The pressure gradient technique was used to evaluate effects of respiration on left ventricular stroke volume in 22 patients: 11 normal patients; eight patients with airway obstruction; and three patients with pericardial tamponade. In normals, stroke volume, systolic pressure, and pulse pressure fell an average of 7, 3 and 11% (P , 0.01), respectively, during inspiration. In patients with airway obstruction, these parameters decreased by 25, 12 and 23% (P , 0.001), respectively. After breath-holding, stroke volume also fell immediately with the onset of inspiration in both groups. These results are consistent with a reduction in left ventricular filling during inspiration as the factor primarily responsible for the fall in stroke volume. In patients with pericardial tamponade, variations in left ventricular stroke volume, systolic pressure and pulse pressure were related to: (1) an immediate fall in stroke volume with the onset of inspiration; and (2) a subsequent increase in stroke volume ...
We determined whether chronic treatment with nipradilol, a β-blocker with vasodilating action, reduces left ventricular cavity dilation (LV remodeling) following myocardial infarction and improves cardiac performance. Myocardial infarction was produced by coronary artery ligation in 16-week-old female rats and then the rats were treated for 3-4 months with nipradilol (10 mg/kg/day) or vehicle (0.5% carboxymethylcellulose). The effect of nipradilol on LV remodeling was evaluated by assessing the left ventricular end-diastolic volume index (LVEDVI)and passive pressure-volume relation curve. Since LVEDVI depends on the infarct size, LVEDVI was compared between the vehicle and nipradilol-treated rats with similar infarct size (10-40%). At 3-4 months after myocardial infarct production, the left ventricular end-diastolic volume index in the vehicle-treated rats with myocardial infarction was significantly increased, compared with that in the sham-operated rats without infarction. The ...
Our data indicate that the benefit of CABG among patients with 3-vessel CAD varies directly with the direction and magnitude of ΔLVEF measured before operation. Thus, these data can facilitate management decisions. Although no previous investigators have undertaken this analysis, our data are consistent with and extend those of 2 previous reports in which preoperative LVEF with exercise was used to identify patients likely to benefit from CABG. Jones and coworkers12 found that the concomitant presence of 3-vessel or left main disease and a positive exercise radionuclide angiogram (either ΔLVEF ≤0% or exercise-induced worsening in wall motion or increase in end-systolic volume ,20 mL with exercise) predicted CABG-associated benefit at 3 years among patients with mildly to markedly subnormal LVEF at rest. The prognostic value of the LVEF exercise response was not evaluated among those with 3-vessel disease alone, and the influence of ischemia severity on prognosis was not examined. In a later ...
OBJECTIVE--To determine whether echocardiography and radionuclide angiography give comparable results when the left ventricular ejection fraction is measured early after myocardial infarction and thus whether, irrespective of the method used, a single value for the ejection fraction could be used as a guide for starting treatment with an angiotensin converting enzyme inhibitor. DESIGN--Prospective comparison of measurement of left ventricular ejection fraction by echocardiography and radionuclide angiography. SETTING--Coronary care units of two university teaching hospitals in Glasgow. PATIENTS--99 patients studied within 36 hours of acute myocardial infarction. OUTCOME MEASURES--Left ventricular ejection fraction assessed by echocardiography and radionuclide angiography. RESULTS--70 (77%) of the 99 patients had ejection fraction measured by both echocardiographic and radionuclide techniques, 30 in centre 1 and 40 in centre 2. In centre 1 the mean difference (SD) in ejection fraction ...
TY - JOUR. T1 - Optimal stroke volume in left-ventricular ejection. AU - Hämäläinen, Jari. PY - 1989. Y1 - 1989. N2 - Optimal value of stroke volume ejected against a given arterial load is studied, i.e. left-ventricular function is described by an optimization model. In the model, end-diastolic volume (V/sub ed/), the linear end-systolic pressure-volume relation, heart rate, and ejection time are given, and arterial load is described by the three-element windkessel model. The cost function of the model takes into account two optimality criteria for ventricular function: energy economy and efficient response to an increase in V/sub ed/. The observed stroke volumes of isolated canine hearts could be predicted quite accurately by the model. It is concluded that the left-ventricular response to a change in arterial load and V/sub ed/ can be explained by an optimization model when contractility and heart rate are kept constant. The results also strongly suggest that energy economy and efficiency ...
