Duygu Inan MD, Omer Abdel Hadi MD, Ufuk Yildiz MD, Serap Bas MD, Alev Kılıcgedik MD
A 39-year-old woman with intermittent palpitations, psoriasis, and a family history of sudden death presented with dilated right heart chambers and an enlarged coronary sinus. Despite a normal bubble study, further evaluation with transesophageal echocardiography revealed an abnormal pulmonary venous return: the left pulmonary veins drained into the coronary sinus. Cardiac computed tomography confirmed this finding, suggesting a partial abnormal pulmonary venous return as the underlying issue. Cardiac catheterization indicated increased pulmonary artery flow with normal pulmonary vascular resistance. The patient was referred for surgery. In this pathway involving the differential diagnosis of right heart dilatation, despite a confusing history and conflicting findings, echocardiographic clues led to the diagnosis.
{"title":"Let's put the clues together and find the aetiology in this patient with dilated right heart!","authors":"Duygu Inan MD, Omer Abdel Hadi MD, Ufuk Yildiz MD, Serap Bas MD, Alev Kılıcgedik MD","doi":"10.1111/echo.15920","DOIUrl":"10.1111/echo.15920","url":null,"abstract":"<p>A 39-year-old woman with intermittent palpitations, psoriasis, and a family history of sudden death presented with dilated right heart chambers and an enlarged coronary sinus. Despite a normal bubble study, further evaluation with transesophageal echocardiography revealed an abnormal pulmonary venous return: the left pulmonary veins drained into the coronary sinus. Cardiac computed tomography confirmed this finding, suggesting a partial abnormal pulmonary venous return as the underlying issue. Cardiac catheterization indicated increased pulmonary artery flow with normal pulmonary vascular resistance. The patient was referred for surgery. In this pathway involving the differential diagnosis of right heart dilatation, despite a confusing history and conflicting findings, echocardiographic clues led to the diagnosis.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 9","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despite being a rare phenomenon, pericardial hydatid cysts present unique diagnostic challenges and require a multimodality imaging as well as a multidisciplinary approach for a curative management. The authors here present a case of a middle aged man who was referred to them for management of new onset atrial flutter with mitral regurgitation.
{"title":"Pericardial hydatid cysts presenting with atrial flutter and mitral regurgitation","authors":"Bhavik Sandip Shah MBBS, MD, DM, Abhinav Anand DM, Girish Sabnis MD, DM","doi":"10.1111/echo.15914","DOIUrl":"10.1111/echo.15914","url":null,"abstract":"<p>Despite being a rare phenomenon, pericardial hydatid cysts present unique diagnostic challenges and require a multimodality imaging as well as a multidisciplinary approach for a curative management. The authors here present a case of a middle aged man who was referred to them for management of new onset atrial flutter with mitral regurgitation.\u0000\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 9","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ida Arentz Taraldsen MD, Rasmus Mogelvang MD, PhD, Frederik Fasth Grund MD, PhD, Christian Hassager MD, DMSc, Peter Søgaard MD, DMSc, Charlotte Burup Kristensen MD, PhD
Aims
Echocardiographic diastolic parameters are used to diagnose and monitor increased left ventricular filling pressure (LVFP) and we hypothesized that increased loading conditions cause increased E/e′. Our aim was to assess the effect of preload augmentation on diastolic parameters among both healthy subjects and subjects with known cardiac disease.
Methods and results
We included 129 subjects merged from two cohorts; one dialysis cohort (n = 47) and one infusion cohort (n = 82). Echocardiography was performed immediately before and after hemodialysis (HD) or saline infusion, under low and high loading conditions. Elevated LVFP was defined as septal E/e′ ≥ 15 and/or lateral E/e′ ≥ 13 at high-loading conditions. The population was divided according to elevated LVFP (n = 31) and normal LVFP (n = 98). The load difference for the population was 972 ± 460 mL, with no differences in load difference between elevated and normal LVFP (p NS). The subjects with elevated LVFP were older (63 ± 11 vs. 46 ± 16 years, p < .001), and had lower LV ejection fraction (50 ± 14 vs. 59 ± 8.1%, p < .01). After augmented preload, EDV increased in the normal LVFP group (p < .01) but remained unchanged in the elevated LVFP group (p NS). Both E and e′ increased among the subjects with normal LVFP, whereas E/e′ remained unchanged (∆E/e′ +.1 [-.5–1.2]), p NS). Among the subjects with elevated, LVFP we observed increased E but not e′, resulting in significantly increased E/e′ (∆ average E/e′ +2.4 [0–4.0], p< .01).
