ECHOCARDIOLOGY SELECTED PAPERS

PRESENTED DURING THE THIRD SYMPOSIUM AT ERASMUS UNIVERSITY, ROTTERDAM, JUNE 20-22, 1979

INTERUNIVERSITY INSTITUTE OF CARDIOLOGY, AMSTERDAM

DEVELOPMENTS IN CARDIOVASCULAR MEDICINE

VOLUME 1

ECHOCARDIOLOGY

Edited by

CHARLES T. LANCEE Thoraxcenter, Erasmus University, Rotterdam

•.. -.

: ~ ~ : 1979

MARTINUS NIJHOFF PUBLISHERS

THE HAGUE / BOSTON / LONDON

The distribution of this book is handled by the following team of publishers:

for the United States and Canada

Kluwer Boston, Inc. 160 Old Derby Street Hingham, MA 02043 U.S.A.

for all other countries

Kluwer Academic Publishers Group Distribution Center P.O. Box 322 3300 AH Dordrecht The Netherlands

Library of Congress Cataloging in Publication Data

Main entry under title:

Echocardiology.

Bibliography: p. Includes index. 1. Ultrasonic cardiography - Congresses.

2. Heart - Diseases Diagnosis- Congresses. I. Lancee, Charles T. II. Erasmus Universiteit. RC683.5.U5E25 616.1'2'0754 79-13045

ISBN-t3: 978-94-009-9326-6 e-ISBN-t3: 978-94-009-9324-2 DOl: to.t0071 978-94-009-9324-2

Copyright © 1979 by Martinus Nijhoff Publishers by, The Hague Softcover reprint of the hardcover 1 st edition 1979 AI! rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, mechanical, photocopying, recording, or otherwise, without the prior written permission ()fthe publisher, Martinus Nijhoff Publishers bu, P.O. Box 566, 2501 CN The Hague, The Netherlands.

FOREWORD

This Symposium is the third of a series of scientific meetings in the field of echocardiology, held at the Erasmus University Rotterdam. * The series was initiated by Klaas Born, who organized the first two meetings with great success. These followed the procedure of two days of parallel sessions with invited speakers only.

This time, we decided to broaden the basis of the meeting and have a three-day program of parallel sessions, combining invited papers, free com­munications and posters.

We decided, however, to maintain one of the most striking features of the last meeting- having the complete proceedings available at the time of the meeting. We confronted the authors-to-be with a very tight schedule in order to make the book a true reflection of the state of the art in echocardiology. As a 'result, editing time was also very limited and neither terminology nor units have been completely standardized.

This book has three main parts. The first, and largest, part consists of contributions on echocardiology in adults, and is divided into four sections. The first section is a general survey of various applications, whereas the remaining three centre round specific applications, i.e. ischemic disease, left ventricular function and cardiac valves, respectively. The second part con­tains applications in pediatric cardiology; due to the wide variety of topics covered, no particular subdivision has been made. The last part of the book is devoted to instrumentation, methods and new developments.

This symposium was organized in association with Interuniversity Institute of Cardiology, Amsterdam, the Netherlands Dutch Society of Ultrasound in Medicine and Biology Dutch Heart Foundation, the Hague, the Netherlands European Society of Cardiology

Financial support was given by Interuniversity Institute of Cardiology, Amsterdam, the Netherlands

- University-fund Rotterdam Foundation, Rotterdam, the Netherlands.

Rotterdam, June 1979 CHARLES T. LANCEE

*The second symposium has been published as: N. Born (ed.), Echocardiology. Martinus Nijhoff Publishers, The Hague/Boston/London, 1977.

ACKNOWLEDGEMENTS

A book of this size is naturally the work of a large team. First of all, I wish to express my gratitude and my admiration for all the lecturers who provided me with their carefully prepared manuscripts, in some cases at very short notice. My colleagues of the organizing committee, Klaas Born, Jos Roelandt, Hans Rijsterborgh and Paul Hugenholtz were always available for assistance and advice. for which I am very grateful.

I am especially indebted to Mary Rose Hoare who, although educated in the field of computers and mathematics, contributed heavily to the reviewing and correcting of the material.

Furthermore, I have to thank our secretaries, Corrie de Bruijn, Ineke van Lieshout and Ria Willemstein, for their continuous good humour, in spite of the endless stream of rush jobs that goes along with the creation of a book like this.

Thanks are due to Len van der Wal, Olchert Bastiaans, Ad van der Schoot and Adri Duijndam who spent hours on the preparation of the list of contributors.

Finally, I would like to pay a special tribute to my wife Saskia, who not only cheerfully accepted my rather unsocial behaviour during the prepara­tion time of the Symposium, but also stimulated me in every possible way.

