Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging最新文献

{"title":"Myocardial Deformation Imaging Using Echocardiography: A Disruptive Innovation","authors":"M. Bansal","doi":"10.4103/jiae.jiae_49_23","DOIUrl":"https://doi.org/10.4103/jiae.jiae_49_23","url":null,"abstract":"","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"300 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123083717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Observational Analysis of Outcomes After Surgical Valve Replacement: A 15 Years' Experience in a Tertiary Care Hospital","authors":"M. Sondh, R. Gupta, Sidhant Sachdeva, R. Tandon","doi":"10.4103/jiae.jiae_46_22","DOIUrl":"https://doi.org/10.4103/jiae.jiae_46_22","url":null,"abstract":"Background: None of the currently available prosthetic valves are comparable to native valves in hemodynamic functions. One has to choose between durability, thrombogenicity, or risk of major bleeds. These questions can be answered effectively with the help of long-term follow-up data. Aims and Objectives: We aimed to assess primary and secondary outcomes in patients who had undergone valve replacement (bioprosthetic or mechanical) over the last 15 years at our institution. Materials and Methods: Retrospective data on clinical outcomes of all patients of valve replacement surgery over the last 15 years was taken. Standardized definitions were used to report primary and secondary outcomes, and appropriate statistical methods were applied to evaluate the data. Results: There were a total of 681 patients (66.7% mechanical and 33.3% bioprosthetic valves) with a median follow-up of 7.5 years. Overall survival rates for bioprosthetic valves for 1,5, and 10 years were 99% and for mechanical valves were 98% and 96% at 5 years and 10 years respectively. Late mortality predictors in the mechanical valve group were pre-operative New York Heart Association (NYHA) class, left ventricular (LV) systolic function, atrial fibrillation, post-operative sub-therapeutic international normalized ratio (INR) values and valve replacement at mitral position. Conclusion: The study showed that mechanical valves had a 96 % survival rate at 10 to 15 years which was dependent upon preoperative NYHA class, preoperative LV functions AF, and postoperative INR values. In contrast, bioprosthetic valves had 99% survival but with a higher incidence of secondary outcomes, mainly in the form of structural valve degeneration.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"134 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123495356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic Evaluation of Cardiac Function in Infants of Mothers with Diabetes","authors":"Maryam Fatima, S. Abqari, Syed Ali, S. Hakim","doi":"10.4103/jiae.jiae_26_23","DOIUrl":"https://doi.org/10.4103/jiae.jiae_26_23","url":null,"abstract":"Introduction: A large number of pregnancies are complicated by diabetes mellitus in the mother which is associated with the risk of various cardiac structural and functional complications in the neonates. A diagnostic tool is needed to detect these dysfunctions early. In contrast to conventional pulsed-wave Doppler, which is influenced by heart rate and the impact of volume changes on transmitral flow, tissue Doppler imaging is the mode of echocardiography that is relatively independent of the loading state. Two-dimensional (2D) speckle-tracking echocardiography-derived strain imaging is a new technology increasingly being used to estimate cardiac systolic and diastolic dysfunction and has superior prognostic value for predicting major adverse cardiac events. Objective: The objective of this study was to evaluate cardiac function in neonates of mothers with diabetes on echocardiography and differences in the extent of cardiac dysfunction between neonates of well-controlled and poorly controlled mothers with diabetes. Methods: This is a cross-sectional observational study which was done on 152 neonates born to mothers with diabetes (22 overt vs. 130 gestational and 23 well-controlled vs. 129 poorly controlled) and 96 born to nondiabetic mothers. Three modes of echocardiography, i.e. M-mode, Doppler (pulsed wave and tissue), and 2D speckle-tracking echocardiography, were done and cardiac functions were compared among different groups. Results: Infants of diabetic mothers (IDMs) had lower ejection fraction on M-mode echocardiography and lower values of global longitudinal strain on 2D speckle-tracking echocardiography along with significantly lower values of mitral and tricuspid E velocity and E/A ratio with higher values of A velocity on pulsed-wave Doppler. Tissue Doppler showed higher left ventricle E/E' in IDM implying more systolic as well as diastolic dysfunction in IDM as compared to non-IDM. In neonates born to mothers with poorly controlled diabetes, Doppler showed lower values of mitral and tricuspid E/A ratio and left ventricle E'/A' ratio signifying more diastolic dysfunction as compared to neonates born to mothers having good glycemic control. Similarly, neonates born to mothers with pregestational diabetes had significantly deranged systolic and diastolic functions. Conclusions: IDMs have significant cardiac dysfunction on echocardiography which is also related to the degree of glycemic control and onset of diabetes.