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PubMed1999

Coping with coronary heart disease: a longitudinal study.

This longitudinal study evaluated the effects of two types of coping strategies, approach and avoidance, on anxiety, depression, and well-being in patients with coronary heart disease. Measurements were made at three timepoints: 1 month, 3 months, and 12 months after the cardiac event. Both cross-sectional and longitudinal relations were explored. At all three measurement points significant negative cross-sectional relations were found between approach and well-being, and significant positive cross-sectional relations were found between approach, on the one hand, and anxiety and depression, on the other. At the first measurement point, avoidance showed a positive association with well-being, and a negative association with anxiety. Longitudinal analyses, however, revealed a negative relationship between approach at the first measurement points and anxiety and depression at later measurement points. Likewise, there was a positive association between approach at the first two measurement points and well-being at later measurement points. The results of this study demonstrate the importance of facing and working through the trauma of the coronary event. Although unfavorable in the short term, working through the trauma can attenuate long-term emotional distress. These results suggest that assessment of the psychological consequences of coronary heart disease and development of interventions should not be based only on cross-sectional data, but should take into account longitudinal relations between coping and psychosocial outcome measures.

Adaptation, Psychological↗
PubMed2002

Differential effects of neuropeptides on circular and longitudinal muscles of the crayfish hindgut.

Proctolin (Arg-Tyr-Leu-Pro-Thr-OH) and crayfish peptide "DF(2)" (Asp-Arg-Asn-Phe-Leu-Arg-Phe-NH(2)) enhance spontaneous contractions of isolated crayfish hindguts. Both peptides increase the frequency and amplitude of spontaneous, rapid contractions. Proctolin induces a slow contraction, which gives the appearance of an increase in overall tonus. DF(2) has no such effect. To determine whether the peptides affect both longitudinal and circular muscles, hindguts were cut into longitudinal strips and into rings, and contractions were recorded from each. The longitudinal strips generated only rapid contractions, and both peptides increased the frequency and amplitude of such contractions without significantly altering tonus. Rapid contractions were observed in only 1 of 14 preparations of rings. Proctolin induced slow contractions in the rings, and DF(2) had no such effect. The results indicate that neuropeptides have different effects on circular and longitudinal muscles of hindgut.

Animals↗
PubMed2003

Gapping phenomenon of longitudinal meniscal tears.

OBJECTIVE: To investigate the gapping behaviour of longitudinal meniscal tears. DESIGN: The gap size of longitudinal meniscal tears was measured in porcine knee joints under various joint loading conditions. BACKGROUND: Many meniscal fixation implants have low pull out forces. However, it is unknown if these forces are less than the forces the implants must resist in vivo. It is also unknown if gapping occurs in longitudinally torn menisci and what joint loads induce gapping. METHODS: Longitudinal tears were set in the medial menisci of eight porcine knee joints. To observe the tears an opaque placeholder of the same shape as the original articular surface replaced the medial tibial plateau. The knees were exposed to flexion-extension cycles in a loading and motion simulator under 30 and 200 N axial joint load without external moments, under tibial rotation moments, varus or valgus moments, and combined moments. For each load condition the maximum gap of the tear was registered. RESULTS: Maximum gapping (1.59 mm, SD 0.47) occurred in the 3 cm tear at 200 N axial joint load under the combination of a valgus and external rotation moment. An internal tibial rotation moment produced the smallest gaps in tears of any length and at any axial joint load. CONCLUSIONS: The maximum gap size found in this study and the previously published pull out stiffnesses of meniscal fixation implants reveal maximum forces on the implant in vivo of only 8.4 N. This explains why meniscal tears fixed with implants of low pull out strength can heal. RELEVANCE: The current study shows that moderate joint loads only lead to small gaps of meniscal tears. Clinically, this means that fixation implants of low pull out strength are not in danger of failure in a normal rehabilitation regimen.

