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1.
Ultrasound Med Biol ; 49(1): 333-346, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36280443

RESUMO

Measurements of cardiac function such as left ventricular ejection fraction and myocardial strain are typically based on 2-D ultrasound imaging. The reliability of these measurements depends on the correct pose of the transducer such that the 2-D imaging plane properly aligns with the heart for standard measurement views and is thus dependent on the operator's skills. We propose a deep learning tool that suggests transducer movements to help users navigate toward the required standard views while scanning. The tool can simplify echocardiography for less experienced users and improve image standardization for more experienced users. Training data were generated by slicing 3-D ultrasound volumes, which permits simulation of the movements of a 2-D transducer. Neural networks were further trained to calculate the transducer position in a regression fashion. The method was validated and tested on 2-D images from several data sets representative of a prospective clinical setting. The method proposed the adequate transducer movement 75% of the time when averaging over all degrees of freedom and 95% of the time when considering transducer rotation solely. Real-time application examples illustrate the direct relation between the transducer movements, the ultrasound image and the provided feedback.


Assuntos
Ecocardiografia Tridimensional , Função Ventricular Esquerda , Volume Sistólico , Reprodutibilidade dos Testes , Estudos Prospectivos , Ecocardiografia/métodos
2.
J Clin Ultrasound ; 50(8): 1051-1059, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36218209

RESUMO

Advanced cardiac imaging (ACI), including myocardial deformation imaging, 3D echocardiography and cardiac magnetic resonance, overcomes the limitations of conventional echocardiography in the assessment of patients with primary mitral regurgitation (MR). They enable a more precise MR quantification and reveal early changes before advanced and irreversible remodeling with depressed heart function occurs. ACI permits a thorough analysis of mitral valvular anatomy and MR mechanisms (important for planning and guiding percutaneous and surgical procedures) and helps to identify structural and functional changes coupled with a high arrhythmogenic potential, especially the occurrence of atrial fibrillation and heart failure development. The key question is how the data provided by ACI can improve the current management of primary MR.


Assuntos
Ecocardiografia Tridimensional , Insuficiência da Valva Mitral , Ecocardiografia/métodos , Ecocardiografia Tridimensional/métodos , Humanos , Valva Mitral/diagnóstico por imagem , Imagem Multimodal
3.
Int J Clin Pract ; 2022: 3415545, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36304977

RESUMO

Objective: This study aimed to explore the early diagnosis of abnormal left ventricular systolic function of rare pathogenic titin (TTN) mutation gene carriers in familial hypertrophic cardiomyopathy (FHCM) by three-dimensional speckle tracking echocardiography (3D-STE) combined with gene detection. Methods: Eighteen members of a Hui nationality family in Ningxia province of China were enrolled in this study in July 2019. The proband was tested with high-throughput sequencing of gene detection technology to detect the whole exome, and the mutation locus of pathogenic TTN gene was analyzed. According to the result, 16 subjects were divided into two groups: carrier group (n = 4) and noncarrier group (n = 12). Related indicators from 2DE were obtained, and myocardial strain indicators from 3D-STE were analyzed by postprocessing software of Tomtec. Strain indicators included global longitudinal strain (GLS), global circumference strain (GCS), global radial strain (GRS), regional longitudinal strain (RLS), regional circumference strain (RCS), and regional radial strain (RRS). All those indicators were compared between the two groups, and a receiver operating characteristic (ROC) curve was used for further analysis. Results: There were 4 subjects diagnosed as asymptomatic TTN gene carriers with the mutation locus of Val135643Ile. Compared with the noncarrier group, GLS and partial RLS were significantly reduced in the carrier group. The ROC curve shows that GLS has the largest AUC, and its sensitivity was better than LVPWD and specificity was better than IVSD and LVMI obtained from 2DE in the carrier group. Conclusions: There were 4 subjects diagnosed as asymptomatic TTN gene carriers with the mutation locus of Val135643Ile, and their GLS and partial RLS were significantly reduced; GLS had the better sensitivity and specificity than LVPWD, IVSD, and LVMI.


