Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Jul 2014
Prognostic value of echocardiographic changes in patients with pulmonary arterial hypertension receiving parenteral prostacyclin therapy.
It is unknown whether the echocardiographic changes observed after treatment of patients with pulmonary arterial hypertension have prognostic value. ⋯ Echocardiographic parameters that estimate RV systolic pressure and assess RV morphology and function improve after 1 year of prostacyclin analogue treatment, and the degree of change has prognostic implications.
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J Am Soc Echocardiogr · Jul 2014
Right ventricular global longitudinal strain provides prognostic value incremental to left ventricular ejection fraction in patients with heart failure.
Right ventricular (RV) global longitudinal strain (RV strain) is a sensitive measure of RV mechanics. Its relationship with standard clinical markers and long-term events in chronic systolic heart failure is not well established. The aim of this study was to examine the ability of RV strain to provide incremental prognostic value to left ventricular (LV) ejection fraction (LVEF) in patients with chronic systolic heart failure. ⋯ In patients with chronic systolic heart failure, worse RV strain provides prognostic value incremental to LV function.
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J Am Soc Echocardiogr · Jul 2014
Semiautomated detection and quantification of aortic plaques from three-dimensional transesophageal echocardiography.
Aortic atherosclerosis is a risk factor for cerebrovascular events. Two-dimensional transesophageal echocardiographic quantification of descending aortic plaques is time-consuming and underestimates plaque burden. The aim of this study was to assess the feasibility and accuracy of a novel semiautomated program that uses three-dimensional (3D) transesophageal echocardiography to identify and quantify aortic plaque severity as determined by plaque thickness, volume, and number. The relationship between maximum plaque thickness and volume was also examined. ⋯ The results of this study demonstrate that semiautomated plaque analysis of 3D transesophageal echocardiographic descending aortic data sets is feasible and accurate in determining plaque severity as measured by plaque thickness, volume, and number. This methodology allows the standardization of plaque quantification, which will improve its utility in clinical trials. A greater understanding of the importance of plaque thickness versus volume is needed.
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J Am Soc Echocardiogr · Jun 2014
Multicenter StudyHemodynamic performance during exercise of the new St. Jude Trifecta aortic bioprosthesis: results from a French multicenter study.
Initial experience with the new St. Jude Trifecta pericardial aortic stented bioprosthesis shows an excellent resting hemodynamic profile. Little is known about changes in the hemodynamic profile of the Trifecta valve during exercise. ⋯ The new Trifecta bioprosthesis provides an excellent hemodynamic profile both at rest and during exercise. This type of valve could be an appropriate choice in patients with small aortic annular diameters, to avoid prosthesis-patient mismatch.
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J Am Soc Echocardiogr · Jun 2014
Comparative StudyComprehensive hemodynamic comparison and frequency of patient-prosthesis mismatch between the St. Jude Medical Trifecta and Epic Bioprosthetic aortic valves.
Patient-prosthesis mismatch (PPM) has been reported with a wide range of bioprosthetic valves after aortic valve replacement (AVR) and has been associated with multiple adverse outcomes. The aim of this study was to test the hypothesis that a novel low-profile stented pericardial tissue bioprosthesis for AVR, the Trifecta aortic valve, would have superior hemodynamics, a lower incidence of PPM, and an improvement in clinical outcomes. Its hemodynamic performance was evaluated, and a comparison was performed with a traditional stented pericardial bioprosthesis (Epic) with respect to hemodynamics, PPM, and clinical events. ⋯ The hemodynamic performance of the Trifecta valve is superior to that of the Epic valve across many conventional prosthesis sizes, and its implantation resulted in lower rates of severe PPM. These improvements were associated with lower valvular-related adverse events.