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Results for “Ventricular Function, Left”

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PubMed1986

[The isovolumetric index: a new index of left ventricular function].

The isovolumic index (IVI%), a new parameter of left ventricular function defined as (isovolumic contraction + isovolumic relaxation time)/left ventricular ejection time, is easily obtained from a routine echocardiogram. By simultaneous recordings of an electrocardiogram, a carotid arterial pulse tracing and the mitral valve echocardiogram, we calculated the IVI% as (time from R wave to MV opening-LVET)/LVET %. 90 normal subjects, mean age 38.32 +/- 11.8 years (range 20-60), underwent an echocardiographic study in order to calculate this index. The value of the IV% was 39.75% +/- 6.82 (range 21.4%-52.3%). The index was heart rate independent and showed a weak positive correlation with age (y = 32.4 + 0.19x; r = 0.33; p less than 0.01). The intraobserver and interobserver variability were 2.6% and 3.6%. The methodologic aspects of the calculation of the IVI% are discussed.

Adult↗

PubMed1994

Effect of successful angioplasty following thrombolysis on infarct size and left ventricular function.

The role of the angioplasty following thrombolysis in acute myocardial infarction has been discussed in several studies, however the effect of successful angioplasty on infarct size and left ventricular function has not been properly evaluated. Successful reperfusion was achieved in 79 out of 104 patients with primary anterior acute myocardial infarction. These patients were classified as follows, according to the type of intervention during the acute phase: 50 patients in which thrombolysis was successful (the thrombolysis group); 12 patients who underwent successful immediate angioplasty following successful thrombolysis (the immediate angioplasty group); and 17 patients in which rescue angioplasty was successful (the rescue angioplasty group). The 25 patients whose infarct-related vessels were not reperfused after intervention were classified as the non-reperfused group. Infarct size, evaluated as defect volume by T1-201 SPECT, 1 month after the onset, was 840 +/- 154 units (mean +/- S.D.) in the immediate angioplasty group and was similar to that in the thrombolysis group (948 +/- 88 units), but significantly smaller than in the non-reperfused group (1759 +/- 108 units). There were no significant differences in left ventricular function in the immediate angioplasty group and the thrombolysis group. Successful rescue angioplasty did not have any beneficial effect on left ventricular functions or infarct size, when compared with the failed thrombolytic group (1105 +/- 169 units vs. 1617 +/- 169 units). End-diastolic volume (52 +/- 3 ml/m2) in the successful rescue angioplasty group, however, was significantly smaller than in the failed thrombolysis group (67 +/- 3 ml/m2).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2004

Acute effects of smoking on left ventricular function and neuro-humoral responses in patients with known or suspected ischaemic heart disease.

Systolic left ventricular function was examined by radionuclide ventriculography in 12 habitual smokers with known or suspected ischaemic heart disease, aged 33-69 years, before, during, and after smoking of two cigarettes in a row and was repeated on a non-smoking control day. Plasma concentrations of adrenaline, noradrenaline, renin, and angiotensin II were determined on the smoking day, before and immediately after smoking. During smoking, there were significant increases in heart rate (+27%), rate-pressure product (+23%), and cardiac output (+14%) in the face of a significant increase in left ventricular end-systolic volume (+5%) and significant decreases in ejection fraction (-6%) and stroke volume (-8%). Blood pressure was virtually unchanged, and total peripheral resistance remained constant. Plasma adrenaline increased by 100%, renin decreased by 21%, and noradrenaline and angiotensin II did not change. The humoral changes were not correlated to changes in any of the haemodynamic variables. Areas of myocardial hypokinesis emerged or widened during smoking in 11 of 12 patients. Thus, in patients with known or suspected ischaemic heart disease, smoking was associated with an acute decrease in systolic ventricular function and development of widespread hypokinesis despite adrenaline stimulation.

Aged↗

PubMed1984

Global left ventricular function and regional wall motion in pure mitral stenosis.

