51
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Miskinyte E, Bucius P, Erley J, Zamani SM, Tanacli R, Stehning C, Schneeweis C, Lapinskas T, Pieske B, Falk V, Gebker R, Pedrizzetti G, Solowjowa N, Kelle S. Assessment of Global Longitudinal and Circumferential Strain Using Computed Tomography Feature Tracking: Intra-Individual Comparison with CMR Feature Tracking and Myocardial Tagging in Patients with Severe Aortic Stenosis. J Clin Med 2019; 8:jcm8091423. [PMID: 31509951 PMCID: PMC6780556 DOI: 10.3390/jcm8091423] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/29/2019] [Accepted: 09/05/2019] [Indexed: 12/31/2022] Open
Abstract
In this study, we used a single commercially available software solution to assess global longitudinal (GLS) and global circumferential strain (GCS) using cardiac computed tomography (CT) and cardiac magnetic resonance (CMR) feature tracking (FT). We compared agreement and reproducibility between these two methods and the reference standard, CMR tagging (TAG). Twenty-seven patients with severe aortic stenosis underwent CMR and cardiac CT examinations. FT analysis was performed using Medis suite version 3.0 (Leiden, The Netherlands) software. Segment (Medviso) software was used for GCS assessment from tagged images. There was a trend towards the underestimation of GLS by CT-FT when compared to CMR-FT (19.4 ± 5.04 vs. 22.40 ± 5.69, respectively; p = 0.065). GCS values between TAG, CT-FT, and CMR-FT were similar (p = 0.233). CMR-FT and CT-FT correlated closely for GLS (r = 0.686, p < 0.001) and GCS (r = 0.707, p < 0.001), while both of these methods correlated moderately with TAG for GCS (r = 0.479, p < 0.001 for CMR-FT vs. TAG; r = 0.548 for CT-FT vs. TAG). Intraobserver and interobserver agreement was excellent in all techniques. Our findings show that, in elderly patients with severe aortic stenosis (AS), the FT algorithm performs equally well in CMR and cardiac CT datasets for the assessment of GLS and GCS, both in terms of reproducibility and agreement with the gold standard, TAG.
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Affiliation(s)
- Emilija Miskinyte
- Department of Internal Medicine/Cardiology, German Heart Center Berlin, 13353 Berlin, Germany
| | - Paulius Bucius
- Department of Internal Medicine/Cardiology, German Heart Center Berlin, 13353 Berlin, Germany
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania
| | - Jennifer Erley
- Department of Internal Medicine/Cardiology, German Heart Center Berlin, 13353 Berlin, Germany
| | - Seyedeh Mahsa Zamani
- Department of Internal Medicine/Cardiology, German Heart Center Berlin, 13353 Berlin, Germany
| | - Radu Tanacli
- Department of Internal Medicine/Cardiology, German Heart Center Berlin, 13353 Berlin, Germany
| | | | - Christopher Schneeweis
- Klinik für Kardiologie und Internistische Intesivmedizin, Krankenhaus der Augustinerinnen, 50678 Köln, Germany
| | - Tomas Lapinskas
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania
| | - Burkert Pieske
- Department of Internal Medicine/Cardiology, German Heart Center Berlin, 13353 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany
- Department of Internal Medicine/Cardiology, Charité Campus Virchow Clinic, 13353 Berlin, Germany
| | - Volkmar Falk
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany
- Department of Cardiothoracic Surgery, German Heart Center Berlin, 13353 Berlin, Germany
| | - Rolf Gebker
- Department of Internal Medicine/Cardiology, German Heart Center Berlin, 13353 Berlin, Germany
| | - Gianni Pedrizzetti
- Department of Engineering and Architecture, University of Trieste, 34127 Trieste, Italy
| | - Natalia Solowjowa
- Department of Cardiothoracic Surgery, German Heart Center Berlin, 13353 Berlin, Germany
| | - Sebastian Kelle
- Department of Internal Medicine/Cardiology, German Heart Center Berlin, 13353 Berlin, Germany.
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany.
- Department of Internal Medicine/Cardiology, Charité Campus Virchow Clinic, 13353 Berlin, Germany.
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Vermersch M, Longère B, Coisne A, Schmidt M, Forman C, Monnet A, Pagniez J, Silvestri V, Simeone A, Cheasty E, Montaigne D, Pontana F. Compressed sensing real-time cine imaging for assessment of ventricular function, volumes and mass in clinical practice. Eur Radiol 2019; 30:609-619. [DOI: 10.1007/s00330-019-06341-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 05/01/2019] [Accepted: 06/26/2019] [Indexed: 02/02/2023]
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53
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Johnson C, Kuyt K, Oxborough D, Stout M. Practical tips and tricks in measuring strain, strain rate and twist for the left and right ventricles. Echo Res Pract 2019; 6:R87-R98. [PMID: 31289687 PMCID: PMC6612062 DOI: 10.1530/erp-19-0020] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 06/13/2019] [Indexed: 01/05/2023] Open
Abstract
Strain imaging provides an accessible, feasible and non-invasive technique to assess cardiac mechanics. Speckle tracking echocardiography (STE) is the primary modality with the utility for detection of subclinical ventricular dysfunction. Investigation and adoption of this technique has increased significantly in both the research and clinical environment. It is therefore important to provide information to guide the sonographer on the production of valid and reproducible data. The focus of this review is to (1) describe cardiac physiology and mechanics relevant to strain imaging, (2) discuss the concepts of strain imaging and STE and (3) provide a practical guide for the investigation and interpretation of cardiac mechanics using STE.
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Affiliation(s)
- Christopher Johnson
- Research institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Katherine Kuyt
- School of Healthcare Science, Manchester Metropolitan University, Manchester, UK
| | - David Oxborough
- Research institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Martin Stout
- School of Healthcare Science, Manchester Metropolitan University, Manchester, UK
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54
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Mirea O, Corîci OM, Berceanu M, Donoiu I, Militaru C, Istratoaie O. Variability of longitudinal strain measurements: levelling the playing field. Acta Cardiol 2019; 74:188-197. [PMID: 29914297 DOI: 10.1080/00015385.2018.1480469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Speckle tracking echocardiography offers a unique opportunity to evaluate myocardial function, and global longitudinal strain (GLS) is currently recommended as a measurement of global left ventricular function. To facilitate clinical applicability of the method, collective efforts have been made to standardise strain measurements and to raise awareness of the potential sources of variability. The purpose of this review is to familiarise the reader with the most common sources of variability of longitudinal strain measurements and detail the possible measures to increase the accuracy and reproducibility of strain parameters.
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Affiliation(s)
- Oana Mirea
- Department of Cardiology, Emergency County Hospital Craiova, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Oana Maria Corîci
- Department of Physiology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Mihaela Berceanu
- Department of Cardiology, Emergency County Hospital Craiova, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Ionuţ Donoiu
- Department of Cardiology, Emergency County Hospital Craiova, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Constantin Militaru
- Department of Cardiology, Emergency County Hospital Craiova, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Octavian Istratoaie
- Department of Cardiology, Emergency County Hospital Craiova, University of Medicine and Pharmacy of Craiova, Craiova, Romania
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55
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Emerek K, Friedman DJ, Sørensen PL, Hansen SM, Larsen JM, Risum N, Thøgersen AM, Graff C, Atwater BD, Kisslo J, Søgaard P. The Association of a classical left bundle Branch Block Contraction Pattern by vendor-independent strain echocardiography and outcome after cardiac resynchronization therapy. Cardiovasc Ultrasound 2019; 17:10. [PMID: 31113440 PMCID: PMC6530090 DOI: 10.1186/s12947-019-0160-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/16/2019] [Indexed: 02/05/2023] Open
Abstract
Background The association of a Classical left bundle branch block (LBBB) contraction pattern and better outcome after cardiac resynchronization therapy (CRT) has only been studied using vendor-specific software for echocardiographic speckle-tracked longitudinal strain analysis. The purpose of this study was to assess whether a Classical LBBB contraction pattern on longitudinal strain analysis using vendor-independent software is associated with clinical outcome in CRT recipients with LBBB. Methods This was a retrospective cohort study including CRT recipients with LBBB, heart failure, and left ventricular (LV) ejection fraction ≤35%. Speckle-tracked echocardiographic longitudinal strain analysis was performed retrospectively on echocardiograms using vendor-independent software. The presence of a Classical LBBB contraction pattern was determined by consensus of two readers. The primary end point was a composite of time to death, heart transplantation or LV assist device implantation. Secondary outcome was ≥15% reduction in LV end-systolic volume. Intra- and inter-reader agreement of the longitudinal strain contraction pattern was assessed by calculating Cohen’s κ. Results Of 283 included patients, 113 (40%) were women, mean age was 66 ± 11 years, and 136 (48%) had ischemic heart disease. A Classical LBBB contraction pattern was present in 196 (69%). The unadjusted hazard ratio for reaching the primary end point was 1.93 (95% confidence interval, 1.36–2.76, p < 0.001) when comparing patients without to patients with a Classical LBBB contraction pattern. Adjusted for ischemic heart disease and QRS duration < 150 milliseconds the hazard ratio was 1.65 (95% confidence interval, 1.12–2.43, p = 0.01). Of the 123 (43%) patients with a follow-up echocardiogram, 64 of 85 (75%) of patients with a Classical LBBB contraction pattern compared to 13 of 38 (34%) without, had ≥15% reduction in LV end-systolic volume (p < 0.001). Cohen’s κ were 0.86 (95% confidence interval, 0.71–1.00) and 0.42 (95% confidence interval, 0.30–0.54) for intra- and inter-reader agreement, respectively. Conclusion Using vendor-independent strain software, a Classical LBBB contraction pattern is associated with better outcome in CRT recipients with LBBB, but inter-reader agreement for the classification of contraction pattern is only moderate.
