Navegando por Palavras-chave "ejection fraction"

Agora exibindo 1 - 3 de 3
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Echocardiographic predictors of early in-hospital heart failure during first ST-elevation acute myocardial infarction: does myocardial performance index and left atrial volume improve diagnosis over conventional parameters of left ventricular function?
    (Biomed Central Ltd, 2011-06-03) Souza, Lilian P. [UNIFESP]; Campos, Orlando [UNIFESP]; Peres, Clovis A. [UNIFESP]; Machado, Cristiano V. [UNIFESP]; Carvalho, Antonio C. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Left ventricular ejection fraction (LVEF) has been considered a major determinant of early outcome in acute myocardial infarction (AMI). Myocardial performance index (MPI) has been associated to early evolution in AMI in a heterogeneous population, including non ST-elevation or previous AMI. Left atrial volume has been related with late evolution after AMI. We evaluated the independent role of clinical and echocardiographic variables including LVEF, MPI and left atrial volume in predicting early in-hospital congestive heart failure (CHF) specifically in patients with a first isolated ST-elevation AMI.Methods: Echocardiography was performed within 30 hours of chest pain in 95 patients with a first ST-elevation AMI followed during the first week of hospitalization. Several clinical and echocardiographic variables were analyzed. CHF was defined as Killip class >= II. Multivariate regression analysis was used to select independent predictor of in-hospital CHF.Results: Early in-hospital CHF occurred in 29 (31%) of patients. LVEF <= 0.45 was the single independent and highly significant predictor of early CHF among other clinical and echocardiographic variables (odds ratio 17.0; [ 95% CI 4.1 - 70.8]; p < 0.0001). MPI alone could not predict CHF in first ST-elevation AMI patients. Left atrial volume was not associated with early CHF in such patients.Conclusion: for patients with first, isolated ST-elevation AMI, LVEF assessed by echocardiography still constitutes a strong and accurate independent predictor of early in-hospital CHF, superior to isolated MPI and left atrial volume in this particular subset of patients.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Heart stroke volume, cardiac output, and ejection fraction in 265 normal fetus in the second half of gestation assessed by 4D ultrasound using spatio-temporal image correlation
    (Informa Healthcare, 2011-09-01) Simioni, Christiane [UNIFESP]; Machado Nardozza, Luciano Marcondes [UNIFESP]; Araujo Junior, Edward [UNIFESP]; Rolo, Liliam Cristine [UNIFESP]; Zamith, Marina [UNIFESP]; Caetano, Ana Carolina [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objectives. the aim of this study was to establish nomograms for fetal stroke volume (SV), cardiac output (CO), and ejection fraction (EF) using four-dimensional ultrasound with spatio-temporal image correlation (STIC) modality.Methods. the fetal heart was scanned using STIC modality, starting with classic four-chamber view plane, during fetal quiescence with abdomen uppermost, at an angle of 20-30 degrees, without color Doppler flow mapping. in post-processing virtual organ, computer-aided analysis technique was used to obtain a sequence of six sections of each ventricular volume in end-systolic volume (ESV) and end-diastolic volume (EDV). the SV (SV = EDV-ESV), CO (CO = SV x fetal heart rate), and EF (EF = SV/EDV) for each ventricle were then calculated. Intra- and interobserver agreement were then calculated.Results. Two hundred sixty-five fetuses, ranging in gestational age (GA) from 20 to 34(+6) weeks, were included in the study. the left and right SV and CO increased exponentially with gestation and EF remained fairly stable through gestational. Mean left and right SV increased from 0.211 ml and 0.220 ml at 20 weeks to 1.925 ml and 2.043 ml, respectively, at 34 weeks. Mean left and right CO increased from 30.25 ml/min and 31.52 ml/min at 20 weeks to 268.49 ml/min and 287.80 ml/min, respectively, at 34 weeks. Both left and right mean EF remained constant at around 0.63 with advancing GA. Nomograms were created for LSV, RSV, LCO, RCO, LEF, and REF vs. gestational age. Intra- and interobserver agreement reached 95%.Conclusions. Four-dimensional ultrasound using STIC represents a simple and reproducible method for estimating fetal cardiac function. STIC seems to overcome many of the pitfalls of conventional ultrasound methods and has the potential to become the method of choice.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Off-pump coronary artery bypass surgery in selected patients is superior to the conventional approach for patients with severely depressed left ventricular function
    (Faculdade de Medicina / USP, 2011-01-01) Caputti, Guido Marco [UNIFESP]; Fonseca, José Honório de Almeida Palma da [UNIFESP]; Gaia, Diego Felipe [UNIFESP]; Buffolo, Enio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: Patients with coronary artery disease and left ventricular dysfunction have high mortality when kept in clinical treatment. Coronary artery bypass grafting can improve survival and the quality of life. Recently, revascularization without cardiopulmonary bypass has been presented as a viable alternative. The aim of this study is to compare patients with left ventricular ejection fractions of less than 20% who underwent coronary artery bypass graft with or without cardiopulmonary bypass. METHODS: From January 2001 to December 2005, 217 nonrandomized, consecutive, and nonselected patients with an ejection fraction less than or equal to 20% underwent coronary artery bypass graft surgery with (112) or without (off-pump) (105) the use of cardiopulmonary bypass. We studied demographic, operative, and postoperative data. RESULTS: There were no demographic differences between groups. The outcome variables showed similar graft numbers in both groups. Mortality was 12.5% in the cardiopulmonary bypass group and 3.8% in the off-pump group. Postoperative complications were statistically different (cardiopulmonary bypass versus off-pump): total length of hospital stay (days)-11.3 vs. 7.2, length of ICU stay (days)-3.7 vs. 2.1, pulmonary complications-10.7% vs. 2.8%, intubation time (hours)-22 vs. 10, postoperative bleeding (mL)-654 vs. 440, acute renal failure-8.9% vs. 1.9% and left-ventricle ejection fraction before discharge-22% vs. 29%. CONCLUSION: Coronary artery bypass grafting without cardiopulmonary bypass in selected patients with severe left ventricular dysfunction is valid and safe and promotes less mortality and morbidity compared with conventional operations.