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   2015| January-March  | Volume 25 | Issue 1  
    Online since June 9, 2015

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Strain echocardiography and myocardial mechanics: From basics to clinical applications
Giovanni Di Salvo, Valeria Pergola, Bahaa Fadel, Ziad Al Bulbul, Pio Caso
January-March 2015, 25(1):1-8
The aim of this review is to summarize the recent developments in strain imaging, an evolving technique - from tissue Doppler to 3D echocardiography - for resolving the complex left ventricular mechanics. Following a brief overview of the different used technique to extract myocardial deformation data, the authors summarize the role of the technique in the assessment of cardiac mechanics and its role in the clinical arena.
  6,350 746 7
The role of multimodality cardiac imaging for the assessment of sports eligibility in patients with bicuspid aortic valve
Antonello D'Andrea, Alessandro Della Corte, Roberto Padalino, Giuseppe Limongelli, Raffaella Scarafile, Fiorella Fratta, Enrica Pezzullo, Adelaide Fusco, Francesca Pisacane, Guido Coppola, Pio Caso, Raffaele Calabṛ, Maria Giovanna Russo
January-March 2015, 25(1):9-18
Bicuspid aortic valve (BAV) cannot be considered an innocent finding, but it is not necessarily a life-threatening condition. Athletes with BAV should undergo a thorough staging of the valve anatomy, taking into consideration hemodynamic factors, as well as aortic diameters and looking for other associated significant cardiovascular anomalies by use of a multimodality cardiac imaging approach. Furthermore an accurate follow-up is mandatory with serial cardiological controls in those allowed to continue sports.
  3,697 109 -
Right ventricular dimensions and function: Why do we need a more accurate and quantitative imaging?
Paola Gripari, Manuela Muratori, Laura Fusini, Gloria Tamborini, Sarah Ghulam Ali, Denise Brusoni, Mauro Pepi
January-March 2015, 25(1):19-25
The right ventricle plays an important role in the morbidity and mortality of patients presenting with symptoms and signs of cardiopulmonary disease. This cardiac chamber has a unique crescent shape, which adds complexity to the quantification of its size and function. Until recently, little uniformity in echocardiographic imaging of the right heart existed because of a lack of familiarity with various techniques, and the enormous attention directed towards left heart quantification. Three-dimensional (3D) echocardiography, a major technological breakthrough in the field of cardiovascular imaging, provides several advantages over two-dimensional (2D) imaging in the quantitative evaluations of right ventricle because of its independence from any geometrical assumption. In this review, we focus on the contribution of this new modality to the evaluation of right ventricle.
  2,872 237 1
Is left ventricular noncompaction only a morphological feature? A case of disappearance of noncompaction after surgical correction of aorto-right ventricular fistula, interventricular septal defect and aortic stenosis
Andrea Ciolli, Giovanni de Matteis, Paolo Trambaiolo, Antonello Castro, Angela Stingone, Giuliano Altamura
January-March 2015, 25(1):26-28
A 55-year-old man complaining of worsening dyspnea on exertion was diagnosed with restrictive interventricular septal defect, left ventricular noncompaction (LVNC), mild aortic valve stenosis and aorto-right ventricular fistula. He underwent surgical aortic valve replacement with a mechanical bileaflet valve (St. Jude n. 23) and contextual direct suture of interventricular septal defect and closure of aorto-right ventricular fistula. At 2 years of follow-up, the patient was in good general condition. A complete echocardiographic examination showed normalization of left ventricular dimensions and ejection fraction. Furthermore, left ventricular trabeculations became less evident and no longer met the diagnostic criteria for noncompaction. In our case, the expected left ventricular reverse remodeling after cardiac surgery was associated with a significant reduction in LVNC features. In conclusion, physicians should be careful in avoiding overdiagnosis of LVNC, whose features may indeed reflect only the hypertrabeculated morphology of a normal or pathological heart.
