Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging

Lang, Roberto M.; Badano, Luigi P.; Mor‐Avi, Victor; Afilalo, Jonathan; Armstrong, Anderson da Costa; Ernande, Laura; Flachskampf, Frank A.; Foster, Elyse; Goldstein, Steven A.; Kuznetsova, Tatiana; Lancellotti, Patrizio; Muraru, Denisa; Picard, Michael H.; Rietzschel, Ernst; Rudski, Lawrence; Spencer, Kirk T.; Tsang, Wendy; Voigt, Jens‐Uwe

doi:10.1016/j.echo.2014.10.003

Cited by 13,134 publications

(12,658 citation statements)

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“…Left ventricular ejection fraction was measured according to the modified biplane Simpson's rule 24. TR severity was quantified by a semiquantitative approach using vena contracta width (mild‐moderate <7 mm and severe ≥7 mm) and hepatic venous flow pattern according to guidelines 3.…”

Section: Methodsmentioning

confidence: 99%

Prognostic Value of Hepatorenal Function By Modified Model for End‐stage Liver Disease (MELD) Score in Patients Undergoing Tricuspid Annuloplasty

Chen

Liu

Seto

et al. 2018

JAHA

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BackgroundThe Model for End‐stage Liver Disease excluding international normalized ratio (MELD‐XI) score and the modified MELD score with albumin replacing international normalized ratio (MELD‐Albumin) score, which reflect both liver and renal function, have been reported as predictors of adverse events in liver and heart disease. Nonetheless, their prognostic value in patients undergoing tricuspid annuloplasty has not been addressed.Methods and ResultsA total of 394 patients who underwent tricuspid annuloplasty were evaluated. Baseline clinical, laboratory, and echocardiographic parameters were recorded. Adverse outcome was defined as the occurrence of heart failure requiring admission or all‐cause mortality. Patients who underwent tricuspid annuloplasty had a high prevalence of preoperative hepatorenal dysfunction that was more common in patients with severe tricuspid regurgitation than those with mild to moderate tricuspid regurgitation. The MELD‐XI and MELD‐Albumin scores were excellent predictors of 1‐year adverse outcome (area under the curve: 0.69 and 0.75, respectively). Kaplan–Meier survival curve demonstrated that a high score on MELD‐XI (≥12.0) and MELD‐Albumin (≥10.7) was associated with an increased risk of adverse events. During a median follow‐up of 40 months, both MELD‐XI and MELD‐Albumin scores were significantly associated with adverse outcome, even after adjusting for potential confounding factors. Significant improvement of hepatorenal function at 1 year postoperation was noted only in patients who had no adverse events, not in those who experienced an adverse outcome.ConclusionsBoth MELD‐XI score and MELD‐Albumin score can provide useful information to predict adverse outcome in patients undergoing tricuspid annuloplasty. The present study supports monitoring of modified MELD score to improve preoperative risk stratification of these patients.

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Section: Methodsmentioning

confidence: 99%

Prognostic Value of Hepatorenal Function By Modified Model for End‐stage Liver Disease (MELD) Score in Patients Undergoing Tricuspid Annuloplasty

Chen

Liu

Seto

et al. 2018

JAHA

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“…In addition, early postoperative echocardiography (<7 days after LVAD implantation) was also analyzed in 101 (79.5%) patients with adequate image quality. Dimensions of the left cardiac chambers were measured in the standard manner 21. LV ejection fraction (LVEF) was obtained by using the Simpson's method from apical 4‐ and 2‐chamber views 21.…”

Section: Methodsmentioning

confidence: 99%

“…Dimensions of the left cardiac chambers were measured in the standard manner 21. LV ejection fraction (LVEF) was obtained by using the Simpson's method from apical 4‐ and 2‐chamber views 21. TR severity was assessed by color Doppler flow mapping of spatial distribution of the regurgitant jet within the right atrium.…”

Section: Methodsmentioning

confidence: 99%

“…First, the RV end‐diastolic and end‐systolic areas were measured by planimetry, tracing the endocardial outline of RV and the plane of TV. RV fractional area change (RVFAC) was then calculated: (RV end‐diastolic area−RV end‐systolic area)/RV end‐diastolic area×100 21. RV contractility was also evaluated by using the peak systolic tissue velocity of the RV lateral wall assessed at the tricuspid annulus.…”

