• Title/Summary/Keyword: Diastolic function

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Echocardiographic Findings after Mitral Valve Replacement (승모판막치환수술 전후 심장초음파 소견의 변화에 관한 연구)

  • 이상진
    • Journal of Chest Surgery
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    • v.27 no.8
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    • pp.656-663
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    • 1994
  • Evaluation of heart function is of importance in assessing the results of valvular heart surgery. Information on volume and functional change of heart chamber can be obtained by cardiac catheterization and echocardiography. We studied 41 patients with mitral stenosis[MS] and 23 patients with mitral regurgitation[MR] using M-mode echocardiography before and after mitral valve replacement[MVR] at Pusan Paik Hospital. Preoperative cardiac catheterization was available in 56 cases, and the results were obtained as follows. 1. In patients with MS, preoperative average LV end-diastolic dimension[EDD] and end-systolic dimension[ESD] were remained within normal range, but postoperative EDD and ESD were significantly decreased[P<0.01]. The preoperative and postoperative LV ejection fraction[EF] were remained within the normal range and no significant change[P>0.05]. The preoperative left atrial dimension[LAD] was enlarged considerably above normal[P<0.01], but was significantly decreased after surgery[P<0.001]. The preoperative LV posterior wall thickness[PWTh] was within normal range, and no significant change after surgery[P>0.05]. 2. In patients with MR, preoperative average end-diastolic dimension[EDD] and end-systolic dimension[ESD] were significantly greater than normal[P<005], but postoperative EDD and ESD were significantly decreased[P<0.01]. The preoperative LV ejection fraction[EF] and fractional shortening[FS] were within normal range, and no significant change after surgery[P>0.05].The preoperative left atrial dimension[LAD] was enlarged considerably above normal [P<0.01], but was significantly decreased after surgery[P<0.001].The preoperative LV posterior wall thickness[PWTh] was within normal range, and no significant change after surgery[P>0.05].

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Effects of Trauma-Related Shock on Myocardial Function in the Early Period Using Transthoracic Echocardiography

  • Ma, Dae Sung
    • Journal of Trauma and Injury
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    • v.34 no.2
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    • pp.119-125
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    • 2021
  • Purpose: The present study aimed to analyze the effect of trauma-related shock on myocardial function in the early stages of trauma through transthoracic echocardiography (TTE) findings. Methods: We performed a retrospective review and analysis of the medical records of patients aged ≥18 years who were evaluated by TTE within 2 days of admission for trauma-related shock (n=72). Patients were selected from a group of 739 patients admitted with trauma-related shock between January 2014 and December 2016. Results: The incidence rate of myocardial dysfunction in the left ventricle (LV) was 6.8% (5/72), with rates of 7.7% (4/52) in the thoracic injury group and 5.0% (1/20) in the non-thoracic injury group. In the diastolic function of LV, relaxation abnormality was present in 55.8% (29/52) of patients in the thoracic injury group and 50% (10/20) of patients in the non-thoracic injury group. Conclusions: This study may suggest that traumatic shock without thoracic injury may influence myocardial function in the early stages after trauma. Therefore, evaluation of myocardial function may be needed for patients experiencing shock after trauma, regardless of the presence of thoracic injury.

Analysis of Left Ventricular Diastolic Function in Coronary Artery Disease with Gated Blood Pool Scan (관상동맥질환에서 Gated Blood Pool Scan을 이용한 좌심실 확장기능의 분석)

  • Choi, Chang-Woon;Lim, Sang-Moo;Chung, June-Key;Lee, Myung-Chul;Park, Young-Bae;Seo, Joung-Don;Lee, Young-Woo;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.20 no.2
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    • pp.39-45
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    • 1986
  • Resting gated blood pool scan was used to derive left ventricular functional changes in normals (N=13, mean age=43) and in patients with coronary artery disease (N=50, mean age=53). Peak filling rates, average filling rates, and ejection fractions were significantly depressed in coronary artery disease. (p<0.0005, each other). And in coronary artery disease with normal ejection fraction (N=21), peak filling rates and average filling rates were depressed also, and peak filling rates of coronary artery disease with normal ejection fraction were abnormal in 61.2% and average fillin rates were abnormal in 71.4%. It appears that (1) resting peak filling rates and average filling rates were sensitive and easily obtainable parameters of the diastolic dysfunction assosiated with coronary artery disease, (2) a significant proportion of coronary artery disease patients without any evidence of abnormal systolic function have depressed resting peak filling rates and average filling rates of the left ventricle.

