743 Left ventricular long-axis function during dobutamine infusion in patients with impaired systolic function of the left ventricle

2003 ◽  
Vol 2 (1) ◽  
pp. 158-159
Author(s):  
K BOUKI ◽  
T KAKAVAS ◽  
K KOSTOPOULOS ◽  
A KOTSAKIS ◽  
K POULOPOULOS ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Systolic Function ◽  
Left Ventricular ◽  
Dobutamine Infusion

scholarly journals Myocardial deformation in patients with a single left ventricle using 2D cardiovascular magnetic resonance feature tracking: a case–control study

2021 ◽  
Author(s):  
Fabian Strodka ◽  
Jana Logoteta ◽  
Roman Schuwerk ◽  
Mona Salehi Ravesh ◽  
Dominik Daniel Gabbert ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Feature Tracking ◽  
Systolic Function ◽  
Radial Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Significant Difference ◽  
Lv Volumes

AbstractVentricular dysfunction is a well-known complication in single ventricle patients in Fontan circulation. As studies exclusively examining patients with a single left ventricle (SLV) are sparse, we assessed left ventricular (LV) function in SLV patients by using 2D-cardiovascular magnetic resonance (CMR) feature tracking (2D-CMR-FT) and 2D-speckle tracking echocardiography (2D-STE). 54 SLV patients (11.4, 3.1–38.1 years) and 35 age-matched controls (12.3, 6.3–25.8 years) were included. LV global longitudinal, circumferential and radial strain (GLS, GCS, GRS) and strain rate (GLSR, GCSR, GRSR) were measured using 2D-CMR-FT. LV volumes, ejection fraction (LVEF) and mass were determined from short axis images. 2D-STE was applied in patients to measure peak systolic GLS and GLSR. In a subgroup analysis, we compared double inlet left ventricle (DILV) with tricuspid atresia (TA) patients. The population consisted of 19 DILV patients, 24 TA patients and 11 patients with diverse diagnoses. 52 patients were in NYHA class I and 2 patients were in class II. Most SLV patients had a normal systolic function but median LVEF in patients was lower compared to controls (55.6% vs. 61.2%, p = 0.0001). 2D-CMR-FT demonstrated reduced GLS, GCS and GCSR values in patients compared to controls. LVEF correlated with GS values in patients (p < 0.05). There was no significant difference between GLS values from 2D-CMR-FT and 2D-STE in the patient group. LVEF, LV volumes, GS and GSR (from 2D-CMR-FT) were not significantly different between DILV and TA patients. Although most SLV patients had a preserved EF derived by CMR, our results suggest that, LV deformation and function may behave differently in SLV patients compared to healthy subjects.

scholarly journals Mitral Valve Prolapse and out-of-hospital cardiac arrest: A case report and literature review.

2021 ◽  
Author(s):  
Antonis Ioannou ◽  
Marios Ioannides ◽  
Christos Eftychiou ◽  
Theodoros Christophides ◽  
Antonis Pitsis ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Systolic Function ◽  
Spontaneous Circulation ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Barlow’S Disease ◽  
Normal Left Ventricular ◽  
Artery Disease

We present the case of a 44-year-old woman who suffered an out of hospital cardiorespiratory arrest. After six direct current shocks and 10 minutes of cardiopulmonary resuscitation she had return of spontaneous circulation and regained consciousness. Transthoracic echocardiography showed normal left ventricular ejection fraction and a mildly dilated left atrium. The mitral valve was thickened with myxomatous degeneration (Barlow’s disease) and moderate regurgitation secondary to bi-leaflet prolapse. Cardiac catheterization showed no coronary artery disease while left ventriculography revealed a mildly dilated left ventricle with preserved systolic function and high-end diastolic pressures. Cardiac MRI revealed an enlarged left ventricle with mitral valve (MV) prolapse and moderate to severe mitral regurgitation (MR). There were no features suggestive of a specific cardiomyopathy other than her valvular heart disease. The patient had an uneventful hospitalization, received an implantable cardioverter defibrillator (ICD), and eventually had MV repair surgery. A genetic investigation revealed two DNA variants, one each in the MYPN and TMPO gene, substitutions of highly conserved aminoacid residues. Family segregation could not establish unequivocally their pathogenicity although the MYPN variant represents the same residue that was shown previously to be substituted by another aminoacid. In this article we also review the literature regarding similar cases and record important data for the epidemiology of the disease and the important research that has been carried out in the identification of prognostic imaging factors and the genetic background of these patients.

