Julián Vega Adauy

Instituto Chileno de Imagen Cardiaca | INCIC · Imagen Cardíaca

Introduction: An increased risk of atrial fibrillation (AF) has been demonstrated in high-performance athletes. Soluble vascular adhesion molecule-1 (sVCAM-1), a biomarker involved in inflammation and cardiac remodeling, is associated with the development of AF in the general population. However, the relationship between sVCAM-1 and left atrial (LA...

This single-blind and cross-sectional study evaluated the role of Rho-kinase (ROCK) as a biomarker of the cardiovascular remodelling process assessed by echocardiography in competitive long-distance runners (LDRs) during the training period before a marathon race. Thirty-six healthy male LDRs (37.0 ± 5.3 years; 174.0 ± 7.0 height; BMI: 23.8 ± 2.8;...

Myocardial tissue T1 constitutes a reliable indicator of several heart diseases related to extracellular changes (e.g. edema, fibrosis) as well as fat, iron and amyloid content. Magnetic resonance (MR) T1-mapping is typically achieved by pixel-wise exponential fitting of a series of inversion or saturation recovery measurements. Good anatomical ali...

This single-blind and cross-sectional study evaluated the role of Rho-kinase (ROCK) as a biomarker of the cardiovascular remodelling process assessed by echocardiography in competitive long-distance runners (LDR) during the training period before a marathon race. Thirty-six healthy male LDR (37.0±5.3 years; 174.0±7.0 height; BMI: 23.8±2.8; VO2-peak...

Heart failure with preserved ejection fraction (HFpEF) burden is increasing. Its diagnostic process is challenging and imprecise due to absence of a single diagnostic marker, and the multiparametric echocardiography evaluation needed. Left ventricular (LV) ejection fraction (LVEF) is a limited marker of LV function; thus, allocating HF phenotypes b...

Tema 14 del curso Experto Universitario en Aplicación Clínica de la Resonancia Magnética Cardíaca, centrado en Taquicardia ventricular y fibrilación auricular.

A 63 year-old-male was admitted with a non-ST-segment elevation acute coronary syndrome. Due to poor acoustic windows ventricular function could not be evaluated by echocardiography. Magnetic resonance (CMR) revealed normal biventricular size and function without fibro- sis and portraying a rare finding consisting of a tubular structure originated...

* Description of Clinical Presentation - A 62-year-old healthy male experience high degree atrioventricular block, being admitted in fair condition to the coronary care unit. - Bedside echocardiography evidenced adequate biventricular size and function, discarded significant valve disease or pulmonary hypertension. - Blood tests, including; complet...

* Description of Clinical Presentation - A 53 year-old hypertensive female, was admitted with a non-ST-elevation-myocardial infarction (MI). Echocardiography displayed normal bi-ventricular size and function. Coronary angiography proved unobstructed coronary arteries, discarding dissection or vasospasm, thus being labeled as myocardial infarction w...

Funding Acknowledgements Type of funding sources: None. Introduction Myocardial T1 mapping constitutes a reliable indicator of heart diseases related to changes of myocardial extracellular content (e.g. oedema, fibrosis) as well as fat, iron and amyloid content. T1-mapping techniques rely on fitting a model to a series of MRI measurements. Alignme...

Funding Acknowledgements Type of funding sources: None. Introduction Myocardial delayed enhancement (MDE) MRI plays an important role in the identification of several cardiac conditions, both ischemic and non-ischemic (e.g. myocarditis, IDC, amyloidosis). 3D imaging offers increased resolution, full heart coverage and better depiction of complex p...

Right ventricular restrictive physiology (RVRP) occurs in diverse clinical scenarios, most frequently after repair of Tetralogy of Fallot (TOF). Cardiac magnetic resonance (CMR) can comprehensively evaluate RVRP using 4D flow along with anatomical and fibrosis characterization. Also, RVRP is associated with less pulmonary regurgitation and fewer ri...

Background Adverse Left Ventricular (LV) remodelling (ALVR) following ST-segment Elevation Myocardial Infarction (STEMI) is the result of numerous mechanical, neurohormonal, micro and macrovascular factors, and remains a major clinical problem. Cardiac Magnetic Resonance (CMR) is a multimodality technique that provides comprehensive functional and...

La fisiología restrictiva del ventrículo derecho (FRVD) se presenta en diversos escenarios clínicos, siendo frecuente encontrarla en el seguimiento de las cardiopatías congénitas, específicamente en la Tetralogía de Fallot (TdF) reparada donde se presenta en más del 50% de los pacientes 1 y se ha asociado a fibrosis extensa del tracto de salida 2....

Right ventricular restrictive physiology (RVRP) occurs in diverse clinical scenarios, most frequently after repair of Tetralogy of Fallot (TOF). Cardiac magnetic resonance (CMR) can comprehensively evaluate RVRP using 4D flow along with anatomical and fibrosis characterization. Also, RVRP is associated with less pulmonary regurgitation and fewer ri...

