Displaying publications 1 - 20 of 190 in total

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  1. Teoh VWY, Kamarulata IL, Loch A
    Heart, 2023 Jul 27;109(16):1215-1262.
    PMID: 37500180 DOI: 10.1136/heartjnl-2023-322843
    Matched MeSH terms: Echocardiography
  2. Tan MP, Bansal SK, Wynn NN, Umerov M, Gillham A, Henderson A, et al.
    J Geriatr Cardiol, 2012 Dec;9(4):328-35.
    PMID: 23341836 DOI: 10.3724/SP.J.1263.2012.06191
    BACKGROUND: Pulmonary arterial systolic pressure (PASP) can be estimated with transthoracic echocardiography. However, the significance of raised PASP on routine echocardiography is uncertain. In this study, we evaluated the mortality and hospitalization rates of subjects with raised PASP in a cohort of patients referred directly by their general practitioners for routine outpatient (open access) echocardiography for further analysis of suspected heart failure.
    RESULTS: A total of 485 subjects were referred for open access echocardiography at our hospital in 2002. A cohort of 209/485 (43%) consecutive subjects with measurable tricuspid regurgitation were followed for a minimum of five years investigating hospitalization rates and survival. Some 62 of 209 (30%) subjects had pulmonary hypertension (PH). Subjects with PH were significantly more likely to have four or more hospital admissions (22% vs. 8%; P < 0.01) and > 30 days of cumulative hospital stay over five years (29% vs. 13%; P < 0.01). PH was significantly associated with mortality (P = 0.003), while moderate to severe PH was an independent predictor of mortality (hazard ratio: 4.31; 95% confidence interval (95% CI): 1.51-12.30). Records from the Office of National Statistics revealed that subjects with PH were more likely to have chronic lung diseases recorded as immediate or contributory causes of death (50% vs. 14%; P < 0.05).
    CONCLUSIONS: PASP ≥ 36 mmHg on routine echocardiography is associated with recurrent hospital admissions, prolonged hospitalizations and increased cause of mortality. Therefore, the diagnosis of PH on echocardiography deserves further clinical evaluation, with future studies designed at defining a suitable diagnostic strategy.
    KEYWORDS: Chronic lung disease; Dyspnoea; Heart failure; Pulmonary hypertension; Transthoracic echocardiography
    Study site: Sunderland Royal Hospital, United Kingdom
    Matched MeSH terms: Echocardiography*
  3. Adi O, Apoo FN, Fong CP, Ahmad AH, Panebianco N
    Am J Emerg Med, 2023 Oct;72:224.e1-224.e4.
    PMID: 37500381 DOI: 10.1016/j.ajem.2023.07.037
    BACKGROUND: Superior vena cava syndrome (SVCS) is a malignancy-related emergency. It is caused by obstruction of blood flow in the superior vena cava (SVC) secondary to intraluminal thrombosis, external compression, or direct invasion of tumor.

    CASE SUMMARY: A 49-year-old male presented to the emergency department (ED) with acute hypoxemic respiratory failure. He was intubated and treated as pneumonia. Post-intubation, he became hypotensive, requiring fluid resuscitation and inotropic support. Resuscitative transesophageal echocardiography (TEE) showed external compression by a lung mass and an intraluminal thrombus causing SVC obstruction. Computed tomography (CT) angiography was performed, and it confirmed the TEE findings. A provisional diagnosis of lung carcinoma was made, and he underwent endovascular therapy for rapid symptomatic relief.

    DISCUSSION: This case report highlights the role of resuscitative TEE in evaluating a hypotensive patient with clinical suspicion of SVCS at the emergency department. TEE performed at the bedside could help to diagnose and demonstrate the pathology causing SVCS in this case. TEE allowed high-quality image acquisition and was able to overcome the limitation of transthoracic echocardiography (TTE). TEE should be considered as an alternative ED imaging modality in the management of SVCS.

