A 52-year-old woman with a lung carcinoma metastatic to bone was admitted to the Cardiology Department for acute chest pain after 1 week of the oncologic therapy. Electrocardiographic examination (ECG) revealed ischemic picture with ST-T wave abnormalities in DI and aVL leads and poor progression of R wave in V1-V4 leads. Two- and three-dimensional transthoracic echocardiography (2D/3D TTE) showed myocardial involvement with infiltration of the anterolateral left ventricular (LV) wall from the epicardial to the endocardial layer, apical hypokinesia, LV ejection fraction (LVEF) and global 3D longitudinal strain reduction, but was absent pericardial effusion. Three months from the beginning of erlotinib, the patient showed a significant reduction in myocardial involvement with no ECG-ST elevation. Echo showed a mild regression of the wall infiltration and a slightly improvement of LVEF and strain. A computed tomography (CT) scan showed partial remission of the primary lung lesion, intracavitary and intramyocardial mass.
Chronic total coronary occlusions (CTO) are found in approximately 15-30% of patients who undergo coronary angiography for suspected or known coronary artery disease. Speckle Tracking Echocardiography (STE) is a novel technology to assessing modifications of myocardial deformation with higher accuracy than the simple visual of regional wall motion. Purpose: The study was to evaluate, using STE applied to dobutamine stress echocardiography (DSE), changes in echo parameters before and after successful recanalization of a CTO. Methods: Eleven patients with subacute or chronic coronary syndromes and angiographic evidence of CTO, scheduled for reopening by percutaneous coronary angioplasty, underwent DSE, using standard protocol, before and 3 months after CTO recanalization. The acquisition of Echo images was performed at baseline and peak stress. Left ventricular ejection fraction (EF), volumes, wall motion score index, parameters of diastolic flow, tissue velocities at mitral annulus, global longitudinal strain (GLS), strain rate (SR), systolic and diastolic longitudinal functional reserve (SLR and DLR respectively) were obtained at baseline and at peak stress before and after percutaneous coronary angioplasty (PCI). Results: The mean follow-up after PCI was 3.09 ± 1 months. Statistical analysis showed significant improvement after PCI in EF, comparing to baseline (P < 0.03) and stress peak (P < 0.001) in systolic SR from the 4 chamber-view (P < 0.02), in DLR (P < 0.01), but there were no significant changes for SLR, GLS and SR. Conclusion: Stress echocardiography associated with new imaging techniques, such as STE provides further improvements of diagnostic accuracy in CTO patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.