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1

Exercise echocardiography in severe asymptomatic aortic stenosis.  

PubMed

The management of asymptomatic patients with severe aortic stenosis is challenging. Unfortunately, evaluation of symptoms such as dyspnoea remains subjective. The use of exercise echocardiography may help to predict major events in patients with asymptomatic severe aortic stenosis. This article explains how to perform the test and discusses which echocardiographic measurements should be obtained, focusing on the diagnostic and prognostic value of these measurements. An increase in mean transaortic pressure gradient >or= 18 mmHg predicts a worse prognosis in patients with severe aortic stenosis. The absence of left ventricular contractile reserve also has an important prognostic impact. Evaluation of filling pressures and looking for a worsening or a new mitral regurgitation are also part of the exam. Further studies are required to determine whether surgery should be recommended in the presence of an abnormal exercise echocardiogram in severe asymptomatic aortic stenosis. PMID:20656637

O'Connor, Kim; Lancellotti, Patrizio; Donal, Erwan; Piérard, Luc A

2010-04-01

2

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

3

[Silent severe tricuspid regurgitation: a study by Doppler echocardiography].  

PubMed

Sixty-eight patients with severe tricuspid regurgitation proven by right ventriculography were examined using pulsed and continuous wave Doppler echocardiography and color Doppler flow imaging. Among the 68 patients, there was no tricuspid regurgitant murmur in 16 (24%) in whom laminar regurgitant flow signals were demonstrated by pulsed Doppler echocardiography. The area in which laminar flow was detected ranged from 8 to 46 mm2 (mean 19.5 +/- 9.8 mm2). The peak velocities in patients without regurgitant murmurs as measured by continuous wave Doppler echocardiography ranged from 1.1 to 1.9 m/sec (mean: 1.61 +/- 0.21 m/sec). Laminar regurgitant flow signals were obtained in six; and turbulent regurgitant flow signals in 46 of 52 patients with tricuspid regurgitant murmurs, and their peak velocities ranged from 1.7 to 5.1 m/sec (2.80 +/- 0.78 m/sec). The peak velocities of the regurgitant flow signals in patients without tricuspid regurgitant murmurs were significantly lower than those in patients with regurgitant murmurs (p less than 0.01). In six patients with laminar regurgitant flow signals and regurgitant murmurs, the areas of laminar flow signals ranged from 3 to 12 mm2 (mean 7.0 +/- 3.5 mm2) and were smaller than those of patients without regurgitant murmurs (p less than 0.001). A characteristic candle flame pattern of regurgitant flow signals was observed in all patients without murmurs. Thus, the absence of a tricuspid regurgitant murmur results from laminar regurgitant flow signals of low velocity and this is characterized by a candle flame pattern using color Doppler flow imaging. PMID:2810038

Yoshida, K; Yoshikawa, J; Akasaka, T; Shakudo, M; Takao, S; Shiratori, K; Okumachi, F; Koizumi, K; Kato, H; Fukaya, T

1989-03-01

4

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

PubMed Central

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

Henri, Christine

2014-01-01

5

Comparative definitions for moderate-severe ischemia in stress nuclear, echocardiography, and magnetic resonance imaging.  

PubMed

The lack of standardized reporting of the magnitude of ischemia on noninvasive imaging contributes to variability in translating the severity of ischemia across stress imaging modalities. We identified the risk of coronary artery disease (CAD) death or myocardial infarction (MI) associated with ?10% ischemic myocardium on stress nuclear imaging as the risk threshold for stress echocardiography and cardiac magnetic resonance. A narrative review revealed that ?10% ischemic myocardium on stress nuclear imaging was associated with a median rate of CAD death or MI of 4.9%/year (interquartile range: 3.75% to 5.3%). For stress echocardiography, ?3 newly dysfunctional segments portend a median rate of CAD death or MI of 4.5%/year (interquartile range: 3.8% to 5.9%). Although imprecisely delineated, moderate-severe ischemia on cardiac magnetic resonance may be indicated by ?4 of 32 stress perfusion defects or ?3 dobutamine-induced dysfunctional segments. Risk-based thresholds can define equivalent amounts of ischemia across the stress imaging modalities, which will help to translate a common understanding of patient risk on which to guide subsequent management decisions. PMID:24925328

Shaw, Leslee J; Berman, Daniel S; Picard, Michael H; Friedrich, Matthias G; Kwong, Raymond Y; Stone, Gregg W; Senior, Roxy; Min, James K; Hachamovitch, Rory; Scherrer-Crosbie, Marielle; Mieres, Jennifer H; Marwick, Thomas H; Phillips, Lawrence M; Chaudhry, Farooq A; Pellikka, Patricia A; Slomka, Piotr; Arai, Andrew E; Iskandrian, Ami E; Bateman, Timothy M; Heller, Gary V; Miller, Todd D; Nagel, Eike; Goyal, Abhinav; Borges-Neto, Salvador; Boden, William E; Reynolds, Harmony R; Hochman, Judith S; Maron, David J; Douglas, Pamela S

2014-06-01

6

Three dimensional echocardiography documents haemodynamic improvement by biventricular pacing in patients with severe heart failure  

Microsoft Academic Search

OBJECTIVESTo quantify the short term haemodynamic effects of biventricular pacing in patients with heart failure and left bundle branch block by using three dimensional echocardiography.DESIGNThree dimensional echocardiography was performed in 15 consecutive heart failure patients (New York Heart Association functional class III or IV) with an implanted biventricular pacing system. Six minute walk tests were performed to investigate the effect

W Y Kim; P Søgaard; P T Mortensen; H Kjærulf Jensen; A Kirstein Pedersen; B Ø Kristensen; H Egeblad

2001-01-01

7

[Transesophageal echocardiography in the assessment of the severity of aortic valve stenosis].  

PubMed

The aortic valve orifice area was measured in 95 patients with valvular aortic stenosis by means of transthoracic and transesophageal echocardiography. These results were compared to invasively determined measurements. The aortic-valve orifice area could be measured by transesophageal echocardiography in 87 patients (92%), and in 13 patients (14%) by the transthoracic approach. A comparison of the valve-orifice area determined by transthoracic and transesophageal echocardiography revealed a correlation coefficient of r = 0.91. There was also a good agreement when the aortic-valve orifice area determined by transesophageal echocardiography was compared to the invasive findings (r = 0.82; p less than 0.001). The morphology of the aortic valve could be better delineated with the transesophageal approach. PMID:2238770

Kasper, W; Geibel, A; Hofmann, T; Meinertz, T; Just, H

1990-09-01

8

Utility of transthoracic echocardiography to estimate severity of right ventricular dysfunction: an MRI comparison study.  

PubMed

Prognostic implications of severe right ventricular (RV) dysfunction are difficult to assess because of limitations in functional characterization using standard echocardiography (TTE) and the cost and availability of options such as MRI. We sought to determine how assessments of RV dysfunction via TTE correlate with RV ejection fraction (EF) by MRI. Patients undergoing MRI and TTE within 21 days of one another were included. Left ventricular (LV) and RV EF were recorded from MRI and subjective assessment of RV function (normal, mild, moderate, or severe dysfunction), right ventricular index of myocardial performance (RIMP), and right ventricular systolic pressure (RVSP) were recorded from TTE. Patients were considered to have significant RV dysfunction if EF ? 35% on MRI and normal function if EF ? 45%. A total of 474 patients were included (age 50 ± 12, 57% male). Of these, 363 (76.6%) had normal function, 54 (11.4%) had mild dysfunction, 41 (8.6%) had moderate dysfunction, and 16 (3.4%) had severe dysfunction on TTE. Moderate or severe dysfunction had good sensitivity (80%) and specificity (97%) for RV EF ? 35%. Furthermore, RIMP > 0.70 and RVSP > 70 mm Hg were very specific for RV EF ? 35% (sensitivity = 29%, 22%, respectively; specificity = 98%, 99%, respectively). Specificity and sensitivity of TTE assessments did not change if LV function or disease indication was considered. A subjective assessment of moderate to severe RV dysfunction on TTE compares favorably with quantitative MRI assessment of the RV EF. Further study is needed to evaluate whether this comparability is true across institutions. PMID:21279688

Kapa, Suraj; Elias, Richard; Connolly, Heidi J; Syed, Imran S; Asirvatham, Samuel J

2012-02-01

9

INTRODUCTION Morphology and physiology of the gastrointestinal tract show several  

E-print Network

3981 INTRODUCTION Morphology and physiology of the gastrointestinal tract show several adaptations digestive capacity could allow some energy and nutrients to escape the gastrointestinal tract unutilized

Mladenoff, David

10

Prevalence and severity of paravalvular regurgitation in the Artificial Valve Endocarditis Reduction Trial (AVERT) echocardiography study  

Microsoft Academic Search

OBJECTIVES The purpose of this study was to determine the prevalence and severity of paravalvular regurgitation (PVR) in the Artificial Valve Endocarditis Reduction Trial (AVERT) cohort. BACKGROUND The initial AVERT cohort consisted of 807 patients randomized to receive either a Silzone-coated prosthetic valve or a conventional prosthetic valve; early clinical reports showed higher rates of valve explant caused by PVR

Victor G. Dávila-Román; Alan D. Waggoner; Elizabeth D. Kennard; Richard Holubkov; W. R. Eric Jamieson; Lars Englberger; Thierry P. Carrel; Hartzell V. Schaff

2004-01-01

11

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

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

Oesophageal echocardiography.  

PubMed

The diagnostic value of oesophageal echocardiography is most striking in patients in whom precordial studies are of inadequate quality or fail to establish a definitive diagnosis. Oesophageal studies have excellent image quality, can be completed within 10 minutes without complications and, in most instances, enables the clinical question to be answered. In 50 patients referred for suspected thoracic aorta pathology, oesophageal echocardiography correctly excluded or diagnosed the type of aortic dissection, aortic aneurysm or the site of coarctation. Of 35 patients referred with suspected infective endocarditis, oesophageal echocardiography revealed complications in 18 patients, including vegetation, mycotic aneurysm, abscess or chordal rupture. Oesophageal echocardiography is extremely helpful to visualize intracardiac mass lesions. In 27 patients with a history of systemic or pulmonary embolism, the technique confirmed the presence, size and position of a mass lesion in 11 patients. Oesophageal color Doppler flow imaging further expands the diagnostic capabilities, particularly in patients with mitral valve prosthesis. Our experience indicates that oesophageal echocardiography significantly extends the diagnostic potential of echocardiography. Detailed knowledge of cardiothoracic anatomy and its pathologic sequelae is, however, a prerequisite for the efficient and safe application of this method. PMID:3323333

Gussenhoven, E J; Taams, M A; Roelandt, J; Bom, K; Honkoop, J; de Jong, N; Ligtvoet, K M

1987-01-01

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

Transoesophageal Echocardiography Related Complications  

PubMed Central

Summary The application of transesophageal echocardiography (TEE) has been continuously increasing over past several decades. It is usually considered a very safe diagnostic and monitoring device. Though the complications are rare, but these complications must be known to the operators performing TEE. The goal of this article is to encapsulate the potential complications associated with TEE. The complications are primarily related to gastrointestinal, cardiovascular and respiratory systems along with some miscellaneous problems related to probe insertion, drugs and inexperience of the operator. Strategies for the prevention of these complications are also analyzed in order to avoid the risk. PMID:20640107

Mathur, S K; Singh, Pooja

2009-01-01

16

American Society of Echocardiography  

MedlinePLUS

American Society of Echocardiography Join Ase Log In About About ASE Board of Directors Committees and Councils Industry Roundtable ... Global Choosing Wisely® Partner Fellow of the American Society of Echocardiography (FASE) Education Annual Meeting Live Courses ...

17

Primary lung tumour visualised by transthoracic echocardiography  

PubMed Central

We present images of a rare case where a primary lung tumour was visualised by transthoracic echocardiography. The patient was a 78-year-old male where Chest X-ray had revealed a tumour-suspected structure in the left lung. Both transthoracic echocardiography and combined PET/CT images showed a large tumour located close to the heart. Fine-needle biopsy showed non-small cell lung cancer. PMID:19087342

Dencker, Magnus; Cronberg, Carin; Damm, Sabine; Valind, Sven; Wadbo, Monica

2008-01-01

18

Human bronchial smooth muscle cell lines show a hypertrophic phenotype typical of severe asthma.  

PubMed

We developed clonal cell lines of human bronchial smooth muscle origin by retroviral transduction of temperature-sensitive simian virus 40 large tumor (T) antigen. These cells show increased growth potential at 33 degrees C, but on shift to the nonpermissive temperature (39 degrees C), they show diminished or arrested growth. In addition to the expected reduction in the level of large T antigen, cells shifted to 39 degrees C show increased expression of the cyclin-dependent kinase inhibitor p21(Waf1/Cip1), characteristic of cells arrested in G1 of the cell cycle. Shifted cells undergo a process of cell hypertrophy, as demonstrated by increased time of flight and forward scatter, as well as increased expression of the contractile proteins alpha-smooth muscle actin, myosin light chain kinase, and SM22. Changes in contractile protein expression were regulated primarily in a posttranscriptional manner. Phosphatidylinositol 3-kinase activity was increased in shifted cells, and chemical inhibition of phosphatidylinositol 3-kinase attenuated alpha-actin and myosin light-chain kinase expression. We have developed clonal cell lines of human bronchial smooth muscle origin that may be useful for the study of airway smooth muscle biology. Furthermore, we demonstrate that arrest of airway smooth muscle cell cycle traversal can induce cellular hypertrophy, which parallels changes observed in the airways of patients with severe asthma. PMID:14693670

Zhou, Limei; Li, Jing; Goldsmith, Adam M; Newcomb, Dawn C; Giannola, Diane M; Vosk, Robert G; Eves, Eva M; Rosner, Marsha R; Solway, Julian; Hershenson, Marc B

2004-03-15

19

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

20

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

21

Multiplane Transesophageal Echocardiography for Multiclinical Dilemmas  

PubMed Central

Introduction Transesophageal echocardiography was introduced 4 decades ago. Its use have had very limited clinical indication. Now it has become very useful clinical tool. Indications for its use are almost as indications for transthoracic echocardiography, especially to assess deeper cardiovascular structures. Transesophageal echocardiography is semi-invasive examination with small number of complications. Aim of the study To determine usefulness of transesophageal echocardiography in various cardiac conditions based in our experience. Also to encourage use of transesophageal echocardiography as reliable examination. Methods All of the patients signed a Term of Free Informed Consent, approved from Ethics Committee. We enrolled 425 patients who have done TEE in last 5 years (2006-2010) by authors. Medical history and Clinical evaluation was carefully performed by expert cardiologists. Procedures were performed in two different centers using machines, PHILIPS iE33 and Siemens accuson CV 70, with equipment attached to a multi frequency 2.5 to 3.5 MHz for TTE and 7.0 MHz for TEE multiplane transducer. TEE were performed and images were obtained according to the standard recommandations. Results The results were analyzed by a standard method of descriptive statistics using Pivot Table of Excel Office 2007. Results. We have analyzed 425 transesophageal echocardiography . The examination of the thoracic aorta in severe hypertension patients was conducted in 96 cases; atrial fibrillation in 118; aortic dissection 49 cases, aortic stenosis was evaluated in 28 cases; finding of source of emboli 36 cases; suspicion for aneurysm of the thoracic aorta in 14 cases, 11 cases with suspected endocarditis; the type of intervention for mitral valve was evaluated in 28 cases. Interatrial septum abnormalities 37 cases; and miscellaneous 18 cases. No minor or mayor complications happened. Conlusion Transesophageal echocardiography can elucidate many dubious serious conditions immediately after it is performed. So, we think that transesophageal echocardiography is very useful tool in everyday clinical use, almost without complications if it is done correctly. PMID:23408794

Kamberi, Lulzim S.; Gorani, Daut R.; Citaku, Hajdin R.; Selmani, Hamza H.; Beqiri, Arton I.; Mustafai, Ardian I.

2011-01-01

22

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

23

Inverted Takotsubo Cardiomyopathy Induced by Dobutamine Stress Echocardiography with Atypical Presentation  

PubMed Central

A 48-year-old woman was scheduled by our lab to perform a standard dobutamine/atropine stress echocardiogram. During the test, the patient referred to a slight chest discomfort and developed a progressive left ventricle akinesia of all midbasal LV segments, thus mimicking a midbasal ballooning. ECG persisted without significant abnormalities and with no raise of Troponin I. Coronary angiography showed normal coronary arteries and ventriculography a severe EF reduction and apical hypercontractility. Echocardiography showed a progressive improvement with a complete recovery 48 hours later. This is a rare case of inverted takotsubo syndrome induced by dobutamine stress echocardiography that occurred with atypical presentation. PMID:24826217

Cadeddu, Christian; Nocco, Silvio; Cadeddu, Fabio; Deidda, Martino; Bassareo, Pierpaolo; Serra, Alessandra; Piga, Mario; Mercuro, Giuseppe

2011-01-01

24

Three-dimensional echocardiography in valve disease  

PubMed Central

This review covers the role of three-dimensional (3D) echocardiography in the diagnosis of heart valve disease. Several factors have contributed to the evolution of this technique, which is currently a simple and routine method: rapid evolution in probe and computer technologies, demonstration that 3D data sets allowed more complete and accurate evaluation of cardiac structures, emerging clinical experience indicating the strong potential particularly in valve diseases, volume and function of the two ventricle measurements and several other fields. This report will review current and future applications of 3D echocardiography in mitral, aortic and tricuspid valve diseases underlying both qualitative (morphologic) and quantitative advantages of this technique. PMID:21977273

COLOMBO, CHIARA; TAMBORINI, GLORIA; PEPI, MAURO; ALIMENTO, MARINA; FIORENTINI, CESARE

2007-01-01

25

Advanced Three-Dimensional Echocardiography.  

E-print Network

??abstract__Abstract__ During the development of echocardiography, 3D echocardiography imaging represents a major innovation in cardiovascular ultrasound (Figure 1). Advancements in computer and transducer technologies permit… (more)

B. Ren (Ben)

2014-01-01

26

Safety of ultrasound contrast agents in stress echocardiography.  

PubMed

Definity and Optison are perflutren-based ultrasound contrast agents used in echocardiography. United States Food and Drug Administration warnings regarding serious cardiopulmonary reactions and death after Definity administration highlighted the limited safety data in patients who undergo contrast stress echocardiography. From 1998 and 2007, 2,022 patients underwent dobutamine stress echocardiography and 2,764 underwent exercise stress echocardiography with contrast at the Cleveland Clinic. The echocardiographic database, patient records, and the Social Security Death Index were reviewed for the timing and cause of death, severe adverse events, arrhythmias, and symptoms. Complication rates for contrast dobutamine stress echocardiography and exercise stress echocardiography were compared with those in a control group of 5,012 patients matched for test year and type who did not receive contrast. Ninety-five percent of studies were performed in outpatients. There were no differences in the rates of severe adverse events (0.19% vs 0.17%, p = 0.7), death within 24 hours (0% vs 0.04%, p = 0.1), cardiac arrest (0.04% vs 0.04%, p = 0.96), and sustained ventricular tachycardia (0.2% vs 0.1%, p = 0.32) between patients receiving and not receiving intravenous contrast, respectively. In conclusion, severe adverse reactions to intravenous contrast agents during stress echocardiography are uncommon. Contrast use does not add to the baseline risk for severe adverse events in patients who undergo stress echocardiography. PMID:18940305

Gabriel, Ruvin S; Smyth, Yvonne M; Menon, Venu; Klein, Allan L; Grimm, Richard A; Thomas, James D; Sabik, Ellen Mayer

2008-11-01

27

Review of the climate science for severe convective storms, extreme precipitation, hurricanes and typhoons, and severe snowstorms and ice storms shows that the ability to  

E-print Network

and typhoons, and severe snowstorms and ice storms shows that the ability to detect and attribute trends varies thunderstorms), 2) extreme precipitation, 3) hurri- canes and typhoons, and 4) severe snowstorms and ice stormsReview of the climate science for severe convective storms, extreme precipitation, hurricanes

Kossin, James P.

28

Progesterone Treatment Shows Benefit in a Pediatric Model of Moderate to Severe Bilateral Brain Injury  

PubMed Central

Purpose Controlled cortical impact (CCI) models in adult and aged Sprague-Dawley (SD) rats have been used extensively to study medial prefrontal cortex (mPFC) injury and the effects of post-injury progesterone treatment, but the hormone's effects after traumatic brain injury (TBI) in juvenile animals have not been determined. In the present proof-of-concept study we investigated whether progesterone had neuroprotective effects in a pediatric model of moderate to severe bilateral brain injury. Methods Twenty-eight-day old (PND 28) male Sprague Dawley rats received sham (n?=?24) or CCI (n?=?47) injury and were given progesterone (4, 8, or 16 mg/kg per 100 g body weight) or vehicle injections on post-injury days (PID) 1–7, subjected to behavioral testing from PID 9–27, and analyzed for lesion size at PID 28. Results The 8 and 16 mg/kg doses of progesterone were observed to be most beneficial in reducing the effect of CCI on lesion size and behavior in PND 28 male SD rats. Conclusion Our findings suggest that a midline CCI injury to the frontal cortex will reliably produce a moderate TBI comparable to what is seen in the adult male rat and that progesterone can ameliorate the injury-induced deficits. PMID:24489882

Geddes, Rastafa I.; Sribnick, Eric A.; Sayeed, Iqbal; Stein, Donald G.

2014-01-01

29

Stress Echocardiography in Hyperthyroidism  

Microsoft Academic Search

Exertion symptoms occur frequently in subjects with hyperthy- roidism. Using stress echocardiography, exercise capacity and global left ventricular function can be assessed noninvasively. To evaluate stress-induced changes in cardiovascular function, 42 patients with untreated thyrotoxicosis were examined using exercise echocardiog- raphy. Studies were performed during hyperthyroidism, after treat- ment with propranolol, and after restoration of euthyroidism. Twenty- two healthy subjects

GEORGE J. KAHALY; STEPHAN WAGNER; JANA NIESWANDT; SUSANNE MOHR-KAHALY; THOMAS J. RYAN

2010-01-01

30

Figure 1. HomeWindow showing the energy usage of several monitors, displays, and computers with colored  

E-print Network

from washing machines, domestic robots, televisions, and lights, showing the camera's imagesFigure 1. HomeWindow showing the energy usage of several monitors, displays, and computers with colored auras. Red is high usage while green is low usage. HomeWindow: An Augmented Reality Domestic

Greenberg, Saul

31

Delayed reactions to drugs show levels of perforin, granzyme B, and Fas-L to be related to disease severity  

Microsoft Academic Search

Background: Drugs can induce different immunologic reactions; T-cell mediated responses produce the most severe reactions. Although in vitro studies show that T cells recognize drugs or their metabolites and induce an effector cytotoxic response, direct in vivo evidence of involvement is lacking. T lymphocytes produce cytotoxic markers that are responsible for 2 major pathways to cell death: granule-mediated exocytosis (perforin

Sinforiano J. Posadas; Antonia Padial; Maria J. Torres; Cristobalina Mayorga; Laura Leyva; Elena Sanchez; Javier Alvarez; Antonino Romano; Carlos Juarez; Miguel Blanca

2002-01-01

32

Contrast echocardiography 1996. A review.  

PubMed Central

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

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

1996-01-01

33

Nuclear Magnetic Resonance Structure Shows that the Severe Acute Respiratory Syndrome Coronavirus-Unique Domain Contains a Macrodomain Fold?  

PubMed Central

The nuclear magnetic resonance (NMR) structure of a central segment of the previously annotated severe acute respiratory syndrome (SARS)-unique domain (SUD-M, for “middle of the SARS-unique domain”) in SARS coronavirus (SARS-CoV) nonstructural protein 3 (nsp3) has been determined. SUD-M(513-651) exhibits a macrodomain fold containing the nsp3 residues 528 to 648, and there is a flexibly extended N-terminal tail with the residues 513 to 527 and a C-terminal flexible tail of residues 649 to 651. As a follow-up to this initial result, we also solved the structure of a construct representing only the globular domain of residues 527 to 651 [SUD-M(527-651)]. NMR chemical shift perturbation experiments showed that SUD-M(527-651) binds single-stranded poly(A) and identified the contact area with this RNA on the protein surface, and electrophoretic mobility shift assays then confirmed that SUD-M has higher affinity for purine bases than for pyrimidine bases. In a further search for clues to the function, we found that SUD-M(527-651) has the closest three-dimensional structure homology with another domain of nsp3, the ADP-ribose-1"-phosphatase nsp3b, although the two proteins share only 5% sequence identity in the homologous sequence regions. SUD-M(527-651) also shows three-dimensional structure homology with several helicases and nucleoside triphosphate-binding proteins, but it does not contain the motifs of catalytic residues found in these structural homologues. The combined results from NMR screening of potential substrates and the structure-based homology studies now form a basis for more focused investigations on the role of the SARS-unique domain in viral infection. PMID:19052085

Chatterjee, Amarnath; Johnson, Margaret A.; Serrano, Pedro; Pedrini, Bill; Joseph, Jeremiah S.; Neuman, Benjamin W.; Saikatendu, Kumar; Buchmeier, Michael J.; Kuhn, Peter; Wuthrich, Kurt

2009-01-01

34

Contrast echocardiography for assessment of left ventricular thrombi.  

PubMed

The diagnosis of intracardiac thrombi remains clinically relevant, with associated risks of systemic embolization and implications for antithrombotic management. Intravenously injected ultrasound contrast agents, composed of microbubbles smaller than red blood cells, have become established essential adjunctive tools for performance of state-of-the-art echocardiography, providing important information on cardiac structure and function. Despite advances in other imaging modalities, echocardiography remains the initial tool for diagnosis and risk stratification in patients predisposed to developing cardiac thrombi. Ultrasound contrast agents are approved for left ventricular (LV) opacification and endocardial border definition. Additionally, the use of contrast echocardiography facilitates LV thrombus detection by providing contrast opacification within the cardiac chambers to clearly show the "filling defect" of an intracardiac thrombus. Furthermore, contrast perfusion echocardiography can provide an assessment of the tissue characteristics of LV masses suspicious for intracardiac thrombi and, by differentiating an avascular thrombus from a tumor, results in improved diagnostic performance of echocardiography. This article presents a clinical vignette highlighting the sound judgment of using contrast echocardiography to aid in the diagnosis of LV thrombi and will review recent advances in imaging modalities for intracardiac thrombus detection. PMID:25063398

Abdelmoneim, Sahar S; Pellikka, Patricia A; Mulvagh, Sharon L

2014-08-01

35

[Hypertrophic cardiomyopathy. Data from Doppler echocardiography].  

PubMed

Hypertrophic cardiomyopathy (HCM) often involves the interventricular septum in the absence of any other cardiac or systemic abnormality capable of explaining this hypertrophy. M mode echocardiography shows septal hypertrophy and a posterior left ventricular wall of normal thickness. Two-dimensional echocardiography gives a better idea of the spatial distribution of the hypertrophy, especially in the short axis parasternal views. Obstruction to left ventricular ejection is another feature of this condition but presence of the obstruction remains a subject of controversy. Doppler studies give easy access to the changes in intraventricular hemodynamics and thereby contribute to fueling the controversy between supporters of intraventricular obstruction and those who prone the theory of hypercontractility. Color coded Doppler enables visualisation of the acceleration of blood flow in the left ventricular outflow tract and the demonstration of mitral regurgitation, which is always present in HCM with obstruction. The echocardiographic evaluation has been facilitated by the recent introduction of transesophageal probes. Doppler studies of mitral blood flow also enable evaluation of left ventricular diastolic function. The evaluation of left ventricular relaxation is often difficult and inaccurate in patients with supraventricular arrhythmias, intraventricular conduction defects or mitral regurgitation. Nevertheless, Doppler echocardiography remains the most reliable and useful method of evaluating HCM. PMID:2114836

Dubourg, O; Delorme, G; Hardy, A; Bourdarias, J P

1990-05-01

36

Physical Activity in the Life of a Woman with Severe Cerebral Palsy: Showing Competence and Being Socially Connected  

ERIC Educational Resources Information Center

We used a life-history approach to investigate the meanings and experiences of physical activity in the life of a 25-year-old woman with severe cerebral palsy (Amy). Amy and her mother were interviewed about Amy's life and her involvement in physical activity. The conversation was audio-recorded and transcribed verbatim. We interpreted Amy's story…

Gaskin, Cadeyrn J.; Andersen, Mark B.; Morris, Tony

2009-01-01

37

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.

Jone, Pei-Ni; Ivy, D. Dunbar

2014-01-01

38

Assessment of electrocardiography, echocardiography, and heart rate variability in dynamic and static type athletes  

PubMed Central

Background: Over the last two decades, morphological cardiac changes induced by athletic conditioning have been of great interest. Therefore, several studies have been orchestrated to delineate electrocardiography (ECG), echocardiography, and heart rate variability (HRV) findings in athletes. Purpose: To assess the ECG, echocardiography, and HRV in a group of dynamic and static type athletes. Methods: Fifty professional athletes (20 static and 30 dynamic exercise athletes) and 50 healthy nonathletes (control group) were recruited. Standard 12-lead ECG and transthoracic echocardiography was performed on all athletes and the control group. Through echocardiography, variables including left ventricular (LV) end-diastolic/systolic diameter, LV mass, and left atrial volume index were measured. In addition, both the athletes and the control group underwent ECG Holter monitoring for 15 minutes and several parameters related to HRV (time and frequency domain) were recorded. Results: The most common ECG abnormalities among the athletes were sinus bradycardia and incomplete right bundle branch block. LV end-diastolic diameter and left atrial volume index were significantly greater in the dynamic athletes (P < 0.001). LV end-systolic diameter was significantly lower in the static group (P < 0.001). LV mass of the dynamic and static athletes was significantly greater than that of the controls (P < 0.001). Among the ECG Holter monitoring findings, the dynamic athletes had lower systolic blood pressure than the controls (P = 0.01). Heart rate was lowest in the control group (P < 0.001). Conclusion: The most common ECG abnormalities among adolescent Iranian athletes were sinus bradycardia and incomplete right bundle branch block. Static exercise seemed to reduce LV end-systolic diameter, while dynamic exercise resulted in increased LV end-diastolic diameter and left atrial volume index. Additionally, Iranian athletes showed no differences in HRV parameters, excluding heart rate and systolic blood pressure, compared with the nonathletes. PMID:22924010

Toufan, Mehrnoush; Kazemi, Babak; Akbarzadeh, Fariborz; Ataei, Amin; Khalili, Majid

2012-01-01

39

Contrast echocardiography in Canada: Canadian Cardiovascular Society/Canadian Society of Echocardiography position paper  

PubMed Central

As an adjunct to transthoracic, transesophageal and stress echocardiography, contrast echocardiography (CE) improves the diagnostic accuracy of technically suboptimal studies when used in conjunction with harmonic imaging. Intravenous ultrasound contrast agents are indicated for left ventricular (LV) opacification and improvement of LV endocardial border delineation in patients with suboptimal acoustic windows. Demonstrated benefits of CE include improvement in the accuracy of LV measurements, regional wall motion assessment, evaluation of noncompaction cardiomyopathy, thrombus detection, Doppler signal enhancement and conjunctive use with stress echocardiography. Studies have shown the value of CE in the assessment and quantification of myocardial perfusion, and recent clinical trials have suggested a role for contrast perfusion imaging in the stratification of patients with suspected coronary artery disease. While it adds some time and cost to the echocardiographic study, CE frequently obviates the need for additional specialized, expensive and less accessible cardiac investigations, and allows for prompt and optimal subsequent patient management. Despite its proven advantages, CE is presently underused in Canada, and this situation will, unfortunately, not improve until several barriers to its use are overcome. Resolving these important hurdles is vital to the future of CE and to its eventual implementation into clinical practice of promising contrast-based diagnostic and therapeutic applications, including the assessment of perfusion by myocardial CE. PMID:17440639

Honos, George; Amyot, Robert; Choy, Jonathan; Leong-Poi, Howard; Schnell, Greg; Yu, Eric

2007-01-01

40

Severe SMA mice show organ impairment that cannot be rescued by therapy with the HDACi JNJ-26481585  

PubMed Central

Spinal muscular atrophy (SMA) is the leading genetic cause of early childhood death worldwide and no therapy is available today. Many drugs, especially histone deacetylase inhibitors (HDACi), increase SMN levels. As all HDACi tested so far only mildly ameliorate the SMA phenotype or are unsuitable for use in humans, there is still need to identify more potent drugs. Here, we assessed the therapeutic power of the pan-HDACi JNJ-26481585 for SMA, which is currently used in various clinical cancer trials. When administered for 64?h at 100?n?, JNJ-26481585 upregulated SMN levels in SMA fibroblast cell lines, including those from non-responders to valproic acid. Oral treatment of Taiwanese SMA mice and control littermates starting at P0 showed no overt extension of lifespan, despite mild improvements in motor abilities and weight progression. Many treated and untreated animals showed a very rapid decline or unexpected sudden death. We performed exploratory autopsy and histological assessment at different disease stages and found consistent abnormalities in the intestine, heart and lung and skeletal muscle vasculature of SMA animals, which were not prevented by JNJ-26481585 treatment. Interestingly, some of these features may be only indirectly caused by ?-motoneuron function loss but may be major life-limiting factors in the course of disease. A better understanding of – primary or secondary – non-neuromuscular organ involvement in SMA patients may improve standard of care and may lead to reassessment of how to investigate SMA patients clinically. PMID:23073311

Schreml, Julia; Riessland, Markus; Paterno, Mario; Garbes, Lutz; Rossbach, Kristina; Ackermann, Bastian; Kramer, Jan; Somers, Eilidh; Parson, Simon H; Heller, Raoul; Berkessel, Albrecht; Sterner-Kock, Anja; Wirth, Brunhilde

2013-01-01

41

Preoperative assessment of cor triatriatum in an adult by dynamic three dimensional echocardiography was more informative than transoesophageal echocardiography or magnetic resonance imaging.  

PubMed Central

Classic cor triatriatum is rarely found in adults. Preoperative assessment of classic cor triatriatum in a 22 year old man without symptoms by three dimensional echocardiography was more informative than transoesophageal echocardiography or magnetic resonance imaging, which both showed only a small hole in the membrane separating the accessory atrium from the true left atrium. The size of the hole indicated a strong likelihood that symptoms would develop in this patient. Dynamic three dimensional echocardiography, however, showed a long wide hole in the separating membrane. This finding was consistent with the absence of symptoms in this patient. Symptom free patients with moderate obstruction do not need early surgical correction. Images PMID:7818973

Bartel, T; Muller, S; Geibel, A

1994-01-01

42

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

43

Echocardiography in the intensive care unit.  

PubMed

As ultrasound technology improves and ultrasound availability increases, echocardiography utilization is growing within intensive care units. Although not replacing the often-needed comprehensive echocardiographic evaluation, limited bedside echocardiography promises to provide intensivists with enhanced diagnostic ability and improved hemodynamic understanding of individual patients. Routine and emergency echocardiography within the intensive care unit focuses on identifying and optimizing medically treatable conditions in a timely manner. Methods for such goal-directed assessments are presented. PMID:21719547

Field, Larry C; Guldan, George J; Finley, Alan C

2011-01-01

44

Transesophageal Echocardiography for Quantifying Size of Patent Foramen Ovale in Patients With Cryptogenic Cerebrovascular Events  

Microsoft Academic Search

Background and Purpose—Patent foramen ovale (PFO) is a risk factor for paradoxical embolism, and severe shunting and wide opening of PFO are risk factors for severe and recurrent cerebrovascular events. Neither contrast echocardiography nor 2-dimensional (2D) measurement of PFO size have been validated or compared with invasive balloon sizing. Methods—We performed transesophageal echocardiography (TEE) in 100 patients with cryptogenic stroke

Herwig W. Schuchlenz; Wolfgang Weihs; Albrecht Beitzke; Jörg-Ingolf Stein; Andreas Gamillscheg; Peter Rehak

2010-01-01

45

The Safety of Contrast Echocardiography: Report of the Committee on Contrast Echocardiography for the American Society of Echocardiography  

NASA Technical Reports Server (NTRS)

The results of a survey of 363 physicians performing were evaluated to assess the relative safety of contrast echocardiography. Fifteen physicians reported a variety of transient side effects, including neurologic and respiratory symptoms. Although contrast echocardiography appeared to carry some risk for side effects, that risk was low (0.062%) and no residual side effects or complications were observed.

Bommer, W. J.; Shah, P. M.; Allen, H.; Meltzer, R.; Kisslo, J.

1984-01-01

46

[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

47

Signal processing in 2 dimensional Doppler echocardiography  

Microsoft Academic Search

Summary Blood flow recordings made by 2 dimensional Doppler echocardiography can sometimes be understood more easily than conventional Doppler recordings, because of the anatomical 2 dimensional presentation. In contrast, signal processing has become more complicated and requires more explanation. In 2 dimensional Doppler echocardiography the analog ultrasonic signal received by the transducer is converted into an audible signal, which next

Hans Bot; Ben J. Delemarre; Cees A. Visser; Arend J. Dunning

1987-01-01

48

Integrated evaluation of relation between coronary lesion features and stress echocardiography results: the importance of coronary lesion morphology  

Microsoft Academic Search

OBJECTIVESThe aim of this study was to analyze, in the same group of patients, the relationship between multiple variables of coronary lesion and results of exercise, dobutamine and dipyridamole stress echocardiography tests.BACKGROUNDIntegrated evaluation of the relation between stress echocardiography results and angiographic variables should include not only the assessment of stenosis severity but also evaluation of other quantitative and qualitative

Branko D Beleslin; Miodrag Ostojic; Ana Djordjevic-Dikic; Rade Babic; Milan Nedeljkovic; Goran Stankovic; Sinisa Stojkovic; Jelena Marinkovic; Ivana Nedeljkovic; Jelena Stepanovic; Jovica Saponjski; Zorica Petrasinovic; Srecko Nedeljkovic; Vladimir Kanjuh

1999-01-01

49

Classical windsock deformity of ruptured sinus of valsalva seen in transesophageal echocardiography.  

PubMed

A 25-year-old male patient found to have ruptured sinus of Valsalva aneurysm with subpulmonic ventricular septal defect was repaired successfully. Intraoperative transesophageal echocardiography images showed classical windsock deformity. PMID:23804790

Gandhi, Sanjay; Asija, Ashish; Chahal, Ashok; Singh, Karampalc; Malhotra, Naveen; Lohchab, Shamsher Singh

2012-04-01

50

Assessment of ventricular functions by tissue Doppler echocardiography in children with asthma.  

PubMed

Patients with asthma develop pulmonary hypertension due to recurrent hypoxia and chronic inflammation, leading to right heart enlargement with ventricular hypertrophy. Patients with severe asthma can experience cor pulmonale later in life, but little is known about ventricular function during the early stages of the disease. This study aimed to investigate ventricular functions in asymptomatic children with asthma as detected by conventional echocardiography and tissue Doppler echocardiography (TDE). Fifty-one pediatric patients (mean age 10.4 ± 2.2 years) with asthma and 46 age- and sex-matched healthy children (mean age 10.9 ± 2.4 years) were studied. All subjects were examined by conventional echocardiography and TDE, and they had pulmonary function tests on spirometry. The right-ventricular (RV) wall was statistically (p = 0.01) thicker among asthmatic patients (4.7 ± 1.5 mm) compared with healthy children (3.6 ± 0.4 mm). However, conventional pulsed-Doppler indices of both ventricles did not differ significantly between asthmatic patients and healthy children (p > 0.05). The results of TDE examining RV diastolic function showed that annular peak velocity during early diastole (E'), annular peak velocity during late diastole (A') (16.4 ± 1.8 and 5.1 ± 1.4 cm/s, respectively), E'/A' ratio (3.2 ± 0.7), isovolumetric relaxation time (67.7 ± 10.2 ms) and myocardial performance index (48.1 % ± 7.0 %) of the lateral tricuspid annulus among asthmatic patients differed significantly (p = 0.01) from those of healthy children (13.2 ± 2.3, 8.2 ± 2.0 cm/s, 1.6 ± 0.5, 46.2 ± 8.7 ms, and 42.0 % ± 5.7 %, respectively). Only peak expiratory flow (PEF) rate from the pulmonary function tests was negatively correlated with the E'/A' ratio of the tricuspid annulus (r = -0.38, p = 0.01). This study showed that although the findings of clinical and conventional echocardiography were apparently normal in children with asthma, TDE showed subclinical dysfunction of the right ventricle, which is negatively correlated with PEF. These findings signify the diagnostic value of TDE in the early detection and monitoring of such deleterious effects among asthmatic patients. PMID:22965765

Ozdemir, Osman; Ceylan, Yasemin; Razi, Cem Hasan; Ceylan, Ozben; Andiran, Nesibe

2013-03-01

51

Echocardiography in children with Down syndrome  

PubMed Central

Congenital heart disease is a common problem in children with Down syndrome (DS). Echocardiography plays an important role in the detection of both structural and functional abnormalities in this group of patients. Fetal echocardiography can help in the early recognition of DS by detecting soft markers of DS, but its main role is to define the exact nature of the suspected cardiac problem in the fetus. Postnatal echocardiography is mandatory in the first month of life for all neonates with DS. It is also indicated before any cardiac surgery and for serial follow-up after cardiac surgery. In this article, we discuss the types and mechanism of cardiac abnormalities in DS children and the role of both fetal and postnatal echocardiography in the detection of these abnormalities. PMID:25254173

Al-Biltagi, Mohammed A

2013-01-01

52

Prosthesis-patient mismatch after transcatheter aortic valve implantation: impact of 2D-transthoracic echocardiography versus 3D-transesophageal echocardiography.  

PubMed

To investigate the role of 2D-transthoracic echocardiography (2D-TTE) and 3D-transesophageal echocardiography (3D-TEE) in the determination of aortic annulus size prior transcatheter aortic valve implantation (TAVI) and its' impact on the prevalence of patient prosthesis mismatch (PPM). Echocardiography plays an important role in measuring aortic annulus dimension in patients undergoing TAVI. This has great importance since it determines both eligibility for TAVI and selection of prosthesis type and size, and can be potentially important in preventing an inadequate ratio between the prosthetic valvular orifice and the patient's body surface area, concept known as prosthesis-patient mismatch (PPM). A total of 45 patients were studied pre-TAVI: 20 underwent 3D-TEE (men/women 12/8, age 84.8 ± 5.6) and 25 2D-TTE (men/women 9/16, age 84.4 ± 5.4) in order to measure aortic annulus diameter. The presence of PPM was assessed before hospital discharge and after a mean period of 3 months. Moderate PPM was defined as indexed aortic valve area (AVAi) ? 0.85 cm(2)/m(2) and severe PPM as AVAi < 0.65 cm(2)/m(2). Immediately post-TAVI, moderate PPM was present in 25 and 28 % of patients worked up using 3D-TEE and 2D-TTE respectively p value = n.s) and severe PPM occurred in 10 % of the patients who underwent 3D-TEE and in 20 % in those with 2D-TTE (p value = n.s). The echocardiographic evaluation 3 months post-TAVI showed 25 % moderate PPM in the 3D-TEE group compared with 24 % in the 2D-TTE group (p value = n.s) and no cases of severe PPM in the 3DTEE group comparing to 20 % in the 2D-TTE group (p = 0.032). Our results indicate a higher incidence of severe PPM in patients who performed 2DTTE compared to those performing 3DTEE prior TAVI. This suggests that the 3D technique should replace the 2DTTE analysis when investigating the aortic annulus diameter in patients undergoing TAVI. PMID:25102782

da Silva, Cristina; Sahlen, Anders; Winter, Reidar; Bäck, Magnus; Rück, Andreas; Settergren, Magnus; Manouras, Aristomenis; Shahgaldi, Kambiz

2014-12-01

53

SUPRASTERNAL NOTCH ECHOCARDIOGRAPHY AND ATRIAL ARRHYTHMIAS  

PubMed Central

Anterior-posterior single-crystal echocardiography has been used in atrial flutter and in sinus rhythm after cardioversion to demonstrate anterior movement of the posterior left atrial wall, representing the effects of atrial flutter and sinus contractions.1 This is thought to be the first report of characteristic superior movement of the inferior left atrial wall during atrial flutter, atrial tachycardia, and sinus rhythm by single-crystal suprasternal notch echocardiography. Images PMID:15216028

Sasse, Lewis; Frolich, Carla R.

