Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Ventricular Function”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,693 records · Page 94Linked to original sources
PubMed1993

Comparison of left ventricular function by echocardiographic automated border detection and by radionuclide ejection fraction.

Echocardiographic automated border detection can provide on-line estimates of left ventricular cavity area by differentiating blood from tissue backscatter characteristics. The objective of this study was to assess the ability of short-axis measurements of left ventricular cavity area by automated border detection to determine left ventricular function by comparing these measurements to radionuclide measures of ejection fraction in the same patients. Eighty-eight consecutive patients, aged 53 +/- 14 years, underwent automated border detection studies within 2 hours of radionuclide ventriculography. Short-axis imaging with automated border detection was attempted at basal, midpapillary muscle, and apical levels. Maximal left ventricular length was also measured from apical 4- and 2-chamber views by standard imaging. Fractional area change--(end-diastolic area-end-systolic area)/end-diastolic area--was determined at each short-axis level. Volumes and ejection fractions were calculated using: volume = 5/6 (midventricular area).length. Simpson's rule for 3 short-axis measurements was calculated using: volume = (length/12) (5.basal area + 2.mid-area + 4.apical area). Technically adequate automated border detection data could be obtained on 69 patients (78%) at basal and mid-levels, and at all 3 short-axis levels in 66 patients (75%). Correlations with radionuclide ejection fraction were as follows: midventricular fractional area change--R = 0.84, SEE = 12%, y = 0.86 x - 7; area-length ejection fraction--R = 0.89, SEE = 9%, y = 0.96 x - 4; and Simpson's rule--R = 0.91, SEE = 8%, y = 0.89 x + 1.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Real-time pressure-volume diagrams for the evaluation of ventricular function.

Using three intraventricular diameter signals obtained from ultrasonic distance gauges and applying the general ellipsoid model to the left ventricle, it was possible to obtain the left ventricular volume signal. Implanting a miniature transducer in the left ventricle the pressure signal was attained. With these two signals the pressure-volume diagrams were constructed on line, and ventricular function during load manoeuvres could be studied from them. Because the whole process was done on line, using a microcomputer, the performance of the left ventricle to load manoeuvres in different conditions could be seen instantly.

Animals↗
PubMed1995

[Echocardiographic evaluation of left ventricular function in patients with arterial hypertension and normal left ventricular mass index].

UNLABELLED: Data about disturbances of the diastolic function of the left ventricle (LV) are well known in literature and registered even in the limited form of hypertension i.e. before the occurrence of myocardial hypertrophy. The aim of this work was to check this hypothesis in patients with arterial hypertension and normal LV mass index. The total number of examined patients was 144. The control group consisted of 30 patients, while the number of hypertensive patients in the other group was 114. The following parameters were observed: blood pressure, heart rate, systolic and diastolic dimensions of LV, wall thickness, left ventricular mass index, wall stress, endsystolic and enddiastolic volume index, cardiac index, ejection fraction, shortening fraction, velocity peak of early and late diastolic filling and their mutual relationship, integral of speed-time of early and late diastolic pressure, as well as the index of early and late filling. A significant difference was found in the size of LV mass index, wall stress, velocity peak of early diastolic filling and the relationship of velocity peak of early and late filling. It should be noted that the values of the observed parameters were in normal ranges, but those in the group of hypertensive patients were closer to pathological values. CONCLUSION: Microstructural changes of LV myocard mass can be registered in hypertensive patients before the significant enlargement of LV mass index. Diastolic disfunction of the left ventricle precedes myocardial hypertrophy.

Adult↗
PubMed1984

Left ventricular mass, volume and biopsy analysis in prediction of ventricular function after surgery for chronic aortic regurgitation.

