Coronary sinus diameter to estimate congestion and predict survival.

Background: Congestion predicts a poor prognosis, but its assessment is challenging in clinical practice and requires a multiparametric approach. We investigated if the coronary sinus (CS) diameter can predict mortality in a human model of rapid fluid unloading.

Methods: We measured by echocardiography the CS, and the inferior vena cava (IVC) for comparison, in 60 patients with end-stage chronic kidney disease (ESKD) immediately before and after hemodialysis (HD; age 76 [57-81] years, 40% female, left ventricular ejection fraction 57 [53-56]%).

Opacification patterns of cardiac masses using low-mechanical index contrast echocardiography: comparison with histopathological findings.

Background: Two-dimensional echocardiography is the main noninvasive imaging tool to identify cardiac masses but is unable to provide detailed tissue characterization.

Aim: The aim of the study was to assess the ability of low mechanical index (MI) contrast echocardiography to detect presence and amount of tissue vascularization as validated by histopathology study of cardiac masses.

Methods And Results: Twelve consecutive patients (5 females and 7 males, age range 51-82 years) underwent conventional and contrast two-dimensional echocardiography with low MI.

Addition of Exercise to Dipyridamole Stress Echocardiography in Order to Carry on the Ischemic Cascade: Role in the Diagnosis of Coronary Artery Disease and Prognostic Value.

Background: Sensitivity of dipyridamole stress echocardiography (SE) is often lower than required. The aim of the present work is the evaluation of the association of dipyridamole and exercise echocardiography.

Methods: From June 2007 to January 2011, 259 consecutive patients referred to Camposampiero Echocardiography Laboratory underwent SE.

Reliability of a Simple Method for Determining Salt Taste Detection and Recognition Thresholds.

The aim of this study was to assess the reliability of a rapid analytical method to determine salt taste detection and recognition thresholds based on the ASTM E679 method. Reliability was evaluated according to criterion of temporal stability with a 1-week interval test-retest, with 29 participants. Thresholds were assessed by using the 3-AFC technique with 15 ascending concentrations of salt solution (1-292 mM, 1.

Stress echocardiography pattern: a promising noninvasive test for detection of myocardial bridging with haemodynamic relevance.

: We reported a case of a young athlete with an underlying myocardial bridging in the left anterior descending coronary artery (LAD) causing myocardial ischemia suspected by contrast exercise stress echocardiography and confirmed by computed tomography coronary angiography. Our report demonstrated that a specific stress echocardiography pattern consisting of reversible focal buckling in the end-systolic to early-diastolic motion of the septum may suggest the presence of an underlying myocardial bridging in the LAD.

Association between Taste Sensitivity and Self-Reported and Objective Measures of Salt Intake among Hypertensive and Normotensive Individuals.

This study investigated the gustatory threshold for salt and its relationship with dietary salt intake among hypertensive (n = 54) and normotensive (n = 54) subjects. Salt intake was evaluated through 24-hour urinary sodium excretion and self-reported measures (discretionary salt, Sodium- Food Frequence Questionnaire (Na-FFQ), and 24-hour recall). Detection and recognition thresholds were higher among hypertensive subjects, as well as the total sodium intake.

Low cerebrovascular event rate in subjects with patent foramen ovale and different clinical presentations: results from a prospective non randomized study on a population including patients with and without patent foramen ovale closure.

Background: There are conflicting data on the role of a patent foramen ovale (PFO) in the pathogenesis of cryptogenic stroke. The aim of this study was to evaluate the incidence of cerebrovascular events associated with PFO in a large population of patients during mid-term follow-up.

Methods And Results: We prospectively investigated 446 consecutive patients (58% female, age 50 ± 14 years) in whom PFO was detected by contrast echocardiography following cryptogenic stroke (30.

Microbubbles contrast inside the cyst: a pathognomonic sign of mitral valve blood cyst.

We report a case of giant blood cyst originating from the anterior mitral valve leaflet in an 18-year-old white girl. Contrast real-time transthoracic echocardiogram showed the presence of microbubbles inside the cystic cavity during diastole, confirming the presence of blood passage between the ventricular cavity and the cyst lumen and suggesting that this is a pathognomonic sign of the presence of a blood cyst. Although, in previous cases, contrast microbubbles inside the cyst have been described during systole, we report the presence of microbubbles during diastole.

Left ventricular dyssynchrony resulting from right ventricular apical pacing: relevance of baseline assessment.

Objectives: Evaluation of left ventricular (LV) dyssynchrony in patients undergoing short-term right ventricular apical (RVA) pacing and correlation with baseline echocardiographic and clinical characteristics.

Background: RVA pacing causes abnormal ventricular depolarization that may lead to mechanical LV dyssynchrony. The relationships between pacing-induced LV dyssynchrony and baseline echocardiographic and clinical variables have not been fully clarified.

Sine-wave pattern on the electrocardiogram and hyperkalaemia.

Hyperkalaemia is an electrolyte disturbance that can have effects on myocardial conduction causing electrocardiographic changes. Several factors may predispose to and promote potassium serum level increase leading to typical electrocardiographic abnormalities. We describe the case of a patient who presented with hyperkalaemia and an electrocardiographic aspect consistent with a sine-wave pattern.

Hypertensive patients and risk factors related to physical activity and nutrition.

The aim of this study was to identify the cardiovascular risk factors related to physical activity and/or nutrition of hypertensive patients (n = 99) seen at a public health care center of a large city in the southeastern part of Brazil. These factors included, diabetes mellitus (36.4% of patients, more frequent in women), dyslipidemia (38.

Transoesophageal echocardiographic evaluation of pulmonary vein anatomy in patients undergoing ostial radiofrequency catheter ablation for atrial fibrillation: a comparison with magnetic resonance angiography.

