جستجوی مقالات مرتبط با کلیدواژه « 3d echocardiography » در نشریات گروه « پزشکی »

Breast cancer, as the most common malignancy among females, is a great concern for global health. Early diagnosis and advanced chemotherapy regimens have improved patients’ survival, while increasing morbidities caused by chemotherapy in the long run. Chemotherapy regimens have caused a decrease in myocardial functional, which can be detected by echocardiography.

The present study aimed to assess the decline curve in the left ventricular function parameters following chemotherapy and to compare the results among patients based on their Human Epidermal Growth Factor Receptor-2 (HER2) status.

This study was conducted on 427 consecutive female patients with breast cancer referred to the Cardio-Oncology Department of Rajaie Cardiovascular, Medical, and Research Center for pre-chemotherapy assessment between January 2019 and December 2020. The patients were divided into two groups based on the HER2 status. All the patients had at least one baseline (pre-chemotherapy) transthoracic echocardiography and were scheduled for four follow-up sessions: early post-anthracycline therapy and 3, 6, and 12 months following chemotherapy. Each echocardiography examination included the assessment of 2D Left Ventricular Ejection Fraction (LVEF), 3D LVEF, Global Longitudinal Strain (GLS), and Global Circumferential Strain (GCS). Linear mixed-effects models were utilized and the results were compared within and between the study groups. The R Project for Statistical Computing was used for data analysis.

The results revealed significant changes in the means of 2D LVEF, 3D LVEF, GLS, and GCS during the 12 months of follow-up (t = -27.04, -37.15, -33.3, and -21.5, respectively; P < 0.001). Besides, the decline was more prominent in the HER2 positive patients (t = -19.86, -15.35, -10.8, and -9.6, respectively; P < 0.001).

The study results revealed a significant decline in the LV function parameters including 2D LVEF, 3D LVEF, GLS, and GCS following chemotherapy with anthracycline. This decline was more prominent in the HER2 positive patients who underwent Herceptin treatment. These results showed that the use of cardioprotective agents might lower the rate of decline in LV function parameters.

Recent advances in the early detection and management of breast cancer have conferred longer patient survival. Breast irradiation-induced cardiotoxicity has been associated with a decrease in the echocardiographic markers of myocardial function and an increase in cardiac mortality.

This study aimed to determine the cardiac effects of radiotherapy on patients with breast cancer based on cancer laterality.

The present study assessed the records of 72 consecutive women with breast cancer who were referred to the Cardio-Oncology Department of Rajaie Cardiovascular Medical and Research Center between April 2017 and September 2020 and had baseline echocardiographic examinations and at least one follow-up echocardiographic examination within the first year of the initial examination. The patients were divided into left- and right-sided breast cancer groups to compare the results. The two groups were compared regarding the means of 2D Left Ventricular Ejection Fraction (LVEF), 3D LVEF, Global Longitudinal Strain (GLS), and Global Circumferential Strain (GCS) before and after radiotherapy. Analysis of Covariance (one-way ANCOVA) was used to compare the results (alpha = 0.05). All analyses were carried out using the SPSS software, version 26.

The changes in the means of 2D LVEF, 3D LVEF, GLS, and GCS were statistically significant among all the patients irrespective of cancer laterality (P < 0.001, P < 0.001, P = 0.001, and P = 0.002, respectively). However, no significant differences were observed between the left- and right-sided breast cancer groups vis-à-vis the means of 2D LVEF, 3D LVEF, GLS, and GCS (P = 0.44, P = 0.65, P = 0.21, and P = 0.25, respectively).

The study results showed significant declines in the means of 2D LVEF, 3D LVEF, GLS, and GCS following radiotherapy. The patients with right-sided breast cancer exhibited a significant decrease in all the mentioned measures, whereas those with left-sided breast cancer showed no significant decline in post-radiotherapy speckletracking parameters. In addition, comparison of the patients with left- and right-sided breast cancers revealed no significant difference in the echocardiographic parameters of cardiotoxicity regarding cancer laterality.

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Most studies have focused on Right Ventricular (RV) dysfunction, while the left ventricle has received less attention in patients with TOF.

This study aimed to investigate the Left Ventricular (LV) function after surgical Pulmonary Valve Replacement (sPVR) in patients with repaired TOF (rTOF) by Speckle Tracking Echocardiography (STE).

This single-center, observational, cross-sectional study was conducted on 58 volunteers (age: 15 - 31 years) divided into three groups as follows: 22 PVR patients (mean age: 18.96 ± 7 year), 16 patients with rTOF, and 20 healthy controls who were matched regarding the PVR age range. 2D echocardiography (including Doppler and M-Mode indices of the right and left ventricles) and Speckle Tracking Echocardiography (STE) (Global Longitudinal Strains (GLS) and 18 segment analyses) were performed for all patients. All analyses were done using the SPSS software and P < 0.05 was considered to be statistically significant.

