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Lazăr MA, Ionac I, Luca CT, Petrescu L, Vacarescu C, Crisan S, Gaiță D, Cozma D, Sosdean R, Arnăutu DA, Cozlac AR, Luca SA, Gurgu A, Totorean C, Mornos C. Reduced Left Ventricular Twist Early after Acute ST-Segment Elevation Myocardial Infarction as a Predictor of Left Ventricular Adverse Remodelling. Diagnostics (Basel) 2023; 13:2896. [PMID: 37761263 PMCID: PMC10528752 DOI: 10.3390/diagnostics13182896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The left ventricular (LV) remodelling process represents the main cause of heart failure after a ST-segment elevation myocardial infarction (STEMI). Speckle-tracking echocardiography (STE) can detect early deformation impairment, while also predicting LV remodelling during follow-up. The aim of this study was to investigate the STE parameters in predicting cardiac remodelling following a percutaneous coronary intervention (PCI) in STEMI patients. METHODS The study population consisted of 60 patients with acute STEMI and no history of prior myocardial infarction treated with PCI. The patients were assessed both by conventional transthoracic and ST echocardiography in the first 12 h after admission and 6 months after the acute phase. Adverse remodelling was defined as an increase in LVEDV and/or LVESV by 15%. RESULTS Adverse remodelling occurred in 26 patients (43.33%). By multivariate regression equation, the risk of adverse remodelling increases with age (by 1.1-fold), triglyceride level (by 1.009-fold), and midmyocardial radial strain (mid-RS) (1.06-fold). Increased initial twist decreases the chances of adverse remodelling (0.847-fold). The LV twist presented the largest area under the receiver operating characteristic (ROC) curve to predict adverse remodelling (AUROC = 0.648; 95% CI [0.506;0.789], p = 0.04). A twist value higher than 11° has a 76.9% specificity and a 72.7% positive predictive value for reverse remodelling at 6 months.
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Affiliation(s)
- Mihai-Andrei Lazăr
- Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (M.-A.L.); (L.P.); (C.V.); (S.C.); (D.G.); (D.C.); (R.S.); (A.-R.C.); (S.-A.L.); (A.G.); (C.T.); (C.M.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Ioana Ionac
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania;
| | - Constantin-Tudor Luca
- Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (M.-A.L.); (L.P.); (C.V.); (S.C.); (D.G.); (D.C.); (R.S.); (A.-R.C.); (S.-A.L.); (A.G.); (C.T.); (C.M.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Lucian Petrescu
- Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (M.-A.L.); (L.P.); (C.V.); (S.C.); (D.G.); (D.C.); (R.S.); (A.-R.C.); (S.-A.L.); (A.G.); (C.T.); (C.M.)
| | - Cristina Vacarescu
- Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (M.-A.L.); (L.P.); (C.V.); (S.C.); (D.G.); (D.C.); (R.S.); (A.-R.C.); (S.-A.L.); (A.G.); (C.T.); (C.M.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Simina Crisan
- Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (M.-A.L.); (L.P.); (C.V.); (S.C.); (D.G.); (D.C.); (R.S.); (A.-R.C.); (S.-A.L.); (A.G.); (C.T.); (C.M.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Dan Gaiță
- Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (M.-A.L.); (L.P.); (C.V.); (S.C.); (D.G.); (D.C.); (R.S.); (A.-R.C.); (S.-A.L.); (A.G.); (C.T.); (C.M.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Dragos Cozma
- Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (M.-A.L.); (L.P.); (C.V.); (S.C.); (D.G.); (D.C.); (R.S.); (A.-R.C.); (S.-A.L.); (A.G.); (C.T.); (C.M.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Raluca Sosdean
- Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (M.-A.L.); (L.P.); (C.V.); (S.C.); (D.G.); (D.C.); (R.S.); (A.-R.C.); (S.-A.L.); (A.G.); (C.T.); (C.M.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Diana-Aurora Arnăutu
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania;
| | - Alina-Ramona Cozlac
- Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (M.-A.L.); (L.P.); (C.V.); (S.C.); (D.G.); (D.C.); (R.S.); (A.-R.C.); (S.-A.L.); (A.G.); (C.T.); (C.M.)
| | - Slivia-Ana Luca
- Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (M.-A.L.); (L.P.); (C.V.); (S.C.); (D.G.); (D.C.); (R.S.); (A.-R.C.); (S.-A.L.); (A.G.); (C.T.); (C.M.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Andra Gurgu
- Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (M.-A.L.); (L.P.); (C.V.); (S.C.); (D.G.); (D.C.); (R.S.); (A.-R.C.); (S.-A.L.); (A.G.); (C.T.); (C.M.)
