A. Alizadehasl, Mazyar Gholampour, M. Madani, M. Peighambari, Mahbubeh Pazouki, A. Mousavi
Acute myocardial infarction can culminate in sudden cardiac death due to cardiogenic shock and ventricular fibrillation, and also rarely due to cardiac rupture. We present a case of post-infarction myocardial rupture after thrombolytic therapy diagnosed with transthoracic echocardiography and treated with direct closure and coronary artery bypass grafting.
{"title":"An echo-dense cap in the pericardial space after acute myocardial infarction: A case report","authors":"A. Alizadehasl, Mazyar Gholampour, M. Madani, M. Peighambari, Mahbubeh Pazouki, A. Mousavi","doi":"10.5812/acvi.26728","DOIUrl":"https://doi.org/10.5812/acvi.26728","url":null,"abstract":"Acute myocardial infarction can culminate in sudden cardiac death due to cardiogenic shock and ventricular fibrillation, and also rarely due to cardiac rupture. We present a case of post-infarction myocardial rupture after thrombolytic therapy diagnosed with transthoracic echocardiography and treated with direct closure and coronary artery bypass grafting.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"16 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116693255","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}
M. Nikparvar, E. Boushehri, H. Samimagham, M. Amrollahi, Tasnim E Eftekhaari
Background: Coronary artery disease (CAD) is prevalent but very difficult to diagnose in hemodialysis (HD) patients compared with nonuremic individuals. Objectives: The aim of this study was to detect undiagnosed ischemic heart disease (IHD) using dipyridamole myocardial perfusion imaging (MPI) in HD patients. Patients and Methods: In this cross-sectional descriptive study, HD patients who met the inclusion criteria were selected. Demographic, clinical, and paraclinical data were obtained via interviews and medical records. Bedside electrocardiography, resting echocardiography, and nuclear MPI with dipyridamole were done. The data were analyzed using descriptive statistical methods for detecting the prevalence of undiagnosed IHD in the HD patients. The chi-square test and the independent t-test were used to identify the high-risk HD patients. Results: Sixty-nine HD patients were studied using dipyridamole MPI with Tc 99 m sestamibi. The mean age, body mass index, and mean duration of HD were 52.1 ± 13.8 years, 21.23 ± 4.79 kg/m2, and 48.2 ± 34.9 months, respectively. The patients were divided into two groups based on MPI: IHD-positive group (21.7%) and IHD-negative group (78.3%). IHD was more prevalent in the patients with diabetes mellitus, hypertension, positive family history of CAD, low HD adequacy index (Kt/V < 1.2), left ventricular hypertrophy, high intact parathyroid hormone levels, electrocardiographic abnormalities, and low ferritin levels. A statistically significant correlation was also detected between IHD and aging (P < 0.05). Conclusions: The prevalence of undiagnosed IHD in the HD patients was considerable. We, therefore, suggest that IHD be assessed in HD patients, especially those at high risk due to positive family history of CAD, hypertension, left ventricular hypertrophy, diabetes mellitus, Kt/V < 1.2, low ferritin levels, and high levels of intact parathyroid hormone.
