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PubMedDate not supplied

Doppler assessment of pulmonary venous flow in healthy subjects and in patients with heart disease.

Pulmonary venous flow as assessed by Doppler echocardiography is a current topic of investigation. Pulmonary venous flow has been used recently as part of a comprehensive assessment of left ventricular diastolic filling dynamics in restrictive myocardial diseases and constrictive pericarditis. Abnormalities of flow have been described in dilated cardiomyopathy, congenital heart disease, and arrhythmias. With the advent of transesophageal echocardiography, pulmonary venous flow can be readily obtained in all patients by pulsed-wave Doppler echocardiography. Recently, it has been used to assess the severity of mitral regurgitation and to estimate mean left atrial pressure. This article emphasizes the utility, physiology, and technique of measuring pulmonary venous flow with Doppler echocardiography in health and in disease.

Blood Flow Velocity↗
PubMed1980

Pulmonary gas exchange after propranolol in patients with ischaemic heart disease.

Pulmonary gas exchange was evaluated after 10 mg i.v. propranolol in 12 patients 3-6 months after acute myocardial infarction undergoing haemodynamic examination in our outpatient department. None of them exhibited clinical signs of heart failure or obstructive airways disease. Routine spirometric examination was normal in all patients. Propranolol led to a distinct deterioration of LV function and to a fall in left ventricular filling pressure both at rest and during exercise. At rest, the administration of propranolol resulted only in a significant decrease of total ventilation. During exercise, its administration was followed by a significant decrease of the tidal volume, alveolar ventilation and VA/VE index. Arterial CO2 tension and physiological dead space ventilation increased significantly. Arterial oxygen tension decreased after propranolol insignificantly both at rest and during exercise. No patient reported dyspnoea after propranolol; 8 patients reported a decrease or disappearance of effort dyspnoea. None exhibited clinical signs of bronchospasm.

Adult↗
PubMedDate not supplied

Air pollution and daily mortality in residential areas of Beijing, China.

The relationship between air pollution and daily mortality in 1989 was examined in two residential areas in Beijing, China. Very high concentrations of sulfur dioxide (SO2) (mean = 102 micrograms/m3, maximum = 630 micrograms/m3) and total suspended particulates (TSPs) (mean = 375 micrograms/m3, maximum = 1,003 micrograms/m3) were observed in these areas. Daily counts of deaths were regressed, using Poisson regression on the logarithm of (SO2) and/or TSPs controlling for effects of temperature, humidity, and day of week. A highly significant association was found between In(SO2) and daily mortality. The risk of total mortality was estimated to increase by 11% (95% confidence interval [95% CI] = 5%-16%) with each doubling in SO2 concentration. Separately, the association of In(TSP) with total daily mortality was positive but not significant (4% increase in mortality with each doubling in TSP; 95% CI = -2%-11%). When mortality was analyzed separately by cause, the association with a doubling in SO2 was significant for chronic obstructive pulmonary disease (29%), pulmonary heart disease (19%), and cardiovascular disease (11%), and marginally significant for the other nonmalignant causes (8%), but not statistically significant for cancer (2%). A similar association was noted for a doubling in TSP (4%, 38%, and 8% for total, chronic obstructive pulmonary disease, and pulmonary heart disease mortality, respectively), but the result was only statistically significant for chronic obstructive pulmonary disease. In the season-specific analysis, both SO2 and TSP were found to be significant predictors of total daily mortality in summer. In winter, SO2 was again significantly associated with increased mortality, but no positive association was found between TSP and mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Air Pollutants↗
PubMed2005

[A pilot survey of the main causes of chronic heart failure in patients treated in primary hospitals in China].

OBJECTIVE: The aim of this investigation is to make clear the main causes of chronic heart failure (CHF) in patients who receive management in primary hospitals in China and to provide scientific evidence for the prevention of CHF in primary hospitals in China. METHODS: The first three main causes of CHF were determined in the way of answering questionnaires by local doctors from 2066 local hospitals (from one hospital at least one doctor) in 17 areas, we got 2100 pieces of valid answer. Input these forms to computer 2 times, check repeatedly till being sure that there were no mistakes in them and then make statistics with SPSS soft kit. RESULTS: In primary hospitals in our country, the first three main causes of CHF are coronary heart disease, hypertension and rheumatic heart disease. In some places chronic pulmonary heart disease is also a main cause of CHF in primary hospitals. CONCLUSIONS: The primary and secondary prevention of coronary heart disease and hypertension is certainly important in the prevention of CHF, but it is equally important to prevent rheumatic heart disease and chronic pulmonary heart disease.

China↗
PubMed1986

Guidelines for clinical use of cardiac radionuclide imaging, December 1986. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Cardiovascular Procedures (Subcommittee on Nuclear Imaging).

