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":"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":"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}

{"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":"7 3","pages":"K27-K30"},"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":"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":"7 3","pages":"I9"},"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":"Left ventricular speckle tracking echocardiographic evaluation before and after TAVI.","authors":"Vasiliki Tsampasian,&nbsp;Vasileios Panoulas,&nbsp;Richard J Jabbour,&nbsp;Neil Ruparelia,&nbsp;Iqbal S Malik,&nbsp;Nearchos Hadjiloizou,&nbsp;Angela Frame,&nbsp;Sayan Sen,&nbsp;Nilesh Sutaria,&nbsp;Ghada W Mikhail,&nbsp;Petros Nihoyannopoulos","doi":"10.1530/ERP-20-0009","DOIUrl":"https://doi.org/10.1530/ERP-20-0009","url":null,"abstract":"<p><strong>Aims: </strong>To assess left ventricular (LV) function before and after transcatheter aortic valve implantation (TAVI) using conventional echocardiographic parameters and global longitudinal LV strain (GLS) and compare outcomes between Edwards S3 and Evolut R valves.</p><p><strong>Methods and results: </strong>Data were collected for consecutive patients undergoing TAVI at Hammersmith hospital between 2015 and 2018. Of the 303 patients, those with coronary artery disease and atrial fibrillation were excluded leading to a total of 85 patients, which constituted our study group. The mean follow-up was 49 ± 39 days. In total, 60% of patients were treated with Edwards S3 and 40% Evolut R. TAVI resulted in an early improvement of GLS (-13.96 to -15.25%, P = 0.01) but not ejection fraction (EF) (47.6 to 50.1%, P = 0.09). LV mass also improved, especially in patients with marked baseline LV hypertrophy (P < 0.001). There were no appreciable differences of LV function improvement and overall LV remodelling after TAVI between the two types of valves used (P = 0.14).</p><p><strong>Conclusions: </strong>TAVI results in reverse remodelling and improvement of GLS, especially in patients with impaired baseline LV function. There were no differences in the extent of LV function improvement between Edwards S3 and Evolut R valves but there was a greater incidence of aortic regurgitation with Evolut R.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"7 3","pages":"29-38"},"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/6b/b8/ERP-20-0009.PMC7487179.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10329025","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":"Global longitudinal strain in chronic asymptomatic aortic regurgitation: systematic review.","authors":"Diana deCampos,&nbsp;Rogério Teixeira,&nbsp;Carolina Saleiro,&nbsp;Ana Botelho,&nbsp;Lino Gonçalve","doi":"10.1530/ERP-20-0024","DOIUrl":"https://doi.org/10.1530/ERP-20-0024","url":null,"abstract":"<p><p>Chronic aortic regurgitation (AR) patients typically remain asymptomatic for a long time. Left ventricular mechanics, namely global longitudinal strain (GLS), has been associated with outcomes in AR patients. The authors conducted a systematic review to summarize and appraise GLS impact on mortality, the need for aortic valve replacement (AVR) and disease progression in AR patients. A literature search was performed using these key terms 'aortic regurgitation' and 'longitudinal strain' looking at all randomized and nonrandomized studies conducted on chronic aortic regurgitation. The search yielded six observational studies published from 2011 and 2018 with a total of 1571 patients with moderate to severe chronic AR. Only two studies included all-cause mortality as their endpoint. The other studies looked at the association between GLS with AVR and disease progression. The mean follow-up period was 4.2 years. We noted a great variability of clinical, methodological and/or statistical origin. Thus, meta-analytic portion of our study was limited. Despite a relevant heterogeneity, an impaired GLS was associated with adverse cardiac outcomes. Left ventricular GLS may offer incremental value in risk stratification and decision-making.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"7 3","pages":"39-48"},"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/de/6f/ERP-20-0024.PMC7576640.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10333665","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 minimum dataset for a Level 1 echocardiogram: a guideline protocol from the British Society of Echocardiography.","authors":"Rakhee Hindocha,&nbsp;David Garry,&nbsp;Nadia Short,&nbsp;Tom E Ingram,&nbsp;Richard P Steeds,&nbsp;Claire L Colebourn,&nbsp;Keith Pearce,&nbsp;Vishal Sharma","doi":"10.1530/ERP-19-0060","DOIUrl":"https://doi.org/10.1530/ERP-19-0060","url":null,"abstract":"<p><p>The British Society of Echocardiography has previously outlined a minimum dataset for a standard transthoracic echocardiogram, and this remains the basis on which an echocardiographic study should be performed. The importance of ultrasound in excluding critical conditions that may require urgent treatment is well known. Several point-of-care echo protocols have been developed for use by non-echocardiography specialists. However, these protocols are often only used in specific circumstances and are usually limited to 2D echocardiography. Furthermore, although the uptake in training for these protocols has been reasonable, there is little in the way of structured support available from accredited sonographers in the ongoing training and re-accreditation of those undertaking these point-of-care scans. In addition, it is well recognised that the provision of echocardiography on a 24/7 basis is extremely challenging, particularly outside of tertiary cardiac centres. Consequently, following discussions with NHS England, the British Society of Echocardiography has developed the Level 1 echocardiogram in order to support the rapid identification of critical cardiac pathology that may require emergency treatment. It is intended that these scans will be performed by non-specialists in echocardiography and crucially are not designed to replace a full standard transthoracic echocardiogram. Indeed, it is expected that a significant number of patients, in whom a Level 1 echocardiogram is required, will need to have a full echocardiogram performed as soon as is practically possible. This document outlines the minimum dataset for a Level 1 echocardiogram. The accreditation process for Level 1 echo is described separately.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"7 2","pages":"G51-G58"},"PeriodicalIF":6.3,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/06/52/ERP-19-0060.PMC7354713.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10329026","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":"Normal reference intervals for cardiac dimensions and function for use in echocardiographic practice: a guideline from the British Society of Echocardiography.","authors":"Allan Harkness,&nbsp;Liam Ring,&nbsp;Daniel X Augustine,&nbsp;David Oxborough,&nbsp;Shaun Robinson,&nbsp;Vishal Sharma","doi":"10.1530/ERP-19-0050","DOIUrl":"https://doi.org/10.1530/ERP-19-0050","url":null,"abstract":"<p><p>The authors and journal apologise for errors in the above paper, which appeared in the March 2020 issue of Echo Research and Practice (volume 7, pages G1–G18, https://doi.org/10.1530/ERP-19-0050).\u0000\u0000The errors relate to values given in Table 2 on page G6. The original text gave the Male moderate LVIDd LV dimension as 61–65 mm, the Male mild LVIDs LV dimension as 41–45 mm and the Female mild LVMi LV mass as 98–115 g/m2.\u0000\u0000This should have stated that the Male moderate LVIDd LV dimension is 62–65 mm, the Male mild LVIDs LV dimension is 42–45 mm and the Female mild LVMi LV mass is 100–115 g/m2. The corrected Table 2 is given in full below:</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":"7 1","pages":"X1"},"PeriodicalIF":6.3,"publicationDate":"2020-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/c2/ERP-19-0050e.PMC8117370.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37757846","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}