Whereas both leaflets tethering is related to preoperative ischemic MR, both leaflets tethering but with predominant contribution from augmented and progressive PML tethering is related to recurrent/persistent ischemic/functional MR late after surgical annuloplasty.

Papillary muscle dysfunction, reducing its longitudinal contraction to induce leaflet tethering, attenuates ischemic MR in patients with basal inferior LV remodeling.

Repeated Waon therapy improved right ventricular positive dP/dt, PH during exercise, exercise tolerance and the QOL in patients with severe COPD.

Our results revealed that the major differences between ADD and DHF were global and longitudinal LV systolic dysfunction and LV enlargement. This study suggests that LV systolic dysfunction plays an important role in the development of DHF.

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ardiac function is difficult to evaluate in small animal models of congestive heart failure (CHF). The Tei index, defined as the sum of isovolume contraction time (ICT) and isovolume relaxation time (IRT) divided by ejection time (ET), can express both systolic and diastolic function. Therefore, global left ventricular (LV) function can be determined and the prognosis of patients with cardiac dysfunction or CHF can be predicted. [1][2][3][4][5] Because of its simplicity, the Tei index can be applicable to even small animal models of CHF. 6 However, the ability of the Tei index to predict the outcome in a small animal model of CHF has not been fully investigated. Therefore, we postulated that the Tei index could also predict the prognosis of animal models of CHF. The present study investigates the relationship between the Tei index and survival in an animal model of CHF. Methods Animal ModelThe study included 48 male UM-X7.1 hamsters at an average age of 19.7±0.4 weeks. Heart function is normal in this model at 15 weeks of age, but cardiac dysfunction be- Circulation Journal Vol.69, August 2005comes significant without overt CHF at 20 weeks. CHF becomes overt at 27 weeks, and cardiac death occurs between 27 and 44 weeks. 7-9 Therefore, these animals have significant cardiac dysfunction but without obvious CHF at 20 weeks of age. The institutional committee of Kagoshima University approved the study protocol. Doppler EchocardiographyStandard 2-dimensional and Doppler echocardiography Background Cardiac function is difficult to evaluate in small animal models of heart disease. The Doppler Tei index is a simple and non-invasive measure that can express global cardiac function even in small animal models of congestive heart failure. However, its ability to predict prognosis has not been evaluated. Methods and ResultsWe tested the hypothesis that cardiac functional indices, such as the Tei index, can predict the prognosis of hamsters with cardiac dysfunction. The Tei index, defined as the sum of the isovolume contraction and relaxation time divided by ejection time, and the percent fractional shortening of the left ventricle was measured in 48 anesthetized male hamsters (19.7±0.4 weeks old) with cardiac dysfunction (UM-X7.1), using Doppler and 2-dimensional echocardiography. The hamsters were separated into 2 groups based on the median Tei index (0.50) and % fractional shortening (FS) (21%). Kaplan-Meier analysis determined the survival rates of the groups. Both the Tei index and %FS enabled significant distinction of better and poorer survival (p<0.01), and the survival curves were less overlapped when the animals were separated according to the Tei index. Conclusion The Tei index can predict prognosis in a small animal model of heart failure. (Circ J 2005; 69: 991 -993)

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