Assuntos
Cardiomiopatia Hipertrófica Familiar , Ecocardiografia Tridimensional , Disfunção Ventricular Esquerda , Humanos , Ecocardiografia Tridimensional/métodos , Função Ventricular Esquerda , Conectina/genética , Reprodutibilidade dos Testes , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/genética , Ecocardiografia/métodos , Diagnóstico Precoce , Mutação
4.
Echocardiography ; 39(11): 1439-1445, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36266744

RESUMO

AIMS: This study sought to examine the feasibility, accuracy and reproducibility of a novel, fully automated 2D transthoracic echocardiography (2D TTE) parasternal long axis (PLAX) view aortic measurements quantification software compared to board-certified cardiologists in controlled clinical setting. METHODS AND RESULTS: Aortic Annulus (AoA), Aortic Sinus (AoS), Sinotubular Junction (STJ) and Proximal Ascending Aorta (AAo) diameter measurements were performed retrospectively on each of 58 subjects in two different ways: twice using a fully automated software (Ligence Heart version 2) and twice manually by three cardiologists (ORG) and one expert cardiologist (EC). Out of 58 studies AoA was measured in 54 (93%), AoS in 55 (95%), STJ in 55 (95%) and AAo in 54 (93%) studies. Automated measurements had a stronger correlation with EC when compared to ORG with the largest correlation difference of .1 for STJ measurements and lowest difference of .01 for AoS measurements. Automated software was in higher agreement with ground truth intervals (ORG measurements mean +- SEM) in three out of four measurements. CONCLUSION: Fully automated 2D TTE PLAX view aortic measurements using a novel AI-based quantification software are feasible and yield results that are in close agreement with what experienced readers measure manually while providing better reproducibility. This approach may prove to have important clinical implications in the automation of the aortic root and ascending aorta assessment to improve workflow efficiency.


Assuntos
Inteligência Artificial , Ecocardiografia Tridimensional , Humanos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Estudos de Viabilidade , Ecocardiografia/métodos , Aorta/diagnóstico por imagem , Valva Aórtica/diagnóstico por imagem , Ecocardiografia Tridimensional/métodos
5.
Ann Card Anaesth ; 25(4): 479-484, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36254914

RESUMO

Background: Transesophageal echocardiography (TEE) is a powerful diagnostic tool which has become an integral part in the management of cardiac surgery patients. We developed a one-day 3D TEE workshop specifically designed to meet the needs of perioperative cardiac anaesthesiologists. We hypothesized that participation in the workshop would increase the uptake of 3D TEE in routine perioperative practice. Aims: To examine the impact of one-day 3D TEE workshop on 3D TEE image acquisition and incorporation into routine perioperative practice. Setting: Tertiary care hospital. Design: Prospective observational monocentric study. Subjects and Methods: A convenience sample of 20 cardiac anesthesiologists (with an option to attend the one- day workshop midway through the study) from a single center consented to have their intraoperative TEE images collected during the course of the study reviewed for research purposes. Images acquired 6 months before, immediately after, and 6 months following the workshop and images were examined by a blinded, expert echocardiographer. Results: Data collected for 16 participants (8 workshop attendees, 8 non-attendees) indicate that the TEE workshop increased the number of 3D TEE images, but not x images acquired immediately following the workshop (P=0.006). No difference was observed in number of 3D images at six months' post workshop. Workshop participants obtained more 3D and multi-plane images after the workshop and more 3D images at 6 months compared to those who did not attend the workshop. Conclusion: Our study suggests that a single day hands-on 3D TEE workshop may have had an impact on the implementation of intraoperative 3D TEE in experienced echocardiographers.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Ecocardiografia Tridimensional , Ecocardiografia/métodos , Ecocardiografia Tridimensional/métodos , Ecocardiografia Transesofagiana/métodos , Humanos
6.
Int J Med Sci ; 19(10): 1576-1585, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36185332

