In this paper we present a method we used to provide quantitative description of the systolic and diastolic temporal function of the left ventricle (LV). Additional parameters, such as peak filling and ejection rates, times to end systole and end diastole, and temporal changes in slow and fast filling are obtained. The volumes associated with these parameters are also calculated. Correlation between LV volume changes during the cardiac style and corresponding "density" variations was confirmed. Time-density curves were obtained from selected cardiac cycles in each study. We used the polynomial fitting technique to fit the time density curves and developed a computer algorithm for deriving the relevant parameters. Data from a total of 18 patients with ischemic heart or valvular diseases, who underwent I.V. ventriculography was analysed using our method. Some of these patients were forwarded for repeated digital subtraction angiography (DSA) examination before and after intervention therapy to evaluate the effectiveness of treatment. In comparison to the geometric method for the analysis of LV performance, our method is generally faster and simpler to employ. The method was effective in detecting variations in the peak ejection and filling rates in our group of patients before and after interventional therapy.

Absorptiometry, Photon↗

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Echocardiographic studies during stress testing using cold pressor test combined with hand grip exercise in asymptomatic patients with severe aortic regurgitation.

The aim of this study was to evaluate stress combining a cold pressor test and hand grip exercise during echocardiographic investigation of predominantly young asymptomatic patients with severe aortic regurgitation. Thirty five patients were catheterised and divided into two groups. Group A (16 cases) with abnormal ejection fraction by angiocardiography (less than 50%) and Group B (19 cases) with normal ejection fraction (greater than or equal to 50%). The above stress test altered significantly the blood pressure and heart rate in both groups. However, echocardiographic end systolic diameter, end diastolic diameter and fractional shortening were significantly worse during stress test only in Group A but not in Group B. In addition when an end systolic diameter greater than or equal to 48 mm is used as a predictor of abnormal ejection fraction, its sensitivity (100%) and specificity (83%) during stress is only marginally superior to the results obtained at rest. Similarly fractional shortening decrease of 10% or more during stress was no better than resting end systolic diameter parameter. The modified peak systolic pressure-end systolic volume slope demonstrated diminished systolic function in Group A in comparison to Group B. In conclusion, in young asymptomatic patients with severe aortic regurgitation, stress testing altered the echocardiographic parameters significantly in group A patients with abnormal ejection fraction but not in group B patients with normal ejection fraction. However, echocardiographic data during stress testing is not significantly superior to resting end systolic diameter in predicting abnormal ejection fraction.

Adult↗