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Echo Research and Practice

Boyang Liu, Nicola C Edwards, Simon Ray, Richard P Steeds
Mitral regurgitation (MR) is the second most common form of valvular disease requiring surgery. Correct identification of surgical candidates and optimising the timing of surgery is key in management. For primary MR, this relies upon a balance between the perioperative risks and rates of successful repair in patients undergoing early surgery when asymptomatic with the potential risk of irreversible left ventricular dysfunction if intervention is performed too late. For secondary MR, recognition that this is a highly dynamic condition where MR severity may change is key, although data on outcomes in determining whether concomitant valve intervention is performed with revascularisation has raised questions regarding timing of surgery...
October 13, 2016: Echo Research and Practice
M Qasem, V Utomi, K George, J Somauroo, A Zaidi, L Forsythe, S Bhattacharrya, G Lloyd, B Rana, L Ring, S Robinson, R Senior, N Sheikh, M Sitali, J Sandoval, R Steeds, M Stout, J Willis, D Oxborough
INTRODUCTION: Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is an inherited pathology that can increase the risk of sudden death. Current Task Force Criteria for echocardiographic diagnosis do not include new, regional assessment tools which may be relevant in a phenotypically diverse disease. We adopted a systematic review and meta-analysis approach to highlight echocardiographic indices that differentiated ARVC patients and healthy controls. METHODS: Data was extracted and analysed from prospective trials that employed a case-control design meeting strict inclusion and exclusion as well as a-priori quality criteria...
September 29, 2016: Echo Research and Practice
Rekha Mankad, Joerg Herrmann
Cardiac tumors are exceedingly rare (0.001-0.03% in most autopsy series). They can present anywhere within the heart and can be attached to any surface or be embedded in the myocardium or pericardial space. Signs and symptoms are non-specific and highly variable, related to the localization, size, and composition of the cardiac mass. Echocardiography, typically ordered for another indication, may be the first imaging modality alerting the clinician to the presence of a cardiac mass. Although echocardiography cannot give histopathology, certain imaging features and adjunctive tools such as contrast imaging may aid in the differential diagnosis as do adjunctive clinical data and the following principles: 1) thrombus or vegetations are the most likely etiology, 2) cardiac tumors are mostly secondary, and 3) primary cardiac tumors are mostly benign...
September 6, 2016: Echo Research and Practice
A King, J Thambyrajah, E Leng, M J Stewart
Herceptin (Trastuzumab) is a widely used and effective drug for the treatment of Her2+ breast cancer but its cardiotoxic side effects require regular monitoring by echocardiography. A 10% reduction in left ventricular ejection fraction can lead to suspension of treatment and therefore has significant implications for patient prognosis in terms of cardiac and cancer outcomes. Assessment of LV function by conventional 2D biplane method of discs (2DEF) has limitations in accuracy and reproducibility. Global longitudinal strain (GLS) is becoming more widely available and user friendly...
September 2016: Echo Research and Practice
John B Chambers
This is a practical description of how replacement valves are assessed using echocardiography. Normal transthoracic appearances including normal variants are described. The problem of differentiating normal function, patient-prosthesis mismatch and pathological obstruction in aortic replacement valves with high gradients is discussed. Obstruction and abnormal regurgitation is described for valves in the aortic, mitral and right-sided positions and when to use echocardiography in suspected infective endocarditis...
September 2016: Echo Research and Practice
James Yates, Colin Forbes Royse, Carolyn Royse, Alistair George Royse, David Jeffrey Canty
BACKGROUND: Ultrasound-assisted examination of the cardiovascular system with focused cardiac ultrasound by the treating physician is non-invasive and changes diagnosis and management of patient's with suspected cardiac disease. This has not been reported in a general practice setting. AIM: To determine whether focused cardiac ultrasound performed on patients aged over 50 years changes the diagnosis and management of cardiac disease by a general practitioner. DESIGN AND SETTING: A prospective observational study of 80 patients aged over 50years and who had not received echocardiography or chest CT within 12months presenting to a general practice...
