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1

Transesophageal echocardiography assessment of severe ostial left main coronary stenosis  

NASA Technical Reports Server (NTRS)

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.

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

2000-01-01

2

Diagnostic Value of Vena Contracta Area in the Quantification of Mitral Regurgitation Severity by Color Doppler 3D Echocardiography  

PubMed Central

Background Accurate quantification of mitral regurgitation (MR) is important for patient treatment and prognosis. Three-dimensional echocardiography allows for the direct measure of the regurgitant orifice area (ROA) by 3D-guided planimetry of the vena contracta area (VCA). We aimed to (1) establish 3D VCA ranges and cutoff values for MR grading, using the American Society of Echocardiography–recommended 2D integrative method as a reference, and (2) compare 2D and 3D methods of ROA to establish a common calibration for MR grading. Methods and Results Eighty-three patients with at least mild MR underwent 2D and 3D echocardiography. Direct planimetry of VCA was performed by 3D echocardiography. Two-dimensional quantification of MR included 2D ROA by proximal isovelocity surface area (PISA) method, vena contracta width, and ratio of jet area to left atrial area. There were significant differences in 3D VCA among patients with different MR grades. As assessed by receiver operating characteristic analysis, 3D VCA at a best cutoff value of 0.41 cm2 yielded 97% of sensitivity and 82% of specificity to differentiate moderate from severe MR. There was significant difference between 2D ROA and 3D VCA in patients with functional MR, resulting in an underestimation of ROA by 2D PISA method by 27% as compared with 3D VCA. Multivariable regression analysis showed functional MR as etiology was the only predictor of underestimation of ROA by the 2D PISA method. Conclusions Three-dimensional VCA provides a single, directly visualized, and reliable measurement of ROA, which classifies MR severity comparable to current clinical practice using the American Society of Echocardiography–recommended 2D integrative method. The 3D VCA method improves accuracy of MR grading compared with the 2D PISA method by eliminating geometric and flow assumptions, allowing for uniform clinical grading cutoffs and ranges that apply regardless of etiology and orifice shape. PMID:21730026

Zeng, Xin; Levine, Robert A.; Hua, Lanqi; Morris, Eleanor L.; Kang, Yuejian; Flaherty, Mary; Morgan, Nina V.; Hung, Judy

2011-01-01

3

Mechanisms of regional ischaemic changes during dipyridamole echocardiography in patients with severe aortic valve stenosis and normal coronary arteries.  

PubMed Central

OBJECTIVE: Vasodilator stress echocardiography can cause myocardial ischaemia in patients with severe aortic valve stenosis and angiographically normal coronary arteries. The aim of the study was to determine the mechanism of ischaemia in this clinical model. METHODS: The study group comprised patients with severe aortic valve stenosis and normal coronary arteries: 25 patients (17 males, eight females; age 63 (SD 11) years) underwent a high dose (up to 0.84 mg/kg over 10 min) dipyridamole echocardiography test both before (2-4 d) and after (10-15 d) aortic valve replacement. Mean aortic pressure gradient was 96 (15) mm Hg, with a left ventricular mass index of 228 (49) g/m2. The dipyridamole echocardiography test was well tolerated and interpretable in all patients. RESULTS: Dipyridamole infusion induced chest pain in seven patients before and in no patient after surgery (28 v 0%, P < 0.01), ST segment depression in 12 patients before and two after surgery (48 v 8%, P < 0.01), and a transient regional dyssynergy in 10 patients before and two after surgery (40 v 8%, P < 0.01). In the preoperative evaluation, patients with an echocardiographically positive dipyridamole echocardiography test were comparable with patients with negative test as far as left ventricular mass index [240 (67) v 230 (64) g/m2, NS] and mean aortic pressure gradient [95 (22) v 92 (21) mm Hg, NS] were concerned. When compared to the preoperative assessment, the resting echo assessment in the postoperative evaluation showed unchanged values of left ventricular mass index [pre 228 (49) g/m2 v post 220 (36) g/m2, NS], but markedly decreased values of mean aortic gradient [pre 95 (15) mm Hg v post 22 (5) mm Hg, P < 0.01] and left ventricular wall stress index [pre 134 (30) g/cm2 v post 89 (19) g/cm2]. CONCLUSIONS: Dipyridamole echocardiography is a suitable clinical technique for assessing the ischaemic vulnerability of the left ventricle in severe aortic valve stenosis with angiographically normal coronary arteries. The frequent disappearance of the ischaemic response early after aortic valve replacement suggests that haemodynamic factors such as compressive diastolic wall stress or afterload reduction are important components of myocardial ischaemic vulnerability under these circumstances. Images PMID:8665343

Baroni, M.; Maffei, S.; Terrazzi, M.; Palmieri, C.; Paoli, F.; Biagini, A.

1996-01-01

4

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

PubMed Central

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

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

5

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

PubMed

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.Fundamento: Estudos têm demonstrado a acurácia diagnóstica e o valor prognóstico da ecocardiografia com estresse físico na doença arterial coronária, mas a predição de mortalidade e de eventos cardíacos maiores, em pacientes com teste ergométrico positivo para isquemia miocárdica, é limitada. Objetivo: Avaliar a predição de mortalidade e de eventos cardíacos maiores pela ecocardiografia com estresse físico em pacientes com teste ergométrico positivo para isquemia miocárdica. Métodos: Trata-se de uma coorte retrospectiva em que foram estudados 866 pacientes consecutivos, com teste ergométrico positivo para isquemia miocárdica, submetidos à ecocardiografia com estresse físico. Os pacientes foram divididos em dois grupos: ecocardiografia com estresse físico negativa (G1) ou positiva (G2) para isquemia miocárdica. Os desfechos avaliados foram mortalidade por qualquer causa e eventos cardíacos maiores, definidos como óbito cardíaco e infarto agudo do miocárdio não fatal. Resultados: O G2 constituiu-se de 205 (23,7%) pacientes. Durante o seguimento médio de 85,6 ± 15,0 meses, ocorreram 26 óbitos, sendo seis por causa cardíaca, e 25 casos de infarto agudo do miocárdio não fatais. Os preditores independentes de mortalidade foram idade, diabetes melito e a ecocardiografia com estresse físico + (hazard ratio: 2,69; intervalo de confiança de 95%: 1,20 - 6,01; p = 0,016), com os seguintes eventos cardíacos maiores: idade, doença arterial coronária prévia, ecocardiografia com estresse físico + (hazard ratio: 2,75; intervalo de confiança de 95%: 1,15 - 6,53; p = 0,022) e ausência do incremento de 10% na fração de ejeção. A mortalidade por qualquer causa e os eventos cardíacos maiores foram significativamente superiores no G2 (p < 0, 001 e p = 0,001, respectivamente). Conclusão: A ecocardiografia com estresse físico oferece informações prognósticas adicionais em pacientes com teste ergométrico positivo para isquemia miocárdica. PMID:25352460

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

2014-11-01

6

Transesophageal Echocardiography  

MedlinePLUS

... blood vessels. TEE is a type of echocardiography (echo). Echo shows the size and shape of the heart ... well the heart chambers and valves are working. Echo can pinpoint areas of heart muscle that aren' ...

7

Three-dimensional echocardiography with tissue harmonic imaging shows excellent reproducibility in assessment of left ventricular volumes  

Microsoft Academic Search

We studied the reproducibility of repeated measurements of left ventricular (LV) volumes by 2-dimensional (biplane method of disks) and 3-dimensional echocardiography (coaxial scanning) with tissue harmonic imaging. Ten healthy subjects underwent estimation of LV volumes by transthoracic echocardiography twice within 1 week by 2 different operators to investigate interexamination and operator variance. In addition, the analysis of LV volume was

W. Yong Kim; Peter Søgaard; Henrik Egeblad; Niels Trolle Andersen; Bent Ø Kristensen

2001-01-01

8

Increasing Severity of Aortic Atherosclerosis in Coronary Artery Bypass Grafting Patients Evaluated by Transesophageal Echocardiography  

PubMed Central

Background Atherosclerotic disease in coronary artery bypass grafting (CABG) patients is a potential contributor to complications in the perioperative periods. This study was undertaken to better define how the frequency of aortic atheromatous disease among patients coming for CABG has evolved over the last decade. Methods Data from elective patients coming for CABG who underwent transesophageal echocardiography (TEE) examinations following induction of anesthesia were obtained for the years 2002 and 2009. Aortas were graded according to the method of Kronzon, with the following interpretations: normal = grade I, intimal thickening = 2, atheroma of less than 5 mm = 3, atheroma of > 5 mm = 4, and any mobile atheroma = 5. The data of 124 patients who underwent comprehensive exam of the aorta by one cardiac anesthesiologist were gathered and assigned into two groups based on the year TEE was done. Student’s t-test was used for statistical analysis. A P value < 0.05 was considered significant. The data were presented as mean ± SD. Results There was significant difference between group 2002 (2.05 ± 1.28) and group 2009 (2.59 ± 1.11) in atheroma grade (P = 0.013). Conclusions Patients coming for CABG in group 2009 exhibited significantly higher grades of aortic atheroma on TEE, compared to group 2002. Understanding the risk of atheroma in the elderly CABG population may help in altering surgical approaches to lessen the risk of catastrophic stroke. Potential options needing further study include the off-pump approach and modification of cross-clamp site and technique as well as other modalities. PMID:25379067

Denny, John T.; Pantin, Enrique; Chiricolo, Antonio; Tse, James; Denny, Julia E.; Mungekar, Sagar S.; Chyu, Darrick; Solina, Alann

2015-01-01

9

Detecting aortic valve bicuspidy in patients with severe aortic valve stenosis: high diagnostic accuracy of colour Doppler transoesophageal echocardiography  

PubMed Central

OBJECTIVES The diagnostic accuracy of multiplane bi-dimensional transoesophageal echocardiography (TEE) in detecting aortic valve bicuspidy is good, but is less reliable when the leaflets are moderately or severely calcified. We hypothesized that systolic colour Doppler analysis might improve the accuracy of diagnosing aortic bicuspidy by TEE in patients with severe symptomatic aortic stenosis (AS). METHODS Two colour Doppler images of a stenotic aortic valve were defined in a preliminary study using multiplane TEE. In type I, the valve opening had a linear, angular or ‘hanger-like’ configuration and in type II it was more star-like or ‘stellar’. The accuracy of this classification in detecting bicuspidy was evaluated. Fifty-one patients (mean age 71 years (range 40–90 years); 52% male) with severe symptomatic AS (defined as aortic valve area ?1 cm2), requiring surgical aortic valve replacement, were included in this prospective study. The surgical findings were compared with the echocardiographic data. RESULTS The incidence of aortic bicuspidy was 43%. The presence of type I colour Doppler configuration was significantly higher for bicuspid than for tricuspid aortic valves (95.5 vs 3.5%, respectively; P < 0.001). Diagnostic accuracy in detecting bicuspidy was high (sensitivity 95.5%; specificity 96.5%; positive predictive value 95.5%). Intra- and inter-observer agreements were excellent (Kappa coefficient = 0.88 and 0.92, respectively). CONCLUSIONS Aortic valve bicuspidy may be accurately diagnosed by colour Doppler valve analysis during TEE in patients with severe AS. Larger prospective studies are required to confirm our results. PMID:23054907

Zegdi, Rachid; Ciobotaru, Vlad; Huerre, Clémence; Allam, Bachir; Bouabdallaoui, Nadia; Berrebi, Alain; Florens, Emmanuelle; Fabiani, Jean-Noël

2013-01-01

10

Real time three-dimensional transesophageal echocardiography guided coronary sinus cannulation during CARILLON mitral annuloplasty device therapy for a patient with chronic severe mitral regurgitation.  

PubMed

The coronary sinus (CS) has become a clinically important structure especially through its role in providing access for different cardiac procedures such as arrhythmia ablation, biventricular pacing and recently, percutaneous valvular interventions. Fluoroscopy with or without two-dimensional transesophageal echocardiography is the widely used method for guidance. A 78-year-old female patient undergoing percutaneous CARILLON mitral annuloplasty device therapy for chronic severe symptomatic mitral regurgitation. After insertion of the CS catheter through the right internal jugular vein, multiple trials for CS cannulation guided by fluoroscopy and two-dimensional transesophageal echocardiography were unsuccessful. So, real time three-dimensional zoom mode was used. Then, the volume was rotated to have the anatomically oriented enface view of the interatrial septum from the right atrial perspective. The CS ostium was identified adjacent to the eustachian valve. Then the catheter was reintroduced through the superior vena cava into the right atrium then easily navigated to cannulate the CS ostium. The position was confirmed by the fluoroscopically known course of the CS plus the pattern of the invasive pressure wave form. CS cannulation is not always feasible using fluoroscopy and/or two-dimensional Echocardiography guidance. Real time three-dimensional transesophageal echocardiography can be used to guide CS cannulation as it provides an anatomically oriented and informative enface view of the CS ostium. It can help reducing fluoroscopic radiation time. PMID:25231878

Mahmoud, Hani M; Al-Ghamdi, Mohammed A; Ghabashi, Abdullah E

2015-01-01

11

Doppler echocardiography  

SciTech Connect

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.

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

1988-01-01

12

Stanford study shows anxiety increases cancer severity in mice  

Cancer.gov

In a new study led by researchers at the Stanford University School of Medicine, anxiety-prone mice developed more severe cancer then their calm counterparts. The study, published online April 25 in PLoS ONE, found that after hairless mice were dosed with ultraviolet rays, the nervous ones — with a penchant for reticence and risk aversion — developed more tumors and invasive cancer.

13

Echocardiography in cardiac amyloidosis.  

PubMed

Echocardiography is the most widely used noninvasive test in patients with heart failure or abnormal cardiac findings on examination. Patients with amyloidosis may have significant cardiac abnormalities, several of which are highly suggestive of the disease. This article reviews echocardiographic features found in cardiac amyloidosis. PMID:25597027

Falk, Rodney H; Quarta, C Cristina

2015-03-01

14

Usefulness of an accelerated transoesophageal stress echocardiography in the preoperative evaluation of high risk severely obese subjects awaiting bariatric surgery  

Microsoft Academic Search

BACKGROUND: Severe obesity is associated with an increased risk of coronary artery disease (CAD). Bariatric surgery is an effective procedure for long term weight management as well as reduction of comorbidities. Preoperative evaluation of cardiac operative risk may often be necessary but unfortunately standard imaging techniques are often suboptimal in these subjects. The purpose of this study was to demonstrate

Sylvie Legault; Mario Sénéchal; Sébastien Bergeron; Marie Arsenault; Michel Tessier; Jean Guimond; Paul Poirier

2010-01-01

15

Importance of echocardiography in patients with severe nonischemic heart failure: the second prospective randomized amlodipine survival evaluation (PRAISE2) echocardiographic study  

Microsoft Academic Search

BackgroundEchocardiography is used commonly in clinical practice when caring for patients with heart failure. It is unknown whether the presence of certain findings provides an incremental ability to predict survival beyond the use of baseline clinical findings alone. The second PRAISE-2 echocardiographic study was prospectively designed to identify echocardiographic predictors of survival among patients with nonischemic cardiomyopathy and heart failure

Christopher H Cabell; Benjamin H Trichon; Eric J Velazquez; Jean G Dumesnil; Kevin J Anstrom; Thomas Ryan; Alan B Miller; Robert N Belkin; Anne B Cropp; Christopher M O'Connor; James G Jollis

2004-01-01

16

The Origin of Echocardiography  

PubMed Central

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

Singh, Siddharth; Goyal, Abha

2007-01-01

17

The Year in Echocardiography  

Microsoft Academic Search

During the past year, progress in echocardiographic research has again been incremental with reports describing both expanded and refined applications of tissue Doppler imag- ing (TDI), myocardial contrast echocardiography (MCE), stress echocardiography, and real-time 3-dimensional (RT3D) imaging. The primary focus this year has been on the use of TDI and speckle tracking (ST) to identify left ventricular (LV) systolic and\\/or

Arthur E. Weyman

2010-01-01

18

Technique of fetal echocardiography  

PubMed Central

Congenital heart disease is the most common abnormality in the human fetus. Fetal echocardiography has been used to detect the majority of cardiac defects, and it is now part of the routine screening method for fetal evaluation. In this article, we present standard ultrasonographic views of the normal fetal heart obtained during the second trimester, first-trimester fetal echocardiography findings, and a modified myocardial performance index. PMID:24328006

Lee, Mi-Young

2013-01-01

19

Basal Cell Nevus Syndrome Showing Several Histologic Types of Basal Cell Carcinoma  

PubMed Central

Basal cell nevus syndrome (BCNS), or Gorlin Syndrome, is an autosomal dominant disorder, characterized by multiple developmental abnormalities and associated with germline mutations in the PTCH gene. Patients show multiple and early onset basal cell carcinomas (BCCs) in skin, odontogeniccysts in the jaw, pits on palms and soles, medulloblastoma, hypertelorism, and calcification of the falx cerebri. Clinical features of BCCs in these patients are indistinguishable from ordinary BCCs. However, some patients show variable histologic findings in subtypes of BCCs, and only one case associated with several histologic types of BCCs in the syndrome has been reported in Korea. We present a case of BCNS characterized by multiple BCCs, odontogenic keratocysts, multiple palmar pits, and calcified falx cerebri. Histopathologic findings of BCCs showed several patterns, which were nodular, superficial, and pigmented types. PMID:22028568

Go, Jae Wan; Kim, Shin Han; Yi, Sang Yeop

2011-01-01

20

Thrombi migration to atrium diagnosed by transesophageal echocardiography.  

PubMed

Two days before surgery in a 70-year-old man with renal cell carcinoma, transthoracic echocardiography showed a dense mass in the inferior vena cava, lying proximally, but no mass was observed in the right atrium. Intraoperative transesophageal echocardiography revealed unexpected tumor thrombi in the right atrium, and the surgical plan was changed. This case highlights the importance of intraoperative transesophageal echocardiography in patients with renal cell carcinoma. PMID:24570534

Erdemli, Özcan; Demir, Asli; Güçlü, Çi?dem Yildirim; Karadeniz, Ümit; Ça?li, Kerim

2013-08-01

21

Echocardiography: an overview.  

PubMed

In the past 25 to 30 years echocardiography has become a basic examination in clinical cardiology. Thus, it is becoming increasingly necessary for clinicians to be able to utilize it intelligently. Like all medical procedures echocardiography has advantages and limitations, and physicians need to know both. Some of the limitations are being minimized with advances in examination techniques and instrumentation, but many still exist. One limitation is that the ability to satisfactorily educate and train persons in the various ultrasonic techniques has not kept pace with the worldwide popularity of the examination. As a result, quality control will remain a problem at least in the immediate future. New developments in echocardiography as invasive and noninvasive tools are exciting and indicate that ultrasonic examination of the heart should play an increasingly important role in clinical cardiology. PMID:6826935

Feigenbaum, H

1983-01-01

22

MRI Shows More Severe Hippocampal Atrophy and Shape Deformation in Hippocampal Sclerosis Than in Alzheimer's Disease  

PubMed Central

While hippocampal atrophy is a key feature of both hippocampal sclerosis (HS) and Alzheimer's disease (AD), the pathology underlying this finding differs in these two conditions. In AD, atrophy is due primarily to loss of neurons and neuronal volume as a result of neurofibrillary tangle formation. While the etiology of HS is unknown, neuron loss in the hippocampus is severe to complete. We compared hippocampal volume and deformations from premortem MRI in 43 neuropathologically diagnosed cases of HS, AD, and normal controls (NC) selected from a longitudinal study of subcortical ischemic vascular disease (IVD Program Project). HS cases (n = 11) showed loss of neurons throughout the rostral-caudal extent of the hippocampus in one or both hemispheres. AD cases (n = 24) met NIA-Reagan criteria for high likelihood of AD. Normal control cases (n = 8) were cognitively intact and showed no significant AD or hippocampal pathology. The mean hippocampal volumes were significantly lower in HS versus AD groups (P < .001). Mean shape deformations in the CA1 and subiculum differed significantly between HS versus AD, HS versus NC, and AD versus NC (P < .0001). Additional study is needed to determine whether these differences will be meaningful for clinical diagnosis of individual cases. PMID:21547227

Zarow, C.; Wang, L.; Chui, H. C.; Weiner, M. W.; Csernansky, J. G.

2011-01-01

23

Myocardial deformation imaging by two-dimensional speckle-tracking echocardiography in comparison to late gadolinium enhancement cardiac magnetic resonance for analysis of myocardial fibrosis in severe aortic stenosis.  

PubMed

Myocardial deformation analysis by speckle-tracking echocardiography (STE) has been used for analysis of myocardial viability and myocardial fibrosis. Patients with severe aortic stenosis are known to develop myocardial fibrosis. This study evaluated the association between myocardial fibrosis determined by late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) and 2-dimensional STE in patients with severe aortic stenosis. In 30 patients (78±7 years) with severe aortic stenosis (mean gradient 53±21 mm Hg), peak systolic circumferential strain based on 2-dimensional echocardiographic parasternal short-axis views and peak systolic longitudinal strain based on apical views were determined for analysis of regional function. LGE CMR was performed to define the amount of fibrosis in each segment within 24 hours of echocardiography. Relative amount of fibrosis was determined based on LGE CMR as gray-scale threshold 6 SDs above the mean signal intensity of the normal remote myocardium. There was a decrease in LGE from base to apex (14.4±8.7% for basal segments, 3.4±3.0% for midventricular segments, and 2.1±3.0% for apical segments; p<0.001). Simultaneously, there was an increase in myocardial deformation expressed as peak systolic longitudinal strain from base to apex (-11.6±7.0% for basal segments, -16.9±6.5% for midventricular segments, and -17.4±7.7% for apical segments; p=0.001). There was a negative correlation between the amount of myocardial fibrosis determined by LGE CMR and peak systolic longitudinal strain for the total left ventricle (r=-0.538, p=0.007). Myocardial fibrosis defined as LGE>10% could be identified by peak systolic longitudinal strain less than -11.6%, with a sensitivity of 65% and a specificity of 75% (area under the receiver operating characteristic curve 0.69). In conclusion, myocardial fibrosis increases from apical to basal left ventricular segments in patients with severe aortic stenosis. There is an association between severity of myocardial fibrosis defined by LGE CMR and myocardial deformation by STE. PMID:25212549

Hoffmann, Rainer; Altiok, Ertunc; Friedman, Zvi; Becker, Michael; Frick, Michael

2014-10-01

24

Supervised echocardiography in internal medicine. An integrated model in a community hospital  

Microsoft Academic Search

Background: The management of patients admitted to an internal medicine ward frequently requires echocardiography, which may often be delayed because of overburdened specialist cardiologist services. The availability of appropriate echocardiography may be improved if internists first perform autonomous echocardiography on their cardiac patients. Our 5-year experience with such a model shows how it can exploit the complementary role of internists

Giuseppe Gheno; Leonardo Cinetto

2004-01-01

25

Microsatellites haplotyping of CF chromosomes shows linkage disequilibrium and several founder effects in Brittany (France)  

SciTech Connect

A large study on cystic fibrosis (CF) is underway in Brittany (France). It is based on 902 CF patients distributed in 795 families who were or are still followed at the {open_quotes}Centre Helio-Marin{close_quotes} in Roscoff and/or were subjected to a molecular analysis at the {open_quotes}Centre de Biogenetique{close_quotes} in Brest. At present, the CF mutations have been identified in 309 patients born in Brittany, most of them of Celtic origin. A microsatellite (MS) study using IVS 17b TA, IVS 17b CA and IVS 8 CA was also completed in 63 CF patients and their parents (carriers of the {Delta}F508 mutation or the G551D mutation or the 1078delT mutation or the W846X mutation). All the 21 chromosomes carrying the 1078delT mutation had the same MS haplotype (16-21-13), which was also found on 9 of the 83 non-CF chromosomes analyzed. All the 16 chromosomes with the G551D mutation carried another MS haplotype (16-7-17), which was also found on 13.3% of the non-CF chromosomes. All the 6 chromosomes with the W846X mutation carried the 16-32-13 haplotype, also found on 6.0% of the non-CF chromosomes. Sixteen different MS haplotypes were found among the 74 chromosomes carrying the{Delta}F508 mutation, three of them representing 74.3% (55/74) of the chromosomes. These were the 23-31-13 haplotype (31/74 - 41.9%), the 17-31-13 haplotype (11/74 - 14.9%), and the 17-32-13 haplotype (13/74 - 17.6%). These results show that the CF mutations observed in Brittany are in linkage disequilibrium with the MS haplotypes. They also suggest that their presence in Brittany is the consequence of several founder effects.

Raguenes, O.; Ferec, C.; Mercier, B. [Universite de Bordeaux II, Paris (France)] [and others

1994-09-01

26

The explosive outbreak and intercontinental spread of Severe Acute Respiratory Syndrome (SARS) shows  

E-print Network

The explosive outbreak and intercontinental spread of Severe Acute Respiratory Syndrome (SARS (Mills and Childs 1998). Monkeypox, hantavirus pulmonary syndrome (HPS), Lassa fever, Argentine evidence for top-down regulation of zoonotic disease reservoirs Richard S Ostfeld1 and Robert D Holt2

27

[Evaluation of echocardiography for determining left ventricular function].  

PubMed

Left ventricular ejection fraction (LVEF) was calculated by echocardiography and gate blood pool (GBP) in 33 patients including those with coronary heart disease, acute and old myocardiac infarction, cardiomyopathy or mitral prolapse. Fourteen of the 33 had segmental wall motion abnormalities and 19 had non-segmental wall motion abnormalities. The results of comparing echocardiography and GBP showed that the former could substitute for other invasive and expensive examinations to determine LVEF (r = 0.804-0.964 in the 5 echocardiography methods used). Mod-Simpsons method of cross-sectioned echocardiography was the most accurate echocardiographic method (r = 0.964, sensitivity 90.9%) in all patients. The Teich method of M-mode echocardiography was useful in patients who had non-segmental wall motion abnormalities only (r = 0.957, sensitivity 94.7%) but not in patients who had segmental wall motion abnormalities (r = 0.703, sensitivity 42.9%). PMID:7954967

Wu, H; Zhu, W; Xu, J

1994-02-01

28

Training in critical care echocardiography  

PubMed Central

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

2011-01-01

29

[Critical care echocardiography].  

PubMed

Critical care echocardiography (CCE) using the transthoracic approach is a noninvasive imaging tool at the bedside and is of great value in the intensive care setting because of its portability, widespread availability, and rapid diagnostic capability. Time-dependent scenarios occur during shock and during cardiopulmonary resuscitation. Potentially treatable causes of shock or cardiac arrest including hypovolemia, cardiac tamponade, left ventricular failure, or massive pulmonary embolism should be detected or excluded as soon as possible. Basic CCE is assessed by means of "focused" or "goal-directed". Performance of such focused or goal-directed echocardiography by intensive care unit (ICU) physicians has been shown to provide new information not assessable by physical examination, and often leads to change in therapeutic management. Competence in basic CCE includes qualitative assessment of left ventricular cavity size, left ventricular systolic function, right ventricular cavity size and function, identification of pericardial fluid, and measurement of inferior vena cava diameter. Basic CCE should be a required part of the training of every ICU physician. This review discusses the application of basic CCE performed by the emphasis on focused or goal-directed assessment. PMID:25255656

Yamamoto, Takeshi

2014-09-01

30

The Evolutionary Development of Echocardiography  

PubMed Central

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

Maleki, Majid; Esmaeilzadeh, Maryam

2012-01-01

31

Diagnosis of right atrial mass by perioperative transesophageal echocardiography  

Microsoft Academic Search

A 67-year-old lady presented with shortness of breath, and was found to have severe triple vessel disease by coronary angiography. Transthoracic echocardiography (TTE) was reported as normal. However a large cystic mass was unexpectedly found in the right atrium by intra-operative transesopha- geal echocardiography (TOE). This mass was attached to the anterior wall, just by the inter-atrial septum. Flow was

Cassiano Moro; Andrew Klein; Kumud Dhital; Julian Gooi

32

Our previous studies on G. dumetorum yielded several aporphine alkaloids that showed significant activity against Leishmania spp.  

E-print Network

Our previous studies on G. dumetorum yielded several aporphine alkaloids that showed significant conducted additional isolation efforts on the minor alkaloids of this species. A standard alkaloid on the identification of alkaloids 1±9 from G. dumetorum (Fig.1). All nine of these metabolites were tested against

Coley, Phyllis

33

Classification of left ventricular size: diameter or volume with contrast echocardiography?  

PubMed Central

Background Left ventricular (LV) size is an important clinical variable, commonly assessed at echocardiography by measurement of the internal diameter in diastole (IDD). However, this has recognised limitations and volumetric measurement from apical views is considered superior, particularly with the use of echocardiographic contrast. We sought to determine the agreement in classification of LV size by different measures in a large population of patients undergoing echocardiography. Methods and results Data were analysed retrospectively from consecutive patients (n=2008, 61% male, median 62?years) who received echocardiographic contrast for LV opacification over 3?years in a single institution. Repeat studies were not included. LVIDD was measured, and LV end-diastolic volume (LVEDV) calculated using Simpson's biplane method. Both measures were indexed (i) to body surface area and categorised according to the American Society of Echocardiography (ASE) guidelines as normal, mild, moderate or severely dilated. Of 320 patients with a severely dilated LVEDVi, only 95 (30%) were similarly classified by LVIDD, with 86 patients (27%) measuring in the normal range. LVIDDi agreement was poorer, with only 43 patients (13%) classified as being severely dilated, and 173 (54%) measuring in the normal range. Conclusions Currently recommended echocardiographic measures of LV size show limited agreement when classified according to currently recommended cut-offs. LV diameter should have a limited role in the assessment of LV size, particularly where a finding of LV dilation has important diagnostic or therapeutic implications. PMID:25525505

Gibson, Patrick H; Becher, Harald; Choy, Jonathan B

2014-01-01

34

Aortic obstruction: anatomy and echocardiography.  

PubMed

Echocardiography is a valuable non-invasive technique for identifying the site and type of aortic obstruction. Knowledge of the morphological details of each type of obstruction is the basis for correct interpretation of the diagnostic images and clinical decisions. This study was undertaken to correlate the echocardiographic images with anatomic specimens of equivalent valvular and supravalvular aortic obstruction. Specimens were part of the collection of the Department of Embryology. Fifty six patients were studied, and forty specimens with aortic obstruction were analyzed. Echocardiographic characteristics: Thirty one (55.3%) patients were women and twenty five (44.7%) men. Valvular aortic obstruction was found in Thirty six patients (64.3 %) and supravalvular aortic obstruction in twenty (35.7%). Anatomic characteristics: Of the forty specimens examined, twenty one (52.5%) had valvular aortic obstruction and nineteen (47.5%) supravalvular aortic obstruction. The anatomoechocardiographic correlation clearly showed that the anatomic findings of the specimen hearts and aortas corresponded to echocardiographic images of valvular and supravalvular aortic obstruction and provided solid corroboration of echocardiographic diagnoses. PMID:17010187

Espinola-Zavaleta, Nilda; Muñoz-Castellanos, Luis; Kuri-Nivon, Magdalena; Keirns, Candace

2006-01-01

35

Aortic obstruction: anatomy and echocardiography  

PubMed Central

Echocardiography is a valuable non-invasive technique for identifying the site and type of aortic obstruction. Knowledge of the morphological details of each type of obstruction is the basis for correct interpretation of the diagnostic images and clinical decisions. This study was undertaken to correlate the echocardiographic images with anatomic specimens of equivalent valvular and supravalvular aortic obstruction. Specimens were part of the collection of the Department of Embryology. Fifty six patients were studied, and forty specimens with aortic obstruction were analyzed. Echocardiographic characteristics: Thirty one (55.3%) patients were women and twenty five (44.7%) men. Valvular aortic obstruction was found in Thirty six patients (64.3 %) and supravalvular aortic obstruction in twenty (35.7%). Anatomic characteristics: Of the forty specimens examined, twenty one (52.5%) had valvular aortic obstruction and nineteen (47.5%) supravalvular aortic obstruction. The anatomoechocardiographic correlation clearly showed that the anatomic findings of the specimen hearts and aortas corresponded to echocardiographic images of valvular and supravalvular aortic obstruction and provided solid corroboration of echocardiographic diagnoses. PMID:17010187

Espinola-Zavaleta, Nilda; Muñoz-Castellanos, Luis; Kuri-Nivon, Magdalena; Keirns, Candace

2006-01-01

36

Important advances in technology: echocardiography.  

PubMed

Echocardiography has evolved over the past 45 years from a simple M-mode tracing to an array of technologies that include two-dimensional imaging, pulsed and continuous wave spectral Doppler, color flow and tissue Doppler, and transesophageal echocardiography. Together, these modalities provide a comprehensive anatomic and functional evaluation of cardiac chambers and valves, pericardium, and ascending and descending aorta. The switch from analog to digital signal processing revolutionized the field of ultrasound, resulting in improved image resolution, smaller instrumentation that allows bedside evaluation and diagnosis of patients, and digital image storage for more accurate quantification and comparison with previous studies. It also opened the door for new advances such as harmonic imaging, automated border detection and quantification, 3-dimensional imaging, and speckle tracking. This article offers an overview of some newer developments in echocardiography and their promising applications. PMID:25574341

Nagueh, Sherif F; Quiñones, Miguel A

2014-01-01

37

Pulsed Wave and Color Doppler Echocardiography and Cardiac Catheterization Findings in Bilateral Pulmonary Vein Stenosis  

Microsoft Academic Search

Pulmonary vein stenosis is a rare condition that usually is congenital in origin; it is almost invariably fatal in its bilateral and severe forms. It is often overlooked, however, during clinical examination, routine echocardiography, and even at cardiac catheterization. This report describes the pulsed Doppler, color flow echocardiography, and hemodynamic findings of bilateral pulmonary vein stenosis that accompany ventricular septal

Jong-Won Ha; Namsik Chung; Junghan Yoon; Yangsoo Jang; Byung-Ok Kim; Seung-Yun Cho; Bum-Koo Cho

1998-01-01

38

Normal adult echocardiography - parasternal views  

PubMed Central

Children with congenital heart disease will grow into adults who may also develop adult heart disease. This article attempts to familiarise practitioners that usually deal with congenital heart disease with the conventional views that are obtained during adult echocardiography. PMID:22368664

Aquilina, O; Felice, H; Fenech, A; Grech, V

2006-01-01

39

Myotubes from Severely Obese Type 2 Diabetic Subjects Accumulate Less Lipids and Show Higher Lipolytic Rate than Myotubes from Severely Obese Non-Diabetic Subjects  

PubMed Central

About 80% of patients with type 2 diabetes are classified as overweight. However, only about 1/3 of severely obese subjects have type 2 diabetes. This indicates that several severely obese individuals may possess certain characteristics that protect them against type 2 diabetes. We therefore hypothesized that this apparent paradox could be related to fundamental differences in skeletal muscle lipid handling. Energy metabolism and metabolic flexibility were examined in human myotubes derived from severely obese subjects without (BMI 44±7 kg/m2) and with type 2 diabetes (BMI 43±6 kg/m2). Lower insulin sensitivity was observed in myotubes from severely obese subjects with type 2 diabetes. Lipolysis rate was higher, and oleic acid accumulation, triacylglycerol content, and fatty acid adaptability were lower in myotubes from severely obese subjects with type 2 diabetes compared to severely obese non-diabetic subjects. There were no differences in lipid distribution and mRNA and protein expression of the lipases HSL and ATGL, the lipase cofactor CGI-58, or the lipid droplet proteins PLIN2 and PLIN3. Glucose and oleic acid oxidation were also similar in cells from the two groups. In conclusion, myotubes established from severely obese donors with established type 2 diabetes had lower ability for lipid accumulation and higher lipolysis rate than myotubes from severely obese donors without diabetes. This indicates that a difference in intramyocellular lipid turnover might be fundamental in evolving type 2 diabetes. PMID:25790476

Bakke, Siril S.; Kase, Eili T.; Moro, Cedric; Stensrud, Camilla; Damlien, Lisbeth; Ludahl, Marianne O.; Sandbu, Rune; Solheim, Brita Marie; Rustan, Arild C.; Hjelmesæth, Jøran; Thoresen, G. Hege; Aas, Vigdis

2015-01-01

40

Echocardiography in Pediatric Pulmonary Hypertension  

PubMed Central

Pulmonary hypertension (PH) can be a rapidly progressive and fatal disease. Although right heart catheterization remains the gold standard in evaluation of PH, echocardiography remains an important tool in screening, diagnosing, evaluating, and following these patients. In this article, we will review the important echocardiographic parameters of the right heart in evaluating its anatomy, hemodynamic assessment, systolic, and diastolic function in children with PH. PMID:25429362

Jone, Pei-Ni; Ivy, D. Dunbar

2014-01-01

41

Echocardiography in Pulmonary Vascular Disease  

Microsoft Academic Search

\\u000a This chapter will focus on the principles and uses of the Doppler echocardiography (DE) examination in patients with pulmonary\\u000a vascular disease (PVD). That is, patients who have pulmonary hypertension that is related to a marked increase in the pulmonary\\u000a vascular resistance (PVR) and loss of large pulmonary artery (PA) compliance. We will also address the role of DE in the

Paul R. Forfia

42

Chloralhydrate in children undergoing echocardiography  

Microsoft Academic Search

Transthoracic echocardiography (TTE) is a painless, noninvasive and risk-free diagnostic method in children with known or\\u000a suspected congenital heart disease. Sedation is frequently required for an optimal achievement of this procedure. The purpose\\u000a of this study was to determine the safety and efficacy of chloral hydrate (CH) sedation in undergoing TTE. The study population\\u000a included 360 patients with a median

Senol Coskun; Hasan Yuksel; Ali Onag

2001-01-01

43

Determination of aortic valve area in valvular aortic stenosis by direct measurement using intracardiac echocardiography: A comparison with the gorlin and continuity equations  

Microsoft Academic Search

Objectives. This study sought to 1) show that intracardiac echocardiography can allow direct measurement of the aortic valve area, and 2) compare the directly measured aortic valve area from intracardiac echocardiography with the calculated aortic valve area from the Gorlin and continuity equations.Background. Intracardiac echocardiography has been used in the descriptive evaluation of the aortic valve; however, direct measurement of

Gary P. Foster; Neil J. Weissman; Michael H. Picard; Phillip J. Fitzpatrick; Samuel J. Shubrooks Jr.; Stuart W. Zarich

1996-01-01

44

Sector-scanning echocardiography  

NASA Technical Reports Server (NTRS)

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.

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

1975-01-01

45

The Dutch experience of open access echocardiography  

PubMed Central

Cardiac disease is not easy to recognise in general practice. An echocardiogram is an excellent way to provide information about left ventricular mass and diastolic (dys)function and the presence of valvular heart disease. To improve diagnostic care of cardiac patients, an open access echocardiography service was established in the referral area of our hospital, where general practitioners were able to ask for an echocardiogram without referring the patient to the cardiologist. Between December 2002 and October 2006 echocardiograms were requested for 471 patients. Thirteen percent of the patients referred for dyspnoea and 3% of patients with a cardiac murmur had a left ventricular ejection fraction <40%. In 28% of patients no cardiac abnormality could be found. If we looked at the prevalence of hypertension in the referred patients, this was very high with a prevalence of up to 60% in the older age groups. If we included hypertension in the analysis, only 16% of patients had no structural cardiac or vascular abnormality. The study shows that the advantage of open access echocardiography in the Netherlands is that the general practitioner is able to make a better diagnosis and unnecessary referrals of patients with suspected cardiac disease can be avoided. (Neth Heart J 2007;15:342-7.18176623) PMID:18176623

Lodewijks-van der Bolt, C.L.B.; Baur, L.H.B.; Lenderink, T.; Guldemond, F.; Nijhof, J.; Winkens, R.; Hundscheid, M.; Stoffers, J.

2007-01-01

46

Oesophageal perforation following perioperative transoesophageal echocardiography.  

PubMed

Transoesophageal echocardiography (TOE) is being used more often by cardiothoracic anaesthetists for the perioperative management of cardiac problems. Reports of iatrogenic oesophageal perforation by instrumentation of the oesophagus are increasing. Although TOE is considered safe, it may be more risky during surgery, because the probe is passed and manipulated in an anaesthetized patient. It may be in place for several hours so the risk of mucosal pressure and thermal damage is increased. Patients on cardiopulmonary bypass are also fully anticoagulated. We describe a case of oesophageal perforation following insertion of the TOE probe in a patient with gross cardiomegaly. Oesophageal distortion by cardiac enlargement may increase the risk of oesophageal perforation. Difficulty in passage of the TOE probe should be regarded with suspicion and withdrawal should be contemplated because the symptoms of oesophageal perforation are often delayed and non-specific. Delay in investigation, diagnosis and treatment will increase morbidity and mortality. PMID:10844846

Massey, S R; Pitsis, A; Mehta, D; Callaway, M

2000-05-01

47

Echocardiography  

MedlinePLUS

... Division of Intramural Research Research Resources Scientific Reports Technology Transfer Clinical Trials What Are Clinical Trials? Children & Clinical Studies NHLBI Trials At NIH Clinical Center ...

48

Speckle tracking echocardiography?- quo vadis?  

PubMed

Although echocardiography is a noninvasive means of visualizing the heart, quantitative and reproducible assessment of myocardial motion remains to be established. Tissue Doppler imaging (TDI) emerged in the early 1990 s as a tool to measure tissue motion velocity. For the purpose of analyzing regional myocardial motion quantitatively, the myocardial velocity gradient (MVG) across the myocardial wall was first introduced by using TDI. MVG is mathematically equal to strain rate. Initially, strain was derived as the time integral of the TDI-derived strain rate, but it revealed substantial errors of measurement, which basically arose from the confusion of Eulerian coordinates with Lagrangian coordinates in fluid dynamics. Speckle tracking echocardiography (STE) has subsequently emerged as a technique that analyzes motion by tracking "speckles" on echocardiograms based on Lagrangian coordinates. Although STE-derived strain is a robust parameter of myocardial deformation, the stress-strain relationship has often been overlooked in the assessment of myocardial function. We should consider (1) blood pressure, (2) left ventricular size, and (3) left ventricular wall thickness, as well as strain. Practical means of normalizing strain by stress should be pursued in the quantitative assessment of myocardial function. Consideration of stress-strain relationships is mandatory when interpreting STE-derived strain. (Circ J 2015; 79: 735-741). PMID:25766514

Uematsu, Masaaki

2015-03-25

49

[Real time 3D echocardiography  

NASA Technical Reports Server (NTRS)

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.

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

2001-01-01

50

Increasing detection of rheumatic heart disease with echocardiography.  

PubMed

Rheumatic heart disease (RHD) is estimated to affect over 20 million people worldwide, the vast majority being in developing countries. Screening for RHD has been recommended by the WHO since 2004. Conventionally, auscultation has been used for diagnosing RHD. Auscultation has its limitation and may not detect mild cases. A large number of studies have reported echocardiographic screening for RHD over the last several years. Most of these studies report an almost 10-fold higher prevalence of RHD by echocardiography as compared to conventional method of auscultation. Early diagnosis of such mild cases may be important as instituting secondary prophylaxis in such cases may reduce the burden of the disease. However, several concerns remain about the significance and natural history of these minor valvular changes detected by echocardiography. Whether secondary prophylaxis will reverse these abnormalities is also unclear. Long term follow up studies are required to answer some of these concerns. PMID:24934495

Saxena, Anita

2014-09-01

51

Interventional imaging: the role of echocardiography.  

PubMed

Interventional echocardiography is a rapidly evolving field requiring imaging expertise. An increasing number of structural heart interventions now require real-time imaging guidance for device placement and immediate functional evaluation. Continuous 2- and 3-dimensional transesophageal echocardiography are now required by many heart teams during complex structural interventions, including percutaneous closure of atrial septal defects, left atrial appendage occlusion, transcatheter aortic valve replacement (TAVR), transcatheter repair of paravalvular regurgitation, and percutaneous mitral valve repair. In this review, we describe the role of echocardiography during the initial structural evaluation, throughout the device placement procedure, and for the assessment of acute device function and complications. PMID:25574345

Maragiannis, Dimitrios; Little, Stephen H

2014-01-01

52

Estimating pulmonary artery pressures by echocardiography in patients with emphysema.  

PubMed

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

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

2007-11-01

53

Transesophageal echocardiography during MitraClip® procedure.  

PubMed

The percutaneous mitral valve (MV) repair procedure performed with the MitraClip delivery system is increasingly used to treat severe mitral regurgitation in high-risk patients. The treatment involves percutaneous insertion and positioning of a clip between the MV leaflets. Transesophageal echocardiography (TEE) plays a key role in the procedure by providing information regarding clip navigation, clip alignment to the MV coaptation line, transmitral advancement of the system, leaflet grasping, confirmation of valve tissue catching, and assessment of the final result. Real-time 3-dimensional TEE has increasing value in percutaneous MV repair providing high-quality visualization of both the heart and the intravascular devices. Optimal visualization by 3-dimensional TEE is obtained through both the atrial and ventricular aspects. In contrast to MV surgery, where TEE is involved in the prebypass assessment phase and in evaluation of the final repair, TEE is mandatory to guide management during MitraClip repair. Cardiac anesthesiologists may provide assistance to interventional cardiologists during the procedure itself in addition to their anesthetic-related tasks. PMID:24842173

Guarracino, Fabio; Baldassarri, Rubia; Ferro, Baldassare; Giannini, Cristina; Bertini, Pietro; Petronio, Anna Sonia; Di Bello, Vitantonio; Landoni, Giovanni; Alfieri, Ottavio

2014-06-01

54

Stress echocardiography: methods, indications and results  

PubMed Central

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

Baur, L.H.B.

2002-01-01

55

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

PubMed

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

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

2008-07-01

56

Update on new technologies in pediatric echocardiography.  

PubMed Central

Advances in ultrasound technology will continue to expand the utility of echocardiography in the assessment of structural and functional cardiac disease in children. Tissue Doppler imaging and dobutamine stress echocardiography are 2 promising clinical applications that are expected to become increasingly used with time. Advances in data compression technology, including JPEG and MPEG techniques, will significantly affect digital archival and transmission of echocardiograms, which also have clinical implications, particularly in the expanding use of telemedicine. Continued research and clinical experience will further define the ultimate roles of these technologies in the future. Images PMID:9456480

Bezold, L I; Lewin, M B; Vick, G W; Pignatelli, R

1997-01-01

57

Ergonovine stress echocardiography: Recent experience and safety in our centre  

PubMed Central

AIM: To study recent experience and safety of ergonovine stress echocardiography in our centre. METHODS: In this study we collected the clinical variables of patients referred since 2002 for ergonovine stress echocardiography, in addition to indications, the results of this test, complications, blood pressure and heart rate values during the test and the number and results of tests requested before this technique. RESULTS: We performed 40 tests in 38 patients, 2 tests were carried out to verify therapy efficacy. The prevalence of classic cardiovascular risk factors was low and the most frequent indication was chest pain (57.5%). Coronary angiography was performed in 32 patients, and showed normal coronary arteries in 27 patients and non-significant stenosis in 5 cases. In 16 patients, coronary angiography was carried out after a positive or inconclusive ischemia test. Another 6 patients had a normal stress test (5 exercise electrocardiography tests and 1 nuclear imaging test). Of the 40 ergonovine stress echocardiography tests, 6 were positive (4 in the right coronary artery territory and 2 in the circumflex coronary artery territory), all of them by echocardiographic criteria, and by electrocardiographic criteria in only 3 (50%). The presence of non-significant coronary artery stenosis was more frequent in patients with positive ergonovine stress echocardiography (50% vs 6%, P = 0.038), and were related to ischemic territory. During the maximum stress stage, there was a higher systolic (130.26 ± 19.17 mmHg vs 136.58 ± 27.27 mmHg, 95% CI: -12.77 to 0.14 mmHg, P = 0.055) and diastolic blood pressure (77.89 ± 13.49 mmHg vs 83.95 ± 15.73 mmHg, 95% CI: -10.41 to -1.69 mmHg, P = 0.008) than at the baseline stage, and the same was registered with heart rate (73 ± 10.96 beats/min vs 79.79 ± 11.72 beats/min, 95% CI: -9.46 to -4.11 beats/min, P < 0.01). Nevertheless, there were only 2 hypertensive reactions during the last stage, which did not force a premature end to the test, without sustained tachy or bradyarrhythmias, and the technique was well tolerated in 58% of cases. A unique complication (2.5%) of this test was a prolonged vasospasm with a slight increase in necrosis biomarkers, however, this was without repercussion. CONCLUSION: Ergonovine stress echocardiography can be performed with safety, is well tolerated in the majority of cases, and is useful for determining the ischemia mechanism in selected cases. PMID:21191545

Cortell, Alejandro; Marcos-Alberca, Pedro; Almería, Carlos; Rodrigo, José L; Pérez-Isla, Leopoldo; Macaya, Carlos; Zamorano, José Luis

2010-01-01

58

The importance of echocardiography in transcatheter aortic valve implantation.  

PubMed

Valvular heart diseases cause serious health problems in Turkey as well as in Western countries. According to a study conducted in Turkey, aortic stenosis (AS) is second after mitral valve disease among all valvular heart diseases. AS is frequently observed in elderly patients who have several cardiovascular risk factors and comorbidities. In symptomatic severe AS, surgical aortic valve replacement (AVR) is a definitive treatment. However, in elderly patients with left ventricular dysfunction and comorbidities, the risk of operative morbidity and mortality increases and outweighs the gain obtained from AVR surgery. As a result, almost one-third of the patients with serious AS are considered ineligible for surgery. Transcatheter aortic valve implantation (TAVI) is an effective treatment in patients with symptomatic severe AS who have high risk for conventional surgery. Since being performed for the first time in 2002, with a procedure success rate reported as 95% and a mortality rate of 5%, TAVI has become a promising method. Assessment of vascular anatomy, aortic annular diameter, and left ventricular function may be useful for the appropriate selection of patients and may reduce the risk of complications. Cardiac imaging methods including 2D and 3D echocardiography and multidetector computed tomography are critical during the evaluation of suitable patients for TAVI as well as during and after the procedure. In this review, we describe the role of echocardiography methods in clinical practice for TAVI procedure in its entirety, i.e. from patient selection to guidance during the procedure, and subsequent monitoring. PMID:24028438

Bilen, Emine; Sari, Cenk; Durmaz, Tahir; Kele?, Telat; Bayram, Nihal A; Akçay, Murat; Ayhan, Hüseyin M; Bozkurt, Engin

2014-01-01

59

Unexpected refractory intra-operative hypotension during non-cardiac surgery: Diagnosis and management guided by trans-oesophageal echocardiography  

PubMed Central

We present a case of severe refractory hypotension in a patient undergoing de-bulking liver resection for massive polycystic liver disease. Emergent trans-oesophageal echocardiography (TOE) revealed dynamic left ventricular outflow tract (LVOT) obstruction with systolic anterior motion (SAM) of the anterior mitral leaflet (AML). Notably, he had a structurally normal heart on pre-operative trans-thoracic echocardiography (TTE). Diagnosis of SAM by TOE, possible mechanisms and specific management of refractory hypotension in this context are discussed. PMID:24700900

Reddy, Sundara; Ueda, Kenichi

2014-01-01

60

Evolving trends in open access echocardiography - experience over eight years  

Microsoft Academic Search

Background The use of open access echocardiography aids early diagnosis and treatment of cardiac conditions by general practitioners (GPs) potentially reducing the burden on secondary care. Increased awareness and advances in treatment are likely to impact on echocardiography demand. Aim To undertake a retrospective review of referrals to an open access echocardiography service and study changes in referral patterns over

Archana Rao; David Henton; John Walsh

61

Prognostic stratification of diabetic patients by exercise echocardiography  

Microsoft Academic Search

OBJECTIVESThe aim of this study was to assess the incremental value of exercise echocardiography for the risk stratification of diabetic patients.BACKGROUNDThere are currently insufficient outcome data in diabetic patients to define the role of stress echocardiography as a prognostic tool.METHODSWe studied the prognostic value of exercise echocardiography in 563 patients with diabetes mellitus (mean age 64 ± 11 years, 336

Abdou Elhendy; Adelaide M Arruda; Douglas W Mahoney; Patricia A Pellikka

2001-01-01

62

Cardiac tumor biopsy under the guidance of intracardiac echocardiography.  

PubMed

Transthoracic echocardiography or transesophageal echocardiography is sometimes useful in intracardiac tumor biopsy. Intracardiac echocardiography was used as an alternative to either of these for performing a biopsy of a right cardiac tumor in a 79-year-old woman. The procedure was well tolerated and no complications occurred. Histopathological findings and immunohistological staining were compatible with the diagnosis of neurogenic sarcoma. PMID:10952166

Oishi, Y; Okamoto, M; Sueda, T; Hashimoto, M; Karakawa, S; Akita, T; Ohkura, M

2000-08-01

63

Echocardiography in the treatment of hypertrophic cardiomyopathy  

Microsoft Academic Search

Echocardiography is the best technique to diagnose, evaluate, follow-up and guide the treatment of hypertrophic cardiomyopathy (HCM). Diagnosis of HCM depends on left ventricular wall thickness ?15 mm. Also noted are mitral valve systolic anterior motion, an- teriorly positioned mitral valve leaflet coaptation, anomalous anterior insertion of papillary muscles, and diastolic dysfunction. Resting left ventricular outflow tract (LVOT) gradient occurs

Dan Musat; Mark V. Sherrid

2006-01-01

64

Determination of cardiac output by Doppler echocardiography  

Microsoft Academic Search

Cardiac output determined by Doppler echocardiography was compared with that determined by thermodilution at rest and during dobutamine infusion in 10 patients (group A) and by the Fick method at rest in 11 patients (group B). All patients had angina pectoris without valvular heart disease. Maximum spatial blood velocity and cross sectional aortic area were estimated by the Doppler technique

H Ihlen; J P Amlie; J Dale; K Forfang; S Nitter-Hauge; J E Otterstad; S Simonsen; E Myhre

1984-01-01

65

Effect of ?-blockade on dobutamine stress echocardiography  

Microsoft Academic Search

Dobutamine is an effective pharmacologic stress used in conjunction with echocardiography because of its ?-agonist properties. Concurrent ?-blockade might after this effectiveness; however, current clinical experience has been variable. The purpose of this study is to determine whether concurrent ?-blockade alters the ability of a dobutamine stress echocardiogram to detect a fixed coronary stenosis by preventing the onset of a

Neil J. Weissman; Michael W. Levangie; J. Luis Guerrero; Arthur E. Weyman; Michael H. Picard

1996-01-01

66

[Acute post-traumatic aortic insufficiency: transesophageal echocardiography in the diagnosis and therapy of the lesions].  

PubMed

A 58-year-old car driver suffered a road accident responsible for severe blunt thoraco-abdominal trauma. Transoephageal echocardiography, performed following the secondary development of a diastolic murmur, confirmed the presence of aortic incompetence due to commissural avulsion and guided the surgical treatment, which consisted of commissural suspension under cardiopulmonary bypass via a mini transverse trans-sternal incision. The rarity of acute aortic valve incompetence following non-penetrating thoracic trauma is illustrated by the data of the literature. This lesion is due to either avulsion of a sigmoid cusp or commissure, or laceration of the valvular tissue. Transthoracic echocardiography confirms the reality of aortic incompetence suggested clinically by appearance of a diastolic murmur, but confirmation of the mechanism of the lesions is based on transoesophageal echocardiography which allows perfectly safe and rapid visualization of the mechanism of the valvular lesion, investigation of associated lesions and guidance of therapeutic management. PMID:9809140

Brandstätt, P; Carlioz, R; Fontaine, B; Hémery, Y; Pats, B; Chapuis, O; Lang-Lazdunsky, L; Jancovici, R; Burlaton, J P; Hvass, U

1998-10-01

67

Use of transoesophageal echocardiography in management of penetrating cardiac injury.  

PubMed

A 53-year-old man who sustained an accidental cardiac nail gun injury presented to us in haemodynamically stable condition. He had an urgent plain radiograph film and contrast CT scan to determine the exact position of the nail. CT showed the nail to be in juxtacardiac position but did not give any conclusive information about breach of pericardium or myocardial wall. An intra-operative transoesophageal echocardiography was done to determine the exact position of the nail. It clearly delineated the position of the nail and guided us towards median sternotomy and removal of nail under direct vision safely. PMID:17644486

Parasramka, S V; Ghotkar, S; Kendall, J; Fabri, B M

2008-07-01

68

Mechanical prosthetic valve-associated strands: Pathologic correlates to transesophageal echocardiography  

Microsoft Academic Search

Echocardiographic detection of prosthetic valve-associated strands has previously been reported, but their clinical relevance is unclear. Limited data are available regarding the cause, composition, and natural history of these strands. This report presents the gross and histopathologic findings of an explanted mechanical prosthetic valve shown by transesophageal echocardiography to have several strands. The patient had not experienced prior neurologic symptoms.

John D. Rozich; William D. Edwards; Richard D. Hanna; Dawn M. Laffey; Gilbert H. Johnson; Kyle W. Klarich

2003-01-01

69

The role of 3D and speckle tracking echocardiography in cardiac amyloidosis: a case report.  

PubMed

Cardiac amyloidosis (CA) is a disorder characterized by amyloid fibrils deposition in cardiac interstitium; it results in a restrictive cardiomyopathy with heart failure (HF) and conduction abnormalities. The "gold standard" for diagnosis of CA is myocardial biopsy but possible sampling errors and procedural risks, limit it's use. Magnetic resonance (RMN) offers more information than traditional echocardiography and allows diagnosis of CA but often it's impossible to perform. We report the case of a man with HF and symptomatic bradyarrhythmia that required an urgent pacemaker implant. Echocardiography was strongly suggestive of CA but wasn't impossible to perform an RMN to confirm this hypothesis because the patient was implanted with a definitive pacemaker. So was performed a Speckle Tracking Echocardiography (STE) and a 3D echocardiography: STE allows to differentiate CA from others hypertrophic cardiomyopathy by longitudinal strain value < 12% and 3D echocardiography shows regional left ventricular dyssynchrony with a characteristic temporal pattern of dispersion of regional volume systolic change. On the basis of these results, finally was performed an endomyocardial biopsy that confirmed the diagnosis of CA. This case underlines the importance of news, noninvasive techniques such as eco 3D and STE for early diagnosis of CA, especially when RMN cannot be performed. PMID:24452946

Nucci, E M; Lisi, M; Cameli, M; Baldi, L; Puccetti, L; Mondillo, S; Favilli, R; Lunghetti, S

2014-01-01

70

Role of modern 3D echocardiography in valvular heart disease  

PubMed Central

Three-dimensional (3D) echocardiography has been conceived as one of the most promising methods for the diagnosis of valvular heart disease, and recently has become an integral clinical tool thanks to the development of high quality real-time transesophageal echocardiography (TEE). In particular, for mitral valve diseases, this new approach has proven to be the most unique, powerful, and convincing method for understanding the complicated anatomy of the mitral valve and its dynamism. The method has been useful for surgical management, including robotic mitral valve repair. Moreover, this method has become indispensable for nonsurgical mitral procedures such as edge to edge mitral repair and transcatheter closure of paravaluvular leaks. In addition, color Doppler 3D echo has been valuable to identify the location of the regurgitant orifice and the severity of the mitral regurgitation. For aortic and tricuspid valve diseases, this method may not be quite as valuable as for the mitral valve. However, the necessity of 3D echo is recognized for certain situations even for these valves, such as for evaluating the aortic annulus for transcatheter aortic valve implantation. It is now clear that this method, especially with the continued development of real-time 3D TEE technology, will enhance the diagnosis and management of patients with these valvular heart diseases. PMID:25378966

2014-01-01

71

Intracardiac echocardiography-guided transcatheter aortic valve replacement.  

