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PubMed2002

Patient populations in clinical trials of the efficacy and tolerability of donepezil in patients with vascular dementia.

There is increasing evidence to suggest that patients with vascular dementia (VaD) exhibit a cholinergic deficit. These patients may therefore benefit from treatment with cholinesterase (ChE) inhibitors such as donepezil. However, there are difficulties in accurately defining patients with VaD. Clinical trials to assess the efficacy and tolerability of donepezil in patients with VaD have been completed. National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) criteria were used to establish inclusion and exclusion criteria: evidence of dementia (impaired memory and two other cognitive domains), and evidence of cerebrovascular disease (CVD) from neuroimaging and physical examination and a possible or probable relationship between dementia and CVD were required for enrollment. Patients with a diagnosis of Alzheimer's disease (AD) or dementia caused by other conditions not associated with the cardiovascular system (e.g., MS, chronic infections, hypothyroidism) were excluded. These criteria ensured that only patients with probable or possible VaD were enrolled. Enrolled patients had a mean Hachinski score of 9.7, with memory impairment the most prominent feature of their dementia. Sixty percent of patients had a history of at least one stroke and 18% of patients had a history of transient ischemic attack (TIA) pre-dementia. Cortical and subcortical infarcts were among the lesions observed on computer-assisted tomography and magnetic resonance imaging scans with significant white matter lesions also present in some patients. Placebo-treated patients demonstrated stable cognitive and global function over the 24 weeks of the study. These observations suggest that the patients enrolled in these trials have a broad range of CVD, and are different from those enrolled in AD trials.

Aged↗

PubMed2004

[Long term impact of treatment in alcoholics. Results from a 10-year longitudinal follow-up study of 850 patients].

BACKGROUND AND OBJECTIVE: Alcohol dependence syndrome is defined as a chronic disease. Nevertheless, few prospective studies have been conducted in order to assess the long term impact of treatment in the course of the disease. Moreover, those studies have not included drinkers from wine drinking cultures. This study was designed to assess prospectively the long term course of alcoholism and the impact of treatment on it, in a sample of Spanish drinkers. PATIENTS AND METHOD: 850 alcoholics aged 16 to 55 years who entered treatment during 1988-1989 in 8 specialized centres of the Catalan Drug Addiction Network were included in the study (75.6% of eligible patients). Patients had to meet DSM III criteria for alcohol dependence, a stable home address and a close relative willing to provide collateral information. Evaluation was carried out at 0, 1, 5 and 10 years. 15 and 20 years assessments are also planned. RESULTS: At 10 years of follow up, 131 (15.4%; 95% confidence interval [CI], 13-18) patients had died, 656 (77.2%; 95% CI, 75-80) were alive and 63 (7.4%; 95% CI, 5-9) could not be located. 54 patients (6.4%; 95% CI, 5-8) refused to be interviewed. Drinking patterns for the last 3 years was evaluated in 588 (70%; 95% CI, 67-73) patients: 311 (37%; 95% CI, 34-40) were abstinent, 58 (7%; 95% CI, 5-9) were controlled drinkers and 219 (26%; 95% CI, 23-29) were heavy drinkers. Abstinent patients had lower morbidity and casualties as well as a less tendency to use emergency room services. Also, abstinence was significantly related to lower levels of psychosocial stress and better global functioning, especially in the sociolaboral area. CONCLUSIONS: Our results challenge the popular belief that alcoholics are chronic relapsers. The changes induced by treatment appear to be long lasting, with better outcomes in the group of abstinent patients. Even though treatment is effective for a high percentage of patients, mortality rates are 4 and 6 times higher than expected for men and women respectively.

Adolescent↗

PubMed2000

Differences between neonates and adults in the urokinase-plasminogen activator (u-PA) pathway of the fibrinolytic system.

