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Pre-Operative Cardiac Sonography May Predict Outcomes

By MedImaging International staff writers
Posted on 03 Aug 2016

Image: A summary of the study (Photo courtesy of Yuichi Notomi / Hayama).

A new study suggests that a simple pre-operative echocardiographic assessment of left ventricular (LV) torsion could predict the outcomes of mitral valve surgery.

Researchers at Hayama Heart Center (Kanagawa, Japan) examined 50 consecutive patients with nonischemic, chronic, secondary severe mitral regurgitation (NICSMR). All patients had advanced heart failure (HF) symptoms, and had received the maximum guideline-directed medical therapy for more than six months. The patients were divided into three groups: preserved LV torsion, lost LV torsion, or patients with a wide QRS who received cardiac resynchronization therapy (CRT). All patients received either mitral valve repair or mitral valve replacement.

Two years after surgery, 19 of the patients had died. The researchers found that LV torsional profile predicted post-surgical outcomes in NICSMR patients with a narrow QRS band, but not in those with a wide QRS band. Patients who received CRT prior to mitral surgery showed significantly worse two-year survival than those who received the procedure during mitral surgery. However, the two groups had similar LV torsion. The study was published on June 27, 2016, in JACC: Basic to Translational Science.

“These findings show that lost left ventricular torsion and previously administered cardiac resynchronization therapy appear to be markers of poor survival after mitral surgery in patients with NICSMR,” said lead author Yuichi Notomi, MD, of the division of cardiovascular imaging. “We also found that reverse remodeling was only observed in patients with preserved left ventricular torsion, demonstrating that lost left ventricular torsion and wide QRS were markers of no reverse remodeling viability.”

“Mechanistically, this study suggests that the loss of torsion in patients with heart failure may reflect irreversible structural damage to the heart which would prevent the heart from recovering after corrective surgery,” said Douglas Mann, MD, editor-in-chief of JACC: Basic to Translational Science. “If correct, this will have much broader implications than improvement after mitral valve surgery, since it may predict which patients with heart failure may get better on medications.”

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64 (85.115432739258): select jos_twitters.link from jos_twitters where cat=10

65 (50.067901611328): select jos_facebook.link from jos_facebook where cat=10

66 (42.915344238281): select jos_google_plus.link from jos_google_plus where cat=10

67 (42.915344238281): select jos_linkedin.link from jos_linkedin where cat=10

68 (!!!!! 1497.9839324951): SELECT fid FROM jos_deeppockets WHERE id=294765438 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294765438 AND published='1' LIMIT 1

69 (91.075897216797): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=214 ORDER BY `ordering`

70 (555.03845214844): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294765438 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (397.92060852051): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294765438 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (57.93571472168): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (81.062316894531): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (58.889389038086): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (47.206878662109): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 3677.1297454834): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294765438 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (130.89179992676): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294765438 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (57.93571472168): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (85.830688476562): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (!!!!! 1904.0107727051): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (114.91775512695): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (112.05673217773): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

105 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

106 (83.92333984375): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294765438 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (631.09397888184): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294765438 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (133.03756713867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

109 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

110 (79.870223999023): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294765438 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (713.82522583008): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294765438 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (886.91711425781): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (701.904296875): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (119.92454528809): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

115 (82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

116 (90.122222900391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

117 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

118 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

119 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

120 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

121 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

122 (430.10711669922): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 63400.983810425): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (!!!!! 1200.9143829346): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294765438 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294765438 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 22968.769073486): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (76.055526733398): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (839.9486541748): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (166.89300537109): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (896.93069458008): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (84.161758422852): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (641.1075592041): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (!!!!! 1327.0378112793): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (58.889389038086): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (43.153762817383): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (!!!!! 1976.0131835938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (612.97416687012): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (68.902969360352): SELECT name FROM jos_deeppockets WHERE id=214

138 (41.007995605469): SELECT name FROM jos_deeppockets WHERE id=214

139 (849.96223449707): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (710.01052856445): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (!!!!! 5033.9698791504): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

142 (184.05914306641): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

143 (!!!!! 22407.77015686): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 6232.9769134521): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294765438 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (!!!!! 3947.9732513428): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294765438 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 2645.0157165527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (147.10426330566): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (239.13383483887): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

149 (82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

150 (!!!!! 5828.857421875): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (!!!!! 3199.1004943848): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

152 (118.01719665527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

153 (78.916549682617): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294765438 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294765438 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (51.021575927734): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=214 or channel_id is null)

155 (45.061111450195): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=214 or channel_id is null)

156 (!!!!! 3108.024597168): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (147.81951904297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

158 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294765438 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294765438 AND published='1' LIMIT 1

159 (!!!!! 4842.0429229736): select jos_twitters.link from jos_twitters where cat=10

160 (142.09747314453): select jos_facebook.link from jos_facebook where cat=10

161 (292.06275939941): select jos_google_plus.link from jos_google_plus where cat=10

162 (50.067901611328): select jos_linkedin.link from jos_linkedin where cat=10

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