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Prominent Crista Terminalis in Patients with Embolic Events
Na, Jin Oh,Kim, Eung Ju,Mun, Sun Joung,Choi, Eun Hee,Mun, Jin Hee,Lee, Hye Ra,Kim, Yun Kyung,Yong, Hwan Seok Korean Society of Echocardiography 2011 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.19 No.3
<P>A prominent crista terminalis is a normal anatomic variant which consist of thick muscular bridge within the right atrium. However, it could be often misdiagnosed with an abnormal mass on the transthoracic echocardiography. The case report presented here, describe the findings of transthoracic echocardiography that suggested a right atrial mass in patients with pulmonary embolism. However, subsequent transesophageal echocardiography and cardiac computed tomography/magnetic resonance imaging differentiated a true right atrial mass from a prominent crista terminalis.</P>
Subclinical Myocardial Dysfunction in Metabolic Syndrome Patients without Hypertension
Seo, Jeong-Min,Park, Tae-Ho,Lee, Dong-Yeol,Cho, Young-Rak,Baek, Hee-Kyung,Park, Jong-Seong,Kim, Moo-Hyun,Kim, Young-Dae,Choi, Sun-Young,Lee, Sun-Mi,Hong, Young-Seoub Korean Society of Echocardiography 2011 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.19 No.3
<P><B>Background</B></P><P>The aim of this study was to evaluate myocardial function in patients with non-hypertensive metabolic syndrome.</P><P><B>Methods</B></P><P>We selected metabolic syndrome patients (n = 42) without evidence of hypertension and compared them to age-matched control individuals (n = 20). All patients were evaluated by two-dimensional and tissue Doppler echocardiography including tissue Doppler derived strain and strain rate measurements.</P><P><B>Results</B></P><P>There were no significant differences between the two groups in mitral E and A inflow velocities or the E/A ratio. However, systolic and early diastolic myocardial velocities, and strain rate were significantly lower in patients with metabolic syndrome than in the control group (all <I>p</I> < 0.05). Multiple stepwise regression analyses revealed that age, waist circumference, and systolic blood pressure were independently associated with peak systolic myocardial velocity.</P><P><B>Conclusion</B></P><P>These results indicate that metabolic syndrome patients without hypertension may have decrease of myocardial systolic and early diastolic velocities on tissue Doppler imaging, even if they appear to have normal systolic and diastolic function on conventional echocardiography.</P>
Hwang, Seung Hwan,Kim, Kye Hun,Yoon, Hyun Ju,Hong, Young Joon,Kim, Ju Han,Ahn, Young Keun,Jeong, Myung Ho,Cho, Jeong Gwan,Park, Jong Chun,Kang, Jung Chaee Korean Society of Echocardiography 2011 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.19 No.2
<P>The prognosis of stress induced cardiomyopathy (SCMP) is generally known to be excellent, however, several fatal complications such as cardiac rupture and left ventricular (LV) thrombosis with subsequent embolic complications have been described. We report a rare case of SCMP complicated by LV thrombosis and multiple cerebral infarctions in a patient with essential thrombocythemia. After intravenous anticoagulation with heparin and general managements for heart failure and cerebral infarctions, her neurologic symptoms and the wall motion abnormalities of the LV apex were improved, and the thrombus was disappeared on follow-up echocardiography.</P>
Impaired Diastolic Recovery after Acute Myocardial Infarction as a Predictor of Adverse Events
Yoon, Hyun Ju,Kim, Kye Hun,Kim, Jong Yoon,Cho, Jae Young,Yoon, Nam Sik,Park, Hyung Wook,Hong, Young Joon,Kim, Ju Han,Ahn, Youngkeun,Jeong, Myung Ho,Cho, Jeong Gwan,Park, Jong Chun Korean Society of Echocardiography 2015 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.23 No.3
<P><B>Background</B></P><P>To investigate the impact of left ventricular (LV) diastolic functional recovery on major adverse cardiac events (MACE) 6 months after acute myocardial infarction (AMI) in patients with preserved LV systolic function.</P><P><B>Methods</B></P><P>A total 463 patients with preserved LV systolic function at 6 months after an AMI were divided into two groups based on the extent of diastolic recovery assessed by echocardiography: group I (n = 241) showed improving diastolic function and group II (n = 222) did not. MACE included death, recurrent myocardial infarction, and rehospitalization due to heart failure, and these events were compared with the patients' characteristics at baseline.</P><P><B>Results</B></P><P>Compared with group I, the patients in group II were older and had a higher prevalence of hypertension and diabetes. Blood levels of hemoglobin and triglyceride were lower in group II, whereas the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and of high-sensitivity C-reactive protein were higher in this group than in group I. MACE were significantly more frequent in group II than in group I. Age, elevated NT-proBNP, and impaired diastolic recovery were significant independent predictors of MACE.</P><P><B>Conclusion</B></P><P>Despite improvement in LV systolic function, LV diastolic function had not improved in 222 patients (47.9%) by the 6-month follow-up after the index AMI, and impaired diastolic functional recovery was found to be an independent predictor of MACE. Evaluation of diastolic function would be a useful way to stratify risk in patients discharged after an index AMI.</P>
Role of Echocardiography in Atrial Fibrillation
Kim, Tae-Seok,Youn, Ho-Joong Korean Society of Echocardiography 2011 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.19 No.2
