Left Displacement Research Articles

Deficits in the Provision of Cardiopulmonary Resuscitation During Simulated Obstetric Crises

Objective Previous work suggests the potential for suboptimal cardiopulmonary resuscitation (CPR) in the parturient but did not directly assess actual performance. Study Design We evaluated 18 videotaped simulations of maternal amniotic fluid embolus and resultant cardiac arrest. A checklist containing 10 current American Heart Association recommendations for advanced cardiac life support (ACLS) in obstetric patients was utilized. We evaluated which tasks were completed correctly and the time required to perform key actions. Results Proper compressions were delivered by our teams 56% of the time and ventilations 50% of the time. Critical interventions such as left uterine displacement and placing a firm back support prior to compressions were frequently neglected (in 44% and 22% of cases, respectively). The mean ± SD overall composite score for the tasks was 45 ± 12% (range, 20–60%). The neonatal team was called in a median (interquartile range) of 1:42 (0:44-2:18) minutes:seconds; 15 of 18 (83%) teams called only after the patient was completely unresponsive. Fifty percent of teams did not provide basic information to the neonatal teams as required by neonatal resuscitation provider guidelines. Conclusion Multiple deficits were noted in the provision of CPR to parturients during simulated arrests, despite current ACLS certification for all participants. Current requirements for ACLS certification and training for obstetric staff may require revision.

Effective management of intracranial haemorrhage with continuous infusion of highly purified von Willebrand factor/factor VIII complex concentrate in an adult with severe haemophilia A.

Effective management of intracranial haemorrhage with continuous infusion of highly purified von Willebrand factor/factor VIII complex concentrate in an adult with severe haemophilia A.

Reliability of an Analysis Method for Measuring Diaphragm Excursion by Means of Direct Visualization with Videofluoroscopy

Objective The purpose of this study was to verify the reproducibility between two different observers of an analysis method for diaphragmatic displacement measurements using direct visualization with videofluoroscopy. Patients and methods 29 mouth breathing children aged 5–12 years from both genders were analyzed. The diaphragmatic displacement evaluation was divided in three parts: videofluoroscopy with VHS recording in standing, sitting, and dorsal positions; digitalization of the images; and measurement of the distance between diaphragmatic domes during a breathing cycle using Adobe Photoshop 5.5 and Adobe Premiere PRO 6.5 software. Results The intraclass correlation coefficients presented excellent reproducibility in all positions, with coefficients always above 0.94. Mean of the measurements of the diaphagramatic domes displacement done by the two observers were similar ( P < .05), with the exception of right diaphragmatic displacement in the seated position and left diaphragmatic displacement in the standing position ( P < .05). Conclusion This study demonstrated that the evaluation of diaphragmatic displacement via videofluoroscopy is a reproducible measurement when two trained investigators are compared. This fact indicates that the present technique can be disseminated and performed by other healthcare professionals.

Case Scenario: Anesthesia for Maternal-Fetal Surgery

Case Scenario: Anesthesia for Maternal-Fetal Surgery

Evaluation of portal blood flow using transcutaneous and intraoperative Doppler ultrasonography in dairy cows with fatty liver

The objective of the study was to investigate portal blood flow (PBF) in dairy cows with fatty liver by means of Doppler ultrasonography. Eighty lactating German Holstein cows less than 100 d in milk were used (mean ± standard error of the mean; body weight: 583±9kg, age: 5±0.2 yr, withers height: 145.4±0.5cm, milk yield: 9±0.6kg). All cows had left abomasal displacement and underwent omentopexy via right flank laparotomy. The size of the liver and the thickness over the portal vein were determined ultrasonographically. Doppler ultrasonographic examinations of PBF were carried out transcutaneously and intraoperatively directly via liver surface. The PBF velocities [peak maximum (vmax), peak minimum (vmin), and mean maximum (vmean) velocity] were recorded. Venous pulsatility index (VPI) was calculated. Because transcutaneous Doppler ultrasonography revealed images of very poor quality in 58 of the 80 cows, only data obtained intraoperatively were presented. Liver biopsies were used for hepatic triacylglycerol (TAG) determination and histological examination. Based on histopathologic and ultrasonographic examinations, none of the cows suffered from hepatic disorders other than hepatic lipidosis. Hepatic TAG content ranged from 5 to 292mg/g of liver fresh weight (FW). Cows were allocated to 1 of 4 groups according to their hepatic TAG content (very severe: TAG >150mg/g of FW, n=27; severe: >100–150mg/g of FW, n=18; moderate: ≥50–100mg/g of FW, n=19; mild: <50mg/g of FW, n=16). The VPI decreased with increasing TAG content (r=−0.55). The VPI did not differ between cows with severe and very severe fatty liver but it differed between cows of these 2 groups and cows with mild and moderate fatty liver. Velocities of PBF (vmean, vmin, vmax) correlated negatively with hepatic TAG content (r=−0.26 to −0.37). Mean PBF velocity of the cows with very severe fatty liver differed from cows with severe, moderate, and mild fatty liver. Variables of PBF were inversely related to hepatic size and thickness (r=−0.06 to −0.35). In conclusion, the lower VPI and PBF velocities in cows with fatty liver and the negative correlations with the degree of hepatosteatosis may be explained by a reduction of vascular compliance in the liver because of fatty infiltration. These changes, which are believed to result from parenchymal swelling, were particularly pronounced when hepatic TAG content exceeded 150mg/g FW.

