Assessment of right heart function and haemodynamics

2011 ◽  
Author(s):  
Luigi P. Badano ◽  
Denisa Muraru
Keyword(s):  
Clinical Decision Making ◽  
Heart Function ◽  
Three Dimensional ◽  
Clinical Decision ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Prognostic Information ◽  
Right Heart Function ◽  
Valve Diseases ◽  
Rv Function

Assessment of right ventricular (RV) size, function, and haemodynamics has been challenging because of its unique cavity geometry. Conventional two-dimensional assessment of RV function is often qualitative. Doppler methods involving tricuspid inflow and pulmonary artery flow velocities, which are influenced by changes in pre- and afterload conditions, may not provide robust prognostic information for clinical decision making. Recent advances in echocardiographic assessment of the RV include tissue Doppler imaging, speckle-tracking imaging, and volumetric three-dimensional imaging, but they need specific training, expensive dedicated equipment, and extensive clinical validation. However, assessment of RV function is crucial, especially in patients with signs of right-sided failure and those with congenital or mitral valve diseases. This chapter aims to address the role of the various echocardiographic modalities used to assess RV and pulmonary vascular bed function. Special emphasis has been placed on technical considerations, limitations, and pitfalls of image acquisition and analysis.

Right ventricle and pulmonary arterial pressure

2016 ◽  
Author(s):  
Annemien E. van den Bosch ◽  
Luigi P. Badano ◽  
Julia Grapsa
Keyword(s):  
Clinical Decision Making ◽  
Complex Geometry ◽  
Three Dimensional ◽  
Clinical Decision ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Prognostic Information ◽  
Recent Developments ◽  
And Function

Right ventricular (RV) performance plays an important role in the morbidity and mortality of patients with left ventricular dysfunction, congenital heart disease, and pulmonary hypertension. Assessment of RV size, function, and haemodynamics has been challenging because of its complex geometry. Conventional two-dimensional echocardiography is the modality of choice for assessment of RV function in clinical practice. Recent developments in echocardiography have provided several new techniques for assessment of RV dimensions and function, include tissue Doppler imaging, speckle-tracking imaging, and volumetric three-dimensional imaging. However, specific training, expensive dedicated equipment, and extensive clinical validation are still required. Doppler methods interrogating tricuspid inflow and pulmonary artery flow velocities, which are influenced by changes in pre- and afterload conditions, may not provide robust prognostic information for clinical decision-making. This chapter addresses the role of the various echocardiographic modalities used to assess the RV and pulmonary circulation. Special emphasis has been placed on technical considerations, limitations, and pitfalls of image acquisition and analysis.

Cardiac masses and tumours

2015 ◽  
pp. 549-562
Author(s):  
Peter Buser ◽  
Thomas Buck ◽  
Björn Plicht
Keyword(s):  
Tissue Characterization ◽  
Clinical Decision Making ◽  
Imaging Modality ◽  
High Sensitivity ◽  
Clinical Decision ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Contrast Imaging ◽  
Cardiac Tumours ◽  
Cardiac Masses

Cardiac tumours represent a rare but important cause of morbidity and mortality in clinical cardiology and are often challenging in diagnostic cardiac imaging. There is a broad spectrum of differential diagnosis for cardiac masses. This chapter is mainly focused on the diagnosis of primary and secondary cardiac tumours and intra-cardiac thrombi. Diagnostic imaging of cardiac tumours provides important clinical decision-making information, such as origin, size, extension, morphology, and mobility of the tumour, involvement of cardiac chambers, valves, myocardium and pericardium, invasiveness, vascularization, and tissue characterization. Echocardiography is usually the first imaging modality providing high sensitivity in detecting cardiac masses, particularly by transoesophageal approach, and detailed analysis of mass characteristics by the use of different imaging modalities, including 3D imaging, tissue Doppler imaging, and contrast imaging.

scholarly journals Strain and Strain Rate To Evaluate Right Heart Function of Ebstein Anomaly (EA) Patients Before and After Operation

2020 ◽  
Vol 23 (5) ◽  
pp. E636-E640
Author(s):  
Xiang-jun Liu ◽  
Lian-yi Wang ◽  
Hong-yin Li ◽  
Jian Cui ◽  
Rui Liu
Keyword(s):  
Strain Rate ◽  
Heart Function ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Right Heart ◽  
Ebstein Anomaly ◽  
Basal Segment ◽  
Right Heart Function ◽  
Strain And Strain Rate ◽  
Before And After

