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Article ; Online: Multimodality cardiac imaging and new display options to broaden our understanding of the tricuspid valve.

Volpato, Valentina / Badano, Luigi P / Figliozzi, Stefano / Florescu, Diana R / Parati, Gianfranco / Muraru, Denisa

2021 Volume 36, Issue 5, Page(s) 513–524

Abstract: Purpose of review: The prognostic impact of tricuspid regurgitation (TR) and the subsequent development of percutaneous procedures targeting the tricuspid valve (TV), has brought to the forefront the role of imaging for the assessment of the forgotten ... ...

Abstract	Purpose of review: The prognostic impact of tricuspid regurgitation (TR) and the subsequent development of percutaneous procedures targeting the tricuspid valve (TV), has brought to the forefront the role of imaging for the assessment of the forgotten valve. As illustrated in several studies and summarized in this review, currently a multimodality imaging approach is required to understand the pathophysiology of TR, due to the complex TV anatomy and the close relationship between the severity of TR and the extent of the remodeling of the right heart chambers. Recent findings: Recently, the advance in the tranhscatheter treatment of the TV has led to a growing interest in the development of dedicated software packages and new display modalities to increase our understanding of the TV. As a consequence, a transversal knowledge of the different imaging modalities is required for contemporary cardiac-imaging physicians. Summary: This review highlights the main features, and the pros and cons of echocardiography, cardiac computed tomography, cardiac magnetic resonance and emerging technologies, as 3D printing and virtual reality, in the assessment of patients with TR.
MeSH term(s)	Cardiac Imaging Techniques ; Echocardiography ; Humans ; Multimodal Imaging ; Tricuspid Valve/diagnostic imaging ; Tricuspid Valve Insufficiency/diagnostic imaging
Language	English
Publishing date	2021-07-27
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	645186-x
ISSN	1531-7080 ; 0268-4705
ISSN (online)	1531-7080
ISSN	0268-4705
DOI	10.1097/HCO.0000000000000890
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Zs.A 2556: Show issues

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Article ; Online: Feasibility and Time Analysis of Three-Dimensional and Myocardial Deformation versus Conventional Two-Dimensional Echocardiography to Assess Cardiac Chambers.

Volpato, Valentina / Ciampi, Pellegrino / Johnson, Rick / Hipke, Katherine / Tomaselli, Michele / Oliverio, Giorgio / Muraru, Denisa / Badano, Luigi P / Lang, Roberto M

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography

2022 Volume 35, Issue 10, Page(s) 1102–1105

MeSH term(s)	Echocardiography/methods ; Echocardiography, Three-Dimensional/methods ; Feasibility Studies ; Heart ; Humans ; Myocardium
Language	English
Publishing date	2022-06-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1035622-8
ISSN	1097-6795 ; 0894-7317
ISSN (online)	1097-6795
ISSN	0894-7317
DOI	10.1016/j.echo.2022.05.017
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Zs.A 2638: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Contemporary Echocardiographic Evaluation of Mitral Regurgitation and Guidance for Percutaneous Mitral Valve Repair.

Marchetti, Davide / Di Lenarda, Francesca / Novembre, Maria Laura / Paolisso, Pasquale / Schillaci, Matteo / Melotti, Eleonora / Doldi, Marco / Terzi, Riccardo / Gallazzi, Michele / Conte, Edoardo / Volpato, Valentina / Bartorelli, Antonio / Andreini, Daniele

Journal of clinical medicine

2023 Volume 12, Issue 22

Abstract: Mitral valve regurgitation (MR) is a multifaceted valvular heart disease. Echocardiography plays a central role in etiology assessment, severity quantification, treatment candidacy, outcome evaluation, and patient follow-up. In this review, we describe ... ...

Abstract	Mitral valve regurgitation (MR) is a multifaceted valvular heart disease. Echocardiography plays a central role in etiology assessment, severity quantification, treatment candidacy, outcome evaluation, and patient follow-up. In this review, we describe the comprehensive echocardiographic assessment of MR, including transthoracic (TTE) and transesophageal (TEE) approaches, 2D and 3D modalities, strain imaging, stress echocardiography, and artificial intelligence (AI) applications. Transcatheter edge-to-edge mitral valve repair (TEER) has been established as a key therapy for patients with severe, symptomatic MR and high surgical risk. TEER is performed under TEE guidance. We outline a practical overview of echocardiographic guidance on TEER.
Language	English
Publishing date	2023-11-15
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12227121
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Article ; Online: Right heart chambers geometry and function in patients with the atrial and the ventricular phenotypes of functional tricuspid regurgitation.

