Background: Dobutamine stress echocardiography (DSE) is frequently used in the evaluation of cardiac risk prior to orthotopic liver transplantation (OLT). In the general cardiac population, an inducible left ventricular outflow tract gradient (LVOT Δ) during DSE has variable prognostic importance. The purpose of this study was to determine the prevalence and clinical significance of LVOT Δ in patients undergoing OLT during DSE. Methods: Consecutive medical records of 106 patients who had undergone OLT at our institution from January 1997 until January 2002 were retrospectively analyzed and divided into two groups based on the presence (Group I, LVOT Δ > 36 mmHg) or absence (Group II, LVOT Δ≤ 36 mmHg) of a significant LVOT Δ measured during DSE. We determined any outcome differences between these two groups with regard to intraoperative hypotension, cardiac mortality, length of hospital stay, graft function, and renal function post‐OLT. Results: Forty‐six patients had an LVOT Δ > 36 mmHg (Group I) and 60 patients had LVOT Δ≤ 36 mmHg (Group II). Baseline demographics were similar in both groups. There was no significant overall difference in cardiac mortality between Group I versus Group II patients (0 versus 1 patient, respectively, P = 0.57). Intraoperative hypotension occurred in 4 patients in Group I versus 0 patient in Group II (P = 0.03). Length of stay, graft function, and postoperative renal function were similar in both groups. Conclusion: A significant LVOT Δ > 36 mmHg is a frequent finding occurring in 46/106 (43%) of patients who have DSE pre‐OLT. Intraoperative hypotension is associated with patients having an LVOT Δ. However, post‐OLT patients with significant LVOT Δ have a similar in‐hospital outcome compared to patients without significant LVOT Δ.

The number of patients with end-stage renal disease (ESRD) has risen dramatically over the last decade. There are 300,000 patients in the United States with ESRD who are receiving hemodialysis (HD), and the incidence is increasing at a rate of 6% to 8% per year. Bacteremia, a prerequisite for infective endocarditis (IE), occurs at a rate of 0.7 to 1.4 episodes per 100 patient-care months. Few other medical conditions, except for chemotherapy-induced neutropenia, immunosuppression, and intravenous drug abuse, are associated with higher rates of bacteremia. IE occurs in approximately 2% to 6% of patients receiving HD. The aim of this article is to review the pathogenesis, diagnosis, current therapeutic options, and determinants of prognosis of IE in patients receiving HD.

EchocardiographyVolume 20, Issue 6 p. 557-559 Resolution of a Primary Intracardiac Lymphoma Suraj Maraj , M.D., Suraj Maraj , M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Jefferson University School of Medicine, Philadelphia, PennsylvaniaSearch for more papers by this authorRichard G. To , M.D., Richard G. To , M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Jefferson University School of Medicine, Philadelphia, PennsylvaniaSearch for more papers by this authorGuillermo Crespo , M.D., Guillermo Crespo , M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Jefferson University School of Medicine, Philadelphia, PennsylvaniaSearch for more papers by this authorLarry E. Jacobs , M.D., Larry E. Jacobs , M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Jefferson University School of Medicine, Philadelphia, PennsylvaniaSearch for more papers by this authorMorris N. Kotler , M.D., Morris N. Kotler , M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Jefferson University School of Medicine, Philadelphia, PennsylvaniaSearch for more papers by this author Suraj Maraj , M.D., Suraj Maraj , M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Jefferson University School of Medicine, Philadelphia, PennsylvaniaSearch for more papers by this authorRichard G. To , M.D., Richard G. To , M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Jefferson University School of Medicine, Philadelphia, PennsylvaniaSearch for more papers by this authorGuillermo Crespo , M.D., Guillermo Crespo , M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Jefferson University School of Medicine, Philadelphia, PennsylvaniaSearch for more papers by this authorLarry E. Jacobs , M.D., Larry E. Jacobs , M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Jefferson University School of Medicine, Philadelphia, PennsylvaniaSearch for more papers by this authorMorris N. Kotler , M.D., Morris N. Kotler , M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Jefferson University School of Medicine, Philadelphia, PennsylvaniaSearch for more papers by this author First published: 14 July 2003 https://doi.org/10.1046/j.1540-8175.2003.03094.x Address for correspondence and reprint requests: Morris N. Kotler, M.D., Albert Einstein Medical Center, 363 Klein Professional Building, 5401 Old York Road, Philadelphia, PA 19141. Fax: (215) 455-6189; 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 Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat References 1 McCallister HA, Fenoglio JJ: Tumors of the cardiovascular system. In: Atlas of Tumor Pathology (2nd Series, Fasicle 15). Washington , DC : Armed Forces Institute of Pathology , 1978, pp. 99–100. 2 Nand S, Mullen GM, Lonchyna VA, et al: Primary lymphoma of the heart. Cancer 1991; 68: 2289–2292. Volume20, Issue6August 2003Pages 557-559 ReferencesRelatedInformation

