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Truong HC, Myagmardorj Y, Miyaso H, Kawagishi K. Exploring heart dissection techniques for enhancing anatomical education: a pilot study to replicate transthoracic echocardiography. Surg Radiol Anat 2024; 46:951-958. [PMID: 38743144 DOI: 10.1007/s00276-024-03342-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 03/05/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE For novice learners, converting two-dimensional (2D) images of echocardiography to three-dimensional (3D) cardiac structures is deemed challenging. This study aimed to develop an accurate dissection method of the heart to reproduce the transthoracic echocardiographic views on cadavers and elucidate new educational methods in human anatomy dissection courses. METHODS A total of 18 hearts were used in this study. After reflecting the anterior thoracic wall inferiorly, the hearts were excised from embalmed cadavers. Thereafter, three landmarks were set on the heart for each plane of the incision, and the hearts were incised to observe the three different echocardiographic views, which include the apical four-chamber view (A4C), parasternal long axis (PLAX) view, and parasternal short axis (PSAX) view at the papillary muscle level. If all structures for observation during routine echocardiography are clearly observed in each view, a successful incision is considered. All procedures and incisions were performed by the medical students. After a successful incision, hearts were returned to the original position in the pericardial sac for further observation. RESULTS The success rates of incision for each view were 83.3% (5/6 success cases), 83.3% (5/6 success cases), and 66.7% (4/6 success cases) in the A4C view, PLAX view, and PSAX view at the papillary muscle level, respectively. CONCLUSION This dissection method could probably be employed to reproduce transthoracic echocardiographic views on cadaveric hearts, which is beneficial for novice learners for a deeper understanding of the anatomy.
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Affiliation(s)
- Huy Cong Truong
- International University of Health and Welfare School of Medicine, 4-3 Kozunomori, Narita, Chiba, 286-8686, Japan
| | - Yanjinlkham Myagmardorj
- International University of Health and Welfare School of Medicine, 4-3 Kozunomori, Narita, Chiba, 286-8686, Japan
| | - Hidenobu Miyaso
- Department of Anatomy, International University of Health and Welfare School of Medicine, 4-3 Kozunomori, Narita, Chiba, 286-8686, Japan
| | - Kyutaro Kawagishi
- Department of Anatomy, International University of Health and Welfare School of Medicine, 4-3 Kozunomori, Narita, Chiba, 286-8686, Japan.
- Department of Anatomy and Structural Science, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, Yamagata, 990-9585, Japan.
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Lu D, Beyer AT, Pursnani SK, Shaw RE, Fang Q, Bibby D, Rosenblatt A, Schiller NB. Left ventricular end‐systolic volume response post‐stress echocardiography: Dilation as a marker of multi‐vessel coronary artery disease. Echocardiography 2022; 39:215-222. [DOI: 10.1111/echo.15291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/21/2021] [Accepted: 12/26/2021] [Indexed: 11/28/2022] Open
Affiliation(s)
- Dai‐Yin Lu
- Division of Cardiology University of California San Francisco California USA
- Institute of Public Health National Yang Ming Chiao Tung University Taipei Taiwan
| | - Anna T. Beyer
- Division of Cardiology University of California San Francisco California USA
- Division of Cardiology California Pacific Medical Center San Francisco California USA
| | - Seema K. Pursnani
- Kaiser Permanente Santa Clara Medical Center Santa Clara California USA
| | - Richard E. Shaw
- Division of Cardiology California Pacific Medical Center San Francisco California USA
| | - Qizhi Fang
- Division of Cardiology University of California San Francisco California USA
| | - Dwight Bibby
- Division of Cardiology University of California San Francisco California USA
| | - Andrew Rosenblatt
- Division of Cardiology California Pacific Medical Center San Francisco California USA
| | - Nelson B. Schiller
- Division of Cardiology University of California San Francisco California USA
- Division of Cardiology California Pacific Medical Center San Francisco California USA
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Fagiry MA, Hassan IA, Mahmoud MZ. Two-dimensional echocardiography in the diagnosis of ischemic heart disease. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2019. [DOI: 10.1080/16878507.2019.1594129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Moram A. Fagiry
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Diagnostic Radiologic Technology Department, College of Medical Radiological Sciences, Sudan University of Science and Technology, Khartoum, Sudan
| | - Ikhlas A. Hassan
- Diagnostic Radiologic Technology Department, College of Medical Radiological Sciences, Sudan University of Science and Technology, Khartoum, Sudan
| | - Mustafa Z. Mahmoud
