Young Earl Choi, H. Cho, E. Song, I. Jeong, N. Yoon, Y. Choi, J. Ma, Y. Cho
{"title":"Clinical Utility of Echocardiography for the Diagnosis and Prognosis in Children with Bronchopulmonary Dsyplasia","authors":"Young Earl Choi, H. Cho, E. Song, I. Jeong, N. Yoon, Y. Choi, J. Ma, Y. Cho","doi":"10.4250/jcu.2016.24.4.278","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.4.278","url":null,"abstract":"Background Bronchopulmonary dysplasia (BPD) may result in chronic pulmonary artery hypertension and right ventricular (RV) dysfunction. Various echocardiographic assessments of RV dysfunction have been used to determine whether echocardiographic measurements of premature infants with BPD could provide sensitive measures of RV function that correlates with BPD severity. Methods Twenty-eight control subjects without BPD (non BPD group), 28 patients with mild BPD, 11 patients with moderate BPD, and six patients with severe BPD underwent echocardiograms with standard measurement such as ejection fraction by M-mode, tricuspid regurgitation pressure gradient, myocardial performance index (MPI) derived from pulse Doppler, and tissue Doppler imaging (TDI) measurements. BPD severity was classified by the NICHD/NHLBI/ORD workshop rating scale. Twenty-eight control subjects without BPD (non BPD group), 28 patients with mild BPD, 11 patients with moderate BPD, and six patients with severe BPD underwent echocardiograms with standard measurement such as ejection fraction by M-mode, tricuspid regurgitation pressure gradient, myocardial performance index (MPI) derived from pulse Doppler, and TDI measurements. BPD severity was classified by the NICHD/NHLBI/ORD workshop rating scale. Results None of the standard echocardiographic findings was significantly different between the control group and BPD groups. However, mean septal TDI-MPI of the severe BPD group (0.68 ± 0.06) was significantly (p < 0.01) higher than that of the non-BPD (0.58 ± 0.10) or the mild BPD group (0.59 ± 0.12). In addition, mean RV TDI-MPI of the severe BPD group (0.71 ± 0.13) was significantly (p < 0.05) higher than that of the non-BPD group (0.56 ± 0.08) or the mild BPD group (0.60 ± 0.125). Linear regression showed a good correlation between the severity of BPD and RV TDI-MPI (p = 0.01, R = 0.30) or septal TDI-MPI (p = 0.04, R = 0.24). Conclusion Echocardiographic evaluation of RV function based on an assessment of RV TDI-MPI can provide RV dysfunction parameter in premature infants with BPD.","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"198 1","pages":"278 - 284"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80020731","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":"Multimodality Imaging for Left Ventricular Hypertrophy Severity Grading: A Methodological Review","authors":"Maaike Alkema, E. Spitzer, O. Soliman, C. Loewe","doi":"10.4250/jcu.2016.24.4.257","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.4.257","url":null,"abstract":"Left ventricular hypertrophy (LVH), defined by an increase in left ventricular mass (LVM), is a common cardiac finding generally caused by an increase in pressure or volume load. Assessing severity of LVH is of great clinical value in terms of prognosis and treatment choices, as LVH severity grades correlate with the risk for presenting cardiovascular events. The three main cardiac parameters for the assessment of LVH are wall thickness, LVM, and LV geometry. Echocardiography, with large availability and low cost, is the technique of choice for their assessment. Consequently, reference values for LVH severity in clinical guidelines are based on this technique. However, cardiac magnetic resonance (CMR) and computed tomography (CT) are increasingly used in clinical practice, providing excellent image quality. Nevertheless, there is no extensive data to support reference values based on these techniques, while comparative studies between the three techniques show different results in wall thickness and LVM measurements. In this paper, we provide an overview of the different methodologies used to assess LVH severity with echocardiography, CMR and CT. We argue that establishing reference values per imaging modality, and possibly indexed to body surface area and classified per gender, ethnicity and age-group, might be essential for the correct classification of LVH severity.","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"46 1","pages":"257 - 267"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85671836","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}
Hee-jin Kwon, Jae‐Hyeong Park, S. Kim, B. Sun, Sun Jin, Jun-Hyung Kim, Jae‐Hwan Lee, Si-Wan Choi, J. Jeong, I. Seong
