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2.
ABC., imagem cardiovasc ; 35(1): eabc245, 2022. ilus, tab
مقالة ي البرتغالية | LILACS | ID: biblio-1369683

الملخص

Introdução: A excursão sistólica do anel tricúspide e a do anel mitral são parâmetros utilizados para se avaliar a função contrátil do ventrículo direito e do ventrículo esquerdo, respectivamente. Pouco se conhece sobre sua relação com a função diastólica ventricular esquerda. Objetivo: Avaliar se os valores de excursão sistólica do anel tricúspide e do anel mitral se correlacionam com parâmetros utilizados na avaliação da função diastólica ventricular esquerda. Métodos: Estudo observacional transversal. Foram selecionados 219 indivíduos, sendo 116 mulheres, com função sistólica preservada de ambos os ventrículos. As análises foram feitas separadamente para os sexos masculino e feminino, por meio dos coeficientes de correlação de Pearson e de Sperman. Foram obtidos: excursão sistólica do anel tricúspide, excursão sistólica do anel mitral, volumes atriais e medidas relacionadas à avaliação da função diastólica do ventrículo esquerdo ao ecocardiograma transtorácico. Resultados: No sexo feminino, a excursão sistólica do anel mitral se correlacionou positivamente com o e' lateral (coeficiente de correlação de Sperman de 0,22; p=0,016) e a excursão sistólica do anel tricúspide se correlacionou positivamente com a relação E/A (coeficiente de correlação de Sperman de 0,23, p=0,037), com o e' lateral (coeficiente de correlação de Sperman de 0,28; p=0,012), com o e' septal (coeficiente de correlação de Sperman de 0,28; p=0,012) e negativamente com a relação E/e' (coeficiente de correlação de Pearson de -0,27; p=0,018) e onda A (coeficiente de correlação de Pearson de -0,29; p= 0,009). No sexo masculino, apenas a excursão sistólica do anel mitral se correlacionou positivamente com a onda E (coeficiente de correlação de Pearson de 0,21; p=0,037), e' lateral (coeficiente de correlação de Sperman de 0,34; p <0,001) e e' septal (coeficiente de correlação de Sperman de 0,26; p=0,008). Não houve correlação entre excursão sistólica do anel mitral e do anel tricúspide e volumes atriais. A presença de hipertensão arterial sistêmica e diabetes melito influenciou nos valores de excursão sistólica do anel tricúspide e do anel mitral correlacionados a ondas E e A, relação E/A, ondas e' septal e lateral e relação E/e'. Conclusão: No presente estudo, os valores da excursão sistólica do anel mitral e do anel tricúspide apresentaram correlação significativa com algumas variáveis da função diastólica ventricular esquerda com maior evidência no sexo feminino.(AU)


Introduction: Tricuspid annular plane systolic excursion and mitral annular systolic excursion are parameters used to assess the systolic function of the right ventricle and left ventricle, respectively. Little is known about its relationship with left ventricular diastolic function. Objective: To assess whether the values of mitral annular systolic excursion and tricuspid annular plane systolic excursion correlate with parameters used in the evaluation of left ventricular diastolic function. Method: Observational cross-sectional study. Two hundred nine individuals were selected, 116 women, with both ventricles normal systolic function. The analyzes were performed for men and women, through Pearson correlation coefficient and Sperman correlation coefficient. Tricuspid annular plane systolic excursion, mitral annular systolic excursion, atrial volumes and left ventricular diastolic function parameters on transthoracic echocardiogram were obtained. Results: In women, mitral annular systolic excursion was positively correlated with lateral e '(Sperman correlation coefficient of 0.22; p=0.016) and tricuspid annular plane systolic excursion was positively correlated with E / A ratio (Sperman correlation coefficient of 0.23; p=0.037), lateral e' (Sperman correlation coefficient of 0.28; p=0.012), and septal e' (Sperman correlation coefficient of 0.28; p=0.012), and negatively with the E/e' ratio (Pearson correlation coefficient of -0.27; p=0.018), and A wave (Pearson correlation coefficient of -0.29; p=0.009). In men, only mitral annular systolic excursion correlated positively with E wave (Pearson correlation coefficient of 0.21; p=0.037), lateral e' (Sperman correlation coefficient of 0.34; p <0.001) and the septal e' (Sperman correlation coefficient of 0.26; p=0.008). There was no correlation between mitral annular systolic excursion E and tricuspid annular plane systolic excursion and atrial volumes. Hypertension and diabetes mellitus influenced tricuspid annular plane systolic excursion and mitral annular systolic excursion values correlated to E and A waves, E/A ratio, septal and lateral e' waves, and E/e' ratio. Conclusion: In the present study, mitral annular systolic excursion and tricuspid annular plane systolic excursion values showed a significant correlation with some parameters of left ventricular diastolic function, with stronger evidence on female sex.(AU)


الموضوعات
Humans , Male , Female , Adolescent , Adult , Middle Aged , Tricuspid Valve/anatomy & histology , Ventricular Function, Left/physiology , Ventricular Dysfunction, Left/complications , Mitral Valve/anatomy & histology , Echocardiography/methods , Ventricular Dysfunction, Left/diagnostic imaging , Diabetes Mellitus/etiology , Heart Ventricles/physiopathology , Hypertension/complications
3.
Int. j. morphol ; 38(3): 596-601, June 2020. tab, graf
مقالة ي الأسبانية | LILACS | ID: biblio-1098293

