Follow-up Of Ventricular Function Research Articles

Assessment of left ventricular systolic and diastolic functions in severely malnourished children

BackgroundMalnourished children endure many changes in body composition and lose heart and skeletal muscle mass. Diastolic dysfunction is one of the major causes of heart failure with preserved ejection fraction.AimTo assess left ventricular systolic and diastolic functions in children with severe acute malnutrition using tissue Doppler imaging technique and to evaluate the effect of nutritional rehabilitation.Patients and MethodsA follow-up case-control study conducted on 60 severely malnourished children (WHZ < -3SD) and 120 age and sex-matched healthy children as a control group. Tissue Doppler imaging (TDI) was done for all included malnourished children at admission and for control to measure left ventricular systolic and diastolic functions. Nutritional rehabilitation was done according to WHO protocol and tissue doppler was repeated after rehabilitation when (WHZ > -2SD) to detect any changes in systolic or diastolic functions.ResultsSystolic function was normal in malnourished children and control. Grade I diastolic dysfunction was detected in 40% and grade II in 30% of severely malnourished children in comparison to 100% normal diastolic function in control group. No correlations between diastolic dysfunction and either anthropometric measurements, electrolyte disturbances or Hb% in malnourished children before nutritional rehabilitation. Mortality from sepsis with associated ventricular dysfunction grade II documented in 3.3% of malnourished children. After nutritional rehabilitation diastolic function improved significantly as 65.6% of children attained normal diastolic function, 31% grade1 and 3.4% grade II. Positive correlations between diastolic function and WAZ, HAZ, WHZ and MUAC after rehabilitation.ConclusionSevere acute malnutrition affects diastolic function in children which is reversible in most of these cases with rehabilitation. TDI is an easy and practical method for detection and follow-up of ventricular function in malnourished children.

Assessment of left ventricular systolic and diastolic functions in severely malnourished children

BackgroundMalnourished children endure many changes in body composition and lose heart and skeletal muscle mass. Diastolic dysfunction is one of the major causes of heart failure with preserved ejection fraction. AimTo assess left ventricular systolic and diastolic functions in children with severe acute malnutrition using tissue Doppler imaging technique and to evaluate the effect of nutritional rehabilitation. Patients and MethodsA follow-up case-control study conducted on 60 severely malnourished children (WHZ < -3SD) and 120 age and sex-matched healthy children as a control group. Tissue Doppler imaging (TDI) was done for all included malnourished children at admission and for control to measure left ventricular systolic and diastolic functions. Nutritional rehabilitation was done according to WHO protocol and tissue doppler was repeated after rehabilitation when (WHZ > -2SD) to detect any changes in systolic or diastolic functions. ResultsSystolic function was normal in malnourished children and control. Grade I diastolic dysfunction was detected in 40% and grade II in 30% of severely malnourished children in comparison to 100% normal diastolic function in control group. No correlations between diastolic dysfunction and either anthropometric measurements, electrolyte disturbances or Hb% in malnourished children before nutritional rehabilitation. Mortality from sepsis with associated ventricular dysfunction grade II documented in 3.3% of malnourished children. After nutritional rehabilitation diastolic function improved significantly as 65.6% of children attained normal diastolic function, 31% grade1 and 3.4% grade II. Positive correlations between diastolic function and WAZ, HAZ, WHZ and MUAC after rehabilitation. ConclusionSevere acute malnutrition affects diastolic function in children which is reversible in most of these cases with rehabilitation. TDI is an easy and practical method for detection and follow-up of ventricular function in malnourished children.

533 Study of the echocardiographic predictors for 10-year survival after thrombolytic therapy of acute myocardial infarction

