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Jongwon Ha - One of the best experts on this subject based on the ideXlab platform.

  • Effects of treadmill exercise on mitral inflow and Annular velocities in healthy adults.
    American Journal of Cardiology, 2015
    Co-Authors: Jongwon Ha, James B Seward, Kent R. Bailey, Fabijan Lulic, Patricia A. Pellikka, A. Jamil Tajik, Jae K Oh
    Abstract:

    Tissue Doppler echocardiography has recently been introduced as a method to evaluate diastolic function by measuring diastolic mitral Annular Velocity. 1,2 Mitral Annular Velocity derived by tissue Doppler echocardiography is relatively independent of preload, and tissue Doppler echocardiography combined with transmitral flow Velocity appears to provide a better estimate of left ventricular (LV) filling pressures compared with other methods, such as pulmonary venous flow pattern or preload reduction. 3 However, exerciseinduced changes in tissue Doppler echocardiography and mitral inflow velocities have not been characterized adequately. The purpose of this study was to evaluate transmitral inflow pattern and the tissue Doppler echocardiographic profile of a mitral annulus in healthy subjects during exercise; this would establish normal reference values to be used in a stress test to assess the extent of the elevation in diastolic filling pressure with exercise. ••• The study group was composed of 31 healthy subjects (13 men and 18 women, aged 59 14 years) without a history of hypertension, ischemic heart disease, cardiovascular symptoms, regular cardiac medication, or abnormal stress test results. Baseline measures of clinical characteristics, hemodynamic variables, mitral inflow, and diastolic velocities of the mitral annulus were obtained in all patients before exercise testing. This study was approved by the Mayo Foundation institutional review board. All subjects underwent a symptom-limited treadmill exercise test using the Bruce protocol. Blood pressure was obtained by a cuff sphygmomanometer at the 3-minute mark of each stage and at peak exercise. The 12-lead electrocardiogram was continuously monitored. All 2-dimensional and Doppler echocardiograms were recorded using a commercially available echocardiographic unit equipped with an imaging transducer and pulse-wave Doppler capability. Ejection fraction was calculated on the basis of 2-dimensional echocardiography and a modification of the method of

  • effects of pericardiectomy on early diastolic mitral Annular Velocity in patients with constrictive pericarditis
    International Journal of Cardiology, 2009
    Co-Authors: Jongwon Ha, Euiyoung Choi, Eui Im, Sungha Park, Young Nam Yoon, Byungchul Chang, Namsik Chung
    Abstract:

    BACKGROUND: In patients with constrictive pericarditis (CP), early diastolic mitral Annular Velocity (E') is usually normal or exaggerated due to limitation of lateral expansion by the constricting pericardium. Although pericardiectomy is the treatment of choice for CP, it is difficult to evaluate its effectiveness. Theoretically, E' may decrease after successful pericardiectomy. However, little data are available regarding the effect of pericardiectomy on E'. The purpose of this study was to assess the change in E' after pericardiectomy in patients with CP. METHODS: We studied 16 patients (12 males, mean age 62.3+/-7.0 years) with surgically confirmed CP for changes in pre-discharge Doppler parameters following pericardiectomy. CP was secondary to previous cardiac surgery in 4 patients, tuberculosis in 4 patients, radiation-induced in 1 patient, and idiopathic in 7 patients. Ten patients underwent complete pericardiectomy (62.5%). E' was measured at the septal annulus before pericardiectomy and a mean duration of 10 (+/-6) days after. RESULTS: E' significantly decreased from 9.2+/-2.7 cm/s to 7.4+/-2.6 after pericardiectomy (p=0.013). The mean percent change of E' after pericardiectomy was 17.9+/-25.9%. The decrement of E' was significantly higher in patients with complete pericardiectomy than in patients who underwent a partial pericardiectomy (2.7+/-2.3 vs. 0.4+/-2.1, p=0.042). Also, more than 15% decrease of E' was significantly higher in patients with improvement of symptom after pericardiectomy (9 (100.0%) vs. 3 (42.9%), p=0.019). CONCLUSION: E' decreased following pericardiectomy in most of the patients with CP. The change of E' after pericardiectomy may be useful in evaluating the effectiveness of pericardiectomy.