scholarly journals 89 Simultaneous ocurrence of hammock mitral valve and no-compaction cardiomyopathy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
D Rodrigo ◽  
U Estandia ◽  
P Perez ◽  
C Perez ◽  
A Cortes ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Cardiac Catheterization ◽  
Mitral Valve Disease ◽  
Systolic Function ◽  
Paranoid Schizophrenia ◽  
Left Ventricular ◽  
Valve Disease

Abstract We report a 62-year-old man with a past medical history of dyslipidemia, paranoid schizophrenia and permanent atrial fibrillation. A ATTE performed at his district hospital revealed rheumatic mitral valve disease with double lesion: severe regurgitation and mild stenosis, plus moderate tricuspid regurgitation and a mean PAP of 32mm Hg. Cardiac catheterization showed no abnormalities of the coronary arteries. He was transferred to our hospital and scheduled for mitral valve replacement and tricuspid ring valvuloplasty. Preoperative transesophageal echocardiography showed an abnormal subvalvular mitral apparatus, with false tendons and multiple papillary muscles, resembling a hammock mitral valve. Most cordae tendinae arose from a single dominant papillary muscle at a posterior medial region, which provoke severe mitral regurgitation due to coaptation defect and mild subvalvular mitral stenosis. It could also be appreciated hypertrabeculation in the lateral medial, basal and apical segments. This suggested no-compaction cardiomyopathy associated with hammock mitral valve. Left ventricular systolic function was preserved. No evidence of rheumatic mitral valve disease was found in transesophageal echocardiographic study performed at our hospital. On the 30th April 2019 he underwent mechanic mitral valve replacement (Bicarbon 29mm) and tricuspid ring valvuloplasty (Edwards Physio 32mm) surgery. Once the patient was weaned from cardiopulmonary bypass, severe left ventricle systolic dysfunction ensued, predominantly localized in the anterior, inferior septal, inferior lateral basal and medial segments. Apical segments had preserved mobility An adrenalin infusion prior weaning from CBP was initiated. Preserved mobility of the mitral prosthesis discs was observed. The patient developed cardiogenic shock in spite of high doses of dobutamin and adrenaline infused. IACB was implanted with 1:1 assistance. The patient was transfered to the hemodynamic room in order to rule out coronary complications. Cardiac catheterization showed no significant angiographic lesions. During the first postoperative hours, the patient was stabilized allowing progressive lowering of the drugs (adrenaline, dobutamine). TTE showed normally functioning prosthetic mitral valve and preserved left ventricle systolic function. An MRI was performed demostrating no-compaction cardiomyopathy Conclusion This case report describes a rare presentation of simultaneous ocurrence of hammock mitral valve and no-compaction cardiomyopathy. Perioperative left ventricle dysfunction in no-compaction cardiomyopathy is related to subendocardial ischemia caused during extracorporeal circulation in the multiple prominent ventricular trabeculations with deep intertrabecular recesses corresponding to non-compacted myocardium .This must be taken account in those patients with no-compaction cardiomyopathy scheduled for cardiac surgery in order to take preventive measures. Abstract 89 Figure. non - compacted myocardium

