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Akay Caglayan H, Kjønås D, Kornev M, Iqbal A, Jazbani M, Rösner A. Resting segmental speckle tracking strain and strain rate in stable coronary artery disease and revascularized myocardial infarction. Int J Cardiovasc Imaging 2024; 40:2077-2086. [PMID: 39179715 PMCID: PMC11499336 DOI: 10.1007/s10554-024-03200-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 07/16/2024] [Indexed: 08/26/2024]
Abstract
Patients with acute coronary artery disease (CAD) exhibit reduced global and regional strain and strain rate (S/SR). However, knowledge about segmental S/SR in stable CAD patients is still limited. This study aimed to investigate whether resting segmental S/SR measurements differ in patients with chronic chest pain who have normal coronary arteries or stenotic coronary arteries, and to compare these measurements to those in patients with revascularized myocardial infarction (MI). We prospectively enrolled 510 patients with chronic chest pain referred for coronary computed tomography angiography (CCTA) and 102 patients revascularized after MI. All participants underwent transthoracic echocardiography featuring S/SR analysis. In addition to the patients with MI, patients with suspected CAD based on CCTA findings subsequently underwent invasive coronary angiography (CAG). We assessed global longitudinal strain (GLS) and averaged segmental peak longitudinal strain during systole (PLS), peak systolic strain rate (SRs), peak early diastolic strain rate (SRe), and post systolic shortening (PSS). We also determined functionally reduced segment percentages using differing S/SR cut-off values. There were significant disparities in all average segmental S/SR metrics between the No-CAD and MI groups. SRe was the only S/SR metric that differed significantly between the No-CAD and PCI groups. Differences in SRe, PLS and GLS measurements were observed between the No-CAD and CABG groups. The proportion of diminished segmental S/SR mirrored these findings. For the percentage of pathological segments with varying cut-off values, segmental SRe below 1.5 s- 1 displayed the most marked difference among the four groups (p < 0.001). Revascularized MI patients or those referred to CABG present with diminished segmental S/SR values. However, among patients with chronic chest pain, only segmental SRe discerns subtle disparities between the No-CAD and the PCI group. The diagnostic accuracy of SRe warrants further exploration in subsequent studies.
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Affiliation(s)
- Hatice Akay Caglayan
- Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway.
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Didrik Kjønås
- Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Gastrointestinal surgery, University Hospital of North Norway, Tromsø, Norway
| | - Mikhail Kornev
- Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Amjid Iqbal
- Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Mehran Jazbani
- Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
| | - Assami Rösner
- Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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O'Driscoll JM, Tuttolomondo D, Gaibazzi N. Artificial intelligence calculated global longitudinal strain and left ventricular ejection fraction predicts cardiac events and all-cause mortality in patients with chest pain. Echocardiography 2023; 40:1356-1364. [PMID: 37964624 DOI: 10.1111/echo.15714] [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: 02/27/2023] [Revised: 09/09/2023] [Accepted: 11/02/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Assessment of left ventricular ejection fraction (LVEF) and myocardial deformation with global longitudinal strain (GLS) has shown promise in predicting adverse cardiovascular events. The aim of this study was to evaluate whether artificial intelligence (AI) calculated LVEF and GLS is associated with major adverse cardiac events (MACE) and all-cause mortality in patients presenting with chest pain. METHODS We studied 296 patients presenting with chest pain, who underwent transthoracic echocardiography (TTE). Clinical data, downstream clinical investigations and patient outcomes were collected. Resting TTE images underwent AI contouring for automated calculation of LVEF and GLS with Ultromics EchoGo Core 2.0. Regression analysis was performed to identify clinical and AI calculated parameters associated with MACE and all-cause mortality. RESULTS During a median follow-up period of 7.8 years (IQR 6.4, 8.8), MACE occurred in 34 (11.5%) patients and all-cause mortality in 60 (20%) patients. AI calculated LVEF (Odds Ratio [OR] .96; 95% CI .93-.99 and .96; 95% CI .93-.99) and GLS (1.11; 95% CI 1.01-1.21 and 1.08; 95% CI 1.00-1.16) were independently associated with MACE and all-cause mortality, respectively. According to Cox proportional hazards, a LVEF < 50% was associated with a 3.7 times MACE and 2.8 times all-cause mortality hazard rate compared to those with a LVEF ≥ 50%. Those with a GLS ≥ 15% was associated with a 2.5 times MACE and 2.3 times all-cause mortality hazard rate compared to those with a GLS ≤ 15. CONCLUSION AI calculated resting LVEF and GLS is independently associated with MACE and all-cause mortality in high CVD risk patients. These results may have significant clinical implications through improved risk stratification of patients with chest pain, accelerated workflow of labour-intensive technical measures, and reduced healthcare costs.
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Affiliation(s)
- Jamie M O'Driscoll
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | | | - Nicola Gaibazzi
- Non-invasive Cardiology, Parma University Hospital, Parma, Italy
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Masada K, Hidaka T, Urabe Y, Mitsuba N, Ueda H. Usefulness of post-systolic index in facilitating stratification of risk in patients with intermediate- or low-risk non-ST-segment elevation acute coronary syndrome. J Echocardiogr 2023; 21:157-164. [PMID: 37436636 DOI: 10.1007/s12574-023-00612-0] [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: 10/24/2022] [Revised: 06/14/2023] [Accepted: 06/29/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Although there is reportedly a usefulness of left ventricular global longitudinal strain (LV GLS) on 2D speckle-tracking echocardiography in excluding significant coronary artery disease (CAD) in suspected intermediate- or low-risk non-ST-segment elevation-acute coronary syndrome (NSTE-ACS), the efficacy of post-systolic index (PSI) in this context is yet unknown. Therefore, we explored the usefulness of PSI in facilitating stratification of risk in patients with intermediate- or low-risk NSTE-ACS. METHODS AND RESULTS We assessed 50 consecutive patients suspected of intermediate- or low-risk NSTE-ACS, and finally analyzed 43 patients whose echocardiographic images were suitable for strain analysis. All patients underwent CAG. Among the 43 analyzed patients, 26 had CAD, and 21 underwent percutaneous coronary intervention (PCI). Patients with CAD had higher PSI (25% [20.8-40.3%] vs 15% [8.0-27.5%], P = 0.007). Receiver-operator characteristic curve analysis identified that a PSI of > 20% detected performance of PCI (sensitivity 80.7%, specificity 70.6%, area under curve [AUC] 0.72, 95% confidence interval [CI] 0.57-0.88). Moreover, the AUC obtained using the GRACE risk score was 0.57 (95% CI 0.39-0.75), and increased to 0.75 (95% CI 0.60-0.90) when PSI and LV GLS were added. Thus, the addition of PSI and LV GLS improved the classification of performance of PCI (net reclassification improvement [95%CI] 0.09 [0.0024-0.18], P = 0.04). CONCLUSIONS Post-systolic index is a useful parameter that can facilitate stratification of risk in patients with intermediate- or low-risk NSTE-ACS. We recommend measuring PSI in routine clinical practice.
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Affiliation(s)
- Kenji Masada
- Department of Cardiology, National Organization Kure Medical Center and Chugoku Cancer Center, Aoyamacho 3-1, Kure, 737-0023, Japan.
| | - Takayuki Hidaka
- Department of Cardiovascular Medicine, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Yoji Urabe
- Department of Cardiovascular Medicine, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Naoya Mitsuba
- Department of Cardiovascular Medicine, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Hironori Ueda
- Department of Cardiovascular Medicine, Hiroshima Prefectural Hospital, Hiroshima, Japan
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Yurdam FS, Gürses E. Myocardial bridge and beta blockers: effect on left ventricular strain parameters. Acta Cardiol 2023:1-7. [PMID: 37171374 DOI: 10.1080/00015385.2023.2209421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVES To assess the effect of beta-blocker treatment on left ventricular global longitudinal strain (LV Gls) as measured by echocardiography in patients with MB (Myocardial Bridge). PATIENTS AND METHODS Between January 2019 and February 2022, a prospective, single-center study was undertaken in which myocardial bridging was identified in individuals who had coronary angiography. One hundred patients with myocardial bridging were systematically recruited and strain echocardiography was performed. Patient data were analysed in two groups - those who weren't using beta-blockers in the last six months (Group I: n = 50) vs. those who were (Group II: n = 50). RESULTS One hundred patients participated in the study (38 females, 62 males; average age: 57.4 years). There was a statistically significant difference in the mean heart rate between groups I and II (p < 0.001). LV Gls was found to be statistically significantly improved in favour of group II when compared to group I [Group I: (-12.57)±3 vs. Group II: (-15.92)±2.9, p < 0.001]. CONCLUSION The negative chronotropic effect of beta-blocker medication in individuals with MB identified by coronary angiography has a beneficial effect on LV Gls as measured by echocardiography.
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Affiliation(s)
- Ferhat S Yurdam
- Department of Cardiology, Bakırçay University Çiğli Training and Research Hospital, İzmir, Turkey
| | - Ecem Gürses
- Department of Cardiology, Bakırçay University Çiğli Training and Research Hospital, İzmir, Turkey
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Yu T, Cui H, Chang W, Li Y, Cui X, Li G. Real-time three-dimensional echocardiography and two-dimensional speckle tracking imaging in the evaluation of left atrial function in patients with triple-vessel coronary artery disease without myocardial infarction. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:445-454. [PMID: 35261038 DOI: 10.1002/jcu.23188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/30/2022] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To evaluate left atrial function in patients with triple-vessel disease (TVD) without myocardial infarction by real-time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging (2D-STE). METHODS Sixty patients with coronary artery disease (CAD) without myocardial infarction were classified into two groups in accordance with the coronary angiography results: group B (all triple-vessel stenosis ≥ 50% and < 75%) and group C (all triple-vessel stenosis ≥ 75%). Thirty healthy individuals were selected as group A. LA volume related parameters including left atrial maximum volume index (LAVImax), LA passive and active ejection fraction (LAPEF, LAAEF) and LA total ejection fraction (LATEF) were measured by RT-3DE. The global peak atrial longitudinal systolic strain (LASRs), early and late diastolic LA strain (LASRe and LASRa) rates were measured by 2D-STE. RESULTS We found statistically significant differences between 2D-STE and RT-3DE related parameters of these three groups. Furthermore, in groups B and C, N-terminal fragment brain natriuretic peptides (NT-pro-BNP) and left ventricular end-diastolic pressure (LVEDP) were found to be significantly correlated with LASRs and LASRa. And NT-pro-BNP had a moderate correlation with LVEDP. CONCLUSIONS 2D-STE and RT-3DE can assess the LA function in patients with TVD without myocardial infarction. And LA strain values may provide additional information for predicting increased LVEDP and NT-pro-BNP.
