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Possible new options and benefits to detect myocarditis, right ventricular remodeling and coronary anomalies by echocardiography in systematic preparticipation screening of athletes.

通过超声心动图在运动员系统参与前筛查中检测心肌炎、右心室重构和冠状动脉异常的可能新选择和益处。

  • 影响因子:0
  • DOI:10.1007/s10554-020-01899-1
  • 作者列表:"Döbel T","Stöbe S","Marshall RP","Hepp P","Fikenzer S","Fikenzer K","Tautenhahn S","Laufs U","Hagendorff A
  • 发表时间:2020-10-01
Abstract

:Exclusion of cardiac abnormalities should be performed at the beginning of the athlete's career. Myocarditis, right ventricular remodeling and coronary anomalies are well-known causes of life-threatening events of athletes, major cardiovascular events and sudden cardiac death. The feasibility of an extended comprehensive echocardiographic protocol for the detection of structural cardiac abnormalities in athletes should be tested. This standardized protocol of transthoracic echocardiography includes two- and three-dimensional imaging, tissue Doppler imaging, and coronary artery scanning. Post processing was performed for deformation analysis of all compounds including layer strain. During 2017 and 2018, the feasibility of successful image acquisition and post processing analysis was retrospectively analyzed in 54 male elite athletes. In addition, noticeable findings inside the analyzed cohort are described. The extended image acquisition and data analyzing was feasible from 74 to 100%, depending on the used modalities. One case of myocarditis was detected in the present cohort. Coronary anomalies were not found. Right ventricular size and function were within normal ranges. Isovolumetric right ventricular relaxation time showed significant regional differences. One case of hypertrophic cardiomyopathy and two subjects with bicuspid aortic valves were found. Due to the excessive cardiac stress in highly competitive sports, high-quality and precise screening modalities are necessary, especially with respect to acquired cardiac diseases like acute myocarditis and pathological changes of left ventricular and RV geometry. The documented feasibility of the proposed extended protocol underlines the suitability to detect distinct morphological and functional cardiac alterations and documents the potential added value of a comprehensive echocardiography.

摘要

: 排除心脏异常应在运动员职业生涯开始时进行。心肌炎、右心室重构和冠状动脉异常是运动员危及生命事件、主要心血管事件和心源性猝死的众所周知的原因。应该测试扩展的综合超声心动图方案用于检测运动员结构性心脏异常的可行性。这种经胸超声心动图的标准化方案包括二维和三维成像、组织多普勒成像和冠状动脉扫描。对包括层应变在内的所有化合物的变形分析进行后处理。在2017和2018期间,回顾性分析了54名男子优秀运动员成功图像采集和后处理分析的可行性。此外,描述了所分析的队列内的显著发现。扩展的图像采集和数据分析是可行的,从74到100%,取决于所使用的模式。在本队列中检测到1例心肌炎。未发现冠状动脉异常。右心室大小及功能均在正常范围内。等容右心室舒张时间呈现明显的区域差异。发现1例肥厚型心肌病和2例二叶主动脉瓣。由于在激烈的竞技运动中心脏压力过大,高质量和精确的筛查模式是必要的,特别是关于获得性心脏疾病,如急性心肌炎和左心室和RV几何形状的病理变化。提出的扩展方案的可行性强调了检测不同形态学和功能性心脏改变的适用性,并记录了综合超声心动图的潜在附加值。

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影响因子:2.41
发表时间:2020-06-12
DOI:10.4244/EIJ-D-18-01138
作者列表:["Pellicano M","Di Gioia G","Ciccarelli G","Xaplanteris P","Delrue L","Toth GG","Van Durme F","Heyse A","Wyffels E","Vanderheyden M","Bartunek J","De Bruyne B","Barbato E"]

METHODS:AIMS:Significant platelet activation after long stented coronary segments has been associated with periprocedural microvascular impairment and myonecrosis. In long lesions treated either with an everolimus-eluting bioresorbable vascular scaffold (BVS) or an everolimus-eluting stent (EES), we aimed to investigate (a) procedure-related microvascular impairment, and (b) the relationship of platelet activation with microvascular function and related myonecrosis. METHODS AND RESULTS:Patients (n=66) undergoing elective percutaneous coronary intervention (PCI) in long lesions were randomised 1:1 to either BVS or EES. The primary endpoint was the difference between groups in changes of pressure-derived corrected index of microvascular resistance (cIMR) after PCI. Periprocedural myonecrosis was assessed by high-sensitivity cardiac troponin T (hs-cTnT), platelet reactivity by high-sensitivity adenosine diphosphate (hs-ADP)-induced platelet reactivity with the Multiplate Analyzer. Post-dilatation was more frequent in the BVS group, with consequent longer procedure time. A significant difference was observed between the two groups in the primary endpoint of ΔcIMR (p=0.04). hs-ADP was not different between the groups at different time points. hs-cTnT significantly increased after PCI, without difference between the groups. CONCLUSIONS:In long lesions, BVS implantation is associated with significant acute reduction in IMR as compared with EES, with no significant interaction with platelet reactivity or periprocedural myonecrosis.

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影响因子:1.67
发表时间:2020-01-01
DOI:10.2174/1573403X15666190513105231
作者列表:["Dev M","Sharma M","Rana N"]

METHODS:BACKGROUND:Aortopulmonary window is an uncommon congenital heart disease, with untreated cases not surviving beyond childhood. However, very rarely it can present in adult patients with features of pulmonary hypertension. Clinically these patients cannot be differentiated from other more common conditions with left to right shunt. Transthoracic echocardiography if performed meticulously, can depict the defect in aortopulmonary septum. RESULTS:We report a case of large unrepaired aortopulmonary window in a 23 years old patient, diagnosed on transthoracic echocardiography.

心脏影像技术方向

心脏结构和心脏血流的可视化,用于诊断评估或通过内窥镜、放射性核素成像等技术来指导心脏手术。

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