Distribution of dyssynchrony in subjects with no known cardiac disease and comparison of velocity vector imaging to color-coded tissue Doppler imaging.

Data on the distribution of dyssynchrony in subjects with normal ejection fraction (EF) and normal QRS are scarce. We studied 100 subjects with no known cardiac disease (52% male, mean age 60 ± 17 years) using velocity vector imaging (VVI). Seventeen percent had septal to lateral (S-L) wall longitudinal delay >75 msec, 63% of subjects had S-L wall radial delay >75 msec, and 25% had a circumferential opposing wall delay >100 msec.

Dyssynchrony in obese subjects without a history of cardiac disease using velocity vector imaging.

Background: The aim of this study was to examine the occurrence of intra-left ventricular (LV) dyssynchrony in obese versus nonobese subjects without known cardiac disease using Velocity Vector Imaging (VVI).

Methods: One hundred ninety consecutive subjects with no known cardiac disease had their echocardiograms analyzed using VVI after excluding subjects with QRS durations>120 msec or LV ejection fractions<55%. Study subjects were divided into two groups on the basis of body mass index: obese (>30 kg/m2) and nonobese (<30 kg/m2).

Discrepancy between gradients derived by cardiac catheterization and by Doppler echocardiography in aortic stenosis: how often does pressure recovery play a role?

Studies have shown very good correlation between Doppler-derived gradients and gradients obtained by cardiac catheterization (cath) in aortic stenosis (AS). However, the phenomenon of pressure recovery may lead to significant overestimation of aortic valve (AV) gradients by Doppler echocardiography (echo). We hypothesized that echo-derived gradients will be higher in mild-moderate AS because of pressure recovery.

Aldosterone receptor antagonists in the medical management of chronic heart failure.

The benefits of aldosterone receptor antagonists (spironolactone and eplerenone) for patients with heart failure were shown in 2 recent randomized controlled trials. Some of the proposed mechanisms of action of aldosterone antagonists are (1) inhibition of myocardial and vascular remodeling, (2) blood pressure reduction, (3) decreased collagen deposition, (4) decreased myocardial stiffness, (5) prevention of hypokalemia and arrhythmia, (6) modulation of nitric oxide synthesis, and (7) immunomodulation. Like many hormone receptors, the aldosterone receptor can be either nuclear or membrane bound.

Why do patients fail to receive beta-blockers for chronic heart failure over time? A "real-world" single-center, 2-year follow-up experience of beta-blocker therapy in patients with chronic heart failure.

Background: The longitudinal pattern of beta-blocker use in a heart-failure practice setting has not been explored. Previous studies have not specifically addressed the use of beta-blockers over time to determine the rate of use and reasons for discontinuation. The long-term compliance rate for beta-blocker drugs outside the context of a clinical trial has not been established.