scholarly journals Left ventricular longitudinal shortening: relation to stroke volume and ejection fraction in ageing, blood pressure, body size and gender in the HUNT3 study

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001243
Author(s):  
Asbjørn Støylen ◽  
Håvard Dalen ◽  
Harald Edvard Molmen
Keyword(s):  
Blood Pressure ◽  
Body Size ◽  
Ejection Fraction ◽  
Stroke Volume ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Health Study ◽  
Cross Sectional ◽  
Relative Contribution ◽  
End Diastolic Volume

BackgroundAims of this cross-sectional study were to assess: the relative contribution of left ventricular (LV) systolic long-axis shortening (mean mitral annular plane systolic excursion, MAPSE) to stroke volume (SV), the mechanisms for preserved ejection fraction (EF) despite reduced MAPSE, the age dependency of myocardial volume and myocardial systolic compression.MethodsLinear dimensions and longitudinal and cross-sectional M-modes were acquired in 1266 individuals without history of heart disease, diabetes or known hypertension from the third wave of the Nord-Trøndelag Health Study. Measurements were entered into a half-ellipsoid LV model for volume calculations, and volumes were related to age, body size (body surface area, BSA), sex and blood pressure (BP).ResultsMean BP and proportion with hypertensive values increased with increasing age. MAPSE contributed to 75% of SV, with no relation to age or BSA as both MAPSE and SV decreased with increasing age. LV end-diastolic volume (LVEDV) and SV increased with BSA and decreased with higher age; EF was not related to age or BSA. Myocardial volume increased with higher age and BSA, with an additional gender dependency. The association of age with myocardial volume was not significant when corrected for BP, while both systolic and diastolic BP were significant associated with myocardial volume. Myocardial compression was less than 3%.ConclusionsMAPSE contributes approximately 75% and short axis shortening 25% to SV. Both decline with age, but their percentage contributions to SV are unchanged. EF is preserved by the simultaneous decrease in LVEDV and SV. Myocardial volume is positively associated with age, but this is only related to higher BP, which may have implications for BP treatment in ageing. The myocardium is near incompressible.

Algorithm for diagnosis and typing of ALCAPA syndrome

2021 ◽  
Vol 3 (2) ◽  
pp. 01-07
Author(s):  
Mariela Céspedes Almira ◽  
Adel Eladio González Morejón ◽  
Giselle Serrano Ricardo ◽  
Tania Rosa González Rodríguez ◽  
Judith Escobar Bermúdez
Keyword(s):  
Coronary Artery ◽  
Left Ventricle ◽  
Left Coronary Artery ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Volume Index ◽  
Cross Sectional ◽  
End Diastolic Volume ◽  
Congenital Origin ◽  
Diagnostic Modalities

ALCAPA syndrome was characterized by anomalous origin of left coronary artery from pulmonary artery. Its clinical presentation is varied and although it is an anomaly of congenital origin, it is not exclusive to pediatric ages. Its epidemiological documentation is difficult. We aimed to make the non-invasive diagnosis of the ALCAPA syndrome and its variants. An observational, prospective and cross-sectional study was conducted with 31 patients with a positive echocardiographic diagnosis of ALCAPA syndrome at Pediatric Cardio Center “William Soler” from 2005 to 2018. The variables with significance for diagnosis were the echocardiographic visualization of the anomalous connection and the reversed flow in the left coronary artery. The variables with significance for typing were age at diagnosis, ischemia in the electrocardiogram, echocardiographic visualization of left ventricle papillary muscles fibrosis, presence of severe mitral regurgitation, left ventricle spheroidal remodeling, left ventricle ejection fraction, left ventricular end-diastolic volume index, and left ventricular end-diastolic diameter index. An algorithm integrated by various diagnostic modalities associated with echocardiography as a tool for the detection of ALCAPA was developed. The documentation of the diagnostic and classificatory aspects of the syndrome is possible by detecting echocardiographic elements in conjunction with electrocardiographic and radiological aspects.

