Echo In Patients Research Articles

Hyperechoic Spots in the Renal Medulla as a Potential Indicator of Early Gouty Nephropathy

Introduction: The aim of the study was to explore the causes and clinical significance of hyperechoic renal medulla observed by ultrasonography in patients with primary gout. Methods: This study included 2,107 patients with primary gout treated in the Gout Clinic of our hospital from 2016 to 2022. The clinical data and biochemical data of these patients were collected and analyzed. According to the presence or absence of punctate hyperechogenicity in the renal medulla on ultrasound examination, the patients were divided into the hyperechoic medulla (HM) and the normal hypoechoic medulla (NM) groups, and the HM group was further divided into the partial HM (P-HM) and fulfilled HM (F-HM) subgroups according to the distribution range of hyperechogenicity. Results: Among the 2,107 patients with primary gout, 380 had hyperechoic renal medulla on renal ultrasound, including 106 patients with F-HM and 274 with P-HM. There were significant differences in the gout duration, urate arthropathy number, serum urate (SU) level, clinical tophi number, blood urea nitrogen, serum creatinine (sCr), and estimated glomerular filtration rate between the HM and NM groups or between the F-HM and P-HM subgroups (p < 0.05). Multivariate regression analysis showed that the presence of HM was positively correlated with gout duration, urate arthropathy number, gout attack frequency, SU, and sCr. The number of clinical tophi and sCr were closely related to F-HM. Conclusion: Ultrasound examination showed that a high medulla echo in patients with gout was often related to renal function damage. P-HM may be a transitory condition between NM and F-HM in patients with gout.

The Diagnostic Value of Musculoskeletal Ultrasound in the Quantitative Evaluation of Skeletal Muscle in Chronic Thyrotoxic Myopathy: A Single-Center Study in China.

This study aimed to evaluate the quadriceps femoris in patients with chronic thyrotoxic myopathy (CTM) using musculoskeletal ultrasound and to explore its practical clinical value for the diagnosis of CTM. A total of 241 subjects recruited from the First Affiliated Hospital of Guangxi Medical University were surveyed for detailed medical history and underwent grip strength tests, fixed-distance walking, and quadriceps femoris ultrasound examinations. Differences in muscle parameters between the CTM, non-CTM, and healthy groups were analyzed. An Receiver operating characteristic (ROC) curve was established to analyze the predictive value of various ultrasound measurements for CTM, and Spearman correlation analysis and binary logistic regression were applied to explore the factors associated CTM. The quadriceps femoris contraction index, muscle thickness, muscle cross-sectional area, and pennation angle in the CTM group were significantly lower than those in the non-CTM and healthy groups (p<0.01). The ROC curve prediction showed that the pennation angle had the best sensitivity and specificity for diagnosing myogenesis, with an area under the curve of 89%. Moreover, the pennation angle of the CTM group was positively correlated with step speed (r=0.245, p=0.031) and body surface area (r=0.276, p=0.014), but negatively correlated with age (r=-0.306, p=0.007). Regression analysis showed that the quadriceps femoris contraction index, muscle thickness, pennation angle, and cross-sectional area were factors that related the CTM. After adjusting for potential confounding factors, the association between Muscle Bundle Length and CTM became significant (OR=1.99, 95% CI: 1.22, 3.35, p=0.007). Muscular echo in patients was observed to varying degrees of enhancement. Musculoskeletal ultrasonography in the quantitative analysis of muscle parameters and muscle echo of the quadriceps femoris can provide essential imaging evidence for predicting CTM.

Echocardiographic classification of anatomical diversity of the tricuspid valve: insights from the bright trial

