Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Oct 2009
Case ReportsSevere left ventricular wall thinning and extensive fibrosis without evolution to end stage disease in a patient with hypertrophic cardiomyopathy.
The authors report the case of a patient with hypertrophic cardiomyopathy who developed progressive and severe left ventricular wall thinning, as assessed by two-dimensional echocardiography, despite a preserved supranormal ejection fraction and an absence of cardiac symptoms. Extensive fibrosis was identified on cardiovascular magnetic resonance.
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J Am Soc Echocardiogr · Oct 2009
ReviewA framework for systematic characterization of the mitral valve by real-time three-dimensional transesophageal echocardiography.
Because of the complex anatomy of the mitral valve, detailed imaging is a challenge. Transesophageal echocardiography (TEE) using two-dimensional echocardiography provides the backbone for the structural evaluation of the mitral valve. Interventional and surgical procedures on the mitral valve demand precise and sophisticated imaging for guidance and support. ⋯ In this review, the authors present a framework for the application of 3D TEE in the evaluation of patients with structural or functional mitral valve disease, outline an examination protocol, and address the advantages and limitations of the current platform for 3D TEE. Real-time 3D TEE has the real potential to become the main imaging tool for the guidance of surgical and interventional procedures on the mitral valve. Although 3D TEE provides impressive images of the mitral valve, it now must be demonstrated, through scientific studies, that these beautiful images add clinical value to the management of patients with mitral valve disease.
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J Am Soc Echocardiogr · Sep 2009
Case ReportsAcute ascending aortic dissection diagnosed with transthoracic echocardiography.
A 79-year-old man with a known ascending aortic aneurysm presented to his physician's office with an episode of severe "tearing" type chest pain after lifting several boxes. Physical examination was notable for low blood pressure and a new diastolic murmur. ⋯ This demonstrated a dissection flap clearly seen superior to the sinuses of Valsalva and severe aortic insufficiency. Computed tomography or transesophageal echocardiography is typically the initial test of choice, but transthoracic echocardiography can rapidly confirm the diagnosis of acute ascending aortic dissection.
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J Am Soc Echocardiogr · Sep 2009
Controlled Clinical TrialAssessment of intraventricular mechanical dyssynchrony and prediction of response to cardiac resynchronization therapy: comparison between tissue Doppler imaging and real-time three-dimensional echocardiography.
We studied the comparability of left ventricular (LV) mechanical dyssynchrony assessment by tissue Doppler imaging (TDI) and real-time three-dimensional echocardiography (RT3DE) in patients with a wide range of LV ejection fractions and different causes of cardiomyopathy. In addition, we evaluated the ability of both techniques to predict response to cardiac resynchronization therapy (CRT). ⋯ Marked differences between techniques are found for the presence of mechanical dyssynchrony when current cutoff values are applied, making interchangeability of these techniques uncertain. Assessment of mechanical dyssynchrony by RT3DE might be an appropriate alternative to TDI for accurate prediction of response to CRT.