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Tomić S, Veljković S, Radoičić D, Đokić O, Šljivo A, Stojanović I, Nikolić A, Bojić M. Characteristics of Akinetic and Dyskinetic Left Ventricular Aneurysms in the Context of Echocardiographic Diagnosis and Treatment Selection. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1141. [PMID: 39064570 PMCID: PMC11278943 DOI: 10.3390/medicina60071141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/25/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives. Distinct pressure curve differences exist between akinetic (A-LVA) and dyskinetic (D-LVA) aneurysms. In D-LVA, left ventricular (LV) ejection pressure decreases relative to the aneurysm size, whereas A-LVA does not impact pressure curves, indicating that the decrease in stroke volume (SV) and cardiac output is proportional to the size of dyskinesia. This study aimed to assess the frequency of A-LVA and D-LVA, determine aneurysm size parameters (volume and surface area), and evaluate predictive parameters using echocardiography in A-LVA and D-LVA. Furthermore, it aimed to compare individual echocardiographic parameters, according to ejection fraction (EF) and SV, with hemodynamic events shown in experimental models of A-LVA and D-LVA and their significance in everyday clinical practice. Materials and Methods. This clinical study included patients with post-infarction left ventricular aneurysm (LVA) admitted to the cardiovascular institute ''Dedinje", Serbia. Echocardiographic volume and surface area of LV and LVA were determined (by the area-length method) along with EF (by Simpson's method). Results. A-LVA was present in 62.9% of patients, while D-LVA was present in 37.1%. Patients with D-LVA had significantly higher systolic aneurysm volume (LVAVs) (94.07 ± 74.66 vs. 51.54 ± 53.09, p = 0.009), systolic aneurysm surface area (LVAAs) (23.22 ± 11.73 vs. 16.41 ± 8.58, p = 0.018), and end-systolic left ventricular surface areas (LVESA) (50.79 ± 13.33 vs. 42.76 ± 14.11, p = 0.045) compared to patients with A-LVA. The ratio of LVA volume to LV volume was higher in the D-LVA in systole (LVAVs/LVESV). The end-diastolic volume of LV (LVEDV) and end-systolic volume of LV (LVESV) did not significantly differ between D-LVA and A-LVA. EF (21.25 ± 11.92 vs. 28.18 ± 11.91, p = 0.044) was significantly lower among patients with D-LVA. Conclusions. Differentiating between A-LVA and D-LVA using echocardiography is crucial since D-LVA causes greater hemodynamic disturbances in LV function, and thus surgical resection of the aneurysm or LV reconstruction must have a positive effect regardless of myocardial revascularization surgery.
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Affiliation(s)
- Slobodan Tomić
- Cardiovascular Institute “Dedinje”, 11040 Belgrade, Serbia; (S.T.); (D.R.); (O.Đ.); (I.S.); (A.N.); (M.B.)
- Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina
| | - Stefan Veljković
- Cardiovascular Institute “Dedinje”, 11040 Belgrade, Serbia; (S.T.); (D.R.); (O.Đ.); (I.S.); (A.N.); (M.B.)
| | - Dragana Radoičić
- Cardiovascular Institute “Dedinje”, 11040 Belgrade, Serbia; (S.T.); (D.R.); (O.Đ.); (I.S.); (A.N.); (M.B.)
| | - Olivera Đokić
- Cardiovascular Institute “Dedinje”, 11040 Belgrade, Serbia; (S.T.); (D.R.); (O.Đ.); (I.S.); (A.N.); (M.B.)
- Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina
| | - Armin Šljivo
- Clinical Center of University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina;
| | - Ivan Stojanović
- Cardiovascular Institute “Dedinje”, 11040 Belgrade, Serbia; (S.T.); (D.R.); (O.Đ.); (I.S.); (A.N.); (M.B.)
- Clinical Center of University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina;
| | - Aleksandra Nikolić
- Cardiovascular Institute “Dedinje”, 11040 Belgrade, Serbia; (S.T.); (D.R.); (O.Đ.); (I.S.); (A.N.); (M.B.)
- Clinical Center of University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina;
| | - Milovan Bojić
- Cardiovascular Institute “Dedinje”, 11040 Belgrade, Serbia; (S.T.); (D.R.); (O.Đ.); (I.S.); (A.N.); (M.B.)
- Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina
- Faculty of Medicine, University of Belgrade, 11040 Belgrade, Serbia
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Dissabandara T, Lin K, Forwood M, Sun J. Validating real-time three-dimensional echocardiography against cardiac magnetic resonance, for the determination of ventricular mass, volume and ejection fraction: a meta-analysis. Clin Res Cardiol 2024; 113:367-392. [PMID: 37079054 PMCID: PMC10881629 DOI: 10.1007/s00392-023-02204-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/11/2023] [Indexed: 04/21/2023]
Abstract
INTRODUCTION Real-time three-dimensional echocardiography (RT3DE) is currently being developed to overcome the challenges of two-dimensional echocardiography, as it is a much cheaper alternative to the gold standard imaging method, cardiac magnetic resonance (CMR). The aim of this meta-analysis is to validate RT3DE by comparing it to CMR, to ascertain whether it is a practical imaging method for routine clinical use. METHODS A systematic review and meta-analysis method was used to synthesise the evidence and studies published between 2000 and 2021 were searched using a PRISMA approach. Study outcomes included left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular ejection fraction (LVEF), left ventricular mass (LVM), right ventricular end-systolic volume (RVESV), right ventricular end-diastolic volume (RVEDV) and right ventricular ejection fraction (RVEF). Subgroup analysis included study quality (high, moderate), disease outcomes (disease, healthy and disease), age group (50 years old and under, over 50 years), imaging plane (biplane, multiplane) and publication year (2010 and earlier, after 2010) to determine whether they explained the heterogeneity and significant difference results generated on RT3DE compared to CMR. RESULTS The pooled mean differences for were - 5.064 (95% CI - 10.132, 0.004, p > 0.05), 4.654 (95% CI - 4.947, 14.255, p > 0.05), - 0.783 (95% CI - 5.630, 4.065, p > 0.05, - 0.200 (95% CI - 1.215, 0.815, p > 0.05) for LVEF, LVM, RVESV and RVEF, respectively. We found no significant difference between RT3DE and CMR for these variables. Although, there was a significant difference between RT3DE and CMR for LVESV, LVEDV and RVEDV where RT3DE reports a lower value. Subgroup analysis indicated a significant difference between RT3DE and CMR for studies with participants with an average age of over 50 years but no significant difference for those under 50. In addition, a significant difference between RT3DE and CMR was found in studies using only participants with cardiovascular diseases but not in those using a combination of diseased and healthy participants. Furthermore, for the variables LVESV and LVEDV, the multiplane method shows no significant difference between RT3DE and CMR, as opposed to the biplane showing a significant difference. This potentially indicates that increased age, the presence of cardiovascular disease and the biplane analysis method decrease its concordance with CMR. CONCLUSION This meta-analysis indicates promising results for the use of RT3DE, with limited difference to CMR. Although in some cases, RT3DE appears to underestimate volume, ejection fraction and mass when compared to CMR. Further research is required in terms of imaging method and technology to validate RT3DE for routine clinical use.
