[Right ventiular function by the tricupid annular motion in inferior myocordial infarction]

Summary To assess the method of tricuspid annular motion and tricuspid annular velocity in the study of the right ventricular function after inferior myocardial infarction. 65 patients with myocardial infarction were studied prospectively. The infarction site was anterior in 30 cases and inferior in 35 cases. 9 patients with inferior infarctus had electrocardiographic signs of right ventricular infarction. 24 healthy individuals served as control patients. The standard echocardiography was completed by the analysis of systolic motion of the tricuspid annulus with the use of M-mode and the recording of tricuspid annular velocity with the use of pulsed-move tissue imaging. The tricuspid annular motion was significantly reduced in inferior myocardial infarction compared with that in healthy individuals [20 and 25 min, p<0.001]. The peak systolic velocity of the tricuspid annulus was significantly reduced in inferior myocardial infarction compared with that in healthy individuals and patients with anterior infarction [11.5; 15; 14 cm/s, p<0.001]. In the group of patients with inferior infarction, the tricuspid annular motion was significantly lower in patients with right ventricular infarction than in patients without right ventricular infarction [16 and 13 mm, p<0.001]. The patients with right ventricular infarction had also a significantly decreased peak systolic tricuspid annular velocity [11 and 1305cm/s, p<0.001], peak early diastolic velocity [9 and 12.5cm/s, p<0.001] and late diastolic velocity [14 and 18 cm/s, p<0.001]. The method of recording the motion and velocity of tricuspid annulus is simple and can be used to assess right ventricular function in patients with inferior myocardial infarction

[Pluse wave doppler tissue imaging in the assessment of regional left ventricular diastolic function in patients with coronary artery disease]

Myocardial ischemia impairs the diastolic left ventricular [LVi function earlier than the systolic function. We evaluated the value of pulse-wave Doppler Tissue Imaging [DTI] in the study of regiona myocardial function of LV in patients with coronary artery disease. We performed a prospective study in 60 patients with coronary artery disease that we compared to 40 healthy individuals in order to assess the value of pulse-wave DTI to study the diastolic LV function. Both groups had a clinical examination, ECG echocardiography and pulse-wave DTI. Only the patients had a coronary angiography. Pulse-wave DTI was applied to the 16 myocardial segments of the LV, we measured the isovolumetric relaxation time [IVRT], early [Ea] and late diastolic [Aa] velocities We have demonstrated that compared with healthy subject patients with coronary artery disease has a significant increase of IVRT [100.2 +/- 20ms vs 62.5 +/- 12.2, p <0.001] and lower Ba [7.6 +/- 1.6 vs. 9.2 +/- 2.6] and report Ea/Aa. These anomalies are more pronounced in akinetic segments compared with hypokinetic segments. Relying on data from the coronary angiography, we found in patients that IVRT had increased, Ea and Ea/Aa lowered in most segments hypoperfused than in normally perfused segments. An IVRT>70ms and Ea <8.3 cm/s emerge as threshold values to identify myocardial ischemia. More coronary lesions are severe mom Ea and Ea/Aa decline and IVRT increase. The culprit coronary artery could be identified by pulse-wave DTI since the DTI parameter anomalies are systemized. The pulsed DTI technique seems to be attractive as a non-invasive evaluation method of ischemic heart disease

Heart diseases in pregnant women

Diagnosis end treatment of heart diseases, physiopathologic changes in pregnancy. Pregnancy in woman with heart disease increases the risk of maternal and fetal complications. The aim of the study is to precise the physiopathologic, diagnostic, and therapeutic characteristics of heart diseases in pregnant woman extensive electronic search of the relevant literature was carried out using Medline. Key words used were: pregnancy, heart disease, maternal outcome, fetal outcome, cardiac complications. Rheumatic heart disease represent the most common cardiopathy found in pregnant woman in our country. Regurgitant valvular diseases are often well tolerated with medical therapy. Severe aortic stenosis is associated with poor prognosis. The use of percutaneous mitral balloon valvuloplasty has transformed treatment of mitral stenosis in symptomatic patients. In developed countries, congenital heart diseases are the most common cause of cardiopathy in pregnant women. Left-to-right shunts are generally well tolerated. Patients with Eisenmenger syndrome should be advised against pregnancy. Obstructive form of hypertrophic cardiomyopathy is associated frequently with hemodynamic deterioration in pregnancy. Dilated cardiomyopathy is usually considered as a contrindication of pregnancy. In the absence of underlying structural heart disease, cardiac arrythmias are uncommon in pregnancy and usually don't require pharmacological treatment. Drug therapy of arrythmias in pregnant woman is limited by side effects on the fetus. The prenatal counsel is based on the assessment of maternofetal risk. The management of pregnant woman requires a multidisciplinary team for optimal maternal and fetal outcomes

thrombus intra-cardiaque: Une complication rare au cours de la maladie de Behcet

Cardiac involvment is rare, and intracardiac thromboses are exceptional in Behcet's disease. We present a 29 years old male patient seen for right heart-failure, thrombophlebitis and pulmonary embolism A right atrial thrombosis was showen at the echocardiography and confirmed by computed tomography and magnetic resonance imaging. The diagnosis of Behcet's disease was established on the finding of bipolar aphtous ulcers and skin hypersensitivity.We conclude that Behcet's disease shoud be considered os a possible cause of cardiac thrombosis in the youngs men of the Mediterranean basin

Enterococcal infections endocardites associated to laubry and pezzi syndrome

Laubry and Pezzi syndrome is a rare but serious complication of ventricular septal defect that increase the infectious endocardits risk. Authors report a case of an 18 years old young girl prescruling an enteracoccus infectious endocarditis associated to Laubry and Pazzi syndrome. Initial course is not favourable requiring a surgical treatment in the acute stage. Bacterial endocarditis combined with Laubry and Pezzi syndrome have a poor prognosis needing observation and strict preventive precautions when a favoriging factor is present