The serial application of electrocardiography and echocardiography to 67 selected patients undergoing valve replacement for chronic severe aortic regurgitation, documented regression of hypertrophy and chamber size within six to twelve months of surgery in all cases experiencing haemodynamic improvement. Those patients who had persistently increased patterns of myocardial hypertrophy and abnormal end-diastolic dimensions in the presence of normal prosthetic (homograft) function usually had persistent, irreversibly depressed myocardial function postoperatively. Preoperative noninvasive and angiographic characteristics could not predict ventricular function after surgery. Thus we could not precisely define what level of depressed ventricular performance or what degree of dilatation and myocardial hypertrophy constituted an irreversible state from this data. Although operative factors such as myocardial protection during cardiopulmonary bypass may influence postoperative cardiac performance, preoperative histological and histochemical data was useful in delineating irreversible morphological and function changes contributing to a depressed cardiac function, and therefore may be of prognostic importance.

Aortic Valve Insufficiency↗
PubMed1983

The mechanics of ventricular function.

The introduction of new pharmacotherapies for long-term treatment of chronic cardiac failure has underscored the need for serial measurement of ventricular function in the ambulatory patient. Management strategies can best be guided by physiologic assessment of the heart's function as a muscular pump that must serve to propel gases to the metabolizing tissues on a moment-to-moment basis.

Heart↗
PubMed2001

Vitamin C augments the inotropic response to dobutamine in humans with normal left ventricular function.

BACKGROUND: We studied the effect of an antioxidant, the intracoronary infusion of vitamin C, on basal and dobutamine-stimulated left ventricular (LV) contractility. METHODS AND RESULTS: Nineteen patients with normal ventricular function participated in this study. A micromanometer-tipped catheter was inserted into the LV. In the experimental group (n=10), an infusion catheter was positioned in the left main coronary artery. LV peak +dP/dt (LV +dP/dt) was measured in response to the intravenous infusion of dobutamine before (Dob) and during (Dob+vit C) the intracoronary infusion of vitamin C. The intracoronary infusion of vitamin C had no effect on basal LV +dP/dt or any other hemodynamic parameter. The infusion of vitamin C augmented the LV +dP/dt response to dobutamine by 22+/-4% (Dob, 1680+/-76 mm Hg/s; Dob+vit C, 1814+/-97 mm Hg/s, P<0.01). In the control group (n=9), LV +dP/dt was measured in response to sequential infusions of dobutamine (Dob, Dob-2) given at the same time intervals as in the experimental group but without the intracoronary infusion of vitamin C. In contrast to the experimental group, no difference in LV +dP/dt was observed between the 2 infusions of dobutamine (Dob, 1706+/-131 mm Hg/s; Dob-2, 1709+/-138 mm Hg/s, P=NS). CONCLUSIONS: The administration of the antioxidant vitamin C augments the inotropic response to dobutamine in humans. This suggests that redox environment contributes to the adrenergic regulation of ventricular contractility.

Adrenergic beta-Agonists↗
PubMed2002

Evaluation of left ventricular function and mass after Medtronic Freestyle versus homograft aortic root replacement using cardiovascular magnetic resonance.

BACKGROUND AND AIM OF THE STUDY: Regression of left ventricular hypertrophy (LVH) after aortic valve replacement has traditionally been measured by echocardiography. However, cardiovascular magnetic resonance (CMR) can be used to measure left ventricular function and mass more accurately and reproducibly. This translates into fewer patients being needed to demonstrate significant changes. The study aim was to demonstrate the feasibility of using CMR to measure left ventricular mass index (LVMI) and function in patients from a prospective randomized trial, and to compare homografts with the Medtronic Freestyle root replacement. METHODS: Among 23 patients recruited, 17 had LVMI and function (end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF)) measured pre- and postoperatively using CMR (eight homograft, nine Freestyle). RESULTS: Significant regression of LVH was seen in both groups one year postoperatively (homograft LVMI 145+/-44 g/m2 preoperative versus 83+/-23 g/m2 one year postoperatively; Freestyle LVMI 140+/-28 g/m2 versus 93+/-21 g/m2, respectively). At six months there was significant regression in the xenograft group (from 140+/-28 to 106+/-22 g/m2; p <0.05) and a trend towards regression in the homograft group (from 145+/-44 to 103+/-25 g/m2; p = NS). There was also a trend towards a reduction in EDV, ESV and SV, and an increase in EF over one year in both groups. CONCLUSION: Regression of LVH was measured using CMR in patients after aortic root replacement and coronary implantation with the homograft and Medtronic Freestyle root replacement. Despite the small number of patients studied, it was possible to demonstrate the extent and pattern of regression of left ventricular mass in the two groups.

