A radial global dyssynchrony index as predictor of left ventricular reverse remodeling after cardiac resynchronization therapy.

Background: Cardiac mechanical efficiency requires that opposing left ventricular regions are coupled both in shortening and lengthening during the same phase of cardiac cycle. Aim of this study was to evaluate whether global measures of mechanical dyssynchrony are able to predict reverse remodeling of the left ventricle in patients receiving cardiac resynchronization therapy (CRT).

Methods: Sixty-two patients underwent a clinical examination, including New York Heart Association class evaluation and 6-minute walking distance and both echocardiographic study before and 6 months after CRT.

End-diastolic wall thickness as a predictor of reverse remodelling after cardiac resynchronization therapy: a two-dimensional echocardiographic study.

Background: The aim of this study was to evaluate whether in patients with ischemic heart failure (HF) with mechanical dyssynchrony the echocardiographic assessment of the extent of scarred ventricular tissue by end-diastolic wall thickness (EDWT) could predict reverse remodeling (RR) after cardiac resynchronization therapy (CRT). Recent studies using cardiac magnetic resonance imaging have shown that the burden of myocardial scar is an important factor influencing response to CRT, despite documented mechanical dyssynchrony. EDWT assessed by two-dimensional (2D) resting echocardiography is a simple and reliable marker to identify scar tissue in patients with ischemic left ventricular dysfunction.

Presence of left ventricular contractile reserve, evaluated by means of dobutamine stress-echo test, is able to predict response to cardiac resynchronization therapy.

Introduction: We evaluated whether the dobutamine stress-echo test can select responders to cardiac resynchronization therapy (CRT). Up to 50% of patients do not respond to CRT. Lack of response may be due to a significant amount of scar or fibrotic tissue at myocardial level.

Factors predicting coronary flow reserve impairment in patients evaluated for chest pain: an ultrasound study.

Objective: To evaluate the impact of multiple cardiovascular risk factors on coronary flow reserve (CFR) in a large patient population with acute chest pain referred for coronary angiography.

Methods: Three hundred and ninety-four consecutive patients (mean age 59 +/- 10 years) were enrolled in the study. Blood flow velocity was measured, using transthoracic echocardiography, in the middle-distal tract of the left anterior descending coronary artery (LAD) at rest and during infusion of high-dose dipyridamole in 6 min.

An unusual presentation of "tako-tsubo cardiomyopathy".

We report a case of tako-tsubo cardiomyopathy, complicated by left ventricular apical thrombus.

Ultrasonographic assessment of basal coronary flow as a screening tool to exclude significant left anterior descending coronary artery stenosis.

Objective: Coronary blood flow exhibits a biphasic pattern at rest with a higher diastolic and a smaller systolic component. In the present investigation, we evaluated whether a decreased diastolic to systolic velocity ratio of basal coronary flow may be useful in the identification of subjects with significant left anterior descending coronary artery (LAD) stenosis.

Methods: One hundred and twenty-nine consecutive patients (62 with unstable angina, 25 with acute myocardial infarction and 42 with chronic coronary artery disease) were included in the study.

Iatrogenic aortic haematoma during primary PTCA: diagnostic value of transesophageal echocardiography in cath lab.

A 60-year-old woman with severe chest pain and ECG diagnostic for acute transmural ischemia was transferred to cath lab for primary PTCA. After procedure, transesophageal echocardiography (TEE) views revealed an intramural haematoma extending from the ostium of the RCA throughout the sino-tubular junction. These findings and the stable clinical conditions of patient guided us to a conservative therapeutic approach.

Effect of acute hyperhomocysteinemia on coronary flow reserve in healthy adults.

Background: B-mode ultrasound studies indicate that hyperhomocysteinemia is associated with preclinical structural and functional arterial abnormalities. This study was designed to evaluate the effect of elevated plasma homocysteine levels on coronary flow reserve (CFR).

Methods: A total of 20 healthy subjects aged 41 +/- 7 years were studied on 2 separate days, a week apart, before and after methionine load (100 mg/kg of body weight) or placebo in a double-blind crossover study.

Reversal of cardiac abnormalities in a young man with idiopathic hypereosinophilic syndrome using a tyrosine kinase inhibitor.

We report a case of idiopathic hypereosinophilic syndrome in a young man, who showed symptoms and electrocardiographic findings mimicking an acute coronary syndrome. Two-dimensional echocardiography, together with laboratory data, allowed us to make the diagnosis and to start a treatment with imatinib mesylate, a 2-phenylamonopyrimidine-based tyrosine kinase inhibitor, which reversed the cardiac abnormalities.

Accuracy and feasibility of a simplified approach to assess the regurgitant orifice area in patients with mitral regurgitation.

Background: Regurgitant orifice area (ROA) has been proposed as a marker of severity in patients with mitral regurgitation (MR). However, such fundamental quantitative echocardiographic parameter has failed to achieve widespread use, since it is difficult to measure. In the present study, we evaluated the accuracy and feasibility of a simplified method for quantification of ROA in patients with varying grades of MR.

Myocardial global performance index as a predictor of in-hospital cardiac events in patients with first myocardial infarction.

Objective: We sought to assess the ability of a Doppler index of global myocardial performance (MPI), measured at entry, to predict inhospital cardiac events in a series of patients with first acute myocardial infarction (AMI).

Methods: A complete 2-dimensional and Doppler echocardiographic examination was performed within 24 hours of arrival at the coronary care department in 96 patients (81 men and 15 women; mean age 58 +/- 9 years) with first AMI. Patients were divided a posteriori into 2 groups according to their inhospital course: group 1 comprised 75 patients with an uneventful course and group 2 comprised 21 patients with a complicated inhospital course (death, heart failure, arrhythmias, or post-AMI angina).

Painless acute aortic dissection presenting as echocardiographically diagnosed left ventricular outflow tract obstruction.

We present an unusual case of painless acute aortic dissection with an atypical echocardiographic presentation that could be confused with an aortic stenosis. Transesophageal echocardiography excluded the presence of aortic stenosis and disclosed a systolic anterior movement of the mitral valve as the cause of left ventricular outflow tract obstruction. It also revealed a type A aortic dissection.