This study deals with plasminogen activation kinetics of fetal and adult Glu-plasminogen types 1 and 2 as well as fetal and adult Lys-plasminogen by urokinase in the presence and absence of the lysine analogues epsilon-amino-n-caproic acid (EACA) and tranexamic acid. In addition, activation kinetics of single-chain urokinase-plasminogen activator (scu-PA) by adult and fetal plasmin types were investigated in the absence and presence of soluble fibrin. All Lys-plasminogen isoforms were more readily activated by urokinase than their corresponding Glu-plasminogen types. No substantial differences of the catalytic constants of urokinase-catalyzed plasminogen activation could be obtained when all fetal plasminogen types were compared to the respective adult types. In the case of all Glu-plasminogen isoforms, EACA as well as tranexamic acid first stimulated the activation process and, at higher concentrations, showed inhibitory properties. Again, the relative ability of all fetal plasminogen types to interact with lysine analogues revealed no differences compared to the respective adult glycoforms. In the absence of soluble fibrin, the catalytic efficiency of scu-PA activation by plasmin was significantly lower for both fetal plasmin isoforms. However, there were no differences in catalytic efficiency between fetal and adult plasmin types in the presence of 4 microM soluble fibrin. In conclusion, no substantial differences exist in urokinase-catalyzed plasminogen activation between neonates and adults, which is in contrast to reported data on plasminogen activation by tissue-type plasminogen activator. In the absence of soluble fibrin, scu-PA activation by fetal plasmin is markedly slower than by adult plasmin. However, this is compensated when fibrin is added at a concentration that is close to the physiological fibrinogen concentration in plasma. It can be summarized that the differences in carbohydrate structures of fetal and adult plasminogen are not associated with major differences in the global function of this part of fibrinolysis, despite functional alterations of scu-PA activation.

Adult↗

PubMed2002

Efficacy of galantamine in probable vascular dementia and Alzheimer's disease combined with cerebrovascular disease: a randomised trial.

BACKGROUND: Vascular dementia is the second commonest form of dementia, and vascular factors contribute to the development of dementia in many patients with Alzheimer's disease. Galantamine amplifies the acetylcholine response by inhibiting acetylcholinesterase and modulating nicotinic receptors. It has shown broad, sustained benefits in patients with Alzheimer's disease. We investigated the effects of galantamine in patients with a diagnosis of probable vascular dementia or Alzheimer's disease combined with cerebrovascular disease. METHODS: Eligible patients were randomly assigned galantamine 24 mg/day (n=396) or placebo (n=196) in a multicentre, double-blind, 6-month trial. Primary endpoints were cognition (Alzheimer's disease assessment scale, cognitive subscale [ADAS-cog]) and global functioning (clinician's interview-based impression of change plus caregiver input [CIBIC-plus]). Secondary endpoints included assessments of activities of daily living and behavioural symptoms. Patients were monitored for adverse events. Analyses were on the basis of observed case or last observation carried forward. FINDINGS: Galantamine showed greater efficacy than placebo on ADAS-cog (galantamine change -1.7 [SE 0.4] vs placebo 1.0 [0.5]; treatment effect 2.7 points; p<0.0001) and CIBIC-plus (213 [74%] vs 95 [59%] patients remained stable or improved, p=0.0001). Activities of daily living and behavioural symptoms were also significantly improved compared with placebo (p=0.002 and p=0.016, respectively). Galantamine was well tolerated. INTERPRETATION: Galantamine showed a therapeutic effect on all key areas of cognitive and non-cognitive abilities in this group of dementia patients.

Aged↗

PubMed1999

The Edinburgh Postnatal Depression Scale: validation for an Italian sample.

A sample of 113 women has been recruited for the Italian validation of Edinburgh Post Natal Depression Scale (EPDS). These women, between the eighth and the twelfth week after delivery, were admnistered the EPDS and diagnosed according the DSM-III-R criteria using the MINI Interview. At the 8/9 cut-off score the sensitivity is 94.4%, specificity 87.4% and PPV 58.6%. The internal consistency of the EPDS Italian version was tested using Chronbach's alpha coefficient (0.7894) and Guttman split-half coefficient (0.8191). Finally a receiver operating characteristic (ROC) analysis was carried out to evaluate the global functioning of the scale: the area under ROC curve AUC is 0.7470 and the logistic estimate for the threshold score of 11/12 fitted the model sensitivity at 75% and model specificity at 67%. Our data confirm the validity of EPDS in identifying postnatal depression also in its Italian version and the scale could be used as an useful instrument in the clinical practice.

Adult↗

PubMed1999

Differential clinical features of early-onset panic disorder.