P3835Improvement of myocardial energetic efficiency during treatment in hypertensive patients: the life study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M A Losi ◽  
C Mancusi ◽  
E Gerdts ◽  
K Wachtell ◽  
S E Kjeldsen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Ejection Fraction ◽  
Stroke Volume ◽  
Left Ventricular ◽  
Energetic Efficiency ◽  
Stroke Work ◽  
Hypertensive Patients ◽  
Life Study ◽  
Over Time

Abstract Background Myocardial energetic efficiency (MEE) per unit of left ventricular (LV) mass significantly predicts composite of cardiovascular (CV) events in treated hypertensive patients and specifically heart failure in an event-free population-based cohort with normal ejection fraction, independently of LV hypertrophy (LVH). Purpose To investigate whether MEEi changes over time in treated hypertensive patients, and whether different treatments have different effects. Methods From the Losartan Intervention For Endpoint study (LIFE Echo Sub-study) we selected 744 hypertensive patients (age 66±7 years; 45% women) with LVH at ECG, without atrial fibrillation, previous or incident myocardial infarction and with normal echocardiographic ejection fraction (>50%). MEE was estimated as the ratio of stroke work to the “double” product of heart rate times systolic blood pressure (BP), simplified as the ratio of stroke volume to heart rate, as previously reported. MEE was normalized for LVM (MEEi) and analyzed in quartiles at baseline and at the end treatment, according to an “intention-to-treat” protocol. Results Age and proportion of women were not significantly different from the highest to the lowest quartiles (from 65±7 to 66±7 years, p for trend=0.352; from 45% to 42%, p=0.946, respectively), whereas diastolic blood pressure (from 97±8 to 100±9 mmHg, p=0.006), prevalence of obesity (from 14 to 31%, p=0.001) and diabetes (from 4 to 14%, 0.004) progressively increased. Prevalence of concentric LV geometry and echocardiographic LVH also progressively increased from the highest to the lowest quartile (from 14 to 70%, and 61 to 90%, both p<0.0001). MEEi increased over time (p<0.007), independently of initial diastolic BP, diabetes and obesity, significantly more in patients treated with atenolol than with losartan (p<0.0001) (Figure), due to both increased stroke volume and decreased heart rate (both p<0.0001). Figure 1 Conclusions In a randomized clinical study, MEEi improves with anti-hypertensive therapy. Improvement is more evident in patients with atenolol than with losartan-based treatment, possibly providing pathophysiologic explanation of the comparable performance in prevention of ischemic heart disease previously reported in the LIFE study.

scholarly journals Left ventricular global strains by linear measurements in three dimensions: interrelations and relations to age, gender and body size in the HUNT Study

Open Heart ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. e001050 ◽  
Author(s):  
Asbjørn Støylen ◽  
Harald Edvard Mølmen ◽  
Håvard Dalen
Keyword(s):  
Body Size ◽  
Normal Values ◽  
Left Ventricular ◽  
Three Dimensions ◽  
Health Study ◽  
Relative Deformation ◽  
Linear Measurements ◽  
Cross Sectional ◽  
Strain Components ◽  
And Gender

BackgroundStrain is a relative deformation and has three dimensions, in the left ventricle (LV) usually longitudinal (εL), transmural (εT) and circumferential (εC) strain. All three components can be measured generically by the basic systolic and diastolic dimension measures of LV wall length, wall thickness and diameter. In this observational study we aimed to study the relations of normal generic strains to age, body size and gender, as well as the interrelations between the three strain components.MethodsGeneric strains derived from dimension measures by longitudinal and cross-sectional M-mode in all three dimensions were measured in 1266 individuals without heart disease from the Nord-Trøndelag Health Study.ResultsThe mean εL was −16.3%, εC was −22.7% and εT was 56.5%. Normal values by age and gender are provided. There was a gradient of εC from the endocardial, via the midwall to the external level, lowest at the external. All strains decreased in absolute values by increasing body surface area (BSA) and age, relations were strongest for εL. Gender differences were mainly a function of BSA differences. The three strain components were strongly interrelated through myocardial incompressibility.ConclusionsGlobal systolic strain is the total deformation of the myocardium; the three strain components are the spatial coordinates of this deformation, irrespective of the technology used for measurement. Normal values are method-dependent and not normative across methods. Interrelation of strains indicates a high degree of myocardial incompressibility and that longitudinal strain carries most of the total information.