| | - Claudia Totorean
- Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (M.-A.L.); (L.P.); (C.V.); (S.C.); (D.G.); (D.C.); (R.S.); (A.-R.C.); (S.-A.L.); (A.G.); (C.T.); (C.M.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Cristian Mornos
- Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (M.-A.L.); (L.P.); (C.V.); (S.C.); (D.G.); (D.C.); (R.S.); (A.-R.C.); (S.-A.L.); (A.G.); (C.T.); (C.M.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
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Dynamic gravity compensation does not increase detection of myocardial ischemia in combined accelerometer and gyro sensor measurements. Sci Rep 2019; 9:2671. [PMID: 30804438 PMCID: PMC6389971 DOI: 10.1038/s41598-018-35630-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 11/05/2018] [Indexed: 12/02/2022] Open
Abstract
Previous studies have shown that miniaturised accelerometers can be used to monitor cardiac function and automatically detect ischemic events. However, accelerometers cannot differentiate between acceleration due to motion and acceleration due to gravity. Gravity filtering is essential for accurate integration of acceleration to yield velocity and displacement. Heart motion is cyclic and mean acceleration over time is zero. Thus, static gravity filtering is performed by subtracting mean acceleration. However, the heart rotates during the cycle, the gravity component is therefore not constant, resulting in overestimation of motion by static filtering. Accurate motion can be calculated using dynamic gravity filtering by a combined gyro and accelerometer. In an animal model, we investigated whether increased accuracy using dynamic filtering, compared to using static filtering, would enhance the ability to detect ischemia. Additionally, we investigated how well the gyro alone could detect ischemia based on the heart’s rotation. Dynamic filtering tended towards lower sensitivity and specificity, using receiver operating characteristics analysis, for ischemia-detection compared to static filtering (area under the curve (AUC): 0.83 vs 0.93, p = 0.125). The time-varying gravity component indirectly reflects the heart’s rotation. Hence, static filtering has the advantage of indirectly including rotation, which alone demonstrated excellent sensitivity to ischemia (AUC = 0.98).
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Cote AT, Hosking M, Voss C, Human DG, Sandor GGS, Harris KC. Coronary artery intimal thickening and ventricular dynamics in pediatric heart transplant recipients. CONGENIT HEART DIS 2018; 13:663-670. [DOI: 10.1111/chd.12629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 05/18/2018] [Accepted: 05/21/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Anita T. Cote
- Department of Pediatrics; University of British Columbia & British Columbia Children’s Hospital Research Institute; Vancouver Canada
- School of Human Kinetics; Trinity Western University; Langley Canada
| | - Martin Hosking
- British Columbia Children’s Hospital, Children’s Heart Centre; Vancouver Canada
| | - Christine Voss
- Department of Pediatrics; University of British Columbia & British Columbia Children’s Hospital Research Institute; Vancouver Canada
- British Columbia Children’s Hospital, Children’s Heart Centre; Vancouver Canada
| | - Derek G Human
- British Columbia Children’s Hospital, Children’s Heart Centre; Vancouver Canada
| | - George G. S. Sandor
- Department of Pediatrics; University of British Columbia & British Columbia Children’s Hospital Research Institute; Vancouver Canada
- British Columbia Children’s Hospital, Children’s Heart Centre; Vancouver Canada
| | - Kevin C. Harris
- Department of Pediatrics; University of British Columbia & British Columbia Children’s Hospital Research Institute; Vancouver Canada
- British Columbia Children’s Hospital, Children’s Heart Centre; Vancouver Canada
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Torres WM, Jacobs J, Doviak H, Barlow SC, Zile MR, Shazly T, Spinale FG. Regional and temporal changes in left ventricular strain and stiffness in a porcine model of myocardial infarction. Am J Physiol Heart Circ Physiol 2018; 315:H958-H967. [PMID: 30004234 DOI: 10.1152/ajpheart.00279.2018] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The aim of the present study was to serially track how myocardial infarction (MI) impacts regional myocardial strain and mechanical properties of the left ventricle (LV) in a large animal model. Post-MI remodeling has distinct regional effects throughout the LV myocardium. Regional quantification of LV biomechanical behavior could help explain changes in global function and thus advance clinical assessment of post-MI remodeling. The present study is based on a porcine MI model to characterize LV biomechanics over 28 days post-MI via speckle-tracking echocardiography (STE). Regional myocardial strain and strain rate were recorded in the circumferential, radial, and longitudinal directions at baseline and at 3, 14, and 28 days post-MI. Regional myocardial wall stress was calculated using standard echocardiographic metrics of geometry and Doppler-derived hemodynamic measurements. Regional diastolic myocardial stiffness was calculated from the resultant stress-strain relations. Peak strain and phasic strain rates were nonuniformly reduced throughout the myocardium post-MI, whereas time to peak strain was increased to a similar degree in the MI region and border zone by 28 days post-MI. Elevations in diastolic myocardial stiffness in the MI region plateaued at 14 days post-MI, after which a significant reduction in MI regional stiffness in the longitudinal direction occurred between 14 and 28 days post-MI. Post-MI biomechanical changes in the LV myocardium were initially limited to the MI region but nonuniformly extended into the neighboring border zone and remote myocardium over 28 days post-MI. STE enabled quantification of regional and temporal differences in myocardial strain and diastolic stiffness, underscoring the potential of this technique for clinical assessment of post-MI remodeling. NEW & NOTEWORTHY For the first time, speckle-tracking echocardiography was used to serially track regional biomechanical behavior and mechanical properties postmyocardial infarction (post-MI). We found that changes initially confined to the MI region extended throughout the myocardium in a nonuniform fashion over 28 days post-MI. Speckle-tracking echocardiography-based evaluation of regional changes in left ventricular biomechanics could advance both clinical assessment of left ventricular remodeling and therapeutic strategies that target aberrant biomechanical behavior post-MI.
