Journal of cardiovascular ultrasound最新文献

{"title":"Gender Differences in Clinical Profiles of Stress-Induced Cardiomyopathy.","authors":"Hyung Yoon Kim,&nbsp;Joon-Hyung Doh,&nbsp;Shin Yi Jang,&nbsp;Eun Kyoung Kim,&nbsp;Joo-Yong Hahn,&nbsp;Duk-Kyung Kim","doi":"10.4250/jcu.2017.25.4.111","DOIUrl":"https://doi.org/10.4250/jcu.2017.25.4.111","url":null,"abstract":"<p><strong>Background: </strong>Although stress-induced cardiomyopathy (SCMP) is reported to be more common in women, little is known about gender differences in patients with SCMP. The aim of the study was to describe clinical features of patients with SCMP according to gender.</p><p><strong>Methods: </strong>One hundred and three patients diagnosed with definite SCMP at a single tertiary institute from January 1997 to August 2014 were enrolled. SCMP was more common in women than in men.</p><p><strong>Results: </strong>Age at presentation was not significantly different between the two groups (<i>p</i> = 0.758). Preceding physical stress, especially acute medical illness, was more common in male patients (<i>p</i> = 0.014), whereas emotional stress was more common in female patients (<i>p</i> = 0.016). Severity of medical illness classified by the Acute Physiology and Chronic Health Evaluation (APACHE) II score at the time of SCMP diagnosis was not significantly different between men and women (<i>p</i> = 0.752). Clinical characteristics, including symptoms, laboratory and electrocardiographic findings, were similar. However, pump failure was more severe in men (<i>p</i> = 0.024). Clinical outcomes were not statistically different (<i>p</i> = 0.220). Preceding physical stress and lower left ventricular systolic function after 2 months were independent risk factors for all-cause mortality for both genders. Women with an APACHE II score ≥ 15 and men with reduced left ventricular ejection fraction after 2 months had a greater risk of poor prognosis.</p><p><strong>Conclusion: </strong>SCMP was more common in female patients. Female patients more commonly experienced preceding emotional stress, whereas physical stress was more common in male patients. Systolic dysfunction was more severe in men. Long-term clinical outcomes appeared to be similar between men and women.</p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"25 4","pages":"111-117"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2017.25.4.111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35736782","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":"Associates and Prognosis of Giant Left Atrium; Single Center Experience.","authors":"Hyoeun Kim,&nbsp;Young-Ah Park,&nbsp;Sung Min Choi,&nbsp;Hyemoon Chung,&nbsp;Jong-Youn Kim,&nbsp;Pil-Ki Min,&nbsp;Young Won Yoon,&nbsp;Byoung Kwon Lee,&nbsp;Bum-Kee Hong,&nbsp;Se-Joong Rim,&nbsp;Hyuck Moon Kwon,&nbsp;Eui-Young Choi","doi":"10.4250/jcu.2017.25.3.84","DOIUrl":"https://doi.org/10.4250/jcu.2017.25.3.84","url":null,"abstract":"<p><strong>Background: </strong>Left atrial (LA) remodeling develops as a result of longstanding pressure overload. However, determinants and clinical outcome of excessive remodeling, so called giant left atrium (GLA), are not clear.</p><p><strong>Methods: </strong>Clinical characteristics of patients with GLA (antero-posterior diameter higher than 65 mm), including echo-Doppler parameters, and follow-up clinical outcomes from a tertiary referral hospital were investigated.</p><p><strong>Results: </strong>Among 68519 consecutive primary patients who underwent echocardiography over a period of 10 years, data from 163 GLA cases (0.24%) were analyzed. Main causes were significant rheumatic mitral stenosis (n = 58, 36%); other causes comprised significant rheumatic mitral regurgitation (MR; n = 10, 6%), mitral valve (MV) prolapse or congenital mitral valvular disease (MVD) (n = 20, 12%), and functional MR (n = 25, 15%). However, mild rheumatic MV disease (n = 4, 3%) or left ventricular (LV) systolic or diastolic dysfunction without significant MR (n = 46, 28%) were also causes of GLA. During median follow-up of 22 months, 42 cases (26%) underwent composite events. MV surgery was related to lower rate of composite events. In multivariate analysis, MV surgery, elevated pulmonary arterial systolic pressure, and increased LA volume index were independent predictors of future events (<i>p</i> < 0.05) regardless of underlying diseases or history of MV surgery.