Doppler analysis of portal vein flow in tricuspid regurgitation.

Portal and hepatic vein flow-velocity profiles were examined by pulsed Doppler in 66 patients with tricuspid regurgitation (color Doppler grading: severe: 37, moderate: 18; mild: 11) and 20 normal subjects to determine if portal vein flow analysis is useful in the evaluation of tricuspid regurgitation. Portal vein flow was defined as one of the following categories: subcontinuous (dependent on respiration), pulsatile systolic (not inverted), inverted after systole, and continuous (not dependent on respiration). An index of portal vein flow pulsatility was also calculated. Standard classification of hepatic vein flow pattern was performed. Portal vein flow was pulsatile in 20% of normals subjects, and in 27.3% 44.5% and 51.3% of patients with respectively mild, moderate and severe tricuspid regurgitation; portal vein flow was inverted after systole in further 32.4% of patients with severe tricuspid regurgitation. Portal vein pulsatility index correlated with color Doppler grading of tricuspid regurgitation (r:0.63; p < 0.001) and right ventricle-atrium pressure gradient (r:0.39; p < 0.01). However, when compared with hepatic vein flow, both sensitivity and specificity of quantitative portal vein flow analysis was less reliable in diagnosing and grading tricuspid regurgitation. In particular, in patients with severe tricuspid regurgitation, the portal vein flow pattern was quite variable (pulsatile in 19 patients, inverted after systole in 12, and continuous in six). Liver biopsy was performed in nine patients, four of them with severe tricuspid regurgitation and continuous portal vein flow. Histology showed severe liver fibrosis in all four.(ABSTRACT TRUNCATED AT 250 WORDS)

Microinjections of flupenthixol into the caudate putamen of rats produce intrasession declines in food-rewarded operant responding.

Results of recent studies suggest that dopamine (DA) transmission in the caudate putamen may be involved in food reward-related learning. The purpose of the present study was to evaluate the contribution of DA terminals in the dorsal caudate putamen to food-rewarded operant responding. Experiment 1, a study measuring circling behaviour in 18 rats receiving systemic amphetamine (1.5 mg/kg) and unilateral intracaudate putamen injections of cis-flupenthixol (0.0, 1.0, 10.0, and 25.0 micrograms in 0.5 microliters), a DA receptor antagonist, or its pharmacologically inactive isomer trans-flupenthixol (25.0 micrograms in 0.5 microliter), determined a behaviourally effective dose of cis-flupenthixol. Results showed that cis-flupenthixol dose dependently increased ipsiversive turning and trans-flupenthixol did not. In Experiment 2, an operant study, 36 rats were trained to press a lever for food on a variable interval 30-s schedule. Rats were then randomly assigned to four groups, three of which received one of the following bilateral intracaudate injections prior to three subsequent test sessions: saline (n = 6; 0.5 microliters), cis-flupenthixol (n = 10; 25.0 micrograms/0.5 microliter), and trans-flupenthixol (n = 10; 25.0 micrograms/0.5 microliters). Rats in the home cage control group (n = 10) received two bilateral intracaudate putamen injections of cis-flupenthixol (25.0 micrograms/0.5 microliters) in their home cages and a final injection of cis-flupenthixol prior to a test session. The results showed that cis-flupenthixol, but not trans-flupenthixol or saline, produced a time-dependent intrasession decline in operant responding. This pattern resembled that seen in extinction.(ABSTRACT TRUNCATED AT 250 WORDS)

Abnormal intraventricular flow patterns in left ventricular dysfunction determined by color Doppler study.

We examined the relation between left ventricular (LV) flow dynamics measured by color Doppler, and either global or regional LV function in 19 normal subjects (group 1), in 55 patients with old myocardial infarction (MI) (29 without [group 2] and 26 with LV aneurysm [group 3]), and in 16 with idiopathic dilated cardiomyopathy (group 4). We calculated by M-mode color Doppler a flow persistence index (FPI) (duration of flow directed in systole toward the apex/LV ejection time). Contrast echocardiography was performed as a control method in 14 patients of the four groups. In normal subjects, rapid systolic inversion of flow toward the aorta was evident (FPI: 0.11 +/- 0.16). In all but one patient in group 2, a similar LV flow pattern was observed, but FPI was greater (0.32 +/- 0.26). In groups 3 and 4, a paradoxical antegrade LV flow pattern was evident during the entire period of systole (FPI: 1.13 +/- 0.42 and 1.28 +/- 0.36, respectively). LV flow patterns were reproduced in echo-contrast studies. FPI was related to LV end-diastolic volume (r = 0.77), end-systolic volume (r = 0.82), and ejection fraction (r = -0.84). However, when data were analyzed separately in the different groups, these correlations were significant only in groups 2 and 3. Paradoxical flow pattern is not peculiar to regional LV dysfunction; it also occurs in global LV dysfunction. This LV flow abnormality may develop after MI even in the absence of severe LV dyssynergy or dilation, and is quantitatively related to the degree of LV dysfunction.