Conventional echocardiography can sometimes pose a challenge to diagnosis due to sub-optimal images.Ultrasound contrast agents(UCAs)have been shown to drastically enhance imaging quality,particularly depicting the lef...Conventional echocardiography can sometimes pose a challenge to diagnosis due to sub-optimal images.Ultrasound contrast agents(UCAs)have been shown to drastically enhance imaging quality,particularly depicting the left ventricular endocardial borders.Their use during echocardiography has become a valuable tool in non-invasive diagnostics.UCAs provide higher-quality images that may ultimately reduce the length of hospital stays and improve patient care.The higher cost associated with UCAs in many situations has been an impediment to frequent use.However,when used as an initial diagnostic test,UCA during rest echocardiogram is more cost-effective than the traditional diagnostic approach,which frequently includes multiple tests and imaging studies to make an accurate diagnosis.They can be easily performed across multiple patient settings and provide optimal images that allow clinicians to make sound medical decisions.This consequently allows for better diagnostic accuracies and improvement in patient care.展开更多
Objective:To investigate the usefulness of the descending aortic retrograde flow area to forward flow area(dAO RF)ratio using echocardiography in managing pulmonary blood flow during the perioperative period following...Objective:To investigate the usefulness of the descending aortic retrograde flow area to forward flow area(dAO RF)ratio using echocardiography in managing pulmonary blood flow during the perioperative period following Blalock-Thomas-Taussig shunt(BTTS)surgery.Methods:This retrospective study analyzed patient characteristics,surgical procedures,and perioperative courses.The dAO RF ratio was measured upon admission to the pediatric intensive care unit(PICU)and 12,24,48,and 72 h post-surgery.Blood pressure,percutaneous oxygen saturation,arterial blood gas values,and lactate levels were measured at the same time as the dAO RF ratio.Results:Seventy-one cases were analyzed.Excessive and low pulmonary blood flow occurred in 17 and two patients,respectively.Four patients required resuscitation within 72 h post-surgery,due to excessive pulmonary blood flow.No deaths occurred within 72 h.The dAO RF ratio was significantly higher in patients with excessive pulmonary blood flow at PICU admission and at its maximum(p=0.049 and p<0.01,respectively).The maximum dAO RF ratio was significantly correlated with lactate levels when measured concurrently;however,there was clinical variability in the resuscitation cases.The dAO RF ratio cutoff of 0.61 was highly accurate(area under the receiver operating characteristic curve:0.91[95%confidence interval:0.82-1.00]),sensitive(82.4%),and specific(94.4%)for detecting excessive pulmonary blood flow.Conclusions:Measuring the dAO RF ratio postoperatively can prevent deterioration in patients with BTTS by accurately detecting excessive pulmonary blood flow,offering a minimally invasive and accurate assessment of perioperative pathophysiology.展开更多
Congenital atrial septal defect(ASD)with severe scoliosis is a rare compound malformation inchildren.Severe sco liosis should be corrected as soon as possible.The growth rod is suitable for patients withearly scoliosi...Congenital atrial septal defect(ASD)with severe scoliosis is a rare compound malformation inchildren.Severe sco liosis should be corrected as soon as possible.The growth rod is suitable for patients withearly scoliosis and obvious scoliosis under 10 years old.However,the fluoroscopic radiopaque of titaniumalloy plate will inevitably partly make the operative field of interventional occlusion blind.We presenta7-year-old Chinese girl with ASD and scoliosis who underwent spinal correction with a dual-growthrod.In this case,we performed transcatheter closure of ASD solely under the guidance of transthoracicechocardiography.Transthoracic echocardiography(TTE)has been reported as efficacious and safe forassessment and guidance of ASD occlusion.For patients with visual field occlusion under fluoroscopy,theapplication of TTE is efficacious and safe for assessmnent and guidance of ASD occlusion.展开更多
Epicardial adipose tissue(EAT)is an active form of visceral adipose tissue that can affect myocardial function due to shared circulation with the myocardium.Given its rapid metabolic activity,EAT is considered a poten...Epicardial adipose tissue(EAT)is an active form of visceral adipose tissue that can affect myocardial function due to shared circulation with the myocardium.Given its rapid metabolic activity,EAT is considered a potential therapeutic target for medications that modulate fat and is a potent marker of metabolic changes including those observed in diabetic cardiomyopathy.Recent investigations propose an association between EAT accumulation and chronic diseases such as type 2 diabetes mellitus(T2DM),atrial fibrillation,and heart failure with preserved ejection fraction.According to the method first described by Iacobellis et al,EAT thickness is identified as the echo-free space between the outer wall of the myocardium and the visceral layer of the pericardium,measured in the parasternal short-and long-axis views at end-systole using ultrasound.Ultrasound of EAT is a safe,cost-effective,and readily available tool for cardiometabolic risk assessment.This minireview investigates the current role of echocardiography in the assessment of EAT thickness in patients with T2DM,regardless of the presence of overt heart failure.We also discuss whether changes in EAT thickness may be used as a significant marker of disease progression and if delta EAT thickness could serve as a surrogate of effective therapy.展开更多
Patent foramen ovale(PFO)is a common congenital heart disorder associated with stroke,decompression sickness and migraine.Combining synchronized contrast transcranial Doppler with contrast transthoracic echocardiograp...Patent foramen ovale(PFO)is a common congenital heart disorder associated with stroke,decompression sickness and migraine.Combining synchronized contrast transcranial Doppler with contrast transthoracic echocardiography has important clinical significance and can improve the accuracy of detecting right-left shunts(RLSs)in patients with PFO.In this letter,regarding an original study presented by Yao et al,we present our insights and discuss how to better help clinicians evaluate changes in PFO-related RLS.展开更多