  2,077 79 2
Multimodality imaging of a silent cardiac hemangioma
Alberto Cresti, Mario Chiavarelli, Marie Aimèe Gloria Munezero Butorano, Luca Franci
January-March 2015, 25(1):31-33
A 74-year-old man underwent echocardiographic exam for hypertension screening. A fixed plurilobulated mass originating from the right ventricular lateral wall and occupying half of the cavity was incidentally diagnosed. On cardiac magnetic resonance (CMR) it appeared homogeneous, intermediate-to-high signal on T1-weighted, and diffusely hyperintense on T2-weighted images. First pass enhancement was late and heterogeneous and no late gadolinium enhancement was present. Computed tomography (CT) showed no extracardiac infiltration, the feeding artery was a branch of therightcoronary artery. The tumor was excised and histological examination demonstrated a hemangioma of the cavernous type. The postoperative course was uneventful. From 1998 to 2014, four cardiac hemangiomas have been diagnosed in our Department, accounting for 8.7% of all primary cardiac tumors and for 9.5% of all benign forms; estimated population prevalence was 0.11/100.000 inhabitants/year. The hemodynamic consequences of unoperated cardiac hemangiomas cannot be predicted and therefore, resection is recommended.
  1,983 71 2
The coronary tree of the anatomical machines of the prince of sansevero: The reality of a legend
Sara Di Michele, Francesca Mirabelli, Giovanni Gregorio, Diana Lama, Giuseppe Paolisso, Domenico Galzerano
January-March 2015, 25(1):34-36
During the 18 th century in Naples, Raimondo di Sangro, Prince of Sansevero, gave definitive form to the family chapel, the so-called "Cappella San Severo". The chapel houses not only extraordinarily beautiful and spectacularly detailed statues but also two human skeletons known as anatomical machines ("Macchine Anatomiche") in the basement. These two skeletons, a man and a pregnant woman, are entirely surrounded by their own circulatory system, just as they were suddenly and mysteriously, fixed. Legend, believed as truth until few years ago, tells that Prince Raimondo had prepared and injected an unknown embalming substance in their blood vessels convicting them to eternal fixity. Most recent investigations, however, demonstrated that while the bones are authentic, the blood vessels are actually an extraordinary artifact, even though the perfect reproduction of the coronary vascular tree, including congenital malformations in detail, raises some doubts about the technique used by the Prince. The dreadful aspect of these two skeletons appears to be in strident contrast with the classic beauty of the statues, which glorifies and celebrates the ideal of morphology. Conversely, the two "Anatomical Machines", protagonists of legends and superstitions since centuries, represent a marvelous example of science and art.
  1,984 55 -
Recurrent supraventricular arrhythmias as the first clinical warning of a right atrium infiltrating pulmonary carcinoma
Cesare de Gregorio, Giampiero Speranza, Pietro Pugliatti, Ines Paola Monte, Giuseppe Anḍ
January-March 2015, 25(1):29-30
We report the case of a 45-year-old Caucasian male with negative cardiovascular history, heavy-smoker, who was referred to our Cardiology Unit for recurrent inexplicable tachycardia. Chaotic atrial tachycardia with intermittent fibrillation was observed at ECG, whereas a smoothed mass (approximately sized 8 × 8 cm) was unexpectedly found at echocardiography likely infiltrating the right atrial wall. Multi-detector computed tomography confirmed the mediastinal mass and the digital post-processing clearly identified its anatomic characteristics and invasivity. This study demonstrates that recurrent and refractory atrial arrhythmias can be early signs of cardiac infiltrating mediastinal masses. The combined approach by echocardiography and computed tomography was confirmed to provide precise anatomical and functional characteristics of the arrhythmogenic disease in this patient.
  1,902 88 -
Intraoperative transesophageal echocardiography influences surgery
Monish S Raut, Arun Maheshwari, Sujay Shad
January-March 2015, 25(1):37-38
  1,302 56 -