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Alaa Mabrouk Salem Omar - One of the best experts on this subject based on the ideXlab platform.
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tissue doppler derived myocardial acceleration during Isovolumetric Contraction predicts pulmonary capillary wedge pressure in patients with significant mitral regurgitation
Ultrasound in Medicine and Biology, 2015Co-Authors: Alaa Mabrouk Salem Omar, Mohamed A E Abdelrahman, Hazem Khorshid, Mostafa Helmy, Hala Raslan, Osama RifaieAbstract:Abstract The aim of this study was to determine whether isovolumic Contraction velocity (IVV) and acceleration (IVA) predict pulmonary capillary wedge pressure (PCWP) in mitral regurgitation. Forty-four patients with mitral regurgitation were studied. PCWP was invasively measured. IVV, IVA and the ratio IVRT/ T e′–E (where IVRT = isovolumic relaxation time, and T e′–E = time difference between the onset of mitral annular e ′ and mitral flow E waves) were measured. Mean age was 59.2 ± 13.3 y. Twenty-six patients had an ejection fraction ≥55%, and 18 patients had an ejection fraction T e′–E was impossible in 11 patients because T e′–E = zero. PCWP correlated with IVV, IVA and IVRT/ T e′–E ; overall ( r = −0.714, −0.892 and, −0.752, all p r = −0.467, −0.749, −0.639, p = 0.016, r = −0.761, −0.911 and −0.833, all p T e′–E , especially when impossible because T e′–E = 0.
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tissue doppler imaging derived myocardial acceleration during Isovolumetric Contraction predicts pulmonary capillary wedge pressure in patients with reduced ejection fraction
Circulation, 2012Co-Authors: Alaa Mabrouk Salem Omar, Hidekazu Tanaka, Kensuke Matsumoto, Kazuhiro Tatsumi, Tatsuya Miyoshi, Mana Hiraishi, Takayuki Tsuji, Akihiro Kaneko, Keiko Ryo, Yuko FukudaAbstract:BACKGROUND Tissue Doppler imaging-obtained Isovolumetric myocardial acceleration (IVA) is load independent, reportedly predicts systolic functions, and correlates with exercise capacity in patients with reduced ejection fraction (EF). We hypothesized that IVA correlates with the pulmonary capillary wedge pressure (PCWP) in patients with reduced EF. METHODS AND RESULTS Of 113 patients, correlations between PCWP and IVA were done for all patients, 48 patients with EF ≥55%, and 65 patients with EF 1.60 m/s(2) can predict PCWP ≥15 mmHg, with a sensitivity of 95%, specificity of 73%, and an area under the curve of 0.867 (P<0.0001). CONCLUSIONS IVA can predict PCWP in patients with reduced EF, and can be considered an alternative to the E/e' ratio for patients with atrial fibrillation or E/e' ratio between 8 and 15.
Jamil A Tajik - One of the best experts on this subject based on the ideXlab platform.
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doppler echocardiographic index for assessment of global right ventricular function
Journal of The American Society of Echocardiography, 1996Co-Authors: Karl S Dujardin, David O Hodge, Kent R Bailey, Michael D Mcgoon, Jamil A TajikAbstract:Abstract Echocardiographic assessment of right ventricular function remains difficult and challenging. However, there is considerable clinical need for a simple, reproducible, and reliable parameter of right ventricular function in patients with right-sided heart disease. The purpose of this study was to assess the clinical value of a Doppler-derived index, combining systolic and diastolic intervals of the right cycle, in assessing global right ventricular function in patients with primary pulmonary hypertension. The study population comprised 26 consecutive patients with primary pulmonary hypertension and 37 age-matched normal subjects. The sum of right ventricular Isovolumetric Contraction time and Isovolumetric relaxation time was obtained by subtracting right ventricular ejection time from the interval between cessation and onset of the tricuspid inflow velocities with pulsed-wave Doppler echocardiography. An index of combined right ventricular systolic and diastolic function was obtained by dividing the sum of both Isovolumetric intervals by ejection time. The index was compared with available parameters of systolic or diastolic function, clinical symptoms, and survival. Right ventricular Isovolumetric Contraction time and Isovolumetric relaxation time were prolonged significantly in patients with primary pulmonary hypertension (85 ± 41 msec and 135 ± 43 msec) compared with normal subjects (38 ± 7 msec and 49 ± 9 msec, respectively; p p p
Yuko Fukuda - One of the best experts on this subject based on the ideXlab platform.
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tissue doppler imaging derived myocardial acceleration during Isovolumetric Contraction predicts pulmonary capillary wedge pressure in patients with reduced ejection fraction
Circulation, 2012Co-Authors: Alaa Mabrouk Salem Omar, Hidekazu Tanaka, Kensuke Matsumoto, Kazuhiro Tatsumi, Tatsuya Miyoshi, Mana Hiraishi, Takayuki Tsuji, Akihiro Kaneko, Keiko Ryo, Yuko FukudaAbstract:BACKGROUND Tissue Doppler imaging-obtained Isovolumetric myocardial acceleration (IVA) is load independent, reportedly predicts systolic functions, and correlates with exercise capacity in patients with reduced ejection fraction (EF). We hypothesized that IVA correlates with the pulmonary capillary wedge pressure (PCWP) in patients with reduced EF. METHODS AND RESULTS Of 113 patients, correlations between PCWP and IVA were done for all patients, 48 patients with EF ≥55%, and 65 patients with EF 1.60 m/s(2) can predict PCWP ≥15 mmHg, with a sensitivity of 95%, specificity of 73%, and an area under the curve of 0.867 (P<0.0001). CONCLUSIONS IVA can predict PCWP in patients with reduced EF, and can be considered an alternative to the E/e' ratio for patients with atrial fibrillation or E/e' ratio between 8 and 15.
