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2.
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
3.
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
4.
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
6.
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
7.
Comput Biol Med ; 148: 105855, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35872413

RESUMO

BACKGROUND: Doppler echocardiographic (echo) assessment of residual mitral regurgitation (MR) after transcatheter edge-to-edge repair (TEER) is challenging and often subjective. This study aimed to evaluate the accuracy and feasibility of standardized quantitative echo methods for assessment of MR severity after MitraClip repair by comparing measurements against a reference MR severity obtained from patient-specific in silico models. METHODS: Post-procedure hemodynamics were simulated under five different MitraClip configurations in previously validated patient-specific in silico models for the treatment of functional MR. The residual regurgitant volume was calculated as in clinical practice using four quantitative virtual echo methods: pulsed Doppler, volumetric, proximal isovelocity surface area (PISA) and vena contracta area (VCA). Multiple permutations were performed for each method. Virtual echo MR results were evaluated against reference MR values directly extracted from the 5 patient-specific in silico models. RESULTS: The echo methods with the greatest accuracy were the three-dimensional (3D) volumetric method (r = 0.957, bias -0.8 ± 1.2 ml, p = 0.01), the 3D VCA method wherein velocity time integrals were evaluated for each jet assessed (r = 0.919, bias -1.5 ± 1.7 ml, p = 0.03), and the 3D PISA method integrating surface areas throughout systole (r = 0.98, bias -2.0 ± 0.9 ml, p = 0.003). The pulsed Doppler and 2D volumetric methods had technical limitations that may result in a high underestimation or overestimation of the MR severity after TEER. In the case of multiple regurgitant jets, a more accurate MR assessment was obtained when all significant jets were evaluated. CONCLUSIONS: Clinically, the 3D volumetric, 3D VCA and 3D PISA methods gave the most accurate MR quantification after TEER. Three-dimensional echo technologies harbor the potential of becoming the non-invasive imaging tool of choice for MR quantification after complex transcatheter mitral interventions.


Assuntos
Ecocardiografia Tridimensional , Insuficiência da Valva Mitral , Simulação por Computador , Ecocardiografia Doppler em Cores , Hemodinâmica , Humanos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença
10.
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
11.
Heart Surg Forum ; 25(3): E403-E406, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35787761

RESUMO

Mitral valve leaflet aneurysm (MVA) is a rare and potentially devastating complication of infective endocarditis. Here, we report the case of a 49-year-old man with mitral endocarditis who had an anterior MVA without aortic morphologic change and only mild regurgitation. By real-time 3D transesophageal echocardiography (TOE), we found two perforations and a hard mass in the aneurysm accompanied with severe regurgitation. The patient underwent valve replacement surgery combined with anti-infection treatment and was successfully discharged. In addition to the case report and literature review related to MVA, we also summarize the application value of RT-3D TOE in these cases.


Assuntos
Aneurisma , Ecocardiografia Tridimensional , Endocardite , Neoplasias , Ecocardiografia Transesofagiana , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia
12.
Sci Rep ; 12(1): 12237, 2022 Jul 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
14.
Anatol J Cardiol ; 26(7): 525-531, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35791708

RESUMO

BACKGROUND: Facioscapulohumeral muscular dystrophy is one of the most common congenital muscle disorders. Whether facioscapulohumeral muscular dystrophy causes cardiac involvement is still controversial. Although electrocardiography and conventional echocardiography studies have been performed, there is no data on strain echocardiography in facioscapulohumeral muscular dystrophy. Our study aims to compare the myocardial strain parameters by 2-dimensional speckle tracking echocardiography in patients with facioscapulohumeral muscular dystrophy and the normal group. METHODS: This prospective single-center study included 35 patients with facioscapulohumeral muscular dystrophy and 54 control patients. Demographic, clinical, and laboratory parameters of both groups were compared. In addition to conventional echocardiography images, myocardial strain parameters were performed using 2-dimensional speckle tracking echocardiography. RESULTS: The median age of the study population was 25 (19-35 IQR) and 51 (57.3%) of them were male. Left ventricle-global circumferential strain was significantly lower in the facioscapulohumeral muscular dystrophy group than in the normal group [−20.3 (−22.0; −19.0) vs. −21.6 (−22.5; −20.0), P = .020]. Two-dimensional speckle tracking echocardiography findings except left ventricle-global circumferential strain [for left ventricle-global longitudinal strain P = .259, for left ventricle-global radial strain P = .338, for right ventricle-global circumferential strain P=.250, and for right ventricle-free wall longitudinal strain P = .288] were similar in both groups. CONCLUSIONS: As a result of our study, there was no significant difference between 2-dimensional speckle tracking echocardiography parameters other than the left ventricle-global circumferential strain between facioscapulohumeral muscular dystrophy and normal groups.