PubMed

Echocardiographic imaging is an essential component of successful transcatheter aortic valve replacement (TAVR). Currently, transesophageal echocardiography (TEE) is the imaging modality of choice for TAVR. However, a limitation of TEE is the need for general anesthesia and endotracheal intubation in most centers. Additionally, the TEE probe can obscure fluoroscopic views during valve positioning and deployment. Intracardiac echocardiography (ICE) has been used for imaging guidance for structural and valvular intervention, though its use has rarely been reported for primary imaging guidance during TAVR. Recently, a new volumetric three-dimensional intracardiac ultrasound (volume ICE) system has become available with the potential for improved visualization of intracardiac structures. We describe a recent TAVR case that was successfully performed with the use of volume ICE exclusively for imaging guidance. We found that assessment of valve positioning and aortic insufficiency were comparable to that provided by conventional TEE imaging, though there were several important limitations. ICE-guided TAVR may represent an important alternative to TEE for TAVR imaging guidance and possibly allow for less-intensive sedation or anesthesia. © 2014 Wiley Periodicals, Inc. PMID:24478152

Kadakia, Mitul B; Silvestry, Frank E; Herrmann, Howard C

2015-02-15

72

Mining Echocardiography Workflows for Disease Discriminative Patterns  

PubMed Central

Objective To provide quick diagnostic insights to medical practitioners into echocardiograms by only analyzing the echocardiogram workflows (defined as the sequence of modalities examined). Methods We define a dictionary of workflows, called subflows, which are commonly encountered in echocardiography workflows but are mutually exclusive. We represent each workflow as a mixture of dictionary subflows and learn discriminative models for various cardiac diseases using Support Vector Machines. Using these discriminative models, we can predict occurrences of diseases for any, yet unseen, echocardiogram workflow. Results Working with a corpus of 2300 echocardiograms workflows, we build a dictionary of 172subflows. Using the associated reports (expert created) we identify the ground-truth diagnoses. We then build discriminative models for 7 different cardiac diseases. Using just the workflow as input, these models can predict diseases on average with over 75% accuracy. Conclusions Mining collection of echocardiography workflows, for the first time, we are able to predict diseases without even looking at the image contents. PMID:24551377

Kumar, Ritwik; Syeda-Mahmood, Tanveer; Beymer, David; Compas, Colin; Brannon, Karen

2013-01-01

73

Coronary flow reserve assessment by dobutamine transesophageal doppler echocardiography  

Microsoft Academic Search

Objectives. This study attempted to determine the sensitivity and specificity of coronary flow reserve derived using transesophageal echocardiography for left anterior descending coronary artery stenosis.Background. Transesophageal echocardiography can be used to measure coronary flow velocity and may provide a less invasive means of assessing coronary flow reserve.Methods. Seventy-eight adult patients were studied by pulsed Doppler transesophageal echocardiography of the proximal

Marcus F. Stoddard; Charles R. Prince; Glenn T. Morris

1995-01-01

74

Intraoperative transesophageal echocardiography for surgical repair of mitral regurgitation.  

PubMed

Surgical repair of the mitral valve is being increasingly performed to treat severe mitral regurgitation. Transesophageal echocardiography is an essential tool for assessing valvular function and guiding surgical decision making during the perioperative period. A careful and systematic transesophageal echocardiographic examination is necessary to ensure that appropriate information is obtained and that the correct diagnoses are obtained before and after repair. The purpose of this article is to provide a practical guide for perioperative echocardiographers caring for patients undergoing surgical repair of mitral regurgitation. A guide to performing a systematic transesophageal echocardiographic examination of the mitral valve is provided, along with an approach to prerepair and postrepair assessment. Additionally, the anatomy and function of normal and regurgitant mitral valves are reviewed. PMID:24534653

Sidebotham, David Andrew; Allen, Sara Jane; Gerber, Ivor L; Fayers, Trevor

2014-04-01

75

[Digital revolution in the echocardiography laboratory. Current status and future perspectives] .  

PubMed

Echocardiography is changing from an operative modality in which most images are stored in analog fashion on videotape into one with most data stored digitally. This transition is accelerating today, fueled by several factors. First, there is widespread recognition of the value of digital storage of echocardiograms, including random access to studies as well as to images within a study, side-by-side comparison with prior studies, easier quantification, and multiplication and remote transmission of images without degradation. Second, continuous improvement of the cost/performance ratio of modern computers makes routine digital echocardiography both feasible and affordable. Finally, the formulation and acceptance within the industry of the DICOM image formatting standard for echocardiography. The acceptance of this standard allows the echo-labs around the world to be free to choose individual echo-machines on the basis of their individual merits for their laboratories with the assurance that these machines will be able to communicate with each other by an internationally agreed upon standard. Advantages of digital echocardiography are overwhelming and there is little doubt that this approach will be essential for the proper utilization of this technique. The technology will undoubtedly continue to change. Those who are waiting for it to be perfected may be waiting for a long time. PMID:11221585

Badano, L P; Di Chiara, A; Werren, M; Sabbadini, C; Fioretti, P M

2000-12-01

76

Pulmonary hypertension: prevalence and mortality in the Armadale echocardiography cohort  

PubMed Central

Background Pulmonary hypertension (PHT) lacks community prevalence and outcome data. Objective To characterise minimum ‘indicative’ prevalences and mortality data for all forms of PHT in a selected population with an elevated estimated pulmonary artery systolic pressure (ePASP) on echocardiography. Design Observational cohort study. Setting Residents of Armadale and the surrounding region in Western Australia (population 165?450) referred to our unit for transthoracic echocardiography between January 2003 and December 2009. Results Overall, 10?314 individuals (6.2% of the surrounding population) had 15?633 echo studies performed. Of these, 3320 patients (32%) had insufficient TR to ePASP and 936 individuals (9.1%, 95% CI 8.6% to 9.7%) had PHT, defined as, ePASP>40?mm?Hg. The minimum ‘indicative’ prevalence for all forms of PHT is 326 cases/100?000 inhabitants of the local population, with left heart disease-associated PHT being the commonest cause (250 cases/100?000). 15 cases of pulmonary arterial hypertension/100?000 inhabitants were identified and an additional 144 individuals (15%) with no identified cause for their PHT. The mean time to death for those with ePASP >40?mm?Hg, calculated from the first recorded ePASP, was 4.1?years (95% CI 3.9 to 4.3). PHT increased mortality whatever the underlying cause, but patients with PHT from left heart disease had the worst prognosis and those with idiopathic pulmonary arterial hypertension receiving disease-specific treatment the best prognosis. Risk of death increased with PHT severity: severe pulmonary hypertension shortened the lifespan by an average of 1.1?years compared with mild pulmonary hypertension. Conclusions In this cohort, PHT was common and deadly. Left heart disease was the most common cause and had the worst prognosis and treated pulmonary arterial hypertension had the best prognosis. PMID:22760869

Strange, Geoff; Stewart, Simon; Deague, Jenny A; Nelson, Helen; Kent, Aaron; Gabbay, Eli

2012-01-01

77

Measurement of Thrombus Flux Using Transesophageal Echocardiography  

NASA Astrophysics Data System (ADS)

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.

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

2006-05-01

78

Technical achievement: transthoracic Doppler echocardiography can be used to detect LAD restenosis after coronary angioplasty.  

PubMed

We investigated the capability of transthoracic Doppler echocardiography (TTE) to detect and quantify the severity of restenosis in the left anterior descending coronary artery (LAD) after percutaneous transluminal coronary angioplasty (PTCA). We studied 10 consecutive patients assigned for quantitative coronary angiography (qCA) due to a recurrent angina pectoris after PTCA of the LAD. The LAD was visualized by TTE, and the presence of local turbulence and an increase in the blood flow velocity was regarded to indicate coronary stenosis. To assess the severity of the stenosis, the increase of blood flow velocity was measured. Angiography showed stenoses of various degrees (27-100%) in all patients. All stenoses were detectable using TTE. Moreover, the ratio of maximal blood flow velocity at the site of stenosis to the pre-stenotic blood flow velocity (M/P-ratio) correlated significantly with the reduction of the luminal diameter of LAD (r = 0.85, P < 0.003). A M/P-ratio higher than 3.0 predicted a diameter reduction of 50% or higher with sensitivity and specificity of 100% in patients with a subtotal stenosis (n = 9). Our results indicate that stenoses in the LAD could be found and the severity of the stenoses could be quantified reliably with TTE. This approach is totally non-invasive and less expensive than coronary angiography and can be used clinically in clarifying restenosis after coronary angioplasty. PMID:11100389

Saraste, M; Koskenvuo, J W; Mikkola, J; Pelttari, L; Toikka, J O; Hartiala, J J

2000-11-01

79

Three-dimensional transesophageal echocardiography in tumors of the heart.  

PubMed

Three-dimensional echocardiography was used to study 5 women, 4 with intracardiac tumors and 1 with a paracardial neoplasia. Three-dimensional transesophageal echocardiography was found to be a valuable way to define the morphologic and spatial characteristics of cardiac and paracardial tumors in vivo, establish their relationships with adjacent structures, and assess the hemodynamic effects they can produce. PMID:12221415

Espinola-Zavaleta, Nilda; Morales, Gunther Hernández; Vargas-Barrón, Jesús; Keirns, Candace; Fraustro, Alberto Aranda

2002-09-01

80

Three-dimensional transesophageal echocardiography in tumors of the heart  

Microsoft Academic Search

Three-dimensional echocardiography was used to study 5 women, 4 with intracardiac tumors and 1 with a paracardial neoplasia. Three-dimensional transesophageal echocardiography was found to be a valuable way to define the morphologic and spatial characteristics of cardiac and paracardial tumors in vivo, establish their relationships with adjacent structures, and assess the hemodynamic effects they can produce. (J Am Soc Echocardiogr

Nilda Espinola-Zavaleta; Gunther Hernández Morales; Jesús Vargas-Barrón; Candace Keirns; Alberto Aranda Fraustro

2002-01-01

81

IMAGE ANALYSIS OF DOPPLER ECHOCARDIOGRAPHY FOR PATIENTS WITH ATRIAL FIBRILLATION  

E-print Network

IMAGE ANALYSIS OF DOPPLER ECHOCARDIOGRAPHY FOR PATIENTS WITH ATRIAL FIBRILLATION Oron Shechner(1, Tel Aviv University, Tel-Aviv, Israel 69978 (2)The Neufeld Cardiac Research Institute, Sheba Medical from Doppler Echocardiography images. Currently, manual methods are subject to large inter- and intra

Greenspan, Hayit

82

[Evaluation of myocardial perfusion using intravenous contrast echocardiography].  

PubMed

The aim of the study was to assess the accuracy of rest myocardial contrast echocardiography (MCE) in detecting perfusion abnormalities after intravenous contrast administration in chronic coronary artery disease. In 21 patients (mean age 49 years) contrast agent was injected intravenously. ATL HDI 5000 ultrasound machine was used. Triggering every fifth cardiac cycle in end-systole apical 2-chamber, 3-chamber and 4-chamber views were used. All patients underwent thallium scintigraphy on the same day and coronary angiography was performed within 24 hours. Second harmonic imaging and power Doppler were used in assessing presence or absence of perfusion, localization and extent of perfusion defects, and their relation with wall motion. In the first group all the 13 patients after myocardial infarction had akinetic segments on echocardiography in accordance with the coronary occlusion detected by coronary angiography. In the second group none of the 8 patients without previous myocardial infarction had wall motion abnormality. Group I: dividing the left ventricle into 16 segments out of 208 segments 44 were akinetic. Perfusion defect was detected by MCE in 29 segments. In 12 segments with wall motion abnormality the normal myocardial perfusion was consistent with viable myocardium, 2 inferior akinetic segments could not be evaluated due to contrast attenuation and in one inferior segment MCE in contrast to the thallium scintigraphy showed no perfusion defect. Group II: good contrast effect was detected in all 128 segments except one inferior segment in which there was a fixed perfusion defect also by thallium scintigraphy and coronary angiography revealed occluded right coronary artery. In conclusion MCE and second harmonic triggered imaging is comparable with thallium scintigraphy in detecting fixed perfusion abnormalities. MCE may contribute to the detection of viable myocardium. PMID:11111385

Nagy, A; Temesvári, A; Pártos, O; Lengyel, M

2000-11-01

83

Comparative value of Doppler echocardiography and cardiac catheterization in the decision to operate on patients with aortic stenosis  

Microsoft Academic Search

With the use of Doppler echocardiography, severity of valvular stenosis, etiology and type of valve lesions, and left ventricular function can be assessed accurately in patients with aortic stenosis. The purpose of this study was to compare the value of noninvasive clinical and Doppler echocardiographic findings, with cardiac catheterization, in the management decision-making for patients with aortic stenosis. One hundred

Laurent Leborgne; Christophe Tribouilloy; Akli Otmani; Marcel Peltier; Jean-Luc Rey; Jean-Philippe Lesbre

1998-01-01

84

Cardiac stroke volume during exercise measured by Doppler echocardiography: comparison with the thermodilution technique and evaluation of reproducibility  

Microsoft Academic Search

Cardiac stroke volume was measured simultaneously by Doppler echocardiography and thermodilution in patients with severe coronary artery disease. One group (20 patients) was examined during supine exercise at 25 W and a second group (20 patients) during sitting exercise at 25 W and 50 W. In a third group (10 patients) the reproducibility of the non-invasive stroke volume estimate was

H Ihlen; K Endresen; S Golf; S Nitter-Hauge

1987-01-01

85

Estimation of aortic valve effective orifice area by Doppler echocardiography: effects of valve inflow shape and flow rate  

Microsoft Academic Search

BackgroundThe effective orifice area (EOA) is the standard parameter for the clinical assessment of aortic stenosis severity. It has been reported that EOA measured by Doppler echocardiography does not necessarily provide an accurate estimate of the cross-sectional area of the flow jet at the vena contracta, especially at low flow rates. The objective of this study was to test the

Damien Garcia; Philippe Pibarot; Champlain Landry; Amélie Allard; Boris Chayer; Jean G Dumesnil; Louis-Gilles Durand

2004-01-01

86

The use of fatty acid methyl ester analysis (FAME) for the identification of heterotrophic bacteria present on three mural paintings showing severe damage by microorganisms  

Microsoft Academic Search

Mural paintings in Carmona (Spain), Herberstein (Austria) and Greene (Germany), showing visible deterioration by microorganisms, were sampled to investigate the biodiversity of the heterotrophic bacteria present. Four hundred twenty-eight bacterial strains were isolated from which 385 were characterized by fatty acid methyl ester analysis (FAME). The isolates were grouped into 41 clusters on the basis of their FAME profiles, 20

J Heyrman; J Mergaert; R Denys; J Swings

1999-01-01

87

Paediatric cardiac telemedicine--transmitting echocardiography images in Wales.  

PubMed

We started a telemedicine service for paediatric cardiology work in 2006, enabling transmission of echocardiography images via videoconferencing equipment to the specialist paediatric cardiac department at Cardiff for review and/or diagnosis. The system has been used regularly for a range of paediatric cardiology cases. Despite increasing the transmission bandwidth to 1 Mbit/s the transmission of live echocardiography was still considered to be suboptimum. Nonetheless, the implementation of a simple telemedicine service has demonstrated the feasibility of transmitting echocardiography images via videoconferencing equipment for diagnosis and second opinions. PMID:20511574

Lewis, Delyth; Morris, Sheryl; Uzun, Orhan; Tranter, Glynis

2010-01-01

88

Monitoring male canoeists' cardiac function by Doppler-echocardiography during heavy load exercise  

NASA Astrophysics Data System (ADS)

This study is to evaluate cardiac systolic and diastolic function of Chinese male canoeists during heavy load exercise training by Doppler echocardiography. Eighteen young male volunteer canoeists were tested, and trained five weeks. Then the change of cardiac systolic and diastolic function of the tester was examined by the Doppler echocardiography method.The results showed that there were no significant differences of LVEF and ?%D, but the E/A ratio of elite canoeists reduced (p<0.05) after the heavy load exercise training. Moreover, the ratio of E/A less than 1 was found in two elite canoeists. The further research is required to understand the mechanism of the change. These results showed that monitoring of diastolic function was more meaningful than monitoring of systolic function during the heavy load exercise training, especially not neglected the cardiac function of elite canoeists.

Xu, Guodong; Tan, Huan; Mao, Zongzhen

2007-05-01

89

Clinical application and laboratory protocols for performing contrast echocardiography  

PubMed Central

Technically difficult echocardiographic studies with suboptimal images remain a significant challenge in clinical practice despite advances in imaging technologies over the past decades. Use of microbubble ultrasound contrast for left ventricular opacification and enhancement of endocardial border detection during rest or stress echocardiography has become an essential component of the operation of the modern echocardiography laboratory. Contrast echocardiography has been demonstrated to improve diagnostic accuracy and confidence across a range of indications including quantitative assessment of left ventricular systolic function, wall motion analysis, and left ventricular structural abnormalities. Enhancement of Doppler signals and myocardial contrast echocardiography for perfusion remain off-label uses. Implementation of a contrast protocol is feasible for most laboratories and both physicians and sonographers will require training in contrast specific imaging techniques for optimal use. Previous concerns regarding the safety of contrast agents have since been addressed by more recent data supporting its excellent safety profile and overall cost-effectiveness. PMID:23809394

Chong, Adrian; Haluska, Brian; Wahi, Sudhir

2013-01-01

90

Low-dose dobutamine gated single-photon emission tomography: comparison with stress echocardiography.  

PubMed

Perfusion scintigraphy provides important information regarding the presence of viable tissue after myocardial infarction. Defects of moderate severity, however, may represent viable myocardium, necrotic tissue or a mixture of both. In this study the presence or absence of inotropic response in the infarcted area was assessed by low-dose dobutamine tetrofosmin gated single-photon emission tomography (LDD gated SPET). Results were compared with those obtained with stress echocardiography (SE). Twenty-five patients with acute myocardial infarction were studied. Gated SPET myocardial perfusion imaging was performed 60 min after the injection of technetium-99m tetrofosmin (925 MBq) at rest using a triple-headed camera equipped with focussing collimators (Cardiofocal). Two consecutive acquisitions were performed according to a "fast" gated SPET protocol (3x20 stops, 9 s/stop, 64x64 pixel matrix, zoom 1.23) with the subjects remaining in the same position. The first acquisition was obtained at rest; the second acquisition was obtained under infusion of 10 microg kg(-1) min(-1) dobutamine. The severity of regional dysfunction, wall thickening severity (WTsev), was assessed and quantified using a method based on circumferential profile analysis. SE was performed at rest and during infusion of 5 and 10 microg kg(-1) min(-1) dobutamine. Two patients could not be analysed because of disturbing gastro-intestinal activity on the perfusion study. Under dobutamine 11 patients presented a significant change in WTsev (three showed normalisation, five an improvement and three a deterioration), while in 12 patients the WTsev score remained unchanged. The overall concordance between LDD gated SPET and SE was 83%. In patients with perfusion defects of moderate severity the concordance was 90% (9/10). It may be concluded that functional changes in infarcted areas induced by dobutamine can be detected with gated SPET. Good agreement was observed between LDD gated SPET and SE for the identification of inotropic reserve in infarcted areas. PMID:10805114

Everaert, H; Vanhove, C; Franken, P R

2000-04-01

91

Simultaneous analysis of wall motion and coronary flow reserve of the left anterior descending coronary artery by transthoracic doppler echocardiography during dipyridamole stress echocardiography  

Microsoft Academic Search

BackgroundCoronary flow reserve (CFR) can be measured in the left anterior descending artery (LAD) by dipyridamole transthoracic Doppler echocardiography (DTTDE). This information may critically improve the diagnostic accuracy of dipyridamole stress echocardiography, which is limited by moderate sensitivity.

Jorge Lowenstein; Cristian Tiano; Gustavo Marquez; Cecilia Presti; Cristina Quiroz

2003-01-01

92

Anatomical M-mode: A novel technique for the quantitative evaluation of regional wall motion analysis during dobutamine echocardiography.  

PubMed

Recognition of abnormal wall motion during dobutamine echocardiography requires an expert observer. Anatomical M-mode echocardiography may offer a novel quantitative approach to interpretation, amenable to less expert readers. We studied the application of this new modality to 124 patients (80 with known coronary anatomy and 44 patients at low probability of coronary disease) who underwent dobutamine echocardiography, using a standard protocol. Wall motion was interpreted by an experienced reader, using digitally stored 2-dimensional echocardiographic images at rest and peak stress. Percentage of systolic thickening was measured offline using anatomical M-mode echocardiography in the basal and mid segments at rest and peak dose, and compared with wall motion scores and coronary angiography. Of 729 segments, wall motion was identified as normal in 449, ischemic or viable in 171 and showed resting WM abnormalities only in 109 segments. After exclusion of the apex, anatomical M-mode measurements were feasible in 729 of 960 possible basal- and mid-zone segments (76%). Measurement of systolic thickening at peak dose was reproducible within (r2 = 0.83) and between observers (r2 = 0.93). Systolic thickening was significantly greater in segments with normal wall motion (37 +/- 2%) compared with ischemic or viable segments (30 +/- 2%, p < 0.001), and scar segments (23 +/- 3%, p < 0.001). There was an increment of thickening from rest to stress in normal and viable segments, no change in scar, and a decrement in ischemic segments. Significant coronary artery disease (defined by stenoses >70% diameter) was present in 59 patients. Systolic thickening showed significant variation between segments interpreted by wall motion scoring and angiography as true and false positive and true and false negative (p < 0.05). Measurement of systolic thickening using anatomical M-mode echocardiography offers an objective method to quantify systolic thickening at dobutamine echocardiography but has limited clinical feasibility. PMID:11219596

Chan, J; Wahi, S; Cain, P; Marwick, T H

2000-08-01

93

Multidimensional visualization in echocardiography: an introduction.  

PubMed

X-ray films depict three-dimensional objects as shadows in a two-dimensional plane; thus, objects become superimposed. Computed tomography and other types of tomographic imaging, such as ultrasonography, acquire two-dimensional images of a material property within a thin slice. Sequential adjacent two-dimensional tomograms can be used to construct three-dimensional displays of objects. Visualization, a field of computer science, enables scientists to measure image attributes (extraction of features), identify features (classification), separate objects from one another (segmentation), and produce comprehensible, information-dense images from three-dimensional data sets (rendering). A three-dimensional rendering of the heart can be used to represent only one component of the heart, such as the atrial septum or the ventricular chamber, and can be shaded or colored to enhance comprehension. Three-dimensional images rendered sequentially over time result in a dynamic four-dimensional display. This report describes multidimensional visualization of objects and tissues and specifically discusses examples from echocardiography. PMID:8474263

Greenleaf, J F; Belohlavek, M; Gerber, T C; Foley, D A; Seward, J B

1993-03-01

94

Real-time three-dimensional echocardiography: technological gadget or clinical tool?  

PubMed

The complex anatomy of cardiac structures requires three-dimensional spatial orientation of images for a better understanding of structure and function, thereby improving image interpretation. Real-time three-dimensional echocardiography is a recently developed technique based on the design of an ultrasound transducer with a matrix array that rapidly acquires image data in a pyramidal volume. The simultaneous display of multiple tomographic images allows three-dimensional perspective and the anatomically correct examination of any structure within the volumetric image. As a consequence, it is less operator-dependent and hence more reproducible. Dedicated software systems and technologies are based on high-performance computers designed for graphic handling of three-dimensional images by providing possibilities beyond those obtainable with echocardiography. This methodology allows simultaneous display of multiple superimposed planes in an interactive manner as well as a quantitative assessment of cardiac volumes and ventricular mass in a three-dimensional format without a pre-established assumption of cardiac chamber geometry. In addition, myocardial contraction and/or perfusion abnormalities are clearly identified. Finally, real-time three-dimensional colour Doppler flow mapping enables complete visualisation of the regurgitant jet and new ways of assessing regurgitant lesion severity. Thus, this technique expands the abilities of non-invasive cardiology and may open new doors for the evaluation of cardiac diseases. In this article, current and future clinical applications of real-time three-dimensional echocardiography are reviewed. PMID:17312431

Badano, Luigi P; Dall'Armellina, Erica; Monaghan, Mark J; Pepi, Mauro; Baldassi, Mara; Cinello, Margherita; Fioretti, Paolo M

2007-03-01

95

Validation of an automatic tool for the assessment of image quality in digital tele-echocardiography.  

PubMed

We investigated a novel tool for assessing image degradation in tele-echocardiography. Different video recordings from an echocardiographic examination were transmitted using commercial videoconferencing equipment via a local area network. Different compression schemes were selected, ranging from MPEG 1 to MPEG 4, with transmission at different bit rates ranging from 1.0 to 4.5 Mbit/s. Three methods were used to compare the transmitted and received video sequences: the peak signal to noise ratio, the Double Stimulus Impairment Scale (DSIS) and the National Telecommunication and Information Administration Virtual Quality Metric (VQM). The results showed that the most useful grading procedure was the subjective DSIS. There was a high correlation between the DSIS results and the VQM. The VQM could be thus an effective tool for evaluating tele-echocardiography transmission systems, avoiding the costs and times associated with conducting subjective tests in repeatable conditions. PMID:18852313

Giansanti, Daniele; Giordano, Andrea; Morelli, Sandra

2008-01-01

96

Speckle reduction in echocardiography by temporal compounding and anisotropic diffusion filtering  

NASA Astrophysics Data System (ADS)

Echocardiography is a medical imaging technique based on ultrasound signals that is used to evaluate heart anatomy and physiology. Echocardiographic images are affected by speckle, a type of multiplicative noise that obscures details of the structures, and reduces the overall image quality. This paper shows an approach to enhance echocardiography using two processing techniques: temporal compounding and anisotropic diffusion filtering. We used twenty echocardiographic videos that include one or three cardiac cycles to test the algorithms. Two images from each cycle were aligned in space and averaged to obtain the compound images. These images were then processed using anisotropic diffusion filters to further improve their quality. Resultant images were evaluated using quality metrics and visual assessment by two medical doctors. The average total improvement on signal-to-noise ratio was up to 100.29% for videos with three cycles, and up to 32.57% for videos with one cycle.

Giraldo-Guzmán, Jader; Porto-Solano, Oscar; Cadena-Bonfanti, Alberto; Contreras-Ortiz, Sonia H.

2015-01-01

97

Need for a standardized protocol for stress echocardiography in provoking subaortic and valvular gradient in various cardiac conditions  

PubMed Central

(Semi) supine exercise testing has an established role in the evaluation of patients with valvular heart disease and can help clinical decision making. Stress echocardiography has the advantages of its wide availability, low cost, and versatility for the assessment of disease severity. However, exercise-induced changes in valve hemodynamics, left ventricular outflow obstruction and pulmonary artery pressure depended on load variation. Changing position from supine to upright rapidly decreases load conditions for the ventricles. Therefore several cardiac centers have proposed exercise stress echocardiography in the upright position with gradient monitoring sometimes also in post-exercise recovery. Doppler measurement of subaortic gradient has been a very helpful and informative examination in several heart diseases (especially in hypertrophic cardiomyopathy, valve heart diseases, prosthesis dysfunction). PMID:25017422

2014-01-01

98

Visualization of elusive structures using intracardiac echocardiography: Insights from electrophysiology  

PubMed Central

Electrophysiological mapping and ablation techniques are increasingly used to diagnose and treat many types of supraventricular and ventricular tachycardias. These procedures require an intimate knowledge of intracardiac anatomy and their use has led to a renewed interest in visualization of specific structures. This has required collaborative efforts from imaging as well as electrophysiology experts. Classical imaging techniques may be unable to visualize structures involved in arrhythmia mechanisms and therapy. Novel methods, such as intracardiac echocardiography and three-dimensional echocardiography, have been refined and these technological improvements have opened new perspectives for more effective and accurate imaging during electrophysiology procedures. Concurrently, visualization of these structures noticeably improved our ability to identify intracardiac structures. The aim of this review is to provide electrophysiologists with an overview of recent insights into the structure of the heart obtained with intracardiac echocardiography and to indicate to the echo-specialist which structures are potentially important for the electrophysiologist. PMID:15253772

Szili-Torok, T; McFadden, EP; Jordaens, LJ; Roelandt, JRTC

2004-01-01

99

Transesophageal Echocardiography during Pulmonary Vein Cryoballoon Ablation for Atrial Fibrillation.  

PubMed

We describe our first 20 cases of cryoablation of atrial fibrillation (AF) using transesophageal echocardiography (TEE). Continuous procedural monitoring with TEE by a cardiologist and senior sonographer assists the electrophysiologist in performance of the cryoballoon procedure of AF. Previously using intracardiac echocardiography (ICE) we have found TEE to have better overall procedural imaging, and monitoring for pericardial effusion or thrombus formation. We have found TEE monitoring to be helpful with positioning for interatrial septal (IAS) puncture, catheter tip avoidance of the left atrial appendage (LAA), and guidance of the balloon catheter into each pulmonary vein (PV), with proper positioning within each PV orifice, and documentation of PV occlusion for the cryoballoon procedure. Procedural equipment and the cryoballoon protocol used are presented in detail. The role of TEE imaging during the procedure and in preventing potential dangers is illustrated. It is the goal of this study to demonstrate how the electrophysiology and echocardiography laboratories work together in this cryoablation procedure. PMID:24813802

Kerut, Edmund Kenneth; Hanawalt, Curtis; McKinnie, James

2015-02-01

100

The role of echocardiography in the management of patients with myxomatous disease.  

PubMed

Degenerative mitral regurgitation (MR), the leading cause of organic MR in western countries, is primarily characterized by mitral valve prolapse but encompasses a wide spectrum of anatomic lesions from fibroelastic deficiency (localized prolapse segment often associated with ruptured chordae) to diffuse myxomatous degeneration (Barlow's disease, diffuse excessive tissue with multiple valvular segments involved). Echocardiography is the method of choice to evaluate patients with degenerative MR and plays a crucial role in clinical management. It allows accurate assessment of MR severity, left ventricular and atrial consequences, etiology, mechanisms and anatomic lesions and consequently defines the probability of mitral valve repair. PMID:23743074

Messika-Zeitoun, David; Topilsky, Yan; Enriquez-Sarano, Maurice

2013-05-01

101

Practical guide for three-dimensional transthoracic echocardiography using a fully sampled matrix array transducer.  

PubMed

Real-time three-dimensional (3D) echocardiography is a major innovation in the history of cardiovascular ultrasound. Advances in computer and transducer technologies, especially the fully-sampled matrix array transducer, have permitted real-time 3D image acquisition and display. Several vendors provide 3D imaging but use different terminology for similar functions, creating confusion for consumers. This article provides a practical guide on how to acquire and analyze 3D images on-cart using currently available ultrasound systems (iE33, Philips Medical System, Andover, MA; Vivid7, GE Healthcare, Wauwatosa, WI) in daily clinical practice. PMID:18765173

Yang, Hyun Suk; Bansal, Ramesh C; Mookadam, Farouk; Khandheria, Bijoy K; Tajik, A Jamil; Chandrasekaran, Krishnaswamy

2008-09-01

102

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

PubMed

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

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

2015-03-01

103

Real time computerization of two-dimensional echocardiography.  

PubMed

A computerized system was developed for real time acquisition, enhanced processing, analysis, and display of cross-sectional images of the left ventricle derived by two-dimensional echocardiography (2DE). The new methodology couples a standard medical imaging computer system to the video output of any current 2DE unit, uses a 128 x 128 or 64 x 64 matrix window and stores the real time 30 frames/sec digitized images on a magnetic disk. Computerized beat-to-beat and frame-by-frame processing employs space-time smoothing the automatic detection of endocardial interfaces by standard threshold and second derivative techniques. Multiple views are displayed in real time with 256 levels of gray and color. The methodology was used to analyze and graphically display frame-by-frame changes throughout the cardiac cycle. In addition, regional wall motion and thickness were analyzed in 12 sectors of individual cross-sections using a standardized angular subdivision originating at the center of area and indexed by an external reference point. An algorithm was developed to correct cross-sectional interference definition from the commonly used trailing-to-leading edge to the more valid leading-to-leading outline technique. Computerized analysis of spatial and temporal variations of cardiac contraction were demonstrated in several clinical and experimental applications, including bicycle exercise testing, investigation of acute myocardial infarction, and assessment of interventions. Initial evaluation indicates that the new real time computerized digital acquisition and data analysis represents a major advances toward quantitation of left ventricular function using 2DE. PMID:7234656

Garcia, E; Gueret, P; Bennett, M; Corday, E; Zwehl, W; Meerbaum, S; Corday, S; Swan, H J; Berman, D

1981-06-01

104

Update of the echocardiography core syllabus of the European Association of Cardiovascular Imaging (EACVI).  

PubMed

The update of the Echocardiography Core Syllabus of European Association of Cardiovascular Imaging (EACVI) is now available online. The Echocardiography Core Syllabus enumerates the elements of knowledge to be taught, represents a framework for the development of local training curricula and provides expected learning outcomes to the echocardiography learner. PMID:23867135

Cosyns, Bernard; Garbi, Madalina; Separovic, Jadranka; Pasquet, Agnes; Lancellotti, Patrizio

2013-09-01

105

Assessment of Myocardial Function in Pediatric Patients with Operated Tetralogy of Fallot: Preliminary Results with 2D Strain Echocardiography  

Microsoft Academic Search

The global myocardial function in patients after repair of tetralogy of Fallot (TOF) can be assessed by cardiovascular magnetic\\u000a resonance (CMR) and measurement of B-type natriuretic peptides. Two-dimensional echocardiography-derived strain and strain\\u000a rate (2D strain) facilitate the assessment of regional myocardial function. We evaluated myocardial function in 16 children\\u000a with residual severe pulmonary valve regurgitation and right ventricular (RV) volume

Walter Knirsch; Ali Dodge-Khatami; Alexander Kadner; Oliver Kretschmar; Johannes Steiner; Petra Böttler; Deniz Kececioglu; Paul Harpes; Emanuela R. Valsangiacomo Buechel

2008-01-01

106

Evaluation of Cardiac Function Using Transthoracic Echocardiography in Patients with Myocardial Injury Secondary to Methomyl Poisoning.  

PubMed

Generally, the mortality rate for cases of carbamate poisoning is low, but fatalities secondary to methomyl poisoning have been reported including a case report of cardiac toxicity following short-term exposure to methomyl. There have been no reports, however, regarding patterns of cardiac toxicity after exposure to methomyl. Therefore, we investigated the prevalence and patterns of myocardial injury using a biochemical marker, troponin I (TnI), and evaluated cardiac function using transthoracic echocardiography (TTE). We conducted a retrospective review of 14 consecutive methomyl poisoning cases that were diagnosed and treated at the emergency department of the Wonju Severance Christian Hospital between January 2009 and December 2013. On ECG analysis, ST depression and T-wave inversion were seen in five patients (35.7 %) and one patient (7.1 %), respectively. On cardiac biochemical marker analysis, initial TnI was elevated in 11 patients (78.6 %). TTE was performed in nine patients among the 11 patients in whom TnI was found to be elevated. Of the nine patients that underwent TTE, three patients (33.3 %) showed a reduced ejection fraction (EF), and RWMA was noted in two patients. There were two patients (22.2 %) that had both reduced systolic function and RWMA. One patient did not regain normal systolic function on admission. None of the three patients with reduced EF received any specific treatment to support cardiac function. One patient expired due to pneumonia, and one patient was transferred as moribund. We followed up on 12 patients who survived to discharge for 6-44 months. One patient (8.3 %) was died to follow-up, and 11 patients survived without any further complications. Methomyl exposure can cause direct myocardial injury and reversible cardiac dysfunction. Monitoring of TnI levels and TTE for evaluation of cardiac function may be useful in the workup of patients suffering from methomyl poisoning. PMID:25410938

Lee, Dong Keon; Cho, Nam Hyub; Kim, Oh Hyun; Go, Jin; Kim, Tae Hoon; Cha, Kyoung Chul; Kim, Hyun; Lee, Kang Hyun; Hwang, Sung Oh; Cha, Yong Sung

2014-11-20

107

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Initially Visualized by Echocardiography and Multidetector Computed Tomography Coronary Angiography  

PubMed Central

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly associated with very high mortality during infancy. We report a 35-year-old female patient with ALCAPA initially visualized by echocardiography. She visited outpatient department presenting with intermittent chest discomfort for 3 weeks. Transthoracic echocardiography showed left coronary artery arising from main pulmonary artery and abundant septal color flow Doppler signals. Transesophageal echocardiography clearly revealed markedly dilated and tortuous right coronary artery showing windsock appearance. Multidetector computed tomography and coronary angiography enabled visualization of anomalous left coronary artery originating from left side of main pulmonary trunk. After treadmill exercise test which showed ST-segment depression presenting inducible myocardial ischemia, patient underwent direct re-implantation of the anomalous coronary artery into the aorta without any complication. PMID:23346290

Kim, Byung-Ho; Park, Yon Woong; Hong, Seung-Pyo; Son, Ja-Yung; Lee, Young-Soo; Lee, Jin-Bae; Choi, Ji-Yong; Kim, Kee-Sik; Chang, Sung-Guk

2012-01-01

108

Estimation of 3D left ventricular deformation from echocardiography  

Microsoft Academic Search

The quantitative estimation of regional cardiac deformation from 3D image se- quences has important clinical implications for the assessment of viability in the heart wall. Such estimates have so far been obtained almost exclusively from Mag- netic Resonance (MR) images, speciflcally MR tagging. In this paper we describe a methodology for estimating cardiac deformations from 3D echocardiography (3DE). The images

Xenophon Papademetris; Albert J. Sinusas; Donald P. Dione; James S. Duncan

2001-01-01

109

Exercise stress echocardiography for the study of the pulmonary circulation  

E-print Network

was investigated by Doppler echocardiography in 25 healthy volunteers aged 19­62 yrs (mean 36 yrs). Mean pulmonary artery pressure (P¯pa) was estimated from the maximum velocity of tricuspid regurgitation. Cardiac output to cardiac output (Q), these patterns would appear at variance. Numerous studies have shown multipoint P

Chesler, Naomi C.

110

AN ANALOGUE ECHOGRAM RANGE GATE TRACKER FOR CLINICAL ECHOCARDIOGRAPHY  

EPA Science Inventory

The fundamental purpose of this paper is to present the results of a feasibility study for an on-line, real-time automatic range gate tracker (ARGT) for clinical echocardiography specifically for the purpose of determining cardiac output noninvasively and in real time. The basic ...

111

Prognostic value of echocardiography after acute myocardial infarction  

Microsoft Academic Search

Echocardiography is useful for risk stratification and assessment of prognosis after myocardial infarction, which is the focus of this review. Various traditional echocardiographic parameters have been shown to provide prognostic information, such as left ventricular volumes and ejection fraction, wall motion score index, mitral regurgitation and left atrial volume. The introduction of tissue Doppler imaging and speckle-tracking strain imaging has

S A Mollema; G Nucifora; J J Bax

2009-01-01

112

Transesophageal echocardiography: first-line imaging for aortic diseases  

NASA Technical Reports Server (NTRS)

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.

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

2000-01-01

113

Magic Show  

Microsoft Academic Search

With a concentration in theatre, I created a magic show from scratch. Over the course of the semester, I researched both the effects (more commonly known as magic tricks) in a variety of styles, especially mentalism, along with the patter, or script, that is integral in making a good effect into something utterly amazing. I chose a certain set of

Zachary Brass

2012-01-01

114

Early Detection of a Cavopulmonary Tumor Embolus with the Use of Transesophageal Echocardiography  

PubMed Central

Pulmonary tumor embolization from renal cell carcinoma is associated with severe cardiopulmonary morbidity and high perioperative mortality rates. We report the case of a 71-year-old woman who presented with right-sided abdominal pain. Magnetic resonance images revealed a mass originating from the upper pole of the right kidney and extending into the infrahepatic portion of the inferior vena cava. Transesophageal echocardiography was continuously used to monitor the mass during intended radical nephrectomy and tumor resection. When the right kidney was mobilized, intracaval thrombus detached and migrated to the patient's right atrium, causing severe hemodynamic instability. After emergent sternotomy and during the initiation of cardiopulmonary bypass, the mass was no longer echocardiographically detectable in the heart; it was soon removed completely from the left pulmonary artery. The mass was a renal cell carcinoma. We recommend the use of transesophageal echocardiography as an efficient diagnostic tool in the early detection of pulmonary tumor embolization during the resection of renal cell carcinoma that involves the inferior vena cava.

Al-Najjar, Raed M.; Aftab, Muhammad; Anton, James M.; Colen, John S.; Reul, Ross M.

2015-01-01

115

[Diagnosis and evaluation of a patient with cor triatriatum using perioperative transesophageal echocardiography].  

PubMed

Cor triatriatum is a rare congenital cardiac anomaly accounting for only 0.1-0.4% of all congenital heart diseases usually diagnosed in infancy or childhood and rarely found in adults. It is characterized by fibromuscular membrane dividing the left atrium into two chambers. This congenital heart disease is reported to be frequently associated with variety of cardiac anomalies such as an atrial septal defect, anomalous pulmonary venous drainage, and persistent left superior vena cava. A woman with no cardiac history was admitted to the hospital due to acute heart failure and diagnosed as severe mitral regurgitation and cor triatriatum by pre-orerative transthoracic echocardiography. Emergency mitral valve plasty was undertaken because of the severity of mitral regurgitation without determining the detailed type of cor triatriatum. Thus, diagnosis of the type of cor triatriatum with perioperative transesophageal echocardiography (TEE) was required to establish correct cardiopulmonary bypass and determine the operative procedure. Perioperative TEE revealed that the type was Lucas-Schmidt- I A, and cardiopulmonary bypass was established safely. Operation was performed without any problems. The TEE skill of our anesthesiologists could contribute to the safe management of the cardiac surgery. PMID:24724446

Kurazumi, Takuya; Suzuki, Takeshi; Morita, Yoshihisa; Masuda, Junich

2014-03-01

116

Comparison of direct planimetry of mitral valve regurgitation orifice area by three-dimensional transesophageal echocardiography to effective regurgitant orifice area obtained by proximal flow convergence method and vena contracta area determined by color Doppler echocardiography.  

PubMed

Direct measurement of anatomic regurgitant orifice area (AROA) by 3-dimensional transesophageal echocardiography was evaluated for analysis of mitral regurgitation (MR) severity. In 72 patients (age 70.6 ± 13.3 years, 37 men) with mild to severe MR, 3-dimensional transesophageal echocardiography and transthoracic color Doppler echocardiography were performed to determine AROA by direct planimetry, effective regurgitant orifice area (EROA) by proximal convergence method, and vena contracta area (VCA) by 2-dimensional color Doppler echocardiography. AROA was measured with commercially available software (QLAB, Philips Medical Systems, Andover, Massachusetts) after adjusting the first and second planes to reveal the smallest orifice in the third plane where planimetry could take place. AROA was classified as circular or noncircular by calculating the ratio of the medial-lateral distance above the anterior-posterior distance (?1.5 compared to >1.5). AROA determined by direct planimetry was 0.30 ± 0.20 cm², EROA determined by proximal convergence method was 0.30 ± 0.20 cm², and VCA was 0.33 ± 0.23 cm². Correlation between AROA and EROA (r = 0.96, SEE 0.058 cm²) and between AROA and VCA (r = 0.89, SEE 0.105 cm²) was high considering all patients. In patients with a circular regurgitation orifice area (n = 14) the correlation between AROA and EROA was better (r = 0.99, SEE 0.036 cm²) compared to patients with noncircular regurgitation orifice area (n = 58, r = 0.94, SEE 0.061 cm²). Correlation between AROA and EROA was higher in an EROA ?0.2 cm² (r = 0.95) than in an EROA <0.2 cm² (r = 0.60). In conclusion, direct measurement of MR AROA correlates well with EROA by proximal convergence method and VCA. Agreement between methods is better for patients with a circular regurgitation orifice area than in patients with a noncircular regurgitation orifice area. PMID:21257014

Altiok, Ertunc; Hamada, Sandra; van Hall, Silke; Hanenberg, Mehtap; Dohmen, Guido; Almalla, Mohammed; Grabskaya, Eva; Becker, Michael; Marx, Nikolaus; Hoffmann, Rainer

2011-02-01

117

Assessment of aortic stenosis by three?dimensional echocardiography: an accurate and novel approach  

PubMed Central

Background Accurate assessment of aortic valve area (AVA) is important for clinical decision?making in patients with aortic valve stenosis (AS). The role of three?dimensional echocardiography (3D) in the quantitative assessment of AS has not been evaluated so far. Objectives To evaluate the reproducibility and accuracy of real?time three?dimensional echocardiography (RT3D) and 3D?guided two?dimensional planimetry (3D/2D) for assessment of AS, and compare these results with those of standard echocardiography and cardiac catheterisation (Cath). Methods AVA was estimated by transthoracic echo?Doppler (TTE) and by direct planimetry using transoesophageal echocardiography (TEE) as well as RT3D and 3D/2D. 15 patients underwent assessment of AS by Cath. Results 33 patients with AS were studied (20 men, mean (SD) age 70 (14)?years). Bland–Altman analysis showed good agreement and small absolute differences in AVA between all planimetric methods (RT3D vs 3D/2D: ?0.01 (0.15)?cm2; 3D/2D vs TEE: 0.05 (0.22)?cm2; RT3D vs TEE: 0.06 (0.26)?cm2). The agreement between AVA assessment by 2D–TTE and planimetry was ?0.01 (0.20)?cm2 for 3D/2D; 0.00 (0.15)?cm2 for RT3D; and ?0.05 (0.30)?cm2 for TEE. Correlation coefficient r for AVA assessment between each of 3D/2D, RT3D, TEE planimetry and Cath was 0.81, 0.86 and 0.71, respectively. The intraobserver variability was similar for all methods, but interobserver variability was better for 3D techniques than for TEE (p<0.05). Conclusions The 3D echo methods for planimetry of the AVA showed good agreement with the standard TEE technique and flow?derived methods. Compared with AV planimetry by TEE, both 3D methods were at least as good as TEE and had better reproducibility. 3D aortic valve planimetry is a novel non?invasive technique, which provides an accurate and reliable quantitative assessment of AS. PMID:17488766

Goland, Sorel; Trento, Alfredo; Iida, Kiyoshi; Czer, Lawrence S C; De Robertis, Michele; Naqvi, Tasneem Z; Tolstrup, Kirsten; Akima, Takashi; Luo, Huai; Siegel, Robert J

2007-01-01

118

Echocardiography Underestimates Stroke Volume and Aortic Valve Area: Implications for Patients With Small-Area Low-Gradient Aortic Stenosis  

PubMed Central

Background Discordance between small aortic valve area (AVA; < 1.0 cm2) and low mean pressure gradient (MPG; < 40 mm Hg) affects a third of patients with moderate or severe aortic stenosis (AS). We hypothesized that this is largely due to inaccurate echocardiographic measurements of the left ventricular outflow tract area (LVOTarea) and stroke volume alongside inconsistencies in recommended thresholds. Methods One hundred thirty-three patients with mild to severe AS and 33 control individuals underwent comprehensive echocardiography and cardiovascular magnetic resonance imaging (MRI). Stroke volume and LVOTarea were calculated using echocardiography and MRI, and the effects on AVA estimation were assessed. The relationship between AVA and MPG measurements was then modelled with nonlinear regression and consistent thresholds for these parameters calculated. Finally the effect of these modified AVA measurements and novel thresholds on the number of patients with small-area low-gradient AS was investigated. Results Compared with MRI, echocardiography underestimated LVOTarea (n = 40; ?0.7 cm2; 95% confidence interval [CI], ?2.6 to 1.3), stroke volumes (?6.5 mL/m2; 95% CI, ?28.9 to 16.0) and consequently, AVA (?0.23 cm2; 95% CI, ?1.01 to 0.59). Moreover, an AVA of 1.0 cm2 corresponded to MPG of 24 mm Hg based on echocardiographic measurements and 37 mm Hg after correction with MRI-derived stroke volumes. Based on conventional measures, 56 patients had discordant small-area low-gradient AS. Using MRI-derived stroke volumes and the revised thresholds, a 48% reduction in discordance was observed (n = 29). Conclusions Echocardiography underestimated LVOTarea, stroke volume, and therefore AVA, compared with MRI. The thresholds based on current guidelines were also inconsistent. In combination, these factors explain > 40% of patients with discordant small-area low-gradient AS. PMID:25151288

Chin, Calvin W.L.; Khaw, Hwan J.; Luo, Elton; Tan, Shuwei; White, Audrey C.; Newby, David E.; Dweck, Marc R.

2014-01-01

119

Assess the clinical applicability of transthoracic echocardiography in laparotomy patients in a general intensive care unit  

PubMed Central

Background: Echocardiography is one of the diagnostic tools that can be applied at the bedside, along with avoiding transporting critically ill patients. This prospective observational study was designed to assess the clinical applicability of the transthoracic echocardiography (TTE) device by noncardiologist intensivists. Materials and Methods: Intensivists performed a limited TTE examination on critically ill patients admitted to the surgical intensive care unit (ICU). After initial cardiac clinical assessment in 85 critically ill adult patients, a limited TTE was performed by an intensivist to assess left ventricular (LV) function and LV volume status as well as valvular function and qualitative factors. Data were analyzed and presented in proportions using descriptive statistics. The setting was in surgical ICU of an academic medical center. Results: Valvular abnormalities (44.8%) as well as qualitative indices (68.3%) were the most frequently detected abnormalities. The ejection fraction was the only alteration, which was affected by the risk factors (P = 0.05, mean = 55.57). Conclusion: Transthoracic approach can provide useful information on cardiac anatomy and function in most ICU patients along with detecting severe previously unknown conditions in some patients. PMID:25097620

Abbasi, Saeed; Fazel, Kamran; Esfahani, Morteza Abdar; Kashefi, Parviz; Harandi, Samaneh Alami

2014-01-01

120

The role of transesophageal echocardiography in aortic valve preserving procedures  

PubMed Central

In selected cases of aortic regurgitation, aortic valve (AV) repair and AV sparing root reconstruction viable alternatives to aortic valve replacement. Repair and preservation of the native valve avoids the use of long-term anticoagulation, lowers the incidence of subsequent thromboembolic events and reduces the risk of endocarditis. Additionally repair has a low operative mortality with reasonable mid-term durability. The success and longer term durability of AVPP has improved with surgical experience. An understanding of the mechanism of the AR is integral to determining feasibility and success of an AVPP. Assessment of AV morphology, anatomy of the functional aortic annulus (FAA) and the aortic root with transesophageal echocardiography (TEE) improves the understanding of the mechanisms of AR. Pre- and intra-operative TEE plays a pivotal role in guiding case selection, surgical planning, and in evaluating procedural success. Post-operative transthoracic echocardiography is useful to determine long-term success and monitor for recurrence of AR. PMID:24973839

Hall, Terri; Shah, Pallav; Wahi, Sudhir

2014-01-01

121

Use of adenosine echocardiography for diagnosis of coronary artery disease  

SciTech Connect

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.

Zoghbi, W.A. (Section of Cardiology Baylor College of Medicine, Methodist Hospital, Houston, TX (USA))

1991-07-01

122

Current Clinical Application of Intracardiac Flow Analysis Using Echocardiography  

PubMed Central

In evaluating the cardiac function, it is important to have a comprehensive assessment of structural factors, such as the myocardial or valvular function and intracardiac flow dynamics that pass the heart. Vortex flow that form during left ventricular filling have specific geometry and anatomical location that are critical determinants of directed blood flow during ejection. The formation of abnormal vortices relates to the abnormal cardiac function. Therefore, vortex flow may offer a novel index of cardiac dysfunction. Intracardiac flow visualization using ultrasound technique has definite advantages with a higher temporal resolution and availability in real time clinical setting. Vector flow mapping based on color-Doppler and contrast echocardiography using particle image velocimetry is currently being used for visualizing the intracardiac flow. The purpose of this review is to provide readers with an update on the current method for analyzing intracardiac flow using echocardiography and its clinical applications. PMID:24459561

Kim, Minji; Pedrizzetti, Gianni; Vannan, Mani A

2013-01-01

123

Adequate images in intraoperative transoesophageal echocardiography: a quality improvement project.  

PubMed

A suggested standard examination (SSE) for intraoperative transoesophageal echocardiography for cardiac surgery was developed at the Green Lane Department of Cardiothoracic and Otorhinolaryngology Anaesthesia at the Auckland City Hospital. The examination includes views to be recorded in all patients pre- and post-cardiopulmonary bypass. There are also additional views to be recorded in patients with valvular pathology. Using the SQUIRE (Standards for Quality Improvement Reporting Excellence) guidelines, we report an audit comparing acquisition ratios before and after introduction of the SSE. A baseline mean acquisition ratio of 0.62 was achieved, which was not significantly changed by the introduction of the SSE. Nevertheless, we found the SSE to be a useful audit tool and believe it might be of interest to others to assist with perioperative transoesophageal echocardiography quality assurance and education. PMID:25233179

Graham, J; Sidebotham, D; Story, D A; Hu, R; Parker, F

2014-09-01

124

On-Orbit Prospective Echocardiography on International Space Station  

NASA Technical Reports Server (NTRS)

A number of echocardiographic research projects and experiments have been flown on almost every space vehicle since 1970, but validation of standard methods and the determination of Space Normal cardiac function has not been reported to date. Advanced Diagnostics in Microgravity (ADUM) -remote guided echocardiographic technique provides a novel and effective approach to on-board assessment of cardiac physiology and structure using a just-in-time training algorithm and real-time remote guidance aboard the International Space Station (ISS). The validation of remotely guided echocardiographic techniques provides the procedures and protocols to perform scientific and clinical echocardiography on the ISS and the Moon. The objectives of this study were: 1.To confirm the ability of non-physician astronaut/cosmonaut crewmembers to perform clinically relevant remotely guided echocardiography using the Human Research Facility on board the ISS. 2.To compare the preflight, postflight and in-flight echocardiographic parameters commonly used in clinical medicine.

Hamilton, Douglas R.; Sargsyan, Ashot E.; Martin, David; Garcia, Kathleen M.; Melton, Shannon; Feiverson, Alan; Dulchavsky, Scott A.

2010-01-01

125

Diagnostic Value of Echocardiography in the Diagnosis of Pulmonary Hypertension  

PubMed Central

Aims To determine the value of echocardiography including tissue Doppler imaging (TDI) and right ventricular (RV) speckle tracking analysis for the diagnosis of pulmonary hypertension (PH) and discrimination between pre- and postcapillary PH. Methods and Results 155 consecutive patients (mean age 70.5±13.0 years, 81 [52%] male gender, BMI 27.2±6.1 kg/m2) with PH undergoing right heart catheterization (RHC) and transthoracic echocardiography (TTE) with TDI between January 2008 and December 2009 were retrospectively evaluated including offline speckle tracking analysis of RV contractility. After RHC 23.2% of patients (36) were diagnosed with precapillary PH. Invasive results from RHC were significantly correlated to TTE measurements (E/é, postcapillary wedge pressure [PCWP], r?=?0.61, P<0.001; mean, systolic pulmonary arterial pressure [mPAP, sPAP], r?=?0.43, P<0.001). Single echocardiographic parameters were of good predictive value for final PH-diagnosis (sPAP, area under the curve [AUC] 0.63, P?=?0.025; lateral apical RV longitudinal strain [RVaSl)], AUC 0.76, P?=?0.001; E/é, AUC 0.84, P<0.001) which could be increased by combining most predictive parameters after receiver operating curves (ROC) cut off analysis (sPAP>69 mmHg, E/é<12, RVaSl ??8.4%). TTE had a sensitivity of 33.33% and a specificity of 100% to identify patients with precapillary PH, and a negative predictive value of 84.72% to rule out precapilary PH. Conclusion Echocardiography allows feasible and reliable estimation of PH and seems helpful to distinguish between pre-and postcapillary PH. Further prospective studies on patients with different manifestations of PH must validate the predictive value of echocardiography in this clinical setting. PMID:22685577

Bors, Lisa; Momcilovic, Diana; Pabst, Stefan; Nickenig, Georg; Skowasch, Dirk

2012-01-01

126

Hemodynamic evaluation of the prone position by transesophageal echocardiography  

Microsoft Academic Search

Study Objective: To evaluate the hemodynamic response in the prone position in surgical patients by measuring the effects of prone positioning on cardiac function using transesophageal echocardiography (TEE).Design: Prospective study.Setting: Elective surgery at a university hospital.Patients: 15 adult ASA physical status I and II patients free of significant coexisting disease undergoing lumbar laminectomy.Interventions and Measurements: Approximately 15 minutes after the

Shigeyoshi Toyota; Yoshikiyo Amaki

1998-01-01

127

Echocardiography-Guided Ethanol Septal Reduction for Hypertrophic Obstructive Cardiomyopathy  

Microsoft Academic Search

Background—Left ventricular outflow tract (LVOT) obstruction is frequently responsible for symptoms in hypertrophic obstructive cardiomyopathy (HOCM). Medical therapy is often not sufficient to control these symptoms, and surgical myotomy-myomectomy is required. Methods and Results—We enrolled 33 symptomatic patients with HOCM and obstruction ( $40 mm Hg gradient at rest or $60 mm Hg dobutamine-provoked). By contrast echocardiography, the bulging septum

Nasser M. Lakkis; Sherif F. Nagueh; Neal S. Kleiman; Donna Killip; Zuo-Xiang He; Mario S. Verani; Robert Roberts; William H. Spencer III

2010-01-01

128

Incremental Value of Live/Real Time Three-Dimensional Transthoracic Echocardiography over Two-Dimensional Echocardiography in Hypertrophic Cardiomyopathy with Mid-Ventricular Obstruction and Apical Aneurysm.  

