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Echo Research and Practice

Philip McCall, Alvin Soosay, John Kinsella, Piotr Sonecki, Ben Shelley
Right ventricular (RV) dysfunction occurs following lung resection and is associated with post-operative complications and long-term functional morbidity. Accurate peri-operative assessment of RV function would have utility in this population. The difficulties of trans thoracic echocardiographic (TTE) assessment of RV function may be compounded following lung resection surgery and no parameters have been validated in this patient group. This study compares conventional TTE methods for assessing RV systolic function to a reference method in a lung resection population...
December 1, 2018: Echo Research and Practice
Michael Roshen, Sophia John, Selda Ahmet, Rajiv Amersey, Sandy Gupta, George Collins
The British Society of Echocardiography (BSE) highlights the importance of patient questionnaires as part of the quality improvement process, To this end, we implemented a novel system whereby paired surveys were completed by patients and physiologists for transthoracic echocardiography scans, allowing for parallel comparison of the experiences of service providers and end users. Anonymised questionnaires were completed for each scan by the patient and physiologist for outpatient echocardiographic scans in a teaching hospital...
December 1, 2018: Echo Research and Practice
Hannah Bellsham-Revell, Navroz Masani
Sequential segmental analysis allows clear description of the cardiac structure in a logical fashion without assumptions and confusing nomenclature. Each segment is analysed, and then the connections described followed by any associated anomalies. For the echocardiographer there are several key features of the cardiac structures to help differentiate and accurately describe them.
November 1, 2018: Echo Research and Practice
Navroz Masani
The Echocardiography Quality Framework is a cohesive, patient-centered program, combining quality assurance and continuous service improvement, which can be adapted to suit the needs of any echocardiography department. The framework encompasses measures of the quality of care, reproducibility and consistency, education and training, and customer feedback. The EQF is scalable and adaptable to benefit any echocardiography service. A catalogue or library of supporting documents is being developed, drawing on expertise around the UK, to made available to any participating department...
October 1, 2018: Echo Research and Practice
Maryam Alsharqi, William Woodward, Angela Mumith, Deborah Markham, Ross Upton, Paul Leeson
Echocardiography plays a crucial role in the diagnosis and management of cardiovascular disease. However, interpretation remains largely reliant on the subjective expertise of the operator. As a result inter-operator variability and experience can lead to incorrect diagnoses. Artificial intelligence (AI) technologies provide new possibilities for echocardiography to generate accurate, consistent and automated interpretation of echocardiograms, thus potentially reducing the risk of human error. In this review, we discuss a subfield of AI relevant to image interpretation, called machine learning, and its potential to enhance the diagnostic performance of echocardiography...
October 1, 2018: Echo Research and Practice
Zhi Hao Teoh, James Roy, Joseph Reiken, Michael Papitsas, Jonathan Byrne, Mark Monaghan
Moderate-to-severe tricuspid regurgitation is associated with higher mortality and morbidity yet remains significantly undertreated. The reasons for this are complex but include a higher operative mortality for patients undergoing isolated tricuspid valve surgery. This study sought to determine the prevalence of patients with moderate-to-severe tricuspid regurgitation and identify those who could be potentially suitable for percutaneous tricuspid valve intervention by screening patients referred for transthoracic echocardiography (ECHO) at a tertiary center...
October 1, 2018: Echo Research and Practice
Mohammed Andaleeb Chowdhury, Jered M Cook, George V Moukarbel, Sana Ashtiani, Thomas A Schwann, Mark R Bonnell, Christopher J Cooper, Samer J Khouri
Background This analysis aims to assess the prognostic value of pre-operative right ventricular echocardiographic parameters in predicting short-term adverse outcomes and long-term mortality after coronary artery bypass graft (CABG). Methods Study design: Observational retrospective cohort. Pre-operative echocardiographic data, perioperative adverse outcomes (POAO) and long-term mortality were retrospectively analyzed in 491 patients who underwent isolated CABG at a single academic center between 2006 and 2014...
