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1.
J Echocardiogr ; 22(1): 34-40, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37747625

RESUMO

PURPOSE: Isovolumic relaxation time (IVRT) is a useful indicator of diastolic dysfunction. However, a measurement method for IVRT has not been established. The Dual Gate Doppler method, which can record two separate pulse-wave Doppler signals simultaneously using two sample gates, may be ideal for measuring IVRT. This study aimed to evaluate the accuracy of IVRT measured using conventional methods versus that measured using the Dual Gate Doppler method. METHODS: A total of 104 patients (mean age 58 ± 21 years, 48 women) were examined using ultrasound equipment with Dual Gate Doppler at our hospital. In addition to Dual Gate Doppler method, IVRTs were measured using seven different methods: pulsed Doppler (PW method), continuous wave Doppler (CW method), and other methods. The IVRT values obtained using the Dual Gate Doppler method were compared with those measured using other methods. RESULTS: All IVRTs measured using conventional methods showed a strong correlation with the that measured using the Dual Gate Doppler method. However, there were slight deifferences among the IVRTs depending on the method. The PW method and the PW time difference method using only the PW showed small statistical bias and were not complicated. The IVRT measured using the CW method was significantly longer than that measured using the Dual Gate Doppler method. CONCLUSIONS: Among the conventional methods, the PW method was the simplest and most practical method for measuring the IVRT in any conditions as arrhythmias. It is important to recognize the characteristics of IVRTs based on the measurement method.


Assuntos
Ecocardiografia Doppler de Pulso , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Ecocardiografia Doppler de Pulso/métodos , Diástole
2.
J Echocardiogr ; 21(2): 74-78, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36306103

RESUMO

OBJECTIVES: Ultrasonography is an essential examination performed in various clinical fields. The number of clinical sonographers has been increasing. However, the working environments and conditions at each facility are different, leading to diverse problems. Among them, the emerging issue is the sexual disagreement between the sonographer and patient at the time of echocardiography. Since the patient must expose their breast during echocardiography, female patients may refuse to undergo the examination when conducted by a male sonographer. This study aimed to conduct a questionnaire survey to understand the measures for sonographer-patient gender mismatch at different facilities. METHODS: A questionnaire on the implementation of echocardiography by male sonographers for female patients was answered by representatives and specialist technicians of the Japanese Society of Echocardiography. RESULTS: Questionnaire responses were obtained from 50 facilities (59 participants). A total of 70% of the facilities restricted male sonographers from conducting echocardiography examinations for female patients. Among them, 81% of the facilities serviced female patients aged 60 years or younger. CONCLUSIONS: It has become clear that the gender selection of echocardiographic examiners varies from facility to facility, and providing a sufficient explanation before echocardiographic examination is necessary to avoid causing uncomfortable situations for female patients.


Assuntos
População do Leste Asiático , Ecocardiografia , Humanos , Masculino , Feminino , Ultrassonografia , Pessoal Técnico de Saúde , Inquéritos e Questionários
3.
Intern Med ; 60(21): 3377-3384, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34719624

RESUMO

Objective Patients with Prader-Willi syndrome (PWS) are known to have a high mortality rate. However, little is known about the exact reason for this, particularly in adults, because so few reports have been published. The present study examined cardiovascular abnormalities to determine the cause of death in adults with PWS. Methods From September 2017 to April 2019, a total of 18 adults with PWS, and, no history of cardiovascular diseases, were enrolled. We investigated the levels of the cardiovascular biomarkers: high-sensitivity C-reactive protein (hs-CRP) and troponin T (TnT). To estimate the cardiac function, we measured the left ventricular ejection fraction (LVEF), global longitudinal systolic strain (GLS) of the left ventricle, ratio of peak early mitral filling velocity (E) to early diastolic mitral annular velocity (E/e' ratio), mitral annular plane systolic excursion (MAPSE) and tricuspid annular plane systolic excursion (TAPSE) using standard and tissue Doppler echocardiography. Results The mean patient age was 28±9 years old. There were 11 men, and the mean body mass index was 45.1 kg/m2. Dyslipidemia (82%), diabetes mellitus (82%) and hypertension (83%) were commonly found as comorbidities. Most patients had elevated levels of hs-CRP (mean 1.007±0.538 mg/dL). The LVEF (mean 61%±5%) showed normal values, while the GLS (mean 15.0%±3.0%) was decreased. The TAPSE was mildly reduced (mean 16±3 mm). Conclusion These results suggest that subtle cardiovascular abnormalities have already begun in young adults with PWS. We need to manage obesity and the resultant obesity-related disorders in order to prevent heart failure and coronary atherosclerosis in PWS patients.


