[Show abstract][Hide abstract] ABSTRACT: Introduction and objectives
This study was performedto evaluate the feasibility and utility of a transthoracichigh frequency transducer to detect and measure the leftanterior descending coronary artery flow in patients withlesions in this artery or anterior myocardial infarction.
Material and methods
We studied 11 subjects with lesionsgreater than 75% and another 10 with anterior myocardialinfarction. We compared the results with a controlgroup of 18 subjects. An ATL HDI 5000 ultrasound unit witha 5-8 MHz transducer was used to identify the left anteriordescending in the anterior interventricular sulcus from anapical four chamber window. We considered that left anteriordescending was detected when a diastolic predominantflow pattern was obtained with pulse Doppler.
Left anterior descending was detected in 37/39of cases (94.4%). Patients with coronary lesions showed adecrease in the limit of significance in the diastolic/systolicpeak velocity ratios: 2.5 (SD 0.7) vs 1.8 (SD 0.3) with a p =0.024. Patients with anterior myocardial infarction obtainedlower diastolic/systolic peak velocity ratios than controls:2.5 (SD 0.7) vs 1.4 (SD 0.3) with a p = 0.001.
Left anterior descending coronary arteryflow can be assessed by transthoracic high frequencyechocardiography in greater than 90% of the cases. Patientswith coronary lesions and those with anterior myocardialinfarction have a decreased diastolic/systolic peakvelocity ratio.
Full-text · Article · Dec 2001 · Revista Espa de Cardiologia
[Show abstract][Hide abstract] ABSTRACT: This study was performed to evaluate the feasibility and utility of a transthoracic high frequency transducer to detect and measure the left anterior descending coronary artery flow in patients with lesions in this artery or anterior myocardial infarction.
We studied 11 subjects with lesions greater than 75% and another 10 with anterior myocardial infarction. We compared the results with a control group of 18 subjects. An ATL HDI 5000 ultrasound unit with a 5-8 MHz transducer was used to identify the left anterior descending in the anterior interventricular sulcus from an apical four chamber window. We considered that left anterior descending was detected when a diastolic predominant flow pattern was obtained with pulse Doppler.
Left anterior descending was detected in 37/39 of cases (94.4%). Patients with coronary lesions showed a decrease in the limit of significance in the diastolic/systolic peak velocity ratios: 2.5 (SD 0.7) vs 1.8 (SD 0.3) with a p = 0.024. Patients with anterior myocardial infarction obtained lower diastolic/systolic peak velocity ratios than controls: 2.5 (SD 0.7) vs 1.4 (SD 0.3) with a p = 0.001.
Left anterior descending coronary artery flow can be assessed by transthoracic high frequency echocardiography in greater than 90% of the cases. Patients with coronary lesions and those with anterior myocardial infarction have a decreased diastolic/systolic peak velocity ratio.
No preview · Article · Feb 2001 · Revista Espa de Cardiologia
[Show abstract][Hide abstract] ABSTRACT: The study with monoclonal antimyosin antibody-111In has proved to be useful in the detection of the myocardial damage present in different processes. There is active myocardial damage and specific antimyosin uptake in myocarditis, as both experimental and clinical trials have shown. In experimental models the evolution of myocardial damage has been studied, where a parallelism between the histological changes of the myocardial damage and the evolution on the antimyosin uptake has been found. In clinical myocarditis it is difficult to do an histological follow up of the inflammatory process, and therefore the evolution of myocardial damage present in myocarditis is unknown. The antimyosin antibody images allow a non-invasive study of this evolution.
a) to study with monoclonal antimyosin antibody-111In, the myocardial damage present regarding the disease evolution in children with suspected clinical diagnosis of myocarditis; b) to evaluate the evolution of the active myocardial damage reflected on the changes on the monoclonal antimyosin antibody-111In uptake.
A study with monoclonal antimyosin antibody-111In was carried out on 43 children, 16 males and 27 females with a median age of 39 months (SD 48 m; range: 2-167) with suspected diagnosis of acute myocarditis defined as the presence of congestive cardiac failure or severe ventricular arrhythmia with less than 12 months of evolution. The image evaluation was done visually and through the heart to lung ratio. Twenty of these patients were also followed up with antimyosin antibody scan for a period of 19 +/- 9 months, and 3.8 +/- 1.7 studies were performed on them in this time.
The prevalence of positive myocardial uptake was 83.72%. There is a negative correlation (r = -0.352; p < 0.02) between the evolution time of the process and the heart to lung ratio: patients studied before two months, have a higher heart to lung ratio and greater prevalence of positive studies than those studied later (heart to lung ratio 2.09 vs 1.74; p = 0.013; 90% vs 69.2%). Of the patients followed up with antimyosin antibody scans, 6 showed a clinical relapse which increased their heart to lung ratio. The other 14 showed an progressive decrease of the heart to lung ratio reaching normality in 14 +/- 6 months.
a) the uptake intensity of monoclonal antimyosin antibody-111In, as a reflection of the myocardial damage, depends on the disease evolution time, as in the first two months is when the major damage happens; b) the uptake intensity slowly decreases, tending to normality around the 14th month, although this evolution may be altered by the appearance of relapses.