  • value of echo doppler derived pulmonary vascular resistance net atrioventricular compliance and tricuspid Annular Velocity in determining exercise capacity in patients with mitral stenosis
    Circulation, 2007
    Co-Authors: Euiyoung Choi, Jongwon Ha, Seokmin Kang, Yangsoo Jang, Jaemin Shim, Chi Young Shim, Sejung Yoon, Donghoon Choi, Namsik Chung
    Abstract:

    BACKGROUND: The present study sought to determine if echo-Doppler-derived pulmonary vascular resistance (PVR echo), net-atrioventricular compliance (Cn) and tricuspid peak systolic Annular Velocity (Sa), as parameters of right ventricular function, have value in predicting exercise capacity in patients with mitral stenosis (MS). METHODS AND RESULTS: Thirty-two patients with moderate or severe MS without left ventricular systolic dysfunction were studied. After comprehensive echo-Doppler measurements, including PVR echo, tricuspid Sa and left-sided Cn, supine bicycle exercise echo and concomitant respiratory gas analysis were performed. Measurements during 5 cardiac cycles representing the mean heart rate were averaged. Increment of resting PVR(echo) (r=-0.416, p=0.018) and decrement of resting Sa (r=0.433, p=0.013) and Cn (r=0.469, p=0.007) were significantly associated with decrease in %VO(2) peak. The predictive accuracy for %VO2 peak could increase by combining these parameters as Sa/PVR echo (r=0.500, p=0.004) or Cn. (Sa/PVR echo) (r=0.572, p=0.001) independent of mitral valve area, mean diastolic pressure gradients or presence of atrial fibrillation. CONCLUSIONS: Measurement of PVR echo, Cn and Sa might provide important information about the exercise capacity of patients with MS.

  • incremental value of combining systolic mitral Annular Velocity and time difference between mitral inflow and diastolic mitral Annular Velocity to early diastolic Annular Velocity for differentiating constrictive pericarditis from restrictive cardiom
    Journal of The American Society of Echocardiography, 2007
    Co-Authors: Euiyoung Choi, Jongwon Ha, Namsik Chung
    Abstract:

    Although normal or exaggerated early diastolic mitral Annular Velocity (E′) provides an excellent specificity for differentiating constrictive pericarditis (CP) from restrictive cardiomyopathy (RCM), its sensitivity has been shown to be lower, especially in patients with CP who had underlying myocardial abnormality. This study sought to evaluate the incremental value of systolic mitral Annular Velocity (S′) and time difference between onset of mitral inflow and onset of E′ (T (E′-E) ) for differentiation between CP and RCM. This study included 44 participants (28 male, 16 female; mean age 47 years, range 10-76): 17 patients with CP, 12 with RCM, and 15 control subjects. Standard mitral inflow Doppler and tissue Doppler echocardiography were performed. E′ (9.5 ± 1.7 vs 4.7 ± 1.6 cm/s, P P (E′-E) (21.0 ± 32.0 vs 53.1 ± 30.4 milliseconds, P = .02) was significantly shorter in patients with CP than with RCM. Diagnostic accuracy of E′ for differentiation of CP from RCM was higher than S′ or T (E′-E) (area under curve 0.99 vs 0.87 vs 0.74, respectively). E′ of 8 cm/s had excellent specificity (100%) for differentiation of CP from RCM but sensitivity (70%) was relatively low. However, when combining E′ with S′ and T (E′-E) , the sensitivity could be increased when compared with E′ alone (70% with E′, 88% with E′ + S′, and 94% with E′ + S′ + T (E′-E) ), P = .001). In conclusion, the measurement of S′ and T (E′-E) can be helpful for differentiating between CP and RCM by providing incremental diagnostic information to E′.

