Global and regional mechanics of the cardiac ventricles were investigated using an anatomicallyaccurate computational model formulated from concise mathematical descriptions ofthe left and right ventricular wall geometries and the non-homogeneous laminar microstructureof cardiac muscle. The finite element method for finite deformation elasticity was developedfor the analysis and included specialised coordinate systems, interpolation schemesand parallel processing techniques for greater computational efficiency.The ventricular mechanics model incorporated the fully orthotropic pole-zero constitutivelaw, based on the three-dimensional architecture of myocardium, to account for the nonlinearmaterial response of resting cardiac muscle, relative to the three anatomically relevant axes.A fibre distribution model was introduced to reconcile some of the pole-zero constitutiveparameters with direct mechanical properties of the tissue (such as the limiting strainsestimated from detailed physiological observations of the collagen helices that surroundmyofibres), whilst other parameters were estimated from in-vitro biaxial tension tests onthin sections of myocardium. A non-invasive approach to in-vivo myocardial materialparameter estimation was also developed, based on a magnetic resonance imaging techniqueto effectively tag ventricular wall tissue.The spatially non-homogeneous distribution of myocardial residual strain was accounted forin the ventricular mechanics model using a specialised growth tensor. A simple model of fluidshift was formulated to account for the changes in local tissue volume due to movement ofintramyocardial blood. Contractile properties of ventricular myofibres were approximatedusing a quasi-static relationship between the fibre extension ratio, intracellular calciumconcentration and active fibre stress, and the framework has been developed to include amore realistic model of active myocardial mechanics, which could be coupled to a realisticdescription of the time-varying spread of electrical excitation throughout the ventricularwalls. Simple volumetric cavity models were incorporated to investigate the effects of arterialimpedance on systolic wall mechanics.Ventricular mechanics model predictions of the cavity pressure versus volume relationships,longitudinal dimension changes, torsional wall deformations and regional distributions ofmyocardial strain during the diastolic filling, isovolumic contraction and ejection phasesof the cardiac cycle showed good overall agreement with reported observations derivedfrom experimental studies of isolated and in-vivo canine hearts. Predictions of the spatialdistributions of mechanical stress at end-diastole and end-systole are illustrated.

Global and regional mechanics of the cardiac ventricles were investigated using an anatomicallyaccurate computational model formulated from concise mathematical descriptions ofthe left and right ventricular wall geometries and the non-homogeneous laminar microstructureof cardiac muscle. The finite element method for finite deformation elasticity was developedfor the analysis and included specialised coordinate systems, interpolation schemesand parallel processing techniques for greater computational efficiency.The ventricular mechanics model incorporated the fully orthotropic pole-zero constitutivelaw, based on the three-dimensional architecture of myocardium, to account for the nonlinearmaterial response of resting cardiac muscle, relative to the three anatomically relevant axes.A fibre distribution model was introduced to reconcile some of the pole-zero constitutiveparameters with direct mechanical properties of the tissue (such as the limiting strainsestimated from detailed physiological observations of the collagen helices that surroundmyofibres), whilst other parameters were estimated from in-vitro biaxial tension tests onthin sections of myocardium. A non-invasive approach to in-vivo myocardial materialparameter estimation was also developed, based on a magnetic resonance imaging techniqueto effectively tag ventricular wall tissue.The spatially non-homogeneous distribution of myocardial residual strain was accounted forin the ventricular mechanics model using a specialised growth tensor. A simple model of fluidshift was formulated to account for the changes in local tissue volume due to movement ofintramyocardial blood. Contractile properties of ventricular myofibres were approximatedusing a quasi-static relationship between the fibre extension ratio, intracellular calciumconcentration and active fibre stress, and the framework has been developed to include amore realistic model of active myocardial mechanics, which could be coupled to a realisticdescription of the time-varying spread of electrical excitation throughout the ventricularwalls. Simple volumetric cavity models were incorporated to investigate the effects of arterialimpedance on systolic wall mechanics.Ventricular mechanics model predictions of the cavity pressure versus volume relationships,longitudinal dimension changes, torsional wall deformations and regional distributions ofmyocardial strain during the diastolic filling, isovolumic contraction and ejection phasesof the cardiac cycle showed good overall agreement with reported observations derivedfrom experimental studies of isolated and in-vivo canine hearts. Predictions of the spatialdistributions of mechanical stress at end-diastole and end-systole are illustrated.

