value of right ventricular outflow-tract fractional shortening for assessment of right ventricular function

Assessment of right ventricular function is important. However, this is not easy to achieve due to the complex anatomy and geometry of the right ventricle, making the evaluation of its function limited. Therefore, a simple reliable and easy method is needed. This work was to evaluate the use of right ventricular outflow tract fractional shortening obtained by M-mode echocardiography as a measure of right ventricular systolic function in patients having inferior wall myocardial infarction with or without evidence of right ventricular infarction [as a model of right ventricular disease]. Fifty patients with first acute inferior wall myocardial infarction, their ages ranged from 30 to 80 years with [mean +/- SD = 54.56 +/- 11.5], were investigated. Ten healthy controls also were studied. M-mode echocardiography was used to measure right ventricular outflow tract fractional shortening and right ventricular long axis excursion. Two-dimension echocardiography was used to measure right ventricular ejection fraction. Ventricular outflow tract fractional shortening [p<0.0001], right ventricular long axis excursion [p<0.0001] and right ventricular ejection fraction [p<0.0001] were reduced in patients compared to controls. Also were reduced in patients in group [B] compared to patients in group [A]. Right ventricular outflow tract fractional shortening correlated with long axis excursion [r=0.86, p<0.0001], right ventricular ejection fraction [r=-0.84, p<0.0001]. Right ventricular outflow tract fractional shortening provides a simple and non-invasive measure of right ventricular systolic function and could be helpful in diagnosis of right ventricular infarction in patients have inferior wall MI. In combination with long axis excursion and Doppler velocities, they should provide comprehensive assessment of right ventricular function

Twenty four-hour ambulatory blood pressure monitoring in detection and management of hypertension compared to clinic readings

Blood pressure measurements taken in a physicianis clinic or by patients themselves don't represent readings throughout the day. Ambulatory blood pressure monitoring [ABPM] overcomes this problem by providing multiple readings over time with minimal intrusion into the patient's daily activities. The purpose of our study was to evaluate the value of 24-hour ABPM in detection and management of hypertension over traditional over traditional office measurements. A total of 100 never-treated or already known essential hypertensive patients divided into 2 groups, first group included 50 patients managed according to 24 hour ambulatory blood pressure monitoring results and the second group 50 patients according to office blood pressure measurements. All patients underwent the following procedures: [i] repeated clinic blood pressure measurements, [ii] blood sampling for routine chemistry examinations; [iii] 24-hour urine collection for microalbuminuria; [iv]echocardiography; and ABPM for the first group. Main indications for ABPM were borderline hypertension [44%], de novo hypertension 20%] and resistant hypertension [36%]. Mean age of the first group was 44.1 +/- 9.8 versus 54.4 +/- 11.6 years [p=0.002] and 24-hour ambulatory blood pressure was 129/80 mmHg with mean +/- SD 11.4/10.1. ambulatory blood pressure monitoring has changed our treatment strategy in 80% of patients. Its parameters were significantly correlated with left ventricular hypertrophy [p=0.04], diastolic dysfunction [p=0.012], hypertension duration and body mass index than traditional clinic measurements did. Twenty four hours ambulatory blood pressure monitoring is an important yet underused tool for the management of hypertension patients especially those with borderline, recent onset and even resistant hypertension. Our collective results revealed superiority over office blood pressure measurement