Background-Left ventricular(LV) torsional deformation is a sensitive index for LV performance but difficult to measure. The present study tested the accuracy of a novel method that uses Doppler tissue imaging(DTI) for...Background-Left ventricular(LV) torsional deformation is a sensitive index for LV performance but difficult to measure. The present study tested the accuracy of a novel method that uses Doppler tissue imaging(DTI) for quantifying LV torsion in humans with tagged magnetic resonance imaging(MRI) as a reference. Methods and Results-Twenty patients underwent DTI and tagged MRI studies. Images of the LV were acquired at apical and basal short-axis levels to assess LV torsion. We calculated LV rotation by integrating the rotational velocity, determined from DTI velocities of the septal and lateral regions, and correcting for the LV radius over time. LV torsion was defined as the difference in LV rotation between the 2 levels. DTI rotational and torsional profiles throughout systole and diastole were compared with those by tagged MRI at isochronal points. Rotation and torsion by DTI were closely correlated with tagged MRI results during systole and early diastole(apical and basal rotation, r=0.87 and 0.90, respectively; for torsion, 0.84; P< 0.0001, by repeated-measures regression models). Maximal torsion showed even better correlation(r=0.95,P< 0.0001). Conclusions-The present study has shown that DTI can quantify LV torsional deformation over time. This novel method may facilitate noninvasive quantification of LV torsion in clinical and research settings.展开更多
Although diabetic autonomic neurop athy involves most or-gans,diagnosis is largely based on c ardiovascular tests.Light reflex pupillography(LRP)non-invasively evaluates pupillary autonomic function.We te sted whether...Although diabetic autonomic neurop athy involves most or-gans,diagnosis is largely based on c ardiovascular tests.Light reflex pupillography(LRP)non-invasively evaluates pupillary autonomic function.We te sted whether LRP demonstrates autonomic pupillary d ysfunction in diabetics independently from cardiac autonom ic neuropathy(CAN)or peripheral neuropathy(PN).In 36type -II diabetics(39-84years)and 36controls(35-78years),we per-formed LRP.We determined diameter(PD),early and late redilation velocities(DV)as sympathetic parameters and reflex amplitude(RA)and constriction velocity(CV)as parasympathetic pupillary indic es.We assessed the frequency of CAN using heart rate variability tests and e-valuated the frequency of PN using neurological examina-tion,nerve conduction studies,thermal and vibratory threshold determination.Twenty-e ight (77.8%)patients had abnormal pupillography results,but only 20patients(56%)had signs of PN or CAN.In nine patient s with PN,only pupillography identified auto nomic neuropathy.Four patients had pupillary dysfunction but no CAN or PN.In comparison to controls,patients had reduced PD,late DV,RA and CV indicating sympathetic and parasympathetic dysfunction.The incidence and seve rity of pupillary ab-normalities did not differ between p atients with and without CAN or PN.LRP demonstrates sympathetic and parasym-pathetic pupillary dysfunction ind ependently from PN or CAN and thus refines the diagnosis of autonomic neuropa-thy in type -II diabetics.展开更多
文摘Background-Left ventricular(LV) torsional deformation is a sensitive index for LV performance but difficult to measure. The present study tested the accuracy of a novel method that uses Doppler tissue imaging(DTI) for quantifying LV torsion in humans with tagged magnetic resonance imaging(MRI) as a reference. Methods and Results-Twenty patients underwent DTI and tagged MRI studies. Images of the LV were acquired at apical and basal short-axis levels to assess LV torsion. We calculated LV rotation by integrating the rotational velocity, determined from DTI velocities of the septal and lateral regions, and correcting for the LV radius over time. LV torsion was defined as the difference in LV rotation between the 2 levels. DTI rotational and torsional profiles throughout systole and diastole were compared with those by tagged MRI at isochronal points. Rotation and torsion by DTI were closely correlated with tagged MRI results during systole and early diastole(apical and basal rotation, r=0.87 and 0.90, respectively; for torsion, 0.84; P< 0.0001, by repeated-measures regression models). Maximal torsion showed even better correlation(r=0.95,P< 0.0001). Conclusions-The present study has shown that DTI can quantify LV torsional deformation over time. This novel method may facilitate noninvasive quantification of LV torsion in clinical and research settings.
文摘Although diabetic autonomic neurop athy involves most or-gans,diagnosis is largely based on c ardiovascular tests.Light reflex pupillography(LRP)non-invasively evaluates pupillary autonomic function.We te sted whether LRP demonstrates autonomic pupillary d ysfunction in diabetics independently from cardiac autonom ic neuropathy(CAN)or peripheral neuropathy(PN).In 36type -II diabetics(39-84years)and 36controls(35-78years),we per-formed LRP.We determined diameter(PD),early and late redilation velocities(DV)as sympathetic parameters and reflex amplitude(RA)and constriction velocity(CV)as parasympathetic pupillary indic es.We assessed the frequency of CAN using heart rate variability tests and e-valuated the frequency of PN using neurological examina-tion,nerve conduction studies,thermal and vibratory threshold determination.Twenty-e ight (77.8%)patients had abnormal pupillography results,but only 20patients(56%)had signs of PN or CAN.In nine patient s with PN,only pupillography identified auto nomic neuropathy.Four patients had pupillary dysfunction but no CAN or PN.In comparison to controls,patients had reduced PD,late DV,RA and CV indicating sympathetic and parasympathetic dysfunction.The incidence and seve rity of pupillary ab-normalities did not differ between p atients with and without CAN or PN.LRP demonstrates sympathetic and parasym-pathetic pupillary dysfunction ind ependently from PN or CAN and thus refines the diagnosis of autonomic neuropa-thy in type -II diabetics.
