Academic literature on the topic 'Echocardiograms; Echocardiography'
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Journal articles on the topic "Echocardiograms; Echocardiography"
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Asada, Dai, Yuma Morishita, Yoko Kawai, Yo Kajiyama, and Kazuyuki Ikeda. "Efficacy of bubble contrast echocardiography in detecting pulmonary arteriovenous fistulas in children with univentricular heart after total cavopulmonary connection." Cardiology in the Young 30, no. 2 (2020): 227–30. http://dx.doi.org/10.1017/s104795111900324x.
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AbstractBackground:Development of pulmonary arteriovenous fistulas in patients with cavopulmonary anastomosis may result in a significant morbidity. Although the use of bubble contrast echocardiography with selective injection into both the branch pulmonary arteries in identifying pulmonary arteriovenous fistulas has been increasing, the actual efficacy of this diagnostic modality has not been properly evaluated. Thus, this study aimed to assess the efficacy of bubble contrast echocardiography in detecting pulmonary arteriovenous fistulas in children with total cavopulmonary connection.Methods:A total of 140 patients were included. All patients underwent cardiac catheterisation. Bubble contrast echocardiographic studies were performed by injecting agitated saline solution into the branch pulmonary arteries. Transthoracic echocardiograms that use an apical view were conducted to assess the appearance of bubble contrast in the systemic ventricles. Then, the contrast echocardiogram results and other cardiac parameters were compared.Results:No correlation was found between contrast echocardiogram grade and other cardiac parameters, such as pulmonary capillary wedge saturation and pulmonary artery resistance. Moreover, only 13 patients had negative results on both the right and left contrast echocardiograms, and 127 of the 140 patients had positive results on contrast echocardiograms even though they had normal pulmonary capillary wedge saturation. Results showed that bubble contrast echocardiography was a highly sensitive method and was likely to obtain false-positive results.Conclusions:Bubble contrast echocardiography might be highly false positive in detecting pulmonary arteriovenous fistulas in patients with cavopulmonary anastomosis. We have to consider how we make use of this method. Further standardisation of techniques is required.
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Chang, Nai-Lun, Priyank Shah, Sharad Bajaj, Hartaj Virk, Mahesh Bikkina, and Fayez Shamoon. "Diagnostic Yield of Echocardiography in Syncope Patients with Normal ECG." Cardiology Research and Practice 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/1251637.
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Aim. This study aimed to assess the role of echocardiography as a diagnostic tool in evaluating syncope patients with normal versus abnormal electrocardiogram.Methods. We conducted a retrospective study of 468 patients who were admitted with syncope in 2011 at St. Joseph’s Regional Medical Center, Paterson, NJ. Hospital records and patient charts, including initial emergency room history and physical, were carefully reviewed. Patients were separated into normal versus abnormal electrocardiogram groups and then further divided as normal versus abnormal echocardiogram groups. Causes of syncope were extrapolated after reviewing all test results and records of consultations.Results. Three hundred twelve of the total patients (68.6%) had normal ECG. Two-thirds of those patients had echocardiograms; 11 patients (5.7%) had abnormal echo results. Of the aforementioned patients, three patients had previous documented history of severe aortic stenosis on prior echocardiograms. The remaining eight had abnormal but nondiagnostic echocardiographic findings. Echocardiography was done in 93 of 147 patients with abnormal ECG (63.2%). Echo was abnormal in 27 patients (29%), and the findings were diagnostic in 6.5% patients.Conclusions. This study demonstrates that echocardiogram was not helpful in establishing a diagnosis of syncope in patients with normal ECG and normal physical examination.
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Oyedeji, Adebayo T., Adeseye A. Akintunde, Olukolade O. Owojori, and Johnson O. Peter. "Spectrum of Echocardiography Abnormalities among 168 Consecutive Referrals to an Urban Private Hospital in South-Western Nigeria." Clinical Medicine Insights: Cardiology 8 (January 2014): CMC.S14320. http://dx.doi.org/10.4137/cmc.s14320.
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Trans-thoracic echocardiography (TTE) is an important non-invasive cardiac examination that provides structural and functional information. It is useful in the diagnosis of cardiac diseases and often guides the management and follow-up of patients with cardiovascular diseases (CVD). The study aimed to present an audit of the echocardiograms performed in an urban private hospital over a two-year period in order to define the pattern of cardiac diseases in our center. Echocardiogram reports of 168 consecutive patients performed between May 2011 and April 2013 at an organized private sector hospital in Lagos, south-west Nigeria were reviewed. Studies were performed with a Toshiba Nemio XG ultrasound machine. The data obtained were analyzed for mean age, sex, clinical indications, and echocardiographic diagnosis in the study subjects. A total of 168 echocardiography reports were examined, comprising of 92 males (54.8%) and 76 females (45.2%). The age range of the subjects was 10-76 years (mean 42.5 ± 12.1 years). The commonest indication for echocardiography was systemic hypertension and hypertension related causes (38.1%), followed by abnormal resting electrocardiogram (14.9%). Routine annual medical screening was the next most common indication, representing 13.1% of the indications for echocardiography. The other indications are as presented in Table 1 . The echocardiogram was normal in 64.3% of the subjects. The commonest abnormality detected was hypertensive heart disease (HHD); accounting for 9.6% of the subjects studied. Isolated atrial enlargement (left, right, or bi-atrial) was the next most common abnormality accounting for 6% of the echocardiographic diagnosis. Pulmonary hypertension was the next most common diagnosis accounting for 4.8% of our findings. The other echocardiographic diagnoses are as listed in Table 2 . Hypertension represents the commonest indication for echocardiography. Normal echocardiogram was the commonest echocardiographic finding while HHD was the commonest echocardiographic abnormality. The prevalence of ischemic heart disease by echocardiography was 2.4%. There was no case of rheumatic heart disease (RHD). The prevalence of hypertrophic cardiomyopathy (HCM) was 1.2%. Ease of access to echocardiography may influence the findings in an echocardiographic audit and policy makers should incorporate appropriateness criteria into their guidelines for reimbursement.
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Rozenbaum, Zach, Yan Topilsky, Shafik Khoury, et al. "Relationship between climate and hemodynamics according to echocardiography." Journal of Applied Physiology 126, no. 2 (2019): 322–29. http://dx.doi.org/10.1152/japplphysiol.00519.2018.
