Mycobiota and co-occurrence of mycotoxins in Capsicum powder.

This study aimed to: (1) determine the mycobiota of Capsicum powder samples, paying a special attention to the mycotoxigenic moulds; (2) evaluate the contamination levels of aflatoxins (AF), ochratoxin A (OTA), zearalenone (ZEA), deoxynivalenol (DON), T2 and HT2 toxins in those samples. Thirty-two samples were obtained through the methods of sampling established by the European Union legislation. Aspergillus and Eurotium were the most frequently found genera. Aspergillus section Nigri had the higher relative frequency in the samples, A. niger aggregate being the most representative group of this section. Other potentially mycotoxigenic Aspergillus, Fusarium and Penicillium species were found, but in a lower frequency. Co-occurrence of mycotoxins was confirmed in the 32 Capsicum powder samples. All samples were contaminated with AF and OTA, 27% with ZEA (36% of chilli and 18% of paprika samples), 9% with DON (18% of chilli and 6% of paprika samples), 6% with T2 (18% of chilli samples) and none of the samples contained HT2. Although in the present study the most common genera found (Aspergillus and Eurotium) belong to storage moulds, some field fungi such as Fusarium spp. were also found, and their toxins were sometimes detected. This fact supports the hypothesis that mycotoxin contamination of Capsicum products may occur both in the field and/or during storage.

Effect of fenpropimorph, prochloraz and tebuconazole on growth and production of T-2 and HT-2 toxins by Fusarium langsethiae in oat-based medium.

Fusarium langsethiae has been isolated from infected cereals in central and northern Europe where it has been identified in the last decade as the main species involved in the occurrence of high levels of T-2 and HT-2 toxins, mainly in oats. The efficacy of three fungicides (prochloraz, tebuconazole, fenpropimorph) for controlling growth of two strains of F. langsethiae isolated from oats was examined at 0.96 and 0.98 a(w) at 15, 20 and 25 °C on oat-based media. The concentrations necessary for 50 and 90% growth inhibition (ED50 and ED90 values) were determined. The effect on the trichothecene type A mycotoxins T-2 and HT-2 was also determined. Without fungicides both strains grew faster at 0.98 than at 0.96 a(w) and the influence of temperature on growth rates was 25>20>15 °C. Prochloraz and tebuconazole were more effective than fenpropimorph against F. langsethiae. Strain, temperature and type of fungicide significantly influenced the ED50 and ED90 values for growth. The concentration ranges under different environmental conditions were: prochloraz (0.03-0.1 and 0.3-1.5), tebuconazole (0.06-0.9 and 1.3-8.2), and fenpropimorph (22-59 and 125-215 mg l⁻¹). Production of T-2 and HT-2 toxins was influenced by temperature, a(w), type of fungicide and dose. Levels of T-2 were usually higher than those of HT-2 under the same conditions. The biosynthesis of T-2 toxin increased after 10 day incubation, but was reduced with decreasing temperature and increasing fungicide dose. At 0.98 a(w) T-2 levels increased in cultures containing fenpropimorph while at 0.96 a(w) the toxin concentrations increased in response to the other two fungicides. Low doses of prochloraz or tebuconazole enhanced toxin production when compared with untreated cultures for strain 2004-59 at 0.96 a(w) and 20-25 °C. HT-2 was hardly detectable in the treatments with prochloraz or tebuconazole at 0.98 a(w). This is the first study on the effect of these anti-fungal compounds on control of growth of F. langsethiae and on production of T-2 and HT-2 toxins in oat-based media.

Impact of non-selective fungicides on the growth and production of ochratoxin A by Aspergillus ochraceus and A. carbonarius in barley-based medium.

