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Article
Prognostic Significance Of Left Ventricular Diastolic Dysfunction With Preserved Systolic Function Following Acute Myocardial Infarction

Author: Mutaz F. Hussain, * CABM, FICMS معتز فوزي حسين
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2006 Volume: 48 Issue: 3 Pages: 246-250
Publisher: Baghdad University جامعة بغداد

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Abstract

Background : The contribution of diastolic dysfunction in patients with preserved left ventricular (LV) systolic function to impaired functional status and cardiac mortality in myocardial infarction (MI) is unknown. Materials and Methods : Assessment of LV diastolic function was performed by Doppler analysis of the mitral and pulmonary venous flow and the propagation velocity of early mitral flow by color M-mode Doppler echocardiography in 150 consecutive patients at day 5-7 following their first acute MI.Results : Patients were classified into four groups: group A: preserved LV systolic and diastolic function (n=59); group B: LV systolic dysfunction with preserved diastolic function (n=8); group C: LV diastolic dysfunction with preserved systolic function (n=49); group D: combined LV systolic and diastolic dysfunction (n=33). The cardiac mortality rate at 6 months was significantly higher in groups C (12%) and D (36%) compared to A (2.5%) (p<0.01). Multivariate regression analysis identified LV diastolic dysfunction (p=0.001), killip class ≥II (p=0.005), and age (0.007) as predictors of cardiac death or readmission due to heart failure. Conclusion : The presence of LV diastolic dysfunction is associated with increased morbidity and mortality following acute MI. Key Words: Prognosis. Diastolic. Myocardial infarction__________________________________________________________________________________________


Article
Evaluation of Subclinical Systolic Dysfunction in Patient with Grade 1 Diastolic Dysfunction

Author: Ahlam Kadhim Abood
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 2 Pages: 1931-1936
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Recent epidemiological studies have demonstrated that nearly half of allpatients with heart failure (HF) have preserved left ventricular ejection fraction(HFPEF). Thereby it is mandatory to include other hemodynamic indices in the traditional evaluation of the systolic function of the heart beside the EF.Aim of the study was to assess the occurrence of subclinical systolic dysfunction in hypertensive patients with diastolic dysfunction referred for echocardiograph assessment of left ventricular function in a hospital.Methods: 30 patients were recruited from the Echocardiography lab. The analysis of diastolic dysfunction was based on the E/A ratio using PW- Doppler echocardiogram. measurement of EF and SV by measuring end systolic and end diastolic dimensions of left ventricle by M-Mode guided 2D echocardiogram. Measurement of HR from ECG. calculation of SI. CO and CI were done.Results & Discussion: The percentages of parameters which were found below normal levels are as follow: SV: 33.3% (10 out of 30 patients). SI : 40%(12 out of 30 patients). CO: 20%(6 out of 30 patients) and CI:53.3%(16 out of 30 patients).Conclusion : EF is not enough in evaluation subclinical systolic impairment in HT patient , CI should be used in concomitant with EF in traditional evaluation of any patient with suspicion of HF.

Keywords

Diastolic dysfunction --- EF --- CI.


Article
THE EFFECTS OF LEFT VENTRICULAR GEOMETRY AND HYPERTROPHY ON THE DIASTOLIC FILLING INDICES IN HYPERTENSION

Author: Dr. Musa Kassiem Hussein: MBChB., F.I.C.M.S (Med.)
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2009 Volume: 12 Issue: 2 Pages: 282-293
Publisher: University of Kufa جامعة الكوفة

