Biomedical subjects

Morteza Rohani

Publications and source records attributed to Morteza Rohani.

6 recordsLinked to original sources

PubMed2005

Left ventricular function in patients with chronic kidney disease evaluated by colour tissue Doppler velocity imaging.

BACKGROUND: Cardiovascular disease is the leading cause of death in chronic kidney disease (CKD) patients. Tissue Doppler velocity imaging (TVI) is a new objective method that accurately quantifies myocardial tissue velocities, deformation, time intervals and left ventricular (LV) filling pressure. In this study, TVI was compared with conventional echocardiography for the assessment of left ventricular (LV) function in pre-dialysis patients with different stages of CKD. The results obtained by TVI were used to analyse possible relationships between LV function and clinical factors such as hyperparathyroidism and hypertension that could influence LV function. METHODS: Conventional echocardiography and TVI images were recorded in 40 patients (36 men and 4 women, mean age 60+/-14 years, range 28-80 years) and in 27 healthy controls (21 men and 6 women, mean age 58+/-17 years, range 28-82 years). Twenty-two patients had mild/moderate CKD (CCr>29 ml/min; Group 1) and 18 patients had severe CKD (CCr<or=29 ml/min; Group 2). Using TVI, the myocardial tissue velocities (v; cm/s) for isovolumetric contraction (IVCv), peak systole (PSv), early (E') and late (A') diastolic filling velocities as well as strain rate (SR), mitral annulus displacement, isovolumetric relaxation time (IVRT) and LV filling pressure were estimated using TVI. The average of six LV wall measurements was used to evaluate LV global function. RESULTS: Using TVI, we were able to identify significantly more patients with diastolic dysfunction than using conventional echocardiography (33 vs 26, P<0.05). There was no difference in the prevalence of diastolic dysfunction between Group 1 and 2. However, using TVI, Group 2 CKD patients had lower E' velocities (6.2+/-1.9 vs 8.0+/-2.9 cm/s, P<0.05) and higher IVRT (137.4+/-13 vs 88.2+/-26 ms, P<0.001) in comparison with controls, indicating more accentuated diastolic dysfunction. Systolic blood pressure (SBP) was associated with E' velocities (rho=-0.68, P<0.005) and E'/A' was strongly associated with SBP (rho=-0.60; P<0.01) and PTH (rho=-0.64, P<0.005) in Group 2. Using conventional echocardiography, there was no difference in the prevalence of systolic and diastolic dysfunction between patients with and without LVH. However, using TVI, patients with LVH had significantly lower IVCv (2.8+/-1.3 vs 3.8+/-1.5 and 3.8+/-1.5 cm/s, P<0.05) and PSv (5.5+/-1.0 vs 6.3+/-1.2 and 6.4+/-1.3 cm/s, P<0.05) compared with patients without LVH and controls, and they also had lower E' velocities (7.1+/-2.7 vs 8.0+/-2.9 cm/s, P<0.05) compared with controls, indicating disturbances in systolic and diastolic left ventricular function. CONCLUSIONS: TVI provided additional information on left ventricular function in CKD patients. In patients with advanced renal failure, TVI revealed more accentuated diastolic dysfunction associated with increased systolic blood pressure (SBP) and increased levels of PTH. TVI also demonstrated disturbances in contractility and contraction in patients with LVH, which could not be detected by conventional echocardiography.

Adult↗

PubMed2005

Morphological changes rather than flow-mediated dilatation in the brachial artery are better indicators of the extent and severity of coronary artery disease.

OBJECTIVES: The aim of this study was to examine the relationship between morphological and functional parameters of the brachial and carotid arteries and the angiographic extent and severity of coronary artery stenosis in patients with severe coronary artery disease (CAD). DESIGN: A cross-sectional study. SETTING: University hospital. MAIN OUTCOME MEASURES: Flow-mediated dilatation (FMD), intima-media thickness (IMT) in the brachial artery and atherosclerotic wall changes in the carotid arteries were measured by B-mode high-resolution ultrasound in 58 patients who had undergone coronary angiography. RESULTS: A significant correlation was seen between the extent of coronary artery stenosis defined as the coronary angiographic score and both the mean brachial artery IMT and intima-media area (IMa; P = 0.01 and P = 0.04, respectively). There was no significant correlation between FMD and the extent of coronary artery stenosis. A significant correlation was seen between the mean carotid artery IMT and the mean brachial artery IMT (r = 0.30, P = 0.03). However, there was no significant correlation between FMD and the mean carotid artery IMT or IMa (r = 0.16, P = 0.23 and r = 0.17, P = 0.24, respectively). CONCLUSIONS: Morphological but not functional parameters of the brachial artery are associated with the extent of coronary artery stenosis and atherosclerotic wall changes in the carotid arteries in patients with severe CAD. These findings indicate a potential of B-mode ultrasonography of morphological parameters in the brachial artery in the diagnostic and prognostic evaluation of patients with suspected CAD.

Aged↗

PubMed2005

Renal adenocarcinoma with intramyopericardial and right atrial metastasis, latter via coronary sinus: report of a case.

