145 Index of subjects A accessory pathways 3 amiodarone 4, 5, 6, 23, 30, 97, 102 angina pectoris 4, 24, 1l0, 137, 139, 140 angulation, of cavity 73, 74 aorta aortic flow velocity 2 aortic insufficiency 123 aortotomy 118 aorto-ventriculoplasty 118 arrhythmia ambulatory ECG-monitoring 4, 22 and clinical relevance 21 classification of 22, 23 and prognosis 21 and sudden death 21 supraventricular 26 ventricular 21 ASH (asymmetric septal hypertrophy) 2, 9, 10, 45, 46, 72, 93, 133 atrium atrial contribution LV filling 81, 82, 85 atrial dependency 82 atrial drive, loss of 3, 83, 89, 90, 93 atrial fibrillation 3, 90, 94 atrial hyperfunction 87 atrial kick 90 atrial pacing, right 78, 79 atrial pump failure 89, 90, 91 atrioprotection 90, 91 atrioventricle 73, 80, 92, 93, 94 AV block 108 A V nodal rhythm 90 B backpressure effect 90 beta blockade 4, 22, 58, 72 'complete' 29 effect on ventricular tachycardia 30 treatment with 101, 116 boosterpump 80 Brockenbrough phenomenon 55, 125 C calcium-antagonists 5 and diastolic function 58 treatmant with 101, 102, 116 calcium channel blockers, see: Calciumantagonists calcium overload 56, 57, 102, 110 calculations of outflow resistance 60 pressure-volume loops 65 volume 60 wall thickness 60 carbon-ll 33, 37, 38 cardiac index 77, 79 cardioplegia 119 cardioversion 5 carotid pulse 105, 106 catheter entrapment 1 catheterization 59, 72, 90, 108, 109 cavity angulation 73, 74, 92 geometry 73 left ventricular 53 size 81,94 chest X-ray 105 clinical course 93 clinical implications 93 compliance, left ventricular 57,81,88,94 complications peri-operative 126, 127 post-operative 125 treatment of 5, 6 computer calculations 61
146 systems 33, 35, 60 concepts, hemodynamic 71 congestive cardiomyopathy 35, 36, 38, 43, 44, 45 congestive heart failure, see: Heart failure contractility 53, 57, 67 contraction, incoordinate 74 coronary artery diameter 108, 110 artery disease 33, 35, 36, 42, 46, 49, 57, 137 intramyocardial arteries 138 blood flow 34, 35, 37 vascular reserve 55 D death causes of 28 sudden, see: Sudden death diastolic function 4, 56, 135, 136 diastolic pressure-volume relation, see: Pressure digitalis 5 distensibility left ventricular 136 dizziness 4, 24 dysfunction (ventricular) global 75 regional 53, 75 dyspnea 4, 109, 110, 140 on exertion 104, 139 E electrocardiogram predictive value of 26 echocardiography 9, 72, 73, 106 echo-density 12 M-mode 9, 12, 15, 17, 18, 19 measuring in 9 and motion, active/passive 17 and septal deformity 13 septal-free wall ratio 9 two-dimensional 10, 11, 15, 17, 19,26 ejection dynamics 72, 73 ejection fraction 1,40,41,42,43,47,48,75,76 ejection pattern 53 elasticity 57 embolism 5 emptying, defective 76 end-diastolic pressure, see: Pressure end-diastolic volume, see: Volume endocarditis, infective 3, 6 bacterial 123 exercise 79 electrocardiography and 36 rationuclide angiography and 42, 49 thallium-201 imaging and 35, 36, 46 F filling capacity 81 characteristics 136 diastolic 66, 136 defective 76 dynamics 72, 73 intra-diastolic exchange of 95 pattern 58 pressure 108, 136, 138 rate 66, 136 first-pass radionuclide angiography 39, 40, 41, 42 fourth heart sound 90 free fatty acids 33,37,38,39,49 function, global cavity 75 left ventricular, see: Ventricular myocardial 59 fusion of non-uniformity 96, 97 G gamma camera 34, 35, 39,40 gated radionuclide angiography 40-49 geometry and ventricular function 73 gradient, see: Pressure H heart failure, congestive 6, 89, 94 hearttransplantation 118 heart volume in HeM 103, 105, 107, 110 hemodynamic concepts 73 hyperplasia, intimal 138 hypertrophy of anterior septum 135 concentric 133 distribution of 135 left ventricular 102, 104, 110, 138 media 138 patterns of 133, 134, 135 types of 10 hypertrophic cardiomyopathy 1,21,36,44,45, 46,47,48,49,53,71, 101, 115, 133 cardinal feature of 72, 92 characteristics of 101, 102, 133 identity of 80, 92 symptoms 103, 139 types of 116
