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Nichting TJ, de Vet CM, van der Ven M, van der Woude DAA, Regis M, van Sloun RJG, Oei SG, van Laar JOEH, van Oostrum NHM. The impact of angles of insonation on left and right ventricular global longitudinal strain estimation in fetal speckle tracking echocardiography. PLoS One 2023; 18:e0287003. [PMID: 37437044 DOI: 10.1371/journal.pone.0287003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/28/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVES Two-dimensional speckle tracking echocardiography has been considered an angle-independent modality. However, current literature is limited and inconclusive on the actual impact of angle of insonation on strain values. Therefore, the primary objective of this study was to assess the impact of angles of insonation on the estimation of fetal left ventricular and right ventricular global longitudinal strain. Secondarily, the impact of different definitions for angles of insonation was investigated in a sensitivity analysis. METHODS This is a retrospective analysis of a prospective longitudinal cohort study with 124 healthy subjects. The analyses were based on the four-chamber view ultrasound clips taken between 18+0 and 21+6 weeks of gestation. Angles of insonation were categorized into three groups: up/down, oblique and perpendicular. The mean fetal left and right ventricular and global longitudinal strain values corresponding to these three groups were compared by an ANOVA test corrected for heteroscedasticity. RESULTS Fetal left and right ventricular global longitudinal strain values were not statistically different between the three angles of insonation (p-value >0.062 and >0.149, respectively). When applying another definition for angles of insonation in the sensitivity analysis, the mean left ventricular global longitudinal strain value was significantly decreased for the oblique compared to the up/down angle of insonation (p-value 0.041). CONCLUSIONS There is no evidence of a difference in fetal left and right ventricular global longitudinal strain between the different angles of insonation in fetal two-dimensional speckle tracking echocardiography.
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Affiliation(s)
- Thomas J Nichting
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Chantelle M de Vet
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Myrthe van der Ven
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Daisy A A van der Woude
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Marta Regis
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Ruud J G van Sloun
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - S Guid Oei
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Judith O E H van Laar
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
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2
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Li Z, Mao X, Cui X, Yu T, Zhang M, Li X, Li G. Evaluate the elasticity of carotid artery in the type 2 diabetes mellitus patients with nonalcoholic fatty liver disease by two-dimensional strain imaging. Medicine (Baltimore) 2022; 101:e30738. [PMID: 36181039 PMCID: PMC9524962 DOI: 10.1097/md.0000000000030738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
To evaluate carotid elasticity by using two-dimensional strain imaging (2DSI) in type 2 diabetes mellitus (T2DM) patients with nonalcoholic fatty liver disease (NAFLD). 98 patients with T2DM diagnosed in our hospital were selected. All the patients were without carotid plaque, which were proved by carotid ultrasonography. According to the fatty liver classification standard, patients were divided into three groups. There were 35 cases without NAFLD in group A, 33 cases with mild NAFLD in group B and 30 cases with moderate to severe NAFLD in group C. By using two-dimensional and M-mode ultrasound to measure the left carotid intima-media thickness (IMT), common carotid arterial systolic diameter (Ds) and diastolic diameter (Dd). The systolic peak velocity was measured by spectral Doppler ultrasound. The systolic global peak circumferential strain (CS), early and late systolic global circumferential strain rate (CSr) were measured by 2DSI. The stiffness parameters β1 and β2 were calculated by M-mode ultrasound and 2DSI separately. Among three groups, the Ds, Dd and systolic peak velocity showed no significant difference (all P > .05). In group C, IMT and β1 were obviously increased than those of groups A and B (all P < .05). Compared groups A and B, there were no significant difference in IMT and β1 (all P > .05). β2 was higher in groups B and C than those in group A, CS, CSr were lower in groups B and C than those in group A (both P > .05). The carotid elasticity of T2DM patients with NAFLD can be evaluated by 2DSI.
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Affiliation(s)
- Zhen Li
- Department of Ultrasound, the Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xin Mao
- Department of Ultrasound, the Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiuxiu Cui
- Department of Ultrasound, the Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tingting Yu
- Department of Ultrasound, the Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Mengmeng Zhang
- Department of Ultrasound, the Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiya Li
- Department of Ultrasound, the Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Guangsen Li
- Department of Ultrasound, the Second Affiliated Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Guangsen Li, Department of Ultrasound, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China (e-mail: )
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Mariano CA, Sattari S, Quiros KAM, Nelson TM, Eskandari M. Examining lung mechanical strains as influenced by breathing volumes and rates using experimental digital image correlation. Respir Res 2022; 23:92. [PMID: 35410291 PMCID: PMC8999998 DOI: 10.1186/s12931-022-01999-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/18/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Mechanical ventilation is often employed to facilitate breathing in patients suffering from respiratory illnesses and disabilities. Despite the benefits, there are risks associated with ventilator-induced lung injuries and death, driving investigations for alternative ventilation techniques to improve mechanical ventilation, such as multi-oscillatory and high-frequency ventilation; however, few studies have evaluated fundamental lung mechanical local deformations under variable loading. METHODS Porcine whole lung samples were analyzed using a novel application of digital image correlation interfaced with an electromechanical ventilation system to associate the local behavior to the global volume and pressure loading in response to various inflation volumes and breathing rates. Strains, anisotropy, tissue compliance, and the evolutionary response of the inflating lung were analyzed. RESULTS Experiments demonstrated a direct and near one-to-one linear relationship between applied lung volumes and resulting local mean strain, and a nonlinear relationship between lung pressures and strains. As the applied air delivery volume was doubled, the tissue surface mean strains approximately increased from 20 to 40%, and average maximum strains measured 70-110%. The tissue strain anisotropic ratio ranged from 0.81 to 0.86 and decreased with greater inflation volumes. Local tissue compliance during the inflation cycle, associating evolutionary strains in response to inflation pressures, was also quantified. CONCLUSION Ventilation frequencies were not found to influence the local stretch response. Strain measures significantly increased and the anisotropic ratio decreased between the smallest and greatest tidal volumes. Tissue compliance did not exhibit a unifying trend. The insights provided by the real-time continuous measures, and the kinetics to kinematics pulmonary linkage established by this study offers valuable characterizations for computational models and establishes a framework for future studies to compare healthy and diseased lung mechanics to further consider alternatives for effective ventilation strategies.
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Affiliation(s)
- C A Mariano
- Department of Mechanical Engineering, University of California at Riverside, Riverside, CA, USA
| | - S Sattari
- Department of Mechanical Engineering, University of California at Riverside, Riverside, CA, USA
| | - K A M Quiros
- Department of Mechanical Engineering, University of California at Riverside, Riverside, CA, USA
| | - T M Nelson
- Department of Mechanical Engineering, University of California at Riverside, Riverside, CA, USA
| | - M Eskandari
- Department of Mechanical Engineering, University of California at Riverside, Riverside, CA, USA.
- BREATHE Center, School of Medicine, University of California at Riverside, Riverside, CA, USA.
- Department of Bioengineering, University of California at Riverside, Riverside, CA, USA.
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4
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Nichting TJ, de Vet CM, van der Ven M, van der Woude DAA, van Sloun RJG, Oei SG, van Oostrum NHM, van Laar JOEH. Angle Independency of Fetal Speckle Tracking Echocardiography: a commentary letter. J Am Soc Echocardiogr 2022; 35:783-785. [PMID: 35271991 DOI: 10.1016/j.echo.2022.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Thomas J Nichting
- Department of gynaecology and obstetrics, Máxima Medical Centre, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands; Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands.
| | - Chantelle M de Vet
- Department of gynaecology and obstetrics, Máxima Medical Centre, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands; Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - Myrthe van der Ven
- Department of gynaecology and obstetrics, Máxima Medical Centre, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands; Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - Daisy A A van der Woude
- Department of gynaecology and obstetrics, Máxima Medical Centre, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands; Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - Ruud J G van Sloun
- Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - S Guid Oei
- Department of gynaecology and obstetrics, Máxima Medical Centre, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands; Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - Noortje H M van Oostrum
- Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Department of gynaecology and obstetrics, University Hospital Gent, 9000 Gent, Belgium
| | - Judith O E H van Laar
- Department of gynaecology and obstetrics, Máxima Medical Centre, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands; Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
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5
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Kotby AA, Ebrahim SOS, Al-Fahham MM. Reference centiles for left ventricular longitudinal global and regional systolic strain by automated functional imaging in healthy Egyptian children. Cardiol Young 2022; 33:1-9. [PMID: 35241202 DOI: 10.1017/s1047951122000129] [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] [Indexed: 11/07/2022]
Abstract
BACKGROUND Two-dimensional speckle tracking echocardiography-derived left ventricular longitudinal systolic strain is an important myocardial deformation parameter for assessing the systolic function of the left ventricle. Strain values differ according to the vendor machine and software. This study aimed to provide normal reference values for global and regional left ventricular longitudinal systolic strain in Egyptian children using automated functional imaging software integrated into the General Electric healthcare machine and to study the correlation between the global longitudinal left ventricular systolic strain and age, body size, vital data, and some echocardiographic parameters. METHODS Healthy children (250) aged from 1 to 16 years were included. Conventional echocardiography was done to measure the left ventricular dimensions and function. Automated functional imaging was performed to measure the global and regional peak longitudinal systolic strain. RESULTS The global longitudinal strain was -21.224 ± 1.862%. The regional strain was -20.68 ± 2.11%, -21.06 ± 1.84%, and -21.86 ± 2.71% at the basal, mid, and apical segments, respectively. The mean values of the systolic longitudinal strain become significantly more negative from base to apex. Age differences were found as regard to global and regional longitudinal strain parameters but no gender differences. The global peak longitudinal systolic strain correlated positively with age. No correlations were found with either the anthropometric parameters or the vital data. CONCLUSIONS Age-specific normal values for two-dimensional speckle tracking-derived left ventricular longitudinal regional and global systolic strain are established using automated functional imaging.
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Affiliation(s)
- Alyaa A Kotby
- Pediatric Department, Pediatric Cardiology Unit, Faculty of Medicine, Ain Shams University, Abbasia 11566, Cairo, Egypt
| | - Sahar O S Ebrahim
- Pediatric Department, Pediatric Cardiology Unit, Faculty of Medicine, Ain Shams University, Abbasia 11566, Cairo, Egypt
| | - Marwa M Al-Fahham
- Pediatric Department, Pediatric Cardiology Unit, Faculty of Medicine, Ain Shams University, Abbasia 11566, Cairo, Egypt
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6
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Haeger C, Hammer K, Braun J, Oelmeier K, Köster HA, Möllers M, Koch R, Steinhard J, Klockenbusch W, Schmitz R. Importance of frame rate for the measurement of strain and synchrony in fetuses using speckle tracking echocardiography. J Perinat Med 2022; 50:176-184. [PMID: 34710317 DOI: 10.1515/jpm-2021-0215] [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: 05/01/2021] [Accepted: 10/05/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess the influence of frame rate settings on longitudinal strain (LS) and mechanical synchrony (SYN) values in Speckle Tracking Echocardiography (STE) of healthy fetuses. METHODS In this prospective study, we collected transversal or apical four-chamber-views of 121 healthy fetuses between 20 and 38 weeks of gestation using three different frame rate (FR) settings (≥ 110, 100 ± 10, 60 ± 10 frames per second). We assessed the segmental and the global LS of both ventricles (2C) and of the left ventricle (LV) offline with QLab 10.8 (Philips Medical Systems, Andover, MA, USA). Inter- and intraventricular SYN were calculated as time difference in peak myocardial strain between the mid-segments of left and right ventricle (interventricular, 2C_Syn) and lateral wall and septum of the left ventricle (intraventricular, LV_Syn), respectively. RESULTS In 84.3% STE was feasible at all three FR settings. The LS increased in both views at higher FRs to a statistically noticeable extent. SYN measurements and the absolute differences at patient level between the FR settings showed no statistically noticeable alterations. CONCLUSIONS STE is feasible at low and high FR settings. SYN emerges to be a robust parameter for fetal STE as it is less affected by the FR. High FRs enable high temporal resolutions and thus an accurate examination of fetal hearts. Future research for the technical implementation of tailored fetal STE software is necessary for reliable clinical application.