Objective:To investigate the evaluation value of cardiac color Doppler echocardiography(CDE)in assessing poor prognosis in patients with coronary atherosclerotic heart disease(CAD).Methods:A retrospective review was c...Objective:To investigate the evaluation value of cardiac color Doppler echocardiography(CDE)in assessing poor prognosis in patients with coronary atherosclerotic heart disease(CAD).Methods:A retrospective review was conducted of 106 patients with coronary artery disease(CAD)who were treated in the hospital’s cardiovascular department between January 2023 and June 2024.All participants received baseline comprehensive Doppler echocardiography(CDE)assessments.Based on whether they experienced a Major Adverse Cardiovascular Event(MACE)within one year of follow-up,the patients were categorized into either a MACE group or a non-MACE group.The study compared baseline clinical information and CDE parameters,specifically left ventricular ejection fraction(LVEF),wall motion score index(WMSI),and mitral annular E/e’ratio,between the two groups.Independent predictors of MACE were identified using multivariate logistic regression analysis.Results:A total of 29 out of the 106 patients experienced MACE during the oneyear follow-up.Compared with the non-MACE group,the MACE group had a higher prevalence of diabetes mellitus.In terms of CDE parameters,the MACE group had a lower LVEF than the non-MACE group(p<0.05),while WMSI,average E/e’,pulmonary artery systolic pressure(PASP),and mitral regurgitation(MR)proportion were all higher in the MACE group than in the non-MACE group(p<0.05).Multifactor logistic regression analysis revealed that after adjusting for confounding factors such as diabetes,WMSI(OR=3.003,95%CI:1.226–7.356,p=0.016)and mean E/e’(OR=1.281,95%CI:1.006–1.539,p=0.008)were independent predictors of the occurrence of major adverse cardiovascular events(MACE).Conclusion:WMSI and E/e’diagnosed by color Doppler echocardiography(CDE)hold significant and independent assessment value for predicting poor prognosis in patients with coronary artery disease(CAD).展开更多
Despite efforts to develop treatment technology for cardiac arrest (CA),CA incidence and mortality rates are still high.^([1,2])A recent study of CA patients in emergency departments revealed that the incidence of CA ...Despite efforts to develop treatment technology for cardiac arrest (CA),CA incidence and mortality rates are still high.^([1,2])A recent study of CA patients in emergency departments revealed that the incidence of CA is increasing annually,and the in-hospital survival rate of CA patients is only approximately 28.7%.^([3])Echocardiography has been widely used as an important monitoring tool in critical care and helps to identify the cause of shock,monitor hemodynamics,and guide fluid therapy utilization.^([4])One study reported that approximately one-third of patients underwent formal echocardiography during hospitalization in the intensive care unit (ICU).展开更多
Congenital heart disease(CHD)is the most common congenital anomaly and a major cause of death among fetal malformations,but prenatal diagnosis is considered to be low.The development of artificial intelligence(AI)in f...Congenital heart disease(CHD)is the most common congenital anomaly and a major cause of death among fetal malformations,but prenatal diagnosis is considered to be low.The development of artificial intelligence(AI)in fetal echocardiography has made it possible to automate and standardise the examination,improving the variation in CHD detection rates between different regions and reducing the reliance on operator experience.AI includes any computer program(algorithms and models)that mimics human logic and intelligence,and its use in fetal echocardiography is mainly to acquire and optimise images,perform automatic measurements,identify discrepant values,and diagnose and classify pathologies.In this review,we will look at the different practical applications of AI in fetal echocardiography.展开更多
Objective: To evaluate of the role of transesophageal echocardiography (TEE)in percutaneous closure of atrial septal defects (ASD) with the Amplatzer septal occluder. Methods:Sixty- two patients (10 to 55 years of age...Objective: To evaluate of the role of transesophageal echocardiography (TEE)in percutaneous closure of atrial septal defects (ASD) with the Amplatzer septal occluder. Methods:Sixty- two patients (10 to 55 years of age) were selected for percutaneous closure of ASD bytrans-esophageal echocardiography, which was also used to monitor the procedure, to select theappropriate size of the Amplatzer device, to verify its position, and to access the immediateresults of the procedure. During the follow-up, transthoracic echocardiography (TTE) or TEE was usedto evaluate the presence and magnitude of residual shunt (RS), device position, and right cardiacchamber diameters. Results: The mean ASD diameter by TTE ([19. 1 +- 5. 8] mm) was significantlysmaller (P< 0. 001) than the stretched diameter of the ASD (25. 1 +- 6. 4) mm. There are nosignificant differences between the TEE -measured value (23. 5+_6. 2) mm and the stretched diameterof the ASD (P > 0. 05). Due to proper patient selection all procedures were successful. There wasimmediate and complete closure in 61/62 patients, only one patients had trivial residual shunt.Follow- up was performed using TTE or TEE right after operation, 1 d, 1 month, 3 months, 6 monthsand yearly thereafter. Ail, patients remain asymptomatic without any clinical or technical problems.Conclusion: With the aid of TEE, percutaneous closure of ASD can be performed successfully, safely,and effectively.展开更多
