'2' much mitral tissue.

A 73-year-old female patient was referred for evaluation after suffering an atypical chest pain. Physical examination and ECG were normal. The echocardiogram showed a normal ventricular function.

Angiotension-converting enzyme gene I/D polymorphism in patients with angina and normal coronary arteriograms.

A polymorphism of the human angiotensin-converting enzyme (ACE) gene has been identified in which the insertion (I) rather than the deletion (D) variant is associated with lower circulating and tissue ACE activity. ACE I allele is associated with resistance and endurance performance. Skeletal muscle metabolic efficiency is reduced in patients with heart failure and is improved by ACE inhibition.

CD14 C(-260)T promoter polymorphism and prevalence of acute coronary syndromes.

Background: Inflammation and infection have been implicated in atherosclerosis and its complications. The CD14 receptor mediates monocyte activation by lipopolysaccharide (LPS) of Gram-negative bacteria. The aim of this study was to assess whether the C(-260)T polymorphism in the promoter of the CD14 receptor gene is associated with a higher prevalence of acute coronary syndromes (ACS) and severity of coronary atherosclerosis.

Management of iatrogenic radial artery perforation.

The aim of this study was to evaluate a new protocol allowing coronary angiography to be performed transradially in spite of the occurrence of iatrogenic radial artery perforation during catheterization. Nine patients with iatrogenic radial artery perforation were managed conservatively by inserting a long arterial sheath in the damaged radial artery up to the brachial artery, after which the diagnostic and/or interventional procedures that had motivated transradial catheterization were completed via the protected radial artery. Radial angiography performed immediately thereafter showed no extravasation, and no major vascular complications developed during follow-up.

[Cardiovascular syndrome X and endothelial dysfunction].

Up to 30% of patients with chest pain who undergo coronary arteriography, have completely normal coronary angiograms. The subgroup with typical angina and a positive response to stress testing is generally included under the diagnosis of cardiovascular syndrome X. Several causes and mechanisms have been investigated in the past twenty years, to explain both chest pain and ischemic angina-like ST segment depression that are commonly observed in these patients.

[Transradial approach to coronary angiography and angioplasty: initial experience and learning curve].

Introduction: The transradial approach has emerged as an attractive alternative to the femoral approach for coronary angiography and interventions. We describe our experience with the transradial approach and analyze the influence of the learning curve.

Patients And Methods: The transradial approach was attempted in patients with a good radial pulse and normal Allen test.

[Exercise echocardiography to differentiate dilated cardiomyopathy from ischemic left ventricular dysfunction].

Objectives: Previous studies have shown the usefulness of dobutamine echocardiography to differentiate dilated cardiomyopathy (DC) from ischemic left ventricular dysfunction (ILVD), but no studies have been made using exercise echocardiography (EE). We hypothesized that most patients with DC have some contractile reserve and experience an increase in left ventricular ejection fraction (LVEF) during exercise, as opposed to patients with ILVD. Differences in response to EE may be useful to clinically differentiate between these two entities.