{"title":"Enhancing Prognostication in Acute Heart Failure: Significance of RV-PA Coupling and the TAPSE/PASP Ratio.","authors":"Ju-Hee Lee","doi":"10.4250/jcvi.2023.0076","DOIUrl":"10.4250/jcvi.2023.0076","url":null,"abstract":"","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"31 4","pages":"207-208"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10622633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71412387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Rare Case of Isolated Papillary Muscle Endocarditis.","authors":"Fernando Mané, Rui Flores, Catarina Vieira","doi":"10.4250/jcvi.2023.0013","DOIUrl":"10.4250/jcvi.2023.0013","url":null,"abstract":"A septuagenarian woman, who had recently undergone ureteral stenting, presented with 3 days of malaise and altered mental status. Physical examination revealed a febrile patient with normal blood pressure, heart and respiratory rate. Skin inspection exhibited maculopapular lesions on the extremities and splinter hemorrhages. Laboratory results were remarkable for a white-cell count of 15,400 /mm 3 and a C-reactive protein level of 237 mg/L. Abdominal computed tomographic scan exposed multiple spleen infarcts and brain magnetic resonance imaging showed multiple small diffusion defects ( Figure 1 ). A transesophageal echocardiogram (TOE) was performed and revealed a large vegetation (29 × 14 mm), protruding into the left ventricular outflow tract, attached to the posteromedial papillary muscle without affecting mitral valve function ( Figures 2 and 3 , Movies 1 and 2 ). Blood and urine cultures isolated methicillin-resistant Staphylococcus aureus (MRSA). Endocarditis associated with urosepsis was diagnosed, appropriate antibiotherapy was initiated and the patient underwent urgent cardiac surgery with preservation of the mitral valve. Histological and microbiological analysis of the resected material from the subvalvular apparatus confirmed endocarditis by MRSA. Staphylococcus aureus is highly virulent, linked to hospital care, and frequently related to non-valvular endocarditis. 1)","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"31 4","pages":"211-213"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10622636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71412382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In-Jeong Cho, Sang-Eun Lee, Dong-Hyeok Kim, Wook Bum Pyun
{"title":"Clinical and Imaging Parameters Associated With Impaired Kidney Function in Patients With Acute Decompensated Heart Failure With Reduced Ejection Fraction.","authors":"In-Jeong Cho, Sang-Eun Lee, Dong-Hyeok Kim, Wook Bum Pyun","doi":"10.4250/jcvi.2023.0004","DOIUrl":"10.4250/jcvi.2023.0004","url":null,"abstract":"<p><strong>Background: </strong>Acute worsening of cardiac function frequently leads to kidney dysfunction. This study aimed to identify clinical and imaging parameters associated with impaired kidney function in patients with acute decompensated heart failure with reduced ejection fraction (HFrEF).</p><p><strong>Methods: </strong>Data from 131 patients hospitalized with acute decompensated HFrEF (left ventricular ejection fraction, < 40%) were analyzed. Patients were divided into two groups according to the glomerular filtration rate (GFR) at admission (those with preserved kidney function [GFR ≥ 60 mL/min/1.73 m²] and those with reduced kidney function [GFR < 60 mL/min/1.73 m²]). Various echocardiographic parameters and perirenal fat thicknesses were assessed by computed tomography.</p><p><strong>Results: </strong>There were 71 patients with preserved kidney function and 60 patients with reduced kidney function. Increased age (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.04-1.12; p = 0.005), increased log N-terminal pro b-type natriuretic peptide (OR, 1.74; 95% CI, 1.14-2.66; p = 0.010), and increased perirenal fat thickness (OR, 1.19; 95% CI, 1.10-1.29; p < 0.001) were independently associated with reduced kidney function, even after adjusting for variable clinical and echocardiographic parameters. The optimal average perirenal fat thickness cut-off value of > 12 mm had a sensitivity of 55% and specificity of 83% for kidney dysfunction prediction.