension. We measured the plasma levels of GDF-15 in 299 untreated hypertensive patients which consisted of 99 with LVH and 200 without LVH using immunoradiometric assay. All subjects were examined by the ultrasonic cardiograph to determine Left ventricular (LV internal diameters, septal thickness, and posterior wall thickness. The associations of GDF-15 with left ventricular mass index (LVMI, LV end-systolic and -diastolic diameters, LV wall thickness, and LV ejection fraction were evaluated. We found that plasma GDF-15 levels in hypertensive patients with LVH [median 1101, 25th-75th percentiles (879-1344 ng/L] were higher than that in hypertensive patients without LVH [median 516, 25th-75th percentiles (344-640 ng/L] (P<0.001. After adjustment for traditional covariates, plasma GDF-15 levels were independently related to LVMI (R(2 = 0.53; β = 0.624, P<0.001, LV interventricular septal thickness (R(2 = 0.23; β = 0.087, P<0.01 and LV posterior wall thickness (R(2 = 0.26; β = 0.103, P<0.05. Our cross-sectional data on a hospital-based sample indicate that plasma GDF-15 levels are associated with LVH in hypertensive patients.

  17. Beneficial effect of isradipine on the development of left ventricular hypertrophy in mild hypertension

    DEFF Research Database (Denmark)

    Mehlsen, J; Fornitz, Gitte Gleerup; Haedersdal, C;

    1993-01-01

    The objective of this study was to analyze the long-term hemodynamic effects of the calcium antagonist isradipine in mild hypertension compared with those of the beta 1-selective adrenoceptor antagonist atenolol, focusing in particular on the development of cardiac hypertrophy. Ten male patients...... isradipine (254 +/- 55 g). The results indicate that antihypertensive treatment with isradipine as monotherapy may prevent the development of left ventricular hypertrophy whereas treatment with atenolol as monotherapy does not appear to offer this possibility....

  18. LEFT VENTRICULAR SYSTOLIC FUNCTION DURING TREADMILL WALKING WITH LOAD CARRIAGE IN ADOLESCENTS

    Directory of Open Access Journals (Sweden)

    Moran Sagiv

    2006-06-01

    Full Text Available Backpack carriage occurs in day-to-day tasks and has applications in school, physical training, recreational activities and sports. Using metabolic cart and echocardiograph, this study determined and examined the effects of two different load carriages on left ventricular function during 30 min. of treadmill walking in healthy adolescent male subjects. Seventeen males (13.1 ± 0.5 yrs. walked on a treadmill at a speed of 4 km·h-1, each carrying a load relative to his body mass at 333 gr·kg-1 body weight during one session and without weight during the other session. Significant (p < 0.05 differences were noted between the 333 gr·kg-1 body weight and the no weights with regard to: VO2 13.6 ± 1.3 and 10.5 ± 1.1 ml·kg-1·min-1; heart rate: 133.2 ± 7.1 and 121.4 ± 5.6 beats·min-1; mean arterial blood pressure; 95. 4 ± 4.3 and 87.5 ± 3.8 mmHg and systolic blood pressure 147.7 ± 7.0 and 129.8 ± 7.1 mmHg respectively. No significant differences were noted between the two exercises with regard to left ventricular function variables. This study suggests that in adolescents as in adults, the vasodilatation mechanism dominates during combined dynamic and isometric exercises. Thus, the opposing force to the left ventricular ejection is reduced which in turn does not change the left ventricular global function. In addition, the vasodilatation mechanism enables oxygen supply to the contracting muscles via aerobic energy pathways

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

    OpenAIRE

    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...

  20. Left ventricular beat to beat performance in atrial fibrillation: dependence on contractility, preload, and afterload

    OpenAIRE

    Muntinga, H; Gosselink, A; Blanksma, P; De Kam, P J; van der Wall, E; Crijns, H.

    1999-01-01

    OBJECTIVE—To assess independent determinants of beat to beat variation in left ventricular performance during atrial fibrillation.
DESIGN—Prospective study.
SETTING—University hospital.
PATIENTS—Seven patients with chronic non-valvar atrial fibrillation.
INTERVENTIONS—Invasive and non-invasive haemodynamic variables were assessed using a non-imaging computerised nuclear probe, a balloon tipped flow directed catheter, and a non-invasive fingertip blood pressure measurement system linked to a p...

  1. Mitral Annular Kinetics, Left Atrial and Left Ventricular Diastolic Function Post Mitral Valve Repair in Degenerative Mitral Regurgitation

    Directory of Open Access Journals (Sweden)

    Chun eSchiros

    2015-08-01

    Full Text Available Objective: The relationship of mitral annular (MA kinetics to left ventricular (LV and left atrial (LA function before and after mitral valve repair has not been well studied. Here we sought to provide comprehensive analysis that relates to MA motions, LA and LV diastolic function post mitral valve repair. Methods: Three-dimensional analyses of mitral annular motion, LA function and LV volumetric and diastolic strain rates were performed on 35 degenerative mitral regurgitation (MR patients at baseline and 1-year post mitral valve repair, and 51 normal controls, utilizing cardiac magnetic resonance imaging with tissue tagging. Results: All had normal LV ejection fraction (EF at baseline. LV and LA EFs decreased 1-year post-surgery vs. controls. LV early-diastolic myocardial strain rates decreased post-surgery along with decreases in normalized early-diastolic filling rate, E/A ratio and early-diastolic MA relaxation rates. Post-surgical LA late active kick remained higher in MR patients vs. control. LV and LA EFs were significantly associated with peak MA centroid to apex shortening. Furthermore, during LV systolic phase, peak LV ejection and LA filling rates were significantly correlated with peak MA centroid to apex shortening rate, respectively. While during LV diastolic phase, both peak early diastolic MA centroid to apex relaxation rate and LA ejection rate were positively significantly associated with LV peak early diastolic filling rate. Conclusions— MA motion is significantly associated with LA and LV function. Mitral annular motion, left atrial function and left ventricular diastolic strain rates are still impaired one year post mitral valve repair. Long term effects of these impairments should be prospectively evaluated.

  2. Blood pressure levels, left ventricular mass and function are correlated with left atrial volume in mild to moderate hypertensive patients.

    Science.gov (United States)

    Milan, A; Caserta, M A; Dematteis, A; Naso, D; Pertusio, A; Magnino, C; Puglisi, E; Rabbia, F; Pandian, N G; Mulatero, P; Veglio, F

    2009-11-01

    Arterial hypertension is associated with an increased risk of atrial fibrillation (AF), and leads to a pronounced increase in morbidity and mortality. Left atrial volume (LAV) is an important prognostic marker in the older populations. The aim of our study was to identify the clinical and echocardiographic determinants of LAV in middle-aged (<70 years old) essential hypertensive patients.We evaluated cardiac structure and function in 458 patients, 394 treated and untreated mild to moderate essential hypertensives patients (mean+/-s.d. age 48.4+/-11.1 years) with no associated clinical condition and 64 normotensive control participants (age 45.7+/-12.8 years; P=0.12). A multivariate analysis was performed to calculate the relative weight of each of the variables considered able to predict LAV. The LAV index (LAVi) was significantly increased in the essential hypertensive group vs the control group and was significantly dependent on blood pressure levels (SBP and DBP, P<0.05 for both) and body mass index (BMI) (P<0.0001). Considering the left ventricular (LV) variables, the LV mass index (LVMI) (R(2)=0.19, P<0.001) and LAV were increased in essential hypertensive patients with left ventricular hypertrophy (LVH), and patients with enlarged LAV showed lower systolic and diastolic function and an increased LVMI. The LAVi is dependent on blood pressure levels and anthropometric variables (age and BMI). Further structural (LVMI) and functional (systolic and diastolic) variables are related to the LAVi; LVMI is the most important variable associated with LAV in mild to moderate essential hypertensive adult patients. These findings highlight the importance of left atrium evaluation in adult, relatively young, essential hypertensive patients. PMID:19262581

  3. APOPTOSIS OF DIFFERENT MYOCARDIAL CELLS CONTRIBUTES TO LEFT VENTRICULAR REMODELING IN SPONTANEOUSLY HYPERTENSIVE RATS

    Institute of Scientific and Technical Information of China (English)

    陈卫兵; 殷明; 秦永文

    2001-01-01

    Objective To study the change and role of apoptosis in hypertensive left ventricular remodeling. Methods Hearts from 16-week-old spontaneously hypertensive rats (SHR) and age-matched normotensive Wistar-Kyoto rats(WKY) were investigated. Apoptosis in left ventricle sections was assessed by in situ end-labeling technique(TUNEL), the feature and type of cells undergoing apoptosis were identified uitrastructurally by transmission electron microscope (ECM). Additionally, localization of Fas protein-a mediator of apoptotic cell death was ex-

  4. Congenital left ventricular diverticulum, a rare chest fluoroscopy finding: a case report

    Institute of Scientific and Technical Information of China (English)

    WANG Zhi-wei; WU Hong-bing; MAO Zhi-fu; HU Xiao-ping

    2011-01-01

    Congenital left ventricular diverticulum is a very rare cardiac abnormality and it is not completely understood about its etiology, clinical manifestation, diagnosis, treatment and prognosis. This article presents a case of large congenital diverticulum of the left ventricle. The clinical manifestation included paroxysmal supraventricular tachycardia. The diagnosis was made by chest fluoroscopy observation and confirmed by 64-slice CT-angiography. The arrhythmia alleviated instead of antiarrhythmic drugs but by radiofrequency catheter ablation. Due to the rapid growth of the diverticulum, the patient underwent surgical resection finally. Owing to the fatal risks, clinicians should improve the understanding of this disease by deeply studying more cases, in order to standardize the treatment.

  5. Prehypertension and Left Ventricular Diastolic Dysfunction in Middle-Aged Koreans

    Science.gov (United States)

    Jang, Shin Yi; Kim, Sujin; Lee, Chang Kwan; Cho, Eun Jeong; Cho, Soo Jin

    2016-01-01

    Background and Objectives Left ventricular diastolic dysfunction is known to be a marker of myocardial damage, in particular myocardial fibrosis resulting from hypertension (HT). However, few studies have shown an association between the grade of diastolic dysfunction and blood pressure classification. We investigated the association between diastolic dysfunction and prehypertension (preHT) in apparently healthy adults who underwent routine health examinations. Subjects and Methods The study sample included 4261 Koreans, 45 to 64 years of age with no previous history of HT, diabetes mellitus, malignancy, proven coronary artery disease, or valvular heart disease based on echocardiography, who underwent routine health examinations including echocardiography. The subjects were classified into three groups based on resting blood pressure: prehypertensive, hypertensive, and normotensive. Results The prevalence of preHT in our study was 42.1%. After adjusting for age, gender, smoking status, alcohol consumption, fasting blood sugar, serum lipid profile, and body mass index, left ventricular diastolic dysfunction grades 1 and 2 were significantly more frequent in subjects with preHT (odds ratio [OR] 1.66 [95% confidence interval {CI} 1.40-1.96] and 1.37 [95% CI 0.95-1.97], respectively). When analyzed according to gender, the increased OR was especially notable in males. Conclusion Left ventricular diastolic dysfunction appears to be significantly associated with preHT in Korean middle-aged males. PMID:27482263

  6. Assessment of Left Ventricular Structural Remodelling in Patients with Diabetic Cardiomyopathy by Cardiovascular Magnetic Resonance

    Science.gov (United States)

    Zhang, Xiaochun; Leng, Weiling

    2016-01-01

    Background. Diabetic cardiomyopathy (DCM) is always accompanied with alteration of left ventricular structure and function. The aims of this study were to assess the structural remodelling in patients with DCM by cardiovascular magnetic resonance (CMR) and correlation of structural remodelling with severity of DCM. Methods. Twenty-five patients (53.8 ± 8.8 years, 52.0% males) with DCM and thirty-one normal healthy controls (51.9 ± 13.6 years, 45.2% males) were scanned by CMR cine to assess function and structure of left ventricular. Length of diabetic history and results of cardiac echocardiography (E′, A′, and E′/A′) were also measured. Results. Compared with normal controls group, DCM group was associated with significantly increased ratio of left ventricular mass at end diastole to end-diastolic volume (MVR) (P 0.05). The ratio correlated with both length of diabetic history and echocardiographic Doppler tissue imaging E′ (all P < 0.05). Conclusions. CMR can be a powerful technique to assess LV remodelling, and MVR may be considered as an imaging marker to evaluate the severity of LV remodelling in patients with DCM.

  7. TNF-Like Weak Inducer of Apoptosis Aggravates Left Ventricular Dysfunction after Myocardial Infarction in Mice

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    Kai-Uwe Jarr

    2014-01-01

    Full Text Available Background. TNF-like weak inducer of apoptosis (TWEAK has recently been shown to be potentially involved in adverse cardiac remodeling. However, neither the exact role of TWEAK itself nor of its receptor Fn14 in this setting is known. Aim of the Study. To analyze the effects of sTWEAK on myocardial function and gene expression in response to experimental myocardial infarction in mice. Results. TWEAK directly suppressed the expression of PGC-1α and genes of oxidative phosphorylation (OXPHOS in cardiomyocytes. Systemic sTWEAK application after MI resulted in reduced left ventricular function and increased mortality without changes in interstitial fibrosis or infarct size. Molecular analysis revealed decreased phosphorylation of PI3K/Akt and ERK1/2 pathways associated with reduced expression of PGC-1α and PPARα. Likewise, expression of OXPHOS genes such as atp5O, cycs, cox5b, and ndufb5 was also reduced. Fn14 -/- mice showed significantly improved left ventricular function and PGC-1α levels after MI compared to their respective WT littermates (Fn14 +/+. Finally, inhibition of intrinsic TWEAK with anti-TWEAK antibodies resulted in improved left ventricular function and survival. Conclusions. TWEAK exerted maladaptive effects in mice after myocardial infarction most likely via direct effects on cardiomyocytes. Analysis of the potential mechanisms revealed that TWEAK reduced metabolic adaptations to increased cardiac workload by inhibition of PGC-1α.

  8. Quantitation of left ventricular regurgitant fraction by first pass radionuclide angiocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Janowitz, W.R.; Fester, A.

    1982-01-01

    A new technique for quantitating left ventricular regurgitant fraction from first pass radionuclide angiocardiographic studies is described. The technique involves measurement of the total number of counts ejected from the right and left ventricles (CR and CL, respectively). In the absence of any valve insufficiency and equal counting efficiency from each ventricle, CR/CL . 1. In the presence of mitral or aortic insufficiency, or both, the regurgitant fraction can be calculated as (CL -- CR)/CL, if no right ventricular regurgitation is present. In this report the theoretical derivation of the method and practical aspects of measuring CL and CR are presented. The technique was tried in a small group of 5 normal volunteers, 7 patients studied with cardiac catheterization without regurgitation and 22 patients with mitral or aortic insufficiency, or both. Excellent correlation was found with cardiac catheterization data in the latter group (r . 0.86, n . 22). This method appears to be a simple and accurate technique for measuring left ventricular regurgitant fraction due to mitral or aortic valve disease, or both.

  9. Echocardiographic Assessment of Left Ventricular Function in Type 1 Gaucher's Disease

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    Mirta Koželj

    2010-01-01

    Full Text Available There is predominate opinion among physicians managing type 1 Gauchers' disease (GD that cardiac involvement is not an issue in these patients. In order to follow this hypothesis, we prospectively investigated 15 adult imiglucerase-treated type 1 GD patients by echocardiography, Doppler, and tissue Doppler echocardiography. This was a case-controlled study with 18 matched healthy volunteers. The obtained data was correlated with the levels of NT-proBNP (brain natriuretic peptide. None of the GD patients had clinical signs of heart disease. In 3 of the 15 patients, we observed echocardiographic signs of aortic and mitral valve calcification. The left ventricular systolic function was within normal limits. Compared to the control group, there was no statistically significant difference observed in the most sensitive indices of left ventricular diastolic function, parameter Em (P=.095, and E/Em ratio (P=.097, as demonstrated by tissue Doppler echocardiography. However, there was a positive correlation between the E/Em ratio and NT-proBNP plasma levels (P=.009. In conclusion, the prospective echocardiographic study of type 1 GD patients did not validate any left ventricular dysfunction. But, the E/Em ratio showed a strong statistical correlation with the most sensitive indicators of heart failure, NT-proBNP. Research on larger groups of patients and the usage of even more sensitive methods as strain-rate imaging will be necessary to confirm eventual myocardial involvement in GD patients.

  10. Serum cystatin C concentration as an independent marker for hypertensive left ventricular hypertrophy

    Institute of Scientific and Technical Information of China (English)

    Xin Li; Hang Zhu; Peng Li; Qian Xin; Jie Liu; Wei Zhang; You-Hong Xing; Hao Xue

    2013-01-01

    Background Serum cystatin C levels can be used to predict morbidity and mortality in patients with cardiovascular disease. However, the clinical relevance of serum cystatin C levels in patients with hypertensive left ventricular hypertrophy (LVH) has rarely been investigated. We designed the present study to investigate whether serum cystatin C levels are associated with cardiac structural and functional alterations in hypertensive patients. Methods We enrolled 823 hypertensive patients and classified them into two groups:those with LVH (n=287) and those without LVH (n=536). All patients underwent echocardiography and serum cystatin C testing. We analyzed the relationship be-tween serum cystatin C levels and LVH. Results Serum cystatin C levels were higher in hypertensive patients with LVH than in those without LVH (P<0.05). Using linear correlation analysis, we found a positive correlation between serum cystatin C levels and interven-tricular septal thickness (r=0.247, P<0.01), posterior wall thickness (r=0.216, P<0.01), and left ventricular weight index (r=0.347, P<0.01). When analyzed by multiple linear regression, the positive correlations remained between serum cystatin C and interventricular septal thickness (β=0.167, P<0.05), posterior wall thickness (β=0.187, P<0.05), and left ventricular weight index (β=0.245, P<0.01). Con-clusion Serum cystatin C concentration is an independent marker for hypertensive LVH.

  11. Quantitative assessment of left ventricular systolic wall thickening using multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kristensen, Thomas S. [Department of Radiology, Diagnostic Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: tskaarup@yahoo.com; Kofoed, Klaus F. [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: kkofoed@dadlnet.dk; Moller, Daniel V. [Department of Cardiology, Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: DVEGA@gmx.net; Ersboll, Mads [Department of Cardiology, Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: ersboell@stud.ku.dk; Kuehl, Tobias [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: tobiaskh@gmail.com; Recke, Peter von der [Department of Radiology, Diagnostic Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: peter.von.der.recke@rh.regionh.dk; Kober, Lars [Department of Cardiology, Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: lk@heart.dk; Nielsen, Michael B. [Department of Radiology, Diagnostic Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: mbn@dadlnet.dk; Kelbaek, Henning [Department of Cardiology, Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen (Denmark)], E-mail: henning.kelbaek@rh.regionh.dk

    2009-10-15

    Background: Multidetector computed tomography (MDCT) of the heart provides both anatomical and functional information. The objective of this study was to evaluate the accuracy of quantitative assessment of left ventricular contractile function in relation to two-dimensional transthoracic echocardiography (TTE). Materials and methods: Sixty-four patients with known or suspected coronary artery disease underwent ECG-gated 64-slice MDCT and TTE. Regional left ventricular contractile function was measured by percent systolic wall thickening (SWT) in 16 myocardial segments using MDCT, and compared with visual evaluation of wall motion score (WMS) by TTE. Global SWT by MDCT was calculated as the mean SWT of all myocardial segments and compared with wall motion index (WMI) by TTE. Results: Eight hundred and eleven segments (81%) were classified as normokinetic, 142 (14%) as hypokinetic, 41 (4%) as akinetic and 5 (0.5%) as dyskinetic by TTE. A significant inverse linear trend was found between regional SWT by MDCT and WMS by TTE (p < 0.001). Sensitivity and specificity for the identification of regional abnormalities of contractile function were 76% and 78%, respectively. A linear correlation between global SWT by MDCT and WMI by TTE was found (r = -0.8, p < 0.001). Sensitivity and specificity for the identification of WMI > 1.5 using global SWT was 91% and 94%, respectively. Conclusion: Quantification of systolic wall thickening by MDCT provides functional information, which is well correlated to visual assessment of global left ventricular contractile function by TTE.

  12. Effect of Xinjikang on left ventricular hypertrophy remodeling in hypertensive rats

    Institute of Scientific and Technical Information of China (English)

    Hong-Bo Liu; Chun-Hua Lin; Guang-Yu Zhou; Guo-Zhen Chen; Wei-Yan Cai

    2013-01-01

    Objective:To investigate the effects ofXinjikang on the left ventricular hypertrophy remodeling and myocardial activity in hypertension.Methods:SixtyWistar rats were randomly divided into four groups.The pressure-loaded left ventricular hypertrophy model was established with abdominal aorta ligation method.Rats inA andB groups were intragastrically administered with physiological saline, whileC andD groups were administered withXinjikang and metoprolol, respectively.The changes in blood pressure,E/A ratio, myocardial pathological morphology, myocardial lipoperoxides and superoxide dismustase activity in four groups were observed and compared before and after treatment. Results:There were statistically significant differences inE/A ratio betweenC group after treatment and model group(P0.05); after treatment the myocardial lipoperoxides and superoxide dismustase contents inC andD groups were improved significantly compared with model group(P<0.05).Conclusions:Xinjikang can improve myocardial injury, restore myocardial parenchyma and myocardial interstitial remodeling functions in hypertensive rats with the left ventricular hypertrophy.

  13. Role of infarction artery status in left ventricular remodeling after acute myocardial infarction.

    Science.gov (United States)

    Sanchis, J; Insa, L; Bodí, V; Egea, S; Monmeneu, J V; Chorro, F J; Llácer, A; López Merino, V

    1997-04-18

    The aim of this study was to evaluate the relation between the infarction artery status and left ventricular volumes, independently of regional ventricular dysfunction, at 4-6 weeks after a first myocardial infarction. The study group consisted of 100 patients, of whom 80 received thrombolytic treatment. Coronary and contrast left ventricular angiograms were performed at 36+/-5 days postinfarction. Left ventricular end-diastolic and end-systolic volumes were measured. The centerline chord motion method was used to calculate the extent of wall motion abnormality (percentage of chords with hypokinetic motion) and its severity (maximum units of S.D. below the normal wall motion reference). Minimum lumen diameter, patency and collateral flow in the infarction artery were also analyzed. Eight patients (group I) showed occlusion with poor collateral flow in the infarction artery, 22 patients (group II) occlusion with good collateral flow, 38 patients (group III) severe residual stenosis (minimum lumen diameter 1 mm). Patients from group I presented greater wall motion abnormality in terms of both extent (P=0.005) and severity (P=0.007), and greater end-diastolic (P=0.07) and end-systolic (P=0.0008) volumes; there were no differences among groups II, III and IV. By stepwise multivariate regression analysis, the extent of wall motion abnormality was the main determinant of end-diastolic (P=0.0001) and end-systolic (P=0.0001) volumes; occlusion with poor collateral flow was also a significant independent factor for end-systolic volume (P=0.03). Total occlusion (including both with and without collaterals) and the minimum lumen diameter did not correlate with end-diastolic and end-systolic volumes. We concluded that (A) the extent of regional dysfunction is the primary determinant of left ventricular volumes at 4-6 weeks postinfarction. (B) The status of the infarction artery is a weak predictor of end-diastolic volume, which is the best descriptor of ventricular remodeling

  14. Anatomy and Physiology of Left Ventricular Suction Induced by Rotary Blood Pumps.

    Science.gov (United States)

    Salamonsen, Robert Francis; Lim, Einly; Moloney, John; Lovell, Nigel Hamilton; Rosenfeldt, Franklin L

    2015-08-01

    This study in five large greyhound dogs implanted with a VentrAssist left ventricular assist device focused on identification of the precise site and physiological changes induced by or underlying the complication of left ventricular suction. Pressure sensors were placed in left and right atria, proximal and distal left ventricle, and proximal aorta while dual perivascular and tubing ultrasonic flow meters measured blood flow in the aortic root and pump outlet cannula. When suction occurred, end-systolic pressure gradients between proximal and distal regions of the left ventricle on the order of 40-160 mm Hg indicated an occlusive process of variable intensity in the distal ventricle. A variable negative flow difference between end systole and end diastole (0.5-3.4 L/min) was observed. This was presumably mediated by variable apposition of the free and septal walls of the ventricle at the pump inlet cannula orifice which lasted approximately 100 ms. This apposition, by inducing an end-systolic flow deficit, terminated the suction process by relieving the imbalance between pump requirement and delivery from the right ventricle. Immediately preceding this event, however, unnaturally low end-systolic pressures occurred in the left atrium and proximal left ventricle which in four dogs lasted for 80-120 ms. In one dog, however, this collapse progressed to a new level and remained at approximately -5 mm Hg across four heart beats at which point suction was relieved by manual reduction in pump speed. Because these pressures were associated with a pulmonary capillary wedge pressure of -5 mm Hg as well, they indicate total collapse of the entire pulmonary venous system, left atrium, and left ventricle which persisted until pump flow requirement was relieved by reducing pump speed. We suggest that this collapse caused the whole vascular region from pulmonary capillaries to distal left ventricle to behave as a Starling resistance which further reduced right

  15. Evaluation of left ventricular structures in normotensive and hypertensive subjects by two-dimensional echocardiography: Anthropometric correlates in hypertension

    Directory of Open Access Journals (Sweden)

    Mr. Agbo Julius Amaechi

    2008-07-01

    Full Text Available This study was conducted with the objective to establish a nomogram for some left ventricular structures and their alterations in hypertension. Correlations between left ventricular structures and anthropometric variables in hypertension were also established. A sample of 320 normotensive and 80 hypertensive subjects were studied. Echocardiograhic end diastolic diameter, posterior wall thickness and septal wall thickness were obtained. Subject height, weight, age and blood pressures were obtained. Blood pressures were measured in sitting position. The values of left ventricular mass (LVM, left ventricular mass index (LVMI and left relative wall thickness (RWT were computed. Parametric tests were conducted. Tests were two tailed with P < 0.05 indicating statistical significance. Normal values of left ventricular structures were established; LVM: 63.72g – 336.18g, LVMI: 38.16g/m – 222.64g/m, and RWT: 0.25 – 0.52. Significant differences (P < 0.05 were established in LVM, LVMI and RWT between normotensive and hypertensive subjects. Positive and significant correlations were noted between these variables and systolic blood pressure in hypertensive subjects. A simple linear regression of RWT on Body surface area gives RWT = - 0.058 BSA + 0.475 in normotensive subjects. Normal values of left ventricular structures and a linear regression model have been established which could be used in the assessment of morbidity in hypertension.

