[The clinical value of coronary flow reserve in ischemic heart disease as measured by dipyridamole stress transesophageal echocardiography]. / A dipyridamol-terheléses transoesophagealis echokardiográfia segítségével számított coronaria-áramlási rezerv klinikai értéke ischaemiás szívbetegségben.

The relationship between coronary flow reserve and the result of coronarography was examined. 152 patients were investigated by stress transoesophageal echocardiography and coronary angiography. The value of coronary flow reserve was significantly lower in cases of significant coronary stenosis than in those patients who had a normal coronarography (in patients with left anterior descending coronary artery stenosis: 1.77 +/- 0.47 vs in cases with normal coronary angiogram: 3.19 +/- 1.15). There was no difference in the value of CFR in those cases where not only LAD stenosis but CX or RC stenosis was also found. The value of coronary flow reserve was significantly higher in RC or CX patients than that of LAD patients. In patients with positive stress and negative coronarography (X syndrome) the coronary flow reserve was 1.23 +/- 0.2, which value was significantly lower as compared to patients with significant coronary stenosis.

[Comparative evaluation of dipyridamole and dobutamine 2-dimensional echocardiography in ischemic heart disease]. / Dipyridamol és dobutamin terheléses 2 dimenziós echocardiographia összehasonlító értékelése ischaemiás szívbetegségben.

Dipyridamole and dobutamine stress were performed in the same 41 angiographically controlled patients. Both tests were followed by 2 dimensional-echocardiography. The dose of dipyridamole was 0.56 mg/kg/4 min. or 0.84 mg/kg over 10 min., while the dose of dobutamine was 10-20-30-40 and 40 micrograms/kg/min. over 3 min. each step. In addition, to reach the submaximal heart rate 0.25 mg/min Atropine was also injected for 4 minutes in 13 cases. One vessel disease was found in 15 cases, and 2 vessel disease was in 2 cases. The number of coronarography negative cases was 24. The sensitivity, specificity, positive and negative predictive values for both tests were 70%, 91%, 85% and 81%, respectively. False positive results were observed in 2 cases and false negative ones were found in 5 cases, mainly at left anterior descendent stenosis. There was a good agreement between the wall motion abnormality and the anatomic localization of stenoses. Both non-invasive tests are suitable for the diagnosis of ischaemic heart disease.

[Doppler echocardiography in the examination of normally functioning artificial mitral and aortic valves]. / Normálisan müködö mitralis és aorta mübillentyük vizsgálata Doppler echocardiographiával.

Patients with prosthetic valves were investigated by Doppler echocardiography in 902 cases between November 1987 and February 1990. The parameters of 209 of 344 mitral and 258 of 299 aortic prosthetic valves were evaluated. No significant correlation was found between the type of aortic or mitral prosthetic valves and the measured gradient. As concerns the size of the valve and the measured gradient, a close correlation for aortic valve replacement was detected. For a normally functioning mitral prosthetic valve, a maximum early diastolic velocity of less than 2 m/s (16 mm Hg gradient) and a pressure half-time of less than 130 ms (mitral valve area 1.8 cm2) were characteristic. In cases of aortic valve replacements, the maximum velocity was less than 3 m/s (36 mm Hg gradient), except for the small-diameter valves. More than 95% of the cases met these criteria. (Even if small-diameter valves were included, a maximum velocity of more than 3 m/s occurred only in 8.9%.) Doppler echocardiography is a suitable tool for detecting normal prosthetic valve function, while colour Doppler allows the optimal alignment of jet direction and Doppler beam.

[Judging the severity of regurgitation in acquired heart defects using color-coded Doppler echocardiography]. / Regurgitatiók súlyossági fokának megítélése színkódolt Doppler echocardiographiával, szerzett vitiumokban.

In the study, 139 valvular regurgitations of 120 patients (55 mitral and 84 aortic regurgitations) were investigated and compared by means of colour flow mapping and heart catheterization. During the echocardiographic examination, the length and width of the regurgitant jets were measured and the jet area was planimetered besides the subjective grades. The above parameters were correlated with the angiographic grades. Good agreement was found between the results of the two methods. As concerns the different parameters of the regurgitant jets in mitral regurgitation, the most severe (grade IV) category was easily distinguished from the others, while in aortic regurgitation all four categories were differentiated by colour flow mapping. These measurements indicated that colour-coded Doppler echocardiography is a suitable tool for detection of the severity of valvular regurgitations in a noninvasive way.