{"title":"Detection of undiagnosed ischemic heart disease in hemodialysis patients using myocardial perfusion imaging","authors":"M. Nikparvar, E. Boushehri, H. Samimagham, M. Amrollahi, Tasnim E Eftekhaari","doi":"10.5812/acvi.29470","DOIUrl":"https://doi.org/10.5812/acvi.29470","url":null,"abstract":"Background: Coronary artery disease (CAD) is prevalent but very difficult to diagnose in hemodialysis (HD) patients compared with nonuremic individuals. Objectives: The aim of this study was to detect undiagnosed ischemic heart disease (IHD) using dipyridamole myocardial perfusion imaging (MPI) in HD patients. Patients and Methods: In this cross-sectional descriptive study, HD patients who met the inclusion criteria were selected. Demographic, clinical, and paraclinical data were obtained via interviews and medical records. Bedside electrocardiography, resting echocardiography, and nuclear MPI with dipyridamole were done. The data were analyzed using descriptive statistical methods for detecting the prevalence of undiagnosed IHD in the HD patients. The chi-square test and the independent t-test were used to identify the high-risk HD patients. Results: Sixty-nine HD patients were studied using dipyridamole MPI with Tc 99 m sestamibi. The mean age, body mass index, and mean duration of HD were 52.1 ± 13.8 years, 21.23 ± 4.79 kg/m2, and 48.2 ± 34.9 months, respectively. The patients were divided into two groups based on MPI: IHD-positive group (21.7%) and IHD-negative group (78.3%). IHD was more prevalent in the patients with diabetes mellitus, hypertension, positive family history of CAD, low HD adequacy index (Kt/V < 1.2), left ventricular hypertrophy, high intact parathyroid hormone levels, electrocardiographic abnormalities, and low ferritin levels. A statistically significant correlation was also detected between IHD and aging (P < 0.05). Conclusions: The prevalence of undiagnosed IHD in the HD patients was considerable. We, therefore, suggest that IHD be assessed in HD patients, especially those at high risk due to positive family history of CAD, hypertension, left ventricular hypertrophy, diabetes mellitus, Kt/V < 1.2, low ferritin levels, and high levels of intact parathyroid hormone.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132244348","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}
M. Nikparvar, N. Akiash, N. Fayazi, S. Fouladi, Fatemeh Jafary, Mahboubeh Pazoki
Background: β-thalassemia is an inherited disorder of β-globin biosynthesis. Dysfunction in hemoglobin chain production, ineffective erythropoiesis, and hemolysis occur in β-thalassemia. Pulmonary arterial hypertension (PAH) is increasingly detected in patients with β-thalassemia, and splenectomy which decreases the need for blood transfusion increases the pulmonary artery pressure (PAP). Objectives: This study aimed to assess the PAP in patients with β-thalassemia (male or female and major or intermedia) who had undergone splenectomy. Methods: A total of 137 patients suffering from β-thalassemia were evaluated during the study. All subjects were referred for cardiac evaluation. Clinical history, presence of cardiac symptoms, and previous splenectomy were noted. Standard M-mode, 2D, and Doppler echocardiographic examinations were performed for all subjects. Patients with a tricuspid regurgitant jet velocity (TRV) ≥2.5 m/s were considered at risk for PAH. Results: Average age of the patients was 21.15±6.68 years. No significant difference was observed in the PAP between the 2 groups of thalassemia major and intermedia and also the 2 sex groups. Indeed, 6.6% of the patients had an increased PAP. The significant finding of the study was that the patients who had had splenectomy were significantly at an increased risk of PAH (P = 0.046). Conclusions: The etiology of PAH in thalassemia is multifactorial such as inflammatory mediators. Also, the absence of the spleen plays an important role in developing a high TRV and PAH.
