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Shibata, Naoki; Sugiura, Tsuyoshi; Tanaka, Akihito; Shimizu, Kiyokazu
doi: 10.1007/s10554-020-01937-ypmid: 32686029
A patient with Takayasu arteritis who underwent CABG using a saphenous vein graft (SVG) experienced ventricular fibrillation due to total SVG occlusion. A drug-eluting stent was implanted; however, follow-up CAG demonstrated an advanced expansion of peri-stent contrast staining. Coronary computed tomography angiography revealed contrast media extending around the SVG. An intravascular ultrasound indicated a worsening stent malapposition and a significant positive remodeling.
Arslan, Uğur; Yenerçağ, Mustafa; Erdoğan, Güney; Görgün, Selim
doi: 10.1007/s10554-020-01939-wpmid: 32681317
Silent cerebral infarctions (SCI) determined by neuron specific enolase (NSE) elevation may develop more during chronic total occlusion (CTO) percutaneous coronary interventions (PCI) than non-CTO interventions. Our aim was to examine CTO and non-CTO PCIs for SCI development. 100 consecutive CTO and 100 non-CTO PCI patients were enrolled. SCI was detected by serum NSE measurements performed at baseline and 12 h after the interventions. New NSE elevations > 12 ng/mL after the procedure were counted as SCI. Post-procedural NSE levels were found to be significantly higher in the CTO PCI group and NSE positivity was more prevalent in the CTO PCI group (56 (56%) vs. 31 (31%), p < 0.001), but PCI of CTOs did not independently increase risk of SCI (OR: 2.39 (0.85–6.73), p: 0.10). Patients who developed SCI after PCI had the characteristics of tough PCI interventions. In the multivariate analysis, two parameters were found to be independently associated with SCI development, namely more contrast volume (OR: 1.014 (1.005–1.023), p: 0.003) and longer procedural time (OR: 1.030 (1.010–1.051), p: 0.003). It has been firstly demonstrated in the literature that CTO PCIs, by its nature, have increased rates of SCI when compared to non-CTO PCIs but presence of a CTO was not an independent predictor of SCI. Mainly, procedural characteristics of the PCIs, especially longer procedural times and more contrast consumption, observed more in CTO PCIs, have been found to be independently associated with elevations of plasma NSE levels.
Gok, G.; Sayar, N.; Oz, D.; Erer, H. B.; Ekmekci, A.; Eren, M.
doi: 10.1007/s10554-019-01673-ypmid: 31342236
Rheumatoid valve disease is a general health problem of developing countries, and it mainly affects after the age of 40. Assessment of the correct mitral valve area (MVA) is important for the treatment of rheumatoid valve disease. However, there are contradictions between the three-dimensional (3D) and two-dimensional (2D) methods. A measurement with 3D echocardiography is a more accurate method to measure the MVA. However, in centers without 3D echocardiography, there are some difficulties in the accurate measurement of the MVA. The aim of this study was to assess the value of 2D transesophageal echocardiography (TEE) mitral valve vena contracta area (VCA) in predicting the severity of rheumatoid mitral stenosis (RMS) by comparing 3D planimetry. A total of 24 patients (10 females and 14 males) who were diagnosed with mild/moderate/severe RMS with using pressure half time, mean transmitral gradient, and planimetry methods were included in this study. 3D images were acquired using the 3D zoom and full volume. 2D TEE VCA was measured at an angle of 140° and 60°, which was perpendicular to the former, with color Doppler and the VCA was measured with an ellipsoid area using mathematical formula. There was statistically significant relationship between the measurements of 2D VCA and 3D zoom mode MVA planimetry and MVA full measurements (MVA full volume) (p < 0.01). Calculation of the valvular area after measuring the mitral valve VCA with 2D TEE is a reliable method that is usable in centers without 3D echocardiography.
