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PubMed2000

Efficacy of single lead VDD pacing in patients with impaired and normal left ventricular function.

Atrial synchronous ventricular pacing seems to be the best pacing mode for patients with advanced AV block and impaired LV function. The long-term follow-up of single lead VDD pacing was studied in 33 patients with impaired LV function and compared to 42 patients with normal LV function. All patients received the same VDD lead and VDDR pacemaker. The lead model with 13-cm AV spacing between the atrial and ventricular electrode was implanted in 89% of the patients. Follow-ups were 1, 3, 6, and 12 months after implantation. The percentage of atrial sensing and the P wave amplitude were determined at each follow-up. Minimal P wave amplitude at implantation was 2.0 +/- 1.4 mV in patients with impaired and 1.7 +/- 0.9 mV with normal LV function (not significant). At the 12-month follow-up, 33 patients with normal and 23 patients with depressed LV function remained paced in the VDD mode. The remaining patients died in five (impaired LV function) and seven cases (normal LV function) or their pacemakers were programmed to the VVI/VVIR pacing mode in four (impaired LV function) and three cases (normal LV function). P wave amplitude did not differ in the two groups (e.g., at month 12: impaired: 1.17 +/- 0.42 mV; normal: 1.09 +/- 0.49 mV). The atrial sensitivity was programmed in most patients to sensitive settings with no differences between the two groups (e.g., at month 12: impaired: 0.13 +/- 0.06 mV; normal: 0.13 +/- 0.05 mV). The diagnostic counters indicated nearly permanent atrial sensing (e.g., at month 12: impaired: 99.3 +/- 2.2%; normal: 99.0 +/- 1.0 mV). In conclusions, single lead VDD pacing restored AV synchronous ventricular pacing in patients with normal and with impaired LV function indicating that it could be an alternative to DDD pacemakers, but not to dual-chamber pacing.

Aged↗
PubMed1992

[Myocardial perfusion and left ventricular function during exercise evaluated by 201Tl myocardial scintigraphy and 99mTc radionuclide ventriculography in patients treated with PTCA].

To evaluate the effects of percutaneous transluminal coronary angioplasty (PTCA), we investigated myocardial ischemia and left ventricular function during exercise before and after successful PTCA in 30 patients. We used extent and severity scores of 201thallium (201Tl) exercise myocardial scintigraphy to assess myocardial ischemia and determined global and regional left ventricular ejection fraction (EF and REF) of 99mTc-RBC exercise radionuclide ventriculography to assess left ventricular function. The extent and severity scores of stress images were significantly less after PTCA than before PTCA. The scores of the redistribution images were unchanged before and after PTCA. Global EF during exercise was significantly higher after PTCA than before PTCA. There was no difference in resting global EF between before and after PTCA. Myocardial ischemia induced by exercise was semi-quantitatively analyzed as transient perfusion defect with severity score. Severity score was significantly less after PTCA than before PTCA. delta EF, which was obtained by subtraction of resting global EF from exercise one, was significantly higher after PTCA than before PTCA. However, the degree of improvement in myocardial ischemia and left ventricular function varied from patient to patient. In 17 patients with one-vessel left anterior descending artery disease, delta REF, which was determined by subtracting resting regional EF from exercise one, was significantly higher in septal and apical segments after PTCA than before PTCA. Myocardial ischemia and left ventricular function under exercise were alleviated by PTCA. However, the degree of improvement varied from patient to patient and it might have been affected by various factors including coronary dissection, edema, thrombus, restenosis, spasm, side branch stenosis or occlusion, distal thrombus, and myocardial hibernation.

Aged↗
PubMed1997

Long-term follow up of patients with implantable cardioverter-defibrillators and mild, moderate, or severe impairment of left ventricular function.