Global and regional mechanics of the cardiac ventricles were investigated using an anatomicallyaccurate computational model formulated from concise mathematical descriptions ofthe left and right ventricular wall geometries and the non-homogeneous laminar microstructureof cardiac muscle. The finite element method for finite deformation elasticity was developedfor the analysis and included specialised coordinate systems, interpolation schemesand parallel processing techniques for greater computational efficiency.The ventricular mechanics model incorporated the fully orthotropic pole-zero constitutivelaw, based on the three-dimensional architecture of myocardium, to account for the nonlinearmaterial response of resting cardiac muscle, relative to the three anatomically relevant axes.A fibre distribution model was introduced to reconcile some of the pole-zero constitutiveparameters with direct mechanical properties of the tissue (such as the limiting strainsestimated from detailed physiological observations of the collagen helices that surroundmyofibres), whilst other parameters were estimated from in-vitro biaxial tension tests onthin sections of myocardium. A non-invasive approach to in-vivo myocardial materialparameter estimation was also developed, based on a magnetic resonance imaging techniqueto effectively tag ventricular wall tissue.The spatially non-homogeneous distribution of myocardial residual strain was accounted forin the ventricular mechanics model using a specialised growth tensor. A simple model of fluidshift was formulated to account for the changes in local tissue volume due to movement ofintramyocardial blood. Contractile properties of ventricular myofibres were approximatedusing a quasi-static relationship between the fibre extension ratio, intracellular calciumconcentration and active fibre stress, and the framework has been developed to include amore realistic model of active myocardial mechanics, which could be coupled to a realisticdescription of the time-varying spread of electrical excitation throughout the ventricularwalls. Simple volumetric cavity models were incorporated to investigate the effects of arterialimpedance on systolic wall mechanics.Ventricular mechanics model predictions of the cavity pressure versus volume relationships,longitudinal dimension changes, torsional wall deformations and regional distributions ofmyocardial strain during the diastolic filling, isovolumic contraction and ejection phasesof the cardiac cycle showed good overall agreement with reported observations derivedfrom experimental studies of isolated and in-vivo canine hearts. Predictions of the spatialdistributions of mechanical stress at end-diastole and end-systole are illustrated.

Global and regional mechanics of the cardiac ventricles were investigated using an anatomicallyaccurate computational model formulated from concise mathematical descriptions ofthe left and right ventricular wall geometries and the non-homogeneous laminar microstructureof cardiac muscle. The finite element method for finite deformation elasticity was developedfor the analysis and included specialised coordinate systems, interpolation schemesand parallel processing techniques for greater computational efficiency.The ventricular mechanics model incorporated the fully orthotropic pole-zero constitutivelaw, based on the three-dimensional architecture of myocardium, to account for the nonlinearmaterial response of resting cardiac muscle, relative to the three anatomically relevant axes.A fibre distribution model was introduced to reconcile some of the pole-zero constitutiveparameters with direct mechanical properties of the tissue (such as the limiting strainsestimated from detailed physiological observations of the collagen helices that surroundmyofibres), whilst other parameters were estimated from in-vitro biaxial tension tests onthin sections of myocardium. A non-invasive approach to in-vivo myocardial materialparameter estimation was also developed, based on a magnetic resonance imaging techniqueto effectively tag ventricular wall tissue.The spatially non-homogeneous distribution of myocardial residual strain was accounted forin the ventricular mechanics model using a specialised growth tensor. A simple model of fluidshift was formulated to account for the changes in local tissue volume due to movement ofintramyocardial blood. Contractile properties of ventricular myofibres were approximatedusing a quasi-static relationship between the fibre extension ratio, intracellular calciumconcentration and active fibre stress, and the framework has been developed to include