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Valvular Regurgitation (valvular + regurgitation)
Selected AbstractsEchocardiographic Evaluation of Valvular Regurgitation and Management Strategies: Getting Better All the TimeECHOCARDIOGRAPHY, Issue 3 2000ARA SADANIANTZ M.D., F.A.C.C., F.E.S.C. No abstract is available for this article. [source] Atrial Endocarditis,The Importance of the Regurgitant Jet LesionECHOCARDIOGRAPHY, Issue 5 2005Shawn A. Gregory M.D. The jet lesions of valvular regurgitation or intracardiac shunts have been hypothesized to play an important role in the pathogenesis of endocarditis for many years. We describe a case of mitral valve endocarditis that involved the left atrium along the path of a jet lesion. This resulted in atrial endocarditis and pericarditis, both of which complicated her presentation and hospital course. Using transesophageal echocardiography, we were able to directly visualize the path and full extent of infection prior to surgery. Special attention should be focused upon the path of eccentric jets in order to fully define the extent of endocarditis. [source] Effect of age and training on murmurs of atrioventricular valvular regurgitation in young ThoroughbredsEQUINE VETERINARY JOURNAL, Issue 3 2000L. E. Young Summary Cardiac auscultation was carried out on 111 Thoroughbred horses age 2,5 years to test the hypothesis that athletic training might influence the development of atrioventricular (AV) valve regurgitation in young Thoroughbreds. Murmurs of valvular regurgitation were identified and graded on a 1,6 scale. There were 2 sources of auscultation data: 1) 55 2-year-old horses that were examined by auscultation before training commenced and 9 months later when at race fitness; 2) 56 horses age 2,5 years that were examined on one occasion only (25 2-year-olds, 23 3-year-olds, five 4-year-olds and five 5-year olds). All horses in the second data set were in full training and racing regularly at the time of the examination. To conclude the study, 35 horses were selected randomly from both groups of horses and examined with colour-flow Doppler echocardiography. The aim of the final part of the study was to check specificity and sensitivity of auscultation for detection of AV valve murmurs and therefore validate the auscultation findings. Priorto training, the prevalence in 2-year-old racehorses of murmurs of mitral regurgitation and tricuspid regurgitation was 7.3% (4/55) and 12.7% (7/55), respectively. After training, the prevalence proportions increased to 21.8% (12/55) and 25.5% (14/55). After training, one horse developed a murmur characteristic of aortic regurgitation. The differences in murmur prevalence were statistically significant for mitral and tricuspid regurgitation (paired t test results: mitral regurgitation, P = 0.019; tricuspid regurgitation, P = 0.007), as were the differences in mean murmurgrade (P= 0.018 and P= 0.0006, respectively). There were no significant effects of age on the prevalence of valvular regurgitation in 56 horses examined at race fitness. Auscultation was a specific (specificity 100%) and reasonably sensitive method for detection of murmurs of mitral and tricuspid regurgitation (mitral regurgitation: positive predictive value 100%, negative predictive value 84%, tricuspid regurgitation: positive predictive value 100%, negative predictive value 65%). These data suggest that the prevalence and grade of murmurs of mitral and tricuspid valvular regurgitation increase in 2-year-old Thoroughbreds after 9 months of athletic training. Whereas the effects of age and growth on the prevalence of murmurs cannot be ruled out from these data, this study suggests that there is an influence of athletic training on the development of atrioventicular valvular regurgitation in flat-racing Thoroughbreds. [source] Rupture of chordae tendineae in patients with ,-thalassemiaEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 4 2004Dimitrios Farmakis Abstract: Cardiac disease is the primary cause of mortality in , -thalassemia patients. Except for ventricular dysfunction and pulmonary hypertension that represent the main forms of heart disease in these patients, valvular abnormalities including valvular regurgitation, endocardial thickening and calcification and mitral valve prolapse have also been described. Here