    Matched MeSH terms: Echocardiography; Echocardiography, Transesophageal/adverse effects
  4. Le TT, Lim V, Ibrahim R, Teo MT, Bryant J, Ang B, et al.
    Eur Heart J Cardiovasc Imaging, 2021 05 10;22(6):670-679.
    PMID: 32255186 DOI: 10.1093/ehjci/jeaa040
    AIMS: Hypertensive left ventricular hypertrophy (LVH) is associated with increased cardiovascular events. We previously developed the remodelling index (RI) that incorporated left ventricular (LV) volume and wall-thickness in a single measure of advanced hypertrophy in hypertensive patients. This study examined the prognostic potential of the RI in reference to contemporary LVH classifications.

    METHODS AND RESULTS: Cardiovascular magnetic resonance was performed in 400 asymptomatic hypertensive patients. The newly derived RI (EDV3t, where EDV is LV end-diastolic volume and t is the maximal wall thickness across 16 myocardial segments) stratified hypertensive patients: no LVH, LVH with normal RI (LVHNormal-RI), and LVH with low RI (LVHLow-RI). The primary outcome was a composite of all-cause mortality, acute coronary syndromes, strokes, and decompensated heart failure. LVHLow-RI was associated with increased LV mass index, fibrosis burden, impaired myocardial function and elevated biochemical markers of myocardial injury (high-sensitive cardiac troponin I), and wall stress. Over 18.3 ± 7.0 months (601.3 patient-years), 14 adverse events occurred (2.2 events/100 patient-years). Patients with LVHLow-RI had more than a five-fold increase in adverse events compared to those with LVHNormal-RI (11.6 events/100 patient-years vs. 2.0 events/100 patient-years, respectively; log-rank P 

