Relationship between mitral leaflets angles, left ventricular geometry and mitral deformation indices in patients with ischemic mitral regurgitation: imaging by echocardiography and cardiac magnetic resonance

Chronic ischemic mitral regurgitation (IMR) is associated with a markedly worse prognosis after myocardial infarction (MI).The study aimed to evaluate the relationship between anterior and posterior mitral leaflet angle (MLA) values, left ventricle remodeling and severity of ischaemic mitral regurgitation (IMR). Methods: Forty-two patients (age 63.5 ± 9.7 years, 36 men) with chronic IMR (regurgitant volume, RV > 20 ml; >6 months after MI) underwent transthoracic echocardiography (TTE) and cardiovascular magnetic resonance (CMR) imaging. Anterior and posterior MLA, determined by echocardiography, were correlated with indices of LV remodeling, mitral apparatus deformation and IMR severity by CMR. The anterior and posterior MLA was 25.41 ± 4.28 and 38.37 ± 8.89° (mean ± SD). In 5 patients (11.9%) the posterior MLA was ≥45°. There was a significant correlation between anterior MLA and RV (r = 0.74, P = 0.01). For patients with RV > 30 ml this correlation was stronger (r = 0.97, P = 0.005) and, in addition, there was a correlation between the RV and posterior MLA (r = 0.90, P = 0.037), between tenting area and posterior MLA (r = 0.90, P = 0.04), and between tenting area and anterior MLA (r = 0.82, P = 0.08). With regard to LV remodeling parameters, there was weaker but significant correlation between posterior MLA and LV end-diastolic volume index (r = 0.35, P = 0.031), LV end-systolic volume index (r = 0.37, P = 0.021), stroke volume (r = 0.35, P = 0.03), sphericity index (r = 0.33, P = 0.041). Anterior MLA correlated with wall motion score index (r = 0.41, P = 0.019). Besides, there was a correlation between posterior MLA and left atrial volume (r = 0.41, P = 0.012). Measurement of anterior and posterior MLA may play an important role in evaluating patients with IMR

Basic rules of dosimetry in endovascular brachytherapy.

Endovascular brachytherapy after percutaneous coronary intervention (PCI), is becoming a standard approach for the treatment and prevention of restenosis. A variety of technical approaches are currently available to deliver ionizing irradiation to the vascular target. Basically two kinds of radioactive isotopes are available that emit gamma radiation (photons) or beta radiation (electrons). The pitfalls and solutions for the optimization of dosimetry are discussed. As might be expected, the inhomogeneous dose distribution across the target volume results in recurrence by underdosage or in complications because of overdosage. Moreover, uniformization of the target definition and reporting of the dose distribution in endovascular brachytherapy is a prerequisite for comparison between the results of the various clinical trials and is absolutely necessary to improve the therapeutic efficacy of this new approach in the prevention of restenosis after coronary angioplasty with or without stenting. (J Interven Cardiol2000; 13:425430

Hibiscus sabdariffa L. aqueous extract attenuates hepatic steatosis through down-regulation of PPAR-gamma and SREBP-1c in diet-induced obese mice

Strategic Alliance for Process Innovation and Biotech Products Derived from Jamaica [87069