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Studies performed in controlled laboratory conditions have shown that environmental thermal application may induce various circulatory changes. We aimed to demonstrate the effect of local climate on hemodynamics according to echocardiography. Echocardiographic studies conducted in ambulatory patients, 18 yr of age or older, between January 2012 and July 2016, at our medical center, for whom climate data on the day of the echocardiogram study were available, were retrospectively included in case climate data. Discomfort index, apparent temperature, temperature-humidity index, and thermal index were computed. Echocardiograms conducted in hotter months (June–November) were compared with those done in colder months (December–May). The cohort consisted of 11,348 individuals, 46.2% women, and mean age of 57.9 ± 18.1 yr. Climate indexes correlated directly with stroke volume ( r = 0.039) and e′ (lateral r = 0.047; septal r = 0.038), and inversely with systolic pulmonary artery pressure (SPAP; r = −0.038) (all P values < 0.05). After adjustment for age and sex, echocardiograms conducted during June–November had a lower chance to show e′ septal < 7 cm/s (odds ratio 0.88, 95% confidence interval 0.78–0.98, P = 0.017) and SPAP > 40 mmHg (odds ratio 0.81, 95% confidence interval 0.67–0.99, P = 0.04) compared with those conducted in other months. The authors concluded that climate may affect hemodynamics, according to echocardiographic assessment in ambulatory patients. NEW & NOTEWORTHY In the present study, we examined 11,348 individuals who underwent ambulatory echocardiography. Analyses of the echocardiographic studies demonstrated that environmental thermal stress, i.e., climate, may affect hemodynamics. Most notably were the effects on diastolic function. Higher values of mitral e′, stroke volume, as well as ejection fraction, and lower values of systolic pulmonary artery pressure and tricuspid regurgitation were demonstrated on hotter days and seasons.
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Chang, J. C., A. M. Knight, R. Xiao, L. M. Mercer-Rosa, and P. F. Weiss. "Use of echocardiography at diagnosis and detection of acute cardiac disease in youth with systemic lupus erythematosus." Lupus 27, no. 8 (2018): 1348–57. http://dx.doi.org/10.1177/0961203318772022.
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Objectives There are no guidelines on the use of echocardiography to detect cardiac manifestations of childhood-onset systemic lupus erythematosus (SLE). We quantify the prevalence of acute cardiac disease in youth with SLE, describe echocardiogram utilization at SLE diagnosis, and compare regional echocardiogram use with incident cardiac diagnoses. Methods Using the Clinformatics® DataMart (OptumInsight, Eden Prairie, MN) de-identified United States administrative database from 2000 to 2013, we identified youth ages 5–24 years with new-onset SLE (≥3 ICD-9 SLE codes 710.0, > 30 days apart) and determined the prevalence of diagnostic codes for pericardial disease, myocarditis, endocarditis, and valvular insufficiency. Multiple logistic regression was used to identify factors associated with echocardiography during the baseline period, up to one year before or six months after SLE diagnosis. We calculated a regional echocardiogram utilization index, which is the ratio of observed use over the mean predicted probability based on all available baseline characteristics. Spearman’s rank correlation coefficient was used to evaluate the association between regional echocardiogram utilization indices and percentage of imaged youth diagnosed with their first cardiac manifestation following echocardiography. Results Among 699 youth with new-onset SLE, 18% had ≥ 1 diagnosis code for acute cardiac disease, of which valvular insufficiency and pericarditis were most common. Twenty-five percent of all youth underwent echocardiogram during the baseline period. Regional echocardiogram use was positively correlated with the percentage of imaged youth found to have cardiac disease (ρ = 0.71, p = 0.05). There was up to a five-fold difference in adjusted odds of baseline echocardiography between low- and high-utilizing regions (OR = 0.19, p = 0.007). Conclusion Nearly one-fifth of youth with new-onset SLE have acute cardiac manifestations; however, use of echocardiograms at SLE diagnosis is highly variable. There may be incremental diagnostic value to early use of echocardiography, but prospective studies are needed to determine whether greater use of echocardiograms modifies outcomes.
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Cartoski, Mark J., Meghan Kiley, and Philip J. Spevak. "Appropriate Use Criteria for paediatric echocardiography in an outpatient practice: a validation study." Cardiology in the Young 28, no. 6 (2018): 862–67. http://dx.doi.org/10.1017/s1047951118000513.
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AbstractBackgroundAlthough transthoracic echocardiography is the dominant imaging modality in CHD, optimal utilisation is unclear. We assessed whether adherence to the paediatric Appropriate Use Criteria for outpatient transthoracic echocardiography could reduce inappropriate use without missing significant cardiac disease.MethodsUsing the Appropriate Use Criteria, we determined the indication and appropriateness rating for each initial echocardiogram performed at our institution during calendar year 2014 (N=1383). Chart review documented ordering provider training, patient demographics, and study result, classified as normal, abnormal, or abnormal motivating treatment within a 2-year follow-up period. We tested whether provider training level or patient age correlated with echocardiographic findings or appropriateness rating.ResultsWe found that 83.9% of echocardiograms were normal and that 66.7% had an appropriate indication. Nearly all abnormal results and all results motivating treatment were in appropriate studies, giving an odds ratio of 2.73 for an abnormal result if an appropriate indication was present (95% confidence interval 1.92–3.89, p<0.001). None of the remaining initial abnormal results with less than appropriate indications became significant, resulting in treatment over 2 years. Results suggest a potential reduction in imaging volume of as much as 33% with application of the criteria. Cardiologists ordered nearly all studies resulting in treatment but also more echocardiograms with less appropriate indications. Most examinations were in older patients; however, most abnormal results were in patients younger than 1 year.ConclusionsThe Appropriate Use Criteria can be used to safely reduce echocardiography volume while still detecting significant heart disease.
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Yadlapati, Ajay, Timothy R. Maher, James D. Thomas, Mark Gajjar, Kofo O. Ogunyankin, and Jyothy J. Puthumana. "Global longitudinal strain from resting echocardiogram is associated with long-term adverse cardiac outcomes in patients with suspected coronary artery disease." Perfusion 32, no. 7 (2017): 529–37. http://dx.doi.org/10.1177/0267659117701563.
