[Spontaneous non-traumatic splenic rupture as a presentation form of light chain amyloidosis. Report of one case].

We report a 35-year-old sportive man who was admitted to the emergency department for worsening of acute spontaneous abdominal pain appearing at rest. He only referred having lifted a tree trunk the day before, but he was used to perform such physical efforts. The clinical course at the emergency department was marked by the development of severe anemia secondary to a progressive splenic hematoma and acute pulmonary distress.

Factors associated with noninvasive coronary flow reserve in severe aortic stenosis.

Background: Coronary flow reserve (CFR) is progressively impaired with aortic stenosis (AS) severity. However, there is a broad range of CFR in patients with severe AS, and the factors responsible for this variability are weakly characterized. The aim of this study was to assess the correlates of noninvasive CFR in patients with severe AS (≤1 cm(2) or ≤0.

Assessment of left ventricular twist mechanics in Tako-tsubo cardiomyopathy by two-dimensional speckle-tracking echocardiography.

Aims: To assess left ventricular (LV) twist mechanics in patients with Tako-tsubo cardiomyopathy (TTC).

Methods And Results: Two-dimensional strain and LV twist by speckle-tracking echocardiography was performed in 17 consecutive patients with typical TTC according to the Mayo clinic criteria [78 ± 8 years, 88% women, and mean left ventricular ejection fraction (LVEF) 45 ± 10%], at the acute phase (within 24 h after admission) and after recovery (1 month later). Seventeen control (C) patients matched for age and sex (mean LVEF 70 ± 7%), and 17 patients with acute anterior myocardial infarction (MI) treated by successful primary angioplasty 24 h before, matched for LVEF, age, and sex, were compared with TTC patients.

Comparison between non-invasive coronary flow reserve and fractional flow reserve to assess the functional significance of left anterior descending artery stenosis of intermediate severity.

Background: Assessment of the functional significance of left anterior descending coronary artery (LAD) stenosis of intermediate severity (50%-70% diameter stenosis) is challenging. The aim of this study was to compare the value of noninvasive coronary flow reserve (CFR) with that of invasive fractional flow reserve (FFR) in the setting of LAD stenosis of angiographic intermediate severity.

Methods: Fifty stable consecutive patients (mean age, 63 ± 13 years; 11 women; mean left ventricular ejection fraction, 61 ± 10%) with angiographic proximal LAD stenoses of intermediate severity (55.

Non-invasive coronary flow reserve after successful primary angioplasty for acute anterior myocardial infarction is an independent predictor of left ventricular recovery and in-hospital cardiac events.

Background: The prediction of left ventricular (LV) recovery and adverse cardiac events after reperfused acute myocardial infarction (AMI) is challenging. The aim of this study was to assess the usefulness of noninvasive coronary flow reserve (CFR) to predict LV recovery and in-hospital adverse cardiac events after AMI by comparison with other available tools.

Methods: Fifty-five consecutive patients (mean age, 59 +/- 13 years; 33% women) with first reperfused ST-elevation anterior AMIs and sustained Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow underwent prospectively, < 24 hours after successful primary coronary angioplasty, standard echocardiography and noninvasive CFR assessment in the distal part of the left anterior descending coronary artery, using intravenous adenosine infusion, while in a stable hemodynamic situation.

Transient impairment of coronary flow reserve in tako-tsubo cardiomyopathy is related to left ventricular systolic parameters.

Aims: Recent studies suggest that coronary flow reserve (CFR) is transiently impaired in tako-tsubo cardiomyopathy (TTC). Mechanisms by which such impairment occurs are still unknown. To assess the relationship between CFR obtained by transthoracic Doppler echocardiography (TDE) and parameters of left ventricular (LV) performance in patients with TTC.

Prognostic value of transthoracic coronary flow reserve in medically treated patients with proximal left anterior descending artery stenosis of intermediate severity.

Aims: Prognostic value of transthoracic coronary flow reserve (T-CFR) is not established in patients with left anterior descending artery (LAD) stenosis of intermediate severity. Objective is to determine the prognosis value of T-CFR>2 in medically treated patients with angiographically intermediate [50-70% QCA (quantitative coronary angiography)] proximal LAD stenosis.

Methods And Results: Among 110 consecutive patients with intermediate LAD stenosis who underwent prospectively T-CFR in the distal part of the LAD after intravenous administration of adenosine to assess the functional significance of the stenosis, 80 patients had T-CFR>2 and were treated medically without revascularization (Group 1).

The coronary flow reserve is transiently impaired in tako-tsubo cardiomyopathy: a prospective study using serial Doppler transthoracic echocardiography.

The clinical features of tako-tsubo cardiomyopathy or transient left apical ballooning syndrome (LABS) have been clearly described, but the mechanisms are still unknown. Our objective was to prospectively assess coronary microcirculation at the acute phase of LABS and after functional recovery, using Doppler transthoracic echocardiography-coronary flow reserve (CFR). Twelve consecutive patients (11 women, mean age 68 +/- 10 years) satisfying the criteria for LABS underwent Doppler transthoracic echocardiography-CFR in the distal part of the left anterior descending coronary artery, using intravenous adenosine infusion (0.

Assessment of coronary flow reserve by transthoracic Doppler echocardiography in left apical ballooning syndrome.

We present the time course of transthoracic coronary flow reserve in the left anterior descending artery in a patient who suffered a transient left apical ballooning syndrome.

Transthoracic coronary flow velocity reserve assessment: comparison between adenosine and dobutamine.

Objective: We sought to compare coronary flow velocity reserve (CFVR) with adenosine and dobutamine in patients scheduled for noninvasive evaluation of coronary artery disease.

Background: Assessment of CFVR in the distal part of the left anterior descending coronary artery (LAD) by Doppler transthoracic echocardiography (TTE) is usually performed with adenosine in various settings. CFVR can also be determined during dobutamine stress echocardiography (DSE), but it has not been established whether TTE CFVR with dobutamine is equivalent to CFVR with adenosine.

Evaluation of left anterior descending coronary artery stenosis of intermediate severity using transthoracic coronary flow reserve and dobutamine stress echocardiography.

Background: The physiologic significance of left anterior descending coronary artery (LAD) stenosis of intermediate angiographic severity is of clinical importance and difficult to assess. Assessment of coronary flow reserve (CFR) by Doppler transthoracic echocardiography (TTE) is a new tool and could allow rapid, noninvasive evaluation of stenosis severity in this setting.

Objective: We sought to evaluate the value of CFR measurement determined by TTE, compared with dobutamine stress echocardiography (DSE), in the setting of LAD stenosis of intermediate angiographic severity.

Significance of systolic anterior motion of the mitral valve during dobutamine stress echocardiography.

Left ventricular outflow tract obstruction related to systolic anterior motion of the mitral valve (SAM) induced during dobutamine stress echocardiography (DSE) is not unusual but its significance is not established. A total of 100 consecutive patients (mean age 62 +/- 12 years; 67% male) without previous transmural myocardial infarction, valvular disease, or hypertrophic cardiomyopathy, undergoing DSE to assess the presence of myocardial ischemia, were prospectively evaluated. A SAM with DSE was searched and correlated with clinical and baseline echocardiographic findings.