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At least 955 records · Page 53Linked to original sources
PubMed1997

Time-related changes in left ventricular function after double valve replacement for combined aortic and mitral regurgitation in a young rheumatic population. Predictors of postoperative left ventricular performance and role of chordal preservation.

BACKGROUND: The long-term effects of double valve replacement on left ventricular function in patients with combined severe rheumatic aortic and mitral regurgitation have not been reported previously. Furthermore, the importance of chordal preservation in this group of patients is unknown. METHODS AND RESULTS: Serial clinical and echocardiographic evaluations were performed prospectively in 44 patients who underwent double valve replacement for combined aortic and mitral regurgitation. Chordae to the posterior mitral leaflet were preserved in 27 patients. Mean follow-up was 40 +/- 19 months. Left ventricular end-diastolic diameter decreased significantly 3 months after surgery (from 66 +/- 10 to 52 +/- 11 mm; P < .001) without a substantial change in end-systolic diameter, resulting in a significant decline in ejection fraction (from 60 +/- 9% to 48 +/- 15%; P < .001). At 1 year, a significant reduction in end-systolic dimension was observed without a concomitant decline in end-diastolic diameter, thus normalizing the ejection fraction (55 +/- 12%; P = .17 versus baseline). No further changes were seen at latest follow-up. Multivariate regression analysis identified baseline end-systolic diameter and ejection fraction as independent predictors of postoperative systolic performance. Chordal preservation did not emerge as a univariate or multivariate predictor. CONCLUSIONS: After an initial postoperative decline in ejection fraction, normalization in left ventricular systolic function may be expected 1 year after double valve replacement for combined rheumatic mitral and aortic regurgitation. End-systolic diameter and ejection fraction are the only independent predictors of postoperative left ventricular performance.

Adolescent↗
PubMed1978

[Significance of sinus rhythm for ventricular function].

The changes in hemodynamics in conditions of dosed loading prior to and post cardioversion were followed up in 21 patients with valvular defects or atherosclerotic myocardiosclerosis and absolute arrhythmia with auricular fibrillation. In conditions of auricular fibrillation all the patients showed data about a deteriorated ventricular function (increased arterial-venous difference--tachycardia), both at rest and at dosed loading. One week after the sinus rhythm restoration, a considerable improvement of ventricular function was observed, at rest and loading (normal arterial-venous difference, higner minute and beat volume), suggesting the favourable effect of the restored sinus activity. The improved ventricular function is due to the restored auricular contraction, together with the restoration of rhythmic cardiac activity.

Adult↗
PubMed1986

Changes in the left ventricular function after application of contrast media.

The authors studied at repeated ventriculographic examinations the changes in the left ventricular function after application of routinely used ionic contrast medium and of newer nonionic medium. They demonstrated that ionic medium does not significantly change the left ventricular volume and ejection fraction, but influences the left ventricular diastolic function. Nonionic contrast material does not significantly change the left ventricular function. The mechanism of side-effects of contrast agents and possible indications for the application of nonionic contrast media are discussed.

Contrast Media↗
PubMed1986

Ventricular function and morphology in chick embryo from stages 18 to 29.

We evaluated wet and dry ventricular and embryo weights, hemodynamic parameters of ventricular function, and myocardial myocyte organelle composition in the developing chick embryo. Phasic and dP/dt ventricular pressure were measured with a servo null pressure system, and phasic, mean, and dV/dt dorsal aortic velocities were measured with a 20-MHz pulsed-Doppler meter. Ventricular and embryo weight increased geometrically with development, but at different rates, so that the ventricle-to-embryo weight ratio decreased from 0.02 to 0.001 just prior to hatching. Ventricular systolic and end-diastolic pressure increased from 1.31 +/- 0.05/0.33 +/- 0.03 mmHg at stage 18 to 3.45 +/- 0.10/0.82 +/- 0.03 mmHg at stage 29, while dP/dt increased from 23.04 +/- 1.32 to 79.55 +/- 3.69 mmHg/s over the same period. Dorsal aortic dV/dt increased from 878 +/- 17 to 2.076 +/- 65 mm/s2 from stage 18 to 29. Myocyte percent volume of myofibrils increased from 16.7 +/- 0.9% at stage 18 to 23.6 +/- 1.1% at stage 27 and diminished to 18.4 +/- 0.8% at stage 29. Mitochondrial percent myocyte volume remained constant at about 11%. These data define the parameters of normal ventricular function and morphology during embryonic development in the chick.