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Affiliation(s)
- William M Torres
- College of Engineering and Computing, University of South Carolina , Columbia, South Carolina.,Cardiovascular Translational Research Center, University of South Carolina School of Medicine and the William Jennings Bryan Dorn Veteran Affairs Medical Center , Columbia, South Carolina
| | - Julia Jacobs
- Cardiovascular Translational Research Center, University of South Carolina School of Medicine and the William Jennings Bryan Dorn Veteran Affairs Medical Center , Columbia, South Carolina
| | - Heather Doviak
- Cardiovascular Translational Research Center, University of South Carolina School of Medicine and the William Jennings Bryan Dorn Veteran Affairs Medical Center , Columbia, South Carolina
| | - Shayne C Barlow
- Cardiovascular Translational Research Center, University of South Carolina School of Medicine and the William Jennings Bryan Dorn Veteran Affairs Medical Center , Columbia, South Carolina
| | - Michael R Zile
- Medical University of South Carolina and Ralph H. Johnson Department of Veterans Affairs Medical Center , Charleston, South Carolina
| | - Tarek Shazly
- College of Engineering and Computing, University of South Carolina , Columbia, South Carolina
| | - Francis G Spinale
- College of Engineering and Computing, University of South Carolina , Columbia, South Carolina.,Cardiovascular Translational Research Center, University of South Carolina School of Medicine and the William Jennings Bryan Dorn Veteran Affairs Medical Center , Columbia, South Carolina
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Intervendor Differences in the Accuracy of Detecting Regional Functional Abnormalities. JACC Cardiovasc Imaging 2018; 11:25-34. [DOI: 10.1016/j.jcmg.2017.02.014] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/24/2017] [Accepted: 02/17/2017] [Indexed: 11/19/2022]
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Badano LP, Muraru D. The Good, the Bad, and the Ugly of Using Left Ventricular Longitudinal Myocardial Deformation by Speckle-Tracking Echocardiography to Assess Patients After an Acute Myocardial Infarction. Circ Cardiovasc Imaging 2017; 10:CIRCIMAGING.117.006693. [PMID: 28701530 DOI: 10.1161/circimaging.117.006693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Luigi P Badano
- From the Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, School of Medicine, Italy.
| | - Denisa Muraru
- From the Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, School of Medicine, Italy
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Abstract
Coronary artery disease (CAD) continues to be a leading cause of morbidity and mortality worldwide. Although invasive coronary angiography has previously been the gold standard in establishing the diagnosis of CAD, there is a growing shift to more appropriately use the cardiac catheterization laboratory to perform interventional procedures once a diagnosis of CAD has been established by noninvasive imaging modalities rather than using it primarily as a diagnostic facility to confirm or refute CAD. With ongoing technological advancements, noninvasive imaging plays a pre-eminent role in not only diagnosing CAD but also informing the choice of appropriate therapies, establishing prognosis, all while containing costs and providing value-based care. Multiple imaging modalities are available to evaluate patients suspected of having coronary ischemia, such as stress electrocardiography, stress echocardiography, single-photon emission computed tomography myocardial perfusion imaging, positron emission tomography, coronary computed tomography (CT) angiography, and magnetic resonance imaging. These imaging modalities can variably provide functional and anatomical delineation of coronary stenoses and help guide appropriate therapy. This review will discuss their advantages and limitations and their usage in the diagnostic pathway for patients with CAD. We also discuss newer technologies such as CT fractional flow reserve, CT angiography with perfusion, whole-heart coronary magnetic resonance angiography with perfusion, which can provide both anatomical as well as functional information in the same test, thus obviating the need for multiple diagnostic tests to obtain a comprehensive assessment of both, plaque burden and downstream ischemia. Recognizing that clinicians have a multitude of tests to choose from, we provide an underpinning of the principles of ischemia detection by these various modalities, focusing on anatomy vs physiology, the database justifying their use, their prognostic capabilities and lastly, their appropriate and judicious use in this era of patient-centered, cost-effective imaging.