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Impact of Pulmonary Arterial Elastance on Right Ventricular Mechanics and Exercise Capacity in Repaired Tetralogy of Fallot

  • Soo-Jin Kim;Mei Hua Li;Chung Il Noh;Seong-Ho Kim;Chang-Ha Lee;Ja-Kyoung Yoon
    • Korean Circulation Journal
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    • v.53 no.6
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    • pp.406-417
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    • 2023
  • Background and Objectives: Pathophysiological changes of right ventricle (RV) after repair of tetralogy of Fallot (TOF) are coupled with a highly compliant low-pressure pulmonary artery (PA) system. This study aimed to determine whether pulmonary vascular function was associated with RV parameters and exercise capacity, and its impact on RV remodeling after pulmonary valve replacement. Methods: In a total of 48 patients over 18 years of age with repaired TOF, pulmonary arterial elastance (Ea), RV volume data, and RV-PA coupling ratio were calculated and analyzed in relation to exercise capacity. Results: Patients with a low Ea showed a more severe pulmonary regurgitation volume index, greater RV end-diastolic volume index, and greater effective RV stroke volume (p=0.039, p=0.013, and p=0.011, respectively). Patients with a high Ea had lower exercise capacity than those with a low Ea (peak oxygen consumption [peak VO2] rate: 25.8±7.7 vs. 34.3±5.5 mL/kg/min, respectively, p=0.003), while peak VO2 was inversely correlated with Ea and mean PA pressure (p=0.004 and p=0.004, respectively). In the univariate analysis, a higher preoperative RV end-diastolic volume index and RV end-systolic volume index, left ventricular end-systolic volume index, and higher RV-PA coupling ratio were risk factors for suboptimal outcomes. Preoperative RV volume and RV-PA coupling ratio reflecting the adaptive PA system response are important factors in optimal postoperative results. Conclusions: We found that PA vascular dysfunction, presenting as elevated Ea in TOF, may contribute to exercise intolerance. However, Ea was inversely correlated with pulmonary regurgitation (PR) severity, which may prevent PR, RV dilatation, and left ventricular dilatation in the absence of significant pulmonary stenosis.

Effect of Vasoactive Intestinal Peptide on Renal Function in Rats (Vasoactive Intestinal Peptide(VIP)의 백서신장기능(白鼠腎臟機能)에 미치는 영향(影響))

  • Kim, Suhn-Hui;Cho, Kyung-W
    • The Korean Journal of Physiology
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    • v.16 no.2
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    • pp.159-163
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    • 1982
  • Vasoactive intestinal peptide (VIP) found in duodenal mucosa originally has been suggested as a neurotransmitter. Its localization, however, now known, is not limited to the gastrointestinal tract, but scattered at many different kinds of tissues, smooth muscles, endocrine gland and exocrine gland as well as central and peripheral neural tissues. To investigate the effect of VIP on renal function, an experiment has been done in anesthetized male rats. The results obtained were: 1) Urinary output and creatinine clearance decreased significantly during the period of infusion of VIP, 2.0ug/rat/7minutes. 2) Urinary excretion of sodium, potassium and chloride decreased but without significance by infusion of VIP. 3) Blood pressure, systolic and diastolic, decreased by VIP administered intravenously in the period of infusion. 4) Changes of urinary output, sodium and chloride excretion was correlated with changes of creatinine clearance. The above data suggest that VIP administered intravenously can suppress the renal hemodynamics indirectly, and also decrease electrolyte excretion through its renal hemodynamic change.

