Videodensitometric assessment of right and left ventricular functions by digital subtraction angiography

International Nuclear Information System (INIS)

Ikeda, Hisao; Yoshiga, Osamu; Shibao, Keigo

1987-01-01

Intravenous digital subtraction (DS) ventriculography was performed in a series of 50 patients with heart diseases to determine right and left ventricular volumes and systolic indices. Right ventricular volume and right ventricular ejection fraction obtained by DS ventriculography were well correlated with those by geometric methods. In 43 patients with left ventricular ejection fraction of 55 % or greater, end-diastolic volume, stroke volume, and ejection fraction in the right ventricle did not differ from those in the left ventricle ; however, both the 1/3 ejection fraction and the peak ejection rate of the right ventricle were significantly lower than those of the left ventricle, suggesting the different modes of left and right ventricular contraction. In the other seven patients with chronic left ventricular failure, right ventricular systolic function may be preserved, even when left ventricular function is severely impaired. Digital subtraction ventriculography has proved to be a simple, useful method in the quanlitative and quantitative assessments of the right and left ventricles. (Namekawa, K.)

Image processing of x-ray left ventricular cineangiocardiograms and displays of cardiac functions

International Nuclear Information System (INIS)

Eiho, Shigeru; Yamada, Shigeru; Kuwahara, Michiyoshi

1980-01-01

Cineangiocardiography has been often used as one of the highly helpful techniques to examine the cardiac function. This paper deals with the method of tracing automatically the boundaries of the left ventricle on cineangiocardiograms, the method to evaluate and display various cardiac functions, the method to reconstruct the left ventricular cavity from biplane cineangiocardiograms and the method to display a 3-dimensional shape of the left ventricle reconstructed. Our algorithm of boundary tracing is based on a heuristic search for a local maximum of the changing rate in the gray level of cineangiocardiogram. The boundaries of endocardial margins of the left ventricle on 80 to 120 consecutive frames are automatically traced by our method. By using the detected boundaries of the left ventricle, a lot of quantitative information may be established on the cardiac function. The volume change, the wall motions and the %-shortening are displayed graphically. The motion of the boundary of the left ventricle is displayed on a CRT as a moving picture. The left ventricular cavity is reconstructed from the detected boundaries of the left ventricle on biplane cineangiocardiograms. A reconstructed image can be shown as superimposed lines or halftone planes to produce a 3-dimensional perspective. The %-shortening which shows the contractility of the regional myocardium is displayed on a silhouette of the left ventricle. We can easily recognize the abnormal area of contraction and the level and spread of abnormality from this displayed image. With the use of the system described in this paper, we can grasp the movement of the left ventricle exactly and evaluate the cardiac function quantitatively. (author)

Testosterone affects hormone-sensitive lipase (HSL) activity and lipid metabolism in the left ventricle

DEFF Research Database (Denmark)

Langfort, Jozef; Jagsz, Slawomir; Dobrzyn, Pawel

2010-01-01

tissue suggests that testosterone regulates HSL activity. To test whether this is also true in the heart, we measured HSL activity in the left ventricle of sedentary male rats that had been treated with testosterone supplementation or orchidectomy with or without testosterone substitution. Left ventricle...... HSL activity against TG was significantly elevated in intact rats supplemented with testosterone. HSL activity against both TG and diacylglyceride was reduced by orchidectomy, whereas testosterone replacement fully reversed this effect. Moreover, testosterone increased left ventricle free fatty acid...... levels, caused an inhibitory effect on carbohydrate metabolism in the heart, and elevated left ventricular phosphocreatine and ATP levels as compared to control rats. These data indicate that testosterone is involved in cardiac HSL activity regulation which, in turn, may affect cardiac lipid...

Interstage evaluation of homograft-valved right ventricle to pulmonary artery conduits for palliation of hypoplastic left heart syndrome.

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Sandeep, Nefthi; Punn, Rajesh; Balasubramanian, Sowmya; Smith, Shea N; Reinhartz, Olaf; Zhang, Yulin; Wright, Gail E; Peng, Lynn F; Wise-Faberowski, Lisa; Hanley, Frank L; McElhinney, Doff B

2018-04-01

Palliation of hypoplastic left heart syndrome with a standard nonvalved right ventricle to pulmonary artery conduit results in an inefficient circulation in part due to diastolic regurgitation. A composite right ventricle pulmonary artery conduit with a homograft valve has a hypothetical advantage of reducing regurgitation, but may differ in the propensity for stenosis because of valve remodeling. This retrospective cohort study included 130 patients with hypoplastic left heart syndrome who underwent a modified stage 1 procedure with a right ventricle to pulmonary artery conduit from 2002 to 2015. A composite valved conduit (cryopreserved homograft valve anastomosed to a polytetrafluoroethylene tube) was placed in 100 patients (47 aortic, 32 pulmonary, 13 femoral/saphenous vein, 8 unknown), and a nonvalved conduit was used in 30 patients. Echocardiographic functional parameters were evaluated before and after stage 1 palliation and before the bidirectional Glenn procedure, and interstage interventions were assessed. On competing risk analysis, survival over time was better in the valved conduit group (P = .040), but this difference was no longer significant after adjustment for surgical era. There was no significant difference between groups in the cumulative incidence of bidirectional Glenn completion (P = .15). Patients with a valved conduit underwent more interventions for conduit obstruction in the interstage period, but this difference did not reach significance (P = .16). There were no differences between groups in echocardiographic parameters of right ventricle function at baseline or pre-Glenn. In this cohort of patients with hypoplastic left heart syndrome, inclusion of a valved right ventricle to pulmonary artery conduit was not associated with any difference in survival on adjusted analysis and did not confer an identifiable benefit on right ventricle function. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier

Functional assessment of the right ventricle with gated myocardial perfusion SPECT

International Nuclear Information System (INIS)

Wadhwa, S.S.; Abbati, D.; Carolan, M.

2002-01-01

Full text: Evaluation of right ventricular function can provide valuable information in a variety of cardiac and non-cardiac conditions. Functional assessment of the right ventricle is difficult owing to its anatomy and geometry. We describe a method of assessing right ventricular function using gated myocardial perfusion SPECT. In 20 patients right and left ventricular ejection fractions (RVEF, LVEF) were determined using gated blood pool (GBPS) and gated myocardial perfusion SPECT (GSPECT). To avoid contamination with right atrial activity the two frame method was adopted for gated blood pool data when measuring RVEF. In 9 patients with normal right ventricles, an index of wall thickening for the right ventricle was derived from the peak systolic and diastolic counts in the free wall. There was good linear correlation between the two methods adopted for calculation of LVEF and RVEF. Bland - Airman analysis demonstrated good agreement between the two methods with no specific bias. The mean LVEF was 47.9 +/-12% (GBPS) and 47.3 +/- 12.4 (GSPECT). The mean RVEF was 43.2 +/- 9.6% (GBPS) and 44.2 +/- 8.5% (GSPECT). In both cases the values were significantly different. The mean wall motion index was 35%. There was no correlation between the wall thickness index and ejection fraction however the index was greater in patients with normal right ventricle than in those with reduced RVER Gated SPECT offers an alternative to GBPS for the functional assessment of the right ventricle. Utilising GSPECT will allow the simultaneous assessment of both the right and left ventricles. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

Evaluation of left ventricular function using digital subtraction angiography

International Nuclear Information System (INIS)

Kozuka, Takahiro; Ohta, Mitsushige

1985-01-01

To evaluate function of the left ventricle and myocardial perfusion images, digital subtraction angiography (DSA) was performed in 45 patients with ischemic heart disease. Validity of the technique was compared with data obtained from cine left ventriculogram in all patients and 201 T1 myocardial images in 20 patients. End-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) calculated from DSA were correlated closely with those from cine left ventriculogram (r = 0.92, r = 0.94 and r = 0.86, respectively). Regional contractility at the antero-lateral wall of the left ventricle, assessed by DSA, was also correlated well with cine left ventriculogram (r = 0.75). Evaluation of the inferior wall motion showed less correlation in both procedures (r = 0.68). Phase and amplitude analysis with the same technique with radionuclide cardiac angiography was successfully applied in left ventriculogram obtained by DSA. The procedure seems to be helpful for objective evaluation of the left ventricular wall motion. Myocardial perfusion image, obtained with modified Radtke's technique, showed good coincidence with 201 T1 images. Thus, DSA is applicable for evaluation of function of the left ventricle and myocardial perfusion in patients with ischemic heart disease. (author)

Isolated Non-Compaction of the Left Ventricle in a Patient with New-Onset Heart Failure: Morphologic and Functional Evaluation with Cardiac Multidetector Computed Tomography

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Lee, Heon [Soonchuhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Kim, Seok Yeon [Seoul Medical Center, Seoul (Korea, Republic of); Schoepf, U. Joseph [Medical University of South Carolina, SC (United States)

2012-03-15

We describe a case of new-onset heart failure in a patient in whom cardiac CT enabled the non-invasive diagnosis of isolated non-compaction and associated functional abnormalities of the left ventricle with the concomitant evaluation of coronary arteries. This case highlights the utility of cardiac CT for the morphological and functional evaluation of the heart as a single imaging modality.

Visualization of Fiber Structure in the Left and Right Ventricle of a Human Heart

International Nuclear Information System (INIS)

Rohmer, Damien; Sitek, Arkadiusz; Gullberg, Grant T.

2006-01-01

The human heart is composed of a helical network of muscle fibers. Anisotropic least squares filtering followed by fiber tracking techniques were applied to Diffusion Tensor Magnetic Resonance Imaging(DTMRI) data of the excised human heart. The fiber configuration was visualized by using thin tubes to increase 3-dimensional visual perception of the complex structure. All visualizations were performed using the high-quality ray-tracing software POV-Ray. The fibers are shown within the left and right ventricles. Both ventricles exhibit similar fiber architecture and some bundles of fibers are shown linking right and left ventricles on the posterior region of the heart

Vortex formation and instability in the left ventricle

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Le, Trung Bao; Sotiropoulos, Fotis; Coffey, Dane; Keefe, Daniel

2012-09-01

We study the formation of the mitral vortex ring during early diastolic filling in a patient-specific left ventricle (LV) using direct numerical simulation. The geometry of the left ventricle is reconstructed from Magnetic Resonance Imaging (MRI) data of a healthy human subject. The left ventricular kinematics is modeled via a cell-based activation methodology, which is inspired by cardiac electro-physiology and yields physiologic LV wall motion. In the fluid dynamics videos, we describe in detail the three-dimensional structure of the mitral vortex ring, which is formed during early diastolic filling. The ring starts to deform as it propagates toward the apex of the heart and becomes inclined. The trailing secondary vortex tubes are formed as the result of interaction between the vortex ring and the LV wall. These vortex tubes wrap around the circumference and begin to interact with and destabilize the mitral vortex ring. At the end of diastole, the vortex ring impinges on the LV wall and the large-scale intraventricular flow rotates in clockwise direction. We show for the first time that the mitral vortex ring evolution is dominated by a number of vortex-vortex and vortex-wall interactions, including lateral straining and deformation of vortex ring, the interaction of two vortex tubes with unequal strengths, helicity polarization of vortex tubes and twisting instabilities of the vortex cores.

ACUTE MYOCARDIAL INFARCTION- AN UNUSUAL PRESENTATION OF A MASS IN LEFT VENTRICLE AND RIGHT VENTRICLE

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Sunil Pisharadi

2010-11-01

Full Text Available Acute Myocardial infarction is not a rare finding in patients with a history of carcinoma with second aries. We report a case of a 38-year old man who presented with symptoms of acute MI. The echocardiography showed a rare finding of a mass in both right and left ventricle

Small atrial septal defect associated with heart failure in an infant with a marginal left ventricle

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Sandra D.K. Kingma

2012-07-01

Full Text Available Atrial septal defect (ASD is usually asymptomatic in infancy, unless pulmonary hypertension or severe co-morbidity is present. We report a case of a 4-week-old infant with moderate- sized ASD, small patent ductus arteriosus (PDA, and a borderline sized left ventricle that developed heart failure. Despite the relatively small diameter of the ASD, this defect influenced the mechanism of heart failure significantly. After surgical closure of both PDA and ASD, the signs of pulmonary hypertension resolved and the patient developed a normal sized left ventricle. This report illustrates that the presence of a small ASD in combination with a marginal left ventricle may result in inadequate left ventricular filling, pulmonary hypertension and heart failure.

Aortic atresia with normal sized left ventricle

OpenAIRE

Priya Jagia; Arun Sharma; Saurabh K Gupta; Munish Guleria

2016-01-01

Aortic atresia with an associated ventricular septal defect and adequate sized left ventricle is extremely rare. We present two cases in which an alternate diagnosis was suggested on echocardiography because the hypoplastic aortic trunk was missed due to its small caliber. The final diagnosis was, however, clinched on dual source computed tomography, which not only showed the thin aortic trunk but also clearly depicted the coronary artery origins from the hypoplastic aortic root. To the best ...

Idiopathic dilated cardiomyopathy: computerized anatomic study of relashionship between septal and free left ventricle wall.

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Juliani, Paulo Sérgio; Costa, Eder França da; Correia, Aristides Tadeu; Monteiro, Rosangela; Jatene, Fabio Biscegli

2014-01-01

A feature of dilated cardiomyopathy is the deformation of ventricular cavity, which contributes to systolic dysfunction. Few studies have evaluated this deformation bearing in mind ventricular regions and segments of the ventricle, which could reveal important details of the remodeling process, supporting a better understanding of its role in functional impairment and the development of new therapeutic strategies. To evaluate if, in basal, equatorial and apical regions, increased internal transverse perimeter of left ventricle in idiopathic dilated cardiomyopathy occurs proportionally between the septal and non-septal segment. We performed an anatomical study with 28 adult hearts from human cadavers. One group consisted of 18 hearts with idiopathic dilated cardiomyopathy and another group with 10 normal hearts. After lamination and left ventricle digital image capture, in three different regions (base, equator and apex), the transversal internal perimeter of left ventricle was divided into two segments: septal and not septal. These segments were measured by proper software. It was established an index of proportionality between these segments, called septal and non-septal segment index. Then we determined whether this index was the same in both groups. Among patients with normal hearts and idiopathic dilated cardiomyopathy, the index of proportionality between the two segments (septal and non-septal) showed no significant difference in the three regions analyzed. The comparison results of the indices NSS/SS among normal and enlarged hearts were respectively: in base 1.99 versus 1.86 (P=0.46), in equator 2.22 versus 2.18 (P=0.79) and in apex 2.96 versus 3.56 (P=0.11). In the idiopathic dilated cardiomyopathy, the transversal dilatation of left ventricular internal perimeter occurs proportionally between the segments corresponding to the septum and free wall at the basal, equatorial and apical regions of this chamber.

Automatic extraction of left ventricle in SPECT myocardial perfusion imaging

International Nuclear Information System (INIS)

Liu Li; Zhao Shujun; Yao Zhiming; Wang Daoyu

1999-01-01

An automatic method of extracting left ventricle from SPECT myocardial perfusion data was introduced. This method was based on the least square analysis of the positions of all short-axis slices pixels from the half sphere-cylinder myocardial model, and used a iterative reconstruction technique to automatically cut off the non-left ventricular tissue from the perfusion images. Thereby, this technique provided the bases for further quantitative analysis

Left ventricular systolic and diastolic function in hyperthyroidism

International Nuclear Information System (INIS)

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

1982-01-01

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

[Endomyocardial fibrosis with massive calcification of the left ventricle].

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Trigo, Joana; Camacho, Ana; Gago, Paula; Candeias, Rui; Santos, Walter; Marques, Nuno; Matos, Pedro; Brandão, Victor; Gomes, Veloso

2010-03-01

Endomyocardial fibrosis is a rare disease, endemic in tropical countries. It is characterized by fibrosis of the endocardium that can extend to myocardium. Important calcification of the endocardium is rare with only a few cases reported in the literature. We report a case of endomyocardial fibrosis in a european caucasian patient, associated with massive calcification of left ventricle.

Selection of reference genes for gene expression studies in heart failure for left and right ventricles.

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Li, Mengmeng; Rao, Man; Chen, Kai; Zhou, Jianye; Song, Jiangping

2017-07-15

Real-time quantitative reverse transcriptase-PCR (qRT-PCR) is a feasible tool for determining gene expression profiles, but the accuracy and reliability of the results depends on the stable expression of selected housekeeping genes in different samples. By far, researches on stable housekeeping genes in human heart failure samples are rare. Moreover the effect of heart failure on the expression of housekeeping genes in right and left ventricles is yet to be studied. Therefore we aim to provide stable housekeeping genes for both ventricles in heart failure and normal heart samples. In this study, we selected seven commonly used housekeeping genes as candidates. By using the qRT-PCR, the expression levels of ACTB, RAB7A, GAPDH, REEP5, RPL5, PSMB4 and VCP in eight heart failure and four normal heart samples were assessed. The stability of candidate housekeeping genes was evaluated by geNorm and Normfinder softwares. GAPDH showed the least variation in all heart samples. Results also indicated the difference of gene expression existed in heart failure left and right ventricles. GAPDH had the highest expression stability in both heart failure and normal heart samples. We also propose using different sets of housekeeping genes for left and right ventricles respectively. The combination of RPL5, GAPDH and PSMB4 is suitable for the right ventricle and the combination of GAPDH, REEP5 and RAB7A is suitable for the left ventricle. Copyright © 2017 Elsevier B.V. All rights reserved.

Fluid Structure Interaction simulation of heart prosthesis in patient-specific left-ventricle/aorta anatomies

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Le, Trung; Borazjani, Iman; Sotiropoulos, Fotis

2009-11-01

In order to test and optimize heart valve prosthesis and enable virtual implantation of other biomedical devices it is essential to develop and validate high-resolution FSI-CFD codes for carrying out simulations in patient-specific geometries. We have developed a powerful numerical methodology for carrying out FSI simulations of cardiovascular flows based on the CURVIB approach (Borazjani, L. Ge, and F. Sotiropoulos, Journal of Computational physics, vol. 227, pp. 7587-7620 2008). We have extended our FSI method to overset grids to handle efficiently more complicated geometries e.g. simulating an MHV implanted in an anatomically realistic aorta and left-ventricle. A compliant, anatomic left-ventricle is modeled using prescribed motion in one domain. The mechanical heart valve is placed inside the second domain i.e. the body-fitted curvilinear mesh of the anatomic aorta. The simulations of an MHV with a left-ventricle model underscore the importance of inflow conditions and ventricular compliance for such simulations and demonstrate the potential of our method as a powerful tool for patient-specific simulations.

Randomized placebo controlled blinded study to assess valsartan efficacy in preventing left ventricle remodeling in patients with dual chamber pacemaker--Rationale and design of the trial.

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Tomasik, Andrzej; Jacheć, Wojciech; Wojciechowska, Celina; Kawecki, Damian; Białkowska, Beata; Romuk, Ewa; Gabrysiak, Artur; Birkner, Ewa; Kalarus, Zbigniew; Nowalany-Kozielska, Ewa

2015-05-01

Dual chamber pacing is known to have detrimental effect on cardiac performance and heart failure occurring eventually is associated with increased mortality. Experimental studies of pacing in dogs have shown contractile dyssynchrony leading to diffuse alterations in extracellular matrix. In parallel, studies on experimental ischemia/reperfusion injury have shown efficacy of valsartan to inhibit activity of matrix metalloproteinase-9, to increase the activity of tissue inhibitor of matrix metalloproteinase-3 and preserve global contractility and left ventricle ejection fraction. To present rationale and design of randomized blinded trial aimed to assess whether 12 month long administration of valsartan will prevent left ventricle remodeling in patients with preserved left ventricle ejection fraction (LVEF ≥ 40%) and first implantation of dual chamber pacemaker. A total of 100 eligible patients will be randomized into three parallel arms: placebo, valsartan 80 mg/daily and valsartan 160 mg/daily added to previously used drugs. The primary endpoint will be assessment of valsartan efficacy to prevent left ventricle remodeling during 12 month follow-up. We assess patients' functional capacity, blood plasma activity of matrix metalloproteinases and their tissue inhibitors, NT-proBNP, tumor necrosis factor alpha, and Troponin T. Left ventricle function and remodeling is assessed echocardiographically: M-mode, B-mode, tissue Doppler imaging. If valsartan proves effective, it will be an attractive measure to improve long term prognosis in aging population and increasing number of pacemaker recipients. ClinicalTrials.org (NCT01805804). Copyright © 2015 Elsevier Inc. All rights reserved.

Left and right ventricle late remodeling following myocardial infarction in rats.

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Stefanon, Ivanita; Valero-Muñoz, María; Fernandes, Aurélia Araújo; Ribeiro, Rogério Faustino; Rodríguez, Cristina; Miana, Maria; Martínez-González, José; Spalenza, Jessica S; Lahera, Vicente; Vassallo, Paula F; Cachofeiro, Victoria

2013-01-01

The mechanisms involved in cardiac remodeling in left (LV) and right ventricles (RV) after myocardial infarction (MI) are still unclear. We assayed factors involved in collagen turnover in both ventricles following MI in rats either presenting signs of heart failure (pulmonary congestion and increased LVEDP) or not (INF-HF or INF, respectively). MI was induced in male rats by ligation of the left coronary artery. Four weeks after MI gene expression of collagen I, connective tissue growth factor (CTGF), transforming growth factor β (TGF-β) and lysyl oxidase (LOX), metalloproteinase-2 (MMP2) and tissue inhibitor metalloproteinase-2 (TIMP2) as well as cardiac hemodynamic in both ventricles were evaluated. Ventricular dilatation, hypertrophy and an increase in interstitial fibrosis and myocyte size were observed in the RV and LV from INF-HF animals, whereas only LV dilatation and fibrosis in RV was present in INF. The LV fibrosis in INF-HF was associated with higher mRNA of collagen I, CTGF, TGF-β and LOX expressions than in INF and SHAM animals, while MMP2/TIMP2 mRNA ratio did not change. RV fibrosis in INF and INF-HF groups was associated with an increase in LOX mRNA and a reduction in MMP2/TIMP2 ratio. CTGF mRNA was increased only in the INF-HF group. INF and INF-HF animals presented different patterns of remodeling in both ventricles. In the INF-HF group, fibrosis seems to be consequence of collagen production in LV, and by reductions in collagen degradation in RV of both INF and INF-HF animals.

Cardiac magnetic resonance imaging in evaluation of anatomical structure and function of the ventricles

International Nuclear Information System (INIS)

Suzuki, Jun-ichi; Usui, Masahiro; Takenaka, Katsu

1990-01-01

Cardiac magnetic resonance imaging (MRI) is being widely employed for evaluation of cardiovascular anatomies and functions. However, the indications for cardiac MRI to obtain information which cannot be obtained using other conventional methods have not yet been determined. To demonstrate the usefulness of MRI in delineating the apex of the left ventricle and free wall of the right ventricle, end-diastolic short axis MRI images were obtained in 20 patients with apical hypertrophy and in 9 normal volunteers. To compare the accuracy of estimations of left ventricular volumes obtained using the modified Simpson's method of MRI with that using the MRI area length method, 19 patients, in whom left ventriculography had been performed, were studied. The apex of the left ventricle was evaluated circumferentially and distribution of hypertrophied muscles was defined. Sixty-five percent of the length of the right ventricular free wall was clearly delineated. Correlation coefficients of the ejection fraction between MRI and angiography were 0.85 with the modified Simpson's method of MRI, and 0.62 with the area length method of MRI. Three themes were chosen to demonstrate good clinical indications for cardiac MRI. (author)

Left and right ventricle late remodeling following myocardial infarction in rats.

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Ivanita Stefanon

Full Text Available BACKGROUND: The mechanisms involved in cardiac remodeling in left (LV and right ventricles (RV after myocardial infarction (MI are still unclear. We assayed factors involved in collagen turnover in both ventricles following MI in rats either presenting signs of heart failure (pulmonary congestion and increased LVEDP or not (INF-HF or INF, respectively. METHODS: MI was induced in male rats by ligation of the left coronary artery. Four weeks after MI gene expression of collagen I, connective tissue growth factor (CTGF, transforming growth factor β (TGF-β and lysyl oxidase (LOX, metalloproteinase-2 (MMP2 and tissue inhibitor metalloproteinase-2 (TIMP2 as well as cardiac hemodynamic in both ventricles were evaluated. RESULTS: Ventricular dilatation, hypertrophy and an increase in interstitial fibrosis and myocyte size were observed in the RV and LV from INF-HF animals, whereas only LV dilatation and fibrosis in RV was present in INF. The LV fibrosis in INF-HF was associated with higher mRNA of collagen I, CTGF, TGF-β and LOX expressions than in INF and SHAM animals, while MMP2/TIMP2 mRNA ratio did not change. RV fibrosis in INF and INF-HF groups was associated with an increase in LOX mRNA and a reduction in MMP2/TIMP2 ratio. CTGF mRNA was increased only in the INF-HF group. CONCLUSIONS: INF and INF-HF animals presented different patterns of remodeling in both ventricles. In the INF-HF group, fibrosis seems to be consequence of collagen production in LV, and by reductions in collagen degradation in RV of both INF and INF-HF animals.

VACTERL association with double-chambered left ventricle: A rare occurrence

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Abdulla Al-Farqani

2013-01-01

Full Text Available VACTERL association is a non-random association of birth defects of unknown etiology derived from structures of embryonic mesoderm. The common cardiac defects seen with VACTERL association are ventricular septal defects, atrial septal defects, and tetralogy of Fallot. We present a 2-year-old child with VACTERL association in whom we detected double-chambered left ventricle on transthoracic echocardiography.

Evaluation of left ventricular function by cardiac CT

International Nuclear Information System (INIS)

Naito, Hiroaki; Kozuka, Takahiro

1982-01-01

Left ventricular function was evaluated by CT, which was compared with the data of left ventriculography for various cardiac diseases. The end diastolic volume of the left ventricle can be readily computed from CT, with a satisfactory correlation with that of left ventriculography (r = 0.95). The left ventricular ejection fraction, calculated from the areal ratio of the left ventricular lumen in end-diastolic imaging to that in end-sytolic imaging, also roughly reflects left ventricular contractile function, but shows correlation with left ventriculography by only r = 0.79. Although the cardiac output is not sensitive for functional evaluation, it can be directly calculated by means of dynamic scanning and shows a satisfactory correlation with the ear piece pigment dilution (r = 0.85). Evaluation of left ventricular function by CT shows a high precision in comparison with left ventriculography, but still lacks temporal resolving power. (Chiba, N.)

The ratio of (18)F-FDG activity uptake between the right and left ventricle in patients with pulmonary hypertension correlates with the right ventricular function.

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Yang, Tao; Wang, Lei; Xiong, Chang-Ming; He, Jian-Guo; Zhang, Yan; Gu, Qing; Zhao, Zhi-Hui; Ni, Xin-Hai; Fang, Wei; Liu, Zhi-Hong

2014-05-01

It is known that patients with pulmonary hypertension (PH) can have elevated F-FDG uptake in the right ventricle (RV) on PET imaging. This study was designed to assess possible relationship between FDG uptake of ventricles and the function/hemodynamics of the RV in patients with PH. Thirty-eight patients with PH underwent FDG PET imaging in both fasting and glucose-loading conditions. The standard uptake value (SUVs) corrected for partial volume effect in both RV and left ventricle (LV) were measured. The ratio of FDG uptake between RV to LV (SUVR/L) was calculated. Right heart catheterization and cardiac magnetic resonance (CMR) were performed in all patients within 1 week. The FDG uptake levels by the ventricles were compared with the result form the right heart catheterization and CMR. The SUV of RV (SUVR) and SUV of LV were significantly higher in glucose-loading condition than in fasting condition. In both fasting and glucose-loading conditions, SUVR and SUVR/L showed reverse correlation with right ventricular ejection fraction derived from CMR. In addition, in both fasting and glucose-loading conditions, SUVR and SUVR/L showed positive correlations with pulmonary vascular resistance. However, only SUVR/L in glucose-loading condition could independently predict right ventricular ejection fraction after adjusted for age, body mass index, sex, mean right atrial pressure, mean pulmonary arterial pressure, and pulmonary vascular resistance (P = 0.048). The FDG uptake of RV increases with decreased right ventricular function in patients with PH. Increased FDG uptake ratio between RV and LV might be useful to assess the right ventricular function.

Lagrangian coherent structures in the left ventricle in the presence of aortic valve regurgitation

Science.gov (United States)

di Labbio, Giuseppe; Vetel, Jerome; Kadem, Lyes

2017-11-01

Aortic valve regurgitation is a rather prevalent condition where the aortic valve improperly closes, allowing filling of the left ventricle of the heart to occur partly from backflow through the aortic valve. Although studies of intraventricular flow are rapidly gaining popularity in the fluid dynamics research community, much attention has been given to the left ventricular vortex and its potential for early detection of disease, particularly in the case of dilated cardiomyopathy. Notably, the subsequent flow in the left ventricle in the presence of aortic valve regurgitation ought to be appreciably disturbed and has yet to be described. Aortic valve regurgitation was simulated in vitro in a double-activation left heart duplicator and the ensuing flow was captured using two-dimensional time-resolved particle image velocimetry. Further insight into the regurgitant flow is obtained by computing attracting and repelling Lagrangian coherent structures. An interesting interplay between the two inflowing jets and their shear layer roll-up is observed for various grades of regurgitation. This study highlights flow features which may find use in further assessing regurgitation severity.

Assessment of ejection fraction of the right and left ventricles in patients with acute myocardial infarction by magnetic resonance imaging

International Nuclear Information System (INIS)

Zhang, Youyi; Imai, Kamon; Araki, Yasushi; Nishino, Yukari; Saito, Satoshi; Ozawa, Yukio; Yasugi, Tadao

1993-01-01

Right and left ventricular function in acute myocardial infarction (AMI) was assessed by ECG-gated magnetic resonance imaging (MRI) in 64 patients and 8 volunteers. Five short axis images for intrinsic cardiac long-axis of the left ventricle were obtained at 9 msec and 309 msec after the R wave as end-diastole and end-systole. Right and left ventricular volumes were measured by Simpson's rule. The intraobserver variabilities in right and left ventricular ejection fraction (RVEF: r=0.94, LVEF: 0.89) were excellent. The interobserver variabilities in RVEF (r=0.61) and LVEF (r=0.77) were fair. LVEF, but not RVEF, was significantly reduced in patients with AMI. Among left ventricular dysfunction (LVEF≤40%) patients, 50% exhibited right ventricular dysfunction (RVEF≤40%). Among patients without left ventricular dysfunction, only 12% exhibited right ventricular dysfunction. In left ventricular and biventricular dysfunction compared with control, the left ventricular end-diastolic volume index increased (65±10 ml/m 2 , 68±12 ml/m 2 vs 54±8 ml/m 2 ), the end-systolic volume index increased (40±16 ml/m 2 , 43±7 ml/m 2 vs 18±1 ml/m 2 ), and the right ventricular end-diastolic volume index decreased (52±13 ml/m 2 , 53±20 ml/m 2 vs 65±8 ml/m 2 ). MRI can thus be used to assess ventricular systolic function. Since patients with left ventricular dysfunction revealed a high incidence of right ventricular dysfunction, an interaction between the left and right ventricles may occur in ventricular dysfunction. (author)

Radionuclide diagnostics of right ventricle

International Nuclear Information System (INIS)

Zaorska-Rajca, J.

1993-01-01

Difficulties in evaluating the right ventricle function motivate to making research into new non-invasive methods. Four radionuclide methods that are used to access the right ventricle have been discussed in this paper: first-pass angiocardiography, gated equilibrium ventriculography with red blood cells labelled in vivo technetium- 99 Tc, ventriculography with radioactive xenon 133 and a computerized single probe. Advantages and disadvantages of using each method have been discussed. RNV 99m Tc method has been recognized as the best one to evaluate RV function. Results of the right ventricle assessment in patients have been discussed in the following clinical groups: chronic cor pulmonale (CP), chronic lung disease without pulmonary arterial hypertension (LD), coronary artery disease (CAD), in patients after infarction (IMA and IMi), dilated cardiomyopathy (KZ) and valvular heart diseases (Wm and Wa). Abnormals in right ventricle function occur with different intensity in all groups, although they no specificity. The highest abnormality occurs in patients with KZ, CP, IMi and Wm, the lowest one - in patients with CAD. Abnormalities are higher in patients with congestive heart failure. In most pathological groups the right ventricle dysfunction is connected with the left ventricle insufficiency. The interdependence between the dysfunction of both ventricles is differs in particular diseases. Assessment of right ventricle function with radionuclide methods plays an important role in diagnosis and control therapy of cardiopulmonary diseases. (author). 385 refs, 48 figs, 6 tabs

Diagnostic value of transient dilatation of the left ventricle in negative dipyridamole-thallium imaging

International Nuclear Information System (INIS)

Seo, Hiromi; Doi, Y.L.; Yonezawa, Yoshihiro; Chikamori, Taishiro; Yamada, Mitsutoshi; Ozawa, Toshio

1994-01-01

To evaluate the diagnostic value of a transient dilatation of the left ventricle during dipyridamole-thallium imaging (DTI) for detecting significant coronary artery disease (CAD) in patients with negative DTI results, 81 consecutive patients were studied. Twenty one patients (26%) had CAD and 60 patients had normal coronary anatomy (NCA). The initial/delayed ratio of the left ventricular dimension, which was measured as the distance between the 2 peaks of a count profile curve on a 45deg left anterior oblique planar image, was defined as the dilatation ratio (DR) of the left ventricle. Patients with CAD had a higher incidence of chest pain after dipyridamole infusion (35 vs 13%; p 1.03) when it was greater than the mean +2 standard deviations of the DR in NCA patients. Seventy-six percent of CAD patients had an abnormal DR. A stepwise discriminant analysis revealed that an abnormal DR alone had the same ability to predict CAD (sensitivity 76%, specificity 98%, chi-square 80.9, p 1.03) is a highly specific marker for detecting CAD, even in patients with negative dipyridamole-thallium imaging. (author)

A robust automated left ventricle region of interest localization technique using a cardiac cine MRI atlas

Science.gov (United States)

Ben-Zikri, Yehuda Kfir; Linte, Cristian A.

2016-03-01

Region of interest detection is a precursor to many medical image processing and analysis applications, including segmentation, registration and other image manipulation techniques. The optimal region of interest is often selected manually, based on empirical knowledge and features of the image dataset. However, if inconsistently identified, the selected region of interest may greatly affect the subsequent image analysis or interpretation steps, in turn leading to incomplete assessment during computer-aided diagnosis or incomplete visualization or identification of the surgical targets, if employed in the context of pre-procedural planning or image-guided interventions. Therefore, the need for robust, accurate and computationally efficient region of interest localization techniques is prevalent in many modern computer-assisted diagnosis and therapy applications. Here we propose a fully automated, robust, a priori learning-based approach that provides reliable estimates of the left and right ventricle features from cine cardiac MR images. The proposed approach leverages the temporal frame-to-frame motion extracted across a range of short axis left ventricle slice images with small training set generated from les than 10% of the population. This approach is based on histogram of oriented gradients features weighted by local intensities to first identify an initial region of interest depicting the left and right ventricles that exhibits the greatest extent of cardiac motion. This region is correlated with the homologous region that belongs to the training dataset that best matches the test image using feature vector correlation techniques. Lastly, the optimal left ventricle region of interest of the test image is identified based on the correlation of known ground truth segmentations associated with the training dataset deemed closest to the test image. The proposed approach was tested on a population of 100 patient datasets and was validated against the ground truth

No upregulation of digitalis glycoside receptor (Na,K-ATPase) concentration in human heart left ventricle samples obtained at necropsy after long term digitalisation.

Science.gov (United States)

Schmidt, T A; Holm-Nielsen, P; Kjeldsen, K

1991-08-01

life is associated with a 34% occupancy of digitalis glycoside receptors with digoxin. In the human heart there was no evidence for upregulation of digitalis glycoside receptor concentration due to long term digitalisation. Thus at receptor level there was no evidence for development of tolerance to digoxin therapy. The lower digitalis glycoside receptor concentration in the left ventricle observed in the heart failure patients may support the report of a relationship between Na,K-ATPase concentration as evaluated by 3H-ouabain binding and left ventricular function.

The estimation diastolic properties of the right and left heart's ventricles by a magnetic resonance imaging

International Nuclear Information System (INIS)

Myagkov, A.P.; Cherepok, A.A.

2003-01-01

On the basis of comparison of data heart's catheterization nd magnetic resonance imaging the technique of determination initial and enddiastolic pressure in heart's ventricles is developed. It has allowed to determine a diastolic extensibility, hardness, initial and enddiastolic pressure gradients for right and left ventricle. All necessary formulas and calculations techniques, control data of the models, received at the research of healthy subjects are described

Automatic determination of the regional ejection fraction of the left ventricle (gated bloodpool)

International Nuclear Information System (INIS)

Feser, J.A.

1982-01-01

The left ventricular volume curve and the ejection fraction are calculated according to the ''sliding region of interest'' method in which the ventricle contour is redetermined for every single picture of the various phases of the heart beat. The original set of data, consisting of 32 pictures in 64 x 64 matrix resolution, is processed by a three-dimensional filtering process in space (x,y) and time (t). The ventricle contour is determined by convolution of the filtered images with a 7-point Laplacian operator in 4 independent directions. The atrial and ventricular phase histograms are then calculated on the basis of this contour. (WU) [de

Cardiac microvascular rarefaction in hyperthyroidism-induced left ventricle dysfunction.

Science.gov (United States)

Freitas, Felipe; Estato, Vanessa; Carvalho, Vinícius Frias; Torres, Rafael Carvalho; Lessa, Marcos Adriano; Tibiriçá, Eduardo

2013-10-01

The pathophysiology underlying hyperthyroidism-induced left ventricle (LV) dysfunction and hypertrophy directly involves the heart and indirectly involves the neuroendocrine systems. The effects of hyperthyroidism on the microcirculation are still controversial in experimental models. We investigated the effects of hyperthyroidism on the cardiac function and microcirculation of an experimental rat model. Male Wistar rats (170-250 g) were divided into two groups: the euthyroid group (n = 10), which was treated with 0.9% saline solution, and the hyperthyroid group (n = 10), which was treated with l-thyroxine (600 μg/kg/day, i.p.) during 14 days. An echocardiographic study was performed to evaluate the alterations in cardiac function, structure and geometry. The structural capillary density and the expression of angiotensin II AT1 receptor in the LV were analyzed using histochemistry and immunohistochemistry, respectively. Hyperthyroidism was found to induce profound cardiovascular alterations, such as systolic hypertension, tachycardia, LV dysfunction, cardiac hypertrophy, and myocardial fibrosis. This study demonstrates the existence of structural capillary rarefaction and the down-regulation of the cardiac angiotensin II AT1 receptor in the myocardium of hyperthyroid rats in comparison with euthyroid rats. Microvascular rarefaction may be involved in the pathophysiology of hyperthyroidism-induced cardiovascular alterations. © 2013 John Wiley & Sons Ltd.

A mathematical model for active contraction in healthy and failing myocytes and left ventricles.

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Li Cai

Full Text Available Cardiovascular disease is one of the leading causes of death worldwide, in particular myocardial dysfunction, which may lead to heart failure eventually. Understanding the electro-mechanics of the heart will help in developing more effective clinical treatments. In this paper, we present a multi-scale electro-mechanics model of the left ventricle (LV. The Holzapfel-Ogden constitutive law was used to describe the passive myocardial response in tissue level, a modified Grandi-Pasqualini-Bers model was adopted to model calcium dynamics in individual myocytes, and the active tension was described using the Niederer-Hunter-Smith myofilament model. We first studied the electro-mechanics coupling in a single myocyte in the healthy and diseased left ventricle, and then the single cell model was embedded in a dynamic LV model to investigate the compensation mechanism of LV pump function due to myocardial dysfunction caused by abnormality in cellular calcium dynamics. The multi-scale LV model was solved using an in-house developed hybrid immersed boundary method with finite element extension. The predictions of the healthy LV model agreed well with the clinical measurements and other studies, and likewise, the results in the failing states were also consistent with clinical observations. In particular, we found that a low level of intracellular Ca2+ transient in myocytes can result in LV pump function failure even with increased myocardial contractility, decreased systolic blood pressure, and increased diastolic filling pressure, even though they will increase LV stroke volume. Our work suggested that treatments targeted at increased contractility and lowering the systolic blood pressure alone are not sufficient in preventing LV pump dysfunction, restoring a balanced physiological Ca2+ handling mechanism is necessary.

Significance of blood pool scintigraphy and echocardiography in the investigation of left heart ventricle

International Nuclear Information System (INIS)

Otto, L.; Krosse, B.; Neumann, G.; Rother, T.; Loebe, M.; Otto, J.; Koegler, A.; Wuensche, A.; Schneider, G.

1990-01-01

Left ventricular ejection (LVEF) was assessed by both radionuclide ventriculography and echocardiography. The correlation coefficient of 0.74 revealed a just good agreement. It was better in the range of normal than of pathological values. The analysis of regional wall motion performed by echocardiography was not as reliable as by radionuclide ventriculography. The main advantage of echocardiography is its good spatial resolution. Its domain is the diagnosis of pathomorphological changes including valvular disorders. Advantages of radionuclide ventriculography are good temporal resolution, registration of the third dimension practicability during exercise and as bedside method (nuclear stethoscope). Functional disturbances of both ventricles are its field of application. (author)

Automatic segmentation of the left ventricle in a cardiac MR short axis image using blind morphological operation

Science.gov (United States)

Irshad, Mehreen; Muhammad, Nazeer; Sharif, Muhammad; Yasmeen, Mussarat

2018-04-01

Conventionally, cardiac MR image analysis is done manually. Automatic examination for analyzing images can replace the monotonous tasks of massive amounts of data to analyze the global and regional functions of the cardiac left ventricle (LV). This task is performed using MR images to calculate the analytic cardiac parameter like end-systolic volume, end-diastolic volume, ejection fraction, and myocardial mass, respectively. These analytic parameters depend upon genuine delineation of epicardial, endocardial, papillary muscle, and trabeculations contours. In this paper, we propose an automatic segmentation method using the sum of absolute differences technique to localize the left ventricle. Blind morphological operations are proposed to segment and detect the LV contours of the epicardium and endocardium, automatically. We test the benchmark Sunny Brook dataset for evaluation of the proposed work. Contours of epicardium and endocardium are compared quantitatively to determine contour's accuracy and observe high matching values. Similarity or overlapping of an automatic examination to the given ground truth analysis by an expert are observed with high accuracy as with an index value of 91.30% . The proposed method for automatic segmentation gives better performance relative to existing techniques in terms of accuracy.

CORONARY EMBOLISM WITH FRAGMENTED THROMBUS FROM THE LEFT VENTRICLE IN PATIENT WITH POSTINFARCTION ANEURYSM

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Yu. F. Salakhova

2011-01-01

Full Text Available The thrombus formation in the left ventricle (LV cavity is a frequent complication of myocardial infarction (MI as well as a risk factor for peripheral arterial embolism. Probability of intraventricular thrombus depends on MI location and its therapy. A case of coronary embolism in a patient with anterior MI and thrombus in the LV aneurysm is considered in details. Successful percutaneous coronary intervention (PCI in the first 90 minutes after admission was performed. Decision to appoint a three-component antithrombotic therapy (acetylsalicylic acid, clopidogrel, warfarin was made on the 4th day of disease onset taking into account the combination of MI, stent placement in the anterior interventricular artery and the presence of left ventricular aneurysm with parietal thrombus. Recurrence of MI developed on the 9th day of disease onset. Aspiration thromboembolectomy was performed taking into account thrombosis of two coronary arteries. Warfarin therapy was discontinued in connection with subsequent clot lysis and development of not intensive nosebleed. Subsequent MI course was uneventful. In conclusion, even in spite of the timely achievement of PCI and early reperfusion, MI course can be complicated by thrombosis of the left ventricle and subsequent development of thromboembolic complications.

The impact of a hyperdynamic left ventricle on right ventricular function measurements in preterm infants with a patent ductus arteriosus.

Science.gov (United States)

Breatnach, Colm R; Franklin, Orla; James, Adam T; McCallion, Naomi; El-Khuffash, Afif

2017-09-01

Right ventricular (RV) functional assessment in premature infants includes basal longitudinal strain (RV BLS), RV systolic tissue Doppler velocity (RV s'), tricuspid annular plane systolic excursion (TAPSE) and RV fractional area change (FAC). A hyperdynamic left ventricle (LV) may influence RV measures of displacement (TAPSE) and velocity (RV s') but not measures of relative change of length (RV BLS) or area (FAC). We aimed to explore this hypothesis in preterm infants with a patent ductus arteriosus (PDA). We measured LV function (ejection fraction (LV EF); left ventricular output) and RV function (RV BLS; RV s'; TAPSE; FAC) on days 1, 2 and 5-7 in infants function measurements were compared between the groups using two-way analysis of variance with repeated measures. 121 infants with a mean (SD) gestation and birth weight of 26.8 (1.4) weeks and 968 (250) g were enrolled. By days 5-7, the PDA remained open in 83 (69%), with evidence of hyperdynamic LV function. There was no difference in RV s' (5.3 (0.9) vs 5.1 (1.0) cm/s, p=0.3) or TAPSE (6.2 (1.3) vs 6.1 (1.2) mm, p=0.7) between infants with and without a PDA, but infants in the PDA group had lower RV FAC (41 (8) vs 47 (10) %, pfunctional parameters must be taken into account when interpreting of RV function using those techniques. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Double Chamber Left Ventricle Associated With Severe Form of the Hypertrophic Cardiomyopathy and High Left Intracavitary Pressure

OpenAIRE

Bejiqi, Ramush; Retkoceri, Ragip; Bejiqi, Hana; Zeka, Naim; Maloku, Arlinda; Berisha, Majlinda

2013-01-01

Double-chambered left ventricle (DCLV) is a rare congenital anomaly, and only a few cases have been reported in the literature, in which a 2-chambered LV is separated by the interventricular septum or an abnormal muscle bundle.We report a case of a girl who was presented at tertiary level for cardiological examination where, during the routine examination systolic murmur was registered. After echocardiographical examination DCLV was confirmed. Anomaly was associated with idiopathic hypertroph...

[Topography of the contours of the inner surface of the wall of the left ventricle of the heart in systole].

Science.gov (United States)

Uglov, F G; Zubtsovskiĭ, V N; Bol'shakov, O P; Mursalova, F A; Tarasov, A N

1984-09-01

Chosen at random 38 diastolic preparations of human hearts from persons having not any cardiac pathology, as demonstrate the postmortem examination, have been investigated. The left ventricle casts have been made during the first 24 hours after death according to a strictly fixed technique by means of filling the cardiac chambers with polymere mass--protacryl--under a physiological pressure of the diastolic filling. The trabecules are arranged as a spiral from the apex of the ventricle up to the atrioventricular fibrous ring, with approaching the apex the spiral step increases and the trabecules straighten. The left ventricle cast is devided into some planes, the envelopes and the trabecularity lines are measured. Average values of the shift in the trabecularity lines I, II, III and in the cross sections B, C, D, E are defined in relation to the plane A and in every case in relation to the previous plane Cn-1. The data obtained are presented in tables and diagrams. The greatest shift demonstrate the trabecularity lines I running predominantly along the posterior wall of the left ventricle in the planes B and which are situated nearer to the atrioventricular ring projection. Owing to the presence of the spiral-shaped course of the trabecules, it is possible to suppose that it influences the blood stream twisting clockwise in the left ventricle during the diastole phase. This indicates the necessity to work out some new constructions of artificial cardiac valves, securing the twisted blood stream. The condition mentioned should be taken into consideration while making prostheses of the cardiac valves.

A Large Left Ventricle Myxoma: Presenting with Epigastric Pain and Weight Loss

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Solmaz Fakhari

2016-01-01

Full Text Available Cardiac myxomas are the most common benign tumors found in the heart. They usually appear in the left atrium. Those originating from the left ventricle (LV are rare. Although clinical presentation may vary, dyspnea and embolism are the most commonly reported symptoms. In the present case study, a 27-year-old woman with a large myxoma originating from the left ventricular free wall is studied. She had atypical complaints, mainly epigastric discomfort, nausea, vomiting, and anorexia. She was hospitalized for acute abdomen, but subsequent investigations revealed a large myxoma that fully filled the LV and severely compromised the flow of the aortic and mitral valves. After successful emergency tumor resection, all symptoms disappeared. The uncommon presentation caused by these tumors is discussed in this study.

Left atrioventricular remodeling in the assessment of the left ventricle diastolic function in patients with heart failure: a review of the currently studied echocardiographic variables

Directory of Open Access Journals (Sweden)

Köhler Ilmar

2008-11-01

Full Text Available Abstract Multiparametric echocardiographic imaging of the failing heart is now increasingly used and useful in decision making in heart failure. The reasons for this, relies on the need of different strategies of handling these patients, as differentiation of systolic or diastolic dysfunction, as well as on the gamma of approaches available, such as percutaneous and surgical revascularization, devices implantations, and valvular regurgitations and stenosis corrections. Congestive heart failure in patients with normal left ventricular diameters or preserved left ventricular ejection fraction had been pointed out recently as present in a proportion so high as 40 to 50 percent of cases of heart failure, mainly due to the epidemics in well developed countries, as is the problem of not well controlled metabolic states (such as obesity and diabetes, but also due to the real word in developing countries, as is the case of hypertension epidemics and its lack of adequate control. As a matter of public utility, the guidelines in the diagnosis and treatment of such patients will have to be cheap, available, easily reproducible, and ideally will furnish answers for the clinician questions not in a binary "black or white" manner, but with graduations, so if possible it has to be quantitative. The present paper aim to focus on the current clinical applications of tissue Doppler and of left atrial function and remodeling, and its pathophysiologic relationship with the left ventricle, as will be cleared in the documented review of echocardiography that follows, considering that the need of universal data on the syndrome of the failing heart does not mean, unfortunately, that all patients and clinicians in developing countries have at their own health facilities the same imaging tools, since they are, as a general rule, expensive.

Endovascular Treatment of Two Pseudoaneurysms Originating From the Left Ventricle

Energy Technology Data Exchange (ETDEWEB)

Cwikiel, Wojciech, E-mail: wcwikiel@gmail.com; Keussen, Inger [Skane University Hospital, Department of Radiology (Sweden); Gustafsson, Ronny; Mokhtari, Arash [Skane University Hospital, Department of Thoracic Surgery (Sweden)

2013-12-15

A 67-year-old woman resented with an acute type A aortic dissection, which was treated surgically with aortic valve replacement as a composite graft with reimplantation of the coronary arteries. At the end of surgery, a left-ventricular venting catheter was placed through the apex and closed with a buffered suture. Consecutive computed tomography (CT) examinations verified a growing apex pseudoaneurysm. Communication between the ventricle and the pseudoaneurysm was successfully closed with an Amplatz septal plug by the transfemoral route. Follow-up CT showed an additional pseudoaneurysm, which also was successfully closed using the same method.

Endovascular Treatment of Two Pseudoaneurysms Originating From the Left Ventricle

International Nuclear Information System (INIS)

Cwikiel, Wojciech; Keussen, Inger; Gustafsson, Ronny; Mokhtari, Arash

2013-01-01

A 67-year-old woman resented with an acute type A aortic dissection, which was treated surgically with aortic valve replacement as a composite graft with reimplantation of the coronary arteries. At the end of surgery, a left-ventricular venting catheter was placed through the apex and closed with a buffered suture. Consecutive computed tomography (CT) examinations verified a growing apex pseudoaneurysm. Communication between the ventricle and the pseudoaneurysm was successfully closed with an Amplatz septal plug by the transfemoral route. Follow-up CT showed an additional pseudoaneurysm, which also was successfully closed using the same method

Automatic segmentation of left ventricle in cardiac cine MRI images based on deep learning

Science.gov (United States)

Zhou, Tian; Icke, Ilknur; Dogdas, Belma; Parimal, Sarayu; Sampath, Smita; Forbes, Joseph; Bagchi, Ansuman; Chin, Chih-Liang; Chen, Antong

2017-02-01

In developing treatment of cardiovascular diseases, short axis cine MRI has been used as a standard technique for understanding the global structural and functional characteristics of the heart, e.g. ventricle dimensions, stroke volume and ejection fraction. To conduct an accurate assessment, heart structures need to be segmented from the cine MRI images with high precision, which could be a laborious task when performed manually. Herein a fully automatic framework is proposed for the segmentation of the left ventricle from the slices of short axis cine MRI scans of porcine subjects using a deep learning approach. For training the deep learning models, which generally requires a large set of data, a public database of human cine MRI scans is used. Experiments on the 3150 cine slices of 7 porcine subjects have shown that when comparing the automatic and manual segmentations the mean slice-wise Dice coefficient is about 0.930, the point-to-curve error is 1.07 mm, and the mean slice-wise Hausdorff distance is around 3.70 mm, which demonstrates the accuracy and robustness of the proposed inter-species translational approach.

Single calibration multiplane stereo-PIV: the effect of mitral valve orientation on three-dimensional flow in a left ventricle model

Science.gov (United States)

Saaid, Hicham; Segers, Patrick; Novara, Matteo; Claessens, Tom; Verdonck, Pascal

2018-03-01

The characterization of flow patterns in the left ventricle may help the development and interpretation of flow-based parameters of cardiac function and (patho-)physiology. Yet, in vivo visualization of highly dynamic three-dimensional flow patterns in an opaque and moving chamber is a challenging task. This has been shown in several recent multidisciplinary studies where in vivo imaging methods are often complemented by in silico solutions, or by in vitro methods. Because of its distinctive features, particle image velocimetry (PIV) has been extensively used to investigate flow dynamics in the cardiovascular field. However, full volumetric PIV data in a dynamically changing geometry such as the left ventricle remain extremely scarce, which justifies the present study. An investigation of the left ventricle flow making use of a customized cardiovascular simulator is presented; a multiplane scanning-stereoscopic PIV setup is used, which allows for the measurement of independent planes across the measurement volume. Due to the accuracy in traversing the illumination and imaging systems, the present setup allows to reconstruct the flow in a 3D volume performing only one single calibration. The effects of the orientation of a prosthetic mitral valve in anatomical and anti-anatomical configurations have been investigated during the diastolic filling time. The measurement is performed in a phase-locked manner; the mean velocity components are presented together with the vorticity and turbulent kinetic energy maps. The reconstructed 3D flow structures downstream the bileaflet mitral valve are shown, which provides additional insight of the highly three-dimensional flow.

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.

Types of Diastolic Dysfunction of the Left Ventricle in Adolescents with Myocardial Pathology

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L.F. Bogmat

2014-05-01

Full Text Available In adolescents with myocardial pathology during isometric tests we detected three types of diastolic dysfunction of the left ventricle (LV of the heart, depending on E/A ratio. The most pronounced signs of diastolic filling disorders were detected in the third group of patients, as evidenced: by a tendency to increase isovolumic relaxation time, a significant increase of slowing down time of the first phase of left ventricular filling, reduced LV filling rate both in the first phase of the passive filling and the second phase of active LV filling, increasing E/A ratio of more than 2, significant dilation of the left atrium, as well as positive increase in diastolic reserve that confirms deeper diastolic dysfunction in these adolescents compared with other subgroups.

Measurement of Strain in the Left Ventricle during Diastole withcine-MRI and Deformable Image Registration

Energy Technology Data Exchange (ETDEWEB)

Veress, Alexander I.; Gullberg, Grant T.; Weiss, Jeffrey A.

2005-07-20

The assessment of regional heart wall motion (local strain) can localize ischemic myocardial disease, evaluate myocardial viability and identify impaired cardiac function due to hypertrophic or dilated cardiomyopathies. The objectives of this research were to develop and validate a technique known as Hyperelastic Warping for the measurement of local strains in the left ventricle from clinical cine-MRI image datasets. The technique uses differences in image intensities between template (reference) and target (loaded) image datasets to generate a body force that deforms a finite element (FE) representation of the template so that it registers with the target image. To validate the technique, MRI image datasets representing two deformation states of a left ventricle were created such that the deformation map between the states represented in the images was known. A beginning diastoliccine-MRI image dataset from a normal human subject was defined as the template. A second image dataset (target) was created by mapping the template image using the deformation results obtained from a forward FE model of diastolic filling. Fiber stretch and strain predictions from Hyperelastic Warping showed good agreement with those of the forward solution. The technique had low sensitivity to changes in material parameters, with the exception of changes in bulk modulus of the material. The use of an isotropic hyperelastic constitutive model in the Warping analyses degraded the predictions of fiber stretch. Results were unaffected by simulated noise down to an SNR of 4.0. This study demonstrates that Warping in conjunction with cine-MRI imaging can be used to determine local ventricular strains during diastole.

Separate neurochemical classes of sympathetic postganglionic neurons project to the left ventricle of the rat heart.

Science.gov (United States)

Richardson, R J; Grkovic, I; Allen, A M; Anderson, C R

2006-04-01

The sympathetic innervation of the rat heart was investigated by retrograde neuronal tracing and multiple label immunohistochemistry. Injections of Fast Blue made into the left ventricular wall labelled sympathetic neurons that were located along the medial border of both the left and right stellate ganglia. Cardiac projecting sympathetic postganglionic neurons could be grouped into one of four neurochemical populations, characterised by their content of calbindin and/or neuropeptide Y (NPY). The subpopulations of neurons contained immunoreactivity to both calbindin and NPY, immunoreactivity to calbindin only, immunoreactivity to NPY only and no immunoreactivity to calbindin or NPY. Sympathetic postganglionic neurons were also labelled in vitro with rhodamine dextran applied to the cut end of a cardiac nerve. The same neurochemical subpopulations of sympathetic neurons were identified by using this technique but in different proportions to those labelled from the left ventricle. Preganglionic terminals that were immunoreactive for another calcium-binding protein, calretinin, preferentially surrounded retrogradely labelled neurons that were immunoreactive for both calbindin and NPY. The separate sympathetic pathways projecting to the rat heart may control different cardiac functions.

A Comparison Between the Hemodynamic Effects of Cisatracurium and Atracurium in Patient with Low Function of Left Ventricle who are Candidate for Open Heart Surgery.

Science.gov (United States)

Ghorbanlo, Masoud; Mohaghegh, Mahmoud Reza; Yazdanian, Forozan; Mesbah, Mehrdad; Totonchi, Ziya

2016-07-27

The need for muscle relaxants in general anesthesia in different surgeries including cardiac surgeries, and the type of relaxant to be used considering its different hemodynamic effects on patients with heart disease can be of considerable importance. In this study, the hemodynamic effects of two muscle relaxants, Cisatracurium and Atracurium in patients whit low function of left ventricle who are candidate for open heart surgery have been considered. This study has been designed as a randomized prospective double-blind clinical trial. The target population included all adult patients with heart disease whose ejection fraction reported by echocardiography or cardiac catheterization was 35% or less before the surgery, and were candidate for open heart surgery in Shahid Rajaei Heart Center. Taking into account the inclusion and exclusion criteria, the patients were randomly placed in two groups of 30 people each. In the induction stage, all the patients received midazolam, etomidate, and one of the considered muscle relaxant, either 0.2 mg/kg of cisatracurium or 0.5mg/kg of Atracurium within one minute. In the maintenance stage of anesthesia, the patients were administered by infusion of midazolam, sufentanil and the same muscle relaxant used in the induction stage. The hemodynamic indexes were recorded and evaluated in different stages of anesthesia and surgery as well as prior to transfer to ICU. In regard with descriptive indexes (age and sex distributions, premedication with cardiac drugs, ejection fraction before surgery, basic disease) there was no statistically significant difference between the groups. The significant difference of hemodynamic indexes between the two groups of this study, and the need for hemodynamic stability in all stages of surgery for patients with low function of left ventricle who are candidate for open heart surgery, proves that administering Cisatracurium as the muscle relaxant is advantageous and better.

Differential effects of the transient outward K(+) current activator NS5806 in the canine left ventricle

DEFF Research Database (Denmark)

Calloe, Kirstine; Soltysinska, Ewa; Jespersen, Thomas

2009-01-01

To examine the electrophysiological and molecular properties of the transient outward current (I(to)) in canine left ventricle using a novel I(to) activator, NS5806, I(to) was measured in isolated epicardial (Epi), midmyocardial (Mid) and endocardial (Endo) cells using whole-cell patch-clamp tech...

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

International Nuclear Information System (INIS)

Liu Xiaozhen; Liu Shaozhong

2011-01-01

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)

Radionuclide evaluation of left ventricular function with nonimaging probes.

Science.gov (United States)

Wexler, J P; Blaufox, M D

1979-10-01

Portable nonimaging probes have been developed that can evaluate left ventricular function using radionuclide techniques. Two modes of data acquisition are possible with these probe systems, first-pass and gated. Precordial radiocardiograms obtained after a bolus injection can be used to determine cardiac output, pulmonary transit time, pulmonary blood volume, left ventricle ejection fraction, and left-to-right shunts. Gated techniques can be used to determine left ventricular ejection fraction and sytolic time intervals. Probe-determined indices of left ventricular function agree excellently with comparable measurements determined by conventional camera-computer methods as well as by invasive techniques. These have begun to be used in a preliminary manner in a variety of clinical problems associated with left ventricular dysfunction. This review discusses the types of probe systems available, the methods used in positioning them, and details the specifics of their data acquisition and processing capacity. The major criticisms of probe methods are that they are nonimaging and that they measure global rather than regional left ventricular function. In spite of these criticisms, probe systems, because of their portability, high sensitivity, and relatively low cost are useful supplements to conventional camera-computer systems for the measurement of parameters of left ventricular performance using radionuclide techniques.

Measurement of the ejection fraction of the left ventricle with the isotope stethoscope

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Marving, J.; Hoeilund-Carlsen, P.F.; Jensen, G. (Koebenhavns Amts Sygehus, Glostrup (Denmark))

1982-01-01

Non-invasive measurements of left ventricular ejection fraction was performed in 21 patients by two observers with the Nuclear Stethoscope, a new, mobile, non-imaging single probe equipment. sup 99mTc was used for erythrocyte-labelling. Measurements were carried out in two different ways: beat-to-beat mode (i.e. for individual beats or a few beats at a time) and by ventricular function mode (i.e. for a composite beat, registered over a preselected period of time). There was good correlation between the two Nuclear Stethoscope modes (r=0.97) and between these and a simultaneous measurement made by gammacamera (r=0.90 and r=0.88). Despite uncertainties in the determination of correct background-level and centering over the left ventricle, there was no difference between the accuracy of the results of the two observers, compared with gammacamera measurements. The Nuclear Stethoscope is considerably cheaper than a gammacamera with computer-system, it is simple to operate, and can easily be used at the bedside, even in severely ill patients. A special feature is its capability of measuring sudden alterations in heart contractility on a beat-to-beat basis. Clinically it can be employed for both diagnostic purposes and for the monitoring of spontaneous courses and the effect of therapeutic interventions.

