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At least 19 recordsLinked to original sources
PubMed1991

Assessment of ventricular function with an ambulatory left ventricular function monitor.

Changes in ventricular function caused by activities of daily living, including standing, walking, stair climbing, and mental stress, were evaluated using a radionuclide device that recorded left ventricular function on a beat-by-beat basis. The ambulatory monitor was positioned over the patient's left ventricle after a gated blood pool scan. Monitoring revealed a 10% increase of left ventricular ejection fraction from baseline to brisk walking, an 18% increase during stair climbing, and a 6% increase with mental stress. In some subjects, however, the increase in ejection fraction during mental stress exceeded that during exercise.

Activities of Daily Living↗
PubMed1992

[Late postoperative left ventricular function and ventricular hypertrophy after prosthetic valve replacement for aortic regurgitation].

Forty-two of 50 patients, who had undergone aortic valve replacement for acquired aortic regurgitation from Jan 1979 to Dec 1985, received late postoperative cardiac catheterization two years after operation. Their ages ranged between 10 and 69 years old (mean +/- S.D., 45.8 +/- 12.2 y.o.) and 37 men and 13 women were included. Postoperative left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV) and left ventricular mass (LVM) decreased significantly compared to preoperative levels, respectively (p less than 0.001). Both postoperative left ventricular end-systolic stress/end-systolic volume ratio (LVESS/ESVI) and tension volume ejection fraction (TVEF) increased significantly (p less than 0.01) compared to preoperative levels. Positive correlations were recognized between preoperative and postoperative values in LVESV, LVM, LVESS/ESVI, TVEF and LVEF. In the patients who had showed preoperative values of LVEDVI less than 180 ml/m2, LVESVI less than 90 ml/m2 and LVEF more than 0.52, their postoperative values were expected to be normal. There were also negative correlations between LVESVI and LVEF, and between LVM and contractile properties. Nineteen patients, who had recovered normal ventricular volumes at the time of postoperative cardiac catheterization, showed normal LV dimensions and % fractional shortening between five and ten years after operation. These results demonstrate the limitation of recovery in LVM and contractile properties in spite of normalization in ventricular volume and ejection performance.

Adolescent↗
PubMed1992

RETRACTED: Right ventricular function in patients with reduced left ventricular function undergoing myocardial revascularization.

Complex interrelationships exist between the right (RV) and the left ventricles (LV). Therefore, in 30 consecutive patients with reduced LV function (left ventricular ejection fraction [LVEF]) less than 40% undergoing myocardial revascularization, RV hemodynamics were studied from the beginning of anesthesia until the end of the operation. The data were compared with 30 consecutive patients with normal LVEF (greater than 70%). Ventricular function was assessed during left heart catheterization, which was carried out within 1 month of the operation. In addition to standard hemodynamic variables, RV ejection fraction (RVEF), RV end-diastolic volume (RVEDV), and RV end-systolic volume (RVESV) were monitored by the thermodilution technique. The two groups did not differ preoperatively with regard to RVEF, pressure (MAP, PAP, PCWP, RAP, RVPsyst, RVEDP), cardiac index (CI), and volume variables (RVESV, RVEDV). However, when the group with preoperatively reduced LVEF was subdivided into patients with severely reduced LVEF (less than 30%; n = 14; mean value 25.1%) and patients with moderately reduced LVEF (30%-40%; n = 16; mean value 37.3%), RVEF was significantly lower in the patients with a LVEF below 30% throughout the entire investigation period. RVEDV and RVESV were significantly higher in these patients. In conjunction with the lower RVEF and normal PAP, this suggests reduced RV function. It can be concluded that a severely reduced preoperative LVEF (less than 30%) may also be associated with impaired RV function.

Analysis of Variance↗
PubMed1979

Assessment of left-to-right shunt and left ventricular function in isolated ventricular septal defect. Echocardiographic study.

