Age-dependent changes in mitral valve

BACKGROUND: To assess the prevalence, determinants, and prognosis value of right ventricular (RV) ejection fraction (EF) impairment in organic mitral regurgitation. METHODS AND RESULTS: Two hundred eight patients (62±12 years, 138 males) with chronic organic mitral regurgitation referred to surgery underwent an echocardiography and biventricular radionuclide angiography with regional function assessment. Mean RV EF was 40.4±10.2%, ranging from 10% to 65%...

BACKGROUND: The authors wanted to investigate whether the remodeling process in AF regarding gap junction proteins, collagen I, and amyloid may be gender dependent in humans. METHODS: In total, 123 patients with sinus rhythm (SR, n = 41) or atrial fibrillation (AF, n = 82) suffering from mitral valve disease undergoing cardiac surgery were included. Of the 123 patients, 66 patients (SR: n = 17, AF: n = 49) were investigated biochemically for the expression of the atrial gap junction proteins connexin40 (Cx40), connexin43 (Cx43) and collagen I and 57 patients (SR: n = 24; AF: n = 33) using histochemical methods for possible amyloid depositions...

BACKGROUND: The aim of this study was to investigate early changes in left ventricular longitudinal systolic function in patients with hypertension (HTN) with and without concomitant diastolic dysfunction (DD) and the clinical implications of these findings. METHOD: We enrolled 299 patients with HTN and 297 age-matched patients with HTN and DD and compared both groups with an age-matched control group consisting of 100 healthy subjects. The long axis systolic function was investigated by determining the average peak systolic velocity of the septal and lateral mitral sites (Sm avg) using spectral pulsed wave tissue Doppler imaging (TDI)...

Lutembacher syndrome is a rare combination of atrial septal defect (ASD) and mitral stenosis. Symptoms depend on the size of ASD, extent of mitral stenosis and degree of changes in the pulmonary circulation. Presentation can be due to cardiac failure, atrial arrhythmias, dyspnoea, exercise intolerance, paradoxical emboli or other disease related complications like pulmonary hypertension and infective endocarditis. Tuberculous meningitis is a chronic infection due to haematogenous dissemination of tubercle bacilli from lungs...

BACKGROUND: Functional analysis of the right ventricle cannot be reliably evaluated by conventional echocardiography, because of its complex geometry and load dependence of ejection phase indices. The Tei index, dP/dt, and myocardial acceleration during isovolumic contraction are parameters of right ventricular (RV) contractility unaffected by RV geometry. However, the effect of loading conditions on these parameters is controversial. The aim of this study was to examine how afterload reduction observed after percutaneous transverse mitral commissurotomy (PTMC) in patients with mitral stenosis affects these measures of RV contractility...

OBJECTIVE: To investigate the degree of calcification of fresh autologous pericardium applied for posterior mitral annuloplasty and its influence on the repaired mitral valve. METHODS: Thirty-nine patients (31 degenerative and 8 infective endocarditis; mean age at surgery: 62 ± 11 years) were enrolled in this study. Sixteen-slice multi-detector computed tomography was performed to identify calcification of autologous pericardium. The mean clinical follow-up was 4...

BACKGROUND: Conventional indices of right ventricular (RV) function are known to be reduced after cardiac surgery, as a consequence of geometric rather than functional alterations. New techniques, such as three-dimensional (3D) transthoracic and two-dimensional speckle-tracking echocardiography, may be useful in postsurgical RV assessment. The aim of this study was to compare indices of RV function obtained using different echocardiographic modalities, before and after surgery. METHODS: Forty-two patients were screened the day before and 6 months after mitral valve repair...

AIMS: We aimed to assess the impact of surgical pulmonary valve replacement (PVR) for severe pulmonary regurgitation (PR) on biventricular function and its effect on exercise capacity. METHODS AND RESULTS: Seventy-three patients (mean age 23.6±11.5 years, 47 females) underwent surgical PVR for PR. Echocardiogram and magnetic resonance imaging to assess ventricular size and function, and a cardiopulmonary exercise test were performed before, and 1-year post-surgery...

AIM: The assessment of diastolic function remains difficult in critical care patients because of unstable preload conditions. Described as fairly insensitive to preload changes, tissue Doppler velocity measurement at the lateral mitral annulus (e' (lat) ) may help evaluate diastolic function. Our aim was to prospectively evaluate e' (lat) changes in relation to fluid expansion in critically ill patients. METHODS: This prospective observational study was conducted in critically ill, mechanically ventilated, patients in sinus rhythm without previously known cardiac disease...

OBJECTIVES: This study sought to compare clinical, echocardiographic, and cardiopulmonary exercise testing response to cardiac resynchronization therapy (CRT) in patients with unfavorable anatomy of coronary sinus (CS) veins, randomized to transvenous versus surgical left ventricular (LV) lead implantation. BACKGROUND: CRT efficacy depends on proper positioning of the LV lead over the posterolateral wall. A detailed pre-operative knowledge of CS anatomy might be of pivotal importance to accomplish a proper LV lead placement over this area...

