Sudden cardiac death(SCD)of an athlete is a rare but tragic event and sport activity might play a trigger role in athletes with underlying structural or electrical heart diseases.Preparticipation screenings(PPs)have b...Sudden cardiac death(SCD)of an athlete is a rare but tragic event and sport activity might play a trigger role in athletes with underlying structural or electrical heart diseases.Preparticipation screenings(PPs)have been conceived for the potential to prevent SCD in young athletes by early identification of cardiac diseases.The European Society of Cardiology protocol for PPs includes history collection,physical examination and baseline electrocardiogram,while further examinations are reserved to individuals with abnormalities at first-line evaluation.Nevertheless,transthoracic echocardiography has been hypothesized to have a primary role in the PPs.This review aims to describe how to approach an athlete-focused echocardiogram,highlighting what is crucial to focus on for the different diseases(cardiomyopathies,valvulopathies,congenital heart disease,myocarditis and pericarditis)and when is needed to pay attention to overlap diagnostic zone(“grey zone”)with the athlete's heart.Once properly tested,focused echocardiography by sports medicine physicians may become standard practice in larger screening practices,potentially available during first-line evaluation.展开更多
An unknown aberrant f low in the right atrium observed on doppler with transesophageal echocardiogram(TEE) in a patient with prior coronary bypass. TEE revealed normal size left ventricle with severely dilated left at...An unknown aberrant f low in the right atrium observed on doppler with transesophageal echocardiogram(TEE) in a patient with prior coronary bypass. TEE revealed normal size left ventricle with severely dilated left atrium. There was moderate aortic regurgitation and moderate aortic stenosis noted. Patient was incidentally found to have an abnormal vascular communication noted to the right atrium. To further evaluate this f inding, the patient underwent cardiac magnetic resonance angiography which revealed that the tubular structure noted on TEE was actually a graft that was abutting onto the coronary sinus, and the f low anomaly was really the graft coming up and running adjacent to the coronary sinus.展开更多
Three dimensional(3D)echocardiogram enables cardiologists to visua-lize suspicious cardiac structures in detail.In recent years,this three-dimensional echocardiogram carries important clinical value in virtual surgica...Three dimensional(3D)echocardiogram enables cardiologists to visua-lize suspicious cardiac structures in detail.In recent years,this three-dimensional echocardiogram carries important clinical value in virtual surgical simulation.However,this 3D echocardiogram involves a trade-off difficulty between accu-racy and efficient computation in clinical diagnosis.This paper presents a novel Flip Directional 3D Volume Reconstruction(FD-3DVR)method for the recon-struction of echocardiogram images.The proposed method consists of two main steps:multiplanar volumetric imaging and 3D volume reconstruction.In the crea-tion of multiplanar volumetric imaging,two-dimensional(2D)image pixels are mapped into voxels of the volumetric grid.As the obtained slices are discontin-uous,there are some missing voxels in the volume data.To restore the structural and textural information of 3D ultrasound volume,the proposed method creates a volume pyramid in parallel with theflip directional texture pyramid.Initially,the nearest neighbors of missing voxels in the multiplanar volumetric imaging are identified by 3D ANN(Approximate Nearest Neighbor)patch matching method.Furthermore,aflip directional texture pyramid is proposed and aggregated with distance in patch matching tofind out the most similar neighbors.In the recon-struction step,structural and textural information obtained from differentflip angle directions can reconstruct 3D volume well with the desired accuracy.Com-pared with existing 3D reconstruction methods,the proposed Flip Directional 3D Volume Reconstruction(FD-3DVR)method provides superior performance for the mean peak signal-to-noise ratio(40.538 for the proposed method I and 39.626 for the proposed method II).Experimental results performed on the cardi-ac datasets demonstrate the efficiency of the proposed method for the reconstruc-tion of echocardiogram images.展开更多
Background Echocardiogram is a simple and useful tool in disease assessment.In ventricular septal defect(VSD)patients with severe pulmonary hypertension(PH),it is difficult to judge whether further intervention is nee...Background Echocardiogram is a simple and useful tool in disease assessment.In ventricular septal defect(VSD)patients with severe pulmonary hypertension(PH),it is difficult to judge whether further intervention is needed.Therefore,this study aimed to investigate the application of echocardiogram in predicting the severity of pulmonary hypertension and guide subsequent management.Methods This study included VSD patients who underwent right heart catheterization(RHC)examination in Guangdong Provincial People's Hospital from January2011 to December 2022.An estimated pulmonary artery systolic pressure(e PASP)higher than 60 mm Hg was defined as severe PH in this study.Logistic regression analysis and receiver operating characteristic curve(ROC)analysis were used.Results A total of 186 VSD patients with severe PH(e PASP more than 60 mm Hg)were included in this study,with 158 cases in the non-correctable group and 28 cases in the collectable group.In univariable logistic regression,left atrium dimension(LA),left ventricular end-diastolic dimension(LVDd),left ventricular end-systolic dimension(LVDs),peak velocity of the pulmonary valve(PV),peak velocities from the early phase of the mitral inflow(MVE),bidirectional shunting and pericardial effusion were associated with a correctable shunt.When adjusted in multivariable model,only PV and bidirectional shunting remained statistically significant.The ROC curve found that PV exhibits good discriminative ability for correctable shunt(AUC[area under the curve]:0.779,95%CI:0.676-0.871)with a cut-off value of 1.465 m/s.The predictive performance of bidirectional shunting was not satisfactory,with a low AUC of 0.669(95%CI:0.571-0.766).Conclusions PV and bidirectional shunting are simple and clinically available parameters from echocardiogram in predicting PH severity,which not only avoids the repeated unnecessary cardiac catheterization,but also provides a reference basis for follow-up evaluation.展开更多
文摘Sudden cardiac death(SCD)of an athlete is a rare but tragic event and sport activity might play a trigger role in athletes with underlying structural or electrical heart diseases.Preparticipation screenings(PPs)have been conceived for the potential to prevent SCD in young athletes by early identification of cardiac diseases.The European Society of Cardiology protocol for PPs includes history collection,physical examination and baseline electrocardiogram,while further examinations are reserved to individuals with abnormalities at first-line evaluation.Nevertheless,transthoracic echocardiography has been hypothesized to have a primary role in the PPs.This review aims to describe how to approach an athlete-focused echocardiogram,highlighting what is crucial to focus on for the different diseases(cardiomyopathies,valvulopathies,congenital heart disease,myocarditis and pericarditis)and when is needed to pay attention to overlap diagnostic zone(“grey zone”)with the athlete's heart.Once properly tested,focused echocardiography by sports medicine physicians may become standard practice in larger screening practices,potentially available during first-line evaluation.