BACKGROUND: Although panic disorder (PD) begins typically in adulthood, an earlier onset is not uncommon. Recent studies on early-onset PD indicate that this subgroup of patients may display distinct clinical characteristics. OBJECTIVE: To compare a subgroup of early-onset PD patients with the rest of the sample. METHOD: A consecutive series of 442 patients with PD were included. Family histories were investigated, and clinical assessment employed the following instruments: Hamilton's scales, Global Functioning Scale, Marks-Mathews' Fears and Phobia Scale, and Panic-Associated Symptom Scale. The age threshold for 'early-onset' was considered at 18 years. RESULTS: A total of 45 patients (10.2%) exhibited early-onset PD, with a mean age at onset of 14.6. They were younger and had a longer duration of illness than later-onset patients. No differences were found in severity of panic symptoms, anxiety or depressive symptoms, and social functioning. They had more comorbidity with simple phobia, social phobia, and substance dependence. Rates of PD among first-degree relatives were higher in the early-onset group. CONCLUSION: Early-onset PD patients displayed a greater familial loading, but clinical severity of their panic-agoraphobia symptoms was not higher. Comorbidity was greater with phobic and substance-related disorders.

Adult↗

PubMed2002

Brain electrical activity and subjective experience during altered states of consciousness: ganzfeld and hypnagogic states.

Manifestations of experimentally induced altered states of consciousness in the brain's electrical activity as well as in subjective experience were explored via the hypnagogic state at sleep onset, and the state induced by exposure to an unstructured perceptual field (ganzfeld). Twelve female paid volunteers participated in sessions involving sleep onset, ganzfeld, and eyes-closed relaxed waking, and were repeatedly prompted for recall of their momentary mentation, according to a predefined schedule. Nineteen channel EEG, two channels EOG and EMG were recorded simultaneously. The mentation reports were followed by the subjects' ratings of their experience on a number of ordinal scales. Two-hundred and forty-one mentation reports were collected. EEG epochs immediately preceding the mentation reports were FFT-analysed and the spectra compared between states. The ganzfeld EEG spectrum, showing no signs of decreased vigilance, was very similar to the EEG spectrum of waking states, even showed a minor acceleration of alpha activity. The subjective experience data were reduced to four principal components: Factor I represented the subjective vigilance dimension, as confirmed by correlations with EEG spectral indices. Only Factor IV, the 'absorption' dimension, differentiated between the ganzfeld state (more absorption) and other states. In waking states and in ganzfeld, the subjects estimated elapsed time periods significantly shorter than in states at sleep onset. The results did not support the assumption of a hypnagogic nature of the ganzfeld imagery. Dream-like imagery can occur in various global functional states of the brain; hypnagogic and ganzfeld-induced states should be conceived as special cases of a broader class of 'hypnagoid' phenomena.

Adult↗

PubMed1997

[Clinical models and decisional algorithm in the management of erectile disorders].

The diagnosis of erectile dysfunction (ED) needs an appropriate evaluation of global function and specific component of the erection. We have used a quantified methodology to grade each of the specific factors: arterial, venous, neurologic, endocrine, psychological and anxiety, in four groups of increasing severity. With this information each patient is them classified organic, psychological or mixed. The prevalence of "mixed" aetiology appears in the statistical objective offered by two different retrospective studies with a 76% rate of psychological prevalence and a 85% of organic prevalence. In two out of three of the patients both factors are present.

Adult↗

PubMed2002

Donepezil in the treatment of Alzheimer's disease: long-term efficacy and safety.

OBJECTIVES: The aim of this study was to evaluate the long-term efficacy, safety and tolerability of donepezil in the treatment of Alzheimer's disease (AD). METHODS: Twenty-five patients (15 females and 10 males) with mild to moderate AD, according to DSM IV criteria, were recruited in the study. The principal efficacy measures were Alzheimer Disease Assessment Scale-cognitive subscale score (ADAS-cog), Mini Mental State Examination (MMSE) and Physical Self-Maintenance Scale (PSMS). Patients were treated with donepezil 5 mg/day for 1 month, after which an increase to 10 mg/day was encouraged. Evaluations were carried out prior to the start of the treatment and every 3 months for a period of 1 year. RESULTS: A significant improvement from baseline score of cognitive performances was seen through Week 24. Beginning with Week 36, performances declined relative to baseline, indicating continued disease progression. CONCLUSIONS: Donepezil improved cognition and global functioning and was well tolerated especially considered the long duration of the observation period.

Activities of Daily Living↗

PubMed2002

Insight in persons with schizophrenia: effects of switching from conventional neuroleptics to atypical antipsychotics.

