Echo Research and Practice最新文献

{"title":"Echocardiographic assessment of aortic stenosis: a practical guideline from the British Society of Echocardiography.","authors":"Liam Ring, Benoy N Shah, Sanjeev Bhattacharyya, Allan Harkness, Mark Belham, David Oxborough, Keith Pearce, Bushra S Rana, Daniel X Augustine, Shaun Robinson, Christophe Tribouilloy","doi":"10.1530/ERP-20-0035","DOIUrl":"10.1530/ERP-20-0035","url":null,"abstract":"<p><p>The guideline provides a practical step-by-step guide in order to facilitate high-quality echocardiographic studies of patients with aortic stenosis. In addition, it addresses commonly encountered yet challenging clinical scenarios and covers the use of advanced echocardiographic techniques, including TOE and Dobutamine stress echocardiography in the assessment of aortic stenosis.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"8 1","pages":"G19-G59"},"PeriodicalIF":3.2,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fe/ab/ERP-20-0035.PMC8115410.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25470008","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":"British Society for Echocardiography and British Cardio-Oncology Society guideline for transthoracic echocardiographic assessment of adult cancer patients receiving anthracyclines and/or trastuzumab.","authors":"Rebecca Dobson, Arjun K Ghosh, Bonnie Ky, Tom Marwick, Martin Stout, Allan Harkness, Rick Steeds, Shaun Robinson, David Oxborough, David Adlam, Susannah Stanway, Bushra Rana, Thomas Ingram, Liam Ring, Stuart Rosen, Chris Plummer, Charlotte Manisty, Mark Harbinson, Vishal Sharma, Keith Pearce, Alexander R Lyon, Daniel X Augustine","doi":"10.1530/ERP-21-0001","DOIUrl":"10.1530/ERP-21-0001","url":null,"abstract":"<p><p>The subspecialty of cardio-oncology aims to reduce cardiovascular morbidity and mortality in patients with cancer or following cancer treatment. Cancer therapy can lead to a variety of cardiovascular complications, including left ventricular systolic dysfunction, pericardial disease, and valvular heart disease. Echocardiography is a key diagnostic imaging tool in the diagnosis and surveillance for many of these complications. The baseline assessment and subsequent surveillance of patients undergoing treatment with anthracyclines and/or human epidermal growth factor (EGF) receptor (HER) 2-positive targeted treatment (e.g. trastuzumab and pertuzumab) form a significant proportion of cardio-oncology patients undergoing echocardiography. This guideline from the British Society of Echocardiography and British Cardio-Oncology Society outlines a protocol for baseline and surveillance echocardiography of patients undergoing treatment with anthracyclines and/or trastuzumab. The methodology for acquisition of images and the advantages and disadvantages of techniques are discussed. Echocardiographic definitions for considering cancer therapeutics-related cardiac dysfunction are also presented.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"8 1","pages":"G1-G18"},"PeriodicalIF":6.3,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/db/ERP-21-0001.PMC8052569.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39075607","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 COVID-19 on UK stress echocardiography practice: insights from the EVAREST sites.","authors":"Cameron Dockerill,&nbsp;William Woodward,&nbsp;Annabelle McCourt,&nbsp;Cristiana Monteiro,&nbsp;Elena Benedetto,&nbsp;Maria Paton,&nbsp;David Oxborough,&nbsp;Shaun Robinson,&nbsp;Keith Pearce,&nbsp;Mark J Monaghan,&nbsp;Daniel X Augustine,&nbsp;Paul Leeson","doi":"10.1530/ERP-20-0043","DOIUrl":"https://doi.org/10.1530/ERP-20-0043","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare delivery is being transformed by COVID-19 to reduce transmission risk but continued delivery of routine clinical tests is essential. Stress echocardiography is one of the most widely used cardiac tests in the NHS. We assessed the impact of the first (W1) and second (W2) waves of the pandemic on the ability to deliver stress echocardiography.</p><p><strong>Methods: </strong>Clinical echocardiography teams in 31 NHS hospitals participating in the EVAREST study were asked to complete a survey on the structure and delivery of stress echocardiography as well as its impact on patients and staff in July and November 2020. Results were compared to stress echocardiography activity in the same centre during January 2020.</p><p><strong>Results: </strong>24 completed the survey in July, and 19 NHS hospitals completed the survey in November. A 55% reduction in the number of studies performed was reported in W1, recovering to exceed pre-COVID rates in W2. The major change was in the mode of stress delivery. 