الملخص

Las valvas cardíacas y especialmente la valva atrioventricular izquierda (VAVI) ha sido considerada por largo tiempo, como una estructura pasiva. Sin embargo, han surgido nuevas teorías que reconocen a esta estructura como una "valva viva", con un funcionamiento de mayor autonomía y dinámico. En esta línea, existen estudios en donde se ha concluido que la ausencia de tejidos contráctiles en una valva, generan ondulaciones no fisiológicas. Por el contrario, se ha señalado la presencia de tejido contráctil en la valva, lo que refleja una activación ondulante. Basado en lo anterior, el objetivo del presente estudio fue determinar la presencia de fibras musculares cardíacas en las cúspides de la VAVI. Se utilizaron 12 cúspides, 6 anteriores y 6 posteriores, de 7 cadáveres adultos (4) y lactantes (3) de distintas edades, sin patologías cardíacas. Las muestras pertenecían a la Facultad de Medicina de la Universidad Estadual de Ciencias da Saúde de Alagoas, Maceió, Brasil. Estas muestras fueron tratadas con procesamiento histológico de rutina. Los hallazgos morfológicos a un aumento de 4x mostraron células musculares que fueron visibles principalmente por el lado atrial en la totalidad de las cúspides, tanto inmersas en el tejido conectivo denso del anillo fibroso como en el tejido conectivo laxo. Al verificar la naturaleza de las fibras con un aumento mayor (100x), se detectaron estrías transversales en todas las muestras estudiadas, lo cual afirma la presencia de fibras musculares estríadas cardíacas en la VAVI. Los resultados obtenidos aportan al conocimiento de la microestructura y tejido contráctil de las cúspides de la VAVI. Por lo tanto, resulta de gran relevancia seguir profundizando en los conocimientos morfológicos de la VAVI, para sentar una base sólida sobre la microestructura contráctil en los diferentes estadíos del ser humano.


Cardiac valves and particularly, the left atrioventricular valve (LAVV) have long been considered passive structures. Nonetheless, there are more recent hypothesis that recognize this structure as a "living valve", with greater autonomy and dynamic function. Along these lines, some studies have concluded that the absence of contractile tissues in a valve, generates non-physiological undulations. In contrast, the presence of contractile tissue in the valve has been reported, reflecting a waving activation. Based on the above, the objective of the present study was to determine the presence of cardiac muscle fibers in the cusps of the LAVV. 12 cusps, 6 anterior and 6 posterior. Therefore, 7 adult (4) and lactating (3) bodies of different ages without cardiac pathologies were used. The samples belonged to the Faculty of Medicine of the Universidade de Ciencias da Saude de Alagos, Maceió, Brazil. The samples were treated with routine histological processing. Morphological findings at an increase of 4x showed muscle cells that were visible mainly from the atrial side in all the cusps, both immersed in the dense connective tissue of the fibrous ring and in loose connective tissue. Transverse striations were detected in all samples studied, when verifying the nature of the fibers with greater increase (100x), confirming the presence of cardiac striated muscle fibers in the LAVV. The results obtained contribute to the knowledge of the microstructure and contractile tissue of the LAVV cusps. Therefore it is relevant to further morphological knowledge of this valve, in order to build a solid foundation on the contractile microstructure in the different stages of the human development.


الموضوعات
Humans , Male , Female , Infant , Adult , Mitral Valve/anatomy & histology , Cadaver , Heart/anatomy & histology
4.
Int. j. cardiovasc. sci. (Impr.) ; 30(2): f:136-l:144, mar.-abr. 2017. tab, graf
مقالة ي البرتغالية | LILACS | ID: biblio-833915

الملخص

Introdução: Depósitos valvares de cálcio quantificados por ecocardiografia transtorácica estão associados à presença de doença aterosclerótica sistêmica, embora seu valor prognóstico e a influência de fatores de risco cardiovascular associados ainda não estejam definidos. Objetivos: Correlacionar o índice de calcificação cardíaca valvar pela ecocardiografia transtorácica com fatores de risco cardiovascular e presença de doença arterial coronariana (DAC). Métodos: Foram selecionados 203 pacientes (61,2 ± 14,3 anos; 57,6% do sexo feminino) que realizaram ecocardiografia transtorácica com quantificação do índice de cálcio cardíaco. A presença ou não de DAC, hipertensão arterial sistêmica (HAS), diabetes mellitus (DM), dislipidemia e tabagismo foi avaliada. Resultados: Idade acima de 65 anos (p < 0,001) e presença de HAS (p < 0,001) mostraram correlação significativa com a presença de calcificação cardíaca, enquanto que o DM (p = 0,056) e a DAC (p = 0,08) apresentaram apenas uma tendência a se correlacionar com a mesma. A calcificação isolada da valva mitral mostrou correlação significativa com idade acima de 65 anos (p < 0,001), presença de DAC (p = 0,004), HAS (p = 0,054) e DM (p = 0,07), sendo que na análise multivariada a DAC (odds ratio [OR] 3,39, intervalo de confiança de 95% [IC95%] 1,58-7,29, p = 0,002) e idade > 65 anos (OR 1,05, IC95% 1,02-1,08, p = 0,003) mostraram correlação significativa e independente com calcificação mitral. A calcificação isolada da valva aórtica não mostrou correlação com a presença de DAC (p = 0,435), mas apresentou uma correlação significativa com idade acima de 65 anos (p < 0,001) e HAS (p < 0,001). Na análise multivariada, apenas a idade (OR 1,1 IC95% 1,06-1,14, p < 0,001) manteve uma correlação independente e significativa com calcificação aórtica. Conclusão: Idade acima de 65 anos e hipertensão arterial sistêmica foram fatores de risco independentes para a presença de calcificação cardíaca valvar, sendo que a calcificação isolada da valva mitral esteve associada de forma significativa e independente com a presença de DAC


