Cardiovascular Ultrasound
A number of factors has an impact on the survival prognosis in aortic stenosis patients. One of these factors is a left ventricular (LV) systolic function. Left ventricular global function index (LVGFI) takes into account the components of LV remodeling: LV volume, LV stroke volume, and LV myocardial volume.
Objective: to evaluate the prognostic value of LVGFI in patients with various aortic stenosis severity using echocardiography.
Material and methods. The study based on the data of previous prospective observational study from 2010–2016, followed by retrospective calculation and analysis of the LVGFI obtained by echocardiography. A total of 377 patients were included to the study, the average age was 79 (75–84) years; 128 (34%) of them were male; 70 patients (19%) had mild aortic stenosis, 116 patients (31%) moderate aortic stenosis, and 191 patients (50%) severe aortic stenosis. LVGFI was calculated as the percentage ratio of LV stroke volume to LV global volume, where LV global volume was defined as the sum of the LV mean cavity volume [(LV end-diastolic volume + LV end-systolic volume)/2] and the myocardium volume. LV myocardial volume was calculated as the ratio of LV myocardial mass to LV density (defined as 1.05 g/mL). The average follow-up period at the moment of analysis was 602.7 ± 48.72 days. All cases of death during the period of follow up were captured.
Results. The significant differences of LVGFI obtained between surviving and deceased patients (15.39% (11.35–20.95%) and 20.12% (15.16–25.98%), respectively, p < 0.001). Values of LVGFI < 18% significantly associated with the risk of death from all causes during two years of follow-up in both mild aortic stenosis and moderate and severe aortic stenosis.
Conclusion. Thus, in patients with aortic stenosis in the group of fatal outcomes the values of the LVGFI were significantly lower than in the group of surviving patients. LVGFI values of less than 18% associated with the risk of death from all causes in any grade of aortic stenosis. LVGFI can be used for mortality risk stratification in patients with aortic stenosis.
This article is a review of the literature devoted to the analysis of promising directions for the use of left atrial strain evaluated using speckle-tracking echocardiography to predict atrial fibrillation (AF). Left atrial strain parameters in various phases of the cardiac cycle are independent predictors of AF both in patients with heart failure and in the general population. The addition of left atrial strain parameters to the traditional echocardiographic parameters will make it possible to effectively select patients with AF both for catheter ablation and to identify patients with a high risk of AF recurrence after catheter ablation.
Obstetrics and Gynecology Ultrasound
The review presents the most common diagnostic models, algorithms and stratification systems developed for the purpose of optimal differential diagnosis of benign and malignant ovarian tumors from 1990 to the present. Four variants of the RMI 1–4 malignancy risk index with their comparative characteristics are described. A proprietary comprehensive ultrasound scoring scale for ovarian tumors is described. Algorithms for the integrated use of echography and tumor markers (CA-125, HE4, ROMA), including the Risk Ovarian Cancer computer system, are presented. All existing IOTA diagnostic models are described: Simple IOTA rules, Simple IOTA rules with quantitative calculation of the risk of malignancy, Logistic regression analysis IOTA LR1 & LR2, Easy IOTA descriptors, IOTA ADNEX. The main algorithms for the integrated use of IOTA models are presented. The principles of using the diagnostic stratification systems GI-RADS and O-RADS are outlined. Clinical examples of the use of diagnostic models are given. The review concludes by presenting the ESGO/ISUOG/IOTA/ESGE consensus on the preoperative diagnosis of ovarian tumors.
Other trends in ultrasound diagnostics
The article presents a pictorial literature review on musculoskeletal ultrasound in gout, which is the most common cause of inflammatory arthropathy in adults. Nowadays, among imaging modalities, ultrasound provides the best capabilities for gout diagnosing and monitoring by revealing of monosodium urate deposits in various joint structures, assessing the presence and severity of synovial inflammation, including for dynamical evaluation on urate-lowering therapy. The main ultrasound features of gout (double contour sign, tophi, aggregates and erosions) are described according to the current clinical guidelines. Knowing of these features provides the correct interpretation of ultrasound findings for timely diagnosis and differential diagnosis of gouty arthropathy, and dynamical assessment on therapy.
The development of new techniques of procedure and line extensions of products for facial contouring injections leads to an increase in the incidence of facial soft tissue complications and adverse reactions. The article presents a clinical case of complications after previous facial contouring injections with hyaluronic acid-based fillers. In high-resolution ultrasound the signs of inflammatory changes in the facial soft tissues were found, which affected the further treatment strategy.
ISSN 2408-9494 (Online)