Cover image for Vol. 32 Issue 11

Early View (Online Version of Record published before inclusion in an issue)

Edited By: Navin C. Nanda

Impact Factor: 1.254

ISI Journal Citation Reports © Ranking: 2014: 88/123 (Cardiac & Cardiovascular Systems)

Online ISSN: 1540-8175


  1. 1 - 93
  1. Original Investigations

  2. Case Reports

    1. Multimodality Imaging Diagnostic Approach of Systemic-to-Pulmonary Vein Fistulae

      Soraya El Ghannudi, Philippe Germain, Mi-Young Jeung, Christine Jahn, Sandrine Hirschi and Catherine Roy

      Article first published online: 24 NOV 2015 | DOI: 10.1111/echo.13116


      A 26-year-old man with a history of bilateral lung transplantation for pulmonary cystic fibrosis 6 months before was admitted in our institution for acute heart failure. Cardiac magnetic resonance imaging (CMR) showed an increased aortic output, as aortic flow assessed by velocity mapping was twofold the pulmonary flow, an occluded superior vena cava (SVC), and enlarged azygos vein. A systemic-to-pulmonary vein fistula (SAPVF) was suspected. The selective angiography showed numerous fistulae between intercostals, thyro-cervical, internal mammary arteries and pulmonary veins. The thoracic CT performed before the CMR, which was initially considered as normal, showed well these arteriovenous fistulae after 3D MIP reconstruction.

  3. Original Investigations

    1. Coronary Flow Reserve Predicts Longitudinal Myocardial Deformation Capacity in Heart-Transplanted Patients

      Tor Skibsted Clemmensen, Brian Bridal Løgstrup, Hans Eiskjær and Steen Hvitfeldt Poulsen

      Article first published online: 24 NOV 2015 | DOI: 10.1111/echo.13123

  4. Case Reports

    1. Extrinsic Esophageal Compression by Cervical Osteophytes in Diffuse Idiopathic Skeletal Hyperostosis: A Contraindication to Transesophageal Echocardiography?

      Kevin Chang, Maya Barghash, Robert Donnino, Robin S. Freedberg, Mari Hagiwara, Genevieve Bennett, Ricardo Benenstein and Muhamed Saric

      Article first published online: 24 NOV 2015 | DOI: 10.1111/echo.13115


      We report a case of diffuse idiopathic skeletal hyperostosis (DISH) in an elderly man in whom extrinsic esophageal compression by cervical osteophytes prevented performance of transesophageal echocardiography (TEE). Compression of the esophagus by vertebral osteophytes is not listed in the current American Society of Echocardiography guidelines as a contraindication to TEE. The incidence of esophageal perforation in patients with DISH and vertebral osteophytes is not well documented. We believe these patients are at increased risk of esophageal perforation during TEE, and thus, TEE may be relatively contraindicated in patients with DISH.

  5. Original Investigations

    1. Patients with Diabetes and Significant Epicardial Coronary Artery Disease Have Increased Systolic Left Ventricular Apical Rotation and Rotation Rate at Rest

      Ravi Rasalingam, Mark R. Holland, Daniel H. Cooper, Eric Novak, Michael W. Rich, James G. Miller and Julio E. Pérez

      Article first published online: 22 NOV 2015 | DOI: 10.1111/echo.13124

  6. Case Reports

    1. The Strange Case of the Infarcted Myxoma

      Amedeo Pergolini, Giordano Zampi, Maria Denitza Tinti, Daniele Pontillo, Barbara Di Paolo, Vitaliano Buffa, Giovanni Pulignano, Paolo Giuseppe Pino, Giovanni Minardi and Francesco Musumeci

      Article first published online: 22 NOV 2015 | DOI: 10.1111/echo.13122


      We describe the case of a patient presenting with an acute coronary syndrome associated with an aneurysmatic apical left ventricular myxoma.

  7. Image Sections

    1. Right Coronary Artery Aneurysm with Fistula to the Coronary Sinus, Persistent Left Superior Vena Cava, Ruptured Anterior Leaflet Chordae Tendineae with Severe Mitral Regurgitation

      Claudia Cajas-Morales, Citlalic Martinez-Beltran, Sergio Criales-Vera, Jose Antonio Arias-Godinez and Nilda Espinola-Zavaleta

      Article first published online: 22 NOV 2015 | DOI: 10.1111/echo.13119


      We are reporting a case of a 52-year-old man with a 2-year history of dyspnea on moderate exertion and orthopnea. In the last year, paroxysmal nocturnal dyspnea developed. Echocardiography showed an aneurysm of the right coronary artery with a fistula to the coronary sinus, persistent left superior vena cava, and ruptured anterior mitral leaflet chordae tendineae with severe mitral regurgitation. The computed tomography confirmed these findings. The patient was scheduled for surgery.

  8. Case Reports

    1. Transcatheter Closure of Atrial Septal Defect with Attenuated Anterior Rim after Transcatheter Aortic Valve Implantation: Can It Be Carried out as a Single Procedure?

      Yung-Tsai Lee, Wei-Hsian Yin, Shen Kou Tsai, Ming C. Hsiung, Jeng Wei and Ho-ping Yu

      Article first published online: 22 NOV 2015 | DOI: 10.1111/echo.13117


      Percutaneous cardiac intervention has become an accepted form of treatment in part because of its less invasive nature. Combined transcatheter aortic valve replacement (TAVR) with atrial septal defect with attenuated anterior rim can be safely performed at the same time. Implanting the TAVR first prior to the occlude device can potentially prevent dislodging of the Amplatzer occlude by the stent of the TAVR.