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Purpose: Measuring myocardial strain using two-dimensional speckle tracking echocardiography has emerged as a new tool to identify subclinical ventricular dysfunction. Abnormal strain has been shown to have superior sensitivity compared with dobutamine stress echocardiography for viability assessment; however, there is a paucity of data regarding the prediction of long-term major adverse cardiac events. We compared the prognostic ability of both global longitudinal strain (GLS) from resting echocardiograms to regional wall motion score index (WMSI) from stress echocardiograms in their ability to predict long-term major adverse cardiac events. Methods: Patients referred for stress echocardiography, who also underwent coronary angiography within 3 months of stress echo (n=122), were enrolled. Patients with reduced ejection fractions (<40%) were excluded. Patients were followed for a median of 3.4 years for major adverse cardiac events, readmissions and repeat cardiac testing. Results: Patients with abnormal GLS (GLS <16.8%) from the resting echocardiogram obtained as part of the exercise echocardiogram experienced a significantly shorter time to major adverse cardiac events (p=0.026), first cardiovascular hospitalization and repeat cardiac testing (p=0.0011) compared to those with normal GLS. Abnormal GLS appears to be a better predictor than abnormal WMSI in predicting major adverse cardiac events (p=0.174) and time to first cardiovascular hospitalization or repeat cardiac testing (p=0.0093). Conclusion: GLS may be a better predictor of long-term major adverse cardiac events, readmissions and repeat cardiac testing than WMSI in patients undergoing stress echocardiography.
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Friedman, Mark A. "Contrast Echocardiography." Einstein Journal of Biology and Medicine 21, no. 1 (2016): 2. http://dx.doi.org/10.23861/ejbm200421443.
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Ultrasound contrast agents are widely used in clinical practice for left ventricle opacification in sub-optimal echocardiograms. Recently, significant research has focused on the use of contrast echocardiography as a non invasive means to evaluate myocardial perfusion. Advances in contrast agents as well as ultrasound technology have enabled investigations into myocardial contrast echocardiography as a possible alternative to nuclear imaging studies. This review will focus on the development and current uses of contrast echocardiography, as well as future indications, including myocardial perfusion and risk stratification following myocardial infarction.
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Klein, Jennifer H., Andrea Beaton, Alison Tompsett, Justin Wiggs, and Craig Sable. "Effect of anaemia on the diagnosis of rheumatic heart disease using World Heart Federation criteria." Cardiology in the Young 29, no. 7 (2019): 862–68. http://dx.doi.org/10.1017/s1047951119000404.
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AbstractBackground:There is overlap between pathological mitral regurgitation seen in borderline rheumatic heart disease using World Heart Federation echocardiography criteria and physiologic regurgitation found in normal children. One possible contributing factor is higher rates of anaemia in endemic countries.Objective:To investigate the contribution of anaemia as a potential confounder in the diagnosis of rheumatic heart disease detected in echocardiographic screening.Method/Design:A novel Server 2012 data warehouse tool was used to incorporate haematology and echocardiography databases. The study included a convenience sample of patients from 5 to 18 years old without structural or functional heart disease that had a haemoglobin value within 1 month prior to an echocardiogram. Echocardiogram images were reviewed to determine presence or absence of World Heart Federation criteria for rheumatic heart disease. The rate of rheumatic heart disease among anaemic and non-anaemic children according to gender- and age-based norms groups was compared.Results:Of the 935 patients who met the study inclusion criteria, 406 were classified as anaemic. There was no difference in the rate of echocardiograms meeting criteria for borderline rheumatic heart disease in anaemic (2.0%, 95% CI 0.6–3.3%) and non-anaemic children (1.3%, 95% CI 0.3–2.3%). However, there was a statistically significant increase in rates of mitral regurgitation of unclear significance among anaemic versus non-anaemic patients (8.6 versus 3.6%; p = 0.0012).Conclusion:Anaemia does not increase the likelihood of meeting echocardiographic criteria for borderline rheumatic heart disease. Future studies should evaluate for the correlation between anaemia and mitral regurgitation in endemic settings.
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Usry, Courtney R., Satoshi R. Shin, James K. Aden, and Rosco Gore. "Optimizing contrast-enhanced echocardiography by employing a sonographer driven protocol." Journal of Echocardiography 19, no. 3 (2021): 173–78. http://dx.doi.org/10.1007/s12574-021-00523-y.
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Abstract Background The use of enhancing agents in echocardiography has been shown to facilitate improved study quality. Despite the known benefits, its use remains limited by institutional policies. Methods We aimed to retrospectively evaluate if allowing sonographers to place a peripheral intravenous catheter and administer enhancing agent led to a decrease in time to complete outpatient transthoracic echocardiograms in comparison to using nursing personnel. Three separate protocols were employed. The ‘nurse driven protocol’ utilized nurses to place a peripheral intravenous catheter and inject enhancing agent. In a ‘mixed protocol,’ a nurse placed a peripheral intravenous catheter and the sonographer gave the enhancing agent. The ‘sonographer driven protocol’ involved the sonographer placing the peripheral intravenous catheter and delivering enhancing agent. Results A total of 232 echocardiograms were included for analysis. Patient characteristics across the three protocols were not statistically significant. The ‘mixed protocol’ had an average study time that was significantly less than the ‘nurse driven protocol’ (49.4 min ± 11.4 vs 54.6 min ± 12.9; p = 0.024). The ‘sonographer driven protocol’ also showed a significant reduction in study time (50.3 min ± 12.6) when compared to the ‘nurse driven protocol’ (p = 0.017). The additional task for the sonographer to place the peripheral intravenous catheter did not significantly increase the time to complete the study. Conclusion Allowing sonographers to administer enhancing agent reduced individual echocardiogram study times by approximately 5 min, supporting that a ‘sonographer driven protocol’ is more efficient with potential downstream economic benefits.
Dissertations / Theses on the topic "Echocardiograms; Echocardiography"
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Mulet, Parada Miguel. "Intensity independent feature extraction and tracking in echocardiographic sequences." Thesis, University of Oxford, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.343557.
