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- Werther Evaldsson, A., et al.
(författare)
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Echocardiographic right ventricular strain from multiple apical views is superior for assessment of right ventricular systolic function
- 2019
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Ingår i: Clinical Physiology and Functional Imaging. - : Wiley. - 1475-0961. ; 39:2, s. 168-176
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Tidskriftsartikel (refereegranskat)abstract
- Background: Right ventricular (RV) systolic function is an important determinant of outcome in patients with pulmonary hypertension (PH). Conventional echocardiographic measures of RV are mainly based on longitudinal contractility. Recently, measurement of RV global longitudinal strain derived from multiple windows (RVGLS) has emerged as an option but has not been well evaluated. The aim of the present study was to evaluate which echocardiographic RV function parameter correlates best with RV ejection fraction derived from cardiac magnetic resonance imaging (RVEFCMR). Methods and results: Fifty-five patients evaluated for PH underwent RV assessment with echocardiography and CMR. Conventional echocardiographic parameters of RV function including tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (S′), RV fractional area change (RVFAC) and RV index of myocardial performance (RIMP). RVGLS was measured from three separate apical views using a 17-segment model and strain from the lateral free wall was calculated separately (RVfree). The study included 55 patients, whereas assessment of RVGLS could be obtained in 29 patients. The Pearson correlation coefficient with RVEFCMR was strong for RVGLS (r = 0·814, P<0·001) and RVfree (r = 0·778, P<0·001), modest for RVFAC (r = 0·681, P<0·001), TAPSE (r = 0·592, P<0·001) and RIMP (r=−0·521, P<0·01), and weak for S′ (r = 0·385, P<0·01). Conclusion: The echocardiographic RV measures, RVGLS and RVfree correlated well with RVEFCMR, whereas correlation with TAPSE, RIMP and S′ was unsatisfactory. Our findings suggest that RVGLS and RVfree are the preferred echocardiographic methods for clinical practice. RVfree is easiest to perform but RVGLS could provide incremental value in selected patients.
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- Platonov, Pyotr, et al.
(författare)
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Detection of inter-atrial conduction defects with unfiltered signal-averaged P-wave ECG in patients with lone atrial fibrillation
- 2000
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Ingår i: Europace. - : Oxford University Press (OUP). - 1532-2092. ; 2:1, s. 32-41
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To demonstrate a possible inter-atrial conduction delay in patients with lone paroxysmal atrial fibrillation (PAF) using 'unfiltered' signal-averaged P-wave ECG (PSAECG) and compare these results with those obtained with conventional filter settings. METHODS AND RESULTS: Twenty one patients with lone PAF and 20 healthy volunteers (control group) were enrolled in the study. An orthogonal lead surface ECG was high-pass filtered at 0.8 Hz, averaged with template matching, and combined into a spatial magnitude ('unfiltered' technique). Results were compared with conventionally filtered (40-300 Hz) PSAECG. The filtered technique revealed no differences in P-wave duration between the two groups (121 +/- 12 vs 128 +/- 15 ms, control and PAF groups respectively, ns). Double-peaked P-wave spatial magnitudes (interpeak distance >30 ms) were revealed in 11 of 21 PAF patients but only in two of 18 controls (P<0.01). The nadir in the spatial magnitude was located significantly later in the PAF group (114 +/- 13 vs 103 +/- 9 ms, P<0.01). CONCLUSION: 'Unfiltered' PSAECG revealed significant differences in orthogonal P-wave morphology in patients with lone PAF, indicating the possibility of an inter-atrial conduction delay, while conventional P-wave duration analysis failed to discriminate between the two groups.
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- Platonov, Pyotr, et al.
(författare)
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Further evidence of localized posterior interatrial conduction delay in lone paroxysmal atrial fibrillation
- 2001
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Ingår i: Europace. - : Oxford University Press (OUP). - 1532-2092 .- 1099-5129. ; 3:2, s. 100-107
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Prolongation of interatrial conduction time has been reported in patients with paroxysmal atrial fibrillation (PAF). The study objective was to localize the region of the conduction delay in patients with lone PAF. METHODS AND RESULTS: Twenty-one patients with lone PAF and 23 patients with AV nodal re-entrant tachycardia ablation without history of PAF (control group) were recruited. Endocardial recordings were made during sinus rhythm and programmed atrial stimulation. The authors measured the interatrial conduction time, the 'right-sided' conduction time between the high lateral right atrium and the proximal coronary sinus (RA-CSp), and the 'left-sided' conduction time between the proximal and the distal coronary sinus (CSp-LA). During sinus rhythm, the interatrial conduction time was longer in the PAF group (103 +/- 19 vs 86 +/- 12 ms, P<0.01) due to delay of right-sided conduction (RA-CSp was 74 +/- 20 vs 56 +/- 10 ms, P<0.01). During programmed stimulation at the distal coronary sinus, the maximal RA-CSp time was also longer in the PAF group (110 +/- 47 vs 69 +/- 16 ms, P<0.05). No differences in CSp-LA time were observed. CONCLUSION: This study supports the role of posterior septal right atrial conduction disturbances in the genesis of lone PAF.
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