This echocardiographic study was designed to assess left ventricular function and pulmonary blood flow in ventricular septal defect. Fifty-one patients aged 2 weeks to 21 years were investigated (group 2). Five of 10 operated patients were studied one week after surgical closure of the defect (group 3) and seven 3 to 6 weeks postoperatively (group 4). The control group consisted of 45 normal subjects aged 2 weeks to 21 (group 1). Left atrium/aortic root dimension ratio (LA/Ao) was used to express the pulmonary systemic flow ratio. Left ventricular chamber size was assessed by measurement of left ventricular end-diastolic dimension and volume. The left ventricular mass and the ratio of end-diastolic volume to left ventricular mass were determined to relate the degree of left ventricular hypertrophy to volume overload. Myocardial function was evaluated using ejection phase indices. Ventricular septal thickness, posterior wall thickness, and echocardiographic patterns of septal motion were also studied. The left atrium/aortic root dimension, end-diastolic volume, and left ventricular mass were significantly greater in group 2 patients (P less than 0.05) than in the normal controls. There was a very good correlation between LA/Ao and pulmonary/systemic flow ratio (r = 0.83). Eleven of the group 2 patients showed asymmetric septal hypertrophy (unrelated to shunt size) but left ventricular function as assessed by ejection phase indices appeared unimpaired. Immediately after operation (group 3) there was a deterioration in left ventricular function in 5 patients as shown by reduced ejection fraction, mean velocity of circumferential shortening, and relative changes in minor axis with systole. Septal motion was impaired but returned to normal in 3 to 6 weeks in 7 patients (group 4). Left atrial/aortic root dimension, end-diastolic volume, and left ventricular mass decreased significantly immediately after operation (group 3) but were still raised at 3 to 6 weeks (group 4).

Adolescent↗
PubMed1991

Body weight is more important than family history of hypertension for left ventricular function.

Left ventricular function was studied in young men with a positive family history of hypertension for two generations (n = 15). The findings were compared with three control groups: one age-, sex-, and weight-matched group with a negative family history of hypertension (n = 14); one normotensive control group unselected as regards family history of hypertension (n = 27); and one group also unselected regarding family history of hypertension but selected with blood pressure criteria to have mild blood pressure elevation (n = 59). The group with a positive family history of hypertension, in comparison with the normotensive control group, was heavier, had higher blood pressure, increased left ventricular wall thickness, increased left ventricular mass, and signs of changes in diastolic and systolic left ventricular function. There were no differences in these variables between the group with a positive family history and the other two control groups. Data clearly indicated that subjects with a positive family history of hypertension, as well as subjects with mild blood pressure elevation, were heavier than the normotensive control group. It is not possible to judge, with available data, if the changes in left ventricular morphology and function in the two groups with a different family history of hypertension and in the group with mild blood pressure elevation occurred as a physiological response to the increase in afterload or if the neurohormonal and metabolic disturbances leading to the condition of slight overweight also affected left ventricular function.

Body Mass Index↗
PubMed1992

Importance of left ventricular function and systolic ventricular interaction to right ventricular performance during acute right heart ischemia.

To determine whether modulation of systolic ventricular interaction influences right ventricular performance during right heart ischemia, the effects of septal ischemia and inotropic stimulation were studied in 15 dogs in an open chest preparation. Right coronary branch occlusions led to right ventricular dilation and free wall dyskinesia, reversed septal curvature and reduced left ventricular diastolic volume. In systole, the septum thickened but bulged paradoxically into the right ventricle generating an active but depressed right ventricular systolic pressure (28.9 +/- 5.5 to 22.1 +/- 4.5 mm Hg), with associated decreases in right ventricular stroke work (5.66 +/- 0.94 to 1.92 +/- 0.53 g.m/m2) and left ventricular systolic pressure (123 +/- 11 to 80 +/- 10 mm Hg). Septal ischemia induced systolic septal thinning, left ventricular dilation and decreased left ventricular systolic pressure (80 +/- 10 to 55 +/- 10 mm Hg) and stroke work. Although the extent of paradoxic septal displacement increased, there were further decrements in right ventricular systolic pressure (22.1 +/- 4.5 to 18.7 +/- 4.3 mm Hg) and stroke work (1.92 +/- 0.53 to 0.7 +/- 0.2 g.m/m2). Dopamine infusion augmented left ventricular free wall contraction and increased left ventricular systolic pressure (55 +/- 10 to 172 +/- 17 mm Hg) and stroke work. Although systolic septal thinning persisted, the extent of paradoxic septal displacement increased strikingly and, despite continued right ventricular free wall dyskinesia, right ventricular systolic pressure increased (18.7 +/- 4.3 to 39.6 +/- 6.2 mm Hg) as did right ventricular stroke work (0.7 +/- 0.2 to 7 +/- 1.6 g.m/m2).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1992

[Ventricular function in hypertrophic cardiomyopathy. Systolic and diastolic ventricular function].