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Cardoso, Liliana de Jesus Casaca. "Comparação de alguns parâmetros ecocardiográficos medidos a partir de cortes transversais e longitudinais em cães." Master's thesis, Universidade de Lisboa. Faculdade de Medicina Veterinária, 2014. http://hdl.handle.net/10400.5/7788.
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Dissertação de Mestrado Integrado em Medicina Veterinária<br>Contexto: Apesar da existência de técnicas mais avançadas, em Portugal, a ecocardiografia trans-torácica é hoje em dia a principal ferramenta dos médicos veterinários no diagnóstico e avaliação da evolução da doença cardíaca em cães e gatos. Uma ecocardiografia completa engloba, além de outras fases, a medição de três parâmetros, o EPSS (E point to septal separation), o rácio átrio esquerdo/aorta (AE/Ao) e a fração de encurtamento sistólica (FS), os quais em conjunto com a restante informação colhida permitem avaliar a função cardíaca e as lesões cardíacas, quando presentes, bem como as suas causas e consequências fisiopatológicas. Devido a dificuldades técnicas na realização dos cortes padrão surge muitas vezes a necessidade de optar por cortes ecocardiográficos alternativos. Objetivos: Este trabalho procura esclarecer o grau de equivalência da medição do EPSS, rácio AE/Ao e FS a partir de cortes transversais em comparação com cortes longitudinais do coração em cães Amostra Populacional: 121 cães, de ambos os sexos (56 fêmeas e 65 machos) e de idades compreendidas entre os 4 meses e os 18 anos de idade, sendo 65 deles de raça pura. Em termos clínicos, 52 dos cães encontravam-se saudáveis e 69 dos cães apresentavam patologia cardíaca. Materiais e Métodos: Foram realizados cortes transversais e longitudinais do coração, descritos na literatura, para medir cada um destes parâmetros em todos os canídeos, e os dados adquiridos foram analisados estatisticamente. Resultados: Em relação ao rácio AE/Ao foi observada uma correlação positiva e razoável entre os valores obtidos através dos dois cortes, e apenas surgiram diferenças estatísticas significativas nos valores obtidos a partir destes mesmos cortes entre fêmeas e machos. Assumindo como padrão o corte transversal e como valor de referência 1,6, verifica-se que para o corte longitudinal o valor de referência que maximiza a especificidade/sensibilidade é 1,5. Em relação ao EPSS a correlação entre os valores obtidos a partir dos dois cortes foi elevada e não surgiram diferenças significativas do ponto de vista estatístico entre os vários grupos analisados (por exemplo, sexo, classes de peso, etc). Assumindo como padrão o corte transversal e como valor de referência 7 mm, verifica-se que, para o corte longitudinal, o valor de referência que maximiza a especificidade/sensibilidade é 6,2 mm. Relativamente à FS, usando o intervalo de referência de 25 a 45% os dois cortes apresentam uma correlação média, o que resultou em diferentes conclusões a partir dos dois cortes, em alguns animais. Conclusões: A medição de parâmetros ecocardiográficos, nomeadamente do rácio AE/Ao, EPSS e FS não deve ser realizada de forma arbitrária a partir de um corte longitudinal ou de um corte transversal, pois os valores obtidos não podem ser considerados absolutamente equivalentes. Em relação ao rácio AE/Ao conclui-se que ambos os cortes poderão ser usados de forma segura, mas sugere-se a utilização de diferentes valores de referência para os dois cortes, nomeadamente, a utilização de 1,6 para o corte transversal e 1,5 para o corte longitudinal. Em relação ao EPSS conclui-se que ambos os cortes poderão também ser usados de forma segura, mas sugere-se a utilização do valor de referência de 7mm para o corte transversal mas de 6,2 mm para o corte longitudinal. Em relação à FS, conclui-se que surgem diferenças significativas entre os dois cortes quando usado o intervalo de referência de 25 a 45%, mas que aumentado o intervalo de referência para 25 a 55% verifica-se concordância, nos dois cortes, em relação à FS em 95% dos casos.<br>ABSTRACT - Comparasion of some echocardiographic parameters measured in long-axis and short-axis views in dogs - Background: Although there are some more advanced techniques, in Portugal, the trans-thoracic echocardiography is still the main tool for the diagnosis and evaluation of heart disease in cats and dogs. A complete echocardiography includes, not only but also, the assessment of three parameters, the EPSS (E point to septal separation), the left atrium to aortic root ratio (LA/Ao) and the shortening fraction (FS). These, in conjugation with other information gathered, allows the veterinarian to conclude about the cardiac function and if there are heart lesions, as well as, their causes and consequences. Unfortunately, sometimes technical problems prevent us to use the standard views forcing us to choose alternative views in order to measure the afore mentioned parameters. Objectives: The aim of this work is to clarify if the long-axis and short-axis views are equally suited for the measurement of EPSS, LA/Ao ratio and FS in dogs. Sample: 121 dogs from both sexes (56 females e 65 males), 65 of them from pure breeds. The dogs were 4 month to 18 years old. 52 of them were healthy and 69 of them presented with heart disease Materials & Methods: The measurements of EPSS, LA/Ao ratio and FS were performed in both long-axis and short-axis views in all dogs, and the gathered data was statistically analyzed. Results: The LA/Ao ratio measurements showed positive and medium correlation between the two views. The only statistical differences detected were between males and females. Assuming that the short-axis view is the standard and that the reference value is 1,6 for that view, it was concluded that the value which maximizes the sensitivity versus specificity is 1,5 for the long-axis view. For EPPS, the correlation was positive and high between the two views and there were no statistical differences between them in any of the groups studied (for example, sex, etc). Assuming that the short-axis view is the standard and that the reference value is 7 mm for that view, it was concluded that the value which maximizes the sensitivity versus specificity for EPPS is 6,2 mm for the long-axis view. Using reference values for FS that ranged from 25 to 45%, the two views showed medium correlation which resulted, in some cases, in different conclusions about the normality of these parameter in long-axis versus short-axis views. Conclusions: The use of long-axis or short-axis views to access echocardiographic parameters should be well thought. It was concluded that is safe to use both views to measure the LA/Ao ratio in dogs, but it is suggested to use different reference values depending on which view it is used. For short-axis view it is suggested the value from the literature, 1,6. For long-axis view it is suggested the use of 1,5. For FS it was concluded that there are significant differences between the two views when using the range of 25 to 45% for reference values, although, when using the range of 25 to 55%, 95% of the cases had the same conclusion for FS in both views.
