Introduction: Electrocardiography (ECG)-gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) for the diagnosis and prognosis of coronary artery disease (CAD) is the most commonly performed imaging procedure in nuclear cardiology. Case Presentation: A 67-year-old man underwent exercise electrocardiography (ECG)-gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) for evaluating his mild dyspnea on exertion (New York Heart Association class I). Images showed inducible ischemia of severe intensity in the interior walls and moderate intensity in the apicoseptal and anteroseptal segments, but exercise stress to induce coronary hyperemia revealed marked ST-segment depressions in low heart rates and the patient complained of only mild dyspnea during these ECG changes. He subsequently underwent coronary angiography, which revealed left main and severe three-vessel disease. This discrepancy between the SPECT perfusion images and the extent of coronary artery disease in this case represents the masking of one ischemic territory (left system) by another more severely ischemic territory (right system). Discussion: The reason is that we assess the relative and not absolute differences of the tracer uptake in this imaging modality. There may be other findings on MPI images which could help us overcome this pitfall, including detecting wall motion abnormalities, lung uptake of the tracer, or transient ischemic dilation. Another important issue is the ECG changes during exercise stress testing, which could point to a more extensive coronary artery disease than the one detected on MPI images alone.
{"title":"Masked ischemia on myocardial perfusion imaging: A case example","authors":"A. Gholoobi","doi":"10.5812/acvi.19700","DOIUrl":"https://doi.org/10.5812/acvi.19700","url":null,"abstract":"Introduction: Electrocardiography (ECG)-gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) for the diagnosis and prognosis of coronary artery disease (CAD) is the most commonly performed imaging procedure in nuclear cardiology. Case Presentation: A 67-year-old man underwent exercise electrocardiography (ECG)-gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) for evaluating his mild dyspnea on exertion (New York Heart Association class I). Images showed inducible ischemia of severe intensity in the interior walls and moderate intensity in the apicoseptal and anteroseptal segments, but exercise stress to induce coronary hyperemia revealed marked ST-segment depressions in low heart rates and the patient complained of only mild dyspnea during these ECG changes. He subsequently underwent coronary angiography, which revealed left main and severe three-vessel disease. This discrepancy between the SPECT perfusion images and the extent of coronary artery disease in this case represents the masking of one ischemic territory (left system) by another more severely ischemic territory (right system). Discussion: The reason is that we assess the relative and not absolute differences of the tracer uptake in this imaging modality. There may be other findings on MPI images which could help us overcome this pitfall, including detecting wall motion abnormalities, lung uptake of the tracer, or transient ischemic dilation. Another important issue is the ECG changes during exercise stress testing, which could point to a more extensive coronary artery disease than the one detected on MPI images alone.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128666680","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}
Valvular heart disease is a considerable finding in the antiphospholipid antibody syndrome (APS). The involvement of the mitral and aortic valves is more common in the form of leaflet thickening or aseptic verrucous vegetations called the Libman-Sacks endocarditis. In addition to the detrimental effects of endocarditis on the valves, it can lead to serious thromboembolic complications. Here we report our experience with a young woman, who had a history of transient ischemic attack 2 months earlier and referred to us due to severe vaginal bleeding. On echocardiography, several irregular masses were observed on the atrial side of both mitral valve leaflets. On rheumatologic work-up, she was found to have positive anticardiolipin IgG and lupus anticoagulant. During hospitalization, the patient suffered thrombotic stroke and computed tomography (CT) scan showed a parietal lobe ischemic lesion. With evidence of positive antiphospholipid antibodies and arterial thrombosis, negative blood culture, and no fever, the diagnosis of the Libman-Sacks endocarditis was established. The patient was discharged with good general condition and received Hydroxychloroquine, Warfarin, and Prednisolone. On follow-up echocardiography, intra-cardiac masses were not detected any more and no residual neurologic deficits were found.
