Comparison of left atrial size by freehand scanning three-dimensional echocardiography and two-dimensional echocardiography.

Aims: As the left ventricular (LV) dimension is a poor indicator of LV volume, there are well-known limitations of left atrial (LA) antero-posterior dimensions as indicators of chamber size. LA volume has been shown to provide a more accurate assessment of LA size than LA dimension. To evaluate two-dimensional (2D)-derived LA volume in assessing LA size, we compared LA dimension and 2D LA volume with three-dimensional (3D)-derived LA volume.

[Validation of a new hand-carried ultrasound device equipped with directional color power Doppler and continuous wave Doppler].

Objectives: This study evaluated the accuracy of the directional color power Doppler (DCPD) and continuous wave Doppler (CWD) methods incorporated in the new hand-carried SonoSite 180PLUS ultrasound device.

Methods: The hand-held ultrasound system with 2.5 MHz transducer and SONOS 5500 was used as a standard ultrasound system with a 2 to 4 MHz wideband transducer.

Pulsed Doppler echocardiographic detection of the origin of musical murmurs in a case of pacemaker implantation.

We report a case of systolic and diastolic musical murmurs that developed 4 years after DDD pacemaker implantation. Echocardiographic examination disclosed no evidence of serious pacemaker-related complications. Pulsed Doppler examination with a sample volume at the right ventricular portion of a pacemaker lead showed prominent harmonic signals.

Noninvasive assessment of flow velocity and flow velocity reserve in the right gastroepiploic artery graft by transcutaneous Doppler echocardiography: comparison with an invasive technique.

Background: The measurement of flow velocity (FV) in coronary artery bypass grafts using a Doppler guidewire has provided useful clinical and physiologic information. The recently developed transcutaneous Doppler echocardiography is a noninvasive technique to measure FV and FV reserve (FVR) in the right gastroepiploic artery (GEA) graft. The purpose of this study was to evaluate whether transcutaneous Doppler echocardiography accurately measures FV and FVR in the right GEA graft in a clinical setting.

Late results of mitral valve repair for mitral regurgitation.

Objective: This study was undertaken to evaluate the long-term results of mitral valve repair for mitral regurgitation.

Methods: Between 1991 and 2000, 301 patients with mitral regurgitation underwent mitral valve repair. There were 167 men and 134 women whose mean age was 56 +/- 14 years.

Single-beat determination of Doppler-derived aortic flow measurement in patients with atrial fibrillation.

The clinical assessment of left ventricular systolic function in patients with atrial fibrillation is unreliable and difficult because of beat-to-beat variation. We initially evaluated an index that is on the basis of the ratio of preceding R-R (RR1) to pre-preceding R-R (RR2) intervals (RR1/RR2) for the measurement of Doppler aortic flow (peak flow velocity [Vp] and time-velocity integral [TVI] proportional to stroke volume) in 20 patients (aged 65 +/- 9.6 years) with atrial fibrillation.

[Assessment of the clinical feasibility of OptiGo for hand-held echocardiography].

Objectives: Hand-held ultrasound devices are becoming available for clinical examination, but the accuracy and precision of such devices are unclear. This study compared the accuracy of a hand-held echo device to a standard echo system.

Methods: Twenty-two patients were examined with the OptiGo (Phillips Medial Systems) hand-held ultrasound system with a 2.

Coronary flow velocity pattern immediately after percutaneous coronary intervention as a predictor of complications and in-hospital survival after acute myocardial infarction.

Background: Recently, it was reported that the degree of microvascular injury and left ventricular functional recovery during the chronic period can be predicted after treatment of the infarct-related artery based on the coronary flow velocity (CFV) pattern assessed using a Doppler guidewire. The aim of this prospective study was to examine whether the CFV pattern may predict complications and in-hospital survival after acute myocardial infarction (AMI).

Methods And Results: The study population consisted of 169 consecutive patients with a first anterior AMI successfully treated with percutaneous coronary intervention (PCI).

Effects of microvascular dysfunction on myocardial fractional flow reserve after percutaneous coronary intervention in patients with acute myocardial infarction.

Fractional flow reserve (FFR) has emerged as a lesion-specific index of the functional severity of coronary stenosis in patients with chronic coronary artery disease. As the coronary blood flow in acute myocardial infarction (AMI) patients with microvascular damage is restricted, the pressure drop across the stenosis during hyperemia may be smaller than expected. However, the effects of microvascular dysfunction on FFR in AMI patients remain undetermined.

Quantitative assessment of harmonic power Doppler myocardial perfusion imaging with intravenous Levovist in patients with myocardial infarction: comparison with myocardial viability evaluated by thallium-201 single-photon emission computed tomography and coronary flow reserve.

