The role of multimodality imaging in the selection for implantable cardioverter-defibrillators in heart failure: A narrative review.

Advanced pharmacologic and interventional therapies have improved survival in heart failure. Implantable cardioverter-defibrillators (ICD) have been shown to reduce mortality in patients with heart failure, but the benefit appears to be uneven in this population. We reviewed the evidence showing the benefit of ICD therapy in heart failure patients, the main issues arising from these studies, and the possible answers for a better risk stratification.

Three-Dimensional Echocardiography is a Feasible and Reproducible Method for the Measurement of Left Atrial Volumes, Regardless of Expertise Level.

Left atrium (LA) assessment has gained significant interest in recent years because of its diagnostic and prognostic role in cardiovascular diseases. We aimed to assess the feasibility and reproducibility of three-dimensional echocardiography (3DE) versus two-dimensional echocardiography (2DE) for LA volumes (LAV) when measurements were performed by users with different levels of expertise in 3DE. We prospectively recruited 35 consecutive patients referred to our echocardiography laboratory.

New insights into the potential utility of the left atrial function analysis in heart failure with preserved ejection fraction diagnosis.

Aims: None of the conventional echocardiographic parameters alone predict increased NTproBNP level and symptoms, making diagnosis of heart failure with preserved ejection fraction (HFpEF) very difficult in some cases, in resting condition. We evaluated LA functions by 2D speckle tracking echocardiography (STE) on top of conventional parameters in HFpEF and preHF patients with diastolic dysfunction (DD), in order to establish the added value of the LA deformation parameters in the diagnosis of HFpEF.

Methods: We prospectively enrolled 125 patients, 88 with HFpEF (68±9 yrs), and 37 asymptomatic with similar risk factors with DD (preHF) (61±8 yrs).

3-D Echocardiography Is Feasible and More Reproducible than 2-D Echocardiography for In-Training Echocardiographers in Follow-up of Patients with Heart Failure with Reduced Ejection Fraction.

Left ventricular volumes (LVVs) and ejection fraction (LVEF) are key elements in the evaluation and follow-up of patients with heart failure with reduced ejection fraction (HFrEF). Therefore, a feasible and reproducible imaging method to be used by both experienced and in-training echocardiographers is mandatory. Our aim was to establish if, in a large echo lab, echocardiographers in-training provide feasible and more reproducible results for the evaluation of patients with HFrEF when using 3-dimensional echocardiography (3-DE) versus 2-dimensional echocardiography (2-DE).

The added value of three-dimensional echocardiography in the late diagnosis of a pacemaker complication in a patient with severe congestive heart failure: a case report.

Background: Three-dimensional echocardiography (3DE) presents an increasingly important role in the management of interventional cardiac procedures, overcoming limitations of conventional two-dimensional echocardiography (2DE). Early use of 3DE might have an added value in the diagnosis of device-related complications, such as lead induced tricuspid regurgitation (LITR), by providing better understanding of its mechanisms and ensuring a prompt and individually tailored treatment strategy.

Case Summary: We report the case of a female patient with repeated hospitalizations for congestive heart failure in the past 2 years, who had a permanent single-chamber ventricular pacemaker (PM) implanted 10 years ago and a misleading diagnosis of severe tricuspid regurgitation (TR) secondary to annular dilation, based on 2DE.

Catecholaminergic Polymorphic Ventricular Tachycardia - Looking to the Future.

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inheritable cardiac disorder, characterized by polymorphic ventricular tachycardia (PVT) or bidirectional ventricular tachycardia, triggered by adrenergic stress, and manifested most frequently as syncope or sudden cardiac death. The disease has a heterogeneous genetic basis, with mutations in the genes encoding the ryanodine and calsequestrin channels accounting for the majority of cases. The diagnosis of CPVT is established in individuals with polymorphic ventricular premature beats, PVT or bidirectional ventricular tachycardia documented during exercise or adrenergic stress, who have a structurally normal heart and normal resting ECG.

Impaired Cardiac Function in Patients with Multiple Sclerosis by Comparison with Normal Subjects.

Multiple sclerosis (MS), neurologic disease affecting young population, may cause cardiovascular dysfunction, due to autonomous nervous dysfunction, physical invalidity, increased oxidative stress, and systemic inflammatory status. However, cardiovascular function is rarely evaluated in these patients. We assessed left and right ventricular (LV and RV) function by 2D, 3D, tissue Doppler, and speckle tracking echocardiography, and vascular function by remodeling, stiffness, and endothelial dysfunction parameters in patients with MS, compared to control subjects.

Cardiovascular Dysfunction in Multiple Sclerosis.

Multiple sclerosis (MS) is a chronic neurological condition, characterized by recurrent episodes of inflammation and demyelination of the central nervous system called relapsing-remitting episodes, and continuous axonal degeneration that leads to irreversible progressive invalidity. Patients with multiple sclerosis present a higher mortality rate compared to the general population, and the excess of mortality may be explained by the increased cardiovascular risk and occurrence of cardiovascular disease. However, the exact pathways to cardiovascular dysfunction are not yet completely elucidated.