1979-01-01

54

Esophageal leiomyoma detected by transesophageal contrast echocardiography.  

PubMed

Transesophageal echocardiography (TEE) provides valuable information in the evaluation of intra- and extracardiac masses. There is no report demonstrating its usefulness in identifying esophageal mass lesions. This is because generally it is contraindicated in patients with esophageal diseases. However, endoscopic ultrasound is used in the evaluation of gastrointestinal pathology. We report a case of an esophageal tumor detected by TEE and the value of contrast echocardiography in further definition of the tumor. PMID:18177392

Meng, Hong; Lee, Pui Wai; Mathieu, Bernier; Chandrasekaran, Krishnaswamy

2008-03-01

55

A review of echocardiography in anaesthetic and peri-operative practice. Part 1: impact and utility.  

PubMed

Echocardiography is migrating rapidly across speciality boundaries and clinical demand is expanding. Echocardiography shows promise for evolving applications in the peri-operative assessment and therapeutic management of patients undergoing non-cardiac surgery, whether it be elective or emergency. Although evidence is limited with regard to significant impact on outcomes from anaesthesia and surgery, there is little doubt about the validity and power of two-dimensional real-time viewing of cardiac anatomy and function. Echocardiography can be used to assist in decision-making along the entire peri-operative pathway, and is increasingly delivered by the previously referring physicians. The discussion around more widespread incorporation of cardiac ultrasound into anaesthetic practice must take into account competency, training and governance. Failure to do so adequately may mean that the use of echocardiography is poorly applied and costly. PMID:24773366

Barber, R L; Fletcher, S N

2014-07-01

56

[Nursing care for patients undergoing pharmacological stress echocardiography: implications for clinical practice].  

PubMed

The study aim was both to identify signs and symptoms previous to and during the pharmacological stress echocardiography test and to describe the nurse's role and nursing care principles for this exam. This is a descriptive study, carried out in cardiac care unit in a University Hospital in Porto Alegre, RS. Two hundred forty-six records of patients submitted to stress echocardiography were retrospectively reviewed, according to four different pharmacological schedules. The statistical comparison showed that signs and symptoms were related to the type of drug used during the exam, namely: typical angina, precordial ache, tiredness, headache and premature complexes. These results enabled a better understanding of pharmacological stress echocardiography and the instrumentalization of nurses in order to plan individualized and qualified nursing care assistance. Aside from helping develop nursing practices for the pharmacological stress echocardiography test this knowledge could also be used by nurses who carry out their activities in institutions that use this diagnostic method. PMID:23155576

de Goes, Marta Georgina Oliveira; Lautert, Liana; Lucena, Amália Fátima

2012-06-01

57

Transesophageal echocardiography during lung transplantation.  

PubMed

Transesophageal echocardiography (TEE) is a semi-invasive monitoring technique increasingly used in cardiac surgery and in major noncardiac surgery for patients with known or supposed cardiac or coronary problems. During lung transplantation (LTx), the close interrelation between heart and lung function makes TEE an invaluable tool for instantly monitoring the physiopathological situation in the subsequent steps of the intervention. In patients scheduled for LTx, induction of anesthesia could be a dangerous moment with the possibility of cardiogenic shock if pulmonary hypertension (PH) exists; pneumatic tamponade is also possible in patients with emphysema caused by alpha(1)-antitrypsin deficiency, with subsequent cardiac insufficiency. One-lung ventilation is a critical phase during LTx; hypoxemia resulting from ventilation of a diseased dependent lung could impair heart oxygenation, particularly if tachycardia is present. Clamping of the pulmonary artery before pneumonectomy could exacerbate cardiac afterload, especially in patients with previous PH. High transmural pressure, linked with low systemic pressure, makes right ventricle (RV) perfusion pressure inadequate. Hypoxemia and PH are the most frequent causes of intraoperative RV decompensation. In this special setting, TEE is irreplaceable in informing the anesthesiologist about the correct time for extracorporeal oxygenation. Lung reperfusion brings with it the possibility of coronary gaseous embolism, easily detected with TEE. After LTx, TEE can be used to detect strictures, thrombi, or permeability of pulmonary venous anastomoses. To summarize, intraoperative TEE during LTx contributes to the immediate recognition of critical events and allows for rapid therapeutic interventions. PMID:17692671

Serra, E; Feltracco, P; Barbieri, S; Forti, A; Ori, C

2007-01-01

58

Current Clinical Applications of Transthoracic Three-Dimensional Echocardiography  

PubMed Central

The advent of three-dimensional echocardiography (3DE) has significantly improved the impact of non-invasive imaging on our understanding and management of cardiac diseases in clinical practice. Transthoracic 3DE enables an easier, more accurate and reproducible interpretation of the complex cardiac anatomy, overcoming the intrinsic limitations of conventional echocardiography. The availability of unprecedented views of cardiac structures from any perspective in the beating heart provides valuable clinical information and new levels of confidence in diagnosing heart disease. One major advantage of the third dimension is the improvement in the accuracy and reproducibility of chamber volume measurement by eliminating geometric assumptions and errors caused by foreshortened views. Another benefit of 3DE is the realistic en face views of heart valves, enabling a better appreciation of the severity and mechanisms of valve diseases in a unique, noninvasive manner. The purpose of this review is to provide readers with an update on the current clinical applications of transthoracic 3DE, emphasizing the incremental benefits of 3DE over conventional two-dimensional echocardiography. PMID:22509433

Boccalini, Francesca; Muraru, Denisa; Bianco, Lucia Dal; Peluso, Diletta; Bellu, Roberto; Zoppellaro, Giacomo; Iliceto, Sabino

2012-01-01

59

[Echocardiography in the diagnosis of lung embolism].  

PubMed

In the Federal Republic of Germany, approximately 10,000 to 20,000 persons die of pulmonary embolism (PE) each year. The mortality of treated PE is about 8% as compared with 18 to 35% in nondiagnosed PE. Massive PE is detected in only about 15 to 30% of the patients while, on the other hand, in 30 to 80% of those in whom PE is suspected the pulmonary angiogram may be normal. On use of pulmonary ventilation-perfusion scintigraphy, in 30 to 40% of the cases, both false negative as well as false positive findings have been described. ROLE OF ECHOCARDIOGRAPHY IN PATIENTS WITH ACUTE PULMONARY EMBOLISM. With echocardiographic imaging, the right heart as well as the central vessels in the proximity of the heart, in particular the pulmonary arteries, can be visualized. In addition to direct detection of right-sided-intraluminal thrombi, echocardiographic diagnosis is based predominantly on indirect signs, such as evidence of an acute cor pulmonale with dilatation of the right atrium and ventricle, the central pulmonary vessels and the inferior vena cava which, however, are relatively unspecific and may also be found in the presence of other diseases. Echocardiographic changes in acute pulmonary embolism can only be expected in the presence of increased pressure in the pulmonary circulation, that is, when at least a 30%-reduction in the cross-sectional area of the pulmonary vascular bed can be found. This can be documented in 60 to 70% of patients with acute PE. According to the literature and our own studies, of a total of 284 patients 84% had dilatation of the right ventricle, 70% paradoxic or hypokinetic motion of the interventricular septum in 102/141 patients there was dilatation of the right pulmonary artery. These changes regressed rapidly after therapeutic intervention. In about 30% of the patients a reduction in the left ventricular dimensions can be seen. Paradoxic septum motion and a decrease in the closing amplitude (EF-slope) of the anterior mitral leaflet can be seen. The extent of dilatation of the right ventricle and the right pulmonary artery correlate with the extent of the angiographic severity of acute PE provided that there is no marked preexisting left ventricular function impairment. NONINVASIVE ESTIMATION OF THE PRESSURE INCREASE IN THE PULMONARY CIRCULATION. On use of Doppler echocardiography, most patients with acute cor pulmonale have tricuspid regurgitation. This enables through determination of the systolic RV-RA pressure gradient an estimation of the systolic right ventricular pressure and, accordingly, the pulmonary artery pressure. In our experience, a systolic acceleration time in the pulmonary artery of less than 90 to 95 ms is PMID:2656458

Kasper, W; Geibel, A; Tiede, N; Hofmann, T; Meinertz, T; Just, H

1989-04-01

60

Echocardiography examinations Conventional echocardiography and 2D color tissue Doppler imaging (TDI) were  

E-print Network

-time color Doppler was superimposed on the gray scale with a high frame rate (> 150 frames/sec). DopplerMethods Echocardiography examinations Conventional echocardiography and 2D color tissue Doppler examined with a Vivid 7 ultrasound unit equipped with 5-7.5 and 2- 5MHz phased-array transducers (GE

Boyer, Edmond

61

Right atrial angiosarcoma with severe biventricular dysfunction and massive pericardial effusion.  

PubMed

This paper presents the case of a 35 year-old woman with symptoms of heart failure from the last month. A physical examination at admission showed paleness, dyspnea, peripheral edema and fatigue. In a two-dimensional echocardiography and transesophageal echocardiography, normal thickness but severe left and right ventricular dysfunction with severe pericardial effusion and thickened pericardium were found. In the enlarged right atrium, an oval-shaped structure was found with features of continuity with lateral right atrial wall and also a bulging of the structure through the orifice of the tricuspid valve to the right ventricle. In the echocardiography, we did not saw any blocking of the tricuspid valve or the inflow from inferior vena cava (IVC) or superior vena cava (SVC) or coronary sinus. On the basis of the echocardiography examination and clinical presentation, tentative diagnosis of the right atrium myxoma was made. A coronary angiography revealed normal coronary arteries and no feeding of tumor by branch of right coronary artery (RCA). Surgical removal of the tumor was performed without complication. The histopathological examination confirmed the diagnosis of angiosarcoma. In the follow-up echocardiography carried out after three months, severe left ventricular (LV) and right ventricular (RV) dysfunction continued and was demonstrated. Magnetic resonance imaging revealed no lymphadenopathy or re-growth of the tumor in the mediastinum or pericardium. PMID:23585321

Sabzi, Feridoun; Dadkhah, Heidar; Shojaei, Sharam; Mahdavi, Masoume; Poormotaabed, Alireza; Javid, Nasrin; Dabiri, Samsam

2013-01-01

62

Dynamic 3D echocardiography in virtual reality  

PubMed Central

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

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

2005-01-01

63

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

64

Echocardiography in the Era of Multimodality Cardiovascular Imaging  

PubMed Central

Echocardiography remains the most frequently performed cardiac imaging investigation and is an invaluable tool for detailed and accurate evaluation of cardiac structure and function. Echocardiography, nuclear cardiology, cardiac magnetic resonance imaging, and cardiovascular-computed tomography comprise the subspeciality of cardiovascular imaging, and these techniques are often used together for a multimodality, comprehensive assessment of a number of cardiac diseases. This paper provides the general cardiologist and physician with an overview of state-of-the-art modern echocardiography, summarising established indications as well as highlighting advances in stress echocardiography, three-dimensional echocardiography, deformation imaging, and contrast echocardiography. Strengths and limitations of echocardiography are discussed as well as the growing role of real-time three-dimensional echocardiography in the guidance of structural heart interventions in the cardiac catheter laboratory. PMID:23878804

Shah, Benoy Nalin

2013-01-01

65

Contrast Echocardiography: Current and Future Applications  

Microsoft Academic Search

Recent updates in the field of echocardiography have resulted in improvements in image quality, especially in those patients whose ultrasonographic (ultrasound) evaluation was previously suboptimal. Intravenous contrast agents are now available in the United States and Europe for the indication of left ventricular opacification and enhanced endocardial border delineation. The use of contrast enables acquisition of ultrasound images of improved

Sharon L Mulvagh; Anthony N DeMaria; Steven B Feinstein; Peter N Burns; Sanjiv Kaul; James G Miller; Mark Monaghan; Thomas R Porter; Leslee J Shaw; Flordeliza S Villanueva

2000-01-01

66

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

67

Assessment of coronary artery intimal thickening in patients with a previous diagnosis of Kawasaki disease by using high resolution transthoracic echocardiography: our experience  

PubMed Central

Background Kawasaki disease (KD) is a generalized systemic vasculitis of unknown etiology involving medium and small size blood vessels, particularly the coronary arteries. In these vessels a progressive stenosis may result from active remodeling with an intimal proliferation and neoangiogenesis. The aim of our study was to assess, by using high-resolution transthoracic 2D Echocardiography, if subjects with a previous diagnosis of Kawasaki disease after several years show a coronary intimal thickening, suggestive of a persistent cardiovascular risk. Methods We assessed measurement of thickening, inner diameter and outer diameter of coronary arteries using 2D Echocardiography (Philips E 33 with multy-frequency S8-3 and S12-4 probes) and examining the proximal portion of left main coronary artery just above the aortic valve with parasternal short axis view. Results We found a significant intimal thickening in patients with previous Kawasaki disease compared to healthy controls. In particular, we noticed that also subjects not suffering from coronary impairment in acute phase have higher values of thickening than healthy controls, and this wall thickening may confer a higher cardiovascular risk. Conclusions Therefore we concluded that the assessment of coronary artery thickening by high-resolution transthoracic 2D Echocardiography may become an essential instrument to evaluate late cardiovascular risk in subjects with a diagnosis of Kawasaki disease in childhood. PMID:25139118

2014-01-01

68

Outcome prediction in sepsis: Speckle tracking echocardiography based assessment of myocardial function  

PubMed Central

Introduction Speckle tracking echocardiography (STE) is a relatively novel and sensitive method for assessing ventricular function and may unmask myocardial dysfunction not appreciated with conventional echocardiography. The association of ventricular dysfunction and prognosis in sepsis is unclear. We sought to evaluate frequency and prognostic value of biventricular function, assessed by STE in patients with severe sepsis or septic shock. Methods Over an eighteen-month period, sixty patients were prospectively imaged by transthoracic echocardiography within 24 hours of meeting severe sepsis criteria. Myocardial function assessment included conventional measures and STE. Association with mortality was assessed over 12 months. Results Mortality was 33% at 30 days (n?=?20) and 48% at 6 months (n?=?29). 32% of patients had right ventricle (RV) dysfunction based on conventional assessment compared to 72% assessed with STE. 33% of patients had left ventricle (LV) dysfunction based on ejection fraction compared to 69% assessed with STE. RV free wall longitudinal strain was moderately associated with six-month mortality (OR 1.1, 95% confidence interval, CI, 1.02-1.26, p?=?0.02, area under the curve, AUC, 0.68). No other conventional echocardiography or STE method was associated with survival. After adjustment (for example, for mechanical ventilation) severe RV free wall longitudinal strain impairment remained associated with six-month mortality. Conclusion STE may unmask systolic dysfunction not seen with conventional echocardiography. RV dysfunction unmasked by STE, especially when severe, was associated with high mortality in patients with severe sepsis or septic shock. LV dysfunction was not associated with survival outcomes. PMID:25015102

2014-01-01

69

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

70

Three dimensional echocardiography in congenital heart defects  

PubMed Central

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

Shirali, Girish S.

2008-01-01

71

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

72

Echocardiography-based left ventricular mass estimation. How should we define hypertrophy?  

PubMed Central

Left ventricular hypertrophy is an important risk factor in cardiovascular disease and echocardiography has been widely used for diagnosis. Although an adequate methodologic standardization exists currently, differences in measurement and interpreting data is present in most of the older clinical studies. Variability in border limits criteria, left ventricular mass formulas, body size indexing and other adjustments affects the comparability among these studies and may influence both the clinical and epidemiologic use of echocardiography in the investigation of the left ventricular structure. We are going to review the most common measures that have been employed in left ventricular hypertrophy evaluation in the light of some recent population based echocardiographic studies, intending to show that echocardiography will remain a relatively inexpensive and accurate tool diagnostic tool. PMID:15963236

Foppa, Murilo; Duncan, Bruce B; Rohde, Luis EP

2005-01-01

73

Cardiac Disease in Pregnancy: Value of Echocardiography  

Microsoft Academic Search

Cardiovascular disease in women during pregnancy poses particular challenges. It continues to be a leading cause of maternal\\u000a mortality and contributes to significant morbidity. Echocardiography is essential in characterizing the extent and effects\\u000a of heart disease prior to, during, and after pregnancy. By understanding the physiologic adaptation in pregnancy with increases\\u000a in heart rate, blood volume, and cardiac output, and

Sarah Tsiaras; Athena Poppas

2010-01-01

74

Paediatric echocardiography by telemedicine--nine years' experience.  

PubMed

In 1987 we established a realtime echocardiography service by telemedicine from the paediatric cardiology department of a tertiary-care hospital in Halifax. The service was initially provided to single regional hospital but was expanded to six regional hospitals in the three Canadian Maritime Provinces. The system used a dial-up broadband video-transmission service provided by the telephone companies. Records of all transmissions were kept prospectively and reviewed to January 1997. A total of 324 transmissions were made. During 1995-96 there were 135 studies: 69 (51%) were urgent examinations of newborn children and 30 (22%) were urgent examinations of older children; repeat studies and postoperative checks (usually for pericardial effusion) accounted for the other 36 studies (27%). The images were of broadcast quality except in five cases where problems with transmission or poor sedation occurred. A comparison of 26 transmitted studies with repeat, 'in person' studies showed no important discrepancies in diagnosis. During the two-year study period, the cost of the network (equipment leasing costs and telecommunications costs) was C$90,000. Use of the telemedicine network saved unnecessary patient transfer in 31 cases. The cost of the transportation avoided was C$100,000-C$118,000. This review confirms our preliminary findings that broadband echocardiography transmission provides a service comparable in availability and accuracy to that provided in our paediatric cardiology division. PMID:9614734

Finley, J P; Sharratt, G P; Nanton, M A; Chen, R P; Bryan, P; Wolstenholme, J; MacDonald, C

1997-01-01

75

RESULTS FROM TWO PHARMACOTHERAPY TRIALS SHOW ALCOHOLIC SMOKERS WERE MORE SEVERELY ALCOHOL DEPENDENT BUT LESS PRONE TO RELAPSE THAN ALCOHOLIC NON-SMOKERS  

E-print Network

Abstract — Aims: To assess the role of smoking on treatment outcome in quitting alcoholics on the background of the priming or coping hypothesis (Rohsenow et al., 1997). Methods: Data sets of placebo treated patients of the German phase III trial of naltrexone (Gastpar et al., 2002) and of acamprosate treated patients of a German phase IV trial (Soyka et al., 2002) were reanalyzed. Differences between smoking and non-smoking alcoholics were evaluated using ? 2-, t- or ANOVA-tests, relapse rates using survival techniques with Cox regression. Results: Smoking alcoholics differed significantly from non-smoking alcoholics regarding sociodemographic variables (e.g. more males, more often living alone) and severity indicators of alcoholism (e.g. quantity, onset, related problems). In the naltrexone study time to first relapse was significantly longer for smoking alcoholics compared to non-smoking alcoholics (hazard ratio = 2.26; P = 0.036). The same effect was seen in the acamprosate study (hazard ratio = 1.34; P = 0.015); estimated abstinencerates after 24 weeks were 38 % for smoking alcoholics compared to 28 % for non-smoking alcoholics (P alcoholics included in two pharmacotherapy trials. Although the underlying mechanisms remain unclear our findings are in favour of the coping hypothesis. The results challenge the validity of the dependence syndrome.

Lutz G. Schmidt; Michael N. Smolka

76

Geographic and ethnic distributions of the more frequent cystic fibrosis mutations in Europe show that a founder effect is apparent for several mutant alleles.  

PubMed

Examination of the European geographic patterns of the 10 relatively most frequent cystic fibrosis mutations, other than the DF508 one, shows that a founder effect is apparent for a number of them. The most evident examples are for the W1282X mutation in Jews, with a probable Asian origin, and the G551D and R117H mutations in Celts. Geographic distributions indicate that the main focus of the 621 + 1 G-->T and DI507 mutations is probably located in Wales. Also, the R1162X mutation probably originates from a circumscribed north Italian region. The N1303K mutation has a wide range in Europe with a clear preponderance in southern countries. Even the relatively common G542X and 1717.1 G-->A mutations have a local preponderance in Spain and Sicily and in northern Italy, respectively. Likelihood estimates for recurrent mutation and identity by descent strongly support the hypothesis of recurrence for the (mainly German) mutation R553X. PMID:7649531

Lucotte, G; Hazout, S

1995-08-01

77

Identification of Hibernating Myocardium: Comparative Accuracy of Myocardial Contrast Echocardiography, Rest-Redistribution Thallium201 Tomography and Dobutamine Echocardiography  

Microsoft Academic Search

Objectives. We sought to evaluate the comparative accuracy of myocardial contrast echocardiography (MCE), quantitative rest-redistribution thallium-201 (Tl-201) tomography and low and high dose (up to 40 ?g\\/kg body weight per min) dobutamine echocardiography (DE) in identifying myocardial hibernation.Background. Myocardial contrast echocardiography can assess myocardial perfusion and may therefore be useful in predicting myocardial hibernation. However, its accuracy in comparison to

Sherif F Nagueh; Periyanan Vaduganathan; Nadir Ali; Alvin Blaustein; Mario S Verani; William L Winters; William A Zoghbi

1997-01-01

78

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

PubMed

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

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

2014-04-01

79

Etiology of pulmonary venous aneurysm diagnosed by a combination of echocardiography and contrast-enhanced computed tomography: a case report.  

PubMed

Pulmonary venous aneurysm is rare and its etiology is still debated. Some studies have shown that acquired aneurysms are caused by an increase in left atrial pressure and mitral regurgitation. However, few reports have provided direct evidence of this pathology. We present a case of pulmonary venous aneurysm diagnosed using a combination of echocardiography and contrast-enhanced computed tomography with strong evidence for an etiology of severe mitral valve regurgitation. A 24-year-old Chinese man was diagnosed with mitral valve perforation with severe mitral regurgitation caused by infectious endocarditis. A right inferior pulmonary venous aneurysm was diagnosed by contrast-enhanced computed tomography. Color Doppler echocardiography revealed a mitral regurgitation jet filling the giant aneurysm. Three-dimensional echocardiography provided a clear stereoscopic view of the aneurysm. These imaging modalities provided direct evidence for the etiology of the pulmonary venous aneurysm. PMID:25239668

Mou, Yun; Cheng, Yan; Feng, Qiang; Ni, Chenyao

2014-01-01

80

Usefulness and limitations of transthoracic echocardiography in heart transplantation recipients  

Microsoft Academic Search

Transthoracic echocardiography is a primary non-invasive modality for investigation of heart transplant recipients. It is a versatile tool which provides comprehensive information about cardiac structure and function. Echocardiographic examinations can be easily performed at the bedside and serially repeated without any patient's discomfort. This review highlights the usefulness of Doppler echocardiography in the assessment of left ventricular and right ventricular

Sergio Mondillo; Massimo Maccherini; Maurizio Galderisi

2008-01-01

81

Screening Echocardiography of Military Aircrew Candidates: Aeromedical Implications  

Microsoft Academic Search

Objectives: Cardiovascular evaluation has a significant aspect in the medical screening process of aircrew candidates. Echocardiography may identify asymptomatic cardiac abnormalities which can jeopardize the aviator and flight safety, as well as conditions which may progress and disqualify a trained aviator. We assessed the value of adding routine echocardiography to the aeromedical screening process. Methods: The study population consisted of

Ori Wand; Alex Prokupetz; Amit Assa; Erez Barenboim

2010-01-01

82

Three-dimensional echocardiography and structural heart interventions.  

PubMed

This article looks at the role of three-dimensional echocardiography in the anatomical assessment of cardiac structures, how this complements standard methods of assessing structural cardiac lesions and the advantages of three-dimensional echocardiography in peri-procedural guidance in the cardiac catheterization laboratory. PMID:25040516

Rana, Bushra S

2014-07-01

83

Contrast echocardiography: contribution to diagnosis of left ventricular non-compaction cardiomyopathy.  

PubMed

Left ventricular non-compaction (LVNC) is a cardiomyopathy considered to be caused by arrest of normal embryogenesis of the endocardium and myocardium. Echocardiography has been the preferred diagnostic procedure; however, the correct diagnosis is often missed or delayed due to the lack of knowledge about this uncommon disease and its similarities to other diseases of the myocardium and endocardium. Here we present two cases: an asymptomatic 39-year-old man who was considered to be suffering from dilated cardiomyopathy (DCM) for four years; and an asymptomatic 19-year-old man who was considered to be suffering from hypertrophic cardiomyopathy. In a recent echocardiography study carried out in our echo lab, we recognized the morphological diagnostic criteria of LVNC. Contrast echocardiography, a low-cost, easy, repeatable, real-time, and non-invasive technique with no ionising radiation, shows a high correlation in the diagnosis of LVNC. In echocardiography, the importance of contrast agents is twofold, as they can be considered essential for a reliable differentiation between the compacted and the non-compacted myocardium, while at the same time they allow accurate measurement of the ratio. Heightened clinical suspicion is necessary for the accurate diagnosis and management of diseases. PMID:21642078

Lampropoulos, Konstantinos M; Dounis, Vasilios G; Aggeli, Constantina; Iliopoulos, Themistoklis A; Stefanadis, Christodoulos

2011-01-01

84

Systematic overview and clinical applications of pacing atrial stress echocardiography.  

PubMed

Pacing atrial stress echocardiography (PASE) has been studied over the past 3 decades for the evaluation of myocardial ischemia. Published studies suggest that PASE may be used as an alternative to exercise or pharmacologic stress imaging. The recent introduction of improved pacing electrodes, together with use of accelerated and shortened pacing protocols and improvements in transthoracic echocardiographic imaging techniques, makes PASE an appealing stress imaging method. A critical analysis of the diagnostic accuracy of PASE shows equivalence with other imaging stress modalities. PASE has been found to be highly feasible and accurate technique that may expedite the diagnosis and risk stratification of patients with coronary artery disease. This review addresses the history, hemodynamics, protocols, accuracy, clinical utility, and cost-effectiveness of PASE as well as elucidating its place among other stress modalities. PMID:16893716

Modi, Shreyas A; Siegel, Robert J; Birnbaum, Yochai; Atar, Shaul

2006-08-15

85

Nepal's noble echocardiography-database with video clips and color still images: a single individual's 6 years' experience at the Echocardiography Lab of Nepal Medical College, Teaching Hospital.  

PubMed

Echocardiographic reporting system is very poor in Nepal. No long-term feasibility and efficacy data about the echocardiography database with video clips has been studied. Snazzi Movie Studio S4 was used to convert analog video signals into MPEG2 and color photographs were converted into JPEG format for storage and use for the database. All together 2272 patients' echocardiography were performed by one individual prospectively at the Nepal Medical College Teaching Hospital from 10th January 2007 to 9th January 2012. Echocardiographic findings of these patients were evaluated. Mean age +/- SD were 44.4 +/- 28.7 years. Male female ratio was 0.8:1. Brahman/Chhetri were the usual ethnic group to undergo echocardiography (943, 41.5%), followed byjanajati (631, 27.8%) and newar (496, 21.8%). Age group of 60-69 years was the most common echo users (519, 22.8%). Total time for echocardiography/report writing with database compared to non database was 13.9 +/- 2.4 minutes vs. 12.3 +/- 0.8 minutes, p = 0.51. Out of all lesions, valvular lesions were the most common lesions detected (4885, 215%). Mild tricuspid regurgitation (1213, 53.4%) was the most common valvular lesion followed by mild mitral regurgitation (742, 32.7%). Patent foramen ovale was the most common congenital heart disease (32, 45.7%) followed by atrial septal defect (12, 17.1%). About one seventh of the total patients (318, 13.9%) had systolic dysfunction. Out of total chronic cor pulmonale (383, 16.9%), severe Pulmonary arterial dysfulction (PAH) was noted in more than one third of the patients (169, 44.1%). PMID:24047011

Shrestha, B

2012-09-01

86

Target heart rate to determine the normal value of coronary flow reserve during dobutamine stress echocardiography  

Microsoft Academic Search

Background  The determination of coronary flow reserve (CFR) is an essential concept at the moment of decision-making in ischemic heart\\u000a disease. There are several direct and indirect tests to evaluate this parameter. In this sense, dobutamine stress echocardiography\\u000a is one of the pharmacological method most commonly used worldwide. It has been previously demonstrated that CFR can be determined\\u000a by this technique.

Ezequiel H Forte; Maria G Rousse; Jorge A Lowenstein

2011-01-01

87

Clinical application of three-dimensional echocardiography.  

PubMed

Echocardiography is one of the most valuable diagnostic tools in cardiology. Technological advances in ultrasound, computer and electronics enables three-dimensional (3-D) imaging to be a clinically viable modality which has significant impact on diagnosis, management and interventional procedures. Since the inception of 3D fully-sampled matrix transthoracic and transesophageal technology it has enabled easier acquisition, immediate on-line display, and availability of on-line analysis for the left ventricle, right ventricle and mitral valve. The use of 3D TTE has mainly focused on mitral valve disease, left and right ventricular volume and functional analysis. As structural heart disease procedures become more prevalent, 3D TEE has become a requirement for preparation of the procedure, intra-procedural guidance as well as monitoring for complications and device function. We anticipate that there will be further software development, improvement in image quality and workflow. PMID:25081399

Morbach, Caroline; Lin, Ben A; Sugeng, Lissa

2014-01-01

88

History of echocardiography and its future applications in medicine.  

PubMed

This review concisely presents the chronology of events that shaped the development of echocardiography. The concept of "seeing" structures using "sound" dates back to the 1920s, when ultrasound produced by piezoelectric crystals was used to detect flaws in metals. In the early 1950s, Hertz and Edler described the use of ultrasound for assessing mitral-valve disease. Subsequently, Harvey Feigenbaum in the 1960s standardized the clinical use of M-mode echocardiography for quantitative assessment of left-ventricular dimensions. The advent of 2-dimensional echocardiography (1970s), pulsed Doppler (1970s), and color Doppler (1980s) introduced new methods for routine assessment of cardiac anatomy and hemodynamics at bedside. Flexible scopes and superior transducers further paved the way to the application of transesophageal echocardiography. Tissue Doppler and contrast echocardiography recently have emerged as important tools for evaluation of regional myocardial function and blood flow. Miniaturization and the ability to pack thousands of crystals in an electronic array have transformed the application of 3-dimensional echocardiography into a bedside tomographic tool. At the current pace of development, echocardiography will be able to provide complete assessment of the heart in terms of its anatomy, coronary flow, and physiology. Training people and making it available at every bedside may be the only remaining challenges. PMID:17667454

Krishnamoorthy, Vijay K; Sengupta, Partho P; Gentile, Federico; Khandheria, Bijoy K

2007-08-01

89

"The Show"  

ERIC Educational Resources Information Center

For the past 16 years, the blue-collar city of Huntington, West Virginia, has rolled out the red carpet to welcome young wrestlers and their families as old friends. They have come to town chasing the same dream for a spot in what many of them call "The Show". For three days, under the lights of an arena packed with 5,000 fans, the state's best…

Gehring, John

2004-01-01

90

Stress-Induced Cardiomyopathy: The Role of Echocardiography  

PubMed Central

Echocardiography is widely used to carry out non-invasive cardiac evaluation at the bedside and provides useful real-time information about hemodynamics. It can also be used to diagnose a stress-induced cardiomyopathy and its complications such as shock, heart failure and apical thrombus. Early diagnosis and management are important to prevent possible complications, and short-term follow-up by echocardiography can readily determine the improvement in these abnormalities. In this brief review, we summarize the role of echocardiography in stress-induced cardiomyopathy, with a special focus on its benefits in the era of new emerging diagnostic technology. PMID:21519485

Lee, Jun-Won

2011-01-01

91

Basis for detection of stenosis using venous administration of microbubbles during myocardial contrast echocardiography: bolus or continuous infusion?  

Microsoft Academic Search

Objectives. This study sought to determine the basis of detection of stenosis by myocardial contrast echocardiography using venous administration of microbubbles and to define the relative merits of bolus injection versus continuous infusion.Background. The degree of video intensity (VI) disparity in myocardial beds supplied by stenosed and normal coronary arteries can be used to quantify stenosis severity after venous administration

Kevin Wei; Ananda R Jayaweera; Soroosh Firoozan; Andre Linka; Danny M Skyba; Sanjiv Kaul

1998-01-01

92

A feasibility study of epicardial coronary angiography from microbubble-contrasted tridimensional echocardiography: segmentation approaches  

NASA Astrophysics Data System (ADS)

Conventional coronary angiography has been the current gold standard for evaluation of coronary stenosis severity. However, this is an invasive procedure, based on ionizing radiation (X-Ray) and dependent of nephrotoxic contrast agents. In the past three decades, echocardiography has emerged as an important medical image modality in Cardiology. With the advent of microbubble-based contrast agents and array transducers, 3D-echocardiography now presents itself as a relative low-cost, non invasive and non ionizing alternative method to visibilize arteries and their dynamics. This paper investigates some segmentation techniques to emphasize and isolate epicardial coronaries in tridimensional microbubblecontrasted echocardiographic images, since available computational tools do not provide adequate processing.

Lage, Danilo Meneses; Tsutsui, Jeane Mike; Furuie, Sérgio Shiguemi

2010-03-01

93

Sci Show  

NSDL National Science Digital Library

The Sci Show, an entertaining series of quirky YouTube videos, tackles topics ranging from âÂÂHow Do Polarized Sunglasses Workâ to âÂÂStrong Interaction: The Four Fundamental Forces of Physics.â Most episodes are less than five minutes long, but they pack a wallop of handy science info. Anyone short on time but long on big questions will benefit from the series. Episodes will be helpful to teachers and parents looking to spark enthusiasm in young minds. Viewers may want to start with recent episodes like âÂÂTodayâÂÂs Mass Extinction,â and the âÂÂWorldâÂÂs First See-Through Animalâ and âÂÂHow Do Animals Change Color?â before digging into the archives for gems like âÂÂThe Truth About Gingersâ and âÂÂThe Science of Lying.âÂÂ

94

The use of echocardiography in observational clinical trials: the EURECA-m registry.  

PubMed

Echocardiography is the most widely used non-invasive imaging technique due to its availability, low cost, transportability and lack of ionizing radiations. However, it suffers from the main limitation of being highly subjective and operator-dependent. Furthermore, specifically, population or disease-dependent issues exist which should be addressed when this technique is applied in multicenter studies. As to the population of patients with end-stage renal disease (ESRD) maintained on chronic dialysis, indexation of echocardiographic parameters and timing of echocardiography in relationship to dialysis represent a specific, main issue that needs to be carefully considered and standardized. Scientific societies recommend the set-up of core laboratories in order to reduce inter- and intra-observer variability when an echocardiographic parameter is considered as an end-point in clinical research. Several studies have shown the superiority of interpretation given by echocardiography core-lab reading. These advantages are counterbalanced by higher costs and complexity. The EURECA-m registry by the EURECA-m working group, an ERA-EDTA initiative, aimed at promoting the scientific collaboration among professionals in the field of cardiovascular and renal medicine. The registry involves several centers in Europe and one of its aims is to measure conventional echocardiographic parameters in ESRD patients on chronic dialysis. A central reading protocol has been set up for the registry in order to give robustness to the echo studies. PMID:23048175

Sicari, Rosa; Gargani, Luna; Wiecek, Andrzej; Covic, Adrian; Goldsmith, David; Suleymanlar, Gultekin; Parati, Gianfranco; Ortiz, Alberto; Massy, Ziad; Martinez-Castelao, Alberto; Lindholm, Bengt; Heine, Gunnar H; Fliser, Danilo; Mallamaci, Francesca; London, Gerard; Zoccali, Carmine

2013-01-01

95

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

96

Usefulness of intraoperative real-time three-dimensional transesophageal echocardiography for pre-procedural evaluation of mitral valve cleft: a case report  

PubMed Central

A precise pre-procedural evaluation of mitral valve (MV) pathology is essential for planning the surgical strategy for severe mitral regurgitation (MR) and preparing for the intraoperative procedure. In the present case, a 38-year-old woman was scheduled to undergo MV replacement due to severe MR. She had a history of undergoing percutaneous balloon valvuloplasty due to rheumatic mitral stenosis during a previous pregnancy. A preoperative transthoracic echocardiography suggested a tear in the mid tip of the anterior mitral leaflet. However, the "en face" view of the MV in the left atrial perspective using intraoperative real time three-dimensional transesophageal echocardiography (RT 3D-TEE) provided a different diagnosis: a torn cleft in the P2-scallop of the posterior mitral leaflet (PML) with rupture of the chordae. Thus, surgical planning was changed intraoperatively to MV repair (MVRep) consisting of patch closure of the PML, commissurotomy, and lifting annuloplasty. The present case shows that intraoperative RT 3D-TEE provides more precise and reliable spatial information of MV for MVRep and facilitates critical surgical decision-making. PMID:24567819

Jung, Hyun Ju; Yu, Ga-Yon; Seok, Jung-Ho; Oh, Chungsik; Kim, Seong-Hyop; Yoon, Tae-Gyoon

2014-01-01

97

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

98

Minimally invasive cardiac surgery and transesophageal echocardiography.  

PubMed

Improved cosmetic appearance, reduced pain and duration of post-operative stay have intensified the popularity of minimally invasive cardiac surgery (MICS); however, the increased risk of stroke remains a concern. In conventional cardiac surgery, surgeons can visualize and feel the cardiac structures directly, which is not possible with MICS. Transesophageal echocardiography (TEE) is essential during MICS in detecting problems that require immediate correction. Comprehensive evaluation of the cardiac structures and function helps in the confirmation of not only the definitive diagnosis, but also the success of surgical treatment. Venous and aortic cannulations are not under the direct vision of the surgeon and appropriate positioning of the cannulae is not possible during MICS without the aid of TEE. Intra-operative TEE helps in the navigation of the guide wire and correct placement of the cannulae and allows real-time assessment of valvular pathologies, ventricular filling, ventricular function, intracardiac air, weaning from cardiopulmonary bypass and adequacy of the surgical procedure. Early detection of perioperative complications by TEE potentially enhances the post-operative outcome of patients managed with MICS. PMID:24732611

Jha, Ajay Kumar; Malik, Vishwas; Hote, Milind

2014-01-01

99

Microlesions induced by microcavitation during contrast echocardiography  

NASA Astrophysics Data System (ADS)

The purpose of this study was to search for histologically identifiable lesions associated with myocardial contrast echocardiography (MCE) in rats. Diagnostic ultrasound scans with 1:4 end-systolic triggering provided a short-axis view of the left ventricle in rats at 1.5 MHz with 1.45-?s pulses of 1.7 Mechanical Index. Two relatively high doses (500 ?l/kg) of OptisonTM ultrasound contrast agent were given 5 min apart during 10 min of MCE. One day after scanning, rats were sacrificed and the hearts fixed for histology. Slides were scored blind by a pathologist, and photomicrographs in the anterior half of the heart sections were characterized by digital image analysis. Microlesions identified by inflammatory infiltrates were scattered primarily over the anterior half of the sections. Pathologically, there was inflammatory cell infiltration in areas of 0.6+/-0.5% of the sections for shams and 3.6+/-3.6% for MCE (P<0.01). Analysis of the photographs from the anterior wall found microlesion areas of 0.5+/-0.8% for shams and 7.4+/-5.0% for MCE (P<0.02). Diagnostic MCE at high Mechanical Index has a potential for causing microscale lesions in the myocardium by nucleation of microcavitation. [Work supported by NIH Grant EB0338.

Miller, Douglas; Li, Peng; Gordon, David; Armstrong, William

2001-05-01

100

Doppler echocardiography in athletes from different sports  

PubMed Central

Background Studies have shown cardiac changes induced by intense and regular physical activity. The purpose of this study was to evaluate cardiac structures and function in soccer players, cyclists and long-distance runners, and compare them with non-athlete controls. Material/Methods Cardiac structural, systolic, and diastolic function parameters in 53 athletes and 36 non-athlete controls were evaluated by Doppler echocardiography. Results Athletes presented higher left atrial volume, left ventricular (LV) thickness, and LV and right ventricular (RV) diastolic diameters (LVDD and RVDD, respectively) compared to non-athletes. Left atrium and LVDD were higher in cyclists than runners, and RVDD was higher in cyclists than soccer players. LV mass index was higher in athletes, and cyclists had higher values than runners and soccer players. LV systolic function did not differ significantly between groups. The only altered index of LV diastolic function was a higher E/A ratio in cyclists compared to controls. There was no difference in LV E/E’ ratio. RV systolic function evaluated by tissue Doppler imaging was higher in cyclists and soccer players than runners. There were no conclusive differences in RV diastolic function. Conclusions Soccer players, runners and cyclists had remodeling of left and right ventricular structures compared to controls. Cardiac remodeling was more intense in cyclists than runners and soccer players. PMID:23478754

Moro, Andre Santos; Okoshi, Marina Politi; Padovani, Carlos Roberto; Okoshi, Katashi

2013-01-01

101

A pedunculated left ventricular thrombus in a women with peripartum cardiomyopathy: evaluation by three dimensional echocardiography.  

PubMed

Peripartum cardiomyopathy is a cardiac condition characterized by development of heart failure during the last month of pregnancy or during the first five months of post partum period without any other identifiable cause of heart failure. The hypercoagulable state in the pregnancy along with left ventricular (LV) systolic dysfunction predisposes the patient to thromboembolic complications like intraventricular thrombi. We report a case of a 30-year-old female with peripartum cardiomyopathy along with a highly mobile mass in the LV cavity on two dimensional echocardiography. Three dimensional transthoracic echocardiography clearly showed the pedicle of the mass attached to the interventricular septum along with internal echolucent areas within the mass. Due to denial of the patient to undergo surgery, she was started on oral anticoagulation, with complete dissolution of the mass within one month. PMID:25309691

Kharwar, Rajiv Bharat; Chandra, Sharad; Dwivedi, Sudhanshu Kumar; Saran, Ram Kirti

2014-09-01

102

A Pedunculated Left Ventricular Thrombus in a Women with Peripartum Cardiomyopathy: Evaluation by Three Dimensional Echocardiography  

PubMed Central

Peripartum cardiomyopathy is a cardiac condition characterized by development of heart failure during the last month of pregnancy or during the first five months of post partum period without any other identifiable cause of heart failure. The hypercoagulable state in the pregnancy along with left ventricular (LV) systolic dysfunction predisposes the patient to thromboembolic complications like intraventricular thrombi. We report a case of a 30-year-old female with peripartum cardiomyopathy along with a highly mobile mass in the LV cavity on two dimensional echocardiography. Three dimensional transthoracic echocardiography clearly showed the pedicle of the mass attached to the interventricular septum along with internal echolucent areas within the mass. Due to denial of the patient to undergo surgery, she was started on oral anticoagulation, with complete dissolution of the mass within one month.

Chandra, Sharad; Dwivedi, Sudhanshu Kumar; Saran, Ram Kirti

2014-01-01

103

[Evaluation of aortic to pulmonary blood flow ratio by Doppler echocardiography in septal defects].  