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Affiliation(s)
- Thilini Dissabandara
- School of Pharmacy and Medical Science, Griffith University, Gold Coast, Australia
| | - Kelly Lin
- Schools of Medicine and Dentistry, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia
| | - Mark Forwood
- School of Pharmacy and Medical Science, Griffith University, Gold Coast, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Jing Sun
- Schools of Medicine and Dentistry, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia.
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
- Institute for Integrated Intelligence and Systems, Griffith University, Brisbane, Australia.
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Castelvecchio S, Frigelli M, Sturla F, Milani V, Pappalardo OA, Citarella M, Menicanti L, Votta E. Elucidating the mechanisms underlying left ventricular function recovery in patients with ischemic heart failure undergoing surgical remodeling: A 3-dimensional ultrasound analysis. J Thorac Cardiovasc Surg 2023; 165:1418-1429.e4. [PMID: 33781593 DOI: 10.1016/j.jtcvs.2021.02.067] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 02/02/2021] [Accepted: 02/10/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The study objective was to elucidate the mechanisms of left ventricle functional recovery in terms of endocardial contractility and synchronicity after surgical ventricular reconstruction. METHODS Real-time 3-dimensional transthoracic echocardiography was performed on 20 patients with anterior left ventricle remodeling and ischemic heart failure before surgical ventricular reconstruction and at 6-month follow-up, and on 15 healthy controls matched by age and body surface area. Real-time 3-dimensional transthoracic echocardiography datasets were analyzed through TomTec software (4D LV-Analysis; TomTec Imaging Systems GmbH, Unterschleissheim, Germany): Left ventricle volumes, ejection fraction, and global longitudinal strain were computed; the time-dependent endocardial surface yielded by 3-dimensional speckle-tracking echocardiography was postprocessed through in-house software to quantify local systolic minimum principal strain as a measure of fiber shortening and mechanical dispersion as a measure of fiber synchronicity. RESULTS Compared with controls, patients with heart failure before surgical ventricular reconstruction showed lower ejection fraction (P < .0001) and significantly impaired mechanical dispersion (P < .0001) and minimum principal strain (P < .0001); the latter worsened progressively from left ventricle base to apex. After surgical ventricular reconstruction, global longitudinal strain improved from -6.7% to -11.3% (P < .0001); mechanical dispersion decreased in every left ventricle region (P ≤ .017) and mostly in the basal region, where computed mechanical dispersion values were comparable to physiologic values (P ≥ .046); minimum principal strain improved mostly in the basal region, changing from -16.6% to -22.3% (P = .0027). CONCLUSIONS At 6-month follow-up, surgical ventricular reconstruction was associated with significant recovery in global left ventricle function, improved mechanical dispersion indicating a more synchronous left ventricle contraction, and improved left ventricle fiber shortening mostly in the basal region, suggesting the major role of the remote myocardium in enhancing left ventricle functional recovery.
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Affiliation(s)
| | - Matteo Frigelli
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy; Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Francesco Sturla
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy; Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
| | - Valentina Milani
- Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Omar A Pappalardo
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Michele Citarella
- Cardiac Surgery Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Lorenzo Menicanti
- Cardiac Surgery Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Emiliano Votta
- 3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy; Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
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Lazar M, Olma A, Streb W. ECHOCARDIOGRAPHIC METHODS FOR ASSESSING LEFT VENTRICULAR SYSTOLIC FUNCTION. POLSKI MERKURIUSZ LEKARSKI : ORGAN POLSKIEGO TOWARZYSTWA LEKARSKIEGO 2023; 51:144-150. [PMID: 37254762 DOI: 10.36740/merkur202302107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Transthoracic echocardiography (TTE) is the recommended primary method of assessing cardiac function. The measurement of LVEF determines the strategy for treatment of patients, as well as influences their prognosis. 3D echocardiography has higher accuracy and reproducibility than 2D echocardiography; hence it is currently recommended for volume and LVEF measurements. New echocardiographic techniques: global longitudinal strain measured by speckle tracking and myocardial work allow earlier detection of myocardial abnormalities. In addition, they have greater sensitivity in detecting ischemia, fibrosis and left ven¬tricular systolic dyssynchrony. In some myocardial pathologies, such as amyloidosis, hypertrophic cardiomyopathy or Chagas disease, we observe characteristic patterns of myocardial deformation (strain), which are their hallmarks. Myocardial work, on the other hand, allows assessment of contractility independent of the effect of afterload. The new echocardiographic techniques provide additional diagnostic tools for assessing left ventricular systolic function and informa¬tion on prognosis, and hence their use can be expected to become more widespread in daily clinical practice.