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Affiliation(s)
- Christina Haeger
- Department of Obstetrics and Gynaecology, University Hospital of Münster, Münster, Germany
| | - Kerstin Hammer
- Department of Obstetrics and Gynaecology, University Hospital of Münster, Münster, Germany
| | - Janina Braun
- Department of Obstetrics and Gynaecology, University Hospital of Münster, Münster, Germany
| | - Kathrin Oelmeier
- Department of Obstetrics and Gynaecology, University Hospital of Münster, Münster, Germany
| | - Helen Ann Köster
- Department of Obstetrics and Gynaecology, University Hospital of Münster, Münster, Germany
| | - Mareike Möllers
- Department of Obstetrics and Gynaecology, University Hospital of Münster, Münster, Germany
| | - Raphael Koch
- Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - Johannes Steinhard
- Department of Fetal Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany
| | - Walter Klockenbusch
- Department of Obstetrics and Gynaecology, University Hospital of Münster, Münster, Germany
| | - Ralf Schmitz
- Department of Obstetrics and Gynaecology, University Hospital of Münster, Münster, Germany
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7
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Parasa R, Weiss KJ, Bourantas CV, Petersen SE, Kelle S, Thomson RJ. Editorial: Insights in cardiovascular imaging: 2021. Front Cardiovasc Med 2022; 9:1061337. [PMID: 36684580 PMCID: PMC9846317 DOI: 10.3389/fcvm.2022.1061337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/07/2022] [Indexed: 01/06/2023] Open
Affiliation(s)
- Ramya Parasa
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.,William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London, London, United Kingdom
| | - Karl J Weiss
- Department of Internal Medicine and Cardiology, German Heart Institute Berlin (DHZB), Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Christos V Bourantas
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.,William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London, London, United Kingdom.,Institute of Cardiovascular Sciences, University College London, London, United Kingdom
| | - Steffen E Petersen
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.,William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London, London, United Kingdom
| | - Sebastian Kelle
- Department of Internal Medicine and Cardiology, German Heart Institute Berlin (DHZB), Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Ross J Thomson
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.,William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London, London, United Kingdom
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8
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Melo MDTD, Paiva MG, Santos MVC, Rochitte CE, Moreira VDM, Saleh MH, Brandão SCS, Gallafrio CC, Goldwasser D, Gripp EDA, Piveta RB, Silva TO, Santo THCE, Ferreira WP, Salemi VMC, Cauduro SA, Barberato SH, Lopes HMC, Pena JLB, Rached HRS, Miglioranza MH, Pinheiro AC, Vrandecic BALM, Cruz CBBV, Nomura CH, Cerbino FME, Costa IBSDS, Coelho Filho OR, Carneiro ACDC, Burgos UMMC, Fernandes JL, Uellendahl M, Calado EB, Senra T, Assunção BL, Freire CMV, Martins CN, Sawamura KSS, Brito MM, Jardim MFS, Bernardes RJM, Diógenes TC, Vieira LDO, Mesquita CT, Lopes RW, Segundo Neto EMV, Rigo L, Marin VLS, Santos MJ, Grossman GB, Quagliato PC, Alcantara MLD, Teodoro JAR, Albricker ACL, Barros FS, Amaral SID, Porto CLL, Barros MVL, Santos SND, Cantisano AL, Petisco ACGP, Barbosa JEM, Veloso OCG, Spina S, Pignatelli R, Hajjar LA, Kalil Filho R, Lopes MACQ, Vieira MLC, Almeida ALC. Brazilian Position Statement on the Use Of Multimodality Imaging in Cardio-Oncology - 2021. Arq Bras Cardiol 2021; 117:845-909. [PMID: 34709307 PMCID: PMC8528353 DOI: 10.36660/abc.20200266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
| | | | | | - Carlos Eduardo Rochitte
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Hospital do Coração (HCOR), São Paulo, SP - Brasil
| | | | - Mohamed Hassan Saleh
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil
| | | | | | - Daniel Goldwasser
- Hospital Federal de Ipanema, Rio de Janeiro, RJ - Brasil
- Hospital Copa D'Or, Rio de Janeiro, RJ - Brasil
- Casa de Saúde São José, Rio de Janeiro, RJ - Brasil
| | - Eliza de Almeida Gripp
- Hospital Pró-Cardíaco, Rio de Janeiro, RJ - Brasil
- Hospital Universitário Antônio Pedro, Rio de Janeiro, RJ - Brasil
| | | | - Tonnison Oliveira Silva
- Hospital Cardio Pulmonar - Centro de Estudos em Cardiologia, Salvador, BA - Brasil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA - Brasil
| | | | | | - Vera Maria Cury Salemi
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | - Silvio Henrique Barberato
- CardioEco Centro de Diagnóstico Cardiovascular, Curitiba, PR - Brasil
- Quanta Diagnóstico, Curitiba, PR - Brasil
| | | | | | | | - Marcelo Haertel Miglioranza
- Instituto de Cardiologia do Rio Grande do Sul - Laboratório de Pesquisa e Inovação em Imagem Cardiovascular, Porto Alegre, RS - Brasil
- Hospital Mãe de Deus, Porto Alegre, RS - Brasil
| | | | | | | | - César Higa Nomura
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Hospital Sírio-Libanês, São Paulo, SP - Brasil
| | - Fernanda Mello Erthal Cerbino
- Clínica de Diagnóstico por Imagem, Rio de Janeiro, RJ - Brasil
- Diagnósticos da América AS, Rio de Janeiro, RJ - Brasil
| | | | | | | | | | - Juliano Lara Fernandes
- Radiologia Clínica de Campinas, Campinas, SP - Brasil
- Instituto de Ensino e Pesquisa José Michel Kalaf, Campinas, SP - Brasil
| | - Marly Uellendahl
- Diagnósticos da América AS, Rio de Janeiro, RJ - Brasil
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP - Brasil
| | | | - Tiago Senra
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil
- Hospital Sírio-Libanês, São Paulo, SP - Brasil
| | - Bruna Leal Assunção
- Universidade de São Paulo Instituto do Câncer do Estado de São Paulo, São Paulo, SP - Brasil
| | - Claudia Maria Vilas Freire
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- ECOCENTER, Belo Horizonte, MG - Brasil
| | | | - Karen Saori Shiraishi Sawamura
- Hospital do Coração (HCOR), São Paulo, SP - Brasil
- Hospital Universitário Antônio Pedro, Rio de Janeiro, RJ - Brasil
- Instituto da Criança da Universidade de São Paulo (USP), São Paulo, SP - Brasil
| | - Márcio Miranda Brito
- Universidade Federal do Tocantins - Campus de Araguaina, Araguaina, TO - Brasil
- Hospital Municipal de Araguaina, Araguaina, TO - Brasil
| | | | | | | | | | - Claudio Tinoco Mesquita
- Hospital Pró-Cardíaco, Rio de Janeiro, RJ - Brasil
- Universidade Federal Fluminense (UFF), Rio de Janeiro, RJ - Brasil
- Hospital Vitória, Rio de Janeiro, RJ - Brasil
| | | | | | - Letícia Rigo
- Hospital Beneficência Portuguesa, São Paulo, SP - Brasil
| | | | | | - Gabriel Blacher Grossman
- Clínica Cardionuclear, Porto Alegre, RS - Brasil
- Hospital Moinhos de Vento, Porto Alegre, RS - Brasil
| | | | - Monica Luiza de Alcantara
- Americas Medical City, Rio de Janeiro, Rio de Janeiro, RJ - Brasil
- Americas Serviços Médicos, Rio de Janeiro, RJ - Brasil
- Rede D'Or, Rio de Janeiro, RJ - Brasil
| | | | | | | | | | | | | | - Simone Nascimento Dos Santos
- Hospital Brasília - Ecocardiografia, Brasília, DF - Brasil
- Eccos Diagnóstico Cardiovascular Avançado, Brasília, DF - Brasil
| | | | | | | | | | | | - Ricardo Pignatelli
- Texas Children's Hospital, Houston, Texas - EUA
- Baylor College of Medicine, Houston, Texas - EUA
| | - Ludhmilla Abrahão Hajjar
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Universidade de São Paulo Instituto do Câncer do Estado de São Paulo, São Paulo, SP - Brasil
| | - Roberto Kalil Filho
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Universidade de São Paulo Instituto do Câncer do Estado de São Paulo, São Paulo, SP - Brasil
| | - Marcelo Antônio Cartaxo Queiroga Lopes
- Hospital Alberto Urquiza Wanderley - Hemodinâmica e Cardiologia Intervencionista, João Pessoa, PB - Brasil
- Hospital Metropolitano Dom José Maria Pires, João Pessoa, PB - Brasil
- Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brasil
| | - Marcelo Luiz Campos Vieira
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Hospital Israelita Albert Einstein, São Paulo, SP - Brasil
| | - André Luiz Cerqueira Almeida
- Santa Casa de Misericórdia de Feira de Santana - Cardiologia, Feira de Santana, BA - Brasil
- Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia, São Paulo, SP - Brasil
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Athamnah SI, Oglat AA, Fohely F. Diagnostice breast elastography estimation from doppler imaging using central difference (CD) and least-squares (LS) algorithms. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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Dodaro MG, Montaguti E, Balducci A, Perolo A, Angeli E, Lenzi J, Lombardo L, Donti A, Gargiulo G, Pilu G. Fetal speckle-tracking echocardiography: a comparison between two-dimensional and electronic spatio-temporal image correlation (e-STIC) technique. J Matern Fetal Neonatal Med 2021; 35:6090-6096. [PMID: 33823732 DOI: 10.1080/14767058.2021.1906855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Speckle tracking technology has been applied to assess ventricular deformation throughout the cardiac cycle. An electronic four dimensional probe that allows rapid acquisition of electronic spatio-temporal image correlation volumes (eSTIC) has been recently introduced. OBJECTIVES The aim of our study was to investigate whether e-STIC acquisition improves deformation analyses reproducibility. STUDY DESIGN We recruited fetuses between 20 and 40 weeks of gestation. We obtained a 2D video clip and an e-STIC volume of a four-chamber view. We focused on left ventricular global strain (LV-GS) and left ventricular ejection fraction (LV-FE). Intraobserver, interobserver and intermethod agreement were assessed by means of intraclass correlation coefficient (ICC) and illustrated by Bland-Altman plots. Systematic differences between measurements were assessed using a paired t-test. RESULTS The mean difference between LV-GS values obtained with e-STIC and 2D analysis was -0.10 (95% CI -2.28, 2.08). No systematic differences were found between the two techniques for LV-GS values (p-value = .927). The mean difference between LV-FE values obtained with e-STIC and 2D analysis was 7.55 (95% CI 4.16, 10.95; p-value <.001). The inter-rater reliability of LV-GS was moderate-to-substantial for both e-STIC and 2D. The inter-rater reliability of LV-FE obtained via e-STIC was superior to that obtained via 2D analysis. The intra-rater reliability of LV-GS obtained with e-STIC was superior to that obtained with 2D analysis (ICC 0.857; 95% IC 0.761-0.917). The intra-rater reliability of LV-FE obtained via e-STIC was superior to that obtained via 2D analysis (ICC 0.647; IC 0.51-0.783). CONCLUSIONS e-STIC seems to be a better technique than 2D analysis for intra-rater reliability of LV-GS. 4D acquisition might improve intrinsic limitations of speckle tracking echocardiography.
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Affiliation(s)
- Maria Gaia Dodaro
- Department of Medical and Surgical Sciences, Obstetric Unit, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy
| | - Elisa Montaguti
- Department of Medical and Surgical Sciences, Obstetric Unit, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy
| | - Anna Balducci
- Department of Cardiac, Thoracic and Vascular Sciences, Paediatric Cardiology and Adult Congenital Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Antonella Perolo
- Department of Medical and Surgical Sciences, Obstetric Unit, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy
| | - Emanuela Angeli
- Department of Pediatric and Adult Congenital Heart Cardiac Surgery, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Bologna, Italy
| | - Lorenzo Lombardo
- Department of Cardiac, Thoracic and Vascular Sciences, Paediatric Cardiology and Adult Congenital Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Andrea Donti
- Department of Cardiac, Thoracic and Vascular Sciences, Paediatric Cardiology and Adult Congenital Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Gaetano Gargiulo
- Department of Pediatric and Adult Congenital Heart Cardiac Surgery, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Gianluigi Pilu
- Department of Medical and Surgical Sciences, Obstetric Unit, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy
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Sakkuru PKR, Velam V, Durgaprasad R, Chanda N, Maddala RNM, Yandrapu MN. Assessment of immediate effects of percutaneous balloon mitral valvuloplasty on right ventricular and pulmonary functions in severe rheumatic mitral stenosis patients using speckle tracking echocardiography and spirometry. J Cardiovasc Thorac Res 2021; 12:280-285. [PMID: 33510876 PMCID: PMC7828756 DOI: 10.34172/jcvtr.2020.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/30/2020] [Indexed: 11/09/2022] Open
Abstract
Introduction: The current study was sought to assess the immediate effect of percutaneous balloonmitral valvuloplasty (PBMV) on right ventricular (RV) and pulmonary functions using speckle tracking echocardiography (STE) and spirometry respectively. Methods: Two-dimensional speckle tracking and doppler studies for strain and strain rate imaging of RV were performed before PBMV, after 48h and 15 days of PBMV using echocardiography and spirometry. Mitral valve area, peak and mean mitral valve transannular pressure gradients, late filling velocities,Wilkins score, Systolic pulmonary artery pressure, TAPSE, RV end-diastolic and end-systolic areas,RV fractional area change and Tei index were measured. Results: There was a significant rise in peak RV global longitudinal strain (GLS) from baseline to48h post PBMV and at 15 days post PBMV. Segmental RV strain at basal septum, mid septum,apical septum and basal RV free wall showed considerable improvement from baseline to 48h post PBMV and 15 days post PBMV. RV longitudinal strain rate parameters did not show significant improvement after PBMV and remained low at follow-up. Post PBMV all patients showed restrictive features on pulmonary function test. The mean FEV1 (% predicted), mean FVC (% predicted), mean PEFR improved from baseline to 48h PBMV and 15 days post PBMV. Though the mean FEV1/FVC increased post PBMV at 15 days follow-up, but it was statistically insignificant. Conclusion: RV performance in MS was decreased mainly due to increase in RV after load which improves after PBMV. Patients with severe MS have impaired pulmonary function which is of restrictive type and successful PBMV improves pulmonary function.
