European Heart Journal - Cardiovascular Imaging, 2020
Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through t... more Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF Ventriculo-arterial coupling (VAC) reflects the interaction between the ventricle and the arterial system and its prognostic role was studied in different clinical settings. VAC can be assessed with echocardiography as the ratio between the arterial elastance (Ea) and the end-systolic left ventricular elastance (EES). Data concerning the role of VAC in severe aortic stenosis (AS) are scarce. We aimed to determine VAC in patients (pts) with severe AS and assess its relationship with symptoms. We included 61 consecutive pts with severe AS (vave area < 1 cm2) and we divided them in 3 groups according to their symptoms: group A consisted of 28 pts (81 ± 10 yrs, 14 men) admitted for acute pulmonary edema, group B consisted of 25 pts (76 ± 12 yrs, 13 men) with either angina, syncope or dyspnea class I-III NYHA and group C consisted of 8 a...
European Heart Journal - Cardiovascular Imaging, 2020
Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through t... more Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF Background Previous studies demonstrated the role of left atrial (LA) deformation parameters in characterisation of left ventricular (LV) diastolic dysfunction. It is a marker of the severity of diastolic dysfunction; LA remodelling also proved to be a predictor of clinical outcome, therefore a prognostic marker in acute coronary syndromes. Purpose In this study we aimed to investigate the correlations between left atrial strain and conventional systolic and diastolic dysfunction parameters in a cohort of young patients with acute ST elevation myocardial infarction (STEMI) treated by primary PCI. Material and methods We included 56 consecutive patients in this study: 46 patients under 50 years of age with STEMI and 10 healthy age and sex matched controls. We performed conventional transthoracic echocardiography for all included patient...
European Heart Journal - Cardiovascular Imaging, 2020
Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through t... more Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF. Background Left ventricule (LV) function plays an important role in the pathophysiology of decompensation after acute ST elevation myocardial infarction (STEMI). LV remodeling (LVR) after STEMI is associated with development of heart failure, predicting poor clinical outcome therefore its identification is of clinical importance to set up preventive strategies. Prediction of the left ventricular remodeling (LVR) after STEMI in patients treated by primary PCI is challenging. Purpose Finding an echocardiographic parameter that can predict left ventricular remodeling in time after STEMI. Materials and methods In this prospective study we included 30 consecutive patients, median age 60 (37-79), 76% male, with STEMI treated by primary PCI. We performed conventional 2D transthoracic echocardiography for all included patients. In addition to...
European Heart Journal - Cardiovascular Imaging, 2020
Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through t... more Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF Background Echocardiographic assessment of diastolic dysfunction and left ventricular (LV) filling pressures is a complex and challenging process, requiring a multiparameter analysis. In recent years strain imaging has been emerging as a promising method for evaluation of left atrium (LA) function, being correlated with LV systolic dysfunction. Purpose We sought to evaluate LA mechanics in a cohort of patients with ischemic heart failure (HF) at one month after ST elevation myocardial infarction (STEMI) Material and methods 40 patients were enrolled in this study: 30 consecutive patients with ischemic HF after STEMI, with LVEF < 50% and 10 healthy age- and sex-matched controls. All patients had standard echocardiographic examination; also LA strain curves were obtained using speckle tracking with measurement of peak LA systolic stra...
European Heart Journal - Cardiovascular Imaging, 2020
Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through t... more Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF Background The prognostic value of LV function in the setting of an acute ST elevation myocardial infarction (STEMI) is well established, but data regarding the association between RV function and adverse events in this population of patients are still scarce, especially for the cases with anterior wall localization of necrosis. Two-dimensional speckle tracking echocardiography (STE) is able to detect subclinical changes in local or regional RV function. AIMS To evaluate the relation between STE parameters of RV global and regional function recorded 24 hours after admission and the occurrence of major non-fatal cardiovascular adverse events (MACE) in anterior STEMI patients treated by primary percutaneous intervention (PCI) Methods We have prospectively analyzed a cohort of 80 consecutive patients (mean age 61.17 years, 68.8% males) pr...