Assuntos
Anormalidades Cardiovasculares , Síndrome de Prader-Willi , Adulto , Ecocardiografia Doppler , Humanos , Masculino , Síndrome de Prader-Willi/complicações , Volume Sistólico , Função Ventricular Esquerda , Adulto Jovem
4.
J Echocardiogr ; 16(1): 1-5, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29362979

RESUMO

Echocardiography plays a pivotal role as an imaging modality in the modern cardiology practice. Information derived from echocardiography is definitely helpful for a patient care. The Japanese Society of Echocardiography has promoted echocardiography for a routine clinical and research use. One of the missions of the Society is to provide information that is useful for high-quality examinations. To ensure it, we believe equipment in good conditions and a comfortable environment are important for both a patient and an examiner. Thus, the Committee for Guideline Writing, the Japanese Society of Echocardiography published brief guidance for the routine use of echocardiography equipment in 2015. Recently, the importance of international standardization has been emphasized in the medical laboratories. Accordingly, the committee has revised and updated our guidance for the routine use of echocardiography equipment.


Assuntos
Ecocardiografia/instrumentação , Ecocardiografia/normas , Manutenção/normas , Infecção Hospitalar/prevenção & controle , Humanos , Japão , Manutenção/organização & administração
8.
Echocardiography ; 33(1): 30-7, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26120955

RESUMO

BACKGROUND: Two-dimensional speckle tracking (2DST) stress echocardiography detects postischemic myocardial diastolic stunning. However, the use of 2DST at rest for detecting diastolic stunning in ischemia is unclear. RESULTS: Thirty-nine patients (age = 65 ± 12 years; male/female = 34/5) with effort angina pectoris that was confirmed by stress myocardial perfusion scintigraphy were enrolled. Ischemic area (I) was determined in the middle LV short axial view using stress myocardial scintigraphy. The area opposite to it was defined as nonischemic area (non-I). Midventricular parasternal short-axis (SAX) radial strains were estimated using 2DST at rest on the following day. LV diastolic function was evaluated using diastolic index (DI, changes in the regional LV radial strain during diastole) and radial strain rate (SR) during early diastolic period. These parameters were compared between I and non-I before and 1 month after percutaneous coronary intervention (PCI) in the I of 3 coronary vessels. For the I, the DI was lower (38 ± 27 vs. 55 ± 27; P = 0.003) and SR was higher (-1.6 ± 0.6 vs. -1.9 ± 0.8; P = 0.007) than in non-I before PCI. One month after PCI, the DI and SR recovered to 53 ± 27 (P = 0.008) and -2.1 ± 0.8 (P = 0.006), respectively. Furthermore, the DI of the LAD and LCX significantly improved (P = 0.0004 and 0.002, respectively); the RCA area showed tendency to improve (P = 0.092), and the SR also improved (P < 0.05) in all areas after PCI. CONCLUSION: Diastolic stunning in ischemic areas can be detected using 2DST at rest and recover 1 month after PCI.


Assuntos
Estenose Coronária/diagnóstico por imagem , Miocárdio Atordoado/diagnóstico por imagem , Idoso , Estenose Coronária/fisiopatologia , Diástole , Feminino , Humanos , Masculino , Miocárdio Atordoado/fisiopatologia , Reprodutibilidade dos Testes , Descanso , Índice de Gravidade de Doença , Ultrassonografia
9.
Circ J ; 79(3): 613-22, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25746546

RESUMO

BACKGROUND: We sought to identify the feasibility of speckle tracking echocardiography (STE) to predict cardiac resynchronization therapy (CRT) responders in a prospective multicenter study. METHODS AND RESULTS: Patients who were newly implanted with a CRT device were enrolled. Time (T) from QRS to maximum peak radial and circumferential strain (CS) in 6 segments on the left ventricular (LV) short-axis plane, and to the maximum peak of longitudinal strain in 18 segments on 3 apical LV planes was measured (Tmax). In segments with multiple peaks on the time-strain curves, time to the first peak (Tfirst) was also assessed. Difference in T between the earliest and latest segment and standard deviation (SD) of T in each strain component were assessed. CRT responders were defined as having LV end-systolic volume reduction >15% at 6 months after CRT. Clinical outcomes were assessed with a composite endpoint of death from cardiac causes or unplanned hospitalization for heart failure. Among 180 patients, 109 patients were identified as responders. Tfirst-SD of CS >116 ms was selected as the best independent predictor of CRT responders (P<0.001, hazard ratio=9.83, 95% confidence interval 3.78-25.6). In addition, Tfirst-SD of CS was associated with the clinical endpoints. CONCLUSIONS: This prospective multicenter study revealed the high feasibility of dyssynchrony assessment by STE, which may improve the ability to predict CRT responders.


