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Plutonium zwierleini is a large plutoniumid centipede of great evolutionary interest, occurring with isolated populations along the western Mediterranean area, from Spain to Italy. Due to its rarity and the extreme paucity of available records, P. zwierleini is among the least known Mediterranean chilopods, and scarce information is currently available on its ecology and natural history. Based on an extensive sampling effort carried out in Sicily between 2022 and 2023, we here provide additional occurrence localities for the species across Sicily, and new insights into its ecology. Overall, 29 novel Sicilian records of P. zwierleini, scattered across 21 localities, were collected thus increasing its known Sicilian distribution area by 117%, and the number of localities by 110%. The species was found in a wide range of habitats such as open areas, woods, buildings, and caves, characterizing Plutonium zwierleini as a habitat generalist, whose fine ecological preferenda need to be further explored. Moreover, to explore the diet and behaviour of the species, some specimens were kept in captivity. The captive individuals fed mostly on dead or poorly mobile soft-bodied prey and inert food, without ever displaying predatory behaviour; this suggests that, contrarily to what is currently assumed, P. zwierleini might be a scavenger rather than a predator. The potential distribution of Plutonium zwierleini in Sicily was inferred based on georeferenced occurrence records and climatic variables. The implemented MaxEnt model forecasts the possible occurrence of P. zwierleini on the whole island, with the single exception of its south-easternmost part, possibly due to the local pattern of precipitation seasonality. We hope that the present work might pave the way for further surveys aimed at a better understanding of the ecology of Plutonium zwierleini and the collection of new data in the other regions inhabited by this secretive species. [ABSTRACT FROM AUTHOR]

Background Left ventricular dilatation and a low ejection fraction after acute myocardial infarction are independent indicators of a poor prognosis. ACE inhibitors have been shown to decrease left ventricular dilatation after myocardial infarction. In the GISSI-3 trial, patients were randomlyassigned, within 24 h of onset of myocardial infarction symptoms, to 6 weeks of treatment with lisinopril, nitroglycerin, both or neither, in an open, 2 × 2 factorial design. The study showed that early treatment in relatively unselected patients with lisinopril decreases mortality at 6 weeks and severe left ventricular dysfunction. We assessed (1) the prognostic value of pre-discharge 2-D echocardiographic variables, and (2) the effects of lisinopril on the progression of left ventricular dilatation. Methods and results 2-D echocardiograms were available pre-discharge in 8619 GISSI-3 trial patients discharged alive. In 6405 of these patients, a 2-D echocardiographic study was also available at 6 weeks, and at 6 months. Pre-discharge end-diastolic and end-systolic volumes, and ejection fraction predicted 6-month mortality and non-fatal clinical congestive heart failure (P<0.01). The increase in left ventricular volumes over time was significantly reduced by 6 weeks' lisinopril treatment in patients with wall motion asynergy pre-discharge of ≥27%. Patients with wall motion asynergy <27% showed no dilatation and lisinopril did not affect volumes at 6 months. Patients randomized to lisinopril also had smaller volumes after withdrawal of treatment at 6 weeks. Lisinopril did not affect left ventricular ejection fraction. Conclusions 2-D echocardiography independently contributes to pre-discharge risk stratification in terms of 6-month mortality and clinical heart failure after myocardial infarction, and early, short-term treatment with lisinopril in unselected myocardial infarction patients attenuates left ventricular dilatation; an effect evident in patients with larger infarcts. These results probably only partly explain the effect of lisinopril on total mortality concentrated in the first week after infarction. [ABSTRACT FROM PUBLISHER]

