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At least 163 records · Page 9Linked to original sources

PubMed1995

Left ventricular volume in thrombolysed patients with acute anterior myocardial infarction: the effect of captopril and xamoterol.

We measured left ventricular volume in 70 asymptomatic patients after first Q-wave anterior myocardial infarction in order to determine whether ventricular dilatation occurs and whether there is evidence for its attenuation or prevention by treatment with captopril or xamoterol--PRevention Of VEntricular Dilatation?: the PROVED? study. 77% of patients received thrombolytic treatment. Patients were randomised a mean of 11 days after infarction to receive either captopril 25 mg three times daily, xamoterol 200 mg twice daily or matching placebo. After 6 months of treatment, 6 patients from the placebo group (n = 24), 1 from the captopril group (n = 23) and 3 from the xamoterol group (n = 23) had been withdrawn from the study because of clinical complications. Left ventricular volume was measured using magnetic resonance imaging, before randomisation and after 6 months of treatment. Changes in left ventricular end-diastolic and end-systolic volume after 6 months of treatment were defined prospectively as the primary endpoints. Mean initial end-diastolic volume index was 85 (S.D. 19) ml/m2, mean end-systolic volume index was 45 (S.D. 18) ml/m2, and mean ejection fraction was 48 (S.D. 11)% for the whole group. There was no significant change in left ventricular volume index in the placebo or either treatment group after 6 months of treatment. Only minimal left ventricular dilatation was evident at 11 days. No further increase in left ventricular volume occurred after six months and there was no additional benefit from treatment with either captopril or xamoterol.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Agonists↗

PubMedDate not supplied

Automated assessment of ventricular volume and function by echocardiography: validation of automated border detection.

To determine the utility of a new on-line echocardiographic automated border detection (ABD) algorithm in assessing ventricular volume and ejection fraction, an optimal model was studied. This open-chest canine model allowed continuous measurement of actual left ventricular volume. In four dogs, true end-systolic and end-diastolic volume and ejection fraction were compared with those obtained by two-dimensional echocardiography with an automated method calculated from a border detection algorithm to define left ventricular endocardium and the single-plane Simpson method to calculate volume. Left ventricular volumes that used manual, off-line tracings of the left ventricle by two-dimensional echocardiograms and the single-plane Simpson method were compared. The automated echocardiographic volumes correlated with true volumes (y = 0.7x + 8.9; standard error of the estimate = 13.5 cc; r = 0.81). A significant mean underestimation of 11 +/- 15 cc was noted (p < 0.0001). Volumes obtained from the manual tracings of left ventricular endocardial contours also correlated well with true volumes (y = 0.89x + 4; standard error of the estimate = 6.7 cc; r = 0.96). However, the 3 +/- 7 underestimation was significantly lower than the error of the ABD method (p = 0.00005). Both on-line ABD and off-line ejection fractions correlated well with true ejection fractions (r = 0.94 and 0.96, respectively). There was no statistically significant difference between the mean errors of the ABD or manually derived ejection fractions. In the setting of optimal left ventricular imaging, the on-line and rapid features of this automated method make it potentially useful for quickly obtaining left ventricular volumes and ejection fraction.

Algorithms↗

PubMed1979

Accuracy of ventricular volume estimation.

Sources of error in the estimation of ventricular volume from CAT scans are discussed and the accuracy of the measurement assessed. Two methods of calculating ventricular volume from an intraventricular injection of radioisotope are described and compared. Finally, the CAT scan and isotope methods are compared and contrasted. The error associated with a single measurement of volume by any of these techniques is between 20% and 30%. In patients with no ventricular catheter there is no choice other than to use CAT scanning, but if intraventricular injection is possible this method offers a potentially more accurate volume determination because of his higher signal-to-noise ratio.

Cerebral Ventricles↗

PubMed1994

Real-time ventricular volumes and cardiac function in the working rat heart.

