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At least 19 recordsLinked to original sources
PubMedDate not supplied

Application of Hilbert transform to radionuclide-gated cardiac studies: analysis of asynchronous emptying and filling in various heart diseases.

Fourier phase analysis has generally been used to investigate asynchronous emptying and filling in various heart diseases. A potential limitation of this form of analysis is curve fitting error, since a truncated Fourier series may not adequately describe the shape of a time-volume curve (TVC) and thus may produce errors in indices calculated from the fit. To overcome this problem, we developed a new method using Hilbert transform. Using Hilbert transform, the instantaneous phase (IP) curve was calculated directly from the TVC obtained from multigated cardiac blood pool images. Four parameters [time to maximum IP [T(max)], time to 0 in IP[T(0)], time to minimum IP[T(min)], and time from 0 to minimum IP [T(min-0)]] were extracted from the IP curves for each pixel, and functional images were constructed in 40 patients with ischemic heart disease (IHD), 16 with hypertrophic cardiomyopathy (HCM), 3 with dilated cardiomyopathy (DCM), and 7 normal controls (N). The standard deviations (SD) of these parameters were then calculated for the left ventricle. In IHD patients with a left ventricle ejection fraction (LVEF) of less than 50% and in DCM, the SDs of all parameters were significantly higher than in group N. In IHD patients with an LVEF of greater than 50%, the SDs of T(min), T(0), and T(min-0) were significantly higher than in group N, but there was no significant difference in the SD of T(max). In HCM patients, the SDs of T(min) and T(min-0) were significantly higher than in group N, suggesting the presence of asynchronous filling. In conclusion, this method appears to be promising for the quantitative analysis of asynchronous emptying and filling in various heart diseases.

Cardiomyopathy, Dilated↗
PubMed1996

[Left cardiac output curve and pulmonary venous return curve in patients with various heart diseases].

This study assessed the cardiac function of humans by drawing simultaneous left cardiac output and pulmonary venous return curves using radionuclide angiocardiography and right heart catheterization which allows recording of the pressure-flow relationship. Thirty-one subjects with various cardiac diseases were divided into two groups [18 patients with New York Heart Association (NYHA) functional class I and 13 patients with NYHA classes II or III]. Mean pulmonary filling pressure (Pmp) was calculated from the formula of Guyton, using pulmonary arterial compliance which was measured by Reuben's method and pulmonary venous compliance measured as reported previously. On the pressure-flow plane, the down slope of the pulmonary venous return curve was drawn by joining the points of (Pmp, 0) and (mean pulmonary capillary wedge pressure, cardiac output). To construct the cardiac output curve, two levels of lower body negative pressure were used to regulate the venous return to the heart. Pmp and the resistance to pulmonary venous return in NYHA II or III patients were significantly higher than those in NYHA I patients (Pmp: 16.3 +/- 1.5 vs 9.0 +/- 0.5 mmHg, p < 0.01; resistance to pulmonary venous return: 0.75 +/- 0.09 vs 0.43 +/- 0.04 mmHg/l/min, p < 0.01, respectively). The slope of pulmonary venous return curve in NYHA II or III patients was smaller than that in NYHA I patients and the pulmonary venous return curve in NYHA II or III patients shifted rightward. The slope of cardiac output curve in NYHA II or III patients was significantly smaller than that in NYHA I patients. This curve in NYHA II or III patients shifted downward and rightward. These results indicate that simultaneous cardiac output and pulmonary venous return curves may be a useful method for assessing the cardiac function in patients with various heart diseases.

Adult↗
PubMed2001

Doppler echocardiography-derived index of myocardial performance (TEI index): comparison with brain natriuretic peptide levels in various heart disease.

Plasma brain natriuretic peptide (BNP) has diagnostic and prognostic value in heart failure. Cardiac dysfunction varies from systolic or diastolic dysfunction alone to the combination of both. In the present study, Doppler echocardiographic parameters, including the Doppler echocardiography-derived index (TEI index), were compared with plasma BNP levels in 74 patients with various heart diseases. Blood sampling was performed before an echocardiographic examination was conducted. The TEI index was defined as the summation of isovolumic contraction and relaxation time divided by ejection time. In patients with left ventricular (LV) systolic dysfunction (ejection fraction <50%), the TEI index and BNP were increased significantly compared with patients with normal LV systolic function (p<0.05). Patients with a TEI index > or =0.45 showed significantly increased BNP levels compared with patients with a TEI index <0.45, irrespective of LV systolic function (241.4+/-451.2 vs 65.9+/-81.8pg/ml; p<0.05). The TEI index was significantly higher in patients with a BNP > or =73pg/ml than in patients with BNP <73pg/ml (0.57+/-0.24 vs 0.46+/-0.17; p<0.05). Other echocardiographic parameters did not correlate significantly with levels of plasma BNP. Of the echocardiographic parameters, a simple Doppler index (TEI index) that combines systolic and diastolic function can detect LV dysfunction in patients with high levels of plasma BNP in various heart diseases.

