Direct 3D ultrasound fusion for transesophageal echocardiography.

Background: Real-time three-dimensional transesophageal echocardiography (3D TEE) has been increasingly used in clinic for fast 3D analysis of cardiac anatomy and function. However, 3D TEE still suffers from the limited field of view (FoV). It is challenging to adopt conventional multi-view fusion methods to 3D TEE images because feature-based registration methods tend to fail in the ultrasound scenario, and conventional intensity-based methods have poor convergence properties and require an iterative coarse-to-fine strategy.

Valvular Disease and Heart Failure with Preserved Ejection Fraction.

Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome of shortness of breath and/or exercise intolerance secondary to elevated left ventricular filling pressures at rest or with exertion either as a result of primary diastolic dysfunction (primary HFpEF) or secondary to specific underlying causes (secondary HFpEF). In secondary HFpEF, early intervention of underlying valvular heart disease generally improves symptoms and prolongs survival. In primary HFpEF, there is increasing awareness of the existence and prognostic implications of secondary atrioventricular valve regurgitation.

Aggressive plaque modification with rotational atherectomy and cutting balloon for optimal stent expansion in calcified lesions.

Objective: To evaluate the factors affecting optimal stent expansion in calcified lesions treated by aggressive plaque modification with rotational atherectomy (RA) and a cutting balloon (CB).

Methods: From January 2014 to May 2015, 92 patients with moderate to severe coronary calcified lesions underwent rotational atherectomy and intravascular ultrasound imaging at Chinese PLA General Hospital (Beijing, China) were included in this study. They were divided into a rotational artherectomy combined with cutting balloon (RACB) group (46 patients treated with RA followed by CB angioplasty) and an RA group (46 patients treated with RA followed by plain balloon angioplasty).

Changes of ventricular and peripheral performance in patients with heart failure and normal ejection fraction: insights from ergometry stress echocardiography.

Aims: We assessed the left ventricular (LV) and peripheral performance at rest and during exercise in healthy and heart failure subjects with normal ejection fraction (HFNEF) or with reduced ejection fraction (HFREF).

Methods: All subjects received echocardiography at rest and with bicycle Ergometer exercise. The exercise images for two-dimensional speckle tracking were acquired with submaximal heart rate of 90-100 beats/min, while images for M-mode and tissue Doppler imaging were stored with attainment of >85% of predicted heart rate.

Impact of a dedicated training program on the reproducibility of systolic dyssynchrony measures using tissue Doppler imaging.

Background: The reproducibility of the measurement of mechanical dyssynchrony by echocardiography including Doppler tissue imaging has recently been questioned. The aim of this study was to ascertain the role of a dedicated training program to improve skills and the reproducibility of dyssynchrony assessment.

Methods: In 70 patients with heart failure, color Doppler tissue images were acquired, and the time to peak systolic velocity of each segment and several dyssynchrony indices, including the standard deviation of time to peak systolic velocity, were measured by an expert to constitute a reference standard.

Investigational devices for mitral regurgitation: state of the art.

The incidence of mitral regurgitation (MR) is rising as a result of an aging population worldwide. Surgical repair or replacement of the mitral valve remains the standard of care for patients with severe MR as the only approach to achieve sustained relief of symptoms or heart failure. However, the majority of patients with severe MR do not undergo surgery because of high perceived perioperative risk.

Impact of cardiac contractility modulation on left ventricular global and regional function and remodeling.

Objectives: This study aimed to evaluate the impact of cardiac contractility modulation (CCM) on left ventricular (LV) size and myocardial function.

Background: CCM is a device-based therapy for patients with advanced heart failure. Previous studies showed that CCM improved symptoms and exercise capacity; however, comprehensive assessment of LV structure, function, and reverse remodeling is not available.

Relation of left ventricular systolic dyssynchrony in patients with heart failure to left ventricular ejection fraction and to QRS duration.

Left ventricular (LV) systolic dyssynchrony is an important pathologic mechanism in patients with heart failure (HF). However, the prevalence of intraventricular dyssynchrony in patients with different LV ejection fractions (EFs) is unknown. This study evaluated 402 consecutive patients with HF (mean age 64.

Left ventricular systolic and diastolic dyssynchrony in coronary artery disease with preserved ejection fraction.

The present study aims to evaluate LV (left ventricular) mechanical dyssynchrony in CAD (coronary artery disease) with preserved and depressed EF (ejection fraction). Echocardiography with TDI (tissue Doppler imaging) was performed in 311 consecutive CAD patients (94 had preserved EF > or =50% and 217 had depressed EF <50%) and 117 healthy subjects to determine LV systolic and diastolic dyssynchrony by measuring Ts-SD (S.D.

Esophageal leiomyoma detected by transesophageal contrast echocardiography.

Transesophageal echocardiography (TEE) provides valuable information in the evaluation of intra- and extracardiac masses. There is no report demonstrating its usefulness in identifying esophageal mass lesions. This is because generally it is contraindicated in patients with esophageal diseases.

Aberrant right subclavian artery from an aneurysmal diverticulum of Kommerell in an 84-year-old man.

The investigators describe an unusual case of tracheal and esophageal compression by atherosclerotic dilatation of the diverticulum of Kommerell associated with a congenital aberrant right subclavian artery, illustrating how aging-related vascular degenerative disease can modify the clinical manifestations of congenital anomalies in an 84-year-old man. In conclusion, the potential interactions between congenital and acquired cardiovascular disease should be considered in the evaluation of cardiovascular symptoms in the elderly population.

Comparison of angiotensin-converting enzyme inhibitor alone and in combination with irbesartan for the treatment of heart failure.

Objective: Angiotensin-converting enzyme inhibitor (ACEI) is beneficial in patients with congestive heart failure (CHF). Some, but not all, angiotensin receptor blocker (ARB) was demonstrated to be effective as "add-on" therapy. We investigated whether irbesartan is useful as an add-on therapy in CHF.

Are left ventricular diastolic function and diastolic asynchrony important determinants of response to cardiac resynchronization therapy?

Cardiac resynchronization therapy (CRT) has been shown to reduce symptoms and reverse left ventricular (LV) remodeling. It is not known, however, whether diastolic function will improve after CRT and diastolic asynchrony will predict LV reverse remodeling. Seventy-six patients (mean age 65 +/- 12 years, 74% men) who received CRT were studied at baseline and after 3 months.

Effect of age and heart rate on atrial mechanical function assessed by Doppler tissue imaging in healthy individuals.

Background: The potential usefulness of Doppler tissue imaging (DTI) to assess atrial mechanical function in cardiac disease has been demonstrated. However, there are few reports on normal values of atrial function by DTI analysis.

Methods: Echocardiography with color-coded DTI was performed in 131 healthy control subjects.