Imaging of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.

Purpose Of Review: The current article reviews obstructive forms of hypertrophic cardiomyopathy and associated morphologic cardiac abnormalities. It focuses on echocardiographic imaging of the left ventricular (LV) outflow tract obstruction, its evaluation, prognostication, and differentiation from other conditions mimicking obstructive hypertrophic cardiomyopathy.

Recent Findings: Symptomatic patients with LV outflow tract (LVOT) gradients at least 50 mmHg on maximally tolerated medical therapy are candidates for advanced therapies.

Prosthesis-patient mismatch following aortic and mitral valves replacement - A comprehensive review.

Prothesis-patient mismatch (PPM) occurs when there is a mismatch between the effective orifice area (EOA) of the prosthetic valve and the required cardiac output to meet the need of the patient's body surface area (BSA). The clinical threshold for PPM occurs when the indexed effective orifice area (iEOA) is ≤0.65 cm/m for the aortic valve prosthesis, and ≤ 1.

Dimensionless index of the mitral valve for evaluation of degenerative mitral stenosis.

Purpose: Degenerative mitral stenosis (DMS) is an increasingly recognized cause of mitral stenosis. The goal of this study was to compare echocardiographic differences between DMS and rheumatic mitral stenosis (RMS), identify echocardiographic variables reflective of DMS severity, and propose a dimensionless mitral stenosis index (DMSI) for assessment of DMS severity.

Methods: This is a single-center, retrospective cohort study.

Echocardiographic Assessment of Degenerative Mitral Stenosis: A Diagnostic Challenge of an Emerging Cardiac Disease.

Degenerative mitral stenosis (DMS) is characterized by decreased mitral valve (MV) orifice area and increased transmitral pressure gradient due to chronic noninflammatory degeneration and subsequent calcification of the fibrous mitral annulus and the MV leaflets. The "true" prevalence of DMS in the general population is unknown. DMS predominantly affects elderly individuals, many of whom have multiple other comorbidities.

Current Perspectives on Left Ventricular Geometry in Systemic Hypertension.

Hypertension (HTN) is a global health problem and a leading risk factor for cardiovascular disease (CVD) morbidity and mortality. The hemodynamic overload from HTN causes left ventricular (LV) remodeling, which usually manifests as distinct alterations in LV geometry, such as concentric remodeling or concentric and eccentric LV hypertrophy (LVH). In addition to being a common target organ response to HTN, LV geometric abnormalities are well-known independent risk factors for CVD.

Development and Implementation of a Quality Improvement Process for Echocardiographic Laboratory Accreditation.

We describe our process for quality improvement (QI) for a 3-year accreditation cycle in echocardiography by the Intersocietal Accreditation Commission (IAC) for a large group practice. Echocardiographic laboratory accreditation by the IAC was introduced in 1996, which is not required but could impact reimbursement. To ensure high-quality patient care and community recognition as a facility committed to providing high-quality echocardiographic services, we applied for IAC accreditation in 2010.

Prediction of All-Cause Mortality by the Left Atrial Volume Index in Patients With Normal Left Ventricular Filling Pressure and Preserved Ejection Fraction.

Objective: To describe the prevalence of left atrial (LA) enlargement (LAE) and its association with all-cause mortality in 10,719 patients with an early diastolic transmitral flow velocity (E) to early diastolic mitral annular velocity (e') ratio-determined normal left ventricular (LV) filling pressure and preserved LV ejection fraction (LVEF).

Methods: We evaluated 10,719 patients (deceased patients: n = 479; mean [SD] age, 65 [14] years; 60% male; surviving patients: n = 10,240; mean (SD) age, 54 (16) years; 48% male) with estimated normal LV filling pressure (E/e' ratio ≤ 8) and preserved LVEF (≥ 50%) to determine the impact of LA volume index (LAVi) on all-cause mortality during a mean (SD) follow-up of 2.2 (1.

Metabolic parameters derived from cardiopulmonary stress testing for prediction of prognosis in patients with heart failure: the ochsner experience.

Cardiopulmonary parameters, particularly peak oxygen consumption, have proven utility in prognostic stratification for patients with heart failure. These have been typically corrected for total body weight as opposed to lean body mass (LBM). For practical purposes, fat consumes virtually no oxygen and receives minimal perfusion.

Impact of left ventricular geometry on prognosis-a review of ochsner studies.

We review data from epidemiologic and population-based studies that demonstrate the impact of abnormal left ventricular geometric patterns, including both concentric remodeling and left ventricular hypertrophy, on major cardiovascular morbidity and mortality. We also review studies from Ochsner Clinic Foundation that assessed the impact of various left ventricular geometric patterns on overall cardiovascular prognosis, especially all-cause mortality.

Overview of transesophageal echocardiography for the chest physician.

Transesophageal echocardiography (TEE) is a growing technology that is frequently utilized in the critical care setting by intensivists, surgeons, anesthesiologists as well as specialists in cardiovascular diseases. The clinical application of TEE continues to emerge, and the indications and diagnostic utility of this technology as currently available are summarized in this review.

Myxosarcoma: a rare primary cardiac tumor.

We describe the case of a patient with myxosarcoma of the left ventricle, a very rare type of primary cardiac sarcoma, who presented with features of acute pericarditis and discuss the management of this condition.

Is a Full Digital Echocardiography Laboratory Feasible for Routine Daily Use?

To determine the feasibility and accuracy of digital echocardiography for routine interpretation of two-dimensional and Doppler echocardiography, we studied 93 consecutive patients chosen at random from our daily workload. The parameters studied included cavity sizes, biventricular regional and global systolic and diastolic function, valvular structure and function, and presence or absence of pericardial disease. The results were first interpreted using quad screen, digital format cine loops.

Benefits of Cardiac Rehabilitation and Exercise Training in Older Persons.

Despite the well-proved benefits of cardiac rehabilitation and exercise training, older persons are frequently not referred to or vigorously encouraged to pursue this therapy after major coronary heart disease (CHD) events. Therefore, we determined the effects of this therapy on plasma lipids, indices of obesity, and exercise capacity in older CHD patients compared with the benefits obtained in a younger cohort. At baseline, the older persons had lower body mass indices (BMI), triglycerides levels, and estimated metabolic equivalent (METs), and the elderly had higher levels of high-density lipoprotein cholesterol (HDL-C).