  16. Prevalence and risk factors for left ventricular hypertrophy and left ventricular geometric abnormality in the patients with hypertension among Han Chinese

    Institute of Scientific and Technical Information of China (English)

    WANG Shu-xia; XUE Hao; ZOU Yu-bao; SUN Kai; FU Chun-yan; WANG Hu; HUI Ru-tai

    2012-01-01

    Background Left ventricular hypertrophy (LVH) and geometric abnormality are associated with morbidity and mortality of cardiovascular disease and stroke.Hypertension is the major cause of LVH.Yet the prevalence and other risk factors of LVH and geometric abnormality in Chinese hypertensive population are unknown.The objective of this study was to investigate the prevalence and risk factors of LVH and geometric abnormality in community-based Chinese hypertensive population.Methods The study was a community-based cross-sectional study,and comprised 4270 hypertension patients with integrated clinical and echocardiographic data.Left ventricular mass was measured by transthoracic echocardiography.LVH was diagnosed by using the criteria of over 49.2 g/m27 for men and 46.7 g/m2.7 for women.LV geometric patterns (normal,concentric remodeling,concentric or eccentric hypertrophy) were calculated according to LVH and relative wall thickness.Logistic regression model was used to determine the odds ratio (OR) and 95% confidence intervals (CI) of the risk factors of LVH.Results The prevalence of LVH was 42.7% in 4270 hypertensive patients,with 37.4% in males and 45.4% in females,respectively.The prevalence of concentric remodeling,concentric or eccentric hypertrophy was 24.7%,20.2%,and 22.6%,respectively.In Logistic regression model,female (OR 1.3,95%CI 1,1-1.5,P <0.01),age (OR 1.02,95%CI 1.01-1.03,P <0.01),body mass index (OR 1.2,95%CI 1.15-1.20,P <0.01),systolic blood pressure (OR 1.02,95%CI 1.01-1.03,P <0.01),and serum triglyceride (OR 1.10,95% CI 1.00-1.20,P<0.01) were risk factors of LVH.Female,age,body mass index,systolic blood pressure and serum triglycedde were also risk factors of left ventricular geometric abnormality.Conclusions The echocardiographic LVH is the major complication of patients with hypertension in rural area of China,especially for women.To effectively treat hypertension,weight loss and control of serum triglyceride may

  17. Phenotyping of Left and Right Ventricular Function in Mouse Models of Compensated Hypertrophy and Heart Failure with Cardiac MRI

    NARCIS (Netherlands)

    B.J. van Nierop (Bastiaan); H.C. van Assen (Hans); E.D. van Deel (Elza); L.B.P. Niesen (Leonie); D.J.G.M. Duncker (Dirk); G.J. Strijkers (Gustav); K. Nicolay (Klaas)

    2013-01-01

    textabstractBackground: Left ventricular (LV) and right ventricular (RV) function have an important impact on symptom occurrence, disease progression and exercise tolerance in pressure overload-induced heart failure, but particularly RV functional changes are not well described in the relevant aorti

  18. Effect of burden and origin sites of premature ventricular contractions on left ventricular function by 7-day Holter monitor.

    Science.gov (United States)

    Xu, Wenhua; Li, Mingfang; Chen, Minglong; Yang, Bing; Wang, Daowu; Kong, Xiangqing; Chen, Hongwu; Ju, Weizhu; Gu, Kai; Cao, Kejiang; Liu, Hailei; Jiang, Qi; Shi, Jiaojiao; Cui, Yan; Wang, Hong

    2015-11-01

    Recent studies have shown that premature ventricular contractions (PVCs) could enlarge the heart, but its risk factors are incompletely understood as a single 24-hour recording cannot reflect the true PVC burden due to day-to-day variability. Our purpose was to investigate the effect of burden and origin sites on left ventricular (LV) function in patients with PVCs by 7-day Holter electrocardiography (ECG). From May 2012 to August 2013, 112 consecutive patients with PVCs were recruited from the authors' affiliated hospital. All patients received 2-dimensional transthoracic echocardiography, 12-lead routing ECG and 7-days Holter ECG. Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were measured. A total of 102 participants with PVCs were included in the final analysis. Origin of PVCs from the tricuspid annulus had the highest burden and NT-proBNP level. LV papillary muscle had a higher LV ejection fraction (EF) level and a lower LV end-systolic dimension (ESD) than other PVC foci (PHolter monitor showed the true PVC burden on patients with PVCs. PVCs with a lower burden or origin from the LV papillary muscle and the fascicle were relatively benign, while PVCs with a higher burden or origin from the tricuspid annulus may lead to cardiac dysfunction.

  19. Gender differences in left ventricular structure and function during antihypertensive treatment: the Losartan Intervention for Endpoint Reduction in Hypertension Study

    DEFF Research Database (Denmark)

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

    2008-01-01

    In hypertensive patients with left ventricular hypertrophy, antihypertensive treatment induces changes in left ventricular structure and function. However, less is known about gender differences in this response. Baseline and annual echocardiograms until the end of study or a primary end point...... occurred were assessed in 863 hypertensive patients with electrocardiographic left ventricular hypertrophy aged 55 to 80 years (mean: 66 years) during 4.8 years of randomized losartan- or atenolol-based treatment in the Losartan Intervention for Endpoint Reduction in Hypertension Echocardiography substudy...... (47% versus 32%; Ptreatment reduction in mean blood pressure. In logistic regression, left ventricular hypertrophy at study end was more common in women (odds ratio: 1.61; 95% CI: 1.16 to 2.26; P

  20. The inter-relationship of diabetes and left ventricular systolic function on outcome after high-risk myocardial infarction

    DEFF Research Database (Denmark)

    Shah, Amil M; Uno, Hajime; Køber, Lars;

    2010-01-01

    Diabetes is a potent risk factor for death and heart failure (HF) hospitalization following myocardial infarction (MI). Whether diabetes modifies the relationship between left ventricular ejection fraction (LVEF) and outcomes in the post-MI population is unknown....

  1. Relation of left ventricular function, mass, and volume to NT-proBNP in type 1 diabetic patients

    DEFF Research Database (Denmark)

    Astrup, A.S.; Kim, W.Y.; Tarnow, L.;

    2008-01-01

    OBJECTIVES: To measure left ventricular mass (LVM), left ventricular volumes, and left ventricular function (LVF) in a cohort of type 1 diabetic patients and to correlate measures of imaging to NH(2)-terminal pro-brain natriuretic peptide (NT-proBNP). RESEARCH DESIGN AND METHODS: In a cross...... with patients with persistent normoalbuminuria. Patients with nephropathy had smaller left ventricular volumes and increased levels of NT-proBNP. Linear regression analysis in patients with diabetic nephropathy showed that NT-proBNP and creatinine were associated with LVM. CONCLUSIONS: Increased LVM...... is identified in asymptomatic type 1 diabetic patients with nephropathy compared with normoalbuminuric patients. Elevated levels of NT-proBNP were associated with increased LVM, which are both markers of increased cardiovascular risk Udgivelsesdato: 2008/5...

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

    DEFF Research Database (Denmark)

    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...

  3. Prevalencia de hipertrofia ventricular izquierda en pacientes diabéticos Prevalence of left ventricular hypertrophy in diabetic patients

    Directory of Open Access Journals (Sweden)

    Diego Valarezo-Sevilla

    2013-03-01

    Full Text Available Con el objetivo de establecer la prevalencia de hipertrofia ventricular izquierda (HVI en pacientes con diabetes mellitus tipo 2 (DM, se realizó un estudio transversal en estos pacientes, estableciendo sus características antropométricas, presión arterial y control metabólico. Para evaluar la presencia de HVI se empleó ecocardiografía transtorácica. El estudio incluyó 91 pacientes, en los cuales la prevalencia de HVI fue de 63,7%, siendo más frecuente en mujeres que en varones (p=0,001. Adicionalmente, se encontró un 46,2% de pacientes con disfunción diastólica del ventrículo izquierdo. Se concluye que existe una importante prevalencia de HVI en pacientes diabéticos sin antecedentes de causas definidas de hipertrofia. No se encontró relación con sexo, control metabólico, IMC y tiempo de diagnósticoIn order to establish the prevalence of left ventricular hypertrophy (LVH in patients with type 2 diabetes mellitus, (DM a cross-sectional study was conducted in these patients studying their anthropometric characteristics, blood pressure and metabolic control. To evaluate the presence of LVH, a trans-thoracic echocardiogram was used. The study included 91 patients, finding a 63.7% prevalence of HVI, with women being more affected than men (p=0.001. Additionally, 46.2% of patients were found to have diastolic dysfunction of the left ventricle. We conclude that there is an important prevalence of LVH in diabetic patients without defined causes of hypertrophy. There was no association with sex, metabolic control, BMI and time of diagnosis

  4. Influence of the atrio-ventricular delay optimization on the intra left ventricular delay in cardiac resynchronization therapy

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    Nienaber Christoph A

    2006-01-01

    Full Text Available Abstract Background Cardiac Resynchronization Therapy (CRT leads to a reduction of left-ventricular dyssynchrony and an acute and sustained hemodynamic improvement in patients with chronic heart failure. Furthermore, an optimized AV-delay leads to an improved myocardial performance in pacemaker patients. The focus of this study is to investigate the acute effect of an optimized AV-delay on parameters of dyssynchrony in CRT patients. Method 11 chronic heart failure patients with CRT who were on stable medication were included in this study. The optimal AV-delay was defined according to the method of Ismer (mitral inflow and trans-oesophageal lead. Dyssynchrony was assessed echocardiographically at three different settings: AVDOPT; AVDOPT-50 ms and AVDOPT+50 ms. Echocardiographic assessment included 2D- and M-mode echo for the assessment of volumes and hemodynamic parameters (CI, SV and LVEF and tissue Doppler echo (strain, strain rate, Tissue Synchronisation Imaging (TSI and myocardial velocities in the basal segments Results The AVDOPT in the VDD mode (atrially triggered was 105.5 ± 38.1 ms and the AVDOPT in the DDD mode (atrially paced was 186.9 ± 52.9 ms. Intra-individually, the highest LVEF was measured at AVDOPT. The LVEF at AVDOPT was significantly higher than in the AVDOPT-50setting (p = 0.03. However, none of the parameters of dyssynchrony changed significantly in the three settings. Conclusion An optimized AV delay in CRT patients acutely leads to an improved systolic left ventricular ejection fraction without improving dyssynchrony.

  5. Evaluation of left ventricular ejection fraction using quantitative gated SPECT (QGS)

    International Nuclear Information System (INIS)

    Electrocardiographic ally gated myocardial perfusion SPECT (G SPECT) is a state-of the art technique for the combined evaluation of myocardial perfusion and left ventricular function within a single study. It is currently one of the most commonly performed cardiology procedures in a nuclear medicine department. Automation of the image processing and quantification has made this techniques highly reproducible, practical and user friendly in the clinical setting . In patients with coronary artery disease, gating enhances the diagnostic and prognostic capability of myocardial perfusion imaging provides incremental information over the the perfusion data, and has shown potentials for myocardial viability assessment and sequential follow-up after therapy. Evaluation of the left ventricular (L V) function is important in clinical cardiology. Quantifying the degree and extent of the L V functional abnormalities permits a systematic assessment of the disease process on the myocardial performance. The aim of this thesis is to evaluate left ventricular ejection fraction (LVEF) in patients with no evidence of ischemic response during the stress test. This investigation was carried out in view of the few reports concerning the findings ventricular function with gated SPECT in these situations in the normal population, which is relevant when considering the possibility of myocardial stunning. Method: We prospectively studied 30 selected patients, in difference age and gender. A one-day protocol was used, with injection 555 MBq - 1.11 MBq (15 - 30 mCi) of 99 mTc-M1 B1 at stress and rest. Gated perfusion SPECT was acquired 30 to 60 minutes after radiotracer injection in both condition and processed using QGSPECT software. Difference between stress and rest LVEF was calculated. Result and conclusion: rest LVEF was higher in the stress (exercise) group, A trend line was done in both groups and r-value was (0.9) and p=0.04 in acceptance value. Standard deviation of LVEF also was

  6. Diastolic function in various forms of left ventricular hypertrophy: contribution of active Doppler stress echo.

    Science.gov (United States)

    Möckel, M; Störk, T

    1996-11-01

    It has been known for a long time that healthy athletes can develop left ventricular hypertrophy with typical electrocardiographic and echocardiographic findings which lead to the definition of the athlete's heart, as a separate physiological feature. In some cases it is difficult to distinguish between pathological versus physiological myocardial hypertrophy. Diastolic dysfunction is an early sign in the temporal sequence of ischemic events in coronary heart disease. Similar changes occur in other types of heart disease due to arterial hypertension or inflammation processes. Diastolic function is changed even in idiopathic hypertrophic cardiomyopathies. In contrast to these groups of patients, diastolic function remains unchanged or is improved in healthy athletes depending on the type of training (isotonic or isometric exercise). In cases with borderline changes, examinations during physical stress (exercise testing) which provokes an oxygen demand/supply imbalance and consecutively impairs early diastolic filling could clarify if an underlying heart disease is present. Although the physiology of diastolic function is complex, the factors contributing to diastolic disturbances can be differentiated into intrinsic and extrinsic left ventricular (LV) abnormalities. Intrinsic mechanisms include a) impaired LV relaxation, b) increased overall chamber stiffness, c) increased myocardial stiffness and d) increased LV asynchrony. All these factors are part of pathological LV hypertrophy. Factors extrinsic to the LV causing diastolic disorders include a) increased central blood volume, which will increase left ventricular pressure without altering the LV pressure-volume relation, and b) ventricular interaction mediated by pericardial restraint, which may cause a parallel upward shift of the diastolic LV pressure-volume curve. Improved understanding of LV relaxation and filling helps to differentiate pathological and physiological myocardial hypertrophy. Ongoing heart

  7. Long pentraxin PTX3 exacerbates pressure overload-induced left ventricular dysfunction.

    Directory of Open Access Journals (Sweden)

    Satoshi Suzuki

    Full Text Available BACKGROUND: Left ventricular hypertrophy is enhanced by an inflammatory state and stimulation of various cytokines. Pentraxin 3 (PTX3 is rapidly produced in response to inflammatory signals, and high plasma PTX3 levels are seen in patients with heart failure. This study aimed to examine the influence of PTX3 on cardiac hypertrophy and left ventricular dysfunction with respect to pressure overload. METHODS AND RESULTS: PTX3 systemic knockout (PTX3-KO mice, transgenic mice with cardiac-specific overexpression of PTX3 (PTX3-TG, and the respective wild-type (WT littermate mice were subjected to transverse aortic constriction (TAC or a sham operation. Cardiac PTX3 expression increased after TAC in WT mice. In vitro, hydrogen peroxide induced the expression of PTX3 in both cardiac myocytes and cardiac fibroblasts. Recombinant PTX3 phosphorylated extracellular signal-regulated kinase 1/2 (ERK1/2 in cardiac fibroblasts. Phosphorylation of cardiac ERK1/2 and nuclear factor kappa-B after TAC was attenuated in the PTX3-KO mice but was enhanced in the PTX3-TG mice compared with WT mice. Interleukin-6 and connective tissue growth factor production was lower in the PTX3-KO mice than in the WT mice, but this was augmented in the PTX3-TG mice than in the WT mice. Echocardiography revealed that adverse remodeling with left ventricular dysfunction, as well as with increased interstitial fibrosis, was enhanced in PTX3-TG mice, while these responses were suppressed in PTX3-KO mice. CONCLUSION: The local inflammatory mediator PTX3 directly modulates the hypertrophic response and ventricular dysfunction following an increased afterload.

  8. Novel parameter for assessment of left atrial size in patients with hypertension: ratio of left atrial volume to left ventricular volume

    Institute of Scientific and Technical Information of China (English)

    LI Yue; CHAI Liang; ZHANG Yun; LI Lei

    2009-01-01

    Background Left atrial enlargement has been suggested as a more robust marker of diastolic dysfunction. We hypothesize that the ratio of left atrial volume to left ventricular volume (LAV/LVV) may be more reasonable to reflect left atrial enlargement in the patients with hypertension, because hypertensive patients have a characteristic of concentric remodeling of the left ventricle which is often accompanied with diastolic dysfunction. The aim of this study was to determine if the LAV/LVV can be used as a new parameter to assess left atrial size in hypertensive patients and the relationship between the LAV/LVV and diastolic dysfunction.Methods Ninety-one patients with hypertension and forty-three normal controls were studied. The hypertensive patients were assigned to the normal wall (NW) and hypertrophic wall (HW) groups. The left atrial diameter (LAD), LAV, left atrial volume index (LAVi), LVV and LAV/LVV were measured and calculated by 2-dimensional echocardiography and real time 3-dimensional echocardiography. All of the above parameters were used to evaluate the size of the left atrium. The ratio of peak E velocity of mitral valve inflow to peak E' velocity of lateral mitral annulus (E/E') was measured by pulse Doppler and tissue Doppler. This parameter was used to evaluate diastolic function. Results The LAD, LAV, LAVi, LAV/LVV and E/E' in hypertensive groups were significantly higher than those in the normal group (P <0.05 or 0.01), and those in the HW group were significantly higher than those in the NW group (P <0.05 or 0.01). The E/E' had a positive correlation with LAV, LAVi and LAV/LVV. The correlation coefficient between E/E' and LAV/LVV was relatively higher than that between E/E' and LAD or LAVi.Conclusion LAV/LVV may be used as a new index to evaluate left atrial size in hypertensive patients with diastolic dysfunction.

  9. Aortic calcification and femoral bone density are independently associated with left ventricular mass in patients with chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Colin D Chue

    Full Text Available BACKGROUND: Vascular calcification and reduced bone density are prevalent in chronic kidney disease and linked to increased cardiovascular risk. The mechanism is unknown. We assessed the relationship between vascular calcification, femoral bone density and left ventricular mass in patients with stage 3 non-diabetic chronic kidney disease in a cross-sectional observational study. METHODOLOGY AND PRINCIPAL FINDINGS: A total of 120 patients were recruited (54% male, mean age 55 ± 14 years, mean glomerular filtration rate 50 ± 13 ml/min/1.73 m(2. Abdominal aortic calcification was assessed using lateral lumbar spine radiography and was present in 48%. Mean femoral Z-score measured using dual energy x-ray absorptiometry was 0.60 ± 1.06. Cardiovascular magnetic resonance imaging was used to determine left ventricular mass. One patient had left ventricular hypertrophy. Subjects with aortic calcification had higher left ventricular mass compared to those without (56 ± 16 vs. 48 ± 12 g/m(2, P = 0.002, as did patients with femoral Z-scores below zero (56 ± 15 vs. 49 ± 13 g/m(2, P = 0.01. In univariate analysis presence of aortic calcification correlated with left ventricular mass (r = 0.32, P = 0.001; mean femoral Z-score inversely correlated with left ventricular mass (r = -0.28, P = 0.004. In a multivariate regression model that included presence of aortic calcification, mean femoral Z-score, gender and 24-hour systolic blood pressure, 46% of the variability in left ventricular mass was explained (P<0.001. CONCLUSIONS: In patients with stage 3 non-diabetic chronic kidney disease, lower mean femoral Z-score and presence of aortic calcification are independently associated with increased left ventricular mass. Further research exploring the pathophysiology that underlies these relationships is warranted.

  10. Association between left ventricular global longitudinal strain and natriuretic peptides in outpatients with chronic systolic heart failure

    DEFF Research Database (Denmark)

    Gaborit, F; Bosselmann, H; Tønder, N;

    2015-01-01

    BACKGROUND: Both impaired left ventricular (LV) global longitudinal strain (GLS) and increased plasma concentrations of natriuretic peptides(NP) are associated with a poor outcome in heart failure (HF). Increased levels of NP reflect increased wall stress of the LV. However, little is known about....... CONCLUSION: Impaired LV GLS is associated with increased plasma concentrations of NP and our data suggest that left ventricular myocardial mechanics estimated by LV GLS reflects myocardial wall stress in chronic systolic HF....

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

    OpenAIRE

    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...

  12. Serum levels of advanced glycation end products are associated with left ventricular diastolic function in patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Berg, T J; Snorgaard, O; Faber, J;

    1999-01-01

    Impairment of left ventricular diastolic function, possibly caused by increased collagen cross-linking of the cardiac muscle, is common in patients with type 1 diabetes even without coronary artery disease. Advanced glycation end products (AGEs) cross-link tissue collagen and are found within...... myocardial fibers. The aim of this study was to examine for a possible association between circulating AGEs and left ventricular cardiac function....

  13. Assessment of left ventricular performance during percutaneous transluminal coronary angioplasty: a study by intravenous digital subtraction ventriculography.

    OpenAIRE

    Norell, M. S.; Lyons, J. P.; Gershlick, A H; Gardener, J E; Rothman, M. T.; Layton, C A; Balcon, R

    1988-01-01

    Left ventricular performance during percutaneous transluminal coronary angioplasty was assessed in 52 patients by intravenous digital subtraction ventriculography. After injection of contrast into the right atrium ventriculograms were obtained before and during balloon inflation. In 37 patients they were also obtained after the procedure. A 12 lead electrocardiogram was monitored throughout. During balloon inflation the left ventricular ejection fraction fell (from 73% to 57%) in all but one ...

  14. Beta-blockers, left and right ventricular function, and in-vivo calcium influx in muscular dystrophy cardiomyopathy.

    Directory of Open Access Journals (Sweden)

    Alison Blain

    Full Text Available Beta-blockers are used to treat acquired heart failure in adults, though their role in early muscular dystrophy cardiomyopathy is unclear. We treated 2 different dystrophic mouse models which have an associated cardiomyopathy (mdx: model for Duchenne Muscular Dystrophy, and Sgcd-/-: model for limb girdle muscular dystrophy type 2F and wild type controls (C57 Bl10 with the beta blocker metoprolol or placebo for 8 weeks at an early stage in the development of the cardiomyopathy. Left and right ventricular function was assessed with cardiac magnetic resonance imaging (MRI and in-vivo myocardial calcium influx with manganese enhanced MRI. In the mdx mice at baseline there was reduced stroke volume, cardiac index, and end-diastolic volume with preserved left ventricular ejection fraction. These abnormalities were no longer evident after treatment with beta-blockers. Right ventricular ejection fraction was reduced and right ventricular end-systolic volume increased in the mdx mice. With metoprolol there was an increase in right ventricular end-diastolic and end-systolic volumes. Left and right ventricular function was normal in the Sgcd-/- mice. Metroprolol had no significant effects on left and right ventricular function in these mice, though heart/body weight ratios increased after treatment. In-vivo myocardial calcium influx with MEMRI was significantly elevated in both models, though metoprolol had no significant effects on either. In conclusion, metoprolol treatment at an early stage in the development of cardiomyopathy has deleterious effects on right ventricular function in mdx mice and in both models no effect on increased in-vivo calcium influx. This suggests that clinical trials need to carefully monitor not just left ventricular function but also right ventricular function and other aspects of myocardial metabolism.

  15. Assessment of left ventricular function in patients with atrial fibrillation by left ventricular filling and function curves determined by ECG gated blood pool scintigraphy

    International Nuclear Information System (INIS)

    Accurate cardiac function in patients with atrial fibrillation (Af) is difficult to assess, since a wide fluctuation of cardiac cycle makes the ventricular hemodynamics variable. Although ECG gated blood pool scintigraphy (EGBPS) is useful to evaluate left ventricular (LV) function, a conventional EGBPS might have a problem in applying to Af. Therefore, a new processing algorithm was devised to make multiple gated images discriminated by preceding R-R intervals (PRR), and LV filling and function curves were obtained in 62 patients with Af to evaluate LV function. LV filling curve, obtained by plotting end-diastolic volume (EDV) againt PRR, demonstrated that the blood filling was impaired in mitral stenosis and constrictive pericarditis, but recovered after mitral commissurotomy. LV function curve, by plotting stroke volume (SV) againt EDV, was quantitatively analysed by the indices such as Slope and Position. Both indices reduced significantly in heart failure. When compared among underlying diseases individually, the indices decreased in the following order; lone Af, hyperthyroidism, senile Af, hypertension, mitral valve disease, ischemic heart disease, dilated cardiomyopathy and aortic regurgitation. After the treatment with digitalis and/or diuretics, left and upward shift of function curve was observed. The rise in heart rate by atropine infusion made Slope and Position unchanged, and which implied that function curve was little influenced by heart rate per se. The rise in systolic blood pressure by angiotensin-II infusion caused shifts in function curve to rightward and downward. Downward shift, mostly seen in patients with gentler slope in control state, may imply afterload mismatch due to a decrease in preload reserve. (J.P.N.)

