RESUMEN
Purpose of this study was to assess if the isovolumic index (IVI%) was able to detect the presence of critical coronary artery disease (CAD) in a group of 43 patients with anginal chest pain and normal left ventricular volumes and ejection fraction. The left ventricular function was before evaluated with invasive method and then the IVI% was allowed in every patient. The IVI% was able to recognize early abnormalities of isovolumetric phases of the left ventricle and differentiated normal subjects (IVI% = 40.07 +/- 2.82) from patients with CAD (IVI% = 60.87 +/- 12.49; p less than 0.01). The only parameter of left ventricular function invasively calculated able to separate normal patients from patients with significant CAD were the muscular stiffness of the left ventricle (p less than 0.01).
Asunto(s)
Enfermedad Coronaria/diagnóstico , Volumen Sistólico , Enfermedad Coronaria/fisiopatología , Femenino , Humanos , Masculino , Contracción MiocárdicaRESUMEN
Nine patients, 7 males, 2 females, mean age 36 years, with myotonic muscular dystrophy who had no cardiac symptoms underwent M-mode echocardiography (e.), systolic time intervals (STI) measurement by simultaneous recordings of the electrocardiogram, phonocardiogram and carotid arterial pulse, and single-pass radionuclide angiocardiography (RNA) in order to assess the left ventricular function. The ejecting phase indexes measured by echocardiography (fractional shortening, mean velocity of circumferential fiber shortening) were slightly depressed in 1 case and an abnormal PEP/LVET ratio was found in 3 cases. The ejection fraction measured by radionuclide angiocardiography was abnormal in 1 case who showed a diffuse hypokinesia. The IVI%, a new isovolumic phase index obtained by echocardiography, was abnormal in all patients. It is concluded that the IVI% seems more sensitive than the ejecting phase indexes calculated by echocardiography or radionuclide angiocardiography and the PEP/LVET ratio in detecting abnormalities of left ventricular function in patients with myotonic muscular dystrophy and no clinical signs of heart disease.
Asunto(s)
Gasto Cardíaco , Distrofias Musculares/fisiopatología , Contracción Miocárdica , Volumen Sistólico , Adolescente , Adulto , Angiocardiografía , Ecocardiografía , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
We report the case of a 45-year-old man with acquired aortic regurgitation and anomalous origin of the left circumflex coronary artery from the pulmonary artery.
Asunto(s)
Anomalías de los Vasos Coronarios/diagnóstico , Insuficiencia de la Válvula Aórtica/fisiopatología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Thirteen patients with atrial septal defect (ASD), 12 ostium secundum type, 1 ostium primum type and left-to-right shunt were studied by M-mode and two-dimensional echocardiography and then by intravenous contrast study. Diagnostic confirmation was obtained in 12 cases by cardiac catheterization and angiocardiography. The purpose of the study was to assess the value of contrast echocardiography in the diagnosis of ASD without pulmonary hypertension, since it is known that the standard echocardiographic investigation is rather unsatisfactory in this type of malformation. M-mode echocardiography with contrast injection has been diagnostic in 12 cases (92.3%), by visualising contrast echos in the mitral tunnel. The overall reliability of the two-dimensional contrast-echocardiography was reduced in our cases by a fairly high number of inaccurate results. The right to left shunting of injected contrast does not seem to depend on the haemodynamic parameters considered, such as right atrial pressure, right ventricular end-diastolic pressure, pulmonary artery pressure, and pulmonary arteriolar resistance.
Asunto(s)
Ecocardiografía , Defectos del Tabique Interatrial/diagnóstico , Adulto , Anciano , Niño , Femenino , Defectos del Tabique Interatrial/fisiopatología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Frequency and importance of secondary pauses (SP) following termination of high rate artrial pacing were evaluated in 64 patients. The maximal values of the first 10 post-pacing cycles, resulting from series of pacing between 70/min--160/min, were compared with the normal post-pacing values of Benditt. SP were present in 1 case (4%) of 23 patients without electrocardiographic signs of sinus node dysfunction (SDF), but in 21 cases (51%) of 41 patients with SDF (p less than 0.01). SP were more frequent in patients with SA-Block and/or sinus pauses (64%) and with bradycardia-tachycardia-syndrome (60%), whereas were more rare (35%) in patients with sinus bradycardia only. Patients with SDF and SP did not significantly differ from patients with SDF without SP concerning absolute and corrected sinus node recovery time, basal heart rate, reduction of cycle length after atropine, abnormal reactions to carotid sinus pressure and frequency of syncopes. In 1 patient SP, present in basal conditions, were not evident after atropine. SP could be interpreted as indication of SDF and should always be searched for because it may be the only evidence of SDF after atrial pacing; therefore SP may reduce the frequency of false negative tests after rapid atrial pacing. Possibly, vagal mechanisms are involved.