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1.
Int Heart J ; 62(1): 95-103, 2021 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-33455980

RESUMO

Enlargement of the mitral valve (MV) has gained attention as a compensatory mechanism for functional mitral regurgitation (FMR). We aimed to determine if MV leaflet area is associated with MV coaptation-zone area and identify the clinical factors associated with MV leaflet size and coaptation-zone area in patients with normal left ventricle (LV) systolic function and size using real-time 3D echocardiography (RT3DE).We performed RT3DE in 135 patients with normal LV size and ejection fraction. MV leaflet and coaptation-zone areas were measured using custom 3D software. The clinical factors associated with MV leaflet and coaptation-zone areas were evaluated using univariate and multivariate linear regression analyses.There was a significant relationship between MV leaflet and coaptation-zone areas (r = 0.499, P < 0.001). MV leaflet area was strongly associated with body surface area (BSA) (r = 0.905, P < 0.001) rather than LV size and age. MV leaflet area/BSA was independently associated with male gender (P = 0.002), lower diastolic blood pressure (P = 0.042), and LV end-diastolic volume (LVEDV) index (P = 0.048); MV coaptation-zone area/BSA was independently associated with lower LVEDV index (P = 0.01).In patients with normal LV systolic function and size, MV leaflet size has a significant impact on competent MV coaptation. MV leaflet area might be intrinsically determined by body size rather than age and LV size, and the MV leaflet area/BSA is relatively constant. On the other hand, some clinical factors might also influence MV leaflet and coaptation-zone area.


Assuntos
Ventrículos do Coração/diagnóstico por imagem , Insuficiência da Valva Mitral/fisiopatologia , Valva Mitral/diagnóstico por imagem , Função Ventricular Esquerda/fisiologia , Idoso , Pressão Sanguínea/fisiologia , Ecocardiografia Tridimensional/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Fatores Sexuais , Volume Sistólico/fisiologia , Sístole
2.
Echocardiography ; 38(2): 222-229, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33368601

RESUMO

AIMS: The aim of this investigation was to evaluate echocardiographic parameters of cardiac function and in particular right ventricular (RV) function as a predictor of mortality in patients with coronavirus disease-2019 (COVID-19) pneumonia. METHODS AND RESULTS: This prospective observational study included 35 patients admitted to a UK district general hospital with COVID-19 and evidence of cardiac involvement, that is, raised Troponin I levels or clinical evidence of heart failure during the first wave of the COVID-19 pandemic (March-May 2020). All patients underwent echocardiography including speckle tracking for right ventricular longitudinal strain (RVLS) providing image quality was sufficient (30 out of 35 patients). Upon comparison of patients who survived COVID-19 with non-survivors, survivors had significantly smaller RVs (basal RV diameter 38.2 vs 43.5 mm P = .0295) with significantly better RV function (Tricuspid annular plane systolic excursion (TAPSE): 17.5 vs 15.3 mm P = .049; average RVLS: 24.3% vs 15.6%; P = .0018). Tricuspid regurgitation (TR) maximal velocity was higher in survivors (2.75 m/s vs 2.11 m/s; P = .0045) indicating that pressure overload was not the predominant driver of this effect and there was no significant difference in left ventricular (LV) ejection fraction. Kaplan-Meier and log-rank analysis of patients split into groups according to average RVLS above or below 20% revealed significantly increased 30-day mortality in patients with average RVLS under 20% (HR: 3.189; 95% CI: 1.297-12.91; P = .0195). CONCLUSION: This study confirms that RVLS is a potent and independent predictor of outcome in COVID-19 patients with evidence of cardiac involvement.


