Echocardiography, Three-Dimensional ; methods ; trends

OBJECTIVETo compare the accuracy of live three-dimensional (Live-3D-TEE) and two-dimensional transesophageal echocardiography (2D-TEE) in the evaluation of functional anatomy of mitral regurgitation. METHDOS: Thirty-eight consecutive patients with severe mitral regurgitation were enrolled prospectively. The accuracy of Live-3D-TEE and 2D-TEE for functional assessment of mitral regurgitation was evaluated against surgical findings.

RESULTSThe accuracy in etiological assessment of mitral regurgitation was 94.7% with Live-3D-TEE and 89.5% with 2D-TEE (P=0.09). For assessment of lesions of the mitral valve, Live-3D-TEE showed an overall accuracy of 93.2%, significantly higher than that of 2D-TEE (88.6%, P=0.001). Live-3D-TEE also showed a significantly higher accuracy than 2D-TEE in localization of mitral valve lesions (93.3% vs 86.7%, P=0.000).

CONCLUSIONBoth Live-3D-TEE and 2D-TEE allow accurate assessment of the etiology of mitral regurgitation, but Live-3D-TEE can be more accurate in the evaluation of the lesions of the mitral valve and their localization.

Adult ; Aged ; Echocardiography ; methods ; Echocardiography, Three-Dimensional ; methods ; Echocardiography, Transesophageal ; methods ; Female ; Humans ; Male ; Middle Aged ; Mitral Valve Insufficiency ; diagnostic imaging ; pathology ; physiopathology ; Young Adult

BACKGROUNDLeft atrial (LA) maximum volume is becoming a prognostic biomarker for left ventricular (LV) diastolic dysfunction. However, we assessed LV diastolic function by measuring LA phasic volumes using real-time threedimensional echocardiography (RT3DE) in patients with stable coronary artery disease (CAD).

METHODSSixty-five stable CAD patients with normal LV ejection fraction (LVEF) were divided into three groups according to degree of coronary stenosis: control (n = 15) with <50% stenosis as control group, mildS (n = 25) with mild stenosis (50%-70%) and severeS (n = 25) with >70% stenosis. LA phasic volumes and function were evaluated and compared using RT3DE and two dimensional echocardiography (2DE). N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were examined. The correlations of RT3DE-derived parameters with other conventional indices were analyzed.

RESULTSSignificant correlations between RT3DE and 2DE for LA volume measurements were: control, r = 0.93; mildS, r = 0.94; severeS, r = 0.90 (all P < 0.05). Patients with severe coronary stenosis presented higher NT-proBNP level, indices of LA minimum volume and volume before atrial contraction, but lower LA total emptying fraction (LAEF) and LAEFpassive. Significant correlations of RT3DE derived LA volume indices with E/E' (r = 0.695) and NF-proBNP (r = 0.630) level were found.

CONCLUSIONSRT3DE derived, LA indices correlate well with NT-proBNP level and may be superior to 2DE measurements for the evaluation of LV diastolic dysfunction. Enlargement of LA minimum volume in stable CAD patients without systolic dysfunction appears earlier and may be better correlated with LV diastolic function than that of LA maximum volume.

Echocardiography ; Echocardiography, Three-Dimensional ; methods ; Female ; Humans ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnosis

Transthoracic echocardiographic characteristics of 17 cases of cardiac amyloidosis (CA), a rare disease in China, were analyzed in order to improve the understanding of the disease. Seventeen cases of biopsy-proven CA, admitted to Wuhan Union Hospital from June 1994 to September 2008 were retrospectively reviewed. Twenty normal volunteers served as control group. Left atrial and ventricular functions and mitral inflow velocity were measured by two-dimensional, and Doppler echocardiography, and tissue Doppler imaging (TDI)-derived peak systolic wall motion velocities (Sv), peak early diastolic wall motion velocities (Ev), and peak late diastolic wall motion (Av) were measured at the septum, lateral, inferior and anterior corners of mitral annulus from the apical 4- and 2 chamber views. Compared with the control group, the interventricular septal thickness (IVSd), the left ventricular posterior wall (LVPWd), right ventricular transverse diameter (RVTDd) near the end of diastole and the interauricular septum thickness (IASs), left atrial anteroposterior diameter (LAADs), right atrial transverse diameter (RATDs) near the end of systole were increased significantly (all P<0.05) and left ventricular ejection fraction (LVEF) decreased (P<0.05) in the CA group. Compared with the control group, Sv, Ev at each wall and Av at almost all walls were significantly decreased in the CA group. In the CA group, Myocardial echoes of interventricular septum and free wall of left ventricle were enhanced evidently and distributed unevenly. The echoes presented as ground glass-like images, with some spotty hyper echoes. Both atria were enlarged, and LVEF decreased, with diastolic function impaired, and mild-moderate hydropericardium found in the CA group. It was concluded that echocardiography was a relatively sensitive and highly specific non-invasive method for the diagnosis of CA.
Amyloidosis/*ultrasonography ; Cardiomyopathies/*ultrasonography ; Case-Control Studies ; Echocardiography ; Echocardiography, Doppler/*methods ; Retrospective Studies ; Sensitivity and Specificity

