The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform
Matteo Di Biase - One of the best experts on this subject based on the ideXlab platform.
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peak myocardial acceleration during Isovolumic Relaxation Time predicts the occurrence of rehospitalization in chronic heart failure data from the daunia heart failure registry
Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, 2014Co-Authors: Michele Correale, Antonio Totaro, Armando Ferraretti, Tommaso Passero, Fiorella De Rosa, Francesco Musaico, Riccardo Ieva, Matteo Di Biase, Natale Daniele BrunettiAbstract:Background Tissue Doppler imaging (TDI) may be useful in identifying subjects at higher risk among patients with chronic heart failure (CHF). The clinical role of new developed TDI parameters, however, still needs to be documented. Methods A total of 113 consecutive patients with CHF enrolled in the Daunia heart failure registry underwent echocardiography assessment and were followed prospectively for 234 ± 262 days. Conventional echocardiography and TDI parameters were calculated. We also calculated peak myocardial acceleration during Isovolumic Relaxation Time (pIVA[r]) derived from TDI (pIVV(r)/AT). Results Subjects readmitted for worsening HF were characterized by lower levels of pIVA(r) (0.8 ± 0.3 vs. 1.3 ± 0.5 m/s2, P < 0.001). pIVA(r) levels predicted the incidence of readmission for worsening HF during follow-up (HR 0.78, 95% confidence interval 0.64–0.96, P < 0.05), even after multivariable analysis. The assessment of pIVA(r) in addition to left ventricular ejection fraction (LVEF) and E/E′ provided additional prognostic value (Log Rank P < 0.05). The presence of abnormal pIVA(r), LVEF, and E/E′ levels identified subjects with a higher risk of hospitalization for worsening dyspnea during follow-up than those with 2 abnormal marker levels or 0–1 (Log Rank P < 0.05). Conclusions Peak myocardial acceleration during Isovolumic Relaxation Time may represent an independent adjunctive tool for the risk stratification of patients with CHF.
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peak myocardial acceleration during Isovolumic Relaxation Time predicts the occurrence of re hospitalization in chronic heart failure data from the daunia heart failure registry
European Heart Journal, 2013Co-Authors: Michele Correale, Antonio Totaro, Armando Ferraretti, Tommaso Passero, Fiorella De Rosa, Francesco Musaico, Natale Daniele Brunetti, Giuseppe Salvemini, L F M Di Martino, Matteo Di BiaseAbstract:Background: Tissue Doppler Imaging (TDI) may be useful in identifying subjects at higher risk among patients with Chronic Heart Failure (CHF). The clinical role of new developed TDI parameters, however, still need to be documented. Methods: A total of 113 consecutive patients with CHF enrolled in the daunia Heart Failure Registry underwent echocardiography assessment and were followed prospectively for a mean 234±262. days. Conventional echocardiography and TDI parameters were calculated. We have also calculated peak myocardial acceleration during Isovolumic Relaxation Time (pIVA(r)) derived from TDI (peak velocity during Isovolumic Relaxation (pIVV(r))/Acceleration Time (AT)). Results: Subjects readmitted for worsening HF were characterized by lower levels of pIVA(r) (0.8±0.3 vs 1.3±0.5 m/s2, p<0.001). pIVA(r) levels predicted the incidence of readmission for worsening HF during follow up (HR 0.78, 95% confidence interval 0.64-0.96, p<0.05), even at multivariable analysis. The assessment of pIVA(r) in addition to Left Ventricular Ejection Fraction (LVEF) and E/E' owned an adjunctive prognostic value (Log Rank p<0.05). The contemporary presence of abnormal pIVA(r), LVEF and E/E' levels identified subjects with a higher risk of hospitalization for worsening dyspnea during follow up than those with 2 abnormal marker levels or 0-1 (Log Rank p<0.05). Conclusion: pIVA(r) may represent an independent adjunctive tool for the risk stratification of patients with CHF.
Patrick J Mcnamara - One of the best experts on this subject based on the ideXlab platform.