Assuntos
/epidemiologia , Ecocardiografia Tridimensional/métodos , Insuficiência Cardíaca/fisiopatologia , Ventrículos do Coração/diagnóstico por imagem , Pandemias , Volume Sistólico/fisiologia , Função Ventricular Direita/fisiologia , Idoso , Comorbidade , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Projetos Piloto , Prognóstico , Estudos Prospectivos
3.
ABC., imagem cardiovasc ; 33(4): eabc98, 20200000.
Artigo em Português | LILACS | ID: biblio-1146297

RESUMO

Fundamento: A fração de ejeção do ventrículo esquerdo é um dos parâmetros ecocardiográficos mais utilizados na prática clínica. Sua estimativa pelo método bidimensional manual (método de Simpson) tem reprodutibilidade e acurácia limitadas, e métodos semiautomáticos têm sido propostos. Torna-se necessário comparar o método bidimensional semiautomático com métodos mais acurados de avaliação da fração de ejeção do ventrículo esquerdo, como a medida pela ecocardiografia tridimensional automática. Objetivo: Comparar as estimativas da fração de ejeção do ventrículo esquerdo e dos volumes diastólico final e sistólico final do ventrículo esquerdo pelo método bidimensional semiautomático com as obtidas pelo método tridimensional automático. Método: Estudo observacional transversal, com pacientes em ritmo sinusal, fração de ejeção do ventrículo esquerdo >50% e sem cardiopatia estrutural significativa, submetidos ao ecocardiograma transtorácico. Teste t de Student, coeficiente de Pearson e análise de Bland-Altman foram usados na análise estatística. Resultados: Foram incluídos 40 pacientes, sendo: 53% mulheres, 35% hipertensos, 25% dislipidêmicos, 10% diabéticos, 10% tabagistas e 13% com angioplastia prévia. Os valores médios da fração de ejeção do ventrículo esquerdo aos métodos tri e bidimensionais foram 62,1 ± 5,8% e 61,7 ± 5,9% (p = 0,50), respectivamente. Houve forte correlação da fração de ejeção do ventrículo esquerdo determinada melos métodos bi e tridimensional (r = 0,74; p<0,001), assim como com o volume diastólico final (r = 0,75; p<0,001) e o sistólico final (r = 0,76; p<0,001). Houve boa concordância entre a fração de ejeção do ventrículo esquerdo bi e tridimensional (diferença média: -0,39; intervalo de confiança 95% -1,7-0,9). Conclusão: A fração de ejeção do ventrículo esquerdo estimada pelo método bidimensional semiautomático mostrou boa concordância com o método tridimensional automático. Os achados sugerem que o método bidimensional semiautomático represente uma alternativa confiável para avaliação dos volumes e fração de ejeção do ventrículo esquerdo.


Background: Left ventricular ejection fraction is one of the most used echocardiographic parameters in clinical practice. Its estimation by twodimensional manual method (Simpson method) has limited reproducibility and accuracy, and semi-automatic methods have been proposed. It becomes necessary to compare the semiautomatic two-dimensional method with more accurate methods of assessing left ventricular ejection fraction, such as measurement by automatic three-dimensional echocardiography. Objective: To compare the left ventricular ejection fraction, and left ventricular end-diastolic and end-systolic volumes estimates by the semiautomatic two-dimensional method with those obtained using the automatic three-dimensional method. Method: Observational cross-sectional study, including patients in sinus rhythm, left ventricular ejection fraction > 50% and without significant structural heart disease, submitted to transthoracic echocardiography. Student's t test, Pearson's coefficient and Bland-Altman analysis wer


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Design de Software , Função Ventricular Esquerda/fisiologia , Volume Sistólico , Padrões de Prática Médica , Ecocardiografia/métodos , Estudos Transversais/métodos , Resultado do Tratamento , Ecocardiografia Tridimensional/métodos
4.
Pediatr Cardiol ; 41(7): 1370-1375, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32488509

