Mitral / aortic flow velocity time integral ratio; its diagnostic power for identification of haemodynamically signification mitral regurgitation

This study aimed to evaluate the diagnostic power of the simple Doppler index of the mitral/aortic flow velocity time integral [VTI] ratio to identify subjects with haemodynamically significant MR compared with three valid quantitative echocardiographic methods [regurgitant volume, fraction and orifice area]. This work studied 30 patients with MR of different grades and etiologies and 10 healthy volunteers as a control group. All were subjected to complete history taking and clinical examination, ECG, plain X-ray, complete echocardiographic and Doppler examination of the heart and determination of the severity of MR by pulsed wave Doppler [PWD]. The study found that the mitral/aortic flow VTI ratio has accepted sensitivity, specificity, P predictive value and total accuracy in quantitation of the severity of MR compared with the quantitative 2D Doppler methods used for quantitation of the severity of MR. Also, it has the advantage of being a very simple method because in the presence of MR, if the mitral/aortic flow VTI ratio is [0.82 +/- 0.12] the MR is mild, if the ratio is [1.11 +/- 0.20] the MR is moderate and if the ratio is [1.39 +/- 0.29] the MR is severe. It was concluded that the mitral/aortic flow VTI ratio has the diagnostic power to identify subjects with hacmodynamically significant MR. Also, it is a simple and accurate method that can be used for grading of MR, sensitive and valid with accepted total accuracy

Prognostic significance of persistent negative T-wave in patients with acute anterior myocardial infarction

The course of T-wave polarity in patients with acute myocardial infarction receiving thrombolytic therapy may have an important diagnostic significance. The aim of the present work was planned to study the relation between negative T-waves in infarcted-related artery and the left ventricular function and angiographic data in patients with acute anterior myocardial infarction. Fifty patients with first time acute anterior myocardial infarction were induced in the present work. According to the polarity of T-wave, they were classified into group I with inverted T-wave [also divided into l[a] and I[b], regarding the time of normalization, early or late [after 4 month], and group II with upright T-wave. Left ventricular function and wall motion abnormalities score index [WMSI] were assessed by echocardiography on discharge and after 4 months, and coronary angiography was performed for all patients. There was a significant difference among both group regarding peak CPK, WMSI and ejection fraction [P<0.05]. In group II there was complete revascularization in 9 [40%] patients versus 3 [10.2%] only in group I [P < 0.0001]. The TlMI score was 1 n group I versus 2-3 in group II. The residual LAD stenosis was [80 +/- 6%] in group I versus [45 +/- 9%] in group II [P < 0.03]. Normalization of infarcted-related leads T -wave on discharge or after 4 months of acute myocardial infarction was associated with good left ventricular function and less residual infracted-related artery stenosis. So the T -wave polarity on discharge or after 4 months of acute myocardial infarction added prognostic significance in patients with AMI

Assessment of myocardial perfusion by harmonic power doppler intermittent imaging and real time Coherent imaging: comparison with SPECT imaging

In this study, 41 patients with suspected or known coronary artery disease were examined by myocardial contrast echocardiography [MCE] using randomly either harmonic power Doppler with intermittent imaging [27 patients] or real time coherent imaging [14 patients] using intravenous Levovist infusion. All patients underwent single photon emission computed tomography [SPECT] after the injection of technetium-99m [Tc-99m] sestamibi or thallium-201 [Th 201] at rest within one to three days of MCE. Both echocardiographic and scintigraphic images were analyzed by two experienced cardiologists in a blinded manner using the same 16-segment model of the left ventricle and the same scale used for perfusion grading. The concordance between MCE [harmonic power Doppler intermittent imaging [HPDI] or real time imaging [RTI]] and SPECT for the detection of segments with normal or abnormal perfusion was analyzed

Left ventricular diastolic and systolic functions in patients with syndrome X [anginia and angiographically normal coronary arteries]

Exercise performance was studied by treadmill exercise test and left ventricular filling dynamics were assessed by Doppler-derived transmitral flow pattern analysis in 25 patients with angina. The same protocol was done in 30 patients with documented coronary artery disease [CAD] and in 15 controls. Unlike the controls, patients with syndrome X [SX] and those with CAD consistently showed exercise- induced ST segment abnormalities and impaired resting left ventricular filling. The peak early diastolic flow velocity was less in SX and CAD patients than in the controls. The peak late diastolic flow velocity was less in SX and CAD patients than in the controls. There was no significant difference between the three groups as regard acceleration and deceleration time of early and late transmitral diastolic flow velocity