A Method for Determining Left Ventricular Mass in Man

Rackley, Charles E.; Dodge, Harold T.; Coble, Yank D.; Hay, Robert E.

doi:10.1161/01.cir.29.5.666

Cited by 428 publications

(70 citation statements)

References 10 publications

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“…10 Circumferential stresses were calculated by the method of Mirsky. 11 The method in our laboratory of analyzing the micromanometer LV pressures also provides for a calculation of the first derivative of LV pressure (dP/dt) at a variable sampling frequency.…”

Section: Discussionmentioning

confidence: 99%

Effects of β-Adrenergic Blocking Therapy on Left Ventricular Diastolic Relaxation Properties in Patients With Dilated Cardiomyopathy

et al. 1999

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Background-The hemodynamic mechanism for the improvement in left ventricle (LV) end-diastolic pressure in cardiomyopathy patients treated with ␤-adrenergic blocking agents is controversial. We hypothesized that the salutary effect of this kind of therapy on LV end-diastolic pressure would be indicative of an improvement in late, passive diastolic relaxation properties. Methods and Results-We studied 14 cardiomyopathy patients in normal sinus rhythm with no arteriographic evidence of coronary artery disease and an LV ejection fraction of Յ40% by radionuclide angiography both before and after 6 months of metoprolol therapy with simultaneous micromanometry and biplane cineventriculography. Four comparable patients who were not treated with metoprolol were studied in a similar fashion and served as control subjects. In those receiving metoprolol, LV end-diastolic pressure decreased (Pϭ0.001). The isovolumic relaxation index, ln , shortened (Pϭ0.03). In a similar fashion, the LV chamber stiffness constant, , decreased (Pϭ0.02), LV volume elastance improved (Pϭ0.04), and the myocardial stiffness constant, e , decreased (Pϭ0.02). A multiple regression analysis revealed that the decrease in LV end-diastolic pressure was indicative of significant improvements in ln and e with the relationship: LV end-diastolic pressureϭϪ4.73ϩ0.27 ln ϩ0.54 e (rϭ0.81, PϽ0.0001). These LV diastolic relaxation properties did not change or worsened in the control cardiomyopathy patients. Conclusions-We conclude that the decrease in LV end-diastolic pressure in cardiomyopathy patients treated with metoprolol is an indicator of improvement in LV diastolic properties resulting from more complete myocardial relaxation. (Circulation. 1999;100:729-735.)

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Section: Discussionmentioning

confidence: 99%

Effects of β-Adrenergic Blocking Therapy on Left Ventricular Diastolic Relaxation Properties in Patients With Dilated Cardiomyopathy

et al. 1999

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“…Ten additional patients, ages 44-61 years, who had coronary artery disease and underwent LV catheterization and angiography and selective coronary arteriography within 2 months before coronary bypass surgery were also studied. Coronary surgery was done because of chronic angina in all 10 Thin sections (0.5 ,um) for electron microscopic examination were cut with a microtome (LKB Ultratome III), mounted on uncoated copper grids, stained with saturated aqueous uranyl acetate and lead citrate and evaluated with an electron microscope (Philips EM 300). Sections were put on a grid and localized at low-power magnification under the electron microscope.…”

Section: Methods Patientsmentioning

confidence: 99%

Reduced volume fraction of myofibrils in myocardium of patients with decompensated pressure overload.