Florescu, Diana R / Muraru, Denisa / Florescu, Cristina / Volpato, Valentina / Caravita, Sergio / Perger, Elisa / Bălșeanu, Tudor A / Parati, Gianfranco / Badano, Luigi P

European heart journal. Cardiovascular Imaging

2021 Volume 23, Issue 7, Page(s) 930–940

Abstract: Aims: Atrial functional tricuspid regurgitation (A-FTR) is a recently defined phenotype of functional tricuspid regurgitation (FTR) associated with persistent/permanent atrial fibrillation. Differently from the classical ventricular form of FTR (V-FTR), ...

Abstract	Aims: Atrial functional tricuspid regurgitation (A-FTR) is a recently defined phenotype of functional tricuspid regurgitation (FTR) associated with persistent/permanent atrial fibrillation. Differently from the classical ventricular form of FTR (V-FTR), patients with A-FTR might present with severely dilated right atrium and tricuspid annulus (TA), and with preserved right ventricular (RV) size and systolic function. However, the geometry and function of the right ventricle, right atrium, and TA in patients with A-FTR and V-FTR remain to be systematically evaluated. Accordingly, we sought to: (i) study the geometry and function of the right ventricle, right atrium, and TA in A-FTR by two- and three-dimensional transthoracic echocardiography; and (ii) compare them with those found in V-FTR. Methods and results: We prospectively analysed 113 (44 men, age 68 ± 18 years) FTR patients (A-FTR = 55 and V-FTR = 58) that were compared to two groups of age- and sex-matched controls to develop the respective Z-scores. Severity of FTR was similar in A-FTR and V-FTR patients. Z-scores of RV size were significantly larger, and those of RV function were significantly lower in V-FTR than in A-FTR (P < 0.001 for all). The right atrium was significantly enlarged in both A-FTR and V-FTR compared to controls (P < 0.001, Z-scores > 2), with similar right atrial (RA) maximum volume (RAVmax) between A-FTR and V-FTR (P = 0.2). Whereas, the RA minimum volumes (RAVmin) were significantly larger in A-FTR than in V-FTR (P = 0.001). Conclusion: Despite similar degrees of FTR and RAVmax size, A-FTR patients show larger RAVmin and smaller TA areas than V-FTR patients. Conversely, V-FTR patients show dilated, more elliptic and dysfunctional right ventricle than A-FTR patients.
MeSH term(s)	Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/physiopathology ; Heart Atria/diagnostic imaging ; Heart Atria/physiopathology ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Humans ; Phenotype ; Tricuspid Valve/diagnostic imaging ; Tricuspid Valve/physiopathology ; Tricuspid Valve Insufficiency/diagnostic imaging ; Tricuspid Valve Insufficiency/physiopathology
Language	English
Publishing date	2021-03-18
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	2638345-7
ISSN	2047-2412 ; 2047-2404
ISSN (online)	2047-2412
ISSN	2047-2404
DOI	10.1093/ehjci/jeab211
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Zs.A 5614: Show issues

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Article ; Online: Automated left atrial volume measurement by two-dimensional speckle-tracking echocardiography: feasibility, accuracy, and reproducibility.

Florescu, Diana R / Badano, Luigi P / Tomaselli, Michele / Torlasco, Camilla / Târtea, Georgică C / Bălșeanu, Tudor A / Volpato, Valentina / Parati, Gianfranco / Muraru, Denisa

European heart journal. Cardiovascular Imaging

2021 Volume 23, Issue 1, Page(s) 85–94

Abstract: Aims: A byproduct of left atrial (LA) strain analysis is the automated measurement of LA maximal volume (LAVmax), which may decrease the time of echocardiography reporting, and increase the reproducibility of the LAVmax measurement. However, the ... ...

