study of the relationship between myocardial performance index and left ventricular end-diastolic pressure in patients with left ventricular systolic dysfunction

Doppler echocardiography is used to evaluate global myocardial performance. An index of myocardial performance [Tei Index] can be of great prognostic value in heart failure. This study was performed to assess the correlation between Tei Index [TI] and left ventricular end diastolic pressure [LVEDP]. The study group consisted of 38 patients. Each patient underwent ventriculographic evaluation [all had EF<%45]. Eighteen patients had LVEDP< 15 [14 males, 4 females, 57 +/- 6 years old] and 20 subjects [15 males, 5 females, 56 +/- 7 years old] had LVEDP>15. Using Doppler echocardiography. TI was determined for all patients and compared. Mean TI value was significantly different between subjects with LVEDP<15 and those with LVEDP > 15 [0.55 +/- 0.18 vs. 0.76 +/- 1 0.19, P<0.001, T 4.1]. In patients with systolic heart failure [EF <% 45], Tei was significantly lower in subjects with LVEDP<15 compared to those with LVEDP>15. Thus, Tei may be useful for noninvasive assessment of LVEDP in heart failure

Cardiac rehabilitation comparison of its effect on improvement of ejection fraction and functional capacity in men and women

Background and Objective: Exercise intolerance is one of the main features of ischemic heart disease. Patients always restrict their activities because of early fatigue and low functional capacity. Cardiac rehabilitation and supervised exercise have positive effect on these patients functional capacity. This may be due to improvement in cardiac performance or reconditioning by alteration in muscular metabolism

Methods: Two hundred and three patients who were referred by their physicians for cardiac rehabilitation after myocardial infarction or CABG entered the study. Forty patients were female. Exercise test and echocardiography were performed in all patients before and after rehabilitation course. The cardiac rehabilitation's exercise program composed of 24 sessions. Each session consisted of one hour of aerobic exercise [10 min warm up, 10 min cool down and 40 min isotonic exercise]

Results: Ejection fraction and functional capacity were increased in both female and male patients after the study period. The differences were significant by paired test in each group [p<0.001]. The difference between male and female was significant for functional capacity and the increase in FC was greater for male patients [p<0.02]. There was no significant increase in EF for female patients [p<0.05]. In male patients EF was increased significantly [p<0.001]

Conclusion: Women are fewer participants in cardiac rehabilitation although they appear to benefit equally well. Thus referral to cardiac rehabilitation programs should be advocated for both men and women and should not be limited by sex