摘要:

Purpose of reviewEchocardiographic assessment plays a major role in the evaluation of aortic stenosis (AS). Because of its proven accuracy, ease of applicability, and safety, it is replacing cardiac catheterization for the assessment of AS in many centers.Recent findingsIn this review, we discuss the basic principles of echocardiographic assessment of AS and clinically challenging scenarios including AS with low cardiac output state or other structural heart disease. Dobutamine stress echocardiography is a useful tool for assessing low cardiac output AS. The role of transesophageal echocardiography in the evaluation of AS is also reviewed.SummaryEchocardiographic techniques provide critical information in the assessment of patients with known or suspected AS and guide decision-making regarding the appropriateness of valve replacement.

ISSN:0268-4705    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The diagnosis of mitral regurgitation is often made from physical diagnosis, but quantitation of severity of valvular dysfunction and timing of intervention are often quite challenging. The purpose of this review is to examine the recent echocardiographic methods reported for quantitative assessment of mitral regurgitation, and the role of echocardiography in guiding medical and surgical management. Refinement of quantitative methods and development of newer technologies, including three-dimensional echocardiography, provide more accurate assessment of mitral anatomy and function. These methods for evaluation of the mitral valve to ascertain etiology or mechanism have important implications for medical or surgical management. This review summarizes the recent literature addressing the role of echocardiography in the diagnosis, management and prognosis of mitral regurgitation.

ISSN:0268-4705    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This review article summarizes recent advances in the care of patients presenting with neurologic events, in which transesophageal echocardiography plays an important role in diagnosis, prognosis, and treatment. New research on the use of transesophageal echocardiography in patients with stroke and atrial fibrillation is discussed, including left atrial clot formation, maintenance of sinus rhythm after cardioversion, and techniques of left atrial appendage occlusion. A discussion of developments in the diagnosis and management of thoracic aortic plaque follows. The association of patent foramen ovale and atrial septal aneurysm with stroke is outlined, and possible reasons for this association are discussed. Recent literature on the use of percutaneous closure devices for patent foramen ovale is reviewed.

ISSN:0268-4705    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Purpose of reviewMyocardial contrast echocardiography (MCE) has evolved into an important clinical tool for imaging coronary microcirculation. It can be used to delineate the spectrum of perfusion derangements that characterize acute myocardial infarction.Recent findingsPresently, MCE uses microcirculatory perfusion as the basis to distinguish myocardial necrosis and viability in the post-infarct stage. Its future role may expand to image cellular integrity, inflammation, and angiogenesis, all of which contribute to the pathophysiology of the myocardial infarction.SummaryThis review provides an update of the current role and future clinical applications of MCE in acute myocardial infarction.

ISSN:0268-4705    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Assessment of myocardial ischemia and viability plays a crucial role in the clinical management of patients with coronary artery disease. Recently, cardiovascular MRI has emerged as an important noninvasive diagnostic modality in the assessment of coronary artery disease. MRI is able to evaluate both myocardial perfusion as well as myocardial contractile reserve. Because of its superior spatial resolution, integration of qualitative and quantitative methodology, and excellent reproducibility, MRI has advantages over conventional noninvasive modalities currently used in the evaluation of myocardial ischemia and viability, and may well emerge as the premier noninvasive technique in the assessment of patients with coronary artery disease. The authors review the rapidly expanding recent literature that has now established cardiovascular MRI (including dobutamine cine MRI and vasodilator perfusion MRI techniques) as an ideal choice in the evaluation of myocardial ischemia and delayed contrast-enhanced MRI and low-dose dobutamine cine MRI for evaluation of viability. Comparisons with more established techniques such as dobutamine stress echocardiography, single photon emission computed tomography perfusion imaging, and positron emission tomography are reviewed.

ISSN:0268-4705    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

During the last few decades, significant strides have been made in the field of noninvasive imaging for the patient with congenital heart disease. Echocardiography and MRI continue to provide improved means of anatomic and functional assessment in children and adults with congenital heart lesions. This review reports some of the recent advances in tissue Doppler, strain rate, and integrated backscatter, and highlights exciting current and future potential developments in their application. We also discuss advances in MR in evaluation of cardiac anatomy and function in congenital heart disease.

ISSN:0268-4705    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0268-4705    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Atherosclerosis is currently regarded as a complex disorder, triggered by gene–gene and gene–environment interactions. Despite the difficulties of multifactorial disease genetic analysis, significant progress has been achieved in the search for atherosclerosis susceptibility genes. Here, we review these advances with regard to genome scan results and candidate gene analysis.

ISSN:0268-4705    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

In addition to necrosis, apoptosis makes a significant contribution to cell death following acute myocardial ischemia; apoptosis is particularly enhanced during reperfusion. Several studies are beginning to indicate that the cell death by apoptosis may be preventable. A boost in the research in this direction has been provided by noninvasive means of detection of apoptosis, such as that achieved by technetium-99m labeled Annexin-A5 scintigraphy. Various levels within the apoptotic cascade are being investigated as therapeutic targets. Caspase inhibitors, mitochondrial stabilizers, and Na+-H+ exchanger inhibitors reduce cell death by apoptosis and infarct size. Although most of the evidence at present is limited to the laboratory animals, this approach seems to hold a promise for the future.

ISSN:0268-4705    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Short- and long-term survival after acute myocardial infarction mainly depends on three factors: the amount of myocardium that had become necrotic, the area of myocardium at further risk of becoming necrotic, and the patency of the infarct-related artery. Echocardiography is a low-cost, safe, bedside, repeatable tool, particularly useful for prognostic stratification after myocardial injury. Two-dimensional echocardiography analyzes left ventricular function, the most powerful predictor of survival immediately after acute myocardial infarction. Myocardial contrast echocardiography measures the infarct size and detects viable myocardium. Stress echocardiography stratifies patients with viable myocardium and/or multivessel coronary artery disease who need further diagnostic and therapeutic interventions. Transthoracic coronary Doppler ultrasonography assesses effective recanalization and coronary flow reserve of the left anterior descending coronary artery. Further technologic advances are needed to allow direct noninvasive measurement of flow by transthoracic Doppler ultrasonography in other coronary arteries.

ISSN:0268-4705    

出版商:OVID    

年代:2003

数据来源: OVID