Abstract	Aims: A byproduct of left atrial (LA) strain analysis is the automated measurement of LA maximal volume (LAVmax), which may decrease the time of echocardiography reporting, and increase the reproducibility of the LAVmax measurement. However, the automated measurement of LAVmax by two-dimensional speckle-tracking analysis (2DSTE) has never been validated. Accordingly, we sought to (i) assess the feasibility of automated LAVmax measurement by 2DSTE; (ii) compare the automated LAVmax by 2DSTE with conventional two-dimensional (2DE) biplane and three-dimensional echocardiography (3DE) measurements; and (iii) evaluate the accuracy and reproducibility of the three echocardiography techniques. Methods and results: LAVmax (34-197 mL) were obtained from 198/210 (feasibility 94%) consecutive patients (median age 67 years, 126 men) by 2DSTE, 2DE, and 3DE. 2DE and 2DSTE measurements resulted in similar LAVmax values [bias = 1.5 mL, limits of agreement (LOA) ± 7.5 mL], and slightly underestimated 3DE LAVmax (biases = -5 mL, LOA ± 17 mL and -6 mL, LOA ± 16 mL, respectively). LAVmax by 2DSTE and 2DE were strongly correlated to those obtained by cardiac magnetic resonance (CMR) (r = 0.946 and r = 0.935, respectively; P < 0.001). However, LAVmax obtained by 2DSTE (bias = -9.5 mL, LOA ± 16 mL) and 2DE (bias = -8 mL, LOA ± 17 mL) were significantly smaller than those measured by CMR. Conversely, 3DE LAVmax were similar to CMR (bias = -2 mL, LOA ± 10 mL). Excellent intra- and inter-observer intraclass correlations were found for 3DE (0.995 and 0.995), 2DE (0.990 and 0.988), and 2DSTE (0.990 and 0.989). Conclusion: Automated LAVmax measurement by 2DSTE is highly feasible, highly reproducible, and provided similar values to conventional 2DE calculations in consecutive patients with a wide range of LAVmax.
MeSH term(s)	Aged ; Echocardiography/methods ; Echocardiography, Three-Dimensional/methods ; Feasibility Studies ; Heart Atria/diagnostic imaging ; Humans ; Male ; Reproducibility of Results
Language	English
Publishing date	2021-10-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2638345-7
ISSN	2047-2412 ; 2047-2404
ISSN (online)	2047-2412
ISSN	2047-2404
DOI	10.1093/ehjci/jeab199
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Zs.A 5614: Show issues

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Article: Cardiac Reverse Remodelling by 2D and 3D Echocardiography in Heart Failure Patients Treated with Sacubitril/Valsartan.

Mantegazza, Valentina / Volpato, Valentina / Mapelli, Massimo / Sassi, Valentina / Salvioni, Elisabetta / Mattavelli, Irene / Tamborini, Gloria / Agostoni, Piergiuseppe / Pepi, Mauro

Diagnostics (Basel, Switzerland)

2021 Volume 11, Issue 10

Abstract: In terms of sacubitril/valsartan (S/V)-induced changes in heart failure with reduced ejection fraction (HFrEF) via three-dimensional (3D) transthoracic echocardiography (TTE) and S/V effects based on HF aetiology, data are lacking. We prospectively ... ...

Abstract	In terms of sacubitril/valsartan (S/V)-induced changes in heart failure with reduced ejection fraction (HFrEF) via three-dimensional (3D) transthoracic echocardiography (TTE) and S/V effects based on HF aetiology, data are lacking. We prospectively enrolled 51 HFrEF patients (24 ischaemic, 27 non-ischaemic). At baseline and at 6-month follow-up (6MFU) after S/V treatment optimisation, we assessed the N-terminal pro-B-type natriuretic peptide (NT-proBNP), and cardiac remodelling by two-dimensional (2D) and 3DTTE. In non-ischaemic patients, 2D and 3DTTE showed an improvement in left ventricular (LV) size and biventricular function at 6MFU vs. baseline: 3D-LV end-diastolic volume (EDV) 103 ± 30 vs. 125 ± 32 mL/m
Language	English
Publishing date	2021-10-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics11101845
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Article ; Online: Tricuspid annular dilation in patients undergoing early mitral valve surgery: is it an old story?

Volpato, Valentina / Mantegazza, Valentina / Tamborini, Gloria / Gripari, Paola / Muratori, Manuela / Fusini, Laura / Zanobini, Marco / Alamanni, Francesco / Pepi, Mauro

The international journal of cardiovascular imaging

2021 Volume 37, Issue 8, Page(s) 2439–2446

Abstract: Patients with mitral valve prolapse (MVP), undergoing early surgery for severe regurgitation, are usually characterized by a low degree of right chambers' remodeling. In this selected population, the mechanisms leading to tricuspid annular (TA) ... ...

