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Journal of the American College of... Feb 2017Strain-based imaging techniques (and specifically speckle-tracking echocardiography) have been shown to have clinical utility in a variety of settings. This technique is... (Review)
Review
Strain-based imaging techniques (and specifically speckle-tracking echocardiography) have been shown to have clinical utility in a variety of settings. This technique is being embraced and increasingly adopted in many echocardiography laboratories worldwide. This review appraised speckle-tracking echocardiography in a clinical context by providing a critical evaluation of the prognostic and diagnostic insights that this technology can provide. In particular, we discuss the use of speckle-tracking strain in selected areas, such as undifferentiated left ventricular hypertrophy, cardio-oncology, aortic stenosis, and ischemic heart disease. The potential utility of regional and chamber strains (namely segmental left ventricular strain, left atrial strain, and right ventricular strain) are also discussed. Future directions for this technology are explored. Before its clinical application, it is particularly important that physicians be cognizant of the technical challenges and inherent limitations of strain data, which are also addressed here.
Topics: Cardiovascular Diseases; Echocardiography, Doppler; Echocardiography, Three-Dimensional; Humans
PubMed: 28231932
DOI: 10.1016/j.jacc.2016.12.012 -
Nature Jan 2023Continuous imaging of cardiac functions is highly desirable for the assessment of long-term cardiovascular health, detection of acute cardiac dysfunction and clinical...
Continuous imaging of cardiac functions is highly desirable for the assessment of long-term cardiovascular health, detection of acute cardiac dysfunction and clinical management of critically ill or surgical patients. However, conventional non-invasive approaches to image the cardiac function cannot provide continuous measurements owing to device bulkiness, and existing wearable cardiac devices can only capture signals on the skin. Here we report a wearable ultrasonic device for continuous, real-time and direct cardiac function assessment. We introduce innovations in device design and material fabrication that improve the mechanical coupling between the device and human skin, allowing the left ventricle to be examined from different views during motion. We also develop a deep learning model that automatically extracts the left ventricular volume from the continuous image recording, yielding waveforms of key cardiac performance indices such as stroke volume, cardiac output and ejection fraction. This technology enables dynamic wearable monitoring of cardiac performance with substantially improved accuracy in various environments.
Topics: Humans; Cardiac Output; Echocardiography; Heart; Heart Ventricles; Stroke Volume; Wearable Electronic Devices; Skin; Equipment Design
PubMed: 36697864
DOI: 10.1038/s41586-022-05498-z -
Critical Care Medicine Nov 2013Portable ultrasound is now used routinely in many ICUs for various clinical applications. Echocardiography performed by noncardiologists, both transesophageal and... (Review)
Review
OBJECTIVE
Portable ultrasound is now used routinely in many ICUs for various clinical applications. Echocardiography performed by noncardiologists, both transesophageal and transthoracic, has evolved to broad applications in diagnosis, monitoring, and management of critically ill patients. This review provides a current update on focused critical care echocardiography for the management of critically ill patients.
METHOD
Source data were obtained from a PubMed search of the medical literature, including the PubMed "related articles" search methodology.
SUMMARY AND CONCLUSIONS
Although studies demonstrating improved clinical outcomes for critically ill patients managed by focused critical care echocardiography are generally lacking, there is evidence to suggest that some intermediate outcomes are improved. Furthermore, noncardiologists can learn focused critical care echocardiography and adequately interpret the information obtained. Noncardiologists can also successfully incorporate focused critical care echocardiography into advanced cardiopulmonary life support. Formal training and proctoring are important for safe application of focused critical care echocardiography in clinical practice. Further outcomes-based research is urgently needed to evaluate the efficacy of focused critical care echocardiography.
Topics: Cardiopulmonary Resuscitation; Critical Care; Echocardiography; Echocardiography, Transesophageal; Humans; Monitoring, Physiologic; Point-of-Care Systems
PubMed: 23989172
DOI: 10.1097/CCM.0b013e31829e4dc5 -
Circulation Journal : Official Journal... Feb 2018Echocardiography is an invaluable tool for characterizing cardiac structure and function in vivo. Technological advances in high-frequency ultrasound over the past 3... (Review)
Review
Echocardiography is an invaluable tool for characterizing cardiac structure and function in vivo. Technological advances in high-frequency ultrasound over the past 3 decades have increased spatial and temporal resolution, and facilitated many important clinical and basic science discoveries. Successful reverse translation of established echocardiographic techniques, including M-mode, B-mode, color Doppler, pulsed-wave Doppler, tissue Doppler and, most recently, myocardial deformation imaging, from clinical cardiology into the basic science laboratory has enabled researchers to achieve a deeper understanding of myocardial phenotypes in health and disease. With high-frequency echocardiography, detailed evaluation of ventricular systolic function in a range of small animal models is now possible. Furthermore, improvements in frame rate and the advent of diastolic strain rate imaging, when coupled with the use of select pulsed-wave Doppler parameters, such as isovolumic relaxation time and E wave deceleration, have enabled nuanced interpretation of ventricular diastolic function. Comparing pulsed-wave Doppler indices of atrioventricular inflow during early and late diastole with parameters that describe the simultaneous myocardial deformation (e.g., tissue Doppler é and á, global longitudinal strain rate and global longitudinal velocity) may yield additional insights related to myocardial compliance. This review will provide a historical perspective of the development of high-frequency echocardiography and consider how ongoing innovation will help future-proof this important imaging modality for 21st century translational research.
