Contrast harmonic imaging.

The behavior of ultrasound contrast agents depends highly on the acoustic pressure of the insonified ultrasound wave. For low pressure the expansion and compression is linear to the pressure, for medium acoustic pressure nonlinear behavior starts to occur and for high pressures, but still in the diagnostic range transient scattering can be noticed, resulting in an enhanced scattering followed by a disappearance of the bubble. The nonlinear and transient regime can be utilized for imaging of the contrast agent in or nearby tissue.

Cardiac sarcoidosis: Case-studies and a brief review of the literature.

Sarcoidosis is a multi-system granulomatous disorder of unknown aetiology. Symptomatic cardiac involvement occurs in approximately 5% of patients. The prevalence of sarcoidosis in the Netherlands is unknown, but estimated to be approximately 20 per 100,000 population (3200 patients).

DDDR pacing for symptomatic patients with hypertrophic obstructive cardiomyopathy: The first experience in the Netherlands with pacing in HOCM.

Background: Hypertrophic obstructive cardiomyopathy (HOCM) is a primary cardiac disorder with a heterogeneous expression. When medical therapy fails in patients with symptomatic HOCM, three additional therapeutic strategies exist: ventricular septal myectomy, alcohol-induced percutaneous transluminal septal myocardial ablation (PTSMA) of the first septal branch of the anterior descending artery and pacemaker implantation. In this paper we present the results of seven patients in whom a dual-chamber pacemaker was implanted to reduce the gradient in the left ventricular outflow tract (LVOT) and to relieve their symptoms.

Imaging of a non-coronary sinus of Valsalva aneurysm with transthoracic echocardiography and multi-slice computed tomography.

A 46-year-old female with a giant aneurysm of the non-coronary sinus of Valsalva, associated with moderate aortic valve regurgitation, is described. The aneurysm was detected by echocardiography in a patient who was complaining of paroxysmal palpitations. The patient was accepted for aneurysmectomy.

Super harmonic imaging: a new imaging technique for improved contrast detection.

For ultrasound contrast agents (UCA), nonlinear imaging now has become fundamental. All of the current contrast-imaging methods are dominantly based on the nonlinear response of UCA bubbles. The discrimination between the perfused tissue and the UCA is the challenge in the field of UCA-imaging.

Angiotensin II type 2 receptors and cardiac hypertrophy in women with hypertrophic cardiomyopathy.

The development of left ventricular hypertrophy in subjects with hypertrophic cardiomyopathy (HCM) is variable, suggesting a role for modifying factors such as angiotensin II. Angiotensin II mediates both trophic and antitrophic effects, via angiotensin II type 1 (AT(1)-R) and angiotensin II type 2 (AT(2)-R) receptors, respectively. Here we investigated the effect of the AT(2)-R gene A/C(3123) polymorphism, located in the 3' untranslated region of exon 3, on left ventricular mass index (LVMI) in 103 genetically independent subjects with HCM (age, 12 to 81 years).

Percutaneous transluminal septal myocardial ablation in hypertrophic cardiomyopathy.

Background: Percutaneous transluminal septal myocardial ablation (PTSMA) is a new interventional technique to treat patients with hypertrophic cardiomyopathy.

Methods: Small doses of ethanol 96% were injected into a targeted septal artery causing a chemical myocardial infarction. Three patients were evaluated, including a follow-up of three months.

[Use of harmonic echocardiographic contrast imaging and intravenous bolus of Levovist for evaluation of the left ventricle].

Harmonic imaging is a new imaging modality using nonlinear acoustic response, which is particularly sensitive for the particles of contrast agents. Our study was designed to compare the potential of harmonic echocardiographic imaging of the left ventricle using a contrast agent, Levovist to improve the detection of endocardium in patients with suboptimal image quality. 40 patients were studied using standard transthoracic apical views of the left ventricle patients using fundamental frequency and second harmonic frequency after and intravenous injection of 2.

Three-Dimensional Echocardiography of the Aortic Valve: Feasibility, Clinical Potential, and Limitations.