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Affiliation(s)
- Kasper Emerek
- Department of Medicine, Division of Cardiology, Duke University Hospital, Durham, NC, USA. .,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Daniel J Friedman
- Department of Medicine, Division of Cardiology, Duke University Hospital, Durham, NC, USA
| | - Peter L Sørensen
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Steen M Hansen
- Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Jacob M Larsen
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Niels Risum
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | | | - Claus Graff
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Brett D Atwater
- Department of Medicine, Division of Cardiology, Duke University Hospital, Durham, NC, USA
| | - Joseph Kisslo
- Department of Medicine, Division of Cardiology, Duke University Hospital, Durham, NC, USA
| | - Peter Søgaard
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
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Coller JM, Gong FF, McGrady M, Jelinek MV, Castro JM, Boffa U, Shiel L, Liew D, Stewart S, Krum H, Reid CM, Prior DL, Campbell DJ. Age-specific diastolic dysfunction improves prediction of symptomatic heart failure by Stage B heart failure. ESC Heart Fail 2019; 6:747-757. [PMID: 31094087 PMCID: PMC6676278 DOI: 10.1002/ehf2.12449] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/26/2019] [Accepted: 04/21/2019] [Indexed: 02/05/2023] Open
Abstract
Aims We investigated whether addition of diastolic dysfunction (DD) and longitudinal strain (LS) to Stage B heart failure (SBHF) criteria (structural or systolic abnormality) improves prediction of symptomatic HF in participants of the SCReening Evaluation of the Evolution of New Heart Failure study, a self‐selected population at increased cardiovascular disease risk recruited from members of a health insurance fund in Melbourne and Shepparton, Australia. Both American Society of Echocardiography and European Association of Cardiovascular Imaging (ASE/EACVI) criteria and age‐specific Atherosclerosis Risk in Communities (ARIC) study criteria, for SBHF and DD, and ARIC criteria for abnormal LS, were examined. Methods and results Inclusion criteria were age ≥60 years with one or more of self‐reported ischaemic or other heart disease, irregular or rapid heart rhythm, cerebrovascular disease, renal impairment, or treatment for hypertension or diabetes for ≥2 years. Exclusion criteria were known HF, or ejection fraction <50% or >mild valve abnormality detected on previous echocardiography or other imaging. Echocardiography was performed in 3190 participants who were followed for a median of 3.9 (interquartile range: 3.4, 4.5) years after echocardiography. Symptomatic HF was diagnosed in 139 participants at a median of 3.1 (interquartile range: 2.1, 3.9) years after echocardiography. ARIC structural, systolic, and diastolic abnormalities predicted HF in univariate and multivariable proportional hazards analyses, whereas ASE/EACVI structural and systolic, but not diastolic, abnormalities predicted HF. ARIC and ASE/EACVI SBHF criteria predicted HF with sensitivities of 81% and 55%, specificities of 39% and 76%, and C statistics of 0.60 (95% confidence interval: 0.57, 0.64) and 0.66 (0.61, 0.71), respectively. Adding ARIC DD to SBHF increased sensitivity to 94% with specificity of 24% and C statistic of 0.59 (0.57, 0.61), whereas addition of ASE/EACVI DD to SBHF increased sensitivity to 97% but reduced specificity to 9% and the C statistic to 0.52 (0.50, 0.54, P < 0.0001). Addition of LS to ARIC or ASE/EACVI SBHF criteria had minimal impact on prediction of HF. Conclusions Age‐specific ARIC DD criteria, but not ASE/EACVI DD criteria, predicted symptomatic HF, and addition of age‐specific ARIC DD criteria to ARIC SBHF criteria improved prediction of symptomatic HF in asymptomatic individuals with cardiovascular disease risk factors. Addition of LS to ASE/EACVI or ARIC SBHF criteria did not improve prediction of symptomatic HF.
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Affiliation(s)
- Jennifer M Coller
- Department of Cardiology, St. Vincent's Hospital, Melbourne, Australia
| | - Fei Fei Gong
- Department of Cardiology, St. Vincent's Hospital, Melbourne, Australia.,Molecular Cardiology, St. Vincent's Institute of Medical Research, 41 Victoria Parade, Fitzroy, Victoria, 3065, Australia.,Department of Medicine, University of Melbourne, Parkville, Australia
| | - Michele McGrady
- Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Michael V Jelinek
- Department of Cardiology, St. Vincent's Hospital, Melbourne, Australia.,Department of Medicine, University of Melbourne, Parkville, Australia
| | - Julian M Castro
- Department of Cardiology, St. Vincent's Hospital, Melbourne, Australia
| | - Umberto Boffa
- School of Public Health and Preventive Medicine, Monash University, Prahran, Australia
| | - Louise Shiel
- School of Public Health and Preventive Medicine, Monash University, Prahran, Australia
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, Prahran, Australia
| | - Simon Stewart
- Department of Cardiology, The Queen Elizabeth Hospital, Adelaide, Australia
| | - Henry Krum
- School of Public Health and Preventive Medicine, Monash University, Prahran, Australia
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Prahran, Australia.,School of Public Health, Curtin University, Bentley, Australia
| | - David L Prior
- Department of Cardiology, St. Vincent's Hospital, Melbourne, Australia.,Department of Medicine, University of Melbourne, Parkville, Australia
| | - Duncan J Campbell
- Department of Cardiology, St. Vincent's Hospital, Melbourne, Australia.,Molecular Cardiology, St. Vincent's Institute of Medical Research, 41 Victoria Parade, Fitzroy, Victoria, 3065, Australia.,Department of Medicine, University of Melbourne, Parkville, Australia
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Enzensberger C, Rostock L, Graupner O, Götte M, Wolter A, Vorisek C, Herrmann J, Axt-Fliedner R. Wall motion tracking in fetal echocardiography-Application of low and high frame rates for strain analysis. Echocardiography 2018; 36:386-393. [PMID: 30585350 DOI: 10.1111/echo.14238] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 11/05/2018] [Accepted: 11/25/2018] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE Compared to adults, fetal heart rates (HR) are elevated necessitating higher frame rates (FR) for strain analysis by speckle tracking echocardiography. The aim of this study was to investigate the influence of high FR compared to low FR on strain analysis in 2D speckle tracking. METHODS Fetal echocardiography was prospectively performed and acquired from the apical or basal four-chamber views of the heart. Images were optimized for clear delineation of myocardial walls and stored in either raw Digital Imaging and Communications in Medicine (DICOM) cine-loop format for offline analysis with a low FR of 60 frames per second (fps) or in the original FR (acoustic FR = AFR). For each loop, right (RV) and left (LV) ventricular fetal longitudinal peak systolic strain (LPSS) values were assessed by 2D Wall Motion tracking. RESULTS One hundred and three healthy fetuses were included with a mean gestational age of 26.3 ± 5.5 weeks. Mean AFR was 127 ± 26 fps. A mean FR/HR ratio was assessed of 0.42 and 0.90 between the low FR and AFR group, respectively. Relating to LPSS values, there was a significant difference between low FR and AFR for both ventricles (LV: -16.5% ± 3.9% (low FR) vs -13.6% ± 3.5% (AFR); and RV: -15.1% ± 3.6% (low FR) vs -12.6% ± 3.7% (AFR), both P < 0.001). CONCLUSIONS Fetal LV and RV LPSS values derived with high AFR were significantly lower than corresponding LPSS values analyzed with low FR of 60 fps. Future studies are needed to clarify the clinical importance of this relationship.
