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

To assess the possible role of restoring forces underlying left ventricular wall motion during rapid filling, the time relations between left ventricular dimensions and filling velocity were studied by digitised M-mode and Doppler echocardiography in 23 normal children and 43 patients: 11 with mild and 17 with severe mitral regurgitation, and 15 with left ventricular hypertrophy due to aortic stenosis. In normal children, peak mitral flow velocity characteristically lagged peak rate of dimension increase by 50 +/- 15 msec, and peak rate of posterior wall thinning by 35 +/- 15 msec, (P less than 0.01 for both). Towards the apex, and along the long axis of the ventricle, these phase differences between dimension and flow velocity were not apparent. The characteristic time relations between flow velocity and transverse dimension were also present in patients with left ventricular hypertrophy or mild mitral regurgitation, but when mitral regurgitation was severe they were lost and there was no significant difference in timing between peak flow velocity and peak rate of dimension change (-2 +/- 30 msec) or wall thinning (-4 +/- 25 msec). We conclude that phase differences between left ventricular wall motion and mitral inflow velocity are present in the normal ventricles of children. They cannot be explained on the basis of simple shape changes or passive filling of the relaxing ventricle, but strongly suggest the additional presence of ventricular restoring forces. They persist in patients with left ventricular hypertrophy or mild mitral regurgitation, but are lost when the regurgitation is severe, the filling pattern reverting to that predicted for passive distension of the ventricular cavity by a high left atrial pressure.
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PMID:Phase differences between left ventricular wall motion and transmitral flow in man: evidence for involvement of ventricular restoring forces in normal rapid filling. 252 30

MR imaging is valuable in defining cardiac anatomy in a variety of cardiac abnormalities. However, evaluation of cardiac function by this technique has been limited by long imaging times and low temporal resolution. New, recently described pulse sequences shorten imaging time considerably and improve temporal resolution. This paper reports our early experience with cine MR imaging of the heart, a technique of gradient-recalled acquisition in the steady state (GRASS) that uses low flip angles and gradient-recalled echoes. Images were obtained in 36 subjects (14 normal volunteers and 22 patients with coronary artery or valvular heart disease) and displayed in a cinegraphic mode for assessment of cardiac function. The acquisition of 10 to 12 levels, covering the whole heart with up to 24 time frames per level, required a maximum imaging time of only 30 min. Because systole and diastole were readily identified, and the contrast between blood and surrounding structures was excellent, systolic wall thickening, wall motion, and motion of the cardiac valves were visualized easily. Regions of myocardial infarcts were clearly visible and characterized by lack of systolic wall thickening and/or diastolic wall thinning. Turbulence caused signal loss within the flowing blood, which usually had higher signal intensity than myocardium. Therefore, turbulent blood flow in valvular regurgitation and in valvular and subvalvular stenosis could be detected. Cine MR imaging is a promising new technique for the evaluation of myocardial and valvular function.
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PMID:Cine MR imaging: potential for the evaluation of cardiovascular function. 1692 19

A 26 year old female patient developed recurrent sustained ventricular tachycardia (VT) after undergoing heart surgery for the third time for chronic pulmonary regurgitation following repair of tetralogy of Fallot. At the last surgery, ventriculotomy was again performed in the outflow tract of the right ventricle. At that time, scar formation and thinning of the cardiac wall were obvious. The surgical result was excellent. Three months later, she lost consciousness. ECG showed VT which was refractory to tolerated doses of antiarrhythmic drugs. Electrophysiologic study showed fragmented activity in the outflow tract of the right ventricle during VT which could be induced and terminated by programmed electrical stimulations. DC energy delivery of 200 Joules to catheter electrodes which recorded local activity 20 msec prior to the onset of the QRS of VT was successful in preventing VT. VT could not be induced by extensive programmed stimulation 1 month later.
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PMID:A successful electrical ablation of recurrent sustained ventricular tachycardia in a postoperative case of tetralogy of Fallot. 376 73

