{"title":"Ultrasound enhancing agents in cardiovascular imaging: expanding horizons beyond coronary arteries.","authors":"Arif Albulushi, Feng Xie, Thomas R Porter","doi":"10.1186/s12947-024-00330-2","DOIUrl":"10.1186/s12947-024-00330-2","url":null,"abstract":"<p><p>From its inception as a two-dimensional snapshot of the beating heart, echocardiography has become an indelible part of cardiovascular diagnostics. The integration of ultrasound enhancing agents (UEAs) marks a pivotal transition, enhancing its diagnostic acumen beyond myocardial perfusion. These agents have refined echocardiography's capacity to visualize complex cardiac anatomy and pathology with unprecedented clarity, especially in non-coronary artery disease contexts. UEAs aid in detailed assessments of myocardial viability, endocardial border delineation in left ventricular opacification, and identification of intracardiac masses. Recent innovations in UEAs, accompanied by advancements in echocardiographic technology, offer clinicians a more nuanced view of cardiac function and blood flow dynamics. This review explores recent developments in these applications and future contemplated studies.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"22 1","pages":"10"},"PeriodicalIF":1.9,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11312391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guihong Chen, Pin Wang, Yanhong Zhang, Na Li, Liman Fu, Yu Chen, Xuna Geng, Yongfeng Han, Lu Qin, Bulang Gao, Tianxiao Yu, Jie Mi
{"title":"Ultrasound parameters of arteries and heart in normal fetuses.","authors":"Guihong Chen, Pin Wang, Yanhong Zhang, Na Li, Liman Fu, Yu Chen, Xuna Geng, Yongfeng Han, Lu Qin, Bulang Gao, Tianxiao Yu, Jie Mi","doi":"10.1186/s12947-024-00328-w","DOIUrl":"10.1186/s12947-024-00328-w","url":null,"abstract":"<p><strong>Background: </strong>Currently, no normal ultrasound data of the fetuses during the 20-40 gestation have been obtained for references of fetal growth and development. If such ultrasound data existed for prenatal diagnosis of possible diseases and abnormalities, neonates would be able to get timely treatment immediately after birth. This study was thus performed to obtain ultrasound parameters of normal fetuses during the 20-40 week gestation and the distribution of ultrasound parameters with the gestational age for references of detecting potential fetal diseases and abnormalities.</p><p><strong>Methods: </strong>Normal fetuses without any abnormalities were enrolled, and the ultrasound parameters of the general biology, arteries, and aorta were measured and analyzed.</p><p><strong>Results: </strong>417 normal fetuses were enrolled. A significant (P < 0.05) negative correlation with the gestational age was detected in the peak systolic velocity/peak diastolic velocity (S/D), pulsatility index (PI) and resistance index (RI) of the umbilical artery (UA). A relatively stable relationship with the gestational age was detected in the fetal weight%, S/D, PI and RI of the middle cerebral artery (MCA), peak systolic velocity (PSV) and velocity time integral (VTI) of the intra-abdominal UA, fetal heart to chest ratio, mitral valve (MV)- and tricuspid valve (TV)-E/A peak flow velocity, aortic isthmic Z-score and displacement, distance between the brachiocephalic artery-left common carotid artery (BA-LCCA) and LCCA-left subclavian artery (LSA), Z-score of aorta, ascending aorta (AAO), pulmonary artery (PA), main pulmonary artery (MPA), and descending aorta (DAO). A significant (P < 0.05) positive correlation with the gestational age was detected in the fetal biological data, MCA PSV and VTI, free-UA PSV and VTI and cardio-thoracic ratio, cardiac parameters, ductus arteriosus (DA) and isthmus diameter, aortic parameters, PA and MPA diameter, MPA PSV and VTI, isthmus flow volume and velocity and PA flow volume, DA and BA parameters, and LCCA and LSA parameters (flow volume, PSV, and VTI).</p><p><strong>Conclusion: </strong>A certain correlation and distribution trend is detected in the ultrasound parameters of normal fetuses, and the ratios among different parameters remain relative stable. These findings can be used for determination of abnormal growth of the fetuses in prenatal ultrasound scan.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"22 1","pages":"9"},"PeriodicalIF":1.9,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
John W Petersen, Natalie Bracewell, Kevin M Schneider, Joshua Latner, Shuang Yang, Yi Guo