Animals↗
PubMed1989

[Characteristics of cardiac hemodynamics and right ventricular function in patients with various types of cardiomyopathy and ischemic heart disease].

The study was undertaken to examine morphofunctional parameters of the right ventricle in relation to cardiohemodynamics of the left heart in 96 patients with hypertrophic and congestive cardiomyopathies, including those with coronary heart disease. Both in congestive and hypertrophic cardiomyopathies, the magnitude and nature of changes in right ventricular function follow left ventricular lesion. In cardiomyopathy unlike coronary heart disease, right ventricular function tends to decrease and shows markedly altered links with the left heart.

Cardiomyopathy, Dilated↗
PubMed1992

Myocardial ischemia and left-ventricular function after ligation of left coronary artery (Bland-White-Garland syndrome): a long-term follow-up.

Left-ventricular function and myocardial perfusion were studied in 8 patients for between 3 and 21 years (mean 16 years) after ligation of the anomalous left coronary artery from the pulmonary artery. While only one patient complained of exercise-dependent stenocardia, 4 patients had abnormal ST-segments in the exercise ECG and all patients showed myocardial ischemia at exercise scintigraphy. At rest, the ejection fraction of the left ventricle was within normal range in all patients. In 5 patients, it failed to increase adequately under exercise conditions, reflecting impaired ventricular function. These results confirm the advantages of surgical procedures establishing a 2-coronary system.

Adolescent↗
PubMed1996

[Study of heart rate variability in acute myocardial infarction and its relationship with ventricular function and other clinical variables].

BACKGROUND: The influence of ventricular function (VF) on prognosis in acute myocardial infarction (AMI) is well known. Heart rate variability (HRV), as a neurohumoral parameter could predict VF after discharge in AMI patients. Our goal is to investigate the possible relation among HRV, VF and another clinical variables in AMI. PATIENTS AND METHODS: We studied 37 patients with AMI after hospital discharge. Age, AMI type, location, enzymes, treatment (thrombolysis versus no thrombolysis) were evaluated. The left ventricular ejection fraction (LVEF) was assessed by radionuclide ventriculography in 27 subjects. Twenty nine subjects without cardiopathy were the control group. Twenty four hour electrocardiographic recordings were obtained and a proper software was used to measure HRV. This was evaluated with time domain measures: RR interval, standard deviation of the mean RR interval (SDNN), standard deviation of the average of the RR intervals measured every 5 minutes during 24 hours (SDANN) and number of two consecutive RR intervals with a variability > 50 ms (pNN50). We considered a decreased variability if SDANN was less than 100 ms. Two groups were established: 1) low heart rate variability (LHRV) if SDANN was less than 100 ms, and 2) normal heart rate variability (NHRV) if SDANN was larger than 100 ms. Continuous variables were examined by the t-test, chi square for discrete ones and linear regression analysis was used to assess the relation among variables. A p < 0.05 was considered significant. RESULTS: The percentage of infarcted patients in the group of LHRV is 75%, whereas it is 14% in the control group (p < 0.05). SDANN, SDNN and pNN50 values are significantly lower (p < 0.05) in the AMI than in the control group. LHRV was more frequent in patients with complicated AMI with congestive heart failure. LVEF was significantly lower (35% vs 56%) in the LHRV than in the NHRV group. No significant differences were found among: site, type infarct, treatment or ventricular ectopy in the Holter before discharge. There is good correlation (r = 0.635; p < 0.05) between LVEF and HRV measures. No correlation was found between HRV and age, or the enzymatic size of infarction. CONCLUSIONS: 1) LHRV is frequent in the late phase of AMI, and 2) LHRV can be an indirect index of left ventricular failure.

