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Chakraborty S, Meyers BA, Iwano H, Hall ME, Vlachos PP. A Wavelet Approach to the Estimation of Left Ventricular Early Filling Wave Propagation Velocity from Color M-Mode Echocardiograms. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:1397-1407. [PMID: 33546924 DOI: 10.1016/j.ultrasmedbio.2021.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 01/07/2021] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
A new approach to calculating left ventricular (LV) early filling propagation velocity (VP) from color M-mode echocardiograms using wavelet analysis is described. Current methods for measuring VP do not account for the spatiotemporal variation in VP. They are confined by empirical assumptions and user inputs that hinder the accuracy of VP, limiting its clinical utility. We evaluated three methods for measuring LV early filling: conventional VP, the strength of propagation (VS) and wavelet propagation velocity (VW) determined from the most energetically significant wave (peak VW). Group A comprised 125 patients (n = 50 normal filling, n = 25 impaired relaxation, n = 25 pseudonormal filling and n = 25 restrictive filling), and group B comprised 69 patients (n = 32 normal, n = 15 dilated and n = 22 hypertrophic). Peak VW most accurately distinguished normal from diseased patients. For group A, the area under the receiver operating characteristic curve was 0.92 for peak VW versus 0.62 for VP, 0.63 for VS and 0.58 for intraventricular pressure difference. These correspond to a 50%-70% improvement in classification ability. Similar improvements were measured in group B. Peak VW may provide a more accurate evaluation of diastolic function than standard methods and enable better diagnostic classification of patients with diastolic dysfunction.
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Affiliation(s)
- Sreyashi Chakraborty
- School of Mechanical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Brett A Meyers
- School of Mechanical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Hiroyuki Iwano
- Division of Cardiology, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA; Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Michael E Hall
- Division of Cardiology, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Pavlos P Vlachos
- School of Mechanical Engineering, Purdue University, West Lafayette, Indiana, USA.
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Usefulness and clinical relevance of left ventricular global longitudinal systolic strain in patients with heart failure with preserved ejection fraction. Heart Fail Rev 2020; 25:67-73. [PMID: 31489515 DOI: 10.1007/s10741-019-09853-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In recent years, several studies have shown the usefulness and clinical relevance of left ventricular global longitudinal systolic strain (GLS) in different cardiovascular diseases. In line with this, the role of GLS in patients with heart failure with preserved ejection fraction (HFpEF) has achieved great importance in this predominant form of heart failure in the last years. In this regard, GLS has shown to be not only a sensitive parameter to detect subtle myocardial abnormalities but also a parameter of clinical and prognostic relevance in patients with HFpEF. In this review, we analyze the current evidence concerning the clinical relevance of GLS in patients with HFpEF and we discuss the potential usefulness of GLS in this complex and heterogeneous condition for which so far no effective therapy exists.
