pulsed wave Doppler ultrasound pulsed Doppler ultrasound [keywords]
- Pulsed-wave Doppler ultrasonographic evaluation of hepatic vein in dogs with tricuspid regurgitation. [JOURNAL ARTICLE]
- J Vet Sci 2016 Aug 10.
This study was performed to identify the relationship between the hepatic vein (HV) measurements, including flow velocity and waveform, performed with pulsed-wave (PW) Doppler ultrasonography and severity of tricuspid regurgitation (TR) in dogs. The study included 22 dogs with TR and 7 healthy dogs. The TR group was subdivided into 3 groups according to the TR jet profile in echocardiographic examination. The hepatic venous waveform was obtained and classified into 3 types. The measurements of HV, including the maximal velocities of the atrial systolic (A), systolic (S), end ventricular systolic (V), and diastolic (D) waves and the ratio of the S- and D- wave velocities (S:D ratio), were acquired. TR severity was significantly correlated with the S- (r= -0.380, p= 0.042), D- (r = 0.468, p = 0.011) wave velocities, and S:D ratio (r= -0.747, p< 0.001). In receiver operating characteristic curve analysis, the highest sensitivity and specificity were found for the S:D ratio (89% and 75%, respectively) at a threshold of 0.97, with excellent accuracy (AUC= 0.911, p< 0.001). In conclusion, PW Doppler ultrasonographic examination of the HV can be used for identifying the presence of clinically significant TR and classifying TR severity in dogs.
- Vein of Galen Aneurysmal malformation (VGAM) in the fetus. A retrospective analysis of perinatal prognostic indicators in a two-center series of 49 cases. [JOURNAL ARTICLE]
- Ultrasound Obstet Gynecol 2016 Aug 12.
Vein of Galen aneurysmal malformation (VGAM) is a rare anomaly in which an adequate perinatal management may warrant good neurological outcome. However, most fetal series are too scant to allow reliable statistical assessment of poor prognostic factors. Aim of this paper is to assess, in a two-center series of 49 cases, the prognostic value of several prenatal variables. The primary endpoint of the analysis is to identify possible prenatal indicators of poor outcome, in terms of mortality and cerebral disabilities.We did a retrospective study involving 49 cases of prenatally diagnosed VGAM managed at two centers over 16 years (1999-2015). All had undergone detailed prenatal cerebral and cardiac assessment by ultrasound, color and pulsed wave Doppler and MRI. The following parameters were analysed: volume of the VGAM (on ultrasound and MRI), presence/absence of straight sinus dilatation, ventriculomegaly and of other major brain abnormalities. Cardio-thoracic ratio, tricuspid regurgitation and reversed blood flow across the aortic isthmus were evaluated on fetal echocardiography. Major brain lesions were considered by definition to be associated with poor outcome in all cases. Pregnancy and feto-neonatal outcome was known in all cases. Feto-neonatal outcome and brain damage were considered as dependent variables in the statistical evaluation. Statistics included Mann-Whitney U test, logistic regression analysis, and Receiving Operating Curve (ROC) analysis.36.7% of the whole series and > 50% of the cases not undergoing late termination are alive and free of sequelae at a mean follow up time of 20 months (range 0-72). Five cases (10.2%) showed progression of the lesion from diagnosis to delivery. On univariate analysis, dilatation of the straight sinus, VGAM volume ≥ 20.000 mm(3) , and tricuspid regurgitation were all significantly related to "poor outcome". However, on logistic regression analysis, the only variables significantly associated with poor outcome were tricuspid regurgitation and, to a lesser extent, an MRV ≥ 20000 mm(3) . The former was also the only variable associated with brain damage.Major brain lesions, tricuspid regurgitation and, to a lesser extent an MRV ≥ 20000 mm3 are the only prenatal variables associated with poor outcome in fetal VGAM. Prenatal multidisciplinary counselling should be based on the results of these variables.
- Tissue Doppler Imaging and Intima-Media Thickness as Noninvasive Methods of Cardiovascular Risk Stratification in Patients After Kidney Transplantation. [Journal Article]
- Transplant Proc 2016 Jun; 48(5):1535-8.
