Brain natriuretic peptide and the severity of aortic regurgitation: is there any correlation?

We aimed to evaluate the correlation between aortic regurgitation severity and brain natriuretic (BNP) levels as a marker for left ventricular dysfunction. Sixty consecutive male patients (mean age 22 +/- 3 years) with isolated chronic aortic regurgitation were enrolled in the study together with a control group of 30 age-matched healthy volunteers (group A). Patients were classified with regard to aortic regurgitation vena contracta width as follows: group B, < 3 mm, mild (n = 16); group C, > or = 3 and < 6 mm, moderate (n = 26); group D, > or = 6 mm, severe (n = 18). BNP measurements were performed with a fluorescence immunoassay kit. BNP levels were increased in patients with aortic regurgitation, and severity of regurgitation had a significant influence on BNP levels. This effect can be explained by the volume loading effect of aortic regurgitation.

Papillary fibroelastoma of the mitral valve with systemic embolization.

Primary tumors of the heart are rare disorders. In autopsy studies, their incidence was reported to be 0.01-0.5%. We present the case of a papillary fibroelastoma of the mitral valve with systemic embolization in a young man.

Assessing the cause of T wave inversion in precordial leads with ECG mapping.

Inversion of the T wave in precordial leads in patients with angina pectoris is a predictor of coronary disease; however, it may also be seen in normal adults. The aim of this study was to assess the cause of T wave inversion by carrying out precordial electrocardiographic (ECG) mapping in 51 patients, who also underwent echocardiography and coronary angiography. The 37 patients in group A had atypical symptoms. They included 11 patients who showed M pattern mapping, of whom 7 had noncoronary cardiac disease and 4 were normal. In 23 other group A patients, whose mappings were in the N pattern, the angiography was normal. In the remaining three patients of this group, mappings were in the I pattern, with angiography revealing coronary disease in two of them and no disease in the third. The 14 group B patients all had typical angina; mappings were in the I pattern in 8 of the patients and in the N pattern in the remaining 6. Angiography revealed coronary artery disease in all patients with the I pattern mapping, while all those with the N pattern were found to be normal. Sensitivity, specificity, and positive predictive value for detecting normal subjects were all 100% for N pattern mapping; for detecting coronary disease, they were 100%, 90%, and 90% for I pattern mapping, respectively. It is concluded that precordial ECG mapping is an accurate method for the assessment of T wave inversion in precordial leads.

A case of Noonan's syndrome with numerous cardiac abnormalities.

OBJECTIVE: To report a case of Noonan's syndrome in a patient with numerous cardiac abnormalities. METHODS: We present a case report of a patient with Noonan's syndrome, including clinical, laboratory, and radiologic findings, and discuss the characteristic features of this condition. RESULTS: A 19-year-old male patient had most of the typical clinical findings of Noonan's syndrome-dysmorphic face, short stature, ear abnormalities, cryptorchidism, webbed neck, and high palate. In addition, mitral valve prolapse, secondary mitral insufficiency, left ventricular hypertrophy, and secondary tricuspid insufficiency were diagnosed. Although some cardiac abnormalities have been reported in patients with this syndrome, a case with numerous cardiac abnormalities has not been described previously. CONCLUSION: Noonan's syndrome is a rare disorder with characteristic clinical features and cardiac abnormalities. Although previously reported cases have described cardiovascular anomalies, on review of the literature we found no other case with numerous cardiac abnormalities.