Echo Research and Practice最新文献

{"title":"A review of thoracic aortic aneurysm disease.","authors":"Paul F Clift,&nbsp;Elena Cervi","doi":"10.1530/ERP-19-0049","DOIUrl":"https://doi.org/10.1530/ERP-19-0049","url":null,"abstract":"<p><p>Aortic diseases may be diagnosed after a long period of subclinical development or they may have an acute presentation. Acute aortic syndrome is often the first sign of the disease, which needs rapid diagnosis and decision making to reduce the extremely poor prognosis. Aortic dilatation is a well-recognised risk factor for acute events and can occur as a result of trauma, infection, or, most commonly, from an intrinsic abnormality in the elastin and collagen components of the aortic wall. Over the years it has become clear that a few monogenic syndromes are strongly associated with aneurysms and often dictate a severe presentation in younger patients while the vast majority have a multifactorial pathogenesis. Conventional cardiovascular risk factors and ageing play an important role. Management strategy is based on prevention consisting of regular follow-up with cross-sectional imaging, chemoprophylaxis of further dilatation with drugs proved to slow down the disease progression and preventative surgery when dimension exceeds internationally recognised cut-off values for aortic diameters and the risk of rupture/dissection is therefore deemed very high.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"7 1","pages":"R1-R10"},"PeriodicalIF":6.3,"publicationDate":"2019-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/fb/ERP-19-0049.PMC6993256.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37607508","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":"EDUCATIONAL SERIES ON THE SPECIALIST VALVE CLINIC: How to run a specialist valve clinic: a collaborative series from the British Heart Valve Society and the British Society of Echocardiography.","authors":"John B Chambers, Richard P Steeds","doi":"10.1530/ERP-19-0035","DOIUrl":"10.1530/ERP-19-0035","url":null,"abstract":"<p><p>As heart valve disease increases in prevalence in an ageing population, comorbidities make patients increasingly hard to assess. Specialist competencies are therefore increasingly important to deliver best practice in a specialist valve clinic and to make best advantage of advances in percutaneous and surgical interventions. However, patient care is not improved unless all disciplines have specialist valve competencies, and there is little guidance about the practical details of running a specialist valve clinic. In this issue of Echo Research and Practice, the British Heart Valve Society (BHVS) and the British Society of Echocardiography (BSE) introduce a series of articles to guide all disciplines in how to run a valve clinic.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"6 1","pages":"E1-E2"},"PeriodicalIF":3.2,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6865359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42921833","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":"Report from the Annual Conference of the British Society of Echocardiography, November 2017, Edinburgh International Conference Centre, Edinburgh","authors":"V. Sharma, M. Stout, K. Pearce, A. Klein, M. Alsharqi, P. Nihoyannopoulos, J. Khan, Timothy Griffiths, K. Sandhu, S. Cabezon, C. Kwok, S. Baig, T. Naneishvili, V. C. K. Lee, A. Pasricha, E. Robins, P. Kanagala, Tamseel Fatima, A. Mihai, R. Butler, S. Duckett, G. Heatlie, H. Gu, P. Chowienczyk, L. Arnold, S. Coffey, M. Loudon, Joanna Wilson, A. Kennedy, S. Myerson, B. Prendergast, A. Jackson, V. Lennie, P. Luke, C. Eggett, Loakim Spyridopoulos, T. Irvine, Nashwah Ismail, A. Macnab, C. Bleakley, M. Eskandari, O. Aldalati, A. Whittaker, Marilou Huang, M. Monaghan, Thomas J Turner, C. Steele, A. Barton, A. Cameron, Sonecki Piotr, Phang Gyee Vuei, C. Voukalis, Hwee Phen Teh, S. Apostolakis, C. Wong, Matthew M. Y. Lee, N. E. R. Goodfield, Emma C Lane, D. Slessor, R. Crawley, T. Ntoskas, Farhanda Ahmad, P. Woodmansey, A. Fletcher, Shaun Robinson, B. Rana, L. Batchelor, Brogan McAdam, C. Coats, L. C. Mayall, N. G. Campbell, H. Garnett","doi":"10.1530/erp-19-0056","DOIUrl":"https://doi.org/10.1530/erp-19-0056","url":null,"abstract":"To evaluate the relation between left ventricular (LV) twist mechanics and left atrial (LA) phasic function in patients with systemic hypertension using speckle tracking echocardiography (STE). We Impaired shortening-deactivation of cardiac myocytes could sustain myocardial