Echocardiography predictors and prognostic value of pulmonary artery systolic pressure in chronic organic mitral regurgitation.

Objective: To evaluate the predictors of pulmonary artery systolic pressure (PASP) in organic mitral regurgitation (MR) and its prognostic value after surgery.

Design: Prospective observational study, conducted from 1998 to 2006.

Setting: Echocardiography and cardiac surgery departments, University Hospital.

Frequency of abdominal aortic aneurysm in patients undergoing coronary artery bypass grafting.

The aims of this study were to clarify the prevalence and the risk factors for unsuspected abdominal aortic aneurysm (AAA) in patients who underwent coronary artery bypass grafting for severe coronary artery disease and to identify the most at risk patients for AAA. Among 217 patients (189 men, mean age 64 +/- 11 years), asymptomatic AAAs, as prospectively identified by echocardiography, were found in 15 patients (6.9%).

Longitudinal right ventricular function as a predictor of functional capacity in patients with mitral stenosis: an exercise echocardiographic study.

Background: The influence of right ventricular (RV) function on exercise capacity has been poorly explored in mitral stenosis (MS). The objective of this study was to assess the determinants of functional status with exercise echocardiography in MS.

Methods: Thirty-nine patients (55 +/- 12 years, 29 female) with MS (1.

[Ankle brachial index measurement at the first visit for hypertension: a safe and very useful tool for aortic coarctation screening. A case report].

A 24-year-old African who had been living in France for few years first consulted at our institution for severe systemic hypertension. He had no prior medical or surgical history. The patient was strictly asymptomatic.

Prospective assessment of multiple cardiac papillary fibroelastomas: an echocardiographic and surgical study.

Multiple cardiac papillary fibroelastomas (PFEs) are thought to account for less than 10% of patients with PFE. We aimed at evaluating the frequency and location of multiple PFEs and the reliability of transthoracic (TTE) and transoesophageal (TEE) echocardiography in diagnosing multiple PFEs. Twenty-six consecutive patients (52±14 years, 65% males) with pathologically confirmed PFE had 21 PFEs diagnosed by TTE, 33 by TEE, and 62 at surgery.

[Management of renal atrophy in hypertensive patients: experience in Lille].

Introduction: In the absence of specific treatment, patients with renal vascular disease develop renal atrophy. This population frequently has hypertension refractory to medical treatment. The patients who may respond to revascularization or at the worst to a nephrectomy must be identified to optimize their therapeutic management.

[Follow up of endovascular abdominal aortic anevrysm repair with contrast ultrasound].

Endovascular aortic aneurysm repair (EVAR) is a widely accepted treatment for anatomically fitted abdominal aortic aneurysms. The increasing use of this procedure has prompted the need for close surveillance and reliable post-operative imaging. The current tool for assessing EVAR technical success is to perform computed tomography angiography (CTA) in order to exclude endoleaks and to confirm the exclusion of the aneurysm sac.

Functional impairment of von Willebrand factor in hypertrophic cardiomyopathy: relation to rest and exercise obstruction.

Background: Hypertrophic obstructive cardiomyopathy submits blood to conditions of high shear stress. High shear stress impairs von Willebrand factor (VWF) and promotes abnormal bleeding in aortic stenosis. We sought to evaluate VWF impairment and its relationships to baseline or exercise obstruction in hypertrophic cardiomyopathy (HCM).

Left ventricular abnormal response during dynamic exercise in patients with heart failure and preserved left ventricular ejection fraction at rest.

Background: The mechanisms that contribute to limit functional capacity are incompletely understood in patients with preserved resting ejection fraction (HFpREF). We assessed left ventricular (LV) systolic response to dynamic exercise in patients with HFpREF and in patients with similar comorbidities to HFpREF patients but without history or evidence of heart failure.

Methods And Results: Twenty-five HFpREF patients in steady-state clinical condition without significant coronary artery disease and 25 hypertensive controls underwent exercise echocardiography.

Clinical value of exercise Doppler echocardiography in patients with cardiac-valvular disease.

Besides its usefulness for the detection of exercise-induced ischemia, conventional exercise testing may help to predict the onset of clinical events and the need for surgery in asymptomatic patients with cardiac-valvular disease. Doppler echocardiography examination during exercise recently emerged as a new stress testing modality that may add useful information regarding dynamism of LV function, valve disease severity and pulmonary circulation. Few studies have demonstrated a correlation between the results of exercise Doppler echocardiography and clinical outcome.

Exercise does not enhance the prognostic value of Doppler echocardiography in patients with left ventricular systolic dysfunction and functional mitral regurgitation at rest.

Background: Functional mitral regurgitation (MR) is a powerful predictor of poor prognosis in patients with chronic heart failure (CHF) due to left ventricular systolic dysfunction (LVSD). However, severity of MR varies with dynamic exercise. Accordingly, we sought to assess the prognostic value of exercise-induced changes in functional MR in patients with LVSD and functional MR at rest.

Assessment of papillary fibroelastomas with live three-dimensional transthoracic echocardiography.

Seven consecutive patients presenting with typical echocardiographic features of papillary fibroelastoma requiring surgery were studied. All patients underwent standard two-dimensional (2D) transthoracic echocardiography (TTE) followed by live three-dimensional (live 3D) echocardiography with data set storage allowing analysis with systematic cropping of the acquired 3D data and volume measurement of the lesions. Assessment of papillary fibroelastoma by 2D and live 3D TTE was compared to operative findings.