Aged↗
PubMed2001

Gender differences in systolic left ventricular function in hypertensive patients with electrocardiographic left ventricular hypertrophy (the LIFE study).

Echocardiography was performed in 944 untreated hypertensive patients (391 women and 553 men, mean age 66 years) who had electrocardiographic left ventricular (LV) hypertrophy at baseline in the Losartan Intervention For End point reduction in hypertension (LIFE) study to evaluate gender-associated differences in systolic LV function. Women had significantly lower diastolic blood pressure (175/97 vs 173/99 mm Hg) and body surface area and a higher body mass index (all p < 0.01). Women also had higher LV ejection fraction (EF), endocardial and midwall fractional shortening (63% vs 60%, 35% and 33%, and 16% vs 15%, respectively, all p < 0.01), higher stress-corrected midwall fractional shortening (98% vs 96%, p < 0.05), and lower circumferential end-systolic wall stress (178 vs 187 kdynes/cm(2), p < 0.01). There was no difference in age or LV mass indexed for height(2.7), but relative wall thickness was higher in women (0.42 vs 0.41, p < 0.05). In multiple regression analyses: (1) EF and endocardial fractional shortening were 2% to 3% higher in women than men, independent of the effects of LV stress, body mass index, and height (multiple r = 0.77 and 0.75, respectively, gender p < 0.02 in both models); (2) midwall fractional shortening was 0.5% higher in women, independent of the effects of age, body mass index, circumferential end-systolic stress, and absence of diabetes (multiple r = 0.36, p = 0.014 for gender); and (3) stress-corrected LV midwall fractional shortening was 2% higher (p = 0.004) in women, independent of the effects of age, height, heart rate, body mass index, and diabetes (multiple r = 0.33). Thus, female gender is an independent predictor of higher systolic LV function in hypertensive patients with electrocardiographic LV hypertrophy.

Aged↗
PubMed1995

The effects of nisoldipine on carotid artery stiffness and left ventricular functions.

Doppler echocardiographic determination, left ventricular (LV) fractional shortening (FS), cardiac output (CO), diastolic function parameter (E/A ratio) and carotid artery pulse wave velocity and stiffness were evaluated in 36 patients with essential hypertension before and after nisoldipine treatment. Blood pressure decreased significantly, and carotid artery width and fractional shortening increased significantly following nisoldipine administration (p < 0.0001). Carotid artery pulse wave peak velocity did not change following the treatment period (p > 0.05). In conclusion, short term nisoldipine administration improved blood pressure and LV systolic function, whereas LV diastolic function and carotid artery stiffness did not change. Nisoldipine did not alter serum biochemical parameters, including cholesterol, triglyceride, HDL-cholesterol, and LDL-cholesterol (p > 0.05). Only one patient manifested symptoms of hypotension as an adverse effect of the drug.

Adult↗
PubMed1992

Systemic and coronary hemodynamic effects of bepridil in patients with depressed left ventricular function.

To assess the effects of oral bepridil therapy (10-14 days) on cardiac performance and myocardial energetics in the presence of depressed left ventricular function, systemic and coronary hemodynamic effects and neurohumoral effects were evaluated in 7 patients with coronary artery disease and reduced ejection fraction at control, submaximal, and maximal pacing rates during atrial pacing stress. After bepridil therapy, arterial, right atrial, and left ventricular filling pressures as well as systemic vascular resistance and left ventricular stroke work index did not change, suggesting no deleterious effects of bepridil on cardiac performance in patients with reduced ejection fraction. Rate-pressure product, myocardial oxygen consumption, coronary sinus blood flow, myocardial lactate extraction, and catecholamine balance remained unchanged. Development of angina during pacing showed a variable response to bepridil. We conclude that despite its potential negative inotropic effect, bepridil does not exert deleterious effects on hemodynamics or left ventricular performance. The mechanism for its beneficial antianginal effect may be due to favorable redistribution of myocardial blood flow to ischemic zones; no clear effect on anginal threshold or sympathetic tone could be demonstrated in these patients.