Animals↗
PubMedDate not supplied

A ten-year longitudinal examination of repetition priming, incidental recall, free recall, and recognition in young and elderly.

The effects of age and time on nondeclarative and declarative memory in young and elderly were examined in a 10-year longitudinal study using tests of word-stem priming, incidental recall, free recall, and recognition. The elderly were significantly impaired on all tests, but no reliable longitudinal decrement by the elderly was detected for priming, incidental recall,or recognition. The elderly demonstrated a significant longitudinal decline in declarative memory as assessed by a test of free recall. While nondeclarative memory declines with age, the longitudinal findings are consistent with the view that declarative memory is more susceptible to the effects of aging.

Adolescent↗
PubMed2002

Longitudinal brainstem laceration associated with complex basilar skull fractures due to a fall: an autopsy case.

This report describes an autopsy case of a rare longitudinal brainstem laceration associated with complex basilar skull fractures. The victim was a 40-year-old male who died immediately after falling from a roof (9.2m in height) of a factory onto a concrete floor. The postmortem examination revealed an incomplete ring fracture of the base of the skull with longitudinal fractures of the sphenoid (clivus of the dorsum sellae turcicae) and occipital bones, cerebral contusions in the frontal and temporal poles, a longitudinal brainstem laceration at the posterior median sulcus of the pons accompanied with multiple contusional hemorrhages in the brainstem and corpus callosum. Related blunt-force injuries were observed in the parieto-occipital region of the head, shoulder and upper back involving the fractures of the cervical and thoracic vertebrae, and sternum and ribs, indicating a huge impact to the occiput and subsequent impression of the vertebral column into the base of the skull due to violent anteroflexion of the neck, which caused the complex basilar skull fractures, contusions and longitudinal laceration of the brainstem.

Accidental Falls↗
PubMed2000

Longitudinal straightening effect of stents is an additional predictor for major adverse cardiac events. Austrian Wiktor Stent Study Group and European Paragon Stent Investigators.

OBJECTIVES: The aim of this study was to perform an investigation of the effects of the longitudinal straightening of coronary arteries by stents and the possible association with major adverse cardiac events (MACE) (primary end point) and angiographic restenosis (secondary end point). BACKGROUND: Stent deployment straightens a tortuous artery, and any consequent arterial longitudinal stretch may contribute to MACE and stent restenosis severity. METHODS: Clinical, qualitative and quantitative angiographic data on 404 patients with single stent implantation were subjected to multivariate nominal logistic regression analysis for the prediction of MACE. The predictive accuracy, sensitivity and specificity values and cut-off points of the continuous variables were determined via receiver operating characteristics curves. The longitudinal straightening effect of stents was characterized through the changes in vessel angle (defined by the tangents to the proximal and distal parts of the stenoses/stents). RESULTS: Follow-up angiography on 354 patients revealed 73 cases of stent restenosis (> or =50% diameter stenosis). Coronary bypass surgery was performed in 4 patients and repeated percutaneous transluminal coronary angioplasty in 56 patients; acute myocardial infarction (AMI) occurred in 2 patients, and 4 patients died during the follow-up. The overall incidence of MACE (death, AMI and revascularization) was 16.3% (66 patients). The best predictive accuracies and sensitivities/specificities of factors indicative of MACE were found for the minimal lumen diameter (MLD) at follow-up (predictive accuracy: 0.9305, sensitivity/specificity: 86.6%), the post-stent MLD (0.773, 77.2%), the percent diameter stenosis (%DS) at follow-up (0.9432, 87.1%), the prestent vessel angulation (0.6797, 68.2%) and the poststent changes in vessel angulation (0.6279, 62.2%). Multivariate nominal logistic regression analysis demonstrated that a poststent MLD < or =2.63 mm (p = 0.0017, odds ratio [OR] = 17.961, 95% confidence interval [CI] = 17.45-20.428), an MLD at follow-up < or =1.7 mm (p = 0.0059, OR = 11.880, 95% CI = 11.490-14.093), a %DS at follow-up > or =42.2% (p = 0.0000, OR = 49.553, 95% CI = 48.024-53.507), a prestent vessel angulation > or =33.5 degrees (p = 0.0477, OR = 5.404, 95% CI = 5.382-7.142) and poststent changes in vessel angulation > or =9.1 degrees (p = 0.0026, OR = 19.161, 95% CI = 18.562-21.750) were significant predictors for MACE. Multiple linear regression revealed that the poststent MLD (multivariate p = 0.0001), the MLD at follow-up (p = 0.0000), the prestent vessel angulation (p = 0.0431) and the changes in vessel angulation after stent implantation (p = 0.0316) were significant independent variables predicting angiographic stent restenosis severity. CONCLUSIONS: The longitudinal straightening effect of coronary artery stents contributes significantly to the occurrence of MACE and angiographic restenosis, and this finding may have an impact on future stent design.