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Affiliation(s)
- Christian Enzensberger
- Department of OB/GYN, Division of Prenatal Medicine, University Hospital UKGM, Justus-Liebig University, Giessen, Germany
| | - Laura Rostock
- Department of OB/GYN, Division of Prenatal Medicine, University Hospital UKGM, Justus-Liebig University, Giessen, Germany
| | - Oliver Graupner
- Department of OB/GYN, University Hospital, Klinikum rechts der Isar, Technische Universität, München, Germany
| | - Malena Götte
- Department of OB/GYN, Division of Prenatal Medicine, University Hospital UKGM, Justus-Liebig University, Giessen, Germany
| | - Aline Wolter
- Department of OB/GYN, Division of Prenatal Medicine, University Hospital UKGM, Justus-Liebig University, Giessen, Germany
| | - Carina Vorisek
- Department of OB/GYN, Division of Prenatal Medicine, University Hospital UKGM, Justus-Liebig University, Giessen, Germany
| | | | - Roland Axt-Fliedner
- Department of OB/GYN, Division of Prenatal Medicine, University Hospital UKGM, Justus-Liebig University, Giessen, Germany
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van Grootel RWJ, Strachinaru M, Menting ME, McGhie J, Roos-Hesselink JW, van den Bosch AE. In-depth echocardiographic analysis of left atrial function in healthy adults using speckle tracking echocardiography and volumetric analysis. Echocardiography 2018; 35:1956-1965. [PMID: 30376599 PMCID: PMC6587812 DOI: 10.1111/echo.14174] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 09/25/2018] [Accepted: 09/27/2018] [Indexed: 12/21/2022] Open
Abstract
Purpose Left atrial (LA) dilatation is predictive for complications in a multitude of cardiac diseases; therefore, adequate assessment is essential. Technological advances have made it possible to quantify LA function with Speckle Tracking Echocardiography (STE); however, there are currently no recommendations for normal values with regard to LA function. We aimed to assess LA myocardial and volumetric function in a healthy cohort and investigate correlations with baseline characteristics. Methods This prospective cohort study included 147 (aged 20–72) healthy individuals and assessed LA volumetric function using maximum, minimum and pre‐a‐wave volumes and myocardial function using reservoir function using peak strain in LA relaxation (LA‐strain), conduit function using peak strain rate in early LA contraction (LA‐SRe) and pump function using peak strain rate in late LA contraction (LA‐SRa). Results Mean LA‐strain was 39.7 ± 6.2%, LA‐SRe −2.78 ± 0.62 s−1 and LA‐SRa −2.56 ± 0.62 s−1. Subjects were divided into 5 age decades (each 50% female). LA‐strain and LA‐SRe were lower in the oldest groups, whereas LA‐SRa was higher. LA‐SRa was higher in males(−2.69 ± 0.68 s−1 vs −2.42 ± 0.52 s−1). Age‐specific values are provided. Age proved to be an independent predictor for LA‐SRa after correction for blood pressure and heart rate. LA expansion index and passive emptying fraction decreased with age, while active emptying fraction increased with age. LA maximum volume did not increase with age. Conclusion This study provides normal values for the three phasic functions of the LA, assessed with STE and volumetric function. Our results suggest the need for age‐specific reference ranges, and normal values for this cohort have been calculated.
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Affiliation(s)
| | | | | | - Jackie McGhie
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
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Rösner A, Khalapyan T, Pedrosa J, Dalen H, McElhinney DB, Friedberg MK, Lui GK. Ventricular mechanics in adolescent and adult patients with a Fontan circulation: Relation to geometry and wall stress. Echocardiography 2018; 35:2035-2046. [DOI: 10.1111/echo.14169] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 01/30/2023] Open
Affiliation(s)
- Assami Rösner
- Department of Cardiology; Division of Cardiothoracic and Respiratory Medicine; University Hospital of North Norway; Tromsø Norway
| | - Tigran Khalapyan
- Department of Cardiothoracic Surgery; Stanford University School of Medicine; Stanford California
| | - João Pedrosa
- Department of Cardiovascular Sciences; K.U. Leuven; Leuven Belgium
| | - Håvard Dalen
- Department of Medicine; Levanger Hospital; Nord-Trøndelag Hospital Trust; Levanger Norway
- Department of Cardiology; St. Olav's University Hospital; Trondheim Norway
- Department of Circulation and Medical Imaging; Norwegian University of Science and Technology; Trondheim Norway
| | - Doff B. McElhinney
- Division of Pediatric Cardiology; Department of Pediatrics; Stanford University School of Medicine; Stanford California
| | - Mark K. Friedberg
- Division of Pediatric Cardiology; Hospital for Sick Children; Toronto Ontario Canada
| | - George K. Lui
- Division of Pediatric Cardiology; Department of Pediatrics; Stanford University School of Medicine; Stanford California
- Division of Cardiovascular Medicine; Department of Medicine; Stanford University School of Medicine; Stanford California
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Zmigrodzki J, Cygan S, Wilczewska A, Kaluzynski K. Quantitative Assessment of the Effect of the Out-of-Plane Movement of the Homogenous Ellipsoidal Model of the Left Ventricle on the Deformation Measures Estimated Using 2-D Speckle Tracking-An In-Silico Study. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2018; 65:1789-1803. [PMID: 30010558 DOI: 10.1109/tuffc.2018.2856127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Effect of the out-of-plane (OOP) movement amplitude on estimates of global displacements (radial, circumferential) and strains (radial , circumferential ) was studied in an ellipsoidal model of the left ventricle using finite-element modeling (FEM), synthetic ultrasonic data, and short-axis view. This effect was assessed using median of the absolute relative error (RE) of the global parameters. FEM provided node displacements for synthetic ultrasonic data and reference data generation. Displacements were estimated using block-matching (BM) and B-spline (BS) methods. FEM-derived data analysis, free from errors resulting from speckle tracking, indicated that the tissue motion introduced REs of global strain estimates below 4.5%. The effect of the OOP motion amplitude on strain estimates was strain specific and depended on the displacement estimation method. In the case of , the increase of the OOP amplitude resulted in quasi-linear increase of the RE from approximately 10% to 15%. The modulus of the end-systolic (ES) errors of the estimates almost linearly increased with increasing OOP amplitude approximately from 10% to 16%. REs of the estimate were close to 80% and 40%, respectively, in the case of the BM and BS methods, and increased with increasing OOP amplitude. The modulus of the ES errors of the estimates in the case of the BS method was about -40% and showed low sensitivity to the OOP amplitude; in the BM case, these errors varied approximately from -70% to -58% for OOP amplitude from 0 to 15 mm.
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Amzulescu MS, Langet H, Saloux E, Manrique A, Slimani A, Allain P, Roy C, de Meester C, Pasquet A, Somphone O, De Craene M, Vancraeynest D, Pouleur AC, Vanoverschelde JL, Gerber BL. Improvements of Myocardial Deformation Assessment by Three-Dimensional Speckle-Tracking versus Two-Dimensional Speckle-Tracking Revealed by Cardiac Magnetic Resonance Tagging. J Am Soc Echocardiogr 2018; 31:1021-1033.e1. [DOI: 10.1016/j.echo.2018.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Indexed: 01/15/2023]
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Abstract
PURPOSE OF REVIEW The assessment of left ventricular function by two-dimensional (2D) transthoracic echocardiography (TTE) is conventionally performed by measuring the ejection fraction, which has been shown to have important prognostic implications. However, left ventricular ejection fraction (LVEF) has notable shortcomings, including limited reproducibility, suboptimal inter/intraobserver variability and dependence on load/volume. Furthermore, subclinical left ventricular dysfunction cannot be measured with LVEF. With the advent of left ventricular deformation (strain) analysis, a new and robust means for assessing left ventricular function has emerged. RECENT FINDINGS Contemporary research and guidelines have attempted to standardize the definition, acquisition and measurement of left ventricular strain. In addition, multiple studies have sought to establish normal values for left ventricular strain in addition to evaluating the benefits and prognostic value of strain assessment. SUMMARY This article reviews the definition of left ventricular strain, outlines the types of strain and reviews how strain is acquired and measured. In addition, the advantages of strain analysis over LVEF as well as the incremental prognostic value of strain are examined. We further review the challenges associated with strain imaging as well as outline the future of strain imaging.
