Objective Assessment of right ventricular function in patients with atrial septal defect(ASD)is difficult.The Doppler myocardial performance index(MPI)may provide a method of assessing function in these patients.The p...Objective Assessment of right ventricular function in patients with atrial septal defect(ASD)is difficult.The Doppler myocardial performance index(MPI)may provide a method of assessing function in these patients.The purposes of this study were to evaluate the right ventricular function and its changes in patients with ASD after transcatheter closure of ASD.Methods MPI,defined as the sum of isovolumic relaxation time and isovolumic contraction time derived by ejection time,was measured from tricuspid inflow and right ventricular outflow;Doppler velocity profiles recorded during routine echocardiography.Twenty nine patients(13 men,16 women;mean age 25.28±12.69,range 6 to 57 years)were diagnosed to secundum ASD[the stretched diameters of ASD were from 9 To 36(24.91±7.98)mm],and had a successfully placed Amplatzer septal occluder(ASO)(the sizes of ASO were from 11 to 40 mm);there were 81 sex-matched,age-matched healthy people(control group 41men,40 women;mean age 29.02±14.22,range 4 to 45 years).MPI was measured again on 3 days and 1 month after closure of ASD.Change in the study group was assessed and compared to the control subjects with structurally normal hearts.A complete 2-dimensional and Doppler echocardiographic examination was performed in all study groups.Results 1)The isovolumic relaxation and isovolumic contraction times[respectively(77.59±14.39)ms vs(60.93±12.94)ms,P<0.0001;(28.28±10.88)ms vs(23.64±9.01)ms,P=0.027]were prolonged,and ejection time[(260.65±21.86)ms vs(271.85±21.92)ms,P=0.033]was shortened in patients with ASD compared with that in control subjects,resulting in a marked increase in the MPI(0.40±0.07 vs 0.31±0.05,P<0.0001)from normal values;2)by Pearson's correlations,the MPI had no correlation with heart rate and blood pressure in control subjects and patients with ASD,but it correlated positively with age in patients with ASD;3)by Pearson's correlations,the MPI correlated positively with the diameter of ASD and pulmonary artery pressure;4)after transcatheter closure of ASD,the MPI decreased markedly.Conclusions 1)MPI is a conceptually new,simple,and reproducible Doppler index in patients with ASD;2)MPI is free from the effect of age,heart rate and blood pressure;(3)MPI appears to be relatively dependent on changes in the diameter of ASD and pulmonary artery pressure;4)the right ventricular function was improved after transcatheter closure of ASD.展开更多
Diabetes (DM) and hypertension (HT) cause changes in cardiac performance. Long-term diabetes and hypertension can lead to changes in cardiac contractility, reduced left ventricular efficiency and heart failure. The ai...Diabetes (DM) and hypertension (HT) cause changes in cardiac performance. Long-term diabetes and hypertension can lead to changes in cardiac contractility, reduced left ventricular efficiency and heart failure. The aim of this study is to evaluate the effect of the coexistence of diabetes mellitus and hypertension on left ventricular myocardial performance and structural changes. The study involved 45 patients with essential hypertension and type 2 diabetes (14 males and 31 females, their mean age was 53.28 ± 13.28 years), and 45 healthy subjects (10 males and 35 females, their mean age was 48.11 ± 13.07 years) as a control group. Transthoracic echocardiography was done for all patients. The echocardiographic measurements included: left ventricle internal diameter at end diastole (LVIDd), left ventricle internal diameter at end systole (LVIDs), peak velocity of early transmitral flow (E), peak velocity of late transmitral flow (A), ejection fraction (EF%), isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT) and ejection time (ET) from which the index of myocardial performance (IMP) was calculated. Results revealed a significant change in the ratio (E/A) between patients and controls (-32.45%) with p value p value 0.05. In conclusion, diabetic patients with hypertension had an increase in IMP and reduced E/A indicating deterioration in cardiac performance despite normal ejection fraction and insignificant change in LV dimensions.展开更多
Background Kawasaki disease (KD) is known as systemic vasculitis, and more than half of the patients with KD have myo-carditis, which can induce ventricular dysfunction. In this study, we evaluate left ventricular (LV...Background Kawasaki disease (KD) is known as systemic vasculitis, and more than half of the patients with KD have myo-carditis, which can induce ventricular dysfunction. In this study, we evaluate left ventricular (LV) dysfunction in patients with KD based on the myocardial performance index (MPI) using pulse Doppler (PD) and tissue Doppler imaging (TDI), from the acute to convalescent phases. Methods We retrospectively studied 89 children diagnosed with KD from January 2010 to August 2012. We assessed the presence of coronary artery lesions (CALs) and the LV ejection fraction, PD-MPI, and TDI-MPI at diagnosis, and 2, 14, and 56 days after intravenous immunoglobulin (IVIG) treatment. We enrolled 70 healthy children as a control group. Results The ejection fraction in patients with KD at diagnosis (67.3 ± 0.9%) was lower than that in the control group (69.8 ± 0.8%,P = 0.035), and the LV TDI-MPIs for patients with KD at diagnosis (0.49 ± 0.01) and 2 days after IVIG treatment (0.48 ± 0.01) were higher than those in the control group (0.45 ± 0.01,P = 0.002,P = 0.033, respectively). No signifi cant diff erences were found in the LV dysfunction between the patients with complete and incomplete KD. Septal TDI-MPIs in patients with KD with CAL at diagnosis (0.52 ± 0.02) were higher than those in patients with KD without CAL (0.47 ± 0.01,P = 0.019). Conclusions Transient LV dysfunction occurred in patients with complete and incomplete KD in the acute stage. In patients with KD with CAL at diagnosis, the LV dysfunction was more prominent. The PD-MPI and TDI-MPI are useful parameters for assessing LV function in patients with KD.展开更多
