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Sample records for echocardiography quantitative evaluation

  1. Echocardiography in the evaluation of athletes

    PubMed Central

    Montserrat, Silvia; Vidal, Bàrbara; Sitges, Marta

    2015-01-01

    Echocardiography is currently a widely available imaging technique that can provide useful data in the field of sports cardiology particularly in two areas: pre-participation screening and analysis of the cardiac adaptation induced by exercise. The application of pre-participation screening and especially, the type and number of used diagnostic tests remains controversial. Echocardiography has shown though, higher sensitivity and specificity as compared to the ECG, following a protocol adapted to athletes focused on ruling out the causes of sudden death and the most common disorders in this population. It is still a subject of controversy the actual cost of adding it, but depending on the type of sport, echocardiography might be cost-effective if added in the first line of examination. Regarding the evaluation of cardiac adaptation to training in athletes,  echocardiography has proved to be useful in the differential diagnosis of diseases that can cause sudden death, analysing both the left ventricle (hypertrophy cardiomyopathy, dilated cardiomyopathy, left ventricle non compaction) and the right ventricle (arrhythmogenic right ventricular cardiomyopathy). The aim of this paper is to review the current knowledge and the clinical practical implications of it on the field of echocardiography when applied in sport cardiology areas. PMID:26236468

  2. Echocardiography.

    PubMed Central

    Chambers, J. B.; Monaghan, M. J.; Jackson, G.

    1988-01-01

    Imaging echocardiography is an important extension of the clinical examination and will answer most questions in an emergency-for example, whether an enlarged cardiac shadow on the chest radiograph represents ventricular dilatation or an effusion. Doppler ultrasonography is essential for hospitals with an interest in cardiology because it provides direct haemodynamic data that are complementary to imaging. It requires more skill than imaging and may also be time consuming. Colour flow Doppler mapping is speedy and simple to use and aids the interpretation of continuous wave Doppler. It is therefore a natural companion to conventional Doppler, but there would have to be a high clinical load to justify its purchase. Images FIG 3 FIG 4 FIG 4 FIG 5 FIG 6 PMID:3143434

  3. Evaluation of Arterial Stiffness by Echocardiography: Methodological Aspects

    PubMed Central

    Cho, Jae Yeong

    2016-01-01

    As humans age, degenerative changes in the arterial structure gradually progress and result in the stiffening of the arteries, which is called arteriosclerosis. Arterial stiffness is now an established risk factor of cardiovascular disease (CVD). This stiffening has adverse effects for both the general population as well as for patients with CVD. Measurements of pulse wave velocity and pulse wave analysis are the two most commonly used methods in the evaluation of arterial stiffness, but these methods just allow indirect measures of arterial stiffness. Echocardiography is the most widely used imaging modality in the evaluation of cardiac structure and function and with recent technical advances, it has become possible to evaluate the structure, function and blood flow hemodynamics of the arteries using echocardiography. In the present review, we will discuss the current status of echocardiography in the evaluation of arterial stiffness, especially focusing on the methodological aspects. PMID:27231673

  4. Quantitative approach using multiple single parameters versus visual assessment in dobutamine stress echocardiography

    PubMed Central

    2012-01-01

    Background A number of myocardial Doppler-derived velocity, strain myocardial imaging parameters (DMI) and speckle tracking imaging (STI) have been proposed for the quantification of myocardial ischemia during stress echocardiography. The purpose of the study was to identify the best single ultrasound quantitative parameter for prediction of significant coronary stenosis and compare it with visual assessment during dobutamine stress echocardiography (DSE). Methods Prospective analysis included data of 151 patients (age 61.8 ± 9.2) who underwent dobutamine stress echocardiography for known (n = 35) or suspected coronary artery disease (CAD) (n = 36) or symptomatic chest pain (n = 80), excluding patients with previous myocardial infarction. Systolic, post-systolic and diastolic velocities, strain and strain rate parameters were obtained at rest and at peak dobutamine challenge. Derivative markers as E'/A' ratio, post-systolic index and changes from rest to stress were calculated (98 parameters overall, predominantly longitudinal). Coronary angiography was chosen as reference method considering at least one stenosis ≥70% per patient as significant CAD. The predictive value of quantitative parameters and wall motion score index (WMSI) was obtained using logistic regression and ROC analysis. Results The value of single parameters discriminated as independent predictors of CAD appeared to be modest (area under the curve [AUC] ranged from 0.63 to 0.72 for 16 PW-DMI, 12 CC-DMI and 12 STI markers), comparing to AUC of WMSI 0.88. Sensitivity, specificity and accuracy of visual DSE evaluation was 82.4% (95%CI 77.4%; 85.2%), 92.6% (95%CI 83.4%; 97.5%) and 86.0% (95%CI 79.5%; 89.6%), respectively, Youden index 0.75. Sensitivity, specificity and accuracy of single predictors ranged from 40.0% to 93.3% (95% CI 22.7%; 99.2%), from 34.2% to 88.7% (95% CI 25.6%; 94.1%) and from 45.8% to 80.0% (95% CI 37.5%; 87.2%) respectively, Youden index ranged from 0.20 to 0

  5. Quantitation of mitral regurgitation after percutaneous MitraClip repair: comparison of Doppler echocardiography and cardiac magnetic resonance imaging

    PubMed Central

    Strugnell, Wendy; Gaikwad, Niranjan; Ischenko, Matthew; Speranza, Vicki; Chan, Jonathan; Neill, Johanne; Platts, David; Scalia, Gregory M.; Burstow, Darryl J.; Walters, Darren L.

    2015-01-01

    limits of agreement compared to echocardiography. Categorical severity grading by CMR using published ranges had good inter-observer agreement (CCC 0.86, 0.62-0.95). Conclusions CMR performs very well in the quantitation of MR after MitraClip insertion, with excellent reproducibility compared to echocardiographic methods. CMR is a useful technique for the comprehensive evaluation of residual regurgitation in patients after MitraClip. Technical limitations exist for both techniques, and quantitation remains a challenge in some patients. PMID:26309843

  6. Stress echocardiography

    MedlinePlus

    Echocardiography stress test; Stress test - echocardiography; CAD - stress echocardiography; Coronary artery disease - stress Echocardiography; Chest pain - stress echocardiography; Angina - stress echocardiography; ...

  7. Doppler echocardiography

    SciTech Connect

    Labovitz, A.J.; Williams, G.A.

    1988-01-01

    The authors are successful in presenting a basic book on clinical quantitative Doppler echocardiography. It is not intended to be a comprehensive text, but it does cover clinical applications in a succinct fashion. Only the more common diseases in the adult are considered. The subjects are presented logically and are easy to comprehend. The illustrations are good, and the book is paperbound. The basic principles of Doppler echocardiography are presented briefly. The book ends with chapters on left ventricular function (stroke volume and cardiac output), congenital heart disease, and color Doppler echo-cardiography. There are numerous references and a good glossary and index.

  8. Fetal echocardiography

    MedlinePlus

    ... Fetal echocardiography is a test that uses sound waves ( ultrasound ) to evaluate the baby's heart for problems ... over the area. The probe sends out sound waves, which bounce off the baby's heart and create ...

  9. Intracardiac Echocardiography Evaluation in Secundum Atrial Septal Defect Transcatheter Closure

    SciTech Connect

    Zanchetta, Mario; Pedon, Luigi; Rigatelli, Gianluca; Carrozza, Antonio; Zennaro, Marco; Di Martino, Roberta; Onorato, Eustaquio; Maiolino, Pietro

    2003-02-15

    Purpose: This study was designed to assess the balloon sizing maneuvers and deployment of an Amplatzer Septal Occluder (ASO). In addition, intraprocedural balloon sizing was compared with off-line intracardiac echocardiographic measurements. Methods: The intracardiac echocardiography (ICE) measurements were: maximum transverse and longitudinal atrial septal defect (ASD) diameters in the aortic valve and four-chamber planes;area of the ASD and its equivalent circle diameter. Thirteen consecutive patients underwent transcatheter implantation of an ASO device using ICE guidance under local anesthesia. The device matching the balloon sizing diameter of the defect was implanted. Qualitative ICE assessment of the ASO devices implanted was performed off line. Results: The mean equivalent circle diameter predicted by ICE was 24.40 {+-} 5.61 mm and was significantly higher(p 0.027) than the ASD measured by balloonsizing (21.38 {+-} 5.28 mm). Unlike previous studies we did not find any correlation between the two measurements (correlation coefficient = 0.47). Only four of the 13 patients had optimal device positioning as shown by the qualitative ICE evaluation, whereas the remaining nine patients had inadequate device placement. This resulted in a waist diameter that was an average 26.1% undersized in seven patients and 12.7% oversized in two patients. Five of the seven patients with an undersized device had ASO-atrial septum misalignment with leftward device deviation. Conclusion: The ICE images allowed careful measurement of the dimensions of the ASD and accurately displayed the spatial relations of the ASO astride the ASD.Moreover, use of the ICE measurement led to selection of a different size of device in comparison with those of balloon sizing. The clinical benefit of this new approach needs to be rigorously tested.

  10. Changes in transmural distribution of myocardial perfusion assessed by quantitative intravenous myocardial contrast echocardiography in humans

    PubMed Central

    Fukuda, S; Muro, T; Hozumi, T; Watanabe, H; Shimada, K; Yoshiyama, M; Takeuchi, K; Yoshikawa, J

    2002-01-01

    Objective: To clarify whether changes in transmural distribution of myocardial perfusion under significant coronary artery stenosis can be assessed by quantitative intravenous myocardial contrast echocardiography (MCE) in humans. Methods: 31 patients underwent dipyridamole stress MCE and quantitative coronary angiography. Intravenous MCE was performed by continuous infusion of Levovist. Images were obtained from the apical four chamber view with alternating pulsing intervals both at rest and after dipyridamole infusion. Images were analysed offline by placing regions of interest over both endocardial and epicardial sides of the mid-septum. The background subtracted intensity versus pulsing interval plots were fitted to an exponential function, y = A (1 − e−βt), where A is plateau level and β is rate of rise. Results: Of the 31 patients, 16 had significant stenosis (> 70%) in the left anterior descending artery (group A) and 15 did not (group B). At rest, there were no differences in the A endocardial to epicardial ratio (A-EER) and β-EER between the two groups (mean (SD) 1.2 (0.6) v 1.2 (0.8) and 1.2 (0.7) v 1.1 (0.6), respectively, NS). During hyperaemia, β-EER in group A was significantly lower than that in group B (1.0 (0.5) v 1.4 (0.5), p < 0.05) and A-EER did not differ between the two groups (1.0 (0.5) v 1.2 (0.4), NS). Conclusions: Changes in transmural distribution of myocardial perfusion under significant coronary artery stenosis can be assessed by quantitative intravenous MCE in humans. PMID:12231594

  11. 3D reconstruction and quantitative assessment method of mitral eccentric regurgitation from color Doppler echocardiography

    NASA Astrophysics Data System (ADS)

    Liu, Qi; Ge, Yi Nan; Wang, Tian Fu; Zheng, Chang Qiong; Zheng, Yi

    2005-10-01

    Based on the two-dimensional color Doppler image in this article, multilane transesophageal rotational scanning method is used to acquire original Doppler echocardiography while echocardiogram is recorded synchronously. After filtering and interpolation, the surface rendering and volume rendering methods are performed. Through analyzing the color-bar information and the color Doppler flow image's superposition principle, the grayscale mitral anatomical structure and color-coded regurgitation velocity parameter were separated from color Doppler flow images, three-dimensional reconstruction of mitral structure and regurgitation velocity distribution was implemented separately, fusion visualization of the reconstructed regurgitation velocity distribution parameter with its corresponding 3D mitral anatomical structures was realized, which can be used in observing the position, phase, direction and measuring the jet length, area, volume, space distribution and severity level of the mitral regurgitation. In addition, in patients with eccentric mitral regurgitation, this new modality overcomes the inherent limitations of two-dimensional color Doppler flow image by depicting the full extent of the jet trajectory, the area of eccentric regurgitation on three-dimensional image was much larger than that on two-dimensional image, the area variation tendency and volume variation tendency of regurgitation have been shown in figure at different angle and different systolic phase. The study shows that three-dimensional color Doppler provides quantitative measurements of eccentric mitral regurgitation that are more accurate and reproducible than conventional color Doppler.

  12. Guidelines for the Use of Echocardiography in the Evaluation of a Cardiac Source of Embolism.

    PubMed

    Saric, Muhamed; Armour, Alicia C; Arnaout, M Samir; Chaudhry, Farooq A; Grimm, Richard A; Kronzon, Itzhak; Landeck, Bruce F; Maganti, Kameswari; Michelena, Hector I; Tolstrup, Kirsten

    2016-01-01

    Embolism from the heart or the thoracic aorta often leads to clinically significant morbidity and mortality due to transient ischemic attack, stroke or occlusion of peripheral arteries. Transthoracic and transesophageal echocardiography are the key diagnostic modalities for evaluation, diagnosis, and management of stroke, systemic and pulmonary embolism. This document provides comprehensive American Society of Echocardiography guidelines on the use of echocardiography for evaluation of cardiac sources of embolism. It describes general mechanisms of stroke and systemic embolism; the specific role of cardiac and aortic sources in stroke, and systemic and pulmonary embolism; the role of echocardiography in evaluation, diagnosis, and management of cardiac and aortic sources of emboli including the incremental value of contrast and 3D echocardiography; and a brief description of alternative imaging techniques and their role in the evaluation of cardiac sources of emboli. Specific guidelines are provided for each category of embolic sources including the left atrium and left atrial appendage, left ventricle, heart valves, cardiac tumors, and thoracic aorta. In addition, there are recommendation regarding pulmonary embolism, and embolism related to cardiovascular surgery and percutaneous procedures. The guidelines also include a dedicated section on cardiac sources of embolism in pediatric populations. PMID:26765302

  13. Standardized Evaluation System for Left Ventricular Segmentation Algorithms in 3D Echocardiography.

    PubMed

    Bernard, Olivier; Bosch, Johan G; Heyde, Brecht; Alessandrini, Martino; Barbosa, Daniel; Camarasu-Pop, Sorina; Cervenansky, Frederic; Valette, Sebastien; Mirea, Oana; Bernier, Michel; Jodoin, Pierre-Marc; Domingos, Jaime Santo; Stebbing, Richard V; Keraudren, Kevin; Oktay, Ozan; Caballero, Jose; Shi, Wei; Rueckert, Daniel; Milletari, Fausto; Ahmadi, Seyed-Ahmad; Smistad, Erik; Lindseth, Frank; van Stralen, Maartje; Wang, Chen; Smedby, Orjan; Donal, Erwan; Monaghan, Mark; Papachristidis, Alex; Geleijnse, Marcel L; Galli, Elena; D'hooge, Jan

    2016-04-01

    Real-time 3D Echocardiography (RT3DE) has been proven to be an accurate tool for left ventricular (LV) volume assessment. However, identification of the LV endocardium remains a challenging task, mainly because of the low tissue/blood contrast of the images combined with typical artifacts. Several semi and fully automatic algorithms have been proposed for segmenting the endocardium in RT3DE data in order to extract relevant clinical indices, but a systematic and fair comparison between such methods has so far been impossible due to the lack of a publicly available common database. Here, we introduce a standardized evaluation framework to reliably evaluate and compare the performance of the algorithms developed to segment the LV border in RT3DE. A database consisting of 45 multivendor cardiac ultrasound recordings acquired at different centers with corresponding reference measurements from three experts are made available. The algorithms from nine research groups were quantitatively evaluated and compared using the proposed online platform. The results showed that the best methods produce promising results with respect to the experts' measurements for the extraction of clinical indices, and that they offer good segmentation precision in terms of mean distance error in the context of the experts' variability range. The platform remains open for new submissions. PMID:26625409

  14. "Hyper-response" evaluated by 3D echocardiography after cardiac resynchronization therapy.

    PubMed

    Hotta, Viviane Tiemi; Vieira, Marcelo Luiz Campos; Rassi, Daniela do Carmo; Nishioka, Silvana Angelina D'orio; Martinelli Filho, Martino; Mathias, Wilson

    2011-06-01

    Cardiac resynchronization therapy consists of a promising treatment for patients with severe heart failure, but about 30% of patients do not exhibit clinical improvement with this procedure. However, approximately 10% of patients undergoing this therapy may have hyperresponsiveness, and three-dimensional echocardiography can provide an interesting option for the selection and evaluation of such patients. PMID:21789343

  15. Layer-specific analysis of dobutamine stress echocardiography for the evaluation of coronary artery disease

    PubMed Central

    Park, Jae Hun; Woo, Jong Shin; Ju, Shin; Jung, Su Woong; Lee, Insoo; Kim, Jin Bae; Kim, Soo Joong; Kim, Weon; Kim, Woo-Shik; Kim, Kwon Sam

    2016-01-01

    Abstract Although dobutamine stress echocardiography (DSE) is a well-defined tool for the diagnosis of coronary artery disease (CAD), false-negative and false-positive results still occur. This study investigated the diagnostic role of layer-specific analysis using 2-dimensional speckle-tracking echocardiography (STE) during DSE. A total of 121 patients who underwent DSE and showed normal wall motion and ejection fraction during baseline echocardiography were enrolled. All patients underwent coronary angiography after DSE within 2 weeks. The patients were divided into the following 4 groups according to DSE results and CAD status: negative DSE with no significant CAD (n = 73), positive DSE with significant CAD (n = 16), negative DSE with significant CAD (n = 17), and positive DSE with no significant CAD (n = 15). Layer-specific global longitudinal strain (GLS) was assessed in the endocardium, mid-myocardium, and epicardium by STE techniques. Patients with significant CAD were older, more male and showed higher glucose level compared to patients without CAD. But coronary risk factors and previous medications were not different between patients with and without CAD. There were no significant differences in whole myocardium or layer-specific GLS found in the baseline echocardiography. During recovery echocardiography, endocardial GLS was significantly different between patients with and without CAD, regardless of the DSE results. A receiver-operating characteristic curve analysis showed that endocardial GLS (>−16%) was superior for identifying significant CAD during the DSE recovery stage. Diagnostic accuracy was improved by applying the results of endocardial GLS compared with visual estimation of DSE. The assessment of layer-specific strain by STE during DSE was feasible, and the evaluation of poststress endocardial function is a more sensitive tool for the detection of CAD. PMID:27512879

  16. Clinical applications of exercise stress echocardiography in the treadmill with upright evaluation during and after exercise

    PubMed Central

    2013-01-01

    Exercise stress echocardiography is the most frequently used stress test in our laboratory. Exercise echocardiography is used mainly in the study of patients with coronary artery disease. However, the technique is increasingly being used to study other diseases. In our centre, we use an original methodology, published by us in 2000, in which we evaluate heart function during exercise in the treadmill. After the exercise, patients are maintained in orthostatic position when appropriate or lying down in left lateral decubitus for further evaluation. Since this method seems to increase the quality and the quantity of information obtained in so many clinical arenas, we now present a detailed review of this methodology and its applications. PMID:23875614

  17. Role of Echocardiography in the Evaluation of Left Ventricular Assist Devices: the Importance of Emerging Technologies.

    PubMed

    Longobardo, Luca; Kramer, Christopher; Carerj, Scipione; Zito, Concetta; Jain, Renuka; Suma, Valentin; Thohan, Vinay; Sulemanjee, Nasir; Downey, Frank X; Khandheria, Bijoy K

    2016-07-01

    The role of left ventricular assist devices (LVAD) in patients with end-stage heart failure is well known, both as a temporary treatment before transplantation and as destination therapy, in a scenario of a relative shortage of donors to satisfy the increasing requests for transplantation. The increased population of LVAD patients needs careful imaging assessment before, during, and after LVAD implantation; echocardiography is the best tool for their evaluation and is considered the diagnostic technique of choice for the assessment before, during, and after device implantation. Although the conventional echocardiographic assessment is quite effective in evaluating the main critical issues, the role of new technologies like three-dimensional echocardiography and myocardial deformation measurements is still not properly clarified. In this review, we aim to provide an overview of the main elements that should be considered in the assessment of these patients, underlining the role that could be played by new techniques to improve the diagnostic and prognostic effectiveness of echocardiography in this setting. PMID:27216842

  18. Evaluation and management of left atrial lymphoma guided by transesophageal echocardiography.

    PubMed

    Willens, Howard J; Ahn, Yeon S; Gallagher, Anthony J

    2003-08-01

    A highly mobile left atrial mass was detected by transesophageal echocardiography in a patient with mediastinal lymphoma. Transesophageal echocardiography also demonstrated resolution of the mass following chemotherapy. PMID:12859371

  19. Echocardiography based cardiac evaluation in the patients suffering from chronic obstructive pulmonary disease.

    PubMed

    Shrestha, B; Dhungel, S; Chokhani, R

    2009-03-01

    Chronic obstructive pulmonary disease (COPD) is the most common medical problem in Nepal. Echocardiography based cardiac evaluation in COPD is rare in Nepal. The purpose of this study is to evaluate the echocardiography based cardiac function in consecutively admitted COPD patients (507) in medical wards of Nepal Medical College Teaching Hospital during 13th April 2007 to 12th April 2008. Male female ratio was 0.9:1. Age (mean +/- SD) was 66.1 +/- 10.9 yr. Brahman and Chhetri ethnic group comprised of more than half of total COPD patients followed by similar number of patients in Newar (22.1%) and Mongolian ethnic groups (21.5%). More than half of the COPD patients were in age group 60-75 years, followed by less number of patients (approximately 20.0%) in both 45-59 years and 75-89 years age groups. Of the total patients (507), 141 patients underwent echocardiographic evaluation. Among them significant number of patients had poor LVEF (29, 20.6%) with statistically significant difference in LVEF (36.0 +/- 10.5 vs. 64.3 +/- 8.5%, p value < 0.01). More than half of the total patients showed features of chronic cor pulmonale (56.3%), followed by valvular heart disease (49.3%), diastolic dysfunction (38.7%) and left ventricular hypertrophy (14.1%). Mild pulmonary artery hypertension (PAH) was detected in approximately half of patients (49.1%), followed by moderate PAH in 17.6% patients. Transthoracic echocardiography was found to be very useful to identify various concomitant cardiac abnormalities demanding special treatment consideration in managing clinically COPD like patients. PMID:19769230

  20. Evaluation of right ventricular function using single-beat three-dimensional echocardiography in neonate.

    PubMed

    Watanabe, Kazuhiro; Hashimoto, Ikuo; Ibuki, Keijiro; Okabe, Mako; Kaneda, Hisashi; Ichida, Fukiko

    2015-06-01

    Aim of our study was to evaluate right ventricular (RV) systolic function in neonate using newly developed single-beat three-dimensional echocardiography (sb3DE). We enrolled 15 healthy or premature neonates (0-53 days after birth). We scanned one beat full volume using Siemens ACUSON SC2000 (Siemens AG) echocardiography with 4Z1c full-volume transducer without ECG gating. RV end-diastolic volume (RVEDV) and RV end-systolic volume (RVESV) were computed with special software dedicated to analysis for RV volume. RV ejection fraction (RVEF) and RV stroke volume (3D-RVSV) were calculated. And RV stroke volume was also determined from the recordings of ejection blood flow velocity and diameter at the level of the pulmonary orifice in RV outflow tract (Doppler-RVSV). Tricuspid annular plane systolic excursion (TAPSE) was also measured by 2D echocardiography. RVEDV ranged from 5.1 to 10.7 ml (average 7.5 ml), RVESV ranged from 2.3 to 5.8 ml (average 3.9 ml). There was a good correlation between 3D-RVSV and Doppler-RVSV (r = 0.77). Bland-Altman plot revealed that 3D-RVSV became underestimation of an average of 1.78 ml compared to Doppler-RVSV. And TAPSE positively correlated with 3D-RVEF (r = 0.58, P = 0.038). Newly developed sb3DE enables us to perform three-dimensional acquisition of RV volume without ECG gating even in neonate. However, 3D-RVSV currently tends to be underestimated in neonatal measurement. PMID:25588573

  1. Evaluation of Long Term Effect of RV Apical Pacing on Global LV Function by Echocardiography

    PubMed Central

    Tilkar, Mahendra; Jain, Siddhant; Mondal, Subrata; Sarkar, Piyabi; Modi, Nitin

    2016-01-01

    Introduction We very often face pacemaker implanted patients during follow-up with shortness of breath and effort intolerance inspite of normal clinical parameters. Aim The aim of our study is to evaluate the cause of effort intolerance and probable cause of sub-clinical Congestive Cardiac Failure (CCF) in a case of long term Right Ventricular (RV) apical pacing on global Left Ventricular (LV) function non- invasively by echocardiography. Materials and Methods We studied 54 patients (Male 42, Female 12) of complete heart block (CHB) with RV apical pacing (40 VVI and 14 DCP). Mean duration of pacing was 58+4 months. All patients underwent 24 hours Holter monitoring to determine the percentage of ventricular pacing beats. 2-D Echocardiography was done to assess the regional wall motion of abnormality and global LV ejection fraction by modified Simpson’s rule. These methods were coupled with the Doppler derived Myocardial Performance Index (MPI), tissue Doppler imaging, and mechanical regional dyssynchrony with 3-D Echocardiography. Data were analysed from 54 RV- apical paced patients and compared with age and body surface area of 60 controlled subjects (Male 46, Female 14). Results Evaluation of LV function in 54 patients demonstrated regional wall motion abnormality and Doppler study revealed both LV systolic and diastolic dysfunction compare with control subjects (regional wall motion abnormality 80±6% vs 30±3% with p-value<0.0001) which is proportional to the percentage of ventricular pacing beats (mean paced beat 78%). Global LVEF 50±4% vs 60±2% (p-valve <0.0001) and MPI 0.46 ±0.12 v/s 0.36±0.09 (p-value <0.0001). Conclusion RV–apical pacing induces iatrogenic electrical dyssynchrony which leads to remodeling of LV and produces mechanical dyssynchrony which is responsible for LV dysfunction. Alternate site of RV pacing and/or biventricular pacing should be done to maintain biventricular electrical synchrony which will preserve the LV function. PMID

  2. Is echocardiography or magnetic resonance imaging superior for precoarctation angioplasty evaluation?

    PubMed

    Mendelsohn, A M; Banerjee, A; Donnelly, L F; Schwartz, D C

    1997-09-01

    We compared the dimensions of the aorta obtained by two-dimensional transthoracic echocardiography (echo) (median, 2.5 mo preangioplasty) and magnetic resonance imaging (MRI) (median, 4.2 mo preangioplasty) to those obtained by angiography (cath) in 13 patients (age, 7.7 +/- 1.6 yr; mean +/- SEM) who underwent evaluation for coarctation balloon angioplasty between April 1993-January 1996. Echo measurements were obtained from the suprasternal and subcostal sagittal planes, MRI measurements from axial and sagittal oblique views, and cath measurements from the straight lateral or oblique views. Measurements of the diameters of the aortic isthmus, coarctation, descending aorta at the diaphragm, and isthmus length were made by all three modalities. Presence of aorto-aortic collaterals was determined, and the coarctation length was delineated. Investigators were blinded to other measurement data prior to statistical analysis. Data analysis by repeated analysis of variance (ANOVA) and Student-Newman-Keuls testing revealed no statistically significant difference between systolic pressure gradient by clinical examination (32.2 +/- 5.9 mm Hg), peak instantaneous Doppler evaluation (37.5 +/- 2.9 mm Hg), or preangioplasty systolic pressure gradient (32.1 +/- 3.3 mm Hg). With the exception of measurements of the descending aorta (echo, 11.7 +/- 0.9 mm vs. MRI, 13.3 +/- 0.8 mm vs. cath, 14.0 +/- 1.3 mm; P = 0.04), there was no statistically significant difference in dimensions of the aortic isthmus (9.2 +/- 0.6 mm vs. 10.5 +/- 0.9 mm vs. 10.8 +/- 0.9 mm), coarctation site diameter (4.8 +/- 0.6 mm vs. 5.6 +/- 0.9 mm vs. 5.3 +/- 0.8 mm), or isthmus length (12.4 +/- 2.1 mm vs. 12.1 +/- 2.2 mm vs. 10.9 +/- 1.7 mm). The correlation coefficients derived from comparisons of MRI vs. cath to echo vs. cath were similar for all dimensions except for isthmus length (P < 0.01). MRI demonstrated aorto-aortic collaterals more frequently than echo, while echocardiography better demonstrated

  3. Transthoracic echocardiography in the evaluation of pediatric pulmonary hypertension and ventricular dysfunction

    PubMed Central

    Friedberg, Mark K.; Nestaas, Eirik; Michel-Behnke, Ina

    2016-01-01

    Abstract Transthoracic echocardiography (TTE) is the most accessible noninvasive diagnostic procedure for the initial assessment of pediatric pulmonary hypertension (PH). This review focuses on principles and use of TTE to determine morphologic and functional parameters that are also useful for follow-up investigations in pediatric PH patients. A basic echocardiographic study of a patient with PH commonly includes the hemodynamic calculation of the systolic pulmonary artery pressure (PAP), the mean and diastolic PAP, the pulmonary artery acceleration time, and the presence of a pericardial effusion. A more detailed TTE investigation of the right ventricle (RV) includes assessment of its size and function. RV function can be evaluated by RV longitudinal systolic performance (e.g., tricuspid annular plane systolic excursion), the tricuspid regurgitation velocity/right ventricular outflow tract velocity time integral ratio, the fractional area change, tissue Doppler imaging–derived parameters, strain measurements, the systolic-to-diastolic duration ratio, the myocardial performance (Tei) index, the RV/left ventricle (LV) diameter ratio, the LV eccentricity index, determination of an enlarged right atrium and RV size, and RV volume determination by 3-dimensional echocardiography. Here, we discuss the potential use and limitations of TTE techniques in children with PH and/or ventricular dysfunction. We suggest a protocol for TTE assessment of PH and myocardial function that helps to identify PH patients and their response to pharmacotherapy. The outlined protocol focuses on the detailed assessment of the hypertensive RV; RV-LV crosstalk must be analyzed separately in the evaluation of different pathologies that account for pediatric PH. PMID:27162612

  4. Transthoracic echocardiography in the evaluation of pediatric pulmonary hypertension and ventricular dysfunction.

    PubMed

    Koestenberger, Martin; Friedberg, Mark K; Nestaas, Eirik; Michel-Behnke, Ina; Hansmann, Georg

    2016-03-01

    Transthoracic echocardiography (TTE) is the most accessible noninvasive diagnostic procedure for the initial assessment of pediatric pulmonary hypertension (PH). This review focuses on principles and use of TTE to determine morphologic and functional parameters that are also useful for follow-up investigations in pediatric PH patients. A basic echocardiographic study of a patient with PH commonly includes the hemodynamic calculation of the systolic pulmonary artery pressure (PAP), the mean and diastolic PAP, the pulmonary artery acceleration time, and the presence of a pericardial effusion. A more detailed TTE investigation of the right ventricle (RV) includes assessment of its size and function. RV function can be evaluated by RV longitudinal systolic performance (e.g., tricuspid annular plane systolic excursion), the tricuspid regurgitation velocity/right ventricular outflow tract velocity time integral ratio, the fractional area change, tissue Doppler imaging-derived parameters, strain measurements, the systolic-to-diastolic duration ratio, the myocardial performance (Tei) index, the RV/left ventricle (LV) diameter ratio, the LV eccentricity index, determination of an enlarged right atrium and RV size, and RV volume determination by 3-dimensional echocardiography. Here, we discuss the potential use and limitations of TTE techniques in children with PH and/or ventricular dysfunction. We suggest a protocol for TTE assessment of PH and myocardial function that helps to identify PH patients and their response to pharmacotherapy. The outlined protocol focuses on the detailed assessment of the hypertensive RV; RV-LV crosstalk must be analyzed separately in the evaluation of different pathologies that account for pediatric PH. PMID:27162612

  5. Midterm follow-up dynamic echocardiography evaluation after aortic valve repair for aortic valve insufficiency.

    PubMed

    D'Ancona, Giuseppe; Amaducci, Andrea; Prodromo, John; Pirone, Francesco; Follis, Marco; Falletta, Calogero; Pilato, Michele

    2012-06-01

    We prospectively evaluated 46 patients who underwent aortic valve repair (AVR) for AV regurgitation. Rest/stress echocardiography follow-up was performed. Follow-up duration was 30.7 months, age 56 ± 14 years, ejection fraction% 57.5 ± 10.5%. Preoperative bicuspid AV was present in 14 (30.4%), leaflets calcifications in 8 (17.4%), thickening in 17 (37.0%) and prolapse in 22 (47.8%). Surgical technique included commissuroplasty (22, 47.8%), leaflet remodelling (17, 37.0%), decalcification (7, 15.2%) and raphe removal (14, 30.4%). At follow-up, rest/stress echocardiography median AV regurgitation (rest 1.0 vs. stress 1.0) and mean indexed AV area (IAVA) (rest 2.6 ± 0.74 cm(2)/m(2) vs. stress 2.8 ± 0.4 cm(2)/m(2)) were unchanged (P = ns). Mean (rest 4.7 ± 3.9 mmHg vs. stress 9.7 ± 5.8 mmHg) and peak (rest 9.5 ± 7.2 mmHg vs. stress 19.0 ± 10.5 mmHg) transvalvular gradients were significantly increased (P < 0.0001). At linear regression, there was an independent inverse correlation between commissuroplasty and AV gradients during stress (B = -9.9, P = 0.01, confidence interval= -17.7 to -2.1). Although follow-up haemodynamics of repaired AVs are satisfactory, there was a fixed IAVA and significant increase in AV gradients. We were not able to identify any pre-existing anatomical condition independently related to this non-physiological behaviour under stress. Moreover, commissuroplasty seems to prevent abnormal increase of the AV gradients. PMID:22368109

  6. Transthoracic echocardiography may be useful for preoperative cardiac evaluation of gynaecological patients undergoing routine surgery.

    PubMed

    Shrestha, B; Pradhan, P; Shakya, G R; Giri, A; Regmi, R; Dhungel, S

    2012-12-01

    Echocardiography has been an integral noninvasive tool for [preoperative] cardiac evaluation that provides with echocardiographic details which may also be useful to perioperative clinicians to tailor their anesthetic deliberation while dealing with preoperative patients. The objective of this study is preoperative evaluation of routine gynecological patients echocardiographically after being referred from respective internists or anesthesiologists. This was a prospective, nonrandomized study of elective 68 cases who underwent echocardiographic evaluation preoperatively from 15th July 2009 to 14th July 2012. The mean age of the patients was 52.1 +/- 10.3 years with the age range of 30-79 years. Valvular heart disease was the most common echocardiographic finding (129.4%) followed by left ventricular diastolic dysfunction, LVDD (48.5%) and left ventricular hypertrophy (22.1%). Systolic dysfunction was detected in 2.9% of patients and pulmonary arterial hypertension in 2.9% patients. Amongst patients referred after preoperative anaesthetic evaluation, patients had different cardiac lesions echocardiographically. Preoperative echocardiographic evaluation may provide important cardiac informations and values which might be employed by perioperative physicians to tailor their treatment. PMID:24579536

  7. Evaluation of fetal echocardiography as a routine antenatal screening tool for detection of congenital heart disease

    PubMed Central

    Nayak, Krishnananda; Shetty, Ranjan; Narayan, Pratap Kumar

    2016-01-01

    Background Fetal echocardiography plays a pivotal role in identifying the congenital heart defects (CHDs) in utero. Though foetal echocardiography is mostly reserved for high risk pregnant women, its role as a routine prenatal screening tool still needs to be defined. Performing foetal echocardiography based on only these indications can lead to a significant numbers of CHD cases going undetected who will be deprived of further management leading to increased early neonatal mortalities. The aim of this study is to assess the incidence of CHDs by fetal echocardiography in an unselected population of pregnant women in comparison with pregnant women with conventional high risk factors for CHD. Methods This study enrolled consecutive pregnant women who attended antenatal clinic between 2008 and 2012 in a tertiary care hospital. These pregnant women were categorized into two groups: high risk group included pregnant women with traditional risk factors for CHD as laid down by Pediatric Council of the American Society of Echocardiography and low risk group. Detailed fetal 2 D echocardiography was done. Results A total of 1,280 pregnant women were included in study. The 118 women were categorized as the high risk group while remaining 1,162 were included in the low risk group. Twenty six cases of CHDs were detected based on abnormal foetal echocardiography (20.3 per 1,000). Two of the 26 cases of CHD occurred in high risk group whereas the remaining 24 occurred in low risk pregnancy. The difference in the incidence of CHDs between the two groups was not significant statistically (P=0.76). Conclusions Our study shows no difference in incidence of CHDs between pregnancies associated with high risk factors compared to low risk pregnancies. So we advocate foetal echocardiography should be included as a part of routine antenatal screening and all pregnant women irrespective of risk factors for CHDs. PMID:26885491

  8. Stress echocardiography

    MedlinePlus

    ... Philadelphia, PA: Elsevier Saunders; 2016:chap 71. Fihn SD, Blankenship JC, Alexander KP, Bittl JA, et al. ... www.ncbi.nlm.nih.gov/pubmed/20538671 . Solomon SD, Wu J, Gillam L, Bulwer B. Echocardiography. In: ...