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Affiliation(s)
| | - Vanajakshamma Velam
- Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Rajasekhar Durgaprasad
- Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Narendra Chanda
- Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Raja Naga Mahesh Maddala
- Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Madhava Naidu Yandrapu
- Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
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12
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Li H, Qu Y, Metze P, Sommerfeld F, Just S, Abaei A, Rasche V. Quantification of Biventricular Myocardial Strain Using CMR Feature Tracking: Reproducibility in Small Animals. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8492705. [PMID: 33553431 PMCID: PMC7847329 DOI: 10.1155/2021/8492705] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 12/16/2020] [Accepted: 01/13/2021] [Indexed: 12/16/2022]
Abstract
Myocardial strain is a well-validated parameter for evaluating myocardial contraction. Cardiovascular magnetic resonance myocardial feature tracking (CMR-FT) is a novel method for the quantitative measurements of myocardial strain from routine cine acquisitions. In this study, we investigated the influence of temporal resolution on tracking accuracy of CMR-FT and the intraobserver, interobserver, and interstudy reproducibilities for biventricular strain analysis in mice from self-gated CMR at 11.7 T. 12 constitutive nexilin knockout (Nexn-KO) mice, heterozygous (Het, N = 6) and wild-type (WT, N = 6), were measured with a well-established self-gating sequence twice within two weeks. CMR-FT measures of biventricular global and segmental strain parameters were derived. Interstudy, intraobserver, and interobserver reproducibilities were investigated. For the assessment of the impact of the temporal resolution for the outcome in CMR-FT, highly oversampled semi-4 chamber and midventricular short-axis data were acquired and reconstructed with 10 to 80 phases per cardiac cycle. A generally reduced biventricular myocardial strain was observed in Nexn-KO Het mice. Excellent intraobserver and interobserver reproducibility was achieved in all global strains (ICC range from 0.76 to 0.99), where global right ventricle circumferential strain (RCSSAX) showed an only good interobserver reproducibility (ICC 0.65, 0.11-0.89). For interstudy reproducibility, left ventricle longitudinal strain (LLSLAX) was the most reproducible measure of strain (ICC 0.90, 0.71-0.97). The left ventricle radial strain (LRSSAX) (ICC 0.50, 0.10-0.83) showed fair reproducibility and RCSSAX (ICC 0.36, 0.14-0.74) showed only poor reproducibility. In general, compared with global strains, the segmental strains showed relatively lower reproducibility. A minimal temporal resolution of 20 phases per cardiac cycle appeared sufficient for CMR-FT strain analysis. The analysis of myocardial strain from high-resolution self-gated cine images by CMR-FT provides a highly reproducible method for assessing myocardial contraction in small rodent animals. Especially, global LV longitudinal and circumferential strain revealed excellent reproducibility of intra- and interobserver and interstudy measurements.
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Affiliation(s)
- Hao Li
- Core Facility Small Animal Imaging, Ulm University, Ulm, Germany
| | - Yangyang Qu
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Patrick Metze
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | | | - Steffen Just
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Alireza Abaei
- Core Facility Small Animal Imaging, Ulm University, Ulm, Germany
| | - Volker Rasche
- Core Facility Small Animal Imaging, Ulm University, Ulm, Germany
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
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13
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Agasthi P, Chao CJ, Siegel RJ, Pujari SH, Mookadam F, Venepally NR, Wang P, Ashraf H, Marcotte F, Brown L, Semkiv OI, Fath AR, Allam MNA, Jokerst CE, Arsanjani R. Comparison of echocardiographic parameters with cardiac magnetic resonance imaging in the assessment of right ventricular function. Echocardiography 2020; 37:1792-1802. [PMID: 33012034 DOI: 10.1111/echo.14877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/27/2020] [Accepted: 09/12/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION The right ventricle (RV) strain measured by speckle tracking (RVS) is an echocardiographic parameter used to assess RV function. We compared RVS to RV fractional area change (FAC%), tricuspid annular plane systolic excursion (TAPSE) and Doppler tissue imaging-derived peak systolic velocity (S') in the assessment of right ventricular (RV) systolic function measured using cardiac magnetic resonance imaging (MRI). METHODS We enrolled consecutive patients who underwent cardiac MRI between Jan 2012 and Dec 2017 and a transthoracic echocardiogram (TTE) within 1 month of the MRI with no interval event. Baseline clinical characteristics and MRI parameters were extracted from chart review. Echocardiographic parameters were measured prospectively. TTE parameters including RVS, TAPSE, S', and FAC% were tested for accuracy to identify impaired RV EF (EF < 45% & <30%) using receiver operator curves. RESULTS The study cohort included 500 patients with mean age 55 years ± 18 and peak tricuspid regurgitation velocity 2.7 ± 1.4 m/s. The area under ROC for RVS was 0.69 (95% CI 0.63-0.75) and 0.78 (95% CI 0.70-0.88) to predict RVEF < 45% & RVEF < 30%, respectively. The RV FAC% had second highest accuracy of predicting RVEF among all the TTE parameters tested in study. CONCLUSION Right ventricular strain is the most accurate echocardiographic method to detect impaired right ventricular systolic function when using MRI as the gold standard.
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Affiliation(s)
- Pradyumna Agasthi
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Chieh-Ju Chao
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Robert J Siegel
- Department of Cardiology, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Sai Harika Pujari
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Farouk Mookadam
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Nithin R Venepally
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Panwen Wang
- Department of Health Sciences Research, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Hasan Ashraf
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Francois Marcotte
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Lisa Brown
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Oksana I Semkiv
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Ayman R Fath
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Mohamed N A Allam
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, USA
| | | | - Reza Arsanjani
- Department of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ, USA
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14
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Andersen MS, Moore C, LeFevre M, Arges K, Friedman DJ, Atwater BD, Kisslo J, Søgaard P, Struijk JJ, von Ramm OT, Schmidt SE. Contractile Fronts In The Interventricular Septum: A Case For High Frame Rate Echocardiographic Imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:2181-2192. [PMID: 32561068 DOI: 10.1016/j.ultrasmedbio.2020.04.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 06/11/2023]
Abstract
The real time high frame rate (HFR) 2-dimensional ultrasound system, T5, at Duke University is capable of imaging at up to 1000 images per second for adult cardiac imaging. A method for detecting and visualizing the mechanical contraction fronts using HFR echocardioagraphy-derived Strain Rate Image (SRI) was described in 26 patients. The Tissue Shortening Onset front durations for echocardiographic normal patients were significantly shorter than conduction disorder patients with left bundle branch block (LBBB) with intrinsic conduction and conduction disorder patients without LBBB (non-LBBB) with simulated LBBB (sLBBB). Echocardiographic normal patients had significantly higher correlation coefficients between their SRIs and spatially inverted versions of themselves compared to non-LBBB patients with intrinsic conduction and sLBBB. In conclusion, SRIs could spatially resolve contractile event fronts in patients.
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Affiliation(s)
| | | | | | | | | | | | - Joseph Kisslo
- Duke University Medical Center, Durham, NC 27710, USA
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15
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Barrington K, El-Khuffash A, Dempsey E. Intervention and Outcome for Neonatal Hypotension. Clin Perinatol 2020; 47:563-574. [PMID: 32713451 DOI: 10.1016/j.clp.2020.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Many observational studies have shown that infants with blood pressures (BPs) that are in the lower range for their gestational age tend to have increased complications such as an increased rate of significant intraventricular hemorrhage and adverse long-term outcome. This relationship does not prove causation nor should it create an indication for treatment. However, many continue to intervene with medication for low BP on the assumption that an increase in BP will result in improved outcome. Only adequately powered prospective randomized controlled trials can answer the question of whether individual treatments of low BP are beneficial.
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Affiliation(s)
| | - Afif El-Khuffash
- The Rotunda Hospital, Dublin and Royal College of Surgeons, Dublin, Ireland
| | - Eugene Dempsey
- Department of Paediatrics and Child Health, INFANT Centre, University College Cork, Ireland.
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16
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Mavrogeni SI, Sfendouraki E, Markousis-Mavrogenis G, Rigopoulos A, Noutsias M, Kolovou G, Angeli C, Tousoulis D. Cardio-oncology, the myth of Sisyphus, and cardiovascular disease in breast cancer survivors. Heart Fail Rev 2020; 24:977-987. [PMID: 31134427 DOI: 10.1007/s10741-019-09805-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The number of breast cancer (BC) survivors has been increasing lately, due to the improvement in early detection strategies and oncological treatments. However, BC survivors are 3 times as likely to develop heart failure (HF) within 5 years of cancer diagnosis, and 7/100 of them will develop HF in a median follow-up of 8.5 years. Furthermore, HF in BC survivors has a worse prognosis compared to other causes of HF. Anthracyclines and trastuzumab have been proven to improve survival. However, they are also considered as the main causative factors of HF in BC survivors. Old patients, those with a pre-existing cardiovascular (CV) risk factors/disease, prior exposure to chemotherapy and radiotherapy are at increased risk. Serial evaluation of troponins and cardiac imaging parameters using echocardiography and cardiovascular magnetic resonance can significantly contribute to the early diagnosis of cardiac involvement before overt HF will develop. Assessment and immediate treatment of traditional CV risk factors is the first step for cardiotoxicity prevention. In BC survivors with known heart disease, the clinical stabilization is strongly recommended for cardiotoxicity prevention. Finally, in high-risk CV patients, primary prevention including cardioprotectants and/or CV drugs should be applied. According to recent studies, the early start of ACE inhibitors and β-blockers and the modification of anti-cancer treatment can prevent the decline in left ventricular ejection fraction. However, further multicenter studies are needed to establish both prevention and treatment protocols to successfully overcome HF development in BC survivors.
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Affiliation(s)
- Sophie I Mavrogeni
- Onassis Cardiac Surgery Center and Kapodistrian, University of Athens, 50 Esperou Street, 175-61 P. Faliro, Athens, Greece.
| | - Elisa Sfendouraki
- First Cardiology Department, Hippokration Hospital, University of Athens, Athens, Greece
| | - George Markousis-Mavrogenis
- Onassis Cardiac Surgery Center and Kapodistrian, University of Athens, 50 Esperou Street, 175-61 P. Faliro, Athens, Greece
| | - Angelos Rigopoulos
- Mid-German Heart Center, Department of Internal Medicine III (KIM III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany
| | - Michel Noutsias
- Mid-German Heart Center, Department of Internal Medicine III (KIM III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany
| | - Genovefa Kolovou
- Onassis Cardiac Surgery Center and Kapodistrian, University of Athens, 50 Esperou Street, 175-61 P. Faliro, Athens, Greece
| | - Constantina Angeli
- First Cardiology Department, Hippokration Hospital, University of Athens, Athens, Greece
| | - Dimitrios Tousoulis
- First Cardiology Department, Hippokration Hospital, University of Athens, Athens, Greece
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Day TG, Charakida M, Simpson JM. Using speckle-tracking echocardiography to assess fetal myocardial deformation: are we there yet? ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 54:575-581. [PMID: 30740804 DOI: 10.1002/uog.20233] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/07/2019] [Accepted: 02/07/2019] [Indexed: 06/09/2023]
Affiliation(s)
- T G Day
- Fetal Cardiology Unit, Department of Congenital Heart Disease, Evelina Children's Healthcare, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Charakida
- Fetal Cardiology Unit, Department of Congenital Heart Disease, Evelina Children's Healthcare, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Division of Imaging Science and Biomedical Engineering, King's College London, London, UK
| | - J M Simpson
- Fetal Cardiology Unit, Department of Congenital Heart Disease, Evelina Children's Healthcare, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Division of Imaging Science and Biomedical Engineering, King's College London, London, UK
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18
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Huntgeburth M, Germund I, Geerdink LM, Sreeram N, Udink Ten Cate FEA. Emerging clinical applications of strain imaging and three-dimensional echocardiography for the assessment of ventricular function in adult congenital heart disease. Cardiovasc Diagn Ther 2019; 9:S326-S345. [PMID: 31737540 DOI: 10.21037/cdt.2018.11.08] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Management of congenital heart disease (CHD) in adults (ACHD) remains an ongoing challenge due to the presence of residual hemodynamic lesions and development of ventricular dysfunction in a large number of patients. Echocardiographic imaging plays a central role in clinical decision-making and selection of patients who will benefit most from catheter interventions or cardiac surgery.. Recent advances in both strain imaging and three-dimensional (3D)-echocardiography have significantly contributed to a greater understanding of the complex pathophysiological mechanisms involved in CHD. The aim of this paper is to provide an overview of emerging clinical applications of speckle-tracking imaging and 3D-echocardiography in ACHD with focus on functional assessment, ventriculo-ventricular interdependency, mechanisms of electromechanical delay, and twist abnormalities in adults with tetralogy of Fallot (TOF), a systemic RV after atrial switch repair or in double discordance ventricles, and in those with a Fontan circulation.