RESUMO

Background: Left ventricular (LV) global area strain (GAS) is a novel index derived from resting 3D speckle-tracking echocardiography (STE), and its clinical significance has rarely been studied. We examined the association of LV GAS and exercise capacity in a health check-up population. Methods: We recruited 94 symptom-free participants (52.2 ± 11.7 years, 62.8% male) without substantial structural heart disease or coronary heart diseases who were undergoing a routine health examination. All participants underwent resting echocardiography and symptom-limited treadmill exercise test according to the Bruce protocol. Four strain parameters were obtained from the analysis, namely 3D GAS (GAS3d), global longitudinal strain, global circumferential strain, and global radial strain. Results: After multivariate analysis for factors of exercise time, we observed a significant association in LV GAS3d (P < 0.001). We divided participants into preserved and impaired exercise capacity groups according to the cutoff value of 8 metabolic equivalent of tasks. LV GAS3d (OR 1.24, 95% CI 1.10-1.39, P < 0.001) was an independent predictor of impaired exercise capacity and the optimal cut-off value was -19.96% at a sensitivity of 77.8% and at a specificity of 92.1%. LV GAS3d could improve the discriminatory power of exercise capacity in individuals with early mitral filling velocity to average mitral annulus velocity ratio (E/e') ≥ 8. Conclusions: LV GAS3d was significantly associated with exercise time and exhibited incremental predictive value on E/e' for exercise capacity in participants undergoing treadmill exercise test.


Assuntos
Ecocardiografia Tridimensional , Disfunção Ventricular Esquerda , Ecocardiografia , Ecocardiografia Tridimensional/métodos , Teste de Esforço , Tolerância ao Exercício , Feminino , Ventrículos do Coração/diagnóstico por imagem , Humanos , Masculino , Reprodutibilidade dos Testes , Disfunção Ventricular Esquerda/diagnóstico por imagem , Função Ventricular Esquerda
7.
Med Arch ; 76(4): 259-266, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36313951

RESUMO

Background: Two-dimensional echocardiography (2DE) Simpson methods is the most frequently used imaging modality to assess Left ventricular ejection fraction (LVEF). LVEF is an important predictor of morbidity and mortality in a wide range of patients and clinical scenarios. Despite its importance in prognosis and clinical decision making, most echocardiography laboratories currently determine EF primarily by visual estimation, which is highly experience-dependent and sensitive to intra- and inter-observer variability and suboptimal accuracy and repeatability. Over the last decade, 3-dimensional echocardiography (3DE) has become increasingly implemented in clinical practice. The automated 3D HeartModelA.I. tracks every frame over the cardiac cycle using 3D speckle technology. HeartModelA.I. is a fully automated program that simultaneously detects LA and LV endocardial surfaces using an adaptive analytics algorithm that consists of knowledge-based identification of initial global shape and orientation followed by patient-specific adaptation. Objective: The objective of the study was to compare the automated 3D HeartModelA.I echocardiography and 2D Simpson methods echocardiography in evaluation of the left ventricular ejection fraction and left ventricular volumes in patients with left heart dysfunction. Methods: The study prospectively enrolled 165 patients with symptoms of LV dysfunction (ischemic or nonischemic) and New York Heart Association (NYHA) functional class I-III, referred for an echocardiographic study to evaluate the LV volumes and LV ejection fraction (LVEF) during the period from March 2020 to March 2022. Echocardiographic images were acquired by experienced echocardiographers using a commercially available Philips EPIQ machine (Koninklijke Philips Ultrasound, USA) equipped with X5-1 Matrix probe for 2DE and DHM 3DE acquisitions, respectively. Results: 2D Simpson methods echocardiography results for estimated LVEF were 38.43 ± 1.70 in patients with NYHA class I-II, 30.53 ± 1.60 in patients with NYHA class III. Using 3D Heart Model, LVEF were 38.23 ± 1.71 in patients with NYHA class I-II and 30.27 ± 1.50 in patients with NYHA class III. The results of 2D Simpson methods echocardiography for estimated LVEDVi in NYHA class I-II and NYHA class III were 99.06 ± 6.36 ml/m2, 121.96 ± 2.93 ml/m2 respectively, LVESVi were 60.91 ± 3.91 ml/m2, 84.74 ± 2.70 ml/m2 respectively, for 3D Heart Model, LVEDVi in NYHA class I-II and NYHA class III were 100.07 ± 6.72, 121.38 ± 3.01 ml/m2 respectively, LVESVi were 61.75 ± 3.94 ml/m2, 84.73 ± 2.33 ml/m2 respectively. 2DE measurement of LV volumes and EF was completed in 6.1 ± 0.8 min. per patient. 3DE HeartModelA.I acquisition and analysis in most patients was completed in <3.2 min., an average time of 2.9 ± 1.3 min. per patient. The result of our study shows that the 3D HeartModelA.I. is a reliable and robust method for LVEF and LV volume analysis, which has similar results to 2D echocardiography performed by experienced sonographers. In this study, we found that 3DE DHM fully automated tool is also significantly faster than 2DE analysis and thus can help overcome the time-consuming nature and its present a strong argument for its incorporation into the clinical workflow. In this study, we found that 3DE DHM fully automated tool is also significantly faster than 2DE analysis and thus can help overcome the time-consuming nature and its present a strong argument for its incorporation into the clinical workflow. Conclusion: 3D DHM provides fast and accurate LV volumes and LVEF quantitation, as it avoids geometric assumptions and left ventricular foreshortening, has better reproducibility and has incremental value to predict adverse outcomes in comparison with conventional 2DE. In the future major benefit of AI in echocardiography is expected from improvements in automated analysis and interpretation to reduce workload and improve clinical outcome.