amore realistic model of active myocardial mechanics, which could be coupled to a realisticdescription of the time-varying spread of electrical excitation throughout the ventricularwalls. Simple volumetric cavity models were incorporated to investigate the effects of arterialimpedance on systolic wall mechanics.Ventricular mechanics model predictions of the cavity pressure versus volume relationships,longitudinal dimension changes, torsional wall deformations and regional distributions ofmyocardial strain during the diastolic filling, isovolumic contraction and ejection phasesof the cardiac cycle showed good overall agreement with reported observations derivedfrom experimental studies of isolated and in-vivo canine hearts. Predictions of the spatialdistributions of mechanical stress at end-diastole and end-systole are illustrated.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Dexamethasone is a drug belonging to the class of corticosteroids, mostly used as an anti-inflammatory. In excess or in indiscriminate chronic use can lead to endocrine and / or cardiovascular complications. Physical exercise can act in the treatment of these diseases by acting as an attenuator or in some cases, reversing some of these complications, allied to traditional drug treatment. Thus, the purpose of this dissertation was: to evaluate the effect of a resistance exercise program on the heart and ventricles in animals submitted to dexamethasone treatment for four weeks. It was detected that aerobic or resistance training is capable of promoting improvements in patients in chronic use of glucocorticoids as a decrease in hyperglycemia, hypertension and improvements in cardiovascular indexes. For the experiments, forty male Wistar rats were selected and divided into four groups. The absolute heart and absolute and dry weight of the left and right ventricles were evaluated. It was verified that the strength exercise associated with dexamethasone (0.2 mg.kg-1.dia-1) did not significantly alter the absolute heart weight and absolute and dry weight of the right ventricle. There was a significant difference in the dry weight of the left ventricle that when normalized by the tibia length ceased to exist. This results suggest that exercise may be effective with some effects arising from the use of glucocorticoids and that four weeks of exercise associated with dexamethasone are not able to change the absolute and dry weight of the heart and ventricles. / A dexametasona é um fármaco pertencente à classe dos corticosteroides, majoritariamente utilizado como anti-inflamatório. Em excesso ou em uso crônico indiscriminado pode levar a complicações endócrinas e/ou cardiovasculares. O exercício físico pode atuar no tratamento dessas enfermidades atuando como um atenuador ou em alguns casos, reverter algumas dessas complicações, aliado sempre ao tratamento medicamentoso tradicional. Desta forma, o objetivo desta dissertação foi: avaliar o efeito de um programa de exercícios resistidos no coração e ventrículos em animais submetidos ao tratamento com dexametasona por quatro semanas. Foi detectado que o exercício físico aeróbio ou resistido é capaz de promover melhorias em pacientes em uso crônico de glicocorticoides como diminuição da hiperglicemia, hipertensão e melhorias nos índices cardiovasculares. Para os experimentos, quarenta ratos Wistar machos foram selecionados e divididos em quatro grupos. Foram avaliados o peso absoluto do coração e peso absoluto e seco dos ventrículos esquerdo e direito. Foi verificado que o exercício de força associado ao dexametasona (0,2 mg.kg-1.dia-1) não alterou significativamente o peso absoluto do coração e peso absoluto e seco do ventrículo direito. Houve uma diferença significativa no peso seco do ventrículo esquerdo que ao normalizar pelo comprimento da tíbia deixou de existir. Os resultados sugerem que o exercício pode ser eficaz com alguns acometimentos decorrentes do uso de glicocorticoides e que quatro semanas de exercício associado a dexametasona não são capazes de alterar o peso absoluto e seco do coração e ventrículos.