  9. Quantitative Assessment of Left Ventricular Function and Myocardial Mass: A Comparison of Coronary CT Angiography with Cardiac MRI and Echocardiography

    PubMed Central

    Kara, Bedia; Nayman, Alaaddin; Guler, Ibrahim; Gul, Enes Elvin; Koplay, Mustafa; Paksoy, Yahya

    2016-01-01

    Summary Background The purpose of this study was to compare the left ventricular parameters obtained from multi-detector row computed tomography (MDCT) studies with two-dimensional echocardiography (2DE), and magnetic resonance imaging (MRI), which is accepted as the gold standard in the evaluation of left ventricular functions. The study also aimed to evaluate whether or not there is a relationship between the MR-Argus and CMR tools software programs which are used in post-process calculations of data obtained by MRI. Material/Methods Forty patients with an average age of 51.4±14.9 years who had been scanned with cardiac MDCT were evaluated with cardiac MRI and 2DE. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), cardiac output (CO), and myocardial mass values calculated by MDCT, MRI, and 2DE were compared with each other. Two different MR software programs were used to compare left ventricular functions. The CMR tools LV tutorials method is accepted as the gold standard because it can be used in three-dimensional functional evaluation. The Pearson Correlation and Bland-Altman analysis were performed to compare the results from the two MR methods (MR-Argus and CMR tools) and the results from both the MDCT and the 2DE with the CMR tools results. Results Strong positive correlations for EF values were found between the MDCT and CMR tools (r=0.702 p<0.001), and between the MR-Argus and CMR tools (r=0.746 p<0.001). The correlation between the 2DE and CMR tools (r=0.449 p<0.004), however, was only moderate. Similar results were obtained for the other parameters. The strongest correlation for ESV, EDV, and EF was between the two MR software programs. The correlation coefficient between the MDCT and CMR tools is close to the correlation coefficient between the two software programs. While the correlation between 2DE and CMR tools was satisfactory for ESV, EDV, and CO values, it was at a moderate level for the other

  10. Noninvasive Evaluation of Myocardial Systolic Dysfunction in the Early Stage of Kawasaki Disease: A Speckle-Tracking Echocardiography Study

    PubMed Central

    Hematian, Mohammad-Nasir; Torabi, Shirin; MalaKan-Rad, Elaheh; Sayadpour-Zanjani, Keyhan; Ziaee, Vahid; Lotfi-Tolkaldany, Masoumeh

    2015-01-01

    Background: Evaluation of myocardial function by speckle-tracking echocardiography is a new method for the early diagnosis of systolic dysfunction. Objectives: We aimed to determine myocardial speckle-tracking echocardiography indices in Kawasaki Disease (KD) patients and compare them with the same indices in control subjects. Patients and Methods: Thirty-two patients (65.5% males) with KD and 19 control subjects with normal echocardiography participated in this study. After their demographic characteristics and clinical findings were recorded, all the participants underwent transthoracic echocardiography. Strain (S), Strain Rate (SR), Time to Peak Strain (TPS), and Strain Rate (TPSR), longitudinal velocity and view point velocity images in the two, three, and four-chamber views were semi-automatically obtained via speckle-tracking echocardiography. Results: Among the patients, Twenty-four cases (75%) were younger than 4 years. Mean global S and SR was significantly reduced in the KD patients compared to controls (17.03 ± 1.28 vs. 20.22 ± 2.14% and 1.66 ± 0.16 vs. 1.97 ± 0.25 1/second, respectively), while there were no significant differences regarding mean TPS, TPSR, longitudinal velocity and view point velocity. Using repeated measure of analysis of variances, we observed that S and SR decreased from base to apical level in both groups. The change in the pattern of age adjusted mean S and SR across levels was significantly different between the groups (P < 0.001 for both parameters). Conclusions: We showed changes in S and SR assessed in KD patients versus control subjects in the acute phase of KD. However, we suggest that further studies be undertaken to compare S and SR in the acute phase and thereafter in KD patients. PMID:26199701

  11. Evaluation of left and right ventricular myocardial function after lung resection using speckle tracking echocardiography

    PubMed Central

    Wang, Zhenhua; Yuan, Jianjun; Chu, Wen; Kou, Yuhong; Zhang, Xijun

    2016-01-01

    Abstract The impact of major lung resections on myocardial function has not been well-investigated. We aimed to identify this impact through the use of speckle tracking echocardiography (STE) to evaluate the right and left ventricular myocardial function in patients who underwent lung resections. Thirty patients who had lung resections were recruited for this study. Ten patients who underwent pneumonectomies were matched by age and sex, with 20 patients who underwent lobectomies. STE was performed on both right and left ventricle (RV and LV). Strain values of pre and postlung resections were compared in both the pneumonectomy group and the lobectomy group. Comparison between the pneumonectomy group and the lobectomy group was also studied. Left ventricular ejection fraction remained normal (>55%), but significantly decreased after lung resection in both the pneumonectomy group and the lobectomy group. An accelerated heart rate was observed in both groups after lung resection, with the pneumonectomy group demonstrating extra rapid heart rate (P < 0.05). Strain values in the RV and LV decreased in both groups after lung resection, with the pneumonectomy group exhibiting a further decrease in longitudinal strain in LV and RV when compared with the lobectomy group (P < 0.05). Right and left ventricular dysfunction can occur after lung resection regardless of pneumonectomy or lobectomy, and lobectomy may have a less significant impact on myocardial functions. This study demonstrated that STE is able to detect acute cardiac dysfunction after lung resection. PMID:27495031

  12. Staphylococcus aureus bacteraemia: evaluation of the role of transoesophageal echocardiography in identifying clinically unsuspected endocarditis.

    PubMed

    Incani, A; Hair, C; Purnell, P; O'Brien, D P; Cheng, A C; Appelbe, A; Athan, E

    2013-08-01

    Staphylococcus aureus bacteraemia (SAB) is an important cause of community and nosocomial sepsis, with a significant mortality rate. Infective endocarditis (IE) is a serious complication, occurring in up to 25 % of cases. Transoesophageal echocardiography (TOE) significantly improves the sensitivity of diagnosis. We compared the sensitivity and specificity of clinical evaluation alone in diagnosing IE. We evaluated all adult patients with SAB at our centre from 1998 to 2006 in order to determine what proportion of clinically unsuspected cases were diagnosed with IE on TOE. IE was defined according to modified Duke criteria. The median age of the patients was 68 years, 77 % were male and the majority of cases did not have a known pre-existing condition. Twenty-one percent were methicillin-resistant Staphylococcus aureus (MRSA). Intravascular device was the most common cause of bacteraemia. TOE was performed in 144 (100 %) of the cases. IE was suspected clinically in 15 % of cases, and the overall prevalence of possible or definite IE on TOE-inclusive Duke criteria was 29 % (n = 41). Following TOE, 22 (15 %) cases were reclassified as either possible or definite endocarditis. TOE detected a vegetation in 37 (90 %) of the 41 cases of IE. Nineteen (46 %) were not suspected clinically by Duke criteria. Sensitivity improved in the presence of pre-existing valve lesion or community acquisition. The overall in-hospital mortality was 10 %. There is a high incidence of endocarditis in SAB and a large percentage of cases are not evident on clinical grounds. TOE evaluation is indicated for all medically suitable adult patients with SAB in order to improve the detection of endocarditis. PMID:23417650

  13. Evaluation of transesophageal echocardiography in detecting cardiac sources of emboli in ischemic stroke patients

    PubMed Central

    Toodeji, Mohammad Amin; Izadi, Sadegh; Shariat, Abdolhamid; Nikoo, Mohamad Hosin

    2015-01-01

    Background: Embolus is one of the causes of ischemic stroke that can be due to cardiac sources such as valvular heart diseases and atrial fibrillation and atheroma of the aorta. Transesophageal echocardiography (TEE) is superior in identifying potential cardiac sources of emboli. Due to insufficient data on TEE findings in ischemic stroke in Iran, the present study was done to evaluate TEE in detecting cardiac sources of emboli. The main aim of this study was to describe the cardiogenic sources of emboli using TEE in the ischemic stroke patients. Methods: This is a cross-sectional study conducted during a 13-month period from January 2012 to February 2013 in Shiraz Nemazee teaching hospital. Patients admitted with stroke diagnosis were included; but hemorrhagic stroke cases were excluded. 229 patients with ischemic stroke diagnosis were included and underwent TEE. Results: Causes of cardiac emboli were detected in 65 cases (40.7%) and categorized to high-risk (29.7%) and potential risk (11%). High risk cardiac sources included atrial fibrillation (8.7%), mitral valve disease (MS or MI) 11 cases (4.75%), aortic valve disease (AS or AI) 8 (3.5%), prosthetic valve 3 (1.35%), dilated cardiomyopathy 45 (19.65%) and congestive heart failure with ejection fraction < 30% in 8 cases (3.5%). Potential cardiac sources of emboli comprised 7 cases (3.05%) of septal aneurysm, 4 (1.75%) left ventricular hypokinesia, 13 (5.7%) mitral annular calcification and 9 cases (3.95%) complex atheroma in the ascending aorta or proximal arch. Conclusion: Our study showed that high risk cardiac sources of emboli can be detected using TEE in a considerable percentage of ischemic stroke patients. The most common high risk cardiac etiologies were dilated cardiomyopathy and valvular heart diseases. PMID:26793628

  14. Echocardiography in shock management.

    PubMed

    McLean, Anthony S

    2016-01-01

    Echocardiography is pivotal in the diagnosis and management of the shocked patient. Important characteristics in the setting of shock are that it is non-invasive and can be rapidly applied.In the acute situation a basic study often yields immediate results allowing for the initiation of therapy, while a follow-up advanced study brings the advantage of further refining the diagnosis and providing an in-depth hemodynamic assessment. Competency in basic critical care echocardiography is now regarded as a mandatory part of critical care training with clear guidelines available. The majority of pathologies found in shocked patients are readily identified using basic level 2D and M-mode echocardiography. A more comprehensive diagnosis can be achieved with advanced levels of competency, for which practice guidelines are also now available. Hemodynamic evaluation and ongoing monitoring are possible with advanced levels of competency, which includes the use of colour Doppler, spectral Doppler, and tissue Doppler imaging and occasionally the use of more recent technological advances such as 3D or speckled tracking.The four core types of shock-cardiogenic, hypovolemic, obstructive, and vasoplegic-can readily be identified by echocardiography. Even within each of the main headings contained in the shock classification, a variety of pathologies may be the cause and echocardiography will differentiate which of these is responsible. Increasingly, as a result of more complex and elderly patients, the shock may be multifactorial, such as a combination of cardiogenic and septic shock or hypovolemia and ventricular outflow obstruction.The diagnostic benefit of echocardiography in the shocked patient is obvious. The increasing prevalence of critical care physicians experienced in advanced techniques means echocardiography often supplants the need for more invasive hemodynamic assessment and monitoring in shock. PMID:27543137

  15. Evaluation of cardiac functions in juvenile systemic lupus erythematosus with two-dimensional speckle tracking echocardiography.

    PubMed

    Dedeoglu, Reyhan; Şahin, Sezgin; Koka, Aida; Öztunç, Funda; Adroviç, Amra; Barut, Kenan; Cengiz, Dicle; Kasapçopur, Özgür

    2016-08-01

    The aim of this study was to investigate subclinical systolic and diastolic dysfunction in juvenile-onset systemic lupus erythematosus (j-SLE) patients with speckle tracking echocardiography (STE) and the effects of disease activity on left ventricular (LV) regional functions. Thirty-five patients with j-SLE and 30 healthy children (control group) were evaluated between January and August 2015. STE was performed on all patients and controls. Medical records, including diagnosis criteria, age at diagnosis, and duration of disease, were evaluated. SLE disease activity was assessed using the SLE Disease Activity Index (SLEDAI). j-SLE patients had lower ejection fraction than did control subjects but still within normal range. LV end-diastolic and end-systolic dimensions were significantly larger in j-SLE patients (32.43 ± 3.2 vs 28.3 ± 3.1 and 21.1 ± 1.9 vs 18.9.0 ± 2.2, respectively; p = 0.001). There was a significant reduction in longitudinal strain of LV segments in the j-SLE patients compared with controls. J-SLE patients were further divided into subgroups. Group 1 comprised patients having SLEDAI scores >8 at the onset of disease but who improved with therapy during follow-up. Group 2 included j-SLE patients with SLEDAI scores >8 at diagnosis and persistently >4 at the end of follow-up. In the LV mid-inferior and mid-inferolateral segments, STE strain measurements of group 2 were significantly lower than those of group 1 (15.9 ± 6.4 vs 20.0 ± 4.4, 17.9 ± 7.2 vs 23.2 ± 3.8; p = 0.075, p = 0.055, respectively). Simple and non-invasive STE would be helpful in predicting cardiovascular prognosis with new therapeutic medications/interventions or in objectively comparing the effects of immunosuppressive drugs in comparison with preceding STE evaluation. PMID:27139514

  16. Usefulness of three-dimensional echocardiography for evaluation of pathological mass in the right atrium.

    PubMed

    Michalski, Błażej; Kasprzak, Jarosław D; Lipiec, Piotr

    2011-04-01

    The authors present a case of 51-year-old male patient with symptoms of congestive heart failure. Two-dimensional transthoracic echocardiography (2D TTE) at the time of admission revealed a spherical, highly mobile structure in the right atrium (4.5 cm in diameter). Despite using multiple views it was impossible to distinguish if this structure had a stalk or was free-floating. The real time three-dimensional transthoracic echocardiography (3D TTE) revealed the presence of thin stalk attached to the roof of the right atrium. Guidance of 2D TTE by 3D TTE findings finally allowed the recognition of the stalk in modified subcostal view. PMID:21349104

  17. The Evaluation of Left Ventricular Functions with Tissue Doppler Echocardiography in Adults with Celiac Disease

    PubMed Central

    Akin, Fatma E.; Sari, Cenk; Özer-Sari, Sevil; Demirezer-Bolat, Aylin; Durmaz, Tahir; Keles, Telat; Ersoy, Osman; Bozkurt, Engin

    2016-01-01

    Background/Aim: The aim of this study was to investigate the effects of celiac disease on cardiac functions using tissue Doppler echocardiography (TDE). Patients and Methods: The study included 30 patients with celiac disease (CD) and 30 healthy volunteers. Echocardiographic examinations were assessed by conventional echocardiography and tissue Doppler imaging. The peak systolic velocity (S'm), early diastolic myocardial peak velocity (E'm), late diastolic myocardial peak velocity (A'm), E'm/A'm ratio, myocardial precontraction time (PCT'm), myocardial contraction time (CT'm), and myocardial isovolumetric relaxation time (IVRT'm), E to E'm ratio were measured. Results: In pulsed wave Doppler echocardiography, mitral late diastolic flow (A) velocity and E to E'm ratio were significantly higher (P = 0.02 and P = 0,017), E/A ratio was significantly lower (P = 0.008) and IVRT was significantly prolonged (P = 0.014) in patients with CD. In TDE, S'm, E'm, and E'm/A'm ratio were significantly lower, IVRT'm was longer (P = 0.009) from septal mitral annulus and S'm, E'm, E'm/A'm ratio were significantly lower, PCT'm, PCT/ET ratio, IVRT'm were longer, and MPI was higher from lateral mitral annulus in celiac group than controls. Conclusion: Our study confirms that patients with CD have impaired diastolic function. More importantly, we also demonstrated an impairment of myocardial systolic function in patients with CD by TDE. We recommend using TDE in addition to conventional echocardiography parameters for the cardiovascular risk assessment of patients with CD. PMID:26997217

  18. Non-Invasive Evaluation of Heart Function with Four-Dimensional Echocardiography

    PubMed Central

    Chen, Ran; Zhu, Meihua; Sahn, David J.; Ashraf, Muhammad

    2016-01-01

    Background The aim of this study is to assess the accuracy and feasibility of left ventricular systolic function determined by four-dimensional echocardiography (4DE). Methods Latex balloons were sewn into the left ventricle (LV) of 20 freshly harvested pig hearts which were then passively driven by a pulsatile pump apparatus. Global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS) and left ventricular ejection fraction (LVEF) derived from 4DEand two-dimensional echocardiography (2DE)-derived LVEF were quantified at different stroke volumes (SV) 30–70 ml and correlated with sonomicrometry data. Results In all comparisons, GLS, GCS, GAS, 2DE-LVEF, and 4DE-LVEF demonstrated strong correlations with sonomicrometry data (r = 0.77, r = 0.89, r = 0.79, r = 0.93, r = 0.96, all P <0.001). Bland-Altman analyses showed slight overestimations of echo-derived GLS, GCS, 2DE-LVEF and 3DE-LVEF over sonomicrometry values (bias = 2.88, bias = 3.99, bias = 3.37, bias = 2.78, respectively). Furthermore, there is better agreement between GCS, 4D LVEF and sonomicrometry values compared with GLS and 2D LVEF. Conclusion Four-dimensional echocardiography accurately assesses LV function. GCS derived by 4DE is a potential alternative parameter to quantify LV systolic function. PMID:27144844

  19. Hand-held echocardiography in the setting of pre-operative cardiac evaluation of patients undergoing non-cardiac surgery: results from a randomized pilot study.

    PubMed

    Cavallari, Ilaria; Mega, Simona; Goffredo, Costanza; Patti, Giuseppe; Chello, Massimo; Di Sciascio, Germano

    2015-06-01

    Transthoracic echocardiography is not a routine test in the pre-operative cardiac evaluation of patients undergoing non-cardiac surgery but may be considered in those with known heart failure and valvular heart disease or complaining cardiac symptoms. In this setting, hand-held echocardiography (HHE) could find a potential application as an alternative to standard echocardiography in selected patients; however, its utility in this context has not been investigated. The aim of this pilot study was to evaluate the conclusiveness of HHE compared to standard echocardiography in this subset of patients. 100 patients scheduled for non-cardiac surgery were randomized to receive a standard exam with a Philips Ie33 or a bedside evaluation with a pocket-size imaging device (Opti-Go, Philips Medical System). The primary endpoint was the percentage of satisfactory diagnosis at the end of the examination referred as conclusiveness. Secondary endpoints were the mean duration time and the mean waiting time to perform the exams. No significant difference in terms of conclusiveness between HHE and standard echo was found (86 vs 96%; P = 0.08). Mean duration time of the examinations was 6.1 ± 1.2 min with HHE and 13.1 ± 2.6 min with standard echocardiography (P < 0.001). HHE resulted in a consistent save of waiting time because it was performed the same day of clinical evaluation whereas patients waited 10.1 ± 6.1 days for a standard echocardiography (P < 0.001). This study suggests the potential role of HHE for pre-operative evaluation of selected patients undergoing non-cardiac surgery, since it provided similar information but it was faster and earlier performed compared to standard echocardiography. PMID:25985940

  20. Quantitative planar and volumetric cardiac measurements using 64 MDCT and 3T MRI versus standard 2D and M-mode echocardiography: Does anesthetic protocol matter?

    PubMed Central

    Drees, Randi; Johnson, Rebecca A; Stepien, Rebecca L; Rio, Alejandro Munoz Del; Saunders, Jimmy H; François, Christopher J

    2016-01-01

    Cross-sectional imaging of the heart utilizing computed tomography (CT) and magnetic resonance imaging (MRI) has been shown to be superior for the evaluation of cardiac morphology and systolic function in humans compared to echocardiography. The purpose of this prospective study was to test the effects of two different anesthetic protocols on cardiac measurements in 10 healthy beagle dogs using 64-multidetector row computed tomographic angiography (64-MDCTA), 3T magnetic resonance (MRI) and standard awake echocardiography. Both anesthetic protocols used propofol for induction and isoflourane for anesthetic maintenance. In addition, protocol A used midazolam/fentanyl and protocol B used dexmedetomedine as premedication and constant rate infusion during the procedure. Significant elevations in systolic and mean blood pressure were present when using protocol B. There was overall good agreement between the variables of cardiac size and systolic function generated from the MDCTA and MRI exams and no significant difference was found when comparing the variables acquired using either anesthetic protocol within each modality. Systolic function variables generated using 64-MDCTA and 3T MRI were only able to predict the left ventricular end diastolic volume as measured during awake echocardiogram when using protocol B and 64-MDCTA. For all other systolic function variables, prediction of awake echocardiographic results was not possible (P = 1). Planar variables acquired using MDCTA or MRI did not allow prediction of the corresponding measurements generated using echocardiography in the awake patients (P=1). Future studies are needed to validate this approach in a more varied population and clinically affected dogs. PMID:26082285

  1. QUANTITATIVE PLANAR AND VOLUMETRIC CARDIAC MEASUREMENTS USING 64 MDCT AND 3T MRI VS. STANDARD 2D AND M-MODE ECHOCARDIOGRAPHY: DOES ANESTHETIC PROTOCOL MATTER?

    PubMed

    Drees, Randi; Johnson, Rebecca A; Stepien, Rebecca L; Munoz Del Rio, Alejandro; Saunders, Jimmy H; François, Christopher J

    2015-01-01

    Cross-sectional imaging of the heart utilizing computed tomography and magnetic resonance imaging (MRI) has been shown to be superior for the evaluation of cardiac morphology and systolic function in humans compared to echocardiography. The purpose of this prospective study was to test the effects of two different anesthetic protocols on cardiac measurements in 10 healthy beagle dogs using 64-multidetector row computed tomographic angiography (64-MDCTA), 3T magnetic resonance (MRI) and standard awake echocardiography. Both anesthetic protocols used propofol for induction and isoflourane for anesthetic maintenance. In addition, protocol A used midazolam/fentanyl and protocol B used dexmedetomedine as premedication and constant rate infusion during the procedure. Significant elevations in systolic and mean blood pressure were present when using protocol B. There was overall good agreement between the variables of cardiac size and systolic function generated from the MDCTA and MRI exams and no significant difference was found when comparing the variables acquired using either anesthetic protocol within each modality. Systolic function variables generated using 64-MDCTA and 3T MRI were only able to predict the left ventricular end diastolic volume as measured during awake echocardiogram when using protocol B and 64-MDCTA. For all other systolic function variables, prediction of awake echocardiographic results was not possible (P = 1). Planar variables acquired using MDCTA or MRI did not allow prediction of the corresponding measurements generated using echocardiography in the awake patients (P = 1). Future studies are needed to validate this approach in a more varied population and clinically affected dogs. PMID:26082285

  2. A systematic method for using 3D echocardiography to evaluate tricuspid valve insufficiency in hypoplastic left heart syndrome

    PubMed Central

    Mart, Christopher Robin; Eckhauser, Aaron Wesley; Murri, Michael; Su, Jason Thomas

    2014-01-01

    With surgical palliation of hypoplastic left heart syndrome (HLHS), the tricuspid valve (TV) becomes the systemic atrioventricular valve and moderate/severe TV insufficiency (TVI), an adverse risk factor for survival to Fontan, has been reported in up to 35% of patients prior to stage I palliation. Precise echocardiographic identification of the mechanism of TVI cannot be determined by two-dimensional echocardiography. Three-dimensional echocardiography (3DE) can provide significant insight into the mechanisms of TVI. It is the intent of this report to propose a systematic method on how to evaluate and display 3DE images of the TV in HLHS which has not been done previously. TV anatomy, function, and the known mechanisms of insufficiency are reviewed. We defined three regions of the TV (anterior, posterior, septal) that can help define valve “leaflets” that incorporates the many variations of TV anatomy. To determine how the surgeon views the TV, a picture of a pathologic specimen of the TV was placed on a computer screen and rotated until it was oriented as it appears during surgery, the “surgeons view.” We have proposed a systematic method for evaluating and displaying the TV using 3DE which can provide significant insight into the mechanisms causing TVI in HLHS. This has the potential to improve both the surgical approach to repairing the valve and, ultimately, patient outcomes. PMID:25298694

  3. Quantitative assessment of systolic left ventricular function with speckle-tracking echocardiography in adult patients with repaired aortic coarctation.

    PubMed

    Menting, Myrthe E; van Grootel, Roderick W J; van den Bosch, Annemien E; Eindhoven, Jannet A; McGhie, Jackie S; Cuypers, Judith A A E; Witsenburg, Maarten; Helbing, Willem A; Roos-Hesselink, Jolien W

    2016-05-01

    Despite successful aortic coarctation (CoA) repair, systemic hypertension often recurs which may influence left ventricular (LV) function. We aimed to detect early LV dysfunction using LV global longitudinal strain (GLS) in adults with repaired CoA, and to identify associations with patient and echocardiographic characteristics. In this cross-sectional study, patients with repaired CoA and healthy controls were recruited prospectively. All subjects underwent echocardiography, ECG and blood sampling within 1 day. With speckle-tracking echocardiography, we assessed LV GLS on the apical four-, three- and two-chamber views. We included 150 subjects: 75 patients (57 % male, age 33.4 ± 12.8 years, age at repair 2.5 [IQR: 0.1-11.1] years) and 75 healthy controls of similar sex and age. LV GLS was lower in patients than in controls (-17.1 ± 2.3 vs. -20.2 ± 1.6 %, P < 0.001). Eighty percent of the patients had a normal LV ejection fraction, but GLS was still lower than in controls (P < 0.001). In patients, GLS correlated with systolic and diastolic blood pressure (r = 0.32, P = 0.009; r = 0.31, P = 0.009), QRS duration (r = 0.34, P = 0.005), left atrial dimension (r = 0.27, P = 0.029), LV mass (r = 0.30, P = 0.014) and LV ejection fraction (r = -0.48, P < 0.001). Patients with either associated cardiac lesions, multiple cardiac interventions or aortic valve replacement had lower GLS than patients without. Although the majority of adults with repaired CoA seem to have a normal systolic LV function, LV GLS was decreased. Higher blood pressure, associated cardiac lesions, and larger left atrial dimension are related with lower GLS. Therefore, LV GLS may be used as objective criterion for early detection of ventricular dysfunction. PMID:26780661

  4. Quantitative evaluation of Alzheimer's disease

    NASA Astrophysics Data System (ADS)

    Duchesne, S.; Frisoni, G. B.

    2009-02-01

    We propose a single, quantitative metric called the disease evaluation factor (DEF) and assess its efficiency at estimating disease burden in normal, control subjects (CTRL) and probable Alzheimer's disease (AD) patients. The study group consisted in 75 patients with a diagnosis of probable AD and 75 age-matched normal CTRL without neurological or neuropsychological deficit. We calculated a reference eigenspace of MRI appearance from reference data, in which our CTRL and probable AD subjects were projected. We then calculated the multi-dimensional hyperplane separating the CTRL and probable AD groups. The DEF was estimated via a multidimensional weighted distance of eigencoordinates for a given subject and the CTRL group mean, along salient principal components forming the separating hyperplane. We used quantile plots, Kolmogorov-Smirnov and χ2 tests to compare the DEF values and test that their distribution was normal. We used a linear discriminant test to separate CTRL from probable AD based on the DEF factor, and reached an accuracy of 87%. A quantitative biomarker in AD would act as an important surrogate marker of disease status and progression.

  5. Quantitative evaluation of dermatological antiseptics.

    PubMed

    Leitch, C S; Leitch, A E; Tidman, M J

    2015-12-01

    Topical antiseptics are frequently used in dermatological management, yet evidence for the efficacy of traditional generic formulations is often largely anecdotal. We tested the in vitro bactericidal activity of four commonly used topical antiseptics against Staphylococcus aureus, using a modified version of the European Standard EN 1276, a quantitative suspension test for evaluation of the bactericidal activity of chemical disinfectants and antiseptics. To meet the standard for antiseptic effectiveness of EN 1276, at least a 5 log10 reduction in bacterial count within 5 minutes of exposure is required. While 1% benzalkonium chloride and 6% hydrogen peroxide both achieved a 5 log10 reduction in S. aureus count, neither 2% aqueous eosin nor 1 : 10 000 potassium permanganate showed significant bactericidal activity compared with control at exposure periods of up to 1 h. Aqueous eosin and potassium permanganate may have desirable astringent properties, but these results suggest they lack effective antiseptic activity, at least against S. aureus. PMID:26456933

  6. Normal Variants in Echocardiography.

    PubMed

    Sanchez, Daniel R; Bryg, Robert J

    2016-11-01

    Echocardiography is a powerful and convenient tool used routinely in the cardiac evaluation of many patients. Improved resolution and visualization of cardiac anatomy has led to the discovery of many normal variant structures that have no known pathologic consequence. Importantly, these findings may masquerade as pathology prompting unnecessary further evaluation at the expense of anxiety, cost, or potential harm. This review provides an updated and comprehensive collection of normal anatomic variants on both transthoracic and transesophageal imaging. PMID:27612473

  7. The ability of live three-dimensional transesophageal echocardiography to evaluate the attachment site of intracardiac tumors.

    PubMed

    Khairnar, Prakash; Hsiung, Ming C; Mishra, Stuti; Nanda, Navin C; Daly, David D; Nayyar, Gaurav; Patel, Adilahmed; Mishra, Jaymala; Chuang, Yi-Cheng; Tsai, Shen-Kou; Yin, Wei-Hsin; Wei, Jeng

    2011-10-01

    In this study, a case of a right ventricular myxoma and a case of a right ventricular hemangioma are used to demonstrate the ability of live three-dimensional transesophageal echocardiography (3DTEE) to assess the site of tumor attachment. Because 3DTEE has the ability to visualize desired structures in multiple planes, we defined the attached portion of the tumors and measured the en face view dimensions. In addition, the improved ability of 3DTEE to evaluate tissue characteristics allowed differentiation of the heterogeneous myxoma and highly vascular hemangioma. On the contrary, because two-dimensional (2D) TEE only allows structures to be viewed in a 2D plane, the attachment site can be located but complete delineation and measurement of area is not possible. As surgical options become less invasive, accurate attachment site location and size will become more important to ensure complete excision. PMID:21929586

  8. Echocardiography as a Predicting Method in Diagnosis, Evaluation and Assessment of Children with Subvalvar Aortic Stenosis

    PubMed Central

    Bejiqi, Ramush; Bejiqi, Hana; Retkoceri, Ragip

    2016-01-01

    BACKGROUND: Obstruction to the left ventricular outflow of the heart may be above the aortic valve (5%), at the valve (74%), or in the subvalvar region (23%). These anomalies represent 3 to 6% of all patients with congenital heart defects (CHD), and it occurs more often in males (male-female ratio of 4:1). AIM: The purpose of this study was to determine the sensitivity and specificity of transthoracic echocardiography in diagnosis of discrete subaortic membrane, to determine convenient time for surgical intervention, and for identifying involvement of the aortic valve by subaortic shelf. MATERIAL AND METHODS: A retrospective review of the medical records and echocardiograms of 18 patients [14 male (77%) and 4 female (23%)] with discrete subaortic membrane, aged 11 month to 12 years, with mean age of 5 years and 3 month, diagnosed at the Pediatric Clinic in Prishtina, during the period September, 1999 and December, 2010 were done. RESULTS: Four patients, in neonatal age were operated from critical coarctation of the aorta and, initial signs of congestive heart failure were presented. 2 of them were operated in Belgrade, Serbia and 2 in Lausanne, Switzerland. CONCLUSION: In all presented patients bicuspid aortic valve was noted, but none of them subaortic membrane was registered. PMID:27275334

  9. [M-mode and two-dimensional echocardiography in the evaluation of right atrial masses].

    PubMed

    Makihata, S; Mihata, S; Nakagawa, Y; Konishiike, A; Tanimoto, M; Yamamoto, T; Kawai, Y; Iwasaki, T; Miyamoto, T

    1983-09-01

    Five cases of miscellaneous right atrial mass were described to illustrate the very valuable diagnostic contribution of two-dimensional echocardiography (2DE). Two patients had a large myxoma in the right atrium, and other two had an extension of hepatoma into the right atrium through the inferior vena cava. The fifth patient with a past history of myocardial infarction had a floating right atrial thrombus. The myxoma in the right atrium appeared as a mottled, ovoid, and sharply demarcated mobile mass attached to the interatrial septum. The diagnosis of these two patients was confirmed at operation. The right atrial myxoma in the first case weighed 310 g and filled almost the entire right atrium and right ventricle. To our knowledge, this was the largest myxoma among previously reported cases. The hepatoma extended into the right atrium resembled myxoma, but was obscurely demarcated. The 2DE was useful to localize a large immobile mass extending into the right atrium. All these right atrial tumors were adequately demonstrated in the right lateral decubitus position with the transducer over the right parasternal position. In the fifth case, bedside real-time 2DE was performed after the attack of pulmonary thromboembolism, and an irregular echogenic mass was seen to float freely, suggesting a thrombus. Following the immediate anticoagulant therapy with heparin, the thrombus echo was no longer visible by 2DE. It was concluded that 2DE should be extensively applied to diagnose right atrial tumors or thrombi. PMID:6086775

  10. Speckle Tracking Echocardiography to Evaluate for Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease.

    PubMed

    Rice, Jessica L; Stream, Amanda R; Fox, Daniel L; Geraci, Mark W; Vandivier, R William; Dorosz, Jennifer L; Bull, Todd M

    2016-10-01

    Pulmonary hypertension (PH) is a common complication of chronic obstructive pulmonary disease (COPD), increasing morbidity and mortality. Current echocardiographic measures have poor predictive value for the diagnosis of PH in COPD. Right ventricular (RV) strain obtained by speckle tracking echocardiography (STE) is a measure of myocardial deformation which correlates with RV function and survival in subjects with pulmonary arterial hypertension. We hypothesized that RV strain measurements would be feasible and correlate with invasive hemodynamic measurements in patients with COPD. Retrospective analysis of RV strain values from subjects with severe COPD with echocardiogram within 48 hours of right heart catheterization was performed. First, 54 subjects were included in the analysis. Right ventricular systolic pressure (RVSP) and RV strain could be estimated in 31% and 57%, respectively. Then, 61% had RV-focused apical views, and of those, RV strain could be obtained for 94%. RV free wall strain correlated with PVR (r = 0.41, p = 0.02). Subjects with pulmonary vascular resistance (PVR) > 3 Wood units (WU) had less negative (worse) RV free wall strain values than those with PVR ≤ 3 WU, with a median strain of -20 (-23, -12) versus -23 (-29, -15), p < 0.05. A receiver operating characteristic curve demonstrated an RV free wall strain of > -23 to be 92% sensitive and 44% specific for identifying PVR > 3 WU (AUC 0.71). RV strain estimates are feasible in the majority of subjects with severe COPD. RV strain correlates with PVR and may improve screening for PH in subjects with COPD. PMID:26829151

  11. Comparison between transesophageal Doppler echocardiography and nuclear cardioangiography for the evaluation of left ventricular filling during coronary artery bypass grafting.

    PubMed

    Samuelsson, S; Brodin, L A; Broman, M; Owall, A; Settergren, G

    1995-01-01

    This study examines the relative contribution of early (E) and atrial (A) filling of the left ventricle. Ten patients were studied under anesthesia before and after coronary artery bypass grafting (CABG) using measurements of the mitral velocity-time integral (VTI) with transesophageal pulsed Doppler echocardiography and nuclear angiocardiography simultaneously. Thermodilution cardiac output measurements were made simultaneously in order to express the E and A filling in quantitative terms. The mean difference between methods in estimating E filling was -1.0 mL and the figures for the mean +/- 2 SD were 5.7 and -7.8 mL, r = 0.98 using regression analysis. The mean difference during A filling was 0.9 mL and the corresponding figures for the mean +/- 2 SD were 7.9 and -6.1 mL, r = 0.88. There was a reduction in the volume entering the left ventricle during the E filling (42-26 mL) and in the A phase (27-22 mL) from before surgery in comparison to after CABG. There was good agreement between transesophageal Doppler echocardiographic and nuclear angiocardiographic methods concerning the volume contribution during E and A phases of left ventricular filling. PMID:7802298

  12. Evaluation of cerebral-cardiac syndrome using echocardiography in a canine model of acute traumatic brain injury.

    PubMed

    Qian, Rong; Yang, Weizhong; Wang, Xiumei; Xu, Zhen; Liu, Xiaodong; Sun, Bing

    2015-01-01

    Previous studies have confirmed that traumatic brain injury (TBI) can induce general adaptation syndrome (GAS), which subsequently results in myocardial dysfunction and damage in some patients with acute TBI; this condition is also termed as cerebral-cardiac syndrome. However, most clinicians ignore the detection and treatment of myocardial dysfunction, and instead concentrate only on the serious neural damage that is observed in acute TBI, which is one of the most important fatal factors. Therefore, clarification is urgently needed regarding the relationship between TBI and myocardial dysfunction. In the present study, we evaluated 18 canine models of acute TBI, by using real-time myocardial contrast echocardiography and strain rate imaging to accurately evaluate myocardial function and regional microcirculation, including the strain rate of the different myocardial segments, time-amplitude curves, mean ascending slope of the curve, and local myocardial blood flow. Our results suggest that acute TBI often results in cerebral-cardiac syndrome, which rapidly progresses to the serious stage within 3 days. This study is the first to provide comprehensive ultrasonic characteristics of cerebral-cardiac syndrome in an animal model of TBI. PMID:26064794

  13. Application of Real-Time Three-Dimensional Echocardiography to Evaluate the Pre- and Postoperative Right Ventricular Systolic Function of Patients with Tetralogy of Fallot

    PubMed Central

    Cui, Cunying; Liu, Lin; Fan, Taibing; Peng, Bangtian; Cheng, Zhaoyun; Ge, Zhenwei; Li, Yanan; Liu, Yuanyuan; Zhang, Yanwei; Ai, Feng; Zhang, Lianzhong

    2015-01-01

    Tetralogy of Fallot (ToF) can be challenging for clinicians to both diagnose and treat, given the multiple heart defects that are by definition associated with the illness. This study investigates the value of real-time three- dimensional echocardiography (RT-3DE) in evaluating the pre-and postoperative right ventricular systolic function of patients with tetralogy of Fallot. A total of 41 ToF patients were divided into two groups: the child group (CG) and the adult group (AG) according to age. The right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), and the right ventricular ejection fraction (RVEF) of ToF patients were measured before surgery, 7 days, and 3 months after the surgery. The correlation between the preoperative Nakata index and RVEF was then analyzed. Compared with the RVEDV and RVESV prior to surgery, those of the postoperative 7-day and 3-month were not statistically significant (p > 0.05). However, RVEF decreased, and the difference was statistically significant (p < 0.05). The differences in RVEDV, RVESV, and RVEF between postoperative 3-month and 7-day were not significant (p > 0.05). Compared with the pre-and postoperative RVEDV and RVESV of CG, those of AG increased. However, RVEF decreased, and the differences were statistically significant (p < 0.05). Our study indicated that the correlation between preoperative Nakata index and RVEF was good. Ultimately, we did confirm that RT-3DE can quantitatively evaluate the right ventricular volume and systolic function of ToF patients, thereby providing clinical significance in determining postoperative efficacy and prognosis evaluation. PMID:27122891

  14. Three-dimensional echocardiography in the evaluation of global and regional function in patients with recent myocardial infarction: a comparison with magnetic resonance imaging.