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Affiliation(s)
- Monika Lazar
- DEPARTMENT OF CARDIOLOGY AND ANGIOLOGY, SILESIAN CENTRE FOR HEART DISEASES IN ZABRZE, ZABRZE, POLAND
| | - Anna Olma
- DEPARTMENT OF CARDIOLOGY AND ANGIOLOGY, SILESIAN CENTRE FOR HEART DISEASES IN ZABRZE, ZABRZE, POLAND
| | - Witold Streb
- DEPARTMENT OF CARDIOLOGY AND ANGIOLOGY, SILESIAN CENTRE FOR HEART DISEASES IN ZABRZE, ZABRZE, POLAND; DEPARTMENT OF CARDIOLOGY, CONGENITAL HEART DISEASES AND ELECTROTHERAPY, FACULTY OF MEDICAL SCIENCES IN ZABRZE, MEDICAL UNIVERSITY OF SILESIA, KATOWICE, POLAND
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5
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Høyland K, Mohamed Ali A, Vegsundvåg J, Chambers JB, Saeed S. Echocardiographic features of left ventricular recess, cleft, diverticulum, and aneurysm: A systematic review. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:339-346. [PMID: 35146770 DOI: 10.1002/jcu.23155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
A pouch protruding into the wall of the left ventricle (LV) may be either a recess, cleft, diverticulum, or aneurysm. Being aware of these anomalies is essential to make accurate diagnosis and guide management decisions. Standard multimodality imaging of the heart enables detailed characterizations of LV fissures and outpouchings. They often present as an incidental finding on echocardiography, and the clinical significance can be difficult to address. We provide an overview of echocardiographic features of LV recess, cleft, diverticulum, pseudoaneurysms/aneurysms, and non-compaction based upon review of the literature as well as present some relevant clinical cases from our echocardiography labs.
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Affiliation(s)
- Kjell Høyland
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Abukar Mohamed Ali
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | | | - John B Chambers
- Cardiothoracic Centre, Guy's and St Thomas' Hospitals, London, UK
| | - Sahrai Saeed
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
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6
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Westenberg JJM, van Assen HC, van den Boogaard PJ, Goeman JJ, Saaid H, Voorneveld J, Bosch J, Kenjeres S, Claessens T, Garg P, Kouwenhoven M, Lamb HJ. Echo planar imaging-induced errors in intracardiac 4D flow MRI quantification. Magn Reson Med 2021; 87:2398-2411. [PMID: 34866236 PMCID: PMC9300143 DOI: 10.1002/mrm.29112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 01/09/2023]
Abstract
Purpose To assess errors associated with EPI‐accelerated intracardiac 4D flow MRI (4DEPI) with EPI factor 5, compared with non‐EPI gradient echo (4DGRE). Methods Three 3T MRI experiments were performed comparing 4DEPI to 4DGRE: steady flow through straight tubes, pulsatile flow in a left‐ventricle phantom, and intracardiac flow in 10 healthy volunteers. For each experiment, 4DEPI was repeated with readout and blip phase‐encoding gradient in different orientations, parallel or perpendicular to the flow direction. In vitro flow rates were compared with timed volumetric collection. In the left‐ventricle phantom and in vivo, voxel‐based speed and spatio‐temporal median speed were compared between sequences, as well as mitral and aortic transvalvular net forward volume. Results In steady‐flow phantoms, the flow rate error was largest (12%) for high velocity (>2 m/s) with 4DEPI readout gradient parallel to the flow. Voxel‐based speed and median speed in the left‐ventricle phantom were ≤5.5% different between sequences. In vivo, mean net forward volume inconsistency was largest (6.4 ± 8.5%) for 4DEPI with nonblip phase‐encoding gradient parallel to the main flow. The difference in median speed for 4DEPI versus 4DGRE was largest (9%) when the 4DEPI readout gradient was parallel to the flow. Conclusions Velocity and flow rate are inaccurate for 4DEPI with EPI factor 5 when flow is parallel to the readout or blip phase‐encoding gradient. However, mean differences in flow rate, voxel‐based speed, and spatio‐temporal median speed were acceptable (≤10%) when comparing 4DEPI to 4DGRE for intracardiac flow in healthy volunteers.
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Affiliation(s)
- Jos J M Westenberg
- CardioVascular Imaging Group, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Hans C van Assen
- CardioVascular Imaging Group, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Pieter J van den Boogaard
- CardioVascular Imaging Group, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jelle J Goeman
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Hicham Saaid
- Institute Biomedical Technology, Ghent University, Ghent, Belgium
| | - Jason Voorneveld
- Department of Biomedical Engineering, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Johan Bosch
- Department of Biomedical Engineering, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sasa Kenjeres
- Department of Chemical Engineering, Delft University of Technology, Delft, the Netherlands
| | - Tom Claessens
- Department of Materials, Textiles and Chemical Engineering, Ghent University, Ghent, Belgium
| | - Pankaj Garg
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Marc Kouwenhoven
- Department of MR R&D-Clinical Science, Philips, Best, the Netherlands
| | - Hildo J Lamb
- CardioVascular Imaging Group, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
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El-Sisi A, Dabour S, Fattouh AM, Assar E, Naguib R, AbdelMassih AF. Biventricular reverse remodeling and relationship with mitral valve prolapse after transcatheter closure of ASD secundum, a 3D echocardiographic study. J Cardiovasc Thorac Res 2020; 12:15-19. [PMID: 32211133 PMCID: PMC7080331 DOI: 10.34172/jcvtr.2020.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 12/04/2019] [Indexed: 12/02/2022] Open
Abstract
Introduction: Mitral valve prolapse (MVP) is the most common anomaly of the mitral valve. Several studies have shown prevalence of MVP in atrial septal defect (ASD) especially secundum types (II). The aims of this study is to show the potential role of 3D echocardiography in improving the diagnosis of MVP and to depict the relationship between reverse remodeling of the right and left ventricles (RV, LV) and MVP after transcatheter closure of ASD II. Methods: Sixty patients underwent transcatheter closure of ASD II and completed follow up by 2D and 3D echocardiography in Cairo University Children Hospital before the procedure and at 24 hours, 1 and 6 months after the procedure. Results: 3D echocardiography was more accurate than 2D echocardiography in detecting MVP frequency in ASD II patients (75% vs. 50%). Maximum statistically significant remodeling was detected by 3D echocardiography 1 month after the procedure (RV: LV ratio by 3D echocardiography 1.9±0.03 24 hours after the procedure vs. 1.6±0.03 1 months after the procedure, P <0.01) while 2D echocardiography was delayed in detecting biventricular reverse remodeling. 3D derived RV: LV ratio was accurate in detecting MVP status with a sensitivity of 88%. Conclusion: MVP in ASD II may be related to Biventricular remodeling; 3D echocardiography is accurate in the detection of reverse remodeling as well as MVP in ASD II patients before and after device closure.
