scholarly journals 430 Validation of Left Atrial Mid Cross-Sectional Area, a Novel 2D Measure of Left Atrial Remodelling, Using 3D Echocardiography in a Cohort of Healthy Subjects

2020 ◽  
Vol 29 ◽  
pp. S231-S232
Author(s):  
F. Fernandez ◽  
S. Nawaz ◽  
H. Chen ◽  
A. Bhat ◽  
D. Makarious ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Left Atrial ◽  
Cross Sectional Area ◽  
3D Echocardiography ◽  
Sectional Area ◽  
Cross Sectional ◽  
Atrial Remodelling

364 Left Atrial Cross Sectional Area as a Measure of Left Atrial Remodelling in Patients With Hypertension and Diabetes.

2020 ◽  
Vol 29 ◽  
pp. S200-S201
Author(s):  
F. Fernandez ◽  
S. Nawaz ◽  
A. Bhat ◽  
H. Chen ◽  
A. Fernandez ◽  
...  
Keyword(s):  
Left Atrial ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Atrial Remodelling

Abstract 17979: Left Atrial Cross Sectional Area is a Novel Echocardiographic Measure Which Improves the Predictive Value of Chads2 Score in Risk Stratification of Cardioembolic Strokes

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Timothy C Tan ◽  
Mark Handschumacher ◽  
Octavio M Pontes-Neto ◽  
Maria C Nunes ◽  
Yong H Park ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Risk Prediction ◽  
Left Atrial ◽  
Stroke Risk ◽  
Thrombus Formation ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Chads2 Score ◽  
Cross Sectional ◽  
C Statistic

Background: Cardioembolic (CE) stroke carries significant morbidity and mortality. Current risk stratification tools such as CHADS2 score do not include any imaging parameters and are based on clinical features, which have limitations. Left atrial (LA) enlargement and remodeling may be associated with CE risk due to predisposition for atrial arrhythmias and thrombus formation. Left atrial cross sectional area (LACSA), a novel echo measure which reflects both LA size and shape, may improve CE stroke risk assessment. Aim: This study examined the value of LACSA in predicting CE stroke risk and the improvement in risk prediction when added to CHADS2 score. Methods: Clinical and echo parameters were examined in a prospective cohort of 1275 consecutive patients with ischemic stroke. Strokes were classified using the Causative Classification of Strokes and 259 (20%) were classified as CE stroke. LACSA was calculated using the formula: π/4*largest measured LA diameter*smallest measured LA diameter where mid LA diameter was measured in the parasternal long axis, 4 chamber and 2 chamber views. Results: Patients with CE stroke had greater LACSA (8.6 ± 2.3 vs 6.4 ± 1.8 cm2/m2; p<0.001) and mean CHADS2 score (2.25 ± 1.28 vs 1.87 ± 1.40; p<0.0001) compared to non-CE stroke patients. LACSA was independently associated with CE strokes (OR 1.21; 95% CI 1.08-1.34; p=0.001) in a multivariable model adjusted for CHADS2, gender, score, BMI, atrial fibrillation, anti-platelet and anti-coagulant use, E/E’ and LVEF. The addition of LACSA to CHADS2 score improved the prediction of CE stroke (c-statistic for predicting CE stroke using CHADS2 alone was 0.59 (95% CI 0.55-0.63) vs CHADS2 and LACSA 0.78 (95% CI 0.72-0.80) (p<0.001). Conclusion: LACSA is a novel measure of LA remodeling and associated with CE stroke. LACSA, an imaging parameter, enhances the risk prediction of the CHADS2 score, a clinical measure of risk, improving risk stratification for CE stroke and impacting therapeutic strategies.

Reliability of side-to-side ultrasound cross-sectional area measurements of lower extremity nerves in healthy subjects

2012 ◽  
Vol 46 (5) ◽  
pp. 717-722 ◽  
Author(s):  
Alberto Tagliafico ◽  
Angela Cadoni ◽  
Erica Fisci ◽  
Bianca Bignotti ◽  
Luca Padua ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Healthy Subjects ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional

scholarly journals Dehydration affects spinal cord cross-sectional area measurement on MRI in healthy subjects

Spinal Cord ◽  
2014 ◽  
Vol 52 (8) ◽  
pp. 616-620 ◽  
Author(s):  
C Wang ◽  
R C Tam ◽  
E Mackie ◽  
D K B Li ◽  
A L Traboulsee
Keyword(s):  
Spinal Cord ◽  
Healthy Subjects ◽  
Cross Sectional Area ◽  
Area Measurement ◽  
Sectional Area ◽  
Cross Sectional

Left atrial cross-sectional area is a novel measure of atrial shape associated with cardioembolic strokes

Heart ◽  
2020 ◽  
Vol 106 (15) ◽  
pp. 1176-1182
Author(s):  
Timothy C Tan ◽  
Maria Carmo Pereira Nunes ◽  
Mark Handschumacher ◽  
Octavio Pontes-Neto ◽  
Yong-Hyun Park ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Flow Velocity ◽  
Left Atrial ◽  
Velocity Profiles ◽  
Left Ventricular ◽  
Cross Sectional Area ◽  
Left Ventricular Ejection ◽  
Sectional Area ◽  
Cross Sectional

