Research in context panel: 445Identifying people at highest risk of ICH may facilitate timely and accurate prognostication to allow mitigation of reversible risk factors for bleeding (e.g. intensive blood pressure control), and selection of participants for clinical trials. While more complex combinations of clinical, biochemical, and radiological markers might further improve stroke risk prediction, balancing accuracy with simplicity will remain important.

This study was carried out to establish a reference table of echocardiographic values for the left ventricle of simple d-transposition of the great arteries (d-TGA) and to determine at what age left ventricular dimensions in these patients become different from those of a normal population. Fifty-three patients with d-TGA and normal pulmonary pressure and 395 normal children ages 1 day to 10 years were studied by M-mode echocardiography. Results show that in d-TGA, left ventricular systolic and diastolic internal diameters are normal at birth. After 1 month, however, both diameters were below normal and despite a progressive increase with age, the mean values were always below normal. The mean posterior wall thickness of patients with d-TGA was also normal at birth but did not increase with age (2.3 mm in diastole and 4.3 mm in systole) and became significantly thinner than normal at 10 months of age in diastole and 7 months in systole. Septal thickness of patients with d-TGA did not differ from that of the control group. The shortening fraction and mean velocity of circumferential fiber shortening were significantly greater in d-TGA at all ages. Left ventricular measurements related to age are presented and should be of help in interpreting M-mode echocardiograms of patients with d-TGA.

No abstract

We evaluated the effect of verapamil therapy on left ventricular hypertrophy and left ventricular diastolic function in 13 patients with mild to moderate hypertension. Left ventricular hypertrophy was determined by M-mode echocardiographic measurements of interventricular septal thickness (IVST), posterior wall thickness (PWT) and left ventricular mass index (LVMI) both before (T0) and after 3 months (T3) of verapamil therapy. Left ventricular diastolic transmitral flow was measured by pulsed Doppler indices of early (E) and atrial (A) velocity, E/A ratio, total area (Ta), A area (Aa), Aa/Ta ratio, E-pressure half-time (E-PHT). A-pressure half-time (A-PHT) and E-PHT/A-PHT ratio both before and after 3 months of verapamil therapy. No significant changes occurred in mean heart rate, systolic function or body weight. We conclude that 3 months' therapy with verapamil resulted in an improvement in left ventricular hypertrophy and left ventricular diastolic function and a normalization of blood pressure, without a corresponding deterioration in left ventricular systolic function.

We evaluated the effect of verapamil therapy on left ventricular hypertrophy and left ventricular diastolic function in 13 patients with mild to moderate hypertension. Left ventricular hypertrophy was determined by M-mode echocardiographic measurements of interventricular septal thickness (IVST), posterior wall thickness (PWT) and left ventricular mass index (LVMI) both before (T0) and after 3 months (T3) of verapamil therapy. Left ventricular diastolic transmitral flow was measured by pulsed Doppler indices of early (E) and atrial (A) velocity, E/A ratio, total area (Ta), A area (Aa), Aa/Ta ratio, E-pressure half-time (E-PHT). A-pressure half-time (A-PHT) and E-PHT/A-PHT ratio both before and after 3 months of verapamil therapy. No significant changes occurred in mean heart rate, systolic function or body weight. We conclude that 3 months' therapy with verapamil resulted in an improvement in left ventricular hypertrophy and left ventricular diastolic function and a normalization of blood pressure, without a corresponding deterioration in left ventricular systolic function.