PubMed

Pulsed Doppler-echocardiography was used to measure systemic and pulmonary blood flows in 22 patients aged from 3 months to 62 years presenting with interatrial (n = 13) or interventricular (n = 9) septal defect. Calculations were based on echographic measurements of aortic and pulmonary orifice areas and on the integral of maximal aortic and pulmonary Doppler velocity curves. Section areas or the arteries, taken as being circular, were deduced from arterial diameter measurements effected above Valsalva's sinus. Doppler velocity curves were recorded at that level, looking for maximal velocities and assuming a flat velocity profile. Blood flow ratios evaluated from Doppler-echocardiography data were compared with data provided by oximetry and showed good correlations (r = 0.92; Y = 0.71x + 0.53; SEE = 0.24). Calculations by categories of lesions showed better results in patients with interatrial septal defect (r = 0.94; Y = 0.73x + 0.507; SEE = 0.22) than in patients with interventricular septal defect (r = 0.83; Y = 0.547x + 0.75; SEE = 0.25). The main difficulties encountered in measuring Doppler-echocardiography blood flow ratios concerned accurate measurement of pulmonary artery diameter, due to problems of lateral resolution, and accurate measurement of turbulent Doppler velocimetry curves. However, this new, non-invasive technique may be useful to determine the best indications for catheterization or even surgery. PMID:3134868

Dequeker, J L; Jimenez, M; Gosse, P; Roudaut, R; Pouydebat, P; Gonçalves do Nascimento, L; Emeriau, J P; Choussat, A

1988-03-01

104

Assessment of the geometric profile of the Amplatzer and Cardioseal septal occluders by three dimensional echocardiography  

PubMed Central

OBJECTIVE—To apply three dimensional echocardiography to describe the geometric profile of the Amplatzer and Cardioseal occluders after deployment for closure of atrial septal defect.?METHODS—20 patients (mean (SD) age, 14 (5) years) were enrolled for transcatheter closure of a secundum atrial septal defect with the Amplatzer occluder (10) or with the Cardioseal occluder (10). The two populations were matched for the stretched diameter of the defect (mean 18 (6) mm). The profile of the two occluders was examined.?RESULTS—Transoesophageal echocardiography did not show any residual shunts after Amplatzer occluder deployment, whereas three patients had a small residual leak after Cardioseal deployment. One patient had transient atrioventricular block with the Amplatzer device. The mean surface area of the Amplatzer occluder was 6.9 (2) cm2, and that of the Cardioseal device 5.4 (3) cm2 (p = 0.03). The mean volume of the Amplatzer occluder was 9.2 (1) cm3, while that of the Cardioseal occluder was 3.5 (1) cm3 (p < 0.0001). From the three dimensional views, the Cardioseal occluder looked like a flat square after deployment whereas the Amplatzer occluder took up a ball shape in the atrial cavity.?CONCLUSIONS—Three dimensional views by multiplane transoesophageal echocardiography allow a realistic in vivo description of atrial septal occluders. The Amplatzer occluder, with its high geometric profile, allows complete closure of large atrial septal defects but with some risk of mechanical complications. Use of the Cardioseal device, with its small surface coverage and high residual shunt rate, should be limited to transcatheter closure of a patent foramen ovale or small atrial septal defects.???Keywords: atrial septal occluder; three dimensional echocardiography PMID:11250975

Acar, P; Saliba, Z; Bonhoeffer, P; Sidi, D; Kachaner, J

2001-01-01

105

Impact of intraoperative echocardiography on surgical management of congenital heart disease.  

PubMed

Intraoperative echocardiography was performed by epicardial, 2-dimensional, low- and high-pulsed repetition frequency, continuous-wave Doppler and color flow mapping in 50 patients. Forty studies were performed before and 44 studies after cardiopulmonary bypass. Studies before cardiopulmonary bypass agreed with preoperative evaluation. After cardiopulmonary bypass, studies revealed that 11 of 25 patients who underwent repair of ventricular septal defects had residual ventricular septal defects, and 1 of 25 patients who underwent atrial septal repair had 1 residual atrial communication. One patient with a "Swiss cheese" ventricular septum underwent repeat cardiopulmonary bypass to close residual ventricular septal defects. The patient with a residual atrial communication required immediate reoperation because of a right to left shunt after a modified Fontan procedure. Eight of 10 remaining residual ventricular septal defects spontaneously closed 1 to 41 days after operation. Assessment of postcardiopulmonary bypass and postoperative valvular regurgitation in 21 valves revealed good correlation (p less than 0.01). However, 1 patient required reoperation for mitral valve replacement on the sixth postoperative day. The correlation was fair between postcardiopulmonary bypass and postoperative residual stenotic pressure gradients in 12 surgically repaired stenotic lesions. This study shows that little additional information is added to a comprehensive preoperative evaluation by precardiopulmonary bypass intraoperative echocardiography. Postcardiopulmonary bypass intraoperative echocardiography is useful in identifying residual shunts. Assessment of stenotic gradients and valvular regurgitation must be interpreted in light of a changing hemodynamic state. PMID:2035454

Hsu, Y H; Santulli, T; Wong, A L; Drinkwater, D; Laks, H; Williams, R G

1991-06-01

106

Contrast echocardiography in critical care: echoes of the future? A review of the role of microsphere contrast echocardiography.  

PubMed

Echocardiography is an important diagnostic modality in the critical care setting. It is a safe, non-invasive bedside investigation that provides important cardiac structural, functional and haemodynamic information. However, in up to 25% of scans, the images are non-diagnostic, which can have a significant impact on patient diagnosis and management. Contrast echocardiography, using contrast microspheres coupled with contrast-specific ultrasound imaging modalities, overcomes many of the limitations that cause suboptimal echocardiograms in the critical care environment. These microspheres are haemodynamically inert and have the same intravascular rheology as red blood cells. By using the differential oscillating properties of myocardium and microspheres, contrast echocardiography can enhance the blood pool-myocardial interface, thus improving endocardial definition. Consequently, this technique can be used to improve the accuracy, feasibility and reproducibility of transthoracic echocardiography. The technique is well accepted and indicated for improving the image quality in suboptimal scans, and for the assessment of global and regional left ventricular (LV) function and LV ejection fraction. It also has a significant role to play in enhancing LV morphology (for conditions such as apical hypertrophic cardiomyopathy, pseudoaneurysm and non-compaction), assessing intracardiac masses and evaluating LV thrombus. Contrast echocardiography is of benefit in various clinical settings, particularly the critical care setting. Here it can salvage a non-diagnostic transthoracic echocardiogram, thus avoiding an alternative, more invasive investigation, while remaining a truly bedside, non-invasive investigative procedure. Future applications for contrast echocardiography could include use as a perfusion modality, enhancement of three-dimensional echocardiography, and targeted delivery of gene therapy. PMID:21355829

Platts, David G; Fraser, John F

2011-03-01

107

[3D echocardiography of the ascending aorta in Marfan's syndrome].  

PubMed

Marfan's syndrome is a cause of dilatation of the aorta, the main complication of which is dissection of the aorta. 2D echocardiography is the reference investigation for measuring the ascending aorta. Asymmetry of sinus dilatation makes a 3D approach necessary. Real time 3D echocardiography is a simple, non-invasive method which, by a biplane mode, allows measurement of the 3 sinuses of Valsalva. The aim of the study was to compare the 2D and 3D echocardiographic methods for measuring the ascending aorta. Fifteen patients (average age 12 +/- 8 years) with Marfan's syndrome were studied prospectively. The maximal 3D diameter was significantly greater than the 2D measurement (31.7 +/- 6.8 mm vs 29.9 +/- 6.6 mm, p< 0.005). In 4 patients, the difference was over 3 mm. The diameter between the right coronary and left coronary sinus was greater than the two others (right coronary-non coronary and left coronary-non coronary). The oldest 5 patients had an MRI aortic measurement very similar to that of 3D echocardiography (36.6 vs 36.7 mm). Real time 3D echocardiography in the biplane mode enables reliable and reproducible measurement of the aortic root in patients with Marfan's syndrome. Larger and multicenter studies are required to allow confirmation of the value of 3D echocardiography in the follow-up of these patients. PMID:15966605

Dulac, Y; Taktak, A; Acar, P; Abadir, S; Chilon, T; Edouard, T; Julia, S; Tauber, M; Hovnanian, A

2005-05-01

108

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

109

Contrast echocardiography displays increased subendocardial perfusion after nitroglycerin administration.  

PubMed

A mechanism proposed to contribute to the antianginal effect of nitroglycerin is a redistribution of coronary blood flow to the subendocardium. Contrast echocardiography combines ultrasound with echogenic contrast agents to assess regional myocardial perfusion. This study aims to assess the effect of nitroglycerin on myocardial transmural perfusion with contrast echocardiography in humans. Nine patients scheduled for coronary angiography received 300 microg intracoronary nitroglycerin. Contrast echocardiographic studies were performed before and immediately after the administration of intracoronary nitroglycerin. Videodensitometric analysis was performed off-line to measure subendocardial and subepicardial opacification. Subendocardial opacification greater than subepicardial opacification increased from six of 13 patients before nitroglycerin administration to 11 of 13 after nitroglycerin administration (p <0.05). Similarly, these observations increased from nine of 13 patients to 13 of 13 after nitroglycerin administration during diastole (p <0.05). Contrast echocardiography demonstrates increased subendocardial perfusion after the administration of nitroglycerin in these patients. PMID:9109685

Chandwaney, R H; Zajac, E; Saldivar, J; Block, R J; Winkelmann, J; Malhotra, V; Rabor, D; Kenner, M D; Feinstein, S B

1997-04-01

110

Detection of left coronary artery stenosis by transoesophageal echocardiography.  

PubMed

The ability of transoesophageal echocardiography to visualize the left coronary artery was retrospectively analysed in 60 consecutive patients without clinical evidence of coronary artery disease. The left main coronary artery was visualized in 56 patients, the proximal circumflex in 34 patients and the proximal anterior descending artery in nine patients. Patency of these arteries was established in all these patients. Subsequently, a prospective study was undertaken in 23 patients with angiographically proven left coronary artery disease. Both the left main coronary artery and the circumflex artery were adequately visualized with transoesophageal echocardiography in all 23 patients, whereas the anterior descending artery was identified in three patients. The extent of stenosis in the left main coronary artery and the circumflex artery was correctly diagnosed in 18 patients. In five patients the degree of stenosis was overestimated. These findings indicate the potential of transoesophageal echocardiography to detect or exclude stenosis of both the left main coronary artery and circumflex artery. PMID:3234407

Taams, M A; Gussenhoven, E J; Cornel, J H; The, S H; Roelandt, J R; Lancée, C T; vd Brand, M

1988-11-01

111

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

112

[Role of echocardiography in the hemodynamic monitorization of critical patients].  

PubMed

The use of echocardiography in intensive care units in shock patients allows us to measure various hemodynamic variables in an accurate and a non-invasive manner. By using echocardiography not only as a diagnostic technique but also as a tool for continuous hemodynamic monitorization, the intensivist can evaluate various aspects of shock states, such as cardiac output and fluid responsiveness, myocardial contractility, intracavitary pressures, heart-lung interaction and biventricular interdependence. However, to date there has been little guidance orienting echocardiographic hemodynamic parameters in the intensive care unit, and intensivists are usually not familiar with this tool. In this review, we describe some of the most important hemodynamic parameters that can be obtained at the patient bedside with transthoracic echocardiography in critically ill patients. PMID:22261614

Ayuela Azcarate, J M; Clau Terré, F; Ochagavia, A; Vicho Pereira, R

2012-04-01

113

Echocardiography for cardiac resynchronization therapy: recommendations for performance and reporting--a report from the American Society of Echocardiography Dyssynchrony Writing Group endorsed by the Heart Rhythm Society.  

PubMed

Echocardiography plays an evolving and important role in the care of heart failure patients treated with biventricular pacing, or cardiac resynchronization therapy (CRT). Numerous recent published reports have utilized echocardiographic techniques to potentially aide in patient selection for CRT prior to implantation and to optimized device settings afterwards. However, no ideal approach has yet been found. This consensus report evaluates the contemporary applications of echocardiography for CRT including relative strengths and technical limitations of several techniques and proposes guidelines regarding current and possible future clinical applications. Principal methods advised to qualify abnormalities in regional ventricular activation, known as dyssynchrony, include longitudinal velocities by color-coded tissue Doppler and the difference in left ventricular to right ventricular ejection using routine pulsed Doppler, or interventricular mechanical delay. Supplemental measures of radial dynamics which may be of additive value include septal-to-posterior wall delay using M-mode in patients with non-ischemic disease with technically high quality data, or using speckle tracking radial strain. A simplified post-CRT screening for atrioventricular optimization using Doppler mitral inflow velocities is also proposed. Since this is rapidly changing field with new information being added frequently, future modification and refinements in approach are anticipated to continue. PMID:18314047

Gorcsan, John; Abraham, Theodore; Agler, Deborah A; Bax, Jeroen J; Derumeaux, Genevieve; Grimm, Richard A; Martin, Randy; Steinberg, Jonathan S; Sutton, Martin St John; Yu, Cheuk-Man

2008-03-01

114

Clinical Application of Cine-MRI in the Visual Assessment of Mitral Regurgitation Compared to Echocardiography and Cardiac Catheterization  

PubMed Central

Background Detecting and quantifying the severity of mitral regurgitation is essential for risk stratification and clinical decision-making regarding timing of surgery. Our objective was to assess specific visual parameters by cine-magnetic resonance imaging (MRI) in the determination of the severity of mitral regurgitation and to compare it to previously validated imaging modalities: echocardiography and cardiac ventriculography. Methods The study population consisted of 68 patients who underwent a cardiac MRI followed by an echocardiogram within a median time of 2.0 days and 49 of these patients who had a cardiac catheterization, median time of 2.0 days. The inter-rater agreement statistic (Kappa) was used to evaluate the agreement. Results There was moderate agreement between cine MRI and Doppler echocardiography in assessing mitral regurgitation severity, with a kappa value of 0.47, confidence interval (CI) 0.29–0.65. There was also fair agreement between cine MRI and cardiac catheterization with a kappa value of 0.36, CI of 0.17–0.55. Conclusion Cine MRI offers a reasonable alternative to both Doppler echocardiography and, to a lesser extent, cardiac catheterization for visually assessing the severity of mitral regurgitation with specific visual parameters during routine clinical cardiac MRI. PMID:22815751

Heitner, John; Bhumireddy, Geetha P.; Crowley, Anna Lisa; Weinsaft, Jonathan; Haq, Salman A.; Klem, Igor; Kim, Raymond J.; Jollis, James G.

2012-01-01

115

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 ...

116

Intracardiac echocardiography: gross anatomy and magnetic resonance correlations and validations  

Microsoft Academic Search

Purpose: The feasibility and safety of intracardiac echocardiography (ICE) in humans, using low frequency transducers, and its excellent tissue contrast capabilities that enhances the differentiation of intracardiac structures have been previously demonstrated. However, correlations among ICE imaging and anatomic sections or magnetic resonance (MR) scan planes have never been described before. This study was designed to correlate a simplified ICE

Mario Zanchetta; Gianluca Rigatelli; Luigi Pedon; Marco Zennaro; Kostantinos Dimopoulous; Eustaquio Onorato; Carla Frescura; Pietro Maiolino; Gaetano Thiene; Annalisa Angelini

2005-01-01

117

Real-time 3D Transesophageal Echocardiography ERIC C. PUA,  

E-print Network

.edu Department of Pediatrics Duke University Medical Center 2 Durham, NC 27708 Transesophageal echocardiography with the Volumetrics Medical Imaging 3D scanner, real-time volumet- ric images of in vivo canine cardiac anatomy have be obtained, enabling visu- alization of cardiac chambers and valves. Because of this closeproximity

Smith, Stephen

118

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

119

Anomalous origin of the left coronary artery from the pulmonary artery initially visualized by echocardiography and multidetector computed tomography coronary angiography.  

PubMed

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; Ryu, Jae-Kean; Choi, Ji-Yong; Kim, Kee-Sik; Chang, Sung-Guk

2012-12-01

120

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

121

Evaluation of left ventricle functions by tissue Doppler, strain, and strain rate echocardiography in patients with primary hyperparathyroidism.  

PubMed

Cardiovascular morbidity and mortality are increased in patients with primary hyperparathyroidism (PHPT). We aimed to evaluate left ventricle systolic and diastolic functions with tissue Doppler imaging (TDI) and strain and strain rate echocardiography in patients with PHPT. Thirty-one patients with PHPT and 29 healthy controls were evaluated with conventional and pulse Doppler echocardiography, TDI and strain and strain rate echocardiography. Myocardial performance index (MPI) was calculated. Strain and peak systolic strain rate in mid and basal segments of lateral, anterior, inferior, and septal walls of left ventricle were determined. TDI showed similar late diastolic myocardial peak velocity in two groups. Peak systolic mitral annular velocity, early diastolic myocardial peak velocity, and ratio of early to late diastolic myocardial peak velocity were lower in PHPT patients (p = 0.01, p < 0.001 and p < 0.001, respectively). MPI calculated by TDI was 0.53 ± 0.15 in PHPT group and 0.44 ± 0.09 in control group (p = 0.013). Strain values were lower in mid and basal segments of septum, lateral and anterior walls, and basal segment of inferior wall in PHPT patients. Mean systolic strain was -20.88 ± 2.30 and -24.25 ± 2.13 in PHPT patients and control group, respectively (p < 0.001). Mean strain rate was lower in PHPT patients compared to control group (-1.38 ± 0.19 vs -1.57 ± 0.25) (p = 0.002). Patients with PHPT, but no cardiac symptoms or documented cardiovascular disease, have subclinical systolic and diastolic myocardial dysfunction. Evaluation of these patients with TDI and S and Sr echocardiography in addition to conventional echocardiography might be valuable to detect subclinical cardiac involvement. PMID:24676760

Ozdemir, Didem; Kalkan, Gulhan Yuksel; Bayram, Nihal Akar; Onal, Eda Demir; Ersoy, Reyhan; Bozkurt, Engin; Cakir, Bekir

2014-11-01

122

Isolated bicuspid pulmonary valve in adult diagnosed by three-dimensional transthoracic echocardiography.  

PubMed

Isolated bicuspid pulmonary valve is a rare arterial valve anomaly with very few reports in the literature, which regard overall cases of postmortem diagnosis. However, the true incidence of bicuspid pulmonary valve could be underestimated because of the difficulty in imaging pulmonary valve morphology with conventional two-dimensional transthoracic echocardiography (TTE). We report a case of isolated bicuspid pulmonary valve in an adult diagnosed by three-dimensional TTE. Off line multidimensional analysis of full-volume 3D allowed to obtain a short axis view of pulmonary valve showing a bicuspid valve characterized by an anterior and a posterior cups, normally thickened and with preserved systolic opening. PMID:22367573

Tagliareni, Francesco; D'Aleo, Antonio; Sanfilippo, Alessandra; Tagliareni, Antonino

2012-06-01

123

Longitudinal Study of Echocardiography-Derived Tricuspid Regurgitant Jet Velocity in Sickle Cell Disease  

PubMed Central

Summary Although echocardiography-derived tricuspid regurgitant jet velocity (TRV) is associated with increased mortality in sickle cell disease (SCD), its rate of increase and predictive markers of its progression are unknown. We evaluated 55 subjects (median age: 38 years, range: 20 – 65 years) with at least 2 measurable TRVs, followed for a median of 4.5 years (range: 1.0 – 10.5 years) in a single-centre, prospective study. Thirty-one subjects (56%) showed an increase in TRV, while 24 subjects (44%) showed no change or a decrease in TRV. A linear mixed effects model indicated an overall rate of increase in the TRV of 0.02 m/s per year (p = 0.023). The model showed that treatment with hydroxycarbamide was associated with an initial TRV that was 0.20 m/s lower than no such treatment (p = 0.033), while treatment with angiotensin converting enzyme inhibitors and inhibitors/ angiotensin receptor blockers was associated with an increase in the TRV (p = 0.006). In summary, although some patients have clinically meaningful increases, the overall rate of TRV increase is slow. Treatment with hydroxycarbamide may decrease the progression of TRV. Additional studies are required to determine the optimal frequency of screening echocardiography and the effect of therapeutic interventions on the progression of TRV in SCD. PMID:23829561

Desai, Payal C.; May, Ryan C.; Jones, Susan K.; Strayhorn, Dell; Caughey, Melissa; Hinderliter, Alan; Ataga, Kenneth I.

2013-01-01

124

Longitudinal study of echocardiography-derived tricuspid regurgitant jet velocity in sickle cell disease.  

PubMed

Although echocardiography-derived tricuspid regurgitant jet velocity (TRV) is associated with increased mortality in sickle cell disease (SCD), its rate of increase and predictive markers of its progression are unknown. We evaluated 55 subjects (median age: 38 years, range: 20-65 years) with at least two measurable TRVs, followed for a median of 4·5 years (range: 1·0-10·5 years) in a single-centre, prospective study. Thirty-one subjects (56%) showed an increase in TRV, while 24 subjects (44%) showed no change or a decrease in TRV. A linear mixed effects model indicated an overall rate of increase in the TRV of 0·02 m/s per year (P = 0·023). The model showed that treatment with hydroxycarbamide was associated with an initial TRV that was 0·20 m/s lower than no such treatment (P = 0·033), while treatment with angiotensin converting enzyme inhibitors and angiotensin receptor blockers was associated with an increase in the TRV (P = 0·006). In summary, although some patients have clinically meaningful increases, the overall rate of TRV increase is slow. Treatment with hydroxycarbamide may decrease the progression of TRV. Additional studies are required to determine the optimal frequency of screening echocardiography and the effect of therapeutic interventions on the progression of TRV in SCD. PMID:23829561

Desai, Payal C; May, Ryan C; Jones, Susan K; Strayhorn, Dell; Caughey, Melissa; Hinderliter, Alan; Ataga, Kenneth I

2013-09-01

125

Speckle tracking echocardiography detects uremic cardiomyopathy early and predicts cardiovascular mortality in ESRD.  

PubMed

Cardiovascular mortality is high in ESRD, partly driven by sudden cardiac death and recurrent heart failure due to uremic cardiomyopathy. We investigated whether speckle-tracking echocardiography is superior to routine echocardiography in early detection of uremic cardiomyopathy in animal models and whether it predicts cardiovascular mortality in patients undergoing dialysis. Using speckle-tracking echocardiography in two rat models of uremic cardiomyopathy soon (4-6 weeks) after induction of kidney disease, we observed that global radial and circumferential strain parameters decreased significantly in both models compared with controls, whereas standard echocardiographic readouts, including fractional shortening and cardiac output, remained unchanged. Furthermore, strain parameters showed better correlations with histologic hallmarks of uremic cardiomyopathy. We then assessed echocardiographic and clinical characteristics in 171 dialysis patients. During the 2.5-year follow-up period, ejection fraction and various strain parameters were significant risk factors for cardiovascular mortality (primary end point) in a multivariate Cox model (ejection fraction hazard ratio [HR], 0.97 [95% confidence interval (95% CI), 0.95 to 0.99; P=0.012]; peak global longitudinal strain HR, 1.17 [95% CI, 1.07 to 1.28; P<0.001]; peak systolic and late diastolic longitudinal strain rates HRs, 4.7 [95% CI, 1.23 to 17.64; P=0.023] and 0.25 [95% CI, 0.08 to 0.79; P=0.02], respectively). Multivariate Cox regression analysis revealed circumferential early diastolic strain rate, among others, as an independent risk factor for all-cause mortality (secondary end point; HR, 0.43; 95% CI, 0.25 to 0.74; P=0.002). Together, these data support speckle tracking as a postprocessing echocardiographic technique to detect uremic cardiomyopathy and predict cardiovascular mortality in ESRD. PMID:24700873

Kramann, Rafael; Erpenbeck, Johanna; Schneider, Rebekka K; Röhl, Anna B; Hein, Marc; Brandenburg, Vincent M; van Diepen, Merel; Dekker, Friedo; Marx, Nicolaus; Floege, Jürgen; Becker, Michael; Schlieper, Georg

2014-10-01

126

Current clinical application of intracardiac flow analysis using echocardiography.  

PubMed

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

Hong, Geu-Ru; Kim, Minji; Pedrizzetti, Gianni; Vannan, Mani A

2013-12-01

127

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

128

Entropy-based straight kernel filter for echocardiography image denoising.  

PubMed

A new filter has been proposed with the aim of eliminating speckle noise from 2D echocardiography images. This speckle noise has to be eliminated to avoid the pseudo prediction of the underlying anatomical facts. The proposed filter uses entropy parameter to measure the disorganized occurrence of noise pixel in each row and column and to increase the image visibility. Straight kernels with 3 pixels each are chosen for the filtering process, and the filter is slided over the image to eliminate speckle. The peak signal-to-noise ratio (PSNR) is obtained in the range of 147 dB, and the root mean square error (RMSE) is very low of approximately 0.15. The proposed filter is implemented on 36 echocardiography images, and the filter has the competence to illuminate the actual anatomical facts without degrading the edges. PMID:24838117

Rajalaxmi, S; Nirmala, S

2014-10-01

129

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

130

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

131

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

132

Transoesophageal echocardiography reduces invasiveness of cavoatrial tumour thrombectomy  

PubMed Central

The traditional approach to cavoatrial thrombus excision requires median sternotomy, cardiopulmonary bypass with or without hypothermia and circulatory arrest and is associated with significant morbidity and mortality. We describe a transoesophageal echocardiography guided balloon catheter assisted technique for cavoatrial thrombectomy that avoids thoracotomy, extracorporeal circulation and circulatory arrest as an alternative to traditional methods. A 74-year-old man presented with a right solid renal mass confined to the kidney with thrombus extension through the right renal vein and the inferior vena cava into the right atrium. A right radical nephrectomy with cavoatrial thrombectomy under transoesophageal echocardiography guidance was successfully achieved using a balloon catheter-assisted technique with minimal intra-and postoperative morbidity. Cavoatrial tumour thrombectomy can be successfully performed without cardiopulmonary bypass, hypothermia and circulatory arrest. PMID:25337178

Sobczy?ski, Robert; Mazur, Piotr; Ch?osta, Piotr

2014-01-01

133

Feasibility of creating estimates of left ventricular flow-volume dynamics using echocardiography  

PubMed Central

Background This study explores the feasibility of non-invasive assessment of left ventricular volume and flow relationship throughout cardiac cycle employing echocardiographic methods. Methods Nine healthy individuals and 3 patients with severe left-sided valvular abnormalities were subject to resting echocardiography with automated endocardial border detection allowing real-time estimation of left ventricular volume throughout the cardiac cycle. Global and regional (6 different left ventricular segments) estimates of flow-volume loops were subsequently constructed by plotting acquired instantaneous left ventricular 2-D area data (left ventricular volume) vs. their first derivatives (flow). Results Flow-volume loop estimates were obtainable in 75% of all echocardiographic images and displayed in normal individuals some regional morphological variation with more pronounced isovolumic events in the paraseptal segments and significantly delayed maximal systolic flow paraapically. In patients with aortic stenosis, maximal systolic flow occurred at a lower estimated left ventricular systolic volume whereas in mitral stenosis, maximal diastolic flow was observed at a higher estimated left ventricular diastolic volume. Aortic regurgitation caused a complex alteration of the estimated flow-volume loop shape during diastole. Conclusion Non-invasive assessment of left ventricular flow-volume relationship with echocardiography is technically feasible and reveals the existence of regional variation in flow-volume loop morphology. Valvular abnormalities cause a clear and specific alteration of the estimates of the normal systolic or diastolic flow-volume pattern, likely reflecting the underlying pathophysiology. PMID:17074099

Söderqvist, Emil; Cain, Peter; Lind, Britta; Winter, Reidar; Nowak, Jacek; Brodin, Lars-Åke

2006-01-01

134

Methodologic comparison of left ventricular stroke volumes in the early neonatal period by echocardiography.  

PubMed

Several methods for evaluating left ventricular stroke volume (SV) in neonates using echocardiography have been reported. However, no studies on methodologic comparison of SV with three-dimensional (3D) echocardiography are available. This is the first detailed report on a methodologic comparison of SV in the early neonatal period. The study group included 70 normal neonates (35 boys and 35 girls). An iE33 echocardiograph and Q-LAB supplied by Philips Electronics were used to examine and calculate volumes. Comparisons of SV were performed using Teichholz (T), the velocity time integral (VTI), Pombo (P), modified Simpson (MS), and 3D methods with normal neonates who had no persistent ductus arteriosus less than 7 days after birth. The mean SVs were 33.7 mL/m(2) (T), 30.6 mL/m(2) (VTI), 22.0 mL/m(2) (P), 17.5 mL/m(2) (3D), and 14.9 mL/m(2) (MS) using Haycock's formula of body surface area. The stroke volumes differed significantly depending on the different methods. The correlation coefficient was highest between the MS and 3D methods. The SVs of the T and VTI methods were significantly greater than those previously reported, and it seemed inappropriate to evaluate volumes in neonates. The 3D and MS methods were appropriate for measuring SV in neonates during the early neonatal period. PMID:24916967

Nagasawa, Hiroyuki; Kohno, Yoshinori; Yamamoto, Yutaka; Kondo, Masashi; Sugawara, Masami; Koyama, Toshinari; Terazawa, Daisuke; Miura, Ryosuke

2014-12-01

135

Augmented Reality Simulator for Training in Two-Dimensional Echocardiography  

Microsoft Academic Search

In two-dimensional echocardiography the sonographer must synthesize multiple tomographic slices into a mental three-dimensional (3D) model of the heart. Computer graphics and virtual reality environments are ideal to visualize complex 3D spatial relationships. In augmented reality (AR) applications, real and virtual image data are linked, to increase the information content. In the presented AR simulator a 3D surface model of

M. Weidenbach; C. Wick; S. Pieper; K. J. Quast; T. Fox; G. Grunst; D. A. Redel

2000-01-01

136

Echocardiography in Hemodialysis Patients: Uses and Challenges.  

PubMed

Patients with end-stage renal disease undergoing hemodialysis have high rates of morbidity and mortality. Cardiovascular disease accounts for almost half of this mortality, with the single most common cause being sudden cardiac death. Early detection of abnormalities in cardiac structure and function may be important to allow timely and appropriate cardiac interventions. Echocardiography is noninvasive cardiac imaging that is widely available and provides invaluable information on cardiac morphology and function. However, it has limitations. Echocardiography is operator dependent, and image quality can vary depending on the operator's experience and the patient's acoustic window. Hemodialysis patients undergo regular hemodynamic changes that also may affect echocardiographic findings. An understanding of the prognostic significance and interpretation of echocardiographic results in this setting is important for patient care. There are some emerging techniques in echocardiographic imaging that can provide more detailed and accurate information compared with conventional 2-dimensional echocardiography. Use of these novel tools may further our understanding of the pathophysiology of cardiac disease in patients with end-stage renal disease undergoing hemodialysis. PMID:24751169

Chiu, Diana Y Y; Green, Darren; Abidin, Nik; Sinha, Smeeta; Kalra, Philip A

2014-11-01

137

Visualization techniques for improved orientation in three-dimensional echocardiography  

NASA Astrophysics Data System (ADS)

Repair of a defect heart valve is of great advantage for the patient in comparison to replacement with a prosthesis. The applicability and the success of heart valve repair can be improved by an exact diagnosis of the valve's pathological modification. The best way for imaging heart valve insufficiencies is echocardiography, since it is fast, relatively cheap, can be used intraoperatively and provides information about morphology as well as blood flow. Three-dimensional echocardiography has been proven to be superior to conventional echocardiographic techniques. Although the overall structures are much better displayed by three-dimensional visualization methods, it is sometimes difficult to comprehend the orientation of the scene, since anatomical landmarks like the aortic outflow tract may be hidden by other structures. Also, such anatomical landmarks often are only partly contained in the acquired data set so that they are clearly visible in a few slices only, making them difficult to find in a three-dimensional visualization. The knowledge of the absolute orientation is of essential value for the surgeon to mentally transfer the preoperatively acquired data to the intraoperative situs. Therefore, it is desirable to have additional hints for orientation in the three-dimensional scene. We present methods that enable better and easier orientation and therefore improve the usability of three-dimensional echocardiography.

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

2002-05-01

138

Use of Doppler echocardiography to support the decision to discontinue secondary prophylaxis for patients with rheumatic fever and normal cardiac auscultation.  

PubMed

Secondary prophylaxis remains the safest way to prevent or minimize heart valve damage in patients with rheumatic fever. However, criteria to determine the duration of prophylaxis have not been well established. This study aimed to evaluate the clinical and Doppler echocardiographic profile of patients with rheumatic fever and a normal clinical examination at least 5 years after the first episode and to discuss the contribution of Doppler echocardiography in supporting the decision to discontinue secondary prophylaxis. An observational longitudinal study analyzing 183 patients with rheumatic fever and a normal clinical examination 5 years or more after the initial attack was conducted. The patients underwent Doppler echocardiography to study the severity of mitral or aortic valvular disease. Of the 183 patients, 77 (42 %) had clinical carditis. Subclinical chronic heart disease occurred for 79 % of the patients with previous clinical carditis and for 25 % of the patients without clinical carditis. Of the 35 patients with previous clinical carditis who were in the period of discontinued prophylaxis, residual valvular heart disease was observed in all, whereas of the 62 patients without clinical carditis, only 27 % showed residual valvular heart disease. Considering Doppler echocardiographic criteria, prophylaxis would be continued for 13 (34 %) of the patients with previous clinical carditis and for only 2 (3 %) of those without clinical carditis. Return of cardiac auscultation to normal is not always accompanied by return of Doppler echocardiographic findings to normal. Criteria regarding Doppler echocardiographic findings and valve morphology should be evaluated by the time secondary prophylaxis is discontinued. However, further studies are needed to demonstrate whether prolonged prophylaxis provides any benefit to patients with persistent echocardiographic findings. PMID:23239309

da Rocha Araújo, Fátima Derlene; de Andrade Goulart, Eugênio Marcos; Meira, Zilda Maria Alves

2013-06-01

139

LVM Assessed by Echocardiography and Cardiac Magnetic Resonance, Cardiovascular Outcomes, and Medical Practice  

PubMed Central

We investigate three important areas related to the clinical use of LVM (LVM): accuracy of assessments by echocardiography and cardiac magnetic resonance (CMR), the ability to predict cardiovascular outcomes, and the comparative value of different indexing methods. The recommended formula for echocardiographic estimation of LVM uses linear measurements and is based on the assumption of the left ventricle as a prolate ellipsoid of revolution. CMR permits a modeling of the left ventricle free of cardiac geometric assumptions or acoustic window dependency, showing better accuracy and reproducibility. However, echocardiography has lower cost, easier availability, and better tolerability. From the Medline database, 26 longitudinal echocardiographic studies and 5 CMR studies, investigating LVM or LV hypertrophy as predictors of death or major cardiovascular outcomes, were identified. LVM and LV hypertrophy were reliable cardiovascular risk predictors using both modalities. However, no study directly compared the methods for the ability to predict events, agreement in hypertrophy classification, or performance in cardiovascular risk reclassification. Indexing LVM to BSA was the earliest normalization process used, but it seems to underestimate the prevalence of hypertrophy in obese and overweight subjects. Dividing LVM by height to 1.7 or 2.7 as allometric powers are the most promising normalization methods in terms of practicality and usefulness from a clinical ans scientific standpoints for scaling myocardial mass to body size. The measurement of LVM, calculation of LVMi, and classification for LVH should be standardized by scientific societies across measurement techniques and adopted by clinicians in risk stratification and therapeutic decision. PMID:22897998

Armstrong, Anderson C.; Gidding, Samuel; Gjesdal, Ola; Wu, Colin; Bluemke, David A; Lima, Joao A.

2012-01-01

140

Postoperative non-invasive assessment of pulmonary vascular resistance using Doppler echocardiography.  

PubMed

Non-invasive monitoring of pulmonary vascular resistance (PVR) in postoperative cardiac surgery patients might be useful, particularly for management of pulmonary hypertension. For this purpose, we sought to assess Doppler echocardiography in the intensive care setting. In 73 patients, hemodynamics was measured using both, invasive gold standard (pulmonary artery catheter), and non-invasively by Doppler echocardiography. Four Doppler parameters: (1) tricuspid regurgitant velocity/time-velocity-integral of right ventricular outflow tract (TRV/VTI(RVOT)), (2) tricuspid annular systolic velocity (S'), (3) tricuspid annular strain, and (4) tricuspid annular strain rate, were compared with invasive PVR, using linear regression analysis and receiver-operating-characteristics. Patients without (n = 25, group 1) and patients with elevated left ventricular filling pressure (wedge pressure ? 15 mmHg, group 2, n = 48) were compared. Correlations were (1) R = 0.874, P < 0.0001, (2) R = -0.765, P < 0.0001, (3) R = 0.279, P = 0.009, (4) R = 0.378, P = 0.001. TRV/VTI(RVOT) showed prediction of PVR >300 dyn*s*/cm(5) (area-under-curve 0.975, cut-off 0.245, sensitivity 100%, specificity 91%). Strain correlated with PVR in group 2 patients only. TRV/VTI(RVOT) and tricuspid annular systolic velocity (S'), are useful for non-invasive monitoring of PVR in postoperative cardiac surgery patients with or without elevated left ventricular filling pressure. Strain may be used in patients with elevated filling pressure. PMID:21729949

Albers, Jörg; Ister, Dilek; Kayhan, Nalan; Vahl, Christian F

2011-12-01

141

Comparison of two-dimensional echocardiography with gated radionuclide ventriculography in the evaluation of global and regional left ventricular function in acute myocardial infarction  

SciTech Connect

Two-dimensional echocardiography and gated radionuclide ventriculography were performed in 93 patients (66 men, 27 women; mean age 61 years) with 95 episodes of acute myocardial infarction within 48 hours and at 10 days after infarction. Abnormal motion of an inferior or posterior wall segment was seen in 91% of inferoposterior infarctions by echocardiography versus 61% seen by radionuclide ventriculography. Ejection fractions determined by echocardiography and radionuclide ventriculography correlated well (r . 0.82) and did not change from the first 48 hours to 10 days after infarction (0.48 +/- 0.14). Similarly, wall motion score showed minimal change from the first 48 hours to 10 days. In-hospital mortality was 37 and 42% in patients with an ejection fraction of 0.35 or less by echocardiography and radionuclide ventriculography, respectively. No mortality was seen in patients with an ejection fraction above 0.40 by either test. The echocardiographic wall motion score was also predictive of mortality (40 versus 2%; score less than or equal to 0.50 versus greater than 0.50). The 1 year mortality rate in the 81 short-term survivors was 17%. Mortality was lowest in patients with an ejection fraction above 0.49 or wall motion score above (0.79 (2 to 5%) and worse in those with an ejection fraction below 0.36 or wall motion score below 0.51 (36 to 63%) by either technique. Thus in acute myocardial infarction, echocardiography and radionuclide ventriculography provide a comparable assessment of left ventricular function and wall motion in anterior infarction. Echocardiography appears more sensitive in detecting inferoposterior wall motion abnormalities. Both techniques are capable of identifying subgroups of patients with a high risk of death during the acute event and with an equally high mortality rate over a 1 year follow-up period.

Van Reet, R.E.; Quinones, M.A.; Poliner, L.R.; Nelson, J.G.; Waggoner, A.D.; Kanon, D.; Lubetkin, S.J.; Pratt, C.M.; Winters, W.L. Jr.

1984-02-01

142

[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

143

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.

144

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; Calabro, Raffaele

2014-01-01

145

Stress Echocardiography for the Diagnosis of Coronary Artery Disease  

PubMed Central

Executive Summary In July 2009, the Medical Advisory Secretariat (MAS) began work on Non-Invasive Cardiac Imaging Technologies for the Diagnosis of Coronary Artery Disease (CAD), an evidence-based review of the literature surrounding different cardiac imaging modalities to ensure that appropriate technologies are accessed by patients suspected of having CAD. This project came about when the Health Services Branch at the Ministry of Health and Long-Term Care asked MAS to provide an evidentiary platform on effectiveness and cost-effectiveness of non-invasive cardiac imaging modalities. After an initial review of the strategy and consultation with experts, MAS identified five key non-invasive cardiac imaging technologies for the diagnosis of CAD. Evidence-based analyses have been prepared for each of these five imaging modalities: cardiac magnetic resonance imaging, single photon emission computed tomography, 64-slice computed tomographic angiography, stress echocardiography, and stress echocardiography with contrast. For each technology, an economic analysis was also completed (where appropriate). A summary decision analytic model was then developed to encapsulate the data from each of these reports (available on the OHTAC and MAS website). The Non-Invasive Cardiac Imaging Technologies for the Diagnosis of Coronary Artery Disease series is made up of the following reports, which can be publicly accessed at the MAS website at: www.health.gov.on.ca/mas"> www.health.gov.on.ca/mas or at www.health.gov.on.ca/english/providers/program/mas/mas_about.html Single Photon Emission Computed Tomography for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Stress Echocardiography for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Stress Echocardiography with Contrast for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis 64-Slice Computed Tomographic Angiography for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Cardiac Magnetic Resonance Imaging for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Pease note that two related evidence-based analyses of non-invasive cardiac imaging technologies for the assessment of myocardial viability are also available on the MAS website: Positron Emission Tomography for the Assessment of Myocardial Viability: An Evidence-Based Analysis Magnetic Resonance Imaging for the Assessment of Myocardial Viability: an Evidence-Based Analysis The Toronto Health Economics and Technology Assessment Collaborative has also produced an associated economic report entitled: The Relative Cost-effectiveness of Five Non-invasive Cardiac Imaging Technologies for Diagnosing Coronary Artery Disease in Ontario [Internet]. Available from: http://theta.utoronto.ca/reports/?id=7 Objective The objective of the analysis is to determine the diagnostic accuracy of stress echocardiography (ECHO) in the diagnosis of patients with suspected coronary artery disease (CAD) compared to coronary angiography (CA). Stress Echocardiography Stress ECHO is a non-invasive technology that images the heart using ultrasound. It is one of the most commonly employed imaging techniques for investigating a variety of cardiac abnormalities in both community and hospital settings. A complete ECHO exam includes M-mode, 2-dimensional (2-D) images and Doppler imaging. In order to diagnosis CAD and assess whether myocardial ischemia is present, images obtained at rest are compared to those obtained during or immediately after stress. The most commonly used agents used to induce stress are exercise and pharmacological agents such as dobutamine and dipyridamole. The hallmark of stress-induced myocardial ischemia is worsening of wall motion abnormalities or the development of new wall motion abnormalities. A major challenge for stress ECHO is that the interpretation of wall motion contractility and function is subjective. This leads to inter-observer variability and reduced reproducibility. Further, it is estimated that approximately 30% of patients have sub-

2010-01-01

146

Diagnostic Errors in Pediatric Echocardiography Development of Taxonomy and Identification of Risk Factors  

PubMed Central

Background Despite increased interest in complications within pediatric cardiology, the domain of imaging-related diagnostic errors has received little attention. We developed a new taxonomy for diagnostic errors within pediatric echocardiography that categorizes errors by severity, preventability, and primary contributor. Our objectives were to examine its findings when applied to diagnostic error cases and to identify risk factors for preventable or possibly preventable diagnostic errors. Methods and Results Diagnostic errors were identified at a high-volume academic pediatric cardiac center from December 2004 to August 2007. Demographic, clinical, and situational variables were collected from these cases and controls. During the study period, ?50 660 echocardiograms were performed. Among the 87 diagnostic error cases identified, 70% affected clinical management or the patient was at risk of or experienced an adverse event. One third of the errors were preventable and 46% were possibly preventable; 69% of preventable errors were of moderate severity or greater. Univariate analysis demonstrated that preventable or possibly preventable errors were more likely to involve younger patients, lower body weight, study location, sedated/anesthetized patients, studies performed and interpreted at night, uncommon diagnoses, and greater anatomic complexity than controls. Multivariate analysis identified the following risk factors: rare or very rare diagnoses (adjusted odds ratio [AOR], 9.2; P<0.001), study location in the recovery room (AOR, 7.9; P<0.001), moderate anatomic complexity (AOR, 3.5; P=0.004), and patient weight <5 kg (AOR, 3.5; P=0.031). Conclusions A diagnostic error taxonomy and knowledge of risk factors can assist in identification of targets for quality improvement initiatives that aim to decrease diagnostic error in pediatric echocardiography. PMID:18519849

Benavidez, Oscar J.; Jenkins, Kathy J.; Geva, Tal

2014-01-01

147

Obesity in show cats.  