Topics: Animals; Diagnostic Imaging; Echocardiography; Echocardiography, Doppler, Pulsed; Heart; Humans; Mice; Research; Zebrafish
PubMed: 29415914
DOI: 10.1253/circj.CJ-18-0027 -
Revista Portuguesa de Cardiologia Aug 2020The number and complexity of percutaneous interventions for the treatment of structural heart disease has increased in clinical practice in parallel with the development... (Review)
Review
The number and complexity of percutaneous interventions for the treatment of structural heart disease has increased in clinical practice in parallel with the development of new imaging technologies, in order to render these interventions safer and more accurate. Complementary imaging modalities are commonly used, but they require additional mental reconstruction and effort by the interventional team. The concept of fusion imaging, where two different modalities are fused in real time and on a single monitor, aims to solve these limitations. This is an important tool to guide percutaneous interventions, enabling a good visualization of catheters, guidewires and devices employed, with enhanced spatial resolution and anatomical definition. It also allows the marking of anatomical reference points of interest for the procedure. Some studies show decreased procedural time and total radiation dose with fusion imaging; however, there is a need to obtain data with more robust scientific methodology to assess the impact of this technology in clinical practice. The aim of this review is to describe the concept and basic principles of fusion imaging, its main clinical applications and some considerations about the promising future of this imaging technology.
Topics: Cardiac Catheterization; Cardiology; Echocardiography, Three-Dimensional; Echocardiography, Transesophageal; Fluoroscopy; Multimodal Imaging
PubMed: 32736908
DOI: 10.1016/j.repc.2020.03.014 -
Methodist DeBakey Cardiovascular Journal 2014Echocardiography has evolved over the past 45 years from a simple M-mode tracing to an array of technologies that include two-dimensional imaging, pulsed and continuous... (Review)
Review
Echocardiography has evolved over the past 45 years from a simple M-mode tracing to an array of technologies that include two-dimensional imaging, pulsed and continuous wave spectral Doppler, color flow and tissue Doppler, and transesophageal echocardiography. Together, these modalities provide a comprehensive anatomic and functional evaluation of cardiac chambers and valves, pericardium, and ascending and descending aorta. The switch from analog to digital signal processing revolutionized the field of ultrasound, resulting in improved image resolution, smaller instrumentation that allows bedside evaluation and diagnosis of patients, and digital image storage for more accurate quantification and comparison with previous studies. It also opened the door for new advances such as harmonic imaging, automated border detection and quantification, 3-dimensional imaging, and speckle tracking. This article offers an overview of some newer developments in echocardiography and their promising applications.
Topics: Cardiovascular Diseases; Diffusion of Innovation; Echocardiography; Echocardiography, Doppler; Echocardiography, Three-Dimensional; Echocardiography, Transesophageal; Humans; Image Interpretation, Computer-Assisted; Predictive Value of Tests; Prognosis; Severity of Illness Index
PubMed: 25574341
DOI: 10.14797/mdcj-10-3-146 -
Journal of Healthcare Engineering 2022Heart space-occupying lesions are a disease that occurs frequently in clinical setting, and therefore, it is important to diagnose and treat this type of pathologies...
Heart space-occupying lesions are a disease that occurs frequently in clinical setting, and therefore, it is important to diagnose and treat this type of pathologies properly. Angiographic echocardiography and transesophageal sonogram are widely used for clinical diagnosis. Their application provides a guarantee for the diagnosis of cardiac space-occupying lesions. In this paper, the application of cardiac contrast echocardiography and transesophageal echocardiography in cardiac space-occupying lesions was studied. Prediction of cardiac lesions can accurately determine the nature of cardiac occupancies and provide a basis for clinical diagnosis and management judgments. The results of pathological analysis and experimental comparison showed that myocardial contrast echocardiography can accurately distinguish tumor and thrombus and make contribution to patients taking appropriate medical measures. At the same time, it can compare conventional transthoracic echocardiography and transesophageal echocardiography. The results showed that TEE could clearly show the cardiac lesions. The experimental data of 76.9% confirmed cases showed that the diagnostic accuracy is greatly improved. TEE can also clearly show small thrombus that TTE cannot, in which 2DTEE can clearly show the boundary between the space-occupying and surrounding tissues, and whether there is a clear boundary between the space-occupying and surrounding tissues is an important distinguishing point of benign and malignant tumors. In addition, the TEE probe can also be used for large angle imaging and multiangle rotation, so as to determine the tumor boundary and the spatial position relationship between the tumor and the surrounding tissue. All in all, myocardial contrast echocardiography and transesophageal echocardiography have better clinical application effect on cardiac space-occupying lesions.