    Matched MeSH terms: Echocardiography
  5. Sachithanandan A, Abdul Muis J, Zurah Z, Mohd R
    Med J Malaysia, 2013 Dec;68(6):475-6.
    PMID: 24632918 MyJurnal
    No abstract available.
    Matched MeSH terms: Echocardiography, Transesophageal*
  6. Singham KT, Anuar M, Ariffin M
    Med J Malaysia, 1978 Jun;32(4):292-3.
    PMID: 732624
    Matched MeSH terms: Echocardiography*
  7. Sachithanandan A, Badmanaban B
    Interact Cardiovasc Thorac Surg, 2011 May;12(5):841-2.
    PMID: 21555445 DOI: 10.1510/icvts.2010.257188A
    Matched MeSH terms: Echocardiography, Transesophageal*; Echocardiography, Three-Dimensional*
  8. Khalid Y
    Med J Malaysia, 1994 Jun;49(2):174-5.
    PMID: 8090099
    Pulsus alternans, the alternating strong and week pulses which occur in patients with severe heart failure, was first described by Traube in 1872. Since then various methods, both invasive1,2 and non-invasive3,4, have been used to study this phenomenon. This study demonstrates the utility of using simultaneous electrocardiography (ECG) and Doppler echocardiography to document pulsus alternans, and to differentiate it from other causes of alternating pulses.
    Matched MeSH terms: Echocardiography, Doppler*
  9. Sidek Nontak MA
    Med J Malaysia, 1981 Mar;36(1):52-7.
    PMID: 7321939
    Matched MeSH terms: Echocardiography/methods*
  10. Yaakob, Z.H., Syed Tamin, S., Nik Zainal, N.H., Chee, K.H., Chong, W.P., Hashim, N.E., et al.
    JUMMEC, 2009;12(2):57-62.
    MyJurnal
    Current selection guideline for CRT uses broad QRS duration (>120 ms) as a marker for ventricular dyssynchrony. However, more recent data supports mechanical marker specifically measured by Tissue Doppler Imaging (TDI) as a better criterion to predict response to CRT. Sixty seven patients with significant left ventricular dysfunction (EF less than 40%) and narrow QRS complex were prospectively enrolled. They underwent Tissue Doppler Imaging (TDI) study to evaluate intraventricular mechanical dyssynchrony. Dyssynchrony index which is defined as standard deviation of time to peak systolic velocity in twelve ventricular segments was measured. A value greater than 32.6 is taken to reflect significant ventricular dyssynchrony. Overall 38 patients (56.7%) demonstrated significant dyssynchrony. There was no significant correlation between QRS duration and the Ts-SD-12 (r = 0.14, p = 0.11). Ventricular mechanical dyssynchrony is common in patients with normal QRS duration. Therefore, QRS duration alone will miss a substantial proportion of suitable patients for CRT and therefore deny them this adjunct therapy. We propose echocardiographic parameters, specifically TDI, to be included in patient selection criteria for CRT.
    Matched MeSH terms: Echocardiography; Echocardiography, Doppler
  11. Soo CS, Ca M, Tay M, Yeoh JK, Sim E, Choo M
    J Am Soc Echocardiogr, 1994 3 1;7(2):159-64.
    PMID: 8185960
    We prospectively studied 37 consecutive patients implanted with the Carbomedics prosthetic heart value in the mitral position (without clinical evidence of prosthetic valve dysfunction) with two-dimensional and Doppler echocardiography. The peak mitral prosthetic gradient ranged from 4.60 to 14.63 (mean 8.97 +/- 2.29) mm Hg; mean mitral prosthetic gradient ranged from 1.67 to 6.18 (mean 3.24 +/- 0.95) mm Hg; pressure half-time derived mitral valve area ranged from 1.67 to 5.30 (mean 2.70 +/- 0.80) cm2. These values compare favorably with that of another bileaflet valve (i.e., the St. Jude Medical valve). There was a wide overlap in peak and mean transmitral gradients, even with the valves of the same size, with a significant but weak inverse relationship between peak mitral gradients and valve size (p = 0.03, r = -0.36). The performance index showed a smaller range of values, again with a significant but weak inverse relationship with valve size (p = 0.001, r = -0.54). The inverse relationship between valve size and peak mitral gradient and performance index should be borne in mind when analyzing Doppler hemodynamic data.
    Matched MeSH terms: Echocardiography; Echocardiography, Doppler*
  12. Jung HJ, Kwon WK, Lee SJ, Mohamed N, Shin BM, Lee J, et al.
    BMC Anesthesiol, 2016 10 04;16(1):83.
    PMID: 27716083
    BACKGROUND: This study reports the efficacy of intraoperative transesophageal echocardiography (TEE) for evaluation of high take-off coronary ostia and proximal coronary arterial flows as an alternative to preoperative coronary angiography.

    CASE PRESENTATION: In a 65-year old male undergoing the bicuspid aortic valve (BAV) repair and the extensive remodeling of dilated sinus and tubular junction, and preoperative coronary angiography were unsuccessfully completed due to an allergic reaction to the contrast medium. Intraoperative TEE by employing various 3-dimensional volume images of coronary ostia and Doppler tracings of the coronary arterial flows enabled a thorough pre-procedural evaluation of the high take-off coronary arteries and post-procedural evaluation by confirming the absence of any compromise in coronary arterial flow.

    CONCLUSION: In the present case, intraoperative application of various TEE imaging modalities enabled comprehensive evaluation of high-taking off coronary artery, as an alternative to preoperative coronary angiography, in a patient undergoing an extensive aortic valve and aortic root repair procedure.

