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ABSTRACT: An 80-year-old man had severe mitral regurgitation caused by myxomatous degeneration of the leaflets and perforation of the anterior leaflet. The patient underwent a transthoracic and transoesophageal echocardiographic study, and three-dimensional echo was used to reinforce the diagnosis. Modern echocardiographic techniques appear to open new horizons in the study and management of valvular diseases, although they are still a long way from replacing traditional methods.
Hellenic journal of cardiology: HJC = Hellēnikē kardiologikē epitheōrēsē 09/2012; 53(5):392-6. · 1.23 Impact Factor
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ABSTRACT: Bifocal pacing in the right ventricle is an option for patients with end-stage heart failure in whom biventricular pacing is not possible, due to failure in left ventricular (LV) lead insertion. The purpose of this prospective study was to document the clinical response of these patients, after bifocal pacing.
From the patients referred for cardiac resynchronization therapy (CRT), from 2009 to 2010, 13 cardiac CRT candidates who underwent unsuccessful LV lead implantation were included. The bifocal system's leads were implanted in the right atrium, the right ventricular (RV) apex, and the RV outflow tract. Initial patient assessment and follow-up evaluation after 6 months included clinical criteria, echocardiographic indices, and biochemical parameters.
From 13 patients (age 68 ± 9 years, nine male), 10 improved clinically. New York Heart Association classification was reduced by one grade (from 3.6 ± 0.5 to 2.8 ± 0.8, p < 0.005 and respectively), while hospitalizations in 6-month time were reduced from three to one (p < 0.001). Six-minute walk test (in meters) increased from 176 ± 86 to 297 ± 91 (p < 0.001) and quality of life improved (EQ-VAS scale changed from 42 ± 12.5 % to 70.8 ± 20.3 %, p < 0.001). Mean shortening in QRS duration was 31.3 ms (from 165.1 ± 16.3 to 133.8 ± 12.7, p < 0.001) and B-type natriuretic peptide (in picograms per milliliter) dropped from 834 ± 350 to 621 ± 283 (p < 0.001). Ejection fraction (in percent) increased from 27.5 ± 4.6 to 33.3 ± 4.4 (p < 0.001), and mitral regurgitation severity decreased by one grade (from 2.7 ± 0.9 to 1.8 ± 0.7, p < 0.05).
RV bifocal pacing seems to offer a substantial clinical benefit to heart failure patients with traditional CRT indications and could be an alternative option when LV access is unsuccessful.
Journal of Interventional Cardiac Electrophysiology 05/2012; 35(1):85-91. · 1.17 Impact Factor
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ABSTRACT: We describe a case where a mild carotid atherosclerotic plaque was assessed by contrast enhanced harmonic ultrasonography and image analysis. Quantitative indices of plaque echogenicity were determined prior and after the injection of microbubbles. Changes in plaque echogenicity were detected possibly due to the flow of microbubbles through vasa vasorum within the plaque and at the plaque base at the adventitial level. Future histological studies remain to be done to link the presence and the extent of plaque and adventitial neovascularization with the visual and quantitative findings derived by contrast enhanced harmonic ultrasound and image analysis.
International journal of cardiology 06/2008; 134(3):e110-2. · 7.08 Impact Factor
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Hellenic journal of cardiology: HJC = Hellēnikē kardiologikē epitheōrēsē 52(2):158-9. · 1.23 Impact Factor