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Youssef G, Saad Z, Ammar W, Sharaf Y. Assessment of left ventricular regional wall motion abnormalities using regional time-volume curves obtained by real time three-dimensional echocardiography. Egypt Heart J 2018; 70:189-194. [PMID: 30190645 PMCID: PMC6123227 DOI: 10.1016/j.ehj.2018.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 02/12/2018] [Indexed: 10/24/2022] Open
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Berbarie RF, Dib E, Ahmad M. Stress echocardiography using real-time three-dimensional imaging. Echocardiography 2018; 35:1196-1203. [DOI: 10.1111/echo.14050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Rafic F. Berbarie
- Division of Cardiology; Department of Internal Medicine; University of Texas Medical Branch; Galveston TX USA
| | - Elie Dib
- Division of Cardiology; Department of Internal Medicine; University of Texas Medical Branch; Galveston TX USA
| | - Masood Ahmad
- Division of Cardiology; Department of Internal Medicine; University of Texas Medical Branch; Galveston TX USA
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Capotosto L, Massoni F, De Sio S, Ricci S, Vitarelli A. Early Diagnosis of Cardiovascular Diseases in Workers: Role of Standard and Advanced Echocardiography. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7354691. [PMID: 29560362 PMCID: PMC5820578 DOI: 10.1155/2018/7354691] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 12/04/2017] [Indexed: 12/30/2022]
Abstract
Cardiovascular disease (CVD) still remains the main cause of morbidity and mortality and consequently early diagnosis is of paramount importance. Working conditions can be regarded as an additional risk factor for CVD. Since different aspects of the job may affect vascular health differently, it is important to consider occupation from multiple perspectives to better assess occupational impacts on health. Standard echocardiography has several targets in the cardiac population, as the assessment of myocardial performance, valvular and/or congenital heart disease, and hemodynamics. Three-dimensional echocardiography gained attention recently as a viable clinical tool in assessing left ventricular (LV) and right ventricular (RV) function, volume, and shape. Two-dimensional (2DSTE) and, more recently, three-dimensional speckle tracking echocardiography (3DSTE) have also emerged as methods for detection of global and regional myocardial dysfunction in various cardiovascular diseases and applied to the diagnosis of subtle LV and RV dysfunction. Although these novel echocardiographic imaging modalities have advanced our understanding of LV and RV mechanics, overlapping patterns often show challenges that limit their clinical utility. This review will describe the current state of standard and advanced echocardiography in early detection (secondary prevention) of CVD and address future directions for this potentially important diagnostic strategy.
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Deng Y, Peng L, Liu YY, Yin LX, Li CM, Wang Y, Rao L. Four-dimensional echocardiography area strain combined with exercise stress echocardiography to evaluate left ventricular regional systolic function in patients with mild single vessel coronary artery stenosis. Echocardiography 2017; 34:1332-1338. [PMID: 28752550 DOI: 10.1111/echo.13638] [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: 02/05/2023] Open
Abstract
BACKGROUND The aim of this prospective study was to assess the diagnosis value of four-dimensional echocardiography area strain (AS) combined with exercise stress echocardiography to evaluate left ventricular regional systolic function in patients with mild single vessel coronary artery stenosis. METHODS Based on treadmill exercise load status, two-dimensional conventional echocardiography and four-dimensional echocardiography area strain were performed on patients suspected coronary artery disease before coronary angiogram. Thirty patients (case group) with mild left anterior descending coronary artery stenosis (stenosis <50%) and thirty gender- and age-matched patients (control group) without coronary artery stenosis according to the coronary angiogram results were prospectively enrolled. RESULTS All the patients had no left ventricular regional wall motion abnormality in two-dimensional echocardiography at rest and exercise stress. There was no significant difference in the 16 segmental systolic peak AS at rest between two groups. After exercise stress, the peak systolic ASrest-stress at mid anterior wall (-7.00%±10.90% vs 2.80%±23.69%) and mid anterolateral wall (-4.40%±18.81% vs 8.80%±19.16%) were decreased, while increased at basal inferolateral wall (14.00%±19.27% vs -5.60%±15.94%) in case group compared with control group (P<.05). CONCLUSIONS In patients with mild single vessel coronary artery stenosis, the area strain was decreased at involved segments, while compensatory increased at noninvolved segments after exercise stress. Four-dimensional echocardiography area strain combined with exercise stress echocardiography could sensitively find left ventricular regional systolic function abnormality in patients with mild single vessel coronary artery stenosis, and locate stenosis coronary artery accordingly.
