KZhead

diastolic dysfunction part I - concept & measurement

Mastering & Guidelines in Ultrasound & Echo-Card
2024 ж. 24 Мам.
137 165 Рет қаралды
Жүктеу

mechanism of diastolic dysfunction and measurements
BY: Seyed A Sadatian MD. RDCS, RDMS. RVT

Пікірлер

  • Dear Dr. Sadatian, I can confidently say you make the best educational videos about echocardiography on KZhead. The videos are simply comprehensive and right to the point. I do really appreciate it.

    @reza9177@reza917711 ай бұрын

    • Thanks and you are very welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology11 ай бұрын

  • Your quote at the end is gold. Great lecture.

    @sangresangre698@sangresangre6983 жыл бұрын

  • Great lecture!

    @EvgeniGaidukov@EvgeniGaidukov4 жыл бұрын

  • Sir u r just an exceptional teacher.......Thank you so much such amazing job to help us learn these concepts in cardiology....💐💐

    @kalpeshpatil6101@kalpeshpatil61013 жыл бұрын

    • you are very welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology3 жыл бұрын

  • Excellent, waiting for the next part. Thanks.

    @yassergabr1844@yassergabr18444 жыл бұрын

    • thanks. there is second parts and other useful topic. check them out in channel.

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology4 жыл бұрын

  • Very nice lecture on LV diastolic function evaluation. Thankyou.

    @udayakumarramachandran9551@udayakumarramachandran9551 Жыл бұрын

    • You are very welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

  • Sir you are the legend in echo teaching,the way you put your efforts in transforming difficult topics into simplest pattern is excellent and very appreciable.You always go to beginner level and start every thing from scratch that is very helpful for the beginners who going to start their echocardiography journey.God Bless you.

    @Kingbhatti99@Kingbhatti993 жыл бұрын

    • Thank you .

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology3 жыл бұрын

  • Thank you for sharing this video and explaining so well!🙌 I am a Cardiovascular sonographer and this has been very enlightening!🙏

    @desertrose7778@desertrose77783 жыл бұрын

    • you are welcome. check other clips I am sure there are some that will be useful in your practice

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology3 жыл бұрын

    • @@masteringEcho-US-cardiology Thank you!😊🙏

      @desertrose7778@desertrose77783 жыл бұрын

  • so many useful Prof.

    @hadialihosseini@hadialihosseini3 жыл бұрын

  • A wonderful lecture and elaborate teaching of echo diastolic measurements. Thank you.

    @TheHeartSpecialist@TheHeartSpecialist3 жыл бұрын

    • you are welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 жыл бұрын

  • Very nice explanations. Congrts

    @JoyForPalestine@JoyForPalestine10 ай бұрын

  • Thank you for very clear and great explanation .

    @monaalizadeh425@monaalizadeh4255 жыл бұрын

    • you are welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology5 жыл бұрын

  • Thank you! Complicated topic explained in a simple manner. This has been very useful.

    @vikasreddy4592@vikasreddy45923 жыл бұрын

    • you are welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology3 жыл бұрын

  • Excellent presentation

    @doctorStamate@doctorStamate3 жыл бұрын

  • Very educative, and you have simplified the issues at hand, many thanks Sir

    @josephkazibwe9714@josephkazibwe97143 жыл бұрын

    • you are very welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology3 жыл бұрын

  • Such a great practical training with lllp😅😅ŕ

    @reynour1@reynour1 Жыл бұрын

  • Always on point Sir! Thank you

    @glob3242@glob32423 жыл бұрын

    • thank you

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology3 жыл бұрын

  • Thank you so much! I've just started to learn echo and was having a really hard time with this topic but your video helped a lot.

    @SkyRyu@SkyRyu2 жыл бұрын

    • Glad it helped!

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 жыл бұрын

  • Hi great man... Do you know?..your approach is better than other prepaid online courses.... Your explanation is very scintefic and concentrated usefully.... Please do not avoid us from your knowledgements... Keep us with your easy benefitfull lectures.. You are nice teacher who has unique way in teaching

    @atheeralsaeed13@atheeralsaeed134 жыл бұрын

    • thank you . If I have enough time I'll cover all important topics for sure

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology4 жыл бұрын

    • You are really great

      @atheeralsaeed13@atheeralsaeed134 жыл бұрын

  • very clear! loved the final thought... thanks!

