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Differential Regurgitation Fraction

Yossra Mahran, Robert Schueler, Marcel Weber, Carmen Pizarro, Georg Nickenig, Dirk Skowasch, Christoph Hammerstingl
AIM: To find parameters from transthorathic echocardiography (TTE) including speckle-tracking (ST) analysis of the right ventricle (RV) to identify precapillary pulmonary hypertension (PH). METHODS: Forty-four patients with suspected PH undergoing right heart catheterization (RHC) were consecutively included (mean age 63.1 ± 14 years, 61% male gender). All patients underwent standardized TTE including ST analysis of the RV. Based on the subsequent TTE-derived measurements, the presence of PH was assessed: Left ventricular ejection fraction (LVEF) was calculated by Simpsons rule from 4Ch...
August 26, 2016: World Journal of Cardiology
Puja Sitwala, Ashraf Abusara, Vatsal Ladia, Vatsal Ladia, Hemang B Panchal, Charles Raudat, Timir K Paul
Unicuspid aortic valve (UAV), which is a rare congenital anomaly, usually presents as aortic stenosis and/or aortic regurgitation. Here we present a case of UAV co-existent with an ascending aortic aneurysm. A 26-year-old male with no significant past medical history presented to the hospital after two episodes of syncope. Transthoracic echocardiogram showed an ejection fraction of 62%, severely stenotic aortic valve, and moderate aortic regurgitation. Computed tomography revealed calcification of the aortic valve, compatible with aortic stenosis and aneurysm of the ascending aorta measuring 4...
March 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Atsuko Kato, Christian Drolet, Shi-Joon Yoo, Andrew N Redington, Lars Grosse-Wortmann
BACKGROUND: The left pulmonary artery (LPA) contributes more than the right (RPA) to total pulmonary regurgitation (PR) in patients after tetralogy of Fallot (TOF) repair, but the mechanism of this difference is not well understood. This study aimed to analyze the interplay between heart and lung size, mediastinal geometry, and differential PR. METHODS: Forty-eight Cardiovascular Magnetic Resonance (CMR) studies in patients after TOF repair were analyzed. In addition to the routine blood flow and ventricular volume quantification cardiac angle between the thoracic anterior-posterior line and the interventricular septum, right and left lung areas as well as right and left hemithorax areas were measured on an axial image...
2016: Journal of Cardiovascular Magnetic Resonance
Puja Sitwala Md, Ashraf Abusara Md, Vatsal Ladia Md, Vatsal Ladia Md, Hemang B Panchal Md, Charles Raudat DO, Timir K Paul Md
Unicuspid aortic valve (UAV), which is a rare congenital anomaly, usually presents as aortic stenosis and/or aortic regurgitation. Here we present a case of UAV co-existent with an ascending aortic aneurysm. A 26-year-old male with no significant past medical history presented to the hospital after two episodes of syncope. Transthoracic echocardiogram showed an ejection fraction of 62%, severely stenotic aortic valve, and moderate aortic regurgitation. Computed tomography revealed calcification of the aortic valve, compatible with aortic stenosis and aneurysm of the ascending aorta measuring 4...
March 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
David H MacIver, Andrew L Clark
The pathophysiological mechanisms underlying the clinical phenotype of sarcomeric hypertrophic cardiomyopathy are controversial. The development of cardiac hypertrophy in hypertension and aortic stenosis is usually described as a compensatory mechanism that normalizes wall stress. We suggest that an important abnormality in hypertrophic cardiomyopathy is reduced contractile stress (the force per unit area) generated by myocardial tissue secondary to abnormalities such as cardiomyocyte disarray. In turn, a progressive deterioration in contractile stress provokes worsening hypertrophy and disarray...
September 2016: Journal of Cardiac Failure
Sheng Cao, Qing Zhou, Jin-Ling Chen, Bo Hu, Rui-Qiang Guo
PURPOSE: To evaluate left atrial (LA) function in patients with ischemic (ICM) or idiopathic dilated (DCM) cardiomyopathy via two-dimensional speckle-tracking imaging. METHODS: We measured the LA maximum volume, minimum volume, and volume before the atrial systole, and calculated total emptying volume, expansion index, active emptying volume, and fraction. We measured strain and strain rate during systole and late diastole using two-dimensional speckle-tracking imaging, and analyzed correlations between variables...
September 2016: Journal of Clinical Ultrasound: JCU
Michael R Joynt, Sunkyung Yu, Adam L Dorfman, Maryam Ghadimi Mahani, Prachi P Agarwal, Jimmy C Lu
Patients with repaired pulmonary stenosis (PS) or tetralogy of Fallot (TOF) both develop pulmonary regurgitation (PR) leading to right ventricular (RV) dilatation and dysfunction. We aimed to characterize differential effects of chronic PR in these populations. Patients with surgically repaired PS were matched 1:2 by age and PR fraction with patients with TOF. Patients with previous pulmonary valve replacement were excluded. Cardiovascular magnetic resonance data were compared; peak longitudinal and circumferential systolic strain by feature tracking were compared to evaluate differential contribution of the RV sinus and outflow tract, respectively...