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Trial funded by Abbott Background As the treatment of tricuspid regurgitation with tricuspid transcatheter edge-to-edge repair (TEER) becomes more widespread, a better understanding of tricuspid anatomy is increasingly important to properly select patients for this therapy. The diversity of tricuspid anatomies in the real-world population is not well known, and strategies for characterization of some anatomic features are not well defined. Purpose To propose a method to accurately and consistently characterize the tricuspid valve anatomy with transthoracic and transesophageal echo in patients receiving tricuspid TEER and investigate the diversity of tricuspid valve anatomies reflected in a real-world population. Methods The bRIGHT trial is a prospective, single-arm, multi-center registry initiated to evaluate the safety and effectiveness of the TriClip transcatheter edge-to-edge repair (TEER) System in patients with severe tricuspid regurgitation (TR) in a real-world post-market setting. Detailed echocardiographic analysis was performed on subjects from 25 sites with available baseline echo. Subjects were evaluated for three key anatomical factors that are anticipated to be critical in determining the feasibility of TEER: number of tricuspid valve leaflets, degree of leaflet restriction, and coaptation gap size. Herein, we present a proposed method for characterizing these factors through echo analysis. Results Between August 2020 and July 2022, 312 patients subjects (age, 78.4±7.6 years, 54% women) at 25 sites were enrolled into the bRIGHT trial and 283 subjects had available baseline echo. Coaptation gap size was measured at the largest clippable location (Figure 1) and was found to range from 2.3 mm to 20.8mm (avg. 8.6 ± 3.3 mm). According to the analysis method proposed by Hahn et. Al, the majority of subjects were found to have 3 leaflets (80%), however 4 and 5 leaflet anatomies were also present (20% and 1% respectively). Severity of leaflet restriction was categorized according to a 4-grade scale. In the subjects studied, restriction severity ranged from none to severe, with 21% of subjects having no restriction, 65% displaying mild restriction, 12% displaying moderate restriction, and 2% severe restriction. Conclusions In this analysis of 283 subjects treated as part of the bRIGHT trial, a proposed method to accurately and consistently characterize the tricuspid valve anatomy from baseline echo was developed. The method reaved the broad range of tricuspid valve anatomies realized in this real-world population. ___________________________________

Assessment of Vascular and Valvular Calcification Improves Screening for Coronary Artery Disease Before Liver Transplantation

Coronary artery disease (CAD) is common in patients with cirrhosis who underwent orthotopic liver transplantation (OLT) evaluation and stress echocardiogram (echo) has a low sensitivity in these patients. This study aimed to assess the impact of vascular and valvular calcification on the ability to identify CAD before OLT. We performed a case-control study of 88 patients with and 97 without obstructive CAD who underwent OLT evaluation. All patients had a preoperative stress echo, abdominal computed tomography, and cardiac catheterization. A series of nested logistic regression models of CAD were fit by adding independent variables of vascular (including coronary) calcification, aortic and mitral valve calcification, age, gender, and history of diabetes mellitus requiring insulin to a baseline model of abnormal stress echo. Compared with stress echo alone, identification of the presence or absence of vascular and valvular calcification on routine preoperative computed tomography and echo improved the diagnostic performance for the detection of CAD based on coronary angiogram when combined with stress echo in patients with cirrhosis who underwent OLT evaluation (area under the curve 0.58 vs 0.73, p <0.001), which is even further improved when age, gender, and history of diabetes mellitus requiring insulin are considered (area under the curve 0.58 vs 0.80, p <0.001). Achieving target heart rate (p=0.92) or rate-pressure product >25,000 (p=0.63) did not improve the ability of stress echo to identify CAD. In conclusion, the use of abdominal vascular, coronary artery, and valvular calcification, along with stress echo, improves the ability to identify and rule out obstructive CAD before OLT compared with stress echo alone.

Prospective comparison of volumetric post-contrast T1-Sampling Perfection with Application optimized Contrasts by using different flip angle Evolutions and Magnetization-Prepared Rapid Acquisition with Gradient Echo in patients with metastatic melanoma.

Volumetric turbo spin echo (3D-TSE) T1-weighted imaging techniques such as T1-SPACE (Sampling Perfection with Application optimized Contrasts by using different flip angle Evolutions) improve detection of intracranial metastases (IM) compared to volumetric magnetisation-prepared gradient recalled echo techniques such as MPRAGE (Magnetization-Prepared Rapid Acquisition with Gradient Echo). However, incomplete vascular suppression can produce false positives when using 3D-TSE. Research into 3D-TSE has generally targeted patients with known or suspected IM, but the clinical implications of false positives are greater in patients with lower likelihood of IM. This study examined additional findings identified by T1-SPACE in patients with metastatic melanoma, targeting patients with a lower incidence of IM. Patients with metastatic melanoma and an upcoming brain MRI booking were identified prospectively. Consent for adding post-contrast T1-SPACE to the MRI protocol (which included MPRAGE) was obtained. Imaging was initially assessed without T1-SPACE. Subsequently, T1-SPACE images were examined and additional findings identified were recorded, including their correlation with MPRAGE. One hundred examinations were performed, 24 having evidence of active IM. T1-SPACE allowed identification of additional lesions in five patients, including two with small solitary IM not identified when first assessing MPRAGE. In 18 examinations, T1-SPACE identified additional equivocal findings, confidently attributed to artefact (most commonly normal vessels) following correlation with MPRAGE. T1-SPACE improves detection of small lesions in patients without known IM, changing patient management. False positives are common but can be clarified with MPRAGE. Combining T1-SPACE and MPRAGE allows both sensitivity and specificity to be optimised.