Global left ventricular function (LVF) and segmental wall motion of the left ventricle are registered in 113 patients presenting a pure mitral stenosis (MS) and in a control group of 50 individuals. The segmental wall motion is measured on the end-diastolic-end-systolic frames of the left ventricle, obtained from right anterior oblique (RAO) monoplane cineangiography. Measurement of the segmental wall shortening is performed using the Stanford method. Group 1 includes 68 patients (60% of the total number of patients studied). These patients show no pathological contraction abnormality. In this group, the global LVF is not different from the control group. Group 2 includes 45 patients (40% of the total) for whom contraction abnormalities are present: anterior hypokinesis in 20% of the cases (anterior area mean shortening (AAS) = 18 +/- 8%; p less than 0.001 vs. group 1 and control group), and posterior hypokinesis in 20% of the cases (posterior area mean shortening (PAS) = 9.8 +/- 5.8%, p less than 0.001 vs. group 1 and control group). In this group, global LVF is impaired; ejection fraction (EF) = 0.57 +/- 0.1% (p less than 0.001 vs. group 1); velocity of circumferential fiber shortening (VCF) = 1 +/- 0.3 circ/s (p less than 0.001 vs. group 1); enddiastolic pressure (EDP) = 11 +/- 5 mmHg (p less than 0.01 vs. group 1). Segmental contraction abnormalities appear to be the main factor involved in the global LVF impairment. Segmental wall motion abnormalities could be related to subvalvular fibrosis, or LV filling difficulties, or principally, to a possible interplay between the right and the left ventricles.

Adult↗

PubMed1990

[Left ventricular function after prolonged exercise].

To determine whether depressed left ventricular (LV) contractile function can occur after exhaustive exercise, echocardiographic studies were performed in eleven athletes before, at the finish (9 minutes) and during recovery (15 hour) after the Biwa Lake Ironman Triathlon (3.2 km Swim, 161 km Bike, 32 km Run). Before racing and during recovery, the studies were performed both at rest and after brief exercise (10-15 minutes). Heart rates after brief exercise were comparable to those attained after racing. Digitized M mode echocardiographic data as to wall thickness, cavity dimension, fractional shortening (FS) and peak circumferential shortening (maxVcf) were obtained. When we compared race finish to pre-race brief exercise, the LV end-diastolic dimension (EDD) was reduced (46 +/- 7 vs 47 +/- 6 mm, less than 0.05) and FS declined (33 +/- 5 vs 39 +/- 6%, p less than 0.05). In spite of reduced wall stress, maxVcf decreased. Individual percent reductions in FS were not correlated with decrease in EDD, but correlated with increases in EDS. Although a persistent reduction in cavity size was observed during recovery, FS and maxVcf returned toward the baseline. The results suggest that prolonged strenuous exercise may result in impaired LV function in part because of a reversible depression in the contractile state.

Adult↗

PubMed2006

Support vector analysis of color-Doppler images: a new approach for estimating indices of left ventricular function.

Reliable noninvasive estimators of global left ventricular (LV) chamber function remain unavailable. We have previously demonstrated a potential relationship between color-Doppler M-mode (CDMM) images and two basic indices of LV function: peak-systolic elastance (Emax) and the time-constant of LV relaxation (tau). Thus, we hypothesized that these two indices could be estimated noninvasively by adequate postprocessing of CDMM recordings. A semiparametric regression (SR) version of support vector machine (SVM) is here proposed for building a blind model, capable of analyzing CDMM images automatically, as well as complementary clinical information. Simultaneous invasive and Doppler tracings were obtained in nine mini-pigs in a high-fidelity experimental setup. The model was developed using a test and validation leave-one-out design. Reasonably acceptable prediction accuracy was obtained for both Emax (intraclass correlation coefficient Ric, = 0.81) and tau (Ric, = 0.61). For the first time, a quantitative, noninvasive estimation of cardiovascular indices is addressed by processing Doppler-echocardiography recordings using a learning-from-samples method.

Algorithms↗

PubMed2003

Impact of acute hyperglycemia on left ventricular function after reperfusion therapy in patients with a first anterior wall acute myocardial infarction.

