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Appropriate echocardiography

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https://www.readbyqxmd.com/read/28925651/exercise-stress-testing-indications-and-common-questions
#1
Kathryn K Garner, William Pomeroy, James J Arnold
Exercise stress testing is a validated diagnostic test for coronary artery disease in symptomatic patients, and is used in the evaluation of patients with known cardiac disease. Testing of asymptomatic patients is generally not indicated. It may be performed in select deconditioned adults before starting a vigorous exercise program, but no studies have compared outcomes from preexercise testing vs. encouraging light exercise with gradual increases in exertion. Preoperative exercise stress testing is helpful for risk stratification in patients undergoing vascular surgery or who have active cardiac symptoms before undergoing nonemergent noncardiac surgery...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28925017/early-treatment-with-resolvin-e1-facilitates-myocardial-recovery-from-ischemia-in-mice
#2
Guizhu Liu, Qian Liu, Yujun Shen, Deping Kong, Yanjun Gong, Bo Tao, Guilin Chen, Shumin Guo, Juanjuan Li, Shengkai Zuo, Yu Yu, Huiyong Yin, Li Zhang, Bin Zhou, Colin D Funk, Jian Zhang, Ying Yu
BACKGROUND AND PURPOSE: An appropriate inflammatory response is necessary for cardiac healing after acute myocardial infarction (MI). Resolvin E1 (RvE1) is an anti-inflammatory and pro-resolution lipid mediator derived from eicosapentaenoic acid. The purpose of this study was to investigate the potential effects of RvE1 on cardiac function recovery after MI in mice. EXPERIMENTAL APPROACH: Acute MI was induced by surgical ligation of the left anterior descending artery (LAD) in mice...
September 19, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28922120/motion-estimation-in-echocardiography-using-sparse-representation-and-dictionary-learning
#3
Nora Ouzir, Adrian Basarab, Herve Liebgott, Brahim Harbaoui, Jean-Yves Tourneret
This paper introduces a new method for cardiac motion estimation in 2D ultrasound images. The motion estimation problem is formulated as an energy minimization, whose data fidelity term is built using the assumption that the images are corrupted by multiplicative Rayleigh noise. In addition to a classical spatial smoothness constraint, the proposed method exploits the sparse properties of the cardiac motion to regularize the solution via an appropriate dictionary learning step. The proposed method is evaluated on one dataset with available ground-truth, including four sequences of highly realistic simulations...
September 18, 2017: IEEE Transactions on Image Processing: a Publication of the IEEE Signal Processing Society
https://www.readbyqxmd.com/read/28921420/causes-of-an-increased-pressure-gradient-through-the-left-ventricular-outflow-tract-a-west-coast-experience
#4
Sayuki Kobayashi, Yoshihiko Sakai, Isao Taguchi, Hiroto Utsunomiya, Takahiro Shiota
BACKGROUND: Left ventricular outflow tract obstruction (LVOTO) occurs from not only obstructive hypertrophic cardiomyopathy but also other conditions such as sigmoid septum or post mitral valve repair. However, the changes of the LVOT pressure gradient (LVOT PG) in LVOTO with various conditions remain unclear. METHODS: The clinical characteristics and echocardiographic parameters of 73 patients with LVOT PG ≥50 mmHg at rest on Doppler ultrasound were retrospectively investigated...
September 18, 2017: Journal of Echocardiography
https://www.readbyqxmd.com/read/28918444/left-atrial-volume-computed-by-3d-rotational-angiography-best-predicts-atrial-fibrillation-recurrence-after-circumferential-pulmonary-vein-isolation
#5
Teresa Strisciuglio, Giuseppe Di Gioia, Sofia Chatzikyriakou, Etel Silva Garcia, Emanuele Barbato, Peter Geelen, Tom De Potter
Left atrium (LA) size is a well-studied predictor of atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). Yet, there is still little agreement on the best imaging technique to size the LA, and on the most appropriate sizing parameter. Volumetric assessment of LA with three-dimensional rotational angiography (3DRA LA volume index) might be a valid alternative to the commonly used transthoracic echocardiography (TTE LA volume index). The aim of our study was to investigate whether LA volume by 3DRA at the time of PVI is able to predict the risk of atrial fibrillation recurrence...