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Affiliation(s)
- Amal El-Sisi
- Pediatric Cardiology Unit, Pediatrics' Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Shaheen Dabour
- Pediatric Cardiology Unit, Pediatrics' Department, Faculty of Medicine, Benha University, Benha, Egypt
| | - Aya M Fattouh
- Pediatric Cardiology Unit, Pediatrics' Department, Faculty of Medicine, Benha University, Benha, Egypt
| | - Effat Assar
- Pediatric Cardiology Unit, Pediatrics' Department, Faculty of Medicine, Benha University, Benha, Egypt
| | - Rasha Naguib
- Pediatric Cardiology Unit, Pediatrics' Department, Faculty of Medicine, Benha University, Benha, Egypt
| | - Antoine Fakhry AbdelMassih
- Pediatric Cardiology Unit, Pediatrics' Department, Faculty of Medicine, Cairo University, Cairo, Egypt.,Pediatric Cardio-Oncology Department, Children's Cancer Hospital Egypt (CCHE 57357), Cairo, Egypt
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8
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Dillinger H, Walheim J, Kozerke S. On the limitations of echo planar 4D flow MRI. Magn Reson Med 2020; 84:1806-1816. [PMID: 32212352 DOI: 10.1002/mrm.28236] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE To compare EPI and GRE readout in high-flow velocity regimes and evaluate their impact on measurement accuracy in silico and in vitro. THEORY AND METHODS Phase-contrast sequences for EPI and GRE were simulated using CFD velocity data to assess displacement artifacts as well as effective spatial resolution. In silico findings were validated experimentally using a steady flow phantom. RESULTS For EPI factor 5 and simulated stenotic flow with peak velocity of 2.2 m s - 1 , displacement artifacts resulted in misregistration of 7.3 mm at echo time and the effective resolution was locally reduced by factors 5 and 8 compared to GRE for flow along phase and frequency encoding directions, respectively. In vitro, a maximum velocity difference between EPI factor 5 and GRE of 0.97 m s - 1 was found. CONCLUSIONS Four-dimensional flow MRI using EPI readout results not only in considerable velocity misregistration but also in spatially varying degradation of resolution. The proposed work indicates that EPI is inferior to standard GRE for 4D flow MRI.
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Affiliation(s)
- Hannes Dillinger
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Jonas Walheim
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
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9
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Kitano T, Nabeshima Y, Otsuji Y, Negishi K, Takeuchi M. Accuracy of Left Ventricular Volumes and Ejection Fraction Measurements by Contemporary Three-Dimensional Echocardiography with Semi- and Fully Automated Software: Systematic Review and Meta-Analysis of 1,881 Subjects. J Am Soc Echocardiogr 2019; 32:1105-1115.e5. [DOI: 10.1016/j.echo.2019.04.417] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/18/2019] [Accepted: 04/19/2019] [Indexed: 12/17/2022]
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10
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Kitano T, Nabeshima Y, Abe Y, Otsuji Y, Takeuchi M. Accuracy and reliability of novel semi-automated two-dimensional layer specific speckle tracking software for quantifying left ventricular volumes and function. PLoS One 2019; 14:e0221204. [PMID: 31469858 PMCID: PMC6716624 DOI: 10.1371/journal.pone.0221204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 08/02/2019] [Indexed: 12/16/2022] Open
Abstract
Purpose To determine whether the semi-automated two-dimensional echocardiography (2DE) layer strain software, compared to cardiac magnetic resonance (CMR), is reliable for left ventricular (LV) volume quantification. Methods and results We retrospectively selected 84 patients who underwent CMR and 2DE on the same day. Novel 2DE layer strain software automatically provides LV contour in 3 myocardial layers and performs layer specific speckle tracking analysis, which calculates LV volumes, ejection fraction (LVEF), and global longitudinal strain (GLS) in each layer. These values were compared with reference values from CMR disk-area summation and feature tracking methods. Coverage probability (CP) was determined using predefined cut-off values and absolute differences in LV volumes of 30 mL, those in LVEF of 10%, and those in GLS of 4%. The software did not work in 3 patients (feasibility: 96%). Different layers resulted in different degrees of under- or over-estimation of LV volumes. Epicardial tracking significantly overestimated the LV volumes and significantly underestimated LVEF and GLS. Mid-myocardial tracking had less underestimation of LV volumes and equivalent CP values of LVEF (0.77 vs. 0.75 using the disk-area summation method and 0.90 vs. 0.94 using the feature tracking method) and GLS (0.95 vs. 0.92) compared with endocardial tracking. The new software showed excellent reproducibility, especially endocardial and mid-myocardial tracking. Conclusions Mid-myocardial tracking with the novel 2DE strain software provided less bias of LV volumes with high CP values of LVEF and GLS, which suggests that mid-myocardial layer speckle tracking analysis approximates CMR derived LV functional parameters.
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Affiliation(s)
- Tetsuji Kitano
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
- * E-mail:
| | - Yosuke Nabeshima
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | | | - Yutaka Otsuji
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, University of Occupational and Environmental Health Hospital, Kitakyushu, Japan
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11
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He J, Yang L. Value of three-dimensional speckle-tracking imaging in detecting left ventricular systolic function in patients with dilated cardiomyopathy. Echocardiography 2019; 36:1492-1495. [PMID: 31268561 PMCID: PMC6772161 DOI: 10.1111/echo.14427] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/22/2019] [Accepted: 06/07/2019] [Indexed: 12/30/2022] Open
Abstract
Objective To explore the value of three‐dimensional speckle‐tracking imaging (3DSTI) in detecting left ventricular systolic function in patients with dilated cardiomyopathy (DCM). Methods Totally 31 DCM patients were enrolled in this study. Left ventricular end‐systolic volume (LVESV), left ventricular end‐diastolic volume (LVEDV), and left ventricular ejection fraction (LVEF) were measured using the 3DSTI, two‐dimensional echocardiography (2DE), and magnetic resonance imaging (MRI). Left ventricular end‐diastolic mass (EDmass) and left ventricular end‐diastolic mass index (LVEDmass I) were also detected by 3DSTI and MRI. The differences in these measurements were analyzed and compared. Results The values of LVESV, LVEDV, and LVEF showed significantly positive correlations among 2DE group, 3DSTI group, and MRI group. The LVEF value showed significant difference among these three groups [(33.3 ± 11.1)%, (30.3 ± 10.6)%, and (26.2 ± 10.7)%; P = 0.04], whereas LVEDV and LVESV values were not significantly different (P > 0.05; respectively). Inter‐group comparison showed the mean of LVEF was significantly lower in MRI group than in 2DE group (P = 0.031), whereas there was no significant difference between 2DE group and 3DSTI group and between 3DSTI group and MRI group (P > 0.05; respectively). The EDmass and EDmassI detected by 3DSTI and MRI were (143.2 ± 40.2) g vs (190.0 ± 58.3) g and (83.2 ± 21.1) g/m2 vs (110.1 ± 29.7) g/m2 (P < 0.001; respectively). Conclusions The LVEF value detected by 3DSTI is closer to that detected by MRI in DCM patients.