    @ignacioscarafia9164@ignacioscarafia91649 ай бұрын

    • You are welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology9 ай бұрын

  • Great lecture from a Great teacher

    @user-sz5ix4to3i@user-sz5ix4to3i2 жыл бұрын

    • thank you

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 жыл бұрын

  • Thank you so very much for this lecture as it has helped me tremendously understand and to prepare for my Echo test this week!😀

    @charlenemacomber1777@charlenemacomber1777 Жыл бұрын

    • you are very welcome I am glad it is helpful. don't forget review those board reviews & SDMS good luck

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

  • Thank you very much again, this was very useful =)!

    @fenitta@fenitta4 жыл бұрын

    • Glad to hear that!

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology3 жыл бұрын

  • Thank you very much for your videos!

    @elvina7659@elvina76594 жыл бұрын

    • you are welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology4 жыл бұрын

  • Excellent teaching 👏👏

    @drgadham@drgadham2 жыл бұрын

    • thank you

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 жыл бұрын

  • Great teaching

    @kellysalazaku9019@kellysalazaku9019 Жыл бұрын

  • Thanks sir, explained well.

    @user-pl8dd4di4b@user-pl8dd4di4b3 жыл бұрын

    • you are welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology3 жыл бұрын

  • Good luck.

    @nabilatallah1057@nabilatallah105711 ай бұрын

  • Thank you so much sir, very useful lecture 🙏🙏🌹🌹

    @shafaafray7313@shafaafray73133 жыл бұрын

    • Most welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology3 жыл бұрын

  • Excellent teaching

    @drbanwarilalnayak409@drbanwarilalnayak4093 жыл бұрын

    • thank you

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology3 жыл бұрын

  • Thank you.

    @peterashford5123@peterashford51233 жыл бұрын

  • thank you sir

    @ahmedayari6889@ahmedayari68895 жыл бұрын

    • you are welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology4 жыл бұрын

  • Great explanation

    @drafsheensultrasound9572@drafsheensultrasound9572 Жыл бұрын

    • Thanks

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

  • God bless u

    @assiaadyadou253@assiaadyadou2534 жыл бұрын

    • thanks

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology4 жыл бұрын

  • excellent

    @dr.fazalurrehmanawan1535@dr.fazalurrehmanawan15355 жыл бұрын

    • Thanks

      @seyedasgharsadatian741@seyedasgharsadatian7415 жыл бұрын

  • Thank you so much!

    @candyjo6960@candyjo69602 жыл бұрын

  • excellent teaching

    @drbanwarilalnayak409@drbanwarilalnayak4092 жыл бұрын

    • thanks

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 жыл бұрын

  • Thank you so much ,i am cardiac sonoghrapher student .it is really usefule and helpeful .Thanks again .

    @niloofarnika5454@niloofarnika54542 жыл бұрын

    • you are very welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 жыл бұрын

  • thank you very much it is very nice and useful ...thanks alot

    @ahmedmostafa1320@ahmedmostafa13202 жыл бұрын

    • you are very welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 жыл бұрын

  • Great sir

    @dr.husainhamdard426@dr.husainhamdard4262 жыл бұрын

    • thanks

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 жыл бұрын

  • M cardiology resident,,,really learn alot from ur knowledge

    @sarakhan-dl2lu@sarakhan-dl2lu2 жыл бұрын

    • Thank you Dr.

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 жыл бұрын

  • Thanks sir...

    @infodiff@infodiff2 жыл бұрын

    • you are welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 жыл бұрын

  • Thank you very much !!! ❤

    @wlodar001@wlodar0012 ай бұрын

    • You are welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 ай бұрын

  • Thank you so much sir❤

    @yuvasrid2224@yuvasrid22243 жыл бұрын

    • you are welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology3 жыл бұрын

  • What advice would you have for a sonography student writing their ARDMS and Sonography Canada exams in the next few weeks? Main topics to focus on, etc... Thank you for amazing videos by the way!

