Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
-
J Am Soc Echocardiogr · Jul 2009
Myocardial function in older male amateur marathon runners: assessment by tissue Doppler echocardiography, speckle tracking, and cardiac biomarkers.
Participation of older men in endurance races continues to increase. Recent studies on marathon runners raised concerns about a transient myocardial dysfunction and damage. The aim of our study was to compare the extent of marathon-induced myocardial dysfunction in young and older runners and to identify its potential correlation to elevated cardiac biomarkers. ⋯ Left ventricular systolic function is preserved after a marathon in older runners. There are right ventricular functional changes as a sign of prolonged myocardial work load. There is no significant difference between older and young runners regarding transient diastolic dysfunction or biomarker release. The latter is not associated with echocardiography parameters of myocardial dysfunction.
-
J Am Soc Echocardiogr · Jun 2009
Case ReportsPercutaneous closure of an atrial septal defect guided by live three-dimensional transesophageal echocardiography.
A 55-year-old man with a history of cryptogenic stroke presented to the authors' department for investigation. On transthoracic echocardiography, he was found to have a small secundum atrial septal defect, and transesophageal echocardiography was performed for a more detailed assessment. Following this, the defect was deemed suitable for percutaneous closure. The case demonstrates the utility and benefits of live three-dimensional transesophageal echocardiography for the assessment of this type of defect and guidance of transcatheter closure.
-
J Am Soc Echocardiogr · May 2009
Size-adjusted left ventricular outflow tract diameter reference values: a safeguard for the evaluation of the severity of aortic stenosis.
We sought to evaluate the relationship among left ventricular outflow tract diameter (LVOTd), gender, and body surface area (BSA) and to evaluate the usefulness of size-adjusted LVOTd reference values in patients with aortic stenosis (AS). AS grading is based on the echocardiographic calculation of the aortic valve area (AVA) and requires LVOTd measurements, one main potential source of error. Transesophageal echocardiography (TEE) is reputed to be more accurate than transthoracic echocardiography (TTE), but validation studies are rare. A safeguard for LVOTd measurements is thus desirable. ⋯ TTE and TEE measurements of the LVOTd provided similar results. LVOTd was significantly associated to BSA and LVOTd, derived from a linear regression linked to BSA independently of gender, provided an acceptable approximation of the AVA. Thus, although accurate measurement of LVOTd is a crucial part of the echocardiographic evaluation of AS severity, the present equation may be used as a safeguard when this measurement is difficult or not possible with TTE.
-
A 58-year-old man admitted to the hospital with an acute stroke was found to have a left atrial mass attached to the interatrial septum via a stalk. Although initially thought to be a myxoma, the mass was pathologically proved to be a thrombus. Clues pointing to thrombus as the etiology were a history of atrial fibrillation, the absence of anticoagulation, an enlarged left atrium, and the presence of spontaneous echo contrast.
-
J Am Soc Echocardiogr · Apr 2009
Minimal sedation second dose strategy with intranasal midazolam in an outpatient pediatric echocardiographic setting.
Anxiety and movement in children during transthoracic echocardiography (TTE) can compromise study quality and reliability. Minimal sedation is often required. Intranasal midazolam (INM), used in various procedures, is an excellent sedative. Optimal INM dosing strategies for uncooperative children undergoing TTE are largely unknown, including second-dose INM strategies, introduced to maximize the potential for successful sedation and minimize risk. The purpose of this retrospective review was to evaluate the effectiveness of a second-dose INM minimal sedation strategy recently adopted at the Children's Hospital of Pittsburgh. ⋯ A second-dose INM strategy was effective in achieving satisfactory minimal sedation in children undergoing TTE. The results of this study also suggest that only a small proportion of patients would benefit from a one-dose INM strategy.