OBJECTIVES: The purpose of our study was to assess the feasibility and potential clinical utility of three-dimensional echocardiography for evaluation of the aortic valve. BACKGROUND: The value of three-dimensional echocardiographic assessment of the aortic valve has not been established yet. METHODS: The study group comprised 32 patients (11 women, 21 men), mean age 56.

Usefulness of power Doppler contrast echocardiography to identify reperfusion after acute myocardial infarction.

Microvascular integrity, as seen by myocardial contrast echocardiography (MCE), assesses whether myocardium has been successfully reperfused after an acute myocardial infarction. Until now this has been demonstrated only with intracoronary injection of an ultrasound contrast agent. Power Doppler imaging is a recently developed myocardial contrast echocardiographic method that counts the contrast microbubbles destroyed by ultrasounds and displays this number in color.

Ultrasound contrast imaging: current and new potential methods.

For 10 years, it was thought that ultrasound (US) contrast agents could be sufficiently detected and imaged with the conventional imaging techniques, now referred to as fundamental imaging. However, it turned out that fundamental imaging was not sensitive enough to detect the contrast agents in the presence of tissue. New imaging techniques that are based on specific properties of the contrast agents, such as nonlinear and transient scattering, proved to be more sensitive.

Optimal rotational interval for 3-dimensional echocardiography data acquisition for rapid and accurate measurement of left ventricular function.

Background: Prolonged 3-dimensional echocardiography (3DE) acquisition time currently limits its routine use for calculating left ventricular volume (LVV) and ejection fraction (EF). Our goal was to reduce the acquisition time by defining the largest rotational acquisition interval that still allows 3DE reconstruction for accurate and reproducible LVV and EF calculation.

Methods: Twenty-one subjects underwent magnetic resonance imaging and precordial 3DE with 2 degrees acquisition intervals.

Detection procedures of ultrasound contrast agents.

In the early days, it was believed that ultrasound contrast agents (UCA) could be sufficiently detected and imaged with the conventional imaging methods nowadays referred to as fundamental imaging. Newer imaging techniques proved to be more sensitive and are based on specific properties of the UCA. In general, these new characteristics involve non-linear and transient characteristics of contrast agents that appear at the high end of the diagnostic acoustic intensity.

Effect of harmonic imaging without contrast on image quality of transesophageal echocardiography.

Harmonic imaging improves endocardial border delineation during transesophageal echocardiography when compared with conventional imaging (26% improvement vs 2% worsening; p <0.001). This allows better assessment of left ventricular function during cardiac surgery, and suggests a role of harmonic imaging for transesophageal echocardiography.

Usefulness of three-dimensional transesophageal echocardiographic imaging for evaluating narrowing in the coronary arteries.

Coronary artery (CA) imaging has relied on invasive techniques for diagnosing stenotic lesions. Two-dimensional techniques are limited in obtaining optimal longitudinal views of all segments of the CA because of their spatial orientations. Three-dimensional echocardiography (3DE) may produce any desired cross-sectional views and reconstruct 3-dimensional images from a volumetric data set.

Comparison of native and contrast-enhanced harmonic echocardiography for visualization of left ventricular endocardial border.

Our study was designed to compare the utility of fundamental and second harmonic imaging (SH) for visualization of the left ventricular (LV) endocardial border. SH is a new imaging modality using nonlinear acoustic response, which may provide better endocardial border delineation. Standard apical views were studied in 42 patients using fundamental frequency (FF), SH without contrast (1.

New ultrasound contrast agents for left ventricular and myocardial opacification.

Until recently, the use of contrast agents with 2-dimensional echocardiography has been limited to the detection of intracardiac shunts or abnormal venous connections. The advent of commercially available transpulmonary contrast agents and progress in imaging technology changed this situation. New indications for contrast echocardiography include improved assessment of ventricular function by endocardial border enhancement and the assessment of myocardial perfusion.

Visualization and quantification of myocardial mass at risk using three-dimensional contrast echocardiography.