OBJECTIVE: To determine whether patients with life threatening ventricular tachyarrhythmias, impaired left ventricular function, and severe heart failure will benefit from implantable cardioverter-defibrillator (ICD) treatment. DESIGN: 410 patients were followed up after ICD implant. Left ventricular function was assessed by the New York Heart Association (NYHA) functional class of heart failure: 50 patients (12%) were in NYHA I-II, 151 (37%) in NYHA II, 117 (29%) in NYHA II-III, and 92 (22%) in NYHA III. Epicardial ICD implantation was performed in 209 patients (51%) and 201 patients (49%) received non-thoracotomy ICDs. RESULTS: Perioperatively, 12 patients (3%) died, more often after epicardial ICD implant (11/209 patients, 5%) than after transvenous implant (1/201 patients, < 1%) (P < 0.05). During a mean (SD) follow up of 28 (24) months (range < 1 to 114 months), 90 patients (23%) died: nine (2%) died from sudden arrhythmia; five (1%) also died suddenly but probably not from arrhythmic causes; 55 (14%) died from cardiac causes (congestive heart failure, myocardial reinfarction); 21 (5%) died from non-cardiac causes. The three year, five year, and seven year survival was 92-96% for arrhythmic mortality in NYHA class I, II and III, compared to a three year survival of 94% and a five year and seven year survival of 84% for patients in NYHA class II-III. 338 patients (82%) received ICD shocks (21 (SD 43) shocks per patient); patients in NYHA class II (83%), class II-III (84%), and class III (90%) received ICD discharges more often than those in class I-II (64%) (P < 0.05). The mean (SD) time interval between ICD implant and the first ICD shock was shorter in NYHA class II (16 (17) months), class II-III (19 (27) months), and class III (16 (19) months) than in class 0-I (22 (24) months) (P < 0.05). CONCLUSIONS: Patients with mild, moderate, and severe left ventricular dysfunction benefit from ICD treatment and these patients survive for a considerable time after the first shock. Survival is influenced by the degree of left ventricular dysfunction; aggressive treatment of heart failure is necessary as well as ICD therapy.

Adolescent↗
PubMed1990

Verapamil but not nifedipine impairs left ventricular function during exercise in hypertensive patients.

Calcium antagonists are popular therapeutic agents in the treatment of systemic hypertension. Although these agents have similar antihypertensive efficacy, they have varied effects on left ventricular function at rest in hypertensive patients. The effect of different calcium antagonists on left ventricular function during exercise and on exercise performance in patients with hypertension, however, is less clear. Fifteen patients with essential hypertension (diastolic blood pressure = 95 to 110 mm Hg) were enrolled in a placebo-controlled, single-blinded crossover study comparing nifedipine with verapamil for rest/exercise heart rate and blood pressure, exercise performance, and rest/exercise left ventricular function. Each drug was titrated to achieve resting diastolic pressures less than 90 mm Hg. All patients underwent maximal exercise testing and rest/exercise gated radionuclide ventriculography at the end of 3-week placebo, nifedipine, and verapamil treatment periods. Both calcium antagonists significantly reduced blood pressure at rest and during exercise compared with placebo. Neither calcium antagonist altered resting heart rate; however, both verapamil and nifedipine significantly reduced heart rate at maximal exercise. Verapamil but not nifedipine impaired left ventricular peak emptying rate and left ventricular peak filling rate during exercise but not at rest. Neither verapamil nor nifedipine, however, significantly altered rest or exercise global left ventricular ejection fraction (LVEF) compared with placebo. There was a trend, however, for impairment in the LVEF response to exercise (delta LVEF) in the verapamil treatment group. Exercise capacity was not significantly altered by either calcium antagonist compared with placebo. Thus verapamil but not nifedipine impairs left ventricular function during exercise in hypertensive patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1993

Effects of graded reductions in internal mammary artery bypass flow on left ventricular function.

This study investigated the controversial relationship between reduction in internal mammary artery (IMA) graft blood flow and left ventricular function in a canine model. Ten dogs underwent IMA grafting to the left anterior descending coronary artery. The left anterior descending coronary artery proximal to the IMA graft was intermittently occluded while IMA flow was mechanically controlled for 5-minute periods to produce four IMA flow groups representing 100%, 75%, 50%, and 25% of unoccluded IMA graft blood flow. As a control, the left ventricle was reperfused with native left anterior descending coronary artery flow between each IMA graft flow period to allow return to steady state. Sonomicrometry was used to obtain stroke work end-diastolic dimension relationship data for regional and global left ventricular function for each of the four flow groups. The global pressure recruitable work area relationship showed a significant rightward shift at 25% of unoccluded IMA flow, whereas the regional pressure recruitable work area relationship shifted at 50% of unoccluded IMA flow. Thus, regional myocardial function is more sensitive to reductions in IMA blood flow than is global left ventricular performance, and there is a significant IMA flow reserve for global left ventricular function.

Animals↗
PubMed1990

[Left ventricular function at the time of left x-ray contrast ventriculography].