BASIC CONSIDERATION: Hypertrophic cardiomyopathy is defined as a primary myocardial disease associated with a hypertrophic non-dilated left ventricle with no other heart or systemic disease that might lead to hypertrophy of the left ventricle. The leading symptoms are effort-associated angina and dyspnea, rapid fatigue, dizziness and syncope. MAIN POINTS DISCUSSED: The hemodynamic situation is characterized by a hyperdynamic systole and impaired diastole and left-ventricular filling. In the obstructive form, hypertrophy of the basal septum and an anteriorly moving mitral valve during systole result in an end-systolic reduction in the cross-section of the outflow tract associated with considerable intraventricular pressure gradients. Disturbances in the myocardial calcium metabolism are presently suspected to be causally involved in the diastolic function impairment.

Cardiomyopathy, Hypertrophic↗
PubMed1992

The value of pixel per pixel multiharmonic Fourier analysis to assess left ventricular function.

Left ventricular systolic and diastolic function can be assessed by peak ejection and filling rates and their time of occurrence. These parameters can be calculated using two different methods: from the global left ventricular time-activity curve analysed with a four harmonic Fourier fit and from each pixel time-activity curve analysed with two and three harmonics (the values being averaged over the left ventricular region of interest). In both cases, values were normalized for heart rate and end diastolic counts. A study was conducted in a series of 11 patients (six without and five with a previous myocardial infarction but a normal left ventricular function) examined at baseline and during an i.v. dobutamine infusion, at a dose known to increase both peak ejection and filling rates. During dobutamine infusion, analysis of global left ventricular time-activity curve demonstrated a statistically significant increase in both peak ejection and filling rates, but the local analysis showed a more significant increase of these parameters. To assess ventricular function, a local harmonic analysis can be used and appears to be a more sensitive approach than analysis of the global left ventricular time-activity curve. The local analysis provides spatial mapping and a histogram of the parameters which can be used as parametric images to describe systolic and diastolic function.

Dobutamine↗
PubMed1977

Left ventricular endomyocardial biopsy. III: ultrastructural characteristics of cardiomyopathy and cardiac hypertrophy with good or poor ventricular function.

Left ventricular endomyocardial biopsies have been obtained from patients with cardiomyopathy and hypertrophy due to aortic valve disease. These biopsies have been examined by electron microscopy and the ultrastructural abnormalities compared. In congestive cardiomyopathy no specific abnormalities were found although myofibrillary degeneration and membrane-bound vacuoles were more commonly present. Crossing of whole groups of sarcomeres was found only in asymmetric septal hypertrophy, but was not present in all cases. Amyloid deposits were demonstrated easily by electron microscopy in patients with restrictive cardiomyopathy. In the patients with hypertrophy due to aortic valve disease, no specific features were found and ultrastructural abnormalities did not differentiate between normal and impaired left ventricular functions.

Aortic Stenosis, Subvalvular↗
PubMed1991

[Signal-averaged ECG and left-ventricular function in patients with severe ventricular arrhythmia in ischemic heart disease].

In 35 patients with ischemic heart disease we evaluated the incidence of ventricular late potentials and left ventricular function. The patients were divided into two groups: group A consisting of 15 patients (14 men, 1 woman) aged from 40 to 71 years (mean age 56) with previously documented ventricular tachycardia or fibrillation, and into group B comprising 20 subject (16 men, 4 women) aged from 35 to 62 years (mean age 50) with ischemic heart disease without the above-mentioned arrhythmias. Time from the development of ventricular tachycardia or fibrillation was 3 weeks to 4 years. The incidence of arterial hypertension and previous myocardial infarction was similar in both groups. Body surface late potentials were recorded by signal averaging technique according to Simson using Frank's orthogonal XYZ lead system. In addition, in all the patients 24-hour ECG monitoring was performed to reveal any ventricular rhythm disturbances and echocardiography was used to evaluate left ventricular function. The presence of the ventricular late potentials meeting at least two of the Simson's--Dene's criteria was found in 13 (87%) patients in group A and in 2 (10%) patients from group B. In the patients after ventricular tachycardia or fibrillation the mean values of th total QRS duration (QRS-D) and the low amplitude signal duration (LAS40) were higher whereas the root mean square voltage of the last 40 ms of th vector magnitude QRS (RMS) was lower (154 ms, 56 ms, 15 muV, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1992

Determinants of subsequent late postoperative left ventricular function and reversal of ventricular dilatation after mitral valve replacement for chronic mitral regurgitation.