    2. Double-Chambered Right Ventricle with Ventricular Septal Defect and Subaortic Membrane— Three-Dimensional Echocardiographic Evaluation

      Rajiv Bharat Kharwar, Sudhanshu Kumar Dwivedi and Akhil Sharma

      Article first published online: 18 NOV 2015 | DOI: 10.1111/echo.13104


      Double-chambered right ventricle (DCRV) is a rare congenital anomaly in which the right ventricle is divided into two compartments with varying pressures due to an anomalous muscle bundle. Here, we describe a case of an adolescent male with DCRV with associated ventricular septal defect and subaortic membrane. Two-dimensional and three-dimensional transthoracic echocardiography with color flow clearly outlined all the three cardiac anomalies as well as their relationship with each other. The diagnosis was confirmed by cardiac catheterization. The patient underwent successful surgical resection of the anomalous muscle bundle along with repair of the associated anomalies.

  9. Images Sections

    1. A Patient with Metastatic Small-Cell Lung Cancer and Giant Right Ventricular Mass

      Rahman Shah, Elizabeth John, Tai-Hwang M. Fan, Genina Ruff, M. Rehan Khan and Lee C. Holt

      Article first published online: 17 NOV 2015 | DOI: 10.1111/echo.13105


      A 62-year-old male presented with right-sided weakens. His MRI of the brain showed multiple ring-enhancing lesions consistent with metastatic disease. His chest X-rays showed a large mass in the right upper lobe. Follow-up chest CT showed a large lobulated mass in the upper lobe of the right lung and a large filling defect in the right ventricle. Transthoracic echocardiography showed a large mass in the right ventricle. Biopsy of the right lung mass showed small-cell carcinoma. We concluded metastasis in the right ventricle and brain from the primary small-cell lung cancer.

  10. Original Investigations

    1. Accuracy of Imaging Modalities in Detection of Baffle Leaks in Patients Following Atrial Switch Operation

      Carolyn M. Wilhelm, Tracey L. Sisk, Sharon L. Roble, Joanne L. Chisolm, Ilija Janevski, John P. Cheatham and Clifford L. Cua

      Article first published online: 15 NOV 2015 | DOI: 10.1111/echo.13097

  11. Research from or in Collaboration with the University of Alabama at Birmingham

    1. Incremental Value of Live/Real Time Three-Dimensional over Two-Dimensional Transesophageal Echocardiography in the Assessment of Atrial Septal Pouch

      Mahmoud Elsayed, Ming C. Hsiung, L. David Meggo-Quiroz, Mostafa Elguindy, Begum Uygur, Rohit Tandon, Tolga Guvenc, Nurgul Keser, Mustafa G. Vural, Serkan Bulur, Jugal R. Chahwala, Firoozeh Abtahi and Navin C. Nanda

      Article first published online: 11 NOV 2015 | DOI: 10.1111/echo.13111

  12. Image Sections

    1. Cardiac Amorphous Tumor on the Mitral Valve

      Cetin Gecmen, Mehmet Inanir, Gonca G. Gecmen, Fatih Yilmaz and Nihal Ozdemir

      Article first published online: 6 NOV 2015 | DOI: 10.1111/echo.13109


      A 62-year-old male patient with a history of hypertension, dialysis-dependent chronic renal failure, and coronary artery bypass graft presented to our clinic with dyspnea. Transthoracic echocardiographic assessment revealed moderate aortic stenosis (mean gradient: 32 mmHg), mild left ventricular systolic dysfunction (global left ventricle ejection fraction: 45%), and a mobile, racket-shaped hyperechogenic mass of 2.1 × 1.1 cm in posterior mitral leaflet, which partially moved into the left ventricle during diastole. Transesophageal echocardiography revealed the mobile mass on the posterior leaflet as well as mild mitral regurgitation. During surgery, the mass was excised from the P2 scallop of posterior mitral leaflet. On histologic examination, hematoxylin and eosin–stained section of the 10 × 20 mm mass showed calcified nodules on an amorphous background of fibrin material and foreign body giant cells.

  13. Original Investigations

    1. Is Right Ventricular Remodeling in Pulmonary Hypertension Dependent on Etiology? An Echocardiographic Study

      Sorin Giusca, Elena Popa, Mihaela Silvia Amzulescu, Ioana Ghiorghiu, Ioan Mircea Coman, Bogdan A. Popescu, Marion Delcroix, Jens-Uwe Voigt, Carmen Ginghina and Ruxandra Jurcut

      Article first published online: 6 NOV 2015 | DOI: 10.1111/echo.13112

  14. Images Sections

    1. Parachute-Like Mitral Valve with Symptomatic Stenosis—Imaging with Transthoracic and Transesophageal Three-Dimensional Echocardiography and Treatment Implications

      Karina Wierzbowska-Drabik and Jarosław Damian Kasprzak

      Article first published online: 6 NOV 2015 | DOI: 10.1111/echo.13114


      Parachute and parachute-like mitral valve are rarely encountered in adults congenital abnormalities in which diagnosis usually relies on detailed echocardiographic examination with special focus on three-dimensional imaging. In children, these valves often coexist with other congenital anomalies such as aortic stenosis, atrial septal defect, hypoplastic left heart syndrome or form Shone complex together with supravalvular mitral ring, subaortic stenosis, and aortic coarctation. We described a woman with moderate stenosis and mild regurgitation of mitral valve diagnosed as congenital parachute-like anomaly during transthoracic and transesophageal examination. Precise recognition of morphology disqualified the patient from percutaneous balloon angioplasty.

