Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Sep 2011
Comparative StudyDeterioration of myocardial function in paradoxical low-flow severe aortic stenosis: two-dimensional strain analysis.
The diagnosis and management of paradoxical low-flow (PLF) aortic stenosis (AS) is challenging in clinical practice. In addition, its pathophysiology has not been fully understood. The aim of this study was to test the hypothesis that left ventricular (LV) myocardial function is deteriorated in PLF AS and that it is closely related to global LV afterload. ⋯ GLS is depressed in patients with PLF AS. This implies that subclinical myocardial dysfunction may be more prominent in PLF AS compared with normal-flow AS and suggests the possible diagnostic and prognostic value of two-dimensional global strain in identifying PLF AS. In addition, global LV afterload is an important determinant of myocardial dysfunction in patients with severe AS.
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J Am Soc Echocardiogr · Sep 2011
Randomized Controlled Trial Comparative StudyRole of Transesophageal Echocardiography Compared to Computed Tomography in Evaluation of Pulmonary Vein Ablation for Atrial Fibrillation (ROTEA study).
Computed tomography (CT) is the gold standard for assessing pulmonary vein (PV) anatomy and stenosis after ablation for atrial fibrillation (AF), but radiation exposure can be a concern. Transesophageal echocardiography (TEE) provides anatomic and functional assessment of the PVs, although no study has prospectively compared findings on TEE with those on CT. ⋯ In the ROTEA study, TEE was feasible in assessing PVs before and after ablation, providing both anatomic and functional information that complemented CT. PV ostial dimensions after ablation can be monitored using either modality, although TEE underestimates PV dimensions, especially for the inferior veins.
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J Am Soc Echocardiogr · Sep 2011
Randomized Controlled Trial Comparative StudyIntracardiac echocardiography: a new guiding tool for transcatheter aortic valve replacement.
Echocardiography has been debated as an adjunct for transcatheter aortic valve replacement (TAVR). The aim of this prospective study was to comparatively evaluate intraprocedural guidance using intracardiac echocardiography (ICE) and transesophageal echocardiography (TEE). ⋯ ICE, which is compatible with sedation and local anesthesia, can be considered an alternative to TEE for intraprocedural guidance during TAVR. It also seems to match the required work flow during TAVR better than TEE.
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J Am Soc Echocardiogr · Sep 2011
ReviewEAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease.
The introduction of devices for transcatheter aortic valve implantation, mitral repair, and closure of prosthetic paravalvular leaks has led to a greatly expanded armamentarium of catheter-based approaches to patients with regurgitant as well as stenotic valvular disease. Echocardiography plays an essential role in identifying patients suitable for these interventions and in providing intra-procedural monitoring. ⋯ Consequently, the European Association of Echocardiography in partnership with the American Society of Echocardiography has developed the recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease. It is intended that this document will serve as a reference for echocardiographers participating in any or all stages of new transcatheter treatments for patients with valvular heart disease.
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J Am Soc Echocardiogr · Sep 2011
Comparative StudyUsefulness of plasma B-type natriuretic peptide in the assessment of disease severity and prediction of outcome after aortic valve replacement in patients with severe aortic stenosis.
The diagnostic and prognostic value of plasma B-type natriuretic peptide (BNP) level in isolated aortic stenosis (AS) has not been fully understood. ⋯ Plasma BNP level reflects the degree of heart failure, is associated with LV structure and function in severe AS, and is an independent predictor of complication and outcome after AVR. BNP level may be useful in risk stratification of patients with AS in conjunction with other clinical and echocardiographic parameters.