Conclusion
Augmented preload does not seem to affect E/e′ among subjects with normal LVFP, whereas E/e′ seems to increase significantly among subjects with elevated LVFP.
{"title":"Increased preload and echocardiographic assessment of diastolic function","authors":"Ida Arentz Taraldsen MD, Rasmus Mogelvang MD, PhD, Frederik Fasth Grund MD, PhD, Christian Hassager MD, DMSc, Peter Søgaard MD, DMSc, Charlotte Burup Kristensen MD, PhD","doi":"10.1111/echo.15917","DOIUrl":"10.1111/echo.15917","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Echocardiographic diastolic parameters are used to diagnose and monitor increased left ventricular filling pressure (LVFP) and we hypothesized that increased loading conditions cause increased E/e′. Our aim was to assess the effect of preload augmentation on diastolic parameters among both healthy subjects and subjects with known cardiac disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>We included 129 subjects merged from two cohorts; one dialysis cohort (<i>n</i> = 47) and one infusion cohort (<i>n</i> = 82). Echocardiography was performed immediately before and after hemodialysis (HD) or saline infusion, under low and high loading conditions. Elevated LVFP was defined as septal E/e′ ≥ 15 and/or lateral E/e′ ≥ 13 at high-loading conditions. The population was divided according to elevated LVFP (<i>n</i> = 31) and normal LVFP (<i>n</i> = 98). The load difference for the population was 972 ± 460 mL, with no differences in load difference between elevated and normal LVFP (<i>p NS</i>). The subjects with elevated LVFP were older (63 ± 11 vs. 46 ± 16 years, <i>p <</i> .001), and had lower LV ejection fraction (50 ± 14 vs. 59 ± 8.1%, <i>p <</i> .01). After augmented preload, EDV increased in the normal LVFP group (<i>p <</i> .01) but remained unchanged in the elevated LVFP group (<i>p NS</i>). Both E and e′ increased among the subjects with normal LVFP, whereas E/e′ remained unchanged (∆E/e′ +.1 [-.5–1.2]), <i>p NS</i>). Among the subjects with elevated, LVFP we observed increased E but not e′, resulting in significantly increased E/e′ (∆ average E/e′ +2.4 [0–4.0], <i>p</i> <i><</i> .01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Augmented preload does not seem to affect E/e′ among subjects with normal LVFP, whereas E/e′ seems to increase significantly among subjects with elevated LVFP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 9","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.15917","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yanni Dong MD, Yiming Li MD, Caijie Liu MD, Yingnan Guo MD, Yanhong Feng MD, PhD
Objective
To analyze the function of the left heart in patients with different courses of gout, the independent influencing factors for left heart functional changes, and interactions between left atrial and left ventricular functions.
Methods
Patients with gout (n = 171) were selected; 87 patients with a disease course <10 years were included in Group I, and 84 patients with a disease course ≥10 years were included in Group II. Ninety-four healthy volunteers comprised the control group.
Results
The intergroup differences in cardiac strain parameters were statistically significant (p < .05). Moreover, the differences gradually declined with disease progression. Multivariate logistic regression analysis showed that uric acid was an independent predictor of decreased left ventricular global longitudinal strain (LVGLS). Moreover, LVGLS had a positive effect on the left atrial systolic rate (LASr) and the left atrial systolic contraction time (LASct) but no interaction with the left atrial systolic contraction duration (LAScd).
Conclusion
The course of the disease significantly affected the function of the left heart in gout patients, and uric acid was observed to be an independent predictor of decreased LVGLS in gout patients.