we present two patients with thalassemia major and mitral chordal rupture, a previously undescribed abnormality in this population. Pathogenesis of this finding may involve thalassemia-related pseudoxanthoma elasticum-like syndrome, a diffuse elastic tissue defect, which is observed with a notable frequency in these patients and has been associated with numerous cardiovascular complications, including valvular ones. [source] Improvement in "uremic" cardiomyopathy by persistent ultrafiltrationHEMODIALYSIS INTERNATIONAL, Issue 1 2007Hüseyin TÖZ Abstract Some patients with end-stage renal disease suffer severe cardiac dilatation with functional disturbances, notably low ejection fraction (EF) and valvular regurgitation. They often have normal or low blood pressure, and tolerate ultrafiltration (UF) poorly. The aim of our study was to investigate to what extent this condition can still be improved by persistent slow UF. Twelve patients with cardiothoracic index >0.54 and EF <0.45 but otherwise uncomplicated were treated by slow, prolonged UF during hemodialysis (3 times a week) sessions, if necessary supplemented by isolated UF sessions on a separate day. Repeated chest X-rays and Doppler echocardiography were applied. During treatment periods varying from 20 to 120 days, all of the patients lost weight (12±10 kg) and became edema free. Cardiothoracic index decreased in all patients from a mean of 0.59±0.04 to 0.47±0.03. Blood pressure decreased when it had been elevated and increased when it was below normal. Ejection fraction increased in all of them from a mean of 0.31±0.9 to 0.50±0.9. Mitral and tricuspid regurgitation were found in every patient and disappeared or improved in all of them. Striking improvement of cardiac dilatation and dysfunction can be achieved by carefully monitored persistent UF in the majority of patients with seemingly intractable dilated cardiomyopathy. [source] Early Prosthetic Valve Failure in a Patient with Rheumatoid ArthritisJOURNAL OF CARDIAC SURGERY, Issue 1 2009Sanjay Asopa M.R.C.S. Most patients do not require cardiac surgical intervention unless they develop complications such as significant valvular regurgitation. Patients with RA often require orthopedic operations and therefore a bioprosthetic valve replacement is normally advocated to avoid problems related to anticoagulation. We report a case of a 64-year-old woman with seropositive RA who had undergone bioprosthetic aortic valve replacement three years previously. She re-presented with early prosthetic valve failure due to accelerated degeneration and calcification. This was treated successfully with redo replacement with a mechanical prosthesis. Here, we discuss our experience and debate the various valve choices available that should be considered in patients with rheumatoid disease. [source] The frequency of cardiac valvular regurgitation in Parkinson's diseaseMOVEMENT DISORDERS, Issue 7 2008Kazuo Yamashiro MD Abstract To investigate the frequency of cardiac valve regurgitation related with low dose dopamine agonists in patients with Parkinson's disease (PD), echocardiograms were analyzed in 527 consecutive PD patients (448 patients treated with dopamine agonists, 79 patients never treated with dopamine agonists as age-matched controls). The frequency of mild or above mild regurgitation of the aortic valve (AR) was significantly higher in the cabergoline group (13.7%, P < 0.05) compared with the controls (2.5%). Odds ratio adjusted by age and sex for AR was significantly higher in the cabergoline group (OR, 6.45; 95% CI, 1.46,28.60; P = 0.01): odds ratio was significantly higher in patients treated with higher daily doses (OR, 14.41; 95% CI, 3.08,67.38; P = 0.0007) and higher cumulative doses (OR, 15.29; 95% CI, 3.19,73.18; P = 0.0006). No statistical difference was identified in the frequency of the tricuspid and mitral regurgitation. None of the other dopamine agonist groups including pergolide gave higher frequency or higher odds ratio compared with the controls. None of our patients showed severe regurgitation or was operated for valvular heart disease. The question as to whether or not longer duration of low dose dopamine agonist treatment would yield the same results needs further studies. © 2008 Movement Disorder Society [source] Assessment of myocardial involvement