Introduction: Valvular deposits of calcium quantified by transthoracic echocardiography are associated with the occurrence of systemic atherosclerotic disease, but its prognostic value and influence of associated cardiovascular risk factors have not been defined yet. Objectives: To correlate the valvular cardiac calcium index by transthoracic echocardiography with cardiovascular risk factors and presence of coronary artery disease (CAD). Methods: We selected 203 patients (61.2 ± 14.3 years; 57.6% females) who underwent transthoracic echocardiography with cardiac calcium index quantification. The presence or absence of CAD, hypertension, diabetes mellitus (DM), dyslipidemia, and smoking was assessed. Results: Age above 65 years (p < 0.001) and the presence of hypertension (p < 0.001) showed a significant correlation with the presence of cardiac calcification, whereas DM (p = 0.056) and CAD (p = 0.08) showed only a trend toward a correlation with calcification. Mitral valve calcification alone correlated significantly with age above 65 years (p < 0.001), presence of CAD (p = 0.004), hypertension (p = 0.054), and DM (p = 0.07). On multivariate analysis, CAD (odds ratio [OR] 3.39, 95% confidence interval [95%CI] 1.58-7.29, p = 0.002) and age > 65 years (OR 1.05, 95%CI 1.02-1.08, p = 0.003) correlated significantly and independently with mitral valve calcification. Aortic valve calcification alone showed no correlation with the presence of CAD (p = 0.435), but correlated significantly with age above 65 years (p < 0.001) and hypertension (p < 0.001). On multivariate analysis, only age (OR 1.1, 95%CI 1.06-1.14, p < 0.001) remained independently and significantly correlated with aortic calcification. Conclusion: Age above 65 years and hypertension were independent risk factors for the presence of valvular cardiac calcification, with mitral valve calcification alone emerging as significantly and independently associated with the presence of CAD


الموضوعات
Humans , Male , Female , Middle Aged , Aged , Calcium Channels , Cardiovascular Diseases/physiopathology , Coronary Artery Disease/complications , Echocardiography/methods , Risk Factors , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Aortic Valve/anatomy & histology , Diabetes Mellitus/diagnosis , Mitral Valve/anatomy & histology , Multivariate Analysis , Observational Study , Data Interpretation, Statistical , Unified Health System , Vascular Calcification/complications
5.
Ann Card Anaesth ; 2014 Oct; 17(4): 279-283
مقالة ي الانجليزية | IMSEAR | ID: sea-153698

الملخص

Aims and Objectives: The objective of this study was to assess the clinical feasibility of using echocardiographic data to generate three‑dimensional models of normal and pathologic mitral valve annuli before and after repair procedures. Materials and Methods: High‑resolution transesophageal echocardiographic data from five patients was analyzed to delineate and track the mitral annulus (MA) using Tom Tec Image‑Arena software. Coordinates representing the annulus were imported into Solidworks software for constructing solid models. These solid models were converted to stereolithographic (STL) file format and three‑dimensionally printed by a commercially available Maker Bot Replicator 2 three‑dimensional printer. Total time from image acquisition to printing was approximately 30 min. Results: Models created were highly reflective of known geometry, shape and size of normal and pathologic mitral annuli. Post‑repair models also closely resembled shapes of the rings they were implanted with. Compared to echocardiographic images of annuli seen on a computer screen, physical models were able to convey clinical information more comprehensively, making them helpful in appreciating pathology, as well as post‑repair changes. Conclusions: Three‑dimensional printing of the MA is possible and clinically feasible using routinely obtained echocardiographic images. Given the short turn‑around time and the lack of need for additional imaging, a technique we describe here has the potential for rapid integration into clinical practice to assist with surgical education, planning and decision‑making.


الموضوعات
Echocardiography, Three-Dimensional/methods , Echocardiography, Transesophageal/methods , Feasibility Studies , Heart Valve Diseases/diagnostic imaging , Humans , Image Processing, Computer-Assisted/methods , Mitral Valve/anatomy & histology , Mitral Valve/diagnostic imaging , Printing, Three-Dimensional , Software
6.
Arq. bras. med. vet. zootec ; Arq. bras. med. vet. zootec. (Online);66(1): 15-21, fev. 2014. ilus, tab
مقالة ي الانجليزية | LILACS | ID: lil-704000

الملخص

Mitral flow propagation velocity (Vp) is an index used to evaluate the left ventricular diastolic function. Its influence on human and small animal cardiopathies has been studied; however there are few reports evaluating this variable in domestic felines. In addition, there is a lack of studies in non-sedated healthy cats. Therefore, the purpose of this study was to establish values for Vp and its correlation with other echocardiographic indexes in non-sedated healthy cats in order to provide new perspectives related to diastolic function in this species. Twenty-six clinically healthy cats were submitted to echocardiography to assess the animals' cardiac conditions. Variables such as age, heart rate (HR), body surface area (BSA), initial (E mitral) and late (A mitral) ventricular filling waves, isovolumic relaxation time (IVRT) and E/IVRT relation were correlated to Vp. No proven relation between any of these variables and Vp was observed in this present study, except for HR and BSA. In the variability analysis, higher values were verified for inter-observer analysis. This study concludes that Vp proved to be an useful index for estimating left ventricular relaxation in non-sedated healthy domestic cats and provides reference ranges for this variable.


