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De Bosscher R, Claeys M, Dausin C, Goetschalckx K, Claus P, Herbots L, Ghekiere O, Van De Heyning C, Paelinck BP, Janssens K, Wright L, Flannery MD, La Gerche A, Willems R, Heidbuchel H, Bogaert J, Claessen G. Three-dimensional echocardiography of the athlete's heart: a comparison with cardiac magnetic resonance imaging. Int J Cardiovasc Imaging 2023; 39:295-306. [PMID: 36151432 DOI: 10.1007/s10554-022-02726-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 09/03/2022] [Indexed: 01/28/2023]
Abstract
Three-dimensional echocardiography (3DE) is the most accurate cardiac ultrasound technique to assess cardiac structure. 3DE has shown close correlation with cardiac magnetic resonance imaging (CMR) in various populations. There is limited data on the accuracy of 3DE in athletes and its value in detecting alterations during follow-up. Indexed left and right ventricular end-diastolic volume (LVEDVi, RVEDVi), end-systolic volume, ejection fraction (LVEF, RVEF) and left ventricular mass (LVMi) were assessed by 3DE and CMR in two-hundred and one competitive endurance athletes (79% male) from the Pro@Heart trial. Sixty-four athletes were assessed at 2 year follow-up. Linear regression and Bland-Altman analyses compared 3DE and CMR at baseline and follow-up. Interquartile analysis evaluated the agreement as cardiac volumes and mass increase. 3DE showed strong correlation with CMR (LVEDVi r = 0.91, LVEF r = 0.85, LVMi r = 0.84, RVEDVi r = 0.84, RVEF r = 0.86 p < 0.001). At follow up, the percentage change by 3DE and CMR were similar (∆LVEDVi r = 0.96 bias - 0.3%, ∆LVEF r = 0.94, bias 0.7%, ∆LVMi r = 0.94 bias 0.8%, ∆RVESVi r = 0.93, bias 1.2%, ∆RVEF r = 0.87 bias 0.4%). 3DE underestimated volumes (LVEDVi bias - 18.5 mL/m2, RVEDVi bias - 25.5 mL/m2) and the degree of underestimation increased with larger dimensions (Q1vsQ4 LVEDVi relative bias - 14.5 versus - 17.4%, p = 0.016; Q1vsQ4 RVEDVi relative bias - 17 versus - 21.9%, p = 0.005). Measurements of cardiac volumes, mass and function by 3DE correlate well with CMR and 3DE accurately detects changes over time. 3DE underestimates volumes and the relative bias increases with larger cardiac size.
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Affiliation(s)
- Ruben De Bosscher
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium. .,Department of Cardiology, University Hospitals Leuven, Leuven, Belgium. .,Department of Cardiovascular Medicine, University Hospitals Leuven, B-3000, Leuven, Belgium.