2D echocardiography showed normal LV Ejection Fraction (LVEF) in all study groups (64% in sPVR, 60% in rTOF (P = 0.127), and 62.5% in the control group). However, the mean GLS of the left ventricle significantly reduced in both sPVR (-17.5 ± 2.5%) and rTOF (-17.1 ± 4.7%) patients in comparison to the control group (-20.2 ± 0.7%) (P = 0.003). Yet, no significant difference was observed between the rTOF and sPVR groups regarding the GLS (P = 0.9). Segmental analysis of the Longitudinal Strain (LS) indicated a significant decrease in the sPVR and rTOF groups in basal anterior, basal septal, basal anterolateral, mid-anterior, and anterolateral segments. Except for the lower LS in the apical-anteroseptal segment, this level was mostly spared in both sPVR and rTOF patients.

LVEF was within the normal range among the sPVR patients, but the pattern of impaired segmental LS and GLS did not change compared to the rTOF group. In conclusion, sPVR might not have a significant effect on the improvement of LV function assessed by STE in patients with rTOF. LV damage occurring during the surgical correction of TOF might have a permanent deteriorating effect on LV function.

Human epidermal growth factor receptor 2(HER2) is a gene that makes proteins in the breast cell. The HER2 gene is present in about 25% - 30% of patients with breast cancers. The most common side effect of drugs is left ventricular dysfunction. Evaluation of left ventricular ejection fraction (LVEF) by 2D echocardiography cannot detect subtle changes in LV systolic function.

We want to draw a comparison between two groups of breast cancer patients (HER2 positive and negative) by advanced echocardiography.

We have conducted a single center prospective study at Rajaie Cardiovascular Medical and Research Center in 2018 - 2019.

This analysis included 58 patients with breast cancer. 15 cases (34%) were HER2 positive. Mean left ventricular ejection fraction (2D LVEF) in HER2 positive patients was 55 % at baseline and in HER2 negative patients was 55 %. In HER2 positive patients we had 10 percent decrease in LVEF during follow-up and the final LVEF was about 45% (P value < 0.05). Mean left ventricular ejection fraction by 3D echocardiography (3D LVEF) in HER positive patients was 57 % and in HER2 negative patients was 55 % at baseline. In HER2 positive patients we had about 20% decrease in 3D LVEF and the final LVEF was 40 % (P value < 0.05). Mean circumferential strain (GCS) in HER2 positive patients was -21 and in HER2 negative patients was -21 at baseline which decreased to -18 in HER positive patients and -17 in HER2 negative patients, showing clinical significance ( P value = 0.008).

In our study HER2 positive breast cancers showed about 10% drop in 2DEF, about 20% drop in 3DLVEF and about 5% drop in HMLVEF, which all were significant (P value < 0.05). We found that GCS is more sensitive than GLS in detecting subclinical involvement, and early changes in GCS is a good predictor of subsequent development of drugs (anthracycline-transtuzumab) induced cardiotoxicity.

Atrial Fibrillation (AF) and Heart Failure (HF) most commonly coexist, and each condition can exacerbate and complicate the course of treatment of the other. The relationship between these two conditions is not entirely understood. Loss of atrial systole is an important contributing factor in decreasing cardiac output and can increase the risk of blood stasis, thromboembolism, inflammation, and cardiac myocyte dysfunction.

This study aimed to assess the relationship between AF and cardiovascular mortality and high-risk clinical, laboratory, and echocardiographic variables in patients with acute decompensated HF.

This historical cohort study was conducted on 298 consecutive patients admitted with acute decompensated HF. The patients were divided into sinus rhythm (198 patients, 66.44%) and AF (100 patients, 33.56%) groups. The two groups were compared regarding demographic, laboratory, and echocardiographic variables and cardiovascular mortality within six months after index hospitalization using independent t-test, chi-square, and Fisher’s exact tests. In addition, independent echocardiographic risk factors for development of AF were determined by a logistic regression model. Variables with P < 0.05 were considered to be significant. All statistical analyses were done by SPSS/PASW software.

The results showed that the patients with AF were older and had female predominance, a lower prevalence of diabetes mellitus, a lower rate of glomerular filtration, and a higher six-month cardiovascular mortality compared to those with sinus rhythm (P = 0.011, 0.05, 0.005, 0.043, and 0.041, respectively). These patients also had a larger left atrial diameter (P < 0.001) and a higher prevalence of right ventricular enlargement, systolic dysfunction, and moderate or severe functional mitral regurgitation compared to those with sinus rhythm (P = 0.02, 0.016, and 0.011, respectively). The results of logistic regression analysis indicated that left atrial diameter was the only independent predictor of AF (odds ratio = 2.27, 95% confidence interval [1.38 – 3.75]).