Apical hypertrophic cardiomyopathy (AHCM) is characterized by primary hypertrophy localized exclusively in the apex of the left ventricle. Previous studies have indicated that AHCM results in a unique combination of cross-sectional echocardiographic (CSE) and ECG findings (‘giant’ Twave inversion and high R wave voltage in the precordial leads). The aims of this study were: (1) to assess the degree of AHCM in a quantitative fashion (2) to evaluate the possible relationship between apical hypertrophy, quantitatively determined, and ECG findings in patients with AHCM (3) to verify the changes in echocardiographic and ECG parameters over time (4) to define the relationship between the severity of AHCM and the clinical course of such patients. Eleven selected patients with AHCM were studied for an average 6 year follow-up period; there were seven men and four women (age from 18 to 62 years, mean 49). Apical hypertrophy was assessed quantitatively by determining the muscle cross-sectional area in the apical region, which was considered an index of myocardial mass. From the end-diastolic apical four chamber view, endocardial and epicardial contours were digitized in order to obtain the total muscle cross-sectional area of the left ventricle. The walls of the left ventricle were then divided into three regions (basal, intermediate, apical). The final value of each cross-sectional muscle area was obtained from the mean measurements of four independent and blinded observers. In AHCM the apical muscle cross-sectional area (AMA) ranged from 10.3 to 17.9 cm, mean 13.2 ±2.6 cm. The comparison between CSE and ECG findings showed that patients with giant negative T wave inversions (T wave >10 mm) and high R wave voltages (R wave >25 mm) had a more severe degree of apical hypertrophy. However, there was incomplete agreement between CSE and ECG findings. During follow-up, negative T wave amplitude increased from 8.5 ±3.4 to 11.9 ±3.6 mm (mean 4.2 ±2.7) in 10 patients (P>0.01) and there was a mild increase of precordial R wave (from 28.0 ±5.9 to 29.3 ± 5.2 mm, mean 1.5 ± 1.6) (P−ns). The AMA change over time, from 13.2 ± 26 to 13.8 ± 2.3 was not significant. All patients were alive at the most recent evaluation, and witliout significant symptomatic deterioration. This study demonstrates a wide spectrum in the degree of severity of apical hypertrophy among patients with AHCM. Furthermore, ECG findings are not uniform and are not significantly related to the severity of the hypertrophy itself Therefore, AHCM should be considered as a part of the morphological spectrum of hypertrophic cardiomyopathy rather than a separate entity with univocal CSE and ECG findings. Follow-up data indicate that despite ECG results worsening over time, a significant progression in apical left ventricular wall thickness does not occur. Changes in negative T wave amplitude are not related to symptoms and are not predictive of the functional severity of AHCM. Finally, the clinical outcome of patients with AHCM seems not be dependent on the entity of apical hypertrophy. [ABSTRACT FROM PUBLISHER]

The effect of atrial fibrillation on pulmonary venous flow patterns is still not well known. Twenty-four patients in atrial fibrillation and 21 patients in sinus rhythm were studied by transoesophageal echocardiography. In ninety-five percent (20/21) of sinus rhythm patients, the early systolic wave due to atrial relaxation or reverse wave due to atrial contraction could be distinguished on pulsed Doppler tracings by transoesophageal echocardiography. However, there was no early systolic wave and/or reverse at the end of diastole in any atrial fibrillation patients. In atrial fibrillation patients without mitral regurgitation (n = 14), the onset of systolic flow was delayed (165±38 vs 50±46 ms, < 0.05), and systolic peak velocities, time-velocity integrals and systolic fractions were reduced (31 ± 13 vs 54±17 cm.s, < 0.05; 5 ± 2 vs 13 ± 6 cm, < 0.05 and 36 ± 8 vs 61±15%, P < 0.05, respectively) as compared to those in sinus rhythm. Significant mitral regurgitation (n = 10) reduced systolic velocity parameters considerably in atrial fibrillation patients but the diastolic flow parameters were not significantly different between sinus rhythm and atrial fibrillation patients. Stepwise multiple regression analysis identified atrial fibrillation as an important independent predictor for changes in systolic flow parameters. The R-R interval is also an important factor for diastolic flow parameters. Thus, the present study demonstrates that atrial fibrillation significantly modifies pulmonary venous flow pattern and is an important factor for systolic flow parameters. Significant mitral regurgitation can further modify systolic flow pattern in atrial fibrillation patients. [ABSTRACT FROM PUBLISHER]