  • triphasic mitral inflow Velocity with mid diastolic flow the presence of mid diastolic mitral Annular Velocity indicates advanced diastolic dysfunction
    T200600821.pdf, 2006
    Co-Authors: Jongwon Ha, Namsik Chung, Jaeyun Moon, Seokmin Kang, Yangsoo Jang, Won Heum Shim
    Abstract:

    Mitral inflow filling pattern usually consists of 2 forward flow velocities in sinus rhythm: early rapid filling (E ) and late filling with atrial contraction (A). However, additional mid-diastolic flow Velocity may be present resulting in triphasic mitral inflow filling pattern. When mitral inflow is triphasic, mitral annulus Velocity recorded by tissue Doppler imaging (TDI) frequently demonstrates a mid-diastolic component (L#). The significance of L# has not been explored previously. The purpose of this study was to explore possible mechanisms and clinical implications of triphasic mitral inflow with or without L# using TDI and proBNP. Of 9004 patients who underwent transthoracic echocardiography from March to November 2003, 83 (0.9%) patients (33 male, 50 female; mean age, 63G 10 years) with a triphasic mitral inflow Velocity pattern, including mid- diastolic flow Velocity of at least 0.2 m/s, and sinus rhythm were prospectively identified in our clinical echocardiography laboratory. Peak Velocity of E, mid- diastolic (L), and A, and deceleration time (DT) of the E wave Velocity were measured. Diastolic mitral Annular velocities were measured at the septal corner of the mitral annulus by TDI from the apical 4-chamber view. ProBNP was measured at Abbreviations: A, peak filling Velocity of mitral inflow during atrial contraction; E, peak filling Velocity of mitral inflow during early diastole; E#, early diastolic mitral Annular Velocity; LV, left ventricular; LVEDP, left ventricular end-diastolic pressure; L#, mid- diastolic component of mitral Annular Velocity; proBNP, N-terminal pro-brain natriuretic peptide; TDI, tissue Doppler imaging.

Namsik Chung - One of the best experts on this subject based on the ideXlab platform.

  • effects of pericardiectomy on early diastolic mitral Annular Velocity in patients with constrictive pericarditis
    International Journal of Cardiology, 2009
    Co-Authors: Jongwon Ha, Euiyoung Choi, Eui Im, Sungha Park, Young Nam Yoon, Byungchul Chang, Namsik Chung
    Abstract:

    BACKGROUND: In patients with constrictive pericarditis (CP), early diastolic mitral Annular Velocity (E') is usually normal or exaggerated due to limitation of lateral expansion by the constricting pericardium. Although pericardiectomy is the treatment of choice for CP, it is difficult to evaluate its effectiveness. Theoretically, E' may decrease after successful pericardiectomy. However, little data are available regarding the effect of pericardiectomy on E'. The purpose of this study was to assess the change in E' after pericardiectomy in patients with CP. METHODS: We studied 16 patients (12 males, mean age 62.3+/-7.0 years) with surgically confirmed CP for changes in pre-discharge Doppler parameters following pericardiectomy. CP was secondary to previous cardiac surgery in 4 patients, tuberculosis in 4 patients, radiation-induced in 1 patient, and idiopathic in 7 patients. Ten patients underwent complete pericardiectomy (62.5%). E' was measured at the septal annulus before pericardiectomy and a mean duration of 10 (+/-6) days after. RESULTS: E' significantly decreased from 9.2+/-2.7 cm/s to 7.4+/-2.6 after pericardiectomy (p=0.013). The mean percent change of E' after pericardiectomy was 17.9+/-25.9%. The decrement of E' was significantly higher in patients with complete pericardiectomy than in patients who underwent a partial pericardiectomy (2.7+/-2.3 vs. 0.4+/-2.1, p=0.042). Also, more than 15% decrease of E' was significantly higher in patients with improvement of symptom after pericardiectomy (9 (100.0%) vs. 3 (42.9%), p=0.019). CONCLUSION: E' decreased following pericardiectomy in most of the patients with CP. The change of E' after pericardiectomy may be useful in evaluating the effectiveness of pericardiectomy.

  • value of echo doppler derived pulmonary vascular resistance net atrioventricular compliance and tricuspid Annular Velocity in determining exercise capacity in patients with mitral stenosis
    Circulation, 2007
    Co-Authors: Euiyoung Choi, Jongwon Ha, Seokmin Kang, Yangsoo Jang, Jaemin Shim, Chi Young Shim, Sejung Yoon, Donghoon Choi, Namsik Chung
    Abstract:

