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Query: UMLS:C0851184 (thinning)
 11,252 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Echocardiographic findings in patients with ischemic heart disease are described; their correlations with clinical, hemodynamic and angiographic data are presented and discussed. Regional abnormalities of left ventricular wall motion and/or thickening during systole are detected in 84 per cent of patients with acute myocardial infarction and in a high percentage of patients with larger than or equal to 75 per cent narrowing of a major coronary artery. These abnormalities may occur with stress and may be reversible. Left ventricular wall thinning during systole indicates acute ischemia or infarction and thin, dense myocardial echoes indicate scar. Echocardiographic evidence of left ventricular dysfunction is useful in predicting heart failure and mortality in patients with acute myocardial infarction and in predicting surgical mortality for patients undergoing aneurysmectomy and/or coronary artery bypass surgery. Echocardiography has not proved useful in determining graft patency following coronary artery bypass surgery. Technical difficulties and limitations of echocardiography in patients with coronary artery disease are discussed.
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PMID:Echocardiography in ischemic heart disease. 32 1

Echocardiographic septal and posterior wall thicknesses and the percent change with systole were measured in 146 patients with the following diagnoses: acute myocardial infarction (40), chronic coronary artery disease (49), congestive cardiomyopathy (8), atrial septal defect (20), and no cardiac disease (29). Mean diastolic thicknesses for the groups of patients with coronary artery disease and congestive cardiomyopathy were not significantly different from normal although there were abnormal values for individual patients within each group. Mean diastolic thickness of the septum was greater than normal for the group with atrial septal defect (P less than 0.02). Wall thinning with systole was associated with acute infarction or ischemia (P less than 0.0001); decreased thickening (less than normal) commonly occurred in patients with acute myocardial infarction, chronic coronary artery disease, and congestive cardiomyopathy. Patients with atrial septal defect had normal thickening with abnormal motion. Results of this study show that 1) systolic thinning is indicative of an acute event; 2) abnormal changes in systolic wall thickening occur commonly in patients with coronary artery disease or congestive cardiomyopathy; and 3) abnormal wall motion may occur without abnormal wall thickening, as the echoes of patients with atrial septal defect indicate.
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PMID:Systolic thickening and thinning of the septum and posterior wall in patients with coronary artery disease, congestive cardiomyopathy, and atrial septal defect. 83 Jan 97

To identify the presence of viable myocardium in areas of severe systolic dysfunction, we studied 22 patients (age 45 to 78 years) with chronic coronary artery disease and left ventricular dysfunction (mean ejection fraction 29 +/- 9%). All subjects underwent thallium-201 single photon emission computed tomography (SPECT), using the reinjection technique, positron emission tomography (PET) with H2(15)O and 18-fluorodeoxyglucose (FDG) to measure regional blood flow and exogenous glucose uptake, respectively, and nuclear magnetic resonance imaging (MRI). From matched transaxial PET, SPECT and MRI tomograms, a total of 290 left ventricular myocardial regions were analyzed. According to the regional wall thickening, measured from MRI, 3 groups of myocardial regions were identified: akinetic-dyskinetic (n = 60), showing either absence of systolic thickening or systolic thinning; hypokinetic (n = 97), showing an absolute wall thickening less than or equal to 2 mm; normal (n = 133), showing an absolute wall thickening greater than 2 mm. Of the 60 akinetic or dyskinetic regions, 3 were normal by SPECT and 37 corresponded to either a total or partially reversible thallium defect: 34 of these 40 regions also showed presence of FDG uptake by PET. The remaining 20 akinetic or dyskinetic regions showed a thallium defect that remained irreversible after reinjection: in 7 of these 20 regions, however, there was evidence of metabolic activity, as expressed by FDG uptake. Thus, 47 (78%) of the myocardial akinetic or dyskinetic regions showed presence of viable tissue.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Identification of viable myocardium in patients with chronic ischemic disease and left ventricular dysfunction: correlations between blood flow, metabolic activity and regional function]. 193 59