Aged↗
PubMed2003

Auditory P300 amplitude as a state marker for positive symptoms in schizophrenia: cross-sectional and retrospective longitudinal studies.

The amplitude of the P300 component of the auditory event-related brain potential (ERP) is consistently reduced in schizophrenia. To determine whether this P300 abnormality can be used as a state marker to reflect the severity of symptoms, we examined both cross-sectionally and longitudinally the relationship between auditory P300 amplitude and symptom severity in patients with schizophrenia. For the cross-sectional study, ERP was elicited by an auditory oddball paradigm, and symptom severity was quantitatively measured by means of the Positive and Negative Syndrome Scale in 93 patients with schizophrenia or schizophreniform disorder (DSM-III-R). For the longitudinal study, ERP and psychopathology measured twice at an average interval of 238 days for 20 patients were retrospectively analyzed. The cross-sectional data showed that P300 amplitude correlated negatively with the positive but not with the negative syndrome scale score. The longitudinal data also showed a significant negative correlation between changes in P300 amplitude and in the positive syndrome scores of the first and second tests. In particular, P300 amplitude recorded at the left, but not right, posterior temporal region significantly correlated with the positive syndrome in both the cross-sectional and longitudinal studies. These findings support the hypotheses that auditory P300 amplitude recorded in the left hemisphere can be used as a state marker to reflect the severity of the positive symptoms and that the positive symptoms may be caused by a possible left-hemisphere deficit in schizophrenia.

Adult↗
PubMed2000

The longitudinal visceral musculature of Drosophila melanogaster persists through metamorphosis.

The larval gut of Drosophila is coated with visceral muscles of mesodermal origin. In the midgut region this musculature comprises circular and longitudinal fibres. The complete visceral musculature is described to be removed during metamorphosis and to be replaced by a newly differentiated imaginal tissue resembling the morphology of the larval musculature. However, progenitors of this imaginal visceral musculature have never been detected prior to differentiation. Here I present results indicating that the longitudinal visceral musculature of the midgut completely persists through metamorphosis. Single cells expressing green fluorescent protein (GFP) as a marker were transplanted at the blastoderm stage. All clones contributing to the longitudinal visceral musculature detected in third instar larvae were recovered after metamorphosis in adult flies. Further evidence for the persistence of the larval visceral musculature was obtained from the P[Gal4] insertion line 5053A. It expresses GAL4 specifically in the longitudinal visceral muscles of the midgut of all developmental stages to the adult fly beginning at the end of embryogenesis. By using GFP as a reporter, it was possible to follow these cells through the entire metamorphosis. Although the muscles undergo dramatic morphological changes including the loss of their contractile system, no evidence for a replacement of the larval visceral musculature by imaginal precursor cells was detected.

Animals↗
PubMed2006

Tubularized longitudinal island flap of the mucosa and skin on the dorsum of the penis in the treatment of hypospadias: experience from 176 cases.