Assuntos
Ecocardiografia Tridimensional , Disfunção Ventricular Esquerda , Humanos , Volume Sistólico , Função Ventricular Esquerda , Ventrículos do Coração/diagnóstico por imagem , Reprodutibilidade dos Testes , Ecocardiografia Tridimensional/métodos , Disfunção Ventricular Esquerda/diagnóstico por imagem , Ecocardiografia
9.
Rev. port. cardiol ; 41(9): 771-779, Sept. 2022. graf, ilus, tab
Artigo em Inglês | Sec. Est. Saúde SP, CONASS, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1393130

RESUMO

INTRODUCTION AND OBJECTIVES: Hypertrophic cardiomyopathy (HCM) is accompanied by pathophysiological changes that predispose to the development of atrial fibrillation (AF). This arrhythmia impacts negatively on the morbidity, mortality and quality of life of these patients. Our objective was to evaluate the behavior of left atrial function, by means of atrial strain (derived from speckle tracking) and volumetric analysis by three-dimensional echocardiography, in patients with HCM with paroxysmal AF. METHOD: We analysed left atrial function in 53 patients with HCM, 25 of whom were paroxysmal AF carriers (mean age 61.7±9.9 years; 56% female) compared with 28 members of the control group (mean age 60.5±10 years; 53.6% female) who were matched especially for sex, age and other demographic data. RESULTS: It was observed that patients with HCM and a history of paroxysmal AF had lower left atrial emptying fractions than individuals in the control group; and the active atrial emptying fraction was a factor independently associated with the presence of this arrhythmia (p=0.018; odds ratio=0.93). Moreover, we found a significant reduction of the left atrial strain in all its components in the total sample of patients, with no difference between the groups. CONCLUSIONS: Measurements of atrial emptying fractions by three-dimensional echocardiography allowed differentiating patients with HCM with and without paroxysmal AF.


Assuntos
Fibrilação Atrial , Cardiomiopatia Hipertrófica , Função Atrial , Ecocardiografia Tridimensional
10.
Echocardiography ; 39(10): 1307-1315, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36126339

RESUMO

AIM: This study aimed to evaluate the role of real-time three-dimensional (four-dimensional) and speckle tracking echocardiography for early detection of left ventricular systolic dysfunction and also for the relationship between myocardial deformation parameters and myocardial iron load which is measured by cardiac magnetic resonance relaxation time T2* values in asymptomatic children with beta-thalassemia major. MATERIAL AND METHODS: This multicenter cross-sectional study included 40 patients (mean age 15.4 ± 2.9, 42.1% male) and 40 healthy children whose age, gender, and body mass index-matched with patients. Each participant underwent conventional echocardiography and tissue Doppler imaging. Left ventricular ejection fraction; global longitudinal, circumferential, radial strains; twist; and torsion were measured by real-time three-dimensional and speckle tracking echocardiography. Cardiac magnetic resonance imaging T2* was measured in patients. RESULTS: Left ventricular global longitudinal, circumferential, and radial strains were decreased despite preserved global ventricular function in patients compared to healthy children (p = p = .029, p = p < .001, p = .003, respectively). There were no statistically significant differences between patients with T2* ≥ 20 ms and patients with T2* < 20 ms for all echocardiographic parameters. Also, there were no significant correlations between all echocardiographic parameters and T2* values in all patients, those with T2* ≥ 20 ms, and T2* < 20 ms. CONCLUSION: We found that even in asymptomatic children with beta-thalassemia major, left ventricular longitudinal, circumferential and, radial functions were impaired by real-time three-dimensional (four-dimensional) and speckle tracking echocardiography. This novel echocardiographic method might be an important tool for detecting subclinical left ventricular systolic dysfunction irrespective of T2* values.