| | - Mathias Claeys
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Piet Claus
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Lieven Herbots
- Department of Cardiology, Hartcentrum, Jessa Ziekenhuis, Hasselt, Belgium.,REVAL/BIOMED, Hasselt University, Diepenbeek, Belgium
| | - Olivier Ghekiere
- REVAL/BIOMED, Hasselt University, Diepenbeek, Belgium.,Department of Radiology, Jessa Ziekenhuis, Hasselt, Belgium
| | - Caroline Van De Heyning
- Department of Cardiovascular Sciences, University of Antwerp, Antwerp, Belgium.,Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium
| | - Bernard P Paelinck
- Department of Cardiovascular Sciences, University of Antwerp, Antwerp, Belgium.,Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium
| | - Kristel Janssens
- Department of Cardiology, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Leah Wright
- Department of Cardiology, Baker Heart and Diabetes Institute, Melbourne, Australia
| | | | - André La Gerche
- Department of Cardiology, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Rik Willems
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Hein Heidbuchel
- Department of Cardiovascular Sciences, University of Antwerp, Antwerp, Belgium.,Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium
| | - Jan Bogaert
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Guido Claessen
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
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Kwon A, Ihm SH, Park CS. Morning blood pressure surge in the early stage of hypertensive patients impacts three-dimensional left ventricular speckle tracking echocardiography. Clin Hypertens 2021; 27:16. [PMID: 34391469 DOI: 10.1186/s40885-021-00173-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to examine left ventricular (LV) function in untreated, newly diagnosed hypertensive patients with morning blood pressure surge (MBPS) status using three-dimensional (3D) speckle tracking echocardiography (STE). METHODS In this study, 163 newly diagnosed hypertensive patients were included, and all patients underwent 24-h ambulatory blood pressure monitoring (ABPM). According to ABPM, participants were divided into a MBPS group and a non-MBPS group. The entire study population was examined by complete two-dimensional (2D) transthoracic echocardiography (TTE) and 3D STE. RESULT The results of this study showed that 3D LV longitudinal strain was significantly decreased in the MBPS group compared with the non-MBPS group (- 30.1 ± 2.0 vs. -31.1 ± 2.7, p = 0.045). Similar trends were observed for 3D twist (9.6 ± 6.1 vs. 12.1 ± 4.8, p = 0.011) as well as for 3D torsion (1.23 ± 0.78 vs. 1.49 ± 0.62, p = 0.042). The LV principal strain was decreased in the MBPS group (- 33.9 ± 1.7 vs. -35.5 ± 2.8, p < 0.001). The 3D LV global longitudinal strain (GLS) and principal strain were significantly associated with quartile of MBPS as measured by systolic blood pressure (SBP). CONCLUSION The 3D STE revealed that LV mechanics were more impaired in the MBPS group than in the non-surge newly diagnosed, untreated hypertensive patients; even the 2D TTE parameters showed no difference.
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Ozkaramanli Gur D, Baykiz D, Gur O, Alpsoy S, Akyuz A, Gurkan S. Evaluation of mechanical prosthetic valves: the role of three dimensional echocardiography in calculating effective orifice area in obese vs non-obese individuals. Int J Cardiovasc Imaging 2021; 37:215-27. [PMID: 32833185 DOI: 10.1007/s10554-020-01978-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
Calculation of effective orifice area (EOA) is crucial for the evaluation of prosthetic valve (PV) function and there is lack of data on the best method, particularly in obese patients, in whom two-dimensional (2D) transthoracic echocardiography (TTE) is cumbersome. We sought to compare two methods of calculating EOA through Continuity equation; one using standard 2D-TTE and other three-dimensional (3D) stoke volume (SV), in patients with bileaflet mechanical PV stratified by body mass index (BMI). On conventional TTE, SV mas measured using standard 2D derived data and 3D derived SV in 38 aortic and 62 mitral PV patients who were referred for further evaluation for mild/moderate symptoms of dyspnea. Patients were categorized with regard to transprosthetic flow into 'normal-flow' and 'high-flow' groups and several echocardiographic data including 2D and 3D EOA were compared. Rates of obesity (BMI ≥ 30) were similar within high and normal flow groups of mitral and aortic PV patients. Correlation and agreement of 2D and 3D EOA was sought in patients with and without obesity. After identifying patients with possible severe obstruction, ROC analysis was carried out to identify whether 2D and 3D derived EOA could discriminate those with obstruction. There was good correlation and agreement between two methods in patients without obesity in both mitral and aortic PV. In obese individuals, however, there was no correlation between 2D and 3D EOA; in whom echocardiographic criteria showing severe obstruction revealed that 3D EOA measurements were more accurate. ROC analysis supported that 3D EOA performs better to identify patients with obstructive characteristics. In patients with bileaflet PV, measurement of EAO by 3D derived SV yields more accurate results irrespective of BMI.