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predictors of respiratory instability in neonates undergoing patient ductus arteriosus ligation after the introduction of targeted milrinone treatment
The Journal of Thoracic and Cardiovascular Surgery, 2016Co-Authors: Joseph Ting, Maura H F Resende, Kiran More, Donna Nicholls, Dany E Weisz, Afif Elkhuffash, Amish Jain, Patrick J McnamaraAbstract:Abstract Introduction The postoperative course of preterm babies undergoing surgical closure of a patent ductus arteriosus (PDA) is often complicated by postligation cardiac syndrome (PLCS). Despite targeted milrinone prophylaxis, some infants continue to experience postoperative respiratory deterioration. Our objective is to describe the immediate postoperative course and identify risk factors for respiratory instability when preterm infants undergoing PDA ligation are managed with targeted milrinone treatment. Methods A retrospective review of a cohort of infants undergoing PDA ligation between January, 2010 and August, 2013 was conducted. All infants had a targeted neonatal echocardiogram performed 1 hour after surgery. Infants received prophylactic milrinone treatment if the left ventricular output was Results Eighty-six infants with a median gestational age of 25 weeks (interquartile range [IQR], 24-26) and a birth weight of 740 g (IQR, 640-853) were included in this study. Forty-nine (57.0%) received milrinone prophylaxis. There were 44 (51.2%) infants who developed oxygenation or ventilation failure, and 7 (8.1%) neonates developed PLCS. Infants with longer Isovolumic Relaxation Time (IVRT ≥30 milliseconds) were more likely to develop either oxygenation or ventilation failure. Conclusions Although the incidence of PLCS has declined after the introduction of targeted milrinone prophylaxis, many preterm infants continue to develop respiratory instability after surgical ligation. In this population, diastolic dysfunction manifested by prolonged IVRT could be associated with an adverse postoperative respiratory course.
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coronary artery perfusion and myocardial performance after patent ductus arteriosus ligation
The Journal of Thoracic and Cardiovascular Surgery, 2012Co-Authors: Arvind Sehgal, Patrick J McnamaraAbstract:Objectives To study coronary artery (CA) perfusion and myocardial performance after patent ductus arteriosus (PDA) ligation. The postoperative course in premature infants undergoing surgical ligation of PDA is often complicated by cardiorespiratory instability secondary to impaired left ventricular performance. Methods Serial echocardiography was performed before and after (1, 8, and 24 hours) PDA ligation to assess systolic (left ventricular output [LVO]) and diastolic (Isovolumic Relaxation Time, E and A wave peak velocity) myocardial performance, and CA diastolic flow (CA velocity Time integral and flow). The ratio of CA flow to LVO was calculated as a surrogate of coronary flow. Results A total of 20 infants (gestational age at birth, 26.3 ± 0.7 weeks) requiring PDA ligation at a median of 28.5 days (range, 9–40) after birth and weight of 780 g (range, 570–2840) were studied. A postoperative increase in the CA flow/LVO ratio was demonstrated. An early decrease in E and A wave peak velocity ( P P r = 0.63, P = .01) at 1 hour and lower systolic blood pressure at 8 hours ( r = 0.5, P = .05). The postoperative need for inotropes (n = 8) was associated with a low baseline CA velocity Time integral at 1 hour (r = 0.52, P P P Conclusions PDA ligation is followed by altered CA perfusion. Perioperative evaluation of the CA perfusion can help identify neonates at risk of impaired myocardial performance, systolic hypotension, and the need for inotropes.
Francisco Gonzalezvilchez - One of the best experts on this subject based on the ideXlab platform.
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comparison of doppler echocardiography color m mode doppler and doppler tissue imaging for the estimation of pulmonary capillary wedge pressure
Journal of The American Society of Echocardiography, 2002Co-Authors: Francisco Gonzalezvilchez, Jose Ayuela, Miguel Ares, Nuria Sanchez Mata, Amparo Garcia Gonzalez, Rafael Martin DuranAbstract:Abstract To overcome the limitations of mitral inflow parameters for predicting pulmonary capillary wedge pressure (PCWP), combined indices (with Doppler tissue imaging or color M-mode Doppler) have been developed. This study was aimed to compare the accuracy of these indices to predict PCWP. Sixty-one patients were studied. The best correlations with PCWP were found for indices that combined Isovolumic Relaxation Time with flow propagation velocity (color M-mode) or early diastolic velocity of the lateral mitral annulus (Doppler tissue). Both closely tracked changes in PCWP. The color M-mode-derived index was the most accurate in patients with normal systolic function. (J Am Soc Echocardiogr 2002;15:1245-50.)
