• Title/Summary/Keyword: Regional wall motion abnormality (RWMA)

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Accuracy Evaluation of Regional Wall Motion Abnormality in Echocardiography and Cardiac Enzymes in the Diagnosis of Ischemic Heart Disease (허혈성심장질환 진단에서 심장초음파의 국소벽운동이상과 심장효소의 정확성 평가)

  • Kim, Hee-Young;Ji, Tae-Jeong
    • Journal of radiological science and technology
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    • v.45 no.4
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    • pp.321-330
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    • 2022
  • Echocardiography and cardiac enzymes test are the tests to assess ischemic heart disease. The purpose of this study was to verify the accuracy by comparing and analyzing two tests for the diagnosis of ischemic heart disease. A retrospective study was conducted on 393 study subjects who underwent echocardiography and cardiac enzymes test. As a result of the study, regional wall motion abnormality (RWMA) increased as the age of the study subjects increased. As a result of ROC analysis, RWMA showed a larger area under the curve (AUC) than cardiac enzymes. RWMA showed the highest accuracy with 81.1% of all cardiac enzymes. Among cardiac enzymes, cTnI showed the highest accuracy. Thus, It was confirmed that RWMA of echocardiography is more accurate than cardiac enzyme is in diagnosing ischemic heart disease.

Evaluation of Cardiac Function by Transthoracic Echocardiography in Patients with Myocardial Injury Secondary to Organophosphate Poisoning (유기인계 중독에 의한 심근손상 환자에서의 경흉부 심장 초음파검사를 사용한 심장기능평가)

  • Lee, Yoonsuk;Kim, Oh Hyun;Kim, Hyung Il;Cha, Kyoung Chul;Kim, Hyun;Lee, Kang Hyun;Hwang, Sung Oh;Cha, Yong Sung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.2
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    • pp.62-70
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    • 2015
  • Purpose: Cardiac complications may occur in cases of organophosphate (OP) poisoning. However, a few studies regarding patterns of cardiac toxicity as determined by transthoracic echocardiography (TTE) after exposure to OP have been reported. In the current study, the authors examined cardiac functions using TTE in patients with myocardial injury caused by exposure to OP. Methods: A retrospective review was conducted on 16 consecutive cases of OP poisoning with myocardial injury (defined as elevated troponin I within 48 hours of arrival at the regional emergency center in South Korea and diagnosed and treated at the center from January 2012 to November 2014. Results: TTE was performed in 11 (69%) of the 16 patients with an elevated troponin I (TnI) level within 48 hours. Of these 11 patients, 5 patients (45.5%) exhibited reduced ejection fraction (EF), and 3 exhibited regional wall motion abnormality (RWMA). Two patients (18.2%) had both reduced systolic function and RWMA. Two of the 5 patients with reduced EF returned to normal systolic function, however two patients did not regain normal systolic function after admission. One patient expired due to multiple organ failure, and 4 patients were transferred with a moribund status. Twelve of 15 patients who survived to discharge (at 4 to 35 months) were followed. Five of these patients died during follow-up and 7 survived without further complications. Conclusion: OP can cause reversible cardiac dysfunction including reduced systolic function and RWMA. Serum TnI may be useful for initial assessment of cardiac function during the workup of patients suffering from OP poisoning. After the initial assessment of cardiac enzyme, further evaluation with TTE in patients with abnormal cardiac enzyme will be necessary to understand the cardiac toxicity.

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ROC Analysis of Visual Assessments Made in Gated Blood Pool Scans of Patients with Coronary Artery Disease (관상동맥질환에서 심장풀 스캔의 육안적 평가에 대한 ROC 분석)

  • Lee, Kyun-Han;Choi, Yoon-Ho;Lee, Bum-Woo;Moon, Dae-Hyuk;Koong, Sung-Soo;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.2
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    • pp.175-181
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    • 1989
  • Visual assessment of regional wall motion abnormality (RWMA) by gated blood pol scan (GBPS) serves as an useful parameter in the diagnosis, functional evaluation, and follow up in various clinical settings, but are still subject to some inherent limitations. On important problem may be the interobserver as well as intraobsever variation that may well be present due to the subjective nature of the interpretations. This study was carried out to determine the reliability and reproducibility of visual assessments made in GBPSs, and to observe the degree to which the results would be influenced by observer variation. Fifty two patients with coronary heart disease had resting GBPS and contrast ventriculography within 4 days appall. Contrast ventriculography-showed normal wall motion in 6 patients and the remaining 46 had RWMA in one or more segments. The anterior and left anterolateral views of all 52 GBPSs were analyzed by three independent observers, who selected from 5 scales, their level of confidence that there was RWMA in that segment. Reciever operating characteristic (ROC) curves for each analysis was plotted and the area under the curve $(\theta)$ was used as a parameter representing each observer's performance in his interpretations. The findings of contrast ventriculographies were used as the standard for RWMA. The apical and inferoapical segments showed the best correlation with contrast ventriculography ($\theta=0.90-0.94$, 0.81-0.94, respectively), and the inferior wall showed the poorest correlation $(\theta=0.70-0.74)$. The interpretations of the inferior, septal, apical, and posteroinferior, segments showed no difference between the observers, but there was significantly better performance in assessment by observer A compared to that by B or C for the anterolateral segments ($\theta=0.87$, 0.78, 0.76, respectively. p<0.01 for A vs B, p<0.05 for A vs C), as well as when all segments were considered altogether ($\theta=0.88$, 0.83, 0.82, respectively. both p<0.05). This was also true for the infero-apical segment between A and C ($\theta=0.09$, 0.81, p<0.05). The intraobserver variation, however, did not appear significant, with only the inferior segment for observer B showing any significant difference when observer A and B repeated the analysis 10 days latter. There was no difference in assessing dyskinesia, with all observers showing a high performance ($\theta=0.98$, 0.87, 0.97, respectively). The visual assessment of left ventricular ejection fraction by all three observers correlated well with the calculated value from a semiautomated method (Spearman's r = 0.91, 0.83, 0.83. p<0.01, p<0.05, p < 0.05). The assessment of LV and RV size also correlated well between the three observers (Kendall's w = 0.80, 0.51, p<0.01 for both left and right ventricles). The above findings suggest that RWMA visually assessed by GBPS correlates well with that done by contrast ventriculography. And although the observer's experience or skill may influence the results in certain segments, visual analysis of GBPS may serve as a reliable and reproducible means for evaluating ventricular function.

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