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Bachner-Hinenzon N, Malka A, Barac Y, Meerkin D, Ertracht O, Carasso S, Shofti R, Leitman M, Vered Z, Adam D, Binah O. Strain Analysis in the Detection of Myocardial Infarction at the Acute and Chronic Stages. Echocardiography 2015; 33:450-8. [PMID: 26412026 DOI: 10.1111/echo.13079] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Myocardial ischemia causes contractile dysfunction in ischemic, stunned, and tethered regions with larger infarcted zones having a negative prognostic impact on patients' outcomes. To distinguish the infarcted myocardium from the other regions, we investigated the diagnostic potential of circumferential strain (CS) and radial strain (RS) during the acute and chronic stages of myocardial infarction. METHODS Ten pigs underwent 90-minute occlusion of the left anterior descending artery, followed by reperfusion. Echocardiography was performed at baseline, after 90-minute occlusion, and at 2 hours, 30, and 60 days postreperfusion. CS and RS were measured using speckle tracking echocardiography. Subsequently, the pigs were sacrificed, and histological analysis for infarct size was performed. RESULTS After 90-minute occlusion, reduced strains were detected for all segments (infarcted anterior wall - baseline: CS: -17.6 ± 5.7%, RS: 54.4 ± 16.9%; 90 min: CS: -10.3 ± 3.0%, RS: 23.3 ± 7.0%; tethered posterior wall - baseline: CS: -18.4 ± 3.5%, RS: 68.7 ± 21.1%; 90 min: CS: -10.7 ± 6.4%, RS: 34.5 ± 14.7%, P < 0.001). However, postsystolic shortening was detected only in the infarcted segments, and the time-to-peak CS was 25% longer (P < 0.05). At 30 and 60 days postreperfusion, time-to-peak CS could only detect large scars in the anterior and anterior-septum walls (P < 0.05), while peak CS also detected smaller scars in the lateral wall (P < 0.05). RS failed to distinguish between normal, stunned/tethered, and infarcted myocardium. CONCLUSIONS During occlusion and 2 hours postreperfusion, time-to-peak CS could distinguish between infarcted and stunned/tethered myocardial segments, while at 30 and 60 days postreperfusion, peak CS was the best detector of infarction.
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Affiliation(s)
| | - Assaf Malka
- Department of Physiology, Technion, Haifa, Israel.,Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Yaron Barac
- Department of Cardiothoracic Surgery, Rabin Medical Center, Petah Tikva, Israel
| | - David Meerkin
- Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Offir Ertracht
- Eliachar Research Laboratory, Medical Center of the Galilee, Nahariya, Israel
| | - Shemy Carasso
- Faculty of Medicine, Bar-Ilan University, Tzfat, Israel.,Poriya Medical Center, Lower Galilee, Israel
| | - Rona Shofti
- Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Marina Leitman
- Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Zvi Vered
- Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dan Adam
- Faculty of Biomedical Engineering, Technion, Haifa, Israel
| | - Ofer Binah
- Department of Physiology, Technion, Haifa, Israel.,Rappaport Faculty of Medicine, Technion, Haifa, Israel
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Kauer F, Geleijnse ML, Dalen BMV. Role of left ventricular twist mechanics in cardiomyopathies, dance of the helices. World J Cardiol 2015; 7:476-482. [PMID: 26322187 PMCID: PMC4549781 DOI: 10.4330/wjc.v7.i8.476] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 02/09/2015] [Accepted: 06/16/2015] [Indexed: 02/06/2023] Open
Abstract
Left ventricular twist is an essential part of left ventricular function. Nevertheless, knowledge is limited in “the cardiology community” as it comes to twist mechanics. Fortunately the development of speckle tracking echocardiography, allowing accurate, reproducible and rapid bedside assessment of left ventricular twist, has boosted the interest in this important mechanical aspect of left ventricular deformation. Although the fundamental physiological role of left ventricular twist is undisputable, the clinical relevance of assessment of left ventricular twist in cardiomyopathies still needs to be established. The fact remains; analysis of left ventricular twist mechanics has already provided substantial pathophysiological understanding on a comprehensive variety of cardiomyopathies. It has become clear that increased left ventricular twist in for example hypertrophic cardiomyopathy may be an early sign of subendocardial (microvascular) dysfunction. Furthermore, decreased left ventricular twist may be caused by left ventricular dilatation or an extensive myocardial scar. Finally, the detection of left ventricular rigid body rotation in noncompaction cardiomyopathy may provide an indispensible method to objectively confirm this difficult diagnosis. All this endorses the value of left ventricular twist in the field of cardiomyopathies and may further encourage the implementation of left ventricular twist parameters in the “diagnostic toolbox” for cardiomyopathies.