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Affiliation(s)
- Tingting Yu
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Hongyan Cui
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Wenxing Chang
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ying Li
- 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
| | - Guangsen Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
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Chamberlain R, Edwards NFA, Scalia GM, Chan J. Novel left and right ventricular strain analysis to detect subclinical myocardial dysfunction in cardiac allograft rejection. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2022; 38:1077-1088. [PMID: 34936051 DOI: 10.1007/s10554-021-02486-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
Abstract
Early detection of acute cellular rejection (ACR) by echocardiography shows potential clinical benefit as ACR remains a significant contributor to morbidity and mortality. This retrospective, longitudinal study sought to investigate the use of novel left (LV) and right ventricular (RV) strain analysis to detect biopsy proven ACR. 46 heart transplant patients (Mean age 46 ± 16 years) with biopsy proven ACR were grouped according to biopsy results: 1R-ACR (n = 36) and 2R-ACR (n = 10). Serial two-dimensional transthoracic echocardiography with strain analysis was performed. Echocardiographic parameters were serially measured: (1) rejection free period (0R-ACR); (2) pre-ACR period (pre-ACR); (3) during ACR (1R-ACR or 2R-ACR) and (4) post-ACR (Post-ACR). Significant reductions for LV Global Longitudinal Strain (LV GLS) and LV Early diastolic Strain rate (LV ESr) were observed between 0R-ACR and pre-ACR (LV GLS 0R-ACR: 17.3% vs Pre-2R ACR: 15.4%, p = 0.016; LV ESr 0R-ACR: 1.00/s vs Pre-2R ACR: 0.74/s, p = 0.007) with LV ESr demonstrating the highest sensitivity (92%) and specificity (81%) to predict ACR. LV ESr and the E/LV ESr ratio were significantly different (p = 0.0001; p = 0.016) during pre-1R ACR period vs 0R whereas LV GLS showed no significant differences for grade 1R-ACR. Diastolic mechanical dispersion showed significant increases in dispersion during ACR for the 1R-ACR group and early significant increases pre-2R ACR. Systolic and diastolic RV strain parameters showed a similar trend for both ACR groups. Systolic and diastolic strain parameters can detect myocardial dysfunction before biopsy confirmed 2R-ACR. Early diastolic strain rate parameters are most sensitive detecting subclinical myocardial dysfunction pre-ACR. Novel strain parameters are potentially useful clinical tool for prediction of early ACR in heart transplant.
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Affiliation(s)
- Robert Chamberlain
- Department of Cardiology, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD, 4032, Australia
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Natalie F A Edwards
- Department of Cardiology, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD, 4032, Australia
| | - Gregory M Scalia
- Department of Cardiology, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD, 4032, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Jonathan Chan
- Department of Cardiology, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD, 4032, Australia.
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
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Grondin J, Lee C, Weber R, Konofagou EE. Myocardial Strain Imaging With Electrocardiogram-Gated and Coherent Compounding for Early Diagnosis of Coronary Artery Disease. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:626-637. [PMID: 35063291 PMCID: PMC8866224 DOI: 10.1016/j.ultrasmedbio.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/22/2021] [Accepted: 12/01/2021] [Indexed: 06/14/2023]
Abstract
Myocardial elastography (ME) is an ultrasound-based technique that uses radiofrequency signals for 2-D cardiac motion tracking and strain imaging at a high frame rate. Early diagnosis of coronary artery disease (CAD) is critical for timely treatment and improvement of patient outcome. The objective of this study was to assess the performance of ME radial and circumferential strains in the detection and characterization of CAD in patients. In this study, 86 patients suspected of CAD were imaged with ME prior to invasive coronary angiography (ICA). End-systolic radial and circumferential left ventricular strains were estimated in all patients in each of their perfusion territories: left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA). ME radial strains were capable of differentiating the obstructive CAD group (55.3 ± 29.8%) from the non-obstructive CAD (72.5 ± 46.8%, p < 0.05) and no CAD groups (73.4 ± 30.4%, p < 0.05) in the RCA territory. ME circumferential strains were capable of differentiating the obstructive CAD group (-3.1 ± 7.5%) from the non-obstructive CAD (-7.2 ± 6.8%, p < 0.05) and normal (-6.9 ± 8.0%, p < 0.05) groups in the LAD territory and to differentiate the normal group (-17.1 ± 8.2%) from the obstructive (-12.8 ± 7.2%, p < 0.05) and non-obstructive CAD (-13.6 ± 8.5%, p < 0.05) groups in the RCA territory. ME circumferential strain performed better than ME radial strain in differentiating normal, non-obstructive and obstructive perfusion territories. In the LCX territory, both ME radial and circumferential strains decreased when the level of stenosis was higher. However, it was not statistically significant. The findings presented herein indicate that ME radial and circumferential estimation obtained from ECG-gated and compounded acquisitions is a promising tool for early, non-invasive and radiation-free detection of CAD in patients.
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Affiliation(s)
- Julien Grondin
- Department of Radiology, Columbia University, New York, New York, USA
| | - Changhee Lee
- Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Rachel Weber
- Department of Biomedical Engineering, Columbia University, New York, New York, USA
| | - Elisa E Konofagou
- Department of Radiology, Columbia University, New York, New York, USA; Department of Biomedical Engineering, Columbia University, New York, New York, USA.
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Knox DB, Lanspa MJ, Wilson E, Haaland B, Beesley S, Hirshberg E, Abraham TP, Vallabhajosyula S, Grissom CK, Drakos SG, Brown SM. Initial Derivation of a Predictive Model for Left Ventricular Longitudinal Strain (LS) in Early Sepsis. J Intensive Care Med 2021; 37:1049-1054. [PMID: 34757892 DOI: 10.1177/08850666211053796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Septic shock is a common deadly disease often associated with cardiovascular dysfunction. Left ventricular longitudinal strain (LV LS) has been proposed as a sensitive marker to measure cardiovascular function; however, it is not available universally in standard clinical echocardiograms. We sought to derive a predictive model for LV LS, using machine learning techniques with the hope that we may uncover surrogates for LV LS. We found that left ventricular ejection fraction, tricuspid annular plane systolic excursion, sepsis source, height, mitral valve Tei index, LV systolic dimension, aortic valve ejection time, and peak acceleration rate were all predictive of LV LS in this initial exploratory model. Future modeling work may uncover combinations of these variables which may be powerful surrogates for LV LS and cardiovascular function.
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Affiliation(s)
- Daniel B Knox
- 98078Intermountain Medical Center, Murray, UT, USA.,14434University of Utah, Salt Lake City, UT, USA
| | - Michael J Lanspa
- 98078Intermountain Medical Center, Murray, UT, USA.,14434University of Utah, Salt Lake City, UT, USA
| | - Emily Wilson
- 98078Intermountain Medical Center, Murray, UT, USA
| | | | - Sarah Beesley
- 98078Intermountain Medical Center, Murray, UT, USA.,14434University of Utah, Salt Lake City, UT, USA
| | - Eliotte Hirshberg
- 98078Intermountain Medical Center, Murray, UT, USA.,14434University of Utah, Salt Lake City, UT, USA
| | | | | | - Colin K Grissom
- 98078Intermountain Medical Center, Murray, UT, USA.,14434University of Utah, Salt Lake City, UT, USA
| | | | - Samuel M Brown
- 98078Intermountain Medical Center, Murray, UT, USA.,14434University of Utah, Salt Lake City, UT, USA
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Akiash N, Mohammadi M, Mombeini H, Nikpajouh A. Myocardial strain analysis as a non-invasive screening test in the diagnosis of stable coronary artery disease. Egypt Heart J 2021; 73:49. [PMID: 34032936 PMCID: PMC8149515 DOI: 10.1186/s43044-021-00173-6] [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: 03/11/2021] [Accepted: 05/13/2021] [Indexed: 11/16/2022] Open
Abstract
Background Coronary artery disease (CAD) is one of the most prevalent diseases around the world; however, finding the best noninvasive, low-cost, and more easily accessible test for its screening has been a challenge for several years. Eighty-nine patients suspected of stable CAD underwent 2D-speckle-tracking echocardiography (2DSTE) at resting position and offline longitudinal myocardial strain analysis, followed by coronary angiography. The correlation of the global longitudinal strain (GLS) and territorial longitudinal strain (TLS) with significant CAD (70% and more stenosis in at least one coronary artery) was then evaluated. Results The statistical analysis showed a significant correlation between low GLS and significant CAD (P=0.0001). The results also showed a significant correlation between low TLS and significant CAD in the left and right coronary artery territories. The optimal cut-off point of GLS for the detection of significant CAD was −19.25, with a sensitivity of 76.5% and specificity of 76.6%. Conclusion This study confirmed the usefulness of 2DSTE myocardial strain analysis in diagnosis of CAD for detecting the affected coronary arteries using GLS and SLS.
