Chronic pericarditis mimicking a pericardial neoplastic mass.

and prognostic value of Doppler echocardiographic coronary flow reserve in the left anterior descending artery in hypertensive and normotensive patients. Tissue Doppler imaging: a new prog-nosticator for cardiovascular diseases. Georgoula G et al. Incremental value of pulse wave velocity in the determination of coronary microcirculatory dysfunction in never-treated patients with essential hypertension. The non-invasive documentation of coronary microcirculation impairment: role of transthoracic echocardiography. imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. impairment of coronary flow reserve and increase in minimum coronary resistance in borderline hypertensive patients. Mitral annular descent velocity by tissue Doppler echocardiography as an index of global left ventricular function. Independent association of coronary flow reserve with left ventricular relaxation and filling pressure in arterial hypertension. Structural analysis of arteriolar and myocardial remodelling in the subendocardial region of patients with hyperten-sive heart disease and hypertrophic cardiomyopathy. Longitudinal systolic shortening of the left ventricle: an echocardiographic study in subjects with and without preserved global function. of coronary flow reserve impairment in human hypertension: an integrated approach by transthoracic and transesophageal echocardiography. Reduced left ventricular functional reserve in hypertensive patients with preserved function at rest. Tissue velocity echo-cardiography shows early improvement in diastolic function with irbesartan and atenolol therapy in patients with hypertensive left ventricular hypertrophy. Incremental predictive value of carotid intima-media thickness to arterial stiffness for impaired coronary flow reserve in untreated hypertensives. A 57-year-old man with a previous history of myocardial infarction was admitted to the emergency department complaining of chest pain, mild dyspnoea, and lower limb oedema. Serum troponin levels were normal. Computed tomography (Panel A) excluded any acute aortic or pulmonary pathology, but detected mitral annular calcification (black arrow), coronary artery calcifications (black arrow-head), and a large, non-enhancing intrapericardial mass (asterisk) with peripheral calcifications. The lesion appeared to be hypoechoic on trans-thoracic echocardiography and determined left ventricular compression with mild inflow and outflow obstructions. Doppler recordings showed partial respiratory interdependence of transmitral/transtricuspid flows. On magnetic resonance (Panels B and C, see Supplementary data, Figure S1), the pericardial mass presented signal characteristics (patchy hyperintensity in T 1-weighted, T 2-weighted, and post-contrast images) typical of chronic inflammation. Besides mild left ventricular inflow and outflow obstructions (see Supplementary data, Movies S1 and S2), the right ventricular pericardial thickening (white arrow) and early-diastolic interventricular septal flattening suggested global pericardial constriction. Cardiac catheterization revealed right coronary artery chronic occlusion, left anterior descending artery stenosis, …