The aim of this study was to assess the influence of the non-selective fungicides mancozeb, copper oxychloride, and sulfur on the growth and capability for producing ochratoxin A (OTA) of ochratoxigenic isolates of Aspergillus carbonarius and A. ochraceus in barley-based medium. Lag phases and growth rates were determined for each fungicide at different doses, at 15°C and 25°C and at 0.97 a(w). Mancozeb at 40 mg l(-1 )inhibited fungal growth and provided lag phases >24 days at 10-20 mg l(-1) and 15°C. OTA was observed only at 25°C and doses <10 mg l(-1). At 15°C, copper oxychloride proved inhibitory at 800 mg l(-1), while at 25°C growth was not delayed and only high doses decreased OTA levels. Sulfur was inhibitory or provided large lag phases at 5-8 g l(-1) (at 15°C) while at 25°C growth took place even at 8 g l(-1), although OTA levels were low or undetectable. The antifungal activity decreased in the order mancozeb > copper oxychloride > sulfur, and was lower at 25°C than at 15°C. OTA accumulation was affected by the type of fungicide, dose, temperature and time. The efficacy of these fungicides on the growth of A. carbonarius and A. ochraceus and OTA production in barley-based medium is assessed for the first time.

Changes in ochratoxin A and type B trichothecenes contained in wheat flour during dough fermentation and bread-baking.

Ochratoxin A (OTA) and type B trichothecenes are mycotoxins that occur frequently in cereals and thus can be found in cereal by-products such as bread. The aim of this work was to study the variation of the levels of OTA, deoxynivalenol (DON), 3-acetyldeoxynivalenol (3-ADON) and nivalenol (NIV) during the bread-making process. This was done by using wheat flour spiked with different levels of toxins. Mycotoxin levels were controlled after fermentation of the dough with yeasts (Saccharomyces cerevisiae) and after further baking at different temperature-time combinations. Analysis of variance (ANOVA) of the results showed a significant reduction in OTA level (p < 0.05) during fermentation of the dough. The reduction ranged between 29.8% and 33.5%, depending on the initial concentration of toxin in the flour. During this period, the level of the other mycotoxins studied was not modified. By contrast, in the baking phase there were significant changes in the levels of the four mycotoxins, although the reduction was similar under all the baking conditions. Considering all the temperature-time conditions tested, it can be concluded that during the baking period the average reduction of OTA, NIV, 3-ADON, and DON was 32.9%, 76.9%, 65.6%, and 47.9%, respectively.

Fumonisin production in rice cultures of Fusarium verticillioides under different incubation conditions using an optimized analytical method.

Fumonisin B1 (FB1) and fumonisin B2 (FB2) are the main members of a family of mycotoxins produced by various fungal species belonging to the Gibberella fujikuroi complex. The present work shows the results of a comparative study of various clean-up and derivatization procedures for analysis of fumonisins in rice cultures. Fumonisins were extracted from rice with acetonitrile/water (50/50, v/v). For clean-up, three solid-phase extraction procedures were assayed (C18 cartridge, SAX cartridge, and a combination of both). Two reagents (o-phthaldialdehyde and 4-fluoro-7-nitro-benzofurazan) were studied comparatively for formation of fluorescent derivatives. The separation was carried out by LC using a fluorescence detector. The best procedure for analysis of fumonisins in rice involved clean-up with C18 cartridge and derivatization with o-phthaldialdehyde. The limit of detection was 0.010 mg kg(-1) for both toxins. In the 10-500 mg kg(-1) spiking level range, the recovery rates for FB1 and FB2 in rice varied from 94.6% to 103.6% and from 96.3% to 101.9%, respectively. The optimized analytical method for determination of fumonisins in rice was applied to the study of FB1 and FB2 production by four isolates of the G. fujikuroi species complex in rice cultures carried out at different temperatures and water activities to establish the influence of strain and environmental conditions on fumonisin production in this cereal. In general, fumonisin production was the highest at 20 degrees C and lowest at 37 degrees C. Four of the five assayed water activity (aw) values (0.97, 0.98, 0.99, and 1.0) did not affect significantly fumonisin accumulation but fumonisins were not detected in cultures when aw was 0.96.

Variability and characterization of mycotoxin-producing Fusarium spp isolates by PCR-RFLP analysis of the IGS-rDNA region.