{"title":"Libman-Sacks endocarditis and cerebral infarction in antiphospholipid syndrome: A case report","authors":"Farahnaz Nikdoust, Mansoureh Eghbalnezhad","doi":"10.5812/acvi.21344","DOIUrl":"https://doi.org/10.5812/acvi.21344","url":null,"abstract":"Valvular heart disease is a considerable finding in the antiphospholipid antibody syndrome (APS). The involvement of the mitral and aortic valves is more common in the form of leaflet thickening or aseptic verrucous vegetations called the Libman-Sacks endocarditis. In addition to the detrimental effects of endocarditis on the valves, it can lead to serious thromboembolic complications. Here we report our experience with a young woman, who had a history of transient ischemic attack 2 months earlier and referred to us due to severe vaginal bleeding. On echocardiography, several irregular masses were observed on the atrial side of both mitral valve leaflets. On rheumatologic work-up, she was found to have positive anticardiolipin IgG and lupus anticoagulant. During hospitalization, the patient suffered thrombotic stroke and computed tomography (CT) scan showed a parietal lobe ischemic lesion. With evidence of positive antiphospholipid antibodies and arterial thrombosis, negative blood culture, and no fever, the diagnosis of the Libman-Sacks endocarditis was established. The patient was discharged with good general condition and received Hydroxychloroquine, Warfarin, and Prednisolone. On follow-up echocardiography, intra-cardiac masses were not detected any more and no residual neurologic deficits were found.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126423045","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 combination of the aging of the population and improved survival after acute myocardial infarction has created a rapid growth in the number of patients currently living with chronic heart failure, with a concomitant increase in morbidity and mortality. Case Presentation: We present two case reports of post-myocardial infarction sequel leading to ischemic cardiomyopathy and peripartum cardiomyopathy leading to biventricular mural thrombi formation and provide a brief review of literature regarding their etiopathogenesis and management. Discussion: There are other causes of dilated cardiomyopathies which could be transient like peripartum cardiomyopathy. The development of biventricular mural thrombi is rare, and it mainly increases the risk of embolization in the systemic and pulmonary circulations.
{"title":"Biventricular mural thrombi in patients with dilated cardiomyopathies: Case reports and review","authors":"P. Jariwala","doi":"10.5812/acvi.19863","DOIUrl":"https://doi.org/10.5812/acvi.19863","url":null,"abstract":"Introduction: The combination of the aging of the population and improved survival after acute myocardial infarction has created a rapid growth in the number of patients currently living with chronic heart failure, with a concomitant increase in morbidity and mortality. Case Presentation: We present two case reports of post-myocardial infarction sequel leading to ischemic cardiomyopathy and peripartum cardiomyopathy leading to biventricular mural thrombi formation and provide a brief review of literature regarding their etiopathogenesis and management. Discussion: There are other causes of dilated cardiomyopathies which could be transient like peripartum cardiomyopathy. The development of biventricular mural thrombi is rare, and it mainly increases the risk of embolization in the systemic and pulmonary circulations.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125835664","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}
S. Altay, C. Altay, N. Erdoğan, Ş. Karasu, O. Oyar
The most frequent congenital heart defects in the neonatal period are ventricular septal defects. Ventricular septal aneurysms can rarely develop from an interventricular septal (IVS) defect in adults. We describe a 47-year-old man with an aneurysm in the IVS growing towards the right ventricle, which was confirmed by cardiac computed tomographic angiography and was missed by echocardiography.
{"title":"Cardiac CT angiography of a membranous ventricular septal aneurysm short title: Ventricular septal aneurysm","authors":"S. Altay, C. Altay, N. Erdoğan, Ş. Karasu, O. Oyar","doi":"10.5812/acvi.19805","DOIUrl":"https://doi.org/10.5812/acvi.19805","url":null,"abstract":"The most frequent congenital heart defects in the neonatal period are ventricular septal defects. Ventricular septal aneurysms can rarely develop from an interventricular septal (IVS) defect in adults. We describe a 47-year-old man with an aneurysm in the IVS growing towards the right ventricle, which was confirmed by cardiac computed tomographic angiography and was missed by echocardiography.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"168 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114260975","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}
