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Cardiac ECHO in mitral regurgitation

Neil K Mehta, Jiwon Kim, Jonathan Y Siden, Sara Rodriguez-Diego, Javid Alakbarli, Antonino Di Franco, Jonathan W Weinsaft
Mitral regurgitation (MR) is a common cause of morbidity worldwide and an accepted indication for interventional therapies which aim to reduce or resolve adverse clinical outcomes associated with MR. Cardiac magnetic resonance (CMR) provides highly accurate means of assessing MR, including a variety of approaches that can measure MR based on quantitative flow. Additionally, CMR is widely accepted as a reference standard for cardiac chamber quantification, enabling reliable detection of subtle changes in cardiac chamber size and function so as to guide decision-making regarding timing of mitral valve directed therapies...
April 2017: Journal of Thoracic Disease
Francesco Versaci, Giampiero Vizzari, Domenico Sergi, Antonio Trivisonno, Giuseppe Andò, Stefano Nardi, Gian Paolo Ussia, Francesco Romeo
MitraClip therapy has been proposed as therapeutic option in selected patients with degenerative or functional mitral regurgitation (FMR), leading to clinical and prognostic benefits. Previous studies demonstrated the safety and the efficacy of MitraClip therapy on symptoms and left ventricular remodeling in cardiac resynchronization therapy (CRT) non-responder patients. We report a case of a CRT non-responder patient treated with MitraClip implantation followed by a new upgrading of the CRT for persistent FMR at the follow-up...
January 17, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Eugenio Picano, Quirino Ciampi, Rodolfo Citro, Antonello D'Andrea, Maria Chiara Scali, Lauro Cortigiani, Iacopo Olivotto, Fabio Mori, Maurizio Galderisi, Marco Fabio Costantino, Lorenza Pratali, Giovanni Di Salvo, Eduardo Bossone, Francesco Ferrara, Luna Gargani, Fausto Rigo, Nicola Gaibazzi, Giuseppe Limongelli, Giuseppe Pacileo, Maria Grazia Andreassi, Bruno Pinamonti, Laura Massa, Marco A R Torres, Marcelo H Miglioranza, Clarissa Borguezan Daros, José Luis de Castro E Silva Pretto, Branko Beleslin, Ana Djordjevic-Dikic, Albert Varga, Attila Palinkas, Gergely Agoston, Dario Gregori, Paolo Trambaiolo, Sergio Severino, Ayana Arystan, Marco Paterni, Clara Carpeggiani, Paolo Colonna
BACKGROUND: Stress echocardiography (SE) has an established role in evidence-based guidelines, but recently its breadth and variety of applications have extended well beyond coronary artery disease (CAD). We lack a prospective research study of SE applications, in and beyond CAD, also considering a variety of signs in addition to regional wall motion abnormalities. METHODS: In a prospective, multicenter, international, observational study design, > 100 certified high-volume SE labs (initially from Italy, Brazil, Hungary, and Serbia) will be networked with an organized system of clinical, laboratory and imaging data collection at the time of physical or pharmacological SE, with structured follow-up information...
January 18, 2017: Cardiovascular Ultrasound
Santosh Kumar Sinha, Shalini Garg, Ramesh Thakur, Vinay Krishna, Karandeep Singh, Mohit Sachan, Amit Goel, Mahamdula Razi, Umeshwar Pandey, Chandra Mohan Varma
BACKGROUND: The optimal timing of surgery in patients with chronic organic severe mitral regurgitation (MR) continues to be debated, especially for those who are asymptomatic. The aim of the study was to determine independent and additive prognostic value of exercise brain natriuretic peptide (eBNP) in patients with severe asymptomatic MR and normal left ventricular ejection fraction (LVEF). METHODS: Two hundred twenty-three consecutive patients with severe MR defined by effective regurgitant orifice (ERO) area ≥ 40 mm(2) and/or residual volume ≥ 60 mL, LVEF > 60%, and normal LV end-systolic diameter < 40 mm underwent symptom limited exercise treadmill test (TMT)...
