Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0232605 (regurgitation)
8,217 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The directional analysis of contrast echographic flow lines is routinely used for tricuspid insufficiency diagnosis. The value of this noninvasive technique for the assessment of pulmonic regurgitation is not yet established. Therefore we evaluated the contrast M-mode echocardiograms at the pulmonary valve in 55 patients. Echographic contrast was obtained by injection of 6-8 ml of indocyanin-saline solution into an antecubital vein. In all 5 patients with documented pulmonic insufficiency (3 patients after repair of tetralogy of Fallot, one with pulmonic endocarditis, one posttraumatic) typical diastolic retrograde directed flow lines crossing the pulmonary valve were recorded. In addition, 6 of 18 patients with primary or secondary pulmonary hypertension exhibited early to middiastolic retrograde flow lines at the pulmonary valve. In contrast, none of the normals (N = 13), and none of 19 patients with various cardiac diseases but unaffected pulmonary valve and normal pulmonary artery pressure, had contrast echographic evidence of pulmonary insufficiency. There were distinctive differences between the contrast flow patterns of the patients with organic pulmonary insufficiency and patients with functional pulmonic regurgitation due to pulmonary hypertension. It is concluded that the directional analysis of contrast echographic flow lines at the pulmonary valve allows a sensitive assessment of pulmonary regurgitation using standard echocardiographic equipment.
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PMID:[Value of contrast echocardiography in the diagnosis of pulmonary valve insufficiency]. 409 May 81

Pulmonary regurgitation appeared after the surgical repair of pulmonary stenosis was investigated with an electromagnetic catheter-tip velocity probe in seven patients. Postoperative catheterization was performed by placing the probe in the pulmonary trunk transvenously and a velocity curve was recorded on a photographic recorder at a paper speed of 150 or 200 mm/sec with electrocardiograms and pulmonary arterial pressure pulse. The velocity curves were recorded under the baseline throughout diastole in patients with pulmonary regurgitation, while the curves in the normal controls were just on the baseline. The amount of regurgitation was evaluated with the ratio of the negative to positive area of velocity curves. The negative area (NA) was defined as an area circumscribed by the diastolic negative velocity curve and the baseline, and the positive area (PA) as an area circumscribed by the systolic positive curve and the baseline. The amount of the regurgitation was also evaluated from either the pulmonary cineangiogram or the volume measurement using the right arteriogram. The results were as follows: The severity of pulmonary regurgitation estimated by the pulmonary arteriogram (grade I to III) tended to be correlated with the ratio of the NA/PA. Right ventricular end-diastolic volume index (RVEDVI) and the NA/PA showed a fair correlation with a coefficient of 0.80. Right ventricular volume overload resulting from pulmonary regurgitation was reflected on the NA/PA. The subtraction of right and left ventricular systolic ejection indices (RVSI-LVSI) or its ratio (RVSI-LVSI)/RVSI, which were considered as the indices of the severity of pulmonary regurgitation from the volume measurement, had fairly good a correlation with the NA/PA.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Evaluation of pulmonary regurgitation with a catheter-tip electromagnetic velocity probe]. 667 92

Sixty patients with pulmonary regurgitation were studied by the pulsed Doppler technique combined with two-dimensional and M-mode echocardiography. Patients with pulmonary regurgitation had abnormal Doppler signals just below the pulmonic valve in the right ventricular outflow tract in diastole on the two-dimensional image. These signals were considered to indicate the regurgitant flow. There are two patterns of pulmonary regurgitant Doppler signals. In pulmonary hypertension, the maximal component of instantaneous flow velocity is sustained at about the same signal strength throughout diastole, but when the pulmonary arterial pressure is normal, the velocity slows down gradually from early diastole to end-diastole. Pulmonary regurgitation was detected by phonocardiography in about half the patients. In the remaining half, pulmonary regurgitant murmur could not be differentiated from aortic regurgitant murmur or was masked by coexistent aortic regurgitation or patent ductus arteriosus, whereas the Doppler technique indicated pulmonary regurgitation.
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PMID:Pulmonary regurgitation studied with the ultrasonic pulsed Doppler technique. 707 62

