Assuntos
Doenças das Artérias Carótidas/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Placa Aterosclerótica , Ultrassonografia , Calcificação Vascular/diagnóstico por imagem , Idoso , Biópsia , Doenças das Artérias Carótidas/patologia , Doenças das Artérias Carótidas/cirurgia , Vasos Coronários/patologia , Vasos Coronários/cirurgia , Endarterectomia das Carótidas , Feminino , Fibrose , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos Testes , Espalhamento de Radiação , Calcificação Vascular/patologia , Calcificação Vascular/cirurgiaRESUMO
BACKGROUND: The association of the tissue characteristics of carotid plaques with coronary artery disease has attracted interest. The present study compared the tissue characteristics of carotid plaques in patients with acute coronary syndrome (ACS) with those in patients with stable angina pectoris (SAP) using the iPlaque system, which is based on ultrasound integrated backscatter. METHODS AND RESULTS: Carotid ultrasound examinations were performed in 26 patients with ACS, and 38 age- and gender-matched patients with SAP. Neither plaque area nor maximal intima-media thickness differed significantly between the two groups. However, the average integrated backscatter value within the plaque was greater in the ACS patients than in the SAP patients. iPlaque analysis revealed that the percentage blue area (lipid pool) was greater in the ACS patients than in the SAP patients (43.4 ± 11.2 vs 18.3 ± 10.3%, p < 0.0001), and that the percentage green area (fibrosis) was lower in the ACS than in the SAP patients (7.5 ± 7.5% vs 20.7 ± 11.7%, p < 0.0001). CONCLUSIONS: The lipid component of carotid plaques is greater in ACS patients than in SAP patients. Our iPlaque system provides a useful and feasible method for the tissue characterization of carotid plaques in the clinical setting.
Assuntos
Síndrome Coronariana Aguda/diagnóstico por imagem , Angina Estável/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Ultrassonografia/métodos , Síndrome Coronariana Aguda/complicações , Idoso , Algoritmos , Angina Estável/complicações , Doenças das Artérias Carótidas/complicações , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Software , Integração de SistemasRESUMO
An 83-year-old woman presented to our echocardiographic center with symptoms of right heart failure. A dual-chamber DDDR pacemaker had been implanted 9 years earlier. Two-dimensional echocardiography revealed right atrial and ventricular enlargement and massive tricuspid regurgitation with immobilization of the anterior leaflet of the tricuspid valve. Three-dimensional transesophageal echocardiography showed that the pacemaker lead had punctured the leaflet. These echocardiographic findings were confirmed during surgery. The pacemaker lead was transected and removed, and pericardial patch closure of the leaflet hole and tricuspid annuloplasty were performed. The mechanism of regurgitation was elucidated by real-time three-dimensional echocardiography, and surgical repair was straightforward.
Assuntos
Angina Estável/diagnóstico , Valva Mitral/fisiopatologia , Função Ventricular Esquerda , Pressão Ventricular , Angina Estável/diagnóstico por imagem , Angina Estável/fisiopatologia , Função do Átrio Esquerdo , Pressão Atrial , Cateterismo Cardíaco , Estudos de Casos e Controles , Ecocardiografia Doppler em Cores , Humanos , Valva Mitral/diagnóstico por imagem , Análise Multivariada , Valor Preditivo dos Testes , Estudos Prospectivos , Fatores de TempoRESUMO
A 67-year-old man was admitted due to insensitiveness of right upper limb and dysarthria, and treated for suspected lacunar infarction or branch atherosclerotic disease. Carotid ultrasonography showed no abnormalities, and agitated contrast transesophageal echocardiography was performed to detect patent foramen ovale (PFO). Intravenously administered microbubbles did not appear in left atrium by 2-dimensional echocardiography, while contrasts were observed in left atrium using 3-dimensional echocardiography. Real-time 3-dimensional contrast transesophageal echocardiography may be the most useful method for the diagnosis of small PFO.
RESUMO
A 75-year-old man was referred to our echocardiography laboratory for presurgical evaluation. His past history included ventricular septal defect closure. He reported chest discomfort in the right decubitus position. Two-dimensional and Doppler echocardiography revealed an anomalous muscle bundle with accelerated blood flow in the right ventricle. The peak flow velocity of the flow increased from 1.4 m/s in the left decubitus position to 2.9 m/s in the right decubitus position. Double-chamber right ventricle with intermittent mid-ventricular obstruction during the right decubitus position was confirmed by transesophageal echocardiography.