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L Bernardes

Publications and source records attributed to L Bernardes.

At least 19 recordsLinked to original sources

Laparoscopic biliopancreatic diversion for the treatment of morbid obesity: initial experience.

BACKGROUND: Open biliopancreatic diversion (BPD) is a proven effective operation for morbid obesity. We developed a technique which permits BPD to be performed laparoscopically. METHODS: 10 patients were submitted to BPD by laparoscopy in July and August 2000 for the treatment of morbid obesity. All patients were morbidly obese (BMI 40-55). RESULTS: All operations were performed by laparoscopy with no need to convert to laparotomy. No complications related to surgery were observed. CONCLUSION: The technique, with an acceptable level of complexity, can be safely executed by laparoscopy as described by Scopinaro.

Adolescent↗

[Isolated left anterior artery disease: angiographic features and clinical evolution of patients submitted to surgical myocardial revascularization or angioplasty].

The option for revascularization and the choice of intervention in isolated left anterior descending artery disease may be controversial. We decided to study retrospectively a group of revascularized patients (PTCA or surgery), with previous isolated LAD disease, to evaluate the angiographic features of LAD lesion, its contribution to the persistence of symptoms after revascularization and also to compare the occurrence of cardiac events in the two subgroups (PTCA and surgery). We studied 87 patients (mean age 57 +/- 10 years) submitted to myocardial revascularization (68 PTCA; 19 surgery), whose clinical evolution was followed for a mean period of 49 +/- 10 months (cardiac events: death, myocardial infarction, angina, heart failure, PTCA, surgery). We evaluated in cineangiography angiographic features of LAD lesions (degree of stenosis, lesion length and diameter, ectasia, luminal irregularity, ulcerated plaque, eccentricity, thrombus, calcification, type of lesion). On comparing angiographic features, we noted coronary lesions were longer in operated patients (p < 0.05) and a tendency for more complex lesions in this group (p = 0.08). After revascularization, 65% of PTCA patients and 26% of operated patients maintained angina (p < 0.01). The frequency of events was significantly higher in patients submitted to PTCA (84%) due to the greater occurrence of angina (65%). Sixteen percent PTCA were redilated and 6% operated whereas 11% of the surgical group were reoperated, without statistical difference regarding reintervention between the two groups. In the PTCA group, the greater frequency of angina and the necessity of a new PTCA could reflect restenosis. The disappearance of angina in operated patients may reflect probable patency of coronary bypass.

Aged↗

[A review of infectious endocarditis due to Candida].

OBJECTIVE: As fungal endocarditis is a serious disease, frequently requiring cardiac surgery, a review was made of the experience of our Departments in this pathology. DESIGN: A retrospective analysis of clinical, echocardiographic and surgical data. SETTING: Patients studied in a tertiary care Hospital with cardiac surgery available. PATIENTS: Between 1984 and 1994 there were ten cases of candida endocarditis in nine patients, four male and five female, mean age--45 +/- 12 years (31-65). INTERVENTIONS: The following parameters were analysed: clinical (predisposing factors, clinical evolution, complications, therapy and mortality), echocardiographic (presence of vegetations, abscesses, valvular regurgitations). Patients studied in other Centres and referred to our Department only for examination (echocardiograms) were excluded from this analysis. RESULTS: Eight cases in seven patients were prosthetic valve endocarditis and two native valve endocarditis. No patient was drug addicted. Seven cases of prosthetic valve endocarditis developed less than one year after surgery and another had a gynecological fungal infection as the cause of the endocarditis. Four patients had had previous endocarditis. There were four embolic events and three developed heart failure. There were three perivalvular infections, six valvular regurgitations and only one case with huge vegetations on echocardiography. Nine patients were treated with amphotericin B, in five fluocytosin was added and in four ketoconazol, which was replaced by flukonazol in one patient. Therapy was continued for at least eight weeks. Six patients were operated during the acute stage and one died. One patient was operated on late after the infection. Three patients died during the active stage. In a follow up of 5.2 +/- 4.8 years (8 months to 8 years) there was one fatal candida endocarditis relapse, one fatal candida sepsis, one non cardiac death, one patient developed a periprosthetic leak and one had recurrent systemic embolization. Abscesses/pseudoaneurysms were found in five out of seven patients submitted to surgery. CONCLUSION: Candida infective endocarditis has a bad prognosis, specially in those patients not operated early; it develops in patients with predisposing factors, which in our series were a previous infective endocarditis (four patients) and/or a prosthetic valve implantation less than one year before; it has important morbidity with multiple embolic events, perivalvular involvement, valvular regurgitation and heart failure.

