Three-dimensional transesophageal echocardiographic evaluation of aortic plaque after cerebrovascular event
Introduction and objectives: Transesophageal echocardiography (TEE) is crucial in order to assess aortic anatomy after stroke. Although routinely used to assess cardiovascular anatomy and function, three-dimensional echocardiography (3D TEE) is less used for aortic evaluation. We thus sought to asse...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-02-01
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| Series: | Revista Portuguesa de Cardiologia |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0870255122005182 |
| _version_ | 1811168458671390720 |
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| author | Ana Clara Rodrigues Gisele Sampaio Silva Claudia G. Monaco Rodrigo Cordovil P.L. Costa Rafael Bonafim Piveta Claudio Henrique Fischer Edgar B. Lira-Filho Samira S. Morhy Marcelo L. Campos Vieira |
| author_facet | Ana Clara Rodrigues Gisele Sampaio Silva Claudia G. Monaco Rodrigo Cordovil P.L. Costa Rafael Bonafim Piveta Claudio Henrique Fischer Edgar B. Lira-Filho Samira S. Morhy Marcelo L. Campos Vieira |
| author_sort | Ana Clara Rodrigues |
| collection | DOAJ |
| description | Introduction and objectives: Transesophageal echocardiography (TEE) is crucial in order to assess aortic anatomy after stroke. Although routinely used to assess cardiovascular anatomy and function, three-dimensional echocardiography (3D TEE) is less used for aortic evaluation. We thus sought to assess prospectively whether additional information on aortic plaque morphology could be obtained with 3D TEE after an ischemic stroke. Methods: Patients within one week of a stroke (confirmed by brain computed tomography/magnetic resonance) underwent TEE and 3D findings were compared with two-dimensional (2D) (aorta plaque number, dimensions, area and the presence of debris and ulcerations). Patients were followed for two years for death or a new stroke. Results: We assessed 78 patients, 43 (55%) male, aged 62 ± 14 years old, 92% in sinus rhythm. Aortic atheroma was found mainly in the descending aorta (50%); plaque thickness was similar for 2D TEE (0.29 ± 0.03 cm) and 3D TEE (0.29 ± 0.04 cm), whereas plaque area was slightly increased for 3D measurements (0.24 ± 0.02 cm2 versus 0.37 ± 0.03 cm2 respectively, p<0.05), with a strong correlation found both for aortic plaque thickness (r=0.91) and area (r=0.80) measurements. While aortic debris were equally seen with both techniques, 3D TEE defines the presence of ulcerations (six ulcerations unseen with 2D TEE better, p=0.03). There were 11 events (six deaths and five new strokes) during follow-up, unrelated to plaque characteristics. Conclusion: To evaluate aortic plaque morphology, 3D TEE is superior to 2D TEE due to improved detection of ulcerated aortic plaque; this might provide additional information in patients after ischemic stroke. Resumo: Introdução e objetivos: O ecocardiograma transesofágico (ETE) é fundamental para avaliação da anatomia aórtica após acidente vascular cerebral (AVC) isquémico; embora frequentemente utilizado para avaliação da anatomia cardíaca, o ETE tridimensional (ETE3D) é menos usado para estudo da aorta; assim, avaliamos prospetivamente se o ETE3D adicionaria informações ao ETE bidimensional (2D) sobre a morfologia do ateroma aórtico. Métodos: Pacientes com uma semana de AVC (confirmados por tomografia de crânio/ressonância magnética) foram submetidos a ETE para comparação de achados morfológicos da aorta (número de placas, dimensões, presença de debris e ulceração) pelo ETE2D e 3D. Os pacientes foram seguidos por dois anos para eventos (morte