JACC. Cardiovascular imaging
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JACC Cardiovasc Imaging · Jun 2010
Comparative StudyRV electrical activation in heart failure during right, left, and biventricular pacing.
To compare right ventricular (RV) activation during intrinsic conduction or pacing in heart failure (HF) patients. ⋯ In HF patients without RV dysfunction treated with CRT, normal RV free wall activation in intrinsic rhythm indicated normal right bundle branch-mediated depolarization. However, the RV was vulnerable to the development of activation delays during RV pacing, whether alone or with CRT-BiV. These were avoided by CRT-LV in patients with normal atrioventricular conduction.
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JACC Cardiovasc Imaging · Jun 2010
Detection of pulmonary congestion by chest ultrasound in dialysis patients.
This study sought to investigate clinical and echocardiographic correlates of the lung comets score. ⋯ Pulmonary congestion is highly prevalent in symptomatic (New York Heart Association functional class III to IV) and asymptomatic dialysis patients. Chest ultrasound is a reliable technique that detects pulmonary congestion at a pre-clinical stage in end-stage renal disease.
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JACC Cardiovasc Imaging · Jun 2010
ReviewTakotsubo cardiomyopathy: a unique cardiomyopathy with variable ventricular morphology.
Takotsubo cardiomyopathy is an important differential diagnosis of acute coronary syndrome. It is characterized by normal (or near-normal) coronary arteries, regional wall motion abnormalities that extend beyond a single coronary vascular bed, and often, a precipitating stressor. Variants of the classical left ventricular apical ballooning, including mid- or basal left ventricular wall motion abnormalities, are increasingly recognized. ⋯ Diagnosis of takotsubo cardiomyopathy has important implications for clinical management at presentation and afterward. The long-term prognosis is generally favorable; however, a small subset has potentially life-threatening complications during the initial presentation. The pathophysiologic mechanism is unknown, but catecholamine excess likely has a central role.
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JACC Cardiovasc Imaging · Apr 2010
ReviewHeart failure with normal ejection fraction: the complementary roles of echocardiography and CMR imaging.
Heart failure with normal ejection fraction (HFNEF), previously referred to as diastolic heart failure, has increased in prevalence as a cause of heart failure, now accounting for up to 50% of all cases. Contrary to initial evidence, the prognostic outlook in HFNEF may be similar to that of heart failure with reduced ejection fraction. According to current consensus statements, the diagnosis of HFNEF requires the demonstration of relatively preserved systolic left ventricular function and evidence of diastolic dysfunction. ⋯ With respect to CMR, this review will highlight its value in the assessment of systolic left ventricular function, will review ancillary CMR findings that may support the diagnosis of HFNEF such as tissue characterization, and will provide a brief overview of CMR techniques to assess diastolic function. We propose that these 2 modalities may play a complementary role in the diagnosis of HFNEF. The importance of imaging in the diagnosis of HFNEF extends to both the individual patient and to clinical trials of therapies for this condition.
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JACC Cardiovasc Imaging · Apr 2010
Comparative StudySensitivity of transcranial Doppler versus intracardiac echocardiography in the detection of right-to-left shunt.
The purpose of this study was to understand the reason for variation in the sensitivity of different methods of detecting right-to-left shunts (RLS). ⋯ Transcranial Doppler with immediate feedback provided by forced expiration against a manometer to 40 mm Hg is more sensitive than echocardiographic imaging for the detection of RLS. These observations have significant implications for determining the incidence of RLS in patients with stroke or migraine.