Identifying errors and inconsistencies in real time while using facilitated echocardiographic reporting.

Background: Facilitated reporting using a discrete set of finding codes (FCs) is a common method of generating echocardiographic reports.

Methods: The investigators developed a tool that allows echocardiographic reports to be evaluated in real time for errors, omissions, and inconsistencies on the basis of a defined group of "rules" applied to the FCs present in the report. At the time of report finalization, conflicts were displayed for the interpreting physicians, and their responses to each rule conflict were logged.

Three-dimensional left ventricular segmentation from magnetic resonance imaging for patient-specific modelling purposes.

Aims: To propose a nearly automated left ventricular (LV) three-dimensional (3D) surface segmentation procedure, based on active shape modelling (ASM) and built on a database of 3D echocardiographic (3DE) LV surfaces, for cardiac magnetic resonance (CMR) images, and to test its accuracy for LV volumes computation compared with 'gold standard' manual tracings and discs-summation method.

Methods And Results: The ASM was created based on segmented LV surfaces (4D LV analysis, Tomtec) from 3DE datasets of 205 patients. Then, it was applied to the cardiac magnetic resonance imaging short-axis (SAX) images stack of 12 consecutive patients.

Calcific extension towards the mitral valve causes non-rheumatic mitral stenosis in degenerative aortic stenosis: real-time 3D transoesophageal echocardiography study.

Objective: Mitral annular/leaflet calcification (MALC) is frequently observed in patients with degenerative aortic stenosis (AS). However, the impact of MALC on mitral valve function has not been established. We aimed to investigate whether MALC reduces mitral annular area and restricts leaflet opening, resulting in non-rheumatic mitral stenosis.

Impact of implantable transvenous device lead location on severity of tricuspid regurgitation.

Background: Implantable device leads can cause tricuspid regurgitation (TR) when they interfere with leaflet motion. The aim of this study was to determine whether lead-leaflet interference is associated with TR severity, independent of other causative factors of functional TR.

Methods: A total of 100 patients who underwent transthoracic two-dimensional and three-dimensional (3D) echocardiography of the tricuspid valve before and after lead placement were studied.

Right ventricular strain in pulmonary arterial hypertension: a 2D echocardiography and cardiac magnetic resonance study.

Background: Right ventricular (RV) strain is a potentially useful prognostic marker in patients with pulmonary arterial hypertension (PAH). However, published reports regarding the accuracy of two-dimensional echocardiography (2DE)-derived RV strain against an independent reference in this patient population are limited. The aims of this study were: (1) to study the relationship between 2DE RV longitudinal strain and cardiovascular magnetic resonance (CMR)-derived RV ejection fraction (RVEF) in patients with PAH; (2) to compare 2DE-derived and CMR-derived RV longitudinal strain in these patients; and (3) to determine the reproducibility of these measurements.

Analysis of myocardial perfusion from vasodilator stress computed tomography: does improvement in image quality by iterative reconstruction lead to improved diagnostic accuracy?

Background: Iterative reconstruction (IR) in cardiac CT has been shown to improve confidence of interpretation of noninvasive coronary CT angiography (CTA).

Objective: We hypothesized that IR would also improve the quality of vasodilator stress coronary CT images acquired with low tube voltage to assess myocardial perfusion and the accuracy of the detection of perfusion abnormalities by using quantitative 3-dimensional (3D) analysis.

Methods: We studied 39 consecutive patients referred for coronary CTA (256-slice scanner; Philips), who underwent additional imaging (100 kV, prospective gating) with regadenoson (0.

Semiautomated detection and quantification of aortic plaques from three-dimensional transesophageal echocardiography.

Background: Aortic atherosclerosis is a risk factor for cerebrovascular events. Two-dimensional transesophageal echocardiographic quantification of descending aortic plaques is time-consuming and underestimates plaque burden. The aim of this study was to assess the feasibility and accuracy of a novel semiautomated program that uses three-dimensional (3D) transesophageal echocardiography to identify and quantify aortic plaque severity as determined by plaque thickness, volume, and number.

Mechanistic insights and characterization of sickle cell disease-associated cardiomyopathy.

Background: Cardiovascular disease is an important cause of morbidity and mortality in sickle cell disease (SCD). We sought to characterize sickle cell cardiomyopathy using multimodality noninvasive cardiovascular testing and identify potential causative mechanisms.

Methods And Results: Stable adults with SCD (n=38) and healthy controls (n=13) prospectively underwent same day multiparametric cardiovascular magnetic resonance (cine, T2* iron, vasodilator first pass myocardial perfusion, and late gadolinium enhancement imaging), transthoracic echocardiography, and applanation tonometry.

Echocardiographic reference ranges for normal cardiac chamber size: results from the NORRE study.