Abstract	Patients with mitral valve prolapse (MVP), undergoing early surgery for severe regurgitation, are usually characterized by a low degree of right chambers' remodeling. In this selected population, the mechanisms leading to tricuspid annular (TA) dilatation (TAD) are not well understood. In this setting, we aimed to evaluate, using three-dimensional echocardiography (3DE), how right chambers affect TA size and might contribute to functional tricuspid regurgitation (FTR) progression. We studied 159 patients treated with early isolated surgery for MVP, characterized by: sinus rhythm; normal biventricular function; normal or elevated pulmonary artery pressure; tricuspid regurgitation (TR) ≤ mild; no concomitant cardiac disease. All patients reached a 3-year echocardiographic follow-up. Based on two-dimensional echocardiography, patients were divided in Group 1 (N = 68, 43%, TAD, TA ≥ 21 mm/m
MeSH term(s)	Cardiac Valve Annuloplasty ; Dilatation ; Humans ; Mitral Valve/diagnostic imaging ; Mitral Valve/surgery ; Predictive Value of Tests ; Tricuspid Valve/diagnostic imaging ; Tricuspid Valve/surgery ; Tricuspid Valve Insufficiency/diagnostic imaging ; Tricuspid Valve Insufficiency/surgery
Language	English
Publishing date	2021-04-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2055311-0
ISSN	1875-8312 ; 1573-0743 ; 1569-5794 ; 0167-9899
ISSN (online)	1875-8312 ; 1573-0743
ISSN	1569-5794 ; 0167-9899
DOI	10.1007/s10554-021-02223-1
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Zs.A 2104: Show issues

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Article: Atrial Functional Tricuspid Regurgitation as a Distinct Pathophysiological and Clinical Entity: No Idiopathic Tricuspid Regurgitation Anymore.

Florescu, Diana R / Muraru, Denisa / Volpato, Valentina / Gavazzoni, Mara / Caravita, Sergio / Tomaselli, Michele / Ciampi, Pellegrino / Florescu, Cristina / Bălșeanu, Tudor A / Parati, Gianfranco / Badano, Luigi P

Journal of clinical medicine

2022 Volume 11, Issue 2

Abstract: Functional tricuspid regurgitation (FTR) is a strong and independent predictor of patient morbidity and mortality if left untreated. The development of transcatheter procedures to either repair or replace the tricuspid valve (TV) has fueled the interest ... ...

Abstract	Functional tricuspid regurgitation (FTR) is a strong and independent predictor of patient morbidity and mortality if left untreated. The development of transcatheter procedures to either repair or replace the tricuspid valve (TV) has fueled the interest in the pathophysiology, severity assessment, and clinical consequences of FTR. FTR has been considered to be secondary to tricuspid annulus (TA) dilation and leaflet tethering, associated to right ventricular (RV) dilation and/or dysfunction (the "classical", ventricular form of FTR, V-FTR) for a long time. Atrial FTR (A-FTR) has recently emerged as a distinct pathophysiological entity. A-FTR typically occurs in patients with persistent/permanent atrial fibrillation, in whom an imbalance between the TA and leaflet areas results in leaflets malcoaptation, associated with the dilation and loss of the sphincter-like function of the TA, due to right atrium enlargement and dysfunction. According to its distinct pathophysiology, A-FTR poses different needs of clinical management, and the various interventional treatment options will likely have different outcomes than in V-FTR patients. This review aims to provide an insight into the anatomy of the TV, and the distinct pathophysiology of A-FTR, which are key concepts to understanding the objectives of therapy, the choice of transcatheter TV interventions, and to properly use pre-, intra-, and post-procedural imaging.
Language	English
Publishing date	2022-01-13
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11020382
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Article ; Online: Prognostic Impact of Extra-Mitral Valve Cardiac Involvement in Patients With Primary Mitral Regurgitation.

van Wijngaarden, Aniek L / Mantegazza, Valentina / Hiemstra, Yasmine L / Volpato, Valentina / van der Bijl, Pieter / Pepi, Mauro / Palmen, Meindert / Delgado, Victoria / Ajmone Marsan, Nina / Tamborini, Gloria / Bax, Jeroen J

JACC. Cardiovascular imaging

2022 Volume 15, Issue 6, Page(s) 961–970

Abstract: Background: In patients with severe primary mitral regurgitation (MR), the indication for surgery is currently based on the presence of symptoms, left ventricular dilatation and dysfunction, atrial fibrillation, and pulmonary hypertension.: Objectives! ...