Adult↗

[The QTc interval and its dispersion in hypertrophic myocardiopathy--its relation to complex ventricular arrhythmias and the effect of anti-arrhythmia agents].

UNLABELLED: The aim of the present study was to evaluate, in patients with hypertrophic cardiomyopathy (HCM): 1. The relation of rate corrected QT interval (QTc) and of QTc interlead variability (QTc dispersion) to complex ventricular arrhythmias (CVA); 2. The effects of amiodarone (Am), beta-blockers (beta B) and calcium antagonists (CA) on QTc and on QTc dispersion. Surface 12 leads ECG was analysed in 55 patients with HCM (39 +/- 12 years, 32 males). All patients were in sinus rhythm, without bundle branch block. Maximum (max), minimum (min) and mean QTc values were considered. QTc dispersion was calculated as: a) max QTc - min QTc (max-min); b) dispersion index (DI) = standard deviation of QTc/mean QTcx100. Patients groups were defined accordingly to: 1--the absence (group A1-35 patients) or the presence (group A2-20 patients) of CVA on 24 hours Holter monitoring; II--absence of cardioactive medication (group B1-20 patients) versus monotherapy with Am (group B3-10 patients), or beta B (group B4-15 patients), or CA (group B5-10 patients). Age, gender, type of HCM (asymmetric versus concentric) and echocardiographic fractional shortening were not different in the studied groups. RESULTS: [table: see text] CONCLUSIONS: 1. Maximum QTc interlead QTc dispersion are increased in patients with HCM that show CVA on Holter monitoring; 2. Amiodarone prolongs QTc but reduces QTc dispersion, while beta-blockers and calcium antagonists do not significantly change neither the duration nor the dispersion of ventricular repolarization.

Adrenergic beta-Antagonists↗

[Emergency catheterization in a coronary intensive care unit. The diagnostic and therapeutic implications].

OBJECTIVE: to evaluate the diagnostic and therapeutic role of emergency hemodynamic studies, in the coronary intensive care (UCI). STUDY DESIGN: Retrospective study of--patients (P) submitted to emergency catheterization. PATIENTS: 183 P (152 M and 31 F), mean age 56 +/- 11.5 years, admitted to UCI of Hospital Santa Marta and who had cardiac catheterization performed, between October 88 and November 92. METHODS: Patient clinical files were reviewed. We considered the reasons for emergency cardiac catheterization; final diagnosis; complications in the first 24 hours; catheterization role in the therapeutic orientation. RESULTS: Reasons for hemodynamic study were: coronary artery disease (CAD) in 127 P (69%); aortic dissection in 33 P (18%); valvular disease in 19 P (10%) and other in 4 P (3%). Clinical diagnosis was confirmed in 92% and changed in 8% by hemodynamic study results. Left main coronary artery disease was diagnosed in 6.5% of CAD patients. Coronary artery disease was excluded in 5 P with previous CAD diagnosis, in 19 P with aortic dissection and in 11 valvular patients. 32% of P were sent to emergent surgery: 93% ascending aortic dissection and 20% of CAD, 76% of valvular disease. The hemodynamic study was decisive in the therapeutic option of myocardial revascularization in 77% of P with CAD: 39 emergent PTCA (31%), 13 primary (33%) and 14 P oriented to elective PTCA (11%); 26 emergent surgery and 19 P oriented to elective surgery (15%). The emergency cardiac catheterization mortality rate was 0.5%, and the morbidity 2.7%. CONCLUSIONS: The contribution of Hemodynamic Department to UCI was decisive in the diagnostic and therapeutic orientation of critical patients.

Adult↗

[Non-invasive evaluation of ventricular ejection force by Doppler echocardiography].

