4.Aorta-to-right atrium fistula, an unusual complication of endocarditis.
Miao-yan CHEN ; Dan-dan ZHONG ; Zhi-qiang YING
Journal of Zhejiang University. Science. B 2009;10(3):230-232
Infective endocarditis (IE) remains a serious disease. Aorta-to-right atrium fistula is a rare but very serious complication of IE and predicts a higher mortality. This report describes a 50-year-old man with endocarditis, vegetation, perforation of noncoronary sinus, and formation of two aorta-to-right atrium fistulas with native valves detected by transthoracic echocardiography. This disease is lethal despite developments in cardiac imaging and antibacterial therapy. Early diagnosis, aggressive antibacterial therapy, and surgical treatment may improve the prognosis.
Aorta
;
diagnostic imaging
;
Arterio-Arterial Fistula
;
complications
;
diagnostic imaging
;
Echocardiography, Doppler
;
Endocarditis
;
complications
;
diagnostic imaging
;
Heart Atria
;
diagnostic imaging
;
Humans
;
Male
;
Middle Aged
6.Novel parameter for assessment of left atrial size in patients with hypertension: ratio of left atrial volume to left ventricular volume.
Yue LI ; Liang CHAI ; Yun ZHANG ; Lei LI
Chinese Medical Journal 2009;122(19):2325-2329
BACKGROUNDLeft atrial enlargement has been suggested as a more robust marker of diastolic dysfunction. We hypothesize that the ratio of left atrial volume to left ventricular volume (LAV/LVV) may be more reasonable to reflect left atrial enlargement in the patients with hypertension, because hypertensive patients have a characteristic of concentric remodeling of the left ventricle which is often accompanied with diastolic dysfunction. The aim of this study was to determine if the LAV/LVV can be used as a new parameter to assess left atrial size in hypertensive patients and the relationship between the LAV/LVV and diastolic dysfunction.
METHODSNinety-one patients with hypertension and forty-three normal controls were studied. The hypertensive patients were assigned to the normal wall (NW) and hypertrophic wall (HW) groups. The left atrial diameter (LAD), LAV, left atrial volume index (LAVi), LVV and LAV/LVV were measured and calculated by 2-dimensional echocardiography and real time 3-dimensional echocardiography. All of the above parameters were used to evaluate the size of the left atrium. The ratio of peak E velocity of mitral valve inflow to peak E' velocity of lateral mitral annulus (E/E') was measured by pulse Doppler and tissue Doppler. This parameter was used to evaluate diastolic function.
RESULTSThe LAD, LAV, LAVi, LAV/LVV and E/E' in hypertensive groups were significantly higher than those in the normal group (P < 0.05 or 0.01), and those in the HW group were significantly higher than those in the NW group (P < 0.05 or 0.01). The E/E' had a positive correlation with LAV, LAVi and LAV/LVV. The correlation coefficient between E/E' and LAV/LVV was relatively higher than that between E/E' and LAD or LAVi.
CONCLUSIONLAV/LVV may be used as a new index to evaluate left atrial size in hypertensive patients with diastolic dysfunction.
Aged ; Diastole ; Female ; Heart Atria ; diagnostic imaging ; pathology ; Heart Ventricles ; diagnostic imaging ; pathology ; Humans ; Hypertension ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Ultrasonography ; Ventricular Function, Left
7.Echocardiographic diagnosis of partial anomalous pulmonary venous connection.
Rong-rong HU ; Guo-ping JIANG ; Jing-jing YE ; Jin HE
Journal of Zhejiang University. Medical sciences 2012;41(4):450-452
OBJECTIVETo investigate partial anomalous pulmonary venous connection (PAPVC) with echocardiography.
METHODSThe right ventricular volume overload was detected by routine echocardiography in 37 child patients, who underwent further echocardiography to find the abnormal locations of pulmonary vein opening at superior, inferior vena cava and right atrium. The ultrasound results were compared with surgical findings.
RESULTSIn 30 patients the ultrasound diagnosis was consistent with surgery results, 7 were misdiagnosed by ultrasound with a detective rate of 81.1 %. All 37 PAPVC patients presented varying degrees of right heart enlargement; PAPVC combined with atrial septal defect (ASD) was found in 34 cases.
CONCLUSIONThe possibility of PAPVC should be considered when unexplained right heart volume overload was detected by echocardiography. Superior, inferior vena cava and right atrium should be inspected when the pulmonary veins were not seen in echocardiography.
Child ; Child, Preschool ; Echocardiography ; Female ; Heart Atria ; abnormalities ; diagnostic imaging ; Heart Septal Defects, Atrial ; diagnostic imaging ; Humans ; Infant ; Male ; Pulmonary Veins ; abnormalities ; diagnostic imaging
8.Correlation between left atrial strain and left ventricular diastolic function in hypertensive patients.
Jin CAI ; Zhongshu LIANG ; Wenchang FENG ; Hui LONG
Journal of Central South University(Medical Sciences) 2023;48(6):846-851
OBJECTIVES:
Early detection of asymptomatic diastolic dysfunction is essential to prevent the development of heart failure in hypertensive patients. Current studies suggest that left atrial strain contributes to the evaluation of left ventricular diastolic function, but there are fewer studies on the correlation between left atrial strain and diastolic function in hypertensive patients. In this study, we applied a two-dimensional speckle tracking technique to evaluate the changes in left atrial strain in hypertensive patients, and to investigate the relationship between left atrial strain and left ventricular diastolic function.
METHODS:
A total of 82 hypertensive patients who were visited the Department of Cardiology at the Third Xiangya Hospital of Central South University from July 2021 to January 2022, were enrolled for this study, and 59 healthy subjects served as a control group. According to the number of left ventricular diastolic function indexes recommended by the 2016 American Society of Echocardiography Diastolic Function Guidelines (mitral annular e´ velocity: Septal e´<7 cm/s, lateral e´<10 cm/s, E/e´ ratio>14, left atrial volume index>34 mL/m2, peak tricuspid regurgitation velocity>2.8 m/s), the hypertensive patients were divided into 3 groups: Group Ⅰ (0 index, n=36 ), Group Ⅱ (1 index, n=39), and Group Ⅲ (2 indexes, n=7). Two-dimensional speckle tracking technique was used to measure left atrial reservoir strain (LASr), conduit strain, and contraction strain, and to analyze the correlation between left atrial strain and left ventricular diastolic function in hypertensive patients.
RESULTS:
The LASr, left atrial conduit strain (LAScd), and LASr/(E/septal e´) of the hypertension group were lower than those of the control group, and E/LASr was higher than that of the control group. There was no significant difference in left atrium volume index between the 2 groups (P>0.05). Compared with Group Ⅰ, LASr, LAScd, and LASr/(E/septal e´) were decreased in Group Ⅱ and Group Ⅲ, LASr/(E/septal e´) was also decreased in Group Ⅲ compared with Group Ⅱ (all P<0.05). Compared with Group Ⅰ, E/LASr was increased in Group Ⅲ. LASr was positively correlated with septal e´, lateral e´, E, and E/A, and negatively correlated with E/septal e´.
CONCLUSIONS
The changes of left atrial function in patients with early hypertension are earlier than those of left atrial structure. Left atrial strain and its combination with conventional ultrasonographic indices [LASr/(E/septal e´)] of diastolic function are potentially useful in assessing left ventricular diastolic function in hypertensive patients.
Humans
;
Atrial Fibrillation
;
Atrial Appendage
;
Heart Atria/diagnostic imaging*
;
Hypertension/complications*
;
Diastole
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