Results A total of 63 patients (49 females) aged from 10 to 60 years were recruited into this study. There was no significant differences in the age (P , 0.05) and the size of PDA (P , 0.05) between groups. The left atrium diameter indexes (35.96 ± 6.60 vs 31.17 ± 6.85 vs 22.24 ± 3.47 mm/m²; P , 0.05) and the left ventricular end diastolic volume indexes (279.45 ± 89.42 vs 162.88 ± 54.13 vs 60.94 ± 9.87 ml/m²; P , 0.05) decreased significantly from group A to group C. The left ventricular diameter/right ventricular diameter ratio in group C (1.86 ± 0.38) was less than that in group A (4.29 ± 1.85; P , 0.05) and group B (3.18 ± 1.21; P , 0.05) but had no significant difference between group A and group B. Linear regression analysis showed a significant correlation between the decrease in pulmonary artery mean pressure and the baseline of left ventricular end diastolic volume index (P , 0.05).. ...
TY - JOUR. T1 - Impact of Lifelong Exercise Training Dose on Ventricular-Arterial Coupling. AU - Hieda, Michinari. AU - Howden, Erin. AU - Shibata, Shigeki. AU - Fujimoto, Naoki. AU - Bhella, Paul S.. AU - Hastings, Jeffrey L. AU - Tarumi Ph.D., Takashi. AU - Sarma, Satyam. AU - Fu, Qi. AU - Zhang, Rong. AU - Levine, Benjamin D. PY - 2018/12/4. Y1 - 2018/12/4. N2 - BACKGROUND: The dynamic Starling mechanism, as assessed by beat-by-beat changes in stroke volume and left ventricular end-diastolic pressure, reflects ventricular-arterial coupling. It deteriorates with age, and is preserved in highly trained masters athletes. Currently, it remains unclear how much exercise over a lifetime is necessary to preserve efficient ventricular-arterial coupling. The purpose of this study was to assess the dose-dependent relationship between lifelong exercise training and the dynamic Starling mechanism in healthy seniors. METHODS: One hundred two seniors were recruited and stratified into 4 groups based on 25 ...
Conventional right ventricular apical pacing may result in asynchronous ventricular contraction with delayed left ventricular activation, interventricular motion abnormalities, and worsening of left ventricular ejection fraction. His pacing is preserving a synchronous contraction and may prevent a decrease in left ventricular ejection fraction.. The aims of our crossover, double-blinded, randomized study is to evaluate the feasibility and long-term safety of permanent His pacing and to compare the effects on left ventricular ejection fraction of permanent His pacing with those of conventional right septal stimulation after 12 months treatment in patients with 2nd or 3rd degree AV-block. ...
TY - JOUR. T1 - Decreased left ventricular ejection fraction in transgenic mice expressing mutant cardiac troponin T-Q92, responsible for hypertrophic cardiomyopathy. AU - Lim, Do Sun. AU - Oberst, Leslie. AU - McCluggage, Meghan. AU - Youker, Keith. AU - Lacy, Jeffrey. AU - DeMayo, Francesco. AU - Entman, Mark L.. AU - Roberts, Robert. AU - Michael, Lloyd H.. AU - Marian, Ali J.. PY - 2000. Y1 - 2000. N2 - The causality of mutant sarcomeric proteins in hypertrophic cardiomyopathy (HCM) is well established. The current emphasis is to elucidate the pathogenesis of HCM in transgenic animal models. We determined the left ventricular ejection fraction (LVEF) in transgenic mice expressing mutant cardiac troponin T (cTnT)-Q92, known to cause HCM in humans. Transgenes were constructed by placing wild-type (R92) or mutant (Q92) full-length human cTnT cDNAs 3 into a 5.5-kb murine [α-myosin heavy chain (MyHC)] promoter injected into fertilized zygotes. Three wild-type and six mutant lines were produced. ...
Background: We sought to evaluate the additional value of a multiparametric cardiac magnetic resonance (CMR) score in comparison with traditional TIMI (Thromolysis in Myocardial Infarction) score and transthoracic echocardiography (TTE) score in prognostic stratification of STEMI patients.. Methods: 209 STEMI patients reperfused by primary PCI underwent TTE and CMR 3 days after the index event. We measured: TIMI score, left ventricle ejection fraction (EFTTE), left ventricle end systolic volume (LVESVTTE) and number of myocardial segment with wall motion abnormalities (WMITTE) measured by TTE, left ventricle ejection fraction (EFCMR), left ventricle end systolic volume (LVESVCMR) and number of myocardial segment with wall motion abnormalities (WMICMR) measured by CMR, myocardial salvage index (MSI) and presence of microvascular obstruction (MVO). The primary clinical endpoint of study was the occurrence of major adverse cardiac events(MACE) defined as combined endpoint of hospitalization, acute ...