{"title":"Is cardiac function associated with the clinical course of disease in patients with gout? A prospective study","authors":"Yanni Dong MD, Yiming Li MD, Caijie Liu MD, Yingnan Guo MD, Yanhong Feng MD, PhD","doi":"10.1111/echo.15911","DOIUrl":"10.1111/echo.15911","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To analyze the function of the left heart in patients with different courses of gout, the independent influencing factors for left heart functional changes, and interactions between left atrial and left ventricular functions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with gout (<i>n</i> = 171) were selected; 87 patients with a disease course <10 years were included in Group I, and 84 patients with a disease course ≥10 years were included in Group II. Ninety-four healthy volunteers comprised the control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The intergroup differences in cardiac strain parameters were statistically significant (<i>p </i>< .05). Moreover, the differences gradually declined with disease progression. Multivariate logistic regression analysis showed that uric acid was an independent predictor of decreased left ventricular global longitudinal strain (LVGLS). Moreover, LVGLS had a positive effect on the left atrial systolic rate (LASr) and the left atrial systolic contraction time (LASct) but no interaction with the left atrial systolic contraction duration (LAScd).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The course of the disease significantly affected the function of the left heart in gout patients, and uric acid was observed to be an independent predictor of decreased LVGLS in gout patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 9","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wei-Min Zhang MD, Kadeyanmu Abulimiti MM, Li-Na Guan MD, Yan Xing MD, Qiang Huo MD
A 35-year-old woman was initially misdiagnosed with a muscular ventricular septal defect but was later correctly diagnosed with a double-chambered left ventricle following evaluation by echocardiography and cardiac computed tomography.
{"title":"Double-chambered left ventricle misdiagnosed as ventricular septal defect","authors":"Wei-Min Zhang MD, Kadeyanmu Abulimiti MM, Li-Na Guan MD, Yan Xing MD, Qiang Huo MD","doi":"10.1111/echo.15912","DOIUrl":"10.1111/echo.15912","url":null,"abstract":"<p>A 35-year-old woman was initially misdiagnosed with a muscular ventricular septal defect but was later correctly diagnosed with a double-chambered left ventricle following evaluation by echocardiography and cardiac computed tomography.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 9","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Behcet's disease (BD) is a systemic disorder characterized by vasculitis, resulting in thickened vascular walls that reduce elasticity and impair function. BD can involve the cardiovascular system in three ways: cardiac, arterial, and venous. In this study, our objective was to evaluate the efficacy of pulmonary arterial stiffness (PAS) and pulmonary pulse transit time (PPTT) measures in demonstrating right ventricular functions in asymptomatic BD patients. We aimed to objectively evaluate right ventricular function in patients with BD using four-dimensional echocardiography (4DE).
Method
This study included 40 patients diagnosed with BD and 40 healthy subjects. Demographic, clinical, laboratory, and echocardiographic parameters were compared. In addition to standard transthoracic echocardiographic evaluation, right ventricle quantification (RVQ) by using the 4DE and 2D-speckle tracking echocardiography were performed.
Results
The sPAP, 4D RVQ, and right ventricular strain values exhibited significant differences between the BD and control groups. Right ventricular end-diastolic diameter (RVDD), right ventricular end-systolic diameter (RVSD), right atrium (RA) area, right ventricular myocardial performance index (RVMPI), and PAS were increased in BD patients compared to the control group. Right ventricular ejection fraction (RVEF), right ventricular fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), Tricuspid S’, and PPTT were decreased in BD patients compared to control subjects. PPTT correlated with right ventricular free wall strain (RV-FWS) and PAS. In a multivariate linear regression analysis, PAS and RVFAC were found to be independent predictors of RVFWS. In addition, RVFAC and TAPSE are independent predictors for PPTT.
Conclusion
Patients with BD may have elevated pulmonary arterial stiffness (PAS) in correlation with decreased PPTT. To ascertain the prognosis for these individuals, right ventricular (RV) functions must be evaluated. Measurements of RVFAC and RVEF via 4DE and deformation imaging techniques may be more useful in identifying subclinical impairment of RV. Individuals with BD, PAS, and PPTT may suggest a link between early pulmonary vascular remodeling and RV subclinical impairment.
