Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Apr 2006
Randomized Controlled TrialEchocardiographic indices of increased left ventricular filling pressure and dilation after acute myocardial infarction.
The relationship between echocardiographic indicators of acute and chronic left ventricular (LV) filling pressure and LV dilation after acute myocardial infarction was assessed in 47 patients. The ratio of early transmitral flow velocity to early mitral annulus velocity (E/e') reflects acute LV filling pressure and the indexed volume of the left atrium is an indicator of chronic LV filling pressure. E/e' was higher (19 vs 10, P = .001) among patients who experienced a greater than 15% increase in indexed LV end-diastolic volume (remodeling group, n = 10). ⋯ There was no relationship between indexed volume of the left atrium and LV dilation. These data suggest that the E/e' ratio may be a useful predictor of LV dilation after acute myocardial infarction. In particular, an E/e' ratio greater than 15 identifies patients at increased risk.
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J Am Soc Echocardiogr · Apr 2006
Controlled Clinical TrialRight heart function in systemic lupus erythematosus: insights from myocardial Doppler tissue imaging.
The purpose of this study was to use Doppler tissue imaging to evaluate heart function and to investigate the correlation between Doppler imaging and pulmonary artery systolic pressure (PASP) and right ventricular (RV) ejection fraction (EF) in patients with systemic lupus erythematosus (SLE). Standard echocardiography and 2-dimensional and color Doppler imaging were used to assess cardiac function in patients given the diagnosis of SLE (n = 40) and healthy control subjects (n = 45). Half of the patients with SLE also presented with pulmonary hypertension (PH). ⋯ Finally, by simple linear regression analysis, we found a significant positive relation between RVEF and systolic tricuspid annular velocity, but a negative relationship between PASP and systolic tricuspid annular velocity. These findings demonstrate that in patients with SLE, systolic tricuspid annular velocity determined by echocardiography and Doppler imaging can be used to assess RV function and PASP. Furthermore, systolic tricuspid annular velocity reflects exercise tolerance in patients with SLE and the length of the isovolumic relaxation time represents the progression of PH.
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J Am Soc Echocardiogr · Apr 2006
Controlled Clinical TrialAssessment of diastolic function with Doppler tissue imaging after cardiac surgery: effect of the "postoperative septum" in on-pump and off-pump procedures.
Doppler tissue imaging (DTI) of mitral annular velocity is useful in assessing diastolic function. Most centers record at the septal or lateral segments of the annulus. Cardiopulmonary bypass produces changes in the motion of the interventricular septum. ⋯ Early diastolic velocity of the septal mitral annulus decreases after operation with cardiopulmonary bypass, but does not change after off-pump operation. In contrast, early diastolic velocity of the lateral segment is not affected by either on-pump or off-pump operation. Measuring lateral segment velocity is recommended for diastolic DTI after cardiopulmonary bypass, as septal DTI may incorrectly suggest diastolic dysfunction.
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J Am Soc Echocardiogr · Apr 2006
Controlled Clinical TrialUse of real-time 3-dimensional transthoracic echocardiography in the evaluation of mitral valve disease.
Three-dimensional (3D) echocardiography (3DE) provides unique orientations of the mitral valve (MV) not obtainable by routine 2-dimensional echocardiography. However, this modality has not been adopted in routine clinical practice because of its cumbersome and time-consuming process. The recent introduction of a full matrix-array transducer has enabled online real-time 3DE (RT3DE) and rendering. ⋯ Using different MV acquisitions RT3DE provides important clinical information such as: (1) identification of a prolapsed/flail scallop; (2) measurement of stenotic valve areas; (3) evaluation of MV leaflet integrity postrepair; and (4) identification of a MV perforation. In general the AML is better visualized than the PML. The parasternal window is the optimal approach to visualize both AML and PMLs.
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J Am Soc Echocardiogr · Apr 2006
Clinical TrialAssessment of stress-induced pulmonary interstitial edema by chest ultrasound during exercise echocardiography and its correlation with left ventricular function.
Ultrasound lung comet images (ULC) are useful for the noninvasive assessment of extravascular lung water (EVLW). We investigated the modification of EVLW, its relation to indices of left ventricular systolic and diastolic function, and noninvasively determined pulmonary capillary wedge pressure (PCWP) (PCWP = 1.24 ratio of early diastolic mitral inflow velocity to early diastolic velocity of the mitral annulus [E/Em] + 1.9) at rest and its variation during exercise echocardiography. A total of 72 patients (mean age 66.4 +/- 8.4 years) with mean ejection fraction of 41.2 +/- 14.4% underwent symptoms-limited exercise echocardiography. ⋯ This study shows that ULC represents a simple way to assess the presence of excess EVLW. Increased EVLW is associated with estimated PCWP and indices of left ventricular systolic and diastolic dysfunction. The additional exercise-induced increase of PCWP, the worsening of left ventricular diastolic function, and extensive wall-motion abnormalities correlate with variations of EVLW.