We studied 16 patients with chronic mitral regurgitation by echocardiography before, and at 3 weeks, at 6-8 months and at 1-9 years after mitral valve replacement (MVR) to investigate serial changes in left ventricular (LV) function and reversal of ventricular dilatation. All patients at an average of 2.6 years after, and 8 patients before MVR were also studied by echocardiography and, except for 3 patients by measuring plasma catecholamines from the right atrium during bicycle exercise. Before operation, all patients were divided into group A (n = 12) with end-systolic dimension (ESD) < 4 cm and systolic blood pressure (SBP)/ESD > 3, and group B (n = 4) with ESD > 4 cm and SBP/ESD < 3. Maximum reduction in end-diastolic dimension (EDD) occurred at 3 weeks in all patients after MVR (from 60.5 +/- 3.7 to 49.0 +/- 4.5 mm, p < 0.05). ESD was reduced significantly (p < 0.5) only in group A. LV function was normal in group A, but it was depressed in group B at early and late periods after MVR. The slopes of the relationship between the mean velocity of circumferential fiber shortening (Vcf) and plasma norepinephrine (NE) during exercise in all patients in group B decreased along with the depression in LV function. After operation, all patients in group A reached New York Heart Association (NYHA) functional class I, while patients in group B were in NYHA class II. It is concluded that the surgical outcome after MVR for chronic MR will be better if preoperative ESD < 4 cm and SBP/ESD > 3. The relationship between mean Vcf and plasma NE during exercise seemed to be a useful index to evaluate the inotropic reserve of the LV.

Echocardiography↗
PubMed1979

Effect of ventricular function on left ventricular ejection time in aortic stenosis.

Since recognition of factors which modify the duration of ejection in aortic stenosis is of clinical importance, the relations among rate-corrected left ventricular ejection time, aortic valve area, and determinants of ventricular performance were studied in 54 catheterised patients. In patients with a normal cardiac index, increasing duration of ejection was linearly related to increasing obstruction. In patients with failing ventricles, on the other hand, the ejection time was less prolonged, and the duration of ejection was unrelated to valve area. At fixed valve area, relation with cardiac output, stroke volume, heart rate, mean aortic valve pressure gradient, mean aortic pressure, and left ventricular end-diastolic pressure could not adequately explain the observed scatter in ejection time. This suggests a multifactorial basis for the wide range of ejection times observed with severe aortic stenosis.

Aortic Valve Stenosis↗
PubMed1990

Right ventricular function and metabolism.

Right ventricular protection may be limited with current methods of cardioplegic delivery. Sensitive measurements of right and left ventricular function and metabolism were made in 30 patients undergoing elective coronary artery bypass surgery with cold cardioplegic arrest. Myocardial adenine nucleotide concentrations decreased with cardioplegia and reperfusion in both the right and left ventricles despite adequate levels of precursors, suggesting perioperative mitochondrial dysfunction. Postoperatively, right and left ventricular pressures were measured with micromanometer catheters and volumes were measured by nuclear ventriculography. Right and left ventricular systolic elastance was calculated by the isochronic method and by the end-systolic method. Both methods provided sensitive indexes of end-systolic elastance. This study demonstrated that right ventricular function and metabolism can be evaluated by methods analogous to methods used in the left ventricle. These results suggest that right ventricular functional and metabolic recovery are delayed despite apparently adequate myocardial protection. Sensitive measurements may permit improved assessment of alternative methods of right ventricular protection.

Adenine Nucleotides↗
PubMed1991

[Notes on the use of equilibrium radionuclide angiography in the study of diastolic ventricular function].