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132101899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aneurysm of Sinus of Valsalva with Fistula to the Coronary Sinus","authors":"Madhu Shukla, JagdishChander Mohan","doi":"10.4103/jiae.jiae_6_23","DOIUrl":"https://doi.org/10.4103/jiae.jiae_6_23","url":null,"abstract":"A 63-year-old female with hypertension, evaluated for atypical chest pain and continuous precordial murmur, was found to have an insignificant stenosis in the proximal right coronary artery with a large tortuous fistula originating from the right sinus of Valsalva to the coronary sinus draining into the right atrium with an unusual course parallel to but distinct from the right coronary artery. Multidetector computed tomographic coronary angiography and cardiac catheterization confirmed the diagnosis. Such an anomaly has not been reported earlier.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122998541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Strain and Sudden Cardiac Death","authors":"G. Vijayaraghavan","doi":"10.4103/jiae.jiae_23_22","DOIUrl":"https://doi.org/10.4103/jiae.jiae_23_22","url":null,"abstract":"Several cardiac conditions are associated with the risk of ventricular arrhythmias (VAs) and sudden cardiac death (SCD). Identification of the individuals at increased risk of these events is essential to facilitate the appropriate measures to prevent SCD. Several clinical, electrocardiographic, and imaging markers have been used for this purpose with varying accuracy. Recently, longitudinal myocardial strain assessed using speckle-tracking echocardiography has been shown to have incremental value in the prediction of SCD risk. Strain imaging allows quantification of the abnormalities in the magnitude and timing of the segmental myocardial contraction, which is a surrogate for underlying myocardial fibrosis and myofiber disarray. Reduced segmental strain and temporal heterogeneity indicate electromechanical dispersion, which is the primary substrate for VAs and SCD. This review summarizes current evidence regarding the utility of longitudinal strain for the prediction of SCD risk.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124481139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Global Longitudinal Strain Imaging in Detecting Significant Coronary Artery Disease in Patients with Non-ST-segment Elevation Myocardial Infarction","authors":"RaviVishnu Prasad, GutteRahul Manikrao, BP Singh, N. Kumar, Goutam Kumar, C. Chandan","doi":"10.4103/jiae.jiae_2_23","DOIUrl":"https://doi.org/10.4103/jiae.jiae_2_23","url":null,"abstract":"Background: Two-dimensional speckle-tracking echocardiography (2D-STE) is a newer method for assessing left ventricular (LV) systolic function. The aim of this study was to assess the predictive value of 2D global longitudinal strain (GLS) in the detection of longitudinal LV systolic dysfunction and the identification of significant coronary artery disease (CAD) in non-ST-segment elevation myocardial infarction (NSTEMI) patients without wall motion abnormalities. Materials and Methods: We enrolled 100 patients who were suspected cases of NSTEMI with echocardiography showing LV ejection fraction >50% and no regional wall motion abnormality. LV myocardial function was assessed using conventional echocardiographic measurements and myocardial deformation analysis with 2D-STE. The patients found to have significant CAD on coronary angiography were included in the cases group and those without significant CAD were considered as controls. Results: Mean age of the patients was 58.36 ± 11.21 years versus 56.54 ± 8.10 years in controls. Male preponderance was found in both case and control groups, with 66% (n = 33) and 56% (n = 28) males, respectively. The patients had significantly lower GLS as compared to the controls (-16.31 ± 1.34% vs -19.17 ± 1.63%, P < 0.001). The patients with positive troponin assay had a lower mean GLS −16.49 ± 1.5% as compared to those with negative troponin assay (−19.32 ± 1.54%, P < 0.001). Multivariate analyses indicated that GLS was an independent predictor of CAD in those with NSTEMI (GLS odds ratio = 0.024, P < 0.001). Conclusions: The present study demonstrates that 2D-STE is superior to conventional echocardiography in excluding significant CAD. It is a promising, easy to perform, bedside tool for diagnosis and prognostication in patients with NSTEMI. GLS has a potential to be used in conjugation with other risk stratification strategies to identify patients at high risk.