Pub Date : 2016-09-01DOI: 10.4250/jcu.2016.24.3.183
R. Markley, Asghar Ali, Jonathan Potfay, W. Paulsen, I. Jovin
The appropriate use of echocardiography may reduce the need for invasive diagnostic cardiac procedures. The right side of the heart has recently gained interest among cardiologists as it became clear that abnormalities of the right heart morphology and function are associated with increased morbidity and mortality. Echocardiography is easy to perform, relatively cheap, readily available and do not pose the risk of ionizing radiation. Conventional 2D and, more recently, 3D echocardiography provides pertinent anatomic and physiologic information about the right side of the heart. Because of the advantages and simplicity of echocardiography it continues to be an excellent tool for evaluating the structure and function of the right side of the heart. This review outlines the uses of echocardiography in evaluating the right heart structure and function.
{"title":"Echocardiographic Evaluation of the Right Heart","authors":"R. Markley, Asghar Ali, Jonathan Potfay, W. Paulsen, I. Jovin","doi":"10.4250/jcu.2016.24.3.183","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.3.183","url":null,"abstract":"The appropriate use of echocardiography may reduce the need for invasive diagnostic cardiac procedures. The right side of the heart has recently gained interest among cardiologists as it became clear that abnormalities of the right heart morphology and function are associated with increased morbidity and mortality. Echocardiography is easy to perform, relatively cheap, readily available and do not pose the risk of ionizing radiation. Conventional 2D and, more recently, 3D echocardiography provides pertinent anatomic and physiologic information about the right side of the heart. Because of the advantages and simplicity of echocardiography it continues to be an excellent tool for evaluating the structure and function of the right side of the heart. This review outlines the uses of echocardiography in evaluating the right heart structure and function.","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"43 1","pages":"183 - 190"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88607426","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 : 2016-09-01DOI: 10.4250/JCU.2016.24.3.253
K. Obase, K. Addetia, Kazue Takahashi, Katsunori Yamamoto, Ai Kawamura, Tomoko Tamada, Koichiro Imai, S. Uemura
A 75-year-old man with atrial fibrillation was hospitalized because of shortness of breath triggered by upper respiratory infection and tachycardia. His symptoms were improved by bed rest and administration of diuretics. Pretreatment echocardiogram reported dilatation of the right ventricle (RV). Follow-up study was performed before discharge. Apical four-chamber view still demonstrated remarkable dilatation of RV (Fig. 1A). In one of the apical four-chamber views, the tricuspid valve showed a bridge-like appearance in systole without valve opening (Fig. 1B and C, Supplementary movie 1). The RV inflow view (Fig. 1D, E, and F, Supplementary movie 2) revealed localized small leaflet defect at posterior septum (Fig. 1D) with the opposing leaflet tip coapting against the RV wall (Fig. 1D). At the anterior side of the "bridge", another valve orifice was observed in RV inflow view as well as parasternal short-axis views (Fig. 1G, H, and I, Supplementary movie 3). Color Doppler images in these views showed flow from the RV to right atrium across two orifices (Fig. 1F and I), suggesting double-orifice tricuspid valve.1),2) There was no pressure gradient across both orifices in diastole. Tricuspid regurgitation jet velocity of less than 3 m/s was observed from both orifices in systole. Three-dimensional transthoracic echocardiography clearly visualized double orifices (Fig. 2, Supplementary movie 4) and confirmed the diagnosis.