Aged↗
PubMed1998

Right ventricular function and exercise performance late after primary repair of tetralogy of Fallot with the transannular patch in infancy.

To evaluate the late effects of chronic pulmonary regurgitation against the putative benefits from the current surgical trend of primary repair of tetralogy of Fallot with a transannular patch in infancy, 10 patients > 10 years after early primary repair and 7 matched normal controls underwent exercise stress test and cine magnetic resonance imaging assessment of ventricular functions. Right ventricular impaired diastolic function and decreased exercise capacity, both significantly associated with pulmonary regurgitation in patients, indicated that early primary repair of tetralogy may not prevent late ventricular dysfunction and diminished exercise performance if chronic regurgitation results from right ventricular outflow tract reconstruction.

Adolescent↗
PubMedDate not supplied

Unusual cause of persistent impairment of ventricular function after repair of coarctation of the aorta.

In neonates with coarctation of the aorta, left ventricular function may be impaired due to an increased afterload and an associated endocardial fibroelastosis. Repair of the coarctation usually results in improvement in left ventricular function over the postoperative weeks. We report a patient in whom, despite successful repair of coarctation, left ventricular performance continued to deteriorate. Investigation revealed the unusual coincidental finding of anomalous left coronary artery from the right pulmonary artery.

Aortic Coarctation↗
PubMed1985

Left ventricular function after myocardial infarction: clinical and angiographic correlations.

There is a paucity of information correlating the angiographic findings immediately after myocardial infarction with the clinical status before infarction. Therefore, the coronary anatomy, collateral circulation and quantitative left ventricular function were studied in 39 patients who underwent angiography within 3 weeks of a first transmural myocardial infarction. In all patients, the vessel supplying the infarct was totally occluded at the time of angiography. Patients without angina before infarction (Group I) had fewer coronary obstructions than did patients with a long history of angina before infarction (Group II) (1.5 +/- 0.5 versus 2.5 +/- 0.5, respectively, p less than 0.001) but worse overall and regional left ventricular function. These paradoxical differences between Groups I and II were evident in patients with anterior as well as inferior infarction. Patients in Group I had significantly lower collateral scores than did patients in Group II (0.6 +/- 0.8 versus 1.9 +/- 0.9, respectively, p less than 0.0001) and 13 of 22 patients in Group I had no collateral vessels compared with only 1 of 17 in Group II (p less than 0.001). Partial preservation of anterior wall function in Group II patients with anterior infarction was related both to the presence of collateral vessels and to the more distal obstruction of the left anterior descending coronary artery in these patients as compared with patients with anterior infarction in Group I. In contrast, in patients with inferior wall infarction, no relation could be found between the presence of collateral vessels and regional left ventricular function, although only two patients in this series with inferior infarction did not have collateral vessels.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗
PubMed1994

Left ventricular function and coronary artery disease progression early after coronary bypass grafting.

To investigate the effects of coronary artery disease progression on left ventricular function in patients who suffer angina early after coronary artery bypass grafting, we studied the progression of coronary stenoses, the occurrence of graft occlusions, and measured left ventricular ejection fraction (regional and global) in 34 consecutive patients who underwent repeat angiography 25.2 +/- 3.5 (standard error of the mean) months postoperatively, from a total population of 550 patients who underwent bypass grafting. Resting left ventricular function and stenosis severity were assessed using a computerized, quantitative analysis system. Coronary stenosis progression was defined as an increase in the percentage of the stenotic occlusion by 30% or more, any increase in lesion severity that resulted in total coronary artery occlusion, or the occurrence of a new stenosis that occluded the artery by 50% or more. Group 1 comprised 21 patients with all grafts patent and group 2 comprised 13 patients with one or more grafts occluded (20 of 34 grafts). Coronary artery disease progressed in all patients in group 1, and this involved 22 of 54 (41%) grafted vessels and 3 of 15 (20%) nongrafted vessels (p < 0.05). Coronary artery disease progressed in 11 patients in group 2, involving 15 of 32 (47%) grafted vessels and 1 of 6 (17%) nongrafted vessels (p < 0.01). An increased collateral circulation was observed in both groups. The left ventricular ejection fraction remained unchanged in both groups (group 1, 0.60 +/- 0.03 versus 0.62 +/- 0.03; group 2, 0.62 +/- 0.05 versus 0.62 +/- 0.04 before and after bypass, respectively; p = not significant) and there was no difference between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Serial assessment of left ventricular function after myocardial infarction.