{"title":"Evaluation of tricuspid regurgitant jet velocity in thalassemia patients with splenectomy","authors":"M. Nikparvar, N. Akiash, N. Fayazi, S. Fouladi, Fatemeh Jafary, Mahboubeh Pazoki","doi":"10.5812/acvi.39394","DOIUrl":"https://doi.org/10.5812/acvi.39394","url":null,"abstract":"Background: β-thalassemia is an inherited disorder of β-globin biosynthesis. Dysfunction in hemoglobin chain production, ineffective erythropoiesis, and hemolysis occur in β-thalassemia. Pulmonary arterial hypertension (PAH) is increasingly detected in patients with β-thalassemia, and splenectomy which decreases the need for blood transfusion increases the pulmonary artery pressure (PAP). Objectives: This study aimed to assess the PAP in patients with β-thalassemia (male or female and major or intermedia) who had undergone splenectomy. Methods: A total of 137 patients suffering from β-thalassemia were evaluated during the study. All subjects were referred for cardiac evaluation. Clinical history, presence of cardiac symptoms, and previous splenectomy were noted. Standard M-mode, 2D, and Doppler echocardiographic examinations were performed for all subjects. Patients with a tricuspid regurgitant jet velocity (TRV) ≥2.5 m/s were considered at risk for PAH. Results: Average age of the patients was 21.15±6.68 years. No significant difference was observed in the PAP between the 2 groups of thalassemia major and intermedia and also the 2 sex groups. Indeed, 6.6% of the patients had an increased PAP. The significant finding of the study was that the patients who had had splenectomy were significantly at an increased risk of PAH (P = 0.046). Conclusions: The etiology of PAH in thalassemia is multifactorial such as inflammatory mediators. Also, the absence of the spleen plays an important role in developing a high TRV and PAH.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116166494","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}
Pub Date : 2015-02-20DOI: 10.5812/acvi.3(1)2015.26377
S. Silvilairat, Kakanang Jantarapagdee, Rekwan Sittiwangku, Y. Pongprot, C. Phornphutkul
Background: Vibratory innocent murmur is the most common precordial innocent murmur in children. The mechanism of vibratory innocent murmur is still unclear. Objectives: The aim of this study is to learn the mechanism of the vibratory innocent murmur. Patients and Methods: The prospective cross-sectional study was conducted using 32 children who had the vibratory innocent murmur (cases) in Chiang Mai University Hospital and 27 normal healthy children (controls). Two-dimension, Doppler, and tissue Doppler echocardiography were performed on each subject to examine the difference between cases and controls. Results: The left ventricular false tendon was present in 84% of cases and 22% of controls (P < 0.001). Left ventricular outflow tract velocity was significantly higher in cases than in controls (P < 0.001). Early diastolic myocardial velocity at the base of the interventricular septum was lower in cases with false tendon than those without false tendon (P = 0.048). No significant difference was found regarding ascending aorta diameter, cardiac output and ejection fraction between the two groups. Left ventricular diastolic function was normal in all cases and controls. Conclusions: The vibratory innocent murmur is associated with the presence of left ventricular false tendon and higher left ventricular outflow tract velocity. The presence of the left ventricular false tendon was somewhat associated with decreased early diastolic myocardial velocity. Normal left ventricular systolic and diastolic function can be used as a reassurance in cases with the vibratory innocent murmur.
{"title":"Echocardiographic assessment of the vibratory innocent murmur in children: a case-control study","authors":"S. Silvilairat, Kakanang Jantarapagdee, Rekwan Sittiwangku, Y. Pongprot, C. Phornphutkul","doi":"10.5812/acvi.3(1)2015.26377","DOIUrl":"https://doi.org/10.5812/acvi.3(1)2015.26377","url":null,"abstract":"Background: Vibratory innocent murmur is the most common precordial innocent murmur in children. The mechanism of vibratory innocent murmur is still unclear. Objectives: The aim of this study is to learn the mechanism of the vibratory innocent murmur. Patients and Methods: The prospective cross-sectional study was conducted using 32 children who had the vibratory innocent murmur (cases) in Chiang Mai University Hospital and 27 normal healthy children (controls). Two-dimension, Doppler, and tissue Doppler echocardiography were performed on each subject to examine the difference between cases and controls. Results: The left ventricular false tendon was present in 84% of cases and 22% of controls (P < 0.001). Left ventricular outflow tract velocity was significantly higher in cases than in controls (P < 0.001). Early diastolic myocardial velocity at the base of the interventricular septum was lower in cases with false tendon than those without false tendon (P = 0.048). No significant difference was found regarding ascending aorta diameter, cardiac output and ejection fraction between the two groups. Left ventricular diastolic function was normal in all cases and controls. Conclusions: The vibratory innocent murmur is associated with the presence of left ventricular false tendon and higher left ventricular outflow tract velocity. The presence of the left ventricular false tendon was somewhat associated with decreased early diastolic myocardial velocity. Normal left ventricular systolic and diastolic function can be used as a reassurance in cases with the vibratory innocent murmur.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130855966","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}