Trabecular cutting: a novel surgical therapy to increase diastolic compliance

2019 ◽  
Vol 127 (2) ◽  
pp. 457-463
Author(s):  
Meagan Oglesby ◽  
Danny Escobedo ◽  
Gladys Patricia Escobar ◽  
Fatemeh Fatemifar ◽  
Edward Y. Sako ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Diastolic Pressure ◽  
Ex Vivo ◽  
Systolic Function ◽  
Wall Stress ◽  
Rabbit Heart ◽  
Left Ventricular ◽  
Before And After ◽  
Diastolic Compliance

Heart failure with preserved ejection fraction (HFpEF) is a common cause of hospital admission in patients over 65 yr old and has high mortality. HFpEF is characterized by left ventricular (LV) hypertrophy that reduces compliance. Current HFpEF therapies control symptoms, but no existing medications or therapies can sustainably increase LV compliance. LV trabeculae develop hypertrophy and fibrosis that contribute to reduced LV compliance. This study expands our previous results in ex vivo human hearts to show that severing LV trabeculae increases diastolic compliance in an ex vivo working rabbit heart model. Trabecular cutting was performed in ex vivo rabbit hearts set up in a working heart perfusion system perfused with oxygenated Krebs-Henseleit buffer. A hook was inserted in the LV to cut trabeculae. End-systolic and end-diastolic pressure-volume relationships during transient preload reduction were recorded using an admittance catheter in the following three groups: control (no cutting; n = 9), mild cutting (15 cuts; n = 5), and aggressive cutting (30 cuts; n = 5). In a second experiment, each heart served as its own control. Hemodynamic data were recorded before and after trabecular cutting ( n = 10) or sham cutting ( n = 5) within the same heart. In the first experiments, trabecular cutting did not affect systolic function ( P > 0.05) but significantly increased overall diastolic compliance ( P = 0.009). Greater compliance was seen as trabecular cutting increased ( P = 0.002, r2 = 0.435). In the second experiment, significant increases in systolic function ( P = 0.048) and diastolic compliance ( P = 0.002) were seen after trabecular cutting compared with baseline. In conclusion, trabecular cutting significantly increases diastolic compliance without reducing systolic function. NEW & NOTEWORTHY We postulate that, in mammalian hearts, free-running trabeculae carneae exist to provide tensile support to the left ventricle and minimize diastolic wall stress. Because of hypertrophy and fibrosis of trabeculae in patients with left ventricular hypertrophy, this supportive role can become pathologic, worsening diastolic compliance. We demonstrate a novel operation involving cutting trabeculae as a method to acutely increase diastolic compliance in patients presenting with heart failure and diastolic dysfunction to improve their left ventricle compliance.

scholarly journals Surgical Cryoablation of Drug Resistant Ventricular Tachycardia and Aneurysmectomy of Postinfarction Left Ventricular Aneurysm

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Marek Pojar ◽  
Jan Harrer ◽  
Nedal Omran ◽  
Martin Vobornik
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Tachycardia ◽  
Left Ventricle ◽  
Systolic Function ◽  
Thrombus Formation ◽  
Transitional Zone ◽  
Left Ventricular ◽  
Left Ventricular Aneurysm ◽  
Wall Thickening ◽  
Left Ventricle Remodelling

Heart failure is usually associated with left ventricle remodelling, wall thickening, and worsening of the systolic function. Ventricular tachycardia is a common and a negative prognostic factor in patients with endocardial scarring following myocardial infarction and aneurysm formation. The authors present a case of a 51-year-old man with ischemic heart disease, who suffered myocardial infarction four years ago. The patient was admitted to the hospital with sustained ventricular tachycardia despite maximal pharmacotherapy and also underwent unsuccessful percutaneous radiofrequency ablation in the right ventricle. Transthoracic echocardiography revealed left ventricle dysfunction with ejection fraction of 25%, aneurysm of the apex of the left ventricle with thrombus formation inside the aneurysm. Surgical therapy consisted of the cryoablation applied at the transitional zone of the scar and viable tissue and the resection of the aneurysm. The patient remained free of any ventricular tachycardia four months later.