RESUMO

3D transesophageal echocardiography (3D-TEE) has proven useful and accurate during some operating room (OR), interventional cardiac catheterization (Cath), and electrophysiologic (EP) procedures. The use of 3D-TEE during similar procedures in patients who have undergone Fontan surgery and its additional value have not been previously reported. To determine if live 3D-TEE during procedures post Fontan has added value, 3D-TEEs in 58 post-Fontan patients over a 5-year study period were reviewed. Additional information provided by 3D-TEE (over 2D-TEE) was classified into the following: A: new information which changed/refined the plan and 0: no new important information. Pre- and post-bypass OR 3D-TEEs were counted as one study. A total of 67 3D-TEEs (41 Cath, 13 OR, and 13 EP procedures) were performed. Median age was 14 years (6-39 years). Median weight was 47 kg (21-109 kg). In Cath procedures, only 2/41 (5%) were graded A (R to L atrial level shunt [Fontan leak], n = 1; thrombus in pulmonary artery stump, n = 1). In the OR, 6/13 (46%) were graded A (atrioventricular valvuloplasty, n = 1; neo-aortic valvuloplasty, n = 1; relief of systemic and pulmonary venous outflow obstruction, n = 2 and n = 2; respectively). In EP procedures, 4/13 (31%) were graded A (thrombus, n = 3; mapping for lead placement to assist in multisite pacing for dyssynchrony, n = 1). 3D-TEE of Fontan improved visualization and frequently added value in the OR/EP lab and may be helpful in select catheterization cases. Future studies with a larger sample could build on this data to identify when 3D-TEE will be most useful.


Assuntos
Ecocardiografia Tridimensional/estatística & dados numéricos , Ecocardiografia Transesofagiana/estatística & dados numéricos , Técnica de Fontan/métodos , Cardiopatias Congênitas/cirurgia , Adolescente , Adulto , Cateterismo Cardíaco/métodos , Criança , Ecocardiografia Tridimensional/métodos , Ecocardiografia Transesofagiana/métodos , Feminino , Átrios do Coração/diagnóstico por imagem , Cardiopatias Congênitas/diagnóstico por imagem , Humanos , Masculino , Trombose/fisiopatologia , Adulto Jovem
5.
Curr Cardiol Rep ; 22(7): 50, 2020 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-32500412

RESUMO

PURPOSE OF REVIEW: The goal of the paper is to highlight the importance of procedural planning and patient selection when using the MitraClip device in treating severe mitral regurgitation (MR). RECENT FINDINGS: Following the recent results of the COAPT trial and FDA approval for functional MR patients, the indications for mitral clip are continuing to expand. Because of this, mitral stenosis from mitral clip can become a problem if the appropriate patients are not selected. Proper valve imaging, utilizing 3D transesophageal echocardiography to identify the pathology, is important to prevent iatrogenic mitral stenosis. In the unfortunate event of severe mitral stenosis as a result of the MitraClip device, surgery is the only treatment.


Assuntos
Ecocardiografia Tridimensional/métodos , Insuficiência da Valva Mitral , Estenose da Valva Mitral , Valva Mitral/diagnóstico por imagem , Ecocardiografia Transesofagiana , Implante de Prótese de Valva Cardíaca , Humanos , Insuficiência da Valva Mitral/terapia , Estenose da Valva Mitral/diagnóstico , Estenose da Valva Mitral/terapia , Resultado do Tratamento
6.
Pediatr Cardiol ; 41(6): 1125-1134, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32367304

RESUMO

To assess the fetal cardiac function and ventricular volumes by three-dimensional (3D) ultrasound using spatio-temporal image correlation (STIC) and virtual organ computer-aided analysis (VOCAL) methods in fetuses from pre-gestational diabetic women. This was a prospective and cross-sectional study that evaluated 53 fetuses from pre-gestational diabetic women and 53 fetuses from healthy mothers between 20 and 34 weeks of gestation. Only fetuses with no structural or genetic abnormalities and singleton pregnant women were included in this study. The fetal cardiac volumes were assessed by STIC and VOCAL methods. The ejection fraction, stroke volume, and cardiac output were calculated from these measurements to evaluate fetal cardiac function. The Mann-Whitney U test was performed to compare the two groups. For calculation of intra- and interobserver reproducibility's, we used concordance correlation coefficients. The mean differences in the right atrial volumes between the diabetic and normal groups ranged from 0.05 mL to 0.1 mL (p = 0.917 and 0.355, respectively). The median of left atrium (LA) volume measurement in pre-gestational diabetic group was significantly lower than healthy mothers (LA: 0.62 vs. 0.68 mL; p < 0.001). The fetal right and left ventricular volumes were similar in both groups. No significant differences in ejection fraction, stroke volume and cardiac output were observed (p value range 0.086-0.815). The majority of fetal atrial/ventricular volumes showed good intra- and interobserver reliabilities. Conversely, the majority cardiac function parameters showed poor intra- and interobserver agreements. STIC and VOCAL methods gave reproducible quantitative results for fetal atrial and ventricular volumes. Significant differences in fetal left atrial volumes were observed between the two groups, which be related to LA atrial dysfunction and /or left ventricle (LV) compliance, reflecting earlier stages of cardiac dysfunction.