The NYHA Functional Classification classifies patients' heart failure according to the severity of their symptoms. The classification is as follows: Class I: no limitation of physical activity, ordinary physical activity does not cause undue fatigue, palpitation, or dyspnea (shortness of breath); Class II: slight limitation to physical activity, comfortable at rest, ordinary physical activity results in fatigue, palpitation or dyspnea; Class III: marked limitation of physical activity, comfortable at rest, less than ordinary activity causes fatigue, palpitation or dyspnea; Class IV: unable to carry on any physical activity without discomfort, symptoms of heart failure at rest, if any physical activity is undertaken, discomfort increases ...
If our observation of incomplete relaxation is of clinical relevance, it would be manifest as a tachycardia-induced reduction in LV end-diastolic volumes. This was indeed observed by Westermann et al. (17), who measured pressure-volume loops in 70 patients after hospital admission for heart failure with a normal ejection fraction. Compared with 20 control subjects, these patients had an increased LV wall thickness, and when paced at 120 beats/min, the LV end-diastolic volume decreased by 28%. In contrast, in control subjects, they found an incremental increase in LV end-diastolic volume. Although the authors could not explain this finding, they argued that this observation may play a substantial role in the development of symptoms in these patients.. The mechanisms underlying diastolic dysfunction in patients with LV hypertrophy are unclear. There are several possible explanations, including an increased mass-to-volume ratio, increased passive stiffness due to changes in collagen and titin, ...
Medicine Journal in MJB authors are : Ali Jasim Mhaimeed Al-Sultani,Ali Jaber Al-Mamoori,Basim Mohammed Madloom Study of Minor Echocardiographic Indices of Cardiac Systolic Function in Subjects with Normal Ejection Fraction and Correlation with Age university of babylon journals in the repository for farther content please log to http://repository.uobabylon.edu.iq
R.I. Jones, A. Lahiri, P. M. M. Cashman, C. Dore, J. C. W. Crawley, E. B. Raftery; Continuous Measurement of Left Ventricular Ejection Fraction during Isometric Handgrip (Ihg) and Cold Stress (Cs) in Normal Subjects. An Assessment of the Response and Reproducibility. Clin Sci (Lond) 1 February 1984; 66 (2): 27P. doi: https://doi.org/10.1042/cs066027Pa_pt2. Download citation file:. ...
Left ventricular volumes Several studies compared 2D echocardiography and CMR for assessment of left ventricular volumes and LVEF.[5, 11-14] These studies differ in number of included patients, aetiology of heart disease and left ventricular function and volume, but all consistently show underestimation of EDV and ESV by 2D echocardiography compared with CMR. Reported mean differences vary considerably between studies and range from 10 to 94 ml for ESV and from 11 to 131 for EDV.[5, 19] We found the discrepancy between the two imaging modalities to be strongly related to left ventricular volume, with increasing differences in larger hearts. This finding is supported by a smaller study by Gruszczynska et al. in ischaemic heart failure patients.[13] It is further corroborated by the observation that studies in hearts with predominantly (near) normal volumes report lower differences, whereas studies including dilated hearts are at the higher end of the spectrum.[5, 11, 14, 20]. The underestimation ...
f(1)= 20, f(3)=13, f(5)=15, f(7)=16, f(9)=11, on [0,6] a, used midpint rule with n=5 to estimate intergral form 0 to 10 f(x)dx b, use trapezoidal rule with n=4 to estimate intergral from 1 to 9 f(x)dx c, used simpsons rule with n=4 to estimate intergal from 1 to 9 (x)dx ...
Emmett, L., Ng, A., Ha, L., Russo, R., Mansberg, R., Zhao, W., Chow, V., Kritharides, L. (2012). Comparative assessment of rest and post-stress left ventricular volumes and left ventricular ejection fraction on gated myocardial perfusion imaging (MPI) and echocardiography in patients with transient ischaemic dilation on adenosine MPI: Myocardial stunning or subendocardial hypoperfusion? Journal of Nuclear Cardiology, 19(4), 735-742. [More Information] ...