BACKGROUND Unroofed coronary sinus syndrome(UCSS)is a rare congenital heart disease,which has variable morphologic features and is strongly associated with persistent left superior vena cava(PLSVC).However,it is often...BACKGROUND Unroofed coronary sinus syndrome(UCSS)is a rare congenital heart disease,which has variable morphologic features and is strongly associated with persistent left superior vena cava(PLSVC).However,it is often difficult to visualize the left-to-right shunt pathway through the CS by transthoracic echocardiography(TTE).CASE SUMMARY A 37-year-old female was admitted to the hepatological surgery department of a hospital with complaint of subxiphoid pain that had started 1 wk prior.Physical examination revealed a grade 3/6 systolic murmur at the left margin of the sternum,between the 2nd and 3rd intercostal cartilage.The patient underwent echocardiography and was diagnosed with ostium primum atrial septal defect(ASD);thus,she was subsequently transferred to the cardiovascular surgery department.A second TTE evaluation before surgery showed type IV UCSS with secundum ASD.Right-heart contrast echocardiography(RHCE)showed that the right atrium and right ventricle were immediately filled with microbubbles,but no microbubble was observed in the CS.Meanwhile,negative filling was observed at the right atrium orifice of the CS and right atrium side of the secundum atrial septal.RHCE identified UCSS combined with secundum ASD but without PLSVC in this patient.CONCLUSION This rare case of UCSS highlights the value of TTE combined with RHCE in confirming UCSS with ASD or PLSVC.展开更多
AIM To evaluate the long-term outcome of catheter ablation of atrial fibrillation(AF)facilitated by preprocedural threedimensional(3-D)transesophageal echocardiography.METHODS In 50 patients,3D transesophageal echocar...AIM To evaluate the long-term outcome of catheter ablation of atrial fibrillation(AF)facilitated by preprocedural threedimensional(3-D)transesophageal echocardiography.METHODS In 50 patients,3D transesophageal echocardiography(3D TEE)was performed immediately prior to an ablation procedure(paroxysmal AF:30 patients,persistent AF:20 patients).The images were available throughout the ablation procedure.Two different ablation strategies were used.In most of the patients with paroxysmal AF,the cryoablation technique was used(Arctic Front Balloon,Cryo Cath Technologies/Medtronic;group A2).In the other patients,a circumferential pulmonary vein ablation was performed using the CARTO system[Biosense Webster;group A1(paroxysmal AF),group B(persistent AF)].Success rates and complication rates were analysed at 4-year follow-up.RESULTS A 3D TEE could be performed successfully in all patients prior to the ablation procedure and all four pulmonaryvein ostia could be evaluated in 84%of patients.The image quality was excellent in the majority of patients and several variations of the pulmonary vein anatomy could be visualized precisely(e.g.,common pulmonary vein ostia,accessory pulmonary veins,varying diameter of the left atrial appendage and its distance to the left superior pulmonary vein).All ablation procedures could be performed as planned and almost all pulmonary veins could be isolated successfully.At 48-mo followup,68.0%of all patients were free from an arrhythmia recurrence(group A1:72.7%,group A2:73.7%,group B:60.0%).There were no major complications.CONCLUSION3 D TEE provides an excellent overview over the left atrial anatomy prior to AF ablation procedures and these procedures are associated with a favourable long-term outcome.展开更多
The present study evaluated the application of three dimensional echocardigraphy （3DE） in the diagnosis of atrial septal defect （ASD） and the measurement of its size by 3DE and compared the size with surgical find...The present study evaluated the application of three dimensional echocardigraphy （3DE） in the diagnosis of atrial septal defect （ASD） and the measurement of its size by 3DE and compared the size with surgical findings. Two-dimensional and real-time three dimensional echocardiography （RT3DE） was performed in 26 patients with atrial septal defect, and the echocardiographic data were compared with the surgical findings. Significant correlation was found between defect diameter by RT3DE and that measured during surgery （r=0.77, P〈0.001）. The defect area changed significantly during cardiac cycle. Percentage change in defect size during cardiac cycle ranged from 6%-70%. Our study showed that the size and morphology of atrial septal defect obtained with RT3DE correlate well with surgical findings. Therefore, RT3DE is a feasible and accurate non-invasive imaging tool for assessment of atrial septal size and dynamic changes.展开更多
BACKGROUND Endocardial fibroelastosis(EFE)is a rare heart disease characterized by thickening of the endocardium caused by massive proliferation of collagenous and elastic tissue,usually leading to impaired cardiac fu...BACKGROUND Endocardial fibroelastosis(EFE)is a rare heart disease characterized by thickening of the endocardium caused by massive proliferation of collagenous and elastic tissue,usually leading to impaired cardiac function.Multimodality cardiovascular imaging for the evaluation of EFE with thrombi is even rarer.CASE SUMMARY We report a rare case of EFE associated with multiple cardiovascular thrombi.Three-dimensional(3D)and contrast echocardiography(CE)were used to assess ventricular thrombi.Anticoagulant therapy was administered to eliminate the thrombi.The peripheral contrast-enhanced thrombi with the highest risk were dissolved with anticoagulant therapy at the time of reexamination,which was consistent with the presumption of fresh loose thrombi.CONCLUSION This new echocardiography technique has a great advantage in the diagnosis and treatment of EFE.On the basis of conventional echocardiography,3D echocardiography is used to display the position,shape,and narrow base of the thrombus.CE does not only help to confirm the diagnosis of thrombus,but also determines its risk.展开更多
The intubation of conventional transesophageal echocardiography（TEE） probes into patients causes serious esophagus irritation, and thus the use of TEE probes in pediatric practice is limited. In this study, we aimed...The intubation of conventional transesophageal echocardiography（TEE） probes into patients causes serious esophagus irritation, and thus the use of TEE probes in pediatric practice is limited. In this study, we aimed at the development of a special probe which could be inserted through the nasopharyngeal cavity into the esophagus to obtain the same high-quality echocardiography images as those obtained by conventional TEE and improve patients＇ experience. During the examination, the patients felt relaxed for a longer time and cooperated with the sonographers in the process of cardiac catheterization conducted in the surgery room or the intensive care unit（ICU）, resulting in improved accuracy of the diagnosis and timely administration of appropriate treatment. Two years ago, Prof. Xin-fang WANG put theories into practice by inserting the probe through the nasal cavity and pharynx into the esophagus of volunteers to successfully detect the heart and great vessels at the retrocardiac space. Later, Prof. Ming-xing XIE performed the transnasal TEE examination in 12 atrial septal defect（ASD） patients and proved the safety and reliability of this method, which could become a new way for clinical diagnosis and treatment.展开更多