Aged↗
PubMed1992

A prospective study of the efficacy and safety of adjuvant metoprolol and xamoterol in combination with amiodarone for resistant ventricular tachycardia associated with impaired left ventricular function.

Combination antiarrhythmic drug therapy may be more effective than treatment with a single agent for control of refractory cases of sustained ventricular tachycardia (VT). In a prospective randomized crossover study of 20 patients with impaired left ventricular function (ejection fraction of 28% +/- 8%) and recurrent VT in spite of treatment with amiodarone, we compared the efficacy and safety of adjuvant therapy with metoprolol, 50 mg two times daily and xamoterol, 200 mg two times daily. Metoprolol caused hemodynamic deterioration in five patients, and only one also experienced intolerance to xamoterol. Sustained VT was inducible in all 20 patients who were receiving amiodarone alone but was suppressed or rendered nonsustained in 8 of 20 patients during treatment with amiodarone plus xamoterol and in 6 of 17 patients during treatment with amiodarone plus metoprolol. Addition of xamoterol restored sinus rhythm in four patients who presented with incessant VT, and metoprolol was effective for three of them. Neither beta-blocker significantly altered tachycardia cycle length or any electrophysiologic parameter other than the slowing of the sinus rate. Both beta-blockers suppressed exercise-induced VT in 3 of 4 patients, and addition of xamoterol significantly increased treadmill exercise duration (7.1 +/- 1.8 min) compared with administration of amiodarone alone (3.8 +/- 1.5 min; p < 0.01). Fourteen patients were discharged with prescriptions for amiodarone-beta-blocker combinations. During a mean follow-up period of 13 months (range, 2 to 24 months), there were three cases of recurrent VT (in all patients VT remained inducible) and no sudden deaths.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1996

[Left ventricular function in patients with chronic ischemic cardiopathy: relationship with the status of myocardial perfusion].

The aim of this study was the evaluation of left ventricular function compared to myocardial perfusion in patients with chronic coronary artery disease (CAD). Thirty-two patients with chronic CAD (27 men and 5 women, mean age 58 +/- 9 years) underwent radionuclide angiography and rest-redistribution thallium-201 (TI-201) single photon emission Computed Tomography (SPECT). Ejection fraction (EF, %), peak filling rate (PFR, end diastolic volume/second), and the coefficient of variation of the regional time to PFR (CV-TPFR, %) were computed. Patients with severe irreversible defects (i.e. with TI-201 uptake < 50%) had lower EF (42 +/- 7% vs 52 +/- 11%, p < 0.01) and lower PFR (1.9 +/- 0.4 vs 3.1 +/- 1.0, p < 0.0005) than those without. Patients with severe irreversible perfusion defects in the left anterior descending artery territory had lower EF (41 +/- 6% vs 50 +/- 11%, p < 0.01), lower PFR (1.8 +/- 0.3 vs 2.8 +/- 1.0, p < 0.005), and higher CV-TPFR (39 +/- 22 vs 13 +/- 7, p < 0.001) than those without. The results of the present study indicate that in patients with chronic CAD left ventricular systolic and diastolic function is more deteriorated when the left anterior descending artery is involved. Similarly, the presence of severe irreversible perfusion defects is clearly associated with significantly lower EF and PFR.

Adult↗
PubMed1993

Girdling effect of nonstimulated cardiomyoplasty on left ventricular function.

The precise hemodynamic effects of latissimus dorsi cardiomyoplasty have not been well characterized. We prospectively studied 11 mongrel dogs using a rapid ventricular pacing model of congestive heart failure. Six dogs received a nonstimulated left latissimus dorsi cardiomyoplasty wrap, and 5 control dogs were paced only. Two-dimensional transthoracic echocardiography was performed on all dogs at baseline and then weekly for 4 weeks. Measurements obtained included left ventricular diameters, lengths, volumes, and ejection fractions. Progressive left ventricular enlargement, increase in volumes, and worsening ejection fractions developed in both groups. However, less left ventricular dilatation and higher ejection fractions were seen in dogs that received a cardiomyoplasty wrap. A nonstimulated cardiomyoplasty wrap significantly attenuated the degree of left ventricular enlargement, increase in left ventricular volumes, and decrease in ejection fraction in a rapid pacing model of congestive heart failure. Apart from its effect on systolic augmentation with a stimulated muscle wrap, cardiomyoplasty may have an important "girdling" effect on the left ventricle that prevents dilatation and deterioration of left ventricular function.

