Héctor Deschle

Diagnostico Maipú

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Alejandro Deviggiano

Diagnostico Maipú

Mariana Carnevalini

Diagnostico Maipú

Norberto Casso

Diagnostico Maipú

Jessica Gantesti

Asociación Psicoanalítica de Buenos Aires

Julio Manuel Lewkowicz

Diagnostico Maipú

Patrícia Carrascosa

Diagnostico Maipú

Guillermina Culaciati

Diagnostico Maipú

Laura Alfie

Diagnostico Maipú

Carolina Torres Bianqui

Diagnostico Maipú

Agustina Amenabar

Diagnostico Maipú

Cooperative Institutions

Diagnostico Maipú

Favaloro Foundation

Fundacion Favaloro Hospital Universitario

University of Buenos Aires

Favaloro University

Instituto de Cardiología y Cirugía Cardiovascular

Sanatorio Otamendi y Miroli

Sociedad Española de Cardiología

Instituto Cardiovascular de Buenos Aires

Consejo Nacional de Investigaciones Científicas y Técnicas

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Evaluation of the size of cardiac structures in patients with high body mass index

Echocardiography (2020)

Mariana Carnevalini Héctor Deschle Agustina Amenabar Norberto Casso Jessica Gantesti

Abstract Aims Isometric indexation of cardiac structures fails in patients with overweight. The aim of the study was to evaluate the LA indexed volume (LAVOL), left ventricular end‐diastolic diameter (LVEDD), left ventricular mass index (LVMI), and the aortic sinus diameter (AOSD) in healthy subjects with normal and high BMI and find the allometric correction exponent. Methods Four hundred and thirty patients without cardiac pathology were analyzed. Patients were divided into groups: Group I BMI < 24.9 187 patients, Group II BMI 25‐29.9 154 patients, Group III BMI 30‐34.9 63 patients, and Group IV 35‐39.9 26 patients. A Doppler echocardiogram was performed. The parameters indexed were compared between groups. When allometric growth was verified, the allometric coefficient was calculated. Results Male sex 242 p (56%), mean age: 44.87 ± 13.10 years, better correlation: LAVOL, LV mass, and AOSD with body surface area (BSA) (LAVOL R : .74, R 2 .55, LV mass R : .73, R 2 : 0.53, AOSD R : .57, R 2 : .35), LVEDD with high ( R : .63, R 2 : .39) were observed. A significant increase was observed in LAVOL and LVMI in the groups with increased BMI. We observed a decrease in the indexed AOSD and a marginal difference between groups in LVEDD. The allometric correction exponent calculated was as follows: LAVOL: 0.96 and for LVMI: 0.97. Conclusions Allometric correction is superior to isometric indexation to assess LAVOL and LVMI in obese and overweight patients. Allometric correction would allow differentiating deviations from VOLAI and IMVI attributable to obesity from those attributable to an associated pathology.

Allometry

10.1111/echo.14589

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187Right atrial strain as a predictor of high pulmonary systolic pressure

European Heart Journal (2018)

Héctor Deschle Agustina Amenabar Norberto Casso Laura Alfie Mariana Carnevalini

Strain (injury)

10.1093/eurheartj/ehy564.187

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Strong negative correlation between estimated pulmonary artery systolic pressure and right atrial strain

Revista Argentina de Cardiologia (2018)

Agustina Amenabar Norberto Casso Jessica Gantesti P Ottonello Carolina Torres Bianqui