CHARLES T. LANCEE

CONTENTS

Foreword v

Acknowledgements VlI

Contributors xv

I. ECHOCARDIOLOGY IN ADULTS

A. GENERAL APPLICATIONS

A.E. AUBERT, B. DENEF, F. VAN DE WERF, and H. KESTELOOT / Echo-mechanocardiographic assessment of cardiac dynamics 5

D.W. BAKER / A comprehensive approach to cardiac measurements 15

D.G. GIBSON / The contribution of digitized echocardiog-raphy to clinical cardiology 29

JA KISSLO / Usefulness of M-mode and cross-sectional echo-cardiography for analysis of right-sided heart disease 37

J. LUBSEN / Determination and consequences of bias and ran-dom error in echocardiographic measurements 49

R.S. RENEMAN, J.J.F. SCHMITZ, L.H.E.H. SNOECKX, and J.A.c. LAMBREGTS / Differences in the echocardiographic dimensions of the heart between females and males 53

P.D.V. BOURDILLON, R.A. FOALE, and A.F. RICKARDS /

Assessment of atrial septal defects by cross-sectional echo-cardiography 61

B. DENEF, F. VAN DE WERF, H. DE GEEST, and H. KESTELOOT /

A combined echocardiographic and phonocardiographic study on the genesis of diastolic heart sounds 67

G. GULLACE / Subxiphoid versus standard M-mode echocardiog-raphy 73

D.S. TUNSTALL PEDOE, P.C. MACPHERSON, and S.J. MELDRUM / Absolute intracardiac blood velocities mea­sured with continuous wave Doppler and a new real-time spectral display 77

x

B. APPLICATIONS IN ISCHEMIC DISEASE

H. FEIGENBAUM, A.E. WEYMAN, B. CORYA, S. RASMUSSEN,

L. SAM WANN, E. ROGERS, R. GODLEY, and J.C. DILLON / Sensitivity and specificity of M-mode and cross-sectional echocardiographic findings in patients with cor-

CONTENTS

onary artery disease 83 R. GRAMIAK, R.C. WAAG, E.A. SCHENK, P.P.K. LEE,

K. THOMSON, and P. MACKINTOSH / Ultrasonic imaging of experimental myocardial infarcts 99

A. BLOCH, J.-D. MORARD, CH. MAYOR, and J.J. PERRENOUD /

Cross-sectional echocardiography in acute myocardial infarction 107

F.J. TEN CATE, P.D. VERDOUW, A.H. BOM, and J.R. ROELANDT /

Effect of coronary artery occlusion and reperfusion on the time course of myocardial wall thickness 111

A. DISTANTE, A. L·ABBATE. A. MASERI, L. LANDINI, and c. MICHELASSI / Echocardiographic changes in vasospastic angma 119

A.F PARISI, PF MOYNIHAN. E.D. FOLLAND, and c.L. FELDMAN / Assessment of regional wall motion in cor-onary artery disease by two-dimensional echocardiography 125

Y.-D. PARK, H. SAKAKIBARA, S NAGATA, S. BEPPU. and Y. NIMURA / Analysis of ventricular asynergy in myocardial infarction: a study with real-time cross-sectional echocardiog-raphy 131

C. APPLICATIONS IN LEFT VENTRICULAR FUNCTION

ANALYSIS

P. HANRATH / Abnormal left ventricular relaxation and diastolic filling patterns in left-sided heart disease

G. BIAMINO, H.J. WESSEL, W. SCHLAG, and R. SCHRODER /

Correlations between aortic root motion and left atrial

137

volume changes 147 G. DROBINSKY, M. EUGENE, J.I. EVANS, and Y. GROSGOGEAT /

Abnormal mitral valve motion, septal hypertrophy and left ventricular outflow tract obstruction. Echocardiographic and haemodynamic study in hypertrophic obstructive cardio-myopathy 153

A. GIAMBARTOLOMEI, T. BONZEL, P. ESENTE, and G.G. GENSINI / Echo-pressures relationship before and after hemodynamic changes 159

R.P. HAYWARD and R.A. FOALE / Effect of Wolf-Parkins on-White syndrome pre-excitation on left ventricular function, as­sessed by M-mode and cross-sectional echocardiography with intracardiac electrophysiological recording 167

CONTENTS

O.M. HESS, J. GRIMM, and H.P. KRA YENBUEHL / Assessment of left ventricular diastolic viscous forces by combined echo-

XI

pressure measurements in men 171 z. KRAJCER, L.w. PECHACEK, V.S. MATHUR, E. GARCIA, and

