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Odd Bechhanssen - One of the best experts on this subject based on the ideXlab platform.
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assessment of pulmonary vascular resistance by Doppler Echocardiography in patients with pulmonary arterial hypertension
Journal of Heart and Lung Transplantation, 2007Co-Authors: Nedim Selimovic, Bengt Rundqvist, Claeshakan Bergh, Bert Andersson, Sofia Petersson, Lena Johansson, Odd BechhanssenAbstract:Background Assessment of pulmonary artery pressures, cardiac output (CO) and pulmonary vascular resistance (PVR) is crucial in the management of patients with pulmonary arterial hypertension (PAH). The aim of the present study was to investigate whether Doppler Echocardiography can be used to determine PVR in patients with PAH. Methods Forty-two patients were included and Doppler Echocardiography was performed simultaneously ( n = 22) and non-simultaneously ( n = 60) with right heart catheterization. The tricuspid regurgitation velocity was used to estimate pulmonary arterial peak systolic and diastolic (PADP) pressures (Bernoulli equation). At the time of pulmonary valve opening, right ventricular pressure equals PADP. The tricuspid regurgitation velocity at the time of pulmonary valve opening was measured by superimposing the time from the QRS to the onset of pulmonary flow on the tricuspid regurgitation velocity envelope. Pulmonary capillary wedge pressure, right atrial pressure and CO were assessed using standard Doppler Echocardiography methods. Right heart catheterization was performed using Swan–Ganz catheters and thermodilution for CO determination. Results The differences (mean ± SD) between catheter and simultaneous/non-simultaneous Doppler Echocardiography were 0.3 ± 0.8 ( p = 0.10)/−0.3 ± 1.1 ( p = 0.06) liter/min for CO, 2.9 ± 5.1 ( p = 0.02)/−1.2 ± 7.4 ( p = 0.2) mm Hg for the transpulmonary gradient (TPG) and 0.3 ± 2.1 ( p = 0.65)/0.8 ± 2.4 ( p = 0.02) Wood unit for PVR. The correlation coefficients between catheter and simultaneous/non-simultaneous Doppler Echocardiography were 0.86/0.75 for CO, 0.92/0.90 for TPG and 0.93/0.92 for PVR. Conclusions A comprehensive hemodynamic assessment that includes CO, TPG and PVR can be provided by Doppler Echocardiography in patients with severe pulmonary hypertension.
Nedim Selimovic - One of the best experts on this subject based on the ideXlab platform.
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assessment of pulmonary vascular resistance by Doppler Echocardiography in patients with pulmonary arterial hypertension
Journal of Heart and Lung Transplantation, 2007Co-Authors: Nedim Selimovic, Bengt Rundqvist, Claeshakan Bergh, Bert Andersson, Sofia Petersson, Lena Johansson, Odd BechhanssenAbstract:Background Assessment of pulmonary artery pressures, cardiac output (CO) and pulmonary vascular resistance (PVR) is crucial in the management of patients with pulmonary arterial hypertension (PAH). The aim of the present study was to investigate whether Doppler Echocardiography can be used to determine PVR in patients with PAH. Methods Forty-two patients were included and Doppler Echocardiography was performed simultaneously ( n = 22) and non-simultaneously ( n = 60) with right heart catheterization. The tricuspid regurgitation velocity was used to estimate pulmonary arterial peak systolic and diastolic (PADP) pressures (Bernoulli equation). At the time of pulmonary valve opening, right ventricular pressure equals PADP. The tricuspid regurgitation velocity at the time of pulmonary valve opening was measured by superimposing the time from the QRS to the onset of pulmonary flow on the tricuspid regurgitation velocity envelope. Pulmonary capillary wedge pressure, right atrial pressure and CO were assessed using standard Doppler Echocardiography methods. Right heart catheterization was performed using Swan–Ganz catheters and thermodilution for CO determination. Results The differences (mean ± SD) between catheter and simultaneous/non-simultaneous Doppler Echocardiography were 0.3 ± 0.8 ( p = 0.10)/−0.3 ± 1.1 ( p = 0.06) liter/min for CO, 2.9 ± 5.1 ( p = 0.02)/−1.2 ± 7.4 ( p = 0.2) mm Hg for the transpulmonary gradient (TPG) and 0.3 ± 2.1 ( p = 0.65)/0.8 ± 2.4 ( p = 0.02) Wood unit for PVR. The correlation coefficients between catheter and simultaneous/non-simultaneous Doppler Echocardiography were 0.86/0.75 for CO, 0.92/0.90 for TPG and 0.93/0.92 for PVR. Conclusions A comprehensive hemodynamic assessment that includes CO, TPG and PVR can be provided by Doppler Echocardiography in patients with severe pulmonary hypertension.
