The study of left ventricular function from digitized echocardiograms

Upton, Mark T.; Gibson, D G

doi:10.1016/0033-0620(78)90003-8

Cited by 142 publications

(46 citation statements)

References 82 publications

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“…LV M-mode echocardiograms were recorded under 2-dimensional control, at a paper speed of 100 mm/s, with a simultaneous ECG. The M-mode tracings were blindly evaluated by a single operator who digitized 4 consecutive cardiac cycles of each echocardiogram, as originally described by Upton and Gibson, 29 by use of a Numosonic 2205 graphic tablet. An IBM personal computer processed digitized data, averaging the 4 cardiac cycles.…”

Section: Echocardiographic Examinationmentioning

confidence: 99%

Insulin and Diastolic Dysfunction in Lean and Obese Hypertensives

et al. 1999

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Abstract-We investigated the influence of genetic predisposition to hypertension by studying the relation between insulin sensitivity and left ventricular (LV) mass and function in untreated lean and obese hypertensives. We selected 50 lean hypertensives with normotensive parents (negative family history of hypertension [FϪ]), 64 lean hypertensives with 1 or both parents hypertensive (positive family history of hypertension [Fϩ]), 40 obese FϪ hypertensives, and 43 obese Fϩ hypertensives. The 4 groups were comparable regarding age, gender, 24-hour blood pressure profile, and known duration of hypertension. We measured glucose, insulin, and C-peptide during fasting and during an oral glucose tolerance test; LV morphology and function were assessed by digitized M-mode echocardiography. Glucose (fasting and test) levels were normal in all and similar among the 4 groups. Insulin and C-peptide (fasting and stimulated) levels were higher in obese hypertensives than in lean hypertensives; at similar body mass index, insulin and C-peptide levels were higher in Fϩ than in FϪ groups. Compared with lean hypertensives, obese hypertensives had greater LV mass index; LV systolic function was normal in all and similar among the groups. The indices of LV diastolic function were significantly lower in Fϩ than in FϪ groups. LV mass index did not correlate with metabolic parameters; the indices of LV diastolic function were inversely correlated with insulin area during test in only the 2 Fϩ groups. In conclusion, genetic predisposition to hypertension is associated with a reduced insulin sensitivity and affects the response of the myocardium to increased insulin levels, inducing a greater impairment of diastolic function. Insulin sensitivity and genetic predisposition to hypertension seem to have no influence on LV mass. (Hypertension. 1999;34:1208-1214.)Key Words: insulin Ⅲ diastole Ⅲ hypertension, essential Ⅲ obesity Ⅲ hypertrophy E ssential hypertension and obesity are often associated, and each one, per se, can induce myocardial hypertrophy and left ventricular (LV) diastolic dysfunction. 1-5 Insulin resistance and hyperinsulinemia have been described in both hypertension and obesity. 6,7 In experimental studies, insulin has been demonstrated to exert a growth-stimulating effect on cardiomyocytes and to increase collagen production in fibroblasts 8 -12 ; therefore, clinical studies have evaluated the possible contribution of insulin resistance and hyperinsulinemia to the development of myocardial hypertrophy and diastolic dysfunction in hypertension and in obesity and have obtained conflicting results. [13][14][15][16][17][18][19][20] Recently, it has been suggested that genetic factors play an important role in the link between insulin resistance, hypertension, and obesity. In fact, a reduced insulin sensitivity has been demonstrated in lean and obese normotensives and hypertensives with hypertensive parents (positive family history of hypertension [Fϩ]) compared with offspring of normotensive parents (negative family history...

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Section: Echocardiographic Examinationmentioning

confidence: 99%

Insulin and Diastolic Dysfunction in Lean and Obese Hypertensives

et al. 1999

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“…Echocardiograms were analysed semiautomatically using a Digital PDP 11/34 minicomputer and an x-y digitizer according to the method of Upton & Gibson (1978). The leading edges were used for analysis of dimension loops, the measurement being performed according to the European standard (Roelandt & Gibson, 1980 …”

Section: Echocardiographymentioning

confidence: 99%

“…The maximal velocity of left ventricular circumferential fibre shortening was obtained from the digitized cardiac cycles as the maximum value of the first derivate of the systolic shortening of the internal diameter divided by left ventricular enddiastolic diameter (Upton & Gibson, 1978).…”

Section: Fs(%)= Lveddmentioning

confidence: 99%

Effect of digoxin on the heart in normal subjects: influence of isometric exercise and autonomic blockade: a noninvasive study.

