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Echocardiographic Assessment (echocardiographic + assessment)

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Medical Sciences	100%

Selected Abstracts

Live/Real Time Three-Dimensional Transthoracic Echocardiographic Assessment of Pericardial Disease

ECHOCARDIOGRAPHY, Issue 10 2009
Carlos Martinez Hernandez M.D.
We studied 19 patients with pericardial disease using two-dimensional and three-dimensional transthorathic echocardiography (2DTTE and 3DTTE, respectively) in order to determine whether 3DTTE provides incremental value on top of 2DTTE in the evaluation of these patients. With 3DTTE a more comprehensive assessment of pericardial effusion can be made and both the parietal and visceral layers of the pericardium can be visualized en face and examined for pathologies and fibrin deposits. In our series of patients, 3DTTE was superior to 2DTTE in uncovering mass lesions involving the pericardium such as tuberculous granulomas and metastatic disease. Furthermore, it provided a better assessment of the nature of pericardial lesions, such as pericardial and mediastinal hematomas, pericardial cysts, and metastatic disease to the pericardium by sequential cropping of the 3D data sets and visualizing the interior of the lesions in a manner not possible with 2DTTE. It was also valuable in determining the extent of pericardial calcification in pericardial constriction and in measuring the size of pericardial masses. These preliminary results suggest the superiority of 3DTTE over 2DTTE in the evaluation of pericardial diseases and that it provides incremental knowledge to the echocardiographer. [source]

Live/Real Time Three-Dimensional Transthoracic Echocardiographic Assessment of Bicuspid Aortic Valve Morphology

ECHOCARDIOGRAPHY, Issue 4 2009
Preeti Singh M.D.
We describe the usefulness of three-dimensional transthoracic echocardiography (3D TTE) in the assessment of bicuspid aortic valve morphology in an adult patient with no stenosis but severe aortic regurgitation. [source]

Differences in Echocardiographic Assessment with Standard Doppler and Tissue Doppler Imaging of Left Ventricular Filling Pressure in Idiopathic and Ischemic Dilated Cardiomyopathy

ECHOCARDIOGRAPHY, Issue 7 2008
Pierluigi Costanzo M.D.
Background: In idiopathic and ischemic dilated cardiomyopathy (DCM) there are differences in left atrial and ventricular relaxation. We assessed the hypothesis of an influence of these dissimilarities in assessing left ventricular filling pressure (LVFP) in these two DCMs by standard Doppler and tissue Doppler imaging. In particular, we focused on early transmitral flow to early diastolic motion velocity of mitral annulus ratio (E/Ea), useful to estimate normal or elevated LVFP. However, when found in intermediate range (8,15), its role is unclear. Methods and Results: We evaluated 26 patients with ischemic and 21 patients with idiopathic DCM. To validate the echocardiographic estimation of LVFP, a sample (12 patients) underwent LVFP assessment by catheterization. In idiopathic DCM, E/Ea directly related to duration of retrograde pulmonary venous flow (ARd) (r = 0.66 P = 0001). In ischemic DCM E/Ea inversely related only to systolic to diastolic velocity ratio of pulmonary venous flow (S/D) (r =,0.56 P = 0002). After a mean follow up of 6 months, by a second echocardiogram we observed a direct relation between E/Ea and ARd percentage variation (r = 0.52 P = 0.02) in idiopathic DCM group, whereas in the ischemic DCM group there was an inverse relation between E/Ea and S/D percentage variation (r =,0.59 P = 0.02).Conclusions: In conclusion, ARd in idiopathic and S/D in ischemic DCM might be used as specific additional information to estimate LVFP when E/Ea falls within intermediate range. [source]

Two- and Three-Dimensional Transthoracic Echocardiographic Assessment of Hiatal Hernia

ECHOCARDIOGRAPHY, Issue 7 2008
Mohit Gupta M.D.
Using two- (2DTTE) and three-dimensional transthoracic echocardiography (3DTTE) and an oral contrast agent (a carbonated beverage), a mass-like lesion behind the left ventricular posterior wall in an elderly female was definitively diagnosed as a hiatal hernia. A 3DTTE provided a more comprehensive evaluation of the hiatal hernia as compared to the 2DTTE in terms of its size and extent and thickness of the wall. The size of the hernia was underestimated by 2DTTE (3.3 × 3.2 cm) as compared to 3DTTE (at least 7 × 4.8 cm). The maximum thickness of the gastric wall was also found to be larger by 3DTTE (11 mm) as compared to 2DTTE (5 mm). Both the size of the hernia and thickness of the wall have important clinical implications. The size has been reported to be the strongest predictor of severity of esophagitis and gastric wall thickness of 10 mm or more has been associated with malignant or potentially malignant gastric lesions. [source]

