[Ergometric evaluation of the aged using electrocardiography and echography].
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Biomedical subjects
Publications and source records attributed to P Mottironi.
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The many aspects of heart electrical activity in hypertrophic cardiomyopathy have recently been described in numerous occasions. A vectorcardiographic study was made of two sisters with an echocardiographic diagnosis of hypertrophy of the free wall of the left ventricle. Both the ECG and the VCG shown evidence of pseudonecrosis and pseudoischaemia associated with left intraventricular conduction disturbances and left atrial dilatation. It is felt that echocardiography, and the two-dimensional examination in particular, is essential in the diagnosis of myocardial hypertrophy, but it is pointed out that ECG, and above all VCG, may sometimes indicate its site and extent with a good degree of approximation.
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With M-mode echocardiography a bicuspid aortic valve can be diagnosed by its eccentric diastolic echoes, particularly when the eccentricity index exceeds 1, 3. However, many false positives and false negatives have been reported. Two-dimensional echocardiography, which identifies the commissures and the closure lines, can make the diagnosis more accurate. With this technique we studied 15 patients with a bicuspid aortic valve and 20 normal subjects. We found 3 different patterns according to the position of the closure line, which can be "horizontal", "vertical" and "oblique". Whenever the closure line is "horizontal", that is perpendicular to the direction of the ultrasonic beam, the M-mode echoes from the valve in diastole appear to be centrally located within the aortic root (false negatives). On the contrary, if the closure line is "vertical", that is parallel to the echo beam, "the echoes" are eccentric (diagnostic images). When the closure line is obliquely oriented, the ultrasonic images can be either central or eccentric. Two-dimensional echocardiography identified 5 "horizontal", 3 "vertical" and 7 "oblique" closure lines. It thus helped clarify the M-mode errors and proved to be more reliable for the diagnosis of bicuspid aortic valve.
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