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At least 19 recordsLinked to original sources
PubMed2002

Candesartan cilexetil improves left ventricular function, left ventricular hypertrophy, and endothelial function in patients with hypertensive heart disease.

Patients with hypertension often develop left ventricular (LV) hypertrophy and deterioration of the cardiac and endothelial functions. Recent clinical trials have shown the added benefits of angiotensin II receptor blockers in hypertensive patients. Twenty-nine patients with hypertensive heart disease (HHD) underwent echocardiography, radionuclide ventriculography and the measurement of endothelial function before and after administration of candesartan (8 mg/day). The subjects were divided into poorly controlled blood pressure (BP) (group P, n=6) and well controlled BP (group C, n=23). Endothelial function was evaluated from flow-dependent dilation, which was calculated as the percent change of the radial artery diameter during reactive hyperemia after upper arm occlusion, measured with a high-resolution ultrasound system. In group C, LV diastolic function and endothelial function were significantly (p<0.05) improved at 3 months after administration, LV systolic function and hypertrophy were significantly (p<0.05) improved after 6 months and these effects were maintained at 12 months. Even in group P, LV function, LV hypertrophy, endothelial function and brain natriuretic peptide were significantly (p<0.05) improved at 6 months after administration. In patients with HHD, candesartan improves LV systolic and diastolic function, LV hypertrophy and endothelial function within 6 months of administration, regardless of the control of BP.

Adult↗
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↗
PubMed1995

Effects of nicorandil on regional perfusion and left ventricular function.

Left ventricular function and regional perfusion were evaluated by two study designs in patient groups with stable ischemic coronary artery disease (CAD): (1) using conventional left ventricular angiographies and (2) applying myocardial contrast echocardiography. The aim of the studies was to establish the effects of sublingually or orally applied nicorandil (N) on pacing-induced myocardial ischemia (MIS). In the first angiographic study, in nine patients with ischemic CAD and with pacing-inducible MIS, the effect of N, 20 mg sublingually, on hemodynamics and regional wall motion (RWM) were studied. There were no parameter changes without MIS being induced when comparing measurements at the 7th and 14th minute after N application to control values (p > 0.05). In the 15th and 16th minutes after N, pacing-induced MIS could no longer be elicited but left ventricular pump function improved; comparing MIS with N versus MIS without N: ejection fraction improved by 21%, cardiac index by 37%, and RWM by 21%, while filling pressure fell by 41% and systemic vascular resistance fell by 29%. Thus, N-mediated "protection from ischemia" with rather improved hemodynamics and RWM corresponds with alterations that theoretically could have been expected after nitroglycerin given under the above conditions. In the second echocardiographic study, regional perfusion was assessed in 10 patients by intracoronary injection of a newly developed echo contrast medium (ECM) and measurement of ECM washout halftime (t1/2) over opacified myocardial regions of interest, which displayed wall motion abnormalities already at rest.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

[Surgical results in mitral insufficiency: prognostic value of the indices of left ventricular function].

Left ventricular function is a major prognostic factor in patients with mitral regurgitation, but the ability of echocardiographic and hemodynamic parameters to predict the surgical result is controversial. We investigated the prognostic role of various pre-operative indices of left ventricular function in 23 consecutive patients who underwent successful surgical correction of chronic mitral regurgitation. At a mean follow-up of 20 +/- 16 months, patients underwent echocardiography and radio-nuclide angiography and were grouped according to the post-operative left ventricular ejection fraction. Group A was made up of 16 patients with a left ventricular ejection fraction greater than or equal to .45: they showed post-operative reduction of the left ventricular end-diastolic diameter (from 36.3 +/- 3.2 to 30.5 +/- 4.5 mm/m2; p less than .001) and of the radius/thickness ratio (from 3.5 +/- 0.6 to 2.9 +/- 0.6; p less than .01). In 7 patients (group B), post-operative left ventricular ejection fraction was less than .45 and no significant changes in the left ventricular end-diastolic diameter (from 41.5 +/- 2.7 to 36.9 +/- 6.1 mm/m2; NS) or the radius/thickness ratio (from 3.9 +/- 0.9 to 3.4 +/- 1.0; NS) were observed. During the follow-up all group A patients remained asymptomatic or minimally symptomatic, whereas 2 group B patients died of refractory left ventricular failure. Pre-operative left ventricular volumes and diameters, both at end-diastole and end-systole, were significantly greater in group B patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

Midwall shortening after coarctation repair: the effect of through-plane motion on single-plane indices of left ventricular function.