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Left ventricular subclinical dysfunction associated with myocardial deformation changes in obstructive sleep apnea patients estimated by real-time 3D speckle-tracking echocardiography. Sleep Breath 2015; 20:135-44. [PMID: 26003787 DOI: 10.1007/s11325-015-1197-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 04/20/2015] [Accepted: 05/13/2015] [Indexed: 01/10/2023]
Abstract
BACKGROUND Previous studies have demonstrated that patients with obstructive sleep apnea (OSA) may develop left ventricular (LV) diastolic dysfunction. We aimed to study whether OSA patients have LV regional systolic dysfunction with myocardial deformation changes, despite a normal LV ejection fraction, using real-time 3D speckle-tracking echocardiography (Rt3D-STE). METHODS Seventy-eight patients with OSA and no comorbidities were studied. They were divided into the following three groups according to the apnea-hypopnea index (AHI): 5~15/h as group I (mild OSA, 26 cases), 15~30/h as group II (moderate OSA, 29 cases), and ≥30/h as group III (severe OSA, 23 cases). Thirty gender-age-matched normal subjects were included as controls. The parameters of LV diastolic function were acquired with traditional echocardiography. The LV myocardial deformation parameters were obtained, including the longitudinal (LS), circumferential (CS), radial (RS), and area (AS) strains, with Rt3D-STE. RESULTS LV global systolic function was normal in all patients, but diastolic function was impaired in groups II and III (E/E' was 9.6 ± 2.8 and 10.4 ± 2.5, respectively, p < 0.0001). The global LS and AS were significantly reduced in groups II and III compared with the controls and group I (LS 15.9 ± 1.4 % and 14.8 ± 1.5 % vs 18.2 ± 1.7 % and 17.8 ± 1.5 %; AS 27.4 ± 1.8 % and 24.9 ± 2.3 % vs 33.4 ± 2.2 % and 32.7 ± 2.9 %, respectively, p < 0.0001), but the global CS and RS were significantly reduced only in group III (17.3 ± 1.4 % and 43.1 ± 6.5 % vs 19.6 ± 1.6 % and 55.4 ± 4.0 %, respectively, <0.0001). The severity of OSA was significantly associated with the LV global AS value (r = -0.80, p < 0.0001), LS (r = -0.64, p < 0.0001), CS (r = -0.51, p < 0.0001), and RS (r = -0.62, p < 0.0001). CONCLUSIONS Patients with moderate and severe OSA tended to have both LV diastolic dysfunction and abnormalities in regional systolic function with myocardial deformation changes, in spite of the normal LV ejection fraction. Myocardial strains of the LV were negatively correlated with the AHI. Rt-3DST had important clinical significance in the early evaluation of cardiac dysfunction in OSA patients.
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Wang D, Sun JP, Lee APW, Ma GS, Yang XS, Yu CM, Ding JD, Liu NF. Evaluation of left ventricular function by three-dimensional speckle-tracking echocardiography in patients with myocardial bridging of the left anterior descending coronary artery. J Am Soc Echocardiogr 2015; 28:674-82. [PMID: 25795472 DOI: 10.1016/j.echo.2015.02.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND To understand the influence of myocardial bridging (MB) on left ventricular (LV) function, myocardial function was studied in patients with MB of the left anterior descending coronary artery (LAD) using three-dimensional speckle-tracking echocardiography (STE). METHODS Left anterior descending coronary artery MB was diagnosed by coronary angiography in 82 subjects. Patients were divided into three groups according to the percentage of systolic narrowing of the compressed segment: 30% to 49% was defined as group I (24 patients), 50% to 74% as group II (28 patients), and ≥75% as group III (30 patients). Thirty gender- and age-matched normal subjects were included as controls. Left ventricular myocardial deformation was estimated by three-dimensional STE. RESULTS Left ventricular ejection fractions were normal in all patients, but diastolic function was impaired in groups II and III (E/E' ratio, 9 ± 3 and 10 ± 3, respectively). The amplitudes of longitudinal strain (LS) and area strain (AS) of the LAD territory was significantly reduced in groups II and III compared with controls and group I (LS, -15 ± 2% and -12 ± 1% vs -19 ± 2% and -18 ± 2%; AS, -22 ± 2% and -13 ± 2% vs -33 ± 4% and -33 ± 3%; P < .0001), but the amplitudes of circumferential and radial strain showed no intergroup differences. Longitudinal strain and AS were significantly lower in patients with fractional flow reserve < 0.75 than in those with fractional flow reserve ≥ 0.75 (P < .0001), with relative preservation of circumferential and radial strain. The severity of LAD compression was significantly associated with AS and LS of the LAD territory (r = -0.92 and r = -0.84, respectively, P < .0001), but the correlations with circumferential and radial strain were modest (r = -0.36 and r = -0.32, respectively, P < .05). CONCLUSIONS With the increasing severity of systolic compression of the mural coronary artery, LV diastolic function and regional systolic deformation (AS and LS) of the MB perfusion territory were reduced. Three-dimensional STE can detect subtle myocardial dysfunction in patients with MB.
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Affiliation(s)
- Dian Wang
- Department of Cardiology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China
| | - Jing Ping Sun
- Division of Cardiology, Institute of Vascular Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Alex Pui-wai Lee
- Division of Cardiology, Institute of Vascular Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China; Lui Che Woo Institute of Innovative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Gen Shan Ma
- Department of Cardiology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China
| | - Xing Sheng Yang
- Division of Cardiology, Institute of Vascular Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Cheuk-man Yu
- Division of Cardiology, Institute of Vascular Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Jian Dong Ding
- Department of Cardiology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China
| | - Nai Feng Liu
- Department of Cardiology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China.
