OBJECTIVETo assess the value of pulsed Doppler tissue imaging (PW-DTI) in evaluating the left ventricular diastolic dysfunction (LVDD) in patients with type 2 diabetes mellitus (DM).

METHODSSeventy-seven type 2 diabetic patients and 43 healthy volunteers underwent PW-DTI and mitral inflow pulsed wave Doppler (MPWD). Six positions of the mitral annulus were measured by PW-DTI for early diastolic velocity (Em), end diastolic velocity (Am), Em/Am ratio. Early mitral inflow velocity (E), end mitral inflow velocity (A), left ventricular isovolumetric relaxation (IVRT) and E/A ratio were measured by MPWD.

RESULTSIn the diabetic patients, Em, Em/Am and E/A ratios were significantly decreased and Am and A increased with prolonged IVRT. The two examination modalities showed a significant correlation between Em/Am and E/A. The detection rate of LVDD in the diabetic group was 94.81% by PW-DTI and 79.22% by MPWD.

CONCLUSIONPW-DTI and MPWD show a significant correlation in assessment of the left ventricular filling, but the former displays better performance in sensitive and accurate diastolic function evaluation and provides early evidence for of diabetic cardiomyopathy of due to its potent ability in differentiation of false-normal presentations.

Adult ; Aged ; Diabetes Mellitus, Type 2 ; complications ; diagnostic imaging ; physiopathology ; Diastole ; Echocardiography, Doppler, Pulsed ; methods ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Ventricular Dysfunction, Left ; diagnostic imaging ; etiology

OBJECTIVETo assess the effect of A-V, V-V delay optimization on cardiac function and clinical improvement in patients with refractory heart failure underwent cardiac resynchronization therapy (CRT).

METHODThirty-two patients with chronic heart failure received CRT and cardiac function was measured at 7 days, 3 months and 6 months post CRT before and after A-V and V-V delay optimizations.

RESULTSA-V delay optimization was initiated in 28, 10 and 6 cases at 7th day, 3rd month and 6th month after CRT. V-V delay optimization was performed in 29, 6 and 5 cases at 7th day, 3rd month and 6th month after CRT. Ts-SD, LVEF, VTI and E/Em were significantly improved after CRT compared to pre-CRT (P < 0.01, P < 0.05, P < 0.05, P < 0.05; respectively). Compared to pre-optimization, the indexes of ventricular synchronization were significantly improved (P < 0.05) while indexes of cardiac function remained unchanged post optimization at 7th day after CRT. The indexes of ventricular synchronization post optimization were similar at 7th, 3rd and 6th months after CRT (P > 0.05). LVEF and diastolic filling time were significantly increased after 6 months CRT post A-V, V-V delay optimization (P < 0.01).

CONCLUSIONA-V, V-V delay optimization at 7th day after CRT can significantly improve ventricular synchronization and is associated with further improved cardiac function 6 months after CRT.

Aged ; Cardiac Pacing, Artificial ; methods ; Chronic Disease ; Echocardiography, Doppler, Pulsed ; Female ; Heart Failure ; diagnostic imaging ; physiopathology ; therapy ; Humans ; Male ; Middle Aged

OBJECTIVETo examine the clinical application of pulsed Doppler tissue imaging (DTI) for regional left ventricular function assessment in normal subjects.

METHODSWe examined 50 healthy subjects (range 12-42 years, mean age 28.3 +/- 6.9 years) using pulsed Doppler tissue imaging to characterize the diastolic and systolic velocity profiles of mitral annulus. Recordings were made along the long axis in the apical 4-chamber, 2-chamber, and long apical views of 6 sites (posterior-septum, lateral, anterior, inferior, anterior-septum, posterior) at the mitral annulus. Myocardial velocities were determined with use of variance F statistical analysis. Correlation analysis was employed to test the relationship between age and mitral annular velocities.

RESULTSBoth early diastolic and systolic velocities at the septum were lower than other sites. There were no differences in mitral annulus late diastolic velocities. Mean early diastolic and systolic velocities was negatively correlated with age.

CONCLUSIONSDoppler tissue imaging can directly reflect regional left ventricular function.

Adolescent ; Adult ; Age Factors ; Blood Flow Velocity ; Child ; Diastole ; Echocardiography, Doppler, Pulsed ; methods ; Female ; Humans ; Male ; Mitral Valve ; diagnostic imaging ; physiology ; Reference Values ; Systole ; Ventricular Function, Left

In atrial fibrillation, cardiac performance is dependent on both preceding RR (RR-1) and prepreceding RR (RR-2) intervals. However, relative contributions were not well defined. Left ventricular outflow peak ejection velocity (Vpe) was measured by echocardiography from 21 patients. The relation between RR-1 and Vpe could be divided into two zones; steep slope in short RR-1 intervals ( 0.5 sec). RR-2 had a weak negative association with Vpe. The mean squared correlation coefficient (r2 ) between RR-2 and Vpe was 0.15 +/-0.13 and improved to 0.29 +/-0.21 (p<0.001), when coordinates with RR-1 Aged ; Aged, 80 and over ; Atrial Fibrillation ; *Atrial Function, Left ; Echocardiography, Doppler, Pulsed/*methods ; Electric Countershock ; Electrocardiography/*methods ; Female ; Heart/*physiology ; Heart Ventricles ; Humans ; Male ; Middle Aged ; Myocardium/pathology ; Time Factors