The international journal of cardiovascular imaging
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Int J Cardiovasc Imaging · Mar 2020
Comparative StudyStroke volume and cardiac output measurement in cardiac patients during a rehabilitation program: comparison between tonometry, impedancemetry and echocardiography.
Given the increasing use of noninvasive techniques for the assessment of cardiac function in clinical practice, the aim of this study was to evaluate if stroke volume (SV) and cardiac output (CO) measurements obtained by PhysioFlow impedance cardiography or HDI CR-2000 pulse wave analysis (Pulse) are interchangeable with measurements obtained by echocardiography in patients with coronary artery disease (CAD) or heart failure (HF). The study involved 48 men with heart disease (CAD or HF). We compared SV and CO measurements with the three devices at rest, as well as relative changes in SV and CO derived from a rehabilitation program. ⋯ The polar plot analysis showed a mean polar angle of 34° ± 22°, and a 30° radial sector containing 52% of the data points. Both Pulse and PhysioFlow devices overestimate absolute SV and CO values compared to values recorded using echocardiography. Similarly, neither Pulse nor PhysioFlow reliably track SV or CO changes after a rehabilitation program compared with echocardiography.
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Int J Cardiovasc Imaging · Feb 2020
Functional tricuspid regurgitation in rheumatic mitral valve disease patients with and without tricuspid annuloplasty: a three-dimensional echocardiography study with one year follow up.
The aim of this study is to analyze the clinical and echocardiographic determinants of functional tricuspid regurgitation (TR) before and after surgical intervention of rheumatic mitral valve disease, with focus on effectiveness of different methods of tricuspid valve annuloplasty (TAP). Three-dimensional echocardiographic images were obtained in 170 patients with mitral valve rheumatic disease before and 1 year after mitral valve replacement, with and without concomitant TAP. Together with standard cardiac chamber quantification, multiplanar reconstruction images of the tricuspid valve (TV) apparatus were analyzed in the septal-lateral and antero-posterior directions, end-diastolic TV annular diameter, TV tenting height and tenting area were measured. ⋯ Both ring and suture TAP groups had postoperative reduction of S-L TV diameters, but isolated MVR group had an 11% increase in S-L TV diameters. Compared with TAP of size 26 mm and 28 mm rings group, suture TAP group had more common significant residual TR (29% vs. 3%, p = 0.001). Our study demonstrated that ring annuloplasty could provide effective reduction of the TV annulus and prevent postoperative TR progression, and for rheumatic mitral valve disease patients with mild functional TR, prophylactic TAP concomitant with MVR might be considered to address the postoperative TV annulus dilation.
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Int J Cardiovasc Imaging · Nov 2019
Comparative StudyNon-invasive CT-derived fractional flow reserve and static rest and stress CT myocardial perfusion imaging for detection of haemodynamically significant coronary stenosis.
Computed tomography derived fractional flow reserve (FFRCT) and computed tomography stress myocardial perfusion imaging (CTP) are techniques to assess haemodynamic significance of coronary stenosis. To compare the diagnostic performance of FFRCT and static rest/stress CTP in detecting fractional flow reserve (FFR) defined haemodynamically-significant stenosis (FFR ≤ 0.8). Fifty-one patients (96 vessels) with suspected coronary artery disease from a single institution planned for elective invasive-angiography prospectively underwent research indicated 320-detector-CT-coronary-angiography (CTA) and adenosine-stress CTP and invasive FFR. ⋯ Receiver-operating-characteristics curve analysis demonstrated larger per vessel area-under-curve (AUC) for FFRCT (0.89) compared with visual CTP (0.70; p < 0.001), TPR (0.58; p < 0.001) and CTA (0.70; p = 0.0007); AUC for CTA + FFRCT (0.91) was higher than CTA + visual CTP (0.77, p = 0.008) and CTA + TPR (0.74, p < 0.001). Per-patient AUC for FFRCT (0.90) was higher than visual CTP (0.69; p = 0.0016), TPR (0.56; p < 0.0001) and CTA (0.68; p = 0.001). Based on this selected cohort of patients FFRCT is superior to visually and semi-quantitatively assessed static rest/stress CTP in detecting haemodynamically-significant coronary stenosis as determined on invasive FFR.
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Int J Cardiovasc Imaging · Nov 2019
Clinical TrialAortic valve calcification volumes and chronic brain infarctions in patients undergoing transcatheter aortic valve implantation.
Chronic silent brain infarctions, detected as new white matter hyperintensities on magnetic resonance imaging (MRI) following transcatheter aortic valve implantation (TAVI), are associated with long-term cognitive deterioration. This is the first study to investigate to which extent the calcification volume of the native aortic valve (AV) measured with cardiac computed tomography angiography (CTA) predicts the increase in chronic white matter hyperintensity volume after TAVI. A total of 36 patients (79 ± 5 years, median EuroSCORE II 1.9%, Q1-Q3 1.5-3.4%) with severe AV stenosis underwent fluid attenuation inversion recovery (FLAIR) MRI < 24 h prior to TAVI and at 3 months follow-up for assessment of cerebral white matter hyperintensity volume (mL). ⋯ In 72% of the patients new chronic white matter hyperintensities developed 3 months after TAVI, with a median increase of 27%. A higher calcification volume in the AV was associated with a larger increase in the white matter hyperintensity volume. These findings show the potential for automated AV calcium screening as an imaging biomarker to predict chronic silent brain infarctions.
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Int J Cardiovasc Imaging · Oct 2019
Left atrial appendage orifice diameter measured with trans-esophageal echocardiography is independently related with peri-device leakage after Watchman device implantation.
Percutaneous left atrial appendage closure (LAAC) has emerged as an alternative of stroke prevention in non-valvular atrial fibrillation (NVAF) patients. Peri-device leakage after LAAC is common. This retrospective, case-control study aimed to identify risk factors related with peri-device leakage after LAAC with Watchman devices. ⋯ Using the TEE orifice size cutoff value of 18.7 mm yielded a sensitivity of 0.92 (specificity 0.52), while the cutoff value of 23.1 mm yielded a high specificity of 0.91 (sensitivity 0.24). Minor peri-device leakage ( < 5 mm) is common after LAAC with Watchman devices. LAA orifice diameter measured with TEE is the independent risk factor predicting peri-device leakage after the implantation.