A 68-year-old man previously subjected to radiotherapy had a prior aortic valve replacement due de radiation induced calcification of the aortic valve. Presently the patient developed severe calcification of the mitral valve ring leading to critical mitral valve stenosis. A supra annular implantation of an On X Conform valve was successfully achiev...

|1| Antecedentes | Hombre de 64 años con valvulopatía aórtica dismórfica e insuficiencia significativa de difícil cuantificación por ecocardiografía (Panel A), se realiza resonancia magnética cardíaca (RMC) 3.0 T con flujo 4D (4DF). |2| Descripción e Interés del caso | - Se efectúan secuencias de CINE SSFP, angiografía gatillada por ECG, contras...

Mujer de 68 años, posterior a una endarterectomía carotidea presenta angina.-Su ECG demuestra negativización de la onda T en DI y aVL, sin alteraciones del segmento ST, la troponina resulta positiva.-Por dolor persistente se efectúa cateterismo cardíaco (Video A) el que objetiva arterias coronarias sin lesiones y acinesia de los segmentos medio-ven...

Late Gadolinium Enhancement (LGE) cardiac MR is a proven tool for the assessment of myocardial fibrosis. Maps of the accumulation of contrast agent are obtained using an inversion recovery (IR) prepared sequence, 10-20 minutes after administration. Recently, 3D sequences capable of IR-prepared LGE acquisition have become clinically available. These...

Bicuspid aortic valve (BAV) disease is generally associated with thoracic aortic dilatation (TAD). Related factors include; genetical, morphological (valvular phenotype) and most recently, hemodynamic profiles associated with flow pattern and wall shear stress. Cardiac magnetic resonance 4D Flow (4DF) can give an integral evaluation of these later...

Introduction Reports have shown increased risk of atrial fibrillation (AF) in athletes. Vascular cell adhesion molecule-1 (VCAM1) is associated with new onset AF in general population. VCAM1 and its relation with left atrial (LA) remodeling have not been investigated in athletes. Purpose To study VCAM1 and LA remodeling in marathon runners. Metho...

El doble orificio de la válvula mitral (DOVM) descrito en 18761 es una cardiopatía congénita inhabitual2, raramente se presenta aislado y frecuentemente se ve asociado a otras cardiopatías congénitas. Existen varias clasificaciones anatómicas, siendo menos prevalente la presentación de dos orificios simétricos divididos completamente por un puente...

Introducción: Atletas altamente entrenados muestran cambios cardíacos estructurales como adaptación a la sobrecarga, producto del ejercicio repetitivo y extenuante. Se han evidenciado elevación de biomarcadores de remodelado y fibrosis miocárdica posterior al ejercicio intenso en atletas. Sin embargo, el comportamiento de estos biomarcadores según...

s: Severe acute aortic regurgitation (SAAR) constitutes a surgical emergency. Its main causes are infective endocarditis and aortic dissection. Three echocardiographic hallmarks aid in its diagnosis and management, namely: premature opening of the aortic valve (POAV), premature mitral valve closure (PMVC) and diastolic mitral regurgitation (DMR), f...

Purpose: Left atrial (LA) contraction is essential for left ventricular (LV) filling during exertion. We sought to evaluate the relationship of LA contraction and exercise capacity in trained athletes. Methods: Sixteen male marathon runners were recruited and allocated into two groups according to their previous training status (≥ or < 100 km pe...

Introducción: El ejercicio físico reduce la mortalidad cardiovascular y genera remodelado cardíaco. Altas cargas de entrenamiento pueden generar remodelado cardíaco adverso. Biomarcadores (BMC) de inflamación Interleukina 6 (IL-6) y de estrés oxidativo Malondialdehído (MDA), potencialmente pueden caracterizar la respuesta al esfuerzo. Objetivo: Ev...

Cardiac myxomas are frequently located in the left or right atria, with multiple locations being rare. We report a 59‐year‐old healthy female with 5 months of cough and exertional dyspnea. A transthoracic echocardiography (TTE) exhibits a 9 × 5 cm nonpedunculated tumor arising from the interatrial septum (IAS) and inhabiting both atria, but was una...

Aporte de la ecocardiografía tridimensional en el diagnóstico y manejo de la endocarditis infecciosa. Experiencia clínica. El diagnóstico ecocardiográfico (eco) de la endocar-ditis infecciosa ha tenido una evolución vertiginosa, destacando el desarrollo de la ecocardiografía transe-sofágica (ETE), la imagen armónica y la ecocardio-grafía tridimensi...

Left ventricular hypertrophy with a characteristic strain pattern A 68 year-old male, with no past medical history, presented progressive shortness of breath on exer-tion and leg edema during the previous year. Trans-thoracic echocardiography depicted; severe left ven-tricular hypertrophy with mild systolic dysfunction (LVEF 50% biplane Simpson's m...

* Introduction: Aortic stenosis (AS) is the most prevalent valvular heart disease in developed countries. Symptomatic severe AS requires surgical intervention, and its echocardiographic criteria encompass: Aortic valve area (AVA) < 1.0 cm2, aortic mean gradient (MG) > 40 mmHg, peak aortic jet velocity > 4 m/s. Usually there is agreement among these...