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Effects of Soaansintang(SOAT) on the hemodynamics and electrocardiogram of isolated rat hearts induced by electrical stimulation (소아안신탕(小兒安神湯)이 STRESS를 유발한 흰쥐의 적출심장(摘出心臟)에 미치는 영향)

  • Lee Seung-Jun;Lee Jin-Yong;Kim Deok-Gon
    • The Journal of Pediatrics of Korean Medicine
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    • v.14 no.2
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    • pp.1-32
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    • 2000
  • It has long been known that SOAT is effective for sudden palpitation occurring unexpectedly in Oriental Medicine. However, effect of SOAT on the isolated heart has not been studied yet. The purpose of this study is to investigate the effect of SOAT on hemodynamics and ECG of isolated rat hearts induced by electrical stimulation using Langendorff perfusion apparatus for nonworking heart. SOAT extract was manufactured by water-alcohol precipitated method. Sprague-Dawley rats weighting $120{\sim}150g$ were used for the experiments, Subject animals were divided into four groups, which are consisted of 1) control(Group orally administered by normal saline 1ml for 14days), 2) sample A(Group orally administered by SOAT extract 1ml for 14days), 3) sample C(Group injected by SOAT extract 0.5ml after stimulation, 4) sample C(Group injected by SOAT extract 1ml after stimulation. To evluate the effects of SOAT on hemodynamics and ECG of isolated rat heart induced by stimulation, heart rate, left ventricular pressure, systolic power, diastolic power, coronary artery perfusion volume and ECG were measured using Langendorff apparatus in both stimulation mode(5 volts, 450 beats/min) and arrythmic mode(5 volts, 420 beats/min including 60 beats/min) The results obtained are as follows : 1. After receiving stressful electrical stimuli, isolated heart showed the heart rate, left ventricular pressure, systolic power, diastolic power, coronary artery perfusion volume were all decreased temporarily, but perfusion continued longer recovery to the control state appeared. However, the coronary artery perfusion volume diminished continuously. 2. The heart rates did not change significantly with both stimulation mode and arrhythmic mode, among experimental groups. 3. The left ventricular pressure showed with both stimulation mode and arrhythmic mode, the significant changes(p<0.05) especially in the injection sample group. In case of stimulation mode, low concentration injection group(0.5ml) was more significantly increased rather than high concentration group(1ml) and in case of arrhythmic mode, high density group(1ml) was so increased than the other(0.5ml). 4. For the systolic power and diastolic power, no significant changes were noticed in the stimulation mode, but in the arrhythmic mode of injection sample groups, significant change(p<0.05) was noticed in both systolic power and diastolic power. Specially the high concentration group(1ml) showed more significant increase than the low concentration group. 5. For the coronary artery perfusion volume, no significant change difference among sample groups was observed in both the stimulation mode and the arrhythmic mode. 6. For the ECG recordings, arrhythmia was induced by electrical stimulus of arrythmia mode and after the stimulus was removed, irregular wave appeared temporarily, but as perpusion continued, recovery to the control state was abtained like the stimulation mode. According to the above results, SOAT significantly changed the hemodynamic data from the electrically stressed, isolated hearts of connected Langendorff perfusion apparatus and we propose SOAT has the direct effects on the muscular function of heart.

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Effect of Therapy on Stress and Quality of Life in Patients Undergoing Hemodialysis (음악요법이 혈액투석환자의 스트레스와 삶의 질에 미치는 영향)