A. Jamil Tajik - One of the best experts on this subject based on the ideXlab platform.
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Effect of Doppler Echocardiography on Utilization of Hemodynamic Cardiac Catheterization in the Preoperative Evaluation of Aortic Stenosis
Mayo Clinic proceedings, 1996Co-Authors: Véronique L. Roger, Guy S. Reeder, A. Jamil Tajik, Sharonne N. Hayes, Charles J. Mullany, Kent R. Bailey, James B. SewardAbstract:Objective To examine the use of Doppler Echocardiography in preoperative assessment of aortic stenosis and to determine its effect on subsequent use of hemodynamic cardiac catheterization. Material and Methods We retrospectively reviewed a consecutive series of 574 adult patients who underwent aortic valve replacement for aortic stenosis between 1990 and 1992 at our institution. The use of Doppler Echocardiography and cardiac catheterization and the predictive factors for use of hemodynamic catheterization were analyzed. Results After Doppler Echocardiography in 423 patients, invasive hemodynamic assessment of the severity of aortic stenosis was performed in only 42% (179 patients). The use of cardiac catheterization declined over time (54% in 1990, 40% in 1991, and 35% in 1992) ( P = 0.003), whereas no significant change in the baseline clinical characteristics of the population or in severity of stenosis as determined by Doppler Echocardiography occurred during that time. Multivariate analysis identified the following variables as independent predictors of use of cardiac catheterization after Doppler Echocardiography: clinically not severe aortic stenosis, mean gradient of less than 50 mm Hg determined by Doppler Echocardiography, Doppler-determined aortic valve area of more than 0.8 cm 2 or not calculated, attending cardiologist not specialized in Echocardiography, and earlier year of assessment. Conclusion After Doppler Echocardiography, less than 50% of our patients undergoing aortic valve replacement for aortic stenosis have cardiac catheterization preoperatively. The use of cardiac catheterization after Doppler Echocardiography—thus, duplication of hemodynamic assessment—declined significantly over time during the study period. Decline in the use of catheterization is related to the degree of diagnostic certainty provided by Doppler Echocardiography and to the level of familiarity of the attending cardiologist with the technique.
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Diagnostic role of Doppler Echocardiography in constrictive pericarditis
Journal of the American College of Cardiology, 1994Co-Authors: Liv Hatle, James B. Seward, Gordon K. Danielson, Hartzell V. Schaff, Guy S. Reeder, A. Jamil TajikAbstract:Abstract Objectives . This study was conducted to assess the diagnostic role of Doppler Echocardiography in constrictive pericarditis. Background . It has been observed that ptients with constrictive pericarditis have a characteristic Doppler pattern of respiratory variation in ventricular filling and central venous flow velocities. However, the observation was based on a small number of patients with known diagnosis. Methods . We reviewed the echocardiographic features of 28 patients (21 mem and 7 women; mean age ± SD 55 ± 15 years) with suspected constrictive pericarditis who underwent exploratory thoracotomy or pericardiectomy. Results . At operation, constrictive pericarditis was diagnosed in 25 patients, restriction in 1 and normal pericardium in 2. Of the 25 patients with constriction, correct preoperative Doppler diagnosis was made in 22 (88%) and Doppler Echocardiography showed restriction in 3. In two patients with a normal pericardium, Doppler features were consistent with constriction in one patient and were normal in the other. In the one patient with restriction, Doppler Echocardiography showed restriction. In 19 patients with surgically proved constriction, repeat Doppler study after pericardiectomy showed normal findings in 14 and restriction in 5. Twelve of the 14 patients with normalized Doppler findings became asymptomatic, whereas all 5 with restrictive Doppler features remained symptomatic. Conclusions . Doppler Echocardiography performed simultaneously with respiratory recording is highly sensitive for diagnosing constrictive pericarditis, and it appears to predict functional response to pericardiectomy.
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Quantitative hemodynamics by Doppler Echocardiography: A noninvasive alternative to cardiac catheterization
Progress in cardiovascular diseases, 1994Co-Authors: Rick A. Nishimura, A. Jamil TajikAbstract:Summary Doppler Echocardiography has greatly enhanced the information provided by two-dimensional Echocardiography. By providing information concerning pressure gradients, intracardiac pressures, volumetric flow, and diastolic filling of the heart, most hemodynamic information that in the past could be obtained only from cardiac catheterization can now be provided accurately and noninvasively by Doppler Echocardiography. Future developments in instrument technology and understanding of the various Doppler velocity curves should further aid in the ability to obtain a complete, noninvasive hemodynamic assessment of the patient with cardiac disease.
Sanjiv Kaul - One of the best experts on this subject based on the ideXlab platform.
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Role of Doppler Echocardiography in Coronary Artery Disease
Journal of intensive care medicine, 1991Co-Authors: Sanjiv KaulAbstract:Doppler Echocardiography can have a major role in the evaluation of patients with coronary artery disease. This review deals with the imaging planes in relation to coronary vascular territories and the role of Doppler Echocardiography in evaluating patients with acute and chronic ischemic syndromes.
Ross M. Ungerleider - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary vein Doppler Echocardiography after left atrial operation
The Annals of thoracic surgery, 1995Co-Authors: J R Herlong, A. R. Bengur, Ross M. UngerleiderAbstract:Background. Intraoperative transesophageal Echocardiography provides the surgical team with important guidance during operations for congenital heart disease. Doppler Echocardiography adds hemodynamic information to that provided by two-dimensional imaging. Here we describe intraoperative pulmonary vein Doppler Echocardiography after operation involving the left atrium. Methods. Intraoperative two-dimensional and pulsed-wave Doppler Echocardiography of pulmonary veins were performed after surgical repair of anomalous pulmonary venous return in 4 patients. Results. In 3 patients, intraoperative pulmonary vein Doppler findings were suggestive of obstruction. The surgical repair was thought to be excellent, and there was no obstruction apparent anatomically or clinically. No further intervention was performed, and all patients recovered uneventfully. No pulmonary venous obstruction was noted on follow-up two-dimensional Echocardiography, and follow-up pulmonary vein Doppler Echocardiography showed the expected pattern. Conclusions. An obstructive pattern in the pulmonary vein Doppler was seen in 3 of 4 patients studied immediately after repair of anomalous pulmonary venous return. No obstruction, however, was manifest then or subsequently. The abnormal Doppler pattern, thus, is not indicative of pulmonary venous obstruction. We propose that acute postoperative changes in left atrial volume and compliance and acute postoperative tissue changes in the left atrium explain the abnormal pulmonary vein Doppler patterns observed.