Cardiovascular Ultrasound最新文献

{"title":"Three-dimensional transesophageal echocardiographic evaluation of pulmonary vein anatomy prior to cryoablation: validation with cardiac CT scan.","authors":"Laszlo Tibor Nagy,&nbsp;Csaba Jenei,&nbsp;Timea Bianka Papp,&nbsp;Reka Urbancsek,&nbsp;Rudolf Kolozsvari,&nbsp;Agnes Racz,&nbsp;Arnold Peter Raduly,&nbsp;Richard Veisz,&nbsp;Zoltan Csanadi","doi":"10.1186/s12947-023-00305-9","DOIUrl":"https://doi.org/10.1186/s12947-023-00305-9","url":null,"abstract":"<p><strong>Background: </strong>Anatomical characteristics of the left atrium and the pulmonary veins (PVs) may be relevant to the success rate of cryoballoon (CB)-ablation for atrial fibrillation (AF). Cardiac computed tomography (CCT) is considered as the gold standard for preablation imaging. Recently, three-dimensional transesophageal echocardiography (3DTOE) has been proposed for preprocedural assessment of cardiac structures relevant to CB-ablation. The accuracy of 3DTOE has not been validated by other imaging modalities.</p><p><strong>Objective: </strong>We prospectively evaluated the feasibility and the accuracy of 3DTOE imaging for the assessment of left atrial and PV structures prior to pulmonary vein isolation (PVI). In addition, CCT was used to validate the measurements obtained with 3DTOE.</p><p><strong>Methods: </strong>PV anatomy of 67 patients (59.7% men, mean age 58.5 ± 10.5 years) was assessed using both 3DTOE and CCT scan prior to PVI with the Arctic Front CB. The following parameters were measured bilaterally: PV ostium area (OA), the major and minor axis diameters of the ostium (a > b) and the width of the carina between the superior and the inferior PVs. In addition, the width of the left lateral ridge (LLR) between the left atrial appendage and the left superior PV. Evaluation of inter-technique agreement was based on linear regression with Pearson correlation coefficient (PCC) and Bland-Altman analysis of biases and limits of agreement.</p><p><strong>Results: </strong>Moderate positive correlation (PCC 0.5-0.7) was demonstrated between the two imaging methods for the right superior PV's OA and both axis diameters, the width of the LLR and left superior PV (LSPV) minor axis diameter (b) with limits of agreement ˂50% and no significant biases. Low positive or negligible correlation (PCC < 0.5) was found for both inferior PV parameters.</p><p><strong>Conclusions: </strong>Detailed assessment of the right superior PV parameters, LLR and LSPV b is feasible with 3DTOE prior to AF ablation. This 3DTOE measurements demonstrated a clinically acceptable inter-technique agreement with those obtained with CCT.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"21 1","pages":"6"},"PeriodicalIF":1.9,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10114354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9422203","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":"Aorto-ventricular tunnel with three orifices: a unique case report diagnosed by transthoracic echocardiography.","authors":"Canying Yang,&nbsp;Juesheng Yang,&nbsp;Xiaoning Huang,&nbsp;Jiwei Wang","doi":"10.1186/s12947-023-00303-x","DOIUrl":"https://doi.org/10.1186/s12947-023-00303-x","url":null,"abstract":"<p><strong>Background: </strong>Aorto-ventricular tunnel (AVT) is an abnormal communication channel between the ascending aorta and the ventricle. It commonly has two orifices, i.e., one aortic opening and one ventricular opening. In this study, we present a unique case of AVT with three orifices: one aortic opening, one LV opening, and one RV opening.</p><p><strong>Case presentation: </strong>A 64-year-old male presented with chest discomfort and dyspnea on exertion lasting the past six months. Physical examination revealed a grade 4/6 continuous biphasic murmur along the left sternal edge and a grade 3/6 systolic murmur at the apex. Transthoracic echocardiography (TTE) demonstrated: (1) an AVT with three orifices, i.e., one aortic opening, one LV opening, and one RV opening. The LV and RV openings were located in the left and right ventricular outflow tracts, respectively. (2) The aortic valve (AV) was calcified with a small aneurysm at the non-coronary cusp. (3)The mitral valve (MV) chordal rupture of the P2 and P3 segments was observed in the posterior leaflet with severe eccentric regurgitation. Subsequent coronary computed tomography angiography (CTA) further confirmed the diagnosis of AVT with three openings, and clarified the coronary arteries normally arose from the aortic sinuses. The patient was then referred for surgical treatment, consisting of closure of three AVT orifices, AV replacement, and MV replacement. Six months following surgery, the patient was asymptomatic. TTE demonstrated normal mechanic AV and MV function, and there was no residual shunt among the ascending aorta, LV and RV.