Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Dec 2015
Correction of Doppler Gradients for Pressure Recovery Improves Agreement with Subsequent Catheterization Gradients in Congenital Aortic Stenosis.
In congenital aortic stenosis (AS), suboptimal agreement between Doppler-derived gradients and catheterization gradients may lead to inappropriate referrals for catheterization. To address this problem, the authors investigated whether adjusting Doppler gradients for pressure recovery (PR) improved their agreement with subsequent catheterization gradients. ⋯ In congenital AS, correcting the peak Doppler gradient for PR significantly improved agreement with the subsequently measured cath gradient. This approach may improve decisions regarding referral for catheterization.
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J Am Soc Echocardiogr · Nov 2015
Randomized Controlled TrialImproving the accuracy of effective orifice area assessment after transcatheter aortic valve replacement: validation of left ventricular outflow tract diameter and pulsed-wave Doppler location and impact of three-dimensional measurements.
Echocardiographic calculation of effective orifice area (EOA) after transcatheter aortic valve replacement is integral to the assessment of transcatheter heart valve (THV) function. The aim of this study was to determine the most accurate method for calculating the EOA of the Edwards SAPIEN and SAPIEN XT THVs. ⋯ The most accurate EOA after implantation of a balloon-expandable THV is calculated using preimplantation LVOT diameter and VTI.
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J Am Soc Echocardiogr · Oct 2015
Comparative StudyDiscrepancies in Left Ventricular Mass Calculation Based on Echocardiography and Cardiovascular Magnetic Resonance Measurements in Patients with Left Ventricular Hypertrophy.
Increased left ventricular (LV) mass is associated with adverse cardiovascular outcomes, and its accurate assessment is important. The aim of this study was to analyze the degree of difference among various methods of LV mass calculation based on transthoracic echocardiographic (TTE) measurements and cardiovascular magnetic resonance (CMR) measurements, especially in patients with aortic stenosis with varying degrees of LV hypertrophy (LVH). The mechanism underlying this disagreement was also investigated. ⋯ Current methods of calculating LVMI from echocardiographic measurements carry a tendency to measure LVMI larger than methods based on CMR measurements, which was more significant in patients with LVH. The change of the left ventricle's shape with LVH may be a plausible explanation for this, and a correction method may be needed when calculating LVMI from echocardiographic measurements, especially in patients with LVH and smaller body size.
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J Am Soc Echocardiogr · Oct 2015
ReviewEarly Bioprosthetic Valve Failure: Mechanistic Insights via Correlation between Echocardiographic and Operative Findings.
Bioprosthetic valves are increasingly implanted, with generally consistent and durable results. Early bioprosthetic valve failure is uncommon, and most clinicians are unfamiliar with the spectrum of early structural complications involving bioprostheses. In this review, the authors organize causes of early bioprosthetic valve failure according to possible pathogenesis, demonstrate the correlation between echocardiographic and anatomic findings, and discuss potential treatments. ⋯ Next, they discuss excessive pannus formation, a hitherto rarely described cause of early bioprosthetic valve failure. Finally, the authors address early structural valve deterioration mediated by calcification or primary tears. Illustrative examples with relevant echocardiographic and operative findings are provided.
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J Am Soc Echocardiogr · Oct 2015
Comparative StudyNovel Approach to Three-Dimensional Echocardiographic Quantification of Right Ventricular Volumes and Function from Focused Views.
Echocardiographic assessment of the right ventricle is difficult because of its complex shape. Three-dimensional echocardiographic (3DE) imaging allows more accurate and reproducible analysis of the right ventricle than two-dimensional methodology. However, three-dimensional volumetric analysis has been hampered by difficulties obtaining consistently high-quality coronal views, required by the existing software packages. The aim of this study was to test a new approach for volumetric analysis without coronal views by using instead right ventricle-focused three-dimensional acquisition with multiple short-axis views extracted from the same data set. ⋯ The new software is fast, reproducible, and accurate compared with CMR over a wide range of RV size and function. Because right ventricle-focused 3DE acquisition is feasible in most patients, this approach may be applicable to a broader population of patients who can benefit from RV volumetric assessment.