ObjectiveCardioembolic (CE) stroke carries significant morbidity and mortality. Left atrial (LA) size has been associated with CE risk. We hypothesised that differential LA remodelling impacts on pathophysiological mechanism of major CE strokes.MethodsA cohort of consecutive patients hospitalised with ischaemic stroke, classified into CE versus non-CE strokes using the Causative Classification System for Ischaemic Stroke were enrolled. LA shape and remodelling was characterised by assessing differences in maximal LA cross-sectional area (LA-CSA) in a cohort of 40 prospectively recruited patients with ischaemic stroke using three-dimensional (3D) echocardiography. Flow velocity profiles were measured in spherical versus ellipsoidal in vitro models to determine if LA shape influences flow dynamics. Two-dimensional (2D) LA-CSA was subsequently derived from standard echocardiographic views and compared with 3D LA-CSA.ResultsA total of 1023 patients with ischaemic stroke were included, 230 (22.5%) of them were classified as major CE. The mean age was 68±16 years, and 464 (45%) were women. The 2D calculated LA-CSA correlated strongly with the LA-CSA measured by 3D in both end-systole and end-diastole. In vitro flow models showed shape-related differences in mid-level flow velocity profiles. Increased LA-CSA was associated with major CE stroke (adjusted relative risk 1.10, 95% CI 1.04 to 1.16; p<0.001), independent of age, gender, atrial fibrillation, left ventricular ejection fraction and CHA2DS2-VASc score. Specifically, the inclusion of LA-CSA in a model with traditional risk factors for CE stroke resulted in significant improvement in model performance with the net reclassification improvement of 0.346 (95% CI 0.189 to 0.501; p=0.00001) and the integrated discrimination improvement of 0.013 (95% CI 0.003 to 0.024; p=0.0119).ConclusionsLA-CSA is a marker of adverse LA shape associated with CE stroke, reflecting importance of differential LA remodelling, not simply LA size, in the mechanism of CE risk.

Abstract 13136: Left Atrial Appendage Structural Characteristics Predict Thrombus Formation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Hyun Kim ◽  
John Ning ◽  
Kaiwei Lu ◽  
Colton Thompson ◽  
Sudhi Tyagi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Thrombus Formation ◽  
Structural Characteristics ◽  
Cross Sectional Area ◽  
Atrial Appendage ◽  
Case Group ◽  
Sectional Area ◽  
Cross Sectional

Introduction: Atrial fibrillation remains highly prevalent in the US with over 6 million diagnosed individuals. Discordant atrial contraction inherent to atrial fibrillation results in stagnant blood flow and increases the risk for thrombus formation particularly within the left atrial appendage (LAA). Anticoagulation is the mainstay of intracardiac thrombus prevention and is initiated based on the CHAD 2 S 2 -VASc risk score that does not account for LAA morphology. The relationship between LAA structural characteristics and thrombus development remains poorly understood. Hypothesis: We hypothesized that in patients with atrial fibrillation, LAA structural characteristics correlate with the presence of thrombus. Methods: We performed a retrospective case-control study of 151 subjects with a history of atrial fibrillation who underwent transesophageal echocardiogram (TEE) to evaluate the LAA for pre-cardioversion indication or Watchman screening evaluation. Subjects discovered to have LAA thrombus on TEE defined the study case group (n = 74) while control subjects did not have LAA thrombus (n = 77). Baseline demographics and echocardiographic characteristics were collected for all subjects. Results: Subjects without thrombus were older than those with thrombus (thrombus: 68.6 ± 13.1 years, no thrombus: 74.7 ± 9.2 years, p = 0.001 ). LAA ostial cross-sectional area was smaller in subjects with thrombus than those without thrombus (thrombus: 251.1 ± 117.4 mm 2 , no thrombus: 332.9 ± 171.2 mm 2 , p < 0.001 ). This finding remained significant in both unadjusted and adjusted logistic regression models ( Table 1 ). CHA 2 DS 2 -VASc score did not significantly differ in those with or without thrombus (thrombus: 4.4 ± 1.8, no thrombus: 4.3 ± 1.7, p = 0.822). Conclusions: Smaller LAA ostial cross-sectional area correlates with thrombus formation. Consideration of LAA structural characteristics may improve precision of anticoagulation management.

scholarly journals Shear wave elastography of the radial nerve in healthy subjects

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098793
Author(s):  
Mohamed A Bedewi ◽  
Mamdouh A Kotb ◽  
Nasser M Aldossary ◽  
Ahmed M Abodonya ◽  
Ayman K Saleh ◽  
...  
Keyword(s):  
Shear Wave ◽  
Radial Nerve ◽  
Healthy Subjects ◽  
Shear Wave Elastography ◽  
Cross Sectional Study ◽  
Cross Sectional Area ◽  
Short Axis ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Mean

Objective This study was performed to examine the sonoelastographic features of the radial nerve in healthy subjects. Methods In this observational cross-sectional study, shear wave elastography was used to evaluate the radial nerve. The cross-sectional area and stiffness were measured. Results The study included 37 nerves in 20 healthy adult subjects. The mean cross-sectional area of the radial nerve at the arm was 6.1 mm2. The mean stiffness of the radial nerve in the short axis was 30.3 kPa, and that in the long axis was 34.9 kPa. The elasticity measurements were significantly different between the long axis and short axis. Conclusion The elastic modulus of the radial nerve was studied in healthy subjects and can serve as a reference for future assessment of different radial nerve pathologies.

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