Measurement of the ejection fraction of the left ventricle with the isotope stethoscope

International Nuclear Information System (INIS)

Marving, J.; Hoeilund-Carlsen, P.F.; Jensen, G.

1982-01-01

Non-invasive measurements of left ventricular ejection fraction was performed in 21 patients by two observers with the Nuclear Stethoscope, a new, mobile, non-imaging single probe equipment. sup 99mTc was used for erythrocyte-labelling. Measurements were carried out in two different ways: beat-to-beat mode (i.e. for individual beats or a few beats at a time) and by ventricular function mode (i.e. for a composite beat, registered over a preselected period of time). There was good correlation between the two Nuclear Stethoscope modes (r=0.97) and between these and a simultaneous measurement made by gammacamera (r=0.90 and r=0.88). Despite uncertainties in the determination of correct background-level and centering over the left ventricle, there was no difference between the accuracy of the results of the two observers, compared with gammacamera measurements. The Nuclear Stethoscope is considerably cheaper than a gammacamera with computer-system, it is simple to operate, and can easily be used at the bedside, even in severely ill patients. A special feature is its capability of measuring sudden alterations in heart contractility on a beat-to-beat basis. Clinically it can be employed for both diagnostic purposes and for the monitoring of spontaneous courses and the effect of therapeutic interventions. (authors)

Left atrial volume and function in patients following ST elevation myocardial infarction and the association with clinical outcome

DEFF Research Database (Denmark)

Lønborg, Jacob Thomsen; Engstrøm, Thomas; Møller, Jacob Eifer

2013-01-01

The left atrium (LA) transfers blood to the left ventricle in a complex manner. LA function is characterized by passive emptying (LA passive fraction), active emptying (LA ejection fraction), and total emptying (LA fractional change). Despite this complexity, the clinical relevance of the LA is b...... function in patients following ST elevation myocardial infarction (STEMI)....

Heart rate variability and hear left ventricle hypertrophy in clean-up workers after Chernobyl accident with essential hypertension

International Nuclear Information System (INIS)

Khomazyuk, Yi.M.; Sidorenko, G.V.

2004-01-01

Correlation of heart rate variability (HRV) and hear left ventricle hypertrophy (LVH) in clean-up workers of Chernobyl accident with essential hypertension was estimated. Lowering of total HRV, parasympathetic and sympathetic activity associated with increased range of LVH was discovered

Quantitative evaluations of left ventricular function obtained by electrocardiographically-gated magnetic resonance imaging

International Nuclear Information System (INIS)

Takeda, Tohru; Iida, Kaname; Sugishita, Yasuro; Anno, Izumi; Akisada, Masayoshi; Matsuda, Mitsuo; Akatsuka, Takao; Koseki, Susumu.

1989-01-01

Using electrocardiographically-gated magnetic resonance imaging, regional cardiac function was evaluated in 12 normal volunteers and in 10 cases of old myocardial infarction. The optimal short axis of the left ventricle was selected at the chordae tendineae level. The left ventricle was divided into 12 segments using a computer-aided system, and percentile shortening fraction (%SF) and percentile wall thickening (%WT) were calculated in each segment by the fixed coordinate method. In the normal volunteers, heterogeneity of both %FS and %WT was observed, ranging from 25±13% and 37±13%, respectively in the septal segment, to 49±13% and 60±21%, respectively in the posterior segment. In the cases of myocardial infarction, decreased %FS and %WT were detected at the affected regions. The abnormal regions revealed by %WT tended to be narrower than those revealed by %FS. Thus the MR technique at the optimal axis may be useful for quantitative evaluations of regional cardiac function. (author)

Macrophage-derived osteopontin is fragmented by MMP-9 to hinder angiogenesis in the post-myocardial infarction left ventricle

DEFF Research Database (Denmark)

Nielsen, Signe Holm; Flynn, E.R.; Lindsey, M.

2017-01-01

Extracellular matrix (ECM) turnover is a key event during remodeling of the left ventricle (LV) following myocardial infarction (MI). Turnover includes ECM degradation of existing ECM to remove necrotic myocytes and synthesis to produce new ECM to form the infarct scar. Matrix metalloproteinases...

Passive and active ventricular elastances of the left ventricle

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Ng Eddie YK

2005-02-01

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

The challenge of preoperative quantification of functional tricuspid regurgitation and of right ventricle function: what information is clinically relevant?

Science.gov (United States)

Hahn, Rebecca T

2017-10-01

Functional or secondary tricuspid regurgitation (TR) is the most common etiology of severe TR in the western world. The presence of functional TR, either isolated or in combination with left heart disease is associated with unfavorable natural history however surgical mortality for isolated tricuspid valve interventions remain higher than for any other single valve surgery. Determining the severity of TR remains a controversial area and will continue to evolve as new techniques for assessing this valve as well as the right ventricle, are investigated. The following review will describe tricuspid anatomy, define echocardiographic views for evaluating tricuspid valve and right heart morphology and function, that are relevant to the pre-procedural assessment of functional TR.

Catheter-based high-intensity ultrasound for epicardial ablation of the left ventricle: device design and in vivo feasiblity

Science.gov (United States)

Salgaonkar, Vasant A.; Nazer, Babak; Jones, Peter D.; Tanaka, Yasuaki; Martin, Alastair; Ng, Bennett; Duggirala, Srikant; Diederich, Chris J.; Gerstenfeld, Edward P.

2015-03-01

The development and in vivo testing of a high-intensity ultrasound thermal ablation catheter for epicardial ablation of the left ventricle (LV) is presented. Scar tissue can occur in the mid-myocardial and epicardial space in patients with nonischemic cardiomyopathy and lead to ventricular tachycardia. Current ablation technology uses radiofrequency energy, which is limited epicardially by the presence of coronary vessels, phrenic nerves, and fat. Ultrasound energy can be precisely directed to deliver targeted deep epicardial ablation while sparing intervening epicardial nerve and vessels. The proof-of-concept ultrasound applicators were designed for sub-xyphoid access to the pericardial space through a steerable 14-Fr sheath. The catheter consists of two rectangular planar transducers, for therapy (6.4 MHz) and imaging (5 MHz), mounted at the tip of a 3.5-mm flexible nylon catheter coupled and encapsulated within a custom-shaped balloon for cooling. Thermal lesions were created in the LV in a swine (n = 10) model in vivo. The ultrasound applicator was positioned fluoroscopically. Its orientation and contact with the LV were verified using A-mode imaging and a radio-opaque marker. Ablations employed 60-s exposures at 15 - 30 W (electrical power). Histology indicated thermal coagulation and ablative lesions penetrating 8 - 12 mm into the left ventricle on lateral and anterior walls and along the left anterior descending artery. The transducer design enabled successful sparing from the epicardial surface to 2 - 4 mm of intervening ventricle tissue and epicardial fat. The feasibility of targeted epicardial ablation with catheter-based ultrasound was demonstrated.

Evaluation of left ventricular function by digital subtraction angiography

International Nuclear Information System (INIS)

Kuribayashi, Sachio; Ootaki, Makoto; Matsuyama, Seiya; Kanemoto, Nariaki; Furuya, Hideo

1985-01-01

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

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......, which is a strong prognostic marker in heart failure, independently depends on both left and right ventricular systolic function. This might, at least in part, explain why BNP holds stronger prognostic value than LVEF alone....... ventricular ejection fraction (LVEF), and left ventricular end-diastolic volume index (LVEDVI) were determined in 105 consecutive patients by first-pass radionuclide ventriculography (FP-RNV) and multiple ECG-gated equilibrium radionuclide ventriculography (ERNV), respectively. BNP was analyzed by immunoassay...

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

Science.gov (United States)

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

2007-09-01

Brain natriuretic peptide (BNP) is increased in heart failure; however, the relative contribution of the right and left ventricles is largely unknown. To investigate if right ventricular function has an independent influence on plasma BNP concentration. 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. Mean LVEF was 0.51 (range 0.10-0.83) with 36% having a reduced LVEF (left and right ventricular systolic function. This might, at least in part, explain why BNP holds stronger prognostic value than LVEF alone.

Normalised radionuclide measures of left ventricular diastolic function

International Nuclear Information System (INIS)

Lee, K.J.; Southee, A.E.; Bautovich, G.J.; Freedman, B.; McLaughlin, A.F.; Rossleigh, M.A.; Hutton, B.F.; Morris, J.G.; Royal Prince Alfred Hospital, Sydney

1989-01-01

Abnormal left ventricular diastolic function is being increasingly recognised in patients with clinical heart failure and normal systolic function. A simple routine radionuclide measure of diastolic function would therefore be useful. To establish, the relationship of peak diastolic filling rate (normalized for either end diastolic volume, stroke volume, or peak systolic emptying rate), and heart rate, age, and left ventricular ejection fraction was studied in 64 subjects with normal cardiovascular systems using routine gated heart pool studies. The peak filling rate when normalized to end diastolic volume correlated significantly with heart rate, age and left ventricular ejection fraction, whereas normalization to stroke volume correlated significantly to heart rate and age but not to left ventricular ejection fraction. Peak filling rate normalized for peak systolic emptying rate correlated with age only. Multiple regression equations were determined for each of the normalized peak filling rates in order to establish normal ranges for each parameter. When using peak filling rate normalized for end diastolic volume or stroke volume, appropriate allowance must be made for heart rate, age and ejection fraction. Peak filling rate normalized to peak ejection rate is a heart rate independent parameter which allows the performance of the patient's ventricle in diastole to be compared with its systolic function. It may be used in patients with normal systolic function to serially follow diastolic function, or if age corrected to screen for diastolic dysfunction. (orig.)

Right Ventricular Outflow Tract Tachycardia with Structural Abnormalities of the Right Ventricle and Left Ventricular Diverticulum

Directory of Open Access Journals (Sweden)

Bortolo Martini

2015-01-01

Full Text Available A 43-year-old woman presented to the emergency room with a sustained ventricular tachycardia (VT. ECG showed a QRS in left bundle branch block morphology with inferior axis. Echocardiography, ventricular angiography, and cardiac magnetic resonance imaging (CMRI revealed a normal right ventricle and a left ventricular diverticulum. Electrophysiology studies with epicardial voltage mapping identified a large fibrotic area in the inferolateral layer of the right ventricular wall and a small area of fibrotic tissue at the anterior right ventricular outflow tract. VT ablation was successfully performed with combined epicardial and endocardial approaches.

The Achilles' heel of left ventricular assist device therapy: right ventricle.

Science.gov (United States)

Ranganath, Neel K; Smith, Deane E; Moazami, Nader

2018-06-01

Many patients suffer from either persistent right ventricular failure (RVF) at the time of left ventricular assist device (LVAD) or have ongoing symptoms consistent with RVF during chronic mechanical circulatory support. The lack of long-term right ventricular assist devices (RVADs) has limited the impact that mechanical circulatory support can provide to patients with biventricular failure. We aim to review the entire spectrum of RVF in patients receiving LVADs and reflect on why this entity remains the Achilles' heel of LVAD therapy. In the early postoperative period, LVAD implantation reduces right ventricle (RV) afterload, but RV dysfunction may be exacerbated secondary to increased venous return. With prolonged therapy, the decreased RV afterload leads to improved RV contractile function. Bayesian statistical models outperform previously published preoperative risk scores by considering inter-relationships and conditional probabilities amongst independent variables. Various echocardiographic parameters and the pulmonary artery pulsatility index have shown promise in predicting post-LVAD RVF. Recent publications have delineated the emergence of 'delayed' RVF. Several devices are currently being investigated for use as RVADs. Post-LVAD RVF depends on the RV's ability to adapt to acute hemodynamic changes imposed by the LVAD. Management options are limited due to the lack of an easily implantable, chronic-use RVAD.

Neurohormones as markers of right- and left-sided cardiac dimensions and function in patients with untreated chronic heart failure

DEFF Research Database (Denmark)

Kjaer, Andreas; Hildebrandt, Per; Appel, Jon

2005-01-01

and that neuroendocrine profiling could be of value. In order to study this, we investigated the relationship between hormones and cardiac dimensions and function of both the right and left ventricle. METHODS: Twenty-three patients with newly diagnosed, untreated CHF were included. Right (RVEF) and left ventricular...... was normal in all subjects as well as right ventricular volumes. Likewise, on average, the lung transit time (LTT) was normal. Brain natriuretic peptide (BNP) significantly correlated with LVEF, left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index (LVESVI...... ejection fractions (LVEF) and volumes were measured by means of first-pass and equilibrium radionuclide ventriculography. RESULTS: LVEF was 0.29 (range: 0.11-0.55). Two-thirds of the patients had dilated left ventricles with volumes above upper reference limit. Right ventricular ejection fraction...

Novel approach for identification of left ventricle geometry in patients with chronic heart failure, AH and IHD in combination with COPD

Directory of Open Access Journals (Sweden)

Potabashniy V.A.

2016-05-01

Full Text Available The aim of this study was to examine the direction of change of left ventricle (LV geometry in patients with chronic heart failure (CHF, arterial hypertension (AH and ischemic heart disease (IHD in combination with chronic obstructive pulmonary disease (COPD in dependence on severity of clinical signs of CHF and COPD based on recommendation of American Society of Echocardiography and European Association of Cardiovascular Images (2015. We examined 67 patients with CHF, associated with AH and stable IHD and stable COPD. By the results of this study there were determined different types of left ventricle geometry: concentric LV hypertrophy (LVH, eccentric LVH, mixed LVH, dilated LVH, dependent on blood pressure level, fibrosic and ischemic myocardial changes,, primary predominant disease – AH, IHD or COPD.

Anizotropy characteristics of the left ventricle false chordae tendineae as one of varieties of myoendocardial formations of the human heart

Science.gov (United States)

Gavrylyak, M. S.; Malyk, Yu. Yu.; Tsyhykalo, O. V.; Semeniuk, T. O.; Penteleichuk, N. P.; Burkovets, D. N.; Yermolenko, S. B.

2018-01-01

The morphological and anizotropy characteristics of the left ventricle false chordae tendineae of human heart in the aspect of their anisotropic properties using spectroscopic-polarization methods was studied. There are given the results of statistical correlation structure of the spectral dependence of the two-dimensional Mueller matrix elements and phase shifts of histological sections of different morphological structure and physiological state. The relationship between the distribution of orientations of the optical axes birefringent miozyn fibrils with a set of statistical moments that characterize the distributions of Mueller matrix elements in different spectral ranges and half-width corresponding autocorrelation functions are established.

Measurement of blood flow in the left ventricle and aorta using clinical 2D cine phase-contrast magnetic resonance imaging

International Nuclear Information System (INIS)

Nakamura, Masanori; Wada, Shigeo; Yokosawa, Suguru; Yamaguchi, Takami; Isoda, Haruo; Takeda, Hiroyasu

2007-01-01

A recent development in phase-contrast magnetic resonance imaging (cine PC-MRI) allows the detailed measurement of the blood flow in humans. The objectives of this study are twofold: to discuss the utility of clinical two-dimensional (2D) cine PC-MRI as a practical tool for analyzing hemodynamics in the aorta and left ventricle; to provide flow information at those places as references for computational fluid dynamics studies. Using 2D cine PC-MRI, we mapped velocity profiles at various cross sections of the aorta and left ventricle. The results illustrated the main flow events in the left ventricle during the cardiac cycle, such as ventricular ejection and suction, while the secondary flows were less clear. The velocity profile at the entrance of the ascending aorta appeared to be slightly skewed posteriorly in early systole, but the flow in the central zone of the section was rapid. The estimated stroke volume, peak Reynolds numbers, and Womersley numbers were within the normal physiological range. A sequence of secondary flow images from the plane of the aortic valve to the descending aorta revealed the evolution of a helical flow within the aorta. Flows entering the aortic branches were captured well. Those results demonstrate that clinical 2D cine PC-MRI is a practical adjunct for analyzing blood flow in vivo and would be useful as references to check validity of flow dynamics obtained by computer simulations. (author)

Non-invasive evaluation of regional function of the left ventricle

International Nuclear Information System (INIS)

Schad, N.; Nickel, O.

1980-01-01

Assessment of regional left ventricular function with first pass angiocardiography in the RAO view almost entirely depends on high image statistics, accurate border definition and background subtraction, as well as an analysis of so called functional images which regionally measure and illustrate functional change during heart action. During first bolus transit the multicrystal camera gives an average of 300,000 cts/sec allowing precise border definition because of steepness of count changes at the LV-border. A varying background adjacent to each border point and also over the LV is subtracted. Measurements of segmental hemiaxis shortening and of zonal ejection fractions in the three zones supplied by the major coronary arteries have been performed. Clinical applications comprise examinations at rest, peak exercise, after nitroglycerin administration and after bypass graft surgery. Wall motion measured by means of hemiaxis shortening (210 segments) showed good correlation with angiocardiography in 91% of segments with normokinesis, in 90% asynergic and 88% of hypokinetic segments. Functional images corrected false negativ and false positiv wall motion measurements. In patients after myocardial infarction, there was (after NTG-administration) a significant increase in hemiaxis shortening in asynergic segment, but not in dyskinesias. Exercise studies in patients with wall motion disorders showed a significantly higher increase in global ejection fraction in patients with resting EF-values and 58% than above that value. Zonal ejection fractions after bypass surgery showed an average increase of 6.4 points if complete vascularization was performed, but no zonal increase or decrease when vascularization was incomplete or the zone included a previous myocardial infarction. (orig.) [de

Determination of Three-Dimensional Left Ventricle Motion to Analyze Ventricular Dyssyncrony in SPECT Images

DEFF Research Database (Denmark)

de Sá Rebelo, Marina; Aarre, Ann Kirstine Hummelgaard; Clemmesen, Karen-Louise

2010-01-01

A method to compute three-dimension (3D) left ventricle (LV) motion and its color coded visualization scheme for the qualitative analysis in SPECT images is proposed. It is used to investigate some aspects of Cardiac Resynchronization Therapy (CRT). The method was applied to 3D gated-SPECT images...... sets from normal subjects and patients with severe Idiopathic Heart Failure, before and after CRT. Color coded visualization maps representing the LV regional motion showed significant difference between patients and normal subjects. Moreover, they indicated a difference between the two groups...

Brief pressure overload of the left ventricle reduces myocardial infarct size via activation of protein kinase C.

Science.gov (United States)

Tang, Chia-Yu; Lai, Chang-Chi; Chiang, Shu-Chiung; Tseng, Kuo-Wei; Huang, Cheng-Hsiung

2015-09-01

We have previously reported that brief pressure overload of the left ventricle reduced myocardial infarct (MI) size. However, the role of protein kinase C (PKC) remains uncertain. In this study, we investigated whether pressure overload reduces MI size by activating PKC. MI was induced by a 40-minute occlusion of the left anterior descending coronary artery and a 3-hour reperfusion in anesthetized Sprague-Dawley rats. MI size was determined using triphenyl tetrazolium chloride staining. Brief pressure overload was achieved by two 10-minute partial snarings of the ascending aorta, raising the systolic left ventricular pressure 50% above the baseline value. Ischemic preconditioning was elicited by two 10-minute coronary artery occlusions and 10-minute reperfusions. Dimethyl sulfoxide (vehicle) or calphostin C (0.1 mg/kg, a specific inhibitor of PKC) was administered intravenously as pretreatment. The MI size, expressed as the percentage of the area at risk, was significantly reduced in the pressure overload group and the ischemic preconditioning group (19.0 ± 2.9% and 18.7 ± 3.0% vs. 26.1 ± 2.6% in the control group, where p overload and ischemic preconditioning (25.2 ± 2.4% and 25.0 ± 2.3%, where p overload of the left ventricle reduced MI size. Since calphostin C significantly limited the decrease of MI size, our results suggested that brief pressure overload reduces MI size via activation of PKC. Copyright © 2015. Published by Elsevier Taiwan.

Cephalometric Assessment of the Fourth Ventricles Using ...

African Journals Online (AJOL)

brain. To provide baseline data for measurements of normal fourth ventricle using ... (2001) normally the left ventricle was larger than the right one and both were larger in males among .... Kennedy, D.N., Caviness, Jr, V.S. and Tsuang,.

The Prognostic Value of 18F-FDG Uptake Ratio Between the Right and Left Ventricles in Idiopathic Pulmonary Arterial Hypertension.

Science.gov (United States)

Li, Wen; Wang, Lei; Xiong, Chang-Ming; Yang, Tao; Zhang, Yan; Gu, Qing; Yang, Yong; Ni, Xin-Hai; Liu, Zhi-Hong; Fang, Wei; He, Jian-Guo

2015-11-01

Metabolic changes occur in the right ventricle (RV) under increased afterload in pulmonary arterial hypertension. FDG PET imaging has potential to assess RV function. In this study, we aimed to determine the prognostic value of metabolic changes of RV using FDG PET imaging in idiopathic pulmonary arterial hypertension (IPAH). In this prospective investigation, patients newly diagnosed with IPAH were recruited. Patients underwent right heart catheterization, FDG PET imaging, and cardiac MR (CMR) within 1 week. Right ventricle hemodynamics, glucose metabolism derived from the FDG uptake levels, and functional parameters were obtained. The FDG uptake ratio between the RV and the left ventricle (LV) and its relation with the patients' survival were analyzed. A total of 45 IPAH patients were enrolled in this study, which included 13 male (28.9%) and 32 female (71.1%). The median follow-up time of this study was 1043 days. At the end of the follow-up, 36 patients survived, whereas 9 patients were deceased because of right heart failure. Multivariate Cox proportional hazard analysis showed that the ratio between the corrected RV and LV FDG uptake (cRV/LV) in both glucose-loading (cRV/LVg) and fasting (cRV/LVf) conditions independently predicted the mortality after adjusting for pulmonary vascular resistance index, mean right atrial pressure, and World Health Organization functional class. Kaplan-Meier survival analysis showed that patients with cRV/LVf greater than 143.65% in fasting condition (log rank, P = 0.030) or cRV/LVg greater than 120.55% in glucose-loading condition (log rank, P = 0.014) had worse prognosis. The FDG uptake ratio between the RV and LV can be an independent predictor for long-term prognosis of IPAH patients.

Estimation of global and regional ejection fraction of the left ventricle using a fully digitalised technique

International Nuclear Information System (INIS)

Tuengerthal, S.; Reifart, N.; Standke, R.; Lang, J.; Kollath, J.; Riemann, H.E.; Frankfurt Univ.; Frankfurt Univ.

1984-01-01

Subtraction angiocardiography (DSAK) with a fully digitalised system (DR 960) provides a well defined demonstration of the left ventricle after peripheral venous contrast injection. Cardiac volume and ejection fractions were calculated by a dedicated software programme and the findings correlated with cine ventriculography (CA) (r=0.91), biplane echo cardiography (2 DE) (r=0.77) and radionucleid ventriculography (RNV) (r=0.85); the method can be used even with reduced cardiac output (EF [de

Fate of tumor cells injected into left ventricle of heart in BALB/c mice: role of natural killer cells

DEFF Research Database (Denmark)

Basse, P; Hokland, P; Heron, I

1988-01-01

The arrest, retention, and elimination (i.e., clearance) of radiolabeled YAC-1 lymphoma cells injected either iv or into the left ventricle (LV) of the heart were studied in male BALB/c mice, with special emphasis on the role of natural killer (NK) cells. After iv injection YAC-1 cells were...

The influence of the perinatal chronic hyperglycaemia on the pattern of NOS isoforms expression in left ventricle myocardium in male rats of pre-pubertal age

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O. V. Gancheva

2016-12-01

Full Text Available The aim of our study was to find out the features of the nitric oxide synthase (NOS isoforms expression in longitudinal and transversal layers of the myocardium of the left ventricle in male rats of 3 months, which are descendants of female rats with experimental gestational diabetes (EGD. Materials and methods. Study was carried out on 10 male rats descendants of female rats with normal course of pregnancy and 10 descendants of female rats with EGD. We evaluated the expression of neuronal, endothelial and inducible isoforms of NOS in histological sections both of transversal and longitudinal layers of the myocardium of left ventricle. With the aim to analyze the pattern of the NOS isoforms expression in 5 um histological slices of left ventricle myocardium we have carried out a complex of histochemical assays. Slices were allocated to 3 groups: 1st one was incubated with rabbit IgG to neuronal NOS (Santa Cruz Biotechnology, USA in dilution of 1:200; 2nd group underwent the incubation with rabbit IgG to endothelial NOS (eNos (Santa Cruz Biotechnology, USA in dilution 1:200; 3rd group was incubated with mice IgG to inducible NOS (iNos conjugated with FITC (Santa Cruz Biotechnology, USA in dilution of 1:200. The analysis of images was carried out with VIDAS-2.5 application package (Kontron Elektronik, Germany. Microimages of the left ventricle myocardium obtained with AxioScope (Carl Zeiss, Germany and COHU 4922 (COHU Inc., USA camera were processed in the system of digital image analysis VIDAS-386 (Kontron Elektronik, Germany. Results. In the study we have found that prenatal hyperglycaemia leads to the significant changes of the expression of NOS isoforms in the myocardium of left ventricle in male rats descendants of females with EGD, and the contain and the allocation of these enzymes are dependent both on type of the enzyme and its location in muscular layers. For eNOS the increase of the expression and the allocation in both transversal and

Evaluation of Pulsed Doppler-Versus Tissue Doppler-Derived Tei Index of Right and Left Ventricle in Fetuses

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Hamid Amoozgar

2011-12-01

Full Text Available Background: The myocardial performance index (MPI, also known as the Tei index, was introduced by Tei et al. to evaluate cardiac function in adults with dilated cardiomyopathy. This index is defined as the sum of isovolumic contraction time (ICT and isovolumic relaxation time (IRT, divided by ejection time (ET. Objectives: To determine the correlation between pulsed Doppler (PD- and tissue Doppler imaging (TDI-derived Tei indices in fetuses. Patients and Methods: Right and left ventricle PD and TDI echocardiographic data were obtained from 59 fetuses (11 pregnant women who were positive for anti-SSA-Ro or anti-SSB-La antibodies, 18 women who were referred due to dysrhythmia, and 30 women who had normal clinical findings. Results: Mean fetal gestational age was 27 ± 6.4 weeks. Mean PD Tei index of the mitral and tricuspid valve was 0.58 ± 0.05 and 0.53 ± 0.08, respectively. Mean TDI indices for the mitral and tricuspid valve were 0.56 ± 0.09 and 0.55 ± 0.08, respectively. There were no significant differences between mitral and tricuspid PD- and TDI-derived Tei indices (P = 0.87, P= 0.21, but the Bland-Altman diagrams showed no fine agreement between the indices (the mean difference ± 1 standard deviation of the right ventricular PD- and TDI-derived Tei indices was 0.24 ± 0.02 and 0.29 ± 0.04 for the left ventricle. There were no significant differences in PD- and TDI-derived Tei indexes between groups of evaluated fetuses (Mitral valve: PD-Tei P=0.69, TDI-Tei P=0.49; Tricuspid valve: PD-Tei P=0.41, TDI-Tei P=0.36. Conclusions: Although the mean values of the two indices did not differ significantly, the TDI-derived and PD-derived Tei indices did not have fine agreement.

Functional reserve of the ischemic left ventricle with ventricular aneurysm to afterload stress

International Nuclear Information System (INIS)

Tsuiki, Kai; Kobayashi, Tadashi; Hayasaka, Makio

1985-01-01

The response of left ventricular function to afterload stress was assessed using DSA for eight patients with old anterior myocardial infarction and ventricular aneurysm including that of the anterior wall. After initial DSA in the basal state, methoxamine was infused intravenously (1 to 2 mg/min). When aortic systolic blood pressure increased by 30 to 50 mmHg, a second DSA was performed for each patient. Left ventricular volumes and ejection fractions were calculated by the area-length method, and regional wall motion was assessed by the visual method according to the AHA classification and the curvature radius of the apical ventricular aneurysm was calculated. Methoxamine induced neither acute heart failure nor angina pectoris in the present series. The heart rates decreased, and there were a significant increase in end-systolic volumes (p ES ). However, ΔESV and ΔR ES did not correlate; ΔR ES was much greater in two patients, who were relatively old. Their aneurysms were circumscribed within the left ventricular anterior wall, their ejection fractions were relatively increased; and their onsets of acute myocardial infarction were relatively recent. (J.P.N.)

Urinary albumin excretion in hospitalized patients with acute myocardial infarction. Prevalence of microalbuminuria and correlation to left ventricle wall thickness

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Taskiran, M; Feldt-Rasmussen, B; Jensen, G B

1998-01-01

was independent of blood pressure, body weight, smoking, diabetes mellitus, renal disease, and thrombolytic treatment. There was a positive correlation between urinary albumin excretion and thickness of the left ventricle wall (R = 0.28; p = 0.001) which was independent of blood pressure. Follow-up examination...

Global left ventricular function in cardiac CT. Evaluation of an automated 3D region-growing segmentation algorithm

International Nuclear Information System (INIS)

Muehlenbruch, Georg; Das, Marco; Hohl, Christian; Wildberger, Joachim E.; Guenther, Rolf W.; Mahnken, Andreas H.; Rinck, Daniel; Flohr, Thomas G.; Koos, Ralf; Knackstedt, Christian

2006-01-01

The purpose was to evaluate a new semi-automated 3D region-growing segmentation algorithm for functional analysis of the left ventricle in multislice CT (MSCT) of the heart. Twenty patients underwent contrast-enhanced MSCT of the heart (collimation 16 x 0.75 mm; 120 kV; 550 mAseff). Multiphase image reconstructions with 1-mm axial slices and 8-mm short-axis slices were performed. Left ventricular volume measurements (end-diastolic volume, end-systolic volume, ejection fraction and stroke volume) from manually drawn endocardial contours in the short axis slices were compared to semi-automated region-growing segmentation of the left ventricle from the 1-mm axial slices. The post-processing-time for both methods was recorded. Applying the new region-growing algorithm in 13/20 patients (65%), proper segmentation of the left ventricle was feasible. In these patients, the signal-to-noise ratio was higher than in the remaining patients (3.2±1.0 vs. 2.6±0.6). Volume measurements of both segmentation algorithms showed an excellent correlation (all P≤0.0001); the limits of agreement for the ejection fraction were 2.3±8.3 ml. In the patients with proper segmentation the mean post-processing time using the region-growing algorithm was diminished by 44.2%. On the basis of a good contrast-enhanced data set, a left ventricular volume analysis using the new semi-automated region-growing segmentation algorithm is technically feasible, accurate and more time-effective. (orig.)

Right and left ventricular cardiac function in a developed world population with human immunodeficiency virus studied with radionuclide ventriculography

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Lebech, Anne-Mette; Gerstoft, Jan; Hesse, Birger

2004-01-01

. No correlations were found between reduced cardiac function and levels of the 3 peptides measured. CONCLUSIONS: No major dysfunction of the left ventricle is present in a developed world HIV population. However, a small but significant part of this population has modestly reduced right-sided systolic function.......-associated morbidity and mortality rates. Accordingly, the prevalence of HIV-associated cardiac dysfunction may also have changed. The aim of the study was to establish the prevalence of right- and left-sided cardiac dysfunction in a Danish HIV population, most of whom were undergoing HAART, with radionuclide...... ventricular ejection fraction and 6 (7%) had a reduced right ventricle ejection fraction (0.35-0.42) compared with reference values from the age- and sex-matched reference population. Patients with HIV and reduced cardiac function did not differ in the duration of HIV, CD4 count, CD4 nadir, or HIV RNA load...

Transcriptional alterations in the left ventricle of three hypertensive rat models.

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Cerutti, Catherine; Kurdi, Mazen; Bricca, Giampiero; Hodroj, Wassim; Paultre, Christian; Randon, Jacques; Gustin, Marie-Paule

2006-11-27

Left ventricular hypertrophy (LVH) is commonly associated with hypertension and represents an independent cardiovascular risk factor. The aim of this study was to test the hypothesis that the cardiac overload related to hypertension is associated to a specific gene expression pattern independently of genetic background. Gene expression levels were obtained with microarrays for 15,866 transcripts from RNA of left ventricles from 12-wk-old rats of three hypertensive models [spontaneously hypertensive rat (SHR), Lyon hypertensive rat (LH), and heterozygous TGR(mRen2)27 rat] and their respective controls. More than 60% of the detected transcripts displayed significant changes between the three groups of normotensive rats, showing large interstrain variability. Expression data were analyzed with respect to hypertension, LVH, and chromosomal distribution. Only four genes had significantly modified expression in the three hypertensive models among which a single gene, coding for sialyltransferase 7A, was consistently overexpressed. Correlation analysis between expression data and left ventricular mass index (LVMI) over all rats identified a larger set of genes whose expression was continuously related with LVMI, including known genes associated with cardiac remodeling. Positioning the detected transcripts along the chromosomes pointed out high-density regions mostly located within blood pressure and cardiac mass quantitative trait loci. Although our study could not detect a unique reprogramming of cardiac cells involving specific genes at early stage of LVH, it allowed the identification of some genes associated with LVH regardless of genetic background. This study thus provides a set of potentially important genes contained within restricted chromosomal regions involved in cardiovascular diseases.

Gender differences in left ventricular function in patients with isolated aortic stenosis.

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Favero, Luca; Giordan, Massimo; Tarantini, Giuseppe; Ramondo, Angelo Bruno; Cardaioli, Paolo; Isabella, Giambattista; Chioin, Raffaello; Lupia, Mario; Razzolini, Renato

2003-05-01

Hypertrophic response of the left ventricle to systolic overload in aortic stenosis appears to be gender-dependent. To examine gender-related differences in left ventricular (LV) function in patients with isolated severe aortic stenosis, 145 patients (65 women, 80 men; mean age 66 +/- 8 years; range: 50 to 89 years) with aortic valve area 199 mmHg, the mass:volume ratio was increased in men compared with women; of note, the mass:volume ratio in women was not increased in this subgroup compared with the general population. LV pump function in this subgroup was normal and did not differ between men and women. Although no clear-cut difference in hemodynamic parameters was seen, there was a trend towards a less compensatory increase in LV mass in females.

Single-breath-hold 3-D CINE imaging of the left ventricle using Cartesian sampling.

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Wetzl, Jens; Schmidt, Michaela; Pontana, François; Longère, Benjamin; Lugauer, Felix; Maier, Andreas; Hornegger, Joachim; Forman, Christoph

2018-02-01

Our objectives were to evaluate a single-breath-hold approach for Cartesian 3-D CINE imaging of the left ventricle with a nearly isotropic resolution of [Formula: see text] and a breath-hold duration of [Formula: see text]19 s against a standard stack of 2-D CINE slices acquired in multiple breath-holds. Validation is performed with data sets from ten healthy volunteers. A Cartesian sampling pattern based on the spiral phyllotaxis and a compressed sensing reconstruction method are proposed to allow 3-D CINE imaging with high acceleration factors. The fully integrated reconstruction uses multiple graphics processing units to speed up the reconstruction. The 2-D CINE and 3-D CINE are compared based on ventricular function parameters, contrast-to-noise ratio and edge sharpness measurements. Visual comparisons of corresponding short-axis slices of 2-D and 3-D CINE show an excellent match, while 3-D CINE also allows reformatting to other orientations. Ventricular function parameters do not significantly differ from values based on 2-D CINE imaging. Reconstruction times are below 4 min. We demonstrate single-breath-hold 3-D CINE imaging in volunteers and three example patient cases, which features fast reconstruction and allows reformatting to arbitrary orientations.

Does post-exercise ST depression reflect local ischemia or some global effect in the left ventricle?

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Carlens, P; Forssell, G; Jonasson, R; Landou, C; Orinius, E

1985-01-01

As exercise-induced ST depressions are most frequent and marked in lead V5 independent of which single coronary artery is obstructed, some other mechanisms of ST depressions than local ischemia should be searched for. Left ventricular hemodynamics during exercise was studied in two groups of patients with severe effort angina, 19 with and 12 without ST depression after exercise (STAE). During supine exercise until angina, stroke index became significantly lower (37 vs. 52 ml/m2) and left ventricular end-diastolic pressure (LVEDP) significantly higher (40 vs. 30 mmHg) in the STAE group. The best discriminator was the early diastolic pressure (LVeDP) (22 vs. 11 mmHg), which is interpreted as a sign of a more ischemic ventricle in the STAE group. The sum of STAE in all leads is correlated to LVeDP but not to LVEDP during exercise. The link between the significant ischemia in various locations and STAE appearing most frequently and markedly in V5 seems to be some global mechanism as the occurrence of STAE and the height of the R wave were positively correlated in the various leads. As STAE in coronary heart disease shows similar configuration and distribution as in aortic valvular stenosis and digoxin medication of healthy subjects, a possible link could be the compensatory increase in contractility in non-ischemic parts of the ventricle.

Evaluation of Left Ventricle Function by Regional Fractional Area Change (RFAC) in a Mouse Model of Myocardial Infarction Secondary to Valsartan Treatment

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Castiglioni, Laura; Colazzo, Francesca; Fontana, Lucia; Colombo, Gualtiero I.; Piacentini, Luca; Bono, Elisa; Milano, Giuseppina; Paleari, Serena; Palermo, Annamaria; Guerrini, Uliano; Tremoli, Elena; Sironi, Luigi

2015-01-01

Aim Left ventricle (LV) regional fractional area change (RFAC) measured by cardiac magnetic resonance (CMR) allows the non-invasive localization and quantification of the degree of myocardial infarction (MI), and could be applied to assess the effectiveness of pharmacological or regenerative therapies. Here we investigate the ability of RFAC to identify regional dysfunction and discriminate the effect of pharmacological treatment with valsartan, a selective antagonist of angiotensin II type 1 receptor, in a model of MI. Methods and Results C57BL/6N mice, undergoing coronary artery ligation, were divided into two groups: untreated (MI) or treated with valsartan (MI+Val). Sham-operated mice were used as a control. Cardiac dimensions and function were assessed at baseline, 24 hours, 1 and 4 weeks post surgery by CMR and echocardiography. At sacrifice histology and whole-genome gene expression profiling were performed. RFAC was able to detect significant differences between treatment groups whereas the global ejection fraction was not. RFAC showed greater loss of regional contraction in remote non-infarcted myocardium in MI group than in MI+Val group. Consistently, in the same region MI+Val mice showed reduced myocyte hypertrophy, fibroblast proliferation, and fibrosis and modulation of target genes; in addition, left atrium volumes, appendage length and duct contraction were preserved. Conclusion In this study, RFAC effectively estimated the degree of systolic dysfunction and discriminated the regions preserved by pharmacological treatment. RFAC index is a promising tool to monitor changes in LV contraction and to assess the effectiveness of therapeutic regimens in clinical settings. PMID:26291973

Convolutional neural network regression for short-axis left ventricle segmentation in cardiac cine MR sequences.

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Tan, Li Kuo; Liew, Yih Miin; Lim, Einly; McLaughlin, Robert A

2017-07-01

Automated left ventricular (LV) segmentation is crucial for efficient quantification of cardiac function and morphology to aid subsequent management of cardiac pathologies. In this paper, we parameterize the complete (all short axis slices and phases) LV segmentation task in terms of the radial distances between the LV centerpoint and the endo- and epicardial contours in polar space. We then utilize convolutional neural network regression to infer these parameters. Utilizing parameter regression, as opposed to conventional pixel classification, allows the network to inherently reflect domain-specific physical constraints. We have benchmarked our approach primarily against the publicly-available left ventricle segmentation challenge (LVSC) dataset, which consists of 100 training and 100 validation cardiac MRI cases representing a heterogeneous mix of cardiac pathologies and imaging parameters across multiple centers. Our approach attained a .77 Jaccard index, which is the highest published overall result in comparison to other automated algorithms. To test general applicability, we also evaluated against the Kaggle Second Annual Data Science Bowl, where the evaluation metric was the indirect clinical measures of LV volume rather than direct myocardial contours. Our approach attained a Continuous Ranked Probability Score (CRPS) of .0124, which would have ranked tenth in the original challenge. With this we demonstrate the effectiveness of convolutional neural network regression paired with domain-specific features in clinical segmentation. Copyright © 2017 Elsevier B.V. All rights reserved.

Quantitative right and left ventricular functional analysis during gated whole-chest MDCT: A feasibility study comparing automatic segmentation to semi-manual contouring

International Nuclear Information System (INIS)

Coche, Emmanuel; Walker, Matthew J.; Zech, Francis; Crombrugghe, Rodolphe de; Vlassenbroek, Alain

2010-01-01

Purpose: To evaluate the feasibility of an automatic, whole-heart segmentation algorithm for measuring global heart function from gated, whole-chest MDCT images. Material and methods: 15 patients with suspicion of PE underwent whole-chest contrast-enhanced MDCT with retrospective ECG synchronization. Two observers computed right and left ventricular functional indices using a semi-manual and an automatic whole-heart segmentation algorithm. The two techniques were compared using Bland-Altman analysis and paired Student's t-test. Measurement reproducibility was calculated using intraclass correlation coefficient. Results: Ventricular analysis with automatic segmentation was successful in 13/15 (86%) and in 15/15 (100%) patients for the right ventricle and left ventricle, respectively. Reproducibility of measurements for both ventricles was perfect (ICC: 1.00) and very good for automatic and semi-manual measurements, respectively. Ventricular volumes and functional indices except right ventricular ejection fraction obtained from the automatic method were significantly higher for the RV compared to the semi-manual methods. Conclusions: The automatic, whole-heart segmentation algorithm enabled highly reproducible global heart function to be rapidly obtained in patients undergoing gated whole-chest MDCT for assessment of acute chest pain with suspicion of pulmonary embolism.

Assessment of sistemic ventricle function in corrected transposition of great arteries with Gated SPECT: comparison with radionuclide ventriculography

International Nuclear Information System (INIS)

Alexanderson, E.; Espinola, N.; Duenas, D.; Fermon, S.; Acevedo, C.; Martinez, C.

2002-01-01

Corrected trasposition of great arteries is a uncommon congenital heart disease where the right ventricle works as the sistemic one. QGS Gated SPECT program was designed to recognize the contours of left ventricle being a good method to evaluate left ventricle ejection fraction. The purpose of this study was to evaluate the right ventricle ejection fraction (RVEF) by gated SPECT using Tc-99mSestaMIBI in comparison with radionuclide ventriculography (RVG) in patients with corrected trasposition of great arteries. Methods: We performed gated SPECT and radionuclide ventriculography within 15 days of each other in 7 adults consecutive patients with the diagnosis of corrected trasposition of great arteries (5 men, 2 women; mean age 47 y). Gated tomographic data, including ventricular volumes and ejection fraction, were processed using QGS automatic algorithm, whereas equilibrium radionuclide ventriculography used standard techniques. Results: We found a good correlation between right ventricle ejection fraction obtained with Gated SPECT compared with equilibrium radionuclide ventriculography. The mean of the RVEF with Gated SPECT was 41.2% compared with 44.2% of RVEF with equilibrium radionuclide ventriculography. Both methods recognized abnormal RVEF in 5 patients ( 50%) with Gated SPECT and abnormal with RVG meanwhile another patient had normal RVEF with RVG and abnormal with Gated SPECT. Conclusion: Quantitative gated tomography, using Tc 99mSestaMIBI, has a good correlation with radionuclide ventriculography for the assessment of right ventricle ejection fraction in patients with corrected trasposition of great arteries. These results support the clinical use of this technique among these patients

Is exercise good for the right ventricle? Concepts for health and disease.

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La Gerche, André; Claessen, Guido

2015-04-01

There is substantial evidence supporting the prescription of exercise training in patients with left-sided heart disease, but data on the effects of exercise are far more limited for conditions that primarily affect the right ventricle. There is evolving evidence that right ventricular (RV) function is of critical importance to circulatory function during exercise. Even in healthy individuals with normal pulmonary vascular function, the hemodynamic load on the right ventricle increases relatively more during exercise than that of the left ventricle, and this disproportionate load is far greater in patients with pulmonary hypertension. Exercise-induced increases in pulmonary artery pressures can exceed RV contractile reserve (so-called arterioventricular uncoupling), resulting in attenuated cardiac output and exercise intolerance. In this review, we explore the spectrum of RV reserve-from transient RV dysfunction observed in athletes after extreme bouts of intense endurance exercise to RV failure with minimal exertion in patients with advanced pulmonary hypertension. Recent advances and novel approaches to echocardiographic and cardiac magnetic resonance imaging have provided more accurate means of assessing the right ventricle and pulmonary circulation during exercise such that quantification of exercise reserve may provide a valuable means of assessing prognosis and response to therapies. We discuss the potential benefits and risks of exercise training in both health and disease while recognizing the need for prospective studies that assess the long-term efficacy and safety of exercise interventions in patients with pulmonary vascular and RV pathologic conditions. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Study on the relationship between plasma BNP levels and left cardiac function in patients with heart failure

International Nuclear Information System (INIS)

Yin Xin; Xu Dandan; Wu Chunxu

2005-01-01

Objective: To investigate the relationship between plasma brain natriuretic peptide (BNP) levels and cardiac function in patients with heart failure. Methods: Plasma levels of BNP (with IRMA) and left cardiac function parameters (examined with echocardiogram) were obtained in 80 patients with heart failure at admission and repeatedly examined in 43 of them later after 2w treatment a swell as in 30 controls. Results: The plasma BNP levels increased along with the deterioration of cardiac function, with significant differences among the patients with different cardiac function grades (P<0.01). After 2w treatment, the plasma BNP levels were significantly lower than those before (P<0.01). The plasma levels of BNP were negatively correlated with left ventricular ejection fraction (LVEF) and left ventricle fraction shortening, but positively correlated with left ventricular end-systolic diameter (LVSd) and left ventricular end-diastolic diameter (LVDd). Conclusion: Plasma levels of BNP were closely related to the severity of heart failure and could serve as a biochemical marker for assessing the left cardiac function. (authors)

Patient-Specific Modeling of Interventricular Hemodynamics in Single Ventricle Physiology

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Vedula, Vijay; Feinstein, Jeffrey; Marsden, Alison

2016-11-01

Single ventricle (SV) congenital heart defects, in which babies are born with only functional ventricle, lead to significant morbidity and mortality with over 30% of patients developing heart failure prior to adulthood. Newborns with SV physiology typically undergo three palliative surgeries, in which the SV becomes the systemic pumping chamber. Depending on which ventricle performs the systemic function, patients are classified as having either a single left ventricle (SLV) or a single right ventricle (SRV), with SRV patients at higher risk of failure. As the native right ventricles are not designed to meet systemic demands, they undergo remodeling leading to abnormal hemodynamics. The hemodynamic characteristics of SLVs compared with SRVs is not well established. We present a validated computational framework for performing patient-specific modeling of ventricular flows, and apply it across 6 SV patients (3SLV + 3SRV), comparing hemodynamic conditions between the two subgroups. Simulations are performed with a stabilized finite element method coupled with an immersed boundary method for modeling heart valves. We discuss identification of hemodynamic biomarkers of ventricular remodeling for early risk assessment of failure. This research is supported in part by the Stanford Child Health Research Institute and the Stanford NIH-NCATS-CTSA through Grant UL1 TR001085 and due to U.S. National Institute of Health through NIH NHLBI R01 Grants 5R01HL129727-02 and 5R01HL121754-03.

The left ventricle in aortic stenosis--imaging assessment and clinical implications.

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Călin, Andreea; Roşca, Monica; Beladan, Carmen Cristiana; Enache, Roxana; Mateescu, Anca Doina; Ginghină, Carmen; Popescu, Bogdan Alexandru

2015-04-29

Aortic stenosis has an increasing prevalence in the context of aging population. In these patients non-invasive imaging allows not only the grading of valve stenosis severity, but also the assessment of left ventricular function. These two goals play a key role in clinical decision-making. Although left ventricular ejection fraction is currently the only left ventricular function parameter that guides intervention, current imaging techniques are able to detect early changes in LV structure and function even in asymptomatic patients with significant aortic stenosis and preserved ejection fraction. Moreover, new imaging parameters emerged as predictors of disease progression in patients with aortic stenosis. Although proper standardization and confirmatory data from large prospective studies are needed, these novel parameters have the potential of becoming useful tools in guiding intervention in asymptomatic patients with aortic stenosis and stratify risk in symptomatic patients undergoing aortic valve replacement.This review focuses on the mechanisms of transition from compensatory left ventricular hypertrophy to left ventricular dysfunction and heart failure in aortic stenosis and the role of non-invasive imaging assessment of the left ventricular geometry and function in these patients.

An Optical Method for the In-Vivo Characterization of the Biomechanical Response of the Right Ventricle.

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Soltani, A; Lahti, J; Järvelä, K; Curtze, S; Laurikka, J; Hokka, M; Kuokkala, V-T

2018-05-01

The intraoperative in-vivo mechanical function of the left ventricle has been studied thoroughly using echocardiography in the past. However, due to technical and anatomical issues, the ultrasound technology cannot easily be focused on the right side of the heart during open-heart surgery, and the function of the right ventricle during the intervention remains largely unexplored. We used optical imaging and digital image correlation for the characterization of the right ventricle motion and deformation during open-heart surgery. This work is a pilot study focusing on one patient only with the aim of establishing the framework for long term research. These experiments show that optical imaging and the analysis of the images can be used to obtain similar parameters, and partly at higher accuracy, for describing the mechanical functioning of the heart as the ultrasound technology. This work describes the optical imaging based method to characterize the mechanical response of the heart in-vivo, and offers new insight into the mechanical function of the right ventricle.

Echocardiographic assessment of the right ventricle in the current era: Application in clinical practice.

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Venkatachalam, Sridhar; Wu, Geru; Ahmad, Masood

2017-12-01

The right ventricle has unique structural and functional characteristics. It is now well recognized that the so-called forgotten ventricle is a key player in cardiovascular physiology. Furthermore, there is accumulating evidence that demonstrates right ventricular dysfunction as an important marker of morbidity and mortality in several commonly encountered clinical situations such as heart failure, pulmonary hypertension, pulmonary embolism, right ventricular myocardial infarction, and adult congenital heart disease. In contrast to the left ventricle, echocardiographic assessment of right ventricular function is more challenging as volume estimations are not possible without the use of three-dimensional (3D) echocardiography. Guidelines on chamber quantification provide a standardized approach to assessment of the right ventricle. The technique and limitations of each of the parameters for RV size and function need to be fully understood. In this era of multimodality imaging, echocardiography continues to remain a useful tool for the initial assessment and follow-up of patients with right heart pathology. Several novel approaches such as 3D and strain imaging of the right ventricle have expanded the usefulness of this indispensable modality. © 2017, Wiley Periodicals, Inc.

Left ventricle expands maximally preceding end-diastole. Radionuclide ventriculography study

International Nuclear Information System (INIS)

Horinouchi, Osamu

2002-01-01

It has been considered that left ventricle (LV) expands maximally at the end-diastole. However, is it exactly coincident with this point? This study was aimed to determine whether the maximal expansion of LV coincides with the peak of R wave on electrocardiogram. Thirty-three angina pectoris patients with normal LV motion were examined using radionuclide ventriculography. Data were obtained from every 30 ms backward frame from the peak of R wave. All patients showed the time of maximal expansion preceded the peak of R wave. The intervals from the peak of R wave and the onset of P wave to maximal expansion of LV was 105±29 ms and 88±25 ms, respectively. This period corresponds to the timing of maximal excurtion of mitral valve by atrial contraction, and the centripetal motion of LV without losing its volume before end-diastole may be interpreted on account of the movement of mitral valve toward closure. These findings suggest that LV expands maximally between P and R wave after atrial contraction, preceding the peak of R wave thought conventionally as the end-diastole. (author)

Quantification of Right and Left Ventricular Function in Cardiac MR Imaging: Comparison of Semiautomatic and Manual Segmentation Algorithms

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Jose Martin Carreira

2013-04-01

Full Text Available The purpose of this study was to evaluate the performance of a semiautomatic segmentation method for the anatomical and functional assessment of both ventricles from cardiac cine magnetic resonance (MR examinations, reducing user interaction to a “mouse-click”. Fifty-two patients with cardiovascular diseases were examined using a 1.5-T MR imaging unit. Several parameters of both ventricles, such as end-diastolic volume (EDV, end-systolic volume (ESV and ejection fraction (EF, were quantified by an experienced operator using the conventional method based on manually-defined contours, as the standard of reference; and a novel semiautomatic segmentation method based on edge detection, iterative thresholding and region growing techniques, for evaluation purposes. No statistically significant differences were found between the two measurement values obtained for each parameter (p > 0.05. Correlation to estimate right ventricular function was good (r > 0.8 and turned out to be excellent (r > 0.9 for the left ventricle (LV. Bland-Altman plots revealed acceptable limits of agreement between the two methods (95%. Our study findings indicate that the proposed technique allows a fast and accurate assessment of both ventricles. However, further improvements are needed to equal results achieved for the right ventricle (RV using the conventional methodology.

Cirugía de tipo uno y medioventricular en la doble salida del ventrículo izquierdo One a half ventricular surgery type in the double outlet of left ventricle

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Luis Marcano Sanz

2012-03-01

Full Text Available La doble salida del ventrículo izquierdo es muy poco frecuente, en la cual la aorta y la arteria pulmonar, emergen completa o predominantemente del ventrículo izquierdo. Cuando se acompañan de comunicación interventricular y de estenosis pulmonar la corrección se realiza usualmente con interposición de un conducto entre el ventrículo derecho y la arteria pulmonar. El objetivo del presente trabajo es presentar un caso tratado con cirugía de tipo uno y medio ventricular, pues, hasta donde conocemos, esta técnica no ha sido empleada en esta enfermedad para evitar el uso de conductos protésicos. Se reporta en una niña de 3 años de edad, a quien se le cerró la comunicación interventricular, se desconectó la arteria pulmonar del ventrículo izquierdo y se anastomosó al nuevo tracto de salida del ventrículo derecho, y se realizó derivación cavopulmonar parcial. Después de 6 años de seguimiento presenta buena evolución clínica, ecocardiográfica y capacidad funcional adecuada.The double outlet of the left ventricle is uncommon, where the aorta and the pulmonary artery emerge total or predominantly from the left ventricle. When they are accompanied of an interventricular communication and of pulmonary stenosis, the correction is usually carried out with the insertion of a conduct between the right ventricle and the pulmonary artery. The objective of present paper is to present a case treated with one half ventricular surgery type and ventricular medium, since until is known, this technique has not used in this disease to avoid the use of prosthetic conducts. Authors reports the case of a girl aged 3 undergoes the closure of the interventricular communication, switching off the pulmonary artery of the left ventricle and anastomosing it to the new outlet tract of right ventricle, carrying out a partial cavopulmonary bypass. After 6 years of follow-up she has a good clinical and echocardiographic evolution as well as a appropriate

Current status of ultrafast CT to evaluate the left ventricle

International Nuclear Information System (INIS)

MacMillan, R.M.; Rees, M.R.; Maranhao, V.

1987-01-01

Contrast-enhanced ultrafast CT with the cine mode can enable reliable assessment of left ventricular mass and function. Two oblique planar views, the long axis and short axis, are required. Right and left ventricular end-diastolic volumes, end-systolic volumes, stroke volume and ejection fraction, left ventricular segmental wall motion, and left ventricular mass can be measured. This exhibit emphasizes the methods and pitfalls in acquiring this information. Results from the authors' studies thus far to validate these measurements against reference standards are reviewed

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

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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)

Increased dependence on slow filling for left ventricular diastolic filling in patients with coronary artery disease and a depressed systolic function

International Nuclear Information System (INIS)

Yamagishi, Takashi; Ozaki, Masaharu; Furutani, Yuhji; Yamamoto, Kouzo; Saeki, Atsushi; Satoh, Shinichi; Kusukawa, Reizo

1990-01-01

Contributions of rapid filling, slow filling and atrial systole to the left ventricular(LV) filling volume were analyzed with the use of radionuclide ventriculography at rest, both globally and regionally, in 34 patients with isolated disease of the left anterior descending coronary artery. The patients included 17 with a normal ejection fraction (EF≥50%; group 1) and 17 with a depressed EF (<50%; group 2), and the data were compared with those obtained from 13 normal subjects. A computer program subdivided the LV image into 4 regions, and time-activity curves were constructed globally and regionally by reverse-gating from the R wave. In both groups the contribution of rapid filling to the LV filling volume was decreased significantly in the affected septal and apical regions, and in the global left ventricle compared with that in normal subjects. In group 1, the contribution of atrial systole showed an increase in these affected regions and in the global left ventricle. In contrast, in group 2, the atrial contribution was not increased globally or regionally as much as was expected. However, the contribution of slow filling was either increased significantly or tended to increase in the affected regions and in the global left ventricle. There were negative correlations between the contribution of rapid filling and that of slow filling in the global left ventricle (r=-0.73, p<0.001) and in each of the septal, apical and lateral regions (r≥-0.60, p<0.001), which suggested that the contribution of slow filling as well as of atrial systole undergoes an increase as rapid filling is impaired. Thus, in patients with coronary artery disease, the left ventricle relies on slow filling as well as atrial systole to affect diastolic LV filling in the affected regions and in the global left ventricle in the presence of LV systolic dysfunction. (author)

Quantitative assessment of left ventricular systolic function using 3-dimensional echocardiography

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Rahul Mehrotra

2013-09-01

Full Text Available Assessment of left ventricular systolic function is the commonest and one of the most important indications for performance of echocardiography. It is important for prognostication, determination of treatment plan, for decisions related to expensive device therapies and for assessing response to treatment. The current methods based on two-dimensional echocardiography are not reliable, have high degree of inter-observer and intra-observer variability and are based on presumptions about the geometry of left ventricle (LV. Real-time three-dimensional echocardiography (RT3DE on the other hand is fast, easy, accurate, relatively operator independent and is not based on any assumptions related to the shape of LV. Owing to these advantages, it is the Echocardiographic modality of choice for assessment of systolic function of the LV. We describe here a step by step approach to evaluation of LV volumes, ejection fraction, regional systolic function and Dyssynchrony analysis based on RT3DE. It has been well validated in clinical studies and is rapidly being incorporated in routine clinical practice.

Selection of permanent pacing position of cardiac ventricle in patients with complete right bundle branch block

International Nuclear Information System (INIS)

Yang Minquan; Zhou Jun; Zhu Yan; Wang Jin; Rong Xin; Zhang Xiaoyi

2005-01-01

Objective: To find out the optimal pacing localization by comparing different pacing positions of the right ventricle in brady-cardiacarrhythmia patients with complete right bundle branch block. Methods: DDD type of double lumen permanent pacemaker was implanted in each of the 8 cases of sick sinus syndrome (SSS) and/or III degree atrioventricular block (III degree AVB) with complete right bundle branch block in normal heart function or class I. For each patient, four pacing positions in right ventricle were compared and the QRS pacing durations were recorded. The position with the shortest the QRS duration was chosen as the permanent pacing position. Heart function, chest X-rays and left ventricle ejection fraction (LVEF) were followed up after the operation. Results: In all the 8 cases, the posterior septum of the right ventricle were chosen as the permanent pacing position, with the shorter pacing QRS duration than that of pre-operation (P<0.05) and other pacing positions of the right ventricle. All parameters of this permanent pacing position were within the normal range. During the follow-up of 6-36 months, no abnormity was found in cardiac functions. Conclusion: In brady-cardiacarrhythmia patients with complete right bundle branch block, the implantation of permanent pacemaker should be at the junction region of inlet and outlet tracts, of the posterior septum of the right ventricle with ideal physiological function. (authors)

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

DEFF Research Database (Denmark)

Qi, P; Thomsen, C; Ståhlberg, F

1993-01-01

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...

PREVENTION OF LEFT VENTRICLE SYSTOLIC DYSFUNCTION IN PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST SEGMENT ELEVATION AFTER CARDIAC REVASCULARIZATION

OpenAIRE

A. L. Alyavi; B. A. Alyavi; M. L. Kenzhaev; S. R. Kenzhaev

2009-01-01

Aim. To study effects of bioflavonoid quercetin (corvitin) on left ventricle (LV) systolic dysfunction in patients with acute coronary syndrome with ST segment elevation (ACS+ST) after cardiac revascularization.Material and methods. 60 patients with ACS+ST (44,2±1,3 y.o.) were examined. Patients were admitted to hospital within 6 hours after complaints beginning. Patients were randomized in two groups. 30 patients of group A had standard therapy and cardiac revascularization. 30 patients of g...

Single ventricle cardiac defect

International Nuclear Information System (INIS)

Eren, B.; Turkmen, N.; Fedakar, R.; Cetin, V.

2010-01-01

Single ventricle heart is defined as a rare cardiac abnormality with a single ventricle chamber involving diverse functional and physiological defects. Our case is of a ten month-old baby boy who died shortly after admission to the hospital due to vomiting and diarrhoea. Autopsy findings revealed cyanosis of finger nails and ears. Internal examination revealed; large heart, weighing 60 grams, single ventricle, without a septum and upper membranous part. Single ventricle is a rare pathology, hence, this paper aims to discuss this case from a medico-legal point of view. (author)

Comparison of left and right ventricular volume measurement using the Simpson's method and the area length method

International Nuclear Information System (INIS)

Hergan, Klaus; Schuster, Antonius; Fruehwald, Julia; Mair, Michael; Burger, Ralph; Toepker, Michael

2008-01-01

Purpose: To compare ventricular volume measurement using a volumetric approach in the three standard cardiac planes and ventricular volume estimation by a geometrical model, the Area-Length method (ALM). Materials and methods: Fifty-six healthy volunteers were examined (27 males, 29 females) on a 1.5 T MR-unit with ECG-triggered steady state free precision (SSFP) Cine-MR sequences and parallel image acquisition. Multiple slices in standardized planes including the short-axis view (sa), 4-chamber view (4ch), left and right 2-chamber views (2ch) were used to cover the whole heart. End-systolic and end-diastolic ventricular volumes (EDV, ESV), stroke volume (SV), and ejection fraction (EF) were calculated with Simpson's rule in all planes and with ALM in the 2ch and 4ch planes. Global function parameters measured in the sa plane were compared with those obtained in the other imaging planes. Results: A very good correlation is observed when comparing functional parameters calculated with Simpson's rule in all imaging planes: for instance, the mean EDV/ESV of the left and right ventricle of the female population group measured in sa, 4ch, and 2ch: left ventricle EDV/ESV 114.3/44.4, 120.9/46.5, and 117.7/45.3 ml; right ventricle EDV/ESV 106.6/46.0, 101.2/41.1, and 103.5/43.0 ml. Functional parameters of the left ventricle calculated with ALM in 2ch and 4ch correlate to parameters obtained in sa with Simpson's rule in the range of 5-10%: for instance, the EDV/ESV of the left ventricle of the male population group measured in the sa, 4ch, and 2ch: 160.3/63.5, 163.1/59.0, and 167.0/65.7 ml. Functional parameters of the right ventricle measured with ALM in 4ch are 40-50% lower and calculated in 2ch almost double as high as compared with the parameters obtained in sa with Simpson's rule: for instance, male right ventricular EDV/ESV measured in sa, 4ch, and 2ch: 153.4/68.1, 97.5/34.5, and 280.2/123.2 ml. The EF correlates for all imaging planes measured with the Simpson's rule

Automated Assessment of Left Ventricular Function and Mass Using Heart Deformation Analysis: Initial Experience in 160 Older Adults.