PubMed

Obesity is an important disease with a high prevalence in cats. Because obesity is related to several other diseases, it is important to identify the population at risk. Several risk factors for obesity have been described in the literature. A higher incidence of obesity in certain cat breeds has been suggested. The aim of this study was to determine whether obesity occurs more often in certain breeds. The second aim was to relate the increased prevalence of obesity in certain breeds to the official standards of that breed. To this end, 268 cats of 22 different breeds investigated by determining their body condition score (BCS) on a nine-point scale by inspection and palpation, at two different cat shows. Overall, 45.5% of the show cats had a BCS > 5, and 4.5% of the show cats had a BCS > 7. There were significant differences between breeds, which could be related to the breed standards. Most overweight and obese cats were in the neutered group. It warrants firm discussions with breeders and cat show judges to come to different interpretations of the standards in order to prevent overweight conditions in certain breeds from being the standard of beauty. Neutering predisposes for obesity and requires early nutritional intervention to prevent obese conditions. PMID:24612018

Corbee, R J

2014-12-01

148

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

149

Supporting the early use of echocardiography in blunt chest trauma  

PubMed Central

This case reports a very unusual mechanism of cardiac rupture following an episode of multiple blunt chest trauma. The patient, a professional jockey, was trampled by horses, and although shocked on hospital admission, he did not present with signs and symptoms that were consistent with cardiogenic shock. This case highlights the difficult and subjective nature of clinical examination in emergency situations when dealing with cases of acute cardiac tamponade. It further emphasises the lack of sensitivity of traditional trauma imaging and investigative approaches such as the standard anteroposterior chest X-ray and electrocardiogram. The diagnosis of acute cardiac tamponade was not made until tertiary-care-centre arrival, when ultrasound technology in the form of bedside echocardiography was used, facilitating emergency surgery to repair a ruptured left ventricle. It is hoped that the sharing of this case will alert fellow clinicians to this uncommon but possible mechanism of cardiac rupture and subsequent tamponade, encourage the early use of echocardiography at the bedside in hypotensive blunt chest trauma cases and reinforce the principles of the Advanced Trauma Life Support course in treating trauma victims. PMID:22870886

2012-01-01

150

Concise Definitive Review: Focused Critical Care Echocardiography in the ICU  

PubMed Central

Objective Portable ultrasound is now used routinely in many intensive care units (ICUs) for various clinical applications. Echocardiography performed by non-cardiologists, both transesophageal (TEE) and transthoracic (TTE), has evolved to broad applications in diagnosis, monitoring, and management of critically ill patients. This review provides a current update on Focused Critical Care Echocardiography (FCCE) for the management of critically ill patients. Method Source data were obtained from a PubMed search of the medical literature, including the PubMed “related articles” search methodology. Summary and Conclusions While studies demonstrating improved clinical outcomes for critically ill patients managed by FCCE are generally lacking, there is evidence to suggest that some intermediate outcomes are improved. Furthermore, non-cardiologists can learn FCCE and adequately interpret the information obtained. Non-cardiologists can also successfully incorporate FCCE into advanced cardiopulmonary life support (ACLS). Formal training and proctoring are important for safe application of FCCE in clinical practice. Further outcomes-based research is urgently needed to evaluate the efficacy of FCCE PMID:23989172

Oren-Grinberg, Achikam; Talmor, Daniel; Brown, Samuel M.

2013-01-01

151

Serial Echocardiography in Very Preterm Infants: A Pilot Randomized Trial  

PubMed Central

Aim To determine whether routine echocardiography increases diagnosis and treatment of patent ductus arteriosus (PDA) and whether randomized non-disclosure is a feasible strategy for studying PDA management. Methods 2 center pilot randomized, controlled trial. 88 infants with birth weights ?1250 grams and gestational ages ?30 weeks were randomized to disclosure or non-disclosure of serial echocardiogram findings. Echocardiograms were performed at 3–5 and 7–10 days of life. The primary outcome was time to regain birth weight. Results 100% of echocardiograms in the disclosure group were disclosed; 16% (echocardiogram #1) and 29% (echocardiogram #2) were disclosed in the non-disclosure group. There was a statistically non-significant decrease in drug therapy for PDA in the non-disclosure group (adjusted odds ratio [AOR] 0.56, 95% confidence interval [CI] 0.24–1.34). There was no difference in time to regain birth weight or in other important neonatal outcomes. However, infants in the non-disclosure group were more likely to demonstrate appropriate weight loss and then regain birth weight within 7–14 days (AOR 2.64, 95% CI 1.08–6.44). Conclusion Randomized non-disclosure of echocardiograms is a feasible strategy for evaluation of approaches to PDA management in very preterm infants. Avoidance of routine echocardiography may reduce drug therapy for PDA without adverse clinical effects. PMID:23952100

DeMauro, Sara B.; Cohen, Meryl S.; Ratcliffe, Sarah J.; Abbasi, Soraya; Schmidt, Barbara

2013-01-01

152

Prognostic Value of Normal Stress Echocardiography in Obese Patients  

PubMed Central

Background. Chest pain is a common problem in obese patients. Because of the body habitus, the results of noninvasive evaluation for CAD may be limited in this group. Methods. We reviewed the records of 1446 consecutive patients who had undergone clinically indicated stress echocardiography (SE). We compared major adverse cardiac events (MACE; myocardial infarction, cardiac intervention, cardiac death, subsequent hospitalization for cardiac events, and emergency department visits) at 1 year in normal weight, overweight, and obese subjects with normal SE. Results. Excluding patients with an abnormal and indeterminate SE and those who were lost to follow-up, a retrospective analysis of 704 patients was performed. There were 366 obese patients (BMI ? 30), 196 overweight patients (BMI 25–29.9), and 142 patients with normal BMI (18.5–24.9). There was no MACE in the groups at 1-year follow-up after a normal SE. Conclusions. In obese patients including those with multiple risk factors and symptoms concerning for cardiac ischemia, stress echocardiography is an effective and reliable noninvasive tool for identifying those with a low 1-year risk of cardiac events. PMID:25258682

Murphy, Michele; Krothapalli, Siva; Cuellar, Jose; Kanjanauthai, Somsupha; Heeke, Brian; Gomadam, Pallavi S.; Guha, Avirup; Barnes, Vernon A.; Litwin, Sheldon E.; Sharma, Gyanendra K.

2014-01-01

153

Stroke volume changes during dobutamine-atropine stress echocardiography: the influence of heart rate and ischaemia  

Microsoft Academic Search

Background: A decrease in stroke volume during dobutamine-atropine stress echocardiography heralds ischaemia and possible hypotension. Hypotension results from worsening of LV-function (as a result of ischaemia) left ventricular outflow tract obstruction or hypovolemia, while an increase of stroke volume indicates the preservation of myocardial contractile reserve. Objective: To assess stroke volume changes during dobutamine stress echocardiography in relation to heart

Don Poldermans; Riccardo Rambaldi; Eric Boersma; Wim Vletter; Stephane Carlier; Abdou Elhendy; Jeroen J. Bax; Jos R. T. C. Roelandt

1999-01-01

154

Physical Examination and ECG Screening in Relation to Echocardiography Findings in Young Healthy Adults  

Microsoft Academic Search

Background and Aims: Cardiovascular screening in young adults is an important tool in many occupational settings. Our aim was to test whether screening physical examination and ECG influence the rate of abnormal echocardiogarphic findings in young healthy subjects. Methods: Consecutive echocardiography results of 18- to 20-year-old flight candidates were analyzed retrospectively. Echocardiographies were performed as part of a screening protocol,

Dan-Avi Landau; Alon Grossman; Yaniv Sherer; David Harpaz; Bella Azaria; Dan Carter; Erez Barenboim; Liav Goldstein

2008-01-01

155

Safety and feasibility of day case patent foramen ovale (PFO) closure facilitated by intracardiac echocardiography.  

PubMed

Ultrasound guided patent foramen ovale (PFO) closure has traditionally utilized transoesophageal echocardiography (TOE) under general anaesthesia. Some centres use fluoroscopic guidance alone to facilitate day case PFO closure. Intracardiac echocardiography (ICE) is performed via femoral vein access using an 11 Fr sheath providing accurate guidance without the necessity for general anaesthesia. The safety and feasibility of PFO closure using ICE guidance as a day case procedure have not been documented. We present a consecutive series of patients undergoing planned day case PFO closure under ICE guidance with transthoracic echocardiogram (TTE) follow up. Patients excluded from day case PFO closure were those with early pregnancy or unfavourable social circumstances. 53 consecutive adult patients (44.2+/-11.0 years; 24 males) were planned for day case PFO closure facilitated by ICE. Referral indications were stroke or TIA (n=39), peripheral embolism (n=6), decompression sickness (n=7) and severe migraine (n=1). All 53 patients underwent ICE, with 9/53 (17%) having an atrial septal aneurysm. In 5 patients no PFO was found. In the remaining 48 patients, PFO closure was achieved using the HELEX occluder (n=47) or the Amplatzer device (n=1). Mean procedure and fluoroscopy times were 31.0+/-12.4 and 5.3+/-3.9 min respectively. One patient failed same day discharge due to groin haematoma. There were no other complications. At 3 month follow up, 45/48 (94%) had no residual shunt, with 3 patients having small residual shunts on colour flow Doppler. In conclusion, percutaneous PFO closure as a day case procedure is safe and feasible when facilitated by ICE. PMID:18037512

Ponnuthurai, Francis A; van Gaal, William J; Burchell, Amy; Mitchell, Andrew R; Wilson, Neil; Ormerod, Oliver J

2009-01-24

156

Valvular heart disease and 3-dimensional echocardiography: ready for prime-time?  

PubMed Central

Significant advances in 3-dimensional echocardiography (3DE) technology have ushered its use into clinical practice. The recent advent of real-time 3DE using matrix array transthoracic and transesophageal transducers has resulted in improved image spatial resolution, and therefore, enhanced visualization of the patho-morphological features of the cardiac valves. Three-dimensional echocardiography provides unique perspectives of valvular structures by presenting “en face” views of valvular structures, allowing for a better understanding of the topographical aspects of pathology, and a refined definition of the spatial relationships of intracardiac structures. Three-dimensional echocardiography makes available indices not described by 2D echocardiography and has been demonstrated to be superior to 2D echocardiography in a variety of valvular disease scenarios. In this review, we discuss the incremental role of 3DE in evaluating valvular anatomic features, volumetric quantification, pre-surgical planning, intra-procedural guidance, and post-procedural assessment of valvular heart disease. PMID:23173101

Moura, Luis M; de Isla, Leopoldo Perez

2012-01-01

157

Obesity in show dogs.  

PubMed

Obesity is an important disease with a growing incidence. Because obesity is related to several other diseases, and decreases life span, it is important to identify the population at risk. Several risk factors for obesity have been described in the literature. A higher incidence of obesity in certain breeds is often suggested. The aim of this study was to determine whether obesity occurs more often in certain breeds. The second aim was to relate the increased prevalence of obesity in certain breeds to the official standards of that breed. To this end, we investigated 1379 dogs of 128 different breeds by determining their body condition score (BCS). Overall, 18.6% of the show dogs had a BCS >5, and 1.1% of the show dogs had a BCS>7. There were significant differences between breeds, which could be correlated to the breed standards. It warrants firm discussions with breeders and judges in order to come to different interpretations of the standards to prevent overweight conditions from being the standard of beauty. PMID:22882163

Corbee, R J

2012-08-11

158

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

159

Not a "reality" show.  

PubMed

The authors of the preceding articles raise legitimate questions about patient and staff rights and the unintended consequences of allowing ABC News to film inside teaching hospitals. We explain why we regard their fears as baseless and not supported by what we heard from individuals portrayed in the filming, our decade-long experience making medical documentaries, and the full un-aired context of the scenes shown in the broadcast. The authors don't and can't know what conversations we had, what documents we reviewed, and what protections we put in place in each televised scene. Finally, we hope to correct several misleading examples cited by the authors as well as their offhand mischaracterization of our program as a "reality" show. PMID:23631336

Wrong, Terence; Baumgart, Erica

2013-01-01

160

Head to head comparisons of two modalities of perfusion adenosine stress echocardiography with simultaneous SPECT  

PubMed Central

Background Real-time perfusion (RTP) contrast echocardiography can be used during adenosine stress echocardiography (ASE) to evaluate myocardial ischemia. We compared two different types of RTP power modulation techniques, angiomode (AM) and high-resolution grayscale (HR), with 99mTc-tetrofosmin single-photon emission computed tomography (SPECT) for the detection of myocardial ischemia. Methods Patients with known or suspected coronary artery disease (CAD), admitted to SPECT, were prospectively invited to participate. Patients underwent RTP imaging (SONOS 5500) using AM and HR during Sonovue® infusion, before and throughout the adenosine stress, also used for SPECT. Analysis of myocardial perfusion and wall motion by RTP-ASE were done for AM and HR at different time points, blinded to one another and to SPECT. Each segment was attributed to one of the three main coronary vessel areas of interest. Results In 50 patients, 150 coronary areas were analyzed by SPECT and RTP-ASE AM and HR. SPECT showed evidence of ischemia in 13 out of 50 patients. There was no significant difference between AM and HR in detecting ischemia (p = 0.08). The agreement for AM and HR, compared to SPECT, was 93% and 96%, with Kappa values of 0.67 and 0.75, respectively (p < 0.001). Conclusion There was no significant difference between AM and HR in correctly detecting myocardial ischemia as judged by SPECT. This suggests that different types of RTP modalities give comparable data during RTP-ASE in patients with known or suspected CAD. PMID:19379491

Gudmundsson, Petri; Shahgaldi, Kambiz; Winter, Reidar; Dencker, Magnus; Kitlinski, Mariusz; Thorsson, Ola; Ljunggren, Lennart; Willenheimer, Ronnie B

2009-01-01

161

Strain and strain rate echocardiography findings in children with asymptomatic congenital aortic stenosis.  

PubMed

The aim of our study was to evaluate myocardial functions with strain/strain rate echocardiography in asymptomatic patients having congenital aortic stenosis (CAS) with normal cardiac functions as determined by conventional echocardiographic techniques and comparing them with those of healthy controls. A total of 58 patients with various degrees of isolated CAS and 52 healthy controls were enrolled in this study. Conventional and two-dimensional speckle tracking (2DSTE) echocardiography were performed. Global longitudinal strain (LS) (-23.1 ± 3.6 and -23.8 ± 4.7), and longitudinal strain rate (LSR) (-1.49 ± 0.32 and -1.76 ± 0.39) values were lower, whereas circumferential strain (CS) (-25.9 ± 4.7 and -22.8 ± 6.4) and circumferential strain rate (CSR) (-1.82 ± 0.46 and -1.69 ± 0.49) values were greater in the patient group than in the control subjects. The difference was significant for global LSR and CS (p < 0.05) values. Regional analysis showed lower LS values in the basal part of the left-ventricular (LV) free wall and lower LSR values in the basal parts of both of the septum and free wall in the patient group (p < 0.05). CS values in the anteroseptal, posterior, and inferior walls were significantly greater in the patients (p < 0.05). 2DSTE detects subtle alterations in myocardial function in asymptomatic children with CAS. Impairment of LV long-axis function occurred earlier and was more prominent in basal parts of the interventricular septum and the free wall of the left ventricle. PMID:23314915

Dogan, Vehbi; Öcal, Burhan; Orun, Utku Arman; Ozgur, Senem; Y?lmaz, Osman; Keskin, Mahmut; Ceylan, Ozben; Karademir, Selmin; ?enocak, Filiz

2013-06-01

162

Tako-Tsubo syndrome after an exercise echocardiography.  

PubMed

The Tako-Tsubo syndrome is a clinical entity recently described that associate a chest pain occurring during a stress, an abnormal ECG and/or an increase in the troponin blood level and a transient left ventricular dysfunction with an akinesis involving generally the midsection and the apex of the heart. It has also been reported that left ventricle (LV) dysfunction may involve only the midventricle, although it seems less common. We report the case of a 66 year old woman that developed a stress-induced cardiomyopathy (Tako-Tsubo syndrome) involving the midventricle when performing an exercise echocardiography. To our knowledge, this is the first case reported in such circumstances. PMID:17692968

Digne, F; Paillole, C; Pillière, R; Elayi, S C; Gérardin, B; Dib, J C; Dahan, M

2008-07-21

163

Quantifying changes in regional myocardial perfusion with aortic contrast echocardiography.  

PubMed

We developed a technique to assess regional myocardial perfusion by quantifying echocardiographic myocardial contrast appearance and intensity after aortic root injection of an agitated diatrizoate meglumine solution. The technique was validated by comparing digitized echocardiographic contrast parameters to regional perfusion in the circumflex bed determined by calibrated Doppler flow probe and antemortem monastral blue staining. Regional perfusion was altered by circumflex stenosis, occlusion, and reactive hyperemia. Contrast effects were measured in an initial subset of six dogs by peak intensity change, time to peak intensity, maximal rate of intensity rise, and mean intensity change integrated over 1, 2, or 3 seconds after contrast appearance (MI1, MI2, MI3). MI2 and MI3 best predicted regional perfusion (r = 0.93, standard error of the estimate [SEE] 0.38 ml/gm/min for each). These findings were confirmed in a second subset of six dogs (r = 0.84, SEE = 0.70 ml/gm/min). Although there was a relatively broad standard error for the prediction of absolute perfusion for the pooled data, for individual dogs data were internally consistent so that each had r greater than 0.88 for its varied flow states. The hyperemic ratio calculated by contrast echocardiography correlated well with the Doppler value (r = 0.85). Observer and study-to-study predictive variabilities were small (SEE 0.19 to 0.32 ml/gm/min). No alterations were seen in hemodynamics or reactive hyperemia after 25 consecutive injections over a 90-minute period. Contrast echocardiography with aortic root contrast injection tracks changes in regional blood flow. This approach can assess regional coronary reserve and detect changes in regional myocardial perfusion during acute ischemia and drug intervention. PMID:2627423

Kemper, A J; Nickerson, D; Boyle, C C; Saleh, R; Parisi, A F

1989-01-01

164

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

165

Three-Dimensional Reconstruction of Coronary Arteries and Its Application in Localization of Coronary Artery Segments Corresponding to Myocardial Segments Identified by Transthoracic Echocardiography  

PubMed Central

Objectives. To establish 3D models of coronary arteries (CA) and study their application in localization of CA segments identified by Transthoracic Echocardiography (TTE). Methods. Sectional images of the heart collected from the first CVH dataset and contrast CT data were used to establish 3D models of the CA. Virtual dissection was performed on the 3D models to simulate the conventional sections of TTE. Then, we used 2D ultrasound, speckle tracking imaging (STI), and 2D ultrasound plus 3D CA models to diagnose 170 patients and compare the results to coronary angiography (CAG). Results. 3D models of CA distinctly displayed both 3D structure and 2D sections of CA. This simulated TTE imaging in any plane and showed the CA segments that corresponded to 17 myocardial segments identified by TTE. The localization accuracy showed a significant difference between 2D ultrasound and 2D ultrasound plus 3D CA model in the severe stenosis group (P < 0.05) and in the mild-to-moderate stenosis group (P < 0.05). Conclusions. These innovative modeling techniques help clinicians identify the CA segments that correspond to myocardial segments typically shown in TTE sectional images, thereby increasing the accuracy of the TTE-based diagnosis of CHD. PMID:24348745

Zhong, Chunyan; Guo, Yanli; Huang, Haiyun; Tan, Liwen; Wu, Yi; Wang, Wenting

2013-01-01

166

[Comparative value of transthoracic echocardiography and angiography for measuring the pulmonary artery annulus in tetralogy of Fallot].  

PubMed

It may be necessary to perform an enlarging pulmonary annuloplasty during surgical cure of Tetralogy of Fallot (TOF) in order to optimise reconstruction of the right ventricular outflow tract. As this additional procedure implies an increase in perioperative mortality, it is useful to prepare for this eventuality before surgery. Two imaging techniques are available: transthoracic echocardiography (diameter of the pulmonary annulus obtained by averaging the measurements obtained in the subcostal and parasternal short axis views of the insertion of the pulmonary valve cusps at end systole) and selective angiography during right heart catheterisation (anteroposterior measurement with comparison to be projected and real size of the catheter at the point of insertion of the cusps at end systole). In this study, these two techniques were compared with reference to the peroperative measurement with Hegar dilators and criteria defined by Naito (minimal diameter of the pulmonary artery annulus with respect to the weight of the child). Seventy-eight children admitted to hospital between January 1986 and April 1994 for curative surgery of TOF were included. The calculation of the intra-class correlation coefficient showed a mediocre correlation with angiography and a very mediocre correlation with echocardiography compared with peroperative measurements. However, the calculation of sensitivities showed angiography to be the predictive investigation for annuloplasty in children not conforming to the Naito criteria: higher sensitivity (83% vs 26% for echocardiography), greater negative predictive value (84% vs 70%). This result holds for all categories of body weight (over and under 10 kg).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7646278

Guérin, P; Baudet, E; Jimenez, M; Laborde, N; Roques, X; Srour, S; Choussat, A

1995-05-01

167

Temporal changes in plasma brain natriuretic Peptide levels during exercise stress-echocardiography in patients with dilated cardiomyopathy.  

PubMed

The aim of this study was to evaluate temporal changes in brain natriuretic petide (BNP) levels during exercise stress-echocardiography in patients with dilated cardiomyopathy with respect to the left ventricular contractile reserve. We studied 55 consecutive patients with dilated cardiomyopathy (mean age, 55 ± 10 years, 49 (89.1%) male). All patients underwent exercise stress-echocardiography on a treadmill using the modified Bruce protocol. Contractile reserve was assessed by measuring changes in the wall motion score index (?WMSI) at rest and and at peak exercise. Levels of BNP were measured at rest, in the first minute, and after 20 minutes following termination of the stress test. Thirty-six patients had preserved left ventricular contractile reserve and 19 patients did not. Patients with preserved left ventricular contractile reserve showed a continuous rise in BNP levels from baseline to peak exercise and to 20 minutes following exertion (83.95 ± 108.51 versus 105.89 ± 116.00 versus 110.95 ± 119.70 ng/L, P < 0.001, respectively). On the other hand, patients without preserved left ventricular contractile reserve showed a decline in BNP levels at peak exercise as compared to baseline (335.49 ± 693.11 versus 320.08 ± 562.60 P = 0.031). ?BNP was positively correlated with preserved contractile reserve (r = 0.46, P = 0.03) and lower NYHA class (r = -0.65, P = 0.001) in patients in whom baseline LVEF was lower than 20%. Multivariate analysis identified only WMSI at rest (beta -3.365, P = 0.008, 95 CI 0.03 to 0.411) as an independent predictor of left ventricular contractile reserve.The increase in BNP levels during exercise stress-echocardiography is associated with preserved left ventricular contractile reserve in patients with dilated cardiomyopathy. PMID:25088584

Peric, Vladan; Jovanovic, Aleksandar; Sovtic, Sasa; Stolic, Radojica; Djikic, Dijana; Otasevic, Petar

2014-09-10

168

Comparison of Transesophageal and Transthoracic Contrast Echocardiography for Detection of a Patent Foramen Ovale  

NASA Technical Reports Server (NTRS)

Presence of a patent foramen ovale may indicate paradoxic embolism in patients with otherwise unexplained embolic disease. Transthoracic contrast echocardiography has been used as a simple technique for detecting patent foramen ovale. However, particularly in patients with poor transthoracic image quality, presence of a patent foramen ovale might be missed. Transesophageal contrast echocardiography provides superior visualization of the atrial septum and therefore is believed to improve diagnostic accuracy. The present study investigates the influence of image quality on the detection of a patent foramen ovale by both transthoracic and transesophageal contrast echocardiography.

Siostrzonek, Peter; Zangeneh, Massoud; Gossinger, Heinz; Lang, Wilfried; Rosenmayr, Georg; Heinz, Gottfried; Stumpflen, Andreas; Zeiler, Karl; Schwarz, Martin; Mosslacher, Herbert

1991-01-01

169

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

170

Contrast echocardiography can assess risk area and infarct size during coronary occlusion and reperfusion: experimental validation  

Microsoft Academic Search

ObjectivesWe sought to validate the ability of real-time myocardial contrast echocardiography (MCE) measures of opacification defect and contrast refilling parameters to estimate risk area (RA) and infarct area (IA) during coronary occlusion and reperfusion.

S. téphane Lafitte; Aya Higashiyama; Hisashi Masugata; Barry Peters; Monet Strachan; O. i Ling Kwan; Anthony N DeMaria

2002-01-01

171

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

PubMed Central

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

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

2014-01-01

172

Left ventricle quantification in 3D echocardiography using a geometric deformable model  

Microsoft Academic Search

Real-time 3D echocardiography can provide accurate left ventricle volume measurement without geometric assumptions with the assist of a robust segmentation algorithm. A new 3D geometric deformable model is introduced for the purpose by combining 3D Gradient vector flow (GVF) and 3D geodesic active contour model. The new model is successfully applied to left ventricle quantification in 3D echocardiography.

X. Hang; N. L. Greenberg; J. D. Thomas

2004-01-01

173

Longitudinal observations of left ventricular end-diastolic dimension in children using echocardiography  

Microsoft Academic Search

Previous studies have evaluated left ventricular dimensions in children using two-dimensional echocardiography, but there\\u000a is little information on gender differences and on the longitudinal development of the dimensions of the left ventricle. Our\\u000a objective was to asses, by two-dimensional echocardiography, the normal size of the left ventricular end-diastolic dimension\\u000a (LVDd) in children, its differences by sex, and the rate of

H. Nagasawa; Y. Arakaki; O. Yamada; T. Nakajima; T. Kamiya

1996-01-01

174

Diagnosis of patent foramen ovale with multiplane transesophageal echocardiography in adult cardiac surgical patients  

Microsoft Academic Search

Objective: To evaluate multiplane transesophageal echocardiography (TEE) for detection of patent foramen ovale (PFO) and to compare multiplane TEE with visual inspection (VI) for PFO detection.Design: A prospective observational study.Setting: University hospital (single institution).Participants: Patients presenting for cardiac surgery requiring TEE.Interventions: Multiplane TEE including 2 atrial views with color-flow Doppler (CFD) and contrast echocardiography (CE) with a provocative respiratory maneuver

John G. Augoustides; Stuart J. Weiss; Justin Weiner; Joshua Mancini; Joseph S. Savino; Albert T. Cheung

2004-01-01

175

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

176

Diagnosis, localization and evaluation of malignancy of heart and mediastinal tumors by conventional and transesophageal echocardiography.  

PubMed

Transesophageal echocardiography is well established in detecting and diagnosing heart tumors. In contrast, its role in assessing presence, growth and evidence of malignancy of tumors originating from the mediastinal site remains widely uncertain. In a prospective and investigator-blind study, we evaluated 72 consecutive patients with cardiac and/or mediastinal tumor lesions to assess the diagnostic impact of transthoracic and transesophageal echocardiography in determining localization, growth and malignancy. All tumor lesions were diagnosed and carefully evaluated by computer tomography and/or magnetic resonance imaging prior to the study. Biopsy demonstrated a malignant tumor in 49 patients and a benign tumor in 23 patients. Transthoracic and transesophageal echocardiography were equally effective in visualizing tumors of the heart in 24 patients (92% vs 100%; N.S.). Tumors originating from the mediastinum were 2.9 times less likely to be detected by the transthoracic approach (p < 0.001). In these patients, transesophageal echocardiography was also superior in diagnosing myocardial infiltration (18 vs 4 patients, p < 0.001) and invasion or intracardiac growth of the tumor (13 vs 6 patients, p < 0.05). When compared to histological findings, transesophageal echocardiography predicted malignancy from the presence of tumor spread both in- and outside the heart, infiltration and invasion in 21/49 patients (43%), a false positive result was obtained in only 1/23 patients with a benign tumor. Conventional echocardiography predicted malignancy in only 4/49 patients (8%, p < 0.005). In conclusion, transesophageal echocardiography is increasingly used in patients with suspected mediastinal tumor lesions. Our study demonstrates, that transesophageal echocardiography is effective and superior to the conventional approach in predicting localization and growth of mediastinal tumors, as well as in accessing evidence of malignancy of the tumor. PMID:8922046

Geibel, A; Kasper, W; Keck, A; Hofmann, T; Konstantinides, S; Just, H

1996-01-01

177

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

178

A primer on the methods and applications for contrast echocardiography in clinical imaging.  

PubMed

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; Lindner, Jonathan R

2014-09-01

179

[Transesophageal echocardiography. A critical appraisal. How to avoid false diagnoses].  

PubMed

In this study the authors make a critical appraisal of transesophageal echocardiography. A retrospective analysis was made of the transesophageal echocardiographic performed in the Thoracic Surgery Center of S. João Hospital, Oporto, over a period of approximately five years. The authors report the limitations and complications of this diagnostic tool with particular emphasis on the leading causes of pitfalls. Between October 1990 and December 1995, 1282 examinations were performed in our echocardiographic laboratory, mean age 49.6 +/- 14 years (5-86), 57% of the patients were female and 43% male. A biplane transducer was used in these examinations. Patient absenteeism was 2% and only one major complication occurred in a patient with an aortic dissection. Pitfalls are of special concern with this technology. The new esophagic window over the heart and the high quality of the cardiac images, depicting structures and anatomic details inaccessible, or difficult to be observed by transthoracic echocardiographic, led to the major causes of transesophageal echocardiographic pitfalls. Once recognized, most of the pitfalls can be avoided. In what concerns our experience, examples of the most common pitfalls are illustrated. PMID:9019142

Almeida, J; Sepúlveda, F; Bastos, P T; Gomes, M R

1996-11-01

180

Two-dimensional echocardiography during percutaneous transluminal coronary angioplasty.  

PubMed

In order to study myocardial and clinical events during transient coronary occlusion in humans, two-dimensional echocardiography was continuously performed in 15 patients undergoing 49 balloon inflations during percutaneous transluminal coronary angioplasty (PTCA). Transient segmental asynergy developed in all patients 8 +/- 3 seconds after balloon inflation and returned to baseline 19 +/- 8 seconds after balloon deflation. Segmental dyskinesis was seen in only 8 of 11 patients undergoing PTCA of the left anterior descending artery (LAD). A wall motion score, based on degree of asynergy of 13 segments of the left ventricle, was significantly higher during LAD than during right coronary artery inflation (7.9 +/- 1.3 vs 4.0 +/- 1.4, p less than 0.01). Left ventricular size index increased significantly during balloon inflation, from 179 +/- 9 to 196 +/- 10 mm (p less than 0.01). Four patients developed transient ST segment changes in the extremity leads of the ECG and five patients had angina pectoris. The very first sign of ischemia in three patients, who developed all of these symptoms together, was consistently asynergy, followed by ECG changes, and last, angina pectoris. Thus during PTCA, transient asynergy and left ventricular dilatation develop, which are often clinically silent. PMID:2940852

Visser, C A; David, G K; Kan, G; Romijn, K H; Meltzer, R S; Koolen, J J; Dunning, A J

1986-06-01

181

First trimester fetal echocardiography: where are we now?  

PubMed

The detailed study of the fetal cardiac anatomy in the first trimester of pregnancy by means of ultrasound is feasible whether using a transvaginal or a transabdominal approach. There is nowadays enough evidence that ultrasound in the first trimester of pregnancy is a safe procedure provided thermal and mechanical indices are taken into account. The best timing for successful imaging of the four chambers and great arteries in early gestation appears to be between around 13 to 14 weeks rather than 11 to 12 weeks. In experienced hands, first-trimester fetal echocardiography is quite sensitive for the detection of major structural cardiac abnormalities. Besides the nasal bone, markers for first trimester screening of chromosomal abnormalities such as nuchal translucency thickness, the flow in the ductus venosus and the flow through the tricuspid valve constitute also markers for cardiac abnormalities. The finding of an increased nuchal translucency, an abnormal flow in the ductus venosus or a tricuspid regurgitation constitutes an indication for more detailed fetal cardiac assessment. Other indication for a detailed cardiac assessment is the finding of an aberrant right subclavian artery and vascular anomalies. The emerging importance of these markers has caused renewed interest in the early study of the fetal heart. PMID:23018477

Votino, C; Cos, T; Strizek, B; Dessy, H; Jani, J C

2012-10-01

182

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

183

Two- and three-dimensional speckle tracking echocardiography: clinical applications and future directions.  

PubMed

Two-dimensional speckle tracking echocardiography (2D STE) is a novel technique of cardiac imaging for quantifying complex cardiac motion based on frame-to-frame tracking of ultrasonic speckles in gray scale 2D images. Two-dimensional STE is a relatively angle independent technology that can measure global and regional strain, strain rate, displacement, and velocity in longitudinal, radial, and circumferential directions. It can also quantify rotational movements such as rotation, twist, and torsion of the myocardium. Two-dimensional STE has been validated against hemodynamics, tissue Doppler, tagged magnetic resonance imaging, and sonomicrometry studies. Two-dimensional STE has been found clinically useful in the assessment of cardiac systolic and diastolic function as well as providing new insights in deciphering cardiac physiology and mechanics in cardiomyopathies, and identifying early subclinical changes in various pathologies. A large number of studies have evaluated the role of 2D STE in predicting response to cardiac resynchronization therapy in patients with severe heart failure. However, the clinical utility of 2D STE in the above mentioned conditions remains controversial because of conflicting reports from different studies. Emerging areas of application include prediction of rejection in heart transplant patients, early detection of cardiotoxicity in patients receiving chemotherapy for cancer, and effect of intracoronary injection of bone marrow stem cells on left ventricular function in patients with acute myocardial infarction. The emerging technique of three-dimensional STE may further extend its clinical usefulness. PMID:23297852

Biswas, Monodeep; Sudhakar, Selvin; Nanda, Navin C; Buckberg, Gerald; Pradhan, Manish; Roomi, Asad Ullah; Gorissen, Willem; Houle, Helene

2013-01-01

184

A Hybrid Method for Endocardial Contour Extraction of Right Ventricle in 4-Slices from 3D Echocardiography Dataset  

PubMed Central

This paper presents a hybrid method to extract endocardial contour of the right ventricular (RV) in 4-slices from 3D echocardiography dataset. The overall framework comprises four processing phases. In Phase I, the region of interest (ROI) is identified by estimating the cavity boundary. Speckle noise reduction and contrast enhancement were implemented in Phase II as preprocessing tasks. In Phase III, the RV cavity region was segmented by generating intensity threshold which was used for once for all frames. Finally, Phase IV is proposed to extract the RV endocardial contour in a complete cardiac cycle using a combination of shape-based contour detection and improved radial search algorithm. The proposed method was applied to 16 datasets of 3D echocardiography encompassing the RV in long-axis view. The accuracy of experimental results obtained by the proposed method was evaluated qualitatively and quantitatively. It has been done by comparing the segmentation results of RV cavity based on endocardial contour extraction with the ground truth. The comparative analysis results show that the proposed method performs efficiently in all datasets with overall performance of 95% and the root mean square distances (RMSD) measure in terms of mean ± SD was found to be 2.21 ± 0.35?mm for RV endocardial contours. PMID:25371675

Dawood, Faten A.; Rahmat, Rahmita W.; Kadiman, Suhaini B.; Abdullah, Lili N.; Zamrin, Mohd D.

2014-01-01

185

A Hybrid Method for Endocardial Contour Extraction of Right Ventricle in 4-Slices from 3D Echocardiography Dataset.  

PubMed

This paper presents a hybrid method to extract endocardial contour of the right ventricular (RV) in 4-slices from 3D echocardiography dataset. The overall framework comprises four processing phases. In Phase I, the region of interest (ROI) is identified by estimating the cavity boundary. Speckle noise reduction and contrast enhancement were implemented in Phase II as preprocessing tasks. In Phase III, the RV cavity region was segmented by generating intensity threshold which was used for once for all frames. Finally, Phase IV is proposed to extract the RV endocardial contour in a complete cardiac cycle using a combination of shape-based contour detection and improved radial search algorithm. The proposed method was applied to 16 datasets of 3D echocardiography encompassing the RV in long-axis view. The accuracy of experimental results obtained by the proposed method was evaluated qualitatively and quantitatively. It has been done by comparing the segmentation results of RV cavity based on endocardial contour extraction with the ground truth. The comparative analysis results show that the proposed method performs efficiently in all datasets with overall performance of 95% and the root mean square distances (RMSD) measure in terms of mean ± SD was found to be 2.21 ± 0.35?mm for RV endocardial contours. PMID:25371675

Dawood, Faten A; Rahmat, Rahmita W; Kadiman, Suhaini B; Abdullah, Lili N; Zamrin, Mohd D

2014-01-01

186

Should echocardiography be performed to assess effects of antihypertensive therapy? Test-retest reliability of echocardiography for measurement of left ventricular mass and function  

Microsoft Academic Search

Objectives. The purpose of this study was to determine the test-retest stability of echocardiography for the measurement of left ventricular mass and function in patients with hypertension.Background. Determination of changes in left ventricular mass may be impaired by study variability. The amount by which variables of mass and left ventricular function must change in an individual patient to exceed temporal

John S. Gottdiener; Sue V. Livengood; Patricia S. Meyer; Gary A. Chase

1995-01-01

187

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

188

Acute Haemodialysis-induced Changes in Tissue Doppler Echocardiography Parameters  

PubMed Central

Background: Tissue Doppler imaging (TDI) is a method that determines the tissue motion and velocity within the myocardium. Aims: To characterize acute haemodialysis (HD)-induced changes in TDI-derived indices for patients that have end-stage renal disease (ESRD). Study Design: Cross sectional study. Methods: Conventional echocardiography and TDI methods were applied to study ESRD patients (n=58) before and after HD. Pulmonary venous flow, mitral inflow, and TDI signals of the lateral and septal mitral annulus were examined for the determination of altered left-ventricular diastolic filling parameters. Flow velocities from early- (E) and late-atrial (A) peak transmitral; peak pulmonary vein systolic (S) and diastolic (D); and myocardial peak systolic (Sm) and peak early (Em) and late (Am) diastolic mitral annular velocities were also assessed for changes. Results: Transmitral E and A velocities and the E/A ratio decreased significantly after HD (p<0.001). Pulmonary vein S (p<0.001) and D (p<0.001) velocities decreased, and S/D ratios increased significantly (p=0.027). HD led to a reduction in septal Em (p<0.001), lateral Em (p=0.006), and Am (p<0.001) velocities. Contrary to the decreases in Em and Am, the Em/Am ratio remained unchanged. Conclusion: A single HD session was associated with an acute deterioration in the diastolic parameters. Since the Em/Am ratio remained unchanged, we conclude that this index is a relatively load-independent measure of diastolic function in HD patients. PMID:25337420

Sag, Saim; Yesilbursa, Dilek; Y?ld?z, Abdulmecit; Dilek, Kamil; Senturk, Tunay; Serdar, Osman Ak?n; Ayd?nlar, Ali

2014-01-01

189

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

190

Stretched size of atrial septal defect predicted by intracardiac echocardiography.  

PubMed

The stretched size of an atrial septal defect (ASD) is important for device selection during transcatheter closure. However, balloon sizing carries potential risks such as hypotension, bradycardia, or laceration of the atrial septum. The aim of the present study was to investigate the accuracy of the predicted stretched size of ASD by intracardiac echocardiography (ICE). From December 2004 to November 2007, 136 consecutive patients with single secundum type ASD undergoing transcatheter closure of their defect using the Amplatzer septal occluder under ICE guidance were enrolled for analysis. There were 43 males and 93 females. The age ranged from 2.2 to 79.1 years with a median age of 13.4 years. The body weight ranged from 12.1 to 93.2 kg with a median body weight of 45.8 kg. The stretched size of ASD measured by a sizing plate was considered as the standard. ASD sizes measured by ICE in bicaval and short-axis views predicted the stretched size by formulae derived from linear regressions. The predicted stretched sizes obtained using 2 formulae, 1.34 x radicalbicaval xshort axis (formula 1) and 1.22 x larger diameter (formula 2), exhibited good agreement with the standard stretched size with Kappa values of 0.91 and 0.90, respectively. The accuracy rate of predicted stretched sizes within 2 mm, 3 mm, and 4 mm range of the standard size were 32.8%, 45.4%, and 57.7% (formula 1) and 33.1%, 50%, and 63.2% (formula 2). The stretched size of ASD predicted by ICE exhibited good agreement with the standard stretched size. This prediction provides helpful information, especially if balloon sizing cannot be adequately performed. PMID:20145353

Lin, Ming-Chih; Fu, Yun-Ching; Jan, Sheng-Ling; Ho, Chi-Lin; Hwang, Betau

2010-01-01

191

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

192

Idiopathic Bilaterally Diffuse Arteriovenous Fistulas Causing Severe Central Cyanosis  

Microsoft Academic Search

We present an extremely rare case of diffuse bilateral pulmonary arteriovenous fistulas (PAVF) of unknown etiology. The patient presented at 15 years of age with increasing cyanosis and chest pain. He had central cyanosis and clubbing, Transcutaneous oxygen saturation was 50%. Transthoracic echocardiography showed no evidence of an intracardiac defect; however, an intravenous bolus of agitated saline demonstrated immediate return

D. Alehan; O. F. Dogan; T. Karagoz

2007-01-01

193

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

194

The Art Show  

ERIC Educational Resources Information Center

This article describes what once was thought to be impossible--a formal art show extravaganza at an elementary school with 1,000 students, a Department of Defense Dependent School (DODDS) located overseas, on RAF Lakenheath, England. The dream of this this event involved the transformation of the school cafeteria into an elegant art show

Scolarici, Alicia

2004-01-01

195

Comparison of echocardiography-guided and fluoroscopy-guided endomyocardial biopsy techniques.  

PubMed

The accuracy of bioptome placement for endomyocardial biopsy was evaluated using standard fluoroscopic guidance and compared simultaneously with two-dimensional echocardiography in six healthy subadult grizzly bears (Ursus arctos horribilis). Despite perceived adequate positioning of the bioptome toward the septum when judged using fluoroscopy, only one out of the six placements were actually positioned in the right ventricular apex toward the septum when evaluated using two-dimensional echocardiography. The bioptome was readily relocated to the right ventricular apex/septal location by echocardiography. The forceps were easily visualized at all times and the open cups were readily directed into the desired location for biopsy. Based on a subjective score for tissue quantity from 1 to 4 (poor to excellent), biopsies collected by echocardiographic-guided technique had a mean score of 3.4, while biopsies collected by fluoroscopic-guided technique had a mean score of 1.8. In summary, this study suggests that endomyocardial biopsy locations can be accurately positioned using two-dimensional echocardiography with the advantages of less radiation, lower procedural costs, and direct visualization of the sampling site. Clear definition of endocardial surface as afforded by echocardiography may enhance tissue sample quality and lower potential complications from this procedure. PMID:15869156

Nelson, O Lynne; Robbins, Charles T

2005-01-01

196

Comparison of dipyridamole-echocardiography with dipyridamole-thallium scintigraphy for the diagnosis of myocardial ischemia  

SciTech Connect

After an intravenous infusion of dipyridamole (0.56 mg/kg), the authors performed both echocardiography and thallium scintigraphy in 63 patients who were referred for known or suspected coronary artery disease. Of those patients, 25 returned for coronary arteriography within 1 month after the tests, thus forming the study group for this report. Sensitivity for detection of coronary artery disease, when analyzed region-by-region, was 80% for thallium scintigraphy and 57% for echocardiography, whereas specificity was 85% and 98%, respectively. When evaluating individual patients for the presence or absence of ischemia, they found a sensitivity of 95% for scintigraphy and 58% for echocardiography; corresponding specificities were 50% and 100%. By using arteriography as the gold standard for comparison, it appears that thallium scintigraphy has a significantly higher sensitivity but lower specificity for the detection of coronary artery disease than does echocardiography. Echocardiography may, however, be a useful adjunct to thallium scintigraphy in the evaluation of patients with coronary artery disease.

Perin, E.C.; Moore, W.; Blume, M.; Hernandez, G.; Dhekne, R.; DeCastro, C.M. (St. Luke's Episcopal Hospital/Texas Heart Institute, Houston (USA))

1991-06-01

197

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

198

Cardiac function in patients with cystic fibrosis: evaluation by two-dimensional and Doppler echocardiography.  