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Makavos G, Ikonomidis I, Palios J, Rigopoulos A, Katogiannis K, Parissis J, Paraskevaidis I, Noutsias M. Cardiac imaging in cardiotoxicity: a focus on clinical practice. Heart Fail Rev 2020; 26:1175-1187. [PMID: 32306221 DOI: 10.1007/s10741-020-09952-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cancer therapeutics induced cardiotoxicity has emerged as an important factor of long-term adverse cardiovascular outcomes in survivors of various malignant diseases. Early detection of myocardial injury in the setting of cancer treatment is important for the initiation of targeted cardioprotective therapy, in order to prevent irreversible cardiac dysfunction and heart failure, while not withholding a potentially life-saving cancer therapy. Cardiac imaging techniques including echocardiography, cardiac magnetic resonance, and nuclear cardiac imaging are the main tools for the identification of cardiotoxicity. There is also growing evidence for the detection of subclinical cardiac dysfunction in cancer patients by speckle tracking echocardiography. In this review article, we focus on current and emerging data regarding the role of cardiac imaging for the detection of changes in myocardial function related with cancer treatment in clinical practice.
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Affiliation(s)
- George Makavos
- 2nd Department of Cardiology, "Attikon" Hospital, National and Kapodistrian University of Athens Medical School, Rimini 1, Haidari, 12462, Athens, Greece.
| | - Ignatios Ikonomidis
- 2nd Department of Cardiology, "Attikon" Hospital, National and Kapodistrian University of Athens Medical School, Rimini 1, Haidari, 12462, Athens, Greece
| | - John Palios
- 2nd Department of Cardiology, "Attikon" Hospital, National and Kapodistrian University of Athens Medical School, Rimini 1, Haidari, 12462, Athens, Greece
| | - Angelos Rigopoulos
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Konstantinos Katogiannis
- 2nd Department of Cardiology, "Attikon" Hospital, National and Kapodistrian University of Athens Medical School, Rimini 1, Haidari, 12462, Athens, Greece
| | - John Parissis
- 2nd Department of Cardiology, "Attikon" Hospital, National and Kapodistrian University of Athens Medical School, Rimini 1, Haidari, 12462, Athens, Greece
| | - Ioannis Paraskevaidis
- Department of Clinical Therapeutics, "Alexandra" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Michel Noutsias
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
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Hanboly NH, Baghdady YM, Diab RH, Lawend SR, Kenawy AA. Value of three-dimensional echocardiography study of left ventricle function correlated to coronary arterial dominance in predicting the outcome of primary percutaneous coronary intervention. J Saudi Heart Assoc 2018; 30:211-221. [PMID: 29989044 PMCID: PMC6035383 DOI: 10.1016/j.jsha.2018.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 01/01/2018] [Accepted: 01/03/2018] [Indexed: 11/24/2022] Open
Abstract
Background Limited information is available regarding the relationship between coronary vessel dominance and outcome after ST-segment elevation myocardial infarction (STEMI). Objectives The study was designed to evaluate the prognostic value of coronary arterial dominance after primary percutaneous coronary intervention (PCI) during hospital stay and at 3 months follow-up regarding cardiac mortality, heart failure, nonfatal myocardial infarction, revascularization, and stroke. Patients and methods The study population consisted of 300 consecutive patients (mean age, 57.35 ± 13.41 years; 91% men) with STEMI who were admitted to Dallah Hospital (Riyadh, Saudi Arabia) from January 2015 to December 2016. These patients underwent successful primary PCI with thrombolysis in myocardial infarction (TIMI) III flow. They were divided into three groups according to angiographic coronary dominance: 227 (75.7%) in the right coronary dominant group, 40 (13.3%) in the left coronary dominant group, and 33 (11%) in the balanced coronary dominant group. They were evaluated with two- (2D) and three-dimensional (3D) echocardiography within 48 hours of admission and at 3 months follow-up after STEMI. Results Right dominance was present in 75.6%, left dominance in 13.3%, and balanced dominance was present in 11% of patients. The main finding of this study was that a left dominant system was associated with increased risk of cardiac mortality, heart failure, nonfatal myocardial infarction, revascularization, and stroke shortly after primary PCI, during hospital stay, and at 3 months follow-up after STEMI. Moreover, a significantly lower left ventricular ejection fraction at admission was observed by both 2D and 3D echocardiography in patients with a left dominant system. Conclusion In patients with STEMI treated with primary PCI, left coronary artery dominance confers a higher risk of various adverse clinical events after primary PCI, during hospital stay, and at 3 months follow-up compared to right and balanced coronary artery dominance.
