[Comparison of left ventricular ejection fraction and ventricular volume in echocardiography and nuclear myocardial perfusion scan]

Radionuclide scanning of the heart has incremental value in diagnosis and risk stratification of coronary artery disease. Gated myocardial perfusion SPECT is a new method and the state of the art in coronary artery disease detection. This study was done to evaluate estimation of LV volume, wall motion diameters and ejection fraction by gated myocardial perfusion scan and make a comparison with trans thoracic echocardiography. In this cross-sectional descriptive study during Sep 2001- Dec 2002, 68 patients suspected of IHD who were referred to nuclear Medicine Department of Imam Reza Hospital in Mashhad University of Medical Sciences were under taken gated myocardial perfusion SPECT, and then referred to echocardiography unit for trans thoracic echocardiography. LV volume, ejection fraction, regional wall motion in different views of 2D-echo was recorded and the results were compared by descriptive statistics. This study was performed on 68 patients. The mean age of patients was 52.8 [min: 38, Max: 75]. 54% of patients were male and 46% were female. Mean end systolic volumes of LV was 32.4ml [sd: 37.1] estimated by echocardiography and 68.3ml [sd: 52.2] stimated by radionuclide scan [pv: 0.00]. Mean end diastolic volume of LV was 129.6ml [sd: 45.8] in echocardiography and 143.7ml [sd: 46.23] in radionuclide scanning [pv: 0.00]. Mean ejection fraction value of LV was 54.6 [sd: 12.44] estimated by echocardiography and 54 [sd: 12.94] by radionuclide scan [pv: 0.00]. Left ventricular end systolic and diastolic volumes and ejection fraction, obtained by gated myocardial perfusion scan and echocardiography, had significant statistic correlations and estimation of LV wall motions and ejection fraction by gated SPECT was as echocardiography

[Evaluation of prevalence and correlation between systolic and distolic dysfunction in patients with congestive heart failure during acute pulmonary edema episodes]

Congestive heart failure [CHF] is a major public health problem. Several hospitals - based reports have documented that a high proportion of patients with CHF have a normal LV systolic function. Some of the clinical and paraclinical findings during heart failure episodes show presence of a normal left ventricular ejection fraction [LVEF]. We evaluated the utility of these predictions in patients with HF during an acute pulmonary edema [APE] episode. In this descriptive study, done in cardiology emergency ward of Imam Reza Hospital in 2000 - 2001, 117 patients with sign and symptoms of HF presented with APE were selected based on history, physical examination, and laboratory tests. Eligible patients underwent 2D / Doppler echocardiography during the 2[nd] or 3[rd] day of hospitalization. Normal systolic function was diagnosed if LVEF>45%. Using simson method, patients with acut MI and exclusively chronic lung diseases were excluded from the study. Data was analyzed using frequency distribution tables and descriptive statistics. Out of 117 patients, 72 [62%] were male and 45[38%] female. Mean age of patients was 66.6 +/- 1.5 years. Left ventricular systolic function was evaluated on the basis of ejection fraction and LVEF >= 45% was regarded as normal. 51 [43.6%] patients with HF had normal systolic function; systolic dysfunction was observed in 62.5% of males and 46.7% of females. 65% of patients with normal systolic function had late relaxation diastolic dysfunction, and sever restrective type was seen in 6%. In 91% of severe diastolic dysfunction patients, meanwhile, the systolic function was also abnormal. Results of this study shew that in a significant proportion of patients with heart failure, systolic function of LV is preserved. Systolic dysfunction is more common among men. In most patients with heart failure and normal systolic function, delayed relaxation pattern of diastolic dysfunction was present, although in patients with systolic dysfunction more severe type of restrictive pattern was seen

Quantitative assessment of cardiac function in children with beta-thalassemia major, using the doppler myocardial performance index

Introduction: Cardiac disease and early death due to my ocardial injuries because of Iron overload and hemosiderosis are still the major problems in the management of patients with beta-thalassemia major [BTM]. Valuable echocardiographic techniques have been limited in early detection of cardiac dysfunction in these patients. A new Doppler index combining systolic and diastolic time intervals [the Tei index] has been reported to be useful for assessment of global ventricular function in many cardiac diseases. The purpose of this study was to assess global ventricular function in children with BTM using Tei index and also to determine its correlation with hematologic parameters

Material and Methods: This analytic cross sectional study was performed on 59 patient with Beta-Thalassemia Major during Jan.2003 until Feb.2004 in hematologic clinics of Imam Reza and Dr. Sheikh Hospitals. Complete physical examination and Doppler Echocardiographic study was done for all the patients and patients' Tei indexes were compared with normal values in other studies statistically

Results: The mean Tei index of left ventricule [LV] and right ventricule [RV] was 0.35 +/- 0.11 [mean +/- SD] and 0.28 +/- 0.12 [mean +/- SD] respectively. There was a significant difference between both right and left ventricular Tei index in-patients with BTM and healthy children. There was also a significant correlation between mean blood transfused volume per year and Tei index in both right [PV70.05] and left ventricule [PV 70.05]. We also find a significant difference between two groups of thalassemic patients according to their mean pre-transfused Hgb per year [Hgb> 9 g/dl and Hgb>9 g/lit] for left ventricular Tei index

Conclusion: The Tei index is a simple, feasible and reproducible measure of global cardiac function in-patients with BTM with early Myocardial dysfunction