The measurement of instantaneous left ventricular volumes throughout the cardiac cycle in a rat heart beating at rates of 300 to 600 min-1 with a chamber volume of only a few tenths of a milliliter is difficult. Combining an x-ray scatter detection system with a small x-ray source collimated to scatter low energy x-rays off a working rat heart, measurements of real-time changes in ventricular volumes can be determined. The x-ray scatter signal is proportional to the volume and can be calibrated to measure the actual volume. Using this system, changes in ventricular function can readily be detected. An example of data obtained from increasing preload with a fixed afterload is shown. This technique not only distinguishes an increasing stroke volume, but also more rapid early diastolic filling and systolic ejection rates with increasing preload. This new x-ray scatter technique appears to be a promising way to measure rapidly changing left ventricular volumes and function in the working rat heart. This could significantly enhance the scientific use of the rat model.

Animals↗

PubMed2000

Early experience with left ventricular volume reduction surgery in Syria.

OBJECTIVE: To review our early experience with left ventricular volume reduction surgery (the Batista operation) in the management of patients with end-stage heart failure. METHODS: Between December 1996 and April 1998, 10 patients (9 males, mean age 32yr) with advanced symptomatic cardiomyopathy underwent left ventricular volume reduction surgery at Damascus University Cardiovascular Surgical Center. The cause of cardiomyopathy was idiopathic in three patients, valvular in four, ischemic in two, and viral myocarditis in one patient. Concomitant procedures included aortic valve replacement in four patients, mitral valve repair in six patients, and coronary artery bypass grafting in two patients. RESULTS: All patients survived the procedure. Echocardiography prior to discharge documented significant improvement in ejection fraction in all but two patients. Mean follow-up was 7.6 months. After discharge, three patients developed progressive congestive heart failure to which they subsequently succumbed, and two more patients died suddenly late postoperatively. Only two patients continue to show both clinical and echocardiographic evidence of improvement. CONCLUSION: Left ventricular volume reduction surgery cannot be freely advocated until better means are found to identify patients who will benefit from the procedure, and proper prophylaxis against fatal postoperative complications can be afforded.

Adolescent↗

PubMed1970

Effects of nitroglycerin on left ventricular volumes and wall tension in patients with ischaemic heart disease.

Since the dimensions of the ventricles are related to both myocardial tension and myocardial oxygen consumption (MVO2), the effects of nitroglycerin on the left ventricular volumes and left ventricular haemodynamics were studied in patients with ischaemic heart disease. The ventricular volumes were estimated using the constant infusion technique (indocyanine green) of Shaffer (1964). Sublingual administration of nitroglycerin (0.6 mg.) resulted in a significant reduction in cardiac output (27%), mean systolic pressure (21%), left ventricular end-diastolic pressure (63%), stroke volume (27%), left ventricular end-diastolic volume (26%), and left ventricular work (41%). Both calculated circumferential myocardial force (40%) and the myocardial tension (33%) decreased during systole, while the pressure-time index decreased by 27%. A similar decrease was also found in the contractile element work (42%), and mean circumferential fibre shortening rate (22%). Thus, this study has shown that the major determinants of MVO2, i.e. myocardial wall tension, the velocity of contraction, and contractile element work, decrease significantly after administration of nitroglycerin.

Angina Pectoris↗

PubMed1998

The effect of ventricular volume reduction surgery in the dilated, poorly contractile left ventricle: a simple finite element analysis.

OBJECTIVES: Ventricular volume reduction surgery has been proposed by Batista to improve cardiac function in patients with dilated cardiomyopathy. However, limited clinical data exist to determine the efficacy of this operation. A finite element simulation is therefore used to determine the effect of volume reduction surgery on left ventricular end-systolic elastance, diastolic compliance, stroke work/end-diastolic volume (preload recruitable stroke work), and stroke work/end-diastolic pressure (Starling) relationships. METHODS: End-diastole and end-systole were represented by elastic finite element models with different unloaded shapes and nonlinear material properties. End-systolic elastance, diastolic compliance, preload recruitable stroke work, and Starling relationships, as well as energy expenditure per gram of unresected myocardium, were calculated. Two different types of volume reduction surgery (apical and lateral) were simulated at 10% and 20% left ventricular mass reduction. RESULTS: Ventricular volume reduction surgery causes diastolic compliance to shift further to the left on the pressure-volume diagram than end-systolic elastance. Volume reduction surgery increases the slope of the preload recruitable stroke work relationship (dilated cardiomyopathy 0.006 J/mL; 20% lateral volume reduction surgery 0.009 J/mL) but decreases the slope of the Starling relationship (dilated cardiomyopathy 0.028 J/mm Hg; 20% lateral volume reduction 0.023 J/mm Hg). For a given amount of resection, lateral volume reduction has a greater effect than apical volume reduction. Ten-percent and 20% lateral volume reduction reduces energy expenditure by 7% and 17%, respectively. CONCLUSION: Ventricular volume reduction surgery shifts end-systolic elastance and diastolic compliance to the left on the pressure-volume diagram. The net effect on ventricular function is mixed. Volume reduction surgery increases the slope of preload recruitable stroke work, but increased diastolic compliance causes a small decrease in the Starling relationship (3 mm Hg difference between dilated cardiomyopathy and volume reduction surgery at stroke work = 0.5 J).

