Reproducibility of Doppler echocardiographic quantification of aortic and mitral valve stenoses: comparison between two echocardiography centers.

Doppler echocardiography has been widely used as a noninvasive method to quantify valvular heart diseases. This study assessed the variability between 2 echocardiography centers concerning 2-dimensional and Doppler echocardiographic results in the quantification of mitral and aortic valve stenoses. Forty-two patients were studied by 2 different echocardiography centers in a blinded, independent fashion.

[Primary atrial heart tumors--a review of 21 cases].

Between 1978 and 1986, atrial heart tumors were found in 21 of our patients, all of them subsequently underwent surgery. Pathological-histological examination in 20 patients confirmed the diagnosis of a myxoma; the one remaining case was a female patient with primary cardiogenic osteosarcoma. Of the 20 patients, 15 (75%) were females; in four female patients (20%) the tumor was localized in the right atrium.

Long-term treatment of hypertrophic cardiomyopathy with verapamil or propranolol in matched pairs of patients: results of a multicenter study.

The effects of a 2-year treatment with high-dose propranolol (mean, 340 +/- 135 mg/day) and verapamil (mean, 493 +/- 136 mg/day) were compared in two groups of patients with hypertrophic cardiomyopathy. Both groups were broadly identical at the beginning of the trial and were formed of matched pairs. Out of 137 patients entering the study, 37 pairs completed the 2 year follow-up.

[Cardiogenic embolisms following silent anterior wall infarct].

A 33-year-old man had suffered recurrent arterial embolisms. Echocardiography identified as the most likely cause a large mobile mass in the left ventricle. Initially a primary heart tumor was discussed, but the ECG finding of an anterolateral scar and an angiographically proven LAD-stenosis were suspicious of an organized thrombus of the left ventricle.

[Ventricular thrombi in the chronic infarct stage].

Left ventricular thrombi were detected in 98 (11%) of 864 consecutive patients examined by 2-D-echocardiography in the chronic phase of myocardial infarction. Using unequivocal criteria in identifying intracavitary masses as thrombus, the sensitivity and specificity of the echocardiographic diagnosis reached 90% compared to intraoperative findings (n = 23). To avoid false positive diagnoses, normal apical structures like muscular trabeculae must be ruled out, preferably by applying high-frequency transducers.

[Ventricular thrombi in the chronic infarct stage: echocardiographic findings, clinical aspects, relations to anticoagulation].

In 10% (n = 139) of 1,383 patients in the chronic phase of myocardial infarction left ventricular mural thrombi on a-/dyskinetic segments were present in the 2D-echocardiogram. Thrombi were more often seen in patients with anterior wall infarct (14% of 734) or combined anterior-posterior infarcts (11% of 337) than in those with posterior wall infarct (0.6% of 312).

[Constrictive pericarditis as a late complication of heart operations].

Constrictive pericarditis is a rare complication of previous cardiac surgery, the rate of incidence being approximately 0.1 to 0.3%.

[Echocardiography diagnosis of infarct complications].

Congestive heart failure, shock or severe arrythmias after myocardial infarction can be caused by mechanical complications suitable for surgical correction. These complications - such as aneurysms, rupture of the ventricular wall, septum or papillary muscle, pericardial tamponade - are reliably detected or excluded by echocardiography. Additional aspects related to the surgical techniques can be evaluated, moinly the resectability of left ventricular aneurysms.

[Echocardiography in coronary heart disease].

Coronary heart disease can be detected via echocardiography, if myocardial ischemia or infarction are present leading to segmental abnormalities of left ventricular function. The capability to demonstrate these regional changes is limited as far as TM echocardiography is concerned, whereas 2D echocardiography is more reliable. For this purpose, cross-sectional imaging of all segments in several planes is necessary.

[Treatment of congestive cardiac failure with vasodilators (author's transl)].

The possibility of development of tolerance of treatment with vasodilators was investigated in 16 patients with severe chronic congestive cardiac failure. Independent of the primary site of action, the first application of a vasodilator resulted in lowering of pulmonary artery pressure by about 30% (isosorbide dinitrate 40 mg orally in delay-action form and 5 mg sublingually, prazosin 2 mg, dihydralazine 75 mg). Only dihydralazine reduced systemic resistance acutely by 42% and increased cardiac minute volume by 66%.

The acute effect of a new positive inotropic agent (AR-L 115 BS) on cardiac hemodynamics and contractility in patients with severe chronic congestive heart failure.

The hemodynamic effect of 2-[(2-methoxy-4-methylsulfinyl)phenyl]- 1H-imidazo[4,5-b]pyridine (AR-L 115 BS), a new positive-inotropic substance, was studied in 10 Patients with chronic congestive heart failure after i.v. infusion of increasing does of 1.

[One- and two-dimensional echography for aneurysms and dissections of the aorta (author's transl)].

Aneurysms and dissections of the aorta--depending on their location--are the cause for a variety of cardiovascular symptoms. In most cases they are the result of a generalised disease of the vessel wall. Consequently, echographic examinations should include the entire aorta from the root to the bifurcation, systematically utilising all accessibilities.