Detection of Subclinical Left Ventricular Dysfunction by Speckle Tracking Echo in Patients with Sepsis

Detection of Subclinical Left Ventricular Dysfunction by Speckle Tracking Echo in Patients with Sepsis

684. Diagnostic Yield of Echocardiography in Coagulase Negative Staphylococcus Bacteremia

BackgroundCoagulase negative Staphylococcus (CoNS) bacteremia is a common clinical finding, but is less commonly associated with infective endocarditis (IE). Echocardiography (Echo) is utilized when clinicians suspect the diagnosis of IE. We sought to evaluate the utilization and yield of Echo in patients who had 1 or ≥ 2 (+) blood cultures (BC) for CoNS, and correlate Echo results with a diagnosis of IE.MethodsA retrospective review in a tertiary care hospital between 2013-2020. Patients with or without cardiac device, who had either 1 or ≥ 2 BC positive for CoNS and who underwent Echo were included. Modified Duke’s (MDC) criteria was used for the diagnosis of IE. Logistic regression was used to examine the association between BC positivity, device existence and the presence of a vegetation on Echo.ResultsWe included 116 patients, median age 58 (41-70) years, 64 (55%) women. Cardiac device was present in 69 (59%): Automated implantable cardioverter defibrillator in 49 (71%), pacemaker in 11(16%), ventricular assist device in four (6%), intra-aortic balloon pump in five (7%). CoNS isolated from 1 BC in 53(46%) patients and from ≥ 2 in 63(54%) patients. Trans- thoracic Echo (TTE) was performed in 42(36%), trans- esophageal Echo (TEE) in 39 patients (33.6%). Sequential Echo (TEE after TTE) was performed in 34 patients (29%). “Definite” IE was diagnosed in none, “possible” IE in 30 (26%), the diagnosis was “rejected” in 86 (74%). Vegetations were noted on device lead in 13(43%) and on valves in 17(57%). Overall yield in patients classified as “possible” IE (n=30) was similar in patients with device (n=26) to those without a device (n=4) (22% vs. 3%; p=0.149). For patients with 1 BC positive for CONS, the presence of a device was not associated with a positive Echo yield (OR, 95% C.I: 1.8 (0.3, 12.9); p=0.474). Patients who had ≥ 2 BC for CoNS had the same Echo yield with or without a cardiac device (15% vs. 24% p=0.243).ConclusionIn our medical center, patients with CoNS bacteremia, no patients had a “definite” diagnosis of IE. Yield of Echo was similar in patients with either one or ≥ 2 positive BC and there was no significant association with the presence of a device.Disclosures All Authors: No reported disclosures

Analysis and Evaluation of Ultrasound Imaging Features and Pathological Results of Ovarian Cancer

To compare and analyze the relationship between the characteristics of ultrasound images of ovarian cancer and the results of postoperative pathological examination. A retrospective analysis of 206 patients with suspected ovarian cancer confirmed by surgical pathology was taken as the research object. The location, size, morphology, partition and wall nodules, cystic solidity, and signal characteristics of the tumor were observed and compared with the results of postoperative pathological examination evaluation and analysis to improve the early clinical diagnosis of ovarian cancer patients. By regression analysis of the histological examination of patients with ovarian tumors of different ages and the proportion of cox postoperative recurrence risk regression models, 154 of 206 ovarian tumor patients were ovarian cancer. There were significant differences in pathological types, lesion locations, maximum diameter lengths, and internal echo in patients with ovarian malignant tumors at different ages (p &lt; 0.05). Ultrasound of ovarian cancer shows that the tumor has large tumor body, strong echo, cyst wall has protrusions, and peripheral and internal blood flow that is mainly high-speed and low-resistance. The sensitivity, specificity, and accuracy of ultrasound for ovarian cancer diagnosis are 84.38%, 66.67%, 81.01%. The accuracy, specificity, and sensitivity of early diagnosis of clinical ovarian cancer patients by ultrasound imaging features provide sufficient imaging evidence to further promote the clinical judgment of benign and malignant tumors, which is beneficial to doctors’ clinical treatment of ovarian cancer patients. The early diagnosis and the higher clinical value were shown.