Cardiotoxicity of Imatinib Mesylate - A Prospective Cross-Sectional Study.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4571-4571
Author(s):  
Henrique Bittencourt ◽  
Milena S. Marcolino ◽  
Nelma Clementino ◽  
Vitor F. Xavier ◽  
Marcia M. Barbosa ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Imatinib Mesylate ◽  
Kinase Inhibitor ◽  
Myeloproliferative Disorders ◽  
Cardiac Risk ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cross Sectional ◽  
End Diastolic Volume ◽  
Cardiac Symptoms

Abstract Imatinib Mesylate (IM), a tyrosine kinase inhibitor, has become the first line of therapy for patients with chronic myeloid leukemia (CML) and the standard treatment of advanced gastrointestinal stromal tumors (GIST). A recent publication (Kerkela et al. Nature2006;12:908) suggest that IM might have myocardial toxicity via c-Abl inhibition. Retrospective studies, however, do not show an increase of cardiac hearth failure (CHF) in patients on IM therapy in clinical trials for CML or GIST (Atallah et al. Blood2007;110:1233 and Verweij et al. Eur J Cancer2007; 43:974). In order to prospectively evaluate IM cardiotoxicity we included 101 patients with CML on treatment with IM. As control group, we also included 57 patients with myeloproliferative disorders not treated with IM (essential thrombocytemia= 27, CML=12, policitemia vera=11, other diagnosis=7). After informed consent, all patients had a complete clinical evaluation (interview and physical examination), blood samples for Brain Natriuretic Peptide (BNP) were taken and an echocardiographic study was performed. Groups were similar regarding age (median 48 vs. 54 years), gender distribution and cardiac risk factors, except for hypertension (lower prevalence in IM group: 26% vs. 45.6% in controls, p<0.05). Median time of IM treatment was 805 (range 50–2122) days, mean and median actual IM dose were 463mg and 400 mg, respectively. Cardiac symptoms and signs were equally distributed between groups, except for peripheral edema, more frequent in IM group (25% vs 5%, p<0.05). There was no statistical difference regarding BNP levels (24.4± 7.7pg/mL vs. 26.5± 6.7pg/mL), end diastolic volume of left ventricle (49.4± 10.3mL vs. 48.0 ± 10.8mL) and ejection fraction (EF, 69± 16% vs. 68±13%) for IM and control group, respectively. Four patients presented BNP level above the upper normal limit (UNL = 100pg/mL) in IM group and none in control group. There was a trend for an association between BNP above UNL and a higher IM actual dose (P=0.08). Two patients in IM group and none in control group presented an ejection fraction below normal (<55%). This study shows that a systematic deterioration of cardiac function mediated by IM therapy was not observed. However, since some patients presented with alteration of BNP and/or EF, there is still a possibility for isolate cardiotoxicity associated with IM. BNP, a simple test to perform, might be use to identify patients at risk for subsequent CHF while on IM therapy.