</p><p><strong>Conclusion: </strong>Although rheumatic MVD with atrial fibrillation is the main contributor to GLA, longstanding atrial fibrillation with LV dysfunction but without MVD also could be related to GLA. Even in GLA state, accurate measurement of LA volume is crucial for risk stratification for future events, regardless of underlying disease.</p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"25 3","pages":"84-90"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2017.25.3.84","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35514114","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":"Current Awareness and Use of the Strain Echocardiography in Routine Clinical Practices: Result of a Nationwide Survey in Korea.","authors":"Ju-Hee Lee,&nbsp;Jae-Hyeong Park,&nbsp;Seung Woo Park,&nbsp;Woo-Shik Kim,&nbsp;Il Suk Sohn,&nbsp;Jung Yeon Chin,&nbsp;Jung Sun Cho,&nbsp;Ho-Joong Youn,&nbsp;Hae Ok Jung,&nbsp;Sun Hwa Lee,&nbsp;Seong-Hwan Kim,&nbsp;Wook-Jin Chung,&nbsp;Chi Young Shim,&nbsp;Jin-Won Jeong,&nbsp;Eui-Young Choi,&nbsp;Se-Joong Rim,&nbsp;Jang-Young Kim,&nbsp;Kye Hun Kim,&nbsp;Joon-Han Shin,&nbsp;Dae-Hee Kim,&nbsp;Ung Jeon,&nbsp;Jung Hyun Choi,&nbsp;Yong-Jin Kim,&nbsp;Seung Jae Joo,&nbsp;Ki-Hong Kim,&nbsp;Kyoung Im Cho,&nbsp;Goo-Yeong Cho","doi":"10.4250/jcu.2017.25.3.91","DOIUrl":"https://doi.org/10.4250/jcu.2017.25.3.91","url":null,"abstract":"<p><strong>Background: </strong>Because conventional echocardiographic parameters have several limitations, strain echocardiography has often been introduced in clinical practice. However, there are also obstacles in using it in clinical practice. Therefore, we wanted to find the current status of awareness on using strain echocardiography in Korea.</p><p><strong>Methods: </strong>We conducted a nationwide survey to evaluate current use and awareness of strain echocardiography from the members of the Korean Society of Echocardiography.</p><p><strong>Results: </strong>We gathered total 321 questionnaires from 25 cardiology centers in Korea. All participants were able to perform or interpret echocardiographic examinations. All participating institutions performed strain echocardiography. Most of our study participants (97%) were aware of speckle tracking echocardiography and 185 (58%) performed it for clinical and research purposes. Two-dimensional strain echocardiography was the most commonly used modality and left ventricle (LV) was the most commonly used cardiac chamber (99%) for clinical purposes. Most of the participants (89%) did not think LV strain can replace LV ejection fraction (LVEF) in their clinical practice. The common reasons for not performing routine use of strain echocardiography was diversity of strain measurements and lack of normal reference value. Many participants had a favorable view of the future of strain echocardiography.</p><p><strong>Conclusion: </strong>Most of our study participants were aware of strain echocardiography, and all institutions performed strain echocardiography for clinical and research purposes. However, they did not think the LV strain values could replace LVEF. The diversity of strain measurements and lack of normal reference values were common reasons for not using strain echocardiography in clinical practice.</p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"25 3","pages":"91-97"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2017.25.3.91","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35514115","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":"Multimodality Imaging of Anomalous Left Coronary Artery from the Pulmonary Artery.","authors":"Byung Gyu Kim,&nbsp;Sung Woo Cho,&nbsp;Dae Hyun Hwang,&nbsp;Jong Chun Nah","doi":"10.4250/jcu.2017.25.3.107","DOIUrl":"https://doi.org/10.4250/jcu.2017.25.3.107","url":null,"abstract":"A 22-year-old man was hospitalized for right femur fracture due to a motorcycle accident. Although he had no known cardiac or family history, he felt intermittent chest tightness during moderate intensity of exercise. His electrocardiography showed patterns of left ventricular strain. The echocardiography showed left ventricular hypertrophy, mild eccentric mitral regurgitation, and regional wall motion abnormality and thinning of left anterior descending (LAD) coronary artery territory with lower normal left ventricular systolic function, in which ejection fraction was 