Assessment of Postsystolic Shortening and Global Longitudinal Strain Improves the Sensitivity of Dobutamine Stress Echocardiography in End-Stage Liver Disease.

Background: Dobutamine stress echocardiography (DSE) remains a widely used method for detection of coronary artery disease (CAD) in patients with end-stage liver disease (ESLD) despite low sensitivity. Speckle-tracking assessment of strain may enhance the sensitivity of DSE in the general population, but the value of strain analysis in ESLD is unknown.

Methods: Dobutamine stress echocardiography with two-dimensional speckle-tracking and quantitative coronary angiography were performed in 146 patients with ESLD.

23rd Annual Feigenbaum Lecture: History of Echocardiography: A Personal Perspective.

Ultrasound was first used to examine the cardiovascular system about 70 years ago. The evolution of echocardiography as a family of diagnostic methods has been marked by ongoing development of novel technologies and clinical applications. The history is interesting and may be of particular interest to those practitioners who use echocardiography to enhance the care of their patients but who do not remember the "early days" of this field.

Prognostic value of left atrial size in hypertensive African Americans undergoing stress echocardiography.

Background: Left atrial (LA) enlargement is a marker of increased risk in the general population undergoing stress echocardiography. African American (AA) patients with hypertension are known to have less atrial remodeling than whites with hypertension. The prognostic impact of LA enlargement in AA with hypertension undergoing stress echocardiography is uncertain.

What is an artificial muscle? A comparison of soft actuators to biological muscles.

Interest in emulating the properties of biological muscles that allow for fast adaptability and control in unstructured environments has motivated researchers to develop new soft actuators, often referred to as 'artificial muscles'. The field of soft robotics is evolving rapidly as new soft actuator designs are published every year. In parallel, recent studies have also provided new insights for understanding biological muscles as 'active' materials whose tunable properties allow them to adapt rapidly to external perturbations.

Local and global growth and remodeling in calcific aortic valve disease and aging.

Aging and calcific aortic valve disease (CAVD) are the main factors leading to aortic stenosis. Both processes are accompanied by growth and remodeling pathways that play a crucial role in aortic valve pathophysiology. Herein, a computational growth and remodeling (G&R) framework was developed to investigate the effects of aging and calcification on aortic valve dynamics.

Cavatappi artificial muscles from drawing, twisting, and coiling polymer tubes.

Compliant, biomimetic actuation technologies that are both efficient and powerful are necessary for robotic systems that may one day interact, augment, and potentially integrate with humans. To this end, we introduce a fluid-driven muscle-like actuator fabricated from inexpensive polymer tubes. The actuation results from a specific processing of the tubes.

Safety and feasibility of dopamine-atropine stress echocardiography.

Background: Dobutamine-atropine stress echocardiography (DSE) has lower sensitivity in patients with advanced liver disease (ALD) due to vasodilation.

Hypothesis: Dopamine-atropine stress echocardiography (DopSE) may be an alternative to DSE in ALD patients by improving the blood pressure response to stress.

Methods: The safety and tolerability of DSE and DopSE were compared in 10 volunteers.

Introducing echocardiography to medical students: A novel echocardiography E-Learning experience.

Background: Echocardiography is fundamental in the understanding of cardiology; however, echocardiography is not routinely taught in medical schools. The aim of this study is to assess whether teaching echocardiography to preclinical medical students using an e-learning software (ELS) is practical and appropriate.

Methods: From 2017 to 2019, 1084 second-year medical students at Indiana University School of Medicine were introduced to echocardiography by using the ELS.

Low dose wall motion score predicts the short and long-term benefit of surgical revascularization in patients with ischemic left ventricular dysfunction.

We investigated the influence of the extent of viability using low dose dobutamine wall motion score index (WMS) on the survival benefit of surgical revascularization (CABG) versus medical therapy. In the STICH trial, viability assessment was not helpful in determining the benefit of CABG. However, the extent of viable myocardium with contractile function was not assessed in the trial.

Diagnostic Performance of Dobutamine Stress Echocardiography in End-Stage Liver Disease.

Objectives: This study determined the test performance of dobutamine stress echocardiography (DSE) in end-stage liver disease (ESLD).

Background: The reported sensitivity of DSE in ESLD has been variable.

Methods: Data from 633 ESLD patients who had coronary angiography within 6 months after DSE was analyzed.

Safety and efficacy of a TTR specific antisense oligonucleotide in patients with transthyretin amyloid cardiomyopathy.

Objectives: Cardiomyopathy is a major cause of death in both the hereditary form of transthyretin (TTR) amyloidosis and the sporadic late-age-onset transthyretin amyloidosis (ATTR wild-type (ATTR)). Clinically disease progression from time of diagnosis to death is usually quoted as 5- to 15-years. In prior studies, significant progression of cardiac parameters in patients with moderate to severe cardiomyopathy has been noted within a 12-month time span.