A right ventricular thrombus (RVT) is an unusual finding on echocardiography. We describe a healthy young male patient who developed RVT with subsequent pulmonary embolism (PE), the etiology of which remains uncertain. (ECHOCARDIOGRAPHY, Volume 20, July 2003)

EchocardiographyVolume 20, Issue 8 p. 737-738 Aortoventricular Fistula and Abscess Caused by Vancomycin-Resistant Enterococcus in a Hemodialysis Patient Suraj Maraj M.D., Suraj Maraj M.D. Echocardiography Laboratory, Division of Cardiology, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorLarry E. Jacobs M.D., Larry E. Jacobs M.D. Echocardiography Laboratory, Division of Cardiology, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorEnakshi Bajpai D.O., Enakshi Bajpai D.O. Echocardiography Laboratory, Division of Cardiology, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorGuillermo Crespo M.D., Guillermo Crespo M.D. Echocardiography Laboratory, Division of Cardiology, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorMorris N. Kotler M.D., Morris N. Kotler M.D. Echocardiography Laboratory, Division of Cardiology, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this author Suraj Maraj M.D., Suraj Maraj M.D. Echocardiography Laboratory, Division of Cardiology, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorLarry E. Jacobs M.D., Larry E. Jacobs M.D. Echocardiography Laboratory, Division of Cardiology, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorEnakshi Bajpai D.O., Enakshi Bajpai D.O. Echocardiography Laboratory, Division of Cardiology, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorGuillermo Crespo M.D., Guillermo Crespo M.D. Echocardiography Laboratory, Division of Cardiology, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorMorris N. Kotler M.D., Morris N. Kotler M.D. Echocardiography Laboratory, Division of Cardiology, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this author First published: 01 December 2003 https://doi.org/10.1111/j.0742-2822.2003.02142.x Address for correspondence and reprint requests: Larry E. Jacobs, M.D., Albert Einstein Medical Center, 363 Klein Professional Building, 5401 Old York Road, Philadelphia, PA 19141; Fax: (215) 456-6189; E-mail: [email protected] Supported in part by The Women's League for Medical Research, Albert Einstein Medical Center. 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 Samuels LE, Kaufman MS, Rodriguez-Vega J, et al: Diagnosis and management of traumatic aorto-ventricular fistulas. Ann Thorac Surg 1998; 65: 288– 292. 2 Roy D, Saba S, Grinberg I, et al: Aorto-right ventricular fistula: A late complication of aortic valve replacement. Tx Heart Inst J 1999; 26: 140– 142. 3 Mizock BA, Nachman SA, Varquez M: Left ventricular outflow tract pulmonary artery fistula in endocarditis. Clin Cardiol 1995; 18: 539– 540. 4 Elian D, Di Segni E, Kaplinsky E, et al: Acquired left ventricular-right atrial communication caused by infective endocarditis detected by transesophageal echocardiography: Case report and review of the literature. J Am Soc Echocardiogr 1995; 8: 108– 110. Volume20, Issue8November 2003Pages 737-738 ReferencesRelatedInformation

Penetrating aortic atherosclerotic ulcers have been recently recognized as an entity among the acute aortic syndromes with a potentially fatal outcome. We describe the case of a patient presenting with severe chest pain who died as a result of a thoracic-aorta penetrating atherosclerotic ulcer complicated by a intramural hematoma of the esophagus and stomach, leading to exsanguination. To our knowledge this is the first case reported in the literature of such a complication from penetrating aortic atherosclerotic ulcers.

