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PubMed1997

Blood pressure, insulin resistance and left ventricular function in alcoholics.

OBJECTIVE: To estimate the arterial blood pressure, left ventricular function and insulin secretion in alcoholics. DESIGN: We examined hospitalized patients between the second and seventh day of acute alcohol withdrawal and after a month of abstinence by 24 h ambulatory blood pressure monitoring, a standard oral glucose-tolerance test with determination of insulinaemia, two-dimensional and M-mode echocardiography and pulsed-wave Doppler statistical analysis was performed using Student's t test P < 0.05 was considered statistically significant PATIENTS: Fifty alcoholics aged 36.3 +/- 5.4 years with a history of alcohol abuse for a mean of 12 years. MAIN OUTCOME: We expected the cessation of drinking to exert an influence by lowering the blood pressure and left ventricular function with a concomitant lowering of the insulin resistance. RESULTS: During acute alcohol withdrawal the systolic (121.6 +/- 7.7 versus +115.8 +/- 8.7 mmHg) and diastolic blood pressures (74.5 +/- 6.3 versus 72.0 +/- 7.9 mmHg) were significantly higher. The nocturnal fall in blood pressure was smaller and the variability of the blood pressure was blunted. This period was characterized by hyperinsulinaemia detected by the glucose-tolerance test [In (SUMins) 8957 +/- 0.47 versus 8558 +/- 0.651] correlated to hyperdynamic circulation (cardiac index 3.38 +/- 0.86 versus 3.09 +/- 0.69 I/min per m2). The early: late atrial filling ratio had increased significantly after 1 month of abstinence (1.98 +/- 0.43 versus 2.08 +/- 0.50). CONCLUSIONS: One month of abstinence from drinking decreases the blood pressure and improves the diurnal profile of the blood pressure and the left ventricular diastolic function. Hyperinsulinaemia, which is observed during acute restriction of alcohol consumption, could be one of the causes responsible for hyperdynamic circulation.

Adult↗
PubMed1980

Left ventricular function in presence of small pericardial effusion. Echocardiography study.

Using echocardiography, various indices of left ventricular function were studied in a group of 11 patients with small posterior pericardial effusion. The only index of left ventricular function that was abnormal in this group was maximum diastolic endocardial velocity (DEVM), a measure of left ventricular relaxation. When evaluated as a group, DEVM was significantly decreased in the presence of effusion as compared with the control group. This change in DEVM in the presence of small effusion, without any other associated changes in left ventricular function, suggests that the mechanism of impaired left ventricular relaxation is a change in compliance of the pericardium. In large effusions, left ventricular relaxation abnormalities are associated with changes in left ventricular dimensions, and impaired relaxation may also be the result of shift in intracardiac structures.

Adolescent↗
PubMed1984

Left ventricular function in patients with diabetes mellitus.

The left ventricular function was assessed in 70 diabetics under 60 years of age without clinically evident heart disease using established non-invasive methods, these include systolic time interval method and echocardiography. The ratio of pre-ejection period to left ventricular ejection time (PEP/ET) was remarkably elevated in diabetics with severe microangiopathy (0.431 +/- 0.037). Even in diabetics without microangiopathy PEP/ET ratio was significantly higher (0.374 +/- 0.037) compared with that in controls (0.331 +/- 0.023, P less than 0.01). Most of diabetics with a PEP/ET value of higher than 0.40 were not under proper care with regard to diabetic control. A tendency toward normalization of PEP/ET values was often observed with the improvement in diabetic control during six to twelve months among the inadequately controlled diabetics. Isovolumic relaxation time in diabetics was longer than in controls (80 +/- 14 msec, 59 +/- 11 msec, P less than 0.005). Our results suggest that abnormalities of left ventricular function in diabetics may be related to not only severity of microangiopathy but also the state of diabetic control. The maintenance of adequate control of diabetes seems to play an important role in the prevention of congestive heart failure in patients with diabetes mellitus.

Adolescent↗
PubMed1988

Contraindications to physical training in patients with impaired ventricular function.