Assuntos
Ecocardiografia Tridimensional , Disfunção Ventricular Esquerda , Talassemia beta , Criança , Humanos , Masculino , Feminino , Função Ventricular Esquerda , Talassemia beta/complicações , Volume Sistólico , Estudos Transversais , Ecocardiografia/métodos , Disfunção Ventricular Esquerda/complicações , Disfunção Ventricular Esquerda/diagnóstico por imagem , Ecocardiografia Tridimensional/métodos
11.
J Clin Ultrasound ; 50(9): 1229-1239, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36054138

RESUMO

OBJECTIVE: Bying comparing the correlation between three-dimensional speckle tracking echocardiography (3D-STE) and troponin I (cTn I), three-dimensional left ventricular ejection fraction (3D-LVEF), to explore the 3D-STE to evaluate the left ventricle of patients with acute ST-segment elevation myocardial infarction (AMI) after percutaneous coronary intervention (PCI) following routine treatment with Tongxinluo drugs. METHODS: Altogether, 61 patients with AMI and 30 healthy adults were selected, and the patients were divided into the routine group and the Tongxinluo group. The serum creatine kinase isoenzyme (CK-MB) and troponin I (cTn I) levels were detected in all patients after admission. All patients underwent PCI, and routine echocardiography and 3D-STE assessments were performed for each group 72 h after PCI and 12 months after PCI to obtain the following left ventricular-related functional parameters: left ventricular end-diastolic diameter (LVEDD), end-ventricular septal end-diastolic thickness (IVSD), left ventricular posterior wall end-diastolic thickness (LVPWD), left ventricular short axis shortening fraction (LVFS), Simpson's left ventricular ejection fraction (Simpson's LVEF), three-dimensional left ventricular ejection fraction (3D-LVEF), global longitudinal strain (GLS), global circumferential strain (GCS), left ventricular twist angle (LVtw), Torsion (Tor), peak strain dispersion (PSD), and myocardial comprehensive index (MCI). The same parameters were collected in the control group, the results were compared. The correlation analysis between 3D-STE parameters and 3D-LVE, cTn I was performed. A total of 10 individuals were selected for repeatability testing. RESULTS: Compared with the control group, the LVFS, LVEF (Simpson), 3D-LVEF, GLS, GCS, LVtw, Tor, and MCI significantly decreased in patients with STEMI after PCI, while the PSD significantly increased (p < 0.05). Compared with the values 72 h after PCI, the LVEDD, LVFS, LVEF (Simpson), 3D-LVEF, GLS, GCS, LVtw, Tor, and MCI significantly increased at 12 m after PCI, while PSD significantly decreased (p < 0.05). No significant difference was observed between the two groups at 72 h after PCI (p > 0.05). At 12 months after PCI, the LVEF, GLS, GCS, LVtw, Tor, and MCI of the Tongxinluo group were higher than those of the routine group. The PSD was significantly lower in the Tongxinluo group (p < 0.05). MCI and 3D-LVEF, cTn I have the strongest correlation and the highest consistency, which can best reflect the changes in the left ventricular function in patients with AMI after PCI. CONCLUSION: 3D-STE can be used to evaluate the protective effect of Tongxinluo on the left ventricular function in patients with AMI after PCI.


Assuntos
Ecocardiografia Tridimensional , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST , Adulto , Humanos , Ecocardiografia/métodos , Ecocardiografia Tridimensional/métodos , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico por imagem , Infarto do Miocárdio com Supradesnível do Segmento ST/tratamento farmacológico , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia , Volume Sistólico , Troponina I , Função Ventricular Esquerda
12.
Echocardiography ; 39(9): 1180-1189, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36029116