EchocardiographyVolume 20, Issue 2 p. 199-200 Cisplatin Induced Localized Aortic Thrombus Sirin Apiyasawat M.D., Sirin Apiyasawat M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorNattawut Wongpraparut M.D., Nattawut Wongpraparut M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorLaura Jacobson M.D., Laura Jacobson M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorHenry Berkowitz M.D., Henry Berkowitz M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorLarry E. Jacobs M.D., Larry E. Jacobs M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorMorris N. Kotler M.D., Morris N. Kotler M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this author Sirin Apiyasawat M.D., Sirin Apiyasawat M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorNattawut Wongpraparut M.D., Nattawut Wongpraparut M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorLaura Jacobson M.D., Laura Jacobson M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorHenry Berkowitz M.D., Henry Berkowitz M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorLarry E. Jacobs M.D., Larry E. Jacobs M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorMorris N. Kotler M.D., Morris N. Kotler M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this author First published: 10 March 2003 https://doi.org/10.1046/j.1540-8175.2003.03002.xCitations: 16 Address for correspondence and reprint requests: Morris N. Kotler, M.D., Albert Einstein Medical Center, 363 Klein Professional Building, 5401 Old York Road, Philadelphia, PA 19141. Fax: 215-456-6189. 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 Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume20, Issue2February 2003Pages 199-200 RelatedInformation

EchocardiographyVolume 19, Issue 1 p. 77-78 Paradoxical Embolism Nattawut Wongpraparut M.D., Nattawut Wongpraparut M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorManila Zaman M.D., Manila Zaman M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorNicholas Langan M.D., Nicholas Langan M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorLarry E. Jacobs M.D., Larry E. Jacobs M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorMorris N. Kotler M.D., Morris N. Kotler M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorAlyson N. Owen M.D., Alyson N. Owen M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this author Nattawut Wongpraparut M.D., Nattawut Wongpraparut M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorManila Zaman M.D., Manila Zaman M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorNicholas Langan M.D., Nicholas Langan M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorLarry E. Jacobs M.D., Larry E. Jacobs M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorMorris N. Kotler M.D., Morris N. Kotler M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorAlyson N. Owen M.D., Alyson N. Owen M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this author First published: 24 July 2003 https://doi.org/10.1046/j.1540-8175.2002.00077.xCitations: 2 Address for correspondence and reprint requests: Morris N. Kotler, M.D., Albert Einstein Medical Center, 363 Klein Professional Building, 5401 Old York Road, Philadelphia, PA 19141. Fax: 215 456-6189. AboutPDF 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 Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume19, Issue1January 2002Pages 77-78 RelatedInformation

Rapid progression of aortic stenosis was associated with 3 variables: patients on hemodialysis, those taking a calcium supplement, and those with elevated serum creatinine. Compared to patients with slow progression of aortic stenosis, rapid progressors should be followed closely with serial clinical and echocardiographic examinations.

BACKGROUND:Survival in patients with infective endocarditis (IE) ranges from 4 to 50% depending on the type of organism, the type of valve involvement and the type of treatment. METHODS:We conducted a retrospective analysis of data in hemodialysis (HD) patients at our center from 1990 to 2000. Demographics, risk factors, and outcome data were extracted in the subgroup of patients with first-episode IE diagnosed primarily by echocardiography. RESULTS:A total of 2239 patients underwent HD at our center. Thirty-two (1.4%) had IE defined using the Duke Criteria. Permanent and temporary venous dialysis catheters, arteriovenous (AV) grafts, and AV fistulae were used in 19 (59%), 12 (38%), and 1 (3%) patient respectively. Mean access duration was 7.6 +/- 7.9 months. Thirty (94%) patients had positive blood cultures, with the majority having Staphylococcus aureus bacteremia. Two (7%) patients had positive echocardiographic findings but negative blood cultures due to the commencement of empiric antibiotic therapy prior to blood cultures. The mitral valve was mainly affected. Transesophageal echocardiography was performed in 23 (72%) patients and detected an intracardiac mass in all 23 patients. One-year mortality was 56.3%. A poor 1-year prognosis was associated with presenting features of low hemoglobin, elevated leukocyte count, hypoalbuminemia, severe aortic and mitral regurgitation, and annular calcification in mitral valve IE. CONCLUSION:The prevalence of IE in HD patients is 1.4%. One-year mortality was 56.3%. Close observation is required during the first year when patients with severe valvular regurgitation and hematological abnormalities have a high mortality.