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Affiliation(s)
- Nehzat Akiash
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Mohammadi
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Hoda Mombeini
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Akbar Nikpajouh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Orlowska M, Ramalli A, Bezy S, Meacci V, Voigt JU, D'Hooge J. In Vivo Comparison of Multiline Transmission and Diverging Wave Imaging for High-Frame-Rate Speckle-Tracking Echocardiography. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:1511-1520. [PMID: 33170777 DOI: 10.1109/tuffc.2020.3037043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
High-frame-rate (HFR) speckle-tracking echocardiography (STE) assesses myocardial function by quantifying motion and deformation at high temporal resolution. Among the proposed HFR techniques, multiline transmission (MLT) and diverging wave (DW) imaging have been used in this context both being characterized by specific advantages and disadvantages. Therefore, in this article, we directly contrast both approaches in an in vivo setting while operating at the same frame rate (FR). First, images were recorded at baseline (resting condition) from healthy volunteers and patients. Next, additional acquisitions during stress echocardiography were performed on volunteers. Each scan was contoured and processed by a previously proposed 2-D HFR STE algorithm based on cross correlation. Then, strain curves and their end-systolic (ES) values were extracted for all myocardial segments for further statistical analysis. The baseline acquisitions did not reveal differences in estimated strain between the acquisition modes ( ); myocardial segments ( ); or an interaction between imaging mode and depth ( ). Similarly, during stress testing, no difference ( p = 0.7 ) was observed for the two scan sequences, stress levels or an interaction sequence-stress level ( p = 0.94 ). Overall, our findings show that MLT and DW compoundings give comparable HFR STE strain values and that the choice for using one method or the other may thus rather be based on other factors, for example, system requirements or computational cost.
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Zhu H, Yang C, Li Y, Guo Y, Meng X, Ren Y, Tan L, Zhang R, Wang F. Two-Dimensional Speckle Tracking Echocardiography Identifies Coronary Artery Disease in 690 Patients: A Retrospective Study from a Single Center. Med Sci Monit 2021; 27:e929476. [PMID: 33561114 PMCID: PMC7883402 DOI: 10.12659/msm.929476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Two-dimensional speckle tracking echocardiography (2D-STE) is a novel and non-invasive technique for the diagnosis of coronary artery disease (CAD). This retrospective study from a single center aimed to identify myocardial ischemia using 2D-STE in CAD patients identified by angiography. MATERIAL AND METHODS From March 1 to November 30, 2019, 690 patients in Beijing Hospital were enrolled. After angiography, 346 patients were diagnosed with CAD. Reduction in vessel diameter of ≥50% by stenosis in at least 1 major coronary artery or its main branch was considered CAD. Analysis of 2D-STE was performed using EchoPAC version 201. RESULTS The global strain was significantly impaired in CAD patients (P<0.01). Global longitudinal peak strain (GLPS) was analyzed in layers. For GLPS of the epicardium, the odds ratio (OR) was 1.297 (1.217-1.382; P=0.002), the area under the curve (AUC) was 0.727, and the cut-off value was -16.95; sensitivity and specificity were 73.7% and 63.0%, respectively. For GLPS of the middle layer, the OR was 1.260 (1.192-1.333; P<0.001), the AUC was 0.732, and the cut-off value was -20.95; sensitivity and specificity were 82.4% and 56.2%, respectively. For GLPS of the endocardium, the OR was 1.193 (1.137-1.251; P<0.001), the AUC was 0.708, and the cut-off value was -22.95; sensitivity and specificity were 82.9% and 52.9%, respectively. CONCLUSIONS The findings from this study support the clinical application of 2D-STE in patient populations with suspected myocardial ischemia due to CAD. Therefore, 2D-STE combined with ECG monitoring may have a future role for early screening of CAD patients.
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Affiliation(s)
- Huolan Zhu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (mainland).,Graduate School, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China (mainland)
| | - Chenguang Yang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (mainland)
| | - Yi Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (mainland).,Graduate School, Medical College, Beijing University, Beijing, China (mainland)
| | - Ying Guo
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (mainland)
| | - Xuyang Meng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (mainland).,Graduate School, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China (mainland)
| | - Yirong Ren
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (mainland).,Graduate School, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China (mainland)
| | - Long Tan
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (mainland).,Graduate School, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China (mainland)
| | - Ruisheng Zhang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (mainland)
| | - Fang Wang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China (mainland)
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12
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Early diastolic strain rate by two-dimensional speckle tracking echocardiography is a predictor of coronary artery disease and cardiovascular events in stable angina pectoris. Int J Cardiovasc Imaging 2020; 36:1249-1260. [PMID: 32405734 DOI: 10.1007/s10554-020-01822-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/20/2020] [Indexed: 10/24/2022]
Abstract
This study aimed to clarify the diagnostic and prognostic potential of strain rate in patients with suspected stable angina pectoris (SAP). Strain rate by 2-dimensional speckle tracking echocardiography (2DSTE) has been suggested to be able to diagnose coronary artery disease (CAD) and predict cardiovascular events in various patient groups. Prospectively enrolled patients (n = 296) with suspected SAP, no previous cardiac disease, and normal left ventricular ejection fraction were examined by 2DSTE, exercise ECG, and coronary angiography. Obstructive CAD was defined as stenosis ≥ 70% in ≥ 1 coronary artery on coronary angiography (n = 107). Major adverse cardiac events (MACE) included myocardial infarction, heart failure, atrial fibrillation, and stroke. In multivariable analysis adjusted for baseline data, conventional echocardiography, and Duke score, early diastolic strain rate (SRe) was independently associated with significant CAD with a 1.35 increased risk of having CAD per 0.1 decrease in SRe (OR = 1.35, 95% CI 1.03-1.76, P = 0.027). Peak velocity of early diastolic filling (E)/SRe was not associated with significant CAD (OR = 1.14, 95% CI 0.81-1.62, P = 0.445). MACE occurred in 34 patients (12%) during follow-up (median 3.5 years) and both SRe (HR 1.26, 95% CI (1.07-1.49), P = 0.006) and E/SRe (HR 1.24, 95% CI (1.04-1.47), P = 0.017) were independent predictors after multivariable adjustment. In patients with suspected SAP, SRe by 2DSTE was independently associated with presence of CAD. In addition, SRe and E/SRe provided independent and incremental prognostic value for predicting future MACE.
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13
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Kropidlowski C, Meier-Schroers M, Kuetting D, Sprinkart A, Schild H, Thomas D, Homsi R. CMR based measurement of aortic stiffness, epicardial fat, left ventricular myocardial strain and fibrosis in hypertensive patients. IJC HEART & VASCULATURE 2020; 27:100477. [PMID: 32099896 PMCID: PMC7026624 DOI: 10.1016/j.ijcha.2020.100477] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/06/2020] [Accepted: 01/24/2020] [Indexed: 12/17/2022]
Abstract
Introduction A combined assessment of different parameters of cardiovascular (CV) risk and prognosis can be supportive and performed with cardiac magnetic resonance (CMR). Aortic stiffness, epicardial fat volume (EFV), left ventricular (LV) strain and fibrosis were evaluated within a single CMR examination and results were related to the presence of hypertension (HTN) and diabetes mellitus (DM). Methods 20 healthy controls (57.2 ± 8.2 years(y); 26.2 ± 3.9 kg/m2), 31 hypertensive patients without DM (59.6 ± 6.7 y; 28.4 ± 4.7 kg/m2) and 12 hypertensive patients with DM (58.8 ± 9.9y; 30.7 ± 6.3 kg/m2) were examined at 1.5Tesla. Aortic stiffness was evaluated by calculation of aortic pulse wave velocity (PWV), EFV by a 3D-Dixon sequence. Longitudinal & circumferential systolic myocardial strain (LS; CS) were analyzed and T1-relaxation times (T1) were determined to detect myocardial fibrosis. Results EFV was highest in hypertensive patients with diabetes (78.4 ± 28.0 ml/m2) followed by only hypertensive patients (64.2 ± 27.3 ml/m2) and lowest in controls (50.3 ± 22.7 ml/m2; p < 0.05). PWV was higher in hypertensive patients with diabetes (9.8 ± 3.3 m/s) compared to only hypertensive patients (8.6 ± 1.7 m/s; p < 0.05) and to controls (8.1 ± 1.9 m/s; p < 0.05). LS&CS were worse in hypertensive patients with diabetes (LS:-20.9 ± 5.1% and CS: -24.4 ± 5.7%) compared to both only hypertensive patients (LS: -24.7 ± 4.6%; CS: -27.1 ± 5.0%; p < 0.05) and to controls (LS: -25.5 ± 3.8; CS: -28.3 ± 4.1%; p < 0.05). Both hypertensive groups with and without DM had higher T1́s (994.0 ± 43.2 ms; 991.6 ± 35.5 ms) than controls (964.6 ± 40.3 ms; p < 0.05). Conclusion CMR revealed increased aortic stiffness and EFV in hypertensive patients, which were even higher in the presence of DM. Also signs of LV myocardial fibrosis and a reduced strain were revealed. These parameters support the assessment of CV risk and prognosis. They can accurately be measured with CMR within a single examination when normally different techniques are needed.
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Affiliation(s)
| | | | - Daniel Kuetting
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Alois Sprinkart
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Hans Schild
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Daniel Thomas
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Rami Homsi
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
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Chamberlain R, Scalia GM, Shiino K, Platts DG, Sabapathy S, Chan J. Diastolic strain imaging: a new non-invasive tool to detect subclinical myocardial dysfunction in early cardiac allograft rejection. Int J Cardiovasc Imaging 2019; 36:317-323. [PMID: 31720881 DOI: 10.1007/s10554-019-01725-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/25/2019] [Indexed: 11/26/2022]
Abstract
Acute cellular rejection (ACR) remains a significant contributor to increased morbidity and mortality in heart transplant recipients. Early detection of ACR by non-invasive imaging is of potential clinical benefit. This study sought to investigate the use of non-invasive early global diastolic strain rate (GDSRe) and global longitudinal strain (GLS) in the detection of biopsy proven ACR. We retrospectively analysed 31 heart transplant patients (Mean age 52 ± 14 years) with biopsy proven ACR who underwent serial transthoracic echocardiographic examination and 2D strain analysis. Traditional echocardiographic systolic and diastolic parameters and novel systolic and diastolic strain imaging were measured during (1) early rejection free period (0R); (2) pre-rejection period (pre-1R); and (3) grade 1R acute cellular rejection (1R-ACR). GDSRe was significantly reduced (p = 0.0001) during the pre-rejection period (pre-1R) (0.74/s) when compared with 0R (0.97/s). GLS was only significantly reduced during 1R-ACR (17.7%), p = 0.001 but could not detect pre-1R (19.9%). Global diastolic strain rate at isovolumic relaxation showed no significant differences between any of the rejection periods. Traditional systolic and diastolic indices showed no significant differences. In conclusion, early global diastolic strain rate is the most sensitive parameter to detect subclinical myocardial dysfunction during early periods of pre-1R prior to biopsy confirmed 1R-ACR. GDSRe is a potential new tool for non-invasive screening of early post-transplant cardiac allograft rejection.
