Journal of cardiography
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Journal of cardiography · Sep 1986
[Pulsed Doppler echocardiographic evaluation of hemodynamics in premature ventricular contractions].
To investigate hemodynamic changes in ventricular premature contractions (VPCs), the blood flow velocities at the left ventricular (LV) outflow and inflow tracts were analyzed by pulsed Doppler echocardiography in 23 patients with VPCs and in two patients with ventricular parasystoles. Percent LV stroke volume of the ectopic and the postectopic sinus beats to the other sinus beats and %LV inflow volume of the sinus beats preceding ectopic beats to the other sinus beats were calculated from the time integral of the blood flow velocity. The following results were obtained. ⋯ These results suggest that not only the coupling interval and the origin of VPCs but the LV diastolic behavior, as well, are important factors determining the hemodynamics in VPCs. They also suggest that the increment of stroke volume in postextrasystolic beats is more prominent in VPCs with shorter coupling intervals, but the LV performance as a whole is more depressed in VPCs with a shorter coupling intervals. In conclusion, pulsed Doppler echocardiography proved a useful noninvasive technique for evaluating the hemodynamics of VPCs.
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Journal of cardiography · Sep 1986
[Magnetic resonance diagnosis of aortic dissection: with special reference to the communicating orifice between the true and false lumens].
Magnetic resonance imaging (MRI) was performed in thirty-one patients with aortic dissection to evaluate its usefulness in diagnosing the site of communicating orifice between the true and false lumens and the presence of retrograde dissection. MRI revealed the site of the entry as a defect in the intimal flap in the images of 12 of 15 patients (80%). The site of the communicating orifice between the true and false lumens in the abdominal aorta could be determined in six of eight patients (75%). ⋯ In conclusion, MRI was a useful diagnostic method for aortic dissection, especially for determining the site of entry in the thoracic aorta. The changes in signal intensity in the false lumen provided useful information for locating the communicating orifice between the true and false lumens and for diagnosis of retrograde dissection. Cross-sectional analysis of dissection in the abdominal aorta was useful for predicting the branching of the main arteries from the true or false lumen.
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Journal of cardiography · Dec 1985
[Tricuspid regurgitation evaluated by Doppler hepatic vein flow patterns].
Hepatic vein flow can be reliably measured because Doppler sampling volumes are easily oriented parallel with the course of the hepatic vein. In this study, the relationship between the Doppler signal in the hepatic vein and the external jugular vein pulse was evaluated, and the contribution of the Doppler echocardiography to the quantitative diagnosis of tricuspid regurgitation was also assessed. The subjects consisted of five healthy persons, four patients with lone atrial fibrillation, 27 patients who underwent cardiac surgery, and 34 patients with tricuspid regurgitation. ⋯ In patients who had cardiac surgery, a systolic backward flow toward the liver or a decrease in the systolic forward flow was usual. However, a prominent systolic backward flow toward the liver was observed in patients with severe tricuspid regurgitation, and a decreased systolic forward flow toward the heart was observed in patients with moderate tricuspid regurgitation in sinus rhythm. We concluded that Doppler measurement of hepatic vein flow does not contribute to the diagnosis of tricuspid regurgitation in the presence of atrial fibrillation or in postoperative conditions, but that it is useful in identifying severe tricuspid regurgitation.
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Journal of cardiography · Sep 1985
Case Reports[Aortic dissection presenting aortic regurgitation induced by diastolic prolapse of an intimal flap into the left ventricle: a case report].
A case of aortic dissection associated with aortic regurgitation which was induced by diastolic prolapse of an intimal flap into the left ventricular outflow tract was reported. This 57-year-old man, referred for evaluation of sudden onset of chest oppression and a heart murmur, was hypertensive for several years. His admission blood pressure was 184/44 mmHg, and a systolic ejection murmur and a diastolic decrescendo murmur were audible along the left sternal border. ⋯ Aortography disclosed type I aortic dissection and severe aortic regurgitation. After medical treatment for four months, the patient underwent a Bentall surgical procedure and recovered. Impaired coaptation of the aortic valve induced by diastolic prolapse of the intimal flap into the left ventricular outflow tract is a newly encountered echocardiographic finding in proximal aortic dissection.
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Journal of cardiography · Mar 1985
Case Reports[An intermittent mid-diastolic musical murmur indicating aortic regurgitation: report of a case].
An unusual mid-diastolic musical murmur developed soon after cardiac catheterization of a 55-year-old man with mitral stenosis. His physical findings consisted of an accentuated first heart sound, an opening snap and a grade 3/6 mid-diastolic rumbling murmur. No early diastolic murmur was audible. ⋯ The frequency patterns of the murmur and the Doppler signals were identical; therefore, the murmur was judged to be produced by aortic valve vibrations. Furthermore, resonance of cardiac structures which accentuate the murmur might be related to the occurrence of this murmur. Pulsed Doppler echocardiography is helpful in identifying the site of origin of this musical murmur.