    Matched MeSH terms: Echocardiography, Transesophageal/methods*; Echocardiography, Doppler, Color/methods; Echocardiography, Three-Dimensional/methods
  13. Acharya UR, Sree SV, Muthu Rama Krishnan M, Krishnananda N, Ranjan S, Umesh P, et al.
    Comput Methods Programs Biomed, 2013 Dec;112(3):624-32.
    PMID: 23958645 DOI: 10.1016/j.cmpb.2013.07.012
    Coronary Artery Disease (CAD), caused by the buildup of plaque on the inside of the coronary arteries, has a high mortality rate. To efficiently detect this condition from echocardiography images, with lesser inter-observer variability and visual interpretation errors, computer based data mining techniques may be exploited. We have developed and presented one such technique in this paper for the classification of normal and CAD affected cases. A multitude of grayscale features (fractal dimension, entropies based on the higher order spectra, features based on image texture and local binary patterns, and wavelet based features) were extracted from echocardiography images belonging to a huge database of 400 normal cases and 400 CAD patients. Only the features that had good discriminating capability were selected using t-test. Several combinations of the resultant significant features were used to evaluate many supervised classifiers to find the combination that presents a good accuracy. We observed that the Gaussian Mixture Model (GMM) classifier trained with a feature subset made up of nine significant features presented the highest accuracy, sensitivity, specificity, and positive predictive value of 100%. We have also developed a novel, highly discriminative HeartIndex, which is a single number that is calculated from the combination of the features, in order to objectively classify the images from either of the two classes. Such an index allows for an easier implementation of the technique for automated CAD detection in the computers in hospitals and clinics.
    Matched MeSH terms: Echocardiography*
  14. Sim EK, Mestres CA, Lim MC, Adebo OA, Lee CN
    Med J Malaysia, 1992 Mar;47(1):77-80.
    PMID: 1387456
    Whenever possible Mitral valve repair should be performed instead of Mitral valve replacement. It is important to assess the adequacy of the repair during the operation so that any corrective steps may be taken immediately. We present three cases of Mitral valve repair in which the intraoperative TEE was used to assess the adequacy of the repair. There was good correlation of the immediate post bypass TEE findings and early post operative transthoracic echocardiographic findings. Intraoperative TEE is a useful tool in the early assessment of Mitral Valve Repair.
    Matched MeSH terms: Echocardiography*
  15. Ng WH
    Med J Malaysia, 1981 Dec;36(4):205-8.
    PMID: 7334953
    The ability to visualise valvular vegetations by echocardiography is a significant advantage in the management oj patients with infective endocarditis. In this report the M-Mode and Cross-Sectional echocardiographic appearances oj infective endocarditis affecting the aortic valve are described. The uses and limitations of echocardiography are discussed.
    Matched MeSH terms: Echocardiography/methods*
  16. Singham KT, Anuar M
    Med J Malaysia, 1983 Mar;38(1):68-70.
    PMID: 6633342
    A patient with a left atrial myxoma is reported to illustrate the value of two dimensional real time echocardiography in the diagnosis of intracavitary cardiac tumours.
    Matched MeSH terms: Echocardiography*
  17. Alsharqi M, Huckstep OJ, Lapidaire W, Williamson W, Mohamed A, Tan CMJ, et al.
    Echocardiography, 2021 Aug;38(8):1319-1326.
    PMID: 34185918 DOI: 10.1111/echo.15149
    AIMS: To investigate the left ventricular response to exercise in young adults with hypertension, and identify whether this response can be predicted from changes in left atrial function at rest.

    METHODS: A total of 127 adults aged 18-40 years who completed clinical blood pressure assessment and echocardiography phenotyping at rest and during cardiopulmonary exercise testing, were included. Measurements were compared between participants with suboptimal blood pressure ≥120/80mm Hg (n = 68) and optimal blood pressure <120/80mm Hg (n = 59). Left ventricular systolic function during exercise was obtained from an apical four chamber view, while resting left atrial function was assessed from apical four and two chamber views.

    RESULTS: Participants with suboptimal blood pressure had higher left ventricular mass (p = 0.031) and reduced mitral E velocity (p = 0.02) at rest but no other cardiac differences. During exercise, their rise in left ventricular ejection fraction was reduced (p = 0.001) and they had higher left ventricular end diastolic and systolic volumes (p = 0.001 and p = 0.001, respectively). Resting cardiac size predicted left ventricular volumes during exercise but only left atrial booster pump function predicted the left ventricular ejection fraction response ( β = .29, p = 0.011). This association persisted after adjustment for age, sex, body mass index, and mean arterial pressure.

