The international journal of cardiovascular imaging
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Int J Cardiovasc Imaging · Jan 2013
Can ischemia and dyssynchrony be detected during early stages of dobutamine stress echocardiography by 2-dimensional speckle tracking echocardiography?
Strain and strain rate (SR) measured with 2-dimensional speckle tracking echocardiography (2-D STE) can quantitatively assess myocardial function. Our aim was to evaluate whether we could detect abnormalities in strain, strain rate, and dyssynchrony by applying 2-D STE in patients with severe coronary artery disease during early stages of dobutamine stress echocardiography. Thirty-four patients with angiographically documented severe 3-vessel coronary artery disease and preserved left ventricular ejection fraction were compared with 42 control patients without evidence of coronary artery disease. ⋯ Compared with control subjects, patients with coronary artery disease showed lower circumferential SR [-1.42 (0.34) s(-1) vs -1.64 (0.34) s(-1); P < .02] and significantly lower longitudinal strain [-15.41% (3.52%) vs -19.37% (3.21%); P < .001] and SR [-0.91 (0.18) s(-1) vs -1.19 (0.24) s(-1); P < .001] at intermediate doses; these values were also compromised at peak dose. The SD of longitudinal time to systolic peak strain at intermediate dose was significantly greater in patients with coronary artery disease than in control patients [37.89 (12.32) vs 27.21 (10.86); P < .001]. The 2-D STE-derived strain and SR detected myocardial dysfunction and asynchrony in patients with coronary artery disease during intermediate doses of dobutamine stress, with minimal changes in regional wall motion abnormalities at this stage.
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Int J Cardiovasc Imaging · Jan 2013
Transthoracic echocardiographic guidance during transcatheter closure of atrial septal defects in children and adults.
The purpose of this study was to evaluate the safety and efficacy of transcatheter atrial septal defect (ASD) closure guided by transthoracic echocardiography (TTE). Since 2004, ASD closure was performed successfully in total 337 patients. Transthoracic echocardiography guidance was used in 206 patients (61.1%) (group 1). ⋯ Transthoracic echocardiography guidance during transcatheter ASD closure is safe and effective in children and in many adults. Even complex ASDs could be closed with TTE in patients with good acoustic windows. Performing the procedure under TTE guidance significantly reduces procedure time and also provides increased patient's comfort.