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122289946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Strain Imaging in Ischemic Heart Disease","authors":"M. Bansal, R. Kasliwal","doi":"10.4103/jiae.jiae_47_23","DOIUrl":"https://doi.org/10.4103/jiae.jiae_47_23","url":null,"abstract":"The potential utility of strain imaging as a tool for quantitative assessment of myocardial contractile function has already been demonstrated in many cardiac conditions. Numerous studies have explored its utility in patients with coronary artery disease (CAD) also. Almost the entire spectrum of CAD has been studied and several different strain parameters and indices derived from global or regional longitudinal, circumferential, radial and area strain as well as left ventricular rotation have been employed. These studies have mostly shown that strain imaging can have an incremental role in the diagnosis and prognosis assessment of CAD. However, a few important limitations are there. Most importantly, CAD involves the left ventricle in a segmental manner and unfortunately, segmental strain at present has significant measurement variability rendering it unsuitable for routine clinical use. Nevertheless, strain imaging has many potential uses in CAD. This review describes the current understanding about the role of strain imaging in the evaluation and management of CAD.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"137 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116025808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right Ventricular Strain: Clinical Application","authors":"Satish Govind","doi":"10.4103/jiae.jiae_48_23","DOIUrl":"https://doi.org/10.4103/jiae.jiae_48_23","url":null,"abstract":"For many decades assessment of right ventricular function has been a challenge, with several parameters available for use but none being reliable and accurate. The oldest and still the most widely used is tricuspid annular plane systolic excursion (TAPSE), which has its own technical limitations. Later, the arrival of tissue Doppler imaging provided an additional parameter, with its measurement of peak systolic velocity of the lateral annulus of the tricuspid annulus, but this being angle-dependent also showed limited utility, like TAPSE. The advent of speckle-tracking echocardiography over the last decade, which is not angle-dependent and less load dependent, heralded a new way of looking at the RV function landscape. Despite some technical challenges, it has shown itself to be acceptable and has increasingly been used as a reliable parameter in clinical settings over the last few years. It has been recommended as a parameter with high feasibility and reproducibility.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130844688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperdominant Right Coronary Artery Occlusion Presenting with Acute Anterior Wall Myocardial Infarction","authors":"Madhu Shukla, JagdishChander Mohan","doi":"10.4103/jiae.jiae_64_22","DOIUrl":"https://doi.org/10.4103/jiae.jiae_64_22","url":null,"abstract":"This case report describes a 69-year-old male who presented with acute anterior myocardial infarction and was detected to have a hyperdominant right coronary artery (RCA) with a large posterior descending branch coursing from the posterior interventricular groove into the apical part of the anterior interventricular space and posterior left ventricular branch coursing in the left atrioventricular groove and supplying the entire free wall. Primary percutaneous intervention of the proximally occluded posterior descending artery resulted in resolution of ST-segment elevation in anterior and inferior leads and also revealed the large vascular territory of the RCA. The occurrence of superdominant RCA and intact left circumflex artery presenting with acute anterior wall myocardial infarction has not been described earlier. Precise morphological and physiological knowledge and evaluation of such a variation assists in opting for the best available therapeutic modality and prognosis.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127421576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended Role of Parametric Mapping with Cardiac Magnetic Resonance in the Evaluation of Endomyocardial Fibrosis – Our Initial Experience","authors":"Sneha Thakur, P. Chudgar, N. Kamat, N. Burkule","doi":"10.4103/jiae.jiae_34_22","DOIUrl":"https://doi.org/10.4103/jiae.jiae_34_22","url":null,"abstract":"Endomyocardial fibrosis (EMF) affects approximately 12 million persons worldwide and is an important cause of restrictive cardiomyopathy in the developing world, with the highest prevalence reported in sub-Saharan Africa, South Asia, and South America. EMF is characterized by apical infiltration with fibrotic tissue in one or both ventricles, often associated with thrombus in early stage of the disease, calcification in late stage of the disease, and typical symptoms of restrictive heart failure. Clinical evaluation, transthoracic echocardiography, and characteristic Doppler findings of restrictive physiology are sufficient to diagnose EMF in most of the cases. However, few cases may require cardiac magnetic resonance due to poor echo window or shadowing due to apical calcification. Tissue characterization ability of cardiac magnetic resonance imaging has evolved further in the era of parametric mapping. We plan to showcase the incremental value of parametric mapping (T1/T2 mapping) in staging, prognostication, and management in two cases of EMF.","PeriodicalId":325663,"journal":{"name":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117139862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}