Chordal cutting VIA aortotomy in ischemic mitral regurgitation: surgical and echocardiographic study.

Background: Chordal cutting through atriotomy has been proposed to treat significant resting ischemic mitral regurgitation (MR) due to anterior leaflet tenting. In addition, MR may exacerbate during exercise not only trough exercise-induced ischemia but also through an increase in tenting area. Accordingly, we aimed to perform chordal cutting through aortotomy in patients with exercise-induced ischemic worsening of MR.

Cardiac correlates of exercise induced pulmonary hypertension in patients with chronic heart failure due to left ventricular systolic dysfunction.

Background: Patients with chronic heart failure (CHF) due to left ventricular systolic dysfunction (LVSD) may develop pulmonary hypertension at rest and during exercise. The cardiac correlates of pulmonary hypertension have been ascertained in the resting state, but seldom during exercise in these patients.

Aims: We sought to determine the cardiac correlates of exercise induced pulmonary hypertension in patients with LVSD by monitoring the estimated pulmonary artery systolic pressure (PASP) by continuous Doppler echocardiography during semirecumbent bicycle exercise.

Cardiovascular risk factors as predictors of early and late survival after bioprosthetic valve replacement for aortic stenosis.

Background And Aim Of The Study: Cardiovascular risk factors have been associated with aortic valve stenosis, which is considered as an atherosclerosis-like process. The study aim was to assess the effect of cardiovascular risk factors on early and late outcome after valve replacement with a bioprosthesis for aortic stenosis (AS), and the impact of these factors on the outcome of the bioprosthesis.

Methods: Preoperative clinical, biological and echocardiographic data were recorded in 222 patients (110 males, 112 females; mean age 73 +/- 8 years) who underwent surgery for severe AS between 1989 and 1993.

Left ventricular response to exercise in aortic stenosis: an exercise echocardiographic study.

Background: While normal at rest, left ventricular (LV) systolic function may become abnormal during exercise in patients with aortic stenosis. Once contraindicated in patients with aortic stenosis, exercise testing is now recommended in asymptomatic patients with aortic stenosis to elicit symptoms and thereby ascertain the need for aortic valve replacement. However, the clinical significance of an abnormal LV response to exercise in asymptomatic patients with aortic stenosis remains unknown.

Low-level exercise echocardiography fails to elicit left ventricular contractile reserve in patients with aortic stenosis, reduced ejection fraction, and low transvalvular gradient.

Background: Low-level exercise echocardiography is useful to assess left ventricular (LV) contractile reserve after an acute myocardial infarction. Whether low-level exercise can elicit LV contractile reserve in patients with severe aortic stenosis, reduced LV systolic function and low transvalvular gradient are unknown. Accordingly, the value of low-level exercise to elicit contractile reserve was assessed in these patients using dobutamine administration as the gold standard method.

[Three-dimensional echography: cardiovascular applications].

Real-time three-dimensional echocardiography is currently used in a standard echocardiographic examination. Volume-rendered images better identify and locate anatomic structures and improve our comprehensive approach to various heart diseases. The assessment of mitral valve disease and congenital cardiopathies and the measurement of left ventricular mass, volume, and ejection fraction are the three main applications of three-dimensional echocardiography.

[Usefulness of magnetic resonance angiography in the screening of renal artery stenosis in hypertensive patients: proposition of a diagnostic algorithm: a study of 245 patients].

Usefulness of magnetic resonance angiography in the screening of renal artery stenosis in hypertensive patients: proposition of a diagnostic algorithm: a study on 245 patients. Different non-invasive techniques, including Duplex, spiral angioscan, and magnetic resonance angiography (MRA) are available for the diagnosis of renal artery stenosis (RAS). The aim of this study was to assess the diagnostic performances of MRA and the MRA-Duplex couple in the diagnosis of RAS.

Cardiac resynchronisation therapy reduces functional mitral regurgitation during dynamic exercise in patients with chronic heart failure: an acute echocardiographic study.

Objectives: To assess non-invasively the acute effects of cardiac resynchronisation therapy (CRT) on functional mitral regurgitation (MR) at rest and during dynamic exercise.

Methods: 21 patients with left ventricular (LV) systolic dysfunction and functional MR at rest, treated with CRT, were studied. Each patient performed a symptom-limited maximal exercise with continuous two dimensional Doppler echocardiography twice.

Myocardial asynchronism is a determinant of changes in functional mitral regurgitation severity during dynamic exercise in patients with chronic heart failure due to severe left ventricular systolic dysfunction.

Aims: Functional mitral regurgitation (MR) and myocardial asynchronism occur commonly in patients with dilated cardiomyopathy and affect adversely their prognosis and symptoms. The aim of this study was to evaluate the mechanisms of changes in MR severity during dynamic exercise in patients with chronic heart failure (CHF).

Methods And Results: Seventy patients with CHF due to left ventricular (LV) systolic dysfunction [LV ejection fraction (EF) <40%] and functional MR were studied.

[The role of carotid and transcranial Doppler sonography in the management of ischemic stroke].

Carotid stenosis is a common cause of ischemic stroke. The management of patients with a carotid lesion is mainly based on the degree of stenosis. Ultrasonography is a reliable and accurate method of quantification of the stenosis.