  • 김영옥
    • Journal of Korean Academy of Nursing
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    • v.23 no.3
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    • pp.431-452
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    • 1993
  • This study was done to determine the effect of music therapy on stress and quality of life in patients undergoing hemodialysis. The research design was a nonequivalent control group pre -post test design. The subjects consisted of 21 patients who received hemodialysis in two hospitals located in Kwang Ju. The fourteen receiving treatment in one hospital were assigned to the experimental group and the seven in the other hospital to the control group. Data were gathered from December 14, 1992 to January 16, 1993 through questionnaires and physiological measurement. Data were analyzed by the SAS package using frequency, t-test, paired t-test and Pearson Prod uct - Moment Correlation Coefficient. The results of this study are summarized as follows ; 1. There were no significant differences between the two groups on stress scores and quality of life scores before the treatment. 2. The mean score on the psychological stress scale for the patients undergoing hemodialysis was 2.48 out of a maximum mean score of four, the items with high stress scores were “feeling of weakness and annoyed by everything”, “limitation of food”, “limitation of fluid”, “change in skin color” in that order. The psychological category showed the highest stress score followed by developmental, scoioeconomic and physiological stress categories in that order. 3. In the experimental group, post - test diastolic blood pressure decerased significantly(t=3.24, p=0.0064), but in the control group pre and post - test diastolic blood pressure were not different. 4. There was no difference between the two groups on the pre and post -test psychological stress scores or the depression scores. 5. The mean score of quality of life for patients undergoing hemodialysis was 2.75 out of a maxi-mum mean score of five. The category of ‘emtional state’ showed the highest score followed by ‘self - esteem’, ‘physical state and function’, ‘economic life’, ‘relationship with neighbors’ and ‘family relationship’ categories in that order. There was no significant difference in the pre and post - test quality of life scores between the two groups. 6. Hypothesis 1 that patients undergoing hemodialysis who received music therapy would have less stress than patients undergoing hemodialysis who did not receive music therapy is divided into two sub - hypotheses. 1) The first sub-hypothesis that patients undergoing hemodialysis who received music therapy would have less physiological stress than patients undergoing hemodialysis who did not receive music therapy was partly supported. Among three physiological stress indices (pulse, systolic blood pressure, diastolic blood pressure), only diastolic blood pressure decreased significantly after the treatment in the experimental group. 2) The second sub-hypothesis that patients undergoing hemodialysis who received music therapy would have less psychological stress than patients undergoing hemodialysis who did not receive music therapy was not supported. Psychological stress score and depression score were not significantly different before and after the treatment. 7. Hypothesis 2 that patients undergoing hemodialysis who received music therapy would have a higher quality of life score than patients undergoing. hemodialysis who did not received music therapy was not supported. There were no significant changes in the quality of life scores before and after the treatment.

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Effect of Korea Red Ginseng on the Symptoms and Hemodynamics in Healthy Elders

  • Jin En-Yuan;Li Ya-Jun;Yang Lian-Xing;Jin Ming;Wei Yu-Lin;Nam Ki Yeul
    • Proceedings of the Ginseng society Conference
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    • 2002.10a
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    • pp.27-34
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    • 2002
  • Clinical study on hemodynamics of healthy elders before and after tread mill. Using doubleblind, placebo-controlled study design. Seventy-five 50-70 years old volunteers without organic disease were divided into two groups, Ginseng group and control group. Each subject was received 3 g Korea Red Ginseng (KRG) capsules or placebo per day for 4 weeks. Before and after administration 4 weeks, the symptoms were asked and hemodynamics parameter such as pump function, systolic function, preload and afterload were recorded before and after tread mill 1,5, 10 minutes by the method of thoracic impedance cardiograph. The result showed that Ginseng could improve quality of life, had obvious effect of increasing PEP (pre-ejection period), PEP/LVET (pre-ejection period/left ventricular ejection period), PCWP (wedged pressure pulmonary capillary). The change rate of HR (heart rate), SV (stroke volume) in KRG group were much lowered, while EF (ejection fraction), LVET (left ventricular ejection period), LVEDP (left ventricular end diastolic pressure) was recovered much quickly. The circulation showed Ginseng could improve the quality of life though its promoting circulation function which are increasing both the systolic function and the preload.

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Postoperative Left Ventricular Dynsfunction in Adult PDA (성인 동맥관 개존증 수술 후 좌심실 기능 저하의 위험 인자 분석)