Cardiovascular complications, including coronary artery disease and chronic heart failure, are the leading causes of death in patients with chronic kidney disease. New echocardiographic techniques, such as tissue Doppler imaging (TDI) with strain and strain rate, are noninvasive, easy-to-perform methods of the estimation of left ventricular (LV) systolic and diastolic function. The aim of the study was to analyze the utility of new noninvasive methods of cardiovascular risk stratification in patients after kidney transplantation.We included 43 consecutive kidney transplant (KT) recipients, with 30 healthy subjects constituting the control group in the study. We evaluated LV morphology and LV systolic and diastolic function by means of echocardiography with TDI and intima-media thickness by ultrasonography of the carotid arteries.LV mass index was significantly higher in transplanted patients, and both mitral inflow E/A and Em/Am ratios from pulsed myocardial imaging were significantly lower in the KT group as compared with the control group. The systolic wave of TDI at the basal segments was much lower in KT patients than in the control patients (P < .05). The mean value of strain rate was reduced in KT recipients as compared with the control patients. IMT was significantly higher in KT recipients.Echocardiography with TDI provided more accurate information about systolic and diastolic LV function. KT recipients showed significant alterations in LV longitudinal myocardial function parameters estimated by strain and strain rate. Strain and strain rate are noninvasive methods, easy to repeat, and valuable for detecting myocardial LV dysfunction in asymptomatic KT recipients.
- Corrected flow time: a noninvasive ultrasound measure to detect preload reduction by nitroglycerin. [JOURNAL ARTICLE]
- Am J Emerg Med 2016 Jun 24.
Monitoring of patient's intravascular volume status without invasive measures remains challenging and unreliable. Our objective was to determine if corrected flow time (FTc) measurement could detect preload reduction with administration of nitroglycerin (NTG) as a surrogate for volume loss.Post hoc FTc analysis was performed for a prospective cohort study of pulsed wave spectral Doppler measurements before and after administration of NTG. Patients enrolled were eligible for inclusion if they were admitted to a chest pain center for cardiac evaluation. Descriptive statistics, t tests, bivariate regression, and intraclass correlation coefficient were performed as appropriate.Fifty-four patients had Doppler measurements available for review. Mean FTc decreased from 339 milliseconds (95% confidence interval, 332-346) to 325 milliseconds (95% confidence interval, 318-331) with administration of 0.3 mg of sublingual NTG (P=.0001). Mean heart rate increased 5 beats/min with administration of NTG (P<.0001); however, there was no significant change in systolic or diastolic blood pressure.Corrected flow time was able to detect a significant difference in preload reduction with 0.3 mg of NTG. The FTc may be an early reliable noninvasive measure to detect changes in intravascular volume status.
- B-Flow Imaging in Lower Limb Peripheral Arterial Disease and Bypass Graft Ultrasonography. [Journal Article]
- Ultrasound Med Biol 2016 Sep; 42(9):2345-51.
Doppler ultrasonography plays a key role in the diagnosis of peripheral arterial disease, but is often limited by pitfalls that may be overcome by B-flow imaging. Thus far, there is little information on B-flow imaging for the assessment of peripheral arterial disease and bypass grafts in lower limbs. This article describes the authors' early experience with B-flow in the lower extremities. Sixty patients were included among a large cohort of patients routinely referred to the vascular laboratory for peripheral arterial disease and bypass graft assessments. Two experienced vascular sonographers performed all scans, comparing color Doppler ultrasonography with B-flow imaging. All scans were performed using a combination of the 9 L linear and C2-9 curvilinear transducers with the LOGIQ E9 system (GE Healthcare, Waukesha, WI, USA). Our experience indicates that this relatively unexplored technology has the potential to significantly improve peripheral blood flow evaluation. Nevertheless, B-flow imaging is not exempt from limitations and should be considered complementary to color Doppler ultrasonography.
- [Assessing resveratrol effect on ocular blood flow in experiment]. [English Abstract, Journal Article]
- Vestn Oftalmol 2016 Mar-Apr; 132(2):55-61.
To study the effect of resveratrol on ocular blood flow in vivo in healthy rats and those that underwent retinal ischemia/reperfusion.The experimental study was performed on 40 Wistar rats (40 eyes). For ocular blood flow evaluation, color Doppler imaging (CDI), power Doppler (PD), and pulsed-wave spectral Doppler ultrasonography were performed using the Voluson E8 Expert ultrasonic diagnostic system (GE Healthcare). All rats were given resveratrol per os for 2 months of the study. Retinal ischemia/reperfusion injury was induced by a subconjunctival injection of endothelin-1. The control group included 10 intact animals.Signs of ischemic damage of the anterior and posterior eye segments were less pronounced in rats that were given resveratrol during both pre-ischemic (30 days) and post-ischemic (30 days) periods of follow-up. There was also a statistically significant increase in the peak systolic and end diastolic velocity of blood flow as well as a decrease in the resistive index of retrobulbar arteries in those rats that underwent ischemia/reperfusion as compared to the controls.Long-term resveratrol use (2 months) has proved effective in improving ocular blood flow in a rat model of retinal ischemia/reperfusion injury.
- [Echocardiopgraphy in European tortoises (Testudo spp.)]. [English Abstract, Journal Article]
- Berl Munch Tierarztl Wochenschr 2016 Mar-Apr; 129(3-4):167-76.
