Echo Research and Practice最新文献

{"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":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/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":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/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":"Latest British Society of Echocardiography recommendations for left ventricular ejection fraction categorisation: potential implications and relevance to contemporary heart failure management.","authors":"Prathap Kanagala, Iain B Squire","doi":"10.1530/ERP-20-0029","DOIUrl":"10.1530/ERP-20-0029","url":null,"abstract":"We read with interest the recent guideline publication from the British Society of Echocardiography (BSE) relating to normal reference intervals for cardiac dimensions and function for use in echocardiographic practice (1). We commend the authors and the Education Committee for attempting to produce updated guidance taking into account contemporary, prospective data to determine new reference ranges for echocardiographic parameters. However, we suggest the newly proposed categories for left ventricular ejection fraction (LVEF) derangements from the BSE may contribute to diagnostic and therapeutic uncertainty and create new challenges for the management of heart failure (HF) patients in the United Kingdom (UK). It is well recognised that HF transitions across the spectrum of LVEF and irrespective of LVEF, and that the prognosis for patients with HF is worse than in those without this diagnosis. Moreover, recent evidence points to adverse outcomes even in the setting of ‘supra-normal’ LVEF (2). As addressed in the recent publication (1), the latest BSE guidance for LV function categorisation (‘severely impaired’, LVEF ≤35%; ‘impaired’, LVEF 36–49%; ‘borderline low’, LVEF 50–54%; and ‘normal’, LVEF ≥55%) is clearly out of keeping with current guideline documents from international echocardiographic societies (American Society of Echocardiography (3), European Association of Cardiovascular Imaging (4)) and with those from international cardiology societies in Europe (European Society of Cardiology (ESC) (5)) and North America (American College of Cardiology/American Heart Association (6)). Both the ESC and the AHA define (heart failure with reduced ejection fraction) HFrEF at, or below, 40%. The ESC and AHA HF diagnostic thresholds have been reached not just on the basis of prognosis alone. Both heart failure with mid-range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) groups are characterised by marked heterogeneity and display differing epidemiological and pathophysiological profiles compared to HfrEF (7, 8, 9, 10). While the BSE document suggests that LVEF displays a continuous relation to prognosis ‘i.e. as the LVEF gets progressively lower, survival is progressively poorer’, LVEF exhibits a U-shaped, rather than a linear, relation to mortality (2). Both HFrEF and those with supra-normal LVEF are associated with the highest degrees of mortality, albeit HFmREF and HFpEF patients have poor prognosis relative to those without HF (11). Current ESC HF diagnostic thresholds have been conceived on the basis of evidence-based treatment response, with the demonstration in multiple clinical -20-0029 ID: 20-0029","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/7e/ERP-20-0029.PMC7487180.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38258881","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":null,"pages":null},"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":"Unique characterization of complex endocarditic vegetations using 3D TOE.","authors":"Muhammad Khan,&nbsp;Ruben De Sousa,&nbsp;Kam Rai,&nbsp;Jamal Nasir Khan","doi":"10.1530/ERP-19-0062","DOIUrl":"https://doi.org/10.1530/ERP-19-0062","url":null,"abstract":"<p><p>A 31-year-old male was admitted with suspected infective endocarditis, given a history of i.v. drug use, lung and cerebral abscesses and Staphylococcus aureus bacteraemia. TTE imaging was limited given supine positioning and mechanical ventilation but suggested a posterior mitral valve leaflet (PMVL) mass. Three-dimensional TOE provided uniquely detailed assessment of two complex infective masses. The attachment of the presumed P2 mass on TTE was indeterminant even on 2D-TOE, appearing attached to the PMVL or AMVL depending on rotational view (Fig. 1). 3D-TOE imaging and subsequent multiplanar and volume-rendered reconstruction revealed this to be a complex, large vegetation attached to the anterior aspect of the anterolateral commissure with mobile heads prolapsing into the left atrium and causing mild mitral regurgitation through a small basal perforation (Figs 2, 3 and Video 1). The second mass was a filamentous vegetation attached to the LVOT, prolapsing towards but not contacting the aortic valve (Fig. 4 and Video 2). Comprehensive assessment of complex vegetations is crucial for optimal surgical planning. 