Echo Research and Practice最新文献

{"title":"Ruptured sinus of Valsalva aneurysm: diagnosis by community echocardiography.","authors":"Peter J Savill, Dhrubo J Rakhit, 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":null,"pages":null},"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":"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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}

{"title":"Prognostic value of resting myocardial contrast echocardiography: a meta-analysis.","authors":"Lijun Qian,&nbsp;Feng Xie,&nbsp;Di Xu,&nbsp;Thomas R Porter","doi":"10.1530/ERP-20-0023","DOIUrl":"https://doi.org/10.1530/ERP-20-0023","url":null,"abstract":"<p><strong>Background: </strong>Resting myocardial perfusion (MP) and wall motion (WM) imaging during real-time myocardial contrast echocardiography (MCE) improves the detection of coronary artery disease (CAD). However, its prognostic role in different clinical settings (emergency department and outpatient setting) remains unclear.</p><p><strong>Methods: </strong>A systematic search in PubMed and Embase databases, and the Cochrane library, was conducted to evaluate the role of resting MP and WM in predicting major adverse cardiac events (MACE), including death, nonfatal myocardial infarction (NFMI) and urgent revascularization in patients presenting to either outpatient clinics or emergency departments with suspected symptomatic CAD. Summary receiver operating characteristic (SROC) curves, sensitivity and specificity plots were applied to assess diagnostic performance using RevMan 5.3.</p><p><strong>Results: </strong>Seven studies met criteria, including 3668 patients (six with follow up ranging from 2 days to 2.6 years). The Relative Risk (RR) for predicting MACE in patients with both abnormal resting MP and WM was 6.1 (95% CI, 5.1-7.2) and 14.3 (95% CI, 10.3-19.8) for death/NFMI, when compared to normal resting MP and WM patients. Having both abnormal resting MP and WM was also more predictive of MACE (RR, 1.7; 95% CI 1.5-1.9) and death/NFMI (RR, 2.2; 95% CI, 1.8-2.7) when compared to abnormal WM with normal resting MP.</p><p><strong>Conclusion: </strong>In this meta-analysis of both ED and outpatient clinic presentations for suspected CAD, having both a resting regional MP and WM abnormality identifies the highest risk patient for adverse events.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/53/ERP-20-0023.PMC7487191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38188689","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":"Response to Latest British Society of Echocardiography recommendations for left ventricular ejection fraction categorisation: potential implications and relevance to contemporary heart failure management.","authors":"Allan Harkness,&nbsp;Liam Ring,&nbsp;Daniel X Augustine,&nbsp;David Oxborough,&nbsp;Shaun Robinson,&nbsp;Vishal Sharma","doi":"10.1530/ERP-20-0031","DOIUrl":"https://doi.org/10.1530/ERP-20-0031","url":null,"abstract":"We thank Dr Kanagala and Professor Squire for their keen interest in our paper and their insight into the challenge of grading left ventricular ejection fraction (LVEF). We must emphasise that our paper's remit was not to be a clinical guide on heart failure nor on its treatment. We have briefly outlined the rationale and context for the BSE cutoff for severe LVEF and why we continue to differ from our European and American colleagues. We then discuss the need for stating the actual LVEF% in reports as opposed to a category alone for guiding appropriate therapeutic choices. Finally we address the concerns raised over clinical harm they perceive may occur from adopting our guideline.","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/b9/ERP-20-0031.PMC7487186.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38263001","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":"Is follow-up echocardiogram mandatory after a STEMI?","authors":"Sathish Kumar Parasuraman,&nbsp;Janaki Srinivasan,&nbsp;Paul Broadhurst","doi":"10.1530/ERP-20-0022","DOIUrl":"https://doi.org/10.1530/ERP-20-0022","url":null,"abstract":"<p><p>Current guidelines do not advise follow-up echocardiograms after ST-segment elevation myocardial infarction (STEMI), unless the left ventricular ejection fraction is ≤40%. We present an interesting case of left ventricular pseudo-aneurysm-diagnosed 6 months after index STEMI presentation. Follow-up echocardiogram was performed in her case, due to jaw pain during routine haemodialysis. The patient was successfully treated with percutaneous closure device. This case raises the question of whether echo follow-up should be routinely advised after STEMI-even in those with minimal cardiac symptoms.