</p><p><strong>Conclusions: </strong>Thick perirenal fat was independently associated with impaired kidney function in patients hospitalized for acute decompensated HFrEF. Measurement of perirenal fat thickness may be a promising imaging marker for the detection of HFrEF patients who are more susceptible to kidney dysfunction.</p>","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"1 1","pages":"169-177"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10622639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71000277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Imaging Marker for Acute Kidney Dysfunction in Patients With Heart Failure.","authors":"Jin Young Kim","doi":"10.4250/jcvi.2023.0054","DOIUrl":"10.4250/jcvi.2023.0054","url":null,"abstract":"and Imaging Parameters Associated With Impaired Kidney Function","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"31 4","pages":"178-179"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10622637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71412388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prognostic Role of Right Ventricular-Pulmonary Artery Coupling Assessed by TAPSE/PASP Ratio in Patients With Acute Heart Failure.","authors":"Youngnam Bok, Ji-Yeon Kim, Jae-Hyeong Park","doi":"10.4250/jcvi.2023.0055","DOIUrl":"10.4250/jcvi.2023.0055","url":null,"abstract":"BACKGROUND Right ventricular (RV) dysfunction is a significant risk of major adverse cardiac events in patients with acute heart failure (AHF). In this study, we evaluated RV-pulmonary artery (PA) coupling, assessed by tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) and assessed its prognostic significance, in AHF patients. METHODS We measured the TAPSE/PASP ratio and analyzed its correlations with other echocardiographic parameters. Additionally, we assessed its prognostic role in AHF patients. RESULTS A total of 1147 patients were included in the analysis (575 men, aged 70.81 ± 13.56 years). TAPSE/PASP ratio exhibited significant correlations with left ventricular (LV) ejection fraction(r = 0.243, p < 0.001), left atrial (LA) diameter(r = −0.320, p < 0.001), left atrial global longitudinal strain (LAGLS, r = 0.496, p < 0.001), mitral E/E′ ratio(r = −0.337, p < 0.001), and right ventricular fractional area change (RVFAC, r = 0.496, p < 0.001). During the median follow-up duration of 29.0 months, a total of 387 patients (33.7%) died. In the univariate analysis, PASP, TAPSE, and TAPSE/PASP ratio were significant predictors of mortality. After the multivariate analysis, TAPSE/PASP ratio remained a statistically significant parameter for all-cause mortality (hazard ratio [HR], 0.453; p = 0.037) after adjusting for other parameters. In the receiver operating curve analysis, the optimal cut-off level of TAPSE/PASP ratio for predicting mortality was 0.33 (area under the curve = 0.576, p < 0.001), with a sensitivity of 65% and a specificity of 47%. TAPSE/PASP ratio < 0.33 was associated with an increased risk of mortality after adjusting for other variables (HR, 1.306; p = 0.025). CONCLUSIONS In AHF patients, TAPSE/PASP ratio demonstrated significant associations with RVFAC, LA diameter and LAGLS. Moreover, a decreased TAPSE/PASP ratio < 0.33 was identified as a poor prognostic factor for mortality.","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"31 4","pages":"200-206"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10622640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71412389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ernest Spitzer, Benjamin Camacho, Blaz Mrevlje, Hans-Jelle Brandendburg, Claire B Ren