Primary renal tumors with intracardiac metastasis are not infrequent. Most of the secondary spread is blood-borne and occurs via inferior vena cava. Patients with such a spread often present with cardiac symptoms. We presume that a metastatic spread in the right atrium through coronary sinus has never been reported in the literature according to the result of a Medline search at the time of writing this report.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2004

Interrelation between the extent of atherosclerosis in the thoracic aorta, carotid intima-media thickness and the extent of coronary artery disease.

Intima-media thickness (IMT) of the common carotid artery and atherosclerosis of the thoracic aorta have been shown to correlate with coronary artery disease (CAD). This study compares the relation between wall changes in the thoracic aorta and the carotid arteries and the angiographic severity and extent of atherosclerotic lesions in the coronary arteries in patients with verified CAD. Atherosclerotic wall changes in the carotid arteries and the thoracic aorta were measured by B-mode ultrasonography and transesophageal echocardiography (TEE), respectively, in 37 subjects aged 65+/-10 years with angiographically verified CAD. The mean value of the common carotid IMT of the right and left sides was 0.87+/-0.21 mm. All subjects had carotid plaques. TEE detected grades II-IV atherosclerotic plaques in the thoracic aorta in 32 of the 37 (86%) patients. A significant correlation was seen between the extent of coronary artery stenosis and aortic plaques score (r=0.46, p=0.008). Mean carotid IMT was also significantly correlated with coronary artery stenosis extent score (r=0.44, p=0.007). Moreover, a significant correlation was seen between the aortic plaque score and the mean carotid IMT (r=0.39, p=0.02). In conclusion, we found a clear and significant relationship between wall changes in the thoracic aorta, common carotid IMT and the angiographic extent of coronary artery stenosis in patients with severe CAD. These findings indicate a potential of B-mode ultrasonography of the carotid arteries and transesophageal echocardiographic aortic examination in the diagnostic and prognostic evaluation of patients with suspected CAD.

Aged↗

PubMed2004

Assessment of the longitudinal and circumferential left ventricular function at rest and during exercise in healthy elderly individuals by tissue-Doppler echocardiography: relationship with heart rate.

Tissue-Doppler echocardiography (TDE) has been introduced to quantify stress echocardiography by means of assessing the left ventricular (LV) segmental myocardial velocities and excursion. The interaction between LV long- and short-axis function during physical exercise has not been elucidated completely. The aim of the present study was to investigate long- and short-axis LV function, as assessed by myocardial velocities and excursions at rest and during exercise and its possible relationship with heart rate in healthy elderly individuals by TDE. Twenty-seven individuals underwent an exercise test in the supine position on a bicycle ergometer. The initial workload was 30 Watts, followed by 20-Watt increments every third minute. Standard echocardiographic images with super-imposed colour TDE were digitized at the end of each step. The following variables were studied in the LV long- and short-axis: myocardial peak systolic velocity (PSV) and excursion, isovolumic contraction and relaxation times, peak velocity at early diastole (E'-wave) and peak velocity at late diastole (A'-wave) and the E'/A' ratio. Increments in myocardial peak systolic velocity and excursion in the LV long-axis were more pronounced during low workloads. The increase in those variables in the short-axis occurred mainly at higher exercise loads. The improvement in LV long- and short-axis functions was closely related to the increase in the heart rate. Shortening of the isovolumic contraction and relaxation times occurred only at the initial stages of exercise. An increase in the long-axis E'/A' ratio occurred during exercise, whereas this ratio was unchanged in the short-axis. In conclusion, during exercise, the LV long- and short-axis functions behave differently, and increases in LV long- and short-axis functions are related to changes in heart rate. Therefore, in the interpretation of echocardiographic findings during exercise stress echocardiography, these facts have to be taken into account.

Aged↗

PubMed2004

Electromechanical coupling, uncoupling, and ventricular function in patients with bundle branch block: a tissue-Doppler echocardiographic study.

BACKGROUND: Left bundle branch block (LBBB) is associated with impaired left ventricular (LV) function and increased morbidity and mortality, especially in patients with structural heart diseases. The mechanisms are poorly understood. SUBJECTS AND METHODS: Subjects with isolated LBBB (n=20), right bundle branch block (RBBB, n=20), and controls (C, n=20) were studied with standard two-dimensional (2D), and color-encoded tissue-Doppler echocardiography (TDE). Inter- and intraventricular systolic and diastolic coordination were assessed from the TDE velocity profiles. LV function was assessed by 2D echocardiography, by TDE-derived peak systolic velocities, and the atrioventricular (AV) plane displacement. RESULTS: Subjects with LBBB had longer electromechanical delays and longer isovolumic relaxation times than did the C and RBBB groups (P <0.001). For the LBBB subjects compared with the RBBB and C groups, ejection times were shorter, peak systolic velocities and AV plane displacements were lower, they had larger LV end-systolic volumes and lower LV ejection fraction (all P <0.001), and the atrial contribution to A-V plane displacement was higher (P <0.01). There were no differences in diastolic or filling times among the groups. CONCLUSIONS: In patients with LBBB, delayed regional electromechanical coupling and uncoupling leads to generalized intra- and interventricular asynchrony, thereby explaining the depressed regional and global LV functions. Assessment of the electromechanical coupling and uncoupling processes and their consequences on cardiac function in patients with BBB and structural heart diseases may be possible using TDE.

Analysis of Variance↗