  15. Original Investigations

    1. Utility of Real Time 3D Echocardiography for the Assessment of Left Ventricular Mass in Patients with Hypertrophic Cardiomyopathy: Comparison with Cardiac Magnetic Resonance

      Gustavo P. Avegliano, Juan P. Costabel, Federico M. Asch, Agustina Sciancalepore, Paola Kuschnir, Marina Huguet, Catalina Tobon-Gomez, Alejandro F. Frangi and Ricardo Ronderos

      Article first published online: 3 NOV 2015 | DOI: 10.1111/echo.13096

    2. Archeological Echocardiography: Digitization and Speckle Tracking Analysis of Archival Echocardiograms in the HyperGEN Study

      Frank G. Aguilar, Senthil Selvaraj, Eva E. Martinez, Daniel H. Katz, Lauren Beussink, Kwang-Youn A. Kim, Jie Ping, Laura Rasmussen-Torvik, Amita Goyal, Jin Sha, Marguerite R. Irvin, Donna K. Arnett and Sanjiv J. Shah

      Article first published online: 3 NOV 2015 | DOI: 10.1111/echo.13095

  16. Review Articles

    1. The Role of Echocardiography in the Evaluation of Pulmonary Arterial Hypertension

      Nicole Pristera, Ray Musarra, Robert Schilz and Brian D Hoit

      Article first published online: 2 NOV 2015 | DOI: 10.1111/echo.13113

  17. Original Investigations

    1. A Novel 13-Segment Standardized Model for Assessment of Right Ventricular Function Using Two-Dimensional iRotate Echocardiography

      Jackie S. McGhie, Myrthe E. Menting, Wim B. Vletter, René Frowijn, Jolien W. Roos-Hesselink, Osama I. I. Soliman, Heleen B. van der Zwaan, Marcel L. Geleijnse and Annemien E. van den Bosch

      Article first published online: 2 NOV 2015 | DOI: 10.1111/echo.13102

  18. Echo Rounds Section Editor: Edmund Kenneth Kerut, M.D.

  19. Original Investigations

    1. Strain Analysis by Tissue Doppler Imaging: Comparison of Conventional Manual Measurement with a Semiautomated Approach

      Johannes Schmid, Reinhard Kaufmann, Martin R. Grübler, Nicolas Verheyen, Frank Weidemann and Josepha S. Binder

      Article first published online: 30 OCT 2015 | DOI: 10.1111/echo.13100

    2. Evaluation of Pulmonary Artery Stiffness in Patients with Obstructive Sleep Apnea Syndrome

      Ibrahim Halil Altıparmak, Muslihittin Emre Erkus, Mustafa Polat, Zafer Hasan Ali Sak, Funda Yalcın, Ozgur Gunebakmaz, Yusuf Sezen, Zekeriya Kaya and Recep Demirbag

      Article first published online: 29 OCT 2015 | DOI: 10.1111/echo.13098

  20. Image Sections

    1. Giant Hydatid Cyst of the Interventricular Septum

      Neeraj Parakh, Priya Jagia, Milind Hote and Sudhir Arava

      Article first published online: 26 OCT 2015 | DOI: 10.1111/echo.13090


      This case illustrates one of the largest reported hydatid cyst of the interventricular septum that almost obliterated both ventricular cavities. Diagnosis of hydatid cyst was confirmed on echocardiography, cardiac MRI, CT chest, and postoperative histopathology.

  21. Original Investigations

    1. Temporal Trends of Cardiac Chambers Function with Trastuzumab in Human Epidermal Growth Factor Receptor II–Positive Breast Cancer Patients

      Sherif Moustafa, Katie Murphy, Bhargava K. Nelluri, Donald Northfelt, Parth Shah, Howard Lee, Susan Wilansky, Tasneem Z. Naqvi, Susan Meyer and Farouk Mookadam

      Article first published online: 24 OCT 2015 | DOI: 10.1111/echo.13087

    2. Correlation of Left Atrial Strain and Doppler Measurements with Invasive Measurement of Left Ventricular End-Diastolic Pressure in Patients Stratified for Different Values of Ejection Fraction

      Matteo Cameli, Stefania Sparla, Maurizio Losito, Francesca M. Righini, Daniele Menci, Matteo Lisi, Flavio D'Ascenzi, Marta Focardi, Roberto Favilli, Carlo Pierli, Massimo Fineschi and Sergio Mondillo

      Article first published online: 23 OCT 2015 | DOI: 10.1111/echo.13094

    3. Predictors of Future Atrial Fibrillation Development in Patients with Hypertrophic Cardiomyopathy: A Prospective Follow-Up Study

      Kamil Tuluce, Selcen Yakar Tuluce, Nihan Kahya Eren, Ugur Kocabas, Filiz Akyildiz Akcay, Ramazan Gunduz, Zehra I. Akyildiz and Oktay Ergene

      Article first published online: 23 OCT 2015 | DOI: 10.1111/echo.13093

  22. Case Reports

    1. Echocardiographic Assessment of Mantle Radiation Mitral Stenosis

      Rachel Bastiaenen, James Sneddon and Rajan Sharma

      Article first published online: 23 OCT 2015 | DOI: 10.1111/echo.13092


      We describe a case of mantle radiation-induced mitral stenosis. This 61-year-old woman presented with breathlessness 42 years after radiotherapy. Two-dimensional and three-dimensional echocardiography demonstrated critical mitral stenosis with characteristic aorto-mitral continuity calcification and absent commissural fusion which precludes balloon valvotomy. The latency period is long and in survivors of Hodgkin's disease the index of suspicion for valvular stenosis increases over time. Aortic valve lesions tend to occur earlier than mitral valve lesions. Given the natural history of mantle radiation valvular disease, a lower threshold for surgical intervention in radiation-induced mitral stenosis may need to be considered if cardiac surgery is planned for other reasons in order to avoid repeated sternotomy in patients with prior irradiation.