</p><p><strong>Conclusions: </strong>It is the first case to report an AVT with three orifices. This paper described the entire process from diagnosis to treatment of this unique case, thus providing some novel insights into AVT.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"21 1","pages":"5"},"PeriodicalIF":1.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10067305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9239922","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 atrial reservoir strain measurements derived from intracardiac echocardiography in patients with atrial fibrillation: comparison with transthoracic echocardiography.","authors":"Jingru Lin,&nbsp;Yuqi Cai,&nbsp;Xu Meng,&nbsp;Shangyu Liu,&nbsp;Fengyang Wang,&nbsp;Limin Liu,&nbsp;Zhenhui Zhu,&nbsp;Mengyi Liu,&nbsp;Ligang Ding,&nbsp;Weichun Wu,&nbsp;Hao Wang,&nbsp;Yan Yao","doi":"10.1186/s12947-023-00302-y","DOIUrl":"https://doi.org/10.1186/s12947-023-00302-y","url":null,"abstract":"<p><strong>Background: </strong>Intracardiac echocardiography (ICE) provides accurate left atrial (LA) anatomical information in the procedure of atrial fibrillation (AF) ablation but lacks LA functional assessment. LA reservoir strain (LASr) is an excellent marker of LA reservoir function. This study aimed to assess the agreement between LASr derived from ICE and transthoracic echocardiography (TTE) in AF patients and analyze the reproducibility of LASr assessed by ICE combined with speckle tracking imaging.</p><p><strong>Methods: </strong>This study prospectively enrolled 110 patients with a clinical diagnosis of AF who were ready for AF ablation, including 71 patients with paroxysmal AF and 39 with persistent AF. TTE and ICE examinations were performed on each individual before AF ablation. LASr measurements derived from ICE and TTE images were using dedicated LA-tracking software. Pearson correlation coefficients (r) and Bland-Altman plots were used to evaluate the agreement of LASr between the two modalities. Intraclass correlation coefficients (ICCs) were used to assess intra- and inter-observer reproducibility.</p><p><strong>Results: </strong>The agreement between LASr obtained from ICE and TTE, especially between LASr_LPV (LASr derived from LA left pulmonary vein view of ICE) and LASr_TTE (LASr derived from TTE) were good in both paroxysmal and persistent AF patients [r = 0.890 (P < 0.001) for overall population; r = 0.815 (P < 0.001) and Bias ± LOA: -0.3 ± 9.9% for paroxysmal AF; r = 0.775 (P < 0.001) and Bias ± LOA: -2.6 ± 3.9% for persistent AF, respectively]. But the values of LASr derived from ICE were slightly lower than those of TTE, especially in patients with persistent AF. The ICCs for LASr derived from ICE were excellent (all ICCs > 0.90).</p><p><strong>Conclusions: </strong>In patients with AF, LASr derived from ICE demonstrated excellent reproducibility and showed good agreement with LASr obtained from TTE. Obtaining LASr from ICE images may be a supplementary method to evaluate LA reservoir function in AF patients and expands the potential of ICE in the field of cardiac function assessment.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"21 1","pages":"4"},"PeriodicalIF":1.9,"publicationDate":"2023-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9951450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10775601","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":"Can transthoracic echocardiography be used to a greater extent in the diagnostics of infective endocarditis to avoid unnecessary transoesophageal examinations without jeopardising accuracy?","authors":"Anna Damlin,&nbsp;Maria J Eriksson,&nbsp;Eva Maret","doi":"10.1186/s12947-023-00301-z","DOIUrl":"https://doi.org/10.1186/s12947-023-00301-z","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis (IE) is a serious condition that requires prompt diagnosis and treatment. Transthoracic echocardiography (TTE) is usually the initial imaging modality, however transoesophageal echocardiography (TOE) is sometimes necessary because of its higher sensitivity for IE. Yet, TOE may imply an increased risk of complications. This project aims to evaluate whether TTE can be used to a greater extent in the diagnostics of IE to avoid unnecessary TOE examinations without jeopardizing diagnostic accuracy.