Percutaneous septal ablation for left mid-ventricular obstructive hypertrophic cardiomyopathy: a case report

BACKGROUND: Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHC) is a rare type of cardiomyopathy. The diagnosis is based on the hourglass appearance on the left ventriculogram and the presence of pressure gradient between apical and basal chamber of the ventriculum on the hemodynamic assessment. CASE PRESENTATION: The present case represents successful percutaneous treatment with septal ablation to patient with MVOHC associated with systolic anterior motion of the mitral valve and obstruction at both the mid-ventricular and outflow levels. CONCLUSION: Alcohol septal ablation has been proposed as less invasive alternatives to surgery in patients with MVOHC

Coronary flow reserve in stress-echo lab. From pathophysiologic toy to diagnostic tool

The assessment of coronary flow reserve by transthoracic echocardiography has recently been introduced into clinical practice with gratifying results for the diagnosis of left anterior descending artery disease simultaneously reported by several independent laboratories. This technological novelty is changing the practice of stress echo for 3 main reasons. First, adding coronary flow reserve to regional wall motion allows us to have – in the same sitting – high specificity (regional wall motion) and a high sensitivity (coronary flow reserve) diagnostic marker, with an obvious improvement in overall diagnostic accuracy. Second, the technicalities of coronary flow reserve shift the balance of stress choice in favour of vasodilators, which are a more robust hyperemic stress and are substantially easier to perform with dual imaging than dobutamine or exercise. Third, the coronary flow reserve adds a quantitative support to the exquisitely qualitative assessment of wall motion analysis, thereby facilitating the communication of stress echo results to the cardiological world outside the echo lab. The next challenges involve the need to expand the exploration of coronary flow reserve to the right and circumflex coronary artery and to prove the additional prognostic value – if any – of coronary flow reserve over regional wall motion analysis, which remains the cornerstone of clinically-driven diagnosis in the stress echo lab

Definitions and incidence of cardiac syndrome X: review and analysis of clinical data

There is no consensus regarding the definition of cardiac syndrome X (CSX). We systematically reviewed recent literature using a standardized search strategy. We included 57 articles. A total of 47 studies mentioned a male/female distribution. A meta-analysis yielded a pooled proportion of females of 0.56 (n = 1,934 patients, with 95% confidence interval: 0.54–0.59). As much as 9 inclusion criteria and 43 exclusion criteria were found in the 57 articles. Applying these criteria to a population with normal coronary angiograms and treated in 1 year at a general hospital, the attributable CSX incidence varied between 3 and 11%. The many inclusion and exclusion criteria result in a wide range of definitions of CSX and these have large effects on the incidence. This shows the need for a generally accepted definition of CSX

Fabricación de materiales compuestos con microestructuras complejas y propiedades mejoradas a partir de suspensiones

11 páginas, 12 figuras.-- Trabajo presentado al XII Congreso Nacional de Propiedades Mecánicas de Sólidos celebrado en Aránzazu-Guipúzcoa (España) en Septiembre de 2010.[EN]: Colloidal processing has demonstrated its suitability for manufacturing ceramics with a great variety of shapes, sizes and complex microstructures. Colloidal methods require the preparation of stable, homogeneous suspensions of the material to be shaped, so that the control of stability is fundamental. cerámicos con una gran variedad de formas y Similarly, metal powders and ceramic-metal mixtures can be succesfully processed by colloidal routes if sedimentation, on one hand, and dissolution and oxidation, on the other hand, are avoided or controlled. In this work some examples of the manufacture of ceramics and composites through a colloidal approach are shown, and the advantages of some simple, economic and reliable shaping techniques are discussed. It is demonstrated that denser and more homogeneous materials with finer and more uniform microstructures and hence, with cerámicos y compuestos mediante una better behavioural properties, can be obtained.[ES]: El procesamiento coloidal ha demostrado su eficacia en la fabricación de materiales cerámicos con una gran variedad de formas y tamaños y microestructuras complejas. Los métodos coloidales suponen la preparación de suspensiones estables y homogéneas del material a conformar, por lo que el control de la estabilidad es fundamental. De forma análoga, los polvos metálicos y las mezclas cerámica- metal se pueden procesar por vía coloidal si se asegura la estabilidad y se evitan o controlan la sedimentación, por una parte, y la disolución y oxidación, por otra. En este trabajo se muestran algunos ejemplos de fabricación de materiales cerámicos y compuestos mediante una aproximación coloidal y se discuten las ventajas de algunas técnicas de conformado sencillas, económicas y reproducibles. Todo ello contribuye a la obtención de materiales más densos y homogéneos, con microestructuras más finas y uniformes, y por tanto, con mejores propiedades de comportamiento.Este trabajo ha sido financiado por los Proyectos MAT2009-14369-C02-01 y PID600200-2009-5.Peer reviewe