R.J. HALL / Left ventricular function and interventricular septal motion in mitral stenosis: echocardiographic abnormalities 175

J.P. LAPORTE, c. ODDOU. F. LAURENT, and P. BRUN / Systolic blood flow pattern estimated from multiple sector-scan pulsed Doppler velocimetry 181

v.s. MATHUR, J.A. GARCIA, A. ALI, C.M. DE CASTRO, E. GARCIA, and R.J. HALL / Atrial septal defect and para-doxical septal motion: an echocardiographic artefact 185

A. RIGHETTI, R. ADAMEC. J. BORZYKOWSKI, G. BRANDON, A. SIMONIN, and J.e. DIDISHEIM / The effects of training on left ventricular dimensions and performance 191

D. APPLICATIONS IN CARDIAC VALVE STUDIES

R. GRAMIAK and N.C. NANDA / Sector scanning and M-mode in aortic root and valve disease 197

R.L. POPP / Reliability of M-mode and cross-sectional echo-cardiographic criteria for the diagnosis of mitral valve disorders 203

M. ALAM, S. GOLDSTEIN, A. MADRAZO, D. MAGILLIGAN, and J.B. LAKIER / M-mode and two-dimensional echocardio-graphic features of porcine valve dysfunction 213

G. CONVERT, J. GILETTI, and J. DELAYE / Echocardiographic assessment of infective endocarditis on Hancock xenograft 219

A.B. DAVIES, R.A. FOALE, and A.F. RICKARDS / Direct assessment of aortic valvular stenosis by cross-sectional echocardiography 225

M. ERI1MAN, J. GLASER, and B. VIDNE / Pre- and postoperative echocardiograms in patients with discrete type subaortic stenosis 229

F. FANTINI, and A. MAGHERINI / Detection of tricuspid regur-gitation with pulsed Doppler echocardiography 233

L. HUMBLET, V. BAUDINET, and P. COLLIGNON / Mitral valve prolapse with aortic root dilatation: an echocardiographic study 237

R. JENNI, W. HUBSCHER, M. CASTY, M. ANLIKER, and H.P. KRA YENBUEHL I Quantitation of aortic regurgitation by a percutaneous 128-channel digital ultrasound Doppler instrument 241

M. KLICPERA, O. PACHINGER, P. PROBST, and F. KAINDL / Mechanism of systolic anterior motion in patients with hyper­trophic obstructive cardiomyopathy, evaluated by phased array sector-scanning 245

Xll

E. ORZAN, Z. KRAJCER, V.S. MATHUR, L.W. PECHACEK, E. GARCIA,

and R.J. HALL I Critical evaluation of the pulmonary valve echocardiogram: usefulness and limitations of E-F slope measurements

A.S. PEARLMAN, R. GENTILE, S.A. RUBENSTEIN, T.K. DOOLEY,

and D.W. FRANKLIN I Echocardiographic detection of mitral regurgitation (MR) in mitral valve prolapse (MVP)

c. VEYRAT, N. CHOLOT, G. ABITBOL, and D. KALMANSON I Validity of echo-pulsed Doppler velocimetry for assessing the diagnosis and severity of aortic valve disease and prosthetic valve function

J.A. YULDE, F.P. RAMOS, e.I. PORCIUNCULA, H.B. CALLEJA, and R.e. SOTO I Echocardiographic detection of aortic insuf­ficiency in the presence of mitral stenosis

II. PEDIATRIC ECHOCARDIOLOGY

J. LINTERMANS I Deductive echocardiographic diagnosis in

CONTENTS

249

255

261

267

congenital heart disease 277 D.l. SAHN I New techniques for echocardiographic evaluation of

cardiac anatomy in congenital heart disease 287 P.J. VOOGD, H. RIJSTERBORGH, G. VAN ZWIETEN, and

J. LUBSEN I Percentiles of echocardiographic dimensions in healthy children and young adolescents. A population study in Dutch schools 299

J.e. AREIAS, S.J. GOLDBERG, S.E.C. SPITAELS, and V.H. DE

VILLENEUVE I Accuracy of range gated pulsed Doppler echo for detecting the presence and localization of left ventricular outflow tract obstruction in children 309

s. BEPPU, Y. NIMURA, S. NAGATA, Y. PARK, and H. SAKAKIBARA I Visualization of mitral cleft in ostium pri­mum atrial septal defect. A study with real-time cross-sectional echocardiography 315

R.A. FOALE, P.D.V. BOURDILLON, J. SOMERVILLE, and A.F. RICKARDS I Cross-sectional echocardiographic features of anomalous systemic and coronary venous return 319