OBJECTIVE: This study was undertaken to assess the relationship between acute hyperglycemia and left ventricular function after reperfusion therapy for acute myocardial infarction (AMI). METHODS: This study consisted of 529 patients with a first anterior wall AMI who underwent coronary angiography followed by coronary angioplasty or thrombolysis within 12 hours after the onset of chest pain. Plasma glucose was measured at the time of hospital admission. Acute hyperglycemia was defined as plasma glucose >10 mmol/L. RESULTS: Although acute hyperglycemia was associated with both lower acute left ventricular ejection fraction (LVEF) (46% +/- 12% vs 48% +/- 10%, P =.026) and lower predischarge LVEF (51% +/- 15% vs 56% +/- 15%, P =.001), the difference was more pronounced in the latter and the change in LVEF was significantly smaller in patients with acute hyperglycemia (4.8% +/- 11.2% vs 8.0% +/- 13.8%, P =.022). Multivariable analysis showed that there was a significant correlation between plasma glucose and impaired predischarge LVEF, even after adjustment of acute LVEF (r = -0.13, P =.005). Thirty-day mortality tended to be higher in patients with acute hyperglycemia than in patients without (7.1% vs 3.5%, P =.06). Multivariable analysis showed that plasma glucose (per 1 mmol/L increase) was an independent predictor of 30-day mortality after AMI (odds ratio 1.12, 95% CI 1.03-1.22, P =.009). CONCLUSION: Acute hyperglycemia was independently associated with impaired left ventricular function and higher 30-day mortality after AMI. These results may provide a potential explanation for poor outcomes of patients with AMI and acute hyperglycemia.

Acute Disease↗

PubMed2003

Apical tissue tracking echocardiography for characterization of regional left ventricular function: comparison with magnetic resonance imaging in patients after myocardial infarction.

OBJECTIVE: The purpose of this study was to characterize the normal pattern of apical tracking and to investigate whether tissue tracking imaging is more useful for evaluation of regional left-ventricular function than noncontrast harmonic echocardiography in patients after myocardial infarction. BACKGROUND: Left ventricular longitudinal shortening plays an important role in cardiac contraction, and can be evaluated online by a new Doppler tissue imaging method. METHODS: We included 40 healthy participants and 40 patients after myocardial infarction. They underwent tissue tracking imaging and noncontrast harmonic imaging by an experienced and an inexperienced observer. Diagnostic accuracy of semiquantitative evaluation of left ventricular function was compared using magnetic resonance imaging as reference method. RESULTS: Velocity-time integrals decreased from basal to apical segments in healthy participants. Tissue tracking imaging has a higher diagnostic sensitivity than noncontrast imaging for the diagnosis of regional wall-motion abnormalities (expert, 78% vs 97%, P <.01; beginner, 63% vs 91%, P <.001), whereas specificity remained unchanged (expert, 99% vs 97%, not significant; beginner, 91% vs 92%, not significant). CONCLUSIONS: Tissue tracking imaging is feasible and evaluates regional systolic myocardial function quantitatively with high diagnostic accuracy compared with magnetic resonance imaging in patients after myocardial infarction, and is more accurate than noncontrast harmonic echocardiography.

Aged↗

PubMed2005

Global left ventricular function in cardiac CT. Evaluation of an automated 3D region-growing segmentation algorithm.

The purpose was to evaluate a new semi-automated 3D region-growing segmentation algorithm for functional analysis of the left ventricle in multislice CT (MSCT) of the heart. Twenty patients underwent contrast-enhanced MSCT of the heart (collimation 16 x 0.75 mm; 120 kV; 550 mAseff). Multiphase image reconstructions with 1-mm axial slices and 8-mm short-axis slices were performed. Left ventricular volume measurements (end-diastolic volume, end-systolic volume, ejection fraction and stroke volume) from manually drawn endocardial contours in the short axis slices were compared to semi-automated region-growing segmentation of the left ventricle from the 1-mm axial slices. The post-processing-time for both methods was recorded. Applying the new region-growing algorithm in 13/20 patients (65%), proper segmentation of the left ventricle was feasible. In these patients, the signal-to-noise ratio was higher than in the remaining patients (3.2+/-1.0 vs. 2.6+/-0.6). Volume measurements of both segmentation algorithms showed an excellent correlation (all P<or=0.0001); the limits of agreement for the ejection fraction were 2.3+/-8.3 ml. In the patients with proper segmentation the mean post-processing time using the region-growing algorithm was diminished by 44.2%. On the basis of a good contrast-enhanced data set, a left ventricular volume analysis using the new semi-automated region-growing segmentation algorithm is technically feasible, accurate and more time-effective.