The application of a positive end-expiratory pressure (PEEP), the cornerstone of noninvasive ventilation (NIV), causes hemodynamic changes in the cardiovascular system. To understand the benefits of NIV it is necessary to resume concepts of cardiovascular physiology and pathophysiology about cardiac function determinants, venous return, ventricular interdependence and heart-lung interaction, and to understand how PEEP interacts with them. The hemodynamic effects of PEEP are mediated by the increase in transpulmonary pressure, which results in increased pulmonary vascular resistance and in an attending small reduction of venous return in conditions of euvolemia, in a substantial reduction of left ventricular afterload and a potential positive effect on left ventricular stroke volume ...
OBJECTIVES:This study sought to evaluate the hypothesis that global longitudinal strain (GLS) guidance of cardioprotective therapy would improve cardiac function of at-risk patients undergoing potentially cardiotoxic chemotherapy, compared with usual care. BACKGROUND:The conventional criteria for diagnosis of chemotherapy-related cardiac dysfunction (CTRCD) are dependent on the recognition of heart failure symptoms and/or changes in left ventricular ejection fraction. However, the measurement variability of left ventricular ejection fraction necessitates broad diagnostic ranges, with the consequence of low sensitivity for CTRCD. Observational data have shown GLS to be a robust and sensitive marker to predict CTRCD and thereby guide the initiation of cardioprotective therapy, but these data are insufficient to justify changing the diagnostic criteria for CTRCD. METHODS:The SUCCOUR (Strain sUrveillance of Chemotherapy for improving Cardiovascular Outcomes) trial is an international multicenter ...
The value of the end systolic volume depends on the arterial blood pressure as well as on the force of ventricular contraction. The arterial blood pressure - especially in the large arteries leaving the heart - is not only pressure outwards against the arterial walls but also back pressure against the aortic valve and the pulmonary valve exerted by the arterial blood. An increased arterial blood pressure results in higher end systolic volume because of more afterload (more resistance to the outflow of blood from the ventricles). Contractility of the ventricular muscle can increase (e.g. from increased stimulation of the heart by the sympathetic nervous system), thereby causing more complete ejection of blood from the ventricle and a resultant lower end systolic volume. ...
Robert S. McKelvie, MD, PhD, FRCPC, Professor of Medicine, Department of Medicine, McMaster University Hamilton, ON.. Heart failure (HF) is usually associated with reduced left ventricular ejection fraction, but approximately 50% of all patients with HF have a preserved ejection fraction. The mortality and morbidity associated with this condition, which may be the most common form of HF in older persons, is substantial and is on the rise. Currently, there are few evidence-based therapies demonstrated to be beneficial for this condition. The usual therapeutic recommendations consist of the aggressive management of the comorbidities and fluid balance associated with this form of HF. Disease management programs may improve outcomes among older persons with HF and preserved ejection fraction ...
The ejection fraction is a measurement of the hearts efficiency and can be used to estimate the function of the left ventricle, which pumps blood to the rest of the body.. The left ventricle pumps only a fraction of the blood it contains. The ejection fraction is the amount of blood pumped divided by the amount of blood the ventricle contains. A normal ejection fraction is more than 55% of the blood volume. If the heart becomes enlarged, even if the amount of blood being pumped by the left ventricle remains the same, the relative fraction of blood being ejected decreases. For example:. ...
While many cardiac patients focus on their cholesterol level as a measuring stick of their cardiovascular health, they may be overlooking an even more important factor influencing long term survival-their ejection fraction. The ejection fraction (EF) is the percentage of volume of blood that is ejected each cardiac cycle. It is easily measured using simple cardiac tests such as an echocardiogram or MUGA scan. A normal EF should be greater than 50%. Patients who have been diagnosed with congestive heart failure, an enlarged heart or suffered a heart attack may have a significantly lower EF. The ejection fraction is directly proportional to survival; patients with a lower EF have a poorer prognosis. One of the main reasons for reduced survival is that patients with a low EF (, 35%) are at high risk of dying suddenly from rapid unstable cardiac arrhythmias called ventricular tachycardia and ventricular fibrillation. These arrhythmias are unpredictable and often result in sudden death. Sudden death ...
Women with advanced heart failure have better prognosis than men (men versus women HR 2.5, 95% CI 1.1-5.5, p=0.03). Although interaction ischemic heart disease-gender was not significant, HR was 1.6 (95% CI 0.5-5.6, p=0.43) for patients with coronary artery disease and 3.4 (95% CI 1.1-10.5, p=0.03) for patients without.
