Normal echocardiographic characteristics of the Sorin Bicarbon bileaflet prosthetic heart valve in the mitral and aortic positions.

Doppler echocardiographic characteristics of normally functioning Sorin Bicarbon prostheses were prospectively assessed in 226 consecutive patients (135 male and 91 female patients, mean age 61 +/- 10 years) with 233 valves in the mitral (n = 67) and aortic (n = 166) positions whose function was considered normal by clinical and echocardiographic evaluation. Patterns of "normal" transprosthetic leakage were assessed with transthoracic echocardiography in all valves and with transesophageal echocardiography in six selected mitral valve prostheses. For the mitral valve prostheses, we found that peak and mean gradient, as well as pressure half-time, were not significantly different in either the 25 or the 31 mm valves (median values from 15 to 10 mm Hg, from 4 to 4 mm Hg, and from 70 to 83 ms; p = Not significant for all).

Changes in effective aortic valve area during ejection in adults with aortic stenosis.

Measurements of valve orifice area in aortic stenosis are based on the assumption that orifice area remains constant throughout ejection and is independent of transvalvular gradients and flow. Recent studies, however, have suggested that the calculated valve area of calcific aortic stenosis may change in different flow conditions. Therefore, we tested the hypothesis that in vivo effective orifice area of a stenotic aortic valve changes continuously during ejection, which would make a single area measurement a potentially inadequate indicator of the severity of the stenosis.

[The methods of using the echocardiogram in outpatients. The role of the cardiologist for more appropriate use of the procedure. The Ligurian Group of the Italian Society of Cardiovascular Echocardiography].

Concerns about the increasing medical care costs are causing the medical community to focus its attention on the appropriate of diagnostic tests such as echocardiography. Prerequisite to a better utilization of the limited economic resources assigned to our health care system is an analysis of how, why, and with which results diagnostic tests with a widespread use and relevant cost, like echocardiography, are requested. During the last 2 weeks of September 1994, a transversal, observational study was carried out at 13 hospital echocardiographic laboratories.

[Doppler echocardiographic evaluation of the new mechanical bileaflet Sorin Bicarbon valve prosthesis compared with St. Jude Medical].

Background: Despite the Bicarbon valve has been marketed for more than two years, no systematic Doppler evaluation of its normal functioning has yet been published. Therefore, the aims of this study were to establish the normal flow characteristics for the Bicarbon bileaflet prosthetic heart valve and to compare them with those obtained from the St. Jude Medical valve prosthesis.

Doppler haemodynamic assessment of clinically and echocardiographically normal mitral and aortic Allcarbon valve prostheses. Valve Prostheses Ligurian Cooperative Doppler Study.

Doppler echocardiographic characteristics of normally functioning Allcarbon prostheses were studied in 149 consecutive patients with 157 valves in the mitral (n = 73) and aortic (n = 84) positions whose function was considered normal by clinical and echocardiographic evaluation. In the mitral position, the mean gradient and the effective mitral orifice area were not significantly different in either the 25-mm or the 31-mm size valves (from 5 +/- 1 to 4 +/- 1 mmHg and from 2.2 +/- 0.

Infective right atrial thrombus: a rare complication of total parenteral nutrition in an adult.

We describe a case of an infective right atrial thrombus, following total parenteral nutrition, in a 21-year-old woman undergoing a surgical procedure for long-standing chronic ulcerative colitis. She presented with high temperature and the illness did not respond to antibiotic therapy. A 2-dimensional echocardiogram showed a mobile right atrial mass that at surgery was identified as a thrombus.

[Age-induced changes in the cardiovascular system in normal subjects].

To assess the effect of age on cardiac structure and function, we performed echocardiograms on 104 physically active, normal, community-dwelling volunteers (68 men and 36 women), ranging in age from 18 to 84 years and having no evidence of hypertension or cardiovascular disease. With advancing adult aging, the following were observed: a decrease in aortic compliance (r = 0.42); an increase in systolic (r = 0.

[Changes in modalities of left ventricular filling associated with aging in normal subjects: secondary to increase in blood pressure and left ventricular mass?].

