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Pulmonary hypertension (PH) is a frequent and detrimental condition. Right heart catheterization (RHC) is the gold standard to identify PH subtype (precapillary from postcapillary PH) and is key for treatment allocation. In this study, the novel echocardiographic biventricular coupling index (BCI), based on the ratio between right ventricular stroke work index and left ventricular E/E′ ratio, was tested for the discrimination of PH subtype using RHC as the comparator.

Interest in transcatheter treatment of tricuspid regurgitation (TR) has grown significantly in recent years due to increasing evidence correlating TR severity with mortality and to limited availability of surgical options often considered high-risk in these patients. Although edge-to-edge repair is currently the main transcatheter therapeutic strategy, tricuspid valve direct annuloplasty can also be performed safely and effectively to reduce TR and improve heart failure symptoms and quality of life. In the annuloplasty procedure, an adjustable band is implanted around the tricuspid annulus to reduce valvular size and improve TR. Patient selection and careful preoperative imaging, including transthoracic echocardiography, transesophageal echocardiography, and computed tomography, are critical for procedural success and proper device implantation. Compared to edge-to-edge repair, perioperative imaging with transesophageal echocardiography and fluoroscopy is particularly challenging. Alignment and insertion of the anchors are demanding but essential to achieve good results and avoid damaging the surrounding structures. The presence of shadowing artifacts due to cardiac devices makes the acquisition of good-quality images even more challenging. In this review, we discuss the current role of multimodality imaging in planning direct transcatheter tricuspid valve annuloplasty and describe all procedural steps focusing on echocardiographic monitoring.

Aortic aneurysms result from degeneration and abnormal production of elastin and collagen. Besides medical therapy, management includes periodical imaging to identify the best moment for surgery. Nowadays, the alternative to traditional surgical techniques is represented by a hybrid approach in which debranching is followed by positioning of an endograft. We describe a case of a patient with multiple atherosclerotic aneurysms and a penetrating ulcer of the aortic arch treated with a hybrid approach.

In idiopathic dilated cardiomyopathy, there are scarce data on the influence of late gadolinium enhancement (LGE) assessed by cardiovascular magnetic resonance on left ventricular (LV) remodeling.

Background Chronic kidney disease is a major risk factor for cardiovascular death and may be detected by measuring serum creatinine levels (SCr). Alternatively, renal function may be evaluated by estimating glomerular filtration rate (GFR) with formulas based on SCr and variables such as age, sex and body weight. The purpose of the study was to compare the predictive value of GFR, calculated with the Cockcroft-Gault (CG) and revised Modification of Diet in Renal Disease formulas, in a population with ischaemic heart disease (IHD).Design Retrospective observational study.Methods Renal function was analysed in 1705 patients (mean age 55 ± 9.2 years, 80% male) who had been admitted to our Institute for IHD. The relationship between reduced GFR and outcome was examined through Kaplan-Meier curves and Cox regression analysis.Results Ten-year mortality was 20% and had as predictors both an abnormal (≥ 1.10 mg/dl) SCr and reduced (<60 ml/min/1.73 m2) Modification of Diet in Renal Disease and CG GFR (P< 0.0001 for each). Using Cox regression analysis, significant coronary atherosclerosis, defined as a greater than 50% stenosis in at least one major vessel, turned out to be the factor most closely linked to increased mortality [HR corresponds to hazard ratio 4.40, 95% (confidence interval) CI 2.78-6.97, P< 0.001], followed by reduced CG GFR (HR 2.08, 95% CI 1.55-2.79, P< 0.001) and left bundle branch block (HR 2.00, 95% CI 1.10-3.61, P< 0.001).Conclusion GFR, especially if calculated with the CG formula, is an important prognostic indicator for IHD among hospitalized patients, and predicts survival more accurately than SCr and conventional coronary risk factors. Eur J Cardiovasc Prev Rehabil15:423-427 © 2008 The European Society of Cardiology

This article shows a case of double-chambered left ventricle in asymptomatic 60-year-old man. This rare congenital entity is usually diagnosed in the neonatal or paediatric age, and it is characterized by the subdivision of the left ventricle in two chambers by an abnormal septum or muscle band. Differential diagnosis includes two other congenital left ventricular (LV) outpouching entities, such as diverticulum and aneurysm. As shown in our case, double-chambered left ventricle exhibits mixed features. A comprehensive cardiovascular magnetic imaging study is useful in the distinction of these closely related congenital diseases and, therefore, important for the correct final diagnosis.