scholarly journals Left Ventricular Metastasis from a Primary Pancreatobiliary Tumor

2015 ◽  
Vol 8 ◽  
pp. CCRep.S25189 ◽  
Author(s):  
Amgad N. Makaryus ◽  
Lawrence Boxt
Keyword(s):  
Left Ventricle ◽  
Computerized Tomography ◽  
Metastatic Disease ◽  
Transthoracic Echocardiography ◽  
Left Ventricular ◽  
First Report

Metastatic disease to the heart is not uncommon. We describe a case of a man in his 60s with an unusual metastasis to the heart and detail its intracardiac location by means of cardiac computerized tomography (CCT) and transthoracic echocardiography. To our knowledge, this is the first report of a pancreatobiliary tumor metastasizing exclusively to the left ventricle (LV) of the heart.

The echocardiographic aspects of diagnostic of phenomenon of trabecularization of myocardium of left ventricle and non-compact myocardium

2016 ◽  
Vol 22 (1) ◽  
pp. 31-36
Author(s):  
Ol’ga N. Dzhioeva ◽  
E. V Kartashova ◽  
I. I Zakharova ◽  
A. V Melekhov ◽  
G. E Gendlin
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricle ◽  
Diagnostic Criteria ◽  
Transthoracic Echocardiography ◽  
Genetic Disorders ◽  
Systolic Dysfunction ◽  
Clinical Manifestations ◽  
Left Ventricular ◽  
Main Role

The left ventricular non-compaction is a disease characterizing by hyper-trabecularization of myocardium causing development of chronic heart failure. In the development of structural damages under this pathology the main role belongs to genetic disorders and dysfunction of organogenesis in early periods of gestation. The clinical manifestations are associated with development of systolic dysfunction of left ventricle, intricate abnormalities of rhythm and thromboembolic occurrences. In patients with systolic dysfunction of left ventricle phenomenon of hyper-trabecularization of myocardium is quite often found during transthoracic echocardiography. The modern diagnostic criteria permit approaching differentially issues of verification of non-compact myocardium and redundant trabecularization in patients with chronic heart failure with reduced fraction of output of left ventricle.

scholarly journals Impact of Diastolic Interventricular Septal Flattening on Clinical Outcome in Patients With Severe Tricuspid Regurgitation

2021 ◽  
Author(s):  
Taku Omori ◽  
Mika Maeda ◽  
Shunsuke Kagawa ◽  
Goki Uno ◽  
Florian Rader ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Clinical Outcome ◽  
Tricuspid Regurgitation ◽  
Transthoracic Echocardiography ◽  
Cardiovascular Events ◽  
Left Ventricular ◽  
Hazard Ratio ◽  
Right Atrial ◽  
Left Ventricular Ejection ◽  
Severe Tricuspid Regurgitation

Background Little is known about the impact of diastolic interventricular septal flattening on the clinical outcome in patients with severe tricuspid regurgitation. This study sought to evaluate the association of diastolic interventricular septal flattening with clinical outcome in patients with severe tricuspid regurgitation. Methods and Results We retrospectively studied 407 patients who underwent 2‐dimensional transthoracic echocardiography and were diagnosed with severe tricuspid regurgitation between January 2014 and December 2015. Cardiovascular events were defined as cardiovascular death or admission for heart failure. The magnitude of interventricular septal flattening was calculated by the eccentricity index (EI) of the left ventricle, and hemodynamic parameters were obtained from transthoracic echocardiography. During follow‐up (median, 200 days; interquartile range, 35–1059), 117 of the patients experienced cardiovascular events. By multivariate analysis including potential covariates, EI at end‐diastole and left ventricular ejection fraction were independent predictors of cardiovascular events (hazard ratio, 5.33 [1.63–17.41]; hazard ratio, 0.98 [0.97–0.99], respectively). An EI of 1.2 at end‐diastole was the optimal cutoff value for identifying poor hemodynamic status defined as cardiac index ≤2.2 L/min per m 2 and right atrial pressure 15 mm Hg, both on transthoracic echocardiography. Patients with D‐shaped left ventricle defined as EI ≥1.2 at end‐diastole showed worse outcomes than those without (adjusted hazard ratio, 1.80 [1.18–2.74]). Conclusions Increasing EI at end‐diastole was strongly associated with worse outcomes in patients with severe tricuspid regurgitation. Furthermore, the presence of D‐shaped left ventricle defined as EI ≥1.2 at end‐diastole provides prognostic value for cardiovascular events.

