scholarly journals Higher Ventricular-Arterial Coupling Derived from Three-Dimensional Echocardiography Is Associated with a Worse Clinical Outcome in Systemic Sclerosis

2021 ◽  
Vol 14 (7) ◽  
pp. 646
Author(s):  
Francesco Tona ◽  
Elisabetta Zanatta ◽  
Roberta Montisci ◽  
Denisa Muraru ◽  
Elena Beccegato ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Three Dimensional ◽  
Signs And Symptoms ◽  
Arterial Elastance ◽  
Cross Sectional ◽  
Ventricular Performance ◽  
Myocardial Involvement ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

Primary myocardial involvement is common in systemic sclerosis (SSc). Ventricular-arterial coupling (VAC) reflecting the interplay between ventricular performance and arterial load, is a key determinant of cardiovascular (CV) performance. We aimed to investigate VAC, VAC-derived indices, and the potential association between altered VAC and survival free from death/hospitalization for major adverse CV events (MACE) in scleroderma. Only SSc patients without any anamnestic and echocardiographic evidence of primary myocardial involvement who underwent three-dimensional echocardiography (3DE) were included in this cross-sectional study and compared with healthy matched controls. 3DE was used for noninvasive measurements of end-systolic elastance (Ees), arterial elastance (Ea), VAC (Ea/Ees) and end-diastolic elastance (Eed); the occurrence of death/hospitalization for MACE was recorded during follow-up. Sixty-five SSc patients (54 female; aged 56 ± 14 years) were included. Ees (p = 0.04), Ea (p = 0.04) and Eed (p = 0.01) were higher in patients vs. controls. Thus, VAC was similar in both groups. Ees was lower and VAC was higher in patients with diffuse cutaneous form (dcSSc) vs. patients with limited form (lcSSc) (p = 0.001 and p = 0.02, respectively). Over a median follow-up of 4 years, four patients died for heart failure and 34 were hospitalized for CV events. In patients with VAC > 0.63 the risk of MACE was higher (HR 2.5; 95% CI 1.13–5.7; p = 0.01) and survival free from death/hospitalization was lower (p = 0.005) than in those with VAC < 0.63. Our study suggests that VAC may be impaired in SSc patients without signs and symptoms of primary myocardial involvement. Moreover, VAC appears to have a prognostic role in SSc.

Subcostal real-time three-dimensional echocardiography of interatrial communications: reconstruction of an oval fossa defect, a superior sinus venosus defect with partially anomalous pulmonary venous drainage, an infero-posterior oval fossa defect, and a coronary sinus defect

2011 ◽  
Vol 22 (2) ◽  
pp. 145-151 ◽  
Author(s):  
Karolina M. G. Bilska ◽  
Claudia M. J. Kehrens ◽  
Gillian Riley ◽  
Robert H. Anderson ◽  
Jan Marek
Keyword(s):  
Real Time ◽  
Coronary Sinus ◽  
Three Dimensional ◽  
Venous Drainage ◽  
Sinus Venosus ◽  
Three Dimensional Reconstruction ◽  
Cross Sectional ◽  
Dimensional Reconstruction ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

AbstractReal-time three-dimensional echocardiography can surpass simple cross-sectional echocardiography in providing precise details of cardiac lesions. For the purpose of optimising treatment, we describe our findings with real-time three-dimensional echocardiography when interrogating different types of communications permitting interatrial shunting. A three-dimensional reconstruction of defects within the oval fossa enabled reliable identification of location, size, and integrity of surrounding rims. In the superior sinus venosus defect associated with partially anomalous pulmonary venous drainage, three-dimensional reconstruction helped to provide a better understanding of the relationship between the interatrial communication, the orifice of the superior caval vein, and the connections of the right upper pulmonary vein. In the defect opening infero-posteriorly within the oval fossa, three-dimensional reconstruction helped to avoid the risk of potentially inappropriate closure of the defect by suturing the hyperplastic Eustachian valve to the atrial wall, which could have diverted the inferior caval venous return into the left atrium, or obstructed the caval venous orifice. In the coronary sinus defect, three-dimensional echocardiography provided a ‘face to face’ view of the entire coronary sinus roof, showing a circular defect communicating with the cavity of the left atrium. Acquisition of the full-volume data sets took less than 2 minutes for the patients having defects within the oval fossa, and no more than 3 minutes for the patients with the sinus venosus and coronary sinus defects. Post-processing for the defects in the oval fossa took from 5 to 8 minutes, and from 12 to 16 minutes for the more complicated defects.ConclusionCross-sectional two-dimensional echocardiography can establish correct diagnosis in all types of atrial communications; however, real-time three-dimensional reconstruction provides additional value to the surgeon and interventionist for better understanding of spatial intracardiac morphology.