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Dons M, Jensen JS, Olsen FJ, de Knegt MC, Fritz-Hansen T, Vazir A, Biering-Sørensen T. Global longitudinal strain corrected by RR-interval is a superior echocardiographic predictor of outcome in patients with atrial fibrillation. Int J Cardiol 2018; 263:42-47. [DOI: 10.1016/j.ijcard.2018.02.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 12/29/2017] [Accepted: 02/09/2018] [Indexed: 12/16/2022]
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Wilke L, Abellan Schneyder FE, Roskopf M, Jenke AC, Heusch A, Hensel KO. Speckle tracking stress echocardiography in children: interobserver and intraobserver reproducibility and the impact of echocardiographic image quality. Sci Rep 2018; 8:9185. [PMID: 29907818 PMCID: PMC6003923 DOI: 10.1038/s41598-018-27412-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 06/03/2018] [Indexed: 11/09/2022] Open
Abstract
Speckle tracking echocardiography (STE) is increasingly used during functional assessments. However, reproducibility and dependence on echocardiographic image quality for speckle tracking stress echocardiography in pediatric patients have not been studied to date. 127 consecutive normotensive children without structural heart disease (mean age 13.4 ± 3.0 years, 50.4% female) underwent a stepwise semisupine cycle ergometric protocol. Left ventricular (LV) myocardial peak strain and strain rate were assessed at rest and during exercise. Interobserver and intraobserver assessments were performed and analyzed regarding echocardiographic image quality. LV peak global strain and strain rate were well reproducible with narrow limits of agreement without any significant bias both at rest and during all stages of exercise testing. Moreover, strain rate reproducibility slightly deteriorated in values between -1.5 and -3 s-1. Surprisingly, there was no significant difference in reproducibility between optimal, intermediate and poor quality of echocardiographic images. STE derived strain and strain rate measurements in children are feasible and highly reproducible during semisupine cycle ergometric stress echocardiography. Echocardiographic image quality does not seem to influence strain (rate) reproducibility. Myocardial deformation measurements in images with suboptimal visualization quality must be interpreted with caution.
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Affiliation(s)
- Lucia Wilke
- HELIOS University Medical Center Wuppertal, Children's Hospital, Center for Clinical & Translational Research (CCTR), Witten/Herdecke University, Witten, Germany
| | - Francisca E Abellan Schneyder
- HELIOS University Medical Center Wuppertal, Children's Hospital, Center for Clinical & Translational Research (CCTR), Witten/Herdecke University, Witten, Germany
| | - Markus Roskopf
- HELIOS University Medical Center Wuppertal, Children's Hospital, Center for Clinical & Translational Research (CCTR), Witten/Herdecke University, Witten, Germany
| | - Andreas C Jenke
- EKO Children's Hospital, Witten/Herdecke University, Oberhausen, Germany
| | - Andreas Heusch
- HELIOS University Medical Center Wuppertal, Children's Hospital, Center for Clinical & Translational Research (CCTR), Witten/Herdecke University, Witten, Germany
| | - Kai O Hensel
- HELIOS University Medical Center Wuppertal, Children's Hospital, Center for Clinical & Translational Research (CCTR), Witten/Herdecke University, Witten, Germany. .,University of Cambridge, Addenbrooke's Hospital, Department of Paediatrics, Cambridge, UK.
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Mansour MJ, AlJaroudi W, Hamoui O, Chaaban S, Chammas E. Multimodality imaging for evaluation of chest pain using strain analysis at rest and peak exercise. Echocardiography 2018; 35:1157-1163. [PMID: 29648692 DOI: 10.1111/echo.13885] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Exercise stress echocardiography (SE) is commonly used for diagnosing coronary artery disease (CAD). The use of quantitative echocardiographic measures such as strain imaging is expected to improve the sensitivity of conventional SE which relies on the visual diagnosis of wall-motion abnormalities (WMAs). This study is set to demonstrate the added value of resting and exercise strain analysis to detect underlying microangiopathy and inducible myocardial ischemia during a resting and SE in comparison with the results of coronary computed tomographic angiogram (CCTA). METHODS A total of 103 consecutive outpatients from the executive screening program were identified and underwent resting and SE. Global longitudinal strain (GLS) and wall-motion changes at rest and peak exercise were analyzed and compared. Baseline demographics, heart rate, and blood pressure measurements were retrospectively extracted for analysis. CCTA was chosen as an alternative test to match with wall motion and strain imaging. RESULTS Patients who had abnormal CCTA had lower resting GLS (14.85% ± 3.05 vs 17.99% ± 2.88, P-value = .001) when compared to patients with normal CCTA. All patients who had abnormal CCTA had higher wall-motion score index (1.35 ± 0.2 vs 1.00, P-value < .0001) and lower and abnormal peak stress GLS (pGLS) as compared to patients with normal CCTA (14.89% ± 3.35 vs 18.44% ± 4.27, P-value = .007). However, all patients with pGLS ≥ 20% had normal/nonobstructive CCTA. Patients with multiple comorbidities showed reduced and lower values of resting and pGLS (P-value < .0001), suggesting associated subclinical left ventricular dysfunction. CONCLUSIONS Global longitudinal strain offers quantitative interpretation of the resting and SE study, detects underlying subclinical left ventricular dysfunction and a peak stress value more than 20% excludes obstructive CAD on CCTA.
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Affiliation(s)
- Mohamad Jihad Mansour
- Division of Cardiology, Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon.,Division of Cardiovascular Medicine, Clemenceau Medical Center, Beirut, Lebanon
| | - Wael AlJaroudi
- Division of Cardiovascular Medicine, Clemenceau Medical Center, Beirut, Lebanon
| | - Omar Hamoui
- Division of Cardiovascular Medicine, Clemenceau Medical Center, Beirut, Lebanon
| | - Sarah Chaaban
- Division of Cardiovascular Medicine, Clemenceau Medical Center, Beirut, Lebanon
| | - Elie Chammas
- Division of Cardiology, Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon.,Division of Cardiovascular Medicine, Clemenceau Medical Center, Beirut, Lebanon
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Hodzic A, Chayer B, Wang D, Porée J, Cloutier G, Milliez P, Normand H, Garcia D, Saloux E, Tournoux F. Accuracy of speckle tracking in the context of stress echocardiography in short axis view: An in vitro validation study. PLoS One 2018; 13:e0193805. [PMID: 29584751 PMCID: PMC5870957 DOI: 10.1371/journal.pone.0193805] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 02/03/2018] [Indexed: 11/18/2022] Open
Abstract
Aim This study aimed to test the accuracy of a speckle tracking algorithm to assess myocardial deformation in a large range of heart rates and strain magnitudes compared to sonomicrometry. Methods and results Using a tissue-mimicking phantom with cyclic radial deformation, radial strain derived from speckle tracking (RS-SpT) of the upper segment was assessed in short axis view by conventional echocardiography (Vivid q, GE) and post-processed with clinical software (EchoPAC, GE). RS-SpT was compared with radial strain measured simultaneously by sonomicrometers (RS-SN). Radial strain was assessed with increasing deformation rates (60 to 160 beats/min) and increasing pulsed volumes (50 to 100 ml/beat) to simulate physiological changes occurring during stress echocardiography. There was a significant correlation (R2 = 0.978, P <0.001) and a close agreement (bias ± 2SD, 0.39 ± 1.5%) between RS-SpT and RS-SN. For low strain values (<15%), speckle tracking showed a small but significant overestimation of radial strain compared to sonomicrometers. Two-way analysis of variance did not show any significant effect of the deformation rate. For RS-SpT, the feasibility was excellent and the intra- and inter-observer variability were low (the intraclass correlation coefficients were 0.96 and 0.97, respectively). Conclusions Speckle tracking demonstrated a good correlation with sonomicrometry for the assessment of radial strain independently of the heart rate and strain magnitude in a physiological range of values. Though speckle tracking seems to be a reliable and reproducible technique to assess myocardial deformation variations during stress echocardiography, further studies are mandated to analyze the impact of angulated and artefactual out-of-plane motions and inter-vendor variability.
