Left Heart Volume Research Articles

Left heart volume and mass quantification in children with left ventricular pressure overload.

This investigation was designed to quantify left ventricular and left atrial volume, volume change, systolic output, and ventricular mass in 31 patients with isolated left ventricular pressure overload secondary to aortic stenosis (AS, n = 14) or coarctation of the aorta (n = 17). These parameters were compared with normal standards and with data from a group of nine patients with a combined pressure and volume overload due to aortic stenosis plus aortic or mitral insufficiency (AS + AI or MI). Volumes were calculated from biplane cineangiocardiograms exposed at 60 frames/sec. Left ventricular end-diastolic volume (LVEDV) was significantly lower than normal in patients with AS (57 ± 11 cc/m 2 ), but was normal (73 ± 12 cc/m 2 ) in patients with coarctation. An increase in the ejection fraction (LVEF) was found in both groups averaging 0.73 ± 0.12 in AS patients and 0.69 ± 0.09 in coarctation patients. Patients with AS + aortic or mitral insufficiency (AI or MI) showed elevated LVEDV (103 ± 29 cc/m 2 ), but had a normal ejection fraction. The LV mass was significantly increased in all groups: normal, 82 ± 10 g/m 2 ; AS, 126 ± 41 g/m 2 ; coarctation, 130 ± 44 g/m 2 ; and AS + AI or MI, 168 ± 42 g/m 2 . The left ventricular systolic index and left atrial maximal volume were both normal in patients with pure pressure overload but were significantly increased in patients with combined pressure and volume overload. The low LVEDV in patients with AS as well as the normal volume in patients with coarctation occurred in the presence of elevated LV end-diastolic pressure and indicates a decrease in LV diastolic distensibility in patients responding to an isolated LV pressure overload by significant muscular hypertrophy without dilatation.

Left heart volume and mass in children following palliative and definitive surgery for ventricular septal defect

Left heart volume and mass in children following palliative and definitive surgery for ventricular septal defect

Characterization of left heart volumes and mass in normal childrenand in infants with intrinsic myocardial disease.

Quantitation of myocardial volumes, mass, and ejection fractions was performed in a group of 26 patients (10 of whom were infants less than 2 years old) with normal left ventricles and in a separate group of 13 children with intrinsic myocardial disease and clinical decompensation. All patients were studied by use of biplane cineangiocardiography, and volumes were determined by the area-length method. Left ventricular end-diastolic volume in "normal" infants below 2 years of age was 44.8 ± 8.5 cc/m 2 , and it was 71.4 ± 8.0 cc/m 2 in older normal children ( P <0.001), ages 3 to 16 years. Left ventricular ejection fraction also was different in the younger normals: 0.76 ± 0.07 versus 0.63 ± 0.05 in older normals ( P <0.001). Left ventricular mass and left atrial maximal volume were not significantly different in normal infants and older children, averaging 81.7 ± 10.0 g/m 2 and 33.6 ± 10.1 cc/m 2 , respectively. All patients in the cardiomyopathy group had significant elevations of left ventricular end-diastolic volume and mass, and the ejection fraction was reduced in all patients except one infant with severe mitral insufficiency. Five infants with chronic left ventricular failure and no mitral insufficiency had normal left atrial maximal volumes. Left atrial maximal volumes were increased significantly in six patients with myocardial disease, all of whom had mitral insufficiency. These results emphasize the potential value of the quantitative estimation of left heart volume and provide normative base-line data for left heart volume and mass parameters in both infants and children.

Left ventricular volume and volume change in endocardial fibroelastosis

Three cases are described in which the clinical and hemodynamic findings permit a diagnosis of endocardial fibroelastosis. Left heart volumes were calculated from biplane angiocardiograms. For each case, values of the fraction of end-diastolic volume ejected during systole, peak dp/dt, and “myocardial contractility index” were significantly less than those in children with normal left hearts or with congenital heart disease causing pressure or volume overload of the left ventricle. Such reduced ventricular contraction and systolic emptying will lead to an increase in chamber volume if forward flow is to be maintained. Conclusions about left ventricular volumes and volume changes cannot be made on the basis of visual inspection of angiocardiograms but require actual measurement. Increased endocardial tension results from increased chamber volume but is unlikely to be the cause of endocardial fibroelastosis since comparable values for endocardial tension are found in subjects with volume overload and no endocardial fibroelastosis.