The mechanisms by which aging alters the pattern of left ventricular diastolic filling are still uncertain. To gain more insight into this tissue, the independent contributions of age, sex, heart rate, arterial blood pressure and left ventricular mass (as well as various indexes of left ventricular morphology and function) to left ventricular diastolic filling abnormalities, were investigated by echocardiography in 81 normal subjects (18 to 84 years of age, mean 50), carefully screened to avoid the confounding effects of coronary artery disease and systemic hypertension. With advancing adult age, we found a significant increase in: body mass index (r = 0.

Concentric left ventricular wall thickening in a patient with primary hypothyroidism. Response to gradual thyroxine replacement.

Asymmetric septal thickening has been described in patients with overt myxedema, but descriptions of concentric left ventricular wall thickening in such patients are rare. Echocardiographic detection of thickened left ventricular and interventricular walls, without pericardial effusion or any other sign of cardiac involvement, in a patient with overt myxedema and primary hypothyroidism, is reported. Furthermore, this is the first case in which the timing and the extent of the response of such abnormalities to L-thyroxine replacement therapy have been serially evaluated.

Frequency, characteristics and significance of supraventricular tachyarrhythmias detected by 24-hour electrocardiographic recording in the late hospital phase of acute myocardial infarction.

The incidence, characteristics and clinical significance of supraventricular tachyarrhythmias occurring in the late hospital phase of acute myocardial infarction (AMI) were assessed in 209 consecutive patients. Arrhythmias were quantified by 24-hour electrocardiographic recording 16 +/- 3 days after AMI, and were classified according to the degree of complexity in 5 classes. Class 0 = less than 5 premature beats/hr; class 1 = between 5 and 100/hr; class 2 = greater than 100/hr or repetitive premature beats; class 3 = atrial-junctional tachycardia; class 4 = atrial flutter-fibrillation.

Clinical course and prognosis of hypertrophic cardiomyopathy in an outpatient population.

Hypertrophic cardiomyopathy has been investigated mainly at referral institutions. Thus, the clinical history of the disease that emerges from published studies could be influenced by a bias in patient selection. In the present study, we compared the clinical features of an outpatient population of 25 patients who had hypertrophic cardiomyopathy with those reported in 78 studies published during the past five years.

[Pacemaker malfunctioning caused by subcutaneous emphysema].

We report a case of early pace-maker malfunction associated with a collection of air which separates the anodal contact plate of a unipolar permanent generator from the underlying tissues. The air pocket resulted from a complication of the percutaneous technique used to introduce the electrocatheter through the subclavian vein. Loss of capture was attributed to a critical increase in impedance to current flow in the pacing system.

The relation between supraventricular tachyarrhythmias and left ventricular dysfunction after acute myocardial infarction.

The clinical characteristics of supraventricular tachyarrhythmias (SVTA) and their relation to left ventricular dysfunction were assessed in 208 consecutive patients with recent myocardial infarction. Arrhythmias were quantified on hospital discharge by 24 hour electrocardiographic recording. All the variables were evaluated between the second and the fourth week after infarction.

[Efficacy of propafenone in the treatment of ventricular hyperkinetic arrhythmias in subjects with a history of myocardial infarction].

A placebo-controlled single-blind study was performed to evaluate the efficacy of oral propafenone on stable potentially malignant ventricular tachyarrhythmias in 13 patients who had suffered a myocardial infarction two months or longer before the trial. All patients exhibited at a 24 hour Holter monitoring a minimum mean frequency of 10 ventricular premature depolarizations (VPDs) per hour and repetitive VPDs. Ventricular tachyarrhythmias characterization was obtained by means of multiple Holter monitorings and exercise stress testings.

Clinical significance of supraventricular tachyarrhythmias after acute myocardial infarction.

160 survivors of acute myocardial infarction (AMI) were evaluated to assess the clinical significance of supraventricular tachyarrhythmias (SVTA) occurring at discharge from the hospital after the acute event. All the variables considered for the study were estimated before hospital discharge; arrhythmias were quantified with a 24 h Holter ECG monitoring system. SVTA occurred in 88 patients (55%).