    @marleighconnolly2777@marleighconnolly27778 ай бұрын

    • Hi Marleiggh, I am not familiar with Canada system but I am sure it will be the same around the world. Reviewing echo registry from SDMS will be the best. On their website (and in ARDMS website too ) there are some mocks test too (you should pay a small ) . Taking those exams give you very good idea what should you focus more (baord exam will be very close to that) but if you review all clips in this channel I am 100% sure you will pass . It will be great to let me know when you passed the exam. you don't need luck, but good luck

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology8 ай бұрын

    • I forgot to mention that those review exams in this channel are very close to board exam too

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology8 ай бұрын

    • Hi Dr. Sadatian, I passed my ARDMS adult echo exam today thanks to your videos. I also wrote the Sonography Canada Cardiac exam today for echocardiography but I won’t get the result of that for a few weeks. I just wanted to say thank you for uploaded such detail videos with excellent examples and descriptions. I truly believe your lectures were the reason I passed. Thank you so much 🙏🏻 Marleigh

      @marleighconnolly2777@marleighconnolly27778 ай бұрын

    • @@marleighconnolly2777 Hi, Congratulation!. great job. You are very welcome . Welcome to the club.

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology8 ай бұрын

  • thank you for the clear expanation.

    @genetkebede846@genetkebede846 Жыл бұрын

    • you are welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

  • It is a fantastic lecture thank you very much. But i wonder if you can elucidate the significance of DT duration and IVCT and IVRT ? What is their clinical significance?

    @nsas955@nsas9554 жыл бұрын

    • thank you. based on new guideline they are used in other unusual cases like Afib... that I am going to explain them in different presentation

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology4 жыл бұрын

  • Thank you very much

    @christianarriola2396@christianarriola23962 жыл бұрын

    • you are welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 жыл бұрын

  • Thanks

    @omerhaghussien4874@omerhaghussien4874 Жыл бұрын

  • Thank you!

    @letrinh226@letrinh226 Жыл бұрын

    • You are welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

  • thanks a lot

    @dvshrai@dvshrai Жыл бұрын

    • You are very welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

  • Is E' something that can change with various external parameters to the heart or is it something that is intrinsic to the heart itself, like a progressive marker of deterioration? I had diastolic dysfunction diagnosed in 2018 with septal E' of 13 and lateral E' of 18 and an E/A ratio of 0.8 with EF of 65%. In 2020 December I had another echocardiogram with EF of 70%, septal E' of 10.1 and lateral E' not listed. E/A ratio was 0.9. I've had significant exercise intolerance and exertional dyspnea that lasts for quite a while afterward since 2015 that began months following an infection + antibiotics. I have reason to believe ciprofloxacin caused the cardiac dysfunction because a year before that I had cardiac evaluation as an athlete with completely normal function at maximal intensity and a VO2 max of 52. The following year after the antibiotics and infection the VO2 max was 38.

    @matt566@matt5662 жыл бұрын

    • it is important to know other parameters (like myocardium thickness , Left Atrium size , ECG... ) talk to your cardiologist, but those findings are at normal range , specially if you are athletic and don't have any specific problem (like hypertension, ... ).

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 жыл бұрын

    • @@masteringEcho-US-cardiology I was athletic when I was younger but for the last 7 years since I became ill I have been extremely exercise intolerant. If I do something like cycling for more than like 30 seconds or 1 minute I get severely short of breath that lasts for hours and hours and have to go to the hospital. Then when I get there I just have tachycardia that persists for hours but they don't think anything else is wrong and they give me fluids then discharge me after several hours. My LAVI on the last echo was 14 (NR 16-32). thickness and walls are normal as far as I know. LVID IVCD LVIDs all like bottom end of normal range. My TAPSE is also below normal at 1.4 CM and has been that way for years.

      @matt566@matt5662 жыл бұрын

    • Another bizarre thing is that I had that echo at healthy capacity with no problems but then another echo one year after the problems started I had mitral valve regurgitation and in the years since I've seen tricuspid regurgitation, pulmonic regurgitation, and mild aortic leaflet calcification show up

      @matt566@matt5662 жыл бұрын

    • My E/A was > 1 up to 1.5 the first couple of years since being sick and now it is always < 1 now

      @matt566@matt5662 жыл бұрын

    • @@matt566 there are common almost majority of people have mild form of those. don't be obsessive with them unless they are moderate to severe

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 жыл бұрын

  • After the A wave I guess there's the mitral regurgitation, right? Thanks.