Objective: This study was aimed to elucidate the feasibility of using right ventricular (RV) strain and strain rate to evaluate right heart function of Ebstein anomaly (EA) patients before and after operation. Methods: Sixty EA patients and 30 healthy controls underwent echocardiography (UCG) for evaluation of right heart function. Preoperative UCG and 1-week and 3-month postoperative UCG were performed in EA patients. RV strain and strain rate were measured on the four-chamber section of tissue Doppler imaging (TDI). Results: The strain and strain rate representative of right ventricle systolic function were reduced prior to operation. RV strain and strain rate improved after the operation (P < .001), most significantly in the basal segment and middle segment of the free wall of the right ventricle as well as the basal segment of the interventricular septum (P < .001). Conclusions: The measurement of RV strain and strain rate on tissue Doppler imaging can be employed to assess the preoperative and postoperative RV function, proves the positive effect of tricuspid valve repair on right heart function, and offers more insight on right heart function evaluation.

scholarly journals Telomere Architecture Correlates with Aggressiveness in Multiple Myeloma

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1969
Author(s):  
Aline Rangel-Pozzo ◽  
Pak Yu ◽  
Sadhana LaL ◽  
Yasmin Asbaghi ◽  
Luiza Sisdelli ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Disease Progression ◽  
Genomic Instability ◽  
Clinical Decision Making ◽  
Three Dimensional ◽  
Clinical Decision ◽  
Response To Treatment ◽  
Average Intensity ◽  
Patient Response ◽  
Smoldering Multiple Myeloma

The prognosis of multiple myeloma (MM), an incurable B-cell malignancy, has significantly improved through the introduction of novel therapeutic modalities. Myeloma prognosis is essentially determined by cytogenetics, both at diagnosis and at disease progression. However, for a large cohort of patients, cytogenetic analysis is not always available. In addition, myeloma patients with favorable cytogenetics can display an aggressive clinical course. Therefore, it is necessary to develop additional prognostic and predictive markers for this disease to allow for patient risk stratification and personalized clinical decision-making. Genomic instability is a prominent characteristic in MM, and we have previously shown that the three-dimensional (3D) nuclear organization of telomeres is a marker of both genomic instability and genetic heterogeneity in myeloma. In this study, we compared in a longitudinal prospective study blindly the 3D telomeric profiles from bone marrow samples of 214 initially treatment-naïve patients with either monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), or MM, with a minimum follow-up of 5 years. Here, we report distinctive 3D telomeric profiles correlating with disease aggressiveness and patient response to treatment in MM patients, and also distinctive 3D telomeric profiles for disease progression in smoldering multiple myeloma patients. In particular, lower average intensity (telomere length, below 13,500 arbitrary units) and increased number of telomere aggregates are associated with shorter survival and could be used as a prognostic factor to identify high-risk SMM and MM patients.

Trends in pediatric imaging: ultrasound

2013 ◽  
Vol 54 (9) ◽  
pp. 1096-1105 ◽  
Author(s):  
Ansgar Berg ◽  
Gottfried Greve
Keyword(s):  
Heart Diseases ◽  
Three Dimensional ◽  
Cost Effective ◽  
Clinical Work ◽  
Ventricular Volume ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Strain And Strain Rate ◽  
2D Echocardiography ◽  
Systolic And Diastolic Function

For the last three decades, two-dimensional (2D) echocardiography and Doppler echocardiography have been the primary imaging modalities for the diagnosis and management of heart disease in infants, children, and adolescents. These methods are non-invasive, highly sensitive, and cost-effective, and widely available, making them very useful in clinical work. During this period, the anatomic and hemodynamic abnormalities associated with different congenital and acquired pediatric heart diseases have been well outlined by echocardiography. Recent advances in computer technology, signal processing, and transducer design have allowed the capabilities of pediatric echocardiography to be expanded beyond qualitative 2D imaging and blood flow Doppler analysis. New modalities such as three-dimensional echocardiography, tissue Doppler imaging and speckle tracking echocardiography have been used to evaluate parameters such as ventricular volume, myocardial velocity, regional strain, and strain rate, providing new insight into cardiovascular morphology and ventricular systolic and diastolic function. Accordingly, a comprehensive and sophisticated quantification of ventricular function is now part of most echocardiography protocols. Use of measurements adjusted for body size and age is common practice today. These developments have further strengthened the position of echocardiography in pediatric cardiology.