contraction, preserving ejection fraction at the expense of diastolic dysfunction. To examine whether an impairment of early systolic ejection is associated with sustained myocardial contraction and diastolic dysfunction. The relation between first-phase ejection fraction the fraction of left ventricular volume ejected from the start of systole to the time of the first peak in LV pressure (corresponding to the Our study demonstrates a clear association between NT-proBNP level and LVFP. This becomes more robust as the level increases &gt;900 ng/L. Left atrial volume appears to correlate with NT-proBNP and is of value in routine assessment of patients with breathlessness. Few patients with raised LVFP had NT-proBNP levels &lt;450 ng/L. There remains debate surrounding the optimal cut-off value. Stress echocardiography (SE) is a widely used diagnostic tool for ischaemic heart disease. However, this type of functional testing has inherent risks and there is limited contemporary data on complication rates. We therefore carried out an audit of complications in a high-volume UK stress echo laboratory. This was a retrospective audit of all SEs carried out in our center over 8 years between 2009 and 2017. Both dobutamine SE (DSE) and exercise SE (ESE) were included. The DSE protocol used a maximum dose of 30 μg/kg/min of dobutamine with atropine and handgrip augmentation as required. For ESEs the Bruce protocol was used on the treadmill and the WHO25 protocol on the semi-supine bicycle. Trans-pulmonary contrast was used in 95% of patients having DSE and 70% of patients having ESE. All complications were recorded even if no therapeutic intervention was required by the operator other than termination of the test. Locally, a results and a predominantly in the We investigated the whether stress echocardiography (SE) is safe and has satisfactory detection rate of ischaemia. retrospective of a total of 426 who had SE within a period of 12 months 2015 to 2016) for assessment of ischaemia. All were followed up for a mean period of 20 months. Collected mode of stressors, complications, management of the positive SE results and readmission of patients with chest pain management procedure pulmonary Currently, echocardiographic data regarding anatomical and functional remodelling of the right ventricle (RV) post-PEA, and whether pre-surgical haemodynamics influence recovery. Left atrium (LA) enlargement is an important predictor of cardiovascular morbidity and mortality. LA size is estimated by 2D echocardiography using several methods. We assessed if discrepancies between methods occurred more commonly in different types of heart disease. A secondary aim was to audit local adherence to BSE guidelines. 218","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"1 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45567482","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":"EDUCATIONAL SERIES ON THE SPECIALIST VALVE CLINIC: How to run a specialist valve clinic: the history, examination and exercise test.","authors":"John B Chambers","doi":"10.1530/ERP-19-0003","DOIUrl":"10.1530/ERP-19-0003","url":null,"abstract":"<p><p>Echocardiography is the key to the detection and initial assessment of valve disease. The examination helps differentiate severe from moderate disease if this is unclear from the echocardiogram, but is less useful than echocardiography for surveillance. However, the history is extremely important because symptoms are an indication for surgery in all types of valve disease. In aortic stenosis, the mortality rises soon after the onset of exertional breathlessness or chest tightness. Exercise testing is an extension of the history and may reveal symptoms in apparently asymptomatic patients. This article discusses the history, examination and exercise testing in patients either newly referred or under routine follow-up in a specialist valve clinic.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"6 4","pages":"T23-T28"},"PeriodicalIF":3.2,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/7f/ERP-19-0003.PMC6865356.