Stroke volume is a description of the amount of blood the heart pumps. Specifically, it describes the blood volume that a single ventricle discharges with each heartbeat. Stroke volume is often used in the medical field to determine how well a patients heart is functioning. The information required
Patients and methods: Prospective study of 57 pts treated at the Institut Curie between 02/2004 and 01/2007 by concurrent T-RT for non-metastatic BC. The perfusion of trastuzumab started either with or after chemotherapy (CT). RT, started at least 4 weeks after the completion of anthracycline-based chemotherapy, consisted of either whole breast (+/- boost) or chest wall normo-fractionated irradiation. When indicated the internal mammary chain (IMC) and supra/infra-clavicular lymph nodes were also irradiated. Left ventricular ejection fractions (LEVF), assessed at baseline, before start of RT (pre-RT), after completion of RT and then every 4-6 months with either echocardiography or multiple gated acquisition scanning, were considered normal if ≥50% or stated so by the cardiologist. A normal LVEF at baseline was one of the inclusion criteria. Skin toxicity was evaluated using CTCAEV3 ...
TY - JOUR. T1 - α2cDel322-325 and β1Arg389 Adrenergic Polymorphisms Are Not Associated With Reduced Left Ventricular Ejection Fraction or Increased Left Ventricular Volume. AU - Canham, Russell M.. AU - Das, Sandeep R.. AU - Leonard, David. AU - Abdullah, Shuaib M.. AU - Mehta, Sameer K.. AU - Chung, Anne K.. AU - Li, Jia Ling. AU - Victor, Ronald G.. AU - Auchus, Richard J.. AU - Drazner, Mark H.. PY - 2007/1/16. Y1 - 2007/1/16. UR - http://www.scopus.com/inward/record.url?scp=33846029483&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=33846029483&partnerID=8YFLogxK. U2 - 10.1016/j.jacc.2006.10.016. DO - 10.1016/j.jacc.2006.10.016. M3 - Article. C2 - 17222742. AN - SCOPUS:33846029483. VL - 49. SP - 274. EP - 276. JO - Journal of the American College of Cardiology. JF - Journal of the American College of Cardiology. SN - 0735-1097. IS - 2. ER - ...
This is as much a statement (and hopefully a reassurance for others in similar situations) as a query. Ive been having moderate PVCs and PACs (mostly isolated, but with occasional couplets and bigemin...
TY - JOUR. T1 - Meta-analysis of Risk of Ventricular Arrhythmias After Improvement in Left Ventricular Ejection Fraction During Follow-Up in Patients With Primary Prevention Implantable Cardioverter Defibrillators. AU - Smer, Aiman. AU - Saurav, Alok. AU - Azzouz, Muhammad Soubhi. AU - Salih, Mohsin. AU - Ayan, Mohamed. AU - Abuzaid, Ahmed. AU - Akinapelli, Abhilash. AU - Kanmanthareddy, Arun. AU - Rosenfeld, Lynda E.. AU - Merchant, Faisal M.. AU - Abuissa, Hussam. PY - 2017/7/15. Y1 - 2017/7/15. N2 - Implantable cardioverter defibrillators (ICDs) reduce the risk of sudden cardiac death in patients with impaired left ventricular ejection fraction (LVEF). However, there are limited data on the long-term benefit of ICD therapy in patients whose LVEF subsequently improves. We conducted a meta-analysis to evaluate the effect of LVEF improvement on ICD therapy during follow-up. Incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated using random-effects modeling. Sixteen ...
1. Santos AB, Kraigher-Krainer E, Bello N. et al. Left ventricular dyssynchrony in patients with heart failure and preserved ejection fraction. European Heart Journal. 2014;35:42-7 2. Yu CM, Zhang Q, Yip GW. et al. Diastolic and systolic asynchrony in patients with diastolic heart failure: a common but ignored condition. J Am Coll Cardiol. 2007;49:97-105 3. Yusuf S, Pfeffer MA, Swedberg K. et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial. Lancet. 2003;362:777-81 4. Cleland JG, Tendera M, Adamus J. et al. The perindopril in elderly people with chronic heart failure (PEP-CHF) study. European Heart Journal. 2006;27:2338-45 5. Massie BM, Carson PE, McMurray JJ. et al. Irbesartan in patients with heart failure and preserved ejection fraction. N Engl J Med. 2008;359:2456-67 6. Morris DA, Vaz Perez A, Blaschke F. et al. Myocardial systolic and diastolic consequences of left ventricular mechanical ...
International Scholarly Research Notices is a peer-reviewed, Open Access journal covering a wide range of subjects in science, technology, and medicine. The journals Editorial Board as well as its Table of Contents are divided into 108 subject areas that are covered within the journals scope.
