Journal of cardiovascular ultrasound最新文献

{"title":"The Value of Elastic Modulus Index as a Novel Surrogate Marker for Cardiovascular Risk Stratification by Dimensional Speckle-Tracking Carotid Ultrasonography","authors":"J. Yoon, I. Cho, H. Chang, J. Sung, Jinyong Lee, H. Ryoo, C. Shim, G. Hong, N. Chung","doi":"10.4250/jcu.2016.24.3.215","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.3.215","url":null,"abstract":"Background Carotid intima media thickness (CIMT) and the presence of carotid plaque have been used for risk stratification of cardiovascular disease (CVD). To date, however, the association between multi-directional functional properties of carotid artery and CVD has not been fully elucidated. We sought to explore the multi-directional mechanics of the carotid artery in relation to cardiovascular risk. Methods Four hundred one patients who underwent carotid ultrasound were enrolled between January 2010 and April 2013. A high risk of CVD was defined as more than 20% of 10-year risk based on the Framingham risk score. Using a speckle-tracking technique, the longitudinal and radial movements were analyzed in the B-mode images. Peak longitudinal and radial displacements, strain and strain rate were also measured. Beta stiffness and elastic modulus index were calculated from the radial measurements. Results Of the overall sample, 13% (52) of patients comprised the high-risk group. In multivariate logistic regression, CIMT and elastic modulus index were independently associated with a high-risk of CVD {odds ratio (OR): 1.810 [95% confidence interval (CI) 1.249–2.622] and OR: 1.767 (95% CI: 1.177–2.652); p = 0.002, 0.006, respectively}. The combination of CIMT and elastic modulus index correlated with a high-risk of CVD more so than CIMT alone. Conclusion The elastic modulus index of the carotid artery might serve as a novel surrogate marker of high-risk CVD. Measurement of the multi-directional mechanics of the carotid artery using the speckle tracking technique has potential for providing further information over conventional B-mode ultrasound for stratification of CVD risk.","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"75 1","pages":"215 - 222"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86290540","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":"Acute Myeloid Leukemia with Intracardiac Thrombus Presenting as Acute Limb Ischemia.","authors":"Rajiv Bharat Kharwar, Kamal Sharma, Sharad Jain","doi":"10.4250/jcu.2016.24.2.174","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.2.174","url":null,"abstract":"A 50-year-old female presented to our emergency department with complaints of acute onset pain in left lower limb for last 5 days. Her previous history was unremarkable. Physical examination revealed a pulse rate of 90 per minute, blood pressure of 120/76 mm Hg and normal jugular venous pulse. The left lower limb was cold and pale. Her left femoral, left popliteal, left dorsalis pedis and left posterior tibial arterial pulsations were absent. All other arterial pulsations were normally present. Cardiac and respiratory examinations were within normal limits. Electrocardiogram was within normal limits with normal sinus rhythm. A diagnosis of acute limb ischemia was made and an emergency computed tomographic angiography of infra renal aorta with both the lower limbs was done. There was a partial filling defect of the aorta just before the bifurcation along with complete thrombotic occlusion of the left common iliac artery with distal reformation by collateral from the arteries of the contralateral limb (Fig. 1). Two dimensional echocardiography showed a large (2.0 × 3.0 cm) mobile thrombus at the apico-septal region of the left ventricle along with normal ejection fraction of 60% (Fig. 2A, Supplementary movie 1). The three dimensional (3D) nature of the thrombus was better appreciated on transthoracic 3D echocardiography (Fig. 2B, Supplementary movie 2). Hematologic studies revealed anemia, with hemoglobin level of 10 g/dL, thrombocytopenia (30 platelets/nL) and leucocytocis (240 white blood cells/nL). Peripheral smear showed 95% blast cells which were peroxidase negative (Fig. 3). Bone marrow aspiration confirmed the diagnosis of acute myeloid leukemia (French American British type M2). Aortic with left ileo-femoral thromboembolectomy was done to salvage the limb. Intra venous heparin therapy was started for left ventricular thrombus. Patient was transferred to the oncology department where induction phase of chemotherapy was started according to acute myeloid leukemia management protocol. \u0000 \u0000 \u0000 \u0000Fig. 1 \u0000 \u0000Computed tomographic angiography of aorta with both lower limb. There is a partially occluding thrombus at the lower aorta just before the bifurcation along with complete thrombotic occlusion of the left common iliac artery from the origin. A: The left ... \u0000 \u0000 \u0000 \u0000 \u0000 \u0000Fig. 2 \u0000 \u0000Transthoracic echocardiography. A: Two dimensional echocardiography in apical four chamber view (A) showing normal sized LV with a 2.0 × 3.0 cm thrombus at the