Marie Bernadette N'cho-Mottoh, K. Yayehd, C. Iklo, J. Koffi, A. Ekou, R. N'Guetta, Jean Baptiste Anzouan Kacou
Background: Tissue Doppler is a promising method that allows the measurement of time of systolic and diastolic tissue velocities. Ventricular dyssynchrony was assessed in patients with heart failure. In sub-Saharan Africa, very few studies have focused on ventricular dyssynchrony in healthy subjects. Objectives: The purpose of this study was to measure time-to-peak of systolic and diastolic velocities of different segments of left ventricle and apply ventricular dyssynchrony markers to healthy black African subjects. Patients and Methods: Fifty healthy black African were enrolled consecutively over a period of 3 months. Time-to-peak systolic velocities (TS) and Time-to-peak early diastolic velocities (TE) were measured at the four basal segments of left ventricle. Five dyssynchrony markers were assessed: difference between maximal time-to-peak systolic velocity and minimal time-to-peak systolic velocity, time between septal time-to-peak systolic velocity and lateral time-to peak systolic velocity, standard deviation of time-to-peak systolic velocity of the four basal segments, difference between maximal time-to-peak early diastolic velocity and minimal time-to-peak early diastolic velocity, and standard deviation of time-to-peak early diastolic velocity of the four basal segments. Results: The frequency of some dyssynchrony markers was similar to that of other studies. The difference between maximal time-to-peak systolic velocity and minimal time-to-peak systolic velocity was correlated with age and was higher among women. The prevalence of diastolic dyssynchrony was higher in black African subjects. Conclusions: Large-scale studies on the healthy black African population could assess the relationship between diastolic dyssynchrony and changes in myocardial performance related to racial differences.
{"title":"Ventricular dyssynchrony markers in healthy black African subjects: A tissue doppler imaging study","authors":"Marie Bernadette N'cho-Mottoh, K. Yayehd, C. Iklo, J. Koffi, A. Ekou, R. N'Guetta, Jean Baptiste Anzouan Kacou","doi":"10.5812/acvi.24305","DOIUrl":"https://doi.org/10.5812/acvi.24305","url":null,"abstract":"Background: Tissue Doppler is a promising method that allows the measurement of time of systolic and diastolic tissue velocities. Ventricular dyssynchrony was assessed in patients with heart failure. In sub-Saharan Africa, very few studies have focused on ventricular dyssynchrony in healthy subjects. Objectives: The purpose of this study was to measure time-to-peak of systolic and diastolic velocities of different segments of left ventricle and apply ventricular dyssynchrony markers to healthy black African subjects. Patients and Methods: Fifty healthy black African were enrolled consecutively over a period of 3 months. Time-to-peak systolic velocities (TS) and Time-to-peak early diastolic velocities (TE) were measured at the four basal segments of left ventricle. Five dyssynchrony markers were assessed: difference between maximal time-to-peak systolic velocity and minimal time-to-peak systolic velocity, time between septal time-to-peak systolic velocity and lateral time-to peak systolic velocity, standard deviation of time-to-peak systolic velocity of the four basal segments, difference between maximal time-to-peak early diastolic velocity and minimal time-to-peak early diastolic velocity, and standard deviation of time-to-peak early diastolic velocity of the four basal segments. Results: The frequency of some dyssynchrony markers was similar to that of other studies. The difference between maximal time-to-peak systolic velocity and minimal time-to-peak systolic velocity was correlated with age and was higher among women. The prevalence of diastolic dyssynchrony was higher in black African subjects. Conclusions: Large-scale studies on the healthy black African population could assess the relationship between diastolic dyssynchrony and changes in myocardial performance related to racial differences.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124142416","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}
Introduction: The term hydropneumopericardium describes the simultaneous accumulation of fluid and gas in the pericardial sac. This condition is mostly caused by primary infiltrative lesions from the adjacent organs, pericardial infections, or trauma and is a very rare situation, usually with favorable outcomes. Case Presentation: We describe a female patient with Lutembacher's syndrome complicated by cardiac tamponade. After surgical treatment, she developed iatrogenic hydropneumopericardium, which was treated conservatively. Conclusions: Iatrogenic hydropneumopericardium can be managed conservatively with supportive measures, and most of these cases resolve spontaneously if they are not large and destabilizing.