  16. Relationship of left atrial enlargement to persistence or development of ECG left ventricular hypertrophy in hypertensive patients: implications for the development of new atrial fibrillation

    DEFF Research Database (Denmark)

    Okin, Peter M; Gerdts, Eva; Wachtell, Kristian;

    2010-01-01

    Persistence and development of ECG left ventricular hypertrophy (LVH) by Cornell product criteria are associated with an increased risk of atrial fibrillation compared with regression or continued absence of LVH. We postulated that this association might be in part mediated via greater left atrial...... enlargement (LAE) in patients with new and persistent ECG LVH....

  17. In vivo quantification of intraventricular flow during left ventricular assist device support

    Science.gov (United States)

    Vu, Vi; Wong, Kin; Del Alamo, Juan; Aguilo, Pablo M. L.; May-Newman, Karen; Department of Bioengineering, San Diego State University Collaboration; Department of Mechanical; Aerospace Engineering, University of California San Diego Collaboration; Mechanical Assist Device Program, Sharp Memorial Hospital Collaboration

    2014-11-01

    Left ventricular assist devices (LVADs) are mechanical pumps that are surgically connected to the left ventricle (LV) and aorta to increase aortic flow and end-organ perfusion. Clinical studies have demonstrated that LVADs improve patient health and quality of life and significantly reduce the mortality of cardiac failure. However, In the presence of left ventricular assisted devices (LVAD), abnormal flow patterns and stagnation regions are often linked to thrombosis. The aim of our study is to evaluate the flow patterns in the left ventricle of the LVAD-assisted heart, with a focus on alterations in vortex development and blood stasis. To this aim, we applied color Doppler echocardiography to measure 2D, time resolved velocity fields in patients before and after implantation of LVADs. In agreement with our previous in vitro studies (Wong et al., Journal of Biomechanics 47, 2014), LVAD implantation resulted in decreased flow velocities and increased blood residence time near the outflow tract. The variation of residence time changes with LVAD operational speed was characterized for each patient.

  18. Computational Modeling of the Effects of Myocardial Infarction on Left Ventricular Hemodynamics

    Science.gov (United States)

    Vedula, Vijay; Seo, Jung Hee; Mittal, Rajat; Fortini, Stefania; Querzoli, Giorgio

    2012-11-01

    Most in-vivo and modeling studies on myocardial infarction and ischemia have been directed towards understanding the left ventricular wall mechanics including stress-strain behavior, end systolic pressure-volume correlations, ejection fraction and stroke work. Fewer studies have focused on the alterations in the intraventricular blood flow behavior due to local infarctions. Changes in the motion of the endocardium can cause local circulation and stagnation regions; these increase the blood cell residence time in the left ventricle and may eventually be implicated in thrombus formation. In the present study, we investigate the effects of myocardial infarction on the ventricular hemodynamics in simple models of the left ventricle using an immersed-boundary flow solver. Apart from the Eulerian flow features such as vorticity and velocity flow fields, pressure distribution, shear stress, viscous dissipation and pump work, we also examine the Lagrangian dynamics of the flow to gain insights into the effect of flow dynamics on thrombus formation. The study is preceded by a comprehensive validation study which is based on an in-vitro experimental model of the left ventricle and this study is also described. This research is supported by the U.S. National Science Foundation through (NSF) CDI-Type II grant IOS-1124804. Computational resources for some of the simulations were also provided in part through the NSF grant NSF-OCI-108849.

  19. The Relationship between Left Atrial Volume and Ventricular Arrhythmias in the Patients with Dilated Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Abdullah Kaplan

    2014-03-01

    Full Text Available Background:: The present study aimed to investigate the relationship between Left Atrial Volume (LAV, a marker of diastolic dysfunction, and the frequency of malignant ventricular arrhythmia in the patients with left ventricular dysfunction and a previously implanted Implantable Cardioverter Defibrillator (ICD device. Methods:: This cross-sectional study was conducted on 32 patients with ischemic or idiopathic dilated cardiomyopathy, each having had an ICD device implanted at least 1 year beforehand. The ventricular arrhythmia episodes which were detected and stored by the device were retrieved and evaluated. In addition to routine echocardiographic measurements, all the patients had their LAV and LAV indexes calculated. After all, student’s t-test, Mann-Whitney U test, and Pearson correlation were used to analyze the data. Besides, P value < 0.05 was considered as statistically significant. Results:: This study was conducted on 4 female and 28 male patients with the mean age of 58.41 ± 9.97 years. Among the study patients, 21 had at least one previous myocardial infarction. In addition, 17 patients had experienced sustained VT or VF within the last year. No significant difference was found between the patients with and without malignant ventricular arrhythmias (sustained VT or VF regarding LAV (17 patients with arrhythmia (68 + 23.39 mL vs. 15 patients without arrhythmia (55.13 ± 20.41 mL; P = 0.100. However, the LAV index was significantly higher in the patients with arrhythmia compared to those without arrhythmia (39.27 ± 12.19 mL / m2 vs. 25.18 ± 7.45 mL / m2; P = 0.004. Both LAV (73.33 ± 17.64 mL and 57.52 ± 23.15 mL, respectively; P = 0.040 and LAV index (40.86 ± 8.47 mL / m2 and 28.20 ± 11.77 mL / m2, respectively; P = 0.010 were significantly greater in the patients with ICD shock therapy within the last year compared to the others. However, both groups were similar regarding Left Ventricular Volume (LVV, LVV index, and

  20. 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

    Institute of Scientific and Technical Information of China (English)

    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

  1. The echo-transponder electrode catheter: a new method for mapping the left ventricle.

    Science.gov (United States)

    Langberg, J J; Franklin, J O; Landzberg, J S; Herre, J M; Kee, L; Chin, M C; Bharati, S; Lev, M; Himelman, R B; Schiller, N B

    1988-07-01

    The ability to locate catheter position in the left ventricle with respect to endocardial landmarks might enhance the accuracy of ventricular tachycardia mapping. An echo-transponder system (Telectronics, Inc.) was compared with biplane fluoroscopy for left ventricular endocardial mapping. A 6F electrode catheter was modified with the addition of a piezoelectric crystal 5 mm from the tip. This crystal was connected to a transponder that received and transmitted ultrasound, resulting in a discrete artifact on the two-dimensional echocardiographic image corresponding to the position of the catheter tip. Catheters were introduced percutaneously into the left ventricle of nine anesthetized dogs. Two-dimensional echo-transponder and biplane fluoroscopic images were recorded on videotape with the catheter at multiple endocardial sites. Catheter location was marked by delivering radiofrequency current to the distal electrode, creating a small endocardial lesion. Catheter location by echo-transponder and by fluoroscopy were compared with lesion location without knowledge of other data. Location by echo-transponder was 8.7 +/- 5.1 mm from the center of the radiofrequency lesion versus 14 + 7.8 mm by fluoroscopy (n = 15, p = 0.023). Echo-transponder localization is more precise than is biplane fluoroscopy and may enhance the accuracy of left ventricular electrophysiologic mapping.

  2. Frequent Premature Ventricular Complexes Originating from the Left Ventricular Summit Successfully Ablated from the Proximal Great Cardiac Vein Using an Impedance-based Electroanatomical Mapping System.

    Science.gov (United States)

    Nagata, Yoshihisa; Ogawa, Masahiro; Goto, Shunichiro; Morii, Joji; Imaizumi, Satoshi; Yasuda, Tomoo; Matsumoto, Naomichi; Saku, Keijiro

    2016-01-01

    We herein report a 58-year-old woman with frequent premature ventricular complexes (PVCs) originating from the left ventricular summit. The earliest ventricular activation of spontaneous PVCs was recorded in the proximal site of the great cardiac vein, which was simultaneously mapped and conducted using an impedance-based electroanatomical mapping system. Irrigated radiofrequency with a starting power output of 20 W and maximal temperature set at 40°C was applied with 10 Ω impedance fall, resulting in total disappearance of the frequent PVCs. The patient has remained free from PVCs for 18 months without requiring antiarrhythmic drug therapy. PMID:27374677

  3. Effect of hypertonic saline solution on the left ventricular functions of isolated hearts from burned rats

    Institute of Scientific and Technical Information of China (English)

    周继红; 刘大维; 王正国; 朱佩芳

    2002-01-01

    To study the effect of hypertonic saline solution on the left ventricular functions of isolated hearts from burned rats. Methods: Thirty-six Wistar rats were used and divided into 4 groups: (1) normal hearts perfused with isotonic Krebs-Henseleit solution; (2) normal hearts perfused with Krebs-Henseleit solution which contained 215 mmol/L Na+; (3) hearts of rats suffered from 25% TBSA third degree burn and perfused with isotonic Krebs-Henseleit solution; (4) hearts of the burned rats perfused with Krebs-Henseleit solution which contained 215 mmol/L Na+. The systolic and diastolic functions of the left ventricle were observed. Results: During perfusion, there were very short periods of decrease in heart systolic and diastolic functions at first, but they recovered very soon and even became stronger than normal both in the normal and burned rats. The systolic and diastolic functions of the hearts increased very significantly when the perfusion solution was changed to isotonic solution from the hypertonic solutions. The effect of the hypertonic saline solution on the ventricular systolic and diastolic improvements was stronger in the hearts of the burned rats than that in the normal hearts. Conclusions: Hypertonic saline solution can directly affect myocardium and significantly improve the ventricular systolic and diastolic functions, especially in the hearts of the burned rats.

  4. Electrophysiologic testing guided risk stratification approach for sudden cardiac death beyond the left ventricular ejection fraction.

    Science.gov (United States)

    Gatzoulis, Konstantinos A; Tsiachris, Dimitris; Arsenos, Petros; Tousoulis, Dimitris

    2016-01-26

    Sudden cardiac death threats ischaemic and dilated cardiomyopathy patients. Anti- arrhythmic protection may be provided to these patients with implanted cardiac defibrillators (ICD), after an efficient risk stratification approach. The proposed risk stratifier of an impaired left ventricular ejection fraction has limited sensitivity meaning that a significant number of victims will remain undetectable by this risk stratification approach because they have a preserved left ventricular systolic function. Current risk stratification strategies focus on combinations of non invasive methods like T wave alternans, late potentials, heart rate turbulence, deceleration capacity and others, with invasive methods like the electrophysiologic study. In the presence of an electrically impaired substrate with formed post myocardial infarction fibrotic zones, programmed ventricular stimulation provides important prognostic information for the selection of the patients expected to benefit from an ICD implantation, while due to its high negative predictive value, patients at low risk level may also be detected. Clustering evidence from different research groups and electrophysiologic labs support an electrophysiologic testing guided risk stratification approach for sudden cardiac death.

  5. Endothelial and non-endothelial coronary blood flow reserve and left ventricular dysfunction in systemic hypertension

    Directory of Open Access Journals (Sweden)

    Aloísio Marchi Rocha

    2009-04-01

    Full Text Available OBJECTIVES: We evaluated the impairment of endothelium-dependent and endothelium-independent coronary blood flow reserve after administration of intracoronary acetylcholine and adenosine, and its association with hypertensive cardiac disease. INTRODUCTION: Coronary blood flow reserve reduction has been proposed as a mechanism for the progression of compensated left ventricular hypertrophy to ventricular dysfunction. METHODS: Eighteen hypertensive patients with normal epicardial coronary arteries on angiography were divided into two groups according to left ventricular fractional shortening (FS. Group 1 (FS >0.25: n=8, FS=0.29 ± 0.03; Group 2 (FS <0.25: n=10, FS= 0.17 ± 0.03. RESULTS: Baseline coronary blood flow was similar in both groups (Group 1: 80.15 ± 26.41 mL/min, Group 2: 100.09 ± 21.51 mL/min, p=NS. In response to adenosine, coronary blood flow increased to 265.1 ± 100.2 mL/min in Group 1 and to 300.8 ± 113.6 mL/min (p <0.05 in Group 2. Endothelium-independent coronary blood flow reserve was similar in both groups (Group 1: 3.31 ± 0.68 and Group 2: 2.97 ± 0.80, p=NS. In response to acetylcholine, coronary blood flow increased to 156.08 ± 36.79 mL/min in Group 1 and to 177.8 ± 83.6 mL/min in Group 2 (p <0.05. Endothelium-dependent coronary blood flow reserve was similar in the two groups (Group 1: 2.08 ± 0.74 and group Group 2: 1.76 ± 0.61, p=NS. Peak acetylcholine/peak adenosine coronary blood flow response (Group 1: 0.65 ± 0.27 and Group 2: 0.60 ± 0.17 and minimal coronary vascular resistance (Group 1: 0.48 ± 0.21 mmHg/mL/min and Group 2: 0.34 ± 0.12 mmHg/mL/min were similar in both groups (p= NS. Casual diastolic blood pressure and end-systolic left ventricular stress were independently associated with FS. CONCLUSIONS: In our hypertensive patients, endothelium-dependent and endothelium-independent coronary blood flow reserve vasodilator administrations had similar effects in patients with either normal or decreased left

  6. Effect of hepatocyte growth factor on left ventricular remodeling after acute myocardial infarction in canine

    Institute of Scientific and Technical Information of China (English)

    Ping LI; Tingshu YANG; Liling LIANG

    2006-01-01

    Background and objectives To investigate the effect of hepatocyte growth factor (HGF) on left ventricular (LV) remodeling after acute myocardial infarction (AMI). Methods AMI was produced by ligation of proximal left anterior descending coronary artery(LAD) in 12 mongrel canines. These animals were randomized into 2 groups. In HGF group (n=6), canines were injected with pcDNA3-HGF lml (about 300ug) at the margin of infarcted myocardium; in control group (n=6) canines were injected with equal volume of normal saline. Cardiac function and left ventricular remodeling were evaluated with echocardiography at 1, 4, 8 weeks after MI. LV myocardium specimens were obtained at 8 weeks and stained with hematoxylin and eosin for histological examination or with sirius red to assess the collagen content. Results Compared with control group, LVEF in HGF group was significantly higher at 4 weeks (49.61+6.66 vs 39.84+6.39; P<0.05) and at 8 weeks (51.57+8.53 vs 40.61+7.67; P<0.05) after AMI, while LVESV was significantly lower in HGF group than that in control group at 8 weeks after AMI (18.98+3.47 vs 25.66+5.86; P<0.05). Posterior left ventricular wall thickness decreased significantly from 1 wk to 8 wks after AMI in control group, while remained unchanged in HGF group. Compared with control group, histological examination showed more neovascularization and less scar, and sirius red staining indicated higher volume of type Ⅲ collagen (7.10±4.06% vs 3.77±1.09%; P<0.05) and lower collagen Ⅰ/Ⅲ ratio value (1.11±0.52 vs 2.94±2.48; P<0.05)in HGF group. Conclusion HGF gene transfer might improve cardiac function and LV remodeling after acute myocardial infarction by stimulating angiogenesis, reducing fibrosis, and reducing myocardial scarring.

  7. Partial nephrectomy in a patient with a left ventricular assist device.

    Science.gov (United States)

    Manger, Jules P; Kern, John A; Krupski, Tracey L

    2011-01-01

    Left ventricular assist device (LVAD) use has increased as a bridge to heart transplant as well as destination therapy in patients with severe heart failure. Presence of LVAD is not a contraindication to noncardiac surgery but does present special challenges to the surgical, anesthesia, and cardiac teams. We present the case of a 40-year-old woman with idiopathic cardiomyopathy necessitating LVAD who underwent left partial nephrectomy for a renal mass. She had undergone three nondiagnostic percutaneous image-guided biopsies. Left partial nephrectomy was performed. Perioperative care was without incident due to careful oversight by a multidisciplinary team. Pathology revealed high-grade clear cell renal cell carcinoma (RCC) with negative margins. Polytetrafluoroethylene (PTFE) bolsters were misidentified six months postoperatively on computed tomography (CT) at an outside institution as a retained laparotomy sponge. This is, to our knowledge, the first report of a partial nephrectomy performed in a patient with LVAD. PMID:22606616

  8. Utility of echocardiographic tissue synchronization imaging to redirect left ventricular epicardial lead placement for cardiac resynchronization therapy

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ye; LI Zhi-an; HE Yi-hua; ZHANG Hai-bo; MENG Xu

    2013-01-01

    Background Cardiac resynchronization therapy (CRT) with biventricular pacing has demonstrated cardiac function improvement for treating congestive heart failure (HF).It has been documented that the placement of the left ventricular lead at the longest contraction delay segment has the optimal CRT benefit.This study described follow-up to surgical techniques for CRT as a viable alternative for patients with heart failure.Methods Between April 2007 and June 2012,a total of 14 consecutive heart failure patients with New York Heart Association (NYHA) Class Ⅲ-Ⅳ underwent left ventricular epicardial lead placements via surgical approach.There were eight males and six females,aged 36 to 79 years ((59.6±9.2) years).The mean left ventricular ejection fraction (LVEF)was (33.6±7.4)%.All patients were treated with left ventricular systolic dyssynchrony and underwent left ventricular epicardial lead placements via a surgical approach.Tissue Doppler imaging (TDI) and intraoperative transesophageal echocardiography were used to assess changes in left heart function and dyssynchronic parameters.Also,echo was used to select the best site for left ventricular epicardial lead placement.Results Left ventricular epicardial leads were successfully implanted in the posterior or lateral epicardial wall without serious complications in all patients.All patients had reduction in NYHA score from Ⅲ-Ⅳ preoperatively to Ⅱ-Ⅲ postoperatively.The left ventricular end-diastolic diameter (LVEDD) decreased from (67.9±12.7) mm to (61.2±7.1) mm (P<0.05),and LVEF increased from (33.6±7.4)% to (42.2±8.8)% (P<0.05).Left ventricular intraventricular dyssynchrony index decreased from (148.4±31.6) ms to (57.3±23.8) ms (P<0.05).Conclusions Minimally invasive surgical placement of the left ventricular epicardial lead is feasible,safe,and efficient.TDI can guide the epicardial lead placement to the ideal target location.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  10. Left Ventricular Wall Stress-Mass-Heart Rate Product and Cardiovascular Events in Treated Hypertensive Patients

    DEFF Research Database (Denmark)

    Devereux, Richard B; Bang, Casper N; Roman, Mary J;

    2015-01-01

    In the Losartan Intervention for End Point Reduction in Hypertension (LIFE) study, 4.8 years' losartan- versus atenolol-based antihypertensive treatment reduced left ventricular hypertrophy and cardiovascular end points, including cardiovascular death and stroke. However, there was no difference...... randomized treatment, the triple product was reduced more by atenolol, with prevalences of elevated triple product of 39% versus 51% on losartan (both P≤0.001). In Cox regression analyses adjusting for age, smoking, diabetes mellitus, and prior stroke, MI, and heart failure, 1 SD lower triple product...... was associated with 23% (95% confidence interval 13%-32%) fewer composite end points, 31% (18%-41%) less cardiovascular mortality, 30% (15%-41%) lower MI, and 22% (11%-33%) lower all-cause mortality (all P≤0.001), without association with stroke (P=0.34). Although losartan-based therapy reduced ventricular mass...

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

    DEFF Research Database (Denmark)

    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......-CSF or placebo injections from day 1 to 7 after the STEMI. Plasma YKL-40, high-sensitivity C-reactive protein (hs-CRP) and CK-MB concentrations were measured at baseline and during the first month. Infarct size and left ventricular ejection fraction (LVEF) were measured by magnetic resonance imaging at baseline...... to LVEF recovery (p = 0.04) but not infarct size. G-CSF injections increased YKL-40 compared to placebo (p infarct size or LVEF recovery. Conclusion: Plasma YKL-40 was significantly increased in STEMI patients at admission and G-CSF treatment caused a further increase...

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

    DEFF Research Database (Denmark)

    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......-CSF or placebo injections from day 1 to 7 after the STEMI. Plasma YKL-40, high-sensitivity C-reactive protein (hs-CRP) and CK-MB concentrations were measured at baseline and during the first month. Infarct size and left ventricular ejection fraction (LVEF) were measured by magnetic resonance imaging at baseline...

  13. Pregnancy and treatment outcome in a patient with left ventricular non-compaction.

    Science.gov (United States)

    Sawant, Rahul D; Freeman, Leisa J; Stanley, Katherine P S; McKelvey, Alistair

    2013-05-01

    Left ventricular non-compaction (LVNC) is a rare form of cardiomyopathy. This case reviews a woman with familial LVNC (EF 45%, NYHA class I, evidence of non-sustained ventricular tachycardia pre-pregnancy) who had significant decompensation with heart failure in the third trimester that required early delivery. Deterioration in symptoms and LV function 7 days after delivery required further hospitalization and aggressive treatment. Suppression of lactation with bromocriptine, together with standard heart failure management, has allowed recovery and return to full activities and work. Acknowledged adverse risk factors in LVNC are considered, and pre-pregnancy risk assessment is reviewed. There is no specific treatment for LVNC in pregnancy besides the usual management of dilated cardiomyopathy. This is the ninth case report of LVNC in pregnancy reported in the literature.

  14. Mildly symptomatic chronic mitral regurgitation. Analysis of left ventricular systolic function and mitral regurgitant fraction under pharmacological influence: echocardiographic study

    Directory of Open Access Journals (Sweden)

    Rivera Ivan Romero

    2003-01-01

    Full Text Available OBJECTIVE: To study echocardiographic parameters of left ventricular systolic function and valvar regurgitation under pharmacological influence in mildly symptomatic patients with chronic mitral regurgitation (MR. METHODS: We carried out a double-blind placebo controlled study in 12 patients with MR, mean aged 12.5 years old, who were randomized in 4 phases: A digoxin; B enalapril; C digoxin + enalapril; D placebo. The medication was administered for 30 days in each phase, and the following variables were analyzed: shortening and ejection fractions, wall stress index of left ventricle, left ventricular meridional end-systolic wall stress, Doppler-derived mean rate of left ventricular pressure rise (mean dP/dt, stroke volume and MR jet area. The clinical variables analysed were heart rate and systemic arterial pressure. RESULTS: No significant variation was observed in the clinical variables analysed. The shortening and ejection fraction, the mean dP/dt and stroke volume significantly increased and the wall stress index of left ventricle, the meridional left ventricular end systolic wall stress and the mitral regurgitation jet area decreased in the phases with medication as compared with that in the placebo phase. CONCLUSION: The parameters of left ventricular systolic function improved significantly and the degree of MR decreased with the isolated administration of digoxin or enalapril in mildly symptomatic patients with chronic MR. The combination of the drugs, however, did not show better results.

