OP21.06: Sizes of fetal cardiovascular structures across gestation
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Abstract:
We sought to define growth parameters of normal fetal heart structures throughout gestation from our database of 2246 normal comprehensive fetal echocardiograms (FECHO). Methods In a retrospective cross sectional study, we evaluated the FECHO results of 2246 normal fetuses. Fetuses had been studied for reasons of family history of congenital heart disease or possible exposure to teratogenic medications, advanced maternal age without karyotyping, suspected abnormalities or difficulty in obtaining complete heart views. None of this group had structural or functional heart disease or arrhythmias. All measurements were performed on a Voluson 730 by one sonographer between 2006 and 2008. Standard cardiovascular diameter measurements were performed on frozen magnified, high resolution images. Valves were measured in long axis at the annulus during diastole with 2 leafets in the image. Systolic and diastolic ventricular measurements were made by follow-the-line methods. These included: ductus venosus size (DV), aorta annulus size (AoV), pulmonary valve annulus size (PV), tricuspid annulus size (TV), mitral annulus size (MV), superior vena cava (SVC) and inferior vena cava (IVC) at the diaphragm sizes, as well as the M-mode measurements including interventricular septum at diastole (IVSD), left ventricular posterior wall dimension at diastole (LVPWD), interventricular septum at systole (IVSS), left ventricular posterior wall dimension at systole (LVPWS) across gestation. ResultsKeywords:
Interventricular septum
Systole
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Interventricular septum
Systole
End-systolic volume
Parasternal line
Equus asinus
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Mitral valve edge-to-edge repair (ETER) alters valve mechanics, which may impact efficacy and durability of the repair. The objective of this paper was to quantify stretches in the central region of the anterior leaflet of the mitral valve after ETER with a single suture and 6 mm suture. Sixteen markers, forming a 4x4 array, were attached onto the central region of the mitral valve anterior leaflet. The mitral valve was subjected to ETER with a single suture and 6 mm suture, and mounted in an in vitro flow loop simulating physiological conditions. Images of the marker array were used to calculate marker displacement and stretch. A total of 9 mitral valves were tested. Two peak stretches were observed during a cardiac cycle, one in systole and the other in diastole under mitral valve edge-to-edge repair condition. The major principal (radial) stretch during systole was significantly greater than that during diastole. However, there was no significant difference between the minor principal (circumferential) stretch during diastole and that during systole. In addition, there were no significant differences in the radial and circumferential, or areal stretches and stretch rates during diastole between the single suture and 6 mm suture. The ETER subjects the mitral valve leaflets to double frequency of loading and unloading. Minor change in suture length may not result in a significant load difference in the central region of the anterior leaflet during diastole.
Systole
Cardiac cycle
Leaflet (botany)
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Objectives
目的: This investigation and report was a clinical study of the mechanism of mitral regurgitation in the papillary muscle dysfunction caused by coronary artery disease. We have studied correlation of the different geometric angles between the mitral valve leaflets and the mitral valve annular and mitral regurgitation severity by using transesophageal echocardiography (TEE) .Methods
104 cases patients, among 44 cases patients with mitral regurgitation and the papillary muscle dysfunction caused by posterior or inferior myocardial ischaemia or infarction by coronary artery disease, intraoperative TEE were recorded in 10 patients after complex mitral valve repair including placement of an annular ring with or without concurrent repair of mitral leaflet tissue itself, and 20 patients control subjects were studied. TEE showed below three view: left ventricular four-chamber view, two-chamber view and apical long-axis view during early systole and lately systole; the geometric angles between the mitral valve leaflets and mitral valve annular in three views were measured by SIEMENS KinetDx DS3000 software system. The geometric angles between the mitral valve anterior leaflet with the mitral valve annular was determined as Aá°, the geometric angles between the mitral valve posterior leaflet with the mitral valve annular was determined as Pá°, the geometric distance from closed point the anterior and posterior leaflets tip of the mitral valve to the mitral valve annular was determined as d(cm), early systole was determined as S1, lately systole was determined as S2, and the geometric maximum area from closed point the anterior with posterior leaflets tip of the mitral valve to the mitral valve annular was determined as Area-max (cm2).Results