This report describes the nuclear cardiology procedures available for use as diagnostic techniques in patients with definite or suspected cardiovascular disease. The usefulness of myocardial imaging, radionuclide angiocardiography, and other radionuclide cardiovascular imaging techniques is classified within specific disease states. The clinical utility of each technique is graded from I to IV, depending on the clinical importance of the technique (I equals most important; IV equals not indicated). A grade of V is given for methods now considered to be in their research phase. The usefulness of these methods is discussed in patients with acute ischemic heart disease, chronic ischemic heart disease, valvular heart disease, pulmonary vascular disease, and hypertensive heart disease. Selected references are provided.

American Heart Association↗
PubMed1983

[Hemodynamics of pulmonary circulation in patients with hypertension complicated by chronic ischemic heart disease].

Pulmonary circulation hemodynamics were studied in 175 patients with essential hypertension (EH), coronary disease (CD), atherosclerotic and post-infarction cardiosclerosis and combinations thereof. Pulmonary hemodynamic disorders were found both in cases of EH and CD, being more pronounced in EH patients. When the two diseases are combined, changes reflecting the state of pulmonary hemodynamics are more marked than those occurring in patients with EH or CD alone. When combined, EH and CD mutually aggravate each other's clinical course and symptomatology.

Chronic Disease↗
PubMed1988

Effect of pH and PCO2 on pulmonary and systemic hemodynamics after surgery in children with congenital heart disease and pulmonary hypertension.

Fourteen children with congenital heart disease and associated pulmonary hypertension (preoperative mean pulmonary artery pressure (MPAP) 48 mm Hg +/- 1 SEM were examined to determine the effect of arterial carbon dioxide tension (PaCO2) and pH on pulmonary and systemic hemodynamics after surgical repair. Baseline measurements were obtained with hyperventilation to PaCO2 20 to 30 mm Hg (pH 7.56 +/- 0.01 mm Hg). The addition of carbon dioxide to inspired gas to achieve a PaCO2 40 to 45 mm Hg (pH 7.35 +/- 0.01) resulted in a significant increase in MPAP, from 32 +/- 5 mm Hg to 47 +/- 8 mm Hg (p less than 0.05). An increase in mean cardiac index (CI) from 2.7 +/- 0.3 L/min/m2 to 3.3 +/- 0.3 L/min/m2 (p less than 0.05) explained in part the associated increase in MPAP. For a subgroup of eight patients with postoperative MPAP greater than 30 mm Hg (at pH 7.35 to 7.40), pulmonary vascular resistance index (PVRI) also significantly increased (p less than 0.05) as PaCO2 was increased, implying a direct pulmonary vasodilating effect of alkalosis. Removal of carbon dioxide from inspired gas returned hemodynamic values to baseline. The higher the MPAP at physiologic pH the greater the absolute amount of MPAP reduction and PVRI reduction (p less than 0.05) with alkalosis. No complications from alkalosis were seen. We suggest that a trial of hypocarbic alkalosis in the child with severe residual pulmonary hypertension after surgical repair of congenital heart disease is warranted to reduce right ventricular afterload.

Adolescent↗
PubMed1995

Noninvasive estimation of pulmonary arterial wedge pressure with Doppler transmitral flow velocity pattern in patients with known heart disease.

Pulmonary arterial wedge pressure (PAWP) is an important marker of cardiac function. Regrettably, it requires catheterization, which can occasionally result in serious complications. A noninvasive method of estimating PAWP would thus be helpful. Recent studies have indicated that the Doppler transmitral flow velocity pattern was strongly dependent on preload and could provide an estimate of PAWP. This study was therefore designed to evaluate the relation between doppler transmitral flow velocity indexes and measured PAWP in 91 patients (learning group: 73 men, mean age 57 +/- 13 years) with ischemic heart disease (n = 41), dilated (n = 29) or hypertrophic cardiomyopathy (n = 4), or aortic stenosis (n = 17). Multiple regression analysis was used to derive an equation for estimation of PAWP, which was subsequently tested in a separate group of 33 patients (testing group: 28 men, mean age 58 +/- 12 years) with similar cardiac conditions. PAWP ranged from 4 to 48 mm Hg in the learning group and from 7 to 40 mm Hg in the testing group. In the learning group, PAWP correlated with the E/A ratio (r = 0.95), atrial filling fraction (r = -0.80), peak E velocity (r = 0.79), isovolumic relaxation period (r = -0.75), and deceleration time (r = -0.61). In the learning group, PAWP was best predicted as PAWP = 18.4 + [17.1.In(E/A ratio)]. This equation allowed prediction of PAWP within 3 mm Hg of the measured value in 24 of 33 patients (73%) in the testing group. In 8 additional patients, the equation also accurately predicted the changes in PAWP induced by volume loading or intravenous nitrates (r = 0.98).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