Left ventricular (LV) function is an important predictor of morbidity and mortality after myocardial infarction (MI). Changes in LV function have been examined during the early and late phases after MI, but serial measurements of LV function during the subacute period have not been performed. To assess sequential changes in LV function during the subacute period after MI, we used quantitative two-dimensional echocardiography to examine 22 patients over a 1-year period. Twenty-one of the 22 patients had a Q-wave MI. Eleven had an anterior MI and 10 had an inferior MI; their peak creatine phosphokinase (CPK) was 1213 mIU/ml +/- 14. Three weeks after acute MI, LV ejection fraction (LVEF) had increased from 45% to 52%. Seven of 19 patients showed an LVEF < 43% at baseline. In five of these patients, LVEF improved, but in two patients, LVEF was still < 43% in week 3. There was a significant enlargement of LV end-diastolic volume (LVEDV) (94 ml to 112 ml, p < 0.05) across the four observations but no change in LV end-systolic volume (LVESV; 54 ml to 56 ml, p = n.s.). When two groups (G1 [depressed], LVEF < or = 43%; G2 [preserved], LVEF > 43%) were compared, the group with depressed LVEF demonstrated a higher probability of improvement in LVEF (34% to 47%, p < 0.001) and stroke volume (38 ml to 65 ml, p < 0.01).

Adult↗
PubMed2005

Endothelin-1 receptor antagonist prevents deterioration of left ventricular function and coronary flow reserve in brain-dead canine heart.

BACKGROUND: Rapid hemodynamic deterioration is caused by induction of brain death, but the exact mechanism is still uncertain. The aim of this study was to investigate the contribution of endothelin-1 by using endothelin-1 receptor antagonist (TAK-044) in a canine brain-death model. METHODS: Dogs were divided into 2 groups: (1) the TAK group, in which TAK-044 was intravenously injected 30 minutes before brain-death induction at a dose of 3 mg/kg; and (2) the control group. Brain death was induced by rapid inflation of a sub-durally placed balloon catheter. Left ventricular function and coronary flow reserve was compared between the 2 groups. RESULTS: Brain death caused a transient hyperdynamic response followed by hemodynamic deterioration after 60 minutes in both groups. Left ventricular function, evaluated by the slope of the end-systolic pressure-volume relation was significantly decreased from 7.7 +/- 0.6 to 3.7 +/- 0.3 mm Hg/ml (p < 0.01) in the control group, but was not decreased in the TAK group (7.7 +/- 0.8 to 7.3 +/- 0.9 mm Hg/ml, p = 0.75). Coronary flow reserve, measured by direct injection of acetylcholine (3 microg) into the coronary artery, was significantly reduced at 60 minutes after brain death in the control group (264.8% to 176.6%, p < 0.01), but not in the TAK group (291.2% to 301.3%, p = 0.84). Exactly the same results were obtained when sodium nitroprusside (SNP; 100 microg) was administered. CONCLUSIONS: TAK-044 can prevent the deterioration of left ventricular function and coronary flow reserve that follows induction of brain death, suggesting that endothelin-1 could play an important role in hemodynamic deterioration by impairment of coronary microcirculation after brain death.

Animals↗
PubMed1995

A comparison of transesophageal and transthoracic echocardiographic assessment of left ventricular function in pediatric patients with congenital heart disease.