文摘Objective Assessment of right ventricular function in patients with atrial septal defect(ASD)is difficult.The Doppler myocardial performance index(MPI)may provide a method of assessing function in these patients.The purposes of this study were to evaluate the right ventricular function and its changes in patients with ASD after transcatheter closure of ASD.Methods MPI,defined as the sum of isovolumic relaxation time and isovolumic contraction time derived by ejection time,was measured from tricuspid inflow and right ventricular outflow;Doppler velocity profiles recorded during routine echocardiography.Twenty nine patients(13 men,16 women;mean age 25.28±12.69,range 6 to 57 years)were diagnosed to secundum ASD[the stretched diameters of ASD were from 9 To 36(24.91±7.98)mm],and had a successfully placed Amplatzer septal occluder(ASO)(the sizes of ASO were from 11 to 40 mm);there were 81 sex-matched,age-matched healthy people(control group 41men,40 women;mean age 29.02±14.22,range 4 to 45 years).MPI was measured again on 3 days and 1 month after closure of ASD.Change in the study group was assessed and compared to the control subjects with structurally normal hearts.A complete 2-dimensional and Doppler echocardiographic examination was performed in all study groups.Results 1)The isovolumic relaxation and isovolumic contraction times[respectively(77.59±14.39)ms vs(60.93±12.94)ms,P<0.0001;(28.28±10.88)ms vs(23.64±9.01)ms,P=0.027]were prolonged,and ejection time[(260.65±21.86)ms vs(271.85±21.92)ms,P=0.033]was shortened in patients with ASD compared with that in control subjects,resulting in a marked increase in the MPI(0.40±0.07 vs 0.31±0.05,P<0.0001)from normal values;2)by Pearson's correlations,the MPI had no correlation with heart rate and blood pressure in control subjects and patients with ASD,but it correlated positively with age in patients with ASD;3)by Pearson's correlations,the MPI correlated positively with the diameter of ASD and pulmonary artery pressure;4)after transcatheter closure of ASD,the MPI decreased markedly.Conclusions 1)MPI is a conceptually new,simple,and reproducible Doppler index in patients with ASD;2)MPI is free from the effect of age,heart rate and blood pressure;(3)MPI appears to be relatively dependent on changes in the diameter of ASD and pulmonary artery pressure;4)the right ventricular function was improved after transcatheter closure of ASD.
文摘Diabetes (DM) and hypertension (HT) cause changes in cardiac performance. Long-term diabetes and hypertension can lead to changes in cardiac contractility, reduced left ventricular efficiency and heart failure. The aim of this study is to evaluate the effect of the coexistence of diabetes mellitus and hypertension on left ventricular myocardial performance and structural changes. The study involved 45 patients with essential hypertension and type 2 diabetes (14 males and 31 females, their mean age was 53.28 ± 13.28 years), and 45 healthy subjects (10 males and 35 females, their mean age was 48.11 ± 13.07 years) as a control group. Transthoracic echocardiography was done for all patients. The echocardiographic measurements included: left ventricle internal diameter at end diastole (LVIDd), left ventricle internal diameter at end systole (LVIDs), peak velocity of early transmitral flow (E), peak velocity of late transmitral flow (A), ejection fraction (EF%), isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT) and ejection time (ET) from which the index of myocardial performance (IMP) was calculated. Results revealed a significant change in the ratio (E/A) between patients and controls (-32.45%) with p value p value 0.05. In conclusion, diabetic patients with hypertension had an increase in IMP and reduced E/A indicating deterioration in cardiac performance despite normal ejection fraction and insignificant change in LV dimensions.
文摘Background Kawasaki disease (KD) is known as systemic vasculitis, and more than half of the patients with KD have myo-carditis, which can induce ventricular dysfunction. In this study, we evaluate left ventricular (LV) dysfunction in patients with KD based on the myocardial performance index (MPI) using pulse Doppler (PD) and tissue Doppler imaging (TDI), from the acute to convalescent phases. Methods We retrospectively studied 89 children diagnosed with KD from January 2010 to August 2012. We assessed the presence of coronary artery lesions (CALs) and the LV ejection fraction, PD-MPI, and TDI-MPI at diagnosis, and 2, 14, and 56 days after intravenous immunoglobulin (IVIG) treatment. We enrolled 70 healthy children as a control group. Results The ejection fraction in patients with KD at diagnosis (67.3 ± 0.9%) was lower than that in the control group (69.8 ± 0.8%,P = 0.035), and the LV TDI-MPIs for patients with KD at diagnosis (0.49 ± 0.01) and 2 days after IVIG treatment (0.48 ± 0.01) were higher than those in the control group (0.45 ± 0.01,P = 0.002,P = 0.033, respectively). No signifi cant diff erences were found in the LV dysfunction between the patients with complete and incomplete KD. Septal TDI-MPIs in patients with KD with CAL at diagnosis (0.52 ± 0.02) were higher than those in patients with KD without CAL (0.47 ± 0.01,P = 0.019). Conclusions Transient LV dysfunction occurred in patients with complete and incomplete KD in the acute stage. In patients with KD with CAL at diagnosis, the LV dysfunction was more prominent. The PD-MPI and TDI-MPI are useful parameters for assessing LV function in patients with KD.
