Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · May 2015
Randomized Controlled Trial Multicenter StudyImpact of initial norwood shunt type on right ventricular deformation: the single ventricle reconstruction trial.
The Single Ventricle Reconstruction trial demonstrated a transplantation-free survival advantage at 12-month follow-up for patients with right ventricle-pulmonary artery shunts (RVPAS) with the Norwood procedure compared with modified Blalock-Taussig shunts but similar survival and decreased global right ventricular (RV) function on longer term follow-up. The impact of the required ventriculotomy for the RVPAS remains unknown. The aim of this study was to compare echocardiography-derived RV deformation indices after stage 2 procedures in survivors with single RV anomalies enrolled in the Single Ventricle Reconstruction trial. ⋯ RV myocardial deformation at 14 months, after stage 2 procedures, was not significantly altered by the type of initial shunt placed. However, abnormal trends were appreciated in circumferential deformation for the RVPAS group in the area of ventriculotomy that may represent early myocardial dysfunction. These data provide a basis for longer term RV deformation assessment in survivors after Norwood procedures.
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J Am Soc Echocardiogr · May 2015
Global longitudinal strain and global circumferential strain by speckle-tracking echocardiography and feature-tracking cardiac magnetic resonance imaging: comparison with left ventricular ejection fraction.
Left ventricular (LV) ejection fraction (EF) is a routine clinical standard to assess cardiac function. Global longitudinal strain (GLS) and global circumferential strain (GCS) have emerged as important LV functional measures. The objective of this study was to determine the relationships of GLS and GCS by speckle-tracking echocardiography and featuring-tracking cardiac magnetic resonance (CMR) to CMR EF as a standard of reference in the same patients. ⋯ GLS and GCS by feature-tracking CMR analysis was a rapid means to obtain myocardial strain similar to speckle-tracking echocardiography. GLS and GCS were closely correlated with CMR EF in this patient series and may play a role in the clinical assessment of LV function.
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J Am Soc Echocardiogr · May 2015
The influence of angle of insonation and target depth on speckle-tracking strain.
Speckle-tracking strain is almost universally cited as being independent of angle of insonation, but there are minimal confirmatory studies, and this claim may not be consistent with the known limitations of ultrasound axial and lateral spatial resolution. The aim of this study was to assess the influence of angle and depth on longitudinal peak systolic strain (LPS). ⋯ Echocardiographically derived LPS values were modestly dependent on angle of insonation and target depth in this pediatric population. Normal strain ranges derived from standard apical images should not be applied to strain derived from sub-costal images, off-axis apical imaging, or applications in which a standard window cannot be defined.
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J Am Soc Echocardiogr · Apr 2015
Three-dimensional printing of intracardiac defects from three-dimensional echocardiographic images: feasibility and relative accuracy.
With the advent of three-dimensional (3D) printers and high-resolution cardiac imaging, rapid prototype constructions of congenital cardiac defects are now possible. Typically, source images for these models derive from higher resolution, cross-sectional cardiac imaging, such as cardiac magnetic resonance imaging or computed tomography. These imaging methods may involve intravenous contrast, sedation, and ionizing radiation. New echocardiographic transducers and advanced software and hardware have optimized 3D echocardiographic images for this purpose. Thus, the objectives of this study were to confirm the feasibility of creating cardiac models from 3D echocardiographic data and to assess accuracy by comparing 3D model measurements with conventional two-dimensional (2D) echocardiographic measurements of cardiac defects. ⋯ Three-dimensional printed models of echocardiographic data are technically feasible and may accurately reflect ventricular septal defect anatomy. Three-dimensional models derived from 3D echocardiographic data sets represent a new tool in procedural planning for children with congenital heart disease.
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J Am Soc Echocardiogr · Apr 2015
Impact of device landing zone calcification on paravalvular regurgitation after transcatheter aortic valve replacement: a real-time three-dimensional transesophageal echocardiographic study.
Determinants of paravalvular regurgitation after transcatheter aortic valve replacement (TAVR) remain unclear. The purpose of this study was to investigate the impact of aortic valve calcification (AVC) on paravalvular regurgitation after TAVR using real-time three-dimensional transesophageal echocardiography. ⋯ Assessment of AVC by real-time three-dimensional transesophageal echocardiography is feasible and has good discriminatory value for paravalvular regurgitation in patients who undergo TAVR. Significant paravalvular regurgitation after TAVR is associated with the location and size of calcification at the aortic annulus and left ventricular outflow tract, not with its severity.