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Left ventricular systolic dyssynchrony in patients with Kawasaki disease: a real-time three-dimensional echocardiography study. Int J Cardiovasc Imaging 2020; 36:1941-1951. [PMID: 32529348 DOI: 10.1007/s10554-020-01909-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 06/01/2020] [Indexed: 12/17/2022]
Abstract
The left ventricular (LV) systolic dyssynchrony index (SDI) is an important prognostic indicator for many cardiovascular diseases; however, the characteristics of the SDI in patients with Kawasaki disease (KD) are unknown. In this study, we aimed to identify and quantify the SDI using real-time three-dimensional echocardiography (RT3DE) in KD patients during different phases. In addition, we intended to explore whether the SDI is associated with systolic dysfunction. Seventy consecutive KD patients and seventy age- and sex-matched controls were enrolled. The SDIs (percent of cardiac cycle) of 16 segments (16-SDI%) and 12 segments (12-SDI%) were calculated based on the defined standard deviation of each segment time from end diastole to the minimal systolic volume according to the 17-segment model (apex excluded). In the acute phase, the 16-SDI% and 12-SDI% were significantly higher in KD patients than in controls (4.40 ± 0.14 vs. 1.98 ± 0.12, P = 0.000; 3.55 ± 1.21 vs. 1.67 ± 0.93, P = 0.009, respectively), and patients with coronary artery aneurysm (CAA) exhibited higher 16-SDI% (P = 0.021) and 12-SDI% (P = 0.034) than patients without CAA. In the convalescent phase, patients with CAA still had higher 16-SDI% (P = 0.002) and 12-SDI% (P = 0.031) than controls, while the SDI in patients without CAA recovered to normal. The 16-SDI% was negatively correlated with the LV ejection fraction obtained from RT3DE (r = - 0.845, P = 0.000). Mechanical dyssynchrony is prevalent in KD patients during the acute phase and transient in patients without CAA, while patients with CAA still have impaired synchrony even in the convalescent phase. LV systolic dysfunction is associated with increased dyssynchrony. RT3DE is a valuable modality for identifying and quantifying dyssynchrony in KD patients.
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Simpson J, Lopez L, Acar P, Friedberg MK, Khoo NS, Ko HH, Marek J, Marx G, McGhie JS, Meijboom F, Roberson D, Van den Bosch A, Miller O, Shirali G. Three-dimensional Echocardiography in Congenital Heart Disease: An Expert Consensus Document from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. J Am Soc Echocardiogr 2016; 30:1-27. [PMID: 27838227 DOI: 10.1016/j.echo.2016.08.022] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Three-dimensional echocardiography (3DE) has become important in the management of patients with congenital heart disease (CHD), particularly with pre-surgical planning, guidance of catheter intervention, and functional assessment of the heart. 3DE is increasingly used in children because of good acoustic windows and the non-invasive nature of the technique. The aim of this paper is to provide a review of the optimal application of 3DE in CHD including technical considerations, image orientation, application to different lesions, procedural guidance, and functional assessment.
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Affiliation(s)
- John Simpson
- Evelina London Children's Hospital, London, United Kingdom.
| | - Leo Lopez
- Nicklaus Children's Hospital, Miami, Florida
| | | | | | - Nee S Khoo
- Stollery Children's Hospital & University of Alberta, Edmonton, Alberta, Canada
| | - H Helen Ko
- Mt. Sinai Medical Center, New York, New York
| | - Jan Marek
- Great Ormond Street Hospital for Children, London, United Kingdom
| | - Gerald Marx
- Boston Children's Hospital and Harvard School of Medicine, Boston, Massachusetts
| | - Jackie S McGhie
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - David Roberson
- Advocate Children's Hospital, Chicago Medical School, Chicago, Illinois
| | | | - Owen Miller
- Evelina London Children's Hospital, London, United Kingdom
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Simpson J, Lopez L, Acar P, Friedberg M, Khoo N, Ko H, Marek J, Marx G, McGhie J, Meijboom F, Roberson D, Van den Bosch A, Miller O, Shirali G. Three-dimensional echocardiography in congenital heart disease: an expert consensus document from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Eur Heart J Cardiovasc Imaging 2016; 17:1071-97. [DOI: 10.1093/ehjci/jew172] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 06/28/2016] [Indexed: 01/02/2023] Open
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Mechanical Dyssynchrony and Abnormal Regional Strain Promote Erroneous Measurement of Systolic Function in Pediatric Heart Transplantation. J Am Soc Echocardiogr 2015; 28:1161-1170, e2. [DOI: 10.1016/j.echo.2015.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Indexed: 11/20/2022]