e/ou novo AVC). Resultados: Estudamos 78 pacientes, 43 (55%) homens, idade de 62 ± 14 anos. Ateroma aórtico foi encontrado mais frequentemente na aorta descendente (50%); a espessura da placa foi semelhante entre ETE2D e 3DTEE (0,29 ± 0,03 cm versus 0,29 ± 0,04 cm, p=NS), com área maior para medidas 3D (0,24 ± 0,02 cm2 versus 0,37 ± 0,03 cm2 respetivamente, p<0,05) e excelente correlação para espessura (r=0,91) e área (r=0,80). Debris foram vistos igualmente por ambas as técnicas, porém ulcerações foram mais frequentes pelo ETE3D (seis ulcerações não visualizadas pelo ETE2D, p=0,03). No seguimento, houve 11 eventos (seis óbitos e cinco AVC), sem relação com características da placa. Conclusão: O ETE 3D é superior ao 2D para avaliação da morfologia da placa aórtica em pacientes com AVC, em função da melhor visualização de ulcerações, podendo adicionar informações a este grupo. |
| first_indexed | 2024-04-10T16:26:40Z |
| format | Article |
| id | doaj.art-3b9fa458e0e946edbac84d2a3fade4ea |
| institution | Directory Open Access Journal |
| issn | 0870-2551 |
| language | English |
| last_indexed | 2024-04-10T16:26:40Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Revista Portuguesa de Cardiologia |
| spelling | doaj.art-3b9fa458e0e946edbac84d2a3fade4ea2023-02-09T04:13:35ZengElsevierRevista Portuguesa de Cardiologia0870-25512023-02-01422149155Three-dimensional transesophageal echocardiographic evaluation of aortic plaque after cerebrovascular eventAna Clara Rodrigues0Gisele Sampaio Silva1Claudia G. Monaco2Rodrigo Cordovil P.L. Costa3Rafael Bonafim Piveta4Claudio Henrique Fischer5Edgar B. Lira-Filho6Samira S. Morhy7Marcelo L. Campos Vieira8Echocardiography Laboratory – MDP – Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Corresponding author.Neurology Department – Hospital Israelita Albert Einstein, Sao Paulo, BrazilEchocardiography Laboratory – MDP – Hospital Israelita Albert Einstein, Sao Paulo, BrazilEchocardiography Laboratory – MDP – Hospital Israelita Albert Einstein, Sao Paulo, BrazilEchocardiography Laboratory – MDP – Hospital Israelita Albert Einstein, Sao Paulo, BrazilEchocardiography Laboratory – MDP – Hospital Israelita Albert Einstein, Sao Paulo, BrazilEchocardiography Laboratory – MDP – Hospital Israelita Albert Einstein, Sao Paulo, BrazilEchocardiography Laboratory – MDP – Hospital Israelita Albert Einstein, Sao Paulo, BrazilEchocardiography Laboratory – MDP – Hospital Israelita Albert Einstein, Sao Paulo, BrazilIntroduction and objectives: Transesophageal echocardiography (TEE) is crucial in order to assess aortic anatomy after stroke. Although routinely used to assess cardiovascular anatomy and function, three-dimensional echocardiography (3D TEE) is less used for aortic evaluation. We thus sought to assess prospectively whether additional information on aortic plaque morphology could be obtained with 3D TEE after an ischemic stroke. Methods: Patients within one week of a stroke (confirmed by brain computed tomography/magnetic resonance) underwent TEE and 3D findings were compared with two-dimensional (2D) (aorta plaque number, dimensions, area and the presence of debris and ulcerations). Patients were followed for two years for death or a new stroke. Results: We assessed 78 patients, 43 (55%) male, aged 62 ± 14 years old, 92% in sinus rhythm. Aortic atheroma was found mainly in the descending aorta (50%); plaque thickness was similar for 2D TEE (0.29 ± 0.03 cm) and 3D TEE (0.29 ± 0.04 cm), whereas plaque area was slightly increased for 3D measurements (0.24 ± 0.02 cm2 versus 0.37 ± 0.03 cm2 respectively, p<0.05), with a strong correlation found both for aortic plaque thickness (r=0.91) and