W.J. GUSSENHOVEN, J. ROHMER, and C.M. LIGTVOET I Congenital heart disease studied with a high resolution linear array system 325

B. POUGET, M. TYNAN, R. ROUDAUT, A. CHOUSSAT,

M. DALLOCCHIO, and F. FONTAN I Echocardiographic studies in patients with tricuspid atresia or single ventricle before and after Fontan procedure 335

c. ROGE, R. SNIDER, and N. SILVERMAN I Echocardiographic evaluation of left ventricular inflow obstruction in children using an 80° two-dimensional sector-scanner 341

CONTENTS Xlll

A.A. SCHMALTZ, Z. IBRAHIM, R.P. HElL, and D.I. BROWN /

Echocardiographic findings and function analysis in infants with endocardial fibroelastosis 345

I.G. STEVENSON, I. KA W ABORI, W.G. GUNTHEROTH,

S.A. RUBENSTEIN, and D.W. BAKER / Pulsed Doppler echo-cardiography - Applications in pediatric cardiology 349

R. VOSTERS, I.W. WLADIMIROFF, and W.B. VLETTER /

Assessment of fetal and neonatal cardiac geometries by means of real-time ultrasound 355

Ill. TECHNOLOGICAL ASPECTS OF ECHOCARDIOLOGY

P.N.T. WELLS / Historical review of echo-instrumentation 361 N. BOM and C.T. LANCEE / Current instrumentation 373 C.B. BURCKHARDT, P.-A. GRANDCHAMP, H. HOFFMAN, and

R. FEHR / A simplified ultrasound phased array sector scanner 385

PH. DEFRANOULD and I. SOUQUET / Ultrasonic array design and performance 395

A.P.G. HOEKS, R.S. RENEMAN, C.l. RUISSEN, and F.A.M. SMEETS / Possibilities and limitations of pulsed Doppler systems 413

L.G. POURCELOT / Real-time blood flow imaging 421 A.I. BERKHOUT and I. RIDDER / Focussing by means of wave

field extrapolation 431 M.A. BRANDESTINI, M.K. EYER, and I.G. STEVENSON / M/Q-

mode echocardiography - The synthesis of conventional echo with digital multigate Doppler 441

B. DELANNOY, R. TORGUET, C. BRUNEEL, and E. BRIDOUX /

Ultrafast electronical image reconstruction device 447 F. HAINE, R. TORGUET, C. BRUNEEL, E. BRIDOUX, and c.

THOMIN / New sector-scan echographic imaging devices 451 I.A. VOGEL, O.L. BASTIAANS, I. ROELANDT, and

I. HONKOOP / Structure recognition and data extraction in two-dimensional echocardiography 457

G. VAN ZWIETEN, O.L. BASTIAANS, I. HONKOOP, and I.A. VOGEL / Video tracing of M-mode echocardiograms 469

Authors and subject index 477

CONTRIBUTORS

Abbate, A.I'., CNR Clinical Physiology Laboratory University of Pisa, Pisa, Italy. Abitbol, G., Dept. of Cardiology, Fondation A. de Rothschild, Paris, France Adamec. R., Hopital Cantonal, Centre de Cardiologie, Geneva, Switzerland. Alam, M., Henry Ford Hospital, Detroit, Michigan, U.S.A. Ali, A., Clayton Foundation for Research Laboratory, St. Luke's Episcopal Hospital and Texas

Heart Institute, Houston, Texas, U.S.A. Anliker, M., Institute for Biomedical Engineering, University and ETH, Zurich, Switzerland. Areias, J.c., University of Porto, Porto, Portugal. Aubert, A.E., Dept. of Pathophysiology, St. Rafael University Hospital, Leuven, Belgium. Baker, D.W., Center for Bioengineering, University of Washington, Seattle, Washington, U.S.A. Bastiaans, O.L., Dept. of Applied Physics, Delft University of Technology, Delft, The

Netherlands. Baudinet, V., University of Liege, Liege, Belgium. Beppu, S., Research Institute, National Cardiovascular Center, Suita, Osaka, Japan. Berkhout, A.J., Dept. of Applied Physics, Delft University of Technology, Delft, The

Netherlands. Biamino, G., Dept. of Cardiopneumology, KJinikum Steglitz, FU Berlin, Berlin, Germany. Bloch, A., Centre de Cardiologie, Hopital Cantonal Universitaire, Geneva, Switzerland. Born, A.H., Thoraxcenter, Erasmus University, Rotterdam, The Netherlands. Born, N., Thoraxcenter, Erasmus University, Rotterdam, The Netherlands. Bonzel, T., Toomey Cardiopulmonary Laboratory and Research Department, St. Joseph's

