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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Regional left ventricular (LV) curvature analysis is a useful tool to assess the pathomorphological changes in LV shape which occur in different heart diseases. As LV shape changes follow regular trajectories, we used the curvature extrema and the normalized curvature variations as the features for identifying the movement of the borders during the cardiac cycle (curvature-motion method: CM). The regional curvature was calculated using a windowed Fourier series approximation of contours, in which the number of harmonics and filter-window were locally chosen in order to minimize the reconstruction errors and to maximize the smoothness of the curve. Analysis programs were tested on a series of ventricle-shaped contours, software generated. Left ventricular diastolic and systolic outlines obtained from RAO 30 degrees LV angiography in 24 patients with aortic insufficiency and in 16 subjects without heart disease were analyzed. Left ventricular curvature and regional wall motion were calculated in each subject. In respect to normal subjects, LV shape in aortic regurgitation definitely appears asymmetric because of the elongation of the anterior hemiperimeter and the prevailing expansion of the apical and anterolateral regions. These alterations in cavity geometry correlate to the decrease in pump function. According to these results wall motion analysis using the CM showed a greater extension of LV asynergy, while usual methods as the centerline or the radial one indicate a greater damage of the apical regions. Thus, the CM method seems to be a promising tool for wall motion analysis.
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PMID:[Analysis of regional kinetics of the left ventricle by integration of morphologic data]. 129 49

In spite of numerous available diagnostic methods, controversies concerning the precise diagnosis of tricuspid regurgitation (TR) still remain. In right ventriculography, catheter placement may modify tricuspid valvular function. Though noninvasive Doppler echocardiography is a useful method, it is sometimes too sensitive for clinical use. Furthermore, it is not applicable to cases in which ultrasound penetration is limited. In this study, we evaluated TR using intravenous digital subtraction angiography (DSA), which can provide good images even in cases with poorly recorded echocardiograms. For this study, we placed a catheter in the superior vena cava. Cardiac DSA examinations were performed in one hundred and one patients with heart disease. We injected 35 ml of contrast medium at a speed of 18 ml/sec via a catheter introduced in the superior vena cava. DSA images by continuous mode were obtained in the RAO projection for 15-20 sec. Sequential DSA images were observed and analyzed by time-density curves of the regions of interest (ROI) which were placed in the right ventricle (RV) and inferior vena cava (IVC). Doppler echocardiography was performed for 16 cases in which TR was suspected. Of these, phonocardiography with jugular pulse tracing was recorded for 14 and contrast echocardiography were performed for six, respectively. In cases without evidence of TR, regurgitation of contrast medium into the IVC during RV systole was not recorded by the DSA method. In cases of clinically-proven TR, regurgitation into the IVC during RV systole was observed. Thus, this was considered a diagnostic feature of positive TR using the DSA method, and 13 of the 16 cases undergoing Doppler echocardiography were diagnosed as having TR using the DSA method. The severity of TR was categorized as mild, moderate and severe according to analyses of time-density curves. The severity established by the DSA method showed a close correlation with the clinical severity of TR. Doppler echocardiography was negative for TR in two of the 13 cases, but positive for TR in two of the 16 suspected cases only by the Doppler method. In cases of moderate to severe TR diagnosed by the DSA method, jugular pulse tracings showed a regurgitant wave. By contrast echocardiography, TR was evident only in cases of severe TR diagnosed by the DSA method. In conclusion, the DSA method proved useful for diagnosing TR.
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PMID:Tricuspid regurgitation diagnosed by intravenous digital subtraction angiography. 307 64

To investigate and determine the local wall motion of normal right ventricles, biplane angiograms from 14 normal subjects were analyzed. In all patients, organic heart disease was excluded by angiography and right heart catheterization under exercise. Using a radial model, segmental systolic area shortening was determined for the anterior, anteroapical and inferior segment in the RAO-projection and the inferior, anteroapical and anterior (free wall) segment in the LAO-projection. The highest segmental shortening was found for the anterior wall in the RAO-projection (45.6 +/- 7.8%) and for the free wall in the LAO-projection with 42.7 +/- 11.3% (RAO: anteroapical 28.1 +/- 6.3%; inferior: 26.5 +/- 7.8%. LAO: anteroapical: 34.7 +/- 18.8%; inferior: 30.6 +/- 21.6%). Corresponding to these different segment shortenings, right ventricular contraction seems to have a disharmonic pattern in comparison to the left ventricle. Normal local wall motion of segmental area shortening was predicted by the means-2SD (95.5%) confidence interval. The confidence interval of the inferior (-12.6%) and anteroapical (-2.9%) segment in the LAO-projection was poor compared to the other segments (RAO: anterior 30.0%; anteroapical 15.5%; inferior: 10.9%; LAO: free wall: 20.1%). For the LAO-inferior and LAO-anteroapical segment, even akinesia was within the 95.5% confidence interval. In conclusion, quantification of local wall motion seems possible with reasonable confidence for RAO segments and the free wall in the LAO-projection only.
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PMID:[Quantitative segmental analysis of wall function of the right ventricle in probands with healthy hearts]. 336 87