OBJECTIVE: To report the result of the treatment of hypospadias using tubularized longitudinal island flap of the mucosa and skin on the dorsum of the penis. METHODS: Between January 1995 and December 2003, 176 patients were operated on using this technique. Among them, 124 patients had penile hypospadias, 35 had the penoscrotal form, four had the scrotal form and three patients had the perineal form. After removing the whole chordee, a longitudinal pedicle island flap of mucosa and skin was created. The flap was transposed to the ventral side of the penis by the buttonhole manoeuvre, and anastomosed to the meatus. The flap was tubularized creating a neourethra. RESULTS: The length of urethral defect varied from 1.5 to 10 cm (mean, 3.5 cm). The single longitudinal flap was used in 171 patients. The combination of a longitudinal flap and a local flap was used in five patients. Fistulae occurred in 13 patients (7.4%). Torsion of the penile axis did not occur in any patient. All children voided with a single straight urinary stream, and had a normal appearance of the meatus. CONCLUSION: The technique has a low fistula occurrence rate and a good cosmetic result.

Adolescent↗
PubMed1996

A simple method for measuring the effects of drugs on intestinal longitudinal and circular muscle.

A tissue preparation is described which makes it possible to examine the effect of drugs on the nerves that control both longitudinal and circular muscles of the small intestine. The preparation consists of a segment of rat ileum set up to measure the tension developed in the longitudinal muscle and intraluminal pressure developed by the circular muscle in response to transmural electrical stimulation. The method showed that both muscles differed in their patterns of responses to transmural stimulation from the threshold of 2.5-60 Hz. All responses were tetrodotoxin-sensitive, the fast longitudinal muscle contraction and the intraluminal pressure response being caused by both pre- and postganglionic cholinergic nerves. The responses differed in their sensitivities to the alpha 2-adrenoceptor agonists clonidine and UK 14,304, whereby the cholinergic responses of the circular but not longitudinal muscle were inhibited by the agonists. Comparison of results with the guinea-pig ileum set up in the same way revealed a marked species variation in responses, in that the intraluminal pressure response of the guinea-pig ileum was not sensitive to alpha 2-adrenoceptor agonists. This clear species difference makes it possible to use the circular muscle of the rat ileum, as measured indirectly via intraluminal pressure, to assess compounds for activity at alpha 2-adrenoceptors over a wide range of frequencies.

Animals↗
PubMed2001

Modulation of appositional and longitudinal bone growth in the rat ulna by applied static and dynamic force.

Appositional and longitudinal growth of long bones are influenced by mechanical stimuli. Using the noninvasive rat ulna loading model, we tested the hypothesis that brief-duration (10 min/day) static loads have an inhibitory effect on appositional bone formation in the middiaphysis of growing rat ulnae. Several reports have shown that ulnar loading, when applied to growing rats, results in suppressed longitudinal growth. We tested a second hypothesis that load-induced longitudinal growth suppression in the growing rat ulna is proportional to time-averaged load, and that growth plate dimensions and chondrocyte populations are reduced in the loaded limbs. Growing male rats were divided into one of three groups receiving daily 10 min bouts of static loading at 17 N, static loading at 8.5 N, or dynamic loading at 17 N. Periosteal bone formation rates, measured 3 mm distal to the ulnar midshaft, were suppressed significantly (by 28-41%) by the brief static loading sessions despite normal (dynamic) limb use between the daily loading bouts. Static loading neither suppressed nor enhanced endocortical bone formation. Dynamic loading increased osteogenesis significantly on both surfaces. At the end of the 2 week loading experiment, loaded ulnae were approximately 4% shorter than the contralateral controls in the 17 N static and dynamic groups, and approximately 2% shorter than the control side in the 8.5 N static group, suggesting that growth suppression was proportional to peak load magnitude, regardless of whether the load was static or dynamic. The suppressed growth in loaded limbs was associated with thicker distal growth plates, particularly in the hypertrophic zone, and a concurrent retention of hypertrophic cell lacunae. Negligible effects were observed in the proximal growth plate. The results demonstrate that, in growing animals, even short periods of static loading can significantly suppress appositional growth; that dynamic loads trigger the adaptive response in bone; and that longitudinal growth suppression resulting from compressive end-loads is proportional to load magnitude and not average load.