Left ventricular midwall function is increased after repair of coarctation of the aorta (CoA). The cause is unclear. This study aimed to examine the variance between fiber shortening derived from 3-dimensional models of myocardial deformation, and 1- and 2-dimensional indices of left ventricular systolic function. In all, 15 young adults after CoA and 15 matched control subjects were recruited. Endocardial and midwall fractional shortening were calculated using M-mode echocardiography. Ejection fraction, midwall fractional shortening, and myocardial deformation were calculated or measured from magnetic resonance (MR) imaging. Echocardiographic and cine-MR imaging midwall fractional shortening were increased after CoA (P = .02 and < .001). In contrast, 3-dimensional MR tagging demonstrated normal midwall circumferential shortening and decreased longitudinal shortening in the CoA group (P < .01). Cine MR midwall shortening, recalculated to allow for through-plane motion, was similar to tagged midwall shortening, with no difference between the CoA and control groups. After CoA, measures of left ventricular function systematically overestimate midwall fiber shortening unless the methodology accounts for through-plane motion.

Adult↗
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↗
PubMed1996

Analysis of effect of two concurrent ischaemic zones on left ventricular function.

Left ventricular (LV) function due to two concurrent ischaemic zones (IZs) is investigated using a cardiovascular system model. The model comprises a three-compartment LV, the venous return and the arterial system. Haemodynamic responses of the LV to changes in the IZ size and myocardial contraction timings are explored. Results show that the greater the degree of asynschonisation is between the normal zone and the IZ, and the larger the ischaemic size, the more severe the LV dysfunction. Pre-load augmentation improves LV function. Model-predicted features are consistent with reported observations associated with myocardial ischaemia. The extent of the usefulness and limitations of this model is also discussed.

Computer Simulation↗
PubMed1998

[Effect of aqueous extract of Lepidium apetalum on dog's left ventricular function].

Left ventricular myocardial contractility, function of pump-blood and coronary flow in dog were increased by i.v. aqueous extract of Lepidium apetalum (AELA) 0.2 ml/kg (containing crude medicinal herb 2 g/ml). The effects were similar to i.v. isoperaline 10 micrograms/kg, but AELA did not obviously change heart rate, arterioveno-oxygen partial pressure difference and arteriovenooxygen solubility. The results indicated the AELA had advantages of cordial effect and increasing coronary flow instead of enhancing oxygen consumption of cardiac muscle.

Animals↗
PubMed1994

[Evaluation of echocardiography for determining left ventricular function].

Left ventricular ejection fraction (LVEF) was calculated by echocardiography and gate blood pool (GBP) in 33 patients including those with coronary heart disease, acute and old myocardiac infarction, cardiomyopathy or mitral prolapse. Fourteen of the 33 had segmental wall motion abnormalities and 19 had non-segmental wall motion abnormalities. The results of comparing echocardiography and GBP showed that the former could substitute for other invasive and expensive examinations to determine LVEF (r = 0.804-0.964 in the 5 echocardiography methods used). Mod-Simpsons method of cross-sectioned echocardiography was the most accurate echocardiographic method (r = 0.964, sensitivity 90.9%) in all patients. The Teich method of M-mode echocardiography was useful in patients who had non-segmental wall motion abnormalities only (r = 0.957, sensitivity 94.7%) but not in patients who had segmental wall motion abnormalities (r = 0.703, sensitivity 42.9%).

Adult↗
PubMed1993

[Intraoperative assessment of left ventricular function with left ventricular pressure-volume relationships in patients with open heart surgery].

There are few reports on the assessment of the left ventricular function from left pressure-volume relationships intraoperatively in open heart surgery. LV Emax, Ea/Ees and EW/PVA efficiency were assessed intraoperatively by using a left ventricular conductance catheter in patients with aortocoronary bypass. After dobutamine administration (DOB, 10 micrograms/kg/min), LV Emax was increased by 33 +/- 23% during cardiopulmonary bypass (CPB) and 60 +/- 38% after weaning from CPB. Ea/Ees changed from 2.14 +/- 1.36 to 1.08 +/- 0.47 after weaning from CPB with dobutamine administration. EW/PVA efficiency changed from 52 +/- 12% to 66 +/- 10%. The change of LV Emax after dobutamine administration was correlated with the change of LV Emax after weaning from CPB and was correlated with Ea/Ees and EW/PVA efficiency after weaning from CPB. We concluded that measuring LV Emax before and after dobutamine administration during CPB is useful to assess left ventricular contraction clinically.