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Cocchia R, D’Andrea A, Conte M, Cavallaro M, Riegler L, Citro R, Sirignano C, Imbriaco M, Cappelli M, Gregorio G, Calabrò R, Bossone E. Patient selection for transcatheter aortic valve replacement: A combined clinical and multimodality imaging approach. World J Cardiol 2017; 9:212-229. [PMID: 28400918 PMCID: PMC5368671 DOI: 10.4330/wjc.v9.i3.212] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 12/15/2016] [Accepted: 01/14/2017] [Indexed: 02/06/2023] Open
Abstract
Transcatheter aortic valve replacement (TAVR) has been validated as a new therapy for patients affected by severe symptomatic aortic stenosis who are not eligible for surgical intervention because of major contraindication or high operative risk. Patient selection for TAVR should be based not only on accurate assessment of aortic stenosis morphology, but also on several clinical and functional data. Multi-Imaging modalities should be preferred for assessing the anatomy and the dimensions of the aortic valve and annulus before TAVR. Ultrasounds represent the first line tool in evaluation of this patients giving detailed anatomic description of aortic valve complex and allowing estimating with enough reliability the hemodynamic entity of valvular stenosis. Angiography should be used to assess coronary involvement and plan a revascularization strategy before the implant. Multislice computed tomography play a central role as it can give anatomical details in order to choice the best fitting prosthesis, evaluate the morphology of the access path and detect other relevant comorbidities. Cardiovascular magnetic resonance and positron emission tomography are emergent modality helpful in aortic stenosis evaluation. The aim of this review is to give an overview on TAVR clinical and technical aspects essential for adequate selection.
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Rohani A, Bigdelu L, Nezafati M, Akbari V. Three-dimensional echocardiography of a tricuspid valve papillary fibroelastoma. J Saudi Heart Assoc 2017; 29:57-59. [PMID: 28127220 PMCID: PMC5247298 DOI: 10.1016/j.jsha.2016.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 04/19/2016] [Accepted: 05/18/2016] [Indexed: 11/03/2022] Open
Abstract
Papillary fibroelastomas (PFE) on tricuspid valve (TV) are rare, accounting for fewer than 11% of all PFE. Most often they are asymptomatic, and detect on mitral valve. We report a case of a typical chest pain found to be due to papillary fibroelastoma of the tricuspid valve.
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Affiliation(s)
- Atooshe Rohani
- Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, aIran
| | - Leila Bigdelu
- Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, aIran
| | - Mohammadhasan Nezafati
- Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, aIran
| | - Vahid Akbari
- Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, aIran
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Sung TY, Kwon WK, Park DH, Park CH, Kim TY. Intraoperative three-dimensional transesophageal echocardiography for evaluating an unusual structure in the left ventricular outflow tract: a case report. Korean J Anesthesiol 2015; 68:505-8. [PMID: 26495063 PMCID: PMC4610932 DOI: 10.4097/kjae.2015.68.5.505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 11/13/2014] [Accepted: 12/04/2014] [Indexed: 12/02/2022] Open
Abstract
Intraoperative three-dimensional (3D) transesophageal echocardiography (TEE) facilitates an understanding of the complex cardiac pathology that is not fully delineated in a two-dimensional (2D) echocardiographic evaluation, and it suggests earlier and more precise surgical planning and intraoperative decision making. In the present case, the intraoperative 2D-TEE midesophageal long-axis view indicated a significant narrowing of the left ventricular outflow tract (LVOT) area by a band-like structure that vertically traversed the middle of the LVOT and connected to the anterior mitral leaflet base and the interventricular septum. However, additional 3D-TEE images of the LVOT and their cropped and rendered 2D images showed that web-like tissue, which presumably had grown around the patch closure from a previous atrioventricular septal defect, was obstructing the LVOT partially.