  15. Pediatric cardiac MRI: automated left-ventricular volumes and function analysis and effects of manual adjustments

    Energy Technology Data Exchange (ETDEWEB)

    Hammon, Matthias; Janka, Rolf; Dankerl, Peter; Kammerer, Ferdinand J.; Uder, Michael; Rompel, Oliver [University Hospital Erlangen, Department of Radiology, Erlangen (Germany); Gloeckler, Martin; Dittrich, Sven [University Hospital Erlangen, Department of Pediatric Cardiology, Erlangen (Germany)

    2015-05-01

    Cardiac MRI is an accurate and reproducible technique for the assessment of left ventricular volumes and function. The accuracy of automated segmentation and the effects of manual adjustments have not been determined in children. To evaluate automated segmentation and the effects of manual adjustments for left ventricular parameter quantification in pediatric cardiac MR images. Left ventricular parameters were evaluated in 45 children with suspected myocarditis (age 13.4 ± 3.5 years, range 4-17 years) who underwent cardiac MRI. Dedicated software was used to automatically segment and adjust the parameters. Results of end-diastolic volume, end-systolic volume, stroke volume, myocardial mass, and ejection fraction were documented before and after apex/base adjustment and after apex/base/myocardial contour adjustment. The software successfully detected the left ventricle in 42 of 45 (93.3%) children; failures occurred in the smallest and youngest children. Of those 42 children, automatically segmented end-diastolic volume (EDV) was 151 ± 47 ml, and after apex/base adjustment it was 146 ± 45 ml, after apex/base/myocardial contour adjustment 146 ± 45 ml. The corresponding results for end-systolic volume (ESV) were 66 ± 32 ml, 63 ± 29 ml and 64 ± 28 ml; for stroke volume (SV) they were 85 ± 25 ml, 83 ± 23 ml and 83 ± 23 ml; for ejection fracture (EF) they were 57 ± 10%, 58 ± 9% and 58 ± 9%, and for myocardial mass (MM) they were 104 ± 31 g, 95 ± 31 g and 94 ± 30 g. Statistically significant differences were found when comparing the EDV/ESV/MM results, the EF results after apex/base adjustment and after apex/base/myocardial contour adjustment and the SV results (except for comparing the SVs after apex/base adjustment and after apex/base/myocardial contour adjustment). Automated segmentation for the evaluation of left ventricular parameters in pediatric MR images proved to be feasible. Automated segmentation + apex/base adjustment provided clinically

  16. Rhythm changes and the function of the left ventricle: analysis of effects on the left ventricular ejection fraction

    Directory of Open Access Journals (Sweden)

    Ferati Fatmir

    2013-03-01

    Full Text Available The purpose of the case report is the analysis of the effects of rhythm changes on ejection fraction (EF of the left ventricle (LV, which can be determined by transthoracal echocardiography. For this purpose, we have analyzed five patients with different rhythm changes. From three of them the conversion was spontaneous, one patient was converted with DC shock of ICD, and the other patient was converted medicamentosly.While analyzing the hemodynamic changes of the heart rhythm, one can see the need and the urgency for converting some of these changes — based on the effects that rhythm changes have in the hemodynamic function of the heart. According to the data, some of hemodynamic changes of the LV are almost minimal, like in the paroxysmal supraventicular tachycardia (PSVT, while the changes are enhanced in the atrial fibrillation (AF with an uncontrolled ventricular rhythm, and especially in the ventricular tachycardia (VT. This indicates the need for a fast conversion of the rhythm in VT and with a DC shock when required. Also in the cases of AF, in cases of inability of conversion of the rhythm in a sinus rhythm, control of the heart rate gives an important hemodynamic effect that can be seen from echocardiographic parameters

  17. Right and left ventricular ejection fraction at rest and during exercise assessed with radionuclide angiocardiography

    International Nuclear Information System (INIS)

    Right (RVEF) and left ventricular ejection fraction (LVEF) assessed with radionuclide angiocardiography were compared to simultaneously obtained catheterization results at rest and during exercise in patients with pulmonary hypertension and ischemic heart disease. Blood pool imaging was performed with red blood cells (RBC) labelled with 99Tcsup(m) in vivo as this method gave more stable 99Tcsup(m) levels in blood compared to 99Tcsup(m)-labelled human serum albumin and because it was more convenient than labelling RBC in vitro. RVEF measured with first pass (FP) technique and equilibrium (EQ) technique correlated well at rest, r = 0.86, and during exercise, r = 0.91. The FP technique had the best reproducibility and reference values at rest were 49+-5 per cent increasing with exercise. When 99Tcsup(m) and 133Xe were compared to assess RVEF with FP technique, the correlation was good, r = 0.88. LVEF assessed with EQ technique and a fixed end-diastolic region of interest was very reproducible at rest and during exercise; reference values at rest were 56+-8 per cent increasing with exercise. In 10 patients with pulmonary hypertension significant negative correlations were found between RVEF assessed with FP technique and pressures in pulmonary artery and right atrium. Abnormal RVEF was found in all patients with right ventricular disfunction. In 22 patients with recent myocardial infarction measurements of LVEF detected left ventricular disfunction better than did measurement of pulmonary artery diastolic pressure. During effort angina in another 10 patients all had abnormal LVEF and abnormal hemodynamics. By combining ejection fraction and stroke volume, ventricular volumes were calculated at rest and during exercise. (author)

  18. [Changes in the left ventricular function in hemodialyzed patients. Role of Doppler echocardiography].

    Science.gov (United States)

    Cavarra, M; Lo Giudice, P; Statella, P; Liuzzo, G; Circo, A

    1993-09-01

    The aim of this study was to provide a further contribution to the study on the alterations of left ventricular diastolic function induced by dialysis, using simple indexes of diastolic function obtained with Doppler. The study is conduced in 15 patients with renal failure aged between 22 and 51 years old by means of echocardiography M-2D a pulsed Doppler analysis of the left ventricular refilling flow, evaluated before and after dialysis. By the results is risen up that the dLA has had a significant reduction (p = 0.032), the dSLV have undergone a reduction that is not being significant, while the dDLV has had a significant reduction (p = 0.029), shortening fraction is improved even if in a not significant manner. Also the Doppler indexes has had a behaviour homogeneous in the group of studied patients. Early ventricular refilling is reduced, as showed by the reduction of E, consequence of the reduction preload, while the diastolic late refilling has showed a little increment, expressed by the increase af the peak A. The variations of these indexes, even if not statistically significant, express an alteration of pattern diastolic Doppler caused by both the reduction of preload and the alteration of ventricular relaxation. Besides this alteration, to our notice, is not to consider expression of myocardial compromise in this group studied patients. It would be however useful enlargement of the study to greater number of patients with follow-up for better comprehension of this cardiopathy and makes a more individual treatment of these patients. PMID:8259230

  19. Management of three cardiogenic pulmonary edemas occurring in a patient scheduled for left ventricular assist device implantation: indicators for determining left ventricular assist device pump speed.

    Science.gov (United States)

    Toyama, Hiroaki; Takei, Yusuke; Saito, Kazutomo; Ota, Takahisa; Kurotaki, Kenji; Ejima, Yutaka; Matsuura, Takeshi; Akiyama, Masatoshi; Saiki, Yoshikatsu; Yamauchi, Masanori

    2016-08-01

    A male patient with Marfan syndrome underwent aortic root replacement and developed left ventricular (LV) failure. Four years later, he underwent aortic arch and aortic valve replacement. Thereafter, his LV failure progressed, and cardiogenic pulmonary edema (CPE) appeared, which we treated with extracorporeal LV assist device (LVAD) placement. Three months later, the patient developed aspiration pneumonia, which caused hyperdynamic right ventricle (RV) and CPE. We treated by changing his pneumatic LVAD to a high-flow centrifugal pump. A month later, he underwent thoracoabdominal aortic replacement. After four weeks, he developed septic thrombosis and LVAD failure, which caused CPE. We treated with LVAD circuit replacement and an additional membrane oxygenator. Four months later, he underwent DuraHeart(®) implantation. During this course, pulmonary artery wedge pressure (PAWP) varied markedly. Additionally, systolic pulmonary artery pressure (sPAP), left atrial diameter (LAD), RV end-diastolic diameter (RVEDD) and estimated RV systolic pressure (esRVP) changed with PAWP changes. In this patient, LV failure and hyperdynamic RV caused the CPEs, which we treated by adjusting the LVAD output to the RV output. Determining LVAD output, RV function and LV end-diastolic diameter are typically referred, and PAWP, LAD, RVEDD, and sPAP could be also referred. PMID:27001080

  20. Management of three cardiogenic pulmonary edemas occurring in a patient scheduled for left ventricular assist device implantation: indicators for determining left ventricular assist device pump speed.

    Science.gov (United States)

    Toyama, Hiroaki; Takei, Yusuke; Saito, Kazutomo; Ota, Takahisa; Kurotaki, Kenji; Ejima, Yutaka; Matsuura, Takeshi; Akiyama, Masatoshi; Saiki, Yoshikatsu; Yamauchi, Masanori

    2016-08-01

    A male patient with Marfan syndrome underwent aortic root replacement and developed left ventricular (LV) failure. Four years later, he underwent aortic arch and aortic valve replacement. Thereafter, his LV failure progressed, and cardiogenic pulmonary edema (CPE) appeared, which we treated with extracorporeal LV assist device (LVAD) placement. Three months later, the patient developed aspiration pneumonia, which caused hyperdynamic right ventricle (RV) and CPE. We treated by changing his pneumatic LVAD to a high-flow centrifugal pump. A month later, he underwent thoracoabdominal aortic replacement. After four weeks, he developed septic thrombosis and LVAD failure, which caused CPE. We treated with LVAD circuit replacement and an additional membrane oxygenator. Four months later, he underwent DuraHeart(®) implantation. During this course, pulmonary artery wedge pressure (PAWP) varied markedly. Additionally, systolic pulmonary artery pressure (sPAP), left atrial diameter (LAD), RV end-diastolic diameter (RVEDD) and estimated RV systolic pressure (esRVP) changed with PAWP changes. In this patient, LV failure and hyperdynamic RV caused the CPEs, which we treated by adjusting the LVAD output to the RV output. Determining LVAD output, RV function and LV end-diastolic diameter are typically referred, and PAWP, LAD, RVEDD, and sPAP could be also referred.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...... conditions prior to and during a simulated hemorrhagic challenge. Heat stress did not change indices of diastolic function. Subsequent volume infusion elevated indices of diastolic function, specifically early diastolic mitral annular tissue velocity (E') and early diastolic propagation velocity (E) relative...

  2. A biomimetic bi-leaflet mitral prosthesis with enhanced physiological left ventricular swirl restorative capability

    Science.gov (United States)

    Tan, Sean Guo-Dong; Kim, Sangho; Leo, Hwa Liang

    2016-06-01

    Mechanical heart valve prostheses are often implanted in young patients due to their durability and long-term reliability. However, existing designs are known to induce elevated levels of blood damage and blood platelet activation. As a result, there is a need for patients to undergo chronic anti-coagulation treatment to prevent thrombosis, often resulting in bleeding complications. Furthermore, recent studies have suggested that the implantation of a mechanical prosthetic valve at the mitral position results in a significant alteration of the left ventricular flow field which may contribute to flow turbulence. This study proposes a bi-leaflet mechanical heart valve design (Bio-MHV) that mimics the geometry of a human mitral valve, with the aim of reducing turbulence levels in the left ventricle by replicating physiological flow patterns. An in vitro three-dimensional particle velocimetry imaging experiment was carried out to compare the hemodynamic performance of the Bio-MHV with that of the clinically established ATS valve. The Bio-MHV was found to replicate physiological left ventricular flow patterns and produced lower turbulence levels.

  3. Left Ventricular Hypertrophy in Chronic Kidney Disease Patients: From Pathophysiology to Treatment.

    Science.gov (United States)

    Di Lullo, Luca; Gorini, Antonio; Russo, Domenico; Santoboni, Alberto; Ronco, Claudio

    2015-10-01

    Cardiovascular diseases represent the main causes of morbidity and mortality in patients with chronic kidney disease (CKD). According to a well-established classification, cardiovascular involvement in CKD can be set in the context of cardiorenal syndrome type 4. Left ventricular hypertrophy (LVH) represents a key feature to provide an accurate picture of systolic-diastolic left heart involvement in CKD patients. Cardiovascular involvement is present in about 80% of prevalent hemodialysis patients, and it is evident in CKD patients since stage IIIb-IV renal disease (according to the K/DOQI CKD classification). According to the definition of cardiorenal syndrome type 4, kidney disease is detected before the development of heart failure, although timing of the diagnosis is not always possible. The evaluation of LVH is a bit heterogeneous, and few standard imaging methods can provide the accuracy of either CT- or MRI-derived left ventricular mass. Key principles in the treatment of LVH in CKD patients are mainly based on anemia and blood pressure control, together with the management of secondary hyperparathyroidism and sudden cardiac death prevention. This review is mainly focused on the clinical aspects of CKD-related LVH to provide practical guidelines both for cardiologists and nephrologists in the daily clinical approach to CKD patients. PMID:26648942

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

    Directory of Open Access Journals (Sweden)

    Hiriyur Shivalingappa Jayanthkumar

    2013-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    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.

  7. Postoperative left ventricular apical ballooning: Transient Takotsubo cardiomyopathy following orthotopic liver transplantation

    Science.gov (United States)

    Bedanova, Helena; Orban, Marek; Nemec, Petr

    2013-01-01

    Patient: Female, 51 Final Diagnosis: Takotsubo cardiomyopathy Symptoms: — Medication: — Clinical Procedure: — Specialty: Cardiology • Transplantology Objective: Rare disease Background: Left ventricular apical ballooning syndrome (LVAB), also known as Takotsubo cardiomyopathy, is a cardiac syndrome characterized by transient left ventricular dysfunction in the absence of obstructive atherosclerotic coronary artery disease. An episode of emotional stress, typically in female patients, is believed to precede and trigger the development of this syndrome. Case Report: We report a case of Takotsubo cardiomyopathy that developed after orthotopic liver transplantation in a 51-year-old woman. On D2 (day 2) the patient had severe hemodynamic compromise. Echocardiography showed systolic dysfunction of the left ventricle (LV), with ejection fraction (EF) of 20% and anteroapical akinesis and ballooning of the apical 2/3 of the LV. Troponin T was elevated but other markers of myocardial necrosis were negative, as was coronary angiography. From D7 onward, there was an improvement in the hemodynamics in conjunction with a gradual increase of LV EF. The patient was dismissed from the hospital on D30 with signs of normal cardiac function and LV motion and EF of 50%. Liver function was also excellent. Conclusions: Every major operation, including liver transplantation, is associated with emotional stress for the patient. Therefore, it is necessary to consider Takotsubo cardiomyopathy in the differential diagnosis of heart failure developing early after LT, and clinicians should subsequently use adequate diagnostic and therapeutic measures. PMID:24298303

  8. Reproducibility of Left Ventricular Mass by Echocardiogram in the ELSA-Brasil

    Directory of Open Access Journals (Sweden)

    Alexandre Pereira Tognon

    2015-02-01

    Full Text Available Background: Echocardiography, though non-invasive and having relatively low-cost, presents issues of variability which can limit its use in epidemiological studies. Objective: To evaluate left ventricular mass reproducibility when assessed at acquisition (online compared to when assessed at a reading center after electronic transmission (offline and also when assessed by different readers at the reading center. Methods: Echocardiographers from the 6 ELSA-Brasil study investigation centers measured the left ventricular mass online during the acquisition from 124 studies before transmitting to the reading center, where studies were read according to the study protocol. Half of these studies were blindly read by a second reader in the reading center. Results: From the 124 echocardiograms, 5 (4% were considered not measurable. Among the remaining 119, 72 (61% were women, mean age was 50.2 ± 7.0 years and 2 had structural myocardial abnormalities. Images were considered to be optimal/ good by the reading center for 110 (92.4% cases. No significant difference existed between online and offline measurements (1,29 g, CI 95% −3.60-6.19, and the intraclass correlation coefficient between them was 0.79 (CI 95% 0.71-0.85. For images read by two readers, the intraclass correlation coefficient was 0.86 (CI 95% 0.78-0.91. Conclusion: There were no significant drifts between online and offline left ventricular mass measurements, and reproducibility was similar to that described in previous studies. Central quantitative assessment of echocardiographic studies in reading centers, as performed in the ELSA-Brasil study, is feasible and useful in clinical and epidemiological studies performed in our setting.

  9. Oxidative Stress Biomarkers and Left Ventricular Hypertrophy in Children with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Dorota Drożdż

    2016-01-01

    Full Text Available Cardiovascular diseases remain the most frequent cause of morbidity and mortality in patients with chronic kidney disease (CKD. The aim of the study was to assess the association between oxidative stress biomarkers and cardiovascular risk factors and left ventricular hypertrophy in children with CKD. Material and Methods. The studied group consisted of 65 patients aged 1.4–18.6 (mean 11.2 years with stages 1 to 5 CKD. Serum oxidized low-density lipoprotein (oxLDL, protein carbonyl group, creatinine, cystatin C, albumin, lipids, high-sensitivity C-reactive protein, intercellular adhesion molecule-1, insulin, plasma renin activity, and aldosterone levels were measured. Patients were divided into groups depending on CKD stage. Anthropometric measurements, ambulatory blood pressure (BP measurements, and echocardiography with left ventricular mass (LVM calculation were performed. Results. Serum oxLDL strongly correlated with creatinine (R=0.246; p=0.048, cystatin C (R=0.346; p=0.006, total cholesterol (R=0.500; p<0.001, triglycerides (R=0.524; p<0.001, low-density lipoprotein concentrations (R=0.456; p<0.001, and 24 hour BP values of systolic (R=0.492; p=0.002, diastolic (R=0.515; p<0.001, and mean arterial pressure (R=0.537; p<0.001. A significant correlation between oxLDL levels and LVM z-scores (R=0.299; p=0.016 was found. Conclusions. Hypertension and dyslipidemia correlated with lipid oxidation in children with CKD. oxLDLs seem to be valuable markers of oxidative stress in CKD patients, correlating with left ventricular hypertrophy.

  10. Reproducibility of Left Ventricular Mass by Echocardiogram in the ELSA-Brasil

    Science.gov (United States)

    Tognon, Alexandre Pereira; Foppa, Murilo; Luft, Vivian Cristine; Chambless, Lloyd Ellwood; Lotufo, Paulo; El Aouar, Lilia Maria Mameri; Fernandes, Luciana Pereira; Duncan, Bruce Bartholow

    2015-01-01

    Background Echocardiography, though non-invasive and having relatively low-cost, presents issues of variability which can limit its use in epidemiological studies. Objective To evaluate left ventricular mass reproducibility when assessed at acquisition (online) compared to when assessed at a reading center after electronic transmission (offline) and also when assessed by different readers at the reading center. Methods Echocardiographers from the 6 ELSA-Brasil study investigation centers measured the left ventricular mass online during the acquisition from 124 studies before transmitting to the reading center, where studies were read according to the study protocol. Half of these studies were blindly read by a second reader in the reading center. Results From the 124 echocardiograms, 5 (4%) were considered not measurable. Among the remaining 119, 72 (61%) were women, mean age was 50.2 ± 7.0 years and 2 had structural myocardial abnormalities. Images were considered to be optimal/ good by the reading center for 110 (92.4%) cases. No significant difference existed between online and offline measurements (1,29 g, CI 95% −3.60-6.19), and the intraclass correlation coefficient between them was 0.79 (CI 95% 0.71-0.85). For images read by two readers, the intraclass correlation coefficient was 0.86 (CI 95% 0.78-0.91). Conclusion There were no significant drifts between online and offline left ventricular mass measurements, and reproducibility was similar to that described in previous studies. Central quantitative assessment of echocardiographic studies in reading centers, as performed in the ELSA-Brasil study, is feasible and useful in clinical and epidemiological studies performed in our setting. PMID:25424165

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Assessment of left ventricular function by tissue Doppler imaging in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Osman Kuloglu

    2012-05-01

    Full Text Available Ankylosing spondylitis (ASpis a chronic, inflammatory and systemic disease affecting pericardium, myocardium and the conduction system of the heart. In this study, we aimed to analyse left ventricular systolic and diastolic functions using tissue Doppler imaging (TDI. 30 patients with ASp and 30 healthy volunteers having the similar demographic characteristics were included. Left ventricular systolic and diastolic functions were assessed by using two dimensional (2D echocardiography, M-mode, pulsed-wave (PW and tissue Doppler echocardiography. The peak systolic velocity (Sm, early diastolic myocardial peak velocity (m, late diastolic myocardial peak velocity (Am, isovolumic acceleration (IVA, myocardial precontraction time (PCTm, myocardial contraction time (CTm, myocardial relaxation time (RTm, and myocardial performance index (MPI were measured at septal and lateral mitral annulus. In conventional echocardiography, end-diastolic interventricular septum and posterior wall diameters were higher in patients with ASp than the control group. The ratio of E/A was significantly lower and deceleration time was significantly prolonged in patients with ASp, but mitral E and A velocities, isovolumic relaxation time and MPI were similar in patient and control group (P>0.05. Left ventricular lateral and septal wall tissue Doppler echocardiography showed that Em, Em/Am ratio and CTm were significantly lower, IVRTm was longer and MPI was higher in patients with ASp. No significant differences were detected between the groups for IVA, Sm, Am, PCTm, PCTm/CTm ratio (P>0.05. We have demonstrated that in patients with ASp, diastolic functions were impaired but systolic functions were preserved by using TDI.

  13. Improved left ventricular function after growth hormone replacement in patients with hypopituitarism: assessment with radionuclide angiography

    Energy Technology Data Exchange (ETDEWEB)

    Cuocolo, A. [Cattedra di Medicina Nucleare, Centro per la Medicina Nucleare del CNR, Universita Federico II, Napoli (Italy); Nicolai, E. [Cattedra di Medicina Nucleare, Centro per la Medicina Nucleare del CNR, Universita Federico II, Napoli (Italy); Colao, A. [Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Universita Federico II, Napoli (Italy); Longobardi, S. [Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Universita Federico II, Napoli (Italy); Cardei, S. [Cattedra di Medicina Nucleare, Centro per la Medicina Nucleare del CNR, Universita Federico II, Napoli (Italy); Fazio, S. [Medicina Interna, Universita Federico II, Napoli (Italy); Merola, B. [Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Universita Federico II, Napoli (Italy); Lombardi, G. [Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Universita Federico II, Napoli (Italy); Sacca, L. [Medicina Interna, Universita Federico II, Napoli (Italy); Salvatore, M. [Cattedra di Medicina Nucleare, Centro per la Medicina Nucleare del CNR, Universita Federico II, Napoli (Italy)

    1996-04-01

    Prolonged growth hormone deficiency (GHD) leads to marked cardiac dysfunction; however, whether reversal of this abnormality may be achieved after specific replacement therapy has not yet been completely clarified. Fourteen patients with childhood-onset GHD (nine men and five women, mean age 27{+-}4 years) and 12 normal control subjects underwent equilibrium radionuclide angiography under control conditions at rest. Patients with GHD were also studied 6 months after recombinant human (rh) GH treatment (0.05 IU/kg per day). Normal control subjects and patients with GHD did not differ with respect to age, gender and heart rate. In contrast, left ventricular ejection fraction (53%{+-}9% vs 66%{+-}6%, P <0.001), stroke volume index (41{+-}11 vs 51{+-}8 ml/m{sup 2}, P <0.01) and cardiac index (2.8{+-}0.6 vs 3.{+-}0.5 l/min/m{sup 2}, P <0.001) were significantly lower in GHD patients than in normal control subjects. None of the GHD patients showed adverse or side-effects during rhGH therapy; thus none required a reduction in GH dose during the treatment period. Heart rate and arterial blood pressure were not significantly modified by rhGH treatment. After 6 months of rhGH therapy a significant improvement in left ventricular ejection fraction (from 53%{+-}9% to 59%{+-}9%, P <0.01), stroke volume index (from 41{+-}11 to 47{+-}13 ml/m{sup 2}, P <0.05) and cardiac index (from 2.8{+-}0.6 to 3.3{+-}0.8 l/min/m{sup 2}, P <0.01) was observed in GHD patients. In conclusion, prolonged lack of GH leads to impaired left ventricular function at rest. Reversal of this abnormality may be observed after 6 months of specific replacement therapy in patients with childhood-onset GHD. (orig.). With 4 figs., 1 tab.

  14. [The role of Doppler echocardiography in assessing left ventricular diastolic function. Case histories].

    Science.gov (United States)

    Lo Giudice, P; Scaccianoce, G; Cavarra, M; Francaviglia, B; Gulizia, M; Circo, A

    1992-12-01

    The aim of this study was to provide a further contribution to evaluate the alterations induced by age on a number of simple Doppler indexes of left ventricular diastolic function. A population of 48 healthy subjects aged between 15 and 78 years old was examined using pulsed Doppler analysis of the left ventricular refilling flow. Linear regression analysis revealed a significant inverse correlation between age and peak speed during rapid refilling (r = -0.80); between age and the ratio between peak speed during rapid refilling and peak during atrial systole (r = -0.92); between age and deceleration time of peak E wave speed, although on the contrary the peak speed of diastolic refilling flow during the atrial systole (r = 0.81) increased significantly with age. Variance analysis showed that indexes of left ventricular diastolic function and age continued on the contrary to be significant n the population as a whole and in both sexes. From these findings it is clear that in the different age groups (15-29, 30-49, 50-65, and over 65) the peak speed of rapid refilling flow was significantly lower in over-65-year-olds than in elderly, middle-aged and young subjects (55 +/- 0.8, 60 +/- 0.5, 65 +/- 0.7 and 75 +/- 0.6 respectively; p < 0.001). The ratio between the peak speed of rapid refilling and that during the atrial systole was lower in over-65-year-olds compared to elderly subjects, middle-aged subjects or the youngest age group (0.94 +/- 0.09, 1.05 +/- 0.13, 1.96 +/- 0.21 and 2.68 +/- 0.50 respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1296152

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

    Directory of Open Access Journals (Sweden)

    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

  16. Congenital left ventricular wall abnormalities in adults detected by gated cardiac multidetector computed tomography: Clefts, aneurysms, diverticula and terminology problems

    Energy Technology Data Exchange (ETDEWEB)

    Erol, Cengiz, E-mail: drcengizerol@yahoo.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey); Koplay, Mustafa, E-mail: koplaymustafa@hotmail.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey); Olcay, Ayhan, E-mail: drayhanolcay@gmail.com [29 May Hospital, Department of Cardiology, Vatan Street, Fatih, 34150 Istanbul (Turkey); Kivrak, Ali Sami, E-mail: alisamikivrak@hotmail.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey); Ozbek, Seda, E-mail: dsadr@hotmail.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey); Seker, Mehmet, E-mail: hikmet.irfan@hotmail.com [29 May Hospital, Department of Radiology, Vatan Street, Fatih, 34150 Istanbul (Turkey); Paksoy, Yahya, E-mail: yahyapaksoy@yahoo.com [Selcuk University, Selcuklu Faculty of Medicine, Department of Radiology, Alaeddin Keykubat Central Campus, Selcuklu, 42250 Konya (Turkey)

    2012-11-15

    Objectives: Our aim was to evaluate congenital left ventricular wall abnormalities (clefts, aneurysms and diverticula), describe and illustrate imaging features, discuss terminology problems and determine their prevalence detected by cardiac CT in a single center. Materials and methods: Coronary CT angiography images of 2093 adult patients were evaluated retrospectively in order to determine congenital left ventricular wall abnormalities. Results: The incidence of left ventricular clefts (LVC) was 6.7% (141 patients) and statistically significant difference was not detected between the sexes regarding LVC (P = 0.5). LVCs were single in 65.2% and multiple in 34.8% of patients. They were located at the basal to mid inferoseptal segment of the left ventricle in 55.4%, the basal to mid anteroseptal segment in 24.1%, basal to mid inferior segment in 17% and septal-apical septal segment in 3.5% of cases. The cleft length ranged from 5 to 22 mm (mean 10.5 mm) and they had a narrow connection with the left ventricle (mean 2.5 mm). They were contractile with the left ventricle and obliterated during systole. Congenital left ventricular septal aneurysm that was located just under the aortic valve was detected in two patients (0.1%). No case of congenital left ventricular diverticulum was detected. Conclusion: Cardiac CT allows us to recognize congenital left ventricular wall abnormalities which have been previously overlooked in adults. LVC is a congenital structural variant of the myocardium, is seen more frequently than previously reported and should be differentiated from aneurysm and diverticulum for possible catastrophic complications of the latter two.