September 2016: Echo Research and Practice
Kevin Emery Boczar, Olexiy Aseyev, Jeffrey Sulpher, Christopher Johnson, Ian G Burwash, Michele Turek, Susan Dent, Girish Dwivedi
BACKGROUND: Cardiotoxicity from anthracycline-based chemotherapy is an important cause of early and late morbidity and mortality in breast cancer patients. Left ventricular (LV) function is assessed for patients receiving anthracycline-based chemotherapy to identify cardiotoxicity. However, animal studies suggest that right ventricular (RV) function may be a more sensitive measure to detect LV dysfunction. The purpose of this pilot study was to determine if breast cancer patients undergoing anthracycline-based chemotherapy experience RV dysfunction...
September 2016: Echo Research and Practice
Y Tayyareci, R Dworakowski, P Kogoj, J Reiken, C Kenny, P MacCarthy, O Wendler, M J Monaghan
OBJECTIVE: To assess the impact of mitral geometry, left ventricular (LV) remodelling and global LV afterload on mitral regurgitation (MR) after trans-catheter aortic valve implantation (TAVI). METHODS: In this study, 60 patients who underwent TAVI were evaluated by 3D echocardiography at baseline, 1 month and 6 months after procedure. The proportional change in MR following TAVI was determined by examining the percentage change in vena contracta (VC) at 6 months...
September 2016: Echo Research and Practice
Umut Kocabas, Esra Kaya, Cahide Soydas Cinar
Extract: A 28-year-old asymptomatic woman was referred to ourclinic for evaluation of a heart murmur. Transthoracic echocardiography (TTE) demonstrated ventricular hypertrophy with septal thickness of 26 mm., consistent with hypertrophic cardiomyopathy (HCM). The diagnosis of HCM was confirmed by contrast-enhanced magnetic resonance imaging, and late gadolinium enhancement was observed in the anterior wall ...
June 17, 2016: Echo Research and Practice
Garvan C Kane, Arun Sachdev, Hector R Villarraga, Naser M Ammash, Jae K Oh, Michael D McGoon, Patricia A Pellikka, Robert B McCully
AIM: It is not well known if advancing age influences normal rest or exercise pulmonary artery pressures. The purpose of the study was to evaluate the association of increasing age with measurements of pulmonary artery systolic pressure at rest and with exercise. SUBJECTS AND METHODS: A total of 467 adults without cardiopulmonary disease and normal exercise capacity (age range: 18-85 years) underwent symptom-limited treadmill exercise testing with Doppler measurement of rest and exercise pulmonary artery systolic pressure...
June 2016: Echo Research and Practice
Mehdi Eskandari, Mark Monaghan
No abstract text is available yet for this article.
June 2016: Echo Research and Practice
Francesca Tedoldi, Maximilian Krisper, Clemens Köhncke, Burkert Pieske
UNLABELLED: SummaryWe present a very rare example of chronic right heart failure caused by torrent tricuspid regurgitation. Massive right heart dilatation and severe tricuspid regurgitation due to avulsion of the tricuspid valve apparatus occurred as a result of a blunt chest trauma following the explosion of a gas bottle 20 years before admission, when the patient was a young man in Vietnam. After this incident, the patient went through a phase of severe illness, which can retrospectively be identified as an acute right heart decompensation with malaise, ankle edema, and dyspnea...
June 2016: Echo Research and Practice
Ingeborg H F Herold, Salvatore Saporito, Massimo Mischi, Hans C van Assen, R Arthur Bouwman, Anouk G W de Lepper, Harrie C M van den Bosch, Hendrikus H M Korsten, Patrick Houthuizen
BACKGROUND: Pulmonary transit time (PTT) is an indirect measure of preload and left ventricular function, which can be estimated using the indicator dilution theory by contrast-enhanced ultrasound (CEUS). In this study, we first assessed the accuracy of PTT-CEUS by comparing it with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Secondly, we tested the hypothesis that PTT-CEUS correlates with the severity of heart failure, assessed by MRI and N-terminal pro-B-type natriuretic peptide (NT-proBNP)...
June 2016: Echo Research and Practice
Benoy N Shah, Roxy Senior
The incidence of significant obesity is rising across the globe. These patients often have a clustering of cardiovascular risk factors and are frequently referred for noninvasive cardiac imaging tests. Stress echocardiography (SE) is widely used for assessment of patients with known or suspected coronary artery disease (CAD), but its clinical utility in morbidly obese patients (in whom image quality may suffer due to body habitus) has been largely unknown. The recently published Stress Ultrasonography in Morbid Obesity (SUMO) study has shown that SE, when performed appropriately with ultrasound contrast agents (whether performed with physiological or pharmacological stress), has excellent feasibility and appropriately risk stratifies morbidly obese patients, including identification of patients who require revascularization...