Animals↗
PubMed2001

The longitudinal effect of depression on functional limitations and disability in older adults: an eight-wave prospective community-based study.

BACKGROUND: The temporal relationship between depression and adverse functional outcomes in older adults is ambiguous. In the present eight-wave prospective community-based study, the longitudinal effect of depression on functional limitations and disability (in terms of disability days and bed days) was studied, thereby taking into account the role of chronic physical diseases. METHODS: The study is based on a sample which at the outset consisted of 325 non-depressed and 327 depressed persons (55-85 years) drawn from a larger random community based sample in the Netherlands. Generalized estimating equations time-lag models were used to examine the longitudinal relation between depression and both functional limitations and disability. RESULTS: Functional limitations were very persistent over time, whereas disability days and bed days were more fluctuating functional outcomes. Only in the presence of chronic physical diseases, there was a significant longitudinal association between depression at the previous measurement and functional limitations, disability days and bed days at the next measurement. The effect on functional limitations was small, which was probably partly due to their persistent nature. CONCLUSIONS: The finding of a longitudinal relationship between depression and functional outcomes in older adults with a compromised health status provides a rationale for treatment of chronic physical diseases as well as depression in depressed chronically ill elderly, in order to prevent a spiralling decline in psychological and physical health.

Aged↗
PubMed2002

Longitudinal (1)H relaxation optimization in TROSY NMR spectroscopy.

A general method to enhance the sensitivity of the multidimensional NMR experiments performed at high-polarizing magnetic field via the significant reduction of the longitudinal proton relaxation times is described. The method is based on the use of two vast pools of "thermal bath" 1H spins residing on hydrogens covalently attached to carbon and oxygen atoms in 13C,15N labeled and fully protonated or fractionally deuterated proteins to uniformly enhance longitudinal relaxation of the 1HN spins and concomitantly the sensitivity of multipulse NMR experiments. The proposed longitudinal relaxation optimization is implemented in the 2D [15N,1H]-LTROSY, 2D [15N,1H]-LHSQC and 3D LTROSY-HNCA experiments yielding the factor 2-2.5 increase of the maximal signal-to-noise ratio per unit time at 600 MHz. At 900 MHz, the predicted decrease of the 1HN longitudinal relaxation times can be as large as one order of magnitude, making the proposed method an important tool for protein NMR at high magnetic fields.

Bacillus subtilis↗
PubMed1985

Longitudinal stability of personality traits: a multitrait-multimethod-multioccasion analysis.

The longitudinal stability of personality was investigated in a group of several hundred adults who were rated by themselves, their marriage partners, and their acquaintances in 1935-1938 and by themselves and their marriage partners in 1954-1955. For both men and women, there were very similar factorial structures in all five sources of ratings. Individual differences in neuroticism, social extraversion, and impulse control had reasonably high levels of longitudinal stability over a 19-year period. Both the synchronic and diachronic correlations converged across methods and discriminated among traits. Self-report personality inventory data available in 1935-1938 and 1954-1955 provided corroborating evidence of the longitudinal and methodological robustness of personality traits. In data gathered on the same panel in 1980-1981, the questionnaire and the life history correlates of neuroticism and social extraversion displayed patterns indicative of temporal stability, methodological convergence, and discrimination among constructs. The data of this longitudinal study carried out over five decades strongly indicate that there is a set of personality traits that are generalizable across methods of assessment and are stable throughout adulthood.

