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Lin X, Lu C, Ma G. The value of TDI combined with myocardial strain parameters in quantitative evaluation of left heart function in parturient with pregnancy-induced hypertension. Sci Rep 2023; 13:21315. [PMID: 38044364 PMCID: PMC10694130 DOI: 10.1038/s41598-023-48599-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/28/2023] [Indexed: 12/05/2023] Open
Abstract
This study aimed to investigate the value of tissue doppler imaging (TDI) and 4D myocardial strain parameters in evaluating left heart function of pregnant women with hypertension and the association between these parameters and relevant factors. Forty-five pregnant women with hypertensive disorder, including 20 with hypertension, 15 with mild preeclampsia, and 10 with severe preeclampsia, were recruited, and their cardiac functions were compared with those of 30 healthy pregnant women as controls. High Left ventricular end-systolic volume (LVESV), Left atrial volume index (LAVI), E/e were observed in hypertensive disorder, while Mitral peak diastolic velocity(E), Early diastolic peak velocity(e), E/A, Left ventricularglobal longitudinal strain (LVGLS), Left ventricularglobal area strain (LVGAS), and Left atrialglobal longitudinal strain (LAGLS) were decreased; for pre-eclampsia, Left ventricular end-systolic diameter (LVESD), Left atrial anteroposterior diameter (LAD-ap), LVESV, LAVI were significantly increased, LVGLS, LAGLS were significantly decreased, Left ventricular end-diastolic diameter (LVEDD), Left ventricular end-diastolic volume (LVEDV), A peak, E/e were increased, while E peak, E/A, e, Left ventricle global radial strain (LVGRS), Left ventricle global circumferential strain (LVGCS), LVGAS were decreased but not significantly; for severe preeclampsia, Left ventricular end diastolic diameter (LVEDD), LVESD, LAD-ap, Left ventricular end-diastolic volume (LVEDV), LVESV, LAVI, A, and E/e were significantly increased, while LVGLS, LVGRS, LVGCS, LVGAS, LAGLS, E peak, E/A, and e were significantly reduced. TDI combined with 4D myocardial strain parameters can detect early changes in cardiac function of hypertensive disorders in pregnancy, with LVGLS, LVGAS, and LAGLS being the most sensitive indicators for early changes. Such findings provide a basis for effective clinical treatment of these symptoms.
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Affiliation(s)
- Xiumei Lin
- Department of Ultrasound, The Affiliated Hospital of Weifang Medical University, 2428 Yuhe Road, Weifang, 261031, Shandong, China
| | - Chengwei Lu
- Liutuan Town Central Health Center, Weifang, Shandong, China
| | - Guifeng Ma
- Department of Ultrasound, The Affiliated Hospital of Weifang Medical University, 2428 Yuhe Road, Weifang, 261031, Shandong, China.
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Smith A, Kumar S, Moore HJ, Iskandrian AE, Nanda NC, Raman VK, Singh S, Fletcher RD, Deedwania P, Fonarow GC, Greenberg MD, Ahmed A, Lam PH. Imaging Modality for Left Ventricular Ejection Fraction Estimation and Effect of Implantable Cardioverter Defibrillator on Mortality in Patients with Heart Failure. Heart Rhythm 2023; 20:886-890. [PMID: 36907232 DOI: 10.1016/j.hrthm.2023.03.010] [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: 01/23/2023] [Revised: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Implantable cardioverter-defibrillators (ICD) improve outcomes in patients with heart failure (HF) with left ventricular ejection fraction (LVEF) ≤35%. Less is known whether outcomes varied between the two non-invasive imaging modalities used to estimate LVEF, the 2-dimensional echocardiography (2DE) and multi-gated acquisition radionuclide ventriculography (MUGA), which use different principles (geometric vs. count-based, respectively). OBJECTIVES To examine if the effect of ICD on mortality in patients with HF and LVEF ≤35% varied based on LVEF measured by 2DE or MUGA. METHODS Of the 2521 patients with HF with LVEF ≤35% in the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), 1676 were randomized to either placebo or ICD, of whom 1386 had LVEF measured by 2DE (n=971) or MUGA (n=415). Hazard ratios (HRs) and 97.5% CIs for mortality associated with ICD use were estimated overall, checking for interaction, and within the two imaging subgroups. RESULTS Among the 1386 patients in the current analysis, all-cause mortality occurred in 23.1% (160/692) and 29.7% (206/694) of patients randomized to ICD or placebo, respectively (HR, 0.77; 97.5% CI, 0.61-0.97), which is consistent with that in 1676 patients in the original report. HRs (97.5% CIs) for all-cause mortality in the 2DE and MUGA subgroups were 0.79 (0.60-1.04) and 0.72 (0.46-1.11), respectively (p for interaction, 0.693). Similar associations were observed for cardiac and arrhythmic mortalities. CONCLUSIONS We found no evidence that in patients with HF and LVEF ≤35%, the effect of ICD on mortality varied by the non-invasive imaging method used to measure LVEF.
