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At least 37 records · Page 2Linked to original sources
PubMed1978

Acute effects of aortocoronary bypass surgery on left ventricular function and regional myocardial mechanics: a clinical study.

The acute effects of myocardial revascularization on overall left ventricular performance and on myocardial segmental wall motion were assessed intraoperatively in 22 patients who had unstable (11 patients) or stable angina pectoris (11 patients). Segmental contraction patterns were evaluated using an ultrasonic transit-time method. In 9 patients with unstable angina pectoris, notable improvement in segmental wall motion was observed as the short-term response to coronary bypass grafting. Hypokinetic patterns were rendered normal after revascularization. Despite marked changes in segmental myocardial function, overall left ventricular performance was not altered notably. In contrast, reperfusion did not lead to acute effects on either segmental wall motion or total left ventricular function in patients with stable angina pectoris. The results indicate that aortocoronary bypass grafting may improve segmental wall motion in patients with unstable angina.

Adult↗
PubMed1977

Improved survival after coronary bypass surgery in patients with poor left ventricular function: role of intraaortic balloon counterpulsation.

The operative mortality rate of aortocoronary bypass surgery in 23 patients with poor left ventricular function (ejection fraction 0.30 or less) operated on in 1973-74 was 34.7 percent. The incidence rate of operative myocardial infarction was 30.4 percent. In an attempt to improve survival, intraaortic balloon counterpulsation was used therafter in 25 similar patients. Counterpulsation was instituted preoperatively and continued intra- and postoperatively for 2 to 5 days. Preoperative studies revealed an "unloading" effect of the left ventricle, with significant reductions of systolic arterial blood pressure, end-diastolic pulmonary arterial pressure and end-diastolic left ventricular volume and pressure. Metabolic improvement was demonstrated by the lesser production of myocardial lactate after pacing-induced tachycardia when the ventricle was balloon-assisted. Intraoperatively, blood flow through the vein graft was found to increase with counterpulsation. The rate of operative myocardial infarction was reduced to 4 percent and the mortality rate to 8 percent. In patients who have sustained a significant loss of functioning myocardium, the beneficial hemodynamic and metabolic effects of intraaortic balloon counterpulsation appear to prevent furhter, possibly critical, myocardial damage in the perioperative period.

Assisted Circulation↗
PubMed1978

Left ventricular function after myocardial infarction: relation between systolic time intervals and quantitative ischaemic ECG changes.

Twentyfour male patients with sustained myocardial infarction (MI) were studied with 12-lead ECG and systolic time intervals (STI) 5 months after the acute episode. From the ECGs were calculated the summed voltages of the R wave (sigma R), the Q wave (sigma Q), and the ST segment deviation (sigma ST). These ischaemic ECG variables were correlated with the STI parameters of left ventricular function: LVETI, PEP and PEP/LVET. Statistically significant regression equations relating the ECG changes to the STI variables were found in anterior MI, for sigma ST in the entire series, but not in inferior MI. Thus a simple and rapid inspection of the resting 12-lead ECG gives an indirect but reliable quantitative estimate of left ventricular function in patients with a sustained myocardial infarction.

Aged↗
PubMed1975

[Effect of increasing doses of dopamine on the left ventricular function in the dog].

A study on eleven dogs of the effects of increasing doses of dopamine on the left ventricular function. A description of the method which consists of a venous shunt connected to an extra-corporeal circuit and which allows modification simply and rapidly of the state of vascular refilling of the animal. The results differ according to the pressure-level of the refilling of the left ventricule. At low pressure, the dopamine increases the arterial pressure, the cardiac output and the systolic activity of the left ventricle for a reduced tachycardic effect. At higher pressure, the average aortic pressure is only slightly increased and the systolic activity is elevated without increase in cardiac output. These facts indicate dopamine in states of shock with a low pressure of refilling.

Animals↗
PubMed1978

Influence of aorto-coronary saphenous vein bypass surgery on left ventricular function. Comparison before and one year after surgery in 80 patients.