  17. Left ventricular outflow tract pseudoaneurysm formation following three aortic valve replacement surgeries

    Directory of Open Access Journals (Sweden)

    Nasrien E Ibrahim

    2015-01-01

    Full Text Available We present a case of a pseudoaneurysm arising from the left ventricular outflow tract/aortic root as a complication of aortic valve surgery. A 45-year-old Nigerian female presented to our institution′s emergency department with chest discomfort. She had three bioprosthetic aortic valve replacements in the preceding year at an outside institution for aortic regurgitation and wanted a second opinion on remaining surgical options. The learning points relevant to this case are as follows: (1 Recognizing potential complications postmultiple valve surgeries, (2 screening patients for chronic infections and rheumatologic conditions that can contribute to failed valve surgeries.

  18. [CLINICAL, BIOCHEMICAL AND HORMONAL PREDICTORS OF LEFT VENTRICULAR HYPERTROPHY IN PATIENTS WITH ACROMEGALY].

    Science.gov (United States)

    Mykytyuk, M R

    2015-01-01

    Examined 76 (26 men and 50 women) patients with active acromegaly aged 20 to 70 years, average age (48.22 ± 12.19). Echocardiographic signs of hypertrophy of the left ventricular (LVH) revealed by 63.2% of patients, including 46%--concentric LVH. Found that high levels of pituitary growth hormone (GH) and insulin like growth factor-1 (IGF-1) were independent predictors of LVH. Influence of GH and IGF-1 on the formation of LVH-mediated through anthropometric parameters and levels of systolic and diastolic blood pressure, which are predictors in patients with acromegaly LVH.

  19. Exercise in heart failure patients supported with a left ventricular assist device

    DEFF Research Database (Denmark)

    Jung, Mette Holme; Gustafsson, Finn

    2015-01-01

    After implantation of a continuous-flow left ventricular assist device (CF-LVAD), exercise capacity in heart failure patients remains reduced with peak oxygen uptake (peak VO2) values averaging from 11 to 20 ml/kg/min. Total cardiac output in CF-LVAD patients during exercise is predominantly...... factors are anemia with low oxygen-carrying capacity, obesity and general deconditioning with low muscle mass. In addition, exercise training in CF-LVAD patients can improve peak VO2. To design interventions to improve functional capacity in patients treated with modern durable LVADs, a detailed...

  20. Normal values of regional left ventricular endocardial motion: multicenter color kinesis study.

    Science.gov (United States)

    Mor-Avi, V; Spencer, K; Gorcsan, J; Demaria, A; Kimball, T; Monaghan, M; Perez, J; Sun, J P; Weinert, L; Bednarz, J; Collins, K; Edelman, K; Kwan, O L; Glascock, B; Hancock, J; Baumann, C; Thomas, J; Lang, R

    2000-11-01

    Our goal was to establish normal values for quantitative color kinesis indexes of left ventricular (LV) wall motion over a wide range of ages, which are required for objective diagnosis of regional systolic and diastolic dysfunction. Color-encoded images were obtained in 194 normal subjects (95 males, 99 females, age 2 mo to 79 yr) in four standard views. Quantitative indexes of magnitude and timing of systolic and diastolic function were studied for age- and gender-related differences. Normal limits of all ejection and filling indexes were in a narrow range (kinesis indexes should allow objective detection of regional LV systolic and diastolic dysfunction.

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

    DEFF Research Database (Denmark)

    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....

  2. Myocardial infarction complicated by left ventricular thrombus and fatal thromboembolism following abrupt cessation of dabigatran.

    Science.gov (United States)

    Weiler, Bethany; Marciniak, Ellen T; Reed, Robert M; McCurdy, Michael T

    2014-07-04

    Novel anticoagulants are increasingly utilised in lieu of warfarin to treat non-valvular atrial fibrillation. Their clinical use in other non-FDA approved settings is also increasing. We present a case in which a patient abruptly stopped taking dabigatran due to a small bowel obstruction and shortly thereafter suffered a myocardial infarction complicated by left ventricular thrombosis with fatal embolisation to the superior mesenteric artery. In this context, we discuss the possibility of a rebound phenomenon of hypercoagulability with abrupt cessation of novel anticoagulants.

  3. Non-Dipper Status and Left Ventricular Hypertrophy as Predictors of Incident Chronic Kidney Disease

    OpenAIRE

    An, Hye Rim; Park, Sungha; Yoo, Tae-Hyun; Kang, Shin-Wook; Ryu, Jung-Hwa; Lee, Yong Kyu; Yu, Mina; Ryu, Dong-Ryeol; Kim, Seung Jung; KANG, DUK-HEE; Choi, Kyu Bok

    2011-01-01

    We have hypothesized that non-dipper status and left ventricular hypertrophy (LVH) are associated with the development of chronic kidney disease (CKD) in non-diabetic hypertensive patients. This study included 102 patients with an estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2. Ambulatory blood pressure monitoring and echocardiography were performed at the beginning of the study, and the serum creatinine levels were followed. During the average follow-up period of 51 months, ...

  4. Radical Cystectomy with Ileal Conduit Urinary Diversion in a Patient with a Left Ventricular Assist Device

    Directory of Open Access Journals (Sweden)

    Joseph J. Pariser

    2015-01-01

    Full Text Available Left ventricular assist device (LVAD is an option for the surgical management of severe heart failure, and radical cystectomy remains the standard of care for muscle-invasive bladder cancer. Given a complicated population in terms of comorbidities and management for patients with an LVAD, there is little experience with major urologic procedures, which require balancing the benefits of surgery with considerable perioperative risks. We report our experience performing the first radical cystectomy with ileal conduit in a patient with an LVAD and muscle-invasive bladder cancer.

  5. Clinical application of BVS5000 left ventricular assist device in heart failure patients

    Institute of Scientific and Technical Information of China (English)

    LUO Xin-jin; HU Sheng-shou; SUN Han-song; XU Jian-ping; LIU Ping; ZHENG Zhe; MA Wei-guo; ZHANG Yan

    2008-01-01

    Background Mechanical ventricular assistance is an important therapeutic method for severe heart failure patients. A variety of ventricular assist devices have been designed for use. The purpose of this report was to describe the experience of using Abiomed BVS5000 as a means of left ventricular support as a clinical treatment for heart failure patients.Methods From February 2004 to April 2006, 12 male patients were supported with Abiomed BVS5000 left ventricular assist device (LVAD) at Fu Wai Hospital. The average age was (55.2+9.6) years (range 39 to 68 years). The mean body surface area was (1.76±0.1) m2 (range 1.6 to 1.9 m2 ). Devices were inserted for post-cardiotomy shock after coronary artery bypass graft in 11 patients (92%) and in 1 dilated cardiomyopathy patient for acute cardiogenic shock. Modified cannulation methods by inserting the arterial cannulae in femoral artery and inserting the venous cannula in left atrium through a segment of bovine jugular vein were used in 7 patients. In this way, the device could be taken off without re-sternotomy when support was finished. A comparison was made between the modified method and routine left atrium-to-ascending aorta cannulating method.Results The median duration of support was 5 (3-43) days, with support flow rate of 3.8-4.5 L/min. There were 9 (75%)patients weaned from support and 8 (67%) patients discharged from the hospital. Four (33%) patients were dead. The most common morbidity was adverse neurological events. There is no statistical difference between modified and routine method on average in BVS5000 support duration, in assisted flow rate, in mechanical ventilation duration, in the intensive care unit stay and thoracic drainage.Conclusions The Abiomed BVS5000 is valuable to support patients with acute cardiogenic shock for short-term use.By the modified cannulating method, the weaning procedure can be effectively simplified. Optimization of inserting indication remains challenging and attributes to

  6. Left ventricular 12 segmental strain imaging predicts response to cardiac resynchronization therapy

    Institute of Scientific and Technical Information of China (English)

    DONG Ying-xue; Jae K.Oh; YANG Yan-zong; Yong-mei Cha

    2013-01-01

    Background The number of non-responders to cardiac resynchronization therapy (CRT) exposes the need for better patient selection criteria for CRT.This study aimed to identify echocardiographic parameters that would predict the response to CRT.Methods Forty-five consecutive patients receiving CRT-D implantation for heart failure (HF) were included in this prospective study.New York Heart Association (NYHA) class,6-minute walk distance,electrograph character,and multi echocardiographic parameters,especially in strain patterns,were measured and compared before and six months after CRT in the responder and non-responder groups.Response to CRT was defined as a decrease in left ventricular endsystolic volume (LVESV) of 15% or more at 6-month follow up.Results Twenty-two (48.9%) patients demonstrated a response to CRT at 6-month follow-up.Significant improvement in NYHA class (P <0.01),left ventricular end-diastolic volume (LVEDV) (P <0.01),and 6-minute walk distance (P <0.01) was shown in this group.Although there was an interventricular mechanical delay determined by the difference between left and right ventricular pre-ejection intervals ((42.87±19.64) ms vs.(29.43±18.19) ms,P=0.02),the standard deviation of time to peak myocardial strain among 12 basal,mid and apical segments (Tε-SD) ((119.97±43.32) ms vs.(86.62±36.86) ms,P=0.01) and the non-ischemic etiology (P=0.03) were significantly higher in responders than non-responders,only the Tε-SD (OR=1.02,95% Cl=1.01-1.04,P=0.02) proved to be a favorable predictor of CRT response after multivariate Logistic regression analysis.Conclusion The left ventricular 12 segmental strain imaging is a promising echocardiographic parameter for predicting CRT response.

  7. Role of invading leukocytes in enhanced atrial eicosanoid production following rabbit left ventricular myocardial infarction.

    OpenAIRE

    Freed, M S; Needleman, P; Dunkel, C G; Saffitz, J E; Evers, A S

    1989-01-01

    The isolated perfused hearts of rabbits previously subjected to in vivo left ventricular myocardial infarction (LVMI) show a 5-10-fold increase in f-Met-Leu-Phe (FMLP) and bradykinin (BK)-stimulated eicosanoid metabolite production relative to noninfarcted hearts. This exaggerated arachidonate metabolism has been shown to occur primarily in the cardiac atria, a site remote from the zone of injury and to be associated with a 10-15-fold increase in atrial FMLP receptor number in the absence of ...

  8. Modeling of Longitudinal Changes in Left Ventricular Dimensions among Female Adolescent Runners

    OpenAIRE

    Norimitsu Kinoshita; Fuminori Katsukawa; Hajime Yamazaki

    2015-01-01

    Purpose Left ventricular (LV) enlargement has been linked to sudden cardiac death among young athletes. This study aimed to model the effect of long-term incessant endurance training on LV dimensions in female adolescent runners. Methods Japanese female adolescent competitive distance runners (n = 36, age: 15 years, height: 158.1 ± 4.6 cm, weight: 44.7 ± 6.1 kg, percent body fat: 17.0 ± 5.2%) underwent echocardiography and underwater weighing every 6 months for 3 years. Since the measurement ...

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    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.

  11. Long-term survival in patients hospitalized with congestive heart failure: relation to preserved and reduced left ventricular systolic function

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Torp-Pedersen, Christian; Brendorp, Bente;

    2003-01-01

    AIMS: The purpose of this study was to evaluate the influence of left ventricular systolic function on the survival in a large consecutive cohort of patients hospitalized with congestive heart failure and to determine how left ventricular systolic function interacts with co-morbid conditions in t...... (1 year mortality, 19%). CONCLUSION: In hospitalized heart failure patients, particularly in younger patients with ischemic heart disease, mortality risk is inversely related to left ventricular systolic function.......AIMS: The purpose of this study was to evaluate the influence of left ventricular systolic function on the survival in a large consecutive cohort of patients hospitalized with congestive heart failure and to determine how left ventricular systolic function interacts with co-morbid conditions in...... terms of prognosis. METHODS AND RESULTS: Analysis of survival data from 5491 patients admitted for new or worsening heart failure to 34 departments of cardiology or internal medicine in Denmark from 1993-1996 was carried out. A standardized echocardiogram was available for 95% of the patients, and left...

  12. Hypertensive Crisis and Left Ventricular Thrombi after an Upper Respiratory Infection during the Long-term Use of Oral Contraceptives.

    Science.gov (United States)

    Suzuki, Natsuko; Suzuki, Keisuke; Mizuno, Tomofumi; Kato, Yukari; Suga, Norihiro; Yoshino, Masabumi; Miura, Naoto; Banno, Shogo; Imai, Hirokazu

    2016-01-01

    A 34-year-old woman who had been using oral contraceptives for 10 years developed hypertensive crisis with papilloedema after an upper respiratory infection. Laboratory data showed hyperreninemic hyperaldosteronism and elevated levels of fibrinogen, fibrin, and fibrinogen degradation products. Echocardiography demonstrated two masses (18 mm) in the left ventricle. On the fourth hospital day, cerebral infarction, renal infarction, and upper mesenteric artery occlusion suddenly occurred despite the blood pressure being well-controlled using anti-hypertensive drugs. Echocardiography revealed the disappearance of the left ventricular masses, which suggested left ventricular thrombi. Cessation of the contraceptives and administration of heparin, warfarin, and anti-platelets drugs improved her general condition.

  13. Congestive heart failure with preserved left ventricular systolic function after acute myocardial infarction: clinical and prognostic implications

    DEFF Research Database (Denmark)

    Møller, Jacob Eifer; Brendorp, Bente; Ottesen, Michael;

    2003-01-01

    AIMS: To characterise the prevalence, in-hospital complications, management, and long-term outcome of patients with congestive heart failure but preserved left ventricular systolic function after acute myocardial infarction. METHODS: 3166 consecutive patients screened for entry in the Bucindolol...... and all cause mortality. RESULTS: Congestive heart failure was seen during hospitalisation in 1464 patients (46%), 717 patients had preserved left ventricular systolic function (wall motion index > or =1.3 corresponding to ejection fraction > or =0.40), and 732 patients had systolic dysfunction (wall.......3 (95% CI 2.8-4.0), and after adjustment for baseline characteristics and left ventricular systolic function in multivariate Cox proportional hazards analysis the risk was 2.1 (95% CI 1.7-2.6), PCongestive heart failure is frequently present in patients with preserved left...

  14. Clinical impact of ' in-treatment' wall motion abnormalities in hypertensive patients with left ventricular hypertrophy: the LIFE study

    DEFF Research Database (Denmark)

    Cicala, S.; Simone, G. de; Wachtell, K.;

    2008-01-01

    Objectives Left ventricular systolic wall motion abnormalities have prognostic value. Whether wall motion detected by serial echocardiographic examinations predicts prognosis in hypertensive patients with left ventricular hypertrophy ( LVH) without clinically recognized atherosclerotic disease has...... to analyze the primary composite endpoint of cardiovascular death, MI, or stroke and, separately, for fatal and nonfatal MI and hospitalized heart failure. Results During a mean follow-up of 4.8 years, an event was recorded in 67 ( 9%) patients. In Cox models after adjusting for age, gender, treatment, blood...... In hypertensive patients with LVH and no history of cardiovascular disease, ' in- treatment' left ventricular wall motion abnormalities are associated with increased likelihood of subsequent cardiovascular events independent of age, gender, blood pressure lowering, treatment modality, and in- treatment left...

  15. Left posterior fascicular block: a new endpoint of ablation for verapamil-sensitive idiopathic ventricular tachycardia

    Institute of Scientific and Technical Information of China (English)

    MA Fu-sheng; MA Jian; TANG Kai; HAN Hao; JIA Yu-he; FANG Pi-hua; CHU Jian-min; PU Jie-lin; ZHANG Shu

    2006-01-01

    Background Verapamil-sensitive, idiopathic left ventricular tachycardia (ILVT) with right bundle branch block configuration and left-axis deviation is known to be due to re-entry mechanism but the exact nature of reentrant circuit in ILVT is not fully elucidated. Radiofrequency (RF) ablation was applied during ventricular tachycardia (VT) and termination of the VT or abolishing the inducibility of the tachycardia was used as an endpoint for successful RF. In this study, the left posterior fascicular block in surface electrocardiogram (ECG)was used as a new endpoint of ablation to cure ILVT.Methods Electrophysiological studies and radiofrequency ablation were performed in 39 consecutive patients [30 men, 9 women; age ranging from 10 to 64 years, mean (29± 16) years] with verapamil-sensitive ILVT and structurally normal hearts. VT could be terminated by the intravenous administration of verapamil in all patients.The target site was the midseptum of LV where the earliest Purkinje potentials were recorded during VT. RF current was applied to the target site with or without late diastolic potential (LDP) during sinus rhythm in 37patients and during VT in 2 patients to meet the ablation endpoint: the left posterior fascicular block in the surface ECG.Results Thirty-seven patients with ILVT had been treated by RF ablation during sinus rhythm and two had been treated during VT. All of them met the endpoint of the left posterior fascicular block. Thirty-eight cases were symptom-free without medications during the follow-up period (range from 3 to 95 months, median 17months). One patient developed a clinical recurrence and the left posterior fascicular block in surface ECG disappeared. The patient received another treatment. The endpoint was met and the procedure was successful.Conclusions The left posterior fascicular block in surface ECG used as an endpoint of RF ablation to treat ILVT is effective. It is important especially in those patients whose VT can not be induced

  16. [Rise of the machines? Left ventricular assist devices for treatment of severe heart failure].

    Science.gov (United States)

    Ujeyl, A; Krüger, M

    2015-11-01

    The use of left ventricular assist devices (LVAD) as a treatment for severe heart failure has gained momentum in recent years. Even at this stage the number of worldwide LVAD implantations far exceeds the volume of heart transplantations in view of the chronic shortage of donor organs. Third generation continuous flow assist devices have helped to improve survival, quality of life and symptom burden of heart failure patients in comparison to a regimen of optimal medication management. Alongside bridging to transplantation, destination therapy has become an established strategy of LVAD implantation. A careful patient selection process is crucial for a good clinical outcome after device implantation and risk assessment for postoperative right ventricular failure is of particular importance in this context. The rate of hospitalization during LVAD support is still high, despite the step-wise attempts to widen the indications to less severely ill heart failure patients. An effective perioperative and postoperative management will help to lower the incidence of complications (e.g. bleeding, infections, thromboembolic events and right ventricular failure) and to improve the encouraging results of mechanical circulatory support. PMID:26530283

  17. [Rise of the machines? Left ventricular assist devices for treatment of severe heart failure].

    Science.gov (United States)

    Ujeyl, A; Krüger, M

    2015-11-01

    The use of left ventricular assist devices (LVAD) as a treatment for severe heart failure has gained momentum in recent years. Even at this stage the number of worldwide LVAD implantations far exceeds the volume of heart transplantations in view of the chronic shortage of donor organs. Third generation continuous flow assist devices have helped to improve survival, quality of life and symptom burden of heart failure patients in comparison to a regimen of optimal medication management. Alongside bridging to transplantation, destination therapy has become an established strategy of LVAD implantation. A careful patient selection process is crucial for a good clinical outcome after device implantation and risk assessment for postoperative right ventricular failure is of particular importance in this context. The rate of hospitalization during LVAD support is still high, despite the step-wise attempts to widen the indications to less severely ill heart failure patients. An effective perioperative and postoperative management will help to lower the incidence of complications (e.g. bleeding, infections, thromboembolic events and right ventricular failure) and to improve the encouraging results of mechanical circulatory support.

  18. Routine evaluation of left ventricular diastolic function by cardiovascular magnetic resonance: A practical approach

    Directory of Open Access Journals (Sweden)

    Vido Diane

    2008-07-01

    Full Text Available Abstract Background Cardiovascular magnetic resonance (CMR has excellent capabilities to assess ventricular systolic function. Current clinical scenarios warrant routine evaluation of ventricular diastolic function for complete evaluation, especially in congestive heart failure patients. To our knowledge, no systematic assessment of diastolic function over a range of lusitropy has been performed using CMR. Methods and Results Left ventricular diastolic function was assessed in 31 subjects (10 controls who underwent CMR and compared with Transthoracic echocardiogram (TTE evaluation of mitral valve (MV and pulmonary vein (PV blood flow. Blood flow in the MV and PV were successfully imaged by CMR for all cases (31/31,100% while TTE evaluated flow in all MV (31/31,100% but only 21/31 PV (68% cases. Velocities of MV flow (E and A measured by CMR correlated well with TTE (r = 0.81, p Conclusion We have shown that there is homology between CMR and TTE for the assessment of diastolic inflow over a wide range of conditions, including normal, impaired relaxation and restrictive. There is excellent agreement of quantitative velocity measurements between CMR and TTE. Diastolic blood flow assessment by CMR can be performed in a single scan, with times ranging from 20 sec to 3 min, and we show that there is good indication for applying CMR to assess diastolic conditions, either as an adjunctive test when evaluating systolic function, or even as a primary test when TTE data cannot be obtained.

  19. [Left ventricular hypertrophy in the cat - "when hypertrophic cardiomyopathy is not hypertrophic cardiomyopathy"].

    Science.gov (United States)

    Glaus, T; Wess, G

    2010-07-01

    According to WHO classification hypertrophic cardiomyopathy (HCM) is a primary genetic cardiomyopathy. Echocardiographically HCM is characterized by symmetric, asymmetric or focal left ventricular hypertrophy (LVH) without recognizable underlying physical cause. However, echocardiographically HCM in cats may not be distinguishable from other causes of a thick appearing left ventricle. Hypovolemia can look like a hypertrophied ventricle but is basically only pseudohypertrophic. Well recognized and logical physical causes of LVH include systemic hypertension and outflow obstruction. LVH similar to HCM may also be found in feline hyperthyroidism. The context of the disease helps to differentiate these physical / physiological causes of LVH. Difficult to distinguish from HCM, particularly when based on a snapshot of a single echocardiographic exam, are myocarditis and . Only the clinical and echocardiographic course allow a reasonably confident etiological diagnosis and the differentiation between HCM and secondary LVH. PMID:20582898

  20. Left ventricular diastolic function is associated with symptom status in severe aortic valve stenosis

    DEFF Research Database (Denmark)

    Dahl, Jordi S; Christensen, Nicolaj L; Videbæk, Lars;

    2014-01-01

    BACKGROUND: In aortic valve stenosis (AS), the occurrence of heart failure symptoms does not always correlate with severity of valve stenosis and left ventricular (LV) function. Therefore, we tested the hypothesis that symptomatic patients with AS have impaired diastolic, longitudinal systolic......%. Independent predictors of symptomatic state were identified using logistic regression analysis. Symptomatic patients were younger (72±10 versus 76±12 years of age; P=0.002), presented less often with atrial fibrillation (13% versus 24%; P=0.05) and chronic obstructive pulmonary disease (2% versus 19%; P<0......±58 versus 268±62 ms; P<0.0001), and increased left atrial volume index (49±18 versus 42±15 mL/m2; P=0.02). When adjusting for age, history of hypertension, atrial fibrillation, and chronic obstructive pulmonary disease in a multivariable logistic regression analysis, LV mass index, relative wall thickness...

  1. Left ventricular structure and diastolic function in subjects with two hypertensive parents

    DEFF Research Database (Denmark)

    Andersen, U B; Steensgaard-Hansen, F; Rokkedal, J;

    2001-01-01

    -parental hypertension and 26 matched controls with normotensive parents. Families with non-insulin-dependent diabetes or morbid obesity were excluded. (i) Echocardiography; (ii) plasma concentrations of renin, angiotensin-II, aldosterone, epinephrine and norepinephrine; (iii) euglycaemic, hyperinsulinemic clamp study......PURPOSE: To examine the influence of (i) strong predisposition to essential hypertension and (ii) insulin sensitivity and plasma levels of cardiomyotrophic hormones on echocardiographic parameters of left ventricular structure and function. METHODS: 26 normotensive subjects (age 18-35) with bi....... RESULTS (means +/- SD): Hypertension-prone subjects vs controls had (i) higher resting systolic (117.0 +/- 14.0 vs 107.1 +/- 11.9 mmHg), and 24-h diastolic blood pressure (77.9 +/- 7.1 vs 72.9 +/- 7.2 mmHg), (ii) higher relative wall thickness (RWT) (0.39 +/- 0.09 vs 0.34 +/- 0.06). They had similar left...