It is demonstrated that right ventricular volumes can be measured accurately by biplane cineangiography using the Simpson's rule or various area-length methods. In order to validate the single plane approach a biplane (30 degrees RAO-60 degrees LAO) right ventricle (RV) cineangiography was performed in 10 adults investigated for chest pain without coronary artery disease or any other heart disease. RV volumes (EDV: end-diastolic; ESV: end-systolic; SV: stroke volume) and EF (ejection fraction) were measured by biplane and single plane analysis with the same area-length method using the pyramide with triangular base as geometric model (Ferlinz). The results are: RVEDV (ml/m2) biplane (B) 81 +/- 10, monoplane (M) 82 +/- 11; RVESV (ml/m2) B 33 +/- 6, M 35 +/- 8; RVSV (ml/m2) B 48 +/- 8, M 47 +/- 10; RVEF (%) B 59 +/- 6, M 57 +/- 8. Equations of linear regression show the following correlations: RVEDV R = 0.82 p less than 0.01; RVESV R = 0.77 p less than 0.01; RVSV R = 0.92 p less than 0.001; RVEF R = 0.85 p less than 0.01. Authors conclude to a good enough correlation between monoplane and biplane analysis especially for RVSV and RVEF. They underline the great variability of individual values.
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PMID:[Measurement of right ventricular volume by cineangiography. Validation of monoplane analysis compared with biplane]. 361 5

Dynamic exercise two-dimensional (2-D) echocardiography has been utilized as a valuable method in the diagnosis of coronary artery disease (CAD). However, there are some limitations in this technique including inability to apply for patients whose physical capacity is limited. Moreover, appropriate echocardiographic recordings are frequently difficult because of bodily movements and/or hyperventilation during exercise. In order to overcome these limitations, we examined whether isoproterenol (ISP) infusion stress 2-D echocardiography could detect transient LV asynergy or not. The subjects consisted of 19 cases with angina pectoris (AP), 16 with old myocardial infarction (OMI), nine with atypical chest pain syndrome and six with miscellaneous heart disease. ISP stress test was performed prospectively as follows: ISP was infused at a rate of 0.02 microgram/kg/min until anginal pain occurred or significant ST depression (elevation) developed. Real time 2-D echocardiograms were obtained in the short-axis or apical RAO views of the LV before and every one minute during ISP infusion test. Coronary artery stenosis was considered to be present if the narrowing was 50% or more in the luminal diameter. The results were as follows: Adequate echocardiographic recordings were obtained in 86.1% of LV segments at rest, and in 82.2% during ISP infusion. Echocardiographic recordings during ISP infusion were feasible in almost all cases. LV wall motion abnormalities were detected in 12 (86%) of the 14 subjects with OMI and two (29%) of the seven subjects with AP at rest, while induced or exaggerated in nine (64%) of the 14 subjects with OMI and all of the 7 subjects with AP during ISP infusion. On the other hand, LV wall motion remained entirely normal during ISP infusion in 11 (92%) of the 12 subjects without CAD. In 4 (40%) of these 10 subjects without CAD, electrocardiographic judgements were positive in the ISP stress test. None had hazardous arrhythmias or severe anginal pain. ISP infusion stress 2-D echocardiography possessed feasibility of detecting LV wall motion abnormalities because this method could exclude difficulty of recordings due to bodily movements and/or hyperventilation seen in exercise echocardiography. Compared with ISP stress electrocardiography, 2-D echocardiography seemed to be superior with respect to the specificity in detecting CAD. In conclusion, ISP stress echocardiography is a safe and useful method in the diagnosis of CAD.
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PMID:[Isoproterenol infusion stress two-dimensional echocardiography in detecting coronary artery disease]. 667 62

Endoaneurysmorrhaphy (EAR) has become an important therapeutic option in the treatment of patients with left ventricular (LV) aneurysm and congestive heart failure. Today, more and more patients are referred for EAR with a dilated akinetic LV rather than a classic dyskinetic LV aneurysm. Little is known about the contribution of the extent of akinesis to perioperative mortality. We reviewed the data of 147 patients with anterior left ventricular aneurysms undergoing EAR. Seventy percent of the patients were male; mean age was 62+/-9 years. Demographic, hemodynamic, angiographic and surgical variables were analyzed using univariate statistic tests in order to determine risk factors for in-hospital mortality.Eighty-two percent of the LV aneurysms had at least some dyskinesia, but 70% were mainly akinetic. 133 patients had additional bypass surgery, one had additional mitral valve replacement. In-hospital mortality was 4.1% (n=6). Risk factors for in-hospital mortality were the total extent of akinetic myocardium (p=0.027) in the 30 degrees RAO view and the duration of cardiopulmonary bypass (CPB, p=0.0068) which was itself dependent on the LV ejection fraction (p=0.001), the number of stenosed coronary arteries (p=0.004), and the extent of akinesis (p=0.023). The extent of dyskinesia was not associated with either perioperative mortality (p=0.36) or CPB duration. EAR can be performed with acceptable perioperative results. Because akinesis increases in many patients with time, and because the duration of ECC was dependent on variables reflecting the severity of the underlying heart disease, our findings underscore the importance of optimal timing for the surgical intervention.
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PMID:The extent of akinesis is predictive of the in-hospital mortality from endoaneurysmorrhaphy. 1567 42