To assess the normal value of left ventricular twist (LVtw) and examine the changes with normal aging by 2-dimensional ultrasound speckle-tracking imaging (STI), 121 healthy volunteers were divided into three age groups: a youth group (19-45 y old), a middle-age group (46-64 y old) and an old-age group (> or = 65 y old). Basal and apical short-axis images of left ventricular were acquired to analyse LV rotation (LVrot) and LVrot velocity. LVtw and LVtw velocity was defined as apical LVrot and LVrot velocity relative to the base. Peak twist (Ptw), twist at aortic valve closure (AVCtw), twist at mitral valve opening (MVOtw), untwisting rate (UntwR), half time of untwisting (HTU), peak twist velocity (PTV), time to peak twist velocity (TPTV), peak untwisting velocity (PUV), time to peak untwisting velocity (TPUV) were separately measured. The results showed that the normal LV performs a wringing motion with a clockwise rotation at the base and a counterclock-wise rotation at the apex (as seen from the apex). The LVtw velocity showed a systolic counterclock-wise twist followed by a diastolic clockwise twist. Peak twist develops near the end of systole (96%+/-4.2% of systole). With aging, Ptw, AVCtw, MVOtw, HTU and PUV increased significantly (P<0.05) and UntwR decreased significantly (P<0.05). However, no significant differences in TPUV, PTV and TPTV were noted among the 3 groups (P>0.05). It is concluded that LV twist can be measured non-invasively by 2-dimensional ultrasound STI imaging. The age-related changes of LVtw should be fully taken into consideration in the assessment of LV function.
Aging ; Echocardiography ; Heart Ventricles/anatomy & histology ; Heart Ventricles/*ultrasonography ; Ventricular Function, Left/*physiology ; Young Adult

Variety of complications following ventriculoperitoneal(V-P) shunt have been reported. However, right ventricular migration of a V-P shunt has never been documented. The authors present a case of migrated peritoneal catheter of a V-P shunt system into the right venticle. To our knowledge, this is the first reported case complicated with migration of a peritoneal tube into the right ventricle. The patient was presented with fever and the migration was diagnosed by chest X-ray, and neck and cardiac ultrasonography.
Catheters* ; Fever ; Heart Ventricles* ; Humans ; Neck ; Thorax ; Ultrasonography

PURPOSE: To identify the essential characteristics of pain which nurse have to obtain for patients with chest pain, 92 patients who were admitted in medical units to take intensive tests for heart disease were investigated cross-sectionally. METHOD: Duration, severity, stress, anxiety, perceived severity, number of painful area, number of accompanying symptoms, triggering activity, and pattern were included as the characteristics of pain. Ejection fraction of left ventricle and number of involved area detected by ultrasonography and number of diseased coronary artery detected by cardiac catheterization were assessed as the variables of heart disease extent. RESULT: Severity of pain was found to be correlated with all three variables of heart disease extent. Perceived severity and number of accompanying symptoms were correlated with two of them. Anxiety, number of painful area and pattern were related with the number of involved area. CONCLUSION: Pain severity reported by patients is found to be the most important variable to be obtained from patient. Variables such as perceived severity. number of accompanying symptoms, anxiety, number of painful area and pattern also have to be carefully assessed to anticipate the extent of heart disease.
Anxiety ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Vessels ; Heart Diseases* ; Heart Ventricles ; Heart* ; Humans ; Ultrasonography