PubMed

We describe a case of hypertrophic cardiomyopathy with mid-left ventricular obstruction and apical aneurysm containing thrombi where live/real time three-dimensional transthoracic echocardiography provided incremental value over two-dimensional echocardiography in assessing the findings. PMID:25418547

Thind, Munveer; Joson, Marisa; Gaba, Saurabh; Elsayed, Mahmoud; Bulur, Serkan; Guvenc, Tolga; Elguindy, Mostafa; Nanda, Navin C

2015-03-01

129

Real-time three-dimensional echocardiography: an overview.  

PubMed

Conventional echocardiography and its representation of the heart in a two-dimensional format only provide partial information about cardiac function. Real-time three-dimensional echocardiography is a recently developed technique based on the design of an ultrasound transducer with a matrix array that instantaneously acquires the image contained in a pyramidal volume. The simultaneous display of multiple tomographic images allows the anatomically correct examination of any structure contained within the volumetric image. Software and technologies based on high performance computers designed for graphic handling of three-dimensional images permit the rapid mapping of the volumetric image and provide possibilities beyond those of the echograph. Using this methodology, it is possible to simultaneously visualize multiple superimposed planes in an interactive manner. Real-time three-dimensional echocardiography also allows a quantitative assessment of cardiac volumes, ventricular mass, and myocardium with contraction and/or perfusion abnormalities. This technique thus expands the abilities of non-invasive cardiology and may open new doors for the evaluation of cardiac disease. PMID:11587457

Panza, J A

2001-06-01

130

Successful transfemoral aortic Edwards(®) SAPIEN(®) bioprosthesis implantation without using iodinated contrast media in a woman with severe allergy to contrast agent.  

PubMed

Severe anaphylactoid reaction after the use of iodinated contrast media are rare but can contraindicate the use of contrast agent. It was the case of a 53-year-old woman suffering from symptomatic severe aortic stenosis, recused for cardiac surgery because of deleterious effects of chest-wall irradiation, with porcelain aorta. We decided to implant a 23-mm Edwards(®) SAPIEN(®) transcatheter aortic valve via a femoral route without using any contrast media. The implantation was successful after surgical approach of the femoral artery, transesophageal echocardiography guiding, and localization of native leaflets and coronary trunk with catheters. Immediate and one month post-interventional follow-up was favorable and echocardiography showed a good functioning of the aortic bioprosthesis. Although conventional angiography is the best way to visualize the good positioning of the valve before deployment, our case suggests that, in special situations, transfemoral implantation of an Edwards(®) SAPIEN(®) aortic bioprosthesis is feasible without any contrast injection. PMID:23197475

Leroux, Lionel; Dijos, Marina; Dos Santos, Pierre

2013-12-01

131

Irinotecan Plus S-1 Followed by Hepatectomy for a Patient with Initially Unresectable Colorectal Liver Metastases, Who Showed Severe Drug Rash with Oxaliplatin Plus 5-FU and Leucovorin (FOLFOX)  

PubMed Central

For unresectable colorectal liver metastases (CRLM), hepatic resection with or without chemotherapy is the only curative treatment that sufficiently achieves long-term survival. However, occasional severe allergic responses to anticancer drugs necessitate treatment discontinuation. A 45-year-old woman presented with metachronous unresectable colorectal liver metastases. Chemotherapy with oxaliplatin plus 5-FU and leucovorin (FOLFOX) was initiated, but severe allergic dermatitis developed after the second cycle. Although she reported no prior history of adverse reactions to tegafur-uracil, a drug lymphocyte stimulation test showed an allergic response to 5-FU. We subsequently replaced with Irinotecan plus S-1 (IRIS) chemotherapy which was well tolerated and resulted in a partial response after 3 cycles. As a result, right trisectionectomy was successfully performed and no recurrence was detected in the following 3 years. A severe allergic reaction to intravenous 5-FU-containing drug regimens can be successfully alleviated by switching to S-1-containing regimens such as IRIS or S-1 plus oxaliplatin (SOX). PMID:25031875

Komori, Hiroyuki; Beppu, Toru; Sakamoto, Yasuo; Miyamoto, Yuji; Hayashi, Hiromitsu; Imai, Katsunori; Nitta, Hidetoshi; Watanabe, Masayuki; Baba, Hideo

2014-01-01

132

A Dynamical Shape Prior for LV Segmentation from RT3D Echocardiography?  

PubMed Central

Real-time three-dimensional (RT3D) echocardiography is the newest generation of three-dimensional (3-D) echocardiography. Segmentation of RT3D echocardiographic images is essential for determining many important diagnostic parameters. In cardiac imaging, since the heart is a moving organ, prior knowledge regarding its shape and motion patterns becomes an important component for the segmentation task. However, most previous cardiac models are either static models (SM), which neglect the temporal coherence of a cardiac sequence or generic dynamical models (GDM), which neglect the inter-subject variability of cardiac motion. In this paper, we present a subject-specific dynamical model (SSDM) which simultaneously handles inter-subject variability and cardiac dynamics (intra-subject variability). It can progressively predict the shape and motion patterns of a new sequence at the current frame based on the shapes observed in the past frames. The incorporation of this SSDM into the segmentation process is formulated in a recursive Bayesian framework. This results in a segmentation of each frame based on the intensity information of the current frame, as well as on the prediction from the previous frames. Quantitative results on 15 RT3D echocardiographic sequences show that automatic segmentation with SSDM is superior to that of either SM or GDM, and is comparable to manual segmentation. PMID:20054422

Papademetris, Xenophon; Sinusas, Albert J.; Duncan, James S.

2009-01-01

133

Advanced Echocardiography in Adult Zebrafish Reveals Delayed Recovery of Heart Function after Myocardial Cryoinjury  

PubMed Central

Translucent zebrafish larvae represent an established model to analyze genetics of cardiac development and human cardiac disease. More recently adult zebrafish are utilized to evaluate mechanisms of cardiac regeneration and by benefiting from recent genome editing technologies, including TALEN and CRISPR, adult zebrafish are emerging as a valuable in vivo model to evaluate novel disease genes and specifically validate disease causing mutations and their underlying pathomechanisms. However, methods to sensitively and non-invasively assess cardiac morphology and performance in adult zebrafish are still limited. We here present a standardized examination protocol to broadly assess cardiac performance in adult zebrafish by advancing conventional echocardiography with modern speckle-tracking analyses. This allows accurate detection of changes in cardiac performance and further enables highly sensitive assessment of regional myocardial motion and deformation in high spatio-temporal resolution. Combining conventional echocardiography measurements with radial and longitudinal velocity, displacement, strain, strain rate and myocardial wall delay rates after myocardial cryoinjury permitted to non-invasively determine injury dimensions and to longitudinally follow functional recovery during cardiac regeneration. We show that functional recovery of cryoinjured hearts occurs in three distinct phases. Importantly, the regeneration process after cryoinjury extends far beyond the proposed 45 days described for ventricular resection with reconstitution of myocardial performance up to 180 days post-injury (dpi). The imaging modalities evaluated here allow sensitive cardiac phenotyping and contribute to further establish adult zebrafish as valuable cardiac disease model beyond the larval developmental stage. PMID:25853735

Kossack, Mandy; Juergensen, Lonny; Fuchs, Dieter; Katus, Hugo A.; Hassel, David

2015-01-01

134

Advanced echocardiography in adult zebrafish reveals delayed recovery of heart function after myocardial cryoinjury.  

PubMed

Translucent zebrafish larvae represent an established model to analyze genetics of cardiac development and human cardiac disease. More recently adult zebrafish are utilized to evaluate mechanisms of cardiac regeneration and by benefiting from recent genome editing technologies, including TALEN and CRISPR, adult zebrafish are emerging as a valuable in vivo model to evaluate novel disease genes and specifically validate disease causing mutations and their underlying pathomechanisms. However, methods to sensitively and non-invasively assess cardiac morphology and performance in adult zebrafish are still limited. We here present a standardized examination protocol to broadly assess cardiac performance in adult zebrafish by advancing conventional echocardiography with modern speckle-tracking analyses. This allows accurate detection of changes in cardiac performance and further enables highly sensitive assessment of regional myocardial motion and deformation in high spatio-temporal resolution. Combining conventional echocardiography measurements with radial and longitudinal velocity, displacement, strain, strain rate and myocardial wall delay rates after myocardial cryoinjury permitted to non-invasively determine injury dimensions and to longitudinally follow functional recovery during cardiac regeneration. We show that functional recovery of cryoinjured hearts occurs in three distinct phases. Importantly, the regeneration process after cryoinjury extends far beyond the proposed 45 days described for ventricular resection with reconstitution of myocardial performance up to 180 days post-injury (dpi). The imaging modalities evaluated here allow sensitive cardiac phenotyping and contribute to further establish adult zebrafish as valuable cardiac disease model beyond the larval developmental stage. PMID:25853735

Hein, Selina J; Lehmann, Lorenz H; Kossack, Mandy; Juergensen, Lonny; Fuchs, Dieter; Katus, Hugo A; Hassel, David

2015-01-01

135

Robust Myocardial Motion Tracking for Echocardiography: Variational Framework Integrating Local-to-Global Deformation  

PubMed Central

This paper proposes a robust real-time myocardial border tracking algorithm for echocardiography. Commonly, after an initial contour of LV border is traced at one or two frames from the entire cardiac cycle, LV contour tracking is performed over the remaining frames. Among a variety of tracking techniques, optical flow method is the most widely used for motion estimation of moving objects. However, when echocardiography data is heavily corrupted in some local regions, the errors bring the tracking point out of the endocardial border, resulting in distorted LV contours. This shape distortion often occurs in practice since the data acquisition is affected by ultrasound artifacts, dropouts, or shadowing phenomena of cardiac walls. The proposed method is designed to deal with this shape distortion problem by integrating local optical flow motion and global deformation into a variational framework. The proposed descent method controls the individual tracking points to follow the local motions of a specific speckle pattern, while their overall motions are confined to the global motion constraint being approximately an affine transform of the initial tracking points. Many real experiments show that the proposed method achieves better overall performance than conventional methods. PMID:23554841

Ahn, Chi Young

2013-01-01

136

[Measurement of left atrial and ventricular volumes in real-time 3D echocardiography. Validation by nuclear magnetic resonance  

NASA Technical Reports Server (NTRS)

The measurement of the left ventricular ejection fraction is important for the evaluation of cardiomyopathy and depends on the measurement of left ventricular volumes. There are no existing conventional echocardiographic means of measuring the true left atrial and ventricular volumes without mathematical approximations. The aim of this study was to test anew real time 3-dimensional echocardiographic system of calculating left atrial and ventricular volumes in 40 patients after in vitro validation. The volumes of the left atrium and ventricle acquired from real time 3-D echocardiography in the apical view, were calculated in 7 sections parallel to the surface of the probe and compared with atrial (10 patients) and ventricular (30 patients) volumes calculated by nuclear magnetic resonance with the simpson method and with volumes of water in balloons placed in a cistern. Linear regression analysis showed an excellent correlation between the real volume of water in the balloons and volumes given in real time 3-dimensional echocardiography (y = 0.94x + 5.5, r = 0.99, p < 0.001, D = -10 +/- 4.5 ml). A good correlation was observed between real time 3-dimensional echocardiography and nuclear magnetic resonance for the measurement of left atrial and ventricular volumes (y = 0.95x - 10, r = 0.91, p < 0.001, D = -14.8 +/- 19.5 ml and y = 0.87x + 10, r = 0.98, P < 0.001, D = -8.3 +/- 18.7 ml, respectively. The authors conclude that real time three-dimensional echocardiography allows accurate measurement of left heart volumes underlying the clinical potential of this new 3-D method.

Bauer, F.; Shiota, T.; Qin, J. X.; White, R. D.; Thomas, J. D.

2001-01-01

137

Diagnostic Performance of Echocardiography for the Detection of Acute Cardiac Allograft Rejection: A Systematic Review and Meta-Analysis  

PubMed Central

Objective Many studies have addressed the diagnostic performance of echocardiography to evaluate acute cardiac allograft rejection compared with endomyocardial biopsy. But the existence of heterogeneity limited its clinical application. Thus, we conducted a comprehensive, systematic literature review and meta-analysis for the purpose. Methods Studies prior to September 1, 2014 identified by Medline/PubMed, EMBASE and Cochrance were examined by two independent reviews. We conducted meta-analysis by using Meta-DiSc 1.4 software. An assessment tool of QUADAS-2 was applied to evaluate the risk of bias and applicability of the studies. Results Thirty studies met the inclusion criteria of meta-analysis. The four parameters of pressure half time, isovolumic relaxation time, index of myocardial performance and late diastolic mitral annular motion velocity were included in the meta-analysis, with a pooled diagnostic odds ratio of 10.43, 6.89, 15.95 and 5.68 respectively, and the area under the summary receiver operating characteristic curves value of 0.829, 0.599, 0.871 and 0.685 respectively. Conclusion The meta-analysis and systematic review demonstrate that no single parameter of echocardiography showed a reliable diagnostic performance for acute cardiac allograft rejection. A result of echocardiography for ACAR should be comprehensively considered by physicians in the context of clinical presentations and imaging feature. PMID:25822627

Pan, Xudong; Sun, Lizhong

2015-01-01

138

Repair of recurrent pseudoaneurysm of the mitral-aortic intervalvular fibrosa: role of transesophageal echocardiography.  

PubMed

Pseudoaneurysm of mitral-aortic intervalvular fibrosa (P-MAIVF) is a rare cardiac surgical condition. P-MAIVF commonly occurs as a complication of aortic and mitral valve replacement surgeries. The surgical trauma during replacement of the valves weakens the avascular mitral and aortic intervalvular area. We present a case of P-MAIVF recurrence 5 years after a primary repair. Congestive cardiac failure was the presenting feature with mitral and aortic regurgitation. In view of the recurrence, the surgical team planned for a double valve replacement. The sewing rings of the two prosthetic-valves were interposed to close the mouth of the pseudoaneurysm and to provide mechanical reinforcement of the MAIVF. Intra-operative transesophageal echocardiography (TEE) helped in delineating the anatomy, extent of the lesion, rupture of one of the pseudoaneurysm into left atrium and severity of the valvular regurgitation. Post-procedure TEE confirmed complete obliteration of the pseudoaneurysm and prosthetic valve function. PMID:24732619

Joshi, Shreedhar S; Thimmarayappa, Ashwini; Nagaraja, P S; Jagadeesh, A M; Furtado, Arul; Bhat, Seetharam

2014-01-01

139

Left Atrium by Echocardiography in Clinical Practice: From Conventional Methods to New Echocardiographic Techniques  

PubMed Central

Although often referred to as “the forgotten chamber”, compared with left ventricle (LV), especially in the past years, the left atrium (LA) plays a critical role in the clinical expression and prognosis of patients with heart and cerebrovascular disease, as demonstrated by several studies. Echocardiographers initially focused on early detection of atrial geometrical abnormalities through monodimensional atrial diameter quantification and then bidimensional (2D) areas and volume estimation. Now, together with conventional echocardiographic parameters, new echocardiographic techniques, such as strain Doppler, 2D speckle tracking and three-dimensional (3D) echocardiography, allow assessing early LA dysfunction and they all play a fundamental role to detect early functional remodelling before anatomical alterations occur. LA dysfunction and its important prognostic implications may be detected sooner by LA strain than by volumetric measurements. PMID:25009828

Caso, Pio; D'Andrea, Antonello; Di Salvo, Giovanni; Arenga, Fortunato; Coppola, Maria Gabriella; Sellitto, Vincenzo; Macrino, Maria; Calabrò, Raffaele

2014-01-01

140

[Echocardiography as a first diagnostic step in kidney tumours].  

PubMed

Intracardiac tumours are usually found after clinical symptoms lead to a positive imaging study, or as an incidental finding of imaging study, usually echocardiography. Cardiac tumours range from non-neoplastic lesions to high grade malignancies. The majority of primary cardiac tumours are myxomas (in 75% cases) or sarcomas (about 10% cases). In this paper we present cases of 2 patients with right atrial tumour, extending from renal carcinoma, invading renal vein and inferior vena cava into right atrium. Two different therapeutic strategies were undertaken in those patients. PMID:21850637

Szymczyk, Ewa; Lipiec, Piotr; Michalski, B?a?ej; Sadowski, Jerzy; Wierzbicki, Karol; Kasprzak, Jaros?aw D

2011-01-01

141

Detection of intracardiac masses in patients with coronary artery disease using cardiac magnetic resonance imaging: a comparison with transthoracic echocardiography.  

PubMed

We sought to evaluate the diagnostic accuracy of contrast-enhanced cardiac magnetic resonance (CMR) imaging for the detection of intracardiac masses and thrombus formation in patients with history of coronary artery disease (CAD) in comparison to transthoracic echocardiography (TTE) under clinical routine conditions. 171 patients with history of CAD (89 male, aged 34-89 years, median 63 ± 11) underwent TTE and CMR during routine clinical examinations. TTE and CMR were independently analysed regarding the presence of intracardiac thrombus formation, masses and related size, dimensions, shape and signal characteristics. TTE depicted intracavitary thrombus formation in 40/171 patients (23.4 %) and intracardiac mass in 12/171 patients (7.0 %). All masses revealed in TTE were correctly detected on CMR and confirmed by histology. However, CMR showed 15 additional thrombi and 3 additional intracardiac masses (p = 0.001) that were not seen in TTE. Patients with poor systolic function (LVEF <30 %) had misleading results when referred to TTE (19 vs. 27 thrombi detected, p < 0.01). The detection of intracardiac masses or thrombi was not significantly different in patient with LVEF >30 %, whereas CMR was superior when the LVEF was <30 %. Routine TTE in patients with CAD leads to lower detection rates of intracardiac masses and thrombus formation in patients with severely impaired EF. Consequently we are missing a significant amount of clinically relevant diagnosis when only assessing patients with TTE. In patients with CAD and severely impaired LVEF, CMR should be considered as first line imaging tool to detect or rule out intracardiac masses and thrombi. PMID:24384859

Staab, Wieland; Bergau, Leonard; Schuster, Andreas; Hinojar, Rocio; Dorenkamp, Marc; Obenauer, Silvia; Lotz, Joachim; Sohns, Christian

2014-03-01

142

Objective structured assessment of technical competence in transthoracic echocardiography: a validity study in a standardised setting  

PubMed Central

Background Competence in transthoracic echocardiography (TTE) is unrelated to traditional measures of TTE competence, such as duration of training and number of examinations performed. This study aims to explore aspects of validity of an instrument for structured assessment of echocardiographic technical skills. Methods The study included 45 physicians with three different clinical levels of echocardiography competence who all scanned the same healthy male following national guidelines. An expert in echocardiography (OG) evaluated all the recorded, de-identified TTE images blindly using the developed instrument for assessment of TTE technical skills. The instrument consisted of both a global rating scale and a procedure specific checklist. Two scores were calculated for each examination: A global rating score and a total checklist score. OG rated ten examinations twice for intra-rater reliability, and another expert rated the same ten examinations for inter-rater reliability. A small pilot study was then performed with focus on content validity. This pilot study included nine physicians who scanned three patients with different pathologies as well as different technical difficulties. Results Validity of the TTE technical skills assessment instrument was supported by a significant correlation found between level of expertise and both the global score (Spearman 0.76, p<0.0001) and the checklist score (Spearman 0.74, p<0.001). Both scores were able to distinguish between the three levels of competence that were represented in the physician group. Reliability was supported by acceptable inter- and intra-rater values. The pilot study showed a tendency to improved scores with increasing expertise levels, suggesting that the instrument could also be used when pathologies were present. Conclusions We designed and developed a structured assessment instrument of echocardiographic technical skills that showed evidence of validity in terms of high correlations between test scores on a normal person and the level of physician competence, as well as acceptable inter- and intra-rater reliability scores. Further studies should, however, be performed to determine the adequate number of assessments needed to ensure high content validity and reliability in a clinical setting. PMID:23537204

2013-01-01

143

Bronchial compression in an infant with isolated secundum atrial septal defect associated with severe pulmonary arterial hypertension.  

PubMed

Symptomatic pulmonary arterial hypertension (PAH) in patients with isolated atrial septal defect (ASD) is rare during infancy. We report a case of isolated ASD with severe PAH in an infant who developed airway obstruction as cardiomegaly progressed. The patient presented with recurrent severe respiratory insufficiency and failure to thrive before the repair of the ASD. Echocardiography confirmed volume overload on the right side of heart and severe PAH (tricuspid regurgitation [TR] with a peak pressure gradient of 55 to 60 mmHg). The chest radiographs demonstrated severe collapse of both lung fields, and a computed tomography scan showed narrowing of the main bronchus because of an intrinsic cause, as well as a dilated pulmonary artery compressing the main bronchus on the left and the intermediate bronchus on the right. ASD patch closure was performed when the infant was 8 months old. After the repair of the ASD, echocardiography showed improvement of PAH (TR with a peak pressure gradient of 22 to 26 mmHg), and the patient has not developed recurrent respiratory infections while showing successful catch-up growth. In infants with symptomatic isolated ASD, especially in those with respiratory insufficiency associated with severe PAH, extrinsic airway compression should be considered. Correcting any congenital heart diseases in these patients may improve their symptoms. PMID:22977443

Park, Sung-Hee; Park, So Young; Kim, Nam Kyun; Park, Su-Jin; Park, Han Ki; Park, Young Hwan; Choi, Jae Young

2012-08-01

144

Left ventricular diastolic function and dysfunction: Central role of echocardiography  

PubMed Central

Comprehensive and precise assessment of left ventricular (LV) systolic and diastolic function is necessary to establish, or exclude, heart failure as a cause or component of dyspnea. Echocardiography with Doppler readily assesses LV diastolic function; advantages include that echocardiography is non-invasive, does not require radiation, is portable, rapid, readily available, and in competent hands, can provide an accurate and comprehensive assessment of LV systolic and diastolic function. Correct assessment of LV diastolic function is relevant in patients with both depressed and preserved LV ejection fraction (EF ? 50%, and < 50%, respectively). Tissue Doppler (TD) imaging has been useful in demonstrating impaired LV relaxation in the setting of preserved LVEF, which, in the setting of increased cardiac volume, can result in elevated LV filling pressures, and dyspnea due to diastolic heart failure. TD imaging is not always critical in patients with depressed LVEF, since such patients by definition have impaired LV relaxation, and thus significant increases in volume will result in increases in LV filling pressure due to impaired LV compliance. Thus, in depressed LVEF, transmitral flow velocities (E and A, and E/A) and deceleration time, pulmonary venous Doppler, left atrial volume, and pulmonary artery (PA) pressures suffice for the accurate assessment of LV filling pressures. Overall, diastolic assessment by echo-Doppler can be readily achieved in by using a comprehensive diastolic assessment—incorporating many 2-dimensional, conventional and tissue Doppler variables—as opposed to relying on any single, diastolic parameter, which can lead to errors.

Dokainish, Hisham

2015-01-01

145

Role of echocardiography in differential diagnosis of broad complex tachycardia.  

PubMed Central

It is not always easy to distinguish between supraventricular tachycardia with aberration and ventricular tachycardia by electrocardiographic analysis alone. M mode echocardiography can often help by providing direct or indirect evidence of the relation between atrial and ventricular contraction. Sixteen consecutive patients with spontaneous sustained broad QRS complex tachycardia with heart rates of 120-225 beats/minute were examined. Echocardiographic evidence of 1:1 conduction was seen in three cases and 2:1 atrioventricular conduction in one (all four had supraventricular tachycardia, confirmed by intracardiac electrocardiography in three). Evidence of retrograde block was seen in 12 (all had ventricular tachycardia, with electrophysiological confirmation in 10). Satisfactory views of the mitral valve were obtained in all patients. Patients with ventricular tachycardia had a variable mitral valve opening time (range 42-110%) compared with those who had supraventricular tachycardia (9-15%). Aortic root and left atrial views gave direct evidence of atrial contraction in three cases, and subcostal right atrial wall views were diagnostic in four of five cases. Seven patients with ventricular tachycardia had been wrongly diagnosed elsewhere as having supraventricular tachycardia. This study confirms that echocardiography is a simple and rapid aid to accurate diagnosis in patients with broad QRS complex tachycardia. Images PMID:4015926

Wren, C; Campbell, R W; Hunter, S

1985-01-01

146

Left atrial ball thrombus diagnosed by two-dimensional echocardiography.  

PubMed

The diagnosis of the ball thrombus in the left atrium has been very difficult by conventional clinical techniques. In the present case, two-dimensional echocardiography successfully demonstrated a spherical tumor moving in unpredictable directions in the left atrium. M-mode echocardiography did not clearly identify the tumor because of the limited visual width and spatial orientation of the technique; however, simultaneous recordings of the M-mode echocardiogram with phonocardiogram, carotid pulse wave, and electrocardiogram provided some diagnostic clues to the occlusive left atrial tumor. In the absence mitral valve occlusion by the tumor, a logarithmic correlation between the ejection time and the preceding R-R interval, and a negative lines correlation between Q to the first sound interval and the preceding R-R interval were found. In the beat following the appearance of the tumor in the mitral orifice, the sudden shortening of the ejection time and the prolongation of Q to the first sound interval were noted. Both of these findings are indirect evidence of decreased left ventricular filling associated with an elevated left atrial pressure resulting from the sudden mitral orifice obstruction by the tumor. Detailed analysis of the data obtained by the conventional noninvasive techniques could provide critical clues for the diagnosis of the occlusive left atrial tumor. PMID:7386368

Sunagawa, K; Orita, Y; Tanaka, S; Kikuchi, Y; Nakamura, M; Hirata, T

1980-07-01

147

The usefulness of contrast during exercise echocardiography for the assessment of systolic pulmonary pressure  

PubMed Central

Background The systolic pulmonary artery pressure (PAPs) can be accurately estimated, non-invasively, using continuous-wave Doppler (CWD) ultrasound measurement of the peak velocity of a tricuspid regurgitant (TR) jet. However, it is often difficult to obtain adequate tricuspid regurgitation signals for measurement of PAPs, what could lead to its underestimation. Therefore, utilization of air-blood-saline contrast has been implemented for the improvement of Doppler signal in several clinical contexts. It is now recommended in the evaluation of patients with pulmonary hypertension. Physical activity is severely restricted in patients with PAH, being exertional dypnea the most typical symptom. Exercise stress echo-Doppler imaging allows assessment of the response to exercise. It is an excellent screening test for patients with suspected PAH. Our purpose was to evaluate the value and accuracy of agitated saline with blood contrast echocardiography, in the improvement of the Doppler signal, to quantify PAPs during treadmill exercise-echocardiography. Purpose To evaluate the value of contrast echocardiography, using agitated saline with blood, in the improvement of the Doppler signal used to quantify the pulmonary artery systolic pressure during exercise. Methods From a total of 41 patients (pts), we studied 38 pts (93%), 35 women, aged 54 ± 12 years-old. 27 with the diagnosis of systemic sclerosis, 10 with history of pulmonary embolism and one patient with a suspected idiopathic PAH, who were referred to the Unity of Heart Failure and Pulmonary Hypertension for screening of PAH. According to the Unity protocol, a transthoracic echocardiogram was made, in left decubitus (LD), with evaluation of right ventricle-right atria gradient (RV/RAg). A peripheral venous access was obtained, with a 3-way stopcock and the patients were placed in orthostatism (O), with a new evaluation of RV/RAg. Exercise echocardiography (EE) was begun, with evaluation of RV/RAg at peak exercise (P) and afterwards agitated saline (8 cc with 1 cc of air and 1 cc of blood) was injected, followed by a new evaluation of RV/RAg (PC) and then the interruption of the EE. Pulmonary Hypertension was diagnosed when RV/RAg at the end of the exercise was superior to 40 mmHg. Results The quality of Doppler signal was deteriorated in 5 pts, maintained in 6 pts and improved in 26 pts, with the use of contrast. In one patient, an interventricular septal defect was diagnosed. In 6 pts, a Doppler signal was only obtained with the use of contrast. In 15 pts, a RV/RAg superior to 40 mmHg was only obtained with the use of contrast. Of these, 9 have already been submitted to right heart cathetherism, that confirmed the diagnosis of pulmonary hypertension in 5 of them (56%). RV/RAg (P) was 44 ± 11 mmHg and RV/RAg (PC) was 54 ± 11 mmHg, p < 0,001. Conclusion 1. The method is applicable in a large number of patients. 2. RV/RA gradients obtained at peak exercise are higher with the use of contrast, and the clinical meaning of this difference should be evaluated in a larger number of pts submitted to right heart cathetherism. The high number of false positives should lead to a higher diagnostic threshold. 3. This method seems to have relevant clinical value in the diagnosis of pulmonary arterial hypertension. PMID:18851729

Lopes, Luis R; Loureiro, Maria J; Miranda, Rita; Almeida, Sofia; Almeida, Ana R; Cordeiro, Ana; Cotrim, Carlos; Carrageta, Manuel

2008-01-01

148

Three-dimensional echocardiography in congenital malformations of the mitral valve  

Microsoft Academic Search

Three-dimensional echocardiography has proved to be valuable in congenital heart disease by enhancing the evaluation of morphologic abnormalities and increasing the understanding of complex relationships. This study was undertaken to determine how 3-dimensional echocardiography could be best used to study some of the congenital malformations of the mitral valve such as mitral arcade, double orifice mitral valve, accessory mitral tissue,

Nilda Espinola-Zavaleta; Jesus Vargas-Barrón; Candace Keirns; Guillermo Rivera; Angel Romero-Cárdenas; Javier Roldán; Fause Attie

2002-01-01

149

[Visualization of thrombi in the left auricular appendix using transesophageal echocardiography. Apropos of a clinical case].  

PubMed

A case of Transesophageal Echocardiography (T.E.E.) Assessment of "Rheumatic Mitral Stenosis" is presented. T.E.E. has been recently referred as having superior resolution than transthoracic Echocardiography on the detection of thrombi. In the presented case a thrombi was detected in the left atrial appendage. This fact has allowed a better planning of surgery. PMID:1786169

Pereira, A J; Ferreira, T; Pereira, A T; Correia, M

1991-11-01

150

Contrast agents provide a faster learning curve in dipyridamole stress echocardiography  

Microsoft Academic Search

Aim: Interobserver variability is an important limitation of the stress echocardiography and depends on the echocardiographer training. Our aim was to evaluate if the use of contrast agents during dipyridamole stress echocardiography would improve the agreement between an experienced and a non-experienced observer in stress echo and therefore if contrast would affect the learning period of dypyridamole stress echo. Methods

Jose Zamorano; Violeta Sánchez; Raúl Moreno; Carlos Almería; Jose Rodrigo; Viviana Serra; Luis Azcona; Adalia Aubele; Luis Mataix; Luis Sánchez-Harguindey

2002-01-01

151

Transthoracic Doppler echocardiography – noninvasive diagnostic window for coronary flow reserve assessment  

Microsoft Academic Search

This review focuses on transthoracic Doppler echocardiography as noninvasive method used to assess coronary flow reserve (CFR) in a wide spectrum of clinical settings. Transthoracic Doppler echocardiography is rapidly gaining appreciation as popular tool to measure CFR both in stenosed and normal epicardial coronary arteries (predominantly in left anterior descending coronary artery). Post-stenotic CFR measurement is helpful in: functional assessment

Pawe? Petkow Dimitrow

2003-01-01

152

Role of Echocardiography in Patients Undergoing Elective Cardioversion of Atrial Fibrillation  

Microsoft Academic Search

Echocardiography has emerged as a fundamental tool in the evaluation of patients with atrial fibrillation (AF). Transthoracic echocardiography remains a primary tool for the evaluation and management of many patients presenting with their first episode of AF, but it is not adequate for exclusion of atrial thrombi. TEE offers excellent visualization of the atria and accurate identification or exclusion of

David I. Silverman; Warren J. Manning

153

Effect of color coding and subtraction on the accuracy of contrast echocardiography  

NASA Technical Reports Server (NTRS)

BACKGROUND: Contrast echocardiography may be used to assess myocardial perfusion. However, gray scale assessment of myocardial contrast echocardiography (MCE) is difficult because of variations in regional backscatter intensity, difficulties in distinguishing varying shades of gray, and artifacts or attenuation. We sought to determine whether the assessment of rest myocardial perfusion by MCE could be improved with subtraction and color coding. METHODS AND RESULTS: MCE was performed in 31 patients with previous myocardial infarction with a 2nd generation agent (NC100100, Nycomed AS), using harmonic triggered or continuous imaging and gain settings were kept constant throughout the study. Digitized images were post processed by subtraction of baseline from contrast data and colorized to reflect the intensity of myocardial contrast. Gray scale MCE alone, MCE images combined with baseline and subtracted colorized images were scored independently using a 16 segment model. The presence and severity of myocardial contrast abnormalities were compared with perfusion defined by rest MIBI-SPECT. Segments that were not visualized by continuous (17%) or triggered imaging (14%) after color processing were excluded from further analysis. The specificity of gray scale MCE alone (56%) or MCE combined with baseline 2D (47%) was significantly enhanced by subtraction and color coding (76%, p<0.001) of triggered images. The accuracy of the gray scale approaches (respectively 52% and 47%) was increased to 70% (p<0.001). Similarly, for continuous images, the specificity of gray scale MCE with and without baseline comparison was 23% and 42% respectively, compared with 60% after post processing (p<0.001). The accuracy of colorized images (59%) was also significantly greater than gray scale MCE (43% and 29%, p<0.001). The sensitivity of MCE for both acquisitions was not altered by subtraction. CONCLUSION: Post-processing with subtraction and color coding significantly improves the accuracy and specificity of MCE for detection of perfusion defects.

Pasquet, A.; Greenberg, N.; Brunken, R.; Thomas, J. D.; Marwick, T. H.

1999-01-01

154

Use of a Simple Criteria Set for Guiding Echocardiography in Nosocomial Staphylococcus aureus Bacteremia  

PubMed Central

(see the editorial commentary and Soriano and Mensa, on pages 10–12.) Background.?Infective endocarditis (IE) is a severe complication in patients with nosocomial Staphylococcus aureus bacteremia (SAB). We sought to develop and validate criteria to identify patients at low risk for the development of IE in whom transesophageal echocardiography (TEE) might be dispensable. Methods.?Consecutive patients with nosocomial SAB from independent cohorts in Europe (Invasive S. aureus Infection Cohort [INSTINCT]) and North America (S. aureus Bacteremia Group [SABG]) were evaluated for the presence of clinical criteria predicting an increased risk for the development of IE (ie, prolonged bacteremia of >4 days' duration, presence of a permanent intracardiac device, hemodialysis dependency, spinal infection, and nonvertebral osteomyelitis). Patients were observed closely for clinical signs and symptoms of IE during hospitalization and a 3-month follow-up period. Results.?IE was present in 13 (4.3%) of 304 patients in the INSTINCT cohort and in 40 (9.3%) of 432 patients in the SABG cohort. Within 14 days after the first positive blood culture result, echocardiography was performed in 39.8% and 57.4% of patients in the INSTINCT and SABG cohorts, respectively. In patients with IE, the most common clinical prediction criteria present were prolonged bacteremia (69.2% vs 90% for INSTINCT vs SABG, respectively) and presence of a permanent intracardiac device (53.8% vs 32.5%). In total, 13 of 13 patients in the INSTINCT cohort and 39 of 40 patients in the SABG cohort with documented IE fulfilled at least 1 criterion (sensitivity, 100% vs. 97.5%; negative predictive value, 100% vs 99.2%). Conclusions.?A simple criteria set for patients with nosocomial SAB can identify patients at low risk of IE. Patients who meet these criteria may not routinely require TEE. PMID:21653295

Fowler, Vance G.; Rieg, Siegbert; Peyerl-Hoffmann, Gabriele; Birkholz, Hanna; Hellmich, Martin; Kern, Winfried V.; Seifert, Harald

2011-01-01

155

Patient-Specific Mitral Valve Closure Prediction using 3D Echocardiography  

PubMed Central

This paper presents an approach to modeling the closure of the mitral valve using patient-specific anatomical information derived from 3D transesophageal echocardiography (3D TEE). Our approach uses physics-based modeling to solve for the stationary configuration of the closed valve structure from the patient-specific open valve structure, which is recovered using a user-in-the-loop, thin-tissue detector segmentation. The method utilizes a tensile shape finding approach based on energy minimization. This method is used to predict the aptitude of the mitral valve leaflets to coapt. We tested the method using ten intraoperative 3D TEE sequences by comparing (a) the closed valve configuration predicted from the segmented open valve, with (b) the segmented closed valve, taken as ground truth. Experiments show promising results, with prediction errors on par with 3D TEE resolution and with good potential for applications in pre-operative planning. PMID:23497987

Burlina, Philippe; Sprouse, Chad; Mukherjee, Ryan; DeMenthon, Daniel; Abraham, Theodore

2013-01-01

156

Does intramedullary canal irrigation reduce fat emboli? A randomized clinical trial with transesophageal echocardiography.  

PubMed

The effect of medullary cavity irrigation on fat emboli during total knee arthroplasty (TKA) was evaluated. Thirty female patients with osteoarthritis were randomly assigned to undergo conventional TKA without irrigation (conventional group) or with medullary canal saline irrigation (irrigation group). The four-chamber view was monitored by transesophageal echocardiography (TEE) and echogenic reflections of fat emboli were observed. The grey-scale score and area ratio of fat emboli were calculated during TKA. Hemodynamic parameters were simultaneously monitored and showed no obvious change between two groups (P>0.05). The average grey-scale score (P=0.016) and area ratio (P=0.033) of emboli were significantly decreased in irrigation group. Removal of medullary contents by irrigation could significantly reduce the formation of fat emboli during TKA. PMID:25458091

Zhao, Jiaqi; Zhang, Jianquan; Ji, Xiufeng; Li, Xuemei; Qian, Qirong; Xu, Qi

2015-03-01

157

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

PubMed Central

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

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

158

Imaging the heart: cardiac scintigraphy and echocardiography in US hospitals (1983)  

SciTech Connect

The rapid growth of cardiac catheterization has raised questions about the availability of less costly, noninvasive tests such as cardiac scintigraphy and echocardiography. To assess their availability and rates of use, we surveyed 3778 non-federal short-term US hospitals in June, 1983. Overall, 2605 hospitals (69%) offered /sup 201/Tl myocardial perfusion scans, 2580 (68%) 99mTc equilibrium gated blood pool scans, and 2483 (67%) cardiac shunt scans; 1679 hospitals (44%) offered M-mode and/or 2-dimensional echocardiography, and 768 (20%) pulsed Doppler echocardiography. Volumes of procedures varied enormously among hospitals capable of performing them. High volumes of both scintigraphy and echocardiography were performed in a small number of hospitals. Larger, voluntary, and teaching hospitals performed higher volumes of both procedures. Despite widespread availability of these noninvasive technologies, high volumes of both cardiac scintigraphy and echocardiography procedures are concentrated in a small number of US hospitals.

McPhee, S.J.; Garnick, D.W.

1986-10-01

159

Right ventricular function and ventricular perfusion defects in adults with congenitally corrected transposition: correlation of echocardiography and nuclear medicine.  

PubMed

We undertook our study in order to evaluate right ventricular function and perfusion by conventional and contrast echocardiography in adults with congenitally corrected transposition who had not undergone cardiac surgery, comparing the echocardiographic findings with those obtained using equilibrium radionuclide ventriculography and gated single-photon emission computed tomography with Technetiumc-99 m sestamibi. We discovered severe tricuspid regurgitation in 8 patients (61%). Right ventricular ejection fraction, as calculated by nuclear medicine, had a correlation of 0.67 (p = 0.059) with area fractional shortening and 0.84 (p = 0.01) with ejection fraction calculated by the method depending on descent of the tricuspid ring. All patients with severe tricuspid regurgitation also had right ventricular dysfunction. Of these 8 patients, 7 had persistent perfusion defects, while 6 also had ischemic perfusion defects. Echo contrast had a high sensitivity, at 91%, and also specificity and positive predictive value, both at 100%, for persistent defects, and a negative predictive value of 66% compared to methods depending on nuclear medicine. The sensitivity of contrast echocardiography for detection of ischemic defects was 66%, the specificity 100%, the positive predictive value 100%, and the negative predictive value 77% compared to the methods involving nuclear medicine. The method depending on descent of the tricuspid ring had the highest correlation with equilibrium radionuclide ventriculography in evaluation of right ventricular function in patients with congenitally corrected transposition. We conclude that contrast echocardiography is extremely valuable when assessing right ventricular myocardial perfusion, having high sensitivity and specificity for detecting persistent defects, although sensitivity was less for detection of ischemic defects than that of gated single-photon emission computed tomography with Technetium-99 m Sestamibi. Persistent and ischemic perfusion defects, together with chronic volume overload from tricuspid regurgitation, are the determining factors of right ventricular dysfunction. PMID:15691407

Espinola-Zavaleta, Nilda; Alexanderson, Erick; Attié, Fause; Castellanos, Luis Muñoz; Dueñas, Roy; Rosas, Martín; Keirns, Candace

2004-04-01

160

Cardiac Impairment Evaluated by Transesophageal Echocardiography and Invasive Measurements in Rats Undergoing Sinoaortic Denervation  

PubMed Central

Background Sympathetic hyperactivity may be related to left ventricular (LV) dysfunction and baro- and chemoreflex impairment in hypertension. However, cardiac function, regarding the association of hypertension and baroreflex dysfunction, has not been previously evaluated by transesophageal echocardiography (TEE) using intracardiac echocardiographic catheter. Methods and Results We evaluated exercise tests, baroreflex sensitivity and cardiovascular autonomic control, cardiac function, and biventricular invasive pressures in rats 10 weeks after sinoaortic denervation (SAD). The rats (n?=?32) were divided into 4 groups: 16 Wistar (W) with (n?=?8) or without SAD (n?=?8) and 16 spontaneously hypertensive rats (SHR) with (n?=?8) or without SAD (SHRSAD) (n?=?8). Blood pressure (BP) and heart rate (HR) did not change between the groups with or without SAD; however, compared to W, SHR groups had higher BP levels and BP variability was increased. Exercise testing showed that SHR had better functional capacity compared to SAD and SHRSAD. Echocardiography showed left ventricular (LV) concentric hypertrophy; segmental systolic and diastolic biventricular dysfunction; indirect signals of pulmonary arterial hypertension, mostly evident in SHRSAD. The end-diastolic right ventricular (RV) pressure increased in all groups compared to W, and the end-diastolic LV pressure increased in SHR and SHRSAD groups compared to W, and in SHRSAD compared to SAD. Conclusions Our results suggest that baroreflex dysfunction impairs cardiac function, and increases pulmonary artery pressure, supporting a role for baroreflex dysfunction in the pathogenesis of hypertensive cardiac disease. Moreover, TEE is a useful and feasible noninvasive technique that allows the assessment of cardiac function, particularly RV indices in this model of cardiac disease. PMID:24828834

Sirvente, Raquel A.; Irigoyen, Maria C.; Souza, Leandro E.; Mostarda, Cristiano; La Fuente, Raquel N.; Candido, Georgia O.; Souza, Pamella R. M.; Medeiros, Alessandra; Mady, Charles; Salemi, Vera M. C.

2014-01-01

161

Physiologic assessment of coronary artery stenosis by coronary flow reserve measurements with transthoracic doppler echocardiography: comparison with exercise thallium-201 single-photon emission computed tomography  

Microsoft Academic Search

OBJECTIVESWe evaluated the value of coronary flow reserve (CFR), as determined by transthoracic Doppler echocardiography (TTDE), for physiologic assessment of coronary artery stenosis severity, and we compared TTDE measurements with those obtained by exercise thallium-201 (Tl-201) single-photon emission computed tomography (SPECT).BACKGROUNDCoronary flow reserve measurements by TTDE have been reported to be useful for assessing angiographic left anterior descending coronary artery

Masao Daimon; Hiroyuki Watanabe; Hiroyuki Yamagishi; Takashi Muro; Kaname Akioka; Kumiko Hirata; Kazuhide Takeuchi; Junichi Yoshikawa

2001-01-01

162

Indium-111 platelet scintigraphy and two-dimensional echocardiography for detection of left ventricular thrombus: influence of clot size and age  

SciTech Connect

Two-dimensional echocardiography and indium-111 platelet scintigraphy were performed on 50 dogs to determine the influence of clot age and size on the detection of experimentally induced left ventricular mural thrombus. Thrombus was induced by apical infarction and injection of a sclerosing agent and thrombin. The animals were classified into four groups according to the time of indium-111 platelet injection after thrombus induction: Group I (17 dogs, 1/2 hour after induction; 3 dogs, before induction), Group II (12 dogs, 24 hours after induction) and Group III (12 dogs, 1 week after induction). In Group IV (six control dogs) apical infarction was produced, but thrombin was not injected; indium-111 platelets were injected 1/2 to 1 hour after infarction. The dogs were studied by indium-111 platelet scintigraphy and by two-dimensional echocardiography 1/2 to 5 hours (Group I) and 1 to 5 and up to 72 hours (Groups II to IV) after platelet administration and before death was induced. Two-dimensional echocardiography showed the best overall sensitivity for detection of acute thrombus (97%; 29 of 30). The sensitivity of indium-111 platelet scintigraphy was 86% (18 of 21) for clots greater than or equal to 0.08 ml in size, and 67% (20 of 30) for detection of all clots. Thrombus did not form in 14 dogs of Groups I to III and in 6 of 6 control dogs. The specificity of scintigraphy was 100% (20 of 20) compared with 80% (16 of 20) for echocardiography. Echocardiography was more sensitive than scintigraphy for detecting very small clots in this experimental model.

Seabold, J.E.; Schroeder, E.C.; Conrad, G.R.; Ponto, J.; Bruch, P.; Petersen, D.; Johnson, J.; Kieso, R.; Hunt, M.; Olson, J.D.

1987-05-01

163

Endurance and Strength Athlete's Heart: Analysis of Myocardial Deformation by Speckle Tracking Echocardiography  

PubMed Central

Background Intensive training induces two morphological myocardial typologies of athlete's heart. Endurance training (ET) induces eccentric remodeling, bradycardia and better diastolic filling. Strength training (ST) determines concentric chamber remodelling maintaining a normal heart rate (HR). Aim of the study was to compare ET and ST athletes' heart using speckle tracking echocardiography (STE). Methods 33 professional ET, 36 ST athletes, and 17 healthy controls (CT) were enrolled. All subjects underwent standard transthoracic echocardiography at rest and STE. Results In ET group, HR was lower than ST group and CT group (p < 0.001; p < 0.01). ET group had higher E/A ratio than ST group and CT group (p < 0.01; p < 0.001). The left ventricular apical circumferential strain in ET group was lower than ST group and CT group (-21.6 ± 4.1% vs. -26.8 ± 7.7%, p < 0.05; vs. -27.8 ± 5.6%, p < 0.01). ET group had lower left ventricular twist (LVT) and untwisting (UTW) than ST group (6.2 ± 0.1° vs. 12.0 ± 0.1°, p < 0.01; -67.3 ± 22.9°/s vs. -122.5 ± 52.8°/s, p < 0.01) and CT group (10.0 ± 0.1°, p < 0.01; -103.3 ± 29.3°/s, p < 0.01). The univariate analysis showed significant correlation between E/A ratio and HR (r = -0.54; p < 0.001), LVT (r = -0.45; p < 0.01), UTW (r = 0.24; p < 0.05). At the multivariate analysis only HR was confirmed as independent predictor of diastolic function in all groups (Beta -0.52; p < 0.001). Conclusion In ET there was a better global systolic and diastolic functional reserve at rest observed with strain analysis and it maybe depended on autonomic modulation. PMID:25580194

Santoro, Amato; Antonelli, Giovanni; Caputo, Maria; Padeletti, Margherita; Lisi, Matteo; Mondillo, Sergio

2014-01-01

164

Echocardiography and heart failure: a glimpse of the right heart.  

PubMed

The catastrophic consequences for patients in the settings of certain clinical conditions such as acute right ventricular infarction or massive pulmonary embolism with right heart failure illustrate the essential role that the right ventricle plays in sustaining life. With the development of more sophisticated diagnostic imaging technologies at the end of the last century and the dawn of this century, the importance of the right ventricle has been clearly demonstrated. The continued and evolving nature of our understanding of the right ventricle was emphasized in 2006, when the National Heart, Blood, and Lung Institute formed a working group focused on developing a better understanding of the right ventricle in both healthy and disease states. The objective of this review paper is to examine the right ventricle structure and function and describe the role of echocardiography in the evaluation of the right ventricle and right heart failure. Special focus will be on echocardiographic images and major society guidelines. PMID:25234293

Pleister, Adam; Kahwash, Rami; Haas, Garrie; Ghio, Stefano; Cittadini, Antonio; Baliga, Ragavendra R

2015-01-01

165

On-Orbit Prospective Echocardiography on International Space Station Crew  

NASA Technical Reports Server (NTRS)

Introduction A prospective trial of echocardiography was conducted on of six crewmembers onboard the International Space Station. The main objective was to determine the efficacy of remotely guided tele-echocardiography, including just-in-time e-training methods and determine what "space normal" echocardiographic data is. Methods Each crewmember operator (n=6) had 2-hour preflight training. Baseline echocardiographic data were collected 55 to 167days preflight. Similar equipment was used in each 60-minute in-flight session (mean microgravity exposure - 114 days (34 -- 190)). On Orbit ultrasound operators used an e-learning system within 24h of these sessions. Expert assistance was provided using ultrasound video downlink and two-way voice. Testing was repeated 5 to 16 days after landing. Separate ANOVA was used on each echocardiographic variable (n=33). Within each ANOVA, three tests were made: a) effect of mission phase (preflight, in-flight, post flight); b) effect of echo technician (two technicians independently analyzed the data); c) interaction between mission phase and technician. Results Nine rejections of the null hypothesis (mission phase or technician or both had no effect) were discovered and considered for follow up. Of these, six rejections were for significant technician effects, not as a result of space flight. Three rejections of the null hypothesis (Aortic Valve time velocity integral, Mitral E wave Velocity and heart rate) were attributable to space flight, however determined not to be clinically significant. No rejections were due to the interaction between technician and space flight. Conclusion No consistent clinically significant effects of long-duration space flight were seen in echocardiographic variables of the given group of subjects.

Hamilton, Douglas R.; Sargsyan, Ashot E.; Martin, David S.; Garcia, Kathleen M.; Melton, Shannon L.; Feiveson, Alan; Dulchavsky, Scott A.

2010-01-01

166

Extreme Tele-Echocardiography: Methodology for Remote Guidance of In-flight Echocardiography Aboard the International Space Station  

NASA Technical Reports Server (NTRS)

Echocardiography is ideally suited for cardiovascular imaging in remote environments, but the expertise to perform it is often lacking. In 2001, an ATL HDI5000 was delivered to the International Space Station (ISS). The instrument is currently being used in a study to investigate the impact of long-term microgravity on cardiovascular function. The purpose of this report is to describe the methodology for remote guidance of echocardiography in space. Methods: In the year before launch of an ISS mission, potential astronaut echocardiographic operators participate in 5 sessions to train for echo acquisitions that occur roughly monthly during the mission, including one exercise echocardiogram. The focus of training is familiarity with the study protocol and remote guidance procedures. On-orbit, real-time guidance of in-flight acquisitions is provided by a sonographer in the Telescience Center of Mission Control. Physician investigators with remote access are able to relay comments on image optimization to the sonographer. Live video feed is relayed from the ISS to the ground via the Tracking and Data Relay Satellite System with a 2 second transmission delay. The expert sonographer uses these images along with two-way audio to provide instructions and feedback. Images are stored in non-compressed DICOM format for asynchronous relay to the ground for subsequent off-line analysis. Results: Since June, 2009, a total of 19 resting echocardiograms and 4 exercise studies have been performed in-flight. Average acquisition time has been 45 minutes, reflecting 26,000 km of ISS travel per study. Image quality has been adequate in all studies, but remote guidance has proven imperative for fine-tuning imaging and prioritizing views when communication outages limit the study duration. Typical resting studies have included 12 video loops and 21 still-frame images requiring 750 MB of storage. Conclusions: Despite limited crew training, remote guidance allows research-quality echocardiography to be performed by non-experts aboard the ISS. Analysis is underway and additional subjects are being recruited to define the impact of microgravity on cardiac structure and systolic and diastolic function.

Martin, David; Borowski, Allan; Bungo, Michael W.; Dulchavsky, Scott; Gladding, Patrick; Greenberg, Neil; Hamilton, Doug; Levine, Benjamin D.; Norwoord, Kelly; Platts, Steven H.; Poston, Sue; Roper, Matthew; Sandoz, Gwenn; Thomas, James D.

2011-01-01

167

History of echocardiography in the Netherlands: 30 years of education and clinical applications  

PubMed Central

The development of ultrasound has created great opportunities for diagnostic cardiac imaging. For more than 30 years, echocardiography has been the most important and cost-effective diagnostic imaging modality in clinical cardiology. Many developments originated in the Netherlands, including the very first practical real-time crosssectional imaging of the moving heart with a linear array. Milestones include the first portable echo apparatus, early versions of echo catheters and transoesophageal echocardiography probes as well as many clinical ‘firsts’ with reference to the more than 100 Dutch dissertations related to echocardiography. The future of echocardiography promises to be as productive and exciting as it has been in the previous three decades, including threedimensional echocardiography, myocardial perfusion echocardiography, tissue Doppler imaging and speckle tracking. New potential therapeutic applications are upcoming. In this article, the advances of echocardiography in the Netherlands are described, in the past and during 30 years of education, as was recently presented by three Dutch pioneers during the ‘Echomiddagen 2006-2007’ organised by the CVOI. (Neth Heart J 2008;16:16-20.18317539) PMID:18317539

Kamp, O.

2008-01-01

168

Feasibility and Reproducibility of Left Ventricular Rotation by Speckle Tracking Echocardiography in Elderly Individuals and the Impact of Different Software  

PubMed Central

Background Changes in ventricular rotation measured by two-dimensional speckle tracking echocardiography (2DSTE) are early indicators of cardiac disease. Data on the clinical feasibility of this important measure are scarce and there is no information on the comparability of different software versions. We assessed the feasibility, reproducibility and within patient temporal variability of 2DSTE in a large community based sample of older adults. We additionally compared 2DSTE results to those generated by 3DSTE. Methods and results 1408 participants underwent transthoracic echocardiography. Using Philips Qlab 8.1 peak LV rotation at either the base or the apex was analysable in 432 (31%) participants. Peak twist measurements were achieved in 274 (20%) participants. 66 participants were randomly selected for the reproducibility study. 20 additional participants had scans 4–6 weeks apart for temporal variability and 3D echocardiography to assess the agreement between 2DSTE and 3DSTE. Reproducibility was evaluated using the intraclass coefficient of correlation (ICC). Better reproducibility for rotation and twist were obtained when measured at the endocardium, and when using more recent software versions, Peak twist and rotation were significantly different using two versions of the same software. Agreement with 3DSTE was better using newer software. Conclusion Feasibility of 2DSTE is low in this cohort of elderly individuals severely limiting its utility in clinical settings. However if high quality images can be acquired assessment of ventricular rotation by 2DSTE is reproducible. Caution should be taken when comparing measurements of ventricular rotation by software from different vendors or different versions of software from the same vendor. PMID:24058652

Park, Chloe M.; March, Katherine; Williams, Suzanne; Kukadia, Suraj; Ghosh, Arjun K.; Jones, Siana; Tillin, Therese; Chaturvedi, Nish; Hughes, Alun D.

2013-01-01

169

Severe mitral regurgitation caused by perivalvular abnormal communication of the mitral valve due to blunt chest trauma.  

PubMed

Perivalvular leaks are usually caused by suture interruption in prosthetic valves or infective endocarditis. Traumatic mitral annular dehiscence is a very uncommon event. We present a rare case of severe mitral regurgitation secondary to perivalvular abnormal communication in a 35-year-old man with a history of blunt chest trauma. He presented with symptoms of cough and chest tightness for 3 months. Preoperative two-dimensional and real time three-dimensional transesophageal echocardiography clearly showed the position and size of the perivalvular abnormal communication and the incident damage of the left ventricular wall. The patient finally underwent successful surgical repair. PMID:23186363

Wu, Wei-Hua; Xie, Xiao-Yi; Ma, Lan; Lu, Jing

2013-03-01

170

Three-dimensional echocardiography in congenital malformations of the mitral valve.  

PubMed

Three-dimensional echocardiography has proved to be valuable in congenital heart disease by enhancing the evaluation of morphologic abnormalities and increasing the understanding of complex relationships. This study was undertaken to determine how 3-dimensional echocardiography could be best used to study some of the congenital malformations of the mitral valve such as mitral arcade, double orifice mitral valve, accessory mitral tissue, cleft mitral valve, and unicuspid mitral valve. Five patients were studied. Three-dimensional echocardiography was found to be helpful in defining spatial location and extent of deformities. PMID:12019431

Espinola-Zavaleta, Nilda; Vargas-Barrón, Jesus; Keirns, Candace; Rivera, Guillermo; Romero-Cárdenas, Angel; Roldán, Javier; Attie, Fause

2002-05-01

171

[Transesophageal echocardiography in patients with chronic atrial fibrillation and cerebral ischemia].  

PubMed

The authors wanted to verify the possibility of discovering, by means of transesophageal echocardiography, cardiac causes that can't be clearly shown with 2D echocardiography, in patients who suffered a cerebral ischaemic pathology and who had a cronic atrial fibrillation. The left atrial appendage is not well visualized by the 2D echocardiographic approach. Transesophageal echocardiography has been shown to be superior to transthoracic imaging in the evaluation of the mass lesions in the left atrium and his appendage and often the best visualization of the mitral valve leaflets and aortic semilunar cusps. PMID:8819808

Pennacchietti, L; Assouad, C C; Balestrini, F; Fratalocchi, S; Funari, R; Vesprini, A; Bellagamba, G

1995-10-01

172

A Study of the Adult Zebrafish Ventricular Function by Retrospective Doppler-Gated Ultrahigh-Frame-Rate Echocardiography  

PubMed Central

The zebrafish (Danio rerio) has become a preferred animal model for studying various human diseases, particularly those related to cardiovascular regeneration; therefore, a noninvasive imaging modality is needed for observing the cardiac function of zebrafish. Because of its high resolution, high-frequency ultrasound B-mode imaging has recently been used successfully to observe the heart of adult zebrafish. However, ultrahigh-frame-rate echocardiography combining B-mode imaging and color flow imaging is still needed to observe the detailed transient motions of the zebrafish ventricle. This study develops an 80-MHz ultrahigh-frame-rate echocardiography system for this purpose, based on retrospective Doppler- gated technology. B-mode and color flow images of the cardiovascular system of the zebrafish were reconstructed by two-dimensional autocorrelation at maximum frame rates of up to 40 000 and 400 fps, respectively. The timings of end diastole (ED) and end systole (ES) of ventricle can be determined by using this high-resolution image system. Two ventricular function parameters—fractional shortening (FS) and fractional area change (FAC)—were measured for evaluating the ventricular function by using ED and ES with their corresponding ventricular dimensions. The experimental results indicated that the measured FS values were 42 ± 4% (mean ± standard deviation) and 60 ± 13% for the long axis and short axis of the ventricle, respectively, and that FAC was 77 ± 9%. This is the first report of these ventricular function parameters for a normal adult zebrafish. The results showed that retrospective high-frequency echocardiography is a useful tool for studying the cardiac function of normal adult zebrafish. PMID:24658716

Liu, Ting-Yu; Lee, Po-Yang; Huang, Chih-Chung; Sun, Lei; Shung, K. Kirk

2014-01-01

173

Two- and three-dimensional echocardiography in primary antiphospholipid syndrome: misdiagnosis as rheumatic valve disease.  