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Affiliation(s)
- Tae-Yun Sung
- Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Won-Kyoung Kwon
- Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Dong-Ho Park
- Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Cheol-Hwan Park
- Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Tae-Yop Kim
- Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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McGhie JS, de Groot-de Laat L, Ren B, Vletter W, Frowijn R, Oei F, Geleijnse ML. Transthoracic two-dimensional xPlane and three-dimensional echocardiographic analysis of the site of mitral valve prolapse. Int J Cardiovasc Imaging 2015; 31:1553-60. [PMID: 26276508 PMCID: PMC4651983 DOI: 10.1007/s10554-015-0734-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 08/03/2015] [Indexed: 02/07/2023]
Abstract
This study sought to assess the value of two-dimensional (2D) transthoracic echocardiography (TTE), 2D xPlane imaging and three-dimensional (3D) TTE for the definition of the site and the extent of mitral valve (MV) prolapse. Fifty patients underwent transthoracic 2D, 2D xPlane and 3D echocardiography. With 2D xPlane a segmental analysis of the MV was performed, by making a lateral sweep across the MV coaptation line as seen in the parasternal short-axis view. Inter-observer agreement for specific scallop prolapse was for 2D xPlane excellent (97 %, kappa = 0.94) and for 3D TTE moderate (85 %, kappa = 0.67). The respective sensitivities of standard 2D TTE, 2D xPlane, and 3D TTE for the identification of the precise posterior scallop prolapse were for P1 92, 85, and 92 %, for P2 96, 96, and 82 %, and for P3 86, 81, and 71 %. In total, 5 (8 %) prolapsing MV scallops were missed by 2D TTE, 7 (12 %) by 2D xPlane, and 12 (20 %) by 3D TTE. The sensitivity of 3D TTE was significantly lower than standard 2D imaging (80 % versus 93 %, P < 0.05). The extent of P2 prolapse was under or overestimated in 5 patients with 2D xPlane and in 9 patients with 3D TTE. 2D xPlane imaging is an accurate, easy to use (compared to 3D TTE) and easy to interpret (compared to 2D and 3D TTE) imaging modality to study the site and the extent of MV prolapse.
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Affiliation(s)
- Jackie S McGhie
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
| | - Lotte de Groot-de Laat
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Ben Ren
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Wim Vletter
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - René Frowijn
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Frans Oei
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Marcel L Geleijnse
- Department of Cardiology, The Thoraxcenter, Erasmus University Medical Center, Room BA 302, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
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Kharwar RB, Sharma A, Sethi R, Narain VS, Saran RK. Pulmonary Artery Stenosis due to Lung Carcinoma: A Rare Cause of Dyspnea. J Cardiovasc Ultrasound 2015; 22:209-12. [PMID: 25580196 PMCID: PMC4286643 DOI: 10.4250/jcu.2014.22.4.209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 08/22/2014] [Accepted: 11/27/2014] [Indexed: 11/22/2022] Open
Abstract
Acquired bilateral pulmonary artery stenosis in adults due to lung malignancy is infrequently reported. We describe an adult male who presented to us with chief complaints of dyspnea on exertion and one episode of hemoptysis. Two dimensional transthoracic echocardiography with color Doppler showed presence of an extra cardiac mass causing severe extrinsic compression of both the right and left pulmonary artery leading to high pressure severe tricuspid regurgitation and extension of the mass into the left atrium. Three dimensional transthoracic echocardiography clearly delineated the anatomy of the left atrial mass and its surrounding anatomical relationship. The diagnosis of non small cell lung carcinoma was confirmed by multidetector computed tomography (MDCT) and with MDCT guided biopsy with histopathology. Patient succumbed one month later due to an episode of massive hemoptysis.
