Geometric Assessment of Regional Left Ventricular Remodeling by Three-Dimensional Echocardiographic Shape Analysis Correlates with Left Ventricular Function

2012 ◽  
Vol 25 (1) ◽  
pp. 80-88 ◽  
Author(s):  
Ivan S. Salgo ◽  
Wendy Tsang ◽  
William Ackerman ◽  
Homaa Ahmad ◽  
Sonal Chandra ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Shape Analysis ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Three Dimensional ◽  
Left Ventricular

scholarly journals Dyssynchrony Induced by Ventricular Preexcitation: A Risk Factor for the Development of Dilated Cardiomyopathy

2020 ◽  
Vol 5 (1) ◽  
pp. 9-18
Author(s):  
Chencheng Dai ◽  
Baojing Guo ◽  
Ling Han ◽  
Caihua Sang ◽  
Jianzeng Dong ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Dilated Cardiomyopathy ◽  
Ventricular Function ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Interventricular Septum ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Accessory Pathways ◽  
Ventricular Preexcitation

Background: Significant left ventricular dysfunction may arise in right-sided accessory pathways with ventricular preexcitation in the absence of recurrent or incessant tachycardia. This has just been realized and not enough attention has been paid to it.Methods: In the last 7 years, we identified 12 consecutive children with a diagnosis of ventricular preexcitation‐induced dilated cardiomyopathy. This report describes the clinical and echocardiographic characteristics of the patients before and after ablation.Results: Dyssynchronous ventricular contraction was observed by M-mode echocardiography and two-dimensional strain analysis in all patients. The basal and middle segments of the interventricular septum became thin and moved similarly to an aneurysm, with typical bulging during the end of systole. The locations of the accessory pathways were the right-sided septum (n=5) and the free wall (n=7). Left ventricular synchrony was obtained shortly after ablation. The left ventricular function recovered to normal and the left ventricular end-diastolic diameter decreased gradually during follow-up.Conclusions: A causal relationship between ventricular preexcitation and the development of dilated cardiomyopathy is supported by the complete recovery of left ventricular function and reversed left ventricular remodeling after the loss of ventricular preexcitation. Preexcitation-related dyssynchrony was thought to be the crucial mechanism. Ventricular preexcitation‐induced dilated cardiomyopathy is an indication for ablation with a good prognosis.

scholarly journals Left Ventricular Remodeling after Late Revascularization Correlates with Baseline Viability

2014 ◽  
Vol 41 (4) ◽  
pp. 381-388 ◽  
Author(s):  
Pravin K. Goel ◽  
Tanuj Bhatia ◽  
Aditya Kapoor ◽  
Sanjay Gambhir ◽  
Prasanta K. Pradhan ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Viable Myocardium ◽  
Spect Mpi ◽  
Percutaneous Coronary ◽  
Infarct Related Artery

The ideal management of stable patients who present late after acute ST-elevation myocardial infarction (STEMI) is still a matter of conjecture. We hypothesized that the extent of improvement in left ventricular function after successful revascularization in this subset was related to the magnitude of viability in the infarct-related artery territory. However, few studies correlate the improvement of left ventricular function with the magnitude of residual viability in patients who undergo percutaneous coronary intervention in this setting. In 68 patients who presented later than 24 hours after a confirmed first STEMI, we performed resting, nitroglycerin-enhanced, technetium-99m sestamibi single-photon emission computed tomography–myocardial perfusion imaging (SPECT–MPI) before percutaneous coronary intervention, and again 6 months afterwards. Patients whose baseline viable myocardium in the infarct-related artery territory was more than 50%, 20% to 50%, and less than 20% were divided into Groups 1, 2, and 3 (mildly, moderately, and severely reduced viability, respectively). At follow-up, there was significant improvement in end-diastolic volume, end-systolic volume, and left ventricular ejection fraction in Groups 1 and 2, but not in Group 3. We conclude that even late revascularization of the infarct-related artery yields significant improvement in left ventricular remodeling. In patients with more than 20% viable myocardium in the infarct-related artery territory, the extent of improvement in left ventricular function depends upon the amount of viable myocardium present. The SPECT–MPI can be used as a guide for choosing patients for revascularization.

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