  23. Doppler Hemodynamics

    1. Spectral Doppler of the Hepatic Veins in Rate, Rhythm, and Conduction Disorders

      Bahaa M. Fadel, Dania Mohty, Aysha Husain, Khadija Alassas, Najmeddine Echahidi, Ziad Dahdouh and Giovanni Di Salvo

      Article first published online: 23 OCT 2015 | DOI: 10.1111/echo.13091

  24. Review Articles

    1. Intrinsic and Extrinsic Cardiac Pseudotumors: Echocardiographic Evaluation and Review of the Literature

      Ryan J. Maybrook, Muhammad R. Afzal, Sonya Parashar, Brent Deibert, Mary Chivington, Jacquelyn Y. Walker, Buddhadeb Dawn and Deepak Parashara

      Article first published online: 23 OCT 2015 | DOI: 10.1111/echo.13089

  25. Case Reports

    1. Large Esophageal Hematoma Following Transesophageal Echocardiography-Guided Device Closure of Atrial Septal Defect

      Deepa Sasikumar and Krishnamoorthy K. Mahadevan

      Article first published online: 23 OCT 2015 | DOI: 10.1111/echo.13088


      A lady underwent device closure of atrial septal defect (ASD) under transesophageal echocardiography guidance. A massive esophageal hematoma was diagnosed 4 days after the procedure, which was aggravated by the use of dual antiplatelets. She was managed conservatively. With careful monitoring, the antiplatelets were stopped and the hematoma resolved by 10 days. The antiplatelets were restarted gradually. Esophageal perforation following device closure of ASD is particularly challenging as the scenario is worsened by the use of antiplatelets, and they have to be discontinued with the attendant risk of thromboembolism.

  26. Image Sections

    1. An Unusual Localization of a Cardiac Pseudoaneurysm Complicated by Paravalvular Leak in a Patient with Prosthetic Heart Valves

      Mehmet A. Vatankulu, Osman Sönmez, Mehmet Akkaya and Cemalettin Aydin

      Article first published online: 23 OCT 2015 | DOI: 10.1111/echo.13086


      An 58-year-old male was admitted to the hospital with exertional dyspnea. He had a history of mitral and aortic valve replacement with St. Jude prosthetic valve twenty years ago. Transesophageal echocardiography showed paravalvular mitral leak and a false chamber, which was expanding during systole and communicating to the right atrium. Real time three-dimensional transesophageal echocardiography demonstrated the origin and flap of the false lumen that was opening during ventricular systole and closing at ventricular diastole from the left ventricular inside. The patient underwent redo aortic and mitral valve surgery.

  27. Case Reports

    1. Abnormal Connection of the Ductus Venosus to a Dilated Coronary Sinus Imaged by Prenatal Echocardiography: Case Report

      Yuan Qian, Han Bing, Cai Ailu, Sun Wei, Wang Yu and Wang Lei

      Article first published online: 23 OCT 2015 | DOI: 10.1111/echo.13084


      We describe a case of a fetus with an ectopic connection of the ductus venosus to a dilated coronary sinus. Neither a persistent left superior vena cava nor an anomalous pulmonary venous connection was present. The postnatal outcome of this fetus was good.

  28. Image Sections

    1. Intramuscular Lipoma as an Unusual Cause of Right Ventricular Outflow Tract Obstruction

      Hong-wei Zhang, Ming-hua Zhong, Wei Meng, Er-yong Zhang, Jun Gu and Jia Hu

      Article first published online: 23 OCT 2015 | DOI: 10.1111/echo.13082


      We report a case with a primary intracardiac lipoma in the right ventricle protruding to the outflow tract and resultant obstruction. As the sustained symptoms and the potential for malignancy were low, the tumor was surgically removed to obtain a suitable route to the right ventricular outlet.

  29. Case Reports

    1. Left Ventricular Thrombus in the Setting of Normal Left Ventricular Function in Patients with Crohn's Disease

      Ravi Rasalingam, Ibrahim M. Saeed, Pamela K. Woodard and Julio E. Pérez

      Article first published online: 23 OCT 2015 | DOI: 10.1111/echo.13081


      Crohn's disease results in a hypercoagulable state increasing the risk of venous or arterial thromboembolism. Cardiac involvement is not well described. Left ventricular thrombi were identified in two patients with Crohn's disease with normal left ventricular systolic function, highlighting an exception to the common belief that apical thrombi are associated with wall motion abnormalities.