{"title":"Correction: Longitudinal strain correlates with 6-minute walk distance whereas ejection fraction and diastolic parameters do not.","authors":"John W Petersen, Natalie Bracewell, Kevin M Schneider, Joshua Latner, Shuang Yang, Yi Guo","doi":"10.1186/s12947-024-00327-x","DOIUrl":"10.1186/s12947-024-00327-x","url":null,"abstract":"","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"22 1","pages":"8"},"PeriodicalIF":1.9,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
César Del Castillo, Fernando Verdugo, Franco Appiani, Francisca Yáñez, Camila Bontá, Carlos Torres-Herrera, Angela Garcia, Zorba Blázquez-Bermejo, Javier Castrodeza, Daniel Requena, Andreina Rodríguez, Arquimedes Silvio, Agustín Gatica, Arnulfo Begazo, Mario Alfaro
{"title":"Echocardiogram by apical-subcostal protocol in prone position during invasive mechanical ventilation in cardiovascular intensive care unit.","authors":"César Del Castillo, Fernando Verdugo, Franco Appiani, Francisca Yáñez, Camila Bontá, Carlos Torres-Herrera, Angela Garcia, Zorba Blázquez-Bermejo, Javier Castrodeza, Daniel Requena, Andreina Rodríguez, Arquimedes Silvio, Agustín Gatica, Arnulfo Begazo, Mario Alfaro","doi":"10.1186/s12947-024-00326-y","DOIUrl":"10.1186/s12947-024-00326-y","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the feasibility of a transthoracic echocardiogram using an apical-subcostal protocol in invasive mechanical ventilation (IMV) and prone position.</p><p><strong>Methods: </strong>Prospective study of adults who required a prone position during IMV. A pillow was placed only under the left hemithorax in the prone position to elevate and ease the apical and subcostal windows. A critical care cardiologist (prone group) acquired and evaluated the images using the apical-subcostal protocol. Besides, we used ambulatory echocardiograms performed as a comparative group (supine group).</p><p><strong>Results: </strong>86 patients were included, 43 in the prone and 43 in the supine. In the prone group, the indication to perform an echocardiogram was hemodynamic monitoring. All patients were ventilated with protective parameters, and the mean end-expiratory pressure was 10.6 cmH2O. The protocol was performed entirely in 42 of 43 patients in the prone group because one patient did not have any acoustic window. In the 43 patients in the prone group analyzed and compared to the supine group, global biventricular function was assessed in 97.7% (p = 1.0), severe heart valve disease in 88.4% (p = 0.055), ruled out of the presence of pulmonary hypertension in 76.7% (p = 0.80), pericardial effusion in 93% (p = 0.12), and volume status by inferior vena cava in 93% (p = 0.48). Comparing prone versus supine position, a statistical difference was found when evaluating the left ventricle apical 2-chamber view (65.1 versus 100%, p < 0.01) and its segmental function (53.4 versus 100%, p < 0.01).</p><p><strong>Conclusion: </strong>The echocardiogram using an apical-subcostal protocol is feasible in patients in the IMV and prone position.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"22 1","pages":"7"},"PeriodicalIF":1.9,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11163713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
John W Petersen, Natalie Bracewell, Kevin M Schneider, Joshua Latner, Shuang Yang, Yi Guo
{"title":"Longitudinal strain correlates with 6-minute walk distance whereas ejection fraction and diastolic parameters do not.","authors":"John W Petersen, Natalie Bracewell, Kevin M Schneider, Joshua Latner, Shuang Yang, Yi Guo","doi":"10.1186/s12947-024-00325-z","DOIUrl":"10.1186/s12947-024-00325-z","url":null,"abstract":"<p><strong>Background: </strong>Impaired functional capacity is a common symptom in patients with heart failure. Standard measures of left ventricular (LV) function, such as ejection fraction (EF) and LV diastolic parameters, do not correlate with measures of functional capacity. The aim of this study is to determine if measures of global and regional LV strain better correlate with 6-minute walk distance than does EF or measures of LV diastolic function.</p><p><strong>Methods: </strong>120 patients referred to a cardiology clinic for evaluation of known or suspected heart failure were approached for enrollment. Of those 120 patients, 58 had an echocardiogram within 3 months of enrollment with images adequate for regional and global strain assessment, had no contra-indication to exercise testing, and had no previously documented non-cardiac explanation for dyspnea on exertion. In those 58 patients, 6-minute walk distance was measured, LV EF was determined with Simpson's biplane method, and global and regional longitudinal strain were measured with TomTec Image Arena 4.5.1 software.