This study was conducted to assess the ability of two-dimensional tissue tracking (2DTT) to evaluate changes in left ventricular (LV) myocardial function associated with sustained high electrical pacing. Pacemakers were implanted at the right ventricular (RV) apex of five female Beagles, and sustained high electrical pacing of 250 beats per minute (bpm) was performed for three consecutive weeks. Conventional echocardiography and 2DTT were performed at baseline, and at every week for three weeks with pacing. The baseline parameters were then compared to those of weeks 1, 2, and 3. Three weeks of pacing resulted in significant reduction of radial and circumferential global strains (p < 0.001). Regional analysis revealed reduction of segmental strains in both radial and circumferential directions, as well as increased dyssynchrony after three weeks of pacing in the radial direction (p = 0.0007). The results of this study revealed the ability of 2DTT to measure radial and circumferential strains in dogs with sustained high-electrical pacing, and allowed assessment of global and regional myocardial function and the degree of dyssynchrony.
Animals ; Cardiac Pacing, Artificial ; Dogs ; Echocardiography/*methods ; Female ; Heart Rate ; Heart Ventricles/*ultrasonography ; *Ventricular Function, Left

This study evaluated pulsed TDI variables including the isovolumic time interval and duration of the major wave in a population of large healthy dogs. Longitudinal myocardial motion at the septal mitral annulus was evaluated with pulsed TDI in 45 healthy adult dogs. Maximal myocardial velocities, isovolumic time intervals, and duration of the myocardial waves were measured. The correlation between time intervals and velocity variables was also investigated. The mean maximal systolic velocity was 6.92 +/- 1.78 cm/sec, the mean early diastolic velocity (Em) was 6.58 +/- 1.81 cm/sec, the mean late diastolic velocity (Am) was 5.10 +/- 2.00 cm/sec, the mean isovolumic contraction time (IVCT) was 53.61 +/- 95.13 msec, and the mean isovolumic relaxation time (IVRT) was 26.74 +/- 57.24 msec. The early diastolic mitral inflow velocity (E)/Em ratio was 10.94 +/- 3.27 while the Em/Am ratio was 1.40 +/- 0.40. There was a negative correlation between Am duration and Am amplitude, and a positive correlation between the IVRT and Em/Am ratio (p < 0.05). The normal LV parameter using pulsed TDI method could be used as the reference range for identifying myocardial dysfunction in dogs.
Animals ; Dogs/*anatomy & histology ; Female ; Heart Ventricles/*ultrasonography ; Male ; Mitral Valve/*ultrasonography ; Ultrasonography, Doppler, Pulsed/methods/*veterinary

The purpose of this study was to determine if contrast media would enhance visualization of the endocardium for assessment of left ventricle (LV) function. In addition, differences between pre- and post-contrast evaluation for the cardiac output measurements including the modified Simpson's method and automated contour tracking (ACT) method were examined. Ten clinically healthy adult beagle dogs (three males and seven females) between 2~3 years old and weighing 6.6~10.8 kg were used. Echocardiographic examinations were performed to compare pre- and postcontrast LV endocardium visualization using a segmental scoring method. Two different methods for measuring cardiac output were also compared. LV visualization was significantly enhanced in post-contrast echocardiography (p < 0.01). Significant differences between pre- and post-contrast measurements for the modified Simpson's method (p < 0.05) were also observed. No significant difference was found for the ACT method. Contrast echocardiography provides better LV chamber opacification and significantly improves wall segment visualization. Furthermore, contrast echocardiography for measuring cardiac output is helpful for the modified Simpson's method.
Adult ; Animals ; Cardiac Output* ; Contrast Media* ; Dogs ; Echocardiography* ; Endocardium ; Heart Ventricles ; Humans ; Male ; Research Design ; Ultrasonography*

