| 1. |
- Arnold, MF, et al.
(författare)
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Editorial: Does atrioventricular ring motion always distinguish constriction from restriction? A Doppler myocardial imaging study
- 2001
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Ingår i: Journal of the American Society of Echocardiography. - : Elsevier BV. - 0894-7317 .- 1097-6795. ; 14:5, s. 391-395
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Constrictive pericarditis and restrictive cardiomyopathy can be difficult to differentiate on clinical examination. Cardiac ultrasonography is increasingly being used as the noninvasive method of choice for confirming the specific morphologic and hemodynamic abnormalities associated with either condition. Interrogation of atrioventricular valve plane motion by Doppler myocardial imaging (DMI) has been suggested as a valuable new approach that can help differentiate one from the other. We report the color DMI, pulsed DMI, and strain rate findings in 2 cases of constrictive pericarditis in which consideration of the annular motion pattern alone would not have allowed such differentiation.
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| 2. |
- Sutherland, George, et al.
(författare)
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Quantitation of left-ventricular asynergy by cardiac ultrasound
- 2000
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Ingår i: American Journal of Cardiology. - 0002-9149 .- 1879-1913. ; 86:4, s. 4-9
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Tidskriftsartikel (refereegranskat)abstract
- The clinical evaluation of regional delays in myocardial motion (myocardial asynchrony) has proved problematic, yet it remains an important functional parameter to evaluate. Prior attempts to quantify regional asynergy have met with limited success, often thwarted by the low temporal resolution of imaging-system data acquisition. If a delay in onset of motion of 30–40 msec is clinically important to measure, then data acquisition at frame rates of 50–100 per second is required. This is out of the current temporal resolution of angiographic, nuclear, or magnetic resonance studies. Only cardiac ultrasound can currently achieve the necessary frame rates. Furthermore, quantitative studies into the accuracy with which a trained observer can identify computed regional myocardial asynchrony in a left-ventricular 2-dimensional (2-D) image have shown that regional delays of <80 msec are not normally recognized in a moving image. This may be improved to 60 msec when either training is undertaken or comparative image review is used. However, this is still out of the temporal resolution required in clinical practice. Thus, visual interpretation of asynchrony is not sufficiently accurate. Two ultrasound data sets based on either integrated backscatter or Doppler myocardial imaging data may provide the solution. Doppler myocardial imaging is a new ultrasound technique which, in either its pulsed or color Doppler format, can achieve the required temporal resolution (with temporal resolutions of 8 msec and 16 msec, respectively). In contrast, color Doppler myocardial imaging, in its curved M-mode format, can display the timing of events during the cardiac cycle for all in-plane myocardial segments. This should allow the quantitation of regional delay for all systolic and diastolic events. Potentially, asynchrony due to regional ischemia, bundle branch block, ventricular premature beats, and ventricular preexcitation could all be identified and the degree of delay quantified. This overview will aim to establish the potential role of these new ultrasound methodologies in the recognition and quantitation of left-ventricular asynergy and how they might best be introduced into clinical practice.
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| 3. |
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| 4. |
- Wilkenshoff, UM, et al.
(författare)
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Age-dependent changes in regional diastolic function evaluated by color Doppler myocardial imaging : A comparison with pulsed Doppler indexes of global function.
- 2001
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Ingår i: Journal of the American Society of Echocardiography. - : Elsevier BV. - 0894-7317 .- 1097-6795. ; 14:10, s. 959-969
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Tidskriftsartikel (refereegranskat)abstract
- The goals of this study were to evaluate possible normal age-related changes in regional myocardial relaxation as detected by color Doppler myocardial imaging (CDMI) velocities and to compare the extent of any such changes with age-induced changes in global diastolic function. In 80 healthy subjects (aged 21 to 72 years, equally subdivided by decades) the mitral flow velocities in early diastole (E) and atrial contraction (A) were recorded as were the velocities of left ventricular (W) motion of early (EDV) and late diastole (LDV) in the 16 standard LV segments, and their ratios were calculated. in healthy persons younger than 40 years, all segments showed an EDV/LDV ratio > 1, whereas in healthy persons aged 40 years or older the mean EDV of all segments decreased, and the mean LDV increased, resulting in a significant decrease of the mean EDV/LDV ratio with age. Values of EDV/LDV ratios were higher than E/A ratios (P < .0001), but their changes with age correlated well with each other (r = 0.805). With increasing age, an EDV/LDV ratio <1 was observed more often in basal segments (P < .001, compared with mid and apical segments) and less often in segments of anteroseptal and posterior walls viewed from the parasternal window. The presence of > 50% segments with an EDV/LDV ratio <1 was associated with an E/A ratio <1. Regional diastolic function indexes as evaluated by CDMI changed with increasing age in a heterogeneous way and influenced global diastolic function parameters.
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| 5. |
- Wilkenshoff, Ursula M., et al.
(författare)
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Regional mean systolic myocardial velocity estimation by real-time color Doppler Myocardial Imaging: A new technique for quantifying regional systolic function
- 1998
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Ingår i: Journal of the American Society of Echocardiography. - : Elsevier BV. - 0894-7317 .- 1097-6795. ; 11:7, s. 683-692
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Tidskriftsartikel (refereegranskat)abstract
- A new color Doppler myocardial imaging (CDMI) system with high spatial and temporal resolution and novel postprocessing modalities has been developed that could allow quantifiable stress echocardiography. The purpose of this study was to determine whether regional myocardial systolic velocities could be accurately and reproducibly measured both at rest and during bicycle ergometry by using CDMI. Thirty normal subjects were examined with CDMI at rest, and peak mean systolic myocardial velocities (MSV) were measured for 34 predetermined left ventricular myocardial segments. Interobserver variability and intraobserver variability were established for all segments. Submaximal bicycle ergometry was performed in 20 normal subjects by using standardized weight-related increases in workload. MSV were measured at each step of exercise for 16 left ventricular stress echo segments. At rest, a base-apex gradient in regional MSV was recorded with highest longitudinal shortening velocities at the base. A similar pattern was noted for circumferential shortening MSV. Measurements were predictable and highly reproducible with low interobserver and intraobserver variability for 26 of 34 segments. Reproducibility was poor for basal anteroseptal segments in all views and mid anterior, anteroseptal, and septal segments in the short-axis views. During exercise, mid and basal segments of all walls showed a significant increase of MSV between each workload step and for apical segments between alternate steps. The resting base-apex velocity gradient observed at rest remained in all walls throughout ergometry. Thus a CDMI system with improved spatial and temporal resolution and postprocessing analysis modalities provided reproducible and accurate quantification of segmental left ventricular circumferential and longitudinal contraction both at rest and during exercise.
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