Aged↗
PubMed1988

Effects of different antihypertensive drugs on left ventricular function.

Left ventricular hypertrophy (LVH) is a response by the heart to haemodynamic overload. It is frequently observed in hypertension as a consequence of work overload secondary to an increased systemic resistance. This increase is not the only cause of LVH; there are other factors which can have a significant effect on its incidence. LVH in arterial hypertension acts initially as a useful compensatory mechanism against increased peripheral resistance. However after a certain amount of time it produces changes of variable intensity which have important consequences for the heart and some of them impair cardiac performance: 1. It affects both systolic and diastolic ventricular function; 2. It reduces coronary reserve; 3. It increases the incidence of angina and heart failure; 4. It increases the incidence of ventricular arrhythmias and sudden death. It therefore seems reasonable to include the reduction of LVH among the basic aims of antihypertensive treatment. Antisympathetic drugs (methyldopa, prazosin, urapidil), adrenergic beta-blockers, calcium antagonists and the converting enzyme inhibitors have proven to have a variable degree of efficacy in effecting a regression of LVH.

Antihypertensive Agents↗
PubMed1981

Effects of intrapleural pressure changes on canine left ventricular function.

Left ventricular diameter, pressure, and dP/dt, as well as aortic and intrapleural pressures, were recorded simultaneously from 10 acute anethetized mongrel dogs. Normal inspiration produced a significant decrease in end-diastolic diameter (46.9 +/- 1.2 to 43.1 +/- 1.0 mm) and end-systolic diameter (35.5 +/- 1.4 to 34.2 +/- 1.7 mm), reducing stroke diameter 2.5 mm. Airway occlusion (greater than or equal to 60%) produced a reduction in the decrease of end-diastolic diameter seen with normal inspiration and, to a lesser degree, in end-systolic diameter. Because only acute airway occlusion greater than or equal to 80% produced a significant increase in left ventricular afterload, the authors conclude that normal spontaneous inspiration results in a decrease in left ventricular preload due to pooling of blood in the pulmonary vasculature. The data suggest that this decrease in left ventricular preload is the predominant mechanism responsible for the inspiratory decrease in left ventricular stroke volume.

Airway Obstruction↗
PubMed1977

Effect of sodium bicarbonate on canine left ventricular function.

Left ventricular performance was evaluated in seven canine right heart bypass preparations during and after the intraauricular administration of sodium bicarbonate (100 ml, 1100 Osm, 60 mEq). Under conditions of constant cardiac input and left ventricular volume, sodium bicarbonate produced mild and brief left ventricular depression, as manifested by a decline of left ventricular dp/dt with simultaneous rise of left ventricular end-diastrolic and left atrial pressures. These findings occurred as aortic impedance fell. Identical results accrued in paced and unpaced preparations. The data lends credence to the proposition that a sudden rise in blood pCO2 produces increased transport of CO2 across the cardiac membranes with intracellular acidosis. However, the data is also compatible with hyperosmolality induced contractile depression. Possible clinical implications are discussed.

Animals↗
PubMed2006

Prognostic value of stress myocardial perfusion imaging in patients with mildly impaired systolic left ventricular function or left ventricular asynergy without chest pain but with suspected coronary artery disease.

BACKGROUND: The prognostic value of myocardial perfusion imaging (MPI) was investigated in patients with mildly impaired left ventricular (LV) function who had no chest pain but were suspected to have coronary artery disease (CAD). METHODS AND RESULTS: Consecutive patients (n=72, mean age =67) who had no chest pain but with mildly impaired systolic LV function (mean LV ejection fraction =52%) or LV asynergy and suspected to have CAD were followed up for 4.9 years after stress MPI. The follow-up time was censored at the occurrence of cardiac death, hospitalization for congestive heart failure (CHF), acute coronary syndromes (ACS), or revascularization. Images were scored using a 20-segment model and a 0-4 scale, and then the summed stress, rest, and difference scores (SDS) were calculated. During follow-up, there were 2 cases of cardiac death, 8 of hospitalization for CHF, 4 of ACS and 2 of revascularization. Cox regression demonstrated that SDS >or=4 was an excellent predictor of cardiac events in all patients (hazard ratio =4.2, p=0.01), and especially in diabetic patients (hazard ratio =28.4, p=0.01). CONCLUSION: Stress MPI is useful for predicting cardiac events and may be performed in patients without chest pain if they have mildly impaired systolic LV function or LV asynergy.