Schwarz¹,

Schaper²,

Kittstein³

et al. 1981

Circulation

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SUMMARY The relation between quantitative ultrastructural changes of the left ventricular (LV) myocardium and contractile function was studied in patients with chronic aortic stenosis (AS). The Thus, intracellular reduction in the volume fraction of myofibrils was the major morphologic finding in LV biopsy samples of patients with decompensated pressure overload.ULTRASTRUCTURAL degenerative changes of the myocardium in hypertrophied right and left ventricles have been proposed as morphologic correlates of impaired cardiac function.'-' However, no attempt has been undertaken to quantify these changes by morphometry of myocardial biopsy samples. Therefore, we examined the ultrastructure of transmural myocardial biopsy tissue from patients with aortic stenosis (AS) and quantitated the intracellular volume fractions of myofibrils (contractile material), sarcoplasm and mitochondria by electron microscopic morphometry, and the interstitial myocardial fibrosis by light microscopic morphometry. We then correlated quantitative ultrastructural findings with preoperative hemodynamics in these patients. Methods PatientsWe studied 19 surgical patients, 15 men and four women, mean age 47 ± 10 years (± SD) (range From the Kerckhoff-Institut and Klinik, Max-Planck Gesellschaft, Bad Nauheim, West Germany.

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“…For the above reasons, we concluded that ventricular mass could be calculated in patients with single ventricle by basically the same method with the use of a shell model in left ventricle. 16 Confirmation of the method for measurement of the wall thickness from the cineangiogram is possible with other, more direct, methods such as echocardiography and autopsy. We evaluated wall thickness by two-dimensional echocardiography in eight patients with each type of single ventricle and obtained a significant linear correlation between the cineangiographic (y) and echocardiographic (x) measurements: y(mm) -0.984x -0.166 (r = .99, p <.O01).…”

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confidence: 99%

Quantitative cineangiographic analysis of ventricular volume and mass in patients with single ventricle: relation to ventricular morphologies.

et al. 1988

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With the use of biplane selective ventriculography, the ventricular volume, ejection fraction, and ventricular mass were evaluated in 28 patients with a single ventricle, and those with the left ventricular type (LV type, 12 patients) and right ventricular type (RV type, 16 patients) were compared. There were no significant differences in terms of age, hemoglobin, systemic oxygen saturation, or pulmonary-to-systemic flow ratio in the two groups. No patients with atrioventricular valve regurgitation were included. The ventricular cavity volume was calculated by the area-length method. The ventricular mass volume was determined as the shell volume created by subtracting the ventricular cavity volume from the total ventricular volume calculated by adding the free wall thickness to the chamber dimensions. The ventricular mass volume was converted to mass by multiplying by the gravity of the heart muscle. There was no significant difference between patients with the LV type and RV type of single ventricle with respect to the end-diastolic ventricular vclume (188 + 53 and 179 + 61 ml/m2 in LV and RV types, respectively), end-systolic volume (88 + 31 and 84 + 27 ml/m2), or ejection fraction (0.54 + 0.06 and 0.52 + 0.06). The following four indexes of the ventricular mass were significantly (p < .001) lower in patients with the RV type of single ventricle: ventricular wall thickness (3.9 ± 1.2 mm in RV type vs 6.9 ± 1.9 mm in LV type), ratio of the ventricular wall thickness to the transverse diameter of the ventricle (6.8 + 1.9% vs 12.1 ± 2.4%), ventricular mass (87 ± 35 vs 160 ± 47 g/m2), and ratio of ventricular mass to end-diastolic volume (0.48 ± 0.11 vs 0.88 + 0.17 g/ml). There was a positive linear correlation between the ventricular mass index and the pulmonary-to-systemic blood flow ratio in patients with LV type (r = .71, p < .01) but no correlation was seen in those with RV type. These results suggest that there is inadequate ventricular hypertrophy (insufficient ventricular mass to ventricular volume) in patients with the RV type of single ventricle compared with that in those with the LV type and this may lead to abnormal contractile state and poor adaptation of ventricular function in patients with the RV type of single ventricle.

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A Method for Determining Left Ventricular Mass in Man

Cited by 428 publications

References 10 publications

Effects of β-Adrenergic Blocking Therapy on Left Ventricular Diastolic Relaxation Properties in Patients With Dilated Cardiomyopathy

Effects of β-Adrenergic Blocking Therapy on Left Ventricular Diastolic Relaxation Properties in Patients With Dilated Cardiomyopathy

Reduced volume fraction of myofibrils in myocardium of patients with decompensated pressure overload.

Quantitative cineangiographic analysis of ventricular volume and mass in patients with single ventricle: relation to ventricular morphologies.

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