scholarly journals A Novel Approach for Detecting Abnormality in Ejection Fraction Using Transthoracic Echocardiography with Deep Learning

2020 ◽  
Vol 16 (13) ◽  
pp. 99
Author(s):  
Prattay Guha Sarkar ◽  
Vishal Chandra
Keyword(s):  
Deep Learning ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Transthoracic Echocardiography ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Systolic Function ◽  
Whole Process

<p class="0abstract">Cardiovascular diseases (CVD) are the prime cause of mortality in people worldwide. Mortality in CVD has been strongly linked to Ejection Fraction (EF) in various studies<sup>1</sup>. Left ventricular ejection fraction (LVEF) is the central measure of left ventricular systolic function. LVEF is the fraction of chamber volume ejected in systole (stroke volume) in relation to the volume of the blood in the ventricle at the end of diastole (end-diastolic volume)<sup>2</sup>. Evaluation of left ventricular systolic function by left ventricle ejection fraction (EF) using Transthoracic echocardiography is usually a first line investigation. Determination of Ejection fraction (EF) is done most commonly by a semi-automatic process in which echocardiographer segments the left ventricle in both systolic and diastolic frames to generate systolic and diastolic chamber dimensions. The whole process in time consuming and highly dependent on operator experience causing a lot of inter-observer and intra-observer variations. Our goal is to develop algorithms so as to reduce the time consumed during whole process and make it more reliable and reproducible. We have used M-Mode of Left ventricle in PLAX view to measure chamber dimensions and calculate EF by Teich method. EF &gt;50% has been categorized as normal ejection fraction. EF &lt; 50% has been categorized as reduced ejection fraction and LV systolic dysfunction. In this research we have used fine-tuned ResNet 50 and trained it with 200 cases. We observed an accuracy of 98% and a F1 score of 77% for reduced EF (&lt;50%) and 77% for normal EF (&gt;50%). Although this is a small dataset, it shows that deep learning algorithms can be applied to medical imaging. ResNet50 is a preferred choice in terms of accuracy. This research will serve as a stepping stone for future research and will determine other cardiac matrices.</p>

A giant left ventricular pseudoaneurysm in Behçet's disease: a case report

2013 ◽  
Vol 24 (2) ◽  
pp. 382-383 ◽  
Author(s):  
Najat Mouine ◽  
Rajae Bennani ◽  
Rachida Amri
Keyword(s):  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Behçet’S Disease ◽  
Transthoracic Echocardiography ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Systolic Dysfunction ◽  
Vascular Complications ◽  
Left Ventricular ◽  
Behcet's Disease

AbstractBehçet's disease is a chronic autoimmune disease with vascular complications that are most frequently manifested as thromboembolism in veins and pseudoaneurysm in arteries. We report the case of a 13-year-old boy admitted for clinical and biological signs of rheumatic fever associated with chest pain. The clinical examination found heart sounds with a discrete systolic murmur of mitral regurgitation. The electrocardiogram showed a microvoltage with diffuse repolarisation disorder. Biologically, he had inflammatory syndrome. Transthoracic echocardiography showed circumferential pericardial effusion with anterosepto-apical hypokinesia of the left ventricle with systolic dysfunction, and a minimal mitral regurgitation. The patient was treated by corticotherapy and antibiotherapy. The outcome was marked by orogenital aphthous ulceration and decreased visual acuity related to intermediate uveitis. The retinal angiography showed a vasculitis. The late appearance of this symptom led to the right diagnosis of Behçet's syndrome. Transthoracic echocardiography showed a hypokinetic dilated cardiomyopathy left ventricular with septo apical and anterior akinesia and severe systolic dysfunction, with a defect of the inferior septal with a collar communicating the left ventricle with a giant pseudo aneurysm. Magnetic resonance imaging showed a giant pseudoaneurysm communicating with the left ventricle. The coronary computed tomography was normal. The patient had undergone surgical treatment for the pseudoaneurysm with good outcomes.