Exercise performance in patients with impaired ventricular function does not correlate well with the severity of dysfunction. Patients with ventricular dysfunction can achieve a fairly high work capacity, and the physiological variables respond in a similar way, regardless of whether or not the patients do or do not have impaired function. Furthermore, patients with pump dysfunction can benefit from a supervised physical training programme by improving their functional capacity and thus, their quality of life. The absolute contraindications for exercise therapy in this group of patients with coronary artery disease should therefore be identical to those who have normal ventricular function. In our opinion, special attention should be exercised in patients who have chronotropic incompetence, lack of an elevation or decrease in blood pressure during exercise performance and in those whose stroke volume is not elevated during even low to moderate work-loads. Recommendations as to the implication of exercise therapy as a therapeutic modality in patients with ventricular impairment must be accepted with caution. The reason for this is that our observations are based on historical, anecdotal trials, most of which included only a modest number of patients. Future research and a prolonged follow-up is needed in order to obtain both a more exact analysis and eventually scientifically based evidence on the benefits and hazards involved.

Coronary Disease↗
PubMed1998

Assessment of left-ventricular function.

There are three distinct phases of the cardiac cycle (contraction, active relaxation, and passive relaxation) which should be examined in order to perform a thorough assessment of global left-ventricular function. Accurate measurements of left-ventricular pressure and volume are necessary to assess these phases of the cardiac cycle. The ideal index of contractility is sensitive to the intropic state of the heart, but insensitive to loading conditions, heart rate, and cardiac size. Indices of contractility may be derived from various aspects of the phase of contraction including isovolumic contraction, the end-systolic pressure-volume relationship, the phase of ejection, and the stress-strain relationship. The indices of contractility most commonly employed and arguably closest to 'ideal' are preload recruitable stroke work, an ejection phase index; the dP/dt - end-diastolic volume relationship, an isovolumic contraction phase index; and end-systolic elastance, an index derived from the end-systolic pressure-volume relationship. The active phase of relaxation is most commonly assessed by the time constant (tau) of the exponential ventricular pressure decline that occurs during the isovolumic period of relaxation. The value for tau varies inversely with ventricular function and reflects the active, energy consuming process of relaxation. tau is influenced by many of the same factors which influence contractility. The end-diastolic pressure-volume relationship reflects the passive properties of the left ventricle and may be used to obtain a measure of diastolic stiffness. The end-diastolic pressure-volume relationship is curvilinear (exponential) when end-diastolic pressures are varied over a wide range, but may be approximated by a linear relationship during low filling pressures. Diastolic stiffness is influenced by the viscoelastic properties of the heart, pericardial constraint, the atrioventricular pressure gradient, and ventricular interaction. Knowledge of the indices of the three phases of the cardiac cycle and their interactions are important to the understanding and interpretation of ventricular function in health and disease.

Animals↗
PubMed1993

Effects of coronary angioplasty on left ventricular function.

It is well known that myocardial revascularization after successful coronary bypass surgery results in improved left ventricular function. Coronary angioplasty also results in successful revascularization, favorably affecting both stunned and hibernating myocardium. We studied 22 patients with chronic stable angina who underwent successful angioplasty for an isolated narrowing of the proximal or midportion of the left anterior descending artery. These patients also performed isometric exercises before and after angioplasty, which can be used to characterize left ventricular function. Revascularization after angioplasty induced an immediate improvement in left ventricular function in those patients with dysfunction secondary to hibernating myocardium. Further studies are needed to assess the possibility of the myocardial stunning phenomenon occurring after angioplasty in those patients without left ventricular improvement.

Angioplasty, Balloon, Coronary↗
PubMed2003

The effects of right ventricular apical pacing on left ventricular function. Stimulation of the right ventricular apex: should it still be the gold standard?

Current pacing practice is undergoing continuous and substantial changes. Initially pacing had an exclusively palliative role, since it was reserved for patients developing complete heart block or severe symptomatic bradycardia. With the appearance of novel pacing indications such as pacing for heart failure and atrial fibrillation, the effect of pacing site on cardiac function has become a critically important issue and a subject for consideration. It seems that the classical pacing site in the right ventricular apex is no longer the gold standard because of possible disadvantageous effects on cardiac function. The aim of this review article is to discuss the effect of right ventricular apical pacing on cardiac function including cellular and hemodynamic changes. We also aim to discuss the role of alternative pacing sites in the light of cardiac function.

Journal Article↗
PubMed1984

Factors affecting left ventricular function after correction of tetralogy of Fallot.