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Zhong SW, Zhang YQ, Chen LJ, Wang SS, Li WH. Evaluation of Left Ventricular Volumes and Function by Real Time Three-Dimensional Echocardiography in Children with Functional Single Left Ventricle: A Comparison between QLAB and TomTec. Echocardiography 2015; 32:1554-63. [DOI: 10.1111/echo.12990] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Shu-Wen Zhong
- Department of Pediatrics; Shanghai Children's Medical Center; Shanghai Jiaotong University School of Medicine; Shanghai China
| | - Yu-Qi Zhang
- Department of Pediatric Cardiology; Shanghai Children's Medical Center; Shanghai Jiaotong University School of Medicine; Shanghai China
| | - Li-Jun Chen
- Department of Pediatric Cardiology; Shanghai Children's Medical Center; Shanghai Jiaotong University School of Medicine; Shanghai China
| | - Shan-Shan Wang
- Department of Pediatrics; Shanghai Children's Medical Center; Shanghai Jiaotong University School of Medicine; Shanghai China
| | - Wei-Hua Li
- Department of Pediatrics; Shanghai Children's Medical Center; Shanghai Jiaotong University School of Medicine; Shanghai China
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Ojala T, Mathur S, Vatanen A, Sinha MD, Jahnukainen K, Simpson J. Repeatability and Agreement of Real Time Three-dimensional Echocardiography Measurements of Left Ventricular Mass and Synchrony in Young Patients. Echocardiography 2014; 32:522-7. [DOI: 10.1111/echo.12672] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Tiina Ojala
- Department of Pediatric Cardiology; Children's Hospital; University of Helsinki and Helsinki University Central Hospital; Helsinki Finland
| | - Sujeev Mathur
- Department of Congenital Heart Disease; Evelina London Children′s Hospital; Guy's and St. Thomas NHS Trust; London United Kingdom
| | - Anu Vatanen
- Division of Pediatric Hematology-Oncology; Children's Hospital; University of Helsinki and Helsinki University Central Hospital; Helsinki Finland
| | - Manish D. Sinha
- Department of Paediatric Nephrology; Evelina London Children′s Hospital; Guy's and St. Thomas NHS Trust; London United Kingdom
| | - Kirsi Jahnukainen
- Division of Pediatric Hematology-Oncology; Children's Hospital; University of Helsinki and Helsinki University Central Hospital; Helsinki Finland
| | - John Simpson
- Department of Congenital Heart Disease; Evelina London Children′s Hospital; Guy's and St. Thomas NHS Trust; London United Kingdom
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Klitsie LM, Roest AAW, van der Hulst AE, Stijnen T, Blom NA, Ten Harkel ADJ. Assessment of intraventricular time differences in healthy children using two-dimensional speckle-tracking echocardiography. J Am Soc Echocardiogr 2013; 26:629-39. [PMID: 23602167 DOI: 10.1016/j.echo.2013.03.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Parameters describing intraventricular time differences are increasingly assessed in both adults and children. However, to appreciate the implications of these parameters in children, knowledge of the applicability of adult techniques in children is essential. Hence, the aim of this study was to assess the applicability of speckle-tracking strain-derived parameters in children, paying special attention to age and heart rate dependency. METHODS One hundred eighty-three healthy subjects (aged 0-19 years) were included. Left ventricular global peak strain, time to global peak strain, and parameters describing intraventricular time differences were assessed using speckle-tracking strain imaging in the apical two-chamber, three-chamber, and four-chamber views (longitudinal strain) and the parasternal short-axis view (radial and circumferential strain). Parameters describing intraventricular time differences included the standard deviation of time to peak strain and differences in time to peak strain between two specified segments. Age and heart rate dependency were evaluated using regression analysis, and intraobserver and interobserver variability were tested. RESULTS Acquisition and analysis of longitudinal six-segment time-strain curves was successful in 94.8% of subjects and radial and circumferential time-strain curves in 89.5%. No clinically significant linear relation was observed between age or heart rate and parameters describing intraventricular time differences. The coefficient of variation of time to global peak strain parameters was <10, while it was >10 for parameters describing intraventricular time differences. CONCLUSIONS The feasibility of speckle-tracking strain analysis in children is relatively good. Furthermore, no linear relation was observed between age or heart rate and parameters describing intraventricular time differences. However, the limited reproducibility of some parameters describing intraventricular time differences will confine their applicability in clinical practice.