Prevalence, etiology, and clinical implications of reduced longitudinal systolic strain in renal transplant candidates.

Aims: Reduced global longitudinal systolic strain (GLS) is a common finding in end-stage renal disease (ESRD) patients with normal ejection fraction (EF), and GLS is a stronger predictor of mortality than EF. We sought to determine what factors may be responsible for the decreased strain in this population.

Methods And Results: The study group was comprised of 139 renal transplant candidates with a normal EF who had echocardiography with assessment of GLS and basal longitudinal systolic strain (BLS).

Prognostic utility of blood pressure-adjusted global and basal systolic longitudinal strain.

Assessment of global longitudinal systolic strain (GLS) and longitudinal systolic strain of the basal segments (BLS) has shown prognostic value in cardiac disorders. However, strain is reduced with increased afterload. We assessed the prognostic value of GLS and BLS adjusted for afterload.

Prevalence and Prognostic Value of Right Ventricular Systolic Dysfunction in Patients With Constrictive Pericarditis Who Underwent Pericardiectomy.

Impaired right ventricular systolic function (RVSF) may complicate the treatment of constrictive pericarditis (CP) by pericardiectomy, which is a procedure that remains with significant morbidity and mortality. We evaluated RVSF in patients with CP who underwent pericardiectomy to determine the prognostic value of RVSF. RVSF was assessed by measuring Tricuspid Annular Plane Systolic Excursion (TAPSE) in 35 patients (mean age 52 ± 15.

Incremental prognostic value of echocardiographic strain and its association with mortality in cancer patients.

Background: Left ventricular global longitudinal systolic strain (GLS) has been shown to be superior to ejection fraction in detecting subclinical dysfunction in patients with cancer and predicting mortality in patients with cardiovascular disease. Cancer-related fatigue is common in the later stages of neoplastic malignancies and may be indicative of nonovert heart failure. The aim of this study was to determine whether reduced strain by echocardiography was associated with all-cause mortality in a cancer cohort.

Improving prediction of outcomes in African Americans with normal stress echocardiograms using a risk scoring system.

Cardiovascular mortality is high in African Americans, and those with normal results on stress echocardiography remain at increased risk. The aim of this study was to develop a risk scoring system to improve the prediction of cardiovascular events in African Americans with normal results on stress echocardiography. Clinical data and rest echocardiographic measurements were obtained in 548 consecutive African Americans with normal results on rest and stress echocardiography and ejection fractions ≥50%.

Frequency, time course, and possible causes of right ventricular systolic dysfunction after cardiac transplantation: a single center experience.

Background: The frequency and causes of right ventricular (RV) systolic dysfunction early after cardiac transplantation are not well defined.

Methods: We investigated the prevalence and causes of RV dysfunction in 27 heart transplant recipients, as measured by lateral tricuspid annular plane excursion (TAPSE) and fractional area change (FAC) at a mean of 15 ± 11 days after transplant. Tissue Doppler imaging was used to assess systolic time velocity integral (TVI) of the RV basal free wall.

A practical approach to using strain echocardiography to evaluate the left ventricle.

Left ventricular (LV) evaluation is the most important use of echocardiography. Speckle tracking strain echocardiography (SE) provides a quantitative regional and global LV assessment, is an independent supplement to wall motion analysis and has been validated over the past 10 years. Despite these facts, SE is not being used routinely, especially in the United States.

Incremental prognostic value of echocardiography in patients with prior mitral valve surgery.

Background And Aim Of The Study: Patients with prior mitral valve surgery are at increased risk for events late after surgery. The study aim was to investigate the value of assessing clinical variables, and left and right heart anatomy and function, to predict outcome in these patients.

Methods: Two-dimensional echocardiography, Doppler echocardiography and tissue Doppler imaging (TDI) were performed in 84 patients at a mean of 7.

Effect of improvement in left ventricular ejection fraction on long-term survival in revascularized patients with ischaemic left ventricular systolic dysfunction.

Aims: The importance of improvement in the ejection fraction to the prognosis of revascularized patients with ischaemic left ventricular (LV) dysfunction is uncertain.

Methods And Results: Eighty-seven patients with ischaemic LV dysfunction (mean ejection fraction 29 ± 8% by biplane Simpson's) had dobutamine echocardiography before revascularization (coronary bypass graft surgery-81, percutaneous intervention-6). Follow-up echocardiograms were performed a mean of 4.

Rate of progression of transthyretin amyloidosis.

Hereditary transthyretin (TTR) amyloidosis is an adult-onset disease characterized mainly by peripheral neuropathy and cardiomyopathy. Although disease progression is usually 5 to 15 years from time of diagnosis to death, no specific measurements of disease progression have been identified. The present study was designed to identify objective parameters to measure progression of hereditary TTR amyloidosis and determine if these parameters would show significant change within 1 year.