Assuntos
Diabetes Gestacional/fisiopatologia , Ecocardiografia Tridimensional/métodos , Coração Fetal/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos , Adulto , Volume Cardíaco , Estudos de Casos e Controles , Estudos Transversais , Diabetes Gestacional/diagnóstico por imagem , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/patologia , Humanos , Gravidez , Estudos Prospectivos , Reprodutibilidade dos Testes , Volume Sistólico , Adulto Jovem
7.
Pediatr Cardiol ; 41(5): 985-995, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32335735

RESUMO

Although the Cone procedure has improved outcomes for patients with Ebstein´s anomaly (EA), neither RV systolic function recovery in long-term follow-up nor the best echocardiographic parameters to assess RV function are well established. Thus, we evaluated RV performance after the Cone procedure comparing two-dimensional (2DEcho) and three-dimensional (3DEcho) echocardiography to cardiac magnetic resonance (CMR). We assessed 27 EA patients after the Cone procedure (53% female, median age of 20 years at the procedure, median post-operative follow-up duration of 8 years). Echocardiography was performed 4 h apart from the CMR. RV global longitudinal strain (GLS), fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), myocardial performance index and tissue Doppler S' velocity were assessed using 2DEcho, whereas 3DEcho was used to evaluate RV volumes and ejection fraction (RVEF). Echocardiographic variables were compared to CMR-RVEF. All patients were in the NYHA functional class I. Median TAPSE was 15.9 mm, FAC 30.2%, and RV-GLS -15%; median RVEF by 3DEcho was 31.9% and 43% by CMR. Among 2DEcho parameters, RV-GLS and FAC had a substantial correlation with CMR-RVEF (r = - 0.63 and r = 0.55, respectively); from 3DEcho, the indexed RV volumes and RVEF were closely correlated with CMR (RV-EDVi, r = 0.60, RV-ESVi, r = 0.72; and RVEF r = 0.60). RV systolic function is impaired years after the Cone procedure, despite a good clinical status. FAC and RV-GLS are useful 2DEcho tools to assess RV function in these patients; however, 3DEcho measurements appear to provide a better RV assessment.


Assuntos
Ecocardiografia Tridimensional/normas , Imagem Cinética por Ressonância Magnética/normas , Disfunção Ventricular Direita/diagnóstico por imagem , Adolescente , Adulto , Criança , Anomalia de Ebstein/cirurgia , Ecocardiografia Tridimensional/métodos , Feminino , Humanos , Imagem Cinética por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Função Ventricular Direita , Adulto Jovem
8.
Ann Thorac Surg ; 110(2): 670-675, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32199821

RESUMO

PURPOSE: In children with a mitral annulus too small to accommodate traditional prostheses, surgical implantation of stent-based valves is a promising option. However no reliable preoperative methods exist to guide patient selection, device sizing, and positioning. We describe a novel methodology to visualize and quantify device fit in 3-dimensional echocardiogram (3DE)-derived heart models. DESCRIPTION: Heart models were created from existing preoperative 3DEs using custom software. Valve models were virtually implanted into the models, and both device fit and left ventricular outflow tract (LVOT) area were quantified. EVALUATION: The 3DEs of 3 patients who underwent Melody valve placement in the mitral position were retrospectively modeled: 1 with LVOT obstruction, 1 with perivalvar leak, and 1 without complications. In all cases 2-dimensional measurements underestimated 3D annular dimensions, and the patient with clinical LVOT obstruction had the lowest predicted LVOT area-to-aortic area ratio (0.5). CONCLUSIONS: 3DE-based preoperative modeling of surgical implantation of stent-based valves in the mitral position may improve quantification of mitral valve dimensions and inform risk stratification for potential LVOT obstruction.


