The role of echocardiography for diagnosis and prognostic stratification in hypertrophic cardiomyopathyMandeş, Leonard; Roşca, Monica; Ciupercă, Daniela; Popescu, Bogdan A.
2020 Journal of Echocardiography
doi: 10.1007/s12574-020-00467-9pmid: 32301048
Hypertrophic cardiomyopathy (HCM) is the most frequent cardiac disease with genetic substrate, affecting about 0.2–0.5% of the population. While most of the patients with HCM have a relatively good prognosis, some are at increased risk of adverse events. Identifying such patients at risk is important for optimal treatment and follow-up. While clinical and electrocardiographic information plays an important role, echocardiography remains the cornerstone in assessing patients with HCM. In this review, we discuss the role of echocardiography in diagnosing HCM, the key features that differentiate HCM from other diseases and the use of echocardiography for risk stratification in this setting (risk of sudden cardiac death, heart failure, atrial fibrillation and stroke). The use of modern echocardiographic techniques (deformation imaging, 3D echocardiography) refines the diagnosis and prognostic assessment of patients with HCM. The echocardiographic data need to be integrated with clinical data and other information, including cardiac magnetic resonance, especially in challenging cases or when there is incomplete information, for the optimal management of these patients.
Relationships among pulmonary capillary wedge pressure, dry weight and natriuretic peptide in patients undergoing hemodialysis: a three-dimensional speckle tracking echocardiography studySato, Hidemaro; Kawasaki, Masanori; Tanaka, Ryuhei; Yoshizane, Takashi; Ono, Koji; Tadokoro, Mitsunobu; Yano, Yoko; Kondou, Takehito; Kariya, Tatsuya; Nagata, Kijun; Gotoh, Koshi; Sawada, Shigeki; Noda, Toshiyuki; Watanabe, Sachiro
2020 Journal of Echocardiography
doi: 10.1007/s12574-020-00461-1pmid: 31997088
BackgroundAlthough the evaluation of fluid status in hemodialysis (HD) patients is useful, relationship among pulmonary capillary wedge pressure (PCWP), dry body weight (DW) and natriuretic peptide has not been elucidated. In addition, there has been no objective marker for instantaneously monitoring hemodynamic improvement in response to HD. We previously reported that PCWP and time constant of left ventricular pressure decline (Tau) can be noninvasively estimated (ePCWP and eTau) by speckle tracking echocardiography (STE). The aim of this study was to elucidate the relationship among ePCWP, eTau, DW and natriuretic peptide in patients undergoing HD.MethodsWe measured ePCWP and body weight (BW) by STE in 81 patients and ANP and BNP by blood examination in 31 patients just before and after HD during sinus rhythm.ResultsThe ePCWP decreased after HD, and this was associated with reductions in ln ANP, eTau and BW (r = 0.523, 0.271 and 0.814, respectively, p < 0.05). The % change in ePCWP was not correlated with the % change in ln BNP (p = 0.47). The change in ePCWP had a stronger correlation with the % change in BW than the change in any other parameters.ConclusionsThe ePCWP is more sensitive to estimate the change in BW during HD than any other parameters such as ANP and BNP. These results indicated that a substantial amount of excess fluid can be assessed real-time by STE using ePCWP.
Sizing of mitral annuloplasty rings using real-time three-dimensional transesophageal echocardiography and the difference between patients with and without recurrent mitral regurgitation: retrospective cohort studyFujii, Tasuku; Yoshitani, Kenji; Kanemaru, Eiki; Nakai, Michikazu; Nishimura, Kunihiro; Ohnishi, Yoshihiko; Nishiwaki, Kimitoshi
2020 Journal of Echocardiography
doi: 10.1007/s12574-020-00465-xpmid: 32144581
BackgroundPrevious studies showed that the mitral inter-commissural (IC) distance differed by a few millimeters between the systolic and diastolic cardiac cycles. However, sizing of the mitral annuloplasty ring with a ring sizer, which should be performed in the systole, is performed in diastole during hyperkalemic cardioplegic arrest. The aim of this study was to investigate whether three-dimensional transesophageal echocardiography (3D-TEE) measurements of the mitral valve in end-systole are effective to determine the size of the annuloplasty ring.MethodsThis study retrospectively reviewed 92 patients who underwent mitral annuloplasty for degenerative. The IC distance and anterior leaflet height of the A2 segment of the mitral valve were measured by 3D-TEE at the end-systole. The annuloplasty ring size was measured by the surgeons using specific ring sizers. We compared the IC distance measured by 3D-TEE with the implanted annuloplasty size. We also investigated differences in IC distance, A2 height, and ratio of A2 height to IC distance in patients with and without recurrent mild to moderate MR for 36 months.ResultsThere was a significant correlation between the IC distance by 3D-TEE and the implanted ring size (R2 = 0.7023, p < 0.001). Eight cases had mild or greater recurrent MR. There was a significant difference in the ratio of A2 height to IC distance between patients with and without recurrent MR (p = 0.006). A2 height was greater in patients with recurrent MR, but this difference was not significant (p = 0.059).ConclusionsOur results demonstrated a larger ratio of A2 height to IC distance in patients with recurrent MR. 3D-TEE could be useful for the ring sizing.
Elderly Japanese Standard Data of Echocardiography; From J-LONG studySeo, Yoshihiro; Ishizu, Tomoko; Ieda, Masaki; Ohte, Nobuyuki; ,
2020 Journal of Echocardiography
doi: 10.1007/s12574-020-00469-7pmid: 32306373
BackgroundAge-related changes in cardiac morphology and function have not been unknown in the elderly. The Japanese eLderly data Of Normal echocardioGraphy (J-LONG) study is a prospective multicenter cohort study and aimed to investigate the echocardiographic data in the healthy Japanese elderly.MethodsThirty domestic facilities participated in this study, and 130 healthy subjects (57 men, 73 women, 79.6 ± 4.7 years, range 75–98 years, interquartile range 76–82 years) were enrolled in this cohort. Echocardiographic and clinical data sets were obtained in each facility, and total analyses were performed in the University of Tsukuba.ResultsAlmost all cardiac morphological data were significantly larger in men than those in women. However, corrected data by body surface area (BSA) were similar or closer between genders. As a gender difference, the negative correlation between BSA and age was observed in women only (r = − 0.46, p < 0.001), showing the independent determinant of women’s left ventricular end-diastolic volume (LVEDV) was age (β = − 0.29, p = 0.01), but not BSA. In men, LVEDV was significantly correlated with BSA (β = 0.42, p = 0.001), but not with age (p = 0.10).Also, women had higher LV ejection fraction (70 ± 7.1 vs. 68 ± 4.9%, p = 0.02), lower E/A (0.67 ± 0.16 vs. 0.75 ± 0.21, p = 0.02), and higher E/eʹ (10 ± 2.7 vs. 8.9 ± 2.5, p = 0.03) as compared to men.ConclusionsThe J-LONG study suggested that correction by the physique was needed to interpret echocardiographic data of the elderly. Also, gender differences and age-related changes in cardiac morphology and function were observed, and further studies are needed to confirm the clinical significance.