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2. Poster Session 4: Friday 9 December 2011, 14:00-18:00 * Location: Poster Area

Author

M. Wang, G. Yan, W. Yue, C. Siu, H. Tse, A. Perperidis, D. Cusack, A. White, T. Macgillivray, W. Mcdicken, T. Anderson, V. Ryabov, V. Shurupov, T. Suslova, V. Markov, N. Elmstedt, K. Ferm Widlund, B. Lind, L.-A. Brodin, M. Westgren, F. Mantovani, A. Barbieri, F. Bursi, C. Valenti, M. Quaglia, M. Modena, D. Peluso, D. Muraru, L. Dal Bianco, M. Beraldo, E. Solda', M. Tuveri, U. Cucchini, A. Al Mamary, L. Badano, S. Iliceto, A. Goncalves, C. Almeria, P. Marcos-Alberca, G. Feltes, R. Hernandez-Antolin, H. Rodriguez, L. Maroto, J. Silva Cardoso, C. Macaya, J. Zamorano, S. Squarciotta, F. Innocenti, A. Guzzo, S. Bianchi, D. Lazzeretti, E. De Villa, S. Vicidomini, B. Del Taglia, C. Donnini, R. Pini, C. Mennie, A. M. Salmasi, V. Kutyifa, V. Nagy, E. Edes, A. Apor, B. Merkely, S. Nyrnes, L. Lovstakken, H. Torp, B. Haugen, K. Said, A. Shehata, Z. Ashour, S. El-Tobgy, M. Cameli, E. Bigio, M. Lisi, F. Righini, F. Franchi, S. Scolletta, S. Mondillo, E. Gayat, L. Weinert, C. Yodwut, V. Mor-Avi, R. Lang, N. Hrynchyshyn, N. Kachenoura, B. Diebold, R. Khedim, M. Senesi, A. Redheuil, E. Mousseaux, L. Perdrix, S. Yurdakul, V. Erdemir, Y. Tayyareci, K. Memic, O. Yildirimturk, V. Aytekin, M. Gurel, S. Aytekin, L. Gargani, C. Fernandez Cimadevilla, S. La Falce, P. Landi, E. Picano, R. Sicari, M. K. Smedsrud, J. Gravning, C. Eek, L. Morkrid, H. Skulstad, L. Aaberge, B. Bendz, J. Kjekshus, T. Edvardsen, G. Bajraktari, V. Hyseni, B. Morina, A. Batalli, R. Tafarshiku, R. Olloni, M. Henein, O. Mjolstad, S. Snare, L. Folkvord, F. Helland, O. Haraldseth, A. Grimsmo, M. Berry, O. Zaghden, J. Nahum, L. Macron, O. Lairez, T. Damy, A. Bensaid, J. Dubois Rande, P. Gueret, P. Lim, N. Nciri, Z. Issaoui, C. Tlili, I. Wanes, H. Foudhil, F. Dachraoui, J. Grapsa, D. Dawson, P. Nihoyannopoulos, L. Gianturco, M. Turiel, F. Atzeni, P. Sarzi-Puttini, D. Stella, L. Donato, L. Tomasoni, P. Jung, M. Mueller, T. Huber, G. Sevilmis, F. Kroetz, H. Sohn, V. Panoulas, A. Bratsas, R. Raso, G. Tartarisco, G. Pioggia, P. Gargiulo, M. Petretta, A. Cuocolo, M. Prastaro, C. D'amore, E. Vassallo, G. Savarese, C. Marciano, S. Paolillo, P. Perrone Filardi, C. Aggeli, I. Felekos, G. Roussakis, E. Poulidakis, P. Pietri, K. Toutouzas, C. Stefanadis, A. Kaladaridis, I. Skaltsiotis, G. Kottis, D. Bramos, D. Takos, I. Matthaios, I. Agrios, E. Papadopoulou, S. Moulopoulos, S. Toumanidis, P. Carrilho-Ferreira, N. Cortez-Dias, C. Jorge, D. Silva, J. Silva Marques, R. Placido, L. Santos, S. Ribeiro, M. Fiuza, F. Pinto, V. Stoickov, S. Ilic, M. Deljanin Ilic, W. Kim, J. Woo, J. Bae, K. Kim, M. Descalzo, J. Rodriguez, S. Moral, I. Otaegui, P. Mahia, L. Garcia Del Blanco, T. Gonzalez Alujas, J. Figueras, A. Evangelista, D. Garcia-Dorado, M. Takeuchi, K. Kaku, K. Otani, M. Iwataki, H. Kuwaki, N. Haruki, H. Yoshitani, Y. Otsuji, M. Kukucka, M. Pasic, A. Unbehaun, S. Dreysse, A. Mladenow, H. Kuppe, R. Hetzer, N. Rajamannan, A. Tanrikulu, L. Kristiansson, S. Gustafsson, K. Lindmark, M. Y. Henein, C. Evdoridis, P. Stougiannos, M. Thomopoulos, M. Fosteris, P. Spanos, G. Sionis, D. Giatsios, A. Paschalis, C. Sakellaris, A. Trikas, Z. Y. Yong, K. Boerlage-Van Dijk, K. Koch, M. Vis, B. Bouma, J. Piek, J. Baan, L. Abid, Z. Frikha, K. Makni, N. Maazoun, D. Abid, M. Hentati, S. Kammoun, P. Barbier, A. Staron, C. Cefalu', G. Berna, P. Gripari, D. Andreini, G. Pontone, M. Pepi, L. Ring, B. Rana, S. Ho, F. Wells, A. Dogan, O. Karaca, G. Guler, E. Guler, H. Gunes, E. Alizade, H. Agus, G. Gol, O. Esen, A. Esen, M. Turkmen, E. Agricola, G. Ingallina, M. Ancona, S. Maggio, M. Slavich, V. Tufaro, M. Oppizzi, A. Margonato, C. Orsborne, B. Irwin, K. Pearce, S. Ray, C. Garcia Alonso, N. Vallejo, C. Labata, J. Lopez Ayerbe, A. Teis, E. Ferrer, R. Nunez Aragon, F. Gual, M. Pedro Botet, A. Bayes Genis, C. M. Santos, M. Carvalho, M. Andrade, H. Dores, S. Madeira, G. Cardoso, A. Ventosa, C. Aguiar, R. Ribeiras, M. Mendes, M. Petrovic, G. Milasinovic, B. Vujisic-Tesic, I. Nedeljkovic, D. Zamaklar-Trifunovic, I. Petrovic, G. Draganic, M. Banovic, M. Boricic, H. Villarraga, C. Molini-Griggs Bs, P. Silen-Rivera Bs, B. Payne Mph Ms, Y. Koshino Md Phd, J. Hsiao Md, V. Monivas Palomero, S. Mingo Santos, C. Mitroi, I. Garcia Lunar, P. Garcia Pavia, V. Castro Urda, J. Toquero, J. Gonzalez Mirelis, M. Cavero Gibanel, I. Fernandez Lozano, Z. Oko-Sarnowska, H. Wachowiak-Baszynska, A. Katarzynska-Szymanska, O. Trojnarska, S. Grajek, D. Bellavia, P. Pellikka, A. Dispenzieri, J. K. Oh, V. Polizzi, F. Pitrolo, F. Musumeci, F. Miller, R. Ancona, S. Comenale Pinto, P. Caso, S. Severino, C. Cavallaro, F. Vecchione, A. D'onofrio, R. Calabro', A. M. Maceira Gonzalez, C. Ripoll, J. Cosin-Sales, B. Igual, J. Salazar, V. Belloch, J. Cosin-Aguilar, B. Pinamonti, A. Iorio, M. Bobbo, M. Merlo, G. Barbati, L. Massa, G. Faganello, A. Di Lenarda, G. F. Sinagra, T. Ishizu, Y. Seo, M. Enomoto, Y. Kameda, N. Ishibashi, M. Inoue, K. Aonuma, A. Saleh, A. Matsumori, H. Negm, H. Fouad, A. Onsy, E. Hamodraka, I. Paraskevaidis, M. Kallistratos, V. Lezos, T. Zamfir, C. Manetos, D. Mavropoulos, L. Poulimenos, D. Kremastinos, A. Manolis, R. Citro, F. Rigo, Q. Ciampi, M. Patella, G. Provenza, C. Zito, E. Tagliamonte, F. Rotondi, F. Silvestri, E. Bossone, P. Beltran Correas, C. Gutierrez Landaluce, M. Gomez Bueno, J. Segovia Cubero, C. Beladan, F. Matei, B. Popescu, A. Calin, M. Rosca, A. Boanta, R. Enache, O. Savu, C. Usurelu, C. Ginghina, A. O. Ciobanu, R. Dulgheru, S. Magda, R. Dragoi, M. Florescu, D. Vinereanu, S. Robalo Martins, C. Calisto, S. Goncalves, I. Barrigoto, J. Carvalho De Sousa, A. Almeida, A. Nunes Diogo, L. Sargento, M. Satendra, C. Sousa, N. Lousada, R. Palma Reis, V. Schiano Lomoriello, R. Esposito, A. Santoro, R. Raia, P. Schiattarella, E. Dores, M. Galderisi, N. Mansencal, V. Caille, A. Dupland, S. Perrot, K. Bouferrache, A. Vieillard-Baron, R. Jouffroy, P. Moceri, E. Liodakis, M. Gatzoulis, W. Li, K. Dimopoulos, M. Sadron, P. E. Seguela, B. Arnaudis, Y. Dulac, T. Cognet, P. Acar, Y. Shiina, H. Uemura, K. Kupczynska, J. Kasprzak, B. Michalski, P. Lipiec, V. Carvalho, A. M. G. Almeida, C. David, J. Marques, P. Ferreira, M. Amaro, P. Costa, A. Diogo, V. Tritakis, I. Ikonomidis, J. Lekakis, S. Tzortzis, N. Kadoglou, I. Papadakis, P. Trivilou, C. Koukoulis, M. Anastasiou-Nana, T. Bombardini, S. Gherardi, G. Arpesella, M. Maccherini, W. Serra, G. Magnani, R. Del Bene, E. Pasanisi, U. Startari, L. Panchetti, A. Rossi, M. Piacenti, M. Morales, I. El Hajjaji, R. El Mahmoud, F. Digne, O. Dubourg, G. Agoston, A. Moreo, L. Pratali, A. Moggi Pignone, A. Pavellini, M. Doveri, F. Musca, A. Varga, F. Faita, S. Rimoldi, C. Sartori, Y. Alleman, C. Salinas Salmon, M. Villena, U. Scherrer, R. Baptista, S. Serra, G. Castro, R. Martins, M. Salvador, P. Monteiro, J. Silva, L. Szudi, A. Temesvary, B. Fekete, I. Kassai, L. Szekely, S. S. Abdel Moneim, M. Martinez, S. Mankad, M. Bernier, A. Dhoble, K. Chandrasekaran, J. Oh, S. Mulvagh, G. R. Hong, J. Y. Kim, S. C. Lee, S. H. Choi, I. S. Sohn, H. S. Seo, J. H. Choi, K. I. Cho, S. J. Yoon, S. J. Lim, P. Wejner-Mik, J. Kusmierek, A. Plachcinska, R. Szuminski, S. Stoebe, A. Tarr, T. Trache, A. Hagendorff, C. Jenkins, H. Kuhl, H. Nesser, T. Marwick, A. Franke, J. Niel, L. Sugeng, S. Soderberg, P. Lindqvist, J. Necas, S. Kovalova, S. K. Saha, A. Kiotsekoglou, R. Toole, S. Govind, A. Gopal, M.-S. Amzulescu, A. Florian, J. Bogaert, S. Janssens, J. Voigt, V. Parisi, M. Losi, L. Parrella, C. Contaldi, E. Chiacchio, A. Caputi, A. Scatteia, A. Buonauro, S. Betocchi, R. Rimbas, S. Mihaila, M. Caputo, R. Navarri, P. Innelli, R. Urselli, E. Capati, P. Ballo, F. Furiozzi, R. Favilli, R. Lindquist, A. Miller, C. Reece, P. O'leary, F. Cetta, B. W. Eidem, M. Cikes, H. Gasparovic, B. Bijnens, V. Velagic, T. Kopjar, B. Biocina, D. Milicic, A. Ta-Shma, A. Nir, Z. Perles, S. Gavri, J. Golender, A. Rein, G. Pinnacchio, L. Barone, I. Battipaglia, A. Cosenza, L. Marinaccio, I. Coviello, G. Scalone, A. Sestito, G. Lanza, F. Crea, S. Cakal, E. Eroglu, B. Ozkan, S. Kulahcioglu, M. Bulut, A. Koyuncu, G. Acar, G. Alici, C. Dundar, F. Labombarda, E. Zangl, A. Pellissier, D. Bougle, P. Maragnes, P. Milliez, E. Saloux, S. Lagoudakou, E. Gialafos, A. Tsokanis, A. Nagy, T. Kovats, H. Vago, A. Toth, B. Sax, A. Kovacs, M. F. Elnoamany, H. Badran, I. Abdelfattah, T. Khalil, M. Salama, T. Butz, C. Taubenberger, F. Thangarajah, A. Meissner, M. Van Bracht, M. Prull, H. Yeni, G. Plehn, H. Trappe, R. Rydman, D. Bone, M. Alam, K. Caidahl, F. Larsen, Z. Gasior, Z. Tabor, P. Sengupta, D. Liu, M. Niemann, K. Hu, S. Herrmann, S. Stoerk, C. Morbach, S. Knop, W. Voelker, G. Ertl, F. Weidemann, P. Cawley, C. Hamilton-Craig, L. Mitsumori, J. Maki, C. Otto, M. Astrom Aneq, E. Nylander, T. Ebbers, J. Engvall, P. Arvanitis, F. Flachskampf, O. Duvernoy, F. De Torres Alba, S. Valbuena Lopez, G. Guzman Martinez, J. Gomez De Diego, J. Rey Blas, E. Armada Romero, E. Lopez De Sa, M. Moreno Yanguela, J. Lopez Sendon, N. Trikalinos, G. Siasos, A. Aggeli, A. Tomaszewski, A. Kutarski, M. Tomaszewski, O. Vriz, C. Driussi, M. Bettio, D. Pavan, F. Antonini Canterin, A. Doltra Magarolas, J. Fernandez-Armenta, E. Silva, N. Solanes, M. Rigol, A. Barcelo, L. Mont, A. Berruezo, J. Brugada, M. Sitges, F. L. Ciciarello, S. Mandolesi, F. Fedele, L. Agati, A. Marceca, S. Rhee, S. Shin, S. Kim, K. Yun, N. Yoo, N. Kim, S. Oh, J. Jeong, and N. Alabdulkarim