{"title":"Bubbles in pericardial fluid: Multimodality imaging in iatrogenic hydropneumopericardium","authors":"A. Attar, M. Sharifkazemi, A. Moaref","doi":"10.5812/acvi.22787","DOIUrl":"https://doi.org/10.5812/acvi.22787","url":null,"abstract":"Introduction: The term hydropneumopericardium describes the simultaneous accumulation of fluid and gas in the pericardial sac. This condition is mostly caused by primary infiltrative lesions from the adjacent organs, pericardial infections, or trauma and is a very rare situation, usually with favorable outcomes. Case Presentation: We describe a female patient with Lutembacher's syndrome complicated by cardiac tamponade. After surgical treatment, she developed iatrogenic hydropneumopericardium, which was treated conservatively. Conclusions: Iatrogenic hydropneumopericardium can be managed conservatively with supportive measures, and most of these cases resolve spontaneously if they are not large and destabilizing.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127016916","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}
Pub Date : 2015-02-20DOI: 10.5812/acvi.3(1)2015.21751
Farahnaz Nikdoust, Mansoureh Eghbalnezhad
Introduction: Coronary angiography can be complicated by some major complications such as stroke. Case Presentation: We describe a patient who presented with hemiparesia. He had undergone coronary angiography on his right and left coronary arteries as well as his left ventricle (LV) via the radial artery access 10 days earlier using a 6-French Tiger catheter. Transthoracic echocardiography showed a large (36 × 25 mm) inhomogeneous mobile mass attached to the apicoseptal LV segment. His serum protein S was low (60% [normal = 77 - 140%]), while his protein C was normal and lupus anticoagulant was negative. During hospitalization, he developed severe abdominal pain, for which mesenteric ischemia was diagnosed. First, he underwent surgery for the resection of the infarcted intestinal segments. Then cardiac surgery was done to remove the mass. The mass was diagnosed as a thrombus. After the surgery, the general condition of the patient deteriorated and blood culture showed acinetobacter septicemia. Finally, he died due to sepsis. A review of his coronary angiography revealed that after the contrast media had left the LV, there was still dye at the contact point between the tip of the catheter and the LV, which was compatible with the location of thrombus formation. Conclusions: Trauma induced by the tip of the catheter at the contact location with the LV wall in a patient with mild hypercoagulable state accounted for intracardiac thrombosis formation and its embolization to the brain and intestines.