Two-dimensional echocardiographic findings in porcine valve dysfunction were compared with pathologic findings in 10 patients (12 valves). Three specific echocardiographic findings were identified in patients with regurgitant lesions: prolapse, fracture and flail leaflets. Prolapse was associated pathologically with thinning of the leaflets, longitudinal tears close to the ring margin and acid mucopolysaccharide accumulation. Valve fracture was seen with and without prolapse and was accompanied pathologically by small pinpoint perforations or tears of the leaflet. A flail leaflet was seen with a linear tear of the free margin and was associated with calcific deposits. Mild degrees of fracture seen pathologically were missed on the echocardiographic study in five patients. Thickening or calcification, when present in moderate or severe amounts, was correctly identified by echocardiography. When all abnormal features were considered collectively, two-dimensional echocardiography correctly identified at least one of them in all patients. Therefore, two-dimensional echocardiography may prove useful in assessing the source of valvular regurgitation in patients with bioprosthetic valves.
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PMID:Correlation of two-dimensional echocardiography and pathologic findings in porcine valve dysfunction. 396 7

Recurrent significant aortic valvular stenosis or regurgitation, or both, after balloon or open valvotomy in pediatric patients often necessitates aortic valve replacement. In an attempt to preserve the aortic valve, we performed extended aortic valvuloplasty in 21 children with recurrent aortic valve stenosis or regurgitation from January 1989 to March 1993. Previous related procedures were one open aortic valvotomy or more (n = 15), balloon valvotomy (n = 4), balloon valvotomy after surgical valvotomy (n = 1), and repair of iatrogenic valve tear (n = 1). Mean age at the time of the extended aortic valvuloplasty was 6 +/- 3.4 years. Mean pressure gradient across the aortic valve was 56 +/- 12 torr. Regurgitation was moderate (grade 2 to 3) in nine and severe (grade 4) in 12 patients. Extended aortic valvuloplasty techniques consisted of thinning of valve leaflets (n = 15), augmentation of scarred and retracted leaflets with autologous pericardium (n = 11), resuspension of the augmented leaflet (n = 14), release of the rudimentary commissure from the aortic wall (n = 5), extension of the valvotomy incision into the aortic wall on both sides of the commissure (n = 20), patch repair of the sinus of Valsalva perforation (n = 1), reapproximation of tears (n = 5), and narrowing of the ventriculoaortic junction (n = 2). No operative deaths occurred. The postoperative mean pressure gradient, assessed by most recent Doppler echocardiography or cardiac catheterization at a follow-up of 18 +/- 6 months, was 19 +/- 6 torr (p < 0.01 versus the preoperative gradient). Aortic regurgitation was absent in 13, mild in 6, and moderate-to-severe, necessitating subsequent aortic valve replacement, in 2. This short-term experience indicates that extended aortic valvuloplasty is a safe and effective surgical approach that minimizes the need for aortic valve replacement in children with significant recurrent aortic valve stenosis or regurgitation.
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PMID:Extended aortic valvuloplasty for recurrent valvular stenosis and regurgitation in children. 815 34

Necropsies were performed on 14 psittacine birds of various species suspected to have proventricular dilatation disease (PDD). Eight of the birds exhibited neurological signs (seizures, ataxia, tremors and uncoordinated movements) and digestive tract signs (crop stasis, regurgitation, inappetance and presence of undigested food in the faeces). At necropsy, the birds had pectoral muscle atrophy, proventricular and ventricular distention, thinning of the gizzard wall, and duodenal dilation. In addition, five birds had a transparent fluid (0.2 to 1.0 ml) in the subarachnoidal space of the brain, and one bird had dilatation of the right ventricle of the heart. The histological lesions differed from earlier reports of PDD in that peripheral (sciatic, brachial and vagal) neuritis was seen in addition to myenteric ganglioneuritis, myocarditis, adrenalitis, myelitis and encephalitis.
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PMID:Peripheral neuritis in psittacine birds with proventricular dilatation disease. 1918 47

