Background
It has been shown that pulsed wave tissue Doppler velocities of mitral annulus correlate well with left ventricular (LV) diastolic and systolic functions. It is not yet clear whether these ...velocities can be used to estimate left ventricular dysfunction in an unselected population of patients with clinical signs and symptoms of heart failure (HF).
Aim
To determine whether LV mitral annulus velocities measured by tissue Doppler imaging (TDI) correlate with plasma N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) levels in patients with HF.
Methods and results
Early diastolic (Em) and systolic (Sm) TDI velocities of septal and lateral mitral annulus were measured in 50 patients with HF together with other conventional echocardiographic parameters, and compared with plasma NT‐proBNP levels. Significant correlations were found between NT‐proBNP level and Em velocity (r=−0.79), Sm velocity (r=−0.43), early transmitral to Em velocity ratio (r=0.38), LV end diastolic diameter (r=0.29), LV ejection fraction (r=−0.44) and tricuspid regurgitant velocity (r=0.31). In multiple regression model (R2=0.733), the Em velocity was the most important predictor of NT‐proBNP level.
Conclusions
Early diastolic mitral annulus velocity measured by TDI correlates strongly with plasma NT‐proBNP levels, and provides a simple, accurate and reproducible echocardiographic index of heart failure.
Following the diagnosis of Fabry disease in a 45-year-old male, in 31 family members alpha-galactosidase A (alpha-Gal) activity in leucocytes was measured and mutation analysis of the alpha-Gal gene ...was performed. In the proband, the unique mutation A10523G/N272S in exon 6 was found, which was subsequently detected in seven males (of which one twin) and 10 female subjects. All males showed decreased to absent alpha-Gal A activity in leucocytes, but three out of 10 female subjects had alpha-Gal A activities within normal range. Although all male patients had symptoms of classical Fabry disease, such as acroparesthesias, hypohydrosis and heat-intolerance, there was considerable variability in organ involvement, especially in deterioration of renal function. Detailed studies of large families with Fabry disease may give insight into factors that influence the phenotype of this disorder.
Summary
Culture-negative endocarditis accounts for 2.5–31% of all endocarditis cases and remains a diagnostic and therapeutic challenge.
Bartonella
spp. has only recently been recognized as an ...important cause of culture-negative endocarditis. We report a case of
Bartonella henselae
endocarditis occurring in an immunocompetent man who owned a cat and had previously been diagnosed with valvulopathy. Diagnosis was made only after prolonged diagnostic work-up with serology and with PCR and subsequent sequencing to identify the microorganism in the excised valves. The duration of treatment in patients with bartonella endocarditis is not clearly defined, and we decided to treat our patient with a prolonged course of antibiotic. Surgical treatment is usually necessary and was also successful in our patient. To our knowledge, this is the first case of bartonella endocarditis occurring in our geographic area.
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