AIMS: Valvular regurgitation, especially on the right side of the heart, is a common finding even in patients without endocardial pacing leads. The severity of valvular regurgitation can change after permanent pacemaker (PPM) implantation. Ventricular pacing has been shown to cause ventricular dysfunction. The purpose of this study was to evaluate the mid-term effects of right ventricular (RV) apical pacing on atrioventricular (AV) valvular regurgitation in patients with a normal left ventricular function before PPM implantation...

BACKGROUND: Accurate segmental mitral valve (MV) analysis is essential for surgical planning. Although real-time three-dimensional (3D) transesophageal echocardiography has improved the ability to visualize the MV, accurate localization of MV pathology from 3D transesophageal echocardiographic images still remains experience dependent. Three-dimensional parametric maps of the MV obtained from these images further simplify the visualization of MV anatomy. The aims of this study were to examine whether 3D parametric maps of the MV could improve the diagnostic accuracy in localizing pathology and to determine their usefulness for readers with different levels of training...

OBJECTIVE: To estimate the degree of biological aging for healthy people by the biological age score equation and observe the differences of various aging biomarkers so as to provide targets for clinical anti-aging intervention. METHODS: A total of 2876 subjects aged 30 - 98 years old were recruited from 3 Chinese cities in 2003. After screening, 852 healthy subjects were finally selected and assigned into 4 groups according to ages: young group (< 45 yr), middle-aged group (45 - 59 yr), young-elder group (60 - 74 yr) and elder group (≥ 75 yr)...

BACKGROUND: Growing attempt to use left ventricular (LV) systolic (LVSIsys) and diastolic (LVSIdia) synchronicity indexes in the process of selecting potential responders to cardiac resynchronization therapy has created a need for normative reference values. HYPOTHESIS: This study sought: (1) to determine normal reference ranges for LVSIsys and LVSIdia, and (2) to assess their relationships to age and conventional parameters reflecting LV systolic and diastolic functions...

BACKGROUND: Real-time three-dimensional (3D) echocardiography and unique software permit mitral annular (MA) tracking throughout systole to assess MA remodeling and function. Whether MA structure and function are altered differently depending on the etiology of mitral regurgitation (MR) is currently not known. METHODS: We evaluated dynamic MA characteristics in patients with significant MR secondary to mitral valve prolapse and functional MR and compared them with normal controls...

AIM: The main indexes of ventricular function used in clinical practice are strongly influenced by the ventricular load conditions. Tissue Doppler imaging (TDI) has been reported to be a powerful modality that enables assessment of ventricular wall motion with a high temporal and spatial resolution. The study of the systolic movements of the mitral annulus has been proposed as a valid index of myocardial contractility. The aim of this study was to verify if the systolic movements of the mitral annulus by TDI are load-dependent in patients undergoing coronary artery bypass grafting...

PURPOSE: Contrasting data exist about the hemodialysis induced changes of ventricular diastolic and systolic functions in adults. Few data in children with end-stage renal disease (ESRD) are reported. The aim of the present study was to evaluate the effect of a single hemodialysis (HD) session on left ventricular (LV) systolic and diastolic function using conventional pulsed-Doppler echocardiography and pulsed tissue Doppler imaging (TDI) in hemodialysis children. METHODS: Thirty-five children with chronic renal failure (15 males, aged 12...

Device closure of atrial septal defect (ASD) is sometimes followed by elevation of plasma brain natriuretic peptide (BNP), a marker of heart failure, and progression to heart failure. This study tested the hypothesis that the underlying diastolic dysfunction, assessed on tissue Doppler images (TDI) before device closure, can predict BNP level after ASD closure. The study subjects were 39 consecutive patients (age 27.5 +/- 16.3 years, range 5 to 63) who underwent device closure for ASD. Echocardiographic evaluation using TDI and 2-dimensional and pulse wave Doppler were performed, together with plasma BNP measurement 1 day before and 2 days after ASD closure...

AIMS: Left atrial (LA) stretch-associated electrophysiological changes in patients with mitral stenosis (MS) predispose to atrial fibrillation. We hypothesized that the normalization of the pressure gradient by percutaneous transvenous mitral balloon valvotomy (PTMV) affects LA but not right atrial (RA) conduction, depending on the site of stimulation. Because direction-dependent (asymmetric) changes of conduction may contribute to arrhythmogenesis, we assessed conduction symmetry in MS patients and tested whether it is restored by PTMV...

It was the purpose of this search to announce that elaborating an optimal tactics for patients with coronary heart disease (CHD), complicated with ischemic mitral regurgitation (IMR). There were operated 85 patients with CHD and IMR in the course of 2006-2008. Previously all patients were separated on 3 groups in dependence of severity of IMR, character of damage of coronary race and changing of left ventricle. In the first and the second groups was realized an aorta-coronary shunting with annuloplasty. In the third group was realized an isolated shunting...