Science.gov (United States)

Lin, Kai; Collins, Jeremy D; Lloyd-Jones, Donald M; Jolly, Marie-Pierre; Li, Debiao; Markl, Michael; Carr, James C

2016-03-01

To assess the performance of automated quantification of left ventricular function and mass based on heart deformation analysis (HDA) in asymptomatic older adults. This study complied with Health Insurance Portability and Accountability Act regulations. Following the approval of the institutional review board, 160 asymptomatic older participants were recruited for cardiac magnetic resonance imaging including two-dimensional cine images covering the entire left ventricle in short-axis view. Data analysis included the calculation of left ventricular ejection fraction (LVEF), left ventricular mass (LVM), and cardiac output (CO) using HDA and standard global cardiac function analysis (delineation of end-systolic and end-diastolic left ventricle epi- and endocardial borders). The agreement between methods was evaluated using intraclass correlation coefficient (ICC) and coefficient of variation (CoV). HDA had a shorter processing time than the standard method (1.5 ± 0.3 min/case vs. 5.8 ± 1.4 min/case, P HDA. There was a systemic bias toward lower LVEF (62.8% ± 8.3% vs. 69.3% ± 6.7%, P HDA compared to the standard technique. Conversely, HDA overestimated LVM (114.8 ± 30.1 g vs. 100.2 ± 29.0 g, P HDA has the potential to measure LVEF, CO, and LVM without the need for user interaction based on standard cardiac two-dimensional cine images. Copyright © 2015 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Selective scanning of the right ventricle with the ultrashort-lived isotope krypton-81m

International Nuclear Information System (INIS)

Horn, M.; Witztum, K.; Neveu, C.; Perkins, G.

1985-01-01

The measurement of right ventricular function using /sup 99m/Tc gated blood-pool imaging is hampered by the difficulty in separating the right ventricle from the left heart as well as from the right atrium. Krypton-81m, an ultrashort-lived isotope (t/sub 1/2/, 13 sec) with a single 190-keV gamma ray, can be infused into the venous circulation to yield stable count rates over the right heart. The authors have developed a technique for delivering a continuous infusion of /sup 81m/Kr via an antecubital vein for gated right ventricle (RV) equilibrium studies. Preliminary rest studies have been performed in 15 normal subjects ranging in age from 23 to 62 years. Right-heart structures including the right atrium, tricuspid valve, right ventricle, pulmonic valve, and pulmonary outflow tract are clearly identifiable. Essentially no counts are present over the left heart. RV ejection fractions in this group averaged 48.3 (+/- 5.7)%. Changes in pulmonary blood flow distribution from supine to upright position, which may be an index of pulmonary arterial pressures, are also easily demonstrated

Cardiac taurine and principal amino acids in right and left ventricles of patients with either aortic valve stenosis or coronary artery disease:the importance of diabetes and gender

OpenAIRE

Lewis, Martin J; Littlejohns, Ben R; Lin, Hua; Angelini, Gianni D; Suleiman, M-Saadeh

2014-01-01

Free intracellular taurine and principal α-amino acids (glutamate, glutamine, aspartate, asparagine and alanine) are abundant in human heart. They are cellular regulators and their concentration can change in response to disease and cardiac insults and have been shown to differ between hypertrophic left ventricle (LV) and the relatively "normal" right ventricle (RV) in patients with aortic valve stenosis (AVS). This difference has not been shown for coronary artery disease (CAD) and there are...

Cardiovascular diseases and systolic function of left ventricle in clean up workers of Chernobyl accident (based on 30 years follow up).

Science.gov (United States)

Bazyka, O D; Belyi, D O

2017-12-01

To study the dynamics of circulatory system diseases during the 30 year period after irradiation, changes in the status of systolic function of heart left ventricle (LV) and the features of its remodeling in clean up workers (CW) of the accident at the Chernobyl nuclear power plant (ChNPP). It was examined 144 CW at ChNPP, including 52 patients, who survived acute radiation sick ness (ARS) grade of severity 1-3, and 105 non irradiated persons (control group - CG). CW have been divided into two subgroups: without signs of ARS (ARS0) and those who suffered from ARS. CW and CG patients were male who had no signs of cardiovascular, nervous, pulmonary or endocrine pathology prior to the Chernobyl accident. Their average age at the beginning of the accident was 33.9-37.7 years. The study program included clinical examina tion, echocardiography, retrospective and statistical analysis. Hypertensive heart disease (HHD) has developed in the CW, including the ARS convalescents, by 12 years, and ischemic heart disease (CHD) at 9-11 years is believed to be earlier than in comparable non irradiated patients. In the post accident period, there was an increased mean value of LV posterior wall (PW) thickness, interventricular septum (IVS), myocardium mass and myocardium mass normalized by body surface area. These indices grew with the increase of HHD duration. Over the 30 year follow up period, between CW and CG from 14.3 to 28.6 % of patients with LV increased volumes it was found a decreased ejection fraction (EF), what indicated the development of sys tolic LV dysfunction with the phenomena of left ventricular heart failure (HF). Reduction of EF correlated with increase of end systolic volume (ESV) having the highest statistical strength. In CW and persons of CG there was from 77.3 to 84.8 % of patients had clinical signs of HF with preserved EF. From this number, 56-63.6 % of patients had concentric and 18.8-26.7 % had eccentric LV hypertrophy (LVH), and in 6.1 to 15.6% of

Unusual right ventricle aneurysm and dysplastic pulmonary valve with mitral valve hypoplasia

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Ozge Pamukcu

2013-01-01

Full Text Available We report a newborn with an unusual combination of aneurysmally dilated thin-walled right ventricle with hypertrophy of the apical muscles of the right ventricle. There was narrow pulmonary annulus, pulmonary regurgitation, and hypoplasia of the mitral valve and left ventricle. We propose that this heart represents a partial form of Uhl`s anomaly.

Repair of double-chambered right ventricle using right ventricular outflow chamber ventriculotomy via left intercostal thoracotomy under beating heart in two dogs

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Keiichi Sato

2014-05-01

Full Text Available Double-chambered right ventricle was diagnosed in two dogs, one of them a pup and the other full grown. Both dogs underwent surgery using the novel approach of right ventricular outflow chamber ventriculotomy via left intercostal thoracotomy with moderate hypothermia and moderate pump flow cardiopulmonary bypass under beating heart. No major complication occurred during and after the operation. On continuous wave Doppler echocardiography, the pressure gradient across the stenosis in the right ventricle decreased from 130 mmHg pre-operatively to 40 mmHg post-operatively at 1 year 5 months in the adult dog, and from 209 mmHg pre-operatively to 47 mmHg post-operatively at 1 year in the pup. Both dogs are active without clinical signs.

Coronary reserve of the right ventricle evaluated by double dose Tl-201 scintigraphy

International Nuclear Information System (INIS)

Sugihara, Hiroki; Adachi, Haruhiko; Nakagawa, Hiroaki

1985-01-01

Thallium-201 double dose scintigraphy was applied to exercise to estimate the coronary blood flow reserve of the left and right ventricles and this was compared with the degree of coronary artery stenosis. As an index of coronary reserve we measured the rate of change of blood flow distribution (ΔF) calculated from the change in myocardial radioactivity following thallium-201 injections, once at rest and once during exercise. With submaximal exercise the increases in ΔF of the left ventricle were less in patients with ischemic heart disease than in the control subjects, and were less as the number of diseased coronary vessels increased. The increases of ΔF of the right ventricle were less in patients with stenosis of the proximal portion of the right coronary artery than in patients without stenosis and in the control subjects. The more severe the stenosis of the proximal portion of the right coronary artery, the smaller the ΔF of the right ventricle. These results indicate that evaluation of the ΔF in the left and right ventricles is useful in estimating coronary artery stenosis. (author)

Impact of obstructive sleep apnea and snoring on left ventricular ...

African Journals Online (AJOL)

Background: Systemic hypertension (HTN) and obstructive sleep apnea (OSA) are individually associated with left ventricular structural and functional adaptations. However, little is known about the impact of OSA on the left ventricle in Africans with HTN. Aim: The aim of this study is to determine the association between ...

Report of an adult with double-outlet right ventricle

International Nuclear Information System (INIS)

Munera E, Ana G; Florez C, Marina; Delgado de B, Jorge A and others

2001-01-01

The case of a 22 -year- old woman with a diagnosis of congenital heart disease, N Y H A class I, who complaints palpitations. By echocardiography, angiography and magnetic resonance imaging a diagnosis of double-outlet right ventricle was done. She was intervened for correction, creating an interventricular tunnel connecting the left ventricle to the aorta through the ventricular septal defect

Deconvolving out indicator smearing in the right ventricle facilities left-to-right shunt quantitation

International Nuclear Information System (INIS)

Eterovic, D.; Popovic, S.; Dujic, Z.

1994-01-01

A simple algorithm is developed to enhance the resolution of components of multimodal pulmonary radiohistogram. Based on the assessed right ventricular ejection fraction (RVEF), it deconvolves out the effect of indicator smearing in the right ventricle on the heart rate samples of the pulmonary radiohistogram, c k . The output is the ideal curve, c k =c k /RVEF-(1-EF)xC k-1 /RVEF, that would be obtained if RVEF equalled unity. Since the formula is not a recursive one it does not suffer from error propagation pertinent to numerical deconvolution. Once RVEF is known, implementation of the algorithm is trivial. If RVEF is not known accurately it may be replaced with its upper estimate, RVEF upp > RVEF, yielding a partial deconvolution of the curve. When applied to patients with left-to-right shunt the method improves the accuracy and lessens the interobserver variation of the Maltz-Treves method. (author)

Effect of fosinopril on progression of the asymptomatic carotid atherosclerosis and left ventricular hypertrophy in hypertensive patients

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Tasić Ivan

2006-01-01

Full Text Available INTRODUCTION The cardiovascular changes (vascular structure changes, hypertrophy of the left ventricle contribute to both the increased cardiovascular morbidity and the mortality of essential hypertension. Therefore, modern treatment strategies should not only target blood pressure (BP reduction but also normalize cardiovascular structure and function. OBJECTIVE Aim of the study was to determine the effect of the ACE inhibitor Fosinopril on the Intima-media thickness of the common carotid artery and on the left ventricle mass after 9-month treatment of hypertensive patients. METHOD The study included 40 patients with the arterial hypertension and the left ventricle hypertrophy verified by echocardiography. The patients were randomized on A ACE-inhibitor - Fosinopril and 6 without ACE inhibitor - atenolol, and they were followed up 9 months. The groups were not different by age, sex, and metabolic status. Color Duplex ultrasonography of the carotid arteries was performed by Acuson Sequia C236 with high-frequency linear probe of 8 MHz. The Intima-media thickness of the common carotids on the left and the right was measured in diastole at 1.5. cm from the highest point of bifurcation under maximal magnification. Using the same device, the left ventricle mass and other parameters of the left ventricle were determined in M-mode and by means of 2D image. RESULTS After 9 months, BP In both groups Was reduced In similar range (group A: systolic BP from 158 to 137 mmHg, and diastolic BP from 94 to 85 mmHg, and group B; systolic BP from 164 to 137 mmHg, and diastolic BP from 87 to 84 mmHg. The thickness of the intimomedial complex in patients using Fosinopril was decreased by 0.0278 ± 0.03 mm, while in the group of patients that did not use the ACE-inhibitor, it was increased by 0.078 ±0.13 mm. The left ventricle mass in patients using Fosinopril was decreased by 5 grams (312 ± 72 g vs. 307 ± 77 g, while in group B patients, it was increased by 15

The effect of milrinone on right and left ventricular function when used as a rescue therapy for term infants with pulmonary hypertension.

Science.gov (United States)

James, Adam T; Corcoran, John D; McNamara, Patrick J; Franklin, Orla; El-Khuffash, Afif F

2016-01-01

Milrinone may be an appropriate adjuvant therapy for infants with persistent pulmonary hypertension of the newborn. We aimed to describe the effect of milrinone administration on right and left ventricular function in infants with persistent pulmonary hypertension not responding to inhaled nitric oxide after 4 hours of administration. This is a retrospective review of infants born after or at 34 weeks of gestation with persistent pulmonary hypertension who received milrinone treatment. The primary endpoint was the effect of milrinone on myocardial performance and haemodynamics, including right and left ventricular outputs, tissue Doppler velocities, right ventricle and septal strain, and strain rate. Secondary endpoints examined included duration of inhaled nitric oxide and oxygen support. A total of 17 infants with a mean (standard deviation) gestation and birth weight of 39.8 (2.0) weeks and 3.45 (0.39) kilograms, respectively, were included in the study. The first echocardiogram was performed 15 hours after the commencement of nitric oxide inhalation. Milrinone treatment was started at a median time of 1 hour after the echocardiogram and was associated with an increase in left ventricular output (p=0.04), right ventricular output (p=0.004), right ventricle strain (p=0.01) and strain rate (p=0.002), and left ventricle s` (pmilrinone as an adjunct to nitric oxide is worth further exploration, with preliminary evidence suggesting an improvement in both oxygenation and myocardial performance in this group of infants.

Age-related normal structural and functional ventricular values in cardiac function assessed by magnetic resonance

International Nuclear Information System (INIS)

Fiechter, Michael; Gaemperli, Oliver; Kaufmann, Philipp A; Fuchs, Tobias A; Gebhard, Catherine; Stehli, Julia; Klaeser, Bernd; Stähli, Barbara E; Manka, Robert; Manes, Costantina; Tanner, Felix C

2013-01-01

The heart is subject to structural and functional changes with advancing age. However, the magnitude of cardiac age-dependent transformation has not been conclusively elucidated. This retrospective cardiac magnetic resonance (CMR) study included 183 subjects with normal structural and functional ventricular values. End systolic volume (ESV), end diastolic volume (EDV), and ejection fraction (EF) were obtained from the left and the right ventricle in breath-hold cine CMR. Patients were classified into four age groups (20–29, 30–49, 50–69, and ≥70 years) and cardiac measurements were compared using Pearson’s rank correlation over the four different groups. With advanced age a slight but significant decrease in ESV (r=−0.41 for both ventricles, P<0.001) and EDV (r=−0.39 for left ventricle, r=−0.35 for right ventricle, P<0.001) were observed associated with a significant increase in left (r=0.28, P<0.001) and right (r=0.27, P<0.01) ventricular EF reaching a maximal increase in EF of +8.4% (P<0.001) for the left and +6.1% (P<0.01) for the right ventricle in the oldest compared to the youngest patient group. Left ventricular myocardial mass significantly decreased over the four different age groups (P<0.05). The aging process is associated with significant changes in left and right ventricular EF, ESV and EDV in subjects with no cardiac functional and structural abnormalities. These findings underline the importance of using age adapted values as standard of reference when evaluating CMR studies

Functional and geometrical interference and interdependency between the right and left ventricle in cor pulmonale: an experimental study on simultaneous measurement of biventricular geometry of acute right ventricular pressure overload.

Science.gov (United States)

Yamashita, H; Onodera, S; Imamoto, T; Obara, A; Tanazawa, S; Takashio, T; Morimoto, H; Inoue, H

1989-10-01

To clarify the effects of right ventricular (RV) pressure overload on functional and geometrical interference and interdependency between the right and left ventricle, both ventricular internal diameters were measured by the microcrystal technique during lycopodium induced pulmonary embolization in the dog. By repeated embolization, RV systolic pressure was increased progressively until it reached a peak value of about 60-70 mmHg, then it began to fall. At the same time, the hemodynamics deteriorated progressively resulting in death. During the experiment, gradual leftward displacement of the interventricular septum (IVS) without any change in left ventricular (LV) free wall geometry was observed. In pulmonary embolic shock, which showed a fall in LV pressure to about 60 mmHg and cardiac output to about 40% of control, the leftward displacement of IVS became marked, and the cooperative movement of IVS to LV contraction disappeared. The IVS position during acute RV pressure overload was able to account for the transseptal pressure gradient. The importance of IVS position and motion in cardiac function during acute RV pressure overload was stressed. Furthermore, to establish the theoretical treatment in acute cardiopulmonary resuscitation, ligation of the descending aorta (AoL) or norepinephrine ("N") or isoproterenol ("I") administration were examined in a canine pulmonary embolic shock model. AoL or "N" improved the deteriorated hemodynamics with restoration of biventricular geometry. However, "I" did not restore the biventricular geometry despite the transiently improved hemodynamics, and the experimental animals were unable to survive. These results suggest the importance of the maintainance of systemic pressure for the restoration of failed RV function. Further integrated studies are required to understand biventricular interference and interdependency.

Influence of chronic prenatal hypoxia on the specialized contact apparatus of rat heart ventricles during ontogeny

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N. S. Petruk

2014-08-01

day of embryogenesis is lower in experimental group by 31,3% (p <0,05 in the left ventricle and 30,8% (p <0,05 in the right ventricle than parameters in the control group. The slowdown of growth of the profile length density of fascia adhaerens in the myocardium increases on the 20th day of cardiogeny and it was lower by 32,9% (p <0,05 in the left ventricle and 37,3% (p <0,05 in the right ventricle as compared with the control. During normal prenatal cardiogeny ventricular level of communicative contacts in cardiomyocytes respectably increases and shows a significant increase in nexus mean length from 14th to 18th day of embryogenesis by 75,5% in the control and insignificant increase in the left ventricle in experimental group – 23,6%. The increase in value of the convolution index of intercalated disc of rats with hypoxic myocardial damage as compared with the corresponding value in the neonatal period was 85,4% (p <0,05 in the left ventricle and 52,3% (p <0,05 in the right ventricle. Conclusion. It was established that the alterative influence of intrauterine hypoxia factor is associated with the formation delay of the mechanical and electrical contacts between the contractive cardiomyocytes of the left and right ventricles of rat heart at the stages of prenatal ontogeny. The increasing complexity of the geometry of the intercalated disc is characterized by slower growth of convolution index.

Left ventricular lipoma with pseudoaneurysm-like appearance.

Science.gov (United States)

Kawarai, Shun-ichi; Yaginuma, Gen-ya; Abe, Kazuo; Hamasaki, Azumi; Ishikawa, Kazunori; Tanaka, Daizo

2010-06-01

We describe an extremely rare cardiac lipoma, with electrocardiographic changes in ST segments and T waves, suggesting ischemic heart disease. The abnormal electrocardiogram was identified during a routine physical examination of an asymptomatic 57-year-old man. Coronary angiography showed no stenotic or occlusive lesions in the coronary arteries except that the left anterior descending artery followed a winding course in the apical region. Left ventriculography revealed a pseudoaneurysm-like mass around the apical portion. Computed tomography and magnetic resonance imaging revealed a cardiac lipoma that communicated with the left ventricle and resembled a pseudoaneurysm. After complete resection of the lipoma and left ventricle patch plasty, the postoperative course was uneventful. Histologically, the tumor was an intramyocardiac lipoma with no evidence of malignancy. To our knowledge, we are the first to describe an intramyocardiac lipoma resembling a left ventricle pseudoaneurysm.

Evaluation of single right atrial volume and function with magnetic resonance imaging in children with hypoplastic left heart

Energy Technology Data Exchange (ETDEWEB)

Vijarnsorn, Chodchanok [University of Alberta, Faculty of Medicine and Dentistry, Stollery Children' s Hospital, Edmonton, AB (Canada); Mahidol University, Siriraj Hospital, Bangkok (Thailand); Myers, Kimberley; Patton, David J. [Alberta Children' s Hospital, Section of Pediatric Cardiology, Department of Pediatrics, Department of Pediatrics, Calgary, AB (Canada); Noga, Michelle; Crawley, Cinzia; Tham, Edythe [University of Alberta, Faculty of Medicine and Dentistry, Stollery Children' s Hospital, Edmonton, AB (Canada)

2016-06-15

Standardized methods to evaluate atrial properties in single ventricles are lacking. To determine the feasibility of quantifying right atrial volumes and function in hypoplastic left heart using MRI. We studied 15 infants with hypoplastic left heart prior to Glenn surgery (mean age 4.2 months [standard deviation 0.3]) who underwent cardiac MRI with evaluation of atrial volumes and emptying fraction using monoplane two-chamber, monoplane four-chamber, and biplane methods, all of which were compared to the atrial short-axial oblique stack method. We compared atrial end-diastolic volume, end-systolic volume and emptying fraction among these methods. We analyzed reproducibility of the methods using Bland-Altman plots. Both four-chamber and biplane methods showed high correlations for atrial end-diastolic volume (r = 0.7 and r = 0.8, respectively; P < 0.01) and end-systolic volume (r = 0.8 and r = 0.9, respectively; P < 0.01) with small mean differences (-0.2 ± 2.9 standard deviation [SD] ml and -0.8 ± 1.6 ml, respectively, for atrial end-diastolic volume and -0.8 ± 1.5 ml and -0.9 ± 0.9 ml, respectively, for atrial end-systolic volume). The short-axial oblique method was the most reproducible, followed by the four-chamber method. MRI assessment of atrial volume and function is feasible in hypoplastic left heart and might provide further insight into single-ventricle mechanics. (orig.)

Evaluation of Right Ventricle Function in Children With Primary Nephrotic Syndrome

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Qiang Qin

2010-06-01

Conclusion: Right ventricle function was impaired in children with PNS. The characteristics were unrelated to blood pressure and IGF-1, but may be correlated with TNF-α and disease duration. Further studies are needed to evaluate the etiology and clinical implications of this abnormality.

Left ventricle segmentation in cardiac MRI images using fully convolutional neural networks

Science.gov (United States)

Vázquez Romaguera, Liset; Costa, Marly Guimarães Fernandes; Romero, Francisco Perdigón; Costa Filho, Cicero Ferreira Fernandes

2017-03-01

According to the World Health Organization, cardiovascular diseases are the leading cause of death worldwide, accounting for 17.3 million deaths per year, a number that is expected to grow to more than 23.6 million by 2030. Most cardiac pathologies involve the left ventricle; therefore, estimation of several functional parameters from a previous segmentation of this structure can be helpful in diagnosis. Manual delineation is a time consuming and tedious task that is also prone to high intra and inter-observer variability. Thus, there exists a need for automated cardiac segmentation method to help facilitate the diagnosis of cardiovascular diseases. In this work we propose a deep fully convolutional neural network architecture to address this issue and assess its performance. The model was trained end to end in a supervised learning stage from whole cardiac MRI images input and ground truth to make a per pixel classification. For its design, development and experimentation was used Caffe deep learning framework over an NVidia Quadro K4200 Graphics Processing Unit. The net architecture is: Conv64-ReLU (2x) - MaxPooling - Conv128-ReLU (2x) - MaxPooling - Conv256-ReLU (2x) - MaxPooling - Conv512-ReLu-Dropout (2x) - Conv2-ReLU - Deconv - Crop - Softmax. Training and testing processes were carried out using 5-fold cross validation with short axis cardiac magnetic resonance images from Sunnybrook Database. We obtained a Dice score of 0.92 and 0.90, Hausdorff distance of 4.48 and 5.43, Jaccard index of 0.97 and 0.97, sensitivity of 0.92 and 0.90 and specificity of 0.99 and 0.99, overall mean values with SGD and RMSProp, respectively.

Three dimensional endo-cardiovascular volume-rendered cine computed tomography of isolated left ventricular apical hypoplasia; A case report and literature review

Energy Technology Data Exchange (ETDEWEB)

Hong, Sun Hwa; Kim, Yang Min; Lee, Hyun Jong [Sejong General Hospital, Bucheon (Korea, Republic of)

2016-02-15

We report multidetector computed tomography (MDCT) and cardiac magnetic resonance (CMR) findings of a 34-year-old female with isolated left ventricular apical hypoplasia. The MDCT and CMR scans displayed a spherical left ventricle (LV) with extensive fatty infiltration within the myocardium at the apex, interventricular septum and inferior wall, anteroapical origin of the papillary muscle, right ventricle wrapping around the deficient LV apex, and impaired systolic function. MDCT visualized morphologic and also functional findings of this unique cardiomyopathy.

Biventricular non-compaction with predominant right ventricular involvement, reduced left ventricular systolic and diastolic function, and pulmonary hypertension in a Hispanic male.

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Said, Sarmad; Cooper, Chad J; Quevedo, Karla; Rodriguez, Emmanuel; Hernandez, German T

2013-01-01

Male, 22 FINAL DIAGNOSIS: Cardiomyopathy Symptoms: Shortness of breath • dispnoea • chest discomfort - Clinical Procedure: Echocardiogram • cardiac MRI Specialty: Cardiology. Challenging differential diagnosis. Non-compaction cardiomyopathy (NCM) is a rare congenital cardiomyopathy characterized by increased trabeculation in one or more segments of the ventricle. The left ventricle is most commonly affected. However, biventricular involvement or right ventricle predominance has also been described. Clinical features of NCM are non-specific and can range from being asymptomatic to symptoms of congestive heart failure, arrhythmia, and systemic thromboembolism. 22-year-old Hispanic male presented with two month history of chest discomfort. Laboratory workup revealed an elevated brain-natriuretic-peptide of 1768 pg/ml. ECG and chest x-ray was nonspecific. Transthoracic echocardiogram revealed prominent trabeculae and spongiform appearance of the left ventricle (LV) with an ejection-fraction of 15-20%; 5 of 9 segments of the LV were trabeculated with deep intertrabecular recesses also involving the right ventricle (RV) with demonstrated blood flow in these recesses on color-doppler. The biventricular spongiform appearance was morphologically suggestive for NCM with involvement of the RV. Confirmatory cardiac MRI was performed, demonstrating excessive trabeculation of the left-ventricular apex and mid-ventricular segments. Hypertrabecularion was exhibited at the apical and lateral wall of the RV. Cardiac catheterization showed an intact cardiac vessel system. The patient was discharged on heart failure treatment and was placed on the heart transplantation list. NCM is a unique disorder resulting in serious and severe complications. The majority of the reported cases describe the involvement of the left ventricle. However, the right ventricle should be taken into careful consideration. The early diagnosis may help to increase the event-free survival.

Aortopathy in adults with tetralogy of Fallot has a negative impact on the left ventricle.

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Shiina, Yumi; Murakami, Tomoaki; Kawamatsu, Naoto; Niwa, Koichiro

2017-02-01

Aortic pressure wave reflection is significantly elevated in patients with congenital heart disease, even in children. Excessive aortic pressure wave reflection provokes cardiovascular events. To assess the influences of the enhanced pressure wave reflection on the left ventricle (LV) in adults with repaired tetralogy of Fallot (TOF). Prospectively, 51 consecutive adults with repaired TOF (35.5±11.6yrs., 25 males) were enrolled and non-invasively assessed the pressure wave reflection using HEM 9000AI. A surrogate maker of the aortic pressure wave reflection, radial augmentation index (rAI) was calculated as reflection wave divided by ejection wave. We also evaluated LV function using echocardiography and magnetic resonance images. Patients were divided into two groups: group A with rAI≧1SD and group B with rAI<1SD. The mean rAI in repaired TOF was 76.9±14.3%. In group A, indexed ascending aortic diameter, LV global longitudinal strain (GLS), LV global circumferential strain (GCS), LV early diastolic strain rate (SR), LV E/A, LV e' were significantly higher than them in group B. The indexed ascending aortic diameter significantly correlated with rAI (r=0.31, P<0.05). On univariate logistic analysis, body surface area, indexed ascending aortic diameter, GLS, GCS, early diastolic SR, LV E/A, LV mass index and creatinine were predictive factors of rAI≧1SD. On multivariate logistic analysis, LV E/A was the most significant predictive factor of rAI≧1SD (Odds ratio 0.044, 95%CI 0.002-0.98 and P<0.05). Aortic pressure wave reflection in adults with repaired TOF has a negative impact on LV function, particularly on diastolic function. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Use of mathematic modeling to compare and predict hemodynamic effects of the modified Blalock-Taussig and right ventricle-pulmonary artery shunts for hypoplastic left heart syndrome.

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Bove, Edward L; Migliavacca, Francesco; de Leval, Marc R; Balossino, Rossella; Pennati, Giancarlo; Lloyd, Thomas R; Khambadkone, Sachin; Hsia, Tain-Yen; Dubini, Gabriele

2008-08-01

Stage one reconstruction (Norwood operation) for hypoplastic left heart syndrome can be performed with either a modified Blalock-Taussig shunt or a right ventricle-pulmonary artery shunt. Both methods have certain inherent characteristics. It is postulated that mathematic modeling could help elucidate these differences. Three-dimensional computer models of the Blalock-Taussig shunt and right ventricle-pulmonary artery shunt modifications of the Norwood operation were developed by using the finite volume method. Conduits of 3, 3.5, and 4 mm were used in the Blalock-Taussig shunt model, whereas conduits of 4, 5, and 6 mm were used in the right ventricle-pulmonary artery shunt model. The hydraulic nets (lumped resistances, compliances, inertances, and elastances) were identical in the 2 models. A multiscale approach was adopted to couple the 3-dimensional models with the circulation net. Computer simulations were compared with postoperative catheterization data. Good correlation was found between predicted and observed data. For the right ventricle-pulmonary artery shunt modification, there was higher aortic diastolic pressure, decreased pulmonary artery pressure, lower Qp/Qs ratio, and higher coronary perfusion pressure. Mathematic modeling predicted minimal regurgitant flow in the right ventricle-pulmonary artery shunt model, which correlated with postoperative Doppler measurements. The right ventricle-pulmonary artery shunt demonstrated lower stroke work and a higher mechanical efficiency (stroke work/total mechanical energy). The close correlation between predicted and observed data supports the use of mathematic modeling in the design and assessment of surgical procedures. The potentially damaging effects of a systemic ventriculotomy in the right ventricle-pulmonary artery shunt modification of the Norwood operation have not been analyzed.

A flexible endoscope-assisted interhemispheric transcallosal approach through the contralateral ventricle for the removal of a third ventricle craniopharyngioma: A technical report.

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Yano, Shigetoshi; Hide, Takuichiro; Shinojima, Naoki; Ueda, Yutaka; Kuratsu, Jun-Ichi

2015-01-01

Intraventricular craniopharyngiomas are difficult to remove. We combined an interhemispheric transcallosal approach with a flexible endoscope (videoscope) for successful tumor removal. A 52-year-old male complained of general fatigue and memory disturbance. Magnetic resonance imaging revealed a well-enhanced third ventricle mass with dilatation of lateral ventricles. During removal with the interhemispheric transcallosal approach, a videoscope that was inserted into the left lateral ventricle revealed the interface of the tumor and the ventricular wall. The tumor was pushed to the right using forceps and removed totally through the right foramen of Monro without any fornix injury. This procedure is a safe option for removing third ventricular tumors especially in the case with hydrocephalus.

A microcomputerized system of nuclear probe for left ventricular function evaluation

International Nuclear Information System (INIS)

Piva, R.M.V.

1987-01-01

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) [pt

Aberrant Glycosylation in the Left Ventricle and Plasma of Rats with Cardiac Hypertrophy and Heart Failure.

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Chiaki Nagai-Okatani

Full Text Available Targeted proteomics focusing on post-translational modifications, including glycosylation, is a useful strategy for discovering novel biomarkers. To apply this strategy effectively to cardiac hypertrophy and resultant heart failure, we aimed to characterize glycosylation profiles in the left ventricle and plasma of rats with cardiac hypertrophy. Dahl salt-sensitive hypertensive rats, a model of hypertension-induced cardiac hypertrophy, were fed a high-salt (8% NaCl diet starting at 6 weeks. As a result, they exhibited cardiac hypertrophy at 12 weeks and partially impaired cardiac function at 16 weeks compared with control rats fed a low-salt (0.3% NaCl diet. Gene expression analysis revealed significant changes in the expression of genes encoding glycosyltransferases and glycosidases. Glycoproteome profiling using lectin microarrays indicated upregulation of mucin-type O-glycosylation, especially disialyl-T, and downregulation of core fucosylation on N-glycans, detected by specific interactions with Amaranthus caudatus and Aspergillus oryzae lectins, respectively. Upregulation of plasma α-l-fucosidase activity was identified as a biomarker candidate for cardiac hypertrophy, which is expected to support the existing marker, atrial natriuretic peptide and its related peptides. Proteomic analysis identified cysteine and glycine-rich protein 3, a master regulator of cardiac muscle function, as an O-glycosylated protein with altered glycosylation in the rats with cardiac hypertrophy, suggesting that alternations in O-glycosylation affect its oligomerization and function. In conclusion, our data provide evidence of significant changes in glycosylation pattern, specifically mucin-type O-glycosylation and core defucosylation, in the pathogenesis of cardiac hypertrophy and heart failure, suggesting that they are potential biomarkers for these diseases.

Evaluation of right ventricular function by coronary computed tomography angiography using a novel automated 3D right ventricle volume segmentation approach: a validation study.

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Burghard, Philipp; Plank, Fabian; Beyer, Christoph; Müller, Silvana; Dörler, Jakob; Zaruba, Marc-Michael; Pölzl, Leo; Pölzl, Gerhard; Klauser, Andrea; Rauch, Stefan; Barbieri, Fabian; Langer, Christian-Ekkehardt; Schgoer, Wilfried; Williamson, Eric E; Feuchtner, Gudrun

2018-06-04

To evaluate right ventricle (RV) function by coronary computed tomography angiography (CTA) using a novel automated three-dimensional (3D) RV volume segmentation tool in comparison with clinical reference modalities. Twenty-six patients with severe end-stage heart failure [left ventricle (LV) ejection fraction (EF) right heart invasive catheterisation (IC). Automated 3D RV volume segmentation was successful in 26 (100%) patients. Read-out time was 3 min 33 s (range, 1 min 50s-4 min 33s). RV EF by CTA was stronger correlated with right atrial pressure (RAP) by IC (r = -0.595; p = 0.006) but weaker with TAPSE (r = 0.366, p = 0.94). When comparing TAPSE with RAP by IC (r = -0.317, p = 0.231), a weak-to-moderate non-significant inverse correlation was found. Interobserver correlation was high with r = 0.96 (p right atrium (RA) and right ventricle (RV) was 196.9 ± 75.3 and 217.5 ± 76.1 HU, respectively. Measurement of RV function by CTA using a novel 3D volumetric segmentation tool is fast and reliable by applying a dedicated biphasic injection protocol. The RV EF from CTA is a closer surrogate of RAP than TAPSE by TTE. • Evaluation of RV function by cardiac CTA by using a novel 3D volume segmentation tool is fast and reliable. • A biphasic contrast agent injection protocol ensures homogenous RV contrast attenuation. • Cardiac CT is a valuable alternative modality to CMR for the evaluation of RV function.

Um sistema de ventrículo pulmonar produzindo pressão pulsátil em único ventrículo: modelo experimental A pulmonary ventricle system producing pulsatile pressure in single ventricle: experimental model

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Bilgein Emrecan

2006-09-01

Full Text Available OBJETIVO: Pacientes com ventrículo único funcional têm prognóstico ruim, que resulta em insuficiência cardíaca, mesmo após tratamento cirúrgico. As operações derivação cavo-pulmonar (exceto pelas conexões do átrio direito ao ventrículo direito não apresentam sistema ventricular pulmonar com pressão pulsátil, além do fluxo reduzido ao ventrículo único. Para resolver o problema, tentamos criar um ventrículo pulmonar que produza pressão pulsátil experimentalmente. MÉTODO: Tentamos criar um sistema ventricular direito que produzisse pressão pulsátil. O modelo experimental foi realizado em seis ovelhas. As pressões do ventrículo pulmonar criado, da artéria pulmonar e do ventrículo esquerdo foram medidas após a saída da circulação extracorpórea. RESULTADOS: A média das pressões arteriais pulmonares sistólica e diastólica foi 15,6 ± 2,0 mmHg e 4,5 ± 1,5 mmHg. A média da pressão sistólica ventricular esquerda foi 76,6 ± 4,4 mmHg. CONCLUSÃO: Um ventrículo que produza pressão pulsátil é necessário para a regulação do fluxo da artéria pulmonar, com pressão venosa central e pressão pulmonar não pulsátil nas anomalias como ventrículos únicos funcionais.OBJECTIVE: Patients with functional single ventricle show bad survey, most of which result in cardiac failure even in the case that they are operated. The right heart bypass operations except for right atrium and right ventricle connections lack pulsatile pulmonary ventricle system besides the volume lack coming to the common ventricle. To solve the problem, we tried to create a pulmonary ventricle which produces pulsatile pressure experimentally. METHODS: We tried to form a right ventricle system which produces pulsatile pressure. The experimental model was carried on six sheep. The pressures of the created pulmonary ventricle, pulmonary artery and the left ventricle were measured after leaving the cardiopulmonary bypass. RESULTS: The mean of the

Results of Cryoenergy and Radiofrequency-Based Catheter Ablation for Treating Ventricular Arrhythmias Arising From the Papillary Muscles of the Left Ventricle, Guided by Intracardiac Echocardiography and Image Integration.

Science.gov (United States)

Rivera, Santiago; Ricapito, Maria de la Paz; Tomas, Leandro; Parodi, Josefina; Bardera Molina, Guillermo; Banega, Rodrigo; Bueti, Pablo; Orosco, Agustin; Reinoso, Marcelo; Caro, Milagros; Belardi, Diego; Albina, Gaston; Giniger, Alberto; Scazzuso, Fernando

2016-04-01

Catheter radiofrequency ablation of ventricular arrhythmias (VAs) arising from the left ventricle's papillary muscles has been associated with inconsistent results. The use of cryoenergy versus radiofrequency has not been compared yet. This study compares outcomes and complications of catheter ablation of VA from the papillary muscles of the left ventricle with either cryoenergy or radiofrequency. Twenty-one patients (40±12 years old; 47% males; median ejection fraction 59±7.3%) with drug refractory premature ventricular contractions or ventricular tachycardia underwent catheter cryoablation or radiofrequency ablation. VAs were localized using 3-dimensional mapping, multidetector computed tomography, and intracardiac echocardiography, with arrhythmia foci being mapped at either the anterolateral papillary muscle or posteromedial papillary muscles of the left ventricle. Focal ablation was performed using an 8-mm cryoablation catheter or a 4-mm open-irrigated radiofrequency catheter, via transmitral approach. Acute success rate was 100% for cryoenergy (n=12) and 78% for radiofrequency (n=9; P=0.08). Catheter stability was achieved in all patients (100%) treated with cryoenergy, and only in 2 (25%) patients treated with radiofrequency (P=0.001). Incidence of multiple VA morphologies was observed in 7 patients treated with radiofrequency (77.7%), whereas none was observed in those treated with cryoenergy (P=0.001). VA recurrence at 6 months follow-up was 0% for cryoablation and 44% for radiofrequency (P=0.03). Cryoablation was associated with higher success rates and lower recurrence rates than radiofrequency catheter ablation, better catheter stability, and lesser incidence of polymorphic arrhythmias. © 2016 American Heart Association, Inc.

On the calculation of principle curvatures of the left-ventricular surfaces.

Science.gov (United States)

Claus, Piet; Choi, Hon Fai; D'hooge, Jan; Rademakers, Frank E

2008-01-01

A local description of the shape of the left ventricle is relevant in assessing the process of adverse ventricular remodeling, associated with most cardiac pathologies, and in monitoring reverse remodeling by therapy. To quantify local shape of the left ventricle, one can calculate the curvature of its epicardial or endocardial surface. The 3D geometry of the heart and especially the ventricles, can typically be described using finite element meshes. From a mathematical point of view these meshes provide a local parametrization of the surface in the 3-dimensional space. We discuss the analytic derivation of the principle curvatures of the left-ventricular surfaces given their smooth finite-element meshes and apply this derivation to assess the regional shape of the normal porcine left ventricle.

Significance of blood-pool scintigraphy and echocardiography in the investigation of left heart ventricle. Stellung von Herzbinnenraumszintigraphie (HBR) und Echokardiographie (Echo) bei der Untersuchung des linken Ventrikels (LV)

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Otto, L.; Neumann, G.; Koegler, A.; Wuensche, A.; Schneider, G. (Leipzig Univ., Klinik fuer Radiologie (Germany)); Krosse, B.; Rother, T.; Loebe, M.; Otto, J. (Leipzig Univ., Klinik fuer Innere Medizin (Germany))

1990-01-01

Left ventricular ejection (LVEF) was assessed by both radionuclide ventriculography and echocardiography. The correlation coefficient of 0.74 revealed a just good agreement. It was better in the range of normal than of pathological values. The analysis of regional wall motion performed by echocardiography was not as reliable as by radionuclide ventriculography. The main advantage of echocardiography is its good spatial resolution. Its domain is the diagnostics of pathomorphological changes including valvular disorders. Advantages of radionuclide ventriculography are good temporal resolution, registration of the third dimension, practicability during exercise and as bed side method (nuclear stethoscope). Functional disturbances of both ventricles are its field of application. (orig.).

Outcomes following the Kawashima procedure for single-ventricle palliation in left atrial isomerism.

Science.gov (United States)

Vollebregt, Anne; Pushparajah, Kuberan; Rizvi, Maleeha; Hoschtitzky, Andreas; Anderson, David; Austin, Conal; Tibby, Shane M; Simpson, John

2012-03-01

Patients with left atrial isomerism and interrupted inferior vena cava palliated with a superior cavopulmonary connection or Kawashima procedure (KP) have a high incidence of developing pulmonary arteriovenous malformations. The necessity for hepatic vein redirection (HVR) and its timing remains a controversy. We aimed to assess the clinical outcome of patients with left atrial isomerism following a KP. The main end points were death, requirement for HVR and the impact of HVR on oxygen saturation. Retrospective review of 21 patients with a diagnosis of left atrial isomerism, interruption of the inferior vena cava and single-ventricle physiology managed with a KP at a single centre between January 1990 and March 2010. Twenty-one patients had a KP, with 12 subsequently undergoing HVR. There was relatively a constant monthly decrement in the proportion of patients who were free from death or HVR up until 60 months following the KP, with a dramatic increase in the hazard after this time. The Cox proportional hazards regression model demonstrated a reduced early risk for HVR or death in patients who underwent pulmonary artery banding versus arterial shunt as the primary procedure (hazard ratio: 0.10; P = 0.01), and an increased risk with bilateral superior vena cavas (SVCs) (hazard ratio: 3.4; P = 0.04) and age at KP (hazard ratio: 1.02 per month increase in age at KP; P = 0.02). HVR mortality was relatively high with 3 of 12 patients dying in the early postoperative period with profound cyanosis. The timing of HVR after the KP did not influence the postoperative rate of increase in oxygen saturation. These findings confirm that the majority of patients who undergo a KP will require HVR. Patients who are older at the time of the KP or having an initial arterial shunt or bilateral SVCs are at higher risk of HVR or death. The relatively high mortality at HVR was characterized by severe postoperative cyanosis.

A New MRI-Based Model of Heart Function with Coupled Hemodynamics and Application to Normal and Diseased Canine Left Ventricles

Science.gov (United States)

Choi, Young Joon; Constantino, Jason; Vedula, Vijay; Trayanova, Natalia; Mittal, Rajat

2015-01-01

A methodology for the simulation of heart function that combines an MRI-based model of cardiac electromechanics (CE) with a Navier–Stokes-based hemodynamics model is presented. The CE model consists of two coupled components that simulate the electrical and the mechanical functions of the heart. Accurate representations of ventricular geometry and fiber orientations are constructed from the structural magnetic resonance and the diffusion tensor MR images, respectively. The deformation of the ventricle obtained from the electromechanical model serves as input to the hemodynamics model in this one-way coupled approach via imposed kinematic wall velocity boundary conditions and at the same time, governs the blood flow into and out of the ventricular volume. The time-dependent endocardial surfaces are registered using a diffeomorphic mapping algorithm, while the intraventricular blood flow patterns are simulated using a sharp-interface immersed boundary method-based flow solver. The utility of the combined heart-function model is demonstrated by comparing the hemodynamic characteristics of a normal canine heart beating in sinus rhythm against that of the dyssynchronously beating failing heart. We also discuss the potential of coupled CE and hemodynamics models for various clinical applications. PMID:26442254

HISTOLOGIC AND ENZYMATIC COMPARISON BETWEEN PANGOLIN AND RAT LEFT MYOCARDIUM

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Medubi LJ

2010-01-01

Full Text Available Pangolin is presumably a primitive mammal compared to rat. However, its cardiac contractile function is maintained longer than that of rat following cutting it away from the body immediately after euthanize. This investigation aim therefore to elucidate the microanatomy of the left ventricle in the pangolins in comparison with that of Wistar rats. Biochemical enzyme quantification was also carried out in both mammals to evaluate differences in the levels of activities of the enzyme lactate dehydrogenase.Following euthanasia and dissection along the thoracic wall, the left ventricles were recovered and divided into two parts. One part was fixed in 10% formal-saline and processed for paraffin embedding while the other was homogenized in sucrose and used for lactate dehydrogenase quantification.Differences in the microanatomy of the left ventricles between pangolins and rats are reported essentially related with cardiomyocyte thickness, elastic fibers distribution, nuclear shapes, and perinuclear spaces. In addition, LDH activity appeared significantly higher in pangolins. Some of the detected differences could be correlated with animal size and perhaps, modes of life.These preliminary results generate expectations about the future possibility of being pangolins suitable models for cardiovascular research. Further investigations are needed in this regard.

Right and Left Ventricular Volumes in Atrial Septal Defect Studied by Radiocardiography

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Ivancevic, D. [Radioisotope Department, Internal Clinic, Rebro, Zagreb, Yugoslavia (Croatia); Vernejoul, P. de; Kellershohn, C. [CEA, Service Hospitalier Frederic Joliot, Departement de Biologie, Orsay (France)

1971-02-15

Radiocardiography with radioiodinated ({sup 131}I) human serum albumin and barium ({sup 137m}Ba) solution injected into the right subclavian vein has been performed in a group of 43 patients with atrial septal defect and left-to-right shunt. Data on the output and ejection index of each ventricle are essential for the estimation of the diastolic and residual volumes of the right and left ventricle. The systemic flow was therefore calculated according to Veall's formula and the pulmonary flow and the shunt How were determined using the method of de Vernejoul and co-workers. The formulas for the calculation of ventricular volumes were modified. The results show that many cases of atrial septal defect have an enlarged right ventricle whereas the left ventricle remains normal or is diminished. These changes correlate well with the amount of the shunt flow. In both ventricles the ventricular volumes show a good correlation with the stroke volumes. For the regulation of the pulmonary blood volume the right ventricle seems to be more important than the left ventricle. The operative closure of atrial septal defect (in 14 patients) has normalized the size of ventricular volumes. (author)

Simulation of left atrial function using a multi-scale model of the cardiovascular system.

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Antoine Pironet

Full Text Available During a full cardiac cycle, the left atrium successively behaves as a reservoir, a conduit and a pump. This complex behavior makes it unrealistic to apply the time-varying elastance theory to characterize the left atrium, first, because this theory has known limitations, and second, because it is still uncertain whether the load independence hypothesis holds. In this study, we aim to bypass this uncertainty by relying on another kind of mathematical model of the cardiac chambers. In the present work, we describe both the left atrium and the left ventricle with a multi-scale model. The multi-scale property of this model comes from the fact that pressure inside a cardiac chamber is derived from a model of the sarcomere behavior. Macroscopic model parameters are identified from reference dog hemodynamic data. The multi-scale model of the cardiovascular system including the left atrium is then simulated to show that the physiological roles of the left atrium are correctly reproduced. This include a biphasic pressure wave and an eight-shaped pressure-volume loop. We also test the validity of our model in non basal conditions by reproducing a preload reduction experiment by inferior vena cava occlusion with the model. We compute the variation of eight indices before and after this experiment and obtain the same variation as experimentally observed for seven out of the eight indices. In summary, the multi-scale mathematical model presented in this work is able to correctly account for the three roles of the left atrium and also exhibits a realistic left atrial pressure-volume loop. Furthermore, the model has been previously presented and validated for the left ventricle. This makes it a proper alternative to the time-varying elastance theory if the focus is set on precisely representing the left atrial and left ventricular behaviors.

Comparison of right and left side heart functions in patients with thalassemia major, patients with thalassemia intermedia, and control group.

Science.gov (United States)

Noori, Noormohammad; Mohamadi, Mehdi; Keshavarz, Kambiz; Alavi, Seyed Mostafa; Mahjoubifard, Maziar; Mirmesdagh, Yalda

2013-01-01

Heart disease is the main cause of mortality and morbidity in patients with beta thalassemia, rendering its early diagnosis vital. We studied and compared echocardiographic findings in patients with beta thalassemia major, patients with beta thalassemia intermedia, and a control group. Eighty asymptomatic patients with thalassemia major and 22 asymptomatic cases with thalassemia intermedia (8-25 years old) were selected from those referred to Ali Asghar Hospital (Zahedan-Iran) between June 2008 and June 2009. Additionally, 80 healthy individuals within the same age and sex groups were used as controls. All the individuals underwent echocardiography, the data of which were analyzed with the Student t-test. The mean value of the pre-ejection period/ejection time ratio of the left ventricle during systole, the diameter of the posterior wall of the left ventricle during diastole, the left and right isovolumic relaxation times, and the right myocardial performance index in the patients with beta thalassemia major and intermedia increased significantly compared to those of the controls, but the other parameters were similar between the two patient groups. The mean values of the left and right pre-ejection periods, left ventricular end systolic dimension, and left isovolumic contraction time in the patients with thalassemia intermedia increased significantly compared to those of the controls. In the left side, myocardial performance index, left ventricular mass index, isovolumic contraction time, and deceleration time exhibited significant changes between the patients with thalassemia major and those with thalassemia intermedia, whereas all the echocardiographic parameters of the right side were similar between these two groups. The results showed that the systolic and diastolic functions of the right and left sides of the heart would be impaired in patients with thalassemia major and thalassemia intermedia. Consequently, serial echocardiography is suggested in

A new "twist" on right heart failure with left ventricular assist systems.

Science.gov (United States)

Houston, Brian A; Shah, Keyur B; Mehra, Mandeep R; Tedford, Ryan J

2017-07-01

Despite significant efforts to predict and prevent right heart failure, it remains a leading cause of morbidity and mortality after implantation of left ventricular assist systems (LVAS). In this Perspective, we review the underappreciated anatomic and physiologic principles that govern the relationship between left and right heart function and contribute to this phenomenon. This includes the importance of considering the right ventricle (RV) and pulmonary arterial circuit as a coupled system; the contribution of the left ventricle (LV) to RV contractile function and the potential negative impact of acutely unloading the LV; the influence of the pericardium and ventricular twist on septal function; the role of RV deformation in reduced mechanical efficiency after device placement; and the potential of ongoing stressors of an elevated right-sided preload. We believe an appreciation of these complex issues is required to fully understand the expression of the unique phenotypes of right heart failure after LVAS implantation and for developing better prognostic and therapeutic strategies. Copyright © 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Quantitative cine-left ventriculography - Superiority of 45 .deg. RAO view to straight AB view -

International Nuclear Information System (INIS)

Lim, Tae Hwan; Han, Man Chung

1981-01-01

The volumetry by cineangiocardiography is known to have the most diagnostic and prognostic value in the evaluation of various valvular heart diseases and ischemic heart diseases. Although many authors favor the area-length method for the volumetry of left ventricle, 45 .deg. RAO projection seems to be more simple, inexpensive and accurate technique, considering the positional relationship of cardiac valves and obliquity of the long axis of left ventricle within the chest cage. Authors present the anatomical, geometrical and radiological basis for the superiority of 45 .deg. RAO protection by analyzing 20 normal heart specimen and 115 cineangiocardiograms of valvular heart diseases, and the results as follows: 1. Blood flow and motility of the mitral and aortic valves can be more clearly demonstrated by 45 .deg. RAO projection than by AP view. 2. The long diameter of left ventricular silhouette made 45 .deg. RAO projection reflects 90% or more of real diameter. 3. In RAO 45 .deg. position, patient's left nipple is optimal and convenient level for the ruler offering accurate magnification coefficient of left ventricle. 4. Ejection fraction after the extrasystole is exaggerated regardless of the left ventricular function, so it is desirable to exclude the 2 or 3 beats after extrasystole

A STUDY OF CHANGES IN DEFORMATION AND METABOLISM IN LEFT VENTRICLE AS A FUNCTION OF HYPERTROPHY IN SPONTANEOUS HYPERTENSIVE RATS USING MICROPET TECHNOLOGY

Energy Technology Data Exchange (ETDEWEB)

Gullberg, Grant, T; Huesman, Ronald, H; Reutter, Bryan, W; Sitek, Arkadiusz; Veress, Alexander, I; Weiss, Jeffrey, A; Yang, Yongfeng

2017-06-13

reconstruct the dynamic sequence. The in-plane image dimensions were doubled to 256x256x83 in order to increase the resolution for the Warping analyses. These image data sets were then cropped to 128x128x83. The end-systolic image data sets were designated as the template images and the end-diastole image data sets were designated as the target images, thus providing an analysis of the diastolic relaxation and filling phases of the cardiac cycle. The template images were manually segmented to create surface definitions representing the epi- and endocardial surfaces. Finite element models of the left ventricles were created using the segmented surfaces and defining a transversely isotropic material with fiber angles varying from the epicardial surface to the endocardial surface. A Warping analyses was performed to obtain the LV strain tensor and fiber stretch distributions. Results: In one study, the average first principal Green-Lagrange strain, fiber stretch, ejection fraction, and metabolic rate of F-18-FDG was 0.22, 1.08, 80%, 0.1 for the WKY rat and 0.16, 1.06, 50%, 0.25 for the SHR rat, respectively. These same rats studied a year later presented with a metabolic rate of F-18-FDG of 0.11 and 0.25 for the WKY and SHR, respectively. A follow-up study the average strain (n=10) and ejection fraction (n=18) was 0.21, 72.7% for WKY and 0.17, 69.8% for the SHR, respectively. Conclusion: In the case of pressure overload there is an increased reliance on carbohydrate oxidation in an attempt to maintain contractile function.

[Desmin content and transversal stiffness of the left ventricle mouse cardiomyocytes and skeletal muscle fibers after a 30-day space flight on board "BION-M1" biosatellite].

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Ogneva, I V; Maximova, M V; Larina, I M

2014-01-01

The aim of this study was to determine the transversal stiffness of the cortical cytoskeleton and the cytoskeletal protein desmin content in the left ventricle cardiomyocytes, fibers of the mouse soleus and tibialis anterior muscle after a 30-day space flight on board the "BION-M1" biosatellite (Russia, 2013). The dissection was made after 13-16.5 h after landing. The transversal stiffness was measured in relaxed and calcium activated state by, atomic force microscopy. The desmin content was estimated by western blotting, and the expression level of desmin-coding gene was detected using real-time PCR. The results indicate that, the transversal stiffness of the left ventricle cardiomyocytes and fibers of the soleus muscle in relaxed and activated states did not differ from the control. The transversal stiffness of the tibialis muscle fibers in relaxed and activated state was increased in the mice group after space flight. At the same time, in all types of studied tissues the desmin content and the expression level of desmin-coding gene did not differ from the control level.

THE EFFECT OF COMBINED ANTIHYPERTENSIVE THERAPY ON THE BASIC PARAMETERS OF THE LEFT VENTRICLE MYOCARDIUM STRUCTURE AND FUNCTION IN WOMEN WITH METABOLIC SYNDROME AND HYPOTHYROIDISM

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V. V. Skibitskiy

2012-01-01

Full Text Available Aim. To study the effect of combined antihypertensive therapy on the basic parameters of the left ventricle (LV myocardium structure and function in women with arterial hypertension (HT, metabolic syndrome (MS and hypothyroidism. Material and methods. Women (n=196 with HT grade 2–3 and MS were included into the study. Standard clinical examination including an assessment of thyroid status, ambulatory blood pressure (BP monitoring and echocardiography was performed at baseline and after 6 months. The patients were split into 3 groups: control (without hypothyroidism with subclinical and manifested (symptomatic hypothyroidism (SH and MH. Depending on baseline heart rate (HR patients of each group received a combination of amlodipine+losartan (A+L in HR <85/min or a combination of amlodipine+moxonidine (A+M in in HR ≥85/min. Results. The significant antihypertensive effect was found in patients of the control group due to both A+L and A+M combination (target BP was reached in 85.7 and 88.2%, respectively. In patients with hypothyroidism significant antihypertensive effects was observed only during A+M therapy (target BP in SH and MH was achieved in 82.8 and 82.4%, respectively. In the control group A+L and A+M combinations increased a number of patients with normal LV geometry (85.7 and 86.7, respectively and diastolic function (78.6 and 80%, respectively. In hypothyroidism A+M therapy resulted in more prominent increase in a number of patients with normal LV geometry (75% in both SH and MH and diastolic function (in SH and MH 83.3 и 85.7%, respectively than these in A+L therapy (р<0.05. Conclusion. The combination of A+M has advantages over A+L combination in antihypertensive efficacy as well as in the effect on the structural and functional state of the LV myocardium in women with HT and MS associated with hypothyroidism.

THE EFFECT OF COMBINED ANTIHYPERTENSIVE THERAPY ON THE BASIC PARAMETERS OF THE LEFT VENTRICLE MYOCARDIUM STRUCTURE AND FUNCTION IN WOMEN WITH METABOLIC SYNDROME AND HYPOTHYROIDISM

Directory of Open Access Journals (Sweden)

V. V. Skibitskiy

2015-12-01

Full Text Available Aim. To study the effect of combined antihypertensive therapy on the basic parameters of the left ventricle (LV myocardium structure and function in women with arterial hypertension (HT, metabolic syndrome (MS and hypothyroidism. Material and methods. Women (n=196 with HT grade 2–3 and MS were included into the study. Standard clinical examination including an assessment of thyroid status, ambulatory blood pressure (BP monitoring and echocardiography was performed at baseline and after 6 months. The patients were split into 3 groups: control (without hypothyroidism with subclinical and manifested (symptomatic hypothyroidism (SH and MH. Depending on baseline heart rate (HR patients of each group received a combination of amlodipine+losartan (A+L in HR <85/min or a combination of amlodipine+moxonidine (A+M in in HR ≥85/min. Results. The significant antihypertensive effect was found in patients of the control group due to both A+L and A+M combination (target BP was reached in 85.7 and 88.2%, respectively. In patients with hypothyroidism significant antihypertensive effects was observed only during A+M therapy (target BP in SH and MH was achieved in 82.8 and 82.4%, respectively. In the control group A+L and A+M combinations increased a number of patients with normal LV geometry (85.7 and 86.7, respectively and diastolic function (78.6 and 80%, respectively. In hypothyroidism A+M therapy resulted in more prominent increase in a number of patients with normal LV geometry (75% in both SH and MH and diastolic function (in SH and MH 83.3 и 85.7%, respectively than these in A+L therapy (р<0.05. Conclusion. The combination of A+M has advantages over A+L combination in antihypertensive efficacy as well as in the effect on the structural and functional state of the LV myocardium in women with HT and MS associated with hypothyroidism.

Peripheral Artery Disease and Continuous Flow Left Ventricle Assist Device: An Engaging Complement Analysis May Help to Guide Treatment.

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Falletta, Calogero; Pasta, Salvatore; Raffa, Giuseppe Maria; Crinò, Francesca; Sciacca, Sergio; Clemenza, Francesco

2018-02-13

Use of continuous flow left ventricle assist device (CF-LVAD) in advanced heart failure (HF) patients results in clinically relevant improvements in survival, functional capacity, and quality of life. Peripheral artery disease (PAD) can occur in patients with CF-LVAD due to the high rate of concomitance between risk factors for atherosclerosis and HF. Diagnosis of PAD can be difficult in the specific setting of a patient supported by this kind of device because of the marked alteration in waveform morphology and velocity created by the artificial physiology of an LVAD. We report the case of a 53-year-old man with HF secondary to ischemic cardiomyopathy supported by the HeartWare HVAD as bridge to transplant, who after the implant developed symptoms suggestive of PAD. We describe additional computational flow analysis for the study of PAD-related hemodynamic disturbances induced by a CF-LVAD. Flow simulations enhance the information of clinical image data, and may have an application in clinical investigations of the risk of hemodynamic disturbances induced by LVAD implantation. © 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Count-based left ventricular volume determination utilizing a left posterior oblique view for attenuation correction

International Nuclear Information System (INIS)

Rabinovitch, M.A.; Kalff, V.; Koral, K.

1984-01-01

This study aimed to determine the inherent error of the left ventricular volume measurement from the gated equilibrium blood pool scintigram utilizing the count-based technique. The study population consisted of 26 patients who had undergone biplane contrast ventriculography. The patients were imaged with a parallel-hole collimator in the left anterior oblique position showing the septum to best advantage. A reference blood sample was counted and radionuclide volumes calculated without correction for attenuation. Attenuation corrected volumes were derived with the factor 1/e/sup -/+d/, where d = distance from skin marker to center of the left ventricle in the orthogonal left posterior oblique view and μ = linear attenuation coefficient. A series of μ values from 0.08 to 0.15 cm -1 was evaluated. The tightest 95% confidence limits achieved for an end-diastolic 150-ml ventricle were +/- 44ml, and for an end-systolic 75-ml ventricle +/- 32 ml. In view of the magnitude of inherent error, the count-based volume measurement may be more suitable for group analyses and in cases in which an individual patient serves as his own control

Endocardial left ventricle feature tracking and reconstruction from tri-plane trans-esophageal echocardiography data

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Dangi, Shusil; Ben-Zikri, Yehuda K.; Cahill, Nathan; Schwarz, Karl Q.; Linte, Cristian A.