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combined use of pulsed and color m mode doppler echocardiography for the estimation of pulmonary capillary wedge pressure an empirical approach based on an analytical relation
Journal of the American College of Cardiology, 1999Co-Authors: Francisco Gonzalezvilchez, Jose Ayuela, Miguel Ares, Luis Javier AlonsoAbstract:OBJECTIVES We sought a noninvasive estimation of pulmonary capillary wedge pressure (Pw) by means of the information obtained from transmitral pulsed Doppler and color M-mode Doppler flow propagation velocity (FPV). BACKGROUND Pulsed Doppler parameters have limited accuracy for the estimation of Pw because they are determined by left atrial pressure and other parameters such as ventricular Relaxation. Recently, a good correlation has been found between the rate of ventricular Relaxation (τ, tau) and FPV measured by color M-mode Doppler echocardiography. METHODS We studied 20 patients who underwent invasive hemodynamic monitoring. By multilinear regression analysis, the relationships between Pw and Doppler parameters, FPV, and a noninvasive estimate (Pest) based on the Weiss’ equation (substituting tau for 1/FPV) were determined. A simplified index based on the results obtained was then tested in an additional group of 34 patients. RESULTS By multiple regression analysis only Isovolumic Relaxation Time (IVRT) (p = 0.0096) and Pest(p = 0.0043) were related to Pw. A derived empirical index, 103/([2·IVRT]+FPV), was strongly correlated with Pw in the entire group according to the regression equation Pw = 4.5·(103/[{2·IVRT} + FPV]) − 9 (r = 0.89, p 15 mm Hg were 90% and 100%, respectively. CONCLUSIONS The combined use of FPV as a surrogate for tau and IVRT permits a close prediction of Pw.
Michele Correale - One of the best experts on this subject based on the ideXlab platform.
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peak myocardial acceleration during Isovolumic Relaxation Time predicts the occurrence of rehospitalization in chronic heart failure data from the daunia heart failure registry
Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, 2014Co-Authors: Michele Correale, Antonio Totaro, Armando Ferraretti, Tommaso Passero, Fiorella De Rosa, Francesco Musaico, Riccardo Ieva, Matteo Di Biase, Natale Daniele BrunettiAbstract:Background Tissue Doppler imaging (TDI) may be useful in identifying subjects at higher risk among patients with chronic heart failure (CHF). The clinical role of new developed TDI parameters, however, still needs to be documented. Methods A total of 113 consecutive patients with CHF enrolled in the Daunia heart failure registry underwent echocardiography assessment and were followed prospectively for 234 ± 262 days. Conventional echocardiography and TDI parameters were calculated. We also calculated peak myocardial acceleration during Isovolumic Relaxation Time (pIVA[r]) derived from TDI (pIVV(r)/AT). Results Subjects readmitted for worsening HF were characterized by lower levels of pIVA(r) (0.8 ± 0.3 vs. 1.3 ± 0.5 m/s2, P < 0.001). pIVA(r) levels predicted the incidence of readmission for worsening HF during follow-up (HR 0.78, 95% confidence interval 0.64–0.96, P < 0.05), even after multivariable analysis. The assessment of pIVA(r) in addition to left ventricular ejection fraction (LVEF) and E/E′ provided additional prognostic value (Log Rank P < 0.05). The presence of abnormal pIVA(r), LVEF, and E/E′ levels identified subjects with a higher risk of hospitalization for worsening dyspnea during follow-up than those with 2 abnormal marker levels or 0–1 (Log Rank P < 0.05). Conclusions Peak myocardial acceleration during Isovolumic Relaxation Time may represent an independent adjunctive tool for the risk stratification of patients with CHF.
