Objective. -The aim of the present study was to evaluate cardiac performance of patients with migraine attacks during the overload produced by phenylephrine infusion. Background. -It is known that circulatory changes ...Objective. -The aim of the present study was to evaluate cardiac performance of patients with migraine attacks during the overload produced by phenylephrine infusion. Background. -It is known that circulatory changes occur during migraine. However, the relationship between this finding and transient cardiac dysfunction is still unknown. Methods. -By means of two-dimensional direct M-mode echocardiography, we measured fractional shortening, ejection fraction, and mean velocity of circumferential fibers shortening in 18 patients with migraine and in 10 normal subjects as a control group. These measures were performed in two different periods: during attack-free intervals and during attacks. Pain intensity of typical migraine attack was evaluated on a 0 to 10 scale. Results. -Cardiac size and function were normal at rest in both groups. However, during migraine attacks, phenylephrine infusion provoked significant decrease in fractional shortening,EF, and mean velocity of circumferential fibers shortening, followed by concomitant increase of headache severity. On the other hand, during the attack-free interval and in the control group phenylephrine infusion did not show significant changes in cardiac function parameters. Conclusions. -Our data suggest that left ventricular dysfunction during the phenylephrine test could participate in the complex pathophysiological mechanism of migraine attacks.展开更多
OBJECTIVES: This study sought to ascertain whether left ventricular systolic dysfunction(LVSD) is more common among clinic patients with rheumatoid disease(RD) compared with the general population, and to assess the d...OBJECTIVES: This study sought to ascertain whether left ventricular systolic dysfunction(LVSD) is more common among clinic patients with rheumatoid disease(RD) compared with the general population, and to assess the diagnostic utility of brain natriuretic peptide(BNP). BACKGROUND:Patients with RD are at increased risk of ischemic heart disease. However, there are few large echocardiographic studies identifying cardiac dysfunction in RD. We hypothesized that LVSD would be more prevalent in RD patients than in the general population. METHODS: A total of 226 hospital out-patients with RD(65% women) underwent clinical evaluation, electrocardiography(ECG), echocardiography, and plasma BNP assay(218 patients). Prevalence of LVSD was compared with local population estimates. RESULTS: Definite LVSD(left ventricular ejection fraction< 40% ) occurred in 5.3% of the RD group: standardized prevalence ratio,3.20; 95% confidence interval, 1.65 to 5.59. Median BNP values were higher in patients with LVSD compared with those without: 16.6 pmol/l versus 8.5 pmol/l, p< 0.005, although values between the two groups overlapped. One in nine patients with an abnormal ECG had definite LVSD. CONCLUSIONS: Definite LVSD was three times more common in RD patients than in the general population. Given the prognostic benefits of treating LVSD, echocardiographic screening of RD patients with an abnormal ECG may be worthwhile.展开更多
The effects of 12 months of therapy were evaluated in 47 mildly symptomatic patients with moderate to severe mitral valve regurgitation; 26 patients received enalapril and 21 received a placebo. Enalapril was associat...The effects of 12 months of therapy were evaluated in 47 mildly symptomatic patients with moderate to severe mitral valve regurgitation; 26 patients received enalapril and 21 received a placebo. Enalapril was associated with a significant reduction in left ventricular diameter and mitral regurgitation volume, with no evidence of change in systolic function indexes. However, enalapril did not hinder progressive aerobic impairment to effort.展开更多
文摘Objective. -The aim of the present study was to evaluate cardiac performance of patients with migraine attacks during the overload produced by phenylephrine infusion. Background. -It is known that circulatory changes occur during migraine. However, the relationship between this finding and transient cardiac dysfunction is still unknown. Methods. -By means of two-dimensional direct M-mode echocardiography, we measured fractional shortening, ejection fraction, and mean velocity of circumferential fibers shortening in 18 patients with migraine and in 10 normal subjects as a control group. These measures were performed in two different periods: during attack-free intervals and during attacks. Pain intensity of typical migraine attack was evaluated on a 0 to 10 scale. Results. -Cardiac size and function were normal at rest in both groups. However, during migraine attacks, phenylephrine infusion provoked significant decrease in fractional shortening,EF, and mean velocity of circumferential fibers shortening, followed by concomitant increase of headache severity. On the other hand, during the attack-free interval and in the control group phenylephrine infusion did not show significant changes in cardiac function parameters. Conclusions. -Our data suggest that left ventricular dysfunction during the phenylephrine test could participate in the complex pathophysiological mechanism of migraine attacks.
文摘OBJECTIVES: This study sought to ascertain whether left ventricular systolic dysfunction(LVSD) is more common among clinic patients with rheumatoid disease(RD) compared with the general population, and to assess the diagnostic utility of brain natriuretic peptide(BNP). BACKGROUND:Patients with RD are at increased risk of ischemic heart disease. However, there are few large echocardiographic studies identifying cardiac dysfunction in RD. We hypothesized that LVSD would be more prevalent in RD patients than in the general population. METHODS: A total of 226 hospital out-patients with RD(65% women) underwent clinical evaluation, electrocardiography(ECG), echocardiography, and plasma BNP assay(218 patients). Prevalence of LVSD was compared with local population estimates. RESULTS: Definite LVSD(left ventricular ejection fraction< 40% ) occurred in 5.3% of the RD group: standardized prevalence ratio,3.20; 95% confidence interval, 1.65 to 5.59. Median BNP values were higher in patients with LVSD compared with those without: 16.6 pmol/l versus 8.5 pmol/l, p< 0.005, although values between the two groups overlapped. One in nine patients with an abnormal ECG had definite LVSD. CONCLUSIONS: Definite LVSD was three times more common in RD patients than in the general population. Given the prognostic benefits of treating LVSD, echocardiographic screening of RD patients with an abnormal ECG may be worthwhile.
文摘The effects of 12 months of therapy were evaluated in 47 mildly symptomatic patients with moderate to severe mitral valve regurgitation; 26 patients received enalapril and 21 received a placebo. Enalapril was associated with a significant reduction in left ventricular diameter and mitral regurgitation volume, with no evidence of change in systolic function indexes. However, enalapril did not hinder progressive aerobic impairment to effort.
