Showing papers by "José Luis Zamorano published in 1997"

Non-invasive assessment of cardiac physiology by tissue Doppler echocardiography. A comparison with invasive haemodynamics.

Abstract: Background Tissue Doppler echocardiography reveals characteristic patterns of myocardial velocities within systole and diastole which are not well understood. Aim The purpose of this study was to determine the relationship of myocardial velocity patterns, as assessed by tissue Doppler echocardiography, to the contraction and relaxation phases of the cardiac cycle, as determined during cardiac catheterization. Methods Recordings of left ventricular/aortic and left ventricular/pulmonary wedge pressures were obtained simultaneously with apical tissue Doppler echocardiographic images of the left ventricle. A total of 210 cardiac cycles from 22 patients (mean age 58 years, 18 male) undergoing cardiac catheterization were analysed. The time intervals of the different phases of the cardiac cycle were measured from the pressure tracings. These time intervals were correlated to the interfaces of colour myocardial velocity patterns obtained by M-mode tissue Doppler echocardiography. Results There was a good correlation between the time intervals assessed haemodynamically and those based on the different velocity interfaces obtained with M-mode tissue Doppler echocardiography. Comparable time intervals (from the R wave) obtained by pressure recordings and tissue Doppler echocardiography were, respectively: isovolumic contraction (70±14 vs 67±9 ms, r=0·79); rapid ejection (206±54 vs 202±49 ms; r=0·95); late ejection (357±36 vs 346±42 ms, r=0·93); isovolumic relaxation (405±43 vs 409±56 ms; r=0·95); rapid filling (514±67 vs 523±64 ms, r=0·91); diastasis (697±153 vs 709±146 ms, r=0·98); atrial contraction (890±128 vs 899±132 ms, r=0·96). Conclusion Tissue Doppler echocardiography has the potential to accurately measure the different phases of the cardiac cycle which until now could only be determined invasively. It may provide a sensitive method for the assessment of changes in both cardiac contraction and relaxation in different clinical settings.

Transesophageal Doppler Analysis of Coronary Sinus Flow A New Method to Assess the Severity of Tricuspid Regurgitation

Abstract: BACKGROUND: Severe mitral regurgitation induces reversal of flow in the pulmonary veins. We hypothesized that severe tricuspid regurgitation may disrupt normal coronary sinus flow. The purpose of this study was to analyze the Doppler flow pattern of the coronary sinus and to determine its value in the assessment of the severity of tricuspid regurgitation. METHODS: The coronary sinus flow was analyzed in 70 consecutive patients with some degree of tricuspid regurgitation (27 mild, 14 moderate, and 29 severe) and in 35 patients without tricuspid regurgitation. The coronary sinus flow was obtained by pulsed-Doppler transesophageal echocardiography in a transverse plane, which showed its drainage into the right atrium. RESULTS: The number of patients with adequate studies of the coronary sinus tended to increase with the severity of the tricuspid regurgitation. In patients without or with only mild tricuspid regurgitation the coronary sinus Doppler flow pattern was formed by two negative waves, a late systolic wave and another diastolic one with higher velocity and longer duration. The systolic wave became reversed in 21 (96%) of the patients with severe tricuspid regurgitation. The sensitivity, specificity, and diagnostic accuracy of the presence of a reversed systolic wave in the coronary sinus for the diagnosis of severe tricuspid regurgitation was 95%, 82%, and 80%, respectively. CONCLUSIONS: Significant tricuspid regurgitation modifies the coronary sinus flow pattern as assessed by transesophageal echocardiography. The presence of a reversed systolic flow in the coronary sinus appears to be a reliable new sign with good sensitivity, specificity, and diagnostic accuracy for the diagnosis of severe tricuspid regurgitation.

Linfoma no hodgkiniano con afectación cardíaca en pacientes con sida: aspectos clínicos y ecocardiográficos

Abstract: We report two patients with AIDS and non-Hodgkin lymphoma evolving myocardium. Clinical findings were nonspecific, but rapid progression and cardiac dysfunction developed. An echocardiogram showed restrictive pericarditis in both cases. One of them showed mitral insufficiency because of an infiltrated and trapped posterior mitral valve.