s S87 Eur J Echocardiography Abstracts Supplement, December 2006 Results: Pts were divided in two groups: group I pts with FT 202 pts (26%), group II without FT 558 (74%). Left ventricle thrombi were found in 16 pts (8%) of group I and in 39 pts of group II (7%) p>0.05. In 6 pts of group I the thrombi were localized or connected to false tendon. These group of pts was treated by thrombolitics, had extensive antero-lateral MI (E?35%) and FT localized in the region of MI. Two patients of group I and 1 of group II had neurological ischemic stroke. As well we analyze frequency of thrombi occurrence dependency of therapy: PCI or thrombolitic. In group of 582 pts treated by PCI we observed thrombus in 23 (4%) cases, in 178 pts treated by thrombolitic therapy thrombi were found in 32 (18%) pts p 90 ms, E/A≤1.04, DT>150 ms). HRV indices and arrhythmic events were evaluated by 24 hour Holter monitoring (view Table; M±SD; *p <0.05). Time and frequency domain HRV indices were significantly reduced in patients with restrictive LV filling patterns compared to those with impaired LV relaxation. Early postinfarction patients with restrictive LV filling showed increased frequency of ventricular arrhythmias during the day. These findings reflect more expressed autonomous nervous imbalance and may predict higher mortality in these patients. Table 1. Correlation: HRV and LV filling patterns HRV indices and Abnormal LV relaxation Restrictive LV filling arrhythmic events (n=144) (n=57) SDNN, msec 115.8±5.48 94.03±2.34 * SDANN, msec 75.9±2.32 61. 8 ±1.47 * SDNN index, msec 51.2±3.61 50.07±l.03,n/s RMSSD, msec 27.0±2.19 22.5±1.26 * PNN50, % 7.1 ±1,38 8.1±0.91* LF, msec2 494.8±23.27 3 89.55±10.45* HF, msec2 9 3.1±7.26 7 9.66±4.86 * LF/HF 5.95±2.7 6.46±2.8* VPB, per day 45.4±10.61 70.14±26.97 * VPB pair, per day 3.02±0.84 5.04±1.76* VT, episodes per day 0.12±0.47 0.34±0.47* Heart Rate, beats/min. 65.0±2.28 79.45±1.66* VPB ventricular premature beats, VT ventricular tachicardia episode 535 Serial echocardiographical follow-up of ventricular function in patients with reperfusion for ST-elevation myocardial infarction correlations with BNP M. Dorobantu 1 ; A.G. Fruntelata 1 ; R. Onut 1 ; A. Scafa-Udriste 1 ; D. Constantinescu 1 ; M. Marinescu 1 ; A. Vasile 1 ; A. Alexandrescu 1 1Emergency Hospital of Bucharest, Cardiology Dept., Bucharest, Romania Background: Echocardiographical assessment of left ventricular ejection fraction and wall motion score index and also of ventricular long axis function, diastolic dysfunction and post-infarction remodeling is crucial for risk stratification in patients with ST-elevation myocardial infarction (STEMI). In this population, elevated brain natriuretic peptide (BNP) levels were significantly associated with adverse outcome beyond left ventricular ejection fraction (LVEF) and identified patients with survival benefit from early invasive strategy. However, correlations of BNP levels to echocardiographical measurements of ventricular function by serial follow-up to predict risk of future clinical events have not been

535 Serial echocardiographical follow-up of ventricular function in patients with reperfusion for ST-elevation myocardial infarction -correlations with BNP

535 Serial echocardiographical follow-up of ventricular function in patients with reperfusion for ST-elevation myocardial infarction -correlations with BNP

Ressonância magnética é útil em valvopatia

Reperfusion injury, hemodynamics, blood volume.conformation, it shows low intra- and interobserver variability and allows right ventricle quantification, a chamber usually difficult to access on echocardiograms. These qualities are the CMR’s calling card for inclusion in the follow-up of ventricular function and mass of patients with valvular heart disease (such as aortic stenosis), as well as for functional comparison after surgical intervention. Velocity-encoded cine-MRI allows the assessment of blood flow velocity across a cardiac vessel or valve. It is equivalent to Doppler echocardiography, but offers the advantage of accessing blood flows in any orientation without being limited by an acoustic window. Using the modified Bernoulli equation, it is possible also to derive transvalvular pressure gradient. One of the cardiologist’s biggest concerns is that of CMR safety in patients with a mechanical prosthetic valve. It is well established that it is safe to expose a patient with this type of prosthesis to the magnetic fields generally used on CMR (1.5 Tesla). The magnetic force acting on the material is too weak compared to that imposed by the surgical attachment of the prosthesis. On the other hand, these prostheses produce artifacts of signal void (dark area on the MRI image), because the magnetic field becomes distorted by the metallic content. These artifacts often extend to the surrounding structures, depending on the pulse sequence used (this is usually less marked in spin-echo sequences). Consequently, the evaluation of turbulent jets, especially those of lower magnitude, is compromised. With bioprostheses, this effect is usually restricted to the valve annulus and does not interfere significantly in the MRI interpretation.Described around six years ago, the delayed-enhanced technique consists in acquiring images approximately 10 to 20 minutes after the intravenous injection of a contrast medium (gadolinium) preceded by an inversion-recovery pulse6. In addition to allowing the visualization of minimal areas of myocardial necrosis/fibrosis, this technique shows excellent correlation with the pathological anatomy in several heart diseases