Adult↗

PubMed1993

Determination of cardiac ejection fraction and left ventricular volume: contrast-enhanced ultrafast cine MR imaging vs IV digital subtraction ventriculography.

OBJECTIVE: To assess the accuracy of contrast-enhanced, single breath-hold cine MR imaging in the calculation of left ventricular volume and ejection fraction, we compared values obtained by using this method with those obtained by using IV digital subtraction angiography (IV-DSA). SUBJECTS AND METHODS: All patients (n = 28) had conventional cine and contrast-enhanced ultrafast cine MR imaging. For ultrafast cine MR imaging, a phase-rewind gradient-echo (rewind-SMASH) sequence was used: TR, 8 msec (standard excitation and acquisition block of 6 msec with phase rewind pulse of 2 msec); TE, 3.2 msec; a 128 x 96 matrix (pile encode factor, 6; k-space segment, 16); a 200-mm field of view; and one excitation. RESULTS: Values for left ventricular volume and ejection fraction obtained with ultrafast cine MR imaging correlated well with those obtained with IV-DSA (end-diastolic volume, y = 0.986x - 7.79, r = .985; end-systolic volume, y = 0.863x + 0.71, r = .984; ejection fraction, y = 0.877x + 6.44, r = .887). In the calculation of left ventricular volume by the area-length method, manual tracing of the left ventricular cavity was more difficult when the conventional cine method was used than when the enhanced ultrafast cine method was used. CONCLUSION: Our results show that cardiac multiphase study with horizontal long-axis, first-pass, contrast-enhanced, single breath-hold, cine MR imaging is an accurate and highly reproducible method of evaluating left ventricular volume and ejection fraction.

Angiography, Digital Subtraction↗

PubMed1993

A comparison of methods for estimating left ventricular volumes from radionuclide ventriculography.

An accurate reproducible measurement of left ventricular volume is important in the evaluation of cardiac disease. Four methods of left ventricular volume measurement by radionuclide ventriculography have been compared and their reproducibility assessed in a patient group. The methods studied were a geometric method, a method based on count data alone and two methods which require a blood sample and an estimate of ventricular depth. The accuracy of absolute volumes is difficult to determine due to the lack of a 'gold standard'. The method using count data alone was found to give reproducible results. Volumes can be calculated quickly and easily from data acquired in a standard radionuclide ventriculogram. End systolic volumes calculated using this method clearly separated normal and abnormal patient groups.

Aged↗

PubMed2000

Effects of losartan and captopril on left ventricular volumes in elderly patients with heart failure: results of the ELITE ventricular function substudy.