EchocardiographyVolume 18, Issue 6 p. 535-536 Dynamic Left Ventricular Outflow Tract Obstruction Complicating Acute Myocardial Infarction Nattawut Wongpraparut M.D., Nattawut Wongpraparut M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorPairoj Rerkpattanapipat M.D., Pairoj Rerkpattanapipat M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorAmitabh Rastogi M.D., Amitabh Rastogi M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorJohn H. Wertheimer M.D., John H. Wertheimer M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorLarry E. Jacobs M.D., Larry E. Jacobs M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorMorris N. Kotler M.D., Morris N. Kotler M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this author Nattawut Wongpraparut M.D., Nattawut Wongpraparut M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorPairoj Rerkpattanapipat M.D., Pairoj Rerkpattanapipat M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorAmitabh Rastogi M.D., Amitabh Rastogi M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorJohn H. Wertheimer M.D., John H. Wertheimer M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorLarry E. Jacobs M.D., Larry E. Jacobs M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorMorris N. Kotler M.D., Morris N. Kotler M.D. Echocardiography Laboratory, Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this author First published: 28 July 2003 https://doi.org/10.1046/j.1540-8175.2001.00535.x Address for correspondence and reprint requests: Morris N. Kotler, M.D., Albert Einstein Medical Center, 363 Klein Professional Building, 5401 Old York Road, Philadelphia, PA 19141. Fax: 215- 456-6189. AboutPDF 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. Volume18, Issue6August 2001Pages 535-536 RelatedInformation

The Doppler-derived mean mitral valve gradient (DeltaP(M)) based on the simplified Bernoulli equation requires computerized integration of the Doppler signal and evaluation by a technician with the use of special equipment. We have noted empirically that the DeltaP(M) can be derived by the equation DeltaP(M) = (P(P) - P(T)) / 3 + P(T). Peak (P(P)) and trough (P(T)) pressures are derived from the simplified Bernoulli equation (P = 4V(2)). This equation can be used by the experienced observer to calculate the mean mitral valve gradient without specialized equipment. The purpose of this study is to validate the above empirically derived equation in patients with mitral stenosis. We retrospectively reviewed 41 consecutive studies done at our institution from October 1, 1997, through September 30, 1998, in which mean mitral valve gradient was assessed. Each study was reviewed and the DeltaP(M), P(P), and P(T) were measured for 3 beats by using the software package on an HP Sonos 2500. DeltaP(M) was also calculated with our formula. A linear regression model was used to compare the results of the measured versus the calculated DeltaP(M). The following sub-categories were also evaluated: transthoracic studies (TTE), transesophageal studies (TEE), native valve gradients (NV), prosthetic valve gradients (PV), sinus rhythm (SR), and atrial fibrillation (AF). The results of the regression analysis of the entire population of mean versus calculated DeltaP(M) are n = 41, r = 0.99, P <.001, and standard error of the estimate (SEE) = 0.67. The regression results for the subgroups are as follows: TTE: n = 30, r = 0.99, P <.001, SEE = 0.51; TEE: n = 11, r = 0.99, P <.001, SEE = 59; NV: n = 26, r = 0.99, P <.001, SEE = 0.59; PV: n = 15, r = 0.98, P <.001, SEE = 0.84; SR: n = 23, r = 0.99, P <.001, SEE = 0.58; and AF: n = 18, r = 0.98, P <.001, SEE = 0.82. In conclusion, the simple formula that we have derived is an accurate method for calculation of mean mitral valve gradient, and it is accurate over multiple subgroups. Furthermore, the formula allows visual verification of mean mitral gradient without specialized software.