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Affiliation(s)
- Amir Hodzic
- Research Unit of Biomechanics and Imaging in Cardiology, University of Montreal Hospital Research Center, Montréal, Québec, Canada
- Department of Cardiology, Echocardiography Laboratory, University Hospital Center, Caen, France
- Inserm Comete, Unicaen, University of Caen Normandy, Caen, France
| | - Boris Chayer
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montréal, Québec, Canada
| | - Diya Wang
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montréal, Québec, Canada
| | - Jonathan Porée
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montréal, Québec, Canada
| | - Guy Cloutier
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montréal, Québec, Canada
| | - Paul Milliez
- Department of Cardiology, Echocardiography Laboratory, University Hospital Center, Caen, France
| | - Hervé Normand
- Inserm Comete, Unicaen, University of Caen Normandy, Caen, France
| | - Damien Garcia
- Research Unit of Biomechanics and Imaging in Cardiology, University of Montreal Hospital Research Center, Montréal, Québec, Canada
| | - Eric Saloux
- Department of Cardiology, Echocardiography Laboratory, University Hospital Center, Caen, France
| | - Francois Tournoux
- Department of Cardiology, Echocardiography Laboratory, Hospital of the University of Montréal, Montréal, Québec, Canada
- * E-mail:
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Rösner A, Khalapyan T, Dalen H, McElhinney DB, Friedberg MK, Lui GK. Classic-Pattern Dyssynchrony in Adolescents and Adults With a Fontan Circulation. J Am Soc Echocardiogr 2018; 31:211-219. [DOI: 10.1016/j.echo.2017.10.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Indexed: 11/25/2022]
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Petterson NJ, Fixsen LS, Rutten MCM, Pijls NHJ, van de Vosse FN, Lopata RGP. Ultrasound functional imaging in an ex vivo beating porcine heart platform. Phys Med Biol 2017; 62:9112-9126. [PMID: 29053103 DOI: 10.1088/1361-6560/aa9515] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In recent years, novel ultrasound functional imaging (UFI) techniques have been introduced to assess cardiac function by measuring, e.g. cardiac output (CO) and/or myocardial strain. Verification and reproducibility assessment in a realistic setting remain major issues. Simulations and phantoms are often unrealistic, whereas in vivo measurements often lack crucial hemodynamic parameters or ground truth data, or suffer from the large physiological and clinical variation between patients when attempting clinical validation. Controlled validation in certain pathologies is cumbersome and often requires the use of lab animals. In this study, an isolated beating pig heart setup was adapted and used for performance assessment of UFI techniques such as volume assessment and ultrasound strain imaging. The potential of performing verification and reproducibility studies was demonstrated. For proof-of-principle, validation of UFI in pathological hearts was examined. Ex vivo porcine hearts (n = 6, slaughterhouse waste) were resuscitated and attached to a mock circulatory system. Radio frequency ultrasound data of the left ventricle were acquired in five short axis views and one long axis view. Based on these slices, the CO was measured, where verification was performed using flow sensor measurements in the aorta. Strain imaging was performed providing radial, circumferential and longitudinal strain to assess reproducibility and inter-subject variability under steady conditions. Finally, strains in healthy hearts were compared to a heart with an implanted left ventricular assist device, simulating a failing, supported heart. Good agreement between ultrasound and flow sensor based CO measurements was found. Strains were highly reproducible (intraclass correlation coefficients >0.8). Differences were found due to biological variation and condition of the hearts. Strain magnitude and patterns in the assisted heart were available for different pump action, revealing large changes compared to the normal condition. The setup provides a valuable benchmarking platform for UFI techniques. Future studies will include work on different pathologies and other means of measurement verification.
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Affiliation(s)
- Niels J Petterson
- Cardiovascular Biomechanics group, Department of Biomedical Engineering, Eindhoven University of Technology, PO Box 513, GEM-Z4.131, 5600 MB Eindhoven, Netherlands
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Amzulescu MS, Langet H, Saloux E, Manrique A, Boileau L, Slimani A, Allain P, Roy C, de Meester C, Pasquet A, De Craene M, Vancraeynest D, Pouleur AC, Vanoverschelde JLJ, Gerber BL. Head-to-Head Comparison of Global and Regional Two-Dimensional Speckle Tracking Strain Versus Cardiac Magnetic Resonance Tagging in a Multicenter Validation Study. Circ Cardiovasc Imaging 2017; 10:CIRCIMAGING.117.006530. [DOI: 10.1161/circimaging.117.006530] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 09/20/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Mihaela Silvia Amzulescu
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
| | - Hélène Langet
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
| | - Eric Saloux
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
| | - Alain Manrique
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
| | - Laurianne Boileau
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
| | - Alisson Slimani
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
| | - Pascal Allain
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
| | - Clotilde Roy
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
| | - Christophe de Meester
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
| | - Agnès Pasquet
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
| | - Mathieu De Craene
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
| | - David Vancraeynest
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
| | - Anne-Catherine Pouleur
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
| | - Jean-Louis J. Vanoverschelde
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
| | - Bernhard L. Gerber
- From the Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Service de Cardiologie, Université Catholique de Louvain, Brussels, Belgium (M.S.A., L.B., A.S., C.R., C.d.M., A.P., D.V., A.-C.P., J.-L.J.V., B.L.G.); Philips Clinical Research Board, Paris, France (H.L.); University Hospital of Caen, France (E.S.); EA 4650, Caen University, FHU REMOD-VHF, France
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van Everdingen WM, Zweerink A, Nijveldt R, Salden OAE, Meine M, Maass AH, Vernooy K, De Lange FJ, van Rossum AC, Croisille P, Clarysse P, Geelhoed B, Rienstra M, Van Gelder IC, Vos MA, Allaart CP, Cramer MJ. Comparison of strain imaging techniques in CRT candidates: CMR tagging, CMR feature tracking and speckle tracking echocardiography. Int J Cardiovasc Imaging 2017; 34:443-456. [PMID: 29043465 PMCID: PMC5847211 DOI: 10.1007/s10554-017-1253-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 09/29/2017] [Indexed: 01/22/2023]
Abstract
Parameters using myocardial strain analysis may predict response to cardiac resynchronization therapy (CRT). As the agreement between currently available strain imaging modalities is unknown, three different modalities were compared. Twenty-seven CRT-candidates, prospectively included in the MARC study, underwent cardiac magnetic resonance (CMR) imaging and echocardiographic examination. Left ventricular (LV) circumferential strain was analysed with CMR tagging (CMR-TAG), CMR feature tracking (CMR-FT), and speckle tracking echocardiography (STE). Basic strain values and parameters of dyssynchrony and discoordination obtained with CMR-FT and STE were compared to CMR-TAG. Agreement of CMR-FT and CMR-TAG was overall fair, while agreement between STE and CMR-TAG was often poor. For both comparisons, agreement on discoordination parameters was highest, followed by dyssynchrony and basic strain parameters. For discoordination parameters, agreement on systolic stretch index was highest, with fair intra-class correlation coefficients (ICC) (CMR-FT: 0.58, STE: 0.55). ICC of septal systolic rebound stretch (SRSsept) was poor (CMR-FT: 0.41, STE: 0.30). Internal stretch factor of septal and lateral wall (ISFsep-lat) showed fair ICC values (CMR-FT: 0.53, STE: 0.46), while the ICC of the total LV (ISFLV) was fair for CMR-FT (0.55) and poor for STE (ICC: 0.32). The CURE index had a fair ICC for both comparisons (CMR-FT: 0.49, STE 0.41). Although comparison of STE to CMR-TAG was limited by methodological differences, agreement between CMR-FT and CMR-TAG was overall higher compared to STE and CMR-TAG. CMR-FT is a potential clinical alternative for CMR-TAG and STE, especially in the detection of discoordination in CRT-candidates.
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Affiliation(s)
| | - Alwin Zweerink
- Department of Cardiology, and Institute for Cardiovascular Research (ICaR-VU), VU University Medical Centre, Amsterdam, The Netherlands
| | - Robin Nijveldt
- Department of Cardiology, and Institute for Cardiovascular Research (ICaR-VU), VU University Medical Centre, Amsterdam, The Netherlands
| | - Odette A. E. Salden
- Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Mathias Meine
- Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Alexander H. Maass
- Department of Cardiology, Thoraxcenter, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Kevin Vernooy
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Albert C. van Rossum
- Department of Cardiology, and Institute for Cardiovascular Research (ICaR-VU), VU University Medical Centre, Amsterdam, The Netherlands
| | - Pierre Croisille
- Université Lyon, UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, CREATIS, 42023 Saint-Etienne, France
| | - Patrick Clarysse
- Université Lyon, UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, CREATIS, 42023 Saint-Etienne, France
| | - Bastiaan Geelhoed
- Department of Cardiology, Thoraxcenter, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Michiel Rienstra
- Department of Cardiology, Thoraxcenter, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Isabelle C. Van Gelder
- Department of Cardiology, Thoraxcenter, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Marc A. Vos
- Department of Medical Physiology, University of Utrecht, Utrecht, The Netherlands
| | - Cornelis P. Allaart
- Department of Cardiology, and Institute for Cardiovascular Research (ICaR-VU), VU University Medical Centre, Amsterdam, The Netherlands
| | - Maarten J. Cramer
- Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands
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Edvardsen T, Donal E, Bucciarelli-Ducci C, Maurovich-Horvat P, Maurer G, Popescu BA. The years 2015-2016 in the European Heart Journal-Cardiovascular Imaging. Part I. Eur Heart J Cardiovasc Imaging 2017; 18:1092-1098. [PMID: 28984893 DOI: 10.1093/ehjci/jex192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 07/08/2017] [Indexed: 11/12/2022] Open
Abstract
The multimodality cardiovascular imaging journal, European Heart Journal-Cardiovascular Imaging, was launched in 2012. It has gained an impressive impact factor of 5.99 during its 5 first years and is now established as the most important cardiovascular imaging journal in Europe. The most important studies from the journal's forth and fifth years will be highlighted in two reports. Part I of the review will focus on studies about myocardial function and risk prediction, myocardial ischaemia, and emerging techniques in cardiovascular imaging, while Part II will focus on valvular heart disease, heart failure, cardiomyopathies, and congenital heart disease.
