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KHIDIR OSMAN M.D. BERT WILLMAN M.D. NAVIN C. NANDA M.D. KEE-SIK KIM M.D. ALBERT D. PACIFICO M.D. 《Echocardiography (Mount Kisco, N.Y.)》1995,12(4):441-446
We describe multiplane transesophageal echocardiographic findings in a patient with severe mitral regurgitation secondary to dehiscence of a Duran ring. 相似文献
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Left Ventricular Mechanics in Functional Ischemic Mitral Regurgitation in Acute Inferoposterior Myocardial Infarction 下载免费PDF全文
Zivile Valuckiene M.D. Justas Ovsianas M.D. Ruta Ablonskyte‐Dudoniene Ph.D. Vaida Mizariene Ph.D. Karolina Melinyte Renaldas Jurkevicius Ph.D. 《Echocardiography (Mount Kisco, N.Y.)》2016,33(8):1131-1142
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目的:本文旨在回顾性研究单中心外科治疗缺血性二尖瓣关闭不全的临床经验。方法:回顾性分析279例缺血性二尖瓣关闭不全患者的临床资料。平均年龄59.2±7.4岁。心功能分级II级141例,III级117例,IV级21例。左室舒末内径57~91mm ,左室射血分数20%~59%。二尖瓣反流程度:中度156例,中-重度75例,重度48例。冠脉造影结果三支病变240例,两支病变30例,单支病变9例。结果:二尖瓣成形术224例,术后即刻TEE示无返流152例,微量返流43例,微量-轻度21例,轻度8例。二尖瓣置换术75例,IABP辅助37例。冠状动脉旁路移植远端吻合口3.6±0.5个。手术死亡13例,死亡率4.7%(13/279)。出院时左室舒末内径46~86mm,左室射血分数20%~62% 。二尖瓣无反流232例,微量26例,轻度12例,轻-中度7例,中度2例。 结论:外科治疗冠心病合并缺血性二尖瓣关闭不全可获得满意的治疗效果,尤其是对于射血分数降低、左心增大、心力衰竭的患者,获益更大。 相似文献
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Alberto Cozzarín M.D. María C. Saccheri M.D. Jorge A. Lax M.D. F.A.C.C. Mario E. Simonetti M.D. Andrea Zappi M.D. Rubén P. Laguens M.D. Ph.D. 《Echocardiography (Mount Kisco, N.Y.)》2014,31(2):E37-E40
We present the case of a 69‐year‐old patient with a history of gynecological neoplasia and a pulmonary metastasis, who in 1996 underwent chemotherapy and mediastinal radiotherapy followed by cancer remission. Ten years later she presented with heart failure and her Doppler echocardiogram showed severe mitral regurgitation with pulmonary hypertension. In 2011, she underwent a mitral valve replacement with a biological prosthesis and the pathology exam revealed valve damage consistent with radiotherapy‐induced changes. This unusual mechanism of mitral regurgitation can be demonstrated clearly by echocardiography and should be disseminated among cardiology physicians and in patients who have survived for long periods after radiotherapy, it is important to remember that cardiac complications may indeed occur, and the treating physician is responsible for detecting them. 相似文献
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Francesca Giordana M.D. Michele Capriolo M.D. Simone Frea M.D. Walter Grosso Marra M.D. Mauro Giorgi M.D. Laura Bergamasco Ph.D. Pier Luigi Omedè M.D. Imad Sheiban M.D. Maurizio D'Amico M.D. Virginia Bovolo M.D. Stefano Salizzoni M.D. Michele La Torre M.D. Mauro Rinaldi M.D. Sebastiano Marra M.D. Fiorenzo Gaita M.D. Mara Morello M.D. 《Echocardiography (Mount Kisco, N.Y.)》2013,30(3):250-257
Objective: This study aims to assess changes in mitral regurgitation (MR) severity after transcatheter aortic valve implantation (TAVI). Background: Existing data on MR after TAVI are contradictory. Methods: Thirty‐five patients with MR graded ≥ 2+ were followed after undergoing TAVI with either the Edwards Sapien or CoreValve device. Echocardiography was performed the week before and 3 months after the procedure. MR was graded on a scale of 0 to 4+, classified as organic or functional, and the effective regurgitant orifice area (EROA) and MR index were calculated. Results: At baseline, MR was graded 4+ in 4 (11.4%) patients, 3+ in 10 (28.6%), and 2+ in 21 (60%). At follow‐up, MR was graded at 3+ in 4 (11.4%) patients, 2+ in 8 (22.9%), and 1+ in 19 (54.3%); 4 (11.4%) exhibited no MR. EROA (24.4 ± 11.5 mm2 pre‐TAVI vs. 11.2 ± 10.3 mm2 post‐TAVI, P < 0.001) and MR index (1.9 ± 0.3 pre‐TAVI vs. 1.3 ± 0.7 post‐TAVI, P < 0.001) were reduced with TAVI, independent of the etiology. MR decreased by at least 1 grade in 28 (80%) patients, with a reduction ≥2 grades in 10 (28.6%) patients; no patient showed a worsened condition. Subgroup analyses showed that the reduction in MR was significant in patients treated with the Edwards Sapien device but not in patients treated with the CoreValve device. Conclusions: This multiparametric echocardiographic evaluation showed that MR improved significantly after TAVI and that this result may be related to the type of valve implanted. 相似文献