PubMed

This is a report of a woman in the fifth decade of life with primary antiphospholipid syndrome and involvement of a heart valve. Diagnosis was reached with echocardiography and serological studies. PMID:11480851

Espinola-Zavaleta, N; Amigo, M C; Vargas-Barrón, J; Keirns, C; Cárdenas, A R; Vidal, M; Roldán, J

2001-01-01

174

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

PubMed Central

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

Esmaeilzadeh, Maryam; Parsaee, Mozhgan; Maleki, Majid

2013-01-01

175

Left atrial thrombus associated with ablation for atrial fibrillation: identification with intracardiac echocardiography  

Microsoft Academic Search

ObjectivesThis study reports the incidence of, risk factors for, and management of left atrial (LA) thrombus documented by intracardiac echocardiography (ICE) during LA ablation for atrial fibrillation (AF).

Jian-Fang Ren; Francis E Marchlinski; David J Callans

2004-01-01

176

Flow quantitation by radio frequency analysis of contrast echocardiography.  

PubMed

Contrast echocardiography has the potential for measuring cardiac output and regional blood flow. However, accurate quantitation is limited both by the use of non-standard contrast agents and by the electronic signal distortion inherent to the echocardiographic instruments. Thus, the aim of this study is to quantify flow by combining a stable contrast agent and a modified echo equipment, able to sample the radio frequency (RF) signal from a region of interest (ROI) in the echo image. The contrast agent SHU-454 (0.8 ml) was bolus injected into an in vitro calf vein, at 23 flow rates (ranging from 376 to 3620 ml/min) but constant volume and pressure. The ROI was placed in the centre of the vein, the RF signal was processed in real time and transferred to a personal computer to generate time-intensity curves. In the absence of recirculation, contrast washout slope and mean transit time (MTT) of curves (1.11-8.52 seconds) yielded excellent correlations with flow: r = 0.93 and 0.95, respectively. To compare the accuracy of RF analysis with that of conventional image processing as to flow quantitation, conventional images were collected in the same flow model by two different scanners: a) the mechanical sector scanner used for RF analysis, and b) a conventional electronic sector scanner. These images were digitized off-line, mean videodensity inside an identical ROI was measured and time-intensity curves were built. MTT by RF was shorter than by videodensitometric analysis of the images generated by the same scanner (p < 0.001). In contrast, MTT by RF was longer than by the conventional scanner (p < 0.001). Significant differences in MTT were also found with changes in the gain setting controls of the conventional scanner. To study the stability of the contrast effect, 6 contrast injections (20 ml) were performed at a constant flow rate during recirculation: the spontaneous decay in RF signal intensity (t1/2 = 64 +/- 8 seconds) was too long to affect MTT significantly. In conclusion, the combination of a stable contrast agent and a modified echocardiographic instrument provides accurate quantitation of flow in an in vitro model; RF analysis is more accurate than conventional processing as to flow quantitation by contrast echocardiography. PMID:8492003

Rovai, D; Lombardi, M; Mazzarisi, A; Landini, L; Taddei, L; Distante, A; Benassi, A; L'Abbate, A

1993-03-01

177

Benzocaine-induced methemoglobinemia: Experience from a high-volume transesophageal echocardiography laboratory  

Microsoft Academic Search

Benzocaine (ethyl aminobenzoate), a topical anesthetic widely used before transesophageal echocardiography, has been reported to cause acquired methemoglobinemia. The incidence of benzocaine-induced methemoglobinemia in clinical practice, however, has been difficult to estimate. After systematic review of our institutional experience for clinically recognized cases of benzocaine-induced methemoglobinemia in patients undergoing transesophageal echocardiography, we report an estimated incidence of 0.115% (95% confidence

Gian M. Novaro; Herbert D. Aronow; Michael A. Militello; Mario J. Garcia; Ellen Mayer Sabik

2003-01-01

178

Noninvasive Visualization and Measurement of Middle Cardiac Vein Flow by Transthoracic Doppler Echocardiography  

Microsoft Academic Search

Transthoracic Doppler echocardiography offers a noninvasive approach for imaging posterior descending coronary artery (PD)\\u000a running in the posterior longitudinal sulcus along the middle cardiac vein (MCV). To evaluate whether the MCV flow velocity\\u000a reserve can reflect the PD flow reserve, 22 children with various heart diseases were examined using transthoracic Doppler\\u000a echocardiography. Introduction of a modified transthoracic two chamber view

Kenji Harada; Masamichi Tamura; Manatoma Toyono

2006-01-01

179

The Echocardiography in the Cardiovascular Laboratory: A Guide to Research with Animals  

PubMed Central

The feasibility and potential for the morphological and hemodynamic investigation of the heart has been increasing the use of the echocardiography in the research setting. Additionally, the development of new technologies, like the real time 3D echocardiography and speckle tracking, demands validation throughout experimental studies before being instituted in the clinical setting. This paper aims to provide information concerning the particularities of the echocardiographic examination in quadruped mammals, targeting the experimental research. PMID:24652090

Abduch, Maria Cristina Donadio; Assad, Renato Samy; Mathias Jr, Wilson; Aiello, Vera Demarchi

2014-01-01

180

Results of a Prospective Echocardiography Trial in International Space Station Crew  

NASA Technical Reports Server (NTRS)

In the framework of an operationally oriented investigation, we conducted a prospective trial of a standard clinical echocardiography protocol in a cohort of long-duration crewmembers. The resulting primary and processed data appear to have no precedents. Our tele-echocardiography paradigm, including just-in-time e-training methods, was also assessed. A critical review of the imaging technique, equipment and setting limitations, and quality assurance is provided, as well as the analysis of "space normal" data.

Hamilton, Douglas R.; Sargsyan, Ashot E.; Martin, David; Garcia, Kathleen M.; Melton, Shannon; Feiverson, Alan; Dulchavsky, Scott A.

2009-01-01

181

The Diane Rehm Show  

NSDL National Science Digital Library

The Diane Rehm Show has its origins in a mid-day program at WAMU in Washington, D.C. Diane Rehm came on to host the program in 1979, and in 1984 it was renamed "The Diane Rehm Show". Over the past several decades, Rehm has played host to hundreds of guests, include Archbishop Desmond Tutu, Julie Andrews, and President Bill Clinton. This website contains an archive of her past programs, and visitors can use the interactive calendar to look through past shows. Those visitors looking for specific topics can use the "Topics" list on the left-hand side of the page, or also take advantage of the search engine. The show has a number of social networking links, including a Facebook page and a Twitter feed.

182

A Primer on the Methods and Applications for Contrast Echocardiography in Clinical Imaging  

PubMed Central

Contrast echocardiography is broadly described as a variety of techniques whereby the blood pool on cardiac ultrasound is enhanced with encapsulated gas-filled microbubbles or other acoustically active nano- or microparticles. The development of this technology has occurred primarily in response to the need improve current diagnostic applications of echocardiography such as the need to better define left ventricular cavity volumes, regional wall motion, or the presence or absence of masses and thrombi. A secondary reason for the development of contrast echocardiography has been to expand the capabilities of echocardiography. These new applications include myocardial perfusion imaging for detection of ischemia and viability, perfusion imaging of masses/tumors, and molecular imaging. The ability to fill all of these current and future clinical roles has been predicated on the ability to produce robust contrast signal which, in turn, has relied on technical innovation with regards to the microbubble contrast agents and the ultrasound imaging paradigms. In this review, we will discuss the basics of contrast echocardiography including the composition of microbubble contrast agents, the unique imaging methods used to optimize contrast signal-to-noise ratio, and the clinical applications of contrast echocardiography that have made a clinical impact. PMID:25309685

Seol, Sang-Hoon

2014-01-01

183

Premature aortic stiffness in systemic lupus erythematosus by transesophageal echocardiography.  

PubMed

To assess aortic stiffness by transesophageal echocardiography (TEE) and to determine its clinical predictors and relation to age, blood pressure, renal function, and atherosclerosis, 50 patients with systemic lupus erythematosus (SLE), 94% women, with a mean age of 38 ± 12 years, and 22 age and gender-matched healthy controls underwent clinical and laboratory evaluations and multiplane TEE to assess stiffness, intima-media thickness (IMT), and plaques of the proximal, mid, and distal descending thoracic aorta. Stiffness at each level and overall aortic stiffness by the pressure-strain elastic modulus was higher in patients than in controls after adjusting for age (overall, 8.25 ± 4.13 versus 6.1 ± 2.5 Pascal units, p = 0.01). Patients had higher aortic stiffness than controls after adjusting both groups to the same mean age, blood pressure, creatinine, and aortic IMT (p = 0.005). Neither IMT nor plaques were predictors of aortic stiffness. Moreover, normotensive patients, those without aortic plaques, and non-smokers had higher stiffness than controls (all p < 0.05). Age at SLE diagnosis and non-neurologic damage score were the only SLE-specific independent predictors of aortic stiffness (both p ? 0.01). Thus, increased aortic stiffness is an early manifestation of lupus vasculopathy that seems to precede the development of hypertension and atherosclerosis. PMID:20813797

Roldan, C A; Joson, J; Qualls, C R; Sharrar, J; Sibbitt, W L

2010-12-01

184

Peripheral vein contrast echocardiography in atrial septal defect.  

PubMed

This study was carried out on 233 children suspected clinically of having atrial septal defect with the aim of investigating the diagnostic capability of peripheral venous contrast echocardiography. The transfer of contrast material from the right atrium into the left atrium was evaluated as "positive contrast", while noncontrast blood, passing from the left atrium into the right atrium was termed "negative contrast". Positive contrasts were quantitated in four grades. A significant negative contrast effect was graded 3- or 4-. Three positive, 4+ and/or 3-, 4- contrast effects were considered definite evidence of an atrial septal defect. Among the cases with the above findings 92 underwent surgical closure of atrial septal defect. The procedure was successful in all patients operated; the size of the defect was large. This result demonstrates that the method applied is a safe and reliable one. However, in a group of cases without the above echocardiographic findings the presence of an atrial septal defect was detected by cardiac catheterization and angiocardiography. Therefore, we can conclude that the method applied is not a sensitive, but a specific one, for definite detection of atrial septal defect. PMID:2692260

Saraçlar, M; Ozme, S; Ozkutlu, S; Bozer, A Y; Yurdakul, Y; Pa?ao?lu, I; Oztunç, F; Ozer, S; Baysal, K; Gedik, S

1989-01-01

185

Use of Echocardiography Reveals Reestablishment of Ventricular Pumping Efficiency and Partial Ventricular Wall Motion Recovery upon Ventricular Cryoinjury in the Zebrafish  

PubMed Central

Aims While zebrafish embryos are amenable to in vivo imaging, allowing the study of morphogenetic processes during development, intravital imaging of adults is hampered by their small size and loss of transparency. The use of adult zebrafish as a vertebrate model of cardiac disease and regeneration is increasing at high speed. It is therefore of great importance to establish appropriate and robust methods to measure cardiac function parameters. Methods and Results Here we describe the use of 2D-echocardiography to study the fractional volume shortening and segmental wall motion of the ventricle. Our data show that 2D-echocardiography can be used to evaluate cardiac injury and also to study recovery of cardiac function. Interestingly, our results show that while global systolic function recovered following cardiac cryoinjury, ventricular wall motion was only partially restored. Conclusion Cryoinjury leads to long-lasting impairment of cardiac contraction, partially mimicking the consequences of myocardial infarction in humans. Functional assessment of heart regeneration by echocardiography allows a deeper understanding of the mechanisms of cardiac regeneration and has the advantage of being easily transferable to other cardiovascular zebrafish disease models. PMID:25532015

Marques, Inês João; Sánchez-Iranzo, Héctor; Jiménez-Borreguero, Luis Jesús; Mercader, Nadia

2014-01-01

186

Pulmonary vein antrum isolation guided by phased-array intracardiac echocardiography  

PubMed Central

Background Pulmonary vein isolation (PVI) has emerged as an important strategy in the treatment of patients with atrial fibrillation (AF). The two most frequently used techniques are segmental PVI and left atrial circumferential ablation. Aim To describe and discuss pulmonary vein antrum isolation guided by phased-array intracardiac echocardiography (ICE) as an alternative approach, and to present initial results. Methods Patients with symptomatic AF were included. The antra (the larger circumferential area around the PVs) were isolated guided by ICE. ICE was also used to titrate the ablation energy. Results 38 patients (3 with persistent AF) were included. Of the 35 patients with paroxysmal AF, 24 are without recurrences, and in six the incidence of paroxysms was significantly reduced after one procedure and a mean follow-up of 201 days. No major complications occurred. Conclusion Pulmonary vein antrum isolation guided by ICE is a promising technique in AF ablation and has the potential to avoid severe complications. ImagesFigure 1Figure 2Figure 4 PMID:25696440

Scholten, M.F.; Thornton, A.S.; Mekel, J.; Rivero-Ayerza, M.J.; Marrouche, N.F.; Jordaens, L.J.

2005-01-01

187

Estimation of diastolic intraventricular pressure gradients by Doppler M-mode echocardiography  

NASA Technical Reports Server (NTRS)

Previous studies have shown that small intraventricular pressure gradients (IVPG) are important for efficient filling of the left ventricle (LV) and as a sensitive marker for ischemia. Unfortunately, there has previously been no way of measuring these noninvasively, severely limiting their research and clinical utility. Color Doppler M-mode (CMM) echocardiography provides a spatiotemporal velocity distribution along the inflow tract throughout diastole, which we hypothesized would allow direct estimation of IVPG by using the Euler equation. Digital CMM images, obtained simultaneously with intracardiac pressure waveforms in six dogs, were processed by numerical differentiation for the Euler equation, then integrated to estimate IVPG and the total (left atrial to left ventricular apex) pressure drop. CMM-derived estimates agreed well with invasive measurements (IVPG: y = 0.87x + 0.22, r = 0.96, P < 0.001, standard error of the estimate = 0.35 mmHg). Quantitative processing of CMM data allows accurate estimation of IVPG and tracking of changes induced by beta-adrenergic stimulation. This novel approach provides unique information on LV filling dynamics in an entirely noninvasive way that has previously not been available for assessment of diastolic filling and function.

Greenberg, N. L.; Vandervoort, P. M.; Firstenberg, M. S.; Garcia, M. J.; Thomas, J. D.

2001-01-01

188

Design of a Matrix Transducer for Three-Dimensional Second Harmonic Transesophageal Echocardiography  

NASA Astrophysics Data System (ADS)

Three-dimensional (3D) echocardiography visualizes the 3D anatomy and function of the heart. For 3D imaging an ultrasound matrix of several thousands of elements is required. To connect the matrix to an external imaging system, smart signal processing with integrated circuitry in the tip of the TEE probe is required for channel reduction. To separate the low voltage integrated receive circuitry from the high voltages required for transmission, our design features a separate transmit and receive subarray. In this study we focus on the transmit subarray. A 3D model of an individual element was developed using the finite element method (FEM). The model was validated by laser interferometer and acoustic measurements. Measurement and simulations matched well. The maximum transmit transfer was 3 nm/V at 2.4 MHz for both the FEM simulation of an element in air and the laser interferometer measurement. The FEM simulation of an element in water resulted in a maximum transfer of 43 kPa/V at 2.3 MHz and the acoustic measurement in 55 kPa/V at 2.5 MHz. The maximum pressure is ~1 MPa/120Vpp, which is sufficient pressure for second harmonic imaging. The proposed design of the transmit subarray is suitable for its role in a 3D 2H TEE probe.

Blaak, Sandra; van Neer, Paul L. M. J.; Prins, Christian; Bosch, Johan G.; Lancée, Charles T.; van der Steen, Antonius F. W.; de Jong, Nico

189

USCOM (Ultrasonic Cardiac Output Monitors) lacks agreement with thermodilution cardiac output and transoesophageal echocardiography valve measurements.  

PubMed

The USCOM (Ultrasonic Cardiac Output Monitors) device is a non-invasive cardiac output monitor, which utilises transaortic or transpulmonary Doppler flow tracing and valve area estimated using patient height to determine cardiac output. We evaluated USCOM against thermodilution cardiac outputs and transoesophageal echocardiography valve area measurements in 22 ASA PS4 cardiac surgical patients. Data collection commenced following pulmonary artery catheter insertion, with cardiac output measurements repeated after sternotomy closure. Failure to obtain transaortic Doppler readings using USCOM occurred in 5% of planned measurements. USCOM transaortic analysis was not planned for 11 patients with known aortic disease. Bias at the aortic window (n = 20) was -0.79 l/min with limits of agreement from -3.66 to 2.08 l/min. At the pulmonary window, failure to obtain Doppler readings occurred in 24% of planned measurements. Bias at the pulmonary window (n = 36) was -0.17 l/min with limits of agreement from -3.30 to 2.97 l/min. The USCOM estimates of valve area based on height showed poor correlation with the echocardiographic measurements of aortic and pulmonary valves (r = 0.57 and r = 0.17, respectively). It was concluded that USCOM showed poor agreement with thermodilution. The estimated valve area was identified as one source of error. PMID:18084981

Van den Oever, H L A; Murphy, E J; Christie-Taylor, G A

2007-12-01

190

Temporal obesity trends in patients undergoing transthoracic echocardiography 2002-2006.  

PubMed

In a recent data brief, the National Center for Health Statistics reported that obesity prevalence has plateaued in recent years, with no increase in obesity from 2003 to 2006. We have subjectively observed a marked increase in clinically severe obesity over this same period in patients presenting to our echocardiographic laboratory. The aim of this study was to determine temporal trends in obesity prevalence in patients presenting for transthoracic echocardiographic studies. A retrospective database analysis was performed using the Cardiovascular Consultants (Kansas City, Missouri) database (ProSolv Cardiovascular, Indianapolis, Indiana). The height and weight of patients who underwent transthoracic echocardiography in 2002 (n = 10,804) and 2006 (n = 17,556) were obtained. Body mass index was calculated as weight/height squared. Patients were grouped into 1 of 6 body mass index categories (underweight, normal weight, overweight, obese, morbidly obese, or super obese). Continuous variables were compared using Student's t test, and categorical variables were compared using chi-square test. In the 2 years, approximately (1/3) of patients were normal weight and (1/3) of patients were overweight. Obesity prevalence increased significantly (by nearly 8%) over the study period, with 28.1% of patients in the obese category by 2006. Clinically severe obesity (morbidly obese and super obese) increased dramatically from 2002 to 2006 (16%, p <0.008, and 41.7%, p <0.001, increases, respectively). In conclusion, clinically severe obesity has markedly increased in our midwestern echocardiographic laboratory in the period from 2002 to 2006. PMID:19231334

Rao, Seshu C; Kusnetzky, Lisa L; Lan, Xiao; Main, Michael L

2009-03-01

191

Comparative Myocardial Deformation in 3 Myocardial Layers in Mice by Speckle Tracking Echocardiography  

PubMed Central

Background. Speckle tracking echocardiography (STE) using dedicated high-resolution ultrasound is a relatively new technique that is useful in assessing myocardial deformation in 3 myocardial layers in small animals. However, comparative studies of STE parameters acquired from murine are limited. Methods. A high-resolution rodent ultrasound machine (VSI Vevo 2100) and a clinically validated ultrasound machine (GE Vivid 7) were used to consecutively acquire echocardiography images from standardized parasternal long axis and short axis at midpapillary muscle level from 13?BALB/c mice. Speckle tracking strain (longitudinal, circumferential, and radial) from endocardial, myocardial, and epicardial layers was analyzed using vendor-specific offline analysis software. Results. Intersystem differences were not statistically significant in the global peak longitudinal strain (?16.8 ± 1.7% versus ?18.7 ± 3.1%) and radial strain (46.8 ± 14.2% versus 41.0 ± 9.5%), except in the global peak circumferential strain (?16.9 ± 3.1% versus 27.0 ± 5.2%, P < 0.05). This was corroborated by Bland Altman analysis that revealed a weak agreement in circumferential strain (mean bias ± 1.96 SD of ?10.12 ± 6.06%) between endocardium and midmyocardium. However, a good agreement was observed in longitudinal strain between midmyocardium/endocardium (mean bias ± 1.96 SD of ?1.88 ± 3.93%) and between midmyocardium/epicardium (mean bias ± 1.96 SD of 3.63 ± 3.91%). Radial strain (mean bias ± 1.96 SD of ?5.84 ± 17.70%) had wide limits of agreement between the two systems that indicated an increased variability. Conclusions. Our study shows that there is good reproducibility and agreement in longitudinal deformation of the 3 myocardial layers between the two ultrasound systems. Directional deformation gradients at endocardium, myocardium, and epicardium observed in mice were consistent to those reported in human subjects, thus attesting the clinical relevance of STE findings in murine cardiovascular disease models.

Tee, Nicole; Gu, Yacui; Murni; Shim, Winston

2015-01-01

192

Intracardiac Echocardiography Evaluation in Secundum Atrial Septal Defect Transcatheter Closure  

SciTech Connect

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.

Zanchetta, Mario; Pedon, Luigi; Rigatelli, Gianluca; Carrozza, Antonio; Zennaro, Marco; Di Martino, Roberta [Department of Cardiovascular Disease, Cittadella General Hospital, Cittadella, Padua (Italy); Onorato, Eustaquio [Operative Unit ofCardiology, Clinica S. Rocco, Ome, Brescia (Italy); Maiolino, Pietro [Department of Cardiovascular Disease, Cittadella General Hospital, Cittadella, Padua (Italy)

2003-02-15

193

Assessing Epicardial Substrate Using Intracardiac Echocardiography During VT Ablation  

PubMed Central

Background Intracardiac echocardiography (ICE) has played a limited role in defining the substrate for ventricular tachycardia (VT). The purpose of this study was to assess whether ICE could identify abnormal epicardial substrate in patients (pts) with nonischemic cardiomyopathy (NICM) and VT. Methods and Results We studied 18 pts with NICM and recurrent VT who had abnormal echogenicity identified on ICE imaging. Detailed LV endocardial (ENDO) and epicardial (EPI) electroanatomic mapping was performed in all pts. Low voltage areas (< 1.0mV) in the epicardium were analyzed. ICE imaging in the NICM group was compared to a control group of 30 pts with structurally normal hearts who underwent ICE imaging for other ablation procedures. In 18 pts (53 ± 13 years, 17 men) with NICM (EF: 37 ± 13%) increased echogenicity was identified in the lateral LV by ICE imaging. LV ENDO electroanatomic mapping identified normal voltage in 9 pts and at least one, confluent low voltage area [6.6 cm2 (minimum 2.1 to maximum 31.7 cm2)] in 9 pts (5 posterolateral LV and 4 perivalvular LV). Detailed EPI mapping revealed areas of low voltage [39 cm2 (minimum 18.5 to maximum 96.3 cm2)] and abnormal, fractionated electrograms (EGMs) in all 18 pts (15 posterolateral LV and 3 lateral LV). In all pts, the EPI scar identified by electroanatomic mapping correlated with the echogenic area identified on ICE imaging. ICE imaging identified no areas of increased echogenicity in the control group. Conclusions ICE imaging identified increased echogenicity in the lateral wall of the LV that correlated to abnormal EPI substrate. These findings suggest that ICE imaging may be useful to identify EPI substrate in NICM. PMID:21880675

Bala, Rupa; Ren, Jian-Fang; Hutchinson, Mathew D.; Desjardins, Benoit; Tschabrunn, Cory; Gerstenfeld, Edward P.; Deo, Rajat; Dixit, Sanjay; Garcia, Fermin C.; Cooper, Joshua; Lin, David; Riley, Michael P.; Tzou, Wendy S.; Verdino, Ralph; Epstein, Andrew E.; Callans, David J.; Marchlinski, Francis E.

2011-01-01

194

Effectiveness of screening for abdominal aortic aneurysm during echocardiography.  

PubMed

Screening patients with abdominal aortic aneurysm (AAA) is associated with reduced AAA-related mortality, but population screening is poorly implemented. Opportunistic screening during imaging for other indications might be efficient. Single-center series reported AAA rates of 0.8% to 6.5% in patients undergoing transthoracic echocardiography (TTE), with disparities due to selection bias. In this first multicenter study, we aimed to assess the feasibility and criteria for screening AAA during TTE in real-life practice. During a week of May 2011, 79 centers participated in a nationwide survey. All patients aged ?65 years requiring TTE for any indication were eligible, except for those with operated abdominal aorta. We defined AAA by an anteroposterior diameter of the infrarenal aorta?30 mm. Of 1,382 consecutive patients, abdominal aorta imaging was feasible in 96.7%, with a median delay of 1.7 minutes (>3 minutes in 3.6% of cases). We found AAA in 50 patients (3.7%). Unknown AAA (2.7%) was more frequent in men than women (3.7% vs 1.3%, respectively, p=0.007) and increased by age at 2.2%, 2.5%, and 5.8% in age bands of 65 to 74, 75 to 84, and 85+ years, respectively. None of the female participants aged <75 years had AAA. Smoking status and family history of AAA were significantly more frequent among patients with AAA. The ascending aorta was larger in those with AAA (36.2±4.7 vs 34.0±5.2 mm, p=0.006), and bicuspid aortic valve and/or major aortic regurgitation were also more frequent (8% vs 2.6%, p=0.017). In conclusion, rapid AAA screening during TTE is feasible and should be limited to men ?65 years and women?75 years. PMID:25127549

Aboyans, Victor; Bataille, Vincent; Bliscaux, Pascale; Ederhy, Stéphane; Filliol, Didier; Honton, Benjamin; Kurtz, Baptiste; Messas, Emmanuel; Mohty, Dania; Brochet, Eric; Kownator, Serge

2014-10-01

195

Echocardiography practice, training and accreditation in the intensive care: document for the World Interactive Network Focused on Critical Ultrasound (WINFOCUS)  

PubMed Central

Echocardiography is increasingly used in the management of the critically ill patient as a non-invasive diagnostic and monitoring tool. Whilst in few countries specialized national training schemes for intensive care unit (ICU) echocardiography have been developed, specific guidelines for ICU physicians wishing to incorporate echocardiography into their clinical practice are lacking. Further, existing echocardiography accreditation does not reflect the requirements of the ICU practitioner. The WINFOCUS (World Interactive Network Focused On Critical UltraSound) ECHO-ICU Group drew up a document aimed at providing guidance to individual physicians, trainers and the relevant societies of the requirements for the development of skills in echocardiography in the ICU setting. The document is based on recommendations published by the Royal College of Radiologists, British Society of Echocardiography, European Association of Echocardiography and American Society of Echocardiography, together with international input from established practitioners of ICU echocardiography. The recommendations contained in this document are concerned with theoretical basis of ultrasonography, the practical aspects of building an ICU-based echocardiography service as well as the key components of standard adult TTE and TEE studies to be performed on the ICU. Specific issues regarding echocardiography in different ICU clinical scenarios are then described. Obtaining competence in ICU echocardiography may be achieved in different ways – either through completion of an appropriate fellowship/training scheme, or, where not available, via a staged approach designed to train the practitioner to a level at which they can achieve accreditation. Here, peri-resuscitation focused echocardiography represents the entry level – obtainable through established courses followed by mentored practice. Next, a competence-based modular training programme is proposed: theoretical elements delivered through blended-learning and practical elements acquired in parallel through proctored practice. These all linked with existing national/international echocardiography courses. When completed, it is anticipated that the practitioner will have performed the prerequisite number of studies, and achieved the competency to undertake accreditation (leading to Level 2 competence) via a recognized National or European examination and provide the appropriate required evidence of competency (logbook). Thus, even where appropriate fellowships are not available, with support from the relevant echocardiography bodies, training and subsequently accreditation in ICU echocardiography becomes achievable within the existing framework of current critical care and cardiological practice, and is adaptable to each countrie's needs. PMID:18837986

Price, Susanna; Via, Gabriele; Sloth, Erik; Guarracino, Fabio; Breitkreutz, Raoul; Catena, Emanuele; Talmor, Daniel

2008-01-01

196

Assessment of Atrial Fibrillation and Vulnerability in Patients with Wolff-Parkinson-White Syndrome Using Two-Dimensional Speckle Tracking Echocardiography  

PubMed Central

Purpose The aim was to assess atrial fibrillation (AF) and vulnerability in Wolff-Parkinson-White (WPW) syndrome patients using two-dimensional speckle tracking echocardiography (2D-STE). Methods All patients were examined via transthoracic echocardiography and 2D-STE in order to assess atrial function 7 days before and 10 days after RF catheter ablation. A postoperative 3-month follow-up was performed via outpatient visit or telephone calls. Results Results showed significant differences in both body mass index (BMI) and supraventricular tachycardia (SVT) duration between WPW patients and DAVNP patients (both P<0.05). Echocardiography revealed that the maximum left atrial volume (LAVmax) and the left ventricular mass index (LVMI) in diastole increased noticeably in patients with WPW compared to patients with DAVNP both before and after ablation (all P<0.05). Before ablation, there were obvious differences in the levels of SRs, SRe, and SRa from the 4-chamber view (LA) in the WPW patients group compared with patients in the DAVNP group (all P<0.05). In the AF group, there were significant differences in the levels of systolic strain rate (SRs), early diastolic strain rate (SRe), and late diastolic strain rate (SRa) from the 4-chamber view (LA) both before and after ablation (all P<0.05). In the non-AF group, there were decreased SRe levels from the 4-chamber view (LA/RA) pre-ablation compared to post-ablation (all P<0.05). Conclusion Our findings provide convincing evidence that WPW syndrome may result in increased atrial vulnerability and contribute to the development of AF. Further, RF catheter ablation of AAV pathway can potentially improve atrial function in WPW syndrome patients. Two-dimensional speckle tracking echocardiography imaging in WPW patients would be necessary in the evaluation and improvement of the overall function of RF catheter ablation in a long-term follow-up period. PMID:25397668

Li, Jing-Jie; Wei, Fang; Chen, Ju-Gang; Yu, Yan-Wei; Gu, Hong-Yue; Jiang, Rui; Wu, Xiu-Li; Sun, Qian

2014-01-01

197

A practical approach to goal-directed echocardiography in the critical care setting.  

PubMed

Urgent cardiac ultrasound examination in the critical care setting is clinically useful. Application of goal-directed echocardiography in this setting is quite distinct from typical exploratory diagnostic comprehensive echocardiography, because the urgent critical care setting mandates a goal-directed approach. Goal-directed echocardiography most frequently aims to rapidly identify and differentiate the cause(s) of hemodynamic instability and/or the cause(s) of acute respiratory failure. Accordingly, this paper highlights 1) indications, 2) an easily memorized differential diagnostic framework for goal-directed echocardiography, 3) clinical questions that must be asked and answered, 4) practical issues to allow optimal image capture, 5) primary echocardiographic views, 6) key issues addressed in each view, and 7) interpretation of findings within the differential diagnostic framework. The most frequent indications for goal-directed echocardiography include 1) the spectrum of hemodynamic instability, shock, and pulseless electrical activity arrest and 2) acute respiratory failure. The differential diagnostic categories for hemodynamic instability can be remembered using the mnemonic 'SHOCK' (for Septic, Hypovolemic, Obstructive, Cardiogenic, and (K) combinations/other kinds of shock). RESP-F (for exacerbation of chronic Respiratory disease, pulmonary Embolism, ST changes associated with cardiac or pericardial disease, Pneumonia, and heart Failure) can be used for acute respiratory failure. The goals of goal-directed echocardiography in the unstable patient are: assessing global ventricular systolic function, identifying marked right ventricular and left ventricular enlargement, assessing intravascular volume, and the presence of a pericardial effusion. In an urgent or emergent setting, it is recommended to go directly to the best view, which is frequently the subcostal or apical view. The five views are the subcostal four-chamber view, subcostal inferior vena cava view, parasternal long axis view, parasternal short axis view, and the apical four chamber view. Always interpret goal-directed echocardiographic findings in the context of clinically available hemodynamic information. When goal-directed echocardiography is insufficient or when additional abnormalities are appreciated, order a comprehensive echocardiogram. Goal-directed echocardiography and comprehensive echocardiography are not to be used in conflict with each other. PMID:25672460

Walley, Patricia E; Walley, Keith R; Goodgame, Ben; Punjabi, Vivek; Sirounis, Demetrios

2014-01-01

198

Cardiac output by Doppler echocardiography in the premature baboon: Comparison with radiolabeled microspheres  

SciTech Connect

Pulsed-Doppler echocardiography (PDE) is a useful noninvasive method for determining left ventricular output (LVO). However, despite increasingly widespread use in neonatal intensive care units, validation studies in prematures with cardiopulmonary disease are lacking. The purpose of this study was to compare radiolabeled microsphere (RLM) and PDE measurements of LVO, using the critically ill premature baboon as a model of the human neonate. Twenty-two paired RLM and PDE measurements of LVO were obtained in 14 animals between 3 and 24 h of age. Average PDE LVO was 152 ml/min/kg (range, 40-258 ml/min/kg) compared to 158 ml/min/kg (range, 67-278 ml/min/kg) measured by RLM. Linear regression analysis of the paired measurements showed good correlation with a slope near unity (gamma = 0.94x + 4.20, r = 0.91, SEE = 25.7 ml). The authors conclude that PDE determinations of LVO compare well with those measured by RLM in the premature baboon. PDE appears to provide a valid estimate of LVO and should be useful in human prematures with cardiopulmonary distress.

Kinsella, J.P.; Morrow, W.R.; Gerstmann, D.R.; Taylor, A.F.; deLemos, R.A. (Wilford Hall U.S.A.F. Medical Center, San Antonio, TX (USA))

1991-04-01

199

New approaches in small animal echocardiography: imaging the sounds of silence  

PubMed Central

Systolic and diastolic dysfunction of the left ventricle (LV) is a hallmark of most cardiac diseases. In vivo assessment of heart function in animal models, particularly mice, is essential to refining our understanding of cardiovascular disease processes. Ultrasound echocardiography has emerged as a powerful, noninvasive tool to serially monitor cardiac performance and map the progression of heart dysfunction in murine injury models. This review covers current applications of small animal echocardiography, as well as emerging technologies that improve evaluation of LV function. In particular, we describe speckle-tracking imaging-based regional LV analysis, a recent advancement in murine echocardiography with proven clinical utility. This sensitive measure enables an early detection of subtle myocardial defects before global dysfunction in genetically engineered and rodent surgical injury models. Novel visualization technologies that allow in-depth phenotypic assessment of small animal models, including perfusion imaging and fetal echocardiography, are also discussed. As imaging capabilities continue to improve, murine echocardiography will remain a critical component of the investigator's armamentarium in translating animal data to enhanced clinical treatment of cardiovascular diseases. PMID:21873501

Ram, Rashmi; Mickelsen, Deanne M.; Theodoropoulos, Catherine

2011-01-01

200

Bicuspid aortic valve and severe aortic stenosis in a newborn exposed to carbamazapine during pregnancy  

PubMed Central

The use of antiepileptic drugs increases the risk of major congenital malformations during pregnancy. Here, we report an infant who had a history of in-utero carbamazepine exposure and who was born with a cardiac malformation. The infant was born at 39 weeks of gestation vaginally to an epileptic mother who had been treated with carbamazepine throughout her pregnancy. He was referred due to cardiac murmur in the second week of his life. The mother had not received folic acid supplementation. Transthoracic echocardiography revealed bicuspid aortic valve, mild aortic stenosis, patent ductus arteriosus, patent foramen ovale and the renal ultrasound revealed mild left hydronephrosis. Follow-up echocardiography performed 14 weeks later showed increased severity of aortic stenosis and percutaneous balloon aortic valvuloplasty was performed. To our knowledge, there is only one case report in the literature mentioning the association of a bicuspid aortic valve and aortic stenosis with oxcarbazepine exposure, which is a structural derivative of carbamazepine. However, there are no reports for association with carbamazepine itself. Bicuspid aorta and aortic stenosis may be among the cardiac malformations that result from the teratogenic effect of carbamazepine. PMID:25584038

Karata?, Zehra; Karata?, Ahmet; Özlü, Tülay; Goksugur, Sevil B.; Varan, Birgül

2014-01-01

201

Extreme Tele-Echocardiography: Methodology for Remote Guidance of In-Flight Echocardiography Aboard the International Space Station  

NASA Technical Reports Server (NTRS)

Methods: In the year before launch of an ISS mission, potential astronaut echocardiographic operators participate in 5 sessions to train for echo acquisitions that occur roughly monthly during the mission, including one exercise echocardiogram. The focus of training is familiarity with the study protocol and remote guidance procedures. On-orbit, real-time guidance of in-flight acquisitions is provided by a sonographer in the Telescience Center of Mission Control. Physician investigators with remote access are able to relay comments on image quality to the sonographer. Live video feed is relayed from the ISS to the ground via the Tracking and Data Relay Satellite System with a 2- second transmission delay. The expert sonographer uses these images, along with twoway audio, to provide instructions and feedback. Images are stored in non-compressed DICOM format for asynchronous relay to the ground for subsequent off-line analysis. Results: Since June, 2009, a total of 27 resting echocardiograms and 5 exercise studies have been performed during flight. Average acquisition time has been 45 minutes, reflecting 26,000 km of ISS travel per study. Image quality has been adequate in all studies, and remote guidance has proven imperative for fine-tuning imaging and prioritizing views when communication outages limit the study duration. Typical resting studies have included 27 video loops and 30 still-frame images requiring 750 MB of storage. Conclusions: Despite limited crew training, remote guidance allows research-quality echocardiography to be performed by non-experts aboard the ISS. Analysis is underway and additional subjects are being recruited to define the impact of microgravity on cardiac structure and systolic and diastolic function.

Martin, David S.; Borowski, Allan; Bungo, Michael W.; Gladding, Patrick; Greenberg, Neil; Hamilton, Doug; Levine, Benjamin D.; Lee, Stuart M.; Norwood, Kelly; Platts, Steven H.; Matz, Timothy; Roper, Matthew; Sandoz, Gwenn; Thomas, James D.

2012-01-01

202

Effect of Obesity on Left Ventricular Longitudinal Myocardial Strain by Speckle Tracking Echocardiography in Children and Adolescents  

PubMed Central

Background: Impaired subclinical ventricular function may contribute to the risk of cardiovascular disease in obesity. Aims: The aim of this study was to determine the influence of obesity on left ventricular (LV) longitudinal myocardial function in normotensive obese children using two-dimensional (2D) speckle tracking echocardiography (STE). Study Design: Case-control study. Methods: Sixty normotensive obese children aged 10–16 years (mean age, 13.9±2.3 years) were compared with 50 normal-weight controls. Obese participants had a body mass index (BMI)?95th percentile. Regional strain/strain rate (SR) values were compared with left ventricular (LV) parameters. The correlation was studied by linear regression analysis. Results: Obese subjects exhibited a significantly higher LV end-diastolic diameter, left atrium/aortic diameter ratio, and LV mass/index when compared to controls (p<0.001). Left ventricular ejection fraction and regional systolic myocardial velocities were similar in the obese and control groups. By 2D STE, regional strain of both the septal wall (average strain: ?16.0±3.9% vs ?21.9±2.4%, p<0.001) and lateral wall (average strain: ?15.6±2.3% vs ?22.9±3.5%, p<0.001); regional SR of both the septal wall (average SRsys: ?0.7±0.22 s?1 vs ?1.3±0.32 s?1, p<0.001) and lateral wall (average SRsys: ?0.67±0.19 s?1 vs ?1.33±0.31 s?1, p<0.001); regional SRE/A of both the septal wall (average SRE/A: 1.8±0.83 vs. 2.2±0.91, p: 0.004) and lateral wall (average SRE/A: 1.4±0.43 vs. 2.4±1.21, p<0.001); and global strain (?14.6±7.34% vs ?20.9±3.24%, p<0.001) were lower in the obese group compared with the controls. These strain imaging parameters appear to be related to the severity of obesity and can contribute to increased BMI. Left ventricular mass was found to be correlated with a decrease in global LV strain. Conclusion: Our study showed that childhood obesity is associated with an alteration in the longitudinal LV function. Segmental analysis of the LV can provide subtle markers for the emergence of future obesity-related cardiac disease. PMID:25759773

Kibar, Ay?e Esin; Pac, Feyza Ay?enur; Ece, ?brahim; Oflaz, Mehmet Burhan; Ball?, ?evket; Bas, Veysel Nejat; Aycan, Zehra

2015-01-01

203

Liquid Medical Marijuana Shows Promise Against Severe Epilepsy  

MedlinePLUS

... director of Advanced Clinical Experience in Neurology at North-Shore-LIJ Health System in Manhasset, N.Y. Stevens ... M.D., director, Advanced Clinical Experience in Neurology, North Shore-LIJ Health System, Manhasset N.Y.; American Academy ...

204

INTRODUCTION Morphology and physiology of the gastrointestinal tract show several  

E-print Network

. Thus, natural selection is expected to match capacity of the digestive system to animals' needs of their dietary substrates (Karasov and Diamond, 1988). The avian digestive system is characterized by high digestive capacity involves costs of maintaining excess organs or enzymes. In contrast, insufficient

Mladenoff, David

205

ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 appropriateness criteria for stress echocardiography: a report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, American Society of Echocardiography, American College of Emergency Physicians, American Heart Association, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance endorsed by the Heart Rhythm Society and the Society of Critical Care Medicine.  

PubMed

The American College of Cardiology Foundation (ACCF) and the American Society of Echocardiography (ASE) together with key specialty and subspecialty societies, conducted an appropriateness review for stress echocardiography. The review assessed the risks and benefits of stress echocardiography for several indications or clinical scenarios and scored them on a scale of 1 to 9 (based upon methodology developed by the ACCF to assess imaging appropriateness). The upper range (7 to 9) implies that the test is generally acceptable and is a reasonable approach, and the lower range (1 to 3) implies that the test is generally not acceptable and is not a reasonable approach. The midrange (4 to 6) indicates a clinical scenario for which the indication for a stress echocardiogram is uncertain. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Use of stress echocardiography for risk assessment in patients with coronary artery disease (CAD) was viewed favorably, while routine repeat testing and general screening in certain clinical scenarios were viewed less favorably. It is anticipated that these results will have a significant impact on physician decision making and performance, reimbursement policy, and will help guide future research. PMID:18342240

Douglas, Pamela S; Khandheria, Bijoy; Stainback, Raymond F; Weissman, Neil J; Peterson, Eric D; Hendel, Robert C; Stainback, Raymond F; Blaivas, Michael; Des Prez, Roger D; Gillam, Linda D; Golash, Terry; Hiratzka, Loren F; Kussmaul, William G; Labovitz, Arthur J; Lindenfeld, JoAnn; Masoudi, Frederick A; Mayo, Paul H; Porembka, David; Spertus, John A; Wann, L Samuel; Wiegers, Susan E; Brindis, Ralph G; Douglas, Pamela S; Hendel, Robert C; Patel, Manesh R; Peterson, Eric D; Wolk, Michael J; Allen, Joseph M

2008-03-18

206

ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 Appropriateness Criteria for Stress Echocardiography. A report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, American Society of Echocardiography, American College of Emergency Physicians, American Heart Association, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance endorsed by the Heart Rhythm Society and the Society of Critical Care Medicine.  

PubMed

The American College of Cardiology Foundation (ACCF) and the American Society of Echocardiography (ASE) together with key specialty and subspecialty societies, conducted an appropriateness review for stress echocardiography. The review assessed the risks and benefits of stress echocardiography for several indications or clinical scenarios and scored them on a scale of 1 to 9 (based upon methodology developed by the ACCF to assess imaging appropriateness). The upper range (7 to 9) implies that the test is generally acceptable and is a reasonable approach, and the lower range (1 to 3) implies that the test is generally not acceptable and is not a reasonable approach. The midrange (4 to 6) indicates a clinical scenario for which the indication for a stress echocardiogram is uncertain. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Use of stress echocardiography for risk assessment in patients with coronary artery disease (CAD) was viewed favorably, while routine repeat testing and general screening in certain clinical scenarios were viewed less favorably. It is anticipated that these results will have a significant impact on physician decision making and performance, reimbursement policy, and will help guide future research. PMID:18314889

Douglas, Pamela S; Khandheria, Bijoy; Stainback, Raymond F; Weissman, Neil J; Peterson, Eric D; Hendel, Robert C; Stainback, Raymond F; Blaivas, Michael; Des Prez, Roger D; Gillam, Linda D; Golash, Terry; Hiratzka, Loren F; Kussmaul, William G; Labovitz, Arthur J; Lindenfeld, Joann; Masoudi, Frederick A; Mayo, Paul H; Porembka, David; Spertus, John A; Wann, L Samuel; Wiegers, Susan E; Brindis, Ralph G; Douglas, Pamela S; Hendel, Robert C; Patel, Manesh R; Peterson, Eric D; Wolk, Michael J; Allen, Joseph M

2008-04-01

207

ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 appropriateness criteria for stress echocardiography: a report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, American Society of Echocardiography, American College of Emergency Physicians, American Heart Association, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance: endorsed by the Heart Rhythm Society and the Society of Critical Care Medicine.  

PubMed

The American College of Cardiology Foundation (ACCF) and the American Society of Echocardiography (ASE) together with key specialty and subspecialty societies, conducted an appropriateness review for stress echocardiography. The review assessed the risks and benefits of stress echocardiography for several indications or clinical scenarios and scored them on a scale of 1 to 9 (based upon methodology developed by the ACCF to assess imaging appropriateness). The upper range (7 to 9) implies that the test is generally acceptable and is a reasonable approach, and the lower range (1 to 3) implies that the test is generally not acceptable and is not a reasonable approach. The midrange (4 to 6) indicates a clinical scenario for which the indication for a stress echocardiogram is uncertain. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Use of stress echocardiography for risk assessment in patients with coronary artery disease (CAD) was viewed favorably, while routine repeat testing and general screening in certain clinical scenarios were viewed less favorably. It is anticipated that these results will have a significant impact on physician decision making and performance, reimbursement policy, and will help guide future research. PMID:18316491

Douglas, Pamela S; Khandheria, Bijoy; Stainback, Raymond F; Weissman, Neil J; Peterson, Eric D; Hendel, Robert C; Stainback, Raymond F; Blaivas, Michael; Des Prez, Roger D; Gillam, Linda D; Golash, Terry; Hiratzka, Loren F; Kussmaul, William G; Labovitz, Arthur J; Lindenfeld, JoAnn; Masoudi, Frederick A; Mayo, Paul H; Porembka, David; Spertus, John A; Wann, L Samuel; Wiegers, Susan E; Brindis, Ralph G; Douglas, Pamela S; Patel, Manesh R; Wolk, Michael J; Allen, Joseph M

2008-03-18

208

Coronary Flow Velocity Reserve during Dobutamine Stress Echocardiography  

PubMed Central

Background A coronary flow velocity reserve (CFVR) ? 2 is adequate to infer a favorable prognosis or the absence of significant coronary artery disease. Objective To identify parameters which are relevant to obtain CFVR (adequate or inadequate) in the left anterior descending coronary artery (LAD) during dobutamine stress echocardiography (DSE). Methods 100 patients referred for detection of myocardial ischemia by DSE were evaluated; they were instructed to discontinue the use of ?-blockers 72 hours prior to the test. CFVR was calculated as a ratio of the diastolic peak velocity (cm/s) (DPV) on DSE (DPV-DSE) to baseline DPV at rest (DPV-Rest). In group I, CFVR was < 2 and, in group II, CFVR was ? 2. The Fisher's exact test and Student's t test were used for the statistical analyses. P values < 0.05 were considered statistically significant. Results At rest, the time (in seconds) to obtain Doppler in LAD in groups I and II was not different (53±31 vs. 45±32; p=0.23). During DSE, LAD was recorded in 92 patients. Group I patients were older (65.9±9.3 vs. 61.2±10.8 years; p=0.04), had lower ejection fraction (61±10 vs. 66±6%; p=0.005), higher DPV-Rest (36.81±08 vs. 25.63 ± 06cm/s; p<0.0001) and lower CFVR (1.67 ± 0.24 vs. 2.53 ± 0.57; p<0.0001), but no difference was observed regarding DPVDSE (61.40±16 vs. 64.23±16cm/s; p=0.42). ?-blocker discontinuation was associated with a 4-fold higher chance of a CFVR < 2 (OR= 4; 95% CI [1.171-13.63], p=0.027). Conclusion DPV-Rest was the main parameter to determine an adequate CFVR. ?-blocker discontinuation was significantly associated with inadequate CFVR. The high feasibility and the time to record the LAD corroborate the use of this methodology. PMID:24676368

de Abreu, José Sebastião; Lima, José Wellington Oliveira; Diógenes, Tereza Cristina Pinheiro; Siqueira, Jordana Magalhães; Pimentel, Nayara Lima; Gomes, Pedro Sabino; de Abreu, Marília Esther Benevides; Paes, José Nogueira

2014-01-01

209

Automated left ventricular diastolic function evaluation from phase-contrast cardiovascular magnetic resonance and comparison with Doppler echocardiography  

PubMed Central

Background Early detection of diastolic dysfunction is crucial for patients with incipient heart failure. Although this evaluation could be performed from phase-contrast (PC) cardiovascular magnetic resonance (CMR) data, its usefulness in clinical routine is not yet established, mainly because the interpretation of such data remains mostly based on manual post-processing. Accordingly, our goal was to develop a robust process to automatically estimate velocity and flow rate-related diastolic parameters from PC-CMR data and to test the consistency of these parameters against echocardiography as well as their ability to characterize left ventricular (LV) diastolic dysfunction. Results We studied 35 controls and 18 patients with severe aortic valve stenosis and preserved LV ejection fraction who had PC-CMR and Doppler echocardiography exams on the same day. PC-CMR mitral flow and myocardial velocity data were analyzed using custom software for semi-automated extraction of diastolic parameters. Inter-operator reproducibility of flow pattern segmentation and functional parameters was assessed on a sub-group of 30 subjects. The mean percentage of overlap between the transmitral flow segmentations performed by two independent operators was 99.7 ± 1.6%, resulting in a small variability (<1.96 ± 2.95%) in functional parameter measurement. For maximal myocardial longitudinal velocities, the inter-operator variability was 4.25 ± 5.89%. The MR diastolic parameters varied significantly in patients as opposed to controls (p < 0.0002). Both velocity and flow rate diastolic parameters were consistent with echocardiographic values (r > 0.71) and receiver operating characteristic (ROC) analysis revealed their ability to separate patients from controls, with sensitivity > 0.80, specificity > 0.80 and accuracy > 0.85. Slight superiority in terms of correlation with echocardiography (r = 0.81) and accuracy to detect LV abnormalities (sensitivity > 0.83, specificity > 0.91 and accuracy > 0.89) was found for the PC-CMR flow-rate related parameters. Conclusions A fast and reproducible technique for flow and myocardial PC-CMR data analysis was successfully used on controls and patients to extract consistent velocity-related diastolic parameters, as well as flow rate-related parameters. This technique provides a valuable addition to established CMR tools in the evaluation and the management of patients with diastolic dysfunction. PMID:21062448

2010-01-01

210

Three-dimensional echocardiography in the assessment of congenital mitral valve disease.  

PubMed

Congenital mitral valve abnormalities are rare and cause mitral stenosis, regurgitation, or a combination of the two. Three-dimensional echocardiography has provided new insight into the structure and function of both normal and abnormal mitral valves. Three-dimensional imaging permits accurate anatomic diagnosis and enhances two-dimensional echocardiographic data. Moreover, it enables echocardiographers to communicate effectively with cardiothoracic surgeons when displaying, analyzing, and describing pathology. The purpose of this report is to review congenital mitral valve disease, focusing on the benefits of three-dimensional echocardiography in its evaluation. PMID:24360740

Kutty, Shelby; Colen, Timothy M; Smallhorn, Jeffrey F

2014-02-01

211

Intracardiac Echocardiography to Guide Biopsy for Two Cases of Intracardiac Masses  

PubMed Central

Pathologic diagnosis of a cardiac mass is vital in determining the proper treatment modality. Open heart surgery or transesophageal echocardiography guided biopsy can be feasible methods to confirm the pathology. However, the former is highly invasive and both methods require general anesthesia. The introduction of intracardiac echocardiography (ICE) can provide good anatomic information of heart and does not require general anesthesia. In this report, we present two cases of cardiac tumors which were confirmed by percutaneous biopsy under the guidance of an ICE. The patients underwent cardiac biopsy without any complications.

Park, Kwang-In; Kim, Mi Joo; Oh, Jin Kyung; Park, Jae-Hyeong; Choi, Si Wan; Jeong, Jin-Ok; Seong, In-Whan

2015-01-01

212

Floating thrombus in the right heart associated with pulmonary embolism: The role of echocardiography  

PubMed Central

Free-floating right heart thrombi are rare and usually represent travelling clots from venous system to the lung. Almost exclusively, they are associated with pulmonary embolism. Despite associated high mortality, they are frequently under-diagnosed. We report a case of bilateral pulmonary embolism which was found to have a free-floating right atrial thrombus on echocardiography. The case, therefore, highlights the importance of echocardiography as a key examination in this setting. It can be performed at bedside to directly visualize the thrombi, assess and monitor right ventricular (RV) function, and help in making treatment decisions.

Naeem, Kashif

2015-01-01

213

Intraobserver and Interobserver Reproducibility for Radial, Circumferential and Longitudinal Strain Echocardiography  

PubMed Central

Objectives: Strain echocardiography (StE) promises to be a new tool for quantitative assessment of cardiac function. Analysis of intra- and interobserver reliability is an important aspect in the process of developing these novel techniques from theory to the implementation into daily routine diagnostics.The purpose of the study was to estimate reliability of the segmental StE. Methods: Left ventricular strain analysis for radial strain (RS), circumferential strain (CS) and longitudinal strain (LS) was performed in 21 healthy volunteers. RS and CS values were obtained in the parasternal short axis at the level of the papillary muscles. LS values were determined in the apical 2-, 3- and 4-chamber views. Cine-loops were recorded and quantitative analyses were conducted on an off-line workstation. Results: Intraobserver reproducibility was highest using LS in the 4-chamber view (9 ± 13.6 % mean deviation, rho = 0.624, p = 0.003), followed by CS (13.3 ± 8.3 %, rho = 0.406, p = 0.068) and lowest in RS (26.3 ± 30.1 %, rho = 0.391, p = 0.080). Interobserver analyses of LS derived from 3-chamber view showed lowest deviation (11.9 ± 9.5 %, rho = 0.513, p = 0.017), followed by CS (15.2 ± 12.0 %, 0.263, p = 0.249) and the least consistent measurements in RS (35.9 ± 46.3 %, rho 0.382, p = 0.088). Conclusion: This study shows that the clinical utility of StE depends on the regional differences of LV wall motion and image quality. LS-values showed promising intra- and interobserver reproducibility values. For quantitative follow-up studies LS should be preferred. PMID:25356089

Leischik, R.; Dworrak, B.; Hensel, K.

2014-01-01

214

Early and late improvement of global and regional left ventricular function after transcatheter aortic valve implantation in patients with severe aortic stenosis: an echocardiographic study  

PubMed Central

The recent development of transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) treatment offers a viable option for high-risk patient categories. Our aim is to evaluate whether 2D strain and strain rate can detect subtle improvement in global and regional LV systolic function immediately after TAVI. 2D conventional and 2D strain (speckle analysis) echocardiography was performed before, at discharge and after three months in thirty three patients with severe AS. After TAVI, we assessed by conventional echocardiography an immediate reduction of transaortic peak pressure gradient (p<0.0001), of mean pressure gradient (p<0.0001) and a concomitant increase in aortic valve area (AVA: 1.08±0.31 cm2/m2; p<0.0001). 2D longitudinal systolic strain showed a significant improvement in all patients, both at septal and lateral level, as early as 72 h after procedure (septal: -14.2±5.1 vs -16.7±3.7%, p<0.001; lateral: -9.4±3.9 vs -13.1±4.5%, p<0.001; respectively) and continued at 3 months follow-up (septal: -18.1±4.6%, p<0.0001; lateral: -14.8±4.4%, p<0.0001; respectively). Conventional echocardiography after TAVI proved a significant reduction of LV end-systolic volume and of LV mass with a mild improvement of LV ejection fraction (EF) (51.2±11.8 vs 52.9±6.4%; p<0.02) only after three months. 2D strain seems to be able to detect subtle changes in LV systolic function occurring early and late after TAVI in severe AS, while all conventional echo parameters seem to be less effective for this purpose. Further investigations are needed to prove the real prognostic impact of these echocardiographic findings. PMID:22254204

Giannini, Cristina; Petronio, Anna Sonia; Talini, Enrica; De Carlo, Marco; Guarracino, Fabio; Grazia, Maria; Donne, Delle; Nardi, Carmela; Conte, Lorenzo; Barletta, Valentina; Marzilli, Mario; Di Bello, Vitantonio

2011-01-01

215

Early and late improvement of global and regional left ventricular function after transcatheter aortic valve implantation in patients with severe aortic stenosis: an echocardiographic study.  