Abstract 15413: Comparison of Right Ventricular Functional Indices Using Two-dimensional and Three-dimensional Echocardiography to Predict Outcomes in Pediatric Pulmonary Hypertension

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Pei-Ni Jone ◽  
SuHong Tong ◽  
D. Dunbar Ivy
Keyword(s):  
Pulmonary Hypertension ◽  
Adverse Events ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Three Dimensional ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography ◽  
Serial Evaluation ◽  
Rv Function

Background: Right ventricular (RV) function is an important determinant of outcomes in pulmonary hypertension (PH) patients. Conventional indices of fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), and RV tissue Doppler imaging myocardial performance index (RV TDI MPI) have been used as surrogates of RV function. RV ejection fraction (EF) from real time three-dimensional echocardiography (RT-3DE) has emerged as a quantitative evaluation of global RV function and has correlated well with cardiac magnetic resonance imaging. In this study, 3D RV EF was compared with conventional indices in the serial evaluation of RV function in pediatric PH patients to predict adverse events. Methods: Forty-eight pediatric PH patients (median age = 10 years (4 months - 27 years)) were evaluated serially (138 visits with median interval visit = 116 days (4 -368 days)) with RT-3DE to follow their ejection fraction (EF) and conventional indices from April, 2014 to May, 2015. Echocardiographic variables include measures of RV function: 3D RV EF, FAC, TAPSE, and RV TDI MPI. Adverse events included: initiation or intensification of intravenous vasodilator therapy, atrial septostomy, Pott’s shunt, or death. Receiver Operating Characteristics (ROC) analyses were performed to identify the best cut-offs in predicting adverse events in serial follow up of pediatric PH patients. Results: Patients were classified based on their World Health Classification (I = 16, II=16, III=11, IV=3). Two patients were not classified as they were too young. There were 13 adverse events. 3D RV EF was a good predictor of adverse events with highest area under curve (AUC) = 0.79, p<0.001(cut-off value of 38% = sensitivity 69%; specificity of 78%) compared to FAC has an AUC = 0.77, p<0.05 (cut-off value of 33% = sensitivity 63%; specificity of 78%). TAPSE and TV TDI MPI were not statistically significant (AUC = 0.54, p = 0.65; AUC 0.63, p = 0.09 respectively). Conclusion: 3D RV EF is a good index in predicting adverse events and was better than FAC, TAPSE, and RV TDI MPI in predicting adverse events in serial follow up of pediatric PH patients. 3D RV EF can be used as a noninvasive tool in the serial evaluation of RV function in pediatric PH patients as it is easily obtained clinically.

scholarly journals Feasibility and Reproducibility of Left Atrium Measurements Using Different Three-Dimensional Echocardiographic Modalities

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1043
Author(s):  
Andreea Motoc ◽  
Bram Roosens ◽  
Esther Scheirlynck ◽  
Kaoru Tanaka ◽  
Maria Luiza Luchian ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Left Atrium ◽  
Three Dimensional ◽  
Minimum Volume ◽  
Heart Model ◽  
Maximum Volume ◽  
Interobserver Reproducibility ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