Aged↗

PubMed1994

Left ventricular function at 3 months after successful thrombolysis. Impact of reocclusion without reinfarction on ejection fraction, regional function, and remodeling.

BACKGROUND: After successful thrombolysis for acute myocardial infarction, reocclusion is observed in about 30% of patients after 3 months and usually occurs without reinfarction. We studied the impact of reocclusion without reinfarction on global and regional left ventricular function and on remodeling during that period. METHODS AND RESULTS: The patients for this analysis constituted a subset of those enrolled in the APRICOT-trial, which was designed to study the efficacy of antithrombotics on the prevention of reocclusion. Patients were selected who had a left anterior descending- or right coronary artery-related myocardial infarction, had an angiographically patent infarct-related vessel when studied < 48 hours after intravenous thrombolysis, and underwent repeat cardiac catheterization at 3 months. Paired contrast ventriculograms of quality sufficient to analyze regional wall motion, global ejection fraction, and ventricular volumes were analyzed in 129 patients. Enzymatic infarct size and baseline left ventricular function as well as other baseline characteristics were similar in patients with (n = 34) and without (n = 95) reocclusion. Ejection fraction improved in anterior infarction without reocclusion from 47 +/- 10% to 54 +/- 13% (P = .0001) but not with reocclusion (baseline, 48 +/- 13%; 3 months, 48 +/- 16%). No improvement was seen in inferior infarction with or without reocclusion. Persistent patency allowed preservation of end-systolic volume index (ESVI) at 3 months (37 +/- 14 mL/m2) to baseline level (38 +/- 13 mL/m2), with a better chance for improvement of > 10 mL/m2 without reocclusion in those with baseline values > 40 mL/m2. After reocclusion, in contrast, ESVI increased from 37 +/- 14 to 43 +/- 20 mL/m2 (P = .08). Comparable mean changes of ESVI in response to persistent patency or reocclusion were seen in anterior versus inferior infarction. Recovery of infarct zone contractility was impaired by reocclusion, both in terms of abnormality of segment shortening and expressed in the number of segments showing abnormal wall motion. In anterior but not in inferior infarction, infarct zone contractility was better with good collaterals to the reoccluded artery compared with poor collaterals. CONCLUSIONS: After successful thrombolysis for acute myocardial infarction, reocclusion without reinfarction withholds salvaged myocardium from regaining contractility. This has deleterious consequences for regional and global left ventricular function and for remodeling. To further optimize prognosis in patients after thrombolysis, future research should focus on the prevention of reocclusion and should evaluate revascularization therapy in patients with reocclusion.

Collateral Circulation↗

PubMed1976

Effects of intravenous nitroglycerin on left ventricular function and ST segment changes in acute myocardial infarction.

It has been shown previously that 30-minute infusions of intravenous nitroglycerin in patients with acute myocardial infarction are able to lower left ventricular filling pressure and improve left ventricular function while lowering mean arterial pressure by only 7 mmHg (0.9 kPa). A decrease in sigmaST in praecordial ST segment mapping studies during nitroglycerin infusion in patients with anterior infarction suggested a decrease in the extent of myocardial ischaemia. In the present study, 30 patients with acute myocardial infarction received 1- to 3-hour infusions of intravenous nitroglycerin at infusion rates sufficient to lower mean arterial pressure by an average of 22 mmHg (2.9 kPa). An improvement in ventricular function was noted in that subgroup of patients with the msot severe left ventricular dysfunction. All patients with anterior myocardial infarction underwent serial ST segment mapping and, irrespective of the presence or absence of left ventricular failure, showed a decrease in sigmaST during nitroglycerin infusion (P less than 0.005). These findings suggest that infusion of nitroglycerin improves left ventricular function and/or alters left ventricular compliance in patients with left ventricular failure complicating myocardial infarction and furthermore decreases sigmaST in all patients, irrespective of the presence or absence of left ventricular failure, suggesting that the extent of myocardial ischaemia is decreased.