2015-03-01

Two-dimensional (2D) ultrasound (US) has been the clinical standard for over two decades for monitoring and assessing cardiac function and providing support via intra-operative visualization and guidance for minimally invasive cardiac interventions. Developments in three-dimensional (3D) image acquisition and transducer design and technology have revolutionized echocardiography imaging enabling both real-time 3D trans-esophageal and intra-cardiac image acquisition. However, in most cases the clinicians do not access the entire 3D image volume when analyzing the data, rather they focus on several key views that render the cardiac anatomy of interest during the US imaging exam. This approach enables image acquisition at a much higher spatial and temporal resolution. Two such common approaches are the bi-plane and tri-plane data acquisition protocols; as their name states, the former comprises two orthogonal image views, while the latter depicts the cardiac anatomy based on three co-axially intersecting views spaced at 600 to one another. Since cardiac anatomy is continuously changing, the intra-operative anatomy depicted using real-time US imaging also needs to be updated by tracking the key features of interest and endocardial left ventricle (LV) boundaries. Therefore, rapid automatic feature tracking in US images is critical for three reasons: 1) to perform cardiac function assessment; 2) to identify location of surgical targets for accurate tool to target navigation and on-target instrument positioning; and 3) to enable pre- to intra-op image registration as a means to fuse pre-op CT or MR images used during planning with intra-operative images for enhanced guidance. In this paper we utilize monogenic filtering, graph-cut based segmentation and robust spline smoothing in a combined work flow to process the acquired tri-plane TEE time series US images and demonstrate robust and accurate tracking of the LV endocardial features. We reconstruct the endocardial LV

One and a half ventricular repair as an alternative for hypoplastic right ventricle.

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Maluf, Miguel Angel; Carvalho, Antonio Carlos; Carvalho, Werther Brunow

2010-01-01

Patients with complex congenital heart disease, characterized by right ventricle hypoplasia, had a palliative surgical option with one and a half ventricular repair. From July 2001 to March 2009, nine patients (mean age 5.2 years, range 3 to 9 years) with hypoplastic right ventricle, underwent correction with one and a half ventricle technique. Preoperative diagnoses included: pulmonary atresia with intact ventricular septum, in six and Ebstein's anomaly, in three cases. Six patients had bidirectional cavo-pulmonary shunt (Glenn operation) previously. The surgical approach was performed with cardiopulmonary bypass to correct intracardiac defects: atrial septal defect closure (nine cases); right ventricle outlet tract reconstruction with porcine pulmonary prosthesis (seven cases); tricuspid valvuloplasty (three cases). There was one (11.1%) hospital death. All the patients left the hospital in good clinical conditions. One patient presented pulmonary stenosis at distal prosthesis anastomosis and needed surgical correction. There was one (12.5%) late deaths after reoperation. At mean follow-up of 39.8 months (range 16 months to 8.4 years) seven patients are alive in functional class I (NYHA). Surgical treatment of congenital cardiac anomalies in the presence of a hypoplastic right ventricle by means of one and a half ventricle repair has the advantages of reducing the surgical risk of biventricular repair compared to the Fontan circulation; it maintains a low right atrium pressure, a pulsatile pulmonary blood flow and improves the systemic oxygen saturation with short and medium-term promising results. Longer follow-up is needed to prove the efficacy of such a repair in the long term.

Isolated pseudohypoplasia of the right ventricle.

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Pastor, Esteban; Aramendi, José I; Luis, Maite; Voces, Roberto; Rodríguez, Miguel A; Galdeano, José M

2007-08-01

We present a case of a 12-year-old girl with severe cyanosis due to abnormal moderator band producing a hidden trabecular component of the right ventricle, mimicking isolated hypoplasia of the right ventricle. A marked hypoplasia was confirmed by echocardiography and catheterization. At operation an anomalously thickened moderator band obstructing the apical infundibulum was found. Repair consisted of a section of the moderator band and closure of the atrial septal defect. Postoperatively the right ventricle showed normal dimension and function.

Quantitative echocardiographic measures in the assessment of single ventricle function post-Fontan: Incorporation into routine clinical practice.

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Rios, Rodrigo; Ginde, Salil; Saudek, David; Loomba, Rohit S; Stelter, Jessica; Frommelt, Peter

2017-01-01

Quantitative echocardiographic measurements of single ventricular (SV) function have not been incorporated into routine clinical practice. A clinical protocol, which included quantitative measurements of SV deformation (global circumferential and longitudinal strain and strain rate), standard deviation of time to peak systolic strain, myocardial performance index (MPI), dP/dT from an atrioventricular valve regurgitant jet, and superior mesenteric artery resistance index, was instituted for all patients with a history of Fontan procedure undergoing echocardiography. All measures were performed real time during clinically indicated studies and were included in clinical reports. A total of 100 consecutive patients (mean age = 11.95±6.8 years, range 17 months-31.3 years) completed the protocol between September 1, 2014 to April 29, 2015. Deformation measures were completed in 100% of the studies, MPI in 93%, dP/dT in 55%, and superior mesenteric artery Doppler in 82%. The studies were reviewed to assess for efficiency in completing the protocol. The average time for image acquisition was 27.4±8.8 (range 10-62 minutes). The average time to perform deformation measures was 10.8±5.5 minutes (range 5-35 minutes) and time from beginning of imaging to report completion was 53.4±13.7 minutes (range 27-107 minutes). There was excellent inter-observer reliability when deformation indices were blindly repeated. Patients with a single left ventricle had significantly higher circumferential strain and strain rate, longitudinal strain and strain rate, and dP/dT compared to a single right ventricle. There were no differences in quantitative indices of ventricular function between patients 10 years post-Fontan. Advanced quantitative assessment of SV function post-Fontan can be consistently and efficiently performed real time during clinically indicated echocardiograms with excellent reliability. © 2016, Wiley Periodicals, Inc.

Fully automated segmentation of left ventricle using dual dynamic programming in cardiac cine MR images

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Jiang, Luan; Ling, Shan; Li, Qiang

2016-03-01

Cardiovascular diseases are becoming a leading cause of death all over the world. The cardiac function could be evaluated by global and regional parameters of left ventricle (LV) of the heart. The purpose of this study is to develop and evaluate a fully automated scheme for segmentation of LV in short axis cardiac cine MR images. Our fully automated method consists of three major steps, i.e., LV localization, LV segmentation at end-diastolic phase, and LV segmentation propagation to the other phases. First, the maximum intensity projection image along the time phases of the midventricular slice, located at the center of the image, was calculated to locate the region of interest of LV. Based on the mean intensity of the roughly segmented blood pool in the midventricular slice at each phase, end-diastolic (ED) and end-systolic (ES) phases were determined. Second, the endocardial and epicardial boundaries of LV of each slice at ED phase were synchronously delineated by use of a dual dynamic programming technique. The external costs of the endocardial and epicardial boundaries were defined with the gradient values obtained from the original and enhanced images, respectively. Finally, with the advantages of the continuity of the boundaries of LV across adjacent phases, we propagated the LV segmentation from the ED phase to the other phases by use of dual dynamic programming technique. The preliminary results on 9 clinical cardiac cine MR cases show that the proposed method can obtain accurate segmentation of LV based on subjective evaluation.

Origins and consequences of congenital heart defects affecting the right ventricle.

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Woudstra, Odilia I; Ahuja, Suchit; Bokma, Jouke P; Bouma, Berto J; Mulder, Barbara J M; Christoffels, Vincent M

2017-10-01

Congenital heart disease is a major health issue, accounting for a third of all congenital defects. Improved early surgical management has led to a growing population of adults with congenital heart disease, including patients with defects affecting the right ventricle, which are often classified as severe. Defects affecting the right ventricle often cause right ventricular volume or pressure overload and affected patients are at high risk for complications such as heart failure and sudden death. Recent insights into the developmental mechanisms and distinct developmental origins of the left ventricle, right ventricle, and the outflow tract have shed light on the common features and distinct problems arising in specific defects. Here, we provide a comprehensive overview of the current knowledge on the development into the normal and congenitally malformed right heart and the clinical consequences of several congenital heart defects affecting the right ventricle. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

Primary left ventricular hydatid cyst in a child: case report

International Nuclear Information System (INIS)

Turkvatan, A.; Yelgec, N.S.; Calikoglu, U.; Olcer, T.

2000-01-01

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)

Primary left ventricular hydatid cyst in a child: case report

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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)

Ganglioglioma in the Third Ventricle: A Case Report and Literature Review

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Higa, Nayuta; Yonezawa, Hajime; Oyoshi, Tatsuki; Hiraki, Tsubasa; Hirano, Hirofumi; Arita, Kazunori

2016-01-01

Gangliogliomas typically arise in the cerebral hemispheres, but may occur rarely in the ventricles. Herein, we report a 38-year-old woman who was treated for hydrocephalus caused by a ganglioglioma of the third ventricle. Magnetic resonance imaging (MRI) revealed a heterogeneously enhanced tumor occupying the anterior part of the third ventricle. A left trans-lateral ventricular trans-foramen of Monroi approach was effective in achieving subtotal resection of the tumor, which had arisen from the medial part of left thalamus to the hypothalamus. Follow-up MRI showed no recurrence of the tumor 5-years after surgery. On pathological examination, the tumor was composed of a glial component that presented features mimicking pilocytic astrocytoma with proliferations of large gangliocytic cells that stained positive for neuronal markers. A review of six similar cases in the literature, including our own, revealed hydrocephalus to be the main symptom of gangliogliomas, with pituitary insufficiencies and visual disturbances having also been reported. In conclusion, we highlight the importance of gangliogliomas in the differential diagnosis of third ventricular tumors presenting with hydrocephalus. PMID:28664007

Serial right ventricle 201Tl imaging after exercise: relation to anatomy of the right coronary artery

International Nuclear Information System (INIS)

Brown, K.A.; Boucher, C.A.; Okada, R.D.; Strauss, H.W.; McKusick, K.A.; Pohost, G.M.

1982-01-01

The relation of the appearance of the right ventricle on serium 201 Tl myocardial imaging to coronary artery anatomy was examined in 88 consecutive patients undergoing exercise 201 Tl testing and coronary angiography for the evaluation of chest pain. Transient defects in the right ventricle were found in 8 patients. All had high grade (greater than or equal to 90%) stenosis of the proximal right coronary artery. Nonvisualization of right ventricular (RV) activity occurred in 10 patients. Nine of the 10 (90%) had significant (greater than or equal to 50% stenosis) disease of the proximal right coronary artery and 7 (70%) had high grade stenosis. The right ventricle appeared normal in 70 patients. Twenty-nine (41%) of these patients had significant proximal right coronary artery disease. Right ventricular appearance was not affected by the presence or absence of disease of the left anterior descending or left circumflex artery or by the appearance of the left ventricle. Thus, with serial RV thallium-201 myocardial imaging after exercise, we found that (1) RV transient defects suggest the presence of high grade proximal right coronary artery stenosis, (2) non-visualization of RV activity also predicts significant proximal right coronary disease, and (3) the right ventricle frequently appears normal despite proximal right coronary artery disease and therefore this finding does not exclude such disease

The thickened left ventricle: etiology, differential diagnosis and implications for cardiovascular radiology

International Nuclear Information System (INIS)

Bischoff, P.; Barkhausen, J.; Hunold, P.; Radke, P.W.

2012-01-01

Hypertrophy of the left ventricular myocardium is a common finding and can be reliably detected by echocardiography, CT and MRI. Common causes include diseases associated with increased cardiac afterload as well as primary and secondary cardiomyopathy. With the opportunity to determine functional parameters and myocardial mass precisely as well as to detect structural changes of the cardiac muscle simultaneously, cardiac MRI is the most precise imaging method for quantifying left ventricular hypertrophy as well as determining the cause and the exact characterization of the myocardial changes. It is mandatory, however, to create a flexible, individually adapted examination protocol. This review presents useful diagnostic algorithms in relation to different underlying pathologies in patients with left ventricular hypertrophy. (orig.)

Assessment of left ventricular function using 201Tl electrocardiogram-gated myocardial single photon emission computed tomography

International Nuclear Information System (INIS)

Nishikubo, Naotsugu; Tamai, Hiroyuki

2013-01-01

Advances in computed tomography (CT) technology make it possible to obtain left ventricular wall motion using 3D reconstruction. In this study, we compared the images obtained from CT and 201 Tl electrocardiogram (ECG) gated single photon emission computed tomography (SPECT). In 20 patients with ischemic heart disease, we performed 201 Tl ECG gated SPECT (GE Healthcare Millennium VG) and ECG gated CT (Philips Medical Systems Brilliance iCT) to evaluate of left ventricular wall motion during the resting phase. In SPECT, left ventricular images were reconstructed using quantitative gated SPECT (QGS) software. In CT, the images were reconstructed using Virtual Place (AZE Software). The left ventricle was classified into five regions (anterior, lateral, inferior, septal, and apical). The amplitude of the wall motion was classified into five grades according to AHA classification. The values of the wall motion were separately checked by two radiographers. Assessment of left ventricular function myocardial wall movement using the three-dimensional movie display with ECG gated myocardial SPECT data was in agreement with the evaluation by cardiac CT inspection, and corresponded with wall motion in 88 of all 100 segments. SPECT analysis has the same quantity as that of obtained from CT for evaluation of left ventricular wall motion. (author)

Age and SPARC Change the Extracellular Matrix Composition of the Left Ventricle

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Lisandra E. de Castro Brás

2014-01-01

Full Text Available Secreted protein acidic and rich in cysteine (SPARC, a collagen-binding matricellular protein, has been implicated in procollagen processing and deposition. The aim of this study was to investigate age- and SPARC-dependent changes in protein composition of the cardiac extracellular matrix (ECM. We studied 6 groups of mice (n=4/group: young (4-5 months old, middle-aged (11-12 m.o., and old (18–29 m.o. C57BL/6J wild type (WT and SPARC null. The left ventricle (LV was decellularized to enrich for ECM proteins. Protein extracts were separated by SDS-PAGE, digested in-gel, and analyzed by HPLC-ESI-MS/MS. Relative quantification was performed by spectral counting, and changes in specific proteins were validated by immunoblotting. We identified 321 proteins, of which 44 proteins were extracellular proteins. Of these proteins, collagen III levels were lower in the old null mice compared to WT, suggestive of a role for SPARC in collagen deposition. Additionally, fibrillin showed a significant increase in the null middle-aged group, suggestive of increased microfibril deposition in the absence of SPARC. Collagen VI increased with age in both genotypes (>3-fold, while collagen IV showed increased age-associated levels only in the WT animals (4-fold, P<0.05. These changes may explain the previously reported age-associated increases in LV stiffness. In summary, our data suggest SPARC is a possible therapeutic target for aging induced LV dysfunction.

Influence of the heart rate and atrioventricular delays on vortex evolution and blood transport inside the left ventricle

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Hendabadi, Sahar; Martinez-Legazpi, Pablo; Benito, Yolanda; Bermejo, Javier; Del Alamo, Juan Carlos; Shadden, Shawn

2013-11-01

Cardiac resynchronization therapy (CRT) is used to help restore coordinated pumping of the ventricles by overcoming delays in electrical conduction due to cardiac disease. This is accomplished by a specialized cardiac pacemaker that is able to adjust the atrioventricular (AV) delay.A major clinical challenge is to adjust the pacing strategy to best coordinate the blood flow mechanics of ventricular filling and ejection. To this end, we have studied the difference in the vortex formation and its evolution inside the left ventricle (LV) for 4 different AV delays in a cohort of patients with implanted pacemakers. A reconstruction algorithm was used to obtain 2D velocity over the apical long-axis view of the LV from color Doppler and B-mode ultrasound data. To study blood transport, we have identified Lagrangian coherent structures to determine moving boundaries of the blood volumes injected to the LV in diastole and ejected to the aorta in systole. In all cases, we have analyzed the differences in filling and ejection patterns and the blood transport during the E-wave and A-wave formation.Finally we have assessed the influence of the AV delay on 2 indices of stasis, direct flow and residence time.The findings shed insight to the optimization of AV delays in patients undergoing CRT. NIH award 5R21HL108268 and grants PIS09/02603 and RD06/0010 from the Plan Nacional de Investigacion Cientifica, Spain.

RIght VErsus Left Apical transvenous pacing for bradycardia: Results of the RIVELA randomized study

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Haran Burri

2017-11-01

Full Text Available Aims: To compare cardiac function when pacing from the right or left ventricular apex in patients with preserved left ventricular systolic function, at 1-year follow-up. Methods: Prospective, multicentre centre randomizing conventional right ventricular apical (RVA versus left ventricular apical (LVA pacing using a coronary sinus lead in patients requiring ventricular pacing for bradycardia. Follow-up was performed using 3D-echocardiography at 6 and 12 months. Results: A total of 36 patients (age 75.4 ± 8.7 years, 21 males were enrolled (17 patients in the RVA group and 19 patients in the LVA group. A right ventricular lead was implanted in 8 patients in the LVA group, mainly because of high capture thresholds. There were no differences in the primary endpoint of LVEF at 1 year (60.4 ± 7.1% vs 62.1 ± 7.2% for the RVA and LVA groups respectively, P = 0.26 nor in any of the secondary endpoints (left ventricular dimensions, left ventricular diastolic function, right ventricular systolic function and tricuspid/mitral insufficiency. LVEF did not change significantly over follow-up in either group. Capture thresholds were significantly higher in the LVA group, and two patients had unexpected loss of capture of the coronary sinus lead during follow-up. Conclusions: Left univentricular pacing seems to be comparable to conventional RVA pacing in terms of ventricular function at up to 1 year follow-up, and is an option to consider in selected patients (e.g. those with a tricuspid valve prosthesis. Keywords: Ventricular pacing, Right ventricle, Left ventricle, Coronary sinus, Ventricular function

Segmentation of left ventricle myocardium in porcine cardiac cine MR images using a hybrid of fully convolutional neural networks and convolutional LSTM

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Zhang, Dongqing; Icke, Ilknur; Dogdas, Belma; Parimal, Sarayu; Sampath, Smita; Forbes, Joseph; Bagchi, Ansuman; Chin, Chih-Liang; Chen, Antong

2018-03-01

In the development of treatments for cardiovascular diseases, short axis cardiac cine MRI is important for the assessment of various structural and functional properties of the heart. In short axis cardiac cine MRI, Cardiac properties including the ventricle dimensions, stroke volume, and ejection fraction can be extracted based on accurate segmentation of the left ventricle (LV) myocardium. One of the most advanced segmentation methods is based on fully convolutional neural networks (FCN) and can be successfully used to do segmentation in cardiac cine MRI slices. However, the temporal dependency between slices acquired at neighboring time points is not used. Here, based on our previously proposed FCN structure, we proposed a new algorithm to segment LV myocardium in porcine short axis cardiac cine MRI by incorporating convolutional long short-term memory (Conv-LSTM) to leverage the temporal dependency. In this approach, instead of processing each slice independently in a conventional CNN-based approach, the Conv-LSTM architecture captures the dynamics of cardiac motion over time. In a leave-one-out experiment on 8 porcine specimens (3,600 slices), the proposed approach was shown to be promising by achieving average mean Dice similarity coefficient (DSC) of 0.84, Hausdorff distance (HD) of 6.35 mm, and average perpendicular distance (APD) of 1.09 mm when compared with manual segmentations, which improved the performance of our previous FCN-based approach (average mean DSC=0.84, HD=6.78 mm, and APD=1.11 mm). Qualitatively, our model showed robustness against low image quality and complications in the surrounding anatomy due to its ability to capture the dynamics of cardiac motion.

PREVENTION OF LEFT VENTRICLE SYSTOLIC DYSFUNCTION IN PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST SEGMENT ELEVATION AFTER CARDIAC REVASCULARIZATION

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A. L. Alyavi

2016-01-01

Full Text Available Aim. To study effects of bioflavonoid quercetin (corvitin on left ventricle (LV systolic dysfunction in patients with acute coronary syndrome with ST segment elevation (ACS+ST after cardiac revascularization.Material and methods. 60 patients with ACS+ST (44,2±1,3 y.o. were examined. Patients were admitted to hospital within 6 hours after complaints beginning. Patients were randomized in two groups. 30 patients of group A had standard therapy and cardiac revascularization. 30 patients of group B received corvitin additionally to standard therapy before cardiac revascularization. Echocardiography initially and stress-echocardiography with dobutamine after status stabilization (at 8-10 days of disease were performed.Results. Dobutamine test (with low and high doses showed myocardial viability in patients of group B. Patients of group A had irreversible LV systolic dysfunction in 32 % of segments. Corvitin slowed down LV dilatation progression in patients with ACS+ST. It resulted in the end-diastolic and end-systolic indexes did not change within 10 days. The LV ejection fraction was more increased in patients of group B in comparison with patients of group A.Conclusion. The early corvitin prescribing has positive effects on LV systolic function and prevents post-reperfusion complications. 

PREVENTION OF LEFT VENTRICLE SYSTOLIC DYSFUNCTION IN PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST SEGMENT ELEVATION AFTER CARDIAC REVASCULARIZATION

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A. L. Alyavi

2009-01-01

Full Text Available Aim. To study effects of bioflavonoid quercetin (corvitin on left ventricle (LV systolic dysfunction in patients with acute coronary syndrome with ST segment elevation (ACS+ST after cardiac revascularization.Material and methods. 60 patients with ACS+ST (44,2±1,3 y.o. were examined. Patients were admitted to hospital within 6 hours after complaints beginning. Patients were randomized in two groups. 30 patients of group A had standard therapy and cardiac revascularization. 30 patients of group B received corvitin additionally to standard therapy before cardiac revascularization. Echocardiography initially and stress-echocardiography with dobutamine after status stabilization (at 8-10 days of disease were performed.Results. Dobutamine test (with low and high doses showed myocardial viability in patients of group B. Patients of group A had irreversible LV systolic dysfunction in 32 % of segments. Corvitin slowed down LV dilatation progression in patients with ACS+ST. It resulted in the end-diastolic and end-systolic indexes did not change within 10 days. The LV ejection fraction was more increased in patients of group B in comparison with patients of group A.Conclusion. The early corvitin prescribing has positive effects on LV systolic function and prevents post-reperfusion complications. 

Effect of Transmural Differences in Excitation-Contraction Delay and Contraction Velocity on Left Ventricle Isovolumic Contraction: A Simulation Study

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J. Vaverka

2018-01-01

Full Text Available Recent studies have shown that left ventricle (LV exhibits considerable transmural differences in active mechanical properties induced by transmural differences in electrical activity, excitation-contraction coupling, and contractile properties of individual myocytes. It was shown that the time between electrical and mechanical activation of myocytes (electromechanical delay: EMD decreases from subendocardium to subepicardium and, on the contrary, the myocyte shortening velocity (MSV increases in the same direction. To investigate the physiological importance of this inhomogeneity, we developed a new finite element model of LV incorporating the observed transmural gradients in EMD and MSV. Comparative simulations with the model showed that when EMD or MSV or both were set constant across the LV wall, the LV contractility during isovolumic contraction (IVC decreased significantly (dp/dtmax⁡  was reduced by 2 to 38% and IVC was prolonged by 18 to 73%. This was accompanied by an increase of transmural differences in wall stress. These results suggest that the transmural differences in EMD and MSV play an important role in physiological contractility of LV by synchronising the contraction of individual layers of ventricular wall during the systole. Reduction or enhancement of these differences may therefore impair the function of LV and contribute to heart failure.

Left-ventricle segmentation in real-time 3D echocardiography using a hybrid active shape model and optimal graph search approach

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Zhang, Honghai; Abiose, Ademola K.; Campbell, Dwayne N.; Sonka, Milan; Martins, James B.; Wahle, Andreas

2010-03-01

Quantitative analysis of the left ventricular shape and motion patterns associated with left ventricular mechanical dyssynchrony (LVMD) is essential for diagnosis and treatment planning in congestive heart failure. Real-time 3D echocardiography (RT3DE) used for LVMD analysis is frequently limited by heavy speckle noise or partially incomplete data, thus a segmentation method utilizing learned global shape knowledge is beneficial. In this study, the endocardial surface of the left ventricle (LV) is segmented using a hybrid approach combining active shape model (ASM) with optimal graph search. The latter is used to achieve landmark refinement in the ASM framework. Optimal graph search translates the 3D segmentation into the detection of a minimum-cost closed set in a graph and can produce a globally optimal result. Various information-gradient, intensity distributions, and regional-property terms-are used to define the costs for the graph search. The developed method was tested on 44 RT3DE datasets acquired from 26 LVMD patients. The segmentation accuracy was assessed by surface positioning error and volume overlap measured for the whole LV as well as 16 standard LV regions. The segmentation produced very good results that were not achievable using ASM or graph search alone.

Multi-slice CT (MSCT) in cardiac function imaging: threshold-value-supported 3D volume reconstructions to determine the left ventricular ejection fraction in comparison to MRI

International Nuclear Information System (INIS)

Ehrhard, K.; Oberholzer, K.; Gast, K.; Mildenberger, P.; Kreitner, K.F.; Thelen, M.

2002-01-01

Purpose: To assess MSCT of the heart to determining left ventricular ejection fraction (EF) based on threshold-value-supported 3D volume reconstructions compared to MRI. Methods: Cardiac MSCT was performed in 7 patients. Images were reconstructed during end-systolic and end-diastolic phases of the cardiac cycle and transformed to 3D volumes to determine end-systolic (ESV) and end-diastolic volume (EDV) by using different lower threshold values: besides fixed lower threshold values, identical for each image sequence, individual lower threshold values dependent on contrast enhancement of the left ventricle were applied. The latter represent the mean value calculated by combining the average CT-density of the myocardium and the contrast-enhanced blood in the left ventricle. The EF derived from ESV and EDV. Results: The best correlation with MR imaging was obtained for ESV and EDV by using the individual lower threshold values for the respective sequence. The correlation coefficient for ESV was 0.95 and for EDV it was 0.93. On average, the ESV was overestimated by 3.72 ml, while the ESD was underestimated by 2.85 ml. The respective standard deviation for the ESV was 14,87 ml, for the EDV it was 26.83 ml. On average, the EF was underestimated by 3.57% with a standard deviation of 9.43% and a correlation coefficient of 0.83 in comparison to MRI. Conclusion: The threshold-value-supported 3D volume reconstruction of the left ventricle represents a good method to determine the left ventricular function parameters. Due to the differences in the contrast enhancement, the use of an individual lower threshold value for every image sequence is of particular importance. (orig.) [de

Fluid mechanics of blood flow in human fetal left ventricles based on patient-specific 4D ultrasound scans.

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Lai, Chang Quan; Lim, Guat Ling; Jamil, Muhammad; Mattar, Citra Nurfarah Zaini; Biswas, Arijit; Yap, Choon Hwai

2016-10-01

The mechanics of intracardiac blood flow and the epigenetic influence it exerts over the heart function have been the subjects of intense research lately. Fetal intracardiac flows are especially useful for gaining insights into the development of congenital heart diseases, but have not received due attention thus far, most likely because of technical difficulties in collecting sufficient intracardiac flow data in a safe manner. Here, we circumvent such obstacles by employing 4D STIC ultrasound scans to quantify the fetal heart motion in three normal 20-week fetuses, subsequently performing 3D computational fluid dynamics simulations on the left ventricles based on these patient-specific heart movements. Analysis of the simulation results shows that there are significant differences between fetal and adult ventricular blood flows which arise because of dissimilar heart morphology, E/A ratio, diastolic-systolic duration ratio, and heart rate. The formations of ventricular vortex rings were observed for both E- and A-wave in the flow simulations. These vortices had sufficient momentum to last until the end of diastole and were responsible for generating significant wall shear stresses on the myocardial endothelium, as well as helicity in systolic outflow. Based on findings from previous studies, we hypothesized that these vortex-induced flow properties play an important role in sustaining the efficiency of diastolic filling, systolic pumping, and cardiovascular flow in normal fetal hearts.

Repair of aorto-left ventricular tunnel arising from the left sinus of valsalva.

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Nezafati, Mohammad Hassan; Maleki, Mahmood Hosseinzadeh; Javan, Hadi; Zirak, Nahid

2010-05-01

Aortico-left ventricular tunnel (ALVT) is a rare congenital cardiac defect that bypasses the aortic valve via a para-valvular connection from the left ventricle to the aorta. In most cases, the tunnel arises from the right aortic sinus. In this case report, we are presenting a case of ALVT, of which the aortic orifice arose from the left aortic sinus, requiring special attention to avoid the left coronary artery injury at the time of surgical repair.

Lung volumes, ventricular function and pulmonary arterial flow in children operated on for left-sided congenital diaphragmatic hernia: long-term results

International Nuclear Information System (INIS)

Abolmaali, Nasreddin; Koch, Arne; Goetzelt, Knut; Vogelberg, Christian; Hahn, Gabriele; Fitze, Guido

2010-01-01

To compare MRI-based functional pulmonary and cardiac measurements in the long-term follow-up of children operated on for left-sided congenital diaphragmatic hernia (CDH) with age- and body size-matched healthy controls. Twelve children who received immediate postnatal surgery for closure of isolated left-sided CDH were included and received basic medical examinations, pulmonary function testing and echocardiography. MRI included measurement of lung volume, ventricular function assessment and velocity-encoded imaging of the pulmonary arteries and was compared with the data for 12 healthy children matched for age and body size. While patients' clinical test results were not suspicious, comparison between the MRI data for patients and those for healthy controls revealed significant differences. In patients, the volumes of the left lungs were increased and the tidal volume was larger on the right side. While the stroke volumes of both ventricles were reduced, heart rate and ejection fraction were increased. Flow, acceleration time and cross-sectional area of the left pulmonary artery were reduced. Functional MRI detected pulmonary and cardiac findings in the late follow-up of CDH children which may be missed by standard clinical methods and might be relevant for decisions regarding late outcome and treatment. (orig.)

Lung volumes, ventricular function and pulmonary arterial flow in children operated on for left-sided congenital diaphragmatic hernia: long-term results

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Abolmaali, Nasreddin; Koch, Arne [Dresden University of Technology, OncoRay - Molecular and Biological Imaging, Medical Faculty Carl Gustav Carus, Dresden (Germany); Goetzelt, Knut; Vogelberg, Christian [University Clinics Carl Gustav Carus, Dresden University of Technology, Clinic and Policlinic for Pediatrics - Pediatric Pulmonology, Dresden (Germany); Hahn, Gabriele [University Clinics Carl Gustav Carus, Dresden University of Technology, Institute and Policlinic for Radiology - Pediatric Radiology, Dresden (Germany); Fitze, Guido [University Clinics Carl Gustav Carus, Dresden University of Technology, Clinic and Policlinic for Pediatric Surgery, Dresden (Germany)

2010-07-15

To compare MRI-based functional pulmonary and cardiac measurements in the long-term follow-up of children operated on for left-sided congenital diaphragmatic hernia (CDH) with age- and body size-matched healthy controls. Twelve children who received immediate postnatal surgery for closure of isolated left-sided CDH were included and received basic medical examinations, pulmonary function testing and echocardiography. MRI included measurement of lung volume, ventricular function assessment and velocity-encoded imaging of the pulmonary arteries and was compared with the data for 12 healthy children matched for age and body size. While patients' clinical test results were not suspicious, comparison between the MRI data for patients and those for healthy controls revealed significant differences. In patients, the volumes of the left lungs were increased and the tidal volume was larger on the right side. While the stroke volumes of both ventricles were reduced, heart rate and ejection fraction were increased. Flow, acceleration time and cross-sectional area of the left pulmonary artery were reduced. Functional MRI detected pulmonary and cardiac findings in the late follow-up of CDH children which may be missed by standard clinical methods and might be relevant for decisions regarding late outcome and treatment. (orig.)

Lung volumes, ventricular function and pulmonary arterial flow in children operated on for left-sided congenital diaphragmatic hernia: long-term results.

Science.gov (United States)

Abolmaali, Nasreddin; Koch, Arne; Götzelt, Knut; Hahn, Gabriele; Fitze, Guido; Vogelberg, Christian

2010-07-01

To compare MRI-based functional pulmonary and cardiac measurements in the long-term follow-up of children operated on for left-sided congenital diaphragmatic hernia (CDH) with age- and body size-matched healthy controls. Twelve children who received immediate postnatal surgery for closure of isolated left-sided CDH were included and received basic medical examinations, pulmonary function testing and echocardiography. MRI included measurement of lung volume, ventricular function assessment and velocity-encoded imaging of the pulmonary arteries and was compared with the data for 12 healthy children matched for age and body size. While patients' clinical test results were not suspicious, comparison between the MRI data for patients and those for healthy controls revealed significant differences. In patients, the volumes of the left lungs were increased and the tidal volume was larger on the right side. While the stroke volumes of both ventricles were reduced, heart rate and ejection fraction were increased. Flow, acceleration time and cross-sectional area of the left pulmonary artery were reduced. Functional MRI detected pulmonary and cardiac findings in the late follow-up of CDH children which may be missed by standard clinical methods and might be relevant for decisions regarding late outcome and treatment.

LEFT ATRIAL FUNCTION: MODERN ASSESSMENT METHODS AND CLINICAL SIGNIFICANCE

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E. N. Pavlyukova

2017-01-01

Full Text Available Assessment of the left atrial (LA function is important aspect of comprehensive cardiovascular system estimation. Many cardiac diseases make an impact to LA work either by direct affect on myocardium or hemodynamic condition changing. It is considered, LA and left ventricle diastolic pressure is interrelated, thus without mitral valve disease LA expanding is a sign of LV filling pressure augmentation. Examination of LA size and function by analysis of atrial reservoir, conduit, and booster pump can predict cardiovascular outcomes in patients with cardiomyopathy, ischemic heart disease and valvular heart disease. The last two decades gave new technologies to accurate and comprehensive LA mechanics estimation, in the first place related to tissue Doppler imaging. Atrial strain and strain rate obtained using two-dimensional speckle-tracking echocardiography have proved to be feasible and reproducible techniques to evaluate LA mechanics.In physiological settings, LA is a highly expandable chamber with relatively low pressures. However in the presence of acute and chronic injury, LA wall stretches. LA stretching is a hallmark of structure changing with myocardial fibrosis and has influence on LA strain and strain rate. LA strain estimation could be useful in the prediction of sinus rhythm restoration and maintenance after cardioversion and catheter ablation. Low values of global longitudinal LA strain indicate irreversible LA remodeling and are related to the atrial fibrillation progression from paroxysmal to permanent forms. The most interesting in these circumstances is the potential contribution of echocardiography to thromboembolic risk stratification in atrial fibrillation and invasive procedures such as atrial ablation. Therefore, at present, the main task is to understand the ways of clinical application of data  obtained during the LA study.

Left ventricle ejection fraction obtained by radioisotopic angiocardiography. Correlation between the values of the conventional ventriclegraphy

International Nuclear Information System (INIS)

Ascer, E.; Pimentel Filho, W.A.; Martins, L.R.F.; Marioni Filho, H.; Queiroga Filho, A.F.; Alonso, G.; Germek, O.A.; Thom, A.F.; Souza, J.E.M.R.

1983-01-01

Forty-two patients with clinical signs of coronary insuficiency underwent cineangiographic and radioisotopic examinations with the purpose of analysing the correlation between the values of left ventricle ejection fraction (LVEF) obtained by both methods. The values of EF obtained by the hemodynamic method (HEMO) ranged from 0.14 to 0.85 (x-bar = 0.566) and by radioisotopic method (RM) from 0.22 to 0.89 (x-bar = 0.573). The Student T test did not demonstrate statistically significant differences between the two methods (mean of differences = 0.007; t = 0.38 and p ≥ 0.353). A regression equation was obtained in order to estimate the EF by HEMO deriving from results obtained by RM (y = 0.11 + 0.80x) and to estimate the EF through RN from the results obtained by HEMO (x = 0.08 + 0.86y), where y = hemodynamic method and x = radioisotopic method. The authors conclude that the calculation of the EF by the methods used showed a good correlation and that this fact is evidenced by the elevated Pearson's correlation coefficient (r = 0.833). (author) [pt

Magnetic resonance tissue phase mapping demonstrates altered left ventricular diastolic function in children with chronic kidney disease

International Nuclear Information System (INIS)

Gimpel, Charlotte; Pohl, Martin; Jung, Bernd A.; Jung, Sabine; Brado, Johannes; Odening, Katja E.; Schwendinger, Daniel; Burkhardt, Barbara; Geiger, Julia; Arnold, Raoul

2017-01-01

Echocardiographic examinations have revealed functional cardiac abnormalities in children with chronic kidney disease. To assess the feasibility of MRI tissue phase mapping in children and to assess regional left ventricular wall movements in children with chronic kidney disease. Twenty pediatric patients with chronic kidney disease (before or after renal transplantation) and 12 healthy controls underwent tissue phase mapping (TPM) to quantify regional left ventricular function through myocardial long (Vz) and short-axis (Vr) velocities at all 3 levels of the left ventricle. Patients and controls (age: 8 years - 20 years) were matched for age, height, weight, gender and heart rate. Patients had higher systolic blood pressure. No patient had left ventricular hypertrophy on MRI or diastolic dysfunction on echocardiography. Fifteen patients underwent tissue Doppler echocardiography, with normal z-scores for mitral early diastolic (V E ), late diastolic (V A ) and peak systolic (V S ) velocities. Throughout all left ventricular levels, peak diastolic Vz and Vr (cm/s) were reduced in patients: Vz base -10.6 ± 1.9 vs. -13.4 ± 2.0 (P < 0.0003), Vz mid -7.8 ± 1.6 vs. -11 ± 1.5 (P < 0.0001), Vz apex -3.8 ± 1.6 vs. -5.3 ± 1.6 (P = 0.01), Vr base -4.2 ± 0.8 vs. -4.9 ± 0.7 (P = 0.01), Vr mid -4.7 ± 0.7 vs. -5.4 ± 0.7 (P = 0.01), Vr apex -4.7 ± 1.4 vs. -5.6 ± 1.1 (P = 0.05). Tissue phase mapping is feasible in children and adolescents. Children with chronic kidney disease show significantly reduced peak diastolic long- and short-axis left ventricular wall velocities, reflecting impaired early diastolic filling. Thus, tissue phase mapping detects chronic kidney disease-related functional myocardial changes before overt left ventricular hypertrophy or echocardiographic diastolic dysfunction occurs. (orig.)

Predictors of the left ventricular dysfunction induced by ventricular arrhythmia

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А. І. Vytryhovskiy

2016-08-01

Full Text Available The most powerful predictor of life-threatening arrhythmia risk is a combination of low heart rate variability with low ejection fraction (EF of the left ventricle. Aim. To identify predictors of left ventricle dysfunction which is induced by ventricular arrhythmia. Materials and methods. To diagnose structural changes of left ventricular functional capacity and reserves in patients with previous myocardial infarction and patients with high and very high cardiovascular risk by SCORE scale and for establishment the relationship between morphological heart changes and pathological phenomenon of heart turbulence echocardiography and study of heart rate turbulence variability were performed. 603 patients were selected for the research. All patients were divided into groups: group 1 – patients with coronary heart disease, but without associated risk factors, such as smoking, obesity, metabolic syndrome; group 2 – patients who smoke tobacco more than 2 years (very high cardiovascular risk by scale SCORE; group 3 – patients with metabolic syndrome without coronary heart disease or arterial hypertension (very high cardiovascular risk by scale SCORE. The control group consisted of 149 persons. Results. The feature of structural changes in patients with myocardial infarction and in patients with a high cardiovascular risk by SCORE with heart rate turbulence compared with cases without НRT is considerably thickening of the left interventricular septum in systole. Based on this, it can be argued that the emergence of ventricular arrhythmia and accordingly phenomenon of heart rate turbulence in patients with existing cardiovascular diseases and risk factors has both morphological and functional character. Significant difference of echocardioscopy parameters in patients with postinfarction cardiosclerosis and risk factors by the SCORE system was established by index of intraventricular septum thickness in systole, and in persons with high risk – in

Left Ventricular Function Improves after Pulmonary Valve Replacement in Patients with Previous Right Ventricular Outflow Tract Reconstruction and Biventricular Dysfunction

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Kane, Colin; Kogon, Brian; Pernetz, Maria; McConnell, Michael; Kirshbom, Paul; Rodby, Katherine; Book, Wendy M.

2011-01-01

Congenital heart defects that have a component of right ventricular outflow tract obstruction, such as tetralogy of Fallot, are frequently palliated in childhood by disruption of the pulmonary valve. Although this can provide an initial improvement in quality of life, these patients are often left with severe pulmonary valve insufficiency. Over time, this insufficiency can lead to enlargement of the right ventricle and to the deterioration of right ventricular systolic and diastolic function. Pulmonary valve replacement in these patients decreases right ventricular volume overload and improves right ventricular performance. To date, few studies have examined the effects of pulmonary valve replacement on left ventricular function in patients with biventricular dysfunction. We sought to perform such an evaluation. Records of adult patients who had undergone pulmonary valve replacement from January 2003 through November 2006 were analyzed retrospectively. We reviewed preoperative and postoperative echocardiograms and calculated left ventricular function in 38 patients. In the entire cohort, the mean left ventricular ejection fraction increased by a mean of 0.07 after pulmonary valve replacement, which was a statistically significant change (P < 0.01). In patients with preoperative ejection fractions of less than 0.50, mean ejection fractions increased by 0.10. We conclude that pulmonary valve replacement in patients with biventricular dysfunction arising from severe pulmonary insufficiency and right ventricular enlargement can improve left ventricular function. Prospective studies are needed to verify this finding. PMID:21720459

Determination of left ventricular function parameters and myocardial mass: comparison of MRI and EBT

International Nuclear Information System (INIS)

Kivelitz, D.E.; Enzweiler, C.N.H.; Wiese, T.H.; Lembcke, A.; Taupitz, M.; Hamm, B.; Borges, A.; Zytowski, M.

2000-01-01

Purpose: Comparative volumetric assessment of the left ventricle by magnetic resonance imaging (MRI) and electron beam tomography (EBT) in patients with ischemic and dilated cardiac disease. Methods: Thirty-two patients underwent cine MRI and EBT in the multislice mode. All studies were triggered to the ECG. Left ventricular ejection fraction (EF), enddiastolic (EDV) and endsystolic volume (ESV), and myocardial mass (MM) were determined by 3D-volumetry by MRI and EBT and results were compared. Results: The correlation between MRI and EBT for EF, EDV, ESV, and MM were r=0.86, r=0.95, r=0.95, and r=0.93, respectively. Conclusions: There is an excellent correlation between MRI and EBT in determining left-ventricular parameters. Both methods are suitable for volumetric assessment of the left ventricie. (orig.) [de

Left heart ventricular angiography

Science.gov (United States)

... blood vessels. These x-ray pictures create a "movie" of the left ventricle as it contracts rhythmically. ... 22578925 www.ncbi.nlm.nih.gov/pubmed/22578925 . Review Date 9/26/2016 Updated by: Michael A. ...

Double Outlet Right Ventricle

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... Right Ventricle Menu Topics Topics FAQs Double Outlet Right Ventricle Double outlet right ventricle (DORV) is a rare form of congenital heart disease. En español Double outlet right ventricle (DORV) is a rare form of congenital ...

Analysis of the stability of housekeeping gene expression in the left cardiac ventricle of rats submitted to chronic intermittent hypoxia

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Guilherme Silva Julian

Full Text Available ABSTRACT Obstructive sleep apnea (OSA has been associated with oxidative stress and various cardiovascular consequences, such as increased cardiovascular disease risk. Quantitative real-time PCR is frequently employed to assess changes in gene expression in experimental models. In this study, we analyzed the effects of chronic intermittent hypoxia (an experimental model of OSA on housekeeping gene expression in the left cardiac ventricle of rats. Analyses via four different approaches-use of the geNorm, BestKeeper, and NormFinder algorithms; and 2−ΔCt (threshold cycle data analysis-produced similar results: all genes were found to be suitable for use, glyceraldehyde-3-phosphate dehydrogenase and 18S being classified as the most and the least stable, respectively. The use of more than one housekeeping gene is strongly advised.

Syndrome of hypoplasic left ventricle, Description of a clinical case with survival after carrying out of Norwood technique

International Nuclear Information System (INIS)

Velasco B, Ana M; Lince V, Rafael; Zapata S, Jorge A and others

2003-01-01

A clinical case of a 72 hours newborn patient admitted to the pediatric intensive care unit for reduced cardiac output syndrome showing anuria, metabolic acidosis and respiratory distress, is reported. Mechanical ventilation, inotropic support and continuous prostaglandin e1 infusion were initiated. The echocardiogram showed hypoplasia of the left ventricle. The Norwood procedure stage i under extracorporeal circulation with deep hypothermia and circulatory arrest, was performed at the 6th day of life. During the early postoperative period, the patient developed hypoxaemia and pulmonary hypertension, which improved with controlled hyperventilation and vasodilatation therapy. Other complications were clinical sepsis and abstinence syndrome, which resolved with medical management. The patient was extubated on the sixth postoperative day. Subsequent echocardiograms showed tricuspid valve regurgitation, right ventricular dysfunction with dilation and an organized thrombus in the left atrium. These improved with diuretics, dopamine, milrinone and heparin. The patient was discharged after 32 days of the surgery without signs of congestive heart failure. This case is important, given the high mortality rate of this pathology. The Norwood procedure proved to be a palliative strategy versus the ortotopic cardiac transplant in newborns, because of the difficulty in finding donators at this age and the immunosuppressive therapy complications. This represents a great advance in the Colombian pediatric cardiology because until recent years these patients did not have any other surgical alternative

Left Atrial Enlargement in Young High-Level Endurance Athletes – Another Sign of Athlete’s Heart?

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Król Wojciech

2016-12-01

Full Text Available Enlargement of the left atrium is perceived as a part of athlete’s heart syndrome, despite the lack of evidence. So far, left atrial size has not been assessed in the context of exercise capacity. The hypothesis of the present study was that LA enlargement in athletes was physiological and fitness-related condition. In addition, we tried to assess the feasibility and normal values of left atrial strain parameters and their relationship with other signs of athlete’s heart. The study group consisted of 114 international-level rowers (17.5 ± 1.5 years old; 46.5% women. All participants underwent a cardio-pulmonary exercise test and resting transthoracic echocardiography. Beside standard echocardiographic measurements, two dimensional speckle tracking echocardiography was used to assess average peak atrial longitudinal strain, peak atrial contraction strain and early left atrial diastolic longitudinal strain. Mild, moderate and severe left atrial enlargement was present in 27.2°%, 11.4% and 4.4% athletes, respectively. There were no significant differences between subgroups with different range of left atrial enlargement in any of echocardiographic parameters of the left ventricle diastolic function, filling pressure or hypertrophy. A significant correlation was found between the left atrial volume index and maximal aerobic capacity (R > 0.3; p < 0.001. Left atrial strain parameters were independent of atrial size, left ventricle hypertrophy and left ventricle filling pressure. Decreased peak atrial longitudinal strain was observed in 4 individuals (3.5%. We concluded that LA enlargement was common in healthy, young athletes participating in endurance sport disciplines with a high level of static exertion and was strictly correlated with exercise capacity, therefore, could be perceived as another sign of athlete’s heart.

[Assessment of Tricuspid Insufficiency and the Function of Right Ventricle Using Cardiac Magnetic Resonance Imaging Combined with Echocardiography].

Science.gov (United States)

Chen, Hui; Zhao, Yanling; Yu, Jianqun

2015-08-01

Right-sided cardiac valvular diseases have traditionally been considered less important than disease of mitral or aortic valve. However, severe tricuspid regurgitation could lead to right ventricle dysfunction and reduce patients' survival rate. In clinic setting, tricuspid valve disease should be paid more attention for patients with secondary tricuspid regurgitation caused by left-sided valvular surgery combined with irreversible annular dilatation increasing the risk of reoperation. In this review, we summarize the epidemiology, anatomy, pathology, diagnosis, ultrasound and cardiac magnetic resonance imaging findings in patients with tricuspid regurgitation.

Peculiarities of cardiac hemodynamics and functional state of left ventricular myocardium in teenagers with connective heart tissue dysplasia

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Makhmudova F.M.

2011-03-01

Full Text Available The aim of investigation is to study heart hemodynamics in teenagers with connective tissue dysplasia of heart (CTDH. 35 patients ages 12 to 15 years with CTDH have been observed: Group I (n=14 are the patients with mitral valve prolapse (MVP without mitral regurgitation (MR and myxomatous degeneration(MD or isolated minor heart abnormalities (MHA, Group II (n=11are patients with MVP and MR in combination with 1 or2 MHA, and Group III (n=10 are patients with MVP and mixoid degeneration (MD in combination with 2 or more MHA. The control group consisted of 15 patients of the same age without MHA. All the children passed Doppler and echocardiography. According to the results significant changes of cardiohemodynamic indices in patients of Group I were not observed. The changes of size and volume indices of the left ventricle (LV, increase in wall thickness and diastolic dysfunction of the LV were observed in Group II. The significant changes of systolic function of left ventricular myocardium were observed in Group III. The study comes to the conclusion that teenagers with CTDH have definite changes of heart hemodynamics and functional state of left ventricular myocardium. These changes depend on mitral regurgitation, myxomatous degeneration and MHA combination

Reduced left ventricular dimension and function following early life stress: A thrifty phenotype hypothesis engendering risk for mood and anxiety disorders

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Jeremy D. Coplan

2018-02-01

Full Text Available Background: Early life stress (ELS in macaques in the form of insecure maternal attachment putatively induces epigenetic adaptations resulting in a “thrifty phenotype” throughout the life cycle. For instance, ELS induces persistent increases in insulin resistance, hippocampal and corpus callosum atrophy and reduced “behavioral plasticity”, which, taken together, engenders an increased risk for mood and anxiety disorders in humans but also a putative sparing of calories. Herein, we test the hypothesis whether a thrifty phenotype induced by ELS is peripherally evident as hypotrophy of cardiac structure and function, raising the possibility that certain mood disorders may represent maladaptive physiological and central thrift adaptations. Methods: 14 adult bonnet macaques (6 males exposed to the maternal variable foraging demand (VFD model of ELS were compared to 20 non-VFD adult subjects (6 males. Left ventricle end-diastolic dimension (LVEDD, Left ventricle end-systolic dimension (LVESD and stroke volume (SV were calculated using echocardiography. Blood pressure and heart rate were measured only in females. Previously obtained neurobehavioral correlates available only in males were analyzed in the context of cardiac parameters. Results: Reduced LVESD (p < 0.05 was observed when controlled for age, sex, body weight and crown-rump length whereas ejection fraction (EF (p = 0.037 was greater in VFD-reared versus non-VFD subjects. Pulse pressure was lower in VFD versus non-VFD females (p < 0.05. Male timidity in response to a human intruder was associated with reduced LVEDD (p < 0.05. Conclusions: ELS is associated with both structural and functional reductions of left ventricular measures, potentially implying a body-wide thrifty phenotype. Parallel “thrift” adaptations may occur in key brain areas following ELS and may play an unexplored role in mood and anxiety disorder susceptibility.

HEMOSTATIC SYSTEM CONDITION AND HEART REMODELING IN PATIENTS WITH Q-WAVE MYOCARDIAL INFARCTION WITH ACUTE ANEURYSMS AND LEFT VENTRICLE THROMBUS

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V. D. Syvolap

2014-02-01

Full Text Available Introduction. Worldwide myocardial infarction (MI is one of the main causes of morbidity and mortality. Thanks to advances in modern cardiology we achieved a significant reduction in mortality and the incidence of fatal complications of acute Q-wave MI. However, keeping in mind the pathogenetic features of myocardial defeat of the left ventricle (LV cavity dilation and thinning at the focus of myocardial infarction, which increase the risk of left ventricular aneurysm development and parietal thrombus formation, it is impossible to reduce significantly the risk of these serious complications development. Post-infarction left ventricular aneurysm, extremely unfavorable prognostic factor complicates the course of Q-wave myocardial infarction in 30% of cases. The likelihood of parietal clot development in the anterior apical localization of aneurysms is 32%. The reasons of parietal clot formation are varied and are not fully disclosed, that is responsible for the relevance of this study. Aim: to investigate the serum level of protein C, von Willebrand factor, the expression of vascular adhesion molecules sVCAM-1, platelet aggregation properties and to evaluate their relationship with the structural and functional performance of the heart in patients with acute Q-wave myocardial infarction with aneurysm and parietal thrombus of LV. Methods. 110 patients (67 men and 43 women, mean age - 63,2 ± 5,7 years, with a diagnosis of acute Q-wave myocardial infarction were involved into the study. The first group included 72 patients with postinfarction left ventricular aneurysm, the second - 38 patients with postinfarction aneurysm and parietal thrombus of LV. Serum levels of protein C, von Willebrand factor, the expression of vascular adhesion molecules sVCAM-1, platelet aggregation properties were studied and their relationship with the structural and functional performance of the heart were evaluated. Results. There were revealed high activity of the key

Magnetic resonance tissue phase mapping demonstrates altered left ventricular diastolic function in children with chronic kidney disease

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Gimpel, Charlotte; Pohl, Martin [Medical Center - University of Freiburg, Department of General Pediatrics, Adolescent Medicine and Neonatology, Center for Pediatrics, Freiburg (Germany); Jung, Bernd A. [Inselspital Bern, Institute of Diagnostic, Interventional and Pediatric Radiology, Bern (Switzerland); Jung, Sabine [Medical Center - University of Freiburg, Department of Nuclear Medicine, Freiburg (Germany); Brado, Johannes; Odening, Katja E. [University Heart Center Freiburg, Department of Cardiology and Angiology I, Freiburg (Germany); Schwendinger, Daniel [University Children' s Hospital Zurich, Zurich (Switzerland); Burkhardt, Barbara [University Children' s Hospital Zurich, Pediatric Heart Center, Zurich (Switzerland); Geiger, Julia [University Children' s Hospital Zurich, Department of Radiology, Zurich (Switzerland); Northwestern University, Department of Radiology, Chicago, IL (United States); Arnold, Raoul [University Hospital Heidelberg, Department of Pediatric and Congenital Cardiology, Heidelberg (Germany)

2017-02-15

Echocardiographic examinations have revealed functional cardiac abnormalities in children with chronic kidney disease. To assess the feasibility of MRI tissue phase mapping in children and to assess regional left ventricular wall movements in children with chronic kidney disease. Twenty pediatric patients with chronic kidney disease (before or after renal transplantation) and 12 healthy controls underwent tissue phase mapping (TPM) to quantify regional left ventricular function through myocardial long (Vz) and short-axis (Vr) velocities at all 3 levels of the left ventricle. Patients and controls (age: 8 years - 20 years) were matched for age, height, weight, gender and heart rate. Patients had higher systolic blood pressure. No patient had left ventricular hypertrophy on MRI or diastolic dysfunction on echocardiography. Fifteen patients underwent tissue Doppler echocardiography, with normal z-scores for mitral early diastolic (V{sub E}), late diastolic (V{sub A}) and peak systolic (V{sub S}) velocities. Throughout all left ventricular levels, peak diastolic Vz and Vr (cm/s) were reduced in patients: Vz{sub base} -10.6 ± 1.9 vs. -13.4 ± 2.0 (P < 0.0003), Vz{sub mid} -7.8 ± 1.6 vs. -11 ± 1.5 (P < 0.0001), Vz{sub apex} -3.8 ± 1.6 vs. -5.3 ± 1.6 (P = 0.01), Vr{sub base} -4.2 ± 0.8 vs. -4.9 ± 0.7 (P = 0.01), Vr{sub mid} -4.7 ± 0.7 vs. -5.4 ± 0.7 (P = 0.01), Vr{sub apex} -4.7 ± 1.4 vs. -5.6 ± 1.1 (P = 0.05). Tissue phase mapping is feasible in children and adolescents. Children with chronic kidney disease show significantly reduced peak diastolic long- and short-axis left ventricular wall velocities, reflecting impaired early diastolic filling. Thus, tissue phase mapping detects chronic kidney disease-related functional myocardial changes before overt left ventricular hypertrophy or echocardiographic diastolic dysfunction occurs. (orig.)

Echocardiographic assessment with right ventricular function improvement following ultrasound-accelerated catheter-directed thrombolytic therapy in submassive pulmonary embolism.

Science.gov (United States)

Doheny, Charles; Gonzalez, Lorena; Duchman, Stanley M; Varon, Joseph; Bechara, Carlos F; Cheung, Mathew; Lin, Peter H

2018-06-01

Introduction The objective of this study was to evaluate the efficacy of ultrasound-accelerated catheter-directed thrombolytic therapy in patients with submassive pulmonary embolism. Methods Clinical records of 46 patients with submassive pulmonary embolism who underwent ultrasound-accelerated catheter-directed pulmonary thrombolysis using tissue plasminogen activator, from 2007 to 2017, were analyzed. All patients experienced clinical symptoms with computed tomography evidence of pulmonary thrombus burden. Right ventricular dysfunction was present in all patients by echocardiographic finding of right ventricle-to-left ventricle ratio > 0.9. Treatment outcome, procedural complications, right ventricular pressures, and thrombus clearance were evaluated. Follow-up evaluation included echocardiographic assessment of right ventricle-to-left ventricle ratio at one month, six months, and one year. Results Technical success was achieved in all patients ( n = 46, 100%). Our patients received an average of 18.4 ± 4.7 mg of tissue plasminogen activator using ultrasound-accelerated thrombolytic catheter with an average infusion time of 16.5± 5.4 h. Clinical success was achieved in all patients (100%). Significant reduction of mean pulmonary artery pressure occurred following the treatment, which decreased from 36 ± 8 to 21 ± 5 mmHg ( p right ventricular dysfunction based on echocardiographic assessment. The right ventricle-to-left ventricle ratio decreased from 1.32 ± 0.18 to 0.91 ± 0.13 at the time of hospital discharge ( p right ventricular function remained improved at 6 months and 12 months of follow-up, as right ventricle-to-left ventricle ratio were 0.92 ± 0.14 ( p right ventricular function in patients with submassive pulmonary embolism.

Relaxation and filling of the left ventricle assessed by Doppler echocardiography

International Nuclear Information System (INIS)

Myreng, Y.

1990-01-01

In patients with coronary disease the Doppler method described in the present work was capable of detecting a delayed left ventricular (LV) relaxation and a shift of LV filling from early towards late diastole. This might reflect changes in LV diastolic function due to myocardial ischemia. Furthermore, the method allowed monitoring of changes during treatment with atenolol and verapamil. These changes indicated that atenolol and verapamil were able to partially correct the relaxation abnormailty and increase the relative contribution of early diastolic filling. Although all the numerous variables that influence LV transmitral filling could be controlled in this noninvasive clinical study, the results suggest that antianginal drugs may have beneficial effect on diastolic function in coronary disease. 62 refs., 3 figs., 4 tabs

Fate of tumor cells injected into left ventricle of heart in BALB/c mice: role of natural killer cells

DEFF Research Database (Denmark)

Basse, P; Hokland, P; Heron, I

1988-01-01

The arrest, retention, and elimination (i.e., clearance) of radiolabeled YAC-1 lymphoma cells injected either iv or into the left ventricle (LV) of the heart were studied in male BALB/c mice, with special emphasis on the role of natural killer (NK) cells. After iv injection YAC-1 cells were...... extent, the bone, skin, and muscle. The only organs that could arrest the LV-injected tumor cells were the lungs and the liver. In the lungs clearance of YAC-1 cells began immediately after the cells were arrested. However, the rate of clearance could be almost abrogated by pretreatment of the recipients...... with anti-asialo GM1 antiserum, which destroys most of the NK cells in vivo and strongly depresses the in vitro NK cell activity. In contrast, YAC-1 cells arrested in the liver were not cleared from this organ during the first 1-2 hours after arrest. After this delay clearance of the cells commenced...

Assessment of left ventricular function and volumes by myocardial perfusion scintigraphy - comparison of two algorithms

International Nuclear Information System (INIS)

Zajic, T.; Fischer, R.; Brink, I.; Moser, E.; Krause, T.; Saurbier, B.

2001-01-01

Aim: Left ventricular volume and function can be computed from gated SPECT myocardial perfusion imaging using emory cardiac toolbox (ECT) or gated SPECT quantification (GS-Quant). The aim of this study was to compare both programs with respect to their practical application, stability and precision on heart-models as well as in clinical use. Methods: The volumes of five cardiac models were calculated by ECT and GS-Quant. 48 patients (13 female, 35 male) underwent a one day stress-rest protocol and gated SPECT. From these 96 gated SPECT images, left ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume (ESV) were estimated by ECT and GS-Quant. For 42 patients LVEF was also determined by echocardiography. Results: For the cardiac models the computed volumes showed high correlation with the model-volumes as well as high correlation between ECT and GS-Quant (r ≥0.99). Both programs underestimated the volume by approximately 20-30% independent of the ventricle-size. Calculating LVEF, EDV and ESV, GS-Quant and ECT correlated well to each other and to the LVEF estimated by echocardiography (r ≥0.86). LVEF values determined with ECT were about 10% higher than values determined with GS-Quant or echocardiography. The incorrect surfaces calculated by the automatic algorithm of GS-Quant for three examinations could not be corrected manually. 34 of the ECT studies were optimized by the operator. Conclusion: GS-Quant and ECT are two reliable programs in estimating LVEF. Both seem to underestimate the cardiac volume. In practical application GS-Quant was faster and easier to use. ECT allows the user to define the contour of the ventricle and thus is less susceptible to artifacts. (orig.) [de

Detection and evaluation of left atrial myxoma by gated radionuclide imaging

International Nuclear Information System (INIS)

Sugihara, Hiroki; Adachi, Haruhiko; Nakagawa, Hiroaki

1985-01-01

Radionuclide imaging plays an important role in diagnosising left atrial myxoma (LAM). We discussed diagnostic value of Fourier analysis with phase image and evaluated left ventricular filling function using indices such as 1/3 Filling Fraction, Rapid Filling Fraction and Peak Filling Rate derived from left ventricular volume curve. Equillibrium radionuclide angiocardiography was performed in 6 LAM patients. Phase delay in the basal portion of the left ventricle was shown in 5 of 6 LAM patients, and standard deviation of left ventricular phase was larger than these of controls. Left ventricular filling disturbance was suggested in 5 of 6 LAM patients. After surgical remove of myxoma phase delay was disappeared and standard deviation was normalized. And left ventricular filling was improved. We concluded that the phase image of Fourier analysis revealed a left atrial mass prolapsing in the left ventricule during the diastole, and that diastolic indices were useful for left ventricular filling disturbance due to LAM. (author)

The effect of exercise training on left ventricular function in young elite athletes

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De Luca Alessio

2011-10-01

Full Text Available Abstract Background Regular training, in particular endurance exercise, induces structural myocardial adaptation, so-called "athlete's heart". In addition to the 2D standard echo parameters, assessment of myocardial function is currently possible by deformation parameters (strain, rotation and twist. Aim of study is to assess the role of rotation and twist parameters for better characterize the heart performance in trained elite young athletes from different kind of sports. Eventually, verify early on any possible impact due to the regular sport activity not revealed by the standard parameters. Methods 50 young athletes (16 cyclists, 17 soccer players, 17 basket players regularly trained at least three times a week for at least 9 months a year and 10 young controls (mean age 18.5 ± 0.5 years were evaluated either by to 2D echocardiography or by a Speckle Tracking (ST multi-layer approach to calculate Left Ventricle (LV endocardial and epicardial rotation, twist, circumferential strain (CS and longitudinal strain (LS. Data were compared by ANOVA test. Results All the found values were within the normal range. Left Ventricle Diastolic Diameter (LVDD 51.7 ± 2.6 mm, Cardiac Mass index (CMi 114.5 ± 18.5 g/m2, epi-CS, epi-LS, epicardial apex rotation and the Endo/Epi twist were significantly higher only in cyclists. In all the groups, a physiological difference of the Endo/Epi basal circumferential strain and twist values have been found. A weak but not significant relationship between the Endo and twist values and LVDD (r2 = 0.44, p = .005 and CMi was also reported in cyclists. Conclusions Progressive increase of apical LV twist may represent an important component of myocardial remodelling. This aspect is particularly evident in the young cyclists group where the CMi and the LVDD are higher. ST multilayer approach completes the LV performance evaluation in young trained athletes showing values similar to adults.