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Affiliation(s)
- Alexander Smith
- Veterans Affairs Medical Center, Washington, District of Columbia; Georgetown University, Washington, District of Columbia; MedStar Washington Hospital Center, Washington, District of Columbia
| | - Sant Kumar
- Veterans Affairs Medical Center, Washington, District of Columbia; Georgetown University, Washington, District of Columbia
| | - Hans J Moore
- Veterans Affairs Medical Center, Washington, District of Columbia; Georgetown University, Washington, District of Columbia; George Washington University, Washington, District of Columbia
| | | | - Navin C Nanda
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Venkatesh K Raman
- Veterans Affairs Medical Center, Washington, District of Columbia; Georgetown University, Washington, District of Columbia
| | - Steven Singh
- Veterans Affairs Medical Center, Washington, District of Columbia; Georgetown University, Washington, District of Columbia
| | - Ross D Fletcher
- Veterans Affairs Medical Center, Washington, District of Columbia; Georgetown University, Washington, District of Columbia
| | | | | | - Michael D Greenberg
- Veterans Affairs Medical Center, Washington, District of Columbia; George Washington University, Washington, District of Columbia
| | - Ali Ahmed
- Veterans Affairs Medical Center, Washington, District of Columbia; Georgetown University, Washington, District of Columbia; George Washington University, Washington, District of Columbia
| | - Phillip H Lam
- Veterans Affairs Medical Center, Washington, District of Columbia; Georgetown University, Washington, District of Columbia; MedStar Washington Hospital Center, Washington, District of Columbia.
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Gao L, Lin Y, Ji M, Wu W, Li H, Qian M, Zhang L, Xie M, Li Y. Clinical Utility of Three-Dimensional Speckle-Tracking Echocardiography in Heart Failure. J Clin Med 2022; 11:6307. [DOI: 10.3390/jcm11216307] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
Heart failure (HF) is an extremely major health problem with gradually increasing incidence in developed and developing countries. HF may lead to cardiac remodeling; thus, advanced imaging techniques are required to comprehensively evaluate cardiac mechanics. Recently, three-dimensional speckle-tracking echocardiography (3D-STE) has been developed as a novel imaging technology that is based on the three-dimensional speckle-tracking on the full volume three-dimensional datasets. Three-dimensional speckle-tracking echocardiography allows a more accurate evaluation of global and regional myocardial performance, assessment of cardiac mechanics, detection of subclinical cardiac dysfunction, and prediction of adverse clinical events in a variety of cardiovascular diseases. Therefore, this review summarizes the clinical usefulness of 3D-STE in patients with HF.
