检索结果-南通市图书馆

Right Ventricular Mechanical Changes after Septal Myectomy for Obstructive Hypertrophic Cardiomyopathy: Vector Velocity Imaging Study

引用

World Journal of Cardiovascular Diseases 2019年第7期9卷 467-488页

作者： hala mahfouz badran Ghada Soltan Naglaa Faheem Mohamed Ezzat Enait Magdi H. Yacoub Cardiology Department Menoufia University Al Minufya Egypt The BAHCM National Program Aswan Heart Center Egypt Imperial College London UK

Objectives: The impairment of right ventricular (RV) myocardial mechanics is evident in hypertrophic cardiomyopathy (HCM). It is independently influenced by LV mechanics and correlated to the severity of LV phenotype. We investigated the changes in RV global and regional deformation following surgical septal myectomy using vector velocity imaging (VVI). Methods: 25 HCM patients, 68% males with mean age (34.5 ± 12 years) were examined before and within two months after surgical myectomy using VVI. In addition to conventional echocardiographic parameters, peak systolic strain (εsys), strain rate (SR) and time to peak εsys (TTP) of regional RV free wall (RVFW) & septal walls were analyzed in longitudinal (long) directions from apical four-chamber view and their (Δ) changes were calculated. Similar parameters were quantified in LV from apical 2 & 4 CH views. Intra-V-delay was defined as SD of TTP and inter-V dyssynchrony was estimated from TTP difference between the most delayed LV segment & RVFW. Results: All study patients showed improvement of their functional class from NYHA class III to class I and reduction of LVOT gradient to below 20 mmHg except one patient who had 30 mmHg gradients at rest. There was significant reduction of septal thickness, left atrial diameter & volume, LVOT gradient, LVMI, severity of mitral regurgitation, tricuspid annular velocities (P < 0.0001), RV diameter (P < 0.02) and increase in LV internal dimensions(P < 0.001) post myectomy. However, there was significant reduction of RV and LV systolic mechanics;RV global εsys % (from -16.1% ± 4.4% to -12.9% ± 2.9%, P < 0.0001) and LV global εsys %: from -11.6% ± 2.8% to -9.4% ± 2.2%, P < 0.0001) respectively. The magnitude of reduction of RV strain (ΔRV εsys %, ΔSRsys) was directly correlated LV maximal wall thickness (r = 0.46, P < 0.01) and ΔRV dyssynchrony (TTP-SD) (r = 0.4, P < 0.05) and negatively correlated to age (r = -0.46, P sys (r = -0.52, P < 0.01) and pre-op LV EF % (r = -0.43, P , t

关键词： Right Ventricle Deformation Imaging Hypertrophic Cardiomyopathy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Impact of Left Bundle Branch Block on Left Ventricular Mechanics in Patients with Idiopathic Dilated Cardiomyopathy

引用

World Journal of Cardiovascular Diseases 2019年第2期9卷 132-148页

作者： Ahmed Emara hala mahfouz badran Waleed Abdou Naglaa Fahim Mohamed Fathi Magdi H. Yacoub Cardiology Department Menoufiya University Menoufia Governorate Egypt The BAHCM National Program Menoufia Governorate Egypt Imperial College London UK

Objectives: Left bundle branch block (LBBB) is commonly associated with heart failure. We evaluated the prevalence and impact of LBBB on left ventricular mechanics using 2D strain imaging in patients with idiopathic dilated cardiomyopathy (IDCM). Methods: We included 101 patients with IDCM with mean age 38 ± 18 years: 74% were males and 13.9% of them were in NYHA Class III-IV. LBBB was present in 26 (37%) of included patients. Myocardial mechanics including longitudinal, circumferential strain and rotation and LV synchronization were assessed using two-dimensional strain imaging. Results: LBBB group had higher LV volumes, and PAP compared with non LBBB. Peak LV longitudinal systolic strain (εsys) of the septum and global LV SRsys were significantly lower in LBBB compared to non LBBB group (P 0.01, 0.03). TTP-d was greater in LBBB in comparison to non LBBB group (274.5 ± 116 versus 209.4 ± 139, P 0.02). The electromechanical delay between septal segments was 35 ± 18 ms and between lateral wall segments: 48 ± 24 ms, between anterior wall segments: 21 ± 11 and between inferior wall segments: 41 ± 12. Consequently, LV mechanical dyssynchrony was more evident in IDCM patients with LBBB. QRS width was correlated inversely with LV longitudinal strain and strain rate and electromechanical delay (P 0.0001) in non LBBB group. In LBBB QRS width was not related to cardiac mechanics. Using univariate analysis and after a multiple covariate adjustment, the baseline LBBB was associated with a significantly increased LV dysfunction. Conclusion:After correcting for potential confounders, LBBB was found to be associated with more deterioration of LV mechanics and exaggerated LV dyssynchrony in patients with IDCM.

关键词： Idiopathic Dilated Cardiomyopathy LBBB 2D Strain Imaging

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Diagnostic value of dobutamine stress Doppler tissue imaging in diabetic patients with suspected coronary artery disease

引用

World Journal of Cardiovascular Diseases 2011年第1期1卷 1-12页

作者： Mohamed Fahmy Elnoamany hala mahfouz badran Tarek Salah Khalil Abdalla Mostafa Kamal Amany Ragab Serag Rehab Ebraheem Yaseen 不详

Background: Coronary artery disease (CAD) is often silent in diabetic patients, and it is typically in ad-vanced stages of development by the time it manifests. Various forms of stress testing have been investigated to detect obstructive CAD in diabetes mellitus. Ob-jectives: To assess the diagnostic value of dobutamine stress pulsed-wave Doppler tissue imaging (DTI) compared with standard wall motion analysis in de-tection of myocardial ischemia in diabetic patients with suspected CAD. Methods: The study comprised 46 diabetic patients with suspected CAD underwent dobutamine stress echocardiography (DSE) with DTI within 4 weeks before coronary angiography(CA). Dobutamine infusion started at 5 μ/kg/min and in-creased up to 40 μ/kg/min with additional atropine during submaximal heart rate responses. In addition to wall-motion score index (WMSI) analysis, pulsed- wave DTI examination of basal and mid segments of posteroseptal, lateral, anterior, inferior and antero- septal walls was performed. Myocardial velocities were measured at rest in the apical 4, 3 and 2-cham- ber views. The measurements were repeated at low dose (10 - 15 μ/kg/min) and at peak stress (40 μ/kg/min). DTI measurements included peak systolic velocity (S), peak early diastolic velocity (E) and peak late diastolic velocity (A) and the results were com-pared to WMSI analysis. Patients were classified into two groups according to CA results;group (I) di-abetics with positive CA (n = 27) and group (II) di-abetics with negative CA (n = 19). Results: There was no significant difference between the two groups in duration of diabetes, global WMSI at rest or the ? changes (stress-rest/rest) of WMSI (P > 0.05). Global S and global E were significantly lower in group I compared to group II at peak stress (11.3 ± 3.7 cm/sec vs. 14.5 ± 2.2 cm/sec, p < 0.01) and (11.3 ± 1.6 cm/sec vs. 13.1 ± 2.1 cm/sec, p < 0.01) respectively. The cutoff points for global S and global E to detect obstructive CAD in diabetics were

关键词： Doppler Tissue Imaging Dobutamine Stress Diabetes Mellitus

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：