To assess the haemodynamic effects of aorto-coronary saphenous vein bypass grafting, pre- and post-angiographic left ventricular end-diastolic pressure (LVEDP) and ejection fraction (EF) were measured before and in average 14 months after surgery in 80 patients. Symptomatic improvement occurred in 91% (73 of 80). In 43 patients with patent graft(s), pre-angiographic LVEDP and EF were unchanged (p always greater than 0.05), while postangiographic LVEDP was significantly reduced. Unchanged pre- and postangiographic LVEDP and EF were observed in 28 patients with double or triple grafts, with at least one graft patent and the other(s) occluded. Unchanged pre- and postangiographic LVEDP and reduced EF were observed in 9 patients with occluded single, double or triple grafts. We conclude that successful aorto-coronary saphenous vein bypass surgery in general does not improve resting left ventricular performance, but that the beneficial effect on left ventricular function can be demonstrated after a stress test such as ventriculography. A single graft to the left anterior descending artery seems to be of particular importance in this connection. On the other hand, deterioration was evident after unsuccessful surgery, particularly in patients with occlusions of 2 or 3 grafts. Digitalis therapy after operation or electrocardiographic indices of postoperative myocardial infarction apparently did not influence left ventricular performance.

Adult↗
PubMed1978

Effects of coronary-artery bypass on global and regional left ventricular function during exercise.

To determine the effect of coronary revascularization on exercise-induced abnormalities of left ventricular-ejection fraction and regional contraction, we obtained electrocardiograph-gated 99mTc radionuclide cineangiograms before and after operation in 23 consecutive patients. At rest, their average ejection fraction remained unchanged: 51 +/- 3 versus 54 +/- 4 per cent (+/- S.E.M.). However, 17 of the patients showed improvement of ejection fraction during postoperative exercise (increase of 51 per cent). The remaining six patients had no change or a decreased ejection fraction during exercise. All patients with improved ejection fractions during exercise were symptomatically improved. No improvement of regional function occurred at rest, but improvement did occur in regions of exercise-induced dysfunction. Although coronary revascularization has little effect on left ventricular function at rest, the ejection fraction during exercise and exercise-induced wall-motion abnormalities improve in most patients who experience symptomatic improvement.

Adult↗
PubMed1979

Left ventricular function after aortocoronary bypass surgery.

Aortocoronary bypass operations without additional myocardial surgery or valve replacement were performed at Ullevål Hospital in 190 patients during the period May 1971 to Dec. 1975. Postoperatively re-examination was made by left-heart catheterization in 124 patients at a mean interval of 18.2 months and right-heart catheterization in 108 patients at a mean interval of 16.0 months after surgery. The mean postoperative values for PCVP at rest, PCVP during exercise, LVEDP before contrast and LVEDP after contrast were significantly lower than the mean pre-operative values. The difference between pre- and postoperative values were largest in patients with elevated PCVP or LVEDP values before surgery, whereas in patients with low pre-operative values the mean values after surgery were unchanged or increased. The results indicate that marked improvement of left ventricular function may occur after aortocoronary bypass operations, even in patients with signs of ventricular failure at rest. A stress test is, however, of importance in evaluating the haemodynamic consequences of coronary surgery. No difference was found in patients with single versus patients with double or triple shunts. Post-operative shunt occlusion was found in 44 of 258 grafts at re-examination. No difference was found between patients with all shunts patent and patients with one or more shunts occluded as regard to mean postoperative PCVP and LVEDP values.

Adult↗
PubMed1978

Left ventricular function in beta-thalassemia and the effect of multiple transfusions.

Left ventricular performance was studied in 23 young patients with severe chronic anemia due to beta-thalassemia major and intermedia. The patients were divided into three groups according to the number of blood transfusions they had received. The left ventricle (LV) was enlarged in patients who had not received blood and larger still in patients who had received multiple transfusions. Echocardiography and systolic time interval measurements showed that systolic function of the LV was good in all the patients and that there was no statistical difference in systolic function in patients who had and those who had not received multiple transfusions. Heart rate was increased in the latter group. Stroke index and cardiac index were high, especially in patients in Group 3. The diastolic closure rate (EF slope) of the anterior mitral leaflet and its amplitude of movement were increased, but less so in Group 3; this may reflect an alteration in diastolic LV distensibility. The results indicate that despite the presence of cardiomegaly and severe clinical congestive heart failure, LV performance is well preserved in patients with beta-thalassemia, even in those who have received repeated blood transfusions. Clinical cardiac failure is the consequence of volume overload and abnormal chamber compliance. There was no evidence in this of a congestive cardiomyopathy.

Adolescent↗
PubMed1979

Aortic root motion for the assessment of left ventricular function in acute myocardial infarction.

