RESUMEN
Delayed diagnosis in chronic Q fever endocarditis is fairly common world wide, we present a case where FDG-PET/CT correctly identified the infected valve, showing promise in management.
Asunto(s)
Endocarditis Bacteriana/diagnóstico , Enfermedades de las Válvulas Cardíacas/diagnóstico , Tomografía de Emisión de Positrones/métodos , Fiebre Q/diagnóstico , Tomografía Computarizada por Rayos X/métodos , Válvula Aórtica/diagnóstico por imagen , Fluorodesoxiglucosa F18 , Humanos , Masculino , Persona de Mediana Edad , Imagen Multimodal/métodos , RadiofármacosRESUMEN
OBJECTIVE: To assess the effect of A-V, V-V delay optimization on cardiac function and clinical improvement in patients with refractory heart failure underwent cardiac resynchronization therapy (CRT). METHOD: Thirty-two patients with chronic heart failure received CRT and cardiac function was measured at 7 days, 3 months and 6 months post CRT before and after A-V and V-V delay optimizations. RESULTS: A-V delay optimization was initiated in 28, 10 and 6 cases at 7th day, 3rd month and 6th month after CRT. V-V delay optimization was performed in 29, 6 and 5 cases at 7th day, 3rd month and 6th month after CRT. Ts-SD, LVEF, VTI and E/Em were significantly improved after CRT compared to pre-CRT (P < 0.01, P < 0.05, P < 0.05, P < 0.05; respectively). Compared to pre-optimization, the indexes of ventricular synchronization were significantly improved (P < 0.05) while indexes of cardiac function remained unchanged post optimization at 7th day after CRT. The indexes of ventricular synchronization post optimization were similar at 7th, 3rd and 6th months after CRT (P > 0.05). LVEF and diastolic filling time were significantly increased after 6 months CRT post A-V, V-V delay optimization (P < 0.01). CONCLUSION: A-V, V-V delay optimization at 7th day after CRT can significantly improve ventricular synchronization and is associated with further improved cardiac function 6 months after CRT.
Asunto(s)
Estimulación Cardíaca Artificial/métodos , Insuficiencia Cardíaca/diagnóstico por imagen , Insuficiencia Cardíaca/terapia , Anciano , Enfermedad Crónica , Ecocardiografía Doppler de Pulso , Femenino , Insuficiencia Cardíaca/fisiopatología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To observe the thoracic aorta features in patients with bicuspid aortic valve (BAV) with echocardiography. METHODS: We retrospectively analyzed the echocardiographic features and clinical manifestations in 273 patients with BAV detected from 1991-04 to 2006-02. RESULTS: (1) Aortic dimensions of the anulus, the sinuses of valsalva, the sinotubular junction, the ascending aorta at the level of its largest diameter of 31 patients with functionally normal BAV were significantly increased compared that in control subjects (P < 0.01 to P < 0.001) while the dimension of the descending aorta posterior to the left atrium was similar between the two groups (P > 0.05). (2) There is no relation between the vulval positions of BAV and aortic dimensions (P > 0.05). (3) The dimensions of the annulus as well as the sinuses of valsalva were negatively related to the aortic valve gradient, and the dimension of the annulus, the sinuses of valsalva and sinotubular junction were positively related to the degree of aortic regurgitation in 273 patients with BAV (all P < 0.05). CONCLUSION: Our results show there is a hemodynamic independent thoracic aortic dilation in patients with functionally normal BAV. Gradient and aortic regurgitation are related to the dimension of the annulus, the sinuses of valsalva and sinotubular junction in patients with BAV.