    @andreac5152@andreac5152 Жыл бұрын

    • we don't judge based on PW for regurgitation even though in significant MR it can pick up some

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

    • @@masteringEcho-US-cardiology can I ask what is that negative wave then? Thank you

      @andreac5152@andreac5152 Жыл бұрын

    • @@andreac5152 partially LVOT flow

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

    • Even sv is a little far from LVOT

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

    • @@masteringEcho-US-cardiology it's me again, tried to understand the issue even if I'm not a sonographer. It seem unreasonable that the LVOT flow can cause a negative wave(toward the atrium). I know that PW can't pickup fast velocities but being the point of measurement a little higher than the MV plane, maybe it can pick up a slight movement of blood toward the mitral valve caused by regurgitation. Is this possible? For instance this patient had at least mild regurgitation?

      @andreac5152@andreac5152 Жыл бұрын

  • Sir my suffering DD In heart. Please is it Clear problem sir please reply me

    @mohapatraabhijit8714@mohapatraabhijit87142 жыл бұрын

    • your cardiologist is the best source for info. if you have any specific question let me know

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 жыл бұрын

  • watch at 1.25 speed.

    @thecurrentology101@thecurrentology1014 жыл бұрын

    • thanks

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology4 жыл бұрын

  • I am a cardiac anesthesiologist TEE certified your lecture is better than MD lecture that is the truth you paid attention to details Thank yo. I am recently retired but still interested in ECHO Thank you

    @freecopt4003@freecopt40034 жыл бұрын

    • Hi Dr. Thank you for your feedback.

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology4 жыл бұрын

    • @@masteringEcho-US-cardiology you deserve it thank you. I remember when i took my TEE board my favorite ultrasound physics and its equation was written by a technician. I remember he was from Arizona but was the reason I passed from the 1st time I took it. Honestly doctors take credits for things were done by their helpers that is the truth and I know it and always said I never could do my job without every one of my team Thank you

      @freecopt4003@freecopt40034 жыл бұрын

  • Sir how can ı adjust sample size??

    @user-qh7oo3xy4d@user-qh7oo3xy4d2 ай бұрын

    • Depends on machine go to different page of control panel and find sample volume options and change it

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology2 ай бұрын

    • @@masteringEcho-US-cardiology thank you

      @user-qh7oo3xy4d@user-qh7oo3xy4d2 ай бұрын

  • @codrut913@codrut91310 ай бұрын

  • Diostolic dysfunction grade 4😢😢 will I survive?

    @Lolvideo1232@Lolvideo1232 Жыл бұрын

    • first make sure what is diagnosis ( it is a finding not diagnosis) for example if it is because of hypertrophy cardiomyopathy with correct treatment you will have almost the same survival as other normal people .

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

  • Sir i am a big fan of your lectures.. I recently joined and subscribed your channel.. One issue is that i cant be able to play all videos?? There is an error saying to join the channel.. Kindly guide me how i should join your channel??

    @fatimanaseer8217@fatimanaseer8217 Жыл бұрын

    • Hi Fatima, Thanks. yes, some videos belong to members. just click on JOIN button then it gives you two option then follow through. welcome to the group

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

    • @@masteringEcho-US-cardiology sir where should i find this join button as i have gone through whole of your channel but couldnt find it.. Kindly guide me as your channel is helping alot to learn echo and i want to watch all of your vidoes and learn them by heart.. Kindly guide me.. Thanks in advance

      @fatimanaseer8217@fatimanaseer8217 Жыл бұрын

    • @@fatimanaseer8217 in channel or under clip there is join button if there isn't click on following link kzhead.info/tools/bG7LU-o9zrIXH5wWYKEMYQ.htmljoin if it didn't work try with another web browser let me know if it worked tnx

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

    • @@masteringEcho-US-cardiology sir link doesnt opens and if i type the whole link in google it says channel doesnt exist.. Neither using anyother browser gives option to join this channel.. In short it didnt work

      @fatimanaseer8217@fatimanaseer8217 Жыл бұрын

    • @@fatimanaseer8217 sorry to here that , we have this problem with some country and regions, if you give me favor and contact youtube support I am sure they can help you. thanks