We read with great interest the article entitled "Echocardiographic abnormalities in patients with sleep apnea syndrome", published online in Archives of Cardiovascular Imaging on January 12th, 2014 (1). The authors sought to determine the cardiovascular disorder at an early stage in patients with sleep apnea syndrome (OSA) with different echocardiographic parameters. They found both relative left ventricular systolic and diastolic dysfunction and dysfunction at some echocardiographic parameters of the right ventricle. We have some comments about this study. Firstly, there is a major concern about the methodology of the study. The study group consists of male subjects whose disease duration is not known. To our knowledge, the disease is frequently seen in woman patients too (2). Furthermore, the disease duration is not known for the subjects. Thus, comparison of the results is not appropriate: for example, suppose that there is a patient with mild OSA of 10 years' duration and there is also another patient with severe OSA of 3-4 years' duration. The authors have mentioned this point in the limitations section, but it should be written in the patients and methods section. Secondly, the fact that the study is not the first study in the literature on the subject was not mentioned in the references. Aslan et al. published their work in Cardiology Journal in 2013 (3). They studied 80 patients with the OSA syndrome while excluding those with hypertension, diabetes, or any known cardiac disease, which makes their study more reliable. They divided the patients into two groups of normal/mild OSA group and moderate/ severe OSA group. Their study, however, was not as comprehensive as the original study. Tissue Doppler echocardiography showed that early diastolic myocardial velocity was lower in the second group (21 ± 5.6/s in group 1 vs. 18.3 ± 5.3 cm/s in group 2; P = 0.01). They concluded that left ventricular (LV) diastolic dysfunction, hypertrophy, and left atrial dilatation occurred in the OSA patients even before the development of hypertension and other cardiovascular disease. In the original study, strain imaging was used and changes at the basal septum strain rate (P =0.005) were associated with OSA severity. We should note that strain imaging is a new and more reliable method in terms of diastolic function. Thirdly, Cicek et al. prospectively studied 64 patients in terms of echocardiographic and aortic parameters (4). Their study was not as comprehensive as the present one with respect to echocardiographic examinations. They found that the LV systolic function did not differ between groups, which was a different result from the present study. They also concluded that the LV diastolic function and aortic elastic parameters deteriorate with the severity of OSA. The different result in terms of the LV systolic function might be due to the small number of subjects in both studies. In conclusion, we thank our colleagues for their effort to encourage us
我们饶有兴趣地阅读了2014年1月12日《Archives of Cardiovascular Imaging》在线发表的题为“睡眠呼吸暂停综合征患者的超声心动图异常”的文章。作者试图通过不同的超声心动图参数来确定睡眠呼吸暂停综合征(OSA)患者早期的心血管疾病。他们发现左心室收缩期和舒张期的相对功能障碍以及右心室的一些超声心动图参数的功能障碍。我们对这项研究有一些看法。首先，有一个主要关注的研究方法。该研究组由男性受试者组成，其病程尚不清楚。据我们所知，这种疾病也常见于女性患者(2)。此外，受试者的病程尚不清楚。因此，对结果进行比较是不合适的:例如，假设有一个病程为10年的轻度OSA患者，还有一个病程为3-4年的重度OSA患者。作者在局限性部分提到了这一点，但它应该写在患者和方法部分。其次，参考文献中没有提到这项研究不是关于该主题的第一项研究。Aslan等人在2013年的Cardiology Journal上发表了他们的研究成果(3)，他们研究了80例OSA综合征患者，同时排除了高血压、糖尿病或任何已知的心脏病患者，这使得他们的研究更加可靠。将患者分为正常/轻度OSA组和中度/重度OSA组。然而，他们的研究并不像最初的研究那样全面。组织多普勒超声心动图显示，第二组舒张期早期心肌速度较低(1组为21±5.6/s, 2组为18.3±5.3 cm/s);P = 0.01)。他们得出结论，OSA患者的左室舒张功能障碍、肥厚和左房扩张甚至在高血压和其他心血管疾病发生之前就已经发生。在最初的研究中，使用了应变成像，基底隔应变率的变化(P =0.005)与OSA严重程度相关。我们应该注意到应变成像在舒张功能方面是一种新的更可靠的方法。第三，Cicek等人对64例患者的超声心动图和主动脉参数进行了前瞻性研究(4)。他们的研究在超声心动图检查方面没有我们的研究那么全面。他们发现左室收缩功能在两组之间没有差异，这与本研究的结果不同。他们还得出结论，左室舒张功能和主动脉弹性参数随着OSA的严重程度而恶化。在左室收缩功能方面的不同结果可能是由于两项研究的受试者数量较少。最后，我们感谢我们的同事努力鼓励我们思考这种疾病。我们认为本研究的方法不适合得出左室和右室功能的结论，需要进一步的研究来得出强有力的结论。我们可能通过另一项研究获得关于OSA患者心血管功能的更好信息。的确，未来的研究应该招募女性受试者和已知病程的受试者，排除高血压、糖尿病和其他心血管疾病患者。