{"title":"Cerebrovascular accident and mesenteric ischemia following diagnostic coronary angiography","authors":"Farahnaz Nikdoust, Mansoureh Eghbalnezhad","doi":"10.5812/acvi.3(1)2015.21751","DOIUrl":"https://doi.org/10.5812/acvi.3(1)2015.21751","url":null,"abstract":"Introduction: Coronary angiography can be complicated by some major complications such as stroke. Case Presentation: We describe a patient who presented with hemiparesia. He had undergone coronary angiography on his right and left coronary arteries as well as his left ventricle (LV) via the radial artery access 10 days earlier using a 6-French Tiger catheter. Transthoracic echocardiography showed a large (36 × 25 mm) inhomogeneous mobile mass attached to the apicoseptal LV segment. His serum protein S was low (60% [normal = 77 - 140%]), while his protein C was normal and lupus anticoagulant was negative. During hospitalization, he developed severe abdominal pain, for which mesenteric ischemia was diagnosed. First, he underwent surgery for the resection of the infarcted intestinal segments. Then cardiac surgery was done to remove the mass. The mass was diagnosed as a thrombus. After the surgery, the general condition of the patient deteriorated and blood culture showed acinetobacter septicemia. Finally, he died due to sepsis. A review of his coronary angiography revealed that after the contrast media had left the LV, there was still dye at the contact point between the tip of the catheter and the LV, which was compatible with the location of thrombus formation. Conclusions: Trauma induced by the tip of the catheter at the contact location with the LV wall in a patient with mild hypercoagulable state accounted for intracardiac thrombosis formation and its embolization to the brain and intestines.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114998638","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}
Z. Haghighi, A. Alizadehasl, H. Moladoust, M. Ardeshiri, A. Mostafavi, Nahid Rezaeiyan, S. H. Ojaghi, F. Safi, Akram Mikaeilpour
Background: Velocity vector imaging (VVI) is a new echocardiography method to assess myocardial deformation in two dimensions. Objectives: In this study, we used VVI to evaluate left ventricular (LV) main torsional parameters in non-ischemic dilated cardiomyopathy (DCM) patients in compared with normal subjects. Patients and Methods: Twenty-six DCM patients and Twenty-four normal subjects were assessed. Echocardiographic images of the short axis apical and basal views of LV were processed by VVI software to measure peak rotation degrees and also peak rotation rates in systole. LV twist was well-defined as the net difference between apical and basal rotation values and also LV torsion was considered as LV twist divided by left ventricular diastolic longitudinal length. In addition, peak untwisting value and untwisting rate were measured in diastole too. Results: LV twist value (5.54 ± 1.94° in DCM VS. 11.5 ± 2.45° in control group) and also LV torsion (0.71 ± 0.28°/cm in DCM VS. 1.53 ± 0.42°/cm in control group) were significantly decreased in DCM patients compared with normal group (P < 0.001 for both); also, the twisting rate was notably lower in DCM vs. control (38.68 ± 14.43°/s in DCM vs. 75.88 ± 17.25°/s in control; P < 0.001) and also untwisting rate (36.28 ± 13.48°/s in DCM vs. -73.79 ± 24.45°/s in control; P < 0.001), However normalization of these times for systolic duration or LV length creates different values. Conclusions: LV twist, torsion and untwist and also rate of them are significantly impaired in DCM and this impairment is well-related to LV global systolic and diastolic dysfunction. VVI is a new noninvasive technique that can be used to evaluate LV torsional parameters.
{"title":"Left ventricular torsional parameters in patients with non-ischemic dilated cardiomyopathy","authors":"Z. Haghighi, A. Alizadehasl, H. Moladoust, M. Ardeshiri, A. Mostafavi, Nahid Rezaeiyan, S. H. Ojaghi, F. Safi, Akram Mikaeilpour","doi":"10.5812/acvi.26751","DOIUrl":"https://doi.org/10.5812/acvi.26751","url":null,"abstract":"Background: Velocity vector imaging (VVI) is a new echocardiography method to assess myocardial deformation in two dimensions. Objectives: In this study, we used VVI to evaluate left ventricular (LV) main torsional parameters in non-ischemic dilated cardiomyopathy (DCM) patients in compared with normal subjects. Patients and Methods: Twenty-six DCM patients and Twenty-four normal subjects were assessed. Echocardiographic images of the short axis apical and basal views of LV were processed by VVI software to measure peak rotation degrees and also peak rotation rates in systole. LV twist was well-defined as the net difference between apical and basal rotation values