Echocardiographic Assessments of Left Atrial Strain and Volume in Healthy Patients and Patients With Mitral Valvular Heart Disease by Tissue Doppler Imaging and 3-Dimensional Echocardiography

BACKGROUND AND OBJECTIVES: The purpose of the current study was to assess left atrial (LA) physiology in relation to associations between LA volume change and regional tissue velocities and strains, and to extend this information to patients with mitral stenosis (MS) or mitral regurgitation (MR). SUBJECTS AND METHODS: Twenty-two healthy persons, 22 patients with moderate-to-severe MS, and 22 patients with moderate-to-severe MR were studied. Tissue velocities, strains, and time-volume curves of the LA were acquired using tissue Doppler imaging and 3-dimensional echocardiography. RESULTS: In healthy controls, the maximal LA volume was negatively correlated with the posterior wall longitudinal systolic strain (r=-0.45, p=0.03). The time-to-maximal LA volume was positively correlated with the time-to-posterior wall longitudinal peak strain (r=0.46, p=0.03) and the time-to-circumferential peak strain (r=0.59, p=0.004). The LA active emptying fraction (LAactEF) was positively correlated with the posterior wall longitudinal peak systolic and late diastolic tissue velocities. In patients with MS, the maximal LA volume was negatively correlated with the posterior wall radial peak systolic velocity and the longitudinal late diastolic velocity. In patients with MS, the LAactEF had an additional positive correlation with the anterior wall longitudinal and circumferential systolic velocities, whereas the patients with MR had an additional positive correlation between the LAactEF and the lateral wall longitudinal peak strain as compared with the healthy cantrols. CONCLUSION: LA longitudinal and circumferential deformations are more related than radial deformation to determining LA volume and function. The LA of patients with MS revealed a greater pathologic physiology than those of patients with MR.

External Compression of the Inferior Vena Cava by Tortuous Abdominal Aorta in the Elderly

Budd-Chiari syndrome (BCS) is an uncommon disease caused by obstruction of hepatic venous outflow. This results in centrilobular congestion and necrosis, ultimately leading to fibrosis and cirrhosis of liver. Stenosis of the inferior vena cava (IVC) can be a one of causes of BCS. We report the a case of a 72-year-old woman who presented significant IVC stenosis due to extrinsic compression resulting by a tortuous abdominal aorta which was incidentally detected by echocardiography and successfully treated by stenting. To the date the extrinsic compression of IVC resulting from tortous aorta has never been reported to cause of BCS.

Dystrophic Endocardial Calcification Associated with Prior Myocardial Infarction

Myocardial calcification is usually classified as either dystrophic or metastatic. Dystrophic calcification is more common and usually occurs in the area of prior myocardial infarction. It is found in 8% of patients who have been survived longer than 6 years after myocardial infarction. The most common site of calcification is in the anterior wall of the left ventricle or apical and anterolateral aspect in the aneurysm of the left ventricle. We report the case of a 50-years old man with a typical dystrophic calcification of the endocardium in area of myocardial necrosis.

Two Cases of Double-Chambered Right Ventricle without Other Congenital Cardiac Anomalies

Double-chambered right ventricle (DCRV) is a congenital cardiac anomaly in which the right ventricle is divided into two chambers by anomalous hypertrophied muscle bundles that cross the right ventricular cavity. DCRV may be associated with other congenital cardiac anomalies, most commonly with ventricular septal defect. We report two cases of DCRV without other congenital cardiac anomalies with review of literatures. We performed echocardiography, cardiac catheterization and right ventricular angiogram to confirm the diagnosis.

Lipomatous Hypertrophy of Interartiral Septum(LHIS)

Lipomatous hypertrophy of interartiral septum (LHIS) is a rare entity that is characterized by the excessive deposition of fat in the interatrial septum. The appearance of LHIS on echocardiogram is a bilobed or dumbbell-shaped in interatrial septum. We report a case of 56-years man with frequent premature ventricular contraction on holter monitoring which may related to his sudden cardiac death diagnosed lipomatous hypertrophy of interatrial septum by echocardiography.

Unroofed Coronary Sinus Associated with Persistent Left Superior Vena Cava : Detection by Agitated Saline Contrast Echocardiography

Unroofed coronary sinus with persistent left superior vena cava is an extremely rare congenital anomaly. It can be suspected by the presence of a markedly dilated coronary sinus and can be confirmed by injection of agitated saline into the left antecubital vein during echocardiography. Agitated saline contrast echocardiography can easily visualize the flow in the persistent left superior vena cava communicating with the unroofed coronary sinus hereby creating a shunt into the left atrium. An agitated saline contrast echocardiography may be performed with a low risk of transient complication. We demonstrate the case of a 32-year-old pregnant woman with unroofed coronary sinus and persistent left superior vena cava, confirmed by agitated saline contrast echocardiography.

Effects of Simvastatin Alone or Combined With Ramipril on Nitric Oxide Bioactivity and Inflammation Markers in Hypercholesterolemic Patients

BACKGROUND AND OBJECTIVES: Because the mechanisms of the biological effects of statin and antiotensin converting enzyme inhibitor therapies differ, the vascular responses to these therapies were studied in hypercholesterolemic patients. MATERIALS AND METHODS: Simvastatin, 20 mg, placebo or ramipril, 10 mg, were administered daily for 2 months, with a 2 month washout, to 32 hypercholesterolemic patients. This was a randomized, double-blind, placebo-controlled, crossover in design study. RESULTS: Simvastatin alone, or in combination with ramipril, significantly changed the lipoproteins, and improved the percentage of the flow-mediated dilator response to hyperemia by 46+/-48% and by 59+/-66%, respectively, relative to the baseline measurements (both p<0.001). The plasma malondialdehyde levels were reduced, relative to baseline measurements, by 6+/-57% (p=0.045) and 13+/-47% (p=0.045 and p<0.001, respectively) and plasma levels of monocyte chemoattractant protein-1 by 3+/-27% and by 9+/-16%, respectively (p=0.113 and p=0.001, respectively). The C-reactive protein were also reduced, relative to baseline measurements, by 17+/-75% and by 17+/-37%, respectively (p=0.003 and p=0.001, respectively). However, simvastatin combined with ramipril changed, to a greater extent, but was statistically insignificant, the percentage of the flow-mediated dilator response to hyperemia, and the plasma monocyte chemoattractant protein-1 levels, than simvastatin alone. CONCLUSION: Compared with simvastatin alone, the addition of ramipril improved the endothelial function to greater extent, but was statistically insignificant, in hypercholes-terolemic patients.

A Case of Febrile Ulceronecrotic Pityriasis Lichenoides et Varioliformis Acuta

No abstract available.

A Case of Febrile Ulceronecrotic Pityriasis Lichenoides et Varioliformis Acuta

No abstract available.