Wiese, Signe; Liang, Mark; Mo, Silje; Bendtsen, Flemming; Hove, Jens D.; Møller, Søren
doi: 10.1007/s10554-020-01920-7pmid: 32613383
Left atrial enlargement is a known marker of chronic diastolic dysfunction and was recently shown to be an independent predictor of mortality in cirrhosis. Real time 3-dimensional echocardiography (3DE) is an emerging modality that enables accurate measurements of the left atrial (LA) volume and function. Assessment of LA volumes with 3DE has never been applied in cases of cirrhosis. We therefore aimed to investigate LA volumes using the novel 3DE technique in relation to liver dysfunction and outcome in patients with cirrhosis. A prospective study of 47 cirrhotic patients without cardiovascular disease and ten healthy controls. The patients underwent clinical evaluation, blood sampling, liver vein catheterization, ECG and tissue Doppler echocardiography, including 3DE. Patients were followed up for a median of 25 months with registration of death and liver transplantation (LT). 3DE-derived maximal left atrial volume index (LAVImax) and minimal left atrial volume index (LAVImin) were higher in patients with a Child Pugh score of 8 or higher than in patients with a score lower than 8 (30.0 vs. 22.3 mL/m2, P=0.008 and 14.6 vs. 9.5 mL/m2, P=0.04, respectively). LA volumes correlated with model for end-stage liver disease (MELD) score (r=0.40, P=0.005), hepatic venous pressure gradient (r=0.34, P=0.04), and biochemical markers of advanced liver disease. Twelve patients experienced the composite end-point of death or LT during follow-up and these patients had increased LA volumes with a higher LAVImax (34.3±14.8 vs. 25.9±7.3 mL/m2, P=0.01) and a higher LAVImin (16.3±7.3 vs. 10.8±5.1 mL/m2, P=0.007). Patients with advanced cirrhosis have increased minimal and maximal left atrial volumes, which correlate with the degree of the liver dysfunction and poor prognosis.
Liu, Wen; Zhang, Yanfen; Liu, Yan; Ma, Chunyan; Yang, Jun; Sun, Dandan
doi: 10.1007/s10554-020-01921-6pmid: 32602022
We conducted this study to investigate left ventricle (LV) systolic function in endocardial, mid-myocardial, and epicardial layers by two-dimensional (2D) speckle tracking echocardiography (STE) in hypertrophic cardiomyopathy (HCM) patients with myocardial injury indexed by elevated serum cardiac troponin I (cTnI). Twenty-nine HCM patients with myocardial injury, thirty-five HCM patients without myocardial injury, and ninty-one healthy controls were enrolled in this study. Serum cTnI > 0.026 ng/mL was defined as myocardial injury. LV longitudinal and circumferential strain (LS and CS) were assessed in endocardial, mid-myocardial and epicardial layers. Layer-specific LS and CS differed significantly (all P < 0.001) among all three groups in all three layers, in a descending order from healthy controls to HCM patients without myocardial injury to HCM patients with myocardial injury. Layer-specific LS and CS were decreased the most in HCM patients with myocardial injury indexed by elevated seum cTnI (all P < 0.05). In HCM patients with myocardial injury, layer-specific LS and CS were significantly lower in the segments with greater hypertrophy (segmental thickness ≥ 15 mm) (all P < 0.001) except for endocardial CS (P > 0.05). Layer-specific evaluation of LV strain may improve understanding of impaired LV systolic function in HCM patients with myocardial injury, thus preventing further damage.
Li, Zhaohuan; Tan, Jing; Liu, Xuebing; Zhang, Wenjun; Meng, Qingguo; Zhou, Mi; Lin, Ni; Cao, Fei; Lu, Jing; Liu, Jun; Yin, Lixue
doi: 10.1007/s10554-020-01922-5pmid:
Resende, Maria Betânia Solis; Ferrari, Teresa Cristina A.; Araujo, Christiano Gonçalves; Vasconcelos, Maria Carmen Melo; Tupinambás, Julia Teixeira; Dias, Rebeca Coeli Teodoro Maciel; Barros, Flávio Coelho; Januário, José Nélio; Barbosa, Marcia Melo; Nunes, Maria Carmo Pereira
Castillo-Sang, Mario; Palmer, Cassady; Truong, Vien T.; Young, Michael; Wolking, Sarah; Alsaied, Tarek; Drake, Daniel; Mazur, Wojciech
doi: 10.1007/s10554-020-01931-4pmid: 32638288
We sought to study the mechanics of ventricular contraction in patients with and outward basal movement. Using echocardiographic parasternal long-axis views we retrospectively screened 760 echocardiograms to enroll 50 individuals with late systolic bileaflet prolapse, papillary muscle traction, and outward movement of the sub-annular base and posterior mitral annulus in late systole. Two-dimensional speckle tracking echocardiography was used to analyze the mechanics of contraction. Global and regional longitudinal strain values between the study group and 45 healthy control subjects were compared. The study group’s global strain was lower compared to the control group. We identified a pattern of weak contraction of the inferior and lateral walls in the late systolic bileaflet prolapse group. The weakest segment in the study group was the basal-inferolateral segment (− 15.8% vs. − 21.5%, p < 0.001). There was no relationship between the mitral annular size, degree of leaflet prolapse, or degree of basal weakness. Late systolic bileaflet mitral prolapse and papillary muscle traction are accompanied by an outward movement of the sub-annular base and posterior mitral annulus in late systole. We demonstrated an abnormal contractile pattern in these ventricles characterized by a weaker contraction of the base, most significant at the inferolateral segment. This weakness of contraction may contribute to the outward movement of the base and posterior annulus.
