The effect of left ventricular hypertrophy resulting from essential hypertension upon left ventricular performance was studied in 30 normotensive normal control subjects and 34 hypertensive patients; 14 hypertensive patients without left ventricular hypertrophy, 8 hypertensive heart disease patients with compensation and 12 hypertensive heart disease patients with decompensation. In hypertensive heart disease patients with decompensation, ejection fraction and mean rate of circumferential shortening was reduced(0.45+/-0.12, 0.67+/-0.20 circ/sec respectively) compaired with normal control(0.70+/-0.05, 1.16+/-0.15 circ/sec respectively), hypertensive patients without left ventricular hypertrophy(0.67+/-0.05, 1.16+/-0.15 circ/sec respectively) and hypertensive heart disease patients with compensation(0.67+/-0.07, 1.09+/-0.14 circ/sec respectively). In contrast, ejection fraction and mean rate of circumferential shortening were not significantly different among the last three groups. These results indicate that left ventricular performance measured by ejection fraction and mean rate of circumferential shortening is well preserved in hypertensive patients without left ventricular hypertrophy and hypertensive heart disease patients with compensation.
Compensation and Redress ; Heart Diseases ; Humans ; Hypertension* ; Hypertrophy, Left Ventricular*

No abstract available.

No abstract available.
Blood Component Transfusion*

No abstract available.
Cadmium*

To analyse the rate of changes of left atrial demension in ventricular diastole in hypertensive heart disease, the velocities of early diastolic(OR) slope and presystolic(AV) slope of the motions of the posterior aortic wall were measured using M-mode echocardiogram. 18 normal subjects(Group I), 17 hypertensive patients without left ventricular thickening(Group II), 16 hypertensive patients with thickening of either interventricular septum or left ventricular posterior wall(Group III), 15 hypertensive patients with both interventricular septum and left ventricular posterior wall without dilation of left ventricle(Group IV) and 5 hypertensive patients with thickening and dilation of left ventricle(Group V) were compared. Whereas %fractional shortening and AV slope decreased in only Group V, there was a progressive increase in left atrial dimension and a progressive decrease in the OR slope and patients without left atrial dilation in Group I also decrease in OR slope. The velocity of OR slope was correlated strongly with the thickness of left ventricular posterior wall(r=-0.62, p<0.001), and weakly with left atrial dimension(r=0.379, p<0.01) but not with heart rate and %fractional shortening and the velocity of AV slope with %fractional shortening(r=0.433, p<0.001). These data suggest that the velocity of OR slope appears to be an early indicator of abnormalities of left ventricular diastolic compliance and the velocity of AV slope and indicator of systolic abnormality and rapid filling of the left ventricle is reduced early in hypertension, even before left atrial dilation or left ventricular thickening are detectable.
Compliance ; Diastole ; Heart Diseases* ; Heart Rate ; Heart Ventricles ; Heart* ; Humans ; Hypertension

The right pulmonary artery(RPA0 of the patients with intracardiac left to right shunt was examined by suprasternal M-mode echocardiography, the subjects were 6 atrial septal defects, 8 ventricular septal defects and 6 patient ductus arteriosus. The enddiastolic and the widest systolic dimension of the RPA were measured from the echogram, and the systolic widening rate was calculated. The systolic widening rate of the RPA in the patients with left to right shunt was significantly larger than that of the 56 apparently healthy control subjects. The systolic widening rate of the RPA was well correlated with the ratio of the pulmonary to systemic blood flow(Qp/Qs) in the patients with left to right shunt thru atrial septal defects(n=6, correlation coefficient=0.918, p<0.01). In 14 patients with either atrial(6 cases) r ventricular septal defects(8 cases) with left to right shunt, the widening rate of the RPA and Qp/Qs ratio were positively correlated with correlation coefficient of 0.787(p<0.001). In conclusion the noninvasive examination of the RPA by suprasternal echocardiography is thought to be very helpful in estimating the Qp/Qs ratio in the patients with left to rifht shunt thru artial or ventricular septal defect.
Ductus Arteriosus ; Echocardiography* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Pulmonary Artery*

