Dobutamine Stress Echocardiography Safety in Chagas Disease Patients.

Background:: A few decades ago, patients with Chagas disease were predominantly rural workers, with a low risk profile for obstructive coronary artery disease (CAD). As urbanization has increased, they became exposed to the same risk factors for CAD of uninfected individuals. Dobutamine stress echocardiography (DSE) has proven to be an important tool in CAD diagnosis.

Recommendations for the imaging assessment of prosthetic heart valves: a report from the European Association of Cardiovascular Imaging endorsed by the Chinese Society of Echocardiography, the Inter-American Society of Echocardiography, and the Brazilian Department of Cardiovascular Imaging.

Prosthetic heart valve (PHV) dysfunction is rare but potentially life-threatening. Although often challenging, establishing the exact cause of PHV dysfunction is essential to determine the appropriate treatment strategy. In clinical practice, a comprehensive approach that integrates several parameters of valve morphology and function assessed with 2D/3D transthoracic and transoesophageal echocardiography is a key to appropriately detect and quantitate PHV dysfunction.

Mitral annulus morphologic and functional analysis using real time tridimensional echocardiography in patients submitted to unsupported mitral valve repair.

Introduction: Mitral valve repair is the treatment of choice to correct mitral insufficiency, although the literature related to mitral valve annulus behavior after mitral repair without use of prosthetic rings is scarce.

Objective: To analyze mitral annulus morphology and function using real time tridimensional echocardiography in individuals submitted to mitral valve repair with Double Teflon technique.

Methods: Fourteen patients with mitral valve insufficiency secondary to mixomatous degeneration that were submitted to mitral valve repair with the Double Teflon technique were included.

Determinants of peak VO2 in heart transplant recipients.

Objective: To establish the determinants of the peak VO2 in heart transplant recipients.

Methods: Patient's assessment was performed in two consecutive days. In the first day, patients performed the heart rate variability assessment followed by a cardiopulmonary exercise test.

Relationship of clot burden and echocardiographic severity of right ventricular dysfunction after acute pulmonary embolism.

The impact of pulmonary embolism on right ventricular (RV) performance can be evaluated by echocardiography, however, the relationship between pulmonary vascular involvement and RV burden is controversial. To assess the effect of clot burden on RV performance we studied 85 patients (aged 53 ± 17 years, 39 female) with confirmed PE by multislice computed tomography (CT) and echocardiography within 24 h of diagnosis. A CT score ranging from 1 to 20 points according to the pulmonary arteries involved was used.

Rare Association: Chagas' Disease and Hypertrophic Cardiomyopathy.

A woman (49 years) with Chagas' disease showed: ECG, right bundle-branch block and left anterior-superior fascicular block; V1 has unusual R > R', and elevated ST segment from V2 to V6 . Additional imaging revealed concomitant HCM and Chagas, which is uncommon. Overlapping of ECG findings can be explained by this rare association of diseases.

Cardiac mechanics evaluated by speckle tracking echocardiography.

Natural myocardial markers, or speckles, originated from constructive and destructive interference of ultrasound in the tissues may provide early diagnosis of myocardial changes and be used in the prediction of some cardiac events. Due to its relatively temporal stability, speckles can be tracked by dedicated software along the cardiac cycle, enabling the analysis of the systolic and diastolic function. They are identified by either conventional 2D grey scale and by 3D echo, conferring independence of the insonation angle, thus allowing assessment of cardiac mechanics in the three spatial planes: longitudinal, circumferential, and radial.

Echocardiographic parameters and survival in Chagas heart disease with severe systolic dysfunction.

Background: Echocardiography provides important information on the cardiac evaluation of patients with heart failure. The identification of echocardiographic parameters in severe Chagas heart disease would help implement treatment and assess prognosis.

Objective: To correlate echocardiographic parameters with the endpoint cardiovascular mortality in patients with ejection fraction < 35%.

Mortality after myocardial infarction: the role of renal function and systolic and diastolic functions of the left ventricle.

Background: The relationship between renal dysfunction and mortality after myocardial infarction (MI) has been demonstrated in patients with reduced ejection fraction. The importance of diastolic dysfunction in this scenario is unknown.

Methods: We studied 749 patients with acute MI who were evaluated within 24 hours of symptom onset.

Contrast echocardiography in myocardial infarction.