September 16, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28917559/predictors-and-outcomes-of-cardiac-resynchronization-therapy-extended-to-the-second-generator
#6
Xuping Li, Dachun Yang, Fred Kusumoto, Win-Guang Shen, Siva Mulpuru, Shenghua Zhou, Jinjun Liang, Gang Wu, Mei Yang, Jin-Qu Liu, Paul A Friedman, Yong-Mei Cha
BACKGROUND: A proportion of patients who receive cardiac resynchronization therapy (CRT) with defibrillator (CRT-D) live to receive a second generator. Controversy exists on whether an implantable cardioverter-defibrillator (ICD) should be offered to patients who have normalized or near normalized left ventricular ejection fraction (LVEF) at the time of generator replacement (GR). OBJECTIVE: To evaluate incidence of appropriate ICD therapy after CRT-D GR. METHODS: This series involved 1,026 consecutive patients who underwent CRT-D implant between January 2002 and December 2012...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28888565/the-use-of-echocardiography-for-pediatric-patients-presenting-with-syncope
#7
Jonathan H Pelletier, Sarah Blanchard, Reid C Chamberlain, Christoph P Hornik, Michael J Campbell, Kevin D Hill
OBJECTIVES: To assess the frequency, yield, and cost of echocardiograms meeting "rarely appropriate" criteria. STUDY DESIGN: Retrospective, single-center study of pediatric patients presenting with syncope. Patients were categorized according to the appropriate use criteria and based upon location of care (emergency department only, primary care setting only, or referred to a pediatric cardiologist). Multivariable regression was used to determine factors associated with performance of a "rarely appropriate" echocardiogram...
September 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28878577/echocardiographic-classification-and-surgical-approaches-to-double-outlet-right-ventricle-for-great-arteries-arising-almost-exclusively-from-the-right-ventricle
#8
Kun-Jing Pang, Hong Meng, Sheng-Shou Hu, Hao Wang, David Hsi, Zhong-Dong Hua, Xiang-Bin Pan, Shou-Jun Li
Selecting an appropriate surgical approach for double-outlet right ventricle (DORV), a complex congenital cardiac malformation with many anatomic variations, is difficult. Therefore, we determined the feasibility of using an echocardiographic classification system, which describes the anatomic variations in more precise terms than the current system does, to determine whether it could help direct surgical plans. Our system includes 8 DORV subtypes, categorized according to 3 factors: the relative positions of the great arteries (normal or abnormal), the relationship between the great arteries and the ventricular septal defect (committed or noncommitted), and the presence or absence of right ventricular outflow tract obstruction (RVOTO)...
August 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28878203/biventricular-cardiac-hypertrophy-in-a-patient-with-primary-aldosteronism-and-atrial-septal-defect
#9
Tjokorda Gde Dalem Pemayun, Ridho M Naibaho, Muhammad Achmad Sungkar
BACKGROUND Primary aldosteronism can be caused by adrenocortical adenoma and is usually associated with left ventricular hypertrophy. Biventricular cardiac hypertrophy and heart failure in the presence of a pre-existing atrial septal defect (ASD) are a rare association of primary aldosteronism. CASE REPORT A 33-year-old woman with resistant hypertension and refractory hypokalemia presented with signs and symptoms of heart failure. She had previously been diagnosed having a right adrenal tumor and ostium secundum type ASD...
September 7, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28875298/2d-longitudinal-lv-speckle-tracking-strain-pattern-in-breast-cancer-survivors-sports-activity-vs-exercise-as-prescription-model
#10
Giorgio Galanti, Gianni Pedrizzetti, Stefano Pedri, Laura Stefani
Prevention strategies are important to optimize and to manage heart care in breast cancer survivors. Regular physical activity at moderate intensity is normally proposed to maintain myocardial performance; however, no data is available about the different impact of different levels of physical exercise. 2D speckle tracking echocardiography (2DSTE) is an accepted method for early detection of myocardial dysfunction. The study aims to monitor the cardiac performances in breast cancer survivors by 2DSTE analysis to manage sports activity vs physical activity...