  2. Effect of candesartan treatment on left ventricular remodeling after aortic valve replacement for aortic stenosis

    DEFF Research Database (Denmark)

    Dahl, Jordi S; Videbaek, Lars; Poulsen, Mikael K;

    2010-01-01

    group had greater improvement in longitudinal LV systolic function assessed by tissue Doppler S' wave (0.6 +/- 0.1-cm/s increase in control group vs 1.4 +/- 0.1 cm/s in candesartan group, p = 0.01, p for trend = 0.02) and a decrease in LA volume (p for trend = 0.01). Treatment had no effect on diastolic......In hypertension, angiotensin receptor blockers can augment regression of left ventricular (LV) hypertrophy. It is not known whether this also is the case after aortic valve replacement (AVR) for severe aortic stenosis (AS). To test the hypothesis that treatment with candesartan in addition...... to conventional treatment is able to augment LV and left atrial (LA) reverse remodeling in patients with AS undergoing AVR, we studied 114 patients scheduled for AVR. Patients were randomized to treatment with candesartan 32 mg 1 time/day or conventional therapy immediately after AVR. Patients were followed...

  3. The Assessment of Left Ventricular Time-Varying Radius Using Tissue Doppler Imaging

    Directory of Open Access Journals (Sweden)

    Fardin Mirbolouk

    2012-03-01

    Full Text Available Background: Left ventricular twist/torsion is believed to be a sensitive indicator of systolic and diastolic performance. To obtain circumferential rotation using tissue Doppler imaging, we need to estimate the time-varying radius of the left ventricle throughout the cardiac cycle to convert the tangential velocity into angular velocity. Objectives: The aim of this study was to investigate accuracy of measured LV radius using tissue Doppler imaging throughout the cardiac cycle compared to two-dimensional (2D imaging. Methods: A total of 35 subjects (47±12 years old underwent transthoracic echocardiographic standard examinations. Left ventricular radius during complete cardiac cycle measured using tissue Doppler and 2D-imaging at basal and apical short axis levels. For this reason, the 2D-images and velocity-time data derived and transferred to a personal computer for off-line analysis. 2D image frames analyzed via a program written in the MATLAB software. Velocity-time data from anteroseptal at basal level (or anterior wall at apical level and posterior walls transferred to a spreadsheet Excel program for the radius calculations. Linear correlation and Bland-Altman analysis were calculated to assess the relationships and agreements between the tissue Doppler and 2D-measured radii throughout the cardiac cycle. Results: There was significant correlation between tissue Doppler and 2D-measured radii and the Pearson correlation coefficients were 0.84 to 0.97 (P<0.05. Bland-Altman analysis by constructing the 95% limits of agreement showed that the good agreements existed between the two methods. Conclusion: It can be concluded from our experience that the tissue Doppler imaging can reasonably estimate radius of the left ventricle throughout the cardiac cycle.

  4. Mitral regurgitation in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both: prognostic significance and relation to ventricular size and function

    DEFF Research Database (Denmark)

    Amigoni, Maria; Meris, Alessandra; Thune, Jens Jakob;

    2007-01-01

    AIMS: Mitral regurgitation (MR) confers independent risk in patients with acute myocardial infarction. We utilized data from the VALsartan In Acute myocardial iNfarcTion echo study to relate baseline MR to left ventricular (LV) size, shape, and function, and to assess the relationship between bas...

  5. Left ventricular stroke volume in the fetal sheep is limited by extracardiac constraint and arterial pressure.

    Science.gov (United States)

    Grant, D A; Fauchère, J C; Eede, K J; Tyberg, J V; Walker, A M

    2001-08-15

    1. Extracardiac constraint and sensitivity to arterial pressure may be critical factors that limit the functional reserves of the developing fetal heart in utero. We hypothesise that extracardiac constraint is the predominant factor that limits fetal stroke volume (SV). To test this hypothesis we studied six chronically instrumented fetal sheep to determine the relative roles that extracardiac constraint and arterial pressure play in determining left ventricular (LV) function. 2. Pregnant ewes (128-131 days gestation, term = 147 days) were anaesthetised (5 mg kg(-1) Propofol I.V., then 1.5 % halothane, 50 % O(2), balance N(2)O by inhalation) and instrumented using sterile surgical techniques to record LV end-diastolic pressure (P(lved)), aortic pressure (P(ao)), pericardial pressure (P(per)), and LV SV. 3. After a minimum of 72 h recovery, LV function was assessed by altering fetal blood volume to vary P(lved). Ventricular function curves were generated using two measures of ventricular function, SV and stroke work index (SWI = SV x P(ao)), and two measures of ventricular filling, P(lved) and LV end-diastolic transmural pressure (P(lved,tm) = P(lved) - P(per)). 4. Although decreasing P(lved) from the resting level decreased SV, increasing P(lved) from the resting level did not increase SV because the ventricular function curve plateaued. This plateau was not explained solely by an increase in aortic pressure, as the plateau remained present in the SWI versus P(lved) curve. When extracardiac constraint was accounted for (SV against P(lved,tm)), the plateau was largely eliminated (approximately 80 %). The remaining portion of the plateau (approximately 20 %) was eliminated when both extracardiac constraint and arterial pressure were accounted for (SWI versus P(lved,tm)). 5. Thus, the major limitation upon LV function in the near-term fetus results from extracardiac constraint limiting ventricular filling while, at the same time, a much smaller limitation arises from

  6. Comparison of determinations of left atrial volume by the biplane area-length and Simpson's methods using 64-slice computed tomography

    International Nuclear Information System (INIS)

    There is increasing evidence that left atrial (LA) size is an important predictor of adverse cardiovascular outcomes such as atrial fibrillation, stroke, and congestive heart failure. The aim of this study was to determine whether there is a difference in results of quantification of LA volume by the area-length and Simpson's methods using multislice computed tomography (MSCT). The study population consisted of 51 patients with sinus rhythm (sinus group) and 20 patients with atrial fibrillation (af group) clinically indicated for MSCT angiography for evaluation of coronary arteries. Maximum LA volume, obtained at end-systole from the phase immediately preceding mitral valve opening, was measured using the area-length and Simpson's methods. In the sinus group, the mean LA volumes, indexed to body surface area, were 48.4±17.9 ml/m2 with the area-length method and 48.3±17.0 ml/m2 with the Simpson's method. In the af group, the mean indexed LA volumes with the area-length method and the Simposon's method were 91.5±47.5 ml/m2 and 90.3±45.9 ml/m2, respectively. LA volumes calculated by the area-length method exhibited a strong linear relationship and agreement with those calculated using Simpson's method in both the groups (sinus group: r=0.99, P<0.0001, af group: r=0.99, P<0.0001). The area-length method is a simple and reproducible means of assessment of LA volume. Standardization of LA volume assessment using MSCT is important for serial follow-up and meaningful communication of results of testing among institutions and physicians. (author)

  7. Beat-to-beat assessment of left ventricular ejection in atrial fibrillation

    International Nuclear Information System (INIS)

    Beat-to-beat left ventricular ejection was evaluated in a group of 20 patients with chronic atrial fibrillation using a computerized single probe detector. The reference group consisted of 10 patients with sinus rhythm. For each patient 30 successive cardiac cycles were analyzed and the relative variations of four parameters were assessed: R-R interval, diastolic and systolic time intervals, and ejection amplitude, corresponding to the left ventricular stroke volume. The mean variations were respectively 3.4%, 10.4%, 8.4%, and 11.8% in patients with sinus rhythm, and 21.9%, 37.9%, 10.6% and 30.5% in patients with artrial fibrillation. This demonstrates that changes in ejection are mainly related to the duration of the filling phase, with nearly constant systolic times. Correlations between R-R intervals and systolic ejection amplitudes were highly significant (P<0.001) in patients with atrial fibrillation in 85% of cases. This information complements the average ejection fraction obtained from multiple cycle superimposition. (orig.)

  8. Evaluation of left ventricular function in patients with atrial fibrillation by ECG gated blood pool scintigraphy

    International Nuclear Information System (INIS)

    ECG gated blood pool scintigraphy (EGBP) is not always valid for the patients with atrial fibrillation (AF), since they have wide variability in cardiac cycle length (CL). To evaluate the left ventricular (LV) function during AF by EGBP, we devised a new processing algorithm to construct multiple gated images discriminated by preceding R-R interval (PRR) from the data acquired in list mode. 18 patients with AF were studied as to; 1) How affect the PRR on cardiac indices such as EF, TES, PER or TPER, 2) Comparison with conventional method getting all CL data, 3) LV filling curves derived by plotting EDV against PRR, 4) The slope and position of LV function curves (LVFC) derived by plotting SV against EDV. In most cases, EF, PER and TES were increased with longer PRR, and those by conventional method nearly corresponded to the average values obtained by our new method. Impairment of ventricular filling was demonstrated in the cases of mitral stenosis and constrictive pericarditis. LVFC of CHF group was situated at right and downward to controls, and left and upward shift was observed after treatment. The slope of LVFC was reduced in relation to the progression of NYHA's functional class. In conclusion, this new algorithm processing irregular CL enables LV filling and function curves to draw, which are useful in the evaluation of cardiac performance in the subjects with AF. (author)

  9. Role of cardiac CTA in estimating left ventricular volumes and ejection fraction

    Institute of Scientific and Technical Information of China (English)

    Robin; Man; Singh; Balkrishna; Man; Singh; Jawahar; Lal; Mehta

    2014-01-01

    Left ventricular ejection fraction(LVEF)is an impor-tant predictor of cardiac outcome and helps in makingimportant diagnostic and therapeutic decisions suchas the treatment of different types of congestive heartfailure or implantation of devices like cardiac resynchro-nization therapy-defibrillator.LVEF can be measuredby various techniques such as transthoracic echo-cardiography,contrast ventriculography,radionuclidetechniques,cardiac magnetic resonance imaging andcardiac computed tomographic angiography(CTA).Thedevelopment of cardiac CTA using multi-detector rowCT(MDCT)has seen a very rapid improvement in thetechnology for identifying coronary artery stenosis andcoronary artery disease in the last decade.During theacquisition,processing and analysis of data to studycoronary anatomy,MDCT provides a unique opportunityto measure left ventricular volumes and LVEF simulta-neously with the same data set without the need foradditional contrast or radiation exposure.The develop-ment of semi-automated and automated software to measure LVEF has now added uniformity,efficiency and reproducibility of practical value in clinical practice rather than just being a research tool.This article will address the feasibility,the accuracy and the limitations of MDCT in measuring LVEF.

  10. Does the ADMA/DDAH/NO pathway modulate early regression of left ventricular hypertrophy with esmolol?

    Science.gov (United States)

    Quintana-Villamandos, Begoña; Delgado-Baeza, Emilio

    2016-02-01

    Hypertensive left ventricular hypertrophy (LVH) is a maladaptive response to chronic pressure overload and a strong independent risk factor for cardiovascular disease. Regression of LVH is associated with improved prognosis. Regression of LVH with antihypertensive therapy (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers, and diuretics) has been reported, although only after long-term treatment. Asymmetrical dimethylarginine (ADMA), the most potent endogenous NO synthase inhibitor, is emerging as an important cardiovascular risk factor in patients with arterial hypertension and LVH, and dimethylarginine dimethylaminohydrolase (DDAH) is the mechanism that most frequently leads to accumulation of ADMA (plasma ADMA is cleared in small part by renal excretion, although the bulk of ADMA is degraded by DDAH). Left ventricular mass is strongly modulated by the NO system. As an important inhibitor of the bioavailability of NO, ADMA is an underlying mechanism of LVH. Beta-blockers can induce regression of LVH and reduced plasma ADMA levels. Oxidative stress is increased in patients with LVH, and this in turn increases generation of ADMA. In a previous preclinical study of spontaneously hypertensive rats, we found that short-term treatment (48 h) with esmolol reverses early LVH, increases the bioavailability of NO, and improves antioxidant status in plasma. Therefore, we propose that the ADMA/DDAH/NO pathway could modulate early regression of LVH with esmolol. PMID:26826640

  11. Influence of filling on left ventricular diastolic pressure-volume curve during pacing ischemia in dogs.

    Science.gov (United States)

    Shintani, H; Glantz, S A

    1994-04-01

    The reversible upward shift of the diastolic pressure-volume curve that occurs during pacing-induced ischemia has not been fully explained by increases in passive chamber stiffness or reductions in relaxation rate. We measured the fully relaxed pressure-volume relation defined by both filling and nonfilling beats and the isovolumic relaxation time constant in nonfilling beats before and during demand ischemia using our in situ left ventricular volume clamping technique in 10 dogs. Pacing-induced ischemia shifted the diastolic pressure-volume curves in filling beats upward compared with the end-diastolic pressure-volume relation of the normally perfused heart. In contrast, the end-diastolic points for nonfilling beats during pacing-induced ischemia fell on the fully relaxed pressure-volume relation defined by the normally perfused heart. Left ventricular filling per se was necessary for the upward shift of the diastolic pressure-volume curve observed during pacing-induced ischemia. We speculate that active force developed during diastole induced by stretch activation or, perhaps, length-dependent changes in calcium sensitivity of the myofilaments in the ischemic myocardium due to stretch of the myocardium during rapid diastolic filling may contribute to the upward shift of the diastolic pressure-volume curve observed during pacing-induced ischemia. PMID:8184915

  12. ASSESSMENT OF LEFT VENTRICULAR FUNCTION IN HEALTHY SUBJECTS BY PUSLED WAVE DOPPLER TISSUE IMAGING

    Institute of Scientific and Technical Information of China (English)

    李靖; 刘延玲; 王浩; 吕秀章; 段福建; 杨洪昌

    2004-01-01

    Objective To examine the clinical application of pulsed Doppler tissue imaging (DTI) for regional left ventricular function assessment in normal subjects. Methods We examined 50 healthy subjects (range 12-42 years, mean age 28.3 ± 6.9 years)using pulsed Doppler tissue imaging to characterize the diastolic and systolic velocity profiles of mitral annulus. Recordings were made along the long axis in the apical 4-chamber, 2-chamber, and long apical views of 6 sites (posterior-septum, lateral, anterior, inferior, anterior-septum, posterior) at the mitral annulus. Myocardial velocities were determined with use of variance F statistical analysis.Correlation analysis was employed to test the relationship between age and mitral annular velocities. Results Both early diastolic and systolic velocities at the septum were lower than other sites.There were no differences in mitral annulus late diastolic velocities. Mean early diastolic and systolic velocities was negatively correlated with age. Conclusions Doppler tissue imaging can directly reflect regional left ventricular function.

  13. Left ventricular geometry and white matter lesions in ischemic stroke patients.

    Science.gov (United States)

    Butenaerts, Demian; Chrzanowska-Wasko, Joanna; Slowik, Agnieszka; Dziedzic, Tomasz

    2016-06-01

    Abnormal left ventricular (LV) geometry is associated with extracardiac organ damage in patients with hypertension. The aim of this study was to determine the relationship between LV geometry and white matter lesions (WMLs) in ischemic stroke patients. We retrospectively analyzed data from 155 patients (median age 62; 49.8% male) with mild ischemic stroke (median National Institutes of Health Stroke Scale score 4) who underwent brain magnetic resonance imaging and echocardiography. Patients were categorized into four groups: normal LV geometry, concentric remodeling, eccentric left ventricular hypertrophy (LVH) and concentric LVH. WMLs were graded using the Fazekas scale on fluid-attenuated inversion recovery images. Extensive WMLs were defined as a Fazekas score > 2. Extensive WMLs were more prevalent in patients with concentric LVH, eccentric LVH and concentric remodeling than in those with normal LV geometry. After adjusting for hypertension, age, diabetes mellitus, hypercholesterolemia, glomerular filtration rate and ischemic heart disease, patients with concentric remodeling [odds ratio (OR) 3.94, 95% confidence interval (CI) 1.26-12.31, p = 0.02] and those with concentric LVH (OR 3.69, 95% CI 1.24-10.95, p = 0.02), but not patients with eccentric LVH (OR 2.44, 95% CI 0.72-8.29, p = 0.15), had higher risk of extensive WMLs than patients with normal LV geometry. PMID:26581453

  14. The Role of Levosimendan in Patients with Decreased Left Ventricular Function Undergoing Cardiac Surgery

    Science.gov (United States)

    Bozhinovska, Marija; Taleska, Gordana; Fabian, Andrej; Šoštarič, Maja

    2016-01-01

    The postoperative low cardiac output is one of the most important complications following cardiac surgery and is associated with increased morbidity and mortality. The condition requires inotropic support to achieve adequate hemodynamic status and tissue perfusion. While catecholamines are utilised as a standard therapy in cardiac surgery, their use is limited due to increased oxygen consumption. Levosimendan is calcium sensitising inodilatator expressing positive inotropic effect by binding with cardiac troponin C without increasing oxygen demand. Furthermore, the drug opens potassium ATP (KATP) channels in cardiac mitochondria and in the vascular muscle cells, showing cardioprotective and vasodilator properties, respectively. In the past decade, levosimendan demonstrated promising results in treating patients with reduced left ventricular function when administered in peri- or post- operative settings. In addition, pre-operative use of levosimendan in patients with severely reduced left ventricular ejection fraction may reduce the requirements for postoperative inotropic support, mechanical support, duration of intensive care unit stay as well as hospital stay and a decrease in post-operative mortality. However, larger studies are needed to clarify clinical advantages of levosimendan versus conventional inotropes.

  15. Developments in control systems for rotary left ventricular assist devices for heart failure patients: a review

    International Nuclear Information System (INIS)

    From the moment of creation to the moment of death, the heart works tirelessly to circulate blood, being a critical organ to sustain life. As a non-stopping pumping machine, it operates continuously to pump blood through our bodies to supply all cells with oxygen and necessary nutrients. When the heart fails, the supplement of blood to the body's organs to meet metabolic demands will deteriorate. The treatment of the participating causes is the ideal approach to treat heart failure (HF). As this often cannot be done effectively, the medical management of HF is a difficult challenge. Implantable rotary blood pumps (IRBPs) have the potential to become a viable long-term treatment option for bridging to heart transplantation or destination therapy. This increases the potential for the patients to leave the hospital and resume normal lives. Control of IRBPs is one of the most important design goals in providing long-term alternative treatment for HF patients. Over the years, many control algorithms including invasive and non-invasive techniques have been developed in the hope of physiologically and adaptively controlling left ventricular assist devices and thus avoiding such undesired pumping states as left ventricular collapse caused by suction. In this paper, we aim to provide a comprehensive review of the developments of control systems and techniques that have been applied to control IRBPs. (topical review)

  16. Suction prevention and physiologic control of continuous flow left ventricular assist devices using intrinsic pump parameters.

    Science.gov (United States)

    Wang, Yu; Koenig, Steven C; Slaughter, Mark S; Giridharan, Guruprasad A

    2015-01-01

    The risk for left ventricular (LV) suction during left ventricular assist devices (LVAD) support has been a clinical concern. Current development efforts suggest LVAD suction prevention and physiologic control algorithms may require chronic implantation of pressure or flow sensors, which can be unreliable because of baseline drift and short lifespan. To overcome this limitation, we designed a sensorless suction prevention and physiologic control (eSPPC) algorithm that only requires LVAD intrinsic parameters (pump speed and power). Two gain-scheduled, proportional-integral controllers maintain a differential pump speed (ΔRPM) above a user-defined threshold to prevent LV suction while maintaining an average reference differential pressure (ΔP) between the LV and aorta. ΔRPM is calculated from noisy pump speed measurements that are low-pass filtered, and ΔP is estimated using an extended Kalman filter. Efficacy and robustness of the eSPPC algorithm were evaluated in silico during simulated rest and exercise test conditions for 1) excessive ΔP setpoint (ES); 2) rapid eightfold increase in pulmonary vascular resistance (PVR); and 3) ES and PVR. Simulated hemodynamic waveforms (LV pressure and volume; aortic pressure and flow) using only intrinsic pump parameters showed the feasibility of our proposed eSPPC algorithm in preventing LV suction for all test conditions. PMID:25396276

  17. Left ventricular geometry and white matter lesions in ischemic stroke patients.

    Science.gov (United States)

    Butenaerts, Demian; Chrzanowska-Wasko, Joanna; Slowik, Agnieszka; Dziedzic, Tomasz

    2016-06-01

    Abnormal left ventricular (LV) geometry is associated with extracardiac organ damage in patients with hypertension. The aim of this study was to determine the relationship between LV geometry and white matter lesions (WMLs) in ischemic stroke patients. We retrospectively analyzed data from 155 patients (median age 62; 49.8% male) with mild ischemic stroke (median National Institutes of Health Stroke Scale score 4) who underwent brain magnetic resonance imaging and echocardiography. Patients were categorized into four groups: normal LV geometry, concentric remodeling, eccentric left ventricular hypertrophy (LVH) and concentric LVH. WMLs were graded using the Fazekas scale on fluid-attenuated inversion recovery images. Extensive WMLs were defined as a Fazekas score > 2. Extensive WMLs were more prevalent in patients with concentric LVH, eccentric LVH and concentric remodeling than in those with normal LV geometry. After adjusting for hypertension, age, diabetes mellitus, hypercholesterolemia, glomerular filtration rate and ischemic heart disease, patients with concentric remodeling [odds ratio (OR) 3.94, 95% confidence interval (CI) 1.26-12.31, p = 0.02] and those with concentric LVH (OR 3.69, 95% CI 1.24-10.95, p = 0.02), but not patients with eccentric LVH (OR 2.44, 95% CI 0.72-8.29, p = 0.15), had higher risk of extensive WMLs than patients with normal LV geometry.

  18. Value of 4D-strain imaging echocardiography in detecting left ventricular systolic dysfunction in patients with aortic stenosis

    Institute of Scientific and Technical Information of China (English)

    ZHENG Zhi-chao; LI He-zhi; LI Chang-mao; CHEN Ou-di; FEI Hong-wen; LIN Qiong-wen

    2016-01-01

    Background The myocyte dysfunction may be present in aortic stenosis (AS) patients with preserved left ventricular ejection fraction (LVEF).Early aortic valve replacement (AVR) can reverse the LV hypertrophy and improve LV systolic performance and clinical outcome.Strain imaging has demonstrated to be the most appropriate method to evaluate LV myocardial contractility.However,4D-strain imaging echocardiography for the detection of subclinical left ventricular dysfunction in AS patients with preserved LVEF is seldom studied.Methods We prospectively enrolled 30 consecutive moderate to severe AS patients with preserved LVEF,and 30 healthy controls.Conventional echocardiography and 4D-strain imaging echocardiography were undergone in two groups.The 4D strain echocardiographic analyses were undertaken by using 4D Auto LVQ software.Results Compared with the healthy controls,the moderate to severe AS patients with preserved LVEF had significantly decreased global radial strain (GRS),global longitudinal strain (GLS),global area strain (GAS) and 4D strain (P < 0.05),had significantly increased left ventricular end-diastolic volume index (LVEDVI) and left ventricular mass index (LVMI) (P < 0.05),and had lower global circumferential strain (GCS) (P > 0.05).Conclusions Impaired LV myocardial contractility exists in moderate to severe AS patients,although LVEF is preserved.4D-strain imaging echocardiography can detect early left ventricular dysfunction in AS patients with preserved LVEF.

  19. Left Ventricular Regional Systolic Function in Patient with Hypertrophic Cardiomyopathy by Quantitative Tissue Velocity Imaging

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The left ventricular regional systolic functions in patients with hypertrophic cardiomyopathy (HCM) were assessed by using quantitative tissue velocity imaging (QTVI). Left ventricular (LV) regional myocardial velocity along long- and short-axis in 31 HCM patients and 20 healthy subjects were analyzed by QTVI, and the regional myocardial systolic peak velocities (MVS) were measured. Mean MVS at each level including mitral annular, basal, middle and apical segments were calculated. The ratio of MVS along long-axis to that along short-axis (Ri) at basal and middle segments of the LV posterior wall and ventricular septum were calculated. The results showed that mean MVS was slower at each level including mitral annular, basal, middle and apical segments in the HCM patients than that in the healthy subjects (P<0.01). There were no significant differences in mean MVS between obstructive and non-obstructive groups in HCM patients. MVS of all regional myocardial segments along long-axis in the HCM patients were significantly slower than that in the healthy subjects (P<0. 05), but there was no significant difference in MVS of all regional myocardial segments along long-axis between hypertrophied and non-hypertrophied group in the HCM patients. Ri was significantly lower in the HCM patients than that in the healthy subjects. The LV regional myocardial contractility along long-axis was impaired not only in the hypertrophied wall but also in the non-hypertrophied one in patients with HCM, suggesting that QTVI can assess accurately LV regional systolic function in patient with HCM and provides a novel means for an early diagnosis before and independent of hypertrophy.