Assuntos
Cateterismo Cardíaco/métodos , Ecocardiografia Tridimensional/métodos , Implante de Prótese de Valva Cardíaca/métodos , Próteses Valvulares Cardíacas , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Feminino , Humanos , Lactente , Masculino , Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/diagnóstico , Desenho de Prótese , Estudos Retrospectivos
11.
Int J Comput Assist Radiol Surg ; 15(4): 617-627, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31955326

RESUMO

PURPOSE: Intensive planning and analysis from echocardiography are a crucial step before reconstructive surgeries are applied to malfunctioning mitral valves. Volume visualizations of echocardiographic data are often used in clinical routine. However, they lack a clear visualization of the crucial factors for decision making. METHODS: We build upon patient-specific mitral valve surface models segmented from echocardiography that represent the valve's geometry, but suffer from self-occlusions due to complex 3D shape. We transfer these to 2D maps by unfolding their geometry, resulting in a novel 2D representation that maintains anatomical resemblance to the 3D geometry. It can be visualized together with color mappings and presented to physicians to diagnose the pathology in one gaze without the need for further scene interaction. Furthermore, it facilitates the computation of a Pathology Score, which can be used for diagnosis support. RESULTS: Quality and effectiveness of the proposed methods were evaluated through a user survey conducted with domain experts. We assessed pathology detection accuracy using 3D valve models in comparison with the novel visualizations. Classification accuracy increased by 5.3% across all tested valves and by 10.0% for prolapsed valves. Further, the participants' understanding of the relation between 3D and 2D views was evaluated. The Pathology Score is found to have potential to support discriminating pathologic valves from normal valves. CONCLUSIONS: In summary, our survey shows that pathology detection can be improved in comparison with simple 3D surface visualizations of the mitral valve. The correspondence between the 2D and 3D representations is comprehensible, and color-coded pathophysiological magnitudes further support the clinical assessment.


Assuntos
Ecocardiografia Tridimensional/métodos , Insuficiência da Valva Mitral/diagnóstico por imagem , Valva Mitral/diagnóstico por imagem , Ecocardiografia/métodos , Feminino , Humanos , Masculino , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/cirurgia , Reprodutibilidade dos Testes
12.
Monaldi Arch Chest Dis ; 90(1)2020 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-31970966

RESUMO

We report a case of a recurrence of 5 cardiac myxomas in both atria with atypical anatomical features difficult to image. Although a multimodality imaging was performed, three-dimensional echocardiography (3DE) was the only technique able to correctly identify all the recurrences and the anatomical characteristics of the myxomas. MRI detected the blood supply of the mass but even after careful review was able to identify only 4 of the 5 lesions. Even though it was already reported the usefulness of 3DE to better delineate the site of attachment of cardiac tumors, it was never reported its sensibility in the setting of multiple myxomas; this case highlights the ability of the 3DE in this challenging scenario and its potential for being considered the key adjunctive modality for the anatomy when advanced surgical plan is required.


Assuntos
Ecocardiografia Tridimensional/métodos , Átrios do Coração/patologia , Mixoma/diagnóstico por imagem , Adulto , Feminino , Neoplasias Cardíacas/patologia , Humanos , Imagem por Ressonância Magnética/métodos , Mixoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Reoperação/métodos , Resultado do Tratamento
13.
Orv Hetil ; 161(5): 169-176, 2020 02.
Artigo em Húngaro | MEDLINE | ID: mdl-31984773