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Prediction of prognosis in patients with left ventricular dysfunction using three-dimensional strain echocardiography and cardiac magnetic resonance imaging. Neth Heart J 2022; 30:572-579. [PMID: 35536478 DOI: 10.1007/s12471-022-01688-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND We evaluated three-dimensional speckle tracking echocardiography (3DSTE) strain and cardiac magnetic resonance (CMR) with delayed contrast enhancement (DCE) for the prediction of cardiac events in left ventricular (LV) dysfunction. METHODS CMR and 3DSTE in 75 patients with ischaemic and 38 with non-ischaemic LV dysfunction were analysed and temporally correlated to cardiac events during 41 ± 9 months of follow-up. RESULTS Cardiac events occurred in 44 patients, more in patients with ischaemic LV dysfunction. LV ejection fraction (LVEF), global circumferential and global area strain were reduced more in patients with more cardiac events, whereas 3DSTE LV end-systolic volumes and 3DSTE LV masses were larger. However, the area under the curve using receiver-operating characteristic analysis showed modest sensitivity and specificity for all evaluated parameters. Additionally, DCE did not differ significantly between the two groups. Univariate analysis showed ischaemic aetiology of LV dysfunction, LVEF and LV mass by CMR to be predictors of cardiac events with an increased relative risk of 2.4, 1.6 and 1.5, respectively. By multivariate analysis, only myocardial ischaemia and LVEF ≤ 39% were independent predictors of events (p = 0.004 and 0.005, respectively). Subgroup analysis in ischaemic and non-ischaemic patients showed only 3DSTE LV mass in ischaemic patients to have a significant association (p = 0.033) but without an increased relative risk. CONCLUSION LVEF calculated by 3DSTE or CMR were both good predictors of cardiac events in patients with LV dysfunction. A reduced LVEF ≤ 39% was associated with a 1.6-fold higher probability of a cardiac event. 3DSTE strain measurements and DCE-CMR did not add to the prognostic value of LVEF.
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Tomoaia R, Beyer RȘ, Zdrenghea D, Dădârlat-Pop A, Popescu MI, Cismaru G, Gușetu G, Șerban AM, Simu GR, Minciună IA, Caloian B, Roșu R, Chețan MI, Pop D. Impact of Three-Dimensional Strain on Major Adverse Cardiovascular Events after Acute Myocardial Infarction Managed by Primary Percutaneous Coronary Intervention-A Pilot Study. Life (Basel) 2021; 11:life11090930. [PMID: 34575079 PMCID: PMC8465252 DOI: 10.3390/life11090930] [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: 08/04/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Three-dimensional speckle-tracking echocardiography (3D-STE) allows simultaneous assessment of multidirectional components of strain. However, there are few data on its usefulness to predict prognosis in patients with acute myocardial infarction (AMI). The objective of our pilot study was to evaluate the prognostic value of four different 3D-STE parameters (global longitudinal strain (GLS-3D), global circumferential strain (GCS-3D), global radial strain (GRS-3D), and global area strain (GAS)) in AMI, after successful revascularization by primary PCI. Methods: We enrolled 94 AMI patients (66 ± 13 years, 56% men) who underwent coronary angiography. All patients had been 3D-STE assessed and followed-up for 1 year for the occurrence of MACE. Results: A total of 25 MACE were recorded over follow-up. Cut-off values of −17% for GAS (HR = 3.1, 95% CI: 1.39–6.92, p = 0.005), −12% for GCS-3D (HR = 3.06, 95% CI: 1.36–6.8, p = 0.006), −10% for GLS-3D (HR = 3.04, 95% CI: 1.36–6.78, p = 0.006), and 25% for GRS-3D (HR = 2.89, 95% CI: 1.29–6.46, p = 0.009) showed moderate accuracy in MACE prediction. Multivariate regression showed that GAS (HR = 1.1, 95% CI: 1.03–1.16), GLS-3D (HR = 1.13, 95% CI: 1.03–1.26), and GCS-3D (HR = 1.13, 95% CI: 1.03–1.23) remained independent predictors of MACE (HR = 1.07, 95% CI: 1.01–1.14 for GAS, and HR = 1.1, 95% CI: 1.01–1.2 for GCS-3D). However, post hoc power analysis indicated adequate sample size (power of 80%) only for GAS and GCS-3D for the ROC curve analysis and for GAS, GCS-3D, and GRS-3D for the log-rank test. Conclusion: Patients with AMI might benefit from early risk stratification with the aid of 3D-STE measurements, particularly GAS and GCS-3D, but larger studies are necessary to determine the optimal cut-off values to predict MACE.