  • 윤태진
    • Journal of Chest Surgery
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    • v.33 no.10
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    • pp.785-791
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    • 2000
  • Left ventricular dysfuction is common in immediate postoperative periods after surgical correction of heart diseases with chronic left ventricular volume overload. We speculated postoperative changes of left ventricular volume and unction in patients with patent ductus osus(PDA) who had underwent surgical repair at ages older than 16 years. Factors influencing postoperative left ventricular volume and function were also analyzed. Material and Method: From August 1989 to August 1999 thirty-siz adult patients with PDA 28 females and 8 males. were enrolled in this study. Their age ranged from 16 years to 57 years(mean :32 years). Types of surgical repair were division with primary closure in 22, division with patch closure in 6, internal obliteration using cardiopulmonary bypass in 4 and ligation in 4. Aortic clamping was combined during surgical repair in 22(61%) and cardiopulmonary bypass was used in 8(22%) Two-dimensional echocardiography studies were performed in 34(94%) preoperatively and in 25(66%) immediate postoperatively to assess postoperative changes of left ventricular internal dimensions. left ventricular volume and ejection fraction. Duration of postoperative follow-up ranged from 1 month to 99 months (mean:22 months) and 10 patients underwent 16 echocardiographic evaluation during this period Result : Preoperative and postoperative left ventricular systolic dimensions(LVIDs) were 42$\pm$8.0mm and 42$\pm$8.3mm left ventricular diastolic dimensions(LVIDd) were 64$\pm$10.0mm and 56$\pm$7.4mm left ventricular end systolic volumes(LVESV) were 62$\pm$19cc (z=1.87$\pm$0.06) and 59$\pm$24cc(z=1.78$\pm$0.08) left ventricular end diastolic volumes(LVEDL) were 169$\pm$40cc(z-1.17$\pm$0.1) and 112$\pm$29cc(z=0.85$\pm$0.1) and ejection fractions(EF) were 66$\pm$6.7% and 48$\pm$12.6% respectively. There were statistically significant differences between preoperative and postoperative values in LVDIDd(p=0.001) LVEDV(p=0.001) and EF(p=0.0001) while no significant difference is LVIDs and LVESV. Postoperative depression of ejcection fraction was significantly related with z-score of preoperative LVESV and LVEDV by univariateanalysis while LVEDV only was significant risk factor for postoperative LV dysfunction by multiple regressioin analysis ($\Delta$LVEF=-13.3-4.62$\times$LVEDV(z), p=0.001) During the follow-up periods ejection fractions become normalized in all except one patients. Conclusion ; Left ventricular function is usually deteriorated after the surgical correction of PDA in adult age and preoperative LVEDV is a major determinant of postoperative LV function.

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Evaluation of short-term cardiac function by tissue Doppler imaging in pre and postoperative period of congenital heart disease (조직 도플러 영상을 이용한 선천성 심장병 수술 전후의 단기 심기능 평가)

  • Lee, Jun-Hwa;Kim, Yeo-Hyang;Hyun, Myung-Chul;Lee, Sang-Bum
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.476-483
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    • 2007
  • Purpose : The objective of this study was to assess ventricular function by tissue Doppler imaging (TDI) in children with congenital heart disease (CHD) who have been undergoing open heart surgery (OHS) using cardiopulmonary bypass. We tried to compare the parameters of tissue Doppler imaging before and after OHS in patients with congenital heart disease. Methods : This study was conducted on 32 patients with CHD after OHS from January 2005 to December 2005 at Kyungpook National University hospital. Patients who underwent 2-D echocardiography before and after their OHS. All patients were divided into three groups, left ventricular volume overloading group (group 1), and right ventricular volume overloading group (group 2), and right ventricular pressure overloading group (group 3). The TDIs were examined before and 1 to 3 months after OHS. Peak early diastolic (E), and peak late diastolic (A) velocity of transmitral flow were measured by pulsed wave Doppler examination. Peak systolic (Sm), peak early diastolic (Em), and peak late diastolic (Am) velocity in apical 4-chamber and 2-chamber views were measured by TDI. The author calculated E/Em ratio. Results : The patients were 14 boys and 18 girls and the average age of patients was 2 years and 3 months. The congenital heart diseases which have to get OHS were ventricular septal defect (13 cases), atrial septal defect (7), atrioventricular septal defect (3), isolated pulmonary stenosis (2) and tetralogy of Fallot (7). There were significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view (P<0.05). Conclusion : This study showed significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view after OHS. These changes might be due to the effects of cardiopulmonary bypass in OHS and/or hemodynamic changes after correction of congenital heart disease. To clarify these changes, further study on more patients is needed.