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Affiliation(s)
- Michael Huntgeburth
- Center for Grown-ups with congenital heart disease (GUCH), Clinic III for Internal Medicine, Department of Cardiology, Heart Center, University Hospital of Cologne, Germany
| | - Ingo Germund
- Department of Pediatric Cardiology, Heart Center, University Hospital of Cologne, Germany
| | - Lianne M Geerdink
- Academic Center for Congenital Heart Disease (ACAHA), Department of Pediatric Cardiology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen.,Division of Pediatric Cardiology, Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Narayanswami Sreeram
- Department of Pediatric Cardiology, Heart Center, University Hospital of Cologne, Germany
| | - Floris E A Udink Ten Cate
- Academic Center for Congenital Heart Disease (ACAHA), Department of Pediatric Cardiology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen.,Division of Pediatric Cardiology, Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
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19
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Badran HM, Ahmed MK, Beshay MM, Zein FEA. A comparative study between transthoracic and transesophageal echo modalities in evaluation of left ventricular deformation. Egypt Heart J 2019; 71:4. [PMID: 31659538 PMCID: PMC6821410 DOI: 10.1186/s43044-019-0004-4] [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: 05/28/2019] [Accepted: 06/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND 2D strain imaging has been proved as an accurate technique for the assessment of left ventricular (LV) function using transthoracic echocardiography (TTE). Transesophageal echocardiography (TEE) has become a standard and essential technique in clinical practice especially when TTE is inconclusive. Adding 2D strain imaging to TEE might be valuable in the evaluation of cardiac performance. The aim of the present study was to compare 2D strain imaging using TTE and TEE in the assessment of left ventricular deformation in patients with cardiovascular diseases. RESULTS This study was conducted on sixty patients, who were referred for TEE for various clinical indications. All patients were examined with both TTE and TEE 2D strain imaging. Global and regional strain parameters including longitudinal (LS), circumferential (CS), and radial (RS) were examined. Analysis of 2D strain using TTE was time sparing than TEE (16 ± 1 vs 19 ± 2 min, P < 0.001). From 1020 segments explored using TTE, 97% (LS) and 93% (CS and RS) of the segments were fully analyzed versus 90% and 88% using TEE respectively (P < 0.01). TEE longitudinal strain has an excellent agreement with TTE-derived measurements and a modest agreement in circumferential strain but a notable disparity in radial strain values. Both regional and global LS and RS measured by TTE showed higher values (P < 0.01, < 0.03) compared with its corresponding values measured by TEE. Whereas segmental and global values of CS were higher using TTE modes, the difference with the analogous TEE values did not reach statistical significance. LS and CS measured by TTE and TEE showed excellent but similar correlation with LV EF and wall motion score index. CONCLUSION 2D strain using TTE is user friendly compared to TEE. However, because of the good agreement, TEE 2D strain might represent an appropriate alternative in the evaluation of global LV deformation.
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20
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Kunovac A, Hathaway QA, Pinti MV, Goldsmith WT, Durr AJ, Fink GK, Nurkiewicz TR, Hollander JM. ROS promote epigenetic remodeling and cardiac dysfunction in offspring following maternal engineered nanomaterial (ENM) exposure. Part Fibre Toxicol 2019; 16:24. [PMID: 31215478 PMCID: PMC6582485 DOI: 10.1186/s12989-019-0310-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 06/06/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Nano-titanium dioxide (nano-TiO2) is amongst the most widely utilized engineered nanomaterials (ENMs). However, little is known regarding the consequences maternal ENM inhalation exposure has on growing progeny during gestation. ENM inhalation exposure has been reported to decrease mitochondrial bioenergetics and cardiac function, though the mechanisms responsible are poorly understood. Reactive oxygen species (ROS) are increased as a result of ENM inhalation exposure, but it is unclear whether they impact fetal reprogramming. The purpose of this study was to determine whether maternal ENM inhalation exposure influences progeny cardiac development and epigenomic remodeling. RESULTS Pregnant FVB dams were exposed to nano-TiO2 aerosols with a mass concentration of 12.09 ± 0.26 mg/m3 starting at gestational day five (GD 5), for 6 h over 6 non-consecutive days. Aerosol size distribution measurements indicated an aerodynamic count median diameter (CMD) of 156 nm with a geometric standard deviation (GSD) of 1.70. Echocardiographic imaging was used to assess cardiac function in maternal, fetal (GD 15), and young adult (11 weeks) animals. Electron transport chain (ETC) complex activities, mitochondrial size, complexity, and respiration were evaluated, along with 5-methylcytosine, Dnmt1 protein expression, and Hif1α activity. Cardiac functional analyses revealed a 43% increase in left ventricular mass and 25% decrease in cardiac output (fetal), with an 18% decrease in fractional shortening (young adult). In fetal pups, hydrogen peroxide (H2O2) levels were significantly increased (~ 10 fold) with a subsequent decrease in expression of the antioxidant enzyme, phospholipid hydroperoxide glutathione peroxidase (GPx4). ETC complex activity IV was decreased by 68 and 46% in fetal and young adult cardiac mitochondria, respectively. DNA methylation was significantly increased in fetal pups following exposure, along with increased Hif1α activity and Dnmt1 protein expression. Mitochondrial ultrastructure, including increased size, was observed at both fetal and young adult stages following maternal exposure. CONCLUSIONS Maternal inhalation exposure to nano-TiO2 results in adverse effects on cardiac function that are associated with increased H2O2 levels and dysregulation of the Hif1α/Dnmt1 regulatory axis in fetal offspring. Our findings suggest a distinct interplay between ROS and epigenetic remodeling that leads to sustained cardiac contractile dysfunction in growing and young adult offspring following maternal ENM inhalation exposure.
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Affiliation(s)
- Amina Kunovac
- Division of Exercise Physiology, West Virginia University School of Medicine, PO Box 9227, 1 Medical Center Drive, Morgantown, WV 26506 USA
- Mitochondria, Metabolism & Bioenergetics Working Group, West Virginia University School of Medicine, Morgantown, WV USA
- Center for Inhalation Toxicology (iTOX), West Virginia University School of Medicine, Morgantown, WV USA
| | - Quincy A. Hathaway
- Division of Exercise Physiology, West Virginia University School of Medicine, PO Box 9227, 1 Medical Center Drive, Morgantown, WV 26506 USA
- Mitochondria, Metabolism & Bioenergetics Working Group, West Virginia University School of Medicine, Morgantown, WV USA
- Center for Inhalation Toxicology (iTOX), West Virginia University School of Medicine, Morgantown, WV USA
| | - Mark V. Pinti
- West Virginia University School of Pharmacy, Morgantown, WV USA
| | - William T. Goldsmith
- Center for Inhalation Toxicology (iTOX), West Virginia University School of Medicine, Morgantown, WV USA
- Department of Physiology, Pharmacology, Morgantown, WV USA
| | - Andrya J. Durr
- Division of Exercise Physiology, West Virginia University School of Medicine, PO Box 9227, 1 Medical Center Drive, Morgantown, WV 26506 USA
- Mitochondria, Metabolism & Bioenergetics Working Group, West Virginia University School of Medicine, Morgantown, WV USA
| | - Garrett K. Fink
- Division of Exercise Physiology, West Virginia University School of Medicine, PO Box 9227, 1 Medical Center Drive, Morgantown, WV 26506 USA
| | - Timothy R. Nurkiewicz
- Center for Inhalation Toxicology (iTOX), West Virginia University School of Medicine, Morgantown, WV USA
- Department of Physiology, Pharmacology, Morgantown, WV USA
| | - John M. Hollander
- Division of Exercise Physiology, West Virginia University School of Medicine, PO Box 9227, 1 Medical Center Drive, Morgantown, WV 26506 USA
- Mitochondria, Metabolism & Bioenergetics Working Group, West Virginia University School of Medicine, Morgantown, WV USA
- Center for Inhalation Toxicology (iTOX), West Virginia University School of Medicine, Morgantown, WV USA
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21
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Bussmann N, El-Khuffash A. Future perspectives on the use of deformation analysis to identify the underlying pathophysiological basis for cardiovascular compromise in neonates. Pediatr Res 2019; 85:591-595. [PMID: 30666047 DOI: 10.1038/s41390-019-0293-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/28/2018] [Accepted: 01/02/2019] [Indexed: 12/28/2022]
Abstract
The assessment of the wellbeing of the cardiovascular status in premature infants has come to the forefront in recent years. There is an increasing realisation that myocardial performance, systemic blood flow and end-organ perfusion (particularly during the transitional period) play an important role in determining short and long-term outcomes in this population. The recent open access series on Neonatologist Performed Echocardiography (NPE) published in this journal outline the necessary techniques for image acquisition and analysis and provide a framework for the potential clinical applications of NPE in neonatal, and specifically preterm care. In this "Future Perspectives" review, we describe the important determinants of adequate cellular metabolism and myocardial performance (e.g. loading conditions, intrinsic contractility and morphological change), we discuss the maladaptive state of the preterm cardiovascular system, and highlight the emerging role that non-invasive echocardiography techniques, such as deformation analysis, serve in identifying the underlying physiological basis for cardiovascular instability.
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Affiliation(s)
- Neidin Bussmann
- Department of Neonatology, The Rotunda Hospital, Dublin, Ireland
| | - Afif El-Khuffash
- School of Medicine, Department of Pediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland.
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22
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Dermlim A, Nakamura K, Morita T, Osuga T, Nisa K, Sasaoka K, Leela-Arporn R, Sasaki N, Ohta H, Takiguchi M. The Repeatability and Left Atrial Strain Analysis Obtained via Speckle Tracking Echocardiography in healthy Dogs. J Vet Cardiol 2019; 23:69-80. [PMID: 31174731 DOI: 10.1016/j.jvc.2019.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 01/22/2019] [Accepted: 01/28/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION In left atrial (LA) strain-derived two-dimensional speckle tracking echocardiography, the reference intervals in healthy dogs can provide useful information to evaluate the LA function in dogs with heart disease. ANIMALS Six laboratory beagles and 120 privately owned dogs without cardiac diseases were recruited. MATERIALS AND METHODS The LA strain and strain rate (SR) and echocardiographic indices were obtained in dogs who underwent standard echocardiography and offline analysis for LA strain and SR measurement by speckle tracking echocardiography. RESULTS The intra-observer within-day variations of strain variables showed adequate repeatability (coefficient of variation <20%). The mean values of strain were 25.37 for the LA reservoir function, 11.06 for the LA conduit function, and 14.17 for the LA booster-pump function; the strain was significantly correlated with the LA fractional volume change at each phasic function. The left atrial longitudinal strain during early ventricular diastole showed moderate correlation with the peak velocity of early diastolic transmitral flow (r = 0.5560) and ratio of peak velocity of early diastolic transmitral flow to peak velocity of late transmitral flow (r = 0.5515). In multiple regression analysis, only age was significantly related to the strain/SR and volumetric change indices, indicating conduit function. CONCLUSIONS Left atrial speckle tracking echocardiographic analysis provided useful information to assess the LA function in healthy dogs. The influencing factors on strain and SR variables including the age, body weight, and heart rate should be considered in interpretation of these parameters in a clinical setting.
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Affiliation(s)
- A Dermlim
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, Japan
| | - K Nakamura
- Laboratory of Internal Medicine, Organization for Promotion of Tenure Track, University of Miyazaki, 1-1 Gakuenkibanadai-nishi, Miyazaki, Japan.
| | - T Morita
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, Japan
| | - T Osuga
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, Japan
| | - K Nisa
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, Japan
| | - K Sasaoka
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, Japan
| | - R Leela-Arporn
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, Japan
| | - N Sasaki
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, Japan
| | - H Ohta
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, Japan
| | - M Takiguchi
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, Japan
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23
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Hathaway QA, Durr AJ, Shepherd DL, Pinti MV, Brandebura AN, Nichols CE, Kunovac A, Goldsmith WT, Friend SA, Abukabda AB, Fink GK, Nurkiewicz TR, Hollander JM. miRNA-378a as a key regulator of cardiovascular health following engineered nanomaterial inhalation exposure. Nanotoxicology 2019; 13:644-663. [PMID: 30704319 DOI: 10.1080/17435390.2019.1570372] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Nano-titanium dioxide (nano-TiO2), though one of the most utilized and produced engineered nanomaterials (ENMs), diminishes cardiovascular function through dysregulation of metabolism and mitochondrial bioenergetics following inhalation exposure. The molecular mechanisms governing this cardiac dysfunction remain largely unknown. The purpose of this study was to elucidate molecular mediators that connect nano-TiO2 exposure with impaired cardiac function. Specifically, we were interested in the role of microRNA (miRNA) expression in the resulting dysfunction. Not only are miRNA global regulators of gene expression, but also miRNA-based therapeutics provide a realistic treatment modality. Wild type and MiRNA-378a knockout mice were exposed to nano-TiO2 with an aerodynamic diameter of 182 ± 1.70 nm and a mass concentration of 11.09 mg/m3 for 4 h. Cardiac function, utilizing the Vevo 2100 Imaging System, electron transport chain complex activities, and mitochondrial respiration assessed cardiac and mitochondrial function. Immunoblotting and qPCR examined molecular targets of miRNA-378a. MiRNA-378a-3p expression was increased 48 h post inhalation exposure to nano-TiO2. Knockout of miRNA-378a preserved cardiac function following exposure as revealed by preserved E/A ratio and E/SR ratio. In knockout animals, complex I, III, and IV activities (∼2- to 6-fold) and fatty acid respiration (∼5-fold) were significantly increased. MiRNA-378a regulated proteins involved in mitochondrial fusion, transcription, and fatty acid metabolism. MiRNA-378a-3p acts as a negative regulator of mitochondrial metabolic and biogenesis pathways. MiRNA-378a knockout animals provide a protective effect against nano-TiO2 inhalation exposure by altering mitochondrial structure and function. This is the first study to manipulate a miRNA to attenuate the effects of ENM exposure.