{"title":"Double-Orifice Tricuspid Valve Visualized by Three-Dimensional Transthoracic Echocardiography","authors":"K. Obase, K. Addetia, Kazue Takahashi, Katsunori Yamamoto, Ai Kawamura, Tomoko Tamada, Koichiro Imai, S. Uemura","doi":"10.4250/JCU.2016.24.3.253","DOIUrl":"https://doi.org/10.4250/JCU.2016.24.3.253","url":null,"abstract":"A 75-year-old man with atrial fibrillation was hospitalized because of shortness of breath triggered by upper respiratory infection and tachycardia. His symptoms were improved by bed rest and administration of diuretics. Pretreatment echocardiogram reported dilatation of the right ventricle (RV). Follow-up study was performed before discharge. Apical four-chamber view still demonstrated remarkable dilatation of RV (Fig. 1A). In one of the apical four-chamber views, the tricuspid valve showed a bridge-like appearance in systole without valve opening (Fig. 1B and C, Supplementary movie 1). The RV inflow view (Fig. 1D, E, and F, Supplementary movie 2) revealed localized small leaflet defect at posterior septum (Fig. 1D) with the opposing leaflet tip coapting against the RV wall (Fig. 1D). At the anterior side of the \"bridge\", another valve orifice was observed in RV inflow view as well as parasternal short-axis views (Fig. 1G, H, and I, Supplementary movie 3). Color Doppler images in these views showed flow from the RV to right atrium across two orifices (Fig. 1F and I), suggesting double-orifice tricuspid valve.1),2) There was no pressure gradient across both orifices in diastole. Tricuspid regurgitation jet velocity of less than 3 m/s was observed from both orifices in systole. Three-dimensional transthoracic echocardiography clearly visualized double orifices (Fig. 2, Supplementary movie 4) and confirmed the diagnosis.","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"1 1","pages":"253 - 255"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74094087","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 : 2016-09-01DOI: 10.4250/jcu.2016.24.3.208
B. Turan, T. Daşlı, A. Erkol, I. Erden, Y. Basaran
Background Incidence of diastolic dyssynchrony (DD) and its impact on functional recovery of left ventricle (LV) after ST segment elevation myocardial infarction (STEMI) is not known. Methods Consecutive patients with STEMI who underwent successful revascularization were prospectively enrolled. Echocardiography with tissue Doppler imaging was performed within 48 hours of admission and at 6 months. LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), ejection fraction (EF), and left atrial volume index (LAVI) were calculated. Diastolic delay was calculated from onset of QRS complex to peak of E wave in tissue Doppler image and presented as maximal temporal difference between peak early diastolic velocity of 6 basal segments of LV (TeDiff). Study patients were compared with demographically matched control group. Results Forty eight consecutive patients (55 ± 10 years, 88% male) and 24 controls (56 ± 6 years, 88% male) were included. TeDiff was higher in STEMI than in controls (35.9 ± 19.9 ms vs. 26.3 ± 6.8 ms, p = 0.025). Presence of DD was higher in STEMI than controls (58% vs. 33%, p = 0.046) according to calculated cut-off value (≥ 29 ms). There was no correlation between TeDiff and change in EDVI, ESVI, and LAVI at 6 months, however TeDiff and change in EF at 6 months was positively correlated (r = 0.328, p = 0.023). Patients with baseline DD experienced remodeling less frequently compared to patients without baseline DD (11% vs. 38%, p = 0.040) during follow-up. Conclusion STEMI disrupts diastolic synchronicity of LV. However, DD during acute phase of STEMI is associated with better recovery of LV thereafter. This suggests that DD is associated with peri-infarct stunned myocardium that is salvaged with primary intervention as well as infarct size.
ST段抬高型心肌梗死(STEMI)后舒张不同步(DD)的发生率及其对左心室(LV)功能恢复的影响尚不清楚。方法前瞻性纳入连续成功行血管重建术的STEMI患者。入院48小时内和6个月时进行超声心动图和组织多普勒成像。计算左室舒张末期容积指数(EDVI)、收缩末期容积指数(ESVI)、射血分数(EF)、左房容积指数(LAVI)。从QRS复音开始到组织多普勒图像E波峰值计算舒张延迟，并表示为左室6个基底段早期舒张速度峰值的最大时间差(TeDiff)。研究患者与人口统计学匹配的对照组进行比较。结果纳入48例患者(55±10岁，88%男性)和24例对照组(56±6岁，88%男性)。STEMI患者的TeDiff高于对照组(35.9±19.9 ms vs. 26.3±6.8 ms, p = 0.025)。根据计算的临界值(≥29 ms)， STEMI患者的DD发生率高于对照组(58% vs. 33%， p = 0.046)。TeDiff与6个月时EDVI、ESVI、LAVI的变化无相关性，而TeDiff与6个月时EF的变化呈正相关(r = 0.328, p = 0.023)。在随访期间，基线DD患者的重塑频率低于无基线DD患者(11% vs 38%， p = 0.040)。结论STEMI破坏左室舒张同步性。然而，STEMI急性期的DD与其后较好的左室恢复相关。这表明，DD与通过初级干预挽救的梗死周围休克心肌以及梗死面积有关。