3D-TOE allows rapid, accurate, unique assessment of such masses through unlimited multiplanar reconstructions, volume-rendered real-time imaging and colour full-volume regurgitation assessment which may not always possible on 2D-TTE or 2D-TOE. 3D imaging should be routinely used in TOE and in particular in suspected endocarditis.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"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/bc/62/ERP-19-0062.PMC7274550.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37960497","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":"When echo gets in the way: physiological factors affecting Doppler data.","authors":"J Jose,&nbsp;K Randall,&nbsp;J Baron,&nbsp;J Khoo","doi":"10.1530/ERP-20-0006","DOIUrl":"https://doi.org/10.1530/ERP-20-0006","url":null,"abstract":"<p><p>Transthoracic echocardiography (TTE) is widely used as a pre-operative screening tool. It can provide extensive information about cardiac function and underlying pathology, which could influence decisions regarding surgery. This patient was referred for TTE as part of pre-op screening, as he had a biological prosthetic aortic valve. This was a rare case where misleading TTE measurements inadvertently led to the patient being referred for transcatheter aortic valve implantation (TAVI), which delayed non-cardiac surgery.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"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/16/1f/ERP-20-0006.PMC7354714.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38003490","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":"Atrial-ventricular function in rheumatic mitral regurgitation using strain imaging.","authors":"Ruchika Meel,&nbsp;Ferande Peters,&nbsp;Bijoy K Khandheria,&nbsp;Elena Libhaber,&nbsp;Mohammed Essop","doi":"10.1530/ERP-19-0034","DOIUrl":"https://doi.org/10.1530/ERP-19-0034","url":null,"abstract":"<p><strong>Background: </strong>Chronic mitral regurgitation (MR) historically has been shown to primarily affect left ventricular (LV) function. The impact of increased left atrial (LA) volume in MR on morbidity and mortality has been highlighted recently, yet the LA does not feature as prominently in the current guidelines as the LV. Thus, we aimed to study LA and LV function in chronic rheumatic MR using traditional volumetric parameters and strain imaging.</p><p><strong>Methods: </strong>Seventy-seven patients with isolated moderate or severe chronic rheumatic MR and 40 controls underwent echocardiographic examination. LV and LA function were assessed with conventional echocardiography and 2D strain imaging.</p><p><strong>Results: </strong>LA stiffness index was greater in chronic rheumatic MR than controls (0.95 ± 1.89 vs 0.16 ± 0.13, <i>P</i> = 0.009). LA dysfunction was noted in the reservoir, conduit, and contractile phases compared with controls (<i>P</i> < 0.05). LA peak reservoir strain (Ɛ_R), LA peak contractile strain, and LV peak systolic strain were decreased in chronic rheumatic MR compared with controls (<i>P</i> < 0.05). Eighty-six percent of patients had decreased LA Ɛ_R and 58% had depressed LV peak systolic strain. Decreased Ɛ_R and normal LV peak systolic strain were noted in 42%. Thirteen percent had normal Ɛ_R and LV peak systolic strain. One patient had normal Ɛ_R with decreased LV peak systolic strain.</p><p><strong>Conclusions: </strong>In chronic rheumatic MR, there is LA dysfunction in the reservoir, conduit, and contractile phases. In this study, LA dysfunction with or without LV dysfunction was the predominant finding, and thus, LA dysfunction may be an earlier marker of decompensation in chronic rheumatic MR.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e5/b6/ERP-19-0034.PMC7219135.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37950523","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":null,"pages":null},"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}

{"title":"Normal reference intervals for cardiac dimensions and function for use in echocardiographic practice: a guideline from the British Society of Echocardiography","authors":"A. Harkness, L. Ring, D. Augustine, D. Oxborough, Shaun Robinson, V. Sharma","doi":"10.1530/ERP-19-0050e","DOIUrl":"https://doi.org/10.1530/ERP-19-0050e","url":null,"abstract":"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:","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49578077","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":"Echocardiographic assessment of the right heart in adults: a practical guideline from the British Society of Echocardiography","authors":"Abbas Zaidi,&nbsp;Daniel S Knight,&nbsp;Daniel X Augustine,&nbsp;Allan Harkness,&nbsp;David Oxborough,&nbsp;Keith Pearce,&nbsp;Liam Ring,&nbsp;Shaun Robinson,&nbsp;Martin Stout,&nbsp;James Willis,&nbsp;Vishal Sharma","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":45749,"journal":{"name":"Echo Research and Practice","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2020-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/2b/ERP-19-0051.PMC7077526.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37683232","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}