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Affiliation(s)
- Thor Edvardsen
- Department of Cardiology, Centre of Cardiological Innovation Oslo University Hospital, Rikshospitalet and University of Oslo, PO Box 4950 Nydalen, NO-0424 Oslo, Norway
| | - Erwan Donal
- Cardiologie Department and CIC-IT 1414, CHU Rennes, Hôpital Pontchaillou, LTSI INSERM U 1099, University Rennes-1, 35000 Rennes, France
| | - Chiara Bucciarelli-Ducci
- Bristol Heart Institute, University Hospitals Bristol NHS Trust, Upper Maudlin St, Bristol, BS2 8HW, UK and Clinical Research and Imaging Centre (CRIC) Bristol, 60 St Michael Hill, Bristol, BS2 8DX, UK
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group (CIRG), Heart and Vascular Center, Semmelweis University, 68 Varosmajor u., 1122 Budapest, Hungary
| | - Gerald Maurer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria
| | - Bogdan A Popescu
- Department of Cardiology, University of Medicine and Pharmacy 'Carol Davila'-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Sos. Fundeni 258, sector 2, 022328 Bucharest, Romania
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Storve S, Torp H. Fast Simulation of Dynamic Ultrasound Images Using the GPU. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2017; 64:1465-1477. [PMID: 28749348 DOI: 10.1109/tuffc.2017.2731944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Simulated ultrasound data is a valuable tool for development and validation of quantitative image analysis methods in echocardiography. Unfortunately, simulation time can become prohibitive for phantoms consisting of a large number of point scatterers. The COLE algorithm by Gao et al. is a fast convolution-based simulator that trades simulation accuracy for improved speed. We present highly efficient parallelized CPU and GPU implementations of the COLE algorithm with an emphasis on dynamic simulations involving moving point scatterers. We argue that it is crucial to minimize the amount of data transfers from the CPU to achieve good performance on the GPU. We achieve this by storing the complete trajectories of the dynamic point scatterers as spline curves in the GPU memory. This leads to good efficiency when simulating sequences consisting of a large number of frames, such as B-mode and tissue Doppler data for a full cardiac cycle. In addition, we propose a phase-based subsample delay technique that efficiently eliminates flickering artifacts seen in B-mode sequences when COLE is used without enough temporal oversampling. To assess the performance, we used a laptop computer and a desktop computer, each equipped with a multicore Intel CPU and an NVIDIA GPU. Running the simulator on a high-end TITAN X GPU, we observed two orders of magnitude speedup compared to the parallel CPU version, three orders of magnitude speedup compared to simulation times reported by Gao et al. in their paper on COLE, and a speedup of 27000 times compared to the multithreaded version of Field II, using numbers reported in a paper by Jensen. We hope that by releasing the simulator as an open-source project we will encourage its use and further development.
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73
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Hensel KO, Abellan Schneyder FE, Wilke L, Heusch A, Wirth S, Jenke AC. Speckle Tracking Stress Echocardiography Uncovers Early Subclinical Cardiac Involvement in Pediatric Patients with Inflammatory Bowel Diseases. Sci Rep 2017; 7:2966. [PMID: 28592829 PMCID: PMC5462781 DOI: 10.1038/s41598-017-03255-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 05/04/2017] [Indexed: 12/20/2022] Open
Abstract
Inflammatory bowel disease (IBD) is an established risk factor for cardiovascular disease (CVD). However, whether cardiac consequences present early in IBD is unknown. This is the first study in children aiming to unmask altered myocardial mechanics in IBD. We enrolled 50 consecutive normotensive children with Crohn’s disease (CD) (n = 28) or ulcerative colitis (UC) (n = 22). The study groups consisted of 18 patients with active inflammatory disease (mean age 14.6 ± 2.5 years) and 32 children with IBD in remission (14.3 ± 2.3 years). 60 age- and gender-matched children served as healthy controls. Speckle tracking stress echocardiography (STE) was used to assess left ventricular (LV) myocardial strain and strain rate. Circumferential strain rate was significantly decreased in children with active IBD (−1.55 ± 0.26 s−1) and IBD in remission (−1.49 ± 0.26 s−1) versus healthy controls (1.8 ± 0.4 s−1) both at rest (p < 0.001) and during exercise (p = 0.021). Moreover, longitudinal strain rate, circumferential strain and E/E′ ratio were significantly impaired in IBD. Pediatric patients with IBD feature subclinical signs of LV systolic and diastolic myocardial impairment early in the course of CD and UC. This may not be reversible even when IBD is clinically controlled. Patients with IBD should be regularly screened for signs of CVD.
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Affiliation(s)
- Kai O Hensel
- HELIOS University Medical Center Wuppertal, Children's Hospital, Department of Pediatric Gastroenterology, Center for Clinical & Translational Research (CCTR), Faculty of Health, Center for Biomedical Education & Research (ZBAF), Witten/Herdecke University, Faculty of Health, Witten, Germany. .,HELIOS University Medical Center Wuppertal, Children's Hospital, Department of Pediatric Cardiology, Center for Clinical & Translational Research (CCTR), Faculty of Health, Center for Biomedical Education & Research (ZBAF), Witten/Herdecke University, Faculty of Health, Witten, Germany.
| | - Francisca E Abellan Schneyder
- HELIOS University Medical Center Wuppertal, Children's Hospital, Department of Pediatric Cardiology, Center for Clinical & Translational Research (CCTR), Faculty of Health, Center for Biomedical Education & Research (ZBAF), Witten/Herdecke University, Faculty of Health, Witten, Germany
| | - Lucia Wilke
- HELIOS University Medical Center Wuppertal, Children's Hospital, Department of Pediatric Cardiology, Center for Clinical & Translational Research (CCTR), Faculty of Health, Center for Biomedical Education & Research (ZBAF), Witten/Herdecke University, Faculty of Health, Witten, Germany
| | - Andreas Heusch
- HELIOS University Medical Center Wuppertal, Children's Hospital, Department of Pediatric Cardiology, Center for Clinical & Translational Research (CCTR), Faculty of Health, Center for Biomedical Education & Research (ZBAF), Witten/Herdecke University, Faculty of Health, Witten, Germany
| | - Stefan Wirth
- HELIOS University Medical Center Wuppertal, Children's Hospital, Department of Pediatric Gastroenterology, Center for Clinical & Translational Research (CCTR), Faculty of Health, Center for Biomedical Education & Research (ZBAF), Witten/Herdecke University, Faculty of Health, Witten, Germany
| | - Andreas C Jenke
- EKO Children's Hospital, Department of Pediatric Gastroenterology, Oberhausen, Witten/Herdecke University, Faculty of Health, Witten, Germany
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Enzensberger C, Achterberg F, Graupner O, Wolter A, Herrmann J, Axt-Fliedner R. Wall-motion tracking in fetal echocardiography-Influence of frame rate on longitudinal strain analysis assessed by two-dimensional speckle tracking. Echocardiography 2017; 34:898-905. [DOI: 10.1111/echo.13542] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Christian Enzensberger
- Division of Prenatal Medicine; Department of OB/GYN; University Hospital UKGM; Justus-Liebig University; Giessen Germany
| | - Friederike Achterberg
- Division of Prenatal Medicine; Department of OB/GYN; University Hospital UKGM; Justus-Liebig University; Giessen Germany
| | - Oliver Graupner
- Department of OB/GYN; University Hospital, Technical University; Munich Germany
| | - Aline Wolter
- Division of Prenatal Medicine; Department of OB/GYN; University Hospital UKGM; Justus-Liebig University; Giessen Germany
| | | | - Roland Axt-Fliedner
- Division of Prenatal Medicine; Department of OB/GYN; University Hospital UKGM; Justus-Liebig University; Giessen Germany
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Enzensberger C, Achterberg F, Degenhardt J, Wolter A, Graupner O, Herrmann J, Axt-Fliedner R. Feasibility and Reproducibility of Two-Dimensional Wall Motion Tracking (WMT) in Fetal Echocardiography. Ultrasound Int Open 2017; 3:E26-E33. [PMID: 28210715 DOI: 10.1055/s-0042-124501] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Objective The primary objective of this study was to determine the feasibility and reproducibility of 2-dimensional speckle tracking imaging based on the wall motion tracking (WMT) technique in fetal echocardiography. The secondary objective was to compare left and right ventricular global and segmental longitudinal peak strain values. Methods A prospective cross-sectional study was performed. Global and segmental longitudinal peak strain values of the left ventricle (LV) and right ventricle (RV) were assessed prospectively. Based on apical 4-chamber views, cine loops were acquired and digitally stored. Strain analysis was performed offline. Intra- and interobserver variabilities were analyzed. Results A total of 29 healthy fetuses with an echocardiogram performed between 19 and 37 weeks of gestation were included. Analysis was performed with a temporal resolution of 60 frames per second (fps). For both examiners, in all cases Cronbach's alpha was>0.7. The interobserver variability showed a strong agreement in 50% of the segments (ICC 0.71-0.90). The global strain values for LV and RV were -16.34 and -14.65%, respectively. Segmental strain analysis revealed a basis to apex gradient with the lowest strain values in basal segments and the highest strain values in apical segments. Conclusion The assessment of fetal myocardial deformation parameters by 2D WMT is technically feasible with good reproducibility.