Gated magnetic resonance imaging (MRI) provides excellent anatomic evaluation of the heart, but its capability for assessing cardiac physiology is less clear. Accordingly, regional left ventricular (LV) wall thickening was evaluated by multiphasic transverse images in 37 patients with a variety of myocardial diseases and in 9 normal subjects. Angiography and 2-dimensional echocardiography (2-D echo) were used for comparison. End-diastolic and end-systolic wall thickness, absolute systolic wall thickening and percent systolic wall thickening were determined in 7 regions. Mean systolic wall thickening in normal subjects was not significantly different among the regions. However, there was considerable individual variation in wall thickening, ranging from 18 to 100%. Patients with LV hypertrophy (n = 4), amyloid cardiomyopathy (n = 1), constrictive pericarditis (n = 5), and hypertrophic cardiomyopathy (n = 3) had absolute and percent systolic wall thickening within normal limits. Infarcted segments in patients with ischemic heart disease (n = 17) had reduced absolute and percent systolic wall thickening, often combined with diastolic wall thinning, whereas mean percent systolic wall thickening in adjacent normal myocardial regions was higher than in normal volunteers (p less than 0.001). In patients with coronary artery disease, MRI had a sensitivity and specificity of 93% in detecting regional wall motion abnormalities. Because sagittal images were not acquired, inferior wall motion abnormalities were not assessed by MRI due to parallel wall sectioning in transverse images.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Regional left ventricular wall thickening by magnetic resonance imaging: evaluation in normal persons and patients with global and regional dysfunction. 294 75

The ability of magnetic resonance to determine regional left ventricular function was investigated in 18 patients--13 with coronary artery disease (nine with previous infarction), one with congestive cardiomyopathy, one with mitral stenosis, one with an atrial septal defect, and two without detectable cardiac abnormality. Coronal magnetic resonance images were acquired through the aortic valve and sagittal images were acquired in the plane of widest diameter of the left ventricle seen in the coronal image, both at end diastole and end systole. Regional wall motion assessed by magnetic resonance was compared with the results of anteroposterior and left lateral x ray ventriculograms by two independent observers. The left ventricular wall was divided into three segments in each plane and the motion of the segments was classified as normal, hypokinetic, akinetic, or dyskinetic. Muscle thickness was measured in each segment of the magnetic resonance images and was considered to be abnormal if in the systolic images it was less than 75% of that in neighbouring segments or if it failed to increase by at least 25% between diastole and systole. Wall motion assessments by the two methods agreed in 68 of 105 segments analysed, but differed by one class in 32 segments and by two classes in five segments. The differences can be explained by the conditions under which the investigations were performed and by the disparity between a tomographic section and an x ray projection. Magnetic resonance showed 25 segments to have abnormal wall thickness. Only one patient with infarction did not have an area of wall thinning and no patient without infarction had an area of thinning. It is concluded that magnetic resonance allows an accurate non-invasive assessment of left ventricular wall motion and thickness.
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PMID:Assessment of regional left ventricular function by magnetic resonance. 376 12

Segmental wall motion abnormalities are common in patients with myocarditis. Left ventricular (LV) regional wall motion was assessed in six patients with myocarditis by two-dimensional echocardiography. Some of our patients demonstrated regional thinning of the wall, similar to myocardial infarction. Therefore, segmental wall motion abnormalities with or without regional wall thinning detected by two-dimensional echocardiography cannot be used to differentiate myocarditis from coronary artery disease. Nevertheless, echocardiography can be performed repeatedly and is useful for evaluating the severity of myocarditis by assessing LV regional wall motion abnormalities, changes in LV wall thickness and cardiac pump function during the course of the disease.
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PMID:Echocardiographic assessment of left ventricular wall motion in myocarditis. 384 73

The long-term effects of Kawasaki disease on the cardiac function were evaluated in 67 patients. Serial M-mode echocardiograms were obtained at the time of the initial diagnosis, 1 to 3 months, at 3 to 12 months, and at greater than 12 months following the diagnosis. Left ventricular and left atrial dimensions, shortening fraction, left and right ventricular systolic time interval ratios, and computer analysis of digitized echoes of the left ventricular chamber and posterior wall were obtained. The left atrial and left ventricular dimensions were abnormal in half of the patients throughout the study periods. The shortening fraction was abnormal initially but became normal by the end of 3 months. The peak rates of emptying of the left ventricle and thickening of the posterior wall were significantly reduced in all evaluation periods. In addition, the peak rate of diastolic thinning of the posterior wall was reduced, although the peak rate of filling remained normal. Finally, more than 30% of patients studied beyond 12 months had a prolonged major filling and thinning period. There was no difference between patients with or without coronary artery aneurysms. All other systolic and diastolic phase intervals and rates of changes were normal. Contrary to previously published reports, we conclude that patients with Kawasaki disease who do not have demonstrable coronary artery disease, exhibit abnormalities of cardiac chamber size and function long after their acute illness.
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PMID:Long-term echocardiographic evaluation of cardiac size and function in patients with Kawasaki disease. 392 39