Live/Real Time Three-Dimensional Transthoracic Echocardiographic Assessment of Left Ventricular Volumes, Ejection Fraction, and Mass Compared with Magnetic Resonance Imaging

ECHOCARDIOGRAPHY, Issue 2 2007
Xin Qi M.D.
Due to reliance upon geometric assumptions and foreshortening issues, the traditionally utilized transthoracic two-dimensional echocardiography (2DTTE) has shown limitations in assessing left ventricular (LV) volume, mass, and function. Cardiac magnetic resonance imaging (MRI) has shown potential in accurately defining these LV characteristics. Recently, the emergence of live/real time three-dimensional (3D) TTE has demonstrated incremental value over 2DTTE and comparable value with MRI in assessing LV parameters. Here we report 58 consecutive patients with diverse cardiac disorders and clinical characteristics, referred for clinical MRI studies, who were evaluated by cardiac MRI and 3DTTE. Our results show good correlation between the two modalities. [source]

Echocardiographic Assessment of Left Ventricular Mass in Neonatal and Adult Mice: Accuracy of Different Echocardiographic Methods

ECHOCARDIOGRAPHY, Issue 10 2006
Alexander Ghanem M.D.
Echocardiography is an established method to estimate left-ventricular mass (LVM) in mice. Accuracy is determined by cardiac size and morphology and influenced by mathematical models. We investigated accuracy of three common algorithms in three early developmental stages. High-resolution echocardiography was performed in 35 C57/BL6-mice. Therefore, two-dimensional-guided M-mode echocardiography and parasternal short- and long-axis views in B-mode were obtained. LVM was assessed in vivo applying Penn (P), Area Length (AL), and Truncated Ellipsoid (TE) algorithms and validated with histomorphometry. Regression analysis of all mice showed fair estimation of LVM assessed with M-mode-based Penn algorithm (y = 0.6*x , 0.12, r: 0.71). In contrast two-dimensional assessment of LVM revealed close linear relationship with histomorphometry (yAL= 1.21*x , 12.1, r: 0.88, yTE= 1.38*x , 2.88, r: 0.86). Bias was lowest for LVM-AL at diastole underestimating 3.2%. In concordance with the summarized data, LVM-P revealed lower regression coefficients and significant underestimation in all three subgroups. Small hearts (<50 mg, n = 12) correlated best with LVM-AL at systole. Hearts of adolescent (50,75 mg, n = 13) and adult (75,100 mg, n = 10) mice revealed close linear relationship with LVM-AL and LVM-TE at diastole. Echocardiographic assessment of LVM is feasible in hearts weighting less than 50 mg and can be estimated best in systole. Hearts weighting more than 50 mg are estimated most accurately by means of LVM-AL at diastole. [source]

Live Three-Dimensional Echocardiographic Assessment of Mitral Stenosis

ECHOCARDIOGRAPHY, Issue 8 2003
Vikramjit Singh M.D.
In the present study, we describe our experience in using live three-dimensional transthoracic echocardiography in the assessment of mitral stenosis. (ECHOCARDIOGRAPHY, Volume 20, November 2003) [source]

Editorial: Doppler Echocardiographic Assessment of Ventricular Function,Time to Move to the Right?

JOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 6 2005
DECVIM (Cardiology), Karsten E. Schober DVM
No abstract is available for this article. [source]

Two-Dimensional Assessment of Right Ventricular Function: An Echocardiographic,MRI Correlative Study

ECHOCARDIOGRAPHY, Issue 5 2007
Nagesh S. Anavekar M.D.
Background: While echocardiography is used most frequently to assess right ventricular (RV) function in clinical practice, echocardiography is limited in its ability to provide an accurate measure of RV ejection fraction (RVEF). Hence, quantitative estimation of RV function has proven difficult in clinical practice. Objective: We sought to determine which commonly used echocardiographic measures of RV function were most accurate in comparison with an MRI-derived estimate of RVEF. Methods: We analyzed RV function in 36 patients who had cardiac MRI studies and echocardiograms within a 24 hour period. 2D parameters of RV function,right ventricular fractional area change (RVFAC), tricuspid annular motion (TAM), and transverse fractional shortening (TFS) were obtained from the four-chamber view. RV volumes and EFs were derived from volumetric reconstruction based on endocardial tracing of the RV chamber from the short axis images. Echocardiographic assessment of RV function was correlated with MRI findings. Results: RVFAC measured by echocardiography correlated best with MRI-derived RVEF (r = 0.80, P < 0.001). Neither TAM (r = 0.17; P = 0.30) nor TFC (r = 0.12; p< 0.38) were significantly correlated with RVEF. Conclusions: RVFAC is the best of commonly utilized echocardiographic 2D measure of RV function and correlated best with MRI-derived RV ejection fraction. Condensed Abstract: While echocardiography is used most frequently to assess RV function in clinical practice, echocardiography is limited in its ability to provide an accurate measure of RV ejection fraction (RVEF). Using cardiac MRI, RV fractional area change (RVFAC), determined either by MRI or echocardiography, was found to correlate best with MRI-derived RVEF. [source]

