Mitral annulus displacement measured by tissue-tracking method with Doppler-tissue images is a useful marker of the severity of heart failure.

OBJECTIVES: This study investigated whether the measurement of mitral annulus displacement by the tissue-tracking method with Doppler-tissue images can provide more accurate information on the severity of heart failure compared to conventional methods, such as left ventricular ejection fraction (LVEF). BACKGROUND: Impaired left ventricular function is an important predictor of poor prognosis. Although LVEF has been used to assess left ventricular function, such indicators do not necessarily correlate well to clinical variables such as New York Heart Association (NYHA) functional class or plasma brain natriuretic peptide (BNP) concentration. METHODS: In 90 subjects with or without various heart diseases, mitral annulus displacement was measured by the tissue-tracking method with Doppler-tissue images and the correlations evaluated with NYHA functional class, plasma BNP concentration, left ventricular mass index and Tei index. RESULTS: Mitral annulus displacement by the tissue-tracking method with Doppler-tissue images was well correlated with NYHA functional class and plasma BNP concentration. LVEF was also correlated with these clinical variables, but significantly more weakly. Furthermore, mitral annulus displacement by the tissue-tracking method with Doppler-tissue images was correlated with left ventricular mass index and Tei index, which indicate left ventricular systolic and diastolic function. CONCLUSIONS: The present study suggests that mitral annulus displacement measured by our technique is a useful and reliable method for assessing the severity of heart failure.

Postprandial increase in plasma concentrations of remnant-like particles: an independent risk factor for restenosis after percutaneous coronary intervention.

Postprandial increase in remnant lipoprotein concentrations has been suggested as an important atherogenic factor. However, the influence of these remnants on the development of restenosis after percutaneous coronary intervention (PCI) remains to be examined. The present study was designed to address this point. In 60 consecutive patients with successful PCI, the influences of possible risk factors on the development of restenosis, including remnant-like particles (RLP) cholesterol (RLP-C) and triglyceride (RLP-TG), were examined. While mean concentrations of RLP-C and RLP-TG were normal in fasting state, postprandial change in RLP-C concentrations was a significant and independent risk factor for restenosis after PCI. The calculated cut-off index (COI) for the change was +64%. When the patients were divided into 2 groups according to this COI, minimal lumen diameter (MLD) and reference coronary diameter were comparable before and immediately after PCI between the high- (COI < 64%) and the low- (COI < 64%) responders. However, follow-up coronary angiography 3 to 6 months after PCI demonstrated that MLD, late loss, and loss index were all worse in the high responders compared with the low responders. These results indicate that post-prandial increase in RLP-C concentrations is an independent risk factor for restenosis after successful PCI, even in patients with normal fasting RLP-C levels.