The Effect of Obesity on Echocardiographic Image Quality

2021 ◽  
Author(s):  
Katherine Ellenberger ◽  
Prajith Jeyaprakash ◽  
Shanthosh Sivapathan ◽  
Sukhmandeep Sangha ◽  
Joanne Kitley ◽  
...  
Keyword(s):  
Image Quality ◽  
Echocardiographic Image

scholarly journals Influence of breast reconstruction on technical aspects of echocardiographic image acquisition compared with physician-assessed image quality

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Joaquin Duarte Ow ◽  
Mohamad Hemu ◽  
Anel Yakupovich ◽  
Parva Bhatt ◽  
Hannah Gaddam ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Image Quality ◽  
Cardiac Function ◽  
Breast Reconstruction ◽  
Clinical Decision Making ◽  
Image Acquisition ◽  
Clinical Decision ◽  
Echocardiographic Image ◽  
Significant Difference

Abstract Introduction Assessment of cardiac function after treatment for breast cancer relies on interval evaluation of ventricular function through echocardiography. Women who undergo mastectomy more frequently choose to undergo breast reconstruction with implant. This could impede assessment of cardiac function in those with left-sided implant. We aimed to examine whether left-sided breast reconstruction with tissue expanders (TE) affect echo image acquisition and quality, possibly affecting clinical decision-making. Methods A retrospective case-control study was conducted in 190 female breast cancer patients who had undergone breast reconstruction with TE at an urban academic center. Echocardiographic technical assessment and image quality were respectively classified as excellent/good or adequate/technically difficult by technicians; and excellent/good or adequate/poor by 2 board-certified cardiologist readers. Likelihood ratio was used to test multivariate associations between image quality and left-sided TE. Results We identified 32 women (81.3% white; mean age 48 years) with left-sided/bilateral TE, and 158 right-sided/no TE (76.6% white, mean age 57 years). In multivariable analyses, we found a statistically significant difference in technician-assessed difficulty in image acquisition between cases and controls (p = 0.01); but no differences in physician-assessed image quality between cases and controls (p = 0.09, Pearson’s r = 0.467). Conclusions Left-sided breast TE appears to affect the technical difficulty of echo image acquisition, but not physician-assessed echo image quality. This likely means that echo technicians absorb most of the impediments associated with imaging patients with breast TE such that the presence of TE has no bearing on downstream clinical decision-making associated with echo image quality.

Effects of Silicone Expanders and Implants on Echocardiographic Image Quality after Breast Reconstruction

2013 ◽  
Vol 132 (2) ◽  
pp. 271-278 ◽  
Author(s):  
Marco Pignatti ◽  
Francesca Mantovani ◽  
Luca Bertelli ◽  
Andrea Barbieri ◽  
Lucrezia Pacchioni ◽  
...  
Keyword(s):  
Image Quality ◽  
Breast Reconstruction ◽  
Echocardiographic Image

scholarly journals P958 Back to basis? Feasibility of standard and novel echocardiographic measurements after breast cancer surgery

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E Orstad ◽  
K Steine ◽  
T Nerdrum
Keyword(s):  
Breast Cancer ◽  
Image Quality ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Two Dimensional ◽  
Echocardiographic Image ◽  
The Impact

Abstract Background It is recommended that breast cancer patients should undergo cardiac follow-up during chemotherapy, with clinical assessment and echocardiogram. Standard measurements are robust and reproducible, but novel echocardiography methods as global longitudinal strain (GLS) and three-dimensional (3D) echocardiography are recommended due to their superior sensitivity. These methods require high-quality images. Breast cancer surgery may lead to reduced echocardiographic image quality in this population, in addition to age, obesity and smoking. Purpose We wanted to explore the feasibility of standard and novel echo methods in an unselected breast cancer population. Methods The present study included consecutive, unselected patients referred to baseline echocardiogram at the cardio oncology outpatient clinic in a large university hospital prior to start of adjuvant chemotherapy. Data on surgery, smoking habits, age and body mass index were collected. Feasibility was defined as the presence or absence to carry out meaningful measurements of left ventricular (LV) systolic function, from standard mitral annular plane systolic excursion (MAPSE) and two-dimensional LV ejection fraction (EF), to novel GLS and 3D LVEF. Multivariable logistic regression was performed to assess the impact of relevant variables on image quality. Results 116 female patients were included. 21 % of these patients had insufficient images for novel analyses. Left sided breast implant (OR 5,77; P 0,04), age (OR 3,89; P 0,02) and daily smoking (OR 3,57; P 0,03) were found to be independently associated with insufficient image quality. Standard analyses like two-dimensional EF and MAPSE were obtainable in 99 and 97 % of the examinations, respectively. Conclusion One of five in a postoperative breast cancer population cannot undergo follow-up using novel, sensitive echocardiographic measurements. Standard measurements, however, are obtainable in almost all patients. It is therefore important that these measurements are included in cardiac follow-up during chemotherapy.