and also LV torsion was considered as LV twist divided by left ventricular diastolic longitudinal length. In addition, peak untwisting value and untwisting rate were measured in diastole too. Results: LV twist value (5.54 ± 1.94° in DCM VS. 11.5 ± 2.45° in control group) and also LV torsion (0.71 ± 0.28°/cm in DCM VS. 1.53 ± 0.42°/cm in control group) were significantly decreased in DCM patients compared with normal group (P < 0.001 for both); also, the twisting rate was notably lower in DCM vs. control (38.68 ± 14.43°/s in DCM vs. 75.88 ± 17.25°/s in control; P < 0.001) and also untwisting rate (36.28 ± 13.48°/s in DCM vs. -73.79 ± 24.45°/s in control; P < 0.001), However normalization of these times for systolic duration or LV length creates different values. Conclusions: LV twist, torsion and untwist and also rate of them are significantly impaired in DCM and this impairment is well-related to LV global systolic and diastolic dysfunction. VVI is a new noninvasive technique that can be used to evaluate LV torsional parameters.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"270 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134444402","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}
A 24-year-old male, diagnosed with post myocarditis dilated cardiomyopathy (DCM), presented with dyspnea and body swelling. On examination, he was ill-looking. Blood pressure was 90/60 mm Hg and his heart rate was 110 beats per minutes. Upon physical examination, pitting edema was noted in bilateral lower extremities and a S3 gallop sound was audible. Jugular venous pulse was raised. Chest X-ray showed cardiomegaly with pulmonary congestion. Electrocardiography showed sinus tachycardia. The cardiac enzymes were within the normal range. What is the echocardio graphic diagnosis based on the Figure 1 and videos 1,2?
{"title":"Simultaneous left ventricle and left atrial appendage thrombi in a patient with dilated cardiomyopathy","authors":"L. Dubey, Ridhi Adhikari","doi":"10.5812/acvi.23631","DOIUrl":"https://doi.org/10.5812/acvi.23631","url":null,"abstract":"A 24-year-old male, diagnosed with post myocarditis dilated cardiomyopathy (DCM), presented with dyspnea and body swelling. On examination, he was ill-looking. Blood pressure was 90/60 mm Hg and his heart rate was 110 beats per minutes. Upon physical examination, pitting edema was noted in bilateral lower extremities and a S3 gallop sound was audible. Jugular venous pulse was raised. Chest X-ray showed cardiomegaly with pulmonary congestion. Electrocardiography showed sinus tachycardia. The cardiac enzymes were within the normal range. What is the echocardio graphic diagnosis based on the Figure 1 and videos 1,2?","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128727062","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}
N. Behzadnia, B. Kashani, M. Mirhosseini, A. Moradi, G. Radmand, Z. Ahmadi
Background: In patients with advanced heart failure, significant improvement in pharmacological and non-pharmacological treatment strategies has conferred better survival rates and quality of life. Objectives: This is a report on echocardiographic findings in heart transplantation (HTx) patients in their first 5 postoperative months. Patients and Methods: Twenty patients undergoing HTx between September 2009 and July 2010 whose clinical and echocardiographic findings had been registered monthly for 5 months after HTx were enrolled. Results: Eleven males and five females at a mean age of 33 years [range = 17-58 years] were enrolled in the study. The mean of the left ventricular ejection fraction (LVEF) was 52 ± 8.2 % and 58 ± 2.5 % on the first day and at 5 months after HTx, respectively. There was no LV enlargement at 5 months' follow-up. The right ventricle (RV) was mildly enlarged, but the reduced baseline RV function showed improvement at the 5th postoperative month (mean TAPSE was 11.7 ± 3.3 mm on the first post-HTx day versus 17.2 ± 6.3 mm after 5 months; P < 0.005). The pulmonary arterial pressure was slightly elevated at baseline, and it showed no significant decrease 5 months after HTx. More than 90% of the cases showed only mild tricuspid regurgitation at 5 months' follow-up. The tissue Doppler imaging-derived velocities of the medial and lateral mitral annuli and the tricuspid annulus demonstrated a gradual increment during the follow-up and reached their highest value at 5 months' follow-up. Conclusions: The cardiac grafts at 5 months' post-HTx follow-up were characterized by normal LV dimensions and EF. Also, RV dysfunction and tricuspid regurgitation were frequent findings, but they were not associated with the clinical signs of congestive heart failure, morbidity, and mortality in the majority of our patients.
