Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Nov 2006
Case ReportsAcquired aortic cusp fusion after chronic left ventricular assist device support.
Explanted hearts from patients with chronic left ventricular assist device (LVAD) support have shown the presence of aortic cusp fusion, which results in valvular stenosis and may complicate weaning of a LVAD. This is the first report of aortic cusp fusion diagnosed solely by transesophageal echocardiography (TEE) in vivo in a patient on chronic LVAD support. ⋯ The explantation procedure was abandoned. This case demonstrates the utility of intraoperative TEE in the evaluation of aortic valvular anatomy and function in patients wtih chronic LVAD support.
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J Am Soc Echocardiogr · Nov 2006
The effect of acute hypertension on left ventricular diastolic pressures in a canine model of left ventricular dysfunction with a preserved ejection fraction and elevated left ventricular filling pressures.
Decompensated heart failure with preserved left ventricular (LV) ejection fraction (EF) is often accompanied by hypertensive episodes. We hypothesized that acute increase in arterial pressure results in elevated early and late diastolic LV pressures as a result of further impaired LV relaxation. ⋯ Pressure loading with normal LV function and with LVDPEF results in increased LV diastolic pressures, which are further exaggerated with LVDPEF as a result of prolonged relaxation and shortened diastolic filling.
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J Am Soc Echocardiogr · Oct 2006
Randomized Controlled Trial Comparative StudyTransthoracic coronary flow velocity reserve assessment: comparison between adenosine and dobutamine.
We sought to compare coronary flow velocity reserve (CFVR) with adenosine and dobutamine in patients scheduled for noninvasive evaluation of coronary artery disease. ⋯ TTE CFVR with dobutamine is comparable to CFVR with adenosine in patients with a wide range of LAD diseases. Dobutamine could be a good alternative to adenosine for TTE CFVR assessment, particularly in patients with a contraindication to adenosine or scheduled for DSE.
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J Am Soc Echocardiogr · Oct 2006
Controlled Clinical TrialAcute improvement in myocardial function assessed by myocardial strain and strain rate after aortic valve replacement for aortic stenosis.
We investigated whether Doppler tissue imaging (tissue velocity, strain, and strain rate) could be useful to detect subtle left ventricular (LV) dysfunction in patients with aortic stenosis and changes in regional myocardial function after aortic valve replacement (AVR). ⋯ Strain and strain rate parameters seemed to relate to LV function and aortic stenosis severity. Further, they seemed to be superior to tissue velocity and conventional echocardiography in detecting subtle changes in myocardial function after AVR before LV mass and LV function showed improvement.