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3. Real-Time Artificial Intelligence–Based Guidance of Echocardiographic Imaging by Novices: Image Quality and Suitability for Diagnostic Interpretation and Quantitative Analysis

Author

Mor-Avi, Victor, Khandheria, Bijoy, Klempfner, Robert, Cotella, Juan I., Moreno, Merav, Ignatowski, Denise, Guile, Brittney, Hayes, Hailee J., Hipke, Kyle, Kaminski, Abigail, Spiegelstein, Dan, Avisar, Noa, Kezurer, Itay, Mazursky, Asaf, Handel, Ran, Peleg, Yotam, Avraham, Shir, Ludomirsky, Achiau, and Lang, Roberto M.

Published
2023
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10. Non-transmural myocardial infarction associated with regional contractile function is an independent predictor of positive outcome: an integrated approach to myocardial viability

Author

Di Bella, Gianluca, Aquaro, Giovanni Donato, Bogaert, Jan, Piaggi, Paolo, Micari, Antonio, Pizzino, Fausto, Camastra, Giovanni, Carerj, Scipione, Campisi, Mariapaola, Bracco, Antonio, Carerj, Maria Ludovica, Emdin, Michele, Khandheria, Bijoy K., and Pingitore, Alessandro

Published
2021
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13. Myocardial work indices in bileaflet mitral valve prolapse patients.

Author

Muthukumar, Lakshmi, Jahangir, Arshad, Ashraf, Muddasir, Schweitzer, McKenzie, Pesek, Kelly, Galazka, Patrycja, Umland, Matt, Khandheria, Bijoy K, and Tajik, A Jamil

Subjects
RISK assessment, MITRAL valve prolapse, RETROSPECTIVE studies, DESCRIPTIVE statistics, MYOCARDIUM, VENTRICULAR arrhythmia, OXYGEN consumption, ECHOCARDIOGRAPHY, LEFT ventricular dysfunction, DISEASE risk factors, DISEASE complications
Abstract

Aims Mechanisms underlying left ventricular dysfunction and arrhythmogenesis in bileaflet mitral valve prolapse (BMVP) patients are not well defined. Myocardial work index (MWI) is a non-invasive assessment that correlates with myocardial oxygen consumption. We aimed to compare global and regional MWI in BMVP patients with normal controls. Methods and results In this retrospective study, we calculated MWI in BMVP patients and controls using GE EchoPAC (GE Healthcare, Chicago, IL, USA) software. Of 147 BMVP patients (59% women, mean age 54 ± 15 years), 16 had a flail mitral leaflet. There was regional heterogeneity in MWIs, with increased posterolateral trident myocardial work (2099 ± 271 vs. 1895 ± 321 mm Hg%, P = 0.039), constructive work (2831 ± 366 vs. 2257 ± 338 mm Hg%, P < 0.001), wasted work [87 (52–194) vs. 71 (42–103) mm Hg%, P = 0.015], peak systolic strain (−23.0 ± 2.4 vs. −19 ± 3%, P < 0.001), and reduction in myocardial work efficiency [95.00 (93.50–97.75) vs. 96.75 (95.00–97.75) %, P = 0.020] in 100 BMVP patients compared with age- and sex-matched controls. BMVP patients' basal septal wall MWIs were lower than those of controls. The higher work indices in patients with BMVP were reduced in those who developed flail leaflets. No significant differences in work indices were seen between ventricular arrhythmia and non-arrhythmia BMVP patients. Conclusion Regional differences in MWIs were noted in the BMVP patients compared with controls, with overall reduced myocardial efficiency in the posterolateral trident and basal septal regions. In cross-sectional analysis, MWIs were not different in patients with ventricular tachyarrhythmias. Impact of MWI on long-term prognosis needs to be determined. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Refining the upper limit of normal for the ascending aorta: In search of optimal criteria ‐‐ a large database study of normal individuals.

Author

Yoon, Ji Ae, Ahmad, Mirza Mujadil, Syed, Muhammad Nabeel, Ahmad, Mirza Nubair, Hussaini, Sharmeen Fatima, Muhammad, Mustafa Noor, Pir, Syed Haris A, Khandheria, Bijoy K, Tajik, A. Jamil, and Ammar, Khawaja Afzal

Abstract

Objectives: The cutoff for dilated mid-ascending aorta (mAA) is controversial and has several definitions. The present study was carried out to determine the prevalence of mAA dilation based on published definitions and to identify the optimal cutoff. Methods: Echocardiographic studies of patients >15 years of age performed at a large tertiary care center over 4 years, n = 49,330, were retrospectively evaluated. Leading-edge-to-leading-edge technique was used to measure the mAA in diastole. Several cutoff criteria were included. In addition, we defined normals in our database as those who, after 28 causes of dilated aorta were excluded, were normal both clinically and echocardiographically (n = 2334). Results: The mean age was 64.2 ± 17.1 years, and 31.5% were men. The prevalence of dilated mAA based on absolute criteria with sex stratification varied between 17% and 23% and based on relative criteria (to age, body surface area, and sex) varied between 6% and 11%. It further decreased to 7.6% on the addition of narrow age stratification (10 year intervals) performed on normals in our database. The multivariate adjusted R 2 (for variation in mAA diameter) was 0.25 for age, decreasing to 0.12 for weight and 0.07 for sex and height. Conclusions: The lowest prevalence of 7.6% probably represents the optimal cutoff for dilated mAA because it includes age, which explains most of the variation in mAA, in narrow (10 year) intervals only performed in our normals, which represents the largest sample size to date. [ABSTRACT FROM AUTHOR]

Published
2024
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31. Prevalence of dilated mid-ascending aorta in individuals 15 years and older: In search of optimal diagnostic criteria and their effect on the burden of disease.

Author

Ahmad, Mirza Mujadil, Yoon, Ji Ae, Syed, Muhammad Nabeel, Ahmad, Mirza Nubair, Hussaini, Sharmeen Fatima, Muhammad, Mustafa Noor, Pir, Syed Haris A, Khandheria, Bijoy K, Tajik, A Jamil, and Ammar, Khawaja Afzal

Subjects
AORTA, BODY surface area, THORACIC aorta
Abstract

Background: Controversy regarding the definition of the upper limit of normal (ULN) for dilated mid-ascending aorta (mAA) stems from variation in criteria, based on several small-sized studies with small datasets of normal subjects (DONS). The present study was carried out to demonstrate this variation in the prevalence of mAA dilation and to identify the optimal definition by creating the largest DONS. Methods: Echocardiographic studies of patients ≥ 15 years of age performed at a large tertiary care center over 4 years (n = 49,330) were retrospectively evaluated. The leading-edge-to-leading-edge technique was used to measure the mAA in diastole. The largest-to-date DONS (n = 2334) was created, including those who were normal on medical record review, did not have any of the 28 causes of dilated aorta, and had normal echocardiograms. Because age had the strongest correlation with mAA (multivariate adjusted R 2 = 0.26), as compared with sex, height, and weight, we created a new ULN based on the DONS with narrow age stratification (10-year intervals). Results: The prevalence of dilated mAA varied between 17% and 23% when absolute criteria were used with sex stratification, and it varied between 6% and 11% when relative criteria (relative to age, body surface area, and sex) were used. Based on new criteria from the DONS, it was 7.6%, with a ULN of 3.07–3.64 cm in women and 3.3–3.91 cm in men. Conclusions: These data demonstrate the undesirable variation in the prevalence of dilated mAA based on prior criteria and propose a new ULN for dilated mAA. [ABSTRACT FROM AUTHOR]

Published
2023
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