apico-septal region. B: The three dimensional (3D) structure of the thrombus is better ... \u0000 \u0000 \u0000 \u0000 \u0000 \u0000Fig. 3 \u0000 \u0000Peripheral blood smear at 400 × magnification (A) and 1000 × magnification (B) using Wright stain. A: There are plenty of blast in the peripheral smear which can be identified by hyperchromatic nuclei with a raised nucleus/cytoplasm ratio. ... \u0000 \u0000 \u0000 \u0000Patients with acute leukemia are at an increased risk of both thrombosis as well as bleeding. Severe haemorrhagic complications are seen in acute promyelocytic","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 2","pages":"174-6"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.2.174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34622993","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":"Head to Head Comparison of Stress Echocardiography with Exercise Electrocardiography for the Detection of Coronary Artery Stenosis in Women.","authors":"Mi-Na Kim,&nbsp;Su-A Kim,&nbsp;Yong-Hyun Kim,&nbsp;Soon Jun Hong,&nbsp;Seong-Mi Park,&nbsp;Mi Seung Shin,&nbsp;Myung-A Kim,&nbsp;Kyoung-Soon Hong,&nbsp;Gil Ja Shin,&nbsp;Wan-Joo Shim","doi":"10.4250/jcu.2016.24.2.135","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.2.135","url":null,"abstract":"<p><strong>Background: </strong>Exercise-stress electrocardiography (ECG) is initially recommended for the diagnosis of coronary artery disease. But its value has been questioned in women because of suboptimal diagnostic accuracy. Stress echocardiography had been reported to have comparable test accuracy in women. But the data comparing the diagnostic accuracy of exercise-stress ECG and stress echocardiography directly are few. The aim of the study was to compare the diagnostic accuracy of exercise-stress ECG and dobutamine stress echocardiography (DSE) in Korean women.</p><p><strong>Methods: </strong>202 consecutive female patients who presented with chest pain in outpatient clinic, and who underwent treadmill exercise test (TET), DSE and coronary angiography were included for the study. The diagnostic accuracy TET and DSE were calculated by the definition of > 50% or > 75% coronary artery stenosis (CAS).</p><p><strong>Results: </strong>The sensitivity and specificity were higher with DSE (70.4, 94.6%) than TET (53.7, 73.6%) for detection of > 50% CAS. The higher accuracy of DSE was maintained after exclusion of the patients who could not achieve over 85% age predicted heart rate before ischemia induction. DSE also showed greater diagnostic accuracy than TET by > 75% CAS criteria, and in subsets of patient with intermediate pretest probability.</p><p><strong>Conclusion: </strong>In the diagnosis of CAS, DSE showed higher accuracy than TET in female patients who presented with chest pain. As well as the test accuracy, adequate stress was more feasible with DSE than TET. These finding suggests DSE may be used as the first-line diagnostic tool in the detection of CAS in women with chest pain.</p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 2","pages":"135-43"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.2.135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34688828","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 Left Atrial Appendage Phantom Structure.","authors":"Christodoulos E Papadopoulos,&nbsp;Athanasios Fotoglidis,&nbsp;Efstathios Pagourelias,&nbsp;Vassilios Vassilikos","doi":"10.4250/jcu.2016.24.2.172","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.2.172","url":null,"abstract":"A 71-year-old female patient was referred for shock cardioversion following diagnosis of lone atrial fibrillation. \u0000 \u0000Transesopageal echocardiography was performed as routine workup. Interestingly a circular membrane like structure in the left atrial appendage (LAA) was observed (Fig. 1A, Supplementary movie 1). Using 2D X plane imaging echocardiography, where an orthogonal view can be acquired through the midline of a primary image and displayed as a secondary image, an extra thin LAA wall was evidenced showing sigmoid anatomy (Fig. 1B). Local pericardial effusion was questioned implicating that this specific structure accounted for the thin LAA wall. 3D echocardiography evidenced the entrance of LAA, surrounded by the pericardial wall at a distance, due to the presence of pericardial effusion (Fig. 1C and D, Supplementary movies 2 and 3). The patient underwent uneventful direct current shock cardioversion and remains in sinus rhythm at nine months follow up. \u0000 \u0000 \u0000 \u0000Fig. 1 \u0000 \u00002D and 3D echocardiography imaging. A: Circular structure into the LAA. B: 2D X plane imaging of the structure. C and D: 3D echocardiography delineating LAA entrance surrounded by pericardial fluid. AO: aorta, LAA: left atrial appendage, LA: left atrium, ... \u0000 \u0000 \u0000 \u0000Cardiac magnetic resonance imaging confirmed the diagnosis of local pericardial effusion in the LAA area. No structure, thrombi or membrane were documented into the LAA (Supplementary movie 4). \u0000 \u0000Local pericardial effusion in the LAA area is an extremely rare