70% of sites stopped their exercise stress service in W1, compared to 19% in W2. In those still using exercise during W1, 50% were wearing FFP3/N95 masks, falling to 38% in W2. There was also significant variability in patient screening practices with 7 different pre-screening questionnaires used in W1 and 6 in W2.</p><p><strong>Conclusion: </strong>Stress echocardiography delivery restarted effectively after COVID-19 with adaptations to reduce transmission that means activity has been able to continue, and exceed, pre-COVID-19 levels during the second wave. Further standardization of protocols for patient screening and PPE may help further improve consistency of practice within the United Kingdom.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"8 1","pages":"1-8"},"PeriodicalIF":6.3,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/c8/ERP-20-0043.PMC8111306.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25495050","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 practical guideline for performing a comprehensive transthoracic echocardiogram in adults: the British Society of Echocardiography minimum dataset.","authors":"Shaun Robinson, Bushra Rana, David Oxborough, Rick Steeds, Mark Monaghan, Martin Stout, Keith Pearce, Allan Harkness, Liam Ring, Maria Paton, Waheed Akhtar, Radwa Bedair, Sanjeev Bhattacharyya, Katherine Collins, Cheryl Oxley, Julie Sandoval, Rebecca Schofield MBChB, Anjana Siva, Karen Parker, James Willis, Daniel X Augustine","doi":"10.1530/ERP-20-0026","DOIUrl":"10.1530/ERP-20-0026","url":null,"abstract":"<p><p>Since cardiac ultrasound was introduced into medical practice around the middle twentieth century, transthoracic echocardiography has developed to become a highly sophisticated and widely performed cardiac imaging modality in the diagnosis of heart disease. This evolution from an emerging technique with limited application, into a complex modality capable of detailed cardiac assessment has been driven by technological innovations that have both refined 'standard' 2D and Doppler imaging and led to the development of new diagnostic techniques. Accordingly, the adult transthoracic echocardiogram has evolved to become a comprehensive assessment of complex cardiac anatomy, function and haemodynamics. This guideline protocol from the British Society of Echocardiography aims to outline the minimum dataset required to confirm normal cardiac structure and function when performing a comprehensive standard adult echocardiogram and is structured according to the recommended sequence of acquisition. It is recommended that this structured approach to image acquisition and measurement protocol forms the basis of every standard adult transthoracic echocardiogram. However, when pathology is detected and further analysis becomes necessary, views and measurements in addition to the minimum dataset are required and should be taken with reference to the appropriate British Society of Echocardiography imaging protocol. It is anticipated that the recommendations made within this guideline will help standardise the local, regional and national practice of echocardiography, in addition to minimising the inter and intra-observer variation associated with echocardiographic measurement and interpretation.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"7 4","pages":"G59-G93"},"PeriodicalIF":3.2,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/00/ERP-20-0026.PMC7923056.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38535875","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":"Echocardiographic RV-E/e' for predicting right atrial pressure: a review.","authors":"A J Fletcher,&nbsp;S Robinson,&nbsp;B S Rana","doi":"10.1530/ERP-19-0057","DOIUrl":"https://doi.org/10.1530/ERP-19-0057","url":null,"abstract":"<p><p>Right atrial pressure (RAP) is a key cardiac parameter of diagnostic and prognostic significance, yet current two-dimensional echocardiographic methods are inadequate for the accurate estimation of this haemodynamic marker. Right-heart trans-tricuspid Doppler and tissue Doppler echocardiographic techniques can be combined to calculate the right ventricular (RV) E/e' ratio - a reflection of RV filling pressure which is a surrogate of RAP. A systematic search was undertaken which found seventeen articles that compared invasively measured RAP with RV-E/e' estimated RAP. Results commonly concerned pulmonary hypertension or advanced heart failure/transplantation populations. Reported receiver operating characteristic analyses showed reasonable diagnostic ability of RV-E/e' for estimating RAP in patients with coronary artery disease and RV systolic dysfunction. The diagnostic