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Zachos P, Nevras V, Milaras N, Karakosta M, Kalesi A, Kasinos N, Destounis A, Kelekis NL, Ikonomidis I, Niakas D. The value of myocardial strain imaging in the evaluation of patients with repaired Tetralogy of Fallot: a review of the literature. Heart Fail Rev 2023; 28:97-112. [PMID: 35286572 DOI: 10.1007/s10741-022-10223-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 02/07/2023]
Abstract
Tetralogy of Fallot (ToF) is considered to be the most common, complex, cyanotic congenital heart disease (CHD) representing 7-10% of all congenital heart defects, whereas the patients with ToF are the most frequently operated in their early infancy or childhood. Cardiac magnetic resonance (CMR) consists a valuable imaging technique for the diagnosis and serial follow-up of CHD patients. Furthermore, in recent years, advanced echocardiography imaging techniques have come to the fore, aiming to achieve a complete and more accurate evaluation of cardiac function using speckle tracking imaging modalities. We conducted a review of the literature in order to assess the myocardial deformation of patients with repaired ToF (rToF) using echocardiographic and CMR parameters. Patients with rToF have impaired myocardial strain parameters, that are well standardized either with the use of speckle tracking echocardiography or with the use of CMR imaging. Subclinical left ventricular dysfunction (low GLS) and myocardial dyssynchrony are commonly identified in rToF patients. Impaired left atrium (LA) and right atrium (RA) mechanics are, also, a common finding in this study population, but the studies using atrial strain are a lot fewer than those with LV and RV strain. No studies using myocardial work were identified in the literature, as far as rToF patients are concerned, which makes it an ideal field for further investigation.
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Affiliation(s)
- Panagiotis Zachos
- Department of Health Economics, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 115 27, Athens, Greece.
- Pediatric Cardiology and Adult Congenital Heart Disease Department, General Hospital of Karditsa, 43100, Karditsa, Tavropou (Terma), Greece.
| | - Vasilios Nevras
- Cardiology Department, General Hospital of Karditsa, 43100, Karditsa, Tavropou (Terma), Greece
| | - Nikias Milaras
- Cardiology Department, General Hospital of Karditsa, 43100, Karditsa, Tavropou (Terma), Greece
| | - Maria Karakosta
- Echocardiography Training Center "D. Beldekos," Cardiology Department, Tzaneio General Hospital of Pireaus, Zanni & 1 Afentouli Ave, 18536, Piraeus, Attica, Greece
| | - Alkistis Kalesi
- Echocardiography Training Center "D. Beldekos," Cardiology Department, Tzaneio General Hospital of Pireaus, Zanni & 1 Afentouli Ave, 18536, Piraeus, Attica, Greece
| | - Nearchos Kasinos
- Echocardiography Training Center "D. Beldekos," Cardiology Department, Tzaneio General Hospital of Pireaus, Zanni & 1 Afentouli Ave, 18536, Piraeus, Attica, Greece
| | - Antonios Destounis
- Echocardiography Training Center "D. Beldekos," Cardiology Department, Tzaneio General Hospital of Pireaus, Zanni & 1 Afentouli Ave, 18536, Piraeus, Attica, Greece
| | - Nikolaos L Kelekis
- Research Unit of Radiology and Medical Imaging/2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 1 Rimini Street, Haidari, 12462, Athens, Greece
| | - Ignatios Ikonomidis
- Echocardiography and Preventive Cardiology Laboratories/2nd Cardiology Department, National and Kapodistrian University of Athens - Attikon University Hospital, 1 Rimini Street, Haidari, 12462, Athens, Greece
| | - Dimitrios Niakas
- Department of Health Economics, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 115 27, Athens, Greece
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Sumerkan MC, Cetin S, Helvaci FB, Yaslikaya SS, Karabay U, Hamit T, Gurdal A, Agirbasli M, Alyan O. Three-dimensional echocardiographic assessment of Chiari’s network relationship with the left ventricular false tendon. Egypt Heart J 2022; 74:49. [PMID: 35704119 PMCID: PMC9200920 DOI: 10.1186/s43044-022-00287-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/03/2022] [Indexed: 11/24/2022] Open
Abstract
Background Left ventricular false tendon (LVFT) is a fibromuscular band crossing the left ventricular cavity. And Chiari’s network (CN) is a highly mobile, mesh-like, echogenic structure in right atrium. In this study, we aimed to evaluate the coexistence of LVFT in patients with CN. CN patients were examined with live/real-time three-dimensional transthoracic echocardiography (TTE) for visualization of LVFT. Results This is a single-center prospective study of 49 patients with CN. In literature studies, the average ratios of LVFT were 22% in the normal population. In our study, an increased ratio of LVFT (n = 31, 63.3%) was found in CN patients evaluated with a three-dimensional TTE (63.3% versus 22%) (p = 0.01). The interatrial septal aneurysm was found in 31 (63.3%) patients with CN. And, the positive contrast echocardiography examination was determined in 22 (61.1%) patients with CN. Conclusions Our study reveals that CN is associated with LVFT and is also associated with cardiac anomalies like an interatrial septal aneurysm, and atrial septal defect. And LVFT can be evaluated better with three-dimensional TTE than with traditional two-dimensional TTE. Patients with CN should be evaluated more carefully by three-dimensional echocardiography as they can be in synergy in terms of the cardiac pathologies they accompany. Supplementary Information The online version contains supplementary material available at 10.1186/s43044-022-00287-5.