Partanen

Heikkilä

Pellinen

et al. 1988

Brit J Clinical Pharma

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1 Eight healthy subjects were studied before digoxin and after successive therapy periods of 1 week 0.125, 0.25 and 0.50 mg of digoxin. The mean serum concentrations (± s. d.) were 0.4 ± 0.2, 0.6 ± 0.3 and 1.4 ± 0.5 nmol I-1, respectively. The effects of digitalis were studied by echocardiography and systolic time intervals at rest and after 3 min handgrip exercise. Effects of simultaneous autonomic blockade induced by atropine and propranolol were also examined. 2 Digoxin in increasing doses slowed the heart rate at rest; with the daily dose of 0.50 mg from 63 ± 10 to 53 ± 6 beats min-', and fractional shortening rose from 28 ± 6 to 33 ± 3% (P < 0.05 for both). Preload, afterload and cardiac output did not change. The electromechanic systolic time index (QS2I) decreased (P < 0.001) and the observed alteration of QS2I was dose-related.3 The influence of digoxin was similar during isometric exercise, except for unchanged fractional shortening. 4 During autonomic blockade digoxin slowed the intrinsic heart rate from 93 ± 6 to 86 ± 6 beats min-' (0.25 mg) and to 83 ± 6 beats min-' (0.50 mg) (P < 0.01 for both). QS2I was shortened (P < 0.01). Echocardiographically determined ejection phase indices remained unchanged. 5 When handgrip stress was induced during autonomic blockade, digoxin evoked a clearcut increase in contractile function, resembling the effects of digoxin alone at rest. Thus, fractional shortening increased by 14% and QS21 decreased by 16 ms (P < 0.01 for both). 6 We conclude that digoxin increases the contractility in normal heart without changes in loading conditions. The rise in inotropy at rest is obvious from both fractional shortening by echo and systolic time intervals. The same takes place during handgrip with autonomic blockade, when the heart lacks sympathetic support. The influence of long-term digoxin on heart rate is partly direct without autonomic mediation. The effect of digoxin is dosedependent.Keywords digoxin isometric exercise autonomic blockade left ventricular contractility echocardiography systolic time intervals

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“…The recordings were analyzed using an x-y digitizer and a PDP 11/30 computer, according to the method described by Upton and Gibson (1978). The leading-edge technique was used in digitization.…”

Section: Echocardiographymentioning

confidence: 99%

Does alcohol intensify the hemodynamic effects of nitroglycerin?

Kupari

Heikkilä

Ylikahri

1984

Clinical Cardiology

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Summary: To evaluate the combined effects of alcohol and nitroglycerin on cardiovascular hemodynamics, Mmode echocardiography and sphygmomanometric blood pressure measurements were perfonned on two groups of nonnal subjects, before and after the administration of nitroglycerin, both in the sober state and during alcohol intoxication. In the first part of the study, 0.5 mg of nitroglycerin was given sublingually to 10 healthy volunteers 5-10 minutes after they had ingested I g/kg body weight of ethanol within a 30-minute period. Control experiments substituted juice for ethanol. The combined effects of ethanol and nitroglycerin on left ventricular diameters, systolic blood pressure, and wall stress were not significantly different from those of juice and nitroglycerin; heart rate and diastolic blood pressure were increased more (p

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The study of left ventricular function from digitized echocardiograms

Cited by 142 publications

References 82 publications

Insulin and Diastolic Dysfunction in Lean and Obese Hypertensives

Insulin and Diastolic Dysfunction in Lean and Obese Hypertensives

Effect of digoxin on the heart in normal subjects: influence of isometric exercise and autonomic blockade: a noninvasive study.

Does alcohol intensify the hemodynamic effects of nitroglycerin?

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