Subjects
education.field_of_study, medicine.medical_specialty, business.industry, Multiple sclerosis, Population, Hemodynamics, General Medicine, Cerebro, medicine.disease, Internal medicine, Cardiology, Medicine, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, education, business
Published
2011

6. Moderated Poster Sessions 1: Valvular heart disease: from bench to bedside * Thursday 8 December 2011, 08:30-12:30 * Location: Moderated Poster Area

Author

M. Weber, R. Schueler, D. Momcilovic, J. Sinning, A. Ghanem, N. Werner, G. Nickenig, C. Hammerstingl, B. Sun, K. Hwang, M. Cho, W. Lee, S. Choi, Y.-G. Kim, D.-H. Kim, J.-M. Song, D.-H. Kang, J.-K. Song, R. Capoulade, M. Clavel, J. Dumesnil, K. Chan, J. Tam, K. Teo, N. Cote, P. Mathieu, J. Despres, P. Pibarot, L. Macron, P. Lim, A. Bensaid, J. Nahum, D. Attias, D. Messika Zeitoun, J. Dubois Rande, P. Gueret, J. Monin, T. Le Tourneau, A. Lardeux, A. Garcia, F. Kyndt, J. Merot, A. Hagege, R. Levine, J. Schott, H. La Marec, V. Probst, K. Niki, M. Sugawara, I. Takamisawa, H. Watanabe, T. Sumiyoshi, S. Hosoda, S. Takanashi, F. Veronesi, E. Caiani, L. Fusini, G. Tamborini, L. Sugeng, F. Alamanni, M. Pepi, R. Lang, P. Gripari, M. Muratori, N. Ajmone Marsan, S. Hooi Ewe, C. Arnold, F. Van Der Kley, J. Bax, J. Adda, C. Mielot, F. Cransac, X. Zirphile, P. Reant, C. Sportouch-Dukhan, S. Lafitte, E. Donal, P. Lancellotti, G. Habib, O. Akbar Ali, M. Chapman, T. Nguyen, Y. Chirkov, and J. Horowitz