To study left ventricular function during radiocontrast ventriculography, 23 patients with a rejected diagnosis of coronary disease were examined. All the patients underwent coronarography, direct ventriculography with the aid of a special catheter with a microtip pressure microtransducer and intravenous biventriculography with injection of a radiocontrast agent to the right atrium with simultaneous monitoring of the pressure in the left ventricle. All the ventriculograms were subjected to a multiframe analysis with the aid of computer. During ventriculography, direct injection of a radiocontrast agent significantly influenced left ventricular function in all the phases of a cardiac cycle. The pressure in the left ventricle and energy parameters of the cycle of heart contraction increased. In the diastole, the elasticity of chamber walls reduced. The end diastolic volume increased, which led to the overstatement of the design parameters of cardiac output (by about 10 to 15%). All that resulted in the distortion of the data and lowered the scientific value of the information derived. Therefore, the search for alternative angiographic methods of estimating left ventricular function is badly needed.

Adult↗
PubMedDate not supplied

The effect of lactate infusion on myocardial metabolism and ventricular function following ischemia and cardioplegia.

Impaired myocardial fatty acid and glucose metabolism following ischemia and cardioplegia may limit the recovery of myocardial oxidative metabolism and ventricular function. Lactate, a simple three carbon compound, can be readily metabolized to pyruvate and is possibly the preferred substrate for aerobic metabolism. Therefore, increasing arterial lactate concentrations may improve myocardial metabolic recovery after ischemia and cardioplegia. Myocardial lactate metabolism and ventricular function were assessed in a canine model of 45 mins of global normothermic ischemia followed by 60 mins of cold potassium cardioplegic arrest. Thirteen dogs received a perioperative infusion of sodium lactate to elevate arterial concentrations (from 6 to 12 mmol/L) and 12 dogs received an equivalent amount of saline. The high arterial lactate concentrations were associated with an increased myocardial lactate consumption and oxidation (as assessed by 14C-labelled lactate) during reperfusion. Myocardial ATP concentrations fell during reperfusion despite improved myocardial oxidation. The recovery of ventricular function (as assessed by a compliant intraventricular balloon) was incomplete and only marginally better with the high arterial lactate concentrations. An infusion of lactate improved myocardial oxidative metabolism following ischemia and cardioplegia. However, the recovery of ventricular function was incomplete perhaps because of inadequate preservation of myocardial ATP.

Adenosine Triphosphate↗
PubMed1991

[Impaired diastolic ventricular function in dilated cardiomyopathy with variously reduced systolic function. A Doppler echocardiography analysis].

Diastolic ventricular function was assessed by Doppler echocardiography in 50 patients with idiopathic dilated cardiomyopathy (DCM) and sinus rhythm. The patients were subdivided into two groups with either a moderately reduced ejection fraction (less than 32%; group 1, n = 25) or a severely reduced ejection fraction (less than 32%; group 2, n = 25), the latter having an unfavorable prognosis. The degree of heart failure according to the NYHA classification was more pronounced in group 2 (p less than 0.05). Mean pulmonary capillary wedge pressure (PCm) was also higher in group 2 (gr. 1:9.8 +/- 5.5 vs. gr. 2: 16.2 +/- 8.9; p less than 0.02), and the morphological parameters obtained by conventional M-mode echocardiography showed increased left ventricular volumes and mass in both groups with DCM, as compared with a control group (n = 16); there was a reduced volume/mass ratio in group 2. The parameters of systolic function derived from M-mode and Doppler echocardiography were reduced in patients with DCM, but were more pronounced in group 2. Doppler parameters of diastolic ventricular filling were differently affected in both groups with DCM. In group 1 there was a reduced contribution of the early diastolic phase to ventricular filling (FE/FA) (contr.: 2.29 +/- 0.99 vs gr. 1: 1.40 +/- 0.45; p less than 0.05) and a reduced early peak Doppler velocity, indicating an impaired ventricular relaxation. In group 2, as compared with controls and group 1, there was an increased ratio of early/late diastolic peak velocities (VE/VA) (contr.: 1.49 +/- 0.54 vs gr. 2: 2.32 +/- 1.37; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗
PubMed2000

Two-dimensional echocardiographic assessment of right ventricular function as a predictor of outcome in hypoplastic left heart syndrome.