Hospital, Syracuse, New York, U.S.A. Borzykowsky, J., Hopital Cantonal, Centre de Cardiologje, Geneva, Switzerland. Bourdillon, PD. V., National Heart Hospital and Cardiothoracic Institute, London, England. Brandestini, M.A., Center for Bioengineering, University of Washington, Seattle, Washington,

U.S.A. Brandon, G., Hopital Cantonal, Centre de CardiologiC, Geneva, Switzerland. Bridoux, E., Universite de Valenciennes, Valenciennes, France. Brown, D.J., Cardiac Dept. of Brompton Hospital, London, England. Brun, P., Groupe de Recherche U 138 de I'I.N.S.E.R.M., Service d'Exploration Fonctionnelle

CHU Henri Mondor, Creteil, France. Bruneel, c., Universite de Valenciennes, Valenciennes, France. Burckhardt, c.B., Central Research Units, F. Hoffmann-La Roche & Co. Basel, Switzerland. Calleja, H.B., Non-invasive and Hemodynamics Laboratory, Philippine Heart Center for Asia,

Quezon City, Philippines. Casty, M., Institute for Biomedical Engineering, University and ETH, Zurich, Switzerland. Castro, C.M. De, Clayton Foundation for Research Laboratory, St. Luke's Episcopal Hospital

and Texas Heart Institute, Houston, Texas, U.S.A. Cate, F.1. ten, Thoraxcenter, Erasmus University, Rotterdam, The Netherlands. Cholot, N., Dept. of Cardiology, Fondation A. de Rothschild, Paris, France. Choussat, A., Hopital Cardiologique, CHU Bordeaux, Pessac, France. Collignon, P., University of Liege, Liege, Belgium. Convert, c., Hopital Cardio-vasculaire et Pneumologique Louis Pradel, Lyon, France. Corya, B., Indiana University"School of Medicine, IndianllPolis, Indiana, U.S.A. Dallocchio, M., Hopital Cardiologique, CHU Bordeaux, Pessac, France. Davies, A.B., National Heart Hospital, London, England. Defranould, Ph., Thomson-CSF, ASM Div.ision, Cagnes-sur-Mer, France. Delannoy, B., Universite de Valenciennes, Valenciennes, France. Delaye, S., Hopital Cardio-vasculaire et Pneumologjque Louis Pradel, Lyon, France.

xvi CONTRIBUTORS

Denef, B., Dept. of Pathophysiology, St. Raphael University Hospital, Leuven, Belgium. Didisheim, J.e., Hopital Cantonal, Centre de Cardiologie, Geneva, Switzerland. Dillon, J.e., Indiana University School of Medicine, Indianapolis, Indiana, U.S.A. Distante, A., CNR Clinical Physiology Laboratory and University of Pisa, Pisa, Italy. Dooley, T.K., University of Washington, Seattle, Washington, U.S.A. Drobinski, G., Hopital de la Salpetriere, Paris, France. Erijman, M., Toor Heart Institute, Beilinson Medical Center, Petah Tiqva, Israel. Esente, P., Toomey Cardiopulmonary Laboratory and Research Department, St. Joseph's

Hospital, Syracuse, New York, U.S.A. Eugene, M., Hopital de la Salpetriere, Paris, France. Evans, 1.1., Itapital de la Salpetriere, Paris, France. Eyer, M.K., Center for Bioengineering, University of Washington, Seattle, Washington, U.S.A. Fantini, F., Cardiology Unit, University of Florence, Florence, Italy. Fehr, R., Central Research Units, F. Hoffmann-La Roche & Co., Basel, Switzerland. Feigenbaum, H., Indiana University School of Medicine, Indianapolis, Indiana, U.S.A. Feldman, e.L., The Electronics for Medicine Corporation, Sudbury, Massachusetts, U.S.A. Foale, R.A., National Heart Hospital and Cardiothoracic Institute, London, England. Folland, E.D., Cardiology Section, Harvard Medical School, Boston, Massachusetts, U.S.A. Fontan, F., Hopital Cardiologique, CHU Bordeaux, Pessac, France. Franklin, D.W., University of Washington, Seattle, Washington, U.S.A. Garcia, E., Clayton Foundation for Research Laboratory, St. Luke's Episcopal Hospital and

Texas Heart Institute, Houston, Texas, U.S.A. Geest, H.de, Dept. of Pathophysiology St. Raphael University Hospital, Leuven, Belgium. Garcia, J.A., Clayton Foundation for Research Laboratory, St. Luke's Episcopal Hospital and

Texas Heart Institute, Houston, Texas, U.S.A. Gensini, G.G., Toomey Cardiopulmonary Laboratory and Research Department, St. Joseph's

Hospital, Syracuse, New York, U.S.A. Gentile, R., University of Washington, Seattle, Washington, U.S.A. Giambartolomei, A., Toomey Cardiopulmonary Laboratory and Research Department, St.