Left atrium (LA) volume is a biomarker of cardiovascular outcomes. Three-dimensional echocardiography (3DE) provides an accurate LA evaluation, but data regarding the optimal 3DE method is scarce. We assessed the feasibility and reproducibility of LA measurements using different 3DE methods. One hundred and ninety-four patients were prospectively analyzed. Conventional 3DE and two semi-automatic 3DE algorithms (Tomtec™ and Dynamic Heart Model (DHM)) were used in 110 patients. Intra- and interobserver reproducibility and intervendor comparison were performed in additional patients’ subsets. Forty patients underwent cardiac magnetic resonance (CMR). Feasibility was 100% for Tomtec, 98.2% for DHM, and 72.8% for conventional 3DE. Tomtec volumes were higher than 3DE and DHM (p < 0.001). Reproducibility was better for DHM (intraobserver LA maximum volume (LAmax) ICC 0.99 (95% CI 1.0–0.99), LA minimum volume (LAmin) 0.98 (95% CI 0.95–0.99), LApreA 0.96 (95% CI 0.91–0.98); interobserver LAmax ICC 0.98 (95% CI 0.96–0.99), LAmin 0.99 (95% CI 0.99–1.00), and LApreA 0.97 (95% CI 0.94–0.99)). Intervendor comparison showed differences between left ventricle (LV) software adapted for LA (p < 0.001). Tomtec underestimated the least LA volumes compared to CMR. These findings emphasize that dedicated software should be used for LA assessment, for consistent clinical longitudinal follow-up and research.

Multiplanar review of three-dimensional echocardiography gives new insights into the morphology of Ebstein’s malformation

2010 ◽  
Vol 20 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Tara Bharucha ◽  
Robert H. Anderson ◽  
Zek S. Lim ◽  
Joseph J. Vettukattil
Keyword(s):  
Three Dimensional ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Diagnostic Features ◽  
Cross Sectional ◽  
Dynamic Morphology ◽  
Clear Differentiation ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography ◽  
The Right

AbstractIntroductionWe aimed to assess the ability of the multiplanar review modality of three-dimensional echocardiography to examine the dynamic morphology and the functional characteristics of malformed tricuspid valves in patients previously identified as having Ebstein’s malformation. Based on these characteristics, we attempted to differentiate Ebstein’s malformation from tricuspid valvar dysplasia.MethodsUsing three-dimensional multiplanar review, analysed with either Qlab 6.0 or Tomtech Image Arena 3.0, we studied 23 patients, aged from 1 day to 70 years, previously diagnosed using cross-sectional echocardiography as having Ebstein’s malformation.ResultsUsing the features of rotational abnormality, and the orientation, of the effective tricuspid valvar orifice as diagnostic features of Ebstein’s malformation, we reclassified 11 patients (48 per cent) as exhibiting tricuspid valvar dysplasia. In addition, we studied the dynamic morphology as well as the function of the tricuspid valve. Surgical treatment was undertaken on 10 patients, revealing good correlation with the findings obtained using three-dimensional multiplanar review. In those with Ebstein’s malformation, we found varying degrees of rotation, with the effective valvar orifice always directed towards the right ventricular outflow tract. The opening of the orifice of dysplastic tricuspid valves, in contrast, was towards the apex of the right ventricle. The degree of delamination, and abnormalities of subcordal apparatus, were similar in the two groups.DiscussionThree-dimensional multiplanar review permits accurate definition of the dynamic morphology of Ebstein’s malformation, permitting clear differentiation from tricuspid valvar dysplasia.

Tricuspid Valve Repair in Infancy Using Neochordae: Three-Dimensional Echocardiographic Imaging

2017 ◽  
Vol 8 (6) ◽  
pp. 740-742
Author(s):  
Billie-Jean Martin ◽  
Nee S. Khoo ◽  
Jeffrey Smallhorn ◽  
Mohammed Al Aklabi
Keyword(s):  
Hospital Discharge ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Three Dimensional ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

Tricuspid regurgitation (TR) in infancy poses a surgical challenge. Both two- and three-dimensional echocardiography (3DE) can provide detailed information about the mechanism(s) of valve failure and insights into valve adaptation during follow-up. We report two patients who underwent tricuspid valve repair using Gore-Tex neochordae, repairs which were facilitated by and assessed with 3DE. Both infants had less than mild residual TR and no valve tethering at hospital discharge. Furthermore, follow-up 3DEs have helped to confirm valve competence, lack of tethering, and growth of the valve and valve apparatus.

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