  20. Effect of dofetilide in patients with recent myocardial infarction and left-ventricular dysfunction: a randomised trial

    DEFF Research Database (Denmark)

    Køber, L; Bloch Thomsen, P E; Møller, M;

    2000-01-01

    -ventricular dysfunction after myocardial infarction. METHODS: In 37 Danish coronary-care units, 1510 patients with severe left-ventricular dysfunction (wall motion index double-blind study comparing dofetilide (n=749) with placebo...... [31%] vs 243 [32%]), cardiac mortality (191 [26%] vs 212 [28%]), or total arrhythmic deaths (129 [17%] vs 140 [18%]). Atrial fibrillation or flutter was present in 8% of the patients at study entry. In these patients, dofetilide was significantly better than placebo at restoring sinus rhythm (25 of 59...... vs seven of 56; p=0.002). There were seven cases of torsade de pointes ventricular tachycardia, all in the dofetilide group. INTERPRETATION: In patients with severe left-ventricular dysfunction and recent myocardial infarction, treatment with dofetilide did not affect all-cause mortality, cardiac...

  1. Prevention of disease progression by cardiac resynchronization therapy in patients with asymptomatic or mildly symptomatic left ventricular dysfunction: insights from the European cohort of the REVERSE (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction) trial

    DEFF Research Database (Denmark)

    Daubert, Claude; Gold, Michael R; Abraham, William T;

    2009-01-01

    that CRT slows disease progression and improves the outcomes of asymptomatic or mildly symptomatic patients with left ventricular (LV) dysfunction and a wide QRS complex. METHODS: We randomly assigned 262 recipients of CRT pacemakers or defibrillators, with QRS > or =120 ms and LV ejection fraction......OBJECTIVES: The aim of this study was to determine the long-term effects of cardiac resynchronization therapy (CRT) in the European cohort of patients enrolled in the REVERSE (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction) trial. BACKGROUND: Previous data suggest...... composite response. The main secondary study end point was left ventricular end-systolic volume index (LVESVi). RESULTS: In the CRT ON group, 19% of patients were worsened versus 34% in the CRT OFF group (p = 0.01). The LVESVi decreased by a mean of 27.5 +/- 31.8 ml/m(2) in the CRT ON group versus 2...

  2. A Case of Isolated Left Ventricular Noncompaction with Basal ECG-Tracing Strongly Suggestive for Type-2 Brugada Syndrome

    Directory of Open Access Journals (Sweden)

    Maria Banci

    2011-01-01

    Full Text Available Isolated left ventricular noncompaction (ILVNC is a cardiomyopathy caused by intrauterine arrest of compaction of the myocardial fibres and meshwork, an important process in myocardial development. ILVNC is clinically accompanied by depressed ventricular function, arrhythmias, and systemic embolization. We reported a case of ILVNC with basal ECG-tracing strongly suggestive for type-2 Brugada syndrome (BrS. Up to now, this is the first report investigating the association between ILVNC and this particular ECG pattern.

  3. Study of left ventricular diastolic dysfunction in recently diagnosed hypertensives in Central Nepal

    Directory of Open Access Journals (Sweden)

    Shankar Laudari

    2016-03-01

    Full Text Available CORRECTION: The conclusion on the PDF of this article was replaced on 17th April 2016. The corrected PDF is now available by clicking on the link below.Background & Objectives: Ectopic Left ventricular diastolic dysfunction is now well established as a cause of left sided heart failure and as a powerful predictor of cardiovascular events. It is attributed mostly to systemic hypertension. The objective of the study was to determine the prevalence of left ventricular diastolic dysfunction in recently diagnosed hypertensives in Nepalese population using echocardiography. Materials & Methods: Two-dimensional echocardiography was performed on 120 newly diagnosed patients of systemic hypertension. Transmitral Doppler indexes of diastolic function, Valsalva maneuver applied to the same mitral inflow pattern, pulsed tissue Doppler of the mitral annulus, deceleration time, isovolumic relaxation time and pulmonary venous flow pattern.Results: The age of the patients in our study ranged from 20 to 84 years with mean age of 50years±14.13 years (standard deviation and male:female ratio being 1.35:1. Hypertensive patients were highest in age group 45-64 years followed by 25-44 years in both the genders. Majority of the patients had stage 1 hypertension (44.16% followed by stage 2 HTN in 34.17% and pre-hypertension in 21.67%. The majority of the patients in our study had Grade 1 LVDD (66.67%, 10.83% patients had Grade II LVDD, only 2.50% had non-restrictive Grade III LVDD and none had LVDD-IV. Stage II hypertensives had more LVDD(I+II+III: 39/41-95.12% than stage I hypertensives(39/53-73.58% and pre-hypertensives (8/26-30.77%. The association between stages of systemic HTN and LVDD was found to be highly statistically significant (p=0.002. Conclusion: Our study showed that left ventricular diastolic dysfunction is a common entity in Nepalese population with systemic hypertension.JCMS Nepal. 2016;12(1:14-18.

  4. The thick left ventricular wall of the giraffe heart normalises wall tension, but limits stroke volume and cardiac output.

    Science.gov (United States)

    Smerup, Morten; Damkjær, Mads; Brøndum, Emil; Baandrup, Ulrik T; Kristiansen, Steen Buus; Nygaard, Hans; Funder, Jonas; Aalkjær, Christian; Sauer, Cathrine; Buchanan, Rasmus; Bertelsen, Mads Frost; Østergaard, Kristine; Grøndahl, Carsten; Candy, Geoffrey; Hasenkam, J Michael; Secher, Niels H; Bie, Peter; Wang, Tobias

    2016-02-01

    Giraffes--the tallest extant animals on Earth--are renowned for their high central arterial blood pressure, which is necessary to secure brain perfusion. Arterial pressure may exceed 300 mmHg and has historically been attributed to an exceptionally large heart. Recently, this has been refuted by several studies demonstrating that the mass of giraffe heart is similar to that of other mammals when expressed relative to body mass. It thus remains unexplained how the normal-sized giraffe heart generates such massive arterial pressures. We hypothesized that giraffe hearts have a small intraventricular cavity and a relatively thick ventricular wall, allowing for generation of high arterial pressures at normal left ventricular wall tension. In nine anaesthetized giraffes (495±38 kg), we determined in vivo ventricular dimensions using echocardiography along with intraventricular and aortic pressures to calculate left ventricular wall stress. Cardiac output was also determined by inert gas rebreathing to provide an additional and independent estimate of stroke volume. Echocardiography and inert gas-rebreathing yielded similar cardiac outputs of 16.1±2.5 and 16.4±1.4 l min(-1), respectively. End-diastolic and end-systolic volumes were 521±61 ml and 228±42 ml, respectively, yielding an ejection fraction of 56±4% and a stroke volume of 0.59 ml kg(-1). Left ventricular circumferential wall stress was 7.83±1.76 kPa. We conclude that, relative to body mass, a small left ventricular cavity and a low stroke volume characterizes the giraffe heart. The adaptations result in typical mammalian left ventricular wall tensions, but produce a lowered cardiac output. PMID:26643090

  5. THE EFFECT OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION ON THE PATHOGENESIS OF ANGINA DECUBITUS

    Institute of Scientific and Technical Information of China (English)

    陈纪林; 高润霖; 姚康宝; 杨跃进; 秦学文; 乔树宾; 姚民

    2000-01-01

    Objective. To investigate the effect of left veraricular diastolic dysfunction on the pathogenesis of angina decubitus (AD).Methods. The study population consisted of three groups: 20 individuals without cardiovascular disease were studied as group Ⅰ . Group Ⅱ included 20 patents with coronary artery disease and without AD. Thirty-one patients with AD and ejection fraction(EF) > 50% were studied as group Ⅲ. Group Ⅱ and Ⅲ were matched for age, EF and extent of coronary artery disease.Results. Left ventricnlography (LVG) showed that left ventricnlar (LV) first 1/3 filling fraction (1/3FF) was significantly lower in group Ⅲ than in group Ⅱ and Ⅰ (both P <0.001),but LV late 1/3 FF was much higher in group Ⅲ than in group Ⅱ and Ⅰ (P < 0.05, P < 0.01). Left ventricular end-diastohc presstrre(LVEDP) was markedly inereased before and after LVGin group Ⅱ and Ⅲ as compared with group Ⅰ (beth P<0.05, beth P<0.001). The difference of LVEDP caused by left atrial contraction (left atrial contraction pressure difference, LACPD) before and after LVG was much higher in group Ⅲ than in group Ⅰ ( P < 0.01, P < 0.001). Howevere, there were significant differences in LVEDP and in LACPD between before and after LVG only in group Ⅲ (both P < 0.01).Conclusion. The patients with AD have LV diastolic dysfunction, which may be closely related to the pathogen-esis of angina decubitus.

  6. Left and right ventricular diastolic dysfunction and diastolic heart failure: does one lead to the other?

    Institute of Scientific and Technical Information of China (English)

    Faramarz Tehrani; Anita Phan; Ernst R. Schwarz

    2009-01-01

    Background and Objective Diastolic dysfunction of the left ventricle is a mechanical abnormality diagnosed primarily by echocardiogram, and can be distinguished into three separate degrees based on the severity of reduction in passive compliance and active myocardial relaxation. Methods A literature search was performed for basic science studies, clinical studies and major practice guidelines on the subject of diastolic dysfunction and diastolic heart failure. Important findings were analyzed and correlated with regard to clinical relevance. Results Left ventricular diastolic dysfunction appears to compromise exercise tolerance and is believed to contribute to the pathophysiology in patients with diastolic heart failure. In the clinical setting, however, oftentimes no clear distinction is made between echocardiographically diagnosed diastolic dysfunction and diastolic heart failure, and adequate treatment recommendations are sparse and aimed to prevent worsening and progression of clinical symptoms. To date, there is a lack of high powered trials assessing the possible progression rate from echocardiographically diagnosed diastolic dysfunction to the clinical diagnosis of diastolic heart failure. Furthermore, there are no solid indices to assess the degree of severity of diastolic dysfunction or its progression. Pure right ventricular diastolic dysfunction appears to be even less understood and under-recognized, although it may play a role in the development of both right and left heart failure. Currently there are few but interesting data on the possible interaction between ventricles with diastolic dysfunction and the overall affect on the development of heart failure. Conclusions The timeline and progression of diastolic dysfunction to diastolic heart failure have not been well established and warrant further investigation.

  7. Evaluation of left ventricular mechanical dyssynchrony in chronic heart failure patients by two-dimensional speckle tracking imaging.

    Science.gov (United States)

    Jiang, Feng-Xia; Guo, Rui-Qiang; Chen, Jin-Ling

    2013-07-01

    The purpose of this study was to evaluate left ventricular mechanical dyssynchrony (LVMD) in chronic heart failure (CHF) patients using two-dimensional speckle tracking imaging (2D-STI), and also to compare the usefulness of three patterns of myocardial deformation in mechanical dyssynchrony assessment. Furthermore, the relationships between left ventricular ejection fraction (LVEF), QRS duration (QRSd), and LVMD were explored. In total, 78 patients and 60 healthy individuals (group 3) were enrolled. The patients were classified into two subgroups: LVEF≤35% (group 1), 35%0.05). CHF patients have different extents of LVMD. Longitudinal deformation shows the best detectability of dyssynchrony motion. Left ventricular systolic function was closely related to mechanical dyssynchrony, whereas QRSd showed no significant correlation.

  8. The left ventricular contractility of the rat heart is modulated by changes in flow and a1-adrenoceptor stimulation

    Directory of Open Access Journals (Sweden)

    P.F. Vassallo

    1998-10-01

    Full Text Available Myocardial contractility depends on several mechanisms such as coronary perfusion pressure (CPP and flow as well as on a1-adrenoceptor stimulation. Both effects occur during the sympathetic stimulation mediated by norepinephrine. Norepinephrine increases force development in the heart and produces vasoconstriction increasing arterial pressure and, in turn, CPP. The contribution of each of these factors to the increase in myocardial performance needs to be clarified. Thus, in the present study we used two protocols: in the first we measured mean arterial pressure, left ventricular pressure and rate of rise of left ventricular pressure development in anesthetized rats (N = 10 submitted to phenylephrine (PE stimulation before and after propranolol plus atropine treatment. These observations showed that in vivo a1-adrenergic stimulation increases left ventricular-developed pressure (Pa1-adrenoceptors and increased flow, increased cardiac performance acting simultaneously and synergistically.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    conditions prior to and during a simulated hemorrhagic challenge. Heat stress did not change indices of diastolic function. Subsequent volume infusion elevated indices of diastolic function, specifically early diastolic mitral annular tissue velocity (E') and early diastolic propagation velocity (E) relative......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...

  10. Increased left ventricular ejection fraction after a meal: potential source of error in performance of radionuclide angiography

    International Nuclear Information System (INIS)

    The effect of a standardized meal on left ventricular (LV) ejection fraction (EF) was determined by equilibrium radionuclide angiography in 16 patients with stable congestive heart failure but without pulmonary or valvular heart disease. LVEF was determined in the fasting state and 15, 30, and 45 minutes after a meal. Patients with moderately depressed fasting LVEF (30 to 50%), Group I, had a mean increase of 6.9 +/- 2.9% (p less than 0.005) in the LVEF at 45 minutes after the meal. Patients with severely depressed fasting LVEF (less than 30%), Group II, had no change after the meal. It is concluded that significant increases in LVEF may occur after meals in patients with moderate but not severe left ventricular dysfunction. Equilibrium radionuclide angiography studies that are not standardized for patients' mealtimes may introduce an important unmeasured variable that will affect the validity of data in serial studies of left ventricular function

  11. Acute impact of pacing at different cardiac sites on left ventricular rotation and twist in dogs.

    Directory of Open Access Journals (Sweden)

    Zhi-Wen Zhou

    Full Text Available We evaluated the acute impact of different cardiac pacing sites on two-dimensional speckle-tracking echocardiography (STE derived left ventricular (LV rotation and twist in healthy dogs.Twelve dogs were used in this study. The steerable pacing electrodes were positioned into right heart through the superior or inferior vena cava, into LV through aorta across the aortic valve. The steerable pacing electrodes were positioned individually in the right atrium (RA, right ventricular apex (RVA, RV outflow tract (RVOT, His bundle (HB, LV apex (LVA and LV high septum (LVS, individual pacing mode was applied at 10 minutes interval for at least 5 minutes from each position under fluoroscopy and ultrasound guidance and at stabilized hemodynamic conditions. LV short-axis images at the apical and basal levels were obtained during sinus rhythm and pacing. Offline STE analysis was performed. Rotation, twist, time to peak rotation (TPR, time to peak twist (TPT, and apical-basal rotation delay (rotational synchronization index, RSI values were compared at various conditions. LV pressure was monitored simultaneously.Anesthetic death occurred in 1 dog, and another dog was excluded because of bad imaging quality. Data from 10 dogs were analyzed. RVA, RVOT, HB, LVA, LVS, RARV (RA+RVA pacing resulted in significantly reduced apical and basal rotation and twist, significantly prolonged apical TPR, TPT and RSI compared to pre-pacing and RA pacing (all P<0.05. The apical and basal rotation and twist values were significantly higher during HB pacing than during pacing at ventricular sites (all P<0.05, except basal rotation at RVA pacing. The apical TPR during HB pacing was significantly shorter than during RVOT and RVA pacing (both P<0.05. The LV end systolic pressure (LVESP was significantly lower during ventricular pacing than during pre-pacing and RA pacing.Our results show that RA and HB pacing results in less acute reduction on LV twist, rotation and LVESP compared

  12. Prognostic value of 18F-FDG positron emission tomography in patients with coronary artery disease and left ventricular dysfunction

    International Nuclear Information System (INIS)

    Objective: To evaluate the prognostic value of 18F-FDG positron emission tomography (PET) in patients (pts) with coronary artery disease (CAD)and left ventricular dysfunction and to clarify whether revascularization (RVS) will decrease the cardiac events in pts with myocardial perfusion-metabolism mismatch(MM). Methods: 107 consecutive pts (mean age 57 +- 9 yr.) with CAD and left ventricular dysfunction [left ventricular ejection fraction (LVEF)=(38 +- 9)%] who underwent 18F-FDG PET imaging and 99Tcm-MIBI SPECT imaging were followed up for (24 +- 5) months. Myocardial segments were classified as myocardial perfusion-metabolism mismatch (MM) and match (M). LVEF and left ventricular end diastolic diameter (LVEDD) were measured with echocardiography (Echo). Results: Fifty-nine pts underwent RVS and 48 pts underwent medical therapy. Three months (POS1) and 6 months (POS2) after RVS, Echo was performed on forty-six pts and 23 pts, respectively. Cardiac death, myocardial infarction, unstable angina pectoris and late RVS (>3 mon) were considered as cardiac events. Among 64 patients with 2 or more MM segments, 35 pts received RVS (MM1) and 29 pts received medical therapy (MM2). Among 43 pts with less than 2 MM segments, 24 pts underwent RVS (M1) and 19 pts underwent medical therapy (M2). After RVS, LVEF in MM1 was increased from (38 +- 8)% to (48 +- 10)% (P0.05). The cardiac event rate of 51.7% (15/29) in MM2 was significantly higher than that of 2.9% (1/35) in MM1 (x2 = 20.14, P2 = 7.02, P24.52, P<0.05). Conclusions: The results suggest that the presence of MM in pts with CAD and left ventricular dysfunction is associated with poor prognosis on medical therapy, and these pts may need aggressive RVS to prevent a future cardiac event and to improve left ventricular function

  13. Use of echocardiographic subxiphoid five-sixth area length (bullet method in evaluation of adequacy of borderline left ventricle in hypoplastic left heart complex

    Directory of Open Access Journals (Sweden)

    Justin T Tretter

    2015-01-01

    Full Text Available Indexed left ventricular end-diastolic volume (ILVEDV is commonly used in evaluating "borderline left ventricle (LV" in hypoplastic left heart complex (HLHC to determine if the LV can sustain adequate systemic cardiac output. Commonly used quantification methods include biplane Simpson or the traditional five-sixth area length "bullet" methods, which have been shown to underestimate true LV volumes, when septal position is mildly abnormal. Subxiphoid five-sixth area length method is proposed as a more accurate estimate of true LV volume in the evaluation of borderline LV.

  14. Surgery for left ventricular aneurysm after myocardial infarction:techniques selection and results assessment

    Institute of Scientific and Technical Information of China (English)

    CHEN Xin; QIU Zhi-bing; XU Ming; LIU Le-le; JIANG Ying-shuo; WANG Li-ming

    2012-01-01

    Background The most appropriate surgical approach for patients with post-infarction left ventricular (LV) aneurysm remains undetermined.We compared the efficacy of the linear versus patch repair techniques,and investigated the mid-term changes of LV geometry and cardiac function,for repair of LV aneurysms.Methods We reviewed the records of 194 patients who had surgery for a post-infarction LV aneurysm between 1998 and 2010.Short-term and mid-term outcomes,including complications,cardiac function and mortality,were assessed.LV end-diastolic and systolic dimensions (LVEDD and LVESD),LV end-diastolic and end-systolic volume indexes (LVEDVI and LVESVI) and LV ejection fraction (LVEF) were measured on pre-operative and follow-up echocardiography.Results Overall in-hospital mortality was 4.12%,and major morbidity showed no significant differences between the two groups.Multivariate analysis identified preoperative left ventricular end diastolic pressure >20 mmHg,low cardiac output and aortic clamping time >2 hours as risk factors for early mortality.Follow-up revealed that LVEF improved from 37% pre-operation to 45% 12 months post-operation in the patch group (P=0.008),and from 44% pre-operation to 40% 12 months postoperation in the linear group (P=0.032).In contrast,the LVEDVI and LVESVI in the linear group were significantly reduced immediately after the operation,and increased again at follow-up.However,in the patch group,the LVEDVI and LVESVI were significantly reduced at follow-up.And there were significant differences in the correct value changes of LVEF and left ventricular remodeling between linear repair and patch groups.Conclusions Persistent reduction of LV dimensions after the patch repair procedure seems to be a procedure-related problem.The choice of the technique should be tailored on an individual basis and surgeon's preference.The patch remodeling technique results in a better LVEF improvement,further significant reductions in LV dimensions

  15. Analysis of Left Ventricular Functional Parameters in Normal Korean Subjects by ECG Gated Blood Pool Scan

    International Nuclear Information System (INIS)

    The demand for refinement in noninvasive and quantitative assessment of left ventricular (LU) function is increasing. To assess normal values of left ventricular functional parameters during both systole and diastole by scintigraphic method using computerized triple-head gamma camera and to evaluate correlations between these parameters. ECG gated blood pool scan with 99mTc-Human serum albumin was performed in 94 normal Korean subjects. Ejection fraction (EF), systolic parameters [peak emptying rate (PER), average emptying rate (AER), time to peak emptying rate (TPER)], and diastolic parameters [peak filling rate (PFR), average filling rate (AFR), time to peak filling rate (TPFR)] were obtained by analysis of LV time-activity curve, the correlation of these parameters to the age and sex, and the correlation between these parameters were evaluated. 1) Mean value of ejection fraction in study subjects was 59.6 ± 5.25% and showed no significant correlation to age (r=0.08) and sex but showed most pronounced correlation to PFR (r=0.46, p<0.001), PER (r=0.41, p<0.001), AFR (r=0.34, p<0.001) and AER (r=0.28, p<0.01). 2) Mean values of systolic parameters were as follows: PER=3.22 + 0.50 end-diastolic volume/sec, AER =2.22 + 0.45 end-diastolic volume/sec, TPER=103.5 + 29.30 msec. They showed no significant correlation to age and sex. 3) Mean values of diastolic parameters were as follows: PFR=2.71+0.51 end-diastolic volume/sec, AFR=1.830.44 end-diastolic volume/sec, TPFR=132.1 + 33.45 msec. They showed strong correlation to age (r=-0/70, -0.64, 0.37, p<0.001). Left ventricular functional parameters in normal Korean subjects were obtained reliably by computerized scintigraphic method and may be applied to the evaluation of cardiac function in diseased patients.

  16. A new index of cardiac left ventricular synergic pumping efficiency to detect kinematically subtle coronary artery disease

    International Nuclear Information System (INIS)

    Detection of kinematically subtle coronary artery disease (CAD) is quite difficult when there is normal global left ventricular ejection fraction response to supine ergometric (isotonic) exercise. A new index of left ventricular synergic pumping efficiency (LV-SPE) has been defined conceptually and mathematically. Hand-grip (isometric) stress induced change of LV-SPE has been found to be a very useful parameter in detecting CAD in the presence of minimally produced wall motion abnormalities, which are liable to be otherwise scintigraphically too blurred when evaluated by isotonic exercise methods and thus evade proper analysis. (author). 21 refs., 2 figs., 1 tab

  17. Regression of electrocardiographic left ventricular hypertrophy during antihypertensive therapy and reduction in sudden cardiac death: the LIFE Study

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Okin, Peter M; Olsen, Michael H;

    2007-01-01

    BACKGROUND: Sudden cardiac death (SCD) occurs more often in patients with ECG left ventricular (LV) hypertrophy. However, whether LV hypertrophy regression is associated with a reduced risk of SCD remains unclear. METHODS AND RESULTS: The Losartan Intervention for End Point Reduction in Hypertens......BACKGROUND: Sudden cardiac death (SCD) occurs more often in patients with ECG left ventricular (LV) hypertrophy. However, whether LV hypertrophy regression is associated with a reduced risk of SCD remains unclear. METHODS AND RESULTS: The Losartan Intervention for End Point Reduction...

  18. Catheter-based intervention for symptomatic patient with severe mitral regurgitation and very poor left ventricular systolic function

    DEFF Research Database (Denmark)

    Loh, Poay Huan; Bourantas, Christos V; Chan, Pak Hei;

    2015-01-01

    Many patients with left ventricular systolic dysfunction have concomitant mitral regurgitation (MR). Their symptoms and prognosis worsen with increasing severity of MR. Percutaneous MitraClip(®) can be used safely to reduce the severity of MR even in patients with advanced heart failure and is as......Many patients with left ventricular systolic dysfunction have concomitant mitral regurgitation (MR). Their symptoms and prognosis worsen with increasing severity of MR. Percutaneous MitraClip(®) can be used safely to reduce the severity of MR even in patients with advanced heart failure...

  19. Deformation of the left and right ventricular longitudinal myocardium in fetuses with umbilical cord around neck

    Institute of Scientific and Technical Information of China (English)

    ZUO Dong-mei; WANG Chao-hong; WANG Yue-heng

    2012-01-01

    Background Umbilical cord around neck,a common obstetric complication,affects fetal hemodynamics.Does it influence fetal cardiac functions? The purpose of this study was to investigate the left and right ventricular systolic and diastolic functions of fetuses with umbilical cord around neck in the third trimester by applying velocity vector imaging (VVI).Methods Thirty-five cases of fetuses with umbilical cord around neck whose gestational ages from 35 to 40 weeks were selected,including 20 cases of umbilical artery ratio of the highest systolic velocity (S) to the lowest diastolic velocity (D) (S/D) <3.0 and 15 cases of umbilical artery S/D ≥3.0,while 20 cases of normal fetuses of 35-40 gestational weeks were selected as the control group.The changes in longitudinal velocity,strain,and strain rate of fetal left and right ventricle in systole and diastole in two groups,and the changes in fetal cardiac function under the situation of umbilical cord around neck were analyzed.Results Longitudinal strain and strain rate overall of fetal left and right ventricle in systole and diastole were less in fetuses with umbilical artery S/D ≥3.0 and umbilical cord around neck than those in fetuses with umbilical artery S/D <3.0and those in control group (P <0.05); there was no significant difference (P >0.05) in longitudinal strain and strain rate overall of fetal left and right ventricle in systole and diastole between fetuses with umbilical artery S/D <3.0 and those in control group.Conclusions Left and right ventricular systolic and diastolic dysfunction was detected in fetuses with umbilical cord around neck and umbilical artery S/D ≥3.0.WI could sensitively respond to cardiac function changes in fetuses with umbilical cord around neck,which provides another valuable method in the evaluation of fetal cardiac function.