An echocardiographic examination was carried out in 71 European tortoises (Testudo spp.) via the cervical-brachial acoustic windows. Simultaneously an electrocardiographic examination was performed. The inflow- and outflow tract of the heart were presented in frontal and sagittal longitudinal sections in B-mode. Within B-mode the size (diameter and area) of the atria and the ventricle (Cavum dorsale), the ventricular wall thickness and the diameter of the origin of the right aorta and of the right Arteria pulmonalis were measured. Also, the fractional shortening (FS%) and a fractional area shortening (FAS%) were calculated for the Cavum dorsale. Standard values for these cardiac parameters were determined for four different tortoise groups (depending on their carapace lengths). The direction of blood flow within the heart could be assessed via colour flow Doppler. By using pulsed-wave Doppler examinations of the inflow- and outflow tract the velocities, pressure gradients, velocity-time-integrals and acceleration- and deceleration times could be determined from the recorded inflow and outflow patterns and standard values were established for these parameters as well.
- Systolic and Diastolic Function in Congestive Heart Failure Pediatric Patients. [Journal Article, Research Support, Non-U.S. Gov't]
- Rom J Intern Med 2016 Jan-Mar; 54(1):37-46.
Two-dimensional (2D) and Doppler echocardiography are the main methods for the non-invasive evaluation of ventricular function in children. Our study monitored the evaluation of systolic and diastolic function in pediatric patients, using classical echocardiographic parameters and pulsed tissue Doppler parameters, as well as the correlation between these.The study included 18 healthy children and 9 children diagnosed with congestive heart failure secondary to congenital heart malformations. The parameters of systolic and diastolic function were measured by 2D echocardiography, 2D guided M mode, color and pulsed Doppler, as well as by pulsed tissue Doppler at the level of the mitral and tricuspid annulus.A relaxation alteration pattern or a pseudonormal pattern of E diastolic velocity compared to the A wave was found (E = A; E > A) in the group of subjects with heart failure. E wave deceleration time had significantly increased values in the case of patients with CHF, being correlated with diastolic dysfunction. Left ventricular flow propagation velocity Vp was decreased in patients with heart failure, the E/Vp ratio being maintained relatively constant in subjects with congestive heart failure and healthy subjects, most probably on account of the concomitant change in the E wave. Associations between the severity of systolic dysfunction and the diastolic dysfunction were found in pediatric patients diagnosed with congestive heart failure (Student test, p < 0.05).Tissue Doppler measurements proved to be useful for the evaluation of pediatric patients with altered ventricular geometry secondary to congenital heart disease, systolic-diastolic dysfunction and heart failure.
- [A Comparison Study on Early Damage Detection of Left Ventricular Function Based on Doppler Imaging Method for Children with Tumor]. [Comparative Study, English Abstract, Journal Article]
- Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2015 Dec; 32(6):1284-7.
The early damage detection and evaluation are of great significance in treatment and prognosis to the left ventricular function for children with tumor. In this paper, it is reported that the early damage of the left ventricular function was observed by pulsed wave Doppler (PWD) and tissue Doppler imaging (TDI) in our laboratory. Eighty children half a year to fourteen years old were included in this study. The cardiac function indices in chemotherapy group and control group were measured and compared. The results showed that there was significant difference in mitral and tricuspid annulus flow spectrum between the two groups. Compared with PWD,TDI is more prompt, objective and accurate in detecting early damage of left ventricular function in children with tumor. And TDI is a good method for early identification of ventricular function damage in children with tumor.
- Effect of Coronary Slow Flow on the Longitudinal Left Ventricular Function Assessed by 2-Dimensional Speckle-Tracking Echocardiography. [Journal Article]
- J Ultrasound Med 2016 Apr; 35(4):723-9.
The coronary slow flow phenomenon is defined as the slow progression of an angiographic contrast agent to the distal part of the coronary arteries on selective coronary angiography in the absence of stenosis. There are some studies with different results about the effect of this phenomenon on left ventricular (LV) function. The aim of our study was to evaluate the longitudinal LV function in the coronary slow flow phenomenon using 2-dimensional (2D) speckle-tracking echocardiography.In a study with a patient-to-patient matched design, 36 patients with the coronary slow flow phenomenon and 36 individuals with normal coronary flow matched for age (±5 years), sex, hypertension, and diabetes mellitus were compared in terms of the longitudinal LV systolic and diastolic functions by pulsed wave tissue Doppler echocardiography and 2D speckle-tracking echocardiography-derived indices.Lateral s' and e' waves were lower in the patients with the coronary slow flow phenomenon, but there were no statistically significant differences between the groups regarding the other tissue Doppler echocardiographic indices and longitudinal systolic strain and systolic and diastolic strain rates derived by 2D speckle-tracking echocardiography.Our results showed that the coronary slow flow phenomenon could not impair the longitudinal LV systolic and diastolic functions.