</p><p><strong>Results: </strong>LV EF had no correlation with 6-minute walk distance (r = 0.22, p = 0.09) even when controlling for age, gender, and BMI (p = 0.07). No measures of LV diastolic function (including E velocity, Deceleration Time, e' annular velocities, or E/e') had a correlation with 6-minute walk distance. Multiple measures of global and regional LV longitudinal systolic function had a correlation with 6-minute walk distance. Longitudinal strain of the basal LV segments had the strongest correlation with 6-minute walk distance (r= -0.36, p = 0.005), and correlation persisted after controlling for age, gender, BMI, and systolic blood pressure (p = 0.004).</p><p><strong>Conclusions: </strong>Longitudinal strain correlates with a measure of functional capacity, but LVEF and traditional measures of LV diastolic dysfunction do not. Measures of longitudinal strain, especially in basal LV segments, will likely be an important marker of clinically relevant LV function.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"22 1","pages":"6"},"PeriodicalIF":1.9,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11157811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141287830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julien La Mela, Laurent Riou, Gilles Barone-Rochette
{"title":"Coronary microvascular dysfunction and atrial reservoir function.","authors":"Julien La Mela, Laurent Riou, Gilles Barone-Rochette","doi":"10.1186/s12947-024-00324-0","DOIUrl":"10.1186/s12947-024-00324-0","url":null,"abstract":"<p><strong>Background: </strong>Coronary microvascular dysfunction (CMD) refers to structural and functional abnormalities of the coronary microcirculation, which may be diagnosed using invasive coronary physiology. CMD is responsible for impaired diastolic cardiac function. It has recently been suggested that left atrial strain (LASr) represents a highly sensitive tool for detecting cardiac diastolic function abnormalities. Accordingly, the aim of this study was to investigate the relationship between CMD and LASr.</p><p><strong>Methods: </strong>Consecutively enrolled patients with non-obstructed coronary arteries (NOCA) underwent CMD and LASr evaluation by invasive thermodilution and noninvasive echocardiography, respectively.</p><p><strong>Results: </strong>Forty-two (42) patients were included, out of which 26 presented with CMD. There were no significant differences between CMD-positive and negative patients in terms of clinical and echocardiographic characteristics. LASr was significantly reduced in patients with CMD (24.6% ± 6.1 vs. 30.3 ± 7.8%, p = 0.01). A moderate correlation was observed between coronary flow reserve and LAsr (r = 0.47, p = 0.002). A multivariate logistic regression analysis demonstrated that CMD was independently associated with LASr (OR = 0.88, 95%CI 0.78-0.99.135, p = 0.04). A LASr cut-off of 25.5% enabled an optimal classification of patients with or without CMD.</p><p><strong>Conclusion: </strong>Patients with NOCA and CMD had a significantly reduced LASr compared with patients without CMD, suggesting the early impairment of diastolic function in these patients.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"22 1","pages":"5"},"PeriodicalIF":1.9,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11092318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Left ventricular and atrial myocardial strain in heart failure with preserved ejection fraction: the evidence so far and prospects for phenotyping strategy.","authors":"Mariane Higa Shinzato, Natasha Santos, Gustavo Nishida, Henrique Moriya, Jorge Assef, Fausto Feres, Renato A Hortegal","doi":"10.1186/s12947-024-00323-1","DOIUrl":"10.1186/s12947-024-00323-1","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with preserved ejection fraction (HFpEF) represents a significant proportion of heart failure cases. Accurate diagnosis is challenging due to the heterogeneous nature of the disease and limitations in traditional echocardiographic parameters.</p><p><strong>Main body: </strong>This review appraises the application of Global Longitudinal Strain (GLS) and Left Atrial Strain (LAS) as echocardiographic biomarkers in the diagnosis and phenotyping of HFpEF. Strain imaging, particularly Speckle Tracking Echocardiography, offers a superior assessment of myocardial deformation, providing a more detailed insight into left heart function than traditional metrics. Normal ranges for GLS and LAS are considered, acknowledging the impact of demographic and technical factors on these values. Clinical studies have demonstrated the prognostic value of GLS and LAS in HFpEF, especially in predicting cardiovascular outcomes and distinguishing HFpEF from other causes of dyspnea. Nevertheless, the variability of strain measurements and the potential for false-negative results underline the need for careful clinical interpretation. The HFA-PEFF scoring system's integration of these biomarkers, although systematic, reveals gaps in addressing the full spectrum of HFpEF pathology. The combined use of GLS and LAS has been suggested to define HFpEF phenogroups, which could lead to more personalized treatment plans.