Relationship of TAPSE Normalized by Right Ventricular Area With Pulmonary Compliance, Exercise Capacity, and Clinical Outcomes.

Background: While tricuspid annular plane systolic excursion (TAPSE) captures the predominant longitudinal motion of the right ventricle (RV), it does not account for ventricular morphology and radial motion changes in various forms of pulmonary hypertension. This study aims to account for both longitudinal and radial motions by dividing TAPSE by RV area and to assess its clinical significance.

Methods: We performed a retrospective analysis of 71 subjects with New York Heart Association class II to III dyspnea who underwent echocardiogram and invasive cardiopulmonary exercise testing (which defined 4 hemodynamic groups: control, isolated postcapillary pulmonary hypertension, combined postcapillary pulmonary hypertension, and pulmonary arterial hypertension).

Evaluation of inter-observer variability regarding aortic and mitral valve findings on transesophageal echocardiograms ordered for suspected endocarditis.

Background: Transesophageal echocardiography (TEE) is the gold standard for the detection of valvular vegetations (VV). Differentiating small VV from degenerative changes is challenging and prone to inter-observer variability. We evaluated inter-observer agreement regarding aortic (AV) and mitral valve (MV) findings on TEEs ordered for suspected infective endocarditis (IE).

A Rare Case of Primary Pericardial Schwannoma.

Schwannomas are typically benign, indolent neoplasms. Primary pericardial schwannomas are extremely rare and arise from the cardiac plexus and vagus nerve innervating the heart. Few case reports have been documented to date.

Technical and clinical study of x-ray-based surface echo probe tracking using an attached fiducial apparatus.

Purpose: Several types of structural heart intervention (SHI) use information from multiple imaging modalities to complete an interventional task. For example, in transcatheter aortic valve replacement (TAVR), placement and deployment of a bioprosthetic aortic valve in the aorta is primarily guided by x-ray fluoroscopy (XRF), and echocardiography provides visualization of cardiac anatomy and blood flow. However, simultaneous interpretation of independent x-ray and echo displays remains a challenge for the interventionalist.

Usefulness of Focused Screening Echocardiography for Collegiate Athletes.

Sudden cardiac death in a young healthy athlete is a rare but catastrophic event. The American Heart Association preparticipation screening guidelines recommend a focused history and physical without routine imaging or electrocardiogram screening. We hypothesized that a focused echocardiogram can identify structural abnormalities that may lead to sudden cardiac death in athletes, which might otherwise go undetected by history and physical.

Comparison of Outcomes of Atrial Fibrillation in Patients With Reduced Versus Preserved Left Ventricular Ejection Fraction.

Patients with newly diagnosed atrial fibrillation (AF) and a rapid ventricular response may present with a reduced left ventricular ejection fraction (LVEF). We compared long-term outcomes of these patients with those with preserved LVEF. This retrospective cohort study included 385 consecutive adults with newly diagnosed AF with rapid ventricular response, presenting to a single medical center from January 2006 to August 2014.

Development of Aortic Valve Disease in Familial Hypercholesterolemic Swine: Implications for Elucidating Disease Etiology.

Background: Familial hypercholesterolemia (FH) is a prevalent hereditary disease associated with increased atherosclerosis and calcific aortic valve disease (CAVD). However, in both FH and non-FH individuals, the role of hypercholesterolemia in the development of CAVD is poorly understood. This study used Rapacz FH (RFH) swine, an established model of human FH, to investigate the role of hypercholesterolemia alone in the initiation and progression of CAVD.

Satisfaction and emergency department revisits in patients with possible acute coronary syndrome.

Background: Patients with possible acute coronary syndrome (ACS) are typically instructed to return to the emergency department (ED) if their condition worsens. Little is known about the relationship between patient satisfaction in the ED and subsequent return visits.

Objective: Our aim was to determine the association between satisfaction with ED care and subsequent ED return visits.

Effects of the HeartMate II left ventricular assist device as observed by serial echocardiography.

Background: The HeartMate II is the most frequently used left ventricular assist device (LVAD) in patients with end-stage heart failure. There is a paucity of data regarding its longitudinal cardiac effects, particularly that on diastole.

Methods: This retrospective study was an evaluation of echocardiograms preoperatively and at 3, 6, and 12 months postoperatively in patients with a HeartMate II.

Ventricular fibrillation risk estimation for conducted electrical weapons: critical convolutions.

The TASER® Conducted Electrical Weapon (CEW) is used by law enforcement agencies about 900 times per day worldwide and has been shown to reduce suspect and officer injuries by about 65%. However, since a CEW delivers rapid electrical pulses through injected probes, the risk of inducing ventricular fibrillation (VF) has been considered. Animal studies have shown that the tip of the probe must come within a few millimeters of the surface of the heart for the CEW to induce VF in a typical animal application.

Three-dimensional echocardiography and mitral valve disease.

Three-dimensional echocardiography is a growing imaging modality, particularly for the evaluation of mitral valve pathology. Functional anatomy in disease states such as mitral regurgitation and stenosis as well as prosthetic valves can be effectively studied, offering superior knowledge to treating physicians. Additionally, three-dimensional echocardiography has the ability to help guide operative and percutaneous interventions, allowing for improved patient outcomes and advancement of clinical research.

Quality of heart failure management: a comparison of care between a comprehensive heart failure program and a general cardiology practice.

This study evaluates adherence to guidelines by heart failure clinicians (HFCs) vs general cardiologists (GCs) for use of implantable cardioverter-defibrillators (ICDs), biventricular pacing devices (cardiac resynchronization therapy; CRT), and use of medications for heart failure (HF). The authors reviewed 563 patients with HF and an ejection fraction View Article and Find Full Text PDF

Estimating the probability that the Taser directly causes human ventricular fibrillation.

This paper describes the first methodology and results for estimating the order of probability for Tasers directly causing human ventricular fibrillation (VF). The probability of an X26 Taser causing human VF was estimated using: (1) current density near the human heart estimated by using 3D finite-element (FE) models; (2) prior data of the maximum dart-to-heart distances that caused VF in pigs; (3) minimum skin-to-heart distances measured in erect humans by echocardiography; and (4) dart landing distribution estimated from police reports. The estimated mean probability of human VF was 0.

To explant or not to explant: an invasive and noninvasive monitoring protocol to determine the need of continued ventricular assist device support.

Predictors of myocardial recovery after ventricular assist device (VAD) implantation are not well defined. The authors report their current VAD weaning protocol. Between 2003 and 2006, 38 patients received VAD implants.

Review of complications in a series of patients with known gastro-esophageal varices undergoing transesophageal echocardiography.

Background: The presence of gastroesophageal varices is considered a relative contraindication to performing transesophageal echocardiography (TEE), but this is based on expert opinion, and there is limited data to support this recommendation. The aim of this study was to review the complications and benefit of performing TEE in patients with known gastroesophageal varices.

Methods: Fourteen patients with known esophageal varices who underwent TEE from 1997 to 2007 were identified.