Multi-parametric speckle tracking analyses to characterize cardiac amyloidosis: a comparative study of systolic left ventricular longitudinal myocardial mechanics.

Cardiac amyloidosis (CAM), the most common cardiac storage disease is associated with significant changes in left-ventricular (LV) morphology and function. To gain particular insights into LV systolic longitudinal myocardial mechanics we investigated seven parameters derived by speckle-tracking-echocardiography (STE) in patients with confirmed CAM (n = 59). The results were compared with those of individuals with healthy heart (n = 150) and another primary myocardial disease with also thickened myocardium and severe diastolic and systolic LV-dysfunction (symptomatic LV-non-compaction-cardiomyopathy, LV-NC, n = 30).

Athletes with valvular heart disease and competitive sports: a position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology.

This article provides an overview of the recommendations from the Sports Cardiology section of the European Association of Preventive Cardiology on sports participation in individuals with valvular heart disease (VHD). The aim of these recommendations is to encourage regular physical activity including sports participation, with reasonable precaution to ensure a high level of safety for all affected individuals. Valvular heart disease is usually an age-related degenerative process, predominantly affecting individuals in their fifth decade and onwards.

Systolic longitudinal global and segmental myocardial mechanics in symptomatic isolated left ventricular non-compaction cardiomyopathy.

Background: Left ventricular (LV) non-compaction cardiomyopathy (LV-NC) is rare, and data of segmental myocardial mechanics are largely lacking. We investigated myocardial longitudinal mechanics in adults with symptomatic LV-NC (n = 30) versus individuals with healthy hearts (n = 150). The contribution of compacted and non-compacted myocardial layer to systolic LV function has to be determined.

Unusual Midventricular LV Obstruction With Flow Aimed to the Apex Due to Apical RV Pacing: Elimination by Sequential Septo-Apical RV Pacing.

We report the case of an 88-year-old man who developed a mid-left-ventricular (LV) obstruction caused by apical pacing to manage third-degree atrioventricular block. The flow generated by the obstruction was directed toward the LV apex and appeared from late systole to early diastole. The obstruction appeared to result from earlier contraction at the apex compared with the midventricular portion of the LV, which was followed by an also earlier apical relaxation.

Physiological left ventricular segmental myocardial mechanics: Multiparametric polar mapping to determine intraventricular gradients of myocardial dynamics.

Objective: We investigated physiological systolic left ventricular (LV) myocardial mechanics and gradients to provide a database for later studies of diseased hearts.

Methods: The analyses were performed in 131 heart-healthy individuals and included seven parameters of myocardial mechanics using speckle tracking echocardiography (STE).

Results: Basal to apical and circumferentially significant physiological intraventricular parameter gradients of myocardial activity were determined.

Echocardiographically derived effective valve opening area in mitral prostheses: a comparative analysis of various calculations using continuity equation and pressure half time method.

Detection of dysfunctional mitral valve prostheses (MP) remains complex even though being optimized by considering echocardiographically derived prosthetic effective orifice area (VA). The purpose was to compare VA in MP, calculated by the continuity equation (CE) using peak velocities (CEVpeak), mean velocities (CEVmean), velocity-time integrals (CEVTI) and the pressure half time method using 220 ms as constant first (PHT220) as well as optimized constants. In 267 consecutive patients with normally functioning MP, we investigated VA within the first postoperative month.

A differentiated morphological parameter-coding system to describe the suitability of mitral valve stenoses intended for percutaneous valvotomy.

Percutaneous balloon-mitral-valvotomy (PBMV) is an alternative to surgery in selected patients with mitral valve (MV) stenosis (MS). Applying echocardiography, suitability for PBMV is assessed by detailed morphological description. Echo-scores alone are suboptimal to describe MV morphology, because single parameters, important for a decision concerning PBMV, are not distinguishable out of a score number.

Left ventricular dyssynchrony predicts clinical response to CRT - a long-term follow-up single-center prospective observational cohort study.

Background: Until now, there is no consensus regarding the definition of a clinical response to cardiac resynchronization therapy (CRT) in patients with chronic heart failure (CHF) and systolic left ventricular (LV) dysfunction. The aim of this study was to evaluate if echocardiography is predictive for an objective improvement in exercise capacity during long-term follow-up of CRT.

Methods: Each patient underwent echocardiography and spiroergometry both at baseline and at last follow-up.

Marked Regression of Left Ventricular Hypertrophy after Outflow Desobliteration in HOCM.

We present an HOCM patient in whom marked regression of left ventricular hypertrophy occurred within two years following outflow desobliteration by percutaneous septal ablation. Maximum wall thickness (initially documented by both echo and MRI) decreased from 34 mm to 22 mm (followup by echo only due to presence of the ICD), crossing the threshold value of 30 mm which was one of the risk markers that had triggered the primary prophylactic ICD implantation in this case prior to septal ablation.