December 1, 2018: Echo Research and Practice
A E Velcea, S Mihaila Baldea, D Muraru, L P Badano, D Vinereanu
Neck venous malformations and their potentially life-threatening complications are rarely reported in the available literature. Cases of aneurysmal or hypo-plastic jugular vein thrombosis associated with systemic embolization have not been frequently reported. We present the case of a 60-year-old male, without any known risk factors for thromboembolic disease, admitted for sudden onset dyspnea. The physical examination was remarkable for a right lateral cervical mass, expanding with Valsalva maneuver. Thoracic CT with contrast established the diagnosis of bilateral pulmonary embolism and raised the suspicion of superior vena cava and right atrial thrombosis...
December 1, 2018: Echo Research and Practice
Thomas E Ingram, Steph Baker, Jane Allen, Sarah Ritzmann, Nina Bual, Laura Duffy, Chris Ellis, Karina Bunting, Noel Black, Marcus Peck, Sandeep S Hothi, Vishal Sharma, Keith Pearce, Richard P Steeds, Navroz Masani
Background Quality assurance (QA) of echocardiographic studies is vital to ensure that clinicians can act on findings of high quality to deliver excellent patient care. To date, there is a paucity of published guidance on how to perform this QA. The British Society of Echocardiography (BSE) has previously produced an Echocardiography Quality Framework (EQF) to assist departments with their QA processes. This article expands on the EQF with a structured yet versatile approach on how to analyse echocardiographic departments to ensure high-quality standards are met...
December 1, 2018: Echo Research and Practice
P Luke, C Eggett, I Spyridopoulos, T Irvine
At present there are two recognised guidelines for the echocardiographic assessment of left ventricular diastolic function provided by the British Society of Echocardiography and American Society of Echocardiography/European Association of Cardiovascular Imaging. However, no direct comparison of these guidelines has been performed to establish whether they provide similar diastolic grading. One hundred and eighty-nine consecutive patients in sinus rhythm who underwent transthoracic echocardiography for a primary indication of either heart failure assessment or assessment of left ventricular systolic function were extracted from our database (McKesson Cardiology)...
December 1, 2018: Echo Research and Practice
Kai Neoh, Jamal N Khan, Khaled Albouaini, Adrian Chenzbraun
A 42-year-old intravenous drug user presented with seizures and septicaemia. CT and MRI were suggestive of multiple brain and systemic emboli, and blood and CSF cultures were positive for Staphylococcus aureus. Initial transthoracic echocardiogram did not show any abnormalities but subsequent transoesophageal echocardiography showed two masses in the left and the right ventricle. The LV mass was large, irregular, non-mobile and attached to the basal anterolateral LV segment abutting but not involving the mitral valve...
December 1, 2018: Echo Research and Practice
Sergio Barros-Gomes, Abdallah El Sabbagh, Mackram F Eleid, Sunil V Mankrad
Non-atherosclerotic myocardial infarction (MI) is an important but often misdiagnosed cause of acute MI. Furthermore, non-atherosclerotic MI with concomitant acute stroke and pulmonary embolism due to in-transit thrombus across a patent foramen ovale (PFO) is a rare but potentially fatal combination (1, 2, 3). Early detection of this clinical entity can facilitate delivery of targeted therapies and avoid poor outcome (1, 2). Here, we describe a 68-year-old female with hypertension, tobacco abuse and chronic obstructive pulmonary disease presenting with facial droop, right arm weakness and aphasia...
December 1, 2018: Echo Research and Practice
Sadie Bennett, Duwarakan Satchithananda, Gareth Law
Summary: A 42-year-old male was admitted with shortness of breath secondary to suspected heart failure and chest infection. An echocardiogram revealed a dilated and impaired left ventricle; ejection fraction 29%, with a large, mobile thrombus within the left ventricular apex. Due to the presence of liver dysfunction, vitamin K antagonists were deemed inappropriate; thus, the decision was taken to use the novel anticoagulation agent Apixaban. After 6 days of receiving Apixaban, a cardiac magnetic resonance scan was preformed, which showed complete resolution of the LV apical thrombus...