BACKGROUND: The diagnosis and estimation of severity of infundibular pulmonic stenosis (PS) is difficult by two-dimensional or M-mode echocardiography. In continuous wave(CW) Doppler signal valvular PS is seen as a parabolic velocity profile but infundibular PS is seen as a velocity signal with its peak in late systole. The purpose of this study is that Doppler echocardiography can discriminate valvular PS from infundibular PS and assess the severity of infundibular obstruction. METHOD: Six patients with valvular and infundibular PS by Doppler echocardiography and cardiac catheterization were studied. All had been undergone surgery. We compared their Doppler echocardiographic and cardiac catheterization finding with surgical finding. RESULT: 1) CW Doppler signal of infundibular PS had lesser peak velocity(2.84m/sec vs 4.33m/sec, p < 0.05) and later systolic peak in velocity(AT/ET ratio : 0.73 vs 0.51, p < 0.05) than that of valvular PS. 2) Pressure gradient across the infundibular obstruction measured by Doppler echocardiography correlated well with that by cardiac catheterization(r=0.89, p < 0.05). 3) Operation finding showed infundibular PS in 5 case but not one and coexisting other anomaly such as ASD in 4 case, TOF in 1 case, PAPVR in 1 case. CONCLUSION: Doppler echocardiography is a useful noninvasive method for the diagnosis and the estimation of severity of infundibular obstruction in patient with PS.
Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography ; Echocardiography, Doppler ; Humans ; Methods ; Pulmonary Valve Stenosis ; Systole

OBJECTIVES: To define the differnce in echocardiographic features between hypertrophic cardiomyopathy(HCM) and severe left ventricular hypertrophy(LVH) accompanying hypertension. METHOD: Two-dimensional, M-mode and Doppler echocardiography were performed in both 16 subjects with typical HCM(Group 1) and 22 subjects with severe LVH accompanying hypertension(Group 2). We andalyzed the echocardiographic features such as distribution of LV hypertrophy, systolic anterior motion of mitral valve(SAM), LV outflow Doppler pressure gradient, interventricular septal thickness(IVST), LV posterior wall thickness(LVPWT). systolic IVS excursion (IVSa) and LVPW excursion (LVPWa), LVPWa/IVSa, LV end-diastolic (LVEDD) and end-systolic dimension (LVESD), fractional shortening(% FS), isovolumic relaxation time(IVRT), peak mitral early filling velocity(peak E), peak atrial filling velocity(peak A) and diastolic deceleration time(DT) from the videotape recordings. RESULTS: 1) There were no definite clinical or electrocardiographic difference between two groups of the subject, except high blood pressure in group 2. 2) By echocardiography, mean LVPWT wa larger in group 2 compared with the HCM group(14±2 vs 11±2mm, p < 0.001), but asymmetric septal hypertrophy(ASH) was more frequent(IVST/LVPWT, 1.7±0.5 vs 1.2±0.2, p < 0.001) in HCM group than in LVH group. 3) IVSa was reduced(6±2 vs 8±2mm). but LVPWa/IVSa ratio was higher(2.3±1.2 vs 1.7±0.4, p < 0.05) in HCM group than in LVH group. CONCLUSION: We conclude that echocardiographic differentiaton between HCM and LVH accompanying hypertension is very difficult, but LVPWT, IVSa from M-mode echocardiography and LVPWa/IVSa ratio seem to be helpful indices, complementary to SAM or ASH, to differentiate each other.
Cardiomyopathy, Hypertrophic ; Deceleration ; Echocardiography ; Echocardiography, Doppler ; Electrocardiography ; Hypertension ; Hypertrophy ; Hypertrophy, Left Ventricular ; Methods ; Relaxation ; Videotape Recording