    PubMed

    Thorstensen, Anders; Dalen, Håvard; Hala, Pavel; Kiss, Gabriel; D'hooge, Jan; Torp, Hans; Støylen, Asbjørn; Amundsen, Brage

    2013-07-01

    We aimed to compare three-dimensional (3D) and two-dimensional (2D) echocardiography in the evaluation of patients with recent myocardial infarction (MI), using late-enhancement magnetic resonance imaging (LE-MRI) as a reference method. Echocardiography and LE-MRI were performed approximately 1 month after first-time MI in 58 patients. Echocardiography was also performed on 35 healthy controls. Left ventricular (LV) ejection fraction by 3D echocardiography (3D-LVEF), 3D wall-motion score (WMS), 2D-WMS, 3D speckle tracking-based longitudinal, circumferential, transmural and area strain, and 2D speckle tracking-based longitudinal strain (LS) were measured. The global correlations to infarct size by LE-MRI were significantly higher (P < 0.03) for 3D-WMS and 2D-WMS compared with 3D-LVEF and the 4 different measurements of 3D strain, and 2D global longitudinal strain (GLS) was more closely correlated to LE-MRI than 3D GLS (P < 0.03). The segmental correlations to infarct size by LE-MRI were also significantly higher (P < 0.04) for 3D-WMS, 2D-WMS, and 2D LS compared with the other indices. Three-dimensional WMS showed a sensitivity of 76% and a specificity of 72% for identification of LV infarct size >12%, and a sensitivity of 73% and a specificity of 95% for identification of segments with transmural infarct extension. Three-dimensional WMS and 2D gray-scale echocardiography showed the strongest correlations to LE-MRI. The tested 3D strain method suffers from low temporal and spatial resolution in 3D acquisitions and added diagnostic value could not be proven. PMID:23347171

  15. Value of transthoracic echocardiography for the detection of high-grade coronary artery stenosis: prospective evaluation in 50 consecutive patients scheduled for coronary angiography.

    PubMed

    Krzanowski, M; Bodzoń, W; Brzostek, T; Nizankowski, R; Szczeklik, A

    2000-12-01

    We prospectively evaluated the feasibility of direct, transthoracic evaluation of coronary arteries to diagnose flow-limiting lesions. Second harmonic mode in B-mode and fundamental mode for Doppler examinations was used. A stenosis was diagnosed when maximal flow velocity at least doubled in comparison with that of the adjacent segment or when local velocity was at least 2 m/s. Of the left anterior descending coronary artery segments assessed, 34 were proximal, 35 middle, and 34 distal segments. The corresponding figures for circumflex coronary artery segments were 17 proximal and 11 middle segments and for the right coronary artery, 14 proximal and 15 distal segments. No distal circumflex and only 1 mid right coronary artery segment was visualized. Twenty-eight stenoses were diagnosed. Specificity for stenosis detection was 96% to 100% and sensitivity was 62% to 66%. Echo-cardiography was unable to document occlusions. Transthoracic echocardiography allows for coronary artery assessment in a significant portion of patients scheduled for coronary angiography. It may be used to document the presence of coronary artery stenosis. With further technologic improvements, transthoracic echocardiography could enable the monitoring of the restenosis process after percutaneous transluminal coronary angioplasty/stent intervention and coronary artery luminal narrowing after heart transplantation. PMID:11119277

  16. [Echocardiography in infirmary].

    PubMed

    Heredia Guerrero, Ericka Nancy

    2007-01-01

    Cardiovascular diseases are the 1st death cause worldwide in the beginning of the third millennium. Due to its high incidence and fatal complications the study of ischaemic cardiopathy had great importance. Echocardiography is an image diagnostic technique, based on the use of ultrasound, applied in the evaluation and recognition of cardiovascular diseases. It is non invasive, harmless, accessible, easy to made and quick to interpret, safe and cheaper than others imaging techniques, its continuous development has allow its use in all cardiology fields. An area where the nursing staff begin their participation in the National Institute of Cardiology "Ignacio Chavez" is the Echocardiography Department where the nurse professional profile must embrace knowledge in different areas, with an active participation in the echocardiographic studies and protocols, optimizing the patient's quality of attention with the use of Nursing Attention Process based in the theory of Dorothea Orem with the aim of standardize and improve the patient's quality of attention along with the interdisciplinary team. PMID:18938734

  17. Evaluation of the anti-ischemic effects of D-ribose during dobutamine stress echocardiography: a pilot study

    PubMed Central

    Sawada, Stephen G; Lewis, Stephen; Kovacs, Roxanne; Khouri, Samer; Gradus-Pizlo, Irmina; St Cyr, John A; Feigenbaum, Harvey

    2009-01-01

    D-Ribose, a pentose sugar, has shown to improve myocardial high-energy phosphate stores depleted by ischemia. This study investigated the ability of D-Ribose with low dose dobutamine to improve the contractile response of viable myocardium to dobutamine and to assess the efficacy of D-ribose in reducing stress-induced ischemia. Twenty-six patients with ischemic cardiomyopathy completed a two-day, randomized, double blind crossover trial comparing the effects of D-Ribose and placebo on regional wall motion. On the first study day, either D-Ribose or placebo was infused for 4.5 hours. Low (5 and 10 μ/kg/min) and subsequently, high (up to 50 μ/kg/min) dose dobutamine echocardiography was then performed. On the second study day, patients crossed over to the alternative article for a similar 4.5 hours infusion time period and underwent a similar evaluation. The wall motion response during low dose dobutamine was the same with D-Ribose and placebo in 77% of segments (203/263, Kappa = 0.37). In segments with discordant responses, more segments improved with D-Ribose than with placebo (41 vs. 19 segments, p = 0.006). With high dose dobutamine infusion, the wall motion response (ischemia vs. no ischemia) was the same with D-Ribose and placebo in 83% of interpretable segments (301/363, kappa = 0.244). In segments with discordant responses, there were more ischemic segments with placebo compared to D-Ribose (36 vs. 26, p = 0.253). Nineteen patients developed ischemia during the dobutamine and placebo infusion and 13 patients had ischemia during dobutamine and D-ribose infusion (p = 0.109). D-Ribose improved contractile responses to dobutamine in viable myocardium with resting dysfunction but had no significant effect in reducing the frequency of stress-induced wall motion abnormalities. PMID:19200398

  18. Transesophageal echocardiography in NeoChord procedure

    PubMed Central

    Demetrio, Pittarello; Andrea, Colli; Gianclaudio, Falasco; Antonio, Marcassa; Gino, Gerosa; Carlo, Ori

    2015-01-01

    Background: Transapical off-pump mitral valve intervention with neochord implantation for degenerative mitral valve disease have been recently introduced in the surgical practice. The procedure is performed under 2D-3D transesophageal echocardiography guidance. Methods: The use of 3D real-time transesophageal echocardiography provides more accurate information than 2D echocardiography only in all the steps of the procedure. In particular 3D echocardiography is mandatory for preoperative assessment of the morphology of the valve, for correct positioning of the neochord on the diseased segment, for the final tensioning of the chordae and for the final evaluation of the surgical result. Result and Conclusion: This article is to outline the technical aspects of the transesophageal echocardiography guidance of the NeoChord procedure showing that the procedure can be performed only with a close and continuous interaction between the anesthesiologist and the cardiac surgeon. PMID:25849688

  19. Echocardiography, nuclear scintigraphy, and stress testing in the emergency department evaluation of acute coronary syndrome.

    PubMed

    Mather, P J; Shah, R

    2001-05-01

    There are between 3 and 5 million visits to EDs each year for complaints of chest pain. Of these, about one half of the patients have a noncardiac cause for their chest pain. Of the remainder, about 30% to 50% have significant coronary disease. It is quite clear that patients who are at high risk for a coronary event should be admitted to the hospital. For the low-to-moderate risk patients, the decision to admit or discharge the patient from the ED is not quite so easy. The emergency physician has to decide which tests can be helpful in the decision-making process, this can be undertaken in conjunction with a consultative cardiologist. It can be argued that if a patient does not have a normal test result whichever that evaluatory test is), then the patient should be admitted for further work-up and evaluation. The easiest test to perform in the ED setting is an echocardiogram. The images can be sent by telecommunication to a qualified echocardiogram reader for interpretation. This also has a reasonable NPV, although not necessarily as good as some of the other modalities available, unless interpreted in light of cardiac enzyme test results. If the index of suspicion is still high, then a stress echocardiogram can be considered. This has an excellent NPV and can be easily performed in [table: see text] most patients. This should not be undertaken in the face of an evolving MI, and patients should be observed for at least 8 hours after their initial presentation to the ED prior to undergoing a provocative test. Nuclear scintigraphy, another modality available for cardiac risk stratification, can be a logistical nightmare. The nuclear isotopes are strictly regulated by the Nuclear Regulatory Commission. The emergency physician may inject the isotopes, provided that he or she has undergone the necessary radiation training. Also, the patient must be removed from the ED to a radioisotope-approved area for the duration of the scan. One of the most difficult questions left

  20. Evaluation of tissue doppler echocardiography and T2* magnetic resonance imaging in iron load of patients with thalassemia major

    PubMed Central

    Saravi, Mehrdad; Tamadoni, Ahmad; Jalalian, Rozita; Mahmoodi – Nesheli, Hassan; Hojati, Mosatafa; Ramezani, Saeed

    2013-01-01

    Background: Iron-mediated cardiomyopathy is the main complication of thalassemia major (TM) patients. Therefore, there is an important clinical need in the early diagnosis and risk stratification of patients. The aim of this study was to evaluate the efficacy of tissue doppler imaging (TDI) to study cardiac iron overload in patients with TM using T2* magnetic resonance (MR) as the gold-standard non-invasive diagnostic test. Methods: A total of 100 TM patients with the mean age of 19±7 years and 100 healthy controls 18.8±7 years were evaluated. Conventional echocardiography, TDI, and cardiac MRI T2* were performed in all subjects. TDI measures included myocardial systolic (Sm), early (Em) and late (Am) diastolic velocities at basal and middle segments of septal and lateral LV wall. The TM patients were also subgrouped according to those with iron load (T2* ≤ 20 ms) and those without (T2* > 20 ms), and also severe (T2* ≤ 10 ms) versus the non-severe (T2* ≤ 10 ms). Results: Using T2* cardiovascular MR, abnormal myocardial iron load (T2* ≤ 20 ms) was detected in 84% of the patients and among these, 50% (42/84) had severe (T2* ≤ 10 ms) iron load. The mean T2* was 11.6±8.6 ms (5–36.7). A negative linear correlation existed between transfusion period of patients and T2* levels (r = -0.53, p=0.02). The following TDI measures were lower in patients than in controls: basal septal Am (p<0.05), mid-septal Em and Am (p<0.05), basal lateral Am (p<0.05), mid-lateral LV wall Sm (p<0.05) and Am (p<0.05). Conclusion: Tissue doppler imaging is helpful in predicting the presence of myocardial iron load in Thalassemia patients. Therefore, it can be used for screening of thalassemia major patients. PMID:24009962

  1. Clinical echocardiography - an overview.

    PubMed Central

    Lalani, A. V.; Lee, S. J.

    1976-01-01

    Echocardiography is a new diagnostic technique for noninvasive assessment of the size, structure and function of the heart, using pulsed ultrasound. The physical principles underlying the generation of the ultrasonic signal for diagnostic use and the three modes (A, B and M) of displaying the reflected "echo" signal are briefly discussed. A full echographic study of the heart includes evaluation of the dimensions and patterns of movement of its various structures and chambers. The normal anatomic relations and echographic appearances of these structures and the changes they undergo in some of the more commonly recognized clinical conditions are described. Assessment of output and contractile behaviour of the left ventricle and recognition of various congenital heart defects are two of the more recent applications of this technique. Two-dimensional sector and multiscanning devices permit several areas of the heart to be visualized simultaneously in "real time". Images FIG. 4 FIG. 5 FIG. 6 FIG. 7 FIG. 8 FIG. 9 FIG. 10 PMID:130201

  2. Myocardial perfusion echocardiography and coronary microvascular dysfunction

    PubMed Central

    Barletta, Giuseppe; Del Bene, Maria Riccarda

    2015-01-01

    Our understanding of coronary syndromes has evolved in the last two decades out of the obstructive atherosclerosis of epicardial coronary arteries paradigm to include anatomo-functional abnormalities of coronary microcirculation. No current diagnostic technique allows direct visualization of coronary microcirculation, but functional assessments of this circulation are possible. This represents a challenge in cardiology. Myocardial contrast echocardiography (MCE) was a breakthrough in echocardiography several years ago that claimed the capability to detect myocardial perfusion abnormalities and quantify coronary blood flow. Research demonstrated that the integration of quantitative MCE and fractional flow reserve improved the definition of ischemic burden and the relative contribution of collaterals in non-critical coronary stenosis. MCE identified no-reflow and low-flow within and around myocardial infarction, respectively, and predicted the potential functional recovery of stunned myocardium using appropriate interventions. MCE exhibited diagnostic performances that were comparable to positron emission tomography in microvascular reserve and microvascular dysfunction in angina patients. Overall, MCE improved echocardiographic evaluations of ischemic heart disease in daily clinical practice, but the approval of regulatory authorities is lacking. PMID:26730291

  3. Myocardial perfusion echocardiography and coronary microvascular dysfunction.

    PubMed

    Barletta, Giuseppe; Del Bene, Maria Riccarda

    2015-12-26

    Our understanding of coronary syndromes has evolved in the last two decades out of the obstructive atherosclerosis of epicardial coronary arteries paradigm to include anatomo-functional abnormalities of coronary microcirculation. No current diagnostic technique allows direct visualization of coronary microcirculation, but functional assessments of this circulation are possible. This represents a challenge in cardiology. Myocardial contrast echocardiography (MCE) was a breakthrough in echocardiography several years ago that claimed the capability to detect myocardial perfusion abnormalities and quantify coronary blood flow. Research demonstrated that the integration of quantitative MCE and fractional flow reserve improved the definition of ischemic burden and the relative contribution of collaterals in non-critical coronary stenosis. MCE identified no-reflow and low-flow within and around myocardial infarction, respectively, and predicted the potential functional recovery of stunned myocardium using appropriate interventions. MCE exhibited diagnostic performances that were comparable to positron emission tomography in microvascular reserve and microvascular dysfunction in angina patients. Overall, MCE improved echocardiographic evaluations of ischemic heart disease in daily clinical practice, but the approval of regulatory authorities is lacking. PMID:26730291

  4. The Origin of Echocardiography

    PubMed Central

    Singh, Siddharth; Goyal, Abha

    2007-01-01

    The original description of M-mode echocardiography in 1953, by Inge Edler (1911–2001) and his physicist friend Hellmuth Hertz, marked the beginning of a new diagnostic noninvasive technique. Edler used this technique primarily for the preoperative study of mitral stenosis and diagnosis of mitral regurgitation. His work was carried forward by cardiologists all over the world, who developed Doppler, 2-dimensional, contrast, and transesophageal echocardiography. These are now standard in cardiologic examinations. Edler also influenced neurologists and obstetricians at Lund University (Sweden) to use ultrasound in their fields. For his landmark discovery, Edler is recognized as the “Father of Echocardiography.” PMID:18172524

  5. Multimodality evaluation of ventricular function: comparison of cardiac magnetic resonance imaging, echocardiography, and planar and SPECT blood pool imaging

    NASA Astrophysics Data System (ADS)

    Feiglin, David H.; Krol, Andrzej; Tillapaugh-Fay, Gwen M.; Szeverenyi, Nikolaus M.; Thomas, Frank D.

    2001-05-01

    Fifteen patients underwent resting echocardiography (EC), ECG gated cardiac MR ventriculography (MRV) and blood pool planar and SPECT ventriculography (SPV) sequentially on the same day. In addition, 36 patients had sequential ECG gated blood pool and SPV and 20 normal volunteers, age > 18 years, had sequential ECG gated cardiac MRI performed on both Siemens closed, 1.5T, and open, 0.2T, magnets. Echocardiography was performed using a HP 5500 system equipped with an S4 transducer in 2D mode. MRV at 0.2T and 1.5T used a circular polarized body coil. Nuclear Medicine studies used 25 mCi Tc- 99m labeled red blood cells. Gated planar and SPV were acquired on a dual head Siemens E-Cam system. We have found that MRV affords the most accurate measurement of ventricular function. SPV and MRV provide similar estimations of left ventricular function (LVEF). Further, SPV consistently provides higher LVEF, as compared to the planar data simultaneously acquired. Observed significant differences in intermodality measurements indicate that follow up studies in patients, especially in patients whose management is critically dependent on functional measurement changes, should be monitored by one modality only.

  6. Functional Neonatal Echocardiography: Indian Experience

    PubMed Central

    Suryawanshi, Pradeep B.; Maheshwari, Rajesh; Patnaik, Suprabha; Malshe, Nandini; Kalrao, Vijay; Lalwani, Sanjay; Surwade, Jitendra

    2015-01-01

    Introduction Functional echocardiography, as opposed to echocardiography as performed by the cardiologist, is the bedside utilization of cardiac ultrasound to take after functional and haemodynamic changes longitudinally. Information reflecting cardiovascular capacity and systemic and pulmonary blood flow in sick preterm and term neonates can be observed utilizing this strategy. Information is lacking on its use in neonatal units in India. Aim To characterize the impact of Functional neonatal echocardiography (FnECHO) programme on decision making in a tertiary care centre in India by evaluating its frequency of use, patient characteristics, and indications. Materials and Methods Prospective observational study of neonates in a tertiary Neonatal Intensive Care Unit (NICU) in Pune (India) from February 2014 to January 2015. All the neonates undergoing FnECHO during this 12 month period based on clinical findings were included in the study. Data extracted from the review of the clinical notes included gestational age, birth-weight, mode of delivery, Apgar scores, details of respiratory and cardiovascular support, timing of FnECHO and any other clinical diagnosis. The findings of echocardiography were recorded and correlated with the clinical and other laboratory or X-ray findings. If these findings indicated a change in management, it was instituted. Results A total of 348 echocardiographic studies were performed in 187 neonates (mean 1.86; SD 2.02). The most frequent indication was Patent Ductus Arteriosus (PDA) assessment (n= 174, 50%), followed by haemodynamic instability (n=43, 12.36%). The results of FnECHO modified treatment in 148 cases (42.50%) in the form of addition and/or change in the treatment or avoidance of unnecessary intervention. Conclusion FnECHO is frequently used in the NICU setting and may be a useful tool to guide treatment. PDA assessment and haemodynamic instability are the most frequent indications. To validate its usefulness, well co

  7. Quantitative nondestructive evaluation: Requirements for tomorrow's reliability

    NASA Technical Reports Server (NTRS)

    Heyman, Joseph S.

    1991-01-01

    Quantitative Nondestructive Evaluation (QNDE) is the technology of measurement, analysis, and prediction of the state of material/structural systems for safety, reliability, and mission assurance. QNDE has impact on everyday life from the cars we drive, the planes we fly, the buildings we work or live in, literally to the infrastructure of our world. Here, researchers highlight some of the new sciences and technologies that are part of a safer, cost effective tomorrow. Specific technologies that are discussed are thermal QNDE of aircraft structural integrity, ultrasonic QNDE for materials characterization, and technology spinoffs from aerospace to the medical sector. In each case, examples are given of how new requirements result in enabling measurement technologies, which in turn change the boundaries of design/practice.

  8. Emerging Concepts in Transesophageal Echocardiography

    PubMed Central

    Maxwell, Cory; Konoske, Ryan; Mark, Jonathan

    2016-01-01

    Introduced in 1977, transesophageal echocardiography (TEE) offered imaging through a new acoustic window sitting directly behind the heart, allowing improved evaluation of many cardiac conditions. Shortly thereafter, TEE was applied to the intraoperative environment, as investigators quickly recognized that continuous cardiac evaluation and monitoring during surgery, particularly cardiac operations, were now possible. Among the many applications for perioperative TEE, this review will focus on four recent advances: three-dimensional TEE imaging, continuous TEE monitoring in the intensive care unit, strain imaging, and assessment of diastolic ventricular function. PMID:26998250

  9. Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC).

    PubMed

    Sicari, Rosa; Nihoyannopoulos, Petros; Evangelista, Arturo; Kasprzak, Jaroslav; Lancellotti, Patrizio; Poldermans, Don; Voigt, Jen-Uwe; Zamorano, Jose Luis

    2008-07-01

    Stress echocardiography is the combination of 2D echocardiography with a physical, pharmacological or electrical stress. The diagnostic end point for the detection of myocardial ischemia is the induction of a transient worsening in regional function during stress. Stress echocardiography provides similar diagnostic and prognostic accuracy as radionuclide stress perfusion imaging, but at a substantially lower cost, without environmental impact, and with no biohazards for the patient and the physician. Among different stresses of comparable diagnostic and prognostic accuracy, semisupine exercise is the most used, dobutamine the best test for viability, and dipyridamole the safest and simplest pharmacological stress and the most suitable for combined wall motion coronary flow reserve assessment. The additional clinical benefit of myocardial perfusion contrast echocardiography and myocardial velocity imaging has been inconsistent to date, whereas the potential of adding - coronary flow reserve evaluation of left anterior descending coronary artery by transthoracic Doppler echocardiography adds another potentially important dimension to stress echocardiography. New emerging fields of application taking advantage from the versatility of the technique are Doppler stress echo in valvular heart disease and in dilated cardiomyopathy. In spite of its dependence upon operator's training, stress echocardiography is today the best (most cost-effective and risk-effective) possible imaging choice to achieve the still elusive target of sustainable cardiac imaging in the field of noninvasive diagnosis of coronary artery disease. PMID:18579481

  10. Incremental value of live/real time three-dimensional over two-dimensional transesophageal echocardiography in the evaluation of right coronary artery fistula.

    PubMed

    Mishra, Jaymala; Puri, Hari Prakash; Hsiung, Ming C; Misra, Stuti; Khairnar, Prakash; Laxmi Gollamudi, Bhargavi; Patel, Adilahmed; Nanda, Navin C; Yin, Wei-Hsian; Wei, Jeng; Tsai, Shen-Kou; Sudhakar, Selvin

    2011-08-01

    We report an adult with a right coronary artery to right atrial fistula in whom live/real time three-dimensional transesophageal echocardiography with its ability to trace the entire course and obtain en face views of the fistula connections, was able to provide significant incremental information over two-dimensional transesophageal echocardiography. PMID:21752093

  11. Significance of high voltage QRS anterior forces in young asymptomatic adults. Evaluation by wide-angle two-dimensional echocardiography.

    PubMed

    Loperfido, F; Digaetano, A; Pennestri, F; Mongiardo, R; Infantino, S; Fanelli, R; Guccione, P; Coppola, E

    1983-07-01

    Thirteen asymptomatic adults less than 40 years old who showed tall right precordial R waves on the ECG were examined by VCG, M-mode and two-dimensional echocardiography (2D Echo). Common causes of QRS anterior displacement, such as right ventricular enlargement or right bundle branch block, were excluded in each subject. Although each subject was normal at physical examination, 2D Echo revealed areas of left ventricular hypertrophy in eight of these 13 subjects. Four had a prevailing hypertrophy of the basal portion of the interventricular septum, three had an isolated apical hypertrophy, and one had a diffuse concentric left ventricular hypertrophy. Results were normal in five cases. 2D Echo classification was confirmed by heart catheterization findings, when available. The subjects with asymmetric septal hypertrophy showed low-voltage QRS leftward forces on the ECG and VCG. ECGs and VCGs were not useful in differentiating the subjects with atypically distributed left ventricular hypertrophy from the normals: high-voltage QRS leftward forces and T wave abnormalities were evident in some subjects of both groups. Tall right precordial R waves may constitute a marker of hypertrophic cardiomyopathy in asymptomatic young adults. 2D Echo is useful to exactly classify these subjects. PMID:6225816

  12. [Real time 3D echocardiography].

    PubMed

    Bauer, F; Shiota, T; Thomas, J D

    2001-07-01

    Three-dimensional representation of the heart is an old concern. Usually, 3D reconstruction of the cardiac mass is made by successive acquisition of 2D sections, the spatial localisation and orientation of which require complex guiding systems. More recently, the concept of volumetric acquisition has been introduced. A matricial emitter-receiver probe complex with parallel data processing provides instantaneous of a pyramidal 64 degrees x 64 degrees volume. The image is restituted in real time and is composed of 3 planes (planes B and C) which can be displaced in all spatial directions at any time during acquisition. The flexibility of this system of acquisition allows volume and mass measurement with greater accuracy and reproducibility, limiting inter-observer variability. Free navigation of the planes of investigation allows reconstruction for qualitative and quantitative analysis of valvular heart disease and other pathologies. Although real time 3D echocardiography is ready for clinical usage, some improvements are still necessary to improve its conviviality. Then real time 3D echocardiography could be the essential tool for understanding, diagnosis and management of patients. PMID:11494630

  13. [Real time 3D echocardiography

    NASA Technical Reports Server (NTRS)

    Bauer, F.; Shiota, T.; Thomas, J. D.

    2001-01-01

    Three-dimensional representation of the heart is an old concern. Usually, 3D reconstruction of the cardiac mass is made by successive acquisition of 2D sections, the spatial localisation and orientation of which require complex guiding systems. More recently, the concept of volumetric acquisition has been introduced. A matricial emitter-receiver probe complex with parallel data processing provides instantaneous of a pyramidal 64 degrees x 64 degrees volume. The image is restituted in real time and is composed of 3 planes (planes B and C) which can be displaced in all spatial directions at any time during acquisition. The flexibility of this system of acquisition allows volume and mass measurement with greater accuracy and reproducibility, limiting inter-observer variability. Free navigation of the planes of investigation allows reconstruction for qualitative and quantitative analysis of valvular heart disease and other pathologies. Although real time 3D echocardiography is ready for clinical usage, some improvements are still necessary to improve its conviviality. Then real time 3D echocardiography could be the essential tool for understanding, diagnosis and management of patients.

  14. Assessment of right ventricular systolic function by tissue Doppler echocardiography.

    PubMed

    Kjærgaard, Jesper

    2012-03-01

    This thesis summarizes a series of studies performed in order to assess the clinical usefulness of a novel echocardiographic technology that allows non-invasive assessment of regional right ventricular myocardial velocities and deformation: tissue Doppler echocardiography. While the technology is a promising tool for improving our understanding of right ventricular hemodynamics, several aspects of the technology must be evaluated. The accuracy and reproducibility of the technology is evaluated in vitro, and normal values, impact of changes in loading of the right ventricle, response to exercise and pharmacological pulmonary vasodilatation is established in normal subjects. The diagnostic and prognostic importance of adding tissue Doppler echocardiography to conventional echocardiographic and clinical parameters was evaluated in studies on patients with diseases associated with different modes of impact on right ventricular hemodynamics: pulmonary embolism, Arrhythmogenic right ventricular cardiomyopathy and pulmonary regurgitation, the latter in an animal model. The conclusions of the thesis are: Color tissue Doppler echocardiography accurately measures velocities, SR and strain in vitro. No systematic bias between ultrasound systems can be found, and accuracy of the measurements is good. However, the reproducibility of measurements in a test-retest design can limit the usefulness of the technology in daily clinical use, as 25% to 80% of change would be needed for the technology to identify a change in individual patients [I]. Normal values of tissue Doppler based measurements of RV regional velocities, SR and strain exist, and apply to both sexes and in all age groups with the exception of slightly decreasing values in strain with increasing age. Increasing preload and afterload changes regional myocardial velocities, but no changes in SR, strain or isovolumic acceleration could be observed [II and III]. Tissue Doppler echocardiography of the RV free wall in non

  15. [Quantitative evaluation of acute myocardial infarction by In-111 antimyosin Fab myocardial imaging].

    PubMed

    Naruse, H; Morita, M; Itano, M; Yamamoto, J; Kawamoto, H; Fukutake, N; Ohyanagi, M; Iwasaki, T; Fukuchi, M

    1991-11-01

    For quantitative evaluation of acute myocardial infarction, In-111 antimyosin Fab myocardial imaging (InAM) was performed in 17 patients with myocardial infarction who underwent Tl-201 (TL) and Tc-99m pyrophosphate (PYP) myocardial imaging in acute phase. For calculating the infarct size, voxel counter method was used for analysis in PYP and InAM, and extent and severity score were used on bull's-eye polar map in TL. The most appropriate cut-off level ranged from 65 to 80% by the fundamental experiment using cardiac phantom. The cut-off level of 0.70 (InAM) and 0.65 (PYP) were used for clinical application of voxel counter analysis. The infarct size calculated by InAM and PYP was compared with wall motion abnormality index by echocardiography (WMAI), TL extent score, TL severity score, peak CK and sigma CK. Infarct size by InAM showed the following correlations with other indices. PYP: r = 0.26 (ns), TL extent score: r = 0.72 (p less than 0.01), TL severity score: r = 0.65 (p less than 0.05), WMAI: r = 0.69 (p less than 0.05). The infarct size by PYP did not show any correlations with these indices. Therefore, the infarct size by InAM showed better correlations with TL and WMAI than that of PYP. So InAM was considered superior to PYP for quantitative evaluation of acute myocardial infarction. PMID:1770642

  16. Computing Myocardial Motion in 4D Echocardiography

    PubMed Central

    Mukherjee, Ryan; Sprouse, Chad; Pinheiro, Aurélio; Abraham, Theodore; Burlina, Philippe

    2012-01-01

    4D (3D spatial+time) echocardiography is gaining widespread acceptance at clinical institutions for its high temporal resolution and relatively low cost. We describe a novel method for computing dense 3D myocardial motion with high accuracy. The method is based on a classical variational optical flow technique, but exploits modern developments in optical flow research to utilize the full capabilities of 4D echocardiography. Using a variety of metrics, we present an in-depth performance evaluation of the method on synthetic, phantom, and intraoperative 4D Transesophageal Echocardiographic (TEE) data. When compared with state-of-the-art optical flow and speckle tracking techniques currently found in 4D echocardiography, the method we present shows notable improvements in error. We believe the performance improvements shown can have a positive impact when the method is used as input for various applications, such as strain computation, biomechanical modeling, or automated diagnostics. PMID:22677256

  17. A Natural Language Processing Tool for Large-Scale Data Extraction from Echocardiography Reports.

    PubMed

    Nath, Chinmoy; Albaghdadi, Mazen S; Jonnalagadda, Siddhartha R

    2016-01-01

    Large volumes of data are continuously generated from clinical notes and diagnostic studies catalogued in electronic health records (EHRs). Echocardiography is one of the most commonly ordered diagnostic tests in cardiology. This study sought to explore the feasibility and reliability of using natural language processing (NLP) for large-scale and targeted extraction of multiple data elements from echocardiography reports. An NLP tool, EchoInfer, was developed to automatically extract data pertaining to cardiovascular structure and function from heterogeneously formatted echocardiographic data sources. EchoInfer was applied to echocardiography reports (2004 to 2013) available from 3 different on-going clinical research projects. EchoInfer analyzed 15,116 echocardiography reports from 1684 patients, and extracted 59 quantitative and 21 qualitative data elements per report. EchoInfer achieved a precision of 94.06%, a recall of 92.21%, and an F1-score of 93.12% across all 80 data elements in 50 reports. Physician review of 400 reports demonstrated that EchoInfer achieved a recall of 92-99.9% and a precision of >97% in four data elements, including three quantitative and one qualitative data element. Failure of EchoInfer to correctly identify or reject reported parameters was primarily related to non-standardized reporting of echocardiography data. EchoInfer provides a powerful and reliable NLP-based approach for the large-scale, targeted extraction of information from heterogeneous data sources. The use of EchoInfer may have implications for the clinical management and research analysis of patients undergoing echocardiographic evaluation. PMID:27124000

  18. A Natural Language Processing Tool for Large-Scale Data Extraction from Echocardiography Reports

    PubMed Central

    Jonnalagadda, Siddhartha R.

    2016-01-01

    Large volumes of data are continuously generated from clinical notes and diagnostic studies catalogued in electronic health records (EHRs). Echocardiography is one of the most commonly ordered diagnostic tests in cardiology. This study sought to explore the feasibility and reliability of using natural language processing (NLP) for large-scale and targeted extraction of multiple data elements from echocardiography reports. An NLP tool, EchoInfer, was developed to automatically extract data pertaining to cardiovascular structure and function from heterogeneously formatted echocardiographic data sources. EchoInfer was applied to echocardiography reports (2004 to 2013) available from 3 different on-going clinical research projects. EchoInfer analyzed 15,116 echocardiography reports from 1684 patients, and extracted 59 quantitative and 21 qualitative data elements per report. EchoInfer achieved a precision of 94.06%, a recall of 92.21%, and an F1-score of 93.12% across all 80 data elements in 50 reports. Physician review of 400 reports demonstrated that EchoInfer achieved a recall of 92–99.9% and a precision of >97% in four data elements, including three quantitative and one qualitative data element. Failure of EchoInfer to correctly identify or reject reported parameters was primarily related to non-standardized reporting of echocardiography data. EchoInfer provides a powerful and reliable NLP-based approach for the large-scale, targeted extraction of information from heterogeneous data sources. The use of EchoInfer may have implications for the clinical management and research analysis of patients undergoing echocardiographic evaluation. PMID:27124000

  19. Training in critical care echocardiography

    PubMed Central

    2011-01-01

    Echocardiography is useful for the diagnosis and management of hemodynamic failure in the intensive care unit so that competence in some elements of echocardiography is a core skill of the critical care specialist. An important issue is how to provide training to intensivists so that they are competent in the field. This article will review issues related to training in critical care echocardiography. PMID:21906268

  20. Foucault test: a quantitative evaluation method.

    PubMed

    Rodríguez, Gustavo; Villa, Jesús; Ivanov, Rumen; González, Efrén; Martínez, Geminiano

    2016-08-01

    Reliable and accurate testing methods are essential to guiding the polishing process during the figuring of optical telescope mirrors. With the natural advancement of technology, the procedures and instruments used to carry out this delicate task have consistently increased in sensitivity, but also in complexity and cost. Fortunately, throughout history, the Foucault knife-edge test has shown the potential to measure transverse aberrations in the order of the wavelength, mainly when described in terms of physical theory, which allows a quantitative interpretation of its characteristic shadowmaps. Our previous publication on this topic derived a closed mathematical formulation that directly relates the knife-edge position with the observed irradiance pattern. The present work addresses the quite unexplored problem of the wavefront's gradient estimation from experimental captures of the test, which is achieved by means of an optimization algorithm featuring a proposed ad hoc cost function. The partial derivatives thereby calculated are then integrated by means of a Fourier-based algorithm to retrieve the mirror's actual surface profile. To date and to the best of our knowledge, this is the very first time that a complete mathematical-grounded treatment of this optical phenomenon is presented, complemented by an image-processing algorithm which allows a quantitative calculation of the corresponding slope at any given point of the mirror's surface, so that it becomes possible to accurately estimate the aberrations present in the analyzed concave device just through its associated foucaultgrams. PMID:27505659

  1. Three dimensional echocardiography in congenital heart defects

    PubMed Central

    Shirali, Girish S.

    2008-01-01

    Three dimensional echocardiography (3DE) is a new, rapidly evolving modality for cardiac imaging. Important technological advances have heralded an era where practical 3DE scanning is becoming a mainstream modality. We review the modes of 3DE that can be used. The literature has been reviewed for articles that examine the applicability of 3DE to congenital heart defects to visualize anatomy in a spectrum of defects ranging from atrioventricular septal defects to mitral valve abnormalities and Ebstein's anomaly. The use of 3DE color flow to obtain echocardiographic angiograms is illustrated. The state of the science in quantitating right and left ventricular volumetrics is reviewed. Examples of novel applications including 3DE transesophageal echocardiography and image-guided interventions are provided. We also list the limitations of the technique, and discuss potential future developments in the field. PMID:20300232

  2. A Method for Quantitatively Evaluating a University Library Collection

    ERIC Educational Resources Information Center

    Golden, Barbara

    1974-01-01

    The acquisitions department of the University of Nebraska at Omaha library conducted a quantitative evaluation of the library's book collection in relation to the course offerings of the university. (Author/LS)

  3. Quantitative Evaluation of Management Courses: Part 1

    ERIC Educational Resources Information Center

    Cunningham, Cyril

    1973-01-01

    The author describes how he developed a method of evaluating and comparing management courses of different types and lengths by applying an ordinal system of relative values using a process of transmutation. (MS)

  4. A Program to Evaluate Quantitative Analysis Unknowns

    ERIC Educational Resources Information Center

    Potter, Larry; Brown, Bruce

    1978-01-01

    Reports on a computer batch program that will not only perform routine grading using several grading algorithms, but will also calculate various statistical measures by which the class performance can be evaluated and cumulative data collected. ( Author/CP)

  5. The Evolutionary Development of Echocardiography

    PubMed Central

    Maleki, Majid; Esmaeilzadeh, Maryam

    2012-01-01

    Echocardiography is a non-invasive diagnostic technique which provides information on cardiac morphology, function, and hemodynamics. It is the most frequently used cardiovascular diagnostic test only after electrocardiography. In less than five decades, the evolution in this technique has made it the basic part of cardiovascular medicine. Herein, the evolution of various forms of echocardiography is briefly described. PMID:23390327

  6. Evaluation of a robotic arm for echocardiography to X-ray image registration during cardiac catheterization procedures.