Acute Disease↗
PubMed1986

Echocardiographic assessment of left ventricular function in left ventricular volume load and the immediate changes after operation.

Cardiac function and changes following surgery was studied with computerized M-mode echocardiography in 12 patients with volume load of the left ventricle. Half of them had congenital lesions, the other half aortic regurgitation. Left ventricular (LV) shortening fraction and LV ejection time were significantly reduced postoperatively and came close to normal mean values. Also cardiac output and LV diameters normalized or at least started its normalization. The computerized values for rates of decrease and increase of left ventricular diameter were reduced postoperatively (p less than 0.01 and p less than 0.05 respectively) compared to elevated preoperative values. The study shows that relief of volume load on the left ventricle immediately leads to normalization of left ventricular function, especially if the myocardium was intact preoperatively.

Adolescent↗
PubMed2004

Relation of serum levels of mast cell tryptase of left ventricular systolic function, left ventricular volume or congestive heart failure.

BACKGROUND: Activated mast cells (MC) present in the myocardium of patients with cardiomyopathy may contribute to left ventricular dilatation and systolic dysfunction. We sought to determine whether peripheral levels of tryptase, an MC-specific protease, are related to indices of left ventricular size and function, as well as congestive heart failure (CHF) or coronary artery disease (CAD). METHODS AND RESULTS: Serum tryptase was measured in 85 patients undergoing cardiac catheterization with left ventriculography and coronary angiography and examined in relation to left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), congestive heart failure (CHF), and angiographically evident CAD. Systemic tryptase levels were lower in patients with increased (>90 mL) LVEDV (6.2 [5.3-8.0] mcg/L versus 8.3 [6.6-10.3] mcg/L, P=.01) and in patients with CHF (6.2 [3.6-7.3] mcg/L versus 8 [6.2-10] mcg/L, P=.02) and tended to be lower in patients with depressed (<55%) LVEF (6.8 [5.2-9] mcg/L versus 8 [6.3-9.9] mcg/L, P=NS). Linear regression did not show a significant relationship between tryptase levels with either LVEF or LVEDV. Finally, tryptase levels were consistently elevated in relation to the presence of CAD. CONCLUSION: Despite increased numbers of MC in the myocardium of patients with cardiomyopathy, systemic levels of MC tryptase appear to be lower in relation to LV systolic dysfunction, LV dilatation, or clinical CHF. In contrast, the presence of angiographically significant CAD is associated with elevated systemic tryptase levels.

Cardiac Catheterization↗
PubMed1992

Effect of left atrial plication for the giant left atrium on left ventricular function.

Left atrial plication (LAP) following Kawazoe's method was performed on eight patients with mitral valve stenosis associated with a giant left atrium. To investigate the effect of LAP particularly on left ventricular function, the preoperative and postoperative left ventricular function in these patients were compared. The data were also compared to that of the non-left atrial plication (non-LAP) group with left atrial dimension of 60 mm or over. In the LAP group, there were significant differences between preoperative and postoperative data in the following parameters; New York Heart Association (NYHA) class, cardiothoracic ratio, mean pulmonary arterial pressure (PAP), left ventricular end-diastolic pressure (LVEDP), left atrial dimension, stroke volume index, ejection fraction and cardiac index. On the contrary, in the non-LAP group, there were significant differences between preoperative and post-operative data in the following two factors; NYHA class and PAP. The size of the left atrium in the non-LAP group remained unchanged over the course of long-term follow-up. Despite severe clinical symptoms and severely reduced cardiac function of the patients in the LAP group, cardiac function in all patients improved satisfactorily. This suggests that left atrial plication has a considerably beneficial effect on left ventricular function, and therefore, may be recommended for patients with a giant left atrium.

Adult↗