[Usefulness of supplemental treatment with glypressin during the eradication phase of esophageal varices using endoscopic sclerotherapy]. / Utilità del trattamento complementare con Glipressina durante la fase di eradicazione delle varici esofagee mediante scleroterapia per via endoscopica.

The response of 20 patients with oesophageal varices randomly assigned to treatment by endoscopic sclerotherapy with or without adjuvant Glipressina was assessed on the basis of the following parameters: mean eradication time for oesophageal varices and frequency of bleeding during that period. The preliminary results suggest that the drug may have a favourable influence on both eradication time and bleeding in sclerotherapy.

A comparison of the assessment of mitral valve area by continuous wave Doppler and by cross sectional echocardiography.

Transmitral pressure half time (PHT) was assessed by continuous wave Doppler in 44 patients with rheumatic mitral valve stenosis (14, pure mitral valve stenosis; 15, combined mitral stenosis and regurgitation; and 15 with associated aortic valve regurgitation). The mitral valve area, derived from transmitral pressure half time by the formula 220/pressure half time, was compared with that estimated by cross sectional echocardiography. The transmitral pressure half time correlated well with the mitral valve area estimated by cross sectional echocardiography. The correlation between pressure half time and the cross sectional echocardiographic mitral valve area was also good for patients with pure mitral stenosis and for those with associated mitral or aortic regurgitation. The regression coefficients in the three groups of patients were significantly different. Nevertheless, a transmitral pressure half time of 175 ms correctly identified 20 of 21 patients with cross sectional echocardiographic mitral valve areas less than 1.5 cm2. There were no false positives. The Doppler formula significantly underestimated the mitral valve area determined by cross sectional echocardiography by 28(9)% in 19 patients with an echocardiographic area greater than 2 cm2 and by 14.8 (8)% in 25 patients with area of less than 2 cm2. In thirteen patients with pure mitral valve stenosis Gorlin's formula was used to calculate the mitral valve area. This was overestimated by cross sectional echocardiography by 0.16 (0.19) cm2 and underestimated by Doppler by 0.13 (0.12) cm2. Continuous wave Doppler underestimated the echocardiographic mitral valve area in patients with mild mitral stenosis. The Doppler formula mitral valve area = 220/pressure half time was more accurate in predicting functional (haemodynamic) than anatomical (echocardiographic) mitral valve area.

Pulsed Doppler echocardiographic analysis of mitral regurgitation after myocardial infarction.

In 72 patients with previous myocardial infarction (MI), mitral regurgitation (MR) was assessed by pulsed-wave Doppler echocardiography and compared with physical and 2-dimensional echocardiographic findings. MR was found by Doppler in 29 of 42 patients (62%) with anterior MI, 11 of 30 (37%) with inferior MI (p less than 0.01) and in none of 20 normal control subjects. MR was more frequent in patients who underwent Doppler study 3 months after MI than in those who underwent Doppler at discharge (anterior MI = 83% vs 50%, p less than 0.01; inferior MI = 47% vs 27%, p = not significant). Of 15 patients who underwent Doppler studies both times, 3 (all with anterior MI) had MR only on the second study. Of the patients with Doppler MR, 12 of 27 (44%) with a left ventricular (LV) ejection fraction (EF) greater than 30% and 1 of 13 (8%) with an EF of 30% or less (p less than 0.01) had an MR systolic murmur. Mitral prolapse or eversion and papillary muscle fibrosis were infrequent in MI patients, whether or not Doppler MR was present. The degree of Doppler MR correlated with EF (r = -0.61), LV systolic volume (r = 0.47), and systolic and diastolic mitral anulus circumference (r = 0.52 and 0.51, respectively). Doppler MR was present in 24 of 28 patients (86%) with an EF of 40% or less and in 16 of 44 (36%) with EF more than 40% (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Assessment of left ventricular hypertrophy by ECG and VCG in patients with inferior and posterior myocardial infarction. A comparison with echocardiographic data.

Electrocardiographic (ECG) and vectorcardiographic (VCG) QRS voltage criteria have been analyzed in 26 patients with inferior and 17 with posterior myocardial infarction (MI) in comparison with left ventricular (LV) mass and global and regional wall motion as assessed by M-mode and two-dimensional (2D) echocardiography. Transverse plane QRS maximal vector correlated significantly with LV mass in patients with both inferior and posterior MI (r = 0.65 and 0.87, respectively, p less than 0.01). A transverse plane QRS maximal vector greater than 1.5 mV correctly recognized 12 of 15 (80%) and 9 of 12 (75%) patients with respectively inferior and posterior MI and LV mass greater than 221 gm. Of the ECG measurements, S V1-2 + R V5-6 correlated moderately with LV mass in patients with inferior MI (r = 0.47), and R V1-2 + R V5-6 correlated moderately with LV mass in those with posterior MI (r = 0.67). ECG and VCG QRS voltage data did not correlate with global and regional LV function as assessed by M-mode and 2D echocardiography. We conclude that: ECG and VCG QRS voltage parameters can be utilized for assessing non-invasively LV enlargement in patients with postero-inferior MI; ECG and VCG QRS voltage parameters should be utilized with caution for analyzing LV function or MI size in postero-inferior MI.