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Affiliation(s)
- Rajiv Bharat Kharwar
- Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Akhil Sharma
- Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rishi Sethi
- Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Varun Shankar Narain
- Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ram Kirti Saran
- Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
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Kharwar RB, Chandra S, Dwivedi SK, Saran RK. A pedunculated left ventricular thrombus in a women with peripartum cardiomyopathy: evaluation by three dimensional echocardiography. J Cardiovasc Ultrasound 2014; 22:139-43. [PMID: 25309691 PMCID: PMC4192412 DOI: 10.4250/jcu.2014.22.3.139] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 03/31/2014] [Accepted: 08/20/2014] [Indexed: 12/05/2022] Open
Abstract
Peripartum cardiomyopathy is a cardiac condition characterized by development of heart failure during the last month of pregnancy or during the first five months of post partum period without any other identifiable cause of heart failure. The hypercoagulable state in the pregnancy along with left ventricular (LV) systolic dysfunction predisposes the patient to thromboembolic complications like intraventricular thrombi. We report a case of a 30-year-old female with peripartum cardiomyopathy along with a highly mobile mass in the LV cavity on two dimensional echocardiography. Three dimensional transthoracic echocardiography clearly showed the pedicle of the mass attached to the interventricular septum along with internal echolucent areas within the mass. Due to denial of the patient to undergo surgery, she was started on oral anticoagulation, with complete dissolution of the mass within one month.
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Affiliation(s)
| | - Sharad Chandra
- Department of Cardiology, King Georges' Medical University, Lucknow, India
| | | | - Ram Kirti Saran
- Department of Cardiology, King Georges' Medical University, Lucknow, India
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Choi WG, Kim SH, Park SD, Baek YS, Shin SH, Woo SI, Kim DH, Park KS, Lee WH, Kwan J. Role of dyssynchrony on functional mitral regurgitation in patients with idiopathic dilated cardiomyopathy: a comparison study with geometric parameters of mitral apparatus. J Cardiovasc Ultrasound 2011; 19:69-75. [PMID: 21860720 PMCID: PMC3150699 DOI: 10.4250/jcu.2011.19.2.69] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 05/19/2011] [Accepted: 05/25/2011] [Indexed: 11/22/2022] Open
Abstract
Background Functional mitral regurgitation (FMR) occurs commonly in patients with dilated cardiomyopathy (DCM). This study was conducted to explore the role of left ventricular (LV) dyssynchrony in developing FMR in patients with DCM in comparison with geometric parameters of the mitral apparatus. Methods Twenty patients without FMR and 33 patients with FMR [effective regurgitant orifice area (ERO) = 0.17 ± 0.10 cm2] were enrolled. MR severity was estimated with ERO area. Dyssynchrony indices (DI) were measured using the standard deviations of time to peak myocardial systolic velocity between eight segments. Using real time 3D echocardiography, mitral valve tenting area (MVTa), anterior (APMD) and posterior papillary muscle distances (PPMD), LV sphericity, and tethering angle of anterior (Aα) and posterior leaflets (Pα) were estimated. All geometrical measurements were corrected (c) by the height of each patient. Results The patient with FMR had significantly higher cDI, cMVTa, cAPMD and cPPMD, LV sphericity, Aα, and Pα than the patients without FMR (all p < 0.05). With multiple logistic regression analysis, cMVTa (p = 0.017) found to be strongest predictor of FMR development. In patients with FMR, cMVTa (r = 0.868), cAPMD (r = 0.801), cPPMD (r = 0.742), Aα (r = 0.454), LV sphericity (r = 0.452), and DI (r = 0.410) showed significant correlation with ERO. On multivariate regression analysis, cMVTa and cAPMD (p < 0.001, p = 0.022, respectively) remained the strongest determinants of the degree of ERO and cAPMD (p < 0.001) remained the strongest determinant of the degree of cMVTa. Conclusion Displacement of anterior papillary muscle and consequent mitral valve tenting seem to play a major role in developing FMR in DCM, while LV dyssynchrony seems to have no significant role.
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Affiliation(s)
- Woong Gil Choi
- Division of Cardiology, Department of Internal Medicine, Konkuk University College of Medicine, Chungju, Korea
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