The contrast agents used in ultrasound are approved for several clinical situations. New echocardiographic techniques, such as harmonic imaging and power pulse inversion imaging, can improve the visualization of microbubbles. In this article we discuss the early development of contrast echocardiography, new technologies that help improve image acquisition and its practical role in the assessment of myocardial infarction.

Streptococcus gallolyticus infective endocarditis in a patient with systemic lupus erythematosus: a three-dimensional echocardiography evaluation.

A 42 year-old woman was referred to our hospital with a history of fever and poor general status for the last 30 days. She presented tachycardia and a systolic apical murmur. Laboratory tests revealed leukocytosis of 13,100/mL, hemoglobin of 8.

Caseous calcification of the mitral annulus: case report.

We present a rare case of probable caseous calcification of the mitral. This pathology is more frequently detected in asymptomatic women older than 70 years. To recognize this image is important because echocardiography is the easiest way to elucidate this diagnosis, and more importantly because this structure could be easily misdiagnosed as tumors, thrombus and vegetations, which are much more common.

Assessing prognosis of pulmonary embolism using tissue-Doppler echocardiography and brain natriuretic peptide.

Objective: To assess prognosis of pulmonary thromboembolism using tissue Doppler echocardiography and brain natriuretic peptide.

Methods: Patients aged over 18 years were evaluated within 24 hours of confirmed diagnosis (chest tomography/pulmonary scintigraphy) of pulmonary embolism using two-dimensional echocardiography and tissue Doppler for right ventricular systolic (s') velocities, strain, tissue tracking and myocardial performance index. Plasma brain natriuretic peptide was also obtained within 24 hour.

Robotic surgery in cardiology: a safe and effective procedure.

Objective: To evaluate the short and medium-term outcomes of patients undergoing robotic-assisted minimally invasive cardiac surgery.

Methods: From March 2010 to March 2013, 21 patients underwent robotic-assisted cardiac surgery. The procedures performed were: mitral valve repair, mitral valve replacement, surgical correction of atrial fibrillation, surgical correction of atrial septal defect, intracardiac tumor resection, totally endoscopic coronary artery bypass surgery and pericardiectomy.

3D Echo pilot study of geometric left ventricular changes after acute myocardial infarction.

Background: Left ventricular remodeling (LVR) after AMI characterizes a factor of poor prognosis. There is little information in the literature on the LVR analyzed with three-dimensional echocardiography (3D ECHO).

Objective: To analyze, with 3D ECHO, the geometric and volumetric modifications of the left ventricle (VE) six months after AMI in patients subjected to percutaneous primary treatment.

Right ventricular assessment by tissue-Doppler echocardiography in acute pulmonary embolism.

Background: Assessment of the right ventricular (RV) function by echocardiography in patients with pulmonary thromboembolism (PTE) is complex and frequently qualitative. Tissue Doppler has been used for the semiquantitative assessment of this chamber, although with some limitations.

Objective: To evaluate RV function in PTE using tissue-Doppler echocardiography, in addition to atrial natriuretic peptide (BNP).

Correlation to NT-ProBNP and remodeling after cardiac surgery.

Background: Few data are available on diastolic function in patients with aortic stenosis (AOS) with indication of surgical treatment. A potential correlation between biomarkers and diastolic function has not been established.

Objective: The aim of our study was to evaluate diastolic function in patients with AOS waiting for aortic valve replacement (AVR) echocardiographically, and to verify its correlation with serum brain natriuretic peptide (NT-proBNP).

Left cardiac sympathetic denervation for treatment of symptomatic systolic heart failure patients: a pilot study.

Aims: To evaluate the feasibility, safety, and potential beneficial effects of left cardiac sympathetic denervation (LCSD) in systolic heart failure (HF) patients.

Methods And Results: In this prospective, randomized pilot study, inclusion criteria were New York Heart Association (NYHA) functional class II or III, left ventricular ejection fraction (LVEF) ≤40%, sinus rhythm, and resting heart rate >65 b.p.

Initial experience with Pomerantzeff's technique for reduction of the size of giant left atrium.

Introduction: The most common indication for surgical correction of giant left atrium is associated with mitral valve insufficiency with or without atrial fibrillation. Several techniques for this purpose are already described with varying results.

Objective: To present the initial experience with the tangential triangular resection technique (Pomerantzeff).