scholarly journals Opportunities of polyhepatography in the assessment of diastolic function of the right ventricle in patients with essential hypertension

Author(s):  
Anna G. Apresyan ◽  
Sergey Yu. Ermolov ◽  
Tatyana V. Ermolova ◽  
Sofya G. Manasyan ◽  
Sergei V. Serdyukov ◽  
...  

The article presents a new method for determining diastolic function of the right ventricle in patients with essential hypertension through evaluation of intrahepatic blood flow by the method of polyhepatography.

2020 ◽  
Vol 19 (2) ◽  
pp. 32-37
Author(s):  
I. N. Shanaev

Aim. Study of heart function in the patients with CVD. Materials and methods. 46 patients with varicosity (VD) and 34 patients with post-thrombotic disease (PTD) were examined; the control group was represented by 15 healthy volunteers. The diagnosis was established using the CEAP basic classification. The study did not include patients with a diagnosed arterial hypertension, diabetes mellitus, chronic lung disease, significant hemodynamic heart defects, coronary heart disease. Ultrasound examination of the heart and veins of the lower extremities was performed on a Saote My Lab Alpha, Acuson Sequoia 512 apparatus. In addition to the standard protocol of heart ultrasound examination, the parameters of the right heart were calculated: sizes of the right ventricle (RV), right atrium, thickness of the anterior wall of the pancreas; to assess the ejection fraction (EF) of the pancreas the mobility of the lateral edge of the tricuspid ring was calculated, and the pressure on the tricuspid valve (TV) was measured. Diastolic ventricular function was studied by spectrograms of tricuspid and mitral blood flow. Results. Most of the indicators of cardiac activity in patients with VD were within normal limits, but a tendency to increase increasing of the right heart size was noted. In addition, the thickness of the interventricular septum and the right ventricle (RV) anterior wall was found to increase from 0.8 to 1.1 cm and from 0.3 to 0.5 cm, respectively, according clinical classes from C2 to C6 (CEAP). Eject fraction (EF) of both the RV and the left ventricle (LV) were also within normal limits, but with a tendency to decrease (67.8 % – C2, to 62 % – C6). The growth of the clinical class is followed by the increasing of percentage of non-restrictive blood flow through the tricuspid valve (TV). The restrictive type of blood flow in patients with VD had not been identified. Patients with PTD also showed a tendency to increase the right heart. However, whereas the size of the RV, as a rule, did not exceed 3.0 cm, the size of the right atrium was slightly higher than normal one in the clinical class C4 and C5.6. All the patients had EF of LV within normal limits, but it slightly decreased by the growth of class. Only patient classes C3 and C4 had EF of RV within the normal range. The 18 % of patient class C5.6 had EF lower than normal with value 48%. Diastolic dysfunction (DD) of the RV was detected in 73.3% of patients with class C3 and 100% with classes C4 and C5.6. Moreover, a restrictive type of blood flow through TV appeared from class C4 and the percentage increased up to 27.2% (class C5,6). Conclusions. DD of the RV was the main hemodynamic disorder.


PEDIATRICS ◽  
1957 ◽  
Vol 19 (6) ◽  
pp. 1139-1147
Author(s):  
Mary Allen Engle

Dr. Engle: When pulmonic stenosis occurs as an isolated congenital malformation of the heart, it usually is due to fusion of the valve cusps into a dome with a small hole in the center. In Figure 1 the pulmonary artery has been laid open so that one can see the three leaflets of the pulmonary valve are completely fused, and that there is only a small, central, pinpoint opening which permits blood to leave the right ventricle and enter the pulmonary circulation. Valvular pulmonic stenosis is much more common than subvalvular or infundibular stenosis, where the obstruction to pulmonary blood flow lies within the substance of the right ventricle. There it may be due to a diaphragm of tissue which obstructs the outflow of the right ventricle, or to an elongated narrow tunnel lined with thickened endocardium, or to a ridge of fibrous or muscular tissue just beneath the pulmonary valve. The changes in the cardiovascular system which result from obstructed pulmonary blood flow are so characteristic that they permit the ready recognition of this condition. Proximal to the constriction, these changes manifest the burden placed on the right ventricle, which enlarges and hypertrophies. On physical examination this is demonstrated by the precordial bulge and tapping impulse just to the left of the sternum, where the rib cage overlies the anterior (right) ventricle. Radiographically, both by fluoroscopy and in roentgenograms in the frontal and both oblique views, right ventricular enlargement is seen. In the electrocardiogram, the precordial leads show a pattern of right ventricular hypertrophy.