UNLABELLED: Left ventricular ejection force as been purpose as a new Doppler ejection phase index, to assess left ventricular performance. In order to evaluate its usefulness, 33 patients undergoing cardiac catheterization were prospectively study. We considered three groups based on angiographic ejection fraction: group A-- > or = 55% (11 patients), group B--35 to 55% (10 patients), and group C-- < or = 35% (10 patients). All patients were in sinus rhythm and mitral regurgitation > I/IV or aortic valve disease were exclusion criterion. The following parameters, derived from Pulsed Doppler aortic velocities curves, were analyzed: peak velocity (cm/s), acceleration time (s), velocity time integral over the acceleration time (VTI Ac-cm), mean acceleration (cm/s2) and ejection force (g.cm/s2). Ejection force as calculated using the mass-acceleration concept, ad: ejection force = mean acceleration x VTI Ac x CsA x 1.06 (CsA - 2D cross sectional area of the aortic annulus; 1.06 - mass density of blood, g/cm3). [table: see text] CONCLUSIONS: The present study confirms that Doppler echocardiography can be used for the assessment of left ventricular performance based on noninvasive measurements and that Doppler derived ejection force is an accurate index for this purpose. However, ejection force evaluation, taking in account the results obtained for mean acceleration, a much less time consuming Doppler derived parameter, appears not to show any clinical advantage.

Adult↗

[The remote noninvasive assessment of left ventricular diastolic pressure by pulsed Doppler echography--the importance of the time of mitral protodiastolic deceleration].

UNLABELLED: To find a possible correlation between the transmitral diastolic flow, obtained by pulsed Doppler echocardiography, and left ventricular end-diastolic pressure (LVedP), we studied 95 patients (p) (58 +/- 9 years), with coronary artery disease (76 p) and dilated cardiomyopathy (19 p). P with atrial fibrillation, heart rate > 100 b/m or mitral regurgitation > 2+/4+ were excluded. We analyzed E and A wave peak velocities (v), time-velocity integrals (i) and diastolic filling intervals. Restriction to filling pattern was considered in the presence of an E wave deceleration time (DecT) < or = 120 ms (Group B- 22 p); the other 73 p (group A) ranged from abnormal relaxation to normal diastolic patterns, with DecT > 120 ms. RESULTS: -LVedP ranged from 3 to 38 mmHg in group A and from 16 to 39 mmHg in group B. In group A, the Ai/Ei ratio showed a significant linear correlation with the LVedP (r = 0.83, y = 14 chi + 2); Ai/El ratio > 1.0 identified pts with LVedP > 18 mmHg with a sensitivity of 85% and a specificity of 98%. In group B, there was a correlation between LVedP and the inverse ratio of integrals (Ei/Ai) (r = 0.72), as well as Ev/Av ratio (r = 0.69). CONCLUSIONS: In myocardial active relaxation abnormalities, Ai/Ei ratio increases proportionally to LVedP. A short DecT (< or = 120 ms) identifies a subgroup of p with predominant impairment of LV compliance and high filling pressures, in which the atrial contribution decreases as LVedP rises. Thus, whatever the prevailing mechanism of diastolic dysfunction, echo-Doppler transmitral diastolic flow can provide a noninvasive assessment of LVedP.

Adolescent↗

[The complications associated with the performance of heart catheterizations (diagnostic and therapeutic). The results in the Hemodynamics Laboratory of Hospital de Santa Marta].

OBJECTIVES: To evaluate the morbidity and mortality with cardiac catheterization (diagnostic and intervention). DESIGN: Retrospective analysis of complications occurring within 24 h of a cardiac catheterization, in three consecutive years (1989-1991). SETTING: Patients admitted to the Haemodynamic Laboratory of Santa Marta Hospital-Lisbon. PATIENTS: 4014 patients submitted to diagnostic and interventional procedures. MATERIALS AND METHODS: Registry analyze in order to obtain the following data: pathology, age, vascular approach and complications of cardiac catheterization. RESULTS: In three years there were 4014 cardiac procedures. 53.6% were performed in patients with coronary artery disease, 20% with valvular heart disease, 8.1% with congenital heart disease, 16.1% with others pathologies and 2.2% revealed normal vessels in coronary angiography. The incidence of ischemic heart disease was progressively higher in the studied years: 51.9% in 1989, 52.4% in 1990 and 55.2% in 1991. Data from population age showed the same tendency: mean age was 51, 53 and 55 years, respectively. Femoral approach was attempted in 95% of the studies, and the axillary in 2.15%. Complications of diagnostic and interventional cardiac procedures occurred in 3% of the patients. Dead occurred in 0.14%; arrhythmia, 0.37%; vascular, 0.14%; vasovagal/pyrogen reactions, 0.73%; myocardial infarction, 0.05%; and others, 1.58%. CONCLUSION: The diagnostic and interventional cardiac catheterization in experienced laboratories are a safe procedure with a reduced incidence of major complications.