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Affiliation(s)
- Raluca Tomoaia
- Cardiology Department, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania; (R.Ș.B.); (A.D.-P.); (A.M.Ș.); (M.I.C.)
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Correspondence:
| | - Ruxandra Ștefana Beyer
- Cardiology Department, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania; (R.Ș.B.); (A.D.-P.); (A.M.Ș.); (M.I.C.)
| | - Dumitru Zdrenghea
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| | - Alexandra Dădârlat-Pop
- Cardiology Department, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania; (R.Ș.B.); (A.D.-P.); (A.M.Ș.); (M.I.C.)
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
| | - Mircea Ioachim Popescu
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
- Cardiology Department, Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania
| | - Gabriel Cismaru
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| | - Gabriel Gușetu
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| | - Adela Mihaela Șerban
- Cardiology Department, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania; (R.Ș.B.); (A.D.-P.); (A.M.Ș.); (M.I.C.)
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
| | - Gelu Radu Simu
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| | - Ioan Alexandru Minciună
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| | - Bogdan Caloian
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| | - Radu Roșu
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| | - Maria Ioana Chețan
- Cardiology Department, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania; (R.Ș.B.); (A.D.-P.); (A.M.Ș.); (M.I.C.)
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
| | - Dana Pop
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
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Nabeshima Y, Seo Y, Takeuchi M. A review of current trends in three-dimensional analysis of left ventricular myocardial strain. Cardiovasc Ultrasound 2020; 18:23. [PMID: 32591001 PMCID: PMC7320541 DOI: 10.1186/s12947-020-00204-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/15/2020] [Indexed: 12/19/2022] Open
Abstract
Three-dimensional (3D) left ventricular (LV) myocardial strain measurements using transthoracic 3D echocardiography speckle tracking analysis have several advantages over two-dimensional (2D) LV strain measurements, because 3D strain values are derived from the entire LV myocardium, yielding more accurate estimates of global and regional LV function. In this review article, we summarize the current status of 3D LV myocardial strain. Specifically, we describe how 3D LV strain analysis is performed. Next, we compare characteristics of 2D and 3D strain, and we explain validation of 3D strain measurements, feasibility and measurement differences between 2D and 3D strain, reference values of 3D strain, and its applications in several clinical scenarios. In some parts of this review, we used a meta-analysis to draw reliable conclusions. We also describe the added value of 3D over 2D strain in several specific pathologies and prognoses. Finally, we discuss novel techniques using 3D strain and suggest its future directions.
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Affiliation(s)
- Yosuke Nabeshima
- Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi, Kitakyushu, 807-8555, Japan.
| | - Yoshihiro Seo
- Department of Cardiology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, School of Medicine, Hospital of University of Occupational and Environmental Health, Kitakyushu, Japan
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Kitano T, Nabeshima Y, Otsuji Y, Negishi K, Takeuchi M. Accuracy of Left Ventricular Volumes and Ejection Fraction Measurements by Contemporary Three-Dimensional Echocardiography with Semi- and Fully Automated Software: Systematic Review and Meta-Analysis of 1,881 Subjects. J Am Soc Echocardiogr 2019; 32:1105-1115.e5. [DOI: 10.1016/j.echo.2019.04.417] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/18/2019] [Accepted: 04/19/2019] [Indexed: 12/17/2022]
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Bendary A, Afifi M, Tawfik W, Mahros M, Ramzy A, Salem M. The predictive value of global longitudinal strain on late infarct size in patients with anterior ST-segment elevation myocardial infarction treated with a primary percutaneous coronary intervention. Int J Cardiovasc Imaging 2018; 35:339-346. [PMID: 30430328 DOI: 10.1007/s10554-018-1498-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/07/2018] [Indexed: 01/30/2023]
Abstract
