Assessment of propagation velocity by contrast echocardiography for standardization of color Doppler propagation velocity measurements

Seo, Yoshihiro; Ishimitsu, Toshiyuki; Ishizu, Tomoko; Obara, Kenichi; Moriyama, Naoko; Kawano, Satoru; Watanabe, Shigeyuki; Yamaguchi, Iwao

doi:10.1016/j.echo.2004.08.028

Cited by 13 publications

(8 citation statements)

References 24 publications

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“…36 In the clinical setting, we developed this technique to assess the propagation of LV inflow, and recently demonstrated a relationship with apical stagnant flow. 21 In the present study, we confirmed the presence of apical stagnant flow in patients with thrombus formation, but LV thrombus may not be generated by apical stagnant flow alone.…”

Section: Discussionsupporting

confidence: 81%

“…[17][18][19][20] In addition, contrast echocardiography can visualize intraventricular flow dynamics, and recently our group reported that it is possible to determine the presence of stagnant flow with this technique. 21 However, systematic and prospective studies of contrast echocardiographic diagnosis of LV thrombus in patients with first anterior AMI have not been performed. Therefore, the purpose of this study was to prospectively study the determinants of LV thrombus using contrast echocardiography in patients with their first anterior AMI.…”

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confidence: 99%

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Peak C-Reactive Protein Concentration Correlates With Left Ventricular Thrombus Formation Diagnosed by Contrast Echocardiographic Left Ventricular Opacification in Patients With a First Anterior Acute Myocardial Infarction

Seo

Maeda

Ishizu

et al. 2006

Circ J

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eft ventricular (LV) thrombus formation is a complication of acute myocardial infarction (AMI) and it is more prevalent in patients with an anterior AMI, because of the extensive area of severe apical wall motion abnormality with stagnant flow. [1][2][3] Before the era of early revascularization (ie, intravenous thrombolysis or primary coronary intervention), LV thrombus developed in 39% of patients with a first anterior AMI. 4 Although recent studies report that the prevalence has decreased because of early revascularization, 5-9 LV thrombus formation is still a risk of arterial embolism in patients with anterior wall AMI. 6,10 Apical contraction abnormalities with stagnant flow are important factors related to LV thrombus formation, but that alone is not sufficient to identify high-risk patients. Therefore, identification of additional risk factors may be useful. Recently, LV diastolic dysfunction and inflammatory reactions have been reported as associated with LV thrombus formation, 11-13 although reliable predictors have not yet been determined.LV thrombus can be diagnosed with transthoracic echocardiography, 14,15 although on occasion, either the vague nature of the thrombus or technical limitations in the examination renders confirmation difficult. 16 Contrast echocardiography is a useful modality for detecting LV thrombus, because the LV opacification can improve endocardial border delineation in the LV apex. [17][18][19][20] In addition, contrast echocardiography can visualize intraventricular flow dynamics, and recently our group reported that it is possible to determine the presence of stagnant flow with this technique. 21 However, systematic and prospective studies of contrast echocardiographic diagnosis of LV thrombus in patients with first anterior AMI have not been performed. Therefore, the purpose of this study was to prospectively study the determinants of LV thrombus using contrast echocardiography in patients with their first anterior AMI. Methods Study PopulationThis Background Wall motion abnormality in the apical legion of the left ventricle (LV) with stagnant flow alone is not sufficient to identify patients at high risk for LV thrombus formation among those with first anterior acute myocardial infarction (AMI). The aim of this study was to identify the determinants of LV thrombus formation using contrast echocardiography. Methods and ResultsIn 75 patients with first anterior AMI, standard and contrast echocardiography was performed to detect LV thrombus. Although LV thrombus was found in 10 patients (13%) using standard echocardiography, it was found in 15 patients (20%) using contrast echocardiography. Apical stagnant flow was observed in 14 patients (93%) with LV thrombus. In addition, patients with LV thrombus had a higher peak C-reactive protein (CRP) concentration (18.2±4.3 vs 7.9±5.5 mg/dl, p<0.0001). In multivariate analysis, only peak CRP concentration was identified as an independent predictor of LV thrombus (p=0.02, odds ratio: 1.400, confidence interval: 1.040-1.884). The receiv...

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Section: Discussionsupporting

confidence: 81%

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confidence: 99%

Peak C-Reactive Protein Concentration Correlates With Left Ventricular Thrombus Formation Diagnosed by Contrast Echocardiographic Left Ventricular Opacification in Patients With a First Anterior Acute Myocardial Infarction

Seo

Maeda

Ishizu

et al. 2006

Circ J

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“…Thus, assignment of a single slope (i.e., Vp) may not be accurate. Furthermore, Vp is subject to variation based on how the isovelocity contour is determined (1,17,20). Finally, Vp has been found to be normal in patients with hypertrophic cardiomyopathy (HCM) who have diastolic dysfunction apparent by other methods (21).…”

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confidence: 99%

Evaluation of LV Diastolic Function From Color M-Mode Echocardiography

Stewart¹,

Kumar²,

Charonko³

et al. 2011

JACC: Cardiovascular Imaging

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early diastolic flow propagation occurs with an initial rapid velocity that abruptly decelerates to a terminal velocity. With diastolic dysfunction, the initial velocity is slower and the deceleration point occurs closer to the mitral annulus than with normal filling. A new parameter that combines these 2 effects (Vs) provides a more accurate assessment of diastolic function than the conventional propagation velocity.

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“…1B). 1 The ratio of the Vp/E was calculated to evaluate the degree of attenuation of intraventricular filling flow compared with the velocity at the mitral tips.…”

Section: Methodsmentioning

confidence: 99%

“…With respect to the hydrodynamics, intraventricular vortices should reflect the global and regional function and geometry of the left ventricle. Recently, we studied left ventricular filling properties using contrast M‐mode echocardiography 1 . In the present study, we characterize diastolic hydrodynamic nature of the left ventricle by two‐dimensional echocardiography with contrast enhancement.…”

Section: Introductionmentioning

confidence: 96%

The Wake of a Large Vortex Is Associated with Intraventricular Filling Delay in Impaired Left Ventricles with a Pseudonormalized Transmitral Flow Pattern

et al. 2006

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Assessment of propagation velocity by contrast echocardiography for standardization of color Doppler propagation velocity measurements

Cited by 13 publications

References 24 publications

Peak C-Reactive Protein Concentration Correlates With Left Ventricular Thrombus Formation Diagnosed by Contrast Echocardiographic Left Ventricular Opacification in Patients With a First Anterior Acute Myocardial Infarction

Peak C-Reactive Protein Concentration Correlates With Left Ventricular Thrombus Formation Diagnosed by Contrast Echocardiographic Left Ventricular Opacification in Patients With a First Anterior Acute Myocardial Infarction

Evaluation of LV Diastolic Function From Color M-Mode Echocardiography

The Wake of a Large Vortex Is Associated with Intraventricular Filling Delay in Impaired Left Ventricles with a Pseudonormalized Transmitral Flow Pattern

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