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In considering whether to extend β-blocker therapy to dilated cardiomyopathy, we encountered a valuable case. A 40-year-old man with dilated cardiomyopathy developed heart failure with quite poor systolic function. After administration of β-blocker, his pump function improved. In echocardiographic monitoring before β-blocker therapy, only his early diastolic filling velocity was very responsive to dobutamine loading among functional parameters, including the systolic phase. This finding supports the hypothesis that the enhancement of left ventricular filling by dobutamine loading is a useful predictor in dilated cardiomyopathy patients of whether β-blocker will be effective or not.

We report a case of flail mitral valve in an elderly man. Contrast enhanced images of the left ventricle were compared with transthoracic echocardiography. MSCT during systolic phase accurately identified the flail P2 cusp of posterior mitral valve leaflet. It can be performed non-invasively without requiring sophisticated software. Our case suggests that MSCT may have a role in preoperative assessment of coronary arteries and mitral valve apparatus before mitral valve surgery.

Digital image analysis supports diagnostic activities by highlighting geometric and temporal features of physiological phenomena that are not perceivable to the human observation. These features can be exploited to build up symbolic representations of visual data in medical reports and to index them within large databases. The comparison of such representations against descriptive queries capturing the properties of significant physiological phenomena supports new diagnostic approaches through the systematic analysis of database reports. A prototype system is presented which supports the construction of symbolic representations and their comparison against descriptive queries capturing geometric and temporal properties of time-varying 2D shapes deriving from dynamic cardiac analyses. The system is embedded within a visual shell allowing physicians to compose content-oriented queries through iconic interaction.

Purpose: To evaluate the physiologic background of aneurysms poorly visualized during 3D-TOF MRA, contrast-enhanced MRA (CEMRA) and DSA due to hemodynamic isolation. Materials and Methods: Using handmade elastic silicon phantoms to represent terminal basilar tip aneurysms, 3D-TOF MRA, CEMRA and DSA were used to determine blood turnover. Aneurysmal neck size was 2 mm and 10 mm, and the use of a pulsatile pump also helped recreate human physiologic parameters. We compared the results with those of computational fluid dynamics. Results: DSA images of the narrow-necked aneurysm showed that a small volume of contrast medium washed into it during the systolic phase. As the width of its neck increased, the turnover volume of fragments of contrast bolus also increased. At CEMRA, the broad-necked aneurysm was visualized as the main bolus of Gd-DT PA passed through it, and at delayed CEMRA, the narrow-necked aneurysm was visualized faintly after the passage of bolus Gd-DT PA. The results correlated closely with those of 3DTOF MRA and computational fluid dynamics. Conclusion: The visualization of intracranial aneurysms at 3D-TOF MRA, CEMRA and DSA was greatly dependent upon blood turnover, which varied according to aneurismal neck size. A narrow-necked aneurysm might be missed at 3D-TOF MRA, CEMRA and DSA due to hemodynamic isolation

Laser speckle is an interference phenomenon which is the result of the interference of the scattered radiations due to the roughness of the surface. By the superposition of the speckle patterns during systolic phase of the cardiac cycle, by time average speckle interfocometry and point-wise filtering methods, the absolute displacements at various locations on the chest above cardiac region are determined. The displacement cardiograph is constructed by IBM 370/155 computer in the form of a three dimensional plot. The results provide the displacement pattern of the complete heart and show that in normal subjects the displacements above the left and right ventricles, aortic and pulmonary outflow tracts are significantly higher than that of the septum region. Depending on the clinical status of the heart in cardiac patients, these patterns show the respective variations.

Pneumopericardium and hydropneumopericardium are rare conditions in which hemodynamic compromise is common. Loss of the M-mode and two-dimensional image coincident with the systolic phase of each cardiac cycle and swirling echogenic bubbles within the pericardial space produce a distinctive M-mode and two-dimensional echocardiographic appearance. This provides an additional method for prompt diagnosis.