LEFT VENTRICULAR END-DIASTOLIC VOLUME FROM EJECTION FRACTION AND STROKE VOLUME IN PIGS DURING INFERIOR VENA CAVAL OCCLUSION

ASAIO Journal ◽  
2001 ◽  
Vol 47 (2) ◽  
pp. 136
Author(s):  
Cecily J. Gallup ◽  
Santos E. Cabreriza ◽  
Joseph P. Hart ◽  
Rowan F. Walsh ◽  
Henry M. Spotnitz
Keyword(s):  
Ejection Fraction ◽  
Stroke Volume ◽  
Inferior Vena ◽  
Left Ventricular ◽  
Inferior Vena Caval ◽  
End Diastolic Volume

scholarly journals A Comparative Study of Bisoprolol with Carvedilol on LV Systolic Function in Patients with Chronic Heart Failure

2018 ◽  
Vol 14 (1) ◽  
pp. 3-8
Author(s):  
Mohammad Ashraf Hossain ◽  
Khurshed Ahmed ◽  
Md Faisal Ibn Kabir ◽  
Md Fakhrul Islam Khaled ◽  
Rakibul H Rashed ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Heart Rate ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
Group I ◽  
End Systolic Volume ◽  
Group Ii

Background: Chronic heart failure (CHF) is the most common and prognostically unfavorable outcome of many diseases of the cardiovascular system. Recent data suggest that beta-blockers are beneficial in patients with CHF. Among β-blocker class of drugs, bisoprolol is a highly selective β1-adrenergic receptor blocker whereas Carvedilol is non-selective. Many large-scale trials have confirmed that both these β-blockers are superior to placebo and other β-blockers. This study was designed to compare the effects of carvedilol and bisoprolol in patients with chronic HF in a single center.Methods: It was a quasi experimental study. A total of 288 cases of heart failure were selected by purposive sampling, from January 2017 to June 2017. Each patient was allocated into either of the two groups, and was continued receiving treatment with either bisoprolol (Group-I) or carvedilol (Group-II). Each patient was evaluated clinically and echocardiographically at the beginning of treatment (baseline) and at the end of 3rd month. Echocardiography was performed to find out change in left ventricular systolic function.Result: After 3 months of treatment, ejection fraction was found higher in the bisoprolol group (42.6 ± 6.5 versus 38.3 ± 4.6%; P < 0.05). Ejection fraction (EF) changes were 8.4% in bisoprolol group and 4.1% in carvedilol group. A significant reduction in left ventricular end-systolic volume (21.9±2.5 in group I versus 14.9±5.7 in group II; P < 0.05) and left ventricular systolic diameter (3.2±0.1 in group I versus 2.3±0.5 in group II; P<0.05) occurred after 3 months of treatment. But no significant differences were observed in left ventricular end-diastolic volume (10.1±3.2 versus 6.1±6.4; P=0.101) and left ventricular diastolic diameter (1.7±0.8 versus 1.3±0.8; P=0.081) between groups. Three months after treatment, heart rate was reduced in the bisoprolol group from 87.7±9 to 74.5±8.1 and carvedilol group from 88.8±9.1 to 80.1±8.7. Differences in heart rate responses between 2 groups were not statistically significant (P=0.113). Assessment of blood pressure three months later of treatment shows, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were improved in both group but difference between two groups were statistically non significant (p>0.05).Conclusion: In this study, bisoprolol was superior to carvedilol in increasing left-ventricular ejection fraction, improving left ventricular end systolic volume and left ventricular end systolic diameter but no significant difference was observed in LV end diastolic volume, LV end diastolic diameter, heart rate and blood pressure.University Heart Journal Vol. 14, No. 1, Jan 2018; 3-8

Abstract 214: Arterial Stiffness in Patients with Metabolic Syndrome: a Cross-Sectional Study in Guayaquil, Ecuador

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Carlos A Peñaherrera ◽  
Ruben E Peñaherrera ◽  
Maria C Duarte ◽  
Ernesto Peñaherrera
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Arterial Stiffness ◽  
Ventricular Hypertrophy ◽  
Laboratory Data ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Sectional Study ◽  
Abdominal Girth ◽  
Cross Sectional