Congenitally corrected transposition of the great arteries (CCTGA) is a rare and complex congenital anomaly characterized by atrial-ventricular (AV) discordance and ventricular-arterial discordance. Ventricular noncompaction (VNC) is a rare unclassified cardiomyopathy due to the arrest in intrauterine endomyocardial morphogenesis and it is characterized by numerous prominent trabeculations and intratrabecular recesses. We reported the case of a 47-year old female patient. When she was 35-year old an "isolated" CCTGA was diagnosed because of a heart murmur. Since then she attended periodically echocardiograms. She showed us 2 of them where right ventricle apical trabeculation was reported, without any others details. We performed a periodic evaluation in a patient still active, with a 6-month history of mild dyspnea occurring during exertion, no episodes of chest discomfort or palpitation. The ECG showed ectopic atrial rhythm, 83 bpm, normal QRS duration, QS complex in V1-V2 leads. The echocardiogram demonstrated: CCTGA, moderate enlargement and dysfunction of the right systemic ventricle, moderate to severe systemic AV valve regurgitation, severe thinning and dyskinesia of the basal segment of the septum, apical and mid-segments prominent and numerous trabeculations with deep intertrabecular recesses, better showed by color Doppler, in continuity with the ventricular cavity. This case presents some distinctive features: (1) the association between two rare congenital anomalies; (2) Striking right VNC, involving the apex and mid-segments, rarely described in literature; right VNC has been proposed according to the presence of 3 over 4 criteria proposed by Jenni et al. (Heart 86:666-671, 2001); (3) Severe thinning and dyskinesia of the basal segment of the septum, probably related to coronary artery abnormalities frequently described in CCTGA patients.
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PMID:Unusual association between "congenitally corrected transposition of the great arteries" and "noncompaction" of the right systemic ventricle. 1968 Jul 80

A low-dose cardiac CT examination for preoperative assessment of coronary artery disease and mitral valve annulus dimensions in 79-year-old female with mitral valve regurgitation, consisting of a prospectively ECG-triggered high-pitch first-pass perfusion scan under adenosine stress and a sequential scan at rest enabled the diagnosis of occlusion of the right coronary artery and high-grade stenosis of the left circumflex artery, reversible perfusion defects of the inferoseptal and inferolateral walls and a persistent inferior wall perfusion defect associated with inferior wall thinning and akinesia. All findings were confirmed with catheter coronary angiography and cardiac magnetic resonance imaging. Because of the diagnosis of peri-infarct ischemia, the patient underwent aortocoronary bypass grafting in addition to mitral valve reconstruction. CT allowed for comprehensive preoperative assessment of cardiac morphology, function, and perfusion at a low cumulative radiation dose of 4.3 mSv.
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PMID:Evaluation of cardiac morphology, function, and perfusion at low radiation dose before mitral valve surgery. 2151 59

We report a case of cardiac sarcoidosis associated with mitral valve regurgitation. A 62-year-old woman with cardiac sarcoidosis was admitted for the treatment of an intractable mitral regurgitation. She had been treated for cardiac sarcoidosis with prednisolone, and she had undergone pacemaker implantation because of advanced complete A-V block 5 years before. However, her hemodynamics deteriorated, and echocardiography revealed severe functional mitral regurgitation, thinning of the ventricular septum, and left ventricular dysfunction. The patient underwent mitral valve replacement with a mechanical prosthetic valve, and her postoperative course was uneventful. She is currently well without exacerbation of heart failure at 2 years after operation. Functional mitral regurgitation is a relatively common complication in patients with cardiac sarcoidosis. Mitral valve replacement should be considered in patients with medically intractable mitral valve dysfunction due to cardiac sarcoidosis.
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PMID:[Successful mitral valve replacement in a patient with functional mitral regurgitation induced by cardiac sarcoidosis;report of a case]. 2574 60

The surgical treatment of mitral valve disease in children is a challenging problem. Mitral stenosis and regurgitation may occur in isolation or together. Mitral valve repair is almost always preferable to replacement. Mitral valve replacement is not an ideal alternative to repair due to limitations of size, growth, structural valve degeneration, anticoagulation and poor survival. Surgical repair of congenital mitral stenosis must address the multiple levels of obstruction, including resection of the supramitral ring, thinning of leaflets and mobilization of the subvalvular apparatus. Sometimes leaflet augmentation is required. Repair of mitral regurgitation in children may involve simple cleft closures, edge-to-edge repairs, triangular resections and annuloplasties. Techniques used in adults, such as annuloplasty bands or artificial chords, may not be appropriate for children. Overall, an imperfect mitral valve repair may be more acceptable than the negative consequences of a replacement in a child.
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PMID:Valve reconstruction for congenital mitral valve disease. 2601 93


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