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Affiliation(s)
- Robert Chamberlain
- Department of Cardiology, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD, 4032, Australia
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Gregory M Scalia
- Department of Cardiology, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD, 4032, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Kenji Shiino
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- Department of Cardiology, Fujita-Health University, Nagoya, Japan
| | - David G Platts
- Department of Cardiology, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD, 4032, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Surendran Sabapathy
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Jonathan Chan
- Department of Cardiology, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD, 4032, Australia.
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
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15
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Ebrahimi F, Gharedaghi MH, Petrossian V, Kohanchi D. Intraoperative Assessment of Coronary Artery Stenosis by 2D Speckle-Tracking Echocardiography: The Correlation Between Peak Strain Rate During Early Diastole and the Severity of Coronary Artery Stenosis in Patients Undergoing Coronary Artery Bypass Grafting. J Cardiothorac Vasc Anesth 2019; 33:2652-2657. [DOI: 10.1053/j.jvca.2019.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 05/04/2019] [Accepted: 05/13/2019] [Indexed: 11/11/2022]
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Heidari Sarvestani A, Separham A, Khezerloo N. Assessment of Strain and Strain Rate in Patients with Coronary Artery Disease Before and After Percutaneous Intervention on Left Anterior Descending Coronary Artery. INTERNATIONAL JOURNAL OF CARDIOVASCULAR PRACTICE 2019. [DOI: 10.29252/ijcp-24016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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17
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Atıcı A, Barman HA, Erturk E, Baycan OF, Fidan S, Demirel KC, Asoglu R, Demir K, Ozturk F, Elitok A, Okuyan E, Sahin I. Multilayer longitudinal strain can help predict the development of no-reflow in patients with acute coronary syndrome without ST elevation. Int J Cardiovasc Imaging 2019; 35:1811-1821. [PMID: 31093895 DOI: 10.1007/s10554-019-01623-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 05/06/2019] [Indexed: 12/22/2022]
Abstract
No-reflow (NR) is one of the major complications of primary percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI). We aim to assess the value of multilayer longitudinal strain parameter to predict NR in patients with NSTEMI and preserved ejection fraction. 230 consecutive patients who were admitted to the emergency department and diagnosed with NSTEMI were prospectively included in this study. Echocardiography was performed 1 h before angiography. Specific analysis for endocardial, mid-myocardial and epicardial layers were performed by two-dimensional (2D) speckle tracking echocardiography (STE) for multilayer longitudinal strain. NR was described as flow grade of ≤ TIMI 2 when mechanical occlusions like dissection, intimal tear, arterial spasm and thromboembolism during angiography were excluded. 49 of 168 patients admitted to the study had NR. No significant differences were observed between the groups regarding age and gender. Multilayer longitudinal strain imaging (endocard, midmyocard and epicard) revealed lower strain values particularly in endocardial layer in patients with NR (GLS-endocard: - 14.14 ± 1.39/- 17.41 ± 2.34, p < 0.001; GLS-midmyocard: - 14.81 ± 1.40/17.81 ± 2.22, p < 0.001; GLS-epicard: - 16.14 ± 1.38/18.22 ± 2.00, p < 0.001). GLS-endocard, GLS-midmyocard, GLS-epicard and ST depression were found to be statistically significant independents parameters respectively to predict NR phenomenon (GLS-endocard: OR: 2.193, p < 0.001; GLS-midmyocard: OR: 1.510, p: 0.016; GLS-epicard: OR: 1.372, p: 0.035; ST depression: OR: 3.694, p: 0.014). We revealed that left ventricular strain study with speckle tracking echocardiography predicts NR formation. This noninvasive method may be useful for detecting NR formation in patients with NSTEMI.
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Affiliation(s)
- Adem Atıcı
- Cardiology Department, İstanbul Gaziosmanpasa Taksim Training and Research Hospital, Osmanbey Caddesi, 621 Sokak, Gaziosmanpaşa, Istanbul, Turkey
| | - Hasan Ali Barman
- Cardiology Department, Okmeydani Training Ve Research Hospital, Darulaceze street No:25, Okmeydani, 34384, Istanbul, Turkey.
| | - Emre Erturk
- Cardiology Department, Medical Park İzmir Hospital, İmbatlı Mahallesi, 1825. Sk., 35575, Karşıyaka/Izmir, Turkey
| | - Omer Faruk Baycan
- Cardiology Department, Istanbul Medeniyet University, Dr. Erkin street, 34722, Istanbul, Turkey
| | - Serdar Fidan
- Cardiology Department, Kartal Koşuyolu High Speciality Educational and Research Hospital, Cevizli Mah. Denizer Cad. Cevizli Kavşağı No:2, 34865, Kartal/Istanbul, Turkey
| | - Koray Celal Demirel
- Cardiology Department, 29 Mayıs State Hospital, Aydınlar Mah. Dikmen Cad. No: 312 PK, 06105, Çankaya/Ankara, Turkey
| | - Ramazan Asoglu
- Cardiology Department, Adiyaman Training Ve Research Hospital, Yunus Emre Mahallesi, 1164 Sokak No:13, Merkez/Adıyaman, Turkey
| | - Koray Demir
- Cardiology Department, Mus State Hospital, Saray, Mus Center, 49200, Mus, Turkey
| | - Fatih Ozturk
- Cardiology Department, Mus State Hospital, Saray, Mus Center, 49200, Mus, Turkey
| | - Ali Elitok
- Cardiology Department, Istanbul University Istanbul School of Medicine, Turgut Ozal street No: 118, Fatih, 34093, Istanbul, Turkey
| | - Erugrul Okuyan
- Cardiology Department, Bagcilar Training Ve Research Hospital, Bagcilar Center, Mimar Sinan street, Bagcilar, 34100, Istanbul, Turkey
| | - Irfan Sahin
- Cardiology Department, Bagcilar Training Ve Research Hospital, Bagcilar Center, Mimar Sinan street, Bagcilar, 34100, Istanbul, Turkey
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Eisenberg S, Cios TJ, Roberts SM. A Case of Myocardial Ischemia Detected by Global Longitudinal Strain Using Intraoperative Speckle-Tracking Echocardiography in a High-Risk Patient Undergoing Abdominal Aortic Aneurysm Repair. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:607-611. [PMID: 31028240 PMCID: PMC6698067 DOI: 10.12659/ajcr.914858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Male, 75 Final Diagnosis: Coronary artery disease Symptoms: Chest pain Medication: — Clinical Procedure: Open abdominal aortic aneurysm repair Specialty: Anesthesiology
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Affiliation(s)
- Seth Eisenberg
- Department of Anesthesiology and Perioperative Medicine, Penn State Health Hershey Medical Center, Hershey, PA, USA
| | - Theodore J Cios
- Department of Anesthesiology and Perioperative Medicine, Penn State Health Hershey Medical Center, Hershey, PA, USA
| | - S Michael Roberts
- Department of Anesthesiology and Perioperative Medicine, Penn State Health Hershey Medical Center, Hershey, PA, USA
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Atici A, Barman HA, Durmaz E, Demir K, Cakmak R, Tugrul S, Elitok A, Onur İ, Sahin İ, Oncul A. Predictive value of global and territorial longitudinal strain imaging in detecting significant coronary artery disease in patients with myocardial infarction without persistent ST-segment elevation. Echocardiography 2019; 36:512-520. [PMID: 30803009 DOI: 10.1111/echo.14275] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 01/12/2019] [Accepted: 01/15/2019] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Two-dimensional (2D) speckle-tracking echocardiographic (STE) imaging is frequently performed in the assessment of cardiovascular diseases. We aim to investigate the role of the global and territorial longitudinal strain (GLS and TLS) values assessed via 2D STE imaging to detect significant coronary artery disease (CAD) in non-ST-segment elevation myocardial infarction (NSTEMI) patients without wall-motion abnormalities. METHODS This study enrolled 150 patients with the diagnosis of NSTEMI. Patients who had typical chest pain with unstable angina characteristics within the last 24 hours were 18-80 years of age and had a typical rise and/or fall of cardiac biomarkers were included. Myocardial functions were assessed via myocardial deformation analyses of 2D STE images. RESULTS The mean age of the CAD group was 52.91 ± 9.11, vs 50.31 ± 8.32 in the control group. In the CAD group, 56 patients were male (65%), whereas 21 were male (60%) in control group. GLS and TLS assessments demonstrated a statistically significant difference between CAD and control groups, with GLS values of -16.27 ± 1.91 and -18.74 ± 1.93 (P < 0.001), TLS-LAD values of -15.67 ± 1.83 and -18.54 ± 1.97 (P < 0.001), TLS-RCA values of -17.04 ± 1.81 and -19.20 ± 1.86 (P < 0.001), and TLS-Cx values of -17.40 ± 2.08 and -18.34 ± 2.18 (P = 0.028), respectively. Correlation analyses revealed that as high-sensitivity troponin (hsTnT) values increased, GLS decreased significantly, and further, an increase in severity of CAD resulted in decreased TLS-LAD, -CX and -RCA (TLS-LAD: P < 0.001, r = -0.743; TLS-CX: P < 0.001, r = -0.449; TLS-RCA: P < 0.001, r = -0.737). Multivariate analyses indicated that GLS and GRACE ACS risk scores are independent predictors of CAD in patients with NSTEMI (GLS: OR = 0.514, P < 0.001; GRACE score: OR = 0.938, P = 0.007). CONCLUSIONS Global longitudinal strain (GLS) assessed with 2D STE is a promising, easy to perform and quick imaging method to predict CAD in patients with NSTEMI.