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Corbett L, Forster J, Gamlin W, Duarte N, Burgess O, Harkness A, Li W, Simpson J, Bedair R. A practical guideline for performing a comprehensive transthoracic echocardiogram in the congenital heart disease patient: consensus recommendations from the British Society of Echocardiography. Echo Res Pract 2022; 9:10. [PMID: 36253815 PMCID: PMC9578224 DOI: 10.1186/s44156-022-00006-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
Transthoracic echocardiography is an essential tool in the diagnosis, assessment, and management of paediatric and adult populations with suspected or confirmed congenital heart disease. Congenital echocardiography is highly operator-dependent, requiring advanced technical acquisition and interpretative skill levels. This document is designed to complement previous congenital echocardiography literature by providing detailed practical echocardiography imaging guidance on sequential segmental analysis, and is intended for implementation predominantly, but not exclusively, within adult congenital heart disease settings. It encompasses the recommended dataset to be performed and is structured in the preferred order for a complete anatomical and functional sequential segmental congenital echocardiogram. It is recommended that this level of study be performed at least once on all patients being assessed by a specialist congenital cardiology service. This document will be supplemented by a series of practical pathology specific congenital echocardiography guidelines. Collectively, these will provide structure and standardisation to image acquisition and reporting, to ensure that all important information is collected and interpreted appropriately.
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Affiliation(s)
- Liam Corbett
- grid.437500.50000 0004 0489 5016Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | - Jan Forster
- grid.415967.80000 0000 9965 1030Leeds Teaching Hospital NHS Trust, Leeds, UK
| | - Wendy Gamlin
- grid.498924.a0000 0004 0430 9101Manchester University NHS Foundation Trust, Manchester, UK
| | - Nuno Duarte
- grid.410421.20000 0004 0380 7336University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Owen Burgess
- grid.410421.20000 0004 0380 7336University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Allan Harkness
- grid.507581.e0000 0001 0033 9432East Suffolk and North Essex NHS Foundation Trust, Colchester, UK
| | - Wei Li
- grid.7445.20000 0001 2113 8111Royal Brompton and Harefield NHS Foundation Trust, Imperial College of London, London, UK
| | - John Simpson
- grid.483570.d0000 0004 5345 7223Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Radwa Bedair
- grid.410421.20000 0004 0380 7336University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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Li YD, Meng H, Pang KJ, Li MZ, Xu N, Wang H, Li SJ, Yan J. Echocardiography in the diagnosis of Shone’s complex and analysis of the causes for missed diagnosis and misdiagnosis. World J Clin Cases 2022; 10:3369-3378. [PMID: 35611202 PMCID: PMC9048561 DOI: 10.12998/wjcc.v10.i11.3369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/23/2021] [Accepted: 02/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Shone’s complex is a rare syndrome characterized by congenital left heart defects that can differ among the patients.
AIM To use echocardiography in the diagnosis of Shone’s complex and analyze the causes of missed diagnosis and misdiagnosis.
METHODS This was a retrospective study of patients who underwent echocardiography and repair surgery from February 14, 2008, to November 22, 2019. The patients were followed once a year at the outpatient clinic after surgery.
RESULTS Sixty-six patients were included. The patients were 2.7 (0.8-5.6) years of age, and 54.5% were male. Ten (15.2%) had a history of heart surgery. The most common heart defect was the Annulo-Leaflet mitral ring (ALMR) (50/66, 75.8%), followed by coarctation of the aorta (CoA) (43/66, 65.2%). The patients had a variety of combinations of defects. Only two (3.0%) patients had all four defects. None of the patients had a family history of congenital heart disease. The preoperative echocardiographic findings were examined against the intraoperative findings. Echocardiography missed an ALMR in 31 patients (47.0%), a parachute mitral valve (PMV) in one patient (1.5%), subaortic stenosis in one patient (1.5%), and CoA in two patients (3.0%).