PubMed

Two-dimensional and Doppler echocardiography were performed in 17 consecutive hospitalized patients with cystic fibrosis aged 6 to 38 years (mean 21 +/- 9) and in 10 normal subjects aged 24 +/- 7 years. Left ventricular and right ventricular ejection fraction were measured by a computerized light pen system and Simpson's rule from two-dimensional echocardiographic apical four and two chamber views. Right ventricular wall thickness, inferior vena cava size and the presence of tricuspid regurgitation by Doppler recording were also assessed. National Institutes of Health (NIH) score of clinical severity ranged from 22 to 72 (mean 51 +/- 15) (100 = excellent, 0 = poor). Four patients, all with an NIH score of 40 or less, died of respiratory failure within 1 year of the echocardiographic study. There was no significant difference between patients with cystic fibrosis and normal subjects with regard to right ventricular ejection fraction (59 +/- 11 versus 61 +/- 10%), left ventricular ejection fraction (67 +/- 8 versus 70 +/- 8%) and right ventricular systolic (5 +/- 1 versus 5 +/- 0.5 mm) and diastolic (2.4 +/- 0.5 versus 2.5 +/- 0.5 mm) wall thicknesses. A dilated inferior vena cava and mild tricuspid regurgitation by Doppler recording were detected in only one patient. A poor correlation was found between right ventricular ejection fraction and NIH clinical score (r = 0.26), chest X-ray score (r = 0.29) and pulmonary function tests. It is concluded that right and left ventricular systolic function is preserved in patients with moderately severe cystic fibrosis; clinical status in these patients is probably determined by the pulmonary rather than cardiac involvement. PMID:4031283

Panidis, I P; Ren, J F; Holsclaw, D S; Kotler, M N; Mintz, G S; Ross, J

1985-09-01

199

Discrepancies between cardiovascular magnetic resonance and Doppler echocardiography in the measurement of transvalvular gradient in aortic stenosis: the effect of flow vorticity  

PubMed Central

Background Valve effective orifice area EOA and transvalvular mean pressure gradient (MPG) are the most frequently used parameters to assess aortic stenosis (AS) severity. However, MPG measured by cardiovascular magnetic resonance (CMR) may differ from the one measured by transthoracic Doppler-echocardiography (TTE). The objectives of this study were: 1) to identify the factors responsible for the MPG measurement discrepancies by CMR versus TTE in AS patients; 2) to investigate the effect of flow vorticity on AS severity assessment by CMR; and 3) to evaluate two models reconciling MPG discrepancies between CMR/TTE measurements. Methods Eight healthy subjects and 60 patients with AS underwent TTE and CMR. Strouhal number (St), energy loss (EL), and vorticity were computed from CMR. Two correction models were evaluated: 1) based on the Gorlin equation (MPGCMR-Gorlin); 2) based on a multivariate regression model (MPGCMR-Predicted). Results MPGCMR underestimated MPGTTE (bias = ?6.5 mmHg, limits of agreement from ?18.3 to 5.2 mmHg). On multivariate regression analysis, St (p = 0.002), EL (p = 0.001), and mean systolic vorticity (p < 0.001) were independently associated with larger MPG discrepancies between CMR and TTE. MPGCMR-Gorlin and MPGTTE correlation and agreement were r = 0.7; bias = ?2.8 mmHg, limits of agreement from ?18.4 to 12.9 mmHg. MPGCMR-Predicted model showed better correlation and agreement with MPGTTE (r = 0.82; bias = 0.5 mmHg, limits of agreement from ?9.1 to 10.2 mmHg) than measured MPGCMR and MPGCMR-Gorlin. Conclusion Flow vorticity is one of the main factors responsible for MPG discrepancies between CMR and TTE. PMID:24053194

2013-01-01

200

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

201

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

202

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

203

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, Jose Sebastiao; Lima, Jose Wellington Oliveira; Diogenes, Tereza Cristina Pinheiro; Siqueira, Jordana Magalhaes; Pimentel, Nayara Lima; Gomes, Pedro Sabino; de Abreu, Marilia Esther Benevides; Paes, Jose Nogueira

2014-01-01

204

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

205

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

206

Chemistry Game Shows  

Microsoft Academic Search

We present a technological improvement to the use of game shows to help students review for tests. Our approach uses HTML files interpreted with a browser on a computer attached to an LCD projector. The HTML files can be easily modified for use of the game in a variety of courses.

Susan Campbell; Jennifer Muzyka

2002-01-01

207

Contrast echocardiography: clinical utility for the evaluation of left ventricular systolic function.  

PubMed

Despite continued improvements in imaging technology, transthoracic echocardiography does not reliably provide images adequate for interpretation in all patients. In these patients, the administration of ultrasound contrast agents can markedly enhance the diagnostic utility of the test. Contrast echocardiography relies on the ultrasound detection of contrast agents composed of encapsulated microbubbles that are generally smaller than red blood cells. Intravenous administration of microbubble contrast agents results in left ventricular opacification and facilitates delineation of the endocardial border. This procedure has been shown to consistently increase the number of myocardial segments that can be interpreted, to improve accuracy of assessing regional and global left ventricular function, to decrease interinterpreter variability, to increase interpreter confidence, and to be a cost-effective strategy. Accordingly, patient selection for contrast echocardiography should be based not only on adequacy of the baseline images, but also on the clinical question being asked. PMID:15604834

Lindner, Jonathan R; Lewis, Christopher

2004-01-01

208

Echocardiography-guided biventricular pacemaker optimization: role of echo Doppler in hemodynamic assessment and improvement.  

PubMed

In spite of improvements in heart failure management and increasing utilization of cardiac resynchronization therapy (CRT), approximately 30-40% of CRT patients remain nonresponders and 50% or more are echocardiographic nonresponders (defined as less than 15% reduction in left ventricular end systolic volume post-CRT). Optimization guided by echocardiography has been studied as one of the methods to improve the nonresponder rate to CRT. Echo-guided biventricular (Biv) pacemaker optimization has been associated with improvement in acute cardiac hemodynamics and improvement in functional class. In this review, the authors discuss various methods to optimize Biv pacemaker by echocardiography, recent advances in pacemaker optimization and the limitations of echocardiography. The authors also demonstrate complex hemodynamic derangements in heart failure via multiple case examples highlighting the role of comprehensive echo Doppler in elucidating cardiac hemodynamics encountered in CRT nonresponders, as well as tailoring of Biv pacemaker optimization to the underlying physiologic derangement. PMID:22908920

Rafie, Reza; Naqvi, Tasneem Z

2012-07-01

209

Mobile ascending aortic atheroma diagnosed by transesophageal echocardiography as source of peripheral vascular embolism.  

PubMed

Complex aortic atheromas are an important differential diagnosis to consider in evaluating sources of arterial embolization. Diagnosis of the embolic source is an essential first step, so treatment can then be initiated to prevent further reoccurrence. We report the case of a 36-year-old man, without significant medical history, who presented to the University of Illinois at Chicago with peripheral vascular embolism to the lower extremities. Computed tomography with contrast angiography and transthoracic echocardiography failed to reveal a source of the thromboembolism. A complex mobile atheroma was discovered in the ascending aorta during transesophageal echocardiography. The case presented is noteworthy when considering the following: the relative rarity of complex atheromas of the ascending aorta, the young age of the patient with no history of atherosclerotic disease, and the failure of computed tomography angiography to reveal the embolic source despite literature supporting high sensitivities for aortic plaque detection compared with transesophageal echocardiography. PMID:19647160

Frazin, Leon J; Glowney, Jason W

2009-08-01

210

Effects of Bariatric Surgery on Early Myocardial Alterations in Adult Severely Obese Subjects  

Microsoft Academic Search

Objective:Aim of this study was to investigate the effect of weight loss on structural and functional myocardial alterations in severely obese subjects treated with bariatric surgery. Patients and Methods: Thirteen severely obese patients (2 males and 11 females) were enrolled in the study. All subjects underwent conventional 2D color Doppler echocardiography. The new ultrasonic techniques used were: (a) integrated backscatter

Vitantonio Di Bello; Ferruccio Santini; Andrea Di Cori; Andrea Pucci; Enrica Talini; Caterina Palagi; Maria Grazia Delle Donne; Alessandro Marsili; Paola Fierabracci; Rocco Valeriano; Giovanna Scartabelli; Monica Giannetti; Marco Anselmino; Aldo Pinchera; Mario Mariani

2008-01-01

211

Left ventricular thrombi: in vivo detection by indium-111 platelet imaging and two dimensional echocardiography  

SciTech Connect

Indium-111 platelet imaging, which can identify sites of active intravascular platelet deposition, and two dimensional echocardiography, which can identify intracardiac masses, can both be used to detect left ventricular thrombi noninvasively. We compared these techniques in 44 men at risk for thrombi from remote transmural myocardial infarction (31 patients) or cardiomyopathy (13 patients). All 44 patients underwent platelet imaging; 35 underwent echocardiography. On platelet imaging nine patients had thrombi and onehad a possible thrombus. Of these 10 studies, none were positive at 2 hours, 5 were positive at 24 hours and all were positive 48 or 72 hours after platelet labeling. Nine of these patients underwent echocardiography, and all had an intraventricular mass. The findings on platelet scanning were negative in six patients who had positive (four patients) or equivocally positive (two patients) findings on echocardiography. All patients with thrombi detected by either noninvasive method had transmural anterior myocardial infarction with ventricular aneurysm. Of the seven patients who underwent cardiac surgery or autopsy, three had thrombi. Platelet imaging failed to identify one thrombus in a patient in whom imaging was performed only at 24 hours after labeling. There were no false positive platelet images in this group. Five of these seven patients (two with throbi, three without) underwent echocardiography; in all cases the echocardiographic findings agreed with the pathologic findings. Both platelet imaging and echocardiography detect ventricular thrombi. Platelet imaging may detect only the most hematologically active thrombi. Both techniques may help define patients at risk of embolization and may be useful for in vivo assessment of antithrombotic drugs.

Stratton, J.R.; Ritchie, J.L.; Hamilton, G.W.; Hammermeister, K.E.; Harker, L.A.

1981-04-01

212

The diagnostic value of exercise echocardiography in ischemic heart disease in relation to quantitative coronary arteriography.  

PubMed

The aim of the study was to assess the diagnostic value of bicycle exercise echocardiography using quantitative coronary arteriography as a reference. Exercise echocardiography was performed in 70 consecutive patients referred for coronary angiography. Digital loops were obtained at rest, peak, and immediately after exercise in the standard views (parasternal long and short axis, apical two and four chamber views). Wall motion analysis was made on the basis of the 16 segment model, scoring each segment from 3 (hyperkinesia) to -1 (hypokinesia). Exercise echocardiography was considered positive when wall motion in at least one segment decreased at least one score from rest to peak or post exercise. Cinefilms were evaluated using automated quantitative coronary arteriography software. Transstenotic pressure gradients were calculated based on flow assumptions at the maximal stenosis flow reserve. Pressure losses > 30 mmHg and quantitatively measured percent diameter stenosis of > 50% were considered clinically significant. Stenoses in the equivocal range of 40-69% were subjected to separate analysis. Exercise echocardiography was superior to exercise-induced ST-segment depression in the diagnosis of coronary artery disease. In the overall sample of 70 patients, the sensitivity of exercise echocardiography against percent diameter stenosis was 84%, against pressure gradient 86%. The specificity against these two parameters was 86% and 84%, respectively. When analysing the subgroup of 40-69% stenoses (N = 14), sensitivity of exercise echocardiography against percent diameter stenosis was 67%, against pressure gradient 88%. The specificity against these two parameters was 100% and 84%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7730677

Atar, D; Ali, S; Steensgaard-Hansen, F; Saunamäki, K; Ramanujam, P S; Egeblad, H; Haunsø, S

1995-03-01

213

Show-Me Center  

NSDL National Science Digital Library

The Show-Me Center is a partnership of four NSF-sponsored middle grades mathematics curriculum development Satellite Centers (University of Wisconsin, Michigan State University, University of Montana, and the Educational Development Center). The group's website provides "information and resources needed to support selection and implementation of standards-based middle grades mathematics curricula." The Video Showcase includes segments on Number, Algebra, Geometry, Measure, and Data Analysis, with information on ways to obtain the complete video set. The Curricula Showcase provides general information, unit goals, sample lessons and teacher pages spanning four projects: the Connected Mathematics Project (CMP), Mathematics in Context (MiC), MathScape: Seeing and Thinking Mathematically, and Middle Grades Math Thematics. The website also posts Show-Me Center newsletters, information on upcoming conferences and workshops, and links to resources including published articles and unpublished commentary on mathematics school reform.

214

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

215

The Truman Show  

Microsoft Academic Search

The Truman Show is hardly a film you would automatically speak about as a game. At first glance, it is tempting to interpret the story of\\u000a Truman Burbank — his perpetual subjection to the artificial (televisual) world of Seahaven and its gargantuan reality TV project,\\u000a his eventual escape from the “OmniCam Ecosphere” building and the paternalistic surveillance of director Christof

Rolf F. Nohr

216

The Graphing Game Show  

NSDL National Science Digital Library

This lesson plan assesses student interpretation of graphs utilizing cooperative learning to further students understanding. Types of graphs used are horizontal and vertical bar graphs, picture graphs, and pictographs. In the lesson students play a game called the Graphing Game Show, in which they must work as a team to answer questions about specific graphs. The lesson includes four student resource worksheets and suggestions for extension and differentiation.

2011-01-01

217

An alternative transseptal intracardiac echocardiography strategy to guide left atrial appendage closure: the first described case.  

PubMed

Transesophageal echocardiography (TEE) is the standard imaging technique to guide device implantation for left atrial appendage (LAA) closure. Unfortunately, TEE was contraindicated in this patient due to the high risk of variceal hemorrhage. Critical information about the exact anatomic characteristics of the LAA can be obtained using intracardiac echocardiography (ICE). However, standard right-side views do not allow a complete visualization of the LAA: in particular, a reliable left circumflex coronary artery short axis view, relevant for device positioning, is not always achievable. Transseptal views of the LAA with ICE might be used in planning an appropriate intervention strategy for patients who are not suitable for TEE imaging. PMID:24964221

Fassini, Gaetano; Dello Russo, Antonio; Conti, Sergio; Tondo, Claudio

2014-11-01

218

Outcome After Normal Exercise Echocardiography and Predictors of Subsequent Cardiac Events: Follow-Up of 1,325 Patients  

Microsoft Academic Search

Objectives. This study sought to examine the outcome of a large group of patients after normal exercise echocardiography and to identify potential predictors of subsequent cardiac events. Background. Earlier studies suggested that prognosis after normal exercise echocardiography is favorable, with a low subse- quent cardiac event rate. These studies involved a small number of patients and did not have sufficient

219

Aortic valve morphology definition with transthoracic combined with transesophageal echocardiography in a population with high prevalence of bicuspid aortic valve  

Microsoft Academic Search

Objective:To assess the utility of transthoracic echocardiography (TTE) with second harmonic combined with transesophageal echocardiography (TEE) in defining aortic valve morphology in a subset of patients with a high prevalence of bicuspid aortic valve. Methods and Materials: Patients (n=174) with dilated aortic root were consecutively evaluated using, initially, TTE. The aortic valve structure was assigned as tricuspid, bicuspid or undefined.

Josep M. Alegret; Oscar Palazón; Ignasi Duran; Josep M. Vernis

2005-01-01

220

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.

R, Leischik; B, Dworrak; K, Hensel

2014-01-01

221

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

222

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

NASA Astrophysics Data System (ADS)

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

2010-10-01

223

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

224

NPR: The Picture Show  

NSDL National Science Digital Library

National Public Radio's "The Picture Show" photo blog is a great way to avoid culling through the thousands of less interesting and engaging photographs on the web. With a dedicated team of professionals, this blog brings together different posts that profile various sets of photographs that cover 19th century war in Afghanistan, visual memories of WWII, unpublished photographs of JFK's presidential campaign, and abandoned buildings on the islands in Boston Harbor. Visitors can search through previous posts, use social media features to share the photo features with friends, and also sign up to receive new materials via their RSS feed. There's quite a nice mix of material here, and visitors can also comment on the photos and recommend the collection to friends and others.

225

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 W.

226

Early transoesophageal echocardiography in cryptogenic and lacunar stroke and transient ischaemic attack  

PubMed Central

OBJECTIVES—To test the hypothesis that transoesophageal echocardiography (TOE) carried out within three days of a first stroke or transient ischaemic attack of cryptogenic or lacunar type may disclose more thrombi or spontaneous echo contrast (SEC) than previously reported. This finding may help early treatment decisions.?METHODS—Patients aged between 40 and 80 years, admitted for transient ischaemic attack or ischaemic stroke during a 40 month period, were prospectively considered. TOE was carried out within 72 hours of symptom onset with a 5 MHz biplanar transducer. Subjects with recurring events, very severe strokes, large artery obstructions, or obvious cardiac sources of embolism were excluded.?RESULTS—Sixty five patients were studied, 43 with a cryptogenic stroke or transient ischaemic attack (66.2%), and 22 with a lacunar stroke (33.8%). The mean (SD) interval between symptom onset and TOE was 43.4 (17.2) hours for cryptogenic, and 48.5 (19.5) hours for lacunar patients. Atrial thrombi were found in one patient with a cryptogenic stroke (2.32% of cryptogenic events; 95% confidence interval 0.06-12.29), whereas SEC was found in five patients (7.7% overall), two with a lacunar and three with a cryptogenic stroke.?CONCLUSIONS—An early TOE does not seem to increase substantially the detection of atrial thrombi or SEC in patients with a first stroke or transient ischaemic attack of cryptogenic or lacunar nature. Therefore, this examination can be carried out when the patients' conditions are stable, and without overloading the cardiovascular laboratory daily schedule.?? PMID:9598678

Censori, B.; Colombo, F.; Valsecchi, M. G.; Clivati, L.; Zonca, A.; Camerlingo, M.; Casto, L.; De Tommasi, M. S.; Mamoli, A.

1998-01-01

227

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

228

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

229

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

230

Diastolic heart failure can be diagnosed by comprehensive two-dimensional and Doppler echocardiography.  

PubMed

There are many myocardial and non-myocardial conditions that cause heart failure with normal left ventricular ejection fraction (LVEF). Among them, diastolic heart failure (heart failure due to diastolic dysfunction) is the most common cause of heart failure with normal LVEF. Diastolic heart failure easily can be diagnosed by comprehensive two-dimensional and Doppler echocardiography, which can demonstrate abnormal myocardial relaxation, decreased compliance, and increased filling pressure in the setting of normal LV dimensions and preserved LVEF. Therefore, diastolic heart failure should always be considered when LVEF is normal on two-dimensional echocardiography in patients with clinical evidence of heart failure. The diagnosis can be confirmed if Doppler echocardiography and myocardial tissue imaging provide evidence for impaired myocardial relaxation (i.e., decreased longitudinal velocity of the mitral annulus during early diastole and decreased propagation velocity mitral inflow), decreased compliance (shortened mitral A-wave duration and mitral deceleration time), and increased filling pressure (shortened isovolumic relaxation time and an increased ratio between early diastolic mitral and mitral annular velocities). Early identification of diastolic dysfunction in asymptomatic patients by the use of echocardiography may provide an opportunity to manage the underlying etiology to prevent progression to diastolic heart failure. PMID:16458127

Oh, Jae K; Hatle, Liv; Tajik, A Jamil; Little, William C

2006-02-01

231

Development of the left ventricular hypertrophy and dilation in adolescent ice hockey players evaluated with echocardiography  

Microsoft Academic Search

Computerized echocardiography at rest was used to follow up the dynamics of left heart enlargement in adolescent ice hockey players aged 11 to 15 years. The first year of strength?endurance training did not lead to any remarkable change of echocardiographic parameters of the left heart ventricular size. A slight tendency to left ventricular hypertrophy appeared after 2 years of training,

Dušan Meško; Alexander Jurko; Mojmír Vrlík; Moniká Novomeská; Eugen Horniak; Dagmar Dzurenková

1993-01-01

232

Impact of myocardial contrast echocardiography on vascular permeability: comparison of three different contrast agents  

Microsoft Academic Search

Microvascular permeabilization, petechial hemorrhage and premature ventricular contractions (PVCs) have been demonstrated in an in vivo rat model of myocardial contrast echocardiography (MCE). The purpose of this study was to compare these effects for three US Food and Drug Administration (FDA)-approved ultrasound (US) contrast agents (US CA): Optison®, Definity® and Imagent®. Evans blue dye, an indicator of microvascular permeability, and

Peng Li; William F. Armstrong; Douglas L. Miller

2004-01-01

233

The influence of agent delivery mode on cardiomyocyte injury induced by myocardial contrast echocardiography in rats  

Microsoft Academic Search

Myocardial contrast echocardiography (MCE) can induce bioeffects in rat hearts by local activation of the contrast agent gas bodies. This study was designed to examine the influence of agent delivery mode on the magnitude of cardiomyocyte injury. A total of 69 hairless rats were anesthetized and mounted vertically in a water bath. Evans blue dye was injected as vital stain

Douglas L. Miller; Chunyan Dou; William F. Armstrong

2005-01-01

234

Real-Time Tracking and Shape Analysis of Atrial Septal Defects in 3D Echocardiography1  

E-print Network

. Echocardiography; real time; atrial septal defect; tracking; segmentation; dynamic morphology. © AUR, 2007 Real.G.L.); Department of Engi- neering, University of Cambridge, Cambridge, UK (A.K.); Department of Cardiology (G NIH R01 HL073647-01. Address correspondence to: M.G.L. e-mail: lingurarum@mail.nih.gov © AUR, 2007 doi

235

Diagnosis of patent foramen ovale by transesophageal echocardiography and correlation with autopsy findings  

Microsoft Academic Search

Transesophageal echocardiography (TEE) is accepted as the method of choice for the diagnosis of a patent foramen ovale (PFO). However, direct anatomic confirmation regarding the presence or absence of a PFO on transesophageal imaging has been obtained in only a limited number of patients. Consequently, this study was performed to assess the diagnostic accuracy of contrast and color Doppler TEE

Birke Schneider; Tomasz Zienkiewicz; Viola Jansen; Thomas Hofmann; Harald Noltenius; Thomas Meinertz

1996-01-01

236

VES: VIRTUAL ECHOCARDIOGRAPHY SYSTEM Sascha Kohn, Rolf H. van Lengen, Gerd Reis, Martin Bertram, Hans Hagen  

E-print Network

, Hans Hagen Intelligent Visualisation and Simulation German Research Center for Artificial Intelligence.de ABSTRACT The objective of the VES project is the research and development of innovative techniques by echocardiography in the management of pa- tients. In this respect, the long range objective of the Vir- tual

Hering-Bertram, Martin

237

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

E-print Network

fluoroscopic guidance. Pure X-ray guidance has a number of disadvantages. Firstly, X-ray images are twoUsing a Robotic Arm for Echocardiography to X-ray Image Registration during Cardiac Catheterization echo probe during cardiac catheterization procedures. By tracking the robotic arm, X-ray table and X-ray

Boyer, Edmond

238

Combination of contrast with stress echocardiography: A practical guide to methods and interpretation  

Microsoft Academic Search

Contrast echocardiography has an established role for enhancement of the right heart Doppler signals, the detection of intra-cardiac shunts, and most recently for left ventricular cavity opacification (LVO). The use of intravenously administered micro-bubbles to traverse the myocardial microcirculation in order to outline myocardial viability and perfusion has been the source of research studies for a number of years. Despite

Stuart Moir; Thomas H. Mar-wick

2004-01-01

239

Do women have impaired regional systolic function in hypertensive heart disease? A 3-dimensional echocardiography study  

Microsoft Academic Search

Aims: In pressure overload left ventricular (LV) hypertrophy, gender- related differences in global LV systolic function have been previously reported. The goal of this study was to determine regional systolic function of the left ventri- cle in male and female patients with hypertensive heart disease. Methods and results: Regional LV function was analyzed from multiplane transeso- phageal echocardiography with three-dimensional

Jurgen Frielingsdorf; Michele Genoni; Otto M. Hess; Frank A. Flachskampf

2007-01-01

240

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

241

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

242

Apex to Base Left Ventricular Twist Mechanics Computed From High Frame Rate Two-Dimensional and Three-Dimensional Echocardiography: A Comparison Study  

PubMed Central

Background The aim of this study was to compare two-dimensional (2D) and three-dimensional (3D) methods for computing left ventricular (LV) rotation. Methods A two-axis linear/rotary system was designed using rotary motors controlled through a digital interface, and 10 freshly harvested pig hearts were studied. Each heart was mounted on the rotary actuator with the base being rotated at different known degrees of rotation (10°, 15°, 20°, and 25°) and was passively driven by a pump with calibrated stoke volume (50 mL) at a constant rate (60 beats/min) simultaneously. Cardiac motion was scanned to acquire 2D short-axis views using a GE Vivid 7 system for assessing rotation, and 3D apical full-volume loops were acquired using a Toshiba Applio Artida ultrasound system. Full-volume 3D image loops were analyzed online with Toshiba Wall Motion Tracking software, and short-axis 2D images were analyzed offline for LV rotation in GE EchoPAC PC at corresponding LV levels. Results At each state, both 2D and 3D echocardiography detected the changes in LV rotation but overestimated the rotation degrees. The biases for overestimation from 3D imaging were smaller compared with 2D imaging at each LV level. Both methods, when compared with each other, showed a linear correlation (r = 0.84, P < .0001). Bland-Altman comparison showed 99% of data points within range, with a constant bias between both methods (adjusted values of 3D = 1.892 + 0.964 × 3D). Conclusions Although 3D echocardiography showed smaller bias, the results between 2D and 3D echocardiography were comparable. PMID:21995883

Ashraf, Muhammad; Zhou, Zhiwen; Nguyen, Thuan; Ashraf, Shiza; Sahn, David J.

2012-01-01

243

Detection of quiescent cardiac phases in echocardiography data using nonlinear filtering and boundary detection techniques.  

PubMed

We describe an algorithm to detect cardiac quiescence within a heartbeat using nonlinear filtering and boundary detection techniques in echocardiography images. The motivation for detection of these quiescent phases is to provide improved cardiac gating to obtain motion-artifact-free images of the heart at cardiac computed tomography (CT). Currently, cardiac gating is provided through electrocardiography (ECG), which does not provide information about the instantaneous mechanical state of the heart. Our goal is to test if information about the actual mechanical motion of the heart obtained from B-mode echocardiographic data could potentially be used for gating purposes. The nonlinear filtering algorithm presented involves anisotropic diffusion to smoothen the homogeneous regions of the B-mode images while preserving image edges that represent myocardial boundaries. Following this, we detect the boundary of a particular region of interest (ROI) using a thresholding step. The positional changes of this ROI are then observed for quiescent phases over multiple cardiac cycles using the ECG's R-R interval. In a pilot study, seven subjects were imaged in the apical, four-chamber view, and quiescence of the interventricular septum was primarily observed in the diastolic region of the ECG signal. However, the position and length of quiescence vary across multiple heartbeats for the same individual and for different individuals as well. The center of quiescence for the seven patients ranged from 51 to 84 % and did not show a trend with heart rates, which ranged from 54 to 83 beats per minute. The gating intervals based on such analysis of echocardiographic signals could potentially optimize cardiac CT gating. PMID:24859726

Ravichandran, Lakshminarayan; Wick, Carson A; McClellan, James H; Liu, Tian; Tridandapani, Srini

2014-10-01

244

Spectrum of congenital heart disease in a tropical environment: an echocardiography study.  

PubMed

Echocardiography is a major mode of cardiovascular imaging with versatile applications. Modern two-dimensional echocordiographic techniques provide a comprehensive means for evaluating virtually all forms of congenital heart disease (CHD) found in both adults and children. CHD is an abnormality in cardiocirculatory structure or function that is present at birth, even if it is discovered much later. We set out to describe the spectrum of CHD using echocardiography in two centers in Kano, northern Nigeria. In this retrospective study, transthoracic echocardiography (TTE) data collected from two echocardiography laboratories in Kano over a period of 48 months (June 2002 to May 2006) were reviewed. Patients with diagnosis of congenital heart disease were selected. Information obtained from the records included the age, gender, clinical diagnosis and echocardiographic findings. One-hundred-twenty-two patients had CHD, making 9.3% of the 1312 patients with abnormal echocardiograms. There were 73 males and 49 females (ratio 1.5:1); and their ages ranged from nine days to 35 years. Forty-one (33.6%) children presented for echocardiography before the age of one year, and 69% presented before the age of five years. Thirteen (10.6%) were > or =18 years. Ventricular septal defect (VSD) was the most common echocardiographic diagnosis present in 56 patients (45.9%). Thirty-two (26.2%) had tetralogy of Fallot, and 15 (12.3%) had atrial septal defect (ASD). Ten (8.2%) had endocardial cushion defect, and nine (7.4%) had other congenital heart abnormalities. Coarctation of the aorta and aortic stenosis were rare. CHD is a common cardiovascular problem in our setting, and a number of patients were diagnosed in adulthood. With increasing availability of echocardiographic facilities, more cases of CHD are likely to be identified early. PMID:17595936

Sani, Mahmoud U; Mukhtar-Yola, Mariya; Karaye, Kamilu M

2007-06-01

245

Combined assessment of reflow and collateral blood flow by myocardial contrast echocardiography after acute reperfused myocardial infarction  

PubMed Central

OBJECTIVE—To evaluate the combined assessment of reflow and collateral blood flow by myocardial contrast echocardiography after myocardial infarction.?DESIGN—Myocardial contrast echocardiography was performed in patients with acute myocardial infarction shortly after successful coronary reperfusion (TIMI 3 patency) by direct angioplasty. Collateral flow was assessed before coronary angioplasty, and contrast reflow was evaluated 15 minutes after reperfusion. The presence of contractile reserve was assessed by low dose dobutamine echocardiography (5 to 15 µg/kg/min) at (mean (SD)) 3 (2) days after myocardial infarction. Recovery of segmental function (myocardial viability) was evaluated by resting echocardiography at a two month follow up. The study was prospective.?PATIENTS—35 consecutive patients referred for acute transmural myocardial infarction.?RESULTS—Contrast reflow was observed in 20 patients (57%) and collateral flow in 14 (40%). Contrast reflow and collateral contrast flow were both correlated with reversible dysfunction on initial dobutamine echocardiography and at follow up (p < 0.05). The presence of reflow or collateral flow on myocardial contrast echocardiography was a highly sensitive (100%) but weakly specific (60%) indicator of segmental dysfunction recovery. Simultaneous presence of contrast reflow and collateral flow was more specific of reversible dysfunction than reflow alone (90% v 60%).?CONCLUSIONS—Combined assessment of reflow and collateral blood flow enhanced the sensitivity of myocardial contrast echocardiography in predicting myocardial viability after acute, reperfused myocardial infarction. The simultaneous presence of reflow and collateral blood flow was highly specific of recovery of segmental dysfunction.???Keywords: contrast echocardiography; coronary reflow; collateral blood flow; dobutamine echocardiography; myocardial dysfunction PMID:10377311

Leclercq, F; Messner-Pellenc, P; Descours, Q; Daures, J; Pasquie, J; Hager, F; Davy, J; Grolleau-Raoux, R

1999-01-01

246

Transcatheter closure of perimembranous ventricular septal defects with Amplatzer occluder assessed by real-time three-dimensional echocardiography.  

PubMed

We report our initial experience in two patients using real-time three-dimensional echocardiography to assess perimembranous ventricular septal defect and device morphology and their relation with contiguous cardiac structure. Defect size and rims as well as device position and profile were displayed from the three-dimensional "en face" views. We think that real-time three-dimensional echocardiography could be a complementary approach to angiography and transesophageal echocardiography in performing transcatheter closure of perimembranous ventricular septal defect. PMID:16600691

Acar, Philippe; Abadir, Sylvia; Aggoun, Yacine

2007-03-01

247

Assessment of myocardial viability in patients with acute myocardial infarction by two-dimensional speckle tracking echocardiography combined with low-dose dobutamine stress echocardiography.  

PubMed

It is clinically important to determine the myocardial viability of regional wall motion abnormality segments in patients with acute myocardial infarction (AMI). The purpose of this study was to ascertain the ability and value of a combination of speckle tracking echocardiography (STE) and low dose dobutamine stress echocardiography (LDDSE) for the evaluation of viable myocardium in patients with AMI. Forty-two hospitalized patients with AMI and left ventricular systolic dysfunction (left ventricular ejection fraction <50%) were underwent STE in conjunction with LDDSE and dual isotope simultaneous acquisition single photon emission computed tomography (DISA-SPECT). Percutaneous coronary intervention (PCI) was performed subsequently in all patients. STE was used to measure radial, circumferential, and longitudinal end-systolic strain and peak systolic strain rate. The movement of each segment was observed by routine echocardiography 1, 3, and 6 months after PCI, and its improvement over time was the criterion of viable myocardium. The sensitivity, specificity and accuracy of DISA-SPECT for the assessment of viable myocardium were 83.6, 74.4, and 80.7%, respectively. Among the radial, circumferential, and longitudinal strain and strain rate parameters, only longitudinal strain (LS) and longitudinal strain rate (LSr) at rest and LDDSE emerged as independent predictors of viable myocardium, When combining LS and LSr at LDDSE, the sensitivity, specificity and accuracy for the assessment of viable myocardium rose to 89.8, 90.2 and 89.9%, respectively. The sensitivity of STE in conjunction with LDDSE was similar to DISA-SPECT for detecting viable myocardium in patients with AMI, but the specificity and accuracy of STE performed with LDDSE were higher than DISA-SPECT. PMID:23358919

Gong, Lei; Li, Dongye; Chen, Junhong; Wang, Xiaoping; Xu, Tongda; Li, Wenhua; Ren, Shaoyang; Wang, Cheng

2013-06-01

248

Utility of 3-dimensional echocardiography, global longitudinal strain, and exercise stress echocardiography to detect cardiac dysfunction in breast cancer patients treated with doxorubicin-containing adjuvant therapy.  

PubMed

Conventional resting left ventricular ejection fraction (LVEF) assessments have limitations for detecting doxorubicin (DOX)-related cardiac dysfunction. Novel resting echocardiographic parameters, including 3-dimensional echocardiography (3DE) and global longitudinal strain (GLS), have potential for early identification of chemotherapy-related myocardial injury. Exercise "stress" is an established method to uncover impairments in cardiac function but has received limited attention in the adult oncology setting. We evaluated the utility of an integrated approach using 3DE, GLS, and exercise stress echocardiography for detecting subclinical cardiac dysfunction in early breast cancer patients treated with DOX-containing chemotherapy. Fifty-seven asymptomatic women with early breast cancer (mean 26 ± 22 months post-chemotherapy) and 20 sex-matched controls were studied. Resting left ventricular (LV) function was assessed by LVEF using 2-dimensional echocardiography (2DE) and 3DE and by GLS using 2-dimensional speckle-tracking echocardiography (2D-STE). After resting assessments, subjects completed cardiopulmonary exercise testing with stress 2DE. Resting LVEF was lower in patients than controls by 3DE (55 ± 4 vs. 59 ± 5 %; p = 0.005) but not 2DE (56 ± 4 vs. 58 ± 3 %; p = 0.169). 10 of 51 (20 %) patients had GLS greater than or equal to -17 %, which was below the calculated lower limit of normal (control mean 2SD); this patient subgroup had a mean 20 % impairment in GLS (-16.1 ± 0.9 vs. -20.1 ± 1.5 %; p < 0.001), despite similar LVEF by 2DE and 3DE compared to controls (p > 0.05). Cardiopulmonary function (VO2peak) was 20 % lower in patients than controls (p < 0.001). Exercise stress 2DE assessments of stroke volume (61 ± 11 vs. 69 ± 15 ml; p = 0.018) and cardiac index (2.3 ± 0.9 vs. 3.1 ± 0.8 l min(-1) m(-2) mean increase; p = 0.003) were lower in patients than controls. Post-exercise increase in cardiac index predicted VO2peak (r = 0.429, p = 0.001). Resting 3DE, GLS, and exercise stress 2DE detect subclinical cardiac dysfunction not apparent with resting 2DE in post-DOX breast cancer patients. PMID:24390149

Khouri, Michel G; Hornsby, Whitney E; Risum, Niels; Velazquez, Eric J; Thomas, Samantha; Lane, Amy; Scott, Jessica M; Koelwyn, Graeme J; Herndon, James E; Mackey, John R; Douglas, Pamela S; Jones, Lee W

2014-02-01

249

Assessment of right ventricular function by three-dimensional echocardiography and myocardial strain imaging in adult atrial septal defect before and after percutaneous closure.  

PubMed

Real-time three-dimensional (3D) echocardiography allows us to measure right ventricular (RV) end-diastolic volume irrespective of its shape. Tissue Doppler imaging (TDI) and speckle tracking imaging (STI) are new tools to assess myocardial function. We sought to evaluate RV function by 3D echocardiography and myocardial strain imaging in adult patients with atrial septal defect (ASD) before and 6 months after transcatheter closure in order to assess the utility of these new indexes in comparison with standard two-dimensional (2D) and Doppler parameters. Thirty-nine ASD patients and 39 healthy age- and sex-matched controls were studied using a commercially available cardiovascular ultrasound system. 2D-Doppler parameters of RV function (fractional area change, tricuspid annular plane systolic excursion, myocardial performance index) were calculated. 3D RV volumes were also obtained. RV peak-systolic velocities, peak-systolic strain, and peak systolic and diastolic strain-rate were measured in the basal, mid and apical segments of lateral and septal walls in apical 4-chamber view by TDI and STI. In open ASD, RV ejection fraction (3D-RVEF) and global and regional RV longitudinal strain were significantly higher than control group and decreased significantly after closure. By multivariate analysis 3D-RVEF, apical strain and strain rate were independent predictors of functional class. ROC analysis showed 3D-RVEF and apical strain to be more sensitive predictors of unfavorable outcome after defect closure compared to 2D-Doppler indexes. 3D echocardiography and myocardial strain imaging give useful insights in the quantitative assessment of RV function in ASD patients before and after closure. PMID:22310981

Vitarelli, Antonio; Sardella, Gennaro; Roma, Angelo Di; Capotosto, Lidia; De Curtis, Guglielmo; D'Orazio, Simona; Cicconetti, Paolo; Battaglia, Daniela; Caranci, Fiorella; De Maio, Melissa; Bruno, Pasqualina; Vitarelli, Massimo; De Chiara, Stefania; D'Ascanio, Michela

2012-12-01

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

Comparison of indium-111 platelet scintigraphy and two-dimensional echocardiography in the diagnosis of left ventricular thrombi  

SciTech Connect

In a study comparing indium-111 platelet scintigraphy and two-dimensional echocardiography as methods of identifying left ventricular thrombi, the results obtained with both techniques were verified at surgery or autopsy in 53 patients-34 with left ventricular aneurysms, and 19 with mitral-valve disease. Left ventricular thrombi were found at surgery or autopsy in 14 of the patients with aneurysms and in none of those with mitral-valve disease. Thirteen of 53 echocardiograms (25%) were technically inadequate and excluded from the analysis. In the group with aneurysms, the sensitivity of scintigraphy in detecting thrombi was 71%, and that of echocardiography was 77%. The specificity of scintigraphy was 100%, and that of echocardiography was 93%. We conclude that indium-111 platelet scintigraphy and two-dimensional echocardiography have useful and complementary roles in the detection of left ventricular thrombi. Both these noninvasive techniques can be used to monitor therapy.

Ezekowitz, M.D.; Wilson, D.A.; Smith, E.O.; Burow, R.D.; Harrison, L.H. Jr.; Parker, D.E.; Elkins, R.C.; Peyton, M.; Taylor, F.B.

1982-06-24

252

Impact of cardiac biomarkers or echocardiography on the management of patients with acute non-massive pulmonary embolism.  

E-print Network

??Background: Cardiac biomarkers or echocardiography for assessing right ventricular function are recommended to risk-stratify patients with acute non-massive pulmonary embolism (PE) but it remains unclear… (more)

Brugger, A K

2011-01-01

253

A 10-second fluid challenge guided by transthoracic echocardiography can predict fluid responsiveness  

PubMed Central

Introduction The accurate assessment of intravascular volume status for the therapy of severe hypovolemia and shock is difficult and critical to critically ill patients. Non-invasive evaluation of fluid responsiveness by the rapid infusion of a very limited amount of volume is an important clinical goal. This study aimed to test whether echocardiographic parameters could predict fluid responsiveness in critically ill patients following a low-volume (50-ml crystalloid solution) infusion over 10?seconds. Methods We prospectively studied 55 mechanically ventilated patients. Echocardiography was performed during a 50-ml infusion of crystalloid solution over 10?seconds and a further 450?ml over 15?minutes. Cardiac output (CO), stroke volume (SV), aortic velocity time index (VTI), and left ventricular ejection fraction (LVEF) were recorded. Patients were classified as responders (Rs) if CO increased by at least 15% following the 500-ml volume expansion or were classified as non-responders (NRs) if CO increased by less than 15%. Area under the receiver operating characteristic curves (AUC) compared CO variations after 50?ml over 10?seconds (?CO50) and 500?ml over 15?minutes (?CO500) and the variation of VTI after infusion of 50?ml of fluid over 10?seconds (?VTI50). Results In total, 50 patients were enrolled, and 27 (54%) of them were Rs. General characteristics, LVEF, heart rate, and central venous pressure were similar between Rs and NRs. In the Rs group, the AUC for ?CO50 was 0.95?±?0.03 (P <0.01; best cutoff value, 6%; sensitivity, 93%; specificity, 91%). Moreover, ?CO50 and ?CO500 were strongly correlated (r?=?0.87; P <0.01). The AUC for ?VTI50 was 0.91?±?0.04 (P <0.01; best cutoff value, 9%; sensitivity, 74%; specificity, 95%). ?VTI50 and ?CO500 were positively correlated (r?=?0.72; P <0.01). Conclusion In critically ill patients, the variation of CO and VTI after the administration of 50-ml crystalloid solution over 10?seconds (?CO50 and ?VTI50) can accurately predict fluid responsiveness. Trial registration Current Controlled Trials ISRCTN10524328. Registered 12 December 2013. PMID:24886990

2014-01-01

254

The emerging role of echocardiography in the screening of patients at risk of heart failure.  

PubMed

A large number of patients without symptoms of heart failure (HF) have asymptomatic left ventricular (LV) dysfunction owing to the compensatory mechanisms acting through the autonomic nervous system and neurohormones. In the setting of screening for prevention, one must identify the subgroup of these patients at high risk for symptomatic HF to establish appropriate therapy. As a first step to identify the subgroup of patients at high risk, clinical screening scores and natriuretic peptide measurements are used. Second, the definite diagnosis of asymptomatic LV dysfunction must be confirmed with echocardiography, occasionally with the help of new technologic developments to establish prompt, appropriate treatment to prevent disease progression. Therefore, the screening role of echocardiography is the early identification of patients with structural cardiopathy who are at risk of developing symptomatic HF and detection of those without LV dysfunction (diabetic and hypertensive) whose condition is prone to advance rapidly to structural cardiopathy or to symptomatic HF. PMID:16399092

Colonna, Paolo; Pinto, Fausto J; Sorino, Margherita; Bovenzi, Francesco; D'Agostino, Carlo; de Luca, Italo

2005-12-19

255

Combination of contrast with stress echocardiography: A practical guide to methods and interpretation  

PubMed Central

Contrast echocardiography has an established role for enhancement of the right heart Doppler signals, the detection of intra-cardiac shunts, and most recently for left ventricular cavity opacification (LVO). The use of intravenously administered micro-bubbles to traverse the myocardial microcirculation in order to outline myocardial viability and perfusion has been the source of research studies for a number of years. Despite the enthusiasm of investigators, myocardial contrast echocardiography (MCE) has not attained routine clinical use and LV opacification during stress has been less widely adopted than the data would support. The purpose of this review is to facilitate an understanding of the involved imaging technologies that have made this technique more feasible for clinical practice, and to guide its introduction into the practice of the non-expert user. PMID:15331015

Moir, Stuart; Marwick, Thomas H

2004-01-01

256

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

PubMed Central

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

2013-01-01

257

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

258

Magnetic resonance imaging of microvascular leakage induced by myocardial contrast echocardiography in rats  

Microsoft Academic Search

The extent and magnitude of microvascular leakage induced by myocardial contrast echocardiography (MCE) were characterized with contrast-aided magnetic resonance imaging (MRI). Evans blue dye, Definity ultrasound contrast agent and Omniscan magnetic resonance contrast agent were injected intravenously in anesthetized rats suspended in a water bath. Diagnostic ultrasound B mode scans with 1:4 end-systolic triggering were performed at 1.5 MHz using

Scott D. Swanson; Chunyan Dou; Douglas L. Miller

2006-01-01

259

Influence of continuous positive airways pressure treatment on ductus arteriosus shung assessed by echocardiography.  