PubMed

The recent development of transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) treatment offers a viable option for high-risk patient categories. Our aim is to evaluate whether 2D strain and strain rate can detect subtle improvement in global and regional LV systolic function immediately after TAVI. 2D conventional and 2D strain (speckle analysis) echocardiography was performed before, at discharge and after three months in thirty three patients with severe AS. After TAVI, we assessed by conventional echocardiography an immediate reduction of transaortic peak pressure gradient (p<0.0001), of mean pressure gradient (p<0.0001) and a concomitant increase in aortic valve area (AVA: 1.08±0.31 cm(2)/m(2); p<0.0001). 2D longitudinal systolic strain showed a significant improvement in all patients, both at septal and lateral level, as early as 72 h after procedure (septal: -14.2±5.1 vs -16.7±3.7%, p<0.001; lateral: -9.4±3.9 vs -13.1±4.5%, p<0.001; respectively) and continued at 3 months follow-up (septal: -18.1±4.6%, p<0.0001; lateral: -14.8±4.4%, p<0.0001; respectively). Conventional echocardiography after TAVI proved a significant reduction of LV end-systolic volume and of LV mass with a mild improvement of LV ejection fraction (EF) (51.2±11.8 vs 52.9±6.4%; p<0.02) only after three months. 2D strain seems to be able to detect subtle changes in LV systolic function occurring early and late after TAVI in severe AS, while all conventional echo parameters seem to be less effective for this purpose. Further investigations are needed to prove the real prognostic impact of these echocardiographic findings. PMID:22254204

Giannini, Cristina; Petronio, Anna Sonia; Talini, Enrica; De Carlo, Marco; Guarracino, Fabio; Grazia, Maria; Donne, Delle; Nardi, Carmela; Conte, Lorenzo; Barletta, Valentina; Marzilli, Mario; Di Bello, Vitantonio

2011-01-01

216

Predictive value of dobutamine echocardiography and positron emission tomography in identifying hibernating myocardium in patients with postischaemic heart failure  

PubMed Central

Objective—To compare the predictive value of dobutamine echocardiography (DE) and positron emission tomography (PET) in identifying reversible chronic left ventricular (LV) dysfunction (hibernating myocardium) in patients with coronary artery disease (CAD) and overt heart failure.?Patients—30 patients (four women) with CAD and heart failure undergoing coronary artery bypass grafting (CABG).?Methods—Myocardial viability was assessed with DE (5 and 10 µg/kg/min) and PET with [18F] 2-fluoro-2-deoxy-D-glucose (FDG) under hyperinsulinaemic euglycaemic clamp. Regional (echo) and global LV function (MUGA) were assessed at baseline and six months after CABG.?Results—192 of the 336 (57%) dysfunctional LV segments improved function following CABG (hibernating) and the LV ejection fraction (EF) increased from 23(7) to 32(9)% (p < 0.0001) (in 17 patients > 5%). DE and PET had similar positive predictive values (68% and 66%) in the identification of hibernating myocardium, but DE had a significantly lower negative predictive value than PET (54% v 96%; p < 0.0001). A significant linear correlation was found between the number of PET viable segments and the changes in EF following CABG (r = 0.65; p = 0.0001). Stepwise logistic regression identified the number of PET viable segments as an independent predictor of improvement in EF > 5%, whereas the number of DE viable segments, the baseline LVEF, and wall motion were not.?Conclusions—DE has a higher false negative rate than PET in identifying recoverable LV dysfunction in patients with severe postischaemic heart failure. The amount of PET viable myocardium correlates with the functional outcome following CABG.?? Keywords: dobutamine echocardiography;  positron emission tomography;  coronary artery disease;  heart failure;  hibernating myocardium PMID:9602663

Pagano, D; Bonser, R; Townend, J; Ordoubadi, F; Lorenzoni, R; Camici, P

1998-01-01

217

Automated Classification of Disease Patterns from Echo-cardiography Images Based on Shape Features of the Left Ventricle  

SciTech Connect

Computer assisted diagnosis using analysis of medical images is an area of active research in health informatics. This paper proposes a technique for indication of heart diseases by using information related to shapes of the left ventricle (LV). LV boundaries are tracked from echo-cardiography images taken from LV short axis view, corresponding to two disease conditions viz. dilated cardiomyopathy and hypertrophic cardiomyopathy, and discriminated from the normal condition. The LV shapes are modeled using shape histograms generated by plotting the frequency of normalized radii lengths drawn from the centroid to the periphery, against a specific number of bins. A 3-layer neural network activated by a log-sigmoid function is used to classify the shape histograms into one of the three classes. Experimentations on a dataset of 240 images show recognition accuracies of the order of 80%.

Das, Shaoli; Parekh, Ranjan [School of Education Technology, Jadavpur University, Kolkata 700032 (India)

2010-10-26

218

Persistent left superior vena cava: diagnosed by bedside echocardiography in a liver transplant patient: a case report  

PubMed Central

In most cases, persistent left superior vena cava (PLSVC) is asymptomatic and discovered accidentally. This case involves a 43-year-old male who underwent an emergency cadaveric liver transplantation. Postoperatively, the left internal jugular vein was cannulated using a sono-guided Seldinger technique in the intensive care unit. But the chest X-ray showed that the catheter followed the left paramediastinal course instead of crossing midline to the right to enter the superior vena cava. In consideration of the patient's status, an intra-arterial or extra-vascular placement could be excluded. For a diagnosis, we performed a bed-side transthoracic echocardiography with an agitated saline micro-bubble test. When agitated saline was injected through the catheter, the coronary sinus was initially opacified, and then the right atrium followed. In conclusion, we were able to make a diagnosis of PLSVC by a bedside test without radiation exposure. PMID:25558346

Kim, Hyerim; Kim, Jin Hee

2014-01-01

219

Aortic valve area assessed with 320-detector computed tomography: comparison with transthoracic echocardiography.  

PubMed

To evaluate the diagnostic accuracy of aortic valve area (AVA) assessment with 320-detector Computed Tomography (MDCT) compared to transthoracic echocardiography (TTE) in a population with mild to severe aortic valve stenosis. AVA was estimated in 169 patients by planimetry on MDCT images (AVA(MDCT)) and by the continuity equation with TTE (AVA(TTE)). To generate a reference AVA (AVA(REF)) we used the stroke volume from MDCT divided by the velocity time integral from CW Doppler by TTE (according to the continuity equation: stroke volume in LVOT = stroke volume passing the aortic valve). AVA(REF) was used as the reference to compare both measures against, since it bypasses the assumption of LVOT being circular in the continuity equation and the potential placement error of PW Doppler in the LVOT. The mean (±SD) age of the patients was 71 (±9) years, 113 (67%) were males. Mean AVA(TTE) was 0.93 (±0.33) cm(2), mean AVA(MDCT) was 0.99 (±0.36) cm(2) and mean AVA(REF) was 1.00 (±0.39) cm(2). The mean difference between AVA(TTE) and AVA(MDCT) was -0.06 cm(2), p = 0.001, mean difference between AVA(TTE) and AVA(REF) was -0.06 cm(2), p < 0.001, and mean difference between AVA(MDCT) and AVA(REF) was -0.01 cm(2), p = 0.60. Calcification of the aortic valve quantified by Agatston score, significantly decreased the correlation between AVA(MDCT) and AVA(REF), (r low Agatston = 0.90, r high Agatston = 0.57). MDCT measured AVA is slightly larger than AVA measured by TTE (0.06 cm(2)). The accuracy and precision errors on AVA measurements are comparable for MDCT and TTE. Valvular calcification may primarily affect the accuracy of AVA(MDCT). PMID:24126620

Larsen, Linnea Hornbech; Kofoed, Klaus Fuglsang; Carstensen, Helle Gervig; Mejdahl, Mads Rams; Andersen, Mads Jønsson; Kjaergaard, Jesper; Nielsen, Olav Wendelboe; Køber, Lars; Møgelvang, Rasmus; Hassager, Christian

2014-01-01

220

Intracardiac Echocardiography Guided Transeptal Catheter Injection of Microspheres for Assessment of Cerebral Microcirculation in Experimental Models  

PubMed Central

The use of microspheres for the determination of regional microvascular blood flow (RMBF) has previously used different approaches. This study presents for the first time the intracardiac injection of microspheres using transeptal puncture under intracardiac echocardiography guidance. Five Merino sheep were instrumented and cardiovascularly supported according to local guidelines. Two catheter sheaths into the internal jugular vein facilitated the introduction of an intracardiac probe and transeptal catheter, respectively. Five million colour coded microspheres were injected into the left atrium via this catheter. After euthanasia the brain was used as proof of principle and the endpoint for determination of microcirculation at different time points. Homogeneous allocation of microspheres to different regions of the brain was found over time. Alternate slices from both hemispheres showed the following flow ranges: for slice 02; 0.57–1.02?mL/min/g, slice 04; 0.45–1.42?mL/min/g, slice 06; 0.35–1.87?mL/min/g, slice 08; 0.46–1.77?mL/min/g, slice 10; 0.34–1.28?mL/min/g. A mixed effect regression model demonstrated that the confidence interval did include zero suggesting that the apparent variability intra- and intersubject was not statistically significant, supporting the stability and reproducibility of the injection technique. This study demonstrates the feasibility of the transeptal injection of microspheres, showing a homogeneous distribution of blood flow through the brain unchanged over time and has established a new interventional model for the measurement of RMBF in ovine models. PMID:24102032

Bellapart, Judith; Dunster, Kimble R.; Diab, Sara; Platts, David G.; Raffel, Christopher; Maybauer, Marc O.; Barnett, Adrian; Boots, Robert James; Fraser, John F.

2013-01-01

221

Echocardiography and right ventricular function in NKF stage III cronic kidney disease: Ultrasound nephrologists' role.  

PubMed

TAPSE measurement during echocardiography is a well known measure of right heart systo-diastolic function. Low TAPSE means reduced cranio-caudal excursion of tricuspidal annulus, sign of both reduced ejection fraction and reduced distensibility of right ventricle. It is a good prognostic index for cardiac mortality risk in CHF patients, adding significant prognostic information to NYHA stadiation. Nephrologists do not always fully aware of right ventricular function in their patients affected by chronic renal failure (CRF), even if this datum is probably crucial in vascular access policy. Our study was designed to study right ventricle function and TAPSE on 202 patients affected by moderate chronic renal failure, free from overt pulmonary hypertension. TAPSE, PAPs, right chambers diameters, classical Framingham factors, estimated glomerular filtration rate were recorded. TAPSE was reduced (<23 mm) in 43% of patients enrolled, while dilated right chambers were present in 24%. PAPs exceeded 30 mmHg in 29% of patients. Echocardiographic signs of left ventricular hypertrophy were found in 36% of patients. The ejection fraction was normal in all patients. Statistical analysis showed a significant indirect correlation between TAPSE and PAPs and between TAPSE and tele-diastolic diameters and volumes of the right ventricle, while a direct correlation was observed between TAPSE and Framingham score. TAPSE showed a bimodal distribution, with a subpopulation "low TAPSE - high PAPs", next to a population characterized by normal values ??for both parameters. A reduction in compliance and systolic function of the right heart chambers is quite early and frequent in course of CKD, a fact that the nephrologist should take in due consideration, managing blood volume or planning vascular access for hemodialysis. PMID:23730390

Floccari, F; Granata, A; Rivera, R; Marrocco, F; Santoboni, A; Malaguti, M; Andrulli, S; Di Lullo, L

2012-12-01

222

Echocardiography and right ventricular function in NKF stage III cronic kidney disease: Ultrasound nephrologists' role?  

PubMed Central

TAPSE measurement during echocardiography is a well known measure of right heart systo-diastolic function. Low TAPSE means reduced cranio-caudal excursion of tricuspidal annulus, sign of both reduced ejection fraction and reduced distensibility of right ventricle. It is a good prognostic index for cardiac mortality risk in CHF patients, adding significant prognostic information to NYHA stadiation. Nephrologists do not always fully aware of right ventricular function in their patients affected by chronic renal failure (CRF), even if this datum is probably crucial in vascular access policy. Our study was designed to study right ventricle function and TAPSE on 202 patients affected by moderate chronic renal failure, free from overt pulmonary hypertension. TAPSE, PAPs, right chambers diameters, classical Framingham factors, estimated glomerular filtration rate were recorded. TAPSE was reduced (<23 mm) in 43% of patients enrolled, while dilated right chambers were present in 24%. PAPs exceeded 30 mmHg in 29% of patients. Echocardiographic signs of left ventricular hypertrophy were found in 36% of patients. The ejection fraction was normal in all patients. Statistical analysis showed a significant indirect correlation between TAPSE and PAPs and between TAPSE and tele-diastolic diameters and volumes of the right ventricle, while a direct correlation was observed between TAPSE and Framingham score. TAPSE showed a bimodal distribution, with a subpopulation “low TAPSE – high PAPs”, next to a population characterized by normal values ??for both parameters. A reduction in compliance and systolic function of the right heart chambers is quite early and frequent in course of CKD, a fact that the nephrologist should take in due consideration, managing blood volume or planning vascular access for hemodialysis. PMID:23730390

Floccari, F.; Granata, A.; Rivera, R.; Marrocco, F.; Santoboni, A.; Malaguti, M.; Andrulli, S.; Di Lullo, L.

2012-01-01

223

Utility of transesophageal echocardiography in the examination of adult patients with patent ductus arteriosus  

Microsoft Academic Search

Thirteen patients with clinical suspicion of patent ductus arteriosus were evaluated by transthoracic and transesophageal echocardiographic studies. Findings were corroborated during corrective surgery in 8 patients and by cardiac catheterization in 5. Transthoracic echocardiography confirmed the diagnosis in 7 patients; in 2 of the patients endarteritis of the pulmonary artery was demonstrated, and in one infective vegetations in aortic and

Alejandra Andrade; Jesus Vargas-Barron; Maria Rijlaarsdam; Angel Romero-Cardenas; Candace Keirns; Nilda Espinola

1995-01-01

224

Echocardiography Doppler in pulmonary embolism: Right ventricular dysfunction as a predictor of mortality rate  

Microsoft Academic Search

To test the hypothesis that right ventricular (RV) systolic dysfunction at the time of diagnosis of pulmonary embolism (PE) is a predictor of mortality rate, 126 consecutive patients with PE were examined with echocardiography Doppler (ED) on the day of diagnosis. RV function was assessed by evaluation of wall motion on a four-point scale. The material was divided into two

Ary Ribeiro; Per Lindmarker; Anders Juhlin-Dannfelt; Hans Johnsson; Lennart Jorfeldt

1997-01-01

225

Dobutamine stress echocardiography for the preoperative evaluation of patients undergoing lung volume reduction surgery  

Microsoft Academic Search

Background: Lung volume reduction surgery has been proposed as a bridge to lung transplantation and as definitive therapy for advanced chronic obstructive lung disease. However, patient selection criteria and optimal preoperative assessment have not been clearly defined. Objective: We investigated the feasibility, safety, and value of dobutamine stress echocardiography as a predictor of major early cardiac events in patients who

Eduardo Bossone; Fernando J. Martinez; Richard I. Whyte; Mark D. Iannettoni; William F. Armstrong; David S. Bach

1999-01-01

226

Effects of Candesartan and Cilazapril on Rats With Myocardial Infarction Assessed by Echocardiography  

Microsoft Academic Search

The purpose of this study was to compare the angiotensin II type 1 receptor antagonist candesartan cilexitil (candesartan) and the angiotensin-converting enzyme inhibitor cilazapril on cardiac function, assessed by Doppler echocardiography and cardiac gene expression associated with cardiac remodeling, in rats with myocardial infarction. Candesartan or cilazapril was administered after myocardial infarction. At 1 and 4 weeks after myocardial infarction,

Minoru Yoshiyama; Kazuhide Takeuchi; Takashi Omura; Shokei Kim; Hiroyuki Yamagishi; Iku Toda; Masakazu Teragaki; Kaname Akioka; Hiroshi Iwao; Junichi Yoshikawa

227

Myocardial abscess secondary to staphylococcal septicemia: diagnosis with 3D echocardiography.  

PubMed

A 56 years old gentleman with staphylococcal septicemia with metastatic abscesses in spleen and heart. Real time 3D trans thoracic echocardiography could not only confirm the diagnosis of myocardial abscess but also well delineate it and identify adjacent structures. PMID:23438629

Jariwala, Pankaj; Punjani, Arshad; Mirza, Shaeq; Harikishan, Boorugu; Madhawar, Dilip Babu

2013-01-01

228

Abstract--Intracardiac echocardiography (ICE) catheters enable high-quality ultrasound imaging within the heart, but  

E-print Network

Abstract-- Intracardiac echocardiography (ICE) catheters enable high-quality ultrasound imaging model for robotic control of commercial ICE catheters. The four actuated degrees of freedom (4-DOF ICE catheters, the methods described here are applicable to any long thin tendon-driven tool (with

229

The feasibility of dobutamine stress echocardiography in the emergency department with telemedicine interpretation  

Microsoft Academic Search

Dobutamine stress echocardiography (DSE) was performed on 26 patients admitted for chest pain deemed at low risk for mycoardial infarction. Pharmacologic stress in the emergency department on a 24-hour basis was administered by nurses and echocardiographic ultrasonographers with electrocardiograms and echocardiograms being interpreted through telemedicine relay by an off-site cardiologist. Target heart rate was achieved in 84% of patients with

James A. Trippi; Greg Kopp; Kamthorn S. Lee; Howard Morrison; Gregory Risk; James H. Jones; William H. Cordell; Margaretha Chrapla; David Nelson

1996-01-01

230

Assessment of left atrial dimensions by cross sectional echocardiography in patients with mitral valve disease  

Microsoft Academic Search

Left atrial dimensions were measured using cross sectional echocardiography in 37 patients with mitral valve disease and 30 normal subjects of similar ages. The anteroposterior (AP), superior-inferior (SI), and medial-lateral (ML) left atrial dimensions were determined at the end of ventricular systole using parasternal long and short axis and apical four chamber views (for SIa and MLa). To assess the

F Loperfido; F Pennestri; A Digaetano; E Scabbia; P Santarelli; R Mongiardo; G Schiavoni; E Coppola; U Manzoli

1983-01-01

231

Effect of ?-adrenergic receptor blockade on the physiologic response to dobutamine stress echocardiography  

Microsoft Academic Search

Dobutamine is an effective pharmacologic stress agent because of its ?-adrenergic receptor agonist properties. Theoretically, concurrent ?-adrenergic receptor blockade might alter this effectiveness, but clinical experience has been variable. Before assessing the relative effectiveness and implications of dobutamine stress echocardiography (DSE) to detect myocardial ischemia in the presence of ?-blockade the physiologic and hemodynamic effects of dobutamine with simultaneous ?-blockade

Neil J. Weissman; Michael W. Levangie; John B. Newell; J. Luis Guerrero; Arthur E. Weyman; Michael H. Picard

1995-01-01

232

Potential Use of Transthoracic Echocardiography in the Assessment of Coronary Flow Reserve  

Microsoft Academic Search

Coronary flow reserve provides a gold standard assessment of the epicardial and microvascular coronary circulation. However, measurement of coronary flow reserve is limited by the invasiveness or complexity of the methods hitherto available. We investigated whether transthoracic echocardiography could be used to assess coronary flow reserve. We imaged distal left anterior descending coronary artery diameter and flow in 14 healthy

David J. R. Hildick-Smith; Leonard M. Shapiro

1999-01-01

233

Noninvasive Assessment of Coronary Flow Reserve with Transthoracic Signal–Enhanced Doppler Echocardiography  

Microsoft Academic Search

Objectives: The feasibility of noninvasive assessment of coronary flow reserve (CFR) in the distal left anterior descending artery (LAD) with echocardiography-enhanced transthoracic pulsed wave Doppler guided by high-resolution transthoracic color Doppler (TTCD) was investigated. The results were compared with the degree of coronary diameter stenosis obtained during cardiac catheterization. Background: Assessment of CFR has proven to be useful in the

Heinz Lambertz; Hans Peter Tries; Thorsten Stein; Harald Lethen

1999-01-01

234

Evaluation of coronary flow reserve in hypertensive patients by dipyridamole transesophageal Doppler echocardiography  

Microsoft Academic Search

This study evaluates the coronary flow reserve (CFR) in hypertensive patients with and without left ventricular (LV) hypertrophy. CFR was assessed by transesophageal Doppler echocardiography in 15 normal subjects (group I), 21 hypertensive patients without LV hypertrophy (group II), and 27 hypertensive patients with LV hypertrophy (group III). All hypertensive patients were complaining of typical anginal pain and had normal

Mohamed S Hamouda; Hanan K Kassem; Mai Salama; Magdy El Masry; Naseem Shaaban; Ekram Sadek; Bijoy K Khandheria; James B Seward; Abdou Elhendy

2000-01-01

235

Echocardiography and cardiac catheterization in the preoperative assessment of ventricular septal defect in infancy  

Microsoft Academic Search

Background Cardiac catheterization is commonly performed before repair of ventricular septal defect (VSD) in infancy. No study has addressed the accuracy of echocardiography alone in defining all of the important anatomic features in this population. Methods Consecutive infants undergoing VSD repair between 1991 and 1995 (n = 156) were reviewed. The number of additional VSDs and the presence of commonly

Alan G. Magee; Christine Boutin; Brian W. McCrindle; Jeffrey F. Smallhorn

1998-01-01

236

Evaluation of cardiac function by tissue Doppler echocardiography: Hemodynamic determinants and clinical application  

Microsoft Academic Search

A total of 32 patients without regional wall motion abnormality of the left ventricle underwent sequential tissue Doppler echocardiography and cardiac catheterization. Peak velocities of systolic (Sa), early diastolic (Ea), and late diastolic (Aa) motion of the mitral annulus were measured. Normal references for Sa, Ea and Aa were obtained from 138 volunteers. Indices of left ventricular (LV) systolic and

Wen-Chung Yu; Wen-Shin Lee; Wen-Pin Huang; Chih-Cheng Wu; Yao-Ping Lin; Chen-Huan Chen

2005-01-01

237

Using a Robotic Arm for Echocardiography to X-ray Image Registration during Cardiac Catheterization  

E-print Network

Using a Robotic Arm for Echocardiography to X-ray Image Registration during Cardiac Catheterization C-arm, we are able to register the 3D echo images with live 2D X-ray images. In addition, we can fluoroscopic guidance. Pure X-ray guidance has a number of disadvantages. Firstly, X-ray images are two

Boyer, Edmond

238

Estimating the Myocardium's Angle of Three-Dimensional Trajectory, Using the Tracking of Sequential Two-Dimensional Echocardiography Images  

PubMed Central

Background In this study, the angle of the myocardium's trajectory in three dimensions (?) was estimated by simultaneous use of long-axis and short-axis views of left ventricle septum two-dimensional images. Then correlation of three-dimensional trajectory's angle with the rotation angle from the long (?) and short (?) axis views was estimated and compared at the three levels of base, mid and apex of the interventricular septum wall. Methods Two-dimensional echocardiography images of long- and short-axis views of 19 healthy men were recorded and analyzed. Using an electrocardiogram of each individual, the images of the two views were synchronized. The interventricular septum wall motion at the three levels of base, mid and apex were estimated, using a block matching algorithm throughout three cardiac cycles. Considering the defined system of coordinates and the position vectors in long and short-axis views, the 3-dimensional angle of the trajectory was calculated. Results Maxima of the ?, ?, and ? angles were extracted at 16.33 ± 3.01, 10.61 ± 3.38, and 15.11 ± 3.30 degrees at base level, 22.77 ± 4.95, 7.78 ± 2.96, and 16.72 ± 2.66 degrees at mid level and 14.60 ± 5.81, 10.37 ± 5.48, and 8.79 ± 3.32 degrees at apex level, respectively, of the septum wall, respectively. This study shows significant correlation between the angle of 3-dimensional trajectory (?) with the angle in short axis view (?) of the septum wall at the apex level; and also with the angle in long axis view (?) of the septum wall at base and mid levels. Conclusion Due to the motion of the wall of the left ventricle in three dimensions, and the non-isotropic structure of myofibers, the angle of 3-dimensional trajectory was estimated using the speckle tracking method of 2-dimentional echocardiography images. PMID:24753804

Mobasheri, Mosayyeb; Roshanali, Faride

2014-01-01

239

Visualization of the intracavitary blood flow in systemic ventricles of Fontan patients by contrast echocardiography using particle image velocimetry  

PubMed Central

Background Flow patterns in univentricular hearts may have clinical value. Therefore, it is our objective to asses and characterize vortex flow patterns with Fontan circulation in comparison with healthy controls. Methods Twenty-three patients (8 Fontan and 15 normal patients) underwent echocardiography with intravenous contrast agent (Sonovue®) administration. Dedicated software was used to perform particle image velocimetry (PIV) and to visualize intracavitary flow in the systemic ventricles of the patients. Vortex parameters including vortex depth, length, width, and sphericity index were measured. Vortex pulsatility parameters including relative strength, vortex relative strength, and vortex pulsation correlation were also measured. Results The data from this study show that it is feasible to perform particle velocimetry in Fontan patients. Vortex length (VL) was significantly lower (0.51 ± 0.09 vs 0.65 ± 0.12, P = 0.010) and vortex width (VW) (0.32 ± 0.06 vs 0.27 ± 0.04, p = 0.014), vortex pulsation correlation (VPC) (0.26 ± 0.25 vs -0.22 ± 0.87, p = 0.05) were significantly higher in Fontan patients. Sphericity index (SI) (1.66 ± 0.48 vs 2.42 ± 0.62, p = 0.005), relative strength (RS) (0.77 ± 0.33 vs 1.90 ± 0.47, p = 0.0001), vortex relative strength (VRS) (0.18 ± 0.13 vs 0.43 ± 0.14, p = 0.0001) were significantly lower in the Fontan patients group. Conclusions PIV using contrast echocardiography is feasible in Fontan patients. Fontan patients had aberrant flow patterns as compared to normal hearts in terms of position, shape and sphericity of the main vortices. The vortex from the Fontan group was consistently shorter, wider and rounder than in controls. Whether vortex characteristics are related with clinical outcome is subject to further investigation. PMID:22348378

2012-01-01

240

Optimal method for early detection of cardiac disorders in thalassemia major patients: magnetic resonance imaging or echocardiography?  

PubMed Central

Background Heart failure resulting from myocardial iron deposition is the most important cause of death in ?-thalassemia major (TM) patients. Cardiac T2*magnetic resonance imaging (MRI), echocardiography, and serum ferritin level serve as diagnostic methods for detecting myocardial iron overload. In this study, we aimed to evaluate the relationship between the above-mentioned methods. Methods T2*MRI and echocardiographic measurement of left ventricular (LV) systolic and diastolic function were performed in 63 patients. Serum ferritin level was measured. The relationships between all assessments were evaluated. Results There were 40 women and 23 men with a mean age of 23.7±5.1 years (range, 15-35 years). There was no statistically significant correlation between serum ferritin level and LV systolic and diastolic function (P=0.994 and P=0.475, respectively). T2*MRI results had a significant correlation with ferritin level; 63.6% of patients with serum ferritin level >2,000 ng/mL had abnormal cardiac MRI, while none of the patients with ferritin level <1,000 ng/mL had abnormal cardiac MRI (P=0.001). There was no significant correlation between MRI findings and LV systolic function (P=1.00). However, we detected a significant difference between LV diastolic function and cardiac siderosis (P=0.03) Conclusion MRI findings are a good predictor of future cardiac dysfunction, even in asymptomatic TM patients; however, diastolic dysfunction may happen prior to cardiac siderosis in some patients, and echocardiography is able to diagnose this diastolic dysfunction while T2*MRI shows normal findings. PMID:25325038

Moussavi, Farideh; Roodpeyma, Shahla; Alavi, Samin; Shakiba, Majid; Gheiratmand, Riaz; Omidghaemi, Maryam

2014-01-01

241

The diagnostic accuracy of pharmacological stress echocardiography for the assessment of coronary artery disease: a meta-analysis  

PubMed Central

Background Recent American Heart Association/American College of Cardiology guidelines state that "dobutamine stress echo has substantially higher sensitivity than vasodilator stress echo for detection of coronary artery stenosis" while the European Society of Cardiology guidelines and the European Association of Echocardiography recommendations conclude that "the two tests have very similar applications". Who is right? Aim To evaluate the diagnostic accuracy of dobutamine versus dipyridamole stress echocardiography through an evidence-based approach. Methods From PubMed search, we identified all papers with coronary angiographic verification and head-to-head comparison of dobutamine stress echo (40 mcg/kg/min ± atropine) versus dipyridamole stress echo performed with state-of-the art protocols (either 0.84 mg/kg in 10' plus atropine, or 0.84 mg/kg in 6' without atropine). A total of 5 papers have been found. Pooled weight meta-analysis was performed. Results the 5 analyzed papers recruited 435 patients, 299 with and 136 without angiographically assessed coronary artery disease (quantitatively assessed stenosis > 50%). Dipyridamole and dobutamine showed similar accuracy (87%, 95% confidence intervals, CI, 83–90, vs. 84%, CI, 80–88, p = 0.48), sensitivity (85%, CI 80–89, vs. 86%, CI 78–91, p = 0.81) and specificity (89%, CI 82–94 vs. 86%, CI 75–89, p = 0.15). Conclusion When state-of-the art protocols are considered, dipyridamole and dobutamine stress echo have similar accuracy, specificity and – most importantly – sensitivity for detection of CAD. European recommendations concluding that "dobutamine and vasodilators (at appropriately high doses) are equally potent ischemic stressors for inducing wall motion abnormalities in presence of a critical coronary artery stenosis" are evidence-based. PMID:18565214

Picano, Eugenio; Molinaro, Sabrina; Pasanisi, Emilio

2008-01-01

242

Real-time three-dimensional transthoracic echocardiography in daily practice: initial experience  

PubMed Central

Aim of the work To evaluate the feasibility and possible additional value of transthoracic real-time three-dimensional echocardiography (RT3D-TTE) for the assessment of cardiac structures as compared to 2D-TTE. Methods 320 patients (mean age 45 ± 8.4 years, 75% males) underwent 2D-TTE and RT3D-TTE using 3DQ-Q lab software for offline analysis. Volume quantification and functional assessment was performed in 90 patients for left ventricle and in 20 patients for right ventricle. Assessment of native (112 patients) and prosthetic (30 patients) valves morphology and functions was performed. RT3D-TTE was performed for evaluation of septal defects in 30 patients and intracardiac masses in 52 patients. Results RT3D-TTE assessment of left ventricle was feasible and reproducible in 86% of patients while for right ventricle, it was (55%). RT3D-TTE could define the surface anatomy of mitral valve optimally (100%), while for aortic and tricuspid was (88% and 81% respectively). Valve area could be planimetered in 100% for the mitral and in 80% for the aortic. RT3D-TTE provided a comprehensive anatomical and functional evaluation of prosthetic valves. RT3D-TTE enface visualization of septal defects allowed optimal assessment of shape, size, area and number of defects and evaluated the outcome post device closure. RT3D-TTE allowed looking inside the intracardiac masses through multiple sectioning, valuable anatomical delineation and volume calculation. Conclusion Our initial experience showed that the use of RT3D-TTE in the assessment of cardiac patients is feasible and allowed detailed anatomical and functional assessment of many cardiac disorders. PMID:22448671

2012-01-01

243

Echocardiography of the normal camel (Camelus dromedaries) heart: technique and cardiac dimensions  

PubMed Central

Background Echocardiography and intra-cardiac dimensions have not previously been reported in adult camels despite its potential application for medical purpose. The aim of this study was to describe the results of a prospective study, aiming to report normal cardiac appearance and normal chamber dimensions in adult camels (Camelus dromedarius). Results On the right side, when the probe was placed in the 5th or 4th intercostal space (ICS), the caudal long-axis four-chamber view of the ventricles, atria, and the interventricular septum was obtained. Placing the probe slightly more cranially in the 4th ICS, the caudal long-axis four-chamber view and the caudal long-axis view of the left ventricular outflow tract (LVOT) were imaged. In 7 camels, a hybrid view between a “four-chamber” and “LVOT view” was imaged from the same position. The short-axis view of the ventricles was obtained in the 4th ICS where the transducer was rotated between 0° and 25°. Placement of the transducer in the 3rd ICS allowed visualisation of the right ventricular outflow tract (RVOT). On the left side, when the probe was placed in the 5th or 4th ICS, a four-chamber view was obtained. The LVOT is imaged in the 4th ICS and the RVOT was seen from the 3rd ICS. Conclusions This study showed that it is possible to obtain good-quality echocardiograms in adult camels and provide normal cardiac dimensions. This study could be used as a reference for further studies concerning camels with cardiac diseases. PMID:22862855

2012-01-01

244

Contrast and harmonic imaging improves accuracy and efficiency of novice readers for dobutamine stress echocardiography  

NASA Technical Reports Server (NTRS)

BACKGROUND: Newer contrast agents as well as tissue harmonic imaging enhance left ventricular (LV) endocardial border delineation, and therefore, improve LV wall-motion analysis. Interpretation of dobutamine stress echocardiography is observer-dependent and requires experience. This study was performed to evaluate whether these new imaging modalities would improve endocardial visualization and enhance accuracy and efficiency of the inexperienced reader interpreting dobutamine stress echocardiography. METHODS AND RESULTS: Twenty-nine consecutive patients with known or suspected coronary artery disease underwent dobutamine stress echocardiography. Both fundamental (2.5 MHZ) and harmonic (1.7 and 3.5 MHZ) mode images were obtained in four standard views at rest and at peak stress during a standard dobutamine infusion stress protocol. Following the noncontrast images, Optison was administered intravenously in bolus (0.5-3.0 ml), and fundamental and harmonic images were obtained. The dobutamine echocardiography studies were reviewed by one experienced and one inexperienced echocardiographer. LV segments were graded for image quality and function. Time for interpretation also was recorded. Contrast with harmonic imaging improved the diagnostic concordance of the novice reader to the expert reader by 7.1%, 7.5%, and 12.6% (P < 0.001) as compared with harmonic imaging, fundamental imaging, and fundamental imaging with contrast, respectively. For the novice reader, reading time was reduced by 47%, 55%, and 58% (P < 0.005) as compared with the time needed for fundamental, fundamental contrast, and harmonic modes, respectively. With harmonic imaging, the image quality score was 4.6% higher (P < 0.001) than for fundamental imaging. Image quality scores were not significantly different for noncontrast and contrast images. CONCLUSION: Harmonic imaging with contrast significantly improves the accuracy and efficiency of the novice dobutamine stress echocardiography reader. The use of harmonic imaging reduces the frequency of nondiagnostic wall segments.

Vlassak, Irmien; Rubin, David N.; Odabashian, Jill A.; Garcia, Mario J.; King, Lisa M.; Lin, Steve S.; Drinko, Jeanne K.; Morehead, Annitta J.; Prior, David L.; Asher, Craig R.; Klein, Allan L.; Thomas, James D.

2002-01-01

245

Echocardiography detects elevated left ventricular filling pressures in heart transplant recipients.  

PubMed

Diastolic dysfunction is a recognized complication in heart transplant (HTx) recipients that limits exercise capacity and is a risk factor for mortality. We investigated the ability of echocardiography to detect elevated pulmonary capillary wedge pressure (mean PCWP>15 mmHg) in HTx recipients. This retrospective study comprised HTx recipients with echocardiography and right heart catheterization within 24 hours (n = 100, 113 investigations). Echocardiographic assessment was performed using mitral inflow (E/A ratio, deceleration time [DT], isovolumic relaxation time [IVRT]), tissue Doppler (E/E' lateral) parameters, and the Doppler-estimated pulmonary artery systolic pressure (Doppler PASP). The right atrial pressure (RAP) was estimated based on size and the effect of respiration or sniffing on the inferior vena cava diameter. Cutoff values were determined from a derivation group (n = 57, receiver operator characteristic curve analysis) and evaluated in a test group (n = 56). Elevated PCWP were found in 38%. The RAP and PCWP were both normal in 58 investigations and elevated in 39 investigations (concordance rate of 86.6%). The presence of signs of increased RAP by echocardiography or with three of five parameters (E/A, DT, IVRT, E/E' lateral, and Doppler PASP) reaching the cutoff values ruled in elevated PCWP with positive likelihood ratios ranging from 15.3 to 9. With normal RAP by echocardiography or none of the other parameters reaching cutoff values elevated PCWP can be ruled out with negative likelihood ratios ranging from 0.07 to 0.19. In conclusion, elevated PCWP in HTx recipients can be assessed using echocardiography. PMID:24995376

Bech-Hanssen, Odd; Al-Habeeb, Waleed; Ahmed, Waqas; Di Salvo, Giovanni; Pergola, Valeria; Al-Admawi, Mohammed; Al-Amri, Mohammed; Al-Shahid, Maie; Al-Buraiki, Jehad; Fadel, Bahaa M

2015-03-01

246

Atrial longitudinal strain parameters predict left atrial reverse remodeling after mitral valve surgery: a speckle tracking echocardiography study.  

PubMed

Volume overload in chronic severe mitral regurgitation (MR) causes left atrial (LA) remodeling. Volume overload generally diminishes after mitral valve surgery and LA size and shape are expected to recover. The recovery of LA functions named as reverse remodeling is said to be related with prognosis and mortality. A few clinical and echocardiographic parameters have been reported to be associated with LA reverse remodeling. In this study, we investigated the relationship between LA peak longitudinal strain (reservoir strain) assessed with 2-dimensional speckle tracking echocardiography (2D STE) and LA reverse remodeling. 53 patients (24 females and 29 males, mean age: 45.7 ± 13.5 years) with severe MR and preserved left ventricular systolic function were included in the study. All patients had normal sinus rhythm. The etiology of MR was mitral valve prolapse (MVP) in 37 patients and rheumatic valvular disease in 16 patients. Mitral valve repair was performed in 30 patients while 23 underwent mitral valve replacement. Echocardiography was performed before the surgery and 6 months later. LA peak atrial longitudinal strain (PALS) was assessed with speckle tracking imaging. LA reverse remodeling was defined as a percent of decrease in LA volume index (LAVI). Left atrial volume index significantly decreased after surgery (58.2 ± 16.6 vs. 43.9 ± 17.2 ml/m2, p ? 0.001). Mean LAVI reduction was 22.5 ± 27.2%. There was no significant difference in LAVI reduction between mitral repair and replacement groups (22.1 ± 22.6 vs. 23.1 ± 32.8 %, p = 0.9). Although the decrease in LAVI was higher in MVP group than rheumatic group, it was not statistically significant (24.4 ± 26.8 vs. 18.2 ± 28.9%, p = 0.4). Correlates of LAVI reduction were preoperative LAVI (r 0.28, p = 0.039), PALS (r 0.36, p = 0.001) and age (r -0.36, p = 0.007). Furthermore, in multivariate linear regression analysis (entering models), preoperative LAVI, age and PALS were all significant predictors of LA reverse remodeling (p ? 0.001, p = 0.04, p = 0.001 respectively). Left atrial peak longitudinal strain measured by 2D STE, in conjunction with preoperative LAVI and age is a predictor of LA reverse remodeling in patients undergoing surgery for severe MR. We suggest that in this patient population, PALS may also be used as a preoperative prognostic marker. PMID:24781032

Candan, Ozkan; Ozdemir, Nihal; Aung, Soe Moe; Hatipoglu, Suzan; Karabay, Can Yucel; Guler, Ahmet; Gecmen, Cetin; Dogan, Cem; Omaygenc, Onur; Bakal, Ruken Bengi

2014-08-01

247

Severe Weather  

ERIC Educational Resources Information Center

Educating the public about safety issues related to severe weather is part of the National Oceanic and Atmospheric Administration's (NOAA) mission. This article deals with a poster entitled, "Severe Weather," that has been created by NOAA to help educate the public about hazardous weather conditions. The four types of severe weather highlighted in…

Forde, Evan B.

2004-01-01

248

Severe Weather  

ERIC Educational Resources Information Center

Educating the public about safety issues related to severe weather is part of the National Oceanic and Atmospheric Administration's (NOAA) mission. This month's insert, Severe Weather, has been created by NOAA to help educate the public about hazardous weather conditions. The four types of severe weather highlighted in this poster are hurricanes,…

Forde, Evan B.

2004-01-01

249

Stretched View Showing 'Victoria'  

NASA Technical Reports Server (NTRS)

[figure removed for brevity, see original site] Stretched View Showing 'Victoria'

This pair of images from the panoramic camera on NASA's Mars Exploration Rover Opportunity served as initial confirmation that the two-year-old rover is within sight of 'Victoria Crater,' which it has been approaching for more than a year. Engineers on the rover team were unsure whether Opportunity would make it as far as Victoria, but scientists hoped for the chance to study such a large crater with their roving geologist. Victoria Crater is 800 meters (nearly half a mile) in diameter, about six times wider than 'Endurance Crater,' where Opportunity spent several months in 2004 examining rock layers affected by ancient water.

When scientists using orbital data calculated that they should be able to detect Victoria's rim in rover images, they scrutinized frames taken in the direction of the crater by the panoramic camera. To positively characterize the subtle horizon profile of the crater and some of the features leading up to it, researchers created a vertically-stretched image (top) from a mosaic of regular frames from the panoramic camera (bottom), taken on Opportunity's 804th Martian day (April 29, 2006).

The stretched image makes mild nearby dunes look like more threatening peaks, but that is only a result of the exaggerated vertical dimension. This vertical stretch technique was first applied to Viking Lander 2 panoramas by Philip Stooke, of the University of Western Ontario, Canada, to help locate the lander with respect to orbiter images. Vertically stretching the image allows features to be more readily identified by the Mars Exploration Rover science team.

The bright white dot near the horizon to the right of center (barely visible without labeling or zoom-in) is thought to be a light-toned outcrop on the far wall of the crater, suggesting that the rover can see over the low rim of Victoria. In figure 1, the northeast and southeast rims are labeled in bright green. Finally, the light purple lines and arrow highlight a small crater.

2006-01-01

250

Prognostic value of coronary flow reserve assessed by transthoracic Doppler echocardiography on long-term outcome in asymptomatic patients with type 2 diabetes without overt coronary artery disease  

PubMed Central

Background Cardiovascular risk stratification of asymptomatic diabetic patients is important and remains a difficult clinical problem. Our aim was to test the hypothesis that coronary flow reserve (CFR) assessed by noninvasive transthoracic Doppler echocardiography predicts prognosis in those patients. Methods From February 2002 to January 2005, we evaluated 135 consecutive asymptomatic patients (74 male; mean age, 63?±?9 years) with type 2 diabetes without a history of coronary artery disease. Adenosine triphosphate (0.14 mg/kg/min) stress Doppler echocardiography was performed to evaluate CFR of the left anterior descending artery. Patients with a CFR?showed that the independent prognostic indicators were male gender (p?echocardiography provides independent prognostic information in asymptomatic patients with type 2 diabetes without overt coronary artery disease. Patients with CFR?

2013-01-01

251

Early Left Ventricular Dysfunction in Children after Hematopoietic Stem Cell Transplantation for Acute Leukemia: A Case Control Study Using Speckle Tracking Echocardiography  

PubMed Central

Background and Objectives Cardiovascular complications are the leading cause of morbidity and mortality in childhood cancer survivors. Hematopoietic stem cell transplantation (HSCT) is a curable therapy for pediatric cancer. However, changes in cardiac function in children after HSCT are not well known. We assessed left ventricular (LV) function in children after HSCT using speckle tracking echocardiography (STE). Subjects and Methods Forty consecutive patients with median age of 11.9 years (range, 1.5-16 years) who received HSCT for acute leukemia and had comprehensive echocardiography before and after (median 9.2 month) HSCT were included in this study. The LV function parameters including conventional tissue Doppler imaging (TDI) and STE data were collected from pre- and post-HSCT echocardiography. These data were compared to those of 39 age-matched normal controls. Results Compared to normal controls, post HSCT patients had similar (p=0.06) LV ejection fraction. However, the following three LV function parameters were significantly decreased in post HSCT patients: rate-corrected velocity of circumferential fiber shortening (p=0.04), mitral inflow E velocity (p<0.001), and mitral septal annular E' velocity (p=0.03). The following four STE parameters were also significantly decreased in post HSCT patients: LV global circumferential systolic strain (p<0.01), strain rate (SR, p=0.01), circumferential diastolic SR (p<0.01), and longitudinal diastolic SR (p<0.001). There was no significant change in TDI or STE parameters after HSCT compared to pre-HSCT. Patients with anthracycline cumulative dose >400 mg/m2 showed significantly (p<0.05) lower circumferential systolic strain and circumferential diastolic SR. Conclusion Subclinical cardiac dysfunction is evident in children after HSCT. It might be associated with pre-HSCT anthracycline exposure with little effect of conditioning regimens. Serial monitoring of cardiac function is mandatory for all children following HSCT. PMID:25653704

Yoon, Ji-Hong; Kim, Hye Jin; Lee, Eun-Jung; Moon, Sena; Lee, Jae Wook; Chung, Nack Gyun; Cho, Bin; Kim, Hack Ki

2015-01-01

252

The Great Cometary Show  

NASA Astrophysics Data System (ADS)

The ESO Very Large Telescope Interferometer, which allows astronomers to scrutinise objects with a precision equivalent to that of a 130-m telescope, is proving itself an unequalled success every day. One of the latest instruments installed, AMBER, has led to a flurry of scientific results, an anthology of which is being published this week as special features in the research journal Astronomy & Astrophysics. ESO PR Photo 06a/07 ESO PR Photo 06a/07 The AMBER Instrument "With its unique capabilities, the VLT Interferometer (VLTI) has created itself a niche in which it provide answers to many astronomical questions, from the shape of stars, to discs around stars, to the surroundings of the supermassive black holes in active galaxies," says Jorge Melnick (ESO), the VLT Project Scientist. The VLTI has led to 55 scientific papers already and is in fact producing more than half of the interferometric results worldwide. "With the capability of AMBER to combine up to three of the 8.2-m VLT Unit Telescopes, we can really achieve what nobody else can do," added Fabien Malbet, from the LAOG (France) and the AMBER Project Scientist. Eleven articles will appear this week in Astronomy & Astrophysics' special AMBER section. Three of them describe the unique instrument, while the other eight reveal completely new results about the early and late stages in the life of stars. ESO PR Photo 06b/07 ESO PR Photo 06b/07 The Inner Winds of Eta Carinae The first results presented in this issue cover various fields of stellar and circumstellar physics. Two papers deal with very young solar-like stars, offering new information about the geometry of the surrounding discs and associated outflowing winds. Other articles are devoted to the study of hot active stars of particular interest: Alpha Arae, Kappa Canis Majoris, and CPD -57o2874. They provide new, precise information about their rotating gas envelopes. An important new result concerns the enigmatic object Eta Carinae. Using AMBER with its high spatial and spectral resolution, it was possible to zoom into the very heart of this very massive star. In this innermost region, the observations are dominated by the extremely dense stellar wind that totally obscures the underlying central star. The AMBER observations show that this dense stellar wind is not spherically symmetric, but exhibits a clearly elongated structure. Overall, the AMBER observations confirm that the extremely high mass loss of Eta Carinae's massive central star is non-spherical and much stronger along the poles than in the equatorial plane. This is in agreement with theoretical models that predict such an enhanced polar mass-loss in the case of rapidly rotating stars. ESO PR Photo 06c/07 ESO PR Photo 06c/07 RS Ophiuchi in Outburst Several papers from this special feature focus on the later stages in a star's life. One looks at the binary system Gamma 2 Velorum, which contains the closest example of a star known as a Wolf-Rayet. A single AMBER observation allowed the astronomers to separate the spectra of the two components, offering new insights in the modeling of Wolf-Rayet stars, but made it also possible to measure the separation between the two stars. This led to a new determination of the distance of the system, showing that previous estimates were incorrect. The observations also revealed information on the region where the winds from the two stars collide. The famous binary system RS Ophiuchi, an example of a recurrent nova, was observed just 5 days after it was discovered to be in outburst on 12 February 2006, an event that has been expected for 21 years. AMBER was able to detect the extension of the expanding nova emission. These observations show a complex geometry and kinematics, far from the simple interpretation of a spherical fireball in extension. AMBER has detected a high velocity jet probably perpendicular to the orbital plane of the binary system, and allowed a precise and careful study of the wind and the shockwave coming from the nova. The stream of results from the VLTI and AMBER

2007-01-01

253

Topology of blood transport in the human left ventricle by novel processing of Doppler echocardiography.  

PubMed

Novel processing of Doppler-echocardiography data was used to study blood transport in the left ventricle (LV) of six patients with dilated cardiomyopathy and six healthy volunteers. Bi-directional velocity field maps in the apical long axis of the LV were reconstructed from color-Doppler echocardiography. Resulting velocity field data were used to perform trajectory-based computation of Lagrangian coherent structures (LCS). LCS were shown to reveal the boundaries of blood injected and ejected from the heart over multiple beats. This enabled qualitative and quantitative assessments of blood transport patterns and residence times in the LV. Quantitative assessments of stasis in the LV are reported, as well as characterization of LV vortex formations from E-wave and A-wave filling. PMID:23817765

Hendabadi, Sahar; Bermejo, Javier; Benito, Yolanda; Yotti, Raquel; Fernández-Avilés, Francisco; del Álamo, Juan C; Shadden, Shawn C

2013-12-01

254

Real-time three-dimensional intracardiac echocardiography: an early single-center experience.  

PubMed

As interventional procedures in structural heart diseases are coming of age, there is a significant lag in the periinterventional imaging development for these procedures to become safe, expedient, accurate, and well tolerated by this patient population. Currently, transesophageal echocardiography (TEE), including real-time three-dimensional (RT-3D), has been used for monitoring and guidance for these procedures. Accurate identification of the pathology, its anatomy, and its relationship with the adjoining structures along with spatial resolution is of paramount importance for wire and catheter placement, device deployment, evaluation of the results, and any potential complications. Two-dimensional intracardiac echocardiography (ICE) has been used extensively for a variety of interventional procedures that undergo conscious sedation of monitored anesthesia. RT-3D ICE has recently become available; we describe our initial experience with this new imaging technology. PMID:25589706

Maini, Brijeshwar

2015-01-01

255

Topology of blood transport in the human left ventricle by novel processing of Doppler echocardiography  

PubMed Central

Novel processing of Doppler-echocardiography data was used to study blood transport in the left ventricle (LV) of 6 patients with dilated cardiomyopathy and 6 healthy volunteers. Bi-directional velocity field maps in the apical long axis of the LV were reconstructed from color-Doppler echocardiography. Resulting velocity field data were used to perform trajectory-based computation of Lagrangian coherent structures (LCS). LCS were shown to reveal the boundaries of blood injected and ejected from the heart over multiple beats. This enabled qualitative and quantitive assessments of blood transport patterns and residence times in the LV. Quantitative assessments of stasis in the LV are reported, as well as characterization of LV vortex formations from E-wave and A-wave filling. PMID:23817765

Hendabadi, Sahar; Bermejo, Javier; Benito, Yolanda; Yotti, Raquel; Fernández-Avilés, Francisco; del Álamo, Juan C.; Shadden, Shawn C.

2013-01-01

256

Age and gender related reference values for transthoracic Doppler-echocardiography in the anesthetized CD1 mouse  

Microsoft Academic Search

Objective: Doppler-echocardiography of the mouse has evolved to a commonly used technique in the past years as recent advances in imaging\\u000a quality have substantially improved spatial and temporal resolution allowing the adaptation of this technique to murine models.\\u000a Although mouse echocardiography is widely used, there is only little information on reference data for wild-type animals available,\\u000a particularly in older mice.

Jörg Stypmann; Markus A. Engelen; Constanze Epping; Harold V. M. van Rijen; Peter Milberg; Christian Bruch; Günter Breithardt; Klaus Tiemann; Lars Eckardt

2006-01-01

257

Evaluation using dobutamine stress echocardiography in patients with insulin-dependent diabetes mellitus before kidney and\\/or pancreas transplantation  

Microsoft Academic Search

The purpose of this study was to examine the ability of dobutamine stress echocardiography to stratify patients with juvenile onset, insulin-dependent diabetes mellitus who are being considered for kidney and\\/or pancreas transplantation, into high- or low-risk groups for future cardiac events. Fifty-three such patients underwent dobutamine stress echocardiography before kidney and\\/or pancreas transplantation. Cardiac events, including cardiac death, nonfatal myocardial

John R. Bates; Stephen G. Sawada; Douglas S. Segar; Anthony J. Spaedy; Olivera Petrovic; Naomi S. Fineberg; Harvey Feigenbaum; Thomas Ryan

1996-01-01

258

Assessment of left ventricular volumes using simplified 3-D echocardiography and computed tomography – a phantom and clinical study  

Microsoft Academic Search

OBJECTIVES: To compare the accuracy of simplified 3-dimensional (3-D) echocardiography vs. multi-slice computed tomography (MSCT) software for the quantification of left ventricular (LV) volumes. DESIGN: Three-D echocardiography (3-planes approach) and MSCT-CardIQ software were calibrated by measuring known volumes of 10 phantoms designed to closely mimic blood-endocardium interface. Subsequently, LV volumes were measured with both the methods in 9 patients referred

Mattias Mårtensson; Reidar Winter; Kerstin Cederlund; Jonaz Ripsweden; Habib Mir-Akbari; Jacek Nowak; Lars-Åke Brodin

2008-01-01

259

Comparison of conventional and transesophageal echocardiography with magnetic resonance imaging for anatomical mapping of thoracic aortic dissection  

Microsoft Academic Search

Thirty-five consecutive patients with clinically suspected aortic dissection were subjected to a dual noninvasive imaging protocol using comprehensive echocardiography and ECG-triggered MRI with multi-slice spin echo and cine sequences in random order. The purpose of this dual imaging study was to compare the diagnostic accuracy of two-dimensional and color-coded Doppler echocardiography using the conventional transthoracic (TTE) and the transesophageal approach

Christoph A. Nienaber; Yskert von Kodolitsch; Carsten J. Brockhoff; Dietmar H. Koschyk; Rolf P. Spielmann

1994-01-01

260

Severe Asthma  

PubMed Central

The National Heart, Lung, and Blood Institute Severe Asthma Research Program (SARP) has characterized over the past 10 years 1,644 patients with asthma, including 583 individuals with severe asthma. SARP collaboration has led to a rapid recruitment of subjects and efficient sharing of samples among participating sites to conduct independent mechanistic investigations of severe asthma. Enrolled SARP subjects underwent detailed clinical, physiologic, genomic, and radiological evaluations. In addition, SARP investigators developed safe procedures for bronchoscopy in participants with asthma, including those with severe disease. SARP studies revealed that severe asthma is a heterogeneous disease with varying molecular, biochemical, and cellular inflammatory features and unique structure–function abnormalities. Priorities for future studies include recruitment of a larger number of subjects with severe asthma, including children, to allow further characterization of anatomic, physiologic, biochemical, and genetic factors related to severe disease in a longitudinal assessment to identify factors that modulate the natural history of severe asthma and provide mechanistic rationale for management strategies. PMID:22095547

Erzurum, Serpil C.; Bleecker, Eugene R.; Calhoun, William J.; Castro, Mario; Comhair, Suzy A. A.; Chung, Kian Fan; Curran-Everett, Douglas; Dweik, Raed A.; Fain, Sean B.; Fitzpatrick, Anne M.; Gaston, Benjamin M.; Israel, Elliot; Hastie, Annette; Hoffman, Eric A.; Holguin, Fernando; Levy, Bruce D.; Meyers, Deborah A.; Moore, Wendy C.; Peters, Stephen P.; Sorkness, Ronald L.; Teague, W. Gerald; Wenzel, Sally E.; Busse, William W.

2012-01-01

261

Pulmonary Edema: Which Role for Echocardiography in the Diagnostic Workup?  

Microsoft Academic Search

\\u000a In the presence of pulmonary edema, the distinction between hydrostatic (often cardiogenic) and permeability (acute respiratory\\u000a distress syndrome) edema is crucial in the hypoxemic critically-ill patient. Importantly, the absence of relevant left ventricular\\u000a (LV) systolic dysfunction fails to rule outa hydrostatic pulmonary edema (e.g., acute valvular regurgitation, volume overload,\\u000a severe diastolic dysfunction, mitral stenosis) and, conversely, acuterespiratory distress syndrome (ARDS)

Philippe Vignon; Frances Colreavy; Michel Slama

262

New Doppler-Based Imaging Method in Echocardiography with Applications in Blood\\/Tissue Segmentation  

Microsoft Academic Search

Knowledge Based Imaging is suggested as a method to distinguish blood from tissue signal in transthoracial echocardiography.\\u000a Parametric model for the autocorrelation functions for turbulent blood flow and slowly moving tissue are augmented for in\\u000a this paper. The model also includes the presence of stationary clutter noise and system white noise. Knowledge Based Imaging\\u000a utilizes the maximum likelihood function to

Sigve Hovda; Håvard Rue; Bjørn Olstad

2007-01-01

263

Assessing functional mitral regurgitation with exercise echocardiography: rationale and clinical applications  

PubMed Central

Secondary or functional mitral regurgitation (FMR) represents an increasing feature of mitral valve disease characterized by abnormal function of anatomically normal leaflets in the context of the impaired function of remodelled left ventricles. The anatomic and pathophysiological basis of FMR are briefly analyzed; in addition, the role of exercise echocardiography for the assessment of FMR is discussed in view of its relevance to clinical practice. PMID:20003417

2009-01-01

264

Intraoperative cardiac assessment with transesophageal echocardiography for decision-making in cardiac anesthesia.  

PubMed

Transesophageal echocardiography is an invaluable hemodynamic monitoring modality. Extended and anatomically based evaluation of cardiac function with transesophageal echocardiography is essential to prompt and accurate decision-making in anesthetic management during cardiac surgery. Fractional shortening and fractional area changes are indices widely used to assess the global systolic performance of the left ventricle. Monitoring regional function using semi-quantitative scoring has been demonstrated to be a more sensitive indicator of myocardial ischemia. Assessment of left ventricular diastolic function should be performed in a systematic way, measuring transmitral flow, pulmonary venous flow, transmitral color M-mode flow propagation velocity, and mitral annulus tissue Doppler imaging. The unique anatomical features of the right ventricle make echocardiographic evaluation complicated and therefore less frequently employed. Right ventricular fractional area change, tricuspid annular plane systolic excursion, maximal systolic tricuspid annular velocity with tissue Doppler imaging, and myocardial performance index are indices successfully incorporated into intraoperative right ventricular assessment. Left ventricular outflow tract obstruction with systolic anterior motion of the mitral valve may develop after cardiac procedures. Transesophageal echocardiography plays a central role in prevention as well as diagnosis of systolic anterior motion. Transesophageal echocardiography is extremely useful not only for detecting and locating intracardiac air, but also for guiding and evaluating the procedures to remove air. Air is likely to persist in the right and left superior pulmonary vein, left ventricular apex, left atrium, right coronary sinus of Valsalva, and ascending aorta. Accurate evaluation of cardiac function depends on performing TEE examination properly and obtaining optimal images. PMID:23404310

Akiyama, Koichi; Arisawa, Shoji; Ide, Masahiro; Iwaya, Masaaki; Naito, Yoshiyuki

2013-06-01

265

Comparative value of transthoracic and transoesophageal echocardiography before balloon dilatation of the mitral valve  

Microsoft Academic Search

Objective—To assess the relative merits of transthoracic and transoesophageal echocardiography before balloon dilatation of the mitral valve.Design—Transthoracic and transoesophageal echocardiograms were prospectively performed in 35 patients being considered for balloon dilatation of the mitral valve. Echocardiograms were analysed for image quality, the assessment of valve morphology, the detection of left atrial thrombus, and the assessment of mitral regurgitation and other

Martyn R Thomas; Mark J Monaghan; David W Smyth; Jennie M Metcalfe; David E Jewitt

1992-01-01

266

Prognostic Value of Dobutamine–Atropine Stress Echocardiography Early After Acute Myocardial Infarction  

Microsoft Academic Search

Objectives. The aim of this multicenter, multinational, prospective, observational study was to assess the relative value of myocardial viability and induced ischemia early after uncomplicated myocardial infarction.Background. Dobutamine–atropine stress echocardiography allows evaluation of rest function (at baseline), myocardial viability (at low dose) and residual ischemia (peak dose, up to 40 ?g with atropine up to 1 mg) in one test.Methods.