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Affiliation(s)
- Jionghong He
- Department of Cardiology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Long Yang
- Department of Cardiology, Guizhou Provincial People's Hospital, Guiyang, China
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Jenner J, Sörensson P, Pernow J, Caidahl K, Eriksson MJ. Contrast Enhancement and Image Quality Influence Two- and Three-dimensional Echocardiographic Determination of Left Ventricular Volumes: Comparison With Magnetic Resonance Imaging. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2019; 13:1179546819831980. [PMID: 30858745 PMCID: PMC6402058 DOI: 10.1177/1179546819831980] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 01/28/2019] [Indexed: 12/21/2022]
Abstract
Purpose: To evaluate the effect of image quality and contrast enhancement (CE) on left ventricular (LV) volume determination by two- (2D) and three-dimensional (3D) echocardiography (2DE/3DE). Methods: We studied 32 post-myocardial infarction (MI) patients without (2DE/3DE) and with CE (CE2DE/CE3DE), in comparison with cardiac magnetic resonance imaging (CMR). Results: Two-dimensional echocardiography showed the largest negative bias versus CMR for diastolic and systolic volumes (−59, −28 mL, respectively) with lower biases for CE2DE (−37, −22 mL), 3DE (−31, −17 mL), and CE3DE (−17, −11 mL). Bias for ejection fraction (EF) ranged from −2.1% for 2DE to +1.4% for CE3DE. Agreement (intraclass correlation coefficient, ICC) for EF between CMR and 3DE (0.86 without and 0.85 with contrast) was better than for 2DE (0.73 without and 0.69 with contrast). The inter-/intra-observer coefficients of variation for EF varied from 16%/10% (2DE) to 6.9%/6.6% (CE2DE), and 8.3%/4.8% (3DE) to 6.7%/6.8% (CE3DE), respectively. The agreement (ICC) with CMR for EF measured by 2DE/3DE changed from 0.64/0.84 with poor image quality to 0.81/0.87 with moderate to good image quality. Conclusions: Three-dimensional echocardiography was more accurate than 2DE for estimating LV volumes, with less inter-/intra-observer variability in EF values. Contrast enhancement improved accuracy for both 2DE and 3DE and improved the inter-observer variability of EF estimates for 2DE and 3DE. Image quality had more impact on the agreement of EF values with CMR for 2DE than for 3DE. Our results emphasize the importance of using the same technique for longitudinal studies of LV EF and specially LV volumes.
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Affiliation(s)
- Jonas Jenner
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Peder Sörensson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - John Pernow
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - Kenneth Caidahl
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria J Eriksson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
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Agha HM, AbdelMassih AF, AbdelRahman MY, Milanesi O, Castaldi B, Geranio G, Putti MC, Kharabish A, Esmail R, El-Kamah G, Hamdy M, El-Baz H, Behairy N, Hanna C, El-Tagy H, Mishriky MA, Mamdouh M, Antonazzo L, Ramadan T. Can myocardial remodeling be a useful surrogate predictor of myocardial iron load? A 3D echocardiographic multicentric study. Pediatr Blood Cancer 2018; 65:e27272. [PMID: 29873876 DOI: 10.1002/pbc.27272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 11/06/2022]
Abstract
The relationship between myocardial iron load and eccentric myocardial remodeling remains an under-investigated area; it was thought that remodeling is rather linked to fibrosis. This study aims to determine whether or not measures of remodeling can be used as predictors of myocardial iron. For this purpose, 60 patients with thalassemia were studied with 3D echocardiography and myocardial relaxometry (T2*) by Cardiac MRI. 3D derived sphericity index was significantly higher in patients with myocardial iron load. It was correlated with T2* with a 100% sensitivity and specificity (cut-off value of 0.34) to discriminate between patients with and without myocardial iron overload.
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Affiliation(s)
- Hala Mounir Agha
- Pediatric, Cardiology Unit, Pediatrics Department, Specialized Children Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Antoine Fakhry AbdelMassih
- Pediatric, Cardiology Unit, Pediatrics Department, Specialized Children Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt.,Children's Cancer Hospital, Egypt 57357, Cairo, Egypt
| | - Mohamed Youssef AbdelRahman
- Pediatric, Cardiology Unit, Pediatrics Department, Specialized Children Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ornella Milanesi
- Pediatric Cardiology Unit, Department of Woman and Child Health, Faculty of Medicine, Padova University, Padova, Italy
| | - Biagio Castaldi
- Pediatric Cardiology Unit, Department of Woman and Child Health, Faculty of Medicine, Padova University, Padova, Italy
| | - Giulia Geranio
- Pediatric Hematology Unit, Department of Woman and Child Health, Faculty of Medicine, Padova University, Padova, Italy
| | - Maria Caterina Putti
- Pediatric Hematology Unit, Department of Woman and Child Health, Faculty of Medicine, Padova University, Padova, Italy
| | - Ahmed Kharabish
- Cardiac MRI Unit, Radiology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Reem Esmail
- Pediatric, Cardiology Unit, Pediatrics Department, Specialized Children Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ghada El-Kamah
- Clinical Genetics Department, National Research Centre, Cairo, Egypt
| | - Mona Hamdy
- Pediatric Hematology Unit, Pediatrics Department, Specialized Children Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Heba El-Baz
- Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Noha Behairy
- Cardiac MRI Unit, Radiology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Carol Hanna
- Computer Science and Software Development Department, American University of Cairo, Cairo, Egypt
| | - Hassan El-Tagy
- Orthopedics Residency Program, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mary Atef Mishriky
- Cardiology Residency Program, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mirna Mamdouh
- Cardiology Residency Program, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Livio Antonazzo
- Pediatric Hematology Unit, Department of Woman and Child Health, Faculty of Medicine, Padova University, Padova, Italy
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Argulian E, Seetharam K. Echocardiographic 3D-guided 2D planimetry in quantifying left-sided valvular heart disease. Echocardiography 2018; 35:695-706. [PMID: 29420834 DOI: 10.1111/echo.13828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Echocardiographic 3D-guided 2D planimetry can improve the accuracy of valvular disease assessment. Acquisition of 3D pyramidal dataset allows subsequent multiplanar reconstruction with accurate orthogonal plane alignment to obtain the correct borders of an anatomic orifice or flow area. Studies examining the 3D-guided 2D planimetry approach in left-sided valvular heart disease were identified and reviewed. The strongest evidence exists for estimating mitral valve area in patients with rheumatic mitral valve stenosis and vena contracta area in patients with mitral regurgitation (both primary and secondary). 3D-guided approach showed excellent feasibility and reproducibility in most studies, as well as time efficiency and good correlation with reference and comparator methods. Therefore, 3D-guided 2D planimetry can be used as an important clinical tool in quantifying left-sided valvular heart disease, especially mitral valve disorders.