Verapamil has a negative inotropic action in isolated cardiac muscle. Its effects on left ventricular function were tested in 25 patients with suspected coronary artery disease. A double-blind, randomized, placebo-controlled study design was used. Verapamil (0.2 mg/kg over 10 minutes) significantly lowered mean arterial pressure (from 105 to 89 mm Hg) while increasing the cardiac index (from 2.8 to 3.1 liters/min/m2). No statistically significant effect was seen on heart rate, left ventricular end-diastolic pressure or end-systolic volume index, ejection fraction, peak rates of systolic wall thickening or diastolic wall thinning, or percentage of hemiaxial shortening. However, there was a small increase in the left ventricular end-diastolic volume index (from 94 to 102 ml/m2). Important findings were a reduction in systemic vascular resistance (from 39 to 30 U . m2), an increase in left ventricular end-diastolic volume index consistent with a negative inotropic effect, and no evidence of improved regional wall dynamics in portions of the left ventricular wall considered hypokinetic because of myocardial ischemia.
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PMID:Effect of verapamil on left ventricular function: a randomized, placebo-controlled study. 634 Apr 53

To explore possible mechanisms of left ventricular early segmental relaxation, complete occlusion of the left anterior descending coronary artery (LAD) was produced in seven open-chest dogs and partial occlusion of the LAD was produced in six open-chest anesthetized dogs. Regional wall thickness was measured both in an ischemic and a normally perfused zone using implanted ultrasonic crystals. Two to three seconds following complete LAD occlusion, thinning of the ischemic wall occurred prematurely during isovolumic relaxation. The extent of premature thinning became more prominent 5 to 10 sec following LAD occlusion. Early thinning of the ischemic wall preceded thinning of the normally perfused wall by 110 +/- 10 msec. Partial occlusion of the LAD produced a 33 +/- 6% reduction of coronary flow and a 23 +/- 4% reduction of systolic wall thickening in the ischemic region. Systolic thickening of the nonischemic wall was unchanged relative to the preocclusion period. Premature early thinning of the mildly ischemic wall preceded thinning of the normally perfused segment by 90 +/- 8 msec. The observation that ischemia can produce segmental early thinning of the ventricular wall may have implications in understanding the mechanism of the angiographic observation of the segmental early relaxation phenomena in patients with coronary artery disease.
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PMID:Early segmental thinning of the left ventricular wall following regional ischemia. 664 Jun 63

The effect of early chronic Chagas's disease on the timing and extent of regional left ventricular wall motion was studied with a frame by frame analysis of left ventriculograms in nine patients and compared with those in 19 normal subjects. In all the patients there was hypokinesis or akinesis in the anteroapical region together with delay in the onset of inward movement. Hypokinesis of the proximal inferior segment was also present, but the time of onset of inward motion here was normal. These differences can be explained on the basis of regional asynchrony within the normal left ventricle, where anteroapical wall motion is delayed with respect to that elsewhere. Thus contraction of the diseased anteroapical segment starts against an appreciable pressure and so may be isometric, whereas the affected proximal inferior segment starts contracting earlier against a lower pressure and so is able to shorten. No abnormalities of wall motion were seen during isovolumic relaxation despite segmental involvement, which is a distinctly different finding from that in patients with coronary artery disease. This may be due partly to the absence of incoordinate relaxation in Chagas's disease and partly to myocardial involvement by Chagas's disease in the mid-anterior segment. This is the site of rapid early diastolic wall thinning, which has been put forward as a major mechanism of normal rapid ventricular filling and whose premature activity causes disturbances in regional wall motion before mitral valve opening when relaxation is incoordinate. Thus quantitative analysis of both the timing and amplitude of wall motion indicates fundamental differences between Chagas's disease and coronary artery disease, when a less complex analysis would have shown a similar pattern of segmental dysfunction in both. Since the effect of the same pathological process on wall motion varies with the site of ventricular involvement, the importance of the disturbances seen in Chagas's disease becomes apparent only when the non-uniformity of normal left ventricular structure and function is taken into account.
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PMID:Left ventricular wall motion in patients with Chagas's disease. 668 24


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