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A Pfeferman

Publications and source records attributed to A Pfeferman.

15 recordsLinked to original sources

[Assessment of pulmonary arterial pressure in adults with Doppler echocardiography].

PURPOSE: To assess the role of pulsed Doppler echocardiography (PDE) in the indirect assessment of pulmonary artery (PA) pressure (P), analysing the pulmonary velocity blood flow curves (PVBFC) profile. PATIENTS AND METHODS: Sixty-one adults with several kinds of heart disease were submitted to heart catheterization to obtain PAP (systolic, diastolic, mean), and other hemodynamic variables. A PDE examination was performed in all to obtain the PVBFC at the level of the pulmonic annulus. Qualitative features of the curve were analysed (morphological pattern, presence of pulmonic regurgitation) as well as quantitative data (acceleration time = AT, right ventricle ejection time = RVET index, AT/RVET index AT corrected for heart rate = ATC), which were compared to the invasive measurements. RESULTS: An abnormal rapid acceleration of the PVBFC, with triangular configuration, was noted in patient with pulmonary hypertension (PH), in contrast to the dome-like shape of the PVBFC in normal PAP. Pulmonary regurgitation was more frequent (p < 0.05) in patients with severe PH (mean PAP > or = 40 mmHg), comparing with patients with PAP < 40 mmHg. Inverse linear correlations were observed between AT and mean PAP, particularly when sinus rhythm was present (r = 0.89; p < 0.05) excluding patients with atrial fibrillation (19 cases). CONCLUSION: PDE is an useful and noninvasive method for indirect evaluation of PAP in adults, especially during stable sinus rhythm, in heart rate range from 60 to 115 bpm.

Adolescent

[Pulmonary artery pressure evaluation in adults by Doppler echocardiography].

PURPOSE: To assess the role of pulsed Doppler echocardiography (PDE) in the indirect assessment of pulmonary artery (PA) pressure (P), analysing the pulmonary velocity blood flow curves (PVBFC) profile. PATIENTS AND METHODS: Sixty-one adults with several kinds of heart disease were submitted to heart catheterization to obtain PAP (systolic, diastolic, mean), and other hemodynamic variables. A PDE examination was performed in all to obtain the PVBFC at the level of the pulmonic annulus. Qualitative features of the curve were analysed (morphological pattern, presence of pulmonic regurgitation) as well as quantitative data (acceleration time = AT, right ventricle ejection time = RVET index, AT/RVET index AT corrected for heart rate = ATC), which were compared to the invasive measurements. RESULTS: An abnormal rapid acceleration of the PVBFC, with triangular configuration, was noted in patient with pulmonary hypertension (PH), in contrast to the dome-like shape of the PVBFC in normal PAP. Pulmonary regurgitation was more frequent (p less than 0.05) in patients with severe PH (mean PAP greater than or equal to 40 mmHg), comparing with patients with PAP less than 40 mmHg. Inverse linear correlations were observed between AT and mean PAP, particularly when sinus rhythm was present (r = 0.89; p less than 0.05) excluding patients with atrial fibrilation (19 cases). CONCLUSION: PDE is an useful and noninvasive method for indirect evaluation of PAP in adults, especially during stable sinus rhythm, in heart rate range from 60 to 115 bpm.

Adolescent

[Fascicular block of the His bundle: critical approach for its identification].

The correct identification of the left and right fascicles blocks of the His bundle will permit to explain different patterns of the ECG and VCG. The differentiation between the right peripheral bundle branch and the left bundle branch division is not only important in anatomic and physiologic grounds, but also in a clinic viewpoint. So, trying to refine the diagnostic criteria and improve the recognition of these intraventricular conduction disturbances, we developed this study. Eighty five patients were evaluated and divided into two groups. Group I included 65 patients with cardiac disease; group II consisted of 20 normal subjects taken as a control. Some classic ECG and VCG criteria were tested as well as new ones. We confirmed the significance of the S2/S3 relation to distinguish the right superior divisional block (RSDB) from the left anterior hemiblock (LAH), and added some new criteria: 1) C morphology in horizontal plane (HP) to the right divisional block (RDB); 2) assessment of aVL lead to separate RSDB from LAH--qR pattern in the last, and different one to RSDB; 3) the qR' pattern in L2, L3 and aVF leads associated with left ventricular hypertrophy (LVH) pattern screened the left posterior hemiblock (LPH). We found no significance in R3/R2 relation to the right inferior divisional block (RIDB). Similarly to what happened to the left bundle branch block in the 70's decade, we expect that an adequate assessment of the RDB can permit a better understanding of its real clinical value.

Bundle-Branch Block