In the present report, a total of 75 Fusarium spp isolates (35 of the Gibberella fujikuroi species complex, 26 of F. oxysporum, 7 of F. graminearum, 5 of F. culmorum, 1 of F. cerealis, and 1 of F. poae) from different hosts were characterized morphologically, physiologically and genetically. Morphological characterization was performed according to macroscopic and microscopic aspects. Physiological characterization was based on their ability to produce fumonisin B1 (FB1), fumonisin B2 (FB2), zearalenone (ZEA) and type B trichothecenes (deoxynivalenol, nivalenol and 3-acetyldeoxynivalenol). FB1, FB2, and ZEA were determined by liquid chromatography and trichothecenes by gas chromatography. Molecular characterization of isolates was carried out using an optimized and simple method for isolation of DNA from filamentous fungi and polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP) of the intergenic spacer region (IGS) of the rDNA. The results indicated that G. fujikuroi complex isolates can be divided into low and high fumonisin producers. The haplotypes obtained with HhaI, EcoRI, AluI, PstI and XhoI enzymes provided very characteristic groupings of G. fujikuroi isolates as a function of host type and fumonisin producing capacity. F. graminearum, F. culmorum and F. cerealis isolates were high ZEA and type B trichothecene producers, while F. oxysporum and the G. fujikuroi complex isolates did not show this ability. The haplotypes obtained with CfoI, AluI, HapII, XhoI, EcoRI and PstI enzymes permitted to discern these five Fusarium species and G. fujikuroi complex isolates but the restriction patterns of the IGS region did not show any relationship with the geographic origin of isolates.

Characterization of Fusarium spp. isolates by PCR-RFLP analysis of the intergenic spacer region of the rRNA gene (rDNA).

In the present study, 44 Fusarium spp. isolates (5 Fusarium culmorum, 7 Fusarium graminearum, 1 Fusarium cerealis, 1 Fusarium poae, 26 Fusarium oxysporum, and 4 Gibberella fujikuroi species complex) were characterized morphologically, physiologically and genetically. All except one (Dutch Collection: CBS 620.72) were isolated from different hosts grown in various Spanish localizations. Morphological characterization was made according to macroscopic and microscopic aspects. Physiological characterization was based on their ability to produce zearalenone (ZEA) and type B trichothecenes (deoxynivalenol, nivalenol and 3-acetyldeoxynivalenol). ZEA was determined by liquid chromatography and trichothecenes by gas chromatography. Confirmation was carried out by liquid chromatography-ion trap-mass spectrometry (ZEA) or gas chromatography-mass spectrometry (trichothecenes). Molecular characterization of isolates was performed using an optimized, simple and low-cost method for isolation of DNA from filamentous fungi and polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP) of the intergenic spacer region (IGS) of the rRNA gene (rDNA). The results indicate that F. graminearum, F. culmorum and F. cerealis isolates were high ZEA and type B trichothecene producers, the F. poae isolate produced very low level of nivalenol while F. oxysporum and the G. fujikuroi complex isolates did not show this ability. Restriction patterns of the IGS region did not show any relationship with the host, geographic origin of the isolate and mycotoxin-producing capacity. However, the haplotypes obtained with six restriction enzymes (CfoI, AluI, HapII, XhoI, EcoRI and PstI) permitted to discern the six assayed Fusarium species. Therefore, this is a rapid and suitable methodology that allows closely related strains to group and to estimate the genetic relationships between the groups.

Influence of environmental factors on the biosynthesis of type B trichothecenes by isolates of Fusarium spp. from Spanish crops.

Various species of Fusarium can produce trichothecene mycotoxins that contaminate food commodities and can represent a risk for human and animal health. In this paper, a full factorial design was applied to study the influence of incubation temperature, water activity (a(w)) and type of isolate on the production of deoxynivalenol (DON), nivalenol (NIV) and 3-acetyldeoxynivalenol (3-AcDON) in corn kernel cultures by three isolates of Fusarium graminearum and three isolates of Fusarium culmorum from crops grown in Spain. The tested temperatures were 15, 20, 28 and 32 degrees C. The a(w)-values were 0.960, 0.970 and 0.980. Moisture of cultures (within the studied range) did not affect significantly production of trichothecenes; however, the temperature affected significantly mycotoxin production and the optimal values were 28, 20 and 15 degrees C for DON, NIV and 3-AcDON, respectively. Four additional isolates of F. graminearum and two additional isolates of F. culmorum were examined for production of these mycotoxins at the optimal temperatures. Of the seven isolates of F. graminearum, four produced DON (0.88-3.97 microg/g), seven produced NIV (1.53-124 microg/g), and three produced 3-AcDON (0.65-10.6 microg/g). Of the five isolates of F. culmorum, four produced DON (1.20-4.93 microg/g), four produced NIV (6.94-701 microg/g), and four produced 3-AcDON (0.83-7.70 microg/g). Practically all isolates seem to belong to the NIV-chemotype. This is the first study done with regard to interaction between strain and ecological variables on type B trichothecene production by isolates of these two species from crops grown in Spain.