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peak myocardial acceleration during Isovolumic Relaxation Time predicts the occurrence of re hospitalization in chronic heart failure data from the daunia heart failure registry
European Heart Journal, 2013Co-Authors: Michele Correale, Antonio Totaro, Armando Ferraretti, Tommaso Passero, Fiorella De Rosa, Francesco Musaico, Natale Daniele Brunetti, Giuseppe Salvemini, L F M Di Martino, Matteo Di BiaseAbstract:Background: Tissue Doppler Imaging (TDI) may be useful in identifying subjects at higher risk among patients with Chronic Heart Failure (CHF). The clinical role of new developed TDI parameters, however, still need to be documented. Methods: A total of 113 consecutive patients with CHF enrolled in the daunia Heart Failure Registry underwent echocardiography assessment and were followed prospectively for a mean 234±262. days. Conventional echocardiography and TDI parameters were calculated. We have also calculated peak myocardial acceleration during Isovolumic Relaxation Time (pIVA(r)) derived from TDI (peak velocity during Isovolumic Relaxation (pIVV(r))/Acceleration Time (AT)). Results: Subjects readmitted for worsening HF were characterized by lower levels of pIVA(r) (0.8±0.3 vs 1.3±0.5 m/s2, p<0.001). pIVA(r) levels predicted the incidence of readmission for worsening HF during follow up (HR 0.78, 95% confidence interval 0.64-0.96, p<0.05), even at multivariable analysis. The assessment of pIVA(r) in addition to Left Ventricular Ejection Fraction (LVEF) and E/E' owned an adjunctive prognostic value (Log Rank p<0.05). The contemporary presence of abnormal pIVA(r), LVEF and E/E' levels identified subjects with a higher risk of hospitalization for worsening dyspnea during follow up than those with 2 abnormal marker levels or 0-1 (Log Rank p<0.05). Conclusion: pIVA(r) may represent an independent adjunctive tool for the risk stratification of patients with CHF.
J W Wladimiroff - One of the best experts on this subject based on the ideXlab platform.
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assessment of mitral a wave transit Time to cardiac outflow tract and Isovolumic Relaxation Time of left ventricle in the appropriate and small for gestational age human fetus
Ultrasound in Medicine and Biology, 1997Co-Authors: P Tsyvian, K Malkin, J W WladimiroffAbstract:Mitral A-wave transit Time (Ta; ms) from the mitral valve to the left ventricular outflow tract and left ventricular Isovolumic Relaxation Time (IRT) were studied by pulsed Doppler ultrasound in 17 appropriate-for-gestational-age fetuses (AGA, 30–39 wk) and 12 small-for-gestational-age fetuses (SGA, 30–36 wk). Ta was measured from the peak of the A-wave to the peak of the reflected A-wave (Ar) from the left ventricular wall. IRT was determined from the interval between the aortic valve closure artefact and the onset of transmitral flow. The mean Ta in the SGA fetus (42 ± 7 [1 SD] ms) was significantly shorter (p < 0.03) than in the AGA fetus (47 ± 11 [1 SD] ms), whereas this was not so for IRT (51 ± 8 [1 SD] ms vs. 60 ± 15 [1 SD] ms). In the SGA fetus, a positive correlation (r = +0.82, p < 0.01) was established between Ta (ms) and gestational age. No such correlation existed for the AGA fetus. It is speculated that, in the SGA fetus, the shorter Ta may reflect an increase in left ventricular stiffness.
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assessment of fetal left cardiac Isovolumic Relaxation Time in appropriate and small for gestational age fetuses
Ultrasound in Medicine and Biology, 1995Co-Authors: P Tsyvian, K Malkin, J W WladimiroffAbstract:Left ventricular Isovolumic Relaxation Time was studied in 22 appropriate-for-gestational-age fetuses (AGA, 26–40 wk) and 12 small-for-gestational-age fetuses (SGA, 29–37 wk). Left ventricular Isovolumic Relaxation Time was determined from the interval between aortic valve closure and maximal left atrial dimension by M-mode, and from the interval between aortic valve closure artefact and onset of transmitral flow by pulsed Doppler. Mean left ventricular Isovolumic Relaxation Time by M-mode (36 ± 6 ms) and by pulsed Doppler (49 ± 10 ms) were significantly different (p < 0.05) in AGA while this was not so in SGA (56 ± 10 ms vs. 60 ± 8 ms). A significant difference (p < 0.05) in mean left ventricular Isovolumic Relaxation Time by M-mode existed between AGA (36 ± 6 ms) and SGA (56 ± 10 ms), whereas this was not so for pulsed Doppler (48 ± 10 ms vs. 60 ± 8 ms). Mean left ventricular Isovolumic Relaxation Time by Doppler was significantly larger (mean difference 14 ± 8 ms; p < 0.05) than by M-mode in AGA. However, there was no difference in mean left ventricular Isovolumic Relaxation Time between the two ultrasound modalities in SGA. These data suggest synchronization of mitral cusp separation and transmitral blood flow in the SGA fetus. We speculate that, in the SGA fetus, delayed left ventricular Isovolumic Relaxation Time may reflect cardiac diastolic dysfunction.