    PubMed

    Ma, Yingliang; Penney, Graeme P; Bos, Dennis; Frissen, Peter; de Fockert, George; King, Andy; Gao, Gang; Yao, Cheng; Totman, John; Ginks, Matthew; Rinaldi, C; Razavi, Reza; Rhode, Kawal S

    2009-01-01

    We present an initial evaluation of a robotic arm for positioning a 3D echo probe during cardiac catheterization procedures. By tracking the robotic arm, X-ray table and X-ray C-arm, we are able to register the 3D echo images with live 2D X-ray images. In addition, we can also use tracking data from the robotic arm combined with system calibrations to create extended field of view 3D echo images. Both these features can be used for roadmapping to guide cardiac catheterization procedures. We have carried out a validation experiment of our registration method using a cross-wire phantom. Results show our method to be accurate to 3.5 mm. We have successfully demonstrated the creation of the extended field of view data on 2 healthy volunteers and the registration of echo and X-ray data on 1 patient undergoing a pacing study. PMID:19964867

  7. Evaluation (not validation) of quantitative models.

    PubMed

    Oreskes, N

    1998-12-01

    The present regulatory climate has led to increasing demands for scientists to attest to the predictive reliability of numerical simulation models used to help set public policy, a process frequently referred to as model validation. But while model validation may reveal useful information, this paper argues that it is not possible to demonstrate the predictive reliability of any model of a complex natural system in advance of its actual use. All models embed uncertainties, and these uncertainties can and frequently do undermine predictive reliability. In the case of lead in the environment, we may categorize model uncertainties as theoretical, empirical, parametrical, and temporal. Theoretical uncertainties are aspects of the system that are not fully understood, such as the biokinetic pathways of lead metabolism. Empirical uncertainties are aspects of the system that are difficult (or impossible) to measure, such as actual lead ingestion by an individual child. Parametrical uncertainties arise when complexities in the system are simplified to provide manageable model input, such as representing longitudinal lead exposure by cross-sectional measurements. Temporal uncertainties arise from the assumption that systems are stable in time. A model may also be conceptually flawed. The Ptolemaic system of astronomy is a historical example of a model that was empirically adequate but based on a wrong conceptualization. Yet had it been computerized--and had the word then existed--its users would have had every right to call it validated. Thus, rather than talking about strategies for validation, we should be talking about means of evaluation. That is not to say that language alone will solve our problems or that the problems of model evaluation are primarily linguistic. The uncertainties inherent in large, complex models will not go away simply because we change the way we talk about them. But this is precisely the point: calling a model validated does not make it valid

  8. Evaluation (not validation) of quantitative models.

    PubMed Central

    Oreskes, N

    1998-01-01

    The present regulatory climate has led to increasing demands for scientists to attest to the predictive reliability of numerical simulation models used to help set public policy, a process frequently referred to as model validation. But while model validation may reveal useful information, this paper argues that it is not possible to demonstrate the predictive reliability of any model of a complex natural system in advance of its actual use. All models embed uncertainties, and these uncertainties can and frequently do undermine predictive reliability. In the case of lead in the environment, we may categorize model uncertainties as theoretical, empirical, parametrical, and temporal. Theoretical uncertainties are aspects of the system that are not fully understood, such as the biokinetic pathways of lead metabolism. Empirical uncertainties are aspects of the system that are difficult (or impossible) to measure, such as actual lead ingestion by an individual child. Parametrical uncertainties arise when complexities in the system are simplified to provide manageable model input, such as representing longitudinal lead exposure by cross-sectional measurements. Temporal uncertainties arise from the assumption that systems are stable in time. A model may also be conceptually flawed. The Ptolemaic system of astronomy is a historical example of a model that was empirically adequate but based on a wrong conceptualization. Yet had it been computerized--and had the word then existed--its users would have had every right to call it validated. Thus, rather than talking about strategies for validation, we should be talking about means of evaluation. That is not to say that language alone will solve our problems or that the problems of model evaluation are primarily linguistic. The uncertainties inherent in large, complex models will not go away simply because we change the way we talk about them. But this is precisely the point: calling a model validated does not make it valid

  9. Quantification of systemic right ventricle by echocardiography.

    PubMed

    Iriart, Xavier; Roubertie, François; Jalal, Zakaria; Thambo, Jean-Benoit

    2016-02-01

    Improvements in cardiac imaging have recently focused a great interest on the right ventricle (RV). In patients with congenital heart disease, the right ventricle (RV) may support the systemic circulation (systemic RV). There are 2 different anatomic conditions providing such physiology: the congenitally corrected transposition of the great arteries (ccTGA) and the TGA surgically corrected by atrial switch. During the last decades, evidence is accumulating that progressive systemic RV failure develops leading to considerable morbidity and mortality. Various imaging modalities have been used to evaluate the systemic RV, but echocardiography is still predominantly used in clinical practice, allowing an anatomic and functional approach of the systemic RV function and the potential associated anomalies. The goal of this review is to offer a clinical perspective of the non-invasive evaluation of the systemic RV by echocardiography. PMID:26850171

  10. A Quantitative Evaluation of Dissolved Oxygen Instrumentation

    NASA Technical Reports Server (NTRS)

    Pijanowski, Barbara S.

    1971-01-01

    The implications of the presence of dissolved oxygen in water are discussed in terms of its deleterious or beneficial effects, depending on the functional consequences to those affected, e.g., the industrialist, the oceanographer, and the ecologist. The paper is devoted primarily to an examination of the performance of five commercially available dissolved oxygen meters. The design of each is briefly reviewed and ease or difficulty of use in the field described. Specifically, the evaluation program treated a number of parameters and user considerations including an initial check and trial calibration for each instrument and a discussion of the measurement methodology employed. Detailed test results are given relating to the effects of primary power variation, water-flow sensitivity, response time, relative accuracy of dissolved-oxygen readout, temperature accuracy (for those instruments which included this feature), error and repeatability, stability, pressure and other environmental effects, and test results obtained in the field. Overall instrument performance is summarized comparatively by chart.

  11. Integrating Qualitative and Quantitative Evaluation Methods in Substance Abuse Research.

    ERIC Educational Resources Information Center

    Dennis, Michael L.; And Others

    1994-01-01

    Some specific opportunities and techniques are described for combining and integrating qualitative and quantitative methods from the design stage of a substance abuse program evaluation through implementation and reporting. The multiple problems and requirements of such an evaluation make integrated methods essential. (SLD)

  12. Contrast echocardiography 1996. A review.

    PubMed Central

    Villarraga, H R; Foley, D A; Mulvagh, S L

    1996-01-01

    Remarkable advances in the field of contrast echocardiography have been made during the last decade. Interest in ultrasound contrast agents that strengthen the backscattered ultrasound signal and improve image display has stimulated further research. Echocardiographic contrast agents providing left ventricular cavity image enhancement after intravenous injection are now available. A role for contrast echocardiography in the assessment of myocardial perfusion has been established within the invasive clinical setting. With the development of newer contrast agents and new ultrasound technology, myocardial perfusion imaging using contrast echocardiography after venous injection is no longer the unattainable "holy grail," but is fast approaching clinical applicability. Images PMID:8792539

  13. Display of cardiac activation pathways with echocardiography

    NASA Astrophysics Data System (ADS)

    Olstad, Bjoern; Brodin, Lars A.; Berg, Sevald

    1997-05-01

    The study of cardiac activation dynamics is an important factor in the characterization of the cardiac function. One such example is the localization of WPW-pathways inside the myocardium. Accurate localization of these pathways can be used to determine if the patient should be treated with catheter techniques or surgical techniques. This paper analyzes the temporal information in tissue velocity imaging with both qualitative and quantitative methods. The clinical experiments indicate that echocardiography can become an alternative technique for non-invasive electrophysiology in these kinds of applications.

  14. A novel method to risk stratify patients undergoing exercise stress echocardiography using a set of combined criteria.

    PubMed

    Wong, Christopher B; Leung, Sue Ellen; Fukuyanagi, Sasa

    2015-03-01

    Background and Purposes A novel method using quantitative long-axis function and tissue Doppler in addition to wall motion analysis in exercise stress echocardiography was evaluated. We hypothesized that the novel criteria added additional accuracy in stress echocardiography. Methods Patients with chest pain and at low-to-intermediate risk for obstructive coronary artery disease (CAD) were retrospectively studied. They underwent stress echocardiography with attention to wall motion abnormalities, left ventricular long-axis function, and tissue Doppler measurement. Results The results showed that the combined novel criteria (i.e., classifying a case as positive if three out of the following four criteria were fulfilled: (1) abnormal segmental wall motion shortly after peak stress; (2) Ee wave after peak stress less than 10 cm/s and Ee/Aa ratio after peak stress less than 1; (3) Sm wave after peak stress less than 10.5 cm/s; (4) abnormal long-axis left ventricular function) offered a better accuracy for predicting obstructive CAD and future revascularization with a high sensitivity (100%) and high negative predictive value (100%) . Conclusion From a practical standpoint, the combined novel criteria may be useful in improving the diagnostic accuracy of stress echocardiography. PMID:25780326

  15. Dynamic Three-Dimensional Echocardiography

    NASA Astrophysics Data System (ADS)

    Matsusaka, Katsuhiko; Doi, Motonori; Oshiro, Osamu; Chihara, Kunihiro

    2000-08-01

    Conventional three-dimensional (3D) ultrasound imaging equipment for diagnosis requires much time to reconstruct 3D images or fix the view point for observing the 3D image. Thus, it is inconvenient for cardiac diagnosis. In this paper, we propose a new dynamic 3D echocardiography system. The system produces 3D images in real-time and permits changes in view point. This system consists of ultrasound diagnostic equipment, a digitizer and a computer. B-mode images are projected to a virtual 3D space by referring to the position of the probe of the ultrasound diagnosis equipment. The position is obtained by the digitizer to which the ultrasound probe is attached. The 3D cardiac image is constructed from B-mode images obtained simultaneously in the cardiac cycle. To obtain the same moment of heartbeat in the cardiac cycle, this system uses the electrocardiography derived from the diagnosis equipment. The 3D images, which show various scenes of the stage of heartbeat action, are displayed sequentially. The doctor can observe 3D images cut in any plane by pushing a button of the digitizer and zooming with the keyboard. We evaluated our prototype system by observation of a mitral valve in motion.

  16. [Real time 3D echocardiography in congenital heart disease].

    PubMed

    Acar, P; Dulac, Y; Taktak, A; Villacèque, M

    2004-05-01

    The introduction of the 3D mode in echocardiography has led to its use in everyday clinical practice. One hundred and fifty real time 3D echocardiographic examinations were performed in 20 foetus, 110 children and 20 adults with various congenital heart lesions (shunts, valvular lesions, aortic diseases). The 4x matricial probe enables the instantaneous acquisition of transthoracic volumes. Four modes of 3D imaging were used: real time, total volume, colour Doppler and biplane. Quantitative measurements were performed at an outlying station. The feasibility of the method in the foetus, the child and the adult was respectively 90%, 99% and 85%. Real time 3D echocardiography did not affect the diagnoses made by standard echocardiography. The 3D imaging gave a more accurate description of atrial septal defects and congenital valvular lesions. Biplane imaging was decisive in the quantitative approach to aortic dilatation of Marfan's syndrome and in segmental analysis of the foetal heart. 3D colour Doppler imaging has been disappointing but the possibilities of volumic quantification of blood flow are very promising. The present limitations of the method are the inadequate resolution in the small child and the absence of quantitative measurement on the echograph. The facility of utilisation of the matricial probe should lead to routine usage of 3D echocardiography as with 2D and the Doppler modes. Its value should be decisive in many congenital cardiac lesions requiring surgery or interventional catheterisation. PMID:15214550

  17. A quantitative method for evaluating alternatives. [aid to decision making

    NASA Technical Reports Server (NTRS)

    Forthofer, M. J.

    1981-01-01

    When faced with choosing between alternatives, people tend to use a number of criteria (often subjective, rather than objective) to decide which is the best alternative for them given their unique situation. The subjectivity inherent in the decision-making process can be reduced by the definition and use of a quantitative method for evaluating alternatives. This type of method can help decision makers achieve degree of uniformity and completeness in the evaluation process, as well as an increased sensitivity to the factors involved. Additional side-effects are better documentation and visibility of the rationale behind the resulting decisions. General guidelines for defining a quantitative method are presented and a particular method (called 'hierarchical weighted average') is defined and applied to the evaluation of design alternatives for a hypothetical computer system capability.

  18. Echocardiography: frontier imaging in cardiology

    PubMed Central

    Steeds, R P

    2011-01-01

    This article reviews the recent developments in echocardiography that have maintained this technology at the forefront of day-to-day imaging in clinical cardiology. The primary reason for most requests for imaging in cardiovascular medicine is to assess left ventricular structure and function. As our understanding of left ventricular mechanics has become more intricate, tissue Doppler and speckle tracking modalities have been developed that deliver greater insights into diagnosis of cardiomyopathy and earlier warning of ventricular dysfunction. Increased accuracy has been achieved with the dissemination of real-time three-dimensional echocardiography, which has also acquired a central role in the pre-operative assessment of patients prior to reparative valvular surgery. The use of contrast has broadened the indications for transthoracic echocardiography and has increased the accuracy of stress echocardiography, while reducing the number of patients who cannot be scanned because of a limited acoustic window. Finally, echocardiography will be seen in the future not only as a diagnostic tool in those affected by cardiovascular disease but also as a method for prediction of risk and perhaps activation of targeted treatment. PMID:22723531

  19. Quantitatively evaluating the CBM reservoir using logging data

    NASA Astrophysics Data System (ADS)

    Liu, Zhidi; Zhao, Jingzhou

    2016-02-01

    In order to evaluate coal bed methane (CBM) reservoirs, this paper select five parameters: porosity, permeability, CBM content, the coal structure index and effective thickness of the coal seam. Making full use of logging and the laboratory analysis data of a coal core, the logging evaluation methods of the five parameters were discussed in detail, and the comprehensive evaluation model of the CBM reservoir was established. The #5 coal seam of the Hancheng mine on the eastern edge of the Ordos Basin in China was quantitatively evaluated using this method. The results show that the CBM reservoir in the study area is better than in the central and northern regions. The actual development of CBM shows that the region with a good reservoir has high gas production—indicating that the method introduced in this paper can evaluate the CBM reservoir more effectively.

  20. Echocardiography in Pregnancy: Part 2.

    PubMed

    Narayanan, Meena; Elkayam, Uri; Naqvi, Tasneem Z

    2016-09-01

    The prevalence of pregnant women with cardiovascular heart disease is increasing. Transthoracic echocardiography is safe during pregnancy, and it is an important diagnostic tool in pregnant women with established heart disease in order to monitor ventricular and valvular anatomy and function. In addition, it can be used to delineate cardiac anatomy in complex congenital heart disease and help stratify maternal risk during pregnancy. This review will focus on the use of echocardiography in the diagnosis and management of pregnant women with common congenital lesions and with prosthetic valves. PMID:27457084

  1. Determination of left ventricular volume, ejection fraction, and myocardial mass by real-time three-dimensional echocardiography

    NASA Technical Reports Server (NTRS)

    Qin, J. X.; Shiota, T.; Thomas, J. D.

    2000-01-01

    Reconstructed three-dimensional (3-D) echocardiography is an accurate and reproducible method of assessing left ventricular (LV) functions. However, it has limitations for clinical study due to the requirement of complex computer and echocardiographic analysis systems, electrocardiographic/respiratory gating, and prolonged imaging times. Real-time 3-D echocardiography has a major advantage of conveniently visualizing the entire cardiac anatomy in three dimensions and of potentially accurately quantifying LV volumes, ejection fractions, and myocardial mass in patients even in the presence of an LV aneurysm. Although the image quality of the current real-time 3-D echocardiographic methods is not optimal, its widespread clinical application is possible because of the convenient and fast image acquisition. We review real-time 3-D echocardiographic image acquisition and quantitative analysis for the evaluation of LV function and LV mass.

  2. Echocardiography in Pregnancy: Part 1.

    PubMed

    Liu, Shuang; Elkayam, Uri; Naqvi, Tasneem Z

    2016-09-01

    Cardiovascular disease (CVD) remains the leading cause of maternal mortality, and clinical diagnosis of CVD in women during pregnancy is challenging. Pregnant women with known heart disease require careful multidisciplinary management by obstetric and medical teams to assess for maternal and fetal risk. Echocardiography is a safe and effective diagnostic tool indicated in pregnant women with cardiac symptoms or women with known cardiac disease for appropriate selection of women who require close monitoring of cardiac condition and valvular function. Echocardiography is the single most important clinical tool to diagnose and manage heart disease during pregnancy. Echocardiography is able to characterize cardiac structural abnormalities and corresponding hemodynamic changes, identifies heart diseases that are poorly tolerated in pregnancy, and helps select patients who may require a cesarean delivery because of hemodynamic instability. An understanding of the physiologic alterations including increased heart rate, blood volume, and cardiac output as well as the decreased vascular resistance is important for early recognition and monitoring of the consequences of cardiac disease in pregnancy. This review will focus on common acquired cardiac lesions encountered during pregnancy and the role of echocardiography in the diagnosis and management of these diseases. PMID:27491768

  3. Novel System for Real-Time Integration of 3-D Echocardiography and Fluoroscopy for Image-Guided Cardiac Interventions: Preclinical Validation and Clinical Feasibility Evaluation

    PubMed Central

    Housden, R. James; Ma, Yingliang; Rajani, Ronak; Gao, Gang; Nijhof, Niels; Cathier, Pascal; Bullens, Roland; Gijsbers, Geert; Parish, Victoria; Kapetanakis, Stamatis; Hancock, Jane; Rinaldi, C. Aldo; Cooklin, Michael; Gill, Jaswinder; Thomas, Martyn; O'neill, Mark D.; Razavi, Reza; Rhode, Kawal S.

    2014-01-01

    Real-time imaging is required to guide minimally invasive catheter-based cardiac interventions. While transesophageal echocardiography allows for high-quality visualization of cardiac anatomy, X-ray fluoroscopy provides excellent visualization of devices. We have developed a novel image fusion system that allows real-time integration of 3-D echocardiography and the X-ray fluoroscopy. The system was validated in the following two stages: 1) preclinical to determine function and validate accuracy; and 2) in the clinical setting to assess clinical workflow feasibility and determine overall system accuracy. In the preclinical phase, the system was assessed using both phantom and porcine experimental studies. Median 2-D projection errors of 4.5 and 3.3 mm were found for the phantom and porcine studies, respectively. The clinical phase focused on extending the use of the system to interventions in patients undergoing either atrial fibrillation catheter ablation (CA) or transcatheter aortic valve implantation (TAVI). Eleven patients were studied with nine in the CA group and two in the TAVI group. Successful real-time view synchronization was achieved in all cases with a calculated median distance error of 2.2 mm in the CA group and 3.4 mm in the TAVI group. A standard clinical workflow was established using the image fusion system. These pilot data confirm the technical feasibility of accurate real-time echo-fluoroscopic image overlay in clinical practice, which may be a useful adjunct for real-time guidance during interventional cardiac procedures. PMID:27170872

  4. Sector-scanning echocardiography

    NASA Technical Reports Server (NTRS)

    Henry, W. L.; Griffith, J. M.

    1975-01-01

    The mechanical sector scanner is described in detail, and its clinical application is discussed. Cross sectional images of the heart are obtained in real time using this system. The sector scanner has three major components: (a) hand held scanner, (b) video display, and (c) video recorder. The system provides diagnostic information in a wide spectrum of cardiac diseases, and it quantitates the severity of mitral stenosis by measurement of the mitral valve orifice area in diagnosing infants, children and adults with cyanotic congenital heart disease.

  5. A study on the quantitative evaluation of skin barrier function

    NASA Astrophysics Data System (ADS)

    Maruyama, Tomomi; Kabetani, Yasuhiro; Kido, Michiko; Yamada, Kenji; Oikaze, Hirotoshi; Takechi, Yohei; Furuta, Tomotaka; Ishii, Shoichi; Katayama, Haruna; Jeong, Hieyong; Ohno, Yuko

    2015-03-01

    We propose a quantitative evaluation method of skin barrier function using Optical Coherence Microscopy system (OCM system) with coherency of near-infrared light. There are a lot of skin problems such as itching, irritation and so on. It has been recognized skin problems are caused by impairment of skin barrier function, which prevents damage from various external stimuli and loss of water. To evaluate skin barrier function, it is a common strategy that they observe skin surface and ask patients about their skin condition. The methods are subjective judgements and they are influenced by difference of experience of persons. Furthermore, microscopy has been used to observe inner structure of the skin in detail, and in vitro measurements like microscopy requires tissue sampling. On the other hand, it is necessary to assess objectively skin barrier function by quantitative evaluation method. In addition, non-invasive and nondestructive measuring method and examination changes over time are needed. Therefore, in vivo measurements are crucial for evaluating skin barrier function. In this study, we evaluate changes of stratum corneum structure which is important for evaluating skin barrier function by comparing water-penetrated skin with normal skin using a system with coherency of near-infrared light. Proposed method can obtain in vivo 3D images of inner structure of body tissue, which is non-invasive and non-destructive measuring method. We formulate changes of skin ultrastructure after water penetration. Finally, we evaluate the limit of performance of the OCM system in this work in order to discuss how to improve the OCM system.

  6. Speckle tracking echocardiography in the critically ill: enticing research with minimal clinical practicality or the answer to non-invasive cardiac assessment?

    PubMed

    S, Orde; Sj, Huang; As, Mclean

    2016-09-01

    Echocardiography is developing rapidly. Speckle tracking echocardiography is the latest semi-automatic tool that has potential to quantitatively describe cardiac dysfunction that may be unrecognised by conventional echocardiography. It is a non-Doppler, angle-independent, feasible and reproducible method to evaluate myocardial function in both non-critically ill and critically ill populations. Increasingly it has become a standard measure of both left and right ventricle function in specific patient groups, e.g. chemotherapy-induced cardiomyopathy or pulmonary hypertension. To date there are few studies in the critically ill, predominantly in sepsis, yet all describe dysfunction beyond standard measures. Other areas of interest include heart-lung interactions, right ventricle function and twist and torsion of the heart. A word of caution is required, however, in that speckle tracking echocardiography is far from perfect and is more challenging, particularly in the critically ill, than implied by many published studies. It takes time to learn and perform and most values are not validated, particularly in the critically ill. We should be cautious in accepting that the latest software used in cardiology cohorts will automatically be the answer in the critically ill. Even with these limitations the technology is enticing and results fascinating. We are uncovering previously undescribed dysfunction and although it currently is essentially a research-based activity, there is great promise as a clinical tool as echocardiography analysis becomes more automated, and potentially speckle tracking echocardiography could help describe cardiac function in critical illness more accurately than is possible with current techniques. PMID:27608336

  7. Detection of left ventricular aneurysm on two dimensional echocardiography.

    PubMed

    Baur, H R; Daniel, J A; Nelson, R R

    1982-07-01

    The differentiation of left ventricular aneurysm from diffuse left ventricular dilation and hypokinesia may have important therapeutic consequences. Thus the diagnostic accuracy of wide angle two dimensional echocardiography for the detection of left ventricular aneurysm was evaluated in a prospective study of 26 consecutive patients with the clinical suspicion of left ventricular aneurysm referred over a 10 month period. Every patients was examined with two dimensional echocardiography and left ventricular cineangiography, and findings were interpreted by two independent observers. A dilated hypokinetic left ventricle without aneurysm formation on cineangiography in nine patients was identified in all with two dimensional echocardiography. A left ventricular aneurysm on cineangiography in 17 patients was correctly identified in 14 with the two dimensional study, as were the site and extent of the lesion (apical in 12, anterior in 1 and inferior in 1). One apical aneurysm was interpreted on the two dimensional study as apical dyskinesia; one anterior and one posterobasal aneurysm were missed with this technique. Mural thrombi were correctly identified with two dimensional echocardiography in seven of seven patients. It is concluded that two dimensional echocardiography is an accurate noninvasive method that allows differentiation of left ventricular aneurysm from diffuse left ventricular dilation in the majority of patients. It provides information regarding the resectability of the aneurysm and may obviate cineangiography in many cases. PMID:7091001

  8. A Computational Framework for Quantitative Evaluation of Movement during Rehabilitation

    NASA Astrophysics Data System (ADS)

    Chen, Yinpeng; Duff, Margaret; Lehrer, Nicole; Sundaram, Hari; He, Jiping; Wolf, Steven L.; Rikakis, Thanassis

    2011-06-01

    This paper presents a novel generalized computational framework for quantitative kinematic evaluation of movement in a rehabilitation clinic setting. The framework integrates clinical knowledge and computational data-driven analysis together in a systematic manner. The framework provides three key benefits to rehabilitation: (a) the resulting continuous normalized measure allows the clinician to monitor movement quality on a fine scale and easily compare impairments across participants, (b) the framework reveals the effect of individual movement components on the composite movement performance helping the clinician decide the training foci, and (c) the evaluation runs in real-time, which allows the clinician to constantly track a patient's progress and make appropriate adaptations to the therapy protocol. The creation of such an evaluation is difficult because of the sparse amount of recorded clinical observations, the high dimensionality of movement and high variations in subject's performance. We address these issues by modeling the evaluation function as linear combination of multiple normalized kinematic attributes y = Σwiφi(xi) and estimating the attribute normalization function φi(ṡ) by integrating distributions of idealized movement and deviated movement. The weights wi are derived from a therapist's pair-wise comparison using a modified RankSVM algorithm. We have applied this framework to evaluate upper limb movement for stroke survivors with excellent results—the evaluation results are highly correlated to the therapist's observations.

  9. Study on the performance evaluation of quantitative precipitation estimation and quantitative precipitation forecast

    NASA Astrophysics Data System (ADS)

    Yang, H.; Chang, K.; Suk, M.; cha, J.; Choi, Y.

    2011-12-01

    Rainfall estimation and short-term (several hours) quantitative prediction of precipitation based on meteorological radar data is one of the intensely studied topics. The Korea Peninsula has the horizontally narrow land area and complex topography with many of mountains, and so it has the characteristics that the rainfall system changes in many cases. Quantitative precipitation estimation (QPE) and quantitative precipitation forecasts (QPF) are the crucial information for severe weather or water management. We have been conducted the performance evaluation of QPE/QPF of Korea Meteorological Administration (KMA), which is the first step for optimizing QPE/QPF system in South Korea. The real-time adjusted RAR (Radar-AWS-Rainrate) system gives better agreement with the observed rain-rate than that of the fixed Z-R relation, and the additional bias correction of RAR yields the slightly better results. A correlation coefficient of R2 = 0.84 is obtained between the daily accumulated observed and RAR estimated rainfall. The RAR will be available for the hydrological applications such as the water budget. The VSRF (Very Short Range Forecast) shows better performance than the MAPLE (McGill Algorithm for Precipitation Nowcasting by Lagrangian) within 40 minutes, but the MAPLE better than the VSRF after 40 minutes. In case of hourly forecast, MAPLE shows better performance than the VSRF. QPE and QPF are thought to be meaningful for the nowcasting (1~2 hours) except the model forecast. The long-term forecast longer than 3 hours by meteorological model is especially meaningful for such as water management.

  10. The Clinical Benefits of Adding a Third Dimension to Assess the Left Ventricle with Echocardiography

    PubMed Central

    Badano, Luigi P.

    2014-01-01

    Three-dimensional echocardiography is a novel imaging technique based on acquisition and display of volumetric data sets in the beating heart. This permits a comprehensive evaluation of left ventricular (LV) anatomy and function from a single acquisition and expands the diagnostic possibilities of noninvasive cardiology. It provides the possibility of quantitating geometry and function of LV without preestablished assumptions regarding cardiac chamber shape and allows an echocardiographic assessment of the LV that is less operator-dependent and therefore more reproducible. Further developments and improvements for widespread routine applications include higher spatial and temporal resolution to improve image quality, faster acquisition, processing and reconstruction, and fully automated quantitative analysis. At present, three-dimensional echocardiography complements routine 2DE in clinical practice, overcoming some of its limitations and offering additional valuable information that has led to recommending its use for routine assessment of the LV of patients in whom information about LV size and function is critical for their clinical management. PMID:24959374

  11. Optimizing Digital Health Informatics Interventions Through Unobtrusive Quantitative Process Evaluations.

    PubMed

    Gude, Wouter T; van der Veer, Sabine N; de Keizer, Nicolette F; Coiera, Enrico; Peek, Niels

    2016-01-01

    Health informatics interventions such as clinical decision support (CDS) and audit and feedback (A&F) are variably effective at improving care because the underlying mechanisms through which these interventions bring about change are poorly understood. This limits our possibilities to design better interventions. Process evaluations can be used to improve this understanding by assessing fidelity and quality of implementation, clarifying causal mechanisms, and identifying contextual factors associated with variation in outcomes. Coiera describes the intervention process as a series of stages extending from interactions to outcomes: the "information value chain". However, past process evaluations often did not assess the relationships between those stages. In this paper we argue that the chain can be measured quantitatively and unobtrusively in digital interventions thanks to the availability of electronic data that are a by-product of their use. This provides novel possibilities to study the mechanisms of informatics interventions in detail and inform essential design choices to optimize their efficacy. PMID:27577453

  12. The Nuclear Renaissance — Implications on Quantitative Nondestructive Evaluations

    NASA Astrophysics Data System (ADS)

    Matzie, Regis A.

    2007-03-01

    The world demand for energy is growing rapidly, particularly in developing countries that are trying to raise the standard of living for billions of people, many of whom do not even have access to electricity. With this increased energy demand and the high and volatile price of fossil fuels, nuclear energy is experiencing resurgence. This so-called nuclear renaissance is broad based, reaching across Asia, the United States, Europe, as well as selected countries in Africa and South America. Some countries, such as Italy, that have actually turned away from nuclear energy are reconsidering the advisability of this design. This renaissance provides the opportunity to deploy more advanced reactor designs that are operating today, with improved safety, economy, and operations. In this keynote address, I will briefly present three such advanced reactor designs in whose development Westinghouse is participating. These designs include the advanced passive PWR, AP1000, which recently received design certification for the US Nuclear Regulatory Commission; the Pebble Bed Modular reactor (PBMR) which is being demonstrated in South Africa; and the International Reactor Innovative and Secure (IRIS), which was showcased in the US Department of Energy's recently announced Global Nuclear Energy Partnership (GNEP), program. The salient features of these designs that impact future requirements on quantitative nondestructive evaluations will be discussed. Such features as reactor vessel materials, operating temperature regimes, and new geometric configurations will be described, and mention will be made of the impact on quantitative nondestructive evaluation (NDE) approaches.

  13. Echocardiography in the flight program

    NASA Technical Reports Server (NTRS)

    Charles, John B.; Bungo, Michael W.; Mulvagh, Sharon L.

    1991-01-01

    Observations on American and Soviet astronauts have documented the association of changes in cardiovascular function during orthostasis with space flight. A basic understanding of the cardiovascular changes occurring in astronauts requires the determination of cardiac output and total peripheral vascular resistance as a minimum. In 1982, we selected ultrasound echocardiography as our means of acquiring this information. Ultrasound offers a quick, non-invasive and accurate means of determining stroke volume which, when combined with the blood pressure and heart rate measurements of the stand test, allows calculation of changes in peripheral vascular resistance, the body's major response to orthostatic stress. The history of echocardiography in the Space Shuttle Program is discussed and the results are briefly presented.

  14. Transesophageal echocardiography: first-line imaging for aortic diseases

    NASA Technical Reports Server (NTRS)

    Yalcin, F.; Thomas, J. D.; Homa, D.; Flachskampf, F. A.

    2000-01-01

    Transesophageal echocardiography (TEE) is now commonly used to evaluate the thoracic aorta, because it is widely available and provides high-resolution images and flow information by Doppler. This article reviews the essential features on TEE of acute and chronic aortic diseases, such as aortic dissection, aneurysm, and atherosclerosis, and discusses its strengths, weaknesses, and indications.

  15. Role of echocardiography in detecting portopulmonary hypertension in liver transplant candidates.

    PubMed

    Cotton, Cynthia L; Gandhi, Sanjay; Vaitkus, Paul T; Massad, Malek G; Benedetti, Enrico; Mrtek, Robert G; Wiley, Thelma E

    2002-11-01

    Portopulmonary hypertension (PPHTN) is a recognized complication of end-stage liver disease that adversely affects the outcome of orthotopic liver transplantation (OLT). There are limited data on the role of Doppler echocardiography in assessing pulmonary artery systolic pressure (PASP) in this population. The purpose of our study was to examine the accuracy of Doppler echocardiography in evaluating pulmonary artery pressures in liver transplant candidates. Clinical and demographic data were gathered retrospectively for 78 liver transplant candidates (48 men and 30 women, mean age 51 +/- 9.6 yr) who had PASP determined both by right heart catheterization (RHC) and echocardiography. Paired sample t-test was used to compare mean PASP by echocardiography and RHC. Correlation of PASP between echocardiography and RHC was determined using Pearson's linear correlation. Positive and negative predictive values for echocardiography for PASP > 50 mmHg are reported as compared with RHC. The mean PASP by echocardiography (43.2 +/- 12.3 mm Hg) was significantly higher than mean PASP by RHC (33.7 +/- 15.5 mm Hg; P <.001). Regarding PASP, there was a significant but weak correlation between echocardiography and RHC (r = 0.46, P =.01). The positive and negative predictive values of echocardiography for identifying clinically significant pulmonary hypertension (PASP > 50 mm Hg) were 37.5% and 91.9%, respectively. Echocardiography is a useful tool in estimating PASP in liver transplant candidates. Patients with apparently elevated PASP by echocardiography should undergo invasive assessment by RHC before being excluded from liver transplant. PMID:12424719

  16. Comparison of left ventricular ejection fraction values obtained using invasive contrast left ventriculography, two-dimensional echocardiography, and gated single-photon emission computed tomography

    PubMed Central

    Garg, Nadish; Dresser, Thomas; Aggarwal, Kul; Gupta, Vishal; Mittal, Mayank K; Alpert, Martin A

    2016-01-01

    Objectives: Left ventricular ejection fraction can be measured by a variety of invasive and non-invasive cardiac techniques. This study assesses the relation of three diagnostic modalities to each other in the measurement of left ventricular ejection fraction: invasive contrast left ventriculography, two-dimensional echocardiography, and quantitative gated single-photon emission computed tomography. Methods: Retrospective chart review was conducted on 58 patients hospitalized with chest pain, who underwent left ventricular ejection fraction evaluation using each of the aforementioned modalities within a 3-month period not interrupted by myocardial infarction or revascularization. Results: The mean left ventricular ejection fraction values were as follows: invasive contrast left ventriculography (0.44±0.15), two-dimensional echocardiography (0.46±0.13), and gated single-photon emission computed tomography (0.37±0.10). Correlations coefficients and associated p values were as follows: invasive contrast left ventriculography versus two-dimensional echocardiography (r=0.69, p<0.001), invasive contrast left ventriculography versus gated single-photon emission computed tomography (r=0.80, p<0.0001), and gated single-photon emission computed tomography versus two-dimensional echocardiography (r=0.69, p<0.001). Conclusion: Our results indicate that strong positive correlations exist among the three techniques studied.

  17. Objective evaluation of changes in left ventricular and atrial volumes during parabolic flight using real-time three-dimensional echocardiography.

    PubMed

    Caiani, E G; Sugeng, L; Weinert, L; Capderou, A; Lang, R M; Vaïda, P

    2006-08-01

    We tested the feasibility of real-time three-dimensional (3D) echocardiographic (RT3DE) imaging to measure left heart volumes at different gravity during parabolic flight and studied the effects of lower body negative pressure (LBNP) as a countermeasure. Weightlessness-related changes in cardiac function have been previously studied during spaceflights using both 2D and 3D echocardiography. Several technical factors, such as inability to provide real-time analysis and the need for laborious endocardial definition, have limited its usefulness. RT3DE imaging overcomes these limitations by acquiring real-time pyramidal data sets encompassing the entire ventricle. RT3DE data sets were obtained (Philips 7500, X3) during breath hold in 16 unmedicated normal subjects in upright standing position at different gravity phases during parabolic flight (normogravity, 1 Gz; hypergravity, 1.8 Gz; microgravity, 0 Gz), with LBNP applied (-50 mmHg) at 0 Gz in selected parabolas. RT3DE imaging during parabolic flight was feasible in 14 of 16 subjects. Data were analyzed (Tomtec) to quantify left ventricular (LV) and atrial (LA) volumes at end diastole and end systole, which significantly decreased at 1.8 Gz and increased at 0 Gz. While ejection fraction did not change with gravity, stroke volume was reduced by 16% at 1.8 Gz and increased by 20% at 0 Gz, but it was not significantly different from 1 Gz values with LBNP. RT3DE during parabolic flight is feasible and provides the basis for accurate quantification of LV and LA volume changes with gravity. As LBNP counteracted the increase of LV and LA volumes caused by changes in venous return, it may be effectively used for preventing cardiac dilatation during 0 Gz. PMID:16601310

  18. Comparison of tissue Doppler dynamics with Doppler flow in evaluating left atrial appendage function by transesophageal echocardiography in prehypertensive and hypertensive patients.