January 15, 2016: American Journal of Cardiology
Qiong Yao, Xi-Hong Hu, Quan-Li Shen, Zhong-Wei Qiao, Mi-Er Pa, Bin Qian, Wei-Li Yan, Guo-Ying Huang
We aimed to compare the diagnostic value of indexed right ventricular end-diastolic volume (RVEDVi) and the ratio of right ventricle volume to left ventricle volume (RV/LV ratio) in prediction of the severity of pulmonary regurgitation (PR) expressed as the PR fraction (PRF) after surgery of tetralogy of Fallot (TOF). Forty-one patients with repaired TOF were included in the study. RVEDVi, LVEDVi, RV/LV ratio, PRF and ejection fraction were measured with magnetic resonance imaging. A PRF of more than 20% was considered significant...
2016: Cardiology
Azza Abdel Gawad Tantawy, Amira Abdel Moneam Adly, Eman Abdel Rahman Ismail, Omneya Ibrahim Youssef, Mohamed ElSayed Ali
BACKGROUND: Heart disease is the leading cause of mortality and one of the main causes of morbidity in β-thalassemia. Growth differentiation factor-15 (GDF-15), a member of the transforming growth factor-β superfamily, is a marker of ineffective erythropoiesis in several anemias. AIM: To determine GDF-15 levels in children and adolescents with TI and the relation to hemolysis, iron overload and cardiovascular complications. METHODS: GDF-15 was measured in 35 TI patients without symptoms for heart disease and correlated to echocardiographic parameters and carotid intima media thickness (CIMT)...
August 2015: Blood Cells, Molecules & Diseases
Sung Min Ko, Jeong Hee Park, Je Kyoun Shin, Jun Suk Kim
BACKGROUND: Regurgitant orifice area (ROA) measurements by cardiac CT have not been compared with a quantitative classification of aortic regurgitation (AR) severity based on regurgitant fraction by phase-contrast cardiovascular magnetic resonance (PC-CMR). OBJECTIVES: To compare ROA using dual-source CT (DSCT) with the grade of AR using PC-CMR for obtaining the cutoff values of the ROA allowing for grading of AR severity. METHODS: We retrospectively enrolled 208 patients (81 women, mean age 53...
July 2015: Journal of Cardiovascular Computed Tomography
Thomas M Gorter, Joost P van Melle, Hendrik G Freling, Tjark Ebels, Beatrijs Bartelds, Petronella G Pieper, Rolf M F Berger, Dirk J van Veldhuisen, Tineke P Willems
In the assessment of pulmonary regurgitation (PR) using phase contrast MRI, phase offset errors affect the accuracy of flow. This study evaluated the use of automated background correction for phase offset in the quantification of PR fraction and volume in patients with repaired tetralogy of Fallot (TOF), and to assess its clinical impact. We retrospectively analyzed 203 cardiac MRI studies, performed on 1.5-T scanner. Pulmonary flow (Q(P)) and systemic flow (Q(S)) was assessed both with and without background correction...
August 2015: International Journal of Cardiovascular Imaging
V Dornberger, H D Dittrich, R Busch
Assessment of the left ventricular ejection fraction plays a key role in the echocardiographic diagnosis of heart failure. The parameter most commonly used is the ejection fraction computed with the biplane disc summation method of Simpson; however, there are numerous limitations to this method, such as the assumption of geometrical symmetry, a substantial intraobserver and interobserver variability, foreshortening of the left ventricle and insufficient image quality for endocardial tracking. Alternative parameters for the evaluation of left ventricular function should be taken into consideration...
April 2015: Herz
Shokoufeh Hajsadeghi, Niloufar Samiee, Seyyed Saied Hosseini, Morteza Hassanzadeh, Scott Reza Jafarian Kerman
BACKGROUND AND AIM: Ischemic mitral regurgitation (IMR) is among the most serious complications of myocardial infarction which doubles the late mortality; mainly treated by undersizing ring annuloplasty. To find some preoperative echocardiographic indices that predict immediate failure of mitral valve annuloplasty (MVA), we designed the present study with more focusing on some novel parameters. METHOD: Transthoracic echocardiography (TTE) indices of consecutive patients referred with 3+ or 4+ IMR were registered 24 hours before surgery...