Background: metabolic syndrome (MetS) can chronically affect blood vessels, leading to cardiovascular disease. Techniques that assess arterial rigidity and age such as Arteriograph® can provide insight on blood vessel function. We aimed to evaluate arterial stiffness in patients with MetS. Methodology: cross-sectional study at Luis Vernaza hospital between November and December 2015. We included patients from the Cardiology Department with a full blood panel. We obtained clinical data for age, gender, history of smoking, hypertension, diabetes, and left ventricular hypertrophy, and measured abdominal girth and blood pressure. Using the Arteriograph®, we measured brachial and central augmentation indexes, central blood pressure, pulse wave velocity (PWV) and arterial age. We retrieved values for triglycerides, HDL, and glycemia from laboratory data. We used IDF criteria to diagnose MetS, but ALAD criteria were used to detect increased abdominal girth. A p value of <0.05 accepted for significance. Results: 95 patients were selected for analysis. 42 (44.2%) were female and 53 (55.8%) were male, with mean age of 61.7 years (SD 13.1). 58 (61.1%) of our patients had hypertension, 29 (30.5%) had diabetes, and 33 (34.7%) had ventricular hypertrophy. 47 (49.5%) of our patients had MetS. We found significant differences in arterial measurements in MetS vs. non-MetS patients, with higher values in the former (Table 1). We obtained non-significant results for the relationship between arterial age and MetS (p=0.32), even after adjusting for smoking (p=0.28) or ventricular hypertrophy (p=0.71). We found non-significant correlation between age and PWV (p=0.32), and found MetS to be significantly more common in women (p<0.001). Conclusion: MetS patients have a higher grade of arterial stiffness. Arterial age was not related to MetS, and it was more prevalent in women. Arteriograph® measurements are helpful to improve diagnosis and management of cardiovascular patients.

Cross-sectional echocardiographic determination of right ventricular volume and myocardial mass in children. Normal values and values in children with interatrial communication

1997 ◽  
Vol 7 (3) ◽  
pp. 302-309 ◽  
Author(s):  
Zhen Jin ◽  
Walter Briedigkeit ◽  
Andreas Gamillscheg ◽  
Felix Berger ◽  
Jonathan R Skinner ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Stroke Volume ◽  
Right Ventricular ◽  
Normal Values ◽  
Muscle Volume ◽  
Cross Sectional ◽  
Interatrial Communication ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume

AbstractCross-sectional echocardiography was performed on 108 healthy children (7 days – 17 years old) and 55 children (6 months - 16.5 years old) with interatrial communication. Right ventricular end-diastolic volume, end-systolic volume, stroke volume, ejection fraction, muscle volume, and the ratio of muscle to cavity were calculated on the basis of outlined cavity and myocardium of an apical fourchamber view.In the normal subjects right ventricular end-diastolic volume, end-systolic volume, stroke volume and muscle volume correlated with body surface area (end-diastolic volume: y=12.5x+7.8x2, r=0.99; end-systolic volume: y=4.8x+3.6x2, r=0.98; stroke volume: y=7.7x+4.2x2, r=0.98; muscle volume: y=14.1x+2.9x2, r=0.97), muscle/cavity ratio (0.85±0.17) and ejection fraction (58.9 ± 6.2%) were unrelated to body surface area. In the subjects with interatrial communication, the right ventricular volumes were significantly larger (p<0.001) than the normal values with a linear relationship to the ratio of pulmonary to systemic flows.Right ventricular volumes can be determined in normal children with acceptable repeatability using a standard apical four-chamber view. The growth related normal values provide a basis for future quantitative studies.

Left Ventricular End-Diastolic Volume from Ejection Fraction and Stroke Volume in Pigs during IVC Occlusion

2002 ◽  
Vol 106 (1) ◽  
pp. 76-81 ◽  
Author(s):  
Cecily J. Gallup ◽  
Santos E. Cabreriza ◽  
Joseph P. Hart ◽  
Rowan Walsh ◽  
Alan Weinberg ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Stroke Volume ◽  
Left Ventricular ◽  
End Diastolic Volume
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