A velocidade de propagação do fluxo mitral (Vp) é um índice utilizado para avaliação da função diastólica do ventrículo esquerdo. Sua importância nas cardiopatias em humanos e pequenos animais vem sendo estudada; porém, há poucos trabalhos avaliando essa variável em gatos domésticos. Nessa espécie, estudos utilizando animais saudáveis e não sedados não foram encontrados na literatura. Dessa forma, objetivou-se estabelecer os valores da Vp e sua correlação com outros índices ecocardiográficos em gatos domésticos saudáveis e não sedados, de forma a fornecer novas perspectivas relacionadas à função diastólica nessa espécie. Foram utilizados 26 gatos domésticos clinicamente saudáveis, submetidos à ecocardiografia para se avaliar a condição cardíaca dos animais. As variáveis idade, frequência cardíaca (FC), área de superfície corporal (SAC), idade, onda de enchimento ventricular inicial (E mitral) e tardio (A mitral), tempo de relaxamento isovolumétrico (TRIV) e a relação E/TRIV foram correlacionadas com a Vp. No presente estudo não foi observada correlação da Vp com nenhuma das variáveis estudas, exceto com a FC e o SAC. Quanto à análise de variabilidade, foi observado um maior valor para a análise inter-observador. O estudo permite concluir que a Vp demonstrou ser um índice útil para se estimar o relaxamento ventricular esquerdo em gatos domésticos saudáveis e não sedados, além de fornecer valores de referência para essa variável.


الموضوعات
Animals , Cats , Heart Diseases/pathology , Diastole , Mitral Valve/anatomy & histology , Cats , Echocardiography
7.
Yonsei med. j ; Yonsei med. j;: 592-598, 2014.
مقالة ي الانجليزية | WPRIM | ID: wpr-58600

الملخص

PURPOSE: Functional mitral regurgitation (FMR) and myocardial dyssynchrony commonly occur in patients with dilated cardiomyopathy (DCM). The aim of this study was to elucidate changes in FMR in relation to those in left ventricular (LV) dyssynchrony as well as geometric parameters of the mitral valve (MV) in DCM patients during dobutamine infusion. MATERIALS AND METHODS: Twenty-nine DCM patients (M:F=15:14; age: 62+/-15 yrs) with FMR underwent echocardiography at baseline and during peak dose (30 or 40 ug/min) of dobutamine infusion. Using 2D echocardiography, LV end-diastolic volume, end-systolic volume (LVESV), ejection fraction (EF), and effective regurgitant orifice area (ERO) were estimated. Dyssynchrony indices (DIs), defined as the standard deviation of time interval-to-peak myocardial systolic contraction of eight LV segments, were measured. Using the multi-planar reconstructive mode from commercially available 3D image analysis software, MV tenting area (MVTa) was measured. All geometrical measurements were corrected (c) by the height of each patient. RESULTS: During dobutamine infusion, EF (28+/-8% vs. 39+/-11%, p=0.001) improved along with significant decrease in cLVESV (80.1+/-35.2 mm3/m vs. 60.4+/-31.1 mm3/m, p=0.001); cMVTa (1.28+/-0.48 cm2/m vs. 0.79+/-0.33 cm2/m, p=0.001) was significantly reduced; and DI (1.31+/-0.51 vs. 1.58+/-0.68, p=0.025) showed significant increase. Despite significant deterioration of LV dyssynchrony during dobutamine infusion, ERO (0.16+/-0.09 cm2 vs. 0.09+/-0.08 cm2, p=0.001) significantly improved. On multivariate analysis, DeltacMVTa and DeltaEF were found to be the strongest independent determinants of DeltaERO (R2=0.443, p=0.001). CONCLUSION: Rather than LV dyssynchrony, MV geometry determined by LV geometry and systolic pressure, which represents the MV closing force, may be the primary determinant of MR severity.


الموضوعات
Aged , Female , Humans , Male , Middle Aged , Dobutamine/administration & dosage , Echocardiography , Mitral Valve/anatomy & histology , Mitral Valve Insufficiency/physiopathology , Ventricular Dysfunction, Left/physiopathology
8.
Int. j. morphol ; 31(4): 1276-1281, Dec. 2013. ilus
مقالة ي الانجليزية | LILACS | ID: lil-702305

الملخص

The atrioventricular valve is the most commonly repaired valve of the heart. Interventional procedures like annuloplasties, valvotomy/valvuloplasty, repair/replacement of the valve for regurgitation or prolapse are increasing by the day. This necessitates a clear understanding of the mitral valve anatomy. The present study is an attempt to revisit the anatomy of mitral valve. The present study was conducted on 34 adult embalmed heart specimens. Based on the newly defined criteria, observations were made on: 1) Number of commissures and their positions, 2) Number and position of leaflets, 3) Number and position of minor commissures, 4) Annular circumference (AC), 5) Length of annular attachment of each leaflet (LAA), 6) Maximum width of coapted/ folded margin (FM) of the anterior and posterior leaflet, 7) The surface area of each leaflet (SA). The observations were analyzed statistically. The findings of the present study and the subsequent statistical analysis offer a dynamic concept of the anatomy of mitral valve leaflets. It suggests that the valvular anatomy depends upon a complex interplay of various valve components. The extra leaflets tend to occur when annular circumference increases and is not appropriately compensated by various valvular elements. The different methodology adopted in the present study and the interpretations deduced hereupon, shall dispel the existing ambiguities in the description of the leaflets and improve our understanding of the structure and function of the mitral valve complex.