Objective:To perform a meta-analysis to evaluate the diagnostic performance of computed tomography(CT) and transthoracic echocardiography(TTE) in complex congenital heart diseases(CHD) in China.Methods:MEDLINE,Cochran...Objective:To perform a meta-analysis to evaluate the diagnostic performance of computed tomography(CT) and transthoracic echocardiography(TTE) in complex congenital heart diseases(CHD) in China.Methods:MEDLINE,Cochrane library and China National Knowledge Infrastructure(CNKI) database from January 1966 to October 2010,were searched for initial studies in China.All the studies,published in English or Chinese,used TTE,CT,or both as diagnostic tests for CHD and reported the rate of true-positive,true-negative,false-positive and false-negative diagnoses of CHD from TTE and CT findings with the surgical results as the 'gold-standard'(15 studies,XX patients) were collected.The statistic software package,'Meta-Disc 1.4',was used to conduct data analysis.A covariate analysis was used to evaluate the influence of patient or study-related factors on sensitivity.Results:Pooled sensitivity for diagnosis of CHD were 95% [95% confidence interval(CI):94%~96%] for CT studies and 87%(95% CI:85%~88%) for TTE studies.The difference between the pooled sensitivity of CT and that of TTE was statistically significant(P<0.001).TTE had higher sensitivity [0.96(95% CI:0.94~0.97)] for cardiac malformation but lower sensitivity [0.78(95% CI:0.76~0.81)] for extracardiac malformation than CT.Conclusion:CT can provide added diagnostic information compared with TTE in patients with CHD in China,especially for patients suspected of extracardiac malformation.展开更多
The present study aimed to dynamically observe the segmental and global myocardial movements of the left ventricle during coronary artery bypass grafting by transesophageal speckle-tracking echocardiography,and to ass...The present study aimed to dynamically observe the segmental and global myocardial movements of the left ventricle during coronary artery bypass grafting by transesophageal speckle-tracking echocardiography,and to assess the effect of sevoflurane on cardiac function.Sixty-four patients scheduled for the off-pump coronary artery bypass grafting were randomly divided into a sevoflurane-based anesthesia(AS)group and a propofolbased total intravenous anesthesia(AA)group.The AS group demonstrated a higher absolute value of left ventricular global longitudinal strain than that of the AA group at both T1(after harvesting all grafts and before coronary anastomosis)and T_(2)(30 min after completing all coronary anastomoses)(P<0.05).Moreover,strain improvement in the segment with the highest preoperative strain was significantly reduced in the AS group,compared with the AA group at both T1 and T_(2)(P<0.01).The flow of the left internal mammary artery-left anterior descending artery graft was superior,and the postoperative concentration of troponin T decreased rapidly in the AS group,compared with the AA group(P<0.05).Compared with total intravenous anesthesia,sevoflurane resulted in a significantly higher global longitudinal strain,stroke volume,and cardiac output.Sevoflurane also led to an amelioration in the condition of the arterial graft.Furthermore,sevoflurane significantly reduced strain improvement in the segmental myocardium with a high preoperative strain value.The findings need to be replicated in larger studies.展开更多
One hundred and twenty-five patients with cardiovascular disease were examined by biplanar transesophageal echocardiography (BTEE), including 67 with rheumatic heart disease (7 monitored during operation), 22 with ao...One hundred and twenty-five patients with cardiovascular disease were examined by biplanar transesophageal echocardiography (BTEE), including 67 with rheumatic heart disease (7 monitored during operation), 22 with aortic diseases, 20 with congenital heart diseases. and 16 with other kinds of heart disease. The results showed that BTEE was not influenced by corpulent and pulmonary emphysema and was better than transthoracic echocardiography at imaging the interatrial septum, left atrium and left atrial appendage, thoracic aorta, and mitral artificial valve and at intraoperative monitoring. BTEE was also better than single-plane transesophageal echocardiography,because BTEE could be used to observe the heart and thoracic aorta in transverse and longitudinal planes, thus enlarging the transmission 'window' as well as allowing the entire lesion to be imaged.This study suggests that BTEE will have good prospects in clinical application.展开更多
One hundred and twenty-four patients with heart disease(75 cases of rheumatic heart disease,26 cases of congenital heart disease,13 cases of aortic disease and 10 cases of other disease)were examined by Omniplane tran...One hundred and twenty-four patients with heart disease(75 cases of rheumatic heart disease,26 cases of congenital heart disease,13 cases of aortic disease and 10 cases of other disease)were examined by Omniplane transesophageal echocardiography(TEE).The result showed that Omniplane TEE transducer can be rotated from 0°to 180°in probe and had the advantages of broader scope,obtaining more information,less stimulation to esophagus and easy to manipulate.It suggests that Omniplane TEE is a efficient technique in clinical diagnosis and can be extensively used in the future.展开更多
The authors report a case of Large Anterior mediastinal mass in which Transoesophageal Echocardiography (TEE) revealed a large mass that was compressing the right atrium, SVC, henceforth, TEE helped in guid</span&g...The authors report a case of Large Anterior mediastinal mass in which Transoesophageal Echocardiography (TEE) revealed a large mass that was compressing the right atrium, SVC, henceforth, TEE helped in guid</span><span style="font-size:10.0pt;font-family:"">ing</span><span style="font-size:10.0pt;font-family:""> aspiration and surgical resection of the cystic mass. Therefore, through this case report, <span>authors emphasize the importance of performing intraoperative real-time</span> TEE in the mediastinal mass. This imaging technique helps in visualizing the external compression of cardio-vascular structure and aid in their management, obviating the possibility of large vascular structures from being injured by the surgeon during intraoperative manipulation.展开更多