November 2016: Journal of Clinical Medicine Research
Gregory Allan, Saman Nouranian, Teresa Tsang, Alexander Seitel, Maryam Mirian, John Jue, Dale Hawley, Sarah Fleming, Ken Gin, Jody Swift, Robert Rohling, Purang Abolmaesumi
We propose a joint information approach for automatic analysis of 2D echocardiography (echo) data. The approach combines a priori images, their segmentations and patient diagnostic information within a unified framework to determine various clinical parameters, such as cardiac chamber volumes, and cardiac disease labels. The main idea behind the approach is to employ joint Independent Component Analysis of both echo image intensity information and corresponding segmentation labels to generate models that jointly describe the image and label space of echo patients on multiple apical views, instead of independently...
January 2017: IEEE Transactions on Medical Imaging
Hisham Dokainish
PURPOSE OF REVIEW: Describe the contemporary assessment of cardiac hemodynamics using a comprehensive echo-Doppler examination in the heart failure (HF) patient. RECENT FINDINGS: Cardiac flow and filling pressures, on both the left and right sides of the heart, are fundamental to the accurate assessment of the HF patient. Accurate assessment of left ventricular (LV) and right ventricular (RV) systolic and diastolic function is necessary to establish, or exclude, HF as a cause or component of dyspnea in a given patient and to help determine causes of hemodynamic instability in HF patients...
September 2016: Current Opinion in Cardiology
Francesco Bandera, Greta Generati, Marta Pellegrino, Andrea Garatti, Valentina Labate, Eleonora Alfonzetti, Maddalena Gaeta, Serenella Castelvecchio, Lorenzo Menicanti, Marco Guazzi
Aims: In heart failure patients with reduced ejection fraction (HFrEF), exercise-induced functional mitral regurgitation (MR) may affect functional capacity and outcome. We sought to study functional and cardiac phenotypes of HFrEF patients according to the MR degree. Methods and results: We performed rest and exercise echocardiography (Ex-Echo), simultaneously combined with cardiopulmonary exercise test (CPET), in 102 HFrEF patients, identifying 3 groups: non-severe (ERO <20 mm2) MR (group A), exercise-induced severe (ERO ≥20 mm2) MR (group B), and rest severe MR (group C)...
March 1, 2017: European Heart Journal Cardiovascular Imaging
Phani Chakravarty Mutnuru, S N Singh, John D'Souza, Lakshmi Manasa Perubhotla
INTRODUCTION: Rheumatic heart disease is the most common cause of valvular heart disease throughout the world. Echocardiography is the dominant imaging investigation in the assessment of cardiac valvular disease and the role of Magnetic Resonance Imaging (MRI) is so far limited. However, due to rapid improvements in the cardiac MRI technology in past few years, this non invasive technique is gaining interest in the examination of cardiac valves. AIM: Our study was undertaken to define the role of MRI in the evaluation of Rheumatic valvular heart disease and to compare the role of MRI with transthoracic echocardiography with regard to quantity of stenosis and volume regurgitation...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
Peter H Ma, Ritu Sachdeva, Elizabeth C Wilson, Nina A Guzzetta
Polyvalvar myxomatous valve degeneration is a clinical pathology rarely encountered during cardiac anesthesia, but, when present, most commonly occurs in the context of a connective tissue disorder. Filamin A mutations have begun to be recognized as a source of progressive myxomatous mitral and tricuspid valve degeneration. These lesions can be diagnosed by echo, but their clinical presentation can be equivocal. We present a patient with significant echocardiographic findings of mitral and tricuspid valvar regurgitation, aortic dilatation, and intraoperative findings of aortic ectasia...
