No abstract available.
Humans ; Hypothermia* ; Systole*

Differences in systolic time intervals(STI's) attributable to the types of mechanocardiographs used for their determinations were studied in a total of 341 healthy adult males. The STI's were measured from mechanocardiograms consisting of simultaneously rocorded electrocardiograms, phonocardiograms and carotid arterial pulse tracings obtained by each of three different types of mechanocardiographs in 125, 56 and 160 subjects, respectively. The study revealed that there were slight to considerabe differences among the three groups in the correlation coefficients between the individual STI's and heart rate. Thus, regression equations using heart rate as variables, for those STI's which were significantly correlated with heart rate, differed slightly to considerably among these groups. In addition, the mean values of those STI's and their derivatives, which showed no significant correlation with heart rate, were also silghtly or significantly different among the three groups. These findings suggest that if STI's obtained from patients are to be adequately evaluated at all, each laboratory must define its own normal standards worked out by using its own methods of recording and analysis of the mechanocardiogram, and cannot rely on those proposed by others.
Adult ; Electrocardiography ; Heart Rate ; Humans ; Male ; Systole*

The measurement of systolic time intervals has become one of the established quantitative noninvasive tests of cardiac function, especially of left ventricular performance, and remain one of the simplest and most reliable to perform. In an attempt to obtain the normal data of the systolic time intervals, we conducted a study in 89 normal Koreans of 43 males and 46 females. The measurements are obtained from the simultaneous high speed recordings (100mm/sec) of electrocardiogram, phonocardiogram, and indirect carotid arterial pulse. The results were as follows. 1. The QS2I, LVETI, and PEPI was 521+/-18 msec, 409+/-13msec, and 112+/-12 msec in males and 529+/-14 msec, 408+/-15 msec, and 121+/-11 msec in females, respectively. 2. The PEP/LVET ratio was 0.29+/-0.04 in males and 0.31+/-0.05 in females. 3. The QS2I and PEPI were significantly more lengthened in femals than in males, but other systolic time interval indices did not significantly relate to the sex. 4. The A2D was significantly shortened with age, but other systolic time intervals did not change with age. 5. According to the regression equations of QS2, LVET, and PEP to the heart rate, QS2 and LVET related more inversely to the heart rate than PEP.
Electrocardiography ; Female ; Heart Rate ; Humans ; Male ; Systole*

Traumatic tricuspid insufficiency(TI) is a relatively uncommon disorder. We experienced a case in which traumatic TI was suspected by history and the diagnosis was confirmed nonivasively by 2-D echocardiography with Doppler technique. Tricuspid valve in this case showed flail anterior leaflet during systole and Doppler echocardiography demonstrated the presence of tricuspid insufficiency.
Diagnosis ; Echocardiography ; Echocardiography, Doppler ; Systole ; Tricuspid Valve

An analysis of echocardiograms was made in 50 patients with pericardial effusion of various origins, diagnosed by clinical and M-mode echocardiographic examinations. In these cases the estimated volume of pericardial effusion ranged between 40 ml and 999 ml. The width of echo-free space behind the left ventricular wall which reflect the amount of effusion showed a significant positive correlation with the systolic excursion and the diastolic mean velocity of both right and left ventricular epicardial surfaces. The echocardiographic patterns of so-called pseudo-mitral valve prolapse and a notch on the right ventricular epicardial surface during systole were found more frequently in patients with large pericardial effusion. Thus, in pericardial effusion, and echocardiographic examination is useful for the visualization of the abnormal motions of cardiac structures as well as for its diagnosis.
Diagnosis ; Echocardiography* ; Humans ; Pericardial Effusion* ; Prolapse ; Systole

The hypotensive action of calcium antagonist has been recognized, however, clinical study on the hypotensive effect is not yet extensively carried out. Auther studied the effect of Dilitiazem(Herben(R)) on 23 hypertensive patients. The age of patient was average 58.5(30-75) years. There were 8 male and 15 female patients. Among 23 cases, 20 cases of essential hypertension had no previous medication for hypertension and they were given 90mg of Diltiazem daily in 3 divied doses for 8 weeks. The blood pressure and pulse were measured at one week interval. In 3 cases of hypertension who were refractory to other hypotensive drugs for 2 weeks. The results were as follows; 1) In 20 cases of untreated essential hypertension, the control average blood pressure was 179.8/106.3mmHg and pulse 77.1/min. After the Diltiazem medication average blood pressure in one week was 153.3/97.3mmHg and pulse 76.6/min, in 3 week 153.0/94.0mmHg, and pulse 76.6/min, in 5 week 143.0/92.0mmHg and pulse 75.4/min, and in 8 week 142.3/90.0mmHg and pulse 73.0/min. These data showed that after one week of medication, blood pressure fell significantly in systole and diastole but there was no significant pulse change. 2) The rate of hypotensive effect by grade were as follows; overall effectiveness in systolic pressure which fell more than 5 mmHg was 85% and more than 20mmHg fall was 70%. In diastolic pressure the overall effectiveness which fell more than 5mmHg was 60% and more than 15 mmhg fall was 40%. 3) In 3 cases which were refractory to other hypotensive drugs, the hypertension became normal blood pressure in one day by 90mg Diltiazem and the fall of blood pressure persisted for 2 weeks by continuous medication.
Blood Pressure ; Calcium ; Diastole ; Diltiazem* ; Female ; Humans ; Hypertension* ; Male ; Systole