50%. Diastolic flow showing peak velocity of 2.5 cm/sec was observed at interventricular septum, which was suspicious of excessive collateral flow at parasternal short axis view (Fig. 1A). Dilated right coronary artery (RCA) ostium of 10 mm was observed (Fig. 1B) on parasternal long axis view, whereas left main coronary artery was not detected in typical situs. Notably, an abnormal retrograde shunt flow was detected (Fig. 1C, Supplementary movie 1) and a drainage site of abnormal shunt flow was observed at the main pulmonary artery (PA) level of parasternal short axis view (Fig. 1D). Thus, we suspected a congenital anomaly of the coronary arteries. Coronary angiography revealed an enlarged and tortuous RCA with abundant septal collateral flows toward the left coronary artery (LCA). An unusual location of the left main coronary artery opening with an abnormal retrograde shunt flow was observed in the left superior part of aorta, most likely PA (Fig. 2A and B, Supplementary movie 2). However, LCA was not shown in the left coronary cusp (Fig. 2C). To specify the location of the left main coronary artery opening, cardiac multidetector computed tomography (CT) was performed and the pISSN 1975-4612 / eISSN 2005-9655 Copyright © 2017 Korean Society of Echocardiography www.kse-jcu.org https://doi.org/10.4250/jcu.2017.25.3.107","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"25 3","pages":"107-109"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2017.25.3.107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35514118","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":"Hand-held Ultrasound Scanners in Medical Education: A Systematic Review.","authors":"Victor Galusko,&nbsp;Mohammed Yunus Khanji,&nbsp;Owen Bodger,&nbsp;Clive Weston,&nbsp;John Chambers,&nbsp;Adrian Ionescu","doi":"10.4250/jcu.2017.25.3.75","DOIUrl":"https://doi.org/10.4250/jcu.2017.25.3.75","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound imaging devices are becoming popular in clinical and teaching settings, but there is no systematic information on their use in medical education. We conducted a systematic review of hand-held ultrasound (HHU) devices in undergraduate medical education to delineate their role, significance, and limitations.</p><p><strong>Methods: </strong>We searched Cochrane, PubMed, Embase, and Medline using the strategy: [(Hand-held OR Portable OR Pocket OR \"Point of Care Systems\") AND Ultrasound] AND (Education OR Training OR Undergraduate OR \"Medical Students\" OR \"Medical School\"). We retained 12 articles focusing on undergraduate medical education. We summarised the patterns of HHU use, pooled and estimated sensitivity, and specificity of HHU for detection of left ventricular dysfunction.</p><p><strong>Results: </strong>Features reported were heterogeneous: training time (1-25 hours), number of students involved (1-an entire cohort), number of subjects scanned (27-211), and type of learning (self-directed vs. traditional lectures + hands-on sessions). Most studies reported cardiac HHU examinations, but other anatomical areas were examined, e.g. abdomen and thyroid. Pooled sensitivity 0.88 [95% confidence interval (CI) 0.83-0.92] and specificity 0.86 (95% CI 0.81-0.90) were high for the detection of left ventricular systolic dysfunction by students.</p><p><strong>Conclusion: </strong>Data on HHU devices in medical education are scarce and incomplete, but following training students can achieve high diagnostic accuracy, albeit in a limited number of (mainly cardiac) pathologies. There is no consensus on protocols best-suited to the educational needs of medical students, nor data on long-term impact, decay in proficiency or on the financial implications of deploying HHU in this setting.</p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"25 3","pages":"75-83"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2017.25.3.75","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35514113","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":"Progression of Right Ventricular Systolic Dysfunction Detected by Myocardial Deformation Imaging in Asymptomatic Preterm Children.","authors":"Soo Jung Kang,&nbsp;Mira Kim,&nbsp;Seo Jung Hwang,&nbsp;Hyo Jin Kim","doi":"10.4250/jcu.2017.25.3.98","DOIUrl":"https://doi.org/10.4250/jcu.2017.25.3.98","url":null,"abstract":"<p><strong>Background: </strong>To detect progression of right ventricular (RV) systolic dysfunction (RVSD) in asymptomatic preterm children from infancy to 24-month corrected age, using velocity vector imaging (VVI).