The influence of anatomic variance in the coronary artery on cardiac function with PCI after acute inferior wall myocardial infarction

International Nuclear Information System (INIS)

Zheng Hongming; Feng Jue; Fang Fengning; Wu Heping; Wang Fengqin; Ma Huili

2006-01-01

Objective: To analyze the influence in anatomic variance of coronary artery on function of left and right ventricles after acute inferior myocardial infarction (AIMI) treated with percutaneous coronary intervention therapy (PCI). Methods: Forty-seven inferior AIMI patients were divided into 2 groups: 12 left dominant group [including equipollent case, i.e. inferior wall of left ventricle supplied by left circumflex coronary artery (LCX), right ventricle by right coronary artery (RCA)] and 35 right dominant group (both inferior wall and right ventricle were supplied by RCA). Equilibrium radionuclide angiocardiography (ERNA) and myocardial perfusion imaging (MPI) were used for comparing the influence between different coronary artery flow patterns on biventricular hemodynamics, blood supply and prognosis of PCI after 3 months. Results: Comparison of ventricular function in left and right dominant coronal artery type groups discharged 7- 10 d after PCI, there were differences in left ventricular ejection fraction (LVEF) [(63.03 ± 5.64)% vs (57.67 ± 7.35)%, P=0.012], peak ejection rate (PER) [(3.52 ± 0.66) end-diastolic volume (EDV)/s vs (2.93 ± 0.73) EDV/s, P =0.011], peak filling rate (PFR) [(2.71 ± 0.88) EDV/s vs (2.11 ± 0.45 ) EDV/s, P=0.004], left free-wall regional ejection fraction [(81.94 ± 20.75)% vs (67.25 ± 16.54)%, P = O.032], and right free-wall regional ejection fraction [(57.86 ± 11.77)% vs (67.83 ± 10.38)%, P=0.012], right ventricular ejection fraction (RVEF) [(37.89 ± 3.86)% vs (41.67 ± 4.81)%, P=0.09]. After 3 months,there was difference only in RVEF [(44.60 ± 5.29)% vs (48.00 ± 3.30)%, P=0.043], but no difference in myocardial perfusion of left ventricle (P=0.357). Conclusions: In acute stage of AIMI right dominant group, there was more severe injury of right ventricle, in convalescent stage most of the right ventricular function resumed. The sustained right ventricular function in part of the patients can be demonstrated by ERNA

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

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

2007-02-15

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

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

International Nuclear Information System (INIS)

Lee, Mu Sook; Choi, Byoung Wook; Choe, Kyu Ok; Chung, Namsik

2007-01-01

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

Atrioventricular valve repair in patients with functional single-ventricle physiology: impact of ventricular and valve function and morphology on survival and reintervention.

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Honjo, Osami; Atlin, Cori R; Mertens, Luc; Al-Radi, Osman O; Redington, Andrew N; Caldarone, Christopher A; Van Arsdell, Glen S

2011-08-01

This study was to determine whether atrioventricular valve repair modifies natural history of single-ventricle patients with atrioventricular valve insufficiency and to identify factors predicting survival and reintervention. Fifty-seven (13.5%) of 422 single-ventricle patients underwent atrioventricular valve repair. Valve morphology, regurgitation mechanism, and ventricular morphology and function were analyzed for effect on survival, transplant, and reintervention with multivariate logistic and Cox regression models. Comparative analysis used case-matched controls. Atrioventricular valve was tricuspid in 67% and common in 28%. Ventricular morphology was right in 83%. Regurgitation mechanisms were prolapse (n = 24, 46%), dysplasia (n = 18, 35%), annular dilatation (n = 8, 15%), and restriction or cleft (n = 2, 4%). Postrepair insufficiency was none or trivial in 14 (26%), mild in 33 (61%), and moderate in 7 (13%). Survival in repair group was lower than in matched controls (78.9% vs 92.7% at 1 year, 68.7% vs 90.6% at 3 years, P = .015). Patients with successful repair and normal ventricular function had equivalent survival to matched controls (P = .36). Independent predictors for death or transplant included increased indexed annular size (P = .05), increased cardiopulmonary bypass time (P = .04), and decreased postrepair ventricular function (P = .01). Ventricular dilation was a time-related factor for all events, including failed repair. Survival was lower in single-ventricle patients operated on for atrioventricular valve insufficiency than in case-matched controls. Patients with little postoperative residual regurgitation and preserved ventricular function had equivalent survival to controls. Lower grade ventricular function and ventricular dilation correlated with death and repair failure, suggesting that timing of intervention may affect outcome. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All

Pulmonary arterial hypertension reduces energy efficiency of right, but not left, rat ventricular trabeculae.

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Pham, Toan; Nisbet, Linley; Taberner, Andrew; Loiselle, Denis; Han, June-Chiew

2018-04-01

Pulmonary arterial hypertension (PAH) triggers right ventricle (RV) hypertrophy and left ventricle (LV) atrophy, which progressively leads to heart failure. We designed experiments under conditions mimicking those encountered by the heart in vivo that allowed us to investigate whether consequent structural and functional remodelling of the ventricles affects their respective energy efficiencies. We found that peak work output was lower in RV trabeculae from PAH rats due to reduced extent and velocity of shortening. However, their suprabasal enthalpy was unaffected due to increased activation heat, resulting in reduced suprabasal efficiency. There was no effect of PAH on LV suprabasal efficiency. We conclude that the mechanism underlying the reduced energy efficiency of hypertrophied RV tissues is attributable to the increased energy cost of Ca 2+ cycling, whereas atrophied LV tissues still maintain normal mechano-energetic performance. Pulmonary arterial hypertension (PAH) greatly increases the afterload on the right ventricle (RV), triggering RV hypertrophy, which progressively leads to RV failure. In contrast, the disease reduces the passive filling pressure of the left ventricle (LV), resulting in LV atrophy. We investigated whether these distinct structural and functional consequences to the ventricles affect their respective energy efficiencies. We studied trabeculae isolated from both ventricles of Wistar rats with monocrotaline-induced PAH and their respective Control groups. Trabeculae were mounted in a calorimeter at 37°C. While contracting at 5 Hz, they were subjected to stress-length work-loops over a wide range of afterloads. They were subsequently required to undergo a series of isometric contractions at various muscle lengths. In both protocols, stress production, length change and suprabasal heat output were simultaneously measured. We found that RV trabeculae from PAH rats generated higher activation heat, but developed normal active stress. Their

Dynamic change in size of the lateral ventricle evaluated by cine MRI

International Nuclear Information System (INIS)

Abe, Toshi

1990-01-01

CSF pulsation suggests variation in the size of the cerebral ventricle during the cardiac cycle. CINE MRI, which is a useful technique for observation of the pulsatile CSF flow, demonstrates a dynamic change in size of the lateral ventricle. CINE MRI was performed on a 0.5 tesla MR imaging system (SMT-50, SHIMADZU). Sixteen different phased images during cardiac cycle were made by a gradient acho technique (STAGE: Short Tip Angle Gradient Echo, TE=14 msec, Flip Angle=30deg). From the measurement of the lateral ventricular areas of two different phases of CINE MRI during cadiac cycle, variation rate of cerebral ventricular area (VRCVA) was calculated. Twenty-five normal volunteers (14 younger adults aged 27-44 years, 11 older adults aged 56-73 years) and six cases of marked diffuse cerebral atrophy were studied. The results included: The mean VRCVA of younger adults was 14.4% (at right body of lateral ventricle) ∼ 30.0% (at left anterior horn of lateral ventricle). The mean VRCVA of younger adults is higher than the mean VRCVA of older adults. In the cases of marked diffuse cerebral atrophy, the mean VRCVA was very lower than the mean VRCVA of older adults. VRCVA of lateral ventricle calculated from CINE MRI seemed to have a good relationship to the brain elasticity. This noninvasive method would be used as an indication of the elastic response of the ventricles and the surrounding brain. (J.P.N.)

Left ventricular dysfunction in repaired tetralogy of Fallot: incidence and impact on atrial arrhythmias at long term-follow up.

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Ait Ali, Lamia; Trocchio, GianLuca; Crepaz, Roberto; Stuefer, Josef; Stagnaro, Nicola; Siciliano, Valeria; Molinaro, Sabrina; Sicari, Rosa; Festa, Pierluigi

2016-09-01

Left ventricle (LV) systolic dysfunction in repaired tetralogy of Fallot (TOF) has been identified as a risk factor for functional status and adverse outcome. The aims of this cross-sectional followed by a prospective study were: (1) to evaluate the prevalence of LV systolic dysfunction in a large cohort of adults with repaired tetralogy of Fallot, (2) to test the relationship between LV systolic dysfunction and other known risk factors and (3) to evaluate the impact of LV systolic dysfunction on adverse cardiac events. In a multicenter study, 237 adults repaired TOF (58 % males, age 30 ± 10 years) were evaluated by cardiac magnetic resonance (CMR). Demographics, surgical history, ECG, Echo-Color Doppler and follow-up data were recorded. LV was dilated (Z value >2) in 16 patients (6 %), however 56 patients (23.6 %) had a reduced LV systolic function left ventricle ejection fraction (LVEF) (Z value <-2). Patients with LV systolic dysfunction were mainly males (82 %), had reduced right ventricle ejection fraction (RVEF), and higher right and left Late Gadolinium Enhanced scores. In a multivariate regression analysis male gender and RVEF resulted to be independent factors associated to LV systolic dysfunction. Atrial arrhythmias were the main adverse cardiac event at the follow-up and were associated to higher biventricular volumes and lower biventricular ejection fraction (EF); however multivariable analysis identified age, right ventricle end-diastolic volume (RVEDVi) and tricuspid regurgitation as independents factors associated to atrial arrhythmias. At long term follow-up at least ¼ of repaired TOF has LV dysfunction. Lower LVEF is associated to male gender and lower RVEF.

Single Ventricle Defects

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... and right ventricle are more normal in size, open-heart surgery may help the heart work better. If ... and right ventricle are more normal in size, open-heart surgery may help the heart work better. If ...

Flow dynamics and energy efficiency of flow in the left ventricle during myocardial infarction.

Science.gov (United States)

Vasudevan, Vivek; Low, Adriel Jia Jun; Annamalai, Sarayu Parimal; Sampath, Smita; Poh, Kian Keong; Totman, Teresa; Mazlan, Muhammad; Croft, Grace; Richards, A Mark; de Kleijn, Dominique P V; Chin, Chih-Liang; Yap, Choon Hwai

2017-10-01

Cardiovascular disease is a leading cause of death worldwide, where myocardial infarction (MI) is a major category. After infarction, the heart has difficulty providing sufficient energy for circulation, and thus, understanding the heart's energy efficiency is important. We induced MI in a porcine animal model via circumflex ligation and acquired multiple-slice cine magnetic resonance (MR) images in a longitudinal manner-before infarction, and 1 week (acute) and 4 weeks (chronic) after infarction. Computational fluid dynamic simulations were performed based on MR images to obtain detailed fluid dynamics and energy dynamics of the left ventricles. Results showed that energy efficiency flow through the heart decreased at the acute time point. Since the heart was observed to experience changes in heart rate, stroke volume and chamber size over the two post-infarction time points, simulations were performed to test the effect of each of the three parameters. Increasing heart rate and stroke volume were found to significantly decrease flow energy efficiency, but the effect of chamber size was inconsistent. Strong complex interplay was observed between the three parameters, necessitating the use of non-dimensional parameterization to characterize flow energy efficiency. The ratio of Reynolds to Strouhal number, which is a form of Womersley number, was found to be the most effective non-dimensional parameter to represent energy efficiency of flow in the heart. We believe that this non-dimensional number can be computed for clinical cases via ultrasound and hypothesize that it can serve as a biomarker for clinical evaluations.

Norwood with right ventricle-to-pulmonary artery conduit is more effective than Norwood with Blalock-Taussig shunt for hypoplastic left heart syndrome: mathematic modeling of hemodynamics.

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Mroczek, Tomasz; Małota, Zbigniew; Wójcik, Elżbieta; Nawrat, Zbigniew; Skalski, Janusz

2011-12-01

The introduction of right ventricle to pulmonary artery (RV-PA) conduit in the Norwood procedure for hypoplastic left heart syndrome resulted in a higher survival rate in many centers. A higher diastolic aortic pressure and a higher mean coronary perfusion pressure were suggested as the hemodynamic advantage of this source of pulmonary blood flow. The main objective of this study was the comparison of two models of Norwood physiology with different types of pulmonary blood flow sources and their hemodynamics. Based on anatomic details obtained from echocardiographic assessment and angiographic studies, two three-dimensional computer models of post-Norwood physiology were developed. The finite-element method was applied for computational hemodynamic simulations. Norwood physiology with RV-PA 5-mm conduit and Blalock-Taussig shunt (BTS) 3.5-mm shunt were compared. Right ventricle work, wall stress, flow velocity, shear rate stress, energy loss and turbulence eddy dissipation were analyzed in both models. The total work of the right ventricle after Norwood procedure with the 5-mm RV-PA conduit was lower in comparison to the 3.5-mm BTS while establishing an identical systemic blood flow. The Qp/Qs ratio was higher in the BTS group. Hemodynamic performance after Norwood with the RV-PA conduit is more effective than after Norwood with BTS. Computer simulations of complicated hemodynamics after the Norwood procedure could be helpful in establishing optimal post-Norwood physiology. Copyright © 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Fibrosis-Related Gene Expression in Single Ventricle Heart Disease.

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Nakano, Stephanie J; Siomos, Austine K; Garcia, Anastacia M; Nguyen, Hieu; SooHoo, Megan; Galambos, Csaba; Nunley, Karin; Stauffer, Brian L; Sucharov, Carmen C; Miyamoto, Shelley D

2017-12-01

To evaluate fibrosis and fibrosis-related gene expression in the myocardium of pediatric subjects with single ventricle with right ventricular failure. Real-time quantitative polymerase chain reaction was performed on explanted right ventricular myocardium of pediatric subjects with single ventricle disease and controls with nonfailing heart disease. Subjects were divided into 3 groups: single ventricle failing (right ventricular failure before or after stage I palliation), single ventricle nonfailing (infants listed for primary transplantation with normal right ventricular function), and stage III (Fontan or right ventricular failure after stage III). To evaluate subjects of similar age and right ventricular volume loading, single ventricle disease with failure was compared with single ventricle without failure and stage III was compared with nonfailing right ventricular disease. Histologic fibrosis was assessed in all hearts. Mann-Whitney tests were performed to identify differences in gene expression. Collagen (Col1α, Col3) expression is decreased in single ventricle congenital heart disease with failure compared with nonfailing single ventricle congenital heart disease (P = .019 and P = .035, respectively), and is equivalent in stage III compared with nonfailing right ventricular heart disease. Tissue inhibitors of metalloproteinase (TIMP-1, TIMP-3, and TIMP-4) are downregulated in stage III compared with nonfailing right ventricular heart disease (P = .0047, P = .013 and P = .013, respectively). Matrix metalloproteinases (MMP-2, MMP-9) are similar between nonfailing single ventricular heart disease and failing single ventricular heart disease, and between stage III heart disease and nonfailing right ventricular heart disease. There is no difference in the prevalence of right ventricular fibrosis by histology in subjects with single ventricular failure heart disease with right ventricular failure (18%) compared with those with normal right

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

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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. © The Author(s) 2016.

Androgenic anabolic steroids also impair right ventricular function.

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Kasikcioglu, Erdem; Oflaz, Huseyin; Umman, Berrin; Bugra, Zehra

2009-05-01

Chronic anabolic steroid use suppresses left ventricular functions. However, there is no information regarding the chronic effects of anabolic steroids on right ventricular function which also plays a key role in global cardiac function. The main objective of the present study was to investigate the effects of androgenic anabolic steroids usage among athletes on remodeling the right part of the heart. Androgenic-anabolic steroids-using bodybuilders had smaller diastolic velocities of both ventricles than drug-free bodybuilders and sedentary counterparts. This study shows that androgenic anabolic steroids-using bodybuilders exhibited depressed diastolic functions of both ventricles.

One-stage surgery for removal of intravascular leiomyomatosis extending to right ventricle.

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Chiang, Ching-Shu; Chen, Po-Lin; Kuo, Tzu-Ting; Chen, I-Ming; Wu, Nai-Yuan; Chang, Hsiao-Huang

2018-03-01

Intravascular leiomyomatosis (IVL) is a rare nonmalignant tumor that can be fatal if untreated. A 49-year-old nulliparous Asian woman who underwent hysterectomy and left salpingo-oophorectomy for multiple uterine leiomyomas 18 months prior presented complaining of intermittent palpitation and chest tightness for approximately 1 month. Echocardiography revealed a large mobile tumor mass extending from the inferior vena cava (IVC) to the right atrium that partially obstructed IVC flow and tricuspid inflow. Thoracicabdominopelvic computed tomography revealed a left adnexal tumor (4.8 × 2.5 cm) causing intravascular obstruction extending from the left internal iliac vein to the IVC, right atrium, and right ventricle. IVL with right heart involvement INTERVENTIONS:: Under cardiopulmonary bypass, a one-stage surgery combining sternotomy and laparotomy was performed. The tumor was approached and extracted via sternotomy, and tumor detachment and removal of residual tumors was accomplished via laparotomy. A firm, smooth, and regularly shape tumor 15.5 × 5.5 × 2.5 in size was completely removed and histopathologically confirmed as IVL. The patient tolerated the surgical procedure well and no postoperative complication was noted. We describe a one-stage surgical approach to completely remove an IVL extending to the right ventricle.

Increased cardiac alpha-myosin heavy chain in left atria and decreased myocardial insulin-like growth factor (Igf-I) expression accompany low heart rate in hibernating grizzly bears.

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Barrows, N D; Nelson, O L; Robbins, C T; Rourke, B C

2011-01-01

Grizzly bears (Ursus arctos horribilis) tolerate extended periods of extremely low heart rate during hibernation without developing congestive heart failure or cardiac chamber dilation. Left ventricular atrophy and decreased left ventricular compliance have been reported in this species during hibernation. We evaluated the myocardial response to significantly reduced heart rate during hibernation by measuring relative myosin heavy-chain (MyHC) isoform expression and expression of a set of genes important to muscle plasticity and mass regulation in the left atria and left ventricles of active and hibernating bears. We supplemented these data with measurements of systolic and diastolic function via echocardiography in unanesthetized grizzly bears. Atrial strain imaging revealed decreased atrial contractility, decreased expansion/reservoir function (increased atrial stiffness), and decreased passive-filling function (increased ventricular stiffness) in hibernating bears. Relative MyHC-α protein expression increased significantly in the atrium during hibernation. The left ventricle expressed 100% MyHC-β protein in both groups. Insulin-like growth factor (IGF-I) mRNA expression was reduced by ∼50% in both chambers during hibernation, consistent with the ventricular atrophy observed in these bears. Interestingly, mRNA expression of the atrophy-related ubiquitin ligases Muscle Atrophy F-box (MAFBx) and Muscle Ring Finger 1 did not increase, nor did expression of myostatin or hypoxia-inducible factor 1α (HIF-1α). We report atrium-specific decreases of 40% and 50%, respectively, in MAFBx and creatine kinase mRNA expression during hibernation. Decreased creatine kinase expression is consistent with lowered energy requirements and could relate to reduced atrial emptying function during hibernation. Taken together with our hemodynamic assessment, these data suggest a potential downregulation of atrial chamber function during hibernation to prevent fatigue and dilation

Hemangioma of the left coronary artery: Diagnosis and treatment

International Nuclear Information System (INIS)

Just, A.; Wiesmann, W.; Peters, P.E.; Haesfeld, M.; Sciuk, J.

1992-01-01

The authors describe the case of a histologically proven hemangioma in the left coronary artery of the left ventricle of a 24-year-old woman. The results of the different medical imaging methods applied are described and the treatment of cardiac angiomas is discussed. (orig.) [de

Indentation in the Right Ventricle by an Incomplete Pericardium on 3-Dimensional Reconstructed Computed Tomography

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Hak Ju Kim

2017-08-01

Full Text Available We report the case of a 17-year-old girl who presented with an indentation in the right ventricle caused by an incomplete pericardium on preoperative 3-dimensional reconstructed computed tomography. She was to undergo surgery for a partial atrioventricular septal defect and secundum atrial septal defect. Preoperative electrocardiography revealed occasional premature ventricular beats. We found the absence of the left side of the pericardium intraoperatively, and this absence caused strangulation of the diaphragmatic surface of the right ventricle. After correcting the lesion, the patient’s rhythm disturbances improved.

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 dilatation...... [high left ventricular end-diastolic volume (EDV) index and concentricity (LVM/EDV)] in hypertensive patients....

Effect of right ventricular pacing lead site on left ventricular function in patients with high-grade atrioventricular block: results of the Protect-Pace study.

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Kaye, Gerald C; Linker, Nicholas J; Marwick, Thomas H; Pollock, Lucy; Graham, Laura; Pouliot, Erika; Poloniecki, Jan; Gammage, Michael

2015-04-07

Chronic right ventricle (RV) apical (RVA) pacing is standard treatment for an atrioventricular (AV) block but may be deleterious to left ventricle (LV) systolic function. Previous clinical studies of non-apical pacing have produced conflicting results. The aim of this randomized, prospective, international, multicentre trial was to compare change in LV ejection fraction (LVEF) between right ventricular apical and high septal (RVHS) pacing over a 2-year study period. We randomized 240 patients (age 74 ± 11 years, 67% male) with a high-grade AV block requiring >90% ventricular pacing and preserved baseline LVEF >50%, to receive pacing at the RVA (n = 120) or RVHS (n = 120). At 2 years, LVEF decreased in both the RVA (57 ± 9 to 55 ± 9%, P = 0.047) and the RVHS groups (56 ± 10 to 54 ± 10%, P = 0.0003). However, there was no significant difference in intra-patient change in LVEF between confirmed RVA (n = 85) and RVHS (n = 83) lead position (P = 0.43). There were no significant differences in heart failure hospitalization, mortality, the burden of atrial fibrillation, or plasma brain natriutetic peptide levels between the two groups. A significantly greater time was required to place the lead in the RVHS position (70 ± 25 vs. 56 ± 24 min, P function requiring a high percentage of ventricular pacing, RVHS pacing does not provide a protective effect on left ventricular function over RVA pacing in the first 2 years. ClinicalTrials.gov number NCT00461734. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

First third filling parameters of left ventricle assessed from gated equilibrium studies in patients with various heart diseases

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Adatepe, M.H.; Nichols, K.; Powell, O.M.; Isaacs, G.H.

1984-01-01

The authors determined the first third filling fraction (1/3 FF), the maximum filling rate (1/3 FR) and the mean filling rate (1/3 MFR) for the first third diastolic filling period of the left ventricle in patients with coronary artery disease (CAD), valvular heart disease (VHD), pericardial effusion (PE), cardiomyopathies (CM), chronic obstructive lung disease (COPD) and in 5 normals-all from resting gated equilibrium studies. Parameters are calculated from the third order Fourier fit to the LV volume curve and its derivative. 1/3 FF% = 1/3 diastolic count - end systolic count / 1/3 diastolic count x 100. Patients with CAD are divided into two groups: Group I with normal ejection fraction (EF) and wall motion (WM); Group II with abnormal EF and WM. Results are shown in the table. Abnormal filling parameters are found not only in CAD but in VHD, PE and CM. The authors conclude that the first third LV filling parameters are sensitive but non-specific indicators of filling abnormalities caused by diverse etiologic factors. Abnormal first third filling parameters may occur in the presence of a normal resting EF and WM in CAD.

Prediction of cardiac events in patients with transient left ventricle dilation on stress myocardial perfusion SPECT images

International Nuclear Information System (INIS)

Fukuda, Hiroshi; Moroi, Masao

2005-01-01

The purpose of this study was to investigate cardiac events in patients with transient left ventricle (LV) dilation on stress myocardial perfusion single-photon emission computed tomography images (MPI). Consecutive patients (n=53, 31 males, mean age 71 years) with transient LV dilation on thallium-201 stress MPI (treadmill: 21, pharmacologic: 32) were followed for 17 months. Follow-up time was censored at the occurrence of cardiac death, congestive heart failure, acute coronary syndrome, or revascularization. Images were scored and then the summed stress score (SSS), summed rest score, and summed difference score were calculated. Cardiac death occurred in 3 patients, hospitalization occurred in 8 patients, and revascularization occurred in 20 patients. The combined cardiac event rate was 59% (76% for exercise stress vs 47% for pharmacologic stress, p=0.034.). Cox regression analysis demonstrated that a combination of higher SSS and slow washout rate was the best predictor of cardiac events (hazard ratio=3.3, p=0.029). A high cardiac event rate is associated with transient LV dilation on thallium-201 stress MPI. The event rate is particularly high for exercise stress MPI. Furthermore, a combination of the SSS and thallium-201 slow washout is the best predictor of cardiac events in patients with transient LV dilation. (author)

Wave Intensity Analysis of Right Ventricular Function during Pulsed Operation of Rotary Left Ventricular Assist Devices.

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Bouwmeester, J Christopher; Park, Jiheum; Valdovinos, John; Bonde, Pramod

2018-05-29

Changing the speed of left ventricular assist devices (LVADs) cyclically may be useful to restore aortic pulsatility; however, the effects of this pulsation on right ventricular (RV) function are unknown. This study investigates the effects of direct ventricular interaction by quantifying the amount of wave energy created by RV contraction when axial and centrifugal LVADs are used to assist the left ventricle. In 4 anesthetized pigs, pressure and flow were measured in the main pulmonary artery and wave intensity analysis was used to identify and quantify the energy of waves created by the RV. The axial pump depressed the intensity of waves created by RV contraction compared with the centrifugal pump. In both pump designs, there were only minor and variable differences between the continuous and pulsed operation on RV function. The axial pump causes the RV to contract with less energy compared with a centrifugal design. Diminishing the ability of the RV to produce less energy translates to less pressure and flow produced, which may lead to LVAD-induced RV failure. The effects of pulsed LVAD operation on the RV appear to be minimal during acute observation of healthy hearts. Further study is necessary to uncover the effects of other modes of speed modulation with healthy and unhealthy hearts to determine if pulsed operation will benefit patients by reducing LVAD complications.

Diastolic compliance and exercise-induced left ventricular diastolic volume changes in patients with coronary artery disease

International Nuclear Information System (INIS)

Choi, W.; Varma, V.; Wasserman, A.; Katz, R.; Reba, R.; Ross, A.

1983-01-01

This study consists of 46 consecutive patients who had supine resting and exercise multigated (MUGA) blood pool studies. All patients had angio-graphically important coronary stenosis in at least one major vessel. Thirty-five out of 46 patients with coronary artery disease increased left ventricular end diastolic volume with a supine exercise. The remaining eleven patients dit not dilate the left ventricle. Those patients, who were able to increase their end diastolic volume during exercise, had better compliance of the left ventricle manifested by lower end diastolic pressures, whereas, patients with poor left ventricular compliance were unable to volume expand during supine exercise

Performance of two-dimensional Doppler echocardiography for the assessment of infarct size and left ventricular function in rats

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Nozawa E.

2006-01-01

Full Text Available Although echocardiography has been used in rats, few studies have determined its efficacy for estimating myocardial infarct size. Our objective was to estimate the myocardial infarct size, and to evaluate anatomic and functional variables of the left ventricle. Myocardial infarction was produced in 43 female Wistar rats by ligature of the left coronary artery. Echocardiography was performed 5 weeks later to measure left ventricular diameter and transverse area (mean of 3 transverse planes, infarct size (percentage of the arc with infarct on 3 transverse planes, systolic function by the change in fractional area, and diastolic function by mitral inflow parameters. The histologic measurement of myocardial infarction size was similar to the echocardiographic method. Myocardial infarct size ranged from 4.8 to 66.6% when determined by histology and from 5 to 69.8% when determined by echocardiography, with good correlation (r = 0.88; P < 0.05; Pearson correlation coefficient. Left ventricular diameter and mean diastolic transverse area correlated with myocardial infarct size by histology (r = 0.57 and r = 0.78; P < 0.0005. The fractional area change ranged from 28.5 ± 5.6 (large-size myocardial infarction to 53.1 ± 1.5% (control and correlated with myocardial infarct size by echocardiography (r = -0.87; P < 0.00001 and histology (r = -0.78; P < 00001. The E/A wave ratio of mitral inflow velocity for animals with large-size myocardial infarction (5.6 ± 2.7 was significantly higher than for all others (control: 1.9 ± 0.1; small-size myocardial infarction: 1.9 ± 0.4; moderate-size myocardial infarction: 2.8 ± 2.3. There was good agreement between echocardiographic and histologic estimates of myocardial infarct size in rats.

Activation delay-induced mechanical dyssynchrony in single-ventricle heart disease

DEFF Research Database (Denmark)

Forsha, Daniel; Risum, Niels; Barker, Piers

2017-01-01

We present the case of an infant with a single functional ventricle who developed ventricular dysfunction and heart failure due to an electrical activation delay and dyssynchrony. Earlier recognition of this potentially reversible aetiology may have changed her poor outcome.......We present the case of an infant with a single functional ventricle who developed ventricular dysfunction and heart failure due to an electrical activation delay and dyssynchrony. Earlier recognition of this potentially reversible aetiology may have changed her poor outcome....

A D-Shaped Bileaflet Bioprosthesis which Replicates Physiological Left Ventricular Flow Patterns.

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Sean Guo-Dong Tan

Full Text Available Prior studies have shown that in a healthy heart, there exist a large asymmetric vortex structure that aids in establishing a steady flow field in the left ventricle. However, the implantation of existing artificial heart valves at the mitral position is found to have a negative effect on this physiological flow pattern. In light of this, a novel D-shaped bileaflet porcine bioprosthesis (GD valve has been designed based on the native geometry mitral valve, with the hypothesis that biomimicry in valve design can restore physiological left ventricle flow patterns after valve implantation. An in-vitro experiment using two dimensional particle velocimetry imaging was carried out to determine the hemodynamic performance of the new bileaflet design and then compared to that of the well-established St. Jude Epic valve which functioned as a control in the experiment. Although both valves were found to have similar Reynolds shear stress and Turbulent Kinetic Energy levels, the novel D-shape valve was found to have lower turbulence intensity and greater mean kinetic energy conservation.

A D-Shaped Bileaflet Bioprosthesis which Replicates Physiological Left Ventricular Flow Patterns

Science.gov (United States)

Tan, Sean Guo-Dong; Kim, Sangho; Hon, Jimmy Kim Fatt; Leo, Hwa Liang

2016-01-01

Prior studies have shown that in a healthy heart, there exist a large asymmetric vortex structure that aids in establishing a steady flow field in the left ventricle. However, the implantation of existing artificial heart valves at the mitral position is found to have a negative effect on this physiological flow pattern. In light of this, a novel D-shaped bileaflet porcine bioprosthesis (GD valve) has been designed based on the native geometry mitral valve, with the hypothesis that biomimicry in valve design can restore physiological left ventricle flow patterns after valve implantation. An in-vitro experiment using two dimensional particle velocimetry imaging was carried out to determine the hemodynamic performance of the new bileaflet design and then compared to that of the well-established St. Jude Epic valve which functioned as a control in the experiment. Although both valves were found to have similar Reynolds shear stress and Turbulent Kinetic Energy levels, the novel D-shape valve was found to have lower turbulence intensity and greater mean kinetic energy conservation. PMID:27258099

Significance of dipyridamole-induced transient dilation of the left ventricle during thallium-201 scintigraphy in suspected coronary artery disease

International Nuclear Information System (INIS)

Chouraqui, P.; Rodrigues, E.A.; Berman, D.S.; Maddahi, J.

1990-01-01

The occurrence and significance of transient dilation of the left ventricle during dipyridamole stress-redistribution thallium-201 scintigraphy was studied in 73 patients who underwent both dipyridamole thallium-201 study and coronary angiography. Transient dilation ratio was calculated from planar anterior images by dividing the computer-derived left ventricular area on the initial image by that of the 4-hour image. In 11 patients with normal coronary arteriograms or less than 50% coronary stenosis, the transient dilation ratio was 0.98 +/- 0.046. An abnormal transient dilation ratio was defined as greater than or equal to 1.12, representing greater than or equal to 3 standard deviations above the mean normal value. When the 15 patients with an abnormal ratio were compared with the 58 with a normal ratio, the former group had a significantly higher frequency of 3 critical (greater than or equal to 90%) coronary stenoses (33 vs 5%), higher prevalence of collaterals (67 vs 24%), more extensive myocardial reversible defects by planar (71 vs 10%) or by single-photon emission computed tomography (87.5 vs 35%) imaging and a higher incidence of dipyridamole-induced anginal chest pain (53 vs 22%). No significant difference between the 2 groups was noted with respect to age, gender, prior myocardial infarction, single or double critical coronary stenosis, dipyridamole-induced ischemic electrocardiographic response and increased lung uptake. An abnormal transient dilation ratio of greater than or equal to 1.12 was a specific marker of multivessel (87%) or 3-vessel (85%) critical coronary artery disease

Total anomalous systemic venous drainage in left heterotaxy syndrome.

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Khandenahally, Ravindranath S; Deora, Surender; Math, Ravi S

2013-04-01

Total anomalous systemic venous drainage is an extremely rare congenital heart defect. In this study we describe an 11-year-old girl who presented with a history of fatigue and central cyanosis that she had had since early childhood with unremarkable precordial examination results. Investigations revealed left heterotaxy with all systemic venous drainage to the left-sided atrium with non-compaction of the left ventricle.

Magnetic resonance findings in arrhythmogenic dysplasia of right ventricle

International Nuclear Information System (INIS)

Ramiro, E.; Villacastin, B. P.; Farre, J.

1999-01-01

To compare the magnetic resonance (MR) findings in patients with arrhythmogenic dysplasia of right ventricle (ADRV) with the images of right ventricle (RV) presenting normal morphology. Three groups of patients were studied by MR: a) a group of 20 healthy volunteers; b) 22 patients with ADRV diagnosed by other methods; and c) 11 patients presenting right ventricular tachycardia (VT) with no evidence of ADRV. When compared with the other two groups, the patients with ADRV were found to have an enlarged right atrium and RV, one wall of RV abnormally thin, changes in the myocardial signal and significant left ventricular involvement. MR is a noninvasive method that is useful in the assessment of RV dilation, ventricular wall thinning, deformities and sacculations and in the detection of changes in the myocardial MR signal produced by the replacement. It aids in the localization, characterization and quantification of morphological changes in RV. (Author) 36 refs

Gender-specific changes in laboratory indexes and structural parameters of the left ventricle myocardium in chronic heart failure on the background of diabetes mellitus type 2 and obesity

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P. P. Bidzilya

2015-12-01

Full Text Available Modern studies have shown that the prevalence of cardiovascular disease and chronic heart failure (CHF specifically, in patients with diabetes mellitus (DM is about 50%. Aim. To study gender-specific changes in laboratory indexes and structural myocardial parameters of left ventricle (LV in CHF on the background of diabetes mellitus (DM type 2. 111 patients with I–III functional class of disease with normal, overweight and abdominal obesity I–III degree were examined. Methods and results. Clinical and biochemical blood tests? glomerular filtration rate were used. Structural parameters of the myocardium were estimated with echocardiography. It is established that in CHF on the background of DM type 2 and obesity there is a tendency to develop anemia and renal dysfunction in women. Structural changes of the myocardium is more pronounced in men and presents the prevalence ofLV hypertrophy and dilatation of the heart cavities. Conclusion. This demonstrates different ways of negative impact of gender factor on the laboratory indexes and structural myocardial parameters in CHF on the background of DM type 2 and obesity.

Systemic Right Ventricle in Adults With Congenital Heart Disease: Anatomic and Phenotypic Spectrum and Current Approach to Management.

Science.gov (United States)

Brida, Margarita; Diller, Gerhard-Paul; Gatzoulis, Michael A

2018-01-30

The systemic right ventricle (SRV) is commonly encountered in congenital heart disease representing a distinctly different model in terms of its anatomic spectrum, adaptation, clinical phenotype, and variable, but overall guarded prognosis. The most common clinical scenarios where an SRV is encountered are complete transposition of the great arteries with previous atrial switch repair, congenitally corrected transposition of the great arteries, double inlet right ventricle mostly with previous Fontan palliation, and hypoplastic left heart syndrome palliated with the Norwood-Fontan protocol. The reasons for the guarded prognosis of the SRV in comparison with the systemic left ventricle are multifactorial, including distinct fibromuscular architecture, shape and function, coronary artery supply mismatch, intrinsic abnormalities of the tricuspid valve, intrinsic or acquired conduction abnormalities, and varied SRV adaptation to pressure or volume overload. Management of the SRV remains an ongoing challenge because SRV dysfunction has implications on short- and long-term outcomes for all patients irrespective of underlying cardiac morphology. SRV dysfunction can be subclinical, underscoring the need for tertiary follow-up and timely management of target hemodynamic lesions. Catheter interventions and surgery have an established role in selected patients. Cardiac resynchronization therapy is increasingly used, whereas pharmacological therapy is largely empirical. Mechanical assist device and heart transplantation remain options in end-stage heart failure when other management strategies have been exhausted. The present report focuses on the SRV with its pathological subtypes, pathophysiology, clinical features, current management strategies, and long-term sequelae. Although our article touches on issues applicable to neonates and children, its main focus is on adults with SRV. © 2018 American Heart Association, Inc.

Double-outlet right ventricle revisited.

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Ebadi, Ameneh; Spicer, Diane E; Backer, Carl L; Fricker, F Jay; Anderson, Robert H

2017-08-01

Double-outlet right ventricle is a form of ventriculoarterial connection. The definition formulated by the International Society for Nomenclature of Paediatric and Congenital Heart Disease is based on hearts with both arterial trunks supported in their greater part by a morphologically right ventricle. Bilateral infundibula and ventricular septal defects are highly debated criteria. This study examines the anatomic controversies surrounding double-outlet right ventricle. We show that hearts with double-outlet right ventricle can have atrioventricular-to-arterial valvular continuity. We emphasize the difference between the interventricular communication and the zone of deficient ventricular septation. The hearts examined were from the University of Florida in Gainesville; Johns Hopkins All Children's Hospital, St Petersburg, Fla; and Lurie Children's Hospital, Chicago, Ill. Each specimen had at least 75% of both arterial roots supported by the morphologically right ventricle, with a total of 100 hearts examined. The morphologic method was used to assess anatomic features, including arterial-atrioventricular valvular continuity, subarterial infundibular musculature, and the location of the hole between the ventricles. Most hearts had fibrous continuity between one of the arterial valves and an atrioventricular valve, with bilateral infundibula in 23%, and intact ventricular septum in 5%. Bilateral infundibula are not a defining feature of double-outlet right ventricle, representing only 23% of the specimens in our sample. The interventricular communication can have a posteroinferior muscular rim or extend to become perimembranous (58%). Double-outlet right ventricle can exist with an intact ventricular septum. Copyright © 2017 The American Association for Thoracic Surgery. All rights reserved.

The Relationship between Left Atrial Mechanical Function and Functional Capacity in Mitral Stenosis

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Mücahit Yetim

2013-11-01

Full Text Available Aim: In this study, left atrial functions of patients with rheumatic mitral stenosis and sinus rhythm, which was determined by transthorasic echocardiography, was compared with those of healhty subjects and the association of left atrial functions with functional capacity was investigated in subgroup analyses.   Material and methods: 32 patients with isolated rheumatic mitral stenosis (median age was 39.1±11  (group 1 and 20 patients in the control group ( median age was 37±8,2 (group 2 were enrolled to study. The average mitral valve area of patients was 1.1±0,3 cm2. When patients were divided according to New York Heart Association (NYHA classification ; 16 patients were NYHA 2 (Grup A and 16 patients were NYHA 3 (Grup B. There were not any asymptomatic patients and no patients were NYHA 4. Left atrium diameters, left atrium volume, left atrium fractional area change and left atrium ejection fractions  of patients in these groups were calculated.   Results: The demographic characteristics of patients is shown in table 1. Left atrium ejection fraction (LAEF and left atrium fractional area change (LAFAC that were determined echocardiographycally were significantly lower in patients with mitral stenosis (32 ± 5, 44 ± 3; p<0.001- 25 ± 11, 32 ± 6; p< 0.02.  When patients were divided according to New York Heart Association (NYHA classification ; 16 patients were NYHA 2 (Grup A and 16 patients were NYHA 3 (Grup B. There were not any asymptomatic patients and no patients were NYHA 4. The clinical and echocardiographic data of patients are shown in table 2. Despite of similar mitral valve area and average mitral gradient ,systolic pulmonary artery pressure was found to be higher in symptomatic group. But there was no difference between left atrial functions of the two groups.   Discussion: In this study we have shown that left atrial functions determined echocardiographically  can decline in patients with mitral stenosis but the

Left Ventricular Myocardial Function in Children With Pulmonary Hypertension: Relation to Right Ventricular Performance and Hemodynamics.

Science.gov (United States)

Burkett, Dale A; Slorach, Cameron; Patel, Sonali S; Redington, Andrew N; Ivy, D Dunbar; Mertens, Luc; Younoszai, Adel K; Friedberg, Mark K

2015-08-01

Through ventricular interdependence, pulmonary hypertension (PH) induces left ventricular (LV) dysfunction. We hypothesized that LV strain/strain rate, surrogate measures of myocardial contractility, are reduced in pediatric PH and relate to invasive hemodynamics, right ventricular strain, and functional measures of PH. At 2 institutions, echocardiography was prospectively performed in 54 pediatric PH patients during cardiac catheterization, and in 54 matched controls. Patients with PH had reduced LV global longitudinal strain (LS; -18.8 [-17.3 to -20.4]% versus -20.2 [-19.0 to -20.9]%; P=0.0046) predominantly because of reduced basal (-12.9 [-10.8 to -16.3]% versus -17.9 [-14.5 to -20.7]%; Pright ventricular free-wall LS (r=0.64; PBrain natriuretic peptide levels correlated moderately with septal LS (r=0.48; P=0.0038). PH functional class correlated moderately with LV free-wall LS (r=-0.48; P=0.0051). The septum, shared between ventricles and affected by septal shift, was the most affected LV region in PH. Pediatric PH patients demonstrate reduced LV strain/strain rate, predominantly within the septum, with relationships to invasive hemodynamics, right ventricular strain, and functional PH measures. © 2015 American Heart Association, Inc.

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

was superior to atenolol-based treatment for reducing new-onset AF and complications, especially stroke, associated with new-onset or pre-existing AF. Potential mechanisms of AF prevention by angiotensin receptor blockade supported by LIFE results include greater reduction in left atrial size and LV......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...... hypertrophy. Differential effects of antihypertensive treatment on the left atrium and left ventricle may help prevent AF and reduce risk of stroke associated with hypertensive heart disease Udgivelsesdato: 2008/12...

Integration of electro-anatomical and imaging data of the left ventricle: An evaluation framework.

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Soto-Iglesias, David; Butakoff, Constantine; Andreu, David; Fernández-Armenta, Juan; Berruezo, Antonio; Camara, Oscar

2016-08-01

Integration of electrical and structural information for scar characterization in the left ventricle (LV) is a crucial step to better guide radio-frequency ablation therapies, which are usually performed in complex ventricular tachycardia (VT) cases. This integration requires finding a common representation where to map the electrical information from the electro-anatomical map (EAM) surfaces and tissue viability information from delay-enhancement magnetic resonance images (DE-MRI). However, the development of a consistent integration method is still an open problem due to the lack of a proper evaluation framework to assess its accuracy. In this paper we present both: (i) an evaluation framework to assess the accuracy of EAM and imaging integration strategies with simulated EAM data and a set of global and local measures; and (ii) a new integration methodology based on a planar disk representation where the LV surface meshes are quasi-conformally mapped (QCM) by flattening, allowing for simultaneous visualization and joint analysis of the multi-modal data. The developed evaluation framework was applied to estimate the accuracy of the QCM-based integration strategy on a benchmark dataset of 128 synthetically generated ground-truth cases presenting different scar configurations and EAM characteristics. The obtained results demonstrate a significant reduction in global overlap errors (50-100%) with respect to state-of-the-art integration techniques, also better preserving the local topology of small structures such as conduction channels in scars. Data from seventeen VT patients were also used to study the feasibility of the QCM technique in a clinical setting, consistently outperforming the alternative integration techniques in the presence of sparse and noisy clinical data. The proposed evaluation framework has allowed a rigorous comparison of different EAM and imaging data integration strategies, providing useful information to better guide clinical practice in

Left Ventricular Myocardial Deformation Parameters Are Affected by Coronary Slow Flow Phenomenon: A Study of Speckle Tracking Echocardiography.

Science.gov (United States)

Gulel, Okan; Akcay, Murat; Soylu, Korhan; Aksan, Gokhan; Yuksel, Serkan; Zengin, Halit; Meric, Murat; Sahin, Mahmut

2016-05-01

The coronary slow flow phenomenon (CSFP) is defined as a delayed distal vessel contrast opacification in the absence of obstructive epicardial coronary artery disease during coronary angiography. There is conflicting data in medical literature regarding the effects of CSFP on the left ventricular functions assessed by conventional echocardiography or tissue Doppler imaging. Therefore, we aimed to evaluate whether there is any abnormality in the myocardial deformation parameters (strain, strain rate (SR), rotation, twist) of the left ventricle obtained by speckle tracking echocardiography (STE) in patients with CSFP. Twenty patients with CSFP were included prospectively in the study. Another 20 patients with similar demographics and cardiovascular risk factors as well as normal coronary angiography were used as the control group. Two-dimensional echocardiographic images of the left ventricle from the apical long-axis, two-chamber, four-chamber, and parasternal short-axis views were used for STE analysis. The analysis of left ventricular circumferential deformation parameters showed that the averaged peak systolic strain, systolic SR, and early diastolic SR values were significantly lower in patients with CSFP (P = 0.009, P = 0.02, and P = 0.02, respectively). Among the left ventricular rotation and twist values, apical rotation was significantly lower in patients with CSFP (P = 0.02). Further, the mean thrombolysis in myocardial infarction frame count value was found to be negatively correlated with the averaged peak circumferential early diastolic SR (r = -0.35, P = 0.03). It was positively correlated with the averaged peak circumferential systolic strain (r = 0.47, P = 0.003) and circumferential systolic SR (r = 0.46, P = 0.005). Coronary slow flow phenomenon leads to significant alterations in the myocardial deformation parameters of the left ventricle as assessed by STE. Specifically, circumferential deformation parameters are affected in CSFP patients. © 2015

Effects of isoflurane concentration on basic echocardiographic parameters of the left ventricle in rats

Czech Academy of Sciences Publication Activity Database

Říha, H.; Papoušek, František; Neckář, Jan; Pirk, J.; Ošťádal, Bohuslav

2012-01-01

Roč. 61, č. 4 (2012), s. 419-423 ISSN 0862-8408 R&D Projects: GA MŠk(CZ) 1M0510; GA AV ČR(CZ) IAA501110901 Institutional research plan: CEZ:AV0Z50110509 Keywords : anesthesia * isoflurane * echocardiography * left ventricular function * rat heart Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 1.531, year: 2012

A study on brain ventricle measurement of normal Korean adults using computed tomography

International Nuclear Information System (INIS)

Kim, Ung Jin; Chang, Kee Hyun; Han, Man Chung

1981-01-01

The study was undertaken to assess the ventricular system of the brain in normal Korean adults on the base of computed tomography. The computerized tomographic examinations of 334 Korean adults between ages of 15 to 50 years, performed at Seoul National University Hospital, were evaluated. The cerebro- or cerebello-ventricular ratio, between ventricular size and brain parenchyme width, has been known to be a reliable indicator of the ventricular size. This ratio was measured at the level of the lateral, third and fourth ventricles respectively. The shape of the quardigeminal and suprasellar cistern was analyzed. The results are as follows: 1. The cerebroventricular ratios of the lateral ventricle at the level of the widest bifrontal and bicaudate diameters were 0.30 ± 0.04 and 0.14 ± 0.02, respectively. The lateral ventricle was asymmetric in 12.6%, of which the left side was usually larger than the right. 2. There was correlation between the cerebroventricular ratio and age, i.e., with increase of age, the C-V ratio increased slightly. 3. The cerebroventricular ratio of the third ventricle was 0.03 ± 0.01. 4. The cerebroventricular ratio of the fourth ventricle in width and height was 0.14± 0.02 and 0.10 ± 0.03, respectively. The anteroposterior position index of the fourth ventricle was 0.42 ± 0.04. 5. The quadrigeminal cistern showed W-shape in 76.6% and U-shape in 23.4%. 6. The suprasellar cistern showed pentagonal shape in 61.1%, round in 28.4% and hexagonal in 10.5%. 7. There was no significant difference between male and female according to the above results

A study on brain ventricle measurements of normal Korean adults using computed tomography

International Nuclear Information System (INIS)

Kim, Ung Jin; Chang, Kee Hyun; Han, Man Chung

1981-01-01

The study was undertaken to assess the ventricular system of the brain in normal Korean adults on the base of computed tomography. The computerized tomographic examinations of 334 Korean adults between ages of 15 to 50 years, performed at Seoul National University Hospital, were evaluated. The cerebro- or cerebello-ventricular ratio, between ventricular size and brain parenchyme width, has been known to be reliable indicator of the ventricular size. This ratio was measured at the level of the lateral, third and fourth ventricles respectively. The shape of the quardigeminal and suprasellar cistern was analyzed. The results are as follows: 1. The cerebroventricular ratios of the lateral ventricle at the level of the widest bifrontal and bicaudate diameters were 0.30 ± 0.04 and 0.14 ± 0.02, respectively. The lateral ventricle was asymmetric in 12.6%, of which the left side was usually larger than the right. 2. There was correlation between the cerebroventricular ratio and age, i.e., with increase of age, the C-V ratio increased slightly. 3. The cerebrocventricular ratio of the third ventricle was 0.03 ± 0.01. 4. The cerebroventricular ratio of the fourth ventricle in width and height was 0.14 ± 0.02 and 0.10 ± 0.03, respectively. The anteroposterior position index of the fourth ventricle was 0.42 ± 0.04. 5. The quadrigeminal cistern showed W-shape in 76.6% and U-shaped in 23.4%. 6. The suprasellar cistern showed pentagonal shape in 61.1%, round in 28.4% and hexagonal in 10.5%. 7. There was no significant difference between male and female according to the above results

Successful surgical treatment of intractable hemifacial spasm: A case report and review of cerebellar hamartomas of the floor of the fourth ventricle

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Joseph H. Miller

2016-12-01

Full Text Available Introduction: Hamartomas involving the floor of the fourth ventricle and cerebellum are rare, but can be associated with medically recalcitrant hemifacial spasm. These lesions present early in the neonatal or infantile period and respond well to surgical excision. Case Report: A 3-month-old white male presented with recurrent left hemifacial spasm, left eye deviation, and absent movement of the extremities. The patient was found to have a left eccentric lesion in the floor of the fourth ventricle and cerebellum. The patient showed no improvement with medical therapy by 6 months of age. He was taken to the operating room for suboccipital craniotomy and removal of the posterior arch of C1 followed by intralesional recording of epileptogenic activity and gross total resection of the lesion. After histologic analysis, the lesion was determined to be ectopic cerebral tissue consistent with a hamartoma. Postoperative MRI showed complete removal of the lesion, and the patient exhibited complete remission of his hemifacial spasm and associated symptoms. Conclusions: Hamartomas involving the floor of the fourth ventricle can present with hemifacial spasm and respond well to surgical excision. Keywords: Cerebellar, Seizure, Epilepsy, Hamartoma

Extraction and analysis of left ventricular contours in cardiac radionuclide angiographies

International Nuclear Information System (INIS)

Jouan, A.

1991-01-01

The analysis of cardiac scintigraphic sequences is commonly realized with the help of functional or parametric images. The decomposition of the original sequence into a linear combination of the main temporal behaviors yields, after orthogonalization, a set of parametric images representing the pure temporal behaviors present in the original data. The properties of these images are used to extract automatically the left ventricular boundary. The Fourier Descriptors method is then used to get a quantified analysis of the shape of the ventricle. Because of their property of invariance by change of scale, the Fourier descriptors method applied on a sequence of left ventricular contours yields a quantified assessment of the cardiac contraction

The effects of nisoldipine on left ventricular filling rate in patients with ischemic heart disease measured with radionuclide gated blood pool scintigraphy

International Nuclear Information System (INIS)

Otto, A.C.; Viviers, A.C.

1988-01-01

Nisoldipine is a newly developed calcium channel blocker with outstanding vasodilatory properties especially with regard to the coronary arteries. Thus it may find wide-spread application as a therapeutic agent in various ischemic heart disease syndromes. The purpose of this study was to evaluate the effect of nisoldipine on the diastolic function of the left ventricle (LV) in the clinical situation. A patient group on nisoldipine treatment was compared to a control group. In the nisoldipine group a maximum decrease of 17 mmHg in the mean systolic blood pressure with an increase in the mean peak ejection rate (0.78 EDV/s) and peak filling rate (0.52 EDV/s) were observed. Mean LV ejection fraction increased by 6.4% and the time to peak filling rate decreased by 36.5 ms. After eight weeks of treatment the acute effects of nisoldipine were similar to the previous study. Nisoldipine therefore tends to improve both the diastolic and systolic function of the left ventricle. (orig.)

Visualisation of regional motility disorders in the left ventricular wall using radionuclide ventriculography

International Nuclear Information System (INIS)

Kaiser, H.

1985-01-01

During this study ECG-triggered intramyocardial scintiscans were obtained following in-vivo labelling of erythrocytes (99mTc) from 74 patients showing coronary heart disease and analysed with the aim to assess the suitability of this method for the detection of mural motility disorders and for visualisation of the accurate size of the left ventricle. The results of the intramyocardial scintiscans were evaluated against those of levocardiograms recorded for reasons of comparison and found to demonstrate mural motility disorders with a specifity of 0.70 and a sensitivity of 0.75. Relatively reliable data to diagnose those myocardial motility disorders were obtained by combined analysis of the individual scintiphotographic displays of amplitudes, phases, ejection fractions and positive gradients. The investigation of further parameters like the recorded stroke volumes and negative gradients provided no additional information. The phase recording proved to be the most suitable parameter to assess the size of the left ventricle. All other recordings gave a distorted picture of the left ventricle in terms of a reduction in size. (TRV) [de

Remodelamento reverso cirúrgico do ventrículo esquerdo: seguimento de 111 meses Surgical reverse remodelling of the left ventricle: 111 months of follow-up

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Rui M. S. Almeida

2009-12-01

post clinical and echocardiographic variables were analyzed retrospectively. Mean age was 59.0 ± 9.5 years, being 23 male patients. Seventeen patients were in NYHA functional class IV and the mean EuroScore was 8.2 ± 2.3. The mean pre-operative values for ejection fraction, end systolic and diastolic left ventricular volumes were 32.3 ± 9.2%, 113.9 ± 36.0 ml e 179.2 ± 48.4 ml, respectively. The BraziliAnVErsion of the SF36 quality of life questionnaire was applied in the late follow up period. RESULTS: Four patients died in the immediate post-operative period, being the major cause of morbidity low cardiac output syndrome and arrhythmias. The mean follow-up period was 5.6 ± 3.2 years. Left ventricle's ejection fraction and aortic cross clamping time were the significant factors for hospital and late mortality with P = 0.0222 and P = 0.0123, respectively. Actuarial survival curve showed a survival of 82.1 ± 7.2%, and 54.7 ± 22.9%, pre and post 107 months, of follow-up. CONCLUSION: EVSE' surgery is an effective option to treat this group of patients, with improvement of left ventricular function (from 32.3 to 46.4% and patients' quality of life.

Adeno-associated Virus Serotype 9 - Driven Expression of BAG3 Improves Left Ventricular Function in Murine Hearts with Left Ventricular Dysfunction Secondary to a Myocardial Infarction.

Science.gov (United States)

Knezevic, Tijana; Myers, Valerie D; Su, Feifei; Wang, JuFang; Song, Jianliang; Zhang, Xue-Qian; Gao, Erhe; Gao, Guofeng; Muniswamy, Madesh; Gupta, Manish K; Gordon, Jennifer; Weiner, Kristen N; Rabinowitz, Joseph; Ramsey, Frederick V; Tilley, Douglas G; Khalili, Kamel; Cheung, Joseph Y; Feldman, Arthur M

2016-12-01

The present study was undertaken to test the hypothesis that gene delivery of BCL2-Associated Athanogene 3 (BAG3) to the heart of mice with left ventricular dysfunction secondary to a myocardial infarction could enhance cardiac performance. BAG3 is a 575 amino acid protein that has pleotropic functions in the cell including pro-autophagy and anti-apoptosis. Mutations in BAG3 have been associated with both skeletal muscle dysfunction and familial dilated cardiomyopathy and BAG3 levels are diminished in non-familial heart failure. Eight-week-old C57/BL6 mice underwent ligation of the left coronary artery (MI) or sham surgery (Sham). Eight weeks later, mice in both groups were randomly assigned to receive either a retro-orbital injection of rAAV9-BAG3 (MI-BAG3 or Sham-BAG3) or rAAV9-GFP (MI-GFP or Sham GFP). Mice were sacrificed at 3 weeks post-injection and myocytes were isolated from the left ventricle. MI-BAG3 mice demonstrated a significantly (p BAG3 injection with further improvement in LVEF, fractional shortening and stroke volume at 3 weeks post-injection without changes in LV mass or LV volume. Injection of rAAV9-BAG3 had no effect on LVEF in Sham mice. The salutary benefits of rAAV9-BAG3 were also observed in myocytes isolated from MI hearts including improved cell shortening (pBAG3 gene therapy may provide a novel therapeutic option for the treatment of heart failure.

Trial of quantitative analysis of cardiac function by 3D reconstruction of multislice cine MR images

International Nuclear Information System (INIS)

Yamamoto, Hideki; Sei, Tetsurou; Nakagawa, Tomio; Hiraki, Yoshio.

1994-01-01

Non-invasive techniques for measuring the dynamic behavior of the left ventricle (LV) can be invaluable tool in the diagnosis of the heart disease. In this paper we present methods for quantitative analysis of cardiac function using a compact magnetic resonance image processing system. A 256 x 256 magnetic resonance transaxial image of the left ventricle in a normal case is obtained. After gray level thresholding and region segmentation, the boundary of the left ventricular chamber is extracted. Then, the boundaries of the left ventricular chamber are displayed three-dimensionally by using the Z-buffer algorithm. Thus, LV volume and ejection fraction are calculated. Here, the value of LV ejection fraction is 60%. These results agree reasonably well with the corresponding data obtained by the echocardiography. (author)

Cardiovascular measurement and cardiac function analysis with electron beam computed tomography in health Chinese people (50 cases report)

International Nuclear Information System (INIS)

Lu Bin; Dai Ruping; Zhang Shaoxiong; Bai Hua; Jing Baolian; Cao Cheng; He Sha; Ren Li

1998-01-01

Purpose: To quantitatively measure cardiovascular diameters and function parameters by using electron beam computed tomography, EBCT. Methods: Men 50 health Chinese people accepted EBCT common transverse and short-axis enhanced movie scan (27 men, 23 women, average age 47.7 years.). The transverse scan was used to measure the diameters of the ascending aorta, descending aorta, pulmonary artery and left atrium. The movie study was used to measure the left ventricular myocardium thickness and analysis global, sectional and segmental function of the right and left ventricles. Results: The cardiovascular diameters and cardiac functional parameters were calculated. The diameters and most functional parameters (end syspoble volume, syspole volume, ejection fraction, cardiac-output, cardiac index) of normal Chinese men were greater than those of women (P>0.05). However, the EDV and MyM(myocardium mass) of both ventricles were significant (p<0.01). Conclusion: EBCT is a minimally invasive method for cardiovascular measurement and cardiac function evaluation

Clinical, angiographic, hemodynamic, perfusional and functional changes after one-vessel left anterior descending coronary angioplasty

International Nuclear Information System (INIS)

Okada, R.D.; Lim, Y.L.; Boucher, C.A.; Pohost, G.M.; Chesler, D.A.; Block, P.C.

1985-01-01

Percutaneous transluminal coronary angioplasty (PTCA) was successfully performed in 20 patients with 1-vessel left anterior descending (LAD) coronary artery disease. Exercise capacity in terms of peak workload, heart rate and systolic blood pressure all increased significantly 1 week after PTCA. All patients had some decrease in stenosis size and gradient. All patients except 1 had an improvement in functional class. Eight of 12 patients with abnormal exercise electrocardiograms before PTCA had normal electrocardiograms after the procedure. Exercise thallium-201 (TI-201) myocardial perfusion images obtained in all 20 patients before and 1 week after PTCA were analyzed using a new computer method designed to quantitate regional myocardial TI-201 distribution, redistribution and clearance rate. Significant improvement in TI-201 activity was present in the anterior and septal segments of the left ventricle 1 week after PTCA. This increase in TI-201 uptake was associated with a significant reduction in the amount of TI-201 redistribution between initial and delayed postexercise images in the same regions. TI-201 clearance rate in the segments supplied by the dilated vessel also improved significantly. Abnormal TI-201 lung uptake was seen in 17 patients before and in 4 patients after PTCA. Exercise ejection fraction response and septal wall motion also improved after PTCA of the LAD stenosis in all 17 patients who had exercise radionuclide ventriculography

Determination of global heart function parameters

International Nuclear Information System (INIS)

Adam, W.E.; Hoffmann, H.; Sigel, H.; Bitter, F.; Nechwatal, W.; Stauch, M.; Ulm Univ.; Freiburg Univ.