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37245926","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":"EDUCATIONAL SERIES ON THE SPECIALIST VALVE CLINIC: What is a valve clinic?","authors":"Sanjeev Bhattacharyya,&nbsp;Denise Parkin,&nbsp;Keith Pearce","doi":"10.1530/ERP-18-0086","DOIUrl":"https://doi.org/10.1530/ERP-18-0086","url":null,"abstract":"<p><p>The prevalence of heart valve disease is increasing as the population ages. A series of studies have shown current clinical practice is sub-optimal. Some patients are referred for surgery at advanced stages of disease with impaired ventricular function or not even considered for surgery. Valve clinics seek to improve patient outcomes by providing an expert-led, patient-centred framework of care designed to provide an accurate diagnosis with active surveillance of valve pathology and timely referral for intervention at guideline directed trigger points. A range of different valve clinic models can be adopted depending on local expertise combining the skill set of cardiologist, physiologist/scientist and nurses. Essential components to all clinics include structured clinical review, echocardiography to identify disease aetiology and severity, patient education and access to both additional diagnostic testing and a multi-disciplinary meeting for complex case review. Recommendations for training in heart valve disease are being developed. There is a growing evidence base for heart valve clinics providing better care with increased adherence to guideline recommendations, more timely referral for surgery and better patient education than conventional care.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"6 4","pages":"T7-T13"},"PeriodicalIF":6.3,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/df/f8/ERP-18-0086.PMC6865861.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37237994","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":"Impact of left ventricular outflow tract flow acceleration on aortic valve area calculation in patients with aortic stenosis","authors":"Andaleeb A Ahmed, Robina Matyal, Feroze Mahmood, Ruby Feng, Graham B Berry, Scott Gilleland, Kamal R Khabbaz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Due to its circular shape, the area of the proximal left ventricular tract (PLVOT) adjacent to aortic valve can be derived from a single linear diameter. This is also the location of flow acceleration (FA) during systole, and pulse wave Doppler (PWD) sample volume in the PLVOT can lead to overestimation of velocity (V₁) and the aortic valve area (AVA). Therefore, it is recommended to derive V₁ from a region of laminar flow in the elliptical shaped distal LVOT (away from the annulus). Besides being inconsistent with the assumptions of continuity equation (CE), spatial difference in the location of flow and area measurement can result in inaccurate AVA calculation. We evaluated the impact of FA in the PLVOT on the accuracy of AVA by continuity equation (CE) in patients with aortic stenosis (AS).</p><p><strong>Methods: </strong>CE-based AVA calculations were performed in patients with AS once with PWD-derived velocity time integral (VTI) in the distal LVOT (VTI_LVOT) and then in the PLVOT to obtain a FA velocity profile (FA-VTI_LVOT) for each patient. A paired sample t-test (P < 0.05) was conducted to compare the impact of FA-VTI_LVOT and VTI_LVOT on the calculation of AVA.</p><p><strong>Result: </strong>There were 46 patients in the study. There was a 30.3% increase in the peak FA-VTI_LVOT as compared to the peak VTI_LVOT and AVA obtained by FA-VTI_LVOT was 29.1% higher than obtained by VTI_LVOT.</p><p><strong>Conclusion: </strong>Accuracy of AVA can be significantly impacted by FA in the PLVOT. LVOT area should be measured with 3D imaging in the distal LVOT.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"6 4","pages":"97-103"},"PeriodicalIF":3.2,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731497","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":"EDUCATIONAL SERIES IN CONGENITAL HEART DISEASE: Echocardiographic assessment of transposition of the great arteries and congenitally corrected transposition of the great arteries","authors":"Meryl S. Cohen, L. Mertens","doi":"10.1530/ERP-19-0047","DOIUrl":"https://doi.org/10.1530/ERP-19-0047","url":null,"abstract":"Echocardiographic assessment of patients with transposition of the great arteries and congenitally corrected transposition requires awareness of the morphology and commonly associated lesions. The pre-operative echocardiography should include a full segmental and sequential analysis. Post-operative assessment is not possible without awareness of the type of surgical procedure performed and consists of assessing surgical connections and residual lesions.","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"6 1","pages":"R107 - R119"},"PeriodicalIF":6.3,"publicationDate":"2019-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49288880","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":"EDUCATIONAL