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Abstract

Objectives:The aim of this study is to show the effects of left ventricular hypertrophy and geometric patterns on the left ventricular diastolic function in patients with essential hypertension. In addition, it’s aimed to identify whether the diastolic dysfunction is associated with systolic dysfunction. Finally, to determine the occurrence of the diastolic dysfunction in hypertensive patients with normal left ventricular mass.Patients and Methods: 135 subjects with essential hypertension of either sex attending echo unit were subjected to medical history, clinical examination, physical measurements, ECG, M-mode and Doppler echocardiography. They were classified as 43 treated hypertensives, and 92 untreated hypertensive patients. In addition to 32 healthy subjects served as control group. Results: The results of this study showed that untreated stage II hypertensive patients have more changes in left ventricular mass and geometry and, hence, a higher percentage of diastolic dysfunction. There was a small percentage of patients having diastolic dysfunction despite they were without LVH. In addition, Doppler echocardiographic examination showed that hypertensive patients with left ventricular diastolic dysfunction were having a normal left ventricular systolic function. Conclusion: Left ventricular hypertrophy and geometric changes have an obvious effects on the Left ventricular diastolic function especially in untreated stage II hypertensive patients.

تمت دراسة حالة 135 مريض من كلا الجنسين مصابين بارتفاع ضغط الدم الاساسي. بعد اخذ التاريخ المرضي واجراء الفحص السريري تم اجراء فحوصات تخطيط القلب الكهربائي وفحص القلب بجهاز الايكو والدوبلر. تم تقسيم المرضى الى 43 مريض تحت العلاج المنتظم، 92 مريض بدون علاج بالاضافة الى 32 شخص صحيح غير مصاب بارتفاع ضغط الدم كمجموعة سيطرة. بينت نتائج الدراسة ان المرضى بدون علاج قد حصلت له تغيرات في كتلة البطين الايسر وبالنتيجة نسبة مئوية اعلى في اضطراب الوظيفة الانبساطي للبطين الايسر للقلب. كانت هناك نسبة مئوية اعلى من المرضى كانت لديهم اضطراب وظيفة انبساطي للبطين الايسر مع انه لم يكونوا مصابين بتضخم البطين الايسر. دراسة الدوبلر بينت ان المرضى المصابين بارتفاع ضغط الدم مع اضطراب وظيفة انبساطي البطين الايسر كان لهم وظيفة انقباظية طبيعة للبطين الايسر.


Article
Echocardiographic Parameters of Left Ventricle Systolic and Diastolic Function in Patients with β-Thalassemia Major

Authors: Asaad Abdullah Abbas --- Basil Najeb --- Alaa Abdulhussein --- Jassim Hanoon Jassim --- et al.
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 4 Pages: 562-568
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Advances in the current treatment of β-thalassemia major have contributed to improve prognosis, and nowadays, an increasing number of patients do survive up to the third or fourth, decade. Cardiac complications are still the most common cause of death in patients with major thalassemia.OBJECTIVE:Assessment of Left ventricular systolic and diastolic parameters in β-Thalassemia Major patients and its relation to ferritin level and to spleen status.PATIENT AND METHODS:A Cross -sectional descriptive study done at Ibn Al- Albalady Hospital for Children and Maternity Baghdad city from beginning of January 2011-to the end of July 2011,( 427) patients with β-thalassemia major were considered for analysis, all patients on regular blood transfusion & chelation therapy. M-mode, 2D and Doppler echocardiographic parameters were averaged over 3 cardiac cycles and all echocardiographic measurements were performed according to the guidelines for performance of a pediatric echocardiogram by American Society of EchocardiographyRESULTS:LA, Aortic diameter ,LA/AO ratio, LV posterior wall thickness , interventricular wall thickness, Left Ventricular end systolic and diastolic diameter were larger in β-thalassemic patients. Peak E, peak A, isovolumic relaxation time were higher in thalassemic patient. There were no difference in E/A flow ratio and E deceleration time. Strok volume, LV mass index and MPI were higher in thalassemic patients. No change in Ejection Fraction and Fraction Shortening. No effect found in all mitral valve Doppler parameters in relation to ferritine level. LV mass index higher in splenctomized patients. No effect found in all mitral valve Doppler parameters in relation to spleen status.CONCLUSION:The findings of this study shows that in β-Thalassemic patients there is good systolic function but decrease in diastolic function and there was no correlation between ferritin level and LV systolic and diastolic function.


