Tei-Index is a useful echocardiographic parameter for evaluating global cardiac function. Conventionally, a value and b value, which the calculation of Tei index is based on, are measured in different cardiac cycle. Therefore, accuracy of Tei index is damaged by cycle dependent variation, especially in patients with arrhythmia. The newly established Dual Doppler modality allows a synchronous measurement of both a value and b value. This study was aimed to explore the value of Tei index measured by Dual Doppler in cardiac function estimation in patients with hypertension. One hundred and forty patients with hypertension were recuited and divided into three groups according to cardiac function. The a value and b value were generated from the transmitral and transaortic flow spectrum of the same cardiac cyle by Dual Doppler modality. The results showed that Tei index was significantly higher in the cardiac dysfunction group than in the control group. There was a high correlation between Tei index and NYHA cardiac performance. Tei index measured by Dual Doppler modality is a highly reproducible parameter with high sensitivity and specificity for cardiac function estimation, even for patients with arrthymia.
Adult ; Aged ; Echocardiography, Doppler, Color ; Female ; Humans ; Hypertension ; complications ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnosis ; etiology ; physiopathology ; Ventricular Function ; Young Adult

Transient left ventricular apical ballooning is characterized by transient wall motion abnormalities involving the left ventricular apex and mid-ventricle in the absence of coronary arterial occlusion. A 66-year-old woman presented to the emergency department with chest pain that mimicked acute myocardial infarction. An aortogram showed akinesis from the mid to apical left ventricle with sparing of the basal segments. Four days later, she underwent MRI, which demonstrated characteristic apical contractile dysfunction, the same as the aortogram, without evidence of myocardial infarction on the MRI. Two weeks later, her symptoms were resolved and follow-up echocardiography showed normal ventricular function.
Ventricular Dysfunction, Left/*diagnosis/*etiology ; Stress, Psychological/*complications ; Myocardial Infarction/diagnosis ; Magnetic Resonance Imaging/*methods ; Humans ; Female ; Electrocardiography ; Echocardiography ; Diagnosis, Differential ; Aged

Many patients who survive an acute myocardial infarction (AMI) remain at risk of recurrent cardiac events and sudden cardiac death after discharge, despite optimal medical treatment. Assessment of the degree of left ventricular dysfunction and residual myocardial ischaemia is useful to identify the patients at greatest risk. In addition, there is increasing evidence that a number of other cardiovascular tests can be used to detect autonomic dysfunction and myocardial substrate abnormalities postAMI that increase the risk of life-threatening ventricular arrhythmias. These investigations include ECG-based tests (signal averaged ECG and T-wave alternans), Holter-based recordings (heart rate variability and heart rate turbulence) and imaging techniques (echocardiography and cardiac magnetic resonance), as well as invasive electrophysiological testing. This article reviews the current evidence for the use of these additional cardiac investigations among survivors of AMI to aid in their risk stratification for malignant ventricular arrhythmias and sudden cardiac death.
Age Factors ; Death, Sudden, Cardiac ; etiology ; Echocardiography ; Electrocardiography ; Electrocardiography, Ambulatory ; Electrophysiologic Techniques, Cardiac ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Myocardial Infarction ; complications ; Risk Assessment ; Sex Factors ; Tachycardia, Ventricular ; complications ; diagnosis ; Ventricular Dysfunction, Left ; complications ; diagnosis

OBJECTIVETo study the characteristics of the TCM syndrome and the changes of ventricular structure and function in heart failure (HF) rats after- myocardial infarction (MI).

METHODSRats were randomly divided in to the model group and the sham-operative group. The HF rat with MI model was induced by ligation of the left coronary artery. Eight weeks after operation, appraisal on TCM syndrome revealed in the model was made from the aspects of general status, breathing frequency, heart rate, exhausting swimming time and electrocardiogram, and left ventricular structure and function were observed with echocardiography.

RESULTSEight weeks after operation, as compared with those in the sham group, in the model group, the heart rate and breathing frequency were accelerated, the exhausting swimming time shortened, the echocardiogram parameters such as interventricular septum end-diastole thickness (IVSTd), posterior wall end-diastole thickness (PWTd), posterior wall end-systolic thickness (PWTs), ejection fraction (EF) and fractional shortening (FS) of the left ventricular reduced (P < 0.01), while left ventricular end-diastolic dimension (LVDd) and end-systolic dimension (LVDs) obviously increased (P < 0.01). In 12 leads electrocardiogram, the leads of ST segment elevated and abnormal Q wave increased. Additionally, the ratio of whole heart weight/body weight increased (P < 0.05).

CONCLUSIONThe HF rats after MI manifests Xin-qi deficiency and blood stasis syndrome, and shows the pathological changes of left ventricular remodeling and function impairment.

Animals ; Diagnosis, Differential ; Echocardiography, Doppler ; Heart Failure ; diagnosis ; diagnostic imaging ; etiology ; Male ; Medicine, Chinese Traditional ; Myocardial Infarction ; complications ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Syndrome ; Ventricular Dysfunction, Left ; diagnosis ; diagnostic imaging ; etiology

Peripartum cardiomyopathy (PPCM) is a rare but serious form of cardiac failure affecting women in the last months of pregnancy or early puerperium. Clinical presentation of PPCM is similar to that of systolic heart failure from any cause, and it can sometimes be complicated by a high incidence of thromboembolism. Prior to the availability of echocardiography, diagnosis was based only on clinical findings. Recently, inclusion of echocardiography has made diagnosis of PPCM easier and more accurate. Its etiopathogenesis is still poorly understood, but recent evidence supports inflammation, viral infection and autoimmunity as the leading causative hypotheses. Prompt recognition with institution of intensive treatment by a multidisciplinary team is a prerequisite for improved outcome. Conventional treatment consists of diuretics, beta blockers, vasodilators, and sometimes digoxin and anticoagulants, usually in combination. In resistant cases, newer therapeutic modalities such as immunomodulation, immunoglobulin and immunosuppression may be considered. Cardiac transplantation may be necessary in patients not responding to conventional and newer therapeutic strategies. The role of the anesthesiologist is important in perioperative and intensive care management. Prognosis is highly related to reversal of ventricular dysfunction. Compared to historically higher mortality rates, recent reports describe better outcome, probably because of advances in medical care. Based on current information, future pregnancy is usually not recommended in patients who fail to recover heart function. This article aims to provide a comprehensive updated review of PPCM covering etiopathogeneses, clinical presentation and diagnosis, as well as pharmacological, perioperative and intensive care management and prognosis, while stressing areas that require further research.
Anesthesia, Obstetrical/adverse effects ; Echocardiography, Doppler ; Female ; Heart Failure/*diagnosis/etiology/therapy ; Humans ; Incidence ; Mortality ; Pregnancy ; Pregnancy Complications, Cardiovascular/*diagnosis/etiology/therapy ; Prognosis ; Recurrence ; Risk Factors ; Ventricular Dysfunction, Left/ultrasonography