Rosa Sicari; Eugenio Picano; Patrizia Landi; Alessandro Pingitore; Riccardo Bigi; Claudio Coletta; Joanna Heyman; Franco Casazza; Mario Previtali; Wilson Mathias; Claudio Dodi; Giovanni Minardi; Jorge Lowenstein; Xenya Garyfallidis; Lauro Cortigiani; Maria Aurora Morales; Mauro Raciti

1997-01-01

267

Assessment of atrial septal defects in adults comparing cardiovascular magnetic resonance with transoesophageal echocardiography  

Microsoft Academic Search

BACKGROUND: Many adult patients with secundum-type atrial septal defects (ASDs) are able to have these defects fixed percutaneously. Traditionally, this has involved an assessment of ASD size, geometry and atrial septal margins by transoesophageal echocardiography (TOE) prior to percutaneous closure. This is a semi-invasive technique, and all of the information obtained could potentially be obtained by non-invasive cardiovascular magnetic resonance

Karen SL Teo; Patrick J Disney; Benjamin K Dundon; Matthew I Worthley; Michael A Brown; Prashanthan Sanders; Stephen G Worthley

2010-01-01

268

Three-Dimensional Imaging in Aortic Disease by Lighthouse Transesophageal Echocardiography Using Intravascular Ultrasound Catheters  

Microsoft Academic Search

Two-dimensional (2D) transesophageal echocardiography (TEE) and 2D intravascular ultrasound (IVUS) imaging face their greatest limitation in visualizing aortic disease in patients. With the aid of three-dimensional (3D) image reconstruction, TEE and IVUS can potentially overcome this limitation but still provide only limited spatial appreciation in aortic disease because 3D imaging of the thoracic aorta requires a broader spatial visualization of

Thomas Buck; Günter Görge; Peter Hunold; Raimund Erbel

1998-01-01

269

Homemade Laser Show  

NSDL National Science Digital Library

With a laser pointer and some household items, learners can create their own laser light show. They can explore diffuse reflection, refraction and diffraction. The webpage includes a video which shows how to set up the activity and also includes scientific explanation. Because this activity involves lasers, it requires adult supervision.

Children's Museum of Houston

2011-01-01

270

A New Method for Pseudo-increasing Frame Rates of Echocardiography Images Using Manifold Learning  

PubMed Central

Increasing frame rate is a challenging issue for better interpretation of medical images and diagnosis based on tracking the small transient motions of myocardium and valves in real time visualization. In this paper, manifold learning algorithm is applied to extract the nonlinear embedded information about echocardiography images from the consecutive images in two dimensional manifold spaces. In this method, we presume that the dimensionality of echocardiography images obtained from a patient is artificially high and the images can be described as functions of only a few underlying parameters such as periodic motion due to heartbeat. By this approach, each image is projected as a point on the reconstructed manifold; hence, the relationship between images in the new domain can be obtained according to periodicity of the heart cycle. To have a better tracking of the echocardiography, images during the fast motions of heart we have rearranged the similar frames of consecutive heart cycles in a sequence. This provides a full view slow motion of heart movement through increasing the frame rate to three times the traditional ultrasound systems. PMID:22606665

Gifani, Parisa; Behnam, Hamid; Sani, Zahra Alizadeh

2011-01-01

271

Prognostic role of transthoracic echocardiography in patients affected by heart failure and reduced ejection fraction.  

PubMed

Heart failure with reduced ejection fraction is a common and malignant condition, which recognizes a lot of causes and that carries a poor long-term prognosis. All patients with reduced left ventricular ejection fraction, both asymptomatic and symptomatic, should be evaluated with transthoracic echocardiography as a depth analysis of first level, due to its characteristics of accuracy, availability, safety and low costs. In fact, echocardiography is an essential tool to establish not only the diagnosis, but also the aetiology and the understanding pathophysiology of heart failure. Moreover, by the new more sensitive and more specific echocardiographic technologies, such as tissue Doppler imaging or strain rate or speckle tracking or three-dimensional echocardiography, it is possible to identify other recognized high-risk parameters associated with adverse outcome, which are useful to guide therapy and follow-up management of heart failure patients. Therefore, this review would underline the prognostic role of some echocardiographic parameters in the evaluation and management of patients with heart failure and reduced ejection fraction. PMID:25355298

Prastaro, Maria; D'Amore, Carmen; Paolillo, Stefania; Losi, Mariangela; Marciano, Caterina; Perrino, Cinzia; Ruggiero, Donatella; Gargiulo, Paola; Savarese, Gianluigi; Trimarco, Bruno; Perrone Filardi, Pasquale

2015-05-01

272

Heart wall motion analysis by dynamic 3D strain rate imaging from tissue Doppler echocardiography  

NASA Astrophysics Data System (ADS)

The knowledge about the complex three-dimensional (3D) heart wall motion pattern, particular in the left ventricle, provides valuable information about potential malfunctions, e.g., myocardial ischemia. Nowadays, echocardiography (cardiac ultrasound) is the predominant technique for evaluation of cardiac function. Beside morphology, tissue velocities can be obtained by Doppler techniques (tissue Doppler imaging, TDI). Strain rate imaging (SRI) is a new technique to diagnose heart vitality. It provides information about the contraction ability of the myocardium. Two-dimensional color Doppler echocardiography is still the most important clinical method for estimation of morphology and function. Two-dimensional methods leads to a lack of information due to the three-dimensional overall nature of the heart movement. Due to this complex three-dimensional motion pattern of the heart, the knowledge about velocity and strain rate distribution over the whole ventricle can provide more valuable diagnostic information about motion disorders. For the assessment of intracardiac blood flow three-dimensional color Doppler has already shown its clinical utility. We have developed methods to produce strain rate images by means of 3D tissue Doppler echocardiography. The tissue Doppler and strain rate images can be visualized and quantified by different methods. The methods are integrated into an interactively usable software environment, making them available in clinical everyday life. Our software provides the physician with a valuable tool for diagnosis of heart wall motion.

Hastenteufel, Mark; Wolf, Ivo; de Simone, Raffaele; Mottl-Link, Sibylle; Meinzer, Hans-Peter

2002-04-01

273

The feasibility of dobutamine stress echocardiography in the emergency department with telemedicine interpretation.  

PubMed

Dobutamine stress echocardiography (DSE) was performed on 26 patients admitted for chest pain deemed at low risk for myocardial infarction. Pharmacologic stress in the emergency department on a 24-hour basis was administered by nurses and echocardiographic ultrasonographers with electrocardiograms and echocardiograms being interpreted through telemedicine relay by an off-site cardiologist. Target heart rate was achieved in 84% of patients with an average peak dobutamine dose of 48 microg/kg/min. Echocardiographic transmission to the cardiologist over standard telephone lines took 9 minutes per quad-screen cine-loop display. The entire protocol added 2.2 hours to the emergency room evaluation. The one patient out of 26 who had incipient myocardial infarction was diagnosed by resting echocardiography. The remaining 25 patients were found clinically to have no infarction or ischemia. Of these, 22 out of 25 had normal DSE in the emergency department; three had wall motion abnormalities on peak stress images. Another three patients had other cardiac diseases documented by echocardiography. Evaluation of chest pain on a 24-hour basis with DSE with telemedicine interpretation appears to be a rapid and safe means of screening patients at low risk in the emergency department. Further experience with this modality is needed before all patients should be enrolled or early discharge of patients on the basis of DSE can be advised. PMID:8849606

Trippi, J A; Kopp, G; Lee, K S; Morrison, H; Risk, G; Jones, J H; Cordell, W H; Chrapla, M; Nelson, D

1996-01-01

274

Implementation of Ultraportable Echocardiography in an Adolescent Sudden Cardiac Arrest Screening Program  

PubMed Central

BACKGROUND Over a 12-month period, adolescent heart-screening programs were performed for identifying at-risk adolescents for sudden cardiac death (SCD) in our community. Novel to our study, all adolescents received an abbreviated, ultraportable echocardiography (UPE). In this report, we describe the use of UPE in this screening program. METHODS AND RESULTS Four hundred thirty-two adolescents underwent cardiac screening with medical history questionnaire, physical examination, 12-lead electrocardiogram (ECG), and an abbreviated transthoracic echocardiographic examination. There were 11 abnormalities identified with uncertain/varying clinical risk significance. In this population, 75 adolescents had a murmur or high ECG voltage, of which only three had subsequent structural abnormalities on echocardiography that may pose risk. Conversely, UPE discovered four adolescents who had a cardiovascular structural abnormality that was not signaled by the 12-lead ECG, medical history questionnaire, and/or physical examination. CONCLUSIONS The utilization of ultraportable, handheld echocardiography is feasible in large-scale adolescent cardiovascular screening programs. UPE appears to be useful for finding additional structural abnormalities and for risk-stratifying abnormalities of uncertain potential of adolescents’ sudden death. PMID:25249762

Vanhecke, Thomas E; Weber, James E; Ebinger, Matthew; Bonzheim, Kimberly; Tilli, Frank; Rao, Sunilkumar; Osman, Abdulfatah; Silver, Marc; Fliegner, Karsten; Almany, Steve; Haines, David

2014-01-01

275

Is tissue Doppler echocardiography the Holy Grail for the intensivist?  

PubMed Central

Assessment of left ventricular diastolic function in the critically ill patient remains a difficult issue in clinical practice. Combined use of routine transmitral and pulmonary venous Doppler patterns in conjunction with tissue Doppler imaging have been claimed to allow bedside diagnosis of diastolic dysfunction. Although in the previous issue of Critical Care it was clearly demonstrated there might be a difference in load dependency of the early myocardial tissue Doppler velocity between lateral and septal placed sample volume, there remain still several unanswered questions, particularly with respect to the preload dependency of these indices. PMID:17567926

Poelaert, Jan; Roosens, Carl

2007-01-01

276

Severe Storms  

NSDL National Science Digital Library

Part of the University of Illinois Weather World 2010 project, this guide uses multimedia technology and the dynamic capabilities of the web to incorporate text, colorful diagrams, animations, computer simulations, audio, and video to introduce topics and concepts in the atmospheric sciences. This module is a combination of two elements. The first is the National Oceanic and Atmospheric Administration (NOAA) Severe Storms Spotters Guide. The second is a section discussing the efforts and results of modeling severe storms. The Spotters Guide contains supplemental instructional resources and a program designed to familiarize meteorologists and advanced severe storm spotters with the building blocks of convective storm structure. The focus of the training series is the development of a thunderstorm spectrum and a discussion of the physical characteristics and severe weather potential of the various storm types in the spectrum.

2010-01-01

277

Producing Turkeys for Show  

E-print Network

. Use top-quality feeds. 4. Follow recommended management practices during the entire brooding and growing period. 5. Cull birds closely and select the show entry properly. Purchasing Poults Most youth livestock shows have rules and regulations governing... with an approved worm- ing compound. a73 Check turkeys monthly for parasites. Pay particular attention to skin around the vent area. Control external para- sites (lice, mites, etc.) with applications of Sevin ? dust. a73 Fire ants can cause skin blisters and must...

Thornberry, Fredrick D.

2005-12-14

278

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

PubMed Central

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 Preventive Health Care. RECOMMENDATIONS: There is fair evidence to recommend echocardiography in patients with stroke and clinical evidence of cardiac disease by history, physical examination, electrocardiography or chest radiography (grade B recommendation). There is insufficient evidence to recommend for or against TEE in patients with normal results of TTE (grade C recommendation). There is insufficient evidence to recommend for or against routine echocardiography in patients (including young patients) without clinical cardiac disease (grade C recommendation). Routine echocardiography is not recommended for patients with clinical cardiac disease who have independent indications for or contraindications to anticoagulant therapy (grade D recommendation). There is fair evidence to recommend anticoagulant therapy in patients with stroke and intracardiac thrombus (grade B recommendation). There is insufficient (no) evidence to recommend for or against any specific therapy for patent foramen ovale (grade C recommendation). VALIDATION: The findings of this analysis were reviewed through an iterative process by the members of the Canadian Task Force on Preventive Health Care. PMID:10551199

Kapral, M K; Silver, F L

1999-01-01

279

The need for annual echocardiography to detect cabergoline-associated valvulopathy in patients with prolactinoma: a systematic review and additional clinical data.  

PubMed

Present recommendations by the US Food and Drug Administration advise that patients with prolactinoma treated with cabergoline should have an annual echocardiogram to screen for valvular heart disease. Here, we present new clinical data and a systematic review of the scientific literature showing that the prevalence of cabergoline-associated valvulopathy is very low. We prospectively assessed 40 patients with prolactinoma taking cabergoline. Cardiovascular examination before echocardiography detected an audible systolic murmur in 10% of cases (all were functional murmurs), and no clinically significant valvular lesion was shown on echocardiogram in the 90% of patients without a murmur. Our systematic review identified 21 studies that assessed the presence of valvular abnormalities in patients with prolactinoma treated with cabergoline. Including our new clinical data, only two (0·11%) of 1811 patients were confirmed to have cabergoline-associated valvulopathy (three [0·17%] if possible cases were included). The probability of clinically significant valvular heart disease is low in the absence of a murmur. On the basis of these findings, we challenge the present recommendations to do routine echocardiography in all patients taking cabergoline for prolactinoma every 12 months. We propose that such patients should be screened by a clinical cardiovascular examination and that echocardiogram should be reserved for those patients with an audible murmur, those treated for more than 5 years at a dose of more than 3 mg per week, or those who maintain cabergoline treatment after the age of 50 years. PMID:25466526

Caputo, Carmela; Prior, David; Inder, Warrick J

2014-11-14

280

Showing What They Know  

ERIC Educational Resources Information Center

Having students show their skills in three dimensions, known as performance-based assessment, dates back at least to Socrates. Individual schools such as Barrington High School--located just outside of Providence--have been requiring students to actively demonstrate their knowledge for years. The Rhode Island's high school graduating class became…

Cech, Scott J.

2008-01-01

281

Demonstration Road Show  

NSDL National Science Digital Library

The Idaho State University Department of Physics conducts science demonstration shows at S. E. Idaho schools. Four different presentations are currently available; "Forces and Motion", "States of Matter", "Electricity and Magnetism", and "Sound and Waves". Information provided includes descriptions of the material and links to other resources.

Shropshire, Steven

2009-04-06

282

Hide / Show Animal Ethics  

E-print Network

the Ethics Secretariat for information on Animal Ethics Courses available at UNSW. All new added personnelHide / Show Animal Ethics Modification for Approved Application New personnel or updated role since last approval New person nominated since last approval You are here: Animal Ethics Application

New South Wales, University of

283

Stage a Water Show  

ERIC Educational Resources Information Center

In the author's book titled "The Incredible Water Show," the characters from "Miss Alaineus: A Vocabulary Disaster" used an ocean of information to stage an inventive performance about the water cycle. In this article, the author relates how she turned the story into hands-on science teaching for real-life fifth-grade students. The author also…

Frasier, Debra

2008-01-01

284

What Do Maps Show?  

ERIC Educational Resources Information Center

This curriculum packet, appropriate for grades 4-8, features a teaching poster which shows different types of maps (different views of Salt Lake City, Utah), as well as three reproducible maps and reproducible activity sheets which complement the maps. The poster provides teacher background, including step-by-step lesson plans for four geography…

Geological Survey (Dept. of Interior), Reston, VA.

285

The Ozone Show.  

ERIC Educational Resources Information Center

Uses a talk show activity for a final assessment tool for students to debate about the ozone hole. Students are assessed on five areas: (1) cooperative learning; (2) the written component; (3) content; (4) self-evaluation; and (5) peer evaluation. (SAH)

Mathieu, Aaron

2000-01-01

286

Show Me the Way  

ERIC Educational Resources Information Center

Because today's students have grown up steeped in video games and the Internet, most of them expect feedback, and usually gratification, very soon after they expend effort on a task. Teachers can get quick feedback to students by showing them videotapes of their learning performances. The author, a 3rd grade teacher describes how the seemingly…

Dicks, Matthew J.

2005-01-01

287

Influence of Positive End-Expiratory Pressure on Myocardial Strain Assessed by Speckle Tracking Echocardiography in Mechanically Ventilated Patients  

PubMed Central

Purpose. The effects of mechanical ventilation (MV) on speckle tracking echocardiography- (STE-)derived variables are not elucidated. The aim of the study was to evaluate the effects of positive end-expiratory pressure (PEEP) ventilation on 4-chamber longitudinal strain (LS) analysis by STE. Methods. We studied 20 patients admitted to a mixed intensive care unit who required intubation for MV and PEEP titration due to hypoxia. STE was performed at three times: (T1) PEEP = 5?cmH2O; (T2) PEEP = 10?cmH2O; and (T3) PEEP = 15?cmH2O. STE analysis was performed offline using a dedicated software (XStrain MyLab 70 Xvision, Esaote). Results. Left peak atrial-longitudinal strain (LS) was significantly reduced from T1 to T2 and from T2 to T3 (P < 0.05). Right peak atrial-LS and right ventricular-LS showed a significant reduction only at T3 (P < 0.05). Left ventricular-LS did not change significantly during titration of PEEP. Cardiac chambers' volumes showed a significant reduction at higher levels of PEEP (P < 0.05). Conclusions. We demonstrated for the first time that incremental PEEP affects myocardial strain values obtained with STE in intubated critically ill patients. Whenever performing STE in mechanically ventilated patients, care must be taken when PEEP is higher than 10?cmH2O to avoid misinterpreting data and making erroneous decisions. PMID:24066303

Faltoni, Agnese; Cameli, Matteo; Muzzi, Luigi; Lisi, Matteo; Cubattoli, Lucia; Cecchini, Sofia; Mondillo, Sergio; Biagioli, Bonizella

2013-01-01

288

Show-Me Magazine  

NSDL National Science Digital Library

Come along as the folks at the University of Missouri show you the history of their college days through the Show Me magazine. It's a wonderful collection of college humor published from 1946 to 1963. First-time visitors would do well to read about the magazine's colorful past, courtesy of Jerry Smith. A good place to start is the November 1920 issue (easily found when you browse by date), which contains a number of parody advertisements along with some doggerels poking good natured fun at the football team and an assortment of deans. Also, it's worth noting that visitors can scroll through issues and save them to an online "bookbag" for later use.

2008-01-01

289

Keeping Show Pigs Healthy  

E-print Network

within a well-managed farm ? Vaccinating to prevent serious diseases ? Deworming the pigs routinely ? Having sick pigs promptly diagnosed and treated ? Using prescribed drugs properly Starting with healthy PigS To prevent disease outbreaks in show... of disease problems. Antibiotics are totally ineffective in preventing common viral diseases such as transmissible gas- troenteritis and swine influenza. Also, vaccines are not available for all swine diseases and must be giv- en long before the pigs...

Lawhorn, D. Bruce

2006-10-13

290

Viewing television talk shows  

Microsoft Academic Search

We examined how motivation, audience activity, and attitudes influenced the likelihood of watching societal?issue and relational topics on television talk programs. Path analysis supported differences in ritualized and instrumental motives for watching talk shows. Information and exciting?entertainment motivation predicted greater’ realism of, affinity with, involvement with, and intent to watch talk television. Pass?time motivation predicted reduced affinity with and intent

Alan M. Rubin; Mary M. Step

1997-01-01

291

Mars Slide Show  

NASA Technical Reports Server (NTRS)

15 September 2006 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows a landslide that occurred off of a steep slope in Tithonium Chasma, part of the vast Valles Marineris trough system.

Location near: 4.8oS, 84.6oW Image width: 3 km (1.9 mi) Illumination from: upper left Season: Southern Autumn

2006-01-01

292

Left ventricular mass and hypertrophy by echocardiography and cardiac magnetic resonance: The Multi-Ethnic Study of Atherosclerosis  

PubMed Central

BACKGROUND Left ventricular mass (LVM) and hypertrophy (LVH) are important parameters, but their use is surrounded by controversies. We compare LVM by echocardiography and cardiac magnetic resonance (CMR), investigating reproducibility aspects and the effect of echocardiography image quality. We also compare indexing methods within and between imaging modalities for classification of LVH and cardiovascular risk. METHODS MESA enrolled 880 participants in Baltimore City; 146 had echocardiograms and CMR on the same day. LVM was then assessed using standard techniques. Echocardiography image quality was rated (good/limited) according to the parasternal view. LVH was defined after indexing LVM to body surface area, height1.7, height2.7, or by the predicted LVM from a reference group. Participants were classified for cardiovascular risk according to Framingham score. Pearson’s correlation, Bland-Altman plots, percent agreement, and kappa coefficient assessed agreement within and between modalities. RESULTS LVM by echocardiography (140 ± 40 g) and by CMR were correlated (r = 0.8, p < 0.001) regardless of the echocardiography image quality. The reproducibility profile had strong correlations and agreement for both modalities. Image quality groups had similar characteristics; those with good images compared to CMR slightly superiorly. The prevalence of LVH tended to be higher with higher cardiovascular risk. The agreement for LVH between imaging modalities ranged from 77% to 98% and the kappa coefficient from 0.10 to 0.76. CONCLUSIONS Echocardiography has a reliable performance for LVM assessment and classification of LVH, with limited influence of image quality. Echocardiography and CMR differ in the assessment of LVH, and additional differences rise from the indexing methods. PMID:23930739

Armstrong, Anderson C.; Gjesdal, Ola; Almeida, André; Nacif, Marcelo; Wu, Colin; Bluemke, David A.; Brumback, Lyndia; Lima, João A. C.

2013-01-01

293

The use of echocardiography in acute cardiovascular care: Recommendations of the European Association of Cardiovascular Imaging and the Acute Cardiovascular Care Association.  

PubMed

Echocardiography is one of the most powerful diagnostic and monitoring tools available to the modern emergency/critical care practitioner. Currently, there is a lack of specific European Association of Cardiovascular Imaging/Acute Cardiovascular Care Association recommendations for the use of echocardiography in acute cardiovascular care. In this document, we describe the practical applications of echocardiography in patients with acute cardiac conditions, in particular with acute chest pain, acute heart failure, suspected cardiac tamponade, complications of myocardial infarction, acute valvular heart disease including endocarditis, acute disease of the ascending aorta and post-intervention complications. Specific issues regarding echocardiography in other acute cardiovascular care scenarios are also described. PMID:25378666

Lancellotti, Patrizio; Price, Susanna; Edvardsen, Thor; Cosyns, Bernard; Neskovic, Aleksandar N; Dulgheru, Raluca; Flachskampf, Frank A; Hassager, Christian; Pasquet, Agnes; Gargani, Luna; Galderisi, Maurizio; Cardim, Nuno; Haugaa, Kristina H; Ancion, Arnaud; Zamorano, Jose-Luis; Donal, Erwan; Bueno, Héctor; Habib, Gilbert

2014-11-01

294

The use of echocardiography in acute cardiovascular care: recommendations of the European Association of Cardiovascular Imaging and the Acute Cardiovascular Care Association.  

PubMed

Echocardiography is one of the most powerful diagnostic and monitoring tools available to the modern emergency/ critical care practitioner. Currently, there is a lack of specific European Association of Cardiovascular Imaging/Acute Cardiovascular Care Association recommendations for the use of echocardiography in acute cardiovascular care. In this document, we describe the practical applications of echocardiography in patients with acute cardiac conditions, in particular with acute chest pain, acute heart failure, suspected cardiac tamponade, complications of myocardial infarction, acute valvular heart disease including endocarditis, acute disease of the ascending aorta and post-intervention complications. Specific issues regarding echocardiography in other acute cardiovascular care scenarios are also described. PMID:25378470

Lancellotti, Patrizio; Price, Susanna; Edvardsen, Thor; Cosyns, Bernard; Neskovic, Aleksandar N; Dulgheru, Raluca; Flachskampf, Frank A; Hassager, Christian; Pasquet, Agnes; Gargani, Luna; Galderisi, Maurizio; Cardim, Nuno; Haugaa, Kristina H; Ancion, Arnaud; Zamorano, Jose-Luis; Donal, Erwan; Bueno, Héctor; Habib, Gilbert

2015-02-01

295

The use of echocardiography in acute cardiovascular care: Recommendations of the European Association of Cardiovascular Imaging and the Acute Cardiovascular Care Association.  

PubMed

Echocardiography is one of the most powerful diagnostic and monitoring tools available to the modern emergency/critical care practitioner. Currently, there is a lack of specific European Association of Cardiovascular Imaging/Acute Cardiovascular Care Association recommendations for the use of echocardiography in acute cardiovascular care. In this document, we describe the practical applications of echocardiography in patients with acute cardiac conditions, in particular with acute chest pain, acute heart failure, suspected cardiac tamponade, complications of myocardial infarction, acute valvular heart disease including endocarditis, acute disease of the ascending aorta and post-intervention complications. Specific issues regarding echocardiography in other acute cardiac care scenarios are also described. PMID:25635106

Lancellotti, Patrizio; Price, Susanna; Edvardsen, Thor; Cosyns, Bernard; Neskovic, Aleksandar N; Dulgheru, Raluca; Flachskampf, Frank A; Hassager, Christian; Pasquet, Agnes; Gargani, Luna; Galderisi, Maurizio; Cardim, Nuno; Haugaa, Kristina H; Ancion, Arnaud; Zamorano, Jose-Luis; Donal, Erwan; Bueno, Héctor; Habib, Gilbert

2015-02-01

296

American History Picture Show  

NSDL National Science Digital Library

In class we read Katie's Picture Show, a book about a girl who discovers art first-hand one day at an art museum in London. She realizes she can climb into the paintings, explore her surroundings, and even solve problems for the subjects of the paintings. As part of our unit on American history, we are going to use art to further learn about some of the important events we have been discussing. Each of these works of art depicts an important event in American History. When you click on a picture, you will be able to see the name of the event as well as the artist who created it. You will be using all three pictures for this assignment.Use the websites ...

Ms. Bennion

2009-11-23

297

Solar Light Show  

NSDL National Science Digital Library

Over the last few days, the Earth has been buffeted by a geomagnetic storm caused by a major solar flare. In addition to disruptions in radio, telecommunications, and electric service, the flare may also produce a dramatic light show as it peaks tonight. Weather permitting, the aurora borealis, or northern lights, may be visible as far south as Washington, D.C. The best viewing time will be local midnight. The sun is currently at the peak of its eleven-year solar cycle, spawning flares and "coronal mass ejections" (CME), violent outbursts of gas from the sun's corona that can carry up to 10 billion tons of electrified gas traveling at speeds as high as 2000 km/s. Geomagnetic storms result when solar winds compress the magnetosphere, sometimes interfering with electric power transmission and satellites, but also creating beautiful aurorae, as many stargazers hope will occur tonight.

de Nie, Michael Willem.

298

Show-Me Center  

NSDL National Science Digital Library

The Show-Me Center, located at the University of Missouri, is a math education project of the National Science Foundation. The center's Web site "provides information and resources needed to support selection and implementation of standards-based middle grades mathematic curricula." There are some sample lesson plans offered, but most of the material is solely for use by teachers. Five different middle grade math curriculums were started in 1992, and now, the implementation and results of each curriculum are presented on this site. Teachers can examine each one, view video clips, and read case studies and other reports to choose which parts of the curriculums would fit best into their own classes.

299

A coupled deformable model for tracking myocardial borders from real-time echocardiography using an incompressibility constraint  

PubMed Central

Real-time three-dimensional (RT3D) echocardiography is a new image acquisition technique that allows instantaneous acquisition of volumetric images for quantitative assessment of cardiac morphology and function. To quantify many important diagnostic parameters, such as ventricular volume, ejection fraction, and cardiac output, an automatic algorithm to delineate the left ventricle (LV) from RT3D echocardiographic images is essential. While a number of efforts have been made towards segmentation of the LV endocardial (ENDO) boundaries, the segmentation of epicardial (EPI) boundaries remains problematic. In this paper, we present a coupled deformable model that addresses this problem. The idea behind our method is that the volume of the myocardium is close to being constant during a cardiac cycle and our model uses this coupling as an important constraint. We employ two surfaces, each driven by the image-derived information that takes into account ultrasound physics by modeling the speckle statistics using the Nakagami distribution while maintaining the coupling. By simultaneously evolving two surfaces, the final segmentation of the myocardium is thus achieved. Results from 80 sets of synthetic data and 286 sets of real canine data were evaluated against the ground truth and against outlines from three independent observers, respectively. We show that results obtained with our incompressibility constraint were more accurate than those obtained without constraint or with a wall thickness constraint, and were comparable to those from manual segmentation. PMID:20350833

Zhu, Yun; Papademetris, Xenophon; Sinusas, Albert J.; Duncan, James S.

2014-01-01

300

Early detection of anthracycline cardiotoxicity in children with acute leukemia using exercise-based echocardiography and Doppler echocardiography.  

PubMed

We performed both supine bicycle ergometer (BEx) and hand-grip (HGx) exercise tests to evaluate cardiac function in 13 asymptomatic children with leukemia who had completed a general treatment protocol. We calculated fractional shortening (FS), end-systolic stress-volume index (ESS/ESVI), left ventricular diastolic filing velocity ratio (A/E) and normalized peak rate of diastolic increase in left ventricular internal dimension (dLVDt/dt/LVDt). Before the exercise, we found that dLVDt/dt/LVDt was decreased in the high-dose anthracycline group (anthracycline cumulative dose of 480-570 mg/m2), even though other cardiac function parameters were not different from those in the control. In BEx, the percent change in ESS/ESVI decreased in an anthracycline cumulative dose-dependent fashion. In HGx, ESS/ESVI showed a decreased response only in the high-dose anthracycline group. Therefore, we conclude that: 1) the diastolic function parameter dLVDt/dt/LVDt might show abnormalities prior to other systolic function parameters, 2) the percent change in ESS/ESVI in BEx is the most sensitive parameter studied, and could detect cardiac function abnormalities even in the small-dose anthracycline group (anthracycline cumulative dose of 175 mg/m2), and 3) BEx is more suitable for the early detection of anthracycline cardiotoxicity than HGx. PMID:7967004

Fukazawa, R; Ogawa, S; Hirayama, T

1994-08-01

301

The utility of intra-operative three-dimensional transoesophageal echocardiography for dynamic measurement of stroke volume.  

PubMed

Measurement of left ventricular stroke volume and cardiac output is very important for managing haemodynamically unstable or critically ill patients. The aims of this study were to compare stroke volume measured by three-dimensional transoesophageal echocardiography with stroke volume measured using a pulmonary artery catheter, and to examine the ability of three-dimensional transoesophageal echocardiography to track stroke volume changes induced by haemodynamic interventions. This study included 40 cardiac surgery patients. Haemodynamic variables were measured before and 2 min after haemodynamic interventions, which consisted of phenylephrine 100 ?g or ephedrine 5 mg. We used Bland-Altman analysis to assess the agreement between the stroke volume measured by three-dimensional transoesophageal echocardiography and by the pulmonary artery catheter. Polar-plot and 4-quadrant plot analyses were used to assess the trending ability of three-dimensional transoesophageal echocardiography compared with the pulmonary artery catheter. Bias and percentage error were -1.2 ml and 20%, respectively. The concordance rate in the 4-quadrant analysis after phenylephrine and ephedrine administration was 75% and 84%, respectively. In the polar-plot analysis, the angular concordance rate was 66% and 73% after phenylephrine and ephedrine administration, respectively. Three-dimensional transoesophageal echocardiography was clinically acceptable for measuring stroke volume; however, it was not sufficiently reliable for tracking stroke volume changes after haemodynamic interventions. PMID:25265890

Suehiro, K; Tanaka, K; Yamada, T; Matsuura, T; Funao, T; Mori, T; Nishikawa, K

2015-02-01

302

(123)I-BMIPP and (99m)Tc-TF discordance on myocardial scintigraphy and it's correlation with functional recovery following acute myocardial infarction: role of conventional echocardiography.  

PubMed

(123)I-beta-methyl-iodophenyl pentadecanoic acid (BMIPP) and (99m)Tc-Tetrofosmin (TF) mismatch designated as stunned myocardium having both systolic and diastolic components. The degree of mismatch might reflect subsequent functional improvement, and this study was designed to unravel the impact of mismatched defect score (MMDS) on recovery of both systolic and diastolic function following acute myocardial infarction (AMI). Forty patients with recent AMI were recruited, and all of them underwent emergency percutaneous coronary intervention. Echocardiography and BMIPP and TF cardiac scintigraphy were performed on 7 +/- 3 days of admission. Follow up echocardiography was performed after 3 months. MMDS were compared with the systolic [ejection fraction (EF) and wall motion score index (WMSI)] and diastolic [peak velocity of early diastolic filling of mitral inflow/peak early diastolic velocity of the mitral annulus(E/E') and left atrial volume index(LAVI)] parameters. BMIPP defect score was significantly higher than the TF defect score and there was a strong positive correlation between them (r = 0.90, P < 0.00001). Thirty-two (80%) patients showed mismatched defect and rest 8(20%) showed matched defect. Of 32 patients 24(75%), 22(69%), 19(59%), and 20(62.5%) showed improved EF, WMSI, E/E' and LAVI respectively. Conversely out of 8 only 2(25%), 1(12.5%), and 2(25%) patients showed improvement of EF, WMSI and LAVI, respectively. E/E' was not improved in patients with matched defect. MMDS were significantly correlated with the improvement of EF (r = -0.46, P = 0.002), WMSI (r = 0.41, P = 0.007), E/E' (r = 0.56, P < 0.0002), and LAVI (r = 0.44, P = 0.004). Mismatched defect score could predict the approximate amount of viable dysfunctional myocardium, and the degree of mismatch showed a significant correlation with the improvement of both systolic and diastolic function. PMID:19768573

Biswas, Shankar K; Sarai, Masayoshi; Toyama, Hiroshi; Yamada, Akira; Motoyama, Sadako; Harigaya, Hiroto; Hara, Tomonori; Iwase, Masatsugu; Hishida, Hitoshi; Ozaki, Yukio

2009-12-01

303

Public medical shows.  

PubMed

In the second half of the 19th century, Jean-Martin Charcot (1825-1893) became famous for the quality of his teaching and his innovative neurological discoveries, bringing many French and foreign students to Paris. A hunger for recognition, together with progressive and anticlerical ideals, led Charcot to invite writers, journalists, and politicians to his lessons, during which he presented the results of his work on hysteria. These events became public performances, for which physicians and patients were transformed into actors. Major newspapers ran accounts of these consultations, more like theatrical shows in some respects. The resultant enthusiasm prompted other physicians in Paris and throughout France to try and imitate them. We will compare the form and substance of Charcot's lessons with those given by Jules-Bernard Luys (1828-1897), Victor Dumontpallier (1826-1899), Ambroise-Auguste Liébault (1823-1904), Hippolyte Bernheim (1840-1919), Joseph Grasset (1849-1918), and Albert Pitres (1848-1928). We will also note their impact on contemporary cinema and theatre. PMID:25273491

Walusinski, Olivier

2014-01-01

304

Limited intervention improves technical skill in focus assessed transthoracic echocardiography among novice examiners  

PubMed Central

Background Previous studies addressing teaching and learning in point-of-care ultrasound have primarily focussed on image interpretation and not on the technical quality of the images. We hypothesized that a limited intervention of 10 supervised examinations would improve the technical skills in Focus Assessed Transthoracic Echocardiography (FATE) and that physicians with no experience in FATE would quickly adopt technical skills allowing for image quality suitable for interpretation. Methods Twenty-one physicians with no previous training in FATE or echocardiography (Novices) participated in the study and a reference group of three examiners with more than 10?years of experience in echocardiography (Experts) was included. Novices received an initial theoretical and practical introduction (2 hours), after which baseline examinations were performed on two healthy volunteers. Subsequently all physicians were scheduled to a separate intervention day comprising ten supervised FATE examinations. For effect measurement a second examination (evaluation) of the same two healthy volunteers from the baseline examination was performed. Results At baseline 86% of images obtained by novices were suitable for interpretation, on evaluation this was 93% (p?=?0.005). 100% of images obtained by experts were suitable for interpretation. Mean global image rating on baseline examinations was 70.2 (CI 68.0-72.4) and mean global image rating after intervention was 75.0 (CI 72.9-77.0), p?=?0.0002. In comparison, mean global image rating in the expert group was 89.8 (CI 88.8-90.9). Conclusions Improvement of technical skills in FATE can be achieved with a limited intervention and upon completion of intervention 93% of images achieved are suitable for clinical interpretation. PMID:22863138

2012-01-01

305

Role of perioperative transesophageal echocardiography in the management of adolescent truncus arteriosus: Rare case report.  

PubMed

Truncus arteriosus (TA) is a rare congenital heart disease defined as a single arterial vessel arising from the heart that gives origin to the systemic, pulmonary and coronary circulations. The truncal valve in majority of the cases is tricuspid though quadricuspid and bicuspid valves have been reported. Patients with TA typically have a large nonrestrictive sub truncal ventricular septal defect. Survival of these infants beyond 1-year is uncommon. Here, we report a unique case of 12-year-old female patient with persistent TA who underwent surgical repair by using transesophageal echocardiography as a monitoring device during the perioperative management. PMID:25849699

Nagaraja, P S; Singh, Naveen G; Simha, Parimala Prasanna; Davan, K R; Manjunath, V; Jagadeesh, A M

2015-01-01

306

[Stress echocardiography: a sensitive method in diagnosis of coronary heart disease].  

PubMed

Prevalence of coronary artery disease requires sensitive diagnostic methods for screening and follow-up. The sensitivity of stress-ECG is low, 201-thallium scintigraphy is more sensitive but has the disadvantages of radiation and costs. Improved echocardiographic resolution with better identification of endocardial border as well as digital imaging technique have increased the interest in stress echocardiography as a diagnostic tool in coronary artery disease since a decade ago the clinical usefulness of stress echocardiography has been demonstrated. For stress echocardiography a semisupine bicycle position for continuous recording of echocardiographic images from the apical position in the two-chamber- and RAO-view was developed. Echocardiographic images were digitized with a frame rate of 30/s and stored on optical discs with a storage capacity of 1 Gbyte. Rest and exercise images were analysed simultaneously for newly-occurring wall motion abnormalities or deterioration of already present hypokinesia or extension of existing wall motion abnormalities. Segmental wall motion was scored according to the scheme in Figure 2. In addition end-diastolic, end-systolic volume, and ejection fraction were calculated. In a patient population of 150, 30 female and 120 male, age 56.6 +/- 8.3 years, we could confirm the results reported by other working groups and demonstrate a high sensitivity in the diagnosis of single vessel disease. Our technique with the patient cycling in semi-supine position allows continuous echocardiographic registration during exercise and offers adequate image quality. The mean workload at peak stress was 127 +/- 30 watts, the maximal heart rate 137 +/- 18 bpm. Digital cine-loop imaging allowed evaluation of the examinations in about 90% of the cases. The sensitivity in the whole study group was 87%, the specificity 80%. Under full antianginal medication, 43% of the patients developed angina pectoris during exercise and 58% had a positive stress-ECG. The sensitivity in single-vessel coronary artery disease was 93% for the left anterior descending, 80% for the left circumflex, and 83% for the right coronary artery. These results in single-vessel disease were superior compared to findings of other authors using different techniques of stress echocardiography. In addition to the qualitative analysis, quantitative measurement of end-systolic volume and ejection fraction seems to be important. We found a significantly more pronounced decrease of ejection fraction at peak exercise in patients with multivessel disease compared to those with single-vessel disease. In single-vessel disease ejection fraction was 61 +/- 12% at rest and 57 +/- 17% during exercise, this difference was not significant.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1757061

Mertes, H; Erbel, R; Nixdorff, U; Mohr-Kahaly, S; Wölfinger, D; Meyer, J

1991-10-01

307

Value of transesophageal echocardiography (TEE) guidance in minimally invasive mitral valve surgery  

PubMed Central

The role of intraoperative transesophageal echocardiography (TEE) has increased tremendously since its first use in 1979. Today intraoperative TEE is a class I indication for surgical mitral valve reconstruction for evaluation of mitral valve pathology, graduation of mitral regurgitation and detection of potential risk factors as well as post-repair assessment. Real-time three-dimensional TEE offers anatomical visualization of the mitral valve apparatus, fundamental for virtual surgical planning of proper annuloplasty ring size. As minimally invasive and even off-pump techniques for mitral valve repair become more popular, image guidance by intraoperative TEE will play an essential role. PMID:24349984

Sgouropoulou, Sophia

2013-01-01

308

Anatomy of the Mitral Valve Apparatus – Role of 2D and 3D Echocardiography  

PubMed Central

The mitral valve apparatus is a complex three–dimensional functional unit that is critical to unidirectional heart pump function. This review details the normal anatomy, histology and function of the main mitral valve apparatus components 1) mitral annulus, 2) mitral valve leaflets, 3) chordae tendineae and 4) papillary muscles. 2 and 3 dimensional Echocardiography is ideally suited to examine the mitral valve apparatus and has provided insights into the mechanism of mitral valve disease. An overview of standardized image acquisition and interpretation is provided. Understanding normal mitral valve apparatus function is essential to comprehend alterations in mitral valve disease and the rationale for repair strategies. PMID:23743068

Dal-Bianco, Jacob P.; Levine, Robert A.

2013-01-01

309

Falsely elevated valve gradients by echocardiography in the 3f aortic bioprosthesis.  

PubMed

The 3f Aortic Bioprosthesis (Medtronic, Inc, Minneapolis, MN) is a stentless aortic valve with a novel design that resembles a "tube within a tube." Although it has the potential for improved durability and hemodynamic performance, long-term data on this valve remain elusive. We present here 3 patients in whom postoperative echocardiography revealed significantly elevated transvalvular gradients of the 3f valve while transcatheter gradients proved to be negligible. By virtue of the unique design of the 3f bioprosthesis, great caution should be taken when interpreting echocardiographically derived gradients. PMID:23816086

Leung Wai Sang, Stephane; Samoukovic, Gordan; Buithieu, Jean; de Varennes, Benoit

2013-07-01

310

Severe Weather  

NSDL National Science Digital Library

Educating the public about safety issues related to severe weather is part of the National Oceanic and Atmospheric Administration's (NOAA) mission. The National Weather Service (NWS)--which is part of NOAA and its parent agency, the Department of Commerce--is charged with the critical responsibility of observing and reporting the weather and with issuing forecasts and warnings of weather and floods in the interest of national safety and economy. Through a massive network of weather-monitoring and reporting stations around the globe, including land, sea, air, and space-borne instruments, NWS scientists constantly assimilate all of the reliable weather data available. Much of this data are then used in numerical computer models of the atmosphere that help to accurately describe and interpret current conditions and produce the best possible forecasts of future weather.

Evan B. Forde

2004-04-01

311

Carcinoid heart disease and the utility of 3D trans-thoracic and trans-esophageal echocardiography: Two clinical cases  

PubMed Central

Carcinoid tumors are rare neuroendocrine malignancies. We present two cases of metastatic carcinoid tumors, complicated by carcinoid syndrome and by cardiac valve involvement. Carcinoid syndrome is characterized by secretory diarrhea, episodic flushing, and bronchospasm. Cardiac involvement occurs in up to 50% of patients with metastatic carcinoid tumors which commonly causes abnormalities of the right sided valves. Echocardiography is the best available and non invasive technique for diagnosis. Characteristic features of carcinoid heart disease are thickened, shortened, retracted, and fixed or partially fixed valve leaflets. Three-dimensional (3D) echocardiography provided an en face view of pulmonary and tricuspid valve, not obtainable by two-dimensional echocardiography, and improved delineation of the relationship between these structures and cardiac chambers. PMID:24578601

Fazlinezhad, Afsoon; Moravvej, Zahra; Azari, Ali; Bigdelu, Leila

2013-01-01

312

Carcinoid heart disease and the utility of 3D trans-thoracic and trans-esophageal echocardiography: Two clinical cases.  

PubMed

Carcinoid tumors are rare neuroendocrine malignancies. We present two cases of metastatic carcinoid tumors, complicated by carcinoid syndrome and by cardiac valve involvement. Carcinoid syndrome is characterized by secretory diarrhea, episodic flushing, and bronchospasm. Cardiac involvement occurs in up to 50% of patients with metastatic carcinoid tumors which commonly causes abnormalities of the right sided valves. Echocardiography is the best available and non invasive technique for diagnosis. Characteristic features of carcinoid heart disease are thickened, shortened, retracted, and fixed or partially fixed valve leaflets. Three-dimensional (3D) echocardiography provided an en face view of pulmonary and tricuspid valve, not obtainable by two-dimensional echocardiography, and improved delineation of the relationship between these structures and cardiac chambers. PMID:24578601

Fazlinezhad, Afsoon; Moravvej, Zahra; Azari, Ali; Bigdelu, Leila

2014-01-01

313

Atrial Septal Aneurysm and Patent Foramen Ovale as Risk Factors for Cryptogenic Stroke in Patients Less Than 55 Years of Age: A Study using Transesophageal Echocardiography  

NASA Technical Reports Server (NTRS)

Background and Purpose: An association between atrial septal aneurysm and embolic events has been suggested. Atrial septal aneurysm has been shown to be associated with patent foramen ovale and,.in some reports, with mitral valve prolapse. These two latter cardiac disorder; have been identified as potential risk factors for ischemic stroke. The aim of this prospective study was to assess the role of atrial septal aneurysm as an independent risk factor for stroke, especially for cryptogenic stroke. Methods: We studied the prevalence of atrial septal aneurysm, patent foramen ovale, and mitral valve prolapse in 100 consecutive patients <55 years of age with ischemic stroke who underwent extensive etiological investigations. We compared these results with those in a control group of 50 consecutive patients. The diagnosis of atrial septal aneurysm and patent foramen ovale relied on transesophageal echocardiography with a contrast study and that of mitral valve prolapse, on two-dimensional transthoracic echocardiography. Results: Stepwise logistic regression analysis showed that atrial septal aneurysm (odds ratio, 4.3; 95% confidence interval, 1.3 to 14.6; P=.01) and patent foramen ovale (odds ratio, 3.9; 95% confidence interval, 1.5 to 10; P=.003) but not mitral valve prolapse were significantly associated with the diagnosis of cryptogenic stroke. The stroke odds of a patient with both atrial septal aneurysm and patent foramen ovale were 33.3 times (95% confidence interval, 4.1 to 270) the stroke odds of a patient with neither of these cardiac disorders. For a patient with atrial septal aneurysm of >lo-mm excursion, the stroke odds were approximately 8 times the stroke odds of a patient with atrial septal aneurysm of <10 mm. Conclusions: This study shows that atrial septal aneurysm and patent foramen ovale are both significantly associated with cryptogenic stroke and that their association has a marked synergistic effect. Atrial septal aneurysms of >lo-mm excursion are associated with a higher risk of stroke. (Stroke. 1993;24:1865-1873.) KEY WORDS aneurysm echocardiography foramen ovale, patent mitral valve prolapse o young adults

Cabanes, L.; Mas, J. L.; Cohen, A.; Amarenco, P.; Cabanes, P. A.; Oubary, P.; Chedru, F.; Guerin, F.; Bousser, M. G.; deRecondo, J.

1993-01-01

314

Stress echocardiography  

MedlinePLUS

... Determine how well your heart is pumping Diagnose coronary artery disease See whether your heart is too large ... the diagnosis of left main and triple vessel coronary artery disease: a comparative meta-analysis. Heart . 2010;96(12): ...

315

Transthoracic Echocardiography in Children and Young Adults with Congenital Heart Disease  

PubMed Central

Transthoracic echocardiography (TTE) is the first-line tool for diagnosis and followup of pediatric and young adult patients with congenital heart disease (CHD). Appropriate use of TTE can reduce the need for more invasive modalities, such as cardiac catheterization and cardiac magnetic resonance imaging. New echocardiographic techniques have emerged more recently: tissue Doppler imaging, tissue tracking (strain and strain rate), vector velocity imaging (VVI), myocardial performance index, myocardial acceleration during isovolumic acceleration (IVA), the ratio of systolic to diastolic duration (S/D ratio), and two dimensional measurements of systolic right ventricular (RV) function (e.g., tricuspid annular plane systolic excursion, TAPSE). These may become valuable indicators of ventricular performance, compliance, and disease progression. In addition, three-dimensional (3D) echocardiography when performed for the assessment of valvular function, device position, and ventricular volumes is being integrated into routine clinical care. In this paper, the potential use and limitations of these new echocardiographic techniques in patients with CHD are discussed. A particular focus is on the echocardiographic assessment of right ventricular (RV) function in conditions associated with increased right ventricular volume (e.g., pulmonary regurgitation after tetralogy of Fallot repair) or pressure (e.g., pulmonary hypertension) in children and young adults. PMID:22778987

Koestenberger, Martin

2012-01-01

316

Non-Invasive Imaging for Congenital Heart Disease: Recent Innovations in Transthoracic Echocardiography  

PubMed Central

Transthoracic echocardiography (TTE) is an important tool for diagnosis and follow-up of patients with congenital heart disease (CHD). Appropriate use of TTE can reduce the need for more invasive and complex modalities, such as cardiac catheterization and cardiac magnetic resonance imaging. New echocardiographic techniques have emerged for the assessment of ventricular systolic and diastolic function: Tissue Doppler imaging, tissue tracking, strain and strain rate imaging, vector velocity imaging (VVI), myocardial performance index, myocardial acceleration during isovolumic contraction (IVA), the ratio of systolic to diastolic duration (S/D ratio), and other measurements of systolic right ventricular (RV) function like tricuspid annular plane systolic excursion (TAPSE). These modalities may become valuable indicators of ventricular performance, compliance and disease progression, with the caveat of preload-dependency of the variables measured. In addition, three-dimensional (3D) echocardiography for the assessment of cardiac anatomy, valvular function, device position, ventricular volumes and ejection fraction is integrated into routine clinical care. In this review, we discuss the potential use and limitations of these new echocardiographic techniques in patients with CHD. A particular focus is on the echocardiographic assessment of right ventricular (RV) function by means of tissue Doppler imaging, tissue tracking, and three-dimensional imaging, in conditions associated with increased right ventricular volume or pressure load. PMID:24163784

Koestenberger, Martin; Friedberg, Mark K.; Ravekes, William; Nestaas, Eirik; Hansmann, Georg

2013-01-01

317

Echocardiographic Evaluation of Cardiac Function in Ischemic Rats: Value of M-Mode Echocardiography  

PubMed Central

Background: Echocardiography is a well-established diagnostic tool for a safe, reproducible and accurate evaluation of cardiac anatomy, hemodynamics and function in clinical practice. Objectives: We sought to demonstrate the efficacy and feasibility of M-mode echocardiography to evaluate cardiac structure and function in normal and MI-induced adult rats. Materials and Methods: All animal procedures were approved by the ethics committee of Tehran University of Medical Sciences and the investigation conformed to the “Guide for the Care and Use of Laboratory Animals” published by the United States National Institutes of Health. Forty-eight male Wistar rats weighing 280-300 grams were obtained from a single breeding colony. The statistical analyses were performed using SPSS 20.0. Results: Echocardiographic measurements were possible in all rats before and after the operation. In our survey, we studied echocardiographic alterations in rats after MI induction. Changes can be seen in all echocardiographic mean values after myocardial infarction (MI), but significant decrease (P < 0.01) of Fractional shortening and Ejection Fraction as well as significant increase (P < 0.05) of end systolic diameter and systolic volume after left anterior descending coronary artery (LAD) ligation can be good signs of MI induction. Conclusions: In light of our results, it can be concluded that we succeeded in establishing a precise echocardiographic method to confidently assess the success of LAD ligation surgery in rats. It is feasible to thoroughly monitor the functional efficiency of regional therapeutic interventions such as intra-myocardial stem cell injection.

Darbandi Azar, Amir; Tavakoli, Fatemeh; Moladoust, Hassan; Zare, Asghar; Sadeghpour, Anita

2014-01-01

318

Assessment of diastolic function by tissue Doppler echocardiography: comparison with standard transmitral and pulmonary venous flow  

NASA Technical Reports Server (NTRS)

The objective of this study was to determine the utility of Doppler tissue echocardiography in the evaluation of diastolic filling and in discriminating between normal subjects and those with various stages of diastolic dysfunction. We measured myocardial velocities in 51 patients with various stages of diastolic dysfunction and in 27 normal volunteers. The discriminating power of each of the standard Doppler indexes of left ventricular filling, pulmonary venous flow, and myocardial velocities was determined with the use of Spearman rank correlation and analysis of variance F statistics. Early diastolic myocardial velocity (E(m)) was higher in normal subjects (16.0 +/- 3.8 cm/s) than in patients with either delayed relaxation (n = 15, 7.5 +/- 2.2 cm/s), pseudonormal filling (n = 26, 7.6 +/- 2.3 cm/s), or restrictive filling (n = 10, 7.4 +/- 2.4 cm/s, P <.0001). E(m ) was the best single discriminator between control subjects and patients with diastolic dysfunction (P =.7, F = 64.5). Myocardial velocities assessed by Doppler tissue echocardiography are useful in differentiating patients with normal from those with abnormal diastolic function. Myocardial velocity remains reduced even in those stages of diastolic dysfunction characterized by increased preload compensation.

Farias, C. A.; Rodriguez, L.; Garcia, M. J.; Sun, J. P.; Klein, A. L.; Thomas, J. D.

1999-01-01

319

Validation of a mouse conductance system to determine LV volume: comparison to echocardiography and crystals.  

PubMed

The application of left ventricular pressure-volume analysis to transgenic mice to characterize the cardiac phenotype has been problematic due to the small size of the mouse heart and the rapid heartbeat. Conductance technology has been miniaturized for the mouse and can solve this problem. However, there has been no validation of this technique. Accordingly, we performed echocardiography followed by simultaneous ultrasonic crystals, flow probe, and conductance studies in 18 CD-1 mice. Raw conductance volumes were corrected for an inhomogenous electrical field (alpha) and parallel conductance (G(pi)) yielding a stroke volume of 14.1 +/- 3.7 microliter/beat, end-diastolic volume of 20.8 +/- 6.5 microliter, and end-systolic volume of 9.0 +/- 5.8 microliter. The mean conductance volumes were no different from those derived by flow probe and echocardiography but did differ from ultrasonic crystals. G(pi) was determined to be 14.9 +/- 8.7 microliter. However, hypertonic saline altered dimension and pressure in the mouse left ventricle. Although G(pi) can be determined by the hypertonic saline method, saline altered hemodynamics, questioning its validity in the mouse. Although mean measures of absolute volume may be similar among different techniques, individual values did not correlate. PMID:11009457

Feldman, M D; Erikson, J M; Mao, Y; Korcarz, C E; Lang, R M; Freeman, G L

2000-10-01

320

Real-Time, Interactive Echocardiography Over High-Speed Networks: Feasibility and Functional Requirements  

NASA Technical Reports Server (NTRS)

Real-time, Interactive Echocardiography Over High Speed Networks: Feasibility and Functional Requirements is an experiment in advanced telemedicine being conducted jointly by the NASA Lewis Research Center, the NASA Ames Research Center, and the Cleveland Clinic Foundation. In this project, a patient undergoes an echocardiographic examination in Cleveland while being diagnosed remotely by a cardiologist in California viewing a real-time display of echocardiographic video images transmitted over the broadband NASA Research and Education Network (NREN). The remote cardiologist interactively guides the sonographer administering the procedure through a two-way voice link between the two sites. Echocardiography is a noninvasive medical technique that applies ultrasound imaging to the heart, providing a "motion picture" of the heart in action. Normally, echocardiographic examinations are performed by a sonographer and cardiologist who are located in the same medical facility as the patient. The goal of telemedicine is to allow medical specialists to examine patients located elsewhere, typically in remote or medically underserved geographic areas. For example, a small, rural clinic might have access to an echocardiograph machine but not a cardiologist. By connecting this clinic to a major metropolitan medical facility through a communications network, a minimally trained technician would be able to carry out the procedure under the supervision and guidance of a qualified cardiologist.

Bobinsky, Eric A.

1998-01-01

321

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

PubMed Central

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

Badano, Luigi P.

2014-01-01

322

Automatic classification of intracardiac tumor and thrombi in echocardiography based on sparse representation.  

PubMed

Identification of intracardiac masses in echocardiograms is one important task in cardiac disease diagnosis. To improve diagnosis accuracy, a novel fully automatic classification method based on the sparse representation is proposed to distinguish intracardiac tumor and thrombi in echocardiography. First, a region of interest is cropped to define the mass area. Then, a unique globally denoising method is employed to remove the speckle and preserve the anatomical structure. Subsequently, the contour of the mass and its connected atrial wall are described by the K-singular value decomposition and a modified active contour model. Finally, the motion, the boundary as well as the texture features are processed by a sparse representation classifier to distinguish two masses. Ninety-seven clinical echocardiogram sequences are collected to assess the effectiveness. Compared with other state-of-the-art classifiers, our proposed method demonstrates the best performance by achieving an accuracy of 96.91%, a sensitivity of 100%, and a specificity of 93.02%. It explicates that our method is capable of classifying intracardiac tumors and thrombi in echocardiography, potentially to assist the cardiologists in the clinical practice. PMID:24691169

Guo, Yi; Wang, Yuanyuan; Kong, Dehong; Shu, Xianhong

2015-03-01

323

Complications of 2-D Echocardiography Guided Transfemoral Right Ventricular Endomyocardial Biopsy  

PubMed Central

Endomyocardial biopsy (EMBx) is a useful tool for diagnosing various cardiac pathologies. However, the routine use of EMBx has not gained widespread acceptance due to the possible complications related to the EMBx. Thus, not much information is available on the complications related to the EMBx. We prospectively evaluated 90 consecutive patients who underwent 2-D echocardiography guided transfemoral right ventricular EMBx at Kyungpook National University Hospital between March 2002 and November 2005 to determine the incidence, nature and subsequent management of complications related to EMBx. The clinical diagnoses before the EMBx were arrhythmogenic right ventricular dysplasia in 54, dilated cardiomyopathy in 19, Brugada syndrome in 9, myocarditis in 6 and miscellaneous in 2 patients. The overall major complication rate was 5.6% and no procedure-related mortality occurred. Myocardial perforation (n=3), which was the most frequent complication, did not progress to cardiac tamponade requiring pericardiocentesis in any patient. Hemodynamically unstable ventricular tachycardia occurred in 1 patient. New and persistent right bundle branch block occurred in another. Our findings suggest that 2-D echocardiography guided transfemoral right ventricular EMBx is a relatively safe procedure. PMID:17179674

Han, Juyup; Park, Yongwhi; Lee, Hyunsang; Kang, Hyunjae; Kim, Hyungseop; Yang, Dong Heon; Park, Hun Sik; Chae, Shung-Chull; Jun, Jae-Eun; Park, Wee-Hyun

2006-01-01

324

Why is intracardiac echocardiography helpful? Benefits, costs, and how to learn  

PubMed Central

Current interventional procedures in structural heart disease and cardiac arrhythmias require peri-interventional echocardiographic monitoring and guidance to become as safe, expedient, and well-tolerated for patients as possible. Intracardiac echocardiography (ICE) complements and has in part replaced transoesophageal echocardiography (TEE), including real-time three-dimensional (RT-3D) imaging. The latter is still widely accepted as a method to prepare for and to guide interventional treatments. In contrast to TEE, ICE represents a purely intraprocedural guiding and imaging tool unsuitable for diagnostic purposes. Patients tolerate ICE much better, and the method does not require general anaesthesia. Accurate imaging of the particular pathology, its anatomic features, and spatial relation to the surrounding structures is critical for catheter and wire positioning, device deployment, evaluation of the result, and for ruling out complications. This review describes the peri-interventional role of ICE, outlines current limitations, and points out future implications. Two-dimensional ICE has become a suitable guiding tool for a variety of percutaneous treatments in patients who are conscious or under monitored anaesthesia care, whereas RT-3DICE is still undergoing clinical testing. Continuous TEE monitoring under general anaesthesia remains a widely accepted alternative. PMID:24144789

Bartel, Thomas; Müller, Silvana; Biviano, Angelo; Hahn, Rebecca T.