Assuntos
Terapia de Ressincronização Cardíaca , Ecocardiografia , Monitorização Fisiológica , Idoso , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos
10.
Circ J ; 74(6): 1081-6, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20453390

RESUMO

BACKGROUND: Transesophageal echocardiography (TEE) is useful for detecting left atrial (LA) thrombus prior to percutaneous LA catheter ablation in patients with atrial fibrillation (AF). This study was designed to evaluate clinical predictors of LA thrombus and determine indications for TEE screening prior to LA ablation. METHODS AND RESULTS: The study consisted of 446 patients with drug-resistant AF who were scheduled to undergo initial LA ablation (age 59+/-11 years, 312 males, 136 persistent AF). TEE was performed in all cases within 24 h before ablation. We assessed clinical parameters including CHADS(2) score and echocardiographic parameters. LA thrombus was detected in 13 cases (2.9%) prior to LA ablation (67+/-8 years, 10 males, 12 persistent AF). In multiple logistic regression analysis, advanced age (odds ratio (OR) 1.1, 95% confidence interval (CI) 1.0-1.2; P<0.05), persistent AF (OR 38.1, 95%CI 1.4-988; P<0.05) and structural heart diseases (OR 29.8, 95%CI 2.8-383; P<0.01) were independent positive predictors of LA thrombus prior to ablation, while CHADS(2) score and LA volume were not significant predictors. None of the 136 patients with paroxysmal lone AF whose age was below 60 years had LA thrombus prior to ablation. CONCLUSIONS: It might be reasonable to omit TEE as a screening examination for LA thrombus prior to LA ablation in younger paroxysmal lone AF patients.


Assuntos
Fibrilação Atrial/cirurgia , Ablação por Cateter , Ecocardiografia Transesofagiana/estatística & dados numéricos , Átrios do Coração , Valor Preditivo dos Testes , Trombose/diagnóstico por imagem , Fatores Etários , Idoso , Fibrilação Atrial/epidemiologia , Ablação por Cateter/estatística & dados numéricos , Feminino , Cardiopatias , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Trombose/diagnóstico
11.
Circ J ; 72(1): 120-6, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18159112

RESUMO

BACKGROUND: The indications and efficacy of cardiac resynchronization therapy (CRT) have not been sufficiently clarified in patients with right bundle branch block (RBBB). METHODS AND RESULTS: This study included 55 patients with normal QRS morphology and duration (Control-Gr) and 49 patients with complete RBBB (CRBBB-Gr). Using tissue Doppler imaging, the time difference (TD) between the electromechanical delay of the septal wall, left ventricular (LV) lateral wall, and right ventricular free wall were measured. Using tissue tracking imaging, the coefficient of the time variation from the beginning of the QRS to the peak displacement time of 6 regions of the LV (CV-PMDLV) was calculated. The TD between the septal wall and that of the LV lateral wall (TDSEPT-LAT) did not differ between the Control-Gr and RBBB-Gr. However, a significant difference was found in the TDSEPT-LAT between the CRBBB patients with LV systolic dysfunction (ejection fraction (EF) < or =50%) and those with normal LV function (EF >50%; p<0.001). The CV-PMDLV was greater in the CRBBB patients with LV systolic dysfunction than in those with a normal LV function (p<0.05). The RBBB-Gr patients with LV dysfunction and a great TDSEPT-LAT, improved clinically after the CRT. CONCLUSIONS: The presence of RBBB and LV dysfunction may indicate LV dyssynchrony and a heterogeneous mechanical dysfunction.