{"title":"Echocardiography Core Laboratory Validation of a Novel Vendor-Independent Web-Based Software for the Assessment of Left Ventricular Global Longitudinal Strain.","authors":"Ernest Spitzer, Benjamin Camacho, Blaz Mrevlje, Hans-Jelle Brandendburg, Claire B Ren","doi":"10.4250/jcvi.2022.0130","DOIUrl":"https://doi.org/10.4250/jcvi.2022.0130","url":null,"abstract":"<p><strong>Background: </strong>Global longitudinal strain (GLS) is an accurate and reproducible parameter of left ventricular (LV) systolic function which has shown meaningful prognostic value. Fast, user-friendly, and accurate tools are required for its widespread implementation. We aim to compare a novel web-based tool with two established algorithms for strain analysis and test its reproducibility.</p><p><strong>Methods: </strong>Thirty echocardiographic datasets with focused LV acquisitions were analyzed using three different semi-automated endocardial GLS algorithms by two readers. Analyses were repeated by one reader for the purpose of intra-observer variability. CAAS Qardia (Pie Medical Imaging) was compared with 2DCPA and AutoLV (TomTec).</p><p><strong>Results: </strong>Mean GLS values were -15.0 ± 3.5% from Qardia, -15.3 ± 4.0% from 2DCPA, and -15.2 ± 3.8% from AutoLV. Mean GLS between Qardia and 2DCPA were not statistically different (p = 0.359), with a bias of -0.3%, limits of agreement (LOA) of 3.7%, and an intra-class correlation coefficient (ICC) of 0.88. Mean GLS between Qardia and AutoLV were not statistically different (p = 0.637), with a bias of -0.2%, LOA of 3.4%, and an ICC of 0.89. The coefficient of variation (CV) for intra-observer variability was 4.4% for Qardia, 8.4% 2DCPA, and 7.7% AutoLV. The CV for inter-observer variability was 4.5%, 8.1%, and 8.0%, respectively.</p><p><strong>Conclusions: </strong>In echocardiographic datasets of good image quality analyzed at an independent core laboratory using a standardized annotation method, a novel web-based tool for GLS analysis showed consistent results when compared with two algorithms of an established platform. Moreover, inter- and intra-observer reproducibility results were excellent.</p>","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"31 3","pages":"135-141"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/19/7f/jcvi-31-135.PMC10374390.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Potential of Blood Speckle Imaging and <sup>18</sup>F-Sodium Fluoride Positron Emission Tomography/Computed Tomography in Evaluating the Progression and Inflammation in Aortic Stenosis.","authors":"Ji-Won Hwang","doi":"10.4250/jcvi.2023.0037","DOIUrl":"https://doi.org/10.4250/jcvi.2023.0037","url":null,"abstract":"https://e-jcvi.org Aortic stenosis disease progression occurs through serial inflammatory reactions, calcification, and fibrosis, which are associated with various physiological pathways.1)2) There are no active disease biomarkers available for its detection or personalized treatments that can delay inflammation progression.1)3) Currently, cardiovascular calcification is visualized using noninvasive conventional imaging modalities such as echocardiography, computed tomography (CT), and cardiac magnetic resonance imaging (CMR).4)","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"31 3","pages":"150-151"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/c8/jcvi-31-150.PMC10374392.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ji Soo Oh, Sang Hyun Lee, Jeongsu Kim, Yong Hyun Park, Kook Jin Chun
{"title":"Successful Patent Ductus Arteriosus Closure in Patients With Severe Pulmonary Arterial Hypertension.","authors":"Ji Soo Oh, Sang Hyun Lee, Jeongsu Kim, Yong Hyun Park, Kook Jin Chun","doi":"10.4250/jcvi.2022.0089","DOIUrl":"https://doi.org/10.4250/jcvi.2022.0089","url":null,"abstract":"https://e-jcvi.org A 48-year-old female was referred to our department due to severe dyspnea for several years in conditions of non-ischemic heart failure and uncontrolled type 2 diabetes. Physical examination revealed rales in both lungs, regular heart sounds without murmurs, clubbing of the toes (Figure 1A), and no pitting edema. Chest X-ray showed cardiomegaly and prominent pulmonary vasculature (Figure 1B). Laboratory findings reported elevated brain natriuretic peptide. Transthoracic echocardiography demonstrated patent ductus arteriosus (PDA) with bidirectional shunting (Figure 2, Supplementary Table 1, Movie 1). Right cardiac catheterization