Abstract:A jobb pitvar echokardiográfiás vizsgálata a jelen gyakorlatban nagy kihívás és csak korlátozott lehetőségek állnak rendelkezésünkre. Az utóbbi évtizedekben végbement technikai fejlesztések lehetővé teszik a komplex jobb pitvari szívciklusos mozgások volumetrikus és funkcionális analízisét. Ennek az összefoglaló közleménynek a célja a jelenleg elérhető rutineljárások mellett a legkorszerűbbnek tekinthető háromdimenziós és/vagy speckle-tracking echokardiográfiás módszerek bemutatása a jobb pitvar vizsgálatában.… Show more
“…1). The endocardial surface of the RA was then automatically reconstructed and a 3D RA cast was performed [2, 4–7]. Fig.…”
Section: Methodsmentioning
confidence: 99%
“…Right heart failure is a principal cause of morbidity and mortality in different disorders like in pulmonary hypertension [1]. The right atrium (RA) has significant functions during the cardiac cycle: it works as a reservoir in systole, it is a conduit in early diastole and a booster pump in late diastole [2]. Classic echocardiographic methodologies offer limited opportunities in assessing RA morphology and function [2].…”
Section: Introductionmentioning
confidence: 99%
“…The right atrium (RA) has significant functions during the cardiac cycle: it works as a reservoir in systole, it is a conduit in early diastole and a booster pump in late diastole [2]. Classic echocardiographic methodologies offer limited opportunities in assessing RA morphology and function [2]. Three-dimensional speckle-tracking echocardiography (3DSTE) is a novel imaging method with objective 3D capability in assessing volumetric and functional properties of heart chambers [2, 3].…”
Section: Introductionmentioning
confidence: 99%
“…Classic echocardiographic methodologies offer limited opportunities in assessing RA morphology and function [2]. Three-dimensional speckle-tracking echocardiography (3DSTE) is a novel imaging method with objective 3D capability in assessing volumetric and functional properties of heart chambers [2, 3]. Strains are objective feature of wall motion and describe wall deformation, which could be calculated from the same 3D model of a particular chamber [2, 3].…”
Section: Introductionmentioning
confidence: 99%
“…Three-dimensional speckle-tracking echocardiography (3DSTE) is a novel imaging method with objective 3D capability in assessing volumetric and functional properties of heart chambers [2, 3]. Strains are objective feature of wall motion and describe wall deformation, which could be calculated from the same 3D model of a particular chamber [2, 3]. In recent studies, usefulness of 3DSTE in assessing RA uni- and multidirectional strains could be demonstrated [4–7].…”
Classic echocardiographic methodologies offer limited opportunities in assessing right atrial (RA) morphology and function. Three-dimensional (3D) speckle-tracking echocardiography (3DSTE) is a novel imaging method with objective 3D capability in assessing volumetric and functional properties of heart chambers. Normal reference values of different 3DSTEderived RA strains are not available, therefore the aim of this prospective study was to establish these parameters in healthy subjects. The present study comprised 295 healthy volunteers, from which 110 were excluded due to inadequate image quality. The final population consisted of 185 healthy subjects in the present study (mean age: 32.1 ± 12.2 years, 89 males). Complete two-dimensional echocardiography and 3DSTE have been performed in all cases. While radial strain (RS) does not change significantly over the years in males, in female subjects it increases with age most significantly between at the age of 40-49, and it starts to decline at the age of 50 in females. While females have higher circumferential (CS) and area (AS) strain values, CS and AS decrease with age in both gender. While LS remains almost unchanged in females until ages 40-49 years with a decline above the age of 50, it decreases over the decades in males. 3D strain (3DS) increases with age in both gender, but almost doubles in females in older ages. Specific pattern of strains at atrial contraction could also be demonstrated. 3DSTE-derived RA normal reference values with age-, gender-dependency and regional values are demonstrated in a healthy population.