Echocardiographic Assessment of Left Ventricular Mass in Neonatal and Adult Mice: Accuracy of Different Echocardiographic Methods

TNF-,-mediated signal transduction pathway is a major determinant of apoptosis in dilated cardiomyopathy

JOURNAL OF CELLULAR AND MOLECULAR MEDICINE, Issue 7 2010
Samarjit Das
Abstract Although J2N-k strain of cardiomyopathic hamsters is an excellent model of dilated cardiomyopathy, the presence and mechanisms of apoptosis in the hearts of these genetically modified animals have not been investigated. This study examined the hypothesis that cardiac dysfunction and apoptosis in the cardiomyopathic hamsters were associated with tumour necrosis factor-alpha (TNF-,)-mediated signalling pathway involving the activation of some pro-apoptotic proteins and/or deactivation of some antiapoptotic proteins. Echocardiographic assessment of 31-week-old hamsters indicated an increase in the internal dimension of the left ventricle as well as decreases in the ejection fraction, fractional shortening and cardiac output without any evidence of cardiac hypertrophy. Increased level of TNF-, and apoptosis in cardiomyopathic hearts were accompanied by increased protein content for protein kinase C (PKC) -, and -, isozymes as well as caspases 3 and 9. Phosphorylated protein content for p38 MAPK and NF,B was increased whereas that for Erk1/2, BAD and Bcl-2 was decreased in cardiomyopathic hearts. These results support the view that TNF-, and PKC isozymes may promote apoptosis due to the activation of p38 MAPK and deactivation of Erk1/2 pathways, and these changes may contribute toward the development of cardiac dysfunction in dilated cardiomyopathy. [source]

Is the Presence of Mitral Annular Calcification Associated with Poor Left Atrial Function?

ECHOCARDIOGRAPHY, Issue 8 2009
Vignendra Ariyarajah M.D.
Introduction: Mitral annular calcification (MAC) is characterized by calcium and lipid deposition in the annular fibrosa of the mitral valve. MAC is associated with cardiovascular events but little is known of its association with left atrial (LA) function. Methods: We prospectively obtained 12-lead electrocardiograms (ECGs) and transthoracic echocardiograms (TTE) on patients scheduled for nonemergent echocardiographic assessment at a tertiary care hospital. MAC was graded as 0 = none, 1 = mild, 2 = moderate, 3 = severe. LA linear and volume measurements (stroke volume, LA passive emptying fraction, LA active emptying fraction and LA kinetic energy) were done specifically in addition to commonly measured TTE parameters. Results: From the 124 considered for the study, 72 patients remained (aged 68±18 years; 44% male) after excluding those with poor ECG tracings and/or poor TTE images. Eighteen patients had MAC; mild MAC = 14, moderate MAC = 3, severe MAC = 1. When patients with MAC were compared to those without MAC, no significant difference was noted, except for LA linear dimension index (2.1±0.4 vs. 1.9±0.3 cm/m2; P = 0.03). For those with mild and moderate MAC, a trend was noted toward lower LA function with increasing MAC severity. In addition, significant differences were noted between those with and without interatrial conduction delay, where those with such delay had significantly impaired LA stroke volume (9.8±3 vs. 19.93±4 ml; P < 0.0001), LA active emptying fraction (18.83±8 vs. 65.71±9%; P < 0.0001) and LA total/reservoir fraction (39.54±6 vs. 75.1±6%; P < 0.0001). Conclusions: MAC is associated with increase in LA linear dimension on TTE and may be equally represented with lower overall LA function. Further study in a much larger cohort is warranted to delineate these and other potential associations of MAC. [source]