Acute Disease↗

PubMed1994

[Left ventricular function and secondary angioplasty after anterior infarction in simple coronary vessel disease].

Arterial patency is a good prognostic factor in terms of survival and left ventricular function after myocardial infarction. The aim of this prospective study was to evaluate the benefit of secondary angioplasty of the infarct-related artery in single vessel, left anterior descending disease, on regional and global left ventricular function. Initial coronary angiography was undertaken at the 7th +/- 2 days after the onset of infarction. Arterial patency was assessed by the TIMI criteria and by percentage stenosis on quantitative angiography. Forty consecutive patients (Group I) underwent conventional angioplasty of the left anterior descending artery at the 9th +/- 2 days. Twelve consecutive patients (Group II) did not undergo angioplasty. A repeat coronary angiographic study was performed at 3 months. The results showed no difference between the two groups of patients in base line values. A significant improvement in arterial patency was observed in Group I (TIMI Grades II or III) and in residual stenosis at 3 months (54.7 +/- 13% versus 80.6 +/- 13%, p < 0.05). In addition, a significant improvement in ejection fraction of +4.7% (p < 0.02), of left anterior descending myocardial regional wall motion of +7.6 (p < 0.02) and a reduction of induced left ventricular end systolic volume of -2.2 ml/m2 (p < 0.05) were observed in Group I. Initial segmental hypokinesia or akinesia improved in 67.5% of patients. However, 50% of patients in Group II improved their segmental wall motion abnormalities at 3 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2003

[Mid- to long-term effects of delayed percutaneous coronary intervention on left ventricular function and prognosis in patients with acute myocardial infarction].

OBJECTIVE: To investigate the mid- to long-term effects of delayed percutaneous coronary intervention (PCI) on the left ventricular function and clinical outcome of patients with acute myocardial infarction (AMI). METHODS: PCI (including percutaneous transluminal coronary angioplasty and stenting) was performed in 42 patients within 1 to 2 weeks following the onset of AMI (PCI group), with another 31 patients who were admitted within the same period to receive medication for AMI serving as the control group. The patients in both groups were observed for comparison of the occurrence of reinfarction and angina, mortality at 1 and 6 months, and findings by ultrasound cardiograms (UCG). RESULTS: In PCI group, the left ventricular function were obviously improved as compared with the control group (P<0.01) 1 month after the onset of AMI, showing greater improvement at 6 months (P<0.01). No death or reinfarction occurred in the PCI group, with only 1 patients experiencing angina 5 months after PCI. In control group, death occurred in 2 cases, reinfarction in 1 case, recurrent angina in 4 cases (include 2 cases of early postinfarction angina). CONCLUSION: Delayed PCI may significantly improve the prognosis of patients with AMI and prolong their survival without cardiovascular accidents and ameliorate their left ventricular functions, with high success rate of the operation.

Adult↗

PubMed2000

[Short- and long-term changes in left ventricular function after surgical correction of mitral regurgitation].