BACKGROUND: Mitral flow velocity with Doppler technique has some limitaion in assessing diastolic dysfunction, especially because of the similarities of normal and pseudonormal mitral pattern. This study was performed to evaluate the usefulness of difference of deceleration time between early transmitral flow and pulmonary venous diastolic flow for differentiating pseudonormal pattern from normal in patients with hypertension. METHODS: Mitral and pulmonary venous flow velocities were recorded by thransthoracic pulsed Doppler ultrasound in 31 normal patients and 44 patients with hypertension, Nineteen patients of 44 patients with hypertension underwent cardiac catheterization and left ventricle pressures were measured. RESULTS: The differences of deceleration time between early transmitral and pulmonary venous diastolic flow(ΔDT) in patients with hypertension who showed normal-like transmitral flow pattern(n=25), were greater than those in normal patients(34±31 ms vs 59±48 ms, p < 0.05). Of patients with hypertension showing normal-like transmitral folw pattern, patients with prolonged ΔDT(≥70 ms, n=12) showed clinical and hemodynamic features by diastolic dysfunction in compared to patients with normal range ΔDT( < 70 ms, n=13). CONCLUSIONS: The difference of deceleration time between early transmitral and pulmonary venous diastolic flow may be useful index for detection pseudonormalization pattern in patients with hypertension.
Cardiac Catheterization ; Cardiac Catheters ; Deceleration ; Heart Ventricles ; Hemodynamics ; Humans ; Hypertension ; Reference Values ; Ultrasonography

Child ; Female ; Fibrosis ; Heart Ventricles ; Humans ; Hypereosinophilic Syndrome ; diagnostic imaging ; surgery ; Myocardium ; pathology ; Thrombosis ; surgery ; Ultrasonography

BACKGROUND: We sought to test whether patients with apical hypertrophic cardiomyopathy (APH) have different clinical features compared to those with typical asymmetric septal hypertrophy (ASH). METHODS: Among 32, 534 patients who underwent routine echocardiography at Asan Medical Center from January 2000 to December 2001, 305 patients (0.9%), who were finally diagnosed with hypertrophic cardiomyopathy (HCMP), were evaluated. The type of HCMP was classified according to the echocardiographic findings. RESULTS: ASH was the most frequent type (n=160, 53%, group I), and APH was the second most frequent (n=91, 30%, group II). Mean age (60.8 +/- 10 vs. 48.2 +/- 14 years, p< 0.001) and prevalence of hypertension (32% vs. 19%, p=0.022) were significantly higher in group II than in group I. Family history of HCMP (4.4% vs. 0% p=0.043) and sudden cardiac death (8.8% vs. 1.1% p=0.014) was more prevalent in group I. During the follow-up period of 32.0 +/- 37.2 months, cardiac events occurred at a significantly higher rate in group I (25.5% vs. 8.8%, p=0.003). CONCLUSION: APH comprises a significant proportion of HCMP in Korea and patients with APH show different clinical features compared to those with ASH.
Cardiomyopathy, Hypertrophic/epidemiology/*ultrasonography ; Comparative Study ; Echocardiography ; Female ; Follow-Up Studies ; *Heart Septum/ultrasonography ; *Heart Ventricles/ultrasonography ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Prevalence ; Retrospective Studies

To evaluate the possibility and accuracy of Doppler tissue image (DTI) on assessment of normal and abnormal ventricular activation and contraction sequence, 9 open chest canine hearts were analyzed by acceleration mode, M-mode, and spectrum mode DTI. Our results showed that: (1) Acceleration mode DTI could show the origin of activation and conduction sequence on line; (2) M-mode DTI revealed that the activation in mid-interventricular septum was earlier than that in mid-left ventricular posterior wall at sinus activation; (3) Spectrum DTI showed the ventricular endocardium was activated earlier than the ventricular epicardium in all segments at sinus rhythm. The earliest site of activation of the normal ventricular wall was at middle interventricular septum; the latest site was at basal-posterior wall; the contraction sequence was different at the different walls; (4) During abnormal ventricular activation, mid-left ventricular posterior wall was activated earliest in accordance with the pacing sites. Abnormal ventricular activation was slower than sinus activation, and the contraction sequence varied at different sites of ventricular wall. It is concluded that DTI can be used to localize the origin of normal or abnormal myocardial activation and to assess the contraction sequence conveniently, accurately and non-invasively.
Echocardiography, Doppler/instrumentation ; Echocardiography, Doppler/*methods ; Heart Ventricles/*ultrasonography ; Myocardial Contraction/*physiology ; Sinoatrial Node/physiology ; Tachycardia/physiopathology ; Tachycardia/ultrasonography