Echocardiography is the most common diagnostic method for assessing atrial function but the technique has some limitations. Traditionally, assessment of left atrial function has been performed by measuring volumes wit...Echocardiography is the most common diagnostic method for assessing atrial function but the technique has some limitations. Traditionally, assessment of left atrial function has been performed by measuring volumes with 2D echocardiography. Additionally, it can be assessed with transmitral Doppler and pulmonary vein Doppler. Recently, an alternative method has been incorporated, namely, measurement of myocardial deformation with color tissue Doppler-derived strain. However, this method has several limitations, such as suboptimal reproducibility, angle-dependence, signal artifacts and the fact that it only measures regional strain and does not obtain information about the curved portion of the atrial roof. To overcome these limitations in the quantification of atrial function, the use of speckle tracking echocardiography (STE) strain has been proposed. This technique is not derived from Doppler but rather from 2D echocardiography; it is angle-independent and allows one to measure global as well as regional atrial strain. In this editorial, we describe the physical and pathophysiological concepts of STE and underline the clinical usefulness of this new technique.展开更多
文摘Conventional echocardiography can sometimes pose a challenge to diagnosis due to sub-optimal images.Ultrasound contrast agents(UCAs)have been shown to drastically enhance imaging quality,particularly depicting the left ventricular endocardial borders.Their use during echocardiography has become a valuable tool in non-invasive diagnostics.UCAs provide higher-quality images that may ultimately reduce the length of hospital stays and improve patient care.The higher cost associated with UCAs in many situations has been an impediment to frequent use.However,when used as an initial diagnostic test,UCA during rest echocardiogram is more cost-effective than the traditional diagnostic approach,which frequently includes multiple tests and imaging studies to make an accurate diagnosis.They can be easily performed across multiple patient settings and provide optimal images that allow clinicians to make sound medical decisions.This consequently allows for better diagnostic accuracies and improvement in patient care.
文摘Objective:To investigate the usefulness of the descending aortic retrograde flow area to forward flow area(dAO RF)ratio using echocardiography in managing pulmonary blood flow during the perioperative period following Blalock-Thomas-Taussig shunt(BTTS)surgery.Methods:This retrospective study analyzed patient characteristics,surgical procedures,and perioperative courses.The dAO RF ratio was measured upon admission to the pediatric intensive care unit(PICU)and 12,24,48,and 72 h post-surgery.Blood pressure,percutaneous oxygen saturation,arterial blood gas values,and lactate levels were measured at the same time as the dAO RF ratio.Results:Seventy-one cases were analyzed.Excessive and low pulmonary blood flow occurred in 17 and two patients,respectively.Four patients required resuscitation within 72 h post-surgery,due to excessive pulmonary blood flow.No deaths occurred within 72 h.The dAO RF ratio was significantly higher in patients with excessive pulmonary blood flow at PICU admission and at its maximum(p=0.049 and p<0.01,respectively).The maximum dAO RF ratio was significantly correlated with lactate levels when measured concurrently;however,there was clinical variability in the resuscitation cases.The dAO RF ratio cutoff of 0.61 was highly accurate(area under the receiver operating characteristic curve:0.91[95%confidence interval:0.82-1.00]),sensitive(82.4%),and specific(94.4%)for detecting excessive pulmonary blood flow.Conclusions:Measuring the dAO RF ratio postoperatively can prevent deterioration in patients with BTTS by accurately detecting excessive pulmonary blood flow,offering a minimally invasive and accurate assessment of perioperative pathophysiology.
基金supported by the National Natural Science Foundation of China(82271725).
文摘Congenital atrial septal defect(ASD)with severe scoliosis is a rare compound malformation inchildren.Severe sco liosis should be corrected as soon as possible.The growth rod is suitable for patients withearly scoliosis and obvious scoliosis under 10 years old.However,the fluoroscopic radiopaque of titaniumalloy plate will inevitably partly make the operative field of interventional occlusion blind.We presenta7-year-old Chinese girl with ASD and scoliosis who underwent spinal correction with a dual-growthrod.In this case,we performed transcatheter closure of ASD solely under the guidance of transthoracicechocardiography.Transthoracic echocardiography(TTE)has been reported as efficacious and safe forassessment and guidance of ASD occlusion.For patients with visual field occlusion under fluoroscopy,theapplication of TTE is efficacious and safe for assessmnent and guidance of ASD occlusion.
文摘Epicardial adipose tissue(EAT)is an active form of visceral adipose tissue that can affect myocardial function due to shared circulation with the myocardium.Given its rapid metabolic activity,EAT is considered a potential therapeutic target for medications that modulate fat and is a potent marker of metabolic changes including those observed in diabetic cardiomyopathy.Recent investigations propose an association between EAT accumulation and chronic diseases such as type 2 diabetes mellitus(T2DM),atrial fibrillation,and heart failure with preserved ejection fraction.According to the method first described by Iacobellis et al,EAT thickness is identified as the echo-free space between the outer wall of the myocardium and the visceral layer of the pericardium,measured in the parasternal short-and long-axis views at end-systole using ultrasound.Ultrasound of EAT is a safe,cost-effective,and readily available tool for cardiometabolic risk assessment.This minireview investigates the current role of echocardiography in the assessment of EAT thickness in patients with T2DM,regardless of the presence of overt heart failure.We also discuss whether changes in EAT thickness may be used as a significant marker of disease progression and if delta EAT thickness could serve as a surrogate of effective therapy.