finding.1),2) It is clinically important to be aware of this benign clinical finding that should be differentiated from LAA obstructive or non-obstructive membranes or thrombi, especially in patients with atrial fibrillation undergoing cardioversion or planned for specific transcatheter therapies such as implantation of LAA closure devices.3),4),5)","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 2","pages":"172-3"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.2.172","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34622992","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 Echocardiographic Measurements in a Korean Population Study: Part II. Doppler and Tissue Doppler Imaging.","authors":"Jin-Oh Choi,&nbsp;Mi-Seung Shin,&nbsp;Mi-Jeong Kim,&nbsp;Hae Ok Jung,&nbsp;Jeong Rang Park,&nbsp;Il Suk Sohn,&nbsp;Hyungseop Kim,&nbsp;Seong-Mi Park,&nbsp;Nam Jin Yoo,&nbsp;Jung Hyun Choi,&nbsp;Hyung-Kwan Kim,&nbsp;Goo-Yeong Cho,&nbsp;Mi-Rae Lee,&nbsp;Jin-Sun Park,&nbsp;Chi Young Shim,&nbsp;Dae-Hee Kim,&nbsp;Dae-Hee Shin,&nbsp;Gil Ja Shin,&nbsp;Sung Hee Shin,&nbsp;Kye Hun Kim,&nbsp;Jae-Hyeong Park,&nbsp;Sang Yeub Lee,&nbsp;Woo-Shik Kim,&nbsp;Seung Woo Park","doi":"10.4250/jcu.2016.24.2.144","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.2.144","url":null,"abstract":"<p><strong>Background: </strong>Hemodynamic and functional evaluation with Doppler and tissue Doppler study as a part of comprehensive echocardiography is essential but normal reference values have never been reported from Korean normal population especially according to age and sex.</p><p><strong>Methods: </strong>Using Normal echOcaRdiographic Measurements in a KoreAn popuLation study subjects, we obtained normal reference values for Doppler and tissue Doppler echocardiography including tricuspid annular velocities according to current guidelines and compared values according to gender and age groups.</p><p><strong>Results: </strong>Mitral early diastolic (E) and late diastolic (A) velocity as well as E/A ratio were significantly higher in women compared to those in men. Conversely, mitral peak systolic and late diastolic annular velocity in both septal and lateral mitral annulus were significantly lower in women compared to those in men. However, there were no significant differences in both septal and lateral mitral early diastolic annular (e') velocity between men and women. In both men and women, mitral E velocity and its deceleration time as well as both E/A and E/e' ratio considerably increased with age. There were no significant differences in tricuspid inflow velocities and tricuspid lateral annular velocities between men and women except e' velocity, which was significantly higher in women compared to that in men. However, changes in both tricuspid inflow and lateral annular velocities according to age were similar to those in mitral velocities.</p><p><strong>Conclusion: </strong>Since there were significant differences in Doppler and tissue Doppler echocardiographic variables between men and women and changes according to age were even more considerable in both gender groups, normal Doppler echocardiographic values should be differentially applied based on age and sex.</p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 2","pages":"144-52"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.2.144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34688829","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":"Identification of a Novel De Novo Mutation of the TAZ Gene in a Korean Patient with Barth Syndrome.","authors":"Tae Yeon Yoo,&nbsp;Mock Ryeon Kim,&nbsp;Jae Sung Son,&nbsp;Ran Lee,&nbsp;Sun Hwan Bae,&nbsp;Sochung Chung,&nbsp;Kyo Sun Kim,&nbsp;Moon-Woo Seong,&nbsp;Sung Sup Park","doi":"10.4250/jcu.2016.24.2.153","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.2.153","url":null,"abstract":"<p><p>Barth syndrome (BTHS) is a rare genetic disorder characterized by various types of cardiomyopathy, neutropenia, failure to thrive, skeletal myopathy, and 3-methylglutaconic aciduria. BTHS is caused by loss-of-function mutations in the tafazzin (TAZ) gene located on chromosome Xq28, leading to cardiolipin deficiency. We report a 13-month-old boy with BTHS who had a novel de novo mutation in the TAZ gene. To the best of our knowledge, this is the first reported case of a BTHS patient with a de novo mutation in Korea. This report will contribute towards expanding the knowledge on the mutation spectrum of the TAZ gene in BTHS. </p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 2","pages":"153-7"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.2.153","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34688830","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":"An Optimistic View towards the Real Time 3D Echocardiography in Congenital Heart Disease: A Simple 'Crop Box' Should Give an Infinite Information in the Near Future!","authors":"Jin-Hee Oh","doi":"10.4250/jcu.2016.24.2.106","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.2.106","url":null,"abstract":"REFER TO THE PAGE 123-127 \u0000 \u0000Recent advancement of technology