Robert M. Hansen, Christian E. Viquerat, Michael A. Matthay, Jeanine P. Wiener-Kronish, Teresa DeMarco, Satinder Bahtia, James D. Marks, Elias H. Botvinick, Kanu Chatterjee; Poor Correlation Between Pulmonary Arterial Wedge Pressure and Left Ventricular End-diastolic Volume after Coronary Artery Bypass Graft Surgery. Anesthesiology 1986;64(6):764-770. Download citation file:. ...
Introduction Left ventricular systolic dysfunction and elevated serum interleukins (ILs) are common in septic patients. However, whether left ventricular diastolic dysfunction is related to mortality in septic patients is a matter of debate. Aim The aim of the study was to assess the effect of myocardial systolic and diastolic functions on mortality in cases of sepsis and to predict an inflammatory marker that could be clearly linked to mortality in sepsis. Patients and methods Twenty patients were prospectively studied, with measurement of the following on admission and on day 7: left ventricular end-diastolic volume, left ventricular end-systolic volume, left ventricular ejection fraction% (echocardiography), mitral annulus S-velocity, Ed/t, and serum levels of ILs (IL-1α, IL-1β, IL-6, and IL-10). Mortality on day 28 was the study endpoint. Results Twenty patients with sepsis and septic shock were studied (45% were male and 55% were female; mean age 52±17 years). The patients were divided ...
Introduction Left ventricular systolic dysfunction and elevated serum interleukins (ILs) are common in septic patients. However, whether left ventricular diastolic dysfunction is related to mortality in septic patients is a matter of debate. Aim The aim of the study was to assess the effect of myocardial systolic and diastolic functions on mortality in cases of sepsis and to predict an inflammatory marker that could be clearly linked to mortality in sepsis. Patients and methods Twenty patients were prospectively studied, with measurement of the following on admission and on day 7: left ventricular end-diastolic volume, left ventricular end-systolic volume, left ventricular ejection fraction% (echocardiography), mitral annulus S-velocity, Ed/t, and serum levels of ILs (IL-1α, IL-1β, IL-6, and IL-10). Mortality on day 28 was the study endpoint. Results Twenty patients with sepsis and septic shock were studied (45% were male and 55% were female; mean age 52±17 years). The patients were divided ...
Objectives:To evaluate the utility of the right ventricular end-diastolic volume index (RVEDVI) as a method of preload assessment in trauma patients during larg
To determine the accuracy of visual analysis of left ventricular (LV) function in comparison with the accepted quantitative gold standard method, cardiac magnetic resonance (CMR). Cine CMR imaging was performed at 1.5 T on 44 patients with a range of ejection fractions (EF, 5-80%). Clinicians (n = 18) were asked to visually assess EF after sequentially being shown cine images of a four chamber (horizontal long axis; HLA), two chamber (vertical long axis; VLA) and a short axis stack (SAS) and results were compared to a commercially available analysis package. There were strong correlations between visual and quantitative assessment. However, the EF was underestimated in all categories (by 8.4% for HLA, 8.4% for HLA + VLA and 7.9% for HLA + VLA + SAS, P all | 0.01) and particularly underestimated in mild LV impairment (17.4%, P | 0.01), less so for moderate (4.9%) and not for severe impairment (1%). Assessing more than one view of the heart improved visual assessment of LV, EF, however, clinicians
Perioperative goal-directed fluid therapy (GDFT) may improve outcome after high-risk surgery. Minimal invasive measurement of stroke volume variation (SVV) has been recommended to guide fluid therapy. We intended to study how perioperative GDFT with arterial-based continuous SVV monitoring influences postoperative complications in a high-risk surgical population. From February 1st 2012, all ASA 3 and 4 patients undergoing abdominal surgery in two university hospitals were assessed for randomization into a control group or GDFT group. An arterial-line cardiac output monitor was used to measure SVV, and fluid was given after an algorithm in the intervention group. Restrictions of the method excluded patients undergoing laparoscopic surgery, patients with atrial fibrillation and patients with severe mitral/aortal stenosis. To detect a decrease in number of complication from 40 % in the control group to 20 % in the GDFT group, n = 164 patients were needed (power 80 %, alpha 0.05, two-sided test). To include
Rest images were obtained after intravenous administration of 8 mCi of 99mTc. 25 mCi of 99mTc was injected hours later and after 0.5 mg of sublingual nitroglycerine and rest gated images obtained. Exercise was deferred in view of clinical background of triple vessel disease and severe left ventricular dysfunction. Rest images showed a moderately dilated left ventricle and no pulmonary uptake of tracer. Perfusion abnormality was noted in the inferior wall and inferolateral segments. There was some improvement of perfusion with nitroglycerine. Gated SPECT analysis showed global hyokinesia with a global ejection fraction of about 23%.. ...