scholarly journals Relationship between mean platelet volume and left ventricular systolic function in patients with metabolic syndrome and ST-elevation myocardial infarction

2011 ◽  
Vol 34 (6) ◽  
pp. 330 ◽  
Author(s):  
Huseyin U Yazici ◽  
Fatih Poyraz ◽  
Nihat Sen ◽  
Yusuf Tavil ◽  
Murat Turfan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Metabolic Syndrome ◽  
Left Ventricle ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
St Elevation Myocardial Infarction ◽  
Ventricular Systolic Function ◽  
St Elevation ◽  
Left Ventricle Systolic Function

Purpose: Mean platelet volume (MPV) is an indicator of platelet activation, which is a central process in the pathophysiology of coronary heart disease. Metabolic syndrome (MS) may lead to worsened left ventricular systolic function by causing recurrent thrombotic events and by aggravating systemic inflammation in the course of acute myocardial infarction. The present study was designed to investigate the relationship between MPV and left ventricular systolic function in patients with metabolic syndrome who had first ST-elevation myocardial infarction. Methods: MPV was measured on admission in 33 patients who had preserved left ventricle systolic function (mean age, 56.9±10.2 years) and in 48 patients who had depressed left ventricle systolic function (mean age, 57.9±10.5 years) with metabolic syndrome and first ST elevation myocardial infarction. Depressed left ventricle systolic function was defined as ≤50% ejection fraction value. MPV levels were compared in the two groups. Results: MPV was significantly higher in patients with depressed left ventricle systolic function in comparison with patients showing preserved left ventricle systolic function (p=0.02). Logistic regression analysis showed an independent relationship between MPV and deteriorated left ventricular systolic function, even after adjustment for potential confounders (1.08 (1.04-1.20), CI: 95%, p=0.02). Conclusions: Increased MPV on admission can be associated with degree of left ventricle systolic depression in patients with metabolic syndrome with first ST-elevation myocardial infarction. MPV may prove to be useful as a prognostic marker in patients with metabolic syndrome and ST elevation MI.

scholarly journals An Assessment of Left Ventricular Systolic Function with the Use of a Continuous Doppler Imaging in Dogs with Spontaneous Mitral Regurgitation. A Preliminary Study

2012 ◽  
Vol 56 (3) ◽  
pp. 399-402 ◽  
Author(s):  
Urszula Pasławska ◽  
Agnieszka Noszczyk-Nowak ◽  
Józef Nicpoń
Keyword(s):  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Systolic Function ◽  
Pressure Rise ◽  
Left Ventricular ◽  
Valvular Disease ◽  
Cardiac Insufficiency ◽  
Doppler Imaging ◽  
Mitral Insufficiency ◽  
Continuous Doppler

Abstract The aim of this study was to evaluate systolic function of left ventricle in dogs with spontaneous mitral regurgitation by estimating the rate of pressure rise in the left ventricle (dP/dt). Ninety-three dogs of different breed and sex, with chronic degenerative valvular disease were examined. All dogs had echocardiography examination with dP/dt estimation assessed from mitral regurgitant jet using continuous Doppler-echocardiography. The dogs were divided into four classes of heart failure according to NYHA class. Results: dogs in NYHA I dP/dt = 2,142 ±1,309, SF=33.6±10.5, EF=66.58± 14; NYHA II dP/dt = 3,062 ±1,798, SF=42 ±10, EF=76.5 ±11.5; NYHA III dP/dt = 3,483 ±2,136, SF=44.2 ±21, EF=75.7 ±13; NYHA IV dP/dt = 4,496 ±1,797, SF=40.6 ±6, EF=70.4 ±16. Dogs with chronic cardiac insufficiency and mitral insufficiency due to chronic degenerative valvular disease had no echocardiograhic evidence of left ventricular systolic dysfunction assessed from mitral regurgitant jet dP/dt.

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