Application of SEM/EDX and metallographic techniques to the diachronic study (6th-18th century) of metallurgical materials found in archaeological excavations on the island of Ibiza (Spain).

This work is the archaeometric study of the different types of materials recovered in the same excavation or archaeological dig (which makes it possible to accurately date the remains found) on the island of Ibiza (Spain). The samples found belong only to the phase of iron forging and span a very wide historical period from the 6th to the 18th century, including the Islamic period. Scanning Electron Microscopy (SEM) is proposed to observe the images obtained of the surfaces of the samples, in order to study the topographical, morphological and microstructural characteristics providing information on the materials contained in the samples. It also permits chemical analysis of the elements in the sample using X-ray Microanalysis (SEM/EDX), which provides both qualitative and semi-quantitative information on the elements in the sample. The archaeometric results suggest that the sole use of the area studied was as a forge workshop over a long period of time. The slag studied show that no reduction or refining activities took place in the area. However, in this forge, pieces of other metals were also produced, especially bronze alloys, polymetallism being a common characteristic throughout history.

Analytical study by SEM/EDX and metallographic techniques of materials used in the iron production process during the iberian period.

This work is the archaeometric study of different types of materials used in iron production in the Iberian Period (6th-2nd century b.c.). The materials were recovered in several archaeological digs (which makes it possible to date the archaeological remains) on different sites in the Levante area of the Iberian Peninsula. The samples selected for this study belong to different materials used in the ancient iron production process such as ores, slags, finished objects, etc. The use of scanning electron microscopy (SEM) is proposed to observe surface images of the samples to determine their morphological, microstructural and topographic characteristics to obtain valuable information on the materials studied. The study also proposes chemical analysis of the elements in the sample by X-ray microanalysis (SEM/EDX) which provides both qualitative and quantitative information. The archaeometric study suggests that the iron obtained was very good quality, but the process was not economically efficient when viewed from today's perspective. Furthermore, the slag produced in the furnace can be related with the slag or impurities contained in the iron. It has also been possible to relate the ores and slag, some furnace conditions, the use of fluxes and also to differentiate types of slag.

Clinical value of parameters derived by the application of the proximal isovelocity surface area method in the assessment of mitral regurgitation.

UNLABELLED: To determine the clinical value of several parameters derived by application of the proximal isovelocity surface area method in the assessment of mitral regurgitation (MR), 28 consecutive patients with angiographic diagnosis of MR underwent color Doppler echocardiography within 48 h of cardiac catheterization. Aliasing velocities (V(N)) were baseline-shifted to 25 cm/s and the maximal radius (R) was measured from the first aliasing boundary to the tips of the mitral valve. By continuity, the regurgitant orifice area (ROA) and regurgitant stroke volume (RSV(PISA)) were obtained. We have related them to the angiographic grade, and with determination of the regurgitant stroke volume (RSV(DE)) and the regurgitant fraction (RF), we calculated the volume of the transmitral flow according to Fisher's method. RESULTS: RSV(DE) correlated well with RSV(PISA) (r = 0.98). A clear relation existed between the isovelocity radius and the RSV(DE) and RF (r = 0.95 and 0.88, respectively). A radius of 8 mm or more was identified well with an RSV(DE) of 40 cm3 or more (sensitivity: 100%, specificity: 95%) and an RF of 35% or more (sensitivity: 88%, specificity: 94%). The ROA was closely related to the RSV(DE) and RF, with r = 0.92 and 0.88, respectively. An ROA of 20 mm2 or more identified well patients with RSV(DE) values of 40 cm3 or more and RF values of 35% or more. The radius, RSV(PISA) and ROA were closely related to the angiographic grade of MR (r = 0.91, 0.83 and 0.92, respectively). A radius of 7 mm or more identified patients with grade III or IV of regurgitation (sensitivity: 82%, specificity: 94%), while an ROA of 15 mm2 or more discriminated well significant regurgitation (sensitivity: 91%, specificity: 94%). CONCLUSIONS: Parameters derived by application of the proximal isovelocity surface area method provide quantitative information that can be helpful in predicting the severity of mitral regurgitation noninvasively.

