Biomedical subjects

S Qirko

Publications and source records attributed to S Qirko.

6 recordsLinked to original sources

PubMed1999

[Relationship between the force of left atrial ejection to left ventricular function in arterial hypertension].

UNLABELLED: The left atrial ejection force (LAEF), defined as that force exerted by the left atrium (LA) to accelerate the blood into the left ventricle during atrial systole, is well accepted for the evaluation of LA systolic function. The aim of this study is to determine whether LAEF is a precursor of the impairement of LV systolic function in patients with arterial hypertension (HTN). For that purpose we studied LAEF in 36 patients with HTN (av. age 58 +/- 8 years) with LV hypertrophy (Lvmi > 134 g/m2 for men and > 110 g/m2 for women). LV systolic function estimated by the fractional shortening (FSh) was 35 +/- 4% (28 to 44); 32 normal subjects (NS) were also analyzed. All subjects were submitted to echo and doppler examinations. METHODS: LAEF was obtained by the formula: 1/3 x MVA x (A-vel)2, where MVA is mitral valve area measured by 2D echo while A-vel. is the late diastolic (atrial) mitral velocity. RESULTS: 1. LAEF increased significantly with age in NS (r = 0.78) p < 0.05). Age corrected LEAF was calculated as % LEAF = (actual LAEF/normal LAEF x 100. 2. Compared to NS. % LAEF was lower in HTN (78 + 25%). 3. There was a significant inverse correlation between LAEF and LV wall thickness (r = -0.46) (p < 0.05). 4. % LAEF was 66 +/- 31% in patients with FSh < 33% and 79 +/- 25% in those with FSh > 33% (p < 0.05). 5. In HTN with the duration > 15 years, % LAEF was lower than in patients with < 15 years (62 +/- 25 vs 76 +/- 24) (p < 0.05). CONCLUSIONS: 1. LAEF is decreased in more advance stages of HTN. 2. This impairment is related to LV hypertrophy and to the duration of the disease. 3. LAEF is a sensitive precursor for LV systolic deterioration in patients with hypertension.

Adult↗

PubMed1999

[Alteration of the longitudinal function of the left ventricle in hypertensives with systolic function of normal appearance].

UNLABELLED: Left ventricular (LV) transverse function is often used by the echocardiography to evaluate the systolic function in arterial hypertension (HTN). It would be interesting to know whether the LV long axis systolic dysfunction may precede the abnormalities of the transverse function in hypertension (HTN). For that purpose we evaluated by echo 36 patients (24 males, 12 females) with LV concentric hypertrophic (Lvmi > 134 g/m2 for men and > 110 g/m2 for women). All subjects were free of coronary heart disease and heart failure. According to the dimensions of the LV wall chickness (WTh) the HTN were subdivided in two groups: Group 1: Wth (12-14 mm) and Group 2: WTh (> 14 mm). The patients were compared to 30 healthy persons (control group) matched for age and LV systolic function (Fractional Shortening). METHODS: LV long axis shortening was measured at the septal and lateral sides of the mitral annulus using M-mode from the apical four chamber view. RESULTS: Compared to control group, septal long axis shortening fell significantly (p < 0.05) in proportion to the degree of the wall thickness: control group: 21 +/- 2 mm. Group 1: 16 +/- 1 mm and Group 2: 14 +/- 1 mm. Lateral shortening was reduced only in the Group 2 (15 +/- 2 vs 20 +/- 2 mm) (p < 0.05). LV wall thickness correlated significantly (p < 0.05) to septal and lateral shortening respectively (r = -0.51) and (r = -0.48). CONCLUSIONS: 1. Significant impairment of LV long axis function occurs in arterial hypertension with concentric hypertrophy even with normal transverse systolic function. 2. This alteration seems to be related to the dimensions of the LV wall thickness. 3. The prognostic implication of this disorder should be investigated further.

Adult↗

PubMed1996

[Left atrial contractility function in hypertension].

UNLABELLED: The purpose of this study was the assessment of the left systolic atrial function (LSAF) in 45 hypertensive subjects (HS) with left ventricular hypertrophy (LVH). (LV mass index) (LVMI) (> 134 g/m2 for men, > 110 g/m2 for women) and in 32 normal subjects (NS). The both groups were matched for age, body surface, heart rate and LV fractional shortening. Left atrial volume (LAV) was calculated by the formula: LAV = 8 A1 x A2/3 pi l in which A1 is the area of the four-chamber view, A2 is the area of the two-chamber view and L is common length in the two views. The atrial function contractility was evaluated by the following parameters: 1. LA stroke volume (LASV) = LAV - LAMV where LAV is the volume before atrial systole and LAMV is the LA minimal volume. 2. LA ejection fraction (LAEF) = LASV/LAV. 3. Atrial ejection force (AEF) = peak A/MOA in which peak A wave is the maximal late diastolic velocity and MOA is the mitral orifice area. 4. Atrial transport (AT) = A/M in which M area is under the mitral velocity curve and A-area under the late diastolic velocity curved assessed by Doppler echo. [table: see text] Thus all above parameters are significantly increased in HS. In HS, LASV is correlated to LAV (r = 0.84; p < 0.001) and to LVMI (r = 0.32; p < 0.05). LAEF is correlated to peak A (r = 0.90; p < 0.001) and LVMI (r = 0.34; p < 0.05). CONCLUSIONS: In HS with LVH in comparison with N, the increase of the LA contractility is considered to be urged by the increase of LAV (Frank-Starling's law). These data could be explained by the less distensibility of LV chamber in relation to LVH.