Assuntos
Bloqueio de Ramo/fisiopatologia , Disfunção Ventricular Esquerda/fisiopatologia , Adulto , Idoso , Bloqueio de Ramo/terapia , Estimulação Cardíaca Artificial , Estudos de Casos e Controles , Técnicas Eletrofisiológicas Cardíacas/métodos , Feminino , Sistema de Condução Cardíaco/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Disfunção Ventricular Esquerda/terapia
12.
Pacing Clin Electrophysiol ; 30 Suppl 1: S13-8, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17302689

RESUMO

BACKGROUND: Tissue synchronization imaging (TSI) and tissue tracking imaging (TTI) might facilitate the evaluation of ventricular dyssynchrony. METHODS: In 22 patients, TSI and TTI were performed before and < 1 month after onset of cardiac resynchronization therapy (CRT). With TSI guidance, maximum left ventricular (LV) intraventricular conduction delay (IVCDmax) was the greatest difference in time-to-peak velocity between septum and lateral wall. IVCD between the basal septum and lateral wall (IVCDbase) was also measured. Using TTI, the mean peak myocardial displacement of the basal septal and lateral walls (PMDbase), and the temporal coefficient of variation of the PMD in six LV regions (CV-PMDLV) were measured. The patients were divided into responders (whose LV end-systolic volume decreased by >/= 15% during a 27 +/- 9 months follow-up) and nonresponders. RESULTS: Before CRT, IVCDbase was similar in both groups, and remained unchanged within the 1st month of CRT in both groups. However, before CRT, IVCDmax was greater in responders than in nonresponders (P < 0.05), and decreased only in the responders during CRT (P < 0.05). No significant difference was observed in PMDbase or CV-PMDLV between the two groups, before or during CRT. CONCLUSIONS: TSI was useful to measure IVCDmax. A greater IVCDmax before CRT that decreased shortly after onset of CRT may predict long-term clinical improvement in CRT recipients.


Assuntos
Estimulação Cardíaca Artificial , Ecocardiografia Doppler , Disfunção Ventricular Esquerda/diagnóstico por imagem , Remodelação Ventricular , Idoso , Fibrilação Atrial/etiologia , Fibrilação Atrial/terapia , Feminino , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Marca-Passo Artificial , Valor Preditivo dos Testes , Resultado do Tratamento
13.
Am J Cardiol ; 95(5): 660-4, 2005 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-15721115

RESUMO

Tissue tracking imaging was performed in 33 patients with idiopathic ventricular arrhythmias before radiofrequency catheter ablation. The site of the arrhythmia origin, defined as the site where the earliest color-coded signal appeared on the myocardium at the onset of the arrhythmia, corresponded to the site of origin as determined on fluoroscopy during activation mapping in all patients. Catheter ablation at that site abolished the arrhythmia in 29 patients (88%).


Assuntos
Ecocardiografia Doppler/métodos , Taquicardia Ventricular/diagnóstico por imagem , Complexos Ventriculares Prematuros/diagnóstico por imagem , Ablação por Cateter , Feminino , Fluoroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Taquicardia Ventricular/cirurgia , Resultado do Tratamento , Complexos Ventriculares Prematuros/cirurgia
14.
Circ J ; 69(2): 194-200, 2005 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15671612

RESUMO

BACKGROUND: The purpose of this study was to determine the utility and efficacy of tissue Doppler imaging (TDI) and strain Doppler imaging (SDI) for evaluating ventricular synchrony and function, and for predicting the long-term clinical improvement in patients undergoing biventricular pacing (BVP). METHODS AND RESULTS: TDI and SDI were performed before and <1 month after initiating BVP in 17 patients with advanced heart failure. An intraventricular conduction delay between the left ventricular (LV) septal and lateral walls was measured by TDI. The average LV strain (LV-strain) was calculated from data obtained at the center of 6 regions of the LV (base and mid-point between the basal and apical portions, and the mid-point between these 2 points on the septal and lateral walls). During a 23+/-7 month follow-up period, 12 patients improved clinically and did not require re-hospitalization for heart failure (responder group), but the remaining 5 did not improve (nonresponder group). Before BVP, the intraventricular conduction delay was greater in the responder group than in the nonresponder group (p<0.01), but after BVP, it did not differ between the 2 groups. LV-strain improved after BVP in the responder group but not in the nonresponder group (p<0.05). CONCLUSION: A high intraventricular conduction delay before BVP and decreased strain shortly after BVP may predict long-term clinical improvement in patients undergoing this treatment.


Assuntos
Estimulação Cardíaca Artificial/métodos , Ecocardiografia Doppler/métodos , Insuficiência Cardíaca/terapia , Valor Preditivo dos Testes , Idoso , Feminino , Sistema de Condução Cardíaco , Insuficiência Cardíaca/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Função Ventricular Esquerda
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