Cardiac Catheterization↗

[Cardiovascular syphilis. Report of 2 cases].

We present two cases of cardiovascular syphilis being one of them a curious case of chronic pericardial effusion associated with cardiovascular complications of lues. In this article we will make as well a review of cardiovascular syphilis.

Adult↗

[Pulmonary artery involvement in Takayasu arteritis. A case of right ventricular failure as presentation form].

Pulmonary involvement in Takayasu's artery disease has been reported since 1940 with an incidence of 14 to 56%. However, the development of severe pulmonary hypertension is an extremely rare event in the natural course of the disease. The authors report a case of a 62 year old male presenting with severe congestive heart failure of recent onset. The initial evaluation and routine exams suggested the presence of pulmonary hypertension of unknown etiology. The absence of left radial pulse in the physical examination led to the performance of a complete angiographic study which confirmed the diagnosis of Takayasu's arteritis with pulmonary involvement and severe pulmonary hypertension.

Heart Failure↗

[Stenosis of the common trunk with and without ostium involvement: clinical and angiographic characteristics].

STUDY OBJECTIVE: To evaluate the clinical and angiographic profile of patients with left main coronary artery stenosis with (LM-OS) and without left coronary ostial stenosis (LM-NOS). DESIGN: Retrospective study of patients submitted to coronary angiography. SETTING: Laboratory of Hemodynamics and Interventional Cardiology at Bellvitge Hospital -Barcelona, Spain. PARTICIPANTS: 4663 consecutive patients (pts) with angiographically defined coronary artery disease. 139 pts had left main stenosis greater than or equal to 50%. Twelve pts were excluded because nonatheroesclerotic disease. Twenty two pts (17%), had LM-OS and 105 (83%) LM-NOS. INTERVENTIONS: Pts records were reviewed, to analyse the following clinical and angiographic variables: age, gender, risk factors to coronary artery disease, history of myocardial infarction, anginal class, presence of unstable angina, basal ECG ischemia, percentage and localization of left main stenosis, number and degree of vessels diseased, indexes of left ventricular function and coronary dominance. MAIN RESULTS: 1. Clinical characteristics--In the LM-OS group 18 pts were male and 4 female, while in the LM-NOS the numbers were respectively 90 and 15, p = ns. As for the gender the age showed also a similarity: 58 +/- 8 and 57 +/- 8 years, p = ns. A history of arterial hypertension was present in 73% of pts with LM-OS and 47% with LM-NOS, p greater than 0.05. With respect to the other clinical variables both groups were similar. The incidence of LM-OS was 0.4%. 2. Angiographic characteristics--The severity of left main stenosis was identical in the two groups: 80 +/- 15 in LM-OS and 75 +/- 16% in LM-NOS (p = NS). Four (18%) of the pts with LM-OS had no associated coronary disease versus 7 (7%) of the LM-NOS (p = 0.08). There were 1.3 +/- 1 diseased vessels in the LM-OS group and 2.1 +/- 1 in the LM-NOS (p greater than 0.01). CONCLUSIONS: In the present series, the clinical and hemodynamic profile of patients with left main disease suggest that the following characteristics are more frequently seen in patients with ostial stenosis: 1) history of arterial hypertension; 2) no associated coronary disease; 3) smaller number of diseased vessels; 4) less significant stenosis.

Aged↗

[Exercise test parameters after acute myocardial infarction. Relationship with coronary angiography].

