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 1,783 records · Page 99Linked to original sources
PubMedDate not supplied

Intracoronary infusion of autologous bone marrow cells and left ventricular function after acute myocardial infarction: a meta-analysis.

Recent clinical studies have demonstrated that intracoronary infusion of autologous bone marrow cells (BMC) in conjunction with standard treatment may improve left ventricular function after an acute myocardial infarction (AMI). However, the results of these studies remain controversial, as the studies were relatively small in size and partially differed in design. We reviewed primary controlled randomized clinical studies comparing intracoronary transfer of autologous non-mobilized BMC combined with standard therapy versus standard therapy alone in patients with AMI. We identified five randomized controlled clinical trials, three of which were also placebo- and bone marrow aspiration-controlled. Non-mobilized BMC were infused into the revascularized coronary target artery 6.6 +/- 6.1 days after AMI. The mean follow- up period of 5.2 +/- 1.1 months was completed by 482 patients, 241 of which received infusion of BMC. The effect of BMC on left ventricular ejection fraction (LVEF) as a major functional parameter was evaluated. Analyzing the overall effect on the change in LVEF between baseline and follow-up value revealed a significant improvement in the BMCtreated group as compared to the control group (P = 0.04). Thus, considering the increase in LVEF during follow-up, transplantation of BMC may be a safe and beneficial procedure to support treatment of AMI. However, the functional improvement observed with this form of therapy was altogether relatively moderate and the studies were heterogeneous in design. Hence, further efforts aiming at large-scale, double-blind, randomized and placebo-controlled multi-center trials in conjunction with better definition of patients, which benefit from BMC infusion, appear to be warranted.

Acute Disease↗
PubMed1997

Effects of enalapril on left ventricular function and exercise performance after a first acute myocardial infarction. The EDEN Study Investigators.

AIMS: To study the effects of early use of enalapril on left ventricular function and exercise capacity after a first acute myocardial infarction, 356 patients without overt signs of congestive heart failure were randomly allocated to receive placebo or enalapril between days 7 and 14 after a first myocardial infarction. The study was conducted double-blind in 40 hospitals throughout Spain. METHODS AND RESULTS: At baseline and after 26 weeks of follow-up exercise stress tests, Doppler-echocardiograms and isotopic ventriculography were performed in study participants. At the end of follow-up, patients in the enalapril group had lower end-systolic volume compared to those in the placebo group (55 vs. 62 ml; P=0.05). No difference in exercise capacity was evident between both groups. CONCLUSION: The present study shows that enalapril therapy administered between 7 and 14 days after a first acute myocardial infarction decreases end-systolic volume and may inhibit the remodeling process of the left ventricle.

Adolescent↗
PubMed2006

Characteristics of Doppler myocardial echocardiography in patients with tricuspid atresia after total cavopulmonary connection with preserved systolic ventricular function.

BACKGROUND: Doppler myocardial echocardiography (DME) may be an excellent additional means of assessing determinants of systolic and diastolic ventricular function in patients with tricuspid atresia (TA) after total cavopulmonary connection (TCPC). METHODS AND RESULTS: Thirty-three patients with TA and normal systolic shortening/ejection fraction (M-mode) after TCPC were studied by DME at a median age of 7.6 years (range 1.5-17 years). These results were compared to 16 age matched normal controls. Median time under a cavopulmonary shunt was 5.2 years (range 0.6-13.3 years). Isovolumic acceleration and isovolumic velocity did not differ significantly. All other systolic (S-wave acceleration-velocity and S-wave duration) and diastolic DME indices (E-deceleration-velocity, A-velocity and E/A ratio) were significantly lower in TCPC patients in comparison to normals (p<0.0001). Furthermore, isovolumic relaxation time (IRT) was significantly prolonged in the patient group (p<0.0001). Even though there was a significant correlation between the time of volume unloading and left ventricular end-diastolic diameter, exclusion of all patients with short period of volume unloading and relatively large systemic ventricles did not alter the results. CONCLUSIONS: Patients with TA after TCPC and normal shortening and ejection fraction have normal isovolumic acceleration. Load dependent DME indices of systolic and diastolic function, however, were significantly reduced. These findings suggest that the described DME indices mirror the "normal" hemodynamics after TCPC in patients with TA. It needs to be assessed, whether this is an index of adverse prognosis in long-term surveillance of these patients.