Background: Echocardiography is used to assess pulmonary artery pressure, but the magnitude of tricuspid regurgitation is a limiting factor. Objectives: The aim of this study was to evaluate the correlation between estimated pulmonary artery systolic pressure and right atrial strain. Methods: A total of 40 patients with sinus rhythm and adequate tricuspid regurgitation were included. Tricuspid annular plane systolic excursion, the velocity of this excursion, right ventricular dimension and right atrial volume were determined. Peak right atrial basal strain and mid-lateral strain during the reservoir phase were averaged. Right atrial strain was compared in patients with estimated pulmonary artery systolic pressure <36 mmHg and ≥36 mmHg using Student’s t test. Pearson’s correlation coefficient was calculated between right atrial strain and estimated pulmonary artery systolic pressure using the bootstrapping method to evaluate the corresponding confidence interval. Results: Mean age was 59±11 years and 45% were men. There were statistically significant differences in right atrial strain between patients with estimated pulmonary artery systolic pressure <36 mmHg and ≥36 mmHg (69.92±11.69 vs. 29.40±11.06; p=0.001; 95% CI: -53.93- -27.09). The correlation between estimated pulmonary artery systolic pressure and right atrial strain was -0.87 (p <0.01; 95% CI: -0.72- -0.93). The correlation coefficient was positive but weaker between estimated pulmonary artery systolic pressure, right atrial volume (r=0.67) and right ventricular dimension (r=0.59). Conclusions: The results show a strong negative correlation between estimated pulmonary artery systolic pressure and right atrial strain which could be useful when tricuspid regurgitation is absent.

10.7775/rac.85.6.12265

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Relationship between Left Ventricular Mass and Echocardiographic Parameters in Hypertensive Patients

Revista Argentina de Cardiología (2016)

Jessica Gantesti Guillermina Culaciati Norberto Casso Mariana Carnevalini María G. Matta

Objetivos: Evaluar el impacto de diferentes grados de incremento del indice de masa ventricular izquierda (IMVI) sobre los parametros de disfuncion diastolica clasicos, el strain longitudinal ventricular y auricular. Metodo: Ingresaron 60 pacientes de entre 30 y 60 anos: 40 hipertensos con IMVI normal o ligeramente aumentada y 20 hipertensos con mayor IMVI (varones:≥ 132 gr/m2; mujeres: ≥ 109 gr/m2). Sexo masculino: 31 (62%). Se efectuaron las mediciones ecocardiograficas convencionales, se registro el Doppler tisular pulsado lateral y septal y se calculo el volumen auricular izquierdo. La masa ventricular (ASE) y el volumen de la AI fueron indexados por superficie corporal. Se obtuvo el strain global longitudinal ventricular sistolico y el strain global auricular izquierdo maximo durante el periodo de reservorio. Para comparar medias se utilizo el test de t. p significativa: < de 0,05. Resultados: Los hipertensos con aumento moderado o mayor de la masa del VI tuvieron un strain auricular significativamente menor (28,35±8.44 vs 35,83±9,33; p=0,019; IC 95% 1,38-13,58) y un volumen de la AI mayor (35,97±9,48 vs 30,32±7,54; p=0,037; IC 95% 0,34-10.95) que aquellos con masa normal o levemente elevada. No hubo diferencias significativas en la relacion E/e (8,02±2,31 vs 9,58±3,06) ni en el strain ventricular (18,42±1,95 vs 18,57±2,25). Conclusiones: En este grupo de pacientes hipertensos el mayor incremento de la masa ventricular izquierda se acompano de disminucion significativa del strain auricular (ya presente en hipertensos sin incremento de la masa del VI) y un incremento del volumen de la AI por encima de los valores normales.

Ventricular Function

10.7775/rac.84.4.7885

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La educación médica continua como eje del desarrollo

Revista Argentina de Cardiología (2022)

Héctor Deschle

10.7775/rac.es.v90.i3.20530

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Mitral Regurgitation Secondary to Cleft Posterior Mitral Valve Leaflet Defect

Revista Argentina de Cardiología (2014)

