32 research outputs found
A novel software tool to semi-automatically characterize tricuspid valve function and shape using trans-thoracic 3D echocardiography
No full textDYNAMIC RIGHT VENTRICULAR SHAPE ANALYSIS IN THE NORMAL HEART USING 3D ECHOCARDIOGRAPHY-DERIVED CURVATURE INDICES
No full textAdvanced imaging of right ventricular anatomy and function
No full textRight ventricular (RV) size and function are important predictors of cardiovascular morbidity and mortality in patients with various conditions. However, non-invasive assessment of the RV is a challenging task due to its complex anatomy and location in the chest. Although conventional echocardiography is widely used, its limitations in RV assessment are well recognised. New techniques such as three-dimensional and speckle tracking echocardiography have overcome the limitations of conventional echocardiography allowing a comprehensive, quantitative assessment of RV geometry and function without geometric assumptions. Cardiac magnetic resonance (CMR) and CT provide accurate assessment of RV geometry and function, too. In addition, tissue characterisation imaging for myocardial scar and fat using CMR and CT provides important information regarding the RV that has clinical applications for diagnosis and prognosis in a broad range of cardiac conditions. Limitations also exist for these two advanced modalities including availability and patient suitability for CMR and need for contrast and radiation exposure for CT. Hybrid imaging, which is able to integrate anatomical information (usually obtained by CT or CMR) with physiological and molecular data (usually obtained with positron emission tomography), can provide optimal in vivo evaluation of Rv functional impairment. This review summarises the clinically useful applications of advanced echocardiography techniques, CMR and CT for comprehensive assessment of RV size, function and mechanics
Dynamic three-dimensional evaluation of tricuspid valve morphology and function in patients with pulmonary hypertension
No full textPulmonary arterial hypertension (PAH) is a common cause of tricuspid valve (TV) dilatation. Because of the impact of PAH on the right ventricle (RV), in-depth understanding of TV morphology and function is important.
Methods: Novel custom software was used to trace and measure TV annulus (TVA) in 10 patients with PH and 10 control subjects (CTRL). To trace the TVA, points were selected in rotated planes and then interpolated. TVA was automatically tracked throughout cardiac cycle. Commissures were identified and used to divide the TVA into three segments. After initialization of the coaptation the TV leaflets were identified. The following parameters were automatically computed in 3D throughout the cardiac cycle: annular area, height, eccentricity and displacement, as well as intercommissural segment lengths.
Results: Compared to CTRL, in patients with PAH, TVA was larger. The TA was also more circular and with less longitudinal displacement. Changes in annular remodeling were not uniform. The anterior and posterior segments were enlarged, while the septal remained unchanged, probably because the septal leaflet is fixed between the fibrous trigones.
Conclusions: This novel software revealed that PAH affects size, shape and function of the TVA, suggesting that 3D analysis may be useful for evaluation of different RV disease states
Relationships between the severity of the regurgitation and the geometry of the tricuspid annulus in patients with functional tricuspid regurgitation
No full textThree-dimensional tricuspid annulus surface area is a better predictor of functional tricuspid regurgitation severity than conventional 2D-echocardiography diameters
No full textIn patients with functional tricuspid regurgitation, tricuspid annulus size by 3D echocardiography is closely related to right heart chamber volumes
No full textDynamic Analysis of the Normal Tricuspid Annulus Using 3D Echocardiography
No full textPurpose: Changes in the geometry of the normal tricuspid annulus (TA) throughout the cardiac cycle, as assessed by three-dimensional transthoracic echocardiography (3DTTE), have not been extensively described. The goal of this study was to characterize normal TA dynamics as a basis for a better understanding of tricuspid valve (TV) pathology.