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Affiliation(s)
- Liselotte M Klitsie
- Department of Pediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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Echocardiographic Assessment of Ventricular Synchrony in Congenital and Acquired Heart Disease in Children. Echocardiography 2013; 30:460-71. [DOI: 10.1111/echo.12110] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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The impact of change in volume and left-ventricular hypertrophy on left-ventricular mechanical dyssynchrony in children with end-stage renal disease. Pediatr Cardiol 2012; 33:1124-30. [PMID: 22441563 DOI: 10.1007/s00246-012-0266-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 02/21/2012] [Indexed: 10/28/2022]
Abstract
Left-ventricular dyssynchrony (LVD) adversely affects systolic performance and has not been previously evaluated in children with end-stage renal disease (ESRD). We hypothesized (1) that LVD in children with ESRD would be significantly increased compared with controls and (2) that volume load and left-ventricular hypertrophy (LVH) would be associated with increased LVD. This was a prospective observational study in which real-time three-dimensional echocardiographic data were acquired in 27 stable children with ESRD (13 peritoneal dialysis [PD] and 14 hemodialysis [HD]) and 29 normal controls. Data were acquired before and after an HD session. Dyssynchrony index (SDI) was defined per standard formulae and was normalized to cardiac cycle duration (SDIp). Left-ventricular mass (LVM) was obtained from M-mode echocardiography and was normalized to height(2.7) (LVM index). The mean age (13.8 vs. 11.3 years) and SDI, SDIp, LVM, and LVM index were significantly greater among children with ESRD than among controls (p < 0.05). Demographics and heart rates were comparable between HD and PD subgroups, whereas SDI 16 and 12 segments, SDIp 16 segments, and LVM were significantly greater in the HD group. SDI and SDIp 16 segments improved after an HD session (p < 0.05); LVM and LVM index remained unchanged. LVD was significantly greater in patients with LVH compared with those without LVH. Children with ESRD had significant LVD and increased LVM compared with controls. Increased LVD in those undergoing HD rather than PD, as well as the improvement in synchrony after HD, suggest that volume may modulate LVD. LVD was increased in children with LVH. LVD in children with ESRD may have pathogenic implications.
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Kleijn SA, Aly MF, Knol DL, Terwee CB, Jansma EP, Abd El-Hady YA, Kandil HI, Sorour KA, van Rossum AC, Kamp O. A meta-analysis of left ventricular dyssynchrony assessment and prediction of response to cardiac resynchronization therapy by three-dimensional echocardiography. Eur Heart J Cardiovasc Imaging 2012; 13:763-775. [DOI: 10.1093/ehjci/jes041] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
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Gowda ST, Ahmad A, Younoszai A, Du W, Singh HR, Pettersen MD, Grimm RA, Boyle GJ. Left Ventricular Systolic Dyssynchrony in Pediatric and Adolescent Patients with Congestive Heart Failure. J Am Soc Echocardiogr 2012; 25:486-93. [DOI: 10.1016/j.echo.2012.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Indexed: 10/28/2022]
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Misra N, Webber SA, DeGroff CG. Adult Definitions for Dyssynchrony Are Inappropriate for Pediatric Patients. Echocardiography 2011; 28:468-74. [DOI: 10.1111/j.1540-8175.2010.01348.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Simpson JM, Miller O. Three-dimensional echocardiography in congenital heart disease. Arch Cardiovasc Dis 2011; 104:45-56. [DOI: 10.1016/j.acvd.2010.11.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 11/15/2010] [Accepted: 11/16/2010] [Indexed: 01/17/2023]
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Cui W, Gambetta K, Zimmerman F, Freter A, Sugeng L, Lang R, Roberson DA. Real-Time Three-Dimensional Echocardiographic Assessment of Left Ventricular Systolic Dyssynchrony in Healthy Children. J Am Soc Echocardiogr 2010; 23:1153-9. [DOI: 10.1016/j.echo.2010.08.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Indexed: 11/26/2022]
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Monaghan M, Bax J, Franke A, Kamp O, Kuehl H, Nihoyannopoulos P, TenCate F. 3-Dimensional Echocardiographic Assessment of Left Ventricular Dyssynchrony. JACC Cardiovasc Imaging 2009; 2:1334-5; author reply 1335-6. [DOI: 10.1016/j.jcmg.2009.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 09/03/2009] [Accepted: 09/11/2009] [Indexed: 11/24/2022]