Subjects
medicine.medical_specialty, business.industry, Thursday, valvular heart disease, medicine, Physical therapy, Radiology, Nuclear Medicine and imaging, General Medicine, Cardiology and Cardiovascular Medicine, medicine.disease, business, Bench to bedside
Published
2011

16. Automated detection of left ventricular wall motion abnormalities from real-time 3D echocardiographic images: comparison with magnetic resonance imaging

Author

CORSI, CRISTIANA, L. Sugeng, H. J. Nesser, L. Weinert, J. Niel, C. Ebner, R. Steringer Mascherbauer F. Schmidt, G. Schummers, V. Mor Avi, R. M. Lang, C. Corsi, L. Sugeng, H.J. Nesser, L. Weinert, J. Niel, C. Ebner, R. Steringer-Mascherbauer F. Schmidt, G. Schummer, V. Mor-Avi, and R.M. Lang

Subjects
real-time 3D echocardiography, regional wall motion abnormalitie, automated analysis
Published
2005

17. Improved Semi-Automated Quantification of Left Ventricular Volumes and Ejection Fraction using Three-Dimensional Echocardiography with a Full-matrix Array Transducer: Comparison with MRI

Author

E. G. Caiani, J. Zamorano, L. Sugeng, P. MacEneaney, L. Weinert, R. Battani, J. L. Gutierrez, R. Koch, L. Perez Isla, V. Mor Avi, R. M. Lang, CORSI, CRISTIANA, E. G. Caiani, C. Corsi, J. Zamorano, L. Sugeng, P. MacEneaney, L. Weinert, R. Battani, J. L. Gutierrez, R. Koch, L. Perez Isla, V. Mor-Avi, and R. M. Lang

Subjects
LV function, real time 3D echocardiography
Abstract

Our goals were to: (1) develop a technique for 3-dimensional (3D) direct, model-independent quantitative assessment of left ventricular (LV) volume and ejection fraction based on semiautomated detection of LV endocardial surface from transthoracic near real-time full matrix-array 3D echocardiographic (FM3DE) imaging; (2) evaluate the accuracy of LV volumes obtained with this technique, using cardiac magnetic resonance imaging (MRI) measurements as the reference for comparison; and (3) determine the effects of contrast enhancement on the accuracy of FM3DE measurements. A total of 46 patients underwent 2-dimensional echocardiography, FM3DE, and cardiac MRI. End-diastolic volume, end-systolic volume, and ejection fraction were derived from endocardial borders manually traced from 2-dimensional echocardiographic images and from semiautomatically detected LV cavity from FM3DE data. In 14 patients, FM3DE was also acquired with contrast. All measurements were compared with MRI values using linear regression and Bland-Altman analyses. FM3DE was feasible in 44 of 46 patients with LV volumes < 345 mL. LV volumes and ejection fraction computed from FM3DE resulted in higher levels of agreement with MRI than conventional 2-dimensional echocardiography, with lower interobserver variability. With contrast enhancement, FM3DE significantly underestimated LV volumes and showed increased interobserver variability. Semiautomated LV endocardial surface detection from FM3DE images is feasible and results in fast and accurate assessment of LV function

Published
2005

21. Real-Time Three-Dimensional Echocardiographic Quantification of Regional Left Ventricular Function: Validation by Magnetic Resonance Imaging

Author

CORSI, CRISTIANA, L. Sugeng, H. J. Nesser, L. Weinert, J. Niel, C. Ebner, R. Steringer Mascherbauer, F. Schmidt, G. Schummers, V. Mor Avi, R. M. Lang, C. Corsi, L. Sugeng, H.J. Nesser, L. Weinert, J. Niel, C. Ebner, R. Steringer-Mascherbauer, F. Schmidt, G. Schummer, V. Mor-Avi, and R.M. Lang

Subjects
wall motion, regional LV function, real-time 3D echocardiography
Published
2005

22. Real-time three-dimensional echocardiographic quantification of left ventricular volumes using a rapid tissue tracking algorithm

Author

L. D. Jacobs, I. S. Salgo, S. Goonewardena, L. Sugeng, L. Weinert, P. D. Coon, D. Bardo, O. Gerard, E. Toledo, V. Mor Avi, R. M. Lang, CORSI, CRISTIANA, L.D. Jacob, I.S. Salgo, S. Goonewardena, L. Sugeng, L. Weinert, P.D.Coon, D. Bardo, O. Gerard, E. Toledo, C. Corsi, V. Mor-Avi, and R.M. Lang

Subjects
real-time 3D echocardiography, LV volume, tissue tracking
Published
2005

26. Semi-automatic surface detection for quantification of left ventricular volumes and mass by real-time three dimensional echocardiography

Author

E. Caiani, L. Sugeng, L. Weinert, R. Battani, V. Mor Avi, R. M. Lang, CORSI, CRISTIANA, H.U. LEMKE, K. INAMURA, K. DOI, A.G. FARMAN, M.W. VANNIER AND J.H.C. REIBER, E. Caiani, C. Corsi, L. Sugeng, L. Weinert, R. Battani, V. Mor-Avi, and R.M. Lang

Subjects
cardiac ma, cardiac magnetic resonance imaging, left ventricular volume
Abstract

Two-dimensional echocardiographic (2DE) assessment of LV function is based on extrapolation of manually traced endocardial borders using geometric modeling. Real-time 3D (RT3D) echocardiography, which does not rely on geometrical assumptions, could potentially provide more accurate measurements. The aim of this study was to use MRI measurements of enddiastolic (EDV) and end-systolic (ESV) LV volumes, ejection fraction (EF), and LV mass to validate a novel semi-automated endocardial and epicardial surface detection technique from (RT3D) images, acquired with a full-matrix array transducer in consecutive patients. Thirteen patients underwent RT3D and cardiac MRI. EDV, ESV and EF were derived from the semi-automatically detected LV cavity from RT3D data. All measurements were compared to MRI values using linear regression and Bland-Altman analyses. RT3D was feasible in all patients and resulted in high correlations with MRI (r, EDV: 0.91; ESV: 0.94; EF: 0.95, LV mass: 0.84). RT3DE also showed a small bias and narrow limits of agreement with MRI (bias ± 2SD , EDV: - 0.6±27.8 ml; ESV: 0.7±15.1 ml; EF: -0.8±8.9 %; LV mass:1.2±37 g). Semi-automated LV endocardial and epicardial surface detection from RT3D images is feasible in consecutive patients and results in fast and accurate assessment of LV dimensions and mass.

Published
2004

28. Feasibility of real-time 3D echocardiography in weightlessness during parabolic flight

Author

E G, Caiani, L, Sugeng, L, Weinert, S, Husson, O, Bailliart, A, Capderou, R M, Lang, and P, Vaida

Subjects
Adult, Weightlessness, Heart Ventricles, Posture, Aerospace Medicine, Echocardiography, Three-Dimensional, Feasibility Studies, Humans, Heart Atria, Hypergravity, Middle Aged, Space Flight, Gravitation
Abstract

Aim of the study was to test the feasibility of transthoracic real-time 3D (Philips) echocardiography (RT3D) during parabolic flight, to allow direct measurement of heart chambers volumes modifications during the parabola. One RT3D dataset corresponding to one cardiac cycle was acquired at each gravity phase (1 Gz, 1.8 Gz, 0 Gz, 1.8 Gz) during breath-hold in 8 unmedicated normal subjects (41 +/- 8 years old) in standing upright position. Preliminary results, obtained by semi-automatically tracing left ventricular (LV) and left atrial (LA) endocardial contours in multiple views (Tomtec), showed a significant (p0.05) reduction, compared to 1 Gz, of LV and LA volumes with 1.8 Gz, and a significant increase with 0 Gz. Further analysis will focus on the right heart.

