Search

Objective: This study was an investigation of the severity of inflammation (SOI) in aspirated material and thrombus age to examine any association with pre-discharge and long-term left ventricular (LV) function after ST-elevation myocardial infarction (STEMI). Methods: The study group comprised 25 patients with STEMI from whom an occlusive thrombus was aspirated from the infarct-related artery with a 7-F catheter. The SOI in the aspirate was determined according to the mean leukocyte count in 5 high-power magnification fields and graded as mild in the presence of ≤100 leukocytes per field or significant if there were >100 leukocytes per field. The thrombi were categorized as fresh or lytic/organized (L/O) using predefined criteria. Echocardiographic assessment was performed prior to discharge and at 1 year. Adverse left ventricular remodeling (LVR) was defined as a 20% increase in LV end-diastolic volume in comparison with baseline values. Results: LVR was observed in 8 patients. The mean leukocyte count of the aspirate (127.5+-86.0 vs 227.2+-120.7; p=0.026) and frequency of significant inflammation (35% vs 75%; p=0.046) were significantly higher in the group with LVR. The serum high-sensitivity C-reactive protein (hsCRP) level was significantly correlated with the leukocyte count of the aspirate (r=0.532; p=0.006). An L/O thrombus was related to better pre-discharge and long-term LV volumes and ejection fraction values compared with a fresh thrombus. Conclusion: A significant increase in the leukocyte count in the aspirate and a fresh thrombus might predict long-term LV functional deterioration irrespective of the clinical and procedure-related characteristics. In addition, serum markers of inflammation, like hsCRP, might also reflect the intensity of the local inflammatory response at the site of occlusion.

Objective: Bicuspid aortic valve (BAV) is a complex developmental anomaly caused by abnormal aortic leaflet formation during valvulogenesis. The present study is an assessment of the effects of BAV disease on the ascending aorta and pulmonary artery (PA), and an evaluation of the consequences for systolic and diastolic functioning of the left and right ventricles. Methods: Total of 66 patients were eligible for inclusion. Pulmonary artery maximum diameter (PAD) was obtained 1 cm distal to the pulmonary annulus. Using pulsed-wave tissue Doppler imaging, left ventricular (LV) early diastolic velocity (E′) measurement was obtained at the annulus with placement of sample volume. Right ventricle (RV) peak global strain rate during systole (RV-SRS), early diastole (RV-SRE), and late diastole (RV-SRA) were calculated. Results: In this study, 40.9% (n=27) of patients were female and average age was 35+-11years. RV-SRS values (β=-.781, t=-2.723; p=0.010) and log-LV tissue Doppler imaging E' (β=-2.996, t=-5.405; p=

Objectives: The aim of this study was to investigate the value of plasma D-dimer (DD) levels for predicting systemic embolism in patients with infective endocarditis (IE). Study design: A total of 42 patients (mean age: 46+-16 years; 78% males) with IE were included. Clinical, laboratory and echocardiographic findings of the patients were evaluated. Results: Increased plasma DD levels were determined in 13 patients with systemic embolism (p=0.016). Moreover, when patients were divided in two groups as DD >500 ng/dl and DD 500 ng/dl group (p=0.036). Receiver operating characteristics (ROC) curve analysis was performed to detect the best cut-off value of DD in the prediction of systemic embolism. DD >425 ng/dl yielded an area under the curve (AUC) value of 0.735 (95% CI 0.560-0.909, p=0.016). DD >425 ng/dl demonstrated a sensitivity of 77% and specificity of 62% for the prediction of clinical embolism. Hematocrit (r=-0.31, p=0.045), platelet count (r=-0.40, p=0.009), albumin (r=-0.37, p=0.026), and globulin (r=0.38, p=0.028) levels were correlated with DD levels. Conclusion: Plasma DD levels are increased in patients with IE who suffered from clinically significant systemic embolism. Further studies are needed to determine the predictive value of DD levels for clinically silent systemic embolism.