147 Iodine-123 33,37,38 Iodine-123, free fatty acids 33, 37, 38, 39, 46 Iodine-123, heptadecanoid acid 38, 46 incoordinate contraction 75 incoordinate relaxation 57, 58, 66, 75 inflow resistance 93, 94 inflow restriction 72 inflow tract 80 L left atrial activity 72 left atrial dilatation 82 left atrial hypertrophy 82 left ventricular function, see: Ventricular function M management 3 mechanisms of pathophysiology, see: Pathophysiology metabolism 37, 38, 39 metabolic clearance rates 38, 39 mitral insufficiency 54, 61, 66, 119, 122, 123, 124 mitral regurgitation 6, 15, 66, 123 mitral-septal contact 75, 77, 93, 139 mitral valve 75 calcification of 6 infection of 6 replacement of 6, 123, 124, 140 monitoring electrocardiographic 4 morphology in HCM 73 mortality 2, 109 peri-operative 123, 124 hospital 125, 128 murmur systolic 6 myectomy trans-aortic 124 myocardium myocardial blood flow 55 myocardial function 59 myocardial ischemia 55, 135, 137, 138, 140 myocardial necrosis 137 myocardial perfusion 133 myocardial scarring 137 myocardial thickening 53, 133 myotomy-myectomy 21, 109, 120, 121, 127, 129, 139, 140 N nifedipine 5 and diastolic function 5 and vasodilatation 5 daily dosage 5, 102 non-uniformity 56,57,66,95,96 o obstruction 1, 2 definition of onset of 61 functional determinants of 94 hemodynamic significance of 72, 77 index of 9 morphologic determinants of 94 onset of 54 of outflow tract 53, 135, 138 relief of 77 time of 77 true obstruction to outflow 1, 54, 76, 77, 138, 139 operation in HCM, see: Surgery outflow tract 1, 53 narrowing of 10, 53 obstruction of 138 pressure gradient, see: Pressure resistance of 60 size of 75 p pacemakers, in treatment of 6 pathophysiology mechanisms of 133, 135, 140 pressure end-diastolic 77, 79, 87 gradient 53, 72, 78, 87, 93, 102, 108, 109, 110, 119, 125, 126, 139 left ventricular 59 measurement of 59 post a wave 85 post-extrasystolic 125 pre a wave 85 transmission 89 pressure pump, left atrium as 81, 89 pressure-volume curve 88 pressure-volume loop 64, 65, 87 pressure-volume relationship 53, 60, 87, 136 prognosis 2 propranolol 4, 22, 23, 77, 78, 80, 81, 109, 128, 129 and atrial activity 86, 87, 90 dosage of 109
148 effect on diastolic PV relation 95 effect on heart rate 94 effect on PV loop 95 and sudden death 94 effect on exercise-induced tachycardia 94 pulmonary congestion 105, 109, 139, 140 edema 90 embolism 124 fribrosis 4 hypertension 89, 90 R radionuclide angiography 39-49, 136, 137 relaxation global 3 and inactivation 56 incoordinate 57, 66, 75, 95 left ventricular 56, 110, 136 and loading 56 and non-uniformity 56, 66, 95 prolonged 57 regional 3 and diastolic wall stress 58 resistance to inflow 93, 94 restrictive cardiomyopathy 44, 45 S SAM (systolic anterior motion) 2, 13, 53, 54, 72, 77, 135 sarcoplasmic reticulum 57 septal deformity 73, 75 distortion 75 excursion 9 septal/free wall ratio 9, 12 morphology 72 pathology 73, 74 resection 5 septal shift 17 site, size, shape of 75 thickening 9, 10, 18 thickening rate 10, 17 thickness 9, 15, 17 Simpson's rule 60 strain definition 57 rate 58 stress calculation of 60 definition of 57 stress-strain relationship 53, 57, 58, 60, 61, 65, 66 stroke index 77, 79 sudden death 2, 3, 21, 24, 26, 27, 72, 116 age 21, 27, 94 arrhythmia 21 causes of 3 prevention of 29 protection against 94 and surgery 97 supraventricular tachycardia, see: Tachycardia surgery 72, 97, 109, 115, 140 indications 116 and longevity 110 management 117 technique 119 treatment 122 syncope 5, 21, 24, 139, 140 T tachycardia supraventricular 23, 25 ventricular 4, 23, 24, 25, 26, 28, 30 technetium-99m 39, 40 thallium-201 34, 35, 36, 37, 43, 45, 46, 49 trans-aortic approach 117, 121 V ventricular arrhythmia 22 fibrillation 3 function: left ventricular 39, 48, 49, 53, 59, 71, 73 right ventricular 40, 43, 45 inflow 87, 92 performance 79 volume calculations of 60 end-diastolic 76, 81, 85, 88 ventriculo-aortic prosthesis 118 ventriculomyotomy 117 Venturi effect 13, 135 verapamil adverse effects 95 dosage of 102, 108 effects on: acute hemodynamics 82 end-diastolic LV compliance 94 electrocardiogram 104 diastolic filling 95, 136 diastolic PV relations 89, 95, 96 end-diastolic pressure 88
149 obstruction 77, 78 effects on: pressure gradient 61, 108, 109 systolic pressure 88 exercise capacity 136 and heart volume 105 infusion of 60 negative chronotropic action of 58 negative inotropic action of 58, 65, 66, 79 plasma levels 103 side effects of 108 therapy with 102, 128 vasodilating effect 58, 65, 95 W wall mass 60 wall stress 57, 59 calculation 60 changes of 60 curves of 62, 63 diastolic 58 end-systolic 57 measurement of 61, 63 systolic 53, 55 types of 61, 62 wall thickness 60, 106