La dysfonction ventriculaire gauche reste sous-diagnostiquée en pratique clinique actuelle car les paramètres conventionnels d’échographie ne sont pas suffisamment sensibles pour détecter des modifications fines de la fonction cardiaque. L’introduction récente de l’échocardiographie de suivi des marqueurs acoustiques (speckle tracking echocardiography) a permis par ses capacités descriptives de la mécanique cardiaque, de revisiter la contraction cardiaque et, de ce fait, de proposer une nouvelle approche échographique de l’évaluation de la fonction ventriculaire gauche.<p><p>A travers trois études, nous avons montré que l’analyse des indices de déformation permet d’objectiver des modifications de fonction ventriculaire gauche indétectables en échocardiographie conventionnelle dans des situations complexes à fraction d’éjection conservée, en dépit de l’augmentation modérée de la fréquence cardiaque qui leur est associée. Les situations que nous avons étudiées sont les suivantes :l’adaptation physiologique à l’hypoxie au niveau de la mer et en altitude, et les situations pathologiques que sont le syndrome de mal d’altitude chronique, et la cardiomyopathie associée à l’ataxie de Friedreich.<p><p>L’intégration de nos résultats et des informations disponibles dans la littérature permet de suggérer que l’utilisation de toutes les ressources offertes par l’échocardiographie de suivi des marqueurs acoustiques permet d’améliorer l’évaluation de la fonction cardiaque au-delà de la fraction d’éjection, en offrant une meilleure identification de situations pathologiques mais également une meilleure compréhension de situations physiologiques et pathologiques. <p><p>L’utilisation généralisée des indices de déformation pour l’évaluation de la fonction ventriculaire gauche en pratique clinique connaît néanmoins d’importantes limitations que nous abordons dans la discussion de ce travail. Au terme d’investigations complémentaires et de standardisation de la technique, l’incorporation d’un algorithme d’évaluation échographique de la fonction cardiaque à FEVG conservée combinant les paramètres échographiques conventionnels et les indices de déformation pourra être évalué de façon prospective pour sa translation en pratique clinique, avec pour finalité la proposition d’une définition mieux adaptée de l’insuffisance cardiaque à FEVG conservée.<p> / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished

BACKGROUND: Right ventricular outflow tract (RVOT) is a common source of ventricular tachycardia, which often requires ablation. However, the mechanisms underlying the RVOT's unique arrhythmia susceptibility remain poorly understood due to lack of detailed electrophysiological and molecular studies of the human RVOT. METHODS: We conducted optical mapping studies in 16 nondiseased donor human RVOT preparations subjected to pharmacologically induced adrenergic and cholinergic stimulation to evaluate susceptibility to arrhythmias and characterize arrhythmia dynamics. RESULTS: We found that under control conditions, RVOT has shorter action potential duration at 80% repolarization relative to the right ventricular apical region. Treatment with isoproterenol (100 nM) shortened action potential duration at 80% repolarization and increased incidence of premature ventricular contractions (=0.003), whereas acetylcholine (100 μM) stimulation alone had no effect on action potential duration at 80% repolarization or premature ventricular contractions. However, acetylcholine treatment after isoproterenol stimulation reduced the incidence of premature ventricular contractions (=0.034) and partially reversed action potential duration at 80% repolarization shortening (=0.029). Immunolabeling of RVOT (n=4) confirmed the presence of cholinergic marker VAChT (vesicular acetylcholine transporter) in the region. Rapid pacing revealed RVOT susceptibility to both concordant and discordant alternans. Investigation into transmural arrhythmia dynamics showed that arrhythmia wave fronts and phase singularities (rotors) were relatively more organized in the endocardium than in the epicardium (=0.006). Moreover, there was a weak but positive spatiotemporal autocorrelation between epicardial and endocardial arrhythmic wave fronts and rotors. Transcriptome analysis (n=10 hearts) suggests a trend that MAPK (mitogen-activated protein kinase) signaling, calcium signaling, and cGMP-PKG (protein kinase G) signaling are among the pathways that may be enriched in the male RVOT, whereas pathways of neurodegeneration may be enriched in the female RVOT. CONCLUSIONS: Human RVOT electrophysiology is characterized by shorter action potential duration relative to the right ventricular apical region. Cholinergic right ventricular stimulation attenuates the arrhythmogenic effects of adrenergic stimulation, including increase in frequency of premature ventricular contractions and shortening of wavelength. Right ventricular arrhythmia is characterized by positive spatial-temporal autocorrelation between epicardial-endocardial arrhythmic wave fronts and rotors that are relatively more organized in the endocardium.

No description available.