This study was undertaken to assess the importance of right ventricular function at the time of initial presentation on early and intermediate outcome in patients with hypoplastic left heart syndrome (HLHS). Several studies have attempted to define physiologic risk factors for poor early outcome following the Norwood palliation for HLHS. No clinical or hemodynamic factors including right ventricular function have been found to reliably predict Norwood I operative survival. The relation between initial ventricular function and later survival has not been investigated. To assess the importance of right ventricular (RV) function at the time of initial presentation on outcome in patients with HLHS, systolic function was determined by qualitative and quantitative methods in 60 consecutive patients before surgical intervention. The effects on stage I operative survival, survival to stage II, and overall survival were analyzed. Initial RV function did not impact on stage I survival. However, analysis of later outcome of the stage I survivors showed that those with prestage I RV dysfunction had significantly greater mortality before stage II. Actuarial survival 18 months after Norwood surgery was 93% for patients with initially normal RV function compared with 47% for those with abnormal function (p = <0.005). The relative risk for later mortality was approximately 11 times greater for patients with initial RV dysfunction. Thus, RV dysfunction identifiable soon after initial presentation does not impact on early survival after Norwood I operation for HLHS. Intermediate and overall survival, however, is significantly decreased in patients with initially diminished RV function.

Cardiac Surgical Procedures↗
PubMed1992

Cardiovascular mass and ventricular function after celiprolol in Wistar-Kyoto and spontaneously hypertensive rats.

OBJECTIVE: The effects of a new beta 1 adrenergic receptor blocking agent with beta 2 receptor agonistic properties on cardiovascular mass, left ventricular function, and aortic distensibility were studied in Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats. METHODS: 20 male SHR and 20 male WKY rats (10 treated and 10 untreated) aged 22 weeks were studied after three weeks of treatment. Cardiovascular mass was measured and left ventricular function was assessed using electromagnetic flowmetry while rapidly infusing whole blood at pharmacologically reduced mean arterial pressure and at pretreatment arterial pressure levels. Aortic distensibility was assessed by obtaining pressure-volume relationships in isolated aortic segments. RESULTS: Mean arterial pressure was reduced without changing cardiac output in SHR (p less than 0.01); it remained unchanged in WKY despite reduced cardiac output. Most noteworthy, and like no other agent studied to date, celiprolol significantly reduced both left and right ventricular as well as aortic mass in both WKY and SHR. Despite these similar mass reductions, celiprolol improved left ventricular function (p less than 0.01) and aortic distensibility (p less than 0.05) only in the SHR, a function maintained even when mean arterial pressure was increased abruptly to pretreatment levels. CONCLUSIONS: Unlike other beta receptor blockers (or any other agent studied in the SHR), celiprolol was effective in reducing mass of right and left ventricles and of aorta; decreasing mean arterial pressure through a fall in total peripheral resistance; and improving left ventricular function and aortic distensibility in the SHR. In contrast, while these structural changes were also produced in WKY, they were not associated with similar functional responses. These findings provide further support for the thesis of a structural and haemodynamic dissociation in antihypertensive therapy.

Adrenergic beta-Antagonists↗
PubMed1992

Left ventricular ejection fraction is increased during transesophageal echocardiography in patients with impaired ventricular function.

Transesophageal echocardiography (TEE) is increasingly being used to assess left ventricular function (LVF). However, little data exist on the quantitative accuracy of this technique and its influence on LVF. Thus 50 ambulatory adult patients (mean age 62 +/- 15 years) were studied with transthoracic echocardiography (TTE) immediately before, before the end, and 10 minutes after TEE. Left ventricular ejection fraction (LVEF) was calculated using the modified Simpson's method. In subjects (n = 24) with impaired LVF (LVEF less than 55% by TTE), TTE-derived LVEF increased from 37 +/- 13% to 45 +/- 15% (p less than 0.001) during TEE. In 13 of 24 subjects with abnormal LVF, LVEF significantly increased during TEE as defined by an increase in LVEF by at least 5 ejection fraction units. In four of these subjects LVF normalized during TEE. LVEF was unchanged during and after TEE in the subjects (n = 26) with normal LVF (LVEF greater than 55%). An excellent correlation was found between LVEF derived by TEE and that derived by TTE performed during TEE (r = 0.93, SEE = 6.6%, p less than 0.001). LVEF determined by TEE compared well with that derived by TTE and should be a useful measure of global left ventricular function. However, an increase in LVEF during TEE occurs in over 50% of patients with impaired LVF and may be important to consider in individual subjects.

