RESUMEN
BACKGROUND: Indexed left ventricular end-diastolic volume (LVEDVi) is a left ventricle (LV) size marker. The "Recommendations for Chamber Quantification" guideline was published in 2006 and updated in 2015. Although the previous guideline maintained uniform cutoff points for both men and women, the latest revision introduced new thresholds that vary between genders. We evaluated the extent of change in labeled indexed LV diastolic volumes in men and women following the adoption of the 2015 guideline. METHODS: Data were extracted from a web-based registry from March 2020 to October 2022. LV indexed volume variables were categorized on the basis of the 2006 and 2015 guidelines. RESULTS: Among the 7598 individuals, the classification of LVEDVi differed in 910 (12.0%) individuals. In 213 (5.5%) female subjects, substantial reclassification (i.e., transitioning from normal to moderate LV enlargement to mild to severe LV enlargement) occurred on the basis of the 2015 guideline. All females classified as having moderately abnormal LVEDVi according to the 2006 guideline were reclassified as having severely abnormal LVEDVi according to the 2015 guideline. Age, LV ejection fraction (LVEF), and significant aortic regurgitation (AR) were common factors contributing to the observed discrepancy in both men and women. Significant mitral regurgitation (MR) and regional or global motion abnormality were correlated with the reclassification of LVEDVi to higher abnormal partitions only in women. CONCLUSION: The observed disparities underscore the importance of ongoing dedicated research to reassess the range of indexed echocardiographic parameters, considering various outcomes and differences in countries.
Asunto(s)
Ecocardiografía , Ventrículos Cardíacos , Guías de Práctica Clínica como Asunto , Volumen Sistólico , Función Ventricular Izquierda , Humanos , Femenino , Masculino , Volumen Sistólico/fisiología , Función Ventricular Izquierda/fisiología , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/fisiopatología , Anciano , Persona de Mediana Edad , Ecocardiografía/métodos , Estudios Retrospectivos , Sistema de Registros , Diástole , Factores SexualesRESUMEN
We report a 47-year-old man who presented with right-sided heart failure. Transthoracic echocardiography revealed a tunnel-shaped communication (ventricular septal defect) between the left ventricle and the right ventricle with a significant left-to-right shunt. The VSD is connected to the lateral wall of the right ventricle by a large tunnel.
RESUMEN
PURPOSE: Although intravenous acetaminophen has been administered to reduce postoperative pain, it has not been used during cardiac implantable electronic devices (CIEDs) implantation. DESIGN: This was a randomized double-blinded interventional study. METHODS: Thirty-two patients who were referred for new CIED implantation during July 2012 until April 2013 randomly received placebo or 1 g of intravenous acetaminophen. All patients were treated with local anesthesia. Pain score during incision, pocket creation, and in the recovery room, and the patients' need for analgesics during the 6 hours after the procedure were recorded in both groups. FINDINGS: Seventeen and 15 patients received acetaminophen and placebo, respectively. Pain scores in patients treated with acetaminophen were significantly lower (4.4 vs 2.9, P = .004), and they received less analgesics (17% vs 60%, P = .014). CONCLUSIONS: Intravenous administration of acetaminophen is effective for pain relief in patients undergoing CIED implantation and decreases the need for postoperative analgesics.