After surgical treatment of mitral regurgitation (MR) left ventricular dysfunction (LVD) can appear, which is an important predictive factor of long-term morbidity and mortality. The aim of our retrospective study was the assessment of left ventricular function (LVF) with M-mode echo measurement in the early and late postoperative period. Between 01. 01. 1992. and 31. 12. 1996. 70 patients with MR (29 men, 41 women, mean age 53.8 years) had at least three M-mode echoes: before surgery (I.), after surgery within 1 year (II.) and after the first postoperative year (mean 2.4 years) (III.). The patients were divided into subgroups: a) prosthetic valve replacement (MB) 58 patients, valvuloplasty (PL) 12 patients, b) coronary bypass grafting (C) 12 patients, no coronary disease (NC) 58 patients, c) chordal rupture (R) 24 patients, other etiology (NR) 46 patients. The evaluation of LVF was based on the ejection fraction (EF) calculated from the end-diastolic (Dd) and end-systolic (Ds) diameters on M-mode echo. Statistical analysis was made by paired and unpaired t test and with correlation analysis. The Dd decreased in the whole group (T) and in all subgroups in the II. and III. measurements compared to the I. (T: 58.9 vs. 52.6 vs. 53.2 mm; p < 0.0001, p < 0.0001). The Ds did not change in any group. In all groups except C the EF decreased at the II. measurement compared to the I. values (T: 57.7 vs. 47.8%, p < 0.0001; MB: 56.6 vs. 46.6%, p < 0.0001; PL: 62.8 vs. 53.8%, p = 0.05; NC: 59.6 vs. 48.3%, p < 0.0001; R: 61.5 vs. 50.4%, p < 0.0003; NR: 55.6 vs. 46.5% p = 0.0002), and it remained significantly lower in the III. measurement as well. At the III. measurement the EF was below 55% in all groups. In the groups T, MB, NC, NR the EF increased at the III. measurement compared to the II. (W: 47.8 vs. 51.3%, p = 0.002; PVR: 46.6 vs. 51.4%, p = 0.001; NC: 48.3 vs. 52.8%, p = 0.005; NR: 46.5 vs. 49.9%, p = 0.05). In the group C the I., II., III. EF values were not significantly different. There were 33 patients with preoperative EF more than 60%. In this group the EF decreased at the II. measurement, but the III. measurement showed normalization of the EF (67.03 vs. 52.58 vs. 59.27%, p < 0.0001, p < 0.01). There was no strong correlation between the preoperative EF, Ds and early or late postoperative EF (r = 0.54, r = -0.58; r = 0.62, r = -0.56). In patients operated for MR the postoperative EF is diminished independently on the preoperative EF, the operative technique or etiology. Left ventricular dysfunction concealed by the volume overload is unmasked by the decreased EF in the early postoperative period. LVD is partly reversible in the majority of the cases, however complete reversibility takes place only in cases with preoperative EF over 60%. Hence the operation of MR in patients with EF less than 60% is considered to be too late for the reversibility of LVD.

Adult↗

PubMed1999

[Left ventricular function evaluation after mitral valve replacement with preservation the subvalvular apparatus].

The objective of this study was to evaluate the left ventricular function after mitral valve replacement (MVR) with preservation of all chordae. Fourteen patients with a diagnosis of mitral regurgitation were studied. These patients, 4 males and 10 females, age from 24 to 59 years, who underwent mitral valve replacement, in which all chordae tendineae were preserved. The mean follow-up interval was 6 months. Preoperation and postoperation multigated equilibrium radionuclide angiography was performed by Elscint Helix Apex SPECT. Each patient was injected with 740MBq 99mTc-HSA, rest ejection fraction (global EF) of LV (%), regional ejection fraction (EF) of LV (%), PER/S and PFR/S were measured. Regional EF was calculated by the method of dividing the left ventricle into five segments by radial axis. The results showed that the postoperative EF of the whole left ventricle of the chordae-preserved patients was significantly greater than their preoperative EF (40.0% +/- 17.8%, to 51.6% +/- 18.2%, P < 0.02), and also the regional EF at the lateral wall of the chordae-preserved MVR was significantly greater than the preoperative regional EF (an increase from 51.0% +/- 18.1% to 69.7% +/- 21.2%, P < 0.01). MVR with preservation of all chordae, the patient's left ventricular function remarkably improved.

Adult↗

PubMed1985

The effects of Valsalva maneuver on global and segmental left ventricular function in presence and absence of coronary artery disease.

To determine the effects of the Valsalva maneuver on global and regional left ventricular function, single-plane left ventriculograms were performed in the 30-degree right anterior oblique projection in 50 patients during normal breath holding and during the late strain phase of the Valsalva maneuver. Thirty-one patients had significant coronary artery disease (greater than 70% luminal narrowing in a major coronary artery). Ventriculograms were analyzed for determination of ejection fraction, end-diastolic, and end-systolic volumes. Regional wall motion was analyzed by a chord method of calculating segmental fractional shortening. Ejection fraction increased significantly in the entire group of patients (62 +/- 16% to 70 +/- 19%, p less than 0.0001), while both end-diastolic (105 +/- 33 cc to 88 +/- 34 cc, p less than 0.0001) and end-systolic volumes (43 +/- 29 cc to 30 +/- 29 cc, p less than 0.0001) showed striking reductions with Valsalva maneuver. Patients without significant coronary disease usually exhibited global augmentation in left ventricular function, while those with coronary disease often exhibited only segmental improvement. This augmentation appeared to be dependent on the patency of the supplying coronary vessel.