Simplified Method for Calculating Left Ventricular Volume from Angiocardiograms

Measurement of volume and volume change of the left ventricle in man extends our understanding of the response of the heart to stress (1, 2) and may provide information of diagnostic importance. In particular, measurement of left heart volumes during the cardiac cycle permits quantitation of valvular insufficiency (3, 4) with the possibility of yielding information about myocardial function. At the present time, angiographic (5) and indicator dilution (6) technics are the only ones available for measuring the volume of a single heart chamber in man. Although the validity of quantitation by angiography has been established (7, 8), such methods have been regarded as too time-consuming for routine clinical use. The present communication describes a clinically applicable procedure for measuring left ventricular volume, based on the method of Arvidsson (5), which requires measurement of only four pairs of angiocardiograms. Methods Sixty-six subjects were studied during diagnostic cardiac catheterization. Selective angiocardiography was performed while the patient was in the supine position and under light anesthesia. Simultaneous recording of arterial pressure, electrocardiogram, and time of x-ray exposure permitted correlation of the radiographic appearances with the events of the cardiac cycle (Fig. 1). Angiocardiograms, measured to the nearest 1 mm as indicated in Figure 2, were used in this study only if they showed adequate opacification of left heart chambers during sinus rhythm. Patients with atrial fibrillation were excluded unless a reasonably regular ventricular contraction was shown during the period of filming. The volume of the left atrium (VLA) was calculated for each pair of angiocardiographic exposures by: where a, b, and c are atrial semiaxes in centimeters and j1 and f2 are the anteroposterior and lateral magnification factors, respectively, measured for each subject. The volume of the left ventricle (VLV) was calculated for each pair of angiocardiographic exposures by: where L, the true long axis of the ventricular ellipsoid is given by: in which β is the angle between the horizontal and the measured long axis, D, of the ventricular ellipsoid in the lateral projection, and A, B, and C are ventricular axes in centimeters. Composite left atrial and ventricular volume curves were constructed by plotting the volumes calculated from an angiographic pair against the time, expressed in fractions of a second, after the R wave of the electrocardiogram at which the exposures were made (4). Values for end-diastolic volume (VED) and end-systolic volume (VES) were determined from these composite volume curves. The records of arterial pressure, time of x-ray exposures, and electrocardiography were then submitted to an independent observer (R.G.G.) who picked two film pairs to represent the end-diastolic volume and two to represent end-systolic volume. For measurement of end-diastolic volume, exposures made just before the Q wave of the electrocardiogram were selected because previous experience indicated that ventricular volumes are maximal at this time. The larger of these was chosen as the end-diastolic volume.

EFFECT OF CHRONIC PRESSURE AND VOLUME OVERLOAD ON LEFT HEART VOLUMES IN SUBJECTS WITH CONGENITAL HEART DISEASE.

Left heart volumes were determined angiographically in 50 subjects of whom 18 had no abnormality of the left heart, 12 had lesions causing pressure overload of the left ventricle, and 20 had lesions causing volume overload of the left ventricle. The left heart volumes were in the normal range in the presence of pressure overload, but, with volume overload, end-diastolic, end-systolic, and atrial volumes were in excess of normal. A linear relationship was demonstrated between end-diastolic and end-systolic volumes, regardless of the pressure load on the ventricle. Thus, for all but one of the cases studied, total left ventricular ejection volume formed a nearly constant proportion of end-diastolic volume.

ISOLATED CONGENITAL MITRAL INSUFFICIENCY WITH PARTICULAR REFERENCE TO LEFT HEART VOLUMES.

Clinical, hemodynamic, and angiocardiographic findings are described in seven cases of congenital mitral insufficiency. The volumes and changes in volume of the left atrium and left ventricle were calculated from the angiocardiograms and were found to be increased above the range of normal. Left ventricular stroke volumes thus obtained were compared with forward flows calculated from indicatordilution curves in order to quantitate regurgitant flow. Regurgitant flows varied between 19 and 94 per cent of the total left ventricular ejection volume, and forward flow was maintained as a result of a considerable increase in left ventricular volume. The left ventricular ejection volume was 50 to 64 per cent of the end-diastolic volume.

Clinical estimation of the volumes of blood in the right heart, left heart, and lungs by use of I 131 albumin