[The evolution of severe postvalvuloplasty mitral insufficiency]. / Evolución de la insuficiencia mitral severa posvalvuloplastia.

Percutaneous mitral valvuloplasty has become the technique of choice for mitral stenosis with favorable anatomic features. However, mitral regurgitation is an important complication of this technique that has not reduced with Inoue technique. This study reports the clinical and echocardiographic follow-up (28 +/- 20 months) of 20 patients who developed severe mitral regurgitation after percutaneous mitral valvuloplasty with Inoue technique. The patients were divided into two groups on the basis of the need for mitral valve replacement during follow-up. We analyzed variables before and after percutaneous mitral valvuloplasty using univariate analysis. Multivariate analysis was performed to identify variables as independent predictors of the need for mitral valve replacement. Ten patients needed mitral valve replacement during follow-up. Multivariate analysis showed that suboptimal result of percutaneous mitral valvuloplasty (MVA < 1.5 cm2) was the only independent predictor of the need of mitral valve replacement. We concluded that the need for MVR in patients who develop severe mitral regurgitation after percutaneous mitral valvuloplasty was related to suboptimal result of procedure.

[The measurement of jet width at its origin in assessing mitral prosthetic regurgitation. The effect of the spatial disposition of the jet]. / Medida de la anchura del jet en su origen en la valoración de la regurgitación protésica mitral. Influencia de la disposición espacial del jet.

INTRODUCTION AND OBJECTIVES: The study was performed to test the influence of the jet spatial disposition on the correlation degree between the measurement of the jet width at its origin and the severity of mitral prosthetic regurgitation by transesophageal Doppler color flow imaging. MATERIAL AND METHODS: In 165 patients with mitral valve prosthesis which were submitted for transesophageal echocardiography examination due to suspected prosthetic dysfunction, we studied 126 with pathological mitral regurgitation. On these patients, studies of jet spatial disposition, maximum width in its origin and severity quantification by means of maximum regurgitation area were performed. RESULTS: For the free jet group of patients (90), jet width at its origin correlated with maximal regurgitation area (r = 0.75); whereas for the wall jet group (36), the correlation degree was 0.59. We observed a relationship (p < 0.05) between severe mitral regurgitation assessed by maximal regurgitant jet size and jet width > or = 5 mm in both groups: the sensitivity and specificity of 72.7% and 95% respectively for free jets, and 70.7% and 64.4% for wall jets. CONCLUSIONS: The correlation between the area measurement and the width in its origin is better for free jets than for wall jets. A statistically significant relationship between the presence of severe mitral regurgitation and width in its origin > or = 5 mm could be observed, independently of the jet spatial disposition.

[Long-term results of percutaneous mitral valvuloplasty]. / Resultados a largo plazo de la valvuloplastia mitral percutánea.

OBJECTIVES: The aim of this study was to assess the long-term results of percutaneous transvenous mitral commisurotomy in our institution, and to evaluate potential predictors of long-term event-free survival. PATIENTS AND METHODS: Between 1990 and 1996, 204 patients underwent percutaneous transvenous mitral commisurotomy with an Inoue balloon. One hundred and thirty two patients were followed for up to 9 months. Mean time of follow-up was 2.6-1.5 years (7 days-5.7 years). End points were considered mitral surgery, death and functional class III-IV. Long-term event-free survival analysis was performed to determine independent predictors of event-free survival. RESULTS: At the end of the study, 88% of patients were classified as New York Heart Association class I-II. Multivariate analysis revealed that independent predictors of major events were stiffness and thickening of the valve, presence of severe left atrial enlargement as factors pre-procedure; with suboptimal results and significant mitral regurgitation after percutaneous transvenous mitral commisurotomy. CONCLUSIONS: Percutaneous transvenous mitral commisurotomy with Inoue balloon is a safe and effective technique. Good results are maintained at long-term follow-up and the best results are obtained in patients with flexible and thin valves, with mild or moderate enlargement of left auricle and in cases with optimal results and without severe mitral regurgitation as a complication of the procedure.