RESUMO

BACKGROUND: Three-dimensional echocardiography (3DE) is an emerging method for volumetric cardiac measurements; however, few vendor-neutral analysis packages exist. Ventripoint Medical System Plus (VMS3.0+) proprietary software utilizes a validated Magnetic resonance imaging (MRI) database of normal ventricular and atrial morphologies to calculate chamber volumes. This study aimed to compare left ventricular (LV) and atrial (LA) volumes obtained using VMS3.0+ to Tomtec echocardiography analysis software. METHODS: Healthy controls (n = 98) aged 0-18 years were prospectively recruited and 3D DICOM datasets focused on the LV and LA acquired. LV and LA volumes and ejection fractions were measured using TomTec Image Arena 3D LV analysis package and using VMS3.0+. Pearson correlation coefficients, Bland-Altman's plots, and intraclass coefficients (ICC) were calculated, along with analysis time. RESULTS: There was a very good correlation between Ventripoint Medical System (VMS) and Tomtec LV systolic (r2  = .88, ICC .89 [95% CI .81, .94]), and diastolic (r2  = .88, ICC .90 [95% CI .77, .95]) volumes, and between VMS and Tomtec LA diastolic (r2  = .75, ICC .89 [95% CI .81, .93]) and systolic (r2  = .88, ICC .91 [95% CI .78, .96]) volumes on linear regression models. Natural log transformations eliminated heteroscedasticity, and power transformations provided the best fit. The time (mins) to analyze volumes using VMS were less than using Tomtec (LV VMS 2.3 ± .5, Tomtec 3.3 ± .8, p < .001; LA: VMS 1.9 ± .4, Tomtec 3.4 ± 1.0, p < .001). CONCLUSIONS: There was a very good correlation between knowledge-based (VMS3.0+) and 3D (Tomtec) algorithms when measuring 3D echocardiography-derived LA and LV volumes in pediatric patients. VMS was slightly faster than Tomtec in analyzing volumetric measurements.


Assuntos
Ecocardiografia Tridimensional , Algoritmos , Criança , Ecocardiografia , Ecocardiografia Tridimensional/métodos , Ventrículos do Coração/diagnóstico por imagem , Humanos , Reprodutibilidade dos Testes , Volume Sistólico , Função Ventricular Esquerda
13.
J Biomech ; 142: 111226, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35963102

RESUMO

Barlow's Disease affects the entire mitral valve apparatus causing mitral regurgitation. Standard annuloplasty procedures lead to an average of 55% annular area reduction of the end diastolic pre-operative annular area in Barlow's diseased valves. Following annular reduction, mitral valvuloplasty may be needed, usually with special focus on the posterior leaflet. An in silico pipeline to perform annuloplasty by utilizing the pre- and -postoperative 3D echocardiographic recordings was developed. Our objective was to test the hypothesis that annuloplasty ring sizes based on a percentage (10%-25%) decrease of the pre-operative annular area at end diastole can result in sufficient coaptation area for the selected Barlow's diseased patient. The patient specific mitral valve geometry and finite element model were created from echocardiography recordings. The post-operative echocardiography was used to obtain the artificial ring geometry and displacements, and the motion of the papillary muscles after surgery. These were used as boundary conditions in our annuloplasty finite element analyses. Then, the segmented annuloplasty ring was scaled up to represent a 10%, 20% and 25% reduction of the pre-operative end diastolic annular area and implanted to the end diastolic pre-operative finite element model. The pre-operative contact area decrease was shown to be dependent on the annular dilation at late systole. Constraining the mitral valve from dilating excessively can be sufficient to achieve proper coaptation throughout systole. The finite element analyses show that the selected Barlow's diseased patient may benefit from an annuloplasty ring with moderate annular reduction alone.


Assuntos
Anuloplastia da Valva Mitral , Insuficiência da Valva Mitral/cirurgia , Prolapso da Valva Mitral/cirurgia , Ecocardiografia Tridimensional , Análise de Elementos Finitos , Humanos , Valva Mitral/anatomia & histologia , Valva Mitral/diagnóstico por imagem , Valva Mitral/patologia , Anuloplastia da Valva Mitral/efeitos adversos , Anuloplastia da Valva Mitral/instrumentação , Anuloplastia da Valva Mitral/métodos , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/etiologia , Prolapso da Valva Mitral/complicações , Prolapso da Valva Mitral/diagnóstico por imagem , Prolapso da Valva Mitral/etiologia , Resultado do Tratamento
17.
Curr Med Sci ; 42(4): 895-901, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35870103