文摘Patent foramen ovale(PFO)is a common congenital heart disorder associated with stroke,decompression sickness and migraine.Combining synchronized contrast transcranial Doppler with contrast transthoracic echocardiography has important clinical significance and can improve the accuracy of detecting right-left shunts(RLSs)in patients with PFO.In this letter,regarding an original study presented by Yao et al,we present our insights and discuss how to better help clinicians evaluate changes in PFO-related RLS.
文摘Objective:To investigate the evaluation value of cardiac color Doppler echocardiography(CDE)in assessing poor prognosis in patients with coronary atherosclerotic heart disease(CAD).Methods:A retrospective review was conducted of 106 patients with coronary artery disease(CAD)who were treated in the hospital’s cardiovascular department between January 2023 and June 2024.All participants received baseline comprehensive Doppler echocardiography(CDE)assessments.Based on whether they experienced a Major Adverse Cardiovascular Event(MACE)within one year of follow-up,the patients were categorized into either a MACE group or a non-MACE group.The study compared baseline clinical information and CDE parameters,specifically left ventricular ejection fraction(LVEF),wall motion score index(WMSI),and mitral annular E/e’ratio,between the two groups.Independent predictors of MACE were identified using multivariate logistic regression analysis.Results:A total of 29 out of the 106 patients experienced MACE during the oneyear follow-up.Compared with the non-MACE group,the MACE group had a higher prevalence of diabetes mellitus.In terms of CDE parameters,the MACE group had a lower LVEF than the non-MACE group(p<0.05),while WMSI,average E/e’,pulmonary artery systolic pressure(PASP),and mitral regurgitation(MR)proportion were all higher in the MACE group than in the non-MACE group(p<0.05).Multifactor logistic regression analysis revealed that after adjusting for confounding factors such as diabetes,WMSI(OR=3.003,95%CI:1.226–7.356,p=0.016)and mean E/e’(OR=1.281,95%CI:1.006–1.539,p=0.008)were independent predictors of the occurrence of major adverse cardiovascular events(MACE).Conclusion:WMSI and E/e’diagnosed by color Doppler echocardiography(CDE)hold significant and independent assessment value for predicting poor prognosis in patients with coronary artery disease(CAD).
基金supported by China National High Level Hospital Clinical Research Funding (2022-PUMCH-B-110)。
文摘Despite efforts to develop treatment technology for cardiac arrest (CA),CA incidence and mortality rates are still high.^([1,2])A recent study of CA patients in emergency departments revealed that the incidence of CA is increasing annually,and the in-hospital survival rate of CA patients is only approximately 28.7%.^([3])Echocardiography has been widely used as an important monitoring tool in critical care and helps to identify the cause of shock,monitor hemodynamics,and guide fluid therapy utilization.^([4])One study reported that approximately one-third of patients underwent formal echocardiography during hospitalization in the intensive care unit (ICU).
文摘Congenital heart disease(CHD)is the most common congenital anomaly and a major cause of death among fetal malformations,but prenatal diagnosis is considered to be low.The development of artificial intelligence(AI)in fetal echocardiography has made it possible to automate and standardise the examination,improving the variation in CHD detection rates between different regions and reducing the reliance on operator experience.AI includes any computer program(algorithms and models)that mimics human logic and intelligence,and its use in fetal echocardiography is mainly to acquire and optimise images,perform automatic measurements,identify discrepant values,and diagnose and classify pathologies.In this review,we will look at the different practical applications of AI in fetal echocardiography.
文摘Objective: To evaluate of the role of transesophageal echocardiography (TEE)in percutaneous closure of atrial septal defects (ASD) with the Amplatzer septal occluder. Methods:Sixty- two patients (10 to 55 years of age) were selected for percutaneous closure of ASD bytrans-esophageal echocardiography, which was also used to monitor the procedure, to select theappropriate size of the Amplatzer device, to verify its position, and to access the immediateresults of the procedure. During the follow-up, transthoracic echocardiography (TTE) or TEE was usedto evaluate the presence and magnitude of residual shunt (RS), device position, and right cardiacchamber diameters. Results: The mean ASD diameter by TTE ([19. 1 +- 5. 8] mm) was significantlysmaller (P< 0. 001) than the stretched diameter of the ASD (25. 1 +- 6. 4) mm. There are nosignificant differences between the TEE -measured value (23. 5+_6. 2) mm and the stretched diameterof the ASD (P > 0. 05). Due to proper patient selection all procedures were successful. There wasimmediate and complete closure in 61/62 patients, only one patients had trivial residual shunt.Follow- up was performed using TTE or TEE right after operation, 1 d, 1 month, 3 months, 6 monthsand yearly thereafter. Ail, patients remain asymptomatic without any clinical or technical problems.Conclusion: With the aid of TEE, percutaneous closure of ASD can be performed successfully, safely,and effectively.