Joseph's Hospital, Syracuse, New York, U.S.A. Gibson, D.G., Brompton Hospital, London, England. Giletti, J., Hopital Cardio-vasculaire et Pneumologique Louis Pradel, Lyon, France. Glaser, J., Toor Heart Institute, Beilinson Medical Center, Petah Tiqva, Israel. Godley, R., Indiana University School of Medicine, Indianapolis, Indiana, U.S.A. Goldberg, SJ., University of Arizona, Tucson, Arizona, U.S.A. Goldstein, S., Henry Ford Hospital, Detroit, Michigan, U.S.A. Gramiak, R., Dept. of Radiology, University of Rochester, Medical Center, Rochester, New

York, U.S.A. Grandchamp, P.-A., Central Research Units, F. Hoffmann-La Roche & Co., Basel, Switzerland. Grimm, J., Medical Policlinic, Department of Internal Medicine, University Hospital Zurich,

Zurich, Switzerland. Grosgogeat, Y., Hopital de la Salpetriere, Paris, France. Gullace, G., Divisione de Cardiologia, Ospedale Civile di Chiari Brescia, Castrezzato, Italy. Guntheroth, W.G., Division of Pediatric Cardiology, University of Washington, Seattle,

Washington, U.S.A. Gussenhoven, W.J., Thoraxcenter, Erasmus University, Rotterdam, The Netherlands. Haine, F., Universite de Valenciennes, Valenciennes, France. Hall, R.J., Clayton Foundation for Research Laboratory, St. Luke's Episcopal Hospital and

Texas Heart Institute, Houston, Texas, U.S.A. Hanrath, P., Dept. of Cardiology, University Hospital, Hamburg, Germany. Hayward, R.P., The National Heart Hospital, London, England. Heil, R.P., Dept. of Pediatric Cardiology, University Children's Hospital, University of

Tiibingen, Tiibingen, Germany. Hess, O.M., Medical Policlinic, Department of Internal Medicine, University Hospital Zurich,

Zurich, Switzerland. Hoeks, A.P.G., University of Limburg, Maastricht, The Netherlands. Hoffmann, H., Central Research Units, F. Hoffmann-La Roche & Co., Basel, Switzerland. Honkoop, J., Thoraxcenter, Erasmus University, Rotterdam, The Netherlands. Hiibscher, W., Medical Policlinic, University Hospital Zurich, University and ETH, Zurich,

Switzerland. Humblet, L., University of Liege. Liege, Belgium.

CONTRIBUTORS XVll

Ibrahim, Z., Medical Policlinic, University of Tuebingen, Tuebingen, Germany. Jenni, R., Medical Policlinic, University Hospital Zurich, University and ETH, Zurich,

Switzerland. Kaindl, F., Cardiological Clinic, University of Vienna, Vienna, Austria. Kalmanson, D., Dept. of Cardiology, Fondation A. de Rothschild, Paris, France. Kawabori, I., Division of Pediatric Cardiology, University of Washington, Seattle, Washington,

U.S.A. Kesteloot, H., Dept. of Pathophysiology, St. Raphael University Hospital, Leuven, Belgium. Kisslo, J.A., Duke University Medical Center, Durham, North Carolina, U.S.A. Klicpera, M., Cardiological Clinic, University of Vienna, Vienna, Austria. Krajcer, Z., Clayton Foundation for Research Laboratory, St. Luke's Episcopal Hospital and

Texas Heart Institute, Houston, Texas, U.S.A. Krayenbuehl, H.P., Medical Policlinic, University Hospital Zurich, University and ETH, Zurich,

Switzerland. Lakier, J.B., Henry Ford Hospital, Detroit, Michigan, U.S.A. Lambregts, J.A.C, Dept. of Physiology, Biomedical Center, University of Limburg, Maastricht,

The Netherlands. Lancee, CT.,. Thoraxcenter, Erasmus University, Rotterdam, The Netherlands. Landini, L., CNR Clinical Physiology Laboratory, University of Pisa, Pisa, Italy. Laporte, J.P., Groupe de Recherche U 138 de I'I.N.S.E.R.M., Service d'Exploration

Fonctionnelle, CH.U., Henri.Mondor, Creteil, France. Laurent, F., Groupe de Recherche U 138 de I'I.N.S.E.R.M., Service d'Exploration Fonctionnelle,