September 5, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28873140/association-of-evidence-based-care-processes-with-mortality-in-staphylococcus-aureus-bacteremia-at-veterans-health-administration-hospitals-2003-2014
#11
Michihiko Goto, Marin L Schweizer, Mary S Vaughan-Sarrazin, Eli N Perencevich, Daniel J Livorsi, Daniel J Diekema, Kelly K Richardson, Brice F Beck, Bruce Alexander, Michael E Ohl
Importance: Staphylococcus aureus bacteremia is common and frequently associated with poor outcomes. Evidence indicates that specific care processes are associated with improved outcomes for patients with S aureus bacteremia, including appropriate antibiotic prescribing, use of echocardiography to identify endocarditis, and consultation with infectious diseases (ID) specialists. Whether use of these care processes has increased in routine care for S aureus bacteremia or whether use of these processes has led to large-scale improvements in survival is unknown...
September 5, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28870679/acc-aats-aha-ase-asnc-hrs-scai-scct-scmr-sts-2017-appropriate-use-criteria-for-multimodality-imaging-in-valvular%C3%A2-heart-disease-a-report-of-the-american-college-of-cardiology-appropriate-use-criteria-task-force-american-association-for-thoracic-surgery-american
#12
https://www.readbyqxmd.com/read/28870377/cardiac-imaging-in-the-diagnosis-of-coronary-artery-disease
#13
Ashvarya Mangla, Estefania Oliveros, Kim Allan Williams, Dinesh K Kalra
Coronary artery disease (CAD) continues to be a leading cause of morbidity and mortality worldwide. Although invasive coronary angiography has previously been the gold standard in establishing the diagnosis of CAD, there is a growing shift to more appropriately use the cardiac catheterization laboratory to perform interventional procedures once a diagnosis of CAD has been established by noninvasive imaging modalities rather than using it primarily as a diagnostic facility to confirm or refute CAD. With ongoing technological advancements, noninvasive imaging plays a pre-eminent role in not only diagnosing CAD but also informing the choice of appropriate therapies, establishing prognosis, all while containing costs and providing value-based care...
October 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28868014/first-line-treatment-with-carboplatin-plus-nab-paclitaxel-and-maintenance-monotherapy-with-nab-paclitaxel-for-a-thymic-carcinoma-a-case-report
#14
Kunihiko Funaishi, Masahiro Yamasaki, Naomi Saito, Wakako Daido, Sayaka Ishiyama, Naoko Deguchi, Masaya Taniwaki, Nobuyuki Ohashi
Thymic carcinomas are rare malignant tumors, located in the anterior mediastinum. For the treatment of these carcinomas, several chemotherapy regimens have been suggested, including carboplatin plus paclitaxel. However, because of the rarity of these tumors, the standard chemotherapy regimen has not yet been established. Here, we report a case of thymic carcinoma that responded to first-line carboplatin plus nanoparticle albumin-bound paclitaxel (nab-paclitaxel) therapy with continuation maintenance nab-paclitaxel monotherapy...
May 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28864152/deformation-analysis-of-myocardial-layers-detects-early-cardiac-dysfunction-after-chemotherapy-in-bone-marrow-transplantation-patients-a-continuous-and-additive-cardiotoxicity-process
#15
Ioannis A Paraskevaidis, George Makavos, Panagiotis Tsirigotis, Panagiotis Psarogiannakopoulos, John Parissis, Konstantinos Gkirkas, Ilias Pessach, Ignatios Ikonomidis
BACKGROUND: Chemotherapy-induced cardiotoxicity has not been extensively validated in bone marrow transplantation (BMT) patients. Speckle-tracking echocardiography is a sensitive method for the detection of subclinical cardiac dysfunction. METHODS: Cardiac function was prospectively assessed in 80 patients (44 men; mean age, 45 ± 11 years) after BMT for non-Hodgkin's lymphoma and acute or chronic myeloid leukemia by means of various echocardiographic techniques...