Objective: Three-dimensional echocardiographic assessment of myocardial ischemia using contrast echocardiography has been hampered by limitations of available contrast agents and analytic software. In the study presented, a three-dimensional perfusion imaging method was evaluated in the porcine model of myocardial ischemia using a novel contrast agent.

Methods: Three-dimensional echocardiography was performed in eight open-chested pigs before, during and after left anterior descending (six animals) or circumflex (two animals) coronary artery occlusion.

Paraplane analysis from precordial three-dimensional echocardiographic data sets for rapid and accurate quantification of left ventricular volume and function: a comparison with magnetic resonance imaging.

Objectives: Three-dimensional echocardiography (3DE) calculates left ventricular volumes (LVV) and ejection fraction (EF) without geometric assumptions, but prolonged analysis time limits its routine use. This study was designed to validate a modified 3DE method for rapid and accurate LVV and EF calculation compared with magnetic resonance imaging (MRI).

Methods: Forty subjects included 15 normal volunteers (group A) and 25 patients with segmental wall motion abnormalities and global hypokinesis caused by ischemic heart disease (group B) who underwent 3DE with precordial rotational acquisition technique (2-degree interval with electrocardiographic and respiratory gating) and MRI at 0.

AT1 receptor A/C1166 polymorphism contributes to cardiac hypertrophy in subjects with hypertrophic cardiomyopathy.

The development of left ventricular hypertrophy (LVH) in subjects with hypertrophic cardiomyopathy (HCM) is variable, suggesting a role for modifying factors such as angiotensin II. We investigated whether the angiotensin II type 1 receptor (AT1-R) A/C1166 polymorphism, the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism, and/or plasma renin influence LVH in HCM. Left ventricular mass index (LVMI) and interventricular septal thickness were determined by 2-dimensional echocardiography in 104 genetically independent subjects with HCM.

Early recovery of wall motion abnormalities after recanalization of chronic totally occluded coronary arteries: a dobutamine echocardiographic, prospective, single-center experience.

Background: Patients with symptomatic myocardial ischemia from a chronic totally occluded coronary (TOC) artery are usually referred for coronary artery bypass surgery. Because guide wire technology has improved considerably in recent years, percutaneous coronary angioplasty has become a useful technique in opening chronic TOC arteries. We evaluated the early functional results of successful percutaneous recanalization by performing dobutamine stress echocardiography (DSE).

Improved quantification of myocardial mass by three-dimensional echocardiography using a deposit contrast agent.

The aim of the study was to assess the usefulness of a novel contrast agent in combination with three-dimensional echocardiography for improved mass quantification. Three-dimensional reconstruction of left ventricular myocardium was performed from images obtained with rotational epicardial acquisition in eight open-chested pigs, before and after injection of a deposit contrast agent, Quantison Depot. Three-dimensional echocardiographic myocardial mass values were in excellent agreement with weighted mass (differences -1.

Measurements and day-to-day variabilities of left ventricular volumes and ejection fraction by three-dimensional echocardiography and comparison with magnetic resonance imaging.

The aim of this study was to assess day-to-day variability of left ventricular (LV) volume and ejection fraction (EF) calculated from 3-dimensional echocardiography (3-DE) and to compare the reproducibility of the measurement with magnetic resonance imaging. Forty-six subjects were examined including 15 normal volunteers (group A) and 31 patients with LV dysfunction (group B). Precordial 3-DE acquisition was performed at 2 degrees rotational intervals and repeated 1 week later.

Left ventricular ejection fraction in patients with normal and distorted left ventricular shape by three-dimensional echocardiographic methods: a comparison with radionuclide angiography.

Background: Serial evaluation of left ventricular (LV) ejection fraction (EF) is important for the management and follow-up of cardiac patients. Our aim was to compare LVEF calculated from two three-dimensional echocardiographic (3DE) methods with multigated radionuclide angiography (RNA), in patients with normal and abnormally shaped ventricles.

Methods And Results: Forty-one consecutive patients referred for RNA underwent precordial rotational 3DE acquisition of 90 cut-planes.