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In contrast to the well-described anatomic and echocardiography abnormalities in patients with GSD II, there is surprisingly little information on LV contractile function in GSD II. De Dominicis et al. (10) reported normal ejection fractions (70% and 68%) measured with echocardiography in two 6-mo-old patients. Bulkley and Hutchins (7) also reported a normal ejection fraction (,70%), measured with LV angiography, in a 5-mo-old girl. In two other case reports (children up to 9 mo of age), invasive assessment of LV function using cardiac catheterization demonstrated normal LV filling pressures (2-3 mmHg), in the presence of severe cardiomegaly (12, 15). In another case report (4 mo of age) normal LV hemodynamics and cardiac index were observed, although early diastolic pressure was elevated with a restrictive LV filling pattern (5). In contrast, markedly elevated LV filling pressures (up to 20 mmHg) and a depressed cardiac index (2.44 l· min−1·m−2) were found in a 4-mo-old child (26). In all ...
The origin of the term ejection fraction is somewhat obscure.[23] After William Harveys description of the basic mechanism of the circulation in 1628, it was initially assumed that the heart emptied completely during systole.[24] However, in 1856 Chauveau and Faivre[25] observed that some fluid remained in the heart after contraction. This was confirmed by Roy and Adami in 1888.[26] In 1906, Henderson[27] estimated the ratio of the volume discharged in systole to the total volume of the left ventricle to be approximately 2/3. In 1933, Gustav Nylin proposed that the ratio of the heart volume/stroke volume (the inverse of ejection fraction) could be used as a measure of cardiac function.[28] in 1952 Bing and colleagues used a minor modification of Nylins suggestion (EDV/SV) to assess right ventricular function using a dye dilution technique.[29] Exactly when the relationship between end diastolic volume and stroke volume was inverted into its current form is unclear. Holt calculated the ratio ...
424 Mobilization of CXCR4+/CD34+ stem cells early in acute myocardial infarction is correlated with left ventricular ejection fraction and NT-proBNP levels after 1 year of follow-up (MRI study). Wojakowski, W.; Wyderka, R.; Maslankiewicz, K.; Ciosek, J.; Ochala, A.; Zebzda, A.; Buszman, P.; Ratajczak, M.Z.; Tendera, M. // European Journal of Heart Failure. Supplements;Jun2006, Vol. 5 Issue 1, p99 An abstract of the study "Mobilization of CXCR4+/CD34+ stem cells early in acute myocardial infarction is correlated with left ventricular ejection fraction and NT-proBNP levels after 1 year of follow-up (MRI study)," by W. Wojakowski and colleague is presented. ...
TY - JOUR. T1 - Right-Sided Cardiac Dysfunction in Heart Failure With Preserved Ejection Fraction and Worsening Renal Function. AU - Mukherjee, Monica. AU - Sharma, Kavita. AU - Madrazo, Jose. AU - Tedford, Ryan J.. AU - Russell, Stuart D.. AU - Hays, Allison. PY - 2017/1/28. Y1 - 2017/1/28. N2 - In urban populations, worsening renal function (WRF) is well established in patients hospitalized with acute decompensated heart failure with preserved ejection fraction (HFpEF). However, the mechanisms for development of WRF in the setting of acute HF in HFpEF are unclear. In the present study, we sought to characterize conventional echocardiographic measures of right ventricular (RV) chamber size and function to determine whether RV dysfunction and/or adverse RV remodeling is related to WRF in patients with HFpEF. Our study included 104 adult patients with HFpEF (EF ≥ 55%) with technically adequate 2-dimensional echocardiograms performed during their hospitalization for acute decompensated HF to ...
Survival from hospital at: 30 days post discharge and 180 days post discharge - Composite endpoint of improved left ventricular regional and global function (both regional wall motion analysis and left ventricular ejection fraction) as measured by echocardiography prior to hospital discharge, survival to discharge and favourable. Left ventricular regional function and left ventricular ejection fraction as measured by echocardiography will be measured prior to discharge or up to 180 days post hospital discharge. ...