CH.U., Henri Mondor, Creteil. France. Lee, P.P.K., Dept. of Radiology, University of Rochester, Rochester, New York, U.S.A. Ligtvoet, CM., Thoraxcenter, Erasmus University, Rotterdam, The Netherlands. Lintermans, J., Service de Cardiologie Pediatrique, Clinique Universitaire St. Joseph, Herent,

Belgium. Lubsen, J., Thoraxcenter, Erasmus University, Rotterdam, The Netherlands. Macintosh, P., Dept. of Radiology, University of Rochester, Rochester, New York, U.S.A. Macpherson, P.C, St. Bartholomew's Hospital, London, England. Madrazo, A., Henry Ford Hospital, Detroit, Michigan, U.S.A. Magherini, A., Cardiology Unit, University of Florence, Florence, Italy. Magilligan, D., Henry Ford Hospital, Detroit, Michigan, U.S.A. Maseri, A., CNR Clinical Physiology Laboratory, University of Pisa, Pisa, Italy. Mathur, V.S., Clayton Foundation for Research Laboratory, St. Luke's Episcopal Hospital and

Texas Heart Institute, Houston, Texas, U.S.A. Mayor, Ch., Centre de Cardiologie, Hopital Cantonal Universitaire, Geneva, Switzerland. Meldrum, S.J., St. Bartholomew's Hospital, London, England. Michelassi, C, CNR Clinical Physiology Laboratory, University of Pisa, Pisa, Italy. Morard, J.-D., Centre de Cardiologie, Hopital Cantonal Universitaire, Geneva, Switzerland. Moynihan, P.F., Cardiology Section, Peter Bent Brigham Hospital, Boston, Massachusetts,

U.S.A. Nanda, N.C, Dept. of Cardiology, University of Rochester, Rochester, New York, U.S.A. Nagata, S., Hospital, National Cardiovascular Center, Suita, Osaka, Japan. Nimura, Y., Research Institute, National Cardiovascular Center, Suita, Osaka, Japan. Oddou, C, Groupe de Recherche U 138 de 1'I.N.S.E.R.M., Service d'Exploration Fonctionnelle

CH.U. Henri Mondor, Creteil, France. Orzan, F., Clayton Foundation for Research Laboratory, St. Luke's Episcopal Hospital and

Texas Heart Institute, Houston, Texas, U.S.A. Pachinger, 0., Cardiological Clinic, University of Vienna, Vi&.na,> Austria. Parisi, A.F., Cardiology Section, West Roxbury YA. Medical Center, Boston, Massachusetts,

U.S.A. Park, Y.-D., Hospital, National Cardiovascular Center, Suita, Osaka, Japan. Pearlman, A.S., University of Washington, Seattle, Washington, U.S.A. Pechacek, L.W., Clayton Foundation for Research Laboratory, St. Luke's Episcopal Hospital

and Texas Heart Institute, Houston, Texas, U.S.A. Perrenoud, J.l., Centre de Cardiologie, Hopital Cantonal Universitaire, Geneva, Switzerland. Popp, C.I., Cardiology Division, Stanford University, Stanford, California, U.S.A. Porciuncula, R.L.,.Non-invasive and Hemodynamics Laboratory, Philippine Heart Center for

Asia, Quezon City, Philippines. Pouget, B., H6pital Cardiologique, CH.U. Bordeaux, Pessac, Franc.:.

xviii CONTRIBUTORS

Pourcelot, L.G., Dept. of Biophysics and Nuclear Medicine, CH.R. Bretonneau, Tours, France. Probst, P., Cardiological Clinic, University of Vienna, Vienna, Austria. Ramos, F.P., Non-invasive and Hemodynamics Laboratory, Philippine Heart Center for Asia,

Quezon City, Philippines. Rasmussen, S., Indiana University School of Medicine, Indianapolis, Indiana, U.S.A. Reneman, R.S., Dept. of Physiology, Biomedical Center, University of Limburg, Maastricht, The

Netherlands. Rickards, A.F., The National Heart Hospital and Cardiothoracic Institute, London, England. Ridder, J., Delft University of Technology, Dept. of Applied Physics, Group of Acoustics, Delft,

The Netherlands. Righetti, A., Hopital Cantonal, Centre de Cardiologie, Geneva, Switzerland. Roelandt, J.R., Thoraxcenter, Erasmus University, Rotterdam, The Netherlands. Roge, C, Cardiovascular Research Institute and Dept. of Pediatrics, University of California,