Echocardiography Reveals Heart Abnormalities in Pediatric Pectus Carinatum

BackgroundSymptoms including chest pain and palpitations are commonly described by pediatric patients with pectus deformity. Cardiac anomalies are thought to be less common in patients with pectus carinatum (PC) than those in patients with pectus excavatum; however, no literature supports this presumption. Echocardiogram (echo) assesses heart structure and function. We hypothesized that a screening echo would 1) determine the relationship between symptoms and echo findings and 2) define the incidence of cardiac defects in patients with PC. Materials and methodsThis is an institutional review board–approved retrospective review of all patients with PC who received an echo from 2015 to 2019 at a tertiary care children's hospital. Echo findings and patient-reported symptoms were collected from electronic health records. Descriptive statistics were used to assess correlation between findings. ResultsWe identified 155 patients with PC who received an echo with complete data available for analysis. Of these, 44 (28.4%) reported chest pain and 13 (8.4%) reported palpitations. Echo results showed that five patients (3.2%) had mitral valve prolapse and 11 (7.1%) had aortic root dilation. Patient-reported symptoms were not significantly associated with abnormal echo findings. ConclusionsChest pain and palpitations frequently occur in the PC population but may not be related to abnormal echo findings. We recommend screening echo in patients with PC regardless of symptoms.

P1706 Trilogy of stroke

Abstract A 53 y/o female patient presented with clinical signs of stroke. Substantial cardiovascular risk factors were present with arterial hypertension, hyperlipidemia, impaired glucose tolerance, and a history of smoking. Transthoracic echocardiography revealed a suspicious structure on the aortic valve. Consequently, transesophageal echocardiography (TEE) was ordered. In TEE, the structure proved to be highly suspicious for fibroelastoma. In addition, significant plaque of the aortic arch, and a persistent foramen ovale (PFO) were diagnosed in this examination. The patient was referred to cardiac surgery for excision of the mass on the aortic valve and for PFO closure. This case stresses the importance of echo in patients presenting with stroke. Apart from left atrial thrombus, several other possible embolic substrates can be diagnosed. Abstract P1706 figure 1

P795 Intraventricular fluid patterns during dobutamine stress echo in patients with significant coronary stenosis

Abstract Background Dobutamine stress echo (DSE) is a useful tool for the evaluation of patients with suspected stable coronary artery disease (CAD). There has been no detailed investigation about the effects of exercise or pharmacological stress on intraventricular fluid dynamics. The possible association between significant CAD and abnormal fluid patterns has not been studied yet. Purpose Aim of the study was to evaluate the intraventricular vortices during dobutamine stress and to find fluid-dynamic patterns associated with the presence of significant CAD. Methods 36 patients scheduled for coronary angiography (CA) and with clinical indication for DSE for suspected CAD were enrolled. Each patient underwent 2D, 3D and contrast echocardiography for Echo-PIV analysis and vortex quantification, both at rest and at peak stress. Vortex geometric and energetic parameters were evaluated using a post- processional software. Intraventricular pressure gradients were evaluated as well. Positive CA for significant CAD was defined as the presence of at least one epicardial coronary stenosis with ≥70% luminal narrowing. Result CA was positive in 58% of patients while DSE in 33%. In the whole population, at peak stress a reduction in vortex area (from 0.36 ± 0.01 to 0.21 ± 0.02; p= 0.001) and in absolute value of vortex intensity (from 0.36 ± 0.1 to 0.26 ± 0.12; p= 0.001) were detected. Vorticity fluctuation and kinetic energy (KE) fluctuation showed a significant increment at peak stress (respectively 0.84 ± 0.17 to 0.93 ± 0.07; p= 0.005; from 1.76 ± 0.37 to 2.47 ± 0.82; p= 0.001), as well as a deviation of flow force momentum angle (φ: from 36 ± 8 to 44 ±9; p= 0.001). Patients with positive CA showed during DSE an higher decrease of the absolute value of vortex intensity (Δ% |vortex intensity| -1.7 ± 0.39 vs -1.3 ± 0.56 vs; p= 0.021), and higher increase of flow force angle (Δ% φ 0.48 ± 0.6 vs 0.1 ± 0.27; p= 0.042). A reversal in the main direction of the vortical flow occurred in 9 patients (25%) at peak stress and 7 of them (64%) were found to have significant right coronary stenosis. This unexpected change in the vortical flow and the presence of right coronary artery stenosis were found significantly associated (X2 p= 0,02). Moreover, patients with circumflex artery stenosis were less likely to have a decrease of vortex length at peak stress (Δ% Vortex length - 0,06 ± 0, 36 vs - 0,34 ± 0,28, p= 0,034). Conclusion Significant changes in intraventricular vortices occur during DSE. The presence of significant CAD evaluated with CA was associated with different behavior of fluid dynamics during DSE. Further studies are needed to assess normal and pathological intraventricular flow patterns evaluated during DSE. Abstract P795 Figure. Vortex reversal at peak stress