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Affiliation(s)
- Quincy A Hathaway
- a Division of Exercise Physiology , West Virginia University School of Medicine , Morgantown , WV , USA.,b Mitochondria, Metabolism & Bioenergetics Working Group , West Virginia University School of Medicine , Morgantown , WV , USA.,c Toxicology Working Group , West Virginia University School of Medicine , Morgantown , WV , USA
| | - Andrya J Durr
- a Division of Exercise Physiology , West Virginia University School of Medicine , Morgantown , WV , USA.,b Mitochondria, Metabolism & Bioenergetics Working Group , West Virginia University School of Medicine , Morgantown , WV , USA
| | - Danielle L Shepherd
- a Division of Exercise Physiology , West Virginia University School of Medicine , Morgantown , WV , USA.,b Mitochondria, Metabolism & Bioenergetics Working Group , West Virginia University School of Medicine , Morgantown , WV , USA
| | - Mark V Pinti
- a Division of Exercise Physiology , West Virginia University School of Medicine , Morgantown , WV , USA.,b Mitochondria, Metabolism & Bioenergetics Working Group , West Virginia University School of Medicine , Morgantown , WV , USA
| | - Ashley N Brandebura
- d Rockefeller Neuroscience Institute , West Virginia University School of Medicine , Morgantown , WV , USA.,e Department of Biochemistry , West Virginia University School of Medicine , Morgantown , WV , USA
| | - Cody E Nichols
- f Immunity, Inflammation, and Disease Laboratory , National Institute of Environmental Health Sciences , Research Triangle Park , NC , USA
| | - Amina Kunovac
- a Division of Exercise Physiology , West Virginia University School of Medicine , Morgantown , WV , USA.,b Mitochondria, Metabolism & Bioenergetics Working Group , West Virginia University School of Medicine , Morgantown , WV , USA
| | - William T Goldsmith
- c Toxicology Working Group , West Virginia University School of Medicine , Morgantown , WV , USA.,g Department of Physiology, Pharmacology & Neuroscience , West Virginia University School of Medicine , Morgantown , WV , USA
| | - Sherri A Friend
- h CDC , National Institute for Occupational Safety and Health , Morgantown , WV , USA
| | - Alaeddin B Abukabda
- c Toxicology Working Group , West Virginia University School of Medicine , Morgantown , WV , USA.,g Department of Physiology, Pharmacology & Neuroscience , West Virginia University School of Medicine , Morgantown , WV , USA
| | - Garrett K Fink
- a Division of Exercise Physiology , West Virginia University School of Medicine , Morgantown , WV , USA
| | - Timothy R Nurkiewicz
- c Toxicology Working Group , West Virginia University School of Medicine , Morgantown , WV , USA.,g Department of Physiology, Pharmacology & Neuroscience , West Virginia University School of Medicine , Morgantown , WV , USA
| | - John M Hollander
- a Division of Exercise Physiology , West Virginia University School of Medicine , Morgantown , WV , USA.,b Mitochondria, Metabolism & Bioenergetics Working Group , West Virginia University School of Medicine , Morgantown , WV , USA
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24
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Atzeni F, Corda M, Gianturco L, Porcu M, Sarzi-Puttini P, Turiel M. Cardiovascular Imaging Techniques in Systemic Rheumatic Diseases. Front Med (Lausanne) 2018; 5:26. [PMID: 29497612 PMCID: PMC5819573 DOI: 10.3389/fmed.2018.00026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 01/25/2018] [Indexed: 01/20/2023] Open
Abstract
The risk of cardiovascular (CV) events and mortality is significantly higher in patients with systemic rheumatic diseases than in the general population. Although CV involvement in such patients is highly heterogeneous and may affect various structures of the heart, it can now be diagnosed earlier and promptly treated. Various types of assessments are employed for the evaluation of CV risk such as transthoracic or transesophageal echocardiography, magnetic resonance imaging (MRI), and computed tomography (CT) to investigate valve abnormalities, pericardial disease, and ventricular wall motion defects. The diameter of coronary arteries can be assessed using invasive quantitative coronarography or intravascular ultrasound, and coronary flow reserve can be assessed using non-invasive transesophageal or transthoracic ultrasonography (US), MRI, CT, or positron emission tomography (PET) after endothelium-dependent vasodilation. Finally, peripheral circulation can be measured invasively using strain-gauge plethysmography in an arm after the arterial infusion of an endothelium-dependent vasodilator or non-invasively by means of US or MRI measurements of flow-mediated vasodilation of the brachial artery. All of the above are reliable methods of investigating CV involvement, but more recently, introduced use of speckle tracking echocardiography and 3-dimensional US are diagnostically more accurate.
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Affiliation(s)
- Fabiola Atzeni
- Rheumatology Unit, University of Messina, Messina, Italy
| | - Marco Corda
- Cardiology Unit, Brotzu Hospital, Cagliari, Italy
| | - Luigi Gianturco
- Cardiology Unit, IRCCS Galeazzi Orthopedic Institute, Milan, Italy
| | | | | | - Maurizio Turiel
- Cardiology Unit, IRCCS Galeazzi Orthopedic Institute, Milan, Italy
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25
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Lecoq L, Moula N, Amory H, Rollin F, Leroux A. Two-dimensional speckle tracking echocardiography in calves: feasibility and repeatability study. J Vet Cardiol 2018; 20:45-54. [PMID: 29395940 DOI: 10.1016/j.jvc.2017.10.008] [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] [Received: 05/10/2016] [Revised: 10/05/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To assess the feasibility and repeatability of two-dimensional speckle tracking echocardiography for the evaluation of left ventricular function in healthy calves. ANIMALS 12 Holstein calves, 62 ± 11.6 days old; 75.25 ± 5.4 Kg. METHODS Observational study. Right parasternal short-axis views at papillary muscle level were recorded in standing calves and subsequently analyzed by two-dimensional speckle tracking for global and regional radial and circumferential strains and strain rates and radial displacement. Echocardiographic examinations were performed by 2 observers to evaluate intra- and interobserver repeatability and variability. RESULTS Two-dimensional speckle tracking was feasible in all calves. Automated tracking was better in systole than in diastole. Repeatability of the technique was good in calves. Systolic radial strain and strain rate peak values showed little variability compared with systolic circumferential strain and strain rate and to all diastolic measurements. Variability of the interobserver measurements was greater than the intraobserver measurements. CONCLUSIONS Two-dimensional speckle tracking is feasible in calves. As in other species, evaluation of systolic radial left ventricular function is more reliable than circumferential and diastolic left ventricular function.
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Affiliation(s)
- L Lecoq
- Clinical Department of Companion Animals and Equids, Faculty of Veterinary Medicine, University of Liege, Quartier Vallée 2 B41, Avenue de Cureghem 5A-5D, 4000 Liège, Belgium.
| | - N Moula
- Department of Animal Production, Faculty of Veterinary Medicine, University of Liege, Quartier Vallée 2 B42, Avenue de Cureghem 7A-7D, 4000 Liège, Belgium
| | - H Amory
- Clinical Department of Companion Animals and Equids, Faculty of Veterinary Medicine, University of Liege, Quartier Vallée 2 B41, Avenue de Cureghem 5A-5D, 4000 Liège, Belgium
| | - F Rollin
- Clinical Department of Production Animals, Faculty of Veterinary Medicine, University of Liege, Quartier Vallée 2 B42, Avenue de Cureghem 7A-7D, 4000 Liège, Belgium
| | - A Leroux
- Clinical Department of Companion Animals and Equids, Faculty of Veterinary Medicine, University of Liege, Quartier Vallée 2 B41, Avenue de Cureghem 5A-5D, 4000 Liège, Belgium
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26
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Recent Advances and Trends in Pediatric Cardiac Imaging. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2018; 20:9. [DOI: 10.1007/s11936-018-0599-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Moreira HT, Nwabuo CC, Armstrong AC, Kishi S, Gjesdal O, Reis JP, Schreiner PJ, Liu K, Lewis CE, Sidney S, Gidding SS, Lima JAC, Ambale-Venkatesh B. Reference Ranges and Regional Patterns of Left Ventricular Strain and Strain Rate Using Two-Dimensional Speckle-Tracking Echocardiography in a Healthy Middle-Aged Black and White Population: The CARDIA Study. J Am Soc Echocardiogr 2017; 30:647-658.e2. [PMID: 28511859 PMCID: PMC5495603 DOI: 10.1016/j.echo.2017.03.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Strain and strain rate are sensitive markers of left ventricular (LV) myocardial function. The aim of this study was to assess reference ranges and regional patterns of LV strain and strain rate using two-dimensional speckle-tracking echocardiography in a large population of black and white subjects. METHODS This study involved a retrospective review of prospectively collected images in 557 participants in the Coronary Artery Risk Development in Young Adults study who remained healthy at the year 25 examination. LV deformation parameters were measured in apical four-chamber, apical two-chamber, and parasternal short-axis views in 509, 391, and 521 subjects, respectively. RESULTS Patients' mean age was 49.6 ± 3.6 years, 61.6% were women, and 69.5% were white. White women showed the highest LV systolic and diastolic deformation values, reflected by a more negative reference range for apical four-chamber longitudinal strain (-16.4%; 95% prediction interval [PI], -20.8% to -12.0%) and a higher positive reference range for early diastolic strain rate (0.93 1/sec; 95% PI, 0.41 to 1.46 1/sec), respectively. The lowest LV systolic and diastolic deformation values were found in black men, with apical four-chamber longitudinal strain (14.7%; 95% PI, -19.1% to -10.3%) and early diastolic strain rate (0.79 1/sec; 95% PI, 0.42 to 1.16 1/sec). Absolute strain increased from the epicardium toward the endocardium. A base-to-apex gradient of longitudinal strain toward the apex was exhibited in inferior and inferoseptal regions and, in contrast, in the opposite direction in anterior and anterolateral walls. Sex had the strongest influence on LV deformation variability. CONCLUSIONS Strain and strain rate reference values were sex and race related. White women showed the highest reference ranges for LV deformation, while the lowest values were found in black men. Significant layer- and level-specific patterns in regional LV deformation were identified.
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Affiliation(s)
- Henrique T Moreira
- School of Medicine, Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland; Ribeirão Preto School of Medicine, Division of Cardiology, Department of Internal Medicine, University of São Paulo, Ribeirão Preto, Brazil
| | - Chike C Nwabuo
- School of Medicine, Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Anderson C Armstrong
- School of Medicine, Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Satoru Kishi
- School of Medicine, Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Ola Gjesdal
- School of Medicine, Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Jared P Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Pamela J Schreiner
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Kiang Liu
- Feinberg School of Medicine, Department of Preventive Medicine, Northwestern University, Chicago, Illinois
| | - Cora E Lewis
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Stephen Sidney
- Kaiser Permanente Division of Research, Oakland, California
| | - Samuel S Gidding
- Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, Delaware
| | - João A C Lima
- School of Medicine, Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Bharath Ambale-Venkatesh
- School of Medicine, Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland.
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28
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Ari ME, Ekici F, Çetin İİ, Tavil EB, Yaralı N, Işık P, Hazırolan T, Tunç B. Assessment of left ventricular functions and myocardial iron load with tissue Doppler and speckle tracking echocardiography and T2* MRI in patients with β-thalassemia major. Echocardiography 2017; 34:383-389. [DOI: 10.1111/echo.13463] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Mehmet Emre Ari
- Department of Pediatric Cardiology; Ankara Children's Hematology and Oncology Research and Training Hospital; Ankara Turkey
| | - Filiz Ekici
- Department of Pediatric Cardiology; Ankara Children's Hematology and Oncology Research and Training Hospital; Ankara Turkey
| | - İbrahim İlker Çetin
- Department of Pediatric Cardiology; Ankara Children's Hematology and Oncology Research and Training Hospital; Ankara Turkey
| | - Emine Betül Tavil
- Department of Pediatric Hematology; Hacettepe University Faculty of Medicine; Ankara Turkey
| | - Neşe Yaralı
- Department of Pediatric Hematology; Ankara Children's Hematology and Oncology Research and Training Hospital; Ankara Turkey
| | - Pamir Işık
- Department of Pediatric Hematology; Ankara Children's Hematology and Oncology Research and Training Hospital; Ankara Turkey
| | - Tuncay Hazırolan
- Department of Radiology; Hacettepe University Faculty of Medicine; Ankara Turkey
| | - Bahattin Tunç
- Department of Pediatric Hematology; Ankara Children's Hematology and Oncology Research and Training Hospital; Ankara Turkey
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29
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Szymczyk E, Lipiec P, Michalski B, Szymczyk K, Shim A, Woźniakowski B, Rotkiewicz A, Stefańczyk L, Kasprzak JD. 2D speckle tracking echocardiography for the assessment of regional contractile reserve after myocardial infarction. J Cardiovasc Med (Hagerstown) 2017; 17:374-81. [PMID: 25304033 DOI: 10.2459/jcm.0000000000000198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS To assess whether quantitative resting assessment of local myocardial function by 2D speckle tracking echocardiography may be helpful for the evaluation of myocardial viability in patients after ST-elevation myocardial infarction (STEMI) and for the prediction of left ventricular function recovery after 12-month follow-up. METHODS The study group comprised 96 patients with first STEMI treated with successful primary percutaneous coronary intervention. Seven to 12 days after STEMI, all patients underwent resting echocardiography and low-dose dobutamine stress echocardiography (LDDSE) with visual assessment of contractile reserve which was the reference method for the evaluation of myocardial viability. After 12 months resting echocardiography with visual assessment of functional recovery was performed. Subsequently, acquired images were analyzed off-line using 2D speckle tracking echocardiography algorithm. Measurements included peak systolic longitudinal and transverse strain (SLS/STS), peak longitudinal and transverse strain (PLS/PTS), systolic longitudinal and transverse strain rate (SLSR/STSR) at baseline and after 12 months. RESULTS All analyzed longitudinal parameters of strain had a very good diagnostic value, while transverse parameters had only good diagnostic value for predicting myocardial viability defined on the basis of LDDSE. Moreover, SLS and PLS had good, whereas SLSR only satisfactory diagnostic value for predicting function recovery after 12-month follow-up. CONCLUSIONS 2D speckle tracking analysis applied during resting echocardiography can be helpful for the prediction of myocardial viability and functional recovery in patients after STEMI. Longitudinal strain parameters allow the prediction of local contractile reserve with SLS showing best correlation with DSE results functional recovery after 12-month follow-up.
