Quantification of regional left ventricular function by magnetic resonance in patients with reversible myocardial ischaemia

Cine magnetic resonance imaging [cine MRI] has advantages over other methods of assessing regional ventricular function. The endocardium and epicardium are readily defined and myocardial thickness and thickening can be measured. These are important parameters for assessing myocardial viability and conditions such as stunning and hibernation. We have assessed myocardial thickness, thickening, and motion, we have established normal ranges for circumferential profiles in four planes, and we have compared the parameters with myocardial perfusion in patients with coronary artery disease. We studied 20 normal volunteers and 14 patients with coronary artery disease. Thirteen patients had reversible perfusion abnormalities by thallium tomography and 5 had fixed defects. Cine magnetic resonance images were acquired in the vertical and horizontal long axis and in basal and apical short axis planes. The endocardium and epicardium were defined manually at end diastole and end systole and circumferential profiles of diastolic wall thickness, systolic thickening, and wall motion were generated. Categories for each variable were assigned in each of 9 segments according to the number of standard deviations from the mean of the normal group. One hundred and twenty six segments were assessed. There was good agreement between the categories of wall motion [normal, hypo-, akinetic] and myocardial perfusion [normal, reversible, and fixed defect], differing by one category or less in 121 segments [96%, K[w] = 0.5]. The agreement between categories of wall thickening and perfusion was moderate [75% agreement, k[w] = 0.42]. The agreement between coronary anatomy and both wall motion and wall thickening was good [82%, k[w] = 0.31 and 78%, k[w] = 0.6 respectively]. We conclude that cine magnetic resonance imaging provides an objective method of assessing myocardial motion, thickness and thickening and that there is agreement between these assessments of function and myocardial perfusion and coronary anatomy

Doppler assessment of right ventricular function in patients with essential hypertension

Forty patients [16 males and 24 females] with essential hypertension [EH] with age ranged between 35-55 years as well as 15 normal subjects with matched age and sex were subjected to Doppler evaluation of right ventricular [RV] diastolic function. Patients were subdivided into 2 groups according to the echocardiographic criteria of left ventricular hypertrophy [LVH]. This study revealed, impaired RV diastolic function in patients with EH. The right ventricular anterior wall thickness [RVAWT] increased significantly in hypertensive patients. This study revealed significant increase in mean pulmonary artery pressure in group I when compared to control group [p <0.001]. There was a good positive correlation between RVAWT and IVST, PLVWT and LVM index in group I and group II. In conclusion, structural and functional changes induced by EH are not limited to the LV but also involve RV and pulmonary circulation

Dermatoglyphics studies among patients with coronary heart disease

Dermatoglyphics patterns were studied in 50 patients with CHD searching for a characteristic pattern which could be taken as a genetic marker for such disease. The following dermatoglyphics feature were significantly different from the control papulation. Low total ridge count in the digits. Increase in arches in right and left hypothernia and thenar area in both plams. Decrease in loops radial in most areas in both plams. Increase in loops ulnar in interdigital area III in both palms and right interdegital area IV. Increase percent distribution of absent pattern and bilateral symmetry in most of the palmer areas. Decrease in bilateral percent distribution of accessory triradii in hypothenar and interdigital areas II and IV. Also characteristic features in toes and planter areas

effect of oxamniquine therapy on the electrocardiogram and echo cardiogram in patients of active hepatosplenic bilharziasis with and without bilharzial cor-pulmonale

The material of this work comprised 25 cases with active intestinal bilharziasis associating bilharzial hepatosplenomegaly with and without cor-pulmonale. All patients were given pxamniquine with a total dose of 60 mg/kgm body weight twice daily for three successive days. All patients were subjected to Biochemical and haematological studies as well as E.C.G. and echocardiography before, one week and one month after oxamniquine. Compacatative electrocardiography though revealing nonsignificant changes as regards the E.C.G. parameters as minor incidence% of S-T and T wave changes and arrhythmia one week after oxamniquine therapy, corrective reversbility in these parameters was the rule. Echocardiographic assessement for left ventricular performance and for indices of myocardial contractility revealed non significant changes short of denoting left vnetricular dysfunction one week after oxamniquine and moreover reversibility pattern for these changes was evident one month after therapy. A non-significant increase in the pulmonary arterial pressure was observed one week after therapy to diminish one month later on. Non-significant aberrations in liver and renal functions as well as non significant increase in HB, R.B.C.S. and W.B.O.S. were observed one week after therapy together with corrective reversibility for these aberration were demonstrable one month later. Cure rate after oxamniquine therapy was 80% in group of hepatosplenomegaly and in the group of compensated bilharzial cor-pulmonale and 60% in decompensated group of bilharzial cor-pulmonale. A suggestion for further work can be targeted towards a comparative evaluation for efficacy and safety of this drug in therapy of active bilharziasis in compensated and decompensated cardiac patients with cardiac disorders aetiologically non-related to bilharzial infection

Bilharzial oval patterns in rectal and colonic mucosa for patients with urinary bilharziasis

Mucosal biopsies from the rectum and colon of 25 males of pure urinary bilharziasis and negative stools were examined directly in the fresh state for bilharzial oval pattern by a slide compression technique. The method proved valuable in the diagnosis of bilharzial nature of the disease as a supplement to routine urine and stool examination. It has the additional balue of indentifying the species of bilharzia in the different levels of rectum and colon. This showed that the bilharzial oval pattern in patients with pure urinary bilharziasis is dominatly that of pure haematobium and dominant haematobium at 10 cm level as compared to a dominant pattern of pure mansoni and dominant mansoni at cm level irrespective of the presence of recent or past history of anti-bilharzial therapy and finally we can conclude that occuld mansoniasis is common in our locality and is discovered only by mucosal biopsy particularly colonic biopsy

P-wave changes in bilharzial patients with chronic obstructive pulmonary disease

55 patients with C.O.P.D. including 18 with bilharzial hepatosplenomegaly and 7 patients with bilharzial cor-pulmonale together with 10 normal control individuals were the material of the present study. P.E.F.R. was taken as the criterion of the presence of C.O.P.D. and changes of arterial blood gases as criteria to score the severity of C.O.P.D. P-Wave changes known to score the severity of C.O.P.D. [axis and amplitude] were assessed. The presence of associating hepatosplenic bilharziasis with or without bilharzial cor-pulmonale in patients with C.O.P.D. having matching severity were found to changes the incidence of P-Wave axis and amplitude changes in C.O.P.D. This leads to the conclusion that the P-Wave changes taken as criteria for screening the severity of C.O.P.D. are no longer valid in the presence of associating hepatosplenic bilharziasis with or without bilharzial cor-pulmonale in patients with C.O.P.D