We present an unusual case of giant caseous calcification of the mitral annulus in a 58-year-old female patient. The mass was detected during echocardiography and was defined as a big, round echodense lesion attached to the posterior mitral ring annulus. The patient was further evaluated with a full spectrum of cardiac noninvasive imaging modalities and the diagnosis was confirmed. Caseous calcification of the mitral annulus is a rare entity usually diagnosed by transthoracic echocardiography. Since it is very important to differentiate it from cardiac tumors, complimentary imaging modalities could be used for this purpose if a doubt exists about the diagnosis.

Hypertrophic biventricular cardiomyopathy is a rare finding and generally caused by systemic infiltrative diseases. Its association with pulmonary stenosis in same patient is even rarer. We report a case report of male patient with biventricular hypertrophy coexisting with pulmonary valve stenosis and systemic hypertension.

BackgroundMachine learning analysis of complex myocardial scar patterns affords the potential to enhance risk prediction of life-threatening arrhythmia in stable coronary artery disease (CAD).ObjectiveTo assess the utility of computational image analysis, alongside a machine learning (ML) approach, to identify scar microstructure features on late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR) that predict major arrhythmic events in patients with CAD.MethodsPatients with stable CAD were prospectively recruited into a CMR registry. Shape-based scar microstructure features characterizing heterogeneous (‘peri-infarct’) and homogeneous (‘core’) fibrosis were extracted. An ensemble of machine learning approaches were used for risk stratification, in addition to conventional analysis using Cox modeling.ResultsOf 397 patients (mean LVEF 45.4 ± 16.0) followed for a median of 6 years, 55 patients (14%) experienced a major arrhythmic event. When applied within an ML model for binary classification, peri-infarct zone (PIZ) entropy, peri-infarct components and core interface area outperformed a model representative of the current standard of care (LVEFClass I): AUROC (95%CI) 0.81 (0.81–0.82) vs. 0.64 (0.63–0.65), p = 0.002. In multivariate cox regression analysis, these features again remained significant after adjusting for LVEFClass I: PIZ entropy hazard ratio (HR) 1.88, 95% confidence interval (CI) 1.38–2.56, p

Abstract Background Cardiovascular magnetic resonance (CMR) derived fractal analysis of the left ventricle (LV) has been shown in adults to be a useful quantitative measure of trabeculation with high reproducibility and accuracy for the diagnosis of LV non-compaction (LVNC). The aim of this study was to investigate the utility and feasibility of fractal analysis in children. Methods Eighty-four subjects underwent CMR: (1) 28 patients with LVNC (as defined by the Petersen criteria with NC/C ratio $$\ge$$ ≥ 2.3); (2) 28 patients referred by clinicians for assessment of hyper-trabeculation and found not to qualify as LVNC (NC/C $$\ge$$ ≥ 1.8 and

Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Three-directional cine multi-slice left ventricular myocardial velocity mapping (3Dir MVM) is a cardiac magnetic resonance (CMR) technique that allows the assessment of cardiac motion in three orthogonal directions. Accurate and reproducible delineation of the myocardium is crucial for accurate analysis of peak systolic and diastolic myocardial velocities. In addition to the conventionally available magnitude CMR data, 3Dir MVM also provides three orthogonal phase velocity mapping datasets, which are used to generate velocity maps. These velocity maps may also be used to facilitate and improve the myocardial delineation. Based on the success of deep learning in medical image processing, we propose a novel fast and automated framework that improves the standard U-Net-based methods on these CMR multi-channel data (magnitude and phase velocity mapping) by cross-channel fusion with an attention module and the shape information-based post-processing to achieve accurate delineation of both epicardial and endocardial contours. To evaluate the results, we employ the widely used Dice Scores and the quantification of myocardial longitudinal peak velocities. Our proposed network trained with multi-channel data shows superior performance compared to standard U-Net-based networks trained on single-channel data. The obtained results are promising and provide compelling evidence for the design and application of our multi-channel image analysis of the 3Dir MVM CMR data.