Clinical evaluation of serum alcohol dehydrogenase activity in horses with acute intestinal obstruction

To measure serum alcohol dehydrogenase (ADH) activity in horses with acute intestinal obstruction and to determine the diagnostic and prognostic utility of this analyte. Prospective observational study. University Veterinary Hospital. Thirty healthy horses (control group) and 77 horses with acute intestinal obstruction, including 36 horses with nonstrangulating obstruction (23 with left ventral colon impaction and 13 with left dorsal displacement [G1], 22 with small intestinal strangulation [G2], and 19 with colon torsion [G3]). Serum ADH activity was assayed spectrophotometerically in all horses. Serum lactate concentration and hepatic enzyme (aspartate aminotransferase, gamma-glutamyl transferase, glutamate dehydrogenase) activities were measured using an automatic analyzer. The median [interquartile range] serum ADH activity in healthy horses was 10.5 [8.7-11 U/L]. ADH activity was significantly increased (P<0.05) in G1=16.5 [13.8-18 U/L], G2=40 [20-74.9 U/L], and G3=63.2 [40-78 U/L] compared with healthy controls. Aspartate aminotransferase and glutamate dehydrogenase activities were also significantly increased in G3 in comparison with controls. ADH activity was correlated with serum lactate concentration in G1 and G3, respectively (P<0.01, r=0.55 and 0.8). Other liver enzymes did not show any significant correlation with lactate. ADH activity was directly related to the probability of strangulation; odds ratio=1.11. ADH activity >20 U/L had 80.6% specificity and 80.5% sensitivity for discriminating horses with strangulating obstruction. Twelve horses euthanized before surgery were excluded from the outcome analysis. Increasing ADH activity was associated with nonsurvival; odds ratio=1.03. ADH activity <80 U/L had 94.44% specificity and 66.67% sensitivity for survival. Serum ADH activity may be a useful clinical parameter in detecting intestinal strangulation in horses and may provide some prognostic value in horses with acute intestinal obstruction.

Fiabilidad de un método de análisis para medir el desplazamiento del diafragma mediante visualización directa con videofluoroscopia

ObjectiveThe purpose of this study was to verify the reproducibility between two different observers of an analysis method for diaphragmatic displacement measurements using direct visualization with videofluoroscopy. Patients and methods29 mouth breathing children aged 5 to 12years from both genders were analyzed. The diaphragmatic displacement evaluation was divided in three parts: videofluoroscopy with VHS recording in standing, sitting, and dorsal positions; digitalization of the images; and measurement of the distance between diaphragmatic domes during a breathing cycle using Adobe Photoshop 5.5 and Adobe Premiere PRO 6.5 software. ResultsThe intraclass correlation coefficients presented excellent reproducibility in all positions, with coefficients always above 0.94. Mean of the measurements of the diaphagramatic domes displacement done by the two observers were similar (P<.05), with the exception of right diaphragmatic displacement in the seated position and left diaphragmatic displacement in the standing position (P<.05). ConclusionThis study demonstrated that the evaluation of diaphragmatic displacement via videofluoroscopy is a reproducible measurement when two trained investigators are compared. This fact indicates that the present technique can be disseminated and performed by other healthcare professionals.