September 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Constantinos G Missouris, Darlington O Okonko, Apurva Bharucha, Mohamed Al-Obaidi, Amit K Mandal, Paul Highett-Smith, Donald R J Singer
BACKGROUND: The epidemiology of heart disease is changing, with rheumatic heart disease becoming less common but degenerative valve disorders, heart failure and atrial fibrillation (AF) increasing. OBJECTIVE: We sought to determine the prevalence of structural cardiac abnormalities in the apparently symptom-free adult population within our prospective echocardiography (echo) registry. METHODS: Our echo registry comprised echo studies and associated demographic and clinical data obtained prospectively from 362 consecutive asymptomatic subjects aged 50-74 years and without known heart disease referred between 2011 and 2012 from general practices in the South East of England...
August 2016: Postgraduate Medical Journal
Barbara Brzezińska, Krystyna Łoboz-Grudzień, Krystian Wita, Katarzyna Mizia-Stec, Zbigniew Gąsior, Jarosław D Kasprzak, Tomasz Kukulski, Celina Wojciechowska, Władysław Sinkiewicz, Ilona Kowalik, Krzysztof Dudek, Edyta Płońska-Gościniak
BACKGROUND AND AIM: The study was undertaken to assess the predictive role of myocardial contractile reserve for functional mitral regurgitation (FMR) improvement after cardiac resynchronisation therapy (CRT), and to define other predictors of FMR improvement (FMRI) and the impact of FMRI on left ventricular (LV) reverse remodelling. METHODS AND RESULTS: Among 90 patients in whom echocardiography was performed one day before and six weeks after CRT implantation, 66 with at least FMR(2+) in a four-point scale (mean age 64 ± 10 years, mean LV ejection fraction [LVEF] 25...
2016: Kardiologia Polska
Rajeev Bhardwaj, Arvind Sood
INTRODUCTION: Rheumatic heart disease (RHD) is still a common cause of morbidity and mortality in India. Rheumatic fever commonly occurs between 5-15 yrs of age. Rheumatic activity is a common cause of deterioration of symptoms in a stable or undiagnosed case of RHD. MATERIAL AND METHODS: 41 consecutive patients of acute rheumatic activity were studied. Presenting symptoms were noted. Physical examination was done for major and minor Jone's criteria. Detailed cardiac examination was done...
April 2015: Journal of the Association of Physicians of India
Takahiro Shiota
Three-dimensional (3D) echocardiography is one of the most promising methods for the diagnosis of cardiac disease. Left and right ventricular size and function are currently evaluated with 2D echocardiography. However, for unpredictable asymmetry of the chamber geometry, conventional 2D echocardiography cannot be used to accurately determine absolute chamber volumes and ejection fraction. As for valvular heart diseases, the 3D echo approach has proven to be the most unique, powerful, and convincing method for understanding the complicated anatomy of the valves and their dynamism...
2015: Circulation Journal: Official Journal of the Japanese Circulation Society
Caroline Le Goffic, Manuel Toledano, Pierre-Vladimir Ennezat, Camille Binda, Anne-Laure Castel, François Delelis, Pierre Graux, Christophe Tribouilloy, Sylvestre Maréchaux
The present prospective study was designed to evaluate the accuracy of quantitative assessment of mitral regurgitant fraction (MRF) by echocardiography and cardiac magnetic resonance imaging (cMRI) in the modern era using as reference method the blinded multiparametric integrative assessment of mitral regurgitation (MR) severity. 2-Dimensional (2D) and 3-dimensional (3D) MRF by echocardiography (2D echo MRF and 3D echo MRF) were obtained by measuring the difference in left ventricular (LV) total stroke volume (obtained from either 2D or 3D acquisition) and aortic forward stroke volume normalized to LV total stroke volume...
November 1, 2015: American Journal of Cardiology
Kevin G Friedman, Lindsay Freud, Maria Escobar-Diaz, Puja Banka, Sitaram Emani, Wayne Tworetzky
Fetal aortic valvuloplasty (FAV) has shown promise in averting the progression of fetal aortic stenosis to hypoplastic left-heart syndrome. Altered loading conditions due to valvar disease, intrinsic endomyocardial abnormalities, and procedures that alter endomyocardial mechanics may place patients with biventricular circulation (BiV) after FAV at risk of abnormal LV remodeling and function. Using the most recent echo data on BiV patients after technically successful FAV (n = 34), we evaluated LV remodeling pattern, risk factors for pathologic LV remodeling, and the association between LV remodeling pattern and LV function...
