J Iannariello | PubMed Health

PubMed1990

[Diastolic function in Chagas disease].

With the purpose of analyzing diastolic function in Chagas, disease (ECh), 42 patients were studied: 31 males (aged 33 +/- 9), 22 of them with positive serology for ECh and 9 with negative serology; 11 female patients (aged 36 +/- 12), 10 with positive serology and 1 with negative serology. In all patients 2 D-Echo and simultaneous EKG, phonocardiogram, apexcardiogram and M-mode Echo at 100 mm/sec were taken. The A2-D, A2-O (total apexcardiographic relaxation-RAT), a/D (diastolic amplitude of "a" wave), ITRAT = A2 - C/RAT, DDVI, DSVI, shortening fraction (FA) and percentage of dimension changes (D D%) were determined. The patients were divided into 4 groups: G - A (n = 10) normal; G - B (n = 15) positive serology, with EKG and Rx and FA normal; G - C (n = 10) positive serology, abnormal EKG, and normal Rx and FA; G - D (n = 7) positive serology, abnormal EKG, mild cardiomegalia and diminished FA. The patients from group B presented significative modification, 46& (7/15) of the FD indexes and those from group D with 70% (5/7), as well as of D D C - E and D D Dm-0 indicative of uncoordinated contraction and relaxation. A progressive worsening of the FD from G - D was observed, reaching in this last one statistically significant values. In the ECh the alterations in the FD precede the systolic, which allows for an early detection of myocardiac damage by noninvasive techniques.

Adult↗

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[Ventricular diastolic function: a correlation between phonomechanocardiography and echo-Doppler].

With the purpose to compare phonomechanocardiography and echo Doppler in the assessment of diastolic function of the left ventricle, we study 45 patients (30 male and 15 female) average age 50 +/- 9 years. We performed phonomechanocardiogram, echo-M, 2-D and Doppler transmitral. They were classified in four group according to mitral flow pattern: normal 14 patients; pattern I by Appleton (PI) 14 patients, 11 with aortic stenosis and 3 with hypertrophic cardiomyopathy; pattern II (PII) 12 patients with dilated cardiomyopathy grade III-IV and the last group of 5 patients with myocardial infarction with normal mitral flow but with impaired diastolic function by phonomechanocardiography. The phonomechanocardiographic index of ventricular relaxation (A2-O, ITRAT), compliance (a/D) and global diastolic function (ITAD) correlated with Doppler index (A2-D, E/A, atrial filling fraction, E-F slope and deceleration time) in N + PI group. The correlation was not significant when N + PI + PII or PI + PII groups were considered. The ITAD and E/A had r = 0.713 (p < 0.001) in N + PI, r = 0.12 (NS) in N + PI + PII and r = -0.308 (NS) in PI + PII. There was a dissociation between increased "a" wave in apexcardiogram and little "A" wave in PII patients suggesting "atrial failure". The patients with myocardial infarction received isosorbide dinitrate 5 mg showing changes of "pseudonormalizated" pattern in PI with normalized ITAD. This findings suggest that assessment of diastolic function by Doppler is dependent of loading conditions (specially preload), and cannot evaluate relaxation in PII but this is possible by phonomechanocardiography. It is advised the combination of the two technics for better assessment of diastolic function.

Adult↗