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15
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Imaging the heart failure patient–need for accurate measurements of left ventricular volumes and ejection fraction. Curr Opin Cardiol 2016; 31:459-68. [DOI: 10.1097/hco.0000000000000312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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16
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Stone GW, Chung ES, Stancak B, Svendsen JH, Fischer TM, Kueffer F, Ryan T, Bax J, Leon A. Peri-infarct zone pacing to prevent adverse left ventricular remodelling in patients with large myocardial infarction. Eur Heart J 2015; 37:484-93. [PMID: 26321236 DOI: 10.1093/eurheartj/ehv436] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 08/12/2015] [Indexed: 11/13/2022] Open
Abstract
AIMS We sought to determine whether peri-infarct pacing prevents left ventricular (LV) remodelling and improves functional and clinical outcomes in patients with large first myocardial infarction (MI). METHODS AND RESULTS A total of 126 patients at 27 international sites within 10 days of onset of anterior or non-anterior MI with creatine phosphokinase >3000 U/L and QRS duration ≤120 ms were randomized 1:1:1 to dual-site biventricular pacing vs. single-site LV only pacing vs. non-implanted control. The primary endpoint was the echocardiographic core laboratory-assessed change in LV end-diastolic volume (ΔLVEDV) from baseline to 18 months between the pooled pacing therapy groups and the control group. ΔLVEDV increased by 15.3 ± 28.6 mL in the control group and by 16.7 ± 30.5 mL in the pooled pacing groups during follow-up (adjusted mean difference (95% CI) = 0.6 (-12.3, 13.5) mL, P = 0.92). There were also no significant between-group differences in the change in LV end-systolic volume or ejection fraction over time. Quality of life, as assessed by the Minnesota Living with Heart Failure (HF) and European Quality of Life-5 Dimension questionnaires and New York Heart Association class, was also similar between groups during 18-month follow-up. Six-minute walk distance improved during follow-up to an equal degree between groups, and there were no significant differences in the 18-month rates of death or HF hospitalization between the pooled pacing therapy vs. control groups (17.4 vs. 21.7% respectively, P = 0.59). CONCLUSIONS In the present multicentre, randomized trial, peri-infarct pacing did not prevent LV remodelling or improve functional or clinical outcomes during 18-month follow-up in patients with large first MI. CLINICALTRIALSGOV IDENTIFIER NCT01213251.
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Affiliation(s)
- Gregg W Stone
- Columbia University Medical Center, New York-Presbyterian Hospital, and the Cardiovascular Research Foundation, 111 E. 59th St., 11th Floor, New York, NY 10022, USA
| | | | - Branislav Stancak
- Eastern Slovakia Institute for Cardiac and Vascular Diseases, Kosice, Slovakia
| | - Jesper H Svendsen
- Rigshospitalet and the University of Copenhagen, Copenhagen, Denmark
| | | | | | - Thomas Ryan
- The Ohio State University, Columbus, OH, USA
| | - Jeroen Bax
- Leiden University Medical Center, Leiden, The Netherlands
| | - Angel Leon
- Emory University School of Medicine, Atlanta, GA, USA
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Measurements of left ventricular volumes and ejection fraction with three-dimensional echocardiography: feasibility and agreement compared to two-dimensional echocardiography. Int J Cardiovasc Imaging 2014; 30:1325-30. [DOI: 10.1007/s10554-014-0478-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 06/20/2014] [Indexed: 01/08/2023]
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18
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Wang W, Lin Q, Wu W, Jiang Y, Lan T, Wang H. Quantification of Mitral Regurgitation by General Imaging Three-Dimensional Quantification: Feasibility and Accuracy. J Am Soc Echocardiogr 2014; 27:268-76. [DOI: 10.1016/j.echo.2013.11.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Indexed: 11/25/2022]
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19
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Gripari P, Muratori M, Fusini L, Tamborini G, Pepi M. Three-Dimensional Echocardiography: Advancements in Qualitative and Quantitative Analyses of Mitral Valve Morphology in Mitral Valve Prolapse. J Cardiovasc Echogr 2014; 24:1-9. [PMID: 28465897 PMCID: PMC5353406 DOI: 10.4103/2211-4122.131985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Degenerative mitral valve disease (MVD) is the leading cause of organic mitral regurgitation (MR), one of the most common valvular heart disease in western countries. Substantial progresses in the surgical treatment of degenerative MVD have improved life expectancy of patients with significant MR. However, prognosis, surgical decision and timing of surgery strongly depend on the accurate characterization of mitral valve (MV) anatomy and pathology and on the precise quantification of MR. Three-dimensional (3D) echocardiography, a major technological breakthrough in the field of cardiovascular imaging, provides several advantages over two-dimensional (2D) imaging in the qualitative and quantitative evaluations of MV apparatus. In this review, we focus on the contribution of this new modality to the diagnosis of degenerative MVD, the quantitative assessment of MR severity, the selection and monitoring of surgical and percutaneous procedures, the evaluation of procedural outcomes. The results of a systematic and exhaustive search of the existing literature, restricted to real-time 3D echocardiography in adults, are here reported.