Objetivo: Alterações do metabolismo energético tem sido identificadas em processos de hipertrofia miocárdica, sendo algumas consideradas benéficas, porém outras estão associadas a insuficiência cardíaca. O objetivo deste trabalho foi comparar a atividade de três enzimas do metabolismo energético em dois protocolos de sobrecarga sistólica do ventrículo direito (VD) num modelo experimental em cabritos. Métodos: 27 cabritos jovens foram divididos em três grupos: Sham (sem sobrecarga), Contínuo (sobrecarga sistólica constante) e Intermitente (4 períodos de 12 horas de sobrecarga sistólica, intercalados com 12 horas de descanso). Durante as 96 horas do protocolo, a sobrecarga sistólica foi ajustada a fim de atingir relação de pressão entre a aorta e o VD de 0,7. Medidas ecocardiográficas e hemodinâmicas foram realizadas antes e após o período de sobrecarga diariamente até o término do protoloco. Após o término do mesmo, os animais foram sacrificados a fim de obter dados morfológicos e a atividade máxima das enzimas Glicose 6 Fosfato Desidrogenase (G6PD), Hexoquinase (HK) e Lactato Desidrogenase (LDH). Resultados: Houve aumento de 92,1% e 46,5% nas massas do VD e septal no grupo Intermitente, respectivamente, quando comparado ao grupo Sham, enquanto que no grupo Contínuo houve incremento de 37,2% somente na massa septal. O VD e Septo dos grupos submetidos à sobrecarga sistólica contínua e intermitente do VD apresentaram um aumento discreto, porém significativo, do conteúdo de água (VD, p=0,0014; Septo, p=0,0004) em relação ao grupo Sham. Ao final do protocolo, foi observado um aumento significativo de 103,8% da espessura do VD no grupo Intermitente, comparado a um aumento de 38,4% do grupo Contínuo. Houve também dilatação ventricular significativa no grupo Contínuo ao longo do protocolo, quando comparado aos outros grupos (p<0,001). Piores índices de desempenho miocárdico ocorreram no grupo Contínuo no momentos 72 e 96 horas, quando comparados ao grupos Sham (P<0,039) e Intermitente (P<0,001). A razão da atividade máxima da G6PD do VD pelo VE revelou um aumento de 130,1% no grupo contínuo (p= 0,012) e de 39,8% no grupo Intermitente (p=0,764), quando comparados ao grupo Sham. O processo de hipertrofia aguda do VD não afetou a atividade enzimática da HK e LDH nos grupos estudados. Conclusões: Apesar de haver uma sobrecarga sistólica proporcionalmente menor no VD do grupo intermitente, a bandagem intermitente do TP promoveu maior hipertrofia do VD. A maior atividade da G6PD observada no grupo contínuo sugere maior produção de radicais livres via NADPH oxidase, haja vista que o ciclo das pentoses Fosfato incrementa a disponibilidade de NADPH citoplasmático, ocasionados pela maior demanda de um estímulo de sobrecarga miocárdica constante, um importante mecanismo de insuficiência cardíaca. Este estudo sugere que a preparação do ventrículo sub-pulmonar com a sobrecarga sistólica intermitente poderá proporcionar melhor resultado para a cirurgia de Jatene em dois estágios que a sobrecarga contínua / Objective: Altered energy metabolism has been identified in myocardial hypertrophy. Some processes are considered beneficial, whereas others are linked to heart failure. The purpose of this study was to compare the activity of three different energy metabolism enzymes in two different protocols of right ventricle (RV) systolic overload in young goats. Methods: 27 young goats were separated into three groups: Sham (no overload), Continuous (continuous systolic overload) and Intermittent (4 periods of 12-hour systolic overload, alternated with a 12-hour resting period). During a 96-hour protocol, systolic overload was adjusted to achieve a 0.7 RV / aortic pressure ratio. Echocardiographic and hemodynamic evaluations were performed before and after systolic overload every day postoperatively. After the study period, the animals were humanely killed for morphological and Glucose-6-phosphate dehydrogenase (G6PD), hexoquinase (HK) and lactate dehydrogenase (LDH) activity assessment. Results: There was a 92.1% and 46.5% increase in RV and septal masses of Intermittent group, respectively, as compared to Sham group, while Continuous systolic overload resulted in 37.2% increase of only septal mass. There was a small, but significant increase in water content in RV and septum of Intermittent and Continuous groups, as compared to Sham group (RV, p=0.0014; Septum, p=0.0004). At the end of protocol, it was observed a greater increase in RV thickness (103.8%) in Intermittent group, as compared to Continous group (38.4%). There was also a significant right ventricle dilatation in Continuos group along the protocol, as compared to the other groups (p<0.001). A worsening RV myocardial performance index occurred in the continuous group at 72 hours and 96 hours, compared with the sham (P<0.039) and intermittent groups (P<0.001). Compared to