Adult↗
PubMed1983

Left ventricular function in preeclamptic patients: an echocardiographic study.

To examine left ventricular function in pregnancy complicated by preeclampsia, echocardiographic dimensions and left ventricular performance indices were determined in 42 preeclamptic patients, 25 normotensive third-trimester patients, and 25 nonpregnant patients. The performance of the left ventricle in normal third-trimester pregnant patients was unchanged as compared to that in nonpregnant patients. Three patients (7%) in the preeclamptic group had diminished values of echocardiographic contractility indices. However, in only one of these patients were there clinical signs of left heart failure; two other patients had latent myocardial dysfunction. Our conclusion is that left ventricular function in most preeclamptic patients is well preserved despite significant volume and pressure overload.

Blood Pressure↗
PubMed1981

[Consequences of continuous positive airway pressure (CPAP) on left ventricular function. Assessment by M-mode echocardiography (author's transl)].

The consequences of continuous positive airway pressure (CPAP) on left ventricular function are uncertain. Left ventricular function was assessed by M-mode echocardiography in 8 young normal subjects during CPAP via face mask. Heart rate and arterial pressure did not change. End-diastolic volume and stroke volume significantly decreased. Ejection fraction remained unchanged. The slight decrease of stroke volume induced by increasing positive airway pressure is in relation to decreased left ventricular preload.

Adult↗
PubMed1986

Smoking: a major predictor of left ventricular function after occlusion of the left anterior descending coronary artery.

The major predictors of left ventricular function after coronary artery occlusion were assessed in 108 consecutive patients who had complete occlusion of the left anterior descending artery as the only important lesion demonstrated at angiography between June 1978 and June 1983. A scoring system was used to identify regional damage on left ventriculograms. Forty two patients were classified as having good left ventricular function and 66 as having varying degrees of impairment. Apart from a history of myocardial infarction, the only variables discriminating between those with good and those with impaired left ventricular function were the area of distribution of the artery beyond the occlusion and cigarette smoking. Hypertension, hypercholesterolaemia, family history of vascular disease, diabetes, obesity, duration of angina, age, and presence of identifiable collaterals were not discriminators. Smoking was itself significantly associated with a history of infarction; but after controlling for this, smoking exerted a significant additional effect on the amount of left ventricular damage. It is concluded that smoking is not only a risk factor for myocardial infarction in patients with single left anterior descending artery occlusion, but that it is also a major factor in determining the extent of associated left ventricular damage.

Adult↗
PubMed1995

Comparison of myocardial contrast echocardiography and low-dose dobutamine stress echocardiography in predicting recovery of left ventricular function after coronary revascularization in chronic ischemic heart disease.

BACKGROUND: Dobutamine stress echocardiography (DSE) and myocardial contrast echocardiography (MCE) can predict recovery of left ventricular function after myocardial infarction. DSE also has been shown to predict left ventricular functional recovery after revascularization in chronic ischemic heart disease, whereas MCE has not been evaluated in such patients. This study was performed to compare DSE and MCE in the prediction of left ventricular functional recovery after revascularization in patients with chronic ischemic heart disease. METHODS AND RESULTS: MCE and DSE were performed in 35 patients with chronic coronary artery disease and significant wall motion abnormalities (mean ejection fraction, 0.36 +/- 0.09). Regional wall motion was scored by use of a 16-segment model wherein 1 = normal or hyperkinetic, 2 = hypokinetic, 3 = akinetic, and 4 = dyskinetic. Each segment was evaluated for contractile reserve by DSE and perfusion by MCE. Revascularization (coronary artery bypass graft [n = 13] and percutaneous transluminal coronary angioplasty [n = 10]) was successful in 23 patients. Follow-up echocardiograms were done to assess wall motion 30 to 60 days later. In 238 segments with resting wall motion abnormalities, perfusion was more likely to present than contractile reserve (97% versus 91%, P < .02). Revascularization resulted in functional recovery in 77 of 95 hypokinetic segments (81%) but only 18 of 57 akinetic segments (32%, P < .0001). DSE and MCE were not significantly different in predicting functional recovery of hypokinetic segments. In akinetic segments, DSE and MCE had similar sensitivities (89% versus 94%, respectively) and negative predictive values (93% and 97%, respectively) in predicting functional recovery. However, DSE had a higher specificity (92% versus 67%, P < .02) and positive predictive value (85% versus 55%, P < .02) than MCE in predicting functional recovery. CONCLUSIONS: Both contractile reserve by DSE and perfusion by MCE are predictive of functional recovery in hypokinetic segments after coronary revascularization in patients with chronic coronary revascularization in patients with chronic coronary artery disease. In akinetic segments, myocardial perfusion by MCE may exist in segments that do not recover contractile function after revascularization. Thus, contractile reserve during low-dose dobutamine infusion is a better predictor of functional recovery after revascularization in akinetic segments than perfusion.