    CONCLUSION: Young adults with suboptimal blood pressure have a reduced left ventricular systolic response to exercise, which can be predicted by their left atrial booster pump function at rest. Echocardiographic measures of left atrial function may provide an early marker of functionally relevant, subclinical, cardiac remodelling in young adults with hypertension.

    Matched MeSH terms: Echocardiography*
  18. Jiee SF, Joo LK, Eng PN, Simon Sumeh A, Jantim A, Shanmuganathan S, et al.
    J Prim Care Community Health, 2024;15:21501319241233178.
    PMID: 38420774 DOI: 10.1177/21501319241233178
    BACKGROUND: Rheumatic heart disease (RHD) is a potentially life-threatening condition that causes long-standing public health concerns. Echocardiography is a reliable diagnostic and screening technique for many cardiovascular conditions, including RHD. It is commonly used in tertiary care facilities worldwide but less so in the community setting. The primary aim of this study was to introduce and elaborate on the echocardiographic screening for RHD that was implemented by a Malaysian primary care clinic in Penampang district, Sabah. We also set out to present the uptake of the service in its initial years of establishment, as well as the challenges faced.

    METHODS: In the first part of this study, document reviews were conducted to compile relevant information about the conceptualization and implementation of this service. Following that, we also obtained secondary data on the echocardiographic screening service from its first implementation in April 2020 until May 2021 to examine the uptake and the patient profile.

    RESULTS: From April 2020 to May 2021, a total of 189 echocardiographic screening was conducted by primary care doctors using handheld ultrasound. Of the 189 children screened, 19 (10.1%) were found to have cardiac anomalies and were referred for a formal echocardiogram. Upon follow-up, 8 were detected with mild mitral regurgitation and referred to the nearest tertiary hospital for further management.

    CONCLUSION: Based on our review, the echocardiographic screening for RHD among children conducted by the Penampang Health Clinic was deemed successful. Echocardiogram service provided by primary care centers located in suburban and rural areas is highly beneficial for patients with poor access to specialized health care services because they stay far away from tertiary care facilities. Tapping into family medicine physicians located closer to communities to conduct echocardiographic screening and review the results can improve the detection of cardiac anomalies requiring further investigation. With the success of this project, echocardiographic services in the primary healthcare setting can be expanded by garnering the necessary collaborative efforts and consistent support from various stakeholders.

    Matched MeSH terms: Echocardiography/methods
  19. Lee TJ, Roslan A, Teh KC, Ghazi A
    Eur Heart J Case Rep, 2019 Jun 01;3(2).
    PMID: 31449618 DOI: 10.1093/ehjcr/ytz056
    BACKGROUND: Intramyocardial dissecting haematoma is a rare complication of myocardial infarction (MI) associated with high mortality rates. Studies and research of this occurrence are limited largely to isolated case reports or case series.

    CASE SUMMARY: We report a case of late presenting MI, where on initial echocardiogram had what was thought to be an intraventricular clot. However, upon further evaluation, the patient actually had an intramyocardial haematoma, with the supporting echocardiographic features to distinguish it from typical left ventricular (LV) clot. While this prevented the patient from receiving otherwise unnecessary anticoagulation, this diagnosis also put him at a much higher risk of mortality. Despite exhaustive medical and supportive management, death as consequence of pump failure occurred after 2 weeks.

    DISCUSSION: This report highlights the features seen on echocardiography which support the diagnosis of an intramyocardial haematoma rather than an LV clot, notably the various acoustic densities, a well visualized myocardial dissecting tear leading into a neocavity filled with blood, and an independent endocardial layer seen above the haematoma. Based on this report, we wish to highlight the importance of differentiating intramyocardial haematomas from intraventricular clots in patients with recent MI.

    Matched MeSH terms: Echocardiography
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