The geometric angles between the mitral valve leaflets and mitral valve annular in three planes of the group of the papillary muscle dysfunction caused by posterior or inferior myocardial ischaemia or infarction by coronary artery disease, both Aá°, Pá°, and d(cm) was significantly difference than the group of the control subjects during early systole and ately systole, respectively (p<0.01). Among of all planes of three patients was showed Pá°<Aá°, but rest both Pá°>Aá°. Whereas the geometric angles between the mitral valve leaflets and mitral valve annular in three planes of the another group (20 cases patients of the papillary muscle dysfunction caused by posterior or inferior myocardial ischaemia or infarction by coronary artery disease) after complex mitral valve repair including placement of an annular ring with or without concurrent repair of mitral leaflet tissue itself was showed both Aá°, Pá°, and d(cm) no significant difference than control subjects during early systole and lately systole, respectively (p>0.05). Determination of the severity of the mitral regurgitation by proximal isovelocity surface area (PISA) by color Doppler flow imaging (CDFI). In the group of the papillary muscle dysfunction, effective regurgitant orifice (ERO, cm2) ranged from 0.20 cm2 to 0.67 cm2 (0.41±0.11 cm2), which was significantly different from after the mitral valve surgical repair, where it ranged from 0 to 0.17 cm2 (0.06±0.04 cm2, p<0.01); also, in the group of the papillary muscle dysfunction, Area-max (cm2) ranged from 1.28 cm2 to 3.91 cm2 (2.20±0.77 cm2), which was significantly different from after the mitral valve surgical repair, where it ranged from 0.46 cm2 to 1.75 cm2 (0.85±0.36 cm2, normal control subjects 0.64±0.23 cm2; p<0.001) .Conclusions
The severity of mitral regurgitation with the papillary muscle dysfunction caused by coronary artery disease relies heavily on geometric maximum angles between mitral valve leaflets and mitral valve annular during early systole or lately systole (max angles r=0.85); likely it deformation from Pá° max (r=0.79) with area-max (cm2) (r=0.69), but seem it no deformation from Aá° (r=0.55), and d(cm) (r=0.37). Therefore, TEE has been suggested as a helpful tool for differentiating the geometry angles between the mitral valve leaflets with the mitral valve annular planes and study of the mechanism of mitral regurgitation in the papillary muscle dysfunction .Systole
Papillary muscle
Cardiac cycle
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Interventricular septum
Systole
Pressure overload
Volume overload
End-systolic volume
Cardiac catheterization
Ventricular pressure
Cardiac cycle
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Present study was done on four apparently healthy mongrel pups. Echocardiography was done from first day of life to 10 months of age at regular intervals of 15 days. Dimensional echocardiographic indices i.e. aortic root dimension (Aom), left ventricular internal dimension at end-systole and end-diastole, left ventricular posterior wall thickness at end-systole and end-diastole, interventricular septal thickness at end-systole and end-diastole were measured. Functional echocardiographic indices i.e. fractional shortening, ejection fraction, left ventricle posterior wall and interventricular septum systolic thickening were calculated. Dimensional echocardiographic indices increased with advancement of age but functional echocardiographic indices were independent of age. Functional echocardiographic indices are better parameters to study morphological and functional cardiac homogeneity.
Interventricular septum
Systole
Fractional shortening
Posterior wall
Cardiac cycle
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Systole
Ventricular outflow tract
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To determine the M-mode echocardiography reference measurements for Brazilian random bred cats in Rio de Janeiro, Brazil, Cats presenting for routine care were examined by M-mode echocardiography. Animals with free wall values of the left ventricle and/or interventricular septum above 5 mm were not included. A total of 125 cats were included in the study. The correlation of the body score condition (BSC) with the echocardiography measurements was positive for left ventricle wall in systole (LVWs) and left ventricular wall in diastole (LVWd) . The LVWd values of BSCs 3 and 4 were different , and those of BSCs 3 and 5 were also different. The LVWs values of BSCs 3 and 5 were different . The correlated effect between BSC and the echocardiography measurements was true for the left atrium , left atrium/aorta ratio, ventricular septum in diastole, ventricular septum in systole, LVWs, LVWd, left ventricle in diastole, left ventricle in systole, ejection fraction and shortening fraction. The M-mode echocardiography evaluation of cats is impacted by the animal’s body mass; therefore, the BSC must be taken into consideration when interpreting echocardiography measurements.
