A case of coronary artery fistula diagnosed in the right decubitus position by transthoracic echocardiography.

A 70-year-old woman was admitted to our hospital for a continuous heart murmur in the fourth intercostal space at the right sternal border. Routine echocardiography demonstrated aneurismal dilatation at the origin of right coronary artery. These findings suggested a coronary artery fistula, although its drainage site could not be identified.

Interatrial septum pacing decreases atrial dyssynchrony on strain rate imaging compared with right atrial appendage pacing.

Background: Interatrial septum pacing (IAS-P) decreases atrial conduction delay compared with right atrial appendage pacing (RAA-P). We evaluate the atrial contraction with strain rate of tissue Doppler imaging (TDI) during sinus activation or with IAS-P or RAA-P.

Methods: Fifty-two patients with permanent pacemaker for sinus node disease were enrolled in the study.

Long-term effect of spironolactone on cardiac structure as assessed by analysis of ultrasonic radio-frequency signals in patients with ventricular hypertrophy.

Background: An effect of aldosterone on ventricular fibrosis has been demonstrated in animals, but remains unclear in human patients. This study aimed to investigate (1) the relationship between left ventricular (LV) fibrosis and myocardial ultrasonic texture as assessed with myocardial radio-frequency (RF) signals analyzed from the viewpoint of their waveform with chaos theory in animals and (2) serial changes in myocardial ultrasonic texture following long-term aldosterone blockade in patients with LV hypertrophy.

Methods And Results: In an animal study, Sprague-Dawley rats were divided into 2 groups with and without adriamycin administration, and the relationship between the RF signals and LV fibrosis was assessed.

Instantaneous assessment of left ventricular midwall mechanics with tissue Doppler tracking technique.

Background: Left ventricular (LV) systolic function is better characterized by midwall mechanics in patients with LV hypertrophy than by endocardial LV function, and the midwall mechanics is an independent predictor of prognosis. However, a complex calculation is currently required to assess it, and it is not routinely assessable in clinical practice. Tissue Doppler imaging enables tracking of a point within the LV wall though a cardiac cycle; we tested our hypothesis that the tissue Doppler tracking technique provides an instantaneous and reliable evaluation of midwall mechanics.