    PubMed

    Tenekecioğlu, Erhan; Karabulut, Aziz; Yilmaz, Mustafa

    2010-07-01

    Increased blood pressure (BP) is associated with an increase in cardiovascular mortality and morbidity. We aimed to analyze the effect of increased BP onto the function of left atrial appendage (LAA) in early stages of hypertension. Transesophageal echocardiography (TEE) was prospectively performed to assess LAA functions in 120 patients with increased BP, and in 58 normotensive subjects without cardiovascular disease. Patients with increased BP were divided according to Joint National Committee VII (JNC VII) report: prehypertensive, stage-1 hypertensive and stage-2 hypertensive patients. During TEE, LAA late-emptying velocities (LAAEV) were significantly reduced only in stage-2 hypertensives as compared with control group (P < 0.001). In contrast, LAA late-contracting velocity (LAA TDI-D2) was significantly reduced in prehypertensive,stage-1 hypertensive and stage-2 hypertensive patients, when compared with control group (P < 0.05, P < 0.001, and P < 0.001, respectively). The LAA maximal areas were increased significantly only in stage-2 hypertensive patients when compared with control group (P < 0.05). During TEE, left atrial spontaneous echocardiographic contrast was found in 2 of 36 patients in prehypertension group, in 7 of 40 patients in stage-1 hypertension group, and in 10 of 44 patients in stage-2 hypertension group. Left atrial thrombi were observed in 3 (6.8%) patients of stage-2 hypertension group. In conclusion, in patients with untreated prehypertension and hypertension, elevation of afterload imposed on left atrium involved both left atrium and LAA, resulting in impairment of the LAA function. Tissue Doppler imaging (TDI) enables the detection of this functional impairment in early stages of hypertension, even in prehypertensive phase, when compared with conventional Doppler flow measurement of the LAA. Even in prehypertensive phase, BP should be decreased to normal levels to prevent the LAA dysfunction. PMID:20345441

  19. Quantitative Evaluation and Selection of Reference Genes for Quantitative RT-PCR in Mouse Acute Pancreatitis

    PubMed Central

    Yan, Zhaoping; Gao, Jinhang; Lv, Xiuhe; Yang, Wenjuan; Wen, Shilei; Tong, Huan; Tang, Chengwei

    2016-01-01

    The analysis of differences in gene expression is dependent on normalization using reference genes. However, the expression of many of these reference genes, as evaluated by quantitative RT-PCR, is upregulated in acute pancreatitis, so they cannot be used as the standard for gene expression in this condition. For this reason, we sought to identify a stable reference gene, or a suitable combination, for expression analysis in acute pancreatitis. The expression stability of 10 reference genes (ACTB, GAPDH, 18sRNA, TUBB, B2M, HPRT1, UBC, YWHAZ, EF-1α, and RPL-13A) was analyzed using geNorm, NormFinder, and BestKeeper software and evaluated according to variations in the raw Ct values. These reference genes were evaluated using a comprehensive method, which ranked the expression stability of these genes as follows (from most stable to least stable): RPL-13A, YWHAZ > HPRT1 > GAPDH > UBC > EF-1α > 18sRNA > B2M > TUBB > ACTB. RPL-13A was the most suitable reference gene, and the combination of RPL-13A and YWHAZ was the most stable group of reference genes in our experiments. The expression levels of ACTB, TUBB, and B2M were found to be significantly upregulated during acute pancreatitis, whereas the expression level of 18sRNA was downregulated. Thus, we recommend the use of RPL-13A or a combination of RPL-13A and YWHAZ for normalization in qRT-PCR analyses of gene expression in mouse models of acute pancreatitis. PMID:27069927

  20. Perioperative transoesophageal echocardiography: current status and future directions.

    PubMed

    Mahmood, Feroze; Shernan, Stanton Keith

    2016-08-01

    Transoesophageal echocardiography (TOE) is used in the perioperative arena to monitor patients during life-threatening emergencies, cardiac and high-risk non-cardiac surgeries. It provides qualitative and quantitative information on valvular and ventricular functions, and dynamic cardiac anatomy can be displayed with a physiological perspective. This technology has evolved from two-dimensional (2D) to the ready availability of real-time three-dimensional (RT-3D) imaging in the operating rooms. Enhanced spatial and temporal resolutions with 3D imaging have most significantly impacted the quality of intraoperative surgical valve repair and replacement decisions. Additionally, 3D imaging has facilitated the advent of minimally invasive and percutaneous interventions for structural heart disease. Information derived from TEE is routinely used to evaluate a patient's suitability for an intervention, provide guidance during the intervention and eventually comment on the quality and success of the procedure. Expertise in perioperative TEE is an integral component of a cardiac anaesthesiologist's skill sets. With structural heart disease interventions becoming more minimally invasive, the intraoperative guidance provided by TEE will continue to be a critical component of these procedures. With improving computational and processing power, the expectations from TEE will continue to be incremental in the perioperative arena. PMID:27048769

  1. Canine fetal echocardiography: correlations for the analysis of cardiac dimensions.

    PubMed

    Giannico, Amália Turner; Gil, Elaine Mayumi Ueno; Garcia, Daniela Aparecida Ayres; Sousa, Marlos Gonçalves; Froes, Tilde Rodrigues

    2016-03-01

    The aim of this study was to develop regression models for correlation of canine fetal heart development with body size to characterize normal development or suggest cardiac anomalies. Twenty clinically healthy pregnant bitches, either brachycephalic and non-brachycephalic, were examined ultrasonographically. Transabdominal fetal echocardiography was conducted every 4 days from the beginning of cardiac chambers differentiation until parturition. Ten cardiac parameters were measured: length, width and diameter of the heart; heart area; left and right ventricular dimensions; left and right atrial dimensions; and aortic and pulmonary artery diameter. Femoral length, biparietal diameter and abdominal cross-sectional area were also recorded. Regression equations were developed for each parameter of fetal body size, and linear and logarithmic models were compared. The model with the highest correlation coefficient was chosen to produce equations to calculate relative dimensions based on the correlations. Only the left-ventricular chamber differed between the two racial groups. Biparietal diameter was the independent parameter that produced the highest correlation coefficient for the most fetal cardiac dimensions, although good correlations were also observed using femoral length and abdominal cross-sectional area. Heart width and heart diameter were used as surrogates of cardiac development, as these measurements showed the best statistical correlation. Quantitative evaluation of fetal cardiac structures can be used to monitor normal and abnormal cardiac development. PMID:26689920

  2. Comparison of methods for quantitative evaluation of endoscopic distortion

    NASA Astrophysics Data System (ADS)

    Wang, Quanzeng; Castro, Kurt; Desai, Viraj N.; Cheng, Wei-Chung; Pfefer, Joshua

    2015-03-01

    Endoscopy is a well-established paradigm in medical imaging, and emerging endoscopic technologies such as high resolution, capsule and disposable endoscopes promise significant improvements in effectiveness, as well as patient safety and acceptance of endoscopy. However, the field lacks practical standardized test methods to evaluate key optical performance characteristics (OPCs), in particular the geometric distortion caused by fisheye lens effects in clinical endoscopic systems. As a result, it has been difficult to evaluate an endoscope's image quality or assess its changes over time. The goal of this work was to identify optimal techniques for objective, quantitative characterization of distortion that are effective and not burdensome. Specifically, distortion measurements from a commercially available distortion evaluation/correction software package were compared with a custom algorithm based on a local magnification (ML) approach. Measurements were performed using a clinical gastroscope to image square grid targets. Recorded images were analyzed with the ML approach and the commercial software where the results were used to obtain corrected images. Corrected images based on the ML approach and the software were compared. The study showed that the ML method could assess distortion patterns more accurately than the commercial software. Overall, the development of standardized test methods for characterizing distortion and other OPCs will facilitate development, clinical translation, manufacturing quality and assurance of performance during clinical use of endoscopic technologies.

  3. A quantitative evaluation of the public response to climate engineering

    NASA Astrophysics Data System (ADS)

    Wright, Malcolm J.; Teagle, Damon A. H.; Feetham, Pamela M.

    2014-02-01

    Atmospheric greenhouse gas concentrations continue to increase, with CO2 passing 400 parts per million in May 2013. To avoid severe climate change and the attendant economic and social dislocation, existing energy efficiency and emissions control initiatives may need support from some form of climate engineering. As climate engineering will be controversial, there is a pressing need to inform the public and understand their concerns before policy decisions are taken. So far, engagement has been exploratory, small-scale or technique-specific. We depart from past research to draw on the associative methods used by corporations to evaluate brands. A systematic, quantitative and comparative approach for evaluating public reaction to climate engineering is developed. Its application reveals that the overall public evaluation of climate engineering is negative. Where there are positive associations they favour carbon dioxide removal (CDR) over solar radiation management (SRM) techniques. Therefore, as SRM techniques become more widely known they are more likely to elicit negative reactions. Two climate engineering techniques, enhanced weathering and cloud brightening, have indistinct concept images and so are less likely to draw public attention than other CDR or SRM techniques.

  4. Quantitative genetic activity graphical profiles for use in chemical evaluation

    SciTech Connect

    Waters, M.D.; Stack, H.F.; Garrett, N.E.; Jackson, M.A.

    1990-12-31

    A graphic approach, terms a Genetic Activity Profile (GAP), was developed to display a matrix of data on the genetic and related effects of selected chemical agents. The profiles provide a visual overview of the quantitative (doses) and qualitative (test results) data for each chemical. Either the lowest effective dose or highest ineffective dose is recorded for each agent and bioassay. Up to 200 different test systems are represented across the GAP. Bioassay systems are organized according to the phylogeny of the test organisms and the end points of genetic activity. The methodology for producing and evaluating genetic activity profile was developed in collaboration with the International Agency for Research on Cancer (IARC). Data on individual chemicals were compiles by IARC and by the US Environmental Protection Agency (EPA). Data are available on 343 compounds selected from volumes 1-53 of the IARC Monographs and on 115 compounds identified as Superfund Priority Substances. Software to display the GAPs on an IBM-compatible personal computer is available from the authors. Structurally similar compounds frequently display qualitatively and quantitatively similar profiles of genetic activity. Through examination of the patterns of GAPs of pairs and groups of chemicals, it is possible to make more informed decisions regarding the selection of test batteries to be used in evaluation of chemical analogs. GAPs provided useful data for development of weight-of-evidence hazard ranking schemes. Also, some knowledge of the potential genetic activity of complex environmental mixtures may be gained from an assessment of the genetic activity profiles of component chemicals. The fundamental techniques and computer programs devised for the GAP database may be used to develop similar databases in other disciplines. 36 refs., 2 figs.

  5. Evaluation of a virucidal quantitative carrier test for surface disinfectants.

    PubMed

    Rabenau, Holger F; Steinmann, Jochen; Rapp, Ingrid; Schwebke, Ingeborg; Eggers, Maren

    2014-01-01

    Surface disinfectants are part of broader preventive strategies preventing the transmission of bacteria, fungi and viruses in medical institutions. To evaluate their virucidal efficacy, these products must be tested with appropriate model viruses with different physico-chemical properties under conditions representing practical application in hospitals. The aim of this study was to evaluate a quantitative carrier assay. Furthermore, different putative model viruses like adenovirus type 5 (AdV-5) and different animal parvoviruses were evaluated with respect to their tenacity and practicability in laboratory handling. To evaluate the robustness of the method, some of the viruses were tested in parallel in different laboratories in a multi-center study. Different biocides, which are common active ingredients of surface disinfectants, were used in the test. After drying on stainless steel discs as the carrier, model viruses were exposed to different concentrations of three alcohols, peracetic acid (PAA) or glutaraldehyde (GDA), with a fixed exposure time of 5 minutes. Residual virus was determined after treatment by endpoint titration. All parvoviruses exhibited a similar stability with respect to GDA, while AdV-5 was more susceptible. For PAA, the porcine parvovirus was more sensitive than the other parvoviruses, and again, AdV-5 presented a higher susceptibility than the parvoviruses. All parvoviruses were resistant to alcohols, while AdV-5 was only stable when treated with 2-propanol. The analysis of the results of the multi-center study showed a high reproducibility of this test system. In conclusion, two viruses with different physico-chemical properties can be recommended as appropriate model viruses for the evaluation of the virucidal efficacy of surface disinfectants: AdV-5, which has a high clinical impact, and murine parvovirus (MVM) with the highest practicability among the parvoviruses tested. PMID:24475079

  6. Evaluation of a Virucidal Quantitative Carrier Test for Surface Disinfectants

    PubMed Central

    Rabenau, Holger F.; Steinmann, Jochen; Rapp, Ingrid; Schwebke, Ingeborg; Eggers, Maren

    2014-01-01

    Surface disinfectants are part of broader preventive strategies preventing the transmission of bacteria, fungi and viruses in medical institutions. To evaluate their virucidal efficacy, these products must be tested with appropriate model viruses with different physico-chemical properties under conditions representing practical application in hospitals. The aim of this study was to evaluate a quantitative carrier assay. Furthermore, different putative model viruses like adenovirus type 5 (AdV-5) and different animal parvoviruses were evaluated with respect to their tenacity and practicability in laboratory handling. To evaluate the robustness of the method, some of the viruses were tested in parallel in different laboratories in a multi-center study. Different biocides, which are common active ingredients of surface disinfectants, were used in the test. After drying on stainless steel discs as the carrier, model viruses were exposed to different concentrations of three alcohols, peracetic acid (PAA) or glutaraldehyde (GDA), with a fixed exposure time of 5 minutes. Residual virus was determined after treatment by endpoint titration. All parvoviruses exhibited a similar stability with respect to GDA, while AdV-5 was more susceptible. For PAA, the porcine parvovirus was more sensitive than the other parvoviruses, and again, AdV-5 presented a higher susceptibility than the parvoviruses. All parvoviruses were resistant to alcohols, while AdV-5 was only stable when treated with 2-propanol. The analysis of the results of the multi-center study showed a high reproducibility of this test system. In conclusion, two viruses with different physico-chemical properties can be recommended as appropriate model viruses for the evaluation of the virucidal efficacy of surface disinfectants: AdV-5, which has a high clinical impact, and murine parvovirus (MVM) with the highest practicability among the parvoviruses tested. PMID:24475079

  7. Quantitative evaluations of ankle spasticity and stiffness in neurological disorders using manual spasticity evaluator

    PubMed Central

    Peng, Qiyu; Park, Hyung-Soon; Shah, Parag; Wilson, Nicole; Ren, Yupeng; Wu, Yi-Ning; Liu, Jie; Gaebler-Spira, Deborah J.; Zhang, Li-Qun

    2013-01-01

    Spasticity and contracture are major sources of disability in people with neurological impairments that have been evaluated using various instruments: the Modified Ashworth Scale, tendon reflex scale, pendulum test, mechanical perturbations, and passive joint range of motion (ROM). These measures generally are either convenient to use in clinics but not quantitative or they are quantitative but difficult to use conveniently in clinics. We have developed a manual spasticity evaluator (MSE) to evaluate spasticity/contracture quantitatively and conveniently, with ankle ROM and stiffness measured at a controlled low velocity and joint resistance and Tardieu catch angle measured at several higher velocities. We found that the Tardieu catch angle was linearly related to the velocity, indicating that increased resistance at higher velocities was felt at further stiffer positions and, thus, that the velocity dependence of spasticity may also be position-dependent. This finding indicates the need to control velocity in spasticity evaluation, which is achieved with the MSE. Quantitative measurements of spasticity, stiffness, and ROM can lead to more accurate characterizations of pathological conditions and outcome evaluations of interventions, potentially contributing to better healthcare services for patients with neurological disorders such as cerebral palsy, spinal cord injury, traumatic brain injury, and stroke. PMID:21674395

  8. Nuclear medicine and imaging research (instrumentation and quantitative methods of evaluation)

    SciTech Connect

    Beck, R.N.; Cooper, M.; Chen, C.T.

    1992-07-01

    This document is the annual progress report for project entitled 'Instrumentation and Quantitative Methods of Evaluation.' Progress is reported in separate sections individually abstracted and indexed for the database. Subject areas reported include theoretical studies of imaging systems and methods, hardware developments, quantitative methods of evaluation, and knowledge transfer: education in quantitative nuclear medicine imaging.

  9. Quantitative methods for somatosensory evaluation in atypical odontalgia.

    PubMed

    Porporatti, André Luís; Costa, Yuri Martins; Stuginski-Barbosa, Juliana; Bonjardim, Leonardo Rigoldi; Conti, Paulo César Rodrigues; Svensson, Peter

    2015-01-01

    A systematic review was conducted to identify reliable somatosensory evaluation methods for atypical odontalgia (AO) patients. The computerized search included the main databases (MEDLINE, EMBASE, and Cochrane Library). The studies included used the following quantitative sensory testing (QST) methods: mechanical detection threshold (MDT), mechanical pain threshold (MPT) (pinprick), pressure pain threshold (PPT), dynamic mechanical allodynia with a cotton swab (DMA1) or a brush (DMA2), warm detection threshold (WDT), cold detection threshold (CDT), heat pain threshold (HPT), cold pain detection (CPT), and/or wind-up ratio (WUR). The publications meeting the inclusion criteria revealed that only mechanical allodynia tests (DMA1, DMA2, and WUR) were significantly higher and pain threshold tests to heat stimulation (HPT) were significantly lower in the affected side, compared with the contralateral side, in AO patients; however, for MDT, MPT, PPT, CDT, and WDT, the results were not significant. These data support the presence of central sensitization features, such as allodynia and temporal summation. In contrast, considerable inconsistencies between studies were found when AO patients were compared with healthy subjects. In clinical settings, the most reliable evaluation method for AO in patients with persistent idiopathic facial pain would be intraindividual assessments using HPT or mechanical allodynia tests. PMID:25627886

  10. Avoiding transthoracic echocardiography and transesophageal echocardiography for patients with variable body mass indexes in infective endocarditis

    PubMed Central

    Sogomonian, Robert; Alkhawam, Hassan; Vyas, Neil; Jolly, JoshPaul; Nguyen, James; Haftevani, Emma A. Moradoghli; Al-khazraji, Ahmed; Ashraf, Amar

    2016-01-01

    Background Echocardiography has been a popular modality used to aid in the diagnosis of infective endocarditis (IE) with the modified Duke criteria. We evaluated the necessity between the uses of either a transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE) in patients with a body mass index (BMI) greater than or equal to 25 kg/m2 and less than 25 kg/m2. Methods A single-centered, retrospective study of 198 patients between 2005 and 2012 diagnosed with IE based on modified Duke criteria. Patients, required to be above age 18, had undergone an echocardiogram study and had blood cultures to be included in the study. Results Among 198 patients, two echocardiographic groups were evaluated as 158 patients obtained a TTE, 143 obtained a TEE, and 103 overlapped with TEE and TTE. Out of these patients, 167 patients were included in the study as 109 (65%) were discovered to have native valve vegetations on TEE and 58 (35%) with TTE. TTE findings were compared with TEE results for true negatives and positives to isolate valvular vegetations. Overall sensitivity of TTE was calculated to be 67% with a specificity of 93%. Patients were further divided into two groups with the first group having a BMI ≥25 kg/m2 and the subsequent group with a BMI <25 kg/m2. Patients with a BMI ≥25 kg/m2 who underwent a TTE study had a sensitivity and specificity of 54 and 92%, respectively. On the contrary, patients with a BMI < 25 kg/m2 had a TTE sensitivity and specificity of 78 and 95%, respectively. Conclusions Patients with a BMI <25 kg/m2 and a negative TTE should refrain from further diagnostic studies, with TEE strong clinical judgment is warranted. Patients with a BMI ≥ 25 kg/m2 may proceed directly to TEE as the initial study, possibly avoiding an additional study with a TTE. PMID:27124167

  11. Qualitative and quantitative evaluation of solvent systems for countercurrent separation.

    PubMed

    Friesen, J Brent; Ahmed, Sana; Pauli, Guido F

    2015-01-16

    Rational solvent system selection for countercurrent chromatography and centrifugal partition chromatography technology (collectively known as countercurrent separation) studies continues to be a scientific challenge as the fundamental questions of comparing polarity range and selectivity within a solvent system family and between putative orthogonal solvent systems remain unanswered. The current emphasis on metabolomic investigations and analysis of complex mixtures necessitates the use of successive orthogonal countercurrent separation (CS) steps as part of complex fractionation protocols. Addressing the broad range of metabolite polarities demands development of new CS solvent systems with appropriate composition, polarity (π), selectivity (σ), and suitability. In this study, a mixture of twenty commercially available natural products, called the GUESSmix, was utilized to evaluate both solvent system polarity and selectively characteristics. Comparisons of GUESSmix analyte partition coefficient (K) values give rise to a measure of solvent system polarity range called the GUESSmix polarity index (GUPI). Solvatochromic dye and electrical permittivity measurements were also evaluated in quantitatively assessing solvent system polarity. The relative selectivity of solvent systems were evaluated with the GUESSmix by calculating the pairwise resolution (αip), the number of analytes found in the sweet spot (Nsw), and the pairwise resolution of those sweet spot analytes (αsw). The combination of these parameters allowed for both intra- and inter-family comparison of solvent system selectivity. Finally, 2-dimensional reciprocal shifted symmetry plots (ReSS(2)) were created to visually compare both the polarities and selectivities of solvent system pairs. This study helps to pave the way to the development of new solvent systems that are amenable to successive orthogonal CS protocols employed in metabolomic studies. PMID:25542704

  12. Incremental Value of Three-Dimensional Transesophageal Echocardiography over the Two-Dimensional Technique in the Assessment of a Thrombus in Transit through a Patent Foramen Ovale.

    PubMed

    Thind, Munveer; Ahmed, Mustafa I; Gok, Gulay; Joson, Marisa; Elsayed, Mahmoud; Tuck, Benjamin C; Townsley, Matthew M; Klas, Berthold; McGiffin, David C; Nanda, Navin C

    2015-05-01

    We report a case of a right atrial thrombus traversing a patent foramen ovale into the left atrium, where three-dimensional transesophageal echocardiography provided considerable incremental value over two-dimensional transesophageal echocardiography in its assessment. As well as allowing us to better spatially characterize the thrombus, three-dimensional transesophageal echocardiography provided a more quantitative assessment through estimation of total thrombus burden. PMID:25827179

  13. Evaluating the Quantitative Capabilities of Metagenomic Analysis Software.

    PubMed

    Kerepesi, Csaba; Grolmusz, Vince

    2016-05-01

    DNA sequencing technologies are applied widely and frequently today to describe metagenomes, i.e., microbial communities in environmental or clinical samples, without the need for culturing them. These technologies usually return short (100-300 base-pairs long) DNA reads, and these reads are processed by metagenomic analysis software that assign phylogenetic composition-information to the dataset. Here we evaluate three metagenomic analysis software (AmphoraNet-a webserver implementation of AMPHORA2-, MG-RAST, and MEGAN5) for their capabilities of assigning quantitative phylogenetic information for the data, describing the frequency of appearance of the microorganisms of the same taxa in the sample. The difficulties of the task arise from the fact that longer genomes produce more reads from the same organism than shorter genomes, and some software assign higher frequencies to species with longer genomes than to those with shorter ones. This phenomenon is called the "genome length bias." Dozens of complex artificial metagenome benchmarks can be found in the literature. Because of the complexity of those benchmarks, it is usually difficult to judge the resistance of a metagenomic software to this "genome length bias." Therefore, we have made a simple benchmark for the evaluation of the "taxon-counting" in a metagenomic sample: we have taken the same number of copies of three full bacterial genomes of different lengths, break them up randomly to short reads of average length of 150 bp, and mixed the reads, creating our simple benchmark. Because of its simplicity, the benchmark is not supposed to serve as a mock metagenome, but if a software fails on that simple task, it will surely fail on most real metagenomes. We applied three software for the benchmark. The ideal quantitative solution would assign the same proportion to the three bacterial taxa. We have found that AMPHORA2/AmphoraNet gave the most accurate results and the other two software were under

  14. [Improved reproducibility of contrast echocardiography by SH U 454. Experimental studies using digital subtraction echocardiography].

    PubMed

    Grube, E; Fritzsch, T

    1986-06-01

    The right heart chambers of 10 animals were contrasted by conventional (NaCl, CO2, H2O2, indocyanine green (ICG), haemaccel) and a newly developed echo-contrast medium (SH U 454) and studied by 2-D echocardiography. By means of digital subtraction echocardiography (DSE) endocardial borders were defined automatically and the results were compared with the manual input of endocardial borders of original and contrast echocardiograms. The area enclosed by these borders served as basis for the calculation of reproducibility (in %) and correlations. The following correlation coefficients (r) and SEE were calculated between the areas defined by the different contrast media and DSE and manually derived borders: r = 0.85, 3.98 cm2 (ICG), and 0.89, 1.00 cm2 (haemaccel). The best calculations were found using SH U 454 in concentrations between 100 and 300 mg/ml. The correlation coefficients were in the range of r = 0.95 and 0.98 with an SEE of 0.21 to 0.56 cm2 between manually and automatically derived contours. Comparing the reproducibility of data between the different evaluation methods we found the following results: manual input of endocardial borders in original echocardiograms 12.3%-16.9%; manual definition of endocardial borders in contrast echocardiograms 2.0% (SH U 454) - 15.7% (CO2); automatic contour finding in original echocardiograms 8.6%-28.9% (mean 21.6%); automatic definition of endocardium by DSE in contrast echocardiograms 7.6% (ICG) - 0.9% (SH U 454, 300 mg/ml). Our results demonstrate that digital subtraction echocardiography is a simple an safe procedure to define endocardial contours if echo contrast media lead to a uniform and homogeneous opacification of the left and right cardiac cavities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3529670

  15. A quantitative evaluation of models for Aegean crustal deformation

    NASA Astrophysics Data System (ADS)

    Nyst, M.; Thatcher, W.

    2003-04-01

    Modeling studies of eastern Mediterranean tectonics show that Aegean deformation is mainly determined by WSW directed expulsion of Anatolia and SW directed extension due to roll-back of African lithosphere along the Hellenic trench. How motion is transferred across the Aegean remains a subject of debate. The two most widely used hypotheses for Aegean tectonics assert fundamentally different mechanisms. The first model describes deformation as a result of opposing rotations of two rigid microplates separated by a zone of extension. In the second model most motion is accommodated by shear on a series of dextral faults and extension on graben systems. These models make different quantitative predictions for the crustal deformation field that can be tested by a new, spatially dense GPS velocity data set. To convert the GPS data into crustal deformation parameters we use different methods to model complementary aspects of crustal deformation. We parameterize the main fault and plate boundary structures of both models and produce representations for the crustal deformation field that range from purely rigid rotations of microplates, via interacting, elastically deforming blocks separated by crustal faults to a continuous velocity gradient field. Critical evaluation of these models indicates strengths and limitations of each and suggests new measurements for further refining understanding of present-day Aegean tectonics.

  16. Quantitative image quality evaluation for cardiac CT reconstructions

    NASA Astrophysics Data System (ADS)

    Tseng, Hsin-Wu; Fan, Jiahua; Kupinski, Matthew A.; Balhorn, William; Okerlund, Darin R.

    2016-03-01

    Maintaining image quality in the presence of motion is always desirable and challenging in clinical Cardiac CT imaging. Different image-reconstruction algorithms are available on current commercial CT systems that attempt to achieve this goal. It is widely accepted that image-quality assessment should be task-based and involve specific tasks, observers, and associated figures of merits. In this work, we developed an observer model that performed the task of estimating the percentage of plaque in a vessel from CT images. We compared task performance of Cardiac CT image data reconstructed using a conventional FBP reconstruction algorithm and the SnapShot Freeze (SSF) algorithm, each at default and optimal reconstruction cardiac phases. The purpose of this work is to design an approach for quantitative image-quality evaluation of temporal resolution for Cardiac CT systems. To simulate heart motion, a moving coronary type phantom synchronized with an ECG signal was used. Three different percentage plaques embedded in a 3 mm vessel phantom were imaged multiple times under motion free, 60 bpm, and 80 bpm heart rates. Static (motion free) images of this phantom were taken as reference images for image template generation. Independent ROIs from the 60 bpm and 80 bpm images were generated by vessel tracking. The observer performed estimation tasks using these ROIs. Ensemble mean square error (EMSE) was used as the figure of merit. Results suggest that the quality of SSF images is superior to the quality of FBP images in higher heart-rate scans.

  17. [Effects of calcinogenic plants--qualitative and quantitative evaluation].

    PubMed

    Mello, J R; Habermehl, G G

    1998-01-01

    Different research methods demonstrated the presence of variable quantities of Vitamin D as well as its metabolites in calcinogenic plants. Most of the experiments indicated that the active component most probably should be the metabolite 1,25 (OH)2D3 linked as a glycoside. By this research it was achieved to evaluate the presence of elements with Vitamin D-like activity in the calcinogenic plants Solanum malacoxylon, Cestrum diurnum, Trisetum flavescens and Nierembergia veitchii by testing different extracts of the above plants by oral application to rachitic chicks within the research model "Strontium added Alimentation". After the oral administration of the extracts, the serum was analysed to determine the level of the elements calcium, phosphorus and alkaline phosphatase. The results gained with chicks demonstrated the presence of substances with Vitamin D-like activity in the 4 plants. Solanum malacoxylon and Cestrum diurnum as well contained substances of hydrosoluble character with elevated activity which was indicated by the significant high levels of calcium and phosphorus combined with a reduced activity of the alkaline phosphatase. This indicated the presence of 1,25 (OH)2D3 in both plants. The hydrosoluble character of the active substance in both plants is most probably explained as a compound of the metabolite 1,25 (OH)2D3, combined as a glycoside in the position O-25 of the molecule. Nierembergia veitchii and Trisetum flavescens contained only minor concentration of elements with hydrosoluble characteristics. The results of the 4 analysed plants were evaluated quantitatively as follows: Solanum malycoxylon--82,800 IU of Vitamin D/kg, Cestrum diurnum--63,200 IU of Vitamin D/kg, Nierembergia veitchii--16,400 IU/kg and Trisetum flavescens 12,000 Vitamin D IU/kg. All concentrations are calcinogenic. PMID:9499629

  18. Echocardiography in pericardial diseases: new developments.

    PubMed

    Veress, Gabriella; Feng, Dali; Oh, Jae K

    2013-05-01

    Echocardiography is one of the most important clinical tools in the diagnosis and management of various pericardial diseases, including constrictive pericarditis, effusive constrictive pericarditis, pericardial effusion, tamponade, absence of the pericardium and cysts or tumors. During recent years, remarkable progress has been made in echocardiography: cardiac tissue Doppler analysis (TDI), strain and strain rate imaging by speckle tracking imaging (STE) and three-dimensional (3D) echocardiography. The assessment of early diastolic annulus velocity and annulus reversus by TDI improves the differentiation of constriction from restrictive myocardial disease, which can be further facilitated by STE as a complementary tool. 3D echocardiography may be useful for the more precise assessment of pericardial diseases, such as pericardial effusion or pericardial masses as it provides incremental value to 2D echocardiography by detecting anatomic structures with higher accuracy. Applications of these newer echocardiographic techniques in the assessment of pericardial diseases are discussed in this chapter. PMID:22752511

  19. Radial Basis Functions for Combining Shape and Speckle Tracking in 4D Echocardiography

    PubMed Central

    Compas, Colin B.; Wong, Emily Y.; Huang, Xiaojie; Sampath, Smita; Lin, Ben A.; Pal, Prasanta; Papademetris, Xenophon; Thiele, Karl; Dione, Donald P.; Stacy, Mitchel; Staib, Lawrence H.; Sinusas, Albert J.; O'Donnell, Matthew; Duncan, James S.

    2014-01-01

    Quantitative analysis of left ventricular deformation can provide valuable information about the extent of disease as well as the efficacy of treatment. In this work, we develop an adaptive multi-level compactly supported radial basis approach for deformation analysis in 3D+time echocardiography. Our method combines displacement information from shape tracking of myocardial boundaries (derived from B-mode data) with mid-wall displacements from radio-frequency-based ultrasound speckle tracking. We evaluate our methods on open-chest canines (N=8) and show that our combined approach is better correlated to magnetic resonance tagging-derived strains than either individual method. We also are able to identify regions of myocardial infarction (confirmed by postmortem analysis) using radial strain values obtained with our approach. PMID:24893257

  20. Doppler tissue energy and stress echocardiography in the diagnosis of myocardial contusion in canines.

    PubMed

    Wenhua, Du; Xiuqin, Xiong; Weimin, Zhang

    2012-03-01

    We sought to evaluate the significance of Doppler tissue energy (DTE) and stressed echocardiography for diagnosing myocardial contusion (MC) in canines. Ten adult healthy dogs were anesthetized (3% pentobarbital sodium/i.v.) and impacted by BIM-II biological impact machine to induce MC. Conventional and stressed echocardiographies were used for segmental abnormal ventricular wall motions; DTE was also used to detect the abnormal ventricular wall motions and areas of injured myocardial fibers after MC, and the results were compared with those of triphenyl tetrazolium chloride (TTC) staining. The data show that both conventional and stressed echocardiographies identified ventricular wall segmental abnormal motions or even aneurysms. These segments were mainly distributed over the front and middle interventricular walls and anterolateral ventricular wall. The ventricular wall motion scoring and wall motion segment index (WMSI) increased remarkably after MC induction. Compared with TTC staining, the conventional echocardiography showed 100% sensitivity and 66.67% specificity, whereas the stressed echocardiography displayed 100% sensitivity and 88.89% specificity. DTE showed both the sensitivity and specificity of 100% for MC diagnosis. Thus, DTE has higher specificity than conventional and stressed echocardiographies. In conclusion, both DTE and stress echocardiography have higher clinical value for MC diagnosis in canines. PMID:22065256

  1. Quantitative comparison between crowd models for evacuation planning and evaluation

    NASA Astrophysics Data System (ADS)

    Viswanathan, Vaisagh; Lee, Chong Eu; Lees, Michael Harold; Cheong, Siew Ann; Sloot, Peter M. A.

    2014-02-01

    Crowd simulation is rapidly becoming a standard tool for evacuation planning and evaluation. However, the many crowd models in the literature are structurally different, and few have been rigorously calibrated against real-world egress data, especially in emergency situations. In this paper we describe a procedure to quantitatively compare different crowd models or between models and real-world data. We simulated three models: (1) the lattice gas model, (2) the social force model, and (3) the RVO2 model, and obtained the distributions of six observables: (1) evacuation time, (2) zoned evacuation time, (3) passage density, (4) total distance traveled, (5) inconvenience, and (6) flow rate. We then used the DISTATIS procedure to compute the compromise matrix of statistical distances between the three models. Projecting the three models onto the first two principal components of the compromise matrix, we find the lattice gas and RVO2 models are similar in terms of the evacuation time, passage density, and flow rates, whereas the social force and RVO2 models are similar in terms of the total distance traveled. Most importantly, we find that the zoned evacuation times of the three models to be very different from each other. Thus we propose to use this variable, if it can be measured, as the key test between different models, and also between models and the real world. Finally, we compared the model flow rates against the flow rate of an emergency evacuation during the May 2008 Sichuan earthquake, and found the social force model agrees best with this real data.

  2. Aging rat vestibular ganglion: I. Quantitative light microscopic evaluation.

    PubMed

    Alidina, A; Lyon, M J

    1990-01-01

    This study was undertaken to quantify age-related changes in the rat vestibular ganglion. Cell number, diameter, and proximal-distal distribution based on size were evaluated. Serial 5-microns plastic sections of the vestibular ganglion from 15 female Wistar rats were examined. Rats were divided into three age groups: young (Y, 3 to 5 months, n = 5), old (0, 24 to 26 months, n = 3), and very old (VO, 28 to 31 months, n = 7). Quantitative analysis indicated no significant differences (P less than .05) in the estimated number of ganglion cells (mean: Y = 1,690, 0 = 2,257, VO = 1,678), ganglion cell profile diameters (mean: Y = 22.5 microns, n = 2,886; O = 23.7 microns, n = 2,313; VO = 22.8 microns, n = 4,061), or proximal-distal localization (proximal: 22.3 microns, 24.4 microns, 22.7 microns; middle: 22.6 microns, 23.1 microns, 22.4 microns; distal: 23.3 microns, 23.4 microns, 23.7 microns; Y, O, and VO, respectively). When pooled, the old animals tended to have slightly larger cell profiles than the other groups. We noted a dramatic age-related increase of aging pigment within the ganglion cell profiles, making the old and very old animals easily distinguishable from the young. In most of the cell profiles, the aging pigment was more or less uniformly distributed throughout the cytoplasm. However, in some, aging pigment was accumulated at one pole of the cell profile. While no typical degenerating cellular profiles were found in any of the sections, several of the ganglion cell profiles from the old animals revealed dense cytoplasm, possibly indicating an early stage of degeneration. PMID:2382785

  3. Dual-band infrared thermography for quantitative nondestructive evaluation

    SciTech Connect

    Durbin, P.F.; Del Grande, N.K.; Dolan, K.W.; Perkins, D.E.; Shapiro, A.B.