    BACKGROUND: The present study sought to determine if echo-Doppler-derived pulmonary vascular resistance (PVR echo), net-atrioventricular compliance (Cn) and tricuspid peak systolic Annular Velocity (Sa), as parameters of right ventricular function, have value in predicting exercise capacity in patients with mitral stenosis (MS). METHODS AND RESULTS: Thirty-two patients with moderate or severe MS without left ventricular systolic dysfunction were studied. After comprehensive echo-Doppler measurements, including PVR echo, tricuspid Sa and left-sided Cn, supine bicycle exercise echo and concomitant respiratory gas analysis were performed. Measurements during 5 cardiac cycles representing the mean heart rate were averaged. Increment of resting PVR(echo) (r=-0.416, p=0.018) and decrement of resting Sa (r=0.433, p=0.013) and Cn (r=0.469, p=0.007) were significantly associated with decrease in %VO(2) peak. The predictive accuracy for %VO2 peak could increase by combining these parameters as Sa/PVR echo (r=0.500, p=0.004) or Cn. (Sa/PVR echo) (r=0.572, p=0.001) independent of mitral valve area, mean diastolic pressure gradients or presence of atrial fibrillation. CONCLUSIONS: Measurement of PVR echo, Cn and Sa might provide important information about the exercise capacity of patients with MS.

  • incremental value of combining systolic mitral Annular Velocity and time difference between mitral inflow and diastolic mitral Annular Velocity to early diastolic Annular Velocity for differentiating constrictive pericarditis from restrictive cardiom
    Journal of The American Society of Echocardiography, 2007
    Co-Authors: Euiyoung Choi, Jongwon Ha, Namsik Chung
    Abstract:

    Although normal or exaggerated early diastolic mitral Annular Velocity (E′) provides an excellent specificity for differentiating constrictive pericarditis (CP) from restrictive cardiomyopathy (RCM), its sensitivity has been shown to be lower, especially in patients with CP who had underlying myocardial abnormality. This study sought to evaluate the incremental value of systolic mitral Annular Velocity (S′) and time difference between onset of mitral inflow and onset of E′ (T (E′-E) ) for differentiation between CP and RCM. This study included 44 participants (28 male, 16 female; mean age 47 years, range 10-76): 17 patients with CP, 12 with RCM, and 15 control subjects. Standard mitral inflow Doppler and tissue Doppler echocardiography were performed. E′ (9.5 ± 1.7 vs 4.7 ± 1.6 cm/s, P P (E′-E) (21.0 ± 32.0 vs 53.1 ± 30.4 milliseconds, P = .02) was significantly shorter in patients with CP than with RCM. Diagnostic accuracy of E′ for differentiation of CP from RCM was higher than S′ or T (E′-E) (area under curve 0.99 vs 0.87 vs 0.74, respectively). E′ of 8 cm/s had excellent specificity (100%) for differentiation of CP from RCM but sensitivity (70%) was relatively low. However, when combining E′ with S′ and T (E′-E) , the sensitivity could be increased when compared with E′ alone (70% with E′, 88% with E′ + S′, and 94% with E′ + S′ + T (E′-E) ), P = .001). In conclusion, the measurement of S′ and T (E′-E) can be helpful for differentiating between CP and RCM by providing incremental diagnostic information to E′.

  • triphasic mitral inflow Velocity with mid diastolic flow the presence of mid diastolic mitral Annular Velocity indicates advanced diastolic dysfunction
    T200600821.pdf, 2006
    Co-Authors: Jongwon Ha, Namsik Chung, Jaeyun Moon, Seokmin Kang, Yangsoo Jang, Won Heum Shim
    Abstract:

    Mitral inflow filling pattern usually consists of 2 forward flow velocities in sinus rhythm: early rapid filling (E ) and late filling with atrial contraction (A). However, additional mid-diastolic flow Velocity may be present resulting in triphasic mitral inflow filling pattern. When mitral inflow is triphasic, mitral annulus Velocity recorded by tissue Doppler imaging (TDI) frequently demonstrates a mid-diastolic component (L#). The significance of L# has not been explored previously. The purpose of this study was to explore possible mechanisms and clinical implications of triphasic mitral inflow with or without L# using TDI and proBNP. Of 9004 patients who underwent transthoracic echocardiography from March to November 2003, 83 (0.9%) patients (33 male, 50 female; mean age, 63G 10 years) with a triphasic mitral inflow Velocity pattern, including mid- diastolic flow Velocity of at least 0.2 m/s, and sinus rhythm were prospectively identified in our clinical echocardiography laboratory. Peak Velocity of E, mid- diastolic (L), and A, and deceleration time (DT) of the E wave Velocity were measured. Diastolic mitral Annular velocities were measured at the septal corner of the mitral annulus by TDI from the apical 4-chamber view. ProBNP was measured at Abbreviations: A, peak filling Velocity of mitral inflow during atrial contraction; E, peak filling Velocity of mitral inflow during early diastole; E#, early diastolic mitral Annular Velocity; LV, left ventricular; LVEDP, left ventricular end-diastolic pressure; L#, mid- diastolic component of mitral Annular Velocity; proBNP, N-terminal pro-brain natriuretic peptide; TDI, tissue Doppler imaging.