</p><p><strong>Conclusion: </strong>GLS and LAS have emerged as pivotal tools in the non-invasive diagnosis and stratification of HFpEF, offering a promise for tailored therapeutic strategies. Despite their potential, a structured approach to incorporating these biomarkers into standard diagnostic workflows is essential. Future clinical guidelines should include clear directives for the combined utilization of GLS and LAS, accentuating their role in the multidimensional assessment of HFpEF.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"22 1","pages":"4"},"PeriodicalIF":1.9,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140020986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michelle Costa Galbas, Hendrik Cornelius Straky, Florian Meissner, Johanna Reuter, Marius Schimmel, Sebastian Grundmann, Martin Czerny, Wolfgang Bothe
{"title":"Cardiac dimensions and hemodynamics in healthy juvenile Landrace swine","authors":"Michelle Costa Galbas, Hendrik Cornelius Straky, Florian Meissner, Johanna Reuter, Marius Schimmel, Sebastian Grundmann, Martin Czerny, Wolfgang Bothe","doi":"10.1186/s12947-023-00321-9","DOIUrl":"https://doi.org/10.1186/s12947-023-00321-9","url":null,"abstract":"Swine are frequently used as animal model for cardiovascular research, especially in terms of representativity of human anatomy and physiology. Reference values for the most common species used in research are important for planning and execution of animal testing. Transesophageal echocardiography is the gold standard for intraoperative imaging, but can be technically challenging in swine. Its predecessor, epicardial echocardiography (EE), is a simple and fast intraoperative imaging technique, which allows comprehensive and goal-directed assessment. However, there are few echocardiographic studies describing echocardiographic parameters in juvenile swine, none of them using EE. Therefore, in this study, we provide a comprehensive dataset on multiple geometric and functional echocardiographic parameters, as well as basic hemodynamic parameters in swine using EE. The data collection was performed during animal testing in ten female swine (German Landrace, 104.4 ± 13.0 kg) before left ventricular assist device implantation. Hemodynamic data was recorded continuously, before and during EE. The herein described echocardiographic measurements were acquired according to a standardized protocol, encompassing apical, left ventricular short axis and long axis as well as epiaortic windows. In total, 50 echocardiographic parameters and 10 hemodynamic parameters were assessed. Epicardial echocardiography was successfully performed in all animals, with a median screening time of 14 min (interquartile range 11–18 min). Referring to left ventricular function, ejection fraction was 51.6 ± 5.9% and 51.2 ± 6.2% using the Teichholz and Simpson methods, respectively. Calculated ventricular mass was 301.1 ± 64.0 g, as the left ventricular end-systolic and end-diastolic diameters were 35.3 ± 2.5 mm and 48.2 ± 3.5 mm, respectively. The mean heart rate was 103 ± 28 bpm, mean arterial pressure was 101 ± 20 mmHg and mean flow at the common carotid artery was 627 ± 203 mL/min. Epicardial echocardiography allows comprehensive assessment of most common echocardiographic parameters. Compared to humans, there are important differences in swine with respect to ventricular mass, size and wall thickness, especially in the right heart. Most hemodynamic parameters were comparable between swine and humans. This data supports study planning, animal and device selection, reinforcing the three R principles in animal research. ","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"5 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139476684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ali Firincioglulari, Hakan Erturk, Mujgan Firincioglulari, Cigdem Biber