Teaching Video Neuro Images : Vestibular neuritis

A 48-year-old man presented with vertigo, unsteadiness, nausea, and vomiting that developed subacutely when he was at work. Hearing was preserved. Apart from left displacement during the Fukuda stepping test, nothing relevant was found through neurologic examination (see video on the Neurology ® Web site at …

Quantification of Left Ventricular Longitudinal Strain, Strain Rate, Velocity, and Displacement in Healthy Horses by 2‐Dimensional Speckle Tracking

The quantification of equine left ventricular (LV) function is generally limited to short-axis M-mode measurements. However, LV deformation is 3-dimensional (3D) and consists of longitudinal shortening, circumferential shortening, and radial thickening. In human medicine, longitudinal motion is the best marker of subtle myocardial dysfunction. To evaluate the feasibility and reliability of 2-dimensional speckle tracking (2DST) for quantifying equine LV longitudinal function. Ten healthy untrained trotter horses; 9.6 ± 4.4 years; 509 ± 58 kg. Prospective study. Repeated echocardiographic examinations were performed by 2 observers from a modified 4-chamber view. Global, segmental, and averaged peak values and timing of longitudinal strain (SL), strain rate (SrL), velocity (VL), and displacement (DL) were measured in 4 LV wall segments. The inter- and intraobserver within- and between-day variability was assessed by calculating the coefficients of variation for repeated measurements. 2DST analysis was feasible in each exam. The variability of peak systolic values and peak timing was low to moderate, whereas peak diastolic values showed a higher variability. Significant segmental differences were demonstrated. DL and VL presented a prominent base-to-midwall gradient. SL and SrL values were similar in all segments except the basal septal segment, which showed a significantly lower peak SL occurring about 60 ms later compared with the other segments. 2DST is a reliable technique for measuring systolic LV longitudinal motion in healthy horses. This study provides preliminary reference values, which can be used when evaluating the technique in a clinical setting.

負のエネルギーバランスを伴った第四胃左方変位乳牛の血中遊離アミノ酸濃度

負のエネルギーバランスに伴って血中β-ヒドロキシ酪酸（BHB）濃度が高くなる第四胃左方変位（LDA）牛について，アミノ酸代謝の特徴を臨床例から検討した．分娩後に発病したLDA牛24頭を対象にBHB濃度 に基づいてABHB群（BHB濃度1.2mmol/ℓ未満，10頭）とHBHB群（BHB濃度1.2mmol/ℓ以上，14頭）の2群に区分して，それぞれの血中遊離アミノ酸（FAA）濃度を比較した．その結果，HBHB群ではバリン，ロイシン，イソロイシンの有意な高値と，アラニン，セリンの有意な低値が観察された．これらの成績から，負のエネルギーバランスを伴ったLDA牛におけるFAA濃度の動態は，エネルギーの著しい不足に対応した体蛋白質の異化亢進に基づいた変化を表しているものと考えられた．

Macromineral status of dairy cows with concurrent left abomasal displacement and fatty liver

AIM: To evaluate the macromineral status of field cases of dairy cows surgically treated for left abomasal displacement (LDA), with concurrent fatty liver of different severity, and compare this for animals that died or recovered. METHODS: Sixty-eight Holstein dairy cows with LDA and 110 control cows, from 28 farms, were used in the study. Blood samples and liver biopsies were obtained during standing surgery for correction of LDA, and from control cows. The concentration of macrominerals in serum, and of total lipids (tLPD) and triglycerides (TG) in liver were determined. Liver was examined histologically, and classified for its severity of fatty liver. Cows with LDA were grouped according to severity of fatty liver. Cows in Groups 1 to 3 recovered, whereas those in Group 4 died within 4 weeks of surgery. Group 1=mild (n=4) or moderate (n=6 cows, n=4 heifers) fatty liver, Group 2 = moderate to severe fatty liver (n=13), Group 3=severe fatty liver (n=15 cows, n=5 heifers), Group 4 = severe fatty liver (n=17 cows, n=4 heifers). RESULTS: The concentration of macrominerals in serum was affected by the concurrence of fatty liver and LDA; Ca, K and Mg were significantly (p<0.05) lower in animals that died than those that survived. For cows with severe fatty liver, concentrations of tLD and TG were higher in the animals that died compared with those that recovered (p<0.01). Cows with LDA and severe fatty liver that died were earlier in lactation (median days in milk (DIM) 13 days) compared with the other cows with LDA (median DIM 21–26 days) (p<0.05); they were also significantly older (median 6 years old) than cows in the other groups (median 4 or 5 years old) (p–0.05). CONCLUSIONS AND CLINICAL RELEVANCE: Concentrations of macrominerals in serum were influenced by the concurrence of LDA and fatty liver. Animals with low concentrations of Ca, K and Mg had a guarded prognosis. The concentration of K should always be evaluated in cows with LDA and concurrent fatty liver when providing a prognosis. Most cows with severe fatty liver were detected in the first 4 weeks of lactation, but older animals and those that had more recently calved had a worse prognosis.