    1993-04-01

    The authors have developed dual-band infrared (DBIR) thermography that is being applied to quantitative nondestructive evaluation (NDE) of aging aircraft. The DBIR technique resolves 0.2 degrees C surface temperature differences for inspecting interior flaws in heated aircraft structures. It locates cracks, corrosion sites, disbonds or delaminations in metallic laps and composite patches. By removing clutter from surface roughness effects, the authors clarify interpretation of subsurface flaws. To accomplish this, the authors ratio images recorded at two infrared bands, centered near 5 microns and 10 microns. These image ratios are used to decouple temperature patterns associated with interior flaw sites from spatially varying surface emissivity noise. They also discuss three-dimensional (3D) dynamic thermal imaging of structural flaws using dual-band infrared (DBIR) computed tomography. Conventional thermography provides single-band infrared images which are difficult to interpret. Standard procedures yield imprecise (or qualitative) information about subsurface flaw sites which are typically masked by surface clutter. They use a DBIR imaging technique pioneered at LLNL to capture the time history of surface temperature difference patterns for flash-heated targets. They relate these patterns to the location, size, shape and depth of subsurface flaws. They have demonstrated temperature accuracies of 0.2{degree}C, timing synchronization of 3 ms (after onset of heat flash) and intervals of 42 ms, between images, during an 8 s cooling (and heating) interval characterizing the front (and back) surface temperature-time history of an epoxy-glue disbond site in a flash-heated aluminum lap joint.

  4. Evaluation of errors in quantitative determination of asbestos in rock

    NASA Astrophysics Data System (ADS)

    Baietto, Oliviero; Marini, Paola; Vitaliti, Martina

    2016-04-01

    The quantitative determination of the content of asbestos in rock matrices is a complex operation which is susceptible to important errors. The principal methodologies for the analysis are Scanning Electron Microscopy (SEM) and Phase Contrast Optical Microscopy (PCOM). Despite the PCOM resolution is inferior to that of SEM, PCOM analysis has several advantages, including more representativity of the analyzed sample, more effective recognition of chrysotile and a lower cost. The DIATI LAA internal methodology for the analysis in PCOM is based on a mild grinding of a rock sample, its subdivision in 5-6 grain size classes smaller than 2 mm and a subsequent microscopic analysis of a portion of each class. The PCOM is based on the optical properties of asbestos and of the liquids with note refractive index in which the particles in analysis are immersed. The error evaluation in the analysis of rock samples, contrary to the analysis of airborne filters, cannot be based on a statistical distribution. In fact for airborne filters a binomial distribution (Poisson), which theoretically defines the variation in the count of fibers resulting from the observation of analysis fields, chosen randomly on the filter, can be applied. The analysis in rock matrices instead cannot lean on any statistical distribution because the most important object of the analysis is the size of the of asbestiform fibers and bundles of fibers observed and the resulting relationship between the weights of the fibrous component compared to the one granular. The error evaluation generally provided by public and private institutions varies between 50 and 150 percent, but there are not, however, specific studies that discuss the origin of the error or that link it to the asbestos content. Our work aims to provide a reliable estimation of the error in relation to the applied methodologies and to the total content of asbestos, especially for the values close to the legal limits. The error assessments must

  5. Real-time transesophageal echocardiography facilitates antegrade balloon aortic valvuloplasty

    PubMed Central

    Ito, Kazato; Yano, Kentaro; Tanaka, Chiharu; Nakashoji, Tomohiro; Tonomura, Daisuke; Takehara, Kosuke; Kino, Naoto; Yoshida, Masataka; Kurotobi, Toshiya; Tsuchida, Takao; Fukumoto, Hitoshi

    2016-01-01

    We report two cases of severe aortic stenosis (AS) where antegrade balloon aortic valvuloplasty (BAV) was performed under real-time transesophageal echocardiography (TEE) guidance. Real-time TEE can provide useful information for evaluating the aortic valve response to valvuloplasty during the procedure. It was led with the intentional wire-bias technique in order to compress the severely calcified leaflet, and consequently allowed the balloon to reach the largest possible size and achieve full expansion of the aortic annulus. PMID:27054107

  6. Longitudinal flexural mode utility in quantitative guided wave evaluation

    NASA Astrophysics Data System (ADS)

    Li, Jian

    2001-07-01

    Longitudinal Non-axisymmetric flexural mode utility in quantitative guided wave evaluation is examined for pipe and tube inspection. Attention is focused on hollow cylinders. Several source loading problems such as a partial-loading angle beam, an axisymmetric comb transducer and an angle beam array are studied. The Normal Mode Expansion method is employed to simulate the generated guided wave fields. For non-axisymmetric sources, an important angular profile feature is studied. Based on numerical calculations, an angular profile varies with frequency, mode and propagating distance. Since an angular profile determines the energy distribution of the guided waves, the angular profile has a great impact on the pipe inspection capability of guided waves. The simulation of non-axisymmetric angular profiles generated by partialloading is verified by experiments. An angular profile is the superposition of harmonic axisymmetric and non-axisymmetric modes with various phase velocities. A simpler equation is derived to calculate the phase velocities of the non-axisymmetric guided waves and is used for discussing the characteristics of non-axisymmetric guided waves. Angular profiles have many applications in practical pipe testing. The procedure of building desired angular profiles and also angular profile tuning is discussed. This angular profile tuning process is implemented by a phased transducer array and a special computational algorithm. Since a transducer array plays a critical role in guided wave inspection, the performance of a transducer array is discussed in terms of guided wave mode control ability and excitation sensitivity. With time delay inputs, a transducer array is greatly improved for its mode control ability and sensitivity. The algorithms for setting time delays are derived based on frequency, element spacing and phase velocity. With the help of the conclusions drawn on non- axisymmetric guided waves, a phased circumferential partial-loading array is

  7. Quantitative evaluation of stiffness of commercial suture materials.

    PubMed

    Chu, C C; Kizil, Z

    1989-03-01

    The bending stiffness of 22 commercial suture materials of varying size, chemical structure and physical form was quantitatively evaluated using a stiffness tester (Taber V-5, model 150B, Teledyne). The commercial sutures were Chromic catgut; Dexon (polyglycolic acid); Vicryl (polyglactin 910); PDS (polydioxanone); Maxon (polyglycolide-trimethylene carbonate); Silk (coated with silicone); Mersilene (polyester fiber); Tycron (polyester fiber); Ethibond (polyethylene terephthalate coated with polybutylene); Nurolon (nylon 66); Surgilon (nylon 66 coated with silicone); Ethilon (coated nylon 66), Prolene (polypropylene); Dermalene (polyethylene), and Gore-tex (polytetraflouroethylene). These are both natural and synthetic, absorbable and nonabsorbable and monofilament and multifilament sutures. All of these sutures were size 2-0, but Prolene sutures with sizes ranging from 1-0 to 9-0 were also tested to determine the effect of suture size on stiffness. The bending stiffness data obtained showed that a wide range of bending stiffness was observed among the 22 commercial sutures. The most flexible 2-0 suture was Gore-tex, followed by Dexon, Silk, Surgilon, Vicryl (uncoated), Tycron, Nurolon, Mersilene, Ethibond, Maxon, PDS, Ethilon, Prolene, Chromic catgut, coated Vicryl, and lastly, Dermalene. The large porous volume inherent in Gore-tex monofilament suture was the reason for its lowest flexural stiffness. Sutures with a braided structure were generally more flexible than those of a monofilament structure, irrespective of the chemical constituents. Coated sutures had significantly higher stiffness than the corresponding uncoated ones. This is particularly true when polymers rather than wax were used as the coating material. This increase in stiffness is attributable to the loss of mobility under bending force in the fibers and yarns that make up the sutures. An increase in the size of the suture significantly increased the stiffness, and the magnitude of increase

  8. Quantitative Evaluation of Atherosclerotic Plaque Using Ultrasound Tissue Characterization.

    NASA Astrophysics Data System (ADS)

    Yigiter, Ersin

    Evaluation of therapeutic methods directed toward interrupting and/or delaying atherogenesis is impeded by the lack of a reliable, non-invasive means for monitoring progression or regression of disease. The ability to characterize the predominant component of plaque may be very valuable in the study of this disease's natural history. The earlier the lesion, the more likely is lipid to be the predominant component. Progression of plaque is usually by way of overgrowth of fibrous tissues around the fatty pool. Calcification is usually a feature of the older or complicated lesion. To explore the feasibility of using ultrasound to characterize plaque we have conducted measurements of the acoustical properties of various atherosclerotic lesions found in freshly excised samples of human abdominal aorta. Our objective has been to determine whether or not the acoustical properties of plaque correlate with the type and/or chemical composition of plaque and, if so, to define a measurement scheme which could be done in-vivo and non-invasively. Our current data base consists of individual tissue samples from some 200 different aortas. Since each aorta yields between 10 to 30 tissue samples for study, we have data on some 4,468 different lesions or samples. Measurements of the acoustical properties of plaque were found to correlate well with the chemical composition of plaque. In short, measurements of impedance and attenuation seem sufficient to classify plaque as to type and to composition. Based on the in-vitro studies, the parameter of attenuation was selected as a means of classifying the plaque. For these measurements, an intravascular ultrasound scanner was modified according to our specifications. Signal processing algorithms were developed which would analyze the complex ultrasound waveforms and estimate tissue properties such as attenuation. Various methods were tried to estimate the attenuation from the pulse-echo backscattered signal. Best results were obtained by

  9. The Role of Echocardiography in Coronary Artery Disease and Acute Myocardial Infarction

    PubMed Central

    Esmaeilzadeh, Maryam; Parsaee, Mozhgan; Maleki, Majid

    2013-01-01

    Echocardiography is a non-invasive diagnostic technique which provides information regarding cardiac function and hemodynamics. It is the most frequently used cardiovascular diagnostic test after electrocardiography and chest X-ray. However, in a patient with acute chest pain, Transthoracic Echocardiography is essential both for diagnosing acute coronary syndrome, zeroing on the evaluation of ventricular function and the presence of regional wall motion abnormalities, and for ruling out other etiologies of acute chest pain or dyspnea, including aortic dissection and pericardial effusion. Echocardiography is a versatile imaging modality for the management of patients with chest pain and assessment of left ventricular systolic function, diastolic function, and even myocardial and coronary perfusion and is, therefore, useful in the diagnosis and triage of patients with acute chest pain or dyspnea. This review has focused on the current applications of echocardiography in patients with coronary artery disease and myocardial infarction. PMID:23646042

  10. Use of adenosine echocardiography for diagnosis of coronary artery disease

    SciTech Connect

    Zoghbi, W.A. )

    1991-07-01

    Two-dimensional echocardiography combined with exercise is sensitive and specific in the detection of coronary artery disease (CAD) by demonstrating transient abnormalities in wall motion. Frequently, however, patients cannot achieve maximal exercise because of various factors. Pharmacologic stress testing with intravenous adenosine was evaluated as a means of detecting CAD in a noninvasive manner. Patients with suspected CAD underwent echocardiographic imaging and simultaneous thallium 201 single-photon emission computed tomography during the intravenous administration of 140 micrograms/kg/min of adenosine. An increase in heart rate, decrease in blood pressure, and increase in double product were observed during adenosine administration. Initial observations revealed that wall motion abnormalities were induced by adenosine in areas of perfusion defects. The adenosine infusion was well tolerated, and symptoms disappeared within 1 to 2 minutes after termination of the infusion. Therefore preliminary observations suggest that adenosine echocardiography appears to be useful in the assessment of CAD.

  11. QUANTITATIVE GENETIC ACTIVITY GRAPHICAL PROFILES FOR USE IN CHEMICAL EVALUATION

    EPA Science Inventory

    A graphic approach termed a Genetic Activity Profile (GAP) has been developed to display a matrix of data on the genetic and related effects of selected chemical agents. he profiles provide a visual overview of the quantitative (doses) and qualitative (test results) data for each...

  12. Quantitative, Notional, and Comprehensive Evaluations of Spontaneous Engaged Speech

    ERIC Educational Resources Information Center

    Molholt, Garry; Cabrera, Maria Jose; Kumar, V. K.; Thompsen, Philip

    2011-01-01

    This study provides specific evidence regarding the extent to which quantitative measures, common sense notional measures, and comprehensive measures adequately characterize spontaneous, although engaged, speech. As such, the study contributes to the growing body of literature describing the current limits of automatic systems for evaluating…

  13. Utility of echocardiography in hypotension in the intensive care unit.

    PubMed

    Verma, Sumit; Kumar, Sumit; Gossage, James R; Shah, Vipul B

    2009-12-01

    A prospective study was performed on the utility of echocardiography in diagnosing hypotension in critically ill patients. In our study, we found that transthoracic echocardiography can help physicians determine the etiology of hypotension in a significant number of patients. Transesophageal echocardiography is useful when results obtained from transthoracic echocardiography are suboptimal. Left ventricular function assessed by echocardiography can be used to predict 30-day mortality. PMID:20877173

  14. Transoesophageal echocardiography during liver transplantation

    PubMed Central

    De Pietri, Lesley; Mocchegiani, Federico; Leuzzi, Chiara; Montalti, Roberto; Vivarelli, Marco; Agnoletti, Vanni

    2015-01-01

    Liver transplantation (LT) has become the standard of care for patients with end stage liver disease. The allocation of organs, which prioritizes the sickest patients, has made the management of liver transplant candidates more complex both as regards their comorbidities and their higher risk of perioperative complications. Patients undergoing LT frequently display considerable physiological changes during the procedures as a result of both the disease process and the surgery. Transoesophageal echocardiography (TEE), which visualizes dynamic cardiac function and overall contractility, has become essential for perioperative LT management and can optimize the anaesthetic management of these highly complex patients. Moreover, TEE can provide useful information on volume status and the adequacy of therapeutic interventions and can diagnose early intraoperative complications, such as the embolization of large vessels or development of pulmonary hypertension. In this review, directed at clinicians who manage TEE during LT, we show why the procedure merits a place in challenging anaesthetic environment and how it can provide essential information in the perioperative management of compromised patients undergoing this very complex surgical procedure. PMID:26483865

  15. [Blood flow patterns in the left ventricle in patients with myocardial infarction and ventricular aneurysm: evaluation using real-time two-dimensional Doppler echocardiography].

    PubMed

    Konishiike, A; Mihata, S; Matsumori, Y; Nishian, K; Ikeoka, K; Yasutomi, N; Tanimoto, M; Makihata, S; Yamamoto, T; Iwasaki, T

    1987-12-01

    To evaluate how the intraventricular blood flow is affected by the size of a left ventricular aneurysm and ventricular dysfunction, systolic left ventricular blood flow patterns were evaluated using two-dimensional Doppler flow images (real-time 2-D Doppler echo). The subjects consisted of 10 normal controls, 35 patients with anteroseptal infarction, two patients with inferior infarction and five patients with anteroseptal-inferior infarctions. The systolic period was divided into three subsets; early, mid- and end-systole. Forty-two patients with myocardial infarction were classified into three groups according to the left ventricular inflow patterns on real-time 2-D Doppler echo using the apical left ventricular long-axis approach; i.e., inflow signals confined to early systole (Group I), visualized up to mid-systole (Group II) and end-systole (Group III). Left ventricular end-diastolic dimension (LVDd), left ventricular end-systolic dimension (LVDs), and % non-contractile circumference (delta L) were calculated by the same echocardiographic approach. Ejection fraction (EF) was calculated by left ventricular cineangiography using the Simpson's method. The left ventricular inflow Doppler signals in the normal controls and Group I turned in the apex and then directed toward the left ventricular outflow tract during late diastole and early systole. Significant differences in EF were observed among the three groups. EF in Group I, II and III was 53 +/- 9%, 41 +/- 8% and 29 +/- 7%, respectively. However, LVDd, LVDs and delta L had the largest values in Group III and the smallest values in Group I. LVDd, LVDs and delta L were smallest in Group I and largest in Group III. In the normal controls, the left ventricular inflow signals proceeded to the apex and directed toward the left ventricular outflow tract in the early systolic period. Various changes in the inflow pattern were observed in patients with myocardial infarction and severe wall motion abnormalities

  16. Standard transthoracic echocardiography and transesophageal echocardiography views of mitral pathology that every surgeon should know

    PubMed Central

    Tan, Timothy C.

    2015-01-01

    The mitral valve is the most commonly diseased heart valve and the prevalence of mitral valve disease increases proportionally with age. Echocardiography is the primary diagnostic imaging modality used in the assessment of patients with mitral valve disease. It is a noninvasive method which provides accurate anatomic and functional information regarding the mitral valve and can identify the mechanism of mitral valve pathology. This is especially useful as it may guide surgical repair. This is increasingly relevant given the growing trend of patients undergoing mitral valve repair. Collaboration between cardiac surgeons and echocardiographers is critical in the evaluation of mitral valve disease and for identification of complex valvular lesions that require advanced surgical skill to repair. This article will provide an overview of transthoracic and transesophageal assessment of common mitral valve pathology that aims to aid surgical decision making. PMID:26539350

  17. [Comparison of vectorcardiography and echocardiography in the evaluation of the site and extent of necrosis in myocardial infarction without Q wave].

    PubMed

    Palmieri, M; Gotti, G; Zilio, G; Chiozza, R; Moratti, P; Della Mea, M T; Magris, R

    1990-04-01

    In order to improve the evaluation of the site and extent of the necrosis in acute myocardial infarction without Q wave (IMNQ), we used a multiparametric method taking into account the enzymatic values of the total CK, a score derived from Frank's VCG and a kinetic score of the VG segments estimated by echo-2D. The literature data have shown, according to the clinical and anatomical correlations, the frequency of the transmural lesions in the IMNQ cases and, on the contrary, of the lesions limited to the endocardial region and partially transmural in infarctions with new pathological Q waves. The heterogeneousness of the anatomo-pathological data can be explained by the mechanisms of the ischaemia, the site of the coronary occlusion, the presence or not of a spasm, the compensation by the collateral flux and eventually the effects of a treatment by fibrinolytic drugs. PMID:2369055

  18. [Quantitative evaluation of the nitroblue tetrazolium reduction test].

    PubMed

    Vagner, V K; Nasonkin, O S; Boriskina, N D

    1989-01-01

    The results of NBT test were assessed by the visual cytochemical method and by the quantitative spectrophotometry technique developed by the authors for the NBT test. The results demonstrate a higher sensitivity and informative value of the new method, in case the neutrophilic tetrazolium activity is rather high; this recommends the NBT test spectrophotometric variant for wide clinical application in studies of the blood leukocyte functional and metabolic activity. PMID:2483198

  19. Quantitative autoradiographic microimaging in the development and evaluation of radiopharmaceuticals

    SciTech Connect

    Som, P.; Oster, Z.H.

    1994-04-01

    Autoradiographic (ARG) microimaging is the method for depicting biodistribution of radiocompounds with highest spatial resolution. ARG is applicable to gamma, positron and negatron emitting radiotracers. Dual or multiple-isotope studies can be performed using half-lives and energies for discrimination of isotopes. Quantitation can be performed by digital videodensitometry and by newer filmless technologies. ARG`s obtained at different time intervals provide the time dimension for determination of kinetics.

  20. Review of progress in quantitative NDE. [Nondestructive Evaluation (NDE)

    SciTech Connect

    Not Available

    1991-01-01

    This booklet is composed of abstracts from papers submitted at a meeting on quantitative NDE. A multitude of topics are discussed including analysis of composite materials, NMR uses, x-ray instruments and techniques, manufacturing uses, neural networks, eddy currents, stress measurements, magnetic materials, adhesive bonds, signal processing, NDE of mechanical structures, tomography,defect sizing, NDE of plastics and ceramics, new techniques, optical and electromagnetic techniques, and nonlinear techniques. (GHH)

  1. Stress echocardiography: what is new and how does it compare with myocardial perfusion imaging and other modalities?

    PubMed

    Tweet, Marysia S; Arruda-Olson, Adelaide M; Anavekar, Nandan S; Pellikka, Patricia A

    2015-06-01

    Cardiovascular disease is a leading cause of morbidity and mortality, and noninvasive strategies to diagnose and risk stratify patients remain paramount in the evaluative process. Stress echocardiography is a well-established, versatile, real-time imaging modality with advantages including lack of radiation exposure, portability, and affordability. Innovative techniques in stress echocardiography include myocardial contrast echocardiography, deformation imaging, three-dimensional (3D) echocardiography, and assessment of coronary flow reserve. Myocardial perfusion imaging with single-photon emission computed tomography (SPECT) or positron emission tomography (PET) are imaging alternatives, and stress cardiac magnetic resonance imaging and coronary computed tomography (CT) angiography, including CT perfusion imaging, are emerging as newer approaches. This review will discuss recent and upcoming developments in the field of stress testing, with an emphasis on stress echocardiography while highlighting comparisons with other modalities. PMID:25911442

  2. Estimating pulmonary artery pressures by echocardiography in patients with emphysema.

    PubMed

    Fisher, M R; Criner, G J; Fishman, A P; Hassoun, P M; Minai, O A; Scharf, S M; Fessler, H E

    2007-11-01

    In patients with emphysema being evaluated for lung volume reduction surgery, Doppler echocardiography has been used to screen for pulmonary hypertension as an indicator of increased peri-operative risk. To determine the accuracy of this test, the present authors compared the results of right heart catheterisations and Doppler echocardiograms in 163 patients participating in the cardiovascular substudy of the National Emphysema Treatment Trial. Substudy patients had both catheterisation and Doppler echocardiography performed before and after randomisation. In 74 paired catheterisations and echocardiograms carried out on 63 patients, the mean values of invasively measured pulmonary artery systolic pressures and the estimated right ventricular systolic pressures were similar. However, using the World Health Organization's definitions of pulmonary hypertension, echocardiography had a sensitivity of 60%, specificity of 74%, positive predictive value of 68% and a negative predictive value of 67% compared with the invasive measurement. Bland-Altman analysis revealed a bias of 0.37 kPa with 95% limits of agreement from -2.5-3.2 kPa. In patients with severe emphysema, echocardiographic estimates of pulmonary artery pressures correlate very weakly with right heart catheterisations, and the test characteristics (e.g. sensitivity, specificity, etc.) of echocardiographic assessments are poor. PMID:17652313

  3. Dynamic 3D echocardiography in virtual reality

    PubMed Central

    van den Bosch, Annemien E; Koning, Anton HJ; Meijboom, Folkert J; McGhie, Jackie S; Simoons, Maarten L; van der Spek, Peter J; Bogers, Ad JJC

    2005-01-01

    Background This pilot study was performed to evaluate whether virtual reality is applicable for three-dimensional echocardiography and if three-dimensional echocardiographic 'holograms' have the potential to become a clinically useful tool. Methods Three-dimensional echocardiographic data sets from 2 normal subjects and from 4 patients with a mitral valve pathological condition were included in the study. The three-dimensional data sets were acquired with the Philips Sonos 7500 echo-system and transferred to the BARCO (Barco N.V., Kortrijk, Belgium) I-space. Ten independent observers assessed the 6 three-dimensional data sets with and without mitral valve pathology. After 10 minutes' instruction in the I-Space, all of the observers could use the virtual pointer that is necessary to create cut planes in the hologram. Results The 10 independent observers correctly assessed the normal and pathological mitral valve in the holograms (analysis time approximately 10 minutes). Conclusion this report shows that dynamic holographic imaging of three-dimensional echocardiographic data is feasible. However, the applicability and use-fullness of this technology in clinical practice is still limited. PMID:16375768

  4. The potential role and limitations of echocardiography in acute respiratory distress syndrome.

    PubMed

    Lazzeri, Chiara; Cianchi, Giovanni; Bonizzoli, Manuela; Batacchi, Stefano; Peris, Adriano; Gensini, Gian Franco

    2016-04-01

    Bedside use of Doppler echocardiography is being featured as a promising, clinically useful tool in assessing the pulmonary circulation in patients with acute respiratory distress syndrome (ARDS). The present review is aimed at summarizing the available evidence obtained with echocardiography on right ventricle (RV) function and pulmonary circulation in ARDS and to highlight the potential of this technique in clinical practice (only articles in English language were considered). According to the available evidence on echocardiographic findings, the following conclusions can be drawn: (a) echocardiography (transthoracic and transesophageal) has a growing role in the management ARDS patients mainly because of the strict interactions between the lung (and ventilation) and the RV and pulmonary circulation; (b) there may be a continuum of alterations in RV size and function and pulmonary circulation which may end in the development of acute cor pulmonale, probably paralleling ARDS disease severity; and (c) the detection of acute cor pulmonale should prompt intensivists to tailor their ventilatory strategy to the individual patient depending on the echocardiography findings. Bearing in mind the clinical role and growing importance of echocardiography in ARDS and the available evidence on this topic, we present a flow chart including the parameters to be measured and the timing of echo exams in ARDS patients. Despite the important progress that echocardiography has gained in the evaluation of patients with ARDS, several open questions remain and echocardiography still appears to be underused in these patients. A more systematic use of echocardiography (mainly through shared protocols) in ARDS could help intensivists to tailor the optimal treatment in individual patients as well as highlighting the limits and potential of this methodology in patients with ALI. PMID:26660667

  5. Evaluation of reference genes for quantitative RT-PCR in Lolium perenne

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Quantitative real-time RT-PCR provides an important tool for analyzing gene expression if proper internal standards are used. The aim of this study was to identify and evaluate reference genes for use in real-time quantitative RT-PCR in perennial ryegrass (Lolium perenne L.) during plant developmen...

  6. Anesthesia and the quantitative evaluation of neurovascular coupling

    PubMed Central

    Masamoto, Kazuto; Kanno, Iwao

    2012-01-01

    Anesthesia has broad actions that include changing neuronal excitability, vascular reactivity, and other baseline physiologies and eventually modifies the neurovascular coupling relationship. Here, we review the effects of anesthesia on the spatial propagation, temporal dynamics, and quantitative relationship between the neural and vascular responses to cortical stimulation. Previous studies have shown that the onset latency of evoked cerebral blood flow (CBF) changes is relatively consistent across anesthesia conditions compared with variations in the time-to-peak. This finding indicates that the mechanism of vasodilation onset is less dependent on anesthesia interference, while vasodilation dynamics are subject to this interference. The quantitative coupling relationship is largely influenced by the type and dosage of anesthesia, including the actions on neural processing, vasoactive signal transmission, and vascular reactivity. The effects of anesthesia on the spatial gap between the neural and vascular response regions are not fully understood and require further attention to elucidate the mechanism of vascular control of CBF supply to the underlying focal and surrounding neural activity. The in-depth understanding of the anesthesia actions on neurovascular elements allows for better decision-making regarding the anesthetics used in specific models for neurovascular experiments and may also help elucidate the signal source issues in hemodynamic-based neuroimaging techniques. PMID:22510601

  7. Echocardiography in the Assessment of Patients with Rheumatologic Diseases.

    PubMed

    Al-Mohaissen, Maha A; Chan, Kwan-Leung

    2016-08-01

    Cardiovascular disease is an important extra-articular manifestation of rheumatologic diseases leading to considerable mortality and morbidity. Echocardiography emerges as a useful non-invasive technique for the screening and evaluation of cardiac involvement in these patients. With the technological advancement in echocardiographic techniques, we have gained a greater appreciation of the prevalence and nature of the cardiac involvement in these patients, as detection of subclinical disease is increasingly feasible. This review discusses cardiac involvement in patients with rheumatoid arthritis, systemic lupus erythematosus, anti-phospholipid antibody syndrome, systemic sclerosis and ankylosing spondylitis, and the role of different echocardiographic modalities in their evaluation. PMID:27306356

  8. Using quantitative interference phase microscopy for sperm acrosome evaluation (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Balberg, Michal; Kalinowski, Ksawery; Levi, Mattan; Shaked, Natan T.

    2016-03-01

    We demonstrate quantitative assessment of sperm cell morphology, primarily acrosomal volume, using quantitative interference phase microscopy (IPM). Normally, the area of the acrosome is assessed using dyes that stain the acrosomal part of the cell. We have imaged fixed individual sperm cells using IPM. Following, the sample was stained and the same cells were imaged using bright field microscopy (BFM). We identified the acrosome using the stained BFM image, and used it to define a quantitative corresponding area in the IPM image and determine a quantitative threshold for evaluating the volume of the acrosome.

  9. A New Simple Interferometer for Obtaining Quantitatively Evaluable Flow Patterns

    NASA Technical Reports Server (NTRS)

    Erdmann, S F

    1953-01-01

    The method described in the present report makes it possible to obtain interferometer records with the aid of any one of the available Schlieren optics by the addition of very simple expedients, which fundamentally need not to be inferior to those obtained by other methods, such as the Mach-Zehnder interferometer, for example. The method is based on the fundamental concept of the phase-contrast process developed by Zernike, but which in principle has been enlarged to such an extent that it practically represents an independent interference method for general applications. Moreover, the method offers the possibility, in case of necessity, of superposing any apparent wedge field on the density field to be gauged. The theory is explained on a purely physical basis and illustrated and proved by experimental data. A number of typical cases are cited and some quantitative results reported.

  10. Quantitative Percussion Diagnostics For Evaluating Bond Integrity Between Composite Laminates

    NASA Astrophysics Data System (ADS)

    Poveromo, Scott Leonard

    Conventional nondestructive testing (NDT) techniques used to detect defects in composites are not able to determine intact bond integrity within a composite structure and are costly to use on large and complex shaped surfaces. To overcome current NDT limitations, a new technology was utilized based on quantitative percussion diagnostics (QPD) to better quantify bond quality in fiber reinforced composite materials. Experimental results indicate that this technology is capable of detecting 'kiss' bonds (very low adhesive shear strength), caused by the application of release agents on the bonding surfaces, between flat composite laminates bonded together with epoxy adhesive. Specifically, the local value of the loss coefficient determined from quantitative percussion testing was found to be significantly greater for a release coated panel compared to that for a well bonded sample. Also, the local value of the probe force or force returned to the probe after impact was observed to be lower for the release coated panels. The increase in loss coefficient and decrease in probe force are thought to be due to greater internal friction during the percussion event for poorly bonded specimens. NDT standards were also fabricated by varying the cure parameters of an epoxy film adhesive. Results from QPD for the variable cure NDT standards and lap shear strength measurements taken of mechanical test specimens were compared and analyzed. Finally, experimental results have been compared to a finite element analysis to understand the visco-elastic behavior of the laminates during percussion testing. This comparison shows how a lower quality bond leads to a reduction in the percussion force by biasing strain in the percussion tested side of the panel.

  11. Online versus Paper Evaluations: Differences in Both Quantitative and Qualitative Data

    ERIC Educational Resources Information Center

    Burton, William B.; Civitano, Adele; Steiner-Grossman, Penny

    2012-01-01

    This study sought to determine if differences exist in the quantitative and qualitative data collected with paper and online versions of a medical school clerkship evaluation form. Data from six-and-a-half years of clerkship evaluations were used, some collected before and some after the conversion from a paper to an online evaluation system. The…

  12. Digital holographic microscopy for quantitative cell dynamic evaluation during laser microsurgery

    PubMed Central

    Yu, Lingfeng; Mohanty, Samarendra; Zhang, Jun; Genc, Suzanne; Kim, Myung K.; Berns, Michael W.; Chen, Zhongping

    2010-01-01

    Digital holographic microscopy allows determination of dynamic changes in the optical thickness profile of a transparent object with subwavelength accuracy. Here, we report a quantitative phase laser microsurgery system for evaluation of cellular/ sub-cellular dynamic changes during laser micro-dissection. The proposed method takes advantage of the precise optical manipulation by the laser microbeam and quantitative phase imaging by digital holographic microscopy with high spatial and temporal resolution. This system will permit quantitative evaluation of the damage and/or the repair of the cell or cell organelles in real time. PMID:19582118

  13. Digital echocardiography 2002: now is the time

    NASA Technical Reports Server (NTRS)

    Thomas, James D.; Greenberg, Neil L.; Garcia, Mario J.

    2002-01-01

    The ability to acquire echocardiographic images digitally, store and transfer these data using the DICOM standard, and routinely analyze examinations exists today and allows the implementation of a digital echocardiography laboratory. The purpose of this review article is to outline the critical components of a digital echocardiography laboratory, discuss general strategies for implementation, and put forth some of the pitfalls that we have encountered in our own implementation. The major components of the digital laboratory include (1) digital echocardiography machines with network output, (2) a switched high-speed network, (3) a high throughput server with abundant local storage, (4) a reliable low-cost archive, (5) software to manage information, and (6) support mechanisms for software and hardware. Implementation strategies can vary from a complete vendor solution providing all components (hardware, software, support), to a strategy similar to our own where standard computer and networking hardware are used with specialized software for management of image and measurement information.

  14. Stress echocardiography: methods, indications and results

    PubMed Central

    Baur, L.H.B.

    2002-01-01

    Stress echocardiography has become an important clinical tool to detect cardiac ischaemia and viability in addition to single photon emission tomography. Stress echocardiography has a high positive and negative predictive value, is less expensive than the nuclear methods and has no radiation exposure. It can easily be used in an emergency room and coronary care unit. Because of its feasibility, low cost and high diagnostic accuracy, it will become a very important technique in every hospital and will soon be a real alternative to the more time-consuming and expensive nuclear techniques. The current article gives a review of the methods of stress echocardiography. ImagesFigure 2Figure 3Figure 4 PMID:25696080

  15. Range sensors on marble surfaces: quantitative evaluation of artifacts

    NASA Astrophysics Data System (ADS)

    Guidi, Gabriele; Remondino, Fabio; Russo, Michele; Spinetti, Alessandro

    2009-08-01

    While 3D imaging systems are widely available and used, clear statements about the possible influence of material properties over the acquired geometrical data are still rather few. In particular a material very often used in Cultural Heritage is marble, known to give geometrical errors with range sensor technologies and whose entity reported in the literature seems to vary considerably in the different works. In this article a deep investigation with different types of active range sensors used on four types of marble surfaces, has been performed. Two triangulation-based active sensors employing laser stripe and white light pattern projection respectively, and one PW-TOF laser scanner have been used in the experimentation. The analysis gave rather different results for the two categories of instruments. A negligible light penetration came out from the triangulation-based equipment (below 50 microns with the laser stripe and even less with the pattern projection device), while with the TOF system this came out to be two orders of magnitude larger, quantitatively evidencing a source of systematic errors that any surveyor engaged in 3D scanning of Cultural Heritage sites and objects should take into account and correct.

  16. A lighting metric for quantitative evaluation of accent lighting systems

    NASA Astrophysics Data System (ADS)

    Acholo, Cyril O.; Connor, Kenneth A.; Radke, Richard J.

    2014-09-01

    Accent lighting is critical for artwork and sculpture lighting in museums, and subject lighting for stage, Film and television. The research problem of designing effective lighting in such settings has been revived recently with the rise of light-emitting-diode-based solid state lighting. In this work, we propose an easy-to-apply quantitative measure of the scene's visual quality as perceived by human viewers. We consider a well-accent-lit scene as one which maximizes the information about the scene (in an information-theoretic sense) available to the user. We propose a metric based on the entropy of the distribution of colors, which are extracted from an image of the scene from the viewer's perspective. We demonstrate that optimizing the metric as a function of illumination configuration (i.e., position, orientation, and spectral composition) results in natural, pleasing accent lighting. We use a photorealistic simulation tool to validate the functionality of our proposed approach, showing its successful application to two- and three-dimensional scenes.

  17. [A new approach to the tricuspid valve in Ebstein's anomaly by real time 3D echocardiography].

    PubMed

    Taktak, A; Acar, P; Dulac, Y; Abadir, S; Chilon, T; Roux, D; Glock, Y; Fournial, G

    2005-05-01

    Ebstein's anomaly affects the tricuspid valve with a large range of anatomical forms. Successful tricuspid valvuloplasty depends mainly on the ability to mobilise the leaflets. Evaluation of the leaflet surface is difficult with 2D echocardiography whereas 3D echocardiography provides intracardiac views of the valve. The authors used this method in 10 patients with 3 modes of imaging: biplane, real time and total volume. The study population (age: 1 day to 30 years) included: 1 prenatal diagnosis, 1 neonate with refractory cyanosis, 5 patients with mild tricuspid regurgitation, 3 patients with severe tricuspid regurgitation, 2 of whom underwent valvuloplasty. 3D echocardiography was disappointing in the foetus and neonate because of poor spatial resolution. The ventricular view of the tricuspid valve in older children and adults allowed analysis of tricuspid leaflet coaptation and of the mechanism of regurgitation. The commissures and leaflet surfaces were assessed. The results of surgical valvuloplasty could be evaluated by 3D echocardiography. 3D echocardiography is now transthoracic and a real time investigation. Technical advances are required before it comes into routine usage: a more manoeuvrable matricial probe (integrating pulsed and continuous wave Doppler) and larger volume real time 3D imaging with better resolution. Its role in the assessment of Ebstein's anomaly should be evaluated in a larger series of patients. PMID:15966604

  18. A Quantitative Investigation of Stakeholder Variation in Training Program Evaluation.

    ERIC Educational Resources Information Center

    Michalski, Greg V.

    A survey was conducted to investigate variation in stakeholder perceptions of training results and evaluation within the context of a high-technology product development firm (the case organization). A scannable questionnaire survey booklet was developed and scanned data were exported and analyzed. Based on an achieved sample of 280 (70% response…

  19. Predictive Heterosis in Multibreed Evaluations Using Quantitative and Molecular Approaches

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Heterosis is the extra genetic boost in performance obtained by crossing two cattle breeds. It is an important tool for increasing the efficiency of beef production. It is also important to adjust data used to calculate genetic evaluations for differences in heterosis. Good estimates of heterosis...