Assuntos
Ecocardiografia Tridimensional , Distrofia Muscular Facioescapuloumeral , Disfunção Ventricular Esquerda , Ecocardiografia , Feminino , Humanos , Masculino , Distrofia Muscular Facioescapuloumeral/diagnóstico por imagem , Estudos Prospectivos , Reprodutibilidade dos Testes , Disfunção Ventricular Esquerda/diagnóstico por imagem
15.
Echocardiography ; 39(7): 954-956, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35751387

RESUMO

Three-dimensional (3D) echocardiography is an important tool in the evaluation of mitral valve anatomy. We illustrate a case of a 67-year-old female who was admitted for non-ST-elevation myocardial infarction (NSTEMI) and underwent two-vessel coronary artery bypass grafting for surgical disease. Her two-dimensional (2D) echocardiographic images intraoperatively demonstrated a mass on the posterior mitral valve leaflet which created a diagnostic challenge; 3D transesophageal imaging was crucial in identifying the true nature of the pathology to be mitral annular calcification with supra-annular extension.


Assuntos
Ecocardiografia Tridimensional , Doenças das Valvas Cardíacas , Insuficiência da Valva Mitral , Idoso , Ecocardiografia Tridimensional/métodos , Ecocardiografia Transesofagiana/métodos , Feminino , Doenças das Valvas Cardíacas/patologia , Humanos , Valva Mitral/diagnóstico por imagem , Valva Mitral/patologia , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/cirurgia
17.
J Am Soc Echocardiogr ; 35(9): 893-909, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35644303

RESUMO

Three-dimensional echocardiography is the only ultrasound technique that offers the ability to image the complex right heart in its complete dimensionality. Over the years, the benefits of three-dimensional echocardiography to improve our understanding of right heart pathologies and ultimately patients' care have emerged from numerous publications. The aims of this review article are to highlight the importance of three-dimensional echocardiography for a more accurate evaluation of the right heart structures, to discuss the most important recent developments in the field and highlight future directions and needs.


Assuntos
Ecocardiografia Tridimensional , Insuficiência da Valva Tricúspide , Coração , Humanos
18.
Sci Rep ; 12(1): 9980, 2022 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-35705586

RESUMO

Increased left ventricular mass (LVM) is a strong independent predictor for adverse cardiovascular events, but conventional echocardiographic methods are limited by poor reproducibility and accuracy. We developed a novel method based on adding the mean wall thickness from the parasternal short axis view, to the left ventricular end-diastolic volume acquired using the biplane model of discs. The participants (n = 85) had various left ventricular geometries and were assessed using echocardiography followed immediately by cardiac magnetic resonance, as reference. We compared our novel two-dimensional (2D) method to various conventional one-dimensional (1D) and other 2D methods as well as the three-dimensional (3D) method. Our novel method had better reproducibility in intra-examiner [coefficients of variation (CV) 9% vs. 11-14%] and inter-examiner analysis (CV 9% vs. 10-20%). Accuracy was similar to the 3D method (mean difference ± 95% limits of agreement, CV): Novel: 2 ± 50 g, 15% vs. 3D: 2 ± 51 g, 16%; and better than the "linear" 1D method by Devereux (7 ± 76 g, 23%). Our novel method is simple, has considerable better reproducibility and accuracy than conventional "linear" 1D methods, and similar accuracy as the 3D-method. As the biplane model forms part of the standard echocardiographic protocol, it does not require specific training and provides a supplement to the modern echocardiographic report.


Assuntos
Ecocardiografia Tridimensional , Ecocardiografia/métodos , Ecocardiografia Tridimensional/métodos , Ventrículos do Coração/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Reprodutibilidade dos Testes
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