To investigate the possible causes of left ventricular dysfunction after total correction of tetralogy of Fallot, 84 patients, aged 1 1/2 to 16 years, were studied by left ventricular cineangiography both before and a mean of 4.6 months after operation. Left ventricular ejection fraction and mean velocity of circumferential fibre shortening were calculated; using multivariate analysis the results were correlated with age at operation, the degree of hypoxia and polycythaemia before operation, occurrence of hypoxic spells, and the duration of operative procedures (cardiopulmonary bypass and aortic cross clamping). The postoperative left ventricular ejection fraction was decreased slightly or moderately in 46% of patients. The variable most significantly associated with altered left ventricular function was a history of hypoxic spells. Age, the degree of chronic hypoxia, and polycythaemia did not correlate significantly with left ventricular function indices. Although no correlation was found between the duration of cardiopulmonary bypass and left ventricular ejection fraction, bypass times exceeding 120 minutes were associated with decreased ejection fractions; this was statistically significant and independent of the variable "hypoxic spells". Thus repeated episodes of acute hypoxia and long operative procedures appear to have a deleterious effect on left ventricular function in tetralogy of Fallot.

Adolescent↗
PubMed2006

[Short term simvastatin use in patients with heart failure of ischemic origin. Changes of blood lipids, markers of inflammation and left ventricular function].

AIM: To study changes of left ventricular function and some markers of inflammation during use of simvastatin in patients with ischemic systolic heart failure. METHODS: Statin naive patients (n=70) with coronary heart disease (CHD), NYHA class II-IV HF and LV ejection fraction (EF) 35% or less after 1 month of stabilization were randomized to simvastatin 40 mg/day (n=36) or no statin (n=34). Lipids, tumor necrosis factor alpha (TNF), and C-reactive protein (CRP) were measured and echocardiography carried out at baseline and in 4 months. In patients with sinus rhythm (n=48) left ventricular diastolic function was assessed by Doppler echo. Seven patients were not restudied and analysis included data from 32 (statin) and 31 (control) patients. RESULTS: Groups were similar except baseline CRP which was significantly higher in controls. In statin treated patients reduction of low density lipoprotein (LDL) cholesterol (CH) was 42%, triglyceride levels also significantly decreased. High density lipoprotein CH rose by 14.4 and 12.9% in statin and control groups, respectively. Despite lower initial level decrease of CRP was significant only in statin group. No significant changes of TNF occurred in either group. Left ventricular EF rose equally in statin treated (+5.7+/-4.7%) and untreated (+4.1+/-4.6%) patients (p=ns). Significant increase of peak atrial filling velocity (A) and decrease of E/A in statin group were difficult to interpret in the presence of systolic dysfunction. CONCLUSION: Short term simvastatin use in patients with systolic heart failure due to CHD caused lowering of LDLCH and CRP however this was not associated with changes of left ventricular EF different from those in control group.

Aged↗
PubMed1990

Comparative effects of pacing-induced and flow-limited ischemia on left ventricular function.

We compared left ventricular (LV) myocardial blood flow and function accompanying severe demand ischemia (rapid atrial pacing in the presence of critical bilateral coronary stenoses) and supply ischemia (complete bilateral coronary occlusion) of the same ischemic regions in 14 pentobarbital-anesthetized dogs. Pacing-induced ischemia resulted in pronounced reductions in average regional epicardial blood flow (0.8 +/- 0.4 vs. control 1.2 +/- 0.4 [+/- SD] ml/g/min, p less than 0.05) and endocardial blood flow (0.4 +/- 0.1 vs. control 1.3 +/- 0.3 ml/g/min, p less than 0.05). More severe reductions in average regional epicardial and endocardial blood flow were seen after bilateral coronary occlusion (BCO) (0.3 +/- 0.3 and 0.1 +/- 0.1 vs. control 1.3 +/- 0.3 ml/g/min, p less than 0.05, respectively). Hemodynamics of postpacing ischemia (PPi) were consistently characterized by systolic impairment including depressed systolic contractile performance [(+)dP/dtmax 1,281 +/- 442 vs. control 2,173 +/- 775 mm Hg/sec, p less than 0.05], ventricular dilation (left ventricular [LV] end-diastolic dimension [EDD] 47.6 +/- 7.8 vs. control 44.7 +/- 8.6 mm, p less than 0.05), and an increase in LV end-diastolic pressure (EDP) (14.4 +/- 2.8 vs. control 4.2 +/- 2.8 mm Hg, p less than 0.05). Abnormalities in early and late diastolic function with PPi included increased time constant of isovolumic relaxation (78.0 +/- 40.4 vs. control 46.4 +/- 20.5 msec, p less than 0.05) and increased chamber stiffness (1.9 +/- 0.77 vs. control 0.81 +/- 0.55 mm Hg/mm, p less than 0.05), respectively. The LV diastolic pressure-dimension relation, however, shifted upward and to the right in eight of nine animals, whereas an upward shift was observed in only one animal. Thus, in this model of postpacing ischemia, we observed contractile failure and passive changes in diastolic function. Alterations in ventricular function occurred consistently earlier and to a greater extent during BCO than PPi, including higher LVEDP (25.3 +/- 8.1 vs. 14.9 +/- 6.6 mm Hg, p less than 0.05), greater ventricular dilation (delta LVEDD 4.9 +/- 2.5 vs. 3.5 +/- 2.8 mm, p less than 0.05), and reduced minor-axis dimension shortening (3.3 +/- 3.1% vs. 6.5 +/- 3.6%, p less than 0.05). To detect potential qualitative differences in ventricular function between the two types of ischemia, we evaluated hemodynamics at comparable loading conditions (30 seconds to 1 minute of BCO).(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1986

