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1.
Acta Cardiol ; 78(1): 109-117, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35900302

RESUMO

BACKGROUND: 2 D Speckle tracking echocardiography (STE) is a non-invasive, angle-independent, semiautomatic and objective technique that quantitatively assesses global and regional longitudinal systolic strain and provides a single bull's eye map for segmental wall strain of the left ventricle. OBJECTIVES: assessment of the accuracy of global longitudinal strain (GLS) using STE in the detection of resting myocardial ischaemia and its severity compared with visual assessment of wall motion score index by conventional 2 D echo. PATIENTS AND METHODS: 100 patients who presented with ACS were included. Wall motion score index (WMSI) was calculated in a 16-segment model and compared with GLS assessed in left ventricle 17 segments and calculated automatically by summation of regional longitudinal peak systolic strain (RLS) using STE. Quantitative coronary angiography was performed on clinical indication and significant stenosis was defined as a 70% reduction of the arterial lumen. RESULTS: 56 patients (56%) of patients were males with a mean age of 58.3 years. GLS showed a significant positive correlation between ejection fraction (EF) and GLS (p < 0.05), (r value 0.514) and a good significant negative correlation between WMSI and GLS (p < 0.05), (r value 0.593). And a good significant correlation between GLS and both severity of the lesion and the number of affected vessels was found (p < 0.05). ROC curves showed the cut-off point of GLS was (-15.9) for predicting lesion ≥70% with 88.1% sensitivity, 90.2% specificity respectively. CONCLUSION: GLS has higher specificity, sensitivity, and diagnostic accuracy for the detection of the severity of lesion and number of the vessel affected than WMSI.


Assuntos
Síndrome Coronariana Aguda , Estenose Coronária , Masculino , Humanos , Pessoa de Meia-Idade , Feminino , Síndrome Coronariana Aguda/diagnóstico por imagem , Eletrocardiografia , Deformação Longitudinal Global , Ecocardiografia/métodos , Estenose Coronária/diagnóstico por imagem , Reprodutibilidade dos Testes
2.
Eye Brain ; 14: 115-126, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36193222

RESUMO

Background: Ultrasonographic measurement of optic nerve sheath diameter is a simple, non-invasive, and reliable method of detecting elevated intracranial pressure (ICP) in critical patients. Optic nerve sheath communicates with the dura mater covering the brain and contains cerebrospinal fluid, allowing pressure transmission from the cranium. Therefore, changes in cerebrospinal fluid (CSF) pressure have been shown to produce changes in ONSD. Objective: This study aimed to assess the accuracy of optic nerve sheath diameter (ONSD) in diagnosis and follow-up patients with disturbed conscious levels compared with CT brain and fundus examination. Patients and Methods: One hundred forty-one participants were included in the study, classified into 76 cases admitted with disturbed conscious levels due to elevated ICP and 65 controls. All patients were subjected to CT brain and optic nerve US and fundus examination at the time of admission and follow-up after 48 h after proper management. Results: The current study showed that ONSD is significant in predicting elevated ICP at the cut-off point of average ONSD of 5.19 mm with 97% sensitivity and 98% specificity, and the area under the curve (AUC) was 0.996. The present study revealed a significant inverse correlation between ONSD and GCS in patients with increased ICP. Conclusion: Ultrasonic measurement of ONSD is a promising technique in diagnosing and following patients with disturbed conscious levels.

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