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ABSTRACT: To elucidate left ventricular function in pulmonary hypertension, we measured parameters of left ventricular as well as right ventricular function by echocardiography in 11 patients with pulmonary hypertension (idiopathic pulmonary artery hypertension in 4, chronic thromboembolic pulmonary hypertension in 5, and other pulmonary hypertension in 2). The percent change in these parameters 6 months after treatment with pulmonary artery vasodilators (beraprost in 8 and sildenafil in 3) was assessed. There was a correlation between the relative change in right ventricular systolic pressure (RVSP) and the relative changes in left ventricular outflow tract velocity-time integral (r = -0.730, P = 0.011) and mitral valve velocity-time integral (r = -0.621, P = 0.041). However, there was no correlation between the relative change in RVSP and the relative changes in left ventricular ejection fraction, left ventricular diastolic dimension, and systolic blood pressure. The relative change in RVSP was also correlated with the relative change in early diastolic myocardial velocity at the medial mitral annulus (r = -0.675, P = 0.023). Reduction of RVSP by pulmonary artery vasodilators might increase left ventricular preload, leading to an increase in stroke volume. Right ventricular load reduction might improve left ventricular diastolic function in patients with pulmonary hypertension, possibly through altered interventricular septal performance.
Heart and Vessels 11/2012; · 2.05 Impact Factor
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ABSTRACT: A 65-year-old woman who had previously undergone aortic root replacement with a bioprosthetic valve (Bentall operation) in treatment of annuloaortic ectasia became feverish after developing dental caries and was admitted to our hospital. Transesophageal echocardiography showed an 18 × 4-mm vegetation on her prosthetic valve. Campylobacter fetus was isolated on blood cultures, and she was diagnosed with infectious endocarditis. Aggressive combined antibiotic treatment was effective for her recovery. C. fetus infection is a rarely reported cause of prosthetic valve endocarditis.
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital 01/2011; 38(5):584-7. · 0.65 Impact Factor
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ABSTRACT: Ischemic mitral regurgitation (MR) is a serious complication after myocardial infarction, and the incidence of heart failure (HF) increases as the severity of MR increases. However, little is known about the relationship between mild MR and HF in the patients with old myocardial infarction (OMI) and a normal ejection fraction (EF).
We hypothesized that a combination of mild MR and impaired distensibility of the left ventricle may increase the risk of diastolic HF in the patients with OMI and a normal EF.
The relationship between HF and mild MR was retrospectively investigated in 62 patients with OMI and EF of > 50% on echocardiography.
Of the 62 patients, 47 (76%) did not have HF and 15 (24%) had HF. There was a significant difference in the incidence of mild MR between the patients with and without HF (p < 0.0001): of the 47 patients without HF, mild MR was detected in 19, but all 15 patients with HF had mild MR. However, there were no significant differences in age, gender, infarct sites, diseased coronary vessels, peak CK level, and observation period between the 2 groups. An increased E-wave and the ratio of the E-wave to the A-wave (E/A), a reduction of the E-wave deceleration time, and an increased brain natriuretic peptide (BNP) level were significantly noted in HF patients with mild MR compared with patients without HF.
Even a mild MR may cause diastolic HF in patients with impaired distensibility of the left ventricle due to ischemic heart disease.
Clinical Cardiology 12/2008; 31(12):567-71. · 2.15 Impact Factor
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ABSTRACT: Right coronary artery to left ventricle fistula is a rare type of coronary artery fistula among congenital coronary artery anomalies. Most patients exhibit no symptoms and some experience chest pain. Coronary angiography sometimes detects the presence of coronary artery fistula, but not coronary arteriosclerosis. A 76-year-old man with unstable angina was admitted because he did not respond to drug therapy. Coronary angiography showed three-vessel coronary artery disease and the contrast agent entered the left ventricle from the terminal of the right coronary artery during diastole. Multidetector-row computer tomography showed similar findings. The patient subsequently underwent coronary artery bypass grafting and obliteration of the coronary artery fistula. The chest pain was relieved and he is now in good condition.
Journal of Cardiology 10/2007; 50(3):193-7. · 1.28 Impact Factor