scholarly journals A different type of acute myocarditis: a case report of acute autoimmune myocarditis mediated by anti-PD-1 T lymphocyte receptor (pembrolizumab)

2020 ◽  
Vol 4 (5) ◽  
pp. 1-6
Author(s):  
Mario Salido Iniesta ◽  
Laura López López ◽  
Francesc Carreras Costa ◽  
Alessandro Sionis
Keyword(s):  
Left Ventricle ◽  
Ejection Fraction ◽  
T Lymphocyte ◽  
Transthoracic Echocardiography ◽  
Acute Myocarditis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
High Dose ◽  
Autoimmune Myocarditis ◽  
Ventricular Ejection Fraction

Abstract Background  Pembrolizumab is an immune check-point inhibitor (ICI), which acts by blocking the T lymphocyte PD-1 inhibitor receptor. It has been increasingly used in advanced or non-responsive tumours with promising results. However, acute myocarditis is an infrequent but potentially life-threatening autoimmune adverse effect related to ICIs. Case summary  This case deals with a 69-year-old gentleman on second-line therapy with pembrolizumab for advanced non-small cell lung cancer. Three weeks after first dose, the patient was diagnosed with an autoimmune hepatitis, treated with decreasing corticoid dosage, followed by acute heart failure. On admission, his electrocardiogram (ECG) showed diffuse repolarization changes and a transthoracic echocardiography revealed severe left ventricle impairment (left ventricular ejection fraction 32%). High-sensitivity cardiac troponin was elevated and a coronary angiogram was performed showing non-significant obstructive disease. An autoimmune myocarditis was suspected, and high-dose intravenous corticoid, intravenous vasodilators, and loop diuretics were started with favourable response. Cardiac magnetic resonance (CMR) imaging, performed 2 weeks after clinical onset, revealed extracellular oedema in the anteroseptal-apical left ventricle segments. A new transthoracic echocardiography, performed after 3 months, showed preserved left ventricle ejection fraction. Finally, the patient was readmitted due to an autoimmune myasthenia-like syndrome. Discussion  Acute autoimmune myocarditis related to ICIs is a challenging diagnosis and its incidence has been underestimated in early studies. Endomyocardial biopsy (EMB) is the gold standard test for its diagnosis. Nevertheless, a definite myocarditis diagnosis is possible without EMB when characteristic clinical syndrome, elevated myonecrosis markers, and electrocardiographic, echocardiographic, and CMR changes are present together.

Clinical and Experimental Analysis of 201Thallium Uptake of the Heart

1978 ◽  
Vol 17 (04) ◽  
pp. 142-148
Author(s):  
U. Büll ◽  
S. Bürger ◽  
B. E. Strauer
Keyword(s):  
Oxygen Consumption ◽  
Left Ventricle ◽  
Muscle Mass ◽  
Myocardial Oxygen Consumption ◽  
Animal Experiments ◽  
Left Ventricular ◽  
Left Ventricular Wall ◽  
Ventricular Wall ◽  
Flow Measurements ◽  
Myocardial Flow

Studies were carried out in order to determine the factors influencing myocardial 201T1 uptake. A total of 158 patients was examined with regard to both 201T1 uptake and the assessment of left ventricular and coronary function (e. g. quantitative ventriculography, coronary arteriography, coronary blood flow measurements). Moreover, 42 animal experiments (closed chest cat) were performed. The results demonstrate that:1) 201T1 uptake in the normal and hypertrophied human heart is linearly correlated with the muscle mass of the left ventricle (LVMM);2) 201T1 uptake is enhanced in the inner (subendocardial) layer and is decreased in the outer (subepicardial) layer of the left ventricular wall. The 201T1 uptake of the right ventricle is 40% lower in comparison to the left ventricle;3) the basic correlation between 201T1 uptake and LVMM is influenced by alterations of both myocardial flow and myocardial oxygen consumption; and4) inotropic interventions (isoproterenol, calcium, norepinephrine) as well as coronary dilatation (dipyridamole) may considerably augment 201T1 uptake in accordance with changes in myocardial oxygen consumption and/or myocardial flow.It is concluded that myocardial 201T1 uptake is determined by multiple factors. The major determinants have been shown to include (i) muscle mass, (ii) myocardial flow and (iii) myocardial oxygen consumption. The clinical data obtained from patient groups with normal ventricular function, with coronary artery disease, with left ventricular wall motion abnormalities and with different degree of left ventricular hypertrophy are correlated with quantitated myocardial 201T1 uptake.

