RESUMO
A double orifice mitral valve (DOMV) represents a rare congenital malformation characterised by two valve orifices with two separate subvalvular apparatus. This case demonstrates the necessity of careful imaging of the mitral valve apparatus, not only in patients with atrioventricular septal defects, but also in patients with congenital left obstructive heart disease.
Assuntos
Valva Mitral/anormalidades , Adulto , Coartação Aórtica/cirurgia , Humanos , Achados Incidentais , Masculino , Valva Mitral/diagnóstico por imagem , UltrassonografiaRESUMO
Aortic stiffness in 78 patients with juvenile forms of ascending aortic dilation with Marfan's syndrome was compared with aortic stiffness in 17 patients without Marfan's syndrome. In the ascending aorta and aortic arch, aortic stiffness was similarly increased in the 2 groups. In the descending aorta, however, aortic stiffness was increased only in patients with Marfan's syndrome.
Assuntos
Aorta Torácica/anatomia & histologia , Aorta Torácica/patologia , Aorta/anatomia & histologia , Aorta/fisiologia , Aneurisma Aórtico/complicações , Dissecção Aórtica/complicações , Adolescente , Adulto , Dissecção Aórtica/patologia , Aneurisma Aórtico/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-IdadeRESUMO
AIM: The aim of this article is to examine whether cardiac resynchronization therapy (CRT) induces improvements in the neurohumoral system. METHODS AND RESULTS: Thirteen patients with HF (left ventricular (LV) ejection fraction <35%) were included. Before and after 6 months of CRT, myocardial (123)I-metaiodobenzylguanidine ((123)I-MIBG) uptake indices, used as an index of neural norepinephrine reuptake and retention, and brain natriuretic peptide (BNP) levels, used as an index of LV end-diastolic pressure, NYHA classification and echocardiographic indices were assessed. Six months of CRT resulted in significant improvement in (1) NYHA classification and reduction in QRS width (P < 0.001), (2) decrease of LV end-diastolic diameter (P = 0.005), LV end-systolic diameter (P = 0.005), septal to lateral delay (P = 0.01) and mitral regurgitation (MR, P = 0.04), (3) delayed (123)I-MIBG heart/mediastinum ratios improved (P = 0.03) and (123)I-MIBG washout decreased (P = 0.001), and (4) BNP levels decreased (P = 0.001). CONCLUSIONS: Parallel to significant functional improvement and echocardiographic reverse remodeling and resynchronization, our data indicate that CRT induces favorable changes in the neurohumoral system.