The primary aim of our study is to evaluate the level of insight during the switch from a classical antipsychotic drug to a atypical neuroleptic. Twenty-two schizophrenic patients were admitted to the study, 9 were male and 13 were female. Standardized questionnaire were: Scale for Assessment of Negative Symptoms (SANS), Scale for Assessment of Positive Symptoms (SAPS), Brief Psychiatric Rating Scale (BPRS) and Schedule for Assessing the three components of Insight (SAI). All patients were receiving haloperidol at time of recruitment. Eight patients were switched to clozapine, 3 to risperidone and 11 to olanzapine. The global function, measured with BPRS, increased after administration of atypical antipsychotics. The positive and negative symptoms were reduced. The level of insight was increased after the administration of the atypical antipsychotics. The cognitive effect of the atypical antipsychotics changed the level of insight and augmented the compliance.

Adult↗

PubMed2000

Neurological rehabilitation of severely disabled cardiac arrest survivors. Part II. Life situation of patients and families after treatment.

BACKGROUND: About half of out-of-hospital cardiac arrest survivors experience secondary anoxic brain damage. Neurological outcome can be influenced by rehabilitative treatment approaches, but the nature and severity of persistent disabilities remain unclear. The aim of the study was to explore persistent neuropsychiatric symptoms, global function and life situation of these patients, and to evaluate quality of life in families. METHODS: 25 months after inpatient rehabilitation, 12 individuals (mean age=51 years; ten M: two F) attended a cross-sectional interdisciplinary follow-up assessment with their carers. Function was investigated by clinical rating scales, neuropsychological standard tests, and clinical psychological inventories. Family members were asked about quality of life and satisfaction with social support. RESULTS: All patients had deficits in at least one or more cognitive areas such as orientation, memory, alertness, and awareness. Three different clinical syndromes were observed: very severe intellectual and physical impairment, (two), mild to moderate dementia, (five), and amnesic syndrome, (five). Prevalence of multiple disabilities, was high. A striking discrepancy was found between self and proxy rating of disabilities (P<0.01). Family members faced dramatically altered life situations after CA; 60% of spouses suffered from psychosomatic problems, 50% complained of lack of social support. CONCLUSION: Despite optimal in-hospital treatment, severe anoxic brain damage resulted in permanent cognitive decline, impaired awareness and self care ability. Families felt isolated, and more than half need more support to prevent burn out.

Acute Disease↗

PubMed2000

Buprenorphine: a controlled clinical trial in the treatment of opioid dependence.

Clinical trials carried out to compare methadone and buprenorphine in the treatment of opioid dependence have generally employed an alcoholic solution of buprenorphine, which has a bioavailability superior to that of the tablets. Since the product available for large scale use is in tablet form, one intended to verify the efficacy of this formulation. In a multicentre randomised controlled double blind study, 72 opioid dependent patients were assigned to treatment with buprenorphine (8 mg/day) or methadone (60 mg/day) for a period of 6 months. The two compounds did not show any significant difference with regard to urinalyses: the average percentage of analyses proving negative was 60.4% for patients assigned to buprenorphine, and 65.5% for those assigned to methadone. With regard to retention, a non-significant trend in favour of methadone was observed. Patients completing the trial improved significantly in terms of psychosocial adjustment and global functioning, as ascertained by the DSM-IV-GAF and symptom checklist-90 (SCL-90) scales, and this was independent of the treatment group. Finally, in the case of buprenorphine, patients who dropped out differed significantly from those who stayed, in terms of a higher level of psychopathological symptoms, and a lower level of psychosocial functioning. The results of the study further support the utility of buprenorphine for the treatment of opioid dependence.

Adolescent↗

PubMed2002

Cloning and characterization of the gene encoding the mouse homologue of CpG binding protein.

Human CpG binding protein (CGBP) is a ubiquitously-expressed transcriptional activator that binds specifically to unmethylated CpG motifs. Several protein domains have been identified within CGBP including two plant homeodomains (PHD), acidic and basic regions, a coiled-coil domain, as well as a CXXC DNA-binding domain. The global function of CGBP remains unclear, although failure to express CGBP results in embryonic lethality in mice. This study reports the identification and characterization of the murine CGBP gene locus. A 2509 bp murine CGBP cDNA was cloned and nucleotide sequence determined. Comparison of the mouse and human CGBP sequences revealed 86% identity at the nucleotide level and 96% identity at the amino acid level. Examination of the deduced translation product revealed that the PHD, CXXC, coiled-coil, and basic domains are identical between mouse and human, while the acidic region exhibits approximately 90% identity with its human counterpart. A single murine CGBP transcript of approximately 2.6 kb was detected in a wide variety of adult tissues as well as embryonic stem cells. Analysis of the mouse gene locus revealed a relatively small gene spanning approximately 5 kb and comprised of 15 exons. Examination of the human CGBP gene showed a similar size and structure with identical intronic splice sites. In contrast to the human CGBP gene, which is located 800 bp upstream of the MBD1 gene, analysis of the murine CGBP gene locus failed to detect the murine MBD1 gene within several kilobases of the CGBP coding region.