<P>Atrial fibrillation (AF) is most common arrhythmia and its prevalence appears to be increasing as the population ages. Echocardiography can play a key role in risk stratification and management of patients with AF. Transthoracic echocardiography allows rapid and comprehensive assessment of cardiac anatomical structure and function. Pulmonary vein flow monitoring using echocardiography has the potential to an increasing role in the evaluation of cardiac function and AF ablation procedures. Transesophageal echocardiography also provides accurate information about the presence of a thrombus in the atria and thromboembolic risk. The novel technique of intracardiac echocardiography has emerged as a popular and useful tool in the everyday practice of interventional electrophysiology. Other imaging modalities, such as computed tomography and magnetic resonance imaging have complementary roles in risk stratification and assessment of patients with AF. Echocardiography continues to be the foundation of clinical evaluation and management of AF.</P>
Koh, Yoon-Seok,Jung, Hae-Ok,Park, Mahn-Won,Baek, Joo-Yeoul,Yoon, Sung-Gyu,Kim, Pum-Joon,Ihm, Sang-Hyun,Chang, Kiyuk,Oh, Yong-Seog,Youn, Ho-Joong,Baek, Sang Hong,Chung, Wook-Sung,Seung, Ki-Bae,Kim, Jae Korean Society of Echocardiography 2009 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.17 No.4
<P>Left ventricular hypertrophy (LVH) has been known as an important predictor of prognosis of cardiovascular disease. Carboxy-terminal propeptide of procollagen type I (PIP) is related with myocardial fibrosis. We sought to analyze the differences in the characteristics of LVH, myocardial fibrosis, and LV functions among hypertension (HBP), diabetes mellitus (DM) and chronic renal failure (CRF).</P>
Park, Chan Seok,An, Gun-Hee,Kim, Young-Woon,Park, Youn-Jung,Kim, Mi-Jeong,Cho, Eun Joo,Ihm, Sang-Hyun,Jung, Hae-Ok,Kim, Hee-Yeol,Jeon, Hui-Kyung,Youn, Ho-Joong,Kim, Jae-Hyung Korean Society of Echocardiography 2011 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.19 No.4
<P><B>Background</B></P><P>Non-dippers were reported as showing different left atrial function, compared to dippers, but no study to date investigated the changes in the left atrial function according to the diurnal blood pressure pattern, using tissue Doppler and strain imaging.</P><P><B>Methods</B></P><P>Forty never treated hypertensive patients between 30 and 80 years of age were enrolled in this study. Patients were classified as non-dippers when, during night time, they had a blood pressure decrease of less than 10%. Strain of the left atrium was measured during late systole, and peak strain rates of the left atrium were measured during systole, early and late diastolic periods.</P><P><B>Results</B></P><P>The left atrial expansion index, left atrial active emptying volume and left atrial active emptying fraction were all significantly increased in non-dippers. They also had increased values of mean peak left atrial strain (dippers = 21.26 ± 4.23% vs. non-dippers = 24.91 ± 5.20%, <I>p</I> = 0.02), strain rate during reservoir (dippers = 1.29 ± 0.23 s<SUP>-1</SUP> vs. non-dippers =1.52 ± 0.27 s<SUP>-1</SUP>, <I>p</I> = 0.01) and contractile period (dippers = -1.38 ± 0.24 s<SUP>-1</SUP> vs. non-dippers = -1.68 ± 0.32 s<SUP>-1</SUP>, <I>p</I> < 0.01).</P><P><B>Conclusion</B></P><P>Strain and strain rate acquired from color Doppler tissue imaging demonstrate exaggerated reservoir and booster pump function in never-treated, non-dipper hypertensive patients. These methods are simple and sensitive for the early detection of subtle changes in the left atrial function.</P>
Extensive primary cardiac lymphoma diagnosed by percutaneous endomyocardial biopsy.
Chin, Jung Yeon,Chung, Mi Hyang,Kim, Jin Jin,Lee, Jae Hak,Kim, Ji Hyun,Maeng, Il Ho,Jung, Soo-Yeon,Hwang, Hui Jeong,Lee, Jea Beom,Youn, Ho-Joong Korean Society of Echocardiography 2009 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.17 No.4
<P>Primary cardiac lymphoma (PCL) is an extranodal non-Hodgkin's lymphoma exclusively located in the heart and/or pericardium. It is rare in immunocompetent patients and represents 1.3% of primary cardiac tumors and 0.5% of extranodal lymphomas. The clinical behavior is aggressive and the early symptoms are cardiac failure, syncope, arrhythmia, or pericardial effusion. Although echocardiography, computed tomography (CT) scan, magnetic resonance image (MRI) are the mainly used imaging techniques to detect cardiac tumors, pathologic examination is always required to confirm the diagnosis. Diagnosis of PCL is difficult due to non-specific clinical manifestations and requires invasive approach to get histopathologic evidence. While surgery with systemic chemotherapy or in combination with irradiation has been attempted, the only effective treatment is chemotherapy. However, the prognosis remains poor. We report on a 42-year-old woman who is diagnosed histopathologically as PCL by cardiac catheterization assisted percutaneous endomyocardial biopsy and treated successfully by anthracycline based chemotherapy.</P>
Kim, Sung-Sik,Jeon, Hui-Kyung,Cho, Gyu-Min,Lee, Jong-Hwan,Kim, Soo-Jung,Park, Mi-Youn,Lee, Seung-Jae,Shim, Byung-Ju,Lee, Dong-Hyeon,Shin, Woo-Seung,Lee, Jong-Min,Youn, Ho-Joong Korean Society of Echocardiography 2010 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.18 No.3
<P>The aim of this study was to evaluate the mid-term changes in cardiac function by transthoracic echocardiogram (TTE) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) according to valsartan dose.</P>