La valva atrioventricular es la valva más comúnmente reparada del corazón. Los procedimientos intervencionistas como anuloplastías, valvotomía/valvoplastía, reparación/reemplazo de la valva por la regurgitación o prolapso están aumentando día a día. Para ello, se requiere una clara comprensión de la anatomía de la valva atrioventricular. El presente estudio intenta volver a examinar la anatomía de la valva atrioventricular. Se estudiaron 34 corazones de adultos embalsamados. Sobre la base de los criterios definidos, se realizaron las siguientes observaciones: 1) número de comisuras y sus posiciones, 2) número y localización de los velos, 3) número y localización de las comisuras menores, 4) circunferencia anular (AC), 5) longitud de la unión anular de cada valva (LAA), 6) ancho máximo del margen de coaptación/margen velar (FM) de los velos anterior y posterior y 7) área de superficie de cada valva (SA). Las observaciones fueron analizadas estadísticamente. Los resultados del presente estudio y el análisis estadístico ofrecen un concepto dinámico de la anatomía de la valva atrioventricular. Se sugiere que la anatomía de las valvas depende de una interacción compleja de varios de sus componentes. Los velos adicionales tienden a aparecer cuando aumenta la circunferencia anulares y no se compensa adecuadamente por diversos elementos valvares. La diferente metodología adoptada en el presente estudio sus interpretaciones, podrían disipar ambigüedades existentes en la descripción de las valvas y mejorar nuestra comprensión de la estructura y función del complejo de la valva atrioventricular.


الموضوعات
Humans , Adult , Mitral Valve/anatomy & histology , Cadaver , India , Heart Valves/anatomy & histology
9.
Ann Card Anaesth ; 2013 Jan; 16(1): 23-27
مقالة ي الانجليزية | IMSEAR | ID: sea-145388

الملخص

Aims and Objectives: Mild and/or moderate ischemic mitral regurgitation (IMR) may resolve after isolated coronary artery bypass grafting (CABG). It has been shown that the loss of saddle shape of the mitral valve is associated with IMR and is determined by an increase in the nonplanarity angle (NPA). The aim of this prospective, observational study was to test the hypothesis that NPA might decrease immediately after CABG alone in patients with mild to moderate IMR. Materials and Methods: This prospective, observational study was conducted in an academic, tertiary care hospital. Twenty patients underwent 2D and 3D transoesophageal echocardiography (TEE) and mitral valve assessment before and immediately after the CABG. NPA, circularity index, and other geometric variables were obtained. They were compared using paired t test. The SPSS (Version 15.0, Chicago, IL, USA) was used for statistical analysis. P <0.05 was considered significant. Results: The NPA was similar in the pre- and post-bypass periods (148° ± 15°, 148° ± 19°, P = 0.88). Circularity index (0.93 ± 0.13, 0.97 ± 0.11, P = 0.41) also was similar. Conclusions: There was no change in the mitral valve NPA with revascularization alone in patients with mild or moderate IMR. Mitral valve does not change its planarity (NPA) with revascularization alone in patients with IMR.


الموضوعات
Coronary Artery Bypass/methods , Echocardiography, Three-Dimensional/methods , Echocardiography, Transesophageal/methods , Humans , Mitral Valve/anatomy & histology , Mitral Valve/physiopathology , Mitral Valve/diagnostic imaging , Mitral Valve Insufficiency/etiology , Mitral Valve Insufficiency/diagnostic imaging , Myocardial Revascularization/methods , Patients , Percutaneous Coronary Intervention/methods
11.
São Paulo; s.n; 2011. 98 p. ilus, tab, graf.
أطروحة جامعية ي البرتغالية | LILACS | ID: lil-619997

الملخص

Introdução: A insuficiência cardíaca congestiva (ICC) ocasionada pela cardiomiopatia dilatada idiopática (CMDId) constitui-se em quadro causador de grande impacto na saúde pública, apresentando morbidade e mortalidade significativas, porém muitos aspectos referentes à sua fisiopatologia ainda permanecem desconhecidos, de modo que trabalhos que estudem tais aspectos poderão contribuir para melhor entendimento desta entidade. Objetivos: Avaliar aspectos anatômicos e histológicos de corações com CMDId e compará-los a um grupo controle de corações normais, obtendo-se as medidas dos perímetros dos anéis atrioventriculares direito (AVD) e esquerdo (AVE) e dos ventrículos direito (VD) e esquerdo (VE) bem como a porcentagem por área de fibras colágenas e elásticas dos anéis atrioventriculares direito e esquerdo. Métodos: Foram analisados 13 corações de pacientes que faleceram vítimas de CMDId e 13 corações normais de pacientes que faleceram por causas não relacionadas à doenças cardiovasculares. Os corações foram fixados em formol, dissecados de forma a manter-se apenas os anéis atrioventriculares e a massa ventricular, com posterior laminação desta em segmentos transversais correspondentes a 20%, 50% e 80% da distância compreendida entre o sulco atrioventricular e o ápice ventricular esquerdo. Os cortes assim obtidos foram submetidos à digitalização fotográfica, que permitiu a aferição de ambos os perímetros ventriculares por meio de software específico, tornando possível a comparação de tais medidas entre os grupos e os segmentos. Os anéis atrioventriculares foram posteriormente dissecados, fotografados e medidos digitalmente para aferição das medidas perimetrais a direita e a esquerda, sendo posteriormente enviados ao laboratório de anatomia patológica, sendo realizadas colorações por meio de hematoxilinaeosina, picrossírius e resorcina fuccina oxidada, permitindo estudo das fibras colágenas e elásticas...