Amino Acid Sequence↗

PubMed1999

Detection of myocardial viability by low-dose dobutamine Cine MR imaging.

The purpose of this work was to test the diagnostic value of dobutamine stress magnetic resonance imaging (MRI) for predicting recovery of regional myocardial contractility after revascularization. Cardiac wall motion abnormalities are due to either non-viable and/or scarred, or viable, but hibernating, myocardial tissue. Dobutamine stress leads to increased systolic wall thickening only in viable myocardium. Twenty-five patients with akinetic or dyskinetic myocardial regions were examined with a Cine FLASH-2D sequence at rest and during dobutamine stress (10 microg/kg/min). Patients were re-examined at rest 3, and in case of persisting wall motion defects, 6 months after revascularization. Criterion of viability was increasing end-systolic wall thickening during stress and/or at follow-up. Akinetic regions related either to the LAD (n = 19) or to the RCA (n = 6) were judged viable if > or = 50% of the affected segments improved. MR studies were completed in all subjects without arrhythmia or need for early terminations due to symptoms. Sensitivity, specificity, and positive predictive value for the prediction of myocardial viability were 61%, 90%, and 87% for the segment-related analysis, and 76%, 100%, and 100% for the patient-related analysis based on coronary artery distribution, respectively. Dobutamine stress MRI allows to predict global functional recovery of akinetic myocardial regions after revascularization with a high positive predictive value and high specificity.

Adult↗

PubMed2000

Right ventricular abnormalities assessed by myocardial single-photon emission computed tomography using technetium-99m sestamibi/tetrofosmin in right ventricle-originated ventricular tachyarrhythmias.

OBJECTIVES: We sought to determine whether right ventricular (RV) perfusion imaging with technetium-99m (Tc-99m) sestamibi or tetrofosmin single-photon emission computed tomography has diagnostic benefit for RV-originated ventricular tachyarrhythmias (RVT). BACKGROUND: Identification of RV abnormalities is clinically important to establish RVT etiology. METHODS: Forty-seven patients with RVT (23 with idiopathic and 24 with organic RVT due to arrhythmogenic RV or dilated cardiomyopathy, cardiac sarcoidosis or myocarditis) were compared to 25 control subjects. Right ventricular uptake score, as assessed by modified tomographic imaging, and regional RV count relative to peak left ventricular (LV) count (RV/LV count ratio) were compared with RV regional and global function. RESULTS: Regional RV uptake score correlated well with the RV/LV count ratio, and segmental abnormality was more frequently (p = 0.001) detected in the organic RVT group (22 [92%] of 24 patients) than in the idiopathic RVT group (4 [17%] of 23 patients) or the control group (8 [32%] of 25 patients). The total RV score (8.4+/-3.8) in the organic RVT group was significantly lower than that in the idiopathic RVT group (15.6+/-1.6) or the control group (15.1+/-1.8). The total RV score correlated with RV EF (r = 0.702, p<0.001). A total RV score <12 differentiated the organic RVT group from the other two groups, with a sensitivity of 79% and a specificity of 100%. The asynergic RV regions had a significantly lower RV/LV count ratio and RV score as compared with the nonasynergic regions and were identified by RV assessment, with a sensitivity of 76.1% and a specificity of 76.6%. CONCLUSIONS: Right ventricular perfusion tomography using a Tc-99m-labeled tracer is clinically useful for the noninvasive detection of RV myocardial damage in patients with RVT and for differentiating organic from idiopathic RVT.

Adolescent↗

PubMed2002

Impact of hydroxymethylglutaryl coenzyme a reductase inhibition on left ventricular remodeling after myocardial infarction: an experimental serial cardiac magnetic resonance imaging study.