Sham, RV to LV G6PD activity ratio was elevated by 130.1% in Continuous group (p= 0,012) and by 39.8% in Intermittent group (p=0.764). The acute hypertrophic process in the RV did not altered the HK and LDH enzymatic activity among study groups. Conclusions: Despite of a proportional lesser exposure to systolic overload, intermittent pulmonary trunk banding promoted greater RV hypertrophy. This study indicates that continuous systolic overload for ventricle retraining causes upregulation and hyperactivity of myocardial G6PD. Since pentose phosphate pathway enhances cytosolic NADPH availability, this altered energy substrate metabolism can elevate levels of free radicals by NADPH oxidase, an important mechanism in the pathophysiology of heart failure. It suggests that Intermittent systolic overload may provide better results for 2-stage Jatene operation as compared to continuous protocol

In dieser Studie sind die Massenvolumina und die Innenvolumina rechter und linker Ventrikel von 36 Patienten (15 Frauen und 21 Männer, im Alter zwischen 24 und 82 Jahren, mittleres Alter 54 Jahre) mittels transösophagealer Echokardiographie (TEE, HP SONOS 1500 mit einen rotierenden 5Mhz Schallkopf) und Magnetresonanztomographie (MRT, 1,5T Ganzkörper-MRT - ACS, Philips. T1-gewichtete Turbo-Gradientenecho-Sequenz) untersucht worden. Ziel ist es beide Untersuchungsmethoden auf Übereinstimmungen und Unterschiede bei Messung von Massenvolumina und Innenvolumina beider Ventrikel unter Berücksichtigung von Sinusrhythmus (26 Ventrikel) und Vorhofflimmern (18 Ventrikel) zu überprüfen. Dabei werden sowohl die Innenvolumina, die freien Wände und die Septen jeweils in der Enddiastole und in der Endsystole verglichen als auch die abgeleiteten Parameter, Ejektionsfraktionen und Schlagvolumina. Beide Methoden werden mit der Scheibchen-Summationsmethode aus jeweils vier Einzelmessungen verglichen. Die graphische und statistische Auswertung erfolgt mittels Bland-Altmann-Plot. Im T-Test für unverbundene Stichproben stellt sich kein signifikanter Unterschied zwischen linken und rechten sowie zwischen großen und kleinen Ventrikeln heraus. Es besteht ein signifikanter Unterschied zwischen Ventrikeln mit Vorhofflimmern und Sinusrhythmus, so dass wir hier einen Vergleich aufstellen. Die enddiastolischen Messungen der Innenvolumina und freien Wände zeigen deutliche Diskrepanzen der Ventrikel mit Sinusrhythmus und Vorhofflimmern - um etwa das Doppelte der Standardabweichung und des systematischen Fehlers. Die enddiastolischen Septen sind annährend gleich gut dargestellt. In der Endsystole liefern die Messungen der Innenvolumina, der freien Wände und der Septen annähernd gleiche Ergebnisse wie in der Enddiastole. Die errechneten Ejektionsfraktionen haben sowohl bei Sinusrhythmus als auch bei Vorhofflimmern gleich gut Standardabweichungen und systematische Fehler. Ähnlich verhält es sich bei den Daten der Schlagvolumina. Absolut betrachtet liefern beide volumetrischen Messmethoden bei Ventrikeln mit Sinusrhythmus und Vorhofflimmern akzeptable Ergebnisse, da die Differenzen nur wenige Milliliter betragen. / This study compares the feasibility of calculating the masses and the inner volumes the of right and left heart ventricles in 36 patients (15 female and 21 male, ages between 24 and 82 years, mean 54 years) with transesophageal echocardiography (TEE, HP SONOS 1500 with a rotating 5Mhz transducer) and cardiac MRI (1,5Tesla whole body MRI, ACS Philips with a Synergy Cardiac Coil, T1-Turbo Gradient Echo). We want to compare both methods in calculating the inner volumes, the septal and the free myocardial masses in endsystolic and enddiastolic phases as well as the ejection fraction (EF) and the stroke volume (SV) in ventricles with sinusrhythm (n=26) and with atrial fibrillation (n=18). Both methods are evaluated by a disc-summation method from a mean value of four different measurement. The statistic analysis is done with a Bland-Altmann-Plot. The T-test shows no significant difference between big and small or right and left ventricular masses, but it shows a significant difference in the measured data of ventricles with sinusrhythm and those with atrail fibrillation. A subgroup analysis is performed on the latter. The standard error of mean and the systemic mistake of the inner- and myocardial-volumes differ about double the size with ventricles in atrial fibrillation from those with sinusrhythm. The septal volumes show no differences in both subgroups. The endsystolic measurements are about equal from those in the enddiastolic phase. The EF and the SV have equal standard error of means and systemic mistakes in both subgroups of sinusrhythm and atrial fibrillation. In conclusion both methods are equally reliable in the volumetric measurement of ventricles with sinusrhythm and atrial fibrillation, because the absolute value differs just a few milliliters.