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Affiliation(s)
- Adem Atici
- Okmeydani Research and Training Hospital Istanbul, Istanbul, Turkey
| | - Hasan Ali Barman
- Okmeydani Research and Training Hospital Istanbul, Istanbul, Turkey
| | - Eser Durmaz
- Okmeydani Research and Training Hospital Istanbul, Istanbul, Turkey
| | - Koray Demir
- Okmeydani Research and Training Hospital Istanbul, Istanbul, Turkey
| | - Ramazan Cakmak
- Okmeydani Research and Training Hospital Istanbul, Istanbul, Turkey
| | - Sevil Tugrul
- Okmeydani Research and Training Hospital Istanbul, Istanbul, Turkey
| | - Ali Elitok
- Okmeydani Research and Training Hospital Istanbul, Istanbul, Turkey
| | - İmran Onur
- Okmeydani Research and Training Hospital Istanbul, Istanbul, Turkey
| | - İrfan Sahin
- Okmeydani Research and Training Hospital Istanbul, Istanbul, Turkey
| | - Aytac Oncul
- Okmeydani Research and Training Hospital Istanbul, Istanbul, Turkey
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Madhavan S, Narayanapillai J, Paikada J, Jayaprakash K, Jayaprakash VL. Two-dimensional speckle tracking echocardiography as a predictor of significant coronary artery stenosis in female patients with effort angina who are treadmill test positive: An angiographic correlation. JOURNAL OF CLINICAL AND PREVENTIVE CARDIOLOGY 2019. [DOI: 10.4103/jcpc.jcpc_6_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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21
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Nichols CE, Shepherd DL, Hathaway QA, Durr AJ, Thapa D, Abukabda A, Yi J, Nurkiewicz TR, Hollander JM. Reactive oxygen species damage drives cardiac and mitochondrial dysfunction following acute nano-titanium dioxide inhalation exposure. Nanotoxicology 2018; 12:32-48. [PMID: 29243970 PMCID: PMC5777890 DOI: 10.1080/17435390.2017.1416202] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 12/07/2017] [Accepted: 12/07/2017] [Indexed: 12/25/2022]
Abstract
Nanotechnology offers innovation in products from cosmetics to drug delivery, leading to increased engineered nanomaterial (ENM) exposure. Unfortunately, health impacts of ENM are not fully realized. Titanium dioxide (TiO2) is among the most widely produced ENM due to its use in numerous applications. Extrapulmonary effects following pulmonary exposure have been identified and may involve reactive oxygen species (ROS). The goal of this study was to determine the extent of ROS involvement on cardiac function and the mitochondrion following nano-TiO2 exposure. To address this question, we utilized a transgenic mouse model with overexpression of a novel mitochondrially-targeted antioxidant enzyme (phospholipid hydroperoxide glutathione peroxidase; mPHGPx) which provides protection against oxidative stress to lipid membranes. MPHGPx mice and littermate controls were exposed to nano-TiO2 aerosols (Evonik, P25) to provide a calculated pulmonary deposition of 11 µg/mouse. Twenty-four hours following exposure, we observed diastolic dysfunction as evidenced by E/A ratios greater than 2 and increased radial strain during diastole in wild-type mice (p < 0.05 for both), indicative of restrictive filling. Overexpression of mPHGPx mitigated the contractile deficits resulting from nano-TiO2 exposure. To investigate the cellular mechanisms associated with the observed cardiac dysfunction, we focused our attention on the mitochondrion. We observed a significant increase in ROS production (p < 0.05) and decreased mitochondrial respiratory function (p < 0.05) following nano-TiO2 exposure which were attenuated in mPHGPx transgenic mice. In summary, nano-TiO2 inhalation exposure is associated with cardiac diastolic dysfunction and mitochondrial functional alterations, which can be mitigated by the overexpression of mPHGPx, suggesting ROS contribution in the development of contractile and bioenergetic dysfunction.
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Affiliation(s)
- Cody E. Nichols
- Division of Exercise Physiology; West Virginia University School of Medicine, Morgantown, WV 26506
- Immunity, Inflammation, and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, United States
| | - Danielle L. Shepherd
- Division of Exercise Physiology; West Virginia University School of Medicine, Morgantown, WV 26506
- Mitochondria, Metabolism & Bioenergetics Working Group; West Virginia University School of Medicine, Morgantown, WV 26506
| | - Quincy A. Hathaway
- Division of Exercise Physiology; West Virginia University School of Medicine, Morgantown, WV 26506
- Mitochondria, Metabolism & Bioenergetics Working Group; West Virginia University School of Medicine, Morgantown, WV 26506
| | - Andrya J. Durr
- Division of Exercise Physiology; West Virginia University School of Medicine, Morgantown, WV 26506
- Mitochondria, Metabolism & Bioenergetics Working Group; West Virginia University School of Medicine, Morgantown, WV 26506
| | - Dharendra Thapa
- Division of Exercise Physiology; West Virginia University School of Medicine, Morgantown, WV 26506
| | - Alaeddin Abukabda
- Department of Physiology and Pharmacology; West Virginia University School of Medicine, Morgantown, WV 26506
| | - Jinghai Yi
- Department of Physiology and Pharmacology; West Virginia University School of Medicine, Morgantown, WV 26506
| | - Timothy R. Nurkiewicz
- Mitochondria, Metabolism & Bioenergetics Working Group; West Virginia University School of Medicine, Morgantown, WV 26506
- Department of Physiology and Pharmacology; West Virginia University School of Medicine, Morgantown, WV 26506
| | - John M. Hollander
- Division of Exercise Physiology; West Virginia University School of Medicine, Morgantown, WV 26506
- Mitochondria, Metabolism & Bioenergetics Working Group; West Virginia University School of Medicine, Morgantown, WV 26506
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Effects of hyperaemia on left ventricular longitudinal strain in patients with suspected coronary artery disease : A first-pass stress perfusion cardiovascular magnetic resonance imaging study. Neth Heart J 2018; 26:85-93. [PMID: 29313213 PMCID: PMC5783894 DOI: 10.1007/s12471-017-1071-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aims Myocardial perfusion imaging during hyperaemic stress is commonly used to detect coronary artery disease. The aim of this study was to investigate the relationship between left ventricular global longitudinal strain (GLS), strain rate (GLSR), myocardial early (E’) and late diastolic velocities (A’) with adenosine stress first-pass perfusion cardiovascular magnetic resonance (CMR) imaging. Methods and results 44 patients met the inclusion criteria and underwent CMR imaging. The CMR imaging protocol included: rest/stress horizontal long-axis (HLA) cine, rest/stress first-pass adenosine perfusion and late gadolinium enhancement imaging. Rest and stress HLA cine CMR images were analysed using feature-tracking software for the assessment of myocardial deformation. The presence of perfusion defects was scored on a binomial scale. In patients with hyperaemia-induced perfusion defects, rest global longitudinal strain GLS (−16.9 ± 3.7 vs. −19.6 ± 3.4; p-value = 0.02), E’ (−86 ± 22 vs. −109 ± 38; p-value = 0.02), GLSR (69 ± 31 vs. 93 ± 38; p-value = 0.01) and stress GLS (−16.5 ± 4 vs. −21 ± 3.1; p < 0.001) were significantly reduced when compared with patients with no perfusion defects. Stress GLS was the strongest independent predictor of perfusion defects (odds ratio 1.43 95% confidence interval 1.14–1.78, p-value <0.001). A threshold of −19.8% for stress GLS demonstrated 78% sensitivity and 73% specificity for the presence of hyperaemia-induced perfusion defects. Conclusions At peak myocardial hyperaemic stress, GLS is reduced in the presence of a perfusion defect in patients with suspected coronary artery disease. This reduction is most likely caused by reduced endocardial blood flow at maximal hyperaemia because of transmural redistribution of blood flow in the presence of significant coronary stenosis. Electronic supplementary material The online version of this article (10.1007/s12471-017-1071-3) contains supplementary material, which is available to authorized users.
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Two-dimensional speckle-tracking global longitudinal strain in high-sensitivity troponin-negative low-risk patients with unstable angina: a “resting ischemia test”? Int J Cardiovasc Imaging 2017; 34:561-568. [DOI: 10.1007/s10554-017-1269-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 11/04/2017] [Indexed: 01/05/2023]
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Interrelations of Epicardial Fat Volume, Left Ventricular T1-Relaxation Times and Myocardial Strain in Hypertensive Patients. J Thorac Imaging 2017; 32:169-175. [DOI: 10.1097/rti.0000000000000264] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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25
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Gunasekaran P, Panaich S, Briasoulis A, Cardozo S, Afonso L. Incremental Value of Two Dimensional Speckle Tracking Echocardiography in the Functional Assessment and Characterization of Subclinical Left Ventricular Dysfunction. Curr Cardiol Rev 2017; 13:32-40. [PMID: 27411342 PMCID: PMC5324318 DOI: 10.2174/1573403x12666160712095938] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 06/26/2016] [Accepted: 06/29/2016] [Indexed: 02/01/2023] Open
Abstract
Subclinical left ventricular (LV) dysfunction refers to subtle abnormalities in LV function which typically precede a reduction in the left ventricular ejection fraction (LVEF). The assessment of myocardial function using LVEF, a radial metric of systolic function, is subject to load dependence, intra-observer and inter-observer variability. Reductions in LVEF typically manifest late in the disease process thus compromising the ability to intervene before irreversible impairment of systolic performance sets in. 2-Dimensional speckle tracking echocardiography (2D-STE), a novel strain imaging modality has shown promise as a sensitive indicator of myocardial contractility. It arms the clinician with a powerful and practical tool to rapidly quantify cardiac mechanics, circumventing several inherent limitations of conventional echocardiography. This article highlights the incremental utility of 2D-STE in the detection of subclinical LV dysfunction.