The Results of the Use of Angiotensin Receptor Inhibitors and Neprilisin in Secondary Functional Mitral Regurgitation in Outpatient Practice

2020 ◽  
Vol 75 (5) ◽  
pp. 514-522
Author(s):  
Alexey S. Ryazanov ◽  
Konstantin I. Kapitonov ◽  
Mariya V. Makarovskaya ◽  
Alexey A. Kudryavtsev
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Effective Area ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Angiotensin Receptor ◽  
Optimal Drug ◽  
Patients With Heart Failure ◽  
Valsartan Group

Background. Morbidity and mortality in patients with functional mitral regurgitation (FMR) remains high, however, no pharmacological therapy has been proven to be effective.Aimsto study the effect of sacubitrile/valsartan and valsartan on functional mitral regurgitation in chronic heart failure.Methods.This double-blind study randomly assigned sacubitrile/valsartan or valsartan in addition to standard drug therapy for heart failure among 100 patients with heart failure with chronic FMR (secondary to left ventricular (LV) dysfunction). The primary endpoint was a change in the effective area of the regurgitation hole during the 12-month follow-up. Secondary endpoints included changes in the volume of regurgitation, the final systolic volume of the left ventricle, the final diastolic volume of the left ventricle, and the area of incomplete closure of the mitral valves.Results.The decrease in the effective area of the regurgitation hole was significantly more pronounced in the sacubitrile/valsartan group than in the valsartan group (0.070.066against0.030.058sm2; p=0.018)in the treatment efficacy analysis, which included 100patients (100%). The regurgitation volume also significantly decreased in the sacubitrile/valsartan group compared to the valsartan group (mean difference:8.4ml; 95%CI, from 13.2 until 1.9;р=0.21). There were no significant differences between the groups regarding changes in the area ofincomplete closure of the mitral valves and LV volumes, with the exception of the index of the final LV diastolic volume (p=0.07).Conclusion.Among patients with secondary FMR, sacubitril/valsartan reduced MR more than valsartan. Thus, angiotensin receptor inhibitors and neprilysin can be considered for optimal drug treatment of patients with heart failure and FMR.

New Hybrid Method for Left Ventricular Ejection Fraction Assessment from Radionuclide Ventriculography Images

2020 ◽  
Vol 16 ◽  
Author(s):  
Halima Dziri ◽  
Mohamed Ali Cherni ◽  
Dorra Ben Sellem
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Positive Predictive Value ◽  
Roc Curve ◽  
Radionuclide Ventriculography ◽  
Left Ventricular ◽  
The Other ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Background: In this paper, we propose a new efficient method of radionuclide ventriculography image segmentation to estimate the left ventricular ejection fraction. This parameter is an important prognostic factor for diagnosing abnormal cardiac function. Methods: The proposed method combines the Chan-Vese and the mathematical morphology algorithms. It was applied to diastolic and systolic images obtained from the Nuclear Medicine Department of Salah AZAIEZ Institute.In order to validate our proposed method, we compare the obtained results to those of two methods of the literature. The first one is based on mathematical morphology, while the second one uses the basic Chan-Vese algorithm. To evaluate the quality of segmentation, we compute accuracy, positive predictive value and area under the ROC curve. We also compare the left ventricle ejection fraction estimated by our method to that of the reference given by the software of the gamma-camera and validated by the expert, using Pearson’s correlation coefficient, ANOVA test and linear regression. Results and conclusion: Static results show that the proposed method is very efficient in the detection of the left ventricle. The accuracy was 98.60%, higher than that of the other two methods (95.52% and 98.50%). Likewise, the positive predictive value was the highest (86.40% vs. 83.63% 71.82%). The area under the ROC curve was also the most important (0.998% vs. 0.926% 0.919%). On the other hand, Pearson's correlation coefficient was the highest (99% vs. 98% 37%). The correlation was significantly positive (p<0.001).

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