RESUMO

Introduction: Hypereosinophilic syndrome (HES) and immunoglobulin light-chain amyloidosis (ALA) are two, rare haematological disorders associated with cardiac alterations. Aim: The goal of the present study was a comparative assessment of left ventricular (LV) deformational parameters in HES and ALA patients using three-dimensional speckle-tracking echocardiography (3DSTE). Method: In the present study, results of 10 HES patients (mean age: 60.9 ± 14.7 years) and 19 ALA patients (mean age: 63.4 ± 7.8 years, 13 males) were analysed. The control group contained 13 age- and gender-matched healthy adults (mean age: 59.2 ± 4.3 years, 5 males). All patients underwent a complete two-dimensional Doppler echocardiography followed by 3DSTE. Results: All basal segmental LV strains were significantly reduced in ALA patients as compared to the control group. Global and mean segmental LV longitudinal strain (LS) values of ALA patients proved to be significantly decreased as compared to those of the healthy control group. During comparison of HES patients and healthy controls, significant difference could be detected in global LV-LS, while segmental basal LV-LS was also significantly reduced in HES patients. Basal LV radial and 3D strains showed significant differences when parameters of HES and ALA patient groups were compared. Conclusion: 3DSTE is a feasible tool for the detailed assessment of LV deformation in HES and ALA patients. Significant LV deformational abnormalities could be detected in both groups. In the case of ALA, these abnormalities are more prominent. Orv Hetil. 2020; 161(5): 169-176.


Assuntos
Cardiomiopatias/diagnóstico por imagem , Ecocardiografia Tridimensional/métodos , Ventrículos do Coração/diagnóstico por imagem , Síndrome Hipereosinofílica , Amiloidose de Cadeia Leve de Imunoglobulina/diagnóstico por imagem , Disfunção Ventricular Esquerda/diagnóstico por imagem , Adulto , Idoso , Cardiomiopatias/imunologia , Cardiomiopatias/fisiopatologia , Estudos de Casos e Controles , Ecocardiografia Doppler , Feminino , Humanos , Amiloidose de Cadeia Leve de Imunoglobulina/imunologia , Amiloidose de Cadeia Leve de Imunoglobulina/fisiopatologia , Masculino , Pessoa de Meia-Idade , Disfunção Ventricular Esquerda/imunologia , Disfunção Ventricular Esquerda/fisiopatologia , Função Ventricular Esquerda
14.
J Card Surg ; 35(2): 375-382, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31794089

RESUMO

BACKGROUND: Patients with bicuspid aortic valves (BAV) are heterogeneous with regard to patterns of root remodeling and valvular dysfunction. Two-dimensional echocardiography is the standard surveillance modality for patients with aortic valve dysfunction. However, ancillary computed tomography or magnetic resonance imaging is often necessary to characterize associated patterns of aortic root pathology. Conversely, the pairing of three-dimensional (3D) echocardiography with novel quantitative modeling techniques allows for a single modality description of the entire root complex. We sought to determine 3D aortic valve and root geometry with this quantitative approach. METHODS: Transesophageal real-time 3D echocardiography was performed in five patients with tricuspid aortic valves (TAV) and in five patients with BAV. No patient had evidence of valvular dysfunction or aortic root pathology. A customized image analysis protocol was used to assess 3D aortic annular, valvular, and root geometry. RESULTS: Annular, sinus and sinotubular junction diameters and areas were similar in both groups. Coaptation length and area were higher in the TAV group (7.25 ± 0.98 mm and 298 ± 118 mm2 , respectively) compared to the BAV group (5.67 ± 1.33 mm and 177 ± 43 mm2 ; P = .07 and P = .01). Cusp surface area to annular area, coaptation height, and the sub- and supravalvular tenting indices did not differ significantly between groups. CONCLUSIONS: Single modality 3D echocardiography-based modeling allows for a quantitative description of the aortic valve and root geometry. This technique together with novel indices will improve our understanding of normal and pathologic geometry in the BAV population and may help to identify geometric predictors of adverse remodeling and guide tailored surgical therapy.