Evaluation of diastolic LV function

2015 ◽  
pp. 323-335
Author(s):  
Johan De Sutter ◽  
Jean-Louis J. Vanoverschelde
Keyword(s):  
Diastolic Function ◽  
Daily Practice ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Lv Function ◽  
Prognostic Information ◽  
Heart Failure Patients ◽  
Lv Mass ◽  
Deformation Measurements

The evaluation of diastolic function in patients with reduced (HFREF) or preserved (HFPEF) left ventricular (LV) ejection fraction is important as it carries both diagnostic and prognostic information. In daily practice, this is most frequently done by standard echocardiographic techniques, including the evaluation of LV mass and LA volumes, as well as transmitral and pulmonary venous PW Doppler, CW Doppler for evaluation of the IVRT, and tissue Doppler imaging of the septal and lateral annular velocities. This permits grading the severity of diastolic dysfunction, which is related to outcome and may be used to estimate LV filling pressures. The latter needs further validation, especially in patients with HFPEF. Newer echocardiographic and cardiac magnetic resonance techniques, including myocardial deformation measurements during diastole, LV twist and untwisting, and parameters of left atrial function, are promising and will hopefully in the future help clinicians to make a more precise evaluation of diastolic function and filling pressures in heart failure patients.

scholarly journals 2326 Prognostic value of left ventricular mitral annular longitudinal displacement measured by tissue Doppler imaging in patients with acute coronary syndrome

2018 ◽  
Vol 2 (S1) ◽  
pp. 46-46
Author(s):  
Mats Lassen ◽  
Kristoffer G. Skaarup ◽  
Allan Z. Iversen ◽  
Peter G. Jørgensen ◽  
Flemming J. Olsen ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Primary Source ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Inferior Wall ◽  
Longitudinal Displacement ◽  
Prognostic Information ◽  
Coronary Syndrome ◽  
Multivariate Adjustment

OBJECTIVES/SPECIFIC AIMS: To investigate the prognostic value of left ventricular mitral annular longitudinal displacement (LD) measured with color tissue Doppler imaging (TDI) in a large population suffering from acute coronary syndrome (ACS). METHODS/STUDY POPULATION: In total, 501 ACS patients underwent an echocardiography within 9 days after a percutaneous coronary intervention. Regional LD was obtained from the 6 mitral annular regions with TDI and GLD was calculated as an average. RESULTS/ANTICIPATED RESULTS: During a median follow-up time of 4.4 years 46 ACS patients suffered CVD. Mean value of GLD in the population was 8.11mm (±2.4). GLD and LD obtained from the inferior wall remained significant independent predictors after multivariate adjustment for clinical parameters, GLD (HR: 1.43, 95% CI: 1.12–1.82, p=0.014, per 1mm decrease), inferior LD (HR: 1.38, 95% CI: 1.14–1.66, p=0.001). Furthermore, inferior wall LD was the primary source of prognostic information in GLD since only inferior LD remained significant when both measures were included in the same model: GLD (HR: 0.95, 95% CI: 0.64–1.40, p=0.781); inferior LD (HR: 1.60, 95% CI: 1.15–2.22, p=0.005). Of all walls, only inferior wall LD remained as an independent predictor after multivariate adjustment. DISCUSSION/SIGNIFICANCE OF IMPACT: GLD provides independent prognostic information in ACS patients over and beyond all conventional echocardiographic measures. Regional inferior LD was the primary source of prognostic information gained from GLD. GLD proved to be a better predictor of cardiovascular events than conventional echocardiographic measures. This could lead to better risk stratification in the clinical setting and open up for earlier intervention in high-risk individuals.

scholarly journals Predicting post-operative right ventricular failure using video-based deep learning

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Rohan Shad ◽  
Nicolas Quach ◽  
Robyn Fong ◽  
Patpilai Kasinpila ◽  
Cayley Bowles ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Clinical Decision Making ◽  
Heart Function ◽  
Clinical Decision ◽  
Right Ventricular Failure ◽  
Circulatory Support ◽  
Ventricular Failure ◽  
Cardiac Wall ◽  
Subjective Assessments ◽  
The Rich

AbstractDespite progressive improvements over the decades, the rich temporally resolved data in an echocardiogram remain underutilized. Human assessments reduce the complex patterns of cardiac wall motion, to a small list of measurements of heart function. All modern echocardiography artificial intelligence (AI) systems are similarly limited by design – automating measurements of the same reductionist metrics rather than utilizing the embedded wealth of data. This underutilization is most evident where clinical decision making is guided by subjective assessments of disease acuity. Predicting the likelihood of developing post-operative right ventricular failure (RV failure) in the setting of mechanical circulatory support is one such example. Here we describe a video AI system trained to predict post-operative RV failure using the full spatiotemporal density of information in pre-operative echocardiography. We achieve an AUC of 0.729, and show that this ML system significantly outperforms a team of human experts at the same task on independent evaluation.

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