ability of RV-E/e' was generally poor in studies of paediatrics, heart failure and mitral stenosis, whilst results were equivocal in other diseases. Bland-Altman analyses showed good accuracy but poor precision of RV-E/e' for estimating RAP, but were limited by only being reported in seven out of seventeen articles. This suggests that RV-E/e' may be useful at a population level but not at an individual level for clinical decision making. Very little evidence was found about how atrial fibrillation may affect the estimation of RAP from RV-E/e', nor about the independent prognostic ability of RV-E/e' . Recommended areas for future research concerning RV-E/e' include; non-sinus rhythm, valvular heart disease, short and long term prognostic ability, and validation over a wide range of RAP.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"7 4","pages":"R11-R20"},"PeriodicalIF":6.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6a/63/ERP-19-0057.PMC7923036.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38689596","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":"Ruptured sinus of Valsalva aneurysm: diagnosis by community echocardiography.","authors":"Peter J Savill,&nbsp;Dhrubo J Rakhit,&nbsp;Benoy N Shah","doi":"10.1530/ERP-20-0020","DOIUrl":"https://doi.org/10.1530/ERP-20-0020","url":null,"abstract":"","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"7 4","pages":"I15-I16"},"PeriodicalIF":6.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/90/ERP-20-0020.PMC7774752.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38654783","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, October 2018, ACC Liverpool, Liverpool.","authors":"V Sharma, L Al Saikhan, C Park, A Hughes, H Gu, S Saeed, A Boguslavskyi, G Carr-White, J Chambers, P Chowienczyk, M Jain, H Jessop, C Turner, G Bassindale-Maguire, W Baig, A Kidambi, S T Abdel-Rahman, D Schlosshan, A Sengupta, A Fitzpatrick, J Sandoval, S Hickman, H Procter, J Taylor, H Kaur, C Knowles, S Wheatcroft, K Witte, K Gatenby, J A Willis, A Kendler-Rhodes, O Slegg, K Carson, J Easaw, S R Kandan, J C L Rodrigues, R MacKenzie-Ross, T Hall, G Robinson, D Little, B Hudson, J Pauling, S Redman, R Graham, G Coghlan, J Suntharalingam, D X Augustine, J W M Nowak, A T Masters","doi":"10.1530/ERP-20-0037","DOIUrl":"10.1530/ERP-20-0037","url":null,"abstract":"","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"7 4","pages":"M1"},"PeriodicalIF":3.2,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/cd/ERP-20-0037.PMC8693154.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38639541","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":"Echocardiographic assessment of the tricuspid and pulmonary valves: a practical guideline from the British Society of Echocardiography.","authors":"Abbas Zaidi,&nbsp;David Oxborough,&nbsp;Daniel X Augustine,&nbsp;Radwa Bedair,&nbsp;Allan Harkness,&nbsp;Bushra Rana,&nbsp;Shaun Robinson,&nbsp;Luigi P Badano","doi":"10.1530/ERP-20-0033","DOIUrl":"https://doi.org/10.1530/ERP-20-0033","url":null,"abstract":"<p><p>Transthoracic echocardiography is the first-line imaging modality in the assessment of right-sided valve disease. The principle objectives of the echocardiographic study are to determine the aetiology, mechanism and severity of valvular dysfunction, as well as consequences on right heart remodelling and estimations of pulmonary artery pressure. Echocardiographic data must be integrated with symptoms, to inform optimal timing and technique of interventions. The most common tricuspid valve abnormality is regurgitation secondary to annular dilatation in the context of atrial fibrillation or left-sided heart disease. Significant pulmonary valve disease is most commonly seen in congenital heart abnormalities. The aetiology and mechanism of tricuspid and pulmonary valve disease can usually be identified by 2D assessment of leaflet morphology and motion. Colour flow and spectral Doppler are required for assessment of severity, which must integrate data from multiple imaging planes and modalities. Transoesophageal echo is used when transthoracic data is incomplete, although the anterior position of the right heart means that transthoracic imaging is often superior. Three-dimensional echocardiography is a pivotal tool for accurate quantification of right ventricular volumes and regurgitant lesion severity, anatomical characterisation of valve morphology and remodelling pattern, and procedural guidance for catheter-based interventions. Exercise echocardiography may be used to elucidate symptom status and demonstrate functional reserve. Cardiac magnetic resonance and CT should be considered for complimentary data including right ventricular volume quantification, and precise cardiac and extracardiac anatomy. This British Society of Echocardiography guideline aims to give practical advice on the standardised acquisition and interpretation of echocardiographic data relating to the pulmonary and tricuspid valves.