[Left ventricular mass identified with tridimensional echocardiography and myocardial tissue Doppler].
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Biomedical subjects
Publications and source records attributed to J Azevedo.
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OBJECTIVE: To compare the polymerase chain reaction (PCR) Amplicor Chlamydia trachomatis test with the cell culture method, in diagnosing urogenital chlamydial infections. SUBJECTS: 439 patients (327 women and 112 men) attending one STD clinic and Family Planning and Gynaecological Clinics in Lisbon, Portugal, between November 1993 and March 1994. METHODS: In women, two endocervical swab samples were collected: one for PCR Amplicor and one for standard culture technique. Men were asked to submit 20 ml of urine (first pass urine) for PCR Amplicor and one urethral specimen was taken for culture. The order of collection of the specimens was rotated every 50 patients. Discrepant results were further analysed by a second PCR with primers directed against the C trachomatis major outer membrane protein (MOMP) and by direct fluorescent antibody (DFA). RESULTS: After analysis of discrepancies, the adjusted sensitivity and specificity of PCR on endocervical specimens were 92.9% and 100% and the positive and negative predictive values were 100% and 99.7% respectively; on the urine samples these values were 100%, 99.1%, 100% and 99.1%, respectively. CONCLUSION: These results indicate that the PCR Amplicor test is a rapid sensitive and specific assay for the detection of C trachomatis in urogenital infections and provides a non-invasive technique for screening chlamydia infection in men.
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We present a clinical case of a 33 years old young male, gypsy, intravenous drug abuser with heroine and cocaine and AIDS diagnosis. The clinical anamnesis was mainly fever and systolic heart murmur in a clinical scenario of AIDS. The two-dimensional echocardiographic study was clearly diagnostic of an hypertrophic obstructive cardiomyopathy of the left ventricle. This study showed also the presence of multiple vegetations of the mitral, aortic and pulmonic valves in a clinical setting of an acute Streptococcus Viridans infective endocarditis. In this case report we discuss the incidence of this type of multiple cardiac lesions and particularly the presence of this specific pathogenic agent in this high risk group of patients with intravenous drug abuse and systemic immunosuppression. We pointed out the rarity of these findings of left side valvular vegetations associated with this type of cardiomyopathy and the different factors related to infective endocarditis.
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Mitral annulus anatomy and dynamics were evaluated in 12 subjects using a three-dimensional transesophageal echocardiographic technique. The mitral annular area, diameters and distance from the left ventricular apex were measured in end-diastole, mid-systole, end-systole and mid-diastole. The mitral annulus had its largest area in end-systole and the smallest area in end-diastole. The shape of the annulus changed during the cardiac cycle with the maximal change occurring in the diameters passing close to the middle of the mitral leaflets. In the vertical plane, the annulus had a shallow ski-slope shape, with the attachment of the anterior leaflet being farthest from the apex. In other words, the highest point of the annulus was situated anteromedially and was visualized in the long axis imaging plane.
Most prior efforts of 3-dimensional (3-D) reconstruction of echocardiographic images have focused on quantitation of ventricular size and function. The resulting images have been displayed in the wire mesh format. Recently, a method for 3-D transesophageal echocardiography using a computer-controlled probe that acquires parallel tomographic slices has been described. This technique provides dynamic 3-D volume-rendered images of the heart. This study was designed to determine if surgical visualization of intracardiac anatomy could be simulated using this imaging system. Data acquired from 8 patients with congenital and acquired heart disease were analyzed. Real-time 3-D images of the cardiac chambers and valves were obtained. Images of the cardiac pathology including fibrocalcific nodules on the aortic valve, mitral valve endocarditis, rheumatic mitral stenosis, and an ostium secundum atrial septal defect were displayed in 3 dimensions that simulated surgical exposure of these structures. These 3-D representations of cardiac anatomy were in some ways superior to standard intraoperative visualization in that they demonstrated the heart as a dynamic structure, as opposed to the empty, nonbeating heart observed while on cardiopulmonary bypass. In conclusion, 3-D images of cardiac structures as seen by the surgeon intraoperatively can be provided using a computer-driven tomographic transesophageal echocardiographic probe. This imaging system can be potentially useful in the planning and evaluation of cardiac surgery. Technical improvements such as 3-D representation of flow jets, the ability to manipulate images to simulate cardiac surgery, and on-line reconstruction can make this a powerful tool in the future.