Right Ventricular Apical Contractility in Acute Pulmonary Embolism: The McConnell Sign Revisited.
Background: The McConnell sign has been regarded as a highly specific echo finding in acute pulmonary embolism (aPE). However, a completely satisfying explanation to account for this observation in aPE remains elusive. We used longitudinal velocity vector imaging (VVI) using a dedicated software pro...
| Publicado en: | Echocardiography Vol. 27; no. 6; pp. 614 - 621 |
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| Autores principales: | , , |
| Formato: | CEU diagnostic images research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jul2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104844329&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104844329 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07422822 GSE jtl: Echocardiography issn: 07422822 maglogo: Y pubinfo: dt: Jul2010 vid: 27 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104844329 59305837 10.1111/j.1540-8175.2009.01103.x NLM20561014 104844329 ppf: 614 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Right Ventricular Apical Contractility in Acute Pulmonary Embolism: The McConnell Sign Revisited. aug: au: López-Candales, Angel Edelman, Kathy Candales, Maria Dolores affil: Cardiovascular Institute at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania sug: subj: Pulmonary Embolism Physiopathology Echocardiography Heart Ventricle, Right Pathology Education, Continuing (Credit) Human Retrospective Design Adult Middle Age Descriptive Statistics P-Value Analysis of Variance Adult: 19-44 years Middle Aged: 45-64 years ab: Background: The McConnell sign has been regarded as a highly specific echo finding in acute pulmonary embolism (aPE). However, a completely satisfying explanation to account for this observation in aPE remains elusive. We used longitudinal velocity vector imaging (VVI) using a dedicated software program (Research Arena, Siemens, California) to assess regional right ventricular global and apical (RVa) mechanics between aPE and chronic pulmonary hypertension (cPH) patients. Methods: Standard echo parameters of RV performance as well as base to apex RV strain and dyssynchrony were quantified using VVI in a total of 30 patients. The population studied was divided into three groups: Group I included 10 healthy volunteers (50 ± 16 years), Group II consisted of 10 patients (47 ± 13 years) with known cPH, and Group III comprised 10 patients (58 ± 18 years; P = 0.323) with documented aPE. Results: Progressively lower indices of RV performance as well as RV basal and apical strain were recorded in Groups II and III, respectively. Most importantly, no difference in RVa segmental strain values was seen between Groups II and III. Conclusions: Based on this pilot data, aPE patients demonstrate a significant reduction in overall RV strain with a similar reduction in RV apical deformation. Therefore, regional RVa function is not truly spared in aPE and the probable visual illusion of preserved contractility might simply reflect tethering of the RVa to a hyperdynamic left ventricle in the presence of an acutely dilated RV. (Echocardiography 2010;27:614-620) pubtype: Academic Journal doctype: CEU diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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