of medical imaging systems has enabled in-depth real time spatiotemporal diagnosis of human heart disease. It is regardless to mention that prognosis of cardiac disease is based critically on prompt 3 dimensional (3D) diagnosis of a structural anomaly, functional analysis and followed by a proper treatment. Although we are in current era of 3D skills in the spotlight, yet real time 3D echocardiography (RT3DE) is not so appealing to very busy pediatric and adult cardiologists. Mental reconstruction of harvested 2 dimensional (2D) echocardiographic images is a still much faster and simpler way to understand complex cardiac structural anomaly than doing a few more steps for subsequent data analysis with a software program of RT3DE. On the other hand, considering superiority of function of volume assessment, RT3DE can be very useful in clinical application as it can provide numeric data more precisely than morphologic visual assessment of each cardiac chambers that enables assessment longitudinally during the clinical course. In congenital heart disease (CHD), volume or pressure overloaded condition frequently results in distortion of septal planes followed by a geometric change in either ventricles that hampers precise ventricular volume assessment using conventional 2D echocardiography.1),2) There are many reports on the reproducibility of RT3DE in clinical application to adults population without a complex heart disease.3) It is known that current RT3DE has relatively a high intraobserver and interobserver variability.4) In pediatric cases with a complex CHD, additional time consuming effort is required for the assessment of detailed anatomical defect during navigation of intriguing small cardiac structures to acquire optimal planes for secondary 3D reconstruction. Novel imaging tools including RT3DE always require its validation steps. Many studies on the left ventricular volume and ejection fraction compared to cardiac magnetic resonance imaging (MRI) data, currently a gold standard method of cardiac volume assessment have been published during the last ten years.5),6) It is known that the results acquired by RT3DE of left ventricular volume assessment has strong correlation with cardiac MRI although ventricular volume by RT3DE has tendency of underestimation.6),7),8) Studying with cardiac MRI in pediatric patients in critical condition with CHD has several limitations as to its long scanning time and practical issues on patient's sedation and infeasibility in patients with pacemaker. If we mention about volumetric assessment of right ventricle considering its 3 dimensionally distorted morphology compared to left ventricle, there should be no doubt on the superiority of RT3DE to 2D echocardiography and related issues are published.9),10) As RT3DE is a noninvasive method, if it can overcome current several issues of its limitation, it might be the most useful tool to examine children w","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 2","pages":"106-7"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.2.106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34688821","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":"Letter Regarding Article, \"Electrocardiogram in a Patient with Takotsubo Syndrome and Cardiogenic Shock\".","authors":"John E Madias","doi":"10.4250/jcu.2016.24.2.179","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.2.179","url":null,"abstract":"I read with interest the paper by Yoo et al.,1) published in the March, 2016 issue of the Journal, about the 41-year-old previously healthy woman, who suffered Takotsubo syndrome (TTS) complicated by cardiogenic shock, necessitating resuscitation and invasive supportive means of extra-corporeal membrane oxygenation, with eventual full recovery of her heart function. The patient's first electrocardiogram (ECG) (Fig. 1A) recorded on her 2nd visit to the hospital, showed low QRS complexes, in keeping with a recent report,2),3) associating transient attenuation of the ECG QRS complexes (attQRS) and TTS. It is difficult to compare this ECG with the one recorded 1month after discharge (Fig. 1B), since the upper panel of the figure has half of the height of the lower panel, but it appears that there was decrease in QRS voltage in all ECG leads of the admission ECG. This transient attQRS has been attributed to myocardial edema (ME),2) as diagnosed by cardiac magnetic resonance imaging (cMRI).4),5) Unfortunately there was no cMRI in this case, early during the clinical course corresponding to the ECG in Fig. 1A, but much later, a month after admission,1) which of course showed no ME. I will be grateful to the authors if they provide us with information about subsequent ECGs during the patient's follow-up, or ECGs recorded before her admission with TTS (unlikely in a previous healthy young woman), regarding the amplitude of the QRS complexes in those ECGs, in comparison with the ECG of Fig. 1A. \u0000 \u0000 \u0000 \u0000Fig. 1 \u0000 \u0000Electrocardiographic findings revealed sinus tachycardia with ST segment elevation in precordial leads at initial admission (A) and