  30. Original Investigations

    1. Echocardiographic Features of Cardiac Angiosarcomas: The Mayo Clinic Experience (1976–2013)

      Daniel F. Kupsky, Darrell B. Newman, Gautam Kumar, Joseph J. Maleszewski, William D. Edwards and Kyle W. Klarich

      Article first published online: 13 OCT 2015 | DOI: 10.1111/echo.13060

    2. Strain Analysis in the Detection of Myocardial Infarction at the Acute and Chronic Stages

      Noa Bachner-Hinenzon, Assaf Malka, Yaron Barac, David Meerkin, Offir Ertracht, Shemy Carasso, Rona Shofti, Marina Leitman, Zvi Vered, Dan Adam and Ofer Binah

      Article first published online: 28 SEP 2015 | DOI: 10.1111/echo.13079

    3. Prognostic Value of Real Time Myocardial Contrast Echocardiography after Percutaneous Coronary Intervention

      Lixia Yang, Chunmei Xia, Yuming Mu, Lina Guan, Chunmei Wang, Qi Tang, Flavia Gomes Verocai, Lea Mirian Barbosa da Fonseca and Ming Chi Shih

      Article first published online: 28 SEP 2015 | DOI: 10.1111/echo.13061

    4. Atrial Function Assessed by Speckle Tracking Echocardiography Is a Good Predictor of Postoperative Atrial Fibrillation in Elderly Patients

      Hugo E. Verdejo, Elia Becerra, Ricardo Zalaquet, Andrea del Campo, Lorena Garcia, Rodrigo Troncoso, Mario Chiong, Arnaldo Marin, Pablo F. Castro, Sergio Lavandero, Luigi Gabrielli and Ramón Corbalán

      Article first published online: 23 SEP 2015 | DOI: 10.1111/echo.13059

  31. Image Sections

    1. Restrictive Physiology of Right Ventricle after Ross Procedure

      Katrien Blanchart, Dimitrios Buklas and Fabien Labombarda

      Article first published online: 20 SEP 2015 | DOI: 10.1111/echo.13078


      A 48-year-old man, lost to medical follow-up, presented a severe restrictive physiology of the right ventricle caused by pulmonary homograft stenosis after a Ross procedure performed 17 years earlier. Right ventricular outflow reconstruction was performed with replacement of the proximal pulmonary artery and implantation of a bioprosthetic valve. Restrictive physiology of the right ventricle is strongly related to deterioration in right ventricular long-axis function and decreased exercise tolerance, even after removal of the obstruction.

    2. Reversible Regional Myocardial Ischemia in a Six-Month-Old Infant Post Arterial Switch Operation Demonstrated by Speckle Tracking Echocardiography

      Gregory J. Skinner and Suhair O. Shebani

      Article first published online: 18 SEP 2015 | DOI: 10.1111/echo.13043


      We present the case of an infant with coronary artery stenosis following an arterial switch operation for transposition of the great arteries. He was demonstrated to have reversible regional myocardial ischemia using speckle tracking echocardiography (STE), which corresponded to the affected territory seen when he underwent cardiac catheterization with revascularization. This demonstrates the utility of STE in infants with regional myocardial dysfunction.

  32. Original Investigations

    1. Cardiac Computed Tomography versus Echocardiography in the Assessment of Stenotic Rheumatic Mitral Valve

      Hale Unal Aksu, Sevket Gorgulu, Mustafa Diker, Omer Celik, Huseyin Aksu, Derya Ozturk, Adem Kırıs, Ali Kemal Kalkan, Mehmet Erturk and İhsan Bakır

      Article first published online: 18 SEP 2015 | DOI: 10.1111/echo.13076

  33. Image Sections

    1. A Bulge in the Mid-Left Cardiac Border: What Is the Diagnosis?

      Anubhav Singhal, Sudeep Kumar, Neetu Soni and Aditya Kapoor

      Article first published online: 18 SEP 2015 | DOI: 10.1111/echo.13077


      Pseudoaneurysm of aorto-mitral intervalvular fibrosa region (AMIVF) is relatively rare and leads to the development of a pulsatile cavity in the mitral–aortic junction communicating with LV outflow tract. We present a young man with a large AMIVF aneurysm in which the x-ray revealed a prominent bulge on mid-left cardiac border. The usual differential diagnosis of such a bulge includes an enlarged LA appendage, ruptured sinus of Valsalva aneurysm, dilated right ventricular subinfundibulum, absent pericardium, pericardial cysts, etc. Our case highlights the fact that physicians may also need to consider the rare possibility of an AMIVF aneurysm in this list.

  34. Original Investigations

    1. Quantitative Assessment of Ventricular Septal Contour for Estimation of Right Ventricular Pressure

      Timotheus Watson, Courtney E. McCracken, Timothy Slesnick, Usama Kanaan, William L. Border and Ritu Sachdeva

      Article first published online: 18 SEP 2015 | DOI: 10.1111/echo.13080

  35. Image Sections

    1. Acute Myocarditis Diagnosed by Layer-Specific 2D Longitudinal Speckle Tracking Analysis

      Thibault Caspar, Philippe Germain, Soraya El Ghannudi, Olivier Morel, Hafida Samet, Annie Trinh, Hélène Petit-Eisenmann, Samy Talha, Marie Fichot, Laurence Jesel and Patrick Ohlmann

      Article first published online: 6 SEP 2015 | DOI: 10.1111/echo.13045


      This is a report of a 34-year-old patient presenting with acute chest pain, whose diagnosis of acute myocarditis was suspected by layer-specific longitudinal speckle tracking analysis, showing preferential alteration of subepicardial deformation in the left ventricular lateral wall, and confirmed by cardiac MRI showing late gadolinium enhancement in the subepicardium of the same LV segments.