{"title":"Evaluation of atherosclerosis as a risk factor in COPD patients by measuring the carotid intima-media thickness.","authors":"Ali Firincioglulari, Hakan Erturk, Mujgan Firincioglulari, Cigdem Biber","doi":"10.1186/s12947-023-00322-8","DOIUrl":"10.1186/s12947-023-00322-8","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate atherosclerosis as comorbidity by measuring the carotid (bulb and common carotid artery) Carotid intima-media thickness in COPD-diagnosed patients and to evaluate the relationship of atherosclerosis with the prevalence of COPD, hypoxemia and hypercapnia.</p><p><strong>Methods: </strong>This study was conducted out between January 2019-December 2019 consisting of a total of 140 participants (70 COPD-diagnosed patients-70 healthy individuals). The COPD-diagnosed patients have been planned according to the selection and diagnosis criteria as per the GOLD 2019 guide. It is planned to evaluate as per prospective matching case-control study of the carotid thickness, radial gas analysis, spirometric and demographic characteristics of COPD diagnosed patients and healthy individuals.</p><p><strong>Results: </strong>The average Carotid intima-media thickness in COPD patients was 0.8746±0.161 (p<0.05), and the thickness of the carotid bulb was 1.04±0.150 (p<0.05). In the control group, the average CCA intima-media thickness was 0.6650±0.139 (p<0.05), and the thickness of the carotid bulb was 0.8250±0.15(p<0.05) For the carotid thickness that has increased in COPD diagnosed patients a significant relationship is determined between hypoxemia (p<0.05) and hypercapnia(p<0.05). A significant relationship determined between CIMT and severity of COPD (p<0.05) The CIMT was high in COPD patients with hypoxemia and hypercapnia(p<0.05).</p><p><strong>Conclusion: </strong>Significant difference was determined between the severity (grades) of COPD (mild, moderate, severe, very severe) in carotid thickness. Also, CIMT was found to be high in patients who is in the early phases of the prevalence of COPD. In COPD-diagnosed patients, it was determined that severity of COPD, hypoxemia, hypercapnia and age were determining factors of atherosclerosis.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"22 1","pages":"2"},"PeriodicalIF":1.9,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10777512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139401942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Signal-to-noise of linear and volume measures of left ventricular and left atrial size","authors":"Yunbo Duan, Nezar Amir, Guy P. Armstrong","doi":"10.1186/s12947-023-00320-w","DOIUrl":"https://doi.org/10.1186/s12947-023-00320-w","url":null,"abstract":"Serial echocardiographic assessments are common in clinical cardiology, e.g., for timing of intervention in mitral and aortic regurgitation. When following patients with serial echocardiograms, each new measurement is a combination of true change and confounding noise. The current investigation compares linear chamber dimensions with volume estimates of chamber size. The aim is to assess which measure is best for serial echocardiograms, when the ideal parameter will be sensitive to change in chamber size and have minimal spurious variation (noise). We present a method that disentangles true change from noise. Linear regression of chamber size against elapsed time gives a slope, being the ability of the method to detect change. Noise is the scatter of individual points away from the trendline, measured as the standard error of the slope. The higher the signal-to-noise ratio (SNR), the more reliably a parameter will distinguish true change from noise. LV and LA parasternal dimensions and apical biplane volumes were obtained from serial clinical echocardiogram reports. Change over time was assessed as the slope of the linear regression line, and noise was assessed as the standard error of the regression slope. Signal-to-noise ratio is the slope divided by its standard error. The median number of LV studies was 5 (4–11) for LV over a mean duration of 5.9 ± 3.0 years in 561 patients (diastole) and 386 (systole). The median number of LA studies was 5 (4–11) over a mean duration of 5.3 ± 2.0 years in 137 patients. Linear estimates of LV size had better signal-to-noise than volume estimates (p < 0.001 for diastolic and p = 0.035 for systolic). For the left atrium, the difference was not significant (p = 0.214). This may be due to sample size; the effect size was similar to that for LV systolic size. All three parameters had a numerical value of signal-to-noise that favoured linear dimensions over volumes. Linear measures of LV size have better signal-to-noise than volume measures. There was no difference in signal-to-noise between linear and volume measures of LA size, although this may be a Type II error. The use of regression lines may be better than relying on single measurements. Linear dimensions may clarify whether changes in volumes are real or spurious. ","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"24 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139083938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}