A 79 year-old-man presented three episodes of upper gastrointestinal bleeding and weight loss. Endoscopy revealed bleeding and extrinsic compression at the pyloric region. Computed tomography scan showed a pancreatic tumor, peritoneal carcinomatosis, vascular infiltration, and incidentally found a partially calcified hypodense lesion of 35 mm in th...

OBJECTIVE: To report the clinical case of a 59-year-old female that underwent surgery because of a gigantic biatrial myxoma. METHODS: The patient refer a five month history of non-productive cough and progressive exertional dyspnea. One month before being admitted at our institution, she presented a pre-syncope episode. On admission, physical exam,...

Aortic regurgitation is a diastolic event in which blood from the aorta regurgitates back to the left ventricle, with several possible mechanisms. Its magnitude is determined by: the regurgitant orifice area, the diastolic gradient between the aorta and the left ventricle and the duration of diastole. In contrast, systolic aortic regurgitation (SAR...

Aortic regurgitation is a diastolic event in which blood from the aorta regurgitates back to the left ventricle, with several possible mechanisms. Its magnitude is determined by: the regurgitant orifice area, the diastolic gradient between the aorta and the left ventricle and the duration of diastole. In contrast, systolic aortic regurgitation (SAR...

Introduction: Aortic stenosis (AS) is the most prevalent valvular heart disease in developed countries. Symptomatic severe AS requires surgical intervention, and its echocardiographic criteria encompass: Aortic valve area (AVA)

We report the case of a 52 y.o. male, with longstanding history of chest pain. Coronariography performed in 2005 showed normal coronary arteries. In the following years he developed progressive abdominal bloating and pain, upper gastrointestinal endoscopy was normal, but atrial fibrillation was diagnosed initiating therapy. During the year 2016 sym...

We report a 23-year-old woman, with three recent exertional syncopes. Transthoracic (TTE) and transesophageal (TEE) echocardiography found a large heterogeneous mass (38 x 35 mm) arising from the posterior mitral annulus, protruding in systole through the left ventricular outflow tract (LVOT). Heart MRI confirmed the echocardiography findings, sugg...

We report a 23-year-old woman, with three recent exertional syncopes. Transthoracic (TTE) and transesophageal (TEE) echocardiography found a large heterogeneous mass (38 x 35 mm) arising from the posterior mitral annulus, protruding in systole through the left ventricular outflow tract (LVOT). Heart MRI confirmed the echocardiography findings, sugg...

ABSTRACT We report the case of an 18 year old man, which underwent valve repair for a mitral leaflet perforation. The patient complain was shortness of breath, and he had a remote history of a knee septic arthritis. Physical examination revealed a holosystolic mitral murmur. Transthoracic echocardiography report a severe mitral regurgitation origin...

We report the case of a 52 y.o. male, with longstanding history of chest pain. Coronariography performed in 2005 showed normal coronary arteries. In the following years he developed progressive abdominal bloating and pain, upper gastrointestinal endoscopy was normal, but atrial fibrillation was diagnosed initiating therapy. During the year 2016 sym...

An 18 year-old man presented with shortness of breath and a remote history of a septic arthritis of the knee. Physical examination revealed a holosystolic mitral valve murmur. Transthoracic echocardiography showed a severe mitral regurgitation originating from de anterior mitral valve leaflet, but the exact mechanism was unclear. Transesophageal ec...

CLEFT OF THE POSTERIOR MITRAL VALVE LEAFLET SIMULATING A THREE LEAFLET VALVE We report the case of a 55 year old woman, previously treated with antibiotics for periodontitis. She was admitted with fever and lumbar pain. An elevated C reactive protein (CRP) and positive blood cultures for Streptococcus Viridans were found and infectious spondylodis...

Background: The effects of inhaled prostanoids on right atrial (RA) function in patients with Pulmonary Arterial Hypertension (PAH) have not been studied. We evaluated acute changes in RA function and right ventricular diastolic function after inhaled iloprost. Methods: We included PAH patients without prior prostanoid treatment. A surface echocard...

Acute primary tricuspid regurgitation (TR) secondary to papillary muscle rupture is an extremely rare clinical situation. We report a 42-year-old male with pulmonary artery hypertension (PAH) secondary to HIV infection, who presented with an acute TR due to spontaneous papillary muscle rupture. He remained in cardiogenic shock despite therapy with...

The assessment of patients with a suspected cardiac failure aims to an early and precise diagnosis and risk stratification. Only natriuretic peptides have demonstrated to be clinically useful. Brain natriuretic peptide stands out due to its diagnostic and prognostic value. However its results should be cautiously interpreted in the clinical context...

The assessment of patients with a suspected cardiac failure aims to an early and precise diagnosis and risk stratification. Only natriuretic peptides have demonstrated to be clinically useful. Brain natriuretic peptide stands out due to its diagnostic and prognostic value. However its results should be cautiously interpreted in the clinical context...

We report a 22-year-old male who experienced several episodes of syncope within a timeframe of few hours. In the emergency room, multiple ventricular fibrillation episodes where documented along with a type 1 Brugada ECG pattern. Isoproterenol in continuous infusion was started, normalizing the ECG and avoiding further arrhythmia recurrences. The p...