Article
Effect of Exercise on Untreated and Treated Hypertensive Patients in Babylon Province

Authors: Rusul Mazin Mohammad --- Ghafil Saihood Hassan --- Haider Jabbar
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 378 -387
Publisher: Babylon University جامعة بابل

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Abstract

Normal blood pressure at rest is diastolic a range of 60-90 mmHg and systolic 100-140 mmHg. Hypertension is chronic elevated arterial systolic blood pressure > 140 mmHg, and diastolic blood pressure > 90 mmHg. Epidemiological indicate studies that elevated blood pressure leads to strike, heart coronary disease, congestive failure heart and end stage of renal disease. There are two types of hypertension; primary (essential) of cause unknown which includes more than 95% of all cases of hypertension, and secondary hypertension which is due to underlying disorder it accounts less than 5% of hypertensive cases. Response to moderate exercise protocol in hypertensive patients. To study the effect of exercise on systolic, diastolic, and lipid profile elements in treated and untreated hypertensive patients. The study was conducted in Marjan medical city in Hilla from April to September 2015. The random sample of 30 patients of hypertension including 16 males and 14 females, their ages from 40 -60 years. Regular treated patients were 23, none treated 7. Patients were recruited from outpatient clinic. History and physical examination were obtained from all patients. Lipid profile tests, BMI, measurement of blood pressure were performed before and after exercise.


Article
Echocardiographic diastolic dysfunction among hypertensive patients
ضعف صدى القلب الانبساطي بين مرضى ارتفاع ضغط الدم

Author: Halgurd F. Ahmed
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2015 Volume: 19 Issue: 1 Pages: 853-858
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Hypertension is a very common medical disorder, affecting nearly 40% of our population. Diastolic dysfunction is one of complications that happens and is regarded as a predictive of subsequent heart failure. The aim of this study was to determine the frequency of left ventricular diastolic dysfunction by echocardiography among hypertensive patients. Methods: This study involved 150 hypertensive cases (82 female and 68 male) age from 25-81 years old. Transthoracic echocardiography approach, using SIEMENS SONOLINE Omnia 2005 machine with the probe of p4-2 was used by the researcher. A comparative 150 normal non-hypertensive healthy adults with hypertensive patients are examined again by echocardiography. The parameter for the diastolic dysfunction measurement is E/A ratio. Results: It was found that 88 (58.7%) of hypertensive patients have diastolic dysfunction, while 4.9% of non-hypertensive group have diastolic dysfunction with significant statistical differences between both groups (P <0.001), who were age >60years have 79%, while age 25-35years old have 21% (P <0.001). Among left ventricular hypertrophy patients, 87.5%, versus 12.5% have diastolic dysfunction (P <0.001). Females are more liable for diastolic dysfunction, who have 70.7% than males who have 44.1% (P <0.001). Conclusion: Diastolic dysfunction is common among hypertensive patients, particularly among females, aged, and who have echocardiographic criteria of left ventricular hypertrophy, represent risk factors for diastolic dysfunction.


Article
Assessment of the Improvement of Global and Segmental Diastolic Dysfunction after Coronary Arteries Revascularization

Author: Haedar Nazar Kadim* , Hassan Farhan**, Mahdi Salih Alzaidi**
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2019 Volume: 18 Issue: 1 Pages: 18-29
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACK GROUND:With respect to cardiovascular performance at rest and exercise, diastolic function is of equalimportance to systolic function, which is the ability of the ventricle to fill at low left atrial pressure anddiastolic HF have hospitalization rates similar to those with systolic dysfunctionOBJECTIVE:To assess the effect of successful coronary revascularization on segmental LV diastolic dysfunction andthe effect of this segmental improvement on global diastolic function.METHODS:patients with diastolic LV dysfunction and ischemic heart disease that are documented by coronaryangiography were selected randomly in a prospective interventional study at Ibn Al-Bitar Hospital ForCardiac Surgery from June 2012 till April 2013 and followed up to one month post coronaryrevascularization with Doppler echo-parameters and tissue myocardial velocities for any Improvementin global or regional diastolic dysfunction.RESULTS:Twenty nine ischemic left ventricular segments of total 43 segments with diastolic dysfunction showedimprovement in diastolic function one month after successful revascularization.CONCLUSION:Segmental diastolic dysfunction can be improved with revascularization of the stenotic coronary arterysupplying that segment.