1980-01-01

1. ECG-triggered scintigraphy of the interior of the heart (radioactive ventriculography) is a reliable non-invasive technique for the acquisition of the global and regional function of the left ventricle. 2. The most important global parameter is the output function (OF) of the left ventricle. It can be measured exactly. The decrease of the OF under load is typical for coronary insufficience under load, but is not specifically. 3. A movement disturbance on the ground of a KHK is recognized with highest sensitivity at the decrease of the maximum relaxation velocity of the global left-ventricular time-activity characteristic (fast phase of filling). 4. Regional wall movement disturbances can be measured quantitatively by means of viewing the radioactive nucleid ventriculogramm at the display. 5. The quantitative measurement of the regional function needs an extensive analysis of the local time-activity characteristics of a representative coronary cycle. For this the amplitude and phase and the contraction and relaxation velocity of all time-activity characteristics is determined by Fourier analysis and their spatial distribution is drawn (parametric scan). 6. The parametric scans (distribution of amplitude, phase, contraction and relaxation velocities) describe the regional wall movement in detail, the reliability of its quantitative acquisition has to be approved by further investigations. (orig.) [de

A Centerline Based Model Morphing Algorithm for Patient-Specific Finite Element Modelling of the Left Ventricle.

Science.gov (United States)

Behdadfar, S; Navarro, L; Sundnes, J; Maleckar, M; Ross, S; Odland, H H; Avril, S

2017-09-20

Hexahedral automatic model generation is a recurrent problem in computer vision and computational biomechanics. It may even become a challenging problem when one wants to develop a patient-specific finite-element (FE) model of the left ventricle (LV), particularly when only low resolution images are available. In the present study, a fast and efficient algorithm is presented and tested to address such a situation. A template FE hexahedral model was created for a LV geometry using a General Electric (GE) ultrasound (US) system. A system of centerline was considered for this LV mesh. Then, the nodes located over the endocardial and epicardial surfaces are respectively projected from this centerline onto the actual endocardial and epicardial surfaces reconstructed from a patient's US data. Finally, the position of the internal nodes is derived by finding the deformations with minimal elastic energy. This approach was applied to eight patients suffering from congestive heart disease. A FE analysis was performed to derive the stress induced in the LV tissue by diastolic blood pressure on each of them. Our model morphing algorithm was applied successfully and the obtained meshes showed only marginal mismatches when compared to the corresponding US geometries. The diastolic FE analyses were successfully performed in seven patients to derive the distribution of principal stresses. The original model morphing algorithm is fast and robust with low computational cost. This low cost model morphing algorithm may be highly beneficial for future patient-specific reduced-order modelling of the LV with potential application to other crucial organs.

Intra- and inter-observer reproducibility of global and regional magnetic resonance feature tracking derived strain parameters of the left and right ventricle

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Schmidt, Björn, E-mail: bjoernschmidt1989@gmx.de [Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937, Cologne (Germany); Dick, Anastasia, E-mail: anastasia-dick@web.de [Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937, Cologne (Germany); Treutlein, Melanie, E-mail: melanie-treutlein@web.de [Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937, Cologne (Germany); Schiller, Petra, E-mail: petra.schiller@uni-koeln.de [Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Kerpener Str. 62, D-50937, Cologne (Germany); Bunck, Alexander C., E-mail: alexander.bunck@uk-koeln.de [Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937, Cologne (Germany); Maintz, David, E-mail: david.maintz@uk-koeln.de [Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937, Cologne (Germany); Baeßler, Bettina, E-mail: bettina.baessler@uk-koeln.de [Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937, Cologne (Germany)

2017-04-15

Highlights: • Left and right ventricular CMR feature tracking is highly reproducible. • The only exception is radial strain and strain rate. • Sample size estimations are presented as a practical reference for future studies. - Abstract: Objectives: To investigate the reproducibility of regional and global strain and strain rate (SR) parameters of both ventricles and to determine sample sizes for all investigated strain and SR parameters in order to generate a practical reference for future studies. Materials and methods: The study population consisted of 20 healthy individuals and 20 patients with acute myocarditis. Cine sequences in three horizontal long axis views and a stack of short axis views covering the entire left and right ventricle (LV, RV) were retrospectively analysed using a dedicated feature tracking (FT) software algorithm (TOMTEC). For intra-observer analysis, one observer analysed CMR images of all patients and volunteers twice. For inter-observer analysis, three additional blinded observers analysed the same datasets once. Intra- and inter-observer reproducibility were tested in all patients and controls using Bland-Altman analyses, intra-class correlation coefficients (ICCs) and coefficients of variation. Results: Intra-observer reproducibility of global LV strain and SR parameters was excellent (range of ICCs: 0.81–1.00), the only exception being global radial SR with a poor reproducibility (ICC 0.23). On a regional level, basal and midventricular strain and SR parameters were more reproducible when compared to apical parameters. Inter-observer reproducibility of all LV parameters was slightly lower than intra-observer reproducibility, yet still good to excellent for all global and regional longitudinal and circumferential strain and SR parameters (range of ICCs: 0.66–0.93). Similar to the LV, all global RV longitudinal and circumferential strain and SR parameters showed an excellent reproducibility, (range of ICCs: 0.75–0

Intra- and inter-observer reproducibility of global and regional magnetic resonance feature tracking derived strain parameters of the left and right ventricle

International Nuclear Information System (INIS)

Schmidt, Björn; Dick, Anastasia; Treutlein, Melanie; Schiller, Petra; Bunck, Alexander C.; Maintz, David; Baeßler, Bettina

2017-01-01

Highlights: • Left and right ventricular CMR feature tracking is highly reproducible. • The only exception is radial strain and strain rate. • Sample size estimations are presented as a practical reference for future studies. - Abstract: Objectives: To investigate the reproducibility of regional and global strain and strain rate (SR) parameters of both ventricles and to determine sample sizes for all investigated strain and SR parameters in order to generate a practical reference for future studies. Materials and methods: The study population consisted of 20 healthy individuals and 20 patients with acute myocarditis. Cine sequences in three horizontal long axis views and a stack of short axis views covering the entire left and right ventricle (LV, RV) were retrospectively analysed using a dedicated feature tracking (FT) software algorithm (TOMTEC). For intra-observer analysis, one observer analysed CMR images of all patients and volunteers twice. For inter-observer analysis, three additional blinded observers analysed the same datasets once. Intra- and inter-observer reproducibility were tested in all patients and controls using Bland-Altman analyses, intra-class correlation coefficients (ICCs) and coefficients of variation. Results: Intra-observer reproducibility of global LV strain and SR parameters was excellent (range of ICCs: 0.81–1.00), the only exception being global radial SR with a poor reproducibility (ICC 0.23). On a regional level, basal and midventricular strain and SR parameters were more reproducible when compared to apical parameters. Inter-observer reproducibility of all LV parameters was slightly lower than intra-observer reproducibility, yet still good to excellent for all global and regional longitudinal and circumferential strain and SR parameters (range of ICCs: 0.66–0.93). Similar to the LV, all global RV longitudinal and circumferential strain and SR parameters showed an excellent reproducibility, (range of ICCs: 0.75–0

The R21C Mutation in Cardiac Troponin I Imposes Differences in Contractile Force Generation between the Left and Right Ventricles of Knock-In Mice

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Jingsheng Liang

2015-01-01

Full Text Available We investigated the effect of the hypertrophic cardiomyopathy-linked R21C (arginine to cysteine mutation in human cardiac troponin I (cTnI on the contractile properties and myofilament protein phosphorylation in papillary muscle preparations from left (LV and right (RV ventricles of homozygous R21C+/+ knock-in mice. The maximal steady-state force was significantly reduced in skinned papillary muscle strips from the LV compared to RV, with the latter displaying the level of force observed in LV or RV from wild-type (WT mice. There were no differences in the Ca2+ sensitivity between the RV and LV of R21C+/+ mice; however, the Ca2+ sensitivity of force was higher in RV-R21C+/+ compared with RV-WT and lower in LV- R21C+/+ compared with LV-WT. We also observed partial loss of Ca2+ regulation at low [Ca2+]. In addition, R21C+/+-KI hearts showed no Ser23/24-cTnI phosphorylation compared to LV or RV of WT mice. However, phosphorylation of the myosin regulatory light chain (RLC was significantly higher in the RV versus LV of R21C+/+ mice and versus LV and RV of WT mice. The difference in RLC phosphorylation between the ventricles of R21C+/+ mice likely contributes to observed differences in contractile force and the lower tension monitored in the LV of HCM mice.

Scintigraphic assessment of double-chambered right ventricle

International Nuclear Information System (INIS)

Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei

1987-01-01

A double-chambered right ventricle is often clinically misdiagnosed and may be missed even during cardiac catheterization. We encountered a 56-year-old male who had abnormal right ventricular thallium-201 uptake and a photon deficient area in the right ventricle by radionuclide cardioangiography. These findings strongly suggested the existence of anomalous muscle band in the right ventricle. It was demonstrated by contrast angiography that the right ventricle was divided into two chambers by a hypertrophic muscular band; the pressure gradient in the right ventricle was 98 mmHg. (author)

Echocardiographic evaluation of changes in left ventricular size and valvular regurgitation associated with physical training during and after maturity in standardbred trotters

DEFF Research Database (Denmark)

Buhl, Rikke; Ersbøll, Annette Kjær

2012-01-01

To assess whether physical training induces cardiac hypertrophy and valvular regurgitation in maturing Standardbred trotters and to establish a prediction model for the size of the left ventricle.......To assess whether physical training induces cardiac hypertrophy and valvular regurgitation in maturing Standardbred trotters and to establish a prediction model for the size of the left ventricle....

Assessment of left ventricular global function

International Nuclear Information System (INIS)

Breuel, H.-P.; Baehre, M.

1985-01-01

Radionuclide ventriculography (RNV), i.e. noninvasive evaluation of left venticular performance following the application of radionuclides has had a major impact on many aspects of cardiology and has proven its clinical value and reliability in the last few years. This article deals mainly with the changes in global left ventricular function. The clinical applications of RNV for coronary artery diseases and valvular heart diseases are described. (Auth.)

Adeno-associated Virus Serotype 9 – Driven Expression of BAG3 Improves Left Ventricular Function in Murine Hearts with Left Ventricular Dysfunction Secondary to a Myocardial Infarction

Science.gov (United States)

Knezevic, Tijana; Myers, Valerie D.; Su, Feifei; Wang, JuFang; Song, Jianliang; Zhang, Xue-Qian; Gao, Erhe; Gao, Guofeng; Muniswamy, Madesh; Gupta, Manish K.; Gordon, Jennifer; Weiner, Kristen N.; Rabinowitz, Joseph; Ramsey, Frederick V.; Tilley, Douglas G.; Khalili, Kamel; Cheung, Joseph Y.; Feldman, Arthur M.

2016-01-01

Objectives The present study was undertaken to test the hypothesis that gene delivery of BCL2-Associated Athanogene 3 (BAG3) to the heart of mice with left ventricular dysfunction secondary to a myocardial infarction could enhance cardiac performance. Background BAG3 is a 575 amino acid protein that has pleotropic functions in the cell including pro-autophagy and anti-apoptosis. Mutations in BAG3 have been associated with both skeletal muscle dysfunction and familial dilated cardiomyopathy and BAG3 levels are diminished in non-familial heart failure. Methods Eight-week-old C57/BL6 mice underwent ligation of the left coronary artery (MI) or sham surgery (Sham). Eight weeks later, mice in both groups were randomly assigned to receive either a retro-orbital injection of rAAV9-BAG3 (MI-BAG3 or Sham-BAG3) or rAAV9-GFP (MI-GFP or Sham GFP). Mice were sacrificed at 3 weeks post-injection and myocytes were isolated from the left ventricle. Results MI-BAG3 mice demonstrated a significantly (p BAG3 injection with further improvement in LVEF, fractional shortening and stroke volume at 3 weeks post-injection without changes in LV mass or LV volume. Injection of rAAV9-BAG3 had no effect on LVEF in Sham mice. The salutary benefits of rAAV9-BAG3 were also observed in myocytes isolated from MI hearts including improved cell shortening (pBAG3 gene therapy may provide a novel therapeutic option for the treatment of heart failure. PMID:28164169

Differential control of collagen synthesis by the sympathetic and renin-angiotensin systems in the rat left ventricle.

Science.gov (United States)

Dab, Houcine; Hachani, Rafik; Hodroj, Wassim; Sakly, Mohsen; Bricca, Giampiero; Kacem, Kamel

2009-12-03

In the present study, we tested the hypothesis of the indirect (via the sympathetic nervous system (SNS)) and direct (via AT1 receptors) contributions of Angiotensin II (Ang II) on the synthesis of collagen types I and III in the left ventricle (LV) in vivo. Sympathectomy and blockade of the Ang II receptor AT1 were performed alone or in combination in normotensive rats. The mRNA and protein synthesis of collagen types I and III were examined by Q-RT-PCR and immunoblotting in the LV. Collagen types I and III mRNA were decreased respectively by 53% and 22% after sympathectomy and only collagen type I mRNA was increased by 52% after AT1 receptor blockade. mRNA was not changed for collagen type I but was decreased by 25% for collagen type III after double treatment. Only collagen protein type III was decreased after sympathectomy by 12%, but collagen proteins were increased respectively for types I and III by 145% and 52% after AT1 receptor blockade and by 45% and 60% after double treatment. Deducted interpretations from our experimental approach suggest that Ang II stimulates indirectly (via SNS) and inhibits directly (via AT1 receptors) the collagen type I at transcriptional and protein levels. For collagen type III, it stimulates indirectly the transcription and inhibited directly the protein level. Therefore, the Ang II regulates collagen synthesis differently through indirect and direct pathways.

Effect of left ventricular diastolic dysfunction on left atrial appendage function and thrombotic potential in nonvalvular atrial fibrillation.

Science.gov (United States)

Demirçelik, Muhammed Bora; Çetin, Mustafa; Çiçekcioğlu, Hülya; Uçar, Özgül; Duran, Mustafa

2014-05-01

We aimed to investigate effects of left ventricular diastolic dysfunction on left atrial appendage functions, spontaneous echo contrast and thrombus formation in patients with nonvalvular atrial fibrillation. In 58 patients with chronic nonvalvular atrial fibrilation and preserved left ventricular systolic function, left atrial appendage functions, left atrial spontaneous echo contrast grading and left ventricular diastolic functions were evaluated using transthoracic and transoesophageal echocardiogram. Patients divided in two groups: Group D (n=30): Patients with diastolic dysfunction, Group N (n=28): Patients without diastolic dysfunction. Categorical variables in two groups were evaluated with Pearson's chi-square or Fisher's exact test. The significance of the lineer correlation between the degree of spontaneous echo contrast (SEC) and clinical measurements was evaluated with Spearman's correlation analysis. Peak pulmonary vein D velocity of the Group D was significantly higher than the Group N (p=0.006). However, left atrial appendage emptying velocity, left atrial appendage lateral wall velocity, peak pulmonary vein S, pulmonary vein S/D ratio were found to be significantly lower in Group D (p=0.028, patrial appendage emptying, filling, pulmonary vein S/D levels and lateral wall velocities respectively (r=-0.438, r=-0.328, r=-0.233, r=-0.447). Left atrial appendage emptying, filling, pulmonary vein S/D levels and lateral wall velocities were significantly lower in SEC 2-3-4 than SEC 1 (p=0.003, p=0.029, patrial fibrillation and preserved left ventricular ejection fraction, left atrial appendage functions are decreased in patients with left ventricular diastolic dysfunction. Left ventricular diastolic dysfunction may constitute a potential risk for formation of thrombus and stroke.

Evaluation of right ventricular function for lung transplantation. Role of electron flow scan

International Nuclear Information System (INIS)

Stern, M.; Joint-Lambert, O.; Tainturier, C.; Seigneur, F.; Caubarrere, I.; Hernigou, A.

1994-01-01

Several invasive or not invasive technics were used to evaluate right ventricular insufficiency associated to severe chronic pulmonary insufficiency. But none of them were very accurate and now the use of EBT appears as a real improvement. We performed a prospective study with 50 patients waiting for a lung transplantation and we compared the values of right ventricular function obtained by EBT to those obtained by nuclear medicine and catheterism. Accuracy of EBT for left ventricle evaluation has already been proved. Stroke volumes calculated by EBT in right and left ventricles are similar and this constitutes a good validation of the method for right ventricle evaluation. Correlations with hemodynamic measurements are poor and nuclear medicine technics underestimate the ejection fraction. So, EBT is recommended for right ventricular study before and after lung transplantation. (authors). 11 refs., 4 figs

Assessment of global and regional LV function obtained by quantitative gated SPECT using {sup 99m}Tc-tetrofosmin. Comparison with left ventricular cineangiography and echocardiography

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Ban, Kazunobu; Nakajima, Toru; Aoki, Naoto; Abe, Sumihisa; Handa, Shunnosuke; Suzuki, Yutaka [Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine

1998-11-01

The quantitative gated SPECT (QGS) software that has automatic edge detection algorithm of the left ventricle, is able to calculate LV volumes and visualize LV wall motion with perfusion throughout the cardiac cycle. We evaluated the reliability of global and regional LV function derived from QGS using {sup 99m}Tc-tetrofosmin by comparing with left ventricular cineangiography (LVG) and echocardiography (ECHO). In 22 cardiac patients, end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (LVEF) were calculated. Using cinematic display, regional LV wall motion were scored on a 3-point scale (1=normal, 2=hypokinesis, 3=akinesis; WMS). EDV, ESV and LVEF correlated well with those by LVG (p<0.001 for each). Correlation between WMS derived from QGS and ECHO was high (r=0.85, p<0.001). There was an inverse correlation between WMS and LVEF (r=0.77, p<0.001). In conclusion, QGS is useful to evaluate global LV function. Regional wall motion evaluated by QGS is good enough for clinical application. (author)

About the non-invasive nuclearmedical assessment of the left ventricular function in coronary heart disease - a comparison with right heart catheterization by floating catheters

Energy Technology Data Exchange (ETDEWEB)

Brugger, P.

1985-09-15

In this paper there has been analysed the diagnostic value of the parameters of the diastolic function (Peak Filling Rate, PFR and Time to Peak Filling Rate, TPFR) which are not to be covered by invasive methods. To this examination we applied a recently discovered nuclearmedical method: we used the Nuclear Stethoscope and with it were able to investigate not only the systolic function (Ejection Fraction) but also the diastolic function (PFR, TPFR). In addition to this we undertook a floating catheter during exercise for the critical examination of the left ventricle. The examined patients consisted of 28 patients, suffering from Coronary Heart Disease, the majority of them after myocardial infarction. In patients suffering from CHD there may be found relations between the nuclearmedical parameters of the diastolic function and the pulmonary capillary wedge pressure as far as in all patients who showed a functional disturbance with the aids of invasive methods this could also be proved non-invasively. (Author).

About the non-invasive nuclearmedical assessment of the left ventricular function in coronary heart disease - a comparison with right heart catheterization by floating catheters

International Nuclear Information System (INIS)

Brugger, P.

1985-01-01

In this paper there has been analysed the diagnostic value of the parameters of the diastolic function (Peak Filling Rate, PFR and Time to Peak Filling Rate, TPFR) which are not to be covered by invasive methods. To this examination we applied a recently discovered nuclearmedical method: we used the Nuclear Stethoscope and with it were able to investigate not only the systolic function (Ejection Fraction) but also the diastolic function (PFR, TPFR). In addition to this we undertook a floating catheter during exercise for the critical examination of the left ventricle. The examined patients consisted of 28 patients, suffering from Coronary Heart Disease, the majority of them after myocardial infarction. In patients suffering from CHD there may be found relations between the nuclearmedical parameters of the diastolic function and the pulmonary capillary wedge pressure as far as in all patients who showed a functional disturbance with the aids of invasive methods this could also be proved non-invasively. (Author)

Quantitative Evaluation of the Fetal Right and Left Ventricular Fractional Area Change Using Speckle Tracking Technology.

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DeVore, Greggory R; Klas, Berthold; Satou, Gary; Sklansky, Mark

2018-03-14

The purpose of this study was to measure the fractional area change (FAC) of the right and left ventricles in normal fetal hearts between 20 and 40 weeks of gestation using speckle-tracking software. The 4-chamber view of the fetal heart was obtained in 200 control fetuses between 20 and 40 weeks of gestation. The FAC was computed from the ventricular areas [((end-diastolic area) - (end-systolic area)/(end-diastolic area)) x 100] for the right and left ventricles and regressed against 7 independent biometric and age variables. The FAC was correlated with longitudinal fractional shortening (LFS) [((end-diastolic longitudinal length) - (end-systolic longitudinal length) /(end-diastolic longitudinal length)) x 100] obtained from the mid ventricular basal-apical lengths of the right and left ventricular chambers and the transverse fractional shortening (TFS) [((end-diastolic transverse length) - (end-systolic transverse length)/(end-diastolic transverse length)) x 100] from three transverse positions (base, mid, apical) located within each ventricular chamber. To evaluate potential clinical utility, the FAC, LFS, and TFS results were examined in 9 fetuses with congenital heart defects (CHD). Regression analysis demonstrated significant associations between the FAC and the biometric and age independent variables (R 2 = 0.13 - 0.15). The FAC was significantly correlated with the LFS (R 2 =0.18 to 0.28) and TFS (R 2 = 0.13 to 0.33). The 9 fetuses with CHD illustrated the interrelationship between the FAC, LFS, and TFS when identifying abnormal ventricular function. This study reports results from measuring the FAC of the right and left ventricles, and demonstrates a correlation with longitudinal fractional shortening (LFS) and transverse fractional shortening (TFS). This article is protected by copyright. All rights reserved.

A combined deep-learning and deformable-model approach to fully automatic segmentation of the left ventricle in cardiac MRI.

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Avendi, M R; Kheradvar, Arash; Jafarkhani, Hamid

2016-05-01

Segmentation of the left ventricle (LV) from cardiac magnetic resonance imaging (MRI) datasets is an essential step for calculation of clinical indices such as ventricular volume and ejection fraction. In this work, we employ deep learning algorithms combined with deformable models to develop and evaluate a fully automatic LV segmentation tool from short-axis cardiac MRI datasets. The method employs deep learning algorithms to learn the segmentation task from the ground true data. Convolutional networks are employed to automatically detect the LV chamber in MRI dataset. Stacked autoencoders are used to infer the LV shape. The inferred shape is incorporated into deformable models to improve the accuracy and robustness of the segmentation. We validated our method using 45 cardiac MR datasets from the MICCAI 2009 LV segmentation challenge and showed that it outperforms the state-of-the art methods. Excellent agreement with the ground truth was achieved. Validation metrics, percentage of good contours, Dice metric, average perpendicular distance and conformity, were computed as 96.69%, 0.94, 1.81 mm and 0.86, versus those of 79.2-95.62%, 0.87-0.9, 1.76-2.97 mm and 0.67-0.78, obtained by other methods, respectively. Copyright © 2016 Elsevier B.V. All rights reserved.

Functional myocardial state and the special features of left ventricle remodeling at chronic heart failure with diabetes mellitus type 2 on the background of overweight and obesity based on gender factor

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Петро Петрович Бідзіля

2016-01-01

Full Text Available Today chronic heart failure (CHF is one of the main causes of death of patients with obesity and at the growth of body mass index (BMI for every 1kg /m2 the risk of CHF increases by 5 % in men and by 7 % in women. There were proved that in the conditions of diabetes mellitus (DM type 2 the mortality from cardiovascular pathology and especially CHF increases in 2-3 times in men and in 3-5 times in women. The aim of research was to study the myocardium functional state and the special features of the left ventricle (LV remodeling at chronic heart failure (CHF with diabetes mellitus (DM type 2 on the background of overweight and obesity depending on gender factor.Methods: there were examined 97 patients with CHF of I-III functional class at DM type 2 on the background of the normal body mass, overweight and abdominal obesity of I-III stage. All patients underwent echocardiographic examination. The processing of received data was carried out by the methods of nonparametric statistics.Results: There was not revealed any reliable difference of index of LV ejection fraction that was a little less in men. The value of the mean pressure of pulmonary artery was almost equal and the prevalence of pulmonary hypertension unreliably predominated in men. The frequency of LV isolated systolic dysfunction (LVSD in both groups did not essentially differ and LV diastolic dysfunction (LVDD that was presented by myocardium relaxation disorder unreliably predominated in women. The percentage of combination of LVSD and LVDD had a tendency to increase in men. There was revealed reliable predominance of the frequency of LV hypertrophy (by 11 % in women that in most cases was presented by its concentric type. The concentric LV remodeling observed in minority of patients unreliably predominated in men.Conclusions: The myocardium functional changes at CHF with DM type 2 on the background of overweight and obesity are characterized with tendency to decrease of LV

Left ventricular pseudoaneurysm versus aneurysm a diagnosis dilemma

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Samarjit Bisoyi

2016-01-01

Full Text Available Free wall rupture of the left ventricle (LV is a rare but life-threatening complication of acute myocardial infaction. Very rarely such rupture may be contained by the adhering pericardium creating a pseudoaneurysm. This condition warrants for an emergency surgery. Left ventricular aneurysm is the discrete thinning of the ventricular wall (<5 mm with akinetic or dyskinetic wall motion causing an out-pouching of the ventricle. Given the propensity for pseudoaneurysms to rupture leading to cardiac tamponade, shock, and death, compared with a more benign natural history for true aneurysms, accurate diagnosis of these conditions is important. True aneurysm, usually, calls for an elective surgery. Clinically differentiating the two conditions remains a challenge. We report the case of a patient with LV pseudoaneurysm, initially diagnosed as true aneurysm at our institution. We have attempted to review the existing literature and discussed the characteristic findings of each entity.

[Spectrum of biventricular aortic connection and double outlet chamber of the right ventricle produced experimentally in the chicken heart by hypothermia (34.5 degrees C)].

Science.gov (United States)

Muñoz Castellanos, L; Kuri Nivón, M; Chévez, A

1982-01-01

In this experimental work, fertilized chicken eggs were subjected to hypothermia (34.5 degrees) as to inhibit the incorporation of the aortic infundibulum into the left ventricle. This produced a spectrum of biventricular connection of the aorta including double outlet right ventricle (DORV), a cardiopathy seen naturally in man and in chicken. It represents the persistence in the postnatal heart of the spectrum of embryonic aortic dextroposition, a fact which allowed us to establish a precise anatomoembryologic correlation. Pathogenetically, the failure in the connection of the aortic infundibulum with the left ventricle is due to inhibition, in different degrees, of the leftward morphogenetic movement of the infundibular segment, an embryologic process which is discussed in relation to different theories on the origin of DORV. The role played by cell death in normal and pathologic morphogenesis, is emphasized and some methodological aspects on experimental teratogeneses are mentioned.

Dosimetric Comparison of Intensity-Modulated Radiotherapy Plans, With or Without Anterior Myocardial Territory and Left Ventricle as Organs at Risk, in Early-Stage Left-Sided Breast Cancer Patients

International Nuclear Information System (INIS)

Tan Wenyong; Wang Xiaohong; Qiu Dasheng; Liu Dong; Jia Shaohui; Zeng Fanyu; Chen Zhengwang; Li Beihui; Xu Jiaozhen; Wei Lai; Hu Desheng

2011-01-01

Purpose: We evaluated heart sparing using an intensity-modulated radiotherapy (IMRT) plan with the left ventricle (LV) and/or the anterior myocardial territory (AMT) as additional organs at risk (OARs). Methods and Materials: A total of 10 patients with left-sided breast cancer were selected for dosimetric planning. Both lungs, the right breast, heart, LV, and AMT were defined as OARs. We generated one tangential field plan and four IMRT plans for each patient. We examined the dose–volume histogram parameters of the planning target volume and OARs. Results: Compared with the tangential field plan, the mean dose to the heart in the IMRT plans did not show significant differences; however, the dose to the AMT and LV decreased by 18.7–45.4% and 10.8–37.4%, respectively. The maximal dose to the heart decreased by 18.6–35.3%, to the AMT by 22.0–45.1%, and to the LV by 23.5–45.0%, And the relative volumes of the heart (V ≥12 ), AMT (V >11 ) and LV (V >10 ) decreased significantly with different levels, respectively. The volume of the heart, AMT, LV, both lungs, and right breast receiving ≥5 Gy showed a significant increase. Compared with the IMRT (H) plan, the mean dose to the heart, AMT, and LV decreased by 17.5–21.5%, 25.2–29.8%, and 22.8–29.8% and the maximal dose by 13.6–20.6%, 23.1–29.6%, and 17.3–29.1%, respectively. The IMRT plans for both lungs and the right breast showed no significant differences. Conclusions: The IMRT plans with the addition of the AMT and/or LV as OARs considerably increased heart sparing. We recommend including the LV as an additional OAR in such plans.

Graph cut-based method for segmenting the left ventricle from MRI or echocardiographic images.

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Bernier, Michael; Jodoin, Pierre-Marc; Humbert, Olivier; Lalande, Alain

2017-06-01

In this paper, we present a fast and interactive graph cut method for 3D segmentation of the endocardial wall of the left ventricle (LV) adapted to work on two of the most widely used modalities: magnetic resonance imaging (MRI) and echocardiography. Our method accounts for the fundamentally different nature of both modalities: 3D echocardiographic images have a low contrast, a poor signal-to-noise ratio and frequent signal drop, while MR images are more detailed but also cluttered and contain highly anisotropic voxels. The main characteristic of our method is to work in a 3D Bezier coordinate system instead of the original Euclidean space. This comes with several advantages, including an implicit shape prior and a result guarantied not to have any holes in it. The proposed method is made of 4 steps. First, a 3D sampling of the LV cavity is made based on a Bezier coordinate system. This allows to warp the input 3D image to a Bezier space in which a plane corresponds to an anatomically plausible 3D Euclidean bullet shape. Second, a 3D graph is built and an energy term (which is based on the image gradient and a 3D probability map) is assigned to each edge of the graph, some of which being given an infinite energy to ensure the resulting 3D structure passes through key anatomical points. Third, a max-flow min-cut procedure is executed on the energy graph to delineate the endocardial surface. And fourth, the resulting surface is projected back to the Euclidean space where a post-processing convex hull algorithm is applied on every short axis slice to remove local concavities. Results obtained on two datasets reveal that our method takes between 2 and 5s to segment a 3D volume, it has better results overall than most state-of-the-art methods on the CETUS echocardiographic dataset and is statistically as good as a human operator on MR images. Copyright © 2017 Elsevier Ltd. All rights reserved.

Relationship between plasma BNP level and perfusion and function of the left ventricle in patients with coronary artery disease

International Nuclear Information System (INIS)

Celinski, R.; Cholewinski, W.; Stefaniak, B.; Tarkowska, A.; Grzywa-Celinska, A.

2004-01-01

Elevation of the plasma BNP is known to occur in heart failure. However, some observations suggest that in patients with CAD an increase in BNP level may be caused also by the myocardial ischaemia. The study population comprised 79 patients with CAD, aged on average 59.6, and 18 healthy volunteers (CG). In patients with CAD g SPECT was performed using 99mT c tetrofosmin and myocardial perfusion and function were assessed quantitatively. Plasma BNP was measured using immunoradiometric method and was analyzed according to LVEF, EDV, ESV and two perfusion parameters: SCD and TPD. In all patients with CAD perfusion defects were found at rest. BNP concentration was significantly higher in CAD than in CG. In the group with dLVEF plasma BNP was distinctly higher than in that with nVEF but that difference was not significant. In pts with dLVEF significant correlation was found between BNP concentration on one hand and LVEF, EDV and ESV on the other. No significant relationships were observed between plasma BNP and both perfusion parameters. In patients with CAD the increase in plasma BNP level is related to the disorders of the left ventricular contractility, to the systolic function impairment first of all. Myocardial ischaemia without concomitant contractility disorders does not lead to elevation of BNP level. (author)

Diagnostic value of visualization of the right ventricle using thallium-201 myocardial imaging

International Nuclear Information System (INIS)

Khaja, F.; Alam, M.; Goldstein, S.; Anbe, D.T.; Marks, D.S.

1979-01-01

The diagnostic significance of visualizing the right ventricle on thallium-201 myocardial perfusion scans (T-scan) at rest was studied in 53 patients. In 33 patients, the right ventricle was visualized clearly on the T-scan (group A). Hemodynamic evidence of right ventricular hypertension with systolic pressure greater than or equal to 30 mm Hg was present in 28 of 33 (85%) of these patients. Right ventricular volume overload with left-to-right shunt > 2:1 was present in three patients. Other tests were diagnostic for right ventricular enlargement and or pulmonary hypertension as follows: chest x-ray (58%), echocardiogram (36%), and electrocardiogram (15%). In an unselected group of 20 patients (group B) where resting T-scan did not show visualization of the right ventricle, the right ventricular systolic pressure was < 30 mm Hg in all. The other noninvasive tests did not reveal presence of right ventricular hypertrophy or enlargement. T-scan appears to be a useful and sensitivie test in detecting right ventricular pressure or volume overload compared with other noninvasive tests. This may be useful in detection of patients with right ventricular hypertrophy or enlargement secondary to pulmonary hypertension or other causes

On Functional Inequalities Originating from Module Jordan Left Derivations

OpenAIRE

Kang Sheon-Young; Chang Ick-Soon; Kim Hark-Mahn

2008-01-01

Abstract We first examine the generalized Hyers-Ulam stability of functional inequality associated with module Jordan left derivation (resp., module Jordan derivation). Secondly, we study the functional inequality with linear Jordan left derivation (resp., linear Jordan derivation) mapping into the Jacobson radical.

Sudden death as presenting symptom caused by cardiac primary multicentric left ventricle rhabdomyoma, in an 11-month-old baby. An immunohistochemical study

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Neri Margherita

2012-12-01

Full Text Available Abstract This case report describes a sudden cardiac death in an apparent healthy 11-month-old infant caused by a multifocal cardiac rhabdomyoma. Parents reported that a few days before the child had fallen to the ground getting a little superficial injury to the scalp. The authors hypothesize that it may have been a transient loss of consciousness episode caused by the cardiac tumour. After the gross examination, histological investigation supported by immunohistochemical analysis using antibody anti- Myoglobin, Actin, Vimentin, Desmin, CD34, S-100, Ki-67 was carried out for the diagnosis. Death was attributed to a multifocal cardiac rhabdomyoma, a benign tumour of striated muscle, which has been completely asymptomatic. In particular, one mass filled the entire posterior wall of the left ventricle. The insidious development of benign cardiac tumours also in infants and children is outlined, focusing on the responsible mechanisms of sudden death in such cases and providing a reference for additional study on these subjects. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7163626988365078

The benefit of image guidance for the contralateral interhemispheric approach to the lateral ventricle.

Science.gov (United States)

Fronda, Chiara; Miller, Dorothea; Kappus, Christoph; Bertalanffy, Helmut; Sure, Ulrich

2008-06-01

Recently, neurosurgeons have increasingly faced small intracerebral lesions in asymptomatic or minimally symptomatic patients. Here, we evaluated a series of four patients with nearly asymptomatic intraventricular tumors close to the corpus callosum that had been treated with the aid of an image-guided transcallosal approach. Four consecutive patients suffering from left intra- and paraventricular tumors were operated on via a contralateral interhemispheric transcallosal approach with the aid of neuronavigation. Our image-guided system directed: (1) the skin incision, (2) the interhemispheric dissection, and (3) the incision of the corpus callosum. Using the image-guided contralateral interhemispheric transcallosal approach to the left ventricle all lesions have been completely resected without the risk of damage to the dominant hemisphere. The callosal incision was kept as limited as possible (1.2-2.1cm) depending on the size of the tumor. No postoperative neurological or neuropsychological deficit was observed in our series. Neuronavigation facilitates a safe and targeted contralateral interhemispheric transcallosal approach to the dominant hemisphere's lateral ventricle. Our technique minimizes the risk of damage to the dominant hemisphere and requires only a limited opening of the corpus callosum, which might decrease the risk of neuropsychological morbidity.

Evaluation of right and left ventricular function during adult respiratory distress syndrom using radionuclide angiocardiography conventional and tomographic approaches

International Nuclear Information System (INIS)

Devaux, J.Y.; Dhainaut, J.F.; Roucayrol, J.C.; Brunol, J.

1982-01-01

Despite numerous experimental and clinical studies, the cardiovascular effects of mechanical ventilation with positive-end-expiratory pressure (PEEP) are unclear. Specially, the constant fall in cardiac output is not well undestood. The purpose of this study was to investigate the effects of PEEP on right and left ventricular systolic and diastolic performance before and after volume expansion using angioscintigraphy with red blood cells, in vitro labelled with 99m Tc, a reliable, non invasive method to assess right and left ventricular dimensions and global and segmental contractility. First results in patients with adult respiratory distress syndrom (ARDS) confirm the capabilities of such a method for evaluation of regional wall motion in both ventricles

Right ventricular function: methodologic and clinical considerations in noninvasive scintigraphic assessment

International Nuclear Information System (INIS)

Manno, B.V.; Iskandrian, A.S.; Hakki, A.H.

1984-01-01

Right ventricular function plays an important role in many cardiac disorders. Changes in left ventricular function, right ventricular afterload and preload, cardiac medications and ischemia may affect right ventricular function. Radionuclide ventriculography permits quantitative assessment of regional and global function of the right ventricle. This assessment can be made at rest, during exercise or after pharmacologic interventions. The overlap between right ventricle and right atrium is a major limitation for gated scintigraphic techniques. The use of imaging with newer short-lived radionuclides may permit more accurate and reproducible assessment of right ventricular function by means of the first pass method. Further work in areas related to improvement of techniques and the impact of right ventricular function on prognosis is needed

Colloid cysts of the third ventricle exhibit heterogeneous clinical picture

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Janez Ravnik

2014-08-01

Full Text Available Background: Colloid cysts are rare benign intracranial tumours generally occurring in the front part of the third ventricle. Clinical picture may be non-specific. Various problems are usually associated with hydrocephalus that these cysts may cause.Methods: Five patients with colloid cyst of the third ventricle were consecutively operated on at our department. All had different clinical pictures. Two patients suffered from acute hydrocephalus, one of them also from rapid deterioration of consciousness. In two patients, the cyst was discovered accidentally owing to non-specific problems. One patient experienced progressive deterioration due to chronic hydrocephalus.Results: All patients had a colloid cyst removed via the right anterior interhemispheric transcallosal approach. One patient had surgical complication with transient left-sided haemiparesis, followed by osteomyelitis. Postoperative course in all other patients was unremarkable.Conclusions: Due to a high risk of potential sudden deterioration the colloid cysts may cause, a rapid surgical intervention is generally needed. The anterior interhemispheric transcallosal approach is a well accepted and safe surgical option.

On Functional Inequalities Originating from Module Jordan Left Derivations

Directory of Open Access Journals (Sweden)

Kang Sheon-Young

2008-01-01

Full Text Available Abstract We first examine the generalized Hyers-Ulam stability of functional inequality associated with module Jordan left derivation (resp., module Jordan derivation. Secondly, we study the functional inequality with linear Jordan left derivation (resp., linear Jordan derivation mapping into the Jacobson radical.

[Surgical angioplasty of the left main coronary artery].

Science.gov (United States)

Vranes, Mile; Velinović, Milos; Kocica, Mladen; Mikić, Aleksandar; Velimirović, Dusan; Djukić, Petar

2010-01-01

The conventional treatment for isolated stenosis of the left main coronary artery is bypass surgery (myocardial revascularization). However, the process of atherosclerosis is not arrested by myocardial revascularization and it will lead to the occlusion of the left main coronary artery. Revascularization will establish retrograde perfusion for 50-70% of the myocardium of the left ventricle. Direct surgical angioplasty of the left main coronary artery enables normal physiological perfusion of the whole myocardium and better myocardial function. The aim of our study is to point out a new surgical approach of treating left main coronary artery stenosis. Between October 2002 and October 2003, direct surgical angioplasty of the main left coronary artery was performed on three patients with isolated stenosis of the left main coronary artery using the anterior approach and the pericardium as a patch. The procedure was performed under total endotracheal anaesthesia and standard cardiopulmonary circulation, moderate hypothermia, anterograde St. Tomas cardioplegia and local cooling. Patients were followed clinically, echocardiographically and by load-tests. All three patients were without complications. In postoperative follow-up (54-68 months) neither angina pectoris nor electrocardiographically registered ischaemic changes were found. Load-tests performed every six months on all three patients were negative. Surgical angioplasty of isolated stenosis of the left main coronary artery is a preferred method for treating this type of coronary disease. Contraindications for this type of treatment are stenosis of the left main coronary artery with bifurcation and advanced calcification of the left main coronary artery.

Clinical findings in right ventricular noncompaction in hypoplastic left heart syndrome.

Science.gov (United States)

Gardner, Monique M; Cohen, Meryl S

2017-12-01

Noncompaction is a poorly understood form of cardiomyopathy that typically affects the left ventricle and may be associated with congenital heart disease. Right ventricular noncompaction (RVNC) may occur when the left ventricle is affected but is rarely seen in isolation. RVNC may have clinical significance affecting surgical and long-term outcomes. We describe the diagnosis and clinical course in three patients at our institution. We performed a retrospective review of patients diagnosed with RVNC over a 12-month period at our institution and reviewed their imaging and clinical course. Three patients were identified. All had diagnosis of RVNC by echocardiography (echo) made on postnatal imaging which reviewed degree of trabeculation, and noncompaction-to-compaction ratio of the myocardium. Patient A was a neonate with hypoplastic left heart syndrome (HLHS) who underwent a Norwood operation with Sano modification. Her postoperative course was notable for low-normal RV function. She returned with a pericardial effusion warranting immediate pericardiocentesis. She continued to have effusions, which were medically managed. She was subsequently found to have an RV apical pseudoaneurysm, which required surgical resection. Patient B was a neonate with HLHS who had a Norwood operation with Sano modification. She had low-normal RV function on echo. She required medical management for pericardial effusion. Patient C was a neonate with HLHS who also underwent a Norwood operation with Sano modification. His postoperative course was notable for elevated serum brain natriuretic peptide, which was treated with digoxin. RVNC is a rare diagnosis with limited known clinical impact. One of these patients had a very rare complication after pericardiocentesis (pseudoaneurysm) that may have been related to the RVNC. Our understanding of this disease process is limited and requires additional investigation, but emphasizes the importance of appropriate diagnosis to allow for timely

Evaluation of left ventricular function using digital subtraction ventriculography

International Nuclear Information System (INIS)

Yiannikas, J.; Detrano, R.

1986-01-01

Digital subtraction ventriculography following injections of contrast via peripheral veins provides excellent images to assess left ventricular function. The images are essentially identical to those following DCV, but allow more uniform mixing of contrast in the left ventricular chamber. Furthermore, few, if any, cardiac arrhythmias occur, hence obviating difficulties that arise from DCV. The spatial resolution of the method is such that regional wall motion assessment of ventricular function is more accurate than that of other noninvasive imaging methods. The use of video-densitometry allows accurate assessment of left ventricular function even when the left ventricular cavity is nonsymmetrically deformed and aneurysmal. In the setting of the cardiac catheterization laboratory, digital ventriculography may provide a safer means of assessing left ventricular function when critical coronary or myocardial disease is present and allows multiple assessments of ventricular function during the same study. Although excellent correlations with standard ventriculography have been noted by all workers, significant discrepancies still exist in individual patients, particularly in the calculations of end diastolic volumes. In the authors experience and in those of most workers, the largest discrepancies existed in patients in whom suboptimal studies are included for analysis. The most frequent reason for the occasional suboptimal study as with all digital subtraction work is the misregistration that results from motion

Primary hemochromatosis: anatomic and physiologic characteristics of the cardiac ventricles and their response to phlebotomy

International Nuclear Information System (INIS)

Dabestani, A.; Child, J.S.; Henze, E.; Perloff, J.K.; Schon, H.; Figueroa, W.G.; Schelbert, H.R.; Thessomboon, S.

1984-01-01

M-mode and 2-dimensional echocardiography and gated equilibrium blood pool imaging (rest and exercise) were used in 10 patients with primary hemochromatosis to characterize the spectrum of pathophysiologic abnormalities of the cardiac ventricles and to determine the response to chronic therapeutic phlebotomy. Dilated and restrictive cardiomyopathic patterns were identified in 1 patient each, but our data do not permit conclusions on when in the natural history a given pattern becomes overt. On entry into study, 3 patients had normal ventricles and 7 had ventricular abnormalities on echocardiography and blood pool angiography. In 2 of the latter patients, biventricular dysfunction and increased left ventricular (LV) mass normalized after phlebotomy; 1 patient achieved a normal LV response to exercise. Of the 4 patients with isolated abnormal LV ejection fraction responses to exercise, the EF normalized in 2 after phlebotomy. In 1 patient, isolated right ventricular enlargement and dysfunction (echocardiographic and radionuclide imaging) normalized after phlebotomy. Thus, primary hemochromatosis can effect LV and RV size and function; clinically occult cardiac involvement can be identified by echocardiography and equilibrium blood pool imaging; therapeutic phlebotomy can ameliorate or reverse the deleterious effects of excess cardiac iron deposition which appears to exert its harm, at least in part, by a mechanism other than irreversible connective tissue replacement

Assessment of cardiac morphology and ventricular function in healthy Chinese individuals using MRI

International Nuclear Information System (INIS)

Lu Minjie; Zhao Shihua; Jiang Shiliang

2011-01-01

Objective: To investigate reproducibility of cardiac MRI for assessment of cardiac morphology and ventricular function in selected normal Chinese Han population. Methods: Two hundred and sixty-nine normal volunteers underwent cardiac MRI using a 1.5 T MR system. HASTE and steady state free precession imaging were performed with long and short axis images and cine mode through the ventricle with wireless vector cardiac gating. The images were reviewed by two independent observers. The dimensions of cardiac chambers and ventricular function including ejection fraction (EF), end diastolic volume (EDV) , end systolic volume (ESV) and myocardial mass were evaluated. The data between male and female were compared by using two-tailed unpaired t test. Results: Total imaging time was (15±3) min. The anteroposterior diameter of the left atrium was (2.87±0.77) cm, the right atrial diameter perpendicular to the atrial septum was (3.61±0.57) cm, the end diastolic diameter of the left ventricle was (4.97± 0.52) cm, the end diastolic diameter of the right ventricle was (2.65±0.48) cm. On the left ventricle, EF was (60.62±7.08)%, EDV was (115.37±26.71) ml, ESV was (46.02±15.72) ml and LV mass was (82.97±24.03) g. On the right ventricle, EF was (47.73±6.50)%, EDV was (128.27±32.16) ml, ESV was (67.7±21.07) ml and RV mass was (48.24±13.42) g. There were no statistically significant differences in LVESV (P=0.144), LVEDV index (P=0.714), LVESV index (P=0.113), LVCI (P=0.199), RVEF (P=0.296) and RV mass (P=0.093), and statistically significant differences in other cardiac parameters between male and female. Conclusion: Cardiac MRI can provide useful information about cardiac function and morphology with a high level of reproducibility in normal Chinese Han population. (authors)

Challenges of management and therapy in patients with a functionally single ventricle after Fontan operation.

Science.gov (United States)

Trojnarska, Olga; Ciepłucha, Aleksandra

2011-01-01

Forty years ago, Fontan and Baudet performed the first life-saving operation on a patient with a functionally single ventricle. This multi-stage procedure established the connection between systemic venous circulation and pulmonary arteries. As a consequence, the pulmonary circulation is supplied in a passive way, whereas the single ventricle pumps the blood into the systemic circulation only. Over the years, the technique of creating the abovementioned vascular connections has undergone several modifications. Due to the fundamental non-physiological hemodynamic relations between arterial pulmonary and systemic venous pressures, numerous complications can be observed in these patients including: supraventricular arrhythmias, thromboemboli, hepatic dysfunction, protein-losing enteropathy, heart failure, worsening cyanosis, systemic venous collateralization, and pulmonary arteriovenous malformations, as well as connective tissue lesions in bronchi. Although based on an ingenious concept, the operation remains of a palliative character. Occasionally, heart transplantation is the ultimate resolution. Pharmacological therapy, and surgical conversion, often appear to be ineffective. However, this procedure has enabled many patients to reach adulthood and enjoy their lives to the full. This fact poses a great challenge for cardiologists wishing to become more knowledgeable and experienced as regards such patients, if we are not to waste such fabulous surgical achievements.

Right-To-Left Ventricular Differences in the Expression of Mitochondrial Hexokinase and Phosphorylation of Akt

Czech Academy of Sciences Publication Activity Database

Wasková-Arnoštová, P.; Elsnicová, B.; Kašparová, D.; Šebesta, O.; Novotný, J.; Neckář, Jan; Kolář, František; Žurmanová, J.

2013-01-01

Roč. 31, č. 1 (2013), s. 66-79 ISSN 1015-8987 R&D Projects: GA AV ČR(CZ) IAAX01110901 Institutional research plan: CEZ:AV0Z50110509 Institutional support: RVO:67985823 Keywords : hexokinase isoforms * akt kinase * left ventricle * right ventricle * mitochondria co-localization Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 3.550, year: 2013

Left and right ventricle assessment with Cardiac CT: validation study vs. Cardiac MR

Energy Technology Data Exchange (ETDEWEB)

Maffei, Erica; Seitun, Sara [Giovanni XXIII Hospital, Cardiovascular Radiology Unit, Monastier di Treviso (Italy); Messalli, Giancarlo; Catalano, Onofrio [SDN Foundation - IRCCS, Naples (Italy); Martini, Chiara; Cademartiri, Filippo [Giovanni XXIII Hospital, Cardiovascular Radiology Unit, Monastier di Treviso (Italy); Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Nieman, Koen; Rossi, Alexia; Mollet, Nico R. [Erasmus Medical Center, Department of Radiology and Cardiology, Rotterdam (Netherlands); Guaricci, Andrea I. [Azienda Ospedaliero-Universitaria di Foggia, Department of Cardiology, Foggia (Italy); Tedeschi, Carlo [Ospedale San Gennaro, Department of Cardiology, Naples (Italy)

2012-05-15

To compare Magnetic Resonance (MR) and Computed Tomography (CT) for the assessment of left (LV) and right (RV) ventricular functional parameters. Seventy nine patients underwent both Cardiac CT and Cardiac MR. Images were acquired using short axis (SAX) reconstructions for CT and 2D cine b-SSFP (balanced-steady state free precession) SAX sequence for MR, and evaluated using dedicated software. CT and MR images showed good agreement: LV EF (Ejection Fraction) (52 {+-} 14% for CT vs. 52 {+-} 14% for MR; r = 0.73; p > 0.05); RV EF (47 {+-} 12% for CT vs. 47 {+-} 12% for MR; r = 0.74; p > 0.05); LV EDV (End Diastolic Volume) (74 {+-} 21 ml/m{sup 2} for CT vs. 76 {+-} 25 ml/m{sup 2} for MR; r = 0.59; p > 0.05); RV EDV (84 {+-} 25 ml/m{sup 2} for CT vs. 80 {+-} 23 ml/m{sup 2} for MR; r = 0.58; p > 0.05); LV ESV (End Systolic Volume)(37 {+-} 19 ml/m{sup 2} for CT vs. 38 {+-} 23 ml/m{sup 2} for MR; r = 0.76; p > 0.05); RV ESV (46 {+-} 21 ml/m{sup 2} for CT vs. 43 {+-} 18 ml/m{sup 2} for MR; r = 0.70; p > 0.05). Intra- and inter-observer variability were good, and the performance of CT was maintained for different EF subgroups. Cardiac CT provides accurate and reproducible LV and RV volume parameters compared with MR, and can be considered as a reliable alternative for patients who are not suitable to undergo MR. circle Cardiac-CT is able to provide Left and Right Ventricular function. circle Cardiac-CT is accurate as MR for LV and RV volume assessment. (orig.)

Interaction of Left Ventricular Remodeling and Regional Dyssynchrony on Long-Term Prognosis after Cardiac Resynchronization Therapy

DEFF Research Database (Denmark)

Tayal, Bhupendar; Sogaard, Peter; Delgado-Montero, Antonia

2017-01-01

BACKGROUND: Left ventricular (LV) remodeling in heart failure (HF) manifested by chamber dilatation is associated with worse clinical outcomes. However, the impact of LV dilatation on the association of measures of dyssynchrony with long-term prognosis and resynchronization potential after cardiac...... resynchronization therapy (CRT) remains unclear. METHODS: Two hundred sixty CRT patients in New York Heart Association classes II to IV, with ejection fractions ≤ 35% and QRS intervals ≥ 120 msec, were prospectively studied. Quantitative echocardiographic assessment of LV volumes and mechanical dyssynchrony...... of the baseline indexed LV end-diastolic volume (EDVI). Patients with less dilated left ventricles (EDVI left ventricles (EDVI ≥ 90 mL/m(2)) for both primary (adjusted hazard ratio [HR], 2.20; 95% CI, 1.44-3.38; P

Rationale and Description of Right Ventricle-Protective Ventilation in ARDS.

Science.gov (United States)

Paternot, Alexis; Repessé, Xavier; Vieillard-Baron, Antoine

2016-10-01

Pulmonary vascular dysfunction is associated with ARDS and leads to increased right-ventricular afterload and eventually right-ventricular failure, also called acute cor pulmonale. Interest in acute cor pulmonale and its negative impact on outcome in patients with ARDS has grown in recent years. Right-ventricular function in these patients should be closely monitored, and this is helped by the widespread use of echocardiography in intensive care units. Because mechanical ventilation may worsen right-ventricular failure, the interaction between the lungs and the right ventricle appears to be a key factor in the ventilation strategy. In this review, a rationale for a right ventricle-protective ventilation approach is provided, and such a strategy is described, including the reduction of lung stress (ie, the limitation of plateau pressure and driving pressure), the reduction of PaCO2 , and the improvement of oxygenation. Prone positioning seems to be a crucial part of this strategy by protecting both the lungs and the right ventricle, resulting in increased survival of patients with ARDS. Further studies are required to validate the positive impact on prognosis of right ventricle-protective mechanical ventilation. Copyright © 2016 by Daedalus Enterprises.

Use of modified Harvard step test for the evaluation of exercise tolerance in patients with a functional single ventricle after total cavopulmonary connection

Directory of Open Access Journals (Sweden)

A. A. Tupikina

2016-01-01

Full Text Available According to the literature, nearly one-third of patients with congenital heart diseases have signs of heart failure. Objective: to assess the possibility and results of using a modified Harvard step test (MHST for the evaluation of exercise tolerance in children with a functional single ventricle. The investigation covered 110 healthy children aged 6 to 16 years and 29 patients aged 3 to 16 years with a functional single ventricle after total cavopulmonary connection with an extracardiac conduit a year after surgery and fenestration closure. MHST using a complete protocol was carried out in 44,8% of the patients. In the other examinees, the reason for stopping the test was premature muscle weakness and dyspnea. This could establish Functional Class (FC II heart failure in 55,2% of the sick children. In the examinees, the MHST index (MHSTI characterizing exercise tolerance ranged from 22,4 to 111. The median MHSTI scores significantly differed between the groups of patients with FC I and II heart failure (p=0,021. Exercise tolerance was lower in 17,2% of the patients with a functional single ventricle; in the others it was average and above average (41,5 and 41,3%, respectively, which was suggestive of good hemodynamic adaptation in patients after surgery. The findings prove the safety and efficiency of using the above test in the evaluation of exercise tolerance in children 3 years of age and older.

Exclusive double outlet right ventricle with atrioventricular concordance and pulmonary stenosis. Results of reconstructive surgery.

Science.gov (United States)

Busquet, J; Fontan, F; Choussat, A; Caianiello, G; Fernandez, G

1988-01-01

Double outlet right ventricle associated with atrioventricular concordance, pulmonary stenosis and situs solitus of the atria is a subset of double outlet right ventricle related through the surgical treatment. From 1974 to 1985, 14 patients, 5 males, 9 females (mean age 8.9 years, range 13 months-22 years) were operated upon. All patients had infundibular stenosis and normal or large pulmonary arteries. The apex of the heart was to the right in 2 patients, the right and left ventricles were superior and inferior in 2 patients and 1 patient had both anomalies. The ventricular septal defect was subaortic in 11 patients (aorto-mitral discontinuity in 5) and non-committed in 3 patients. Three patients had 2 ventricular septal defects. The aorta was anterior in 3 patients and to the right of the pulmonary artery in 11 patients. All patients, through a transventricular and transatrial approach, had a reconstructive surgery. In 3 patients, an aortic homograft valved conduit was used. One patient had the ventricular septal defect enlarged. There was one early death (7.1%) from high residual right ventricle pressure and no late death. One patient had a transient atrioventricular block. One patient was reoperated upon for a residual ventricular septal defect. All survivors had a good clinical result. Re-evaluation in 8 patients confirmed excellent haemodynamics: the right ventricle to pulmonary artery pressure gradient decreased from 80 mm Hg (range 60-95) preoperatively to 24 mm Hg (range 3-32) postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Is right ventricular mid-septal pacing superior to apical pacing in patients with high degree atrio-ventricular block and moderately depressed left ventricular function?

Science.gov (United States)

Chen, Kang; Mao, Ye; Liu, Shao-hua; Wu, Qiong; Luo, Qing-zhi; Pan, Wen-qi; Jin, Qi; Zhang, Ning; Ling, Tian-you; Chen, Ying; Gu, Gang; Shen, Wei-feng; Wu, Li-qun

2014-06-01

We are aimed to investigate whether right ventricular mid-septal pacing (RVMSP) is superior to conventional right ventricular apical pacing (RVAP) in improving clinical functional capacity and left ventricular ejection fraction (LVEF) for patients with high-degree atrio-ventricular block and moderately depressed left ventricle (LV) function. Ninety-two patients with high-degree atrio-ventricular block and moderately reduced LVEF (ranging from 35% to 50%) were randomly allocated to RVMSP (n=45) and RVAP (n=47). New York Heart Association (NYHA) functional class, echocardiographic LVEF, and distance during a 6-min walk test (6MWT) were determined at 18 months after pacemaker implantation. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured using an enzyme-linked immunosorbent assay (ELISA) kit. Compared with baseline, NYHA functional class remained unchanged at 18 months, distance during 6MWT (485 m vs. 517 m) and LVEF (36.7% vs. 41.8%) were increased, but BNP levels were reduced (2352 pg/ml vs. 710 pg/ml) in the RVMSP group compared with those in the RVAP group, especially in patients with LVEF 35%-40% (for all comparisons, Pfunction capacity and LV function measurements were not significantly changed in patients with RVAP, despite the pacing measurements being similar in both groups, such as R-wave amplitude and capture threshold. RVMSP provides a better clinical utility, compared with RVAP, in patients with high-degree atrioventricular block and moderately depressed LV function whose LVEF levels ranged from 35% to 40%.

Left ventricular regional myocardial motion and twist function in repaired tetralogy of Fallot evaluated by magnetic resonance tissue phase mapping

International Nuclear Information System (INIS)

Chang, Meng-Chu; Peng, Hsu-Hsia; Wu, Ming-Ting; Weng, Ken-Pen; Su, Mao-Yuan; Menza, Marius; Huang, Hung-Chieh

2018-01-01

We aimed to characterise regional myocardial motion and twist function in the left ventricles (LV) in patients with repaired tetralogy of Fallot (rTOF) and preserved LV global function. We recruited 47 rTOF patients and 38 age-matched normal volunteers. Tissue phase mapping (TPM) was performed for evaluating the LV myocardial velocity in longitudinal, radial, and circumferential (Vz, Vr, and VOe) directions in basal, middle, and apical slices. The VOe peak-to-peak (PTP) during systolic phases, the rotation angle of each slice, and VOe inconsistency were computed for evaluating LV twist function and VOe dyssynchrony. As compared to the controls, the rTOF patients presented decreased RV ejection fraction (RVEF) (p = 0.002) and preserved global LV ejection fraction (LVEF). They also demonstrated decreased systolic and diastolic Vz in several LV segments and higher diastolic Vr in the septum (all p < 0.05). A lower VOe PTP, higher VOe inconsistency, and reduced peak net rotation angle (all p < 0.05) were observed. The aforementioned indices demonstrated an altered LV twist function in rTOF patients in an early disease stage. MR TPM could provide information about early abnormalities of LV regional motion and twist function in rTOF patients with preserved LV global function. (orig.)

Left ventricular regional myocardial motion and twist function in repaired tetralogy of Fallot evaluated by magnetic resonance tissue phase mapping

Energy Technology Data Exchange (ETDEWEB)

Chang, Meng-Chu; Peng, Hsu-Hsia [National Tsing Hua University, Department of Biomedical Engineering and Environmental Sciences, Hsinchu (China); Wu, Ming-Ting [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (China); National Yang-Ming University, Faculty of Medicine, Taipei (China); Weng, Ken-Pen [National Yang-Ming University, Faculty of Medicine, Taipei (China); Kaohsiung Veterans General Hospital, Department of Pediatrics, Kaohsiung (China); Shu-Zen Junior College of Medicine and Management, Department of Physical Therapy, Kaohsiung (China); Su, Mao-Yuan [National Taiwan University Hospital, Department of Medical Imaging, Taipei (China); Menza, Marius [Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Department of Radiology, Medical Physics, Freiburg (Germany); Huang, Hung-Chieh [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (China)

2018-01-15

We aimed to characterise regional myocardial motion and twist function in the left ventricles (LV) in patients with repaired tetralogy of Fallot (rTOF) and preserved LV global function. We recruited 47 rTOF patients and 38 age-matched normal volunteers. Tissue phase mapping (TPM) was performed for evaluating the LV myocardial velocity in longitudinal, radial, and circumferential (Vz, Vr, and VOe) directions in basal, middle, and apical slices. The VOe peak-to-peak (PTP) during systolic phases, the rotation angle of each slice, and VOe inconsistency were computed for evaluating LV twist function and VOe dyssynchrony. As compared to the controls, the rTOF patients presented decreased RV ejection fraction (RVEF) (p = 0.002) and preserved global LV ejection fraction (LVEF). They also demonstrated decreased systolic and diastolic Vz in several LV segments and higher diastolic Vr in the septum (all p < 0.05). A lower VOe PTP, higher VOe inconsistency, and reduced peak net rotation angle (all p < 0.05) were observed. The aforementioned indices demonstrated an altered LV twist function in rTOF patients in an early disease stage. MR TPM could provide information about early abnormalities of LV regional motion and twist function in rTOF patients with preserved LV global function. (orig.)

The effect of childhood obesity on cardiac functions.