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Affiliation(s)
- Paola Gripari
- Centro Cardiologico Monzino, Istituto di ricovero e cura a carattere scientifico, Milano, Italy
| | - Manuela Muratori
- Centro Cardiologico Monzino, Istituto di ricovero e cura a carattere scientifico, Milano, Italy
| | - Laura Fusini
- Centro Cardiologico Monzino, Istituto di ricovero e cura a carattere scientifico, Milano, Italy
| | - Gloria Tamborini
- Centro Cardiologico Monzino, Istituto di ricovero e cura a carattere scientifico, Milano, Italy
| | - Mauro Pepi
- Centro Cardiologico Monzino, Istituto di ricovero e cura a carattere scientifico, Milano, Italy
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Badano LP. The clinical benefits of adding a third dimension to assess the left ventricle with echocardiography. SCIENTIFICA 2014; 2014:897431. [PMID: 24959374 PMCID: PMC4052480 DOI: 10.1155/2014/897431] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 01/23/2014] [Indexed: 05/09/2023]
Abstract
Three-dimensional echocardiography is a novel imaging technique based on acquisition and display of volumetric data sets in the beating heart. This permits a comprehensive evaluation of left ventricular (LV) anatomy and function from a single acquisition and expands the diagnostic possibilities of noninvasive cardiology. It provides the possibility of quantitating geometry and function of LV without preestablished assumptions regarding cardiac chamber shape and allows an echocardiographic assessment of the LV that is less operator-dependent and therefore more reproducible. Further developments and improvements for widespread routine applications include higher spatial and temporal resolution to improve image quality, faster acquisition, processing and reconstruction, and fully automated quantitative analysis. At present, three-dimensional echocardiography complements routine 2DE in clinical practice, overcoming some of its limitations and offering additional valuable information that has led to recommending its use for routine assessment of the LV of patients in whom information about LV size and function is critical for their clinical management.
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Affiliation(s)
- Luigi P. Badano
- Department of Cardiac, Thoracic and Vascular Sciences, School of Medicine, University of Padua, Via Giustiniani 2, 35123 Padua, Italy
- *Luigi P. Badano:
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Wood PW, Choy JB, Nanda NC, Becher H. Left ventricular ejection fraction and volumes: it depends on the imaging method. Echocardiography 2013; 31:87-100. [PMID: 24786629 PMCID: PMC4231568 DOI: 10.1111/echo.12331] [Citation(s) in RCA: 157] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background and Methods In order to provide guidance for using measurements of left ventricular (LV) volume and ejection fraction (LVEF) from different echocardiographic methods a PubMed review was performed on studies that reported reference values in normal populations for two-dimensional (2D ECHO) and three-dimensional (3D ECHO) echocardiography, nuclear imaging, cardiac computed tomography, and cardiac magnetic resonance imaging (CMR). In addition all studies (2 multicenter, 16 single center) were reviewed, which included at least 30 patients, and the results compared of noncontrast and contrast 2D ECHO, and 3D ECHO with those of CMR. Results The lower limits for normal LVEF and the normal ranges for end-diastolic (EDV) and end-systolic (ESV) volumes were different in each method. Only minor differences in LVEF were found in studies comparing CMR and 2D contrast echocardiography or noncontrast 3D echocardiography. However, EDV and ESV measured with all echocardiographic methods were smaller and showed greater variability than those derived from CMR. Regarding agreement with CMR and reproducibility, all studies showed superiority of contrast 2D ECHO over noncontrast 2D ECHO and 3D ECHO over 2D ECHO. No final judgment can be made about the comparison between contrast 2D ECHO and noncontrast or contrast 3D ECHO. Conclusion Contrast 2D ECHO and noncontrast 3D ECHO show good reproducibility and good agreement with CMR measurements of LVEF. The agreement of volumes is worse. Further studies are required to assess the clinical value of contrast 3D ECHO as noncontrast 3D ECHO is only reliable in patients with good acoustic windows.
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Affiliation(s)
- Peter W Wood
- Division of Cardiology, Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada
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Maffessanti F, Mirea O, Tamborini G, Pepi M. Three-dimensional echocardiography of the mitral valve: lessons learned. Curr Cardiol Rep 2013; 15:377. [PMID: 23686753 DOI: 10.1007/s11886-013-0377-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Three-dimensional echocardiography has markedly improved our understanding of normal and pathologic mitral valve (MV) mechanics. Qualitative and quantitative analysis of three-dimensional (3D) data on the mitral valve could have a clinical impact on diagnosis, patient referral, surgical strategies, annuloplasty ring design and evaluation of the immediate and long-term surgical outcome. This review covers the contribution of 3D echocardiography in the diagnosis of MV disease, its role in selecting and monitoring surgical procedures, and in the assessment of surgical outcomes. Moreover, advantages of this technique versus the standard 2D modality, as well as future applications of advanced analysis techniques, will be reviewed.
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Evaluation of left ventricular structure and function by three-dimensional echocardiography. Curr Opin Crit Care 2013; 19:387-96. [DOI: 10.1097/mcc.0b013e328364d75e] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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24
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Ruddox V, Mathisen M, Bækkevar M, Aune E, Edvardsen T, Otterstad JE. Is 3D echocardiography superior to 2D echocardiography in general practice? Int J Cardiol 2013; 168:1306-15. [DOI: 10.1016/j.ijcard.2012.12.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 09/11/2012] [Accepted: 12/01/2012] [Indexed: 02/07/2023]
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Huang XS, Gu CX, Yang JF, Wei H, Li JX, Zhou QW. Off-pump anteroapical aneurysm plication following left ventricular postinfarction aneurysm: effect on cardiac function, clinical status and survival. Can J Surg 2013; 56:119-27. [PMID: 23351499 DOI: 10.1503/cjs.022111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND In patients with coronary disease and aneurysm, ventricular reconstruction with revascularization is a surgical option. Details of patient selection and optimal surgical technique are still debated. We report our results with off-pump aneurysm plication after ventricular aneurysm with relative wall thinning. METHODS We retrospectively reviewed the records of 248 patients who had an operation for postinfarction left ventricular aneurysm. Reconstruction was accomplished by off-pump anteroapical aneurysm plication. The following variables were recorded: preoperative clinical, angiographic and echocardiographic findings and operative procedures. Outcomes were early mortality, long-term survival and poor 5-year result, defined as the need for transplantation or repeated hospitalization for congestive heart failure. Risk factors were pinpointed using the t test and survival curves. Independent risk factors were identified using Cox regression methods. RESULTS Hospital mortality was low (2.0%). Mean follow-up was 5.8 (standard deviation [SD] 3.8) years. Actuarial survival at 1 and 5 years was 94% and 84%. Among the 232 survivors, 200 were in functional class I or II, and the average increase in ejection fraction was 14.0% (SD 3.1%). As determined by multivariable analysis, factors predicting poor outcome were advanced age, ejection fraction less than 0.35, conicity index less than 1, end-systolic volume index greater than 80 mL/m2, advanced New York Heart Association functional class and congestive heart failure. CONCLUSION Using wall thinning as a criterion for patient selection, the technique of off-pump anteroapical aneurysm plication can be performed with low operative mortality and provides good symptomatic relief and long-term survival.