Ma, Mingming; Li, Yuhui; Chen, Ran; Huang, Chao; Mao, Yankai; Zhao, Bowen
doi: 10.1007/s10554-020-01932-3pmid: 32642877
The main objective of this study was to investigate the diagnostic performance of FINE in generating and displaying 3 specific abnormal fetal echocardiography views such as left ventricular outflow tract (LVOT) view, right ventricular outflow tract (RVOT) view, and 3-vessels and trachea (3VT) view in fetuses with double-outlet right ventricle (DORV). In this prospective study, thirty fetuses diagnosed with DORV by fetal echocardiography in the second and third trimesters were enrolled. One or more STIC volume data-sets were collected from the 4-chamber view as initial view for each fetus, one optimal volume per fetus was selected for on-line analysis using FINE, and the diagnosis plane image was optimized using the Virtual Intelligent Sonographer Assistance (VIS-assistance).The visualization rates of 3 specific abnormal fetal echocardiography views of DORV and key diagnostic elements were calculated. One or more STIC volumes (n = 30 total) were obtained in 25 patients. A single STIC volume per patient was analyzed using the FINE method. FINE was able to successfully generate and display 3 specific abnormal fetal echocardiography views. The display rates of the 3 specific abnormal fetal echocardiography views (3VT, LVOT, RVOT) were 84.0%, 76.0% and 84.0%, respectively. By applying intelligent navigation technology to STIC volume data-sets, the FINE method can successfully generate three specific abnormal cardiac fetal echocardiography diagnostic views in fetuses with DORV, the FINE method can be used for screening and remote consultation of fetal DORV.
Showing 1 to 10 of 25 Articles
Use of echocardiography to evaluate the characteristics of right heart and pulmonary artery of Tibetans with hepatic hydatidosis living in a high plateau area. We recruited 222 Tibetan adults diagnosed with hydatidosis from June 2016 to June 2017 in Shiqu and Seda areas of Tibet; 40 healthy control from the same area, denoted as the high plateau group. We also include 755 Healthy adults of Han nationality living in the plain from the EMINCA study as the low altitude group. Compared to high plateau group, hydatidosis individuals showed decreased RVADed, RVTDed, increased E(T)/A(T) and reduced RVFAC and TAPSE (p < 0.05). The 2 groups did not differ in the incidence rate of tricuspid regurgitation (TR) and pulmonary regurgitation (PR) (63.9% vs. 55.0%, p = 0.281 and 15.3% vs. 5.0%, p = 0.135, respectively) or incidence of pulmonary hypertension (PH) (13.9% vs. 20.5%, p = 0.167). PH risk did not differ between hydatidosis individuals and high plateau controls (OR 0.559, 95% CI 0.243–1.287). The RVADed and TAPSE were higher and E(T)/A(T) was lower for high plateau group than low altitude group (p < 0.05). The decreased right ventricular size and reduced diastolic and systolic function were found in Tibetans with hydatidosis. Hepatic hydatidosis had no significant effect on the incidence of pulmonary hypertension in Tibetans. Healthy Tibetans showed increased right ventricular size, decreased diastolic function, and increased systolic function compared to the Han counterparts.
doi: 10.1007/s10554-020-01924-3pmid: 32621039
Cardiovascular complications have been increasingly detected in patients with sickle cell disease (SCD). Two-dimensional speckle-tracking echocardiography (STE) detects early myocardial changes in a number of pathophysiological processes, which may be useful in SCD. This study was designed to examine the value of STE in predicting clinical outcome in adult patients with SCD. A total of 219 patients, mean age 33 ± 12 years were prospectively enrolled. Several clinical, laboratory and echocardiographic variables including left ventricular global longitudinal strain (LVGLS) by STE were assessed. The endpoint was a composite of the following events: (1) all-cause mortality, (2) three or more acute painful episodes that require hospitalization in one year, (3) acute chest syndrome and (4) hospitalization due to disease complication. The majority of the patients had enlargement of LV and left atrial (LA) with preserved ejection fraction. During the mean follow-up of 30 months, 69 patients (32%) had reached the endpoint, including eight deaths (3.7%). No difference was observed in the parameters of diastolic function comparing the patients with and without events. LVGLS ranged from − 12.25 to − 25.44 (mean − 20.26 ± 2.5), with higher values in the patients who had events compared with those who did not. In the multivariable analysis, higher LVGLS values were associated with adverse events (adjusted OR 1.25; 95% CI 1.04–1.51; p = 0.021), independently of the TR maximal velocity and LV ejection fraction. In patients with SCD, higher LV global longitudinal strain was a predictor of adverse outcome, independently of age, TR velocity and LV function.