Abstract	Background: In patients with severe primary mitral regurgitation (MR), the indication for surgery is currently based on the presence of symptoms, left ventricular dilatation and dysfunction, atrial fibrillation, and pulmonary hypertension. Objectives: The aim of this study was to evaluate the prognostic impact of the presence of extra-mitral valve cardiac involvement (including known risk factors but also severe left atrial [LA] dilatation and right ventricular [RV] dysfunction) in a large multicenter study of patients with primary MR. Methods: Patients with severe primary MR undergoing surgery were included and categorized according to the extent (highest) of cardiac involvement: group 0, no cardiac involvement; group 1, left ventricular involvement; group 2, LA involvement; group 3, pulmonary vasculature or tricuspid valve involvement; or group 4, RV involvement. The outcome was all-cause mortality. Results: A total of 1,106 patients were included (mean age 63 ± 12 years, 68% male). In total, 377 patients (34%) were classified in group 0, 239 (22%) in group 1, 213 (19%) in group 2, 180 (16%) in group 3, and 97 (9%) in group 4. Kaplan-Meier curve analysis revealed significantly worse survival (log-rank chi-square = 43.4; P < 0.001) with higher group. On multivariable analysis, age, male sex, chronic obstructive pulmonary disease, kidney function, and group of cardiac involvement were independently associated with all-cause mortality. For each increase in group, a 17% higher risk for all-cause mortality was observed (95% CI: 1.051-1.313; P = 0.005) during a median follow-up time of 88 months. Conclusions: In patients with severe primary MR, a novel classification system based on extra-mitral valve cardiac involvement may help refine risk stratification and timing of surgery, particularly including severe LA dilatation and RV dysfunction in the assessment.
MeSH term(s)	Aged ; Female ; Humans ; Male ; Middle Aged ; Mitral Valve/diagnostic imaging ; Mitral Valve/surgery ; Mitral Valve Insufficiency/diagnostic imaging ; Mitral Valve Insufficiency/surgery ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Tricuspid Valve ; Ventricular Dysfunction, Right/diagnostic imaging ; Ventricular Dysfunction, Right/etiology
Language	English
Publishing date	2022-01-12
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2491503-8
ISSN	1876-7591 ; 1936-878X
ISSN (online)	1876-7591
ISSN	1936-878X
DOI	10.1016/j.jcmg.2021.11.009
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Zs.A 6846: Show issues

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Article ; Online: Effective Study: Development and Application of a Question-Driven, Time-Effective Cardiac Magnetic Resonance Scanning Protocol.

Torlasco, Camilla / Castelletti, Silvia / Soranna, Davide / Volpato, Valentina / Figliozzi, Stefano / Menacho, Katia / Cernigliaro, Franco / Zambon, Antonella / Kellman, Peter / Moon, James C / Badano, Luigi P / Parati, Gianfranco

Journal of the American Heart Association

2021 Volume 11, Issue 1, Page(s) e022605

Abstract: Background Long scanning times impede cardiac magnetic resonance (CMR) clinical uptake. A "one-size-fits-all" shortened, focused protocol (eg, only function and late-gadolinium enhancement) reduces scanning time and costs, but provides less information. ... ...

Abstract	Background Long scanning times impede cardiac magnetic resonance (CMR) clinical uptake. A "one-size-fits-all" shortened, focused protocol (eg, only function and late-gadolinium enhancement) reduces scanning time and costs, but provides less information. We developed 2 question-driven CMR and stress-CMR protocols, including tailored advanced tissue characterization, and tested their effectiveness in reducing scanning time while retaining the diagnostic performances of standard protocols. Methods and Results Eighty three consecutive patients with cardiomyopathy or ischemic heart disease underwent the tailored CMR. Each scan consisted of standard cines, late-gadolinium enhancement imaging, native T1-mapping, and extracellular volume. Fat/edema modules, right ventricle cine, and in-line quantitative perfusion mapping were performed as clinically required. Workflow was optimized to avoid gaps. Time target was <30 minutes for a CMR and <35 minutes for a stress-CMR. CMR was considered impactful when its results drove changes in diagnosis or management. Advanced tissue characterization was considered impactful when it changed the confidence level in the diagnosis. The quality of the images was assessed. A control group of 137 patients was identified among scans performed before February 2020. Compared with standard protocols, the average scan duration dropped by >30% (CMR: from 42±8 to 28±6 minutes; stress-CMR: from 50±10 to 34±6 minutes, both
MeSH term(s)	Cardiomyopathies/diagnostic imaging ; Contrast Media ; Gadolinium ; Humans ; Magnetic Resonance Imaging, Cine/methods ; Magnetic Resonance Spectroscopy ; Myocardial Ischemia ; Predictive Value of Tests
Chemical Substances	Contrast Media ; Gadolinium (AU0V1LM3JT)
Language	English
Publishing date	2021-12-31
Publishing country	England
Document type	Journal Article
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.121.022605
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