June 2016: Echo Research and Practice
Cátia Costa, Teresa González-Alujas, Filipa Valente, Carlos Aranda, José Rodríguez-Palomares, Laura Gutierrez, Giuliana Maldonado, Laura Galian, Gisela Teixidó, Artur Evangelista
BACKGROUND: Left atrial deformation (LAD) parameters are new markers of atrial structural remodelling that seem to be affected in atrial fibrillation (AF) and atrial flutter (AFL). This study aimed to determine whether LAD can identify patients with a higher risk of thrombosis and unsuccessful electrical cardioversion (ECV). METHODS: Retrospective study including 56 patients with AF or AFL undergoing ECV, with previous transthoracic (TTE) and transoesophageal echocardiography (TEE) studies...
June 2016: Echo Research and Practice
Ashley Miller, Justin Mandeville
Echocardiography is ideally suited to guide fluid resuscitation in critically ill patients. It can be used to assess fluid responsiveness by looking at the left ventricle, aortic outflow, inferior vena cava and right ventricle. Static measurements and dynamic variables based on heart-lung interactions all combine to predict and measure fluid responsiveness and assess response to intravenous fluid resuscitation. Thorough knowledge of these variables, the physiology behind them and the pitfalls in their use allows the echocardiographer to confidently assess these patients and in combination with clinical judgement manage them appropriately...
June 2016: Echo Research and Practice
John Fryearson, Nicola C Edwards, Sagar N Doshi, Richard P Steeds
Transcatheter aortic valve implantation is now accepted as a standard mode of treatment for an increasingly large population of patients with severe aortic stenosis. With the availability of this technique, echocardiographers need to be familiar with the imaging characteristics that can help to identify which patients are best suited to conventional surgery or transcatheter aortic valve implantation, and what parameters need to be measured. This review highlights the major features that should be assessed during transthoracic echocardiography before presentation of the patient to the 'Heart Team'...
June 2016: Echo Research and Practice
Apostolos Vrettos, David Dawson, Chrysanthos Grigoratos, Petros Nihoyannopoulos
BACKGROUND: In this study, we investigate the correlation between reduced global longitudinal peak systolic strain (GLPSS) and the SYNTAX score (SS) in patients undergoing coronary angiography. METHODS: We examined 71 patients undergoing both echocardiogram and coronary angiography within 15 days. All patients had normal global and/or regional wall motion on resting echocardiogram. We calculated GLPSS using two-dimensional speckle-tracking echocardiography. SS was calculated for each group of patients based on the presence and/or the severity of coronary artery disease (CAD): no CAD on angiogram (n=10, control group), low SS (n=36, SS<22) and high SS (n=25, SS≥22)...
June 2016: Echo Research and Practice
Sitara G Khan, Dimitris Klettas, Stam Kapetanakis, Mark J Monaghan
Cardiac resynchronisation therapy (CRT) can profoundly improve outcome in selected patients with heart failure; however, response is difficult to predict and can be absent in up to one in three patients. There has been a substantial amount of interest in the echocardiographic assessment of left ventricular dyssynchrony, with the ultimate aim of reliably identifying patients who will respond to CRT. The measurement of myocardial deformation (strain) has conventionally been assessed using tissue Doppler imaging (TDI), which is limited by its angle dependence and ability to measure in a single plane...
March 2016: Echo Research and Practice
Rajesh Janardhanan, Muhammad Umar Kamal, Irbaz Bin Riaz, M Cristy Smith
UNLABELLED: SummaryIn intravenous drug abusers, infective endocarditis usually involves right-sided valves, with Staphylococcus aureus being the most common etiologic agent. We present a patient who is an intravenous drug abuser with left-sided (aortic valve) endocarditis caused by Enterococcus faecalis who subsequently developed an anterior mitral valve aneurysm, which is an exceedingly rare complication. A systematic literature search was conducted which identified only five reported cases in the literature of mitral valve aneurysmal rupture in the setting of E...
March 2016: Echo Research and Practice
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