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MARIE-CHRISTINE HERREGODS M.D. PH.D. ANCA TAU M.D. ANNE VANDEPLAS M.D. BART BIJNENS M.Sc. FRANS VAN DE WERF M.D. PH.D. 《Echocardiography (Mount Kisco, N.Y.)》1997,14(6):529-533
Objectives. The present study was designed to investigate the dimensions of mitral valve annulus in the presence of mitral regurgitation. Method. Fifty-four patients were examined. On transthoracic echocardiographic images, we performed linear measurements in the parasternal plane in order to define the size of the left ventricle, left atrium, and mitral valve annulus. We compared these findings with those obtained in 16 control subjects. Results. Twenty-one patients with mild or moderate mitral regurgitation demonstrated no significant change of the mitral valve annulus compared with the control group (P > 0.05). Seventeen patients with severe mitral regurgitation (grade of 4) had a significant increase of the dimensions of the mitral valve annulus, left ventricle, and left atrium (P < 0.05). The etiology of mitral regurgitation was degenerative in 32 patients, rheumatic in 2 patients, and mitral valve prolapse in 4 patients. All patients had normal left ventricular systolic function. Thirty-one patients were in normal sinus rhythm, and seven were in atrial fibrillation. Conclusions. The measurement of the diameter of the mitral valve annulus is feasible with transthoracic echo-cardiography. In addition to the evaluation of mitral valve leaflets and subvalvular apparatus, the measurement of the mitral valve annulus is important in the evaluation of mitral regurgitation, as its enlargement is indicative for severe mitral regurgitation . 相似文献
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Orlando Parise M.Sc. Fabiana Lucà M.D. Emile Cheriex M.D. Ph.D. Roberto Lorusso M.D. Ph.D. Enrico Vizzardi M.D. Carmelo Massimiliano Rao M.D. Gian Franco Gensini M.D. Jos Maessen M.D. Ph.D. 《Echocardiography (Mount Kisco, N.Y.)》2012,29(10):1191-1200
Objective: We investigated the impact of papillary muscle dyssynchrony (DYS‐PAP) in predicting recurrent mitral regurgitation (MR) in patients with ischemic cardiomyopathy (ICM) undergoing undersized mitral ring annuloplasty (UMRA). Methods: One hundred forty‐four ICM patients (left ventricular ejection fraction <35%) in sinus rhythm undergoing UMRA between January 2001 and December 2010 at three Institutions (University Hospital, Maastricht, The Netherlands; Careggi Hospital, Florence, Italy; Civic Hospital, Brescia, Italy) were recruited. The primary endpoint was the recurrence of MR at the latest echocardiographic study defined as insufficiency ≥2+ in patients with no/trivial MR at discharge. The assessment of DYS‐PAP was performed by applying two‐dimensional (2D) speckle‐tracking imaging. Results: In patients with MR recurrence, DYS‐PAP significantly worsened (84.1 ± 8.8 msec vs.65.4 ± 8.8 msec at baseline, P < 0.001) whereas in patients with no MR recurrence, DYS‐PAP did not vary (22.3 ± 5.3 msec vs. 25.9 ± 7.2 msec at baseline, P = 0.8). Recurrent MR was positively correlated with preoperative DYS‐PAP (P < 0.001), baseline anterior mitral leaflet tethering angle α (P < 0.001) and tethering symmetry index α/β before surgery (P < 0.001). There was no significant correlation between MR recurrence and other echocardiographic parameters. Logistic regression analysis revealed that baseline values of DYS‐PAP (OR: 5.4 [95% CI: 3.1–7.7], P < 0.001), α (OR: 5.0 [2.6–6.7], P < 0.001), and α/β (OR: 3.9 [2.5–5.7], p < 0.001) were predictors of recurrent MR. A DYS‐PAP value ≥ 58 msec predicted recurrence of MR with 100% sensitivity and 83% specificity (area under the curve [AUC]: 0.92 [0.7–1], P < 0.001). Conclusions: A DYS‐PAP cutoff value of 58 msec is useful to identify patients in whom UMRA is likely to fail. That way decision making in ischemic functional MR might be facilitated. 相似文献
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Caglar Emre Cagliyan M.D. Vedat Davutoglu M.D. Ibrahim Sari M.D. Serdar Turkmen M.D. Orhan Ozer M.D. Ibrahim Halil Tanboga M.D. Kamuran Tekin M.D. Mehmet Balli M.D. Rabia Eker Akilli M.D. Mehmet Aksoy M.D. 《Echocardiography (Mount Kisco, N.Y.)》2012,29(9):1031-1037