In a group of patients with various cardiac disorders positive correlation between aortic root motion amplitude and stroke volume was observed: (y=3.41 + 0.061 chi, r=0.719n=27), where y is the aortic wall motion amplitude in mm and chi is the stroke volume in ml. During the serial investigation of 40 patients with acute myocardial infarction aortic root systolic motion amplitude was significantly different between patients groups, selected by the categories of Killip (1967). Biggest amplitudes were found in patients with complicated course, smallest amplitudes in cardiogenic shock. Aortic root systolic motion increased in a parallel direction with the clinical improvement of the patients. Aortic root echos are easily detectable, independent from segmental dysfunction, therefore useful in monitoring of left ventricular function of patients with acute myocardial infarction.

Acute Disease↗
PubMedDate not supplied

Left ventricular systolic wall stress as a primary determinant of myocardial oxygen consumption: comparative studies in patients with normal left ventricular function, with pressure and volume overload and with coronary heart disease.

Left ventricular dynamics, coronary blood flow (Vcor), and myocardial oxygen consumption (MVO2) were determined in normal patients (N), in chronic pressure overload (aortic stenosis, AS), in chronic volume overload (aortic incompetence, AI), and in coronary heart disease (CHD). Peak systolic and enddiastolic wall stress were increased in AS and AI by 26-52 per cent, the systolic stress being preferably increased in AS, whereas enddiastolic stress was markedly greater in AI. Vcor and MVO2 were elevated in both groups by 45-55 per cent (p less than 0.001). Sufficient correlation was present between peak systolic wall stress and the MVO2 (r equal to 0.82). Since at a given wall stress the MVO2 was somewhat increased in AI and AS when compared with N and CHD, the considerable inhancement of the rate of pressure development (AS) was well as of the external cardiac work (AI) may contribute to the increase in overall oxygen consumption. It is concluded that systolic wall stress represents a primary determinant of MVO2 in pressure and volume overload and that the MVO2 increases in these diseases when hypertrophy becomes inappropriate with regard to the pressure and volume demands imposed to the left ventricle.

Aortic Valve Insufficiency↗
PubMed1979

Normal left ventricular function.

The Starling relationship in the normal human ventricle may be different than usually portrayed. In normal, resting, supine man the ventricular function curve is at its peak at a left ventricular end-diastolic pressure of approximately 10 mm Hg. Below this point is a strong direct relation between filling pressure and stroke work, while at higher filling pressures, a plateau occurs. Limitation of ventricular response is related to a sharply rising ventricular pressure-volume curve at a normal level of filling pressure. Thus, in the supine position, the normal heart is not on the active portion of the ventricular function curve, but is in a unique position in which cardiac output is probably controlled by factors other than ventricular filling pressure. In ventricular failure, the peak of the ventricular function curve is displaced to a higher level.

Blood Pressure Determination↗
PubMed1979

Influence of post-extrasystolic potentiation on left ventricular function estimated by means of systolic time intervals.

Systolic time intervals were measured in 50 patients with frequent premature ventricular beats. The patients were divided into two groups: group I included those which showed in the beat that preceded an extrasystole a pre-ejection period/left ventricular ejection time (PEP/LVET) ratio greater than or equal to 0.43, and group II with PEP/LVET ratio greater than 0.44. Systolic time intervals recorded during post-extrasystolic potentiation were compared with those measured in the preextrasystolic complex. Also the measured intervals were tested against the hourly rate of premature beats obtained by electrocardiographic telemetric monitoring. The results confirmed the following results of previous reports: a) ventricular premature beats are followed by sinus-potentiated contractions inversely related to the coupling interval and dependent on adequate compensatory pauses; b) potentiated contractions are greater in patients with ventricular dysfunction. No relationship was found between left ventricular performance and the rate of premature beats. It is concluded that the effect of an antiarrhythmic intervention on the left ventricular function might be adequately evaluated by means of systolic time intervals and provoked post-extrasystolic potentiation, with the advantage of using totally non-invasive procedures.

Cardiac Complexes, Premature↗
PubMed1977

Influence of left ventricular function and other parameters on early and late mortality following coronary bypass surgery.