基金Supported by The "East Carolina Heart Institute"
文摘An unknown aberrant f low in the right atrium observed on doppler with transesophageal echocardiogram(TEE) in a patient with prior coronary bypass. TEE revealed normal size left ventricle with severely dilated left atrium. There was moderate aortic regurgitation and moderate aortic stenosis noted. Patient was incidentally found to have an abnormal vascular communication noted to the right atrium. To further evaluate this f inding, the patient underwent cardiac magnetic resonance angiography which revealed that the tubular structure noted on TEE was actually a graft that was abutting onto the coronary sinus, and the f low anomaly was really the graft coming up and running adjacent to the coronary sinus.
文摘Three dimensional(3D)echocardiogram enables cardiologists to visua-lize suspicious cardiac structures in detail.In recent years,this three-dimensional echocardiogram carries important clinical value in virtual surgical simulation.However,this 3D echocardiogram involves a trade-off difficulty between accu-racy and efficient computation in clinical diagnosis.This paper presents a novel Flip Directional 3D Volume Reconstruction(FD-3DVR)method for the recon-struction of echocardiogram images.The proposed method consists of two main steps:multiplanar volumetric imaging and 3D volume reconstruction.In the crea-tion of multiplanar volumetric imaging,two-dimensional(2D)image pixels are mapped into voxels of the volumetric grid.As the obtained slices are discontin-uous,there are some missing voxels in the volume data.To restore the structural and textural information of 3D ultrasound volume,the proposed method creates a volume pyramid in parallel with theflip directional texture pyramid.Initially,the nearest neighbors of missing voxels in the multiplanar volumetric imaging are identified by 3D ANN(Approximate Nearest Neighbor)patch matching method.Furthermore,aflip directional texture pyramid is proposed and aggregated with distance in patch matching tofind out the most similar neighbors.In the recon-struction step,structural and textural information obtained from differentflip angle directions can reconstruct 3D volume well with the desired accuracy.Com-pared with existing 3D reconstruction methods,the proposed Flip Directional 3D Volume Reconstruction(FD-3DVR)method provides superior performance for the mean peak signal-to-noise ratio(40.538 for the proposed method I and 39.626 for the proposed method II).Experimental results performed on the cardi-ac datasets demonstrate the efficiency of the proposed method for the reconstruc-tion of echocardiogram images.
基金supported by the Guangdong Peak Project(No.DFJH201802)the National Natural Science Foundation of China(No.82371963)+1 种基金Guangdong Basic and Applied Basic Research Foundation(No.2021A1515012232/No.2023A1515011366)the Natural Science Foundation lauching fund of the Guangdong Provincial People's Hospital(No.8197070830/No.8207070477/No.8227070211)。
文摘Background Echocardiogram is a simple and useful tool in disease assessment.In ventricular septal defect(VSD)patients with severe pulmonary hypertension(PH),it is difficult to judge whether further intervention is needed.Therefore,this study aimed to investigate the application of echocardiogram in predicting the severity of pulmonary hypertension and guide subsequent management.Methods This study included VSD patients who underwent right heart catheterization(RHC)examination in Guangdong Provincial People's Hospital from January2011 to December 2022.An estimated pulmonary artery systolic pressure(e PASP)higher than 60 mm Hg was defined as severe PH in this study.Logistic regression analysis and receiver operating characteristic curve(ROC)analysis were used.Results A total of 186 VSD patients with severe PH(e PASP more than 60 mm Hg)were included in this study,with 158 cases in the non-correctable group and 28 cases in the collectable group.In univariable logistic regression,left atrium dimension(LA),left ventricular end-diastolic dimension(LVDd),left ventricular end-systolic dimension(LVDs),peak velocity of the pulmonary valve(PV),peak velocities from the early phase of the mitral inflow(MVE),bidirectional shunting and pericardial effusion were associated with a correctable shunt.When adjusted in multivariable model,only PV and bidirectional shunting remained statistically significant.The ROC curve found that PV exhibits good discriminative ability for correctable shunt(AUC[area under the curve]:0.779,95%CI:0.676-0.871)with a cut-off value of 1.465 m/s.The predictive performance of bidirectional shunting was not satisfactory,with a low AUC of 0.669(95%CI:0.571-0.766).Conclusions PV and bidirectional shunting are simple and clinically available parameters from echocardiogram in predicting PH severity,which not only avoids the repeated unnecessary cardiac catheterization,but also provides a reference basis for follow-up evaluation.