Topics: Echocardiography; Echocardiography, Transesophageal; Heart; Humans; Thorax; Thrombosis
PubMed: 35126908
DOI: 10.1155/2022/2066033 -
The Veterinary Clinics of North... Aug 1991Before the development of echocardiography, cardiac disease in the horse was diagnosed if a loud heart murmur (grade III-IV/VI or louder) and clinical signs of... (Review)
Review
Before the development of echocardiography, cardiac disease in the horse was diagnosed if a loud heart murmur (grade III-IV/VI or louder) and clinical signs of congestive heart failure (coughing, edema, venous distention, jugular pulsations) were detected on physical examination. Arrhythmias that persisted during and after exercise also indicated cardiac disease, which could be characterized electrocardiographically. Electrocardiography, thoracic radiography, angiography, cardiac catheterization, and oximetry could add only small pieces of information about the heart. M-mode echocardiography provided the first "window" with which to evaluate the heart and its intracardiac structures, albeit an ice-pick one-dimensional view. With M-mode echocardiography, the diameter of the aorta at the valves, the left ventricle, right ventricle, and left atrial appendage, as well as the thickness of the interventricular septum and left ventricular free wall, could be measured. Motion and thickness of the tricuspid, mitral, and aortic valves could be assessed, but only in a one-dimensional plane. Two-dimensional echocardiography provided an added dimension, resulting in visualization of all the intracardiac structures, aorta, and pulmonary artery. Two-dimensional echocardiography became the diagnostic technique of choice for the evaluation and characterization of congenital cardiac disease in critically ill neonates, as well as in adult horses. Two-dimensional echocardiography also improved the ability to diagnose valvular regurgitations, characterize valvular lesions (bacterial endocarditis, ruptured chorda tendineae), myocardial function (segmental wall motion abnormalities), atrial size, mass lesions (endocarditis, neoplasia, and thrombi), and pericardial effusion. Information about blood flow was obtained using contrast echocardiography but was limited to certain cardiac abnormalities (congenital cardiac defects and tricuspid regurgitation). This information about blood flow was limited to the detection of positive or negative contrast jets. Comprehensive information about blood flow was lacking until the application of Doppler echocardiography to equine cardiology. Pulsed-wave and color flow Doppler echocardiography resulted in precise localization of the abnormal blood flow and semiquantitation of the shunt flow or regurgitant jet. Color flow Doppler echocardiography sped up the localization and semiquantitation of the jet in many instances and provided some information about blood flow velocity in the enhanced and variance modes. The peak velocity of jets can be determined using continuous-wave Doppler echocardiography. This value then can be used to estimate pressure difference between cardiac chambers or to calculate cardiac output noninvasively if angles parallel to flow can be obtained. Thus, information about cardiac size, function, and blood flow can be combined to diagnose cardiac disease in horses and to formulate a prognosis for life and performance.
Topics: Animals; Echocardiography; Echocardiography, Doppler; Heart Diseases; Horse Diseases; Horses
PubMed: 1933572
DOI: 10.1016/s0749-0739(17)30508-4 -
BMJ (Clinical Research Ed.) Feb 2004
Topics: Ambulatory Care; Echocardiography; Heart Diseases; Humans; Point-of-Care Systems
PubMed: 14764464
DOI: 10.1136/bmj.328.7435.300 -
JACC. Cardiovascular Imaging Jan 2013Involvement of the cardiovascular system in patients with end-stage liver disease (ESLD) is well recognized and may be seen in several scenarios in adult liver... (Review)
Review
Involvement of the cardiovascular system in patients with end-stage liver disease (ESLD) is well recognized and may be seen in several scenarios in adult liver transplantation (LT) candidates. The hemodynamic effects of ESLD may result in apparent heart disease, or in some instances may mask cardiac disease. Alternatively, cardiac disease can occasionally be the underlying etiology of ESLD. LT imposes significant hemodynamic stresses, with cardiovascular complications accounting for considerable perioperative mortality and morbidity. Pre-operative assessment of the cardiac status of LT candidates is thus critically important for risk stratification and management. Cardiac imaging plays an integral role in the assessment of LT candidates. In this review, we discuss the role of cardiac imaging, including transthoracic echocardiography with Doppler and contrast enhancement, noninvasive functional assessment for routine pre-operative assessment of coronary artery disease, and transesophageal echocardiography in select cases to aid in intra-operative fluid management and monitoring in LT candidates.
Topics: Aged; Contrast Media; Echocardiography; Echocardiography, Doppler, Color; Echocardiography, Stress; Echocardiography, Transesophageal; End Stage Liver Disease; Female; Heart Diseases; Hemodynamics; Humans; Liver Transplantation; Male; Middle Aged; Predictive Value of Tests; Preoperative Care
PubMed: 23328568
DOI: 10.1016/j.jcmg.2012.11.002