correlation between left and right ventricular ejection fractions in patients with ischemic heart disease, documented by cardiac magnetic resonance imaging

Introduction: The correlation between right and left ventricular ejection fractions [RVEF and LVEF, respectively] has been studied in only a small number of patients with a marked decrease in RVEF and LVEF. The aim of the present study was to compare LVEF and RVEF in patients with ischemic heart disease. RVEF and LVEF were measured by Cardiovascular Magnetic Resonance [CMR] imaging

Materials and Methods: This observational study was done in Ghaem general hospital in 2014. LVEF and RVEF were measured in a series of 33 patients with ischemic heart disease, undergoing CMR for the evaluation of myocardial viability. The correlation between RVEF and LVEF in patients with ischemic heart disease was studied, using Pearson product-moment correlation coefficient analysis

Results: Right ventricular end diastolic volume [186.33 +/- 58.90] and left ventricular end diastolic volume [121.72 +/- 61.64] were significantly correlated [r=0.223, P=0.005]. Moreover, there was a significant correlation between right ventricular end systolic volume [88.18 +/- 40.90] and left ventricular end systolic volume [140.96 +/- 35.33] [r=0.329, P=0.000]. The most significant association was observed between RVEF and LVEF [r=0.913, P=0.000]

Conclusion: Based on the findings, RVEF and LVEF were significantly correlated in patients with ischemic heart disease, although this association was not always present in all cardiac patients. The cause of this discrepancy is still unknown

Cardiac MRI in a patient with coincident left ventricular non-compaction and hypertrophic cardiomyopathy

Left ventricular non-compaction cardiomyopathy is a rare congenital cardiomyopathy that affects both children and adults. Since the clinical manifestations are not sufficient to establish diagnosis, echocardiography is the diagnostic tool that makes it possible to document ventricular non-compaction and establish prognostic factors. We report a 47-year-old woman with a history of dilated cardiomyopathy with unknown etiology. Echocardiography showed mild left ventricular enlargement with severe systolic dysfunction [EF = 20-25%]. According to cardiac magnetic resonance imaging findings non-compaction left ventricle with hypertrophic cardiomyopathy was considered, and right ventricular septal biopsy was recommended. Right ventricular endomyocardial biopsy showed moderate hypertrophy of cardiac myocytes with foci of myocytolysis and moderate interstitial fibrosis. No evidence of infiltrative deposition was seen

[Mid-term results of pulmonary valve replacement in patients with total correction of tetralogy of Fallot in Rajaei heart center, Tehran, Iran]

The aim of this study was to evaluate the mid-term outcomes of concurrent total correction of Tetralogy of Fallot [TOF] after pulmonary valve [PV] replacement and its relation to QRS duration and MRI results. In this study, 51 patients with TOF who had the TOF surgery and PV replacement enrolled the study. Demographic data, MRI results such as, right ventricular end diastolic volume, right ventricular end systolic volume, systolic and diastolic indexes noted. Moreover, QRS duration and the patients' cardiac functional class were evaluated immediately before and 6 months after the surgery. From 51 patients, 27.5% were female and 72.5% were male. The mean age of participants was 23.48 [SD=5.82] years. Functional class changes were statistically different [P<0.001] comparing the status before and after the surgery. The mean QRS duration before surgery was 130.20 [SD=16.89] ms which was in significant contrast with post-surgical states, 122.45 [SD=16.90] ms [P<0.001]. Mean QRS duration before and after surgery was statistically lower in asymptomatic patients [P=0.028 and P=0.025, respectively]. There was a statistical relationship between pre-surgical systolic and diastolic indexes to post-surgical functional class as asymptomatic patients had lower systolic and diastolic indexes [P=0.005 and P=0.028, respectively]. This study demonstrated that QRS duration before and after surgery can be an indicator to evaluate the cardiac function after surgery for Tetralogy of Fallot. Moreover, systolic and diastolic indexes are factors affecting the good prognosis of patients; therefore, PVR surgery needs to be done before the deterioration of systolic and diastolic indexes and cardiomegaly

Echocardiographic assessment of adults with repaired tetralogy of fallot: a cardiovascular magnetic resonance comparison study

Surgical management of the tetralogy of Fallot [TOP] results in anatomic and functional abnormalities in the majority of patients. Right ventricular [RV] dilation from pulmonary regurgitation [PR], residual atrial and/or ventricular septal defect, tricuspid regurgitation, right ventricular outflow tract [RVOT] aneurysm, and pulmonary artery peripheral stenosis are some of the abnormalities frequently encountered in patients with repaired TOP. Cardiovascular magnetic resonance [CMR] can provide assessments of anatomical connections, biventricular function, flow measurement, and more, without ionizing radiation. Echocardiography is the most frequently used modality for the initial assessment and follow-up of most patients with CHD. We sought to evaluate adult patients with repaired TOP by transthoracic echocardiography and compare them with CMR. 156 patients [52 women, mean age= 23 +/- 5.5 years] late after TOP repair with severe PR were evaluated. Ventricular size and function and TOP -associated anomalies such as patent ductus arteriosus [PDA], peripheral pulmonary stenosis [PPS], and persistent left superior vena cava [LSVC] were evaluated by transthoracic echocardiography and CMR separately. Mean of LV ejection fraction by CMR was 52 +/- 9% and by echocardiography was 47 +/- 5.1%. We found a significant correlation between LVEF assessed by CMR and 2D visual assessment in multiple views. Mean of RVEF by CMR was 37 +/- 8% and RV end diastolic volume index was 161 +/- 57.3 mm[3]. Linear correlation between CMR-RVEF and RVEF measured by echocardiography was weak. There was almost perfect agreement between CMR and echocardiography for the diagnosis of LSVC [99.2%]. Agreement was 88.3% in the diagnosis of PDA, 66.4% in the diagnosis of PPS, and 93% in the diagnosis of the right aortic arch was. Adults late after repaired TOF have significantly reduced biventricular systolic function. Despite abnormal LV geometry, visual assessment of LV systolic function by an expert echocardiologist has an acceptable agreement compared to the quantitative measurement of LV systolic function by CMR. However, the correlation between CMR-RVEF and RVEF measured by echocardiography is weak. We found incremental diagnostic value of CMR in PPS and PDA. Atrial septal defect and ventricular septal defect are found more frequently by echocardiography