  36. Review Articles

  37. Challenging Cases

  38. Original Investigations

    1. Assessment of Left Atrial Mechanics in Patients with Preexcitation Syndrome Scheduled for Catheter Ablation

      Süleyman Karakoyun, Ibrahim Halil Tanboğa, Tayyar Gökdeniz, Zakir Lazoğlu, Selim Topçu, Hüseyin Karal, Enbiya Aksakal and Serdar Sevimli

      Article first published online: 24 AUG 2015 | DOI: 10.1111/echo.13040

  39. Case Reports

    1. Echocardiography and Cardiac Rupture: Is Contrast Extravasation an Indication for Surgery?

      Jonathan S. Katz, Moshe Heching, Darryl M. Hoffman, Tatyana Danilov and Robert F. Tranbaugh

      Article first published online: 24 AUG 2015 | DOI: 10.1111/echo.13033


      Contrast echocardiography demonstrating microbubbles in the pericardial space has often been cited as evidence of ventricular rupture requiring emergent surgical intervention. We report a case where no myocardial perforation was found during post-MI surgery despite prior echocardiographic evidence of contrast extravasation into the pericardial effusion. Clinical decision making requires balancing imaging evidence with clinical circumstances to determine the optimal timing for surgical intervention.

  40. Image Sections

    1. Left Ventricular Side Obstructive Pannus Formation after Rheumatic Mitral Valve Replacement with Preservation of the Subvalvular Apparatus

      Macit Kalçık, Mahmut Yesin, Sabahattin Gündüz, Mustafa Ozan Gürsoy, Emrah Bayam and Mehmet Özkan

      Article first published online: 7 AUG 2015 | DOI: 10.1111/echo.13034

      Mini Abstract

      The preservation of the subvalvular apparatus (SVA) during mitral valve replacement (MVR) surgery due to rheumatic valve disease remains controversial. The presence of intense fibrosis and calcification in rheumatic valves may promote impingement of the pannus tissue on the prosthesis and cause obstruction of the mitral inflow tract. Here we present an obstructive left ventricular side mitral pannus tissue image in a patient who had undergone rheumatic MVR with the preservation of SVA.

  41. Original Investigations

    1. Reproducibility of Echocardiograph-Derived Multilevel Left Ventricular Apical Twist Mechanics

      Glenn M. Stewart, Akira Yamada, Justin J. Kavanagh, Luke J. Haseler, Jonathan Chan and Surendran Sabapathy

      Article first published online: 6 AUG 2015 | DOI: 10.1111/echo.13020

    2. Predictive Value of D-Dimer Levels and Tissue Doppler Mitral Annular Systolic Velocity for Detection of Left Atrial Appendage Thrombus in Patients with Mitral Stenosis in Sinus Rhythm

      Naresh Kurakula, Rajasekhar Durgaprasad, Vanajakshamma Velam, Vidya Sagar Akula, Latheef Kasala and Kalyan Venkateswarlu Muvva

      Article first published online: 2 AUG 2015 | DOI: 10.1111/echo.13026

  42. Image Section

    1. Severe Aortic Regurgitation Caused by Unicuspid Aortic Valve Based on Quadricuspid Aortic Valve

      Kumiko Dokuni, Hidekazu Tanaka, Yasuhide Mochizuki, Kensuke Matsumoto, Yutaka Okita and Ken-ichi Hirata

      Article first published online: 2 AUG 2015 | DOI: 10.1111/echo.13032


      A 41-year-old man was admitted to our hospital because of shortness of breath. Two-dimensional transesophageal echocardiography revealed the presence of a horseshoe-shaped unicuspid aortic valve (UAV) with two raphes at 4 and 8 o'clock positions of the aortic leaflet, and prolapse of the noncoronary cusp. Three-dimensional transesophageal echocardiography (3DTEE) clearly showed UAV, and another raphe was observed at the 7 o'clock position of the aortic leaflet. The Bentall procedure was performed, and surgical inspection confirmed the diagnosis of UAV based on the quadricuspid aortic valve. The excised specimen of the aortic valve was remarkably similar to the findings of 3DTEE.

  43. Original Investigations

    1. Reference Values for Echocardiography in Middle-Aged Population: The Cardiovascular Risk in Young Finns Study

      Saku Ruohonen, Juha W. Koskenvuo, Maria Wendelin-Saarenhovi, Mikko Savontaus, Mika Kähönen, Tomi Laitinen, Terho Lehtimäki, Eero Jokinen, Jorma Viikari, Markus Juonala, Leena Taittonen, Päivi Tossavainen, Merja Kallio, Jeroen J. Bax and Olli Raitakari

      Article first published online: 1 AUG 2015 | DOI: 10.1111/echo.13025

  44. Case Reports

    1. Discordant Electrocardiogram Left Ventricular Wall Thickness and Strain Findings in Influenza Myocarditis

      Nael Hawwa, Zoran B. Popovic and Hussain A. Isma'eel

      Article first published online: 1 AUG 2015 | DOI: 10.1111/echo.13024


      A 42-year-old man presented with a viral prodrome and tested positive for influenza A. He rapidly deteriorated developing cardiogenic shock, rhabdomyolysis and acute kidney injury. Patient improved 1 week later with supportive measures including vasopressors, inotropes and an intraaortic balloon pump. We report this case as it highlights the discordance between echocardiographic ventricular wall thickening as a result of myocardial edema, and electrocardiographic findings at presentation, with a reversal in findings at time of resolution. Additionally there was some suggestion of a regional pattern to the reduced longitudinal strain.

