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BackgroundMetabolic syndrome is associated with the development of diabetes mellitus and cardiovascular disease. The impact of metabolic syndrome on the progression of atherosclerosis has been well documented. This study was designed to evaluate the impact of metabolic syndrome on global left ventricular function by using left ventricular myocardial performance index (LVMPI).MethodsThe diagnosis of metabolic syndrome was made as per the criteria of the International Diabetes Federation. Echocardiography was performed with a Philips IE33 machine using a 1–5MHz transthoracic probe. LVMPI was calculated by adding isovolumic contraction time with isovolumic relaxation time and dividing it by ejection time.ResultsThe mean LVMPI value in metabolic syndrome was 0.64±0.09, while that in controls was 0.48±0.06 (p

Clinically the isovolumic contraction time (IVCT) can be measured by 3 echocardiographic methods of M-mode, pulse-wave Doppler (PWD), and tissue Doppler imaging (TDI). But IVCT can be clinically different by the 3 methods. This study is to investigate whether there is a potentially unidentified phase causing the discrepancies by analyzing electric mechanical delay time (EMD), IVCT, and pre-ejection period (PEP). A total of 30 healthy subjects were recruited for the study. EMD, IVCT, and PEP were obtained by the 3 methods, respectively. MCT (the interval from the onset of the QRS wave to the closure point of the mitral valve measured by TDI) and ICMC (the interval from the onset of IVC wave S1 to the closure point of the mitral valve measured by TDI) were both measured by color TDI. IVCTt (IVCT measured by TDI) was significantly longer than IVCTm or IVCTd (IVCT measured by M-mode or PWD) (both P .05) and ICMC did not differ significantly from EMDm or EMDd minus EMDt or IVCTt minus IVCTm or IVCTd (P > .05), in other words, ICMC almost equaled to (EMDm or EMDd minus EMDt) or (IVCTt minus IVCTm or IVCTd). There may be an unidentified phase between the end of atrial contraction and the closure of mitral valve causing the discrepancies in IVCT, which is named as the pre-isovolumic contraction phase. It is a non-isovolumic phase and is included in the traditional isovolumic contraction phase.

Objective. Volume unloading of the functional single ventricle after a bidirectional Glenn anastomosis (BDG) prior to 1 year of age leads to improved global ventricular function as measured by the myocardial performance index (MPI), a Doppler-derived measurement of combined systolic and diastolic ventricular function. Systolic function remains unchanged after BDG according to previous studies; however, acute changes in global and diastolic function have not been previously investigated in this cohort. Our objective was to assess the short-term effects of the BDG on global ventricular function in patients with a functional single ventricle. Design. Echocardiograms to obtain MPI, isovolumic contraction time, and isovolumic relaxation time were performed at four time periods: in the operating room, in the operating room prior to BDG, shortly after separation from cardiopulmonary bypass, less than 24 hours postoperatively, and either prior to hospital discharge or at the first clinic follow-up visit. Results. Twenty-six patients were enrolled. There was significant ventricular dysfunction noted shortly after separation from cardiopulmonary bypass, median MPI 0.63 (0.39–0.81), that persisted in the short term postoperatively median MPI 0.50 (0.40–0.63). Isovolumic contraction time did not change, however, isovolumic relaxation time was significantly prolonged following BDG. Conclusion. In the postoperative patient after BDG, systolic function is preserved; however, there is evidence of diastolic and global ventricular dysfunction, at least in the short term.

The accuracy of tissue Doppler parameters of right ventricular function including Isovolumic relaxation time (IVRT) and Isovolumic contraction time (IVCT) have not been validated sufficiently in pulmonary hypertensive patients (pts). To assess the ability of tissue Doppler imaging (TDI) - as a

(89.3±14.5 vs 74.7±13.1 ms, p

Purpose:The object of this study was to determine the difference between two methods for myocardial performance index(MPI) in children, using the conventional and pulsed Doppler echocardiography. Methods:A total of 27 children with anatomically normal hearts were enrolled for the study. all were examined by conventional and pulsed Doppler echocardiography at Gangneung Asan Hospital between December, 2005 and February, 2006. First, we measured the time interval(a1) between the mitral inflows from apical 4-chamber view, and the ejection time(ET1) from apical 5-chamber view. And then, we calculated MPI1, isovolumic contraction time(ICT1) and isovolumic relaxation time (IRT1). Secondly, we measured ICT2, ET2 and IRT2 from apical 5-chamber view with a Dopper signal placed at just below junction between mitral and aortic valve at the same cardiac cycle. And then, we calculated MPI2. We compared MPI1 to MPI2. All MPIs were calculated by using the formula, MPI=(ICT＋IRT)/ET. Results:The mean age was 5.7±2.2 years old(M:F=15:12). The MPI2 was higher than MPI1: 0.277±0.083 vs. 0.428±0.081(MPI1 vs MPI2, P=0.000). Also, the ICT2 was higher than ICT1: 56±15 msec vs 97±18 msec(ICT1 vs ICT2, P=0.000) and the IRT2 was higher than IRT1: 42±8 msec vs 53±9 msec(IRT1 vs IRT2, P=0.000). But, the ET2 was lower than ET1: 260±16 msec vs 254±14 msec (ET1 vs ET2, P=0.01). There was, as well, positive linear correlation between MPI1 and MPI2. Conclusion:This study showed that there is a difference between MPI1 and MPI2 in connection with estimating methods. However, the two MPIs had a positive linear correlation. Judging from our results, the MPI of the new method might be a useful index of venticular global function in children