THE RELATIONSHIP BETWEEN OBESITY AND ECHOCARDIOGRAPHIC IMAGE QUALITY: A CASE FOR CONTRAST

2019 ◽  
Vol 73 (9) ◽  
pp. 1613
Author(s):  
Katherine Ellenberger ◽  
Joanne Kitley ◽  
Prajith Jeyaprakash ◽  
Avitasha Darshni ◽  
Sukhmandeep Sangha ◽  
...  
Keyword(s):  
Image Quality ◽  
Echocardiographic Image ◽  
The Relationship

scholarly journals 434 Feasibility and reproducibility of parameters of cardiac function and dimension by transthoracic echocardiography in obesity patients

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Snelder ◽  
J O Younge ◽  
J E Van Velzen ◽  
J A Akkerhuis ◽  
F Zijlstra ◽  
...  
Keyword(s):  
Image Quality ◽  
Cardiac Function ◽  
Transthoracic Echocardiography ◽  
Global Longitudinal Strain ◽  
Volume Index ◽  
Observer Variability ◽  
Echocardiographic Image ◽  
Echocardiographic Parameters ◽  
Broad Variety ◽  
Feasibility Test

Abstract Background Cardiac disease occurs more frequently in obesity patients. Imaging by transthoracic echocardiography (TTE) can be limited due to poor acoustic windows. An increase of the number of obesity patients who need to undergo TTE is expected. Purpose The aim of this study was to evaluate the feasibility, test-retest variability and inter- and intra-observer variability of parameters of cardiac function and dimension by TTE in obesity patients as compared to non-obese controls. Methods 100 obesity patients (BMI≥35kg/m2) and 50 non-obese controls (BMI < 30kg/m2) without known cardiovascular disease were prospectively enrolled and underwent an echocardiogram. Feasibility of echocardiographic parameters was assessed by categorizing the image quality and by evaluating the availability of the echocardiographic parameters. Intra-observer reproducibility was assessed by one observer on the same echocardiographic loop in 50 patients. A second observer assessed interobserver reproducibility in these patients. In 37 obesity patients and 17 non-obese controls images were obtained by two physicians to investigate test-retest variability. Results Image quality was excellent in 11% of the obesity patients as compared to 60% of the non-obese controls. Nevertheless, apart from global longitudinal strain (GLS), all investigated parameters of cardiac function and dimension were available in both groups (Table). GLS was obtainable in 93% of obesity patients versus 98% of non-obese controls (p = 0.20). For the vast majority of parameters inter- and intra-observer variability was comparable between obesity patients and non-obese controls. There were no significant differences between obesity patients and non-obese controls regarding the test-retest variability (Table). Conclusion Although non-obese controls on average had better echocardiographic image quality than obesity patients, feasibility of assessment of a broad variety of parameters of cardiac function and dimension was excellent in obesity patients and there were no important differences regarding variability of measurements. Echocardiographic parameters Available obesity patients (n = 100) Available non-obese controls (n-50) Intra-observer variability obese (n = 50) Intra-observer variability non-obese (n = 25) Inter-observer variability obese (n = 50) Interobeserver variability non-obese (n = 25) Test-retest variability obese (n = 37) Test-rest variability non-obese(n= 17) IVSd 100% 100% 10.6 ± 6.3 6.8 ± 6.3* 10.8 ± 6.9 8.5 ± 4.5 11.1 ± 9.0 10.1 ± 6.4 LVEDD 100% 100% 5.4 ± 4.7 6.7 ± 5.3 5.5 ± 3.7 5.5 ± 3.3 6.7 ± 5.1 6.1 ± 5.2 PWd 100% 100% 12.4 ± 9.0 13.7 ± 9.6 11.5 ± 9.7 9.7 ± 6.7 12.4 ± 9.4 9.8 ± 6.4 E/A ratio 100% 100% 5.9 ± 9.6 2.1 ± 3.0 4.9 ± 5.0 3.8 ± 3.4 8.9 ± 5.7 8.5 ± 5.7 LA-volume index 100% 100% 12.3 ± 7.8 8.7 ± 6.5 11.0 ± 6.9 9.2 ± 4.8 13.6 ± 11.8 10.1 ± 6.3 GLS 93% 98% 6.8 ± 5.2 5.6 ± 4.6 6.4 ± 4.9 5.6 ± 4.6 8.8 ± 7.6 6.9 ± 5.3 Selection of various echocardiographic parameters. *p < 0.05

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