EchocardiographyVolume 18, Issue 7 p. 619-620 Biventricular Thrombi Nattawut Wongpraparut M.D., Nattawut Wongpraparut M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorSirin Apiyasawat M.D., Sirin Apiyasawat M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorLarry E. Jacobs M.D., Larry E. Jacobs M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorMorris N. Kotler M.D., Morris N. Kotler M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this author Nattawut Wongpraparut M.D., Nattawut Wongpraparut M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorSirin Apiyasawat M.D., Sirin Apiyasawat M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorLarry E. Jacobs M.D., Larry E. Jacobs M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this authorMorris N. Kotler M.D., Morris N. Kotler M.D. Division of Cardiology, Department of Medicine, Albert Einstein Medical Center, Philadelphia, PennsylvaniaSearch for more papers by this author First published: 28 July 2003 https://doi.org/10.1046/j.1540-8175.2001.00619.xCitations: 1 Address for correspondence and reprint requests: Morris N. Kotler, M.D., Albert Einstein Medical Center, 363 Klein Professional Building, 5401 Old York Road, Philadelphia, PA 19141. Fax: 215-456-6189. AboutPDF 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.Citing Literature Volume18, Issue7October 2001Pages 619-620 RelatedInformation

Clinical prediction of portopulmonary hypertension(PPHTN) is critical in the preoperative evaluation of candidates for orthotopic liver transplantation (OLT) because of its association with significant morbidity and mortality. To determine the clinical, laboratory, and echocardiographic predictors of PPHTN, we retrospectively evaluated 55 candidates before OLT From those, 8 candidates had pulmonary hypertension ([HTN] group A) and 47 candidates did not (group B). Pulmonary HTN was defined as a mean pulmonary artery pressure (PAP) of 25 mm Hg or greater and either elevated pulmonary vascular resistance or normal pulmonary artery wedge pressure. The significant predictors of PPHTN were (1) systemic arterial HTN (63% in group A v 9% in group B; P < .001), (2) loud pulmonary component of the second heart sound (38% v 2%; P = .001), (3) right ventricular (RV) heave (38% v 4%; P = .002), (4) RV dilatation by echocardiogram (63% v 0%; P < .001), (5) RV hypertrophy by echocardiogram (38% v 0%; P = .001), and (6) echocardiogram-estimated systolic PAP (SPAP) greater than 40 mm Hg (63% v 2%; P < .001). The sensitivity of these variables for the detection of pulmonary HTN ranges from 37% to 63%, and their specificity from 91% to 100%. We conclude that several clinical and echocardiographic features are significantly associated with pulmonary HTN in patients with cirrhosis. In particular, echocardiogram-estimated SPAP greater than 40 mm Hg is strongly associated with pulmonary HTN and is specific. These predictors, however, are not sensitive enough to identify all the patients with PPHTN. Therefore, the evaluation of a combination of these variables may be useful for the preoperative identification of pulmonary HTN in liver transplant candidates.

Acquired immunodeficiency syndrome is a serious problem worldwide. Recent advances in the knowledge about human immunodeficiency virus (HIV) replication and the treatment of HIV infection have improved survival in HIV patients. Because of the longer survival in HIV patients, the more manifestations of late-stage HIV infection will be seen, including HIV-related cardiac diseases. The common cardiac manifestations in patients with the acquired immunodeficiency virus are pericardial effusion, myocarditis, dilated cardiomyopathy, endocarditis, pulmonary hypertension, malignant neoplasms, and drug-related cardiotoxicity. This review focuses on these cardiac manifestations in patients with the acquired immunodeficiency syndrome.

Aortic intramural hematoma (IMH) is a clinical condition that has still not been completely defined. We conducted a meta-analysis of reported cases and analyzed the demographic profiles, imaging modalities, pathologic sites, and treatment strategies in relation to outcome in 143 patients with IMH. We performed an English language search of Medline for manuscripts with the keywords "aortic diseases," "aorta AND hematoma," and "intramural hematoma." Data from 143 reported cases were extracted. IMH of the aorta has a reported incidence of 5% to 20% among patients with acute aortic syndromes and a mortality rate of 21%. Most patients were men (61%) and median age was 68 years (range 15 to 88). Hypertension was a predisposing factor in 53% of the patients. Most patients had chest and/or back pain (80%). Transesophageal echocardiography, computer tomographic scan, or magnetic resonance imaging may be effectively used to diagnose this condition. There is no difference in the overall mortality rates in Stanford type A versus type B patients. Patients with Stanford type A IMH who underwent surgery, compared with those who underwent medical management, had a significantly better prognosis (14% vs 36% mortality, respectively, p <0.02). Patients in Stanford group A who received medical treatment had a higher mortality rate than those in group B who received medical treatment (36% vs 14% mortality respectively, p <0.02). In type B patients, medical and surgical outcomes were similar.