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In conclusion, this study demonstrates, in an animal model, that analysis of the digitized two-dimensional echocardiogram may detect the acute changes in mean gray level (occurring as early as 30 minutes after coronary artery ligation) caused by myocardial ischemia. The clinical application of our findings to humans requires further study.

This study showed that (1) the prevalence of MVP in patients with Wolff-Parkinson-White syndrome and AV nodal reentrant tachycardia was similar to that of the general population; (2) the location of accessory pathways was not related to the presence of MVP; and (3) MVP was persistently present after elimination of preexcitation. These findings suggest that MVP may have an independent association with PSVT. The study limitations are: (1) Acquisition bias should be noted because the prevalence of PSVT in patients found to have MVP was not obtained. (2) Comparison between patients with PSVT and an ageand sex-matched population sample in whom MVP was assessed by identical methods was not performed; thus, the association between MVP and this family of arrhythmias was not obtained. Furthermore, the higher prevalence of MVP in patients with both accessory pathway-mediated and AV nodal reentrant tachycardia must be reassessed.

Mitral regurgitation (MR) was evaluated by Doppler echocardiography in 59 patients with mitral stenosis before, immediately after and 1 year after balloon mitral valvuloplasty (BMV). The severity of MR was graded on a scale from 1+ to 4+. Echocardiographic and hemodynamic variables were analyzed to study the potential factor(s) that might predict the long-term persistence of MR. Echocardiographic variables were mitral valve thickness and motion, subvalvular change, left atrial dimension, commissural calcification and effective balloon/mitral anular diameters. Hemodynamic variables were mitral pressure gradient, pulmonary arterial pressure, ejection fraction, mitral valve area index, age, gender and cardiac rhythm. Mitral valve area index increased from 0.9 +/- 0.5 to 1.5 +/- 0.8 cm2/m2 immediately after BMW, and to 1.4 +/- 0.3 cm2/m2 at 1 year follow-up (p less than 0.01). Immediately after BMV, MR grading did not change in 30 patients (51%), increased by 1+ in 23 patients (39%), by 2+ in 2 patients (3.3%) and by 3+ in 2 patients (3.3%), and decreased by 1+ in 2 others. At 1-year follow-up, only 1 patient with severe MR required valve replacement. Fifty-one patients (88%) had no change in the extent of MR (less than or equal to 1+) and 6 patients (10%) had a 1-grade decrease in their MR; only 1 patient had a 1-grade increase in MR. No clinical or hemodynamic variables or morphologic characteristics of the mitral valve could predict the development of significant MR after BMV. It is concluded that an increment in MR severity less than or equal to 2+ is frequently seen after BMV.(ABSTRACT TRUNCATED AT 250 WORDS)