SERIES ON THE SPECIALIST VALVE CLINIC: The central role of the cardiac imager in heart valve disease","authors":"E. Donal, E. Galli, A. Anselmi, A. Bidaut, G. Leurent","doi":"10.1530/ERP-19-0046","DOIUrl":"https://doi.org/10.1530/ERP-19-0046","url":null,"abstract":"In this review, we discuss the central role of the imager in the heart team in the successful application of current guidelines for heart valve diseases to daily practice, and for improving patient care through new approaches, new techniques and new strategies for dealing with increasingly complex cases. This is an opportunity to emphasize the importance of having good imagers and the value of continuous learning in a modern heart team. It is essential to employ technological improvements and to appropriately adapt guidelines to the patients we see day to day.","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"6 1","pages":"T15 - T21"},"PeriodicalIF":6.3,"publicationDate":"2019-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46641022","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":"Impact of left ventricular outflow tract flow acceleration on aortic valve area calculation in patients with aortic stenosis","authors":"A. Ahmed, R. Matyal, Feroze Mahmood, R. Feng, Graham B Berry, Scott Gilleland, K. Khabbaz","doi":"10.1530/ERP-19-0017","DOIUrl":"https://doi.org/10.1530/ERP-19-0017","url":null,"abstract":"Objective Due to its circular shape, the area of the proximal left ventricular tract (PLVOT) adjacent to aortic valve can be derived from a single linear diameter. This is also the location of flow acceleration (FA) during systole, and pulse wave Doppler (PWD) sample volume in the PLVOT can lead to overestimation of velocity (V1) and the aortic valve area (AVA). Therefore, it is recommended to derive V1 from a region of laminar flow in the elliptical shaped distal LVOT (away from the annulus). Besides being inconsistent with the assumptions of continuity equation (CE), spatial difference in the location of flow and area measurement can result in inaccurate AVA calculation. We evaluated the impact of FA in the PLVOT on the accuracy of AVA by continuity equation (CE) in patients with aortic stenosis (AS). Methods CE-based AVA calculations were performed in patients with AS once with PWD-derived velocity time integral (VTI) in the distal LVOT (VTILVOT) and then in the PLVOT to obtain a FA velocity profile (FA-VTILVOT) for each patient. A paired sample t-test (P < 0.05) was conducted to compare the impact of FA-VTILVOT and VTILVOT on the calculation of AVA. Result There were 46 patients in the study. There was a 30.3% increase in the peak FA-VTILVOT as compared to the peak VTILVOT and AVA obtained by FA-VTILVOT was 29.1% higher than obtained by VTILVOT. Conclusion Accuracy of AVA can be significantly impacted by FA in the PLVOT. LVOT area should be measured with 3D imaging in the distal LVOT.","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"6 1","pages":"97 - 103"},"PeriodicalIF":6.3,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44182018","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":"3D echocardiography allows rapid and accurate surgical planning in complex aortic root abscess cases.","authors":"Viren Ahluwalia, Faizel Osman, Jitendra Parmar, Jamal Nasir Khan","doi":"10.1530/ERP-19-0043","DOIUrl":"10.1530/ERP-19-0043","url":null,"abstract":"<p><p>Despite 3D echocardiography (3DE) acquiring significantly greater data than standard 2D echocardiography (2DE), it is underutilized in assessing cardiac anatomy and physiology. A key advantage is the ability of a single 3DE acquisition to be post-processed to generate volume rendered 3D models and an unlimited number of multiplanar reconstruction (MPR) images. We describe the case of a highly anxious patient with life-threatening complex aortic valve endocarditis and aortic root abscess, refusing transesophageal echocardiography (TOE) under general anaesthesia with tachycardia, breathlessness and acute kidney injury precluding accurate or safe gated (computed tomography) CT, who was comprehensively assessed with a rapid 3DE-TOE under sedation. This led to timely surgery and an excellent outcome for the patient.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"6 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6893311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48138197","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}