Left Ventricular Systolic Function Indexes by Echocardiography in Hypertensive Subjects

BACKGROUND: The evaluation of cardiac performance is very important to management and prognostication in hypertensive patients. Although ejection phase indexes have been used for assessing left ventricular systolic function they are highly dependent on cardiac loading conditions. In addition, these load-dependent indexes may not differentiate accurately between the effects of altered loading canditions and intrinsic abnormalities in contractile function of cardiac muscle. In recent years, the end-systolic pressure to volume of dimension relations have emerged as a reliable measure of the myocardial contractility. The authors studied the changes of end-systolic pressure to volume or dimension relations according to pre-load and after-load by using the Echocardiogram. METHODS: By 2-D and M-mode Echocardiogram we measured the ratio of end-systolic wall stress to end-systolic volume index(EWS/ESVI), peak systolic pressure or end-systolic dimension of left ventricle(PSP/ESD), peak systolic pressure to end-systolic volume index(PSP/ESVI) to assess myocardial contractility in 139 normal subjects and 55 patients with untreated essential hypertension. Then we compare these indexes to systemic blood pressure & left ventriclular end-diasolic dimension. RESULTS: 1) EF, %FS, and mVcf were similar in both groups, but PSP/ESD, PSP/ESVI, EWS/ESVI for the hypertensive group were greater than that for the normal group. 2) There was poor relation between arterial blood pressure and EWS/ESVI than oter load independent indexes in both groups. 3) There was poor reation between left ventricle end diastolic dimension than oter load independent indexes in both groups. CONCLUSION: The ratio of end-systolic wall stress to end-systolic volume index(EWS/ESVI) is a relible load independent index to assess myocardial contractility in hypertension.

Two Cases of Cor Triatriatum Associated with Acute Onset Dyspnea in Old Age

Cor triatriatum is a rare congenital heart disease. In the calssic form the left atrium is divided into two chambers by a fibromuscular diaphragm covered by endocardium. The dorsal chamber receives the pulmonary veins, and the ventral chamber gives rise to the left atrial appendage and leads to the mitral valve. Even though the calssic case of cor triatriatum clinically looks like pulmonary venous obstruction, the association, location, and size of the ASD, as well as other cardiac anomalies, may influence symptoms, making the diagnosis difficult. The diagnosis of cor triatriatum is made chiefly from two-dimensional echocardiography and transesophageal echocardiography. The diagnosis can be established by the surgical exploration. In this paper we will report two cases of non-obstruction or triatriatum and review of literature was made.