</p><p><strong>Methods: </strong>Data from all TOE examinations performed on patients hospitalized with clinical suspicion of IE between 2019-05-01 and 2020-04-30 at a university hospital in Stockholm, Sweden, were obtained and analysed. Variables included for analysis were age, sex, blood culture results, aetiology, results from TOE, number of TOEs during the inclusion period, results from positron emission tomography/computed tomography (PET/CT), new regurgitation, cardiac murmur, previous IE, prosthetic valve, predisposing factors, i.e. cardiac comorbidities, injection drug use, fever, vascular phenomena, and immunological phenomena. To assess associations between predisposing factors or aetiology of IE and TOE findings, chi square tests and logistic regression models were used. For continuous variables, linear regression was used for comparisons of means and quantile regression was used for comparisons of medians. P < 0.05 was considered significant.</p><p><strong>Results: </strong>In total 195 TOE examinations (Table 1) from 160 patients were included, of which 61 (31%) were positive for IE. In total, 36 examinations had negative TTE prior to TOE of which 32 (86%) also had negative TOE. Of the 5 (14%) negative TTE prior to TOE that had positive TOE, all had cardiovascular implantable electronic device (CIED) and/or prosthetic valves.</p><p><strong>Conclusions: </strong>The existing recommendations for TOE in patients with clinical suspicion of IE are probably broad enough not to miss patients with IE, but there might be an unnecessarily large number of patients being referred for TOE with negative results. Negative TTE examination with good image quality and no CIED or prosthetic valves, may be sufficient without jeopardizing the IE diagnosis.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"21 1","pages":"3"},"PeriodicalIF":1.9,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9887897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9152686","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":"Echocardiographic reference ranges for noninvasive left ventricular 18-segment myocardial work index and work efficiency in a healthy Asian population.","authors":"Jian Wu,&nbsp;Xinyi Huang,&nbsp;Kunhui Huang,&nbsp;Yiruo Tang,&nbsp;Qiumei Gao,&nbsp;Xu Chen,&nbsp;Bo Jing,&nbsp;Xinyu Wang,&nbsp;Biqin Lin,&nbsp;Maolong Su","doi":"10.1186/s12947-023-00299-4","DOIUrl":"https://doi.org/10.1186/s12947-023-00299-4","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular (LV) myocardial work index (WI) and work efficiency (WE) have become the latest indicators for assessing LV function. Reference ranges for normal LV segmental WI and WE have not been established.</p><p><strong>Methods: </strong>Four hundred eleven healthy Asian subjects (47% men, median age: 35 years) were enrolled prospectively. WI and WE were analysed using the LV pressure-strain loop (LVPSL) with specific software.</p><p><strong>Results: </strong>WI and WE differed significantly between segments as well as between walls and levels of the left ventricle. The anteroseptal basal segment had the lowest WI and WE (1440 mmHg ± 324 and 92% [88-96], respectively) among the eighteen segments. Significant WI and WE differences were found between sexes and age groups. No correlation was observed between age groups and the average WI of any wall or level in men, while the average WI of several different walls and levels in women showed significant differences between age groups. The average WI of most walls and levels increased with age in women. No correlation was found between age groups and the average WE of any wall or level in either men or women.</p><p><strong>Conclusions: </strong>This study establishes the normal reference values of WI and WE of eighteen segments for clinical work and clinical experiments. There were significant differences in WI and WE between segments, levels, and walls of the normal left ventricle. Sex should be considered when analysing WI and WE. Age should be considered when analysing WI in women.