No abstract available.
Humans ; Hypothermia* ; 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

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*

BACKGROUND: Although the cardiac pump mechanists and the thoracic pump mechanism have been suggested, the mechanism of blood flow generated by precordial compression in human remains controversial. We hypothesized that, during compression systole, the proximal descending thoracic aorta would be distended by forward blood flow if the heart acts as a pump, and be contacted or unchanged if increased intrathoracic pressure generates blood flow. METHODS: Fourteen patients with cardiac angst underwent transesophageal echocardiogaphy to verify the morphologic changes of the descending thoracic aorta during standard manual cardiopulmonary resuscitation. The aortic dimensions including cross sectional area and diameters at the end of compression and of relaxation were measured proximal to and at the maximal compressing site of the descending thoracic aorta. RESULTS: At the point of maximal compression, deformations of the descending thoracic aorta were observed during compression in all patients and ratio of the longest to shortest diameter of the aorta deceased during compression than relaxation(0.58+/-0.15 versus 0.81+/-0.11, p=0.001). Cross sectional area of the aorta at the maxim compression deceased during compression than relaxation(3.01+/-1.91 versus 7.26+/-14.70 cm2, p=0.035). Ratio of the longest to shortest diameter of the proximal descending thoracic aorta remained unchanged during compression and relaxation(1.0+/- 0.88 versus 1.0+/-0.9, p=0.345). Cross sectional area of the proximal descending thoracic aorta increased during compression than relaxation(4.81+/-2.86 versus 4.29+/-2.51 cm2, p=0.011). CONCLUSION: Distention of the proximal descending thoracic aorta and deformation of the aorta at the maximal compression during the compression systole suggests that the heart act as a pump during standard manual cardiopulmonary resucitation in human.
Aorta ; Aorta, Thoracic ; Cardiopulmonary Resuscitation* ; Echocardiography* ; Heart ; Humans ; Relaxation ; Systole

BACKGROUND: Pulmonary venous flow(PVF) is closely related to left atrial pressure(LAP) and percutaneous mitral commissurotomy(PMC) reduces LAP rapidly. However, PVF pattern in mitral stenosis(MS) with sinus rhythm after PMC remains to be elucidated. METHODS: Transesophageal echocardiographic pulsed Doppler examination was performed within 24 hours before and after PMC to evaluate PVF pattern in 10 patients of MS with sinus rhythm. RESULTS: Before PMC, both peak velocity(PV) and velocity time integral(VTI) during systole had significant negative correlations with mean LAP(r=-0.70, r=-0.79, respectively). After PMC, both systolic PV and VTI increased significantly without significant changes in diastolic PV and VTI. However, there was no significant correlation between systolic PV and mean LAP, and between systolic VTI and mean LAP after PMC. CONCLUSION: In mitral stenosis with sinus rhythm, these data suggest that systolic PVF decreases with increase of mean LAP and PMC could reverse this change without affecting diastolic PVF. However, acute hemodynamic changes of left atrium induced by PMC may contribute to the absence of correlation between mean LAP and systolic PVF after PMC.
Echocardiography* ; Heart Atria ; Hemodynamics ; Humans ; Mitral Valve Stenosis ; 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.

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