Role of cardiovascular echo in patients with Takayasu arteritis.

Takayasu arteritis is an important differential diagnosis in young female patients presenting with fever, fatigue, hypertension, and/or neck pain. Aortic arch branch vessels are frequently affected and the carotid artery can have diffuse, homogeneous wall thickening, known as the 'macaroni sign'. The descending aorta can be stenotic with 'pseudo-coarctation'. Cardiovascular echo plays an important role in the screening and characterization of arterial lesions in patients with Takayasu arteritis.

An automatic method for myocardial T2* curve fitting in thalassemia patients with severe iron overload

Purpose: Myocardial iron overload assessment by multislice multiecho T2* technique is used in the clinical management of thalassemia major (TM) patients. Signal decay curves are extracted from the 16 left ventricular (LV) segments and the fitting of these curves to a mono-exponential model provides the corresponding T2* values. In patients with severe cardiac iron overload, where signal will decay quickly becoming comparable to image noise, manual truncation of signal decay curves excluding later echo times (TEs) is adopted. In this study an automatic truncation method avoiding the variability associated with the manual selection of the truncation point is introduced and validated. Methods: Twenty patients (13 males, age 33±7 years) enrolled in the MIOT Network and diagnosed for severe iron overload (T2*<10 ms) were considered. Using a previously validated software the segmental T2* values were evaluated by the standard methodology (i.e. manual truncation). Images were independently analysed by the developed automated approach. The percentage fitting error (e) was computed as the root mean square error between the signal decay curve and the mono-exponential model normalized to the mean value of the signal. If e was > 5%, the algorithm cut-off the last TE and performed again the fitting. The procedure was iterated until the error become <5% or the number of TEs become equal to three. To assess the inter-operator variability, the dataset was processed by a second operator. Results: The Coefficient of Variability (CoV) for inter-observer variability was 6.82±4.01%. The CoV between automated and manual analysis was 6.15±3.92%, not significantly different from inter-observer variability (P=0.332). No significant difference was detected between mid-septum and global T2* values evaluated with manual and automated procedure (P=0.26 and P=0.91, respectively). The mean fitting error was not significantly different in manual and automated analysis (4.10±2.11 vs. 4.52±2.12, P=0.53). In segmental analysis, no significant differences were found between manual and automatic procedure (P>0.01 for all segments). Conclusions: Truncation of signal decay curve needed to compensate for low signal in later echoes in patients with severe iron overload can be effectively automatized avoiding operator induced variability.

Echoes from childhood—imitation in Gilles de la Tourette Syndrome

Tourette syndrome patients are reported to show automatic imitation (echopraxia), but this has not yet been proven experimentally. Video clips showing either tics of other Tourette patients or spontaneous movements of healthy subjects were presented to Tourette patients and healthy subjects. Participants' responses were assessed using blinded review of video recordings by 2 independent raters and related to stimuli presented. Both raters detected more echoes in patients. In a permutation analysis, no healthy subject had echoes above chance level. In contrast, 6 and 5 patients were classified as echoers according to rater 1 and rater 2, respectively, in 1 analysis, and 9 patients were so classified in a second analysis (according to rater 2 only). Concordance between raters was high. Patients echoed both following stimuli showing tics and following stimuli showing spontaneous movements. Most echoes were part of patients' individual tic repertoire. Echopraxia is a hallmark of Tourette syndrome.