Adolescent↗

PubMed1995

[Echocardiographic evaluation of left atrial emptying index in hypertension].

UNLABELLED: The atrial emptying index (AEI) was used to access the rapid phase of diastolic filling of the left ventricle (LV) in 27 hypertensive (HTA) untreated patients and in 27 normotensive (N) subjects, matched for age, body, surface and heart rate. All the patients had left ventricular hypertrophy (LVH): LV mass index (LVmi) > 134 g/m2 for men, 110 g/m2 for women. All subjects had normal systolic function by echocardiography. We derived: LV wall thickness (h); antero-posterior radius (r); h/r ratio; LVmi; LAmi (before atrial contraction); AEI; A/E ratio. RESULTS: [table: see text] The AEI demonstrated a negative correlation with LAvi in N (r = -0.49; p = 0.005) and in HTA (r = -0.53; p = 0.002). This index was correlated significantly to A/E (r = 0.74; p < 0.001) and to LV mi (r = -0.32; p < 0.05 only in HTA. CONCLUSION. In HTA with LVH in comparison with N, there are conjointly an increase of the A/E ratio and a reduction of the AEI which is considered to be compensated by the increase of LAvi. These data could be explained by the less distensibility of LV chamber in relation to LVH.

Adult↗

PubMed1992

[Doppler echocardiographic evaluation of right and left ventricular filling in hypertension].

Left (LV) and right ventricular (RV) filling was evaluated by pulsed doppler echocardiography in 56 hypertensive (HTN) untreated patients and in 30 normotensive (N) subjects, matched for age, body surface and heart rate. HTN were classified in two groups: HTN1: with normal LV mass index (LV mi) (< 135 g.m-2 for men, < or = 115 g.m.-2 for women); HTN2: with increased LV mi (> or = 135 g.m-2 for men, > or = 115 g.m-2 for women). All subjects had normal systolic function by echo. We derived: LV wall thickness (h), antero-posterior radius (r), h/r ratio, LV mi, ratio of early to late filling (E/A) in both ventricle. RESULTS. h and h/r were significantly in HTN1 (p < 0.01 vs N) and particularly in HTN2 (p < 0.001 vs N and HTA1). E/ALV and E/ARV were significantly decreased (p < 0.001) in both HTA compared to N. There was no significant difference between HTN1 and HTN2 concerning E/ALV and E/ARV. Relations of E/ALV and E/ARV with age, systolic blood pressure (SBP), LV mi, h, h/r: [table: see text] E/ALV is correlated to E/ARV (r = 0.37; p < 0.01) only in HTA. CONCLUSIONS. 1) In HTN in comparison with N: h, h/r are higher in the presence but also in the absence of increased LV mi. 2) In N and HTN: E/ALV and E/ARV are better correlated to h (and also to h/r in N) than to LV mi. Though the respective values of E/ALV and E/ARV are identical, they are correlated significantly only in HTN. 3) In the absence of the direct measures of the RV pressures and volumes, the interpretation of the results concerning the RV filling in uncertain. Only in HTN, they could be explained at least in part by the diastolic interplay between the two ventricles.

Adult↗

PubMedDate not supplied

[Incidence and clinical and echocardiographic characteristics of left ventricular insufficiency with normal systolic function in permanent arterial hypertension].

In Arterial hypertension abnormalities of left ventricular filling are constant and appear at an early stage, and in most cases signs of left ventricular failure (LVF) precede alterations in the left ventricular systolic function. The purpose of this study was to evaluate the frequency as well as the clinical and echocardiographic characteristics of LVF with normal systolic function in permanent arterial hypertension. 113 permanently hypertensive patients with normal left ventricular performance at echocardiography were studied clinically (functional class, congestive signs of LVF and/or presystolic gallop) and by means of echocardiographic recordings (dimensions of the left ventricle, mitral EF slope, left atrial diameter). The left ventricular wall thickness was normal (less than or equal to 11 mm) in 31 patients (group I), increased with asymmetrical septal hypertrophy in 36 patients (group II) and diffusely and symmetrically increased in 46 patients (group III). The EF slope was significantly smaller and left atrial dilatation was significantly more frequent in groups II and III than in group I. Clinical signs of LIF and presystolic gallop were observed in only groups II and III. Clinical LVF was found in 33/113 hypertensive patients (29%) and was always accompanied by symmetrical or asymmetrical left ventricular mural hypertrophy. Moreover, presystolic gallop (n = 8, i.e. 24%) and left atrial dilatation were significantly more frequent in patients with LVF than in those without LVF. Thus, LVF with normal systolic function is frequent in permanent hypertension. It results exclusively from abnormalities of left ventricular relaxation and/or compliance.

Adult↗