Published
2005

31. A study of functional anatomy of aortic-mitral valve coupling using 3D matrix transesophageal echocardiography

Author

Enrico G. Caiani, Victor Mor-Avi, Federico Veronesi, Claudio Lamberti, Lynn Weinert, Roberto M. Lang, Cristiana Corsi, Lissa Sugeng, F. Veronesi, C. Corsi, L. Sugeng, V. Mor-Avi, E.G. Caiani, L. Weinert, C. Lamberti, and R.M. Lang.

Subjects
Aortic valve, Adult, Male, medicine.medical_specialty, Echocardiography, Three-Dimensional, Internal medicine, Mitral valve, medicine, Humans, Radiology, Nuclear Medicine and imaging, Cardiac skeleton, Systole, Isovolumetric contraction, Aged, Cardiac cycle, business.industry, Middle Aged, Coupling (electronics), medicine.anatomical_structure, Aortic Valve, Functional anatomy, cardiovascular system, Cardiology, Mitral Valve, Female, Cardiology and Cardiovascular Medicine, business, Echocardiography, Transesophageal
Abstract

Background— Mitral and aortic valves are known to be coupled via fibrous tissue connecting the two annuli. Previous studies evaluating this coupling have been limited to experimental animals using invasive techniques. The new matrix array transesophageal transducer provides high-resolution real-time 3D images of both valves simultaneously. We sought to develop and test a technique for quantitative assessment of mitral and aortic valve dynamics and coupling. Methods and Results— Matrix array transesophageal (Philips iE33) imaging was performed in 24 patients with normal valves who underwent clinically indicated transesophageal echocardiography. Custom software was used to detect and track the mitral and aortic annuli in 3D space throughout the cardiac cycle, allowing automated measurement of changes in mitral and aortic valve morphology. Mitral annulus surface area and aortic annulus projected area changed reciprocally over time. Mitral annulus surface area was 8.0�2.1 cm 2 at end-diastole and decreased to 7.7�2.1 cm 2 in systole, reaching its maximum (10.0�2.2 cm 2 ) at mitral valve opening. Aortic annulus projected area was 4.1�1.2 cm 2 at end-diastole, then increased during isovolumic contraction reaching its maximum (4.8�1.3 cm 2 ) in the first third of systole and its minimum (3.6�1.0 cm 2 ) during isovolumic relaxation. The angle between the mitral and aortic annuli was maximum (136�13�) at end-diastole and decreased to its minimum value (129�11�) during systole. Conclusions— This is the first study to report quantitative 3D assessment of the mitral and aortic valve dynamics from matrix array transesophageal images and describe the mitral-aortic coupling in a beating human heart. This ability may have impact on patient evaluation for valvular surgical interventions and prosthesis design.

Published
2009

32. Semi-automatic detection and tracking of mitral and aortic annuli from real-time 3D transesophageal echocardiographic images

Author

Claudio Lamberti, L. Weinert, Federico Veronesi, Enrico G. Caiani, Victor Mor-Avi, Cristiana Corsi, R.M. Lang, Lissa Sugeng, F. Veronesi, C. Corsi, V. Mor-Avi, L. Sugeng, E.G. Caiani, L. Weinert, C. Lamberti, and R.M. Lang

Subjects
Cardiac cycle, business.industry, Optical flow, Initialization, Tracking (particle physics), Transducer, Position (vector), Temporal resolution, cardiovascular system, Computer vision, Annulus (zoology), Artificial intelligence, business, Mathematics
Abstract

The recently developed echocardiographic matrix array transesophageal (mTEE) transducer provides real-time 3D images of high spatial and temporal resolution that may be suitable for detailed simultaneous study of functional anatomy of the mitral and aortic valves. We developed software that detects and tracks throughout the cardiac cycle mitral and aortic annuli (MA and AoA) and tested it in 15 patients with normal valves. Following manual initialization of each annulus in 15 planes rotated around the valvepsilas axis, the position of each annulus was tracked using a two-step 3D feature tracking algorithm based on maximum likelihood and Lucas-Kanade optical flow techniques and parameters of valve geometry were automatically measured throughout the cardiac cycle. Frame-by-frame detection and tracking of MA and AoA was possible in all patients. This approach allowed for the first time non-invasive quantitative measurements of the 3D dynamic geometry of normal MA and AoA and their coupling from mTEE data.

Published
2008

33. Quantification of Mitral Apparatus Dynamics in Functional and Ischemic Mitral Regurgitation Using Real-Time 3D Echocardiography

Author

Sergio Cerutti, Enrico G. Caiani, Cristiana Corsi, Roberto M. Lang, Federico Veronesi, Victor Mor-Avi, Lynn Weinert, Lissa Sugeng, Claudio Lamberti, F. Veronesi, C. Corsi, L. Sugeng, E.G. Caiani, L. Weinert, V. Mor-Avi, S. Cerutti, C. Lamberti, and R.M. Lang

Subjects
Male, medicine.medical_specialty, Echocardiography, Three-Dimensional, Myocardial Ischemia, Sensitivity and Specificity, mitral apparatus dynamics, Computer Systems, Internal medicine, Image Interpretation, Computer-Assisted, medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Papillary muscle, 3 dimensional echocardiography, Mitral regurgitation, Ischemic cardiomyopathy, Cardiac cycle, Ischemic mitral regurgitation, business.industry, Mitral Valve Insufficiency, Reproducibility of Results, Dilated cardiomyopathy, Middle Aged, medicine.disease, medicine.anatomical_structure, Ventricle, Cardiology, cardiovascular system, Mitral Valve, Female, real-time 3D echocardiography, Cardiology and Cardiovascular Medicine, business
Abstract

Mitral regurgitation (MR) in dilated cardiomyopathy (DCM-MR) and MR in ischemic cardiomyopathy (ISC-MR) usually occurs as a result of mitral annulus (MA) dilatation and papillary muscle displacement secondary to global left ventricle remodelling. We propose a method to determine MA area and motion throughout the cardiac cycle and to define papillary muscle position in 3-dimensional space using real-time 3-dimensional echocardiography. Real-time 3-dimensional echocardiography was performed in 24 healthy individuals, and in 30 patients with DCM-MR (n = 15) or ISC-MR (n = 15). Significant intergroup differences were noted in MA surface area (control: 6.4 +/- 1.7 cm(2); DCM-MR: 11.1 +/- 2.6 cm(2); ISC-MR: 9.0 +/- 2.0 cm(2)) and in peak MA motion (control: 8.7 +/- 3.0 mm; DCM-MR: 3.4 +/- 1.7 mm; ISC-MR: 4.9 +/- 1.5 mm). In patients with DCM-MR, papillary muscle symmetry was preserved, whereas in patients with ISC-MR, papillary tethering lengths were unequal as a result of wall-motion abnormalities. Our methodology for dynamic volumetric measurements of the mitral apparatus allows better understanding of MR mechanisms.