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Affiliation(s)
- Yan Deng
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.,Department of Cardiovascular Ultrasound and Noninvasive Cardiology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, School of Clinical Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Long Peng
- Department of Cardiovascular Ultrasound and Noninvasive Cardiology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, School of Clinical Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Yuan-Yuan Liu
- Department of Health Statistics, School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
| | - Li-Xue Yin
- Department of Cardiovascular Ultrasound and Noninvasive Cardiology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, School of Clinical Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Chun-Mei Li
- Department of Cardiovascular Ultrasound and Noninvasive Cardiology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, School of Clinical Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Yi Wang
- Department of Cardiovascular Ultrasound and Noninvasive Cardiology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, School of Clinical Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Li Rao
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Johri AM, Chitty DW, Hua L, Marincheva G, Picard MH. Assessment of image quality in real time three-dimensional dobutamine stress echocardiography: an integrated 2D/3D approach. Echocardiography 2014; 32:496-507. [PMID: 25059625 DOI: 10.1111/echo.12692] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Three-dimensional (3D) stress echocardiography is a relatively new technique offering the potential to acquire images of the entire left ventricle from 1 or 2 transducer positions in a time-efficient manner. Relative to two-dimensional (2D) imaging, the ability to quickly acquire full volume images during peak stress with 3D echocardiography can eliminate left ventricular (LV) foreshortening while reducing inter-operator variability. Our objectives were to (1) determine the practicality of a novel integrated 2D/3D stress protocol in incorporating 3D imaging into a standard 2D stress echocardiogram and (2) to determine whether the quality of imaging using the novel 2D/3D protocol was sufficient for interpretation. METHODS Twenty-five patients referred for stress echocardiography underwent an integrated 2D/3D image acquisition protocol. LV segments were scored from 0 (absent or no clear endocardial visualization) to 3 (excellent/full visualization of endocardial border) with each modality. 2D segment quality scoring was compared with 3D. An integrated score was compared with either 2D or 3D imaging alone. RESULTS Two-dimensional and 3D imaging were optimal for differing segments and the integrated protocol was superior to either modality alone. 3D imaging was superior in visualizing the anterior and anterolateral region of the base segments, compared to 2D imaging. 3D imaging was less useful for the base, the mid-inferior, and the inferoseptal segments, thus emphasizing the need to retain 2D imaging in stress echocardiography at this time. CONCLUSION The integrated 2D/3D protocol approach to stress echocardiography is technically feasible and maximizes image quality of dobutamine stress echocardiography, improving patient assessment.
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Affiliation(s)
- Amer M Johri
- Division of Cardiology, Queen's University, Kingston, Ontario, Canada
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Abstract
Echocardiography is one of the most valuable diagnostic tools in cardiology. Technological advances in ultrasound, computer and electronics enables three-dimensional (3-D) imaging to be a clinically viable modality which has significant impact on diagnosis, management and interventional procedures. Since the inception of 3D fully-sampled matrix transthoracic and transesophageal technology it has enabled easier acquisition, immediate on-line display, and availability of on-line analysis for the left ventricle, right ventricle and mitral valve. The use of 3D TTE has mainly focused on mitral valve disease, left and right ventricular volume and functional analysis. As structural heart disease procedures become more prevalent, 3D TEE has become a requirement for preparation of the procedure, intra-procedural guidance as well as monitoring for complications and device function. We anticipate that there will be further software development, improvement in image quality and workflow.
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Qin C, David Meggo-Quiroz L, Nanda NC, Wang X, Xie M. Early effect of essential hypertension on the left ventricular twist-displacement loop by two-dimensional ultrasound speckle tracking imaging. Echocardiography 2013; 31:631-7. [PMID: 24304461 DOI: 10.1111/echo.12456] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To investigate two-dimensional (2D) ultrasound speckle tracking imaging (STI) in the evaluation of the early changes in the left ventricular (LV) twist-displacement loop in patients with hypertension (EH). METHODS Sixty-five EH patients with left ventricular normal geometry (LVN) - including 33 cases with non-left atrial enlargement (NLAE) and 32 cases with left atrial enlargement (LAE) - along with 45 healthy individuals were enrolled in this study. Basal and apical 2D LV short-axis images were acquired and analyzed to obtain the LV rotation (LVrot) and LV radial displacement. Once the LV twist and LV radial displacement were calculated, an LV twist-displacement loop was constructed. Group comparisons between peak twist (Ptw), twist at mitral valve opening (MVOtw), untwisting rate (Utw R), systolic radial displacement (SD), systolic slope (SS), isovolumic relaxation radial displacement (IVRD) and isovolumic relaxation slope (IVRS) were performed. RESULTS (1) The Ptw and MVOTw were greater in the NLAE and LAE groups when compared to the normal group while the UTw R was lower in likewise comparison. (2) The LV twist was correlated to the radial displacement in systole and in the isovolumic relaxation period. The SS and IVRS were greater in the NLAE and LAE groups when compared to the normal group. CONCLUSIONS The LV twist-displacement loop can be reconstructed noninvasively by 2D ultrasound STI. EH affects the systolic and early diastolic component of the twist-displacement loop by increasing the LV twist and decreasing the LV untwisting respectively impairing LV relaxation. The assessment of the LV twist-displacement loop may be useful in the evaluation of early features of LV dysfunction in EH patients.
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Affiliation(s)
- Chuan Qin
- Department of Ultrasound Imaging Diagnosis, Union Hospital of Huazhong University of Science and Technology, Wuhan, China
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Advances In Contrast Stress Echocardiography. CURRENT CARDIOVASCULAR IMAGING REPORTS 2013. [DOI: 10.1007/s12410-013-9228-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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