Adolescent↗
PubMed1987

Studies on ultrastructure and cytochemical ATPase activity in human cardiac myocytes from biopsies from patients with various heart diseases.

Ultrastructural localization and intensity of ATPase activity were studied in myocardial cells from biopsies with reference to fine-structural alterations and cardiac functions in patients with various heart diseases. ATPase activity was found to be intense in the sarcoplasmic reticulum (SR), the matrices of the mitochondria (Mt), on the myofilaments (Mf) and along the gap-junctions of intercalated discs in the control myocardial cells. ATPase activity was more intense in cardiac myocytes from well-functioning or ultrastructurally well preserved hearts. In failing and degenerating hearts, ATPase activity was decreased. ATPase activity was more intense in clinically-improving than in clinically-worsening patients. However, the localized pattern of ATPase activity was similar in each heart disease. These results suggest that cytochemical observation of ATPase activity can reflect not only fine structural changes in cardiac myocytes, but also the metabolic state in the diseased heart, and is valuable therefore from the standpoint of clinical medicine.

Adenosine Triphosphatases↗
PubMed2000

Enzyme-linked immunosorbent assay for anti-tropomyosin antibodies and its clinical application to various heart diseases.

Tropomyosin is one of the key proteins for muscle contraction. We developed an enzyme-linked immunosorbent assay for antibodies to porcine muscle tropomyosin and measured serum anti-tropomyosin antibodies in patients with heart diseases and in normal controls. The mean values of absorbance in the ELISA assay of patients with ischemic heart disease (n=36, P<0.001), dilated cardiomyopathy (n=28, P<0.005), valvular heart disease (n=27, P<0.05), and collagen disease (n=38, P<0.05) were significantly higher than those of normal controls (n=53), but the value in patients with hypertrophic cardiomyopathy (n=19) was not significantly different from that of normal controls. When the cut-off value was fixed at the mean+2 SD of absorbance in normal controls, positive reactions were found in 19.4%, 7.1%, 18.5% and 15.8% of patients with ischemic heart disease, dilated cardiomyopathy, valvular heart disease, and collagen disease, respectively. An inhibition study revealed that anti-tropomyosin antibodies were different from anti-myosin antibodies, but there was a partial cross-reactivity between the two. Thus, there was a weak correlation of the titers of the two types of antibody within the group of heart diseases. These data indicate that measurement of anti-tropomyosin antibodies by ELISA is helpful for detecting autoimmune abnormalities in various heart diseases.

Adult↗
PubMed1978

Left ventricular performance in various heart diseases with or without heart failure:--an appraisal by quantitative one-plane cineangiocardiography.

Quantitative one-plane cineangiocardiography in right anterior oblique position for evaluation of LV performance was carried out in 62 patients with various heart diseases and in 13 subjects with normal LV. Parameters for evaluating both pump and muscle performances were derived from volume and pressure measurements. Of 31 patients with either systolic hypertension or LV myocardial diseases (coronary artery disease or idiopathic cardiomyopathy), 14 had clinical evidence of LV failure before the study. It was found that mean VCF and EF were most sensitive indicators of impaired LV performance among the various parameters. There was a close correlation between mean VCF and EF, yet discordant changes of both parameters were noted in some patients. Furthermore, wall motion abnormalities were not infrequently observed in patients with coronary artery disease or primary cardiomyopathy. Therefore, assessment of at least three ejection properties (EF, mean VCF and wall motion abnormalities) are considered to be essential for full understanding of derangement of LV function in heart disease. This is especially true of patients with coronary artery disease. LV behavior in relation to different pathological stresses or lesions, such as chronic pressure or volume load, myocardial disease and mitral stenosis, was also studied and possible cause of impaired LV myocardial function in mitral stenosis was discussed.

Adolescent↗
PubMed1987

Analysis of papillary muscle images on planar thallium-201 myocardial scintigrams in various heart diseases.