Anaphylaxis: Clinical concepts and research priorities

EMERGENCY MEDICINE AUSTRALASIA, Issue 2 2006
Simon GA Brown
Abstract Anaphylaxis is a severe immediate-type hypersensitivity reaction characterized by life-threatening upper airway obstruction bronchospasm and hypotension. Although many episodes are easy to diagnose by the combination of characteristic skin features with other organ effects, this is not always the case and a workable clinical definition of anaphylaxis and useful biomarkers of the condition have been elusive. A recently proposed consensus definition is ready for prospective validation. The cornerstones of management are the supine position, adrenaline and volume resuscitation. An intramuscular dose of adrenaline is generally recommended to initiate treatment. If additional adrenaline is required, then a controlled intravenous infusion might be more efficacious and safer than intravenous bolus administration. Additional bronchodilator treatment with continuous salbutamol and corticosteroids are used for severe and/or refractory bronchospasm. Aggressive volume resuscitation, selective vasopressors, atropine (for bradycardia), inotropes that bypass the ,-adrenoreceptor and bedside echocardiographic assessment should be considered for hypotension that is refractory to treatment. Management guidelines continue to be opinion- and consensus-based, with retrospective studies accounting for the vast majority of clinical research papers on the topic. The clinical spectrum of anaphylaxis including major disease subgroups requires clarification, and validated scoring systems and outcome measures are needed to enable good-quality prospective observational studies and randomized controlled trials. A systematic approach with multicentre collaboration is required to improve our understanding and management of this disease. [source]

Tissue Doppler echocardiographic assessment of cardiac function in children with bronchial asthma

PEDIATRICS INTERNATIONAL, Issue 6 2007
CENAP ZEYBEK
Abstract Background: The aim of the present study was to evaluate the role of tissue Doppler echocardiography in assessment of ventricular function in pediatric patients with bronchial asthma (BA). Patients and methods: Fifty-one pediatric patients with BA and 30 age- and sex-matched healthy subjects were studied. BA patients were divided into two groups: mild BA (n = 33) and moderate to severe BA (n = 18). All subjects were examined on conventional and tissue Doppler echocardiography, and 44 patients had pulmonary function tests on spirometry within 1 week of echocardiographic examination. Results: Conventional echocardiographic parameters were all similar in mild asthmatic patients and control subjects. Tricuspid E velocity, E/A ratio and isovolumetric relaxation time (IVRT) in moderate and severe cases differed significantly from mild cases and control subjects. E,, A,, E,/A, ratio and IVRT of the lateral tricuspid annulus, and IVRT of the medial and lateral mitral annuli were different between mild cases and control subjects. E, velocity and IVRT of the lateral tricuspid annulus and IVRT of the medial and lateral mitral annuli were also different between mild cases and moderate to severe cases. Pulmonary function tests correlated well with E,, E,/A, and IVRT of lateral tricuspid annulus. Conclusion: Patients with BA have subclinical right ventricular diastolic dysfunction even in the early stages. The severity of the functional impairment is parallel with the severity of the disease. Tissue Doppler echocardiography has a greater predictive value than conventional imaging, and is useful for evaluating ventricular function in patients with BA. [source]

Inhaled nitric oxide improves oxygenation in very premature infants with low pulmonary blood flow

ACTA PAEDIATRICA, Issue 1 2004
R Desandes
Aim: Inhaled nitric oxide (iNO) is used to reduce right-to-left extrapulmonary shunting by decreasing pulmonary vascular resistance in term or near-term infants. The objectives of this study were to determine, first, the pulmonary blood flow status of very preterm infants with hypoxaemic respiratory failure, then the response of oxygenation to iNO therapy according to pulmonary blood flow (PBF) and, finally, to verify the lack of adverse side effects of iNO on the ductus arteriosus. Methods: Infants below 32 wk gestational age (GA) with hypoxic respiratory failure and aAO2 < 0.22 were randomized as the control or iNO group. PBF was evaluated by pulsed Doppler measurement of mean pulmonary blood flow velocity (MPBFV) in the left pulmonary artery. Low PBF (LPBF) was defined as MPBFV >0.2m/s. Results: Seventy infants of 23 to 31 wk GA with hypoxic respiratory failure were randomized either to receive or not to receive 5 ppm iNO in addition to optimal care. Twenty-eight infants were diagnosed with LPBF (11/35 in iNO vs 17/35 in the control groups). Thirty minutes after receiving iNO the number of LPBF infants dropped to 8/35. In the iNO group, aAO2 increased significantly from 0.14 ± 0.05 to 0.24 ± 0.08 after iNO, but only in the LPBF infants (mean ± SD; p= 0.027). Conclusion: In infants below 32 wk GA with hypoxic respiratory failure, Doppler echocardiographic assessment of LPBF seems to be able to determine which patients are likely to benefit from iNO therapy on systemic oxygenation. [source]