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Your search keyword '"S. Mihaila"' showing total 2 results
Start Over Author "S. Mihaila" Publisher oxford university press
2 results on '"S. Mihaila"'

1. The added value of three-dimensional echocardiography in the late diagnosis of a pacemaker complication in a patient with severe congestive heart failure: a case report.

Author

Mihaila Baldea S, Velcea AE, Siliste C, and Vinereanu D

Abstract

Background: Three-dimensional echocardiography (3DE) presents an increasingly important role in the management of interventional cardiac procedures, overcoming limitations of conventional two-dimensional echocardiography (2DE). Early use of 3DE might have an added value in the diagnosis of device-related complications, such as lead induced tricuspid regurgitation (LITR), by providing better understanding of its mechanisms and ensuring a prompt and individually tailored treatment strategy., Case Summary: We report the case of a female patient with repeated hospitalizations for congestive heart failure in the past 2 years, who had a permanent single-chamber ventricular pacemaker (PM) implanted 10 years ago and a misleading diagnosis of severe tricuspid regurgitation (TR) secondary to annular dilation, based on 2DE. Conversely, current 3DE assessment of the TR mechanisms revealed that the PM lead was not placed between the commissures, but in the middle segment of the septal leaflet, causing impingement of the leaflet and severe TR., Discussion: Given the growing indication for cardiac devices, it is necessary to better define LITR and to establish its impact on patient prognosis. Due to lacking in proper diagnostic techniques, LITR is generally recognized as a late complication of PM/ICD implantation. Two-dimensional echocardiography has important limitations, whereas 3DE provides more accurate information on the TV apparatus in relation to the endocardial leads. Our case shows the usefulness of 3DE for a correct diagnosis of a device-related complication. Its utility in the follow-up of patients receiving cardiac devices remains to be determined, as well as its potential value in the guidance of lead insertion.

Published
2019
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2. Relationship between mitral annulus function and mitral regurgitation severity and left atrial remodelling in patients with primary mitral regurgitation.

Author

Mihaila S, Muraru D, Miglioranza MH, Piasentini E, Aruta P, Cucchini U, Iliceto S, Vinereanu D, and Badano LP

Subjects
Adult, Age Factors, Aged, Case-Control Studies, Echocardiography, Female, Humans, Male, Middle Aged, Mitral Valve diagnostic imaging, Mitral Valve surgery, Mitral Valve Annuloplasty methods, Mitral Valve Insufficiency surgery, Multivariate Analysis, Observer Variation, Prognosis, Reference Values, Regression Analysis, Risk Assessment, Severity of Illness Index, Sex Factors, Ventricular Dysfunction, Left physiopathology, Atrial Remodeling physiology, Echocardiography, Three-Dimensional methods, Image Interpretation, Computer-Assisted, Mitral Valve physiopathology, Mitral Valve Insufficiency diagnostic imaging, Ventricular Dysfunction, Left diagnostic imaging
Abstract

Aims: To explore the relationship between the mitral annular (MA) remodelling and dysfunction, mitral regurgitation (MR) severity, left ventricular (LV) and atrial (LA) size and function in patients with organic MR (OMR)., Methods and Results: A total of 52 patients (57 ± 15 years, 31 men) with mild to severe OMR and 52 controls underwent 3D transthoracic echocardiography acquisitions of the mitral valve (MV), LA, and LV. MA geometry and dynamics, LV and LA volumes, LV ejection fraction (LVEF) and emptying fractions (LAEF) were assessed using dedicated software packages. LA and LV myocardial deformations were assessed using 2D speckle-tracking echocardiography. OMR patients presented larger and more spherical MA than controls during the entire systole (P < 0.001). Although the MA non-planarity at early-systole was similar between OMR and controls (157 ± 13° vs. 153 ± 12°, P = NS), the MA became flatter from mid- to end-systole (153 ± 12 vs. 146 ± 10° and 157 ± 12 vs. 147 ± 8°, P < 0.01) in OMR. MA area fractional change was lower in patients with OMR (22 ± 5% vs. 28 ± 5%, P < 0.001), and correlated with the MR orifice and volume (r = -0.52 and r = -0.55). MA fractional area change correlated with LA minimum and maximum volumes (r = 0.77 and r = 0.70), total and active LAEF (r = 0.72 and r = 0.76), and LA negative strain and strain rate (r = 0.52 and r = 0.57), but not with the LVEF or LV global longitudinal strain. In a multivariate regression model using LAEF and LVEF, solely active LAEF correlated with the MA fractional area change (β = 0.51, P = 0.005)., Conclusion: In patients with OMR, MA reduced function correlates with the MR severity and the LA size and function, but not with the LV function., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.)

Published
2016
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