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/8b/ERP-20-0022.PMC7487183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10333668","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":"Delayed bubble, coil and trouble: young stroke as a presentation of paradoxical embolism from previously unrecognised pulmonary arterio-venous malformation (PAVM).","authors":"Trisha Singh,&nbsp;Jonathan Hinton,&nbsp;Rosie Swallow,&nbsp;James Kersey,&nbsp;Charles Hillier","doi":"10.1530/ERP-20-0001","DOIUrl":"https://doi.org/10.1530/ERP-20-0001","url":null,"abstract":"<p><p>Young stroke patients should be investigated thoroughly to look for cardiac and extra-cardiac sources of emboli. We present a patient who was investigated for a cardiac source of emboli following an ischemic stroke. She was found to have a small patent foramen ovale (PFO), but due to the late appearances of bubbles on the bubble study it was thought that this was an incidental finding. Further investigation confirmed a PAVM was the source of emboli causing her stroke.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/11/af/ERP-20-0001.PMC7424326.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38188675","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":"Stuck on a diagnosis: prosthetic mitral valve thrombosis vs dyssynchrony.","authors":"Patrick Savage,&nbsp;Michael Connolly","doi":"10.1530/ERP-20-0012","DOIUrl":"https://doi.org/10.1530/ERP-20-0012","url":null,"abstract":"<p><p>Prosthetic valve thrombosis is a rare but serious complication of mechanical valve replacement requiring prompt diagnosis and treatment. Unfortunately, it is often difficult to evaluate this based on single modality imaging alone. We demonstrate a case where the use of both 3D-TOE and valve fluoroscopy allowed for the differentiation between prosthetic valve thrombosis vs prosthetic mitral valve dyssychrony. Using transoesphageal echocardiography, it is noted that there is valve dyssynchrony; however, it is unclear if there is leaflet restriction (Video 1). Using fluoroscopy, it can be seen clearly that their overall mobility is normal (Video 2). Additionally, using 3D-TOE it can be clearly noted that there is no evidence of pannus or thrombus (Video 3). Using these two imaging modalities in concert facilitated the clear diagnosis of valve dyssynchrony vs valve thrombosis.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/69/ERP-20-0012.PMC7487181.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10333667","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":"Fulminant myocarditis: use of echocardiography from diagnosis to extracorporeal membrane oxygenation.","authors":"Na Hyun Park,&nbsp;Hazem Lashin,&nbsp;Rosalba Spiritoso","doi":"10.1530/ERP-20-0005","DOIUrl":"https://doi.org/10.1530/ERP-20-0005","url":null,"abstract":"<p><p>Fulminant myocarditis can present with life-threatening arrhythmias and cardiogenic shock due to ventricular failure. The diagnosis of myocarditis usually requires histological and immunological information, as its aetiology may be infectious (viral or non-viral), autoimmune or drug related. The treatment of fulminant myocarditis depends on the underlying cause but usually includes high dose systemic steroids as well as physiological support. Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) can be used to support patients as a bridge to recovery by supporting biventricular function and decompressing the heart. V-A ECMO carries risks and complications of its own such as thrombus formation or bleeding. Different diagnostic modalities, such as transthoracic echocardiogram (TTE) and transoesophageal echocardiogram (TOE), are central to the monitoring of progression of disease and recovery of heart function. This case highlights the importance of early recognition and early support with V-A ECMO in fulminant myocarditis, as well as the role of repeated echocardiography when weaning from physiological support.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/7f/ERP-20-0005.PMC7424325.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38188677","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}