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Mild Mitral Regurgitation (mild + mitral_regurgitation)
Selected AbstractsEchocardiographic Estimation of Systemic Systolic Blood Pressure in Dogs with Mild Mitral RegurgitationJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 5 2006DACVIM, Sandra P. Tou DVM Background:Systemic hypertension is likely underdiagnosed in veterinary medicine because systemic blood pressure is rarely measured. Systemic blood pressure can theoretically be estimated by echocardiography. According to the modified Bernoulli equation (PG = 4v2), mitral regurgitation (MR) velocity should approximate systolic left ventricular pressure (sLVP), and therefore systolic systemic blood pressure (sSBP) in the presence of a normal left atrial pressure (LAP) and the absence of aortic stenosis. The aim of this study was to evaluate the use of echocardiography to estimate sSBP by means of the Bernoulli equation. Hypothesis:Systemic blood pressure can be estimated by echocardiography. Animal: Seventeen dogs with mild MR. No dogs had aortic or subaortic stenosis, and all had MR with a clear continuous-wave Doppler signal and a left atrial to aorta ratio of , 1.6. Methods:Five simultaneous, blinded continuous-wave measurements of maximum MR velocity (Vmax) and indirect sSBP measurements (by Park's Doppler) were obtained for each dog. Pressure gradient was calculated from Vmax by means of the Bernoulli equation, averaged, and added to an assumed LAP of 8 mm Hg to calculate sLVP. Results:Calculated sLVP was significantly correlated with indirectly measured sSBP within a range of 121 to 218 mm Hg (P= .0002, r= .78). Mean ± SD bias was 0.1 ± 15.3 mm Hg with limits of agreement of-29.9 to 30.1 mm Hg. Conclusion: Despite the significant correlation, the wide limits of agreement between the methods hinder the clinical utility of echocardiographic estimation of blood pressure. [source] Risk of Heart Failure Due to a Combination of Mild Mitral Regurgitation and Impaired Distensibility of the Left Ventricle in Patients with Old Myocardial InfarctionCLINICAL CARDIOLOGY, Issue 12 2008Shu Inami MD Abstract Background Ischemic mitral regurgitation (MR) is a serious complication after myocardial infarction, and the incidence of heart failure (HF) increases as the severity of MR increases. However, little is known about the relationship between mild MR and HF in the patients with old myocardial infarction (OMI) and a normal ejection fraction (EF). Hypothesis We hypothesized that a combination of mild MR and impaired distensibility of the left ventricle may increase the risk of diastolic HF in the patients with OMI and a normal EF. Methods The relationship between HF and mild MR was retrospectively investigated in 62 patients with OMI and EF of > 50% on echocardiography. Results Of the 62 patients, 47 (76%) did not have HF and 15 (24%) had HF. There was a significant difference in the incidence of mild MR between the patients with and without HF (p < 0.0001): of the 47 patients without HF, mild MR was detected in 19, but all 15 patients with HF had mild MR. However, there were no significant differences in age, gender, infarct sites, diseased coronary vessels, peak CK level, and observation period between the 2 groups. An increased E-wave and the ratio of the E-wave to the A-wave (E/A), a reduction of the E-wave deceleration time, and an increased brain natriuretic peptide (BNP) level were significantly noted in HF patients with mild MR compared with patients without HF. Conclusions Even a mild MR may cause diastolic HF in patients with impaired distensibility of the left ventricle due to ischemic heart disease. Copyright © 2008 Wiley Periodicals, Inc. [source] No increased risk of valvular heart disease in adult poststreptococcal reactive arthritisARTHRITIS & RHEUMATISM, Issue 4 2009J. M. van Bemmel Objective Poststreptococcal reactive arthritis (ReA) is a (poly)arthritis presenting after a Streptococcus group A infection. Acute rheumatic fever (ARF), albeit caused by the same pathogen, has different risk characteristics and is considered to be a separate entity. Whereas ARF is known to cause carditis, the risk of carditis in adult poststreptococcal ReA is unknown. Consequently, the prevailing recommendations regarding long-term antibiotic prophylaxis in poststreptococcal ReA are imprecise and derived from the data on ARF. This study was undertaken to investigate the development of valvular heart disease in an unselected cohort of adult patients with poststreptococcal ReA