title: [Harmonic echocardiography of tissue in the diagnosis of aneurysms of the interatrial septum. Study of 550 consecutive ambulatory patients].
abstract: BACKGROUND
  It has been assessed whether echocardiographic harmonic imaging improves the detection of atrial septal aneurysm (ASA) compared with fundamental imaging.
  
  
  METHODS
  We studied consecutively, using fundamental and harmonic imaging, 550 patients (with or without cardiopathy; 300 females and 250 males) in an outpatients' department (age 23-76 years, mean 50 years). We used a multifrequency transthoracic probe transmitting at 2 Mhz and receiving at 4 Mhz. The ASA was classified in three types according to Hanley et al. Type 1A, protruding into the right atrium without oscillation; Type 1B protruding into the right atrium with oscillation, and Type 2, protruding into the left atrium with oscillation. We compared atrial septal aneurysm definition in fundamental and harmonic mode, and assessed the interobserver agreement in the diagnosis of ASA. The echocardiographic images were recorded on magneto-optical disk and analysed by two blinded observer. With Pearson test we assessed the interobserver concordance in the ASA study; so we quantified the advantage of harmonic imaging as reduction of the inter-observer variability.
  
  
  RESULTS
  Among 550 consecutive subjects in the echocardiographic study population, ASA was diagnosed in 8 (1.45%) and 15 (2.72%) patients using fundamental and harmonic methods respectively. A significant reduction of the inter-observer variability in the ASA diagnosis was found with harmonic imaging (harmonic imaging: r = 0.96; fundamental imaging: r = 0.70).
  
  
  CONCLUSIONS
  The harmonic methods drastically improves echocardiographic imaging of ASA, it may be used routinely and reduces the need for more invasive technique such as transesophageal echocardiography.
authors.affiliation: Dipartimento di Terapia Medica, Università degli Studi di Roma La Sapienza, Roma. pugliesemarco@libero.it
authors.forename: M
authors.initials: M
authors.lastname: Pugliese
authors.forename: V
authors.initials: V
authors.lastname: Paoletti
authors.forename: E
authors.initials: E
authors.lastname: Rinaldi
authors.forename: M
authors.initials: M
authors.lastname: Paradiso
authors.forename: A
authors.initials: A
authors.lastname: Mammarella
authors.forename: A
authors.initials: A
authors.lastname: Musca
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006322:Heart Aneurysm / Q000000981:diagnostic imaging*; D006346:Heart Septum / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged
vernacular_title: Ecocardiografia in armonica tissutale nella diagnosi dell'aneurisma del setto interatriale. Studio su 550 pazienti ambulatoriali consecutivi.