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Affiliation(s)
- Ewa Szymczyk
- aDepartment of Cardiology, Medical University of Lodz bDepartment of Radiology, Barlicki Teaching Hospital, Medical University of Lodz, Poland
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30
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Wong C, Chen S, Iyngkaran P. Cardiac Imaging in Heart Failure with Comorbidities. Curr Cardiol Rev 2017; 13:63-75. [PMID: 27492227 PMCID: PMC5324322 DOI: 10.2174/1573403x12666160803100928] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 06/30/2016] [Accepted: 07/05/2016] [Indexed: 01/19/2023] Open
Abstract
Imaging modalities stand at the frontiers for progress in congestive heart failure (CHF) screening, risk stratification and monitoring. Advancements in echocardiography (ECHO) and Magnetic Resonance Imaging (MRI) have allowed for improved tissue characterizations, cardiac motion analysis, and cardiac performance analysis under stress. Common cardiac comorbidities such as hypertension, metabolic syndromes and chronic renal failure contribute to cardiac remodeling, sharing similar pathophysiological mechanisms starting with interstitial changes, structural changes and finally clinical CHF. These imaging techniques can potentially detect changes earlier. Such information could have clinical benefits for screening, planning preventive therapies and risk stratifying patients. Imaging reports have often focused on traditional measures without factoring these novel parameters. This review is aimed at providing a synopsis on how we can use this information to assess and monitor improvements for CHF with comorbidities.
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Affiliation(s)
- Chiew Wong
- Flinders University, NT Medical School, Darwin Australia
| | - Sylvia Chen
- Flinders University, NT Medical School, Darwin Australia
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31
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Hathaway QA, Nichols CE, Shepherd DL, Stapleton PA, McLaughlin SL, Stricker JC, Rellick SL, Pinti MV, Abukabda AB, McBride CR, Yi J, Stine SM, Nurkiewicz TR, Hollander JM. Maternal-engineered nanomaterial exposure disrupts progeny cardiac function and bioenergetics. Am J Physiol Heart Circ Physiol 2016; 312:H446-H458. [PMID: 28011589 PMCID: PMC5402018 DOI: 10.1152/ajpheart.00634.2016] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 12/07/2016] [Accepted: 12/07/2016] [Indexed: 01/25/2023]
Abstract
Nanomaterial production is expanding as new industrial and consumer applications are introduced. Nevertheless, the impacts of exposure to these compounds are not fully realized. The present study was designed to determine whether gestational nano-sized titanium dioxide exposure impacts cardiac and metabolic function of developing progeny. Pregnant Sprague-Dawley rats were exposed to nano-aerosols (~10 mg/m3, 130- to 150-nm count median aerodynamic diameter) for 7-8 nonconsecutive days, beginning at gestational day 5-6 Physiological and bioenergetic effects on heart function and cardiomyocytes across three time points, fetal (gestational day 20), neonatal (4-10 days), and young adult (6-12 wk), were evaluated. Functional analysis utilizing echocardiography, speckle-tracking based strain, and cardiomyocyte contractility, coupled with mitochondrial energetics, revealed effects of nano-exposure. Maternal exposed progeny demonstrated a decrease in E- and A-wave velocities, with a 15% higher E-to-A ratio than controls. Myocytes isolated from exposed animals exhibited ~30% decrease in total contractility, departure velocity, and area of contraction. Bioenergetic analysis revealed a significant increase in proton leak across all ages, accompanied by decreases in metabolic function, including basal respiration, maximal respiration, and spare capacity. Finally, electron transport chain complex I and IV activities were negatively impacted in the exposed group, which may be linked to a metabolic shift. Molecular data suggest that an increase in fatty acid metabolism, uncoupling, and cellular stress proteins may be associated with functional deficits of the heart. In conclusion, gestational nano-exposure significantly impairs the functional capabilities of the heart through cardiomyocyte impairment, which is associated with mitochondrial dysfunction.NEW & NOTEWORTHY Cardiac function is evaluated, for the first time, in progeny following maternal nanomaterial inhalation. The findings indicate that exposure to nano-sized titanium dioxide (nano-TiO2) during gestation negatively impacts cardiac function and mitochondrial respiration and bioenergetics. We conclude that maternal nano-TiO2 inhalation contributes to adverse cardiovascular health effects, lasting into adulthood.
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Affiliation(s)
- Quincy A Hathaway
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, West Virginia.,Mitochondria, Metabolism & Bioenergetics Working Group, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Cody E Nichols
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Danielle L Shepherd
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, West Virginia.,Mitochondria, Metabolism & Bioenergetics Working Group, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Phoebe A Stapleton
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Sarah L McLaughlin
- Department of Cancer Cell Biology, West Virginia University School of Medicine; Morgantown, West Virginia; and
| | - Janelle C Stricker
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Stephanie L Rellick
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Mark V Pinti
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Alaeddin B Abukabda
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Carroll R McBride
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Jinghai Yi
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Seth M Stine
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, West Virginia.,Mitochondria, Metabolism & Bioenergetics Working Group, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Timothy R Nurkiewicz
- Department of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, West Virginia.,Mitochondria, Metabolism & Bioenergetics Working Group, West Virginia University School of Medicine, Morgantown, West Virginia
| | - John M Hollander
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, West Virginia; .,Mitochondria, Metabolism & Bioenergetics Working Group, West Virginia University School of Medicine, Morgantown, West Virginia
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Taqatqa A, Bokowski J, Al-Kubaisi M, Khalil A, Miranda C, Alaksham H, Fughhi I, Kenny D, Diab KA. The Use of Speckle Tracking Echocardiography for Early Detection of Myocardial Dysfunction in Patients with Duchenne Muscular Dystrophy. Pediatr Cardiol 2016; 37:1422-1428. [PMID: 27452803 DOI: 10.1007/s00246-016-1451-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/09/2016] [Indexed: 11/27/2022]
Abstract
Cardiac complications are the leading cause of death in patients with Duchenne muscular dystrophy (DMD). Two-dimensional echocardiography is the current standard for monitoring of LV systolic function in these patients, but it might not detect early systolic dysfunction. The current study examined the use of speckle tracking echocardiography (STE) to detect early signs of cardiac dysfunction in DMD patients. A retrospective review of charts and offline strain analysis of transthoracic echocardiographic studies of DMD patients at our institution from April 2014 to January 2015 were performed and compared to age-matched healthy male subjects. Nineteen DMD patients (age range 12.6 ± 3.1 years) with normal ejection fraction and shortening fraction were compared with sixteen controls. The global circumferential strain was lower in DMD patients compared with controls (-14.7 ± 4.7 vs. -23.1 ± 2.9 %, respectively, p value: 0.001). Circumferential strain measured at basal, mid-ventricular and apical parasternal short-axis views was lower in DMD patients compared with controls. Segmental circumferential strain was lower in DMD patients in most segments compared with controls. The global longitudinal strain was lower in DMD patients compared with controls (-13.6 ± 5 vs. -18.8 ± 3 %, respectively, p value: 0.001). Segmental longitudinal strain measured in various segments was lower in DMD patients compared with controls. DMD patients can have occult cardiovascular dysfunction as shown by reduction in circumferential and longitudinal strain measurements with STE despite normal standard echocardiographic parameters. The clinical significance of early detection of cardiac dysfunction in these patients warrants further studies.
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Affiliation(s)
- Anas Taqatqa
- Rush Congenital Echocardiography Laboratory, Rush Center for Congenital Heart Disease, Rush University Medical Center, PAV 667 A 1653 W. Congress Parkway, Chicago, IL, 60612, USA
| | - John Bokowski
- Rush Congenital Echocardiography Laboratory, Rush Center for Congenital Heart Disease, Rush University Medical Center, PAV 667 A 1653 W. Congress Parkway, Chicago, IL, 60612, USA
| | - Maytham Al-Kubaisi
- Rush Congenital Echocardiography Laboratory, Rush Center for Congenital Heart Disease, Rush University Medical Center, PAV 667 A 1653 W. Congress Parkway, Chicago, IL, 60612, USA
| | - Ahmad Khalil
- Rush Congenital Echocardiography Laboratory, Rush Center for Congenital Heart Disease, Rush University Medical Center, PAV 667 A 1653 W. Congress Parkway, Chicago, IL, 60612, USA
| | - Carlos Miranda
- Rush Congenital Echocardiography Laboratory, Rush Center for Congenital Heart Disease, Rush University Medical Center, PAV 667 A 1653 W. Congress Parkway, Chicago, IL, 60612, USA
| | - Hamad Alaksham
- Rush Congenital Echocardiography Laboratory, Rush Center for Congenital Heart Disease, Rush University Medical Center, PAV 667 A 1653 W. Congress Parkway, Chicago, IL, 60612, USA
| | - Ibtihaj Fughhi
- Rush Congenital Echocardiography Laboratory, Rush Center for Congenital Heart Disease, Rush University Medical Center, PAV 667 A 1653 W. Congress Parkway, Chicago, IL, 60612, USA
| | - Damien Kenny
- Rush Congenital Echocardiography Laboratory, Rush Center for Congenital Heart Disease, Rush University Medical Center, PAV 667 A 1653 W. Congress Parkway, Chicago, IL, 60612, USA
| | - Karim A Diab
- Rush Congenital Echocardiography Laboratory, Rush Center for Congenital Heart Disease, Rush University Medical Center, PAV 667 A 1653 W. Congress Parkway, Chicago, IL, 60612, USA.
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Shepherd DL, Nichols CE, Croston TL, McLaughlin SL, Petrone AB, Lewis SE, Thapa D, Long DM, Dick GM, Hollander JM. Early detection of cardiac dysfunction in the type 1 diabetic heart using speckle-tracking based strain imaging. J Mol Cell Cardiol 2016; 90:74-83. [PMID: 26654913 PMCID: PMC4725063 DOI: 10.1016/j.yjmcc.2015.12.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 11/11/2015] [Accepted: 12/02/2015] [Indexed: 12/14/2022]
Abstract
Enhanced sensitivity in echocardiographic analyses may allow for early detection of changes in cardiac function beyond the detection limits of conventional echocardiographic analyses, particularly in a small animal model. The goal of this study was to compare conventional echocardiographic measurements and speckle-tracking based strain imaging analyses in a small animal model of type 1 diabetes mellitus. Conventional analyses revealed differences in ejection fraction, fractional shortening, cardiac output, and stroke volume in diabetic animals relative to controls at 6-weeks post-diabetic onset. In contrast, when assessing short- and long-axis speckle-tracking based strain analyses, diabetic mice showed changes in average systolic radial strain, radial strain rate, radial displacement, and radial velocity, as well as decreased circumferential and longitudinal strain rate, as early as 1-week post-diabetic onset and persisting throughout the diabetic study. Further, we performed regional analyses for the LV and found that the free wall region was affected in both the short- and long-axis when assessing radial dimension parameters. These changes began 1-week post-diabetic onset and remained throughout the progression of the disease. These findings demonstrate the use of speckle-tracking based strain as an approach to elucidate cardiac dysfunction from a global perspective, identifying left ventricular cardiac regions affected during the progression of type 1 diabetes mellitus earlier than contractile changes detected by conventional echocardiographic measurements.
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Affiliation(s)
- Danielle L Shepherd
- Department of Exercise Physiology, Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, 26505, United States
| | - Cody E Nichols
- Department of Exercise Physiology, Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, 26505, United States
| | - Tara L Croston
- Department of Exercise Physiology, Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, 26505, United States
| | - Sarah L McLaughlin
- Department of Cancer Cell Biology, School of Medicine, West Virginia University, Morgantown, WV 26505, United States
| | - Ashley B Petrone
- Department of Neurobiology and Anatomy, School of Medicine, West Virginia University, Morgantown, WV 26505, United States
| | - Sara E Lewis
- Department of Exercise Physiology, Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, 26505, United States
| | - Dharendra Thapa
- Department of Exercise Physiology, Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, 26505, United States
| | - Dustin M Long
- Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV 26505, United States
| | - Gregory M Dick
- Department of Exercise Physiology, Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, 26505, United States
| | - John M Hollander
- Department of Exercise Physiology, Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, 26505, United States.
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Breatnach CR, Levy PT, James AT, Franklin O, El-Khuffash A. Novel Echocardiography Methods in the Functional Assessment of the Newborn Heart. Neonatology 2016; 110:248-260. [PMID: 27287615 DOI: 10.1159/000445779] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 03/24/2016] [Indexed: 11/19/2022]
Abstract
Echocardiography in the neonatal intensive care unit has led to improvements in our ability to assess the neonatal heart in health and disease. Advances in neonatal cardiac imaging have provided the capability to obtain quantitative information that often supersedes the qualitative information provided by conventional methods. Novel quantitative measures of function include the assessment of the velocity of muscle tissue movement during systole and diastole using tissue Doppler velocity imaging, and evaluation of deformation and rotational characteristics of the myocardium utilizing speckle tracking echocardiography or tissue Doppler-derived strain imaging. A comprehensive understanding of these novel functional modalities, their predictive value, and limitations can greatly assist in managing both the normal and maladaptive responses in the newborn period. This article discusses the novel and emerging methods for assessment of left and right heart function in the neonatal population.