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Affiliation(s)
| | | | | | | | - Luis Afonso
- Division of Cardiology, Wayne State University, Detroit Medical Center, 3990 John R, 8-Brush, Harper University Hospital, Detroit, Michigan-48201. United States
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Rumbinaitė E, Žaliaduonytė-Pekšienė D, Vieželis M, Čeponienė I, Lapinskas T, Žvirblytė R, Venclovienė J, Morkūnaitė K, Bielinis A, Šlapikas R, Vaškelytė JJ. Dobutamine-stress echocardiography speckle-tracking imaging in the assessment of hemodynamic significance of coronary artery stenosis in patients with moderate and high probability of coronary artery disease. MEDICINA-LITHUANIA 2016; 52:331-339. [PMID: 27932192 DOI: 10.1016/j.medici.2016.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 10/17/2016] [Accepted: 11/10/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVE Myocardial deformation indices are considered as sensitive markers of ischemia and may be useful in the quantification of hemodynamic significance of coronary artery disease (CAD). We sought to determine the diagnostic value of speckle-tracking echocardiography derived myocardial deformation parameters at rest and during stress to determine hemodynamically significance coronary artery stenosis in patients with moderate and high probability of CAD. MATERIALS AND METHODS In 81 patients (mean age, 64±8.6 years) with stable CAD inducible myocardial ischemia was evaluated by dobutamine stress echocardiography (DSE) and adenosine magnetic resonance imaging (AMRI). Based on AMRI patients were divided into two groups: nonpathologic (n=41) and pathologic (n=40). Strain and strain rate (SR) parameters and their changes from the rest (BASE) to low stress (MIN), peak stress (MAX), and recovery (REC) were analyzed using 2D speckle-tracking imaging (STI). RESULTS In the nonpathologic group, systolic longitudinal and circumferential strain increased significantly from BASE to MIN, as well as systolic SR from BASE to MIN and from MIN to MAX in longitudinal plane. In contrast, in the pathologic group, insignificant longitudinal systolic SR increase and radial and circumferential systolic SR decrease from MIN to MAX was observed. Discriminant function analysis revealed that select STI derived parameters best classify patients into predefined AMRI groups (pathologic and nonpathologic) with the accuracy respectively 90.9% and 83.3%. According to ROC analysis these myocardial deformation parameters had the greatest predictive value of significant coronary artery stenoses: longitudinal strain at high dose (AUC 0.811, sensitivity 89.4%, specificity 64.7%), longitudinal strain rate at high dose (AUC 0.855, sensitivity 88.1%, specificity 71.0% at high doses). The sensitivity and specificity of inducible wall motion abnormalities were 74.0% and 85.0% (AUC 0.798) and was lower compared with the diagnostic value of longitudinal myocardial deformation parameters. CONCLUSIONS Left ventricular strain and strain rate analyses during DSE can be used in the assessment of hemodynamic significance of coronary artery stenosis in patients with moderate and high risk for CAD.
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Affiliation(s)
- Eglė Rumbinaitė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | | | - Mindaugas Vieželis
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Indrė Čeponienė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Tomas Lapinskas
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rūta Žvirblytė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jonė Venclovienė
- Laboratory of Clinical Cardiology, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Kristina Morkūnaitė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Augustinas Bielinis
- Faculty of Medicine, Medical Academy, University of Health Sciences, Kaunas, Lithuania
| | - Rimvydas Šlapikas
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jolanta Justina Vaškelytė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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27
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Resting multilayer 2D speckle-tracking transthoracic echocardiography for the detection of clinically stable myocardial ischemic segments confirmed by invasive fractional flow reserve. Part 1: Vessel-by-vessel analysis. Int J Cardiol 2016; 218:324-332. [DOI: 10.1016/j.ijcard.2016.05.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 04/12/2016] [Accepted: 05/12/2016] [Indexed: 11/23/2022]
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28
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Rumbinaite E, Zaliaduonyte-Peksiene D, Lapinskas T, Zvirblyte R, Karuzas A, Jonauskiene I, Viezelis M, Ceponiene I, Gustiene O, Slapikas R, Vaskelyte JJ. Early and late diastolic strain rate vs global longitudinal strain at rest and during dobutamine stress for the assessment of significant coronary artery stenosis in patients with a moderate and high probability of coronary artery disease. Echocardiography 2016; 33:1512-1522. [DOI: 10.1111/echo.13282] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Egle Rumbinaite
- Lithuanian University of Health Sciences Cardiology Clinic; Kaunas Lithuania
| | | | - Tomas Lapinskas
- Lithuanian University of Health Sciences Cardiology Clinic; Kaunas Lithuania
| | - Ruta Zvirblyte
- Lithuanian University of Health Sciences Cardiology Clinic; Kaunas Lithuania
| | - Arnas Karuzas
- Lithuanian University of Health Sciences; Kaunas Lithuania
| | | | - Mindaugas Viezelis
- Lithuanian University of Health Sciences Cardiology Clinic; Kaunas Lithuania
| | - Indre Ceponiene
- Lithuanian University of Health Sciences Cardiology Clinic; Kaunas Lithuania
| | - Olivija Gustiene
- Lithuanian University of Health Sciences Cardiology Clinic; Kaunas Lithuania
| | - Rimvydas Slapikas
- Lithuanian University of Health Sciences Cardiology Clinic; Kaunas Lithuania
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Schiano-Lomoriello V, Galderisi M, Mele D, Esposito R, Cerciello G, Buonauro A, Della Pepa R, Picardi M, Catalano L, Trimarco B, Pane F. Longitudinal strain of left ventricular basal segments and E
/e
′ ratio differentiate primary cardiac amyloidosis at presentation from hypertensive hypertrophy: an automated function imaging study. Echocardiography 2016; 33:1335-43. [DOI: 10.1111/echo.13278] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
| | | | - Donato Mele
- Department of Advanced Biomedical Sciences; Federico II University Hospital; Naples Italy
| | - Roberta Esposito
- Department of Clinical Medicine and Surgery; Federico II University Hospital; Naples Italy
| | - Giuseppe Cerciello
- Department of Clinical Medicine and Surgery; Federico II University Hospital; Naples Italy
| | - Agostino Buonauro
- Department of Clinical Medicine and Surgery; Federico II University Hospital; Naples Italy
| | - Roberta Della Pepa
- Department of Clinical Medicine and Surgery; Federico II University Hospital; Naples Italy
| | - Marco Picardi
- Department of Clinical Medicine and Surgery; Federico II University Hospital; Naples Italy
| | - Lucio Catalano
- Department of Clinical Medicine and Surgery; Federico II University Hospital; Naples Italy
| | - Bruno Trimarco
- Cardiology Department; University Hospital of Ferrara; Ferrara Italy
| | - Fabrizio Pane
- Department of Clinical Medicine and Surgery; Federico II University Hospital; Naples Italy
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30
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Right atrial morphology and function in patients with systemic sclerosis compared to healthy controls: a two-dimensional strain study. Clin Rheumatol 2016; 35:1733-42. [DOI: 10.1007/s10067-016-3279-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 03/12/2016] [Accepted: 04/14/2016] [Indexed: 10/21/2022]
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31
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Vrettos A, Dawson D, Grigoratos C, Nihoyannopoulos P. Correlation between global longitudinal peak systolic strain and coronary artery disease severity as assessed by the angiographically derived SYNTAX score. Echo Res Pract 2016; 3:29-34. [PMID: 27248153 PMCID: PMC4989094 DOI: 10.1530/erp-16-0005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 04/12/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND In this study, we investigate the correlation between reduced global longitudinal peak systolic strain (GLPSS) and the SYNTAX score (SS) in patients undergoing coronary angiography. METHODS We examined 71 patients undergoing both echocardiogram and coronary angiography within 15 days. All patients had normal global and/or regional wall motion on resting echocardiogram. We calculated GLPSS using two-dimensional speckle-tracking echocardiography. SS was calculated for each group of patients based on the presence and/or the severity of coronary artery disease (CAD): no CAD on angiogram (n=10, control group), low SS (n=36, SS<22) and high SS (n=25, SS≥22). We hypothesised that GLPSS at rest is inversely correlated with the angiographically derived SS. RESULTS Age, sex and most of the risk factors were equally distributed among the groups. There was a significant inverse correlation between GLPSS and SS values (r(2)=0.3869, P<0.001). This correlation was weaker in the low-SS group (r(2)=0.1332, P<0.05), whereas it was lost in the high-SS group (r(2)=0.0002, P=NS). Receiver operating characteristic curve analysis identified that the optimal cut-off for the detection of high-SS patients was 13.95% (sensitivity=71%, specificity=90%, P<0.001). CONCLUSIONS The results of our study suggest that GLPSS might be promising for the detection of patients with high SYNTAX score on coronary angiogram. There is an inverse correlation between resting GLPSS and SS as assessed by coronary angiography. In patients with the highest SS, however, the correlation with GLPSS was less significant.
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Affiliation(s)
- Apostolos Vrettos
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital, London, UK
| | - David Dawson
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital, London, UK
| | - Chrysanthos Grigoratos
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital, London, UK
| | - Petros Nihoyannopoulos
- Imperial College London, National Heart and Lung Institute, Hammersmith Hospital, London, UK
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32
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Moaref A, Zamirian M, Safari A, Emami Y. Evaluation of Global and Regional Strain in Patients with Acute Coronary Syndrome without Previous Myocardial Infarction. Int Cardiovasc Res J 2016. [DOI: 10.17795/icrj-10(1)6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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33
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Malik V, Subramaniam A, Kapoor PM. Strain and strain rate: An emerging technology in the perioperative period. Ann Card Anaesth 2016; 19:112-21. [PMID: 26750682 PMCID: PMC4900405 DOI: 10.4103/0971-9784.173026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Newer noninvasive parameters are being used for perioperative detection of myocardial ischaemia. TDI and global strain rate are some of these parameters. TDI signal is a modification of the routine Doppler flow signal. It is obtained by using thresholding and filtering algorithms that reject echoes originating from the blood pool (by-passing the high pass filter). Set-Up of the machine by activating the TDI function allows decreasing the system gain using a low pass filter and eliminates the signal produced by blood flow. Doppler shift obtained from myocardial tissue motion are of higher amplitudes (reflectivity 40 dB higher) and move about 10 times slower than blood (velocity range: 0.06 to 0.24 m/s). Speckle tracking echocardiography (tissue tracking, 2D strain) utilizes routine gray-scale 2D echo images to calculate myocardial strain. Interactions of ultrasound with myocardium result in reflection and scattering. These interactions generate a finely gray-shaded, speckled pattern (acoustic marker). This speckled pattern is unique for each myocardial region and relatively stable throughout the cardiac cycle. Spatial and temporal image processing of acoustic speckles in both 2D and 3D allows for the calculation of myocardial velocity, strain, and Strain rate.