The systolic time intervals, hemodynamics, and indices of myocardial contractility were measured in 158 normal Koreans with average age of 34(14~69) years by non-invasive technique, i.e. simultaneous recording of ECG, PCG, and carotid and femoral pulse tracing with paper speed 100mm/sec. by cardiograph. 1. Normal values of systolic time intervals were as follows(M+/-SD): QS1was 61.5+/-10.8, ICT 41.9+/-12.0, PEP 10.+/-14, LVET 281+/-24, and QS2 385+/-26 msec. 2. Regression equations of systolic time intervals to pulse rate were as follows: QS1; 0.04 x PR + 60.0 (r=+0.038, p>0.05), ICT; -0.2 x PR + 59.6 (r=-0.234, p<0.01), PEP; -0.2 x PR + 117 (r=-0.162, pp<0.05), LVET; -1.5 x PR + 389 (r=-0.725, pp<0.001), QS2; -1.7 x PR + 507 (r=-0.745, pp<0.001). 3. Each phase of systolic time intervals was affected by various factors: ICT and PEP by pulse rate, diastolic pressure and stroke volume, LVET by pulse rate and stroke volume, QS1by diastolic pressure, and QS2by pulse rate. Multiple linear regression analysis results in the following formulas for prediction of the systolic time intervals from the pulse rate, diastolic pressure and stroke volume: ICT; -0.299PR+0.230Pd-0.139Vs+28.1(r=0.38), PEP; -0.272PR+0.356Pd-0119Vs+104.8 (r=0.39), LVET; -1.475PR+0.167Vs+376.6 (r=0.74). 4. Systolic time intervals were not influenced by height, weight or body surface, but LVET and QS2were prolonged significantly in female group. 5. Normal values of hemodynamics calculated by Wezler's formula were as follows: stroke volume was 68.1+/-21.7ml, stroke index 50.2+/-14.9ml/m2, cardiac output 4.9+/-1.71/min., cardiac index 3.6+/-1.3 1min/m2, peripheral resistance 1696+/-507 dyne sec. cm(-5), and volume elasticity coefficient 1916+/-422 dyne cm(-5). 6. Normal values of non-invasive indices of myocardial contractility were as follows: ICT was 42+/-21 msec. PEP 10.+/-14 msec., 1/PEP2 9.87x10-5+/-2.79x10-5msec., 1/ICT28.56x10-3+/-1.65+/-10-3msec-2., Pd/ICT 1.96+/-0.92 mmHg/msec., Pd/PEP 0.723+/-0.125 mmHg/msec., PEP/LVEE 0.37+/-0.06, LVET/PEP 2.77+/-0.47, and LVET/ICT 7.45+/-3.19. 7. Each index of myocardial contractility was affected by various factors: ICT, PEP, 1/PEP2, PEP/LVET, LVET/PEP and LVET/ICT by pulse rate, diastolic pressure and stroke volume, 1/ICT2by pulse rate, and Pd/ICT and PD/PEP by pulse rate and diastolic pressure. 8. Correlation coefficients between PEP/LVET and other indices were relatively high in PEP, 1/PEP2and LVET/PEP, and relatively low in ICT, 1/ICT2Pd/ICT, Pd/PEP and LVET/ICT.
Blood Pressure ; Cardiac Output ; Elasticity ; Electrocardiography ; Female ; Heart Rate ; Hemodynamics* ; Humans ; Linear Models ; Reference Values ; Stroke ; Stroke Volume ; Systole* ; Vascular Resistance