Free jets were compared in vitro by colour Doppler flow mapping with jets striking a flat and a hemispherical surface, located 3 and 6 cm from a circular orifice (5 mm in diameter). The angles of the impinging jets were 45° and 90°. Flow rates from 6–52 ml. s were tested (pulsatile jets, 0.5 s duration). Free jet areas (21.7±9.6 cm) were larger (P<0.01) than that of impinging jets (14.3± 5.6 cm). The distance of the target was a significant factor for reducing areas of striking jets (P< 0.001). The angle of incidence of the striking jet and the shape of the target surface were not independent factors, but they were important when interacting with flow rate (P<0.001). The percentage of total jet area of impinging jets occupied by swirling flow was larger for targets located at 3 cm (P<0.01), for a 90° angle of incidence (P <0.01), for a flat target surface (P<0.05). We conclude that jets visualized in vitro by colour Doppler flow mapping are significantly modified when impinging a surface, with the interplay of several factors. This can be of importance in clinical settings. [ABSTRACT FROM PUBLISHER]

Colour Doppler flow mapping (CD) has proved to be a very sensitive and specific means of diagnosing valvular regurgitation and obtaining a rapid semiquantitative estimation of the severity of regurgitation itself. We tried to compare a semiquantitative evaluation of aortic and mitral regurgitation, without time-consuming calculations of regurgitant jet areas, with the conventional visual semiquantitative angiographic estimation. We have also evaluated in detail the interobserver variability of this type of semiquantitation. Two independent observers (OB) have reviewed CD studies of a selected group of 47 consecutive patients who underwent both cineventriculography and aortography for aortic regurgitalion (AR) and/or mitral regurgitation (MR), then graded as mild, moderate or severe. AtCD, AR and MR were classified as present or absent and graded as mild, moderate or severe. The following interobserver percentage agreements were noted for AR presence or absence, AR grade, MR presence or absence, MR grade, respectively: 96%, 83%, 96%, 83%. Likewise, the respective echo-angio agreements were 90%, 58%, 80%, 70%. Agreement was significant (P<0.001) in all cases. Thus, good interobserver and echo-angio agreement was found in the CD assessment of AR and MR. However, under- or over estimation of CD vs. angio was noted in several cases (mostly by one grade). Underestimation of CD vs. angio was 27% for AR and 18.5% for MR; overestimation of CD vs. angio was 15% for AR and 11.5% for MR. CD has proved to be a useful technique not only for the qualitative but also for the semiquantitative evaluation of aortic and mitral regurgitation, as assessed in the same subjects, with good interobserver agreement. The disagreement between CD and angio has been generally by one grade of severity and is probably due mainly to the different type of information given by the two techniques. [ABSTRACT FROM PUBLISHER]

The influence of aortic regurgitation on the Doppler assessment of pressure half-time (T) and on the derived calculation of the mitral-valve area has not yet been adequately evaluated in patients with mitral stenosis and associated aortic regurgitation. Therefore this study was undertaken to verify the accuracy of the T method for the noninvasive estimation of mitral-valve area in patients with mitral stenosis and associated aortic regurgitation. Data were obtained from 31 selected patients who underwent cardiac catheterization within 24 h of the noninvasive examination. From the Doppler velocity curve, T was calculated as the interval between the peak transmitral velocity and velocity/. Mitral-valve area was measured from the T with a computerized system using the equation: 220/T, in cm. Calculation of the mitral-valve area at catheterization was derived applying the modified Gorlin formula. Mean mitral-valve area, as determined at catheterization, ranged from 0.5 to 2.8 cm (1.3±0.6). Mean mitral-valve area, as calculated by continuous-wave Doppler, ranged from 0.7 to 2.7 cm (1.5 ± 0.6). Linear-regression analysis of data revealed a good correlation between Gorlin and Doppler measurements of the mitral-valve area (r = 0.90, SEE = 0.28 cm, <0.001, = 1.0 + 0.2). Doppler showed a systematic overestimate of the mitral-valve area (26%) in patients with mitral stenosis and aortic regurgitation as compared to the Gorlin formula. The overestimate of continuous-wave Doppler was even greater (39%) in a subgroup of patients with 2 + or 3 + angiographic aortic regurgitation. Thus the Doppler T method still provides accurate noninvasive estimates of mitral-valve area in patients with mitral stenosis and associated aortic regurgitation. However, when the degree of aortic regurgitation is significant, Doppler can lead to important overestimation of the mitral orifice size. [ABSTRACT FROM PUBLISHER]

