Echocardiography is the sector of cardiology that uses ultrasound as a means of depiction of the heart and provides valuable information about the anatomy and the physiology of the heart. The Anglo-Saxon culture first imported the word echocardiogram or echogram for the illustrative diagram that is received on ultrasound examination of the heart. The translation of this term into the Greek language is or expresses conceptually the basic attribute of ultrasound to be reflected and to cause the acoustic phenomenon, the echo. The first synthetic form of the word echocardiography refers to Greek mythology, and specifically to the nymph Echo and the various fables that were created to interpret the phenomenon of reflection of sounds (echo). It appears that Greek myths are integrated into contemporary science and civilization, so spontaneously and easily, and yet they can still amaze us with their uniqueness and the power of their symbolization.

Methods: Prospective study in 51 patients (58±16 years, 31% male) with stable angina and myocardial ischemia in non-invasive tests, submitted to elective coronary angiography.Virtual histology data were obtained by intra-coronary ultrasound with a 30 mHz probe and analysed with the VolcanoTM system.This system codes by colours four types of plaque composition (Fibrous -F, Fibro-lipidic -FL, Necrotic -N and Calcified -C).Plaques with at least 25% of fibro-lipidic component were considered as predominant fibro-lipidic plaques (11 patients) and these patients were compared in terms of age, gender, risk factors for coronary artery disease and quantitative vessel characteristics (vessel diameter, lumen diameter, lumen area, plaque area and calcium percentage).Results: In this population, 71% were hypertensive patients, 27% diabetics, 27% smokers and 67% had hyperlipidemia.In hypertensive patients (vs nonhipertensive), mean composition of the plaque (in percentage) was: F 58% vs 59%, FL 15% vs 18%, N 16% vs 14%, C 11% vs 9%, Mann-Whitney p=NS.In diabetics (vs non-diabetics): F 58% vs 58%, FL 12% vs 17%, 17% vs 15%, C 13% vs 9%, p=NS.In smokers (vs non-smokers): F 63% vs 56%, FL 18% vs 15%, N 16% vs 12%, C 7% vs 12%, p=NS.In patients with hyperlipidemia (vs normal lipid profile): F 56% vs 62%, FL 17% vs 14%, N 16% vs 14%, C 11% vs 9%, p=NS.When we compare patients with predominant FL plaques, there were no statistical significant differences, except for the percentage of calcium (4% in FL vs 13% in the remaining patients, p=0.02).Also the presence of smoking was associated with a FL predominant plaque (OR 4.8, p=0. 05).Conclusions: There was no difference in plaque composition according to each risk factor.Fibro-lipidic plaques were more frequent in smokers with a consequent higher risk for acute coronary events.Calcium in these plaques has a smaller percentage, which could suggest less chronicity of those lesions.

The LA maximal (Volmax), pre-atrial contraction (Volpre-a), and minimal (Volmin) volumes were calculated by Simpson's rule and LA passive (LAPEF), LA active (LAAEF) and LA total (LATEF) emptying fractions were derided and used as a surrogate el LA conduit, LA contractile lunction and LA global performance, peak E and A waves, and deceleration time were also obtained, A covariance model was used to assess the left atrial and lelt ventricular determinants el LATEF and LAAEF, including gender, age and etiology. Results:The peak E wave velocity (p=0.017) and LA diameter (LAD) (p=0,002) were independently predictive of LAPEF (R2=0,71).LAAEF was determined by ERe (R2=0,54).The etiology (p=0,054), gender (p=0,29) and age (p=0,4), were not significant.See Table 1 (*p<0,05).Table 1 Variables ALL (n=54) RD (N=23) MVP (n=31) Age 46,6 (16) 34.7 (11) 56,4 (13)" Sex (M/F) 30/24 6/17 24/7* EF (%) 658 (6) 643(4) 66,8 (6) Peak E (era/s) 1372 (32) 1422 (35) 133.5 (28) PeakA (ern/s) 635 (23) 68.3 (29) 59.9 (18) LA (em) 5.2 (0.7) 6.3 (0.8) 6.0 (06) Ivol max (rnl/rn 2) 83,86 (33) 928 (38) 773 (26) Ivol rnin (rnl/m 2) 48.13 (25) 599 (30) 41.6 (17)* LATEF (%) 45 ( 9) 41 ( 10) 47 (7)* LAAEF (%) 25 ( 9) 20 ( 5) 27 ( 7)* *p

Left atrium dilatation (LAD) is a frequent finding in patients (pts) with arterial hypertension (HTN) and it is considered a risk factor for atrial fibrillation or cerebral ischaemic events. The age of the pts as well as the left ventricular (LV) hypertrophy are associated with the development of LAD, while the contribution of coronary artery disease (CAD) is a frequent and independent factor. 100 pts with chronic HTN, who underwent cardiac catheterization for the evaluation of angina, were studied. CAD was detected in 62 pts. From the echo-doppler study, LAD (>38mm in female and >42 mm in male pts) was present in 35 pts. LV structure as well as LV systolic and diastolic function was also evaluated. Pts with LAD were relatively older (66 vs 60-years-old, p=0,004), without any statistically significant difference in the indices of LV structure or systolic function (p=NS). However, they had higher end-diastolic transmitral velocities (A: 85 vs 67cm/sec, p=0,0005), lower E/A ratios (0,71 vs 0,84, p=0,04), increased deceleration, isovolumic relaxation as well as whole relaxation times (261 vs 230msec, p=0,03, 131 vs 118msec, p=0,002 and 392 vs 348msec, p=0,003 respectively). In the subgroup of pts with CAD, the pts with LAD also had increased A-wave velocities (83 vs 66 cm/sec, p= 0,01), increased deceleration, isovolumic relaxation as well as whole relaxation times (272 vs 237msec, p=0,05, 138 vs 123msec, p=0,03 and 410 vs 360msec, p=0,007 respectively). In pts with HTN without CAD, there was a difference in the age of the pts (66 vs 58 years, p=0,03) and the A-wave velocity (88 vs 68 cm/sec, p=0,01). The LAD was significantly correlated (p<0,00001) with the age, LV mass index, the A-wave velocity and the isovolumic relaxation time (r= 0.36, 0.24, 0.34, 0.30). In the multivariate analysis (r=0.59, F=12.7, p<0.00001), the independently predictive values of LAD were the age (p=0.01), the LV mass (p=0.001), the A-wave (p=0.001) and the isovolumic relaxation time (0.0001). It is concluded that in pts with HTN, LAD is mostly correlated with the LV diastolic function, especially in the presence of angiographically documented CAD.