{"title":"Diastolic Dyssynchrony in Acute ST Segment Elevation Myocardial Infarction and Relationship with Functional Recovery of Left Ventricle","authors":"B. Turan, T. Daşlı, A. Erkol, I. Erden, Y. Basaran","doi":"10.4250/jcu.2016.24.3.208","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.3.208","url":null,"abstract":"Background Incidence of diastolic dyssynchrony (DD) and its impact on functional recovery of left ventricle (LV) after ST segment elevation myocardial infarction (STEMI) is not known. Methods Consecutive patients with STEMI who underwent successful revascularization were prospectively enrolled. Echocardiography with tissue Doppler imaging was performed within 48 hours of admission and at 6 months. LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), ejection fraction (EF), and left atrial volume index (LAVI) were calculated. Diastolic delay was calculated from onset of QRS complex to peak of E wave in tissue Doppler image and presented as maximal temporal difference between peak early diastolic velocity of 6 basal segments of LV (TeDiff). Study patients were compared with demographically matched control group. Results Forty eight consecutive patients (55 ± 10 years, 88% male) and 24 controls (56 ± 6 years, 88% male) were included. TeDiff was higher in STEMI than in controls (35.9 ± 19.9 ms vs. 26.3 ± 6.8 ms, p = 0.025). Presence of DD was higher in STEMI than controls (58% vs. 33%, p = 0.046) according to calculated cut-off value (≥ 29 ms). There was no correlation between TeDiff and change in EDVI, ESVI, and LAVI at 6 months, however TeDiff and change in EF at 6 months was positively correlated (r = 0.328, p = 0.023). Patients with baseline DD experienced remodeling less frequently compared to patients without baseline DD (11% vs. 38%, p = 0.040) during follow-up. Conclusion STEMI disrupts diastolic synchronicity of LV. However, DD during acute phase of STEMI is associated with better recovery of LV thereafter. This suggests that DD is associated with peri-infarct stunned myocardium that is salvaged with primary intervention as well as infarct size.","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"83 1","pages":"208 - 214"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73245950","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 : 2016-09-01DOI: 10.4250/jcu.2016.24.3.243
K. Kim, J. Choi, Y. Doo, Y. Yun, Jongwook Kim, Jae Beom Lee
Common atrium is a rare congenital heart disease characterized by complete absence of the interatrial septum, and is commonly accompanied by malformation of the atrioventricular valve. Most patients with common atrium experience symptoms during childhood. Here, we describe a patient with common atrium who experienced his first obvious symptom at 48 years of age.
{"title":"Well-Tolerated and Undiscovered Common Atrium until Late Adulthood","authors":"K. Kim, J. Choi, Y. Doo, Y. Yun, Jongwook Kim, Jae Beom Lee","doi":"10.4250/jcu.2016.24.3.243","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.3.243","url":null,"abstract":"Common atrium is a rare congenital heart disease characterized by complete absence of the interatrial septum, and is commonly accompanied by malformation of the atrioventricular valve. Most patients with common atrium experience symptoms during childhood. Here, we describe a patient with common atrium who experienced his first obvious symptom at 48 years of age.","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"75 1","pages":"243 - 246"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79984314","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 : 2016-09-01DOI: 10.4250/jcu.2016.24.3.239
Gee-Hee Kim, Chul-Min Kim, Bo-Hyun Jang, Hyeong-Han Lee, S. Hong, Sang-hoon Eum, Howook Jeon, D. Moon
A 58-year-old man had been diagnosed with non-obstructive hypertrophic cardiomyopathy (HCMP) according to echocardiography findings 16 years ago. Echocardiography showed ischemic cardiomyopathy (CMP)-like features with decreased systolic function but a non-dilated chamber. Coronary angiography was performed but showed a normal coronary artery. Cardiac magnetic resonance imaging (MRI) revealed multifocal transmural and subepicardial delayed-enhancing areas at the anteroseptal, septal, and inferoseptal left ventricular (LV) wall, and wall thinning and decreased motion of the anteroseptal LV wall. Findings of ischemic CMP-like features by echocardiography suggested microvascular dysfunction. This late stage of HCMP carries a high risk of sudden death. Cardiac MRI evaluation may be necessary in cases of ischemic CMP-like features in HCMP. In this case, the diagnosis of end-stage HCMP with microvascular dysfunction was confirmed by using cardiac MRI after a follow-up period of more than 16 years.