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Affiliation(s)
- Colm R Breatnach
- Department of Neonatology, The Rotunda Hospital, Dublin, Ireland
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35
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Ma CY, Liu S, Yang J, Tang L, Zhang LM, Li N, Yu B. Evaluation of global longitudinal strain of left ventricle and regional longitudinal strain in the region of left ventricular leads predicts the response to cardiac resynchronization therapy in patients with ischemic heart failure. Cell Biochem Biophys 2015; 70:143-8. [PMID: 24619820 DOI: 10.1007/s12013-014-9870-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Myocardium viability in ischemic heart failure (HF) may affect the effect of cardiac resynchronization therapy (CRT). We hypothesized that longitudinal strain of 2D-STE, which reflects myocardium viability, can predict the response to CRT in patients with ischemic HF. 2D-STE was performed in 42 patients with HF, 1 week before and 1 year after CRT. GLS, RLS, and the LV synchrony index (SI), defined as the difference in timing to peak radial strain between LV anterior septal and posterior wall in LV short axis view, were calculated. A decrease in the LV end-systolic volume (LVESV) value of ≥ 15 % 1 year after CRT was defined as response to CRT. Twenty-nine patients responded to CRT (CRT-R group), while 13 patients did not respond and were assigned as CRT-NR group. Pre-CRT RLS and GLS were higher, while SI is lower, in CRT-R patients compared with CRT-NR group (p < 0.001). The ROC curve revealed that RLS of -11.5 % predicted response to CRT with sensitivity of 80.0 % and specificity of 77.9 % (AUC = 0.84, p < 0.001). Further, GLS of -13 % predicted response to CRT with sensitivity of 73.0 % and specificity of 73.4 % (AUC = 0.79, p < 0.001). In conclusion, LV dyssynchrony, GLS, and RLS calculated by 2D-STE can predict long-term response to CRT in patients with ischemic HF.
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Affiliation(s)
- Chun-Yan Ma
- Department of Cardiovascular Ultrasound, The First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping, Shenyang, 110001, Liaoning, China,
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36
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Kim HL, Seo JB, Chung WY, Kim SH, Kim MA, Zo JH. Independent association between brachial-ankle pulse wave velocity and global longitudinal strain of left ventricle. Int J Cardiovasc Imaging 2015; 31:1563-70. [DOI: 10.1007/s10554-015-0744-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 08/13/2015] [Indexed: 12/01/2022]
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37
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Bravo PE, Luo HC, Pozios I, Zimmerman SL, Corona-Villalobos CP, Sorensen L, Kamel IR, Bluemke DA, Wahl RL, Abraham MR, Abraham TP. Late gadolinium enhancement confined to the right ventricular insertion points in hypertrophic cardiomyopathy: an intermediate stage phenotype? Eur Heart J Cardiovasc Imaging 2015; 17:293-300. [PMID: 26077330 DOI: 10.1093/ehjci/jev154] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 05/23/2015] [Indexed: 01/22/2023] Open
Abstract
AIMS To investigate whether hypertrophic cardiomyopathy (HCM) patients with late gadolinium enhancement (LGE) confined to the right ventricular insertion points (RVIP) differ phenotypically from patients without LGE or intramural LGE in the left ventricle (LV). METHODS AND RESULTS Sixty-two HCM patients underwent cardiac magnetic resonance for quantification of LGE (% LV mass) and were classified as group (i) no-LGE (n = 18), group (ii) LGE-RVIP (n = 19), and group (iii) intramural LGE (n = 25). All patients also underwent vasodilator N-13 ammonia PET to quantify myocardial blood flow (MBF) and myocardial flow reserve (MFR), and echocardiography to measure longitudinal LV strain. LGE extent (17 ± 11% vs. 4 ± 4% vs. 0%; P < 0.001) and LV thickness (21.7 ± 3.4 vs. 18.8 ± 3.9 vs. 16.3 ± 2.8 mm; P < 0.001) were significantly greater in group 3, intermediate in group 2, and lower in group 1. In contrast, stress MBF (1.62 ± 0.44 vs. 1.90 ± 0.37 vs. 2.22 ± 0.48 mL/min/g; P < 0.001); MFR (1.92 ± 0.47 vs. 2.15 ± 0.52 vs. 2.71 ± 0.52; P < 0.001), and longitudinal LV strain (-11.4 ± 3.8 vs. -12.6 ± 3.2 vs. -14.4 ± 4.1%; P = 0.04) were lower in group 3, intermediate in group 2, and higher in group 1. CONCLUSIONS From an imaging viewpoint, patients with LGE confined to only the RVIP appear to represent an intermediate-stage phenotype between patients with no LGE and intramural LGE in the LV.
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Affiliation(s)
- Paco E Bravo
- Department of Cardiology, University of Washington, 1959 NE Pacific Street, PO Box 356422, Seattle, WA 98195, USA Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | | | | | | | | | - Lars Sorensen
- Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Ihab R Kamel
- Johns Hopkins Medical Institutions, Baltimore, MD, USA
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Değirmenci H, Demirelli S, Arısoy A, Ermiş E, Araz Ö, Bakırcı EM, Hamur H, Büyüklü M, Topal E. Myocardial deformation and total atrial conduction time in the prediction of cardiac involvement in patients with pulmonary sarcoidosis. CLINICAL RESPIRATORY JOURNAL 2015; 11:68-77. [DOI: 10.1111/crj.12307] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/23/2015] [Accepted: 04/21/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Hüsnü Değirmenci
- Faculty of Medicine; Cardiology; Erzincan University; Erzincan Turkey
| | - Selami Demirelli
- Department of Cardiology; Education and Research Hospital; Erzurum Turkey
| | - Arif Arısoy
- Faculty of Medicine; Cardiology; Gaziosmanpasa University; Tokat Turkey
| | - Emrah Ermiş
- Department of Cardiology; Education and Research Hospital; Erzurum Turkey
| | - Ömer Araz
- Faculty of Medicine; Pulmonary of Disease; Ataturk University; Erzurum Turkey
| | | | - Hikmet Hamur
- Faculty of Medicine; Cardiology; Erzincan University; Erzincan Turkey
| | - Mutlu Büyüklü
- Faculty of Medicine; Cardiology; Erzincan University; Erzincan Turkey
| | - Ergün Topal
- Faculty of Medicine; Cardiology; Erzincan University; Erzincan Turkey
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Forsha D, Risum N, Rajagopal S, Dolgner S, Hornik C, Barnhart H, Kisslo J, Barker P. The Influence of Angle of Insonation and Target Depth on Speckle-Tracking Strain. J Am Soc Echocardiogr 2015; 28:580-6. [DOI: 10.1016/j.echo.2014.12.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Indexed: 11/15/2022]
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40
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Kurt M, Tanboga IH, Aksakal E. Two-Dimensional Strain Imaging: Basic principles and Technical Consideration. Eurasian J Med 2015; 46:126-30. [PMID: 25610311 DOI: 10.5152/eajm.2014.28] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 05/29/2013] [Indexed: 11/22/2022] Open
Abstract
Tissue Doppler Imaging (TDI) and TDI-derived strain provide considerably accurate information in the non-invasive assessment of local myocardial functions. Given its high temporal and spatial resolution, TDI allows assessment of local myocardial functions in each phase of cardiac cycle. However, the most important limitation of this method is its angle dependence. New techniques to measure myocardial deformation, such as speckle tracking echocardiography, overcome the angle-dependence limitation of TDI-derived strain. Moreover, these techniques provide more unique information about myocardial fiber orientation. This review examines the architectural structure and function of the myocardium and includes technical revisions of this information that will provide a basis for STE.
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Affiliation(s)
- Mustafa Kurt
- Department of Cardiology, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
| | | | - Enbiya Aksakal
- Department of Cardiology, Ataturk University Faculty of Medicine, Erzurum, Turkey
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Atta S, Abdalrahman H, Bashandy M, Sayed A. Impact of pre-excitation syndrome on left ventricular systolic function and cardiac synchronization assessed by tissue Doppler imaging and speckle tracking techniques. Egypt Heart J 2014. [DOI: 10.1016/j.ehj.2013.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Rimbaş RC, Mihăilă S, Vinereanu D. Sources of variation in assessing left atrial functions by 2D speckle-tracking echocardiography. Heart Vessels 2014; 31:370-81. [DOI: 10.1007/s00380-014-0602-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 10/31/2014] [Indexed: 10/24/2022]
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Age-related changes in familial hypertrophic cardiomyopathy phenotype in transgenic mice and humans. ACTA ACUST UNITED AC 2014; 34:634-639. [PMID: 25318870 DOI: 10.1007/s11596-014-1329-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 09/11/2014] [Indexed: 10/24/2022]
Abstract
β-myosin heavy chain mutations are the most frequently identified basis for hypertrophic cardiomyopathy (HCM). A transgenic mouse model (αMHC(403)) has been extensively used to study various mechanistic aspects of HCM. There is general skepticism whether mouse and human disease features are similar. Herein we compare morphologic and functional characteristics, and disease evolution, in a transgenic mouse and a single family with a MHC mutation. Ten male αMHC(403) transgenic mice (at t-5 weeks, -12 weeks, and -24 weeks) and 10 HCM patients from the same family with a β-myosin heavy chain mutation were enrolled. Morphometric, conventional echocardiographic, tissue Doppler and strain analytic characteristics of transgenic mice and HCM patients were assessed. Ten male transgenic mice (αMHC(403)) were examined at ages -5 weeks, -12 weeks, and -24 weeks. In the transgenic mice, aging was associated with a significant increase in septal (0.59±0.06 vs. 0.64±0.05 vs. 0.69±0.11 mm, P<0.01) and anterior wall thickness (0.58±0.1 vs. 0.62±0.07 vs. 0.80±0.16 mm, P<0.001), which was coincident with a significant decrease in circumferential strain (-22%±4% vs. -20%±3% vs. -19%±3%, P=0.03), global longitudinal strain (-19%±3% vs. -17%±2% vs. -16%±3%, P=0.001) and E/A ratio (1.9±0.3 vs. 1.7±0.3 vs. 1.4±0.3, P=0.01). The HCM patients were classified into 1st generation (n=6; mean age 53±6 years), and 2nd generation (n=4; mean age 32±8 years). Septal thickness (2.2±0.9 vs. 1.4±0.1 cm, P<0.05), left atrial (LA) volume (62±16 vs. 41±5 mL, P=0.03), E/A ratio (0.77±0.21 vs. 1.1±0.1, P=0.01), E/e' ratio (25±10 vs. 12±2, P=0.03), global left ventricular (LV) strain (-14%±3% vs. -20%±3%, P=0.01) and global LV early diastolic strain rate (0.76±0.17 s(-1) vs. 1.3±0.2 s-1, P=0.01) were significantly worse in the older generation. In β-myosin heavy chain mutations, transgenic mice and humans have similar progression in morphologic and functional abnormalities. The αMHC(403) transgenic mouse model closely recapitulates human disease.
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Xu QQ, Ding YY, Lv HT, Zhou WP, Sun L, Huang J, Yan WH. Evaluation of left ventricular systolic strain in children with Kawasaki disease. Pediatr Cardiol 2014; 35:1191-7. [PMID: 24859168 DOI: 10.1007/s00246-014-0915-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 04/25/2014] [Indexed: 11/25/2022]
Abstract
The current study aimed to assess left ventricular (LV) longitudinal systolic strains in children with KD using two-dimensional speckle-tracking imaging and to analyze the relationship of LV myocardial deformation to coronary lesions and laboratory markers. The study enrolled 101 children with acute KD. An additional 50 age- and gender-matched normal children were enrolled as control subjects. During different phases of KD, echocardiograms were recorded for 61 children. Two-dimensional strain analysis software was used to track myocardial movement and obtain the strain from each LV segment. The LV longitudinal systolic strain decreased significantly in children with acute KD but increased immediately after intravenous immunoglobulin therapy. At 6-8 weeks after the onset of KD, all LV strains had recovered to normal. The LV systolic strain was not associated with coronary dilation in either acute or convalescent KD. In acute KD, aspartate transaminase, alanine transaminase, erythrocyte sedimentation rate, C-reactive protein (CRP), and hemoglobin (Hb) were found to be associated with coronary dilation, whereas LV systolic strains were found to be correlated with elevated CRP and decreased Hb. Speckle-tracking imaging of LV systolic strain was simple and accurate in evaluating LV function during different phases of KD. No association between LV dysfunction and coronary dilation was observed, but a relationship with CRP and Hb was found. Further studies are recommended to validate the current study results and explore further how these findings can improve clinical practice.
