Giornale italiano di cardiologia
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Comparative Study
[Doppler tissue imaging: a new method in the study of diastolic function in left ventricular hypertrophy].
Many factors influence diastolic function indexes obtained by monitoring left ventricular filling. Recent reports suggest that the study of myocardial wall velocity with Doppler tissue imaging (DTI) can give diastolic function parameters that are less affected by the same factors. An altered diastolic function has been demonstrated with invasive methods in patients with left ventricular hypertrophy (LVH). The aims of this study were 1) to compare a group of healthy subjects with a group of patients with LVH and presumably affected by diastolic dysfunction, to try to demonstrate if DTI could give new indexes to discriminate between the two groups; 2) to compare the indexes obtained with DTI against the ones given by Doppler study of left ventricular filling in the two populations. ⋯ Diastolic function indexes achieved by DTI can offer additional information that is independent of the data derived from left ventricular filling.
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Between May 1990 and January 1998, 68 patients underwent bidirectional cavo-pulmonary anastomosis. We evaluated all patients in whom the bidirectional cavo-pulmonary anastomosis was associated with additional pulmonary flow (group A) and those in whom it was associated with biventricular repair (group B). Group A included 23 patients (33.8%), 14 males and 9 females, mean age 25 years and 6 months (range 4 months-16 years). ⋯ Bidirectional cavo-pulmonary anastomosis can be associated with additional pulmonary flow with good short- and intermediate-term outcome. Concern remains for the ability to properly regulate the amount of effective pulmonary blood flow. Bidirectional cavo-pulmonary anastomosis can be associated with biventricular repair in patients with diminutive right ventricles, amenable to anatomic complete correction, with good clinical outcome.
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Spinal cord stimulation (SCS) is an alternative therapy in patients with refractory angina pectoris when coronary revascularization cannot be performed. Several hypotheses have been given to explain the effects of SCS in reducing the number and the intensity of anginal crises. These hypotheses include possible variations in myocardial blood flow (MBF). The aim of our study was to assess regional MBF in a group of patients with spinal cord stimulator, using positron emission tomography (PET). ⋯ Our study suggests that the beneficial effects of SCS in refractory angina may also be related to an increase in mean MBF and to a redistribution of MBF between the regions with low or normal basal flow and the regions with high basal flow.