Diastolic ventricular heart failure, as an isolated pathologic process, recently assumed a great speculative interest and become a fashionable concept, although not so readily defined and understood. Gated blood pool radionuclide ventriculography allows the measure of parametric data which investigate the dynamics of ventricular filling volumetric changes. Radionuclide ventriculography presents peculiar characteristics of non geometric analysis with practically tridimensional approach to the study of ventricular imaging. The parametric data obtained are indicated to verify diastolic functional condition in many types of cardiovascular pathology, but present same practical limitations, due in part to the impossibility of a precise identification of the four fundamental components of diastole on time-activity curve. Keeping these limitations in mind, and also the incomplete definition of pathophysiological mechanism of diastolic derangement, nuclear cardiology still offers way of serially investigate diastolic function in many clinical settings. From a review of our preceding researches, the radio between maximal rates of diastolic and systolic ventricular volumetric changes (PFR/PER) is here considered. Purpose of this review is a deeper knowledge of radionuclide parameters which investigate the function and dynamics of ventricular filling.

Diastole↗
PubMed1991

Effects of nisoldipine on systolic and diastolic function in postinfarction patients with reduced left ventricular function: a randomized, double-blind, placebo controlled study.

The long-term effects of oral nisoldipine or placebo on clinical variables, exercise test results and echo Doppler-determined systolic and diastolic functions were studied in 30 consecutive patients with reduced left ventricular function (predischarge echocardiographic wall motion score greater than or equal to 8) following myocardial infarction. Groups were comparable in clinical variables, exercise results, echo Doppler measurements and coronary anatomy. During 6 months follow-up, death, reinfarction and bypass surgery or balloon angioplasty were equally distributed. A significant increase in exercise duration and time to onset of ST-depression was found in the nisoldipine treatment group, compared to the placebo group after 3 and 6 months. Time to onset of angina was not significantly different. Echocardiographic indices of left ventricular systolic function (ejection fraction and wall motion score) were unaltered; however, the time-velocity integral of the early diastolic filling phase and the early vs late diastolic flow velocity ratio were significantly increased while the atrial time-velocity integral vs total time-velocity integral was significantly decreased in the nisoldipine treatment group after 3 and 6 months of follow-up. In conclusion, nisoldipine reduced exercise-induced ischaemia, improved exercise capacity and diastolic left ventricular function in postinfarction patients with reduced left ventricular function.

Cardiac Catheterization↗
PubMed1992

Clinical evaluation of right ventricular function in patients with left ventricular assist device (LVAD).

Right ventricular function (RVF) during LVAD support can be a threat for patient survival. Despite extensive research, RVF and its interference with left heart function is unclear. This study examines RVF in a retrospective analysis of 14 patients. Hemodynamic data were collected, including heart rate (HR), central venous pressure (CVP), mean pulmonary artery pressure (mPAP), total cardiac output (CO), calculated stroke volume index (SVI) and right ventricular stroke work index (RVSWI). In all patients, CO increased gradually throughout the study period; CVP showed no significant decrease; mPAP and PCWP decreased significantly over the time period; SVI improved and RVSWI increased from the starting level prior to implantation of the LVAD. We conclude that the CO improved with a lowering of the right ventricular afterload combined with a decrease in total circulating volume. The improvement of RVF with LV assist makes this device an option as a bridge to transplant.

Blood Pressure↗
PubMed1991

Mild pressure loading alters right ventricular function in fetal sheep.

Right ventricular function before and during 10 days of mild pressure loading (10 mm Hg increase in mean pulmonary arterial pressure) was compared with right ventricular function in unloaded near-term fetal sheep. Pressure loading did not alter fetal arterial blood gases or vascular pressures. The right ventricular function curve (stroke volume versus mean right atrial pressure) was not significantly altered by loading. However, the relation between right ventricular stroke volume and increased arterial pressure was dramatically shifted upward, indicating improved ventricular function after the 10-day loading period. Normalized free wall of the loaded right ventricles became thicker (1.2 +/- 0.2 versus 0.9 +/- 0.2 mm/kg, p less than 0.01) and heavier (2.7 +/- 0.4 g/kg versus 2.2 +/- 0.4 g/kg, p less than 0.05) than control, and the ratio of the equatorial radius of curvature to wall thickness decreased (3.2 +/- 0.5 versus 4.5 +/- 0.9, p less than 0.005). Left ventricular free wall and septal weights and thicknesses were not significantly changed. The in vitro diastolic pressure-volume curves of both ventricular chambers of loaded hearts shifted to the left, indicating smaller ventricles than controls at physiological filling pressures. These data suggest the transduction of right ventricular loading effects to the left ventricle. Improved right ventricular function after loading is predicted by the law of Laplace based on the decreased radius of curvature-to-wall thickness ratio.

Animals↗