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Affiliation(s)
- Christian Enzensberger
- Division of Prenatal Medicine, Department of OB&GYN, University Hospital UKGM, Justus-Liebig-University, Giessen, Germany
| | - Friederike Achterberg
- Division of Prenatal Medicine, Department of OB&GYN, University Hospital UKGM, Justus-Liebig-University, Giessen, Germany
| | - Jan Degenhardt
- Division of Prenatal Medicine, Department of OB&GYN, University Hospital UKGM, Justus-Liebig-University, Giessen, Germany
| | - Aline Wolter
- Division of Prenatal Medicine, Department of OB&GYN, University Hospital UKGM, Justus-Liebig-University, Giessen, Germany
| | - Oliver Graupner
- Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Johannes Herrmann
- Statistical Consulting Service Giessen, Statistikberatung, Giessen, Germany
| | - Roland Axt-Fliedner
- Division of Prenatal Medicine, Department of OB&GYN, University Hospital UKGM, Justus-Liebig-University, Giessen, Germany
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Rösner A, Schirmer H, Iqbal A, Bijnens B, Avenarius D, Malm S. Assessment of myocardial ischemia by strain dobutamine stress echocardiography and cardiac magnetic resonance perfusion imaging before and after coronary artery bypass grafting. Echocardiography 2017; 34:557-566. [DOI: 10.1111/echo.13471] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
| | - Henrik Schirmer
- University Hospital North Norway; Tromsø Norway
- Department of Clinical Medicine; University of Tromsø, The Arctic University; Tromsø Norway
| | - Amjid Iqbal
- University Hospital North Norway; Tromsø Norway
| | - Bart Bijnens
- ICREA-Universitat Pompeu Fabra; Barcelona Spain
- K.U. Leuven; Leuven Belgium
| | | | - Siri Malm
- University Hospital North Norway; Tromsø Norway
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77
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Collier P, Phelan D, Klein A. A Test in Context: Myocardial Strain Measured by Speckle-Tracking Echocardiography. J Am Coll Cardiol 2017; 69:1043-1056. [DOI: 10.1016/j.jacc.2016.12.012] [Citation(s) in RCA: 280] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 11/28/2016] [Accepted: 12/04/2016] [Indexed: 12/22/2022]
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78
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Menting ME, McGhie JS, Koopman LP, Vletter WB, Helbing WA, van den Bosch AE, Roos-Hesselink JW. Normal myocardial strain values using 2D speckle tracking echocardiography in healthy adults aged 20 to 72 years. Echocardiography 2016; 33:1665-1675. [DOI: 10.1111/echo.13323] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
| | | | - Laurens P. Koopman
- Department of Pediatrics; Division of Pediatric Cardiology; Erasmus MC - Sophia Children's Hospital; Rotterdam The Netherlands
| | - Wim B. Vletter
- Department of Cardiology; Erasmus MC; Rotterdam The Netherlands
| | - Willem A. Helbing
- Department of Pediatrics; Division of Pediatric Cardiology; Erasmus MC - Sophia Children's Hospital; Rotterdam The Netherlands
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Bouchez S, Heyde B, Barbosa D, Vandenheuvel M, Houle H, Wang Y, D'hooge J, Wouters PF. In-vivo validation of a new clinical tool to quantify three-dimensional myocardial strain using ultrasound. Int J Cardiovasc Imaging 2016; 32:1707-1714. [PMID: 27535041 DOI: 10.1007/s10554-016-0962-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 08/12/2016] [Indexed: 11/30/2022]
Abstract
Three-dimensional (3D) strain analysis based on real-time 3-D echocardiography (RT3DE) has emerged as a novel technique to quantify regional myocardial function. The goal of this study was to evaluate accuracy of a novel model-based 3D tracking tool (eSie Volume Mechanics, Siemens Ultrasound, Mountain View, CA, USA) using sonomicrometry as an independent measure of cardiac deformation. Thirteen sheep were instrumented with microcrystals sutured to the epi- and endocardium of the inferolateral left ventricular wall to trace myocardial deformation along its three directional axes of motion. Paired acquisitions of RT3DE and sonomicrometry were made at baseline, during inotropic modulation and during myocardial ischemia. Accuracy of 3D strain measurements was quantified and expressed as level of agreement with sonomicrometry using linear regression and Bland-Altman analysis. Correlations between 3D strain analysis and sonomicrometry were good for longitudinal and circumferential strain components (r = 0.78 and r = 0.71) but poor for radial strain (r = 0.30). Accordingly, agreement (bias ± 2SD) was -5 ± 6 % for longitudinal, -5 ± 7 % for circumferential, and 15 ± 19 % for radial strain. Intra-observer variability was low for all components (intra-class correlation coefficients (ICC) of respectively 0.89, 0.88 and 0.95) while inter-observer variability was higher, in particular for radial strain (ICC = 0.41). The present study shows that 3D strain analysis provided good estimates of circumferential and longitudinal strain, while estimates of radial strain were less accurate between observers.
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Affiliation(s)
- S Bouchez
- Department of Anesthesiology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
| | - B Heyde
- Laboratory on Cardiovascular Imaging and Dynamics, KU Leuven, Leuven, Belgium
| | - D Barbosa
- Laboratory on Cardiovascular Imaging and Dynamics, KU Leuven, Leuven, Belgium
| | - M Vandenheuvel
- Department of Anesthesiology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
| | - H Houle
- Ultrasound Division, Siemens Medical Solutions, Mountain View, CA, USA
| | - Y Wang
- Ultrasound Division, Siemens Medical Solutions, Mountain View, CA, USA
| | - J D'hooge
- Laboratory on Cardiovascular Imaging and Dynamics, KU Leuven, Leuven, Belgium
| | - P F Wouters
- Department of Anesthesiology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
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80
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McGhie JS, Menting ME, Vletter WB, Frowijn R, Roos-Hesselink JW, van der Zwaan HB, Soliman OI, Geleijnse ML, van den Bosch AE. Quantitative assessment of the entire right ventricle from one acoustic window: an attractive approach. Eur Heart J Cardiovasc Imaging 2016; 18:754-762. [DOI: 10.1093/ehjci/jew165] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 07/13/2016] [Indexed: 02/04/2023] Open
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81
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Khan U, Hjertaas JJ, Greve G, Matre K. Optimal Acquisition Settings for Speckle Tracking Echocardiography-Derived Strains in Infants: An In Vitro Study. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:1660-1670. [PMID: 27085385 DOI: 10.1016/j.ultrasmedbio.2016.02.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 02/02/2016] [Accepted: 02/21/2016] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to investigate the effect of frame rate and probe frequency on the accuracy of speckle tracking echocardiography-derived strain measurements in infants. An infant-sized left ventricle phantom with sonomicrometer crystals was made from polyvinyl alcohol. The examined stroke rates were 60, 120 and 180 strokes per min (SPM). Longitudinal strain and circumferential strain measurements were analyzed from a total of 1860 cine loops. These cine loops were acquired using two pediatric probes of different frequencies at both fundamental and harmonic imaging modes. Both probes were examined at different settings (in total, 30 different frame rate-frequency combinations). At optimal settings, both longitudinal and circumferential strain displayed high accuracy. Frequency settings did not have a consistent effect on accuracy, while low frame rates led to less accurate measurements. We recommend a frame rate/heart ratio >1 frame per second/beats per min, especially for circumferential strain.