Leucoencefalopatia multifocal progressiva e paracoccidioidomicose disseminada em paciente com AIDS

A 39-year-old man with a previous diagnosis of acquired immunodeficiency syndrome (AIDS) was admitted to hospital with a 2-week history of fever, weight loss, headache, diplopia and confusion. His last CD4 + count was of 9 cells/mm 3 . Physical examination revealed painful and enlarged cervical, axillary and inguinal lymph nodes and ptosis of the left eyelid. Magnetic resonance (MR) showed a tumoral lesion in the cavernous sinus with a left internal carotid artery displacement (Figure A). MR also revealed another bilateral cerebral lesion suggestive of progressive multifocal leukoencephalopathy surrounding the third ventricle (Figure B). A cervical lymph node biopsy showed numerous leveduriform structures of Paracoccidioid es brasiliensis (Figure C). He was treated with conventional amphotericin B for 36 days followed by itraconazole for 21 days with a slow and progressive recovery. Just before dismissal he was started on HAART (tenofovir, lamivudine, efavirenz). Four months later, at the outpatient clinic, he was asymptomatic.

Echocardiographic study of left ventricular 3-dimension displacement during different ventricular pacing in vivo:a canine model

Objective To evaluate the changes of left ventricular(LV) 3-dimension peak displacement (3D-D) during different cardiac pacing patterns. To provide a reliable mechanical data base for the optimization cardiac pacing. Methods Cardiac pacings in open-chest Beagle canine models( n = 10) were performed using three patterns[I, e. , right ventricular apical pacing (RVA-P), LV lateral pacing (LVL-P)and LV apical pacing(LVA-P)],3D full volumetric real-time imaging were acquired in a completed cardiac cycle. The 3D-D,3D-D peak time (3D-DTc) and the standard deviation of TC(3D-DTSD) were calculated and analyzed in different pacing patterns for difference and spatial correlationship. Results ① The 3D-D of LVL-P and LVA-P state decreased compared with BASE and RVA-P state, there were significant 3D-D difference of mid anterior,mid anteriorspetal, mid interior,mid posterior, mid lateral between LVL-P and BASE, RVA-P patterns( P ＜0.05). There were significant 3D-D difference of mid anterior,mid lateral,mid posterior between LVA-P and RVA-P patterns groups( P ＜0.05). There were significant 3D-D difference of all segments in apical level between LVL-P,LVA-P and BASE, RVA-P states( P ＜0.05). ② Corrected by the heart rate,the 3D-DTC of different cardiac pacing patterns were shorter than BASE state. ③ There were no significant 3D-DTSD difference between different cardiac pacings and BASE patterns. There were significant 3D-DTSD difference between RVA-P and LVA-P patterns (P ＜ 0.05). Conclusions LV mechanical activation and synchronization could be maintained during RVA-P rather than LVA-P and LVL-P. Echocardiographic study of left ventricular 3D-D can actually reveal myocardial mechanical state during different cardiac pacings and BASE patterns. Key words: Echocardiography; three-dimensional; Cardiac pacing, artificial; Ventricular function, left

Carina Angle Measurements for Diagnosis of Patent Ductus Arteriosus in Preterm Infants

Background: Bedside diagnosis of patent ductus arteriosus (PDA) continues to be important, especially when echocardiography is not readily available. Objective: The aim of our study was to evaluate whether measurement of left main bronchus displacement portrayed on a chest X-ray as a widened carina angle (CA) may support the presumptive diagnosis of PDA. Methods: Displacement of the left bronchus was assessed by measuring the angle between the two main bronchi at the level of the carina in 47 infants with PDA and 73 with no evidence of ductus, all born before 32 weeks of gestation. Results: The PDA group had a significantly wider CA (99.9 ± 12.1°) compared to the no-ductus group (72.9 ±15.7°; p < 0.001). Resolution of the PDA resulted in closure of the CA (62.3 ± 10.8°). We observed a significant and positive association between an increased CA measurement and PDA occurrence (OR = 1.7, 95% CI = 1.4–2.1). A CA cutoff point of 90° had the highest sensitivity (85%) and specificity (85%) for indicating the presence of PDA. Conclusions: Measurement of the CA is an easily accessible and reliable tool that may assist in establishing the diagnosis of PDA.