2011 ◽  
pp. 55-62
Author(s):  
James R. Munis

What does right atrial pressure (PRA) do to cardiac output (CO)? On the one hand, we've been taught that PRA represents preload for the right ventricle. That is, the higher the PRA, the greater the right ventricular output (and, therefore, CO). This is simply an application of Starling's law to the right side of the heart. On the other hand, we've been taught that PRA represents the downstream impedance to venous return (VR) from the periphery. That is, the higher the PRA, the lower the VR, and therefore, the lower the CO. The point of intersection between the 2 curves defines a unique blood flow rate, which is both CO and VR at the same time.


Neonatology ◽  
2012 ◽  
Vol 101 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Hans Henrik Odland ◽  
Grete A.B. Kro ◽  
Thor Edvardsen ◽  
Erik Thaulow ◽  
Ola Didrik Saugstad

2011 ◽  
Vol 13 (Suppl 1) ◽  
pp. O83 ◽  
Author(s):  
Carl Carlhäll ◽  
Alexandru G Fredriksson ◽  
Jakub Zajac ◽  
Jonatan Eriksson ◽  
Petter Dyverfeldt ◽  
...  

2015 ◽  
Vol 14 (4) ◽  
pp. 42-50
Author(s):  
E. V. Fomenko ◽  
S. B. Tkachenko ◽  
N. F. Beresten ◽  
E. S. Pavochkina

Introduction and aim. Minor heart anomalies (MHA) are the visceral form of connective tissue dysplasia (CTD) that lead to a deterioration in both systolic and diastolic function of the left ventricle (LV). Information about functional state of the myocardium of the right ventricle (RV) of patients with MHA is not available widely. The aim of the study is to evaluate the frequency of occurrence of different types of MHA and features of intracardiac hemodynamic using Tissue Doppler (TD) examination of patients with CTD. Materials and methods. Total were surveyed 1240 people, of which were selected 67 patients with SHD and control group of 27 healthy persons (average age 30.1±4.0 years). Evaluation of systolic and diastolic function of LV and RV was carried out based on results of pulse-wave tissue Doppler of lateral and medial parts of the mitral fibrous annulus (MFAlat, MFFm) and tricuspid fibrous annulus (TEA), including the calculation of the index Tei. Results and discussion. The incidence of SHD was 23 %. Patients of first and second groups both have significantly higher Tei index MFAlat, MFFm and TFA, and at the same time the maximum values of Tei index were observed of patients with multiple MHA (0.50±0.09; 0.56±0.08; 0.49±0.10 standard units respectively). Conclusions. Evaluation of central hemodynamics using TD is very useful to identify disorders of myocardial performance of both the left and right ventricle. Increased Tei index is an early marker of diastolic dysfunction of both ventricles.


2011 ◽  
Vol 10 (3) ◽  
pp. 105-110
Author(s):  
L. I. Agapitov ◽  
Yu. M. Belozerov ◽  
Yu. L. Mizernitsky ◽  
S. E. Tsyplenkova

We studied pulmonary hemodynamics and right ventricular diastolic function in 300 healthy children and 392 children with chronic bronchopulmonary pathology in an isometric exercise. Using echocardiography were determined systolic, diastolic, mean, pulmonary artery pressure, total pulmonary resistance, diastolic function of the right ventricle. Defined normal values of reactivity of pulmonary hemodynamics and diastolic function of the right ventricle in an isometric load. In patients with chronic bronchopulmonary pathology set higher increase of systolic, diastolic, mean, pulmonary artery pressure, decrease diastolic reserve the right ventricle compared to the control. The worst violations of pulmonary hemodynamics and diastolic function of the right ventricle during isometric load observed in patients with chronic Infectious-inflammatory and interstitial lung disease.