Science.gov (United States)

Üner, Abdurrahman; Doğan, Murat; Epcacan, Zerrin; Epçaçan, Serdar

2014-03-01

Obesity is a metabolic disorder defined as excessive accumulation of body fat, which is made up of genetic, environmental, and hormonal factors and has various social, psychological, and medical complications. Childhood obesity is a major indicator of adult obesity. The aim of this study is to evaluate the cardiac functions via electrocardiography (ECG), echocardiography (ECHO), and treadmill test in childhood obesity. A patient group consisting of 30 obese children and a control group consisting of 30 non-obese children were included in the study. The age range was between 8 and 17 years. Anthropometric measurements, physical examination, ECG, ECHO, and treadmill test were done in all patients. P-wave dispersion (PD) was found to be statistically significantly high in obese patients. In ECHO analysis, we found that end-diastolic diameter, end-systolic diameter, left ventricle posterior wall thickness, and interventricular septum were significantly greater in obese children. In treadmill test, exercise capacity was found to be significantly lower and the hemodynamic response to exercise was found to be defective in obese children. Various cardiac structural and functional changes occur in childhood obesity and this condition includes important cardiovascular risks. PD, left ventricle end-systolic and end-diastolic diameter, left ventricle posterior wall thickness, interventricular septum thickness, exercise capacity, and hemodynamic and ECG measurements during exercise testing are useful tests to determine cardiac dysfunctions and potential arrhythmias even in early stages of childhood obesity. Early recognition and taking precautions for obesity during childhood is very important to intercept complications that will occur in adulthood.

Treatment of right ventricle to pulmonary artery conduit stenosis in infants with hypoplastic left heart syndrome.

Science.gov (United States)

Münsterer, Andrea; Kasnar-Samprec, Jelena; Hörer, Jürgen; Cleuziou, Julie; Eicken, Andreas; Malcic, Ivan; Lange, Rüdiger; Schreiber, Christian

2013-09-01

To determine the incidence of right ventricle-to-pulmonary artery (RV-PA) conduit stenosis after the Norwood I operation in patients with hypoplastic left heart syndrome (HLHS), and to determine whether the treatment strategy of RV-PA conduit stenosis has an influence on interstage and overall survival. Ninety-six patients had a Norwood operation with RV-PA conduit between 2002 and 2011. Details of reoperations/interventions due to conduit obstruction prior to bidirectional superior cavopulmonary anastomosis (BSCPA) were collected. Overall pre-BSCPA mortality was 17%, early mortality after Norwood, 6%. Early angiography was performed in 34 patients due to desaturation at a median of 8 days after the Norwood operation. Fifteen patients (16%) were diagnosed with RV-PA conduit stenosis that required treatment. The location of the conduit stenosis was significantly different in the patients with non-ringed (proximal) and the patients with ring-enforced conduit (distal), P = 0.004. In 6 patients, a surgical revision of the conduit was performed; 3 of them died prior to BSCPA. Another 6 patients had a stent implantation and 3 were treated with balloon dilatation followed by a BSCPA in the subsequent 2 weeks. All patients who were treated interventionally for RV-PA conduit obstruction had a successful BSCPA. Patients who received a surgical RV-PA conduit revision had a significantly higher interstage (P = 0.044) and overall mortality (P = 0.011) than those who received a stent or balloon dilatation of the stenosis followed by an early BSCPA. RV-PA conduit obstruction after Norwood I procedure in patients with HLHS can be safely and effectively treated by stent implantation, balloon dilatation and early BSCPA. Surgical revision of the RV-PA conduit can be reserved for patients in whom an interventional approach fails, and an early BSCPA is not an option.

Angiographic determination of the left-ventricular myocardial volume with the help of digital image processing

International Nuclear Information System (INIS)

Radtke, W.

1981-01-01

In this paper, digital image processing could for the first time be introduced as a new method to screen the myocardium in the left-ventricular angiocardiography. The method makes a reliable quantitative determination of the muscle mass of the left ventricle possible. (orig./MG) [de

Functional and anatomical connectivity abnormalities in left inferior frontal gyrus in schizophrenia.

Science.gov (United States)

Jeong, Bumseok; Wible, Cynthia G; Hashimoto, Ryu-ichiro; Kubicki, Marek

2009-12-01

Functional studies in schizophrenia demonstrate prominent abnormalities within the left inferior frontal gyrus (IFG) and also suggest the functional connectivity abnormalities in language network including left IFG and superior temporal gyrus during semantic processing. White matter connections between regions involved in the semantic network have also been indicated in schizophrenia. However, an association between functional and anatomical connectivity disruptions within the semantic network in schizophrenia has not been established. Functional (using levels of processing paradigm) as well as diffusion tensor imaging data from 10 controls and 10 chronic schizophrenics were acquired and analyzed. First, semantic encoding specific activation was estimated, showing decreased activation within the left IFG in schizophrenia. Second, functional time series were extracted from this area, and left IFG specific functional connectivity maps were produced for each subject. In an independent analysis, tract-based spatial statistics (TBSS) was used to compare fractional anisotropy (FA) values between groups, and to correlate these values with functional connectivity maps. Schizophrenia patients showed weaker functional connectivity within the language network that includes left IFG and left superior temporal sulcus/middle temporal gyrus. FA was reduced in several white matter regions including left inferior frontal and left internal capsule. Finally, left inferior frontal white matter FA was positively correlated with connectivity measures of the semantic network in schizophrenics, but not in controls. Our results indicate an association between anatomical and functional connectivity abnormalities within the semantic network in schizophrenia, suggesting further that the functional abnormalities observed in this disorder might be directly related to white matter disruptions. 2009 Wiley-Liss, Inc.

[Bioelectrical activity of the myocardium in children born to parents irradiated during the Chernobyl disaster with isolated abnormal chords of the left ventricle].

Science.gov (United States)

Kondrashova, V H

2010-01-01

A total 156 children of the main group (children born to parents irradiated during the Chernobyl disaster), who according to echocardiography revealed a different number of isolated abnormal chords of the left ventricle, 20 healthy children, 24 children of nosological control group and 50 children of referent group have been observed. It was found that isolated AHLV in children born to irradiated parents, was associated with changes in standard ECG, reflecting the presence of arrhythmias or predictors of their development. No significant differences in subgroups of children with different number of isolated AHLV have been established. Children with isolated AHLV born to parents irradiated during the Chernobyl accident, as all patients with minor structural anomalies of the heart, should be refered to a risk group in connection with the possibility of the development, in the first place, ventricular extrasystoles, paroxysmal ventricular tachycardia. Early diagnosis of isolated AHLV will allow to assess the outlook for further course of the disease and develop a plan of treatment and preventive measures.

The Miracle Baby Grows Up: Hypoplastic Left Heart Syndrome in the Adult.

Science.gov (United States)

Lewis, Matthew; Rosenbaum, Marlon

2017-08-01

Hypoplastic left heart syndrome (HLHS) is characterized by underdevelopment of the mitral valve, left ventricle, and aorta and is ultimately palliated with a single-ventricle repair. Universally fatal in infancy prior to the advent of modern surgical techniques, the majority of HLHS patients will now reach adulthood. However, despite improvements in early survival, the HLHS population continues to face significant morbidity and early mortality. This review delineates common sources of patient morbidity and highlights areas in need of additional research for this growing segment of the adult congenital heart disease population. It has become increasingly clear that palliated adult single ventricle patients, like those with HLHS, face significant life-long morbidity from elevated systemic venous pressures as a consequence of the Fontan procedure. Downstream organ dysfunction secondary to elevated Fontan pressures has the potential to significantly impact long-term management decisions, including strategies of organ allocation. Because of the presence of a morphologic systemic right ventricle, HLHS patients may be at even higher risk than other adult patients with a Fontan. Because the adult HLHS population continues to grow, recognition of common sources of patient morbidity and mortality is becoming increasingly important. A coordinated effort between patients and providers is necessary to address the many remaining areas of clinical uncertainty to help ensure continued improvement in patient prognosis and quality of life.

Renal denervation improves cardiac function in rats with chronic heart failure: Effects on expression of β-adrenoceptors

Science.gov (United States)

Zheng, Hong; Liu, Xuefei; Sharma, Neeru M.

2016-01-01

Chronic activation of the sympathetic drive contributes to cardiac remodeling and dysfunction during chronic heart failure (HF). The present study was undertaken to assess whether renal denervation (RDN) would abrogate the sympathoexcitation in HF and ameliorate the adrenergic dysfunction and cardiac damage. Ligation of the left coronary artery was used to induce HF in Sprague-Dawley rats. Four weeks after surgery, RDN was performed, 1 wk before the final measurements. At the end of the protocol, cardiac function was assessed by measuring ventricular hemodynamics. Rats with HF had an average infarct area >30% of the left ventricle and left ventricular end-diastolic pressure (LVEDP) >20 mmHg. β1- and β2-adrenoceptor proteins in the left ventricle were reduced by 37 and 49%, respectively, in the rats with HF. RDN lowered elevated levels of urinary excretion of norepinephrine and brain natriuretic peptide levels in the hearts of rats with HF. RDN also decreased LVEDP to 10 mmHg and improved basal dP/dt to within the normal range in rats with HF. RDN blunted loss of β1-adrenoceptor (by 47%) and β2-adrenoceptor (by 100%) protein expression and improved isoproterenol (0.5 μg/kg)-induced increase in +dP/dt (by 71%) and −dP/dt (by 62%) in rats with HF. RDN also attenuated the increase in collagen 1 expression in the left ventricles of rats with HF. These findings demonstrate that RDN initiated in chronic HF condition improves cardiac function mediated by adrenergic agonist and blunts β-adrenoceptor expression loss, providing mechanistic insights for RDN-induced improvements in cardiac function in the HF condition. PMID:27288440

Effects of oral appliances and CPAP on the left ventricle and natriuretic peptides

NARCIS (Netherlands)

Hoekema, Aarnoud; Voors, Adriaan A.; Wijkstra, Peter J.; Stegenga, Boudewijn; van der Hoeven, Johannes H.; Tol, Cornelis G.; de Bont, Lambert G. M.

2008-01-01

Background: In patients without cardiac disease, obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with systolic and diastolic dysfunction and left ventricular hypertrophy. Although continuous positive airway pressure ( CPAP) therapy has been demonstrated to improve left ventricular

Increased angiotensin-converting enzyme activity in the left ventricle after infarction

Directory of Open Access Journals (Sweden)

V.C.W. Busatto

1997-05-01

Full Text Available An increase in angiotensin-converting enzyme (ACE activity has been observed in the heart after myocardial infarction (MI. Since most studies have been conducted in chronically infarcted individuals exhibiting variable degrees of heart failure, the present study was designed to determine ACE activity in an earlier phase of MI, before heart failure development. MI was produced in 3-month old male Wistar rats by ligation of the anterior branches of the left coronary artery, control rats underwent sham surgery and the animals were studied 7 or 15 days later. Hemodynamic data obtained for the anesthetized animals showed normal values of arterial blood pressure and of end-diastolic pressure in the right and left ventricular cavities of MI rats. Right and left ventricular (RV, LV muscle and scar tissue homogenates were prepared to determine ACE activity in vitro by measuring the velocity of His-Leu release from the synthetic substrate Hyp-His-Leu. ACE activity was corrected to the tissue wet weight and is reported as nmol His-Leu g-1 min-1. No significant change in ACE activity in the RV homogenates was demonstrable. A small nonsignificant increase of ACE activity (11 ± 9%; P0.05 was observed 7 days after MI in the surviving left ventricular muscle. Two weeks after surgery, however, ACE activity was 46 ± 11% (P<0.05 higher in infarcted rats compared to sham-operated rats. The highest ACE activity was demonstrable in the scar tissue homogenate. In rats studied two weeks after surgery, ACE activity in the LV muscle increased from 105 ± 7 nmol His-Leu g-1 min-1 in control hearts to 153 ± 11 nmol His-Leu g-1 min-1 (P<0.05 in the remaining LV muscle of MI rats and to 1051 ± 208 nmol His-Leu g-1 min-1 (P<0.001 in the fibrous scar. These data indicate that ACE activity increased in the heart after infarction before heart failure was demonstrable by hemodynamic measurements. Since the blood vessels of the scar drain to the remaining LV myocardium, the

Left atrial function in heart failure with impaired and preserved ejection fraction.

Science.gov (United States)

Fang, Fang; Lee, Alex Pui-Wai; Yu, Cheuk-Man

2014-09-01

Left atrial structural and functional changes in heart failure are relatively ignored parts of cardiac assessment. This review illustrates the pathophysiological and functional changes in left atrium in heart failure as well as their prognostic value. Heart failure can be divided into those with systolic dysfunction and heart failure with preserved ejection fraction (HFPEF). Left atrial enlargement and dysfunction commonly occur in systolic heart failure, in particular, in idiopathic dilated cardiomyopathy. Atrial enlargement and dysfunction also carry important prognostic value in systolic heart failure, independently of known parameters such as left ventricular ejection fraction. In HFPEF, there is evidence of left atrial enlargement, impaired atrial compliance, and reduction of atrial pump function. This occurs not only at rest but also during exercise, indicating significant impairment of atrial contractile reserve. Furthermore, atrial dyssynchrony is common in HFPEF. These factors further contribute to the development of new onset or progression of atrial arrhythmias, in particular, atrial fibrillation. Left atrial function is an integral part of cardiac function and its structural and functional changes in heart failure are common. As changes of left atrial structure and function have different clinical implications in systolic heart failure and HFPEF, routine assessment is warranted.

Transtentorial herniation of the fourth ventricle

International Nuclear Information System (INIS)

Rosenfeld, D.L.; Lis, E.; DeMarco, K.

1995-01-01

Transtentorial herniation (TTH) of the fourth ventricle is the result of a progressive enlargement of an isolated fourth ventricle which herniates through the tentorial incisure into the middle cranial fossa. The characteristic CT-MR and neurosonographic findings are described. (orig.)

Radiological evaluation of double-outlet right ventricle - An analysis of cinecardioangiography in 44 cases -

Energy Technology Data Exchange (ETDEWEB)

Park, Cheong Hee; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1984-03-15

Double-outlet right ventricle is defined as follows: both great arteries arise completely or nearly completely from the right ventricle; neither semilunar valve is in fibrous continuity with either atrioventricular valve; and usually a ventricular septal defect is present and the only outlet from the left ventricle. A total of 44 cases of double-outlet right ventricle is analyzed, in which cineangiocardiographies were done at the Department of Radiology, Seoul National University Hospital in recent 4 year and 6 months, with specific reference to the segmental combinations, the height of conus, the relationship of great arteries, the location of ventricular septal defects, and associated anomalies. The results were as follows; 1. Among 44 cases, 36 cases had normal cardiac position, 4 cases had dextrocardia with situs inversus 2 cases had dextrocardia with situs solitus, 1 case had levocardia with situs inversus, and another 1 case had mesocardia with situs ambiguus. 2. Segmental sets were [S,D,D] in 36 cases, [I,L,L] in 3 cases, [I,D,D] in 2 cases, [S,D,L], [S,L,L] and [A,D,D] in 1 case respectively. 3. All cases had bilateral conus. Aortic valve rings were same level as pulmonary valve rings in 25 cases, lower than pulmonary valve rings in 17 cases in which 15 cases were type A., and higher than pulmonary valve rings in 2 cases. 4. The relation of the great arteries were normal in 15 cases, side-by-side in 13 cases, dextromalposition in 13 cases, and levomal position in 3 cases. 5. The position of the ventricular septal defects with respect to the origins of the great arteries is subaortic (type A and type B) in 23 cases, subpulmonary (type C) in 13 cases, doubly committed (type D) in 3 cases, and uncommitted (type E) in 5 cases. 6. Associated cardiac malformations are pulmonary stenosis in 24 which had all cases of type A and type E, aortic stenosis in 6 which were only in type C, left SVC in 6, abnormality of atrioventricular valve in 5, single coronary artery

[Experts consensus on the management of the right heart function in critically ill patients].

Science.gov (United States)

Wang, X T; Liu, D W; Zhang, H M; Long, Y; Guan, X D; Qiu, H B; Yu, K J; Yan, J; Zhao, H; Tang, Y Q; Ding, X; Ma, X C; Du, W; Kang, Y; Tang, B; Ai, Y H; He, H W; Chen, D C; Chen, H; Chai, W Z; Zhou, X; Cui, N; Wang, H; Rui, X; Hu, Z J; Li, J G; Xu, Y; Yang, Y; Ouyan, B; Lin, H Y; Li, Y M; Wan, X Y; Yang, R L; Qin, Y Z; Chao, Y G; Xie, Z Y; Sun, R H; He, Z Y; Wang, D F; Huang, Q Q; Jiang, D P; Cao, X Y; Yu, R G; Wang, X; Chen, X K; Wu, J F; Zhang, L N; Yin, M G; Liu, L X; Li, S W; Chen, Z J; Luo, Z

2017-12-01

To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle. (2) Right heart function management is a key step of the hemodynamic therapy in critically ill patients. (3) Fluid resuscitation means the process of fluid therapy through rapid adjustment of intravascular volume aiming to improve tissue perfusion. Reversed fluid resuscitation means reducing volume. (4) The right ventricle afterload should be taken into consideration when using stroke volume variation (SVV) or pulse pressure variation (PPV) to assess fluid responsiveness.(5)Volume overload alone could lead to septal displacement and damage the diastolic function of the left ventricle. (6) The Starling curve of the right ventricle is not the same as the one applied to the left ventricle,the judgement of the different states for the right ventricle is the key of volume management. (7) The alteration of right heart function has its own characteristics, volume assessment and adjustment is an important part of the treatment of right ventricular dysfunction (8) Right ventricular enlargement is the prerequisite for increased cardiac output during reversed fluid resuscitation; Nonetheless, right heart enlargement does not mandate reversed fluid resuscitation.(9)Increased pulmonary vascular resistance induced by a variety of factors could affect right heart function by obstructing the blood flow. (10) When pulmonary hypertension was detected in clinical scenario, the differentiation of

Initial shunt type at the Norwood operation impacts myocardial function in hypoplastic left heart syndrome.

Science.gov (United States)

Ruotsalainen, Hanna K; Pihkala, Jaana; Salminen, Jukka; Hornberger, Lisa K; Sairanen, Heikki; Ojala, Tiina

2017-08-01

We investigated the impact of initial shunt type, a Blalock-Taussig (BT) shunt versus a right ventricle to pulmonary artery conduit (RV-PA) on myocardial function at different stages of surgical palliation in patients with hypoplastic left heart syndrome (HLHS). A population-based cohort of 63 Finnish children with HLHS (BT n  = 23, RV-PA n  = 40) born between 2003 and 2010 were studied retrospectively by echocardiography prior to Stages 1, 2 and 3 palliation and 0.5-3 years after Stage 3. For comparison of systolic myocardial function, we evaluated the RV fractional area change (FAC), strain, strain rate and mechanical synchrony from the apical 4-chamber view by velocity vector imaging. There were no intergroup differences in demographics during the study period. At baseline, no intergroup differences were detected in RV systolic myocardial function. Before Stage 2, RV FAC was higher ( P  = 0.03) in the RV-PA conduit group. At Stage 3, an increase in all systolic myocardial functional parameters was observed in the BT shunt group. After Stage 3, the BT shunt group had better RV systolic function. In multiple regression analysis, the shunt type and the stage of palliation had an impact on myocardial function. Although patients with HLHS initially palliated with a BT shunt demonstrate lower RV FAC after Stage I, RV FAC improves after Stage 2 with better systolic performance after Stage 3 compared with those initially palliated with an RV-PA conduit. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Disorders of cardiac hemodynamic in attack period of bronchial asthma in children

Directory of Open Access Journals (Sweden)

Kondratiev V.А.

2016-05-01

Full Text Available By dopplerechocardiography method there was studied functional state of cardiac ventricles and character of hemodynamic disorders in 48 patients aged 5-17 years in attack period of moderately-severe and severe bronchial asthma. Group of comparison included 40 healthy peers. Disorders of central and peripheral hemodynamic in attack period of bronchial asthma in children were accompanied both by systolic and diastolic dysfunction of the left and right heart ventricles, herewith right ventricle was functioning in the mode of hyperdynamic, and left one – in the mode of hypodynamic. Combined systolic-diastolic variant of dysfunction both of right and left ventricles was developing in 58,3% of patients with moderately-severe and in 91,6% of patients with severe bronchial asthma. In the attack period of bronchial asthma in children equal directionality of systolic and diastolic dysfunction of heart ventricles was developing; this was characterized by synchronization of their function. Assessment of functional interaction of the ventricles under conditions of severe asthma attack showed direct and high (r=0,67 correlative interaction between finding of Tei index of the left and right ventricles, which characterize their systolic function; this, under conditions of increased hemodynamic pre-loading testified to compensatory increase of systolic interaction of ventricles. Direct and high (r=0,69 correlative interaction between time indices of isovolumic relaxation of the left and right ventricles, characterizing their diastolic function, testified to compensatory increase of diastolic interaction of ventricles under conditions of increase of hemodynamic post-loading. Imbalance of central and peripheral link of hemodynamic in attack period of bronchial asthma in children testified to development of cardiac insufficiency, which was compensated predominantly at the expense of increase of heart contractions rate.

Iatrogenic Perforation of the Left Ventricle during Insertion of a Chest Drain

OpenAIRE

Kim, Dongmin; Lim, Seong-Hoon; Seo, Pil Won

2013-01-01

Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining ...

Congenital left ventricular wall abnormalities in adults detected by gated cardiac multidetector computed tomography: Clefts, aneurysms, diverticula and terminology problems

International Nuclear Information System (INIS)

Erol, Cengiz; Koplay, Mustafa; Olcay, Ayhan; Kivrak, Ali Sami; Ozbek, Seda; Seker, Mehmet; Paksoy, Yahya

2012-01-01

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.

Improving left ventricular segmentation in four-dimensional flow MRI using intramodality image registration for cardiac blood flow analysis.

Science.gov (United States)

Gupta, Vikas; Bustamante, Mariana; Fredriksson, Alexandru; Carlhäll, Carl-Johan; Ebbers, Tino

2018-01-01

Assessment of blood flow in the left ventricle using four-dimensional flow MRI requires accurate left ventricle segmentation that is often hampered by the low contrast between blood and the myocardium. The purpose of this work is to improve left-ventricular segmentation in four-dimensional flow MRI for reliable blood flow analysis. The left ventricle segmentations are first obtained using morphological cine-MRI with better in-plane resolution and contrast, and then aligned to four-dimensional flow MRI data. This alignment is, however, not trivial due to inter-slice misalignment errors caused by patient motion and respiratory drift during breath-hold based cine-MRI acquisition. A robust image registration based framework is proposed to mitigate such errors automatically. Data from 20 subjects, including healthy volunteers and patients, was used to evaluate its geometric accuracy and impact on blood flow analysis. High spatial correspondence was observed between manually and automatically aligned segmentations, and the improvements in alignment compared to uncorrected segmentations were significant (P  0.05). Our results demonstrate the efficacy of the proposed approach in improving left-ventricular segmentation in four-dimensional flow MRI, and its potential for reliable blood flow analysis. Magn Reson Med 79:554-560, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Simultaneous determination of left ventricular perfusion and function

International Nuclear Information System (INIS)

Gremillet, E.; Champailler, A.; Esquerre, J.P.; Ouhayoun, E.; Coca, F.; Furber, A.; Le Jeune, J.J.

1997-01-01

Myocardial perfusion scintigraphy is a very useful tool for the diagnosis and prognosis of coronary artery disease. The evaluation of left ventricular function during stress testing in also very useful to determine the prognosis of coronary artery disease. This chapter highlights three different imaging methods to assess left ventricular function and myocardial perfusion/ The first one consists of sequential dual isotope myocardial SPECT with ECG-gating. The second concerns magnetic resonance imaging and the third explores first pass exercise ventriculography and myocardial perfusion scintigraphy simultaneously evaluated by means of 99m Tc-sestamibi. (authors)

Studies of left ventricular volume estimation from single photon emission computed tomography

International Nuclear Information System (INIS)

Hiraki, Yoshio; Shimizu, Mitsuharu; Joja, Ikuo; Aono, Kaname; Yanagi, Hidekiyo; Indo, Haruaki; Seno, Yoshimasa; Teramoto, Shigeru; Nagaya, Isao.

1988-01-01

We studied the comparative accuracy of 99m Tc cardiac blood pool Single Photon Emission Computed Tomography (SPECT) for the measurement of left ventricular volume in 20 patients undergoing SPECT and single plane contrast left ventriculography (LVG). Left ventricular volume was calculated based on the total number of voxels in left ventricle. End-diastolic left ventricular volume (EDV) and end-systolic left ventricular volume (ESV) calculated from SPECT were compared with those from LVG. SPECT volume values showed a high degree of correlation with those by LVG (r = 0.923 for EDV, r = 0.903 for ESV). We appreciated the usefulness and accuracy of SPECT in measuring left ventricular volume because of its three-dimensional information. (author)

Annular subvalvular left ventricular aneurysm in Bahia, Brazil.

Science.gov (United States)

Guimarães, A C; Filho, A S; Esteves, J P; Abreu, W N; Vinhaes, L A; de Almeida Souza, J A; Machado, A

1976-10-01

Two cases of left ventricular aneurysm, a 16-year-old black boy and a 23-year-old white girl, from Bahia, Brazil, are presented. In both patients there was enlargement of the cardiac silhouette and a prominent bulge of the left inferior border. On the right oblique view a ring of calcium at the ventricular opening of the aneurysms was visualized. A left ventriculogram showed a huge aneurysm in the first case and a bulge on the lateral wall of the left ventricle in the other. Cardiac catheterization showed a rise in left and right ventricular end-diastolic pressures and in the mean pulmonary artery pressure. In the first case the contour of the right ventricular pressure curve showed a restrictive pattern. The similarities of these aneurysms with the annular submitral type described in young black Africans are stressed.

Visualization of hypertrophied papillary muscle mimicking left ventricular mass on gated blood pool and T1-201 myocardial perfusion imaging

International Nuclear Information System (INIS)

Bunko, H.; Nakajima, K.; Tonami, N.; Asanoi, H.; Hisada, K.

1981-01-01

A sixty-year old man with acute myocardial infarction was incidentally found to have a hypertrophied anterolateral papillary muscle (ALPPM) of the left ventricle on gated blood pool (GBP) and T1-201 myocardial perfusion images. Hypertrophy of the ALPPM was visualized as a movable defect in the lateral basal area on GBP imaging throughout the cardiac cycle and on the TI-201 study as a radionuclide accumulating structure, consistent with the defect in the GBP. A combination of these findings may suggest the presence of a hypertrophied papillary muscle of the left ventricle

Intracavitary ultrasound impairs left ventricular performance: presumed role of endocardial endothelium

NARCIS (Netherlands)

Gillebert, T. C.; de Hert, S. G.; Andries, L. J.; Jageneau, A. H.; Brutsaert, D. L.

1992-01-01

Irradiation of isolated cardiac muscle by high-power, high-frequency, continuous wave ultrasound selectively damages endocardial endothelium (EE). We evaluated this ultrasound effect in vivo on the performance of the intact ejecting canine left ventricle (LV). A cylindrical ultrasound probe (0.9

[Left ventricular projectile migration after an accidental close-range gunshot wound].

Science.gov (United States)

Driessen, A; Tjardes, T; Eikermann, C; Trojan, S; Fröhlich, M; Grimaldi, G; Kosse, N

2016-07-01

We report the case of a 24-year-old female after sustaining a shotgun wound in the left upper extremity and chest. Initial emergency diagnostics revealed numerous shotgun pellets scattered throughout the left-side soft tissue, chest and upper lung lobe with one pellet having migrated into the left ventricle of the heart.Due to the devastating injury pattern, gunshot wounds are interdisciplinarily challenging and should include extended initial diagnostics, such as contrast agent CT. The potential toxicity of elevated lead blood levels have to be taken into further account.

Functional measurements based on feature tracking of cine magnetic resonance images identify left ventricular segments with myocardial scar

Directory of Open Access Journals (Sweden)

Nylander Eva

2009-11-01

Full Text Available Abstract Background The aim of the study was to perform a feature tracking analysis on cine magnetic resonance (MR images to elucidate if functional measurements of the motion of the left ventricular wall may detect scar defined with gadolinium enhanced MR. Myocardial contraction can be measured in terms of the velocity, displacement and local deformation (strain of a particular myocardial segment. Contraction of the myocardial wall will be reduced in the presence of scar and as a consequence of reduced myocardial blood flow. Methods Thirty patients (3 women and 27 men were selected based on the presence or absence of extensive scar in the anteroseptal area of the left ventricle. The patients were investigated in stable clinical condition, 4-8 weeks post ST-elevation myocardial infarction treated with percutaneous coronary intervention. Seventeen had a scar area >75% in at least one anteroseptal segment (scar and thirteen had scar area Results In the scar patients, segments with scar showed lower functional measurements than remote segments. Radial measurements of velocity, displacement and strain performed better in terms of receiver-operator-characteristic curves (ROC than the corresponding longitudinal measurements. The best area-under-curve was for radial strain, 0.89, where a cut-off value of 38.8% had 80% sensitivity and 86% specificity for the detection of a segment with scar area >50%. As a percentage of the mean, intraobserver variability was 16-14-26% for radial measurements of displacement-velocity-strain and corresponding interobserver variability was 13-12-18%. Conclusion Feature tracking analysis of cine-MR displays velocity, displacement and strain in the radial and longitudinal direction and may be used for the detection of transmural scar. The accuracy and repeatability of the radial functional measurements is satisfactory and global measures agree.

Independence of intrapericardial right and left ventricular performance in septic pulmonary hypertension

International Nuclear Information System (INIS)

Boeck, J.C.; Eichstaedt, H.; Barker, B.C.; Lewis, F.R.; Lim, A.D.; Pollycove, M.

1990-01-01

To study the effect of septic pulmonary hypertension on right/left ventricular intrapericardial interactions thirteen trauma patients, seven septic and six nonseptic controls, were compared. Ventricular volumes were derived from firstpass or gated equilibrium radionuclide angiocardiography, and related to body surface area. Systemic and pulmonary pressures were measured invasively. Pulmonary arterial pressure was significantly increased in the sepsis group. Although right ventricular end-diastolic volumes were higher in sepsis, left ventricular end-diastolic volumes were not decreased. In terms of intrapericardial right/left ventricular interactions these results indicate that the right and left ventricles operate independently in septic pulmonary hypertension. (orig.) [de

Percutaneous Repair of Postoperative Mitral Regurgitation After Left Ventricular Assist Device Implant.

Science.gov (United States)

Cork, David P; Adamson, Robert; Gollapudi, Raghava; Dembitsky, Walter; Jaski, Brian

2018-02-01

Mitral regurgitation commonly improves after implantation of a left ventricular assist device without concomitant valvular repair owing to the mechanical unloading of the left ventricle. However, the development (or persistence) of significant mitral regurgitation after implantation of a left ventricular assist device is associated with adverse clinical events. We present a case of a left ventricular assist device patient who successfully underwent a percutaneous MitraClip procedure for repair of persistent late postoperative mitral insufficiency with demonstrable clinical and hemodynamic improvement. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Inter-observer variation in estimates by nuclear angiography of left ventricular ejection fraction and ejection rate

International Nuclear Information System (INIS)

Young, K.C.; Railton, R.

1980-01-01

The recent decline in the cost of computing has led to the introduction of data processing of gamma-camera images in many medical centres, allowing the development and widespread use of radionuclide techniques for assessing left ventricular performance. Methods such as ECG-gated blood-pool imaging have the advantage of being less invasive than contrast ventriculography and do not rely on geometrical assumptions about the shape of the ventricle. A study has been made of the inter-observer variation in estimates of ejection fraction and average and maximum systolic contraction rates using a micro-computer (VIP-450 Video Image Processor, Ohio-Nuclear Limited, Rugby) to analyse gated blood-pool images of the left ventricle. (author)

Normal and Pathological NCAT Image and Phantom Data Based on Physiologically Realistic Left Ventricle Finite-Element Models

International Nuclear Information System (INIS)

Veress, Alexander I.; Segars, W. Paul; Weiss, Jeffrey A.; Tsui, Benjamin M.W.; Gullberg, Grant T.

2006-01-01

The 4D NURBS-based Cardiac-Torso (NCAT) phantom, which provides a realistic model of the normal human anatomy and cardiac and respiratory motions, is used in medical imaging research to evaluate and improve imaging devices and techniques, especially dynamic cardiac applications. One limitation of the phantom is that it lacks the ability to accurately simulate altered functions of the heart that result from cardiac pathologies such as coronary artery disease (CAD). The goal of this work was to enhance the 4D NCAT phantom by incorporating a physiologically based, finite-element (FE) mechanical model of the left ventricle (LV) to simulate both normal and abnormal cardiac motions. The geometry of the FE mechanical model was based on gated high-resolution x-ray multi-slice computed tomography (MSCT) data of a healthy male subject. The myocardial wall was represented as transversely isotropichyperelastic material, with the fiber angle varying from -90 degrees at the epicardial surface, through 0 degrees at the mid-wall, to 90 degrees at the endocardial surface. A time varying elastance model was used to simulate fiber contraction, and physiological intraventricular systolic pressure-time curves were applied to simulate the cardiac motion over the entire cardiac cycle. To demonstrate the ability of the FE mechanical model to accurately simulate the normal cardiac motion as well abnormal motions indicative of CAD, a normal case and two pathologic cases were simulated and analyzed. In the first pathologic model, a subendocardial anterior ischemic region was defined. A second model was created with a transmural ischemic region defined in the same location. The FE based deformations were incorporated into the 4D NCAT cardiac model through the control points that define the cardiac structures in the phantom which were set to move according to the predictions of the mechanical model. A simulation study was performed using the FE-NCAT combination to investigate how the

Ventricle morphology in pelagic elasmobranch fishes.

Science.gov (United States)

Emery, S H; Mangano, C; Randazzo, V

1985-01-01

Ventricle weights of the warm-bodied great white shark, Atlantic shortfin mako, and the common thresher shark (the latter presumed to be warm-bodied) are similar to those of ectothermic blue sharks, sandbar sharks, dusky sharks, tiger sharks and scalloped hammerhead sharks. Ventricle muscularity, as estimated by the ratio of cortical to spongy layer thickness, is almost twice as great in the former three species than in the latter elasmobranchs. Measurements of ventricular volumes suggest that the ventricles of the great white, Atlantic shortfin mako and common thresher sharks are better adapted to respond to demands for increases in cardiac output via increased heartbeat frequency in comparison with ectothermic species of shark.

Evaluation of state-of-the-art segmentation algorithms for left ventricle infarct from late Gadolinium enhancement MR images.

Science.gov (United States)

Karim, Rashed; Bhagirath, Pranav; Claus, Piet; James Housden, R; Chen, Zhong; Karimaghaloo, Zahra; Sohn, Hyon-Mok; Lara Rodríguez, Laura; Vera, Sergio; Albà, Xènia; Hennemuth, Anja; Peitgen, Heinz-Otto; Arbel, Tal; Gonzàlez Ballester, Miguel A; Frangi, Alejandro F; Götte, Marco; Razavi, Reza; Schaeffter, Tobias; Rhode, Kawal

2016-05-01

Studies have demonstrated the feasibility of late Gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging for guiding the management of patients with sequelae to myocardial infarction, such as ventricular tachycardia and heart failure. Clinical implementation of these developments necessitates a reproducible and reliable segmentation of the infarcted regions. It is challenging to compare new algorithms for infarct segmentation in the left ventricle (LV) with existing algorithms. Benchmarking datasets with evaluation strategies are much needed to facilitate comparison. This manuscript presents a benchmarking evaluation framework for future algorithms that segment infarct from LGE CMR of the LV. The image database consists of 30 LGE CMR images of both humans and pigs that were acquired from two separate imaging centres. A consensus ground truth was obtained for all data using maximum likelihood estimation. Six widely-used fixed-thresholding methods and five recently developed algorithms are tested on the benchmarking framework. Results demonstrate that the algorithms have better overlap with the consensus ground truth than most of the n-SD fixed-thresholding methods, with the exception of the Full-Width-at-Half-Maximum (FWHM) fixed-thresholding method. Some of the pitfalls of fixed thresholding methods are demonstrated in this work. The benchmarking evaluation framework, which is a contribution of this work, can be used to test and benchmark future algorithms that detect and quantify infarct in LGE CMR images of the LV. The datasets, ground truth and evaluation code have been made publicly available through the website: https://www.cardiacatlas.org/web/guest/challenges. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Colloid cysts of the third ventricle

International Nuclear Information System (INIS)

Pina, J.I.; Medrano, J.; Benito, J.L. de; Lasierra, R.; Lopez, S.; Fernandez, J.A.; Villavieja, J.L.

1994-01-01

Colloid cysts (CC) are uncommon cystic endo dermal tumors located in the roof of the third ventricle. The clinical features depend on their capacity for obstructing the foramen of Monro, which results in univentricular or biventricular hydrocephalus. We present three cases of colloid cysts of the third ventricle, diagnosed by CT, reviewing their diagnostic, clinical and pathological features

Variation of left heart function and thyroid hormone in cirrhosis

International Nuclear Information System (INIS)

Liu Junchi; Du Sujun; Mao Shaorong; Lu Jun; Tang Xiaoling

1996-01-01

The observation of 52 cases of cirrhosis left heart function indices traced with 113 In m in quiet and motion, and the combining determination of thyroid hormone serum levels with RIA are described. The cirrhosis to the function of liver damage increased, the indices of left heart function has great change. Moreover, the serum levels of T 3 , FT 3 in thyroid hormone are decreased obviously and the serum level of rT 3 is also increased significantly

[Multiple coronary fistulas to the left ventricle. An unusual cause of myocardial ischemia].

Science.gov (United States)

Piovaccari, G; Melandri, G; Marzocchi, A; Scarfoglio, D; Sanguinetti, M; Magnani, B

1989-04-01

Diffuse communications between the left coronary artery and the left ventricular cavity were found in a 54-years-old man presenting with angina pectoris and reversible ischemia documented on stress Thallium scintigraphy. During atrial pacing the patient experienced chest pain which was accompanied by lactate production. Atenolol, but not nifedipine, did ameliorate the symptoms. The anatomical types and the embriogenesis of coronary microfistulas along with possible mechanisms of ischemia are discussed.

Measuring Regional Changes in the Diastolic Deformation of the Left Ventricle of SHR Rats Using microPET Technology and Hyperelastic Warping

International Nuclear Information System (INIS)

Gullberg, Grant T; VERESS, ALEXANDER I.; WEISS, JEFFREY A.; HUESMAN, RONALD H.; REUTTER, BRYAN W.; TAYLOR, SCOTT E.; SITEK, AREK; FENG, BING; YANG, YONGFENG; GULLBERG, GRANT T.

2008-01-01

The objective of this research was to assess applicability of a technique known as hyperelastic warping for the measurement of local strains in the left ventricle (LV) directly from microPET image data sets. The technique uses differences in image intensities between template (reference) and target (loaded) image data sets to generate a body force that deforms a finite element (FE) representation of the template so that it registers with the target images. For validation, the template image was defined as the end-systolic microPET image data set from a Wistar Kyoto (WKY) rat. The target image was created by mapping the template image using the deformation results obtained from a FE model of diastolic filling. Regression analysis revealed highly significant correlations between the simulated forward FE solution and image derived warping predictions for fiber stretch (R2 = 0.96), circumferential strain (R2 = 0.96), radial strain (R2 = 0.93), and longitudinal strain (R2 = 0.76) (p < 0.001 for all cases). The technology was applied to microPET image data of two spontaneously hypertensive rats (SHR) and a WKY control. Regional analysis revealed that, the lateral freewall in the SHR subjects showed the greatest deformation compared with the other wall segments. This work indicates that warping can accurately predict the strain distributions during diastole from the analysis of microPET data sets

Measuring Regional Changes in the Diastolic Deformation of the Left Ventricle of SHR Rats Using microPET Technology and Hyperelastic Warping

Energy Technology Data Exchange (ETDEWEB)

Gullberg, Grant T; VERESS , ALEXANDER I.; WEISS, JEFFREY A.; HUESMAN, RONALD H.; REUTTER, BRYAN W.; TAYLOR , SCOTT E.; SITEK , AREK; FENG, BING; YANG , YONGFENG; GULLBERG, GRANT T.

2008-04-04

The objective of this research was to assess applicability of a technique known as hyperelastic warping for the measurement of local strains in the left ventricle (LV) directly from microPET image data sets. The technique uses differences in image intensities between template (reference) and target (loaded) image data sets to generate a body force that deforms a finite element (FE) representation of the template so that it registers with the target images. For validation, the template image was defined as the end-systolic microPET image data set from a Wistar Kyoto (WKY) rat. The target image was created by mapping the template image using the deformation results obtained from a FE model of diastolic filling. Regression analysis revealed highly significant correlations between the simulated forward FE solution and image derived warping predictions for fiber stretch (R2 = 0.96), circumferential strain (R2 = 0.96), radial strain (R2 = 0.93), and longitudinal strain (R2 = 0.76) (p<0.001for all cases). The technology was applied to microPET image data of two spontaneously hypertensive rats (SHR) and a WKY control. Regional analysis revealed that, the lateral freewall in the SHR subjects showed the greatest deformation compared with the other wall segments. This work indicates that warping can accurately predict the strain distributions during diastole from the analysis of microPET data sets.

Exercise Training in Athletes with Bicuspid Aortic Valve Does Not Result in Increased Dimensions and Impaired Performance of the Left Ventricle

Directory of Open Access Journals (Sweden)

Laura Stefani

2014-01-01

Full Text Available Background. Bicuspid aortic valve (BAV is one of the most common congenital heart disease (0.9%–2% and is frequently found in the athletes and in the general population. BAV can lead to aortic valve dysfunction and to a progressive aortic dilatation. Trained BAV athletes exhibit a progressive enlargement of the left ventricle (LV compared to athletes with normal aortic valve morphology. The present study investigates the possible relationship between different aortic valve morphology and LV dimensions. Methods. In the period from 2000 to 2011, we investigated a total of 292 BAV subjects, divided into three different groups (210 athletes, 59 sedentaries, and 23 ex-athletes. A 2D echocardiogram exam to classify BAV morphology and measure the standard LV systo-diastolic parameters was performed. The study was conducted as a 5-year follow-up echocardiographic longitudinal and as cross-sectional study. Results. Typical BAV was more frequent in all three groups (68% athletes, 67% sedentaries, and 63% ex-athletes than atypical. In BAV athletes, the typical form was found in 51% (107/210 of soccer players, 10% (21/210 of basketball players, 10% track and field athletics (20/210, 8% (17/210 of cyclists, 6% (13/210 swimmers, and 15% (32/210 of rugby players and others sport. Despite a progressive enlargement of the LV (P<0.001 observed during the follow-up study, no statistical differences of the LV morphology and function were evident among the diverse BAV patterns either in sedentary subjects or in athletes. Conclusion. In a large population of trained BAV athletes, with different prevalence of typical and atypical BAV type, there is a progressive nonstatistically significant enlargement of the LV. In any case, the dimensions of the LV remained within normal range. The metabolic requirements of the diverse sport examined in the present investigations do not seem to produce any negative impact in BAV athletes

New and emerging biomarkers in left ventricular systolic dysfunction--insight into dilated cardiomyopathy.

Science.gov (United States)

Gopal, Deepa M; Sam, Flora

2013-08-01

Dilated cardiomyopathy (DCM) is characterized by deteriorating cardiac performance, impaired contraction and dilation of the left ventricle (or both ventricles). Blood markers--known as "biomarkers"--allow insight into underlying pathophysiologic mechanisms and biologic pathways while predicting outcomes and guiding heart failure management and/or therapies. In this review, we provide an alternative approach to conceptualize heart failure biomarkers: the cardiomyocyte, its surrounding microenvironment, and the macroenvironment, integrating these entities which may impact cellular processes involved in the pathogenesis and/or propagation of DCM. Newer biomarkers of left ventricular systolic dysfunction can be categorized under: (a) myocyte stress and stretch, (b) myocyte apoptosis, (c) cardiac interstitium, (d) inflammation, (e) oxidative stress, (f) cardiac energetics, (g) neurohormones, and (h) renal biomarkers. Biomarkers provide insight into the pathogenesis of DCM while predicting and potentially providing prognostic information in these patients with heart failure.

Parvalbumin-expressing ependymal cells in rostral lateral ventricle wall adhesions contribute to aging-related ventricle stenosis in mice.

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Filice, Federica; Celio, Marco R; Babalian, Alexandre; Blum, Walter; Szabolcsi, Viktoria

2017-10-15

Aging-associated ependymal-cell pathologies can manifest as ventricular gliosis, ventricle enlargement, or ventricle stenosis. Ventricle stenosis and fusion of the lateral ventricle (LV) walls is associated with a massive decline of the proliferative capacities of the stem cell niche in the affected subventricular zone (SVZ) in aging mice. We examined the brains of adult C57BL/6 mice and found that ependymal cells located in the adhesions of the medial and lateral walls of the rostral LVs upregulated parvalbumin (PV) and displayed reactive phenotype, similarly to injury-reactive ependymal cells. However, PV+ ependymal cells in the LV-wall adhesions, unlike injury-reactive ones, did not express glial fibrillary acidic protein. S100B+/PV+ ependymal cells found in younger mice diminished in the LV-wall adhesions throughout aging. We found that periventricular PV-immunofluorescence showed positive correlation to the grade of LV stenosis in nonaged mice (wall adhesions and LV stenosis was significantly lower in mid-aged (>10-month-old) PV-knock out (PV-KO) mice. This suggests an involvement of PV+ ependymal cells in aging-associated ventricle stenosis. Additionally, we observed a time-shift in microglial activation in the LV-wall adhesions between age-grouped PV-KO and wild-type mice, suggesting a delay in microglial activation when PV is absent from ependymal cells. Our findings implicate that compromised ependymal cells of the adhering ependymal layers upregulate PV and display phenotype shift to "reactive" ependymal cells in aging-related ventricle stenosis; moreover, they also contribute to the progression of LV-wall fusion associated with a decline of the affected SVZ-stem cell niche in aged mice. © 2017 Wiley Periodicals, Inc.

A young patient with atypical type-B Wolff–Parkinson–White syndrome accompanied by left ventricular dysfunction

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Takeuchi, Takahiro; Tomita, Takeshi; Kasai, Hiroki; Kashiwagi, Daisuke; Yoshie, Koji; Yaguchi, Tomonori; Oguchi, Yasutaka; Kozuka, Ayako; Gautam, Milan; Motoki, Hirohiko; Okada, Ayako; Shiba, Yuji; Aizawa, Kazunori; Izawa, Atsushi; Miyashita, Yusuke; Koyama, Jun; Hongo, Minoru; Ikeda, Uichi

2014-01-01

A 15-year-old asymptomatic male patient presented with an electrocardiographic abnormality and left ventricular (LV) dysfunction (left ventricle ejection fraction of 40%) in a physical examination performed 2 years previously. LV dysfunction did not improve despite optimal medical therapy for dilated cardiomyopathy. Twelve-lead electrocardiography revealed a normal PR interval (138 ms) with a small delta-like wave in V2, but not a typical diagnostic wave that could be diagnosed as Wolff–Parkinson–White (WPW) syndrome by an electrocardiogram auto-analysis. Transthoracic echocardiography showed a remarkable asynchronous septal motion. An electrophysiological study was performed to exclude WPW syndrome. An accessory pathway (AP) was revealed on the lateral wall of the right ventricle, and radiofrequency catheter ablation was successfully performed to disconnect the AP. Thereafter, the dyssynchrony disappeared, and LV function improved. The intrinsic atrioventricular nodal conduction was very slow (A-H, 237 ms). The results of electrocardiogram auto-analysis could not be used to confirm the diagnosis of WPW syndrome because of the atypical delta wave. Conduction via the right lateral AP caused electrical dyssynchrony in the LV. This case suggests that atypical delta waves should be evaluated without depending on electrocardiographic auto-analyses in patients with LV dysfunction accompanied by dyssynchrony. PMID:26336525

A young patient with atypical type-B Wolff–Parkinson–White syndrome accompanied by left ventricular dysfunction

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Takahiro Takeuchi, MD

2015-02-01

Full Text Available A 15-year-old asymptomatic male patient presented with an electrocardiographic abnormality and left ventricular (LV dysfunction (left ventricle ejection fraction of 40% in a physical examination performed 2 years previously. LV dysfunction did not improve despite optimal medical therapy for dilated cardiomyopathy. Twelve-lead electrocardiography revealed a normal PR interval (138 ms with a small delta-like wave in V2, but not a typical diagnostic wave that could be diagnosed as Wolff–Parkinson–White (WPW syndrome by an electrocardiogram auto-analysis. Transthoracic echocardiography showed a remarkable asynchronous septal motion. An electrophysiological study was performed to exclude WPW syndrome. An accessory pathway (AP was revealed on the lateral wall of the right ventricle, and radiofrequency catheter ablation was successfully performed to disconnect the AP. Thereafter, the dyssynchrony disappeared, and LV function improved. The intrinsic atrioventricular nodal conduction was very slow (A-H, 237 ms. The results of electrocardiogram auto-analysis could not be used to confirm the diagnosis of WPW syndrome because of the atypical delta wave. Conduction via the right lateral AP caused electrical dyssynchrony in the LV. This case suggests that atypical delta waves should be evaluated without depending on electrocardiographic auto-analyses in patients with LV dysfunction accompanied by dyssynchrony.

Global and regional left ventricular function and tomographic radionuclide perfusion: the Western Washington Intracoronary Streptokinase In Myocardial Infarction Trial

International Nuclear Information System (INIS)

Ritchie, J.L.; Davis, K.B.; Williams, D.L.; Caldwell, J.; Kennedy, J.W.

1984-01-01

The Western Washington Intracoronary Streptokinase In Myocardial Infarction Trial enrolled 250 patients with acute myocardial infarction. After the coronary angiographic diagnosis of thrombosis, patients were randomly assigned to receive either conventional therapy with heparin or intracoronary streptokinase followed by heparin. Of the 232 patients who survived at least 60 days, 207 (89%) underwent radionuclide ventriculographic determination of global and regional ejection fraction at a single institution at 62 +/- 35 days after infarction. In the first 100 patients, infarct size was also determined by quantitative single-photon emission tomographic imaging with thallium-201 ( 201 Tl) and expressed as a percentage of the left ventricle with a perfusion defect. Overall, global ejection fraction did not differ between patients treated with streptokinase (45.9 +/- 13.9%; n . 115) and control patients (46.1 +/- 14.4%; n . 92, p . NS). Similarly, the regional posterolateral, inferior, and anteroseptal ejection fraction did not differ between the two groups. Infarct size as measured by 201 Tl tomography was 19.4 +/- 12.8% (n . 52) of the left ventricle for the streptokinase group and 19.6 +/- 11.8% (n . 48; p . NS) for the control group. When patients were compared within groups by electrocardiographic location of infarction, time to treatment, or the presence or absence of vessel opening, there were no significant differences between streptokinase and control patients. Statistical inclusion of the 18 patients who died early and were unavailable for study also failed to modify the results, except for a possible reduction in inferior infarct size as measured by 201 Tl tomography

Hypoplastic left heart syndrome

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Thiagarajan Ravi

2007-05-01

Full Text Available Abstract Hypoplastic left heart syndrome(HLHS refers to the abnormal development of the left-sided cardiac structures, resulting in obstruction to blood flow from the left ventricular outflow tract. In addition, the syndrome includes underdevelopment of the left ventricle, aorta, and aortic arch, as well as mitral atresia or stenosis. HLHS has been reported to occur in approximately 0.016 to 0.036% of all live births. Newborn infants with the condition generally are born at full term and initially appear healthy. As the arterial duct closes, the systemic perfusion becomes decreased, resulting in hypoxemia, acidosis, and shock. Usually, no heart murmur, or a non-specific heart murmur, may be detected. The second heart sound is loud and single because of aortic atresia. Often the liver is enlarged secondary to congestive heart failure. The embryologic cause of the disease, as in the case of most congenital cardiac defects, is not fully known. The most useful diagnostic modality is the echocardiogram. The syndrome can be diagnosed by fetal echocardiography between 18 and 22 weeks of gestation. Differential diagnosis includes other left-sided obstructive lesions where the systemic circulation is dependent on ductal flow (critical aortic stenosis, coarctation of the aorta, interrupted aortic arch. Children with the syndrome require surgery as neonates, as they have duct-dependent systemic circulation. Currently, there are two major modalities, primary cardiac transplantation or a series of staged functionally univentricular palliations. The treatment chosen is dependent on the preference of the institution, its experience, and also preference. Although survival following initial surgical intervention has improved significantly over the last 20 years, significant mortality and morbidity are present for both surgical strategies. As a result pediatric cardiologists continue to be challenged by discussions with families regarding initial decision

Left ventricular responses to dopamine in dilated cardiomyopathy as assessed by two-dimensional echocardiography and compared with findings of thallium-201 scintigraphy

International Nuclear Information System (INIS)

Oda, Hirotaka

1987-01-01

The effects of dopamine on the left ventricular regional wall motion were studied in 11 patients with dilated cardiomyopathy by use of two-dimentional echocardiography and compared with the findings on the uptake of thallium-201. There were no significant changes in heart rate after dopamine infusion (6 μg/kg/min). However, the administration of dopamine significantly reduced PEP/ET and increased the systolic blood pressure, fractional shortening, ejection fraction and mV cf. The percentage of segments with reduced thallium-uptake area was significantly higher in abnormal wall motion segments than in normal wall segments both before and after dopamine administration. The percentage of segments with reduced thallium-uptake area was significantly higher in abnormal wall motion segments after loading than in normal wall segments before loading or in dopamine responding segments. However, in reduced uptake area, the asynergy of the left ventricle was improved significantly after dopamine administration. These results demonstrated that the abnormality of Tl-uptake was correlated roughly to the asynergy of the left ventricle, but that the state of remaining myocardium was not necessarily evaluated correctly by Tl-uptake. Dopamine loading seemed to be useful for more accurate evaluation of myocardial residual function. (author)

Regional wall movement of the left ventricle in coronary heat diseases

International Nuclear Information System (INIS)

Schad, N.

1979-01-01

The regional wall movement of the left ventriculus is a substantial criterion for the treatment of coronary heart diseases. The non-invasive and riskless intravenous injections of a bolus of Technetium 99m-Pertechnetat and the recording of the first passage through the heart allow to present the regional wall movement of the left ventriculus and, in addition, to make a statement on the haemodynamic feed back effects on lungs and the right heart. The congruency with the wall movement determined invasively, in the contrast substance angiocardiogram, is high both for the normokinesis and for hypo-, A - and dyskinesis (90-92%). The examination proved good in following groups of patients and makes the decision on the further proceding easier: 1) After myocardial infarction. 2) In ishaemia-ECG or persistent ST-elevation. 3) In unstable progressive angina pectoris. 4) In unclear breast aches and negative ECG on exertion. 5) For course control after conservative and surgial therapy. The myocardial reserve can be shown using a after nitroglycerin administration. An investigation on exertion can find out affected vessel territories in the circulation. (orig.) [de

Right and Left Ventricular Function and Mass in Male Elite Master Athletes: A Controlled Contrast-Enhanced Cardiovascular Magnetic Resonance Study.

Science.gov (United States)

Bohm, Philipp; Schneider, Günther; Linneweber, Lutz; Rentzsch, Axel; Krämer, Nadine; Abdul-Khaliq, Hashim; Kindermann, Wilfried; Meyer, Tim; Scharhag, Jürgen

2016-05-17

It is under debate whether the cumulative effects of intensive endurance exercise induce chronic cardiac damage, mainly involving the right heart. The aim of this study was to examine the cardiac structure and function in long-term elite master endurance athletes with special focus on the right ventricle by contrast-enhanced cardiovascular magnetic resonance. Thirty-three healthy white competitive elite male master endurance athletes (age range, 30-60 years) with a training history of 29±8 years, and 33 white control subjects pair-matched for age, height, and weight underwent cardiopulmonary exercise testing, echocardiography including tissue-Doppler imaging and speckle tracking, and cardiovascular magnetic resonance. Indexed left ventricular mass and right ventricular mass (left ventricular mass/body surface area, 96±13 and 62±10 g/m(2); Pright ventricular mass/body surface area, 36±7 and 24±5 g/m(2); Pleft ventricular end-diastolic volume and right ventricular end-diastolic volume (left ventricular end-diastolic volume/body surface area, 104±13 and 69±18 mL/m(2); Pright ventricular end-diastolic volume/body surface area, 110±22 and 66±16 mL/m(2); PRight ventricular ejection fraction did not differ between athletes and control subjects (52±8 and 54±6%; P=0.26). Pathological late enhancement was detected in 1 athlete. No correlations were found for left ventricular and right ventricular volumes and ejection fraction with N-terminal pro-brain natriuretic peptide, and high-sensitive troponin was negative in all subjects. Based on our results, chronic right ventricular damage in elite endurance master athletes with lifelong high training volumes seems to be unlikely. Thus, the hypothesis of an exercise-induced arrhythmogenic right ventricular cardiomyopathy has to be questioned. © 2016 American Heart Association, Inc.

Aortopathy in Congenital Heart Disease in Adults: Aortic Dilatation with Decreased Aortic Elasticity that Impacts Negatively on Left Ventricular Function.

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Niwa, Koichiro

2013-04-01

Bicuspid aortic valve and/or coarctation of the aorta are consistently associated with ascending aortic and para-coarctation medial abnormalities. Medial abnormalities in the ascending aorta are prevalent in other types of patients with a variety of forms congenital heart disease (CHD), such as single ventricle, persistent truncus arteriosus, transposition of the great arteries, hypoplastic left heart syndrome, tetralogy of Fallot. These abnormalities encompass a wide age range, and may predispose to dilatation, aneurysm, and rupture that necessitates aortic valve and root surgery. This dilatation can develop in CHD patients without stenotic region. These CHDs exhibit ongoing dilatation of the aortic root and reduced aortic elasticity and increased aortic stiffness that may relate to intrinsic properties of the aortic root. The concept of aortic dilatation is shifting a paradigm of aortic dilatation, as so called post stenotic dilatation, to primary intrinsic aortopahy. These aortic dilatation and increased stiffness can induce aortic aneurysm, rupture of the aorta and aortic regurgitation, but also provoke left ventricular hypertrophy, reduced coronary artery flow and left ventricular failure. We can recognize this association of aortic pathophysiological abnormality, aortic dilation and aorto-left ventricular interaction as a new clinical entity: "aortopathy".

OSTEOPONTIN, INTERLEUKIN-15 AND DYSFUNCTION OF LEFT VENTRICULAR MYOCARDIUM IN HYPERTENSIVE PATIENTS WITH CHRONIC HEART FAILURE

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O. M. Kovalyova

2016-12-01

Full Text Available Based on a survey of 108 patients with hypertension complicated by chronic heart failure, studied the connection concentration of osteopontin, interleukin-15 inserum and morpho-functional characteristics of the left ventricle of the heart. In patients with CHF osteopontin levels were significantly higher, it revealed a relationship between adverse LV filling state and knots in serum osteopontin, while the level of IL-15 did not show such a relationship. The results indicate the potential value of osteopontin as a biomarker for the diagnosis of CHF.

The position of the left and right ventricular outlets during septation. A comparison of chicken and rat development

NARCIS (Netherlands)

Wagenaar, J. A.; Lamers, W. H.; Los, J. A.

1986-01-01

A comparative study was made of the relative position of the outflow tracts of chicken and rat hearts with respect to the ventricles during septation. For this purpose the position of the left and right ventricular outlet including the aortic and pulmonary valve primordia and the left and right

Effect of coronary artery recanalization on right ventricular function in patients with acute myocardial infarction

International Nuclear Information System (INIS)

Verani, M.S.; Tortoledo, F.E.; Batty, J.W.; Raizner, A.E.

1985-01-01

The effects of coronary artery recanalization by intracoronary administration of streptokinase on left ventricular function during acute myocardial infarction have received increasing attention in recent years. Although myocardial dysfunction is often more pronounced in the right ventricle than in the left ventricle in patients with acute inferior wall myocardial infarction, the effect of coronary artery recanalization on right ventricular dysfunction has not been previously addressed. Accordingly, in this investigation, 54 patients who participated in a prospective, controlled, randomized trial of recanalization during acute myocardial infarction were studied. Among 30 patients with inferior wall infarction, 19 had right ventricular dysfunction on admission; 11 of these 19 had positive uptake of technetium-99m pyrophosphate in the right ventricle, indicative of right ventricular infarction. Patients with successful recanalization exhibited improved right ventricular ejection fraction from admission to day 10. However, control patients and patients who did not undergo recanalization also exhibited improvement. These data indicate that the right ventricular dysfunction commonly associated with inferior wall infarction is often transient, and improvement is the rule, irrespective of early recanalization of the infarct vessel

Effect of race on the timing of the Glenn and Fontan procedures for single-ventricle congenital heart disease.

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Ingaramo, Oscar A; Khemani, Robinder G; Markovitz, Barry P; Epstein, David

2012-03-01

Disparities in health care have been documented between different racial groups in the United States. We hypothesize that there will be racial variance in the timing of the Glenn and Fontan procedures for children with single-ventricle physiology. We performed a retrospective review of a national pediatric intensive care unit database (Virtual PICU Performance System, LLC). Children with hypoplastic left heart syndrome, tricuspid atresia, and common ventricle, admitted from January 2006 to July 2008, were included. Data included race, weight, age, medical length of stay, Paediatric Index of Mortality 2 score, and survival. None. There were 423 patients from 29 hospitals. The study population was 7.6% black, 13.0% Hispanic, 59.8% white, 9.2% "other," and 11.6% had missing racial/ethnic information. Diagnoses included 255 patients with hypoplastic left heart syndrome, 91 with tricuspid atresia, and 77 with common ventricle. The median age for the Glenn procedure (n = 205) was 5.5 months (interquartile range, 4.6-7.0 months) and 39.7 months (interquartile range, 32.4-50.6 months) for the Fontan procedure (n = 218). There was no difference between the median age at the time of the Glenn or Fontan procedures between the different racial/ethnic groups (p = .65 and p = .16, respectively). The medical length of intensive care unit stay for patients receiving the Glenn and Fontan procedures was 3.7 days (interquartile range, 1.9-6.1 days) and 3.7 days (interquartile range, 1.9-6.8 days), respectively. There were no differences in medical length of intensive care unit stay for the Glenn procedure between the different racial/ethnic groups (p = .21). Hispanic patients had a longer medical length of intensive care unit stay (6.3 days; interquartile range, 3.1-9.9 days) than white patients (2.9 days; interquartile range, 1.8-5.3 days) for the Fontan procedure (p = .008). The timing of single-ventricle palliative procedures was not affected by race/ethnicity.