SUMMARY In this report we describe the follow–up of two patients who underwent total correction (ventricular septation) of a Van Praagh type C single ventricle. At the time of this report the patients are 93 and 37 months after operation, have led a normal life and have nearly normal hemodynamics. Ventricular cavity volumes were estimated from biplane cineangiocardiogravns. In the first patient, left and right ventricular end–diastolic volume indexes (LVEDVI and RVEDVI) were 133 and 98 ml/m2, respectively. Left plus right ventricular end–diastolic volume (LVEDV + RVEDV) was approximately 136% of the sum of the normal values of the left and right ventricular volumes. The right–to–left ventricular end–diastolic volume ratio (RVEDV/LVEDV) was 0.74 and the right–to–left ventricular end–systolic volume ratio (RVESV/ LVESV) was 0.56. Ejection fractions of the left and right ventricles (LVEF and RVEF) were 0.50 and 0.61, respectively. In the second patient, LVEDVI and RVEDVI were 139 and 93 mI/M2, respectively. LVEDV + RVEDV was approximately 166% of the sum of the normal values of the left and right ventricular volumes. RVEDV/LVEDV and RVESV/LVESV were 0.67 and 0.50, respectively. LVEF and RVEF were 0.31 and 0.49, respectively. Cineangiocardiograms showed that the prosthetic ventricular septums shifted toward the right ventricle 7–9 mm in the systolic phase. This movement of the prosthetic septum made LVEF lower than RVEF. The shift of the prosthetic septum was dependent upon the right ventricular pressure being lower than the left. Cardiac output in response to exercisewas excellent in the first patient and poor in the second.

In the assessment of the main determinants of cardiac function the study of the systolic phase and diastolic filling appear to be of paramount importance[1–3].

This study is intended to elucidate the process of urinary transport through the pelvi-calyceal system (PCS). PCS-motility of a total of 28 PCS was qualitatively and quantitatively determined in 9 stone patients and 14 control persons by examination of contrast medium excretion. From X-ray videograms recorded by means of Siemens urography, four different urinary transport types could be distinguished as well as the duration of the contraction periods and the intervals between the PCS-contractions. In stone patients physiological types of urinary transport are less common (33%) than in control subjects (81.25%). In stone patients the PCS is often characterized by reduced or even absent motility. Calyceal reflux is usually found in the systolic phase of PCS-contractions, which may apparently be regarded as a physiological process.

1. Cine-cholangiomanometry serves to supplement conventional T-tube cholangiography by the demonstration of the common duct in its functioning phases under varying choledochal pressures.2. This modality will demonstrate the mechanism of action of the sphincter choledochus which consists of a contractile or systolic phase and a relaxation or diastolic phase.3. The morphologic changes and duration of each of these phases are recorded in normotensive and induced hypertensive states. With increasing pressures, the interval of each phase of the cycle is prolonged.4. Serial cine-cholangiom anometry offers a method of distinguishing between edematous functional obstruction and organic fibrous obstruction in the vaterian segment.5. Observations relative to pain production and the mechanism of pancreatic duct filling are discussed.

Shape changes of cardiac chambers characterize a normal cardiac cycle. The importance of shape analysis is underlined in literature by studies of several forms of cardiac disease, revealing abnormalities in shape deformations. The aim of the paper is to describe an approach to an automated extraction of endocardial contours from a single end-systolic frame obtained by color kinesis technique, applied to 4-chamber apical view echocardiographic images. Then, global and regional indexes are applied to provide a quantification of left ventricular shape both at the beginning and at the end of systolic phase. The results prove that this approach can be useful in the assessment of the cardiac functionality.

It is customary to speak of hypertension as an entity, in the same way that we might speak of fever. This is due to the fact that the clinical estimations of blood pressure in the beginning were applicable only to the systolic phase and not until more recently, after the auscultatory method had been discovered, were we able to make estimation of the diastolic pressure as well. At present it is not correct to speak of an elevation of blood pressure without designating both systolic and diastolic phases. When we study blood pressure curves by determinations that have been carried out under control conditions, we find peculiarities in the systolic and diastolic phases which make it impossible to explain the departures from normal in so simple a way as is usually done. For example, we notice elevations in both systolic and diastolic phases, and this is the most common type