[Value of echocardiography in the diagnosis of aortic insufficiency].
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Biomedical subjects
Publications and source records attributed to C Mayor.
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M-mode and two-dimensional echocardiography (echo) were performed in 51 patients with pure or predominant mitral stenosis. Echocardiographic assessment of the severity of the stenosis was compared to the results of cardiac catheterization (cath); surgical evaluation of the mitral valve area was also obtained in 20 patients. M-mode is an excellent method for the diagnosis of mitral stenosis. However two-dimensional echo is much better for the assessment of its severity; in the present study correlations with cardiac catheterization have been excellent (r = 0.89, p less than 0.001). Major disagreement between echo and cath were found in 4 patients; 3 of them have been operated on and surgery has confirmed the echo results in all 3. Two-dimensional echo has also allowed correct prediction in the presence of mitral calcifications in 6 of the operated patients, whereas several false positive and negative diagnosis was made on M-mode. Two-dimensional echocardiography is therefore an excellent non-invasive technique for the diagnosis of mitral stenosis, measurement of mitral valve area and identification of mitral calcifications.
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The aim of this study was to compare the results of unidimensional and cross-sectional echocardiography and cardiac catheterisation in the assessment of mitral and aortic stenosis. 21 patients with mitral stenosis, 21 patients with aortic stenosis and 21 patients without valvular disease were studied by unidimensional and cross-sectional echocardiography and cardiac catheterisation. Although unidimensional echocardiography in the external cardiac investigation of choice for the qualitative diagnosis of mitral stenosis, a better assessment of the severity of the stenosis is obtained with cross-sectional echocardiography. The valve surface measured by cross-sectional echocardiography correlates well with the value obtained by catheterisation with the application of the Gorlin formula (r = 0.85). Cross-sectional echocardiography is therefore an important advance in the external assessment of mitral stenosis. The aortic valve can only be measured in one third of cases of aortic stenosis with unidimensional echocardiography, whilst this measurement can be performed in 90 p. 100 of cases with cross-sectional echocardiography. The values obtained in 9 patients with severe aortic stenosis were 3.7 +/- 0.7 mm/m2, in 7 patients with moderate aortic stenosis: 5.4 +/- 0.8 mm/m2 and in 5 patients with mild aortic stenosis: 6.8 +/- 1,2 mm/m2. There is a clear demarcation between the different groups if the average values are compared. Therefore cross-sectional echocardiography gives reliable semi-quantitative assessment of the severity of aortic stenosis.
Echocardiographic demonstration of vegetations has been achieved in 11 out of 19 patients with bacterial endocarditis. The present study shows that echocardiography is particularly useful in patients in whom the duration of symptoms before treatment is greater than 6 weeks. It also shows that a positive echocardiogram is indicative of a poor prognosis.