Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · May 2008
Prognostication of valvular aortic stenosis using tissue Doppler echocardiography: underappreciated importance of late diastolic mitral annular velocity.
Intact left atrial booster pump function helps maintain cardiac compensation in patients with aortic valve stenosis (AS). Because late diastolic mitral annular (A') velocity reflects left atrial systolic function, we hypothesized that A' velocity correlates with plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) level and clinical outcome in AS. ⋯ In patients with AS and normal ejection fraction, annular tissue Doppler echocardiographic indices may better reflect the physiologic consequences of afterload burden on the left ventricle than body surface area-indexed aortic valve area. Lower A' velocity is a predictor of cardiac death and need for valve surgery, suggesting an important role for compensatory left atrial booster pump function.
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J Am Soc Echocardiogr · May 2008
The effect of left ventricular size on right ventricular hemodynamics in pediatric survivors with hypoplastic left heart syndrome.
Outcome status in patients with hypoplastic left heart syndrome (HLHS) is partially dependent on right ventricular (RV) systolic function. In other disease states, ventricular function is impacted by anatomy and physiology of the contralateral ventricle. In HLHS, it is suggested that a relatively larger left ventricular (LV) size may negatively impact RV function because it becomes a "passenger" without providing any systolic or diastolic physiologic benefit. The purpose of this study was to determine whether LV size adversely affects RV systolic function in surviving patients with HLHS. ⋯ In surviving patients with HLHS, larger LV size does not seem to negatively impact RV function before or after Norwood procedure nor does it seem to have an adverse effect on RV function chronically (after Fontan). However, further study with larger population size will be necessary to see whether these findings remain negative and are true for nonsurvivors as well.
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J Am Soc Echocardiogr · Apr 2008
Case ReportsLigation or distortion of the right circumflex artery during minimal invasive mitral valve repair detected by transesophageal echocardiography.
A 43-year-old male patient undergoing mitral valve repair because of severe mitral regurgitation as a result of P2 prolapse was treated with insertion of neochords and a 36 Carpentier-Edwards physio-ring. After weaning from cardiopulmonary bypass, S-T elevation in leads II, III, and aVF occurred. ⋯ During reoperation 4 sutures placed at the P1 segment of the mitral valve annuloplasty were corrected. Transesophageal echocardiography could detect a good flow of the circumflex artery and the electrocardiographic changes disappeared.
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J Am Soc Echocardiogr · Mar 2008
Clinical TrialAtrium-driven mitral annulus motion velocity reflects global left ventricular function and pulmonary congestion during acute biventricular pacing.
The short-term effect of acute biventricular pacing on cardiac function in patients with chronic heart failure undergoing heart surgery is widely unknown. The present study was designed to determine whether mitral annular tissue Doppler imaging (TDI) is useful to predict acute changes in global systolic function determined by the continuous cardiac output method that was measured postoperatively during various pacing configurations in patients with depressed left ventricular (LV) function. ⋯ Peak Am mitral annular velocity correlates well with CI and PCW, respectively, thus providing an easy means to assess LV systolic function and pulmonary congestion during cardiac pacing in chronic heart failure.