</p><p><strong>Methods: </strong>Retrospective study comparing sequential RV longitudinal peak systolic strain (LPSS) from 24 children born at < 33 weeks of gestational age and 10 term infants recruited as controls, obtained at a mean of 4-month (first exam) and 24-month corrected age (second exam).</p><p><strong>Results: </strong>In 7/24 (29.2%) of preterm children, RV LPSS of < 16%, defined as RVSD, was detected at the second exam; 5/7 of these children had RV LPSS > 16% at the first exam, and only 2/7 of these children had a history of moderate or severe bronchopulmonary dysplasia.</p><p><strong>Conclusion: </strong>In asymptomatic preterm children, routine echocardiographic screening using VVI could detect RVSD which could progress from 4-24 month corrected age.</p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"25 3","pages":"98-104"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2017.25.3.98","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35514116","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":"<i>Streptococcus sanguinis</i> Endocarditis Involving All Valves in a Patient with Ventricular Septal Defect.","authors":"Christos Zivlas,&nbsp;Steve Ramcharitar,&nbsp;Badrinathan Chandrasekaran","doi":"10.4250/jcu.2017.25.3.105","DOIUrl":"https://doi.org/10.4250/jcu.2017.25.3.105","url":null,"abstract":"","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"25 3","pages":"105-106"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2017.25.3.105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35514117","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, Electrocardiographic Changes and Clinical Outcomes of Patients Who Respond to Cardiac Resynchronization Therapy after One Year.","authors":"Young Choi,&nbsp;Jaeho Byeon,&nbsp;Mi-Hyang Jung,&nbsp;Hae Ok Jung,&nbsp;Ho-Joong Youn","doi":"10.4250/jcu.2017.25.2.63","DOIUrl":"https://doi.org/10.4250/jcu.2017.25.2.63","url":null,"abstract":"<p><strong>Background: </strong>Response to cardiac resynchronization therapy (CRT) is commonly assessed after 6 or 12 months. We evaluated subsequent echocardiographic changes, serial QRS duration, and clinical outcomes in patients showing delayed responses to CRT after 12 months.</p><p><strong>Methods: </strong>Among all patients who received CRT in Seoul St. Mary's Hospital, 36 one-year survivors were enrolled. Indicators of a positive CRT response were ≥ 15% reduction in left ventricular end-systolic volume (LVESV) or ≥ 10% increase in left ventricular ejection fraction (LVEF) on any follow up echocardiogram. We defined the early responders as patients responding before one year, the late responders as patients responding after one year, and the non-responders as patients who did not respond on any follow-up echocardiogram.</p><p><strong>Results: </strong>We identified 17 early responders, 10 late responders, and 9 non-responders. The late responders showed modest improvement in LVESV and LVEF at two years after CRT. QRS duration was shortened the day after CRT in all three groups. Narrowed QRS was maintained for two years in early and late responders, whereas it was continuously prolonged over time in non-responders. Incidence of all-cause death or heart failure hospitalization was comparable between early and late responders, while non-responders showed worst prognosis.</p><p><strong>Conclusion: </strong>Patients responding to CRT after one year show modest echocardiographic improvement but clinical outcome is similar to early responders. Shorter baseline QRS duration and long-term maintenance of QRS duration shortening are important features of the late responders to CRT.