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34
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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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35
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Pokharel P, Fujikura K, Bella JN. Clinical applications and prognostic implications of strain and strain rate imaging. Expert Rev Cardiovasc Ther 2015; 13:853-66. [DOI: 10.1586/14779072.2015.1056163] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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36
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Hong Z, Yuming M, Chunmei W, Xue Y. The value of myocardial torsion and aneurysm volume for evaluating cardiac function in rabbit with left ventricular aneurysm. PLoS One 2015; 10:e0121876. [PMID: 25855970 PMCID: PMC4391835 DOI: 10.1371/journal.pone.0121876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 02/18/2015] [Indexed: 11/30/2022] Open
Abstract
Objective This study aimed to investigate the effect of left ventricular aneurysm (LVA) volume and left ventricular global torsion on cardiac function by real time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging(2D-STI), to determine the accuracy of RT-3DE and 2D-STI in assessing LV function. Methods Thirty New Zealand rabbit models of with LVA were prepared by ligation of the middle segment of the left anterior descending and left circumflex arteries. Four weeks post-procedure, RT-3DE was conducted to obtain data on LVEF, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and LVA volume (LVAV), Peak rotation angles at the mitral valve annulus level (MV-ROT), peak rotation angles at the apical level (AP-ROT), and left ventricular global torsion angles (LV-TOR) were measured by 2D-STI. Results Compared with controls, LVEDV and LVESV were significantly increased in the LVA group, while LVEF, MV-ROT, AP-ROT, and LV-TOR were consistently reduced (p<0.01). Moreover, LVEF correlated with LVA volume and LV torsion angle (r= -0.778 and 0.821, p<0.01). LVA volume/LVEDV had the strongest inverse relationship with LVEF (r= -0.911, p<0.01). Conclusion LVA volume, LVA volume/LVEDV, and LV torsion may be used as an indicator for evaluation of cardiac function after LVA. Moreover, LVA volume/LVEDV may be a more sensitive and reliable marker of cardiac function after LVA formation.
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Affiliation(s)
- Zhai Hong
- Department of Ultrasonography, Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Mu Yuming
- Department of Echocardiography, First Affiliated Hospital, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
- * E-mail:
| | - Wang Chunmei
- Department of Echocardiography, First Affiliated Hospital, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Yan Xue
- Department of Echocardiography, First Affiliated Hospital, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
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Dahlslett T, Karlsen S, Grenne B, Eek C, Sjøli B, Skulstad H, Smiseth OA, Edvardsen T, Brunvand H. Early Assessment of Strain Echocardiography Can Accurately Exclude Significant Coronary Artery Stenosis in Suspected Non–ST-Segment Elevation Acute Coronary Syndrome. J Am Soc Echocardiogr 2014; 27:512-9. [DOI: 10.1016/j.echo.2014.01.019] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Indexed: 12/22/2022]
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38
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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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Park SM, Ahn CM, Hong SJ, Kim YH, Park JH, Shim WJ, Lim DS. Acute changes of left ventricular hemodynamics and function during percutaneous coronary intervention in patients with unprotected left main coronary artery disease. Heart Vessels 2014; 30:432-40. [DOI: 10.1007/s00380-014-0495-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 02/28/2014] [Indexed: 11/30/2022]
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40
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Salem M, Bendary A, Moustafa S, Ramzy A, Sanad O. Acute effect of sildenafil on myocardial ischemic territories in patients with stable coronary artery disease. Egypt Heart J 2014. [DOI: 10.1016/j.ehj.2013.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Sehgal A, Doctor T, Menahem S. Cardiac function and arterial indices in infants born small for gestational age: analysis by speckle tracking. Acta Paediatr 2014; 103:e49-54. [PMID: 24127769 DOI: 10.1111/apa.12465] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 09/28/2013] [Accepted: 10/03/2013] [Indexed: 11/26/2022]
Abstract
AIM To compare strain indices between small for gestational age (SGA) infants and asymptomatic appropriate for gestational age (AGA) infants and to ascertain correlations with arterial biophysical properties. METHODS In this prospective observational echocardiographic study, 20 inborn term SGA infants weighing <3rd centile for gestational age were compared with 20 AGA infants. Demographic and echocardiographic data were analysed regarding cardiac strain and strain rate and arterial indices (stiffness, impedance and strain elastic modulus). Correlations between variables were assessed using Pearson's coefficient of correlation. RESULTS Ponderal index was significantly lower in SGA infants (24.6 ± 2.9 vs. 29.5 ± 2.5). Left ventricular global longitudinal strain (GLS) was noted to be significantly impaired in the SGA infants (-15.9% ± 2.1 vs. -21.3% ± 2.8, p < 0.001). A basal to apical gradient was noted in segmental strain. Arterial biophysical measurements were significantly altered in the SGA infants. Significant correlations were noted between GLS and arterial stiffness (r = -0.4, p = 0.03), weight-indexed stiffness (r = -0.45, p = 0.02) and pressure-strain elastic modulus (r = -0.49, p = 0.01). CONCLUSION Impairment in myocardial deformation was noted in the presence of altered arterial biophysical properties in the SGA infants.
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Affiliation(s)
- Arvind Sehgal
- Monash Newborn, Monash Children's, Melbourne, Vic., Australia; Department of Pediatrics, Monash University, Melbourne, Vic., Australia
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Biering-Sørensen T, Hoffmann S, Mogelvang R, Zeeberg Iversen A, Galatius S, Fritz-Hansen T, Bech J, Jensen JS. Myocardial Strain Analysis by 2-Dimensional Speckle Tracking Echocardiography Improves Diagnostics of Coronary Artery Stenosis in Stable Angina Pectoris. Circ Cardiovasc Imaging 2014; 7:58-65. [DOI: 10.1161/circimaging.113.000989] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Two-dimensional strain echocardiography detects early signs of left ventricular dysfunction; however, it is unknown whether myocardial strain analysis at rest in patients with suspected stable angina pectoris predicts the presence of coronary artery disease (CAD).
Methods and Results—
In total, 296 consecutive patients with clinically suspected stable angina pectoris, no previous cardiac history, and normal left ventricular ejection fraction were included. All patients were examined by 2-dimensional strain echocardiography, exercise ECG, and coronary angiography. Two-dimensional strain echocardiography was performed in the 3 apical projections. Peak regional longitudinal systolic strain was measured in 18 myocardial sites and averaged to provide global longitudinal peak systolic strain. Duke score, including ST-segment depression, chest pain, and exercise capacity, was used as the outcome of the exercise test. Patients with an area stenosis ≥70% in ≥1 epicardial coronary artery were categorized as having significant CAD (n=107). Global longitudinal peak systolic strain was significantly lower in patients with CAD compared with patients without (17.1±2.5% versus 18.8±2.6%;
P
<0.001) and remained an independent predictor of CAD after multivariable adjustment for baseline data, exercise test, and conventional echocardiography (odds ratio, 1.25 [
P
=0.016] per 1% decrease). Area under receiver operating characteristic curve for exercise test and global longitudinal peak systolic strain in combination was significantly higher than that for exercise test alone (0.84 versus 0.78;
P
=0.007). Furthermore, impaired regional longitudinal systolic strain identifies which coronary artery is stenotic.
Conclusions—
In patients with suspected stable angina pectoris, global longitudinal peak systolic strain assessed at rest is an independent predictor of significant CAD and significantly improves the diagnostic performance of exercise test. Furthermore, 2-dimensional strain echocardiography seems capable of identifying high-risk patients.