Animals↗
PubMed1983

The acute and chronic effects of verapamil on left ventricular function in patients with hypertrophic cardiomyopathy.

Verapamil therapy improves exercise tolerance and decreases symptoms in many patients with both obstructive and nonobstructive forms of hypertrophic cardiomyopathy. These salutory clinical effects result from favorable modification by verapamil of the pathophysiologic abnormalities in left ventricular function characteristic of this disease: impaired early diastolic relaxation and filling, reduced end-diastolic volume and stroke volume, hypercontractile systolic function, and, in many patients, subvalvular outflow tract obstruction. The acute administration of intravenous verapamil produces both significant negative inotropic effects and significant effects on left ventricular diastolic function, resulting in reduced contractile state, diminished outflow gradient, increased end-diastolic volume and stroke volume and improved relaxation and diastolic filling. In some patients, one effect may predominate over the other, and improved diastolic function may be masked by the profound changes in systolic function. During short-term oral therapy, enhanced diastolic function is the predominant effect, although negative inotropic mechanisms are evident in some patients. These effects on left ventricular systolic and diastolic function persist during chronic oral verapamil therapy, contributing to the long-term clinical improvement experienced by many patients.

Blood Pressure↗
PubMed2002

Does dobutamine improve ventricular function in dogs with regional myocardial dysfunction?

UNLABELLED: We studied the effect of systemic dobutamine infusion (4 microg. kg(-1). min(-1) IV) on regional wall motion abnormalities (RWMAs) in eight anesthetized open-chested dogs. We hypothesized that infusion of small doses of dobutamine would reduce RWMAs and improve global ventricular function. Apical RWMAs were induced by local intracoronary boluses of 9.0 mg esmolol. Phase angles, effective stroke volume (SV), maximum SV, stroke work, and segmental shortening were compared among four left ventricular (LV) regions (apical, papillary, chordal, and basal) during baseline, dobutamine, esmolol, and dobutamine-esmolol treatments. The minimal global LV volume was designated as 0 degrees, and the cardiac cycle was divided into 360 intervals. Regional phase angles were defined as the distance (in degrees) that regional minimum volume differed from global minimal LV volume (end-systole). RWMA decreased blood pressure (92 +/- 2 mm Hg to 84 +/- 3 mm Hg) and increased LV end-diastolic pressure (1.8 +/- 0.5 mm Hg to 4.2 +/- 0.8 mm Hg). RWMA delayed regional contraction (-2.9 degrees +/- 1.6 degrees to 52.3 degrees +/- 1.5 degrees ) and decreased effective SV (2.3 +/- 0.4 mL to 1.6 +/- 0.3 mL) in the affected apical region but did not decrease maximal SV. Systemic infusion of dobutamine restored global LV function but failed to eliminate RWMA, as evidenced by decreased apical synchrony, effective SV, and stroke work. We concluded that systemic dobutamine restored global LV function but failed to correct RWMA. IMPLICATIONS: We examined the effect of systemic dobutamine on regional wall motion abnormalities (RWMAs) induced by intracoronary esmolol infusion in eight anesthetized dogs. Esmolol dilated the heart and decreased regional synchrony of contraction. Dobutamine restored cardiac function but failed to correct the asynchrony of regional contraction caused by esmolol-induced RWMAs.

Adrenergic beta-Antagonists↗
PubMed1986

Advantages and applications of the centerline method for characterizing regional ventricular function.