{"title":"An invitation for rethinking about echocardiographic abnormalities in patients with sleep apnea syndrome","authors":"U. Eryılmaz, D. Çiçek, T. Ilgenli","doi":"10.5812/acvi.20175","DOIUrl":"https://doi.org/10.5812/acvi.20175","url":null,"abstract":"We read with great interest the article entitled \"Echocardiographic abnormalities in patients with sleep apnea syndrome\", published online in Archives of Cardiovascular Imaging on January 12th, 2014 (1). The authors sought to determine the cardiovascular disorder at an early stage in patients with sleep apnea syndrome (OSA) with different echocardiographic parameters. They found both relative left ventricular systolic and diastolic dysfunction and dysfunction at some echocardiographic parameters of the right ventricle. We have some comments about this study. Firstly, there is a major concern about the methodology of the study. The study group consists of male subjects whose disease duration is not known. To our knowledge, the disease is frequently seen in woman patients too (2). Furthermore, the disease duration is not known for the subjects. Thus, comparison of the results is not appropriate: for example, suppose that there is a patient with mild OSA of 10 years' duration and there is also another patient with severe OSA of 3-4 years' duration. The authors have mentioned this point in the limitations section, but it should be written in the patients and methods section. Secondly, the fact that the study is not the first study in the literature on the subject was not mentioned in the references. Aslan et al. published their work in Cardiology Journal in 2013 (3). They studied 80 patients with the OSA syndrome while excluding those with hypertension, diabetes, or any known cardiac disease, which makes their study more reliable. They divided the patients into two groups of normal/mild OSA group and moderate/ severe OSA group. Their study, however, was not as comprehensive as the original study. Tissue Doppler echocardiography showed that early diastolic myocardial velocity was lower in the second group (21 ± 5.6/s in group 1 vs. 18.3 ± 5.3 cm/s in group 2; P = 0.01). They concluded that left ventricular (LV) diastolic dysfunction, hypertrophy, and left atrial dilatation occurred in the OSA patients even before the development of hypertension and other cardiovascular disease. In the original study, strain imaging was used and changes at the basal septum strain rate (P =0.005) were associated with OSA severity. We should note that strain imaging is a new and more reliable method in terms of diastolic function. Thirdly, Cicek et al. prospectively studied 64 patients in terms of echocardiographic and aortic parameters (4). Their study was not as comprehensive as the present one with respect to echocardiographic examinations. They found that the LV systolic function did not differ between groups, which was a different result from the present study. They also concluded that the LV diastolic function and aortic elastic parameters deteriorate with the severity of OSA. The different result in terms of the LV systolic function might be due to the small number of subjects in both studies. In conclusion, we thank our colleagues for their effort to encourage us","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123781145","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. Samiei, N. Hadizadeh, M. Borji, A. Hashemi, Mozhgan Parsaee, M. Esmaeilzadeh., Z. Haghighi
Background: Some studies have evaluated the right ventricular (RV) function in volume-overload and pressure-overload conditions and have always categorized pulmonary arterial hypertension (PAH) in the latter group. However, PAH and pulmonary stenosis (PS) are two frequent diseases, both resulting in the RV pressure overload. Objectives: The aim of this study was to evaluate the RV response to two causes of the RV pressure overload: severe PAH and PS. Patients and Methods: Eighteen patients with PAH at a mean age of 43 ± 12 years (66.6% female) and 16 patients with PS at a mean age of 33 ± 17 years (56.35% female) were enrolled. Standard echocardiography, tissue Doppler, and longitudinal strain imaging at the base, mid, and apical levels of the RV free wall were done. Results: Significant tricuspid regurgitation was more prevalent in the PAH group than in the PS group (61% vs. 18.5%; P < 0.001). The abnormalities in the RV myocardial performance index, RV areas, and RV fractional area change were significantly more robust in the PAH group (all Ps < 0.05) despite the higher net RV systolic pressure in the PS group as compared to the PAH group (121 ± 39 vs. 88 ± 26 mmHg; P < 0.001). Conclusions: It seems that severe PAH aggravates the RV function more severely.