No preview · Article · Jan 1998 · Revista Espa de Cardiologia
[Show abstract][Hide abstract] ABSTRACT: Hypertrophic cardiomiopathy is a peculiar process with different anatomical and functional abnormalities which are present in different degrees in each case. Echocardiography and Doppler techniques have contributed definitively to the knowledge of this process and these procedures are choices for establishing the diagnosis of hypertrophic cardiomyopathy and to evaluate the clinical and morphological diversity of this process consisting of a spectrum of abnormalities with a variable presence in each case. Disproportionate septal hypertrophy is the most frecuent finding but the hypertrophy can involve other segments and different patterns can be present; concentric hypertrophy, apical, involving right ventricle, inverted asymetric, etc. Anterior mitral valve motion can be produced by the interrelation between anatomic factors of the valve, geometry of the outflow tract and physical forces produced by flow changes. Doppler echocardiography allows us to evaluate subaortic obstruction, to define its site, to demonstrate and measure the degree of mitral regurgitation and to carry out intraoperative studies. In hypertrophy cardiomyopathy the pattern of delayed relaxation is the most frequent but patients with severe obstruction and mitral regurgitation can pseudonormalize this pattern and even show restrictive patterns.
No preview · Article · Mar 1996 · Revista Espa de Cardiologia
[Show abstract][Hide abstract] ABSTRACT: Diagnosis and risk stratification in angina pectoris is supported on clinical evaluation, rest electrocardiogram, exercise stress test and coronary angiography. Use and timing application of that diagnostic methods depend on coronary artery disease prevalence and on clinical situation. This review describe diagnostic and prognostic value of the tests in angina pectoris.
No preview · Article · Jul 1995 · Revista Espa de Cardiologia
[Show abstract][Hide abstract] ABSTRACT: A case of suddenly increasing dyspnea in a patient with hypertrophic obstructive cardiomyopathy is reported. Transesophageal echocardiography showed severe mitral regurgitation secondary to ruptured chordae tendineae. Mitral valve replacement was done, correcting both mitral regurgitation and subaortic gradient. Utility of transesophageal echocardiography in diagnosis and therapeutic options are discussed.
No preview · Article · Jan 1994 · Revista Espa de Cardiologia
[Show abstract][Hide abstract] ABSTRACT: We present a case of a sinus of Valsalva aneurysm ruptured into right atrium secondary to aortic endocarditis. Early surgical procedure was indicated bases on transthoracic echocardiography. This technique demonstrated a abscess image enlarged into the right atrium and color Doppler showed a turbulent flow from aortic valve to right atrium. Cardiac surgery was performed with transesophageal echocardiography monitoring. This technique allowed anatomical and functional aortic valve evaluation and the abscess location and extension. This case shows the value of transthoracic and transesophageal color Doppler echocardiography in the diagnosis and management of patients with complications secondary to infective endocarditis.
No preview · Article · Nov 1991 · Revista Espa de Cardiologia
[Show abstract][Hide abstract] ABSTRACT: The heart is often injured in the setting of blunt chest trauma with a broad spectrum of cardiac lesions. We present a twenty-nine years old man with interventricular septal and rupture and left ventricular free wall rupture following chest trauma. Doppler echocardiography was essential in the diagnostic and therapeutic procedure. We concluded that Doppler-echocardiography must be performed in all patients with suspicion of cardiac affectation after blunt chest trauma.
No preview · Article · Oct 1991 · Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology
[Show abstract][Hide abstract] ABSTRACT: We studied the left ventricular diastolic function with Doppler Echocardiography in 61 patients: the first group (A) was conformed by 20 patients with cerebral stroke in evolution (24 to 48 hours) with age between (45 to 63 year old) every one had carotid obstructive lesion shown by angiography. The (B) group had 21 patients with ischemic heart disease and all of them had selective coronary arteriography with atheromatous obstructive lesions (45 to 63 years old); 17 of this patients had previous myocardial infarction. The third group (C) was formed by 20 healthy people between 40 and 62 years of age. We found an increase in the late diastolic peak velocity, in the (A/E) ratio in the early diastolic time; in the early diastolic acceleration and in early diastolic desceleration. The difference between groups (A) and (B) with the (C) was evident (P less than 0.001). We conclude that patients of (A) and (B) groups had reduced left ventricular compliance and the (B) group with evidence of ischemic heart disease show more prominent abnormality.
No preview · Article · Sep 1989 · Archivos del Instituto de Cardiología de México
[Show abstract][Hide abstract] ABSTRACT: Eleven patients with left bundle branch block and chest pain suggestive of coronary arterial disease were analyzed using thallium-201 exercise scintigraphy, M-mode echocardiography and coronary arteriography. The coronary arteries were shown to be normal in all patients. A reversible anteroseptal defect on thallium-201 scintigraphy and an asynchronous septal motion on echocardiography were evident in eight patients. Thus, symptomatic patients with left bundle branch block may have reversible anteroseptal defects on thallium-201 scintigraphy which do not indicate coronary artery disease. Rather, they may be due to functional ischemia secondary to abnormal septal motion.
No preview · Article · Aug 1987 · International Journal of Cardiology