OBJECTIVE: To analyze the relation between characteristics of symptom-limited treadmill exercise stress test, after acute myocardial infarction (MI) and coronariographic results (number of diseased vessels). Both tests were performed before hospital discharge. DESIGN: Retrospective study with comparative analysis between variable defined groups. POPULATION AND SETTING: From 232 patients interned in the department of Cardiology of Hospital de Santa Marta with a first acute MI, a population of 112 patients submitted to exercise stress test and coronary angiography before discharge were selected (aged 29 to 69 years). METHODS: Symptom-limited treadmill exercise stress tests were performed according to Bruce protocol, with no heart-rate limitation. The following parameters were analyzed: Stress test duration (DUR); Double product variation (varDP); Metabolic equivalent units (METS); Maximal heart rate (FCmax); Percentage of the maximal reached heart rate (% FCmax); Incidence of ST segment depression (InfST); Maximal ST segment depression (Max-InfST); Onset minute of ST segment depression (MinInfST); Heart rate at the onset of ST segment depression (FCInfST); Double product at the onset of ST segment depression (DPInfST); Recovery minute of ST segment depression (MinRInfST); Onset minute of angina (MinAng); Heart rate at the onset of angina (FCAng); Double product at the onset of angina (DPAng). RESULTS: Statistical significant differences were obtained between coronariographic groups concerning the following parameters: DUR: 1-vessel/3-vessel P = 0.02; VarDP: 1-vessel/3-vessel p = 0.008, 2-vessel/3-vessel p = 0.004; METS: 1-vessel/3-vessel p = 0.01. No differences were seen between anterior and inferior myocardial infarctions regarding all the stress test parameters. However in patients with anterior MI significant differences were obtained concerning the following variables: VarDP: 1-vessel/2-vessel p = 0.02; InfraST: 1-vessel/2-vessel p = 0.006, 1-vessel/3-vessel p = 0.03; MaxInfST: 1-vessel/2-vessel p = 0.01, 1-vessel/3-vessel p = 0.0006; Angina: 1-vessel/2-vessel p = 0.0005, 1-vessel/3-vessel p = .001. In inferior myocardial infarctions only the stress duration differed between 1-vessel and 3-vessel groups (p = 0.003). CONCLUSIONS: Symptom-limited treadmill exercise stress tests, safely performed in our institution, were an important method for post MI evaluation and allowed the diagnosis of a great number of patients with residual ischemia. Statistical significant differences were found in ergometric parameters, between coronariographic groups (defined by the number of diseased vessels), emphasising the importance of stress tolerance analysis.

Adult↗

[Residual myocardial function in dilated myocardiopathy. Response to post-extrasystolic potentiation].

OBJECTIVE: to evaluate the effectiveness of post-extrasystolic potentiation (PESP) to detect latent residual contraction function in patients (pts) with idiopathic dilated cardiomyopathy. DESIGN: retrospective study in pts referred for cardiac catheterization. SETTING: Haemodynamic Laboratory of Cardiology Service, Bellvitge Hospital. Barcelona, Spain. PATIENTS: the criteria for including pts with sinus rhythm were (SR): 1-The appearance of an extra beat R' on the ventriculogram; 2-The location of R' in relation to the preceding sinus beat R1 and the following beat R2 being such that R1-R' less than R'-R2. In patients with atrial fibrillation (AF), the criteria were: 1-An early beat Re had to be identified; 2-R1-Re interval had to be at most half of the Re-R2 interval; 3-The length of the cardiac cycle preceding R, has to be equal to the mean cycle length. All the patients with an increase of the ejection fraction (EF) from R, to R2 less than 12% were included in group A: 12 patients (3 females, 9 males, mean age 51 years, 5 SR, FE 27 +/- 10%). In group B were included patients with an increase of the ejection fraction greater than or equal to 12%; 14 patients (4 females, 10 males, mean age 50 years, 7 SR, FE = 31 +/- 7%). MEASUREMENTS: In each ventriculogram we assessed the performance of left ventricle on R1 and R2 beats by determining: 1-Left ventricular end diastolic (EDV), end systolic (ESV), stroke (SV) volumes; 2-Volumes index (EDVI), (ESVI) (SVI); 3 - Ejection fraction (EF) - Change in ventricular contractility from R1 to R2, delta EF. RESULTS: in the sinus rhythm group the values of R1 and R2 were respectively: EDV: (184 +/- 48 ml/m2; 191 +/- 17 ml/m2; NS); SVI (53 +/- 19 ml/m2; 80 +/- 22 ml/m2; p less than 0.01) FE (29 +/- 7%; 42 +/- 10%; p less than 0.01), delta EF 13 +/- 6%. The change of the ejection fraction from R1 to R2 in pts with SR and AF were respectively: 13 +/- 6% and 11.5 +/- 6.4%; NS. Group A: Deterioration of the functional class and two deaths occurred. Group B: Improvement in functional class in all cases but one. CONCLUSION: our data suggest that augmented ventricular filling and consequent Starling's effect is not a significant contribute for PESP in pts with dilated cardiomyopathy. The analysis of post extrasystolic beat in SR pts and the beat following an early beat with a long diastole in AF, is a valuable method of determining the residual left ventricular function in this group of pts.