Héctor Deschle Rafaela Pinto Reyes

Diagnostico Maipu, Vicente Lopez, Provincia de Buenos Aires MTSAC Full Member of the Argentine Society of Cardiology Cleft mitral valve leaflet is defined as a discontinuity of the mitral leaflet from the free edge of the mitral ring, which results in a certain degree of regurgitation. (1) Embryologically, the upper cushion originates the portion of the anterior mitral leaflet, and the left lateral cushion the posterior leaflet. (2) In most cases, cleft mitral valve leaflet is due to a cleft of the anterior leaflet. Cleft of the posterior mitral valve leaflet is a rare anomaly, not associated with septal defects. It is usually seen within the P2 segment. (Figure 1). (1-3) 3D echocardiography allows perspective views that improve cleft visualization and location of the defect present in the middle and posterior leaflet scallops. (4-5) The images correspond to a 64-year-old female patient with hypertension, dyslipidemia, history of dyspnea in FC II and palpitations. Physical examination showed a holosystolic murmur as the only significant finding, with II/IV intensity in the mitral area and transmission to the anterior axillary line. Baseline ECG did not show alterations. Transthoracic echocardiography showed mild septal hypertrophy, left ventricular diameter just above the normal limit, preserved left ventricular systolic function, moderate left atrial dilation (area 29 cm2), mild tricuspid regurgitation that allowed calculation of systolic pulmonary pressure of 42 mm Hg, and mitral regurgitation with moderately severe central regurgitant jet. A solution of continuity was seen in the left parasternal short axis view (mitral valve level) on the posterior leaflet, consistent with a cleft (see Figure 1). A 3D transthoracic echocardiography was performed, which confirmed the presence of a cleft in the middle portion (P2 segment) of the posterior leaflet (Figure 2, Video 1). No abnormalities of the mitral valve apparatus or defects in the interatrial septum were observed.

10.7775/rac.82.3.4030

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On-site Attendance: The New Challenge. The SAC opens its doors

Revista Argentina de Cardiología (2022)

Héctor Deschle

Doors

Attendance

Chorus

10.7775/rac.v90.i1.20494

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Atheromatosis of the Thoracic Aorta as Predictor of Cardiovascular Mortality and Cerebrovascular and Coronary Events

Revista Argentina de Cardiologia (2011)

Héctor Deschle Pablo Oberti Jorge Lowenstein Carlos Rodríguez Correa G Lanternier

Objective To evaluate the severity of atheromatosis of the thoracic aorta and its relation with mortality and cerebrovascular and coronary events. Material and Methods Between 2005 and 2007, 601 patients (ps) were referred for evaluation with transesophageal echocardiography (TEE). Age: 64.53±13.61 years Male gender: 337ps. The following variables were included: Reason for ordering the study: embolic source (37.7%), endocarditis (22.1%), previous to cardioversion (11.5%), mitral valve disease (9.8%), other reasons (18.95%). Risk factors: diabetes, smoking habits, hypertension, dyslipidemia. Presence of atrial fibrillation. The patients were divided into two groups: With uncomplicated aortic plaques < 4 mm: ps = 465. With complex aortic atheromatosis (CAA): aortic plaques ≥ 4 mm, with ulcers, thrombi or aortic debris: ps = 136. Follow-up: 1596 days (mean: 759 days). A total of 520 ps (86.52%) were contacted; the following events were considered: transient ischemic attack or stroke, AMI, angina, revascularization and/or cause of mortality during that period. Multivariate analysis was used to identify independent predictors. A p value < 0.01 was considered statistically significant. Results Cardiovascular mortality: 3.2% (13/407 ps) in group a and 18.6% (21/113 ps) in group b (p<0.01). Combined vascular events: 91/407 ps (22.4%) in group a and 45/113 ps (39.8%) in group b (p<0.01). Multivariate analysis showed that CAA was an independent predictor of cardiovascular mortality (OR 4.54, 95% CI 1.52-13.58, p<0.01) and of cerebrovascular and/or coronary events (OR 3.33, 95% CI 1.66-6.67, p<0.01). Conclusions In this population, CAA was an independent predictor of cardiovascular mortality and combined vascular events.

Stroke

Thoracic aorta

Dyslipidemia

10.7775/rac.79.3.390

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Análisis de los estudios de perfusión posangioplastia. El tiempo entre angioplastia y perfusión. Reestenosis e isquemia

Revista Argentina de Cardiología (2009)

Julio Manuel Lewkowicz Alejandro Deviggiano Edgardo Repezza Patrícia Carrascosa Carlos Capuñay

Resumen es: Introduccion Los consensos internacionales coinciden en senalar que el mejor momento para analizar pacientes posangioplastia con estudios de perfusion es...

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Congenital Ventricular Crypt, Diverticulum or Aneurysm? A Finding to be Considered

Revista Argentina de Cardiología (2015)

Mariana Carnevalini Héctor Deschle

10.7775/rac.v83.i4.5804

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