201Tl myocardial imaging can, noninvasively, visualize the various cardiac structures; such as the left ventricle, right ventricle and, occasionally, the atrium. We have noted that certain patients exhibit a prominent appearance of the papillary muscle on a scintigram. Thus, we analyzed 201Tl myocardial scintigrams for evidence of activity which corresponded to the anterolateral (A-PM) and posteromedial (P-PM) papillary muscles. Twenty normal subjects, 81 patients with ischemic heart disease (IHD), 11 with hypertrophic cardiomyopathy (HCM) and 13 with dilated cardiomyopathy (DCM) were examined. Patients with DCM had rest imaging only, while the remaining ones performed exercise studies. The prevalence of a positive A-PM image was not high (9%-23%) and there was no significant difference among groups. The P-PM was seen in only 15% of the normal group and in 18% of the HCM group, while the prevalence was high in the IHD (34.6%) and DCM (53.8%) groups. In the IHD, the positive images of the P-PM were largely from the sub-group with single vessel left anterior descending (LAD) coronary artery disease (78.9%). However, even in the presence of a defect in the left ventricular wall supplied by the LAD coronary artery, the patients with multi-vessel coronary artery disease did not tend to disclose the P-PM on the scintigram (30.8%). Thus, we conclude that positive P-PM imaging on a planar 201Tl myocardial scintigram is frequently observed under some cardiac states and seems to be related to reduced wall motion, sound blood supply to the P-PM and the existence of a defect in the anterior left ventricular wall overlapping the P-PM.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1979

Atrial acetylcholinesterase activity in various heart diseases of man.

Distribution and activity of the acetylcholinesterase enzyme in the human atrial myocardium was studied histochemically in a clinical series of patients subjected to cardiac surgery for (1) uncomplicated atrial septal defect (ASD), (2) ischaemic heart disease (IHD), (3) mitral and/or aortic valvular disease (VHD) necessitating replacement with a prosthetic valve, without major symptoms or signs of myocardial incompensation, or (4) clinically overt congestive heart failure (CHF) due to VHD prior to cardiac surgery. In all specimens, a rich distribution of acetylcholinesterase-positive single axons and small fascicles, constituting a three-dimensional nerve net, was observed within the myocardial tissue. This nerve net was obviously mainly parenchymatous, i.e. unrelated to the blood vessels. Small groups of acetylcholinesterase-positive small nerve cells were observed in some specimens, with loosely woven fascicles of axons emerging from one pole of the ganglia. No differences in the distribution of the acetylcholinesterase activity or in the pattern of the inbuilt intrinsic nervous apparatus were observed in the various groups of patients. All specimens were completely devoid of non-specific cholinesterase activity. It was concluded that (I) the human atrial myocardium is richly supplied with cholinergic intrinsic (post-ganglionic vagal) axons and (II) the acetylcholinesterase activity is not a major determinant of the parasympathetic abnormalities associated with cardiac diseases, especially with myocardial pump failure.

Acetylcholinesterase↗
PubMed1977

Studies of auricular catecholamines by fluorescence histochemistry in various heart diseases of man.

A comparative histochemical and clinical study concerning the state of the intrinsic adrenergic innervation of the human atrial myocardium was carried out, using the glyoxylic acid-induced fluorescence histochemical method. Specimens from the right auricular appendage were obtained during open-heart surgery from patients suffering from 1. ischaemic heart disease (IHD), 2. atrial septal defect of the secundum type (ASD), and 3. left-sided univalvular or multivalvular heart disease (VHD) with or without congestive heart failure (CHF) experienced prior to surgery. In the IHD group the densities of both the perivascular and the "free" myocardial adrenergic nerve net were greater than in the ASD group and especially in the VHD/CHF group. Secondly, the intensity of fluorescence of the adrenergic structures was generally higher in the IHD group than that in the VDH/CHF group. Further, the average size of the varicosities, the number of varicosities per given length of axon, and the proportional share of the large varicosities were greater in the IHD group than in the ASD and VHD/CHF groups. The difference between the IHD and ASD groups was not great but was obvious in any case. In some patients with VHD/CHF fluorescing axons were observed only occasionally, and the tiny varicosities exhibited a hardly discernible fluorescence. Thus the amount of noradrenaline (NA) in the adrenergic fibres in the IHD group seems to be higher than in the ASD and especially VHD/CHF groups. The level of NA in the IHD group is assumed to constitute a contributory factor in both intracellular metabolic changes and the systemic changes typical of myocardial ischaemia and infarction. In one patient with IHD and in six patients with VHD/CHF with significantly higher heart volume (mean+/-SD) compared with the rest of the patients (P less than 0.001), huge local axonal accumulations of NA in the form of "droplet fibres" were found. These enlarged, bulging adrenergic axons are assumed to be a consequence of mechanical trauma with stretching or disruption of the axons due to myodegenerative processes. It is further assumed that these "droplet fibres" are relatively common in those patients with diseased myocardium. They may constitute an extra contributory factor to the tendency to arrhythmiility of non-atuomatic tissue.

