Left ventricular dyssynchrony and abnormalities in wall motion, assessed by gated-SPECT as ischemic auxiliary markers.

INTRODUCTION: Left ventricular dyssynchrony (LVD) quantified by gated myocardial perfusion studies (MPS), through phase analysis (PA), has shown controversial results in myocardial stunning. OBJECTIVES: Assessment of LVD and regional wall motion abnormalities (RWMA) in normal and ischemic patients. METHODS: A cohort of 172 patients were studied. Summed Stress Score (SSS), Summed Resting Score (SRS), and Summed Difference Score (SDS) were evaluated. Group 1-patients with normal MPS (N = 133) and Group 2-patients with myocardial ischemia in the MPS (N = 39). LVD was evaluated through PA and RWM by visual analysis. RESULTS: SSS 0 vs 9.8 ± 3.9 P = .0001; SDS 0 vs 9.8 ± 3.9 P = .0001; SRS 0 vs 0 P = NS, in G1 and G2. Significant differences were found in LVD between G1 and G2, bandwidth 36 ± 14 vs 63 ± 46 P = .0001; standard deviation 16 ± 10 vs 26 ± 15 P = .0001. In G1, 16% had LVD vs RWMA in 0%, P = .0001 and in G2, 59% with LVD vs 33% with RWMA, P = .03. Sensitivity for LVD 59% and for RWMA 33%, P = .03 and specificity for LVD 83% and for RWMA 100%, P = .0001. CONCLUSION: Ischemic patients have LVD post-stress due to myocardial stunning. LVD measured by PA could be a useful tool to identify ischemia.

Correction to: Left ventricular dyssynchrony and abnormalities in wall motion, assessed by gated-SPECT as ischemic auxiliary markers.

In Figure 3, sensitivity and specificity were interchanged. The corrected Figure 3 is shown below. The author names listed in reference 14 have been corrected; the correct reference reads: Nakanishi R, Gransar H, Slomka P, Arsanjani R, Shalev A, Otaki Y, et al. Predictors of high-risk coronary artery disease in subjects with normal SPECT myocardial perfusion imaging. J Nucl Cardiol 2016;23:530-41. The units of standard deviation (SD) and bandwidth (BW) in the abstract, results and in table 3 are expressed in degrees from 0 to 360°.

[Embolism predictors of infective endocarditis]. / Variables predictoras de embolias en endocarditis infecciosa.

The embolic event (EE) increases the morbidity and mortality of infective endocarditis (IE). Prevalence of EE ranges between 22% and 50%, death rates being up to 25% of patients. EE may occur prior to diagnosis, during treatment or afterwards. The objective of this study was to evaluate the demographic, clinical, microbiological, echocardiographic and therapeutic characteristics in patients suffering from IE (with or without emboli) in order to determine predictors for EE. A descriptive study based on observations of patient population diagnosed with IE was conducted at the Hospital Italiano of La Plata during the period March 1996 - December 2004. Fifty-three patients with IE were analyzed (35 without EE and 18 with EE) in retrospect. We found that the presence of vegetations in the transthoracic (TTE) and/or transesophagic (TEE) echocardiographies at the time of diagnosis, the size > or = 10 mm and the compromise of the native mitral valve were the variables that showed significant statistical association with EE to be considered as predictors. The size _ 10 mm was the only variable associated with EE in the logistic regression analysis. During the elective antibiotic treatment, there was a reduction in EE, without their being present from the second week onwards.

Variables predictoras de embolias en endocarditis infecciosa / Embolism predictors of infective endocarditis

El evento embólico (EE) aumenta la morbi-mortalidad de la endocarditis infecciosa (EI). La prevalencia de EE oscila entre 22% y 50%, pudiendo ocasionar hasta el 25% de las muertes de los pacientes que lo presentan. El EE puede ocurrir previamente al diagnóstico, durante el tratamiento o bien posteriormente al mismo. Nuestro objetivo fue analizar las características demográficas, clínicas, microbiológicas, ecocardiográficas y terapeúticas, de pacientes con EI (con y sin embolias) para tratar de establecer variables predictoras del EE. Se realizó en el Hospital Italiano de La Plata, desde marzo de 1996 hasta diciembre de 2004, un estudio descriptivo observacional de una cohorte de pacientes con diagnóstico de EI. Se analizaron en forma retrospectiva 53 pacientes con EI (35 sin EE y 18 con EE). La presencia de vegetación (en el ecocardiograma transtorácico (ETT) y/o en el transesofágico (ETE) al momento del diagnóstico, el tamaño ³ 10 mm y el compromiso de la válvula mitral nativa, fueron las variables en las que existió una asociación estadísticamente significativa con el EE para ser consideradas como predictoras. El tamaño ³ 10 mm fue la única variable asociada a EE en el análisis de regresión logística. Durante el tratamiento antibiótico electivo hubo una reducción de EE, no observándose a partir de la segunda semana.