Assuntos
Aorta/diagnóstico por imagem , Valva Aórtica/diagnóstico por imagem , Ecocardiografia Tridimensional/métodos , Doenças das Valvas Cardíacas/diagnóstico por imagem , Idoso , Aorta/patologia , Valva Aórtica/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
16.
J Clin Ultrasound ; 48(5): 263-268, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31737908

RESUMO

INTRODUCTION: The right atrium (RA) roles include being a systolic reservoir, an early diastolic conduit, and a late-diastolic booster pump. The present study aimed to assess normal reference values of three-dimensional speckle-tracking echocardiography (3DSTE)-derived RA volumetric data and volume-based functional properties in healthy adult subjects. METHODS: We included 260 healthy adult subjects in sinus rhythm with complete clinical and demographic dataset, but excluded 110 of them because of inferior image quality. The remaining population sample comprised 150 subjects (31.0 ± 11.6 years, 79 males). Complete two-dimensional Doppler echocardiography and 3DSTE have been performed in all subjects. RESULTS: Systolic RA volumetric variables did not show changes over time, but after 50 years, a significant reduction could be demonstrated in RA stroke volume and emptying fraction. While early diastolic RA volume increased over time, RA stroke volume and emptying fraction decreased. While late-diastolic RA volume increased over age decades, similar increase could be detected in RA stroke volume but a reduction occurred in older ages. Late-diastolic RA emptying fraction showed an increasing (after the 40s)-decreasing (after the 50s) pattern. CONCLUSIONS: Our study provides normal reference values of 3DSTE-derived RA volumes and volume-based functional properties and their age- and gender dependency in healthy adult subjects.


Assuntos
Função do Átrio Direito/fisiologia , Função Atrial/fisiologia , Ecocardiografia Tridimensional/métodos , Adolescente , Adulto , Feminino , Voluntários Saudáveis , Átrios do Coração/diagnóstico por imagem , Humanos , Masculino , Valores de Referência , Adulto Jovem
17.
Biomed Tech (Berl) ; 65(2): 209-218, 2020 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-31527290

RESUMO

Traditional two-dimensional (2D) ultrasound speckle tracking echocardiography (STE) studies have shown a wide range of twist values, also for normal hearts, which is due to the limitations of short-axis 2D ultrasound. The same limitations do not apply to three-dimensional (3D) ultrasound, and several studies have shown 3D ultrasound to be superior to 2D ultrasound, which is unreliable for measuring twist. The aim of this study was to develop a left ventricular twisting phantom and to evaluate the accuracy of 3D STE twist measurements using different acquisition methods and volume rates (VR). This phantom was not intended to simulate a heart, but to function as a medium for ultrasound deformation measurement. The phantom was made of polyvinyl alcohol (PVA) and casted using 3D printed molds. Twist was obtained by making the phantom consist of two PVA layers with different elastic properties in a spiral pattern. This gave increased apical rotation with increased stroke volume in a mock circulation. To test the accuracy of 3D STE twist, both single-beat, as well as two, four and six multi-beat acquisitions, were recorded and compared against twist from implanted sonomicrometry crystals. A custom-made software was developed to calculate twist from sonomicrometry. The phantom gave sonomicrometer twist values from 2.0° to 13.8° depending on the stroke volume. STE software tracked the phantom wall well at several combinations of temporal and spatial resolution. Agreement between the two twist methods was best for multi-beat acquisitions in the range of 14.4-30.4 volumes per second (VPS), while poorer for single-beat and higher multi-beat VRs. Smallest offset was obtained at six-beat multi-beat at 17.1 VPS and 30.4 VPS. The phantom proved to be a useful tool for simulating cardiac twist and gave different twist at different stroke volumes. Best agreement with the sonomicrometer reference method was obtained at good spatial resolution (high beam density) and a relatively low VR. 3D STE twist values showed better agreement with sonomicrometry for most multi-beat recordings compared with single-beat recordings.