Double chambered right ventricle

International Nuclear Information System (INIS)

Cho, Chul Koo; Yu, Yun Jeong; Yeon, Kyung Mo; Han, Man Chung

1983-01-01

Fourteen cases of double chambered right ventricle were diagnosed angiographically and of these nine cases were confirmed after operation and autopsy at Seoul National University Hospital in recent four years since 1979. The clinical and radiological findings with the emphasis on the cinecardiographic findings were analysed. The summaries of the analysis are as follows: 1. Among 14 cases, 6 cases were male and 8 cases were female. Age distribution was from 4 years to 36 years. 2. In chest x-ray findings, pulmonary vascularity was increased in 8 cases, decreased in 4 cases, and normal in 2 cases. Cardiomegaly was observed in 8 cases and other showed normal heart size. 3. In cinecardiography, 11 cases had interventricular septal defect. Among these 11 cases, VSD located in proximal high pressure chamber was in 2 cases and located in distal low pressure chamber was in 9 cases. 4. The location of aberrant muscle bundle in sinus portion of right ventricle was in 8 cases. In the rest 6 cases, the aberrant muscle bundle was located below the infundibulum of right ventricle. 5. For accurate diagnosis and differential diagnosis with other congenital cardiac anomalies such as Tetralogy of Fallot or isolated pulmonic stenosis, biplane cineangiography and catheterization is an essential procedure

Double chambered right ventricle

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Cho, Chul Koo; Yu, Yun Jeong; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1983-12-15

Fourteen cases of double chambered right ventricle were diagnosed angiographically and of these nine cases were confirmed after operation and autopsy at Seoul National University Hospital in recent four years since 1979. The clinical and radiological findings with the emphasis on the cinecardiographic findings were analysed. The summaries of the analysis are as follows: 1. Among 14 cases, 6 cases were male and 8 cases were female. Age distribution was from 4 years to 36 years. 2. In chest x-ray findings, pulmonary vascularity was increased in 8 cases, decreased in 4 cases, and normal in 2 cases. Cardiomegaly was observed in 8 cases and other showed normal heart size. 3. In cinecardiography, 11 cases had interventricular septal defect. Among these 11 cases, VSD located in proximal high pressure chamber was in 2 cases and located in distal low pressure chamber was in 9 cases. 4. The location of aberrant muscle bundle in sinus portion of right ventricle was in 8 cases. In the rest 6 cases, the aberrant muscle bundle was located below the infundibulum of right ventricle. 5. For accurate diagnosis and differential diagnosis with other congenital cardiac anomalies such as Tetralogy of Fallot or isolated pulmonic stenosis, biplane cineangiography and catheterization is an essential procedure.

Surgical myocardial revascularization in patients with reduced systolic left ventricular function.

Science.gov (United States)

Bruno, Piergiorgio; Iafrancesco, Mauro; Massetti, Massimo

2018-04-20

Surgical myocardial revascularization in patients with reduced left ventricular function has been a matter of debate for decades. Recently published 10-years extension follow-up of the STICH trial have conclusively demonstrated benefit of surgical myocardial revascularization in patients with significant coronary artery disease and low left ventricular ejection fraction. However, selection of patients for surgery remains challenging as well as decision to perform percutaneous rather than surgical revascularization in this class of patients. New evidence helped to clarify the role of preoperative patients' characteristics as risk factors for surgery and to identify those patients who may benefit the most from surgery. Focus of this review is to review epidemiology, aetiology and pathophysiology of coronary artery disease in patients with reduced left ventricular function, role of viability and results of observational and investigational studies on revascularization in patients with reduced left ventricular function with a particular emphasis on relative indication of coronary artery bypass grafting and percutaneous coronary intervention and the surgical implications of development of ischemic mitral regurgitation or ischemic left ventricular aneurysm.

Left ventricular hypertrophy: virtuous intentions, malign consequences.

Science.gov (United States)

Pokharel, Saraswati; Sharma, Umesh C; Pinto, Yigal M

2003-06-01

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 Ca(2+) homeostasis, there are structural changes in myofilaments, disorganization of the cytoskeletal framework and increased collagen synthesis. LVH is associated with progressive left ventricular remodeling that culminates to heart failure. The modern treatment of left ventricular hypertrophy is now largely based on the hypothesis that neuroendocrine activation is important in the progression of the disease and inhibition of neurohormones is likely to have long-term benefit with regard to morbidity and mortality. Drugs specifically designed to unload the left ventricle, such as diuretics and vasodilators, appears to be less effective in reducing LV mass and improving prognosis. Thus, the evolution of treatment for LVH itself has provided much enlightenment for our understanding of the fundamental biology of the disorder.

Right-ventricular and left-ventricular function parameters in patients with and without outflow tract patches as determined by radionuclide methods at least 10 years following surgical correction of Fallot's tetralogy in the adult individuals

International Nuclear Information System (INIS)

Seidel, P.

1988-01-01

During a period starting in 1983 and ending in April 1984 radionuclide ventriculography was performed in 26 patients subjected to surgical correction of Fallot's tetralogy after having reached adulthood. They were divided into two groups according to the surgical methods used. Patients showing no right-ventricular outflow patch were assigned to group I, while group II was made up of individuals that had received outflow tract patches of Dacron or Teflon for pressure reduction in the right ventricle. The parameters registered during radionuclide ventriculography, in which the tracer substance TC 99m was administered into a peripheral vein, included the endiastolic volume, endsystolic volume, stroke volume, global ejection fraction and cardiac index. For resting patients, these values were calculated using the first-pass technique, the determinations during exercise on the ergometer were based on equilibrium radionuclide ventriculography. It could be concluded from the results obtained here that non-invasive endocardial scintigraphy is a sensitive method that can be used both at rest and during exercise on the ergometer to detect function disorders of the right and left ventricles. (orig./MG) [de

Functional requirements of a mathematical model of the heart.

Science.gov (United States)

Palladino, Joseph L; Noordergraaf, Abraham

2009-01-01

Functional descriptions of the heart, especially the left ventricle, are often based on the measured variables pressure and ventricular outflow, embodied as a time-varying elastance. The fundamental difficulty of describing the mechanical properties of the heart with a time-varying elastance function that is set a priori is described. As an alternative, a new functional model of the heart is presented, which characterizes the ventricle's contractile state with parameters, rather than variables. Each chamber is treated as a pressure generator that is time and volume dependent. The heart's complex dynamics develop from a single equation based on the formation and relaxation of crossbridge bonds. This equation permits the calculation of ventricular elastance via E(v) = partial differentialp(v)/ partial differentialV(v). This heart model is defined independently from load properties, and ventricular elastance is dynamic and reflects changing numbers of crossbridge bonds. In this paper, the functionality of this new heart model is presented via computed work loops that demonstrate the Frank-Starling mechanism and the effects of preload, the effects of afterload, inotropic changes, and varied heart rate, as well as the interdependence of these effects. Results suggest the origin of the equivalent of Hill's force-velocity relation in the ventricle.

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...

The right ventricle in pulmonary arterial hypertension: disorders of metabolism, angiogenesis and adrenergic signaling in right ventricular failure.

Science.gov (United States)

Ryan, John J; Archer, Stephen L

2014-06-20

The right ventricle (RV) is the major determinant of functional state and prognosis in pulmonary arterial hypertension. RV hypertrophy (RVH) triggered by pressure overload is initially compensatory but often leads to RV failure. Despite similar RV afterload and mass some patients develop adaptive RVH (concentric with retained RV function), while others develop maladaptive RVH, characterized by dilatation, fibrosis, and RV failure. The differentiation of adaptive versus maladaptive RVH is imprecise, but adaptive RVH is associated with better functional capacity and survival. At the molecular level, maladaptive RVH displays greater impairment of angiogenesis, adrenergic signaling, and metabolism than adaptive RVH, and these derangements often involve the left ventricle. Clinically, maladaptive RVH is characterized by increased N-terminal pro-brain natriuretic peptide levels, troponin release, elevated catecholamine levels, RV dilatation, and late gadolinium enhancement on MRI, increased (18)fluorodeoxyglucose uptake on positron emission tomography, and QTc prolongation on the ECG. In maladaptive RVH there is reduced inotrope responsiveness because of G-protein receptor kinase-mediated downregulation, desensitization, and uncoupling of β-adrenoreceptors. RV ischemia may result from capillary rarefaction or decreased right coronary artery perfusion pressure. Maladaptive RVH shares metabolic abnormalities with cancer including aerobic glycolysis (resulting from a forkhead box protein O1-mediated transcriptional upregulation of pyruvate dehydrogenase kinase), and glutaminolysis (reflecting ischemia-induced cMyc activation). Augmentation of glucose oxidation is beneficial in experimental RVH and can be achieved by inhibition of pyruvate dehydrogenase kinase, fatty acid oxidation, or glutaminolysis. Therapeutic targets in RV failure include chamber-specific abnormalities of metabolism, angiogenesis, adrenergic signaling, and phosphodiesterase-5 expression. The ability to

Right ventricular exclusion and univentricular palliation for failed one and a half ventricle repair for Ebstein's anomaly.

Science.gov (United States)

Sasikumar, Navaneetha; Krishna Manohar, Soman R; Philip, Saji; Cherian, Kottoorathu Mammen; Suresh Kumar, Raghavannair

2013-08-01

A 20 year-old male was diagnosed to have Ebstein's anomaly with severe right ventricular dysfunction. He was taken up for 1.5 ventricle repair. Post procedure, there was difficulty in weaning from cardiopulmonary bypass due to progressive right ventricular dilatation compromising the systemic output. An atrial septectomy did not help. Progressive right ventricular dilatation compressing the left ventricle, demonstrated on transoesophageal echocardiogram, prompted us to perform a right ventricular exclusion and univentricular palliation. The patient was successfully weaned off cardiopulmonary bypass and had a smooth postoperative recovery. Judicious use of right ventricular exclusion and univentricular palliation could be an effective bailout strategy in difficult surgical scenarios in Ebstein's anomaly. Copyright © 2012 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

"Heart rate-dependent" electrocardiographic diagnosis of left ventricular hypertrophy.

Science.gov (United States)

Madias, John E

2013-05-01

A case is presented revealing the common phenomenon of heart rate-dependent diagnosis of electrocardiographic (ECG) diagnosis of left ventricular hypertrophy (LVH), which consists of satisfaction of LVH criteria only at faster rates whereas ECGs with a slow heart rate do not satisfy such criteria. The mechanism of the phenomenon has been attributed to the tachycardia-mediated underfilling of the left ventricle bringing the electrical "centroid" of the heart closer to the recording electrodes, which results in augmentation of the amplitude of QRS complexes, particularly in leads V2-V4. ©2012, The Author. Journal compilation ©2012 Wiley Periodicals, Inc.

Biochemical and biomechanical properties of the pacemaking sinoatrial node extracellular matrix are distinct from contractile left ventricular matrix.

Directory of Open Access Journals (Sweden)

Jessica M Gluck

Full Text Available Extracellular matrix plays a role in differentiation and phenotype development of its resident cells. Although cardiac extracellular matrix from the contractile tissues has been studied and utilized in tissue engineering, extracellular matrix properties of the pacemaking sinoatrial node are largely unknown. In this study, the biomechanical properties and biochemical composition and distribution of extracellular matrix in the sinoatrial node were investigated relative to the left ventricle. Extracellular matrix of the sinoatrial node was found to be overall stiffer than that of the left ventricle and highly heterogeneous with interstitial regions composed of predominantly fibrillar collagens and rich in elastin. The extracellular matrix protein distribution suggests that resident pacemaking cardiomyocytes are enclosed in fibrillar collagens that can withstand greater tensile strength while the surrounding elastin-rich regions may undergo deformation to reduce the mechanical strain in these cells. Moreover, basement membrane-associated adhesion proteins that are ligands for integrins were of low abundance in the sinoatrial node, which may decrease force transduction in the pacemaking cardiomyocytes. In contrast to extracellular matrix of the left ventricle, extracellular matrix of the sinoatrial node may reduce mechanical strain and force transduction in pacemaking cardiomyocytes. These findings provide the criteria for a suitable matrix scaffold for engineering biopacemakers.

Differences in graph theory functional connectivity in left and right temporal lobe epilepsy.

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Chiang, Sharon; Stern, John M; Engel, Jerome; Levin, Harvey S; Haneef, Zulfi

2014-12-01

To investigate lateralized differences in limbic system functional connectivity between left and right temporal lobe epilepsy (TLE) using graph theory. Interictal resting state fMRI was performed in 14 left TLE patients, 11 right TLE patients, and 12 controls. Graph theory analysis of 10 bilateral limbic regions of interest was conducted. Changes in edgewise functional connectivity, network topology, and regional topology were quantified, and then left and right TLE were compared. Limbic edgewise functional connectivity was predominantly reduced in both left and right TLE. More regional connections were reduced in right TLE, most prominently involving reduced interhemispheric connectivity between the bilateral insula and bilateral hippocampi. A smaller number of limbic connections were increased in TLE, more so in left than in right TLE. Topologically, the most pronounced change was a reduction in average network betweenness centrality and concurrent increase in left hippocampal betweenness centrality in right TLE. In contrast, left TLE exhibited a weak trend toward increased right hippocampal betweenness centrality, with no change in average network betweenness centrality. Limbic functional connectivity is predominantly reduced in both left and right TLE, with more pronounced reductions in right TLE. In contrast, left TLE exhibits both edgewise and topological changes that suggest a tendency toward reorganization. Network changes in TLE and lateralized differences thereof may have important diagnostic and prognostic implications. Published by Elsevier B.V.

Divergent functions of the left and right central amygdala in visceral nociception.

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Sadler, Katelyn E; McQuaid, Neal A; Cox, Abigail C; Behun, Marissa N; Trouten, Allison M; Kolber, Benedict J

2017-04-01

The left and right central amygdalae (CeA) are limbic regions involved in somatic and visceral pain processing. These 2 nuclei are asymmetrically involved in somatic pain modulation; pain-like responses on both sides of the body are preferentially driven by the right CeA, and in a reciprocal fashion, nociceptive somatic stimuli on both sides of the body predominantly alter molecular and physiological activities in the right CeA. Unknown, however, is whether this lateralization also exists in visceral pain processing and furthermore what function the left CeA has in modulating nociceptive information. Using urinary bladder distension (UBD) and excitatory optogenetics, a pronociceptive function of the right CeA was demonstrated in mice. Channelrhodopsin-2-mediated activation of the right CeA increased visceromotor responses (VMRs), while activation of the left CeA had no effect. Similarly, UBD-evoked VMRs increased after unilateral infusion of pituitary adenylate cyclase-activating polypeptide in the right CeA. To determine intrinsic left CeA involvement in bladder pain modulation, this region was optogenetically silenced during noxious UBD. Halorhodopsin (NpHR)-mediated inhibition of the left CeA increased VMRs, suggesting an ongoing antinociceptive function for this region. Finally, divergent left and right CeA functions were evaluated during abdominal mechanosensory testing. In naive animals, channelrhodopsin-2-mediated activation of the right CeA induced mechanical allodynia, and after cyclophosphamide-induced bladder sensitization, activation of the left CeA reversed referred bladder pain-like behaviors. Overall, these data provide evidence for functional brain lateralization in the absence of peripheral anatomical asymmetries.

Double Outlet Right Ventricle With Intact Ventricular Septum: Avulsion or Exclusion.

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Menon, Sabarinath; Kumar, C J Ashok; Mathew, Thomas; Venkateshwarn, S; Jayakumar, K; Dharan, Baiju S

2016-03-01

Double outlet right ventricle (DORV) is almost always associated with a ventricular septal defect. The variant of DORV with intact ventricular septum is very uncommon and may be associated with fetal demise or death immediately after birth. Reports of successful palliation of these patients to the stage of superior cavopulmonary anastomosis (bidirectional Glenn shunt) are rare. We describe the case of a child with DORV with intact ventricular septum who underwent successful palliation. This condition often provides a diagnostic, interventional, and surgical challenge. Patients generally require either balloon atrial septostomy or surgical atrial septectomy for survival, with the addition of a Blalock-Tausig shunt or pulmonary artery band depending on the pulmonary blood flow. Very few patients survive to a Glenn procedure. For those who do survive, a decision must be made regarding the management of the hypertensive and hypoplastic left ventricle (LV) and associated mitral regurgitation. The LV can be excluded by either mitral valve avulsion or closure (exclusion) of the mitral valve with a patch. The choice of the technique should be carefully made and depends in part on the size of the LV. In our patient, who was successfully palliated by bidirectional Glenn shunt, the LV was managed by means of mitral valve avulsion. © The Author(s) 2015.

Correlation between Left Ventricular Global and Regional Longitudinal Systolic Strain and Impaired Microcirculation in Patients with Acute Myocardial Infarction

DEFF Research Database (Denmark)

Løgstrup, Brian B; Høfsten, Dan Eik; Christophersen, Thomas Brøcher

2012-01-01

investigated if LRS and GLS imaging is superior to conventional measures of left ventricle (LV) function. Methods: In a consecutive population of first time AMI patients, who underwent successful revascularization, we performed comprehensive TTE. GLS and LRS were obtained from the three standard apical views...... elevation myocardial infarction. The GLS was -15.2 [-19.3;-10.1]% in the total population of 183 patients. Total wall motion score index (WMSI) in the population was 1.19 [1;1.5]. Eighty-five patients suffered from culprit lesion in left anterior descending artery (LAD). The CFR in these patients was 1......Objectives: We investigated the correlation between left ventricular global and regional longitudinal systolic strain (GLS and LRS) and coronary flow reserve (CFR) assessed by transthoracic echocardiography (TTE) in patients with a recent acute myocardial infarction (AMI). Furthermore, we...

Use of myocardial tomo-scintigraphy by {sup 123}I - MIBG in right ventricle arrhythmia-gen dysplasia; Interet de la tomoscintigraphie myocardique a la {sup 123}I - MIBG dans la dysplasie arrythmogene du ventricule droit

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Agostini, D.; Manrique, A.; Darlas, Y. [Service de Medecine Nucleaire, CHU Cote de Nacre, Caen (France); Loiselet, P.; Scanu, P.; Grollier, G.; Potier, J.C. [Service de Cardiologie, CHU Cote de Nacre, Caen (France); Bouvard, G. [Service de Medecine Nucleaire, CHU Cote de Nacre, Caen (France)

1997-12-31

The dysfunction of myocardial sympathetic system was implied in occurrence of ventricular arrhythmias in patients with a right ventricle arrhythmia-gen dysplasia (RVAD). The goal of this study is to evaluate the myocardial pre-synaptic adrenergic regional function by using the cardiac tomo-scintigraphy with {sup 123}I - meta-iodo-benzyl-guanidine (MIBG). Fourteen patients (12 M, 2 F, age: 46{+-} 13) in whom the disease`s diagnosis was done on the basis of the parameters of European Task Force (electric, angiographic, histologic), were studied. Six healthy subjects (32 {+-} 12 years) were at the same time studied as control group. Each patient benefited by an at-rest tomo-scintigraphy by {sup 201}Tl to eliminate any hypo-perfusion which could hinder the interpretation of MIBG fixation. A 48 h delay was necessary between the two isotopic examinations. After blocking the thyroid by Lugol fort, an at-rest tomo-scintigraphy by {sup 123}I - MIBG was effected 4 h after the injection IV of 259 MBq of tracer following a classical acquisition of a myocardial tomography with a tracer-adopted collimator (Elscint camera). Global and regional evaluations of the cardiac adrenergic neuronal function were effected by using the cardio-mediastinal ratio (CMR) and the circumferential profile, respectively, for the localization, extension and amplitude of regional adrenergic defects. The CMR is within the normal limits (236 {+-} 39% vs 234 {+-} 14% in healthy subjects). The adrenergic defects are present in 11/14 patients (a reduction of 50% of capture of MIBG as compared with the control group, < average - 2 ET) in the anterior and lateral regions of left ventricle. In conclusion, the tomo-scintigraphy by {sup 123}I - MIBG allows the detecting of presence of a sympathetic dys-innervation of left ventricle in patients afflicted with RVAD

Right Valsalva Sinus Aneurysm Protruding Into the Right Ventricle: A Case Report

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Ata H. Afshar

2015-09-01

Full Text Available A separation between the aortic media and annulus fibrosus causes a rare cardiac abnormality called sinus of Valsalva aneurysm (SVA that may be congenital or acquired. It is more prevalent in the right coronary sinus (65%-85% but it has been seen rarely in non-coronary (10%-30%or Left coronary sinus (<5%. The most common complication is rupture of the Aneurysm. We present an 80-year-old male with expanding right Valsalva sinus aneurysm and protruding into right ventricle. The conventional treatment is surgical repair under cardio-pulmonary bypass or percutaneous catheter closure. The aneurysm was successfully excised surgically under direct guidance of trans-esophageal echocardiography (TEE.

Rest and exercise ventricular function in adults with congenital ventricular septal defects

International Nuclear Information System (INIS)

Jablonsky, G.; Hilton, J.D.; Liu, P.P.; Morch, J.E.; Druck, M.N.; Bar-Shlomo, B.Z.; McLaughlin, P.R.

1983-01-01

Rest and exercise right and left ventricular function were compared using equilibrium gated radionuclide angiography in 19 normal sedentary control subjects and 34 patients with hemodynamically documented congenital ventricular septal defect (VSD). Gated radionuclide angiography was performed at rest and during each level of graded supine bicycle exercise to fatigue. Heart rate, blood pressure, maximal work load achieved, and right and left ventricular ejection fractions were assessed. The control subjects demonstrated an increase in both the left and right ventricular ejection fractions with exercise. All study groups failed to demonstrate an increase in ejection fraction in either ventricle with exercise. Furthermore, resting left ventricular ejection fraction in Groups 2 and 3 was lower than that in the control subjects and resting right ventricular ejection fraction was lower in Group 3 versus control subjects. Thus left and right ventricular function on exercise were abnormal in patients with residual VSD as compared with control subjects; rest and exercise left ventricular ejection fractions remained abnormal despite surgical closure of VSD in the remote past; resting left and right ventricular function was abnormal in patients with Eisenmenger's complex; lifelong volume overload may be detrimental to myocardial function

Left ventricular calcification following postpartum toxic shock syndrome

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Stella C Pak

2018-01-01

Full Text Available Toxic shock syndrome (TSS is a rare but lethal clinical event that can occur during the postpartum period. Early recognition and intervention is critical to improve patient outcomes. This is a case of TSS complicated by cardiac arrest and left ventricular calcification. This is a case report of streptococcal TSS in a 29-year-old female in the postpartum period who presented with fever, abdominal distension, and a purpuric rash. Her hospital course was characterized by multiple organ failure, including respiratory distress syndrome, liver failure, renal failure, and coagulopathy. She was found to have acute compartment syndrome, which resulted in a below-the-knee amputation. She deteriorated further after experiencing cardiac arrest and the development of hypoxic-ischemic encephalopathy with hemorrhagic transformation. A computed tomography scan of the chest revealed evidence of dystrophic myocardial calcification in the left ventricle. She improved clinically but remained ventilator dependent upon discharge to an extended acute care facility. Sepsis-induced cardiomyopathy can result in myocardial calcification. As dystrophic calcification can significantly affect cardiac function, clinicians should rule out cardiac calcification in patients who have had severe septic shock.

Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR

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Lee, Lik Chuan; Zhihong, Zhang; Hinson, Andrew; Guccione, Julius M.

2013-01-01

Injection of Algisyl-LVR, a treatment under clinical development, is intended to treat patients with dilated cardiomyopathy. This treatment was recently used for the first time in patients who had symptomatic heart failure. In all patients, cardiac function of the left ventricle (LV) improved significantly, as manifested by consistent reduction of the LV volume and wall stress. Here we describe this novel treatment procedure and the methods used to quantify its effects on LV wall stress and function. Algisyl-LVR is a biopolymer gel consisting of Na+-Alginate and Ca2+-Alginate. The treatment procedure was carried out by mixing these two components and then combining them into one syringe for intramyocardial injections. This mixture was injected at 10 to 19 locations mid-way between the base and apex of the LV free wall in patients. Magnetic resonance imaging (MRI), together with mathematical modeling, was used to quantify the effects of this treatment in patients before treatment and at various time points during recovery. The epicardial and endocardial surfaces were first digitized from the MR images to reconstruct the LV geometry at end-systole and at end-diastole. Left ventricular cavity volumes were then measured from these reconstructed surfaces. Mathematical models of the LV were created from these MRI-reconstructed surfaces to calculate regional myofiber stress. Each LV model was constructed so that 1) it deforms according to a previously validated stress-strain relationship of the myocardium, and 2) the predicted LV cavity volume from these models matches the corresponding MRI-measured volume at end-diastole and end-systole. Diastolic filling was simulated by loading the LV endocardial surface with a prescribed end-diastolic pressure. Systolic contraction was simulated by concurrently loading the endocardial surface with a prescribed end-systolic pressure and adding active contraction in the myofiber direction. Regional myofiber stress at end-diastole and

Functional substrate for memory function differences between patients with left and right mesial temporal lobe epilepsy associated with hippocampal sclerosis.

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Jin, Seung-Hyun; Chung, Chun Kee

2015-10-01

Little is known about the functional substrate for memory function differences in patients with left or right mesial temporal lobe epilepsy (mTLE) associated with hippocampal sclerosis (HS) from an electrophysiological perspective. To characterize these differences, we hypothesized that hippocampal theta connectivity in the resting-state might be different between patients with left and right mTLE with HS and be correlated with memory performance. Resting-state hippocampal theta connectivity, identified via whole-brain magnetoencephalography, was evaluated. Connectivity and memory function in 41 patients with mTLE with HS (left mTLE=22; right mTLE=19) were compared with those in 46 age-matched healthy controls and 28 patients with focal cortical dysplasia (FCD) but without HS. Connectivity between the right hippocampus and the left middle frontal gyrus was significantly stronger in patients with right mTLE than in patients with left mTLE. Moreover, this connectivity was positively correlated with delayed verbal recall and recognition scores in patients with mTLE. Patients with left mTLE had greater delayed recall impairment than patients with right mTLE and FCD. Similarly, delayed recognition performance was worse in patients with left mTLE than in patients with right mTLE and FCD. No significant differences in memory function between patients with right mTLE and FCD were detected. Patients with right mTLE showed significantly stronger hippocampal theta connectivity between the right hippocampus and left middle frontal gyrus than patients with FCD and left mTLE. Our results suggest that right hippocampal-left middle frontal theta connectivity could be a functional substrate that can account for differences in memory function between patients with left and right mTLE. This functional substrate might be related to different compensatory mechanisms against the structural hippocampal lesions in left and right mTLE groups. Given the positive correlation between

Impaired right ventricular contractile function in childhood obesity and its association with right and left ventricular changes: a cine DENSE cardiac magnetic resonance study.

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Jing, Linyuan; Pulenthiran, Arichanah; Nevius, Christopher D; Mejia-Spiegeler, Abba; Suever, Jonathan D; Wehner, Gregory J; Kirchner, H Lester; Haggerty, Christopher M; Fornwalt, Brandon K

2017-06-28

Pediatric obesity is a growing public health problem, which is associated with increased risk of cardiovascular disease and premature death. Left ventricular (LV) remodeling (increased myocardial mass and thickness) and contractile dysfunction (impaired longitudinal strain) have been documented in obese children, but little attention has been paid to the right ventricle (RV). We hypothesized that obese/overweight children would have evidence of RV remodeling and contractile dysfunction. One hundred and three children, ages 8-18 years, were prospectively recruited and underwent cardiovascular magnetic resonance (CMR), including both standard cine imaging and displacement encoding with stimulated echoes (DENSE) imaging, which allowed for quantification of RV geometry and function/mechanics. RV free wall longitudinal strain was quantified from the end-systolic four-chamber DENSE image. Linear regression was used to quantify correlations of RV strain with LV strain and measurements of body composition (adjusted for sex and height). Analysis of variance was used to study the relationship between RV strain and LV remodeling types (concentric remodeling, eccentric/concentric hypertrophy). The RV was sufficiently visualized with DENSE in 70 (68%) subjects, comprising 36 healthy weight (13.6 ± 2.7 years) and 34 (12.1 ± 2.9 years) obese/overweight children. Obese/overweight children had a 22% larger RV mass index (8.2 ± 0.9 vs 6.7 ± 1.1 g/m 2.7 , p right ventricles in obese/overweight children.

Homocyst(e)ine impairs endocardial endothelial function.

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Tyagi, S C; Smiley, L M; Mujumdar, V S

1999-12-01

Homocyst(e)ine injured vascular endothelium and modulated endothelial-dependent vascular function. Endothelium plays an analogous role in both the vessel and the endocardium. Therefore, we hypothesized that homocyst(e)ine modulated endocardial endothelium (EE) dependent cardiac function. The ex vivo cardiac rings from normal male Wistar-Kyoto rats were prepared. The contractile responses of left and right ventricular rings were measured in an isometric myobath, using different concentrations of CaCl2. The response was higher in the left ventricle than right ventricle and was elevated in endocardium without endothelium. The half effective concentration (EC50) and maximum tension generated by homocyst(e)ine were 10(6) and 5-fold lower than endothelin (ET) and angiotensin II (AII), respectively. However, in endothelial-denuded endocardium, homocyst(e)ine response was significantly increased (pine, and endothelial nitric oxide in EE function, cardiac rings were pretreated with AII (10(-10) M) or ET (10(-13) M) and then treated with homocyst(e)ine (10(-8) M). Results suggested that at these concentrations AII, ET, or homocyst(e)ine alone had no effect on cardiac contraction. However, in the presence of 10(-10) M AII or 10(-13) M ET, the cardiac contraction to homocyst(e)ine (10(-8) M) was significantly enhanced (pine. These results suggested that homocyst(e)ine impaired EE-dependent cardiac function and acted synergistically with AII and ET in enhancing the cardiac contraction.

Effect of changes in contractility on the index of myocardial performance in the dysfunctional left ventricle

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Lavine Steven J

2006-11-01

Full Text Available Abstract Background The index of myocardial performance has prognostic power in patients with cardiomyopathy and following myocardial infarction. As the index of myocardial performance has been shown to be preload and afterload dependent, the effect of altering contractility on IMP and its components with left ventricular dysfunction has been incompletely delineated. Methods Chronic left ventricular dysfunction was induced in 10 canines using coronary microsphere embolization. Each dog was instrumented and imaged with 2D echo and Doppler. At the same atrially paced rate, contractility was increased with a dobutamine infusion and then following 4 weeks of oral digoxin. Results With chronic left ventricular dysfunction, a reduced left ventricular ejection fraction (42 ± 3%, p Conclusion Increased inotropy with digoxin and dobutamine reduced the index of myocardial performance in dogs with left ventricular dysfunction. Shortened isovolumic contraction time, increased diastolic filling period, and reduced left ventricular end diastolic pressure with digoxin may provide insight into its efficacy in heart failure.

Left Ventricle Non compaction: Physiopathology and Findings by Magnetic Resonance

International Nuclear Information System (INIS)

Parra R, Rodrigo; Cadavid Lina

2009-01-01

A Left ventricular non compaction (LVNC) has recently been classified as a primary cardiomyopathy with a genetic origin. It is morphologically characterized by numerous prominent trabeculations and deep inter trabecular recesses. LVNC is probably secondary to an arrest in the normal process of myocardial compaction during fetal life. LVNC may be an isolated finding in the absence of any coexisting cardiac anomaly or may be associated with other congenital heart anomalies or neuromuscular disorders. LVNC includes both asymptomatic and symptomatic patients with severe heart failure, systemic embolism, arrhythmia or sudden death. Diagnosis has moved from autopsy to recognition during life by non-invasive means: echocardiography and more recently cardiac magnetic resonance imaging.

Doença de Chagas em Virgem da Lapa, Minas Gerais, Brasil. IV. Aspectos clínicos e epidemiológicos do aneurisma ventricular esquerdo Chagas' disease in Virgem da Lapa County, Minas Gerais State, Brazil. IV. Clinical and epidemiological aspects of the left ventricle aneurism

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José Borges-Pereira

1998-10-01

Full Text Available Com o objetivo de avaliar as características clínicas e epidemiológicas do aneurisma ventricular esquerdo na doença de Chagas crônica, 388 indivíduos não selecionados: 298 chagásicos e 90 não-chagásicos, foram submetidos ao exame ecocardiográfico. A função ventricular foi avaliada ao modo M através do cálculo da fração de ejeção e ao bidimensional através da análise subjetiva da função sistólica global e a contratilidade regional foi avaliada pelo modelo da Sociedade Americana de Ecocardiografia. Foram diagnosticados 56 (18,8% aneurismas do ventrículo esquerdo, todos entre os chagásicos, sendo 38 (12,7% no segmento apical, 10 (3,4% no septo interventricular, 2 (0,7% ápico-septal, 2 (0,7% na parede posterior, 2 (0,7% na parede inferior e 2 (0,7% no segmento ínfero-posterior. Não houve diferença significativa nas freqüências dos aneurismas em relação à faixa etária, ao sexo e à etnia. Não houve associação entre aneurismas e hipertensão arterial. Dos 56 indivíduos com aneurismas, 55 (98,2% eram sintomáticos com predominância de palpitações, 53 (94,6,% apresentaram ECG anormais, com predominância de extra-sístoles ventriculares, seguidas de alterações da condução e 34 (60,7% apresentaram comprometimento da função ventricular, sem diferença quanto ao segmento acometido. Diante destes resultados podemos considerar o aneurisma ventricular esquerdo, principalmente apical, como um marcador de doença de Chagas e um indicador da alta morbidade da infecção humana pelo T. cruzi em Virgem da Lapa.The study aimed at the evaluation of the clinical and epidemiological characteristics of the aneurism found in the left ventricle in chronic Chagas' disease patients. Three handred, eighty eight people (298 chagasic patients and 90 randomly selected healthy individuals were submitted to echocardiography. The ventricular function was assessed in the M mode by calculating the fraction of ejection, and in the

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

of PALS and left ventricular longitudinal strain (global longitudinal strain) in large-scale populations in regard to prognosis. METHODS AND RESULTS: We prospectively included 843 patients (mean age 62.1+/-11.8; 74% male) with acute myocardial infarction and measured global longitudinal strain, left......BACKGROUND: 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...

Septum formation of the lateral ventricles

International Nuclear Information System (INIS)

Celik, Hakan H.; Aldur, Mustafa M.; Tatar, I.; Tascioglu, A.B.

2005-01-01

In an MRI study examining anomalies of the septum pellucidum in 505 cases, we detected bilateral septum formation of the lateral ventricles in a 17-months-old-baby. In this study, we evaluate 505 (242 males and 263 females) patients referred to the Emaray Imaging Center, Ankara, Turkey with various prediagnoses. We specially selected all the cases from a non-psychotic population. We obtained MRI scans on a 1-Tesla imager (Picker International, Highland Heights, Ohio, USA), with slices of 5 and 6 mm thickness. In the axial and coronal sections, we observed septum formation laterally between the anterior horn and the ventricular body of the lateral ventricles. Radio opaque septum formations started from the caudate nucleus and stretched to the genu of the corpus callosum. There was a second septum formation between the posterior horn and the ventricular body of the right lateral ventricle. It started from the caudate nucleus and stretched to the cavum vergae. (author)

Mitral valve disease with rheumatic appearance in the presence of left ventricular endomyocardial fibrosis

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Lurildo R. Saraiva

1999-03-01

Full Text Available This is a report of a nine-year-old boy with both mitral stenosis and regurgitation and extensive endomyocardial fibrosis of the left ventricle. Focus is given to the singularity of the fibrotic process, with an emphasis on the etiopathogenic aspects.

Novel nonsurgical left ventricular assist device and system.

Science.gov (United States)

Misiri, Juna; DeSimone, Christopher V; Park, Soon J; Kushwaha, Sudhir S; Friedman, Paul A; Bruce, Charles J; Asirvatham, Samuel J

2013-01-01

Treatment options for advanced stages of congestive heart failure remain limited. Left ventricular assist devices (LVADs) have emerged as a means to support failing circulation. However, these devices are not without significant risk such as major open chest surgery. We utilized a novel approach for device placement at the aorto-left atria continuity as a site to create a conduit capable of accommodating a percutaneous LVAD system. We designed and developed an expandable nitinol based device for placement at this site to create a shunt between the LA and aorta. Our experiments support this anatomic location as an accessible and feasible site for accommodation of an entirely percutaneous LVAD. The novelty of this approach would bypass the left ventricle, and thereby minimize complications and morbidities associated with current LVAD placement. Copyright © 2013 Elsevier Inc. All rights reserved.

[Diastolic dysfunction in the elderly subjects. Disease or a physiological manifestation of ageing?].

Science.gov (United States)

Meluzín, J; Podroužková, H; Gregorová, Z; Panovský, R

2013-05-01

The purpose of this summary paper is to discuss the current knowledge of the impact of age on diastolic function of the left ventricle. Data from the literature: Reports published till this time have convincingly demonstrated a significant relationship of age to diastolic function of the left ventricle. Ageing is a physiological process accompanied by structural changes in both myocardium and arterial bed resulting in worsening of parameters characterizing the left ventricular diastolic function. This "physiological" diastolic dysfunction in the elderly subjects can be explained by the deterioration of passive left ventricular filling properties and by worsening of left ventricular relaxation. The detailed analysis of published reports shows problems in distiguishing this "physiological" diastolic dysfunction resulting from physiological tissue ageing from "pathological" diastolic dysfunction reflecting a disease of cardiovascular system. To interprete correctly values of parameters quantifying diastolic function of the left ventricle, one should take into account the age of subjects under the examination. Further studies are necessary to distinguish exactly "physiological" deterioration of diastolic function associated with ageing from really "pathological" diastolic dysfunction in the elderly subjects.

The effect of heart failure and left ventricular assist device treatment on right ventricular mechanics: a computational study.

Science.gov (United States)

Park, Jun I K; Heikhmakhtiar, Aulia Khamas; Kim, Chang Hyun; Kim, Yoo Seok; Choi, Seong Wook; Song, Kwang Soup; Lim, Ki Moo

2018-05-22

Although it is important to analyze the hemodynamic factors related to the right ventricle (RV) after left ventricular assist device (LVAD) implantation, previous studies have focused only on the alteration of the ventricular shape and lack quantitative analysis of the various hemodynamic parameters. Therefore, we quantitatively analyzed various hemodynamic parameters related to the RV under normal, heart failure (HF), and HF incorporated with continuous flow LVAD therapy by using a computational model. In this study, we combined a three-dimensional finite element electromechanical model of ventricles, which is based on human ventricular morphology captured by magnetic resonance imaging (MRI) with a lumped model of the circulatory system and continuous flow LVAD function in order to construct an integrated model of an LVAD implanted-cardiovascular system. To induce systolic dysfunction, the magnitude of the calcium transient function under HF condition was reduced to 70% of the normal value, and the time constant was reduced by 30% of the normal value. Under the HF condition, the left ventricular end systolic pressure decreased, the left ventricular end diastolic pressure increased, and the pressure in the right atrium (RA), RV, and pulmonary artery (PA) increased compared with the normal condition. The LVAD therapy decreased the end-systolic pressure of the LV by 41%, RA by 29%, RV by 53%, and PA by 71%, but increased the right ventricular ejection fraction by 52% and cardiac output by 40%, while the stroke work was reduced by 67% compared with the HF condition without LVAD. The end-systolic ventricular tension and strain decreased with the LVAD treatment. LVAD enhances CO and mechanical unloading of the LV as well as those of the RV and prevents pulmonary hypertension which can be induced by HF.

Radionuclide Angiocardiographic Evaluation of Left-to-Right Cardiac Shunts: Analysis of Time-Active Curves

International Nuclear Information System (INIS)

Kim, Ok Hwa; Bahk, Yong Whee; Kim, Chi Kyung

1987-01-01

The noninvasive nature of the radionuclide angiocardiography provided a useful approach for the evaluation of left-to-right cardiac shunts (LRCS). While the qualitative information can be obtained by inspection of serial radionuclide angiocardiograms, the quantitative information of radionuclide angiocardiography can be obtained by the analysis of time-activity curves using advanced computer system. The count ratios method and pulmonary-to-systemic flow ratio (QP/QS) by gamma variate fit method were used to evaluate the accuracy of detection and localization of LRCS. One hundred and ten time-activity curves were analyzed. There were 46 LRCS (atrial septal defects 11, ventricular septal defects 22, patent ductus arteriosus 13) and 64 normal subjects. By computer analysis of time-activity curves of the right atriurn, ventricle and the lungs separately, the count ratios modified by adding the mean cardiac transit time were calculated in each anatomic site. In normal subjects the mean count ratios in the right atrium, ventricle and lungs were 0.24 on average. In atrial septal defects, the count ratios were high in the right atrium, ventricle and lungs, whereas in ventricular septal defects the count ratios were higher only in the right ventricle and lungs. Patent ductus arteriosus showed normal count ratios in the heart but high count ratios were obtained in the lungs. Thus, this count ratios method could be separated normal from those with intracardiac or extracardiac shunts, and moreover, with this method the localization of the shunt level was possible in LRCS. Another method that could differentiate the intracardiac shunts from extracardiac shunts was measuring QP/QS in the left and right lungs. In patent ductus arteriosus, the left lung QP/QS was higher than those of the right lung, whereas in atrial septal defects and ventricular septal defects QP/ QS ratios were equal in both lungs. From this study, it was found that by measuring QP/QS separately in the lungs

Influence of slice thickness on the determination of left ventricular wall thickness and dimension by magnetic resonance imaging

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Ohnishi, Shusaku; Fukui, Sugao; Atsumi, Chisato and others

1989-02-01

Wall thickness of the ventricular septum and left ventricle, and left ventricular cavity dimension were determined on magnetic resonance (MR) images with slices 5 mm and 10 mm in thickness. Subjects were 3 healthy volunteers and 7 patients with hypertension (4), hypertrophic cardiomyopathy (one) or valvular heart disease (2). In visualizing the cardiac structures such as left ventricular papillary muscle and right and left ventricles, 5 mm-thick images were better than 10 mm-thick images. Edges of ventricular septum and left ventricular wall were more clearly visualized on 5 mm-thick images than 10 mm-thick images. Two mm-thick MR images obtained from 2 patients yielded the most excellent visualization in end-systole, but failed to reveal cardiac structures in detail in end-diastole. Phantom studies revealed no significant differences in image quality of 10 mm and 5 mm in thickness in the axial view 80 degree to the long axis. In the axial view 45 degree to the long axis, 10 mm-thick images were inferior to 5 mm-thick images in detecting the edge of the septum and the left ventricular wall. These results indicate that the selection of slice thickness is one of the most important determinant factors in the measurement of left ventricular wall thickness and cavity dimension. (Namekawa, K).

Influence of slice thickness on the determination of left ventricular wall thickness and dimension by magnetic resonance imaging

International Nuclear Information System (INIS)

Ohnishi, Shusaku; Fukui, Sugao; Atsumi, Chisato

1989-01-01

Wall thickness of the ventricular septum and left ventricle, and left ventricular cavity dimension were determined on magnetic resonance (MR) images with slices 5 mm and 10 mm in thickness. Subjects were 3 healthy volunteers and 7 patients with hypertension (4), hypertrophic cardiomyopathy (one) or valvular heart disease (2). In visualizing the cardiac structures such as left ventricular papillary muscle and right and left ventricles, 5 mm-thick images were better than 10 mm-thick images. Edges of ventricular septum and left ventricular wall were more clearly visualized on 5 mm-thick images than 10 mm-thick images. Two mm-thick MR images obtained from 2 patients yielded the most excellent visualization in end-systole, but failed to reveal cardiac structures in detail in end-diastole. Phantom studies revealed no significant differences in image quality of 10 mm and 5 mm in thickness in the axial view 80 degree to the long axis. In the axial view 45 degree to the long axis, 10 mm-thick images were inferior to 5 mm-thick images in detecting the edge of the septum and the left ventricular wall. These results indicate that the selection of slice thickness is one of the most important determinant factors in the measurement of left ventricular wall thickness and cavity dimension. (Namekawa, K)

Exercises in anatomy: holes between the ventricles.

Science.gov (United States)

Anderson, Robert H; Sarwark, Anne E; Spicer, Diane E; Backer, Carl L

2014-01-01

Holes between the ventricles are the commonest congenital cardiac malformations. As yet, however, there is no consensus as to how they can best be described and categorized. In this, our third exercise in cardiac anatomy, we address the issue of classification of ventricular septal defects. We begin our demonstration by analysing the normal heart. We show that the larger part of the ventricular septum is made up of its muscular component. The membranous part accounts for only a small portion, which is located centrally within the cardiac base. This small membranous part forms a boundary between the right-sided chambers and the aortic root. Holes at this site, therefore, which account for the commonest defects closed surgically, will open centrally in the cardiac base, being located postero-inferiorly relative to the supraventricular crest. We then show that the larger part of the crest itself is a free-standing muscular sleeve, which lifts the leaflets of the pulmonary valve away from the cardiac base. Only a very small part of the muscle forming the right ventricular outlet is located in the septal position. Turning our attention to malformed hearts, we show how holes between the ventricles can open centrally at the cardiac base, open to the inlet or outlet of the right ventricle or open within the substance of the apical muscular septum. We demonstrate, however, that description of such geographical location of the defects does not paint the full picture, since lesions with markedly different phenotypic features can open in comparable geographic locations. We illustrate how it is the phenotypic features, as seen from the right ventricle, which convey the crucial information for the surgeon with regard to the location of the atrioventricular conduction axis, using hearts with holes opening to the inlet of the right ventricle with muscular as opposed to partially fibrous borders to emphasize this point. We continue by showing how holes with different phenotypes can

Functional specialization of the left ventral parietal cortex in working memory

Directory of Open Access Journals (Sweden)

Jennifer Lou Langel

2014-06-01

Full Text Available The function of the ventral parietal cortex (VPC is subject to much debate. Many studies suggest a lateralization of function in the VPC, with the left hemisphere facilitating verbal working memory and the right subserving stimulus-driven attention. However, many attentional tasks elicit activity in the VPC bilaterally. To elucidate the potential divides across the VPC in function, we assessed the pattern of activity in the VPC bilaterally across two tasks that require different demands, an oddball attentional task with low working memory demands and a working memory task. An anterior region of the VPC was bilaterally active during novel targets in the oddball task and during retrieval in WM, while more posterior regions of the VPC displayed dissociable functions in the left and right hemisphere, with the left being active during the encoding and retrieval of WM, but not during the oddball task and the right showing the reverse pattern. These results suggest that bilateral regions of the anterior VPC subserve non-mnemonic processes, such as stimulus-driven attention during WM retrieval and oddball detection. The left posterior VPC may be important for speech-related processing important for both working memory and perception, while the right hemisphere is more lateralized for attention.

Radionuclide analysis of right and left ventricular response to exercise in patients with atrial and ventricular septal defects

International Nuclear Information System (INIS)

Peter, C.A.; Bowyer, K.; Jones, R.H.

1983-01-01

In patients with ventricular or atrial septal defect, the ventricle which is chronically volume overloaded might not appropriately respond to increased demand for an augmentation in output and thereby might limit total cardiac function. In this study we simultaneously measured right and left ventricular response to exercise in 10 normal individuals, 10 patients with ventricular septal defect (VSD), and 10 patients with atrial septal defect (ASD). The normal subjects increased both right and left ventricular ejection fraction, end-diastolic volume, and stroke volume to achieve a higher cardiac output during exercise. Patients with VSD failed to increase right ventricular ejection fraction, but increased right ventricular end-diastolic volume and stroke volume. Left ventricular end-diastolic volume did not increase in these patients but ejection fraction, stroke volume, and forward left ventricular output achieved during exercise were comparable to the response observed in healthy subjects. In the patients with ASD, no rest-to-exercise change occurred in either right ventricular ejection fraction, end-diastolic volume, or stroke volume. In addition, left ventricular end-diastolic volume failed to increase, and despite an increase in ejection fraction, left ventricular stroke volume remained unchanged from rest to exercise. Therefore, cardiac output was augmented only by the heart rate increase in these patients. Right ventricular function appeared to be the major determinant of total cardiac output during exercise in patients with cardiac septal defects and left-to-right shunt

Factors of Formation of Various Types of Left Ventricular Diastolic Filling in Adolescents with Myocardium Pathology

Directory of Open Access Journals (Sweden)

L.F. Bogmat

2016-08-01

of general peripheral vascular resistance and cardiac output, and geometric one includes left atrial diameter and the left ventricular end-diastolic size. Formation of left ventricular diastolic dysfunction type 3 is influenced by such components of the neurohormonal system, as renin and angiotensin-II, then the process subsequently includes peripheral vascular tone and a geometric factor in the form of left atrial diameter and left ventricular end-diastolic size. Thus, in the initial stages of left ventricular diastolic dysfunction in adolescents with myocardial pathology, a significant role is played by the sympathoadrenal system, peripheral vascular tone and left atrial function, and then sequentially the renin-angiotensin system is being involved, which causes an increase in myocardial stiffness and, as a result, the inclusion in the pathological process not only of the left atrium, but also the structure (end-diastolic volume and function of the left ventricle (stroke volume.

Right ventricle performances with echocardiography and 99mTc myocardial perfusion imaging in pulmonary arterial hypertension patients.

Science.gov (United States)

Liu, Jie; Fei, Lei; Huang, Guang-Qing; Shang, Xiao-Ke; Liu, Mei; Pei, Zhi-Jun; Zhang, Yong-Xue

2018-05-01

Right heart catheterization is commonly used to measure right ventricle hemodynamic parameters and is the gold standard for pulmonary arterial hypertension diagnosis; however, it is not suitable for patients' long-term follow-up. Non-invasive echocardiography and nuclear medicine have been applied to measure right ventricle anatomy and function, but the guidelines for the usefulness of clinical parameters remain to be established. The goal of this study is to identify reliable clinical parameters of right ventricle function in pulmonary arterial hypertension patients and analyze the relationship of these clinical parameters with the disease severity of pulmonary arterial hypertension. In this study, 23 normal subjects and 23 pulmonary arterial hypertension patients were recruited from January 2015 to March 2016. Pulmonary arterial hypertension patients were classified into moderate and severe pulmonary arterial hypertension groups according to their mean pulmonary arterial pressure levels. All the subjects were subjected to physical examination, chest X-ray, 12-lead electrocardiogram, right heart catheterization, two-dimensional echocardiography, and technetium 99m ( 99m Tc) myocardial perfusion imaging. Compared to normal subjects, the right heart catheterization indexes including right ventricle systolic pressure, right ventricle end diastolic pressure, pulmonary artery systolic pressure, pulmonary artery diastolic pressure, pulmonary vascular resistance, and right ventricle end systolic pressure increased in pulmonary arterial hypertension patients and were correlated with mean pulmonary arterial pressure levels. Echocardiography parameters, including tricuspid regurgitation peak velocity, tricuspid regurgitation pressure gradient, tricuspid annular plane systolic excursion and fractional area, right ventricle-myocardial performance index, were significantly associated with the mean pulmonary arterial pressure levels in pulmonary arterial hypertension patients

Radionuclide detection and differential diagnosis of left-to-right cardiac shunts by analysis of time-activity curves

International Nuclear Information System (INIS)

Kim, Ok-Hwa

1986-01-01

The noninvasive nature of the radionuclide angiocardiography provided a useful approach for the evaluation of left-to-right cardiac shunts (LRCS). While the qualitative information can be obtained by inspection of serial radionuclide angiocardiograms, the quantitative information of radionuclide angiocardiography can be obtained by the analysis of time-activity curves using advanced computer system. The count ratios method and pulmonary-to-systemic flow ratio (QP/QS) by gamma variate fit method were used to evaluate the accuracy of detection and localization of LRCS. One hundred and ten time-activity curves were analyzed. There were 46 LRCS (atrial septal defects 11, ventricular septal defects 22, patent ductus arteriosus 13) and 64 normal subjects. By computer analysis of time-activity histograms of the right atrium, ventricle and the lungs separately, the count ratios modified by adding the mean cardiac transit time were calculated in each anatomic site. In normal subjects the mean count ratios in the right atrium, ventricle and lungs were 0.24 on average. In atrial septal defects, the count ratios were high in the right atrium, ventricle and lungs, whereas in ventricular septal defects the count ratios were higher only in the right ventricle and lungs. Patent ductus arteriosus showed normal count ratios in the heart but high count ratios were obtained in the lungs. Thus, this count ratios method could be separated normal from those with intracardiac or extracardiac shunts, and moreover, with this method the localization of the shunts level was possible in LRCS. Another method that could differentiate the intracardiac shunts from extracardiac shunts was measuring QP/QS in the left and right lungs. In patent ductus arteriosus, the left lung QP/QS was hight than those of the right lung, whereas in atrial septal defects and ventricular septal defects QP/QS ratios were equal in both lungs. (J.P.N.)

Differential control of MMP and t-PA/PAI-1 expressions by sympathetic and renin-angiotensin systems in rat left ventricle.

Science.gov (United States)

Dab, Houcine; Hachani, Rafik; Hodroj, Wassim; Sakly, Mohsen; Bricca, Giampiero; Kacem, Kamel

2009-10-05

In the present study, we tested the hypothesis that angiotensin II (Ang II) has both direct (via AT1 receptors) and indirect (via sympathostimulator pathway) actions on the synthesis and activity of the enzymes involved in the extracellular matrix degradation in vivo. For this purpose, sympathectomy and blockade of the Ang II receptor AT1 were performed alone or in combination in normotensive rats. The mRNA of the plasminogen activator (t-PA) and its inhibitor (PAI-1), the mRNA, protein and activity of the matrix metalloproteinases MMP-2 and MMP-9 were examined by Q-RT-PCR, immunoblotting and zymographic methods in the left ventricle. t-PA and PAI-1 mRNA were decreased after sympathectomy and remained unchanged after AT1 receptors blockade. mRNA was increased for t-PA and decreased by similar degree for PAI-1 after double treatment. MMPs mRNA and protein levels were decreased either after sympathectomy or AT1 receptors blockade and an additive effect was acquired after double treatment. MMPs activity was decreased by similar degree in the three treated groups. Deducted interpretations from our experimental approach suggest that Ang II inhibits directly (via AT1 receptors) and indirectly (via sympathostimulator pathway) t-PA mRNA synthesis. It seems unable to influence directly PAI-1 mRNA, but stimulates indirectly PAI-1 mRNA synthesis. Ang II stimulates directly (via AT1 receptors) and indirectly (via sympathostimulator pathway) MMPs synthesis at both transcriptional and protein levels. The enzymatic activity of MMPs does not seem to be influenced directly by Ang II but it could be stimulated indirectly (via sympathostimulator pathway).

Double-chambered right ventricle, ventricular septal defect, patent ductus arteriosus in a dog

Energy Technology Data Exchange (ETDEWEB)

Morozumi, M. [Togasaki Animal Hospital, Misato, Saitama (Japan); Kurosu, Y.; Kogure, K.; Chimura, S.; Shibata, S.; Kanemoto, I.

1989-12-15

A 4-month-old female mongrel puppy was presented with an anophthalmos. On physical examination, systolic murmur was heard at the 4th left intercostal space near the sternum. However the dog appeared healthy without cyanosis and had no history of exercise intolerance. The phonocardiogram revealed a pansystolic murmur and a continuous murmur on the mitral area. A systolic ejection murmur was also recorded on the pulmonic area. The electrocardiogram indicated bi-ventricular hypertrophy. Left ventricular enlargement was seen on chest radiographs. Ventricular septal defect (VSD) and patent ductus arteriosus (PDA) were diagnosed from these findings. PDA closure was performed at 2 years of age. After 2 months from the operation, the dog died during an attempted repair of the VSD. At necropsy, it was found that the double-chambered right ventricle (DCRV) was formed by an anomalous septal band. The VSD was localized on the proximal conus and was 8 mm in diameter. (author)

Double-chambered right ventricle, ventricular septal defect, patent ductus arteriosus in a dog

International Nuclear Information System (INIS)

Morozumi, M.; Kurosu, Y.; Kogure, K.; Chimura, S.; Shibata, S.; Kanemoto, I.

1989-01-01

A 4-month-old female mongrel puppy was presented with an anophthalmos. On physical examination, systolic murmur was heard at the 4th left intercostal space near the sternum. However the dog appeared healthy without cyanosis and had no history of exercise intolerance. The phonocardiogram revealed a pansystolic murmur and a continuous murmur on the mitral area. A systolic ejection murmur was also recorded on the pulmonic area. The electrocardiogram indicated bi-ventricular hypertrophy. Left ventricular enlargement was seen on chest radiographs. Ventricular septal defect (VSD) and patent ductus arteriosus (PDA) were diagnosed from these findings. PDA closure was performed at 2 years of age. After 2 months from the operation, the dog died during an attempted repair of the VSD. At necropsy, it was found that the double-chambered right ventricle (DCRV) was formed by an anomalous septal band. The VSD was localized on the proximal conus and was 8 mm in diameter. (author)

Functional resting-state connectivity of the human motor network: differences between right- and left-handers.

Science.gov (United States)

Pool, Eva-Maria; Rehme, Anne K; Eickhoff, Simon B; Fink, Gereon R; Grefkes, Christian

2015-04-01

Handedness is associated with differences in activation levels in various motor tasks performed with the dominant or non-dominant hand. Here we tested whether handedness is reflected in the functional architecture of the motor system even in the absence of an overt motor task. Using resting-state functional magnetic resonance imaging we investigated 18 right- and 18 left-handers. Whole-brain functional connectivity maps of the primary motor cortex (M1), supplementary motor area (SMA), dorsolateral premotor cortex (PMd), pre-SMA, inferior frontal junction and motor putamen were compared between right- and left-handers. We further used a multivariate linear support vector machine (SVM) classifier to reveal the specificity of brain regions for classifying handedness based on individual resting-state maps. Using left M1 as seed region, functional connectivity analysis revealed stronger interhemispheric functional connectivity between left M1 and right PMd in right-handers as compared to left-handers. This connectivity cluster contributed to the individual classification of right- and left-handers with 86.2% accuracy. Consistently, also seeding from right PMd yielded a similar handedness-dependent effect in left M1, albeit with lower classification accuracy (78.1%). Control analyses of the other resting-state networks including the speech and the visual network revealed no significant differences in functional connectivity related to handedness. In conclusion, our data revealed an intrinsically higher functional connectivity in right-handers. These results may help to explain that hand preference is more lateralized in right-handers than in left-handers. Furthermore, enhanced functional connectivity between left M1 and right PMd may serve as an individual marker of handedness. Copyright © 2015 Elsevier Inc. All rights reserved.

Contemporary Assessment of Left Ventricular Diastolic Function in Older Adults

DEFF Research Database (Denmark)

Shah, Amil M.; Claggett, Brian; Kitzman, Dalane

2017-01-01

Background: Although age-Associated changes in left ventricular diastolic function are well recognized, limited data exist characterizing measures of diastolic function in older adults, including both reference ranges reflecting the older adult population and prognostically relevant values...

Left ventricular function in chronic aortic regurgitation

International Nuclear Information System (INIS)

Iskandrian, A.S.; Hakki, A.H.; Manno, B.; Amenta, A.; Kane, S.A.

1983-01-01

Left ventricular performance was determined in 42 patients with moderate or severe aortic regurgitation during upright exercise by measuring left ventricular ejection fraction and volume with radionuclide ventriculography. Classification of the patients according to exercise tolerance showed that patients with normal exercise tolerance (greater than or equal to 7.0 minutes) had a significantly higher ejection fraction at rest (probability [p] . 0.02) and during exercise (p . 0.0002), higher cardiac index at exercise (p . 0.0008) and lower exercise end-systolic volume (p . 0.01) than did patients with limited exercise tolerance. Similar significant differences were noted in younger patients compared with older patients in ejection fraction at rest and exercise (both p . 0.001) and cardiac index at rest (p . 0.03) and exercise (p . 0.0005). The end-diastolic volume decreased during exercise in 60% of the patients. The patients with a decrease in volume were significantly younger and had better exercise tolerance and a larger end-diastolic volume at rest than did patients who showed an increase in volume. The mean corrected left ventricular end-diastolic radius/wall thickness ratio was significantly greater in patients with abnormal than in those with normal exercise reserve (mean +/- standard deviation 476 +/- 146 versus 377 +/- 92 mm Hg, p less than 0.05). Thus, in patients with chronic aortic regurgitation: 1) left ventricular systolic function during exercise was related to age, exercise tolerance and corrected left ventricular end-diastolic radius/wall thickness ratio, and 2) the end-diastolic volume decreased during exercise, especially in younger patients and patients with normal exercise tolerance or a large volume at rest

Atrial conduction times and left atrial mechanical functions and their relation with diastolic function in prediabetic patients.

Science.gov (United States)

Gudul, Naile Eris; Karabag, Turgut; Sayin, Muhammet Rasit; Bayraktaroglu, Taner; Aydin, Mustafa

2017-03-01

The aim of this study was to investigate atrial conduction times and left atrial mechanical functions, the noninvasive predictors of atrial fibrillation, in prediabetic patients with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Study included 59 patients (23 males, 36 females; mean age 52.5 ± 10.6 years) diagnosed with IFG or IGT by the American Diabetes Association criteria, and 43 healthy adults (22 males, 21 females; mean age 48.5 ± 12.1 years). Conventional and tissue Doppler echocardiography were performed. The electromechanical delay parameters were measured from the onset of the P wave on the surface electrocardiogram to the onset of the atrial systolic wave on tissue Doppler imaging from septum, lateral, and right ventricular annuli. The left atrial volumes were calculated by the disk method. Left atrial mechanical functions were calculated. The mitral E/A and E'/A' ratios measured from the lateral and septal annuli were significantly lower in the prediabetics compared to the controls. The interatrial and left atrial electromechanical delay were significantly longer in prediabetic group compared to the controls. Left atrial active emptying volume (LAAEV) and fraction (LAAEF) were significantly higher in the prediabetics than the controls. LAAEV and LAAEF were significantly correlated with E/A, lateral and septal E'/A'. In the prediabetic patients, the atrial conduction times and P wave dispersion on surface electrocardiographic were longer before the development of overt diabetes. In addition, the left atrial mechanical functions were impaired secondary to a deterioration in the diastolic functions in the prediabetic patients.

Quantitation of global and regional left ventricular function by MRI

NARCIS (Netherlands)

van der Geest, RJ; Reiber, JHC; Reiber, JHC; VanDerWall, EE

1998-01-01

Magnetic resonance imaging (MRI) provides several imaging strategies for assessing left ventricular function. As a three-dimensional imaging technique, all measurements can be performed without relying on geometrical assumptions. Global and regional function parameters can be derived from