[Cardiac transplant in single ventricle]. / Transplante cardíaco en el ventrículo único.

Univentricular heart is an uncommon congenital heart disease. A select group of these patients (those with severe pulmonary stenosis or atresia) can reach adult age with different degrees of heart failure and severe chronic hypoxemia. Patients with adequate pulmonary tree development are likely to undergo heart transplantation when usual palliative techniques are contraindicated. Three cases of univentricular heart with pulmonary stenosis in which heart transplantation was the optimal choice are reported. Different techniques used to assess pulmonary tree development are analysed.

[Predictive variables of early mortality after orthotopic heart transplant in adults]. / Variables predictoras de mortalidad precoz tras el trasplante cardíaco ortotópico en adultos.

OBJECTIVE: The purpose of the study was to analyze some variables of donors, recipients and surgical procedures in order to discover factors that could predict mortality during the early stage (< 30 days) of orthotopic heart transplants. MATERIAL AND METHOD: 125 consecutive orthotopic heart transplants in adults were analyzed. The average age was 51 +/- 11 (range: 12-67), 109 (87%) were men, 16 were women (13%). Two groups were compared: 15 patients who died within 30 days after heart transplant and 110 who survived during that period. Immunosuppressive protocol: preoperative: Cyclosporin + Azathioprine. Intraoperative: Methylprednisolone Postoperative: Methylprednisolone (first 24 h), antilymphocyte monoclonal antibodies (7-10 days after heart transplant) + Cyclosporin + Azathioprine + Corticoids. The following parameters of the recipient were analyzed: sex, age, weight, size, thoracic perimeter, pretransplant cardiopathy, previous thoracic operations, functional stage or need for catecholamines during the days prior to the transplant, pulmonary artery pressure and resistance, history of systemic arterial hypertension, elevation of creatinine, blood type, urgent transplant indication, receptor/donor weight relationship. The following parameters of donors and operation were analyzed: sex, age, weight, thoracic perimeter, period in intensive care unit, dose of dopamine and dobutamine, blood type, origin of the organ, cause of death, ischaemia time, cardiopulmonary by-pass time and cardioplegia type. RESULTS: The rate of early mortality was 12%. The univariate analysis showed differences in: prior cardiovascular surgery, receptor blood type, need for urgent transplantation, pulmonary artery resistance > 2.5 Wood Units, cardiopulmonary by-pass time, weight relationship between receptor and donor. The death cause of the donor proved significant. On multivariate analysis, the following parameters independently predicted early mortality: history of operation with extracorporeal circulation, high pulmonary artery resistance, urgent transplant, receptor/donor weight relation and time of extracorporeal circulation. CONCLUSIONS: We believe that the results of our experience can help to stratify the risk in the orthotopic heart transplant recipient and even to contraindicate the procedure in some cases showing an accumulation of poor prognostic factors in borderline recipients.

[Coronary involvement in Takayasu's arteritis]. / Afectación coronaria en la arteritis de Takayasu.

Takayasu's arteritis is a chronic inflammatory disease that primarily affects young women. Cardiac involvement is infrequent and it includes aortic regurgitation, pericarditis, angor pectoris or myocardial infarction due to coronary narrowing and cardiac heart failure due to coronary involvement and/or high blood pressure. A patient with Takayasu's aortitis and angina pectoris due to severe narrowing of the left coronary arterial ostia is described.

[Heart angiosarcoma and heart transplantation. Report of a case]. / Angiosarcoma cardíaco y trasplante cardíaco. A propósito de un caso.

We present the case of a 29-year-old women with a cardiac primary angiosarcoma diagnosis. The initial symptom was a cardiac tamponade. The tests for screening metastasis proved negative. She was preoperatively treated with chemotherapy, followed by a heart transplant. There were no incidents related to surgery nor to the transplant except for a rejection in the second week biopsy. Four weeks after the transplant, the patient had a sudden dyspnea, the radiological tests confirmed the existence of a massive pleural overflow and lung and pleural metastasis. All types of therapeutical approaches were rejected except for pleurodesis. The patient died 60 days after the heart transplant.