OBJECTIVE: To determine the quantitative utility of transesophageal echocardiographic assessments of left ventricular function in pediatric patients with congenital heart disease by evaluating the variability between observers and between echocardiographic windows. DESIGN: Retrospective, blinded analysis. SETTING: University-associated pediatric hospital. PARTICIPANTS: Transthoracic and transesophageal echocardiographic images of 25 pediatric patients with congenital heart disease were reviewed. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: End-diastolic area, end-systolic area, and fractional area change were measured from short-axis images of the left ventricle at the midpapillary level by two separate investigators. These measurements were compared by the method of Bland and Altman and Sheiner and Beal. Significant differences in measurements of end-diastolic and end-systolic area by different observers were noted, but they were systematic. A similar situation was noted for the comparison of transthoracic and transesophageal measurements of end-diastolic and end-systolic area. In the comparison of fractional area change between observers or windows, bias and absolute prediction error were lower, with 95% confidence limits of bias or absolute prediction error of 10% or less. CONCLUSIONS: The potential error in the measurement of fractional area change in 10% under optimal conditions. This would suggest that the assessment of ventricular function in the operating room or intensive care unit, under less than optimal conditions, should be viewed as a qualitative, rather quantitative, measurement. There may be significant interobserver and interwindow variability.

Bias↗
PubMed1991

[Investigation of the relation of impedance rheopneumogram with pulmonary hemodynamics and right ventricular function in patients with chronic obstructive pulmonary disease].

In order to investigate the relation of impedance rheopneumogram with pulmonary hemodynamics and right ventricular function in patients with chronic obstructive pulmonary disease (COPD), we measured impedance rheopneumogram and did right heart catheterization in 150 COPD patients simultaneously both at rest and after exercise. The results showed that impedance rheopneumogram was mainly influenced by right ventricular after-load, while the influences of right ventricular pre-load, right ventricular contraction, right ventricular stroke work index and cardiac output were rather small, suggesting that in COPD patients impedance rheopneumogram is valuable in predicting pulmonary arterial pressure noninvasively, but not so use in judging the right ventricular function.

Cardiac Catheterization↗
PubMed1978

[Changes in the subvalvular apparatus and left ventricular function in pure mitral stenosis].

Disordered left ventricular function and changes in the sub-valvular apparatus appear to be associated in patients with isolated mitral stenosis (MS). Left ventricular cine-angiography has demonstrated two groups of patients, according to the presence (group II) or absence (group I) of changes in the sub-valvular apparatus. There was no significant difference between the two groups in terms of age, heart rate, left ventricular end diastolic pressure, surface area of the mitral valve, or ventricular ejection time. However, group II patients had a lowered ejection fraction (EF), systolic ejection volume (SEB), speed of shortening of circular fibres (VCF), and systolic work index (SWI) compared with group I cases (respectively 0.49 +/- 0.06 and 0.58 +/- 0.04 for the EF, 36 +/- 7 ml.m-2 and 41 +/- 7 ml.m-2 for the SEV, 0.85 +/- 0.12 circ.s-1 and 1.09 +/- 0.16 circ.s-1 for the VCF, 45 +/- 11 gm.m-2 and 57 +/- 11 gm.m-2 for the SWI. Nevertheless, it appears that changes in the sub-valvular apparatus indicate rather than cause dysfunction of the left ventricle, which occurs in a certain number of patients who have a normal sub-valvular apparatus.

Adult↗
PubMed1993

Right ventricular function at rest and during submaximal exercise assessed by 81Krm equilibrium ventriculography in normal subjects.

81Krm equilibrium ventriculography was used to study right ventricular function in 37 healthy male volunteers. 'Anatomical' lung subtraction using 99Tcm lung perfusion scintigraphy was compared with conventional background correction in the calculation of resting right ventricular ejection fraction (RVEF). Resting RVEF was significantly greater following 'anatomical' lung subtraction than that using background correction (0.59 +/- 0.06 versus 0.55 +/- 0.05). The exercise response of the normal right ventricle was defined in 23 subjects during exercise. Right ventricular ejection fraction showed a progressive increase during graded submaximal exercise (0.55 +/- 0.05 at rest, 0.60 +/- 0.05 at 50 W and 0.66 +/- 0.05 at 100 W). Right heart 81Krm equilibrium ventriculography is well suited to the evaluation of right ventricular function at rest and during exercise. The absolute value of RVEF will however be dependent upon the method of image analysis.

Adult↗