  • triphasic mitral inflow Velocity with mid diastolic flow the presence of mid diastolic mitral Annular Velocity indicates advanced diastolic dysfunction
    European Journal of Echocardiography, 2006
    Co-Authors: Jongwon Ha, Namsik Chung, Jaeyun Moon, Seokmin Kang, Yangsoo Jang, Won Heum Shim
    Abstract:

    Mitral inflow filling pattern usually consists of 2 forward flow velocities in sinus rhythm: early rapid filling ( E ) and late filling with atrial contraction ( A ). However, additional mid-diastolic flow Velocity may be present resulting in triphasic mitral inflow filling pattern. When mitral inflow is triphasic, mitral annulus Velocity recorded by tissue Doppler imaging (TDI) frequently demonstrates a mid-diastolic component ( L ′). The significance of L ′ has not been explored previously. The purpose of this study was to explore possible mechanisms and clinical implications of triphasic mitral inflow with or without L ′ using TDI and proBNP. Of 9004 patients who underwent transthoracic echocardiography from March to November 2003, 83 (0.9%) patients (33 male, 50 female; mean age, 63±10 years) with a triphasic mitral inflow Velocity pattern, including mid-diastolic flow Velocity of at least 0.2m/s, and sinus rhythm were prospectively identified in our clinical echocardiography laboratory. Peak Velocity of E , mid-diastolic ( L ), and A , and deceleration time (DT) of the E wave Velocity were measured. Diastolic mitral Annular velocities were measured at the septal corner of the mitral annulus by TDI from the apical 4-chamber view. ProBNP was measured at the time of echocardiogram using a quantitative electrochemiluminescence immunoassay. Mean heart rate was 54±6beats/min (range, 40–67). Mean left ventricular (LV) ejection fraction (EF) was 64±13% and LV systolic dysfunction (EF<40%) was present in only 6 (7%). Patients were classified into 2 groups: group 1 ( n =47) included those who had L ′ and group 2 ( n =36) included those without L ′. Group 1 patients had significantly higher peak Velocity (35±14 vs 26±6cm/s, p =0.0002) and TVI (35±14 vs 26±6cm/s, p =0.0002) of L , E / E ′ (18±8 vs 14±6, p =0.02), and left atrial volume index (42±14 vs 34±10ml/m2, p =0.0037). E ′ (4.7±1.3 vs 6.2±2.3cm/s, p =0.001) and A ′ (6.2±2.0 vs 8.6±3.4cm/s, p =0.0006) were significantly lower in group 1 compared with those of group 2. ProBNP was significantly higher in group 1 (847±1461 vs 438±1039pmol/l, p =0.0012) and it was above normal in all except in 1 patient of group 1. In conclusion, the presence of L ′ in subjects with triphasic mitral inflow Velocity pattern with mid-diastolic flow is associated with higher E / E ′, elevated proBNP and enlarged left atrium indicating advanced diastolic dysfunction with elevated filling pressures. This unique mitral Annular Velocity pattern should be helpful in identifying the patients with advanced diastolic dysfunction and increased LV filling pressures.

Rolf Nordlander - One of the best experts on this subject based on the ideXlab platform.