Background Right ventricular-pulmonary artery coupling (RVPAC) reflects the mechanical efficiency... more Background Right ventricular-pulmonary artery coupling (RVPAC) reflects the mechanical efficiency of the interaction between the right ventricle (RV) and the pulmonary circulation unit. Although it has been traditionally assessed with right heart catheterisation (RHC), modern imaging techniques enable the non-invasive estimation of the RVPAC, which proved to correlate well with measurements derived from RHC. Methods We used three-dimensional (3D) echocardiography to study 88 consecutive patients (60.4±13.4 years, 69 men) with dilated cardiomyopathy (DCM) and left ventricular ejection fraction<40% and we measured the RV volumes and RV ejection fraction (RVEF) using dedicated software. 15 healthy individuals served as controls. RVPAC was estimated non-invasively as the ratio between the RV end-systolic volume and stroke volume. Right-sided heart failure was defined as either elevated jugular venous pressure, pedal oedema or congestive hepatomegaly. Results Patients with DCM showed ...
Background: We aimed to evaluate whether right ventricle (RV) longitudinal strain indexed to pulm... more Background: We aimed to evaluate whether right ventricle (RV) longitudinal strain indexed to pulmonary arterial systolic pressure (PASP) has prognostic significance in patients undergoing cardiac resynchronization therapy (CRT). Methods: Patients undergoing CRT were prospectively included. The primary endpoint was adverse cardiovascular events (death and HF-related hospitalizations). RV global longitudinal strain (RVGLS) and RV free wall strain (RVfwS) were measured by speckle tracking and indexed to echocardiographic estimated PASP. Results: A total of 54 patients (64.0 ± 13.8 years; 58% male) were included. After 33 ± 12.9 months, the primary endpoint occurred in 18 patients. Baseline RVGLS/PASP and RVfwS/PASP showed good discriminative ability for response to CRT (AUC = 0.88, 95% CI (0.74–1) and AUC = 0.87, 95% CI (0.77–1)). RVGLS/PASP and RVfwS/PASP were significantly associated with high risk of events at univariate analysis (HR 0.039, 95% CI (0.001–0.8) p < 0.05, respective...
The pathophysiology of accelerated atherosclerosis in people living with Human Immunofediciency v... more The pathophysiology of accelerated atherosclerosis in people living with Human Immunofediciency virus (HIV) is complex. Coronary artery disease (CAD) has become an important cause of mortality in these patients. They often have atypical symptoms, leading to frequently missed diagnoses. We report a case of a 51-year-old male undergoing antiretroviral therapy who was admitted for acute coronary syndrome. He had severe coronary artery disease that involved difficult management.
Right ventricular – arterial (RV‐PA) coupling can be estimated by echocardiography using the rati... more Right ventricular – arterial (RV‐PA) coupling can be estimated by echocardiography using the ratio between (TAPSE) and pulmonary arterial systolic pressure (PASP). TAPSE/PASP ratio proved to be a prognostic parameter in patients with heart failure and reduced ejection fraction (HFrEF).
Hypertrophic cardiomyopathy (HCM) and arterial hypertension (HTN) are conditions with different p... more Hypertrophic cardiomyopathy (HCM) and arterial hypertension (HTN) are conditions with different pathophysiology, but both can result in left-ventricular hypertrophy (LVH). The role of left-atrial (LA) functional changes detected by two-dimensional speckle-tracking echocardiography (STE) in indicating LVH etiology is unknown. Methods: We aimed to characterize LA mechanics using STE in LVH patients with HCM and HTN. LA 2D volumetric and STE parameters were analyzed in 86 LVH patients (43 HCM and 43 isolated HTN subjects) and 33 age- and sex-matched controls. Results: The volumetric study showed that LA reservoir and conduit function were impaired in the HCM group compared to controls, while, in the HTN group, only LA conduit function was deteriorated. The HCM group had all three STE-derived LA functions impaired compared to controls. The HTN group, consistently with volumetric analysis, had solely LA conduit function reduced compared to controls. Ratios of LA booster-pump strain (S) a...
Pharmacological stress echocardiography (SE) in hypertensive patient with anterior thoracic pain ... more Pharmacological stress echocardiography (SE) in hypertensive patient with anterior thoracic pain (ATP) may reveal alteration of myocardial deformation, despite non-significant coronary artery disease (CAD). The objective of our study is to highlight the impact of hypertension (HT) on the myocardial strain under stress echocardiography in patients with normal epicardial coronary arteries but with angina. We evaluated myocardial deformation by global longitudinal strain (GLS) expressed through GLS18 segments, at each stage of dobutamine stress echocardiography. Patients with ATP at presentation, but without significant CAD at coronary angiography assessment were selected. The group of patients included was: 44 patients with mean age 54 years (9.5 years standard deviation), 63% women, 70% hypertensive patients. We obtained the following results: at the maximum dose of 40 mcg/Kg/min dobutamine we observed an alteration of GLS in the hypertensive versus non hypertensive patients (p=0.038...