{"title":"Severe Aortic Stenosis Associated with Unicommissural Unicuspid Aortic Valve in a Middle Aged Male","authors":"Hee-jin Kwon, Jae‐Hyeong Park, S. Kim, B. Sun, Sun Jin, Jun-Hyung Kim, Jae‐Hwan Lee, Si-Wan Choi, J. Jeong, I. Seong","doi":"10.4250/jcu.2016.24.3.247","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.3.247","url":null,"abstract":"Unicuspid aortic valve (UAV) is an extremely rare form of congenital aortic valvular abnormality. Although UAV shows similar clinical characteristics to bicuspid aortic valve, the clinical symptoms develop at earlier age and progress at a faster pace in UAV. In this report, we are presenting a 42-year-old male with severe aortic stenosis associated with unicommissural UAV. The patients underwent a successful Bentall operation.","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"35 1","pages":"247 - 250"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89785721","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":"Comprehensive Echocardiographic Assessment of the Right Ventricle in Murine Models","authors":"A. Kohut, Nishi H. Patel, Harpreet Singh","doi":"10.4250/jcu.2016.24.3.229","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.3.229","url":null,"abstract":"Background Non-invasive high-resolution echocardiography to evaluate cardiovascular function of small animals is increasingly being used due to availability of genetically engineered murine models. Even though guidelines and standard values for humans were revised by the American Society of Echocardiography, evaluations on murine models are not performed according to any standard protocols. These limitations are preventing translation of preclinical evaluations to clinical meaningful conclusions. We have assessed the right heart of two commonly used murine models according to standard clinical guidelines, and provided the practical guide and sample values for cardiac assessments. Methods Right heart echocardiography evaluations of CD1 and C57BL/6 mice were performed under 1–3% isoflurane anesthesia using Vevo® 2100 Imaging System with a high-frequency (18–38 MHz) probe (VisualSonics MS400). We have provided a practical guide on how to image and assess the right heart of a mouse which is frequently used to evaluate development of right heart failure due to pulmonary hypertension. Results Our results show significant differences between CD1 and C57BL/6 mice. Right ventricle structural assessment showed significantly larger (p < 0.05) size, and pulmonary artery diameter in CD1 mice (n = 11) compared to C57BL/6 mice (n = 15). Right heart systolic and diastolic functions were similar for both strains. Conclusion Our practical guide on how to image and assess the right heart of murine models provides the first comprehensive values which can be used for preclinical research studies using echocardiography. Additionally, our results indicate that there is a high variability between mouse species and experimental models should be carefully selected for cardiac evaluations.","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"5 1","pages":"229 - 238"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80782406","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":"Assessing Right Ventricular Function: The Role of Echocardiography in a Murine Model of Pulmonary Hypertension","authors":"Kyung-Hee Kim","doi":"10.4250/JCU.2016.24.3.199","DOIUrl":"https://doi.org/10.4250/JCU.2016.24.3.199","url":null,"abstract":"A wide variety of small animal heart failure models are available. 1-3) The role of these models for understanding the disease and developing new treatment cannot be overemphasized. Many investigators have scaled down from large animal models to small models because they are easier to manipulate, cheaper to maintain, and similar to the human cardiovascular system. Moreover, recent advances in echocardiography and micronanometer conductance catheters have made it possible to reliable evaluate cardiac function in small animal models. Complete hemodynamic assessment of the animals used is essential , including assessment of both static and dynamic parameters as well as structural remodeling in determining the magnitude of these parameters. However, many of these advances involving the assessment of left heart only. In humans, echocardiographic assessment of right ventricular (RV) size and pulmonary hypertension is particularly challenging due to the retrosternal position and unusual crescent shape of RV. Small animal models have the added challenges of small size and extremely rapid heart rates (250–600 beat/min). In this issue of the Journal, Kohut et al., 6) in their research using high-frequency transducer probe (VisualSonics MS400, with a frequency range of 18–38 MHz), they have assessed