The results showed that AF was associated with increased cardiovascular mortality and high-risk clinical, laboratory, and echocardiographic markers in patients with decompensated HF.

Most patients with mitral valve prolapse (MVP) are asymptomatic with a normal life expectancy; however, between 5% and 10% of them have progression to severe mitral regurgitation (MR). Because of this silent progression, the size and ejection fraction of the left ventricle are very important in decision-making for surgery in asymptomatic patients with MR. A 3D assessment of LV volumes and ejection fraction is preferred to 2D echocardiography because of its accuracy and reproducibility.

Between April 3, 2018, and February 20, 2019, the present study enrolled 50 patients suffering MVP with relatively severe MR undergoing transesophageal echocardiography at Rajaie Cardiovascular, Medical, and Research Center, affiliated with Iran University of Medical Sciences. The ejection fraction was analyzed via the visual 2D method, in addition to 3 other

the Simpson biplane, 3D full volume, and 3D heart model.

Of the 4 measurement methods, the 3D heart model had the highest agreement with the Simpson biplane method (ICC: 0.859, 95% CI: 0.745 to 0.922). The agreement rate between the 3D heart model and the 3D full volume was 72% and between the 3D heart model and the visual 2D method was 64%. In the measurement of the end-diastolic volume, there was a remarkable agreement between the 3D heart model and both the Simpson biplane and 3D full-volume methods (98% and 95%, respectively). Similarly, in the measurement of the end-systolic volume, the rate of agreement between the 3D heart model and both the Simpson biplane and 3D full-volume methods was 91% and 92%, correspondingly.

This study showed that the use of the 3D heart model and the Simpson biplane method was more accurate in the study of the left ventricular ejection fraction than that of the visual 2D and 3D full-volume methods. It appears that the use of all 3 methods (ie, the Simpson biplane, 3D full volume, and 3D heart model) in the measurement of the end-systolic and end-diastolic volumes is reliable. (Iranian Heart Journal 2020; 21(2): 41-47)

The aim of this study was to determine if there is any correlation between patent ductus arteriosus (PDA) dimensions measured by two dimensional echocardiography (2DE) and three dimensional echocardiography (3DE) in comparison with angiographic data as the gold standard technique. Such correlation may help us to immediately detect ductal spasm and select the proper device according to echocardiographic assessments. In this comparative study, we successively selected 26 pediatric patients with isolated PDA, who referred for elective percutaneous PDA closure at Nemazee Hospital, affiliated to Shiraz University of Medical Sciences (SUMS) since January 2016 till March 2017. All patients underwent full 2DE and 3DE before device closure at the day of angiography (less than 5 hours before catheterization). We emphasized the dimension of pulmonic and aortic end diameter and length of PDA by these modalities and comparison of our data. The study population had a mean age of 28.7 months and a mean weight of 10.67 Kg; the majority of our patients were female (84.6%). The difference in pulmonic end of PDA was not significant statistically by all modalities. The difference in aortic end of PDA was significant and there was no correlation between 2DE and 3DE with angiographic data. Comparison of data obtained from 2DE and 3DE revealed that the length of PDA in 2DE, 3DE angiography well correlated with each other. One case developed ductal spasm during angiography. The ductus pulmonic end and length dimensions measured by echocardiography and angiography well correlated with each other and were interchangeable. Such findings may be helpful during percutaneous transcatheter occlusion if any ductal spasm happens. Thus, we may recommend the use of a suitable device according to the maximum size of PDA that was measured either by echocardiography or angiographic studies

Left ventricular (LV) pseudoaneurysms due to late rupture after mitral valve replacement (MVR) are very rare. Surgical management of LV pseudoaneurysms is inevitable because of their potential risk of enlargement and rupture.
A 53-year-old woman was referred to our echocardiography lab because of exertional dyspnea. She had recently undergone MVR and had an uneventful in-hospital course. Echocardiographic study revealed an LV pseudoaneurysm, just below the annulus in the left atrioventricular groove. She refused repeated surgery at this stage.
Rupture of the LV wall after MVR could be a fatal complication. Echocardiography is the most widely used method for the diagnosis of LV pseudoaneurysms. Cardiologists should be aware of this complication and consider it while assessing MVR cases.

Cleft in the anterior mitral leaflet is an infrequent congenital anomaly most often encountered in association with other congenital heart defects. The importance of the lesion is that it is often a correctable cause of Mitral Regurgitation (MR).