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"21 1","pages":"2"},"PeriodicalIF":1.9,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9869544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10604371","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":"Pulmonary hypertension at admission predicts ICU mortality in elderly critically ill with severe COVID-19 pneumonia: retrospective cohort study.","authors":"Marko Kurnik,&nbsp;Helena Božič,&nbsp;Anže Vindišar,&nbsp;Petra Kolar,&nbsp;Matej Podbregar","doi":"10.1186/s12947-023-00300-0","DOIUrl":"https://doi.org/10.1186/s12947-023-00300-0","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (POCUS) is a useful diagnostic tool for non-invasive assessment of critically ill patients. Mortality of elderly patients with COVID-19 pneumonia is high and there is still scarcity of definitive predictors. Aim of our study was to assess the prediction value of combined lung and heart POCUS data on mortality of elderly critically ill patients with severe COVID-19 pneumonia.</p><p><strong>Methods: </strong>This was a retrospective observational study. Data of patients older than 70 years, with severe COVID-19 pneumonia admitted to mixed 25-bed, level 3, intensive care unit (ICU) was analyzed retrospectively. POCUS was performed at admission; our parameters of interest were pulmonary artery systolic pressure (PASP) and presence of diffuse B-line pattern (B-pattern) on lung ultrasound.</p><p><strong>Results: </strong>Between October 2020 and March 2021, 117 patients aged 70 years or more (average age 77 ± 5 years) were included. Average length of ICU stay was 10.7 ± 8.9 days. High-flow oxygenation, non-invasive ventilation and invasive mechanical ventilation were at some point used to support 36/117 (31%), 39/117 (33%) and 75/117 (64%) patients respectively. ICU mortality was 50.9%. ICU stay was shorter in survivors (8.8 ± 8.3 vs 12.6 ± 9.3 days, p = 0.02). PASP was lower in ICU survivors (32.5 ± 9.8 vs. 40.4 ± 14.3 mmHg, p = 0.024). B-pattern was more often detected in non-survivors (35/59 (59%) vs. 19/58 (33%), p = 0.005). PASP and B-pattern at admission, and also mechanical ventilation and development of VAP, were univariate predictors of mortality. PASP at admission was an independent predictor of ICU (OR 1.061, 95%CI 1.003-1.124, p = 0.039) and hospital (OR 1.073, 95%CI 1.003-1.146, p = 0.039) mortality.</p><p><strong>Conclusions: </strong>Pulmonary artery systolic pressure at admission is an independent predictor of ICU and hospital mortality of elderly patients with severe COVID-19 pneumonia.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"21 1","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9847083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9535073","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":"Life-threatening paradoxical thromboembolism in a patient with patent foramen ovale.","authors":"Antonio Rizza,&nbsp;Francesco Negro,&nbsp;Tommaso Gasbarri,&nbsp;Roberto Arpesani,&nbsp;Baldassare Ferro,&nbsp;Paolo Roncucci,&nbsp;Cataldo Palmieri,&nbsp;Simone Sorbo,&nbsp;Emilio Maria Pasanisi,&nbsp;Marco Solinas,&nbsp;Sergio Berti","doi":"10.1186/s12947-022-00298-x","DOIUrl":"https://doi.org/10.1186/s12947-022-00298-x","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism represents the third most frequent acute cardiovascular syndrome worldwide. Its clinical manifestations are deep vein thrombosis and/or pulmonary embolism. Despite a considerable mortality, diagnosis is often missed.  CASE PRESENTATION: We report the management of a female patient with high-risk pulmonary thromboembolism treated initially with thromboaspiration, complicated by embolus jailing in a patent foramen ovale. In this situation, left cardiac chambers and systemic circulation were jeopardized by this floating embolus.</p><p><strong>Conclusions: </strong>High-risk pulmonary embolism requires reperfusion strategy but sometimes mechanical thromboaspiration may be not fully successful; transesophageal echocardiography led to a prompt diagnosis of this unexpected finding; in this very particular case, open surgery represented a bail-out procedure to avoid cerebral and systemic embolism.