  • Effects of first myocardial infarction on left ventricular systolic and diastolic function with the use of mitral Annular Velocity determined by pulsed wave doppler tissue imaging.
    Journal of The American Society of Echocardiography, 2000
    Co-Authors: Mahbubul Alam, Johan Wardell, Eva Andersson, Bassem A Samad, Rolf Nordlander
    Abstract:

    This study was undertaken to assess the effect of a first myocardial infarction (MI) on the systolic and diastolic Velocity profiles of the mitral annulus determined by pulsed wave Doppler tissue imaging and thereby evaluate left ventricular (LV) function after MI. Seventy-eight patients with a first MI were examined before discharge. Peak systolic, peak early diastolic, and peak late diastolic velocities were recorded at 4 different sites on the mitral annulus corresponding to the septum, anterior, lateral, and inferior sites of the left ventricle. In addition, the amplitude of mitral Annular motion at the 4 above LV sites, the ejection fraction, and conventional Doppler diastolic parameters were recorded. Nineteen agematched healthy subjects served as controls. Compared with healthy subjects, the MI patients had a significantly reduced peak systolic Velocity at the mitral annulus, especially at the infarction sites. A relatively good linear correlation was found between the ejection fraction and the mean systolic Velocity from the 4 LV sites (r = 0.74, P < .001). The correlation was also good when the mean peak systolic mitral Annular Velocity was tested against the magnitude of the mean mitral Annular motion (r = 0.77, P < .001). When the patients were divided into 2 different groups with respect to an ejection fraction ≥0.50 or

  • effects of first myocardial infarction on left ventricular systolic and diastolic function with the use of mitral Annular Velocity determined by pulsed wave doppler tissue imaging
    Journal of The American Society of Echocardiography, 2000
    Co-Authors: Mahbubul Alam, Johan Wardell, Eva Andersson, Bassem A Samad, Rolf Nordlander
    Abstract:

    This study was undertaken to assess the effect of a first myocardial infarction (MI) on the systolic and diastolic Velocity profiles of the mitral annulus determined by pulsed wave Doppler tissue imaging and thereby evaluate left ventricular (LV) function after MI. Seventy-eight patients with a first MI were examined before discharge. Peak systolic, peak early diastolic, and peak late diastolic velocities were recorded at 4 different sites on the mitral annulus corresponding to the septum, anterior, lateral, and inferior sites of the left ventricle. In addition, the amplitude of mitral Annular motion at the 4 above LV sites, the ejection fraction, and conventional Doppler diastolic parameters were recorded. Nineteen agematched healthy subjects served as controls. Compared with healthy subjects, the MI patients had a significantly reduced peak systolic Velocity at the mitral annulus, especially at the infarction sites. A relatively good linear correlation was found between the ejection fraction and the mean systolic Velocity from the 4 LV sites (r = 0.74, P < .001). The correlation was also good when the mean peak systolic mitral Annular Velocity was tested against the magnitude of the mean mitral Annular motion (r = 0.77, P < .001). When the patients were divided into 2 different groups with respect to an ejection fraction ≥0.50 or <0.50, a cutoff point of mean systolic mitral Annular Velocity of ≥7.5 cm/s had a sensitivity of 79% and a specificity of 88% in predicting a preserved global LV systolic function. Similar to systolic velocities, the early diastolic Velocity was also reduced, especially at the infarction sites. The peak mitral Annular early diastolic Velocity correlated well with both LV ejection fraction (r = 0.66, P < .001) and mean systolic mitral Annular motion (r = 0.68, P < .001). However, no correlation existed between the early diastolic Velocity and conventional diastolic Doppler parameters. The reduced peak systolic mitral Annular Velocity seems to be an expression of regionally reduced systolic function. The peak early diastolic Velocity is also reduced, especially at the infarction sites, and reflects regional diastolic dysfunction. Thus, quantification of myocardial Velocity by Doppler tissue imaging opens up a new possibility of assessing LV function along its long axis. (J Am Soc Echocardiogr 2000;13:343-52.)