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Affiliation(s)
- Umael Khan
- Bergen Hypertension and Cardiac Dynamics Group, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Johannes Just Hjertaas
- Bergen Hypertension and Cardiac Dynamics Group, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Gottfried Greve
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Knut Matre
- Bergen Hypertension and Cardiac Dynamics Group, Department of Clinical Science, University of Bergen, Bergen, Norway.
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82
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Negoita M, Zolgharni M, Dadkho E, Pernigo M, Mielewczik M, Cole GD, Dhutia NM, Francis DP. Frame rate required for speckle tracking echocardiography: A quantitative clinical study with open-source, vendor-independent software. Int J Cardiol 2016; 218:31-36. [PMID: 27232908 DOI: 10.1016/j.ijcard.2016.05.047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 05/12/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To determine the optimal frame rate at which reliable heart walls velocities can be assessed by speckle tracking. BACKGROUND Assessing left ventricular function with speckle tracking is useful in patient diagnosis but requires a temporal resolution that can follow myocardial motion. In this study we investigated the effect of different frame rates on the accuracy of speckle tracking results, highlighting the temporal resolution where reliable results can be obtained. MATERIAL AND METHODS 27 patients were scanned at two different frame rates at their resting heart rate. From all acquired loops, lower temporal resolution image sequences were generated by dropping frames, decreasing the frame rate by up to 10-fold. RESULTS Tissue velocities were estimated by automated speckle tracking. Above 40 frames/s the peak velocity was reliably measured. When frame rate was lower, the inter-frame interval containing the instant of highest velocity also contained lower velocities, and therefore the average velocity in that interval was an underestimate of the clinically desired instantaneous maximum velocity. CONCLUSIONS The higher the frame rate, the more accurately maximum velocities are identified by speckle tracking, until the frame rate drops below 40 frames/s, beyond which there is little increase in peak velocity. We provide in an online supplement the vendor-independent software we used for automatic speckle-tracked velocity assessment to help others working in this field.
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Affiliation(s)
- Madalina Negoita
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital Campus, London W12 0NN, UK.
| | - Massoud Zolgharni
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital Campus, London W12 0NN, UK
| | - Elham Dadkho
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital Campus, London W12 0NN, UK
| | - Matteo Pernigo
- University of Verona, Department of Medicine, Section of Cardiology, Italy
| | - Michael Mielewczik
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital Campus, London W12 0NN, UK
| | - Graham D Cole
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital Campus, London W12 0NN, UK
| | - Niti M Dhutia
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital Campus, London W12 0NN, UK
| | - Darrel P Francis
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital Campus, London W12 0NN, UK
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Dahle GO, Stangeland L, Moen CA, Salminen PR, Haaverstad R, Matre K, Grong K. The influence of acute unloading on left ventricular strain and strain rate by speckle tracking echocardiography in a porcine model. Am J Physiol Heart Circ Physiol 2016; 310:H1330-9. [PMID: 26968547 DOI: 10.1152/ajpheart.00947.2015] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/10/2016] [Indexed: 11/22/2022]
Abstract
Noninvasive measurements of myocardial strain and strain rate by speckle tracking echocardiography correlate to cardiac contractile state but also to load, which may weaken their value as indices of inotropy. In a porcine model, we investigated the influence of acute dynamic preload reductions on left ventricular strain and strain rate and their relation to the pressure-conductance catheter-derived preload recruitable stroke work (PRSW) and peak positive first derivative of left ventricular pressure (LV-dP/dtmax). Speckle tracking strain and strain rate in the longitudinal, circumferential, and radial directions were measured during acute dynamic reductions of end-diastolic volume during three different myocardial inotropic states. Both strain and strain rate were sensitive to unloading of the left ventricle (P < 0.001), but the load dependency for strain rate was modest compared with strain. Changes in longitudinal and circumferential strain correlated more strongly to changes in end-diastolic volume (r = -0.86 and r = -0.72) than did radial strain (r = 0.35). Longitudinal, circumferential, and radial strain significantly correlated with LV-dP/dtmax (r = -0.53, r = -0.46, and r = 0.86), whereas only radial strain correlated with PRSW (r = 0.55). Strain rate in the longitudinal, circumferential and radial direction significantly correlated with both PRSW (r = -0.64, r = -0.58, and r = 0.74) and LV-dP/dtmax (r = -0.95, r = -0.70, and r = 0.85). In conclusion, the speckle tracking echocardiography-derived strain rate is more robust to dynamic ventricular unloading than strain. Longitudinal and circumferential strain could not predict load-independent contractility. Strain rates, and especially in the radial direction, are good predictors of preload-independent inotropic markers derived from conductance catheter.
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Affiliation(s)
- Geir Olav Dahle
- Section of Cardiothoracic Surgery, Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; and Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Lodve Stangeland
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Pirjo-Riitta Salminen
- Section of Cardiothoracic Surgery, Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; and Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Rune Haaverstad
- Section of Cardiothoracic Surgery, Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; and Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Knut Matre
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Ketil Grong
- Department of Clinical Science, University of Bergen, Bergen, Norway
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Hensel KO, Grimmer F, Roskopf M, Jenke AC, Wirth S, Heusch A. Subclinical Alterations of Cardiac Mechanics Present Early in the Course of Pediatric Type 1 Diabetes Mellitus: A Prospective Blinded Speckle Tracking Stress Echocardiography Study. J Diabetes Res 2016; 2016:2583747. [PMID: 26839891 PMCID: PMC4709644 DOI: 10.1155/2016/2583747] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 10/21/2015] [Accepted: 10/27/2015] [Indexed: 01/14/2023] Open
Abstract
Diabetic cardiomyopathy substantially accounts for mortality in diabetes mellitus. The pathophysiological mechanism underlying diabetes-associated nonischemic heart failure is poorly understood and clinical data on myocardial mechanics in early stages of diabetes are lacking. In this study we utilize speckle tracking echocardiography combined with physical stress testing in order to evaluate whether left ventricular (LV) myocardial performance is altered early in the course of uncomplicated type 1 diabetes mellitus (T1DM). 40 consecutive asymptomatic normotensive children and adolescents with T1DM (mean age 11.5 ± 3.1 years and mean disease duration 4.3 ± 3.5 years) and 44 age- and gender-matched healthy controls were assessed using conventional and quantitative echocardiography (strain and strain rate) during bicycle ergometer stress testing. Strikingly, T1DM patients had increased LV longitudinal (p = 0.019) and circumferential (p = 0.016) strain rate both at rest and during exercise (p = 0.021). This was more pronounced in T1DM patients with a longer disease duration (p = 0.038). T1DM patients with serum HbA1c > 9% showed impaired longitudinal (p = 0.008) and circumferential strain (p = 0.005) and a reduced E/A-ratio (p = 0.018). In conclusion, asymptomatic T1DM patients have signs of hyperdynamic LV contractility early in the course of the disease. Moreover, poor glycemic control is associated with early subclinical LV systolic and diastolic impairment.
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Affiliation(s)
- Kai O. Hensel
- Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten/Herdecke University, Heusnerstraße 40, 42283 Wuppertal, Germany
- *Kai O. Hensel:
| | - Franziska Grimmer
- Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten/Herdecke University, Heusnerstraße 40, 42283 Wuppertal, Germany
| | - Markus Roskopf
- Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten/Herdecke University, Heusnerstraße 40, 42283 Wuppertal, Germany
| | - Andreas C. Jenke
- Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten/Herdecke University, Heusnerstraße 40, 42283 Wuppertal, Germany
| | - Stefan Wirth
- Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten/Herdecke University, Heusnerstraße 40, 42283 Wuppertal, Germany
| | - Andreas Heusch
- Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten/Herdecke University, Heusnerstraße 40, 42283 Wuppertal, Germany
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