文摘BACKGROUND Unroofed coronary sinus syndrome(UCSS)is a rare congenital heart disease,which has variable morphologic features and is strongly associated with persistent left superior vena cava(PLSVC).However,it is often difficult to visualize the left-to-right shunt pathway through the CS by transthoracic echocardiography(TTE).CASE SUMMARY A 37-year-old female was admitted to the hepatological surgery department of a hospital with complaint of subxiphoid pain that had started 1 wk prior.Physical examination revealed a grade 3/6 systolic murmur at the left margin of the sternum,between the 2nd and 3rd intercostal cartilage.The patient underwent echocardiography and was diagnosed with ostium primum atrial septal defect(ASD);thus,she was subsequently transferred to the cardiovascular surgery department.A second TTE evaluation before surgery showed type IV UCSS with secundum ASD.Right-heart contrast echocardiography(RHCE)showed that the right atrium and right ventricle were immediately filled with microbubbles,but no microbubble was observed in the CS.Meanwhile,negative filling was observed at the right atrium orifice of the CS and right atrium side of the secundum atrial septal.RHCE identified UCSS combined with secundum ASD but without PLSVC in this patient.CONCLUSION This rare case of UCSS highlights the value of TTE combined with RHCE in confirming UCSS with ASD or PLSVC.
文摘AIM To evaluate the long-term outcome of catheter ablation of atrial fibrillation(AF)facilitated by preprocedural threedimensional(3-D)transesophageal echocardiography.METHODS In 50 patients,3D transesophageal echocardiography(3D TEE)was performed immediately prior to an ablation procedure(paroxysmal AF:30 patients,persistent AF:20 patients).The images were available throughout the ablation procedure.Two different ablation strategies were used.In most of the patients with paroxysmal AF,the cryoablation technique was used(Arctic Front Balloon,Cryo Cath Technologies/Medtronic;group A2).In the other patients,a circumferential pulmonary vein ablation was performed using the CARTO system[Biosense Webster;group A1(paroxysmal AF),group B(persistent AF)].Success rates and complication rates were analysed at 4-year follow-up.RESULTS A 3D TEE could be performed successfully in all patients prior to the ablation procedure and all four pulmonaryvein ostia could be evaluated in 84%of patients.The image quality was excellent in the majority of patients and several variations of the pulmonary vein anatomy could be visualized precisely(e.g.,common pulmonary vein ostia,accessory pulmonary veins,varying diameter of the left atrial appendage and its distance to the left superior pulmonary vein).All ablation procedures could be performed as planned and almost all pulmonary veins could be isolated successfully.At 48-mo followup,68.0%of all patients were free from an arrhythmia recurrence(group A1:72.7%,group A2:73.7%,group B:60.0%).There were no major complications.CONCLUSION3 D TEE provides an excellent overview over the left atrial anatomy prior to AF ablation procedures and these procedures are associated with a favourable long-term outcome.
基金supported by a grant from the Youth Science Foundation of China (No.30600213)
文摘The present study evaluated the application of three dimensional echocardigraphy （3DE） in the diagnosis of atrial septal defect （ASD） and the measurement of its size by 3DE and compared the size with surgical findings. Two-dimensional and real-time three dimensional echocardiography （RT3DE） was performed in 26 patients with atrial septal defect, and the echocardiographic data were compared with the surgical findings. Significant correlation was found between defect diameter by RT3DE and that measured during surgery （r=0.77, P〈0.001）. The defect area changed significantly during cardiac cycle. Percentage change in defect size during cardiac cycle ranged from 6%-70%. Our study showed that the size and morphology of atrial septal defect obtained with RT3DE correlate well with surgical findings. Therefore, RT3DE is a feasible and accurate non-invasive imaging tool for assessment of atrial septal size and dynamic changes.
基金Supported by National Natural Science Foundation of China,No.81571686.
文摘BACKGROUND Endocardial fibroelastosis(EFE)is a rare heart disease characterized by thickening of the endocardium caused by massive proliferation of collagenous and elastic tissue,usually leading to impaired cardiac function.Multimodality cardiovascular imaging for the evaluation of EFE with thrombi is even rarer.CASE SUMMARY We report a rare case of EFE associated with multiple cardiovascular thrombi.Three-dimensional(3D)and contrast echocardiography(CE)were used to assess ventricular thrombi.Anticoagulant therapy was administered to eliminate the thrombi.The peripheral contrast-enhanced thrombi with the highest risk were dissolved with anticoagulant therapy at the time of reexamination,which was consistent with the presumption of fresh loose thrombi.CONCLUSION This new echocardiography technique has a great advantage in the diagnosis and treatment of EFE.On the basis of conventional echocardiography,3D echocardiography is used to display the position,shape,and narrow base of the thrombus.CE does not only help to confirm the diagnosis of thrombus,but also determines its risk.
基金supported by the Natural Science Foundation of Hubei Province(No.2016CFB229)
文摘The intubation of conventional transesophageal echocardiography（TEE） probes into patients causes serious esophagus irritation, and thus the use of TEE probes in pediatric practice is limited. In this study, we aimed at the development of a special probe which could be inserted through the nasopharyngeal cavity into the esophagus to obtain the same high-quality echocardiography images as those obtained by conventional TEE and improve patients＇ experience. During the examination, the patients felt relaxed for a longer time and cooperated with the sonographers in the process of cardiac catheterization conducted in the surgery room or the intensive care unit（ICU）, resulting in improved accuracy of the diagnosis and timely administration of appropriate treatment. Two years ago, Prof. Xin-fang WANG put theories into practice by inserting the probe through the nasal cavity and pharynx into the esophagus of volunteers to successfully detect the heart and great vessels at the retrocardiac space. Later, Prof. Ming-xing XIE performed the transnasal TEE examination in 12 atrial septal defect（ASD） patients and proved the safety and reliability of this method, which could become a new way for clinical diagnosis and treatment.