October 2015: Pediatric Cardiology
Antonio Vitarelli, Enrico Mangieri, Claudio Terzano, Carlo Gaudio, Felice Salsano, Edoardo Rosato, Lidia Capotosto, Simona D'Orazio, Alessia Azzano, Giovanni Truscelli, Nino Cocco, Rasul Ashurov
BACKGROUND: Our aim was to compare three-dimensional (3D) and 2D and 3D speckle-tracking (2D-STE, 3D-STE) echocardiographic parameters with conventional right ventricular (RV) indexes in patients with chronic pulmonary hypertension (PH), and investigate whether these techniques could result in better correlation with hemodynamic variables indicative of heart failure. METHODS AND RESULTS: Seventy-three adult patients (mean age, 53±13 years; 44% male) with chronic PH of different etiologies were studied by echocardiography and cardiac catheterization (25 precapillary PH from pulmonary arterial hypertension, 23 obstructive pulmonary heart disease, and 23 postcapillary PH from mitral regurgitation)...
March 19, 2015: Journal of the American Heart Association
Francesco Maisano, Diana Reser, Jovana Pavicevic, Fabian Nietlispach, Oliver Gämperli, Markus Schmid, Dominique Bettex, Volkmar Falk
AIMS: A "valve-in-ring" (ViR) procedure involves the transcatheter implant of a valved stent in a prosthetic mitral ring. The presence of a partial dehiscence of the prosthetic ring is a major contraindication for a ViR due to inefficacious sealing. We describe an alternative method of ViR implant to achieve proper valve sealing in the case of ring dehiscence. METHODS AND RESULTS: A 76-year-old male patient suffered from severe central mitral regurgitation due to annuloplasty ring dehiscence and leaflet tethering...
December 2014: EuroIntervention
Ameen Mosa Mohammad
BACKGROUND: Cardiac complications are among the most serious problems of thalassemia intermedia patients. The current study was initiated to address the latter issue through the study of the echocardiographic findings and correlate it with clinical characteristics of thalassemia intermedia patients in Duhok, Kurdistan region, Iraq. METHODS: An echocardiographic assessment of 61 beta-thalassemia intermedia cases was performed. It included 30 males and 31 females, with a mean age 19...
December 11, 2014: BMC Cardiovascular Disorders
Richard J Kovacs, Giuliana Maldonado, Analia Azaro, Maria S Fernández, Federico L Romero, Juan M Sepulveda-Sánchez, Mary Corretti, Michael Carducci, Melda Dolan, Ivelina Gueorguieva, Ann L Cleverly, N Sokalingum Pillay, Jose Baselga, Michael M Lahn
Transforming growth factor-beta (TGF-β) signaling plays an important role in the fetal development of cardiovascular organs and in the repair mechanisms of the heart. Hence, inhibitors of the TGF-β signaling pathway require a careful identification of a safe therapeutic window and a comprehensive monitoring of the cardiovascular system. Seventy-nine cancer patients (67 glioma and 12 solid tumor) enrolled in a first-in-human dose study and received the TGF-β inhibitor LY2157299 monohydrate (LY2157299) as monotherapy (n = 53) or in combination with lomustine (n = 26)...
October 2015: Cardiovascular Toxicology
M Iori, N Bottoni, F Quartieri, A Manari
AIM: Clinical experience shows that about 2 out of 3 patients with indication to resynchronization therapy (CRT) may have improvements in NYHA class, echocardiographic parameters and survival. However, specific clinical or technical parameters that identify responder patients have not yet been found. Aim of the present study was to assess the efficacy of CRT and to estimate the predictive value of specific echocardiographic parameters. METHODS: All patients who underwent CRT from January 2004 till June 2009, at our Institution, were clinically examined and evaluated by echo and ECG before implant...
August 2014: Minerva Cardioangiologica
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