Aims: Availability of normative reference values for cardiac chamber quantitation is a prerequisite for accurate clinical application of echocardiography. In this study, we report normal reference ranges for cardiac chambers size obtained in a large group of healthy volunteers accounting for gender and age. Echocardiographic data were acquired using state-of-the-art cardiac ultrasound equipment following chamber quantitation protocols approved by the European Association of Cardiovascular Imaging.

Age-related normal range of left ventricular strain and torsion using three-dimensional speckle-tracking echocardiography.

Background: Three-dimensional (3D) speckle-tracking echocardiography (STE) is an emerging technology used to quantify left ventricular (LV) function. However, the accuracy and normal values of LV strain and twist using 3D STE have not been established in a large group of normal subjects. The aims of this study were to (1) to evaluate the accuracy of 3D STE analysis of LV strain against a cardiac magnetic resonance (CMR) reference and (2) to establish age-related normal values of LV strain and torsion using real-time 3D echocardiographic (RT3DE) images.

Sample size and cost analysis for pulmonary arterial hypertension drug trials using various imaging modalities to assess right ventricular size and function end points.

Background: Placebo-controlled trials for pulmonary arterial hypertension are no longer acceptable because new therapies must show clinically significant effects on top of standard treatment. The purpose of this study was to estimate sample sizes and imaging costs for the planning of a hypothetical pulmonary arterial hypertension drug trial using imaging to detect changes in right ventricular size and function in response to combined therapy.

Methods And Results: Same-day cardiovascular MR (CMR) and 2-dimensional (2D) and 3D transthoracic echocardiography (2DTTE and 3DTTE) were performed in 22 patients with pulmonary arterial hypertension (54±13 years of age) twice, 6 months apart.

Association of the frontal QRS-T angle with adverse cardiac remodeling, impaired left and right ventricular function, and worse outcomes in heart failure with preserved ejection fraction.

Background: No prior studies have investigated the association of QRS-T angle with cardiac structure and function and outcomes in heart failure with preserved ejection fraction (HFpEF). The aim of this study was to test the hypothesis that increased frontal QRS-T angle is associated with worse cardiac function and remodeling and adverse outcomes in HFpEF.

Methods: A total of 376 patients with HFpEF (i.

Interinstitutional measurements of left ventricular volumes, speckle-tracking strain, and dyssynchrony using three-dimensional echocardiography.

Background: Three-dimensional echocardiographic (3DE) analysis provides better measurements of left ventricular (LV) volumes, ejection fraction, myocardial deformation, and dyssynchrony. Many studies have shown that this technique has high intrainstitutional reproducibility. However, interinstitutional reproducibility is low, limiting its adoption.

Effect of Optison on pulmonary artery systolic pressure and pulmonary vascular resistance.

Ultrasound contrast agent safety has received recent attention based on reports of associated serious adverse events. The US Food and Drug Administration requested this postmarketing study of the effects of Optison on pulmonary hemodynamics. The aim of this study was to compare Optison and a placebo for effects on pulmonary artery systolic pressure (PASP) and pulmonary vascular resistance (PVR) during right-sided cardiac catheterization.

Evaluation of left ventricular structure and function by three-dimensional echocardiography.

Purpose Of Review: To summarize research on the use of 3-dimensional (3D) echocardiography for quantifying left ventricular (LV) volumes, ejection fraction, and mass, and to describe emerging applications of the technology.

Recent Findings: Several publications have provided reference values for LV volumes and ejection fraction by 3D transthoracic echocardiography (3DTTE) in normal patients.

Summary: With real-time 3DTTE, one can acquire and display a 3D image encompassing the entire LV within seconds.

Percutaneous transcatheter closure of infarct related ventricular septal defects assisted with portable miniaturized extracorporeal membrane oxygenation: a case series.

Infarct associated ventricular septal defects (VSDs) are associated with considerable morbidity and mortality and are typically treated via an open surgical approach with the assistance of full mechanical bypass support in the setting of cardiogenic shock. We present two patients with infarct related VSDs and cardiogenic shock (CS) following acute ST segment elevation myocardial infarction (STEMI) and a review of the literature. Each patient successfully underwent percutaneous transcatheter closure of infarct related VSDs and initiation of extracorporeal membrane oxygenation (ECMO) via a portable miniaturized system that resulted in improvement in the patients' hemodynamics.

Three-dimensional modeling of the right ventricle from two-dimensional transthoracic echocardiographic images: utility of knowledge-based reconstruction in pulmonary arterial hypertension.

Background: Right ventricular (RV) volume and functional assessments are essential in the management of pulmonary arterial hypertension but are often difficult to perform. Three-dimensional (3D) echocardiography is limited by acoustic dropout of the RV free wall in dilated ventricles. The aim of this study was to test the hypothesis that knowledge-based reconstruction, a novel method for 3D modeling of RV endocardium from two-dimensional echocardiographic images, could provide accurate measurements of RV volumes and systolic function.