背景:一些研究评估了右心室(RV)在容量过载和压力过载情况下的功能，并将肺动脉高压(PAH)归为后一组。然而，PAH和肺动脉狭窄(PS)是两种常见疾病，均导致右心室压力过载。目的:本研究的目的是评估RV对两种原因的反应:严重PAH和PS。患者和方法:18例PAH患者平均年龄为43±12岁(66.6%)，16例PS患者平均年龄为33±17岁(56.35%)。标准超声心动图、组织多普勒和纵向应变成像在左心室游离壁的基部、中部和根尖水平。结果:PAH组明显的三尖瓣反流比PS组更普遍(61% vs. 18.5%;P < 0.001)。尽管PAH组右心室净收缩压高于PAH组(121±39比88±26 mmHg)，但PAH组右心室心肌功能指数、右心室面积和右心室分数面积变化的异常更为明显(均p < 0.05);P < 0.001)。结论:重度PAH对RV功能的影响似乎更为严重。
{"title":"Which type of right ventricular pressure overload is worse? An echocardiographic comparison between pulmonary stenosis and pulmonary arterial hypertension","authors":"N. Samiei, N. Hadizadeh, M. Borji, A. Hashemi, Mozhgan Parsaee, M. Esmaeilzadeh., Z. Haghighi","doi":"10.5812/acvi.22232","DOIUrl":"https://doi.org/10.5812/acvi.22232","url":null,"abstract":"Background: Some studies have evaluated the right ventricular (RV) function in volume-overload and pressure-overload conditions and have always categorized pulmonary arterial hypertension (PAH) in the latter group. However, PAH and pulmonary stenosis (PS) are two frequent diseases, both resulting in the RV pressure overload. Objectives: The aim of this study was to evaluate the RV response to two causes of the RV pressure overload: severe PAH and PS. Patients and Methods: Eighteen patients with PAH at a mean age of 43 ± 12 years (66.6% female) and 16 patients with PS at a mean age of 33 ± 17 years (56.35% female) were enrolled. Standard echocardiography, tissue Doppler, and longitudinal strain imaging at the base, mid, and apical levels of the RV free wall were done. Results: Significant tricuspid regurgitation was more prevalent in the PAH group than in the PS group (61% vs. 18.5%; P < 0.001). The abnormalities in the RV myocardial performance index, RV areas, and RV fractional area change were significantly more robust in the PAH group (all Ps < 0.05) despite the higher net RV systolic pressure in the PS group as compared to the PAH group (121 ± 39 vs. 88 ± 26 mmHg; P < 0.001). Conclusions: It seems that severe PAH aggravates the RV function more severely.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"440 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125777753","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. Sadeghpour, A. Alizadehasl, A. Diz, M. Akbarzadeh, N. Rezaeian, Mahbubeh Zeighami, A. Hashemi
Background: Differentiating ischemic from nonischemic cardiomyopathy is important both prognostically and therapeutically, although it may be difficult clinically. Objectives: We aimed to determine the diagnostic power of Cardiogoniometry (CGM) in the differentiation of the ischemic from the nonischemic etiology of left bundle branch block (LBBB). Patients and Methods: We studied 37 patients with LBBB on the electrocardiogram (ECG) and left ventricular ejection fraction (LVEF) <30%. All of them underwent coronary angiography, and 33 patients were included. Eighteen patients were categorized as the ischemic cardiomyopathy group, and 15 patients with normal coronary angiography were assigned to the nonischemic cardiomyopathy group. Then, CGM parameters were studied and compared between the two groups. Results: Both ischemic and nonischemic cardiomyopathy groups were similar in age, LVEF, weight, height, and body mass index. Interestingly, there were no significant differences in the average value of the 40 CGM parameters that were analyzed in this study between the two study groups. Conclusions: When LBBB is the underlying rhythm, CGM cannot differentiate ischemic from nonischemic patients with good accuracy. Large studies, however, are needed to confirm our results.