Introduction: Congestive heart failure caused by idiopathic dilated cardiomyopathy causes great impact on public health, with significant morbidity and mortality, but many aspects related to its pathophysiology remain unknown, so further studies can contribute to better understanding of this entity. Objectives: To evaluate anatomical and histological aspects of hearts from patients who died victims of idiopathic dilated cardiomyopathy and compare them to a control group, to evaluate the behavior of the perimeters of the right and left atrioventricular rings and left and right ventricles and to compare the percentage area of collagen and elastic fibers of the right and left atrioventricular rings in both groups. Methods: We analyzed 13 hearts of patients who died from idiopathic dilated cardiomyopathy and 13 normal hearts from patients who died of causes not related to cardiovascular disease. The hearts were fixed in formalin, dissected in order to keep only the ventricular mass and atrioventricular rings, with subsequent lamination of segments corresponding to 20%, 50% and 80% of the distance between the atrioventricular groove and the left ventricular apex . The sections obtained were subjected to photo scanning, which allowed the measurement of ventricular perimeters by means of specific software, making it possible to compare these measures between groups and segments. The atrioventricular rings were then dissected, photographed and measured digitally to evaluate the right and left perimeters, later being sent to the pathology laboratory, and stained by hematoxylin-eosin, picrosirius and oxidized resorcin fuccin, enabling study of collagen and elastic fibers...


الموضوعات
Humans , Cardiomyopathy, Dilated/pathology , Heart/anatomy & histology , Heart , Ventricular Remodeling , Mitral Valve/anatomy & histology , Tricuspid Valve/anatomy & histology
12.
Pesqui. vet. bras ; Pesqui. vet. bras;29(10): 852-858, out. 2009. tab, ilus
مقالة ي الانجليزية | LILACS | ID: lil-537595

الملخص

Atrioventricular valve complex of 30 Jafarabadi water buffaloes, adult males were studied in this research with no heart diseases. The animals were obtained from a slaughterhouse in Brazilian State of Parana. The hearts were opened at the third portion affording access to the valve complex. The complexes had its area, number and type of tendinous cords submitted to analysis. The results showed that the complex is composed by two cusps and four accessory cusps, two or three papillary muscles in which 10-25 tendinous cords fix on the cusps that face the ventricle wall. The total area of the complex was on average 38.56cm², with a minimum of 24.96cm² and a maximum of 55.54cm². Statistically, no relation between the number of cords and the cusps' area where they are inserted or with the number of papillary muscle where they originated from was observed.


Foram estudados os complexos valvares atrioventricular esquerdo de 30 búfalos da raça Jafarabadi, machos e adultos, sem alterações cardíacas, provenientes de abatedouros do Estado do Paraná. Os corações foram examinados em seu terço médio para acesso ao complexo valvar, que foi submetido a estudos de área, número e tipificação de cordas tendíneas. Os resultados demonstram que este complexo é formado por duas cúspides principais e quatro cúspides acessórias, apresentam em sua formação de 2-3 músculos papilares, nos quais se inserem de 10-25 cordas tendíneas, que se fixam em cúspides voltadas para a parede do ventrículo. A área total deste complexo apresenta uma média de 38,56cm² com um mínimo de 24,96cm² e um máximo de 55,54cm². Estatisticamente não há relação entre número de cordas e a área da cúspide onde estas estão inseridas, nem com o número de músculos papilares dos quais elas provem.


الموضوعات
Animals , Male , Adult , Chordae Tendineae/anatomy & histology , Mitral Valve/anatomy & histology , Heart Ventricles/anatomy & histology , Buffaloes/anatomy & histology
13.
Rev. bras. ciênc. vet ; 16(1): 46-48, 2009.
مقالة ي البرتغالية | LILACS, VETINDEX | ID: biblio-1491370

الملخص

Objetiva-se relatar um caso de endocardite da válvula mitral em cadela da raça boxer, com seis anos de idade, que foi encaminhada ao HV da UFRPE. Durante o exame clínico o animal veio a óbito. Na necropsia notou-se no fígado um abscesso de três centímetros de diâmetro e no útero havia grande quantidade de material muco-purulento. No ventrículo esquerdo do coração percebiam-se várias formações de aspecto vegetativo aderidas à válvula mitral. À histopatologia evidenciou-se hiperplasia endometrial cística e endometrite purulenta. Nos fragmentos do coração constatou-se que as massas aderidas às válvulas eram constituídas por tecido conjuntivo frouxo, leucócitos, fibrina, debris celulares e sangue. Cultura da secreção uterina, do abscesso hepático e dos trombos valvulares revelou a presença de Staphylococcus sp. Os achados anatomo-histopatológicos e microbiológicos permitem concluir tratar-se de endocardite bacteriana valvular mitral vegetativa consequente a endometrite crônica.


