Transthoracic echocardiography using second harmonic imaging with Valsalva manoeuvre for the detection of right to left shunts.
AIMS: To assess transthoracic echocardiography (TTE) using second harmonic imaging with Valsalva manoeuvre compared to transesophageal echocardiography (TEE) for the diagnosis of right to left cardiac and pulmonary shunts. METHODS AND RESULTS: One hundred and ten patients referred for TEE underwent...
| Main Authors: | , , , |
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| Format: | Journal article |
| Language: | English |
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2004
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| _version_ | 1826301124765810688 |
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| author | Clarke, N Timperley, J Kelion, A Banning, A |
| author_facet | Clarke, N Timperley, J Kelion, A Banning, A |
| author_sort | Clarke, N |
| collection | OXFORD |
| description | AIMS: To assess transthoracic echocardiography (TTE) using second harmonic imaging with Valsalva manoeuvre compared to transesophageal echocardiography (TEE) for the diagnosis of right to left cardiac and pulmonary shunts. METHODS AND RESULTS: One hundred and ten patients referred for TEE underwent TTE with bubble contrast. Bubbles in the left atrium within three cardiac cycles were considered diagnostic for a patent foramen ovale (PFO) and later as a pulmonary shunt. Greater than 20 bubbles in the left atrium was considered a large shunt and less than 20 a small shunt. TEE was performed immediately afterwards and read blinded to the TTE results. Pick-up rates were similar with 19 TEE positive (13 PFO) and 18 TTE positive (14 PFO) patients. There were five TEE positive/TTE negative cases who had significantly poorer TTE image quality score (2.7 +/- 0.8 vs 1.9 +/- 0.6, p < 0.05). There were six TEE negative/TTE positive cases, two cases requiring Valsalva manoeuvre to become positive. The Valsalva manoeuvre significantly increased the number of bubbles shunting (10 +/- 11 vs 20 +/- 19, p < 0.005). CONCLUSION: TTE with Valsalva manoeuvre is as good as TEE in diagnosing shunts. Valsalva manoeuvre increases the size of shunt. Both techniques produce false negative results. |
| first_indexed | 2024-03-07T05:27:38Z |
| format | Journal article |
| id | oxford-uuid:e11d66bb-8022-4ae0-98cd-9c62816a4fbe |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T05:27:38Z |
| publishDate | 2004 |
| record_format | dspace |
| spelling | oxford-uuid:e11d66bb-8022-4ae0-98cd-9c62816a4fbe2022-03-27T09:52:01ZTransthoracic echocardiography using second harmonic imaging with Valsalva manoeuvre for the detection of right to left shunts.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e11d66bb-8022-4ae0-98cd-9c62816a4fbeEnglishSymplectic Elements at Oxford2004Clarke, NTimperley, JKelion, ABanning, AAIMS: To assess transthoracic echocardiography (TTE) using second harmonic imaging with Valsalva manoeuvre compared to transesophageal echocardiography (TEE) for the diagnosis of right to left cardiac and pulmonary shunts. METHODS AND RESULTS: One hundred and ten patients referred for TEE underwent TTE with bubble contrast. Bubbles in the left atrium within three cardiac cycles were considered diagnostic for a patent foramen ovale (PFO) and later as a pulmonary shunt. Greater than 20 bubbles in the left atrium was considered a large shunt and less than 20 a small shunt. TEE was performed immediately afterwards and read blinded to the TTE results. Pick-up rates were similar with 19 TEE positive (13 PFO) and 18 TTE positive (14 PFO) patients. There were five TEE positive/TTE negative cases who had significantly poorer TTE image quality score (2.7 +/- 0.8 vs 1.9 +/- 0.6, p < 0.05). There were six TEE negative/TTE positive cases, two cases requiring Valsalva manoeuvre to become positive. The Valsalva manoeuvre significantly increased the number of bubbles shunting (10 +/- 11 vs 20 +/- 19, p < 0.005). CONCLUSION: TTE with Valsalva manoeuvre is as good as TEE in diagnosing shunts. Valsalva manoeuvre increases the size of shunt. Both techniques produce false negative results. |
| spellingShingle | Clarke, N Timperley, J Kelion, A Banning, A Transthoracic echocardiography using second harmonic imaging with Valsalva manoeuvre for the detection of right to left shunts. |
| title | Transthoracic echocardiography using second harmonic imaging with Valsalva manoeuvre for the detection of right to left shunts. |
| title_full | Transthoracic echocardiography using second harmonic imaging with Valsalva manoeuvre for the detection of right to left shunts. |
| title_fullStr | Transthoracic echocardiography using second harmonic imaging with Valsalva manoeuvre for the detection of right to left shunts. |
| title_full_unstemmed | Transthoracic echocardiography using second harmonic imaging with Valsalva manoeuvre for the detection of right to left shunts. |
| title_short | Transthoracic echocardiography using second harmonic imaging with Valsalva manoeuvre for the detection of right to left shunts. |
| title_sort | transthoracic echocardiography using second harmonic imaging with valsalva manoeuvre for the detection of right to left shunts |
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