Noninvasive assessment of exercise tolerance using mitral annular velocities.

Purpose: To investigate the feasibility of evaluating exercise tolerance using lateral and septal mitral annular velocities in patients with preserved left ventricular ejection fraction (LVEF) and those with reduced LVEF.

Method: We studied 36 patients with LVEF ≥50% and 36 with LVEF <50%. We measured peak early diastolic velocity of transmitral flow (E) and peak early diastolic velocities of the lateral (LEa) and septal (SEa) mitral annulus.

Nonbacterial thrombotic endocarditis demonstrated by repeat echocardiography.

We report a case of nonbacterial thrombotic endocarditis (NBTE) in a patient with bladder cancer presenting with multiple cerebral infarctions. Initial transthoracic and transesophageal echocardiography did not show any abnormalities. However, repeat transthoracic and transesophageal echocardiography demonstrated a vegetation on the anterior leaflet of the mitral valve with mild mitral regurgitation and no evidence of leaflet destruction.

Donepezil-induced torsades de pointes without QT prolongation.

We report a case of torsades de pointes (TdP) induced by donepezil without QT prolongation. An 86-year-old woman was admitted to our hospital because of a syncopal attack. She had been treated for Alzheimer's disease with donepezil.

Impact of milrinone on mitral annular velocity in patients with congestive heart failure.

Purpose: The purpose of this study is to assess the impact of milrinone on mitral annular velocity in patients with congestive heart failure.

Method: We studied 27 patients with congestive heart failure. All patients underwent transthoracic echocardiography both before and after administration of milrinone.

Effects of mineralocorticoid receptor antagonist spironolactone on atrial conduction and remodeling in patients with heart failure.

Background: Spironolactone was shown to reduce mortality in patients with heart failure (HF). However, the effect of spironolactone on the incidence of atrial fibrillation remains unknown. Therefore, we examined the effects of spironolactone on atrial conduction and remodeling in patients with HF.

Defibrillation efficacy of a subcutaneous array lead: A case report.

We report a case of Brugada syndrome with a high defibrillation threshold (DFT) in whom a subcutaneous array lead was used to lower the DFT in combination with a transvenous right ventricular defibrillation lead. The patient had previously received pacemaker implantation due to sick sinus syndrome. An implantable cardioverter defibrillator (ICD) with a transvenous right ventricular defibrillation lead alone required a high DFT.

Impact of intraoperative transesophageal echocardiography in cardiac and thoracic aortic surgery: experience in 1011 cases.

Background: Although intraoperative transesophageal echocardiography (IOTEE) has been widely used in cardiovascular surgery, the exact incidence of abnormalities detected by IOTEE in each type of surgical procedure is still unclear. The aim of this study was to review our experiences of IOTEE, in patients who underwent different types of cardiovascular surgery and to evaluate the clinical usefulness of IOTEE.

Methods And Results: Our database of 1011 consecutive patients, who underwent cardiovascular surgery and IOTEE monitoring was reviewed.

Cardio-ankle vascular index is superior to brachial-ankle pulse wave velocity as an index of arterial stiffness.

Both cardio-ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV) are noninvasive methods to estimate arterial stiffness. The purpose of this study is to determine whether CAVI or baPWV is superior as an index of arterial stiffness. One hundred and thirty patients with chest pain syndrome who underwent coronary angiography (CAG) were included in this study.

Cardio-ankle vascular index is a new noninvasive parameter of arterial stiffness.

Background: Beta is an index of arterial stiffness independent of blood pressure. Beta of the thoracic descending aorta (TDA) has been obtained by transesophageal echocardiography (TEE) and the cardio-ankle vascular index (CAVI) is a new noninvasive estimation of beta.

Methods And Results: The purpose of this study was to evaluate the accuracy and usefulness of CAVI and to compare it with other parameters of arteriosclerosis by carotid ultrasound (CU).

Ratio of early transmitral velocity to lateral mitral annular early diastolic velocity has the best correlation with wedge pressure following cardiac surgery.

Background: Although previous investigators reported that mitral annular velocity predicts mean pulmonary capillary wedge pressure (PCWP), it is unknown whether the lateral or septal mitral annular velocity more faithfully predicts PCWP after cardiac surgery.