December 1, 2018: Echo Research and Practice
Victor Galusko, Owen Bodger, Adrian Ionescu
Introduction: Hand-held imaging devices are widely used in clinical practice and are a useful tool. There is no published review examining the diagnostic parameters achieved with these devices in clinical practice. Methods: We searched three online medical literature databases (PubMed, EMBASE and MEDLINE) for all literature published up until January 2018. We selected studies that (1) were conducted in the adult population; (2) used a truly hand-held device; (3) featured sensitivities and/or specificities on the use of the hand-held scanner...
December 1, 2018: Echo Research and Practice
C Bleakley, M Eskandari, O Aldalati, K Moschonas, M Huang, A Whittaker, M J Monaghan
Background: The mitral valve orifice area (MVOA) is difficult to assess accurately by 2D echocardiography because of geometric assumptions; therefore, 3D planimetry may offer advantages. We studied the differences in MVOA measurements between the most frequently used methods, to determine if 3D planimetry would result in the re-grading of severity in any cases, and whether it was a more accurate predictor of clinical outcomes. Methods: This was a head-to-head comparison of the three most commonly used techniques to grade mitral stenosis (MS) by orifice area and to assess their impact on clinical outcomes...
December 1, 2018: Echo Research and Practice
Neil David Hauser, Justiaan Swanevelder
Transoesophageal echocardiography (TOE) has, in certain clinical situations, become an almost universal monitor and diagnostic tool. In the perioperative environment, TOE is frequently used to guide anaesthetic management and assist with surgical decision making for, but not limited to, cardiothoracic, major vascular and transplant operations. The use of TOE is not limited to the theatre environment being frequently used in outpatient clinics, emergency departments and intensive care settings. Two case reports, one of oesophageal perforation and another of TOE utilization in a patient having previously undergone an oesophagectomy, introduce the need for care while using TOE and highlight the need for vigilance...
December 1, 2018: Echo Research and Practice
Keith Pearce, John Chambers
Dr Porter in his editorial comment (1) on a physiologist-led stress echo service (2) acknowledges that the service was safe in terms of adverse effects but is concerned that ‘the interpretation of the study was also done by the cardiac physiologist’. He reminds us ‘that the biggest danger associated with dobutamine stress echocardiography is in misinterpreting the data obtained…’.
December 1, 2018: Echo Research and Practice
Athina Chasapi, Adam Hobbs, Theodore Velissaris, Benoy N Shah
A 77-year-old male underwent elective bioprosthetic aortic valve replacement (23 mm Carpentier-Edwards Perimount MagnaEase) for severe aortic stenosis. His pre-discharge transthoracic echocardiogram (TTE) was normal. He presented 9 days after surgery with dyspnea and fever. He was in sinus rhythm. Blood cultures were taken and he was commenced on empirical antibiotics for possible infective endocarditis (subsequently all negative). Repeat TTE showed a well-seated prosthesis without regurgitation but elevated gradients (peak/mean gradients 69/48mmHg respectively)...
September 1, 2018: Echo Research and Practice
Sothinathan Gurunathan, Roxy Senior
Summary: We present the case of a 32-year-old man who presented with a remote history of chest pain and was diagnosed with non-compaction cardiomyopathy on echocardiography. On presentation, he was relatively asymptomatic with normal cardiac function. Unfortunately, he presented 1 year later with a catastrophic embolic stroke. Learning points: Left ventricular non-compaction (LVNC) is a myocardial disorder characterised by prominent left ventricular (LV) trabeculae, a thin compacted layer and deep intertrabecular recesses...
September 1, 2018: Echo Research and Practice
Manasawee Indrabhinduwat, Maria C Arciniegas Calle, Joseph P Colgan, Hector R Villarraga
Summary: Thirty-seven-year-old male presented with cough, dyspnea, significant weight loss (20 kg) and subacute fever for the past 2 months. Physical examination revealed inspiratory and expiratory wheezing bilaterally. A normal S1, S2 and a 3/6 systolic ejection murmur at the left upper parasternal border with respiratory variation were found during cardiac auscultation. Kidney and bone marrow biopsy reported a high-grade B-cell lymphoma. Echocardiography and cardiac CT findings consisted of multiple intracardiac masses affecting the right ventricular (RV) outflow track, RV apex, medial portion of the right atrium and posterior left atrium, as well as mild impairment of the RV systolic function...
September 1, 2018: Echo Research and Practice
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