RESUMO

OBJECTIVE: To establish a quantitative evaluation of the left ventricle's systolic function in patients with chronic kidney failure (CKF) by three-dimensional speckle-tracking echocardiography. METHODS: Two-dimensional and three-dimensional transthoracic echocardiography was performed on 30 patients with CKF. The ejection fraction, mass and global peak longitudinal strain, global circumferential strain, global area strain, and global radial strain of the left ventricle were calculated. RESULTS: The ejection fraction, mass and global peak longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), and global radial strain (GRS) in the CKF group were significantly lower than those in the control group. Simultaneously, the GLS, GCS, GAS and GRS were well correlated with the ejection fraction. For patients with normal ejection fraction in the CKF group, the GLS, GCS, GAS and GRS were lower than those in the control group, while the left ventricular mass was significantly higher in CKF patients than in the control group. For patients with hypertension in the CKF group, ejection fraction, GLS, GCS, GAS and GRS calculated using three-dimensional echocardiography were significantly lower than those in patients with normal blood pressure; however, the myocardial mass was higher. CONCLUSIONS: The parameters (GLS, GCS, GAS and GRS) calculated using three-dimensional speckle-tracking software were lower in the CKF group. Simultaneously, the left ventricular mass was higher in CFK patients than in the control group, thus showing that the myocardial contraction function was impaired and that myocardial remodeling had occurred.


Assuntos
Ecocardiografia Tridimensional , Falência Renal Crônica , Ecocardiografia/métodos , Ecocardiografia Tridimensional/métodos , Humanos , Contração Miocárdica/fisiologia , Função Ventricular Esquerda/fisiologia
18.
Echocardiography ; 39(8): 1146-1148, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35819102

RESUMO

INTRODUCTION: Subaortic membrane is an uncommon cause of left ventricular outflow tract obstruction. DISCUSSION: Whereas traditionally described of as a membrane, it is in fact a discreet circumferential shelf of raised endocardium in the left ventricular outflow tract, causing a fixed outflow obstruction. The circumferential nature of subaortic membranes is poorly appreciated on 2-dimensional imaging. CONCLUSION: Using a three-dimensional imaging and recently available on-cart rendition techniques of acquired images, we were able to better visualize the true extent of a sub-aortic membrane while also gaining insight into its origin and structure.


Assuntos
Ecocardiografia Tridimensional , Obstrução do Fluxo Ventricular Externo , Aorta , Humanos
19.
Sci Rep ; 12(1): 12237, 2022 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-35856087

RESUMO

Chagas disease (CD) is a neglected infectious disease associated with early mortality and substantial disability. Three-dimensional speckle tracking (3D STE) may play a role in the evaluation of CD. We aim to characterize new echocardiographic variables in patients with CD and to assess the hypothesis that 3D STE may predict outcomes. Seventy-two patients with CD were included. Clinical and conventional 2D and 3D STE analysis were performed. Patients were followed up for 60 months. Clinical events were defined as hospitalization for heart failure, complex ventricular arrhythmias, heart transplant and all-cause death. Seventy-two patients were recruited and enrolled in three groups: left ventricular ejection fraction (LVEF) < 0.40 (N = 22; reduced LVEF or rLVEF); 0.40 ≤ LVEF ≤ 0.50 (N = 10; mildly reduced LVEF or mrLVEF) and LVEF > 0.50 (N = 30; preserved LVEF or pLVEF). After a Cox model analysis, the top predictors of composite endpoints were 2D LV global longitudinal strain (GLS) ≤ - 11.3% (AUC = 0.87), 2D LV global circumferential strain (GCS) ≤ - 10.1% (AUC = 0.79), 3D LV GLS ≤ - 13% (AUC = 0.82), 3D LV area strain ≤ - 16% (AUC = 0.81) and right ventricle (RV) GLS ≤ - 17.2% (AUC = 0.78). Patients with CD and mrLVEF were morphologically similar to the rLVEF patients despite the benign evolution as the pLVEF group. RV GLS, 2D LV GLS, 2D LV GCS, 3D LV GLS, and 3D LV area strain are strong predictors of 60 months outcomes in patients with CD.


Assuntos
Cardiomiopatia Chagásica , Ecocardiografia Tridimensional , Disfunção Ventricular Esquerda , Cardiomiopatia Chagásica/diagnóstico por imagem , Ecocardiografia Tridimensional/métodos , Humanos , Reprodutibilidade dos Testes , Volume Sistólico , Função Ventricular Esquerda
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