PubMed Central

In a preterm infant with the respiratory distress syndrome complicated by patent ductus arteriosus, continuous positive airways pressure (CPAP) treatment relieved the signs of cardiac decompensation associated with left-to-right shunt. Echocardiography enabled the change in left atrial size, an indirect measure of the shunt, to be followed. In this way the rapid effect of CPAP in reducing left-to-right shunting could be monitored. This noninvasive technique could have many applications in neonatology. Images Fig. 1 PMID:335982

Bjorkhem, G E; Lundstrom, N R; Svenningsen, N W

1977-01-01

260

The clinical impact of dynamic intraventricular obstruction during dobutamine stress echocardiography  

Microsoft Academic Search

We selected 73 consecutive patients without myocardial infarction, hypertrophic cardiomyopathy or hypertension complaining of effort chest discomfort\\/dyspnoea, and\\/or reporting exercise ischaemic ECG changes, and submitted them to simultaneous dobutamine stress echocardiography (DSE) and 99mTc tetrofosmin SPECT (T SPECT) and to coronary angiography to evaluate the clinical impact of intraventricular obstruction (IVO) during dobutamine infusion. Sixteen patients (22%, 7 males, mean

G Barletta; M. R Del Bene; C Gallini; S Salvi; E Costanzo; M Masini; G Galeota; F Fantini

1999-01-01

261

[The study of left ventricular diastolic function by Doppler echocardiography: the essential for the clinician].  

PubMed

The study of diastolic function by Doppler-echocardiography is complex and demanding. The cardiologist/echocardiographist must have a systematic approach to the study of left ventricular diastolic function, not only based on the Doppler index, but integrating Doppler patterns with other echo-parameters (chamber dimensions, wall thicknesses, systolic function, valve function and morphology) and clinical information. A rational interpretation of clinical and instrumental data can allow a correct diagnosis, which is essential for clinical decision-making. PMID:19645209

Vizzardi, Enrico; Faggiano, Pompilio; Chiari, Ermanna; Maffeo, Diego; Frattini, Silvia; Bellandi, Francesca; Nodari, Savina; Dei Cas, Livio

2009-03-01

262

The role of echocardiography in diagnosing double chambered right ventricle in adults  

PubMed Central

Objective: To evaluate the utility of echocardiography in diagnosing double chambered right ventricle (DCRV) in adults. Design: A retrospective study. Setting: Department of Congenital Heart Diseases and Department of Cardiac Surgery, Institute of Cardiology, Warsaw, Poland. Patients: 32 patients, mean age 32.5 years, 21 female, and 11 male. Intervention: Transthoracic (TTE) and transoesophageal (TOE) echocardiographic examination in patients with suspected DCRV. Main outcome measures: Direct inspection during surgical treatment of 28 patients diagnosed as having DCRV as an isolated lesion or associated with other pathologies. Results: Echocardiography allowed the final diagnosis of DCRV in 26 patients (81%) out of 32 studied. TTE was diagnostic in 5 (15.6%) whereas TOE was diagnostic in 21 of 21 studied by this technique. Of 6 patients with negative TTE, DCRV was identified by cardiac catheterisation in 3 and directly during surgery in the remaining 3. Of 26 patients diagnosed by echocardiography, the anomalous muscle bundle was discrete in 20 (77%) and diffuse in 6 (23%). In 23 patients (88%) right ventricular outflow obstruction was localised low in the right ventricle, and in the remaining 3 (11.5%), the obstruction was localised high in the right ventricle. Abnormal bundles localised high were discrete, bundles localised in the lower part of right ventricle were discrete in 17 (74%) and diffuse in the remaining 6 (26%). DCRV was an isolated lesion in only 2 patients (6.2%). In all subjects surgical inspection confirmed echocardiographic data. Conclusions: Echocardiography was very useful to diagnose DCRV in adults as well as to identify its anatomic type. Comparing two different approaches, TOE better defines the entire scope of pathology, including estimation of the resultant systolic pressure gradient within the right ventricular cavity. PMID:15201250

Hoffman, P; Wojcik, A W; Rozanski, J; Siudalska, H; Jakubowska, E; Wlodarska, E K; Kowalski, M

2004-01-01

263

Pediatric cardiac surgery after exclusively echocardiography-based diagnostic work-up  

Microsoft Academic Search

This study was performed to evaluate the accuracy of exclusively non-invasive preoperative diagnostic work-up based on echocardiography and to assess the safety of cardiac surgery using this diagnostic approach in children with heart disease. During a 3.5-year period, accuracy of preoperative (invasive and non-invasive) diagnostic work-up was prospectively tested by comparison with the intraoperative findings obtained by surgical inspection and

Jean-Pierre Pfammatter; Pascal Berdat; Mark HämmerIi; Thierry Carrel

2000-01-01

264

Field-by-field evaluation of intraoperative transoesophageal echocardiography interpretative skills  

Microsoft Academic Search

A quality assurance system is essential for the credibility and structured growth of anaesthesiology-based transoesophageal echocardiography (TEE) programmes. We have developed software (Q\\/A Kappa), involving a 400-line source code, capable of directly reporting kappa correlation coefficient values, using external reviewer interpretations as the `gold standard', and thereby allowing systematic assessment of the validity of intraoperative echocardiographic interpretation. This paper presents

Michael Griffin; Bruce Edwards; Jon Judd; Robert Workman; Terence Rafferty

2000-01-01

265

The Role of Transesophageal Echocardiography in Endovascular Repair of Traumatic Aortic Transection  

PubMed Central

Traumatic rupture of the thoracic aorta is a leading cause of death, following major blunt trauma, and endovascular repair has evolved as a viable alternative to open repair. This report highlights the role of transesophageal echocardiography as a valuable imaging tool for locating the exact position of the lesion, guiding placement of the endograft, detecting leaks around it and supplementing information derived from angiography during endograft deployment. PMID:25337315

Al-Shamsi, Sulaiman Saif; Sabek, Said Abdelrahman; Al-Hajri, Mahmood

2014-01-01

266

Severe storms  

NASA Technical Reports Server (NTRS)

An overview of severe storms given by a representative of the U.S. Department of Commerce/NOAA and how they affect aviation is presented. What is being done and the organizations responsible for the work in this area are briefly discussed. A partial list of the things that the representative feels need to be done is also presented.

Connolly, J. W.

1978-01-01

267

"Show me" bioethics and politics.  

PubMed

Missouri, the "Show Me State," has become the epicenter of several important national public policy debates, including abortion rights, the right to choose and refuse medical treatment, and, most recently, early stem cell research. In this environment, the Center for Practical Bioethics (formerly, Midwest Bioethics Center) emerged and grew. The Center's role in these "cultural wars" is not to advocate for a particular position but to provide well researched and objective information, perspective, and advocacy for the ethical justification of policy positions; and to serve as a neutral convener and provider of a public forum for discussion. In this article, the Center's work on early stem cell research is a case study through which to argue that not only the Center, but also the field of bioethics has a critical role in the politics of public health policy. PMID:17926217

Christopher, Myra J

2007-10-01

268

Investigation of vascular compression of the trachea: the complementary roles of barium swallow and echocardiography.  

PubMed Central

To determine the preferred investigation of congenital vascular compression of the trachea, preoperative investigation in 40 patients undergoing surgery 1981-91 was analysed. The importance of preoperative identification of detailed arterial anatomy in determining surgical technique was also assessed in 122 consecutive patients undergoing surgery 1952-91. Of the 40 patients (median age 5 months) seen 1981-91, barium swallow before referral suggested the diagnosis of vascular compression in 26 of 27 (96%). Angiography (1/3), bronchoscopy (0/6), and echocardiography (2/6) were generally unhelpful in diagnosing vascular compression before referral. Echocardiography was performed after referral in 18 consecutive patients since 1986 and the correct arterial anatomy was identified in 16 (88%); hyperinflation resulted in inadequate images in the two others. Barium swallow is the investigation of choice to screen for suspected vascular compression of the trachea; echocardiography at the referral centre can define the arterial anatomy in nearly all patients. Further investigation can be reserved for selected cases. Images PMID:8481037

Burch, M; Balaji, S; Deanfield, J E; Sullivan, I D

1993-01-01

269

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.

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

270

Use of echocardiography for the phenotypic assessment of genetically altered mice.  

PubMed

Transgenic mice displaying abnormalities in cardiac development and function represent a powerful new tool for understanding molecular mechanisms underlying normal cardiovascular function and the pathophysiological bases of human cardiovascular disease. Complete cardiac evaluation of phenotypic changes in mice requires the ability to noninvasively assess cardiovascular structure and function in a serial manner. However, the small mouse heart beating at rates in excess of 500 beats/min presents unique methodological challenges. Two-dimensional and Doppler echocardiography have been recently used as effective, noninvasive tools for murine imaging, because quality images of cardiac structures and valvular flows can be obtained with newer high-frequency transthoracic transducers. We will discuss the use of echocardiography for the assessment of 1) left ventricular (LV) chamber dimensions and wall thicknesses, 2) LV mass, 3) improved endocardial border delineation using contrast echocardiography, 4) LV contractility using ejection phase indices and load-independent indices, 5) vascular properties, and 6) LV diastolic performance. Evaluation of cardiovascular performance in closed chest mice is feasible in a variety of murine models using Doppler echocardiographic imaging. PMID:12746467

Collins, Keith A; Korcarz, Claudia E; Lang, Roberto M

2003-05-13

271

Selective coronary angiography versus two-dimensional echocardiography for diagnosis of left atrial thrombi.  

PubMed

Coronary angiographic findings indicative for left atrial thrombi (neovascularization in the region of the left atrium) were compared with echocardiographic ones. Of 214 patients who had mitral surgery, the authors had all the available data for 161 (31 of whom had left atrial thrombi). The presence of a neovascularization had a sensitivity of 61%, a specificity of 100%, predictive accuracy of 100%, and predictive value of 92%, while echocardiography had a sensitivity of 52%, specificity of 96%, predictive accuracy of 76%, and predictive value of 89%. There was no difference in the sensitivity of both methods for the detection of thrombi located in the left atrium as a whole cavity (p less than 0.05). However, coronary angiography was superior to echocardiography in the diagnosis of thrombi located in the left atrial appendage (p less than 0.05). The diagnosis of left thrombi could be improved by using both methods (specificity 77%, predictive value 95%). Thus, selective coronary angiography is a useful diagnostic method, in addition to echocardiography, in the diagnosis of left atrial thrombi. PMID:1952276

Babic, U U; Popovic, Z; Vucinic, M; Djurisic, Z; Pejcic, P; Grujicic, S

1991-11-01

272

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

273

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

274

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.

Forde, Evan B.

2004-04-01

275

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

PubMed Central

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

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

2013-01-01

276

Measurements of left ventricular volumes and ejection fraction with three-dimensional echocardiography: feasibility and agreement compared to two-dimensional echocardiography.  

PubMed

Recent guidelines regard three-dimensional echocardiography (DE) derived measurements of left ventricular (LV) volumes and ejection fraction (EF) as the method of choice. The feasibility of 3DE and agreement between 2DE and 3DE was examined. Our hypothesis was that a number of patients can only be examined with 2DE in a patient population admitted to a general hospital. Hospitalised patients referred for echocardiography by residents on call who found grounds to perform a pocket-sized ultrasound examination (PCU) were included. A subsequent 2DE and 3DE was planned. 3DE was considered unfeasible in the presence of irregular heart rhythm and poor quality imaging (included inability to hold breath). Agreement was evaluated with correlation and Bland-Altman analyses. Of 273 consecutive patients examined with 2DE, 202 (74 %) had satisfactory 3DE images for LV volume and EF measurements. Reasons for exclusion of 71 patients from the 3DE study included irregular heart rhythm in 58 patients and poor quality images in 13 patients. Median LV end-diastolic volume was 146 mL with 3DE and 161 mL with 2DE (p < 0.001). The respective values for LV end-systolic volume were 76 mL and 83 mL (p < 0.001), and for LVEF 48 % and 49 % (p = 0.061). Optimal 3DE assessment of LV volumes and EF could only be performed in 3/4 of patients. A significant overestimation of LV volumes was observed in terms of 2DE versus 3DE, whereas no such difference was found for LVEF. PMID:24972778

Ruddox, Vidar; Edvardsen, Thor; Bækkevar, Morten; Otterstad, Jan Erik

2014-10-01

277

Severe right heart failure in a patient with chronic obstructive lung disease: a diagnostic challenge.  

PubMed

A 55-year-old male was admitted for evaluation of severe dyspnoea and hypoxaemia. Physical examination upon admission showed elevated jugular venous pressure and an accentuated second heart sound. Chest radiograph showed cardiomegaly with increased bibasilar markings. Arterial blood gas analysis while breathing room air showed marked hypoxaemia. High resolution computed tomography angiography of the chest showed modestly enlarged mediastinal lymph nodes with discrete diffuse ground-glass attenuation especially at the lower lung zones. Positron emission tomography using 18F labelled 2-deoxy-D-glucose (FDG) demonstrated the mediastinal lymph nodes were FDG-avid. Transthoracic echocardiography showed dilated hypokinetic right heart chambers with bulging of the interventricular septum to the left, compatible with acute cor-pulmonale. From the tricuspid regurgitation jet measurement a systolic pulmonary artery pressure (PAP) of 48 mmHg was estimated. Patent foramen ovale was suspected on bubble test. Right heart catheterisation confirmed pulmonary arterial hypertension: mPAP 47 mmHg, pulmonary artery occlusion pressure 5 mmHg, cardiac index 1.1 L/min/m2, pulmonary vascular resistance (PVR) 959 dyne.sec.cm(-5). Pulmonary function tests showed a marked diffusing capacity for carbon monoxide (DLCO) decrease of 32% predicted but no obstructive lung deficit. Before an open lung biopsy could be scheduled the patient developed acute cardiogenic shock. At autopsy pulmonary veno-occlusive disease with marked pulmonary hypertension was diagnosed. PMID:24380224

Meysman, M; Pipeleers-Marichal, M; Geers, C; Ilsen, B; Vincken, W

2013-01-01

278

Stress Echocardiography with Contrast for the Diagnosis of Coronary Artery Disease  

PubMed Central

Executive Summary In July 2009, the Medical Advisory Secretariat (MAS) began work on Non-Invasive Cardiac Imaging Technologies for the Diagnosis of Coronary Artery Disease (CAD), an evidence-based review of the literature surrounding different cardiac imaging modalities to ensure that appropriate technologies are accessed by patients suspected of having CAD. This project came about when the Health Services Branch at the Ministry of Health and Long-Term Care asked MAS to provide an evidentiary platform on effectiveness and cost-effectiveness of non-invasive cardiac imaging modalities. After an initial review of the strategy and consultation with experts, MAS identified five key non-invasive cardiac imaging technologies for the diagnosis of CAD. Evidence-based analyses have been prepared for each of these five imaging modalities: cardiac magnetic resonance imaging, single photon emission computed tomography, 64-slice computed tomographic angiography, stress echocardiography, and stress echocardiography with contrast. For each technology, an economic analysis was also completed (where appropriate). A summary decision analytic model was then developed to encapsulate the data from each of these reports (available on the OHTAC and MAS website). The Non-Invasive Cardiac Imaging Technologies for the Diagnosis of Coronary Artery Disease series is made up of the following reports, which can be publicly accessed at the MAS website at: www.health.gov.on.ca/mas or at www.health.gov.on.ca/english/providers/program/mas/mas_about.html Single Photon Emission Computed Tomography for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Stress Echocardiography for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Stress Echocardiography with Contrast for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis 64-Slice Computed Tomographic Angiography for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Cardiac Magnetic Resonance Imaging for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Pease note that two related evidence-based analyses of non-invasive cardiac imaging technologies for the assessment of myocardial viability are also available on the MAS website: Positron Emission Tomography for the Assessment of Myocardial Viability: An Evidence-Based Analysis Magnetic Resonance Imaging for the Assessment of Myocardial Viability: an Evidence-Based Analysis The Toronto Health Economics and Technology Assessment Collaborative has also produced an associated economic report entitled: The Relative Cost-effectiveness of Five Non-invasive Cardiac Imaging Technologies for Diagnosing Coronary Artery Disease in Ontario [Internet]. Available from: http://theta.utoronto.ca/reports/?id=7 Objective The objective of this report is to compare echocardiography (ECHO) performed with microsphere contrast agents (contrast echocardiography) to ECHO performed without contrast and to single photon emission computed tomography (SPECT). Contrast ECHO Contrast agents for ECHO have been available since the technology was first introduced in the 1990s. Composed of tiny ‘microbubbles’ of an inert gas encapsulated within a lipid, protein, or polymer coat, these agents act to scatter incident ultrasound waves at the gas/liquid interface to increase the strength of a returning ECHO signal. When injected into a patient’s arm, they are transported throughout even the smallest capillaries to greatly enhance the blood pool signal, which would otherwise appear black on conventional two dimensional ECHO. The enhanced signal then helps cardiologists to determine what parts of the patient’s heart muscle are poorly perfused. The first commercially available microsphere contrast agent was Albunex, which received approval by the Food and Drug Administration in the United States in 1994. This original microsphere agent was limited by its rapid gas volume loss which caused a decline in the ultrasound signal. It worked well in the right chambers of the heart, but disso

2010-01-01

279

A case of anastomosis malposition of the Blalock-Taussig shunt diagnosed using perioperative transesophageal echocardiography monitoring.  

PubMed

The perioperative transesophageal echocardiography (TEE) is a very useful and minimal invasive monitoring not only for the cardiac anesthesia management, but also for the anesthesia management of the non-cardiac operations of the heart high risk patients. In this case report, we report a case of the urgent Blalock-Taussig shunt (BT shunt) operation for a small patient of Fallot's tetralogy with anoxic spell, which showed an atypical change of hemodynamics and SpO2 with the shunt opening. After the BT shunt anastomosis, the diastolic blood pressure decreased with the shunt opening, however, the expected rise of SpO2 was not provided. By the perioperative TEE monitoring with the single plane TEE transducer for neonate; UST-52110S (Hitachi Aloka Medical, Tokyo, Japan) with 4.5 mm in diameter, the cause of this atypical change of hemodynamics and SpO2 was diagnosed to be an accidental anastomosis malposition of the BT shunt to the right pulmonary vein and reported to the operator during the operation, and the operation was performed correctly. PMID:24046098

Yamamoto, Tomohiro; Schindler, Ehrenfried

2014-04-01

280

Midterm Picnic ELI Talent Show  

E-print Network

Highlights Midterm Picnic ELI Talent Show Notes from the Office Birthdays Manners Grammar The will be on the Activities Board and in next week's Weekly. ELI Talent Show Do you have a talent? Show it to us at the ELI Talent Show! The talent show is open to ELI students, faculty, staff, and LAs. Acts can include

Pilyugin, Sergei S.

281

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

282

Electrical dissociation within the left atrium and left atrial appendage diagnosed with transesophageal echocardiography.  

PubMed

The authors describe the case of a 79-year-old man with prior mitral valve repair and a maze procedure who developed recurrent atrial fibrillation, in whom transesophageal echocardiography revealed an accessory lobe of the left atrial appendage in sinus rhythm when the remaining body of the left atrial appendage was in atrial fibrillation or flutter. Electrophysiology confirmed dissociated rhythm within the left atrium. This case emphasizes the need for careful Doppler interrogation of the left atrial appendage and its lobes to look for dissociated atrial rhythm. PMID:20434878

Naqvi, Tasneem Z; Rafie, Reza; Cesario, David

2010-10-01

283

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

284

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

285

Soccer Tournament ELI Talent Show  

E-print Network

Highlights Soccer Tournament ELI Talent Show Notes from your Teachers Notes from the Office very quickly! ELI Talent Show As you probably already know, the ELI is going to have its second annual Talent Show. The talent show is open to ELI students, faculty, staff, and LAs. Acts can include

Pilyugin, Sergei S.

286

Stress echocardiography  

MedlinePLUS

... for heart disease Have heart valve problems The results of this stress test can help your doctor: Determine how well a heart treatment is working and change your treatment, if needed ... coronary artery disease See whether your heart is too large

287

Real-time detection of migratory thrombi by transesophageal echocardiography in a patient undergoing thrombectomy.  

PubMed

We report a 44-year-old male patient who sustained a right atrial (RA) thrombosis with evolvement into right pulmonary artery embolism in consequence of placement of a temporary pacing lead and was successfully treated with surgical thrombectomy under the guidance of perioperative transesophageal echocardiography (TEE). Because of intermittent complete atrioventricular block he therefore underwent implantation of a transvenous temporary pacing. On the ensuing day a large mass was incidentally found echographically in the RA suggestive of a large thrombus. Immediate surgical removal of the mass was indicated. During the emergent open-heart surgery the mass in RA dehiscenced with fragments migrating to the right main pulmonary artery, and exploration of both the RA and right pulmonary artery was done. This migratory mass, which proved to be a fresh thrombus, was surgically removed. The cardiopulmonary bypass was then terminated and the spontaneous contraction of heart was resumed. However, another mass lesion was found in RA on the TEE screen just following the removal of the problematic transvenous pacing wire. The right atrium was thus re-opened immediately and the second thrombus was cleared. Over the on-going surgical course no further abnormal echogenic objects were visible in the cardiac chambers. It is perceivable that transvenous pacing might cause thrombois or dislodgement and dehiscence of thrombi already in existence in the cardiac chamber. Careful and continuous intraoperative surveillance with echocardiography over a patient who is undergoing cardiac embolectomy is quite important in detecting thrombus escape and residual thrombi during surgery. PMID:16060408

Liang, Ching-Huang; Lai, Hui-Chun; Yang, Ya-Ling; Liu, Tsun-Jui; Lai, Hui-Chin

2005-06-01

288

Intracardiac echocardiography for percutaneous closure of atrial septal defects: initial experiences in Japan.  

PubMed

Transcatheter closure of secundum atrial septal defect (ASD) has been widely performed as a less invasive alternative to surgery with zero mortality so far in Japan. In the US and Europe, intracardiac echocardiography (ICE) has replaced transesophageal echocardiography (TEE) as a primary imaging tool during percutaneous ASD closure. However, the experience of ICE in ASD closure is limited in Japan. Consecutive 51 patients underwent percutaneous ASD closure with ICE guidance. Clinical results were compared to those of 41 patients who underwent ASD closure with TEE guidance. Pediatric patients and patients with multiple ASDs who were expected to need multiple devices were excluded. Success rate was similar in both groups (ICE 96.1 %, TEE 92.7 %). Catheterization laboratory time was significantly shortened with ICE than with TEE (131 vs. 155 min, p = 0.0003). There were no complications related to the use of ICE. ICE-guided ASD closure is feasible in most adult patients. ICE is superior to TEE in shortening catheterization laboratory time and eliminating general anesthesia, and can potentially replace TEE as the primary image guide during percutaneous ASD closure. PMID:23709325

Shimizu, Sayaka; Kawamura, Akio; Arai, Takahide; Ohno, Yohei; Mogi, Satoshi; Kodaira, Masaki; Anzai, Atsushi; Kawakami, Takashi; Kanazawa, Hideaki; Hayashida, Kentaro; Yuasa, Shinsuke; Maekawa, Yuichiro; Fukuda, Keiichi

2013-10-01

289

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

290

An enabling system for echocardiography providing adaptive support through behavioral analysis.  

PubMed

Echocardiography requires the integrated application of a broad spectrum of cognitive and practical skills, e.g. diagnostic knowledge (symbolic), image interpretation (visual perception) and handling of the ultrasound probe (sensorimotor). This complex expertise is acquired through extensive practical training guided by a skilled cardiologist that is often incompatible with clinical reality. Especially for beginners, the most critical point during an echocardiographic examination is the steering of the ultrasound probe to navigate between different cardiological standard planes (sensorimotor skill) without loosing orientation. These transitions or "standard trajectories" can roughly be described by specific movement patterns. We propose an enabling system based on an Augmented Reality simulator for two-dimensional echocardiography imitating this apprenticeship [1]-[3]. During a simulated ultrasound examination the system monitors the activities of the trainee and analyzes the motion pattern of the ultrasound probe. The simulator reacts by mapping the motion patterns onto cognitive orientation demands and providing adaptive feedback in the form of context sensitive help (animations). It partly takes the role of the critical teacher. PMID:11317802

Trochim, S; Weidenbach, M; Pieper, S; Wick, C; Berlage, T

2001-01-01

291

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; Muller, Silvana; Biviano, Angelo; Hahn, Rebecca T.

2014-01-01

292

Role of three-dimensional echocardiography in management of acquired intracardiac shunts.  

PubMed

Gerbode defect and sinus of Valsalva aneurysm fistula are congenital and acquired forms of intracardiac shunt. The increasing prevalence of invasive, recurrent cardiovascular procedures cause tissue damage and has led to more iatrogenic and acquired cases of predominantly congenital shunt over time. We report 2 cases of acquired intracardiac fistula precisely defined by Real time three-dimensional transesophageal echocardiography (3DTEE). The first case is a 70-year-old male with Gerbode defect after second aortic valve replacement surgery due to prosthetic valve endocarditis and the other case is a 41-year-old male with sinus of Valsalva aneurysm fistula between aorta and right atrium post subclinical infective endocarditis. Advanced cardiac imaging techniques such as cardiac computerized tomography, MRI and Real time three-dimensional (3D) echocardiography help to precisely detect intracardiac fistula and provide detailed anatomic and physiologic information. The relatively low cost, lack of radiation exposure, portability and guiding characteristic make real time 3DTEE an imaging technique with arguably the most advantages. Surgical repair is the usual treatment for intracardiac shunt, and percutaneous catheter-based closure is a less invasive alternative. PMID:25039665

Taskesen, Tuncay; Goldberg, Steven L; Gill, Edward Allen

2014-09-01

293

Identification of viable myocardium with contrast echocardiography in patients with poor left ventricular systolic function caused by recent or remote myocardial infarction  

Microsoft Academic Search

We hypothesized that viable myocardium can be identified in patients with poor left ventricular (LV) systolic function caused by recent or prior infarction using myocardial contrast echocardiography. Accordingly, 39 patients with reduced LV ejection fraction (range 0.10 to 0.40) and recent (n = 30) or remote (n = 9) myocardial infarction were studied. Echocardiography was performed at baseline and at

Gustavo Camarano; Michael Ragosta; Lawrence W. Gimple; Eric R. Powers; Sanjiv Kaul

1995-01-01

294

Patent foramen ovale: Association between the degree of shunt by contrast transesophageal echocardiography and the risk of future ischemic neurologic events  

Microsoft Academic Search

This study investigated whether there is an association between the degree of interatrial shunting across a patent foramen ovale, as determined by saline contrast transesophageal echocardiography, and the risk of subsequent systemic embolic events, including stroke. Thirty-four patients found to have patent foramen ovale during transesophageal echocardiography were divided into two groups on the basis of the maximum number of

David A. Stone; Joel Godard; Mary C. Corretti; Steven J. Kittner; Cindy Sample; Thomas R. Price; Gary D. Plotnick

1996-01-01

295

Impact of Fetal Echocardiography on Trends in Disease Patterns and Outcomes of Congenital Heart Disease in a Neonatal Intensive Care Unit  

Microsoft Academic Search

Background: Congenital heart disease (CHD) is the most common developmental malformation and the leading cause of neonatal mortality and morbidity. The introduction of fetal echocardiography has made prenatal diagnosis of CHD possible. Objective: This study was conducted to investigate the impact of fetal echocardiography on the changing disease patterns and outcomes of CHD. Methods: A retrospective analysis of data from

Mi Lim Chung; Byong Sop Lee; Ellen Ai-Rhan Kim; Ki-Soo Kim; Soo-Young Pi; Yeon Mi Oh; In Sook Park; Dong Man Seo; Hye Sung Won

2010-01-01

296

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 ...

297

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

298

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.

299

28. MAP SHOWING LOCATION OF ARVFS FACILITY AS BUILT. SHOWS ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

28. MAP SHOWING LOCATION OF ARVFS FACILITY AS BUILT. SHOWS LINCOLN BOULEVARD, BIG LOST RIVER, AND NAVAL REACTORS FACILITY. F.C. TORKELSON DRAWING NUMBER 842-ARVFS-101-2. DATED OCTOBER 12, 1965. INEL INDEX CODE NUMBER: 075 0101 851 151969. - Idaho National Engineering Laboratory, Advanced Reentry Vehicle Fusing System, Scoville, Butte County, ID

300

Single histidine button in cardiac troponin I sustains heart performance in response to severe hypercapnic respiratory acidosis in vivo  

PubMed Central

Intracellular acidosis is a profound negative regulator of myocardial performance. We hypothesized that titrating myofilament calcium sensitivity by a single histidine substituted cardiac troponin I (A164H) would protect the whole animal physiological response to acidosis in vivo. To experimentally induce severe hypercapnic acidosis, mice were exposed to a 40% CO2 challenge. By echocardiography, it was found that systolic function and ventricular geometry were maintained in cTnI A164H transgenic (Tg) mice. By contrast, non-Tg (Ntg) littermates experienced rapid and marked cardiac decompensation during this same challenge. For detailed hemodymanic assessment, Millar pressure-conductance catheterization was performed while animals were treated with a ?-blocker, esmolol, during a severe hypercapnic acidosis challenge. Survival and load-independent measures of contractility were significantly greater in Tg vs. Ntg mice. This assay showed that Ntg mice had 100% mortality within 5 min of acidosis. By contrast, systolic and diastolic function were protected in Tg mice during acidosis, and they had 100% survival. This study shows that, independent of any ?-adrenergic compensation, myofilament-based molecular manipulation of inotropy by histidine-modified troponin I maintains cardiac inotropic and lusitropic performance and markedly improves survival during severe acidosis in vivo.—Palpant, N. J., D'Alecy, L. G., Metzger, J. M. Single histidine button in cardiac troponin I sustains heart performance in response to severe hypercapnic respiratory acidosis in vivo. PMID:19141534

Palpant, Nathan J.; D'Alecy, Louis G.; Metzger, Joseph M.

2009-01-01

301

Antenatal diagnosis of pompe disease by fetal echocardiography: impact on outcome after early initiation of enzyme replacement therapy.  

PubMed

Hypertrophic cardiomyopathy (HCM) affects most infants with Pompe disease (PD), and may serve as a marker for its antenatal diagnosis (ANDx) by fetal echocardiography (FE). Fetuses diagnosed with HCM between 2006 and 2009 were included in this study. HCM, defined as Z-score of mean left ventricular wall thickness (LVWT) and/or mass (LVM) above 2, was detected in 5/1,268 fetuses (0.39%) carried by 1,137 pregnant women referred for FE. Three fetuses (0.24%) had postnatal confirmation of PD. Their gestational age and fetal weight at diagnosis was (mean ± standard deviation) 31 ± 3.6 weeks and 1.9 ± 0.2 kg, respectively. Fetal Z-score of LVM and LVWT was 3.8 ± 0.9 and 3.1 ± 0.6, respectively. Postnatally, acid ?-glucosidase (GAA) enzyme activity was nearly absent in all patients, 2 were homozygous for the mutation 1327-2A>G in the GAA gene, and 1 was homozygous for 340insT. Enzyme replacement therapy (ERT) was initiated 4.9 ± 7.8 days after birth (range 2 h-14 days), and continued every 2 weeks. Two infants are alive at 4 and 31 months, and one died of aspiration pneumonia at 19 months. Cardiac hypertrophy resolved after 10-12 weeks of ERT in all patients, and none required any respiratory support. One patient had normal neurodevelopmental assessment at 25 months, and one had severe global delay at 15 months before death. ANDx of PD by FE is feasible based on fetal HCM. It promotes early initiation of ERT which may improve outcome in some patients. However, larger studies and longer follow-ups are required. PMID:20821053

Hamdan, Mohamed A; El-Zoabi, Bushra A; Begam, Muzibunnisa A; Mirghani, Hisham M; Almalik, Mohamed H

2010-12-01

302

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

303

RISK AVERSION IN GAME SHOWS  

Microsoft Academic Search

We review the use of behavior from television game shows to infer risk attitudes. These shows provide evidence when contestants are making decisions over very large stakes, and in a replicated, structured way. Inferences are generally confounded by the subjective assessment of skill in some games, and the dynamic nature of the task in most games. We consider the game

Steffen Andersen; Glenn W. Harrison; Morten I. Lau; E. Elisabet Rutstrom

304

Industrial electrification trend shows strength  

SciTech Connect

One outcome of the oil embargo and cartel has been that, on the average, the price ratio of electricity to oil and gas has been cut in half. Some observers of the electric-utility industry may consider this change unimportant as electricity is still four times as expensive as oil or gas based on dollars per delivered Btu. For numerous uses, however, a given amount of electricity can replace several times as much fossil-fuel energy when relative efficiencies are considered. Thus with decreasing cost ratio, electricity can be justified by certain processes where it was previously uneconomical. A study of industrial activity suggests that several large industries are poised for a substantial shift to electric processing. Among them are the steel, aluminum, copper, glass, cement, petroleum, and paper industries. The potential and incentive for further electrification, from a thermodynamic standpoint, are strongest in manufacturing sectors that require high processing temperatures. 2 figures.

Burwell, C.C.

1983-05-01

305

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

PubMed

We compared the dimensions of the aorta obtained by two-dimensional transthoracic echocardiography (echo) (median, 2.5 mo preangioplasty) and magnetic resonance imaging (MRI) (median, 4.2 mo preangioplasty) to those obtained by angiography (cath) in 13 patients (age, 7.7 +/- 1.6 yr; mean +/- SEM) who underwent evaluation for coarctation balloon angioplasty between April 1993-January 1996. Echo measurements were obtained from the suprasternal and subcostal sagittal planes, MRI measurements from axial and sagittal oblique views, and cath measurements from the straight lateral or oblique views. Measurements of the diameters of the aortic isthmus, coarctation, descending aorta at the diaphragm, and isthmus length were made by all three modalities. Presence of aorto-aortic collaterals was determined, and the coarctation length was delineated. Investigators were blinded to other measurement data prior to statistical analysis. Data analysis by repeated analysis of variance (ANOVA) and Student-Newman-Keuls testing revealed no statistically significant difference between systolic pressure gradient by clinical examination (32.2 +/- 5.9 mm Hg), peak instantaneous Doppler evaluation (37.5 +/- 2.9 mm Hg), or preangioplasty systolic pressure gradient (32.1 +/- 3.3 mm Hg). With the exception of measurements of the descending aorta (echo, 11.7 +/- 0.9 mm vs. MRI, 13.3 +/- 0.8 mm vs. cath, 14.0 +/- 1.3 mm; P = 0.04), there was no statistically significant difference in dimensions of the aortic isthmus (9.2 +/- 0.6 mm vs. 10.5 +/- 0.9 mm vs. 10.8 +/- 0.9 mm), coarctation site diameter (4.8 +/- 0.6 mm vs. 5.6 +/- 0.9 mm vs. 5.3 +/- 0.8 mm), or isthmus length (12.4 +/- 2.1 mm vs. 12.1 +/- 2.2 mm vs. 10.9 +/- 1.7 mm). The correlation coefficients derived from comparisons of MRI vs. cath to echo vs. cath were similar for all dimensions except for isthmus length (P < 0.01). MRI demonstrated aorto-aortic collaterals more frequently than echo, while echocardiography better demonstrated cardiac function and intracardiac anomalies. Both modalities detected the single patient with a long segment coarctation. We conclude that echocardiography and MRI provide similar definition of the coarcted thoracic aorta, and either test may be individually advantageous in specific clinical situations. PMID:9286533

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

1997-09-01

306

Comparison of /sup 111/In platelet scintigraphy and two-dimensional echocardiography in the diagnosis of left ventricular thrombi  

SciTech Connect

In a study comparing /sup 111/In platelet scintigraphy and two-dimensional echocardiography as methods of identifying left ventricular thrombi, the results obtained with both techniques were verified at surgery or autopsy in 53 patients--34 with left ventricular aneurysms, and 19 with mitral-valve disease. Left ventricular thrombi were found at surgery or autopsy in 14 of the patients with aneurysms and in none of those with mitral-valve disease. Thirteen of 53 echocardiograms (25 per cent) were technically inadequate and excluded from the analysis. In the group with aneurysms, the sensitivity of scintigraphy in detecting thrombi was 71 per cent, and that of echocardiography was 77 per cent. The specificity of scintigraphy was 100 per cent, and that of echocardiography was 93 per cent. We conclude that /sup 111/In platelet scintigraphy and two-dimensional echocardiography have useful and complementary roles in the detection of left ventricular thrombi. Both these noninvasive techniques can be used to monitor therapy.

Ezekowitz, M.D.; Wilson, D.A.; Smith, E.O.; Burow, R.D.; Harrison, L.H. Jr.; Parker, D.E.; Elkins, R.C.; Peyton, M.; Taylor, F.B.

1982-06-24

307

Biophysical characteristics of radiofrequency lesion formation in vivo: Dynamics of catheter tip–tissue contact evaluated by intracardiac echocardiography  

Microsoft Academic Search

During clinical radiofrequency catheter ablation a wide range of delivered power may be necessary to achieve success despite an apparently stable catheter position on fluoroscopy. The purpose of this study was to use intracardiac echocardiography to characterize the relation between catheter tip–tissue contact and the efficiency of heating during applications of radiofrequency energy in vivo and to determine whether intracardiac

Jonathan M. Kalman; Adam P. Fitzpatrick; Jeffrey E. Olgin; Michael C. Chin; Randall J. Lee; Melvin M. Scheinman; Michael D. Lesh

1997-01-01

308

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

309

Advances in catheter-based ultrasound imaging Intracardiac Echocardiography and the ACUSON AcuNavTM Ultrasound Catheter  

Microsoft Academic Search

Conventional transthoracic and transesophageal ultrasound imaging often cannot satisfy imaging requirements for many advanced catheter-based interventional cardiac procedures due to restricted access to the anatomy. Intracardiac echocardiography (ICE) can provide almost unrestricted access and has been shown to be very effective in accurately guiding interventional cardiac procedures by providing high quality visualization of intracardiac anatomy and intracardiac devices. ICE is

T. L. Proulx; D. Tasker; J. Bartlett-Roberto

2005-01-01

310

Interobserver and intraobserver variability in detection of patent foramen ovale and atrial septal aneurysm with transesophageal echocardiography  

Microsoft Academic Search

Background: An accurate diagnosis of patent foramen ovale (PFO) and atrial septal aneurysm (ASA) may be of decisional importance in the management of patients with ischemic stroke. Very few studies have been devoted to observer agreement in the diagnosis of these atrial septum abnormalities using contrast transesophageal echocardiography, which is considered as the method of choice for the diagnosis. The

Laure Cabanes; Joël Coste; Geneviève Derumeaux; Xavier Jeanrenaud; Catherine Lamy; Mathieu Zuber; Jean-Louis Mas

2002-01-01

311

Diagnosis of patent foramen ovale by contrast versus color Doppler by transesophageal echocardiography: Relation to atrial size  

Microsoft Academic Search

To ascertain the factors related to the transesophageal echocardiographic diagnosis of patent foramen ovale, the primary echocardiographic data were reviewed from 74 patients with that diagnosis. Similar detection rates were observed with contrast echocardiography (82%) and color flow mapping (78%), but contrast was more sensitive in patients with normal-sized atria (94%) and isolated right atrial enlargement (100%) than in those

Jing Ping Sun; William J. Stewart; Joseph Hanna; James D. Thomas

1996-01-01

312

Evolution of Dobutamine Echocardiography Protocols and Indications: Safety and Side Effects in 3,011 Studies Over 5 Years  

Microsoft Academic Search

Objectives. This study sought to document the safety of dobutamine stress echocardiography as it has evolved at a single center and to define predictors of adverse events.Background. The indications and protocol for dobutamine stress testing have evolved over 5 years of clinical use, but the influence of these changes on the safety and side effects of the test is undefined.Methods.

Maria-Anna Secknus; Thomas H Marwick

1997-01-01

313

CT Angiography of the Aorta Is Superior to Transesophageal Echocardiography for Determining Stroke Subtypes in Patients with Cryptogenic Ischemic Stroke  

Microsoft Academic Search

Background: The etiology of ischemic strokes remains cryptogenic in about one third of patients, even after extensive workup in specialized centers. Atherosclerotic plaques in the aorta can cause thromboembolic events but are often overlooked. They can elude standard identification by transesophageal echocardiography (TEE), which is invasive or at best uncomfortable for many patients. CT angiography (CTA) can be used as

A. Chatzikonstantinou; R. Krissak; S. Flüchter; D. Artemis; A. Schaefer; S. O. Schoenberg; M. G. Hennerici; C. Fink

2012-01-01

314

Acceleration time in the aorta and pulmonary artery measured by Doppler echocardiography in the midtrimester normal human fetus  

Microsoft Academic Search

The time to peak velocity was measured by Doppler echocardiography in the pulmonary artery in 102 normal human fetuses (gestational age 16-30 weeks). Time to peak velocity in the aorta was measured in 72. In 58 both measurements could be made in the same fetus. The time to peak velocity was shorter in the pulmonary artery than in the aorta.

M V Machado; S C Chita; L D Allan

1987-01-01

315

Evaluation of Diastolic Filling of Left Ventricle in Health and Disease: Doppler Echocardiography Is the Clinician’s Rosetta Stone  

Microsoft Academic Search

Abnormalities of diastolic function have a major role in producing the signs and symptoms of heart failure. However, diastolic function of the heart is a complex sequence of multiple interrelated events, and it has been difficult to understand, diagnose and treat the various abnormalities of diastolic filling that occur in patients with heart disease. Recently, Doppler echocardiography has been used

Rick A Nishimura; A. Jamil Tajik

1997-01-01

316

Prevalence of left ventricular hypertrophy in patients with mild hypertension in primary care: impact of echocardiography on cardiovascular risk stratification  

Microsoft Academic Search

BackgroundLeft ventricular hypertrophy (LVH) is an important predictor of cardiovascular risk, and its detection contributes to risk stratification. The aims of the present study were to estimate the prevalence of echocardiographic LVH and to evaluate the influence of echocardiography (ECHO) on cardiovascular risk stratification in hypertensive patients presenting in primary care.

Teresa Sancho; Eduardo Armada; José M. Rubio; José L. Antón; Alberto Torre; Javier Palau; Paloma Seguido; Jaime Gallo; Isabel Saenz; Enrique Polo; Rosa Torres; José Oliver; Juan G. Puig

2003-01-01

317

Left atrial volume measurement with automated border detection by 3-dimensional echocardiography: comparison with magnetic resonance imaging  

Microsoft Academic Search

OBJECTIVE: Left atrial size is an important marker for adverse cardiovascular events. There is general consensus that left atrial volume index (LAVI) is the best measurement of size. The current LAVI measurement techniques are laborious. Semi-automated measurement with a 3-dimensional echocardiography (3DE) system may be a practical clinical alternative to measure LAVI, but it has not been adequately evaluated against

Ramin Artang; Raymond Q Migrino; Leanne Harmann; Mark Bowers; Timothy D Woods

2009-01-01

318

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

319

Maternal hemodynamic effects of uterine contractions by M-mode and pulsed-Doppler echocardiography.  

PubMed

Nineteen normotensive term gravid women were studied by M-mode and pulsed-Doppler echocardiography to noninvasively evaluate the hemodynamic consequences of uterine contractions on maternal left ventricular function. These laboring subjects were placed in the left lateral decubitus position with epidural labor anesthesia. Ejection fraction was not affected by firm contractions, although a small increase in left ventricular end-diastolic measurements was noted. There was a tendency for maternal heart rate to decrease (-5%); however, this trend was not statistically significant. A 16% increase in left ventricular stroke volume (75 +/- 15 to 89 +/- 17 ml) (p less than 0.001) was associated with an overall 11% augmentation of maternal cardiac output (6.31 +/- 1.79 to 7.12 +/- 1.93 L/min) (p less than 0.001). These findings support the hypothesis that uterine contractions increase maternal stroke volume through autotransfusion of uteroplacental blood and cardiac preload augmentation during normal labor. PMID:2801847

Lee, W; Rokey, R; Miller, J; Cotton, D B

1989-10-01

320

In vitro characterization of an aortic bioprosthetic valve using Doppler echocardiography and qualitative flow visualization.  

