Aims: Real time full-volume 3D echocardiography (3DE) allows rapid and noninvasive measurement of left (LA) and right atrial (RA) volume without geometric assumptions. Different algorithms from different commercial providers are available. Older software requires manual tracing of endocardial contours. Recently, software with semiautomatic endocardial contour-finding algorithms has become available, which considerably speeds up the procedure. Our aim was to compare, in the same dataset, both LA and RA volumes determined by an algorithm involving manual tracing to the corresponding volumes obtained by an algorithm with semiautomatic contour detection. Methods: Maximal atrial volumes were measured in 88 patients using a multiplane interpolation method algorithm based on manual planimetry of 8 slices. These volumes were compared with volumes determined by the QLAB 8.1 software using semiautomatic border detection. Results: Linear regression showed excellent correlation between volumes determined by manual and by semiautomatic software for both LA and RA (r 2 = 0.90 and 0.89, respectively, P < 0.001). Bland-Altman analysis of manual versus semiautomatic volume determination showed narrow 95% limits of agreement (À15.9 to +12.0 mL for LA volume and À13.9 to +12.2 mL for RA volume) with a minimal bias of À1.9 AE 7.0 mL and À0.8 AE 6.5 mL, respectively, by the semiautomatic method. Conclusion: The semiautomatic border detection method shows excellent correlation for maximal LA and RA volume determination compared to the more time-consuming, multiplane interpolation method, with only slight underestimation. The results indicate that values of LA and RA volumes obtained by either algorithm can be compared, for example, during follow-up examinations. (Echocardiography 2014;31:499-507)
The HeartMate II is a continuous-flow left ventricular assist device that can be explanted from patients after cardiac recovery. We implanted a HeartMate II in a 21-year-old man who had idiopathic cardiomyopathy. A year later, he developed thyrotoxicosis, presumably secondary to amiodarone administered for ventricular fibrillation. Four months after the diagnosis of thyrotoxicosis, thyroid hormone levels had returned to normal, and native cardiac function had improved remarkably. After a support period of 24 months, the HeartMate II was explanted. Six years later, the patient continues to be in New York Heart Association functional Class I. Amiodarone-induced thyrotoxicosis may have contributed to myocardial recovery.
ight ventricular (RV) infarction, which is now recognized to occur in approximately 50% of all inferior myocardial infarctions (MIs), 1 has a significant early mortality in patients with RV dysfunction. 2,3 In this article we report the midterm results of 3 patients who had isolated RV failure after acute inferior MI and in whom a cavobipulmonary shunt was carried out to reestablish an adequate left ventricular (LV) filling and decrease the RV volume overload in the presence of significant tricuspid regurgitation.
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