Left ventricular performance, coronary anatomy and postoperative clinical parameters of 66 control patients (group 1) randomly selected from 797 survivors of coronary bypass surgery were compared with those of 45 patients who died within 30 days of operation (group II) and 53 patients who died late (average, 22+/-2 mo) (group III). Average preoperative left ventricular end-diastolic pressure, ejection fraction and mean circumferential fibre shortening rate were significantly better in group I than in group III patients. These same parameters were not significantly different when group I was compared to group II. Abnormal wall motion was significantly less frequent in patients from group I than in patients from group II and III. Triple-vessel disease was present preoperatively in 40 (61%) controls compared with 37 (82%) early deaths (P = 0.021) and 35 (66%) late deaths (NS). The number of grafts placed per patient was not significantly different in the three groups. Perioperative myocardial in farction (MI) and low cardiac output syndrome were the commonest causes of early death. Late complications such as MI and heart failure occurred in 4 (6%) v; 15 (32%) (P = 0.0006) and 4 (6%) v. 27 (57%) (Pless than 0.0001) group I v. group III patients, respectively. Surgical expertise, preoperative ventricular performance and triple-vessel disease are important determinants of early mortality following bypass surgery and preoperative left ventricular performance is one of the most important determinants of late mortality,

Coronary Artery Bypass↗
PubMed2026

Recurrence of peripartum cardiomyopathy in subsequent pregnancy stratified by left ventricular function: a systematic review and meta-analysis.

AIMS: Subsequent pregnancy in women with prior peripartum cardiomyopathy (PPCM) carries a risk of relapse and adverse maternal outcomes. This meta-analysis aimed to determine the recurrence of PPCM relapse and associated maternal and foetal outcomes during subsequent pregnancy, stratified by baseline (pre-subsequent pregnancy) left ventricular ejection fraction (LVEF). METHODS: A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Nine databases were searched through June 2025 for cohort studies reporting subsequent pregnancy outcomes in women with prior PPCM, stratified as recovered (LVEF &#x2265;50%) or non-recovered (LVEF <50%) groups. Outcomes included PPCM relapse, maternal mortality, LVEF during and after pregnancy, LV recovery, symptom worsening, and obstetric/neonatal events. Risk of bias was assessed with ROBINS-E, and random-effects models were used. RESULTS: Six cohort studies comprising 266 women were included (174 in recovered group and 92 in non-recovered group). Relapse occurred in both groups with no significant difference [rate ratio (RR) 0.77, 95% CI 0.50-1.19; I2 = 3%]. Maternal mortality was significantly lower in the recovered group (1.7% vs 10.9%; RR 0.27, 95% CI 0.09-0.87; I2 = 0%). Recovered group had higher mean LVEF during subsequent pregnancy (mean difference [MD] 17.0; P < .001), higher postpartum LVEF (MD 11.69; P = .005; I2 = 84%), and greater likelihood of LV recovery (RR 2.07; P = .005; I2 = 0%). No significant differences were observed in symptom worsening or obstetric/neonatal outcomes. CONCLUSION: Recovered LVEF prior to subsequent pregnancy is associated with improved maternal outcomes, yet relapse remains common. Left ventricular ejection fraction alone is insufficient for risk stratification, and individualized multidisciplinary care is essential for all women with prior PPCM.

Female↗
PubMed1977

Cardiac work demands and left ventricular function in end-stage renal disease.

Cardiac hemodynamics were assessed by right and left heart catheterizations in nine patients on hemodialysis. Results showed increased stroke work index and left ventricular work indices. Left ventricular end-diastolic pressure was elevated in all patients (markedly so in five) and did not fall with occlusion of arteriovenous communications. Cardiac output was significantly elevated, but fell to normal postocclusion. Myocardial oxygen consumption, indirectly assessed by tension time and pressure rate indices, appeared increased. Six patients died: four from complications attributed to myocardial failure without infarction, one from transplant-related complications, and one from bacterial meningitis. Five had increased cardiac weights at autopsy, but none showed infarction. This study suggests that increased cardiac work is present in chronic renal failure. Myocardial mass increases result in increased myocardial oxygen demand; however, the increased oxygen requirements may not be met because of reduced erythrocyte mass. Persistance of pressure-volume overload and severe anemia are conducive to myocardial failure.

Adult↗
PubMed1976

[Laevocardiographic evaluation of left ventricular function. III. Aortic valve insufficiency (author's transl)].

1. The normally functioning left ventricle is characterised by a definite relationship between end-diastolic volume and ejection fraction (reduction of lateral systolic projectional area by 50 to 60%. 2. With increasing volume, the left fentricle shows increasing, end-diastolic size. 3. With pure aortic insufficiency, end-diastolic ventricular size is larger than it is with combined aortic valve disease. Hypertrophy is the predominant reaction of the left ventricle to increased resistance, but also to co-existent insufficiency. In addition the ejection fraction rises with increasing resistance. 4. End-diastolic areas up to 85 cm.2 and end-diastolic pressures up to 20 mmHg. can be regarded, rare cases excepted, as indices of normal contraction and are associated with a normal ejection fraction.

Adult↗