Section: Methodsmentioning

confidence: 99%

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Prevalence, Predictors, and Prognostic Value of Residual Tricuspid Regurgitation in Patients With Left Ventricular Assist Device

Nakanishi

Homma

Han

et al. 2018

JAHA

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BackgroundAlthough implantation of a left ventricular assist device (LVAD) generally improves tricuspid regurgitation (TR) in short‐term follow‐up, the clinical significance of residual TR in patients with mid‐ to long‐term LVAD support is unknown. This study aimed to identify the prevalence, predictors, and prognostic value of residual TR in LVAD patients in association with tricuspid valve (TV) deformation.Methods and ResultsThe study cohort consisted of 127 patients who underwent LVAD implantation without TV procedure and were supported with LVAD at least 1 year. All patients underwent echocardiographic examination preoperatively and 1 year after LVAD implantation. TR was quantitatively assessed by ratio of TR color jet area/right atrial area, and significant residual TR was defined as ≥20% of %TR at follow‐up echocardiographic examination. Detailed echocardiographic measurements were also performed, including TV annulus diameter, TV leaflet displacement, and left ventricular and right ventricular systolic function. LVAD implantation significantly improved ratio of TR color jet area/right atrial area as well as left ventricular and right ventricular systolic function and tethering distance (all P<0.05), whereas it enlarged TV annulus diameter (P=0.002). Significant residual TR was observed in 30 (23.6%) patients. Age, preoperative TV annulus diameter, and residual mitral regurgitation were significantly associated with significant residual TR (all P<0.05), whereas TV tethering was not. During a mean follow‐up of 21±17 months, patients with residual TR had significantly higher mortality than those without residual TR (log‐rank P<0.001).ConclusionsSignificant residual TR was observed in ≈25% patients supported with LVAD over 1 year and was associated with unfavorable outcome.

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“…LV volumes were measured from the apical four‐ and two‐chamber views. Left ventricular end‐systolic volume and end‐diastolic volume were calculated using Simpson's biplane method of discs 9. LVEF was subsequently derived and expressed as a percentage.…”

Section: Methodsmentioning

confidence: 99%

A prospective evaluation of the established criteria for heart failure with preserved ejection fraction using the Alberta HEART cohort

et al. 2017

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AimsHeart failure with a preserved ejection fraction (HF‐PEF) remains a difficult clinical diagnosis. The aim of this study was to test the utility of established criteria to classify patients with HF‐PEF. We prospectively enrolled patients into one of five groups across a spectrum of cardiac disease and applied three different criteria for HF‐PEF and calculated diagnostic metrics.Methods and resultsA total of 565 patients were included in the analysis, including 170 patients with an adjudicated diagnosis of HF‐PEF, 152 patients with heart failure with reduced ejection fraction, 152 patients at risk for heart failure, and 91 age‐matched healthy controls. For the diagnosis of HF‐PEF, the positive likelihood ratios were 6.1, 6.9, and 4.8 for the Zile, European Society of Cardiology (ESC) 2007, and ESC 2016 criteria, respectively. The negative likelihood ratios were 0.58, 0.60, and 0.42 for the Zile, ESC 2007, and ESC 2016 criteria, respectively. All three criteria lacked sensitivity to detect HF‐PEF (46.5%, 44.1%, and 51.8%, respectively) but were highly specific (92.4%, 93.9%, and 89%, respectively). We further evaluated the criteria to distinguish HF‐PEF from other diagnoses after excluding heart failure with reduced ejection fraction; the results were similar.ConclusionsIn this community based cohort, the likelihood ratios of the existing criteria for HF‐PEF were not at the level necessary to be considered diagnostic. Improved criteria for the diagnosis of patients with HF‐PEF are needed.

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Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging

Cited by 13,134 publications

References 215 publications

Prognostic Value of Hepatorenal Function By Modified Model for End‐stage Liver Disease (MELD) Score in Patients Undergoing Tricuspid Annuloplasty

Prognostic Value of Hepatorenal Function By Modified Model for End‐stage Liver Disease (MELD) Score in Patients Undergoing Tricuspid Annuloplasty

Prevalence, Predictors, and Prognostic Value of Residual Tricuspid Regurgitation in Patients With Left Ventricular Assist Device

A prospective evaluation of the established criteria for heart failure with preserved ejection fraction using the Alberta HEART cohort

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