Adolescent↗
PubMed1987

Effects of Ethmozine (moricizine HCl) on ventricular function using echocardiographic, hemodynamic and radionuclide assessments.

Ventricular arrhythmias combined with left ventricular (LV) dysfunction in patients portend a poor prognosis. Most antiarrhythmic agents have not been sufficiently investigated to adequately describe detrimental effects on LV function; we report the effects of moricizine HCl on ventricular function in 4 trials highlighting patients with LV dysfunction. Quantitative 2-dimensional echocardiography was used to evaluate 81 patients pre- and posttreatment. There was no change in mean global LV ejection fraction (EF) during placebo compared with moricizine HCl therapy (47 +/- 15% vs 46 +/- 14%, p greater than 0.05). In a separate trial, radionuclide LVEF at rest and exercise tolerance testing were performed in 24 patients with life-threatening ventricular arrhythmias who had a mean control LVEF of 40 +/- 19%. No significant change during moricizine HCl therapy (38 +/- 19%, p greater than 0.05) was detected and exercise parameters were unchanged. Rest and exercise LV function was measured during right-sided heart catheterization in a placebo-controlled study of 20 patients with ventricular tachycardia. Moricizine HCl was well tolerated without hemodynamic deterioration in all but 3 patients, who could be identified by their inability to increase stroke volume index during exercise. Finally, the relation between initial LV function and resultant antiarrhythmic efficacy indicates that moricizine HCl controls arrhythmias best in patients with LVEF greater than 30%.

Adult↗
PubMed1986

[Severity and extent of coronary artery disease and their relationship to left ventricular functional reserve in the chronic disease state].

Our previous observations showed that left ventricular wall motion abnormality (asynergy) induced by stress was observed in the phase response of radionuclide technique, and the severity and extent of coronary artery disease (CAD) assessed by the Pujadas score (PS) correlated well with the maximal phase delay response (delta MPD) but not with the ejection fraction response (delta EF) in patients with CAD without old myocardial infarction (MI). This study evaluated the usefulness of EF, MPD and the first-third filling fraction (FF, divided by the volume accrued throughout diastole) at rest and during stress, using ergometer and first-pass radionuclide angiocardiography (RNA), to determine the severity of CAD, and to evaluate any abnormalities in the systolic and diastolic coupling in left ventricular function during stress. Seventy-four patients with significant CAD, including 41 with previous transmural MI (MI group) and 33 without MI (angina group) were the subjects of this study. EF at rest and during stress inversely correlated, and MPD on stress linearly correlated with PS in angina group with PS greater than 10, while no such correlations were found in MI group. A normal EF response (delta EF greater than or equal to 5%) was accompanied by a greater-than-normal response in FF (delta FF) in both groups. A lower EF response was accompanied by a smaller delta FF in angina group, but by a larger delta FF in MI group. The difference was statistically significant (p less than 0.03), without significant differences by age, PS, peak heart rate, systolic blood pressure, and ischemia on ECG during stress. Resting EF and FF by the RNA method correlated with those by left ventriculography (LVG), respectively. It was suggested that RNA is an accurate method for determining EF and FF, while phase analysis may provide some additional information different from that provided by LVG. We concluded that EF and MPD during stress are as useful as delta MPD with the exception of a few cases in predicting the severity of CAD, and that scar tissue within the ventricular wall in MI may play an important role in determining the ventricular diastolic mechanical property during stress.

Angina Pectoris↗
PubMed2003

Long-term treatment with low-dose, but not high-dose, guanethidine improves ventricular function and survival of rats with heart failure after myocardial infarction.