Late infarct size (IS) after ST segment elevation myocardial infarction (STEMI) is a determinant of subsequent mortality. Late Gadolinium enhancement in cardiac magnetic resonance imaging (LGE-CMRI) is the gold standard for IS measurement, however, it is not readily accessible in many areas. We aimed to evaluate the value of early baseline 2D-echocardiographic global longitudinal strain (GLS) for the prediction of late IS after STEMI. From October 2017 to July 2018, we studied 100 patients with their 1st anterior STEMI treated with primary percutaneous coronary intervention. Baseline GLS calculation was performed within 48 h of admission. In addition, the average value of the nine segments supplied by the LAD was assessed separately (anterior GLS). Infarct size was assessed 3 months later using LGE-CMRI, and large infarcts were defined as ≥ 20% LV myocardium covered by scar. Based on CMRI, we defined two groups; 57 patients with large infarcts (group I) and 43 patients with small infarcts (group II). Both groups were matched in all baseline demographics and risk factors. There was a good and significant correlation between GLS and late IS (r = - 0.840, P < 0.001). This correlation was even higher for anterior GLS (r = - 0.867, P < 0.001). ROC analysis showed a cut-off point of GLS (- 13%) that identified large late IS with a sensitivity and specificity of 66.7% and 88.4% respectively (AUC = 0.85). For anterior GLS, the cut-off point was - 9.6% (Sensitivity 94%, specificity 86%, AUC = 0.9). We concluded that baseline GLS significantly predicts late IS after anterior STEMI.
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Affiliation(s)
- Ahmed Bendary
- Cardiology Department, Benha Faculty of Medicine, Benha University, Benha, Egypt.
| | - Mohamed Afifi
- Radiology Department, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Wael Tawfik
- Cardiology Department, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Mohamed Mahros
- Cardiology Department, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Ahmed Ramzy
- Cardiology Department, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Mohamed Salem
- Cardiology Department, Benha Faculty of Medicine, Benha University, Benha, Egypt
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Diao KY, Yang ZG, Ma M, He Y, Zhao Q, Liu X, Gao Y, Xie LJ, Guo YK. The Diagnostic Value of Global Longitudinal Strain (GLS) on Myocardial Infarction Size by Echocardiography: A Systematic Review and Meta-analysis. Sci Rep 2017; 7:10082. [PMID: 28855658 PMCID: PMC5577208 DOI: 10.1038/s41598-017-09096-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 07/20/2017] [Indexed: 02/05/2023] Open
Abstract
A systematic review and meta-analysis of prospective randomized studies were performed to evaluate the diagnostic value of measuring global longitudinal strain (GLS) using speckle tracking echocardiography (STE) in determining myocardial infarction (MI) size, which is usually measured based on late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR). Eleven trials with a total of 765 patients were included. The pooled correlation was 0.70 (95% CI: 0.64, 0.74) between two-dimensional (2D) GLS and the LGE percentage, and it was 0.55 (95% CI: 0.19, 0.78) for three-dimensional (3D) GLS. Pooled diagnostic estimates for 2D GLS to differentiate an MI size >12% were as follows: sensitivity, 0.77 (95% CI: 0.61, 0.90); specificity, 0.86 (95% CI: 0.68, 0.96); positive likelihood ratio (PLR), 8.13 (95% CI: 1.90, 26.61); negative likelihood ratio (NLR), 0.28 (95% CI: 0.10, 0.54); and diagnostic odds ratio (DOR), 39.87 (95% CI: 4.12, 172.83). The estimated area under the curve (AUC) of the summary receiver operating characteristic (SROC) curve was 0.702. The 2D STE results positively correlated with the infarction size quantified by CMR for patients who had experienced their first MI. This approach can serve as a good diagnostic index for assessing infarction area. However, more consolidated STE studies are still needed to determine the value of 3D STE.
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Affiliation(s)
- Kai-Yue Diao
- Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Zhi-Gang Yang
- Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
| | - Min Ma
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
- Department of Cardiology, The Sixth People's Hospital of Chengdu, Chengdu, China
| | - Yong He
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Qin Zhao
- Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Xi Liu
- Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Yue Gao
- Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Lin-Jun Xie
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Ying-Kun Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
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