We sought to identify theoretical advantages and applications of the centerline method for quantitative assessment of regional ventricular function. Motion was measured along 100 chords constructed perpendicular to a centerline drawn midway between the end-diastolic and end-systolic contours, and normalized for heart size. Abnormality was expressed in units of standard deviations from the mean motion in a normal reference population to indicate both the severity and significance of the wall motion abnormality. The mean abnormality averaged over 100 chords correlated highly with the area ejection fraction (r = .97). The centerline method uses a "sliding window" to measure motion where it is abnormal, because assessment of wall motion in predefined regions of the ventricular contour underestimates abnormality. From the 100 data points, the extent (% of contour) of regional abnormalities can also be determined. The severity of hypokinesis at the site of acute myocardial infarction correlated better with infarct size estimated from creatine kinase release (r = -.78) than did the ejection fraction or the circumferential extent of hypokinesis. Because the centerline method measures motion along locally determined vectors, and requires no apex, origin, coordinate system, or geometric reference figure, it can be applied to contours as dissimilar as the 60 degree left anterior oblique projection of the left ventricle and the 75 degree left anterior oblique projection of the right ventricle.

Computers↗
PubMed1989

Thrombolysis and Angioplasty in Myocardial Infarction (TAMI-1) trial: influence of infarct location on arterial patency, left ventricular function and mortality.

The influence of infarct location on arterial patency, left ventricular function and mortality after 150 mg of intravenous recombinant tissue-type plasminogen activator (rt-PA) and selective coronary angioplasty was studied in 386 patients with acute myocardial infarction. In 329 patients with acute and 1 week angiograms, the 90 min infarct-related artery patency rate after rt-PA in the left anterior descending, the left circumflex and the right coronary artery was 77, 68 and 68%, respectively. Angioplasty, performed in half the patients, resulted in a final acute patency rate of 93%, which was not related to arterial distribution. Repeat catheterization and revascularization were required in 12% of patients before day 7 and were independent of arterial distribution. The reocclusion rate for the right coronary artery (21%) was higher than that for the left anterior descending (12%) or left circumflex (5%) artery (p = 0.01). Acute and 1 week contrast ventriculograms suitable for analysis were available in 266 patients. Whereas serial left ventricular ejection fraction did not improve during the course of this study, serial regional wall motion (centerline chord method) improved in each arterial distribution. The in-hospital mortality rate of 6% was not related to arterial distribution, although death was twice as likely with proximal compared with distal lesions. Ten of 11 patients who died in the group with the left anterior descending artery as the infarct-related artery had a lesion proximal to the first septal perforator branch.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1999

Effects of low-dose dobutamine on left ventricular function in normal subjects as assessed by gated single-photon emission tomography myocardial perfusion studies.

Electrocardiography gated single-photon emission tomography (gated SPET) allows the assessment of regional perfusion and function simultaneously and in full spatial congruency. In this study changes in global and regional left ventricular function in response to dobutamine infusion were assessed in ten healthy volunteers using sequential gated SPET myocardial perfusion acquisitions. Four consecutive gated SPET images were recorded 60 min after injection of 925 MBq technetium-99m tetrofosmin on a three-head camera equipped with focussing collimators. Two acquisitions were made at rest (baseline 1 and 2), and the third and fourth acquisitions were started 5 min after the beginning of the infusion of 5 and 10 microg kg(-1) min(-1) dobutamine, respectively. Systolic wall thickening (WT) was quantified using a method based on circumferential profile analysis. Left ventricular ejection fraction (LVEF) and volumes were calculated automatically using the Cedars-Sinai program. Nine of the ten subjects presented a definite increase in WT during dobutamine infusion. WT increased on average from 46%+/-14% at baseline to 71%+/-23% (range: 37%-106%; P<0.05) during 5 microg kg(-1) min(-1) dobutamine infusion and to 85%+/-25% (range: 62%-123%; P<0.05 with respect to WT at 5 microg kg(-1) min(-1)) during 10 microg kg(-1) min(-1) dobutamine infusion. Apical segments showed the largest WT at baseline. The average WT response to dobutamine was similar for all parts of the myocardium. It is concluded that changes in WT induced by infusion of low-dose dobutamine can be assessed by sequential gated SPET myocardial perfusion studies. The "stress gated SPET" protocol proposed in this study might be helpful to distinguish viable from scar tissue in patients with coronary artery disease, by demonstrating a preserved inotropic response in hypoperfused myocardium.

Adrenergic beta-Agonists↗