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Otsuki, Denise Aya. "Hemodiluição normovolêmica aguda: estudo experimental comparativo utilizando amido hidroxietílico a 6% ou solução de Ringer lactato." Universidade de São Paulo, 2004. http://www.teses.usp.br/teses/disponiveis/10/10137/tde-03022005-113414/.
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Hemodiluição normovolêmica aguda é um procedimento utilizado para diminuir a necessidade de transfusões sangüíneas em diversas cirurgias de grande porte. Poucos trabalhos avaliam as alterações hemodinâmicas e perfusão tecidual através de estudo ecocardiográfico e tonometria gástrica. Foram utilizados 23 porcos (peso 46.6 ± 6.0 kg) anestesiados com quetamina, fentanil e propofol e instrumentados para monitorização hemodinâmica convencional. Os animais foram randomizados em três grupos 30 minutos após estabilização da anestesia: Grupo I (Controle), Grupo II (amido hidroxietílico) e Grupo III (Ringer lactato). Os animais do grupo II e III foram submetidos ao protocolo de hemodiluição com hematócrito alvo de 15%. A retirada de sangue foi realizada em 30 minutos e a expansão plasmática feita simultaneamente com amido hidroxietílico ou Ringer lactato nas proporções de 1:1 ou 1:3 em relação ao sangue retirado. Os parâmetros hemodinâmicos e de oxigenação, pH gástrico, ecocardiografia transesofágica (fração de ejeção através do método Simpson) foram coletados antes da hemodiluição (T0), no fim do procedimento de hemodiluição (T1) e após uma e duas horas (T2, T3). Os dados foram submetidos a análise de variância para medidas repetidas, seguida pelo teste Tukey e teste T student. Resultados: Em relação aos parâmetros do grupo controle, não houve diferença significante durante todo o procedimento. No grupo II e grupo III, houve aumento no índice cardíaco após hemodiluição (T0=5,80±1,46; T1=10,64±1,69 L.min-1.m2 e T0=5,53±1,18, T1=7,91±1,40 L.min-1.m2 respectivamente), e diminuição do índice de resistência vascular sistêmica (T0=1753±336, T1=822±140 dina.s.cm-5.m-2 e T0=1673±566, T1=1026±190 dina.s.cm-5.m-2 respectivamente), ambos estatisticamente significante. A fração de ejeção apresentou aumento significativo após a hemodiluição no grupo II. O pH gástrico diminuiu significativamente no grupo III. O lactato arterial aumentou de forma significante no grupo III após a hemodiluição. A microscopia eletrônica do ventrículo esquerdo mostraram discreta destruição de miofilamentos no grupo II. Houve destruição importante nas miofibrilas no grupo III. Conclusão: Estes resultados sugerem que na hemodiluição moderada a grave, o amido hidroxietílico consegue preservar melhor a estabilidade hemodinâmica do que a solução de Ringer lactato.<br>Normovolemic acute hemodilution is a procedure utilized to decrease the needs of blood transfusion during a variety of surgical procedures. Nevertheless, there are few works that evaluate its pulmonary effects as well as hemodynamic changes by means of echocardiography and tonometric evaluation. Methods: 23 anesthetized pigs (weight 46.6 ± 6.0 kg) were instrumented for standard hemodynamic monitoring. In order to prevent possible effects of inhaled anesthetics on pulmonary mechanics, intravenous anesthesia was chosen and consisted of ketamine, fentanyl and propofol administered throughout the study. Thirty minutes after anesthesia stabilization animals were randomized in three groups: Group I (Control), Group II (hydroxyethyl starch) and Group III (Lactated Ringers). Animals of group II and III were submitted to acute normovolemic hemodilution to reach a pre-established hematocrit around 15%. Blood withdrawal was accomplished in thirty minutes and plasma expansion was performed simultaneously with hydroxyethyl starch or Lactated Ringers administered in a proportion of 1:1 or 3:1 in relation to the amount of bloods withdrawn. Hemodynamic, gastric pH, transesophageal echography (ejection fraction, by Simpon method) and oxygen transport were measured before blood withdrawal (T0), at the end of hemodilution (T1), one and two hours after the end of hemodilution (T2, T3). Data were submitted to analysis of Variance for repeated measures followed by the Tukey test and also to a student T test. Results: In regard to all parameters of Group I (Control), there were no significant difference during the whole procedure. In Group II and Group III, there was an increase in cardiac index after hemodilution (T0=5.80±1.46; T1=10.64±1.69 L.min-1.m2 and T0=5.53±1.18, T1=7.91±1.40 L.min-1.m2), and a decrease in systemic vascular resistance index (T0=1753±336, T1=822±140 dyne.s.cm-5.m-2 and T0=1673±566, T1=1026±190 dyne.s.cm-5.m-2), both statistically significant. Ejection Fraction increased significantly after hemodilution in group II. Gastric pH decreased significantly in Group III, and arterial lactate increased significantly after hemodilution in group III. Electron microscopy of left ventricular bipsies showed a slight destruction in filament and preserved myofibrillar ultrastructure in group II. There was important destruction in myofibrillar ultrastructure in group III. Conclusion: These results suggest that in severe hemodilution, hydroxyethyl starch preserves hemonodynamic stability better than Lactate Ringers.
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Rosa, Kaleizu Teodoro. "Influência dos barorreceptores e da pressão arterial na resposta cardíaca à hipertensão renovascular em ratos." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/5/5131/tde-14102008-144613/.