OBJECTIVES: We sought to assess the influence of long-term hydroxymethylglutaryl coenzyme A reductase inhibition (statin) therapy on left ventricular (LV) remodeling after myocardial infarction (MI) by use of serial cardiac magnetic resonance imaging (CMRI) studies. BACKGROUND: Statin therapy has been shown to reduce cardiac hypertrophy in vitro and in vivo, but the influence on LV post-MI remodeling is largely unknown. METHODS: The CMRI measurements were taken four and 12 weeks after left coronary artery ligation in a 7.05-tesla Biospec. The MI size, LV mass and volumes, cardiac output (CO), and ejection fraction were determined. Rats were treated for 12 weeks with either placebo (P), cerivastatin (C; 0.6 mg/kg body weight per day) as a dietary supplement, or cerivastatin plus the nitric oxide synthase (NOS) inhibitor N-methyl-L-arginine methyl ester (L-NAME, 76 mg/100 ml) and hydralazine (8 mg/100 ml) in drinking water (CLH) to assess the contribution of endogenous nitric oxide formation. RESULTS: Administration of cerivastatin attenuated hypertrophy after MI, and this effect was completely abolished by NOS inhibition (increase of LV mass from 4 to 12 weeks after MI: 235.3 +/- 33.7 mg with P vs. 59.8 +/- 20.5 mg with C vs. 239.5 +/- 16.0 mg with CLH; p < 0.05 vs. P and CLH). Left ventricular dilation was not changed (increase of end-diastolic volume from 4 to 12 weeks after MI: 108.7 +/- 28.8 with P vs. 126.6 +/- 20.5 with C vs. 173.7 +/- 25.1 with CLH; p = NS). The CO was higher in the cerivastatin group (12 weeks: 76.1 +/- 2.9 ml/min with P vs. 95.8 +/- 4.8 ml/min with C; p < 0.05). The effects of cerivastatin were abolished by NOS inhibition in the CLH group (CO at 12 weeks: 69.3 +/- 2.8 ml/min, p < 0.05 vs. C). CONCLUSIONS: Left ventricular remodeling was profoundly changed by statin treatment. Hypertrophy was attenuated, and global function was improved. These positive effects were abolished by NOS inhibition.

Animals↗

PubMedDate not supplied

Characterization of myocardial tissue in patients undergoing maintenance hemodialysis by quantitative echocardiography.

The uremic state affects myocardial structure, bringing about, among other things, interstitial calcium deposition. Abnormalities of myocardial structure can be assessed quantitatively and noninvasively during life by the analysis of the gray-level distribution of conventional two-dimensional echocardiograms. The aim of this study was to evaluate the role of quantitative echocardiography in providing information on myocardial structure in patients under maintenance hemodialysis and to relate the ultrasonic findings with abnormalities in calcium-phosphate metabolism. Forty patients undergoing dialysis without abnormalities in left ventricular regional and global function and 17 hypertensive patients with comparable left ventricular hypertrophy were studied. The distribution of the gray levels within a region of interest in the interventricular septum was analyzed off-line by an array processor-based computer. Compared with hypertensive patients, patients undergoing dialysis showed a greater myocardial echogenicity (mean 92 +/- 20 versus 72 +/- 15; p = 0.004) and a reduced homogeneity of distribution of gray levels (entropy 4.5 +/- 0.2 versus 4.2 +/- 0.2, p < 0.01; uniformity 0.010 +/- 0.003 versus 0.020 +/- 0.004, p < 0.005). In the same patients, a significant negative linear relation was found between entropy and calcium-phosphate product (r = -0.66; p = 0.001). Quantitative analysis of conventional two-dimensional echocardiograms allows the detection of a pathologic myocardial structure in patients under maintenance hemodialysis with normal left ventricular function. These abnormalities are related to disorders of calcium-phosphate metabolism and bear no relationship to the degree of left ventricular hypertrophy.

Adult↗

PubMedDate not supplied

Comparison of digital with videotape echocardiography in patients with chest pain in the emergency department.

We prospectively compared digital echocardiographic images, by a minimal digital-acquisition strategy, with videotape images to determine the diagnostic utility of digital imaging in patients admitted to the emergency department with chest pain. Digital acquisition has many potential advantages for evaluating echocardiographic images, especially in the acute-care setting. It is not yet known how much the imaging study can be condensed with digital technology and still provide the necessary information needed for clinical echocardiographic diagnosis. One hundred seventeen patients with diagnoses consisting of coronary artery disease, pericardial disease, and valvular disease were studied. Overall agreement between videotape and digital recordings with regard to normal versus abnormal wall motion was 94% (p < 0.001). The wall motion score index, a semiquantitative measure of global function, also correlated well (r = 0.94). Complete concordance was noted in all patients with aortic stenosis and pericardial effusion. Digital echocardiographic imaging, by a minimal-acquisition strategy, is an accurate summary of the complete echocardiographic examination and provides the relevant diagnostic data needed for the assessment of patients with chest pain in the emergency department.

Chest Pain↗