Background: Intravenous myocardial contrast echocardiography with harmonic power Doppler imaging is a novel technique for assessing myocardial perfusion.

Aims: The aim of this study was to quantitatively assess myocardial perfusion by harmonic power Doppler imaging in patients with a previous myocardial infarction and compare myocardial contrast echocardiography results with myocardial viability evaluated by thallium-201 single-photon emission computed tomography ((201)Tl-SPECT) and the results of Doppler flow measurement of coronary flow velocity reserve.

Methods: Twenty-three patients with anterior myocardial infarction who were scheduled for adenosine stress (201)Tl-SPECT underwent myocardial contrast echocardiography with harmonic power Doppler imaging.

Non-invasive automated assessment of the ratio of pulmonary to systemic flow in patients with atrial septal defects by the colour Doppler velocity profile integration method.

Background: The recent introduction of the automated cardiac flow measurement (ACM) method, using spatiotemporal integration of the Doppler velocity profile, provides a quick and accurate automated calculation of cardiac output.

Objective: To evaluate the ACM method against oximetry during cardiac catheterisation for estimating the Qp/Qs (pulmonary to systemic flow) ratio in patients with an atrial septal defect.

Methods: Left and right ventricular stroke volume (LVSV, RVSV) were calculated by ACM in 22 patients with an atrial septal defect who underwent cardiac catheterisation and in 11 patients without heart disease (control group).

Impact of insulin resistance on neointimal tissue proliferation after coronary stent implantation. Intravascular ultrasound studies.

Serial intravascular ultrasound (IVUS) studies in 55 nondiabetic patients showed that neointimal tissue proliferation after stent implantation in patients with impaired glucose tolerance (IGT) was greater than that in patients with normal glucose tolerance at follow-up. Multiple regression analysis showed that the sum of insulin levels was the best predictor of the greater neointimal index at follow-up. Another group of serial IVUS studies were performed in 62 stented lesions in 52 patients with Type 2 diabetes mellitus (DM).

Flexibility of the mitral annulus with the Duran ring at six years post-implantation.

Background And Aim Of The Study: Although, in theory, the mitral annulus with the Duran flexible ring should change size and shape during the cardiac cycle, no clinical reports are available of such flexibility several years after surgery. The study aim was to evaluate mitral annulus flexibility at medium-term follow up after surgery.

Methods: Eleven patients (mean age 60+/-8 years) were enrolled for this study.

[Incidence of systolic pulmonary venous flow reversal in patients with mitral valve prolapse: influence of the prolapse site].

Objectives: Systolic pulmonary venous flow reversal identified by pulsed Doppler echocardiography is useful for the diagnosis of severe mitral regurgitation. The direction of the mitral regurgitant jet in severe mitral regurgitation significantly influences the systolic pulmonary venous flow reversal in an experimental model. This study investigated the influence of the site of mitral valve prolapse on the incidence of systolic pulmonary venous flow reversal in patients with severe mitral regurgitation using transthoracic color Doppler echocardiography.

[Three-dimensional transesophageal echocardiographic measurement of left ventricular volumes using the average rotation method: comparison with the disk summation method].

Objectives: Three-dimensional(3-D) echocardiography accurately calculates left ventricular volumes without geometric assumptions. Conventional 3-D echocardiography using the disk summation method is limited in practical use because of the long analysis time. This study validated the average rotation method for rapid and accurate left ventricular volume measurement compared with the conventional disk summation method.

Identification of cardiac abnormal structures with harmonic power Doppler contrast echocardiography.

We describe two cases in which echocardiographic image enhancement with an intravenous contrast agent using harmonic power Doppler (HPD) imaging established the diagnosis of abnormal structures in the left ventricle (LV).

Troglitazone reduces neointimal tissue proliferation after coronary stent implantation in patients with non-insulin dependent diabetes mellitus: a serial intravascular ultrasound study.

Objectives: The aim of the present study was to determine whether troglitazone reduces neointimal tissue proliferation after coronary stent implantation in patients with non-insulin dependent diabetes mellitus (NIDDM).

Background: Increased in-stent restenosis in patients with diabetes mellitus is due to accelerated neointimal tissue proliferation after coronary stent implantation. Troglitazone inhibits intimal hyperplasia in experimental animal models.

Hyperinsulinemia during oral glucose tolerance test is associated with increased neointimal tissue proliferation after coronary stent implantation in nondiabetic patients: a serial intravascular ultrasound study.