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Affiliation(s)
- Xin-sheng Huang
- The Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
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Thavendiranathan P, Phelan D, Thomas JD, Flamm SD, Marwick TH. Quantitative Assessment of Mitral Regurgitation. J Am Coll Cardiol 2012; 60:1470-83. [DOI: 10.1016/j.jacc.2012.05.048] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 05/07/2012] [Accepted: 05/10/2012] [Indexed: 11/28/2022]
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Performance of 3-dimensional echocardiography in measuring left ventricular volumes and ejection fraction: a systematic review and meta-analysis. J Am Coll Cardiol 2012; 59:1799-808. [PMID: 22575319 DOI: 10.1016/j.jacc.2012.01.037] [Citation(s) in RCA: 281] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 01/04/2012] [Accepted: 01/31/2012] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The primary aim of this systematic review is to objectively evaluate the test performance characteristics of three-dimensional echocardiography (3DE) in measuring left ventricular (LV) volumes and ejection fraction (EF). BACKGROUND Despite its growing use in clinical laboratories, the accuracy of 3DE has not been studied on a large scale. It is unclear if this technology offers an advantage over traditional two-dimensional (2D) methods. METHODS We searched for studies that compared LV volumes and EF measured by 3DE and cardiac magnetic resonance (CMR) imaging. A subset of those also compared standard 2D methods with CMR. We used meta-analyses to determine the overall bias and limits of agreement of LV end-diastolic volume (EDV), end-systolic volume (ESV), and EF measured by 3DE and 2D echocardiography (2DE). RESULTS Twenty-three studies (1,638 echocardiograms) were included. The pooled biases ± 2 SDs for 3DE were -19.1 ± 34.2 ml, -10.1 ± 29.7 ml, and - 0.6 ± 11.8% for EDV, ESV, and EF, respectively. Nine studies also included data from 2DE, where the pooled biases were -48.2 ± 55.9 ml, -27.7 ± 45.7 ml, and 0.1 ± 13.9% for EDV, ESV, and EF, respectively. In this subset, the difference in bias between 3DE and 2D volumes was statistically significant (p = 0.01 for both EDV and ESV). The difference in variance was statistically significant (p < 0.001) for all 3 measurements. CONCLUSIONS Three-dimensional echocardiography underestimates volumes and has wide limits of agreement, but compared with traditional 2D methods in these carefully performed studies, 3DE is more accurate for volumes and more precise in all 3 measurements.
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Greupner J, Zimmermann E, Grohmann A, Dübel HP, Althoff TF, Althoff T, Borges AC, Rutsch W, Schlattmann P, Hamm B, Dewey M. Head-to-head comparison of left ventricular function assessment with 64-row computed tomography, biplane left cineventriculography, and both 2- and 3-dimensional transthoracic echocardiography: comparison with magnetic resonance imaging as the reference standard. J Am Coll Cardiol 2012; 59:1897-907. [PMID: 22595410 DOI: 10.1016/j.jacc.2012.01.046] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 12/27/2011] [Accepted: 01/17/2012] [Indexed: 01/28/2023]
Abstract
OBJECTIVES This study was designed to compare the accuracy of 64-row contrast computed tomography (CT), invasive cineventriculography (CVG), 2-dimensional echocardiography (2D Echo), and 3-dimensional echocardiography (3D Echo) for left ventricular (LV) function assessment with magnetic resonance imaging (MRI). BACKGROUND Cardiac function is an important determinant of therapy and is a major predictor for long-term survival in patients with coronary artery disease. A number of methods are available for assessment of function, but there are limited data on the comparison between these multiple methods in the same patients. METHODS A total of 36 patients prospectively underwent 64-row CT, CVG, 2D Echo, 3D Echo, and MRI (as the reference standard). Global and regional LV wall motion and ejection fraction (EF) were measured. In addition, assessment of interobserver agreement was performed. RESULTS For the global EF, Bland-Altman analysis showed significantly higher agreement between CT and MRI (p < 0.005, 95% confidence interval: ±14.2%) than for CVG (±20.2%) and 3D Echo (±21.2%). Only CVG (59.5 ± 13.9%, p = 0.03) significantly overestimated EF in comparison with MRI (55.6 ± 16.0%). CT showed significantly better agreement for stroke volume than 2D Echo, 3D Echo, and CVG. In comparison with MRI, CVG-but not CT-significantly overestimated the end-diastolic volume (p < 0.001), whereas 2D Echo and 3D Echo significantly underestimated the EDV (p < 0.05). There was no significant difference in diagnostic accuracy (range: 76% to 88%) for regional LV function assessment between the 4 methods when compared with MRI. Interobserver agreement for EF showed high intraclass correlation for 64-row CT, MRI, 2D Echo, and 3D Echo (intraclass correlation coefficient >0.8), whereas agreement was lower for CVG (intraclass correlation coefficient = 0.58). CONCLUSIONS 64-row CT may be more accurate than CVG, 2D Echo, and 3D Echo in comparison with MRI as the reference standard for assessment of global LV function.
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Jackson BM, Gorman RC. Invited commentary. Ann Thorac Surg 2010; 91:121-2. [PMID: 21172498 DOI: 10.1016/j.athoracsur.2010.09.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Revised: 09/20/2010] [Accepted: 09/24/2010] [Indexed: 10/18/2022]
Affiliation(s)
- Benjamin M Jackson
- Department of Surgery, University of Pennsylvania, 4 Silverstein Pavilion, 3400 Spruce St, Philadelphia, PA 19104, USA.
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