The goal of this paper is present a case of mitral valve endocarditis in a 6-year-old female dog due chronic endometritis. The animal was guided to the Veterinary Hospital at Universidade Federal Rural de Pernambuco, Brazil, but the animal died during the physical examination. At the necropsy, a liver abscess, 3,0 cm in diameter, uterine with purulent content and some also vegetative formations adhered to the mitral valve were visually recognized in the left ventricle of the heart. Histopathologically, cystic endometrial hyperplasia (CEH), and purulent endometritis were observed. In the valves a mass adhered was present, which one was constituted by slack conjunctive tissue, leukocyte, fibrin, cellular scraps and blood. Uterine secretion, hepatic abscess content and the valvular clots culture revealed the presence of Staphylococcus sp. In conclusion, this case revealed the importance of the anatomohistopathological and microbiological diagnosis for the vegetative mitral valve endocarditis in dogs with endometritis.


الموضوعات
Female , Animals , Dogs/classification , Endocarditis/parasitology , Mitral Valve/anatomy & histology , Liver Abscess/physiopathology , Endometritis/pathology , Mucus
14.
São Paulo; s.n; 2008. [132] p. ilus, graf, tab.
أطروحة جامعية ي البرتغالية | LILACS | ID: lil-528269

الملخص

INTRODUÇÃO: O conhecimento anatômico desempenha importante papel no desenvolvimento de técnicas diagnósticas e cirúrgicas. Com esse objetivo, na área cardiológica, se mostra fundamental para o entendimento do processo de remodelamento cardíaco que acompanha as cardiomiopatias dilatadas (CMD) tanto isquêmicas (CMDIsq) como idiopáticas (CMDId), de modo particular do ventrículo esquerdo (VE) e sua correlação com alterações do anel atrioventricular esquerdo, levando a graus variáveis de insuficiência cardíaca (IC). OBJETIVOS: Os objetivos desta pesquisa são: 1) Obter medidas do anel atrioventricular esquerdo (mitral) e do ventrículo esquerdo em corações normais, com CMDIsq ou CMDId, comparando-as entre si; 2) Analisar a proporcionalidade entre segmentos da câmara ventricular esquerda dos corações com CMDIsq ou CMDId em relação ao normal; 3) Determinar a esfericidade ou não da câmara ventricular esquerda nos corações com CMDIsq ou CMDId. MÉTODO: Foram analisados 43 corações humanos, divididos em três grupos: NORMAL (n=10), CMDIsq (n=15) e CMDId (n=18). De posse da medida da distância do sulco atrioventricular posterior até o ápice do VE, foram realizados cortes transversais baso-apicais seqüenciais e, após digitalização dos mesmos, por meio de método computadorizado, foram obtidas medidas perimetrais e espessura das paredes. Empregando-se o mesmo método, mensurou-se o perímetro do anel mitral. Foram criados índices de proporção porcentual entre os perímetros dos segmentos provenientes dos cortes do VE, comparando-os intergrupos. Nos dilatados os perímetros segmentares mensurados foram comparados com os perímetros esperados se considerássemos a câmara ventricular como uma esfera perfeita. Realizou-se a análise estatística dessas medidas e índices. RESULTADOS: O perímetro do anel mitral teve o seguinte resultado: somente o grupo CMDIsq teve média significativamente maior que o grupo NORMAL e houve baixo coeficiente de correlação com os perímetros ventriculares...


BACKGROUND: Anatomic knowledge is the cornerstone for the development of surgical and diagnostic image techniques and for understanding pathological entities. Understanding cardiac anatomy is essential for understanding cardiac remodeling in both ischemic and idiopathic dilated cardiomyopathies. Dysfunction in the physiological relationship between the morphology of left ventricle and its mitral ring plays an important role in the cardiac insufficiency etiopathogenesis. OBJECTIVES: 1) To compare morphology of left ventricle and its mitral ring among normal, ischemic and idiopathic dilated cardiomyophatic anatomic specimens; 2) To compare intra specimen ventricular segmental perimeters relationships between normal and dilated specimens; 3) To verify the presence of the spheroid shape of left ventricular chamber in dilated specimens. METHODS: It was analyzed 43 specimens of human hearts, classified in three groups: normal (n=10), dilated due to ischemic (n=15) or idiopathic cardiomyopathies (n=18). Several lengths were measured: the length from the posterior atrioventricular sulcus to the ventricular apex in the intact specimen; followed by three sequential transversal ventricular slicing in the basal, equatorial and apical level. Digital pictures were taken from these slices, in order to be analyzed in a computer assisted fashion. Internal perimeter and ventricular walls width of each slice were measured, as well the mitral ring perimeter. The three intra group perimeters were compared and correlated between themselves. Basal, equatorial and apical perimeter of each group was compared to their correspondent pairs inter groups. Regarding intra group relationships, for a given group, each slice perimeter was measured and considered as a percentage of the equatorial slice (index). This percentage was compared inter groups. Three perimeters were evaluated in both dilated groups, each one was compared to its expected value when considering left ventricular...