area (r=0.80) measurements. While aortic debris were equally seen with both techniques, 3D TEE defines the presence of ulcerations (six ulcerations unseen with 2D TEE better, p=0.03). There were 11 events (six deaths and five new strokes) during follow-up, unrelated to plaque characteristics. Conclusion: To evaluate aortic plaque morphology, 3D TEE is superior to 2D TEE due to improved detection of ulcerated aortic plaque; this might provide additional information in patients after ischemic stroke. Resumo: Introdução e objetivos: O ecocardiograma transesofágico (ETE) é fundamental para avaliação da anatomia aórtica após acidente vascular cerebral (AVC) isquémico; embora frequentemente utilizado para avaliação da anatomia cardíaca, o ETE tridimensional (ETE3D) é menos usado para estudo da aorta; assim, avaliamos prospetivamente se o ETE3D adicionaria informações ao ETE bidimensional (2D) sobre a morfologia do ateroma aórtico. Métodos: Pacientes com uma semana de AVC (confirmados por tomografia de crânio/ressonância magnética) foram submetidos a ETE para comparação de achados morfológicos da aorta (número de placas, dimensões, presença de debris e ulceração) pelo ETE2D e 3D. Os pacientes foram seguidos por dois anos para eventos (morte e/ou novo AVC). Resultados: Estudamos 78 pacientes, 43 (55%) homens, idade de 62 ± 14 anos. Ateroma aórtico foi encontrado mais frequentemente na aorta descendente (50%); a espessura da placa foi semelhante entre ETE2D e 3DTEE (0,29 ± 0,03 cm versus 0,29 ± 0,04 cm, p=NS), com área maior para medidas 3D (0,24 ± 0,02 cm2 versus 0,37 ± 0,03 cm2 respetivamente, p<0,05) e excelente correlação para espessura (r=0,91) e área (r=0,80). Debris foram vistos igualmente por ambas as técnicas, porém ulcerações foram mais frequentes pelo ETE3D (seis ulcerações não visualizadas pelo ETE2D, p=0,03). No seguimento, houve 11 eventos (seis óbitos e cinco AVC), sem relação com características da placa. Conclusão: O ETE 3D é superior ao 2D para avaliação da morfologia da placa aórtica em pacientes com AVC, em função da melhor visualização de ulcerações, podendo adicionar informações a este grupo.http://www.sciencedirect.com/science/article/pii/S0870255122005182Ecocardiograma tridimensionalAteroma aórticoAcidente vascular cerebral |
| spellingShingle | Ana Clara Rodrigues Gisele Sampaio Silva Claudia G. Monaco Rodrigo Cordovil P.L. Costa Rafael Bonafim Piveta Claudio Henrique Fischer Edgar B. Lira-Filho Samira S. Morhy Marcelo L. Campos Vieira Three-dimensional transesophageal echocardiographic evaluation of aortic plaque after cerebrovascular event Revista Portuguesa de Cardiologia Ecocardiograma tridimensional Ateroma aórtico Acidente vascular cerebral |
| title | Three-dimensional transesophageal echocardiographic evaluation of aortic plaque after cerebrovascular event |
| title_full | Three-dimensional transesophageal echocardiographic evaluation of aortic plaque after cerebrovascular event |
| title_fullStr | Three-dimensional transesophageal echocardiographic evaluation of aortic plaque after cerebrovascular event |
| title_full_unstemmed | Three-dimensional transesophageal echocardiographic evaluation of aortic plaque after cerebrovascular event |
| title_short | Three-dimensional transesophageal echocardiographic evaluation of aortic plaque after cerebrovascular event |
| title_sort | three dimensional transesophageal echocardiographic evaluation of aortic plaque after cerebrovascular event |
| topic | Ecocardiograma tridimensional Ateroma aórtico Acidente vascular cerebral |
| url | http://www.sciencedirect.com/science/article/pii/S0870255122005182 |
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