The embolic event (EE) increases the morbidity and mortality of infective endocarditis (IE). Prevalence of EE ranges between 22% and 50%, death rates being up to 25% of patients. EE may occur prior to diagnosis, during treatment or afterwards. The objective of this study was to evaluate the demographic, clinical, microbiological, echocardiographic and therapeutic characteristics in patients suffering from IE (with or without emboli) in order to determine predictors for EE. A descriptive study based on observations of patient population diagnosed with IE was conducted at the Hospital Italiano of La Plata during the period March 1996 - December 2004. Fifty-three patients with IE were analyzed (35 without EE and 18 with EE) in retrospect. We found that the presence of vegetations in the transthoracic (TTE) and/or transesophagic (TEE) echocardiographies at the time of diagnosis, the size ³ 10 mm and the compromise of the native mitral valve were the variables that showed significant statistical association with EE to be considered as predictors. The size ³ 10 mm was the only variable associated with EE in the logistic regression analysis. During the elective antibiotic treatment, there was a reduction in EE, without their being present from the second week onwards.

Variables predictoras de embolias en endocarditis infecciosa / Embolism predictors of infective endocarditis

El evento embólico (EE) aumenta la morbi-mortalidad de la endocarditis infecciosa (EI). La prevalencia de EE oscila entre 22% y 50%, pudiendo ocasionar hasta el 25% de las muertes de los pacientes que lo presentan. El EE puede ocurrir previamente al diagnóstico, durante el tratamiento o bien posteriormente al mismo. Nuestro objetivo fue analizar las características demográficas, clínicas, microbiológicas, ecocardiográficas y terapeúticas, de pacientes con EI (con y sin embolias) para tratar de establecer variables predictoras del EE. Se realizó en el Hospital Italiano de La Plata, desde marzo de 1996 hasta diciembre de 2004, un estudio descriptivo observacional de una cohorte de pacientes con diagnóstico de EI. Se analizaron en forma retrospectiva 53 pacientes con EI (35 sin EE y 18 con EE). La presencia de vegetación (en el ecocardiograma transtorácico (ETT) y/o en el transesofágico (ETE) al momento del diagnóstico, el tamaño ³ 10 mm y el compromiso de la válvula mitral nativa, fueron las variables en las que existió una asociación estadísticamente significativa con el EE para ser consideradas como predictoras. El tamaño ³ 10 mm fue la única variable asociada a EE en el análisis de regresión logística. Durante el tratamiento antibiótico electivo hubo una reducción de EE, no observándose a partir de la segunda semana. (AU)

The embolic event (EE) increases the morbidity and mortality of infective endocarditis (IE). Prevalence of EE ranges between 22% and 50%, death rates being up to 25% of patients. EE may occur prior to diagnosis, during treatment or afterwards. The objective of this study was to evaluate the demographic, clinical, microbiological, echocardiographic and therapeutic characteristics in patients suffering from IE (with or without emboli) in order to determine predictors for EE. A descriptive study based on observations of patient population diagnosed with IE was conducted at the Hospital Italiano of La Plata during the period March 1996 - December 2004. Fifty-three patients with IE were analyzed (35 without EE and 18 with EE) in retrospect. We found that the presence of vegetations in the transthoracic (TTE) and/or transesophagic (TEE) echocardiographies at the time of diagnosis, the size ³ 10 mm and the compromise of the native mitral valve were the variables that showed significant statistical association with EE to be considered as predictors. The size ³ 10 mm was the only variable associated with EE in the logistic regression analysis. During the elective antibiotic treatment, there was a reduction in EE, without their being present from the second week onwards.(AU)