Adolescent↗
PubMed2005

Stability, growth, and decline in adult life span development of declarative memory: cross-sectional and longitudinal data from a population-based study.

Five-year changes in episodic and semantic memory were examined in a sample of 829 participants (35-80 years). A cohort-matched sample (N=967) was assessed to control for practice effects. For episodic memory, cross-sectional analyses indicated gradual age-related decrements, whereas the longitudinal data revealed no decrements before age 60, even when practice effects were adjusted for. Longitudinally, semantic memory showed minor increments until age 55, with smaller decrements in old age as compared with episodic memory. Cohort differences in educational attainment appear to account for the discrepancies between cross-sectional and longitudinal data. Collectively, the results show that age trajectories for episodic and semantic memory differ and underscore the need to control for cohort and retest effects in cross-sectional and longitudinal studies, respectively.

Adult↗
PubMed1999

Quantification of longitudinal tissue pO2 gradients in window chamber tumours: impact on tumour hypoxia.

We previously reported that the arteriolar input in window chamber tumours is limited in number and is constrained to enter the tumour from one surface, and that the pO2 of tumour arterioles is lower than in comparable arterioles of normal tissues. On average, the vascular pO2 in vessels of the upper surface of these tumours is lower than the pO2 of vessels on the fascial side, suggesting that there may be steep vascular longitudinal gradients (defined as the decline in vascular pO2 along the afferent path of blood flow) that contribute to vascular hypoxia on the upper surface of the tumours. However, we have not previously measured tissue pO2 on both surfaces of these chambers in the same tumour. In this report, we investigated the hypothesis that the anatomical constraint of arteriolar supply from one side of the tumour results in longitudinal gradients in pO2 sufficient in magnitude to create vascular hypoxia in tumours grown in dorsal flap window chambers. Fischer-344 rats had dorsal flap window chambers implanted in the skin fold with simultaneous transplantation of the R3230AC tumour. Tumours were studied at 9-11 days after transplantation, at a diameter of 3-4 mm; the tissue thickness was 200 microm. For magnetic resonance microscopic imaging, gadolinium DTPA bovine serum albumin (BSA-DTPA-Gd) complex was injected i.v., followed by fixation in 10% formalin and removal from the animal. The sample was imaged at 9.4 T, yielding voxel sizes of 40 microm. Intravital microscopy was used to visualize the position and number of arterioles entering window chamber tumour preparations. Phosphorescence life time imaging (PLI) was used to measure vascular pO2. Blue and green light excitations of the upper and lower surfaces of window chambers were made (penetration depth of light approximately 50 vs >200 microm respectively). Arteriolar input into window chamber tumours was limited to 1 or 2 vessels, and appeared to be constrained to the fascial surface upon which the tumour grows. PLI of the tumour surface indicated greater hypoxia with blue compared with green light excitation (P < 0.03 for 10th and 25th percentiles and for per cent pixels < 10 mmHg). In contrast, illumination of the fascial surface with blue light indicated less hypoxia compared with illumination of the tumour surface (P < 0.05 for 10th and 25th percentiles and for per cent pixels < 10 mmHg). There was no significant difference in pO2 distributions for blue and green light excitation from the fascial surface nor for green light excitation when viewed from either surface. The PLI data demonstrates that the upper surface of the tumour is more hypoxic because blue light excitation yields lower pO2 values than green light excitation. This is further verified in the subset of chambers in which blue light excitation of the fascial surface showed higher pO2 distributions compared with the tumour surface. These results suggest that there are steep longitudinal gradients in vascular pO2 in this tumour model that are created by the limited number and orientation of the arterioles. This contributes to tumour hypoxia. Arteriolar supply is often limited in other tumours as well, suggesting that this may represent another cause for tumour hypoxia. This report is the first direct demonstration that longitudinal oxygen gradients actually lead to hypoxia in tumours.