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"20 1","pages":"28"},"PeriodicalIF":1.9,"publicationDate":"2022-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9703718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10328442","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":"Reduced left atrial contractile strain with speckle tracking analysis predicts abnormal plasma NTproBNP in an asymptomatic community population.","authors":"Lin Liu,&nbsp;Baowei Zhang,&nbsp;Ying Yang,&nbsp;Litong Qi,&nbsp;Shuo Wang,&nbsp;Lei Meng,&nbsp;Wei Ma,&nbsp;Yong Huo","doi":"10.1186/s12947-022-00297-y","DOIUrl":"https://doi.org/10.1186/s12947-022-00297-y","url":null,"abstract":"<p><strong>Background: </strong>The left atrium (LA) is closely related to left ventricular diastolic function. Two-dimensional speckle tracking strain and strain rate (SR) imaging has been applied in the study of LA function. We intended to explore the relationship between global LA deformation parameters and plasma NTproBNP levels in asymptomatic community residents with normal ejection fraction and normal LA volume.</p><p><strong>Methods: </strong>A cross-sectional sample of Beijing residents underwent comprehensive Doppler echocardiography and medical record review in 2009. Global LA longitudinal strain and SR indexes were obtained in the apical four-chamber view. LA stiffness index (LASI) was calculated as the ratio of early diastolic velocity of transmitral flow/early diastolic mitral annular motion velocity (E/E') to LA reservoir strain.</p><p><strong>Results: </strong>A total of 620 individuals (mean age = 65.8 years, left ventricular ejection fraction = 70.8%, LA volume index = 17.9 ml/m²) were investigated in our study. 117 individuals had increased plasma NTproBNP (≥ 125 pg/ml). LA reservoir and contractile function by LA strain and SR indexes were significantly reduced in the abnormal NTproBNP group compared with the normal NTproBNP group. Multiple regression analysis indicated that LA contractile strain was a negative predictor of plasma NTproBNP in addition to indexed LA volume and E/E'. LASI was higher in the abnormal NTproBNP group and was significantly correlated with NTproBNP (r = 0.342, P < 0.001). The area under ROC analysis for LASI in predicting elevated plasma NTproBNP was 0.690, similar with LA contractile strain, E/E' and LAVI. The cut-off value of LASI was 0.612.</p><p><strong>Conclusions: </strong>LA reservoir and contractile functions demonstrated by LA strain and SR were significantly impaired in the community-based population with increased plasma NTproBNP levels. LA contractile strain adds incremental information in predicting abnormal NTproBNP levels. As a single index, LASI showed similar diagnostic value with LAVI and E/E' in predicting abnormal NTproBNP.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"20 1","pages":"27"},"PeriodicalIF":1.9,"publicationDate":"2022-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9701031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10326695","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":"Medical student medium-term skill retention following cardiac point-of-care ultrasound training based on the American Society of Echocardiography curriculum framework.","authors":"Satoshi Jujo, Brandan I Sakka, Jannet J Lee-Jayaram, Akihisa Kataoka, Masaki Izumo, Kenya Kusunose, Atsushi Nakahira, Sayaka Oikawa, Yuki Kataoka, Benjamin W Berg","doi":"10.1186/s12947-022-00296-z","DOIUrl":"10.1186/s12947-022-00296-z","url":null,"abstract":"<p><strong>Background: </strong>No studies have demonstrated medium- or long-term skill retention of cardiac point-of-care ultrasound (POCUS) curriculum for medical student. Based on the American Society of Echocardiography (ASE) curriculum framework, we developed a blended-learning cardiac POCUS curriculum with competency evaluation. The objective of this study was to investigate the curriculum impact on image acquisition skill retention 8 weeks after initial training.</p><p><strong>Methods: </strong>This study was a prospective, pre-post education intervention study for first- and second-year medical students, with blinded outcome assessment. The curriculum included a pre-training ASE online module and healthy volunteer hands-on training to obtain 5 views: parasternal long-axis (PLAX), parasternal short-axis (PSAX), apical 4-chamber (A4C), subcostal 4-chamber (S4C), and subcostal inferior vena cava (SIVC) views. Students took 5-view image acquisition skill tests at pre-, immediate post-, and 8-week post-training, using a healthy volunteer. Three blinded assessors rated the image quality using a validated 10-point maximum scoring system. Students used a hand-held ultrasound probe (Butterfly iQ).