  20. Simulation for transthoracic echocardiography of aortic valve.

    PubMed

    Nanda, Navin C; Kapur, K K; Kapoor, Poonam Malhotra

    2016-01-01

    Simulation allows interactive transthoracic echocardiography (TTE) learning using a virtual three-dimensional model of the heart and may aid in the acquisition of the cognitive and technical skills needed to perform TTE. The ability to link probe manipulation, cardiac anatomy, and echocardiographic images using a simulator has been shown to be an effective model for training anesthesiology residents in transesophageal echocardiography. A proposed alternative to real-time reality patient-based learning is simulation-based training that allows anesthesiologists to learn complex concepts and procedures, especially for specific structures such as aortic valve. PMID:27397455

  1. Simulation for transthoracic echocardiography of aortic valve

    PubMed Central

    Nanda, Navin C.; Kapur, K. K.; Kapoor, Poonam Malhotra

    2016-01-01

    Simulation allows interactive transthoracic echocardiography (TTE) learning using a virtual three-dimensional model of the heart and may aid in the acquisition of the cognitive and technical skills needed to perform TTE. The ability to link probe manipulation, cardiac anatomy, and echocardiographic images using a simulator has been shown to be an effective model for training anesthesiology residents in transesophageal echocardiography. A proposed alternative to real-time reality patient-based learning is simulation-based training that allows anesthesiologists to learn complex concepts and procedures, especially for specific structures such as aortic valve. PMID:27397455

  2. Pocket ultrasound devices for focused echocardiography

    PubMed Central

    2012-01-01

    Pocket ultrasound devices have recently been developed and may be particularly useful for emergency assessment. These devices can be stored in a pocket but share only some technical features with conventional echocardiographic machines. Two-dimensional imaging and color flow mode are available, with possible adjustments of global gain and depth, but Doppler features are lacking. These devices are particularly fitted for focused echocardiography. In this issue, a trial compares a pocket ultrasound device with a conventional echocardiographic machine for focused echocardiography in patients admitted to the emergency department. This commentary will put these findings into perspective. PMID:22748159

  3. Coronary Artery Imaging with Transthoracic Doppler Echocardiography.

    PubMed

    Takeuchi, Masaaki; Nakazono, Akemi

    2016-07-01

    Coronary artery imaging with transthoracic Doppler echocardiography is a simple and useful technique to diagnose significant coronary artery stenosis. The visualization of mosaic flow in the proximal left coronary artery provides a direct indication of the presence of significant stenosis at the corresponding site during routine echocardiography. Coronary flow velocity reserve (CFVR) has a high diagnostic accuracy and feasibility in detecting the presence of functionally significant coronary stenosis in the left anterior descending coronary artery (LAD) and in the right coronary artery. The measurement of CFVR in the LAD also provides prognostic information in patients with intermediate coronary stenosis. This review summarizes the utility of transthoracic coronary artery imaging. PMID:27216843

  4. A quantitative evaluation of the AVITEWRITE model of handwriting learning.

    PubMed

    Paine, R W; Grossberg, S; Van Gemmert, A W A

    2004-12-01

    Much sensory-motor behavior develops through imitation, as during the learning of handwriting by children. Such complex sequential acts are broken down into distinct motor control synergies, or muscle groups, whose activities overlap in time to generate continuous, curved movements that obey an inverse relation between curvature and speed. The adaptive vector integration to endpoint handwriting (AVITEWRITE) model of Grossberg and Paine (2000) [A neural model of corticocerebellar interactions during attentive imitation and predictive learning of sequential handwriting movements. Neural Networks, 13, 999-1046] addressed how such complex movements may be learned through attentive imitation. The model suggested how parietal and motor cortical mechanisms, such as difference vector encoding, interact with adaptively-timed, predictive cerebellar learning during movement imitation and predictive performance. Key psychophysical and neural data about learning to make curved movements were simulated, including a decrease in writing time as learning progresses; generation of unimodal, bell-shaped velocity profiles for each movement synergy; size scaling with isochrony, and speed scaling with preservation of the letter shape and the shapes of the velocity profiles; an inverse relation between curvature and tangential velocity; and a two-thirds power law relation between angular velocity and curvature. However, the model learned from letter trajectories of only one subject, and only qualitative kinematic comparisons were made with previously published human data. The present work describes a quantitative test of AVITEWRITE through direct comparison of a corpus of human handwriting data with the model's performance when it learns by tracing the human trajectories. The results show that model performance was variable across the subjects, with an average correlation between the model and human data of 0.89+/-0.10. The present data from simulations using the AVITEWRITE model

  5. Photoacoustic microscopy for quantitative evaluation of angiogenesis inhibitor

    NASA Astrophysics Data System (ADS)

    Chen, Sung-Liang; Burnett, Joseph; Sun, Duxin; Xie, Zhixing; Wang, Xueding

    2014-03-01

    We present the photoacoustic microscopy (PAM) for evaluation of angiogenesis inhibitors on a chick embryo model. Microvasculature in the chorioallantoic membrane (CAM) of the chick embryos was imaged by PAM, and the optical microscopy (OM) images of the same set of CAMs were also acquired for comparisons, serving for validation of the results from PAM. The angiogenesis inhibitors, Sunitinib, with different concentrations applied to the CAM result in the change in microvascular density, which was quantified by both PAM and OM imaging. Similar change in microvascular density from PAM and OM imaging in response to angiogenesis inhibitor at different doses was observed, demonstrating that PAM has potential to provide objective evaluation of anti-angiogenesis medication. Besides, PAM is advantageous in three-dimensional and functional imaging compared with OM so that the emerging PAM technique may offer unique information on the efficacy of angiogenesis inhibitors and could benefit applications related to antiangiogenesis treatments.

  6. Quantitative evaluation of phonetograms in the case of functional dysphonia.

    PubMed

    Airainer, R; Klingholz, F

    1993-06-01

    According to the laryngeal clinical findings, figures making up a scale were assigned to vocally trained and vocally untrained persons suffering from different types of functional dysphonia. The different types of dysphonia--from the manifested hypofunctional to the extreme hyperfunctional dysphonia--were classified by means of this scale. Besides, the subjects' phonetograms were measured and approximated by three ellipses, what rendered possible the definition of phonetogram parameters. The combining of selected phonetogram parameters to linear combinations served the purpose of a phonetographic evaluation. The linear combinations were to bring phonetographic and clinical evaluations into correspondence as accurately as possible. It was necessary to use different kinds of linear combinations for male and female singers and nonsingers. As a result of the reclassification of 71 and the new classification of 89 patients, it was possible to graduate the types of functional dysphonia by means of computer-aided phonetogram evaluation with a clinically acceptable error rate. This method proved to be an important supplement to the conventional diagnostics of functional dysphonia. PMID:8353627

  7. Quantitative vertebral compression fracture evaluation using a height compass

    NASA Astrophysics Data System (ADS)

    Yao, Jianhua; Burns, Joseph E.; Wiese, Tatjana; Summers, Ronald M.

    2012-03-01

    Vertebral compression fractures can be caused by even minor trauma in patients with pathological conditions such as osteoporosis, varying greatly in vertebral body location and compression geometry. The location and morphology of the compression injury can guide decision making for treatment modality (vertebroplasty versus surgical fixation), and can be important for pre-surgical planning. We propose a height compass to evaluate the axial plane spatial distribution of compression injury (anterior, posterior, lateral, and central), and distinguish it from physiologic height variations of normal vertebrae. The method includes four steps: spine segmentation and partition, endplate detection, height compass computation and compression fracture evaluation. A height compass is computed for each vertebra, where the vertebral body is partitioned in the axial plane into 17 cells oriented about concentric rings. In the compass structure, a crown-like geometry is produced by three concentric rings which are divided into 8 equal length arcs by rays which are subtended by 8 common central angles. The radius of each ring increases multiplicatively, with resultant structure of a central node and two concentric surrounding bands of cells, each divided into octants. The height value for each octant is calculated and plotted against octants in neighboring vertebrae. The height compass shows intuitive display of the height distribution and can be used to easily identify the fracture regions. Our technique was evaluated on 8 thoraco-abdominal CT scans of patients with reported compression fractures and showed statistically significant differences in height value at the sites of the fractures.

  8. Usefulness of contrast perfusion echocardiography for differential diagnosis of cardiac masses.

    PubMed

    Tang, Qiao-Ying; Guo, Ling-Dan; Wang, Wen-Xuan; Zhou, Wei; Liu, Ya-Ni; Liu, Hong-Yun; Li, Li; Deng, You-Bin

    2015-09-01

    The aim of this study was to assess the usefulness of contrast perfusion echocardiography in the differential diagnosis of different types of cardiac masses. Conventional echocardiography and contrast perfusion echocardiography were performed in 72 patients with cardiac masses. The degree of contrast enhancement of the mass and an adjacent section of myocardium after injection of contrast agent was determined by visual inspection and quantitative time-signal intensity curve analysis. The difference in maximal steady-state pixel intensity between the mass and the adjacent myocardium (ΔAmass-myocardium) was calculated. All masses had a pathologic diagnosis or resolved after anticoagulation. All 16 cardiac masses without enhancement on visual inspection were confirmed to be cardiac thrombi. Twenty-four masses with incomplete enhancement on visual inspection were recognized as benign tumors with validation methods. Of the 32 cardiac masses with complete enhancement, 30 were confirmed as malignant tumors and two as benign tumors with validation methods. The sensitivity and specificity of ΔAmass-myocardium in differentiating thrombi from tumors were 93% and 100%, respectively, and 100% and 97% in differentiating malignant tumors from benign tumors and thrombi. Both visual and quantitative assessment of degree of enhancement of cardiac masses in relation to the adjacent myocardium during contrast perfusion echocardiography had high diagnostic accuracy for differentiation of a thrombus from a tumor or a benign tumor from a malignant tumor. PMID:26087885

  9. A quantitative evaluation of two methods for preserving hair samples

    USGS Publications Warehouse

    Roon, David A.; Waits, L.P.; Kendall, K.C.

    2003-01-01

    Hair samples are an increasingly important DNA source for wildlife studies, yet optimal storage methods and DNA degradation rates have not been rigorously evaluated. We tested amplification success rates over a one-year storage period for DNA extracted from brown bear (Ursus arctos) hair samples preserved using silica desiccation and -20C freezing. For three nuclear DNA microsatellites, success rates decreased significantly after a six-month time point, regardless of storage method. For a 1000 bp mitochondrial fragment, a similar decrease occurred after a two-week time point. Minimizing delays between collection and DNA extraction will maximize success rates for hair-based noninvasive genetic sampling projects.

  10. Echocardiography for the Assessment of Congenital Heart Defects in Calves.

    PubMed

    Mitchell, Katharyn Jean; Schwarzwald, Colin Claudio

    2016-03-01

    Congenital heart disease should be considered when evaluating calves with chronic respiratory signs, failure to thrive, poor growth, or if a murmur is heard on physical examination. Echocardiography is currently the gold standard for diagnosing congenital heart defects. A wide variety of defects, either alone or in combination with a ventricular septal defect, are possible. A standardized approach using sequential segmental analysis is required to fully appreciate the nature and severity of more complex malformations. The prognosis for survival varies from guarded to poor and depends on the hemodynamic relevance of the defects and the degree of cardiac compensation. PMID:26922111

  11. Object-oriented fault tree evaluation program for quantitative analyses

    NASA Technical Reports Server (NTRS)

    Patterson-Hine, F. A.; Koen, B. V.

    1988-01-01

    Object-oriented programming can be combined with fault free techniques to give a significantly improved environment for evaluating the safety and reliability of large complex systems for space missions. Deep knowledge about system components and interactions, available from reliability studies and other sources, can be described using objects that make up a knowledge base. This knowledge base can be interrogated throughout the design process, during system testing, and during operation, and can be easily modified to reflect design changes in order to maintain a consistent information source. An object-oriented environment for reliability assessment has been developed on a Texas Instrument (TI) Explorer LISP workstation. The program, which directly evaluates system fault trees, utilizes the object-oriented extension to LISP called Flavors that is available on the Explorer. The object representation of a fault tree facilitates the storage and retrieval of information associated with each event in the tree, including tree structural information and intermediate results obtained during the tree reduction process. Reliability data associated with each basic event are stored in the fault tree objects. The object-oriented environment on the Explorer also includes a graphical tree editor which was modified to display and edit the fault trees.

  12. Quantitative Evaluation of the Reticuloendothelial System Function with Dynamic MRI

    PubMed Central

    Liu, Ting; Choi, Hoon; Zhou, Rong; Chen, I-Wei

    2014-01-01

    Purpose To evaluate the reticuloendothelial system (RES) function by real-time imaging blood clearance as well as hepatic uptake of superparamagnetic iron oxide nanoparticle (SPIO) using dynamic magnetic resonance imaging (MRI) with two-compartment pharmacokinetic modeling. Materials and Methods Kinetics of blood clearance and hepatic accumulation were recorded in young adult male 01b74 athymic nude mice by dynamic T2* weighted MRI after the injection of different doses of SPIO nanoparticles (0.5, 3 or 10 mg Fe/kg). Association parameter, Kin, dissociation parameter, Kout, and elimination constant, Ke, derived from dynamic data with two-compartment model, were used to describe active binding to Kupffer cells and extrahepatic clearance. The clodrosome and liposome were utilized to deplete macrophages and block the RES function to evaluate the capability of the kinetic parameters for investigation of macrophage function and density. Results The two-compartment model provided a good description for all data and showed a low sum squared residual for all mice (0.27±0.03). A lower Kin, a lower Kout and a lower Ke were found after clodrosome treatment, whereas a lower Kin, a higher Kout and a lower Ke were observed after liposome treatment in comparison to saline treatment (P<0.005). Conclusion Dynamic SPIO-enhanced MR imaging with two-compartment modeling can provide information on RES function on both a cell number and receptor function level. PMID:25090653

  13. Computerized quantitative evaluation of mammographic accreditation phantom images

    SciTech Connect

    Lee, Yongbum; Tsai, Du-Yih; Shinohara, Norimitsu

    2010-12-15

    Purpose: The objective was to develop and investigate an automated scoring scheme of the American College of Radiology (ACR) mammographic accreditation phantom (RMI 156, Middleton, WI) images. Methods: The developed method consisted of background subtraction, determination of region of interest, classification of fiber and mass objects by Mahalanobis distance, detection of specks by template matching, and rule-based scoring. Fifty-one phantom images were collected from 51 facilities for this study (one facility provided one image). A medical physicist and two radiologic technologists also scored the images. The human and computerized scores were compared. Results: In terms of meeting the ACR's criteria, the accuracies of the developed method for computerized evaluation of fiber, mass, and speck were 90%, 80%, and 98%, respectively. Contingency table analysis revealed significant association between observer and computer scores for microcalcifications (p<5%) but not for masses and fibers. Conclusions: The developed method may achieve a stable assessment of visibility for test objects in mammographic accreditation phantom image in whether the phantom image meets the ACR's criteria in the evaluation test, although there is room left for improvement in the approach for fiber and mass objects.

  14. Transesophageal echocardiography assessment of severe ostial left main coronary stenosis

    NASA Technical Reports Server (NTRS)

    Firstenberg, M. S.; Greenberg, N. L.; Lin, S. S.; Garcia, M. J.; Alexander, L. A.; Thomas, J. D.

    2000-01-01

    Doppler echocardiography is commonly used in the assessment of stenotic valvular orifices. We describe the application of transesophageal echocardiography for the detection of a critical ostial left main coronary stenosis. Because preoperative coronary angiography often is not routinely performed in young patients undergoing valve surgery, application of Doppler echocardiography can potentially prevent catastrophic complications, particularly in atypical cases.

  15. Recent advances in echocardiography for valvular heart disease

    PubMed Central

    Hahn, Rebecca

    2015-01-01

    Echocardiography is the imaging modality of choice for the assessment of patients with valvular heart disease. Echocardiographic advancements may have particular impact on the assessment and management of patients with valvular heart disease. This review will summarize the current literature on advancements, such as three-dimensional echocardiography, strain imaging, intracardiac echocardiography, and fusion imaging, in this patient population. PMID:26594349

  16. Improved field experimental designs and quantitative evaluation of aquatic ecosystems

    SciTech Connect

    McKenzie, D.H.; Thomas, J.M.

    1984-05-01

    The paired-station concept and a log transformed analysis of variance were used as methods to evaluate zooplankton density data collected during five years at an electrical generation station on Lake Michigan. To discuss the example and the field design necessary for a valid statistical analysis, considerable background is provided on the questions of selecting (1) sampling station pairs, (2) experimentwise error rates for multi-species analyses, (3) levels of Type I and II error rates, (4) procedures for conducting the field monitoring program, and (5) a discussion of the consequences of violating statistical assumptions. Details for estimating sample sizes necessary to detect changes of a specified magnitude are included. Both statistical and biological problems with monitoring programs (as now conducted) are addressed; serial correlation of successive observations in the time series obtained was identified as one principal statistical difficulty. The procedure reduces this problem to a level where statistical methods can be used confidently. 27 references, 4 figures, 2 tables.

  17. Quantitative Evaluation of Strain Near Tooth Fillet by Image Processing

    NASA Astrophysics Data System (ADS)

    Masuyama, Tomoya; Yoshiizumi, Satoshi; Inoue, Katsumi

    The accurate measurement of strain and stress in a tooth is important for the reliable evaluation of the strength or life of gears. In this research, a strain measurement method which is based on image processing is applied to the analysis of strain near the tooth fillet. The loaded tooth is photographed using a CCD camera and stored as a digital image. The displacement of the point in the tooth flank is tracked by the cross-correlation method, and then, the strain is calculated. The interrogation window size of the correlation method and the overlap amount affect the accuracy and resolution. In the case of measurements at structures with complicated profiles such as fillets, the interrogation window maintains a large size and the overlap amount should be large. The surface condition also affects the accuracy. The white painted surface with a small black particle is suitable for measurement.

  18. Quantitative Ultrasonic Evaluation of Mechanical Properties of Engineering Materials

    NASA Technical Reports Server (NTRS)

    Vary, A.

    1978-01-01

    Progress in the application of ultrasonic techniques to nondestructive measurement of mechanical strength of engineering materials is reviewed. A dormant concept in nondestructive evaluation (NDE) is invoked. The availability of ultrasonic methods that can be applied to actual parts to assess their potential susceptibility to failure under design conditions is discussed. It was shown that ultrasonic methods yield measurements of elastic moduli, microstructure, hardness, fracture toughness, tensile strength, yield strength, and shear strength for a wide range of materials (including many types of metals, ceramics, and fiber composites). It was also indicated that although most of these methods were shown feasible in laboratory studies, more work is needed before they can be used on actual parts in processing, assembly, inspection, and maintenance lines.

  19. Towards the quantitative evaluation of visual attention models.

    PubMed

    Bylinskii, Z; DeGennaro, E M; Rajalingham, R; Ruda, H; Zhang, J; Tsotsos, J K

    2015-11-01

    Scores of visual attention models have been developed over the past several decades of research. Differences in implementation, assumptions, and evaluations have made comparison of these models very difficult. Taxonomies have been constructed in an attempt at the organization and classification of models, but are not sufficient at quantifying which classes of models are most capable of explaining available data. At the same time, a multitude of physiological and behavioral findings have been published, measuring various aspects of human and non-human primate visual attention. All of these elements highlight the need to integrate the computational models with the data by (1) operationalizing the definitions of visual attention tasks and (2) designing benchmark datasets to measure success on specific tasks, under these definitions. In this paper, we provide some examples of operationalizing and benchmarking different visual attention tasks, along with the relevant design considerations. PMID:25951756

  20. Advanced quantitative magnetic nondestructive evaluation methods - Theory and experiment

    NASA Technical Reports Server (NTRS)

    Barton, J. R.; Kusenberger, F. N.; Beissner, R. E.; Matzkanin, G. A.

    1979-01-01

    The paper reviews the scale of fatigue crack phenomena in relation to the size detection capabilities of nondestructive evaluation methods. An assessment of several features of fatigue in relation to the inspection of ball and roller bearings suggested the use of magnetic methods; magnetic domain phenomena including the interaction of domains and inclusions, and the influence of stress and magnetic field on domains are discussed. Experimental results indicate that simplified calculations can be used to predict many features of these results; the data predicted by analytic models which use finite element computer analysis predictions do not agree with respect to certain features. Experimental analyses obtained on rod-type fatigue specimens which show experimental magnetic measurements in relation to the crack opening displacement and volume and crack depth should provide methods for improved crack characterization in relation to fracture mechanics and life prediction.

  1. Student tutors for hands-on training in focused emergency echocardiography – a randomized controlled trial

    PubMed Central

    2012-01-01

    Background Focused emergency echocardiography performed by non-cardiologists has been shown to be feasible and effective in emergency situations. During resuscitation a short focused emergency echocardiography has been shown to narrow down potential differential diagnoses and to improve patient survival. Quite a large proportion of physicians are eligible to learn focused emergency echocardiography. Training in focused emergency echocardiography usually comprises a lecture, hands-on trainings in very small groups, and a practice phase. There is a shortage of experienced echocardiographers who can supervise the second step, the hands-on training. We thus investigated whether student tutors can perform the hands-on training for focused emergency echocardiography. Methods A total of 30 volunteer 4th and 5th year students were randomly assigned to a twelve-hour basic echocardiography course comprising a lecture followed by a hands-on training in small groups taught either by an expert cardiographer (EC) or by a student tutor (ST). Using a pre-post-design, the students were evaluated by an OSCE. The students had to generate two still frames with the apical five-chamber view and the parasternal long axis in five minutes and to correctly mark twelve anatomical cardiac structures. Two blinded expert cardiographers rated the students’ performance using a standardized checklist. Students could achieve a maximum of 25 points. Results Both groups showed significant improvement after the training (p < .0001). In the group taught by EC the average increased from 2.3±3.4 to 17.1±3.0 points, and in the group taught by ST from 2.7±3.0 to 13.9±2.7 points. The difference in improvement between the groups was also significant (p = .03). Conclusions Hands-on training by student tutors led to a significant gain in echocardiography skills, although inferior to teaching by an expert cardiographer. PMID:23107588

  2. Physical Stress Echocardiography: Prediction of Mortality and Cardiac Events in Patients with Exercise Test showing Ischemia

    PubMed Central

    de Araujo, Ana Carla Pereira; Santos, Bruno F. de Oliveira; Calasans, Flavia Ricci; Pinto, Ibraim M. Francisco; de Oliveira, Daniel Pio; Melo, Luiza Dantas; Andrade, Stephanie Macedo; Tavares, Irlaneide da Silva; Sousa, Antonio Carlos Sobral; Oliveira, Joselina Luzia Menezes

    2014-01-01

    Background Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective To evaluate the effectiveness of physical stress echocardiography in the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia. Methods This is a retrospective cohort in which 866 consecutive patients with exercise test positive for myocardial ischemia, and who underwent physical stress echocardiography were studied. Patients were divided into two groups: with physical stress echocardiography negative (G1) or positive (G2) for myocardial ischemia. The endpoints analyzed were all‑cause mortality and major cardiac events, defined as cardiac death and non-fatal acute myocardial infarction. Results G2 comprised 205 patients (23.7%). During the mean 85.6 ± 15.0-month follow-up, there were 26 deaths, of which six were cardiac deaths, and 25 non-fatal myocardial infarction cases. The independent predictors of mortality were: age, diabetes mellitus, and positive physical stress echocardiography (hazard ratio: 2.69; 95% confidence interval: 1.20 – 6.01; p = 0.016). The independent predictors of major cardiac events were: age, previous coronary artery disease, positive physical stress echocardiography (hazard ratio: 2.75; 95% confidence interval: 1.15 – 6.53; p = 0.022) and absence of a 10% increase in ejection fraction. All-cause mortality and the incidence of major cardiac events were significantly higher in G2 (p < 0. 001 and p = 0.001, respectively). Conclusion Physical stress echocardiography provides additional prognostic information in patients with exercise test positive for myocardial ischemia. PMID:25352460

  3. A Quantitative Evaluation of Medication Histories and Reconciliation by Discipline

    PubMed Central

    Stewart, Michael R.; Fogg, Sarah M.; Schminke, Brandon C.; Zackula, Rosalee E.; Nester, Tina M.; Eidem, Leslie A.; Rosendale, James C.; Ragan, Robert H.; Bond, Jack A.; Goertzen, Kreg W.

    2014-01-01

    Abstract Background/Objective: Medication reconciliation at transitions of care decreases medication errors, hospitalizations, and adverse drug events. We compared inpatient medication histories and reconciliation across disciplines and evaluated the nature of discrepancies. Methods: We conducted a prospective cohort study of patients admitted from the emergency department at our 760-bed hospital. Eligible patients had their medication histories conducted and reconciled in order by the admitting nurse (RN), certified pharmacy technician (CPhT), and pharmacist (RPh). Discharge medication reconciliation was not altered. Admission and discharge discrepancies were categorized by discipline, error type, and drug class and were assigned a criticality index score. A discrepancy rating system systematically measured discrepancies. Results: Of 175 consented patients, 153 were evaluated. Total admission and discharge discrepancies were 1,461 and 369, respectively. The average number of medications per participant at admission was 8.59 (1,314) with 9.41 (1,374) at discharge. Most discrepancies were committed by RNs: 53.2% (777) at admission and 56.1% (207) at discharge. The majority were omitted or incorrect. RNs had significantly higher admission discrepancy rates per medication (0.59) compared with CPhTs (0.36) and RPhs (0.16) (P < .001). RPhs corrected significantly more discrepancies per participant than RNs (6.39 vs 0.48; P < .001); average criticality index reduction was 79.0%. Estimated prevented adverse drug events (pADEs) cost savings were $589,744. Conclusions: RPhs committed the fewest discrepancies compared with RNs and CPhTs, resulting in more accurate medication histories and reconciliation. RPh involvement also prevented the greatest number of medication errors, contributing to considerable pADE-related cost savings. PMID:25477614

  4. Applying Quantitative Approaches to the Formative Evaluation of Antismoking Campaign Messages

    PubMed Central

    Parvanta, Sarah; Gibson, Laura; Forquer, Heather; Shapiro-Luft, Dina; Dean, Lorraine; Freres, Derek; Lerman, Caryn; Mallya, Giridhar; Moldovan-Johnson, Mihaela; Tan, Andy; Cappella, Joseph; Hornik, Robert

    2014-01-01

    This article shares an in-depth summary of a formative evaluation that used quantitative data to inform the development and selection of promotional ads for the antismoking communication component of a social marketing campaign. A foundational survey provided cross-sectional data to identify beliefs about quitting smoking that campaign messages should target, as well as beliefs to avoid. Pretesting draft ads against quantitative indicators of message effectiveness further facilitated the selection and rejection of final campaign ads. Finally, we consider lessons learned from the process of balancing quantitative methods and judgment to make formative decisions about more and less promising persuasive messages for campaigns. PMID:24817829

  5. Quantitative evaluation of proximal contacts in posterior composite restorations. Part I. Methodology.

    PubMed

    Wang, J C; Hong, J M

    1989-07-01

    An in vivo method of quantitative measuring intertooth distance before and after placement of a Class 2 composite resin restoration has been developed. A Kaman Sciences KD-2611 non-contact displacement measuring system with a 1 U unshield sensor, based upon the variable resistance of eddy current, was used for the intraoral measurement. Quantitative evaluation of proximal wear, therefore, can be made preoperatively, postoperatively, and at subsequent recall interval for posterior composite resin restorations. PMID:2810447

  6. Nuclear medicine and imaging research (instrumentation and quantitative methods of evaluation). Progress report, January 15, 1992--January 14, 1993

    SciTech Connect

    Beck, R.N.; Cooper, M.; Chen, C.T.

    1992-07-01

    This document is the annual progress report for project entitled ``Instrumentation and Quantitative Methods of Evaluation.`` Progress is reported in separate sections individually abstracted and indexed for the database. Subject areas reported include theoretical studies of imaging systems and methods, hardware developments, quantitative methods of evaluation, and knowledge transfer: education in quantitative nuclear medicine imaging.

  7. Patent Ductus Arteriosus in Extreme Prematurity: Role of Echocar-diography and Other Imaging Techniques.

    PubMed

    Yap, Norah; Bharucha, Tara

    2016-01-01

    Clinical signs alone are unreliable in the diagnosis of patent ductus arteriosus (PDA) in preterm infants, and therefore echocardiography remains the mainstay of diagnosis of this common condition. Echocardiography also facilitates understanding of the hemodynamic effects of a PDA, and thus aids in management decisions. Several echocardiographic parameters, including duct size, maximum ductal velocity, left atrial: aorta ratio, mitral inflow E:A ratio, and isovolumic relaxation time, have been utilized in the assessment of PDA, but no single measurement can be used in isolation to inform clinical judgement. Therefore, it is important that echocardiographers on the neonatal unit have a comprehensive understanding of available methods and their limitations. Newer echocardiographic techniques, such as 3 Dimensional echocardiography, tissue Doppler imaging and strain imaging, are now providing insights into myocardial function in the adaptation of preterm infants to extra-uterine life, and into the effects of a PDA causing systemic-to-pulmonary artery shunting. Magnetic resonance imaging delivers excellent diagnostic information and accurate hemodynamic evaluation; however this modality is not easily accessible for most preterm infants, in comparison to echocardiography, which is readily available at the cotside in most neonatal units. Further developments in echocardiography may further refine the contribution it makes to individualized clinical decisionmaking in the management of premature infants with PDA. PMID:27197955

  8. Registration of multi-view apical 3D echocardiography images

    NASA Astrophysics Data System (ADS)

    Mulder, H. W.; van Stralen, M.; van der Zwaan, H. B.; Leung, K. Y. E.; Bosch, J. G.; Pluim, J. P. W.

    2011-03-01

    Real-time three-dimensional echocardiography (RT3DE) is a non-invasive method to visualize the heart. Disadvantageously, it suffers from non-uniform image quality and a limited field of view. Image quality can be improved by fusion of multiple echocardiography images. Successful registration of the images is essential for prosperous fusion. Therefore, this study examines the performance of different methods for intrasubject registration of multi-view apical RT3DE images. A total of 14 data sets was annotated by two observers who indicated the position of the apex and four points on the mitral valve ring. These annotations were used to evaluate registration. Multi-view end-diastolic (ED) as well as end-systolic (ES) images were rigidly registered in a multi-resolution strategy. The performance of single-frame and multi-frame registration was examined. Multi-frame registration optimizes the metric for several time frames simultaneously. Furthermore, the suitability of mutual information (MI) as similarity measure was compared to normalized cross-correlation (NCC). For initialization of the registration, a transformation that describes the probe movement was obtained by manually registering five representative data sets. It was found that multi-frame registration can improve registration results with respect to single-frame registration. Additionally, NCC outperformed MI as similarity measure. If NCC was optimized in a multi-frame registration strategy including ED and ES time frames, the performance of the automatic method was comparable to that of manual registration. In conclusion, automatic registration of RT3DE images performs as good as manual registration. As registration precedes image fusion, this method can contribute to improved quality of echocardiography images.

  9. Evaluation of four genes in rice for their suitability as endogenous reference standards in quantitative PCR.

    PubMed

    Wang, Chong; Jiang, Lingxi; Rao, Jun; Liu, Yinan; Yang, Litao; Zhang, Dabing

    2010-11-24

    The genetically modified (GM) food/feed quantification depends on the reliable detection systems of endogenous reference genes. Currently, four endogenous reference genes including sucrose phosphate synthase (SPS), GOS9, phospholipase D (PLD), and ppi phosphofructokinase (ppi-PPF) of rice have been used in GM rice detection. To compare the applicability of these four rice reference genes in quantitative PCR systems, we analyzed the target nucleotide sequence variation in 58 conventional rice varieties from various geographic and phylogenic origins, also their quantification performances were evaluated using quantitative real-time PCR and GeNorm analysis via a series of statistical calculation to get a "M value" which is negative correlation with the stability of genes. The sequencing analysis results showed that the reported GOS9 and PLD taqman probe regions had detectable single nucleotide polymorphisms (SNPs) among the tested rice cultivars, while no SNPs were observed for SPS and ppi-PPF amplicons. Also, poor quantitative performance was detectable in these cultivars with SNPs using GOS9 and PLD quantitative PCR systems. Even though the PCR efficiency of ppi-PPF system was slightly lower, the SPS and ppi-PPF quantitative PCR systems were shown to be applicable for rice endogenous reference assay with less variation among the C(t) values, good reproducibility in quantitative assays, and the low M values by the comprehensive quantitative PCR comparison and GeNorm analysis. PMID:20961039

  10. Quantitative phase evaluation of dynamic changes on cell membrane during laser microsurgery.

    PubMed

    Yu, Lingfeng; Mohanty, Samarendra; Liu, Gangjun; Genc, Suzanne; Chen, Zhongping; Berns, Michael W

    2008-01-01

    The ability to inject exogenous material as well as to alter subcellular structures in a minimally invasive manner using a laser microbeam has been useful for cell biologists to study the structure-function relationship in complex biological systems. We describe a quantitative phase laser microsurgery system, which takes advantage of the combination of laser microirradiation and short-coherence interference microscopy. Using this method, quantitative phase images and the dynamic changes of phase during the process of laser microsurgery of red blood cells (RBCs) can be evaluated in real time. This system would enable absolute quantitation of localized alteration/damage to transparent phase objects, such as the cell membrane or intracellular structures, being exposed to the laser microbeam. Such quantitation was not possible using conventional phase-contrast microscopy. PMID:19021378

  11. Objective evaluation of reconstruction methods for quantitative SPECT imaging in the absence of ground truth

    PubMed Central

    Jha, Abhinav K.; Song, Na; Caffo, Brian; Frey, Eric C.

    2015-01-01

    Quantitative single-photon emission computed tomography (SPECT) imaging is emerging as an important tool in clinical studies and biomedical research. There is thus a need for optimization and evaluation of systems and algorithms that are being developed for quantitative SPECT imaging. An appropriate objective method to evaluate these systems is by comparing their performance in the end task that is required in quantitative SPECT imaging, such as estimating the mean activity concentration in a volume of interest (VOI) in a patient image. This objective evaluation can be performed if the true value of the estimated parameter is known, i.e. we have a gold standard. However, very rarely is this gold standard known in human studies. Thus, no-gold-standard techniques to optimize and evaluate systems and algorithms in the absence of gold standard are required. In this work, we developed a no-gold-standard technique to objectively evaluate reconstruction methods used in quantitative SPECT when the parameter to be estimated is the mean activity concentration in a VOI. We studied the performance of the technique with realistic simulated image data generated from an object database consisting of five phantom anatomies with all possible combinations of five sets of organ uptakes, where each anatomy consisted of eight different organ VOIs. Results indicate that the method provided accurate ranking of the reconstruction methods. We also demonstrated the application of consistency checks to test the no-gold-standard output. PMID:26430292

  12. Objective evaluation of reconstruction methods for quantitative SPECT imaging in the absence of ground truth

    NASA Astrophysics Data System (ADS)

    Jha, Abhinav K.; Song, Na; Caffo, Brian; Frey, Eric C.

    2015-03-01

    Quantitative single-photon emission computed tomography (SPECT) imaging is emerging as an important tool in clinical studies and biomedical research. There is thus a need for optimization and evaluation of systems and algorithms that are being developed for quantitative SPECT imaging. An appropriate objective method to evaluate these systems is by comparing their performance in the end task that is required in quantitative SPECT imaging, such as estimating the mean activity concentration in a volume of interest (VOI) in a patient image. This objective evaluation can be performed if the true value of the estimated parameter is known, i.e. we have a gold standard. However, very rarely is this gold standard known in human studies. Thus, no-gold-standard techniques to optimize and evaluate systems and algorithms in the absence of gold standard are required. In this work, we developed a no-gold-standard technique to objectively evaluate reconstruction methods used in quantitative SPECT when the parameter to be estimated is the mean activity concentration in a VOI. We studied the performance of the technique with realistic simulated image data generated from an object database consisting of five phantom anatomies with all possible combinations of five sets of organ uptakes, where each anatomy consisted of eight different organ VOIs. Results indicate that the method pro- vided accurate ranking of the reconstruction methods. We also demonstrated the application of consistency checks to test the no-gold-standard output.

  13. Cartilage Repair Surgery: Outcome Evaluation by Using Noninvasive Cartilage Biomarkers Based on Quantitative MRI Techniques?

    PubMed Central

    Jungmann, Pia M.; Baum, Thomas; Bauer, Jan S.; Karampinos, Dimitrios C.; Link, Thomas M.; Li, Xiaojuan; Trattnig, Siegfried; Rummeny, Ernst J.; Woertler, Klaus; Welsch, Goetz H.