In order to evaluate the usefulness of contrast echocardiography in the diagnosis of tricuspid (TI) and pulmonary insufficiency (PI), 30 patients with various heart diseases and 7 controls were examined. The dimensions of the inferior vena cava and pulmonary artery were also measured on the two-dimensional echocardiogram. Cardiac catheterization was performed in 18 patients to study the relationship between the diameters of the vessels and the intracardiac pressures. The following results were obtained. 1) TI was detected without difficulty by contrast method using two-dimensional echocardiography on the four-chamber view. The diagnostic sensitivity was higher than that of conventional methods. 2) PI was also detected by the parasternal approach. The regurgitation of the contrast material across the pulmonary valve was easily confirmed because of pulmonary arterial dilatation. 3) In the cases with TI, the dimension of the inferior vena cava was larger than 20 mm. The right ventricular systolic pressure and the mean right atrial pressure were higher than 40 mmHg and 6 mmHg, respectively.
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PMID:[Relationship between vascular diameter and intracardiac pressure in tricuspid or pulmonary insufficiency detected by contrast echocardiography (author's transl)]. 732 May 27

Using Doppler echocardiography, the prevalence of tricuspid and pulmonary valve regurgitation was determined prospectively in 173 normal children, aged 8.3 +/- 2.7 (range 5-14) years. Pulmonary regurgitation was defined as a red-yellow or mosaic coloured regurgitant flow, continuing to end-diastole with continuous-wave Doppler. It was found in 84% of the children. Tricuspid regurgitation was defined as a blue-green or mosaic coloured regurgitant flow from the tricuspid valve into the right atrium lasting > 0.5 systole, as determined by continuous-wave Doppler. Tricuspid regurgitation was present in only 8% of the children. Tricuspid regurgitation flow of very short duration, considered to be due to valve closure, was found in 75%. No effect of age, presence of a vibratory innocent heart murmur or gender on the prevalence of right-sided valvular regurgitation could be demonstrated. All regurgitations were haemodynamically insignificant. Thus right-sided valvular regurgitation in normal schoolchildren is a normal physiological finding with relatively high prevalence. In the absence of functional reasons for these regurgitations and in the absence of structural pulmonary or tricuspid valve disease, these signals should be considered physiological in order to avoid iatrogenic heart disease.
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PMID:Right-sided valvular regurgitation in normal children determined by combined colour-coded and continuous-wave Doppler echocardiography. 819 3

110 healthy subjects (45 men and 65 women ranging in age between 24 and 60 years) were studied by 2-dimensional echocardiography. In each subject the diameters of the cardiac chambers, the thickness of the intraventricular septum and posterior wall of the left ventricle in diastole, as well as the diameters and circumferences of the aortic and mitral rings were measured. Moreover, in each subject color doppler echocardiography was performed. Pulmonary valve regurgitation was observed in 47 subjects (42.7%). This finding was not correlated in a statistically significant manner to either age, sex, body weight, or height. The incidence of pulmonary regurgitation, however, tended to decrease with age. In 37 subjects (33.6%), tricuspid regurgitation was detected without any correlation to the above parameters. In 11 cases (10%), mitral regurgitation was observed; its correlation to age was statistically significant (p < 0.05). Aortic regurgitation was noted in 9 (8.2%) cases; its incidence was directly correlated to age (p < 0.01). The observed regurgitations were defined as "physiological" and precise characteristics were chosen so as to distinguish such "physiological" from "pathological" regurgitations.
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PMID:An anatomical study of the healthy human heart by echocardiography with special reference to physiological valvular regurgitation. 830 96

The current literature suggests that right-sided heart pressures can be obtained noninvasively in approximately 60% of patients. We hypothesized that with a focused echocardiographic Doppler examination, measurable tricuspid or pulmonary valve regurgitation suitable for measuring pressures could be obtained in a higher percentage of patients. The study group consisted of 200 consecutive patients undergoing echocardiographic and Doppler hemodynamic evaluation. All patients were first examined by an ultrasonographer instructed to attempt to record tricuspid and pulmonary regurgitant velocities. After this examination, a designated cardiologist performed a focused examination with the intent of improving the signal quality and increasing the number of measurable signals for evaluation. Tricuspid regurgitation of measurable quality was recorded in 147 (73.5%) of 200 patients by the ultrasonographer; this result was improved to 172 patients (86%) by the designated cardiologist. Pulmonary regurgitation was obtainable in 147 (95%) of 154 patients and was of measurable quality in 137 (89%). When results of tricuspid and pulmonary regurgitation were combined, a quantifiable signal was obtained in 194 (97%) of 200 consecutive unselected patients. This study demonstrates that a well-trained ultrasonographer or echocardiologist can obtain right-sided pressures in at least 95% of all unselected cardiovascular patients.
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PMID:Frequency of Doppler measurable pulmonary artery pressures. 894 43