Computer assisted echocardiographic assessment of left ventricular function before and after anatomical correction of transposition of the great arteries.

Left ventricular function before and after anatomical correction of transposition of the great arteries was assessed by computer assisted analysis of 78 echocardiographs from 27 patients obtained one year before to five years after operation. Sixteen patients had simple transposition, and 11 had complex transposition with additional large ventricular septal defect. Immediately after correction mean shortening fraction fell from 46(9)% to 33(8)%. There was a corresponding drop in normalised peak shortening rate from 5.4(3.7) to 3.3(1.1) s-1 and normal septal motion was usually absent. Systolic shortening fraction increased with time after correction and left ventricular end diastolic diameter increased appropriately for age. The preoperative rate of free wall thickening was significantly higher in simple (5.6(2.8) s-1) and complex transposition (4.5(1.8) s-1) than in controls (2.9(0.8) s-1). After operation these values remained high in both the short and long term. Thus, computer assisted analysis of left ventricular dimensions and their rates of change before and after anatomical correction showed only slight postoperative changes which tended to become normal with time. Septal motion was commonly absent after operation. This was associated with an increase in the rate of posterior wall thickening that suggested normal ventricular function associated with an altered contraction pattern. Computer assisted echocardiographic analysis may be helpful in the long term assessment of ventricular function after operation for various heart abnormalities.

Child↗
PubMed1995

Evaluation of left ventricular function in Kawasaki disease using equilibrium multigated blood pooling ventriculography.

Twenty-eight children ranging in age from 1-6 years (11 girls, 17 boys) with Kawasaki disease and, for comparison, 30 normal children ranging in age from 1-8 years (8 girls, 22 boys) without any cardiovascular disease were included in this study. The left ventricular functions of the children were evaluated by equilibrium multigated blood pooling ventriculography (EMBPV), which was performed after in vivo labeling of red blood cells using 10 mCi Tc-99m pertechnetate. Scintigraphy was performed using a digital gamma camera with the aid of an electrocardiogram gate. The left ventricular functions were determined by Fourier analysis of the time-activity curve in the left ventricles. The parameters of the left ventricular functions included: 1) systolic phase--[a] ejection fraction (EF), [b] ejection time (ET), [c] peak ejection rate (PER), and [d] first 1/3 ejection rate mean (1/3ERM), and 2) diastolic phase--[a] peak filling rate (PFR), [b] fast filling fraction (FFF), [c] time to peak filling rate (TPFR), and [d] first 1/3 filling rate mean (1/3FRM). The results showed that no significant differences existed between the two groups in any parameter of the left ventricular function. The authors suggest that the left ventricular functions in children with Kawasaki disease are not apparently impaired. The results were proven by the presentation of the EMBPV in this study.

Case-Control Studies↗
PubMed2001

Effect of exercise training on postexercise oxygen uptake kinetics in patients with reduced ventricular function.

