الفهرس 
Nvestigations of vsdOnly 14 pages are availabe for public view
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Abstract
The present study was designed to evaluate cardiac changes in the
left ventricle of 30 patients with VSD. by MPI (Tei index). They were
divided into (group 1) (20 patients with VSD only. and (group 2) 10
patients with VSD. and pulmonary hypertension).
(group 3) 10 healthy children were taken as control group.
All patients were subjected to full history taking, full clinical
examination, X-ray, Electrocardiogram, Echocardiography.
The children with VSD was investigated by echocardiography by
M-Mode to obtain the best estimation of measurements of left ventricle
chamber and have proven effective in assessing left ventricular mass. But
only records a very small portion of the left ventricle. So the technique is
only accurate when measuring left ventricles of symmetrical shape.
In our study the Doppler technique was done to measure
myocardial performance index (MPI) or (Tei index).
Myocardial performance index (MPI) is a simple and accurate tool
for quantitative assessment of right and left ventricular functions and
because of easy application and reproducibility, it could be regarded as an
important measurement in a comprehensive hemodynamic study,
especially in those with abnormal ventricular geometry.
The myocardial performance index (MPI) is a simple, quantitative,
nongeometric index of ventricular function that is readily applicable to
the study of LV function as well as the assessment of distorted ventricular
morphologies present in congenital heart disease. The Doppler- derived
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Summary and Conclusion
index independent on the heart rate and is easily reproducible in chidren
and adults because it measures relatively large time intervals.
There was statistical significant difference between the three
groups as regarding weight, where G2 was less than G1 and G3. The
weight in patients with VSD and pulmonary hypertension were failing to
thrive.
There were statistical significant difference between the three
groups as regarding length, where G2 was shorter than G1 and G3 as the
growth retardation is already present in more than 80% of patients with of
VSD and pulmonary hypertension.
The main clinical symptoms and signs namely shortness of
breathing, excessive sweating, repeated chest infection, failing to thrive,
Presence of thrill and pansytolic murmur. These were increased in G2
more than G1. This was expected as the function of left ventricle in
patients of (G2) was more worse than (G1).
The mean Tei index was not affected by the age of patients in G1.
The patients of G2 can’t be evaluated regarding to age, because of small
number of patients, however in this group the Tei index was not affected
by age.
The control group (G3) can’t be evaluated regarding to age,
because of small number of (G3), however the Tei index showed a
progressive reduction from birth up to the age of 2 years, then it showed
no further changes in children older than 2 years.
There was no statistical significant difference between patients of
G1 and G3 regarding to echo measurements.
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Summary and Conclusion
There was statistical significant difference in patients of G2 when
compared with G3 as regard echo measurements.
That there was significant difference between G1 and G2 as regard
echo measurements.
There was statistical significant difference among the studied
groups, which was more significant in G2 than G1 and G3,there reflect
more complications of (G2).
There was negative correlation between Tei index and E.F. in G1.
Tei index increase when the systolic function of left ventricle decrease in
patients of V.S.D with out pulmonary hypertension, there was significant
negative correlation between Tei index, E.F in G2
There was statistical significant difference between G1 and G3,
regarding to a, b value.
There was statistical significant difference between patients of G2
when compared with G3 regarding to a, b value.
There was no statistical significant difference between G1 and G2
regarding to a,b value.
There was only significant positive correlation between Tei index
when compared with (G1) related to LVEDD.
There was statistical significant difference between the Tei index
and echo measurements in patients of G2.