San Francisco, California, U.S.A. Rogers, E., Indiana University School of Medicine, Indianapolis, Indiana, U.S.A. Rohmer, J., University Hospital, Leiden, The Netherlands. Roudaut, R., Hopital Cardiologique, CH.U. Bordeaux, Pessac, France. Rubenstein, S.A., Division of Pediatric Cardiology, University of Washington, Seattle,

Washington, U.S.A. Ruissen, CJ., University of Limburg, Maastricht, The Netherlands. Rijsterborgh, H., Thoraxcenter, Erasmus University, Rotterdam, The Netherlands. Sahn, OJ., Dept. of Pediatrics, University of Arizona, Health Sciences Center, Tucson, Arizona,

U.S.A. Sakakibara, H., Hospital, National Cardiovascular Center, Suita, Osaka, Japan. Sam Wann, L., Indiana University School of Medicine, Indianapolis, Indiana, U.S.A. Schenk, E.A., Pathology Dept., University of Rochester, Rochester, New York, U.S.A. Schlag, W., Dept. of Cardiopneumology, Klinikum Steglitz FU Berlin, Berlin, Germany. Schmaltz, A.A., Dept. of Pediatric Cardiology, University Children's Hospital, Tuebingen,

Germany. Schmitz, J.J.F., Dept. of Physiology, Biomedical Center, University of Limburg, Maastricht. The

Netherlands. Schroder, R., Dept. of Cardiopneumology, Klinikum Steglitz FU Berlin, Berlin, Germany. Silverman, N., Cardiovascular Research Institute and Dept. of Pediatrics, University of

California, San Francisco, California, U.S.A. Simonin, A., Hopital Cantonal, Centre de Cardiologl~, Geneva, Switzerland. Smeets, F.A.M., University of Limburg, Maastricht, The Netherlands. Snider, R., Cardiovascular Research Institute and Dept. of Pediatrics, University of California,

San Francisco, California, U.S.A. Snoeckx, L.H.E.H., Dept. of Physiology, Biomedical Center, University of Limburg, Maastricht,

The Netherlands. Somerville, J., The National Heart Hospital and Cardiothoracic Institute, London, England. So to, R.C, Non-invasive and Hemodynamics Laboratory, Philippine Heart Center for Asia,

Quezon City, Philippines. Souquet, J., Thomson CSF, ASM Division, Cagnes-sur-Mer, France. Spitaels, S.E.C., Sophia Children's Hospital, Erasmus University, Rotterdam, The Netherlands. Stevenson, J.G., Division of Pediatric Cardiology, University of Washington, Seattle,

Washington, U.S.A. Thomin, C, Universite de Valenciennes, Valenciennes, France. Thomson, K., Dept. of Radiology, University of Rochester, Rochester, New York, U.S.A. Torguet, R., Universite de Valenciennes, Valenciennes, France. Tunstall Pedoe, D.S., St. Bartholomew's Hospital, London, England. Tynan, M., Hopital Cardiologique, CH.U. Bordeaux, Pessac, France. Verdouw, P.O., Thoraxcenter, Erasmus University, Rotterdam, The Netherlands. Veyn.t, C, Dept. of Cardiology, Fondation A. de Rothschild, Paris, France. Vidne, 8., Toor Heart Institute, Beilinson Medical Center, Petah Tiqva, Israel. Villeneuve, V.H. de, Sophia Children's Hospital, Erasmus University, Rotterdam, The

Netherlands. Vletter, W.B., Thoraxcenter, Erasmus University, Rotterdam, The Netherlands. Vogel, J.A., Thoraxcenter, Erasmus University, Rotterdam, The Netherlands. Voogd, PJ., Dept. of Cardiology, University Hospital, Leiden, The Netherlands. Vosters, R., Dept. of Obstetrics and Gynaecology, Erasmus University, Rotterdam, The Nether­

lands.

CONTRIBUTORS XIX

Waag, R.c., Electrical Engineering Dept., University of Rochester, Rochester, New York, U.S.A. Wens, P.N.T., Bristol Health District, Dept. of Medical Physics, Bristol General Hospital,

Bristol, England. Werf, F. van de, Dept. of Pathophysiology, St. Raphael University Hospital, Leuven, Belgium. Wessel, H.J., Dept. of Cardiopneumology, Klinikum Steglitz, FU Berlin, Berlin, Germany. Weyman, A.E., Indiana University School of Medicine, Indianapolis, Indiana, U.S.A. Wladimiroff, J.W., Dept. of Obstetrics and Gynaecology, Erasmus University, Rotterdam, The

Netherlands. Yulde, J.A., Non-invasive and Hemodynamics Laboratory, Philippine Heart Center for Asia,

Quezon City, Philippines. Zwieten, G. van, Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.