OBJECTIVES: We sought to evaluate the effects of various doses of guanethidine, a sympathoinhibitory drug, on ventricular function and survival in chronic heart failure (CHF) after myocardial infarction (MI) in rats. BACKGROUND: Direct inhibition of sympathetic outflow by a sympathoinhibitory drug might be an effective approach to therapy of CHF. However, recent clinical trials suggest that excessive suppression of sympathetic activity has an adverse effect on outcome. It remains unclear whether the beneficial effects of the sympathoinhibitory drug would be modified by its dosage. METHODS: Three doses of guanethidine (low-dose [LG], 1 mg/kg/day; medium-dose, 3 mg/kg/day; high-dose, 10 mg/kg/day) were administered via an osmotic mini-pump for 4 weeks. Hemodynamics, left ventricular (LV) diameters, plasma and myocardial norepinephrine (NE) levels, and survival were determined for four weeks after MI. RESULTS: As compared with MI rats receiving vehicle, LG suppressed LV dilation (9.2 +/- 0.9 mm vs. 11.0 +/- 0.8 mm, p < 0.05) and improved LV fractional shortening (25.0 +/- 4.5% vs. 16.4 +/- 4.7%, p < 0.05) in association with a reduction of plasma NE levels (520 +/- 250 pg/ml vs. 1,000 +/- 570 pg/ml, p < 0.05), but not with a significant reduction of noninfarcted myocardial NE levels (154 +/- 71 ng/g vs. 207 +/- 71 ng/g). Low-dose guanethidine reduced 24-h (6%) and 28-day mortality (6%), as compared with untreated MI rats (36% and 52%, respectively). High-dose guanethidine also reduced 24-h mortality (12%) but increased 28-day mortality (91%), in association with a depletion of myocardial NE. Medium-dose guanethidine had no beneficial effects on LV hemodynamics or long-term survival. CONCLUSIONS: These results indicate that the dosage of the sympathoinhibitory drug might be quite important for the treatment of CHF.

Animals↗
PubMed1985

Evaluation of relationship between myocardial contractile state and left ventricular function in patients with aortic regurgitation.

We studied the relationship between myocardial contractile state and left ventricular functional response to exercise in 14 asymptomatic patients with isolated moderate-to-severe aortic regurgitation and six control subjects. The slope of the systolic blood pressure-left ventricular end-systolic volume (pressure-volume) relationship determined by radionuclide ventriculography during angiotensin infusion was used as an indirect measure of myocardial contractility and was compared with left ventricular ejection fraction at rest and during both isometric handgrip and dynamic bicycle exercise. The slope of the pressure-volume relationship was significantly lower in patients with aortic regurgitation than in the control subjects (1.75 +/- 0.57 vs 2.78 +/- 0.42, p less than 0.01). The slope correlated exponentially with resting ejection fraction and was linearly related to changes in left ventricular ejection fraction during both handgrip and bicycle exercise. In patients with aortic regurgitation, resting ejection fraction may overestimate myocardial function. The slope of the pressure-volume relationship measured during afterload stress and left ventricular ejection fraction response to exercise intervention more reliably reflect the degree of left ventricular dysfunction.

Adult↗
PubMed2006

Comparison of 64-slice CT with gated SPECT for evaluation of left ventricular function.

UNLABELLED: Precise and reliable assessment of left ventricular (LV) function and dimensions is prognostically important in cardiac patients. As the integration of SPECT and multislice CT into hybrid scanners will promote the combined use of both techniques in the same patient, a comparison of the 2 methods is pertinent. We aimed at comparing LV dimensions, muscle mass, and function obtained by electrocardiographically gated 64-slice CT versus gated-SPECT. METHODS: Sixty patients (mean age, 64 +/- 8 y) referred for evaluation of coronary artery disease underwent 99mTc-tetrofosmin gated SPECT and 64-slice CT within 4 +/- 2 d. LV ejection fraction (LVEF), end-systolic volume (ESV), and end-diastolic volume (EDV) from CT were compared with SPECT. Additionally, LV muscle mass and quantitative regional wall motion were assessed in 20 patients with both methods. RESULTS: CT was in good agreement with SPECT for quantification of LVEF (r = 0.825), EDV (r = 0.898), and ESV (r = 0.956; all P < 0.0001). LVEF was 59% +/- 13% measured by SPECT and slightly higher but not significantly different by CT (60% +/- 12%; mean difference compared with SPECT, 1.1% +/- 1.7%; P = not significant). A systematic overestimation using CT for EDV (147 +/- 60 mL vs. 113 +/- 52 mL; mean difference, 33.5 +/- 23.1 mL) and ESV (63 +/- 55 mL vs. 53 +/- 49 mL; mean difference, 9.3 +/- 15.9 mL; P < 0.0001) was found compared with SPECT. A good correlation for muscle mass was found between the 2 methods (r = 0.868; P < 0.005). However, muscle mass calculated by SPECT was significantly lower compared with CT (127 +/- 24 g vs. 148 +/- 37 g; mean difference, 23.0 +/- 12.2 g; P < 0.001). The correlation for regional wall motion between the 2 methods was moderate (r = 0.648; P < 0.0001). CONCLUSION: LVEF and LV functional parameters as determined by 64-slice CT agree over a wide range of clinically relevant values with gated SPECT. However, interchangeable use of the 2 techniques should be avoided for LV volumes, muscle mass, and regional wall motion because of variances inherent to the different techniques.

