ABSTRACT
Patients with severe cystic fibrosis can develop cor pulmonale, but little is known about the function of the right ventricle (RV) early in the disease. We hypothesized that such patients might have subclinical RV dysfunction, detectable by tissue Doppler echocardiography, and related to the severity of lung disease. We studied 21 clinically stable patients (Group 1), five patients with severe lung disease (Group 2), and 23 age-matched healthy subjects. Patients had impaired RV systolic function. The mean (SD) systolic velocities of the RV free wall were 8.9 (1.7) cm/s in Group 1, 7.7 (1.0) in Group 2, and 10.8 (1.9) in healthy subjects (p < 0.001). The velocities of the tricuspid annulus were less in patients (p < 0.0001). Patients had a greater isovolumic relaxation time (p < 0.001), indicating RV diastolic dysfunction. RV wall thickness was greater in patients (0.4 [0.1] versus 0.3 [0.1] cm/m(2), p < 0.01). RV systolic function was related to C-reactive protein (r = - 0.66, p < 0.001) and FEV(1) (r = 0.62, p = 0.003) and diastolic function to interleukin-6 (r = 0.64, p < 0.005). Patients with cystic fibrosis have subclinical RV dysfunction, which correlates with the severity of lung disease. Tissue Doppler echocardiography provides a quantifiable indicator useful for detection and monitoring of disease progression.
Subject(s)
Cystic Fibrosis/complications , Echocardiography, Doppler , Ventricular Dysfunction, Right/diagnostic imaging , Ventricular Dysfunction, Right/etiology , Adult , Case-Control Studies , Cystic Fibrosis/immunology , Female , Hemodynamics , Humans , Inflammation Mediators/blood , Male , Regression Analysis , Respiratory Function Tests , Statistics, NonparametricABSTRACT
A case of thrombosis on an aortic bioprosthesis after the fourth month of implantation is presented. The patient had been well anticoagulated for the first three months after surgery. A suspicious diagnosis was made when the patient started with symptoms of cardiac failure and angina and an Echo-Doppler showed a significant transvalvular gradient. The definitive diagnosis will be determined with the removal of the valve at surgery. Although this is a rarity as an early complication, it should be kept in mind in such cases. Surgical intervention is mandatory and life-saving.