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No presente estudo, duas importantes situações foram abordadas no intuito de se melhor entender os mecanismos homeostáticos dos pressorreceptores na gênese da hipertrofia cardíaca em resposta à hipertensão renovascular: o efeito do tempo de clipe na artéria renal e o efeito dos níveis pressóricos e da variabilidade da pressão arterial. O curso temporal mostrou que, antes mesmo da instalação da hipertensão, há alteração da morfologia cardíaca, qual seja o desenvolvimento de uma hipertrofia ventricular excêntrica e, como forma de mecanismo compensatório, um aumento da expressão de algumas proteínas da homeostase do cálcio (fosfolambam fosforilada pela serina-16 e corrigido pelo fosfolambam total em 100% e fosfolambam fosforilado pela treonina-17 e corrigido pelo fosfolambam total em 54%). Uma vez instalada a hipertensão, observou-se um remodelamento ventricular esquerdo para o tipo concêntrico, com prejuízo da função diastólica e um desbalanço do sistema nervoso autonômico, com aumento da atividade simpática, observado pelo aumento da razão dos componentes de baixa freqüência (LF) e alta freqüência (HF) no tacograma (0,44 ± 0,10 vs. 0,20 ± 0,03 nos controles). A análise do efeito da pressão arterial e da variabilidade da pressão arterial mostrou uma correlação positiva com o grau de hipertrofia ventricular esquerda (r=0,76, p<0,01). A secção cirúrgica dos pressorreceptores somada à implantação do clipe na artéria renal mostrou adaptações cardiovasculares em níveis semelhantes (mesmo nível de hipertensão) e, por vezes maiores (modulação simpática para o coração e para os vasos, hipertrofia ventricular esquerda e disfunção diastólica), ao grupo cuja artéria renal foi estenosada e que permaneceu com os barorreceptores intactos. Estas respostas aconteceram num período de tempo três vezes menor na ausência do barorreflexo. Tais observações ressaltam o importante efeito homeostático do barorreflexo na gênese das respostas cardíacas adaptativas à hipertensão arterial<br>In the present study, two important situations were observed to evaluate the role of the baroreceptors in the genesis of cardiac hypertrophy in response to hypertension: the effect of the time-course of the clip in the renal artery and the effect of the level of arterial blood pressure (ABP) and blood pressure variability (ABPV). The time-course evaluation showed that even before hypertension was installed, cardiac alterations could be observed, as a left ventricular eccentric hypertrophy. Compensatory mechanisms, such as an increase in some calcium homeosthatic proteins, could also be noticed (increase in phosphorilated phospholmaban at threonin-17 corrected by total phospholamban in 54% and increase in phosphorilated phospholmaban at serine-16 corrected by total phospholamban in 100%). However, once hypertension was established, left ventricle morphology changed to a concentric hypertrophy, accompanied by a diastolic dysfunction and enhanced sympathetic modulation, observed by relation between low-frequency component (LF) and high-frequency component (HF) at tachogram (0,44 ± 0,10 vs. 0,20 ± 0,03 in control group). ABP and ABPV analyses showed an important positive correlation with the degree of left ventricular hypertrophy (r=0,76, p<0,01). However, the absence of baroreceptors in one of the hypertensive groups, evoked the same cardiovascular alterations (same level of hypertension) or even worse (sympathetic modulation for heart and vessels, left ventricular hypertrophy and diastolic dysfunction) reached by the hypertensive baroreceptors-preserved group. These cardiovascular responses were observed in a period that correspond one third of time to the group with intact baroreflex. These observations lead us to conclude the importance of homeosthatic effects of the baroreflex in the genesis of cardiac responses to hypertension
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Campos, Paulo César Gobert Damasceno [UNIFESP]. "Regurgitação valvar funcional em insuficiência cardíaca congestiva descompensada: monitoração não-invasiva por bioimpedância cardíaca e ecocardiografia e resposta à terapêutica." Universidade Federal de São Paulo (UNIFESP), 2009. http://repositorio.unifesp.br/handle/11600/10021.
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Publico-11760b.pdf: 1959621 bytes, checksum: 2665d88fb8fec237d73fdc84aa78a26a (MD5)<br>Introdução: A insuficiência cardíaca congestiva (ICC) descompensada pode ser definida como a evidência de sinais e sintomas de insuficiência cardíaca (IC) ao repouso e representa estado de ativação neuro-hormonal intensa, secundária ao déficit de perfusão renal. Regurgitações valvares funcional mitral e tricúspide são causas reversíveis de diminuição de fluxo sanguíneo sistêmico eficaz. O impacto de tais regurgitações sobre o débito cardíaco, sobre o conteúdo de fluido torácico, sobre as dimensões de câmaras cardíacas e sobre a função do aparato valvular pode ser monitorado de forma não-invasiva, antes e após a otimização do tratamento clínico. Objetivo: Avaliar o papel das regurgitações valvares funcional mitral e tricúspide como causas reversíveis de redução do débito cardíaco em ICC descompensada, e que acompanham a disfunção ventricular sistólica em miocardiopatias isquêmica e não-isquêmica. Métodos: catorze pacientes do sexo masculino (66 ± 8 anos de idade), fração de ejeção (24 ± 5%) secundária às miocardiopatias isquêmica (71%) e não-isquêmica (29%), apresentaram ICC descompensada com evidência clínica de regurgitações valvares mitral e tricúspide, foram avaliados por Bioimpedância cardíaca e ecocardiografia antes e uma semana após otimização de tratamento clínico. Resultados: o tratamento farmacológico de ICC descompensada foi acompanhado de redução de peso corpóreo de 82,9 a 76 kg (P<0,01), elevação no índice cardíaco (de 2,1 para 2,6 L/min/m2; P<0,01), redução na pressão sistólica da artéria pulmonar (de 58 para 35 mm Hg; P<0,001), conteúdo de fluido torácico (de 39 para 32 kOhm; P<0,001) e resistência vascular sistêmica (de 1633 para 1209 dinas/seg/cm5; P<0.001). A melhora dessas regurgitações incluiu redução nas dimensões das câmaras atriais esquerda e direita (de 27 para 24 cm2 e de 26 para 23 cm2, respectivamente; (P<0,001), diminuição das regurgitações mitral e tricúspide detectadas pelo Doppler colorido (P < 0,01), do volume regurgitante mitral (de 105 para 65 ml; P<0,001), e do tamanho efetivo do orifício regurgitante mitral (de 0,8 para 0,6 cm2; P<0,01). Conclusões: Na ICC descompensada, as regurgitações funcionais mitral e tricúspide contribuem para redução do débito cardíaco, aumento do conteúdo fluido torácico e da resistência vascular sistêmica, simultaneamente ao aumento de câmaras atriais e do orifício valvar, os quais podem ser melhorados com tratamento clínico. A bioimpedância cardíaca e a ecocardiografia fornecem avaliação seriada não-invasiva de parâmetros hemodinâmicos e função valvar nestes pacientes.