European heart journal cardiovascular Imaging
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Eur Heart J Cardiovasc Imaging · Jan 2013
Global longitudinal strain predicts left ventricular dysfunction after mitral valve repair.
Despite a successful surgical procedure and adherence to current recommendations, postoperative left ventricular (LV) dysfunction after mitral valve repair (MVr) for organic mitral regurgitation (MR) may still occur. New approaches are therefore needed to detect subclinical preoperative LV dysfunction. LV global longitudinal strain (GLS), assessed with speckle-tracking echocardiographic analysis, has been proposed as a novel measure to better depict latent LV dysfunction. The aim of this study was to investigate the value of GLS to predict long-term LV dysfunction after MVr. ⋯ In a large series of patients operated within the last decade, MVr resulted in a low incidence of long-term LV dysfunction. A GLS of >-19.9% demonstrated to be a major independent predictor of long-term LV dysfunction after adjustment for parameters currently implemented into guidelines.
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Eur Heart J Cardiovasc Imaging · Jan 2013
Validation of the isovolumetric relaxation time for the estimation of pulmonary systolic arterial blood pressure in chronic pulmonary hypertension.
Transthoracic echocardiography is a useful technique for non-invasive detection of pulmonary arterial systolic pressure (PASP). Isovolumic relaxation time (IVRT) measured by Doppler tissue imaging (DTI) is a sensitive measurement of changes in pulmonary vasculature. Our aim was to validate IVRT in the echocardiographic assessment of pulmonary hypertension (PH) patients. ⋯ The determination of IVRT by DTI is a simple and reproducible method that correlates well with PASP. It is, therefore, a parameter to consider in the echocardiographic assessment of patients with PH, and may be particularly important when the tricuspid Doppler signal is poor.
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The classic entity of life-threatening aortic dissection represents one pathology of a spectrum of acute conditions coined the acute aortic syndrome comprising dissection, intramural haematoma, penetrating atherosclerotic ulcer, and contained aortic rupture of any cause. The common denominator is disruption of the aortic media layers associated with severe pain and a variety of other symptoms. Any clinical suspicion of acute aortic syndrome should prompt immediate action and confirmatory non-invasive imaging; with respect to sensitivity and specificity for acute aortic pathology modern contrast-enhanced CT technology, MR imaging and ultrasound techniques have similar diagnostic accuracy near 100%. Since the prognosis of most patients with acute aortic dissection is related to undelayed diagnosis and (often surgical) treatment swift diagnostic imaging should be the primary goal in the work-up of any patient with suspected acute aortic syndrome; transfer and in-hospital logistics and local expertise for the differential use of various imaging modalities should be constantly improved.