[Microalbuminuria and left ventricular geometry in essential arterial hypertension]

The association between left ventricular hypertrophy and microalbumiuria is actually admitted. Recent studies shown that patients with microalbuminuria have higher left ventricular mass index, worst systolic function and often concentric geometric kind of left ventricular hypertrophy. The efficiency of an adapted and early therapeutic on a potential relation sheep between reduction of microalbuminuria and improvement of target organ injury, principally heart and kidney, is still to evaluate. The aim of our study is to review geometric and hemodynamic aspect of left ventricular hypertrophy in hypertensive microalbuminuric patients

[Differentiation between physiological left ventricular hypertrophy and hypertrophic cardiomyopathy of athletes, usefulness Doppler tissue imaging]

Athlete's heart is a cardiac adaptation to long-term, intensive training, wich includes physiological changes as increased ventricular cavity, wall thickness and mass. Maron highlighted a "gray zone" of wall thickness with difficult distinction between physiological left ventricular hypertrophy of athletes from hypertrophic cardiomyopathy [HCM]. The aim of the study is to analyse the data published about the diagnostic tools wich differentiate between physiological athlete's left ventricular hypertrophy and HCM. Even if the standard two-dimensional echocardiography represents an irreplaceable method in the evaluation of cardiac adaptations to physical exercice, the data currently available suggests the usefulness of Doppler tissue imaging [DTI] in the distinction between HCM and athlete's heart. The authors, will report the best DTI parameters recommended in this setting. The best DTI parameter to differentiate pathological hypertrophy of HCM from physiological hypertrophy of athletes was the gradient of diastolic velocity between the endocardium and the epicardium. On this ground, DTI may be taken into account in the Maron's diagnosis cascade

Floating left atrial thrombus and dysfunction of mitral prosthetic. A case report

Echocardiographic evidence of parietal atrial thrombus is frequently and easily diagnosed in mitral valve diseases. In the opposite, mobile left atrial thrombus is rare; its diagnosis require special attention. Our case report is about a 52 years old lady, with prothetic mitral valve and atrial fibrillation who presented with ischemic cerebral stroke. Oral anticoagulation was inappropriately observed. Transthoracic and transesophageal echocardiography showed an organised intra left atrial appendage thrombus with two floating thrombus into the left atrial cavity. In spite of adequate intravenous anticoagulation, the patient died within 48 hours after a massive second ischemic cerebral stroke. This case report shows the therapeutic challenge of left atrial thrombus management in the acute phase of ischemic cerebral stroke