Intracoronary measurement of pulsus alternans

Michaels, Andrew D.; Browne, Amanda E.M.; Varghese, P. Jacob; Chou, Tony M.

doi:10.1002/1522-726x(200011)51:3<335::aid-ccd23>3.0.co;2-#

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Right ventricular pulsus alternans has been reported in cases with severe right ventricular failure, primary pulmonary hypertension, prosthetic mitral valve thrombosis, diastolic or systolic left ventricular dysfunction, reactive airway disease, pulmonary embolus, and mitral stenosis [11–13]. Biventricular pulsus alternans has been described in a patient with severe left ventricular dysfunction and left anterior descending coronary artery disease [14], similar to the current case.…”

Section: Discussionsupporting

confidence: 70%

Biventricular Pulsus Alternans

Vidwan

Stouffer

2009

Cardiology Research and Practice

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Pulsus alternans is a rare hemodynamic condition characterized by beat-to-beat variability in systolic pressure. It is attributed to variations in stroke volume with alternate cardiac cycles and is typically seen in patients with advanced myopathic conditions. Left ventricular pulsus alternans is rare, and right ventricular pulsus alternans is even less common. There are only a few reports of biventricular pulsus alternans. We report the case of a 62-year-old female with a recent anterior wall myocardial infarction who had biventricular pulsus alternans at the time of cardiac catheterization.

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Section: Discussionsupporting

confidence: 70%

Biventricular Pulsus Alternans

Vidwan

Stouffer

2009

Cardiology Research and Practice

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“…But this procedure is expensive and needs expert hand, modern facilities. 6 Doppler alternans is an objective evidence of Pulsus alternance noninvasively by Echocardiography.…”

mentioning

confidence: 99%

Objective Evidence of Pulsus Alternans by Echocardiography in Acute Severe Heart Failure

et al. 2020

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Acute coronary syndrome may leads to heart failure. Severity of heart failure is identified by NYHA classification clinically. Color Doppler echocardiography is the key investigation to identify the acute systolic heart failure. For the quantification of systolic heart failure diagnosis, Ejection fraction (EF) can be measured by Simpson method. EF > 30% is defined as severe systolic heart failure. Pulsus alternans is found in severe heart failure patients. Pulsus alternans is a poor prognostic sign of severe heart failure patients in acute MI setting. This cross sectional observation study was aimed to identify the objective evidence of Pulsus alternance noninvasively by Echocardiography. Color Doppler echocardiography was done 100 acute coronary syndrome with heart failure NYHA III and IV patients in department of Cardiology, BSMMU, from July 2018 to June 2019. Age 18 to 70 yrs, male is 79 and female is 21. Pulsus alternans was found in 32 patients, 39 had low volume and 29 had normal volume pulse. 50% patients had ST depression and T inversion and diagnosed as case of Unstable Agina or Non STEMI, 44 had STEMI and 7 had developed new onset of LBBB. 87 Patients who have EF < 30 % was marked as Severe LV systolic dysfunction. Among them, 3 had mild, 14 had moderate and rest 70 had severe Mitral regurgitation. 38 (43.67%) patients had Doppler alternans in severe LV systolic dysfunction group. P value for Doppler alternans is 0.039 which is significant. Doppler alternans by Echocardiography in Severe LV systolic dysfunction patients showed 49% sensitivity and 78% specificity. 38 patients had Severe RV systolic dysfunction by M- mode echo measurement of TAPSE<10 mm. 22 (57.89%) had Doppler alternans across Tricuspid valve in case of severe RV systolic dysfunction. Sensitivity of Doppler alternans by Doppler Echocardiography in TV severe RV systolic dysfunction is 51% and specificity for it is 82%. University Heart Journal Vol. 16, No. 2, Jul 2020; 92-98

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Ionic characteristics in cardiac alternans suppression using T ± ϵ feedback control

Liang

Le²,

Lai

et al. 2016

EPL

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Using the Luo-Rudy I model, the recently proposed feedback control for suppressing cardiac alternans is investigated. It is shown that cardiac alternans, induced by fast pacing (of period T), can be dramatically reduced by small changes of fixed magnitude (ϵ) under feedback control when ϵ exceeds a critical threshold. Detail information on various ionic currents and cytosolic calcium concentration are examined when the cardiac cell is under control. In particular, the alternans in ionic currents and [Ca]i are also reduced under the control. Furthermore, when ϵ exceeds the threshold value, the average [Ca]i level is significantly higher when the alternans is under control, suggesting a possible physiological improvement of cardiac contractions.

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Intracoronary measurement of pulsus alternans

Cited by 3 publications

References 15 publications

Biventricular Pulsus Alternans

Biventricular Pulsus Alternans

Objective Evidence of Pulsus Alternans by Echocardiography in Acute Severe Heart Failure

Ionic characteristics in cardiac alternans suppression using T ± ϵ feedback control

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