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12
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Nacar AB, Topcu S, Kurt M, Tanboga IH, Karakaş MF, Buyukkaya E, Aksakal E, Sen N, Akcay AB, Bilen E. Effect of Remote Ischemic Postconditioning on Left Ventricular Mechanics. Echocardiography 2015; 32:448-53. [DOI: 10.1111/echo.12677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Selim Topcu
- School of Medicine; Ataturk University; Erzurum Turkey
| | - Mustafa Kurt
- Mustafa Kemal University; School of Medicine; Hatay Turkey
| | | | | | - Eyup Buyukkaya
- Mustafa Kemal University; School of Medicine; Hatay Turkey
| | | | - Nihat Sen
- Mustafa Kemal University; School of Medicine; Hatay Turkey
| | | | - Emine Bilen
- Ankara Ataturk Education and Research Hospital; Ankara Turkey
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13
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Changes in Right Ventricular Free Wall Strain in Patients with Coronary Artery Disease Involving the Right Coronary Artery. J Am Soc Echocardiogr 2014; 27:230-8. [DOI: 10.1016/j.echo.2013.11.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Indexed: 11/20/2022]
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14
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Song CF, Zhou Q, Guo RQ. Alteration in the global and regional myocardial strain patterns in patients with inferior ST-elevation myocardial infarction prior to and after percutaneous coronary intervention. Kaohsiung J Med Sci 2014; 30:29-34. [PMID: 24388056 DOI: 10.1016/j.kjms.2013.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Accepted: 03/14/2013] [Indexed: 10/26/2022] Open
Abstract
This study was designed to investigate the alteration on regional and global strains of left and right ventricle (LV, RV) in patients with inferior wall ST-elevation myocardial infarction (MI). Patients were examined prior to and 7 days after percutaneous coronary intervention (PCI) using speckle-tracking techniques. Fifty-nine patients (36 males and 23 females) and 60 healthy controls (40 males and 20 females) were enrolled in this study. LV strains were measured from three deformations including radial, longitudinal, and circumferential. RV strains were measured only from the longitudinal. Three types of LV global strains were significantly lower in patients than in controls, and LV global longitudinal and circumferential strains were moderately improved by PCI. The LV regional strains reduced significantly in most of the segments (87%) after inferior wall MI and over half of them (60%) were improved by PCI. The RV global longitudinal strains were significantly lower in patients than in controls, and they were moderately improved by PCI. In conclusion, the regional and global strains of LV and RV were reduced in patients with inferior wall MI, and PCI most markedly improved the global strains and regional strains of the infarct and adjacent myocardium in the apical and middle levels.
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Affiliation(s)
- Chen-Fang Song
- Department of Ultrasonography, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qing Zhou
- Department of Ultrasonography, Renmin Hospital of Wuhan University, Wuhan, China
| | - Rui-Qiang Guo
- Department of Ultrasonography, Renmin Hospital of Wuhan University, Wuhan, China.
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15
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Spinelli L, Morisco C, Assante di Panzillo E, Izzo R, Trimarco B. Reverse left ventricular remodeling after acute myocardial infarction: the prognostic impact of left ventricular global torsion. Int J Cardiovasc Imaging 2012. [PMID: 23179752 DOI: 10.1007/s10554-012-0159-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Reverse left ventricular (LV) remodeling (>10 % reduction in LV end-systolic volume) may occur in patients recovering for acute ST-elevation myocardial infarction (STEMI), undergoing percutaneous revascularization of infarct-related coronary artery (PCI). To detect whether LV global torsion obtained by two-dimensional speckle-tracking echocardiography was predictive of reverse LV remodeling, 75 patients with first anterior wall STEMI were studied before (T1) and after PCI (T2) and at 6-month follow-up. Two-year clinical follow-up was also accomplished. LV volumes and both LV sphericity index and conic index were obtained by three-dimensional echocardiography. Reverse remodeling was observed in 25 patients (33 %). By multivariate analysis, independent predictors of reverse LV remodeling were: LV conic index, T2 LV torsion and Δ torsion (difference between T2 and T1 LV torsion expressed as percentage of this latter). According to receiver operating characteristic analysis, 1.34°/cm for T2 LV torsion (sensitivity 88 % and specificity 80 %) and 54 % for Δ torsion (sensitivity 92 % and specificity 82 %) were the optimal cutoff values in predicting reverse LV remodeling. In up to 24 month follow-up, 4 non-fatal re-infarction, 7 hospitalization for heart failure and 4 cardiac deaths occurred. By multivariate Cox analysis, the best variable significantly associated with event-free survival rate was reverse LV remodeling with a hazard ratio = 9.9 (95 % confidence interval, 7.9-31.4, p < 0.01). In conclusion, reverse LV remodeling occurring after anterior wall STEMI is associated with favorable long-term outcome. The improvement of global LV torsion following coronary artery revascularization is the major predictor of reverse LV remodeling.
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Affiliation(s)
- Letizia Spinelli
- Department of Medicine, Cardiovascular and Immunological Sciences, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy.