ORAL PRESENTATION

ORAL PRESENTATION

377 Right Ventricular Strain on Bedside Echocardiography: Does It Help in the Diagnosis of a Pulmonary Embolism?

377 Right Ventricular Strain on Bedside Echocardiography: Does It Help in the Diagnosis of a Pulmonary Embolism?

Right ventricular quantification in clinical practice: two-dimensional vs. three-dimensional echocardiography compared with cardiac magnetic resonance imaging

To establish the additional value of three-dimensional echocardiography (3D echo) for assessment of right ventricular (RV) size and function in patients with congenital heart disease (CHD) in everyday clinical practice, the accuracy and reproducibility of 3D echo were compared with conventional two-dimensional echocardiography (2D echo) and cardiac magnetic resonance (CMR) imaging as reference. Patients with CHD and primarily affected right ventricles (n = 62), patients with CHD and primarily affected left ventricles (LV group, n = 27), and healthy controls (n = 31) were studied. 2D echo-, 3D echo- and CMR data sets were obtained. Moderate correlations were found between RV dimensions by 2D echo and CMR-derived RV end-diastolic volumes (r = 0.32-0.77). The correlations between RV volumes obtained by 3D echo and CMR imaging were better (r = 0.71-0.97) than the 2D echo-derived correlations (P < 0.001). Only the 2D echo-derived RV inlet diameter correlated better in healthy controls than in the RV group. Receiver operating characteristic curve analysis revealed that 3D echo-derived end-diastolic volume best identified RV dysfunction (sensitivity 95% and specificity 100%). The 3D echo-derived measurements were as reproducible as the 2D echo-derived measurements (n = 37, coefficients of variation ranging from 5 to 19%), with tricuspid annular plane systolic excursion being the most reproducible measurement (coefficient of variation of 6%). 3D echo improved quantitative RV size and function assessment compared with 2D echo in patients as well as in healthy controls. Everyday clinical use of 3D echo for RV assessment can be reality with the currently available software and provides incremental benefit in assessment of the right ventricle.

Trans-oesophageal echo in patients with vertebral osteophytes: not a harmless procedure

Trans-oesophageal echo in patients with vertebral osteophytes: not a harmless procedure

Prognostic Value of Exercise Stress Test and Dobutamine Stress Echo in Patients with Known Coronary Artery Disease

The aim of this study was to compare the feasibility of dobutamine stress echocardiography (DSE) and exercise stress test (EST) between patients in different age groups and to evaluate their proportional prognostic value in a population with established coronary artery disease (CAD). The study sample included 323 subjects, subdivided in group 1 (G1), comprising 246 patients aged <75 years, and group 2 (G2), with 77 subjects aged >or=75 years. DSE and EST were performed before enrollment in a cardiac rehabilitation program; for prognostic assessment, end points were all-cause mortality and hard cardiac events (cardiac death or nonfatal myocardial infarction). During DSE, G2 patients showed worse wall motion score index (WMSI), but the test was stopped for complications in a comparable proportion of cases (54 G1 and 19 G2 patients, P = NS). EST was inconclusive in similarly high proportion of patients in both groups (76% in G1 vs. 84% in G2, P = NS); G2 patients reached a significantly lower total workload (6 +/- 1.6 METs in G1 vs. 5 +/- 1.2 METs in G2, P < 0.001). At multivariate analysis, a lower peak exercise capacity (HR 0.566, CI 0.351-0.914, P = 0.020) was associated with higher mortality, while a high-dose WMSI >2 (HR 5.123, CI 1.559-16.833, P = 0.007), viability (HR 3.354, CI 1.162-9.678, P = 0.025), and nonprescription of beta-blockers (HR 0.328, CI 0.114-0.945, P = 0.039) predicted hard cardiac events. In patients with known CAD, EST and DSE maintain a significant prognostic role in terms of peak exercise capacity for EST and of presence of viability and an extensive wall motion abnormalities at peak DSE.

Normalization of Ejection Fraction in Subjects with Systolic Heart Failure: Is It Really Normal? A Myocardial Deformation Study

Introduction: With advancement of medical treatment for systolic heart failure (SHF), normalization of ejection fraction (LVEF) as measured by echocardiography (echo) is not uncommon. Normalization of LVEF can occur despite histologically demonstrable irreversible myocyte damage, thus the safety of reducing or ceasing heart failure medications is unclear. The aim of this project was to examine left ventricular function using novel myocardial deformation echo in patients with SHF whose LVEF had normalized.