The feasibility and the intrinsic variability of six different methods of echocardiographic and Doppler flow determination of cardiac output were analysed in 34 healthy volunteers. Four were excluded because of poor quality echocardiograms. The mean (range) age of the remaining 30 (12 women, 18 men) was 21 years (13-36 years). Cardiac output was calculated by six methods as a product of echocardiographically determined cross sectional area of the aorta (apical and suprasternal views), pulmonary trunk, tricuspid annulus, and mitral annulus (circular and corrected for diastolic variations), and the flow velocity integral measured by Doppler. Cardiac output ranged from 2.79 to 6.56 1/min (4.45 (1.29) 1/min) (mean (SD)). The feasibility of the methods ranged from 87% (26 patients) for the aorta from the suprasternal notch to 100% (30 patients) for the mitral orifice corrected for diastolic variations and for the tricuspid valve. The corresponding results for all 34 individuals were 76% and 88% respectively. Three way analysis of variance was performed in the 23 healthy volunteers in whom all six methods were feasible. Interobserver and intraobserver interpretative variabilities were 6.8% and 5.9% respectively. The intrinsic variability of each single measurement of cardiac output, independently of the observer and the method used, was 25%. Provided the image was suitable for analysis echocardiographic and Doppler flow determination of cardiac output was feasible in most healthy volunteers. But there was significant intrinsic variability for each of different methods. A single value of cardiac output in an individual should be interpreted with caution. [ABSTRACT FROM PUBLISHER]

We studied by cross-sectional echocardiography seven patients affected by idiopathic haemochromatosis without clinical signs of heart failure. In two patients the heart muscle showed a peculiar echocardiographic texture at the level of the endocardium. No differences were noticed in clinical and haematological findings of the patients with and without abnormal texture. Increased echogenicity of the subendocardial myocardium should be looked for in patients with idiopathic haemochromatosis. [ABSTRACT FROM PUBLISHER]

An excessive alcohol intake has been reported as one of the possible causes or risk factors of ‘alcoholic cardiomyopathy’. The possibility that this cardiomyopathy may improve or even reverse if the alcohol abuse has been terminated has been suggested, but unequivocal echocardiographic documentation of this improvement has never been described. This study reports the normalization of cardiac chamber dimensions and of variables of left ventricular function documented by M-mode and cross-sectional echocardiographic follow-up studies, after cessation of excessive consumption of alcohol, in three cases of alcoholic cardiomyopathy. [ABSTRACT FROM PUBLISHER]