Impact of diabetes and hypertension on left ventricular longitudinal systolic function

Background The assessment of the longitudinal component of left ventricular (LV) function is of major clinical importance for the early detection of LV contractile impairment. The aim of this study was to compare the impact of isolated type-2 diabetes, isolated hypertension, and co-existence of both on LV longitudinal systolic performance, with particular focus on their potential interaction effect. Methods The study population included 163 consecutive patients: 84 patients with hypertension, 36 with diabetes, and 43 who have both hypertension and diabetes; 70 healthy controls were also recruited. Systolic mitral annulus velocity ( S m) by Tissue Doppler and left atrioventricular plane displacement (AVPD) by M-mode were measured in all subjects. Results AVPD was similarly reduced in hypertensives (13.2 ± 2.2 mm) and diabetics (13.5 ± 2.3 mm) when compared with the controls (15.1 ± 2.4 mm), and further depressed in diabetic hypertensives (11.5 ± 3.0 mm). Similar results were found for S m. General linear model analysis revealed no significant interaction terms between diabetes and hypertension. Conclusions Normotensive diabetics and nondiabetic hypertensives show comparable depression in LV longitudinal systolic indices when compared with age- and gender-matched healthy controls; the co-existence of diabetes and hypertension leads to further impairment in LV longitudinal systolic function in an additive manner.

Rupture of the mesocolon as a cause of recurrent colic in a showjumper mare

SummaryAn 11‐year‐old Italian Saddlebred showjumper mare was referred for investigation of recurrent colic. The mare had undergone surgery for left dorsal displacement of the ascending colon 5 years previously and had subsequently experienced several episodes of colic that had responded to medical treatment. Due to deterioration of the mare's clinical condition in the last episode, characterised by unrelenting pain and worsening of the cardiovascular parameters, the mare underwent repeat surgery for suspected colonic displacement. Exploratory laparotomy revealed a complete rupture of the mesocolon of the ascending colon. The mesocolon was repaired and the mare recovered uneventfully. She returned to training and competition and only a single episode of mild transient colic was recorded in the follow‐up.

Echocardiographic Effects of Changing Atrioventricular Delay in Cardiac Resynchronization Therapy Based on Displacement

In studies showing benefits of cardiac resynchronization therapy (CRT), individual atrioventricular (AV) delays have been optimized using echocardiography. However, the method for AV delay optimization remains controversial. In 100 consecutive patients with CRT device implantation, AV delay was optimized using echocardiography. The optimal AV delay was determined by changing the interval in 20-ms increments while measuring displacement in 6 basal left ventricular segments (averaged and reported as left ventricular displacement [D(LV)]) and other echocardiographic measures. A single optimal AV delay existed for each patient, and the associated highest D(LV) corresponded with the maximal velocity-time integral (VTI) in the left ventricular outflow tract (VTI(LVOT)) and the E/e' ratio. Significant increases in D(LV) and the VTI(LVOT) from before to after implantation with standard settings and from standard to optimal AV delay by displacement were found. Diastolic filling time corresponded poorly with D(LV) and the VTI(LVOT). Individual optimal AV delay programming provides significant improvement in left ventricular performance and hemodynamics. Displacement analysis and the VTI(LVOT) are interchangeable, whereas diastolic filling time cannot be recommended.

Fatores de risco, achados clínicos, laboratoriais e avaliação terapêutica em 36 bovinos com deslocamento de abomaso