Published
2008

34. Improved quantification of left ventricular mass based on endo- and epicardial surface detection using real-time three-dimensional echocardiography

Author

Lissa Sugeng, Peter MacEneaney, Lynn Weinert, Roberto M. Lang, Enrico G. Caiani, Cristiana Corsi, Victor Mor-Avi, E. G. Caiani, C. Corsi, L. Sugeng, L. Weinert, V. Mor-Avi, and R. M. Lang

Subjects
Surface (mathematics), Male, Heart Ventricles, Echocardiography, Three-Dimensional, Image processing, Cardiovascular Medicine, computer.software_genre, Three-dimensional space, Magnetic resonance angiography, Left ventricular mass, image processing, real-time 3D echocardiography, Level set, Voxel, medicine, Humans, Observer Variation, medicine.diagnostic_test, business.industry, Three dimensional echocardiography, Magnetic resonance imaging, Heart, Middle Aged, Feasibility Studies, Female, Cardiology and Cardiovascular Medicine, Nuclear medicine, business, computer, Magnetic Resonance Angiography
Abstract

Objective: To develop a technique for volumetric analysis of real time three dimensional echocardiography (RT3DE) data aimed at quantifying left ventricular (LV) mass and to validate the technique against magnetic resonance (MR) assumed as the reference standard. Design: RT3DE, which has recently become widely available, provides dynamic pyramidal data structures that encompass the entire heart and allows four dimensional assessment of cardiac anatomy and function. However, analysis techniques for the quantification of LV mass from RT3DE data are fundamentally two dimensional, rely on geometric modelling, and do not fully exploit the volumetric information contained in RT3DE datasets. Twenty one patients underwent two dimensional echocardiography (2DE), RT3DE, and cardiac MR. LV mass was measured from 2DE and MR images by conventional techniques. RT3DE data were analysed to semiautomatically detect endocardial and epicardial LV surfaces by the level set approach. From the detected surfaces, LV mass was computed directly in the three dimensional space as voxel counts. Results: RT3DE measurement was feasible in 19 of 21 patients and resulted in higher correlation with MR ( r = 0.96) than did 2DE ( r = 0.79). RT3DE measurements also had a significantly smaller bias (−2.1 g) and tighter limits of agreement (2SD = ±23 g) with MR than did the 2DE values (bias (2SD) −34.9 (50) g). Additionally, interobserver variability of RT3DE (12.5%) was significantly lower than that of 2DE (24.1%). Conclusions: Direct three dimensional model independent LV mass measurement from RT3DE images is feasible in the clinical setting and provides fast and accurate assessment of LV mass, superior to the two dimensional analysis techniques.

Published
2006

35. Quantification of Regional Left Ventricular Function from Real-Time 3D Echocardiography in Patients with Poor Acoustic Windows: Effects of Contrast Enhancement Tested Against Cardiac Magnetic Resonance

Author

Cristiana Corsi, Lynn Weinert, Sascha Goonewardena, Roberto M. Lang, Tamar S. Polonsky, Federico Veronesi, Dianna M. E. Bardo, Victor Mor-Avi, Claudio Lamberti, Lissa Sugeng, Enrico G. Caiani, Patrick D. Coon, C. Corsi, P. Coon, S. Goonewardena, L. Weinert, L. Sugeng, T. S. Polonsky, F. Veronesi, E. G. Caiani, C. Lamberti, D. Bardo, R. M. Lang, and V. Mor-Avi

Subjects
Male, medicine.medical_specialty, Contrast enhancement, Image quality, Movement, media_common.quotation_subject, Echocardiography, Three-Dimensional, Sensitivity and Specificity, Ventricular Dysfunction, Left, Computer Systems, Internal medicine, Image Interpretation, Computer-Assisted, Humans, Medicine, Contrast (vision), Radiology, Nuclear Medicine and imaging, In patient, media_common, Left ventricular wall motion, Intravenous contrast, 3 dimensional echocardiography, business.industry, Myocardium, Reproducibility of Results, Middle Aged, Magnetic Resonance Imaging, Myocardial Contraction, Echocardiography, Cardiology, Feasibility Studies, Female, Cardiology and Cardiovascular Medicine, business, Nuclear medicine, Cardiac magnetic resonance
Abstract

Objective Regional left ventricular function can be assessed by real-time 3-dimensional echocardiography (RT3DE) in patients with good image quality. Our goals were to: (1) test the feasibility of RT3DE quantification of regional wall motion (RWM) in patients with poor acoustic windows who require contrast for endocardial visualization; and (2) validate these measurements against cardiac magnetic resonance (CMR) reference. Methods RT3DE datasets and CMR images were obtained in 24 patients. In 16 of 24 patients with suboptimal endocardial definition, RT3DE imaging was repeated with intravenous contrast and triggering at end systole and end diastole. RT3DE datasets were analyzed using custom software designed to semiautomatically detect and segment the endocardial surface and calculate RWM values. CMR images were analyzed using commercial software to obtain reference values for RWM. Results In 8 of 24 patients with good endocardial definition, RT3DE values of RWM correlated well with CMR ( r = 0.73) with a small bias (−1.0 mm). In the remaining 16 patients, analysis of nonenhanced RT3DE datasets yielded lower correlation with CMR ( r = 0.61) and a slightly greater bias (−1.5 mm). The agreement with CMR improved significantly ( r = 0.76, bias −1.1 mm) with contrast enhancement. Conclusions The agreement between RT3DE and CMR values of RWM is directly related to RT3DE image quality. In patients with poor acoustic windows, dual-triggered contrast enhancement improves the accuracy of RWM quantification to a level similar to that noted in patients with good images without contrast.

Published
2006

36. Dual triggering improves the accuracy of left ventricular volume measurements by contrast-enhanced real-time three-dimensional echocardiography

Author

Caiani, ENRICO GIANLUCA, Coon, P., Corsi, C., Goonewardena, S., Bardo, D., Rafter, P., Sugeng, L., Mor Avi, V., Lang, R. M., E. G. Caiani, P. Coon, C. Corsi, S. Goonewardena, D. Bardo, P. Rafter, L. Sugeng, V. Mor-Avi, and R. M. Lang

Subjects
contrast medium, real-time 3D echocardiography, LV volume
Abstract

Real-time 3-dimensional echocardiographic continuous imaging (CIM) with contrast underestimates left ventricular (LV) volumes. We studied the effects of dual-triggered (DT) acquisition on the accuracy of LV volume measurements for patients with poor acoustic windows. Real-time 3-dimensional echocardiographic imaging was performed in 20 patients during LV opacification (Definity) on the same day as cardiac magnetic resonance imaging. Both CIM and DT data were analyzed using custom software to calculate end-systolic volume (ESV) and end-diastolic volume (EDV), which were compared with the cardiac magnetic resonance reference. CIM correlated well with the cardiac magnetic resonance reference (EDV. r = 0.89; ESV: r = 0.93), but underestimated EDV and ESV by 17% and 19%, respectively. In contrast, DT resulted in higher correlation (EDV. r = 0.95; ESV- r = 0.96) and smaller biases (9% and 6%, respectively). in conclusion, because the accuracy of LV volume measurements depends on the acquisition strategy of contrast-enhanced real-time 3-dimensional echocardiographic images, the use of DT instead of the conventional CIM acquisition is recommended.

Published
2005

37. Volumetric quantification of global and regional left ventricular function from real-time three-dimensional echocardiographic images

Author

Lynn Weinert, Claudio Lamberti, Roberto M. Lang, Enrico G. Caiani, Federico Veronesi, Victor Mor-Avi, Cristiana Corsi, Peter MacEneaney, C. Corsi, R.M. Lang, L. Sugeng, F. Veronesi, L. Weinert, E.G. Caiani, C. Lamberti, V. Mor-Avi, R. M. Lang, E. G. Caiani, and P. MacEneaney

Subjects
Cardiac function curve, Adult, Cardiomyopathy, Dilated, Male, imaging, echocardiography, magnetic resonance imaging, Heart Diseases, Systole, Diastole, Echocardiography, Three-Dimensional, Heart Valve Diseases, Coronary Artery Disease, Aortic Coarctation, Ventricular Function, Left, Ventricular Dysfunction, Left, Physiology (medical), Linear regression, medicine, Humans, Aged, Lv function, Ventricular function, medicine.diagnostic_test, Cardiac cycle, business.industry, Magnetic resonance imaging, Middle Aged, Female, Cardiology and Cardiovascular Medicine, Nuclear medicine, business, Software
Abstract

Background— Real-time 3D echocardiographic (RT3DE) data sets contain dynamic volumetric information on cardiac function. However, quantification of left ventricular (LV) function from 3D echocardiographic data is performed on cut-planes extracted from the 3D data sets and thus does not fully exploit the volumetric information. Accordingly, we developed a volumetric analysis technique aimed at quantification of global and regional LV function. Methods and Results— RT3DE images obtained in 30 patients (Philips 7500) were analyzed by use of custom software based on the level-set approach for semiautomated detection of LV endocardial surface throughout the cardiac cycle, from which global and regional LV volume (LVV)–time and wall motion (WM)–time curves were obtained. The study design included 3 protocols. In protocol 1, time curves obtained in 16 patients were compared point-by-point with MRI data (linear regression and Bland-Altman analyses). Global LVV correlated highly with MRI ( r =0.98; y =0.99 x +2.3) with minimal bias (1.4 mL) and narrow limits of agreement (±20 mL). WM correlated highly only in basal and midventricular segments ( r =0.88; y =0.85 x +0.7). In protocol 2, we tested the ability of this technique to differentiate populations with known differences in LV function by studying 9 patients with dilated cardiomyopathy and 9 normal subjects. All calculated indices of global and regional systolic and diastolic LV function were significantly different between the groups. In protocol 3, we tested the feasibility of automated detection of regional WM abnormalities in 11 patients. In each segment, abnormality was detected when regional shortening fraction was below a threshold obtained in normal subjects. The automated detection agreed with expert interpretation of 2D WM in 86% of segments. Conclusions— Volumetric analysis of RT3DE data is clinically feasible and allows fast, semiautomated, dynamic measurement of LVV and automated detection of regional WM abnormalities.