Adult↗
PubMed1996

Relationship between pulmonary capillary wedge V wave and transmitral and pulmonary venous flow velocity patterns in various heart diseases.

BACKGROUND: A large V wave in a pulmonary capillary wedge pressure (PCWP) tracing is characteristic of mitral regurgitation. However, the V wave is often increased in patients without or with no significant mitral regurgitation. METHODS AND RESULTS: The V wave was in the PCWP tracing investigated in 65 patients using transmitral flow (TMF) and pulmonary venous flow (PVF) velocity patterns obtained by transesophageal pulsed Doppler echocardiography. A large V wave was defined if the peak V wave minus the mean PCWP (V-mPCWP) was greater than 7 mmHg. Three study groups were formed: 15 patients with large V waves and significant mitral regurgitation, 15 patients with large V waves with no significant mitral regurgitation, and 35 patients with small V waves. The mPCWP and left ventricular end-diastolic pressure were greatest in the group with large V waves and no significant mitral regurgitation. Peak early diastolic TMF and PVF velocities were significantly greater in the two groups with large V waves. The peak second systolic PVF velocity was lowest in the group with large V waves and significant mitral regurgitation, followed by the group with large V waves and no significant mitral regurgitation. The V-mPCWP was positively correlated with the peak early diastolic TMF and PVF velocities and negatively correlated with the peak second systolic PVF velocities. Additionally, mitral regurgitation severity in patients with large V waves and significant mitral regurgitation was positively correlated with the peak early diastolic TMF and PVF velocities and negatively correlated with the peak second systolic PVF velocity. CONCLUSIONS: These results suggest that large V waves in PCWP tracings appear not only in severe mitral regurgitation, but also in any condition with markedly elevated left ventricular end-diastolic pressure. Combined analysis of the TMF and PVF velocity patterns is helpful in determining the etiology of these hemodynamic abnormalities.

Blood Flow Velocity↗
PubMed1986

Age-associated myocardial changes in various heart diseases. A clinicopathologic analysis in biopsied and autopsied myocardium.

Age-associated changes in histopathologic and ultrastructural aspects of cardiac myocytes were systematically compared with clinical problems. The study material consisted of 1,515 endomyocardial biopsies; 150 normal and 50 diseased cardiac myocytes from pediatric autopsy specimens; 34 intraoperative endomyocardial biopsy specimens from the left ventricle and 28 surgical biopsy specimens from the right or left atrium. The following results were obtained: The myocytes developed to adult size by the age of 15 years. Thereafter, the size did not change up to the age of 59. Short-term hemodynamic overloading to the ventricle caused reactive hyperfunction and hypertrophy of myocytes. Stable hypertrophy resulted in long-term overloading. In cardiomyopathy, compensated or stable hypertrophy occurred, but progression to decompensated or gradual exhaustion and progressive cardiosclerosis (Meerson) took place. Progress of endocardial thickening was often observed during the course of the disease. In the right and left atrial myocardium, extremely advanced pathology was observed and changes were related to the duration of the disease rather than to the severity of the hemodynamics.

Aging↗
PubMed1992

Prognosis of patients with congestive heart failure: its determinants in various heart diseases in Japan.

We investigated the prognosis of patients with congestive heart failure (CHF) and the factors which influence the prognosis of Japanese patients with this condition. From among the patients admitted to our hospital from January 1, 1978 to December 31, 1985, the 298 patients who were diagnosed having CHF were investigated. Patients with CHF had a rather poor prognosis, with the 1-year, 3-year, and 5-year cumulative survival rates being 76%, 60%, and 49%, respectively. The factors influencing the prognosis of patients with CHF were the type of underlying heart disease, the left ventricular ejection fraction, the left ventricular end-diastolic dimension, and the central venous pressure. Survival rates differed significantly depending on the type of underlying heart disease. The cumulative 5-year survival rate was 35% for coronary artery disease, 40% for dilated cardiomyopathy, 53% for rheumatic valvular heart disease, and 80% for hypertensive heart disease.

Adult↗