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Innovation in three-dimensional echocardiography and cardiac computed tomographic angiography. Cardiol Young 2009; 19 Suppl 2:35-42. [PMID: 19857348 DOI: 10.1017/s1047951109991600] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Veeram Reddy SR, Du W, Zilberman MV. Left Ventricular Mechanical Synchrony and Global Systolic Function in Pediatric Patients Late after Ventricular Septal Defect Patch Closure: A Three-dimensional Echocardiographic Study. CONGENIT HEART DIS 2009; 4:454-8. [DOI: 10.1111/j.1747-0803.2009.00332.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
PURPOSE OF REVIEW This study will outline recent advances in echocardiography and their impact in the understanding of cardiac morphology and ventricular function. RECENT FINDINGS Evaluation of morphologic abnormalities in pediatric cardiology has benefited greatly from three-dimensional echocardiography, particularly with the introduction of high-frequency transducers. The size of cardiovascular structures is frequently affected by heart disease, and a systematic approach to adjust measurements for the effects of body size and age has helped to distinguish a normal structure from an abnormal one. Quantification of diastolic and systolic function continues to be a major focus in echocardiography. New modalities such as tissue Doppler imaging and speckle tracking echocardiography have provided new parameters to assess myocardial performance, and these parameters include myocardial velocities, ventricular twist and torsion, strain and strain rate, and mechanical dyssynchrony. Mechanical dyssynchrony analysis has been particularly useful in cardiac resynchronization therapy, a novel treatment for heart failure which shows great promise. SUMMARY Improved delineation of cardiac morphology has greatly augmented the current understanding of congenital heart diseases, and management strategies have been modified based on three-dimensional echocardiographic findings. The introduction of new parameters to evaluate ventricular function has provided early markers for cardiovascular impairment in several disease states, thereby allowing clinicians to monitor these patients more closely.
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Health-e-Child project: mechanical dyssynchrony in children with dilated cardiomyopathy. J Am Soc Echocardiogr 2009; 22:1289-95. [PMID: 19766450 DOI: 10.1016/j.echo.2009.07.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2008] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Left ventricular mechanical dyssynchrony has been poorly studied in the pediatric population with dilated cardiomyopathy. We investigated the degree of dyssynchrony in children with dilated cardiomyopathy using tissue Doppler imaging and speckle tracking strain. METHODS Twenty-five children with dilated cardiomyopathy were compared with healthy subjects. Left ventricular mechanical dyssynchrony was assessed by speckle tracking strain and tissue Doppler imaging. Both radial and longitudinal dyssynchrony were analyzed. Left ventricular end-diastolic diameter was measured to assess the relation between dyssynchrony and ventricular function and remodeling. RESULTS Radial and longitudinal dyssynchrony parameters were significantly higher in the dilated cardiomyopathy group and correlated with Z-score left ventricular end-diastolic diameter. A logarithmic correlation between left ventricular ejection fraction and left ventricular end-diastolic diameter parameters was found. CONCLUSION In children with dilated cardiomyopathy, tissue Doppler imaging and speckle tracking strain allowed the detection of dyssynchrony, which correlates with the severity of left ventricular function.
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Nemes A, Geleijnse ML, Soliman OII, Vletter WB, Forster T, ten Cate FJ. New method for evaluation of left ventricular dyssynchrony and success of cardiac resynchronization therapy: real-time 3-dimensional echocardiography. Orv Hetil 2009; 150:1834-8. [DOI: 10.1556/oh.2009.28713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A klinikai tapasztalat azt mutatja, hogy a jelenleg elérhető kritériumok alapján kiválasztott szívelégtelen betegek közel egyharmada a kardiális reszinkronizációs terápia (CRT) ellenére nonreszpondernek bizonyul, vagyis az optimális kezelés ellenére klinikai állapotukban javulás nem észlelhető. Ez a tény vezetett ahhoz a kutatási irányhoz, hogy találjunk olyan, noninvazív képalkotó diagnosztika (például echokardiográfia) során mérhető és/vagy számítható értéket, amely alkalmas a diszszinkrónia megítélésére és jobban segíti kiválasztani a CRT-re alkalmas betegeket. Ennek az áttekintő közleménynek a célja a legújabb noninvazív echokardiográfiás módszer, a real-time háromdimenziós echokardiográfia lehetséges szerepének bemutatása lenne az elérhető irodalom alapján.
