Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
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J Am Soc Echocardiogr · Aug 2021
Multicenter Study Observational StudyDetermining Which Hospitalized Coronavirus Disease 2019 Patients Require Urgent Echocardiography.
Patients hospitalized with coronavirus disease 2019 (COVID-19) often have abnormal findings on transthoracic echocardiography (TTE). However, although not all abnormalities on TTE result in changes in clinical management, performing TTE in recently infected patients increases disease transmission risks. It remains unknown whether common biomarker tests, such as troponin and B-type natriuretic peptide (BNP), can help distinguish in which patients with COVID-19 TTE may be safely delayed until infection risks subside. ⋯ Troponin and BNP were highly associated with urgent echocardiographic findings and may be used in triaging algorithms for determining in which patients TTE can be safely delayed until after their peak infectious window has passed.
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J Am Soc Echocardiogr · Apr 2021
Multicenter StudyEchocardiographic Predictors of Successful Extracorporeal Membrane Oxygenation Weaning After Refractory Cardiogenic Shock.
Limited data are available regarding echocardiographic predictors for successful weaning from venoarterial (VA) extracorporeal membrane oxygenation (ECMO). We sought to determine whether echocardiographic parameters during ECMO flow study could predict successful weaning from ECMO. ⋯ Improvement of lateral e' velocity and tricuspid annular S' velocity during VA-ECMO flow study may better represent cardiac reserve from a recovering heart than conventional echocardiographic parameters at minimal flow. Assessment of tissue Doppler parameters during ECMO flow study is a simple and feasible method to guide physicians on the optimal time to wean from ECMO.
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J Am Soc Echocardiogr · Mar 2019
Multicenter StudyCharacterization of Medical Professional Liability Risks Associated With Transesophageal Echocardiography.
Medical claim data offer the possibility to improve patient care and mitigate liability. Although published analyses exist in cardiology, no information is available for transesophageal echocardiography (TEE). In this study, the authors reviewed medical claims involving TEE to identify potential risk management concerns so that these lessons could be used to improve the safety and quality of transesophageal echocardiographic practice. ⋯ Liability claims associated with TEE involve failure to order and perform TEE in an appropriate clinical scenario and in a timely manner; failure to properly document medical decision making; failure to inform patients regarding risks of TEE; failure to properly monitor the patient before, during, and after TEE; and technical difficulties in performing the procedure. Cardiologists should recognize guideline-based indications when TEE is needed and be mindful of the complication rates of this procedure. When screening a patient for TEE, consider expert input that may reduce the risks of TEE (e.g., a spine specialist for a neck injury, a gastroenterologist for esophageal comorbidity). Informed consent and medical record documentation should be practiced as a vehicle to inform patients of these risks and chronicle decision-making processes.
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J Am Soc Echocardiogr · Jan 2019
Multicenter StudyThe Prognostic Value of Coronary Flow Velocity Reserve in Two Coronary Arteries During Vasodilator Stress Echocardiography.
Vasodilator stress echocardiography (SE) allows combined evaluation of regional wall motion and Doppler coronary flow velocity reserve (CFVR) of both the left anterior descending coronary artery (LAD) and the right coronary artery (RCA). The aim of this study was to prospectively assess the prognostic correlates of LAD and RCA CFVR on SE. ⋯ Ischemia on SE with high peak wall motion score index identifies a high-risk subset regardless of the underlying CFVR response. Absence of ischemia on SE is associated with intermediate risk, and LAD CFVR is essential to identify a truly low-risk subset. RCA CFVR is less useful than LAD CFVR but may have a role for further risk stratification in patients without ischemia and normal LAD CFVR.
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J Am Soc Echocardiogr · Dec 2015
Multicenter StudyCardiovascular Health in Young Adulthood and Association with Left Ventricular Structure and Function Later in Life: The Coronary Artery Risk Development in Young Adults Study.
The aim of this study was to determine the association between cardiovascular health (CVH) in young adulthood and left ventricular (LV) structure and function later in life. ⋯ Greater levels of CVH in young adulthood are associated with lower LV mass and lower risk for diastolic dysfunction 25 years later.