  • right ventricular function in patients with first inferior myocardial infarction assessment by tricuspid Annular motion and tricuspid Annular Velocity
    American Heart Journal, 2000
    Co-Authors: Mahbubul Alam, Johan Wardell, Eva Andersson, Bassem A Samad, Rolf Nordlander
    Abstract:

    Background Unlike left ventricular function, right ventricular (RV) function has not been widely studied after a myocardial infarction (MI). The current study describes RV function determined by tricuspid Annular motion and tricuspid Annular Velocity after MI. Methods and Results Thirty-eight patients with a first acute inferior MI were prospectively compared with 33 patients with a first anterior MI and 24 age-matched healthy individuals. Association of RV infarction in inferior MI was defined as the presence of ≥1-mm ST-segment elevation at the right precordial lead, V4R, of the electrocardiograms. From the echocardiographic opical 4-chamber views, the systolic motion of the tricuspid annulus was recorded at the RV free wall with the use of 2-dimensional guided M-mode recordings. Peak systolic and peak early and late diastolic velocities of the tricuspid annulus at the RV free wall also were recorded with the use of pulsed-wave Doppler tissue imaging. The tricuspid Annular motion was reduced in inferior MI compared with that in healthy individuals (20.5 and 25 mm, P < .001). The peak systolic Velocity of the tricuspid annulus was significantly reduced in inferior MI compared with that in healthy individuals (12 vs 14.5 cm/s, P < .001) and patients with anterior M1 (12 and 14.5 cm/s, P < .001). Patients with inferior MI were divided into 2 subgroups: those with and those without electrocardiographic signs of RV infarction. The tricuspid Annular motion was significantly lower in patients with RV infarction than in patients without RV infarction (17 and 22.7 mm, P < .001). In addition, compared with patients without electrocardiographic signs of RV infarction, patients with RV infarction also had a significantly decreased peak systolic tricuspid Annular Velocity (13.3 and 10.3 cm/s, P < .001) and peak early diastolic Velocity (13 and 8.2 cm/s, P < .001). Conclusions These results suggest that tricuspid Annular motion and tricuspid Annular Velocity can be used to assess RV function in association with inferior MI.

Shenghsiung Sheu - One of the best experts on this subject based on the ideXlab platform.

  • Myocardial Performance Index Derived from Preejection Period: A Novel and Feasible Parameter in Evaluation of Cardiac Performance in Patients with Permanent Atrial Fibrillation
    Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, 2011
    Co-Authors: Homing Su, Shenghsiung Sheu, Wenchol Voon
    Abstract:

    Background: Using tissue Doppler echocardiography, we can measure preejection period (PEPa), defined as the interval measured from the onset of QRS to the onset of the systolic mitral Annular Velocity pattern, isovolumic relaxation time (IVRTa), defined as the interval measured from the end of systolic mitral Annular Velocity pattern to the onset of diastolic mitral Annular Velocity pattern, and ejection time (ETa), defined as the interval measured from the onset to the end of systolic mitral Annular Velocity pattern on the same cardiac cycle. The aim of this study is to test the applicability of PEPa-derived myocardial performance index (MPI), defined as the ratio of PEPa + IVRTa to ETa, as an indicator of combined left ventricular systolic and diastolic function in patients with permanent atrial fibrillation. Methods: Echocardiographic examination was performed in 54 consecutive patients with permanent atrial fibrillation. Clinical and echocardiographic parameters were compared and analyzed. Results: After a multivariate analysis, the average RR interval on the tissue Doppler image (β=−0.328, P = 0.002), left ventricular ejection fraction (β=−0.260, P = 0.024), and early diastolic mitral Annular Velocity (β=−0.408, P < 0.001) were the major determinants of PEPa-derived MPI. Conclusions: PEPa-derived MPI had a significant correlation with echocardiographic left ventricular diastolic and systolic function. It may be a novel and feasible indicator in assessment of global left ventricular function in patients with permanent atrial fibrillation. (Echocardiography 2011;28:1081-1087)

  • usefulness of time interval between end of diastolic mitral Annular Velocity pattern and onset of qrs for predicting left ventricular end diastolic pressure
    American Journal of Cardiology, 2007
    Co-Authors: Homing Su, Wenchol Voon, Kaihung Cheng, Shenghsiung Sheu
    Abstract:

    Diastolic mitral Annular motion may terminate earlier in patients with higher left ventricular end-diastolic pressure (LVEDP). It was therefore hypothesized that the time interval measured from the end of the diastolic mitral Annular Velocity pattern to the onset of QRS (the AQ interval) would be a useful parameter in predicting LVEDP. The aim of this study was to evaluate the relation between the AQ interval and LVEDP. Forty-six patients with suspected coronary artery disease who underwent Doppler echocardiographic studies and cardiac catheterization were included. LVEDP was determined using a micromanometer-tipped catheter. On univariate analysis, the AQ interval had positive correlations with the PR interval (r = 0.405, p = 0.005), transmitral E-wave Velocity (r = 0.502, p

Hirotsugu Yamada - One of the best experts on this subject based on the ideXlab platform.