Introduction: Dynamic mitral regurgitation (MR) is frequently investigated in patients with left ventricular systolic dysfunction (LVSD). Data about the dynamic MR in patients with organic valve disease are limited. The aim of this study was to evaluate the alteration of MR by exercise in patients with rheumatic valve disease (RVD). Methods: Asymptomatic patients with rheumatic MR and normal left ventricular function had been included in our study. Transthoracic echocardiography and Doppler measurements were performed at rest and just after submaximal exercise test performed with treadmill. Severity of MR was evaluated quantitatively by measuring effective regurgitant orifice area (EROA) with flow convergence method. Results: A total of 34 patients with rheumatic MR had been included. Severity of MR increased in 10 patients with exercise (Group 1) and decreased in 24 of them (Group 2). When the variables of two groups were compared; diastolic blood pressure after exercise, EROA, left atrial volume, left ventricular diastolic volume and mitral annular area values were significantly higher in Group 1 patients. A linear regression model was constructed by considering change of EROA by exercise the dependent, and the variables showing significant differences as the independents. Mitral annular area was found to be independently associated with EROA increase with exercise (R2= 0.499; P < 0.001). Conclusion: Mitral annular dilation is independently associated with increase of MR with submaximal exercise in asymptomatic patients with MR due to RVD with normal left ventricular function. 相似文献
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Masao Daimon M.D. Giuseppe Saracino M.S.E.E. Shota Fukuda M.D. Yasushi Koyama M.D. Jun Kwan M.D. Jong‐Min Song M.D. Deborah A. Agler R.D.C.S. A. Marc Gillinov M.D. James D. Thomas M.D. F.A.C.C. Takahiro Shiota M.D. F.A.C.C. 《Echocardiography (Mount Kisco, N.Y.)》2010,27(9):1069-1077
Objective: In patients with ischemic mitral regurgitation (IMR), we assessed dynamic changes in mitral annular geometry and motion during the cardiac cycle, and examined their association with the severity of IMR, using our computerized three‐dimensional (3D) echo method. Methods: Real‐time 3D echo was performed in 12 normal controls and 25 patients with IMR. The saddle‐shaped annulus was reconstructed in every 3D volume/frame during a cardiac cycle. For each 3D volume/frame, we assessed the mitral annular area (MAA) and the annular contraction that was expressed as the percentage of the largest MAA accounted for by the change in MAA from largest to smallest calculated value. Results: In IMR patients, the minimum MAA occurred in late‐systole, while it occurred in early‐systole in the controls. IMR patients had a larger minimum MAA (6.7 ± 1.3 vs. 3.6 ± 0.8 cm2, P < 0.001) and reduced annular contraction (23.0 ± 6.5 vs. 42.6 ± 7.0%, P < 0.001) when compared to controls. Both minimum MAA and annular contraction had significant correlations with IMR severity (r = 0.67 and r = 0.78, P < 0.001 for both). Conclusion: The contraction of the dilated mitral annulus occurred in late‐systole in patients with IMR. The alterations of annular geometry and motion may be associated with the development of IMR. (Echocardiography 2010;27:1069‐1077) 相似文献
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Ryoichi Miyazaki Keita Watanabe Masakazu Kaneko Sho Nagamine Nobuhiro Hara Tomofumi Nakamura Yasutoshi Nagata Toshihiro Nozato Takashi Ashikaga 《Internal medicine (Tokyo, Japan)》2021,60(9):1417
An 80-year-old woman with acute posterolateral myocardial infarction, cardiogenic shock, and acute heart failure was admitted to our hospital. Transthoracic echocardiography (TTE) showed dysfunction of the left ventricular inferolateral wall motion and severe mitral valve regurgitation (MR). Emergency coronary angiography revealed triple-vessel stenosis. We performed transesophageal echocardiography in the catheter room to diagnose the cause of MR. Severe tenting of the mitral valve and no rupture of the papillary muscles were revealed. We considered ischemic MR likely to improve with revascularization and performed percutaneous coronary intervention. Subsequently, the patient''s circulatory dynamics rapidly stabilized, and MR was significantly improved on follow-up TTE. 相似文献