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"7 4","pages":"G95-G122"},"PeriodicalIF":6.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/29/ERP-20-0033.PMC8052586.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38727381","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 prognostic value of Tei index in acute myocardial infarction: a systematic review.","authors":"Sadie Bennett,&nbsp;Chun Wai Wong,&nbsp;Timothy Griffiths,&nbsp;Martin Stout,&nbsp;Jamal Nasir Khan,&nbsp;Simon Duckett,&nbsp;Grant Heatlie,&nbsp;Chun Shing Kwok","doi":"10.1530/ERP-20-0017","DOIUrl":"https://doi.org/10.1530/ERP-20-0017","url":null,"abstract":"<p><strong>Background: </strong>Echocardiographic evaluation of left ventricular ejection fraction (LVEF) is used in the risk stratification of patients with an acute myocardial infarction (AMI). However, the prognostic value of the Tei index, an alternative measure of global cardiac function, in AMI patients is not well established.</p><p><strong>Methods: </strong>We conducted a systematic review, using MEDLINE and EMBASE, to evaluate the prognostic value of the Tei index in predicting adverse outcomes in patients presenting with AMI. The data was collected and narratively synthesised.</p><p><strong>Results: </strong>A total of 16 studies were including in this review with 2886 participants (mean age was 60 years from 14 studies, the proportion of male patients 69.8% from 14 studies). Patient follow-up duration ranged from during the AMI hospitalisation stay to 57.8 months. Tei index showed a significant association with heart failure episodes, reinfarction, death and left ventricular thrombus formation in 14 out of the 16 studies. However, in one of these studies, Tei index was only significantly predictive of cardiac events in patients where LVEF was <40%. In two further studies, Tei index was not associated with predicting adverse outcomes once LVEF, left ventricular end-systolic volume index and left ventricular early filling time was taken into consideration. In the two remaining studies, there was no prognostic value of Tei index in relation to patient outcomes.</p><p><strong>Conclusions: </strong>Tei index may be an important prognostic marker in AMI patients, however, more studies are needed to better understand when it should be used routinely within clinical practice.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"7 4","pages":"49-58"},"PeriodicalIF":6.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/a4/ERP-20-0017.PMC7707827.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38624962","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":"Cor triatriatrum or divided left atrium presenting as mitral stenosis in an adult patient.","authors":"Alfonso Pecoraro,&nbsp;Jacques Janson,&nbsp;Jacob Daniel Cilliers","doi":"10.1530/ERP-20-0016","DOIUrl":"https://doi.org/10.1530/ERP-20-0016","url":null,"abstract":"A 26-year-old male patient presented to the hospital with a 2-month history of progressive dyspnoea. He denied chest pain, coughing, orthopnoea, paroxysmal nocturnal dyspnoea, syncope or pre-syncope. He had no other significant comorbidities and he was not on any chronic medication. His cardiovascular examination revealed an undisplaced apex beat with a parasternal heave and a loud second heart sound (P2) suggestive of pulmonary hypertension. On auscultation, the first heart sound was normal with a loud second heart sound and a diastolic rumble. Given these findings, a clinical diagnosis of severe mitral stenosis with pulmonary hypertension was made. ECG was atypical for mitral stenosis, it revealed a dilated LA with left axis deviation due to a left anterior hemiblock. No features of right ventricular hypertrophy was noted. To our surprise, echocardiographic evaluation (Figs 1 and 2) revealed a primum ASD with the normal function of the left and right atrioventricular (AV) valve. A left-sided supra-valvular ridge or divided left atrium was identified with peak and mean gradients of 43/21 mmHg, respectively (Fig. 3). Video 1 is an apical four-chamber view of the defect, pre-operatively. -20-0016 ID: 20-0016","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"7 4","pages":"I11-I13"},"PeriodicalIF":6.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/80/ERP-20-0016.PMC7576639.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38470874","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}