2014-01-01

325

Usefulness of intraoperative real-time three-dimensional transesophageal echocardiography in preprocedural evaluation of cortriatriatum -a case report-.  

PubMed

Cortriatriatum is a rare congenital cardiac disorder with fibromuscular band (diaphragm) dividing the left atrium (LA) into the proximal and distal parts. Surgical correction of cortriatriatum requires full preoperative evaluation of the structural anomalies including the LA diaphragm and their pathophysiology. In the present case, a 44 year-old lady diagnosed as cortriatriatum underwent surgical correction. Intraoperative three-dimensional transesophageal echocardiography provided detailed information regarding the shape and extent of the LA diaphragm, which had been partially evaluated by preoperative two-dimensional transthoracic and transesophageal echocardiography, and facilitated the intraoperative patient management and surgical decision making. PMID:24427465

Sidik, Hanafi Bin; Park, Jung-Min; Lee, Yea-Ji; Kim, Ju-Deok; Kang, Woon-Seok; Kim, Seong-Hyop; Yoon, Tae-Gyoon; Kim, Tae-Yop; Shin, Jae-Gyun

2013-12-01

326

Usefulness of intraoperative real-time three-dimensional transesophageal echocardiography in preprocedural evaluation of cortriatriatum -a case report-  

PubMed Central

Cortriatriatum is a rare congenital cardiac disorder with fibromuscular band (diaphragm) dividing the left atrium (LA) into the proximal and distal parts. Surgical correction of cortriatriatum requires full preoperative evaluation of the structural anomalies including the LA diaphragm and their pathophysiology. In the present case, a 44 year-old lady diagnosed as cortriatriatum underwent surgical correction. Intraoperative three-dimensional transesophageal echocardiography provided detailed information regarding the shape and extent of the LA diaphragm, which had been partially evaluated by preoperative two-dimensional transthoracic and transesophageal echocardiography, and facilitated the intraoperative patient management and surgical decision making. PMID:24427465

Sidik, Hanafi Bin; Park, Jung-Min; Lee, Yea-Ji; Kim, Ju-Deok; Kang, Woon-Seok; Kim, Seong-Hyop; Yoon, Tae-Gyoon; Shin, Jae-Gyun

2013-01-01

327

Complementarity of Contrast Transcranial Doppler and Contrast Transesophageal Echocardiography for the Detection of Patent Foramen ovale in Stroke Patients  

Microsoft Academic Search

All studies concerning the detection of patent foramen ovale (PFO) have compared transthoracic or transesophageal echocardiography (c-TEE) to transcranial Doppler ultrasound after contrast injection (c-TCD), but combining both techniques in the search of PFO has received no consideration. Our study aims to substantiate this claim in 37 patients with cryptogenic stroke. It includes two protocols for the detection of PFO

G. Devuyst; P.-A. Despland; J. Bogousslavsky; X. Jeanrenaud

1997-01-01

328

How does computer-assisted digital wall motion analysis influence observer agreement and diagnostic accuracy during stress echocardiography?  

Microsoft Academic Search

This study assessed interobserver and intraobserver variation and diagnostic accuracy during 25 dipyridamole stress echocardiography tests interpreted with different analysis systems: a) computer display of high frame rate digital cineloops (47 frames\\/s); b) computer display of lower frame rate digital cineloops (24 frames\\/s); and c) videotape recordings. The majority of the patients (84%) had documented coronary artery disease with baseline

Knut Bjørnstad; Svend Aakhus; Hans G. Torp

1997-01-01

329

Quantification of Left Ventricular Regional Phase Asynchrony in Patients with Left Bundle Branch Block Using Tissue Doppler Echocardiography  

E-print Network

Block Using Tissue Doppler Echocardiography Suresh Mulukutla, George Stetten, Didier Jacques, John that tissue Doppler (TD) can quantify LV asynchrony, 17 pts with LBBB (11 with heart failure) and 10 normal assessed for motion-correlation between -1 (out of phase) and 1 (in phase) over the cardiac cycle. Mean

Stetten, George

330

Initial clinical experience of real-time three-dimensional echocardiography in patients with ischemic and idiopathic dilated cardiomyopathy  

NASA Technical Reports Server (NTRS)

The geometry of the left ventricle in patients with cardiomyopathy is often sub-optimal for 2-dimensional ultrasound when assessing left ventricular (LV) function and localized abnormalities such as a ventricular aneurysm. The aim of this study was to report the initial experience of real-time 3-D echocardiography for evaluating patients with cardiomyopathy. A total of 34 patients were evaluated with the real-time 3D method in the operating room (n = 15) and in the echocardiographic laboratory (n = 19). Thirteen of 28 patients with cardiomyopathy and 6 other subjects with normal LV function were evaluated by both real-time 3-D echocardiography and magnetic resonance imaging (MRI) for obtaining LV volumes and ejection fractions for comparison. There were close relations and agreements for LV volumes (r = 0.98, p <0.0001, mean difference = -15 +/- 81 ml) and ejection fractions (r = 0.97, p <0.0001, mean difference = 0.001 +/- 0.04) between the real-time 3D method and MRI when 3 cardiomyopathy cases with marked LV dilatation (LV end-diastolic volume >450 ml by MRI) were excluded. In these 3 patients, 3D echocardiography significantly underestimated the LV volumes due to difficulties with imaging the entire LV in a 60 degrees x 60 degrees pyramidal volume. The new real-time 3D echocardiography is feasible in patients with cardiomyopathy and may provide a faster and lower cost alternative to MRI for evaluating cardiac function in patients.

Shiota, T.; McCarthy, P. M.; White, R. D.; Qin, J. X.; Greenberg, N. L.; Flamm, S. D.; Wong, J.; Thomas, J. D.

1999-01-01

331

Real-time 3-dimensional echocardiography in assessing atrial and ventricular septal defects: An echocardiographic-surgical correlative study  

Microsoft Academic Search

ObjectiveThe aim of this study is to explore the feasibility and the value of real-time 3-dimensional echocardiography (RT3DE) in quantitative evaluation of the size of atrial septal defect (ASD) and ventricular septal defect (VSD) and to correlate with the surgical findings.

Tsung O. Cheng; Ming-Xing Xie; Xin-Fang Wang; Ying Wang; Qing Lu

2004-01-01

332

Validation of real-time three-dimensional echocardiography for quantifying left ventricular volumes in the presence of a left ventricular aneurysm: in vitro and in vivo studies  

NASA Technical Reports Server (NTRS)

OBJECTIVES: To validate the accuracy of real-time three-dimensional echocardiography (RT3DE) for quantifying aneurysmal left ventricular (LV) volumes. BACKGROUND: Conventional two-dimensional echocardiography (2DE) has limitations when applied for quantification of LV volumes in patients with LV aneurysms. METHODS: Seven aneurysmal balloons, 15 sheep (5 with chronic LV aneurysms and 10 without LV aneurysms) during 60 different hemodynamic conditions and 29 patients (13 with chronic LV aneurysms and 16 with normal LV) underwent RT3DE and 2DE. Electromagnetic flow meters and magnetic resonance imaging (MRI) served as reference standards in the animals and in the patients, respectively. Rotated apical six-plane method with multiplanar Simpson's rule and apical biplane Simpson's rule were used to determine LV volumes by RT3DE and 2DE, respectively. RESULTS: Both RT3DE and 2DE correlated well with actual volumes for aneurysmal balloons. However, a significantly smaller mean difference (MD) was found between RT3DE and actual volumes (-7 ml for RT3DE vs. 22 ml for 2DE, p = 0.0002). Excellent correlation and agreement between RT3DE and electromagnetic flow meters for LV stroke volumes for animals with aneurysms were observed, while 2DE showed lesser correlation and agreement (r = 0.97, MD = -1.0 ml vs. r = 0.76, MD = 4.4 ml). In patients with LV aneurysms, better correlation and agreement between RT3DE and MRI for LV volumes were obtained (r = 0.99, MD = -28 ml) than between 2DE and MRI (r = 0.91, MD = -49 ml). CONCLUSIONS: For geometrically asymmetric LVs associated with ventricular aneurysms, RT3DE can accurately quantify LV volumes.

Qin, J. X.; Jones, M.; Shiota, T.; Greenberg, N. L.; Tsujino, H.; Firstenberg, M. S.; Gupta, P. C.; Zetts, A. D.; Xu, Y.; Ping Sun, J.; Cardon, L. A.; Odabashian, J. A.; Flamm, S. D.; White, R. D.; Panza, J. A.; Thomas, J. D.

2000-01-01

333

Transoesophageal cross-sectional echocardiography with a phased array transducer system. Technique and initial clinical results.  

PubMed Central

Cardiac imaging by transthoracic two dimensional echocardiography is impaired in patients with chronic lung disease, those with obesity, and those with abnormal chest wall configuration. In order to overcome these limitations, a miniature phased array ultrasound transducer fitted to the tip of a commercially available gastroscope was developed. Transducer position and orientation can be adjusted completely by external control of vertical displacement inside the oesophagus, rotation, and angulation. Introduction and operation of the transducer gastroscope system are usually well tolerated by the patients, since no mechanical vibrations are generated and there is no need for an oil bag to secure oesophageal wall contact. Cardiac images of high quality are obtained even from structures and regions that are poorly or not at all imaged from external transducer positions. Images PMID:7082516

Schlüter, M; Langenstein, B A; Polster, J; Kremer, P; Souquet, J; Engel, S; Hanrath, P

1982-01-01

334

A 10-Fr ultrasound catheter with integrated micromotor for 4-D intracardiac echocardiography.  

PubMed

We developed prototype real-time 3-D intracardiac echocardiography catheters with integrated micromotors, allowing internal oscillation of a low-profile 64-element, 6.2-MHz phased-array transducer in the elevation direction. Components were designed to facilitate rotation of the array, including a low-torque flexible transducer interconnect and miniature fixtures for the transducer and micromotor. The catheter tip prototypes were integrated with two-way deflectable 10-Fr catheters and used in in vivo animal testing at multiple facilities. The 4-D ICE catheters were capable of imaging a 90° azimuth by up to 180° elevation field of view. Volume rates ranged from 1 vol/sec (180° elevation) to approximately 10 vol/sec (60° elevation). We successfully imaged electrophysiology catheters, atrial septal puncture procedures, and detailed cardiac anatomy. The elevation oscillation enabled 3-D visualization of devices and anatomy, providing new clinical information and perspective not possible with current 2-D imaging catheters. PMID:21768032

Lee, Warren; Griffin, Weston; Wildes, Douglas; Buckley, Donald; Topka, Terry; Chodakauskas, Thaddeus; Langer, Mark; Calisti, Serge; Bergstøl, Svein; Malacrida, Jean-Pierre; Lanteri, Frédéric; Maffre, Jennifer; McDaniel, Ben; Shivkumar, Kalyanam; Cummings, Jennifer; Callans, David; Silvestry, Frank; Packer, Douglas

2011-07-01

335

Color atlas of real-time two-dimensional Doppler echocardiography  

SciTech Connect

This atlas represents efforts to provide two-dimensional echocardiography coordinated with simultaneous color-coded Doppler studies. During the past 10 years, real-time two-dimensional echocardiographic images have contributed to the study and understanding of cardiac disease. The recent application of the Doppler technique has also contributed to the understanding and demonstration of cardiac disease and functions in various pathologic conditions. It has also permitted the calculation of various cardiac functions, which previously were only available by invasive studies. This book presents an extension of the Doppler capabilities in the development of an instantaneous color-coded display of normal and abnormal cardiac function in contrast with those that require timely and extensive calculations.

Omoto, R.

1984-01-01

336

Quantification of congenital aortic valve stenosis in pediatric patients: comparison between cardiac magnetic resonance imaging and transthoracic echocardiography.  

PubMed

Previous studies showed the reliability of cardiac magnetic resonance imaging (cMRI) in the quantification of aortic valve stenosis in adults. The aim of this retrospective study was to assess the ability of cMRI in the quantification of congenital aortic valve stenosis (CAS) in children. Nineteen patients (mean age 14.0 ± 3.2 years, 15 boys and 4 girls) with CAS were imaged by cMRI and transthoracic echocardiography (TTE). cMRI was performed on a 1.5-Tesla MR scanner (Magnetom Avanto; Siemens Healthcare, Erlangen, Germany) using cine steady-state free precession sequences for the assessment of the aortic valve area (AVA) by MR planimetry and left-ventricular function. Phase-contrast measurement was used in cMRI to assess peak flow velocity above the aortic valve. A positive correlation was found between maximum systolic pressure gradient (MPG) as assessed by cMRI and TTE (28.9 ± 21.2 vs. 41.3 ± 22.7 mmHg, r = 0.84, p = 0.001) with a mean underestimation of 12.4 mmHg by cMRI. Only a weak correlation could be observed between AVA by cMRI and MPG at the aortic valve by TTE (r = -0.50, p = 0.029) and cMRI (r = -0.27, p = 0.40). Furthermore, a positive correlation between myocardial mass (cMRI) and MPG (TTE, r = 0.57, p = 0.01), but not between myocardial mass (cMRI) and AVA (cMRI, r = 0.07, p = 0.77), was found. The assessment of MPG by cMRI in patients with CAS is feasible with a trend toward underestimatation compared with TTE. Moreover, MPG seems to be a more accurate parameter than AVA regarding the prediction of myocardial hypertrophy. PMID:24343730

Sirin, Selma; Nassenstein, Kai; Neudorf, Ulrich; Jensen, Christoph J; Mikat, Christian; Schlosser, Thomas

2014-06-01

337

Effect of scanline orientation on ventricular flow propagation: assessment using high frame-rate color Doppler echocardiography  

NASA Technical Reports Server (NTRS)

Color M-mode echocardiography has recently been utilized to describe diastolic flow propagation velocity (Vp) in the left ventricle. While increasing temporal resolution from 15 to 200 Hz, this M-mode technique requires the user to select a single scanline, potentially limiting quantification of Vp due to the complex three-dimensional inflow pattern. We previously performed computational fluid dynamics simulations to demonstrate the insignificance of the scanline orientation, however geometric complexity was limited. The purpose of this study was to utilize high frame-rate 2D color Doppler images to investigate the importance of scanline selection in patients for the quantification of Vp. 2D color Doppler images were digitally acquired at 50 frames/s in 6 subjects from the apical 4-chamber window (System 5, GE/Vingmed, Milwaukee, WI). Vp was determined for a set of scanlines positioned through 5 locations across the mitral annulus (from the anterior to posterior mitral annulus). An analysis of variance was performed to examine the differences in Vp as a function of scanline position. Vp was not effected by scanline position in sampled locations from the center of the mitral valve towards the posterior annulus. Although not statistically significant, there was a trend to slower propagation velocities on the anterior side of the valve (60.8 +/- 16.7 vs. 54.4 +/- 13.6 cm/s). This study clinically validates our previous numerical experiment showing that Vp is insensitive to small perturbations of the scanline through the mitral valve. However, further investigation is necessary to examine the impact of ventricular geometry in pathologies including dilated cardiomyopathy.

Greenberg, N. L.; Castro, P. L.; Drinko, J.; Garcia, M. J.; Thomas, J. D.

2000-01-01

338

Novel indices for left-ventricular dyssynchrony characterization based on highly automated segmentation from real-time 3-d echocardiography.  

PubMed

Cardiac resynchronization therapy (CRT) using a biventricular pacemaker is an invasive and expensive treatment option for left ventricular mechanical dyssynchrony (LVMD). The CRT candidate selection is a crucial issue due to the unreliability of the current standard CRT indicators. Real-time three-dimensional (3-D) echocardiography (RT3DE) provides four-dimensional (4-D) (3-D+time) information about the LV and is suitable for LVMD assessment. In this article, the complex left ventricle (LV) shape and motion of 50 RT3DE datasets are represented by novel 4-D descriptors - 4-D sphericity, volume and shape, from which novel indices were derived by principal component analysis (PCA) and subsequently analyzed by a support vector machine (SVM) classifier to assess their capability of LVMD characterization and CRT outcome prediction. These novel indices outperformed clinical indices and have promising capabilities in disease characterization and great potential in CRT outcome prediction. To enable efficient quantitative RT3DE analysis, a segmentation method was developed to combine the powers of active shape models and optimal graph search. Various aspects of the method were designed to handle varying RT3DE image quality among datasets and LV segments. An application with graphical user interface was developed to provide the user with simple and intuitive control. The developed method was robust to inter-observer variability and produced very good accuracy - 3.2±1.1 mm absolute surface positioning error, <1 mm mean signed error and <5% mean volume difference. The computer method's classification performance was compared with the independent standard, showing that the 4-D shape modal indices were not only the most capable of all tested options when employed for disease characterization but also the least sensitive to segmentation imperfections. PMID:23141901

Zhang, Honghai; Abiose, Ademola K; Gupta, Dipti; Campbell, Dwayne N; Martins, James B; Sonka, Milan; Wahle, Andreas

2013-01-01

339

Two-Dimensional Echocardiography in the Assessment of Long-Term Prognosis in Patients with Pulmonary Arterial Hypertension  

PubMed Central

Objective To investigate the relationship between cardiac diastolic dysfunction and outcomes in patients with pulmonary arterial hypertension (PAH) and to clarify the potential effect of two-dimensional echocardiography (2D-echo) on prognostic value in patients with PAH. Methods Patients diagnosed with PAH (as WSPH (World Symposia on Pulmonary Hypertension) classification I) confirmed by right heart catheterization (RHC), received targeted monotherapy or combination therapy. 2D-echo parameters, World Health Organization (WHO) functional classification and 6-minute walking distance (6MWD) were recorded. The clinical prognosis of patients was assessed by the correlation between echo parameters and clinical 6MWD using receiver operating characteristic (ROC) curve analysis. Results Fifty-eight patients were included. Left and right ventricular diastolic dysfunction (LVDD and RVDD) scores measured by 2D-echo had good correlation with 6MWD at baseline (rLVDD ?=??0.699; rRVDD ?=??0.818, both P<0.001) and at last follow-up (rLVDD ?=??0.701; rRVDD ?=??0.666, both P<0.001). Furthermore, bi-ventricular (LVDD+RVDD) scores measured by 2D-echo had a better correlation with 6MWD at baseline and last follow-up (r?=??0.831; r?=??0.771, both P<0.001). ROC curve analysis showed that the area under curves (AUCs) for LVDD score, RVDD score and (LVDD+RVDD) scores were 0.823 (P<0.0001), 0.737 (P?=?0.0002), and 0.825 (P<0.0001), respectively. Compared with ROC analysis of other single parameters, cardiac diastolic function score was more accurate in predicting survival in patients with PAH. Conclusion LVDD score, RVDD score and (LVDD+RVDD) scores yielded a comprehensive quantitative assessment of LV and RV diastolic function that correlated moderately with clinical functional parameters and might be useful in the assessment of PAH. PMID:25485890

Sun, Ling-yue; Zhao, Hang; Kang, Yu; Shen, Xue-dong; Cai, Zong-ye; Shen, Jie-yan; He, Ben; Yang, Cheng-de

2014-01-01

340

Cardiomyoplasty improves contractile reserve after myocardial injury in mice: functional and morphological investigations with reconstructive three-dimensional echocardiography.  

PubMed

Cellular cardiomyoplasty (CMP) is a novel therapeutic approach to myocardial injury (MI). Post-MI remodeling of the left ventricle (LV) comprises dilatation and impairment of systolic function and gives rise to progressive hemodynamic deterioration. We aimed to investigate: a) the impact of CMP on global and regional parameters of LV remodeling (LVR) as well as contractile reserve and b) the suitability and validity of different echocardiographic methods in this scenario. Murine ventricular cardiomyocytes (E13.5-E16.5) were transplanted into cryolesioned hearts of male HIM-OF1 mice. Echocardiography was performed at rest 4 and 14 days postoperatively. For quantification of akinetic myocardial mass and contractile reserve 2 weeks postoperatively additionally low-dose dobutamine stress echocardiography was conducted. Reconstructive 3D-echocardiography (r3D-echo) was compared to "plain" echocardiographic investigations and was compared to invasive measurements with conduction catheter. CMP significantly attenuated LV dilatation and reduced LV function decline on day 14, as obtained with all echocardiographic modalities and confirmed with conduction catheter measurements. In contrast to plain echocardiography and invasive testing, r3D-echo allowed noninvasive quantification of scar size and assessment of regional contractile reserve. Cell transplanted hearts demonstrated a significant decrease of akinetic myocardial mass (-CMP: 13 ± 2%; +CMP 7 ± 1%; p < 0.001) and increased regional contractile reserve, an indirect sign of myocardial viability. The present study demonstrates beneficial effects of CMP on global and regional parameters of LVR and contractile reserve after MI. In contrast to "simple" 2D echocardiography, r3D-echo allowed the assessment of regional contractile reserve and quantification of akinetic myocardial mass as additive functional and morphological measures of LVR. PMID:21439129

Ghanem, Alexander; Röll, Wilhelm; Bostani, Toktam; Dewald, Oliver; Fleischmann, Bernd K; Stypmann, Jörg; Nickenig, Georg; Tiemann, Klaus

2011-01-01

341

Role of echocardiography in diagnosis and risk stratification in heart failure with left ventricular systolic dysfunction  

PubMed Central

Heart failure (HF) is a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. Echocardiography represents the "gold standard" in the assessment of LV systolic dysfunction and in the recognition of systolic heart failure, since dilatation of the LV results in alteration of intracardiac geometry and hemodynamics leading to increased morbidity and mortality. The functional mitral regurgitation is a consequence of adverse LV remodelling that occurs with a structurally normal valve and it is a marker of adverse prognosis. Diastolic dysfunction plays a major role in signs and symptoms of HF and in the risk stratification, and provides prognostic information independently in HF patients and impaired systolic function. Ultrasound lung comets are a simple echographic sign of extravascular lung water, more frequently associated with left ventricular diastolic and/or systolic dysfunction, which can integrate the clinical and pathophysiological information provided by conventional echocardiography and provide a useful information for prognostic stratification of HF patients. Contractile reserve is defined as the difference between values of an index of left ventricular contractility during peak stress and its baseline values and the presence of myocardial viability predicts a favorable outcome. A non-invasive echocardiographic method for the evaluation of force-frequency relationship has been proposed to assess the changes in contractility during stress echo. In conclusion, in HF patients, the evaluation of systolic, diastolic function and myocardial contractile reserve plays a fundamental role in the risk stratification. The highest risk is present in HF patients with a heart that is weak, big, noisy, stiff and wet. PMID:17910744

Ciampi, Quirino; Villari, Bruno

2007-01-01

342

Abnormal diastolic left ventricular filling by pulsed Doppler echocardiography in patients on continuous ambulatory peritoneal dialysis.  

PubMed

To determine characteristics of diastolic left ventricular (LV) function in patients on continuous ambulatory peritoneal dialysis (CAPD), two groups of CAPD patients without (n = 23; group 1) vs with (n = 25; group 2) LV hypertrophy (greater than 13 mm) were compared with a group of untreated non-renal hypertensive patients with LV hypertrophy (n = 11; group 3) using Doppler-echocardiography. Age and body surface area were comparable in all three groups, mean CAPD-duration (32 +/- 28 vs 26 +/- 23 months; p = NS) was comparable in renal patients. LV systolic function in echocardiography (LVEF: 62 vs 64 vs 63%) and systolic time intervals were normal and comparable in all three groups. Atrial maximum filling velocities (96 +/- 25 vs 91 +/- 25 vs 67 +/- 8 cm/s) were comparably increased, the ratio of maximal early/atrial filling velocities was comparably decreased (0.73 +/- 0.25 vs 0.77 +/- 0.21 vs 0.99 +/- 0.05) in both groups of renal patients as compared to group 3 (p less than 0.05-0.01). Atrial filling fractions were increased in all three groups, more pronounced in group 1 than in group 3 (50 +/- 11 vs 40 +/- 7%; p less than 0.05). The normal correlation of Doppler parameters with age and with LV radius/thickness ratio was altered in renal patients such that high patient age tended to have an additional negative influence on LV diastolic function of hypertrophied, but not of normal myocardium. Isovolumic relaxation time was prolonged in all three groups (134 +/- 38 vs 131 +/- 34 vs 116 +/- 17 ms; p = NS). We conclude that in patients on CAPD, diastolic LV filling is impaired both in normal and hypertrophied myocardium. High age is a factor that further attributes to diastolic dysfunction of hypertrophied myocardium in CAPD. PMID:1832347

Hüting, J; Kramer, W; Reitinger, J; Kühn, K; Schütterle, G; Wizemann, V

1991-07-01

343

Superior Vena Cava Echocardiography as a Screening Tool to Predict Cardiovascular Implantable Electronic Device Lead Fibrosis  

PubMed Central

Background Currently there is no noninvasive imaging modality used to risk stratify patients requiring lead extractions. We report the novel use of superior vena cava (SVC) echocardiography to identify lead fibrosis and complex cardiac implantable electronic device (CIED) lead extraction. With an aging population and expanding indications for cardiac device implantation, the ability to deal with the complications associated with chronically implanted device has also increased. Methods This was a retrospective analysis of Doppler echocardiography recorded in our outpatient Electrophysiology/Device Clinic office over 6 months. Images from 109 consecutive patients were reviewed. Results 62% (68/109) did not have a CIED and 38% (41/109) had a CIED. In patients without a CIED, 6% (4/68) displayed turbulent color flow by Doppler in the SVC, while 22% (9/41) of patients with a CIED displayed turbulent flow. Fisher's exact test found a statistically significant difference between the two groups (p value < 0.05). The CIED group was subdivided into 2 groups based on device implant duration (< 2 years vs. ? 2 years). Of the CIED implanted for ? 2 years, 27% (9/33) had turbulent flow in the SVC by Doppler, while no patients (0/8) with implant durations < 2 years demonstrated turbulent flow. Nine patients underwent subsequent lead extraction. A turbulent color pattern successfully identified all 3 patients that had significant fibrosis in the SVC found during extraction. Conclusion Our data suggests that assessing turbulent flow using color Doppler in the SVC may be a valuable noninvasive screening tool prior to lead extraction in predicting complex procedures.

Yakish, S. Jeffrey; Narula, Arvin; Foley, Robert; Kutalek, Steven

2015-01-01

344

Evaluation of right ventricular function performed by 3d-echocardiography in scleroderma patients.  

PubMed

The impairment of the right ventricle (RV) in systemic sclerosis (SSc) is usually related to pulmonary arterial hypertension (PAH). New echocardiographic techniques, such as 3-dimensional echocardiography (3DE) and 2-dimensional speckle tracking (2DSTE), allow an accurate evaluation of the RV function. The aim of this study was to evaluate the RV function using 3DE and 2DSTE in SSc patients with no history of heart disease and no PAH. Forty-five SSc patients, 42 females and 3 males, 28 with limited cutaneous SSc (lcSSc) and 17 with diffuse cutaneous SSc (dcSSc), were studied. Forty-three age- and gender-matched healthy subjects were enrolled as controls. All of them underwent a 3DE and 2DSTE ecocardiographic evaluation of the RV function. Systolic pulmonary arterial pressure (sPAP) and total pulmonary vascular resistance (tPVR) were also estimated by power doppler. RV echocardiographic parameters were compared in the different subsets of SSc patients. A statistical analysis was performed by t-test, ANOVA and multiple logistic regression. RV areas in 2DSTE and volumes in 3DE were higher and RV function parameters were reduced in SSc patients compared with controls. Also sPAP and tVPR were higher, but they did not reach pathological values. Echocardiographic alterations were more pronounced in patients with lcSSc. 3DE and 2DSTE echocardiography allowed us to detect morphological and functional alterations of the RV in a group of SSc patients with no clinical signs of heart disease and no PAH. These patients had significantly higher sPAP and tPVR than healthy controls without reporting values compatible with PAH. These data suggest that RV alterations are related to a pressure overload rather than to an intrinsic myocardial involvement in SSc. PMID:25829185

Pigatto, E; Peluso, D; Zanatta, E; Polito, P; Miatton, P; Bourji, K; Badano, L P; Punzi, L; Cozzi, F

2015-01-01

345

Left atrial function as assessed by speckle-tracking echocardiography in hypertension.  

PubMed

We investigated left atrial (LA) function in relation to hypertension using 2-dimensional speckle-tracking echocardiography (STE) in subjects with preserved left ventricular (LV) ejection fraction, while accounting for LA enlargement and LV mass and diastolic function.We performed standard 2-dimensional and Doppler echocardiography and LA volumetric measurements and STE strain imaging in hypertensive patients (systolic/diastolic blood pressure ?140/90?mmHg, or use of antihypertensive drugs, n?=?124) and age- and sex-matched normotensive subjects (n?=?124). We measured the peak LA velocity, strain, and strain rate during systole and early and late diastole, respectively. We investigated the associations of interests in the presence or absence of LA enlargement (LA volume index ?28?mL/m).Hypertensive and normotensive subjects had similar LV ejection fraction and LA diameter (P???0.22). However, hypertensive compared with normotensive subjects had enlarged LV and impaired diastolic function, and had increased LA volumetric measurements and decreased LA emptying fractions (P?

Xu, Ting-Yan; Sun, Jing P; Lee, Alex Pui-Wai; Yang, Xing S; Ji, Ling; Zhang, Zhihua; Li, Yan; Yu, Cheuk-Man; Wang, Ji-Guang

2015-02-01

346

Cocaine-Induced Vasoconstriction in the Human Coronary Microcirculation: New Evidence from Myocardial Contrast Echocardiography  

PubMed Central

Background Cocaine is a major cause of acute coronary syndrome (ACS), especially in young adults; however, the mechanistic underpinning of cocaine-induced ACS remains limited. Previous studies in animals and in patients undergoing cardiac catheterization suggest that cocaine constricts coronary microvessels, yet direct evidence is lacking. Methods and Results We used myocardial contrast echocardiography (MCE) to test the hypothesis that cocaine causes vasoconstriction in the human coronary microcirculation. Measurements were performed at baseline and after a low non-intoxicating dose of intranasal cocaine (2 mg/kg) in 10 healthy cocaine-naïve young men (median age 32 years). Post-destruction time-intensity MCE kinetic data were fit to the equation: y = A(1-e- ? t) to quantify functional capillary blood volume (A), microvascular flow velocity (?), and myocardial perfusion (A × ?). Heart rate (HR), mean arterial pressure (MAP), and LV work (two-dimensional echocardiography) were measured before and 45 minutes after cocaine. Cocaine increased MAP (+14±2 mmHg; mean ± SE), HR (+8±3 beats/min), and LV work (+50±18 mmHg·mL-1·bpm-1). Despite increasing these determinants of myocardial oxygen demand, myocardial perfusion decreased by 30% (103.7±9.8 to 75.9±10.8 a.u/s, p<0.01) due mainly to decreased capillary blood volume (133.9±5.1 to 111.7±7.7 a.u., p<.05) with no significant change in microvascular flow velocity (0.8±0.1 to 0.7±0.1 a.u.). Conclusions In healthy cocaine-naïve young adults, a low-dose cocaine challenge evokes a sizeable decrease in myocardial perfusion. Moreover, the predominant effect is to decrease myocardial capillary blood volume rather than microvascular flow velocity, suggesting a specific action of cocaine to constrict terminal feed arteries. PMID:23812179

Gurudevan, Swaminatha V.; Nelson, Michael D.; Rader, Florian; Tang, Xiu; Lewis, Joshua; Johannes, Jimmy; Belcik, J. Todd; Elashoff, Robert M.; Lindner, Jonathan R.; Victor, Ronald G.

2013-01-01

347

Intimal Pulmonary Artery Sarcoma Presenting as Severe Dyspnea and Right Heart Insufficiency  

Microsoft Academic Search

SummaryBackground: Pulmonary artery sarcoma is a rare tumor with a poor prognosis. Case Report: We report the case of a 64-year-old man with an intimal pulmonary artery sarcoma presenting with severe high oxygen flow-demanding dyspnea and weight loss of 12 kg in the last 6 months. On echocardiography, right heart insufficiency, markedly elevated right ventricular pressure, a pressure gradient along

Michael Halank; Christiane Jakob; Martin Kolditz; Gerd Hoeffken; Utz Kappert; Gerhard Ehninger; Matthias Weise

2010-01-01

348

Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging.  

PubMed

Recognizing the critical need for standardization in strain imaging, in 2010, the European Association of Echocardiography (now the European Association of Cardiovascular Imaging, EACVI) and the American Society of Echocardiography (ASE) invited technical representatives from all interested vendors to participate in a concerted effort to reduce intervendor variability of strain measurement. As an initial product of the work of the EACVI/ASE/Industry initiative to standardize deformation imaging, we prepared this technical document which is intended to provide definitions, names, abbreviations, formulas, and procedures for calculation of physical quantities derived from speckle tracking echocardiography and thus create a common standard. PMID:25623220

Voigt, Jens-Uwe; Pedrizzetti, Gianni; Lysyansky, Peter; Marwick, Tom H; Houle, Hélène; Baumann, Rolf; Pedri, Stefano; Ito, Yasuhiro; Abe, Yasuhiko; Metz, Stephen; Song, Joo Hyun; Hamilton, Jamie; Sengupta, Partho P; Kolias, Theodore J; d'Hooge, Jan; Aurigemma, Gerard P; Thomas, James D; Badano, Luigi Paolo

2015-02-01

349

Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging.  

PubMed

Recognizing the critical need for standardization in strain imaging, in 2010, the European Association of Echocardiography (now the European Association of Cardiovascular Imaging, EACVI) and the American Society of Echocardiography (ASE) invited technical representatives from all interested vendors to participate in a concerted effort to reduce intervendor variability of strain measurement. As an initial product of the work of the EACVI/ASE/Industry initiative to standardize deformation imaging, we prepared this technical document which is intended to provide definitions, names, abbreviations, formulas, and procedures for calculation of physical quantities derived from speckle tracking echocardiography and thus create a common standard. PMID:25525063

Voigt, Jens-Uwe; Pedrizzetti, Gianni; Lysyansky, Peter; Marwick, Tom H; Houle, Helen; Baumann, Rolf; Pedri, Stefano; Ito, Yasuhiro; Abe, Yasuhiko; Metz, Stephen; Song, Joo Hyun; Hamilton, Jamie; Sengupta, Partho P; Kolias, Theodore J; d'Hooge, Jan; Aurigemma, Gerard P; Thomas, James D; Badano, Luigi Paolo

2015-01-01

350

Racial Differences in the Prevalence of Severe Aortic Stenosis  

PubMed Central

Background In an era of expanded treatment options for severe aortic stenosis, it is important to understand risk factors for the condition. It has been suggested that severe aortic stenosis is less common in African Americans, but there are limited data from large studies. Methods and Results The Synthetic Derivative at Vanderbilt University Medical Center, a database of over 2.1 million de?identified patient records, was used to identify individuals who had undergone echocardiography. The association of race with severe aortic stenosis was examined using multivariable logistic regression analyses adjusting for conventional risk factors. Of the 272 429 eligible patients (mean age 45 years, 44% male) with echocardiography, 14% were African American and 82% were Caucasian. Severe aortic stenosis was identified in 106 (0.29%) African?American patients and 2030 (0.91%) Caucasian patients (crude OR 0.32, 95% CI [0.26, 0.38]). This difference persisted in multivariable?adjusted analyses (OR 0.41 [0.33, 0.50], P<0.0001). African?American individuals were also less likely to have severe aortic stenosis due to degenerative calcific disease (adjusted OR 0.47 [0.36, 0.61]) or congenitally bicuspid valve (crude OR 0.13 [0.02, 0.80], adjusted OR dependent on age). Referral bias against those with severe valvular disease was assessed by comparing the prevalence of severe mitral regurgitation in Caucasians and African Americans and no difference was found. Conclusions These findings suggest that African Americans are at significantly lower risk of developing severe aortic stenosis than Caucasians. PMID:24870936

Patel, Devin K.; Green, Kelly D.; Fudim, Marat; Harrell, Frank E.; Wang, Thomas J.; Robbins, Mark A.

2014-01-01

351

Use of Exercise Echocardiography for Prognostic Evaluation of Patients With Known or Suspected Coronary Artery Disease fn1 fn1 This study would not have been possible without the support of the sonographers, fellows and staff of the Echocardiography Laboratory of the Cleveland Clinic Foundation  

Microsoft Academic Search

Objectives. This study prospectively compared the incremental prognostic benefit of exercise echocardiography with that of exercise testing in a large cohort.Background. Exercise echocardiography is widely accepted as a diagnostic tool, but the prognostic information provided by this test, incremental to clinical and stress testing evaluation, is ill- defined.Methods. Clinical, exercise and echocardiographic variables were studied in a consecutive group of

Thomas H. Marwick; Rajendra Mehta; Kristopher Arheart; Michael S. Lauer

1997-01-01

352

Comparison of Radiological Findings of Chest X-Ray With Echocardiography in Determination of the Heart Size  

PubMed Central

Background: Heart size is an important and effective parameter in chest X-ray (CXR) interpretation. Studies indicate that, especially in middle-aged men, increased cardiothoracic ratio (CTR) is associated with ischemic heart disease (IHD) and increased rate of morbidity and mortality. The CXR is the most common imaging examination of the heart. Objectives: A good quality posterior-anterior (PA) chest radiograph is an important indicator of the cardiac size. Nowadays, CXR has given its place to more advanced approaches such as two-dimensional echocardiography. However, CXR is still more accessible and feasible for most of the physicians. This study was designed to compare the findings of CXR and echocardiography in determination of the heart size. Patients and Methods: This cross-sectional study was carried out from 2006 to 2007. A total of 197 patients entered the study. The cases had been undergone PA CXR and 2-D echocardiography maximum within two days. Results: Of participants, 24.9% had cardiomegaly according to the findings of CXR and 50.8% based on echocardiography. There was a statistically significant difference between the mean size of Right Ventricular End Diastolic Diameter in the patients with cardiothoracic ratio < 50% and ? 50% (P = 0.002) as well as Left Ventricular End Diastolic Diameter (P = 0.023). Also, a statistically significant difference was seen between echocardiography and CXR findings with regard to determination of the heart size (P = 0.003). Nonetheless, it is noteworthy that sensitivity and specificity of CXR findings in the diagnosis of cardiomegaly were 34%, and 84.5%, respectively. Conclusions: CTR is the most common method of describing the heart size. Increased CTR in CXR is associated with poor prognosis, which is suggestive of importance and necessity of early diagnosis. Although CXR may not have the same diagnostic accuracy as echocardiography, its easy accessibility and high specificity in diagnosis of cardiomegaly is very helpful, which can play an important and a cost-benefit role, particularly in screening the enlarged heart size. Moreover, according to the statistics released by Medical Council of Iran, most of Iranian physicians are general practitioners and a few of them are cardiologist.

Biharas Monfared, Ali; Agha Farajollah, Shahnaz; Sabour, Fahimeh; Farzanegan, Roya; Taghdisi, Shahram

2015-01-01

353

Casimir experiments showing saturation effects  

SciTech Connect

We address several different Casimir experiments where theory and experiment disagree. First out is the classical Casimir force measurement between two metal half spaces; here both in the form of the torsion pendulum experiment by Lamoreaux and in the form of the Casimir pressure measurement between a gold sphere and a gold plate as performed by Decca et al.; theory predicts a large negative thermal correction, absent in the high precision experiments. The third experiment is the measurement of the Casimir force between a metal plate and a laser irradiated semiconductor membrane as performed by Chen et al.; the change in force with laser intensity is larger than predicted by theory. The fourth experiment is the measurement of the Casimir force between an atom and a wall in the form of the measurement by Obrecht et al. of the change in oscillation frequency of a {sup 87}Rb Bose-Einstein condensate trapped to a fused silica wall; the change is smaller than predicted by theory. We show that saturation effects can explain the discrepancies between theory and experiment observed in all these cases.

Sernelius, Bo E. [Division of Theory and Modeling, Department of Physics, Chemistry and Biology, Linkoeping University, SE-581 83 Linkoeping (Sweden)

2009-10-15

354

Systemic vascular resistance in cirrhosis: a predictor of severity?  

PubMed Central

Background The aim of this study was to investigate whether systemic vascular resistance (SVR) correlates with validated prospective scoring systems such as Model for End-stage Liver Disease (MELD) and its modifications. Methods Patients with cirrhosis, who were admitted to hospital with decompensation (as defined by development of ascites, hepatic encephalopathy, and variceal bleeding) and underwent echocardiography were included in this study. Laboratory data required for computing MELD score, serum bilirubin, serum creatinine, international normalized ratio, and serum sodium were collected for every patient. We tabulated hemodynamic and echocardiography parameters that enabled calculation of SVR. We analyzed the correlation between SVR and each of the individual prognostic scores. Results A total of 771 patients with a diagnosis of decompensated cirrhosis were included in the study. Two hundred and sixty-two patients were found to have a low sodium level (<135 mEq/L) and 509 were found to have a normal sodium level (>135 mEq/L). In the patients with hyponatremia, we found statistically significant inverse correlations between SVR and validated liver severity models. However, these correlations were not seen in patients with normonatremia. Conclusion We observed a statistically significant inverse correlation between SVR and all the validated liver disease severity models used in this study among patients with hyponatremia but not in those with normonatremia. PMID:25187743

Gaduputi, Vinaya; Abdulsamad, Molham; Sakam, Sailaja; Abbas, Naeem; Tariq, Hassan; Ihimoyan, Ariyo

2014-01-01

355

Can Transthoracic Echocardiography Be Used to Predict Fluid Responsiveness in the Critically Ill Patient? A Systematic Review  

PubMed Central

Introduction. We systematically evaluated the use of transthoracic echocardiography in the assessment of dynamic markers of preload to predict fluid responsiveness in the critically ill adult patient. Methods. Studies in the critically ill using transthoracic echocardiography (TTE) to predict a response in stroke volume or cardiac output to a fluid load were selected. Selection was limited to English language and adult patients. Studies on patients with an open thorax or abdomen were excluded. Results. The predictive power of diagnostic accuracy of inferior vena cava diameter and transaortic Doppler signal changes with the respiratory cycle or passive leg raising in mechanically ventilated patients was strong throughout the articles reviewed. Limitations of the technique relate to patient tolerance of the procedure, adequacy of acoustic windows, and operator skill. Conclusions. Transthoracic echocardiographic techniques accurately predict fluid responsiveness in critically ill patients. Discriminative power is not affected by the technique selected. PMID:22400109

Mandeville, Justin C.; Colebourn, Claire L.

2012-01-01

356

Preoperative quantification of aortic valve stenosis: comparison of 64-slice computed tomography with transesophageal and transthoracic echocardiography and size of implanted prosthesis  

Microsoft Academic Search

Precise measurements of aortic complex diameters are essential for preoperative examinations of patients with aortic stenosis\\u000a (AS) scheduled for aortic valve (AV) replacement. We aimed to prospectively compare the accuracy of transthoracic echocardiography\\u000a (TTE), transoesophageal echocardiography (TEE) and multi-slice computed tomography (MSCT) measurements of the AV complex and\\u000a to analyze the role of the multi-modality aortic annulus diameter (AAd) assessment

Katarzyna Mizia-StecPiotr; Piotr Pysz; Marek Jasi?ski; Tomasz Adamczyk; Agnieszka Drzewiecka-Gerber; Artur Chmiel; Micha? Krejca; Andrzej Bochenek; Stanis?aw Wo?; Maciej Sosnowski; Zbigniew G?sior; Maria Trusz-Gluza; Micha? Tendera

357

Assessment of effect of angiotensin II receptor antagonist losartan on aortic distensibility in patients with essential hypertension by echocardiography  

Microsoft Academic Search

Summary  The effects of angiotensin II receptor antagonist losartan on elastic properties of aorta in patients with mild to moderate\\u000a essential hypertension were assessed. The ascending aortic distensibility in 26 patients (48±3 years) with mild to moderate\\u000a essential hypertension before and after 12 weeks of treatment with losartan (50 mg\\/day) was evaluated by using two-dimensional\\u000a echocardiography. M-mode measurements of aortic systolic

Yang Haoyi; Deng Youbin; Li Chunlei; Bi Xiaojun; Pan Min; Chang Qing

2002-01-01

358

Rapid and accurate left ventricular surface generation from three-dimensional echocardiography by a catalog based method  

Microsoft Academic Search

Background: Quantitative analysis from three-dimensional (3D) echocardiography requires accurate reconstruction of left ventricular (LV) surfaces. This currently requires time-consuming manual image tracing. We describe and validate an alternative rapid method of generating LV surfaces. Methods: A 3D-image set is acquired using transthoracic scanning. Images from five standard echo views are displayed and border points selected where anatomic landmarks are well

Selwyn P. Wong; Richard K. Johnson; Florence H. Sheehan

2003-01-01

359

[Consequences of continuous positive airway pressure (CPAP) on left ventricular function. Assessment by M-mode echocardiography (author's transl)].  

PubMed

The consequences of continuous positive airway pressure (CPAP) on left ventricular function are uncertain. Left ventricular function was assessed by M-mode echocardiography in 8 young normal subjects during CPAP via face mask. Heart rate and arterial pressure did not change. End-diastolic volume and stroke volume significantly decreased. Ejection fraction remained unchanged. The slight decrease of stroke volume induced by increasing positive airway pressure is in relation to decreased left ventricular preload. PMID:7036795

Schlemmer, B; De Vernejoul, F; Dhainaut, J F; Bons, J; Weber, S; Neveux, E; Monsallier, J F

1981-01-01

360

Phased-array intracardiac echocardiography monitoring during pulmonary vein isolation in patients with atrial fibrillation. impact on outcome and complications  

Microsoft Academic Search

Background—The objective of this study was to assess the impact of intracardiac echocardiography (ICE) on the long-term success and complications in patients undergoing pulmonary vein isolation (PVI) for treatment of atrial fibrillation (AF). Methods and Results—Three hundred fifteen patients underwent PVI for treatment of AF. Each patient underwent ostial isolation of all PVs using a cooled-tip ablation catheter. PVI was

Nassir F. Marrouche; David O. Martin; Oussama Wazni

2003-01-01

361

[The use of transesophageal echocardiography to guide the trans-septal puncture. Practical guide, tips and tricks].  

PubMed

Transesophageal echocardiography is very useful to guide transseptal puncture for left atrial ablation procedures. This paper is a practical guide for the ultrasonographer who seeks to meet the expectations of the electrophysiologist, but also for young EP's in order to improve their understanding of the echocardiographical views and to ameliorate the communication between the two specialists. The tips and tricks of all the steps of the exam are presented. PMID:24934858

Latcu, D G; Rinaldi, J-P; Yaici, K; Saoudi, N

2015-02-01

362

Usefulness of coronary flow reserve over regional wall motion when added to dual-imaging dipyridamole echocardiography  

Microsoft Academic Search

Vasodilator stress echocardiography allows semi-simultaneous imaging of left anterior descending (LAD) coronary flow and regional wall function. To assess the relative (and additive?) value of regional flow and function for noninvasive identification of angiographically assessed LAD disease in patients with chest pain syndrome, we studied 230 consecutive in-hospital patients (134 men, aged 63.5 ± 11 years) with chest pain syndrome

Fausto Rigo; Margherita Richieri; Emilio Pasanisi; Valeria Cutaia; Carlo Zanella; Patrizia Della Valentina; Francesco Di Pede; Antonio Raviele; Eugenio Picano

2003-01-01

363

2013 Goat Shows Show Date Show Name Entries Due Eligibility Weigh In Show Time Contact Phone Extra Info  

E-print Network

2013 Goat Shows Show Date Show Name Entries Due Eligibility Weigh In Show Time Contact Phone Extra/13/2013 Cannon Co. Day of Show Youth Must 8 a.m. to 12 p.m. Carol 615-563-5260 Bring own Jr. Goat $1.00 a head Control 10 a.m. Melton Bedding Association Goat 7/20/2013 Overton Co. Day of Show Youth Before 5 p.m. 6

Grissino-Mayer, Henri D.

364

Prediction of Left Atrial Fibrosis With Speckle Tracking Echocardiography in Mitral Valve Disease: A Comparative Study With Histopathology  

PubMed Central

Background and Objectives Left atrial (LA) fibrosis is a main determinant of LA remodeling and development of atrial fibrillation. However, non-invasive prediction of LA fibrosis is challenging. We investigated whether preoperative LA strain as measured by speckle tracking echocardiography could predict the degree of LA fibrosis and LA reverse remodeling after mitral valve (MV) surgery. Subjects and Methods Speckle tracking echocardiography and LA volume measurements were performed in 50 patients one day before MV surgery. LA tissues were obtained during the surgery, and the degrees of their interstitial fibroses were measured. LA volume measurements were repeated within 30 days after surgery (n=50) and 1-year later (n=39). Results Left atrial global strain was significantly correlated with the degree of LA fibrosis (r=-0.55, p<0.001), and its correlation was independent of age, underlying rhythm, presence of rheumatic heart disease and type of predominant MV disease (B=-1.37, 95% confidence interval -2.32 - -0.41, p=0.006). The degree of LA fibrosis was significantly correlated with early (r=-0.337, p=0.017) and 1-year (r=-0.477, p=0.002) percent LA volume reduction after MV surgery, but LA global strain was not significant. Conclusion Left atrial strain as measured by speckle tracking echocardiography might be helpful for predicting the degree of LA fibrosis in patients with MV disease. PMID:22701133

Her, Ae-Young; Shim, Chi Young; Song, Byoung Wook; Lee, Sak; Ha, Jong-Won; Rim, Se-Joong; Hwang, Ki Chul; Chang, Byung Chul; Chung, Namsik

2012-01-01

365

Non-invasive Cardiac Monitoring in Pregnancy: Impedance Cardiography versus Echocardiography  

PubMed Central

Objectives The objective of this study was to report thoracic impedance cardiography (ICG) measurements and compare them to echocardiography (echo) measurements throughout pregnancy and in varied maternal positions. Methods A prospective cohort study involving 28 healthy parturients was performed using ICG and echo at three time points and in two maternal positions. Pearson correlations, Bland-Altman plots and paired t-tests were used for statistical analysis. Results Significant agreements between many but not all ICG and echo contractility, flow and resistance measurements were demonstrated. Differences in stroke volume due to maternal position were also detected by ICG in the antepartum period. Significant trends were observed by ICG for cardiac output and thoracic fluid content (TFC) (p < 0.025) with advancing pregnancy stages. Conclusions ICG and echo demonstrate significant correlations in some but not all measurements of cardiac function. ICG has the ability to detect small changes in SV associated with maternal position change. ICG measurements reflected maximal cardiac contractility in the antepartum period yet reflected a decrease in contractility and an increase in TFC in the postpartum period. PMID:23680787

Burlingame, Janet; Ohana, Patrick; Aaronoff, Michael; Seto, Todd

2013-01-01

366

Three-dimensional transesophageal echocardiography of atrial septal defect device closure.  

PubMed

Most secundum atrial septal defects (ASD) are amenable to device closure. Three- dimensional transesophageal echocardiography (3DTEE) can be used to obtain an en face view of the ASD and important surrounding structures which provides for analysis of the type, size, shape, orientation, number and position of orifices, ASD rims and important surrounding structures in a single live 3D echo view. Also, 3DTEE is ideal for monitoring the position and configuration of devices and delivery hardware using live real -time imaging techniques. In this chapter we will describe and illustrate the methods to obtain and optimize 3DTEE en face views of the ASD during device closure using 3D zoom, live 3D and 3D full volume plus iCrop modalities. The respective 3D TEE modalities, imaging protocols, advantages and limitations will be discussed. Because it is useful, accurate and fairly simple to use, we have adopted 3D TEE for routine clinical use during ASD device closure. PMID:24458293

Roberson, David A; Cui, Vivian Wei

2014-02-01

367

Three-dimensional (3D) echocardiography: reconstruction algorithm and diagnostic performance of resulting images  

NASA Astrophysics Data System (ADS)

To date, 3D ultrasound imaging has been hampered by fractionated, job specific computer procedures, and the need for significant operator interaction. This paper presents our data processing algorithm for cardiac structure visualization from serial transesophageal echocardiographic (TEE) images. Major steps in the algorithm are: 1) image registration, 2) histogram operations for contrast enhancement, 3) noise and speckle filtering, 4) segmentation of composite color Doppler flow images, and 5) coordinate system conversion and interpolation. Three-dimensional reconstructions of clinical TEE examinations were compared to the corresponding serial 2D scans using receiver operator characteristics (ROC) analysis. The results demonstrated significantly better trade-off between diagnostic sensitivity and specificity in the 3D method when compared to the original 2D tomograms. We conclude that 3D echocaridography based on our algorithm is clinically feasible. Moreover, the ROC analysis on a limited group of patients indicated that 3D imaging facilitated comprehension of complex anatomic relationships and diagnostic capabilities of conventional 2D TEE echocardiography.

Belohlavek, Marek; Foley, David A.; Seward, James B.; Greenleaf, James F.

1994-09-01

368

Routine tests for both planning and evaluating image quality in tele-echocardiography.  

PubMed

Both in real-time and "store & forward" tele-echocardiography (T-E), a coding process has to be applied to the echocardiographic videoclips in order to limit the bandwidth needed and adapt it to the bandwidths furnished by network providers. The compression process degrades the videoclips, affecting thus the quality of the videoclips and potentially compromising the diagnostic accuracy of the T-E. In this work the authors investigated on the use of automatic tools for the video quality assessment by means of objective methods with particular care to the role of the system administrator. As the use of tests on video quality assessment (based on subjective methods) is hampered by the high number of needed resources (persons, laboratories and time). The use of valid objective methods is thus desirable. The study reviewed different tools with this specific aim. One of the more suitable tool was found to be represented by a software package designed by the Institute of Telecommunication Sciences and the National Telecommunication and Information Administration, the NTIA/ITS VQM tool. This tool gives back objective-quantitative data as outcomes, however embeds models emulating the subjective perception. This study reviewed and analyzed in depth the functionalities of the tool to improve the image quality in TE over the network. The tool was also found suitable for a more general process of T-E assessment, from a health technology assessment (HTA) perspective. PMID:20061658

Morelli, Sandra; Giordano, Andrea; Giansanti, Daniele

2009-01-01

369

Prediction of thrombus-related mechanical prosthetic valve dysfunction using transesophageal echocardiography  

NASA Technical Reports Server (NTRS)

Identification of thrombus-related mechanical prosthetic valve dysfunction (MPVD) has important therapeutic implications. We sought to develop an algorithm, combining clinical and echocardiographic parameters, for prediction of thrombus-related MPVD in a series of 53 patients (24 men, age 52 +/- 16 years) who had intraoperative diagnosis of thrombus or pannus from 1992 to 1997. Clinical and echocardiographic parameters were analyzed to identify predictors of thrombus and pannus. Prevalence of thrombus and diagnostic yields relative to the number of predictors were determined. There were 22 patients with thrombus, 19 patients with pannus, and 12 patients with both. Forty-two of 53 masses were visualized using transesophageal echocardiography (TEE), including 29 of 34 thrombi or both thrombi and panni and 13 of 19 isolated panni. Predictors of thrombus or mixed presentation include mobile mass (p = 0.009), attachment to occluder (p = 0.02), elevated gradients (p = 0.04), and an international normalized ratio of < or = 2.5 (p = 0.03). All 34 patients with thrombus or mixed presentation had > or = 1 predictor. The prevalence of thrombus in the presence of < or = 1, 2, and > or = 3 predictors is 14%, 69%, and 91%, respectively. Thus, TEE is sensitive in the identification of abnormal mass in the setting of MPVD. An algorithm based on clinical and transesophageal echocardiographic predictors may be useful to estimate the likelihood of thrombus in the setting of MPVD. In the presence of > or = 3 predictors, the probability of thrombus is high.

Lin, S. S.; Tiong, I. Y.; Asher, C. R.; Murphy, M. T.; Thomas, J. D.; Griffin, B. P.

2000-01-01

370

Assessment of mitral Björk-Shiley prosthetic dysfunction using digitised M mode echocardiography.  