Little informaition is available concerning the relation between the echocardiographic findings and the pulmonic to systemic flow ratio. Accordingly the author assessed the pattern of the systolic interventricular septal motion and the relation between the type of the systolic interventricular septal motion and the pulmonic to systemic flow ratio in 30 cases with catheterization evidence of secundum atrial septal defect employing the M-mode echocardiographic technique. The results were as follows: 1) Analysis of the pattern of the systolic interventricular septal motion (SESM) allowed classification of cases into 5 groups: Type 1A (4 cases)-Both the right (RS) and left (LS) sides of the interventricular septum move anteriorly during ventricular systole: Type1V (5 cases)-Both RS and LS of the interventricular septum move posteriorly during ventricular systole:Type 2A (9 cases)-LS of the interventricular septum moves posteriorly, while RS fo the interventricular septum remains relatively flat during ventricular systole; Type 2B (8 cases)-RS of the interventricular septum moves anteriorly, while LS of the interventricular septum remains relatively flat during ventricular systole;Type 3(4 cases)-SISM is the same as type 2 and the motion of the left ventricular posterior wall is relatively hyperactive. 2) The pulmonec to systemic flow ratio (Qp/Qs) was statistically different between type 1, 2, and 3 of SISm (Qp/Qs in type 3=2.3+/-0.33;Qp/Qs in type 2=3.4+/-0.79;Qp/Qs in type 3=5.1+/-1.37). 3) Qp/Qs was not different between type 1A and 1B (Qp/Qs in type 1A=2.3+/-0.28;Qp/Qs in type 1B=2.3+/-0.39) and between type 2A and 2B (Qr/Qs in type 2A=2.20+/-0.80; Qp/Qs in type 2B=3.7+/-0.76). 4) Tyep 2 in SISm predicts Qp/Qs> or =2.5(sensitivity=87.5%;specificity=100%;accuracy=90%), and type 3 in SiSm predicts Qp/Qs> or =4.0(sensitivity=40;specificity=100%;accuracy=80%). In conclusion, the pattern of the systolic interventricular septal motion (SISM) in the M-mode echocardiogram may be useful for the semiquantitative assessment of the pulmonic to systemic flow ratio (Qp/Qs) in cases with secundum atrial septal defect.
Catheterization ; Catheters ; Classification ; Echocardiography ; Heart Septal Defects, Atrial* ; Systole

In order to establish the predicted normal values of the systolic time intervals the duration of the systolic time intervals measured from simultaneous recordings of the electrocardiogram, the phonocardiogram and the carotid pulse tracing. The subjects studied were 160 healthy males and 160 females. The mean ages of males and females were 29 and 31 years old, respectively. The transformation period was not closely related to heart rate, and its mean values for males and females were 58 and 56 msec., respectively, and the mean for males and females combined was 57 msec. The remainder of the systolic time intervals, however, showed a significant linear and inverse relation to heart rate. Thus, based upon these data regression equations for the prediction of the normal values of electromechanical systole, left ventricular ejection time, mechinical systole, precjection period andisovolumiccontraction time for males, females, and males and females combined were obtained.
Adult ; Electrocardiography ; Female ; Heart Rate ; Humans ; Male ; Reference Values* ; Systole*

BACKGROUNDRight ventricular apical pacing has been reported to reduce cardiac performance. But there are few reports on the effects of dual chamber (DDD) pacing on cardiac function compared to sinus rhythm. In this study, we evaluated the effects of right atrial and ventricular DDD pacing on cardiac function and ventricular contraction synchrony using equilibrium radionuclide angiography.

METHODSTen patients implanted with a right atrial and ventricular DDD pacemaker underwent equilibrium radionuclide angiography. The scintigraphic data were obtained during sinus rhythm and pacing rhythm. Cardiac function parameters were obtained semimanually. Phase analysis was used to study the ventricular activation sequence and ventricular synchrony.

RESULTSThe left ventricular 1/3 ejection fraction decreased significantly during pacing compared with that during sinus rhythm [(23.4 +/- 6.1)% vs (27.7 +/- 4.5)%, P = 0.01]. Regional ejection fraction also decreased during pacing, although the difference was not statistically significant. Phase analysis showed that the right ventricle was activated earlier than the left ventricle during pacing, and that the phase shift was significantly greater during pacing than that during sinus rhythm [64.13 degrees +/- 16.80 degrees vs 52.88 degrees +/- 9.26 degrees, P = 0.007]. The activation of both ventricles occurred simultaneously during sinus rhythm, with the activation sequence from proximal septum or base of left ventricle to apex. The earliest activation during pacing occurred at the right ventricular apex, and subsequently spread to the base and left ventricle.

CONCLUSIONRight atrial and ventricular DDD pacing impairs left ventricular systolic function and ventricular synchrony.

UNLABELLEDObjective To compare the impact of right ventricular apical (RVA) versus right ventricular outflow tract (RVOT) pacing on left ventricular systolic synchronization.

METHODSSixty patients were prospectively recruited and randomized into RVA group (n=30) with the right ventricle leads placed in the RVA and RVOT group (n=30) with right ventricle leads placed in the septum of the RVOT. Speckle tracking imaging was performed with 100% ventricle pacing to measure the differences in the time to maximum left ventricle (LV) radial strain.

RESULTSIn RVA group, the difference in the time to 6-segment maximum LV radial strain after pacing was 105.27 ± 19.74 ms, significantly greater than that in RVOT group (41.65 ± 12.17 ms, P<0.001). The standard difference of time to 6-segment maximum LV radial strain was also significantly greater in RVA group than in RVOT group (42.71 ± 17.63 vs 17.63 ± 5.62 ms, P<0.001).

CONCLUSIONLeft ventricle systolic synchronizaition after RVOT pacing is superior to RVA pacing.