{"title":"Is there any difference in cardiogoniometry parameters of ischemic and nonischemic cardiomyopathy in patients with left bundle branch block?","authors":"A. Sadeghpour, A. Alizadehasl, A. Diz, M. Akbarzadeh, N. Rezaeian, Mahbubeh Zeighami, A. Hashemi","doi":"10.5812/acvi.22903","DOIUrl":"https://doi.org/10.5812/acvi.22903","url":null,"abstract":"Background: Differentiating ischemic from nonischemic cardiomyopathy is important both prognostically and therapeutically, although it may be difficult clinically. Objectives: We aimed to determine the diagnostic power of Cardiogoniometry (CGM) in the differentiation of the ischemic from the nonischemic etiology of left bundle branch block (LBBB). Patients and Methods: We studied 37 patients with LBBB on the electrocardiogram (ECG) and left ventricular ejection fraction (LVEF) <30%. All of them underwent coronary angiography, and 33 patients were included. Eighteen patients were categorized as the ischemic cardiomyopathy group, and 15 patients with normal coronary angiography were assigned to the nonischemic cardiomyopathy group. Then, CGM parameters were studied and compared between the two groups. Results: Both ischemic and nonischemic cardiomyopathy groups were similar in age, LVEF, weight, height, and body mass index. Interestingly, there were no significant differences in the average value of the 40 CGM parameters that were analyzed in this study between the two study groups. Conclusions: When LBBB is the underlying rhythm, CGM cannot differentiate ischemic from nonischemic patients with good accuracy. Large studies, however, are needed to confirm our results.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114787421","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}
H. Poorzand, A. Abdollahi, Mostafa Sajadian, T. Moghiman
Background: The left ventricular ejection fraction (LVEF) measurement is a common tool for evaluating the LV systolic function. The application of the global longitudinal systolic strain (GLS) parameter in the assessment of the myocardial function has also received special attention recently. Objectives: This study was aimed at comparing the LVEF and LV volumes obtained by the two methods of catheterization and two-dimensional (2D) echocardiography (available in our institution) and assessing the correlation between the LVEF and the GLS. Patients and Methods: In this cross-sectional study, 45 patients were recruited from coronary angiography candidates. The patients underwent echocardiography immediately before catheterization. The LVEF and LV volumes were measured via echocardiography using the apical four- and two chamber-views. The GLS was calculated through the automated functional imaging algorithm. Left ventriculography was performed by calculating the LVEF in the right and left oblique views. Results: The LVEF values obtained by the two methods of ventriculography and echocardiography were not significantly different. The highest correlation regarding the echocardiographic LVEF was obtained in the angiographic right anterior oblique view (P < 0.001, r = 0.95). There was a good agreement as regards the biplane LVEF between 2D echocardiography and ventriculography (-0.5 ± 13.27; CI of 95%). The GLS showed a signi.cant correlation with the estimated EF in both methods, the highest being with the Biplane Simpson method (r = -0.84; P < 0.001). Linear regression was used to obtain the formula for estimating the 2D LVEF from the GLS [LVEF = 2.53 (GLS) + 10.48]. The GLS values ≤ -11.7 and ≥ -21.7% were consistent with normal and severe global LV systolic dysfunction, respectively. The inter- and intra-observer agreement was more evident in the GLS measurement rather than in the LVEF. Conclusions: Despite the widespread use of 2D LVEF and its good agreement with ventriculography, strain analysis seems to be more reliable as a quantitative tool for ventricular assessment.
{"title":"Left ventricular volume and function assessment: a comparison study between echocardiography and ventriculography","authors":"H. Poorzand, A. Abdollahi, Mostafa Sajadian, T. Moghiman","doi":"10.5812/acvi.20737","DOIUrl":"https://doi.org/10.5812/acvi.20737","url":null,"abstract":"Background: The left ventricular ejection fraction (LVEF) measurement is a common tool for evaluating the LV systolic function. The application of the global longitudinal systolic strain (GLS) parameter in the assessment of the myocardial function has also received special attention recently. Objectives: This study was aimed at comparing the LVEF and LV volumes obtained by the two methods of catheterization and two-dimensional (2D) echocardiography (available in our institution) and assessing the correlation between the LVEF and the GLS. Patients and Methods: In this cross-sectional study, 45 patients were recruited from coronary angiography candidates. The patients underwent echocardiography immediately before catheterization. The LVEF and LV volumes were measured via echocardiography using the apical four- and two chamber-views. The GLS was calculated through the automated functional imaging algorithm. Left ventriculography was performed by calculating the LVEF in the right and left oblique views. Results: The LVEF values obtained by the two methods of ventriculography and echocardiography were not significantly different. The highest correlation regarding the echocardiographic LVEF was obtained in the angiographic right anterior oblique view (P < 0.001, r = 0.95). There was a good agreement as regards the biplane LVEF between 2D echocardiography and ventriculography (-0.5 ± 13.27; CI of 95%). The GLS showed a signi.cant correlation with the estimated EF in both methods, the highest being with the Biplane Simpson method (r = -0.84; P < 0.001). Linear regression was used to obtain the formula for estimating the 2D LVEF from the GLS [LVEF = 2.53 (GLS) + 10.48]. The GLS values ≤ -11.7 and ≥ -21.7% were consistent with normal and severe global LV systolic dysfunction, respectively. The inter- and intra-observer agreement was more evident in the GLS measurement rather than in the LVEF. Conclusions: Despite the widespread use of 2D LVEF and its good agreement with ventriculography, strain analysis seems to be more reliable as a quantitative tool for ventricular assessment.","PeriodicalId":429543,"journal":{"name":"Archives of Cardiovascular Imaging","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133111436","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：