JACC. Cardiovascular imaging
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JACC Cardiovasc Imaging · Nov 2010
ReviewEchocardiography-guided biventricular pacemaker optimization.
Optimization of atrioventricular delay (AVD) and interventricular delay (VVD) in patients with a biventricular (Biv) pacemaker has been associated with improvement in cardiac output acutely, a reduction in heart failure symptoms, and improved exercise capacity. Several individual echocardiography (echo) Doppler parameters have been used for pacemaker optimization. ⋯ The goals of this paper are to discuss studies in echo-guided pacemaker optimization, provide a systemic guide to pacemaker interrogation and optimization in patients after Biv pacing who may have complex hemodynamic derangement, and finally, to discuss studies in optimization with exercise or atrial pacing. Case examples highlighting hemodynamic derangement in heart failure, tailoring of Biv pacemaker optimization to the underlying physiologic derangement, and its improvement with optimization are presented.
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JACC Cardiovasc Imaging · Nov 2010
Comparative StudyAn alternative isovelocity surface model for quantitation of effective regurgitant orifice area in mitral regurgitation with an elongated orifice application to functional mitral regurgitation.
The purpose of this study was to develop and test a simple, clinically practical alternative isovelocity surface (ISVS) model for calculating effective regurgitant orifice area (EROA) in mitral regurgitation (MR) when the regurgitant orifice is elongated, such as in functional MR. ⋯ The traditional spherical PISA model underestimates EROA in functional MR. For elongated MR orifices, an ISVS model that mirrors orifice shape yields more accurate EROA values. Correction to the ISVS area for obtuse leaflet angulation improves accuracy of EROA estimation.
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JACC Cardiovasc Imaging · Nov 2010
Letter Case ReportsReal-time 3D TEE for multiperforated interatrial septum.