Methods And Results: To assess the effect of cardiac surgery on the predictive values for PCWP by measuring mitral annular velocity, 52 consecutive patients undergoing cardiac surgery were studied. All patients underwent transthoracic echocardiography and right-sided cardiac catheterization both before and after surgery.

Augmentation of left ventricular apical endocardial rotation with inotropic stimulation contributes to increased left ventricular torsion and radial strain in normal subjects: quantitative assessment utilizing a novel automated tissue tracking technique.

Background: The difference in the left ventricular (LV) torsion of the endo- and epicardium (Endo, Epi) with inotropic stimulation and its relation to radial strain (RS) remain unclear.

Methods And Results: LV basal and apical short-axis images were recorded in 13 normal subjects at rest and during dobutamine infusion (5, 10 microg x kg (-1) x min(-1)). A total of 8 points (anterior, lateral, posterior and septum in both Endo and Epi) were manually placed by 2-dimensional tissue tracking technique and the movement of these points during a cardiac cycle was tracked, after which the rotation angles and RS were calculated.

[Cardioversion of amiodarone-insensitive atrial fibrillation by bepridil in heart failure: two case reports].

Two patients presented with atrial fibrillation which was refractory to amiodarone but successfully treated with bepridil. A 76-year-old man with ischemic cardiomyopathy, non-sustained ventricular tachycardia (NSVT) and atrial fibrillation received amiodarone for NSVT, which disappeared but atrial fibrillation was sustained. A month after receiving amiodarone, interstitial pneumonia occurred.

Aging and transmitral flow pattern in patients with systemic hypertension.

Purpose: Currently, the transmitral flow (TMF) pattern is routinely recorded as the first step in the assessment of left ventricular diastolic function. In young, healthy subjects, it is known that the early diastolic flow (E wave) of TMF is larger than the late diastolic flow (A wave). The E/A ratio then gradually decreases with age.

Usefulness of mitral annular velocity in predicting exercise tolerance in patients with impaired left ventricular systolic function.

Left ventricular (LV) diastolic function is 1 of the determinants of exercise tolerance. However, the relation between early diastolic velocity of the mitral annulus (Ea) obtained by tissue Doppler imaging and exercise tolerance is unknown in patients with impaired LV systolic function. To investigate the feasibility of evaluating exercise tolerance using tissue Doppler imaging, we studied 53 consecutive patients (mean age 58 +/- 14 years) with a LV ejection fraction of <50% (mean 37 +/- 9%).

Can transthoracic Doppler echocardiography predict the discrepancy between left ventricular end-diastolic pressure and mean pulmonary capillary wedge pressure in patients with heart failure?

Background: Left ventricular end-diastolic pressure (LVEDP) is difficult to measure continuously; therefore, pulmonary capillary wedge pressure (PCWP) is frequently used instead for hemodynamic monitoring in patients with heart failure. However, a discrepancy between LVEDP and mean PCWP is sometimes observed.

Methods And Results: To assess the feasibility of evaluating this discrepancy using echo-Doppler indexes, 140 consecutive patients with heart disease were studied.

Significance of predischarge BNP on one-year outcome in decompensated heart failure--comparative study with echo-Doppler indexes.

Background: Cardiac natriuretic peptides and echo-Doppler indexes are important as prognostic indicators of congestive heart failure (CHF). However, differences between etiologies have not been fully investigated. This study aimed to assess the prognostic value of transmitral flow (TMF) and B-type natriuretic peptide (BNP) on admission or predischarge in patients with acutely decompensated CHF of ischemic and nonischemic etiologies.

Echocardiographic predictors of remote outcome in patients with angiographically successful reflow after acute myocardial infarction.

Background: The angiographically no-reflow phenomenon after percutaneous coronary intervention (PCI) predicts poor left ventricular (LV) functional recovery and a high risk of cardiac events in patients with their first acute myocardial infarction (AMI). However, risk factors of long-term adverse outcome for patients with angiographically successful reflow (TIMI (Thrombolysis in Myocardial Infarction) flow grade 3) for the AMI remain unknown.

Methods And Results: Of 168 echocardiograms were performed before PCI and at discharge, 113 were suitable for analysis.