Role of echocardiography in assessing cardiac amyloidoses: a systematic review.

Cardiac amyloidosis is a manifestation of one of several systemic amyloidoses, and is characterized by increased left-ventricular (LV) wall thickness and normal or decreased LV cavity size. Congestive heart failure in cardiac amyloidosis is characterized by a predominant diastolic LV dysfunction, and systolic dysfunction occurs only in late-stage disease. Echocardiography is a noninvasive, reproducible method for assessing cardiac morphology and function in cardiac amyloidosis, and some echocardiographic indices are prognostic for amyloidoses. This review describes the advances in echocardiography and its role in the diagnosis and management of cardiac amyloidoses. Our review suggests that LV longitudinal function and the cyclic variation of myocardial integrated backscatter may be the best predictors of adverse outcomes. In the future, new echocardiographic techniques, such as fully automated echocardiogram interpretation, should provide further useful information for assessing cardiac function and prognosis in cardiac amyloidosis patients.

The short-term effect of alcoholic beverage-intake on blood glucose levels in type 2 diabetic patients.

We examined changes in blood glucose levels within 2h after the respective intake of three kinds of alcoholic beverages in six type 2 diabetic men treated by diet alone. Blood glucose level following beer consumption was 195.0+/-15.8 mg/dl after 60 min and those following sake consumption was 151.2+/-9.0mg/dl after 60 min. There was no significant increase in blood glucose levels after drinking shochu. It should be considered that in diabetic patients, the elevation of blood glucose was induced by the sugar contained in the alcoholic beverages, and the limited intake of alcoholic drinks is required to keep well blood glucose levels.

Increased intima-media thickness of the carotid artery in Japanese female type 2 diabetic patients with 'midband lipoprotein'.

Among a number of different lipoprotein abnormalities, 'midband lipoprotein' migrating at a position between LDL and VLDL on polyacrylamide gel electrophoresis (PAGE), is an atherogenic lipoprotein and intima-media thickness (IMT) of the carotid artery is a useful marker of atherosclerotic diseases. The present study evaluated relationships between the presence of 'midband lipoprotein' and carotid IMT in subjects with type 2 diabetes. The average IMT of the carotid artery was determined from the means of maximal thicknesses of both left and right common carotid arteries, carotid bulb, and internal carotid artery using ultrasound B mode imaging in 118 Japanese patients (72 men, 46 women) and 43 healthy controls. Multivariate regression analyses indicated that the duration of diabetes and presence of 'midband lipoprotein' were independent determinants of carotid artery IMT in 46 female subjects with diabetes, and these subjects were then subclassified into midband-positive (n=24) and midband-negative (n=22) groups. IMT of the carotid artery was significantly different between midband-positive (0.98+/-0.32mm) and midband-negative (0.79+/-0.17mm) groups (P=0.02). These findings suggest that 'midband lipoprotein' is a possible risk factor for IMT of the carotid artery in Japanese female type 2 diabetic patients.

Mesenteric malignant lymphoma detected with routine color Doppler ultrasonography.

This report concerns a case of primary mesenteric malignant lymphoma detected with routine color Doppler ultrasonography. When a 44-year-old man underwent a first-time medical checkup, ultrasonographic imaging and computed tomography showed the presence of a large tumor measuring about 8 cm in transverse diameter. Color Doppler ultrasonography identified the characteristic vessel structure of a nodal lesion, namely, a hilar vessel, a curved section of the central vessel together with peripheral branches, and focal absence of perfusion in a hypoechoic imaging of the left periumbilical area. These findings contributed to the diagnosis of a malignant lymphoma and the surgical treatment of the tumor was successful.