{"title":"Evaluation of right ventricular function in patients with Behcet's disease by four-dimensional echocardiography","authors":"Zeynep Ulutas MD, Hakan Tasolar MD, Mirac Karaagac MD, Siho Hidayet MD, Yucel Karaca MD, Adil Bayramoglu MD, Servet Yolbas MD, Julide Akaycan MD, Necip Ermis MD, Mehmet Cansel MD, Hasan Pekdemir MD","doi":"10.1111/echo.15918","DOIUrl":"https://doi.org/10.1111/echo.15918","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Behcet's disease (BD) is a systemic disorder characterized by vasculitis, resulting in thickened vascular walls that reduce elasticity and impair function. BD can involve the cardiovascular system in three ways: cardiac, arterial, and venous. In this study, our objective was to evaluate the efficacy of pulmonary arterial stiffness (PAS) and pulmonary pulse transit time (PPTT) measures in demonstrating right ventricular functions in asymptomatic BD patients. We aimed to objectively evaluate right ventricular function in patients with BD using four-dimensional echocardiography (4DE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This study included 40 patients diagnosed with BD and 40 healthy subjects. Demographic, clinical, laboratory, and echocardiographic parameters were compared. In addition to standard transthoracic echocardiographic evaluation, right ventricle quantification (RVQ) by using the 4DE and 2D-speckle tracking echocardiography were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sPAP, 4D RVQ, and right ventricular strain values exhibited significant differences between the BD and control groups. Right ventricular end-diastolic diameter (RVDD), right ventricular end-systolic diameter (RVSD), right atrium (RA) area, right ventricular myocardial performance index (RVMPI), and PAS were increased in BD patients compared to the control group. Right ventricular ejection fraction (RVEF), right ventricular fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), Tricuspid S’, and PPTT were decreased in BD patients compared to control subjects. PPTT correlated with right ventricular free wall strain (RV-FWS) and PAS. In a multivariate linear regression analysis, PAS and RVFAC were found to be independent predictors of RVFWS. In addition, RVFAC and TAPSE are independent predictors for PPTT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with BD may have elevated pulmonary arterial stiffness (PAS) in correlation with decreased PPTT. To ascertain the prognosis for these individuals, right ventricular (RV) functions must be evaluated. Measurements of RVFAC and RVEF via 4DE and deformation imaging techniques may be more useful in identifying subclinical impairment of RV. Individuals with BD, PAS, and PPTT may suggest a link between early pulmonary vascular remodeling and RV subclinical impairment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 9","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142100503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mustafa Alkhawam MD, Weihan Chen MD, Abdullah Mahmood MD, Ali J. Ebrahimi MD, Navin C. Nanda MD, Mustafa I. Ahmed MD
Fusion imaging (FI) technology using EchoNavigator that integrates live transesophageal echocardiogram and overlays on real-time fluoroscopy. We present our experience placing a right ventricular (RV) support device, a ProtekDuo, in our patient with post-operative RV failure using FI to guide the implantation.
使用 EchoNavigator 的融合成像（FI）技术将实时经食道超声心动图与实时透视重叠在一起。我们将介绍使用 FI 引导植入右心室支持装置 ProtekDuo 的经验，该装置适用于术后右心室功能衰竭的患者。
{"title":"Use of fusion imaging in safe, rapid, and accurate placement of percutaneous right ventricular assist device in the management of acute post-surgical right ventricular failure","authors":"Mustafa Alkhawam MD, Weihan Chen MD, Abdullah Mahmood MD, Ali J. Ebrahimi MD, Navin C. Nanda MD, Mustafa I. Ahmed MD","doi":"10.1111/echo.15909","DOIUrl":"https://doi.org/10.1111/echo.15909","url":null,"abstract":"<p>Fusion imaging (FI) technology using EchoNavigator that integrates live transesophageal echocardiogram and overlays on real-time fluoroscopy. We present our experience placing a right ventricular (RV) support device, a ProtekDuo, in our patient with post-operative RV failure using FI to guide the implantation.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 9","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142100500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ting Wu PhD, Lu Chen MS, Yin Li MS, Chunquan Zhang PhD
Background and Aim
Type 2 diabetes mellitus (T2DM) frequently presents subclinical left ventricular systolic dysfunction. The TyG index is a surrogate indicator of insulin resistance and is closely related to heart failure (HF). This study aimed to evaluate subclinical systolic dysfunction in T2DM by combining myocardial work (MW) and the TyG index and to investigate the risk factors for MW.
