Subject(s)
Mitral Valve Prolapse/epidemiology , Mitral Valve/pathology , Outpatients , Patient Selection , Adolescent , Adult , Aged , Cohort Studies , Echocardiography , Female , Genetic Predisposition to Disease/epidemiology , Genetic Predisposition to Disease/genetics , Greece/epidemiology , Humans , Hypertrophy , Male , Middle Aged , Mitral Valve/diagnostic imaging , Mitral Valve Insufficiency/diagnosis , Mitral Valve Insufficiency/epidemiology , Mitral Valve Insufficiency/genetics , Mitral Valve Prolapse/diagnosis , Mitral Valve Prolapse/genetics , Prevalence , Sex FactorsABSTRACT
Fifteen hypertensive patients (13 men) with left ventricular hypertrophy, mean age 69 6 5 years, having complete heart block and paced in the DDD mode, were studied by two-dimensional and Doppler echo in 100 and 200 ms atrioventricular delays. ANF plasma levels were measured at rest and at peak exercise, during pacing with the two different atrioventricular delays. ANF plasma levels were significantly higher at pacing with long atrioventricular delays (200 ms), at rest (152.47 6 12.38 pg/mL vs 119 6 12.38 pg/mL, P, 0.001) and at exercise (180.93 6 11.51 vs 123.67 6 16.24 pg/mL, P, 0.0001). ANF plasma levels were significantly increased at exercise, compared to those at rest during pacing with the two different atrioventricular delays, but we found a more pronounced increase of ANF levels (from 152.47 6 10.49 pg/mL to 180.93 6 11.51 pg/mL), when the atrioventricular delays was set to 200 ms (P, 0.0001). A significant decrease of isovolumic relaxation time (from 123.33 6 20.5 to 105.33 6 11.06 ms, P, 0.001) was observed, during pacing with the short atrioventricular delays. Moreover, the peak early (E) to peak atrial (A) velocity ratio (E/A) was declined (from 0.89 6 0.7 to 0.57 6 0.18, P, 0.05). We also noticed that patients with small left ventricles exhibit greater increase in ANF plasma levels during DDD pacing with long atrioventricular delays (r 5 20.792, P 5 0.000). In conclusion, left ventricular diastolic function of our patients seems to be improved during DDD pacing with short (100 ms) atrioventricular delays, as it was expressed by echocardiographic and hormonal measurements.
Subject(s)
Activities of Daily Living , Atrial Natriuretic Factor/blood , Atrioventricular Node/physiopathology , Cardiac Pacing, Artificial/methods , Hypertension/complications , Physical Exertion/physiology , Ventricular Function, Left/physiology , Aged , Atrioventricular Node/diagnostic imaging , Cardiac Volume/physiology , Diastole , Echocardiography , Echocardiography, Doppler , Exercise Test , Female , Heart Block/complications , Heart Block/diagnostic imaging , Heart Block/therapy , Humans , Hypertrophy, Left Ventricular/complications , Male , Middle Aged , Myocardial Contraction/physiology , Rest/physiologySubject(s)
Ear, External/injuries , Endocarditis, Bacterial/microbiology , Tricuspid Valve Insufficiency/microbiology , Adult , Echocardiography , Endocarditis, Bacterial/diagnostic imaging , Female , Humans , Staphylococcus epidermidis/isolation & purification , Tricuspid Valve Insufficiency/diagnostic imagingABSTRACT
Left ventricular diastolic function was studied by Doppler echocardiography in 35 patients with non-Q-wave myocardial infarction, on the third and tenth day of hospitalization and six weeks after hospitalization and was correlated with electrocardiogram, serum enzyme values, and angiographic data. Normal diastolic function on the first echocardiographic study predicted (p = 0.0001) the existence of no or single-vessel disease, and excluded (p = 0.005) the presence of 3-vessel or left main disease, whereas an abnormal study on either the second or third echocardiographic discriminated (p = 0.0001), with higher sensitivity (80.97%, 92.31%, respectively), patients with 3-vessel or left main vessel disease.
Subject(s)
Coronary Disease/complications , Myocardial Infarction/physiopathology , Ventricular Function, Left , Adult , Aged , Algorithms , Coronary Disease/diagnostic imaging , Echocardiography, Doppler , Female , Humans , Male , Middle Aged , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/etiology , Myocardial Infarction/therapySubject(s)
Atrial Fibrillation/physiopathology , Echocardiography, Transesophageal , Pulmonary Veins/physiopathology , Atrial Fibrillation/diagnostic imaging , Blood Flow Velocity , Blood Pressure/physiology , Echocardiography, Doppler , Electric Countershock , Electrocardiography , Female , Humans , Male , Middle Aged , Mitral Valve/diagnostic imaging , Mitral Valve/physiopathology , Phonocardiography , Pulmonary Veins/diagnostic imaging , Regional Blood Flow , Systole/physiologyABSTRACT
The extent and functional capacity of coronary collateral circulation in patients with systemic hypertension has not been elucidated. In the present study, 313 patients with coronary artery disease were studied to evaluate coronary collateral circulation in relation to the presence of systemic hypertension and left ventricular hypertrophy. Patients had greater than or equal to 95% diameter luminal obstruction of either the left anterior descending or the right coronary artery. Patients were classified into 2 groups: The hypertensive group consisted of 61 patients, mean age 55 +/- 9 years, with systemic hypertension, and the normotensive group consisted of 252 patients, mean age 53 +/- 8 years, without hypertension. The hypertensive group had more severe angina pectoris and less history of healed myocardial infarction than the normotensive group (p less than 0.001). Left ventricular wall thickness was 1.26 +/- 0.1 cm in the hypertensive and 1.03 +/- 0.06 cm in the normotensive group (p less than 0.001). The hypertensive group had more extensive coronary collateral circulation than the normotensive group (p less than 0.01). There was a positive relation between coronary collateral circulation and left ventricular wall thickness (p less than 0.001). These results indicate that patients with systemic hypertension and coronary artery disease have an increase in coronary collateral circulation corresponding to the degree of left ventricular wall thickness.