CONCLUSION Echocardiography is an effective method to diagnose the Shone’s complex. Due to this disease’s complexity and interindividual variability, Improving the understanding of the disease can reduce misdiagnosis and missed diagnosis.
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Affiliation(s)
- Ye-Dan Li
- Department of Echocardiography, Fuwai Hospital, Beijing 100037, China
| | - Hong Meng
- Department of Echocardiography, Fuwai Hospital, Beijing 100037, China
| | - Kun-Jing Pang
- Department of Echocardiography, Fuwai Hospital, Beijing 100037, China
| | - Mu-Zi Li
- Department of Echocardiography, Fuwai Hospital, Beijing 100037, China
| | - Nan Xu
- Department of Echocardiography, Fuwai Hospital, Beijing 100037, China
| | - Hao Wang
- Department of Echocardiography, Fuwai Hospital, Beijing 100037, China
| | - Shou-Jun Li
- Department of Cardiovascular Surgery, Fuwai Hospital, Beijing 100037, China
| | - Jun Yan
- Department of Cardiovascular Surgery, Fuwai Hospital, Beijing 100037, China
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Pushparajah K. Non-invasive Imaging in the Evaluation of Cardiac Shunts for Interventional Closure. Front Cardiovasc Med 2021; 8:651726. [PMID: 34222361 PMCID: PMC8253251 DOI: 10.3389/fcvm.2021.651726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 04/08/2021] [Indexed: 11/13/2022] Open
Abstract
Multimodality imaging provides important information to guide patient selection and pre-procedural decision making for shunt lesions in CHD. While echocardiography, CT, and CMR are well-established, 3D printing and now virtual reality imaging are beginning to show promise.
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Affiliation(s)
- Kuberan Pushparajah
- School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London, United Kingdom.,Department of Paediatric Cardiology, Evelina London Children's Hospital, London, United Kingdom
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Tsuda T, Kernizan D, Del Grippo E, Thacker D, Kharouf R, Srivastava S. Echocardiographic assessment of ventricular function: Conventional and advanced technologies and their clinical applications. PROGRESS IN PEDIATRIC CARDIOLOGY 2020. [DOI: 10.1016/j.ppedcard.2020.101269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Yoon SA, Hong WH, Cho HJ. Congenital heart disease diagnosed with echocardiogram in newborns with asymptomatic cardiac murmurs: a systematic review. BMC Pediatr 2020; 20:322. [PMID: 32605548 PMCID: PMC7325562 DOI: 10.1186/s12887-020-02212-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 06/16/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND More than 50% of newborns with congenital heart disease (CHD) are unrecognized at birth; however, the use of echocardiogram (Echo) for diagnosing CHD in newborns with asymptomatic, non-syndromic cardiac murmurs (ANCM), has not been systematically reviewed yet. We aimed to identify the incidence of CHD diagnosed with Echo and systematically review whether Echo should be recommended in this patient group. METHODS The methodology utilized in this systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Using the MEDLINE, EMBASE, Web of Science, and Cochrane Library databases, we performed a systematic review of publications reporting CHD diagnosed with Echo in newborns with cardiac murmurs. The quality of the included studies was evaluated using the Study Quality Assessment Tools developed by the National Institutes of Health. RESULTS Of the 630 studies screened, six cohort studies, four cross-sectional studies, and two case reports were included in this review. The incidence of cardiac murmurs ranged from 0.6-8.6%. Among the 1928 newborns with ANCM, 719 (37.3%) were diagnosed with Echo as having CHD, and ventricular septal defect was the most common congenital malformation. More than 50% of the newborns showed moderate CHD necessitating outpatient cardiology follow-up, and 2.5% had severe CHD requiring immediate interventions, such as cardiac catheterization and heart surgery. CONCLUSIONS In this systematic review, a high incidence of CHD in newborns with ANCM was detected using Echo. This indicates that the use of Echo for diagnosing CHD in healthy newborns with cardiac murmurs could be helpful in earlier detection of CHD, thereby improving clinical outcomes for newborns with severe CHD.
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Affiliation(s)
- Shin Ae Yoon
- Department of Pediatrics, Chungbuk National University Hospital, (28644) 1 Chungdae-ro, Seowon-gu, Cheongju-si, Chungcheongbuk-do South Korea
| | - Woi Hyun Hong
- College of Medicine, Medical Research Information Center, Chungbuk National University, (28644) 1 Chungdae-ro, Seowon-gu, Cheongju-si, Chungcheongbuk-do South Korea
| | - Hwa Jin Cho
- Department of Pathology, Inje University Busan Paik Hospital, (47392) 75 Bokji-ro, Busanjin-gu, Busan, South Korea
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