Methods:Westudied 98 subjects (45+15 years, range 19-80 years, BSA 1.81+0.22m2, 44 men) with normal TV who underwent 3DTTE full volume imaging of the right ventricle (RV) from the apical 4-chamber view (Philips, iE33 and GE Vivid E9) at 2 University Hospitals. All study subjects had a normal 2DTTE study, RV systolic pressure ≤35 mmHg and RV ejection fraction 1⁄4 55+7% (TomTec 4D RV software). Measurements were
made (QLAB 9.0, Philips and EchoPAC BT 12, GE) of the TA area, antero-posterior (AP) and septal-lateral (SL) TA dimensions at the onset of systole (closure of the TV), endsystole (prior to TV opening), mid-systole (mid-point between onset and end-systole), early-diastole (initial TV leaflet opening) and late-diastole (TV opening after atrial contraction).
Results:MeanTAareaanddimensions varied throughout the cardiac cycle (Table), being the largest in late-diastole and smallest at the onset of systole. TA fractional area change was38%.TAAPdimensionwaslarger than theSLdimension throughout the cardiac cycle (fig.A). Fractional changes in AP and SL dimensions were 23% and 18%, respectively. No significant differences were noted between genders (fig.B) or age groups.
Conclusions:NormalTAis ahighly dynamicstructure andthis has important implications for its sizing. Customized software to characterize TA remodeling and dynamics throughout the entire cardiac cycle is needed for a better understanding of TV pathology
Value of 3D echocardiography in the diagnosis of arrhythmogenic right ventricular cardiomyopathy
No full textAims: The 2010 Task Force Criteria (TFC) require that both right ventricular (RV) regional wall-motion abnormalities (WMA) and specific RV size cut-offs be met in order to fulfil one of the major criterion for arrhythmogenic right ventricular cardiomyopathy (ARVC) diagnosis. Currently, 2D echocardiography (2DE) and cardiovascular magnetic resonance imaging (cMRI) are used to determine if these criteria are met. Little is known about the diagnostic value of 3D echocardiography (3DE) in ARVC. The aim of this study was to determine whether a combination of 2DE-3DE is non-inferior to the currently used 2DE-cMRI combination in the diagnosis of patients with ARVC. Methods and results: Thirty-nine individuals (47±15 years) with suspected ARVC underwent evaluation of the RV with cMRI, 2DE, and 3DE. 3DE and cMRI were independently used to obtain RV volumes, ejection fraction (EF) and determine the presence of segmental RV WMA. Studies were blindly classified as meeting criteria for ARVC in accordance with the 2010 TFC. Kappa statistics were used to test the concordance between 2DE-cMRI and 2DE-3DE approaches. Using the 2DE-cMRI approach, 3/39 were not affected, 5/39 possible, 8/39 borderline, and 23/39 definite ARVC. The proposed 2DE-3DE approach yielded 5/39 not affected, 7/39 possible, 8/39 borderline, and 19/39 definite diagnoses. The two approaches were highly concordant (k = 0.71; 95% confidence interval: 0.44-0.84). Although 3DE underestimated RV volumes in comparison with cMRI, interfering, in some instances with the fulfilment of a major criterion, it was able to identify more RV WMA (28/39) than 2DE (11/39), with a detection-rate comparable to cMRI (33/39) highlighting a unique advantage. Conclusion: The combination of 2DE-3DE for ARVC diagnosis is comparable to the conventional 2DE-cMRI approach. 3DE should be performed in all suspected ARVC patients to aide in the detection of WMA
Concordance of left ventricular global longitudinal strain measurements between echocardiographic vendors
No full textAbstract
Background: Chronic cerebrospinal venous insufficiency (CCSVI) is a new vascular pattern recently associated with multiple sclerosis (MS). Aim of this study was to assess the presence of CCSVI parameter and vascular abnormalities, in the Internal Jugular Veins (IJVs) and/or Vertebral Veins (VVs) in sitting and supine posture, in MS patients versus first degree relatives with MS familiarity and general population. Methods: We investigated in 272 MS patients, in 118 first degree relative of MS patients and in 97 healthy controls, morphologic and hemodynamic venous abnormalities of the IJVs and/or VVs by means of high resolution B-mode ultrasounds. Diagnostic five parameters recently approved in a consensus conference were calculated in both supine and sitting positions. Results: CCSVI showed positiveness for at least 2 criteria in 179/272 (83%) MS patients, in 24/118 (20%) first degree relatives and in 24/97 (25%) of healthy controls. MS patients showed a statistically signific