Published
2005

39. Quantification of regional left ventricular function by real-time 3D echocardiography: Validation by magnetic resonance imaging and clinical utility

Author

Corsi, C., Lissa Sugeng, Nesser, H. J., Weinert, L., Niel, J., Ebner, C., Steringer-Mascherbauer, R., Schmidt, F., Schummers, G., Lang, R. M., Mor-Avi, V., C. Corsi, L. Sugeng, J. Nesser, L. Weinert, J. Niel, C. Ebner, R. Steringer-Mascherbauer, F. Schmidt, G. Schummer, R.M. Lang, and V. Mor-Avi

Subjects
cardiovascular system, regional LV function, cardiovascular diseases, real-time 3D echocardiography
Abstract

Quantitative information on regional left ventricular (LV) function from real-time 3D echocardiographic (RT3DE) images has significant clinical potential, but needs validation. Our goals were to validate these measurements against cardiac magnetic resonance (CMR) and test the feasibility of automated detection of regional wall motion (RWM) abnormalities from RT3DE data. RT3DE and CMR images were obtained in 31 pts and analyzed using prototype software to calculate regional volumes and ejection fractions. Indices were compared between RT3DE and CMR. Additionally, CMR images were reviewed by an expert, whose RWM grades were used as a reference for the automated detection of RWM abnormalities. RT3DE measurements resulted in good agreement with CMR. Automated detection showed high levels of agreement with expert reading, similar for CMR and RT3DE. Analysis of RT3DE data provides accurate quantification of regional function and allows automated detection of RWM abnormalities.

40. Quantification of aortic valve stenosis using transesophageal real-time 3D echocardiographic images

Author

Veronesi, F., Corsi, C., Mor-Avi, V., Sugeng, L., Wienert, L., Lang, R. M., CLAUDIO LAMBERTI, F. Veronesi, C. Corsi, V. Mor-Avi, L Sugeng, L. Wienert, R.M. Lang, and C. Lamberti

Abstract

Aortic stenosis (AS) is the most common native valve disease. The assessment of its severity is routinely performed using transthoracic 2D echocardiography. In particular, aortic valve area (AVA) is usually assessed by continuity equation, although this measurement relies on geometrical assumptions, or by planimetry on transesophageal echocardiography. Accordingly, the aim of this study was to develop and test a new technique to assess the severity of AS using data acquired with realtime 3D matrix transesophageal echocardiographic (MTEE) probe. We studied 20 patients undergoing clinically indicated TEE. MTEE imaging was performed in 10 subjects with normal mitral and normal aortic valves and in 10 patients with moderate to severe AS (AVA < 1.4 cm²) and normal mitral valve. Our technique allowed quantitative volumetric measurements of dynamic AV parameters, and thus constitutes a new tool for objective assessment of the severity of AS.

41. Long-Term Results of the Atrial Septal Defect Occluder ASSURED Trial for Combined Pivotal/Continued Access Cohorts.

Author

Qureshi AM, Sommer RJ, Morgan G, Paolillo JA, Gray RG, Love B, Goldstein BH, Sugeng L, and Gillespie MJ

Subjects
Humans, Prospective Studies, Time Factors, Female, Male, Treatment Outcome, Child, Adolescent, Child, Preschool, Young Adult, Risk Factors, Adult, United States, Middle Aged, Arrhythmias, Cardiac therapy, Arrhythmias, Cardiac physiopathology, Europe, Heart Septal Defects, Atrial therapy, Heart Septal Defects, Atrial diagnostic imaging, Septal Occluder Device, Cardiac Catheterization instrumentation, Cardiac Catheterization adverse effects, Prosthesis Design
Abstract

Background: The GORE CARDIOFORM ASD Occluder (GCA, W. L. Gore & Associates) was approved in 2019 for ostium secundum atrial septal defect (ASD) closure., Objectives: This study sought to report the combined pivotal and continued access cohorts of the ASSURED (Safety and Efficacy Study of Transcatheter Closure of Ostium Secundum ASDs) trial results through 36 months., Methods: This prospective, multicenter, single-arm trial evaluated procedural and clinical outcomes of ASD closure with the GCA. The primary endpoints were 6-month closure success following device implantation and composite clinical success (deployment/retention of device, safety, and closure). Technical and procedure success, safety, clinically significant new arrhythmia (CSNA) secondary endpoints, and wire frame fracture (WFF, with fluoroscopy) at 6 and 36 months were evaluated., Results: Of 569 patients (median age of 10.4 years and median weight of 35.0 kg) who underwent attempted secundum ASD closure, 526 were technical successes. The mean stop-flow ASD diameter was 17.6 ± 5.3 mm. All 478 patients with 6-month imaging achieved closure success. Composite clinical success at 6 and 36 months was achieved in 87.6% (468/534) and 84.0% (351/418) of patients, respectively. Technical failure occurred in 8.1% (43/548), 30-day device- or procedure-related serious adverse event in 3.9% (21/534), and 6-month device events in 2.8% (15/534) of patients. At 30 days, 21 of 569 patients (3.7%) had CSNA. At 6 months, 138 of 436 (31.7%) patients had WFFs and 105 of 185 (56.8%) at 36 months (without sequelae)., Conclusions: In this large congenital ASD device trial, the GCA had acceptable results. WFFs, although common, did not result in any clinical sequelae. The unique features, size range, and safety profile expand the options for secundum ASD closure. (Safety and Efficacy Study of Transcatheter Closure of Ostium Secundum ASDs [ASSURED]; NCT02985684)., Competing Interests: Funding Support and Author Disclosures This study was sponsored by W. L. Gore & Associates. Dr Qureshi is a consultant for W. L. Gore & Associates, Medtronic, and B. Braun. Dr Sommer has received institutional funding from W. L. Gore & Associates for working on their national PFO and ASD trials; and serves on the Advisory Board for Conformal Medical. Dr Morgan is a consultant/proctor for W. L. Gore & Associates. Dr Paolillo is a consultant, proctor, and preceptor for W. L. Gore & Associates. Dr Goldstein is a consultant for Medtronic, W. L. Gore & Associates, Edwards Lifesciences, and Mezzion Pharmaceuticals. Dr Sugeng serves on the Speakers Bureau for Philips Healthcare; and is a consultant for Siemens Healthineers and Yale Echo Corelab YCRG. Dr Gillespie is a consultant for W. L. Gore & Associates and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2024
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42. In-hospital outcomes and postdischarge mortality in patients with acute coronary syndrome and atrial fibrillation.