Adult↗
PubMed1980

Anomalous left coronary artery in the infant: recovery of ventricular function following early direct aortic implantation.

A successful direct aortic implantation of an anomalous left coronary artery (ALCA) in an infant is reported. Detailed evaluation of postoperative ventricular function, including repeat cardiac catheterization and serial echocardiography, demonstrated progressive enhancement of ventricular contractility and function. Postoperative angiography confirmed vascular patency. These data support the concept that the ALCA should be corrected by direct aortic implantation early in infancy rather than by expectant treatment or graft interposition.

Aorta, Thoracic↗
PubMed1980

Angiotensin infusion effects on left ventricular function. Assessment in normal subjects and in patients with coronary disease.

Radionuclide multigating of the cardiac cycle was employed to assess effects of angiotensin infusion on left ventricular function. In six normal subjects, angiotensin infusion decreased heart rate (HR) from 72 +/- SEM 2 to 57 +/- 2 beats/min (P less than 0.001); while systolic blood pressure (BP) increased from 119 +/- 2 to 178 +/- 1 mm Hg (P less than 0.001), and ejection fraction (EF) declined from 58 +/- 1 to 47 +/- 2 percent (P less than 0.05). In contrast, in 11 normal subjects, supine exercise increased HR and systolic BP by 55 and 49 percent, whereas EF increased from 64 +/- 1 to 71 +/- 1 (P less than 0.001). In ten patients with CAD, angiotensin infusion produced no change in HR, increased systolic BP by 34 percent, and decreased EF by 11 percent. Angiotensin infusion induced left ventricular depression in normal subjects and in patients with CAD. It cannot substitute for exercise in intervention radionuclide ventriculography.

Adult↗
PubMed1994

[Right ventricular function and postural changes during surgery of the lumbar spine].

The aim of the study was to assess the effects of the sitting prone position on right ventricular function in a group of patients requiring low back surgery with using of right heart catheterization with a low fast response thermodilution technique. This posture involves moderated hemodynamic effects. A discrete right ventricle impairment characterised by a decreased compliance was observed and may be due to a moderate compression by the sternum and was improved by fluid challenge. Thus, the sitting prone position appears a safe position.

Humans↗
PubMed2001

Accuracy of three-dimensional quantification of left ventricular function using magnetic sensor acquisition: a dynamic in vitro model.

OBJECTIVE: To evaluate the accuracy of a three-dimensional (3D) magnetic position sensor system in the quantification of ventricular stroke volumes in a dynamic model. METHODS: A latex balloon model of the left ventricle was suspended in a water bath connected to a pump producing 10 different pulsatile stroke volumes (15-65 ml/beat). Scanning was performed using a 5.0 mHz transducer mounted with a Flock of Birds (FOB) magnetic receiver (GE System Five). The probe was scanned to sweep continuously across and over the balloon volume over 3-7 seconds. Digital loops were stored on magneto-optical disks and reviewed retrospectively using 3D Echopac software (GE) based on Simpson's method and compared with a two-dimensional (2D) biplane area-length method (1/2 L x R) measurements at end systole and end diastole. Both 3D and 2D derived stroke volumes were compared with the reference stroke volume calculated by direct measurement of balloon capacity. RESULTS: There was an improved correlation between 3D stroke volume and reference stroke volume (y = 0.91x + 0.41, r = 0.97, SEE = 2.83 ml, P = 0.0001) compared to 2D stroke volume and reference stroke volume (y = 0.49x + 8.68, r = 0.87, SEE = 3.87 ml, P = 0.0011, difference between 2D and 3D P < 0.003). CONCLUSION: 3D magnetic FOB scanning is practical, accurate and should facilitate assessment of left ventricular function.