During January through December 1993, twelve symptomatic infants and children (6 females, 6 males) with human immunodeficiency virus infection were prospectively evaluated for their cardiovascular clinical manifestations and ventricular functions, using two-dimensional, M-mode and Doppler echocardiographic examination. From auscultation, the pulmonic component of the second heart sound was accentuated in 8 cases and the murmur of atrioventricula valve regurgitation and pericardial friction rub were audible in 7 and 6 patients, respectively. Cardiomegaly and venous congestion were present on chest roentgenogram in 6 cases and electrocardiogram was abnormal in 5. The echocardiogram demonstrated elevated pulmonary arterial pressure in 9 patients. There were 5 cases of non-tamponade pericardial effusion. Five patients had mitral and pulmonary insufficiency while six had tricuspid insufficiency. The ejection fraction and shortening fraction were increased in all. The incidence of pulmonary hypertension was more frequent than previously reported.
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PMID:Cardiovascular manifestations and left ventricular functions in human immunodeficiency virus infection in infants and children in Thailand. 944 23

A prospective study was performed on in-hospital patients between June 1985 and July 1992 to assess the 5 year results of surgical detransposition of the great arteries. Clinical examination, electrocardiography, echocardiography, right and left heart catheterisation with selective coronary angiography, isotopic right and left ventricular ejection fractions at rest and with infusion of dobutamine and SestaMibi myocardial perfusion scintigraphy at rest and with dipyridamole, were performed during the 5th year after surgery. Twenty-six children underwent this protocol: eight others did not come for examination because they had moved from the region, one of whom had suffered regressive postoperative myocardial infarction. All patients were asymptomatic and had only minor electrocardiographic changes. Stenosis of the pulmonary tract was observed in 38.5% but only one case of stenosis at the origin of the right pulmonary artery required percutaneous angioplasty, which was successful. Pulmonary regurgitation was a common echocardiographic finding (65.4% of cases) but rarely severe (1/26: 3.9%). Aortic regurgitation was also observed commonly (53.8%), nearly always mild, grade I (13/14 cases). No significant stenosis of the aortic anastomosis was observed. The right and left ventricular ejection fractions were normal at rest except in one case and all values improved with dobutamine. Myocardial scintigraphy did not show any perfusion defect and there was no stenosis or occlusion of the coronary arteries at coronary angiography. The authors conclude that the results of arterial detransposition at 5 years are satisfactory in this series, with no cases of major obstructive lesions, major ventriculo-arterial regurgitation, ventricular dysfunction or coronary lesions. However, longer term trials with larger numbers of patients are required to determine the real incidence of coronary lesions and the long-term outcome of the pulmonary valve in the systemic position.
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PMID:[5-year results of arterial correction in transposition of great vessels]. 974 12

Repair of congenital right ventricular outflow tract obstruction often requires reconstruction with a transannular patch to alleviate pulmonary stenosis. Post repair pulmonary insufficiency with right ventricular dilatation and volume overload may result and lead to acute or progressive right heart failure. The use of a monocusp valve has been proposed as a means to prevent this problem. Fresh pericardium is well known to fail clinically, leading to pulmonary insufficiency limiting mid- and long-term results. In a chronic dog model (147 +/- 34 days), three valve types were evaluated: 1) polytetrafluoroethylene (PTFE; n = 9), 2) fresh pericardium (PERI; n = 6), and glutaraldehyde fixed pericardium (GLU; n = 6). Hemodynamics, angiography, and echocardiography were performed at implantation and sacrifice. Gross and microscopic pathology were evaluated. No significant differences were found among the three groups with regard to stenosis as evaluated by echocardiography, measured right ventricular wall thickness, and hemodynamic pressure gradients across the valve. By echocardiography, both PTFE (1 of 9) and GLU (0 of 6) showed less regurgitation than PERI (5 of 6) (p < 0.05). This was confirmed by angiography. PTFE showed less neo-intimal hyperplasia, less thrombus formation, and less calcification than GLU or PERI (p = NS). The PTFE monocusp developed no prohibitive gradients, no early pathologic deterioration, and maintained competence compared with the GLU and PERI groups. Although continued investigation of long-term durability and competence of the PTFE monocusp valve is warranted, both PTFE and GLU values seem to demonstrate less regurgitation than the PERI monocusp valve in an adult dog model of right ventricular outflow tract reconstruction.
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PMID:Monocusp valve and transannular patch reconstruction of the right ventricular outflow tract: an experimental study. 980 77


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