  • left ventricular mass influences relationship between filling pressure and early diastolic ratio of inflow Velocity to mitral Annular Velocity e e
    Circulation, 2017
    Co-Authors: Masahiro Nakabachi, Kazuaki Wakami, Kenya Kusunose, Satoshi Yamada, Hiroyuki Iwano, Taichi Hayashi, Kazunori Okada, Kiyotaka Watanabe, Tomoko Ishizu, Hirotsugu Yamada
    Abstract:

    BACKGROUND: Early-diastolic mitral Annular Velocity (e') and the ratio of early-diastolic left ventricular (LV) inflow Velocity (E) to e' (E/e') have been widely used as indexes of LV relaxation and filling pressure, respectively. However, many recent studies have demonstrated that they are not reliable in various clinical settings. We thus investigated the factors influencing these echocardiographic parameters in a multicenter study.Methods and Results:The study group comprised 69 patients, referred for cardiac catheterization, and enrolled in 5 university hospitals. Time constant (τ) and LV mean diastolic pressure (LVMDP) were measured using a micromanometer-tipped catheter. Although e' only weakly correlated with τ (r=-0.35, P<0.01), E/e' modestly correlated with LVMDP (r=0.48, P<0.001). Multivariable analysis revealed that hypertension (β=-0.33, P<0.01) and LV ejection fraction (LVEF) (β=0.44, P<0.001) were the independent determinants of e', and LV mass index (LVMI) (β=0.37, P<0.001) and LVMDP (β=0.47, P<0.001) were those of E/e'. Additionally, E/e' significantly correlated with LVMDP in patients with normal LVMI (r=0.74, P<0.001) but not in those with increased LVMI. CONCLUSIONS: The coincidence of hypertension and LVEF affected the relationship between LV relaxation and e', whereas LVMI altered the relationship between LV filling pressure and E/e'. Thus, clinical conditions associated with an increase in LVMI, such as LV hypertrophy and LV dilatation, should be considered when estimating the filling pressure from E/e'.

  • Left Ventricular Mass Influences Relationship Between Filling Pressure and Early-Diastolic Ratio of Inflow Velocity to Mitral Annular Velocity (E/e′)
    Circulation, 2017
    Co-Authors: Masahiro Nakabachi, Kazuaki Wakami, Kenya Kusunose, Satoshi Yamada, Hiroyuki Iwano, Taichi Hayashi, Kazunori Okada, Kiyotaka Watanabe, Tomoko Ishizu, Hirotsugu Yamada
    Abstract:

    BACKGROUND: Early-diastolic mitral Annular Velocity (e') and the ratio of early-diastolic left ventricular (LV) inflow Velocity (E) to e' (E/e') have been widely used as indexes of LV relaxation and filling pressure, respectively. However, many recent studies have demonstrated that they are not reliable in various clinical settings. We thus investigated the factors influencing these echocardiographic parameters in a multicenter study.Methods and Results:The study group comprised 69 patients, referred for cardiac catheterization, and enrolled in 5 university hospitals. Time constant (τ) and LV mean diastolic pressure (LVMDP) were measured using a micromanometer-tipped catheter. Although e' only weakly correlated with τ (r=-0.35, P

  • interval from the onset of transmitral flow to Annular Velocity is a marker of lv filling pressure
    Jacc-cardiovascular Imaging, 2013
    Co-Authors: Kenya Kusunose, Hirotsugu Yamada, Susumu Nishio, Rina Tamai, Toshiyuki Niki, Koji Yamaguchi, Yoshio Taketani, Takashi Iwase, Takeshi Soeki, Tetsuzo Wakatsuki
    Abstract:

    Recently, the time interval between the onset of early diastolic transmitral flow Velocity (E) and mitral Annular Velocity (e′) (TE-e′) was proposed as a new index representing left ventricular (LV) relaxation. A problem with the measurement of TE-e′ was that E and e′ could not be measured