Cardiomyopathy, Dilated↗

[Mitral prostheses with and without dysfunction: evaluation using 2-D Doppler echocardiography].

STUDY OBJECTIVE: To evaluate the flow characteristics of normal and abnormal functioning mechanical and bioprosthetic (B) mitral valves. DESIGN: Prospective study in patients submitted to mitral valve replacement. SETTING: Laboratory of Echocardiography at Santa Marta Hospital. PATIENTS: 61 consecutive and asymptomatic patients with normally functioning mitral prosthesis (prt)--37 Bjork-Shiley (B-S), 11 Carpentier-Edwards (C-E), 5 Hancok (HAN), 7 Ionescu-Shiley (I-S) and 1 Wessex--and 15 pts with abnormal prosthetic function (6 B-S, 5 Hall-Kaster, 2 C-E, 1 I-S and 1 HAN). INTERVENTION: Prosthetic mitral flow record, using 2D-Doppler echocardiography, to analyse: peak velocity (PV), peak gradient (PG), mean gradient (MG), pressure half time (PHT), area (A) and presence of regurgitation (R). RESULTS: Normally functioning prosthetic valves--PV ranged from 88 to 186 cm/s (134.6 +/- 24.3) in B-S prt and 133 to 198 cm/s (157.4 +/- 18.8) in B, p less than 0.0001. The prt B-S showed a greater PG (10.3 +/- 2.5 vs 7.6 +/- 2.6 mmHg), MG (3.1 +/- 1.1 vs 2.6 +/- 1 mmHg) and smaller area (2.3 +/- 0.4 vs 2.5 +/- 0.4 cm2) then Bioprosthetic ones, p less than 0.0001, p = 0.003, p = 0.003 respectively. There was a significant correlation between PG and MG: r = 0.84, r = 0.87, r = 0.84 respectively in B-S prt, Bioprosthesis and both, p less than 0.001. Mild regurgitation was present in 8 pts with prt B-S and 4 with B. Malfunctioning prosthetic valves--The mean of PV was 238.5 +/- 29.2 cm/s in prt B-S compared to 265.48.2 +/- 48.2 cm/s in B. Significant regurgitation, was detected by Doppler technic in 100% of B and 72% of mechanical prt. PV greater than 2 m/s has a 100% sensitivity and specificity to separate normal from abnormal prosthesis function. CONCLUSIONS: These data may be useful as reference values to the follow-up of pts with these types of prt. The prt B-S seems to have more optimal hemodynamics profile than B ones. Protodiastolic transprosthetic PV greater than 2 m/s suggest abnormal functioning valve. PG is a significant determinant of MG.

Adult↗

[Non-invasive evaluation of systolic pressure of the pulmonary artery in patients with tricuspid regurgitation, using Doppler echocardiography].

STUDY OBJECTIVE: To quantify the systolic pulmonary artery pressure (SPAP) by continuous wave Doppler echocardiography and record the prevalence of tricuspid regurgitation (TR). DESIGN: Prospective analysis of 42 patients (pts), submitted to right heart catheterization (RHC). SETTING: Pts referred to the Echocardiographic Laboratory at Sta. Marta Hospital - H.C.L. PATIENTS: Sequential sample of 42 pts with several cardiac pathologies, subjected to RHC and 2D Doppler Echocardiography. INTERVENTIONS: The right ventricular and SPAP were recorded in the hemodynamic exam. We considered pulmonary hypertension (PH) if SPAP was greater than 35 mmHg or mean pressure greater than 20 mmHg. The pts were divided into two groups: I-pts without PH and II-pts with PH. The 2D Doppler echocardiography was made within 24 H of the hemodynamic one. Peak gradient (pg) of TR and the correlation with catheterization data were analysed. RESULTS: Hemodynamic--The mean SPAP in the sample was 46 +/- 21.5 mmHg (27 +/- 4.6 in group I and 55 +/- 20.2 mmHg in II). In 35 pts with TR the mean SPAP was 50.3 +/- 21.2 mmHg. Doppler--The pressure gradient was 40 +/- 18.7 mmHg. 57% pts of the group I and 96% II had TR p less than 0.001. The correlation between Doppler gradient and SPAP was r = 0.95, and no change was noted when 7 is used as a constant. CONCLUSION: Continuous wave Doppler echocardiography is a non invasive technic useful to the quantitative analysis of SPAP.

Adult↗