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16
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Liao SS, Ruan QY, Lin MY, Yan L. Value of segmental myocardial strain by 2-dimensional strain echocardiography for assessment of scar area induced in a rat model of myocardial infarction. Cardiovasc Ultrasound 2012; 10:17. [PMID: 22471966 PMCID: PMC3347994 DOI: 10.1186/1476-7120-10-17] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Accepted: 04/03/2012] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Two-dimensional strain echocardiography (2DSE) technique has enabled accurate quantification of regional myocardial function. This experimental study was aimed to investigate the value of 2DSE in detection of segmental regional myocardial dysfunction induced by fibrosis following myocardial infarction in a small animal (rat) model. METHODS A rat model of myocardial infarction was established by ligation of the proximal left anterior descending coronary artery in 17 SD rats. Regional myocardial function was detected by 2DSE at baseline and 4-weeks post-infarction, including end-systolic radial strain and strain rate (SR and SrR) and end-systolic circumferential strain and strain rate (SC and SrC) of each of six segments at papillary level. According to the size of scar found by histologic Masson staining, the optimal cutoff points of parameters for detecting scar area were analyzed and the sensitivity and specificity of every parameter to detect myocardial scar were obtained using ROC. RESULTS (1) Comparing with parameters measured at baseline, there were significant decreases in SR, SrR, SC and SrC of each segment at 4 weeks post-infarction, with the worst in the infarct area (32.90 ± 8.79 vs 11.18 ± 3.89, 6.28 ± 1.35 vs 3.18 ± 0.47, -14.46 ± 2.21 vs -6.30 ± 2.17 and 4.93 ± 0.95 vs 2.59 ± 1.16, respectively) (all P < 0.05). (2)By 4 weeks, the myocardium of infarct area (anteroseptum, anterior and anterolateral) had fibrosis (31.33 ± 9.89, 73.42 ± 13.21 and 13.99 ± 3.24%, respectively) with minimal fibrosis in inferoseptal segment (0.32 ± 0.19%), no fibrosis was found in the inferior and inferolateral segments. (3)Significant negative correlations were found between the size of segmental scar and 2DSE parameters (r-value -0.61 ~ -0.80, all P < 0.01) with the strongest correlation in SR. SR less than 10% has 84% sensitivity and 98% specificity for detecting segments of scar area greater than 30% with AUC = 0.97. CONCLUSIONS 2DSE is able to assess regional myocardial dysfunction in a rat model of myocardial infarction and has high accuracy in detecting infarct segments with scar area greater than 30%.
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Affiliation(s)
- Shu-sheng Liao
- Department of Ultrasound, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
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17
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Sun JP, Lee APW, Wu C, Lam YY, Hung MJ, Chen L, Hu Z, Fang F, Yang XS, Merlino JD, Yu CM. Quantification of left ventricular regional myocardial function using two-dimensional speckle tracking echocardiography in healthy volunteers--a multi-center study. Int J Cardiol 2012; 167:495-501. [PMID: 22365315 DOI: 10.1016/j.ijcard.2012.01.071] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Revised: 01/10/2012] [Accepted: 01/21/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although two-dimensional speckle tracking (2DST) has been validated in animal and early clinical studies for quantitative evaluation of myocardial motion and contractility, there are only limited measurements in large healthy population to be used as reference data, which severely restricts its clinical application. This study aimed at determining the age-specific normal values of left ventricular (LV) longitudinal, circumferential and radial strain in healthy adults. METHODS We studied 228 healthy subjects (109 males, mean age 44 ± 15 years, range 18-78 years). Their LV longitudinal, circumferential and radial strains were measured by 2DST at basal, middle and apical levels of parasternal short-axis and apical 2-, 4- and 3-chamber views. The effects of age, gender and echocardiographic machines (52 patients had measurements obtained by both GE and Philips machines) on these parameters were also evaluated. RESULTS The longitudinal and circumferential strains were -20.4 ± 3.4% and -22.9 ± 3.1%, respectively with higher values being observed at basal than apical segments. On the contrary, the radial strain which ranged 42.6 ± 12.9% decreased towards apical segments. The longitudinal strain declined, the circumferential strain rose and the radial strain remained similar during aging. Adult females had slightly higher circumferential and longitudinal strains than males (23 ± 3% vs -22 ± 3%, -21 ± 3% vs -20 ± 3% respectively; both p<0.01). Strains measured by the 2 different echo machines had good correlations but Phillips-assessed strains (longitudinal and circumferential) were 10% higher than GE measurements. Inter- and intra-observer variabilities were acceptable. CONCLUSIONS Strain measurements by 2DST echocardiography varies with age, gender and echocardiographic vendors in healthy adults. These findings are important to differentiate between health and disease and to assess the severity of disease.