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Morris DA, Ma XX, Belyavskiy E, Aravind Kumar R, Kropf M, Kraft R, Frydas A, Osmanoglou E, Marquez E, Donal E, Edelmann F, Tschöpe C, Pieske B, Pieske-Kraigher E. Left ventricular longitudinal systolic function analysed by 2D speckle-tracking echocardiography in heart failure with preserved ejection fraction: a meta-analysis. Open Heart 2017; 4:e000630. [PMID: 29018535 PMCID: PMC5623331 DOI: 10.1136/openhrt-2017-000630] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 06/23/2017] [Accepted: 07/18/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The purpose of this meta-analysis was to confirm if the global longitudinal systolic function of the left ventricle (LV) is altered in patients with heart failure with preserved ejection fraction (HFpEF). METHODS We searched in different databases (Medline, Embase and Cochrane) studies that analysed LV global longitudinal systolic strain (GLS) in patients with HFpEF and in controls (such as healthy subjects or asymptomatic patients with arterial hypertension, diabetes mellitus or coronary artery disease). RESULTS Twenty-two studies (2284 patients with HFpEF and 2302 controls) were included in the final analysis. Patients with HFpEF had significantly lower GLS than healthy subjects (mean -15.7% (range -12% to -18.9%) vs mean -19.9% (range -17.1% to -21.5%), weighted mean difference -4.2% (95% CI -3.3% to -5.0%), p < 0.001, respectively). In addition, patients with HFpEF had also significantly lower GLS than asymptomatic patients (mean -15.5% (range -13.4% to -18.4%) vs mean -18.3% (range -15.1% to -20.4%), weighted mean difference -2.8%(95% CI -1.9% to -3.6%), p < 0.001, respectively). In line, 10 studies showed that the rate of abnormal GLS was significantly higher in patients with HFpEF (mean 65.4% (range 37%-95%)) than in asymptomatic subjects (mean 13% (range 0%-29.6%)). Regarding the prognostic relevance of abnormal GLS in HFpEF, two multicentre studies with large sample size (447 and 348) and high number of events (115 and 177) showed that patients with abnormal GLS had worse cardiovascular (CV) outcomes than those with normal GLS (HR for CV mortality and HF hospitalisation 2.14 (95% CI 1.26 to 3.66) and 1.94 (95% CI 1.22 to 3.07)), even adjusting these analyses for multiples clinical and echocardiographic variables. CONCLUSION The present meta-analysis analysing 2284 patients with HFpEF and 2302 controls confirms that the longitudinal systolic function of the LV is significantly altered in high proportion of patients with HFpEF. Further large multicentre studies with the aim to confirm the prognostic role of abnormal GLS in HFpEF are warranted.
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Affiliation(s)
- Daniel Armando Morris
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, DZHK (German Centre for Cardiovascular Research) partner site Berlin and Berlin Institute of Health (BIH), Berlin, Germany
| | - Xin-Xin Ma
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Evgeny Belyavskiy
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, DZHK (German Centre for Cardiovascular Research) partner site Berlin and Berlin Institute of Health (BIH), Berlin, Germany
| | - Radhakrishnan Aravind Kumar
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, DZHK (German Centre for Cardiovascular Research) partner site Berlin and Berlin Institute of Health (BIH), Berlin, Germany
| | - Martin Kropf
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, DZHK (German Centre for Cardiovascular Research) partner site Berlin and Berlin Institute of Health (BIH), Berlin, Germany
| | - Robin Kraft
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, DZHK (German Centre for Cardiovascular Research) partner site Berlin and Berlin Institute of Health (BIH), Berlin, Germany
| | - Athanasios Frydas
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, DZHK (German Centre for Cardiovascular Research) partner site Berlin and Berlin Institute of Health (BIH), Berlin, Germany
| | - Engin Osmanoglou
- Department of Internal Medicine and Cardiology, Meoclinic, Berlin, Germany
| | - Esteban Marquez
- Department of Radiology, Private Clinic of Radiology (Q-Diagnostica-Scanner Murcia), Murcia, Spain
| | - Erwan Donal
- Department of Cardiology, CHU Rennes, Pontchaillou Hospital, Rennes, France
| | - Frank Edelmann
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, DZHK (German Centre for Cardiovascular Research) partner site Berlin and Berlin Institute of Health (BIH), Berlin, Germany
| | - Carsten Tschöpe
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, DZHK (German Centre for Cardiovascular Research) partner site Berlin and Berlin Institute of Health (BIH), Berlin, Germany
| | - Burkert Pieske
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, DZHK (German Centre for Cardiovascular Research) partner site Berlin and Berlin Institute of Health (BIH), Berlin, Germany.,Department of Internal Medicine and Cardiology, German Heart Institute, Berlin, Germany
| | - Elisabeth Pieske-Kraigher
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, DZHK (German Centre for Cardiovascular Research) partner site Berlin and Berlin Institute of Health (BIH), Berlin, Germany
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