Adult↗

PubMed2005

Effects of simvastatin on blood lipids, vitamin E, coenzyme Q10 levels and left ventricular function in humans.

BACKGROUND: As statin therapy has been reported to reduce antioxidants such as vitamin E and coenzyme Q10 and there are indications that this reduction may cause impairment of left ventricular function (LVF), we studied the influence of simvastatin on LVF and serum vitamin E and coenzyme Q10 levels in humans. MATERIAL AND METHODS: We assessed the effect of simvastatin on left ventricular function and coenzyme Q10 levels in 21 (11 male, 10 female) hypercholesterolaemic subjects (mean age = 56 years) with normal LVF, over a period of 6 months. Subjects were re-tested after a 1-month wash-out period (7 months). Echocardiography was performed on all subjects before commencement of simvastatin (20 mg day(-1)), and at 1, 3, 6 and 7 months after initiation of treatment. Fasting blood samples were also collected at these intervals to assess lipids, apoproteins, vitamin E and coenzyme Q10. RESULTS: Serum lipids showed the expected reductions. Plasma vitamin E and coenzyme Q10 levels were reduced by 17 +/- 4% (P < 0.01) and 12 +/- 4% (P < 0.03) at 6 months. However, the coenzyme Q10/LDL-cholesterol ratio and vitamin E/LDL-cholesterol ratio increased significantly. Left ventricular ejection fraction (EF) decreased transiently after 1 month, while no significant change was observed at 3 and 6 months. Other markers of left ventricular function did not change significantly at any time point. CONCLUSION: Despite reduced plasma vitamin E and coenzyme Q10, 20 mg of simvastatin therapy is associated with a significantly increased coenzyme Q10/LDL-cholesterol ratio and vitamin E/LDL-cholesterol ratio. Simvastatin treatment is not associated with impairment in left ventricular systolic or diastolic function in hypercholesterolaemic subjects after 6 months of treatment.

Adult↗

PubMedDate not supplied

[Evaluation of left ventricular function with a 16-slice multidetector tomograph (MDCT-16): correlation with cardiovascular magnetic resonance imaging].

UNLABELLED: The evaluation of Left ventricular function has both prognostic as well as therapeutic implications in patients with heart disease. Non-invasive coronary angiography with computed tomography using 16 slices (MDCT-16) allows to obtain images of the coronary anatomy due to its high spatial and temporal resolution, and also, to obtain data regarding Left ventricular function. The objective of this study was to correlate the use of MDCT-16 for the evaluation of the Left ventricular parameters using MRI as the Standard of reference. METHODS: MRI: Se A 1.5 Tesla GE CvI Scanner optimized for cardiovascular applications was used. Using an ECG gated steady state fast precession sequence (SSFP, Thickness 10 mm, Flip Angle 45, FOV 36 cm. NEX 1, Frequency 256, Phase 128, Partial FOV 0.75, 16VPS), 6 to 8 short axis images of from base to apex of the left ventricle were obtained. Tomography: Using a 16 slice Multidetector tomograph (GE Lightspeed) and using ECG synchronization, images of the heart were obtained after the administration of 80 mls. of no-ionic contrast. The images were reconstructed off-line to obtain from 6 to 8 slices in a similar fashion to that of MR. Both studies were independently analyzed by 2 operators who obtained the ventricular function data. Linear correlation and a Paired T Student test was used to analyze the data and was considered significant when p < 0.05. RESULTS: 20 consecutive patients were evaluated with MDCT-16 and MRI, 18 males, mean age 52 +/- 15 years. There was no significant difference among the measurements for cardiac CT and MRI of the end-diastolic volume (EDV) and end-sistolic volume (ESV), stroke volume (SV), LV Mass or LV ejection fraction (LVEF). CONCLUSION: This results show a high correlation among the clinically relevant ventricular function parameters evaluated by cardiovascular CT and MRI. This findings suggest that ventricular function can be successfully evaluated along with the coronary anatomy using MDCT-16.

Coronary Angiography↗