Author

Saleh M, Coleman K, Fishbein J, Gandomi A, Yang B, Kossack A, Varrias D, Jauhar R, Lasic Z, Kim M, Mihelis E, Ismail H, Sugeng L, Singh V, Epstein LM, Kuvin J, and Mountantonakis SE

Subjects
Humans, Male, Female, Aged, Anticoagulants therapeutic use, Incidence, Retrospective Studies, Survival Rate trends, Middle Aged, Risk Factors, Follow-Up Studies, Stroke epidemiology, Stroke etiology, Stroke mortality, Atrial Fibrillation complications, Atrial Fibrillation mortality, Atrial Fibrillation drug therapy, Acute Coronary Syndrome mortality, Acute Coronary Syndrome complications, Acute Coronary Syndrome therapy, Hospital Mortality trends, Patient Discharge
Abstract

Background: It is unclear whether advances in management of acute coronary syndrome (ACS) and introduction of novel oral anticoagulants have changed outcomes in patients with ACS with concomitant atrial fibrillation (AF)., Objective: This study aimed to examine the incidence of AF in patients admitted for ACS and to evaluate its association with adverse outcomes, given the recent advances in management of both diseases., Methods: Natural language processing search algorithms identified AF in patients admitted with ACS across 13 Northwell Health Hospitals from 2015 to 2021. Hierarchical generalized linear mixed modeling was used to assess the association between AF and in-hospital mortality, bleeding, and stroke outcomes; marginal Cox regression modeling was used to assess the association between AF and postdischarge mortality., Results: Of 12,315 patients admitted for ACS, 3018 (24.5%) had AF with 1609 (53.3%) newly diagnosed. AF patients more commonly received anticoagulation with an oral anticoagulant (80.4% vs 12.3%) or heparin (61.9% vs 56.9%), had lengthier intensive care unit stay (72 vs 49 hours), and underwent fewer percutaneous coronary interventions (31.9% vs 53.1%). In-hospital bleeding, stroke, and mortality were higher in the AF group (15.3% vs 5.0%, 7.4% vs 2.4%, and 6.9% vs 2.1%, respectively). AF was an independent risk factor for all in-hospital outcomes (odds ratios of 2.5, 2.7, and 2.0 for bleeding, stroke, and mortality, respectively) as well as for postdischarge mortality (hazard ratio, 1.3; 95% CI, 1.2-1.5)., Conclusion: AF is present in 25% of ACS patients and increases risk of in-hospital and postdischarge adverse outcomes. Additional data are required to direct optimal management., Competing Interests: Disclosures The authors have no conflicts of interest to disclose., (Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Published
2024
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43. Delayed Intradevice Leak Due to Torn Left Atrial Appendage Occlusion Device Membrane.

Author

Miklin DJ, Gabriels JK, Wharton R, Sugeng L, Willner J, Beldner S, Epstein LM, and Mitra R

Subjects
Humans, Septal Occluder Device adverse effects, Male, Aged, Female, Atrial Appendage surgery, Atrial Appendage diagnostic imaging, Atrial Fibrillation surgery
Abstract

Competing Interests: Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Published
2024
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44. High- versus low-gradient aortic stenosis: Is our evaluation limited by aorto-mitral angle on cardiovascular CT?

Author

See C, Kim Y, Park J, Wang Y, Reinhardt SW, Shkolnik E, Faridi KF, Lombo B, Bellumkonda L, McNamara RL, Sugeng L, and Hur DJ

Subjects
Humans, Male, Female, Aged, Aged, 80 and over, Retrospective Studies, Mitral Valve diagnostic imaging, Aortic Valve diagnostic imaging, Echocardiography methods, Tomography, X-Ray Computed methods, Severity of Illness Index, Transcatheter Aortic Valve Replacement methods, Aortic Valve Stenosis diagnostic imaging
Abstract

Background: Accurate assessment of aortic valve (AV) stenosis (AS) on transthoracic echocardiogram is crucial for appropriate clinical management. However, discordance between aortic valve area (AVA) and Doppler can complicate the diagnosis of severe AS in low-gradient (LG) AS phenotypes., Methods: We reviewed 220 consecutive patients with suspected severe AS and AVA ≤1.0 cm 2 on transthoracic echocardiogram who were evaluated for transcatheter AV replacement (TAVR) within a large health system from 2015 to 2019. We compared AV calcium score and aorto-mitral angle (AMA) on 3-chamber views from ECG-gated cardiovascular CT among patients with high-gradient (HG) AS (N = 19), paradoxical low-flow low-gradient (PLFLG) AS (N = 24) and normal-flow low-gradient (NFLG) AS (N = 14)., Results: All groups had comparable age, comorbidities, and AV calcium scores. Compared to patients with HG AS (mean AMA 120 ± 10°), those with PLFLG AS (104 ± 12°; p < 0.001) and NFLG AS (106 ± 13°; p = 0.008) had narrower mean AMA values on cardiovascular CT., Conclusion: LG AS patients have significantly narrower AMA than HG AS patients on cardiovascular CT. Due to difficulty obtaining parallel Doppler alignment, narrower AMA may contribute to AVA-Doppler discordance on echocardiogram. These findings emphasize the need for additional information in the setting of LG AS., Competing Interests: Declaration of competing interest Dr. Kamil Faridi receives research funding from the National Institutes of Health/National Heart, Lung, and Blood Institute (K23HL161424), outside the scope of the current work. Dr. David Hur receives research support from the National Institutes of Health/National Heart, Lung, and Blood Institute (R01HL168473), outside the scope of the current work. The remaining authors have no conflicts of interest relevant to this manuscript., (Published by Elsevier B.V.)

Published
2024
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45. Variation in Reader-Reported Severity of Paradoxical Low-Flow Low-Gradient Aortic Stenosis.

Author

Shah NN, Sugeng L, Zhang Z, Wang K, McNamara RL, Agarwal V, Hur DJ, Lombo B, Bellumkonda L, Mankbadi M, Basem Dajani AR, Forrest JK, Krumholz HM, Reinhardt SW, Velazquez EJ, and Faridi KF

Subjects
Humans, Aortic Valve, Severity of Illness Index, Stroke Volume, Treatment Outcome, Aortic Valve Stenosis diagnostic imaging
Abstract

Competing Interests: Conflicts of Interest None.

Published
2024
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46. Incidence of Severe Adverse Drug Reactions to Ultrasound Enhancement Agents in a Contemporary Echocardiography Practice.

Author

Ali MT, Johnson M, Irwin T, Henry S, Sugeng L, Kansal S, Allison TG, Bremer ML, Jones VR, Martineau MD, Wong C, Marecki G, Stebbins J, Michelena HI, McCully RB, Svatikova A, Padang R, Scott CG, Kanuga MJ, Arsanjani R, Pellikka PA, Kane GC, and Thaden JJ

Subjects
Humans, Retrospective Studies, Prospective Studies, Incidence, Echocardiography, Headache, Back Pain, COVID-19 Vaccines, Drug-Related Side Effects and Adverse Reactions diagnosis, Drug-Related Side Effects and Adverse Reactions epidemiology, Fluorocarbons
Abstract

Objectives: Prior data indicate a very rare risk of serious adverse drug reaction (ADR) to ultrasound enhancement agents (UEAs). We sought to evaluate the frequency of ADR to UEA administration in contemporary practice., Methods: We retrospectively reviewed 4 US health systems to characterize the frequency and severity of ADR to UEA. Adverse drug reactions were considered severe when cardiopulmonary involvement was present and critical when there was loss of consciousness, loss of pulse, or ST-segment elevation. Rates of isolated back pain and headache were derived from the Mayo Clinic Rochester stress echocardiography database where systematic prospective reporting of ADR was performed., Results: Among 26,539 Definity and 11,579 Lumason administrations in the Mayo Clinic Rochester stress echocardiography database, isolated back pain or headache was more frequent with Definity (0.49% vs 0.04%, P < .0001) but less common with Definity infusion versus bolus (0.08% vs 0.53%, P = .007). Among all sites there were 201,834 Definity and 84,943 Lumason administrations. Severe and critical ADR were more frequent with Lumason than with Definity (0.0848% vs 0.0114% and 0.0330% vs 0.0010%, respectively; P < .001 for each). Among the 3 health systems with >2,000 Lumason administrations, the frequency of severe ADR with Lumason ranged from 0.0755% to 0.1093% and the frequency of critical ADR ranged from 0.0293% to 0.0525%. Severe ADR rates with Definity were stable over time but increased in more recent years with Lumason (P = .02). Patients with an ADR to Lumason since the beginning of 2021 were more likely to have received a COVID-19 vaccination compared with matched controls (88% vs 75%; P = .05) and more likely to have received Moderna than Pfizer-Biotech (71% vs 26%, P < .001)., Conclusion: Severe and critical ADR, while rare, were more frequent with Lumason, and the frequency has increased in more recent years. Additional work is needed to better understand factors, including associations with recently developed mRNA vaccines, which may be contributing to the increased rates of ADR to UEA since 2021., Competing Interests: Conflicts of Interest None., (Copyright © 2023 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.)

