Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · May 2004
Case ReportsAcquired partially flail leaflet causing severe mitral regurgitation in a congenital double-orifice mitral valve.
Double orifice mitral valve is a rare congenital malformation. We report a 48-year-old woman with new onset congestive heart failure and mitral regurgitation. Transesophageal echocardiography showed a partially flail mitral valve and severe mitral regurgitation. A deep transgastric view showed a double orifice mitral valve with a smaller accessory anterolateral orifice, and identified the origin of the regurgitant jet from the larger posteromedial orifice.
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J Am Soc Echocardiogr · Apr 2004
Comparative StudyThe clinical use of supine left lateral leg cycle ergometry for exercise electrocardiographic testing in women, as used in exercise echocardiography.
Two-dimensional exercise echocardiography is commonly performed in the supine (SUP) left lateral posture (SLL) to optimize imaging quality. ⋯ SLL is not a suitable modality for the assessment of functional status or for the derivation of target heart rates for exercise training in UP posture. However, SLL leg cycle ergometry exercise provokes a comparable stimulus for the detection of coronary artery disease, as it will increase myocardial oxygen demand to the same extent as UP leg cycle exercise.
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J Am Soc Echocardiogr · Mar 2004
ReviewA practical approach to the echocardiographic evaluation of diastolic function.
A number of recent community-based epidemiologic studies suggest that 40% to 50% of the cases of heart failure have preserved left ventricular systolic function. Although diastolic heart failure is often not well clinically recognized, it is associated with marked increases in morbidity and all-cause mortality. Doppler echocardiography has emerged as the principal clinical tool for the assessment of left ventricular diastolic function. ⋯ Unfortunately, these Doppler flow variables are significantly influenced by loading conditions and, therefore, the results from these standard techniques can be inconclusive. Recently, color M-mode and Doppler tissue imaging have emerged as new modalities that are less affected by preload and, thus, provide a strong complementary role in the assessment of diastolic function. This review will discuss the diastolic properties of the left ventricle, Doppler echocardiographic evaluation, and grading of diastolic dysfunction.
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J Am Soc Echocardiogr · Mar 2004
Comparative StudyPrevalence, clinical characteristics, quality of life, and prognosis of patients with congestive heart failure and isolated left ventricular diastolic dysfunction.
Prevalence of isolated left ventricular (LV) diastolic dysfunction has been reported to be as high as one-third of all heart failure (HF) cases, with an increasing prevalence in the elderly population. However, there is a paucity of prospective data about the prevalence and prognosis of isolated LV diastolic dysfunction in an unselected population of patients hospitalized with HF. Therefore, we prospectively evaluated 179 consecutive patients discharged from our hospital with HF to assess the prevalence of systolic versus diastolic LV dysfunction among patients hospitalized with HF and to compare their demographics, clinical features, self-perceived quality of life (QOL), and 6-month readmission rate and mortality. ⋯ Finally, 6-month survival, adjusted for age and sex, was similar between patients with LV diastolic or systolic dysfunction (hazard ratio 0.68; 95% confidence interval 0.20-2.35). Using standardized echocardiographic criteria, isolated LV diastolic dysfunction among unselected patients hospitalized with HF was less than previously reported. Patients with HF and isolated diastolic dysfunction showed similar clinical symptoms, self-perceived QOL, readmission rate, and 6-month mortality to patients with prevalent LV systolic dysfunction.