A contínua seleção genética para maior produção de leite em conjunto com o aumento da capacidade digestiva e profundidade corporal aumentou a susceptibilidade à ocorrência de abomasopatias, incluindo o deslocamento do abomaso. Este trabalho objetivou realizar um estudo retrospectivo sobre o deslocamento de abomaso em 36 bovinos atendidos na Clínica de Bovinos, Campus Garanhuns da Universidade Federal Rural de Pernambuco, durante o período de janeiro de 2000 a fevereiro de 2009. Foram diagnosticados 27 casos de deslocamento do abomaso à direita, seis casos de deslocamento do abomaso à esquerda e três casos de vólvulo abomasal. Onze casos considerados moderados, sem grave distensão abdominal, apetite presente para a forragem e delimitação de som metálico até o 8º espaço intercostal, foram tratados clinicamente; enquanto 20 casos com distensão abdominal moderada a severa, associada a distúrbios sistêmicos, foram considerados graves e tratados cirurgicamente. Duas vacas foram eutanasiadas devido peritonite difusa ou alterações graves na serosa do abomaso, totalizando 18 animais submetidos ao tratamento cirúrgico. Dois animais foram encaminhados para abate e três vacas chegaram prostradas e morreram sem receber nenhum tratamento. A análise dos fatores de risco identificou a estação chuvosa como estatisticamente significativa. O maior número de deslocamento do abomaso ocorreu em vacas mestiças com 24 casos (66,6%), seguida por bovinos da raça Holandesa com 11 (30,5%) e Gir com um (2,9%) caso. A composição da alimentação oferecida variou bastante e caracterizou-se por conter excesso de carboidratos e, na maioria dos casos, fibra de baixa qualidade. Os sinais clínicos mais frequentes foram comportamento apático, desidratação, timpanismo ruminal leve a severo com motilidade ausente ou diminuída, som de líquido ao balotamento do flanco direito, som de chapinhar metálico e/ou observação de uma estrutura similar a uma víscera distendida no gradil costal do lado correspondente ao deslocamento; fezes liquefeitas, enegrecidas e de odor fétido. Os achados hematológicos revelaram, na maioria dos casos, leucocitose neutrofílica e hiperfibrinogenemia. Na análise do fluido ruminal havia comprometimento da dinâmica da flora e fauna microbiana, e elevação no teor de cloreto em 93,9% dos casos, com o índice médio alcançando 47,66 mEq/L. O índice de recuperação clínica e cirúrgica alcançou 100% e 72,2%, respectivamente. As condutas descritas são opções viáveis para o tratamento dos deslocamentos leves e severos, no entanto a prevenção permanece a melhor alternativa a ser adotada.

Deficits in the provision of cardiopulmonary resuscitation during simulated obstetric crises

Previous work suggests the potential for suboptimal cardiopulmonary resuscitation (CPR) in the parturient but did not directly assess actual performance. We evaluated 18 videotaped simulations of maternal amniotic fluid embolus and resultant cardiac arrest. A checklist containing 10 current American Heart Association recommendations for advanced cardiac life support (ACLS) in obstetric patients was utilized. We evaluated which tasks were completed correctly and the time required to perform key actions. Proper compressions were delivered by our teams 56% of the time and ventilations 50% of the time. Critical interventions such as left uterine displacement and placing a firm back support prior to compressions were frequently neglected (in 44% and 22% of cases, respectively). The mean +/- SD overall composite score for the tasks was 45 +/- 12% (range, 20-60%). The neonatal team was called in a median (interquartile range) of 1:42 (0:44-2:18) minutes:seconds; 15 of 18 (83%) teams called only after the patient was completely unresponsive. Fifty percent of teams did not provide basic information to the neonatal teams as required by neonatal resuscitation provider guidelines. Multiple deficits were noted in the provision of CPR to parturients during simulated arrests, despite current ACLS certification for all participants. Current requirements for ACLS certification and training for obstetric staff may require revision.

Improvement of systolic and diastolic heart function after physical training in sedentary women

The present study examined the cardiac effects of football training and running for inactive pre-menopausal women by standard echocardiography and tissue Doppler imaging. Thirty-seven subjects were randomized to two training groups (football: FG; n=19; running; RG; n=18) training 1 h with equal average heart rates twice a week for 16 weeks and compared with a matched inactive control group (CG; n=10). During the training period, left ventricular end-diastolic volume increased by 13% in FG and 11% in RG (P<0.05). Left ventricular posterior wall thickness increased in FG from 8.5+/-1.4 to 9.0+/-1.3 mm (P<0.05). Right ventricle diameter increased by 12% in FG and 10% in RG (P<0.05). Tissue Doppler imaging demonstrated increased left ventricular systolic and diastolic performances in both training groups. Peak systolic velocity increased by 26% in FG and 17% in RG (P<0.05) and left ventricular longitudinal displacement increased in both groups by 13% (P<0.05). Isovolumetric relaxation time decreased significantly more in FG than in RG (26% vs 14%, respectively P<0.05). In conclusion, 16 weeks of football and running exercise training induced significant changes of cardiac dimensions and had favorable effects on both left ventricular systolic and diastolic function. These training-induced cardiac adaptations appeared to be more consistent after football training compared with running.