who did not receive antibiotic prophylaxis and were followed up prospectively. Methods All patients presenting with early arthritis to an inception cohort of >2,000 white patients were evaluated. Patients presenting with poststreptococcal ReA (n = 75) were selected. After a median followup of 8.9 years, the occurrence of valvular heart disease was evaluated by transthoracic echocardiography in 60 patients. Controls were matched for age, sex, body surface area, and left ventricular function, with a patient-to-control ratio of 1:2. Results No differences were seen in left ventricular dimensions. Morphologic abnormalities of the mitral or aortic valves were not more prevalent among patients than among controls. Mild mitral regurgitation was present in 23% and 21% of patients and controls, respectively. Mild aortic regurgitation was present in 10% and 11%, and mild tricuspid regurgitation in 43% and 39%, respectively, revealing no significant differences. Conclusion Our findings indicate that there is no increased risk of valvular heart disease in adult poststreptococcal ReA. Based on these data, routine long-term antibiotic prophylaxis is not recommended in adult poststreptococcal ReA. [source] Diastolic Blood Pressure-Estimated Left Ventricular dp/dtECHOCARDIOGRAPHY, Issue 2 2002Hüseyin Y, lmaz M.D. Background: Peak dp/dt is one of the best isovolumic phase indexes of the myocardial contractile state requiring invasive procedures or presence of mitral regurgitation severe enough to measure in clinical practice by Doppler echocardiography. In this study, we sought the correlation between two noninvasive methods of measurements for left ventricular dp/dt-diastolic blood pressure- (DBP) estimated and continuous-wave Doppler-derived dp/dt-min electrocardiographic/echocardiographic study to emphasize the clinical feasibility of the DBP-estimated method. Method: Thirty-six randomized patients (27 male, 9 female; 58 ± 8 years) with mild mitral regurgitation were enrolled in this study. DBP-estimated dp/dt was calculated from DBP minus the left ventricular end-diastolic pressure (LVEDP) over the isovolumetric contraction time (IVCT). LVEDP was assumed to be 10 mmHg for all patients. Doppler-determined left ventricular dp/dt was derived from the continuous-wave Doppler spectrum of mitral regurgitation jet by dividing the magnitude of the left ventricular atrial pressure gradient rise between 1 mm/sec,3 mm/sec of mitral regurgitant velocity signal by the time taken for this change. Results: Left ventricular dp/dt by Doppler was 1122 ± 303 mmHg/sec and blood pressure-estimated dp/dt was 1063 ± 294 mmHg/sec. There was a high correlation (r = 0.97, P < 0.001) of dp/dt between the two techniques. Conclusions: DBP and IVCT can generate left ventricular dp/dt without invasive procedures, even in the absence of mitral regurgitation in clinical practice. [source] Incidence and Predictors of Sudden Cardiac Death in Patients with Diastolic Heart FailureJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 12 2007M.H.S., SANA M. AL-KHATIB M.D. Introduction: Although it is known that patients with diastolic heart failure are at an increased risk of death, their mode of death has not been clearly defined. We conducted this study to examine the incidence and predictors of sudden cardiac death (SCD) in patients with isolated diastolic heart failure. Methods and Results: Using the Duke Databank for Cardiovascular Disease, we identified patients with a history of congestive heart failure (CHF) and an ejection fraction of greater than 50% who were enrolled in the database from 1995 through 2004. Mode of death was adjudicated by two independent reviewers. Of the 1,941 patients who met our inclusion criteria, 548 (28%) died (40 were SCD). Using a Cox proportional hazards model, five variables were found to be independently associated with a significant increase in the risk of SCD. These variables include diabetes mellitus (P < 0.01), the presence of mild mitral regurgitation (P < 0.01), severity of CHF (P < 0.01), the occurrence of a myocardial infarction within 3 days prior to the date of the index cardiac catheterization (P = 0.01), and severity of coronary artery disease (P = 0.02). Conclusions: SCD is not uncommon in patients with isolated diastolic heart failure. We identified some clinical variables that are associated with a significant increase in the risk of SCD and that may be used in the risk stratification of patients for SCD. Studies are needed to validate our findings. [source] | ||||||||||