RESUMEN
Evaluation of left ventricular function in the presence of valvular regurgitation is still a clinical problem because ejection phase indices including ejection fraction are heavily dependent on preload and afterload and cannot be regarded as reliable indices of contractility in diseases associated with altered loading conditions. The authors attempted to evaluate the usefulness of the new index-corrected ejection fraction in the evaluation of left ventricular (LV) function in patients with chronic mitral (MR) or aortic regurgitation (AR). The study included 21 patients with chronic severe MR (11 patients) and AR (10 patients) with a mean age of 18 years. All patients underwent valve replacement or repair. Echo Doppler study was performed preoperatively and postoperatively and included measurement of the following LV parameters: end-diastolic dimension (EDD), end-diastolic volume (EDV), end-systolic dimension (ESD), end-systolic volume (ESV), ejection fraction (EF), systolic blood pressure/end-systolic dimension (SBP/ESD); also mitral and aortic stroke volume were calculated cross-sectional area (CSA) x time velocity integral TVI. Corrected ejection fraction (EFc) was derived from the following equation: EFc = [EF + square root of (ASV x MSV) / EDV] / 2. The mean preoperative EFc did not change significantly after surgical correction of mitral or aortic regurgitation. Preoperative EFc did not show significant difference compared with postoperative EF in the two groups. Preoperative EFc correlated significantly with other preoperative and postoperative indices of LV function. Postoperative EFc showed very close correlation with other postoperative parameters. Thus, using the new index-corrected ejection fraction in the assessment of LV function in patients with mitral or aortic regurgitation has several advantages: Noninvasive, independent of loading changes, helpful in predicting the immediate postoperative clinical course, and a reliable index for evaluation of LV systolic function preoperatively and postoperatively.
Asunto(s)
Insuficiencia de la Válvula Aórtica/fisiopatología , Insuficiencia de la Válvula Mitral/fisiopatología , Volumen Sistólico , Función Ventricular Izquierda , Adolescente , Adulto , Insuficiencia de la Válvula Aórtica/diagnóstico por imagen , Enfermedad Crónica , Ecocardiografía Doppler , Estudios de Evaluación como Asunto , Femenino , Humanos , Masculino , Insuficiencia de la Válvula Mitral/diagnóstico por imagenRESUMEN
Laboratory experiments were undertaken to investigate the autotoxic effects ofAnastatica hierochuntica and possible effects on five other desert plants:Rumex cyprius, Trigonella stellata, Diplotaxis harra, Cleome droserifolia, andFarsetia aegyptia. Seed germination, seedling growth, and cell division of all species tested were inhibited by the shoot aqueous extract ofA. hierochuntica. A gradual increase in the percentage of prophase and decrease in the other mitotic stages as well as the mitotic index were observed with increasing extract concentration. At an extract concentration of 8% the mitotic index was reduced from the control by 55% inC. droserifolia, 54% inT. stellata, 45% inF. aegyptia, 43% inA. hierochuntica, and 35% inR. cyprius. The inhibitory substances are apparently released onto soil by repeated washing of the standing plants by rain and dew interception.