Parameters of the left ventricular performance were evaluated by echocardiographic examination in 66 normal subjects. Effects of pulse rate, systemic arterial pressure, peripheral resistance and left ventricular end-diastolic dimension on the parameters were also observed. Normal value(mean+/-SD) of fractional shortening was 34.0+/-5.2%, ejection fraction 0.71+/-0.07, mean rate of circumferential fiber shortening 1.15+/-0.19 circ/sec, mean posterior wall velocity 4.05+/-0.70cm/sec, maximal posterior wall velocity 6.31+/-1.26cm/sec, mean normalized posterior wall velocity 0.82+/-0.14/sec, and maximal normalized posterior wall velocity 1.28+/-0.24/sec. There were negative correlations of peripheral resistance to fractional shortening, ejection fraction and mean rate of circumferential fiber shortening. Pulse rate and left ventricular end-diastolic dimension did not have significant effects on these parameters. Mean and maximal posterior wall velocity had negative correlations to peripheral resistance and positive correlations to left ventricular end-diastolic dimension. But mean and maximal normalized posterior wall velocity had no correlations to any of them.
Arterial Pressure ; Echocardiography* ; Heart Rate ; Vascular Resistance

To evaluate the changes of Doppler echocardiographic parameters of left ventricular(LV) filling in hypertensive subjects, 34 patients(M : F=17 : 17) with and without LV hypertrophy and 19 healthy, age-matched control subjects(M : F=10 : 9) were examined by M-mode, 2 dimensional and Doppler echocardiography. From the Doppler recording, A2 D(time from second heart sound to the onset of early diastolic mitral flow), peak velocity at early diastole(E) and late diastole(A), ratio of E to A velocity, diastolic filling times, early diastolic deceleration rate(EDDR) and flow velocity integral(FVI) were measured. In the patients without LV hypertrophy, A2 D only was significantly prolonged(127+/-21 vs 83+/-24 msec P<0.01) as compared with the normal subjects, but the patients with LV hypertrophy had more prolonged A2 D(149+/-31 vs 83+/-24 msec P<0.01), higher late diastolic peak velocity(A : 0.58+/-0.17 vs 0.47+/-0.09m/sec, P<0.01) and lower E/A velocity ratio(0.95+/-0.19 vs 1.24+/-0.29, P<0.01) than the normal subjects. There was a significant correlation between A2 D and LV muscle mass index in entire patients with hypertension(r=0.42P<0.01). These data suggest that A2D is the earliest parameter indicating abnormality of LV diastolic function and E/A ratio is not likely to be a definite index of LV diastolic dysfunction but rather be a reliable index of LV hypertrophy in hypertensive patients with preserved LV systolic funtion.
Deceleration ; Echocardiography* ; Echocardiography, Doppler ; Heart Sounds ; Humans ; Hypertrophy

To determine the level of exercise for dynamic exercise echocardiography and to evaluate the changes of cardiac work loads in normal subjects, the authors performed M-mode echocardiography at rest and during 20degrees supine bicycle exercise in 10 normal subjects with good image of left ventricle. A special, self-made 20degrees supine exercise table was used on which the subject's chest could be immobilized to record echocardiograms during exercise. The recordings were always performed just below the tip of the anterior mitral leaflet. Interpretable left ventricular M-mode echocardiograms were obtained at a submaximal exercise level with mean heart rate of 132+/-21 beat/min. Left ventricular end-diastolic dimension, an index of preload, showed no significant change during exersise. But left ventricular end-systolic dimension decreased significantly(p<0.01) and % fractional shortening increased significantly(p<0.01). Peak-systolic left ventricular wall stress increased signficantly(p<0.01) during exercise but end-systolic wall stress did not. Both end-systolic wall stress/end systolic dimension ratio and systolic blood pressure/end-systolic dimension ratio increased during exercise(p<0.01). The results suggest that dynamic exercise echocardiography is a suitable method measuring various parameters of cardiac mechanics during submaximal exercise, whereas it's not available during maximal exercise.
Echocardiography* ; Heart Rate ; Heart Ventricles ; Mechanics ; Thorax ; Ventricular Function, Left*