using cardiac troponin-I and echocardiography in rheumatic carditis in ,zmir, TurkeyPEDIATRICS INTERNATIONAL, Issue 1 2008Vedide Tavli Abstract Background: Acute rheumatic carditis is still a major problem in developing countries. Cardiac troponin-I (cTnI) has been identified as a sensitive and specific marker in the diagnosis of myocarditis in children and adults. Methods: A prospective study was performed using Doppler echocardiography and cTnI in order to detect myocardial involvement in 26 consecutive patients with acute rheumatic valvular disease. Patients were divided into two groups: group 1, rheumatic fever with carditis (n > 16); group 2, rheumatic fever without carditis (n > 10). Results: Clinically age, gender, body temperature, heart rate and white blood count did not differ significantly between the groups and the age-matched control group. C-reactive protein, erythrocyte sedimentation rate, anti-streptolysin-O were significantly different. Left ventricular fractional shortening was normal in all patients (group 1, 37 ± 10%; group 2, 34 ± 5%; NS). Left ventricular dimensions were larger in group 1, in which all patients except two had moderate to severe mitral and/or aortic valvular regurgitation (5.05 ± 0.75 cm/m2) compared to group 2, in which none had valvular regurgitation (3.27 ± 0.26 cm/m2, P < 0.05). None of the patients in either group presented with or developed pericarditis. Mean cTnI was 0.12 ± 0.034 ng/mL in group 2 and 0.077 ± 0.02 in group 1, the difference of which was not statistically significant. Neither significant cTnI elevations nor echocardiographic systolic function abnormalities were found in the present patients with rheumatic carditis. Conclusions: The present results indicate the absence of myocardial involvement in acute rheumatic carditis without congestive heart failure. [source] Prediction of prognosis by echocardiography in patients with midgut carcinoid syndrome,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 6 2001G. Westberg Background: The association between malignant midgut carcinoid tumours and right-sided cardiac lesions is well known, but the pathogenetic link between tumour secretion and valvular disease is still obscure. The purpose of this investigation was to describe the morphological and functional changes of valvular heart disease in a large patient series and to correlate these findings with hormonal secretion and prognosis. Methods: Of 64 consecutive patients with the midgut carcinoid syndrome followed between 1985 and 1998, valvular heart disease was evaluated in 52 patients by two-dimensional echocardiography, Doppler estimation of valvular regurgitation and flow profiles. A majority was also evaluated with exercise electrocardiography and spirometry. Results: Structural and functional abnormalities of the tricuspid valve were found in 65 per cent of patients, while only 19 per cent had pulmonary valve regurgitation. Long-term survival was related to excessive urinary excretion of 5,hydroxyindole acetic acid of over 500 µmol in 24 h, but the main predictor of prognosis was the presence of severe structural and functional abnormalities of the tricuspid valve. Although advanced tricuspid abnormalities were prevalent in this series, only one patient died from right ventricular heart failure. Conclusion: Tricuspid valvular disease is a common manifestation of the midgut carcinoid syndrome and advanced changes are associated with poor long-term survival. Active surgical and medical therapy of the tumour disease reduced the hormonal secretion and, combined with cardiological surveillance, made right ventricular heart failure a rare cause of death in these patients. © 2001 British Journal of Surgery Society Ltd [source] Critical stenosis of aortic and mitral valves after mediastinal irradiationCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2004A. Selcuk Adabag MD Abstract Radiotherapy is used widely in cancer treatment. Mediastinal irradiation is associated with valvular regurgitation; however, stenosis is rare. We present a patient with critical aortic and mitral valve stenosis after mediastinal irradiation and discuss the natural history, treatment, and prognosis of radiation-associated valvular heart disease. Catheter Cardiovasc Interv 2004;63:247,250. © 2004 Wiley-Liss, Inc. [source] | ||||||||||