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Affiliation(s)
- Qiu-Qin Xu
- Department of Pediatric Cardiology, Children's Hospital Affiliated of Soochow University, 303 Jingde Road, Suzhou, 215003, Jiangsu, China
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Bakos Z, Ostenfeld E, Markstad H, Werther-Evaldsson A, Roijer A, Arheden H, Carlsson M, Borgquist R. A comparison between radial strain evaluation by speckle-tracking echocardiography and cardiac magnetic resonance imaging, for assessment of suitable segments for left ventricular lead placement in cardiac resynchronization therapy. Europace 2014; 16:1779-86. [DOI: 10.1093/europace/euu167] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Duncan AE, Alfirevic A, Sessler DI, Popovic ZB, Thomas JD. Perioperative assessment of myocardial deformation. Anesth Analg 2014; 118:525-44. [PMID: 24557101 DOI: 10.1213/ane.0000000000000088] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Evaluation of left ventricular performance improves risk assessment and guides anesthetic decisions. However, the most common echocardiographic measure of myocardial function, the left ventricular ejection fraction (LVEF), has important limitations. LVEF is limited by subjective interpretation that reduces accuracy and reproducibility, and LVEF assesses global function without characterizing regional myocardial abnormalities. An alternative objective echocardiographic measure of myocardial function is thus needed. Myocardial deformation analysis, which performs quantitative assessment of global and regional myocardial function, may be useful for perioperative care of surgical patients. Myocardial deformation analysis evaluates left ventricular mechanics by quantifying strain and strain rate. Strain describes percent change in myocardial length in the longitudinal (from base to apex) and circumferential (encircling the short-axis of the ventricle) direction and change in thickness in the radial direction. Segmental strain describes regional myocardial function. Strain is a negative number when the ventricle shortens longitudinally or circumferentially and is positive with radial thickening. Reference values for normal longitudinal strain from a recent meta-analysis by using transthoracic echocardiography are (mean ± SD) -19.7% ± 0.4%, while radial and circumferential strain are 47.3% ± 1.9% and -23.3% ± 0.7%, respectively. The speed of myocardial deformation is also important and is characterized by strain rate. Longitudinal systolic strain rate in healthy subjects averages -1.10 ± 0.16 s. Assessment of myocardial deformation requires consideration of both strain (change in deformation), which correlates with LVEF, and strain rate (speed of deformation), which correlates with rate of rise of left ventricular pressure (dP/dt). Myocardial deformation analysis also evaluates ventricular relaxation, twist, and untwist, providing new and noninvasive methods to assess components of myocardial systolic and diastolic function. Myocardial deformation analysis is based on either Doppler or a non-Doppler technique, called speckle-tracking echocardiography. Myocardial deformation analysis provides quantitative measures of global and regional myocardial function for use in the perioperative care of the surgical patient. For example, coronary graft occlusion after coronary artery bypass grafting is detected by an acute reduction in strain in the affected coronary artery territory. In addition, assessment of left ventricular mechanics detects underlying myocardial pathology before abnormalities become apparent on conventional echocardiography. Certainly, patients with aortic regurgitation demonstrate reduced longitudinal strain before reduction in LVEF occurs, which allows detection of subclinical left ventricular dysfunction and predicts increased risk for heart failure and impaired myocardial function after surgical repair. In this review, we describe the principles, techniques, and clinical application of myocardial deformation analysis.
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Affiliation(s)
- Andra E Duncan
- From the Departments of Cardiothoracic Anesthesia, Outcomes Research, and Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
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Gasparovic H, Cikes M, Kopjar T, Hlupic L, Velagic V, Milicic D, Bijnens B, Colak Z, Biočina B. Atrial apoptosis and fibrosis adversely affect atrial conduit, reservoir and contractile functions. Interact Cardiovasc Thorac Surg 2014; 19:223-30; discussion 230. [PMID: 24722519 DOI: 10.1093/icvts/ivu095] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Chronic atrial volume overload and atrial fibrillation (AF) induce structural changes within atrial myocardium. The aim of this study was to evaluate the effect of adverse cellular remodelling on echocardiographic strain rate (SR) deformation indices of atrial contractile, conduit and reservoir functions. METHODS Forty-four consecutive patients with organic mitral regurgitation were analysed. Twenty-eight patients had long-standing persistent AF (AF group), while 16 were in normal sinus rhythm (NSR group). Left atrial (LA) samples were harvested from all the patients for histological analysis. Postoperative echocardiographic data acquisition was performed exclusively during organized atrial electrical activity in order to assess the contractile reserve of patients from both groups. RESULTS Fibrotic atria had inferior conduit (SR-E: r = -0.36, P = 0.017), reservoir (SR-S: r = -0.31, P = 0.041) and contractile functions (SR-A: r = -0.33, P = 0.027). Analogously, atria with greater apoptotic burdens showed a negative correlation with multiple indices of left atrial functions (SR-E: r = -0.38, P = 0.010; SR-S: r = -0.33, P = 0.028; SR-A: r = -0.28, P = 0.067). The efficiency of atrial contractility was significantly reduced among AF-group patients after conversion to sinus rhythm, when compared with patients in the NSR group (LA active emptying fraction: 20 ± 12 vs 30 ± 10%, P = 0.004; SR-A: 1.1 ± 1.0 vs 2.8 ± 1.9 s(-1), P < 0.001). Superior strain-rate indices of atrial conduit and reservoir functions were noted in the NSR group (SR-E: 3.5 ± 2.3 vs 1.3 ± 1.0 s(-1), P < 0.001; LA expansion index: 86 ± 31 vs 60 ± 42%, P = 0.004). Fibrosis was evident in 7.2 [3.3;9.4]% of the LA tissue sample in the AF group, while it accounted for 3.4 [1.2;8.1]% of atrial tissue in the NSR group (P = 0.054). Apoptosis was documented in 13 (46%) patients in the AF group, whereas none of the patients in the NSR group exhibited signs of programmed cell death (P = 0.001). Myocyte degeneration was more prevalent in the AF group (odds ratio: 7.0, 95% confidence interval: 1.3-36.7, P = 0.021). Age showed a positive correlation with worsening degrees of atrial fibrosis and apoptosis (r = 0.41, P = 0.006; r = 0.49, P = 0.001, respectively). Multiple regression analysis identified SR-S (β = -1.263, P = 0.036) and age (β = 0.144, P = 0.057) as independent predictors of fibrosis. Independent determinants of apoptosis were preoperative AF (β = 4.539, P = 0.007), age (β = 0.188, P = 0.009) and SR-S (β = -1.780, P = 0.002). CONCLUSIONS Atria exhibiting greater fibrotic and apoptotic burdens had impaired conduit, reservoir and contractile function, as evaluated by deformation imaging. Among patients with chronic LA volume overload, exposure to long-standing persistent AF induced more pronounced degrees of adverse atrial cellular remodelling. Strain-rate descriptors of atrial reservoir function harboured potential to predict atrial fibrosis and apoptosis.
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Affiliation(s)
- Hrvoje Gasparovic
- Department of Cardiac Surgery, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Maja Cikes
- Department of Cardiology, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Tomislav Kopjar
- Department of Cardiac Surgery, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Ljiljana Hlupic
- Department of Pathology, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Vedran Velagic
- Department of Cardiology, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Davor Milicic
- Department of Cardiology, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Bart Bijnens
- ICREA - Universitat Pompeu Fabra, Barcelona, Spain
| | - Zeljko Colak
- Department of Cardiac Surgery, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Bojan Biočina
- Department of Cardiac Surgery, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
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Forsha D, Risum N, Kropf PA, Rajagopal S, Smith PB, Kanter RJ, Samad Z, Sogaard P, Barker P, Kisslo J. Right ventricular mechanics using a novel comprehensive three-view echocardiographic strain analysis in a normal population. J Am Soc Echocardiogr 2014; 27:413-22. [PMID: 24508364 PMCID: PMC4052609 DOI: 10.1016/j.echo.2013.12.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although quantitative right ventricular (RV) strain analysis may be useful in congenital and acquired heart disease populations with RV failure, a comprehensive, standardized approach is lacking. An 18-segment RV strain analysis obtained from three standardized RV apical echocardiographic images was used to determine the feasibility, normal values, and reproducibility of the method in normal adults. METHODS Forty healthy, prospectively enrolled volunteers with no cardiac histories and normal QRS durations underwent echocardiography optimized for strain analysis including three RV apical views. Two-dimensional speckle-tracking longitudinal strain analysis was performed using EchoPAC software. Eleven retrospectively identified subjects with RV disease were included as a pilot population. All had been imaged using the same protocol including the three RV apical views. RESULTS All control subjects had normal anatomic morphology and function by echocardiography. Feasibility of the RV strain analysis was good (adequate tracking in 696 of 720 segments [97%]). RV global peak systolic strain was -23 ± 2%. Peak strain was highest in the RV free wall and lowest in the septum. Dyssynchrony indices demonstrated no dyssynchrony using left ventricular criteria. Reproducibility of most strain measures was acceptable. This methodology identified important disease not seen in the four-chamber apical view alone in the pilot population of 11 patients with RV disease. Strain patterns and values were different from those in the control population, indicating that differences do exist from normal. CONCLUSIONS Eighteen-segment RV strain analysis is feasible, with strain measures falling into discrete ranges in this normal population. Those with RV disease illustrate the potential utility of this approach. These data indicate that this model can be used for more detailed studies evaluating abnormal RV populations, in which its full potential can be assessed.
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Affiliation(s)
- Daniel Forsha
- Division of Pediatric Cardiology, Duke University Medical Center, Durham, North Carolina.
| | - Niels Risum
- Department of Cardiology, Gentofte University Hospital, Gentofte, Denmark
| | - P Andrea Kropf
- Division of Pediatric Cardiology, Duke University Medical Center, Durham, North Carolina
| | - Sudarshan Rajagopal
- Division of Cardiovascular Disease, Duke University Medical Center, Durham, North Carolina
| | - P Brian Smith
- Duke Clinical Research Institute, Durham, North Carolina
| | - Ronald J Kanter
- Division of Pediatric Cardiology, Duke University Medical Center, Durham, North Carolina
| | - Zainab Samad
- Division of Cardiovascular Disease, Duke University Medical Center, Durham, North Carolina
| | - Peter Sogaard
- Department of Cardiology, Aalborg University, Aalborg, Denmark
| | - Piers Barker
- Division of Pediatric Cardiology, Duke University Medical Center, Durham, North Carolina
| | - Joseph Kisslo
- Division of Cardiovascular Disease, Duke University Medical Center, Durham, North Carolina
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Kadappu KK, Kuncoro AS, Hee L, Aravindan A, Spicer ST, Suryanarayanan G, Xuan W, Boyd A, French JK, Thomas L. Chronic kidney disease is independently associated with alterations in left atrial function. Echocardiography 2014; 31:956-64. [PMID: 24447093 DOI: 10.1111/echo.12503] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is associated with increased cardiovascular morbidity and mortality; hence detection of early cardiovascular involvement in CKD is important to prevent future adverse cardiovascular events. Left atrial (LA) enlargement and dysfunction has been reported in end stage renal disease. However, there is a paucity of published data regarding the evaluation of LA function in CKD using noninvasive imaging parameters. In this study, we evaluated biplane LA volume as well as LA function (LA global systolic strain (GS) and strain rate [SR]) in stage 3 CKD patients (eGFR 30-59 mL/min per 1.73 m(2) ) to determine if LA function parameters are more significantly altered by the presence of CKD in addition to changes due to hypertension alone. METHODS Thirty-three CKD patients (eGFR 30-59 mL/min per 1.73 m(2) ) with hypertension were compared to 33 normal controls and 34 hypertensive (HT) subjects with normal renal function; all participants underwent a detailed transthoracic echocardiogram. Indexed biplane LA volume (LAVI), LA segmental function, and GS and SR (systolic, early, and late diastole) derived from tissue Doppler imaging (TDI) were measured. Univariate predictors of LA strain were determined. Multiple logistic regression analysis was used to examine the effect of patient group (i.e. CKD) on GS and SR as well as LAVI. RESULTS Left atrial volume indexed was significantly increased in both the HT and CKD with HT group compared to normal controls (28 ± 9 mL/m(2) vs. 28 ± 9 mL/m(2) vs. 23 ± 5 mL/m(2) , respectively, P = 0.02). However, LAVI was similar in the HT and CKD with HT group (28 ± 9 mL/m(2) vs. 28 ± 9 mL/m(2) ; P = NS). LA GS and SR were reduced in both the CKD with HT and HT group, compared to controls. However, a significantly lower LA GS was present in the CKD with HT group (Controls vs. HT vs. CKD with HT: 54.9 ± 14.5% vs. 34.5 ± 6.2% vs. 25.7 ± 9.3%, respectively; P = 0.001). To examine the effect of group, (i.e. presence of CKD) multiple logistic regression analysis was performed with univariate predictors including indexed left ventricular mass (LVMI), LV diastolic grade, LAVI, peak A-wave velocity, β-blocker therapy, GS and SR; this demonstrated that CKD had an independent effect on LA GS and SR (systolic, early, and late diastole). GS demonstrated moderate correlation with systolic blood pressure (r = -0.5, P = 0.01), diastolic grade (r = -0.5, P = 0.01), E' velocity (r = 0.6, P = 0.0001), peak A velocity (r = -0.5, P = 0.004), and LAVI (r = -0.6, P = 0.002). CONCLUSIONS Left atrial dysfunction is evident in stage 3 CKD with associated LA enlargement. This study demonstrates that LA GS and SR were reduced in the CKD group despite similar LAVI in the CKD with HT and HT group. Hence LA GS and SR may be a more sensitive noninvasive tool to detect cardiovascular involvement in CKD.
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Affiliation(s)
- Krishna K Kadappu
- South Western Sydney Clinical School, The University of New South Wales, Sydney, Australia; Cardiology Department, Liverpool Hospital, Liverpool, Australia; Cardiology Department, Campbelltown Hospital, University of West Sydney, Campbelltown, Australia
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Longitudinal strain and strain rate by two-dimensional speckle tracking in non-sedated healthy cats. Res Vet Sci 2013; 95:1175-80. [DOI: 10.1016/j.rvsc.2013.07.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 06/15/2013] [Accepted: 07/16/2013] [Indexed: 11/22/2022]
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