PubMed

A 19 mm diameter prototype bioprosthetic valve mounted in a cardiac pulse duplicator was characterized using Doppler echocardiography and qualitative flow visualization at a heart rate of 72 bpm. Analysis of the flow visualization images revealed that the prototype and control valve leaflets open symmetrically but close asymmetrically. The asymmetry in the closing of the valves is likely due to the large pressure gradients across the valves and may have implications for the long term mechanical failure of the valves. The relatively high peak systolic velocity of 309.9 cm/s, which was measured in the prototype 19 mm valve, can be attributed to the small valve diameter and the high cardiac output used in the current study. PMID:23367452

Dellimore, Kiran; Kemp, Iain; Rodriguez, Reynaldo; Scheffer, Cornie

2012-01-01

321

Transesophageal echocardiography using cypress-miniaturized echocardiogram unit: initial clinical experience.  

PubMed

Transesophageal echocardiography (TEE) was introduced clinically in the United States in 1987. Recent technologic advances have resulted in the creation of a small portable hand-carried ultrasound (HCU) device that can be easily carried throughout the hospital with greater flexibility for cardiac imaging. These HCU devices have harmonic, color, and spectral Doppler (continuous/pulsed wave). Siemens Medical Solutions USA, Inc. has incorporated a TEE connector, which connects to its Cypress (highly miniaturized echocardiogram unit) and allows the performance of a TEE with this unit, which is mildly heavier than a typical HCU. We describe our initial clinical experience with this unit. The image quality is comparable to routine TEEs, with the advantages of shorter duration, portability, affordable cost, avoiding the use of high-end machine from the echo lab, availability of non-HCU units for other studies, and preventing the need for an echo technician to be involved in the procedure. PMID:16343162

Herzog, Eyal; Pudpud, Danny; Chaudhry, Farooq A

2005-11-01

322

A proposed method to visualize the ductus arteriosus on transesophageal echocardiography.  

PubMed

The ductus arteriosus occupies a uniquely privileged position in the management of heart disease; it initiated not only the surgical management of congenital lesions but also the percutaneous management of this subset. During trans-thoracic echocardiography (TTE) the ductus is often visualized using 'high' parasternal (or the 'ductal' view) or suprasternal windows. It is generally agreed that imaging ductus during transesophageal echo (TEE) can be sub-optimal. During TEE imaging, visualization of the ductus arteriosus is obscured by the acoustic impedance offered by the left main bronchus; adjunct techniques such as insertion of a saline filled balloon in this airway have been used. We describe a simple maneuver that allows visualization of the patent ductus arteriosus during TEE imaging without the use of any adjuncts. PMID:25281628

Gogia, Raviraj; Kumar, Bhupesh; Jayant, Aveek

2014-01-01

323

Role of echocardiography in the diagnosis and management of infective endocarditis  

PubMed Central

Infective endocarditis is one of the most common causes of serious infection and carries a high risk of morbidity and mortality. It represents the fourth leading cause of life-threatening infections after urosepsis, pneumonia, and intra-abdominal sepsis. There is still a continuous rise in the incidence of infective endocarditis, with a rate of about 20,000 new cases in the United States alone. This rise in incidence of infective endocarditis is mainly caused by increasing numbers of intravenous drug abusers, patients with artificial valves and elderly patients. In this paper, we will briefly review the crucial role of echocardiography in the diagnosis and management of infective endocarditis. ImagesFigure 1Figure 2Figure 3

Al Hashimi, H.; Al Windy, N.; McGhie, J.C.; Galema, T.W.; ten Cate, F.J.; Simoons, M.L.

2004-01-01

324

Low Cardiac Output Secondary to a Malpositioned Umbilical Venous Catheter: Value of Targeted Neonatal Echocardiography  

PubMed Central

Systemic hypotension is common in very low birthweight preterm infants but the nature of the precipitating cause may be unclear. Targeted neonatal echocardiography (TnEcho) is being increasingly used to support hemodynamic decisions in the neonatal intensive care unit (NICU), including identifying impairments in the transitional circulation of preterm infants, providing timely re-evaluation after institution of therapies and evaluating the placement of indwelling catheters. We present a case of a preterm infant with systemic hypotension and low cardiac output secondary to a large transatrial shunt induced by a malpositioned umbilical venous catheter. Repositioning of the line led to resolution of the hemodynamic disturbance and clinical instability, highlighting the utility of TnEcho in the NICU. PMID:25032055

Weisz, Dany E.; Poon, Wei Bing; James, Andrew; McNamara, Patrick J.

2014-01-01

325

[Usefulness of Echocardiography for Detecting Prosthetic valve Dysfunction;Report of a Case].  

PubMed

A 78-year-old woman with a history of mitral valve stenosis underwent open mitral commissurotomy in 1976. In 1990, she underwent mitral valve replacement (Medtronic-Hall 29 mm), tricuspid annuloplasty(DeVega method), and pacemaker implantation for bradycardiac atrial fibrillation. However, in June 2012, she developed anemia of unknown cause. Prosthetic valve dysfunction was suspected, because intermittent changes in the left ventricular inflow was detected by echocardiography. Fluoroscopy actually confirmed the presence of prosthetic valve dysfunction. Therefore mitral valve re-replacement(ATS Medical, Inc. 29 mm) and tricuspid annuloplasty (Cosgrove ring 30 mm) were performed. Monitoring the changes in the left ventricular inflow is recommended when prosthetic valve dysfunction in a single leaflet is suspected. PMID:25292382

Oyama, Shogo; Ohuchi, Shingo; Okubo, Tadashi; Kumagai, Kazuya

2014-10-01

326

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

327

Comparison between transthoracic and transesophageal echocardiography in screening for infective endocarditis in patients with Staphylococcus aureus bacteremia.  

PubMed

Echocardiography is an important diagnostic tool in evaluating a patient with Staphylococcus aureus bacteremia (SAB) for diagnosing infective endocarditis (IE). We sought to compare the utility of transthoracic echocardiography (TTE) with transesophageal echocardiography (TEE) in screening for IE in patients with SAB. We performed a retrospective chart review of 285 adult patients from two tertiary care hospitals with at least one positive blood culture for S. aureus between 2010 and 2012. Patients who underwent echocardiography were divided into two groups: TTE (screened with TTE only) and TEE (screened with both TTE and TEE). The demographic factors and clinical outcomes were compared between the groups. Of the 285 charts reviewed, 213 (74.7 %) patients were screened with echocardiography: 183 (85.9 %) were screened with TTE alone and 30 (14.1 %) were screened with both TTE and TEE. TEE disclosed more cases of definite IE than TTE (8 [26.7 %] vs. 22 [12.0 %], p?=?0.046). The TEE group had higher mortality than the TTE group (15 [50.0 %] vs. 43 [23.5 %], p?=?0.004). In patients with definite IE, mortality was higher in the TEE group than in the TTE group (6 [75.0 %] vs. 6 [27.3 %], p?=?0.034). TEE discovered additional findings that were missed by TTE in 36.7 % of cases and refuted the findings of TTE in 13.3 % of cases. We do not support the routine use of TEE in patients with uncomplicated SAB. High-risk patients in which IE is a serious consideration should undergo investigation with TEE. PMID:24930043

Wong, D; Keynan, Y; Rubinstein, E

2014-11-01

328

Relation between number of component views and accuracy of left ventricular mass determined by three-dimensional echocardiography.  

PubMed

Three-dimensional echocardiography (3DE) allows the accurate determination of left ventricular (LV) mass, but the optimal number of component or extracted 2-dimensional (2D) image planes that should be used to calculate LV mass is not known. This study was performed to determine the relation between the number of 2D image planes used for 3DE and the accuracy of LV mass, using cardiovascular magnetic resonance (CMR) imaging as the reference standard. Three-dimensional echocardiography data sets were analyzed using 4, 6, 8, 10 and 20 component 2D planes as well as biplane 2D echocardiography and CMR in 25 subjects with a variety of LV pathologies. Repeated-measures analysis of variance and the Bland-Altman method were used to compare measures of LV mass. To further assess the potential clinical impact of reducing the number of component image planes used for 3DE, the number of discrepancies between CMR and each of the 3DE estimates of LV mass at prespecified levels (i.e., > or =5%, > or =10%, and > or =20% difference from CMR LV mass) was tabulated. The mean LV mass by magnetic resonance imaging was 177 +/- 56 g (range 91 to 316). Biplane 2-dimensional echocardiography significantly underestimated CMR LV mass (p <0.05), but LV mass by 3DE was not statistically different from that by CMR regardless of the number of planes used. However, error variability and Bland-Altman 95% confidence intervals decreased with the use of additional image planes. In conclusion, transthoracic 3DE measures LV mass more accurately than biplane 2-dimensional echocardiography when > or =6 component 2D image planes are used. The use of >6 planes further increases the accuracy of 3DE, but at the cost of greater analysis time and potentially increased scanning times. PMID:17478166

Chuang, Michael L; Salton, Carol J; Hibberd, Mark G; Manning, Warren J; Douglas, Pamela S

2007-05-01

329

Left ventricular strain examination of different aged adults with 3D speckle tracking echocardiography.  

PubMed

The purpose of this study was to identify traits of the left ventricular (LV) global longitudinal strain (GLS), global radial strain (GRS), global circular strain (GCS), and global area tracking (GAT) with three-dimensional speckle tracking echocardiography (3DSTE), and to determine the relationship between strain and age in healthy adults of different ages. A total of 153 volunteers were divided into young adult, middle-aged, and elderly groups, and examined with echocardiography to obtain general data and live two-dimensional (2D) images of the apical four-chamber view, which were assembled to obtain the full volume view of the LV. The images were then analyzed with 3DSTE software. Compared with the young adult and middle-aged groups, elderly adults demonstrated lower GLS, GRS, GCS, and GAT. Significant differences were not noted in GLS, GRS, and GCS between the young adult and middle-aged groups; however, the GAT of the middle-aged group was lower than that of the young adult group. The longitudinal strain (LS), radial strain (RS), and area tracking (AT) of 16 LV segments of the young adult group decreased gradually in level from the mitral valve to the apex, and increased in circular strain (CS). The LS, RS, CS, and AT of the middle-aged group also decreased gradually. The LS, RS, CS, and AT of the elderly people were highest from the mitral valve to the apex level and lowest at the papillary muscle. The results of this study demonstrated that LV GLS, GRS, GCS, and GAT decrease with age. PMID:24028413

Xia, Ji-zhu; Xia, Ji-yi; Li, Gang; Ma, Wen-yan; Wang, Qing-qing

2014-03-01

330

Utility of hand-held echocardiography in outpatient pediatric cardiology management.  

PubMed

Adult patient series have shown hand-held echocardiography (echo) units (HHE) to be accurate for rapid diagnosis and triage. This is the first study to evaluate the ability of HHE to inform decision making in outpatient pediatric cardiology. New pediatric cardiology patients in outpatient clinics staffed by six pediatric cardiologists (experience 1-17 years) were prospectively enrolled if an echocardiogram (echo) was ordered during their initial visit. After history and physical examination and before a standard echo, the cardiologists performed a bedside HHE examination (GE Vscan 1.7-3.8 MHz), documented findings, and made a clinical decision. Diagnoses and decisions based on HHE were compared with final management after the standard echo. The study enrolled 101 subjects (ages 9 days to 19 years). The cardiologists considered HHE imaging adequate for decision making for 80 of the 101 subjects. For 77 of the 80 subjects with acceptable HHE imaging (68/68 normal and 9/12 abnormal standard echoes), the HHE-based primary diagnoses and decisions agreed with the final management. The sensitivity of HHE was 75 % (95 % confidence interval [CI] 43-94 %) and the positive predictive value 100 % (95 % CI 66-100 %) for pediatric heart disease. The agreement between standard echocardiography and HHE imaging was substantial (? = 0.82). Excluding one of the least experienced cardiologists, HHE provided the basis for correct cardiac diagnoses and management for all the subjects with acceptable HHE imaging (58/58 normal and 9/9 abnormal echoes). In outpatient pediatric cardiology, HHE has potential as a tool to complement physical examination. Further investigation is needed to evaluate how value improves with clinical experience. PMID:24913414

Riley, Alan; Sable, Craig; Prasad, Aparna; Spurney, Christopher; Harahsheh, Ashraf; Clauss, Sarah; Colyer, Jessica; Gierdalski, Marcin; Johnson, Ashley; Pearson, Gail D; Rosenthal, Joanna

2014-12-01

331

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

332

The Value of Assessing Myocardial Deformation at Recovery after Dobutamine Stress Echocardiography  

PubMed Central

Background The purpose of this study was to evaluate whether performing an assessment of myocardial deformation using speckle tracking imaging during the recovery period after dobutamine stress echocardiography (DSE) allows detection of significant coronary artery disease (CAD) in patients with chest discomfort. Methods DSE and coronary angiography were performed in 44 patients with chest discomfort. The mean global longitudinal peak systolic strain (GLS) was measured at rest, at low stress (dobutamine infusion rate of 10 µg/kg/min) and at recovery (5 min after cessation of dobutamine infusion) of DSE using automated function imaging with apical views. Fractional flow reserve (FFR) was also performed in patients with intermediate coronary stenosis. CAD was defined as having a ? 70% diameter stenosis on coronary angiography or as having a FFR < 0.8. Patients were divided two groups based on the absence or presence of CAD [CAD (-) group vs. CAD (+) group]. Results There were no significant differences in the clinical characteristics and results of conventional echocardiography between the two groups. GLS at recovery was lower in the CAD (+) group than in the CAD (-) group (-18.0 ± 3.4% vs. -21.0 ± 1.9%, p = 0.003). The optimal cutoff of GLS at recovery for detection of CAD was -19% (sensitivity of 70.6%, specificity of 83.3%). Conclusion Assessment of GLS at recovery of DSE is a reliable and objective method for detection of CAD. This finding may suggest that systolic myocardial stunning remains even after recovery of wall motion abnormalities in patients with CAD. PMID:25309689

Hwang, Hui-Jeong; Lee, Hyae-Min; Yang, In-Ho; Lee, Jung Lok; Pak, Hyun Young; Park, Chang-Bum; Jin, Eun-Sun; Cho, Jin-Man; Kim, Chong-Jin

2014-01-01

333

2013 Goat Shows Show Date Show Name Entries Due Eligibility Weigh In Show Time Contact Phone Extra Info  

E-print Network

:00 p.m. Mark 931-319-2205 $2 at gate Fair Must Ledford 931-823-4295 Limit 5 Control animals/ Goat Fee Must 5:30 p.m. Tracey 615-464-5229 Show Control Lawrence Goat 8/2/2013 Smith Co. 7/25/2013 Youth 3 of Show TN Exhibit. 11:00 a.m. to 4:00 p.m. John 931-684-5971 Limit 5 Region Entry Fee 4-12 grade 1:00 p

Grissino-Mayer, Henri D.

334

Application of 3-d echocardiography and gated micro-computed tomography to assess cardiomyopathy in a mouse model of duchenne muscular dystrophy.  

PubMed

The purpose of this study was to measure changes in cardiac function as cardiomyopathy progresses in a mouse model of Duchenne muscular dystrophy using 3-D ECG-gated echocardiography. This study is the first to correlate cardiac volumes acquired using 3-D echocardiography with those acquired using retrospectively gated micro-computed tomography (CT). Both were further compared with standard M-mode echocardiography and histologic analyses. We found that although each modality measures a decrease in cardiac function as disease progresses in mdx/utrn(-/-) mice (n = 5) compared with healthy C57BL/6 mice (n = 8), 3-D echocardiography has higher agreement with gold-standard measurements acquired by gated micro-CT, with little standard deviation between measurements. M-Mode echocardiography measurements, in comparison, exhibit considerably greater variability and user bias. Given the radiation dose associated with micro-CT and the geometric assumptions made in M-mode echocardiography to calculate ventricular volume, we suggest that use of 3-D echocardiography has important advantages that may allow for the measurement of early disease changes that occur before overt cardiomyopathy. PMID:25308942

Bondoc, Andrew B; Detombe, Sarah; Dunmore-Buyze, Joy; Gutpell, Kelly M; Liu, Linshan; Kaszuba, Amanda; Han, Seongryoung; McGirr, Rebecca; Hadway, Jennifer; Drangova, Maria; Hoffman, Lisa M

2014-12-01

335

The OOPSLA trivia show (TOOTS)  

Microsoft Academic Search

OOPSLA has a longstanding tradition of being a forum for discussing the cutting edge of technology in a fun and participatory environment. The type of events sponsored by OOPSLA sometimes border on the unconventional. This event represents an atypical panel that conforms to the concept of a game show that is focused on questions and answers related to OOPSLA themes.

Jeff Gray; Douglas C. Schmidt

2009-01-01

336

Magic Carpet Shows Its Colors  

NASA Technical Reports Server (NTRS)

The upper left image in this display is from the panoramic camera on the Mars Exploration Rover Spirit, showing the 'Magic Carpet' region near the rover at Gusev Crater, Mars, on Sol 7, the seventh martian day of its journey (Jan. 10, 2004). The lower image, also from the panoramic camera, is a monochrome (single filter) image of a rock in the 'Magic Carpet' area. Note that colored portions of the rock correlate with extracted spectra shown in the plot to the side. Four different types of materials are shown: the rock itself, the soil in front of the rock, some brighter soil on top of the rock, and some dust that has collected in small recesses on the rock face ('spots'). Each color on the spectra matches a line on the graph, showing how the panoramic camera's different colored filters are used to broadly assess the varying mineral compositions of martian rocks and soils.

2004-01-01

337

Detection of severe left anterior descending coronary artery stenosis by transthoracic evaluation of resting coronary flow velocity dynamics  

E-print Network

In the presence of severe stenosis, coronary artery flow may be reduced at rest. Recent advances in echocardiography have made noninvasive sampling of velocities in the left an-terior descending coronary artery (LAD) possible. The aim of our study was to evaluate feasi-bility and capability of transthoracic Doppler to detect severe stenosis of the LAD. The study population consisted of 42 subjects with suspected coronary artery disease scheduled for coronary angiography. All had complete

Dawod Sharif; Amal Sharif-rasslan; Camilia Shahla; Edward G Abinader

338

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.

339

Measurement of aortic valve calcification using multislice computed tomography: correlation with haemodynamic severity of aortic stenosis and clinical implication for patients with low ejection fraction  

Microsoft Academic Search

BackgroundMeasurement of the degree of aortic valve calcification (AVC) using electron beam computed tomography (EBCT) is an accurate and complementary method to transthoracic echocardiography (TTE) for assessment of the severity of aortic stenosis (AS). Whether threshold values of AVC obtained with EBCT could be extrapolated to multislice computed tomography (MSCT) was unclear and AVC diagnostic value in patients with low

Caroline Cueff; Jean-Michel Serfaty; Claire Cimadevilla; Jean-Pierre Laissy; Dominique Himbert; Florence Tubach; Xavier Duval; Bernard Iung; Maurice Enriquez-Sarano; Alec Vahanian; David Messika-Zeitoun

2010-01-01

340

Tricuspid Valve Dysplasia with Severe Tricuspid Regurgitation: Fetal Pulmonary Artery Size Predicts Lung Viability in the Presence of Small Lung Volumes  

Microsoft Academic Search

Congenital tricuspid valve disease (Ebstein’s anomaly, tricuspid valve dysplasia) with severe tricuspid regurgitation and cardiomegaly is associated with poor prognosis. Fetal echocardiography can accurately measure right atrial enlargement, which is associated with a poor prognosis in the fetus with tricuspid valve disease. Fetal lung volumetric assessments have been used in an attempt to predict viability of fetuses using ultrasonogram and

A. T. Nathan; B. S. Marino; T. Dominguez; S. Tabbutt; S. Nicolson; D. D. Donaghue; T. L. Spray; J. Rychik

2010-01-01

341

"Medicine show." Alice in Doctorland.  

PubMed

This is an excerpt from the script of a 1939 play provided to the Institute of Social Medicine and Community Health by the Library of Congress Federal Theater Project Collection at George Mason University Library, Fairfax, Virginia, pages 2-1-8 thru 2-1-14. The Federal Theatre Project (FTP) was part of the New Deal program for the arts 1935-1939. Funded by the Works Progress Administration (WPA) its goal was to employ theater professionals from the relief rolls. A number of FTP plays deal with aspects of medicine and public health. Pageants, puppet shows and documentary plays celebrated progress in medical science while examining social controversies in medical services and the public health movement. "Medicine Show" sharply contrasts technological wonders with social backwardness. The play was rehearsed by the FTP but never opened because funding ended. A revised version ran on Broadway in 1940. The preceding comments are adapted from an excellent, well-illustrated review of five of these plays by Barabara Melosh: "The New Deal's Federal Theatre Project," Medical Heritage, Vol. 2, No. 1 (Jan/Feb 1986), pp. 36-47. PMID:10301683

1987-01-01

342

Virtual reality 3D echocardiography in the assessment of tricuspid valve function after surgical closure of ventricular septal defect  

PubMed Central

Background This study was done to investigate the potential additional role of virtual reality, using three-dimensional (3D) echocardiographic holograms, in the postoperative assessment of tricuspid valve function after surgical closure of ventricular septal defect (VSD). Methods 12 data sets from intraoperative epicardial echocardiographic studies in 5 operations (patient age at operation 3 weeks to 4 years and bodyweight at operation 3.8 to 17.2 kg) after surgical closure of VSD were included in the study. The data sets were analysed as two-dimensional (2D) images on the screen of the ultrasound system as well as holograms in an I-space virtual reality (VR) system. The 2D images were assessed for tricuspid valve function. In the I-Space, a 6 degrees-of-freedom controller was used to create the necessary projectory positions and cutting planes in the hologram. The holograms were used for additional assessment of tricuspid valve leaflet mobility. Results All data sets could be used for 2D as well as holographic analysis. In all data sets the area of interest could be identified. The 2D analysis showed no tricuspid valve stenosis or regurgitation. Leaflet mobility was considered normal. In the virtual reality of the I-Space, all data sets allowed to assess the tricuspid leaflet level in a single holographic representation. In 3 holograms the septal leaflet showed restricted mobility that was not appreciated in the 2D echocardiogram. In 4 data sets the posterior leaflet and the tricuspid papillary apparatus were not completely included. Conclusion This report shows that dynamic holographic imaging of intraoperative postoperative echocardiographic data regarding tricuspid valve function after VSD closure is feasible. Holographic analysis allows for additional tricuspid valve leaflet mobility analysis. The large size of the probe, in relation to small size of the patient, may preclude a complete data set. At the moment the requirement of an I-Space VR system limits the applicability in virtual reality 3D echocardiography in clinical practice. PMID:17306019

Bol Raap, Goris; Koning, Anton HJ; Scohy, Thierry V; ten Harkel, A Derk-Jan; Meijboom, Folkert J; Kappetein, A Pieter; van der Spek, Peter J; Bogers, Ad JJC

2007-01-01

343

Acute effect of oral flavonoid-rich dark chocolate intake on coronary circulation, as compared with non-flavonoid white chocolate, by transthoracic Doppler echocardiography in healthy adults  

Microsoft Academic Search

PurposeTo assess the effects of the oral intake of flavonoid-rich dark chocolate on coronary circulation, we measured coronary flow velocity reserve (CFVR) by noninvasive transthoracic Doppler echocardiography (TTDE) in healthy adult subjects.

Yumi Shiina; Nobusada Funabashi; Kwangho Lee; Taichi Murayama; Koki Nakamura; Yu Wakatsuki; Masao Daimon; Issei Komuro

2009-01-01

344

A noninvasive sizing method to choose fitted Amplatzer septal occluder by transthoracic echocardiography in patients with secundum atrial septal defects.  

PubMed

To simplify the conventional procedure, we developed a technique for transcatheter closure of atrial septal defects (ASDs) under transthoracic echocardiographic (TTE) sizing without balloon sizing. At present, device closure of interatrial communication has become a well-established technique to adequately treat severe left-to-right shunt associated with ASDs. During the traditional procedure, fluoroscopy with the waist of a compliant balloon is used to determine the appropriate size of the closure device and defect sizing. Choice of adequate closure device using transthoracic echocardiography (TTE) has been hitherto unreported. Between December 2002 and August 2004, 40 patients (15 males, 25 females, mean age 11.7 +/- 7.8 years) with secundum ASDs underwent transcatheter closure at our institution. In group 1, 30 patients had the procedure by balloon sizing and TTE sizing. In 10 patients (group 2), TTE sizing was used as the sole tool for selecting device size and the device size was chosen to be based on the Amplatzer septal occluder (ASO) size and TTE size ratio in group 1. The procedure was performed under continuous transesophageal echocardiographic monitoring with general anesthesia. A correlation was found between TTE and stretched balloon sizing diameter SBD (y = 1.2645x - 1.4465; R2 = 0.9861), and between TTE size and ASO size (y = 1.3412x - 1.2864; R2 = 0.9929) in group 1. In group 2, a statistical correlation between TTE and ASO (y = 1.3419x - 0.1172; R2 = 0.9934) was also found. Good linear regression between TTE size and ASO chosen size was noted in group 1 and group 2 (R2 = 0.99). In group 2, successful device implantation was accomplished in all patients whose device size was chosen to be based on the ASO and TTE ratio in group 1. Transthoracic echocardiographic sizing is a safe and ideal method to measure interatrial defect and choose the occluding device, respectively. With our experience, the sizing based on TTE is generally easier than measurement from the balloon sizing. PMID:17653518

Chien, Kuang-Jen; Lee, Cheng-Liang; Huang, Ta-Cheng; Lin, Chu-Chuan; Weng, Ken-Pen; Huang, Shih-Hui; Hsieh, Kai-Sheng

2007-07-01

345

Right atrial to left atrial area ratio on early echocardiography predicts long-term survival after acute pulmonary embolism  

PubMed Central

Background Current guidelines recommend that transthoracic echocardiography (TTE) should be performed for acute risk stratification following acute pulmonary embolism (PE), but it is unclear whether the initial TTE can predict long-term outcome beyond six months. We sought to assess the potential of the initial right atrial (RA) to left atrial (LA) area ratio (RA/LA ratio) on TTE to predict long-term mortality in survivors of submassive PE. Methods A derivation cohort comprised a previously reported group of 35 consecutive patients with acute PE who were intensively studied by serial TTE at 1, 2, 5 days, 2, 6, 12 and 26 weeks and RA/LA ratio related to long-term outcome. The Day 1 RA/LA ratio findings were then further related to long-term outcome in 158 patients followed for 3.6?±?2.3 years. Results In the derivation cohort, total mortality was 28.6% (n?=?10) following a mean (±standard deviation) follow-up of 4.3?±?1.9 years. The RA/LA ratio was highly dynamic, being increased at day 1, but normalised rapidly within 2–5 days of presentation and this was most marked amongst long-term non-survivors. A RA/LA ratio?>?1.0 on day 1 was independently associated with a three-fold increase in long-term mortality on Kaplan-Meier analysis. Pooled analysis of 158 patient indicated that age, Charlson Comorbidity Index (CCI), simplified Pulmonary Embolism Severity Score (PESI), troponin T, day 1 RA/LA Ratio and pulmonary arterial systolic pressure (PASP) were univariate predictors of long-term mortality. Multivariate analysis identified Day 1 RA/LA Ratio (HR 1.7 per 10% increase,p?=?0.002), CCI (HR 2.2 per 1 unit increase, p?=?0.004) and age (HR 1.1, p?=?0.03) as the only independent predictors of long-term mortality. Conclusion A RA/LA Ratio >1.0 at presentation with acute PE was associated with a three-fold increased risk of long-term mortality. The RA/LA ratio on presentation with an acute PE is a simple, novel predictor of long-term survival. PMID:23725312

2013-01-01

346

Magnetic resonance imaging compared with echocardiography in the evaluation of pulmonary artery abnormalities in children with tetralogy of Fallot following palliative and corrective surgery  

Microsoft Academic Search

Background. Abnormalities of the pulmonary arteries following palliative or corrective surgery for tetralogy of Fallot (TOF) are common.\\u000a Our purpose was to compare the usefulness of magnetic resonance imaging (MRI) and echocardiography in the post- operative\\u000a evaluation of the pulmonary arteries in children with TOF. Objective. Our hypothesis was that MRI is more sensitive than echocardiography in the detection of

S. Bruce Greenberg; Kristin L. Crisci; Peter Koenig; Brad Robinson; Paul Anisman; P. Russo

1997-01-01

347

Acute coronary occlusion in non-ST-elevation acute coronary syndrome: outcome and early identification by strain echocardiography  

Microsoft Academic Search

ObjectivesTo compare infarct size and left ventricular ejection fraction in patients with non-ST-elevation myocardial infarction (NSTEMI) with and without acute coronary occlusions, and determine if myocardial strain by speckle-tracking echocardiography can identify acute occlusions in patients presenting with non-ST-elevation acute coronary syndrome (NSTE-ACS).Methods111 patients with suspected NSTE-ACS were enrolled shortly after admittance. Echocardiographic measurements were performed a median of 1

Bjørnar Grenne; Christian Eek; Benthe Sjøli; Thomas Dahlslett; Michael Uchto; Per K Hol; Helge Skulstad; Otto A Smiseth; Thor Edvardsen; Harald Brunvand

2010-01-01

348

Performance of two-dimensional Doppler echocardiography for the assessment of infarct size and left ventricular function in rats.  

PubMed

Although echocardiography has been used in rats, few studies have determined its efficacy for estimating myocardial infarct size. Our objective was to estimate the myocardial infarct size, and to evaluate anatomic and functional variables of the left ventricle. Myocardial infarction was produced in 43 female Wistar rats by ligature of the left coronary artery. Echocardiography was performed 5 weeks later to measure left ventricular diameter and transverse area (mean of 3 transverse planes), infarct size (percentage of the arc with infarct on 3 transverse planes), systolic function by the change in fractional area, and diastolic function by mitral inflow parameters. The histologic measurement of myocardial infarction size was similar to the echocardiographic method. Myocardial infarct size ranged from 4.8 to 66.6% when determined by histology and from 5 to 69.8% when determined by echocardiography, with good correlation (r = 0.88; P < 0.05; Pearson correlation coefficient). Left ventricular diameter and mean diastolic transverse area correlated with myocardial infarct size by histology (r = 0.57 and r = 0.78; P < 0.0005). The fractional area change ranged from 28.5 +/- 5.6 (large-size myocardial infarction) to 53.1 +/- 1.5% (control) and correlated with myocardial infarct size by echocardiography (r = -0.87; P < 0.00001) and histology (r = -0.78; P < 00001). The E/A wave ratio of mitral inflow velocity for animals with large-size myocardial infarction (5.6 +/- 2.7) was significantly higher than for all others (control: 1.9 +/- 0.1; small-size myocardial infarction: 1.9 +/- 0.4; moderate-size myocardial infarction: 2.8 +/- 2.3). There was good agreement between echocardiographic and histologic estimates of myocardial infarct size in rats. PMID:16648907

Nozawa, E; Kanashiro, R M; Murad, N; Carvalho, A C C; Cravo, S L D; Campos, O; Tucci, P J F; Moises, V A

2006-05-01

349

Correlation of echocardiographic epicardial fat thickness with severity of coronary artery disease in patients with acute myocardial infarction.  

PubMed

The aim of this study was to test the hypotheses that epicardial adipose tissue (EAT) can be a marker of severe coronary artery disease in patients with acute myocardial infarction. Overall, 373 cases who underwent coronary angiography were classified into 2 groups by SYNTAX score: low-score and high-score group. EAT was measured by transthoracic echocardiography. Obtained data were compared using Pearson correlation analyses and univariate and multiple logistic regression analysis. The results showed that EAT in the high-score group was significantly greater than in the normal group (5.6 ± 1.1 vs. 4.1 ± 1.0 mm, P < 0.01). EAT had a positive correlation with SYNTAX score (r = 0.61, P < 0.01). Receiver operating characteristic (ROC) curve analyses showed that EAT could reliably discriminate patients with high SYNTAX score (?33) [AUC: 0.86, 95% confidence interval (CI): 0.822-0.898, P < 0.01]. Multivariate regression analyses showed that EAT was an independent predictor for major in-hospital events. These data showed an association between EAT and SYNTAX score. PMID:24645963

Wang, Tao; Liu, Qiang; Liu, Cuixia; Sun, Ling; Li, Daixu; Liu, Aihua; Jia, Ruyi

2014-11-01

350

[Evaluation of the size of the left-right shunt using pulse Doppler echocardiography in children--personal experience].  

PubMed

The purpose of the present study was to verify the value of a two-dimensional pulsed Doppler echocardiographic method for measurement of pulmonary (QP) and systemic blood flow (QS) in comparison with the radiocardiography in patients with ventricular and atrial septal defects. We reviewed 42 children with ventricular septal defect and 23 children with atrial septal defect. Two-dimensional echocardiography was employed to measure the diameter of the aorta and pulmonary artery and pulsed Doppler for measurement of pulmonary and systemic blood flow velocity in the pulmonary artery and left ventricular outflow tract. By comparing pulmonary and systemic blood flow ratios by pulsed Doppler echocardiography and radiocardiography, the correlation coefficient for children with atrial septal defect and those with ventricular septal defect respectively amounted to r = 0.71 and r = 0.81. The authors conclude that two-dimensional pulsed Doppler echocardiography, although a semiquantitative technique, appears to be a reliable non-invasive method for measuring pulmonary and systemic blood flow in patients with left-to-right sgunt. PMID:8170279

Kokos, Z; Fabeci?-Sabadi, V; Lukanovi?, T; Marki?evi?-Ruzici?, K

1993-01-01

351

Relationship between peripheral and coronary function using laser Doppler imaging and transthoracic echocardiography.  

PubMed

Vascular dysfunction in the coronary and peripheral circulations is an early prognostic marker of future cardiovascular events. Measurements of coronary and peripheral vascular function in resistance vessels can be made, but rely on invasive procedures, which make them unsuitable for routine application. An assessment of the direct correlation between vascular responses in skin and coronary vessels has not been made previously. In 27 normal healthy subjects (18-55 years of age), we examined the relationship between peripheral and coronary vascular function. Cutaneous perfusion was measured using the non-invasive technique of laser Doppler imaging during iontophoresis of acetylcholine and sodium nitroprusside, and cutaneous vascular conductance was calculated (laser Doppler perfusion/mean arterial pressure). Coronary flow reserve was measured using transthoracic echocardiography during intravenous adenosine infusion. Mean diastolic velocities were measured at baseline and peak hyperaemic conditions from the Doppler signal recordings. CVR (coronary velocity reserve) was defined as the ratio of hyperaemic to basal mean diastolic velocities. There were significant positive correlations between CVR and cutaneous vascular conductance for acetylcholine (r=0.399, P=0.039) and sodium nitroprusside (r=0.446, P=0.020). These results support the idea that peripheral measurements of skin blood flow are representative of generalized microvascular function including that of the coronary circulation in normal healthy subjects. PMID:18338981

Khan, Faisel; Patterson, Dean; Belch, Jill J F; Hirata, Kumiko; Lang, Chim C

2008-11-01

352

Assessment of left ventricular aneurysm resectability by two-dimensional echocardiography.  

PubMed

Mortality of surgical resection of a left ventricular (LV) aneurysm is largely determined by size and function of nonaneurysmal or residual myocardium. A residual myocardial index was determined using 2-dimensional echocardiography (2-D echo) in 56 consecutive patients scheduled for LV aneurysmectomy, and these results were correlated with surgical outcome. The index was calculated using 3 apical cross sections: the 2- and 4-chamber views and the long-axis view. These views were recorded at mutual angles of 60 degrees. In each view the end-diastolic length of normally moving endocardium of the 2 opposite walls was expressed as a fraction of the end-diastolic LV long axis. The index was assessed by averaging the 6 ratios obtained. In 41 survivors the index ranged from 40 to 71% (mean +/- standard deviation 53 +/- 7.8) and in 15 nonsurvivors from 29 to 67% (mean 38 +/- 8.5, p less than 0.01). With 1 exception, this echocardiographic index sharply separated survivors from nonsurvivors. The lower limit to survive aneurysmectomy was 40%. PMID:4061326

Visser, C A; Kan, G; Meltzer, R S; Moulijn, A C; David, G K; Dunning, A J

1985-11-15

353

The use of laryngeal mask airway during transesophageal echocardiography in pediatric patients  

PubMed Central

Background: Transesophageal echocardiography (TEE) in the cardiac lab is usually performed in pediatric patients under general anesthesia with an endotracheal intubation (ET). This study was performed to investigate the safety and efficacy of using the laryngeal mask airway (LMA) as an alternative to ET to maintain pediatric airway during the general anesthesia for TEE. Materials and Methods: A total of 50 pediatric patients undergoing TEE in the cardiac lab were randomized to have their airway maintained during the procedure with either LMA (LMA group) or ET (ET group). Hemodynamic, respiratory parameters, time to extubation, recovery time, the incidence of complication and operator satisfaction were compared between the two groups. Results: There were no differences between both groups in hemodynamic and respiratory parameters. Laryngeal spasm was reported in one patient in the LMA group and two patients in the ET group. TEE operators were equally satisfied with the procedure in groups. The time to extubation was shorter in the LMA group (P < 0.01). The mean recovery time was also significantly shorter in the LMA than in the ET group (44 ± 8 min and 59 ± 11 min, respectively; P < 0.001). Conclusion: The LMA is safe and effective in securing the airway of children undergoing diagnostic TEE.

Shafi Ahmed, Mohammed A.; Al-Ghamdi, Abdulmohsin A.; Mowafi, Hany A.; Al-Metwalli, Roshdy R.; Mousa, Wesam F.; Lardhi, Amer A.

2014-01-01

354

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

355

Left Ventricular Ejection Time on Echocardiography Predicts Long-Term Mortality in Light Chain Amyloidosis  

PubMed Central

Light chain amyloidosis (AL) is associated with high mortality. The aim was to identify echocardiographic parameters that predict AL long-term mortality. Methods/Results 42 biopsy-proven AL subjects (43% females; 61±12 years) had echocardiography and followed 29±16 (median 29.4) months. Standard echocardiographic and clinical parameters and heart failure (HF) class were tested using univariate/multivariable Cox proportional hazard regression analyses to identify markers of mortality. 23 subjects died with 1-year mortality of 44%. Univariate predictors of mortality were HF class (p<0.001), left ventricular systolic ejection time (ET, p=0.002), alkaline phosphatase (p<0.001), aspartate and alanine aminotransferase (p=0.003 each). On multivariable analysis, only HF Class (hazards ratio, 95% confidence interval, p-value: 4.86, 1.58-14.9, p=0.006), ET (10 ms increase, 0.87, 0.78-0.97, p=0.01) and alkaline phosphatase (10 U/L increase, 1.04, 1.01-1.06, p=0.01) were prognostic. ET?240 ms had sensitivity/specificity of 61/90% in predicting 1-year mortality and 73/90% in predicting 1-year cardiac mortality. Conclusions AL amyloidosis was associated with high long-term mortality. Among echocardiographic and clinical parameters, only ET and alkaline phosphatase had incremental value to HF class in predicting mortality. This may be useful to identify high-risk patients. PMID:19880277

Migrino, Raymond Q.; Mareedu, Ravi; Eastwood, Daniel; Bowers, Mark; Harmann, Leanne; Hari, Parameswaran

2009-01-01

356

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

357

Fall Schedule This fall we have several great shows for you and your  

E-print Network

Lights before Dawn this Fall It's late summer and early autumn for us in the Northern Hemisphere, which, Saturn was 9.65 Astronomical Units away at the time, so it took light from all the waving Earth dwellers is the best time of year to see the zodiacal light, also known as the false dawn. With the moon out

Huang, Haiying

358

Smokers Beware: Study Shows Increased Cadmium Levels in the Brain May Cause Severe Neurological Disorders  

ERIC Educational Resources Information Center

Tobacco is one crop that accumulates cadmium, making smokers susceptible to higher levels of the metal in their bodies. The findings suggest that even a low-level exposure to a heavy metal like cadmium is likely to cause a change in the functions of neurons in the brain and the behavioral response to drugs of abuse.

King, Angela G.

