ABSTRACT
Purpose: The aim of this study was to estimate the role of multidetector computed tomography (MDCT) in the evaluation of LV regionalwall motion abnormalities (RWMA) in subjects complaining of coronary artery heart disease (CAD) and to compare MDCT data with twodimension standard echocardiography (2DSE) as the standard reference. Patients and Methods: Sixty subjects with supposed coronaryartery heart disease were submitted to retrospective gating contrast-enhanced MDCT. 10 phases of the cardiac cycle were performed todetect end-systolic and end-diastolic phases at LV short-axis view. LV Regional wall motion was assessed qualitatively (visually in cinemode) and quantitatively (measuring the percentage of systolic wall thickening on static end-diastolic and end-systolic images) on cardiacshort-axis view and long-axis views using a 17-segment model. 2DSE was performed within two weeks before MDCT. Results: Goodsegmental agreement was found between echocardiography and MDCT (k=0.7; p < 0.001), MDCT detected 720 (98.7%) of 729 segmentsthat showed normal motility, 172 (74.7%) of 230 segments showed hypokinesia and 49 (80.3%) of 61 segments showed akinesia ordyskinesia. Regarding the diagnostic performance, the sensitivity, specificity, and accuracy of MDCT reached 80.4%, 97.4%, and 93.5%,respectively, assuming 2DSE as the gold standard. Conclusion: Evaluation of regional left ventricular function by using MDCT is a precisemethod, with good agreement with 2D ECG.
ABSTRACT
This study included 30 portal hypertensive cirrhotic ascitic patients assigned into 3 groups of 10 patients each, well matched as regards age and sex. Groups I, II and III were put on diuretics, beta blocker propranolol, and both, respectively, and restudied 1 month latter. Serum-ascites albumin gradient [S-AAG] was found to correlate positively with grade of esophageal varices and portal vein diameter [P <0.001] and the reduction of portal blood flow [P <0.05]. Diuretics with or without beta blockers propranolol gave a good therapeutic response as regards body weight [P <0.001], 24-hour urine output [P <0.001] and sodium excretion [P <0.05], whereas propranolol alone was found to have deleterious effect on ascites. There was a decrease in renal blood flow in the 3 groups which was more by the use of propranolol. It was concluded that S-AAG is a good predictor of portal hypertension and its response to beta blockers. The portal hypotensive effect of beta blockers showed no beneficial effect on ascites for renal hemodynamic changes resulting in less water and sodium excretion