Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
-
J Am Soc Echocardiogr · Oct 2018
Comparative Study Observational StudyAortic Stenosis with Severe Tricuspid Regurgitation: Comparative Study between Conservative Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement Combined With Tricuspid Repair.
Severe aortic stenosis (AS) and severe tricuspid regurgitation (TR) may coexist. The aim of this study was to determine the change in right ventricular (RV) function and TR after surgical aortic valve replacement combined with tricuspid valve repair (SAVR+TVr), transcatheter aortic valve replacement (TAVR), or conservative management and compare outcomes dependent on RV functional parameters and treatment allocation. ⋯ In this nonrandomized, retrospective, observational study, SAVR+TVr and TAVR were associated with reductions in TR in patients with severe AS combined with severe TR. Importantly, RV function improved after TAVR but not after SAVR+TVr. Patients with severe AS and TR have a very poor prognosis with conservative therapy. When contemplating invasive procedures, assessment should include quantitative functional RV parameters.
-
J Am Soc Echocardiogr · Sep 2018
Three-Dimensional Inferior Vena Cava for Assessing Central Venous Pressure in Patients with Cardiogenic Shock.
The inferior vena cava (IVC) has a complex three-dimensional (3D) shape, but measurements used to estimate central venous pressure (CVP) remain based on two-dimensional (2D) echocardiographic imaging. The aim of this study was to investigate the accuracy of IVC size and collapsibility index obtained by 3D echocardiography for assessing CVP in patients with cardiogenic shock. ⋯ In patients with cardiogenic shock, IVCCI from area by 3D echocardiography is reproducible and accurate to evaluate CVP.
-
J Am Soc Echocardiogr · Sep 2018
Long-Term Hemodynamic Improvement after Transcatheter Mitral Valve Repair.
Correction of mitral regurgitation (MR) alters the load on the left ventricle. There are few data on the long-term hemodynamic adaptations of the cardiovascular system after transcatheter mitral valve repair (TMVR). The aim of this study was to determine a comprehensive hemodynamic status using noninvasive pressure-volume analysis. ⋯ One year after TMVR, patients showed reverse remodeling and improved LV performance that was associated with improved symptom status. This hemodynamic improvement supports TMVR as long-term effective therapy for patients with symptomatic MR.
-
J Am Soc Echocardiogr · Aug 2018
Three-Dimensional Echocardiography for the Assessment of Right Ventriculo-Arterial Coupling.
The analysis of right ventriculo-arterial coupling (RVAC) from pressure-volume loops is not routinely performed. RVAC may be approached by the combination of right heart catheterization (RHC) pressure data and cardiac magnetic resonance (CMR)-derived right ventricular (RV) volumetric data. RV pressure and volume measurements by Doppler and three-dimensional echocardiography (3DE) allows another way to approach RVAC. ⋯ Three-dimensional echocardiography-derived PA Ea, RV Emax, and RVAC correlated well with the reference RHC-CMR measurements. Ea and RVAC but not Emax were significantly different between patients with different levels of afterload, suggesting failure of the right ventricle to maintain coupling in severe pulmonary hypertension.