</p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"25 2","pages":"63-69"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2017.25.2.63","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35238893","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":"Bifid Cardiac Apex in an Old Woman.","authors":"Constantina Masoura,&nbsp;Constantina Aggeli,&nbsp;Konstantinos Aznaouridis,&nbsp;Ioannis Felekos,&nbsp;Dimitris Tousoulis","doi":"10.4250/jcu.2017.25.2.70","DOIUrl":"https://doi.org/10.4250/jcu.2017.25.2.70","url":null,"abstract":"During the embryonic development of the heart, the two ventricles develop as independent structures on the two sides of the primitive plate. Normally, the two ventricles merge together at the apex and their cavities are separated by a bridge formed by muscle fibers (interventricular septum). An apical cardiac notch indicates the developing interventricular septum, and normally disappears later during organogenesis. Bifid cardiac apex arises when this process is abnormal, resulting in a defective union of the two ventricles at the apex and persistence of the cardiac notch. Bifid cardiac apex is a common finding in sea mammals like whales and manatees, however this abnormality is very rare in humans. Only few cases have been reported in the literature, most of which were accompanied by additional congenital cardiac abnormalities. We are presenting the images of a 73-year-old woman with bifid cardiac apex who was admitted in our Department with palpitations, dizziness and diaphoresis. Her past medical history included a transient ischemic attack 5 years ago. Cardiac examination revealed regular rate and rhythm with normal heart sounds, without any murmurs. The systemic physical examination was unremarkable. Chest X-ray was clear with a normal cardiac shillouette. ECG revealed minimal ST-T depression on precordial leads. Ambulatory ECG showed an episode of slow ventricular tachycardia at 105 bpm with a duration of 20 seconds and four shorter ventricular runs. Transthoracic 2D and contrast echocardiography (Fig. 1, Supplementary movie 1, 2, and 3) demonstrated a cleft-like small chamber between the left and right ventricles (bifid left ventricle) with normal systolic function, similar thickness to normal myocardium, and normal perfusion. The right ventricle seemed hypoplastic with adequate systolic function. The atria were of normal size. No additional heart abnormality was detected with echocardiography. Considering the above findings, the lack of a history of coronary artery disease or myocardial infarction, and the abpISSN 1975-4612 / eISSN 2005-9655 Copyright © 2017 Korean Society of Echocardiography www.kse-jcu.org https://doi.org/10.4250/jcu.2017.25.2.70","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"25 2","pages":"70-71"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2017.25.2.70","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35238894","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":"Systematic Left Ventricular Assist Device Implant Eligibility with Non-Invasive Assessment: The SIENA Protocol.","authors":"Matteo Cameli,&nbsp;Ferdinando Loiacono,&nbsp;Stefania Sparla,&nbsp;Marco Solari,&nbsp;Elisabetta Iardino,&nbsp;Giulia Elena Mandoli,&nbsp;Sonia Bernazzali,&nbsp;Massimo Maccherini,&nbsp;Sergio Mondillo","doi":"10.4250/jcu.2017.25.2.39","DOIUrl":"https://doi.org/10.4250/jcu.2017.25.2.39","url":null,"abstract":"<p><p>In patients with end-stage left ventricular (LV) heart failure who receive LV assist device (LVAD) implantation, right ventricular (RV) failure represents a possible critical complication that heavily affects morbidity and mortality. Several clinical, laboratory, hemodynamic, and echocardiographic variables have been found to be associated with RV failure occurrence after surgery. Different models and risk scores have been proposed, with poor results. No accordance has ever been reached about RV pre-operative evaluation, and time has come to introduce a standardized systematic protocol for LVAD suitability assessment according to RV function. We analyzed imaging parameters associated with LVAD implantation-related RV failure, in order to identify the minimum number for pre-operative reliable prediction of post-operative RV failure. A few echocardiographic parameters have been identified as the most reliable, or promising, and reproducible tools in this field: free-wall RV longitudinal strain, RV fractional area change, RV sphericity index, and RV ejection fraction with 3D-echocardiography. We propose the Systematic LVAD Implant Eligibility with Non-invasive Assessment protocol-the SIENA protocol-as a new and simple way of pre-operative evaluation of patients candidates to LVAD implantation.</p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"25 2","pages":"39-46"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2017.25.2.39","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35238890","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}