normalized ST segment on follow up electrocardiogram at 1 month after discharge (B).","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 2","pages":"179"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.2.179","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34686395","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 Needed Dobutamine Stress Echocardiography for the Detection of Coronary Artery Stenosis in Women?","authors":"Hye Sun Seo","doi":"10.4250/jcu.2016.24.2.110","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.2.110","url":null,"abstract":"REFER TO THE PAGE 135-143 \u0000 \u0000By American Heart Association statistics updated at 2013, more than one in three female adults has some form of cardiovascular disease (CVD). Since 1984, the number of CVD deaths for females has exceeded those for males.1) Twenty-six percent of women age 45 and older who have an initial recognized myocardial infarction (MI) die within a year compared with 19% of men. In addition, 64% of women who died suddenly of coronary heart disease (CHD) had no previous symptoms.1) \u0000 \u0000Compared with men, women have a 10-to-20-year lag in the initial presentation of CHD. Additionally, women do not always present with the \"characteristic\" pattern of chest pain. Other typical symptoms for women during their initial presentation include shortness of breath, diaphoresis, nausea, epigastric pain, and fatigue.2) \u0000 \u0000Therefore, early diagnosis of CHD is very important to women to reduce the incidence of disease and prevent sudden cardiac death. However it is not easy. Electrocardiograms and exercise electrocardiograms are less sensitive to changes in women, making it more difficult for providers to diagnose CHD.3) \u0000 \u0000What was worse, as seen on angiography, plaque in women tends to be distributed diffusely, rather than in clumps, causing women's angiographic studies to be misinterpreted as \"normal\".4) \u0000 \u0000We also should consider the risk factors that affect women specifically. For example, men tend to develop hypertension at younger ages than women; women's low-density lipoprotein cholesterol levels tend to be lower than men's at younger ages but exceed those of men in advanced age; and while triglyceride levels decline in men of middle and older age, they rise in women of comparable ages.5) \u0000 \u0000Therefore, the addition of the measurement of C-reactive protein to screening based on lipid levels may provide an improved method of identifying women at risk for cardiovascular events.6) \u0000 \u0000The wide spread use of echocardiography has contributed to the early recognition of several distinct cardiac diseases in women as well as management of women-specific cardiac diseases.7) Dobutamine stress echocardiography (DSE) is being used for the diagnosis of CHD especially patients with chest pain who cannot exercise adequately. And this test showed sensitivity for detecting coronary artery disease of 78% and a specificity of 93%.8) DSE is especially useful in women with chest pain because as we commented above, electrocardiograms and exercise electrocardiograms are less sensitive to changes in women and this test has been relatively high sensitivity and specificity. \u0000 \u0000In this issue, DSE and execise electrocardiography for the detection of CHD in women with chest discomfort was compared.9) About two hundred consecutive female patients who presented with chest pain in outpatient clinic, and who underwent treadmill exercise test (TET), DSE and coronary angiography were included for the study. The results showed that the sensitivity and specificity were higher w","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 2","pages":"110-1"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.2.110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34688823","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":"Successfully Treated Acute Fulminant Myocarditis Induced by Ulcerative Colitis with Extracorporeal Life Support and Infliximab.","authors":"Han-Kyul Kim,&nbsp;Kun Il Kim,&nbsp;Sung Won Jung,&nbsp;Hee-Sun Mun,&nbsp;Jung Rae Cho,&nbsp;Namho Lee,&nbsp;Min-Kyung Kang","doi":"10.4250/jcu.2016.24.2.163","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.2.163","url":null,"abstract":"<p><p>We report a case of successfully treated acute fulminant myocarditis induced by ulcerative colitis with extracorporeal life support and infliximab. Myocarditis is a rare but crucial complication during an exacerbation of inflammatory bowel disease. In our case, we applied extracorporeal membrane oxygenation (ECMO) for cardiac rest under impression of acute myocarditis associated with ulcerative colitis, and added infliximab for uncontrolled inflammation by corticosteroid. As a result, our patient was completely recovered with successful weaning of ECMO. </p>","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"24 2","pages":"163-7"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4250/jcu.2016.24.2.163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34622989","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}