BACKGROUND: The mechanism by which angiotensin-converting enzyme inhibitors reduce mortality rates and disease progression in patients with heart failure is likely mediated in part through prevention of adverse ventricular remodeling. This study examined the effects of the angiotensin-converting enzyme inhibitor captopril and the angiotensin II type 1 receptor antagonist losartan on ventricular volumes and function in elderly patients with heart failure and reduced left ventricular ejection fraction (< or =40%). METHODS: Patients underwent radionuclide ventriculograms (RVG) at baseline and were randomized to either captopril (n = 16) or losartan (n = 13). After 48 weeks, another RVG was obtained. Therapy was then withdrawn for at least 5 days, and the RVG was repeated while the patient was not receiving the drug. RESULTS: At 48 weeks both captopril and losartan significantly reduced left ventricular (LV) end-diastolic volume index (135 +/- 26 to 128 +/- 23 mL/m(2) for losartan, P <.05 vs baseline; 142 +/- 25 to 131 +/- 20 mL/m(2) for captopril, P <.01; mean (SD). Captopril also reduced LV end-systolic volume index (98 +/- 24 to 89 +/- 21 mL/m(2), P <.01 vs. baseline), whereas a nonsignificant trend was observed for the losartan group (97 +/- 23 to 90 +/- 16 mL/m(2), P = not significant). The between-group differences in the changes in LV volumes were not statistically significant. After drug withdrawal, LV end-diastolic volume index remained significantly lower than baseline in the captopril group (P <.01). CONCLUSIONS: Both captopril and losartan prevent LV dilation, representing adverse ventricular remodeling, previously seen with placebo treatment. Reverse remodeling was observed in the captopril group. On the basis of these results, the relative effects on LV remodeling do not provide a rationale for a survival benefit of losartan over captopril.

Aged↗

PubMed2003

Is there a correlation between operative results and change in ventricular volume after shunt placement? A study of 60 cases of idiopathic normal-pressure hydrocephalus.

In patients with communicating or normal-pressure hydrocephalus, ventricular volume decreases following implantation of differential pressure valves. We implanted hydrostatic (Miethke dual-switch) valves in 60 patients with normal-pressure hydrocephalus (NPH) between September 1997 and December 2001. The patients underwent CT 1 year after operation, and we measured the Evans index. Although 83% of the patients showed no change in ventricular volume as assessed by this index, 72% nevertheless showed good to excellent and 16% satisfactory clinical improvement, while 12% showed no improvement. Moderate or marked reduction in ventricular size was observed in 17%, of whom 40% of these patients showed good to excellent and 20% satisfactory clinical improvement; 40% showed unsatisfactory improvement. The favourable outcome following implantation of a hydrostatic shunt thus did not correlate with decreased ventricular volume 1 year after operation, better outcomes being observed in patients with little or no alteration in ventricular size than in those with a marked decrease. Postoperative change in ventricular volume in NPH thus does not have the same significance as in patients with high-pressure hydrocephalus.

Aged↗

PubMed1986

Simplified count-based estimates of left ventricular volume.

Accurate count-based radionuclide estimates of left ventricular volume without the use of a blood sample have not been well described. Resting gated blood pool scans were obtained within 24 hours of catheterization in 31 patients (group 1), and simultaneously with thermodilution cardiac outputs in 29 other patients (group 2) at rest and during an induced-volume change (intervention). End-diastolic and end-systolic volumes were calculated from the single-plane angiogram in Group 1 and from the combination of thermodilution stroke volume and radionuclide ejection fraction in group 2. Excellent correlations were noted between scintigraphic counts and angiographic volumes (r = 0.964), between scintigraphic counts and thermodilution-derived volumes (r = 0.979), and between interventional scintigraphic counts and interventional thermodilution-derived volumes (r = 0.941). Thermodilution and scintigraphic volume changes during the intervention were well correlated (r = 0.85). Accurate count based estimates of left ventricular volume without a blood sample are feasible at rest and during an intervention.

Adult↗

PubMed2004

Right ventricular volume measurements in ventilated preterm neonates.

Pulmonary hypertension is associated with worse perinatal outcomes in infants with respiratory disorders. In these infants, right ventricular dysfunction may result in poor pulmonary blood flow. The objective of this study was to follow changes in right ventricular volumes during the first 2 days of life in infants with respiratory distress syndrome. Serial echocardiographic examinations were performed on days 0-2 on infants ventilated for respiratory distress syndrome. Two-dimensional echocardiography with the ellipsoid approximation was used to calculate systolic and diastolic volumes. In 17 ventilated preterm infants, right ventricular volumes were significantly lower on day 2 compared with day 0 and decreased from a median (interquartile range) end systolic volume of 0.80 ml/kg (0.66-0.91 ml/kg) to 0.45 ml/kg (0.39-0.54 ml/kg) ( p < 0.001). End diastolic volume decreased from a median (interquartile range) of 1.54 ml/kg (1.44-1.65 ml/kg) to 1.30 ml/kg (1.22-1.60 ml/kg) ( p = 0.039). Right ventricular ejection fraction increased from a median (interquartile range) of 0.48 ml/kg (0.44-0.56 ml/kg) to 0.62 ml/kg (0.58-0.71 ml/kg) during the same period ( p < 0.001), as did right ventricular output from a median (interquartile range) 120 ml/kg/min (96-125 ml/kg/min) to 140 ml/kg/min (113-168 ml/kg/min) ( p = 0.044). Right ventricular volume decreases during the first 2 days of life in ventilated preterm infants. However, right ventricular performance is maintained.