Objectives: The purpose of this study was to determine whether hyperinsulinemia during the oral glucose tolerance test is associated with increased neointimal tissue proliferation after coronary stent implantation in nondiabetic patients.

Background: Although hyperinsulinemia induces increased vascular smooth muscle cell proliferation in experimental models, it has not been determined whether hyperinsulinemia is associated with increased neointimal tissue proliferation after coronary stent implantation.

Methods: Serial (postintervention and six-month follow-up) intravascular ultrasound (IVUS) was used to study 67 lesions treated with Palmaz-Schatz stents in 55 nondiabetic patients.

Relation of phasic coronary flow velocity characteristics with TIMI perfusion grade and myocardial recovery after primary percutaneous transluminal coronary angioplasty and rescue stenting.

Background: A residual stenosis and/or microvascular damage have been proposed as mechanisms of TIMI 2 flow for acute myocardial infarction. Coronary flow dynamics were assessed in patients with TIMI 2 flow to predict whether additional intervention would improve TIMI grade.

Methods And Results: In 35 patients who had a successfully recanalized anterior acute myocardial infarction using angioplasty or rescue stenting, coronary flow patterns were compared with corresponding TIMI grade and regional left ventricular wall motion (LVWM) 1 month after the intervention.

Compensatory enlargement of the coronary artery in acute myocardial infarction.

Compensatory enlargement occurred in 71% of lesions in patients with acute myocardial infarction and was more common in these patients than in patients with stable effort angina pectoris. These results suggest that compensatory enlargement may be associated with plaque rupture and subsequent acute myocardial infarction.

Value of acceleration flow and the prestenotic to stenotic coronary flow velocity ratio by transthoracic color Doppler echocardiography in noninvasive diagnosis of restenosis after percutaneous transluminal coronary angioplasty.

Objectives: The study evaluated the value of coronary flow velocity measurement by transthoracic color Doppler echocardiography (TTCDE) for the noninvasive diagnosis of restenosis after percutaneous transluminal coronary angioplasty (PTCA) for left anterior descending coronary artery (LAD) lesions.

Background: Recent advances in TTCDE provide coronary flow velocity measurements in the LAD under the guidance of color flow mapping.

Methods: We studied 53 patients who underwent successful PTCA for LAD lesions and follow-up coronary angiography (18 patients with restenosis [Group-R], 35 patients without restenosis [Group-N]).

[Measurement of left ventricular filling by automated contour tracking method in echocardiography: comparison with radionuclide ventriculography].

Recent development of an automated contour tracking (ACT) method using the energy minimization principle provides automated edge detection and tracking of the endocardial boundary of the left ventricle, without tracing a region of interest. This study determined whether left ventricular filling indexes obtained from the ACT method provide a reliable estimate of left ventricular diastolic filling. Fourteen patients were examined by the ACT method and equilibrium radionuclide ventriculography.

Broader clinical spectrum of Fukuyama-type congenital muscular dystrophy manifested by haplotype analysis.

Fukuyama-type congenital muscular dystrophy, Walker-Warburg syndrome, and muscle-eye-brain disease are clinically similar autosomal-recessive diseases, characterized by congenital muscular dystrophy, cobblestone lissencephaly, and eye anomalies. The classification of these disorders remains controversial. We analyzed five patients with congenital muscular dystrophy from four families who had severe eye and brain anomalies, such as retinal dysplasia and hydrocephalus, using polymorphic microsatellite markers flanking the Fukuyama-type congenital muscular dystrophy locus on chromosome 9q31.

Prediction of progression or regression of type A aortic intramural hematoma by computed tomography.

Background: It has been reported that early surgery should be required for patients with type A aortic intramural hematoma (IMH) because it tends to develop classic aortic dissection or rupture. However, the anatomic features of type A IMH that develops dissection or rupture are unknown. The purpose of this study was to investigate the predictors of progression or regression of type A IMH by computed tomography (CT).

Can coronary blood flow velocity pattern after primary percutaneous transluminal coronary angioplasty [correction of angiography] predict recovery of regional left ventricular function in patients with acute myocardial infarction?

Background: In the era of primary percutaneous transluminal coronary angioplasty (PTCA), it is important to judge whether myocardium within acute ischemic injury is viable. This study sought to investigate parameters derived from the coronary blood flow velocity spectrum immediately after primary PTCA in patients with acute myocardial infarction and to elucidate the clinical value of coronary blood flow measurement in predicting myocardial viability.

Methods And Results: Using a Doppler guidewire, we measured coronary blood flow velocity after successful completion of primary PTCA in 23 consecutive patients with acute anterior myocardial infarction.