Assuntos
Ecocardiografia Tridimensional/métodos , Ventrículos do Coração/fisiopatologia , Volume Sistólico/fisiologia , Ecocardiografia Tridimensional/instrumentação , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Imagens de Fantasmas , Software , Ultrassonografia
18.
Anesth Analg ; 130(2): 300-306, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31453871

RESUMO

BACKGROUND: Currently available 2-dimensional (2D) echocardiographic methods for accurately assessing the mitral valve orifice area (MVA) after mitral valve repair (MVr) are limited due to its complex 3-dimensional (3D) geometry. We compared repaired MVAs obtained with commonly used 2D and 3D echocardiographic methods to a 3D orifice area (3DOA), which is a novel echocardiographic measurement and independent of geometric assumptions. METHODS: Intraoperative 2D and 3D transesophageal echocardiography (TEE) images from 20 adult cardiac surgery patients who underwent MVr for mitral regurgitation obtained immediately after repair were retrospectively reviewed. MVAs obtained by pressure half-time (PHT), 2D planimetry (2DP), and 3D planimetry (3DP) were compared to those derived by 3DOA. RESULTS: MVAs (mean value ± standard deviation [SD]) after MVr were obtained by PHT (3 ± 0.6 cm), 2DP (3.58 ± 0.75 cm), 3D planimetry (3DP; 2.78 ± 0.74 cm), and 3DOA (2.32 ± 0.76 cm). MVAs obtained by the 3DOA method were significantly smaller compared to those obtained by PHT (mean difference, 0.68 cm; P = .0003), 2DP (mean difference, 1.26 cm; P < .0001), and 3DP (mean difference, 0.46 cm; P = .003). In addition, MVA defined as an area ≤1.5 cm was identified by 3DOA in 2 patients and by 3DP in 1 patient. CONCLUSIONS: Post-MVr MVAs obtained using the novel 3DOA method were significantly smaller than those obtained by conventional echocardiographic methods and may be consistent with a higher incidence of MVA reduction when compared to 2D techniques. Further studies are still needed to establish the clinical significance of 3D echocardiographic techniques used to measure MVA after MVr.


Assuntos
Ecocardiografia Tridimensional/métodos , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Ecocardiografia/métodos , Ecocardiografia/normas , Ecocardiografia Tridimensional/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
20.
Physiol Rep ; 7(23): e14300, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31814325

RESUMO

We hypothesized that left ventricular and left atrial volume ratio (LVLAVR) assessed by three-dimensional echocardiography (3DE) reflects age- and gender-related change in left chamber size. We aimed to (1) determine the reference values of LVLAVR, (2) investigate their age and gender dependency, and (3) clarify which anthropometric and echocardiography parameters are closely associated with these indices. Both left ventricular (LV) and left atrial (LA) volume curves were obtained using 3DE speckle tracking analytical software, and the LVLAVR curve throughout one cardiac cycle was created, from which LVLAVR at ventricular end-diastole and at ventricular end-systole were determined in 313 healthy subjects (age, 20-85 years; 51% men). The mean values of LVLAVR at ventricular end-diastole and ventricular end-systole in male subjects were 5.74 ± 1.54 and 1.37 ± 0.35, respectively. Corresponding values in female subjects were significantly lower (5.20 ± 1.47, p = .003 and 1.13 ± 0.29, p < .001) than the values in male subjects. LVLAVR at ventricular end-diastole step wisely decreased to advanced aging, and had a highest F ratio compared with other left chamber volumetric parameters in both genders. LV mass and LA ejection fraction were significantly associated with LVLAVR at ventricular end-diastole. In contrast, LV mass and LV ejection fraction were significantly coupled with LVLAVR at ventricular end-systole. This study provides the reference values for LVLAVR from a relatively large number of healthy subjects. LVLAVR may be a sensitive parameter to reflect age- and gender-related change in LV and LA volumes. Further studies should be required to determine its clinical usefulness over traditional echocardiography parameters in various cardiovascular diseases.


Assuntos
Envelhecimento/fisiologia , Ecocardiografia Tridimensional/normas , Átrios do Coração/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/patologia , Ecocardiografia Tridimensional/métodos , Feminino , Átrios do Coração/crescimento & desenvolvimento , Ventrículos do Coração/crescimento & desenvolvimento , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Fatores Sexuais
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