<br>Objective: We hypothesized that functional mitral and tricuspid valvular incompetence (MR and TR, respectively) are reversible causes of reduced cardiac output in decompensated heart failure (DF) that accompanies systolic dysfunction in ischemic or nonischemic cardiomyopathy. Background: DF, defined as signs and symptoms of heart failure at rest, is rooted in a salt-avid state transduced by neurohormonal activation secondary to impaired renal perfusion. Functional MR and TR are reversible causes of reduced systemic blood flow. Their impact on cardiac output, thoracic fluid content, cardiac chamber dimensions, and valvular apparatus function can be monitored noninvasively, before and after optimized medical management. Methods: Fourteen male subjects (66 ± 8 years old) with reduced ejection fraction (24 ± 5%) secondary to ischemic (71%) or nonischemic (29%) cardiomyopathy, who developed DF with clinical evidence of mitral (MR) and tricuspid (TR) valvular incompetence, were each assessed by bioimpedance and echocardiography before and 1 week after optimized medical management restored compensated failure. Results: Pharmacologic elimination of DF was accompanied by a reduction in body weight (p<0.01). Hemodynamic improvements included a rise in cardiac index (2.1 to 2.6 L/min/m2; p<0.01) and a reduction in predicted pulmonary artery systolic pressure (58 to 35 mm Hg; p<0.001), thoracic fluid content (39 to 32 kOhm; p<0.001), and systemic vascular resistance (1633 to 1209 dynes/sec/cm5; p<0.001). Improvements in functional MR and TR included reductions in left and right atrial areas (27 to 24 cm and 26 to 23 cm2, respectively; p<0.001), color-flow grading of MR and TR severity (p<0.01), mitral regurgitant volume (105 to 65 mL; p<0.001), and effective MR orifice size (0.8 to 0.6 cm2; p<0.01). Conclusions: In DF, functional MR and TR contribute to reduced cardiac output, increased thoracic fluid content, and systemic vascular resistance, together with enlarged atria and valvular orifice size, which can be improved by medical management. Bioimpedance and echocardiography provide for serial noninvasive assessments of hemodynamic status and valvular function in such cases.<br>TEDE<br>BV UNIFESP: Teses e dissertações
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Duque, Mariana Perez da Costa de Albuquerque. "Intraoperative transesophageal echocardiografy: review and evolution." Dissertação, 2016. https://repositorio-aberto.up.pt/handle/10216/88029.
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Duque, Mariana Perez da Costa de Albuquerque. "Intraoperative transesophageal echocardiografy: review and evolution." Master's thesis, 2016. https://repositorio-aberto.up.pt/handle/10216/88029.
Full textBooks on the topic "Echocardiograms; Echocardiography"
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Echocardiographic anatomy: Understanding normal and abnormal echocardiograms. Appleton & Lange, 1996.
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C, Pearson Anthony, ed. Transesophageal echocardiography: Basic principles and clinical applications. Lea & Febiger, 1992.
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Torres, Río Aguilar, Luigi P. Badano, and Dimitrios Tsiapras. Cardiac transplant patients. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0050.
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Echocardiography has a pivotal role in the care of heart transplant (HT) recipients. This chapter discusses the use of echocardiographic techniques for the assessment of HT patients. In the early post-transplant period, echocardiography has demonstrated its utility to assess the normal and abnormal structural and physiological changes of the transplanted heart, as well as to detect complications such as graft failure. During follow-up, development of acute/chronic graft rejection and cardiac allograft vasculopathy remains the leading causes of mortality in HT recipients and the role of conventional and new echocardiographic techniques in detecting these complications is discussed. Finally, the role of stress echocardiography, which provides additional functional information to the anatomical data obtained with invasive coronary angiography and intravascular ultrasound, is highlighted. The last sections of the chapter are dedicated to the echocardiographic monitoring of endomyocardial biopsies and how to schedule serial echocardiograms during the follow-up of HT recipients.
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Ángel García Fernández, Miguel, and José Juan Gómez de Diego. Transthoracic echocardiography. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0002.
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The echocardiogram is an extremely useful and versatile technique that enables collection of all relevant information on morphology and function of the heart in a wide range of clinical situations.Echocardiography has been pivotal in the development of modern cardiology and is an indispensable tool to effectively manage cardiological patients.The echocardiogram is a highly operator-dependent technique in which the skills of the operator in achieving optimized images and adapting the study to the possible findings is simply fundamental.1 In this chapter we will review the technical aspects involved in achieving the images required for a standard echocardiographic examination.
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Pearson, A. C., and Arthur J., M.D. Labovitz. Transesophageal Echocardiography: Basic Principles and Clinical Applications. Lea & Febiger, 1993.
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Kasprzak, Jaroslaw D., Anita Sadeghpour, and Ruxandra Jurcut. Doppler echocardiography. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0003.
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Doppler examination is an integral part of the echocardiogram. Current systems are equipped with spectral Doppler in continuous wave mode (offering measurements of high velocities with limited spatial specificity due to integration of signal along the scan line), pulsed wave mode (high spatial specificity with maximal recordable velocity reduced by the Nyquist limit), and colour Doppler flow mapping (allowing rapid identification of flow pattern within a cross-sectional B-mode sector). Tissue Doppler echocardiography emerged as a basic tool for sampling regional myocardial velocities, in pulsed wave or colour velocity mapping mode. Finally, three-dimensional systems improve spatial presentation of flow phenomena by integrating Doppler-derived flow patterns in three-dimensional datasets.
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Fernández, Miguel Ángel García, and José Juan Gómez de Diego. Transthoracic echocardiography/two-dimensional and M-mode echocardiography. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0002.