  45. Original Investigations

    1. Association between Left Ventricular Postsystolic Shortening and Diastolic Relaxation in Asymptomatic Patients with Systemic Hypertension

      Shimpei Nogi, Takahide Ito, Shun Kizawa, Shinsaku Shimamoto, Koichi Sohmiya, Masaaki Hoshiga and Nobukazu Ishizaka

      Article first published online: 1 AUG 2015 | DOI: 10.1111/echo.13022

  46. Case Reports

    1. Oral Everolimus for Treatment of a Giant Left Ventricular Rhabdomyoma in a Neonate—Rapid Tumor Regression Documented by Real Time 3D Echocardiography

      Robert Wagner, Frank Thomas Riede, Hiroshi Seki, Frauke Hornemann, Steffen Syrbe, Ingo Daehnert and Michael Weidenbach

      Article first published online: 22 JUL 2015 | DOI: 10.1111/echo.13015


      The authors report on rapid tumor regression of a giant rhabdomyoma with Everolimus treatment documented by three-dimensional echocardiography.

  47. Image Sections

    1. Giant Caseous Calcification on Tricuspid Annulus Mimicking Cardiac Metastasis in a Patient with Colon Cancer

      Mahmut Yesin, Cüneyt Toprak, Macit Kalçık, Emrah Bayam, Mehmet İnanır and Mehmet Özkan

      Article first published online: 22 JUL 2015 | DOI: 10.1111/echo.13018


      Caseous calcification is usually an incidental finding on the atrioventricular valvular annulus. The exact mechanism of pathogenicity for the caseous calcifications has not been defined yet. Differential diagnosis includes vegetation, thrombus, or metastatic tumors. We presented a case of a large tricuspid mass as an incidental finding by transthoracic echocardiography in a patient with metastatic colon cancer. The distinction between caseous calcification and metastatic tumor was made based on the typical location of calcification, possible extension to the whole mitral annulus, well-defined borders, and the internal echolucent area.

  48. Original Investigations

    1. Left Ventricular Myocardial Mechanics in Cirrhosis: A Speckle Tracking Echocardiographic Study

      Efstathios D. Pagourelias, Panagiota Sotiriou, Christodoulos E. Papadopoulos, Evaggelos Cholongitas, Olga Giouleme and Vassilios Vassilikos

      Article first published online: 14 JUL 2015 | DOI: 10.1111/echo.13010

    2. Carotid Ultrasound Maximum Plaque Height–A Sensitive Imaging Biomarker for the Assessment of Significant Coronary Artery Disease

      Amer M. Johri, Pearl Behl, Marie-France Hétu, Mohammad Haqqi, Paul Ewart, Andrew G. Day, Brendan Parfrey and Murray F. Matangi

      Article first published online: 29 JUN 2015 | DOI: 10.1111/echo.13007

    3. Aortic and Mitral Calcification Is Marker of Significant Carotid and Limb Atherosclerosis in Patients with First Acute Coronary Syndrome

      Anna Sannino, Maria-Angela Losi, Giuseppe Giugliano, Grazia Canciello, Evelina Toscano, Alessandra Giamundo, Fernando Scudiero, Linda Brevetti, Laura Scudiero, Maria Prastaro, Cinzia Perrino, Pasquale Perrone-Filardi, Maurizio Galderisi, Bruno Trimarco and Giovanni Esposito

      Article first published online: 29 JUN 2015 | DOI: 10.1111/echo.13006

    4. Diastolic Stunning as a Marker of Severe Coronary Artery Stenosis: Analysis by Speckle Tracking Radial Strain in the Resting Echocardiogram

      Hiroyo Kaseno, Takuji Toyama, Hiroki Okaniwa, Hiroyuki Toide, Eiji Yamashita, Ren Kawaguchi, Hitoshi Adachi, Hiroshi Hoshizaki and Shigeru Oshima

      Article first published online: 29 JUN 2015 | DOI: 10.1111/echo.12999

    5. The Utility of Systolic and Diastolic Echocardiographic Parameters for Predicting Coronary Artery Disease Burden as Defined by the SYNTAX Score

      Shuangbo Liu, Motaz Moussa, Anthony W. Wassef, Brett M. Hiebert, Farrukh Hussain and Davinder S. Jassal

      Article first published online: 26 JUN 2015 | DOI: 10.1111/echo.12995

    6. Importance of End-Diastolic Rather than End-Systolic Right Atrial Size in Chronic Pulmonary Hypertension

      Angel Lopez-Candales, Denada S. Palm, Francisco R. Lopez, Reynerio Perez and Maria D. Candales

      Article first published online: 20 JUN 2015 | DOI: 10.1111/echo.12968

    7. Screening of Congenital Heart Diseases by Three-Dimensional Ultrasound Using Spatiotemporal Image Correlation: Influence of Professional Experience

      Juliana Y. Novaes, Marina M. Zamith, Edward Araujo Júnior, Enoch Q. de Sá Barreto, Fernanda S. B. Barros and Antonio F. Moron

      Article first published online: 20 JUN 2015 | DOI: 10.1111/echo.13002

    8. Right Ventricular Structure and Function in Idiopathic Pulmonary Fibrosis with or without Pulmonary Hypertension

      Antonello D'Andrea, Anna Stanziola, Enza Di Palma, Maria Martino, Michele D'Alto, Santo Dellegrottaglie, Rosangela Cocchia, Lucia Riegler, Meredyth Vanessa Betancourt Cordido, Maurizia Lanza, Marco Maglione, Veronica Diana, Raffaele Calabrò, Maria Giovanna Russo, Mani Vannan and Eduardo Bossone

