Cardiac aging phenomenon and its clinical features by echocardiographyXu, Boqing; Daimon, Masao
2016 Journal of Echocardiography
doi: 10.1007/s12574-016-0292-6pmid: 27169598
Even in healthy subjects, the heart ages along with other organs of the body. A prominent change is progressive left ventricular (LV) diastolic dysfunction, even though LV mass increases slightly during aging. Accordingly, assessment of LV dysfunction can be employed as a surrogate marker of cardiac age. The clinical factors that may accelerate the cardiac aging process include visceral obesity, diabetes mellitus, dyslipidemia, and hypertension. At the molecular level in cardiac myocytes, reactive oxygen species, transforming growth factor-β, mitochondrial function, and lysosomal function are also related to cardiac age. Furthermore, age-related LV dysfunction has been shown to be one of the main risk factors for future heart failure. Consequently, assessment of LV diastolic function is necessary for both preventing cardiac events and assessing cardiac age. Echocardiography provides a noninvasive assessment of cardiac structure and function. This review describes how to assess cardiac aging using echocardiography, and how to interpret the clinical relevance of the findings.
Practical echocardiographic approach for risk stratification of patients with acute pulmonary embolismShafiq, Qaiser; Moukarbel, George; Gupta, Rajesh; Hernandez, Dawn-Alita; Khouri, Samer
2016 Journal of Echocardiography
doi: 10.1007/s12574-016-0306-4pmid: 27510333
Acute pulmonary embolism remains a common cause of mortality. Early diagnosis and appropriate risk stratification is necessary to individualize treatment strategy. Computed tomography scan of the pulmonary arteries is routinely used to diagnose acute pulmonary embolism and in some cases is useful to assess right ventricular dilation. In patients with acute pulmonary embolism, right ventricular dilation and dysfunction indicates a high-risk situation where immediate administration of thrombolytic agent, catheter-directed thrombolysis, or surgical embolectomy could be considered. A bedside 2D echocardiogram at the time of presentation could provide additional morphological, functional, and hemodynamic parameters including right ventricular dilation, McConnell’s sign, reduced tricuspid annular plane systolic excursion (TAPSE), interventricular septal flattening, abnormal right ventricular hemodynamics and in rare cases thrombi in the inferior vena cava, right atrium or ventricle en route to pulmonary arteries may also be visualized. This additional information is useful for selection of appropriate treatment modality. Thus, our objective is to provide a practical echocardiographic approach for risk stratification of patients with acute pulmonary embolism.