Objective: A detailed definition of pulmonary vein (PV) anatomy is of great importance in patients undergoing radiofrequency catheter ablation for atrial fibrillation. In fact, it is known that variations in the number and anatomy of the PV ostia are more frequent than thought. The aim of this study was to assess the usefulness of transoesophageal echocardiography (TOE) in defining the exact PV anatomy by comparing it with magnetic resonance angiography (MRA), which is proven to be very accurate.

Systolic and diastolic function in renal replacement therapy: a cross-sectional study.

Background: Heart disease is the main cause of death among uremic patients (pts). Our study aimed to assess left ventricular (LV) systolic and diastolic function in all of our pts on renal replacement therapy (RRT), investigating any differences between hemodialysis (HD), peritoneal dialysis (PD) and transplantation (TX) pts.

Methods: All pts on RRT at our nephrology unit were enrolled in the study and evaluated once over a period of 6 months: 125 pts were studied: 61 pts on HD, 30 pts on PD and 34 TX pts.

Transesophageal echocardiographic follow-up of pulmonary veins in patients undergoing ostial radiofrequency catheter ablation for atrial fibrillation.

Background: Ostial radiofrequency catheter ablation (RFCA) of pulmonary veins (PVs) is a promising invasive approach for the non-pharmacologic treatment of atrial fibrillation, but PV stenosis has been reported as a possible complication of this intervention. The aim of this study was to assess PV anatomy and stenosis (i.e.

Unusual tumor-like calcification of the mitral annulus: diagnosis and tissue characterization by ultrasound, computed tomography and magnetic resonance imaging.

Calcification of the mitral annulus is a common echocardiographic finding in the elderly, particularly in females. Calcium deposits are generally located in the posterior mitral ring, sometimes extending to the whole mitral annulus and involving the mitral valve apparatus. The present report refers to 2 patients with a very atypical mass-like calcification of the mitral annulus resembling a cardiac tumor.

Left ventricular diastolic function in pregnancy-induced hypertension.

Background: Hypertension occurs in some 10% of pregnancies and its effects on the left ventricular (LV) morphology and systolic function have been well elucidated. Little is known, however, about the changes in LV diastolic function in such a condition. The aim of this study was to evaluate the LV diastolic function in women with pregnancy-induced hypertension (PIH) using new Doppler echocardiographic methods.

Dissection of the ascending aorta mimicking an acute coronary syndrome: usefulness of transthoracic echocardiography for the differential diagnosis.

We describe the case of 2 patients presenting with chest pain and electrocardiographic signs of myocardial ischemia, in whom a transthoracic echocardiogram, performed urgently at the bedside, allowed a diagnosis of dissection of the ascending aorta. Prompt recognition of this condition avoided inappropriate aggressive medical treatments and permitted emergency surgical intervention. Aortic dissection can mimic other conditions including an acute coronary syndrome.

Interatrial septal aneurysm and genetic prothrombotic disorders: possible interaction in the pathogenesis of pediatric stroke.

Stroke in children is a rare condition and has a multifactorial etiology. The association between ischemic stroke in young adults and some minor cardiac abnormalities such as atrial septal aneurysm with or without interatrial shunting has recently been reported: however, the pathogenetic mechanism still remains unclear. Genetic and acquired prothrombotic disorders are also risk factors for cerebral ischemic events in children.

Biventricular pacing and atrioventricular junction ablation as treatment of low output syndrome due to refractory congestive heart failure and chronic atrial fibrillation.

A 71-year-old male patient with end-stage heart failure, atrial fibrillation, congestive and low output symptoms, underwent biventricular pacing and atrioventricular junction ablation while anuric and hypotensive. Following atrioventricular junction ablation blood pressure increased by 20 mmHg during biventricular but not during right ventricular apical pacing. A rapid clinical improvement was observed and the patient was discharged from the hospital in NYHA functional class III.

Dynamic Left Ventricular Outflow Tract Obstruction During Myocardial Ischemia in Mitral Valve Prolapse Syndrome.

Systolic anterior motion of the mitral valve (MV) with dynamic left ventricular (LV) outflow tract obstruction is a well known phenomenon in hypertrophic cardiomyopathy, or other forms of hyperdynamic LV function associated with hypovolemic states, or LV hypertrophy. We report three patients with MV prolapse in the absence of the above predisposing factors, who developed an LV outflow dynamic gradient during acute transient myocardial ischemia. An interaction between structural abnormalities of the mitral apparatus and ischemia-dependent LV shape deformity most likely accounted for the outflow gradient.

Anomalous origin of the left circumflex coronary artery from the right aortic sinus of valsalva and sudden death.

Anomalous origin of the left circumflex coronary artery from the right aortic sinus is generally considered a benign condition. We report a 53-year-old man with clinical and pathologic evidence of myocardial infarction and sudden death in the setting of this anomaly, with no evidence of obstructive coronary atherosclerosis.

[The complete regression of multiple cardiac rhabdomyomas in childhood].

Rhabdomyoma, even if rare, is the most common primary cardiac tumor in infancy and childhood. We present the case of a newborn in whom several intramural and intracavitary cardiac masses were found at birth by two-dimensional echocardiography, and showed complete regression at the follow-up examinations. Except for supraventricular arrhythmias, there were no symptoms or signs of cardiac involvement at birth: the baby was acyanotic and is no apparent distress; no murmur was detected and chest roentgenogram revealed normal heart size; association with Tuberous Sclerosis was excluded.

[A case of transient hypertrophic cardiomyopathy in a twin infant of a diabetic mother].

The case is reported of a dizygotic twin infant of a diabetic mother with transient hypertrophic cardiomyopathy. The clinical course and eco-ecg reports are described. The etiopathogenesis is discussed since no evidence of cardiomyopathy was found in the second twin.