EchocardiographyVolume 20, Issue 4 p. 387-388 Metastatic Hepatocellular Carcinoma Into the Right Atrium and Ventricle: Echocardiographic Diagnosis and Follow-Up Ioannis Vlasseros , M.D., Ioannis Vlasseros , M.D. State Department of Cardiology, Hippokration Hospital, Athens, GreeceSearch for more papers by this authorEfstratios Tapanlis , M.D., Efstratios Tapanlis , M.D. State Department of Cardiology, Hippokration Hospital, Athens, GreeceSearch for more papers by this authorAndreas Katsaros , M.D., Andreas Katsaros , M.D. State Department of Cardiology, Hippokration Hospital, Athens, GreeceSearch for more papers by this authorDimitrios Kountouras , M.D., Dimitrios Kountouras , M.D. State Department of Cardiology, Hippokration Hospital, Athens, GreeceSearch for more papers by this authorIoannis Gialafos , M.D., Ioannis Gialafos , M.D. State Department of Cardiology, Hippokration Hospital, Athens, GreeceSearch for more papers by this author Ioannis Vlasseros , M.D., Ioannis Vlasseros , M.D. State Department of Cardiology, Hippokration Hospital, Athens, GreeceSearch for more papers by this authorEfstratios Tapanlis , M.D., Efstratios Tapanlis , M.D. State Department of Cardiology, Hippokration Hospital, Athens, GreeceSearch for more papers by this authorAndreas Katsaros , M.D., Andreas Katsaros , M.D. State Department of Cardiology, Hippokration Hospital, Athens, GreeceSearch for more papers by this authorDimitrios Kountouras , M.D., Dimitrios Kountouras , M.D. State Department of Cardiology, Hippokration Hospital, Athens, GreeceSearch for more papers by this authorIoannis Gialafos , M.D., Ioannis Gialafos , M.D. State Department of Cardiology, Hippokration Hospital, Athens, GreeceSearch for more papers by this author First published: 14 May 2003 https://doi.org/10.1046/j.1540-8175.2003.03047.xCitations: 6 Address for correspondence and reprint requests: Ioannis Vlasseros, M.D., 13 Kyparissias street, Galatsi, 11147, Athens, Greece. Fax: +30 (1) 06718768; E-mail: [email protected] Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. References 1 Baba HA, Engers R, Heintzen MP: Right atrial metastasis as primary clinical manifestation of hepatocellular carcinoma. Int J Cardiol 1995; 47: 281– 284. 2 Kato Y, Tanaka N, Kobayashi K, et al: Growth of hepatocellular carcinoma into the right atrium. Ann Intern Med 1955; 99: 472– 474. 3 Van Camp G, Abdulsater J, Cosyns B, et al: Transesophageal echocardiography of right atrial metastasis of a hepatocellular carcinoma. Chest 1994; 105: 945– 947. Citing Literature Volume20, Issue4May 2003Pages 387-388 ReferencesRelatedInformation

Introduction: Guidelines for anthracyclines cardiotoxicity (ACT) monitoring required LV ejection fraction (EF%) as unique gold standard parameter for decision making; but its prediction power for late developing of cardiomiopathy (CM) remains not strictly and timely accurate.Methods: We started prospective study for evaluating potential incremental value of newer markers of ACT: diastolic Doppler indexes, both by conventional technique and myocardial tissue imaging (TDI), and propeptide brain natriuretic peptide (pro-BNP, Roche Elecsys 2010).Both at baseline and at end-therapy (ET) we measured: LVEF%, E/A ratio and DT, Ev and Ev/Av ratio, and pro-BNP.Results: To today, we collected complete data from 36 breast cancer young patients (mean 50yrs, range 29-60).At ET time, none pt presented signs of CM, while after mean 18 months follow-up 4 pts developed overt CM: 2pts NYHA Class II and 2pts NYHA III (mean LVEF: 38% ±5).Table 1 (part A) shows data both at baseline and at ET for all 36 pts and (part B) data from the 4-CM pts.At ET time, we observed mean normal values of LVEF, also in 4 pts developing late CM; otherwise, Doppler indexes and proBNP mean values were already abnormal in the same time.

We present the case of a 66-year-old man with a history of coronary artery disease and chronic lymphocytic leukemia (CLL) who was admitted to the hospital complaining of chest discomfort and shortness of breath on exertion. The echocardiogram revealed a severe pericardial effusion and a large echogenic mass that infiltrated the lateral wall of the right atrium and ventricle and created a moderate tricuspid valve stenosis. B cell intracardiac non-Hodgkin lymphoma/CLL was diagnosed, and the patient was treated with six courses of CHOP chemotherapy. After the third course, the mass disappeared and the patient's general condition was substantially improved.