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Does the Increase of Body Mass Index (BMI) or Waist to Hip Ratio (WHR) Affect Left Ventricular Myocardial Performance Index (MPI) in Normal Men?
هل تؤثر زيادة مؤشر كتلة الجسم أو نسبة الخصر إلى الورك على مؤشر كفاءة البطين الأيسر في الرجال الطبيعيين؟

Author: *Dr. Akeel AMH., Zwain (PhD., UK), Dr. Asaad H. Noaman (MB.Ch.B)
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2011 Volume: 14 Issue: 2 Pages: 11-19
Publisher: University of Kufa جامعة الكوفة

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Abstract

Background: Despite its clinical use as a sensitive measure of left ventricular performance, little is known about whether MPI is influenced by increasing BMI or WHR. Aim: The present study is targeted at investigating the impact of different grades of BMI and WHR on left ventricular myocardial performance index in normal men. Method: 82 normal male subjects were involved in this study. The subjects were divided as per BMI groups into group Ia (BMI= 20-24.9, n=34, mean age 32.315±10.179 as a control group) and group IIa (BMI= >24.9, n=44, mean age 38.181±11.501); as well as, by dividing the subjects in to two groups according to Waist-Hip ratio, group Ib (WHR <0.8-0.9, n=45, mean age 31.8±8.91) and group IIb (WHR >0.9, n=37, age 39.918±12.239). MPI was determined in all these subjects using the formula proposed by Tie as MPI=IVCT+IVRT/ET. Results: There were statistically no significant variations in MPI with increased BMI (p>0.05) or WHR (p>0.05). There was no linear correlation between MPI and BMI (r= 0.0023), and MPI and WHR (r=0.0007). Conclusion: MPI is a simple and accurate tool for quantitative assessment of left ventricular functions and because of easy application, cost effectiveness, and reproducibility; it could be regarded as an important measurement in a comprehensive hemodynamic study, especially in those with increased BMI or WHR, in whom the increased BMI or WHR was found to have no effect on MPI.

خلفية الدراسة: على الرغم من استعمال مؤشر كفاءة البطين الأيسر كقياس حساس لمعرفة كفاءة البطين الأيسر,القليل من المعلومات متوفرة فيما إذا كان هذا المؤشر يتأثر بزيادة مؤشر كتلة الجسم أو زيادة نسبة الخصر إلى الورك.الهدف من الدراسة: تحرّت الدراسة الحالية عن تأثير الدرجات المختلفة لمؤشر كتلة الجسم ونسبة الخصر إلى الورك على مؤشر كفاءة البطين الأيسر في الرجال الطبيعيين.الطريقة: الدراسة تضمنت 82 متبرع من الذكور الطبيعيين, قسّموا حسب دليل كتلة الجسم إلى مجموعتين, مجموعة 1أ (مؤشر كتلة الجسم 20-24,9, العدد=34, متوسط العمر=32,315±10,179) ومجموعة 2أ (مؤشر كتلة الجسم أكثر من 24,9, العدد= 44, متوسط العمر=38,181±11,501). كذلك قسموا إلى مجموعتين حسب نسبة الخصر إلى الورك, مجموعة 1ب (نسبة الخصر إلى الورك= اقل من 0,8 إلى 0,9, العدد=45, متوسط العمر=31,8±8,91 ) و مجموعة 2ب (نسبة الخصر إلى الورك= اكثرمن0,9, العدد=37, متوسط العمر=39,918±12,239).النتائج: إحصائيا لا توجد هناك اختلافات معنوية بين مؤشر كفاءة البطين الأيسر مع زيادة مؤشر كتلة الجسم أو نسبة الورك إلى الخصر. كذلك لاتوجد هناك علاقة خطية بين مؤشر كفاءة البطين الأيسر مع مؤشر كتلة الجسم أو نسبة الورك إلى الخصر. الاستنتاج: مؤشر كفاءة القلب أداة بسيطة ودقيقة للتقييم الكمي لوظائف البطين الأيسر,وبسبب التطبيق السهل لهذا المؤشر لذا يمكن استخدامه في دراسات جهاز الدوران الشاملة خصوصا أولئك الذين لديهم زيادة في مؤشر كتلة الجسم أو نسبة الورك إلى الخصر حيث إن هذه الزيادة لا تؤثر بشكل ملحوظ عليه.


Article
Detection of the Early Cardiac changes of hypertension by Echocardiography

Authors: Ramaq G. Wahbi Al-Kadi, --- Muataz F. Hussein --- Anmar S. Zaki,
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 2 Pages: 123-126
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Hypertension causes changes on the cardiac performance, and this effect is more profound on the LV where systolic high pressure is present. Patients and Methods: We studied 30 patients (14 females and 16 males of average age of 54.8±13.5) with hypertension and 20 normal individuals, the control group (age range 45.6±17.8, 11 females and 9 males). Measurements of early filling velocity E, late filling velocity A at atrial contraction and ejection fraction were taken, also isovolumetric relaxation, and contraction times and ejection times were taken. MPI myocardial performance index was calculated. Results: Results shows a significant increase in the isovolumetric relaxation time IRT (30%),were IRT for the patients group was(105.4±20.8)compared to(73±6.86) for the normal group. The late velocity A (42%), were A for the patients group was (89.28±18) compared to (51.1±18) for the normal group. Ejection time ET (26%), were ET (438.2±88) for the patients group compared to (324±34) for the normal group. And the ratio A/E (41%), were A/E for patients group (1.33) compared to (0.78) for the normal group. While no significant change was observed on ejection fraction (EF %), isovolumetric contraction time (ICT), early velocity E, and myocardial performance index (MPI). Conclusion: Diastolic function impairment was found to occur earlier than systolic function impairment in hypertensive patients.


Article
The Use of Myocardial Performance Index (Mpi)in Assessment of Heart Function

Authors: M-ALsaynee السايني --- F. Salim سالم --- Basil N. Saeed باسل نجيب سعيد --- L.-Sunbul سنبل
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2009 Volume: 5 Issue: 1 Pages: 62-65
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Ejection fraction have been used frequently for assessment of the left ventricular function, but can be associated with errors in which myocardial performance index have been used as another parameter to measure the left ventricular function.Objective: selecting another echocardiography parameter for the assessment of myocardial in function instead of the ejection fraction.Methods: 160 patients referred to the echocardiogram unit from the period december 2007 to august 2008 requesting assessment of left ventricular function. After clinical examination, routine blood tests; chest x-ray and electrocardiographic recording have been completed. All patients informed to come for this unit after the first visit monthly for three successive months. For the purpose of comparison (30) thirty volunteers admitted to this study as control having same age range. The (160) patients were categorized into two groups.Group (A) includes (70) patients with ischemic heart disease with complications like pulmonary oedema, myocardial infarction, recent admission to coronary care unit because of recurrent severs chest pain. Group (B) includes (90) patients with ischemic heart disease without any of the above complications. Myocardial performance index is done by using the four chambers view and pulse wave and curser along the mitral inflow of the blood jet.Results: Assessment of left ventricular function by using the myocardial performance index in group A was more significant than using the ejection fraction in comparison to the control group (P value 0.02, 0.03 respectively) the same was found in group B in comparison to control group (P value 0.01; 0.05 respectively).Conclusion The myocardial performance index (MPI) in the control groups was 0.44-0.36 MS indicating that its range is very narrow in the control group, The (MPI) in the two groups of patients was high in comparisons with control group.

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