Methods
This study included 102 diabetic patients and 78 healthy control subjects, and the diabetic group was divided into three subgroups based on the TyG index. LV global longitudinal strain (GLS), global myocardial work index (GWI), global constructive work (GCW), global wasted work (GWW), and global myocardial work efficiency (GWE) were measured in all subjects. GLS and MW were compared between the diabetic and control groups and between subgroups. Regression models were applied to analyze the risk factors for MW in diabetic patients.
Results
GLS, GWI, GCW, and GWE significantly increased, and GWW significantly decreased in the diabetic group (all p < .01). GWI and GCW were significantly lower in the T3 subgroup than in the T1 and T2 subgroups (all p < .05). The TyG index, sex (female), BMI, systolic blood pressure (SBP), and total cholesterol (TC) were independent risk factors for GWI and GCW, and HbA1c was an independent risk factor for GWI.
Conclusions
MW accurately revealed subtle changes in subclinical LV systolic dysfunction in T2DM patients. An elevated TyG index was strongly associated with decreased GWI and GCW. The TyG index, sex (female), BMI, SBP, and TC were independent risk factors for GWI and GCW, and HbA1c was an independent risk factor for GWI.
{"title":"Evaluation of subclinical left ventricular systolic dysfunction in patients with type 2 diabetes mellitus by combining myocardial work and triglyceride-glucose index","authors":"Ting Wu PhD, Lu Chen MS, Yin Li MS, Chunquan Zhang PhD","doi":"10.1111/echo.15913","DOIUrl":"https://doi.org/10.1111/echo.15913","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Type 2 diabetes mellitus (T2DM) frequently presents subclinical left ventricular systolic dysfunction. The TyG index is a surrogate indicator of insulin resistance and is closely related to heart failure (HF). This study aimed to evaluate subclinical systolic dysfunction in T2DM by combining myocardial work (MW) and the TyG index and to investigate the risk factors for MW.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 102 diabetic patients and 78 healthy control subjects, and the diabetic group was divided into three subgroups based on the TyG index. LV global longitudinal strain (GLS), global myocardial work index (GWI), global constructive work (GCW), global wasted work (GWW), and global myocardial work efficiency (GWE) were measured in all subjects. GLS and MW were compared between the diabetic and control groups and between subgroups. Regression models were applied to analyze the risk factors for MW in diabetic patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>GLS, GWI, GCW, and GWE significantly increased, and GWW significantly decreased in the diabetic group (all <i>p</i> < .01). GWI and GCW were significantly lower in the T3 subgroup than in the T1 and T2 subgroups (all <i>p</i> < .05). The TyG index, sex (female), BMI, systolic blood pressure (SBP), and total cholesterol (TC) were independent risk factors for GWI and GCW, and HbA1c was an independent risk factor for GWI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MW accurately revealed subtle changes in subclinical LV systolic dysfunction in T2DM patients. An elevated TyG index was strongly associated with decreased GWI and GCW. The TyG index, sex (female), BMI, SBP, and TC were independent risk factors for GWI and GCW, and HbA1c was an independent risk factor for GWI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 9","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142100501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lei Yang MD, Shuang Zheng MD, Fei Xiao MD, Bin Xiao MD, Guang-mei Zheng MD, Tiantian Li MD, Hong-xia Jing MD
Shone's syndrome (SS) is a rare congenital cardiac anomaly characterized by a spectrum of developmental abnormalities. It predominantly presents as consisting of a variety of left ventricular inflow and outflow tract lesions, with inflow tract lesions typically including parachute mitral valve and supravalvular mitral ring. However, reports of SS involving double-orifice mitral valve are scarce.