The echographic isovolumic contraction time (ICT) of the left ventricle (LV) was measured in order to assess alterations of LV performance in children with various forms of cardiac disease. The echographic ICT was defined as the interval between coaptation of the anterior and posterior mitral valve leaflets and aortic cusp opening. Four groups of patients were evaluated: normal (48); LV myocardial disease (20); patent ductus arterosus (PDA) (19); and aortic stenosis (AS) (15). In normal children ICT shortened with decreasing age and increasing heart rate. Isovolumic contraction time was more influenced by heart rate (HR) than age, but the relationship was still weak (r = 0.61). In patients with LV myocardial disease ICT was markedly prolonged, while in children with patent ductus arteriosus and aortic stenosis it was shortened as compared with normal children (P less than 0.01).

A sensitive technic for frequency analysis of the first heart sound (S 1 ) during isovolumic contraction time (ICT) was developed. Recorded heart sounds were filtered with a dynamic analyzer. Amplitudes of frequencies between 30 and 70 cps were plotted as a percentage of peak total energy of S 1 against frequency. A consistent and reproducible frequency "fingerprint" was obtained in 74 normal subjects. Frequencies of S 1 were shown to be directly proportional to ventricular elasticity (VE) and inversely proportional to combined ventricular mass (VM). VM is constant during ICT. Amplitude at 40 cps was less than at 30 cps because of reduced VE (myocardial infarction), increased VM (athletes), or combined reduction in VE and increased VM (myocardiopathy). Normal patterns were found in aortic insufficiency (increased VE and VM). Diagnostic patterns were found in 21 of 24 patients with acute myocardial infarction (MI) but were similar to patterns found in patients with healed infarcts and myocardiopathy and athletes. Acute pulmonary embolism could be differentiated from MI.

One hundred patients admitted to a cardiac care unit had indirect serial determinations of left ventricular systolic ejection times. Patients were divided into groups with transmural infarction, nontransmural infarction, and no infarction, according to clinical, biochemical, and electrocardiographic criteria. Total electromechanical systole and left ventricular ejection time were shortened in acute myocardial infarction, whereas the pre-ejection period and its components, the Q-S 1 and isovolumic contraction time intervals, were prolonged. The most abnormal measurements were observed in patients with transmural infarction. Patients with nontransmural infarction demonstrated less severe abnormalities of the systolic ejection times, and the patients without infarction were the least affected. Some of the greatest deviations in the measured intervals were observed in the transmural infarction patients who died. Indirect measurement of left ventricular systolic ejection time is a valuable adjunct in the bedside assessment of left ventricular performance and provides a prognostic index for patients with acute myocardial infarction.

In a patient with intermittent type A Wolff-Parkinson-White (WPW) syndrome, the echocardiogram revealed late "double peaked " anterior motions (the former in the late systole, the latter in the early diastole) of left ventricular posterior wall during WPW conduction. In the same condition, phonocardiographic and mechanocardiographic observations indicated a prolonged electromechanical interval, but the external isovolumic contraction time (EICT) and left ventricular ejection time/EICT ratio remained unaltered. In addition, definite but slight alteration in the spatial ventricular gradient was observed. These observations by non-invasive methods present additional informations supporting the concept that conduction abnormalities per se are not responsible for abnormalities of ventricular function unless there is severe underlying heart disease.

International audience; The pre-ejection period of the right ventricle in d-transposition of the great arteries is known to be prolonged, compared with the same interval of the left ventricle of normal subjects. In the present study, the echocardiographic measurement of the components of the pre-ejection period of the right ventricle of 14 patients with d-transposition of the great arteries shows that the isometric contraction time of the right ventricle in d-transposition of the great arteries is similar to the same interval calculated on the left ventricle of 76 normal children of comparable age. On the other hand, the electromechanical delay was significantly greater for the right ventricle of d-transposition of the great arteries than for the left ventricle of the normal subjects. It is concluded that the prolonged pre-ejection period of the right ventricle in d-transposition of the great arteries is not the result of right ventricular dysfunction but solely of a longer electromechanical delay.

(1) By the use of polygraphic tracing including apex cardiogram, phonocardiogram and indirect carotid tracing, an almost full and precise phasic analysis of the cardiac cycle may be obtained. (2) New methods for the measurement of the ejection period and mechanical systole are presented.