revealed severe pulmonary arterial hypertension (PAH) with right ventricle dysfunction (mean pulmonary artery pressure [PAP]: 78 mmHg, pulmonary capillary wedge pressure: 12 mmHg, pulmonary vascular resistance [PVR]: 27.8 Wood units [WU], Qp/Qs: 1.18, and cardiac output: 4.1 L/min by Fick method). We diagnosed PAH associated with PDA1) and started treatment with oral sildenafil (20 mg) 3 times a day in addition to ambrisentan (5 mg) once a day. We conducted a 15-minute closure test on the PDA by measuring the pressure gradient between the central aorta and PA. A decrease of mean PAP by 15 mmHg was observed without any change in cardiac output (Figure 3, Supplementary Table 1). Finally, we performed PDA closure with an Amplatzer septal occluder (8/6 mm). The patient has been in a stable condition with advanced medical treatment for three years (Figure 4, Supplementary Table 1, Movie 2). Although current guidelines recommend PDA closure in patients with high PVR (>5 WU) and Qp/Qs >1.52)3) (class IIb), shunt closure may also be J Cardiovasc Imaging. 2023 Jul;31(3):152-154 https://doi.org/10.4250/jcvi.2022.0089 pISSN 2586-7210·eISSN 2586-7296","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"31 3","pages":"152-154"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/1c/jcvi-31-152.PMC10374387.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeffrey Yim, Michael Y C Tsang, Anand Venkataraman, Shane Balthazaar, Ken Gin, John Jue, Parvathy Nair, Christina Luong, Darwin F Yeung, Robb Moss, Sean A Virani, Jane McKay, Margot Williams, Eric C Sayre, Purang Abolmaesumi, Teresa S M Tsang
{"title":"Cardiac Phenotyping of SARS-CoV-2 in British Columbia: A Prospective Echo Study With Strain Imaging.","authors":"Jeffrey Yim, Michael Y C Tsang, Anand Venkataraman, Shane Balthazaar, Ken Gin, John Jue, Parvathy Nair, Christina Luong, Darwin F Yeung, Robb Moss, Sean A Virani, Jane McKay, Margot Williams, Eric C Sayre, Purang Abolmaesumi, Teresa S M Tsang","doi":"10.4250/jcvi.2022.0120","DOIUrl":"https://doi.org/10.4250/jcvi.2022.0120","url":null,"abstract":"<p><strong>Background: </strong>There is limited data on the residual echocardiographic findings including strain analysis among post-coronavirus disease (COVID) patients. The aim of our study is to prospectively phenotype post-COVID patients.</p><p><strong>Methods: </strong>All patients discharged following acute COVID infection were systematically followed in the post-COVID-19 Recovery Clinic at Vancouver General Hospital and St. Paul's Hospital. At 4-18 weeks post diagnosis, patients underwent comprehensive echocardiographic assessment. Left ventricular ejection fraction (LVEF) was assessed by 3D, 2D Biplane Simpson's, or visual estimate. LV global longitudinal strain (GLS) was measured using a vendor-independent 2D speckle-tracking software (TomTec).</p><p><strong>Results: </strong>A total of 127 patients (53% female, mean age 58 years) were included in our analyses. At baseline, cardiac conditions were present in 58% of the patients (15% coronary artery disease, 4% heart failure, 44% hypertension, 10% atrial fibrillation) while the remainder were free of cardiac conditions. COVID-19 serious complications were present in 79% of the patients (76% pneumonia, 37% intensive care unit admission, 21% intubation, 1% myocarditis). Normal LVEF was seen in 96% of the cohort and 97% had normal right ventricular systolic function. A high proportion (53%) had abnormal LV GLS defined as < 18%. Average LV GLS of septal and inferior segments were lower compared to that of other segments. Among patients without pre-existing cardiac conditions, LVEF was abnormal in only 1.9%, but LV GLS was abnormal in 46% of the patients.</p><p><strong>Conclusions: </strong>Most post-COVID patients had normal LVEF at 4-18 weeks post diagnosis, but over half had abnormal LV GLS.</p>","PeriodicalId":15229,"journal":{"name":"Journal of Cardiovascular Imaging","volume":"31 3","pages":"125-132"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/c4/jcvi-31-125.PMC10374389.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}