1. 1. An external isotope method for estimating intracardiac and pulmonary blood volumes has been studied in 41 subjects with and without cardiac disease. 2. 2. Intracardiac blood volume estimated from radioactivity of the cardiac area 10 minutes after intravenous injection of 100 μc of I 131 albumin averaged 345 ± 55 ml./M. 2 in 16 subjects without heart disease. 3. 3. In general, intracardiac blood volume was proportional to the size of the heart shadow; but there was slightly less blood in relation to the size of the heart in subjects with cardiac hypertrophy. In 2 persons with pericardial effusion the intracardiac blood volumes were approximately 500 ml. less than would have been expected from the size of the cardiac shadow, suggesting an area of diagnostic usefulness for this technique. 4. 4. By dividing the curve of precordial radioactivity during the first circulation of the isotope into the right and left heart components, the portion of the intracardiac blood in each side of the heart and the pulmonary blood volume were estimated. 5. 5. The right heart volume in subjects without heart disease was 170 ± 25 ml./M. 2, and the left heart volume was 185 ± 50 ml./M. 2. 6. 6. In normal subjects, pulmonary blood volume was 490 ± 130 ml./M. 2. Similar results were obtained in subjects with mitral stensos and with other forms of heart disease. 7. 7. The isotope methods used in the present studies contain important technical defects. Accurate and reliable techniques will require further development of instrumentation and procedure.

Left-heart volumes in coarctation of the aorta

Arvidsson's method of estimating volumes of the left-heart chambers by angiocardiographic techniques has been found to be practical in application. The method has been applied in 10 studies of seven patients with compensated coarctation of the aorta. Left ventricular stroke volumes were found to average 46 ml./M. 2 (range, 34 to 59), and the end-systolic volume in the left ventricle to average 19 ml./M. 2 (range, 10 to 30). This evidence indicates that left ventricular ejection is highly efficient. Changes in left atrial stroke volume were much less marked, averaging only 15 ml./M. 2 (range, 10 to 21) during any cardiac cycle. No significant differences in changes of left-heart volume were found in three patients who were studied both before and 4 to 5 years after surgical correction of the coarctation.

Determination of human body surface area from height and weight.

ARTICLESDetermination of Human Body Surface Area From Height and WeightJulius Sendroy JR., and Louis P. CecchiniJulius Sendroy JR., and Louis P. CecchiniPublished Online:01 Jul 1954https://doi.org/10.1152/jappl.1954.7.1.1MoreSectionsPDF (2 MB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat Back to Top Next Download PDF FiguresReferencesRelatedInformation Cited ByPassende Verordnungsmenge und Applikation von Topika15 December 2017 | Der Hautarzt, Vol. 69, No. 6Cell–Cell Junctions Organize Structural and Signaling Networks9 June 2017 | Cold Spring Harbor Perspectives in Biology, Vol. 10, No. 4I.V. busulfan in pediatrics: a novel dosing to improve safety/efficacy for hematopoietic progenitor cell transplantation recipients5 April 2004 | Bone Marrow Transplantation, Vol. 33, No. 10The 3D scanner for measuring body surface area: a simplified calculation in the Chinese adultApplied Ergonomics, Vol. 34, No. 3Predictors of body surface areaJournal of Clinical Anesthesia, Vol. 4, No. 1Occupational Hot Exposures: A Review of Heat and Mass Transfer Theory5 August 2016 | Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, Vol. 203, No. 3Human exposure estimation for 2,3,7,8-TCDDChemosphere, Vol. 16, No. 8-9Renal hemodynamic changes in humansThe American Journal of Medicine, Vol. 81, No. 5Short-term protein loading in assessment of patients with renal diseaseThe American Journal of Medicine, Vol. 77, No. 5Interventricular septal thickness and left ventricular hypertrophy. An echocardiographic study.Circulation, Vol. 60, No. 5Subendocardial blood flow in children with congenital aortic stenosis.Circulation, Vol. 54, No. 6Age-related changes in size of the aortic valve annulus in manAmerican Heart Journal, Vol. 90, No. 5Quantification of Left Heart Volume and Systolic Output in Transposition of the Great ArteriesCirculation, Vol. 44, No. 5Left Heart Volume Estimation in Infancy and ChildhoodCirculation, Vol. 43, No. 6Hemodynamic Responses to Oxygen Breathing in Children with Severe AnemiaCirculation, Vol. 40, No. 4Cardiovascular Function in Children with Severe AnemiaCirculation, Vol. 39, No. 6Chronic renal homograft functionThe American Journal of Medicine, Vol. 43, No. 6Body density, fat, and fat-free weightThe American Journal of Medicine, Vol. 30, No. 6Tolazoline hydrochloride (Priscoline) An effective pulmonary vasodilatorAmerican Heart Journal, Vol. 61, No. 1The lungs in rheumatoid spondylitisThe American Journal of Medicine, Vol. 29, No. 4 More from this issue > Volume 7Issue 1July 1954Pages 1-12 Copyright & PermissionsCopyright © 1954 the American Physiological Societyhttps://doi.org/10.1152/jappl.1954.7.1.1PubMed13174464History Published online 1 July 1954 Published in print 1 July 1954 Metrics