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The echocardiogram is an extremely useful technique that gives all relevant information on morphology and function of the heart in a wide range of clinical situations. The very first step in echo is how to achieve the images needed for the cardiac evaluation. This chapter covers the basics of echo imaging acquisition including patient positioning and the pivotal concepts of echocardiographic window and view. The two-dimensional echo planes are carefully explained with a detailed description of the cardiac structures that can be studied in every view. The clinical scenarios where a specific imaging mode or orientation could be especially useful are also detailed. Finally M-mode imaging is covered, including detailed explanations of the habitual findings in normal studies.
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Lancellotti, Patrizio, and Bernard Cosyns. Adult Congenital Heart Disease. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713623.003.0013.
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Echocardiography has a fundamental role in patients with adult congenital heart disease. This chapter identifies the role of echocardiography in atrial septal defects, ventricular septal defects, atrioventricular septal defects, patent ductus arteriosus, and persistent left superior vena cava. For each condition, the role of transthoracic and transoesophagael echocardiogram are shown alongside examples of main types and features and haemodynamic effect. Echocardiographic findings of LV outflow tract obstruction, supravalvular aortic stenosis, aortic stenosis, and aortic coarction are covered, as well as an examination of complex congenital lesions, including the tetralogy of Fallot and Ebstein’s anomaly of the tricuspid valve.
Book chapters on the topic "Echocardiograms; Echocardiography"
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Bosch, H. G., J. H. C. Reiber, G. van Burken, J. J. Gerbrands, and J. R. T. C. Roelandt. "Automated Contour Detection on Short-Axis Transesophageal Echocardiograms." In Transesophageal Echocardiography. Springer Berlin Heidelberg, 1989. http://dx.doi.org/10.1007/978-3-642-74257-6_30.
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Lai, Wyman W., and H. Helen Ko. "The Normal Pediatric Echocardiogram." In Echocardiography in Pediatric and Congenital Heart Disease. John Wiley & Sons, Ltd, 2016. http://dx.doi.org/10.1002/9781118742440.ch4.
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Bierig, S. Michelle. "Contrast for Resting Echocardiograms." In Dynamic Echocardiography. Elsevier, 2011. http://dx.doi.org/10.1016/b978-1-4377-2262-8.00087-6.
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Phelps, Janey. "Cardiology." In The Pediatric Procedural Sedation Handbook, edited by Cheryl K. Gooden, Lia H. Lowrie, and Benjamin F. Jackson. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190659110.003.0040.
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Congenital heart disease is the most common type of birth defect and is estimated to affect nearly 1% of all births per year in the United States. Echocardiograms are necessary to fully evaluate these defects, and depending on the age of the child, sedation may be required to ensure optimal imaging. This chapter discusses the sedation/anesthesia options for transthoracic echocardiography, transesophageal echocardiography, and cardioversion. For all of these procedures high-risk patients should be triaged to a pediatric anesthesia provider and in some cases, a pediatric cardiac anesthesiologist. Transthoracic echocardiograms can be completed with distraction and/or minimal sedation with oral or intranasal midazolam. If moderate sedation is required due to patient characteristics or previous history of failure with minimal sedation, intranasal dexmedetomidine is a good option. Transesophageal echocardiography is an invasive procedure; patients <2 years of age should be intubated and those >2 years of age can maintain a native airway with deep sedation with propofol. The need for cardioversion is infrequent in pediatrics but when needed, propofol is a good choice.
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Caselli, Stefano, and Flavio D’Ascenzi. "Echocardiogram: morphological and functional evaluation including new echocardiographic techniques." In The ESC Textbook of Sports Cardiology, edited by Antonio Pelliccia, Hein Heidbuchel, Domenico Corrado, Mats Börjesson, and Sanjay Sharma. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198779742.003.0015.
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Echocardiography is the most important imaging technique for the characterization of athlete’s heart as it allows evaluation of morphological and functional cardiac adaptations induced by exercise. It is usually performed when abnormalities are found on clinical examination and/or on resting or stress echocardiograms, and is particularly helpful for differential diagnosis of pathological conditions at risk for sudden cardiac death such as hypertrophic, dilated, arrhythmogenic, or non-compaction cardiomyopathies. This chapter reviews useful methods for performing a standard echocardiographic examination in competitive athletes and for correct interpretation of findings by discussing determinants and upper limits of cardiac adaptations, reference values, and specific clues for the differential diagnosis of pathological conditions.
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Stewart, Mike. "Echocardiography—requesting an echocardiogram." In Practical Guide to Common Clinical Procedures and Emergencies. CRC Press, 2005. http://dx.doi.org/10.1201/b14653-65.
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Otto, Catherine M., Rebecca Gibbons Schwaegler, and Rosario V. Freeman. "The Transthoracic Echocardiogram." In Echocardiography Review Guide: Companion to the Textbook of Clinical Echocardiography. Elsevier, 2011. http://dx.doi.org/10.1016/b978-1-4377-2021-1.00002-3.
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Otto, Catherine M., Rebecca Gibbons Schwaegler, and Rosario V. Freeman. "The Transesophageal Echocardiogram." In Echocardiography Review Guide: Companion to the Textbook of Clinical Echocardiography. Elsevier, 2011. http://dx.doi.org/10.1016/b978-1-4377-2021-1.00003-5.
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Gera, Rani. "Pediatric Echocardiogram Report and its Pitfalls." In Pediatric Echocardiography. Jaypee Brothers Medical Publishers (P) Ltd., 2010. http://dx.doi.org/10.5005/jp/books/11125_10.
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kulkarni, Snehal, and Prashant Bobhate. "General Guidelines for Performing Fetal Echocardiogram." In Fetal Echocardiography. Jaypee Brothers Medical Publishers (P) Ltd., 2018. http://dx.doi.org/10.5005/jp/books/13107_3.
Full textConference papers on the topic "Echocardiograms; Echocardiography"
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Zhang, Ping, Lie Yang, Shaoyin Duan, et al. "Echocardiograpy and 64-MSCTA in Diagnosing Coronary Artery Fistula." In 2010 International Conference on Biomedical Engineering and Computer Science (ICBECS). IEEE, 2010. http://dx.doi.org/10.1109/icbecs.2010.5462329.
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Sheriff, Yunus, and Raghupathi Narasimhan. "Prospective study of echocardiograpy in chronic obstructive pulmonary disease in tertiary hospital." In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa1114.
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