The intraobserver, interobserver and beat to beat interpretative reproducibility of two-dimensional echocardiographic images of the mitral valve area has been studied retrospectively in a group of 37 patients affected by rheumatic mitral valve disease. Reproducibility has been expressed either in terms of mean absolute or percent error of duplicate measurements. A group of 11 normal subjects was used for comparison. In our normal group the intraobserver, interobserver and beat to beat reproducibility averaged 1.8±2.1%, 3.1±1.4%, 2.7±2.0% or 0.12± 0.14 cm, 0.21±0.10cm, 0.17±0.13 cm, respectively. In our patient population the intraobserver, interobserver and beat to beat reproducibility averaged 2.7±2.7%, 4.1±4.9%, 4.6± 3.6% or 0.05±0.05 cm, 0.08± 0.10cm, 0.08±0.06cm. In both groups there was no statistical difference among intraobserver, interobserver and beat to beat reproducibility either in terms of percent or absolute value. The mean percent error did not significantly differ between normal or stenotic valves or, in this latter group, among valves of different sizes (≤1.4cm; 1.5–2.4 cm; 2.5 cm). The mean absolute error, on the contrary, statistically differed between the two groups or among valves of different sizes, being larger in normals or in valves ≥1.5 cm. Thus, the interpretative reproducibility for two-dimensional echocardiographic images of the mitral valve area is small and acceptable for most clinical purposes. The use of mean percent error of duplicate measurements makes the quantification of reproducibility easily comprehensible in clinical practice and insensitive to the actual cross sectional area of the structure examined thus allowing the data to be extended to cardiac structures of different sizes. [ABSTRACT FROM PUBLISHER]

In this paper, we report a case of dilated cardiomyopathy with right atrial thrombi and pulmonary artery thromboemboli, in which regression of thromboemboli followed fibrinolytic therapy, and normalization of left ventricular dimensions and function were documented at echocardiographic follow-up. The important role of transoesophageal echocardiography in diagnosis and follow-up of right intracavitary masses and thromboemboli in the main pulmonary arteries is discussed, as is the role of echocardiography in follow-up of cardiomyopathy. [ABSTRACT FROM PUBLISHER]

The variability of the interpretation by two individuals of a combined echocardiographic and Doppler method of calculating output was studied in 30 normal adults. In each subject three separate cardiac cycles were recorded to calculate maximal mitral valve orifice, the ratio of mean to maximal mitral valve leaflet separation, and the mean flow velocity through the mitral valve. The recordings were digitised twice by two independent observers. Estimates of cardiac output ranged from 3.2 to 8.11 1/min. Analysis of variance showed that interobserver and intraobserver variability for these measurements was 5.8% and 6.1% respectively. It is concluded that the reproducibility for interpreting this non-invasive method is adequate for clinical use in adults with cardiac outputs within the normal range. [ABSTRACT FROM PUBLISHER]

Right atrial thrombosis is a rare complication of permanent endocardial pacing. We report two cases with large right atrial thrombi which occurred during permanent endocardial electrical stimulation. Both patients were women, aged 83 and 89 years, who died suddenly, respectively, one month and 24 days after pacemaker implantation. At the time of death the two patients were in severe persistent refractory congestive heart failure despite appropriate medical treatment. At necropsy large mobile right atrial thrombi were found in both cases. [ABSTRACT FROM PUBLISHER]

An abstract of the article "The Pattern of Right Ventricular Function Recovery After Acute Myocardial Infarction, As Assessed by Serial Echocardiographic Follow-Up: The GISSI-3 Echo Substudy" by B. A. Popescu and colleagues is presented.

An abstract of the article "Long-Term Clinical and Echocardiographic Follow-Up After Biventricular Pacing in Patients With Severe Heart Failure" by B. A. Popescu and colleagues is presented.

An abstract of the article "Left atrial remodeling after acute myocardial infarction in a low risk population. The GISSI-3 Echo Substudy" by B. A. Popescu, F. Macor, F. Antonini-Canterin, P. Giannuzzi, P. L. Temporelli, R. Piazza, E. Cervesato, and G. L. Nicolosi is presented.

An abstract of the article "Effect of statins on the progression of aortic valve sclerosis and aortic valve stenosis: a long-term echocardiographic study" by F. Antonini-Canterin and colleagues is presented.

An abstract of the article "Reliability of a new simplified echocardiographic index in assessing the effective orifice area of bioprosthetic aortic valves," by F. Antonini-Canterin and colleagues is presented.