Article
EFFECT OF BODY MASS INDEX ON LEFT VENTRICULAR MASS

Author: May Fadheel Estephan
Journal: Al-Nahrain Journal of Science مجلة النهرين للعلوم ISSN: (print)26635453,(online)26635461 Year: 2010 Volume: 13 Issue: 2 Pages: 114-123
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: Increased left ventricular mass (LVM) as determined by 2-dimensioned M-modeechocardiography is a predictor of cardiovascular morbidity and mortality.Objective: The aim of this study was to investigate the relationship between LVM and body massindex (BMI) categories in cross section study.Methods: LVM were measured by using M-mode echocardiography in a sample of 160 individuals(male 71, female 89) with age ranging from 16-80 years, referred by a physician. Those with apositive history of hypertension (HT), diabetes mellitus (DM), coronary artery disease (CAD)constituted 82 individuals; the remaining 78 were regarded as a control group negative for cardiacapparent problems.Results: Mean interior ventricular septum diastolic (IVSd), left ventricular posterior wall diastolic(LVPWd) and LVM were increased in cases group (the subjects with one or more of the followingillness ((HT), (DM), and (CAD)) compared to normal control.The mean IVSd, LVPWd showed a statistical of significant weak positive linear correlationwith BMI while the mean of the left ventricular interior dimension diastolic (LVIDd) and LVM wassignificantly higher among obese subjects compared to the subjects with normal BMI among thetotal sample. Among the subgroup of controls, only the LVM retained its positive linear correlationwith BMI.Conclusions: LVM was positively associated with BMI and this association seems to beindependent of other cardiac diseases associated with BMI.The remaining three parameters showed a weak association after adjusting for age, gender, and presence problems

تعتبر تقنية تخطيط صدى القلب بالموجات الفوقالصوتية من نوع ام مود أحدى الطرق الشائعة لحساب كتلةالبطين الأيسر إن اي زيادة في كتلة البطين الأيسر تعتبرمؤشر مهم في تحديد الحالة المرضية لعضلة القلب.الهدف من الدراسة :تهدف هذه الدراسة أيجاد علأقة بين. BMI وبين معامل كتلة الجسم LVM كتلة البطين الأيسرطريقة العمل : تم قياس بواسطة جهاز تخطيط صدى القلببالموجات الفوق الصوتية ل 160 شخص ( 71 من الذكور،80 سنة.تم - و 89 من الأناث) و بأعمار تتراوح ما بين 16تقسيم عينة الأشخاص الى مجموعتين :مجموعة تمثل82 شخص مصابين بأمراض القلب وهي :ضغط الدمو مرض الشريان ،(DM) البول السكري ،(HT) العاليومجموعة عددهم ( 78 ) شخص تتمثل .(CAD) التاجيبالأشخاص الأصحاء السليمين من أمراض القلب.النتائج : تبين الدراسة أن كل من :معدل الفاصل الأماميو المعدل الجدار الخلفي IVSd لأنبساط البطيني الأيسرLVM و كتلة البطين الأيسر LVPWd للأنبساط البطينيكانتا تظهر زيادة مؤشرة عند مجموعة الأشخاص المرضىLVPWd و IVSd بأمراض القلب.أما معدل قيمتي كل منفقد أظهرتا علاقة أرتباط ضعيفة مع معامل كتلة الجسمأن قطر البطين الأيسر في حالة أنبساط عضلة .BMIكانتا (LVM) وكتلة البطين الأيسر (LV1Dd) القلبعالية جداً عند الشخص البدين مقارنة مع الشخص ذوالوزن الطبيعي. كما و بينت الدراسة و جود علاقة أرتباطعند مجموعة الاشخاص BMI و LVM أيجابية بينالأصحاء.الأستنتاجات: نستنج من هذه الدراسة أن هناك علاقة أرتباطوأن هذه العلاقة لا تعتمد ، BMI وال LVM أيجابية بينلهذا .BMI على وجود امراض في القلب لها علاقة مععلى وجود BMI نقترح الى المزيد من البحث لمعرفة تأثيرأمراض قلبية.معامل ، (LVM) مفتاح الكلمات : كتلة البطين الأيسرالفاصل الامامي البطيني في حالة ، (BMI) كتلة الجسمالجدار الخلفي لأنبساط البطين ، (IVSd) إنبساط القلبأبعاد البطين الأيسر في حالة إنبساط ،(LVPWd) الأيسر.(LVIDd) القل


