Mitral annular velocity in early diastole(E') gradually decreases following exacerbation of left ventricular(LV) diastolic dysfunction. Patients with an E'≤5cm/s may have LV diastolic dysfunction similar to those with the ratio of the mitral E velocity to E'(E/E')≥15. An E/A>1 obtained by Doppler evaluation of transmitral inflow is considered to indicate greater LV diastolic dysfunction, if E' is low. This study was designed to investigate whether echocardiographic Doppler studies predict the development of heart failure(HF). The present study group comprised 159 subjects of 2040 underwent echocardiographic studies who had an E'≤5cm/s, normal systolic function and sinus rhythm. Subjects were divided into 2 groups based on whether they had evidence of heart failure during 18 months follow-up(HF group and non-HF group). Eleven percent of the subjects were in HF group. Twenty five percent of the subjects with an E/E'≥15 were in HF group, as were 32% of those with an E/A>1. Furthermore, subjects with an E/E'≥15 and an E/A>1 had a higher incidence(5 of 11 patients, 45%) of heart failure. Tissue Doppler and pulse Doppler studies may provide useful information about whether patients with preserved LV systolic function are susceptible to developing heart failure in the elderies.
Left ventricular free wall rupture is usually sudden and fatal. We report our experience with impending blowout rupture diagnosed by Computed Tomography(CT) and treated by sutureless repair. A 70-year-old female was admitted with a diagnosis of acute myocardial infarction. An echocardiography confirmed cardiac rupture of oozing type. However, meticulous examination of CT revealed impending blowout rupture with left ventricular defect. Then, she underwent emergency sutureless repair with cardiac arrest using cardiopulmonary bypass. Her postoperative course was uneventful.