BACKGROUND: The time required for oxygen uptake (O(2)) to return to baseline level (recovery kinetics) is prolonged in patients with reduced ventricular function, and the degree to which it is prolonged is related to the severity of heart failure, markers of abnormal ventilation, and prognosis. In the present study, we sought to determine the effect of exercise training on O(2) recovery kinetics in patients with reduced ventricular function. METHODS: Twenty-four male patients with reduced ventricular function after a myocardial infarction were randomized to either a 2-month high-intensity residential exercise training program or to a control group. O(2) kinetics in recovery from maximal exercise were calculated before and after the study period and expressed as the slope of a single exponential relation between O(2) and time during the first 3 min of recovery. RESULTS: Peak O(2) increased significantly in the exercise group (19.4 +/- 3.0 mL/kg/min vs 25.1 +/- 4.7 mL/kg/min, p < 0.05), whereas no change was observed in control subjects. The O(2) half-time in recovery was reduced slightly after the study period in both groups (108.7 +/- 33.1 to 102.1 +/- 50.5 s in the exercise group and 122.3 +/- 68.7 to 107.5 +/- 36.0 s in the control group); neither the change within or between groups was significant. The degree to which O(2) was prolonged in recovery was inversely related to measures of exercise capacity (peak O(2), watts achieved, and exercise time; r = - 0.48 to - 0.57; p < 0.01) and directly related to the peak ventilatory equivalents for oxygen (r = 0.59, p < 0.01) and carbon dioxide (r = 0.57, p < 0.01). CONCLUSION: Two months of high-intensity training did not result in a faster recovery of O(2) in patients with reduced ventricular function. This suggests that adaptations to exercise training manifest themselves only during, but not in, recovery from exercise.

Carbon Dioxide↗
PubMed1996

Assessment of left ventricular function and hemodynamics with transesophageal echocardiography.

Transesophageal echocardiography (TEE) plays an important role in the evaluation of left ventricular function and hemodynamics in the critical care setting. The technique provides immediate data regarding regional myocardial ischemia, global ventricular function, volume, and the presence of cardiac tamponade. This article outlines the role of TEE in the evaluation of left ventricular function in the intensive care unit and presents practical information for the use of TEE in evaluating systolic function, diastolic function, and cardiac tamponade.

Cardiac Output↗
PubMed1996

Assessment of left ventricular function: comparison between radionuclide angiography and semiquantitative two-dimensional echocardiographic analysis.

Measurement of global left ventricular function is important in the follow-up of cardiac patients and is a good prognostic indicator in acute cardiac situations. We compared quantitative measurements of global left ventricular function made with radionuclide angiography (RNA) and contrast cardiac ventriculography (CVG) to visual semiquantitative estimates from two-dimensional echocardiographic images (2D-echo). Three hundred and thirty-nine consecutive patients who underwent RNA were assessed with 2D-echo within 3 months. In addition, 92 of these patients also underwent CVG (correlation of ejection fraction between CVG and RNA: r=0.82; P<0.0001). The RNA mean ejection fractions in the four 2D-echo groups (0=normal, 1=slightly, 2=moderate, or 3=severe reduced left ventricular function) differed markedly (P<0.0001); however, there was overlapping among the groups (2D-echo score/RNA ejection fraction: 0=57.3%+/-12.8%; 1=46.0%+/-12.9%; 2=29.6%+/- 12.2%; and 3=24.6%+/-11. 5%) and the difference between 2D-echo scores 2 and 3 was not significant. 2D-echo showed a good concordance in RNA classes (0=>/=505; 1=35%-49%; 2=21%-34%; and 3=</=20% ejection fraction) 0 (133/166; 80%) and 3 (18/30; 60%) but low concordance in classes 1 (27/82; 33%) and 2 (21/61; 34%). For accurate assessment of global left ventricular ejection fraction, visual semiquantitative judgement of a 2D echocardiographic image is limited in comparison to CVG or RNA, especially in patients with a slight or moderate reduction in left ventricular ejection fraction.

Cardiac Catheterization↗
PubMed1994

Right latissimus dorsi cardiomyoplasty improves left ventricular function by increasing peak systolic elastance (Emax).