Echocardiography, Three-Dimensional↗
PubMed2002

Beneficial effects of L-carnitine in dialysis patients with impaired left ventricular function: an observational study.

BACKGROUND: Recent studies have shown that L-carnitine may improve clinical status and reduce the need for erythropoietin in dialysis patients with cardiovascular diseases. In this observational study, we investigated whether the addition of L-carnitine to conventional therapy might improve cardiac function (as assessed by M-mode and two-dimensional echocardiography) and clinical status in dialysis patients with left ventricular dysfunction. METHODS: Eleven dialysis patients with reduced left ventricular function (EF < 45%) were treated with L-carnitine for 8 months. Two-dimensional (2-D) echocardiography was performed at baseline and every 2 months up to the end of the treatment period. The dosage of erythropoietin was also monitored during the study and the patients' clinical status was assessed by a questionnaire. RESULTS: Carnitine increased mean LV ejection fraction from 32.0% to 41.8% (p < 0.05 vs baseline). There was also a slight reduction of erythropoietin dosage and an improvement of clinical status. CONCLUSIONS: Eight months' therapy with carnitine appears to improve LV function and clinical status in dialysis patients with impaired LVF.

Aged↗
PubMed1995

Evaluation of right ventricular function by assessment of cardiac efficiency: influence of induction of anaesthesia in coronary artery bypass grafting patients.

Considering the heart as a physical pump cardiac efficiency is calculated from the ratio of cardiac work performed to the maximum level of energy of the heart. The aim of the study was to compare cardiac efficiency with cardiac output and right ventricular ejection fraction. Nine patients scheduled for coronary artery bypass grafting were investigated. A femoral arterial and a right ventricular ejection fraction pulmonary artery catheter were placed in the awake state. Anaesthesia was induced with eltanolone and fentanyl. Cardiac output, pulmonary artery and central venous pressures, and right ventricular ejection fraction were measured in the awake state (baseline), 2 min after induction of anaesthesia and 1 and 5 min after intubation. Cardiac efficiency was calculated by dividing the stroke work by the maximum energy of the heart as calculated from the pressure volume diagram. An analysis of variance was carried out for cardiac efficiency, cardiac output and right ventricular ejection fraction. Cardiac efficiency was significantly (p < 0.05) reduced 1 min after intubation from 28 +/- 11 to 14 +/- 5%. In contrast the right ventricular ejection fraction (from 48 +/- 10 to 35 +/- 13%) and cardiac output (from 6.5 +/- 1.5 to 5.3 +/- 1.2 L/min) did not change significantly during the induction of anaesthesia. Cardiac efficiency was found to be a more sensitive parameter to describe changes in the right ventricular function than the ejection fraction and cardiac output during induction of anaesthesia with eltanolone and fentanyl which was used as a model to vary cardiac performance and afterload.

Aged↗
PubMed1988

Echocardiographic evaluation of the effects of gallopamil on left ventricular function.

Two-dimensional echocardiography was used to determine global and regional left ventricular function in 32 patients treated with gallopamil (methoxyverapamil) for angina pectoris. Ejection fraction (EF), pressure/volume ratio (PVR), and segmental wall motion were assessed. Evaluations were made before therapy (T1) and repeated 3 weeks later; this assessment included examination 2 and 8 hours after the morning dose (T2 and T3, respectively). Patients were randomized to either a placebo group or three study groups (25, 37.5, and 50 mg t.i.d.). In the 37.5 and 50 mg groups there was an increase in EF (T1 = 53.8% and 54.5%, T2 = 57.9% and 60.1%, and T3 = 57.6% and 60%) and PVR values (T1 = 5.2 and 7.2 mm Hg/ml/m2, T2 = 5.8 and 7.7 mm Hg/ml/m2, and T3 = 5.9 and 7.6 mm Hg/ml/m2, respectively). Wall motion remained the same or improved in 92.3% of the patients. In conclusion, gallopamil had no cardiodepressant effects in most patients. On the contrary, EF, PVR, and segmental contractility tended to improve with the higher doses.