文摘Objective:To perform a meta-analysis to evaluate the diagnostic performance of computed tomography(CT) and transthoracic echocardiography(TTE) in complex congenital heart diseases(CHD) in China.Methods:MEDLINE,Cochrane library and China National Knowledge Infrastructure(CNKI) database from January 1966 to October 2010,were searched for initial studies in China.All the studies,published in English or Chinese,used TTE,CT,or both as diagnostic tests for CHD and reported the rate of true-positive,true-negative,false-positive and false-negative diagnoses of CHD from TTE and CT findings with the surgical results as the 'gold-standard'(15 studies,XX patients) were collected.The statistic software package,'Meta-Disc 1.4',was used to conduct data analysis.A covariate analysis was used to evaluate the influence of patient or study-related factors on sensitivity.Results:Pooled sensitivity for diagnosis of CHD were 95% [95% confidence interval(CI):94%~96%] for CT studies and 87%(95% CI:85%~88%) for TTE studies.The difference between the pooled sensitivity of CT and that of TTE was statistically significant(P<0.001).TTE had higher sensitivity [0.96(95% CI:0.94~0.97)] for cardiac malformation but lower sensitivity [0.78(95% CI:0.76~0.81)] for extracardiac malformation than CT.Conclusion:CT can provide added diagnostic information compared with TTE in patients with CHD in China,especially for patients suspected of extracardiac malformation.
基金supported by Jiangsu Province Hospital(the First Affiliated Hospital of Nanjing Medical University)Clinical Capacity Enhancement and was awarded to the first author,Chanjuan Gong(Grant No.JSPH-MC-2022-4).
文摘The present study aimed to dynamically observe the segmental and global myocardial movements of the left ventricle during coronary artery bypass grafting by transesophageal speckle-tracking echocardiography,and to assess the effect of sevoflurane on cardiac function.Sixty-four patients scheduled for the off-pump coronary artery bypass grafting were randomly divided into a sevoflurane-based anesthesia(AS)group and a propofolbased total intravenous anesthesia(AA)group.The AS group demonstrated a higher absolute value of left ventricular global longitudinal strain than that of the AA group at both T1(after harvesting all grafts and before coronary anastomosis)and T_(2)(30 min after completing all coronary anastomoses)(P<0.05).Moreover,strain improvement in the segment with the highest preoperative strain was significantly reduced in the AS group,compared with the AA group at both T1 and T_(2)(P<0.01).The flow of the left internal mammary artery-left anterior descending artery graft was superior,and the postoperative concentration of troponin T decreased rapidly in the AS group,compared with the AA group(P<0.05).Compared with total intravenous anesthesia,sevoflurane resulted in a significantly higher global longitudinal strain,stroke volume,and cardiac output.Sevoflurane also led to an amelioration in the condition of the arterial graft.Furthermore,sevoflurane significantly reduced strain improvement in the segmental myocardium with a high preoperative strain value.The findings need to be replicated in larger studies.
文摘One hundred and twenty-five patients with cardiovascular disease were examined by biplanar transesophageal echocardiography (BTEE), including 67 with rheumatic heart disease (7 monitored during operation), 22 with aortic diseases, 20 with congenital heart diseases. and 16 with other kinds of heart disease. The results showed that BTEE was not influenced by corpulent and pulmonary emphysema and was better than transthoracic echocardiography at imaging the interatrial septum, left atrium and left atrial appendage, thoracic aorta, and mitral artificial valve and at intraoperative monitoring. BTEE was also better than single-plane transesophageal echocardiography,because BTEE could be used to observe the heart and thoracic aorta in transverse and longitudinal planes, thus enlarging the transmission 'window' as well as allowing the entire lesion to be imaged.This study suggests that BTEE will have good prospects in clinical application.
文摘One hundred and twenty-four patients with heart disease(75 cases of rheumatic heart disease,26 cases of congenital heart disease,13 cases of aortic disease and 10 cases of other disease)were examined by Omniplane transesophageal echocardiography(TEE).The result showed that Omniplane TEE transducer can be rotated from 0°to 180°in probe and had the advantages of broader scope,obtaining more information,less stimulation to esophagus and easy to manipulate.It suggests that Omniplane TEE is a efficient technique in clinical diagnosis and can be extensively used in the future.
文摘The authors report a case of Large Anterior mediastinal mass in which Transoesophageal Echocardiography (TEE) revealed a large mass that was compressing the right atrium, SVC, henceforth, TEE helped in guid</span><span style="font-size:10.0pt;font-family:"">ing</span><span style="font-size:10.0pt;font-family:""> aspiration and surgical resection of the cystic mass. Therefore, through this case report, <span>authors emphasize the importance of performing intraoperative real-time</span> TEE in the mediastinal mass. This imaging technique helps in visualizing the external compression of cardio-vascular structure and aid in their management, obviating the possibility of large vascular structures from being injured by the surgeon during intraoperative manipulation.
文摘Echocardiography is the most common diagnostic method for assessing atrial function but the technique has some limitations. Traditionally, assessment of left atrial function has been performed by measuring volumes with 2D echocardiography. Additionally, it can be assessed with transmitral Doppler and pulmonary vein Doppler. Recently, an alternative method has been incorporated, namely, measurement of myocardial deformation with color tissue Doppler-derived strain. However, this method has several limitations, such as suboptimal reproducibility, angle-dependence, signal artifacts and the fact that it only measures regional strain and does not obtain information about the curved portion of the atrial roof. To overcome these limitations in the quantification of atrial function, the use of speckle tracking echocardiography (STE) strain has been proposed. This technique is not derived from Doppler but rather from 2D echocardiography; it is angle-independent and allows one to measure global as well as regional atrial strain. In this editorial, we describe the physical and pathophysiological concepts of STE and underline the clinical usefulness of this new technique.