PubMed Central

Digitised M mode echocardiograms were analysed in 22 patients with possible Björk-Shiley mitral prosthetic dysfunction. Patients with paraprosthetic mitral regurgitation had a significantly greater shortening fraction, an increased peak rate of dimension change during systole, and an increased peak velocity of circumferential fibre shortening than those with poor left ventricular function. Patients with a clotted prosthesis had lower values for shortening fraction and peak rate of dimension change during systole than patients with paraprosthetic regurgitation. In this latter group, the peak rate of dimension change during diastole and peak lengthening rate were greater than in either those patients with poor left ventricular function or those with a clotted prosthesis. In addition, the peak lengthening rate was greater in those with a clotted prosthesis than in those with poor left ventricular function. Thus M mode echocardiography is a useful method of assessing mitral prosthetic dysfunction and allows patients with paraprosthetic regurgitation to be distinguished from those with either poor left ventricular function or a clotted prosthesis. PMID:6691866

Dawkins, K D; Cotter, L; Gibson, D G

1984-01-01

371

Feasibility of radial and circumferential strain analysis using 2D speckle tracking echocardiography in cats  

PubMed Central

The purpose of the present study is to investigate the feasibility of strain analysis using speckle tracking echocardiography (STE) in cats and to evaluate STE variables in cats with hypertrophic cardiomyopathy (HCM). Sixteen clinically healthy cats and 17 cats with HCM were used. Radial and circumferential strain and strain rate variables in healthy cats were measured using STE to assess the feasibility. Comparisons of global strain and strain variables between healthy cats and cats with HCM were performed. Segmental assessments of left ventricle (LV) wall for strain and strain rate variables in cats with HCM were also performed. As a result, technically adequate images were obtained in 97.6% of the segments for STE analysis. Sedation using buprenorphine and acepromazine did not affect any global strain nor strain rate variable. In LV segments of cats with HCM, reduced segmental radial strain and strain rate variables had significantly related with segmental LV hypertrophy. It is concluded that STE analysis using short axis images of LV appeared to be clinically feasible in cats, having the possibility to be useful for detecting myocardial dysfunctions in cats with diseased heart. PMID:25373881

TAKANO, Hiroshi; ISOGAI, Tomomi; AOKI, Takuma; WAKAO, Yoshito; FUJII, Yoko

2014-01-01

372

Integration of trans-esophageal echocardiography with magnetic tracking technology for cardiac interventions  

NASA Astrophysics Data System (ADS)

Trans-esophageal echocardiography (TEE) is a standard component of patient monitoring during most cardiac surgeries. In recent years magnetic tracking systems (MTS) have become sufficiently robust to function effectively in appropriately structured operating room environments. The ability to track a conventional multiplanar 2D TEE transducer in 3D space offers incredible potential by greatly expanding the cumulative field of view of cardiac anatomy beyond the limited field of view provided by 2D and 3D TEE technology. However, there is currently no TEE probe manufactured with MTS technology embedded in the transducer, which means sensors must be attached to the outer surface of the TEE. This leads to potential safety issues for patients, as well as potential damage to the sensor during procedures. This paper presents a standard 2D TEE probe fully integrated with MTS technology. The system is evaluated in an environment free of magnetic and electromagnetic disturbances, as well as a clinical operating room in the presence of a da Vinci robotic system. Our first integrated TEE device is currently being used in animal studies for virtual reality-enhanced ultrasound guidance of intracardiac surgeries, while the "second generation" TEE is in use in a clinical operating room as part of a project to measure perioperative heart shift and optimal port placement for robotic cardiac surgery. We demonstrate excellent system accuracy for both applications.

Moore, John T.; Wiles, Andrew D.; Wedlake, Chris; Bainbridge, Daniel; Kiaii, Bob; Trejos, Ana Luisa; Patel, Rajni; Peters, Terry M.

2010-02-01

373

Noninvasive estimation of coronary flow reserve by transthoracic Doppler echocardiography with a high-frequency transducer.  

PubMed

Recent technological advances in transthoracic Doppler echocardiography (TTDE) provide visualization of the coronary blood flow signal and noninvasive analysis of coronary flow reserve with a high frequency transducer. Coronary flow velocity and coronary flow reserve measured by TTDE were compared with those measured by a Doppler guide wire. Values of mean coronary flow velocity and coronary flow reserve measured by TTDE were closely correlated with values measured by the invasive Doppler guide wire (r = 0.97, y = 0.94x + 0.40; r = 0.94, y = 0.95x + 0.21, respectively). This noninvasive technique was applied to patients who underwent coronary angiography to evaluate coronary artery disease. There was a significant difference in coronary flow reserve measured by TTDE between patients with and without significant left anterior descending coronary artery stenosis (% diameter stenosis > 70%) (1.5 +/- 0.2 vs 2.6 +/- 0.4, p < 0.001). Coronary flow reserve < 2.0 obtained by TTDE had a high sensitivity (92%) and a high specificity (86%) for the presence of significant left anterior descending coronary artery stenosis. TTDE with a high-frequency transducer can be applied to noninvasive estimation of coronary flow reserve in the clinical setting, and is useful in noninvasive diagnosis of significant coronary stenosis in patients with coronary artery disease. PMID:11433827

Hozumi, T; Akasaka, T; Yoshida, K; Yoshikawa, J

2001-01-01

374

[Non-invasive assessment of coronary flow reserve with transthoracic echocardiography: physiopathology, methodology and clinical value].  

PubMed

The assessment of coronary flow reserve with transthoracic Doppler echocardiography, measured as the ratio between hyperemic and baseline coronary flow velocities, is a new tool for the evaluation of coronary artery disease and coronary microcirculation. Color-guided pulsed Doppler allows almost optimal identification of flow velocities at the middle and distal left anterior descending artery and good visualization of the right coronary artery. The development of ultrasound technology (second harmonic, contrast agents, dedicated softwares) is responsible for great feasibility (until 98% for the left anterior descending artery and 40-50% for the right coronary artery) and very good reproducibility of this tool. Doppler-derived coronary flow reserve has excellent concordance with that obtainable with intravascular Doppler flow wire. Diagnosis of stenosis and restenosis after stent implantation in the middle and/or proximal left anterior descending artery and of stenosis of the right coronary artery is very accurate. In the absence of stenosis of epicardial coronary arteries, the reduction in coronary flow reserve implies a damage of coronary microcirculation, which can be a determinant of angina pectoris and signs of myocardial ischemia in arterial hypertension, diabetes mellitus and coronary X syndrome. Further progress may be expected by using myocardial contrast agents for quantitation of regional myocardial coronary flow reserve. PMID:12784752

Guarini, Pasquale; Scognamiglio, Giancarlo; Cicala, Silvana; Galderisi, Maurizio

2003-03-01

375

Feasibility of radial and circumferential strain analysis using 2D speckle tracking echocardiography in cats.  

PubMed

The purpose of the present study is to investigate the feasibility of strain analysis using speckle tracking echocardiography (STE) in cats and to evaluate STE variables in cats with hypertrophic cardiomyopathy (HCM). Sixteen clinically healthy cats and 17 cats with HCM were used. Radial and circumferential strain and strain rate variables in healthy cats were measured using STE to assess the feasibility. Comparisons of global strain and strain variables between healthy cats and cats with HCM were performed. Segmental assessments of left ventricle (LV) wall for strain and strain rate variables in cats with HCM were also performed. As a result, technically adequate images were obtained in 97.6% of the segments for STE analysis. Sedation using buprenorphine and acepromazine did not affect any global strain nor strain rate variable. In LV segments of cats with HCM, reduced segmental radial strain and strain rate variables had significantly related with segmental LV hypertrophy. It is concluded that STE analysis using short axis images of LV appeared to be clinically feasible in cats, having the possibility to be useful for detecting myocardial dysfunctions in cats with diseased heart. PMID:25373881

Takano, Hiroshi; Isogai, Tomomi; Aoki, Takuma; Wakao, Yoshito; Fujii, Yoko

2015-03-01

376

Myocarditis Leading to Severe Dilated Cardiomyopathy in a Patient with Dengue Fever  

PubMed Central

Background. Majority of dengue fever cases follow a benign self-limiting course but recently rare presentations and complications are increasingly seen due to rising burden of disease. Cardiac involvement in dengue fever with fatal outcome is a very rare complication. We report a case of 44-year-old patient who presented with symptoms of severe acute congestive heart secondary to myocarditis induced cardiomyopathy caused by dengue virus infection. Case Presentation. A 44-year-old man presented to ER with the complaints of high fever, fatigue, and shortness of breath. Patient was lethargic and blood pressure was low when he was brought to the ER. CXR showed cardiomegaly with pulmonary congestion and echocardiography revealed dilated left ventricle and ejection fraction of 10%. Patient condition worsened and he got admitted to the ICU because of acute hypoxic respiratory failure. Despite aggressive measures, patient died on day 5. Conclusion. Dilated cardiomyopathy is a rare complication of dengue myocarditis. Early recognition of acute DCM caused by dengue myocarditis is imperative in the management of dengue fever as early detection and management of cardiac failure can improve the survival of patient. PMID:25802766

Daruwalla, Vistasp; Hayat, Saleem

2015-01-01

377

Real time three-dimensional transesophageal echocardiography in partial posteromedial papillary muscle rupture.  

PubMed

A 60-year-old hypertensive male with non-ST segment elevation myocardial infarction had a hyperdynamic LV with mild posterior leaflet mitral valve prolapse without significant regurgitation on transthoracic echocardiogram. Two-dimensional (2D) TEE showed severe mitral regurgitation with prolapse of P2 and P3 scallops. Posteromedial papillary muscle rupture was suspected. Three-dimensional (3D) TEE demonstrated severely prolapsing P2 and P3 valve scallops with a clear view of the partially ruptured posteromedial papillary muscle. Patient underwent emergency coronary bypass and mitral valve replacement. Surgical pathology of papillary muscle confirmed coagulative necrosis. 3D TEE was superior in identifying the partial posteromedial papillary muscle rupture. PMID:23488568

Havins, Jeremiah; Lick, Scott; Boor, Paul; Arora, Harvinder; Ahmad, Masood

2013-07-01

378

Real-time transmission of full-motion echocardiography over a high-speed data network: impact of data rate and network quality of service  

NASA Technical Reports Server (NTRS)

With high-resolution network transmission required for telemedicine, education, and guided-image acquisition, the impact of errors and transmission rates on image quality needs evaluation. METHODS: We transmitted clinical echocardiograms from 2 National Aeronautics and Space Administration (NASA) research centers with the use of Motion Picture Expert Group-2 (MPEG-2) encoding and asynchronous transmission mode (ATM) network protocol over the NASA Research and Education Network. Data rates and network quality (cell losses [CLR], errors [CER], and delay variability [CVD]) were altered and image quality was judged. RESULTS: At speeds of 3 to 5 megabits per second (Mbps), digital images were superior to those on videotape; at 2 Mbps, images were equivalent. Increasing CLR caused occasional, brief pauses. Extreme CER and CDV increases still yielded high-quality images. CONCLUSIONS: Real-time echocardiographic acquisition, guidance, and transmission is feasible with the use of MPEG-2 and ATM with broadcast quality seen above 3 Mbps, even with severe network quality degradation. These techniques can be applied to telemedicine and used for planned echocardiography aboard the International Space Station.

Main, M. L.; Foltz, D.; Firstenberg, M. S.; Bobinsky, E.; Bailey, D.; Frantz, B.; Pleva, D.; Baldizzi, M.; Meyers, D. P.; Jones, K.; Spence, M. C.; Freeman, K.; Morehead, A.; Thomas, J. D.

2000-01-01

379

Pheochromocytoma with markedly abnormal liver function tests and severe leukocytosis.  

PubMed

Pheochromocytoma is a rare neuroendocrine tumor arising from the medulla of the adrenal glands, which causes an overproduction of catecholamines. The common symptoms are headache, palpitations, and sweating; however, various other clinical manifestations might also be present. Accurate diagnosis of pheochromocytoma is important because surgical treatment is usually successful, and associated clinical problems are reversible if treated early. A 49-year-old man with a history of uncontrolled hypertension and diabetes mellitus presented with chest pain, fever, and sweating. His liver function tests and white blood cell counts were markedly increased and his echocardiography results suggested stress-induced cardiomyopathy. His abdominal computed tomography showed a 5×5-cm-sized tumor in the left adrenal gland, and laboratory tests confirmed catecholamine overproduction. After surgical resection of the left adrenal gland, his liver function tests and white blood cell counts normalized, and echocardiography showed normal cardiac function. Moreover, his previous antihypertensive regimen was deescalated, and his previously uncontrolled blood glucose levels normalized without medication. PMID:24741459

Eun, Chai Ryoung; Ahn, Jae Hee; Seo, Ji A; Kim, Nan Hee

2014-03-01

380

Pheochromocytoma with Markedly Abnormal Liver Function Tests and Severe Leukocytosis  

PubMed Central

Pheochromocytoma is a rare neuroendocrine tumor arising from the medulla of the adrenal glands, which causes an overproduction of catecholamines. The common symptoms are headache, palpitations, and sweating; however, various other clinical manifestations might also be present. Accurate diagnosis of pheochromocytoma is important because surgical treatment is usually successful, and associated clinical problems are reversible if treated early. A 49-year-old man with a history of uncontrolled hypertension and diabetes mellitus presented with chest pain, fever, and sweating. His liver function tests and white blood cell counts were markedly increased and his echocardiography results suggested stress-induced cardiomyopathy. His abdominal computed tomography showed a 5×5-cm-sized tumor in the left adrenal gland, and laboratory tests confirmed catecholamine overproduction. After surgical resection of the left adrenal gland, his liver function tests and white blood cell counts normalized, and echocardiography showed normal cardiac function. Moreover, his previous antihypertensive regimen was deescalated, and his previously uncontrolled blood glucose levels normalized without medication. PMID:24741459

Eun, Chai Ryoung; Ahn, Jae Hee; Seo, Ji A

2014-01-01

381

Managing Beef Cattle for Show  

E-print Network

This publication gives advice on raising beef cattle to exhibit at shows. Topics include animal selection, feeding, general health management, disease prevention, calf handling, and preparing for the show....

Herd, Dennis B.; Boleman, Chris; Boleman, Larry L.

2001-11-16

382

What Do Blood Tests Show?  

MedlinePLUS

... page from the NHLBI on Twitter. What Do Blood Tests Show? Blood tests show whether the levels ... changes may work best. Result Ranges for Common Blood Tests This section presents the result ranges for ...

383

Asia: Showing the Changing Seasons  

NSDL National Science Digital Library

SeaWiFS false color data showing seasonal change in the oceans and on land for Asia. The data is seasonally averaged, and shows the sequence: fall, winter, spring, summer, fall, winter, spring (for the Northern Hemisphere).

Jesse Allen

1998-09-09

384

ELI Talent Show Final Exams  

E-print Network

Highlights ELI Talent Show Final Exams Scholarship Nominees Graduate Admissions Workshop Reminders from the Office Manners, Cultures, & Grammar TheELIWeekly ELI Talent Show It's going to be a blast! Come one, come all! The 2nd Annual ELI Talent Show will be on Tuesday, April 15th

Pilyugin, Sergei S.

385

Acute Effects of an Energy Drink on Myocardial Function Assessed by Conventional Echo-Doppler Analysis and by Speckle Tracking Echocardiography on Young Healthy Subjects  

PubMed Central

Purpose. Previous studies have underlined the effects of the energy drinks containing caffeine end taurine on the cardiovascular system. The aim of this study was to determine acute changes on echocardiographic parameters assessed by conventional echo-Doppler analysis and by speckle tracking echocardiography after the consumption of an energy drink in a young healthy population. Methods. measurement of blood pressure, electrocardiographic, and echocardiographic examination were performed on 35 healthy subjects (mean age 25 ± 2 years, 16 men), at baseline and one hour after the consumption of a body surface area indexed amount of an energy drink (168?mL/m2) containing caffeine (0.03%) and taurine (0.4%). Results. The analysis of left ventricular function showed a significant increase of mean relative values of MAPSE (+11%; P < 0.001), global longitudinal strain (+10%, P = 0.004), and left ventricular twisting (+22%, P < 0.0001) in respect to baseline. Also, right ventricular function parameters appeared significantly increased after energy drink consumption, as TAPSE (+15%, P < 0.0001), global, and free wall right ventricular longitudinal strain (+8%, P = 0.001; +5%, P = 0.1, resp.). Conclusion. In conclusion, the consumption of the ED in our population showed a significant increase of right and left ventricular myocardial function, suggesting a possible positive inotropic effect related to the substances contained therein. PMID:24319592

Menci, Daniele; Righini, Francesca Maria; Cameli, Matteo; Lisi, Matteo; Benincasa, Susanna; Focardi, Marta; Mondillo, Sergio

2013-01-01

386

Comparison of one- and 12-month outcomes of transcatheter aortic valve replacement in patients with severely stenotic bicuspid versus tricuspid aortic valves (results from a multicenter registry).  

PubMed

The aim of the study was to evaluate the transcatheter aortic valve replacement (TAVR) in high-risk patients with severe bicuspid aortic valve (BAV) stenosis and to compare the outcomes with a matched group of patients with tricuspid aortic valve. TAVR became an alternative treatment method in high-risk patients with symptomatic aortic stenosis; however, BAV stenosis is regarded as a relative contraindication to TAVR. The study population comprised 28 patients with BAV who underwent TAVR. BAV was diagnosed based on a transesophageal echocardiography. CoreValve and Edwards SAPIEN prostheses were implanted. The control group consisted of 84 patients (3:1 matching) with significant tricuspid aortic valve stenosis treated with TAVR. There were no significant differences between patients with and without BAV in device success (93% vs 93%, p = 1.0), risk of annulus rupture (0% in both groups), or conversion to cardiosurgery (4% vs 0%, respectively, p = 0.25). The postprocedural mean pressure gradient (11.5 ± 6.4 vs 10.4 ± 4.5 mm Hg, p = 0.33), aortic regurgitation grade ?2 of 4 (32% vs 23%, p = 0.45), 30-day mortality (4% vs 7%, p = 0.68), and 1-year all-cause mortality (19% vs 18%, p = 1.00) did not differ between the groups. Echocardiography showed well-functioning valve prosthesis with a mean prosthetic valve area of 1.6 ± 0.4 cm(2) versus 1.7 ± 0.3 cm(2) (p = 0.73), a mean pressure gradient of 10.3 ± 5.4 versus 9.8 ± 2.8 mm Hg (p = 0.64), and aortic regurgitation grade ?2 of 4 (22% vs 22%, p = 1.00) for the 2 groups. In conclusion, selected high-risk patients with BAV can be successfully treated with TAVR, and their outcomes are similar to those reported in patients without BAV. PMID:25037674

Kochman, Janusz; Huczek, Zenon; Scis?o, Piotr; Dabrowski, Maciej; Chmielak, Zbigniew; Szyma?ski, Piotr; Witkowski, Adam; Parma, Rados?aw; Ochala, Andrzej; Chodór, Piotr; Wilczek, Krzysztof; Reczuch, Krzysztof W; Kubler, Piotr; Rymuza, Bartosz; Ko?towski, Lukasz; Scibisz, Anna; Wilimski, Rados?aw; Grube, Eberhard; Opolski, Grzegorz

2014-09-01

387

Accuracy and Reproducibility of Right Ventricular Quantification in Patients with Pressure and Volume Overload Using Single-Beat Three-Dimensional Echocardiography  

PubMed Central

Background The right ventricle is a complex structure that is challenging to quantify by two-dimensional (2D) echocardiography. Unlike disk summation three-dimensional (3D) echocardiography (3DE), single-beat 3DE can acquire large volumes at high volume rates in one cardiac cycle, avoiding stitching artifacts or long breath-holds. The aim of this study was to assess the accuracy and test-retest reproducibility of single-beat 3DE for quantifying right ventricular (RV) volumes in adult populations of acquired RV pressure or volume overload, namely, pulmonary hypertension (PH) and carcinoid heart disease, respectively. Three-dimensional and 2D echocardiographic indices were also compared for identifying RV dysfunction in PH. Methods A prospective cross-sectional study was performed in 100 individuals who underwent 2D echocardiography, 3DE, and cardiac magnetic resonance imaging: 49 patients with PH, 20 with carcinoid heart disease, 11 with metastatic carcinoid tumors without cardiac involvement, and 20 healthy volunteers. Two operators performed test-retest acquisition and postprocessing for inter- and intraobserver reproducibility in 20 subjects. Results: RV single-beat 3DE was attainable in 96% of cases, with mean volume rates of 32 to 45 volumes/sec. Bland-Altman analysis of all subjects (presented as mean bias ± 95% limits of agreement) revealed good agreement for end-diastolic volume (?2.3 ± 27.4 mL) and end-systolic volume (5.2 ± 19.0 mL) measured by 3DE and cardiac magnetic resonance imaging, with a tendency to underestimate stroke volume (?7.5 ± 23.6 mL) and ejection fraction (?4.6 ± 13.8%) by 3DE. Subgroup analysis demonstrated a greater bias for volumetric underestimation, particularly in healthy volunteers (end-diastolic volume, ?11.9 ± 18.0 mL; stroke volume, ?11.2 ± 20.2 mL). Receiver operating characteristic curve analysis showed that 3DE-derived ejection fraction was significantly superior to 2D echocardiographic parameters for identifying RV dysfunction in PH (sensitivity, 94%; specificity, 88%; area under the curve, 0.95; P = .031). There was significant interobserver test-retest bias for RV volume underestimation (end-diastolic volume, ?12.5 ± 28.1 mL; stroke volume, ?10.6 ± 23.2 mL). Conclusions Single-beat 3DE is feasible and clinically applicable for volumetric quantification in acquired RV pressure or volume overload. It has improved limits of agreement compared with previous disk summation 3D echocardiographic studies and has incremental value over standard 2D echocardiographic measures for identifying RV dysfunction. Despite the ability to obtain and postprocess a full-volume 3D echocardiographic RV data set, the quality of the raw data did influence the accuracy of the data obtained. The technique performs better with dilated rather than nondilated RV cavities, with a learning curve that might affect the test-retest reproducibility for serial RV studies. PMID:25499839

Knight, Daniel S.; Grasso, Agata E.; Quail, Michael A.; Muthurangu, Vivek; Taylor, Andrew M.; Toumpanakis, Christos; Caplin, Martyn E.; Coghlan, J. Gerry; Davar, Joseph

2015-01-01

388

Development of Left Ventricular Longitudinal Speckle Tracking Echocardiography in Very Low Birth Weight Infants with and without Bronchopulmonary Dysplasia during the Neonatal Period  

PubMed Central

Objectives In preterm infants, postnatal myocardial adaptation may be complicated by bronchopulmonary dysplasia (BPD). We aimed to describe the development of left ventricular function by serial 2D, Doppler, and speckle tracking echocardiography (2D-STE) in infants with and without BPD during the neonatal period and compare these to anthropometric and conventional hemodynamic parameters. Study Design Prospective echocardiography on day of life (DOL) 1, 7, 14, and 28 in 119 preterm infants <1500 g birth weight of whom 36 developed BPD (need for oxygen supplementation at 36 weeks gestational age). Non-BPD and BPD infants differed significantly in median (IQR) gestational age (25.5(24–26.5) weeks vs. 29(27–30) weeks, p<0.001) and birth weight (661(552–871) g vs. 1100(890–1290) g, p<0.001). Results The intra- and inter-observer variability of the 2D-STE parameters measured did not depend on time of measurement, although there were significant differences in the reproducibility of the parameters. Low intra- and inter-observer variability was seen for longitudinal systolic strain and strain rate mid septum with a median CV (coefficient of variation) of <4.6%. Much higher CVs (>10%) were seen for the apical segment. While anthropometric parameters show rapid development during the first 4 weeks of life, the speckle tracking parameters did not differ statistically significantly during the neonatal period. Infants with and without BPD differed significantly (p<0.001) in the development of anthropometric parameters, conventional hemodynamic parameters except for heart rate, and 2D-STE parameters: global longitudinal systolic strain rate (GLSSR) and longitudinal systolic strain for the mid left wall (LSSR). The largest differences were seen at DOL 1 and 7 in GLSSR (p<0.001) and in LSSR (p<0.01). Conclusions Reproducible 2D-STE measurements are possible in preterm infants <1500 g. Cardiac deformation reveals early (DOL 1 and 7) ventricular changes (GLSSR and LSSR) in very low birth weight infants who develop BPD. PMID:25184634

Czernik, Christoph; Rhode, Stefanie; Helfer, Sven; Schmalisch, Gerd; Bührer, Christoph; Schmitz, Lothar

2014-01-01

389

Feasibility of Doppler hemodynamic evaluation of primary and secondary mitral regurgitation during exercise echocardiography.  

PubMed

Exercise transthoracic echocardiography (ExE) was recently proposed to evaluate tolerance and help risk stratification of mitral regurgitation (MR). Few data are available on the feasibility of Doppler echocardiographic recordings at exercise in daily practice in both secondary and primary MR. Comprehensive resting and ExE were performed in 72 unselected patients (age 59 ± 15 years, 62 % men), with no or minimal symptoms, with at least moderate (mean effective regurgitant orifice area (ERO) = 36 ± 14 mm(2)) primary or secondary MR in two French university hospitals. At rest, quantification of ERO was more challenging in semi-supine position than in classic left lateral decubitus position (55/72; 76 % vs 66/72; 92 %; p = 0.012), particularly in mitral valve (MV) prolapse (35/47; 74 %). During exercise, ERO was only obtained in 30/55 (55 %) patients and was more difficult to assess in MV prolapse than in rheumatic or ischemic MR (respectively in 43, 67 and 88 %, p = 0.046). At peak exercise, ERO was more frequently obtained in symptomatic than asymptomatic patients (77 vs 37 %, p = 0.046) because peak heart rate was lower (113 ± 20 vs 133 ± 23 bpm, p = 0.026). Systolic pulmonary artery pressure (SPAP) was obtained in 69 patients (96 %) at rest and in 60 patients (83 %) at peak exercise (Pex). LV contractile reserve (CR), monitored in all patients (100 %), was found in 51/72 patients (71 %). In daily ExE, monitoring of the CR and SPAP appeared less challenging than MR quantification by the PISA method. Monitoring of ERO was more feasible in ischemic MR than in MV prolapse. PMID:25326411

Coisne, Augustin; Levy, Franck; Malaquin, Dorothée; Richardson, Marjorie; Quéré, Jean Paul; Montaigne, David; Tribouilloy, Christophe

2015-02-01

390

Beat to beat 3-dimensional intracardiac echocardiography: theoretical approach and practical experiences.  

PubMed

Three-dimensional (3D)-imaging provides important information on cardiac anatomy during electrophysiological procedures. Real-time updates of modalities with high soft-tissue contrast are particularly advantageous during cardiac procedures. Therefore, a beat to beat 3D visualization of cardiac anatomy by intracardiac echocardiography (ICE) was developed and tested in phantoms and animals. An electronic phased-array 5-10 MHz ICE-catheter (Acuson, AcuNav/Siemens Medical Solutions USA/64 elements) providing a 90° sector image was used for ICE-imaging. A custom-made mechanical prototype controlled by a servo motor allowed automatic rotation of the ICE-catheter around its longitudinal axis. During a single heartbeat, the ICE-catheter was rotated and 2D-images were acquired. Reconstruction into a 3D volume and rendering by a prototype software was performed beat to beat. After experimental validation using a rigid phantom, the system was tested in an animal study and afterwards, for quantitative validation, in a dynamic phantom. Acquisition of beat to beat 3D-reconstruction was technically feasible. However, twisting of the ICE-catheter shaft due to friction and torsion was found and rotation was hampered. Also, depiction of catheters was not always ensured in case of parallel alignment. Using a curved sheath for depiction of cardiac anatomy there was no congruent depiction of shape and dimension of static and moving objects. Beat to beat 3D-ICE-imaging is feasible. However, shape and dimension of static and moving objects cannot always be displayed with necessary steadiness as needed in the clinical setting. As catheter depiction is also limited, clinical use seems impossible. PMID:23065102

Stapf, Daniel; Franke, Andreas; Schreckenberg, Marcus; Schummers, Georg; Mischke, Karl; Marx, Nikolaus; Schauerte, Patrick; Knackstedt, Christian

2013-04-01

391

Structural Heart Disease and ST2: Cross-Sectional and Longitudinal Associations With Echocardiography.  

PubMed

To further explore the potential role of sST2 in the progression of cardiac disease, this section reviews both the associations with cross-sectional findings and longitudinal changes in cardiac structure and function measured by echocardiography and cardiac magnetic resonance imaging with sST2 levels in a variety of patient populations with or at-risk for cardiovascular disease. In a Pro-Brain Natriuretic Peptide Investigation of Dyspnea in the Emergency Department substudy in patients with acute dyspnea, sST2 levels were found associated with left ventricular ejection fraction (LVEF), and both estimated right ventricular (RV) systolic pressure and RV hypokinesis. In a large cohort of ambulatory patients referred for echocardiograms, sST2 was predominantly associated with RV and not LV structural findings. In contrast, in the Framingham Heart Study, a community cohort of >3,300 participants, sST2 was not associated with either echocardiographic finding, although in the Cardiovascular Health Study, sST2 appeared strongly associated with the presence of diastolic dysfunction. Little evidence exists on the relation of sST2 levels with longitudinal change in cardiac structure and function. A substudy of Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) evaluated the association among LV remodeling (defined as an increase in LV end-systolic and -diastolic volumes), sST2, and the benefit of eplerenone and found that sST2 levels were good surrogates of left ventricular remodeling. In the same line, the ProBNP Outpatient Tailored Chronic Heart Failure (PROTECT) study found that more time spent with an sST2 level less than the cutoff of 35 ng/L identified patients with a greater probability of a decrease in LV diastolic index over 1 year. PMID:25702279

deFilippi, Christopher; Daniels, Lori B; Bayes-Genis, Antoni

2015-04-01

392

Adaptation of heart to training: A comparative study using echocardiography & impedance cardiography in male & female athletes  

PubMed Central

Background & objectives: Intensive regular physical exercise training is associated with a physiological changes in left ventricular (LV) morphology and functions. This cardiac remodeling observed in the athletes is associated with the specific haemodynamic requirements of the exercise undertaken. The main objective of this study is to evaluate the effect of endurance training on cardiac morphology, systolic and diastolic LV functions and haemodynamic parameters both in male and female athletes. Methods: Seventy nine healthy athletes (age 20.0 ± 2.6 yr; 49% male) and 82 healthy sedentary adolescent (age 20.8 ± 2.2 yr, 49% male) volunteered to participate in this study. All subjects underwent transthoracic echocardiography and impedance cardiography. Results: Both female and male athletes had greater LV end-diastolic cavity sizes, LV mass and stroke volume (SV) values when compared with controls. Also, in male athletes, LV mass index was higher than in female athletes. While male athletes had lower resting heart rate compared to female athletes, they had higher mean arterial blood pressure. In male athletes, basal septal and mid septal strain values were higher compared to controls. There were no significant differences in strain and peak systolic strain rate values between female athletes and controls. In male athletes, there was a weak positive correlation between SV and LV mass, basal lateral and septal strain values. In female athletes, only a weak positive correlation was found between SV and basal septal strain values. Interpretation & conclusions: Endurance-trained male and female athletes had higher LV mass, LV cavity dimensions and SV compared to sedentary controls. Although there was no difference in diastolic cardiac functions between athletes and controls, local enhanced systolic function was found with increase of SV. Both morphologic and haemodynamic differences were more evident in male athletes. PMID:23852292

Yilmaz, Dilek Cicek; Buyukakilli, Belgin; Gurgul, Serkan; Rencuzogullari, Ibrahim

2013-01-01

393

Left atrial function by speckle-tracking echocardiography in chronic asymptomatic alcoholic patients.  

PubMed

Although the effects of chronic alcoholism on left ventricular (LV) systolic function are well established, diastolic impairment has been evaluated partially. In addition, there are scarce data available about the relation of LV diastolic function to either or both duration and quantity of drinking among alcoholics. The aim of the study was to evaluate the left atrial (LA) function in chronic asymptomatic alcoholic patients by using two-dimensional speckle-tracking echocardiography (2D-STE). We enrolled 30 healthy subjects (age 34.8 ± 5.8 years) and 75 asymptomatic male alcoholics (age 39.8 ± 6.5 years) divided into two groups, according to total lifetime dose of ethanol: group I, <15 kg/kg and group II, ?15 kg/kg. In the 2D-STE analysis of the LA, strain during ventricular systole (LA-Res), during late diastole (LA-Pump) and strain rate during ventricular contraction (LA-SRs), during passive ventricular filling (LA-SRe), during active atrial contraction (LA-SRa) were obtained. Deceleration time was longer, E/A and V p were smaller, and E/E m was higher in alcoholics. Although parameters of diastolic dysfunction were comparable in alcoholic groups, LA-Res and LA-Pump were found significantly different among the alcoholics. However, there were no differences in LA-SRs and LA-SRe between the controls and alcoholic groups. LA function is reduced in chronic alcohol abuse, and heavy alcohol consumption may play an important role in LA function impairment. PMID:25245871

Kocabay, Gonenc; Karabay, Can Yucel; Kalayc?, Arzu; Oduncu, Vecih; Akgun, Taylan; Guler, Ahmet; K?l?cgedik, Alev; Kalkan, Sedat; ?zgi, Akin; K?rma, Cevat

2015-04-01

394

Modified optical flow technique for cardiac motions analysis in echocardiography images.  

PubMed

The quantitative analysis of cardiac motions in echocardiography images is a noteworthy issue in processing of these images. Cardiac motions can be estimated by optical flow (OF) computation in different regions of image which is based on the assumption that the intensity of a moving pattern remains constant in consecutive frames. However, in echocardiographic sequences, this assumption may be violated because of unique specifications of ultrasound. There are some methodsapplying the brightness variation effect in OF. Almost all of them have presented a mathematical brightness variation model globally in the images. Nevertheless, there is not a brightness variation model for echocardiographic images in these methods. Therefore, we are looking for a method to apply brightness variations locally in different regions of the image. In this study, we proposed a method to modify ausual OF technique by considering intensity variation. To evaluate this method, we implement two other OF-based methods, one usual OF method and a modified OF method applying brightness variation as a multiplier and an offset (generalized dynamic imaging model [GDIM]) and compare them with ours. These algorithms and ours were implemented on real 2D echocardiograms. Our method resulted in more accurate estimations than two others. At last, we compared our method with expert'spoint of view and observed that three distance metrics between them was appropriately smaller than other methods. The Haussdorff distance between the estimated curve defined by the proposed method and the expert defined curve is 4.81 pixels less than this distance for Lucas-Kanade and 2.28 pixels less than GDIM. PMID:23717803

Torkashvand, Paria; Behnam, Hamid; Sani, Zahra Alizadeh

2012-07-01

395

Planning a Successful Tech Show  

ERIC Educational Resources Information Center

Tech shows are a great way to introduce prospective students, parents, and local business and industry to a technology and engineering or career and technical education program. In addition to showcasing instructional programs, a tech show allows students to demonstrate their professionalism and skills, practice public presentations, and interact…

Nikirk, Martin

2011-01-01

396

The Maths File Game Show  

NSDL National Science Digital Library

The British Broadcasting Corporation offers this great collection of fun, educational games that help children learn basic concepts of mathematics. Twelve interactive games are available in all, illustrating principles of data handling, numbers, algebra, and measurement. Children can practice interpreting Cartesian coordinates by guiding a space ship across a grid, or compete with an animated character in a test of fractions and percentages. In addition to the online games, several other activities are presented in one-page documents for easy printing.

2007-12-12

397

Upgrade Summer Severe Weather Tool  

NASA Technical Reports Server (NTRS)

The goal of this task was to upgrade to the existing severe weather database by adding observations from the 2010 warm season, update the verification dataset with results from the 2010 warm season, use statistical logistic regression analysis on the database and develop a new forecast tool. The AMU analyzed 7 stability parameters that showed the possibility of providing guidance in forecasting severe weather, calculated verification statistics for the Total Threat Score (TTS), and calculated warm season verification statistics for the 2010 season. The AMU also performed statistical logistic regression analysis on the 22-year severe weather database. The results indicated that the logistic regression equation did not show an increase in skill over the previously developed TTS. The equation showed less accuracy than TTS at predicting severe weather, little ability to distinguish between severe and non-severe weather days, and worse standard categorical accuracy measures and skill scores over TTS.

Watson, Leela

2011-01-01

398

Pilot study of nurse-led rheumatic heart disease echocardiography screening in Fiji--a novel approach in a resource-poor setting.  

PubMed

We designed a pilot study of a training module for nurses to perform rheumatic heart disease echocardiography screening in a resource-poor setting. The aim was to determine whether nurses given brief, focused, basic training in echocardiography could follow an algorithm to potentially identify cases of rheumatic heart disease requiring clinical referral, by undertaking basic two-dimensional and colour Doppler scans. Training consisted of a week-long workshop, followed by 2 weeks of supervised field experience. The nurses' skills were tested on a blinded cohort of 50 children, and the results were compared for sensitivity and specificity against echocardiography undertaken by an expert, using standardised echocardiography definitions for definite and probable rheumatic heart disease. Analysis of the two nurses' results revealed that when a mitral regurgitant jet length of 1.5 cm was used as the trigger for rheumatic heart disease identification, they had a sensitivity of 100% and 83%, respectively, and a specificity of 67.4% and 79%, respectively. This pilot supports the principle that nurses, given brief focused training and supervised field experience, can follow an algorithm to undertake rheumatic heart disease echocardiography in a developing country setting to facilitate clinical referral with reasonable accuracy. These results warrant further research, with a view to developing a module to guide rheumatic heart disease echocardiographic screening by nurses within the existing public health infrastructure in high-prevalence, resource-poor regions. PMID:23040535

Colquhoun, Samantha M; Carapetis, Jonathan R; Kado, Joseph H; Reeves, Benjamin M; Remenyi, Boglarka; May, William; Wilson, Nigel J; Steer, Andrew C

2013-08-01

399

Using Graphs to Show Connections  

NSDL National Science Digital Library

The purpose of this resource is to show how graphs of GLOBE data over time show the interconnectedness of Earth's system components at the local level. Students visit a study site, where they observe and recall their existing knowledge of air, water, soil, and living things to make a list of interconnections among the four Earth system components. They make predictions about the effects of a change in a system, inferring ways these changes affect the characteristics of other related components.

The GLOBE Program, University Corporation for Atmospheric Research (UCAR)

2003-08-01

400

Impact of Duration of Mitral Regurgitation on Outcomes in Asymptomatic Patients With Myxomatous Mitral Valve Undergoing Exercise Stress Echocardiography  

PubMed Central

Background Significant mitral regurgitation (MR) typically occurs as holosystolic (HS) or mid?late systolic (MLS), with differences in volumetric impact on the left ventricle (LV). We sought to assess outcomes of degenerative MR patients undergoing exercise echocardiography, separated based on MR duration (MLS versus HS). Methods and Results We included 609 consecutive patients with ?III+myxomatous MR undergoing exercise echocardiography: HS (n=487) and MLS (n=122). MLS MR was defined as delayed appearance of MR signal during mid?late systole on continuous?wave Doppler while HS MR occurred throughout systole. Composite events of death and congestive heart failure were recorded. Compared to MLS MR, HS MR patients were older (60±14 versus 53±14 years), more were males (72% versus 53%), and had greater prevalence of atrial fibrillation (16% versus 7%; all P<0.01). HS MR patients had higher right ventricular systolic pressure (RVSP) at rest (33±11 versus 27±9 mm Hg), more flail leaflets (36% versus 6%), and a lower number of metabolic equivalents (METs) achieved (9.5±3 versus 10.5±3), compared to the MLS MR group (all P<0.05). There were 54 events during 7.1±3 years of follow?up. On step?wise multivariable analysis, HS versus MLS MR (HR 4.99 [1.21 to 20.14]), higher LV ejection fraction (hazard ratio [HR], 0.94 [0.89 to 0.98]), atrial fibrillation (HR, 2.59 [1.33 to 5.11]), higher RVSP (HR, 1.05 [1.03 to 1.09]), and higher percentage of age? and gender?predicted METs (HR, 0.98 [0.97 to 0.99]) were independently associated with adverse outcomes (all P<0.05). Conclusion In patients with ?III+myxomatous MR undergoing exercise echocardiography, holosystolic MR is associated with adverse outcomes, independent of other predictors. PMID:25672368

Naji, Peyman; Asfahan, Fadi; Barr, Tyler; Rodriguez, L. Leonardo; Grimm, Richard A.; Agarwal, Shikhar; Thomas, James D.; Gillinov, A. Marc; Mihaljevic, Tomislav; Griffin, Brian P.; Desai, Milind Y.

2015-01-01

401

Characterization of the left atrial vortex flow by two-dimensional transesophageal contrast echocardiography using particle image velocimetry.  

PubMed

This article is the first clinical investigation of the quantitative left atrial (LA) vortex flow by two-dimensional (2-D) transesophageal contrast echocardiography (2-D-TECE) using vector particle image velocimetry (PIV). The aims of this study were to assess the feasibility of LA vortex flow analysis and to characterize and quantify the LA vortex flow in controls and in patients with atrial fibrillation (AF). Thirty-five controls and 30 patients with AF underwent transesophageal contrast echocardiography. The velocity vector was estimated by particle image velocimetry. The morphology and pulsatility of the LA vortex flow were compared between the control and AF groups. In all patients, quantitative LA vortex flow analysis was feasible. In the control group, multiple, pulsatile, compact and elliptical-shaped vortices were seen in the periphery of the LA. These vortices were persistently maintained and vectors were directed toward the atrioventricular inflow. In the AF group, a large, merged, lower pulsatile and round-shaped vortex was observed in the center of the LA. In comparisons of vortex parameters, the relative strength was significantly lower in the AF group (1.624 ± 0.501 vs. 2.105 ± 0.226, p < 0.001). It is feasible to characterize and quantify the LA vortex flow by transesophageal contrast echocardiography in patients with AF, which offers a new method to obtain additional information on LA hemodynamics. The approach has the potential for early detection of the LA dysfunction and in decisions regarding treatment strategy and guiding anticoagulation treatment in patients with AF. PMID:23079000

Park, Kyu-Hwan; Son, Jang-Won; Park, Won-Jong; Lee, Sang-Hee; Kim, Ung; Park, Jong-Seon; Shin, Dong-Gu; Kim, Young-Jo; Choi, Jung-Hyun; Houle, Helene; Vannan, Mani A; Hong, Geu-Ru

2013-01-01

402

A rare type of double aortic arch diagnosed by echocardiography in an asymptomatic 9-year-old patient.  

PubMed

A case of double aortic arch with an atretic left arch distal to the origin of the left subclavian artery was suspected by echocardiography (ECHO) in an asymptomatic 9-year-old girl and confirmed by magnetic resonance imaging (MRI). The authors report their ECHO findings, which could be an important diagnostic tool for symptomatic patients because confusion exists in the literature regarding the differentiation of the aforementioned rare malformation from a right arch with mirror image branching. The authors support their ECHO proposal with an explanation based on the hypothetical double aortic arch plan set by Edwards. PMID:20204347

Trapali, Christina; Nika, Angeliki; Papaphylactou, Maria; Maria, Papaphylactou; Iacovidou, Nicoletta

2010-07-01

403

National Orange Show Photovoltaic Demonstration  

SciTech Connect

National Orange Show Photovoltaic Demonstration created a 400KW Photovoltaic self-generation plant at the National Orange Show Events Center (NOS). The NOS owns a 120-acre state fairground where it operates an events center and produces an annual citrus fair known as the Orange Show. The NOS governing board wanted to employ cost-saving programs for annual energy expenses. It is hoped the Photovoltaic program will result in overall savings for the NOS, help reduce the State's energy demands as relating to electrical power consumption, improve quality of life within the affected grid area as well as increase the energy efficiency of buildings at our venue. In addition, the potential to reduce operational expenses would have a tremendous effect on the ability of the NOS to service its community.

Dan Jimenez (NOS)Sheri Raborn, CPA (National Orange Show); Tom Baker (California Construction Authority)

2008-03-31

404

Diarrheal Disease in Show Swine  

E-print Network

D iarrhea is one of the most important problems in show pigs. It can occur at any time, from first obtaining a show pig through the last day of exhi- bition. It can become a chronic condition that persists for weeks. Diarrhea can be caused..., in itself, cause loose stools or diarrhea. If a pig is grow- ing well but has a chronically loose stool, reduce the pro- tein and/or increase fiber in the diet. If the stool does not firm up, there are probably other causes of diarrhea. Parasitic Causes...

Lawhorn, D. Bruce

2007-02-27

405

Hemodynamic Changes of the Middle Hepatic Vein in Patients with Pulmonary Hypertension Using Echocardiography  

PubMed Central

The aim of this study was to analyze the changes of the middle hepatic vein (MHV) spectra in patients with pulmonary hypertension (PH) caused by congenital heart disease (CHD) and determine the proper parameters of MHV to predict PH. Eighty patients with CHD were included, whose pulmonary artery pressure was measured via right heart catheterization, and the MHV spectra were detected via echocardiography. The peak value of velocity (V) and velocity time integral (VTI) of the waves, including S wave, D wave and A wave, were measured at the end of inspiration. The values of the MHV parameters that were predictive of PH were evaluated and their cut-off points were determined. Compared with the control group, V of S wave (S), VTI of S wave (SVTI), V of D wave (D), VTI of D wave (DVTI) decreased and V of A wave (A), VTI of A wave (AVTI), A/S, AVTI/SVTI, A/(S+D), AVTI/ (SVTI+DVTI) increased in the PH group. These differences were statistically significant (P<0.05). A correlation analysis determined that the ratios of A/S, A/(S+D), AVTI/(SVTI+DVTI) were positively correlated with pulmonary artery mean pressure (r=0.529,0.575,0.438,P<0.001). An ROC curve analysis determined that the diagnostic effect of A/(S+D) was superior to the other two parameters. On the ROC curve, when the ratio of A/(S+D) was 0.30, the sensitivity was 85.37% and specificity was 75.00% for predicting PH. The spectral parameters of MHV, including the ratios of A/S, A/(S+D) and AVTI/(SVTI+DVTI), increased with increasing pulmonary pressure in CHD patients. When the ratio of A/(S+D) was 0.30 in MHV spectra, it had sufficient sensitivity and specificity for diagnosing PH, and this method could be used as a new non-invasive complementary echocardiographic parameter for predicting PH. PMID:25821961

Yuan, Li Jun; Duan, Yun You; Hou, Ying; Zhou, Fang Ping

2015-01-01

406

Hemodynamic changes of the middle hepatic vein in patients with pulmonary hypertension using echocardiography.  

PubMed

The aim of this study was to analyze the changes of the middle hepatic vein (MHV) spectra in patients with pulmonary hypertension (PH) caused by congenital heart disease (CHD) and determine the proper parameters of MHV to predict PH. Eighty patients with CHD were included, whose pulmonary artery pressure was measured via right heart catheterization, and the MHV spectra were detected via echocardiography. The peak value of velocity (V) and velocity time integral (VTI) of the waves, including S wave, D wave and A wave, were measured at the end of inspiration. The values of the MHV parameters that were predictive of PH were evaluated and their cut-off points were determined. Compared with the control group, V of S wave (S), VTI of S wave (SVTI), V of D wave (D), VTI of D wave (DVTI) decreased and V of A wave (A), VTI of A wave (AVTI), A/S, AVTI/SVTI, A/(S+D), AVTI/ (SVTI+DVTI) increased in the PH group. These differences were statistically significant (P<0.05). A correlation analysis determined that the ratios of A/S, A/(S+D), AVTI/(SVTI+DVTI) were positively correlated with pulmonary artery mean pressure (r=0.529,0.575,0.438,P<0.001). An ROC curve analysis determined that the diagnostic effect of A/(S+D) was superior to the other two parameters. On the ROC curve, when the ratio of A/(S+D) was 0.30, the sensitivity was 85.37% and specificity was 75.00% for predicting PH. The spectral parameters of MHV, including the ratios of A/S, A/(S+D) and AVTI/(SVTI+DVTI), increased with increasing pulmonary pressure in CHD patients. When the ratio of A/(S+D) was 0.30 in MHV spectra, it had sufficient sensitivity and specificity for diagnosing PH, and this method could be used as a new non-invasive complementary echocardiographic parameter for predicting PH. PMID:25821961

Sun, Dan Dan; Hou, Chuan Ju; Yuan, Li Jun; Duan, Yun You; Hou, Ying; Zhou, Fang Ping

2015-01-01

407

Transesophageal echocardiography: an objective tool in defining maximum ventricular response to intravenous fluid therapy.  

PubMed

Ventricular preload is an important determinant of cardiac function, which is indirectly measured in the clinical setting by the pulmonary capillary wedge pressure (PCWP). Transesophageal echocardiography (TEE) is rapidly gaining acceptance as a monitor of cardiac function. Although it provides high-resolution images of cardiac structures, clinical assessment of ventricular preload using TEE has been subjective, since quantitative measurements have been difficult to perform in a timely fashion. Automated border detection (ABD) is a new technology used in conjunction with TEE that allows quantitative real-time, two-dimensional measurement of cavity areas. To determine whether enddiastolic area (EDA) measured by ABD can be used to determine an appropriate end point for intravenous fluid administration, nine mongrel dogs were studied. Anesthetized animals were hemorrhaged to achieve a central venous pressure of 0-5 mm Hg. Each animal was then given intravenous fluid (autologous blood followed by hetastarch) until a peak in thermodilution cardiac output (CO) was achieved. Measures of PCWP, EDA, CO, and left ventricular stroke work (LVSW) were obtained after each fluid bolus. Bivariate plots displaying administered volume versus CO, LVSW, and EDA revealed parallel curves for each of these variables with peaks evident at cumulative volumes of 50-55 mL/kg. Multiple regression with mixed model analysis of covariance was performed to determine the significance of EDA in relation to changes in CO and LVSW. Analysis was likewise performed comparing the relationship between PCWP and changes in CO or LVSW. A significant relationship was demonstrated when comparing EDA to changes in CO and LVSW (P = 0.03 and P < 0.0001, respectively). Similar analysis comparing PCWP to changes in CO and LVSW failed to demonstrate a significant relationship (P = 0.54 and P = 0.36, respectively). These data suggest that changes in EDA measured using TEE with ABD are related to trends in cardiac function and can suggest an appropriate end point for intravenous fluid administration as defined by maximum CO and LVSW. PCWP did not demonstrate a significant relationship to changes in CO and LVSW. PMID:8942577

Swenson, J D; Harkin, C; Pace, N L; Astle, K; Bailey, P

1996-12-01

408

Carotid artery ultrasound and echocardiography testing to lower the prevalence of Alzheimer's disease.  

PubMed

The use of two clinic office techniques, carotid artery ultrasound and echocardiography (CAUSE), to detect deficient brain blood flow delivery in the healthy, cognitively normal, older individual is proposed. Evidence indicates that persistent heart-to-brain blood flow deficit involving low cardiac output or low ejection fraction and carotid artery narrowing can promote cognitive impairment and that such impairment may lead to Alzheimer's disease (AD) or vascular dementia (VaD). A number of independent epidemiologic studies reported cardiovascular and cerebrovascular disease to be risk factors to AD and VaD. The clinical rationale for CAUSE is to detect and prevent progression of cognitive dysfunction in elderly persons and is based on the general understanding that mild cognitive impairment is a preclinical threshold to AD or VaD with high conversion rates to either dementia. The use of CAUSE is anticipated to prevent or attenuate, by appropriate clinical management, mild cognitive impairment arising from persistent brain hypoperfusion, a condition implicated in the promotion of cognitive impairment in the elderly and a common preclinical feature seen in AD and VaD. As detection of lowered cerebral perfusion from cardiac and carotid artery pathology is achieved using these cost-effective, noninvasive, and relatively accurate ultrasound procedures, a significant reduction in the number of new AD and VaD cases would be anticipated after appropriate patient treatment. In this context, a brief summary is presented outlining recent medical and surgical treatments that may improve cerebral blood flow insufficiency. The merit of CAUSE in screening and treating mentally healthy elderly persons who are identified as being at risk of cognitive decline is that it could blunt the soaring socioeconomic impact that will hammer the health care system of many nations by the mounting dementia prevalence rate expected in the next 25 years. A 5- year delay in the onset of AD could reduce the prevalence of AD by 50%. We are making preparations to test the merit of CAUSE in a clinical study of a cognitively healthy elderly population. PMID:19560690

de la Torre, Jack C

2009-01-01

409

Midterm Picnic ELI Talent Show  

E-print Network

Highlights Midterm Picnic ELI Talent Show Notes from the Office Birthdays Manners Grammar The the new ELI students. All ELI students, staff, and friends are invited to the Midterm/Welcome picnic Where: Broward Beach (Behind Broward and Yulee Halls, across 13th Street from the ELI). What to Bring

Pilyugin, Sergei S.

410

Producing Talent and Variety Shows.  

ERIC Educational Resources Information Center

Identifies key aspects of producing talent shows and outlines helpful hints for avoiding pitfalls and ensuring a smooth production. Presents suggestions concerning publicity, scheduling, and support personnel. Describes types of acts along with special needs and problems specific to each act. Includes a list of resources. (MJP)

Szabo, Chuck

1995-01-01

411

Undiagnosed interrupted aortic arch in a 59-year-old male patient with severe aortic valve stenosis: A case report and literature review  

PubMed Central

BACKGROUND Interrupted aortic arch (IAA) is defined by a lack of the luminal continuity between the ascending and descending thoracic aorta. It is a rare, severe congenital heart defect which without surgery is associated with high mortality in the neonatal period. The aims of this study were to present a case with IAA who was alive until the age of 59 years without any surgical intervention and to review the literatures that have presented IAA cases. CASE REPORT The patient was admitted with respiratory distress and pulmonary edema. Echocardiography showed the sever stenosis in aortic valve and sever left ventricular dysfunction. Cardiac catheterization and angiography confirmed interrupted aorta (type A). The descending thoracic aorta was supplied by extensive collateral vessels from the vertebrobasilar system down to the posterior chest wall and the spine. Surgical correction including coronary artery bypass graft and aortic valve replacement and repair of interruption of the aorta was performed. Three weeks later the patient was died due to uncontrollable gastrointestinal bleeding and hospital acquired pneumonia. We described diagnosis and management of our case. CONCLUSION This case was very interesting for us, because the patient had not been diagnosed until the recent presentation. Similar cases with this diagnosis do not reach adulthood, but our patient was alive up to 59 years of age. PMID:25258640

Mehrpooya, Maryam; Eskandari, Ramin; Salehi, Mehrdad; Shajirat, Zeinab; Golabchi, Allahyar; Satarzadeh, Roya; Zand-Parsa, Amir Farhang

2014-01-01

412

Left ventricular radial colour and longitudinal pulsed-wave tissue Doppler echocardiography in 39 healthy domestic pet rabbits.  

PubMed

This paper reports radial colour and longitudinal mitral annulus pulsed-wave tissue Doppler findings in a large cohort of healthy, adult pet rabbits. Thirty-nine rabbits (22 Dwarf Lops, 14 French Lops and three Alaskans) underwent conscious echocardiography. The median age of the rabbits was 22 months and the median weight was 2.8 kg (Dwarf Lop 2.4 kg/French Lop 6.0 kg). Adequate radial colour and longitudinal pulsed-wave tissue Doppler traces were obtained in 100% and 85% of cases, respectively. Most systolic tissue Doppler parameters were significantly higher in French Lops than in Dwarf Lops. Separation of mitral inflow diastolic waves was present in 40% of cases using conventional spectral Doppler and in >60% of cases using pulsed-wave tissue Doppler which could be beneficial when evaluating diastolic function in rabbits. This study can be used as a reference for normal echocardiographic tissue Doppler values for adult rabbits undergoing conscious echocardiography in clinical practice. PMID:25089025

Casamian-Sorrosal, Domingo; Saunders, Richard; Browne, William; Elliot, Sarah; Fonfara, Sonja

2014-10-01

413

Noninvasive aortic bloodflow by Pulsed Doppler Echocardiography (PDE) compared to cardiac output by the direct Fick procedure  

NASA Technical Reports Server (NTRS)

Left ventricular stroke volume was estimated from the systolic velocity integral in the ascending aorta by pulsed Doppler Echocardiography (PDE) and the cross sectional area of the aorta estimated by M mode echocardiography on 15 patients with coronary disease undergoing right catheterization for diagnostic purposes. Cardiac output was calculated from stroke volume and heart volume using the PDE method as well as the Fick procedure for comparison. The mean value for the cardiac output via the PDE method (4.42 L/min) was only 6% lower than for the cardiac output obtained from the Fick procedure (4.69 L/min) and the correlation between the two methods was excellent (r=0.967, p less than .01). The good agreement between the two methods demonstrates that the PDE technique offers a reliable noninvasive alternative for estimating cardiac output, requiring no active cooperation by the subject. It was concluded that the Doppler method is superior to the Fick method in that it provides beat by beat information on cardiac performance.

1980-01-01

414

The use of pocket-size imaging devices: a position statement of the European Association of Echocardiography.  

PubMed

Pocket-size imaging devices are a completely new type of echo machines which have recently reached the market. They are very cheap, smartphone-size hand-held echo machines with limited technical capabilities. The aim of this European Association of Echocardiography (EAE) position paper is to provide recommendations on the use of pocket-size imaging devices in the clinical arena by profiling the educational needs of potential users other than cardiologists experts in echo. EAE recommendations about pocket-size imaging devices can be summarized in: (1) pocket-size imaging devices do not provide a complete diagnostic echocardiographic examination. The range of indications for their use is therefore limited. (2) Imaging assessment with pocket-size imaging devices should be reported as part of the physical examination of the patient. Image data should be stored according to the applicable national rules for technical examinations. (3) With the exception of cardiologists who are certified for transthoracic echocardiography according to national legislation, specific training and certification is recommended for all users. The certification should be limited to the clinical questions that can potentially be answered by pocket-size devices. (4) The patient has to be informed that an examination with the current generation of pocket-size imaging devices does not replace a complete echocardiogram. PMID:21216764

Sicari, Rosa; Galderisi, Maurizio; Voigt, Jens-Uwe; Habib, Gilbert; Zamorano, Jose L; Lancellotti, Patrizio; Badano, Luigi P

2011-02-01

415

Rocks and Minerals Slide Show  

NSDL National Science Digital Library

This interactive slide show of common rocks and minerals allows students to choose from two sets of minerals and click on a thumbnail to see a larger photograph with a full description of the mineral including color, streak, hardness, cleavage/fracture, and chemical composition. Also included are its use and where it is found. The rocks are divided into igneous, sedimentary, and metamorphic and can be accessed in the same manner. They are described on the basis of crystal size and mineral composition as well as use.

416

What can Doppler wave forms of the left internal thoracic artery teach us? -The efficacy of apical transthoracic approach of Doppler echocardiography-.  

PubMed

The Doppler wave form along the proximal left internal thoracic artery (LITA), which is detected by the parasternal or suplaclavicular view, shows a different pattern from that of the distal side of the LITA due to the effect of blood pulsatility from the subclavian artery. We evaluated postoperative LITA function immediately after surgery with an apical approach of transthoracic pulsed Doppler echocardiography in 124 patients and compared its results with that of one month postoperative Doppler findings and graft angiogram. The LITA was effectively detected and good quality Doppler waveforms obtained in 120 (96.8%) patients. The LITA diameter was significantly enlarged in the first month after surgery compared with that of the postoperative early phase (1.99 0.31 vs. 1.71 0.72 mm, p<0.05). The diastolic peak velocity