Objectives of the study: We evaluated the prevalence of cardiac autonomic neuropathy (CAN) and it... more Objectives of the study: We evaluated the prevalence of cardiac autonomic neuropathy (CAN) and its potential as a prognostic marker in patients with right heart failure secondary to pulmonary arterial hypertension (PAH) in a pilot study. Furthermore, we investigated its correlation with the clinical status and a series of paraclinical parameters, and prognostic implications of this association. Methodology: 17 consecutive patients with PAH were evaluated in our study. The evaluation of CAN was realized by Holter ECG/24h monitoring with heart rate turbulence (HRT) and heart rate variability (HRV) analysis in time and frequency domains. Echocardiography was performed with focus on specific right heart parameters. All patients had previously undergone right heart catheterization with measurement of left ventricular filling pressure, pulmonary artery wedge pressure, right heart oxygen saturations and assessment of pulmonary hypertension. Conclusions: Our pilot study shows that a signifi...
The aim of this study was to assess right ventricular (RV) involvement in patients with acute ST-... more The aim of this study was to assess right ventricular (RV) involvement in patients with acute ST-segment elevation myocardial infarction before undergoing primary PCI and to evaluate the changes in RV function throughout hospitalization. Considering that patients with essential hypertension are majority, we also thought to assess if there are specific changes in RV function during acute ST elevation myocardial infarction in this category. 53 patients with a first acute myocardial infarction (MI) referred for primary PCI were included and prospectively analyzed. 32 of them (60.4%) had anterior and 21 (39.6%) had nonanterior MI, while 11 (20.8%) patients had signs of RV necrosis on the surface ECG. Serial echocardiograms were performed before PCI, 24 hours afterwards and at discharge. In order to accurately quantify RV function, we used a multi-parametric approach, with conventional as well as novel parameters derived from 2D strain echocardiography. Right ventricular myocardial perfo...
Valoarea cuantificãrii strainului longitudinal bidimensional în timpul ecocardiografiei de stres ... more Valoarea cuantificãrii strainului longitudinal bidimensional în timpul ecocardiografiei de stres în detectarea bolii coronariene la pacienåii cu sindrom coronarian acut cu risc scãzut – studiu pilot Obiective: Evaluarea deformãrii miocardice (strain longitudinal) în timpul ecocardiografiei de stres farmacologic. Pornind de la acest studiu pilot aducem în discuåie fiziopatologia æi rolul alterãrii strainului longitudinal în detectarea bolii coronariene ischemice. Metode: Studiul a inclus 10 pacienåi care s-au prezentat la camera de gardã pentru durere toracicã acutã stratificatã ca sindrom coronarian acut la risc scãzut pe baza scorului de risc GRACE. La 24 ore de la internare toåi pacienåii au fost evaluaåi prin ecocardiografie de stres utilizandu-se protocoale standardizate: 5 pacienåi au fost examinaåi cu dipiridamol, 5 cu dobutaminã-atropinã. Deformarea miocardicã longitudinalã a fost evaluatã prin metoda speckle tracking în repaus, la fiecare treaptã de stres æi în perioada de r...
The geometry of the left ventricle (LV) can be altered by many pathologies such as primary struct... more The geometry of the left ventricle (LV) can be altered by many pathologies such as primary structural disorders or secondary to hemodynamic conditions, with consequences to ventricular relaxation and contractility. Arterial hypertension is one of the most common causes of the left ventricular mass increase, secondary to afterload increase. Structural changes lead to subclinical alterations of contractility detectable through advanced echocardiographic techniques even in the absence of systolic dysfunction. In our study, we assessed the correlation between the changes of myocardial deformation and left ventricular mass evaluated by longitudinal strain. We performed transthoracic echocardiography to a cohort of 64 patients and assessed the LV mass and longitudinal strain using speckle tracking technique. Subsequently, all patients underwent coronary angiography to exclude significant coronary lesions. The results showed that patients with increased left ventricular mass had a more alt...
