Echocardiographic evaluation of left ventricular function permits the demonstration of preclinical diabetic cardiomyopathy. In order to define the relationship between diabetic retinopathy and precence of myocardial dysfunction, M-mode echocardiograms were recorded in three groups of diabetics ; group 1, no retinopathy, group 2, background retinopathy, group 3, proliferative retinopathy, and normal controls without evidence fo coronary heart disease. The resultant traces were digitized, and systolic and diastolic parameters were evaluated. None of parameters fo systolic function was modified. however peak velocity of posterior wall thinning was decreased in group 3(p<0.005), peak velocity of left ventricular demension increase was decreased in all three groups(p<0.005, P<0.001, P<0.001 respectively), duration of rapid thinning of posterior wall increased in group 2 and 3(p<0.001, p<0.001 respectively), and duration of rapid inflow of left ventricle was increased in group 3(p<0.005). These results indicate a diminution of myocardial compliance and relaxation in diabetics with retinopathy. It is concluded that abnormalities of left ventricular diastolic function is present in diabetics when left ventricular systolic function is normal and that more severe abnormalities of left ventricular diastolic function in diabetics with proliferative retinopathy reflect a subclinical diabetic cardiomyopathy due to small vessel disease.
Compliance ; Coronary Disease ; Diabetes Mellitus ; Diabetic Cardiomyopathies ; Diabetic Retinopathy ; Echocardiography* ; Heart Ventricles ; Relaxation ; Ventricular Function, Left*

No abstract available.
Aneurysm* ; Cerebral Infarction* ; Foramen Ovale, Patent*

No abstract available.
Cor Triatriatum*

BACKGROUND: Color Doppler echocardiography is sensitive in detecting mitral regurgitation and useful in quantitating its severity. The presence of an eccentric regurgitant jet suggests that regurgitation is caused by prolapsing or flail leaflet of mitral valve. Until recently the direction of regurgitant jet in mitral valve prolapse has been examined in a single(parasternal short axis view) or orthogonal plane using color Doppler echocardiography, and few in the apical rotation method of a transducer. The purpose of this study was to clarify the usefullness of the apical rotation method of a transducer in detection of the direction of mitral regurgitant jet and diagnosis of the sites of mitral valve prolapse. METHODS: Twenty four patients(8 men and 16 women, mean age:47.3+/-18.8 years) with mitral valve prolapse with eccentric regurgitant jet were examined by two-dimensional and color Doppler echocardiograply using conventional parasternal long and short axis views, and four apical longitudinal planes(four chamber, vertical, two chamber and transverse views) obtained by the apical retation method of a transducer. RESULTS: Thirty one regurgitant jets were detected in twenty four patients, eighteen patients had anterior, nine patints posterior, and three patients bi-leaflet(anterior and posterior) prolapse. In eighteen patients with anterior leaflet prolapse, ten had medial, eight had middle, three had lateral, and three had two portions(two, medial and middle; one, middle and lateral) prolapse. In nine patients with posterior leaflet prolapse, five had medial, three had middle, two had lateral, and one had two(medial and middle) scallop prolapse. CONCLUSION: Color Doppler echocardiography by the apical rotation method of transducer is useful in assessment of the site of prolapse in patients with mitral valve prolapse with eccentric regurgitation.
Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Echocardiography, Doppler, Color ; Female ; Humans ; Male ; Mitral Valve Insufficiency ; Mitral Valve Prolapse* ; Mitral Valve* ; Pectinidae ; Prolapse* ; Transducers*

To detect the cardiac source of embolism in patient of ischemic stroke of uncertain etiology, biplane transesophageal echocardiography and contrast echocardiography with hand-agitated saline were performed 27 patients(sixteen men and eleven women) of transient ischemic attack and cerebral infarction without definitive cardiac symptom and sign. Transesophageal echocardiography showed potential sources of embolism in nineteen patients (70.4%) including atrial septal aneurysm(n = 9, three of them had patent foramen ovale), spontaneous contrast echo(n = 3), mitral valve prolapse(n= 1), unknown thickening of the tip of the mitral valve(n = 1) and atherosclerotic plaque in descending aorta(n = 7). Thus transesophageal echocardiography and contrast echocardiography identify potential cardiac source of embolism, and provide the rationale of the thrombolytic and anticoagulant therapy in patients with ischemic stroke without obvious cardiac disease.
Cerebral Infarction ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Heart Diseases ; Humans ; Ischemic Attack, Transient ; Male ; Mitral Valve ; Plaque, Atherosclerotic ; Stroke