</p><p><strong>Results: </strong>Fifty-four students completed hands-on training, and pre- and immediate post-training skill tests. Twenty-seven students completed 8-week post-training skill tests. Skill test score improvement between pre- and 8-week post-training was 2.11 points (95% CI, 1.22-3.00; effect size, 1.13).</p><p><strong>Conclusion: </strong>The cardiac POCUS curriculum demonstrated medium-term skill retention. The curriculum was sufficient for S4C and SIVC skill retention, but inadequate for PLAX, PSAX, and A4C. Therefore, instructional design modifications or re-training for PLAX, PSAX, and A4C are needed to make the curriculum more effective for clinically relevant skill retention.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":" ","pages":"26"},"PeriodicalIF":1.9,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9554392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33502948","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":"Evaluation of left ventricular systolic function in patients with systemic lupus erythematosus using ultrasonic layer-specific strain technology and its association with cardiovascular events: a long-term follow-up study.","authors":"Hebin Zhang,&nbsp;Cunxin Yang,&nbsp;Feng Gao,&nbsp;Shanting Hu,&nbsp;Hui Ma","doi":"10.1186/s12947-022-00295-0","DOIUrl":"https://doi.org/10.1186/s12947-022-00295-0","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) is a multisystem, autoimmune disease with potential cardiovascular involvement. Layer-specific strain (LSS) analysis is a new method that allows early detection of subtle left ventricular (LV) systolic dysfunction. The aim of this study was to evaluate LV systolic function in patients with SLE using conventional echocardiographic measurements and longitudinal strain (LS) and circumferential strain (CS) by LSS. Furthermore, the association between echocardiographic parameters and the occurrence of cardiovascular events was assessed.</p><p><strong>Methods: </strong>A total of 162 patients with SLE (the SLE group) who underwent a dedicated multidisciplinary assessment, including echocardiography, were analyzed at the time of their first visits. The control group consisted of 68 age- and sex-matched healthy subjects. LS and CS on endocardial, mid-myocardial, and epicardial layers at 17 cardiac segments were measured. Transmural strain gradient was calculated as the differences in systolic strain between the endocardial and epicardial layers.</p><p><strong>Results: </strong>Compared with control subjects, patients with SLE had significantly lower LV ejection fraction, LS, and CS values in all layers (P < 0.05); LV LS and CS gradient were all lower than control subjects (P < 0.05). During a median follow-up period of 83 months (interquartile range: 64-95 months), 59 patients (36.4%) developed cardiovascular events. Using multivariate Cox regression analysis, we found that LV endocardial LS (hazard ratio, 1.014; 95% CI, 1.002-1.035; P = 0.025) and CS (hazard ratio, 1.051; 95% CI, 1.027-1.077; P < 0.001) demonstrated independent associations with cardiovascular events; whereas LV ejection fraction was not significantly associated with cardiovascular events. The Kaplan-Meier survival curves showed that patients with SLE with lower LV endocardial LS and CS (based on the cutoff values of -21.5% and -29.0%, respectively) experienced higher cumulative rates of cardiovascular events compared with those with higher LV endocardial LS and CS.</p><p><strong>Conclusions: </strong>In patients with SLE, LV systolic function measured by LV endocardial LS and CS were significantly lower than that of the control group and were associated with cardiovascular events, potentially representing a new technology to improve risk stratification in these patients.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":" ","pages":"25"},"PeriodicalIF":1.9,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9541079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33512845","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}