Article
The relationship between Hypertension and weight status in Iraqi population
العلاقة بين ارتفاع ضغط الدم وبين وزن الجسم في المجتمع العراقي

Author: Issa M. Kadhim عيسى محمد كاظم
Journal: Baghdad Science Journal مجلة بغداد للعلوم ISSN: 20788665 24117986 Year: 2011 Volume: 8 Issue: 3 Pages: 751-755
Publisher: Baghdad University جامعة بغداد

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Abstract

Most medical books and researches documented that increased body weight is a predisposing factor to hypertension , and there is recent work in this field as well.In this research , the relationships between hypertension and body weight with age were studied in Iraqi population .It is concluded that diastolic hypertension is separated from systolic and combined hypertension and increased body weight has little effect on increased blood pressure.

يذكر في معظم الكتب الطبية والبحوث ان زيادة الوزن تعتبر عامل مساعد في ارتفاع ضغط الدم وتوجد بحوث حديثة كثيرة في هذا المجال .اجري هذا البحث في المجتمع العراقي واخذ بنظر الاعتبار عامل العمر لكونه له علاقة بالوزن وزيادته.جد ان ارتفاع الضغط الانبساطي يختلف عن ارتفاع الضغط الانقباضي وارتفاع الضغط المركب ( الانبساطي والانقباضي معا) وان تأثير زيادة وزن الجسم قليل جدا.


Article
The Prognostic Value of the Left Ventricular End Diastolic Volume, Ejection Fraction and the Development of Dyarrhythmia in Ischemic Heart Disease.

Author: Basil N. Saeed* MRCP, MD, FACC د. باسل نجيب سعيد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 4 Pages: 345-347
Publisher: Baghdad University جامعة بغداد

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Abstract

Summary:Background: Study the correlation between the left ventricular end diastolic volume (LVEDV), ejection fraction (EF) and the development of arrhythmia. Patients and methods: Two hundreds patients with documented acute coronary syndrome and myocardial infection with dysrhythmia documented by ECG and holter monitoring assessed at the cardiac department at Baghdad teaching hospital over the period Jan-Dec 2007. These dysrhythmias were corelated with left ventricular end diastolic volume and ejection fraction. Results: The patients were divided into 4 groups according to LVEDD and EF. The 1st group, 40 patients (20%) found to have non sustained ventricular tachycardia was associated with higher LVEDD (62-72mm) and low EF (30-39%) in comparison with other groups. A 2nd group of 80 patients (40%) have occasionally ventricular ectopic, their left ventricular end diastolic dimension is (52-58 mm) and ejection fraction in higher than the 3rd group 10 patients (5%) who had atrial fibrillation were having normal left ventricular end diastolic volume but ejection fraction was 45%. A 4th group of 40 patients (20%) were having occasional atrial ectopic have both normal ejection fraction and left ventricular end diastolic volume, the remaining 30 patients (15%) from the total did not develop any arrhythmia and their left ventricular end diastolic volume and ejection fraction were normal considered an control groups. Conclusion: It was found that the development of arrhythmia is very significantly correlated with the abnormal increased left ventricular end diastolic volume and more lowering of ejection fraction.Key wards: Arrhythmia left ventricular end diastolic volume, ejection fraction.

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