the right heart of CD1 and C57BL/6 which are two commonly used murine models according to standard clinical guidelines and provided the practical guide and standard valued for cardiac assessments. A strongpoint of this study is accurate and in detail measurement of right heart dimension in different view, right heart systolic function with RV index of myocardial performance , tricuspid annular plane systolic excursion, S' and fractional area change, right heart diastolic function using pulse wave Doppler of the trans-tricuspid flow including the peak early filing, the late diastolic filling, the ratio of E/A wave velocities and deceleration time and finally pulmonary artery he-modynamics with pulmonary artery acceleration time, pulmonary ejection time. They describe a protocol for assessing RV and pulmonary vascular function in a specific mouse model of pulmonary hypertension; however this protocol is applicable to any diseases affecting the pulmonary vasculature or right heart. They provide a detailed description of animal preparation , image acquisition and hemodynamic calculation. Several new techniques, including cardiac MRI and small conduc-tance catheter (pressure-volume analysis) are available for assessing RV function. MRI is highly accurate for the assessment of RV function. 7) However, despite the excellent image quality and reproducibility, availability is still limited and the data acquisition and analysis is …","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"1 1","pages":"199 - 200"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82339703","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}
J. Jang, J. Seo, B. Sun, Dae‐Hee Kim, Jong-Min Song, D. Kang, Jae-Kwan Song
{"title":"Impact of Valvuloarterial Impedance on Concentric Remodeling in Aortic Stenosis and Its Regression after Valve Replacement","authors":"J. Jang, J. Seo, B. Sun, Dae‐Hee Kim, Jong-Min Song, D. Kang, Jae-Kwan Song","doi":"10.4250/jcu.2016.24.3.201","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.3.201","url":null,"abstract":"Background Left ventricle (LV) in patients with aortic stenosis (AS) faces a double hemodynamic load incorporating both valvular stenosis and reduced systemic arterial compliance (SAC). This study aimed to evaluate the impact of global LV afterload on LV hypertrophy (LVH) before and after aortic valve replacement (AVR). Methods The study cohort included 453 patients (247 males; mean age, 64 ± 11 years) who underwent AVR. Pre- and post-AVR echocardiographic examinations were retrospectively analyzed including an index of valvuloarterial impedance (ZVA) and LV mass index/LV end-diastolic volume index (LVMI/LVEDVI) as a parameter of LVH. Results Pre-AVR LVMI/LVEDVI was 2.7 ± 0.9 g/mL with an aortic valve area (AVA) of 0.6 ± 0.2 cm2. ZVA was 5.9 ± 1.9 mm Hg/mL/m2 and showed a stronger correlation (β = 0.601, p < 0.001) with pre-AVR LVMI/LVEDVI than indexed AVA (β = 0.061, p = 0.19), transvalvular peak velocity (β = 0.211, p < 0.001). During a median follow-up of 3.5 years, patients had a 18.8 ± 10.4% decrease in the LV geometry index with a decrease in SAC from 1.20 ± 0.48 to 1.00 ± 0.38 mL/m2/mm Hg (p < 0.001). Pre-AVR LV ejection fraction (r = 0.284, p < 0.001) and ZVA (r = 0.523, p < 0.001) were independent factors associated with LVH regression in 322 patients with follow-up duration >1 year after AVR. Conclusion ZVA is a major determinant of concentric remodeling in AS before AVR and LVH regression after AVR, which should be incorporated in routine evaluation of AS.","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"57 1","pages":"201 - 207"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81445318","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}
Ibrahim Khaddash, A. Hawatmeh, Cynthia Dayrit-Demetillo, A. Hamdan
{"title":"Migrated Subclavian Venous Stent into the Right Atrium","authors":"Ibrahim Khaddash, A. Hawatmeh, Cynthia Dayrit-Demetillo, A. Hamdan","doi":"10.4250/JCU.2016.24.3.251","DOIUrl":"https://doi.org/10.4250/JCU.2016.24.3.251","url":null,"abstract":"Central venous stenosis or occlusion occurs in 11–50% of hemodialysis patients with prior subclavian vein cannulation and ipsilateral fistula or shunt.1) Treatment for central venous stenosis includes percutaneous balloon angioplasty or stent implantation. Migration of intravenous stents is rare but it can be life-threatening. Migration of stents to the innominate vein, right atrium, right ventricle, and pulmonary artery have been previously reported.2),3),4)","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"15 1","pages":"251 - 252"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84700559","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}