[Obstructive and non-obstructive hypertrophic cardiomyopathy: clinical, electrocardiographic, and echocardiographic differences]. / Miocardiopatía hipertrófica obstructiva y no obstructiva: diferencias clínicas, electrocardiográficas y ecocardiográficas.

AIM: The purpose of the study was to analyse echocardiographic, electrocardiographic and clinical variables in patients with hypertrophic cardiomyopathy, as well as to compare the possible differences between the non-obstructive (NOHCM) and the obstructive form (OHCM). METHOD: 44 consecutive patients were studied and diagnosed with hypertrophic cardiomyopathy (NOHCM 26 and OHCM 18). The following variables were analysed: 1) echocardiographic: right ventricle (RV), interventricular septum (IVS), posterior wall (pW), telediastolic and telesystolic diameter of the left ventricle (TDD-LV and TSD-LV), size of the left atrium (LA), systolic anterior motion of the mitral valve (SAM), mitral insufficiency and direction of the jet (MI and MIpW), mitral anular calcium (MAC), filling pattern (A > E); 2) electrocardiographic: repolarization disorders (RD), left ventricular hypertrophy (LVH), negative "T" waves in the precordial leads (T-), pathological "q" waves, super or ventricular arrhythmias (SA or VA), short PR, right or left bundle branch block (RBBB and LBBB), and 3) clinical: presence of dyspnea, angina, syncope, palpitations and response to treatment with beta-blockers (B-b) or Calcium-antagonists (C-A). RESULTS: There were no differences in age or sex between the obstructive and non-obstructive groups: 1) echocardiographic differences: there were none in RV, pW, TDD-LV, LA nor A > E wave. Significant differences were found (p < 0.05) in the rest of the variables; IVS (16 +/- 3 mm in NOHCM vs 22 +/- 5 mm in OHCM), TSD-LV (26 +/- 5 mm in NOHCM vs 22 +/- 6 mm in OHCM), SAM (38% in NOHCM vs 89% in OHCM), MI (19% in NOHCM vs 78% in OHCM), MIpW (20% in NOHCM vs 79% in OHCM), MAC (15% in NOHCM vs 44% in OHCM); 2) electrocardiographic differences: there were none in the presence of RD, pathological "q", VA, short PR, RBBB nor LBBB. The presence of "T" negatives was on the limit of significance in the precordial leads (31% in NOHCM vs 11% in OHCM; p = 0.09). Differences were found in the rest of the variables; LVH (58% in NOHCM vs 83% in OHCM), SA (50% in NOHCM vs 17% in OHCM); 3) clinical differences: there were none in the presence of dyspnea, angina, syncope or palpitations. Differences were found in the improvement with treatment; B-b (60% in NOHCM vs 57% in OHCM), C-A (100% in NOHCM vs 100% in OHCM). CONCLUSIONS: 1) in our patients, the most frequent cardiomyopathy is the non-obstructive one, with no predominance of age or sex; 2) in OHCM, IVS is much wider, with smaller TSD-LV, there is a greater incidence of MI, generally directed towards the posterior wall of the left atrium, and a larger tendency to calcify the mitral annulus; 3) the most frequent electrocardiographic abnormality is the alteration of repolarization. NOHCM has a greater incidence of SA and a lower degree of LVH with more prevalence of negative "T" waves in the precordial leads; 4) there are no clinical parameters differentiating the two groups, although the sustained improvement obtained with treatment is more likely to be produced by the calcium-antagonists than by beta-blockers in both types of cardiomyopathy.

[Doppler ultrasonography diagnosis of right ventricular outflow tract obstruction caused by mediastinal tumor and its reversibility after treatment]. / Diagnóstico por ecocardiografía-Doppler de obstrucción al tracto de salida del ventrículo derecho por tumor mediastínico y su reversibilidad después del tratamiento.

Doppler-echocardiography has proved useful in the assessment of mediastinal masses. We present the case of a young man with fever and new systolic murmur. Echocardiographic examination revealed a paracardiac mass compressing the right ventricular outflow tract and Doppler flow study detected marked acceleration in luminal narrowing. Complete remission of the tumour was obtained with subtotal resection and chemotherapy. Histological diagnosis was of embryonary carcinoma with areas of endodermic sinus. A new Doppler-echocardiography study showed disappearance of both the mass and the compression and showed normal right ventricular outflow tract flow.