Dehong Kong

Left Ventricular Longitudinal and Circumferential Layer‐Specific Myocardial Strains and Their Determinants in Healthy Subjects

The reference values and impact of physiologic variables on echocardiographic quantification of left ventricular (LV) longitudinal and circumferential layer‐specific myocardial strains in large series of healthy persons remain unknown. This study prospectively investigated the impact of age, gender, and other physiologic parameters on LV longitudinal and circumferential layer‐specific myocardial strains.

Right Ventricular Regional Systolic Function and Dyssynchrony in Patients with Pulmonary Hypertension Evaluated by Three-Dimensional Echocardiography

BACKGROUND The aim of this study was to evaluate right ventricular (RV) regional systolic function and dyssynchrony in patients with pulmonary hypertension (PH) using real-time three-dimensional echocardiography. METHODS Real-time three-dimensional echocardiographic images were acquired to obtain RV regional (inflow, body, and outflow) ejection fraction (EF) and time to minimum systolic volume in 70 patients with PH and 26 normal controls. Pulmonary artery systolic pressure (PASP) and pulmonary vascular resistance measured by echocardiography in all subjects and by right heart catheterization in 17 patients were recorded. RESULTS Inflow EF and global EF were significantly lower in patients with PH than in controls (P < .05). Body EF was significantly decreased in patients with moderate (PASP, 50-69 mm Hg) and severe (PASP ≥ 70 mm Hg) PH (P < .05). Outflow EF was significantly lowered in patients with severe PH (P < .001). The standard deviation of regional time to minimum systolic volume corrected by heart rate was significantly prolonged in patients with severe PH (P < .05). Inflow EF and global EF were negatively correlated with PASP (r = -0.731 and r = -0.769, respectively, P < .001) and with pulmonary vascular resistance (r = -0.789 and r = -0.801, P < .001). CONCLUSIONS In patients with PH, RV inflow and global systolic function was impaired in inverse relationship with PASP and pulmonary vascular resistance. RV systolic synchronicity was impaired in patients with severe PH. Evaluation of RV regional systolic function using real-time three-dimensional echocardiography may play a potential role in the noninvasive assessment of the severity of PH.

A novel method for sensitive determination of subclinical right ventricular systolic dysfunction in patients with obstructive sleep apnea

The aim of this study was to evaluate right ventricular (RV) regional systolic function and dyssynchrony in patients with newly diagnosed obstructive sleep apnea using real‐time three‐dimensional (3D) echocardiography.

Rare variant of mixed total anomalous pulmonary venous drainage (TAPVD) in a 55-year-old patient

A 55-year-old man presented with recent-onset oedema of lower extremity. He had cyanosis and clubbing since childhood, but his exercise tolerance was relatively good. Transthoracic echocardiography (TTE) demonstrated significantly dilated and hypertrophied right ventricle, moderate pulmonary stenosis and an atrial septal defect (ASD) of 27 mm with right-to-left shunt ( Panels A–C and Supplementary data online, Video S1 ). Peak pressure …

Subclinical myocardial dysfunction in coronary slow flow phenomenon: identification by speckle tracking echocardiography

This study aimed to determine whether STE could help detect subclinical myocardial dysfunction in patients with CSFP.

Percutaneous left atrial appendage closure through a patent foramen ovale evaluated by intraprocedural transesophageal echocardiography.

A 59-year-old man with persistent atrial fibrillation (AF) and recent ischemic stroke presented to our hospital for evaluation of percutaneous left atrial appendage (LAA) closure. He had suffered from recurrent palpitation for more than 1 year. On admission, his blood pressure was 130/88 mmHg and heart rate was 79 bpm. The level of B-type natriuretic peptide (BNP) was 850.3 pg/ml. Transthoracic echocardiography showed a dilated left atrium with the anteroposterior dimension of 46 mm. The patient refused to accept antithrombotic therapy and chose LAA closure for personal reasons. Pre-procedural two-dimensional and three-dimensional transesophageal echocardiography (TEE) revealed a windsock-shaped LAA with a width of 22 mm and a depth of 23 mm. No evidence of LAA thrombus was detected (Fig. 1a, b). A patent foramen ovale (PFO) with left-toright shunt was noted (Fig. 1c), and was used for left atrial access during percutaneous closure of LAA in this case. Intraprocedural TEE was performed to monitor the delivery of the sheath through PFO (Fig. 1d, e). Angiography results confirmed TEE-measured landing zone diameters (Fig. 1f). A 27-mm WATCHMAN device was implanted. TEE demonstrated a mild residual leak at 130 (Fig. 1g). A 24-mm Amplatzer occluder was deployed to the PFO after LAA closure (Fig. 1h, i). There was no residual interatrial shunt shown by TEE.

Unusual intravascular leiomyomatosis arising from the pulmonary artery

A middle-aged women presented with a mass in the right ventricle revealed by echocardiography during a routine medical checkup. The patient had no medical history of gynaecological surgery or uterine leiomyomatosis. Transthoracic echocardiography showed a floating mass occupying the pulmonary artery and the right ventricle ( Panel A , see Supplementary data online, Video S1 …

New echocardiographic indexes for evaluating cardiac function in idiopathic pulmonary arterial hypertension using three-dimensional echocardiography.

Purpose Noninvasive real-time three-dimensional echocardiography (RT3DE) was utilized to explore new indexes for evaluating cardiac function in patients with idiopathic pulmonary arterial hypertension (IPAH). Methods Parameters of cardiac function were evaluated in 24 patients with IPAH and 24 normal control subjects. End-systolic volume (ESV), enddiastolic volume (EDV), and ejection fractions (EFs) of the right and left ventricles (RV, LV, respectively) were measured using a four-dimensional RV and LV quantification method. Right heart catheterization was performed in IPAH patients within one day of the RT3DE examination to obtain measurements of pulmonary vascular resistance (PVR). A 6-minute walk test (6MWT) was also performed within 48 hours. Results RT3DE showed RV volumes were increased while LV volumes were decreased in IPAH patients as compared to volumes in normal control subjects (P <0.001, respectively). Additionally, the RVEFs in IPAH patients were significantly lower compared to those in control individuals; however, the two groups showed no difference in LVEF. We then termed RVEDV/LVEDV and RVESV/LVESV as “new indexes,” and found both values were higher in IPAH patients compared to control subjects. A linear regression analysis revealed that neither RVEDV nor RVESV, but rather LVEDV and LVESV negatively correlated with PVR and results on the 6MWT. RVEF correlated negatively with PVR. Both “new indexes” showed a significant positive correlation with PVR and 6MWT results. Conclusions Our results suggest that evaluation of biventricular volume and function using RT3DE might be useful for non-invasive assessment of cardiac function in IPAH.