Echo Research and Practice最新文献

{"title":"Echocardiographic assessment of the right heart in adults: a practical guideline from the British Society of Echocardiography","authors":"A. Zaidi, Daniel S. Knight, D. Augustine, A. Harkness, D. Oxborough, K. Pearce, L. Ring, Shaun Robinson, M. Stout, J. Willis, V. Sharma","doi":"10.1530/ERP-19-0051","DOIUrl":"https://doi.org/10.1530/ERP-19-0051","url":null,"abstract":"The structure and function of the right side of the heart is influenced by a wide range of physiological and pathological conditions. Quantification of right heart parameters is important in a variety of clinical scenarios including diagnosis, prognostication, and monitoring response to therapy. Although echocardiography remains the first-line imaging investigation for right heart assessment, published guidance is relatively sparse in comparison to that for the left ventricle. This guideline document from the British Society of Echocardiography describes the principles and practical aspects of right heart assessment by echocardiography, including quantification of chamber dimensions and function, as well as assessment of valvular function. While cut-off values for normality are included, a disease-oriented approach is advocated due to the considerable heterogeneity of structural and functional changes seen across the spectrum of diseases affecting the right heart. The complex anatomy of the right ventricle requires special considerations and echocardiographic techniques, which are set out in this document. The clinical relevance of right ventricular diastolic function is introduced, with practical guidance for its assessment. Finally, the relatively novel techniques of three-dimensional right ventricular echocardiography and right ventricular speckle tracking imaging are described. Despite these techniques holding considerable promise, issues relating to reproducibility and inter-vendor variation have limited their clinical utility to date.","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48699696","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":"The 34th Annual Advances in Contrast Ultrasound International Bubble Conference, Chicago 2019: synopsis and take-home messages.","authors":"Stella Kyung,&nbsp;Alan Goldberg,&nbsp;Steven Feinstein,&nbsp;Stephanie Wilson,&nbsp;Sharon Mulvagh,&nbsp;Petros Nihoyannopoulos","doi":"10.1530/ERP-19-0055","DOIUrl":"https://doi.org/10.1530/ERP-19-0055","url":null,"abstract":"<p><p>The 34th annual Advances in Contrast Ultrasound (ACU) International Bubble Conference convened in Chicago, IL, USA, on September 5-6, 2019 to feature new directions of research, preclinical and first-in-man clinical trials, and novel clinical applications highlighting the diversity and utility of contrast enhanced ultrasound (CEUS). An expert group comprising clinicians, engineers, basic scientists, government officials, attorneys, and industry partners convened to collaborate on cutting-edge ultrasound enhancement technology. Utilizing this information, the International Contrast Ultrasound Society (ICUS) continues to have cause to advocate for the safe and appropriate use of CEUS with expanding indications and applications.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/0d/ERP-19-0055.PMC7040858.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37686379","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":"Idiopathic eosinophilic myocarditis presenting with features of an acute coronary syndrome.","authors":"Nam Tran,&nbsp;Chun Shing Kwok,&nbsp;Sadie Bennett,&nbsp;Karim Ratib,&nbsp;Grant Heatlie,&nbsp;Thanh Phan","doi":"10.1530/ERP-19-0044","DOIUrl":"https://doi.org/10.1530/ERP-19-0044","url":null,"abstract":"<p><strong>Summary: </strong>A 62-year-old female was admitted with severe left-sided chest pain, nausea and pre-syncope. She had widespread T wave inversion on ECG and elevated troponins and was suspected to have an acute coronary syndrome event. Invasive coronary angiogram revealed normal coronary anatomy with no flow-limiting lesions. Echocardiography and cardiac MRI revealed impaired left ventricular (LV) systolic impairment, a mobile LV apical thrombus and a moderate global pericardial effusion with no significant compromise. Full blood count analysis indicated the patient to have significant eosinophilia, and the patient was diagnosed with idiopathic eosinophilic myocarditis. She was commenced on Prednisolone and Apixaban, and eosinophil levels returned to normal after 10 days of steroids. Over the course of 3 months, the patient had a complete recovery of her LV function and resolution of the LV thrombus. This case highlights a rare, reversible case of idiopathic eosinophilic myocarditis which may present similar to acute coronary syndrome.</p><p><strong>Learning points: </strong>Eosinophilic myocarditis (EM) is a rare disease that can exhibit symptoms similar to acute coronary syndrome events.The diagnosis of EM should be considered in patients with chest pain, normal coronary angiogram and pronounced eosinophilia levels.Endomyocardial biopsy is the gold standard diagnostic tool; however, it has a low sensitivity detection rate and its use is not indicated in some patients.Echocardiography is useful in the initial detection of cardiac involvement and complications. However, echocardiography lacks diagnostic specificity for all forms of myocarditis including EM.Cardiac magnetic resonance is a useful method and may add in diagnosing all forms of myocarditis including EM.Patients with EM should be identified promptly and treated with high doses of oral glucocorticoid to reduce the risk of permanent cardiac dysfunction.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/31/ERP-19-0044.PMC7040860.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37686378","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":"Coming undone: annuloplasty ring suture degeneration post mitral valve repair.","authors":"Patrick Savage, Michael Connolly","doi":"10.1530/ERP-19-0058","DOIUrl":"10.1530/ERP-19-0058","url":null,"abstract":"<p><p>Mitral valve repair is the gold standard treatment for degenerative mitral valve disease with superior perioperative and long-term morbidity and mortality outcomes versus mitral valve replacement. The 10 year survival freedom from redo valve repair varies from 72 to 90%. Often, failure of valve repair necessitating redo surgery is directly related to disease progression however rarely it can be attributed to technical complications such as annuloplasty dehiscence, leaflet suture rupture, incorrect artificial chord length or incorrect annuloplasty position. We report one such case of severe mitral regurgitation secondary to a degenerative annuloplasty ring suture occurring one year post valve repair.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/9f/ERP-19-0058.PMC7040856.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37606170","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 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":null,"pages":null},"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":null,"pages":null},"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 >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 <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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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}