2005-01-01

359

Memantine shows promise in reducing gambling severity and cognitive inflexibility in pathological gambling: a pilot study  

Microsoft Academic Search

Rationale  Although pathological gambling (PG) is relatively common, pharmacotherapy research for PG is limited. Memantine, an N-methyl\\u000a d-aspartate receptor antagonist, appears to reduce glutamate excitability and improve impulsive decision making, suggesting\\u000a it may help individuals with PG.\\u000a \\u000a \\u000a \\u000a \\u000a Objective  This study sought to examine the safety and efficacy of Memantine in PG.\\u000a \\u000a \\u000a \\u000a Methods  Twenty-nine subjects (18 females) with DSM-IV PG were enrolled in a

Jon E. Grant; Samuel R. Chamberlain; Brian L. Odlaug; Marc N. Potenza; Suck Won Kim

2010-01-01

360

Giant Dilatation of the Right Coronary Aortic Bulb with Compression of the Right Ventricular Outflow Tract Mimicking a Ventricular Septal Defect: Diagnostic workup Using Echocardiography, Heart Catheterization, and Cardiac Computed Tomography  

PubMed Central

Annuloaortic ectasia is a relatively rare diagnosis. Herein, we report an unusual case of an annuloaortic ectasia with asymmetric dilatation of the right coronary bulb mimicking a membranous ventricular septal defect (VSD) with Eisenmenger reaction by transthoracic echocardiography. Aortic angiography showed a dilated aortic root and moderate aortic regurgitation. Right cardiac catheterization, on the other hand, exhibited normal pulmonary artery blood pressure and normal pulmonary resistance, whereas normal venous gas values were measured throughout the caval vein and the right atrium, excluding relevant left-right shunting. Further diagnostic workup by cardiac computed tomography angiography (CCTA) unambiguously illustrated the asymmetric geometry of the ectatic aortic cusp and root causing compression of the right heart and of the right ventricular (RV) outflow tract. After review of echocardiographic acquisitions, the blood flow detected between the left and right ventricles (mimicking VSD) was interpreted as turbulent inflow from the left ventricle into the ectatic right coronary cusp. Furthermore, elevated pulmonary artery blood pressure measured by echocardiography was attributed to “functional pulmonary stenosis” due to compression of the RV outflow tract by the aorta, as demonstrated by CCTA. PMID:22952479

Hofmann, Nina P.; Abdel-Aty, Hassan; Siebert, Stefan; Katus, Hugo A.; Korosoglou, Grigorios

2012-01-01

361

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

362

Severity of acute pulmonary embolism: evaluation of a new spiral CT angiographic score in correlation with echocardiographic data  

Microsoft Academic Search

.   The purpose of this study was to investigate whether the severity of acute pulmonary embolism (PE) could be quantitatively\\u000a assessed with spiral CT angiography (SCTA). Thirty-six consecutive patients without underlying cardiopulmonary disease and\\u000a high clinical suspicion of PE underwent prospectively thin-collimation SCTA and echocardiography at the time of the initial\\u000a diagnosis (T0) and after initial therapy (T1; mean interval

Ioana Mastora; Martine Remy-Jardin; Pascal Masson; Eric Galland; Valérie Delannoy; Jean-Jacques Bauchart; Jacques Remy

2003-01-01

363

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

364

Diagnostic Value of Electrocardiography Compared with Echocardiography in Measuring Left Ventricular Mass Index in Major Thalassemia Patients Over 10 Years of Age  

PubMed Central

Background: Patients suffering from major beta thalassemia need frequent blood transfusions and, if not treated well, would be at risk of heart dysfunction. This study was performed to determine the diagnostic value of electrocardiography versus echocardiography in measuring the left ventricular mass index in these patients. Methods Between July 2010 and June 2011, 82 asymptomatic patients over 10 years of age with major thalassemia (42 men with a mean age of 17.65 ± 3.39 years and 40 women with a mean age of 16.9 ± 3.38 years) were enrolled in this study. For all the patients, standard electrocardiography (to measure R in aVL and S in V3 and calculate left ventricular mass index by electrocardiography) and echocardiography (to measure interventricular septum diameter in diastole, left ventricular posterior wall diameter in diastole, and left ventricular diameter in diastole in order to calculate left ventricular mass index by echocardiography) were performed, at least one week after transfusion. The calculated left ventricular mass indices were thereafter compared between the two methods (electrocardiography and echocardiography). Results: Sensitivity, specificity, positive predictive value, and negative predictive value in the two techniques in determining the left ventricular mass index were 67%, 25%, 89%, and 7% in the females, 65%, 33%, 92%, and 6% in the males, and 67%, 14%, 89%, and 3% in the total population, respectively. Furthermore, this study demonstrated that the average left ventricular mass index by echocardiography and electrocardiography was 104.86 ± 21.65 gr/m2 and 91.69 ± 12.03 gr/m2, respectively. Echocardiography was much more accurate than electrocardiography in determining the left ventricular mass index (p value = 0.0001). Conclusion: The findings of this study demonstrated that echocardiography was more accurate and more reliable than electrocardiography in determining the left ventricular mass index in major thalassemia patients. PMID:24396360

Noori, Noormohammad; Mahjoubifard, Maziar; Alavi, Seyed Mostafa; Hosseini, Saeid; Sanati, Hamidreza; Mirmesdagh, Yalda

2013-01-01

365

Coronary Autoregulation is Abnormal in Syndrome X: Insights Using Myocardial Contrast Echocardiography  

PubMed Central

Background Syndrome X in women is thought to be caused by coronary microvascular dysfunction, the exact site of which is unknown. The aim of this study was to characterize the microvascular site of dysfunction in these patients using myocardial contrast echocardiography (MCE). Methods Women with exertional angina, a positive test on stress imaging, but no coronary artery disease (study group, n=18), and age-matched control women also with no coronary artery disease (n=17) were enrolled. MCE was performed at rest and during dipyridamole-induced hyperemia. Mean microbubble velocity (?) and myocardial blood volume (A) were measured, and myocardial blood flow (A ?) was computed. In addition, plasma concentrations of eicosanoids, female sex hormones, and C-reactive protein were measured. Results Rest ? and myocardial blood flow (A·?) were higher in the study compared to the control women (1.61±0.68 vs. 0.74±0.44, P=0.0001, and 157±121 vs. 54±54, P=0.0001, respectively) despite similar heart rate and systolic blood pressure. After administration of dipyridamole, whereas the changes in A, and A·? were not significantly different between the 2 groups, ? reserve (the ratio of stress/rest ?) was markedly lower in the study group (1.48±0.62 vs. 2.78±0.94, P=0.0001). Blood hematocrit, eicosanoids, female sex hormones, glucose, and C-reactive protein were not different between the 2 groups. Conclusion Coronary autoregulation is abnormal in patients with Syndrome X (higher resting ? and myocardial blood flow and lower ? reserve), which suggests that the coronary resistance vessels are the site of microvascular abnormality. PMID:23313388

Rinkevich, Diana; Belcik, Todd; Gupta, Nandita C.; Cannard, Elizabeth; Alkayed, Nabil J.; Kaul, Sanjiv

2012-01-01

366

Stress Echocardiography and Major Cardiac Events in Patients with Normal Exercise Test  

PubMed Central

Background Exercise test (ET) is the preferred initial noninvasive test for the diagnosis and risk stratification of coronary artery disease (CAD), however, its lower sensitivity may fail to identify patients at greater risk of adverse events. Objective To assess the value of stress echocardiography (SE) for predicting all-cause mortality and major cardiac events (MACE) in patients with intermediate pretest probability of CAD and a normal ET. Methods 397 patients with intermediate CAD pretest probability, estimated by the Morise score, and normal ET who underwent SE were studied. The patients were divided into two groups according to the absence (G1) or presence (G2) of myocardial ischemia on SE .End points evaluated were all-cause mortality and MACE, defined as cardiac death and nonfatal acute myocardial infarction (AMI). Results G1 group was comprised of 329 (82.8%) patients. The mean age of the patients was 57.37 ± 11 years and 44.1% were male. During a mean follow-up of 75.94 ± 17.24 months, 13 patients died, three of them due to cardiac causes, and 13 patients suffered nonfatal AMI. Myocardial ischemia remained an independent predictor of MACE (HR 2.49; [CI] 95% 1.74-3.58). The independent predictors for all-cause mortality were male gender (HR 9.83; [CI] 95% 2.15-44.97) and age over 60 years (HR 4.57; [CI] 95% 1.39-15.23). Conclusion Positive SE for myocardial ischemia is a predictor of MACE in the studied sample, which helps to identify a subgroup of patients at higher risk of events despite having normal ET. PMID:23765384

Calasans, Flavia Ricci; Santos, Bruno Fernandes de Oliveira; Silveira, Debora Consuelo Rocha; de Araujo, Ana Carla Pereira; Melo, Luiza Dantas; Barreto-Filho, Jose Augusto; Sousa, Antonio Carlos Sobral; Oliveira, Joselina Luzia Menezes

2013-01-01

367

Assessment of cardiovascular volume status by transoesophageal echocardiography and dye dilution during cardiac surgery.  

PubMed

Conventional evaluation of cardiovascular volume status by filling pressures is unreliable in critically ill patients. Measurements of left ventricular end diastolic area index by transoesophageal echocardiography and of intrathoracic blood volume index by dye indicator dilution are new approaches to this problem. In this study, different indices of cardiovascular volume status were analysed to define their relation during the pronounced haemodynamic changes associated with systemic inflammation after cardiopulmonary bypass. Correlations were performed with left ventricular end diastolic area index, intrathoracic blood volume index, central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP). Data from 15 patients receiving coronary artery bypass grafts were compared after induction of anaesthesia and in the intensive care unit. Spearman's correlation coefficient for perioperative absolute changes in left ventricular end diastolic area index and intrathoracic blood volume index was 0.87 (P < 0.05). However, an increase in intrathoracic blood volume index by 125 mL m-2 was necessary to maintain a baseline left ventricular end diastolic area index. Absolute values of all variables varied widely, with the only significant correlation found between CVP and PCWP. Changes in CVP and PCWP did not correlate with changes in left ventricular end diastolic area index or intrathoracic blood volume index. Provided simultaneous baseline measurements are available and a supranormal intrathoracic blood volume index compensates for the haemodynamic changes in systemic inflammation, left ventricular end diastolic area index and intrathoracic blood volume index may substitute for each other during the evaluation of cardiovascular volume status in patients with stable cardiac function. PMID:9884847

Hinder, F; Poelaert, J I; Schmidt, C; Hoeft, A; Möllhoff, T; Loick, H M; Van Aken, H

1998-11-01

368

Mapping myocardial fiber orientation using echocardiography-based shear wave imaging.  

PubMed

The assessment of disrupted myocardial fiber arrangement may help to understand and diagnose hypertrophic or ischemic cardiomyopathy. We hereby proposed and developed shear wave imaging (SWI), which is an echocardiography-based, noninvasive, real-time, and easy-to-use technique, to map myofiber orientation. Five in vitro porcine and three in vivo open-chest ovine hearts were studied. Known in physics, shear wave propagates faster along than across the fiber direction. SWI is a technique that can generate shear waves travelling in different directions with respect to each myocardial layer. SWI further analyzed the shear wave velocity across the entire left-ventricular (LV) myocardial thickness, ranging between 10 (diastole) and 25 mm (systole), with a resolution of 0.2 mm in the middle segment of the LV anterior wall region. The fiber angle at each myocardial layer was thus estimated by finding the maximum shear wave speed. In the in vitro porcine myocardium (n=5) , the SWI-estimated fiber angles gradually changed from +80° ± 7° (endocardium) to +30° ± 13° (midwall) and -40° ± 10° (epicardium) with 0° aligning with the circumference of the heart. This transmural fiber orientation was well correlated with histology findings. SWI further succeeded in mapping the transmural fiber orientation in three beating ovine hearts in vivo. At midsystole, the average fiber orientation exhibited 71° ± 13° (endocardium), 27° ± 8° (midwall), and -26° ± 30° (epicardium). We demonstrated the capability of SWI in mapping myocardial fiber orientation in vitro and in vivo. SWI may serve as a new tool for the noninvasive characterization of myocardial fiber structure. PMID:22020673

Lee, Wei-Ning; Pernot, Mathieu; Couade, Mathieu; Messas, Emmanuel; Bruneval, Patrick; Bel, Alain; Hagège, Albert A; Fink, Mathias; Tanter, Mickaël

2012-03-01

369

Prospective echocardiography assessment of pulmonary hypertension and its potential etiologies in children with sickle cell disease.  

PubMed

Pulmonary hypertension (PH) is associated with adverse outcomes in adults with sickle-cell disease (SCD), but its importance in children is less clear. The aim of this study was to define the incidence and causes of PH in pediatric patients with SCD. Children with SCD (n = 310) and matched controls (n = 54) were prospectively enrolled under basal conditions. Participants underwent echocardiography, pulse oximetry, 6-minute walk tests, and hematologic testing. Echocardiographic measures were compared between patients with SCD and control subjects before and after adjusting for hemoglobin. Correlations of echocardiographic and clinical parameters were determined. Tricuspid regurgitation velocity (TRV) was elevated compared to controls (2.28 vs 2.10 m/s, p <0.0001). Increased TRV was associated with left ventricular diastolic diameter, hemoglobin, and estimated left atrial pressure. TRV remained elevated when controlling for left ventricular diameter and left atrial pressure. Echocardiographically derived pulmonary resistance was not significantly different between patients with SCD and controls, although it was elevated in the SCD subgroup with elevated TRV. When controlling for hemoglobin, TRV was no longer statistically different, but pulmonary insufficiency velocity, septal wall thickness, and estimated pulmonary resistance were statistically higher. TRV, pulmonary insufficiency end-diastolic velocity, and markers of increased cardiac output were correlated with indicators of adverse functional status, including history of acute chest syndrome, stroke, transfusions, and 6-minute walk distance. In conclusion, children with SCD had mildly increased TRV that was correlated with increased cardiac output and left ventricular filling pressures. Hemoglobin-adjusted analysis also suggested a contribution of primary vascular changes. PMID:19699350

Dham, Niti; Ensing, Gregory; Minniti, Caterina; Campbell, Andrew; Arteta, Manuel; Rana, Sohail; Darbari, Deepika; Nouraie, Mehdi; Onyekwere, Onyinye; Lasota, Malgorzata; Kato, Gregory J; Gladwin, Mark T; Castro, Oswaldo; Gordeuk, Victor; Sable, Craig

2009-09-01

370

Three-dimensional transesophageal echocardiography for descending aortic atheroma: a preliminary study.  

PubMed

Transesophageal echocardiography (TEE) is an efficient method for characterization of aortic atherosclerotic plaques (AAP). The aim of our study was to evaluate the feasibility and the additional contribution of three-dimensional (3D) TEE in the evaluation of AAPs in descending thoracic aorta. We studied 82 patients referred for TEE regardless of the indication. All patients underwent two-dimensional (2D) conventional acquisitions. A 3D TEE study was performed for all AAPs localized in the descending thoracic aorta. Thickness, degree of calcification, the presence of ulceration or mobile debris were compared for 2D and 3D modes. From 3D data, three types of AAPs were defined according to their morphological characteristics (surface and contours). Among 192 AAPs found on 2D acquisition, 189 (98.4 %) were also identified by 3D TEE. For AAP characterization, agreement was good between 2D TEE and 2D extracted from 3D with the multiplanar reconstruction mode: 83.6 % (k = 0.69) for thickness and 82.5 % (k = 0.72) for degree of calcification. All AAPs ulcerations (n = 13) and mobile debris (n = 3) seen in 2D were identified in 3D. 2D characteristics of the 3D AAPs' morphological types were different: type I plaques were thin and rarely calcified; type III plaques were thicker and often calcified; and type II presented intermediate characteristics. There was overlap among groups and the 3D morphology could not be predicted from 2D data. 3D TEE is a feasible method for the analysis of AAPs. In addition to conventional characterization, 3D TEE provides a new morphological approach to AAPs. PMID:25056253

Hammoudi, Nadjib; Ihaddaden, Malek; Lang, Sylvie; Laveau, Florent; Ederhy, Stephane; Michel, Pierre-Louis; Alamowitch, Sonia; Cohen, Ariel

2014-12-01

371

[Doppler echocardiography in the functional evaluation of patients with pure mitral valve stenosis].  

PubMed

To evaluate the utility of echo-Doppler (ED; PW, CW and color), 67 patients affected by pure mitral stenosis (20 M, 47 F, mean age 52 years) were submitted to ED examination. Right and left cardiac catheterization were performed in 20 patients within 24 hours before ED. Mitral area obtained by Doppler method (Hatle's formula) correlated highly with both echo-2 dimensional and hemodynamic area (r = 0.93, p less than 0.001; r = 0.95, p less than 0.001 respectively). It was possible to calculate systolic pulmonary pressure, in patients with tricuspid incompetence, (43.9 +/- 14.9 mmHg, range 25-80) which correlated significantly (r = 0.95, p less than 0.001) with hemodynamic data (40.2 +/- 12.7 mmHg, range 20-70). The left atrial-left ventricular pressure gradient was 15.6 +/- 6.9 mmHg, range 6-32; the mean pressure gradient was 8.4 +/- 3.7 mmHg, range 3-17; the pressure half time 170.2 +/- 62.3 ms, range 83-330. We observed different types of direction of transmitral jets: centrally directed (n = 34); forward antero-lateral wall (n = 28); toward interventricular septum (n = 5). The transmitral jets presented 4 different appearances: scimitar-shaped (n = 28); candle flame (n = 24); mushroom (n = 9); double-jets (n = 6). No correlation was observed between the different types of transmitral jets (direction and appearance) and the parameters obtained by Doppler (PW and CW): velocities, pressure half-time, gradients. Thus, Doppler echocardiography permits a complete anatomic and functional evaluation of patients with pure mitral stenosis. We have not observed any correlation between the hemodynamic data and the different types of transmitral jets visualized by color Doppler. PMID:2208198

Tartarini, G; Balbarini, A; Baglini, R; Di Marco, S; Mengozzi, G; Passaglia, C; Mariotti, R; Mariani, M

1990-02-01

372

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

373

Comparison of three-dimensional imaging to transesophageal echocardiography for preoperative evaluation in mitral valve prolapse.  

PubMed

Transesophageal echocardiography (TEE) is not optimally suited for recognizing which valve segments are involved in type II mitral valve dysfunction. This study was conducted to compare the diagnostic value of TEE and 3-dimensional image reconstruction (3DIR) in the assessment of Carpentier type II mitral valve lesions. In 74 patients (mean age 59+/-13 years) with mitral regurgitation due to type II valve dysfunction, TEE and 3DIR were performed and analyzed by 2 experts before surgical repair. Leaflet scallops and commissures were displayed in short-axis en face and long-axis views. Echocardiographic results were surgically validated. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated, broken down by valve segments and Barlow's disease. Interobserver variability was also determined. Compared with TEE, 3DIR was superior with respect to sensitivity, positive and negative predictive values, and accuracy, although not always significantly (p<0.05). Specificity was higher for P2 lesions. The clearest advantage of 3DIR over TEE was higher sensitivity in commissural and bileaflet defects (p<0.05). Interobserver agreement on 3DIR was stronger than on TEE results (kappa values 0.52 vs 0.82, p<0.0001). There were 16 disagreements (23%) on TEE but only 5 (7%) on 3DIR readings. In conclusion, the more complex the lesion, the more valuable 3DIR is compared with TEE. Before repair, 3DIR is beneficial for the evaluation and classification of the specific pathology in type II mitral valve dysfunction. PMID:16828601

Müller, Silvana; Müller, Ludwig; Laufer, Günther; Alber, Hannes; Dichtl, Wolfgang; Frick, Matthias; Pachinger, Otmar; Bartel, Thomas

2006-07-15

374

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; Buhrer, Christoph; Schmitz, Lothar

2014-01-01

375

Subacute left ventricle free wall rupture after acute myocardial infarction: awareness of the clinical signs and early use of echocardiography may be life-saving  

PubMed Central

Left ventricular free wall rupture (LVFWR) is a fearful complication of acute myocardial infarction in which a swift diagnosis and emergency surgery can be crucial for successful treatment. Because a significant number of cases occur subacutely, clinicians should be aware of the risk factors, clinical features and diagnostic criteria of this complication. We report the case of a 69 year-old man in whom a subacute left ventricular free wall rupture (LVFWR) was diagnosed 7 days after an inferior myocardial infarction with late reperfusion therapy. An asymptomatic 3 to 5 mm saddle-shaped ST-segment elevation in anterior and lateral leads, detected on a routine ECG, led to an urgent bedside echocardiogram which showed basal inferior-wall akinesis, a small echodense pericardial effusion and a canalicular tract from endo to pericardium, along the interface between the necrotic and normal contracting myocardium, trough which power-Doppler examination suggested blood crossing the myocardial wall. A cardiac MRI further reinforced the possibility of contained LVFWR and a surgical procedure was undertaken, confirming the diagnosis and allowing the successful repair of the myocardial tear. This case illustrates that subacute LVFWR provides an opportunity for intervention. Recognition of the diversity of presentation and prompt use of echocardiography may be life-saving. PMID:17118207

Raposo, Luis; Andrade, Maria Joao; Ferreira, Jorge; Aguiar, Carlos; Couto, Rute; Abecasis, Miguel; Canada, Manuel; Jalles-Tavares, Nuno; da Silva, Jose Aniceto

2006-01-01

376

The coronary flow reserve is transiently impaired in tako-tsubo cardiomyopathy: a prospective study using serial Doppler transthoracic echocardiography.  

PubMed

The clinical features of tako-tsubo cardiomyopathy or transient left apical ballooning syndrome (LABS) have been clearly described, but the mechanisms are still unknown. Our objective was to prospectively assess coronary microcirculation at the acute phase of LABS and after functional recovery, using Doppler transthoracic echocardiography-coronary flow reserve (CFR). Twelve consecutive patients (11 women, mean age 68 +/- 10 years) satisfying the criteria for LABS underwent Doppler transthoracic echocardiography-CFR in the distal part of the left anterior descending coronary artery, using intravenous adenosine infusion (0.14 mg/kg/min over 2 minutes) at the acute phase and 25 +/- 3 days later. CFR was calculated as the ratio of hyperemic to basal mean diastolic flow velocity. Wall-motion score (WMS) was calculated using the 16-segment model during the same echocardiographic examination (normal WMS = 16). Doppler transthoracic echocardiography-CFR increased between the two examinations from 2.2 +/- 0.4 at the acute phase to 2.9 +/- 0.3 (P < .01), whereas WMS decreased (from 31 +/- 6 at the acute phase to 16.5 +/- 0.8, delta WMS = -14.6 +/- 6, P < .01). All patients exhibited an increase of CFR between the two tests (delta CFR = 0.73 +/- 0.39, range: 0.3-1.6). A significant correlation was observed between delta CFR and delta WMS (r = -0.89, P < .01). In conclusion, serial noninvasive CFR measurements performed in LABS suggested transient microcirculatory impairment during the acute phase of the syndrome. The wall-motion improvement parallel to the dynamic improvement of the microcirculation suggests a role of coronary microcirculatory damage in the pathogenesis of acute and transient wall-motion abnormalities in LABS. PMID:17628401

Meimoun, Patrick; Malaquin, Dorothée; Sayah, Smain; Benali, Tahar; Luycx-Bore, Anne; Levy, Franck; Zemir, Hamdane; Tribouilloy, Christophe

2008-01-01

377

The Physics of Equestrian Show Jumping  

NASA Astrophysics Data System (ADS)

This article discusses the kinematics and dynamics of equestrian show jumping. For some time I have attended a series of show jumping events at Spruce Meadows, an international equestrian center near Calgary, Alberta, often referred to as the "Wimbledon of equestrian jumping." I have always had a desire to write an article such as this one, but when I searched the Internet for information and looked at YouTube presentations, I could only find simplistic references to Newton's laws and the conservation of mechanical energy principle. Nowhere could I find detailed calculations. On the other hand, there were several biomechanical articles with empirical reports of the results of kinetic and dynamic investigations of show jumping using high-speed digital cameras and force plates. They summarize their results in tables that give information about the motion of a horse jumping over high fences (1.40 m) and the magnitudes of the forces encountered when landing. However, they do not describe the physics of these results.

Stinner, Art

2014-04-01

378

Anomalous origin of the left coronary artery from the pulmonary artery detected by echocardiography in an asymptomatic adult.  

PubMed

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital malformation. It is unusual for an ALCAPA patient to survive to adulthood. We present a case of an asymptomatic 54-year-old woman with this syndrome in which visualization of a markedly enlarged and tortuous right coronary artery and intercoronary collaterals by echocardiography raises suspicion for this disease and subsequently guides a step-by-step diagnosis. The patient lives well without surgery 3 years after diagnosis. PMID:23318854

Tian, Zhuang; Fang, Li-Gang; Liu, Yong-Tai; Zhang, Shu-Yang

2013-01-01

379

Severe Acne: 4 Types  

MedlinePLUS

AcneNet Article Severe Acne: 4 types Severe acne can affect many facets of a person’s life, causing a great deal of embarrassment and stress. Severe ... experience treating the different types of severe acne. Four types of severe acne, described in detail below, ...

380

Examples show system-performance upgrade  

SciTech Connect

This paper reviews several techniques to quantify the performance of a turboexpander refrigeration system's expander and compressor. It proposes that improvements in cycle efficiency can best be implemented through a combined effort of those responsible for the operation of the gas processing plant and the design engineers familiar with the performance of the specialized components within the system. It points out that the manufacturers of the turbomachinery should be able to recommend specific changes to improve performance and quantify the net benefits these changes have on plant efficiency. It presents graphs showing the effect of heat exchanger fouling, performance loss, and cost of lost performance. It attempts to operate a compressor at a higher efficiency on its efficiency vs. Q/N (flow rate/shaft speed) performance curve and explains that operating curves can be prepared based on field-measured values.

McIntire, R.

1982-07-12

381

Three-dimensional quantitation of mitral valve coaptation by a novel software system with transthoracic real-time three-dimensional echocardiography.  

PubMed

We investigated the degree of mitral valve coaptation with a custom quantitation software system using transthoracic three-dimensional (3D) echocardiography. With real-time 3D echocardiography, we obtained transthoracic volumetric images in 20 healthy subjects and 20 patients with dilated cardiomyopathy. With our novel software system, the surface area of mitral valve tenting in the onset of mitral leaflet closure [O] and the timing of maximum closure of mitral leaflet [M] were reconstructed for quantitative measurement. The coaptation index was calculated by the following formula: [(3D tenting surface area in O-3D tenting surface area in M)/3D tenting surface area in O]. The coaptation index in patients with dilated cardiomyopathy was significantly smaller than that in healthy subjects (11% +/- 4.1% vs. 18% +/- 8.0%, P = .004). The custom quantitation software system with 3D echocardiography allowed us to assess the degree of mitral valve coaptation. PMID:17628419

Tsukiji, Miwako; Watanabe, Nozomi; Yamaura, Yasuko; Okahashi, Noriko; Obase, Kikuko; Neishi, Yoji; Toyota, Eiji; Kawamoto, Takahiro; Okura, Hiroyuki; Ogasawara, Yasuo; Yoshida, Kiyoshi

2008-01-01

382

Prediction of gradients in fibrous subaortic stenosis by continuous wave two-dimensional Doppler echocardiography: animal studies.  

PubMed

The purpose of this study was to assess the accuracy of continuous wave, two-dimensional Doppler echocardiography for predicting pressure gradients across discrete subaortic stenoses. Twenty-three Newfoundland dogs with subaortic stenosis were studied by closed chest Doppler interrogation of aortic velocity from an apical view of the left ventricular outflow tract simultaneously with measurements of pressure gradient during cardiac catheterization. Continuous mode Doppler interrogation was used with two-dimensional echographic guidance (Irex model IIIB) to compare the Doppler-derived maximal velocity with the pressure gradient across the obstruction at rest and after provocation with amyl nitrite inhalation and isoproterenol infusion. The maximal velocities recorded by Doppler ranged from 98 to 539 cm/s and correlated with hemodynamic gradients ranging from 3 to 123 mm Hg (r = 0.92, SEE = 37 cm/s). Doppler velocities were converted to gradients using a simplification of the Bernoulli relation (gradient = 4 X maximal velocity2); the resulting Doppler-derived gradients also correlated closely with the catheterization-measured pressure gradients (r = 0.95, SEE = 7.1 mm Hg). The predictive capability of Doppler echocardiography for estimating the pressure gradient across fibromuscular subaortic obstructions in this group of dogs with a spectrum of disease similar to that found in human beings was validated. The results also indicate that Doppler methods may have clinical applications in patients with subaortic stenosis. PMID:2860146

Valdes-Cruz, L M; Jones, M; Scagnelli, S; Sahn, D J; Tomizuka, F M; Pierce, J E

1985-06-01

383

Intraoperative two-dimensional echocardiography and color flow Doppler imaging: a basic transesophageal single plane patient examination sequence.  

PubMed Central

Recent advances in technology have allowed application of transesophageal echocardiography to intraoperative care of critically ill patients. Early clinical application primarily involved evaluation of left ventricular regional wall motion. However, valid intraoperative use of transesophageal echocardiography should also encompass systematic assessment of the entire heart as well as the great vessels. This report describes a 10-step sequence of single plane, two-dimensional echocardiographic views which constitute a basic patient examination capable of being performed by a practitioner whose primary responsibility is the delivery of anesthesia care. A 5-step color flow Doppler examination sequence is also presented. These views complement the two-dimensional echocardiographic steps. Representations of methods for grading Doppler-defined valvular regurgitation complete the report. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 13 Figure 14 Figure 15 Figure 16 Figure 17 Figure 18 Figure 19 Figure 20 Figure 21 Figure 22 Figure 23 Figure 24 Figure 25 Figure 26 PMID:7825339

Rafferty, T. D.; Lippmann, H.

1993-01-01

384

Coexisting bicuspid aortic and pulmonary valves with normally related great vessels diagnosed by live/real time three-dimensional transesophageal echocardiography.  

PubMed

Coexistence of bicuspid aortic and pulmonary valves in the same patient is a very rare entity identified mainly during surgery and postmortem. To the best of our knowledge, only one case has been diagnosed by two-dimensional echocardiography in a newborn with malposition of the great arteries but no images were presented. Here, we are reporting the first case of bicuspid pulmonary and aortic valves diagnosed by live/real time three-dimensional transesophageal echocardiography in an adult with normally related great arteries. PMID:24446750

Kemalo?lu Öz, Tu?ba; Karadeniz, Fatma Özpamuk; Gundlapalli, Hareesh; Erer, Betul; Sharma, Rohit K; Ahmed, Mustafa; Nanda, Navin C; Y?ld?r?m, Ayd?n; Orhan, Gökçen; Öz, Ayhan; Eren, Mehmet

2014-02-01

385

Right ventricular cavity near obliteration in neonatal severe biventricular hypertrophic cardiomyopathy.  

PubMed

A newborn presenting with cyanosis at day 9 of life was admitted to the local hospital. Initial local echocardiography confirmed a cardiac issue and the patient was transferred to a tertiary cardiac hospital. Further imaging confirmed a rare presentation of cardiomyopathy with severe right ventricular outflow tract obstruction. Surgery was performed but with postoperative haemodynamic instability complicated by incessant ventricular tachycardia. Following discussion with the family, care was withdrawn. Postmortem demonstrated a rare form of hypertrophic cardiomyopathy with right ventricular outflow tract obstruction not previously described in a neonate. PMID:25336549

Jivanji, Salim Gm; Daubeney, Piers; Franklin, Rodney; Sheppard, Mary

2014-01-01

386

Geometric differences of the mitral valve tenting between anterior and inferior myocardial infarction with significant ischemic mitral regurgitation: quantitation by novel software system with transthoracic real-time three-dimensional echocardiography.  

PubMed

We sought to investigate the 3-dimensional geometric differences of mitral leaflet tenting in ischemic mitral regurgitation, comparing inferior and anterior myocardial infarction (MI). Using real-time 3-dimensional echocardiography, we obtained transthoracic volumetric images for patients with significant ischemic mitral regurgitation (9 inferior and 7 anterior). With our novel software system, 3-dimensional images of the leaflets were reconstructed for quantitation. Mitral leaflet configuration was then represented in contour in which the degree of the tenting could be observed. Calculated percent of tethered leaflet area (>5-mm tenting from the annular level) was compared in inferior and anterior MI. Percent of tethered leaflet area was significantly smaller in inferior than anterior MI, reflecting the localized leaflet tenting in inferior MI (16.7 +/- 18.8% vs 38.9 +/- 9.7%, P = .01). In anterior MI, mitral valve leaflets were widely tethered toward the left ventricle, in contrast with inferior MI showing localized tenting of the leaflet. PMID:16423672

Watanabe, Nozomi; Ogasawara, Yasuo; Yamaura, Yasuko; Yamamoto, Katsunori; Wada, Nozomi; Kawamoto, Takahiro; Toyota, Eiji; Akasaka, Takashi; Yoshida, Kiyoshi

2006-01-01

387

A minicomputer system for audio-animatronics show data generation  

Microsoft Academic Search

Audio-Animatronics® shows have been produced by Disney since the introduction of several attractions at the 1964 New York World's Fair. Since then a variety of shows have been permanently installed at both Disneyland and Walt Disney World. They typically consist of a stage, or some enclosed show area, and a variety of special lighting effects, mechanized characters and other movable

Philip C. Stover; R. David Snyder

1980-01-01

388

Zoomable user interfaces as a medium for slide show presentations  

Microsoft Academic Search

In this paper, the authors propose Zoomable User Interfaces as an alternative presentation medium to address several common presentation problems. Zoomable User Interfaces offer new techniques for managing multiple versions of a presentation, providing interactive presentation navigation, and distin- guishing levels of detail. These zoomable presentations may also offer several cognitive benefits over their commercial slide show counterparts. The authors

Lance Good; Benjamin B. Bederson

2002-01-01

389

A comparison of left ventricular mass between two-dimensional echocardiography, using fundamental and tissue harmonic imaging, and cardiac MRI in patients with hypertension  

Microsoft Academic Search

Purpose: To compare left ventricular mass (LVM) as measured by two-dimensional (2D) echocardiography using two different calculation methods: truncated ellipse (TE) and area length (AL), in both fundamental and tissue harmonic imaging frequencies, to LVM as measured by, the current gold standard, cardiac magnetic resonance imaging (MRI). Turbo gradient echo (TGE) pulse sequence was utilized for MRI. Materials and methods:

Khaled Alfakih; Tim Bloomer; Samantha Bainbridge; Gavin Bainbridge; John Ridgway; Gordon Williams; Mohan Sivananthan

2004-01-01

390

Speckle-Tracking and Tissue-Doppler Stress Echocardiography in Arterial Hypertension: A Sensitive Tool for Detection of Subclinical LV Impairment  

PubMed Central

Early diagnosis of cardiac alterations in hypertensive heart disease is still challenging. Since such patients might have depressed global LV systolic strain or strain rate when EF is still normal, speckle-tracking echocardiography (STE) and tissue-Doppler imaging (TDI) combined with stress echocardiography might improve early diagnosis of cardiac alterations. In this prospective study standard 2D Doppler echocardiography, STE, and TDI were performed at rest and during bicycle exercise in 92 consecutive patients—46 hypertensive subjects with normal ejection fraction and 46 healthy controls. STE and TDI were used to measure global peak systolic LV circumferential strain (CS), longitudinal strain (LS), and longitudinal strain rate (SR). Mean arterial blood pressure was significantly higher in hypertensive patients at rest (100.8?mmHg SD 13.5?mmHg; P = 0.002) and during physical exercise testing (124.2?mmHg SD 13.4?mmHg; P = 0.003). Hypertensive patients had significantly reduced values of systolic CS (P = 0.001), LS (P = 0.014), and SR (P < 0.001) at rest as well as during physical exercise—CS (P < 0.001), LS (P < 0.001), and SR (P < 0.001). Using STE and TDI, reduced LV systolic strain and strain rate consistent with early cardiac alterations can be detected in patients with arterial hypertension. These findings were evident at rest and markedly pronounced during exercise echocardiography. PMID:25389528

Hensel, Kai O.; Leischik, Roman

2014-01-01

391

Validation of viability assessment by electromechanical mapping by three-dimensional reconstruction with dobutamine stress echocardiography in patients with coronary artery disease  

Microsoft Academic Search

We evaluated the ability of electromechanical mapping (EMM) to discriminate between normal, viable, and nonviable (scarred) myocardium in patients with coronary artery disease versus dobutamine stress echocardiography (DSE) when the correspondence between the test and reference data sets is established via a common 3-dimensional reconstruction of the left ventricle. We studied 21 patients with coronary artery disease who underwent angiography,

Athena Poppas; Florence H Sheehan; Mark Reisman; Verna Harms; Ran Kornowski

2004-01-01

392

Errors as a result of metal in the near environment when using an electromagnetic locator with freehand three-dimensional echocardiography  

Microsoft Academic Search

Background: Quantitative ventriculography by freehand 3-dimensional (3D) echocardiography with an acoustic spatial locator has been proven to provide highly accurate reproducible measurements of left ventricular volume, mass, and function. It has been shown to be 2 to 3 times better than conventional 2-dimensional echocardiographic techniques. Although accurate, the acoustic spatial locator uses a spark gap to generate hypersound for locating

Donald L. King

2002-01-01

393

Abrupt formation and spontaneous resolution of a right atrial thrombus detected by intraoperative transesophageal echocardiography during replacement of an abdominal aortic aneurysm.  

PubMed

Intraoperative formation of a thrombus in the right atrium and its management has occasionally been reported. However, spontaneous resolution of right atrial thrombi, without any event, is rare. We report a case of abrupt right atrial thrombus formation and spontaneous resolution, with no events, detected by transesophageal echocardiography during the replacement of an abdominal aortic aneurysm. PMID:20238231

Sung, Tae-Yun; Kim, Seong-Hyop; Kim, Duk-Kyung; Yoon, Tae-Gyoon; Kim, Tae-Yop; Lim, Jeong-Ae; Woo, Nam-Sik

2010-06-01

394

A rupture of both atrioventricular valves after blunt chest trauma: the usefulness of transesophageal echocardiography for a life-saving diagnosis.  

PubMed

Survival after the rupture of the both mitral and tricuspid valves in blunt thoracic trauma is uncommon and requires prompt diagnosis and treatment. We present a case in which transesophageal echocardiography performed in the operating room by the anesthesiologist identified the etiology of hemodynamic instability and facilitated successful emergency replacement of both valves. PMID:15845663

Petkov, Milen P; Napolitano, Charles A; Tobler, H Gareth; Ferrer, Thomas J; Palacios, J Mauricio; Wangler, Michael D

2005-05-01

395

Should One Use Echocardiography or Contrast Transcranial Doppler Ultrasound for the Detection of a Patent Foramen Ovale after an Ischemic Cerebrovascular Accident?  

Microsoft Academic Search

Patent foramen ovale is frequently associated with embolic cerebrovascular accidents. The diagnosis of patent foramen ovale is easier since the advent of transesophageal echocardiography. However, this method is semi-invasive and is not readily available in all units. Contrast transcranial Doppler ultrasound enables the detection of the passage of a contrast material injected into a peripheral vein to the cerebral circulation

Jean-Philippe Baguet; Gérard Besson; Frédéric Tremel; Lionel Mangin; Christelle Richardot; Jean-Michel Mallion

2001-01-01

396

Comparison of ability to identify left atrial thrombus by three-dimensional tomography versus transesophageal echocardiography in patients with atrial fibrillation  

Microsoft Academic Search

We sought to determine the potential use of recently introduced cardiac 3-dimensional computed tomography as an alternative to transesophageal echocardiography for examination of the left atrial appendage. Our data suggest that computed tomography is a potential alternative for assessing the anatomy of the left atrial appendage and for detecting thrombi.

Wael A. Jaber; Richard D. White; Stacie A. Kuzmiak; Janet M. Boyle; Andrea Natale; Carolyn Apperson-Hansen; James D. Thomas; Craig R. Asher

2004-01-01

397

Role of fetal echocardiography in the management of isolated fetal heart block with ventricular rate <55 bpm.  

PubMed

Persistent bradycardia is an uncommon cardiac problem in fetuses but carries a high mortality in those with a ventricular rate <55 bpm. Fetal heart block is one of the most common causes of persistent fetal bradycardia (PFB). An optimal method for assessing and monitoring cardiovascular compensation in the setting of PFB due to heart block has not been fully established. We report the application of two-dimensional and Doppler echocardiography in close monitoring of cardiac function and hemodynamics in a third-trimester fetus with a ventricular rate <55 bpm due to heart block, which assisted in successful management of the pregnancy to term. Hemodynamic and cardiac adaptive changes in compromised fetuses, particularly due to heart block, are discussed. PMID:10333392

Singh, G K; Shumway, J B; Amon, E; Marino, C J; Nouri, S; Winn, H N

1998-01-01

398

Assessment of left ventricular twist mechanics by speckle tracking echocardiography reveals association between LV twist and myocardial fibrosis in patients with hypertrophic cardiomyopathy.  

PubMed

We aimed to investigate whether left ventricular (LV) twist analysis can detect the extent of myocardial fibrosis in patients with hypertrophic cardiomyopathy (HCM). This prospective case-control study recruited 81 consecutive patients with HCM examined between January 2012 and April 2013. Data of 76 patients were analyzed after excluding 5 patients whose echocardiographic images were of poor quality. Healthy volunteers (n = 46) served as controls. Both groups underwent comprehensive echocardiographic examination (i.e., Bas-Rotation, AP-Rotation, LVEF, LADs, IVST, LAVi, E/Em, LVMI, advanced LV-twist analysis by speckle tracking echocardiography) and magnetic resonance imaging. Between-group differences were analyzed by independent t test; logistic regression analysis was performed to identify effect factors. No significant differences were found between baseline characteristics of HCM and control groups (all p > 0.05). HCM patients had significantly higher Bas-Rotation, AP-Rotation, LV Twist, LVEF, LADs, IVST, LAVi, E/Em and LVMI than controls (all p < 0.0001) and significantly lower LVDd and E/A (both p < 0.001). Bas-Rotation, AP-Rotation, LV-Twist, LADs, IVST, LAVi, E/Em and LVMI were significantly higher in HCM patients with fibrosis than in those without fibrosis (p < 0.001), but no significant differences in other echocardiographic parameters were found between those with and without fibrosis. Age, Bas-Rotation, AP-Rotation, LV twist, LADs, IVST, LAVi, E/A, E/Em, and LVMI were significant effect factors for fibrosis. AUROC analysis showed that LV twist had high discriminatory power to detect extent of myocardial fibrosis (AUC 0.996, 95 % CI 0.989-1.004, p < 0.001). Left ventricular twist mechanics are associated with the extent of myocardial fibrosis. LV-twist assessment by STE may be clinically useful. PMID:25106760

Zhang, Hong-Ju; Wang, Hao; Sun, Tao; Lu, Min-Jie; Xu, Nan; Wu, Wei-Chun; Sun, Xin; Wang, Wu-Gang; Lin, Qiong-Wen

2014-12-01

399

Geometric differences of the mitral apparatus between ischemic and dilated cardiomyopathy with significant mitral regurgitation: real-time three-dimensional echocardiography study  

NASA Technical Reports Server (NTRS)

BACKGROUND: This study was conducted to elucidate the geometric differences of the mitral apparatus in patients with significant mitral regurgitation caused by ischemic cardiomyopathy (ICM-MR) and by idiopathic dilated cardiomyopathy (DCM-MR) by use of real-time 3D echocardiography (RT3DE). METHODS AND RESULTS: Twenty-six patients with ICM-MR caused by posterior infarction, 18 patients with DCM-MR, and 8 control subjects were studied. With the 3D software, commissure-commissure plane and 3 perpendicular anteroposterior (AP) planes were generated for imaging the medial, central, and lateral sides of the mitral valve (MV) during mid systole. In 3 AP planes, the angles between the annular plane and each leaflet (anterior, Aalpha; posterior, Palpha) were measured. In ICM-MR, Aalpha measured in the medial and central planes was significantly larger than that in the lateral plane (39+/-5 degrees, 34+/-6 degrees, and 27+/-5 degrees, respectively; P<0.01), whereas Palpha showed no significant difference in any of the 3 AP planes (61+/-7 degrees, 57+/-7 degrees, and 56+/-7 degrees, P>0.05). In DCM-MR, both Aalpha (38+/-8 degrees, 37+/-9 degrees, and 36+/-7 degrees, P>0.05) and Palpha (59+/-6 degrees, 58+/-5 degrees, and 57+/-6 degrees, P>0.05) revealed no significant differences in the 3 planes. CONCLUSIONS: The pattern of MV deformation from the medial to the lateral side was asymmetrical in ICM-MR, whereas it was symmetrical in DCM-MR. RT3DE is a helpful tool for differentiating the geometry of the mitral apparatus between these 2 different types of functional mitral regurgitation.

Kwan, Jun; Shiota, Takahiro; Agler, Deborah A.; Popovic, Zoran B.; Qin, Jian Xin; Gillinov, Marc A.; Stewart, William J.; Cosgrove, Delos M.; McCarthy, Patrick M.; Thomas, James D.

2003-01-01

400

Detection of coronary artery disease with exercise two-dimensional echocardiography. Description of a clinically applicable method and comparison with radionuclide ventriculography  

SciTech Connect

Two-dimensional echocardiography (2-D echo) was performed in 73 patients evaluated for coronary artery disease (CAD) and in four normal volunteers before and immediately after a maximal treadmill exercise test. Diagnostic images were obtained from the apical and parasternal windows. In 17 patients with normal coronary arteriograms, ejection fraction (EF) increased from 66 +/- 9% (+/- SD) at rest to 73 +/- 8% after exercise (p less than 0.001), while in 56 patients with proved CAD, EF fell from 56 +/- 13% at rest to 53 +/- 16% after exercise (p less than 0.01). The sensitivity of postexercise 2-D echo for detecting CAD (based on abnormal EF response and/or regional dyssynergy) was 91% (51 of 56 patients) and the specificity was 88% (15 of 17). Sensitivity for one-, two- and three-vessel disease was 64% (seven of 11), 95% (20 of 21) and 100%, respectively. Patients with multivessel disease showed a significant fall in a wall motion score index, from 0.79 +/- 0.25 to 0.63 +/- 0.26. Exercise radionuclide ventriculography (RNV) was also performed in 41 of the subjects (17 normals and 24 CAD patients) on a bicycle ergometer. The overall sensitivity of 2-D echo in this subgroup was 92%, compared with 71% for RNV. The sensitivity of 2-D echo for one-vessel disease (n . 4) was 50%, that for two-vessel disease (n . 12) was 100% and that for three-vessel disease (n . 12) was 100%. Respective values for RNV were 0%, 80% and 90%. The specificity of 2-D echo was 88% and that of RNV was 82%. A significantly higher peak heart rate response was observed on the treadmill than on the bicycle ergometer in both CAD patients and normal subjects. We conclude that postexercise 2-D echo is a clinically applicable technique for the diagnosis and evaluation of CAD patients and compares favorably with exercise RNV.

Limacher, M.C.; Quinones, M.A.; Poliner, L.R.; Nelson, J.G.; Winters, W.L. Jr.; Waggoner, A.D.

1983-06-01

401

Contractility evaluation by 2 dimensional echocardiography and gated SPECT myocardial perfusion scintigraphy in hypertensive patients with clinical presentation of atypical chest pain  

PubMed Central

Background: Hypertension (HT) is a growing health problem in the population and associated with increased cardiovascular event risk and mortality. In hypertensive patients, progressive left ventricular (LV) contractility deterioration is detectable by gated single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy9. We planned this study to explore the agreement in ejection fraction (EF) determination between 2 dimensional echocardiography and gated SPECT analysis in selected group of patients with hypertension. Patients and Methods: We studied 26 consecutive patients (mean age 56.5 ± 8.8 years; 6 men) with hypertension. Quantitative contractility analysis by both echocardiography and SPECT at rest was performed to investigate the agreement between two diagnostic tests. Results: EF at rest was greater than 55 % in all patients. All patients had a clinical presentation of atypical chest pain. Therefore, in addition to quantitative contractility analysis at rest by