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Affiliation(s)
| | | | | | - Wim B. Vletter
- 1 Erasmus MC Thoraxcentrum, Kardiológiai Klinika Rotterdam
| | - Tamás Forster
- 2 Szegedi Tudományegyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika és Kardiológiai Központ Szeged Korányi fasor 6. 6720
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Harkel AT, Van Osch-Gevers M, Helbing W. Real-Time Transthoracic Three Dimensional Echocardiography: Normal Reference Data for Left Ventricular Dyssynchrony in Adolescents. J Am Soc Echocardiogr 2009; 22:933-8. [DOI: 10.1016/j.echo.2009.04.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2008] [Indexed: 10/20/2022]
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Sonne C, Sugeng L, Takeuchi M, Weinert L, Childers R, Watanabe N, Yoshida K, Mor-Avi V, Lang RM. Real-Time 3-Dimensional Echocardiographic Assessment of Left Ventricular Dyssynchrony. JACC Cardiovasc Imaging 2009; 2:802-12. [DOI: 10.1016/j.jcmg.2009.03.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2008] [Revised: 03/17/2009] [Accepted: 03/25/2009] [Indexed: 10/20/2022]
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Imaging Mechanical Dyssynchrony With 3-Dimensional Echocardiography. JACC Cardiovasc Imaging 2009; 2:813-5. [DOI: 10.1016/j.jcmg.2009.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Revised: 02/19/2009] [Accepted: 02/23/2009] [Indexed: 11/23/2022]
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Usefulness of live three-dimensional transesophageal echocardiography in a congenital heart disease center. Am J Cardiol 2009; 103:1025-8. [PMID: 19327435 DOI: 10.1016/j.amjcard.2008.11.060] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2008] [Revised: 11/21/2008] [Accepted: 11/21/2008] [Indexed: 11/24/2022]
Abstract
Three-dimensional (3D) transesophageal echocardiography (TEE) has numerous potential applications in the care of patients with congenital heart disease (CHD). However, there were few data examining its utility in this setting. The aim was to describe the initial experience and feasibility of this modality at a tertiary CHD center. Twenty-seven 3D-TEE studies using the x7-2t live 3D matrix TEE transducer with an iE33 echocardiographic scanner (Philips Medical Systems, Bothell, Washington) were attempted. The utility of this method was examined in the 3 settings of interventional catheterizations (n = 16), intraoperative studies (n = 4), and diagnostic studies (n = 7). The probe was successfully inserted in 26 of 27 patients (weight 22.6 to 110 kg). In conclusion, the current matrix-array 3D-TEE probe was found to have a wide variety of clinical applications in a CHD center.
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Quantification of Left Ventricular Systolic Dyssynchrony by Real-Time Three-Dimensional Echocardiography. J Am Soc Echocardiogr 2009; 22:232-9. [DOI: 10.1016/j.echo.2008.11.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Indexed: 11/18/2022]
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Shiota T. 3D echocardiography: The present and the future. J Cardiol 2008; 52:169-85. [DOI: 10.1016/j.jjcc.2008.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Accepted: 09/04/2008] [Indexed: 12/14/2022]
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Migrino RQ, Harmann L, Woods T, Bright M, Truran S, Hari P. Intraventricular dyssynchrony in light chain amyloidosis: a new mechanism of systolic dysfunction assessed by 3-dimensional echocardiography. Cardiovasc Ultrasound 2008; 6:40. [PMID: 18687125 PMCID: PMC2525629 DOI: 10.1186/1476-7120-6-40] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Accepted: 08/07/2008] [Indexed: 11/10/2022] Open
Abstract
Background Light chain amyloidosis (AL) is a rare but often fatal disease due to intractable heart failure. Amyloid deposition leads to diastolic dysfunction and often preserved ejection fraction. We hypothesize that AL is associated with regional systolic dyssynchrony. The aim is to compare left ventricular (LV) regional synchrony in AL subjects versus healthy controls using 16-segment dyssynchrony index measured from 3-dimension-al (3D) echocardiography. Methods Cardiac 3D echocardiography full volumes were acquired in 10 biopsy-proven AL subjects (60 ± 3 years, 5 females) and 10 healthy controls (52 ± 1 years, 5 females). The LV was subdivided into 16 segments and the time from end-diastole to the minimal systolic volume for each of the 16 segments was expressed as a percent of the cycle length. The standard deviations of these times provided a 16-segment dyssynchrony index (16-SD%). 16-SD% was compared between healthy and AL subjects. Results Left ventricular ejection fraction was comparable (control vs. AL: 62.4 ± 0.6 vs. 58.6 ± 2.8%, p = NS). 16-SD% was significantly higher in AL versus healthy subjects (5.93 ± 4.4 vs. 1.67 ± 0.87%, p = 0.003). 16-SD% correlated with left ventricular mass index (R 0.45, p = 0.04) but not to left ventricular ejection fraction. Conclusion Light chain amyloidosis is associated with left ventricular regional systolic dyssynchrony. Regional dyssynchrony may be an unrecognized mechanism of heart failure in AL subjects.
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Affiliation(s)
- Raymond Q Migrino
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
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