Interventricular septum
Systole
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To determine the M-mode echocardiography reference measurements for Brazilian random bred cats in Rio de Janeiro, Brazil, Cats presenting for routine care were examined by M-mode echocardiography. Animals with free wall values of the left ventricle and/or interventricular septum above 5 mm were not included. A total of 125 cats were included in the study. The correlation of the body score condition (BSC) with the echocardiography measurements was positive for left ventricle wall in systole (LVWs) and left ventricular wall in diastole (LVWd) . The LVWd values of BSCs 3 and 4 were different , and those of BSCs 3 and 5 were also different. The LVWs values of BSCs 3 and 5 were different . The correlated effect between BSC and the echocardiography measurements was true for the left atrium , left atrium/aorta ratio, ventricular septum in diastole, ventricular septum in systole, LVWs, LVWd, left ventricle in diastole, left ventricle in systole, ejection fraction and shortening fraction. The M-mode echocardiography evaluation of cats is impacted by the animal’s body mass; therefore, the BSC must be taken into consideration when interpreting echocardiography measurements.
Interventricular septum
Systole
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The impact of the transseptal pressure gradient (TSP) during the entire heart cycle has not been assessed. This study explores in anesthetized open-chest dogs the interventricular septum's relative position to the anteroposterior transverse diameter (Dap) of the left ventricle (LV). By varying preload and afterload for both LV and right ventricle (RV) and inotropy in LV, a wide range of TSP was generated. By ultrasonomicrometry the distance between the Dap and the midpoint of septum was recorded. 1) Loops of the septal-LV free-wall diameter vs. Dap showed that the LV transverse cross section independent of loading conditions tended to reach a circular form during systole. 2) Paradoxical movement of the intraventricular septum occurred when TSP was less than zero but was not dependent on an increase of TSP. 3) TSP's influence on septum's position was reduced to one-tenth when changing from end diastole to end systole. 4) During systole independent of level of LV performance, LV pressure had approximately 50% less influence on septal position than RV pressure. 5) During depressed LV performance a similar pattern was evident during diastole. 6) The pericardium had no influence on septum's position. This study demonstrates that the position of the intraventricular septum is significantly influenced by the time-varying elastance of LV and the septum itself, and that RV pressure changes have a greater impact on septal position than LV pressure changes.
Interventricular septum
Systole
Afterload
Preload
Cardiac cycle
Position (finance)
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Aim:The aim of this study was to establish M-mode echocardiographic reference values in Pantja goats and to study the effect of gender and body weight (BW) on these parameters. Materials and Methods:A total of 18, clinically healthy, adult Pantja goats of either sex, aged 2-4 years and weighing 10-44 kg were included in the study.Echocardiographic examination was performed in the standing unsedated animal.All measurements were made from the right parasternal long-axis left ventricular outflow tract view of the heart.The following parameters were recorded: Left ventricular internal diameter at diastole and systole, interventricular septal thickness at diastole and systole, left ventricular posterior wall (LVPW) thickness at diastole and systole, end diastolic and systolic volumes, stroke volume, fractional shortening, ejection fraction, percent systolic thickening of interventricular septum, percent systolic thickening of LVPW, cardiac output, left atrial (LA) diameter at diastole and systole, aortic (AO) root diameter at diastole and systole, LA/AO, LA posterior wall thickness at diastole and systole, left ventricular ejection time, DE amplitude, EF slope, AC interval and e-point to septal separation.Results: This study demonstrated specific reference ranges of M-mode echocardiographic parameters and indices in healthy Pantja goats.Normal echocardiographic values obtained in Pantja goats were quite different from other goat breeds.Gender had no influence on echocardiographic parameters, while high correlations were found between most echocardiographic parameters and BW. Conclusion:The echocardiographic values obtained in the study may serve as a reference for future studies in this breed, for cardiovascular disease diagnosis and for utilizing the goat as a model for cardiac disorders in humans.
Interventricular septum
Systole
End-systolic volume
Parasternal line
Cardiac cycle
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