肖恩氏综合征（SS）是一种罕见的先天性心脏畸形，以一系列发育异常为特征。它主要表现为各种左心室流入道和流出道病变，流入道病变通常包括降落伞二尖瓣和二尖瓣上环。然而，涉及二尖瓣双孔的 SS 报告很少。
{"title":"Double-orifice mitral valve associated with mild mitral stenosis and coarctation of the aortic isthmus: A rare case of incomplete form of Shone's syndrome","authors":"Lei Yang MD, Shuang Zheng MD, Fei Xiao MD, Bin Xiao MD, Guang-mei Zheng MD, Tiantian Li MD, Hong-xia Jing MD","doi":"10.1111/echo.15916","DOIUrl":"https://doi.org/10.1111/echo.15916","url":null,"abstract":"<p>Shone's syndrome (SS) is a rare congenital cardiac anomaly characterized by a spectrum of developmental abnormalities. It predominantly presents as consisting of a variety of left ventricular inflow and outflow tract lesions, with inflow tract lesions typically including parachute mitral valve and supravalvular mitral ring. However, reports of SS involving double-orifice mitral valve are scarce.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 9","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142100502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alan P. Wang MD, Cassandra Polsen RDCS, Jamie Penk , Nazia Husain MD, Amanda Hauck MD, Pei-Ni Jone MD
Background
The atrium augments ventricular function, but the significance of atrial function in hypoplastic left heart syndrome (HLHS) has not been well evaluated.
Objective
We investigated the association of atrial reservoir strain (common atrial strain [CAS]) to death or need for transplantation in patients with HLHS.
Methods
In this retrospective single-center study, echocardiograms from three timepoints (pre-stage 1 palliation [S1P], 4–8 weeks post-S1P, and pre-Glenn) were analyzed in infants with classic HLHS. Patients were separated based on transplant-free survival to Fontan (survivors) versus death or heart transplant prior to Fontan (composite outcome). Echocardiographic parameters evaluated included CAS, right ventricle (RV) global longitudinal strain (RVGLS), RV fractional area change (FAC), and tricuspid annular plane systolic excursion (TAPSE). An equal variance t-test, regression, and receiver operating characteristic (ROC) analyses were performed.
Results
A total of 45 HLHS patients (25 survivors, 20 patients meeting endpoint) were included in this study. There were no significant differences in any of the functional parameters during the pre-stage 1 or post-stage 1 timepoints. Pre-Glenn CAS and RVGLS were significantly worse in those meeting composite endpoint compared to survivors. CAS was significantly correlated to RVGLS during the pre-S1P and pre-Glenn timepoints. A pre-Glenn CAS < 19.5 had an area under the curve of .78 and a 75% sensitivity and 83% specificity for death or need for transplantation.
Conclusion
Pre-Glenn CAS is significantly lower in patients with mortality or need for the transplantation prior to Fontan completion and may carry prognostic significance in patients with HLHS.
{"title":"Common atrial reservoir strain during the interstage period is a predictor of poor outcomes prior to Fontan completion in hypoplastic left heart syndrome","authors":"Alan P. Wang MD, Cassandra Polsen RDCS, Jamie Penk , Nazia Husain MD, Amanda Hauck MD, Pei-Ni Jone MD","doi":"10.1111/echo.15910","DOIUrl":"10.1111/echo.15910","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The atrium augments ventricular function, but the significance of atrial function in hypoplastic left heart syndrome (HLHS) has not been well evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We investigated the association of atrial reservoir strain (common atrial strain [CAS]) to death or need for transplantation in patients with HLHS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective single-center study, echocardiograms from three timepoints (pre-stage 1 palliation [S1P], 4–8 weeks post-S1P, and pre-Glenn) were analyzed in infants with classic HLHS. Patients were separated based on transplant-free survival to Fontan (survivors) versus death or heart transplant prior to Fontan (composite outcome). Echocardiographic parameters evaluated included CAS, right ventricle (RV) global longitudinal strain (RVGLS), RV fractional area change (FAC), and tricuspid annular plane systolic excursion (TAPSE). An equal variance <i>t</i>-test, regression, and receiver operating characteristic (ROC) analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 45 HLHS patients (25 survivors, 20 patients meeting endpoint) were included in this study. There were no significant differences in any of the functional parameters during the pre-stage 1 or post-stage 1 timepoints. Pre-Glenn CAS and RVGLS were significantly worse in those meeting composite endpoint compared to survivors. CAS was significantly correlated to RVGLS during the pre-S1P and pre-Glenn timepoints. A pre-Glenn CAS < 19.5 had an area under the curve of .78 and a 75% sensitivity and 83% specificity for death or need for transplantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pre-Glenn CAS is significantly lower in patients with mortality or need for the transplantation prior to Fontan completion and may carry prognostic significance in patients with HLHS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 8","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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