BACKGROUND: Radiofrequecy(RF) catheter ablation is the choice of treatment of refractory supraventricular tachycardia. Althogh catheter ablation is invasive, it is well-known that this procedure is safe. However RF catheter ablation may provoke some adverse conditions. The purpose of this study was to assess functional and morphologic changes shortly after radiofrequency catheter ablation in patients with supraventricular tachycardia by means of two-dimensional echocardiography. METHOD: Echocardiogram underwent 1 day before and within 3 days after RF catheter ablation. Cardiac chamber size, wall thickness, and valve motion in the M-mode were Measured. Left ventricular volume, area, dimension, pericardial effusion and segmental wall motion were measured by means of two-dimensional echocardiography and valve incompetence were also measured with color Doppler echocardiography. RESULTS: New echocardiographic abnormalities were observed in 4(5.4%) among 73 patients. One mild aortic regurgitation,one increase in severity of tricuspid imcompetence, one increase in severity of mitral regurgitation and one mild pericardial effusion were found. CONCLUSION: We concluded that echocardiographic changes after radiofrequency ablation are rate and of minor significance.
Catheter Ablation ; Echocardiography ; Echocardiography, Doppler, Color ; Humans ; Methods ; Mitral Valve Insufficiency ; Pericardial Effusion ; Tachycardia, Supraventricular

BACKGROUND: In latent type of hypertrophic obstructive cardiomyopathy, there is no pressure gradient at rest in left ventricular outflow tract(LVOT), but it develops with provocation. Dobutamine increase myocardial contractility and may inducce outflow tract obstruction. To evaluate the usefulness of dobutamine induced outflow tract obstruction as a provocation test, nine patients with latent obstructive cardiomyopathy were studied. METHOD: 680 cases of dobutamine stress echocardiography were reviewed. Nine patients developed late peaking outflow velocity pattern in response to dobutamine infusion(inducible group). Ten patients developed early peaking velocity pattern were included as control group. Left ventricular dimension, outflow tract diameter were measured, and pattern of septal hypertrophy was classified. Changes of peak velocity and acceleration time/ejection time ratio (AT/ET) were measured at rest and peak dose dobutamine. RESULTS: The peak outflow velocity at rest was not different in both groups(1.49±0.45, 1.18±0.11m/sec). Peak velocity and AT/ET ratio were significantly increased in inducible group(4.2±0.9m/sec, 0.66±0.17), but no significant changes were noted in control group. Patients with inducible group had greater septal thickness, smaller outflow tract diameter and greater prevalence of septal bulge morphology. CONCLUSION: These results suggest that dobutamine stress Doppler echocardiography could be a useful provocation test to diagnosis of latent obstructive cardiogyopathy.
Acceleration ; Cardiomyopathies ; Cardiomyopathy, Hypertrophic ; Diagnosis ; Dobutamine ; Echocardiography, Doppler ; Echocardiography, Stress ; Humans ; Hypertrophy ; Methods ; Prevalence

The authors encountered a 4-month-old, female Shiba dog weighing 4.0 kg, who had been exhibiting abdominal distension and increasing ascites for 2 months. She was brought for further examination and treatment with the chief complaints of ascites and dyspnoea during sleep. The dog was diagnosed with ascites caused by cor triatriatum dexter based on the physical and imaging findings. Under general anaesthesia, she was treated with hybrid balloon dilation under transoesophageal echocardiography guidance. Her postoperative recovery was quite rapid and uneventful. This method appears to be a useful, new, and less-invasive treatment option for cor triatriatum dexter.
Animals ; Ascites ; Cor Triatriatum ; Dogs ; Echocardiography ; Echocardiography, Transesophageal ; Female ; Heart Defects, Congenital ; Humans ; Infant ; Methods

The role of cardiac computed tomography (CT) for evaluating the mitral valve (MV) has been limited since echocardiography is the main method of evaluation. However, recent advances in cardiac CT have enable detailed evaluation of the anatomy and geometry of the MV. We describe assessments of the anatomy and coaptation geometric parameters of normal MVs, and also review repair of diseased/damaged MV. We also discuss pre- and post-surgical imaging of MV pathology using cardiac CT and various CT images. We found that cardiac CT could be used as an alternative imaging modality to echocardiography for pre-operative MV evaluation and to predict clinical outcomes following repair.
Echocardiography ; Heart Valves ; Methods ; Mitral Valve Insufficiency ; Mitral Valve* ; Pathology