Evaluation of Left Ventricular Function by Echocardiography

Fortuin, Nicholas J.; Hood, William P.; Craige, Ernest

doi:10.1161/01.cir.46.1.26

Cited by 210 publications

(22 citation statements)

References 28 publications

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“…The increase in percentage thickening of the septum and of the posterior wall of the ventricle indicated an increase in the force of contraction of the left ventricle myocardium (Mason et al 1979;Carstensen et al 1995). The decrease in end systolic volume and the increase in ejection fraction showed an increase in the amplitude and efficiency of the left ventricle beat (Fortuin et al 1972;Crippa et al 1992). These changes in the contractile function of the left ventricle seen in M-mode EC are associated with effects on the aortic flow that were assessed by Doppler measurements.…”

Section: Discussionmentioning

confidence: 93%

Use of M-mode and Doppler echocardiography to investigate the cardiotoxicity of minoxidil in beagle dogs

Hanton

Gautier

Bonnet

2004

Archives of Toxicology

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Doppler and M-mode echocardiography (EC) were used to investigate the effects of minoxidil on the cardiac function of the dog and potentially to clarify the pathogenesis of cardiac lesions, in particular the necrotic lesion in the left ventricle and the haemorrhagic lesion in the right atrium. Groups of three dogs were treated with a single oral dose of 0.5 or 2 mg/kg minoxidil or control vehicle, and M-mode and Doppler parameters were recorded at different time points before as well as 1, 3 and 24 h after treatment. The treatment produced a number of changes in M-mode parameters that indicate an increase in left ventricle contractility, in particular, increases in the percentage of thickening of the left ventricle wall during systole and in ejection fraction, and decrease of systolic volume. There was also a decrease in diastolic volume, which indicates a decrease in filling of the left ventricle probably due to the tachycardia and subsequent decrease in inter-systolic time. Doppler EC showed an increase in the velocity of the aortic flow, which indicates an increase in cardiac contractility. There was also a mild increase in stroke volume, which together with the tachycardia resulted in a marked increase in cardiac output. Together, Doppler and M-mode recordings gave evidence of an increase in the contractility of the left ventricle. This change is consistent with the generally accepted mechanism for the development of the left ventricle lesion induced by minoxidil. Minoxidil also produced changes in atrio-ventricular flows. The velocity and/or acceleration of E- and A-waves of the mitral and tricuspid flows increased, and the E/A ratio decreased. The changes in the E-wave indicate a faster diastole of the ventricle probably to compensate for the decrease in inter-systolic time. The changes in A wave are characteristic of an increased amplitude and velocity of the atrial contraction. This latter change is much more marked for tricuspid than for mitral flow. For both flows the E/A ratio decreased, which indicates that the contraction of the atria plays an increased role in ventricle filling after minoxidil treatment. This stimulation of atrial contraction that we evaluate with Doppler EC may play a key role in the development of the atrial lesion produced by minoxidil. The fact that the change is more marked in the right than in the left atrium may explain why the lesion occurs only in the right atrium in dogs. This study showed, therefore, that Doppler EC associated with M-mode EC is a useful method for obtaining pertinent information on the pathogenesis of the left ventricle lesion induced by haemodynamic mechanisms. Moreover, Doppler EC allowed the assessment of changes in the function of the right atrium that may be involved in the development of the right atrial lesion.

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Section: Discussionmentioning

confidence: 93%

Use of M-mode and Doppler echocardiography to investigate the cardiotoxicity of minoxidil in beagle dogs

Hanton

Gautier

Bonnet

2004

Archives of Toxicology

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“…Frishman et al [10] using M-mode echocardiography found that pindolol increased the ejection fraction, but propranolol caused a decrease. That study can be faulted on the grounds of the technique used for assessing left ventricular performance, which had accepted limitations [30,31], and also because the doses of propranolol (up to 40 mg four times a day) and pindolol (up to 10 mg four times a day) may not have exerted equivalent beta-blocking activity. Two studies have assessed the influence of intrinsic sympathomimetic activity on left ventricular function using radionuclide ventriculography [12,29].…”

Section: Discussionmentioning

confidence: 99%

Left ventricular function and beta-blockers: Does intrinsic sympathomimetic activity have any influence during chronic therapy?

Northcote

Cooke

Ballantyne

1988

Cardiovasc Drug Ther

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A study comparing the chronic effects of propranolol (n = 21) and pindolol (n = 19) on male patients with stable angina pectoris was performed. Left ventricular function was assessed by serial radionuclide ventriculography. Radionuclide ventriculography was performed at rest and during cold pressor test. Both drugs improved symptoms of angina pectoris by at least one division of the New York Heart Association classification. Cold pressor testing caused increases in heart rate and blood pressure in both groups throughout the study. At rest, pretreatment ejection fraction was similar in both groups. During propranolol treatment this rose sequentially from 49% to 55% at 26 weeks. No change in the resting ejection fraction occurred in those taking pindolol. The difference in response between the groups reached significance at 26 weeks. In those with subnormal left ventricular ejection fraction (less than 50%), resting ejection fraction improved significantly throughout treatment with propranolol rising from a basal value of 39% to 51% at 26 weeks. In comparison, pindolol caused no significant change. There is no apparent advantage to intrinsic sympathomimetic activity in terms of preservation or improvement of left ventricular performance in patients with stable angina pectoris prescribed beta-blockers for extended periods of time.

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“…Die teilweise erheblichen Unterschiede zwischen dem errechneten Volumen und dem tatsäch-lichen Volumen entstehen vor allem durch die Ableitung des Ventrikelvolumens aus einer schrägen Schicht durch den Ventrikel unterhalb der Papillarmuskeln [10,14,24,31]. Auch bei der zweidimensionalen Echokardiographie bleibt eine sehr hohe Variabilität bestehen, da nur schwer konstante Schichten zur Berechnung herangezogen werden können [9,16,30].…”

Section: Bestimmung Der Myokardmasseunclassified