“…1). The endocardial surface of the RA was then automatically reconstructed and a 3D RA cast was performed [2, 4–7]. Fig.…”
Section: Methodsmentioning
confidence: 99%
“…Right heart failure is a principal cause of morbidity and mortality in different disorders like in pulmonary hypertension [1]. The right atrium (RA) has significant functions during the cardiac cycle: it works as a reservoir in systole, it is a conduit in early diastole and a booster pump in late diastole [2]. Classic echocardiographic methodologies offer limited opportunities in assessing RA morphology and function [2].…”
Section: Introductionmentioning
confidence: 99%
“…The right atrium (RA) has significant functions during the cardiac cycle: it works as a reservoir in systole, it is a conduit in early diastole and a booster pump in late diastole [2]. Classic echocardiographic methodologies offer limited opportunities in assessing RA morphology and function [2]. Three-dimensional speckle-tracking echocardiography (3DSTE) is a novel imaging method with objective 3D capability in assessing volumetric and functional properties of heart chambers [2, 3].…”
Section: Introductionmentioning
confidence: 99%
“…Classic echocardiographic methodologies offer limited opportunities in assessing RA morphology and function [2]. Three-dimensional speckle-tracking echocardiography (3DSTE) is a novel imaging method with objective 3D capability in assessing volumetric and functional properties of heart chambers [2, 3]. Strains are objective feature of wall motion and describe wall deformation, which could be calculated from the same 3D model of a particular chamber [2, 3].…”
Section: Introductionmentioning
confidence: 99%
“…Three-dimensional speckle-tracking echocardiography (3DSTE) is a novel imaging method with objective 3D capability in assessing volumetric and functional properties of heart chambers [2, 3]. Strains are objective feature of wall motion and describe wall deformation, which could be calculated from the same 3D model of a particular chamber [2, 3]. In recent studies, usefulness of 3DSTE in assessing RA uni- and multidirectional strains could be demonstrated [4–7].…”
Classic echocardiographic methodologies offer limited opportunities in assessing right atrial (RA) morphology and function. Three-dimensional (3D) speckle-tracking echocardiography (3DSTE) is a novel imaging method with objective 3D capability in assessing volumetric and functional properties of heart chambers. Normal reference values of different 3DSTEderived RA strains are not available, therefore the aim of this prospective study was to establish these parameters in healthy subjects. The present study comprised 295 healthy volunteers, from which 110 were excluded due to inadequate image quality. The final population consisted of 185 healthy subjects in the present study (mean age: 32.1 ± 12.2 years, 89 males). Complete two-dimensional echocardiography and 3DSTE have been performed in all cases. While radial strain (RS) does not change significantly over the years in males, in female subjects it increases with age most significantly between at the age of 40-49, and it starts to decline at the age of 50 in females. While females have higher circumferential (CS) and area (AS) strain values, CS and AS decrease with age in both gender. While LS remains almost unchanged in females until ages 40-49 years with a decline above the age of 50, it decreases over the decades in males. 3D strain (3DS) increases with age in both gender, but almost doubles in females in older ages. Specific pattern of strains at atrial contraction could also be demonstrated. 3DSTE-derived RA normal reference values with age-, gender-dependency and regional values are demonstrated in a healthy population.
IntroductionSimilarly to the ventricles, the atria are under sympathetic/parasympathetic neural regulation. Accordingly, correlations were investigated between Ewing's standard cardiovascular reflex tests (SCRTs) and three‐dimensional speckle‐tracking echocardiography (3DSTE)‐derived right atrial (RA) volumes and strains in healthy subjects.Materials and MethodsThe study comprised 45 healthy adults, but 5 subjects were excluded due to inferior image quality for 3DSTE‐derived RA assessments. The remaining 40 individuals being in sinus rhythm had a mean age of 35.1 ± 3.5 years (20 men). Two‐dimensional, Doppler, 3DSTE and SCRTs were performed in all cases.ResultsRA maximum volume and total and passive RA stroke volumes correlated with the Valsalva ratio. Active RA stroke volume and emptying fraction showed correlations with 30/15 ratio. Peak global and mean segmental RA circumferential (CS) and longitudinal strains (LS) showed correlation with the Valsalva ratio. At atrial contraction, global RA‐LS and mean segmental RA‐CS showed correlations with the Valsalva ratio. Moreover, mean segmental RA‐CS correlated with 30/15 ratio and mean segmental RA radial strain showed correlations with systolic blood pressure in response to standing. Autonomic neuropathy score correlated with peak global RA‐LS.ConclusionsAutonomic function parameters have significant associations with specific RA functions in healthy adults, making the latter possible indicators of autonomic dysregulation.
Background
In dextro-transposition of the great arteries (dTGA), the aorta and the pulmonary artery are transposed. The present study aimed a three-dimensional speckle-tracking echocardiography-derived determination of volumetric and functional features of the atrium being on the morphologic right side [‘right atrium (RA)] in adult patients with dTGA.
Methods
The present study comprised 18 adult dTGA patients, four of whom were excluded due to inferior image quality. From the remaining 14 patients (mean age: 29.7 ± 8.1 years, 9 males), 7 cases underwent Mustard-procedure, while another 7 subjects underwent Senning-procedure. Their results were compared to that of 28 age- and gender-matched healthy subjects (28.8 ± 1.4 years, 20 males).
Results
Increased RA volumes respecting the cardiac cycle could be demonstrated in dTGA patients compared to controls. RA stroke volumes (SVs) for reservoir and conduit function were reduced together with impaired RA emptying fractions (EFs) featuring all phases of RA function. Mustard-operated patients showed tendentiously lower RA volumes and increased SVs and EFs respecting the cardiac cycle compared to those of Senning-operated patients suggesting beneficial results for Mustard-procedure. Reduced RA global and mean segmental peak RA strains and RA strains at atrial contraction could be detected in dTGA patients compared to those of controls with tendentiously lower values in Mustard-operated patients compared to those of Senning-operated subjects.
Conclusions
Significant RA volumetric and functional abnormalities could be detected in adult dTGA patients following atrial switch repair. While RA volumetric data proved to be better in Mustard-operated patients, RA strains were enhanced in Senning-operated subjects.
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