September 2015: Echocardiography
Kenya Kusunose, Paul C Cremer, Rayji S Tsutsui, Richard A Grimm, James D Thomas, Brian P Griffin, Zoran B Popović
OBJECTIVES: This study hypothesized that regurgitation severity, as determined by using the regurgitant volume index, would better delineate differential cardiac dysfunction in asymptomatic patients with moderate to severe aortic regurgitation (AR) and mitral regurgitation (MR). BACKGROUND: Frequent surveillance echocardiography is considered appropriate in asymptomatic patients with moderate to severe AR and MR. However, the evidence to support this practice and to define the appropriate frequency is limited...
January 2015: JACC. Cardiovascular Imaging
Sabrina L O'Dwyer, Manish Gupta, John Anthony
OBJECTIVE: To describe the etiology and obstetric outcome in women presenting with pulmonary edema during pregnancy and the puerperium. As a secondary objective, we evaluated the utility of echocardiography in the investigation and management of such women. METHODS: Retrospective case note analysis of 53 cases of pulmonary edema that resulted in severe respiratory distress and admission to intensive care. The study population were women accessing obstetric care at a tertiary referral center in South Africa...
November 2015: Journal of Perinatal Medicine
Ralf Wassmuth, Florian von Knobelsdorff-Brenkenhoff, Henriette Gruettner, Wolfgang Utz, Jeanette Schulz-Menger
AIMS: Bicuspid aortic valve (BAV) represents the most frequent congenital cardiac abnormality resulting in premature valvular degeneration and aortic dilatation. In a large series of consecutive patients, we evaluated the distribution of BAV types and the associated valvular and aortic abnormalities. METHODS AND RESULTS: We investigated 266 patients (58 ± 14 years) with BAV using a 1.5 T cardiac magnetic resonance (CMR) scanner. Valve morphology was described according to the Sievers classification...
June 2014: European Heart Journal Cardiovascular Imaging
M Gutberlet
Cardiac magnetic resonance imaging (CMR) has evolved over the past 20 years from a research-based imaging modality to an indispensable routine procedure in cardiac diagnostics. In addition to the morphological representation of cardiac anatomy, whereby only noninvasive multidetector computed tomography (MDCT) is superior, another strength of CMR is the assessment of cardiac function and tissue differentiation. This requires that the radiologist performing the examination and analyzing the results has good knowledge of cardiac and thoracic anatomy and a detailed knowledge of the various cardiovascular diseases, hemodynamics, and pathophysiology...
November 2013: Der Radiologe
Thierry Bove, Kristof Vandekerckhove, Daniel Devos, Joseph Panzer, Katya De Groote, Hans De Wilde, Daniel De Wolf, Julie De Backer, Laurent Demulier, Katrien François
OBJECTIVE: Follow-up after tetralogy of Fallot (ToF) repair is directed to detect timely right ventricular (RV) dysfunction by following pulmonary regurgitation and global RV size, with little attention for the effective contribution of regional RV dysfunction. This study investigates the contribution of regional RV dysfunction on exercise capacity after ToF repair. METHODS: Forty-two patients were investigated with cardiac magnetic resonance imaging for regional RV dysfunction in relation to global RV function by functional quantification of the sinus and outflow part of the RV...
February 2014: European Journal of Cardio-thoracic Surgery
Liang Zhao, Shaohui Wu, Weifeng Jiang, Li Zhou, Jun Gu, Yuanlong Wang, Yugang Liu, Xiaodong Zhang, Xu Liu
BACKGROUND: It is unknown if baseline characteristics and prognosis of patients with longstanding persistent (defined as history greater than 1 year) atrial fibrillation (LS-AF) differ among those with either recurrent atrial tachycardia (R-AT) or recurrent AF (R-AF) after first ablation. METHODS: In 222 consecutive LS-AF patients treated for R-AT or R-AF after first ablation, activation and entrainment mapping was used to identify R-AT mechanism and to guide the following ablation, and the ablation endpoints for all patients included complete pulmonary vein isolation, bidirectional block of lines, and disappearance of complex fractionated atrial electrograms...
March 2014: Journal of Cardiovascular Electrophysiology
Hermann Reichenspurner, Wolfgang Schillinger, Stephan Baldus, Jörg Hausleiter, Christian Butter, Ulrich Schäefer, Giovanni Pedrazzini, Francesco Maisano
OBJECTIVES: Percutaneous treatment with the MitraClip device represents an alternative option for selected patients with degenerative mitral regurgitation (DMR) considered ineligible for surgery due to contraindications or high surgical risk by an inter-disciplinary heart team. We describe 12-month outcomes following treatment with the MitraClip device in DMR patients. METHODS: The MitraClip Therapy Economic and Clinical Outcomes Study Europe (ACCESS-EU) Study has completed the enrolment of 567 patients as of April 2011, 117 of whom were DMR...
October 2013: European Journal of Cardio-thoracic Surgery
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