American heart journal
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American heart journal · Dec 1996
Comparative StudyCorrespondence of aortic valve area determination from transesophageal echocardiography, transthoracic echocardiography, and cardiac catheterization.
The correspondence of aortic valve area measurements from transesophageal echocardiography, transthoracic echocardiography, and cardiac catheterization was determined in 100 patients with severe aortic stenosis (aortic valve area < or = 0.75 cm2), moderate aortic stenosis (aortic valve area > 0.75 to < or = 1.2 cm2), mild aortic stenosis (aortic valve area > 1.2 to < or = 2.0 cm2), and nonstenotic aortic valves (aortic valve area > 2.0 cm2). Because high correlation does not require high agreement, data were assessed by analysis of agreement. ⋯ Similar levels of agreement when comparing these independent methods for determining the aortic valve area indicate that direct planimetry by transesophageal echocardiography, the continuity equation with transthoracic echocardiography, and the Gorlin formula are equally accurate and may be used interchangeably. Clinically important discrepancies between methods are uncommon and are readily settled by adding a third method.
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American heart journal · Nov 1996
Randomized Controlled Trial Comparative Study Clinical TrialTreatment and post-treatment effects of alpha- versus beta-receptor blockers on left ventricular structure and function in essential hypertension.
This study was undertaken to compare the effects of alpha-receptor blockade and beta-receptor blockade on left ventricular structure and function in essential hypertension. The increase in left ventricular mass in patients with essential hypertension is at least partly induced by the sympathetic nervous system. We conducted a double-blind, randomized, controlled clinical trial to compare the effects of alpha-blockers and beta-blockers on left ventricular structure and function. ⋯ Furthermore, the increase in diastolic filling was lost shortly after withdrawal of metoprolol concomitant with the increase in heart rate. We conclude that alpha-blockers and beta-blockers are equally capable of reducing left ventricular mass in hypertensive patients. beta-Blockers lead to an increase in diastolic left ventricular filling. This effect may be of therapeutic value because diastolic dysfunction may precede systolic dysfunction in hypertensive heart disease.
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American heart journal · Oct 1996
Multicenter Study Comparative StudyTranscatheter closure with single or multiple Gianturco coils of patent ductus arteriosus in infants weighing < or = 8 kg: retrograde versus antegrade approach.
Experience with transcatheter closure (TCC) of patent ductus arteriosus (PDA) in small infants is limited. Our goals were to evaluate the immediate and short-term results of TCC of PDA in small infants (< or = 8 kg) as attempted with single or multiple Gianturco coils and to compare results for PDA < or = 2.5 mm versus PDA > 2.5 mm. Twenty-four infants underwent an attempt at TCC of PDA at a median age of 0.7 years (range 2 weeks to 1.5 years) and median weight of 6.5 kg (range 2.3 to 8 kg). ⋯ The median fluoroscopy time was 19 minutes. Complications included transient loss of femoral pulse in 2 infants, mild left pulmonary artery obstruction in 2, and nonretrievable coil migration to the right lung in one. We conclude that TCC is effective therapy for small infants with a PDA of diameter < or = 5.2 mm by the single-or multiple-coil technique on an outpatient basis and that TCC can be performed in neonates as small as 2.3 kg.