背景:在晚期心力衰竭患者中,药物和非药物治疗策略的显著改善赋予了更好的生存率和生活质量。目的:报告心脏移植(HTx)患者术后5个月的超声心动图表现。患者与方法:入选2009年9月至2010年7月期间接受HTx治疗的20例患者,这些患者在HTx治疗后5个月内每月登记一次临床和超声心动图表现。结果:11名男性和5名女性被纳入研究,平均年龄33岁[范围= 17-58岁]。HTx术后第1天和5个月左室射血分数(LVEF)平均值分别为52±8.2%和58±2.5%。随访5个月未见左室扩大。右心室(RV)轻度增大,但减少的基线RV功能在术后第5个月有所改善(htx术后第一天的平均TAPSE为11.7±3.3 mm, 5个月后为17.2±6.3 mm;P < 0.005)。肺动脉压在基线时略有升高,HTx后5个月无明显下降。超过90%的病例在随访5个月时仅出现轻度三尖瓣反流。二尖瓣内、外侧环和三尖瓣环的组织多普勒成像速度在随访期间逐渐增加,并在随访5个月时达到最高值。结论:经htx术后5个月随访,心脏移植物左室尺寸和心功能正常。此外,右心室功能障碍和三尖瓣反流是常见的发现,但在我们的大多数患者中,它们与充血性心力衰竭的临床症状、发病率和死亡率无关。
{"title":"Echocardiographic evaluation of orthotopic heart transplantation: Single-Center experience","authors":"N. Behzadnia, B. Kashani, M. Mirhosseini, A. Moradi, G. Radmand, Z. Ahmadi","doi":"10.5812/acvi.24391","DOIUrl":"https://doi.org/10.5812/acvi.24391","url":null,"abstract":"Background: In patients with advanced heart failure, significant improvement in pharmacological and non-pharmacological treatment strategies has conferred better survival rates and quality of life. Objectives: This is a report on echocardiographic findings in heart transplantation (HTx) patients in their first 5 postoperative months. Patients and Methods: Twenty patients undergoing HTx between September 2009 and July 2010 whose clinical and echocardiographic findings had been registered monthly for 5 months after HTx were enrolled. Results: Eleven males and five females at a mean age of 33 years [range = 17-58 years] were enrolled in the study. The mean of the left ventricular ejection fraction (LVEF) was 52 ± 8.2 % and 58 ± 2.5 % on the first day and at 5 months after HTx, respectively. There was no LV enlargement at 5 months' follow-up. The right ventricle (RV) was mildly enlarged, but the reduced baseline RV function showed improvement at the 5th postoperative month (mean TAPSE was 11.7 ± 3.3 mm on the first post-HTx day versus 17.2 ± 6.3 mm after 5 months; P < 0.005). The pulmonary arterial pressure was slightly elevated at baseline, and it showed no significant decrease 5 months after HTx. More than 90% of the cases showed only mild tricuspid regurgitation at 5 months' follow-up. The tissue Doppler imaging-derived velocities of the medial and lateral mitral annuli and the tricuspid annulus demonstrated a gradual increment during the follow-up and reached their highest value at 5 months' follow-up. Conclusions: The cardiac grafts at 5 months' post-HTx follow-up were characterized by normal LV dimensions and EF. Also, RV dysfunction and tricuspid regurgitation were frequent findings, but they were not associated with the clinical signs of congestive heart failure, morbidity, and mortality in the majority of our patients.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129956478","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}