The importance of training in echocardiography: a validation study using pocket echocardiography.

Aims: To investigate the training effect in echocardiography by using recent hand-held ultrasound scanners (HANDs).

Methods: In this prospective study, 320 consecutive patients were scanned with HAND by an inexperienced ultrasonographer over a period of 8 weeks. Imaging studies were compared with high-end echocardiography as gold standard.

Myocardial fibrosis severity on cardiac magnetic resonance imaging predicts sustained arrhythmic events in hypertrophic cardiomyopathy.

Background: The purpose of our study was to correlate the incidence of adequate implantable cardioverter-defibrillator (ICD) interventions in hypertrophic cardiomyopathy (HCM) patients with risk markers (RMs) for sudden cardiac death (SCD) plus myocardial fibrosis as detected by late gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) imaging.

Methods: In all, 87 patients with HCM underwent LGE-CMR imaging prior to ICD implantation, performed for secondary (n = 2; 2%) or primary SCD prophylaxis (n = 85; 98%). Fibrosis was graded with a 17-segment left ventricular model (0 = absent, 1 = point-shaped, 2 = limited to 1 left ventricular segment, 3 = involving ≥ 2 segments).

The occurrence of atrial fibrillation in former top-level handball players above the age of 50.

Objective: Cardiac adaptation to sports activity in endurance athletes is considerably different from that in power athletes. The effects of a high-level team sport like handball, one of the most popular sports in the world, performed at a younger age, on cardiac rhythm in individuals above the age of 50 have not been investigated to date.

Methods: Thirty-three former top-level handball players from the first German league (6 former world champions and numerous Olympians) (57.

Diagnostic performance of handheld echocardiography for the assessment of basic cardiac morphology and function: a validation study in routine cardiac patients.

Aims: To investigate the intra- and interrater variability of expert users in the interpretation of handheld echocardiographic studies (HAND).

Methods: We scanned 320 consecutive patients with both HAND and high-end (HIGH) scanners. Images were interpreted independently by two blinded level III echocardiographers.

Effective valve opening area in the detection of dysfunctional aortic valve prostheses: a differentiated statistical analysis of this parameter including the introduction of minimal expected normal values as borderline to dysfunctional stenotic prostheses.

Background: Dysfunction of heart valve prostheses (VP) is a life-threatening complication and the diagnosis remains difficult. The motivation for this study was to improve the detection of dysfunctional VP by optimizing application of the prosthetic effective orifice area (VA). For this reason the minimal expected normal VA (VA(expected)) was introduced.

Myocardial fibrosis is associated with biventricular dysfunction in patients with hypertrophic cardiomyopathy.

Aims: To assess left (LV) and right ventricular (RV) function by two-dimensional (2D) speckle tracking echocardiography and its relation to myocardial fibrosis in hypertrophic cardiomyopathy (HCM).

Methods: We enrolled 50 HCM patients (30 male; 47.3 ± 9.

Real-time three-dimensional transoesophageal echocardiography during percutaneous transcatheter occlusion of mitral periprosthetic paravalvular leak.

We present the case of an 86-year-old female patient with a history of mitral valve replacement due to relevant stenosis. After surgery, an increasing periprosthetic valvular leak (PVL) became obvious causing regurgitation and an increasing haemolysis. Conventional two-dimensional transoesophageal echocardiography (2D TEE) showed a defect of 15 mm length located from the lateral to the posterior circumference subdivided by two surgical sutures into three parts.

Successful correction of a total anomalous venous connection in a 63-year-old male--case report and review of the literature.

Total anomalous pulmonary venous connection is a rare variant of cyanotic congenital heart disease and usually requires surgical correction within the first few months of life. We report midterm results of a 63-year-old male with intracardiac total anomalous venous return into the coronary sinus who presented with congestive predominantly right heart failure and underwent corrective surgery with unroofing of the coronary sinus and patch closure of the secundum atrial septal defect.

Electrocardiogram analysis using a combination of statistical, geometric, and nonlinear heart rate variability features.

Objective: The paper addresses a common and recurring problem of electrocardiogram (ECG) classification based on heart rate variability (HRV) analysis. Current understanding of the limits of HRV analysis in diagnosing different cardiac conditions is not complete. Existing research suggests that a combination of carefully selected linear and nonlinear HRV features should significantly improve the accuracy for both binary and multiclass classification problems.

Percutaneous balloon mitral valvulotomy and coexisting left atrial hemangioma: case report and long-term follow-up.

Hemangiomas of the heart are extremely rare. The prognosis is quite variable, because this benign tumor may grow, involute, or stop growing; therefore, resection is usually the treatment of choice. In patients with tumors of the left atrium, percutaneous balloon mitral valvulotomy is generally contraindicated.