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

  • How to joint the channel

    @dikraaldobai4856@dikraaldobai4856 Жыл бұрын

    • Hi. Just in the channel click on Join button, here is: kzhead.info/sun/e5SDhqirr4OkoYE/bejne.html welcome to the group

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

  • How can i join the community

    @johnkabengele4628@johnkabengele46288 ай бұрын

    • In channel click on join button (under any clips or at top) then follow it . Welcome to the group

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology8 ай бұрын

  • HFrEF criteria is EF

    @emessawmte4613@emessawmte46134 жыл бұрын

    • BAsed on 2017 ACC/AHA/HFSA CRITERIA FOR EF IS

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology4 жыл бұрын

    • @@masteringEcho-US-cardiology i did, not find a change in the definition of heart failure in acc guideline 2017. Can you give me your source?

      @emessawmte4613@emessawmte46134 жыл бұрын

    • @@emessawmte4613 CHECK OUT THESE: www.acc.org/latest-in-cardiology/ten-points-to-remember/2017/04/27/15/50/2017-acc-aha-hfsa-focused-update-of-hf-guideline www.heart.org/-/media/files/affiliates/swa/qi-files/guidelines-for-prevention--management-of-heart-failure.pdf?la=en&hash=23BC75960E457B587BE0B7452D6FB1BD68BA20BE www.acoi.org/sites/default/files/uploads/LinkCHF.pdf

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology4 жыл бұрын

    • @@masteringEcho-US-cardiology this data were for update in management of heart failure, not for definition. Data are limited for Mid range Ef 40-50%

      @emessawmte4613@emessawmte46134 жыл бұрын

    • @@emessawmte4613 THAT'S RIGHT

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology4 жыл бұрын

  • Sir what is normal A duration value?

    @kishankotadiya3879@kishankotadiya3879 Жыл бұрын

    • A duration depends on age, gender, heart rate .. and it doesn't have normal range. the most important issue with A dur is Ar- A : if it goes over 30 ms it strongly suggests high LVEDP

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

    • Sir so we can't calculate A duration in LVDD like other parameters E velocity,A velocity,E/A ratio , IVRT,DT etc right?

      @kishankotadiya3879@kishankotadiya3879 Жыл бұрын

    • We do but based on new guideline we don't use it regularly unless in those pts with arrhythmia, sepsis,, on ventilator,... . In these cases beside of other parameters ( IVRT, S', DT, S, D waves ..) we measure A dur & Ar dur too. (check the part 3 lecture in diastolic dysfunction

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

    • Okk thank you sir

      @kishankotadiya3879@kishankotadiya3879 Жыл бұрын

    • @@kishankotadiya3879 any time

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын

  • Sir me bahut pareshan hu pls mere help kar dijije😭 sir sach me bahut jyada pareshan hu sir maine apne echo test karaya tha usme mera ejection fraction toh 58 percent aaya h pr lvdd present likhkar aaya h dir mujhe ye samaj n aa rha mujhe kis grade ka lvdd h kaise pata kru

    @VarunvarshaYadav@VarunvarshaYadav3 ай бұрын

    • your ejection fraction is normal, how much was LVDD?

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology3 ай бұрын

    • @@masteringEcho-US-cardiology sir bs lvdd present likha hai kitna h ye nhi likha n hi grade likha h

      @VarunvarshaYadav@VarunvarshaYadav3 ай бұрын

    • @@VarunvarshaYadav so why you are worry. I don't see anything that makes you feel like that. even why don't you ask your Dr?

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology3 ай бұрын

    • @@masteringEcho-US-cardiology sir app report dekh lenge

      @VarunvarshaYadav@VarunvarshaYadav3 ай бұрын

    • Sir unhone kuch bola hi nhi

      @VarunvarshaYadav@VarunvarshaYadav3 ай бұрын

  • Thank you sir

    @saurabhmishra6514@saurabhmishra65143 жыл бұрын

    • you are welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology3 жыл бұрын

  • Thank you very much

    @dmohamed81@dmohamed81 Жыл бұрын

    • you are very welcome

      @masteringEcho-US-cardiology@masteringEcho-US-cardiology Жыл бұрын
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