Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Jul 2009
Myocardial function in older male amateur marathon runners: assessment by tissue Doppler echocardiography, speckle tracking, and cardiac biomarkers.
Participation of older men in endurance races continues to increase. Recent studies on marathon runners raised concerns about a transient myocardial dysfunction and damage. The aim of our study was to compare the extent of marathon-induced myocardial dysfunction in young and older runners and to identify its potential correlation to elevated cardiac biomarkers. ⋯ Left ventricular systolic function is preserved after a marathon in older runners. There are right ventricular functional changes as a sign of prolonged myocardial work load. There is no significant difference between older and young runners regarding transient diastolic dysfunction or biomarker release. The latter is not associated with echocardiography parameters of myocardial dysfunction.
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J Am Soc Echocardiogr · Jun 2009
Case ReportsPercutaneous closure of an atrial septal defect guided by live three-dimensional transesophageal echocardiography.
A 55-year-old man with a history of cryptogenic stroke presented to the authors' department for investigation. On transthoracic echocardiography, he was found to have a small secundum atrial septal defect, and transesophageal echocardiography was performed for a more detailed assessment. Following this, the defect was deemed suitable for percutaneous closure. The case demonstrates the utility and benefits of live three-dimensional transesophageal echocardiography for the assessment of this type of defect and guidance of transcatheter closure.
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J Am Soc Echocardiogr · May 2009
Size-adjusted left ventricular outflow tract diameter reference values: a safeguard for the evaluation of the severity of aortic stenosis.
We sought to evaluate the relationship among left ventricular outflow tract diameter (LVOTd), gender, and body surface area (BSA) and to evaluate the usefulness of size-adjusted LVOTd reference values in patients with aortic stenosis (AS). AS grading is based on the echocardiographic calculation of the aortic valve area (AVA) and requires LVOTd measurements, one main potential source of error. Transesophageal echocardiography (TEE) is reputed to be more accurate than transthoracic echocardiography (TTE), but validation studies are rare. A safeguard for LVOTd measurements is thus desirable. ⋯ TTE and TEE measurements of the LVOTd provided similar results. LVOTd was significantly associated to BSA and LVOTd, derived from a linear regression linked to BSA independently of gender, provided an acceptable approximation of the AVA. Thus, although accurate measurement of LVOTd is a crucial part of the echocardiographic evaluation of AS severity, the present equation may be used as a safeguard when this measurement is difficult or not possible with TTE.
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A 58-year-old man admitted to the hospital with an acute stroke was found to have a left atrial mass attached to the interatrial septum via a stalk. Although initially thought to be a myxoma, the mass was pathologically proved to be a thrombus. Clues pointing to thrombus as the etiology were a history of atrial fibrillation, the absence of anticoagulation, an enlarged left atrium, and the presence of spontaneous echo contrast.
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J Am Soc Echocardiogr · Apr 2009
Comparative StudyLeft ventricular filling pressure estimation at rest and during exercise in patients with severe aortic valve stenosis: comparison of echocardiographic and invasive measurements.
The Doppler index of left ventricular (LV) filling (E/e') is recognized as a noninvasive measure for LV filling pressure at rest but has also been suggested as a reliable measure of exercise-induced changes. The aim of this study was to investigate changes in LV filling pressure, measured invasively as pulmonary capillary wedge pressure (PCWP), at rest and during exercise to describe the relation with E/e' in patients with severe aortic stenosis. ⋯ E/e' is well correlated with PCWP at rest. However, E/e' cannot be used to detect exercise-induced changes in PCWP in patients with severe aortic stenosis. Using the ratio of E during exercise to e' at rest may result in a better estimate of the increase in PCWP during exercise.