diastole ( Video 3 ). The thrombus was entrapped in the patent foramen ovale (PFO) and extended to the left atrium, protruding into the left ventricle through the mitral valve ( Video 4 ). There was no sign of peripheral emboli. The patient underwent urgent
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Rezvanieh Salehi, Rezayat Parvizi, and Leili Pourafkari
Daniel P Walsh, Kadhiresan R Murugappan, Achikam Oren-Grinberg, Vanessa T Wong, John D Mitchell, and Robina Matyal
management software application, we created a self-paced, self-testing, and interactive online repository of echocardiography media clips of normal and various degrees of abnormal left ventricles (LV) for our residents. By creating this resource to be used
Ruchika Meel, Ferande Peters, Bijoy K Khandheria, Elena Libhaber, and Mohammed Essop
Introduction Chronic mitral regurgitation (MR) results in volume overload of the left ventricle (LV) and left atrium (LA) ( 1 ). The LA compensates by increasing compliance through neurohormonal modulation and undergoing structural changes
Christopher Johnson, Katherine Kuyt, David Oxborough, and Martin Stout
becomes integral to produce adequate stroke volume for each cardiac cycle. Each myocyte is arranged in a ‘scaffold’ that maintains the arrangement of cardiac cells and the muscle fibres in the required configuration ( 2 ). In the left ventricle (LV), the
Caroline Schneider, Lynsey Forsythe, John Somauroo, Keith George, and David Oxborough
Background
Left ventricular (LV) function is dependent on load, intrinsic contractility and relaxation with a variable impact on specific mechanics. Strain (ε) imaging allows the assessment of cardiac function; however, the direct relationship between volume and strain is currently unknown. The aim of this study was to establish the impact of preload reduction through head-up tilt (HUT) testing on simultaneous left ventricular (LV) longitudinal and transverse function and their respective contribution to volume change.
Methods
A focused transthoracic echocardiogram was performed on 10 healthy male participants (23 ± 3 years) in the supine position and following 1 min and 5 min of HUT testing. Raw temporal longitudinal ε (Ls) and transverse ε (Ts) values were exported and divided into 5% increments across the cardiac cycle and corresponding LV volumes were traced at each 5% increment. This provided simultaneous LV longitudinal and transverse ε and volume loops (deformation volume analysis – DVA).
Results
There was a leftward shift of the ε-volume loop from supine to 1 min and 5 min of HUT (P < 0.001). Moreover, longitudinal shortening was reduced (P < 0.001) with a concomitant increase in transverse thickening from supine to 1 min, which was further augmented at 5 min (P = 0.018).
Conclusions
Preload reduction occurs within 1 min of HUT but does not further reduce at 5 min. This decline is associated with a decrease in longitudinal ε and concomitant increase in transverse ε. Consequently, augmented transverse relaxation appears to be an important factor in the maintenance of LV filling in the setting of reduced preload. DVA provides information on the relative contribution of mechanics to a change in LV volume and may have a role in the assessment of clinical populations.
Clare M Jackson, Helen E Ellis, Mark C Dodd, and Laurence O'Toole
the Intensive Care Unit. The TTE demonstrated severe global hypokinesia of the left ventricle, normal wall thickness and internal dimensions. The left atrium contained a multi-lobulated, mobile mass arising from one of the left pulmonary veins. This
Ashley Miller and Justin Mandeville
assessment for accurate circulating volume assessment. It can be used to assess the effect of a fluid challenge. The most prevalent ways of using echocardiography for assessing volume status are discussed here. Left ventricle LV size Although
Ingeborg H F Herold, Salvatore Saporito, Massimo Mischi, Hans C van Assen, R Arthur Bouwman, Anouk G W de Lepper, Harrie C M van den Bosch, Hendrikus H M Korsten, and Patrick Houthuizen
clips, indicator dilution curves (IDCs) were generated by measuring the time evolution of, respectively, acoustic intensity (echocardiography) or MR signal from regions of interest (ROIs) drawn within the right and left ventricle ( Fig. 1 ). As for both
Rienzi Díaz-Navarro and Petros Nihoyannopoulos
Background A pseudoaneurysm (Ps) of the left ventricle (LV) is a severe complication of acute myocardial infarction (AMI) resulting from a free cardiac wall rupture that is contained by the pericardium, thrombus or adhesions ( 1 ). Most
Annari van Rensburg, Philip Herbst, and Anton Doubell
with the posteroinferior ventricular septum. A point was then placed into the centre of the left ventricle, and the position of both papillary muscles in degrees of arc was then measured around the point representing the centre of the left ventricle