    2014-01-01

    Background. New quantitative magnetic resonance imaging (MRI) techniques are increasingly applied as outcome measures after cartilage repair. Objective. To review the current literature on the use of quantitative MRI biomarkers for evaluation of cartilage repair at the knee and ankle. Methods. Using PubMed literature research, studies on biochemical, quantitative MR imaging of cartilage repair were identified and reviewed. Results. Quantitative MR biomarkers detect early degeneration of articular cartilage, mainly represented by an increasing water content, collagen disruption, and proteoglycan loss. Recently, feasibility of biochemical MR imaging of cartilage repair tissue and surrounding cartilage was demonstrated. Ultrastructural properties of the tissue after different repair procedures resulted in differences in imaging characteristics. T2 mapping, T1rho mapping, delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), and diffusion weighted imaging (DWI) are applicable on most clinical 1.5 T and 3 T MR scanners. Currently, a standard of reference is difficult to define and knowledge is limited concerning correlation of clinical and MR findings. The lack of histological correlations complicates the identification of the exact tissue composition. Conclusions. A multimodal approach combining several quantitative MRI techniques in addition to morphological and clinical evaluation might be promising. Further investigations are required to demonstrate the potential for outcome evaluation after cartilage repair. PMID:24877139

  14. Role of echocardiography in patients with stroke.

    PubMed

    Nakanishi, Koki; Homma, Shunichi

    2016-08-01

    Investigation of potential embolic source is an important diagnostic step in treating patients with ischemic stroke and transient ischemic attack. Cardiogenic embolism has been estimated to be the causative factor in 15-30% of all cases of ischemic stroke. Cardioembolic strokes are generally severe and recurrence and mortality rate high. Various cardiac disorders including atrial fibrillation, ventricular thrombus, valvular heart disease, cardiac tumors, and structural heart defects can cause cardioembolic stroke. Although the aortic arch is not a cardiac structure, it is usually considered under source of cardiac embolism (cardioaortic source) and is reviewed in this article. Echocardiography (both transthoracic and transesophageal) is a widely used and versatile technique that can provide comprehensive information of thromboembolic risk in patients with stroke. This article reviews potential cardiac sources of stroke and discusses the role of echocardiography in clinical practice. PMID:27256218

  15. Echocardiography in a Patient on Mechanical Ventilation.

    PubMed

    Sachdeva, Ankush

    2015-07-01

    Cardiopulmonary interactions or effects of spontaneous and mechanical ventilation (MV) were first documented in the year 1733. Stephen Hales showed that the blood pressure of healthy individual fell during spontaneous inspiration and he later went on to discover the ventilator. A year later Kussmaul described pulsus paradoxus (inspiratory absence of radial pulse) in patients with tubercular pericarditis. Echocardiography can help to diagnose a wide variety of cardiovascular diseases and can guide therapeutic decisions in patients on mechanical ventilation. PMID:26731826

  16. [Hand-held echocardiography in clinical practice].

    PubMed

    Mondillo, Sergio; Galderisi, Maurizio

    2005-05-01

    In the last years the industry has created echocardiographic portable machines of reduced size, available for a growing number of operators. After the first experiences of the '70s, hand-held echocardiography (HHE) is earned interesting commercial positions. The transportability of these machines allows to perform examinations outside the echo-lab and provides diagnostic information in heterogeneous locations such as intensive care unit, emergency room and outpatient structures, at the bedside and even in ambulance. HHE can be useful for detection of several pathologies including aortic aneurysms and left ventricular hypertrophy, regional wall motion abnormalities, pericardial and pleural effusion. To date, four main kinds of HHE can be distinguished: a first, high-cost variety, including miniaturized machines, equipped with instrumentations of standard echocardiography and even new softwares for tissue Doppler and myocardial contrast echocardiography; a second kind of machines of high level but not miniaturized; a third (intermediate level and low cost), and a fourth one (basic level and very low cost), including "cardioscopes" corresponding to the ultrasound stethoscope, able to complete efficaciously the clinical examination. The introduction of HHE opens controversy about its diagnostic accuracy, the opportunity to establish the clinical scenario where it should be utilized and the identification of the potential users and the needed competence level. Preliminary experiences show the possibility of improving and anticipating the diagnosis of several cardiac diseases but also the need to plan specific ultrasound training to avoid inappropriate use of HHE. PMID:15934422

  17. Mechanical Model Analysis for Quantitative Evaluation of Liver Fibrosis Based on Ultrasound Tissue Elasticity Imaging

    NASA Astrophysics Data System (ADS)

    Shiina, Tsuyoshi; Maki, Tomonori; Yamakawa, Makoto; Mitake, Tsuyoshi; Kudo, Masatoshi; Fujimoto, Kenji

    2012-07-01

    Precise evaluation of the stage of chronic hepatitis C with respect to fibrosis has become an important issue to prevent the occurrence of cirrhosis and to initiate appropriate therapeutic intervention such as viral eradication using interferon. Ultrasound tissue elasticity imaging, i.e., elastography can visualize tissue hardness/softness, and its clinical usefulness has been studied to detect and evaluate tumors. We have recently reported that the texture of elasticity image changes as fibrosis progresses. To evaluate fibrosis progression quantitatively on the basis of ultrasound tissue elasticity imaging, we introduced a mechanical model of fibrosis progression and simulated the process by which hepatic fibrosis affects elasticity images and compared the results with those clinical data analysis. As a result, it was confirmed that even in diffuse diseases like chronic hepatitis, the patterns of elasticity images are related to fibrous structural changes caused by hepatic disease and can be used to derive features for quantitative evaluation of fibrosis stage.

  18. Interdisciplinary program for quantitative nondestructive evaluation. Semi-annual report, October 1, 1982-February 28, 1983

    SciTech Connect

    Not Available

    1983-01-01

    Separate abstracts were prepared for the papers published in the following areas: (1) Application of Ultrasonic Quantitative Nondestructive Evaluation to Radio Frequency System Window Problems, (a) Improvements in Probability of Detection and (b) Sizing of Internal Flaws in Bore and Web Geometries; (2) Electromagnetic Detection and Sizing; (3) New Technical Opportunities; and (4) New Flaw Detection Techniques.

  19. Quantitative Evaluation of a First Year Seminar Program: Relationships to Persistence and Academic Success

    ERIC Educational Resources Information Center

    Jenkins-Guarnieri, Michael A.; Horne, Melissa M.; Wallis, Aaron L.; Rings, Jeffrey A.; Vaughan, Angela L.

    2015-01-01

    In the present study, we conducted a quantitative evaluation of a novel First Year Seminar (FYS) program with a coordinated curriculum implemented at a public, four-year university to assess its potential role in undergraduate student persistence decisions and academic success. Participants were 2,188 first-year students, 342 of whom completed the…

  20. Raman spectral imaging for quantitative contaminant evaluation in skim milk powder

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study uses a point-scan Raman spectral imaging system for quantitative detection of melamine in milk powder. A sample depth of 2 mm and corresponding laser intensity of 200 mW were selected after evaluating the penetration of a 785 nm laser through milk powder. Horizontal and vertical spatial r...

  1. Evaluation of reference genes for quantitative RT-PCR in Lolium temulentum under abiotic stress

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Lolium temulentum is a valuable model grass species for the study of stress in forage and turf grasses. Gene expression analysis by quantitative real time RT-PCR relies on the use of proper internal standards. The aim of this study was to identify and evaluate reference genes for use in real-time q...

  2. Evaluating the Effectiveness of Remedial Reading Courses at Community Colleges: A Quantitative Study

    ERIC Educational Resources Information Center

    Lavonier, Nicole

    2014-01-01

    The present study evaluated the effectiveness of two instructional approaches for remedial reading courses at a community college. The instructional approaches were strategic reading and traditional, textbook-based instruction. The two research questions that guided the quantitative, quasi-experimental study were: (a) what is the effect of…

  3. Are Teacher Course Evaluations Biased against Faculty That Teach Quantitative Methods Courses?

    ERIC Educational Resources Information Center

    Royal, Kenneth D.; Stockdale, Myrah R.

    2015-01-01

    The present study investigated graduate students' responses to teacher/course evaluations (TCE) to determine if students' responses were inherently biased against faculty who teach quantitative methods courses. Item response theory (IRT) and Differential Item Functioning (DIF) techniques were utilized for data analysis. Results indicate students…

  4. Toward Web-Site Quantitative Evaluation: Defining Quality Characteristics and Attributes.

    ERIC Educational Resources Information Center

    Olsina, L; Rossi, G.

    This paper identifies World Wide Web site characteristics and attributes and groups them in a hierarchy. The primary goal is to classify the elements that might be part of a quantitative evaluation and comparison process. In order to effectively select quality characteristics, different users' needs and behaviors are considered. Following an…

  5. An Elephant in the Room: Bias in Evaluating a Required Quantitative Methods Course

    ERIC Educational Resources Information Center

    Fletcher, Joseph F.; Painter-Main, Michael A.

    2014-01-01

    Undergraduate Political Science programs often require students to take a quantitative research methods course. Such courses are typically among the most poorly rated. This can be due, in part, to the way in which courses are evaluated. Students are generally asked to provide an overall rating, which, in turn, is widely used by students, faculty,…

  6. Poem Generator: A Comparative Quantitative Evaluation of a Microworlds-Based Learning Approach for Teaching English

    ERIC Educational Resources Information Center

    Jenkins, Craig

    2015-01-01

    This paper is a comparative quantitative evaluation of an approach to teaching poetry in the subject domain of English that employs a "guided discovery" pedagogy using computer-based microworlds. It uses a quasi-experimental design in order to measure performance gains in computational thinking and poetic thinking following a…

  7. 6DoF catheter detection, application to intracardiac echocardiography.

    PubMed

    Ralovich, Kristóf; John, Matthias; Camus, Estelle; Navab, Nassir; Heimann, Tobias

    2014-01-01

    Hybrid imaging systems, consisting of fluoroscopy and echocardiography, are increasingly selected for intra-operative support of minimally invasive cardiac interventions. Intracardiac echocardiograpy (ICE) is an emerging modality with the promise of removing sedation or general anesthesia associated with transesophageal echocardiography (TEE). We introduce a novel 6 degrees of freedom (DoF) pose estimation approach for catheters (equipped with radiopaque ball markers) in single X-Ray fluoroscopy projection and investigate the method's application to a prototype ICE catheter. Machine learning based catheter detection is implemented in a Bayesian hypothesis fusion framework, followed by refinement of ball marker locations through template matching. Marker correspondence and 3D pose estimation are solved through iterative optimization. The method registers the ICE volume to the C-arm coordinate system. Experiments are performed on synthetic and porcine in-vivo data. Target registration error (TRE), defined in the echo cone, is the basis of our preliminary evaluation. The method reached 8.06 ± 7.2 mm TRE on 703 cases. Potential uses of our hybrid system include structural heart disease interventions and electrophysiologycal mapping or catheter ablation procedures. PMID:25485433

  8. Genetic toxicology at the crossroads-from qualitative hazard evaluation to quantitative risk assessment.

    PubMed

    White, Paul A; Johnson, George E

    2016-05-01

    Applied genetic toxicology is undergoing a transition from qualitative hazard identification to quantitative dose-response analysis and risk assessment. To facilitate this change, the Health and Environmental Sciences Institute (HESI) Genetic Toxicology Technical Committee (GTTC) sponsored a workshop held in Lancaster, UK on July 10-11, 2014. The event included invited speakers from several institutions and the contents was divided into three themes-1: Point-of-departure Metrics for Quantitative Dose-Response Analysis in Genetic Toxicology; 2: Measurement and Estimation of Exposures for Better Extrapolation to Humans and 3: The Use of Quantitative Approaches in Genetic Toxicology for human health risk assessment (HHRA). A host of pertinent issues were discussed relating to the use of in vitro and in vivo dose-response data, the development of methods for in vitro to in vivo extrapolation and approaches to use in vivo dose-response data to determine human exposure limits for regulatory evaluations and decision-making. This Special Issue, which was inspired by the workshop, contains a series of papers that collectively address topics related to the aforementioned themes. The Issue includes contributions that collectively evaluate, describe and discuss in silico, in vitro, in vivo and statistical approaches that are facilitating the shift from qualitative hazard evaluation to quantitative risk assessment. The use and application of the benchmark dose approach was a central theme in many of the workshop presentations and discussions, and the Special Issue includes several contributions that outline novel applications for the analysis and interpretation of genetic toxicity data. Although the contents of the Special Issue constitutes an important step towards the adoption of quantitative methods for regulatory assessment of genetic toxicity, formal acceptance of quantitative methods for HHRA and regulatory decision-making will require consensus regarding the

  9. Utility of transesophageal echocardiography in infective endocarditis. A review.

    PubMed Central

    Jessurun, C; Mesa, A; Wilansky, S

    1996-01-01

    Despite recent diagnostic and therapeutic advances, infective endocarditis continues to be a very serious illness, with high patient morbidity and mortality rates. The diagnosis of infective endocarditis has been based primarily on clinical signs and positive blood cultures. Echocardiography is currently recognized as the technique of choice for the detection of valvular vegetations, which are the hallmark of endocarditis. We briefly review the use of echocardiography in the diagnosis of suspected infective endocarditis, with emphasis on transesophageal echocardiography. High-resolution imaging of the cardiac valves with transesophageal echocardiography has proved to be invaluable in the management of infective endocarditis. Images PMID:8792540

  10. 77 FR 41985 - Use of Influenza Disease Models To Quantitatively Evaluate the Benefits and Risks of Vaccines: A...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-17

    ... HUMAN SERVICES Food and Drug Administration Use of Influenza Disease Models To Quantitatively Evaluate... public workshop entitled: ``Use of Influenza Disease Models to Quantitatively Evaluate the Benefits and... hypothetical influenza vaccine, and to seek from a range of experts, feedback on the current version of...

  11. Measurement of Thrombus Flux Using Transesophageal Echocardiography

    NASA Astrophysics Data System (ADS)

    Yamaguchi, Tadashi; Hirai, Kazuki; Aoki, Masami; Miyagi, Jin; Suzuki, Masahiko; Moriya, Hideshige; Hachiya, Hiroyuki

    2006-05-01

    Deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE) are serious problem of total knee replacement (TKR). These diseases may be caused by a thrombus formed during the TKR operation. Therefore, understanding the flow volume of thrombus is important for curing and preventing PTE. In this paper, we tried to understanding the situation of the flow of thrombus by using transesophageal echocardiography movies. We applied the signal processing technique the FSET to extract the anomalous information from ultrasonic echo image. As a result of processing, the time change of the flow volume of thrombus was confirmed.

  12. Contrast stress echocardiography in hypertensive heart disease

    PubMed Central

    2011-01-01

    Hypertension is associated with atherosclerosis and cardiac and vascular structural and functional changes. Myocardial ischemia may arise in hypertension independent of coronary artery disease through an interaction between several pathophysiological mechanisms, including left ventricular hypertrophy, increased arterial stiffness and reduced coronary flow reserve associated with microvascular disease and endothelial dysfunction. The present case report demonstrates how contrast stress echocardiography can be used to diagnose myocardial ischemia in a hypertensive patient with angina pectoris but without significant obstructive coronary artery disease. The myocardial ischemia was due to severe resistant hypertension complicated with concentric left ventricular hypertrophy and increased arterial stiffness. PMID:22093163

  13. Predicting and measuring fluid responsiveness with echocardiography

    PubMed Central

    Mandeville, Justin

    2016-01-01

    Echocardiography is ideally suited to guide fluid resuscitation in critically ill patients. It can be used to assess fluid responsiveness by looking at the left ventricle, aortic outflow, inferior vena cava and right ventricle. Static measurements and dynamic variables based on heart–lung interactions all combine to predict and measure fluid responsiveness and assess response to intravenous fluid resuscitation. Thorough knowledge of these variables, the physiology behind them and the pitfalls in their use allows the echocardiographer to confidently assess these patients and in combination with clinical judgement manage them appropriately. PMID:27249550

  14. Predicting and measuring fluid responsiveness with echocardiography.

    PubMed

    Miller, Ashley; Mandeville, Justin

    2016-06-01

    Echocardiography is ideally suited to guide fluid resuscitation in critically ill patients. It can be used to assess fluid responsiveness by looking at the left ventricle, aortic outflow, inferior vena cava and right ventricle. Static measurements and dynamic variables based on heart-lung interactions all combine to predict and measure fluid responsiveness and assess response to intravenous fluid resuscitation. Thorough knowledge of these variables, the physiology behind them and the pitfalls in their use allows the echocardiographer to confidently assess these patients and in combination with clinical judgement manage them appropriately. PMID:27249550

  15. Evaluation of Quantitative Performance of Sequential Immobilized Metal Affinity Chromatographic Enrichment for Phosphopeptides

    PubMed Central

    Sun, Zeyu; Hamilton, Karyn L.; Reardon, Kenneth F.

    2014-01-01

    We evaluated a sequential elution protocol from immobilized metal affinity chromatography (SIMAC) employing gallium-based immobilized metal affinity chromatography (IMAC) in conjunction with titanium-dioxide-based metal oxide affinity chromatography (MOAC). The quantitative performance of this SIMAC enrichment approach, assessed in terms of repeatability, dynamic range, and linearity, was evaluated using a mixture composed of tryptic peptides from caseins, bovine serum albumin, and phosphopeptide standards. While our data demonstrate the overall consistent performance of the SIMAC approach under various loading conditions, the results also revealed that the method had limited repeatability and linearity for most phosphopeptides tested, and different phosphopeptides were found to have different linear ranges. These data suggest that, unless additional strategies are used, SIMAC should be regarded as a semi-quantitative method when used in large-scale phosphoproteomics studies in complex backgrounds. PMID:24096195

  16. Establishment and evaluation of event-specific quantitative PCR method for genetically modified soybean MON89788.

    PubMed

    Takabatake, Reona; Onishi, Mari; Koiwa, Tomohiro; Futo, Satoshi; Minegishi, Yasutaka; Akiyama, Hiroshi; Teshima, Reiko; Furui, Satoshi; Kitta, Kazumi

    2010-01-01

    A novel real-time PCR-based analytical method was established for the event-specific quantification of a GM soybean event MON89788. The conversion factor (C(f)) which is required to calculate the GMO amount was experimentally determined. The quantitative method was evaluated by a single-laboratory analysis and a blind test in a multi-laboratory trial. The limit of quantitation for the method was estimated to be 0.1% or lower. The trueness and precision were evaluated as the bias and reproducibility of the relative standard deviation (RSD(R)), and the determined bias and RSD(R) values for the method were both less than 20%. These results suggest that the established method would be suitable for practical detection and quantification of MON89788. PMID:21071908

  17. Business Scenario Evaluation Method Using Monte Carlo Simulation on Qualitative and Quantitative Hybrid Model

    NASA Astrophysics Data System (ADS)

    Samejima, Masaki; Akiyoshi, Masanori; Mitsukuni, Koshichiro; Komoda, Norihisa

    We propose a business scenario evaluation method using qualitative and quantitative hybrid model. In order to evaluate business factors with qualitative causal relations, we introduce statistical values based on propagation and combination of effects of business factors by Monte Carlo simulation. In propagating an effect, we divide a range of each factor by landmarks and decide an effect to a destination node based on the divided ranges. In combining effects, we decide an effect of each arc using contribution degree and sum all effects. Through applied results to practical models, it is confirmed that there are no differences between results obtained by quantitative relations and results obtained by the proposed method at the risk rate of 5%.

  18. Evaluation of quantitative accuracy in CZT-based pre-clinical SPECT for various isotopes

    NASA Astrophysics Data System (ADS)

    Park, S.-J.; Yu, A. R.; Kim, Y.-s.; Kang, W.-S.; Jin, S. S.; Kim, J.-S.; Son, T. J.; Kim, H.-J.

    2015-05-01

    In vivo pre-clinical single-photon emission computed tomography (SPECT) is a valuable tool for functional small animal imaging, but several physical factors, such as scatter radiation, limit the quantitative accuracy of conventional scintillation crystal-based SPECT. Semiconductor detectors such as CZT overcome these deficiencies through superior energy resolution. To our knowledge, little scientific information exists regarding the accuracy of quantitative analysis in CZT-based pre-clinical SPECT systems for different isotopes. The aim of this study was to assess the quantitative accuracy of CZT-based pre-clinical SPECT for four isotopes: 201Tl, 99mTc, 123I, and 111In. The quantitative accuracy of the CZT-based Triumph X-SPECT (Gamma-Medica Ideas, Northridge, CA, U.S.A.) was compared with that of a conventional SPECT using GATE simulation. Quantitative errors due to the attenuation and scatter effects were evaluated for all four isotopes with energy windows of 5%, 10%, and 20%. A spherical source containing the isotope was placed at the center of the air-or-water-filled mouse-sized cylinder phantom. The CZT-based pre-clinical SPECT was more accurate than the conventional SPECT. For example, in the conventional SPECT with an energy window of 10%, scatter effects degraded quantitative accuracy by up to 11.52%, 5.10%, 2.88%, and 1.84% for 201Tl, 99mTc, 123I, and 111In, respectively. However, with the CZT-based pre-clinical SPECT, the degradations were only 9.67%, 5.45%, 2.36%, and 1.24% for 201Tl, 99mTc, 123I, and 111In, respectively. As the energy window was increased, the quantitative errors increased in both SPECT systems. Additionally, the isotopes with lower energy of photon emissions had greater quantitative error. Our results demonstrated that the CZT-based pre-clinical SPECT had lower overall quantitative errors due to reduced scatter and high detection efficiency. Furthermore, the results of this systematic assessment quantifying the accuracy of these SPECT

  19. Quantitative Methods for Evaluating the Efficacy of Thalamic Deep Brain Stimulation in Patients with Essential Tremor

    PubMed Central

    Wastensson, Gunilla; Holmberg, Björn; Johnels, Bo; Barregard, Lars

    2013-01-01

    Background Deep brain stimulation (DBS) of the thalamus is a safe and efficient method for treatment of disabling tremor in patient with essential tremor (ET). However, successful tremor suppression after surgery requires careful selection of stimulus parameters. Our aim was to examine the possible use of certain quantitative methods for evaluating the efficacy of thalamic DBS in ET patients in clinical practice, and to compare these methods with traditional clinical tests. Methods We examined 22 patients using the Essential Tremor Rating Scale (ETRS) and quantitative assessment of tremor with the stimulator both activated and deactivated. We used an accelerometer (CATSYS tremor Pen) for quantitative measurement of postural tremor, and a eurythmokinesimeter (EKM) to evaluate kinetic tremor in a rapid pointing task. Results The efficacy of DBS on tremor suppression was prominent irrespective of the method used. The agreement between clinical rating of postural tremor and tremor intensity as measured by the CATSYS tremor pen was relatively high (rs = 0.74). The agreement between kinetic tremor as assessed by the ETRS and the main outcome variable from the EKM test was low (rs = 0.34). The lack of agreement indicates that the EKM test is not comparable with the clinical test. Discussion Quantitative methods, such as the CATSYS tremor pen, could be a useful complement to clinical tremor assessment in evaluating the efficacy of DBS in clinical practice. Future studies should evaluate the precision of these methods and long-term impact on tremor suppression, activities of daily living (ADL) function and quality of life. PMID:24255800

  20. Imaging Aortic Regurgitation: The Incremental Benefit of Speckle Tracking Echocardiography

    PubMed Central

    Garg, Pankaj; Yassin, Firas; Leischik, Roman

    2015-01-01

    Aortic regurgitation (AR) affects global left ventricular mechanics. However, limited literature is available on how it may affect regional longitudinal strain. We present a case where severe AR jet is thrashing the anterior-septal wall and reducing its overall longitudinal performance most likely secondary to increased wall shear stress in diastole. This new insight into patho-physiological process using deformation study may have supplementary impact in decision making for surgical intervention. Transthoracic echocardiography is the primary imaging modality for the assessment of AR as it offers evaluation of severity of AR, aetiology of AR, left ventricular (LV) dilatation, LV systolic function, left ventricular mass, diastolic function and global strain. This case highlights the regional disturbances in longitudinal strain in eccentric AR. PMID:27006711

  1. Exercise Echocardiography in Asymptomatic Patients with Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction

    PubMed Central

    Henri, Christine

    2014-01-01

    The management of asymptomatic patients with severe aortic stenosis (AS) remains controversial. Recent series reported that early aortic valve replacement might be associated with improved clinical outcomes. However, the risk-benefit ratio should be carefully evaluated and early surgery only be proposed to a subset of asymptomatic patients considered at higher risk. Exercise echocardiography can help unmask symptomatic patients combined with assessment of the hemodynamic consequences of AS. Recent studies have demonstrated that exercise echocardiography can provide incremental prognostic value to identify patients who may benefit most from early surgery. In "truly" asymptomatic patients, an increase in mean aortic gradient ≥ 18-20 mmHg, a limited left ventricular contractile reserve or a pulmonary hypertension during exercise are predictive parameters of adverse cardiac events. Exercise echocardiography is low-cost, safe and available in many referral centers, and does not expose patients to radiation. The purpose of this article is to describe the role of exercise testing and echocardiography in the management of asymptomatic patients with severe AS and preserved left ventricular ejection fraction. PMID:24753801

  2. Measurement of myocardial perfusion and infarction size using computer-aided diagnosis system for myocardial contrast echocardiography.

    PubMed

    Du, Guo-Qing; Xue, Jing-Yi; Guo, Yanhui; Chen, Shuang; Du, Pei; Wu, Yan; Wang, Yu-Hang; Zong, Li-Qiu; Tian, Jia-Wei

    2015-09-01

    Proper evaluation of myocardial microvascular perfusion and assessment of infarct size is critical for clinicians. We have developed a novel computer-aided diagnosis (CAD) approach for myocardial contrast echocardiography (MCE) to measure myocardial perfusion and infarct size. Rabbits underwent 15 min of coronary occlusion followed by reperfusion (group I, n = 15) or 60 min of coronary occlusion followed by reperfusion (group II, n = 15). Myocardial contrast echocardiography was performed before and 7 d after ischemia/reperfusion, and images were analyzed with the CAD system on the basis of eliminating particle swarm optimization clustering analysis. The myocardium was quickly and accurately detected using contrast-enhanced images, myocardial perfusion was quantitatively calibrated and a color-coded map calibrated by contrast intensity and automatically produced by the CAD system was used to outline the infarction region. Calibrated contrast intensity was significantly lower in infarct regions than in non-infarct regions, allowing differentiation of abnormal and normal myocardial perfusion. Receiver operating characteristic curve analysis documented that -54-pixel contrast intensity was an optimal cutoff point for the identification of infarcted myocardium with a sensitivity of 95.45% and specificity of 87.50%. Infarct sizes obtained using myocardial perfusion defect analysis of original contrast images and the contrast intensity-based color-coded map in computerized images were compared with infarct sizes measured using triphenyltetrazolium chloride staining. Use of the proposed CAD approach provided observers with more information. The infarct sizes obtained with myocardial perfusion defect analysis, the contrast intensity-based color-coded map and triphenyltetrazolium chloride staining were 23.72 ± 8.41%, 21.77 ± 7.8% and 18.21 ± 4.40% (% left ventricle) respectively (p > 0.05), indicating that computerized myocardial contrast echocardiography can

  3. Subclinical Alterations of Cardiac Mechanics Present Early in the Course of Pediatric Type 1 Diabetes Mellitus: A Prospective Blinded Speckle Tracking Stress Echocardiography Study

    PubMed Central

    Hensel, Kai O.; Grimmer, Franziska; Roskopf, Markus; Jenke, Andreas C.; Wirth, Stefan; Heusch, Andreas

    2016-01-01

    Diabetic cardiomyopathy substantially accounts for mortality in diabetes mellitus. The pathophysiological mechanism underlying diabetes-associated nonischemic heart failure is poorly understood and clinical data on myocardial mechanics in early stages of diabetes are lacking. In this study we utilize speckle tracking echocardiography combined with physical stress testing in order to evaluate whether left ventricular (LV) myocardial performance is altered early in the course of uncomplicated type 1 diabetes mellitus (T1DM). 40 consecutive asymptomatic normotensive children and adolescents with T1DM (mean age 11.5 ± 3.1 years and mean disease duration 4.3 ± 3.5 years) and 44 age- and gender-matched healthy controls were assessed using conventional and quantitative echocardiography (strain and strain rate) during bicycle ergometer stress testing. Strikingly, T1DM patients had increased LV longitudinal (p = 0.019) and circumferential (p = 0.016) strain rate both at rest and during exercise (p = 0.021). This was more pronounced in T1DM patients with a longer disease duration (p = 0.038). T1DM patients with serum HbA1c > 9% showed impaired longitudinal (p = 0.008) and circumferential strain (p = 0.005) and a reduced E/A-ratio (p = 0.018). In conclusion, asymptomatic T1DM patients have signs of hyperdynamic LV contractility early in the course of the disease. Moreover, poor glycemic control is associated with early subclinical LV systolic and diastolic impairment. PMID:26839891

  4. Subclinical Alterations of Cardiac Mechanics Present Early in the Course of Pediatric Type 1 Diabetes Mellitus: A Prospective Blinded Speckle Tracking Stress Echocardiography Study.

    PubMed

    Hensel, Kai O; Grimmer, Franziska; Roskopf, Markus; Jenke, Andreas C; Wirth, Stefan; Heusch, Andreas

    2016-01-01

    Diabetic cardiomyopathy substantially accounts for mortality in diabetes mellitus. The pathophysiological mechanism underlying diabetes-associated nonischemic heart failure is poorly understood and clinical data on myocardial mechanics in early stages of diabetes are lacking. In this study we utilize speckle tracking echocardiography combined with physical stress testing in order to evaluate whether left ventricular (LV) myocardial performance is altered early in the course of uncomplicated type 1 diabetes mellitus (T1DM). 40 consecutive asymptomatic normotensive children and adolescents with T1DM (mean age 11.5 ± 3.1 years and mean disease duration 4.3 ± 3.5 years) and 44 age- and gender-matched healthy controls were assessed using conventional and quantitative echocardiography (strain and strain rate) during bicycle ergometer stress testing. Strikingly, T1DM patients had increased LV longitudinal (p = 0.019) and circumferential (p = 0.016) strain rate both at rest and during exercise (p = 0.021). This was more pronounced in T1DM patients with a longer disease duration (p = 0.038). T1DM patients with serum HbA1c > 9% showed impaired longitudinal (p = 0.008) and circumferential strain (p = 0.005) and a reduced E/A-ratio (p = 0.018). In conclusion, asymptomatic T1DM patients have signs of hyperdynamic LV contractility early in the course of the disease. Moreover, poor glycemic control is associated with early subclinical LV systolic and diastolic impairment. PMID:26839891

  5. QUANTITATIVE EVALUATION OF ANTERIOR SEGMENT PARAMETERS IN THE ERA OF IMAGING

    PubMed Central

    Dorairaj, Syril; Liebmann, Jeffrey M.; Ritch, Robert

    2007-01-01

    Purpose To review the parameters for quantitative assessment of the anterior segment and iridocorneal angle and to develop a comprehensive schematic for the evaluation of angle anatomy and pathophysiology by high-resolution imaging. Methods The published literature of the last 15 years was reviewed, analyzed, and organized into a construct for assessment of anterior segment processes. Results Modern anterior segment imaging techniques have allowed us to devise new quantitative parameters to improve the information obtained. Ultrasound biomicroscopy, slit-lamp optical coherence tomography, and anterior segment optical coherence tomography provide high-resolution images for analysis of physiologic and pathologic processes. These include iridocorneal angle analysis (eg, angle opening distance, angle recess area, trabecular-iris space area), anterior and posterior chamber depth and area, iris and ciliary body cross-sectional area and volume, quantitative anatomic relationships between structures, and videographic analysis of iris movement and accommodative changes under various conditions. Modern devices permit imaging of the entire anterior chamber, allowing calculation of anterior chamber and pupillary diameters and correlating these with measurement of anterior chamber dynamics in light vs dark conditions. We have tabulated all reported anterior segment measurement modalities and devised a construct for assessment of normal and abnormal conditions. Conclusion Quantitative measurement of static and dynamic anterior segment parameters, both normal and abnormal, provides a broad range of parameters for analysis of the numerous aspects of the pathophysiology of the anterior segment of the eye. PMID:18427599

  6. Quantitative evaluation of image registration techniques in the case of retinal images

    NASA Astrophysics Data System (ADS)

    Gavet, Yann; Fernandes, Mathieu; Pinoli, Jean-Charles

    2012-04-01

    In human retina observation (with non mydriatic optical microscopes), an image registration process is often employed to enlarge the field of view. Analyzing all the images takes a lot of time. Numerous techniques have been proposed to perform the registration process. Its good evaluation is a difficult question that is then raising. This article presents the use of two quantitative criterions to evaluate and compare some classical feature-based image registration techniques. The images are first segmented and the resulting binary images are then registered. The good quality of the registration process is evaluated with a normalized criterion based on the ɛ dissimilarity criterion, and the figure of merit criterion (fom), for 25 pairs of images with a manual selection of control points. These criterions are normalized by the results of the affine method (considered as the most simple method). Then, for each pair, the influence of the number of points used to perform the registration is evaluated.

  7. Evaluate the Impact of your Education and Outreach Program Using the Quantitative Collaborative Impact Analysis Method

    NASA Astrophysics Data System (ADS)

    Scalice, D.; Davis, H. B.

    2015-12-01

    The AGU scientific community has a strong motivation to improve the STEM knowledge and skills of today's youth, and we are dedicating increasing amounts of our time and energy to education and outreach work. Scientists and educational project leads can benefit from a deeper connection to the value of evaluation, how to work with an evaluator, and how to effectively integrate evaluation into projects to increase their impact. This talk will introduce a method for evaluating educational activities, including public talks, professional development workshops for educators, youth engagement programs, and more. We will discuss the impetus for developing this method--the Quantitative Collaborative Impact Analysis Method--how it works, and the successes we've had with it in the NASA Astrobiology education community.

  8. Simulation-based transthoracic echocardiography: “An anesthesiologist's perspective”

    PubMed Central

    Magoon, Rohan; Sharma, Amita; Ladha, Suruchi; Kapoor, Poonam Malhotra; Hasija, Suruchi

    2016-01-01

    With the growing requirement of echocardiography in the perioperative management, the anesthesiologists need to be well trained in transthoracic echocardiography (TTE). Lack of formal, structured teaching program precludes the same. The present article reviews the expanding domain of TTE, simulation-based TTE training, the advancements, current limitations, and the importance of simulation-based training for the anesthesiologists. PMID:27397457

  9. Saline contrast echocardiography for the detection of patent foramen ovale in hypoxia: a validation study using intracardiac echocardiography.

    PubMed

    Fenster, Brett E; Curran-Everett, Douglas; Freeman, Andrew M; Weinberger, Howard D; Kern Buckner, J; Carroll, John D

    2014-04-01

    Although the "3 beat rule" is widely utiized to discriminate patent foramen ovale (PFO)-mediated right-to-left shunt (RTLS) from intrapulmonary RTLS using saline contrast transthoracic echocardiography (SCE), SCE diagnostic performance has yet to be validated using an invasive intracardiac standard. Percutaneous PFO occluder placement was recently shown to ameliorate hypoxia in patients with suspected PFO-mediated RTLS. We evaluated the ability of SCE to predict PFO presence and size using intracardiac echocardiography (ICE) as a gold standard in a hypoxic cohort. Sixty-three hypoxic patients with suspected PFO-mediated RTLS who underwent SCE at rest, with Valsalva maneuver, and with cough prior to ICE were evaluated retrospectively. PFO RTLS was defined by ICE findings including PFO anatomy, RTLS by saline contrast and color Doppler, and probe patency. SCE shunt severity and timing of left heart saline target appearance were compared to the presence of ICE-defined PFO RTLS. Forty-seven patients (75%) met criteria for PFO-mediated RTLS. A 4 beat cutoff for resting SCE provided optimal diagnostic performance for detection of PFO-mediated RTLS with a 71% sensitivity, 94% specificity, and 97% positive predictive value (PPV). Valsalva and cough maneuvers improved sensitivity compared to rest SCE (89% and 80%, respectively). Valsalva SCE shunt severity more accurately predicted PFO size than resting SCE. In contrast to the widely accepted "3 beat rule," resting SCE for the detection of PFO RTLS in a hypoxic population performs optimally using a 4-cycle cutoff with both excellent specificity and PPV. PMID:24138568

  10. Preventive health care, 1999 update: 2. Echocardiography for the detection of a cardiac source of embolus in patients with stroke

    PubMed Central

    Kapral, M K; Silver, F L

    1999-01-01

    OBJECTIVE: To develop guidelines for the use of echocardiography in the investigation of patients with stroke. OPTIONS: (1) Routine transthoracic echocardiography (TTE); (2) routine transesophageal echocardiography (TEE); (3) routine TTE followed by TEE if the TTE findings are noncontributory; (4) selective TTE or TEE in patients with cardiac disease who would not otherwise receive anticoagulant therapy. OUTCOMES: This article reviews the available evidence on the yield of TTE and TEE in detecting cardiac sources of cerebral emboli in patients with stroke, the effectiveness of treatment for cardiac sources of emboli and the effectiveness of screening echocardiography for secondary stroke prevention. EVIDENCE: MEDLINE was searched for relevant articles published from January 1966 to April 1998; also reviewed were additional articles identified from the bibliographies and citations obtained from experts. BENEFITS, HARMS AND COSTS: Echocardiography can detect intracardiac masses (thrombus, vegetation or tumour) in about 4% (with TTE) to 11% (with TEE) of stroke patients. The yield is lower among patients without clinical evidence of cardiac disease by history, physical examination, electrocardiography or chest radiography (less than 2%) than among patients with clinical evidence of cardiac disease (less than 19%). The risks of echocardiography to patients are small. TTE has virtually no risks, and TEE is associated with cardiac, pulmonary and bleeding complications in 0.18%. Patients with an identified intracardiac thrombus are at increased risk for embolic events (absolute risk uncertain, range 0%-38%), and this appears to be reduced with anticoagulant therapy (absolute risk reduction uncertain). Anticoagulant therapy carries a risk of major hemorrhage of 1% to 3% per year. The overall effectiveness of echocardiography in the prevention of recurrent stroke is unknown. VALUES: The strength of evidence was evaluated using the methods of the Canadian Task Force on