JACC. Cardiovascular imaging
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JACC Cardiovasc Imaging · Jul 2011
ReviewClinical utility of multimodality LA imaging: assessment of size, function, and structure.
The reservoir, conduit, and contractile functions of the left atrium are integral to overall cardiac performance. Recent advances in cardiac imaging offer the accurate assessment of LA phasic functions and structure, using techniques such as 3-dimensional echocardiography, color tissue Doppler imaging, and speckle tracking, as well as cardiac computed tomography and magnetic resonance imaging. ⋯ This review article highlights and contrasts the imaging of the size, mechanics, and structure of the left atrium using multiple modalities. The authors discuss recent studies on the clinical applications of the various techniques in disease conditions.
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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 · Sep 2010
ReviewAnatomy of right atrial structures by real-time 3D transesophageal echocardiography.
The rapid development of catheter ablation techniques for atrial arrhythmias has triggered a renewed interest in the anatomy of the right atrium. In particular, some atrial arrhythmias such as focal atrial arrhythmias or atrial flutter have been linked to the anatomic architecture of specific structures such as the crista terminalis or cavotricuspid isthmus. ⋯ This review describes a step-by-step approach for acquisition and processing of RT 3D TEE images of right atrial structures of relevance to electrophysiologists. For anatomical correlations of RT 3D TEE images, selected images of right atrial structures were matched to anatomical specimens.
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JACC Cardiovasc Imaging · Jul 2010
ReviewEchocardiographic evaluation of patent foramen ovale prior to device closure.
High-quality imaging of the atrial septum has never been so relevant to the adult cardiologist. This article focuses on the role of echocardiography in the evaluation of patent foramen ovale for closure. It provides a systematic and comprehensive approach to transesophageal echocardiographic study in such a patient. The salient information required for planning the device and equipment needed for the closure procedure are discussed.
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JACC Cardiovasc Imaging · Jun 2010
ReviewTakotsubo cardiomyopathy: a unique cardiomyopathy with variable ventricular morphology.
Takotsubo cardiomyopathy is an important differential diagnosis of acute coronary syndrome. It is characterized by normal (or near-normal) coronary arteries, regional wall motion abnormalities that extend beyond a single coronary vascular bed, and often, a precipitating stressor. Variants of the classical left ventricular apical ballooning, including mid- or basal left ventricular wall motion abnormalities, are increasingly recognized. ⋯ Diagnosis of takotsubo cardiomyopathy has important implications for clinical management at presentation and afterward. The long-term prognosis is generally favorable; however, a small subset has potentially life-threatening complications during the initial presentation. The pathophysiologic mechanism is unknown, but catecholamine excess likely has a central role.