Angioplasty, Balloon, Coronary↗
PubMed1999

Left ventricular function in adults with mild pulmonary insufficiency late after Fallot repair.

OBJECTIVE: To assess left ventricular function in adult Fallot patients with residual pulmonary regurgitation. SETTING: The radiology department of a tertiary referral centre. PATIENTS: 14 patients with chronic pulmonary regurgitation and right ventricular volume overload after repair of tetralogy of Fallot and 10 healthy subjects were studied using magnetic resonance imaging. MAIN OUTCOME MEASURES: Biventricular volumes, global biventricular function, and regional left ventricular function were assessed in all subjects. RESULTS: The amount of pulmonary regurgitation in patients (mean (SD)) was 25 (18)% of forward flow and correlated significantly with right ventricular enlargement (p < 0.05). Left ventricular end diastolic volume was decreased in patients (78 (11) v 88 (10) ml/m(2); p < 0.05), ejection fraction was not significantly altered (59 (5)% v 55 (7)%; NS). No significant correlation was found between pulmonary regurgitation and left ventricular function. Overall left ventricular end diastolic wall thickness was significantly lower in patients (5.06 (0.72) v 6.06 (1.06) mm; p < 0. 05), predominantly in the free wall. At the apical level, left ventricular systolic wall thickening was 20% higher in Fallot patients (p < 0.05). Left ventricular shape was normal. CONCLUSIONS: Adult Fallot patients with mild chronic pulmonary regurgitation and subsequent right ventricular enlargement showed a normal left ventricular shape and global function. Although the left ventricular free wall had reduced wall thickness, compensatory hypercontractility of the apex may contribute to preserved global function.

Adult↗
PubMedDate not supplied

Factors affecting ventricular function and survival after partial left ventriculectomy.

BACKGROUND: Partial left ventriculectomy (PLV) helps some patients but is deleterious in others. Selection of patients who will benefit from PLV, and exclusion of those who will not is necessary for safe and effective application of the procedure. METHODS: Sixty-nine consecutive patients who underwent PLV were monitored with pressure-volume relationship analyses, Doppler echocardiography, and histopathologic studies of excised myocardium. These parameters were correlated with postoperative stroke volume (SV, ml), cardiac output (CO, L/min), ventricular function (improved, no change, or deteriorated), and postoperative course (duration of survival and/or hospital discharge). RESULTS: Positive responders (n = 36) with increased SV at reduced end diastolic pressure had significantly larger preoperative end-systolic dimension, smaller SV, and less stroke work with milder fibrosis than non- or negative responders (n = 33). In multivariate analyses, poor preoperative hemodynamics were associated with increased SV and CO, but these improvements did not lead to improved survival. Postoperative survival was negatively affected by larger preoperative left ventricular end-diastolic volume and larger excised-muscle-weight. Milder fibrosis and thicker excised wall were consistently related to improved ventricular function and survival. CONCLUSION: Although effects of PLV are related to preoperative status, factors affecting postoperative ventricular function and survival were often discordant. While poor preoperative ventricular function was associated with functional improvement without survival benefit, milder fibrosis, thicker excised wall and less myocardial resection were positive contributors to improved ventricular function, discharge, and survival. Preoperative evaluation with more cases and variables are needed to identify patients more likely to benefit from PLV.

Adult↗
PubMed2000

Echocardiographic evaluation of left ventricular function in pure mitral stenosis.

Echocardiographic evaluation of left ventricular function was performed in 22 cases of pure rheumatic mitral stenosis and 22 age matched normal persons. Cases with any evidence of rheumatic activity in the preceding six months, those with gross tricuspid regurgitation and paradoxical movement of the interventricular septum and cases with atrial fibrillation were excluded. None of the patients showed systolic left ventricular dysfunction. Left ventricular end diastolic dimension was also not affected. Echocardiographic parameters did not have any relation for mitral valve area. Our observations show that mitral stenosis per se does not affect left ventricular function.

Adolescent↗