August 29, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28845401/the-role-of-nt-probnp-in-the-diagnosis-of-ventricular-arrhythmias-in-patients-with-systemic-sclerosis
#16
Lucian Muresan, Ana Petcu, Crina Muresan, Mirela Rinzis, Gabriel Gusetu, Dana Pop, Dumitru Zdrenghea, Simona Rednic
BACKGROUND: In patients with systemic sclerosis, NT-proBNP is a useful diagnostic marker for pulmonary hypertension and ventricular dysfunction, with important prognostic significance. The aim of this study was to assess the relationship between the NT-proBNP levels and the presence and severity of ventricular arrhythmias in patients with scleroderma. METHODS: Forty consecutive patients with a diagnostic of systemic sclerosis according to the EULAR criteria admitted at the Rheumatology Clinic of Cluj-Napoca, Romania, from Jan 2014 to Apr 2014 were enrolled...
July 2017: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/28838362/improving-the-appropriate-use-of-transthoracic-echocardiography-the-echo-wisely-trial
#17
RANDOMIZED CONTROLLED TRIAL
R Sacha Bhatia, Noah M Ivers, X Cindy Yin, Dorothy Myers, Gillian C Nesbitt, Jeremy Edwards, Kibar Yared, Rishi K Wadhera, Justina C Wu, Aaron P Kithcart, Brian M Wong, Mark S Hansen, Adina S Weinerman, Steven Shadowitz, Debra Elman, Michael E Farkouh, Paaladinesh Thavendiranathan, Jacob A Udell, Amer M Johri, Chi-Ming Chow, Judith Hall, Zachary Bouck, Ashley Cohen, Kevin E Thorpe, Harry Rakowski, Michael H Picard, Rory B Weiner
BACKGROUND: Appropriate use criteria (AUC) have defined transthoracic echocardiogram (TTE) indications for which there is a clear lack of benefit as rarely appropriate (rA). OBJECTIVES: This study sought to investigate the impact of an AUC-based educational intervention on outpatient TTE ordering by cardiologists and primary care providers. METHODS: The authors conducted a prospective, investigator-blinded, multicenter, randomized controlled trial of an AUC-based educational intervention aimed at reducing rA outpatient TTEs...
August 29, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28837121/diagnostic-approach-to-pulmonary-hypertension-in-premature-neonates
#18
REVIEW
Vasantha H S Kumar
Bronchopulmonary dysplasia (BPD) is a form of chronic lung disease in premature infants following respiratory distress at birth. With increasing survival of extremely low birth weight infants, alveolar simplification is the defining lung characteristic of infants with BPD, and along with pulmonary hypertension, increasingly contributes to both respiratory morbidity and mortality in these infants. Growth restricted infants, infants born to mothers with oligohydramnios or following prolonged preterm rupture of membranes are at particular risk for early onset pulmonary hypertension...
August 24, 2017: Children
https://www.readbyqxmd.com/read/28822667/doppler-parameters-derived-from-transthoracic-echocardiography-accurately-detect-bioprosthetic-mitral-valve-dysfunction
#19
Ryan J Spencer, Ken G Gin, Michael Y C Tsang, Teresa S M Tsang, Parvathy Nair, Pui K Lee, John Jue
BACKGROUND: Detecting bioprosthetic mitral valve dysfunction on transthoracic echocardiography can be challenging because of acoustic shadowing of regurgitant jets and a wide normal range of transvalvular gradients. Several studies in mechanical mitral valves have demonstrated the utility of the transthoracically derived parameters E (peak early mitral inflow velocity), pressure half-time, and the ratio of mitral inflow velocity-time integral (VTIMV) to left ventricular outflow tract velocity-time integral (VTILVOT) in detecting significant prosthetic dysfunction...
August 16, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28820544/use-of-adjuncts-reduces-cardiopulmonary-bypass-time-during-minimally-invasive-aortic-valve-replacement
#20
Alice Wang, Sharon L McCartney, Judson B Williams, Asvin Ganapathi, Donald D Glower, Alina Nicoara, Jeffrey G Gaca
BACKGROUND: Minimally invasive aortic valve replacement (MIAVR) through a mini-thoracotomy is comparable to AVR through a sternotomy, but may have increased surgical times. The development of adjuncts such as the automatic knot fastener and percutaneous coronary sinus (CS) catheter may reduce this disadvantage. METHODS: A retrospective review conducted between 2002 and 2015 at a single institution revealed 78 patients who underwent MIAVR with adjuncts. The automatic knot fastener was used on all patients, and a successful CS catheter was placed and confirmed by echocardiography in 67 patients (86%)...
March 2017: Journal of Heart Valve Disease
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