Clinical InvestigationsEchocardiographic Features of Cardiac Masses and DiagnosisEchocardiographic Markers in the Diagnosis of Cardiac Masses
Section snippets
Study Population
This observational cohort study included all consecutive patients who underwent noninvasive imaging investigations (transthoracic echocardiography, CCT, and CMR) for suspected CMs at University Hospital Policlinico Sant’Orsola Malpighi in Bologna, Italy, from January 2004 to September 2022. A definitive diagnosis was achieved by the histologic examination of biopsy or surgical samples or, in the case of cardiac thrombi, by radiologic evidence of thrombus resolution after adequate anticoagulant
Results
A total of 369 patients included in the Bologna Cardiac Masses Registry underwent complete recorded transthoracic and/or transesophageal echocardiographic evaluation from January 2004 to September 2022. As shown in the study flowchart (Supplemental Figure 1), we excluded 83 cases with unavailable histology, extracardiac masses as confirmed by second-level investigations, poor acoustic windows, and masses that were not visualized on echocardiography. The latter included nine pericardial masses,
Discussion
The aim of this study was to describing the echocardiographic parameters of a large population of histologically confirmed CMs and look for practical clues to improve the diagnostic accuracy of malignancy. In the complex approach to CMs, the noninvasive echocardiographic approach may help simplify and optimize the subsequent diagnostic process with the support of second-level noninvasive imaging techniques (i.e., CMR, CCT, and positron emission tomography) when needed.
In summary, our main
Conclusion
Our study in a large cohort of patients with histologically proven CMs confirmed that certain echocardiographic features are strongly related to malignancy. Most important, we found that the simple addition of specific parameters improves the diagnostic accuracy and the correct identification of the masses’ nature. Furthermore, a step-based approach using three characteristics provides improved discrimination in the echocardiographic evaluation of such patients. The identification of these
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Cited by (0)
Drs. Paolisso and Foà contributed equally to this work.
Dr. Paolisso has received a research grant from the CardioPaTh PhD Program.
Conflicts of interest: None.