European Heart Journal - Cardiovascular Imaging, 2020
Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through t... more Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF Ventriculo-arterial coupling (VAC) reflects the interaction between the ventricle and the arterial system and its prognostic role was studied in different clinical settings. VAC can be assessed with echocardiography as the ratio between the arterial elastance (Ea) and the end-systolic left ventricular elastance (EES). Data concerning the role of VAC in severe aortic stenosis (AS) are scarce. We aimed to determine VAC in patients (pts) with severe AS and assess its relationship with symptoms. We included 61 consecutive pts with severe AS (vave area < 1 cm2) and we divided them in 3 groups according to their symptoms: group A consisted of 28 pts (81 ± 10 yrs, 14 men) admitted for acute pulmonary edema, group B consisted of 25 pts (76 ± 12 yrs, 13 men) with either angina, syncope or dyspnea class I-III NYHA and group C consisted of 8 a...
European Heart Journal - Cardiovascular Imaging, 2020
Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through t... more Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF Background Previous studies demonstrated the role of left atrial (LA) deformation parameters in characterisation of left ventricular (LV) diastolic dysfunction. It is a marker of the severity of diastolic dysfunction; LA remodelling also proved to be a predictor of clinical outcome, therefore a prognostic marker in acute coronary syndromes. Purpose In this study we aimed to investigate the correlations between left atrial strain and conventional systolic and diastolic dysfunction parameters in a cohort of young patients with acute ST elevation myocardial infarction (STEMI) treated by primary PCI. Material and methods We included 56 consecutive patients in this study: 46 patients under 50 years of age with STEMI and 10 healthy age and sex matched controls. We performed conventional transthoracic echocardiography for all included patient...
European Heart Journal - Cardiovascular Imaging, 2020
Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through t... more Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF. Background Left ventricule (LV) function plays an important role in the pathophysiology of decompensation after acute ST elevation myocardial infarction (STEMI). LV remodeling (LVR) after STEMI is associated with development of heart failure, predicting poor clinical outcome therefore its identification is of clinical importance to set up preventive strategies. Prediction of the left ventricular remodeling (LVR) after STEMI in patients treated by primary PCI is challenging. Purpose Finding an echocardiographic parameter that can predict left ventricular remodeling in time after STEMI. Materials and methods In this prospective study we included 30 consecutive patients, median age 60 (37-79), 76% male, with STEMI treated by primary PCI. We performed conventional 2D transthoracic echocardiography for all included patients. In addition to...
European Heart Journal - Cardiovascular Imaging, 2020
Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through t... more Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF Background Echocardiographic assessment of diastolic dysfunction and left ventricular (LV) filling pressures is a complex and challenging process, requiring a multiparameter analysis. In recent years strain imaging has been emerging as a promising method for evaluation of left atrium (LA) function, being correlated with LV systolic dysfunction. Purpose We sought to evaluate LA mechanics in a cohort of patients with ischemic heart failure (HF) at one month after ST elevation myocardial infarction (STEMI) Material and methods 40 patients were enrolled in this study: 30 consecutive patients with ischemic HF after STEMI, with LVEF < 50% and 10 healthy age- and sex-matched controls. All patients had standard echocardiographic examination; also LA strain curves were obtained using speckle tracking with measurement of peak LA systolic stra...
European Heart Journal - Cardiovascular Imaging, 2020
Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through t... more Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF Background The prognostic value of LV function in the setting of an acute ST elevation myocardial infarction (STEMI) is well established, but data regarding the association between RV function and adverse events in this population of patients are still scarce, especially for the cases with anterior wall localization of necrosis. Two-dimensional speckle tracking echocardiography (STE) is able to detect subclinical changes in local or regional RV function. AIMS To evaluate the relation between STE parameters of RV global and regional function recorded 24 hours after admission and the occurrence of major non-fatal cardiovascular adverse events (MACE) in anterior STEMI patients treated by primary percutaneous intervention (PCI) Methods We have prospectively analyzed a cohort of 80 consecutive patients (mean age 61.17 years, 68.8% males) pr...