  20. An evaluation of the left atrial/aortic root ratio in children with ventricular septal defect.

    Science.gov (United States)

    Lester, L A; Vitullo, D; Sodt, P; Hutcheon, N; Arcilla, R

    1979-08-01

    Echocardiograms were performed in 80 infants and children with isolated ventricular septal defect (VSD) who underwent cardiac catheterization. The pulmonary-to-systemic flow ratio (Qp/Qs) was correlated with the echocardiographic left atrial-to-aortic root diameter ratio (LA/Ao), and a relatively poor correlation (r = 0.62) was found. The end-systolic diameters of the left atrium and aorta at the level of the aortic root, obtained from lateral cineangiograms of 55 of the 80 patients, were compared with the corresponding echocardiographic dimensions. To assess the possible effect of transducer beam angulation upon the echocardiographic determinations, the angiographic measurements were made at 0 degrees position (perpendicular to the frontal plane) and at angles of 5 degrees, 10 degrees, 15 degrees and 20 degrees from zero, using the aortic root center as the point of intersection. The echocardiographic and angiographic aortic root measurements were comparable (r = 0.95), and the angiographically derived aortic diameter did not vary with different angle projections. However, the left atrial angiographic dimensions were significantly influenced by the angle of projection. We conclude that the echocardiographic LA/Ao ratio cannot reliably estimate the severity of the shunt flow in VSD.

  1. Exercise testing in asymptomatic or minimally symptomatic aortic regurgitation: relationship of left ventricular ejection fraction to left ventricular filling pressure during exercise

    International Nuclear Information System (INIS)

    Exercise radionuclide angiography is being used to evaluate left ventricular function in patients with aortic regurgitation. Ejection fraction is the most common variable analyzed. To better understand the rest and exercise ejection fraction in this setting, 20 patients with asymptomatic or minimally symptomatic severe aortic regurgitation were studied. All underwent simultaneous supine exercise radionuclide angiography and pulmonary gas exchange measurement and underwent rest and exercise measurement of pulmonary artery wedge pressure (PAWP) during cardiac catheterization. Eight patients had a peak exercise PAWP less than 15 mm Hg (group 1) and 12 had a peak exercise PAWP greater than or equal to 15 mm Hg (group 2). Group 1 patients were younger and more were in New York Heart Association class I. The two groups had similar cardiothoracic ratios, changes in ejection fractions with exercise, and rest and exercise regurgitant indexes. Using multiple regression analysis, the best correlate of the exercise PAWP was peak oxygen uptake (r . -0.78, p less than 0.01). No other measurement added significantly to the regression. When peak oxygen uptake was excluded, rest and exercise ejection fraction also correlated significantly (r . -0.62 and r . -0.60, respectively, p less than 0.01). Patients with asymptomatic or minimally symptomatic severe aortic regurgitation have a wide spectrum of cardiac performance in terms of the PAWP during exercise. The absolute rest and exercise ejection fraction and the level of exercise achieved are noninvasive variables that correlate with exercise PAWP in aortic regurgitation, but the change in ejection fraction with exercise by itself is not

  2. Effect of pericardiocentesis on right and left ventricular function and volumes in pericardial effusion.

    Science.gov (United States)

    Manyari, D E; Kostuk, W J; Purves, P

    1983-07-01

    To assess the effects of pericardial effusion on ventricular performance and volumes, electrocardiographically gated blood pool cardiac scintigraphy was performed immediately before and after 14 pericardiocenteses in 10 patients, 7 men and 3 women, aged 28 to 73 years (mean 50). Cardiac tamponade was present in 5 patients. After removal of 140 to 1,100 ml of pericardial fluid (527 +/- 305 ml [mean +/- standard deviation]), left ventricular (LV) ejection fraction increased from 63 +/- 5 to 64 +/- 4% (p greater than 0.05) and right ventricular (RV) ejection fraction decreased from 47 +/- 4 to 46 +/- 2% (p greater than 0.05). LV end-diastolic and end-systolic volumes increased (p less than 0.01) by 28 and 33%, and RV volumes by 40 and 43%, respectively. There were 8 patients with normal LV function (ejection fraction greater than 60%) and 6 patients with subnormal LV function. Changes in ejection fraction were nonsignificant in the 4 subgroups. LV end-diastolic volume changes were more marked (p less than 0.01) in patients with cardiac tamponade (+ 56%) than in those without tamponade (+ 17%), and in those with normal LV function (+ 36%) than in those with subnormal LV function (+ 21%). RV end-diastolic volume increased more markedly (p less than 0.05) in patients with tamponade (+ 72%) than in those without tamponade (+ 23%), but were similar in patients with normal (+ 38%) and abnormal (+ 43%) LV function. After pericardiocentesis, RV volume increased more markedly than did LV volume. Thus, hemodynamic and clinical improvement after pericardiocentesis may be related only to an increase in stroke volume. RV and LV ejection fraction, a measure of myocardial contractility, was not affected significantly by the presence of pericardial effusion, even in those patients who had cardiac tamponade.

  3. Computer-based assessment of left ventricular wall stiffness in patients with ischemic dilated cardiomyopathy

    Science.gov (United States)

    Su, Y.; Teo, S. K.; Tan, R. S.; Lim, C. W.; Zhong, L.

    2013-02-01

    Ischemic dilated cardiomyopathy (IDCM) is a degenerative disease of the myocardial tissue accompanied by left ventricular (LV) structural changes such as interstitial fibrosis. This can induce increased passive stiffness of the LV wall. However, quantification of LV passive wall stiffness in vivo is extremely difficult, particularly in ventricles with complex geometry. Therefore, we sought to (i) develop a computer-based assessment of LV passive wall stiffness from cardiac magnetic resonance (CMR) imaging in terms of a nominal stiffness index (E*); and (ii) investigate whether E* can offer an insight into cardiac mechanics in IDCM. CMR scans were performed in 5 normal subjects and 5 patients with IDCM. For each data sample, an in-house software was used to generate a 1-to-1 corresponding mesh pair of the LV from the ED and ES phases. The E* values are then computed as a function of local ventricular wall strain. We found that E* in the IDCM group (40.66 - 215.12) was at least one order of magnitude larger than the normal control group (1.00 - 6.14). In addition, the IDCM group revealed much higher inhomogeneity of E* values manifested by a greater spread of E* values throughout the LV. In conclusion, there is a substantial elevated ventricular stiffness index in IDCM. This would suggest that E* could be used as discriminator for early detection of disease state. The computational performance per data sample took approximately 25 seconds, which demonstrates its clinical potential as a real-time cardiac assessment tool.

  4. Evaluation of Physiological Control Systems for Rotary Left Ventricular Assist Devices: An In-Vitro Study.

    Science.gov (United States)

    Pauls, Jo P; Stevens, Michael C; Bartnikowski, Nicole; Fraser, John F; Gregory, Shaun D; Tansley, Geoff

    2016-08-01

    Rotary left ventricular assist devices (LVADs) show weaker response to preload and greater response to afterload than the native heart. This may lead to ventricular suction or pulmonary congestion, which can be deleterious to the patient's recovery. A physiological control system which optimizes responsiveness of LVADs may reduce adverse events. This study compared eight physiological control systems for LVAD support against constant speed mode. Pulmonary (PVR) and systemic (SVR) vascular resistance changes, a passive postural change and exercise were simulated in a mock circulation loop to evaluate the controller's ability to prevent suction and congestion and to increase exercise capacity. Three active and one passive control systems prevented ventricular suction at high PVR (500 dyne s cm(-5)) and low SVR (600 dyne s cm(-5)) by decreasing LVAD speed (by 200-515 rpm) and by increasing LVAD inflow cannula resistance (up to 1000 dyne s cm(-5)) respectively. These controllers increased LVAD preload sensitivity (to 0.196-2.415 L min(-1) mmHg(-1)) compared to the other control systems and constant speed mode (0.039-0.069 L min(-1) mmHg(-1)). The same three active controllers increased pump speed (600-800 rpm) and thus LVAD flow by 4.5 L min(-1) during exercise which increased exercise capacity. Physiological control systems that prevent adverse events and/or increase exercise capacity may help improve LVAD patient conditions. PMID:26833037

  5. Clinical usefulness of cine MRI for evaluation of left ventricular volume and diagnosis of heart and great vessel diseases

    Energy Technology Data Exchange (ETDEWEB)

    Kondo, Takeshi; Anno, Hirofumi; Uritani, Tomizo (Fujita-Gakuen Health Univ., Toyoake, Aichi (Japan)) (and others)

    1990-01-01

    ECG-gated cine mode magnetic resonance (MR) imaging was performed in 20 patients with various heart deseases. Left ventricular volume (LVV) and left ventricular ejection fraction (LVEF) were calculated on MR images obtained in left ventricular vertical and horizontal long axis views. The findings were compared with those obtained from left ventriculography. There was a significant positive correlation between MR imaging and ventriculography for both LVV and LVEF (p<0.001). In Marfan syndrome after surgery for dissecting aneurysm of the aorta, MR imaging was capable of visualizing not only the whole aorta in a single plane but also enlargement of the aortic root. It also depicted asynergy and thinned wall of the infarcted myocardium for myocardial infarction; an enlarged left auricle, the thickened septum, and constricted outflow tract for idiopathic hypertrophic subaortic stenosis; shunt flow for ventricular septum defect; and an enlarged aortic root for aortitis syndrome. Using ventriculography as the standard, cine MR imaging was frequently false positive for the detection of mitral regurgitation. There was, however, good concordance between MR imaging and ventriculography in detecting aortic regurgitation. In addition, MR imaging was equivalent to color Doppler technique for detecting valvular regurgitation. (N.K.).

  6. Clinical usefulness of cine MRI for evaluation of left ventricular volume and diagnosis of heart and great vessel diseases

    International Nuclear Information System (INIS)

    ECG-gated cine mode magnetic resonance (MR) imaging was performed in 20 patients with various heart deseases. Left ventricular volume (LVV) and left ventricular ejection fraction (LVEF) were calculated on MR images obtained in left ventricular vertical and horizontal long axis views. The findings were compared with those obtained from left ventriculography. There was a significant positive correlation between MR imaging and ventriculography for both LVV and LVEF (p<0.001). In Marfan syndrome after surgery for dissecting aneurysm of the aorta, MR imaging was capable of visualizing not only the whole aorta in a single plane but also enlargement of the aortic root. It also depicted asynergy and thinned wall of the infarcted myocardium for myocardial infarction; an enlarged left auricle, the thickened septum, and constricted outflow tract for idiopathic hypertrophic subaortic stenosis; shunt flow for ventricular septum defect; and an enlarged aortic root for aortitis syndrome. Using ventriculography as the standard, cine MR imaging was frequently false positive for the detection of mitral regurgitation. There was, however, good concordance between MR imaging and ventriculography in detecting aortic regurgitation. In addition, MR imaging was equivalent to color Doppler technique for detecting valvular regurgitation. (N.K.)

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

    Directory of Open Access Journals (Sweden)

    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

  8. In vivo left ventricular function and collagen expression in aldosterone/salt-induced hypertension.

    Science.gov (United States)

    Ramirez-Gil, J F; Delcayre, C; Robert, V; Wassef, M; Trouve, P; Mougenot, N; Charlemagne, D; Lechat, P

    1998-12-01

    Cardiac fibrosis is linked to aldosterone-induced hypertension, but the effects on in vivo left ventricular (LV) function are not established. We studied the relations between in vivo LV function and aldosterone/salt cardiac fibrosis. Adult guinea pigs (GPs) were treated for 3 months with an aldosterone infusion and high-salt diet. This treatment induced arterial hypertension (+35%) and moderate LV hypertrophy (LVH; +60%) without right ventricular (RV) hypertrophy. Echo-Doppler LV assessment demonstrated unaltered cardiac output, stroke volume, or LV relaxation. Type I collagen messenger RNA (mRNA) was significantly increased in both ventricles (LV, +48%; RV, +77%) and accompanied by a significant increase in total collagen deposition (LV, from 0.52% in controls to 4.4% in treated GPs; RV, from 0.82 to 5.5% in treated GPs). Plasma norepinephrine levels increased 2.6-fold (p < 0.01) and correlated with the increase in collagen deposition in both ventricles. Collagen content was not correlated with hypertension or LVH. We conclude that aldosterone administration induces cardiac collagen accumulation and a sympathetic stimulation, which might preserve systolic and diastolic function. PMID:9869498

  9. Females have greater left ventricular twist mechanics than males during acute reductions to preload.

    Science.gov (United States)

    Williams, Alexandra M; Shave, Rob E; Stembridge, Mike; Eves, Neil D

    2016-07-01

    Compared to males, females have smaller left ventricular (LV) dimensions and volumes, higher ejection fractions (EF), and higher LV longitudinal and circumferential strain. LV twist mechanics determine ventricular function and are preload-dependent. Therefore, the sex differences in LV structure and myocardial function may result in different mechanics when preload is altered. This study investigated sex differences in LV mechanics during acute challenges to preload. With the use of conventional and speckle-tracking echocardiography, LV structure and function were assessed in 20 males (24 ± 6.2 yr) and 20 females (23 ± 3.1 yr) at baseline and during progressive levels of lower body negative pressure (LBNP). Fourteen participants (8 males, 6 females) were also assessed following a rapid infusion of saline. LV end-diastolic volume, end-systolic volume, stroke volume (SV), and EF were reduced in both groups during LBNP (P mechanics following saline infusion. Females have larger LV twist and a faster untwisting velocity than males during large reductions to preload, supporting that females have a greater reliance on LV twist mechanics to maintain SV during severe reductions to preload.

  10. Cardiac resynchronization therapy: Dire need for targeted left ventricular lead placement and optimal device programming

    Institute of Scientific and Technical Information of China (English)

    Sokratis; Pastromas; Antonis; S; Manolis

    2014-01-01

    Cardiac resynchronization therapy(CRT) effected via biventricular pacing has been established as prime therapy for heart failure patients of New York Heart Association functional class Ⅱ, Ⅲ and ambulatory Ⅳ, reduced left ventricular(LV) function, and a widened QRS complex. CRT has been shown to improve symptoms, LV function, hospitalization rates, and survival. In order to maximize the benefit from CRT and reduce the number of non-responders, consideration should be given to target the optimal site for LV lead implantation away from myocardial scar and close to the latest LV site activation; and also to appropriately program the device paying particular attention to optimal atrioventricular and interventricular intervals. We herein review current data related to both optimal LV lead placement and device programming and their effects on CRT clinical outcomes.

  11. Carney complex with right ventricular myxoma following second excision of left atrial myxoma.

    Science.gov (United States)

    Tamura, Yamato; Seki, Toshio

    2014-01-01

    We report a case of Carney complex with massive right ventricular myxoma after two-time excision of a left atrial myxoma. The patient was a 45-year-old woman with pyrexia. She temporarily lost consciousness during examination, and echocardiography and computed tomography (CT) showed a massive tumor in the right ventricle. Loss of consciousness was determined to be caused by intracardiac obstruction of blood flow due to the tumor, and corrective surgery was performed. Pathological findings indicated myxoma with no malignancy. Myxomas are benign, but there is frequent recurrence of tumors associated with Carney complex. Because her myxomas were accompanied by unusual skin pigmentation, she was diagnosed with Carney complex. Carney complex has a high rate of myxoma recurrence, and often runs in families. In all cases, it is necessary to observe the patient's course closely.

  12. Left ventricular motion reconstruction with a prolate spheroidal B-spline model

    Energy Technology Data Exchange (ETDEWEB)

    Li Jin; Denney, Thomas S Jr [Electrical and Computer Engineering Department, 200 Broun Hall, Auburn University, AL 36849-5201 (United States)

    2006-02-07

    Tagged cardiac magnetic resonance (MR) imaging can non-invasively image deformation of the left ventricular (LV) wall. Three-dimensional (3D) analysis of tag data requires fitting a deformation model to tag lines in the image data. In this paper, we present a 3D myocardial displacement and strain reconstruction method based on a B-spline deformation model defined in prolate spheroidal coordinates, which more closely matches the shape of the LV wall than existing Cartesian or cylindrical coordinate models. The prolate spheroidal B-spline (PSB) deformation model also enforces smoothness across and can compute strain at the apex. The PSB reconstruction algorithm was evaluated on a previously published data set to allow head-to-head comparison of the PSB model with existing LV deformation reconstruction methods. We conclude that the PSB method can accurately reconstruct deformation and strain in the LV wall from tagged MR images and has several advantages relative to existing techniques.

  13. Left ventricular motion reconstruction with a prolate spheroidal B-spline model

    Science.gov (United States)

    Li, Jin; Denney, Thomas S., Jr.

    2006-02-01

    Tagged cardiac magnetic resonance (MR) imaging can non-invasively image deformation of the left ventricular (LV) wall. Three-dimensional (3D) analysis of tag data requires fitting a deformation model to tag lines in the image data. In this paper, we present a 3D myocardial displacement and strain reconstruction method based on a B-spline deformation model defined in prolate spheroidal coordinates, which more closely matches the shape of the LV wall than existing Cartesian or cylindrical coordinate models. The prolate spheroidal B-spline (PSB) deformation model also enforces smoothness across and can compute strain at the apex. The PSB reconstruction algorithm was evaluated on a previously published data set to allow head-to-head comparison of the PSB model with existing LV deformation reconstruction methods. We conclude that the PSB method can accurately reconstruct deformation and strain in the LV wall from tagged MR images and has several advantages relative to existing techniques.

  14. Left Ventricular Endocardium Tracking by Fusion of Biomechanical and Deformable Models

    Directory of Open Access Journals (Sweden)

    Hussin Ketout

    2014-01-01

    Full Text Available This paper presents a framework for tracking left ventricular (LV endocardium through 2D echocardiography image sequence. The framework is based on fusion of biomechanical (BM model of the heart with the parametric deformable model. The BM model constitutive equation consists of passive and active strain energy functions. The deformations of the LV are obtained by solving the constitutive equations using ABAQUS FEM in each frame in the cardiac cycle. The strain energy functions are defined in two user subroutines for active and passive phases. Average fusion technique is used to fuse the BM and deformable model contours. Experimental results are conducted to verify the detected contours and the results are evaluated by comparing themto a created gold standard. The results and the evaluation proved that the framework has the tremendous potential to track and segment the LV through the whole cardiac cycle.

  15. Progressive Left Ventricular Hypertrophy after Heart Transplantation: Insights and Mechanisms Suggested by Multimodal Images.

    Science.gov (United States)

    Ananthasubramaniam, Karthik; Garikapati, Kiran; Williams, Celeste T

    2016-02-01

    Immunosuppression is the typical measure to prevent rejection after heart transplantation. Although rejection is the usual cause of cardiac hypertrophy, numerous other factors warrant consideration. Calcineurin inhibitors rarely cause hypertrophic cardiomyopathy; the few relevant reports have described children after orthotopic kidney or liver transplantation. We present the case of a 73-year-old woman, an asymptomatic orthotopic heart transplantation patient, in whom chronic immunosuppression with prednisone and cyclosporine apparently caused a phenotype of hypertrophic cardiomyopathy. The natural course of her midapical hypertrophy was revealed by single-photon-emission computed tomography, positron-emission tomography, and 2-dimensional echocardiography. Clinicians and radiographers should be alert to progressive left ventricular hypertrophy and various perfusion patterns in heart transplantation patients even in the absence of underlying coronary artery disease. Toward this end, we recommend that advanced imaging methods be used to their fullest extent. PMID:27047289

  16. Beneficial effect of isradipine on the development of left ventricular hypertrophy in mild hypertension

    DEFF Research Database (Denmark)

    Mehlsen, J; Fornitz, Gitte Gleerup; Haedersdal, C;

    1993-01-01

    with mild essential hypertension were entered into a double-blind crossover study. Examinations were carried out after 2 weeks of placebo run-in, and after 6 and 12 months of active treatment. Mean resting blood pressure was reduced from 115 +/- 12 mm Hg to 106 +/- 12 mm Hg with atenolol, and to 107 +/- 8...... mm Hg with isradipine. The increase in the product of heart rate times blood pressure was significantly greater during isradipine treatment, as was the maximum exercise capacity. Left ventricular mass was increased from 228 +/- 36 g to 305 +/- 68 g with atenolol whereas it remained unchanged......The objective of this study was to analyze the long-term hemodynamic effects of the calcium antagonist isradipine in mild hypertension compared with those of the beta 1-selective adrenoceptor antagonist atenolol, focusing in particular on the development of cardiac hypertrophy. Ten male patients...

  17. Congestive Heart Failure With Apparently Preserved Left Ventricular Systolic Function: A 10-Year Observational Study.

    Science.gov (United States)

    El-Menyar, Ayman; Shabana, Adel; Arabi, Abdulrahman; Al-Thani, Hassan; Asaad, Nidal; AlBinALi, Hajar; Singh, Rajvir; Gomaa, Mohammed; Gehani, A

    2015-09-01

    We analyzed the clinical presentation and outcomes (from 2003 to 2013) of heart failure (HF) with apparently normal systolic function (HFPEF). Based on the echocardiographic left ventricular ejection fraction (LVEF), patients were divided into 2 groups, group 1 (<50%) and group 2 (≥50%). Of 2212 patients with HF, 20% were in group 2. Patients in group 2 were more likely to be older, females, Arabs, hypertensive, and obese (P = .001). Patients in group 1 were mostly Asians and had more troponin-T positivity (P = .001). Inhospital cardiac arrest, shock, and deaths were significantly greater in group 1. On multivariate analysis, age, ST-segment elevation myocardial infarction, lack of on-admission β-blockers, and angiotensin-converting enzyme inhibitors use were independent predictors of mortality. HFPEF is associated with less mortality compared to those who presented with reduced LVEF. On admission, use of evidence-based medications could in part predict this difference in the hospital outcome. PMID:25248442

  18. Dosage dependent hormonal counter regulation to combination therapy in patients with left ventricular dysfunction

    DEFF Research Database (Denmark)

    Galløe, A.M.; Skagen, K.; Christensen, Niels Juel;

    2006-01-01

    and bumetanide was tested in a double blind, double placebo-controlled, randomized, multiple cross-over study in a 16 times six balanced incomplete Latin square design. Patients reported optimal quality of life on the sub maximal dose bumetanide. Bumetanide decreased left ventricular function and increased heart...... rate and plasma noradrenaline in a dose dependent manner. Doses of bumetanide of more than 0.5 mg, given twice daily significantly decreased the quality of life and increased diuresis. Weight loss was maximal on 0.5 mg bumetanide twice daily. Trandolapril significantly reduced systolic blood pressure......The present study attempts to assess the efficacy combination therapy for heart failure. Genuine dose-response studies on combination therapy are not available and published studies involved adding one drug on top of 'usual treatment'. Sixteen different dosage combinations of trandolapril...

  19. Natriuretic peptides in the monitoring of anthracycline induced reduction in left ventricular ejection fraction

    DEFF Research Database (Denmark)

    Daugaard, Gedske; Lassen, Ulrik; Bie, Peter;

    2005-01-01

    BACKGROUND: The use of anthracyclines in treatment of cancer is limited by cardiotoxicity of these compounds and may lead to heart failure. Therefore monitoring of cardiac function is necessary during therapy. AIM: We evaluated the value of natriuretic peptides (N-terminal pro-atrial natriuretic...... measurements, 19% showed a significant EF decrease (>0.10) and ended with a final EF value below 0.50. Baseline EF was no predictor of a change in EF during treatment. Neither baseline levels of N-ANP or BNP nor a change in the same variables during therapy were predictive of a change in EF. CONCLUSIONS...... peptide (N-ANP) and brain natriuretic peptide (BNP)) for monitoring and predicting anthracycline induced cardiotoxicity using radionuclide left ventricular ejection fraction (EF) measurements as reference. METHODS AND RESULTS: A total of 107 consecutive patients receiving anthracycline as part...

  20. Evolvement of left ventricular assist device: the implications on heart failure management.

    Science.gov (United States)

    Chair, Sek Ying; Yu, Doris Sf; Ng, Michael Timothy; Wang, Qun; Cheng, Ho Yu; Wong, Eliza Ml; Sit, Janet Wh

    2016-07-01

    Heart failure (HF) is a potentially fatal disease that affects increasing number of people worldwide. Although heart transplant is the "gold standard" therapy for HF, due to the limited availability of organs, many patients died when waiting for the transplant. Left ventricular assist device (LVAD), as a mechanical circulatory support, has become a new light for patients with HF. With the technical advancements, LVADs work not only as a bridge to transplant, but also assist heart recovery and even as a destination therapy in long-term treatment. This observation paper reviewed the development of LVAD and its clinical roles. The challenges and possible solutions in nursing care for patients with LVAD at different stage of implantation were discussed. The healthcare professionals could obtain a better understanding about the LVAD treatment for HF patients. PMID:27594870