{"title":"Findings of Cardiac Magnetic Resonance Imaging in Hypertrophic Cardiomyopathy after 16 Years","authors":"Gee-Hee Kim, Chul-Min Kim, Bo-Hyun Jang, Hyeong-Han Lee, S. Hong, Sang-hoon Eum, Howook Jeon, D. Moon","doi":"10.4250/jcu.2016.24.3.239","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.3.239","url":null,"abstract":"A 58-year-old man had been diagnosed with non-obstructive hypertrophic cardiomyopathy (HCMP) according to echocardiography findings 16 years ago. Echocardiography showed ischemic cardiomyopathy (CMP)-like features with decreased systolic function but a non-dilated chamber. Coronary angiography was performed but showed a normal coronary artery. Cardiac magnetic resonance imaging (MRI) revealed multifocal transmural and subepicardial delayed-enhancing areas at the anteroseptal, septal, and inferoseptal left ventricular (LV) wall, and wall thinning and decreased motion of the anteroseptal LV wall. Findings of ischemic CMP-like features by echocardiography suggested microvascular dysfunction. This late stage of HCMP carries a high risk of sudden death. Cardiac MRI evaluation may be necessary in cases of ischemic CMP-like features in HCMP. In this case, the diagnosis of end-stage HCMP with microvascular dysfunction was confirmed by using cardiac MRI after a follow-up period of more than 16 years.","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"33 1","pages":"239 - 242"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73996251","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 : 2016-09-01DOI: 10.4250/jcu.2016.24.3.223
Chang Sin Kim, Sora Park, L. Eun
Background The speckle tracking echocardiography can benefit to assess the regional myocardial deformations. Although, previous reports suggested no significant change in left ventricular (LV) torsion with aging, there are certain differences in LV rotation at the base and apex. The purpose of this study was to evaluate the change and relationship of LV rotation for torsion with aging in children. Methods Forty healthy children were recruited and divided into two groups of twenty based on whether the children were preschool-age (2–6 years of age) or school-age (7–12 years of age). After obtaining conventional echocardiographic data, apical and basal short axis rotation were assessed with speckle tracking echocardiography. LV rotation in the basal and apical short axis planes was determined using six myocardial segments along the central axis. Results Apical and basal LV rotation did not show the statistical difference with increased age between preschool- and school-age children. Apical radial strain showed significant higher values in preschool-age children, especially at the anterior (52.8 ± 17.4% vs. 34.7 ± 23.2%, p < 0.02), lateral (55.8 ± 20.4% vs. 36.1 ± 22.7%, p < 0.02), and posterior segments (57.1 ± 17.6% vs. 38.5 ± 21.7%, p < 0.01). The torsion values did not demonstrate the statistical difference between two groups. Conclusion This study revealed the tendency of higher rotation values in preschool-age children than in school-age children. The lesser values of rotation and torsion with increased age during childhood warrant further investigation.
{"title":"Myocardial Rotation and Torsion in Child Growth","authors":"Chang Sin Kim, Sora Park, L. Eun","doi":"10.4250/jcu.2016.24.3.223","DOIUrl":"https://doi.org/10.4250/jcu.2016.24.3.223","url":null,"abstract":"Background The speckle tracking echocardiography can benefit to assess the regional myocardial deformations. Although, previous reports suggested no significant change in left ventricular (LV) torsion with aging, there are certain differences in LV rotation at the base and apex. The purpose of this study was to evaluate the change and relationship of LV rotation for torsion with aging in children. Methods Forty healthy children were recruited and divided into two groups of twenty based on whether the children were preschool-age (2–6 years of age) or school-age (7–12 years of age). After obtaining conventional echocardiographic data, apical and basal short axis rotation were assessed with speckle tracking echocardiography. LV rotation in the basal and apical short axis planes was determined using six myocardial segments along the central axis. Results Apical and basal LV rotation did not show the statistical difference with increased age between preschool- and school-age children. Apical radial strain showed significant higher values in preschool-age children, especially at the anterior (52.8 ± 17.4% vs. 34.7 ± 23.2%, p < 0.02), lateral (55.8 ± 20.4% vs. 36.1 ± 22.7%, p < 0.02), and posterior segments (57.1 ± 17.6% vs. 38.5 ± 21.7%, p < 0.01). The torsion values did not demonstrate the statistical difference between two groups. Conclusion This study revealed the tendency of higher rotation values in preschool-age children than in school-age children. The lesser values of rotation and torsion with increased age during childhood warrant further investigation.","PeriodicalId":88913,"journal":{"name":"Journal of cardiovascular ultrasound","volume":"42 1","pages":"223 - 228"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87282255","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}
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