Background Right ventricular-pulmonary artery coupling (RVPAC) reflects the mechanical efficiency... more Background Right ventricular-pulmonary artery coupling (RVPAC) reflects the mechanical efficiency of the interaction between the right ventricle (RV) and the pulmonary circulation unit. Although it has been traditionally assessed with right heart catheterisation (RHC), modern imaging techniques enable the non-invasive estimation of the RVPAC, which proved to correlate well with measurements derived from RHC. Methods We used three-dimensional (3D) echocardiography to study 88 consecutive patients (60.4±13.4 years, 69 men) with dilated cardiomyopathy (DCM) and left ventricular ejection fraction<40% and we measured the RV volumes and RV ejection fraction (RVEF) using dedicated software. 15 healthy individuals served as controls. RVPAC was estimated non-invasively as the ratio between the RV end-systolic volume and stroke volume. Right-sided heart failure was defined as either elevated jugular venous pressure, pedal oedema or congestive hepatomegaly. Results Patients with DCM showed ...
Background: We aimed to evaluate whether right ventricle (RV) longitudinal strain indexed to pulm... more Background: We aimed to evaluate whether right ventricle (RV) longitudinal strain indexed to pulmonary arterial systolic pressure (PASP) has prognostic significance in patients undergoing cardiac resynchronization therapy (CRT). Methods: Patients undergoing CRT were prospectively included. The primary endpoint was adverse cardiovascular events (death and HF-related hospitalizations). RV global longitudinal strain (RVGLS) and RV free wall strain (RVfwS) were measured by speckle tracking and indexed to echocardiographic estimated PASP. Results: A total of 54 patients (64.0 ± 13.8 years; 58% male) were included. After 33 ± 12.9 months, the primary endpoint occurred in 18 patients. Baseline RVGLS/PASP and RVfwS/PASP showed good discriminative ability for response to CRT (AUC = 0.88, 95% CI (0.74–1) and AUC = 0.87, 95% CI (0.77–1)). RVGLS/PASP and RVfwS/PASP were significantly associated with high risk of events at univariate analysis (HR 0.039, 95% CI (0.001–0.8) p < 0.05, respective...
The pathophysiology of accelerated atherosclerosis in people living with Human Immunofediciency v... more The pathophysiology of accelerated atherosclerosis in people living with Human Immunofediciency virus (HIV) is complex. Coronary artery disease (CAD) has become an important cause of mortality in these patients. They often have atypical symptoms, leading to frequently missed diagnoses. We report a case of a 51-year-old male undergoing antiretroviral therapy who was admitted for acute coronary syndrome. He had severe coronary artery disease that involved difficult management.
Right ventricular – arterial (RV‐PA) coupling can be estimated by echocardiography using the rati... more Right ventricular – arterial (RV‐PA) coupling can be estimated by echocardiography using the ratio between (TAPSE) and pulmonary arterial systolic pressure (PASP). TAPSE/PASP ratio proved to be a prognostic parameter in patients with heart failure and reduced ejection fraction (HFrEF).
Hypertrophic cardiomyopathy (HCM) and arterial hypertension (HTN) are conditions with different p... more Hypertrophic cardiomyopathy (HCM) and arterial hypertension (HTN) are conditions with different pathophysiology, but both can result in left-ventricular hypertrophy (LVH). The role of left-atrial (LA) functional changes detected by two-dimensional speckle-tracking echocardiography (STE) in indicating LVH etiology is unknown. Methods: We aimed to characterize LA mechanics using STE in LVH patients with HCM and HTN. LA 2D volumetric and STE parameters were analyzed in 86 LVH patients (43 HCM and 43 isolated HTN subjects) and 33 age- and sex-matched controls. Results: The volumetric study showed that LA reservoir and conduit function were impaired in the HCM group compared to controls, while, in the HTN group, only LA conduit function was deteriorated. The HCM group had all three STE-derived LA functions impaired compared to controls. The HTN group, consistently with volumetric analysis, had solely LA conduit function reduced compared to controls. Ratios of LA booster-pump strain (S) a...
Pharmacological stress echocardiography (SE) in hypertensive patient with anterior thoracic pain ... more Pharmacological stress echocardiography (SE) in hypertensive patient with anterior thoracic pain (ATP) may reveal alteration of myocardial deformation, despite non-significant coronary artery disease (CAD). The objective of our study is to highlight the impact of hypertension (HT) on the myocardial strain under stress echocardiography in patients with normal epicardial coronary arteries but with angina. We evaluated myocardial deformation by global longitudinal strain (GLS) expressed through GLS18 segments, at each stage of dobutamine stress echocardiography. Patients with ATP at presentation, but without significant CAD at coronary angiography assessment were selected. The group of patients included was: 44 patients with mean age 54 years (9.5 years standard deviation), 63% women, 70% hypertensive patients. We obtained the following results: at the maximum dose of 40 mcg/Kg/min dobutamine we observed an alteration of GLS in the hypertensive versus non hypertensive patients (p=0.038...