Aged↗
PubMed1991

Impaired left ventricular function during exercise in hypertensive patients with normal coronary arteriograms.

Patients with left ventricular hypertrophy (LVH) often exhibit manifestations of myocardial ischemia. In 17 hypertensive patients (group 1, mean age of 56 +/- 4 years, 10 females, 7 males) with ST-segment depression during the exercise electrocardiogram (ECG) and effort angina and normal coronary arteriograms, the left ventricular function at rest and during exercise was studied by heart catheterization. The results were compared with 17 hypertensive patients (group 2, mean age of 56 +/- 6 years, 6 females, 11 males) with coronary artery disease (CAD). The normal pulmonary wedge pressure at rest (group 1, 8.9 +/- 3 mm Hg; group 2, 8.9 +/- 3 mm Hg) was pathologically increased (p less than 0.001) in both groups (group 1, 27.1 +/- 5 mm Hg; group 2, 28.8 +/- 7 mm Hg) even at a work load of 50 W with a further increase at 75 W to 31 +/- 4 and 29.7 +/- 4 mm Hg, respectively. Cardiac output was normal. There was no significant correlation between ST-segment depression, pulmonary wedge pressure, LVH, and Holter ECG. Hypertensive patients without CAD may reveal a disturbed pump function due to ischemia even at low work loads, which does not differ significantly from patients with CAD. This may provoke subendocardial fibrosis and thereby contribute to the development of heart failure.

Blood Pressure↗
PubMed1981

Left ventricular function and volume during supine exercise in subjects with coronary artery disease.

Left ventricular function and volume changes during supine isotonic exercise were assessed in 32 patients with coronary artery disease (CAD) and 12 normal subjects by electrocardiographically gated blood pool cardiac scintigraphy. Ejection fraction (EF) in normal subjects was 49 +/- 10% at rest, 54 +/- 10% during intermediate exercise (P less than 0.05 vs. rest), and 62 +/- 14% during maximal exercise (P less than 0.01 vs. rest). In patients with CAD the resting EF was 42 +/- 14%, 43 +/- 23% at intermediate exercise (P = nonsignificant vs. rest) and 36 +/- 11% at maximal exercise (P less than 0.01 vs. rest). Changes of average and maximal ejection rates from rest to exercise were similar to those of EF but had a lesser degree of statistical significance. End-diastolic volume index (EDVI) in patients with CAD, at intermediate exercise was equal to that at rest, but it increased during maximal exercise (P less than 0.01). In normal subjects EDVI did not change with exercise. Thus, during supine exercise the Frank-Starling mechanism is apparent in patients with CAD but not in normal subjects. Analysis of EF response to exercise is a highly sensitive technique to detect CAD provided that adequate exercise is achieved.

Adult↗
PubMed1988

[Hemodynamic changes and left ventricular function in patients with hypertension during an acute trial of urapidil].

The left ventricular hemodynamic changes were studied in 9 hypertensive patients (6 patients with hypertensive attack and 3 patients with a severe form of the disease) by simultaneous recordings of the M-type echocardiogram, apexcardiogram and phonocardiogram in an acute trial with Urapidil administered intravenously in a dose of 0,7 mg/kg body mass. The arterial pressure and the peripheral vascular resistance decrease. The stroke and the minute volume do not change. The heart rate increases. The telediastolic and telesystolic dimensions of the left ventricle decrease. The percentage amplitude of the aI-wave of the apexcardiogram also decreases. The fraction of the shortening of the left ventricular dimension increases with 23,0%, the ejection fraction increases with 13,5% and the average speed of the circumferential fibres shortening increases with 21,4%. Urapidil applied i.v. exerts a rapid hypotensive action and improves the left ventricular function.

Adult↗