الموضوعات
Humans , Male , Female , Adult , Middle Aged , Cardiomyopathy, Dilated/pathology , Heart/anatomy & histology , Ventricular Remodeling , Mitral Valve/anatomy & histology , Mitral Valve/pathology , Heart Ventricles/anatomy & histology , Heart Ventricles/pathology , Myocardium/pathology
17.
Braz. j. morphol. sci ; 22(1): 37-40, jan.-mar. 2005. ilus
مقالة ي الانجليزية | LILACS | ID: lil-413783

الملخص

The mitral-aortic intervalvular fibrosa of the heart is of great clinical and surgical importance, because of its involvement in the anatomical and functional integrity of these two valves. In this work, we examined the morphology of the mitralaortic intervalvular fibrosa and its relationship to the mitral and aortic valves. Thirty formaldehyde-fixed adult human hearts of both sexes were dissected and the structural organization, dimensions and area of the mitral-aortic intervalvular fibrosa were determined. The mitral-aortic intervalvular fibrosa was a thin, translucent membranous area located between the root of the aortic artery and the left atrioventricular orifice. In most cases (63 por cento), the mitral-aortic intervalvular fibrosa was approximately triangular in shape, with an area of 93.9 ± 47.4 mm². The lower edge was associated with the anterior cusp of the mitral valve and was 18.0 ± 2.2 mm long, whereas the anterior edge was continuos with the left fibrous trigone and was 10.6 ± 3.0 mm long. The posterior edge was associated with the aortic wall and was continuos with the right fibrous trigone. This edge was 11.7 ± 3.4 mm long. These results may be useful for manufacturing protheses to substitute this injured membrane.


الموضوعات
Humans , Adult , Middle Aged , Mitral Valve , Myocardium/metabolism , Mitral Valve/anatomy & histology , Mitral Valve/metabolism , Mitral Valve/ultrastructure , Cadaver , Membranes/metabolism
18.
Rev. bras. cir. cardiovasc ; Rev. bras. cir. cardiovasc;19(4): 372-377, nov.-dez. 2004. ilus, tab, graf
مقالة ي البرتغالية | LILACS | ID: lil-393588

الملخص

OBJETIVO: Este trabalho objetivou analisar a relação anatômica entre o ânulo da valva atrioventricular esquerda (mitral), a artéria circunflexa e a artéria posterior do ventrículo esquerdo, relacionando a distância entre as estruturas citadas ao padrão de dominância coronariano. MÉTODO: Foram estudados 85 corações humanos, previamente fixados em solução de formaldeido a 10 por cento. Inicialmente, avaliou-se o padrão de dominância coronariana. A seguir, realizou-se atriotomia e ventriculotomia esquerdas na parede posterior do coração, a partir das veias pulmonares em direção ao ápice cardíaco, seccionando-se o ânulo mitral. Removeu-se a parede atrial ao nível do ânulo, em toda a porção da cúspide posterior. Sobre o ânulo foram demarcados cinco pontos: 1 - comissural anterior, 2 - entre o comissural anterior e o ponto médio posterior do ânulo, 3 - ponto médio posterior do ânulo, 4 - entre o ponto médio posterior do ânulo e o comissural posterior, 5 - comissural posterior. Nestes pontos foi medida a distância entre as estruturas com um paquímetro eletrônico. RESULTADOS: Padrão de dominância direita foi observado em 81,17 por cento dos casos, circulação balanceada em 16,47 por cento e dominância esquerda em 2,35 por cento. Nos corações que apresentaram dominância direita observou-se que a região de maior proximidade entre o ânulo e as estruturas vasculares foi a comissural anterior, 3,996 ± 1,865mm, enquanto a região de menor proximidade foi a comissural posterior, medindo 7,78 ± 2,615mm. CONCLUSAO: Este estudo propiciou melhor compreensão da relação anatômica entre a valva mitral e as artérias coronárias adjacentes, podendo auxiliar o cirurgião na diminuição de complicações cirúrgicas.


الموضوعات
Humans , Male , Female , Adult , Middle Aged , Coronary Circulation/physiology , Myocardial Infarction/physiopathology , Cardiac Surgical Procedures , Mitral Valve/anatomy & histology , Mitral Valve/surgery , Mitral Valve/physiopathology
19.
Rev. méd. (La Paz) ; 8(2): 46-50, ene.-abr. 2003. ilus, graf
مقالة ي الأسبانية | LILACS | ID: lil-333599

الملخص

Se describe un caso de prolapso de valvula mitral de origen primario, con degeneracion mixomatosa en un paciente de 19 años, operado con cambio de valvula mitral


الموضوعات
Male , Adolescent , Mitral Valve/anatomy & histology , Mitral Valve/surgery
20.
Rev. chil. anat ; 18(1): 103-7, 2000. ilus, tab
مقالة ي الانجليزية | LILACS | ID: lil-270875

الملخص

Se realizó este estudio para constatar la periocidad y cantidad en que se encuentran las valvas en la vena facial. Las venas faciales, derecha e izquierda de 50 cadáveres, adultos, de sexo masculino, previamente sumergidos en formol al 10 por ciento, fueron disecadas y abiertas longitudinalmente, desde su origen hasta su desembocadura, con el fin de constatar la presencia y ubicación de las valvas. Se observaron valvas en 41 casos (82 por ciento). Estas eran bien desarrolladas y fueron clasificadas en valvas ostiales y parietales. Entre las valvas ostiales habían unicúspides y bicúspides, mientras que las parietales eran solamente bicúspides. El trecho de la vena facial que presentó el mayor número de valvas fue el que se encuentra a nivel de la glándula submaxilar. Las paredes venosas que tenían valvas, presentaban seno valvular. Las relaciones entre variaciones anatómicas, constitución de la pared venosa y la presencia de valvas, son discutidas a lo largo del presente trabajo


الموضوعات
Humans , Male , Face/blood supply , Jugular Veins/anatomy & histology , Cadaver , Skull/blood supply , Eye/blood supply , Mitral Valve/anatomy & histology
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