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Echocardiography (Mount Kisco, N.Y.) Aug 2023Adequate grading of mitral regurgitation (MR) in patients with mitral valve prolapse (MVP) in the presence of mid-late systolic jets can represent a major challenge. In...
Adequate grading of mitral regurgitation (MR) in patients with mitral valve prolapse (MVP) in the presence of mid-late systolic jets can represent a major challenge. In this entity, jets are commonly overestimated by echocardiography. Correct quantification is crucial and highly relevant for the further management and prognosis of these oftentimes young patients. This case points out potential pitfalls and underlines the importance to systematically include qualitative, quantitative, and semi-quantitative parameters into the echocardiographic assessment.
Topics: Humans; Mitral Valve Prolapse; Mitral Valve Insufficiency; Echocardiography; Prognosis; Heart Murmurs
PubMed: 37138500
DOI: 10.1111/echo.15583 -
Echocardiography (Mount Kisco, N.Y.) Aug 2023There are relatively few studies investigating cardiac structural and functional abnormalities associated with systemic lupus erythematous (SLE). The long-term prognosis... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
There are relatively few studies investigating cardiac structural and functional abnormalities associated with systemic lupus erythematous (SLE). The long-term prognosis of SLE patients is closely related to the cardiovascular events caused by SLE. Accordingly, it is necessary to assess early myocardial systolic function and synchrony.
METHODS
Overall, 90 patients with SLE were randomly selected from our outpatient and inpatient clinics and divided according to SLE Disease Activity Index (SLE-DAI-2000) scores: group A, stable (scores 0-4); group B, mildly active stage (scores 5-9); and group C, moderately active stage (scores ≥10). Each group included 30 patients. Further, 30 sex- and age-matched healthy individuals who were referred for check-ups at the same period were selected as controls (group D). The minimum age for entry into the group was 17 years old. Autostrain LV and three-dimensional quantitative analysis (3DQA) were applied to obtain left ventricular systolic function parameters, information on strain parameters, and correlations between parameters. Simultaneity parameters measured by Autostrain LV and 3DQA were tested for reproducibility.
RESULTS
A two-by-two comparison of groups A-C showed that as the disease activity score increased, AP4LS%, AP2LS%, AP3LS%, and the LV mean overall longitudinal strain all gradually decreased, while LV longitudinal strain peak time standard deviation (Tls-SD) gradually increased, with all differences being statistically significant (p < .05). In groups A-C compared with controls, Tmsv-17-SD, Tmsv-17-Dif, Tmsv-17-SD%, and Tmsv-17-Dif% were all significantly prolonged (p < .05). Further, Tls-SD was positively correlated with Tmsv-17-SD and Tmsv-17-Dif, and there was good agreement between Autostrain and 3DQA for the measurement of left ventricular synchrony indexes, with Tmsv-17-Dif having the best repeatability (intraobserver interclass correlation coefficient (ICC) = .979; interobserver ICC = .848, p < .01).
CONCLUSION
Autostrain LV can accurately detect changes in left ventricular myocardial strain in patients with SLE early in the disease, with simple operation. The 3DQA technique can quantitatively evaluate left ventricular systolic synchronization in patients with SLE, and Autostrain LV synchronization index measurements correlate significantly with 3DQA. Both methods are reproducible, but 3DQA is more sensitive to left ventricular synchronous motion changes.
Topics: Humans; Adolescent; Ventricular Dysfunction, Left; Reproducibility of Results; Ventricular Function, Left; Heart; Lupus Erythematosus, Systemic; Heart Murmurs
PubMed: 37126423
DOI: 10.1111/echo.15562 -
IEEE Transactions on Bio-medical... Sep 2023Development of a contact microphone-driven screening framework for the diagnosis of coexisting valvular heart diseases (VHDs).
OBJECTIVE
Development of a contact microphone-driven screening framework for the diagnosis of coexisting valvular heart diseases (VHDs).
METHODS
A sensitive accelerometer contact microphone (ACM) is employed to capture heart-induced acoustic components on the chest wall. Inspired by the human auditory system, ACM recordings are initially transformed into Mel-frequency cepstral coefficients (MFCCs) and their first and second derivatives, resulting in 3-channel images. An image-to-sequence translation network based on the convolution-meets-transformer (CMT) architecture is then applied to each image to find local and global dependencies in images, and predict a 5-digit binary sequence, where each digit corresponds to the presence of a specific type of VHD. The performance of the proposed framework is evaluated on 58 VHD patients and 52 healthy individuals using a 10-fold leave-subject-out cross-validation (10-LSOCV) approach.
RESULTS
Statistical analyses suggest an average sensitivity, specificity, accuracy, positive predictive value, and F1 score of 93.28%, 98.07%, 96.87%, 92.97%, and 92.4% respectively, for the detection of coexisting VHDs. Furthermore, areas under the curve (AUC) of 0.99 and 0.98 are respectively reported for the validation and test sets.
CONCLUSION
The high performances achieved prove that local and global features of ACM recordings effectively characterize heart murmurs associated with valvular abnormalities.
SIGNIFICANCE
Limited access of primary care physicians to echocardiography machines has resulted in a low sensitivity of 44% when using a stethoscope for the identification of heart murmurs. The proposed framework provides accurate decision-making on the presence of VHDs, thus reducing the number of undetected VHD patients in primary care settings.
Topics: Humans; Heart Valve Diseases; Heart Murmurs; Heart Auscultation; Echocardiography; Predictive Value of Tests
PubMed: 37028021
DOI: 10.1109/TBME.2023.3253381