Impaired myocardial systolic contraction and diastolic relaxation have been suggested as possible mechanisms contributing to the decreased stroke volume (SV) observed at high altitude (HA). To determine whether intrinsic myocardial performance is a limiting factor in the generation of SV at HA, we assessed left ventricular (LV) systolic and diastolic mechanics and volumes in 10 healthy participants (aged 32 ± 7; mean ± SD) at rest and during exercise at sea level (SL; 344 m) and after 10 days at 5,050 m. In contrast to SL, LV end-diastolic volume was ∼19% lower at rest (P = 0.004) and did not increase during exercise despite a greater untwisting velocity. Furthermore, resting SV was lower at HA (∼17%; 60 ± 10 vs. 70 ± 8 ml) despite higher LV twist (43%), apical rotation (115%), and circumferential strain (17%). With exercise at HA, the increase in SV was limited (12 vs. 22 ml at SL), and LV apical rotation failed to augment. For the first time, we have demonstrated that EDV does not ...
This is a research study to investigate the effectiveness and safety of a device for patients with heart failure with preserved ejection fraction (HFpEF). Patients with a left ventricular ejection fraction greater than or equal to 40%, symptoms of heart failure and elevated filling pressures on a test called a right heart catheterization may be eligible to enroll. Participation in this multicenter study involves being randomly assigned either to implantation of an Inter Atrial Shunt Device (IASD) System II, or a sham procedure. Participants will be followed by the Tufts Heart Failure Research Team at regular intervals, for a total of 5 years; however they will remain under the care of their usual Cardiologist. The IASD System II consists of a self-expanding metal structure that is placed into the wall between the upper chambers of the heart (right and left atria) to enable blood to move between these chambers. For HFpEF patients with high pressures in the left atrium, it is thought that enabling ...
TY - JOUR. T1 - Time-dependent regional myocardial strains in patients with heart failure with a preserved ejection fraction. AU - Smith, Shane P.. AU - Secomb, Timothy W.. AU - Hong, Brian D.. AU - Moulton, Michael J. PY - 2016. Y1 - 2016. N2 - Objectives. To better understand the etiology of HFpEF in a controlled human population, regional time-varying strains were computed using echocardiography speckle tracking in patients with heart failure with a preserved ejection fraction and normal subjects. Methods. Eleven normal volunteers and ten patients with echo-graded diastolic dysfunction and symptoms of heart failure were imaged with echocardiography and longitudinal, circumferential, and rotational strains were determined using speckle-tracking. Diastolic strain rate was also determined. Patient demographics and echo-derived flows, volumes, and pressures were recorded. Results. Peak longitudinal and circumferential strain was globally reduced in patients (p ,0.001), when compared to controls. ...
Measurements and main results: Demographic, status discharge, EF, morbidity and use of resources were evaluated. Statistical analysis was performed with ANOVA of two ways and χ2. An excellent correlation between EF and mortality, reoperations, acute renal failure, multiorganic dysfunction, cardiorrespiratory arrest, and the use of Swanz-Ganz catheter, intra-aortic ballon counterpulsation, mechanical ventilation, dialysis and blood products was observed ...
Evaluation of the degree of myocardial injury as a result of myocardial necrosis in the acute phase of ST-segment elevation myocardial infarction (STEMI) may be of clinical importance to guide further revascularisation and add important diagnostic and prognostic information in these patients. Left ventricular ejection fraction (LVEF) measured by echocardiography during initial hospitalisation is a well-established marker of LV global function and predicts short- and long-term morbidity and mortality in patients with acute myocardial infarction. However, the measurement of LVEF presents a number of challenges related to image quality, assumptions of LV geometry and high observer variability. Measurement of myocardial deformation by strain has emerged as a promising tool to evaluate regional and global function. The aim of this thesis in clinical cardiology was to investigate the ability of strain to predict myocardial necrosis, LV function and clinical cardiac outcome in patients with acute ...
By combining conventional methods for recording pressures from the left ventricle and pleural cavity with a new procedure for estimating end-diastolic volume (EDV) and end-systolic volume (ESV) of the left ventricle it was found in the closed-chest dog that plethora increased EDV, ESV and stroke volume while hemorrhage had the opposite effect. There were linear relationships between EDV and ESV, and between EDV and stroke volume. There was little change in left ventricular "effective" end-diastolic pressure when the EDV changed over a wide range, beginning with the smallest EDV consistent with life; but after a certain large EDV had been reached, large increases in effective end-diastolic pressure were associated with little or no further increase in EDV.. ...