BACKGROUND: Mitral valve prolapse(MVP) is now recognized as noe of the most common cardiovascular disorders, particularly in young women with a slender body habitus. However, there is little clinical information about young men with mitral valve prolapse. The purpose of this study was to evaluate the physical and echocardiographic characteristics of young men about 20 years old with mitral valve prolapse. METHOD: Twenty young men with mitral valve prolapse(MVP graoup, mean age ; 19.9±2.4 years) and twenty healthy volunteers(control group, mean age ; 19.9±3.2 years) were examined using physical examination, chest X-ray, computed thoracic tomography and two dimensional and Doppler echocardiography. RESULTS: Compared with control group, MVP group had a smaller chest circumference(p < 0.001), a larger height-arm span difference(p < 0.01), smaller anteroposterior chest diameters(by chest X-ray ; p < 0.001 and computed tomography ; p < 0.01) and smaller anteroposterior/transverse chest diameter ratio(chet X-ray ; p < 0.01 and computed tomography ; p < 0.05). In MVP group, mitral regurgitation was noted 15 men(75%), those had posteriorly directed jets suggesting anterior mitral leaflet anomalies. CONCLUSION: Healthy young men having mitral valve prolapse had narrow chest and slender physical characteristics and anterior mitral leaflet abnormalities.
Clinical Study ; Echocardiography ; Echocardiography, Doppler ; Female ; Humans ; Male ; Methods ; Mitral Valve Insufficiency ; Mitral Valve Prolapse ; Mitral Valve ; Physical Examination ; Thorax

BACKGROUND: Echocardiography gives a window to mediastinal or paracardiac structures. When mediastinal or paracardiac masses are detected by a routine chest X-ray and thoracic CT, the difference between vascular and nonvascular lesions may be difficult to diagnose. In these situations, echocardiography has been successfully used recently. CT can be easily standardized and allows visualization of the whole chest, but it is less precise in defining highly mobile structures, more expensive and difficult to perform in patients with orthopnea. But echocardiography is easy to perform, gives real time images. We performed this study to evaluate the usefulness of echocardiography in the identification and investigation of the structural and functional effects of paracardiac masses. METHODS: Twenty patients with paracardiac masses detected by chest X-ray and thoracic CT were examined by transthoracic and/or transesophageal echocardiography. We studied the characteristics of masses and compression site by 2-D echocardiographic techniques and also evaluation of functional effects of a paracardiac masses on heart and great vessels by color pulsed waved Doppler echocardiographic techniques. RESULTS: Nine patients(45.0%) had cystic masses, eleven patients(55.0%) had solid masses. All cystic masses revealed benign, and all solid masses revealed malignant. Among metastatic paracardiac tumors, the most frequent primary site were lung. heart chambers were compressed by paracardiac masses in five cases(26.7%) and great vessel compressed in thirteen cases(76.4%). Turbulent flow and peak velocity documented by color and PW dopple suggested that it is hemodynamically significant compression states of the great vessels by masses. CONCLUSIONS: We consider that echocardiography is as useful as other noninvasive radiographic techniques in the evaluation of paracardiac masses and their mechanical effect upon the function of the heart and great vessels.
Echocardiography* ; Echocardiography, Doppler ; Echocardiography, Transesophageal ; Heart ; Humans ; Lung ; Thorax