Animals↗
PubMed2003

Decreased left ventricular longitudinal contraction in normotensive and normoalbuminuric patients with Type II diabetes mellitus: a Doppler tissue tracking and strain rate echocardiography study.

Type II diabetes mellitus is associated with congestive heart failure with preserved ejection fraction. This group of patients has been assumed to have isolated diastolic dysfunction; however, the longitudinal systolic contraction of the left ventricle has not been studied previously. The objective of the present study was to investigate the longitudinal contraction of the left ventricle in normotensive Type II diabetes mellitus patients with normal ejection fraction. We examined 32 normotensive patients with Type II diabetes mellitus with ejection fraction >0.55 and fractional shortening >0.25. Exclusion criteria were angina pectoris, cardiac valve disease, albuminuria, retinopathy or neuropathy. Normal subjects (n =32) served as controls. A 16 segment model of motion amplitude assessed left ventricular longitudinal contraction and the average of the segments was calculated as the tissue tracking score index. Peak systolic velocity and strain rate was also obtained in each segment. Patients with Type II diabetes mellitus had a significantly lower tissue tracking score index compared with normal subjects (5.8+/-1.6 mm compared with 7.7+/-1.1 mm; P <0.001). Mean peak systolic velocity was also significantly lower (4.3+/-1.5 cm/s compared with 5.4+/-1.0 cm/s; P <0.001), as well as peak systolic strain rate (-1.2+/-0.3 s(-1) compared with -1.6+/-0.4 s(-1); P <0.001). Patients with Type II diabetes mellitus and preserved diastolic function had a significantly lower tissue tracking score index compared with normal subjects (6.6+/-1.5 mm; P <0.001), but patients with diastolic dysfunction had an even more profound decrease in tissue tracking score index compared with patients without diastolic dysfunction (4.9+/-0.9 mm; P <0.01). In conclusion, the longitudinal systolic contraction was significantly decreased in normotensive patients with Type II diabetes mellitus with normal ejection fraction, which was most profound in patients with concomitant diastolic dysfunction.

Case-Control Studies↗
PubMed2004

Relationship between longitudinal and radial contractility in subclinical diabetic heart disease.

Subclinical left ventricular (LV) dysfunction may be identified by reduced longitudinal contraction. We sought to define the effects of subclinical LV dysfunction on radial contractility in 53 patients with diabetes mellitus with no LV hypertrophy, normal ejection fraction and no ischaemia as assessed by dobutamine echocardiography, in comparison with age-matched controls. Radial peak myocardial systolic velocity (Sm) and early diastolic velocity (Em), strain and strain rate were measured in the mid-posterior and mid-anteroseptal walls in parasternal views and each variable was averaged for individual patients (radial contractility). These variables were also measured in the mid-posterior and mid-anteroseptal walls in the apical long-axis view and each variable was averaged for individual patients (longitudinal contractility). Mean radial Sm, strain and strain rate were significantly increased in diabetic patients (2.9 +/- 0.6 cm/s, 28 +/- 5% and 1.8 +/- 0.4 s(-1) respectively) compared with controls (2.4 +/- 0.7 cm/s, 23 +/- 4% and 1.6 +/- 0.3 s(-1) respectively; all P<0.001), but there was no difference in Em (3.3 +/- 1.2 compared with 3.1 +/- 1.1 cm/s, P=not significant). In contrast, longitudinal Sm, Em, strain and strain rate were significantly lower in diabetic patients (3.6 +/- 1.1 cm/s, 4.3 +/- 1.6 cm/s, 21 +/- 4% and 1.6 +/- 0.3 s(-1) respectively) than in controls (4.3 +/- 1.0 cm/s, 5.7 +/- 2.3 cm/s, 26 +/- 4% and 1.9 +/- 0.3 s(-1) respectively; all P< or =0.001). Thus radial contractility appears to compensate for reduced longitudinal contractility in subclinical LV dysfunction occurring in the absence of ischaemia or LV hypertrophy.

Adult↗