Novelties in 3D Transthoracic Echocardiography

Cardiovascular imaging is developing at a rapid pace and the newer modalities, in particular three-dimensional echocardiography, allow better analysis of heart structures. Identifying valve lesions and grading their severity represents crucial information and nowadays is strengthened by the introduction of new software, such as transillumination, which provide detailed morphology descriptions. Chambers quantification has never been so rapid and accurate: machine learning algorithms generate automated volume measurements, including left ventricular systolic and diastolic function, which is extremely important for clinical decisions. This review provides an overview of the latest innovations in the echocardiography field, and is helpful by providing a better insight into heart diseases

Comparison between Automatic and Semiautomatic System for the 3D Echocardiographic Multiparametric Evaluation of RV Function and Dimension

Background: The right ventricle (RV) plays a pivotal role in cardiovascular diseases and 3-dimensional echocardiography (3DE) has gained acceptance for the evaluation of RV volumes and function. Recently, a new artificial intelligence (AI)–based automated 3DE software for RV evaluation has been proposed and validated against cardiac magnetic resonance. The aims of this study were three-fold: (i) feasibility of the AI-based 3DE RV quantification, (ii) comparison with the semi-automatic 3DE method and (iii) assessment of 2-dimensional echocardiography (2DE) and strain measurements obtained automatically. Methods: A total of 203 subject (122 normal and 81 patients) underwent a 2DE and both the semi-automatic and automatic 3DE methods for Doppler standard, RV volumes and ejection fraction (RVEF) measurements. Results: The automatic 3DE method was highly feasible, faster than 2DE and semi-automatic 3DE and data obtained were comparable with traditional measurements. Both in normal subjects and patients, the RVEF was similar to the two 3DE methods and 2DE and strain measurements obtained by the automated system correlated very well with the standard 2DE and strain ones. Conclusions: results showed that rapid analysis and excellent reproducibility of AI-based 3DE RV analysis supported the routine adoption of this automated method in the daily clinical workflow

Unadjusted simple Pearson correlation pattern between plasma and RBC analytes.

*<p>P<0.05,</p>†<p>P<0.01,</p>‡<p>P<0.001.</p

Demographic and clinical characteristics of CAD patients and Ctrl subjects.

<p>Quantitative variables were expressed as mean ± SD and categorical variables as n (%).</p><p>P value: Wilcoxon test for continous variables and Chi Square test for categorical variables.</p><p>P value adjusted for sex and age after log-transformation of the data.</p

Immunostaining of NO synthase (NOS) protein in human red blood cells (RBCs).

<p>NOS was detected in RBCs from CAD patients (A) and from Ctrl (B). RBCs were incubated with a monoclonal anti eNOS antibody (2.5 µg/ml) and with an anti-mouse conjugated secondary antibody (40 µg/ml; Alexa Fluor488). The samples were mounted with fluorescent mounting medium and examined by laser scanning confocal microscope (LSM710, Carl Zeiss) using a 63×/1.3 oil immersion objective lens. Fluorescent images were captured with a digital camera using the image processor Zen (Carl Zeiss). (C) Fluorescence intensity (densitometric sum of grey) was quantified. Data are expressed as the log median of total fluorescence intensity per field ± interquartile range subtracted of the negative control value. Means derive from n = 10 CAD and n = 10 Ctrl.</p

RBC levels of analytes involved in Arginine/NO pathway.

<p>(A) L-arginine (Arg), L-citrulline (Cit), L-ornithine (Orn) were simultaneously determined by LC-MS/MS. (B) Arg bioavailability and the relative activity of arginase and RBC-NOS enzymes are expressed as Arg/(Orn+Cit) and Orn/Cit ratios, respectively. (C) The endogenous inhibitors asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) were determined by LC-MS/MS. (D) Tetrahydrobiopterin (BH₄) and oxidized biopterins (Box) were detected by HPLC after selective oxidation with iodine. Data are presented as age and sex adjusted geometric means and 95% C.I. Comparisons between groups (CAD, n = 22; Ctrl, n = 20) were performed by covariance analysis, adjusting for age and sex.</p

Partial Pearson correlation pattern between plasma and RBC analytes, adjusted for the effects of all other analytes.

*<p>P<0.05,</p>†<p>P<0.01,</p>‡<p>P<0.001.</p