BACKGROUND: Dynamic cardiomyoplasty remains a promising but poorly understood surgical modality for selected patients with dilated cardiomyopathy. Despite encouraging clinical results, objective evidence of enhanced ventricular function using traditional indexes (cardiac output, ejection fraction, and dP/dt) has been difficult to document after cardiomyoplasty. Several investigators have suggested that cardiomyoplasty acts partly by unloading the left ventricle. These indexes all depend somewhat on loading conditions, however, and might not detect such an interaction. The time-varying elastance model provides an index of contractility, Emax, that is relatively insensitive to changes in loading conditions. We applied this model to study the effect of right latissimus dorsi cardiomyoplasty on left ventricular function in an acute canine model. METHODS AND RESULTS: Five dogs underwent acute cardiomyoplasty using untrained right latissimus dorsi muscle. Instrumentation included Millar pressure transducers in the left ventricle and aortic root, an electromagnetic flow probe around the ascending aorta, and a volume conductance catheter in the left ventricle. A cuffed nerve electrode around the thoracodorsal nerve and a right ventricular sensing lead were connected to a Medtronic Cardiomyostimulator (5 V, 30 Hz, 1:1 synchronization). Transient caval occlusions were performed with the stimulator both off and on to calculate Emax and the slope of the end-systolic pressure-volume relationship (Ees). Turning the stimulator on significantly increased peak systolic elastance (Emax) and end-systolic elastance (Ees) in all five dogs by an average of 56% and 78%, respectively (P < .05). End-diastolic volume and end-systolic volume decreased by 18% and 28%, respectively (P < .05). All other measured hemodynamic parameters, including peak left ventricular pressure, mean arterial pressure, cardiac output, stroke volume, stroke work, ejection fraction, preload-recruitable stroke work, and dP/dt, did not change significantly. CONCLUSIONS: These results show that, in this acute canine model, right latissimus dorsi cardiomyoplasty significantly improves left ventricular function while decreasing left ventricular volumes. The results are consistent with the theory that cardiomyoplasty increases contractility while unloading the ventricle by decreasing end-diastolic volume. This increase in Emax despite inconsistent changes in other indexes underlies the importance of using load-insensitive indexes of ventricular function when studying cardiomyoplasty.

Animals↗
PubMedDate not supplied

[ACE gene polymorphism correlation (I/D) with the ventricular function in patients with ischemic and idiopathic dilated cardiomyopathy].

UNLABELLED: Dilated cardiomyopathy is a myocardial disease, characterized by biventricular expansion. Renin-angiotensin-aldosterone system (RAAS) is closely related with the progress of this pathology. Has been shown that angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism influences as much in the plasmatic concentration as in activity of ACE. In addition, ACE IID polymorphism has been associated with remodeling phenomena and an increased risk to develop several cardiovascular diseases. On virtue of the influence of ACE gene polymorphism on RAAS, we studied the correlation between ACE I/D polymorphism with morphologic and functional clinical alterations in ischemic or idiopathic dilated cardiomyopathy in one attempt to establish its utility as prognosis factor. METHODS AND RESULTS: We studied 30 patients of The National Institute of Cardiology. Ventricular function was evaluated by transthoracic echocardiography. ACE genotype was determined by polymerase chain reaction (PCR). Results for left ventricle shown: Tei Index was increased in patients with II genotype (0.84 vs. 0.48) when were compared to patients with DD genotype p < 0.01. Eccentricity Index was lesser in the group with II genotype (0.64), than in the group DD (0.86) p < 0.01. Ventricular mass was increased in DD patients when was compared with II group (174 g vs. 133 g) Isovolumetric contraction time was shorter in group DD than in II (45 mseg vs. 139 mseg) p < 0.05. These findings denote better preservation of left ventricular function in patients with DD genotype. In opposition, right ventricle shown an increased Tei Index in the group with DD genotype (1.01) when was compared with II genotype (0.55), p < 0.05. Pulmonary artery systolic pressure tended to be higher in DD genotype group without reach statistic significance. CONCLUSIONS: In our group of study, patients with DD genotype shown better left ventricular function in ischemic or idiopathic dilated cardiomyopathy. On the opposite right ventricular function were more deteriorated in patients with ACE DD genotype.

Cardiomyopathy, Dilated↗
PubMedDate not supplied

Evaluation of right-ventricular function by Doppler echocardiography in patients with chronic respiratory failure.

In patients with chronic respiratory failure, right-ventricular function was non-invasively evaluated by Doppler echocardiography. A total of 31 patients (16 men, 15 women; mean age 65.8 +/- 7.12 years) with pulmonary tuberculosis sequelae who had received home oxygen therapy during the preceding 6 or more months, were studied. Right-ventricular inflow and outflow waveforms were recorded, and right-ventricular function was evaluated using a new Doppler index combining systolic and diastolic function. On continuous wave Doppler echocardiography, estimated systolic pulmonary arterial pressure was calculated from the gradient between the right atrium and right ventricle. There was no correlation between the new Doppler index and systolic pulmonary arterial pressure, and some patients showed high index values despite low systolic pulmonary arterial pressure. The new Doppler index facilitated evaluation of ventricular function irrespective of right-ventricular afterload.

Aged↗