Cardiotonic Agents↗

PubMedDate not supplied

Impact of photon energy recovery on the assessment of left ventricular volume using myocardial perfusion SPECT.

BACKGROUND: Photon energy recovery (PER) is a spectral deconvolution technique validated for scatter removal in patients and phantom studies. The purpose of this study was to examine the impact of PER on left ventricular volume measurement based on myocardial perfusion single photon emission computed tomography (SPECT). METHODS AND RESULTS: SPECT acquisitions were performed by use of a static cardiac phantom and in 25 patients after a rest injection of technetium 99m sestamibi by use of multiple energy windows (126-136, 137-144, and 145-154 keV). Data were successively reconstructed with and without PER, by use of iterative reconstruction and post-processing filtering (Butterworth filter; order, 5; cutoff, 0.30 cycles/pixel). Image contrast was evaluated in reconstructed data, and volumes were calculated by use of QGS. PER increased reconstructed image contrast from 62% +/- 2.7% to 84.3% +/- 5.7% in the phantom studies (P <.0001) and from 49% +/- 2% to 73% +/- 2% in patients (P <.0001). Although it remained underestimated (P <.0001), phantom volume was higher after PER correction compared with uncorrected data (50.9 +/- 0.8 mL vs 44.6 +/- 1 mL, P <.0001). The error in volume measurement was decreased by PER correction (16.6% +/- 1.3% vs 27% +/- 1.7% [uncorrected data], P <.0001). In patients, left ventricular volume increased from 83 +/- 10 mL to 91 +/- 10 mL (P <.0001), and the PER-induced volume increase was correlated with the image contrast increase (r = 0.61, P =.001). Finally, the percentage of volume increase was higher in patients with small left ventricular volumes. CONCLUSIONS: PER has a significant impact on image contrast and left ventricular volume measurement by use of perfusion SPECT. PER improves the accuracy of phantom volume assessment. In patients, volume increase is correlated to image contrast increase and is higher in those with small ventricles.

Aged↗

PubMed1997

Changes in right ventricular volume in early human neonates.

To evaluate changes in the right ventricular volume in early human neonates, twenty fullterm infants were examined at 2, 24 and 120 h of age by two-dimensional echocardiography. End-diastolic and end-systolic right ventricular volumes (RVEDV and RVESV, respectively) were calculated with a computer system based on the bi-plane Simpson's rule using the apical four chamber and parasternal short axis views. Then right ventricular stroke volume (RVSV), ejection fraction (RVEF), and the mean normalized systolic ejection rate were obtained. The inner diameter of the ductus arteriosus was also measured simultaneously. RVEDV increased significantly by 24 h of age, but remained constant thereafter. RVESV remained virtually unchanged from 2 to 120 h, resulting in a significant increase (36%) of RVSV at 24 h compared with that at 2 h. The mean normalized systolic ejection rate remained unchanged. There was a good correlation between RVEDV and RVSV (r = 0.83). All ductus arteriosus except three narrow ones was closed by 24 h of age. In conclusion, at 24 h of age, the significantly increased RVEDV was closely related to the increased RVSV, which might be induced by increased volume load to the right ventricle because of the closure of the ductus arteriosus.

Ductus Arteriosus↗

PubMed1987

Right and left ventricular volumes in vitro by a new nongeometric method.