Karl S Dujardin - One of the best experts on this subject based on the ideXlab platform.
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doppler echocardiographic index for assessment of global right ventricular function
Journal of The American Society of Echocardiography, 1996Co-Authors: Karl S Dujardin, David O Hodge, Kent R Bailey, Michael D Mcgoon, Jamil A TajikAbstract:Abstract Echocardiographic assessment of right ventricular function remains difficult and challenging. However, there is considerable clinical need for a simple, reproducible, and reliable parameter of right ventricular function in patients with right-sided heart disease. The purpose of this study was to assess the clinical value of a Doppler-derived index, combining systolic and diastolic intervals of the right cycle, in assessing global right ventricular function in patients with primary pulmonary hypertension. The study population comprised 26 consecutive patients with primary pulmonary hypertension and 37 age-matched normal subjects. The sum of right ventricular Isovolumetric Contraction time and Isovolumetric relaxation time was obtained by subtracting right ventricular ejection time from the interval between cessation and onset of the tricuspid inflow velocities with pulsed-wave Doppler echocardiography. An index of combined right ventricular systolic and diastolic function was obtained by dividing the sum of both Isovolumetric intervals by ejection time. The index was compared with available parameters of systolic or diastolic function, clinical symptoms, and survival. Right ventricular Isovolumetric Contraction time and Isovolumetric relaxation time were prolonged significantly in patients with primary pulmonary hypertension (85 ± 41 msec and 135 ± 43 msec) compared with normal subjects (38 ± 7 msec and 49 ± 9 msec, respectively; p p p
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Doppler index combining systolic and diastolic myocardial performance : Clinical value in cardiac amyloidosis
Journal of the American College of Cardiology, 1996Co-Authors: Chuwa Tei, Karl S Dujardin, David O Hodge, A. Jamil Tajik, Robert A. Kyle, James B. SewardAbstract:Objectives. This study was designed to determine the clinical value of a Doppler-derived index of combined systolic and diastolic myocardial performance in the assessment of cardiac amyloidosis. Background. Cardiac amyloidosis is an infiltrative disease with diastolic and systolic dysfunction. Therefore, the index of myocardial performance combining systolic and diastolic time intervals could be a useful predictor of clinical outcome in cardiac amyloidosis. Methods. The study included 45 patients with biopsy-proved amyloidosis and 45 age-matched normal subjects. All patients had typical echocardiographic features of amyloid cardiac involvement.t A Doppler-derived index, defined as the sum of Isovolumetric Contraction time and Isovolumetric relaxation time divided by ejection time, was measured from left ventricular outflow and mitral inflow Doppler velovity profiles recorded during routine echocardiography. The index as well as conventional systolic or diastolic echocardiographic/Doppler variables were related to subsequent outcome. Results. The Isovolumetric Contraction and relaxation times were prolonged and ejection time was shortened (p < 0.001) in patients with amyloidosis compared with that in normal subjects, resulting in a marked increase of the index from normal values (p < 0.001). In the amyloid group the index was highest in patients with a low stroke index or with both shortened mitral deceleration time and lower ejection fraction. By univariate analysis, New York Heart Association functional class, the index, ejection fraction and mitral deceleration time were significant predictors of outcome. However, by multivariate stepwise regression analysis, functional class and the index were the only independent predictors of survival. Conclusions. The Doppler-derived index of combined systolic and diastolic myocardial performance correlates with global cardiac dysfunction and is a useful predictor of clinical outcome in patients with cardiac amyloidosis.
Robert S. Reneman - One of the best experts on this subject based on the ideXlab platform.
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The onset of ventricular Isovolumetric Contraction as reflected in the carotid artery distension waveform
Critical Care, 2007Co-Authors: M Van Houwelingen, Arnold P.g. Hoeks, Robert S. RenemanAbstract:The blood pressure waveform carries information about the cardiac Contraction and the impedance characteristics of the vascular bed. Here, we demonstrate that the start of isovolumic ventricular Contraction is persistently reflected as an inflection point in the pressure wave as recorded in the aortic root (TPIC) as well as in the carotid artery distension waveform (TDIC) as it travels down the arterial tree. In a group of six patients with normal pressure gradients across the aortic valve after valve replacement, the TPIC had a small delay with respect to the onset of isovolumic ventricular Contraction (
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the onset of ventricular Isovolumetric Contraction as reflected in the carotid artery distension waveform
Critical Care, 2007Co-Authors: M Van Houwelingen, Arnold P.g. Hoeks, Robert S. RenemanAbstract:The blood pressure waveform carries information about the cardiac Contraction and the impedance characteristics of the vascular bed. Here, we demonstrate that the start of isovolumic ventricular Contraction is persistently reflected as an inflection point in the pressure wave as recorded in the aortic root (TPIC) as well as in the carotid artery distension waveform (TDIC) as it travels down the arterial tree. In a group of six patients with normal pressure gradients across the aortic valve after valve replacement, the TPIC had a small delay with respect to the onset of isovolumic ventricular Contraction (<10 ms). In a group (n = 21) of young, presumably healthy, volunteers, the inflection point occurred persistently in the carotid distension waveform, as recorded by means of ultrasound, before the systolic foot (intersubject delay between inflection point and systolic foot: mean ± SD = 40.0 ± 9.4 ms, intrasubject SD 4.6 ms). Retrograde coronary blood flow during isovolumic ventricular Contraction may be the origin of the persistent end-diastolic pressure and distension perturbation. This study shows that the duration of the isovolumic Contraction can be reliably extracted from the carotid artery distension waveform. Figure 1