Published
2024
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47. Factors associated with reporting left ventricular ejection fraction with 3D echocardiography in real-world practice.

Author

Faridi KF, Zhu Z, Shah NN, Crandall I, McNamara RL, Flueckiger P, Bachand K, Lombo B, Hur DJ, Agarwal V, Reinhardt SW, Velazquez EJ, and Sugeng L

Subjects
Male, Humans, Female, Stroke Volume, Ventricular Function, Left, Echocardiography, Three-Dimensional
Abstract

Background: Guidelines recommend 3D echocardiography (3DE) to assess left ventricular ejection fraction (LVEF) on transthoracic echocardiogram (TTE) when possible, but it is unclear which factors are most strongly associated with reporting 3DE LVEF in real-world practice., Methods: We evaluated 3DE LVEF reporting by age, sex, BMI, TTE location and variation in reporting by sonographer and reader. All TTEs were performed without contrast enhancement agent at a large medical center from 9/2015 to 12/2020 using ultrasound machines capable of 3DE. We used multivariable logistic regression to assess which factors were most associated with reporting 3DE LVEF., Results: Among 35 641 TTEs included in this study, 57.4% were performed on women. 3DE LVEF was reported on 18 391 TTEs (51.6% of cohort; 50.5% for women and 52.4% for men). Portable inpatient TTEs (n = 5569) had the lowest rates of 3DE LVEF reporting (30.9%), while general outpatient TTEs (n = 15 933) had greater reporting (56.9%). Outpatient TTEs with an indication for chemotherapy (n = 3244) had the highest rates of 3DE LVEF (87.2%). The median (IQR) percentage of TTEs reporting 3D LVEF was 52.7% (43.1%-68.1%) among sonographers and 51.6% (46.5%-59.6%) among readers. Among 20082 (56.3%) TTEs with 3DE LVEF measured by sonographers, 91.6% were included by readers in the final report. After adjustment, performing sonographer in the highest reporting quartile was most strongly associated with reporting 3DE LVEF (OR 7.04, 95% CI 6.55-7.56), while an inpatient portable study had the strongest negative association for reporting (OR .38, 95% CI .35-.40)., Conclusions: Use of 3DE LVEF in real-world practice varies substantially based on performing sonographer and is low for hospitalized patients, but can be frequently used for chemotherapy. Initiatives are needed to increase sonographer 3DE acquisition in most clinical settings., (© 2024 Wiley Periodicals LLC.)

Published
2024
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48. Guidelines for the Evaluation of Prosthetic Valve Function With Cardiovascular Imaging: A Report From the American Society of Echocardiography Developed in Collaboration With the Society for Cardiovascular Magnetic Resonance and the Society of Cardiovascular Computed Tomography.

Author

Zoghbi WA, Jone PN, Chamsi-Pasha MA, Chen T, Collins KA, Desai MY, Grayburn P, Groves DW, Hahn RT, Little SH, Kruse E, Sanborn D, Shah SB, Sugeng L, Swaminathan M, Thaden J, Thavendiranathan P, Tsang W, Weir-McCall JR, and Gill E

Subjects
Adult, Humans, Magnetic Resonance Imaging, Echocardiography, Prostheses and Implants, Magnetic Resonance Spectroscopy, Heart, Heart Valve Diseases diagnosis, Heart Valve Diseases surgery
Abstract

In patients with significant cardiac valvular disease, intervention with either valve repair or valve replacement may be inevitable. Although valve repair is frequently performed, especially for mitral and tricuspid regurgitation, valve replacement remains common, particularly in adults. Diagnostic methods are often needed to assess the function of the prosthesis. Echocardiography is the first-line method for noninvasive evaluation of prosthetic valve function. The transthoracic approach is complemented with two-dimensional and three-dimensional transesophageal echocardiography for further refinement of valve morphology and function when needed. More recently, advances in computed tomography and cardiac magnetic resonance have enhanced their roles in evaluating valvular heart disease. This document offers a review of the echocardiographic techniques used and provides recommendations and general guidelines for evaluation of prosthetic valve function on the basis of the scientific literature and consensus of a panel of experts. This guideline discusses the role of advanced imaging with transesophageal echocardiography, cardiac computed tomography, and cardiac magnetic resonance in evaluating prosthetic valve structure, function, and regurgitation. It replaces the 2009 American Society of Echocardiography guideline on prosthetic valves and complements the 2019 guideline on the evaluation of valvular regurgitation after percutaneous valve repair or replacement., (Copyright © 2023. Published by Elsevier Inc.)

Published
2024
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49. Continuous non-invasive hemodynamic monitoring in early onset severe preeclampsia.

Author

Ackerman-Banks CM, Bhinder J, Eder M, Heerdt P, Sugeng L, Testani J, Alian A, Lipkind H, Velazquez E, Reddy U, and Chou JC

Subjects
Pregnancy, Female, Humans, Monitoring, Physiologic, Cardiac Output, Vascular Resistance, Pre-Eclampsia diagnosis, Hemodynamic Monitoring
Abstract

Objectives: Continuous hemodynamic monitoring offers the opportunity to individualize management in severe preeclampsia (PEC). We compared cardiac output (CO) and total peripheral resistance (TPR) measured by bioreactance (NICOM), Clearsite™ Fingercuff [CS), and 3D-echocardiography (3DE)., Study Design: This prospective observational study included 12 pregnant patients with early PEC. CO and TPR were measured simultaneously by NICOM, CS, and 3DE antepartum and 1-2 days postpartum. Using 3DE as the standard, CS and NICOM interchangeability, precision, accuracy, and correlation were assessed., Results: Compared to 3DE-CO, CS-CO was highly correlated (R 2  = 0.70, p = <0.0001) with low percentage error (PE 29%) which met criteria for interchangeablity. CS-TPR had strong correlation (R 2  = 0.81, p = <0.0001) and low PE (29%). While CS tended to slightly overestimate CO (bias + 2.05 ±1.18 L/min, limit of agreement (LOA) -0.20 to 4.31) and underestimate TPR (bias -279 ±156 dyes/sec/cm 5 ; LOA -580 to 18.4) these differences were unlikely to be clinically significant. Thus CS could be interchangeable with 3DE for CO and TPR. NICOM-CO had only moderate correlation with 3DE-CO (R 2  = 0.29, p = 0.01) with high PE (52%) above threshold for interchangeability. NICOM-CO had low mean bias (-1.2 ±1.68 L/min) but wide 95% LOA (-4.41 to 2.14) suggesting adequate accuracy but low precision in relation to 3DE-CO. NICOM-TPR had poor correlation with 3DE-TPR (R 2  = 0.32, p = 0.001) with high PE (67%), relatively low mean bias (238 ±256), and wide 95% LOA (-655 to 1131). NICOM did not meet the criteria for interchangeable with 3DE for CO and TPR., Conclusions: Clearsite Fingercuff, but not NICOM, has potential to be clinically useful for CO and TPR monitoring in severe preeclampsia., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)

Published
2023
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50. Building and Optimizing the Interdisciplinary Heart Team.

Author

Lee C, Tully A, Fang JC, Sugeng L, Elmariah S, Grubb KJ, and Young MN

Abstract

A multidisciplinary care team model, or Heart Team approach, has become a central tenet of cardiovascular care. Though initially applied to the management of heart transplantation and subsequently complex coronary artery disease, the Heart Team is now utilized broadly across cardiovascular medicine, including in the treatment of valvular disease, pulmonary embolism, cardiogenic shock, high-risk pregnancies in patients with pre-existing cardiovascular disease, and adult congenital heart disease. The Heart Team model improves interdisciplinary collaboration among specialties, adherence to societal guidelines, and shared decision-making with patients and families. In this review, we highlight the development and rationale supporting the Heart Team model, address the challenges of implementing a multidisciplinary care team, and discuss the optimal methods to continue to build, optimize, and implement this approach., (© 2023 The Author(s).)

Published
2023
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