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[Relationship between left ventricular systolic function and the myocardial gray level distribution in patients with
W Aerbajinai1, S Goto, S Ogawa
1Department of Internal Medicine, Keio University School of Medicine, Tokyo.
Insights
Dilated cardiomyopathy (DCM) patients
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Dilated cardiomyopathy (DCM) involves progressive left ventricular (LV) systolic dysfunction.
- The etiology of DCM is often nonspecific.
- Echocardiography is a key tool for assessing cardiac function.
Purpose of the Study:
- To evaluate serial changes in LV systolic function in DCM patients.
- To assess myocardial tissue character using echocardiographic gray level distribution.
- To identify echocardiographic parameters predictive of functional decline in DCM.
Main Methods:
- Serial echocardiographic observations over 4.5 years in 59 DCM patients.
- Calculation of ejection fraction using Pombo's method.
- Analysis of myocardial gray level distribution (corrected myocardial gray level - CMD) in various LV regions.
Main Results:
- Seven patients (group A) showed significant ejection fraction decrease (>10%).
- Group A patients exhibited distinct myocardial gray level distributions compared to group B.
- CMD analysis provided insights into myocardial tissue character changes.
Conclusions:
- Echocardiographic assessment of myocardial gray level distribution may help identify DCM patients at risk of functional decline.
- Serial echocardiography can track disease progression and changes in myocardial tissue character.
- Further research into CMD as a prognostic marker in DCM is warranted.
Abstract:
Dilated cardiomyopathy (DCM) is characterized by progressive left ventricular (LV) systolic dysfunction of nonspecific etiology. Fifty-nine DCM patients were serially observed by echocardiography for 4.5 +/- 2.6 years, and 7.3 +/- 3.4 times M-mode and two-dimensional echocardiography was performed during the observation period using SSH-11A (Toshiba). To assess LV systolic function, ejection fraction was calculated by Pombo's method. Myocardial gray level distribution shown by echocardiography was calculated to assess the myocardial tissue character. Two-dimensional echocardiographic images were obtained in the parasternal short-axis view, recorded on U-matic videotape, and transferred to an image processing computer system (MIPRON, Kontron). The images were digitized and stored on the computer. The regions of interest (ROI) were placed in the LV septum, posterior papillary muscle, posterior wall, anterior papillary muscle and entire LV wall. The gray level distributions in each ROI and its quantitative parameters (mean, SD, skewness, excess) were calculated. The corrected myocardial gray level of every ROI (CMD) was also calculated and expressed as the ratio to the mean gray level of the LV cavity. Seven patients exhibited significant decreases in ejection fraction (more than 10%) during the observation period (group A); the remainders showed less change (group B).(ABSTRACT TRUNCATED AT 250 WORDS)