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Affiliation(s)
- Tor Biering-Sørensen
- From the Department of Cardiology, Gentofte Hospital (T.B.-S., S.H., R.M., A.Z.I., S.G., T.F.-H., J.B., J.S.J.) and Institute of Clinical Medicine, Faculty of Health and Medical Sciences (T.B.-S., J.S.J.), University of Copenhagen, Copenhagen, Denmark
| | - Soren Hoffmann
- From the Department of Cardiology, Gentofte Hospital (T.B.-S., S.H., R.M., A.Z.I., S.G., T.F.-H., J.B., J.S.J.) and Institute of Clinical Medicine, Faculty of Health and Medical Sciences (T.B.-S., J.S.J.), University of Copenhagen, Copenhagen, Denmark
| | - Rasmus Mogelvang
- From the Department of Cardiology, Gentofte Hospital (T.B.-S., S.H., R.M., A.Z.I., S.G., T.F.-H., J.B., J.S.J.) and Institute of Clinical Medicine, Faculty of Health and Medical Sciences (T.B.-S., J.S.J.), University of Copenhagen, Copenhagen, Denmark
| | - Allan Zeeberg Iversen
- From the Department of Cardiology, Gentofte Hospital (T.B.-S., S.H., R.M., A.Z.I., S.G., T.F.-H., J.B., J.S.J.) and Institute of Clinical Medicine, Faculty of Health and Medical Sciences (T.B.-S., J.S.J.), University of Copenhagen, Copenhagen, Denmark
| | - Søren Galatius
- From the Department of Cardiology, Gentofte Hospital (T.B.-S., S.H., R.M., A.Z.I., S.G., T.F.-H., J.B., J.S.J.) and Institute of Clinical Medicine, Faculty of Health and Medical Sciences (T.B.-S., J.S.J.), University of Copenhagen, Copenhagen, Denmark
| | - Thomas Fritz-Hansen
- From the Department of Cardiology, Gentofte Hospital (T.B.-S., S.H., R.M., A.Z.I., S.G., T.F.-H., J.B., J.S.J.) and Institute of Clinical Medicine, Faculty of Health and Medical Sciences (T.B.-S., J.S.J.), University of Copenhagen, Copenhagen, Denmark
| | - Jan Bech
- From the Department of Cardiology, Gentofte Hospital (T.B.-S., S.H., R.M., A.Z.I., S.G., T.F.-H., J.B., J.S.J.) and Institute of Clinical Medicine, Faculty of Health and Medical Sciences (T.B.-S., J.S.J.), University of Copenhagen, Copenhagen, Denmark
| | - Jan Skov Jensen
- From the Department of Cardiology, Gentofte Hospital (T.B.-S., S.H., R.M., A.Z.I., S.G., T.F.-H., J.B., J.S.J.) and Institute of Clinical Medicine, Faculty of Health and Medical Sciences (T.B.-S., J.S.J.), University of Copenhagen, Copenhagen, Denmark
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43
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Ternacle J, Gallet R, Champagne S, Teiger E, Gellen B, Dubois Randé JL, Gueret P, Lim P. Changes in Three-Dimensional Speckle-Tracking–Derived Myocardial Strain during Percutaneous Coronary Intervention. J Am Soc Echocardiogr 2013; 26:1444-9. [DOI: 10.1016/j.echo.2013.09.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Indexed: 01/21/2023]
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44
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Mak GS, Sawaya H, Khan AM, Arora P, Martinez A, Ryan A, Ernande L, Newton-Cheh C, Wang TJ, Scherrer-Crosbie M. Effects of subacute dietary salt intake and acute volume expansion on diastolic function in young normotensive individuals. Eur Heart J Cardiovasc Imaging 2013; 14:1092-8. [PMID: 23515219 DOI: 10.1093/ehjci/jet036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIMS Chronic excess salt intake may have blood pressure-independent adverse effects on the heart such as myocardial hypertrophy and fibrosis. Effects of subacute sodium loading with excess dietary salt on diastolic function in normotensive individuals have been conflicting and the mechanisms are poorly understood. METHODS AND RESULTS Thirteen healthy normotensive subjects (age 24 ± 4 years) entered a 2-week crossover study with 1 week of a low-salt diet <10 mEq/day and 1 week of a high-salt diet >200 mEq/day. At the end of each study week, left ventricular dimensions, systolic, and diastolic function were assessed with echocardiography before and after 2 L of normal saline infusion. One week of high-salt and low-salt diets did not lead to differences in echocardiographic parameters of systolic or diastolic function, even after rapid volume expansion with saline infusion. The peak early diastolic strain rate (SR) increased after volume loading both after completion of low-salt (1.62 ± 0.23/s vs. 1.82 ± 0.14/s, P < 0.05) and high-salt diets (1.67 ± 0.16/s vs. 1.86 ± 0.22/s, P < 0.05). There was a positive correlation between the peak early diastolic SR and the cardiac index (r = 0.52, P = 0.017). CONCLUSION In healthy normotensive individuals, subacute excess dietary sodium intake does not affect diastolic function. The peak early diastolic SR, similar to other mitral Doppler and tissue Doppler parameters of diastolic function, appears to be strongly dependent on pre-load.
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Affiliation(s)
- Gary S Mak
- Cardiac Ultrasound Laboratory and Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
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45
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Zhai H, Mu Y, Guan L, Li Y. The Value of Aneurysm Volume and Myocardial Strain Rate for Evaluating Cardiac Function of Ischemia-Related Left Ventricular Aneurysm in a Rabbit Model Using Real Time Three-Dimensional Echocardiographic Imaging Combined with Speckle Tracking Imaging. Echocardiography 2013; 30:837-42. [PMID: 23432407 DOI: 10.1111/echo.12144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Hong Zhai
- Department of Echocardiography; First Affiliated Hospital; Xinjiang Medical University; Urumqi; China
| | - Yuming Mu
- Department of Echocardiography; First Affiliated Hospital; Xinjiang Medical University; Urumqi; China
| | - Lina Guan
- Department of Echocardiography; First Affiliated Hospital; Xinjiang Medical University; Urumqi; China
| | - Yanhong Li
- Department of Echocardiography; First Affiliated Hospital; Xinjiang Medical University; Urumqi; China
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46
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Yang B, Daimon M, Ishii K, Kawata T, Miyazaki S, Hirose K, Ichikawa R, Chiang SJ, Suzuki H, Miyauchi K, Daida H. Prediction of Coronary Artery Stenosis at Rest in Patients With Normal Left Ventricular Wall Motion. Int Heart J 2013; 54:266-72. [DOI: 10.1536/ihj.54.266] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Bei Yang
- Department of Cardiology, Juntendo University School of Medicine
- Department of Cardiology, The Fourth Hospital of Kunming Medical College
| | - Masao Daimon
- Department of Cardiology, Juntendo University School of Medicine
| | | | - Takayuki Kawata
- Department of Cardiology, Juntendo University School of Medicine
| | - Sakiko Miyazaki
- Department of Cardiology, Juntendo University School of Medicine
| | - Kuniaki Hirose
- Department of Cardiology, Juntendo University School of Medicine
| | - Ryoko Ichikawa
- Department of Cardiology, Juntendo University School of Medicine
| | - Shuo-Ju Chiang
- Department of Cardiology, Juntendo University School of Medicine
| | - Hiromasa Suzuki
- Department of Cardiology, Juntendo University School of Medicine
| | - Katsumi Miyauchi
- Department of Cardiology, Juntendo University School of Medicine
| | - Hiroyuki Daida
- Department of Cardiology, Juntendo University School of Medicine
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47
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Diagnostic accuracy of global myocardial deformation indexes in coronary artery disease: a velocity vector imaging study. Int J Cardiovasc Imaging 2012; 28:1931-42. [DOI: 10.1007/s10554-012-0025-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 01/26/2012] [Indexed: 10/28/2022]
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48
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Smedsrud MK, Sarvari S, Haugaa KH, Gjesdal O, Ørn S, Aaberge L, Smiseth OA, Edvardsen T. Duration of Myocardial Early Systolic Lengthening Predicts the Presence of Significant Coronary Artery Disease. J Am Coll Cardiol 2012; 60:1086-93. [DOI: 10.1016/j.jacc.2012.06.022] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 06/04/2012] [Accepted: 06/26/2012] [Indexed: 11/30/2022]
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49
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Zhao S, Deng YB, Chen XL, Liu R. Assessment of right ventricular function in recipient twin of twin to twin transfusion syndrome with speckle tracking echocardiography. ULTRASOUND IN MEDICINE & BIOLOGY 2012; 38:1502-1507. [PMID: 22766115 DOI: 10.1016/j.ultrasmedbio.2012.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 05/02/2012] [Accepted: 05/11/2012] [Indexed: 06/01/2023]
Abstract
This study was undertaken to evaluate the right ventricular myocardial systolic function and its relation to the fetal volume and pressure overload in recipient twin of twin to twin transfusion syndrome with speckle tracking echocardiography. Longitudinal peak systolic strains of the right ventricle were measured by speckle tracking echocardiography in 17 patients with twin-to-twin transfusion syndrome (TTTS) and 19 normal monochorionic diamniotic pregnancies. The right ventricular free wall thickness in recipient twin (0.43 ± 0.14 cm) was significantly larger than that in the donor (0.21 ± 0.04 cm, p < 0.05) and the control group (0.18 ± 0.03 cm, p < 0.05 for larger twin and 0.17 ± 0.02 cm, p < 0.05 for smaller twin). Although there were no significant differences in the right ventricular fractional shortening and cavity area percent change among control and the TTTS groups, the absolute value of peak systolic strains of ventricular septum, right ventricular free wall and global right ventricle in recipients were all significantly lower than those of the donors and the control group. Besides, the global right ventricular peak systolic strain correlated well with gestational age adjusted right ventricular free wall thickness (r = 0.65, p = 0.04) but not with gestational age adjusted right ventricular end-diastolic dimension (r = 0.38, p = 0.28) and cavity area percent change (r = 0.33, p = 0.35). Right ventricular systolic dysfunction measured with decreased right ventricular peak systolic longitudinal strain exists despite the absence of diminished fractional shortening and cavity area percent change and this reduced systolic function correlates with the right ventricular pressure overload as shown by increased right ventricular free wall thickness.
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Affiliation(s)
- Sheng Zhao
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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50
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Effect of embolic particles during coronary interventional procedures on regional wall motion in patients with stable angina pectoris. Am J Cardiol 2012; 109:1142-7. [PMID: 22245408 DOI: 10.1016/j.amjcard.2011.11.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2011] [Revised: 11/28/2011] [Accepted: 11/28/2011] [Indexed: 11/21/2022]
Abstract
Microembolization during percutaneous coronary intervention (PCI) causes minor myocardial injury, and a Doppler guidewire can detect embolic particles as high-intensity transient signals (HITS). The present study investigated the effect of microembolization during PCI on regional wall motion using a Doppler guidewire and myocardial strain analysis. We performed PCI to the left anterior descending coronary artery in 25 patients (18 men and 7 women, 68 ± 8 years old) with stable angina pectoris. Coronary flow spectrums were obtained with a Doppler guidewire to count the total number of HITS throughout the PCI procedures. On the days before and after PCI, we recorded echocardiography and measured the longitudinal peak systolic strain, peak strain rate, and early diastolic strain rate in the left anterior descending territory using a 2-dimensional speckle tracking method. PCI was successfully performed, and 10 ± 6 HITS (range 0 to 22, median 9) were recognized during PCI. The echocardiographic study showed no visible wall motion abnormalities in the left anterior descending territory either after or before PCI. In cases in which the total number of HITS was ≥10, the peak systolic strain, peak strain rate, and early diastolic strain rate worsened on the day after PCI compared with those on the day before PCI (p <0.01). The rates of change in peak systolic strain and early diastolic strain rate, defined as the ratios of those parameters after PCI to those before PCI, had modest to strong inverse correlations with the total number of HITS (R(2) = 0.35 and R(2) = 0.46, respectively). In conclusion, periprocedural microembolization during PCI reduces subclinical cardiac function in patients with stable angina pectoris.
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