ABSTRACT
Objective To assess right ventricular(RV)systolic function in patients with pulmonary arterial hypertension(PAH)by 2-dimensional strain(2DS).Methods According to pulmonary artery systolic pressure,patients with PAH were divided into mild(17),moderate(15)and severe(10)PAH groups.Logitudinal peak systolic strain values were measured in RV global and free wall for basal,mid and apical segment in 42 patients with PAH and 31 healthy controls by 2DS from the apical 4-chamber view,and compared between groups and assessed the determinants of the RV functional parameters.Results Logitudinal peak systolic strain of RV global and free wall for all segments were significantly impaired in patients with PAH compared with controls and were most altered in patients with the severe PAH group compared with mild patients(P＜0.05 for all).Pulmonary vascular resistance and pulmonary artery systolic pressure were the determinants of RV function (γ1=-0.491～-0.641 and γ2=-0.403～-0.489,respectively,P＜0.05 for both).There were good correlations between tricuspid annular systolic peak velocity and strain of all segments in patients with PAH(γ=0.463～0.587,P＜0.001).Conclusions RV function in patients with PAH was decreased,RV longitudinal systolic function can be accurately and objectively studied by 2DS.
ABSTRACT
PURPOSE: In this study, we analyzed the results of transesophageal echocardiography (TEE) in acute peripheral arterial occlusion patients. METHOD: Over the course of eight years, 124 patients were treated for acute peripheral artery occlusion, and 51 patients underwent transthoracic echocardiogram (TTE) and TEE postoperatively to evaluate for a possible cardiac source of thromboemboli. TEE findings in atrial fibrillation (AF) patients were compared with TEE findings in patients who had AF without thromboembolic events. RESULT: AF was the most common cardiac pathology (35/51). Remnant cardiac thrombi were found in 15 patients, all in the left atrium. The average thrombus size was 1.22x0.99 cm. Surgical thrombectomy was performed in two patients, and oral anticoagulation was performed in the others. During a mean follow-up period of 38 months, 7 patients (13.7%) had recurrent thromboembolic events, even while being treated with anticoagulation. Eleven of 15 patients with remnant cardiac thrombus showed no specific clinical events during the follow-up period. CONCLUSION: Remnant cardiac thrombus was found in 1/3 of patients with acute peripheral arterial occlusion caused by AF. The remnant thrombus could be safely treated with anticoagulation. Left atrial enlargement and spontaneous echogenicity were found to be risk factors for thromboembolism in AF.