Sujets)
Humains , Imagerie diagnostique/méthodes , Échocardiographie/méthodes , Management par la qualité , Agrément/méthodes , Échocardiographie transoesophagienne/méthodes , Échocardiographie de stress/méthodes , Matériel de diagnostic/normes , Professions de santé/normes , Patients , Expertise/méthodesRésumé
OBJECTIVES: We compared left ventricular regional wall motion, the global left ventricular ejection fraction, and the New York Heart Association functional class pre- and postoperatively. INTRODUCTION: Endomyocardial fibrosis is characterized by fibrous tissue deposition in the endomyocardium of the apex and/or inflow tract of one or both ventricles. Although left ventricular global systolic function is preserved, patients exhibit wall motion abnormalities in the apical and inferoapical regions. Fibrous tissue resection in New York Heart Association FC III and IV endomyocardial fibrosis patients has been shown to decrease morbidity and mortality. METHODS: We prospectively studied 30 patients (20 female, 30±10 years) before and 5±8 months after surgery. The left ventricular ejection fraction was determined using the area-length method. Regional left ventricular motion was measured by the centerline method. Five left ventricular segments were analyzed pre- and postoperatively. Abnormality was expressed in units of standard deviation from the mean motion in a normal reference population. RESULTS: Left ventricular wall motion in the five regions did not differ between pre- and postoperative measurements. Additionally, the left ventricular ejection fraction did not change after surgery (0.45±0.13 percent x 0.43±0.12 percent pre- and postoperatively, respectively). The New York Heart Association functional class improved to class I in 40 percent and class II in 43 percent of patients postoperatively (p<0.05). CONCLUSIONS: Although endomyocardial fibrosis patients have improved clinical symptoms after surgery, the global left ventricular ejection fraction and regional wall motion in these patients do not change. This finding suggests that other explanations, such as improvements in diastolic function, may be operational.
Sujets)
Adulte , Femelle , Humains , Mâle , Fibrose endomyocardique/physiopathologie , Complications postopératoires/physiopathologie , Dysfonction ventriculaire gauche/physiopathologie , Diastole/physiologie , Fibrose endomyocardique/complications , Fibrose endomyocardique/chirurgie , Ventricules cardiaques/physiopathologie , Études prospectives , Indice de gravité de la maladie , Statistique non paramétrique , Débit systolique/physiologie , Dysfonction ventriculaire gauche/étiologieRésumé
La utilización de la ecocardiografía en forma precoz en el infarto agudo de miocardio, permite identificar en forma prospectiva y confiable a aquellos pacientes con riesgo de expansión del infarto. La ecocardiografía utilizada con la metodología señalada, identifica las complicaciones del infarto agudo de miocardio y la necesidad de realizar otros procedimientos para evitar o minimizar las complicaciones emergentes del mismo