Objectives of the study: We evaluated the prevalence of cardiac autonomic neuropathy (CAN) and it... more Objectives of the study: We evaluated the prevalence of cardiac autonomic neuropathy (CAN) and its potential as a prognostic marker in patients with right heart failure secondary to pulmonary arterial hypertension (PAH) in a pilot study. Furthermore, we investigated its correlation with the clinical status and a series of paraclinical parameters, and prognostic implications of this association. Methodology: 17 consecutive patients with PAH were evaluated in our study. The evaluation of CAN was realized by Holter ECG/24h monitoring with heart rate turbulence (HRT) and heart rate variability (HRV) analysis in time and frequency domains. Echocardiography was performed with focus on specific right heart parameters. All patients had previously undergone right heart catheterization with measurement of left ventricular filling pressure, pulmonary artery wedge pressure, right heart oxygen saturations and assessment of pulmonary hypertension. Conclusions: Our pilot study shows that a signifi...
The aim of this study was to assess right ventricular (RV) involvement in patients with acute ST-... more The aim of this study was to assess right ventricular (RV) involvement in patients with acute ST-segment elevation myocardial infarction before undergoing primary PCI and to evaluate the changes in RV function throughout hospitalization. Considering that patients with essential hypertension are majority, we also thought to assess if there are specific changes in RV function during acute ST elevation myocardial infarction in this category. 53 patients with a first acute myocardial infarction (MI) referred for primary PCI were included and prospectively analyzed. 32 of them (60.4%) had anterior and 21 (39.6%) had nonanterior MI, while 11 (20.8%) patients had signs of RV necrosis on the surface ECG. Serial echocardiograms were performed before PCI, 24 hours afterwards and at discharge. In order to accurately quantify RV function, we used a multi-parametric approach, with conventional as well as novel parameters derived from 2D strain echocardiography. Right ventricular myocardial perfo...
Valoarea cuantificãrii strainului longitudinal bidimensional în timpul ecocardiografiei de stres ... more Valoarea cuantificãrii strainului longitudinal bidimensional în timpul ecocardiografiei de stres în detectarea bolii coronariene la pacienåii cu sindrom coronarian acut cu risc scãzut – studiu pilot Obiective: Evaluarea deformãrii miocardice (strain longitudinal) în timpul ecocardiografiei de stres farmacologic. Pornind de la acest studiu pilot aducem în discuåie fiziopatologia æi rolul alterãrii strainului longitudinal în detectarea bolii coronariene ischemice. Metode: Studiul a inclus 10 pacienåi care s-au prezentat la camera de gardã pentru durere toracicã acutã stratificatã ca sindrom coronarian acut la risc scãzut pe baza scorului de risc GRACE. La 24 ore de la internare toåi pacienåii au fost evaluaåi prin ecocardiografie de stres utilizandu-se protocoale standardizate: 5 pacienåi au fost examinaåi cu dipiridamol, 5 cu dobutaminã-atropinã. Deformarea miocardicã longitudinalã a fost evaluatã prin metoda speckle tracking în repaus, la fiecare treaptã de stres æi în perioada de r...
The geometry of the left ventricle (LV) can be altered by many pathologies such as primary struct... more The geometry of the left ventricle (LV) can be altered by many pathologies such as primary structural disorders or secondary to hemodynamic conditions, with consequences to ventricular relaxation and contractility. Arterial hypertension is one of the most common causes of the left ventricular mass increase, secondary to afterload increase. Structural changes lead to subclinical alterations of contractility detectable through advanced echocardiographic techniques even in the absence of systolic dysfunction. In our study, we assessed the correlation between the changes of myocardial deformation and left ventricular mass evaluated by longitudinal strain. We performed transthoracic echocardiography to a cohort of 64 patients and assessed the LV mass and longitudinal strain using speckle tracking technique. Subsequently, all patients underwent coronary angiography to exclude significant coronary lesions. The results showed that patients with increased left ventricular mass had a more alt...
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