2020 ◽  
Vol 48 (4) ◽  
pp. 280-284
Author(s):  
M. V. Tarayan ◽  
E. S. Efremov ◽  
I. O. Bondareva ◽  
N. V. Shkarina ◽  
S. N. Kavaidin

Primary cardiac tumors are very rare in children. Rhabdomyoma is the most common benign tumor in fetuses and neonates. Most cases do not require any surgical intervention due to absence of clinical symptoms and a high rate of spontaneous regression within the first year of life. However, some neonates can have significant abnormalities of intracardial hemodynamics related to the obstruction of the left and right ventricle outflows; this is an indication to emergency surgery. As a rule, complete or partial resection of the tumor mass provides uneventful postoperative course and is not associated with a relapse of rhabdomyoma in the long-term.We present a clinical case of a 15-days old neonate who underwent an emergency surgery due to advanced tumor obstruction of the blood flow in the right ventricle outflow tract (RVOT). At preoperative echocardiography, there was a pulmonary artery systolic pressure gradient of 90 mm Hg. Moderate hypoxemia (SaO2 90%), breathing rate of up to 55 per minute, together with echocardiographic results, indicated the impaired pulmonary blood flow and the need for the tumor resection. The tumor was completely resected through the right ventricle access with cardiopulmonary bypass and cardioplegia, with subsequent autologous pericardium patching of the right ventricle. The postoperative period was uneventful; the patient was extubated at day 2 and discharged at day 11 after surgery. The diagnosis of rhabdomyoma was confirmed histologically. At one month after surgery, no additional tumor masses were found in the heart chambers and septum.Rhabdomyoma causing severe obstruction of the RVOT in a newborn is a rare life-threatening complication of the natural course of benign heart tumors in children. The presence of dyspnea at rest, moderate desaturation, and echocardiographic data determined the rejection of the conservative management commonly adopted in most cases of cardiac rhabdomyomas, and were indications for an emergency surgery. In the long-term postoperative period, magnetic resonance imaging should be done to exclude tuberous sclerosis.


1965 ◽  
Vol 208 (6) ◽  
pp. 1211-1216 ◽  
Author(s):  
William D. Love ◽  
Myra D. Tyler

The effect of hypoxia and hypercapnia on regional coronary blood flow and vascular resistance (CVR) was studied in dogs without thoracotomy. Gas tensions were varied by ventilation at controlled rates with gas mixtures containing 4–100% O2 and 0–24% CO2. After 10 min intravenous infusion of Rb86, the animals were killed and the heart isotope content determined. Blood flow to the left ventricle was calculated by the Fick principle from the isotope uptake and the mean difference in radioactivity of arterial and coronary sinus blood. Patterns of flow elsewhere were estimated from the rates of regional Rb86 clearance. Myocardial Rb86 clearance in the right and left ventricles has been previously shown to be closely related to the rate of coronary blood flow. Hypoxemia and severe hypercapnia (pCO2 above 100 mm Hg) both produced a profound fall in CVR. With hypoxemia this decrease was more marked in the right ventricle. Elevation of pCO2 exaggerated the normal difference in Rb86 uptake between inner and outer thirds of the wall of the left ventricle, while hypoxemia reversed the normal gradients. Hypercapnia did not affect these gradients in the right ventricle, but hypoxemia significantly reduced them.


Author(s):  
Shi-Joon Yoo ◽  
Willem A Helbing

Double-outlet right ventricle (DORV) encompasses a wide variety of abnormalities and requires precise demonstration of the cardiovascular abnormalities using a segmental approach for surgical decision and planning. The most important is whether the left ventricle can be directed surgically to the aorta without obstruction of the pulmonary outflow tract of the right ventricle. Echocardiography is the baseline imaging modality in preoperative assessment of DORV. In complex cases, cardiovascular magnetic resonance (CMR) provides comprehensive information regarding important surgical anatomy, blood flow, and ventricular volumes. Three-dimensional (3D) angiograms and 3D print models may provide undisputable information regarding surgical anatomy and allows practice surgery on the models prior to actual surgery. DORV is frequently associated with post-operative residual findings that require reintervention. CMR is particularly useful in post-operative assessment, as it provides accurate quantitative information regarding ventricular volumes and blood flow for decision and timing of surgical or interventional procedures.


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