We present an evaluation of a new nongeometric technique for calculating right and left ventricular volumes. This method calculates ventricular chamber volumes from multiple cross-sectional echocardiographic views taken from a single point as the echo beam is tilted progressively through the ventricle. Right and left ventricular volumes are calculated from both the approximate short axis and approximate apical position on 20 in vitro human hearts and compared with the actual chamber volumes. The results for both ventricles from both positions are excellent. Correlation coefficients are > 0.95 for all positions; the standard errors are in the range of 5 to 7 mL and the slopes and intercepts for the regression lines are not significantly different from 1 and 0, respectively (except for the left ventricular short-axis intercept). For all positions, approximately 6 to 8 views are needed for peak accuracy (7.5 degrees to 10 degrees separation). This approach offers several advantages. No geometric assumptions about ventricular shape are made. All images are acquired from a single point (or window), and the digitized points can be used to make a three-dimensional reconstruction of the ventricle. Also, during the calculations a volume distribution curve for the ventricle is produced. The shape of this curve can be characteristic for certain situations (ie, right ventricle, short axis) and can be used to make new simple equations for calculating volume. We conclude that this is an accurate nongeometric method for determining both right and left ventricular volumes in vitro.

Adult↗

PubMedDate not supplied

Comparison of electron beam computed tomography with magnetic resonance imaging in assessment of right ventricular volumes and function.

OBJECTIVE: Intraindividual comparison of right ventricular volumes and function using electron beam computed tomography (EBT) and magnetic resonance imaging (MRI). METHODS: Twenty-seven patients with a known cardiac history were referred for evaluation of ventricular function parameters. The following standardized protocols were used: contrast-enhanced multislice mode EBT and gradient echo sequence MRI. Right ventricular end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) were calculated using a slice summation method. Interobserver variability was calculated. RESULTS: The correlation between the 2 methods was: r = 0.901 for EDV, r = 0.938 for ESV, r = 0.823 for SV, and r = 0.953 for EF. Electron beam computed tomography overestimated EDV and ESV slightly when compared with MRI (P < 0.05). No significant differences (P > 0.05) were found between SV and EF. Mean values determined by EBT and MRI were as follows: 168.6 +/- 62.3 mL and 153.7 +/- 59.1 mL for EDV, 104.7 +/- 60.4 mL and 95.1 +/- 54.8 mL for ESV, 63.2 +/- 19.3 mL and 58.7 +/- 19.8 mL for SV, and 40.2% +/- 14.1% and 40.2% +/- 13.6% for EF, respectively. Interobserver variability ranged between 1.0% and 3.2%. CONCLUSION: Electron beam computed tomography shows good agreement with a close correlation and an acceptable interobserver variability for right ventricular volumes and global function, with a small but significant overestimation of EDV and ESV when compared with MRI.

Adult↗

PubMed2002

Comparison of right ventricular volume measurement between segmented k-space gradient-echo and steady-state free precession magnetic resonance imaging.

PURPOSE: To compare right ventricular volume measurements and their reproducibility between steady-state free precession (SSFP) and conventional turbo gradient-echo (TGE) imaging. MATERIALS AND METHODS: Right ventricular volumes and observer variabilities were compared between SSFP and TGE in 31 subjects (21 normal volunteers and 10 subjects with heart failure). For further internal validation of the right ventricular volumes, the left ventricle (LV) and right ventricle (RV) stroke volumes were compared for the normal volunteers. RESULTS: The volumes as measured by SSFP were significantly larger than for TGE (mean bias end-diastolic volume [EDV] 11.1 +/- 14.2, end-systolic volume [ESV] 9.8 +/- 9.75). SSFP had lower interobserver variability (SSFP EDV -10.1 +/- 11.6 vs. TGE EDV -6.2 +/- 18.5) and intra-observer variability (SSFP EDV -2.0 +/- 6.3 vs. TGE EDV -6.1 +/- 14.8). The mean absolute differences between LV and RV stroke volumes for 21 normal volunteers were: TGE 5.8 +/- 12.9 (r(2) = 0.72), SSFP 4.6 +/- 6.9 (r(2) = 0.92). CONCLUSION: SSFP and TGE yield different measurement values of RV volumes with SSFP, providing a more reproducible measurement.

Case-Control Studies↗