      Article first published online: 11 JUN 2015 | DOI: 10.1111/echo.12992

    9. Left Atrial Dysfunction Assessed by Two-Dimensional Speckle Tracking Echocardiography in Patients with Impaired Left Ventricular Ejection Fraction and Sleep-Disordered Breathing

      Dawid Miśkowiec, Kupczyńska Karolina, Błażej W. Michalski, Barbara Uznańska-Loch, Małgorzata Kurpesa, Jarosław D. Kasprzak and Piotr Lipiec

      Article first published online: 8 JUN 2015 | DOI: 10.1111/echo.12987

    10. Assessment of Myocardial Function in Children before and after Autologous Peripheral Blood Stem Cell Transplantation

      Hala ElMarsafawy, Mohamed Matter, Mohamed Sarhan, Rasha El-Ashry and Youssef Al-Tonbary

      Article first published online: 8 JUN 2015 | DOI: 10.1111/echo.12988

    11. Utility of Isovolumic Contraction Peak Velocity for Evaluation of Adult Patient Status after Transcatheter Closure of Atrial Septal Defect

      Takuma Sawa, Hidekazu Tanaka, Yoshiki Motoji, Mana Hiraishi, Yasuhide Mochizuki, Keiko Ryo, Kensuke Matsumoto, Hiromasa Otake, Toshiro Shinke and Ken-ichi Hirata

      Article first published online: 6 JUN 2015 | DOI: 10.1111/echo.12982

    12. A New Method for Direct Three-Dimensional Measurement of Left Atrial Appendage Dimensions during Transesophageal Echocardiography

      Chaim Yosefy, Avishag Laish-Farkash, Yulia Azhibekov, Vladimir Khalameizer, Boris Brodkin and Amos Katz

      Article first published online: 6 JUN 2015 | DOI: 10.1111/echo.12983

    13. Comparison between Regional and Local Pulse-Wave Velocity Data

      Iana Simova, Tzvetana Katova, Ciro Santoro and Maurizio Galderisi

      Article first published online: 6 JUN 2015 | DOI: 10.1111/echo.12985

    14. The Value of Quality Improvement Process in the Detection and Correction of Common Errors in Echocardiographic Hemodynamic Parameters in a Busy Echocardiography Laboratory

      Zaher Fanari, Usman I. Choudhry, Vivek K. Reddy, Chete Eze-Nliam, Sumaya Hammami, Paul Kolm, William S. Weintraub and Erik S. Marshall

      Article first published online: 1 JUN 2015 | DOI: 10.1111/echo.12976

    15. Ratio of Acceleration Time to Ejection Time for Assessing Aortic Stenosis Severity

      Sergio Gamaza-Chulián, Santiago Camacho-Freire, Rocío Toro-Cebada, Alberto Giráldez-Valpuesta, Javier Benezet-Mazuecos and José Carlos Vargas-Machuca

      Article first published online: 22 MAY 2015 | DOI: 10.1111/echo.12978

    16. Characteristics of Left Atrial Deformation Parameters and Their Prognostic Impact in Patients with Pathological Left Ventricular Hypertrophy: Analysis by Speckle Tracking Echocardiography

      Chiharuko Iio, Katsuji Inoue, Kazuhisa Nishimura, Akira Fujii, Takayuki Nagai, Jun Suzuki, Takafumi Okura, Jitsuo Higaki and Akiyoshi Ogimoto

      Article first published online: 8 MAY 2015 | DOI: 10.1111/echo.12961

    17. Intervendor Variabilities of Left and Right Ventricular Myocardial Velocities among Three Tissue Doppler Echocardiography Systems

      Kiyoshi Abe, Satoshi Yuda, Yasumi Sato, Kenji Yasui, Ryosuke Nishi, Kyosuke Hanada, Naoko Hashimoto, Mina Kawamukai, Hidemichi Kouzu, Atsuko Muranaka, Akiyoshi Hashimoto, Kazufumi Tsuchihashi, Naoki Watanabe and Tetsuji Miura

      Article first published online: 29 APR 2015 | DOI: 10.1111/echo.12962

    18. Assessment of Left Atrial Function in Patients with Celiac Disease

      Nermin Bayar, Ayhan Hilmi Çekin, Şakir Arslan, Göksel Çağırcı, Zehra Erkal, Serkan Çay, Erkan Köklü and Selçuk Küçükseymen

      Article first published online: 28 APR 2015 | DOI: 10.1111/echo.12963

    19. The Relationship between Epicardial Fat Thickness and Endothelial Dysfunction in Type I Diabetes Mellitus

      Abdullah Nabi Aslan, Telat Keleş, Hüseyin Ayhan, Hacı Ahmet Kasapkara, Murat Akçay, Tahir Durmaz, Cenk Sarı, Serdal Baştuğ, Bekir Çakır and Engin Bozkurt

      Article first published online: 27 APR 2015 | DOI: 10.1111/echo.12960

    20. Exercise-Induced Abnormal Increase of Systolic Pulmonary Artery Pressure in Adult Patients With Sickle Cell Anemia: An Exercise Stress Echocardiography Study

      Newton Nunes de Lima-Filho, Maria Stella Figueiredo, Perla Vicari, Rodolfo Cançado, Antonio Carlos de Camargo Carvalho, José Orlando Bordin and Orlando Campos

      Article first published online: 18 DEC 2014 | DOI: 10.1111/echo.12853


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