BACKGROUND: Coronary stenting is one of effective and well-accepted treatments for coronary artery disease. On the other hand, side branch occlusion (SBO) is a known complication of percutaneous transluminal coronary angioplasty (PTCA) and coronary stenting. Accordingly, this study was designed to determine the incidence, predictors and acute clinical outcomes of SBO. METHODS: Coronary angiographic findings of 45 patients who had total 98 side branches originating from the stented segments were analized before and just after coronary stenting. Bifurcation lesions were divided into 3 types : type 1, type 2, type 3 and each type was subdivided into type A with significant ostial narrowing (diameter stenosis >or=50%) and type B without significant ostial narrowing of side branches. Side branch occlusion was defined as development of total occlusion or morphologic changes from type B to type A or reduction of TIMI flow more than grade 1 compared with pre-stenting flow of side branches. RESULTS: After coronary stenting, SBO occurred in 20 of 98 side branches (20.4%). SBO was significantly related with history of previous myocardial infarction (p=0.02), threatened side branch morphology (p=0.016) and poor pre-stenting flow of side branches (p=0.014). There were no serious clinical events such as myocardial infaction and death associated with acute SBO. CONCLUSION: Acute SBO can be developed in a few stented patients. Signifiant clinical and angiographic predictors of SBO just after coronary stenting were the history of previous myocardial infarction, threatened side branch morphology and poor pre-stenting flow of side branches.
Angioplasty, Balloon, Coronary ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Stenosis ; Hand ; Humans ; Incidence ; Myocardial Infarction ; Stents*

Isolated noncompaction of the ventricular myocardium (INVM) is a rare cardiomyopathy resulting from a failure of normal endomyocardial embryogenesis and it has been categorized as a form of unclassified cardiomyopathy. The disorder is characterized by an excessively prominent trabecular meshwork with deep intertrabecular recesses. Although the disorder is sporadic, familial incidence may occur. Clinical symptoms and prognosis of INVM may differ markedly, and range from an asymptomatic course to a severe cardiac disability. The diagnostic method of choice for IVNM is echocardiography, which reveals multiple prominent trabeculations with deep intertrabecular spaces communicating with the left ventricular cavity in the middle and apical segments of the left ventricle. The authors report a case of INVM in a family in which three adult members (a brother and two sisters) were found to be affected by this disorder. They were all asymptomatic. The diagnosis of the disorder was made first in the 36-year-old brother by transthoracic echocardiography (TTE) and multidetector CT (MD CT), during the process of preoperative evaluation for surgical treatment of low back intervertebral herniated disc. TTE and MD CT showed similar and peculiar findings of INVM. Echocardiographic screening in all first-degree relatives of this patient, in order to identify asymptomatic patients, demonstrated INVM in two elder sisters.
Adult ; Echocardiography ; Heart Defects, Congenital/*diagnosis ; Humans ; Male ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: Stress induced cardiomyopathy has been reported as reversible left ventricular dysfunction with electrocardiographic changes. Although the exact mechanism of this dysfunction has not been clarified, catecholamine "surge" is suspected as a potential cause of this disease. It has not been undergone the studies about the effect of chronic or recurrent psychological stress on the myocardium. We suspect that reversible ischemic change of myocardium could be induced by chronic or recurrent emotional stress. MATERIALS AND METHOD: The clinical, echocardiographic and angiographic data of 189 patients (72 women) who presented with ischemic symptoms and eletrocardiographic changes were participated. BAI (Beck anxiety inventory) and BDI (Beck Depression inventory) were obtained and analyzed for evaluation of degree of psychological stress. RESULTS: 54 patients who had left ventricular apical wall motion abnormalities without significant angiographical stenosis in the coronary artery were younger than the others with left ventricular wall motion abnormalities and angiographic stenosis. And they increased the BAI and BDI as tools of evaluation of psychological stress (p<0.05). CONCLUSION: Data of this study suggested that psychological stress can be associated with myocardial dysfunction. It can be postulated that psychological stress should be considered as one of the cause of non-coronary myocardial injury.
Anxiety ; Cardiomyopathies ; Constriction, Pathologic ; Coronary Vessels ; Depression ; Echocardiography ; Electrocardiography ; Heart Ventricles* ; Humans ; Myocardium ; Stress, Psychological ; Ventricular Dysfunction, Left