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Affiliation(s)
- Jing Ping Sun
- Division of Cardiology, S.H. Ho Cardiovascular and Stroke Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
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18
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Different impacts of acute myocardial infarction on left ventricular apical and basal rotation. Eur Heart J Cardiovasc Imaging 2011; 13:483-9. [DOI: 10.1093/ejechocard/jer272] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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19
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Medicetty S, Wiktor D, Lehman N, Raber A, Popovic ZB, Deans R, Ting AE, Penn MS. Percutaneous adventitial delivery of allogeneic bone marrow-derived stem cells via infarct-related artery improves long-term ventricular function in acute myocardial infarction. Cell Transplant 2011; 21:1109-20. [PMID: 22004910 DOI: 10.3727/096368911x603657] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Acute myocardial infarction (AMI) results in ischemic damage and death of cardiomyocytes and loss of vasculature. Stem cell therapy has emerged as a potentially promising strategy for maximizing cardiac function following ischemic injury. Issues of cell source, delivery, and quantification of response have challenged development of clinically viable strategies. In this study we investigate the effects of a well-defined bone marrow-derived allogeneic cell product delivered by catheter directly to the myocardium via the infarct-related vessel on global and regional measures of left ventricular (LV) function in a porcine model of anterior wall myocardial infarction. Multipotent adult progenitor cells (MAPCs) were derived and expanded from the bone marrow of a donor Yorkshire pig. Anterior wall myocardial infarction (AMI) was induced by 90 min of mid-LAD occlusion using a balloon catheter. Two days after AMI was induced, either vehicle (Plasma Lyte-A, n = 7), low-dose (20 million, n = 6), or high-dose (200 million, n = 6) MAPCs were delivered directly to the myocardium via the infarct-related vessel using a transarterial microsyringe catheter-based delivery system. Echocardiography was used to measure LV function as a function of time after AMI. Animals that received low-dose cell treatment showed significant improvement in regional and global LV function and remodeling compared to the high-dose or control animals. Direct myocardial delivery of allogeneic MAPCs 2 days following AMI through the vessel wall of the infarct-related vessel is safe and results in delivery of cells throughout the infarct zone and improved cardiac function despite lack of long-term cell survival. These data further support the hypothesis of cell-based myocardial tissue repair by a paracrine mechanism and suggest a clinically translatable strategy for delivering cells at any time after AMI to modulate cardiac remodeling and function.
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Affiliation(s)
- Satish Medicetty
- Regenerative Medicine Department, Athersys, Inc., Cleveland, OH 44309, USA
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20
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Evaluation of left ventricular twist in acute myocardial infarction patients using speckle tracking imaging. Cell Biochem Biophys 2011; 61:673-8. [PMID: 21713529 DOI: 10.1007/s12013-011-9223-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study is to evaluate the differences of left ventricular (LV) twist and untwisting rate in patients with acute myocardial infarction (AMI) as compared with healthy subjects by means of Speckle Tracking Imaging (STI). 45 AMI patients (AMI group) and 48 healthy subjects (NOR group) were studied. Two-dimensional STI was performed in all patients. Peak apical rotation, peak basal rotation, peak LV twist, peak basal untwisting rate, peak apical untwisting rate, peak LV untwisting rate, time to peak LV twist, and untwisting rate were measured. In comparison with the NOR group, peak LV rotational parameters were found to be decreased in the AMI group (P < 0.01). A strong correlation was found between the peak LV twist and LV ejection fraction in the overall study population (P < 0.001). The LV twist is strongly related to LV systolic function, and the impairment of LV function observed in patients with AMI is associated with a decrease of LV twist and untwist rate. The STI appears to accurately evaluate LV function.
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21
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Culwell NM, Bonagura JD, Schober KE. Comparison of echocardiographic indices of myocardial strain with invasive measurements of left ventricular systolic function in anesthetized healthy dogs. Am J Vet Res 2011; 72:650-60. [DOI: 10.2460/ajvr.72.5.650] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Nucifora G, Marsan NA, Bertini M, Delgado V, Siebelink HMJ, van Werkhoven JM, Scholte AJ, Schalij MJ, van der Wall EE, Holman ER, Bax JJ. Reduced Left Ventricular Torsion Early After Myocardial Infarction Is Related to Left Ventricular Remodeling. Circ Cardiovasc Imaging 2010; 3:433-42. [DOI: 10.1161/circimaging.109.926196] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Gaetano Nucifora
- From the Department of Cardiology (G.N., N.A.M., M.B., V.D., H.-M.J.S., J.M.v.W., A.J.S., M.J.S., E.E.v.d.W., E.R.H., J.J.B.), Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiopulmonary Sciences (G.N.), University Hospital Santa Maria della Misericordia, Udine, Italy; and the Interuniversity Cardiology Institute of the Netherlands (E.E.v.d.W.), Utrecht, the Netherlands
| | - Nina Ajmone Marsan
- From the Department of Cardiology (G.N., N.A.M., M.B., V.D., H.-M.J.S., J.M.v.W., A.J.S., M.J.S., E.E.v.d.W., E.R.H., J.J.B.), Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiopulmonary Sciences (G.N.), University Hospital Santa Maria della Misericordia, Udine, Italy; and the Interuniversity Cardiology Institute of the Netherlands (E.E.v.d.W.), Utrecht, the Netherlands
| | - Matteo Bertini
- From the Department of Cardiology (G.N., N.A.M., M.B., V.D., H.-M.J.S., J.M.v.W., A.J.S., M.J.S., E.E.v.d.W., E.R.H., J.J.B.), Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiopulmonary Sciences (G.N.), University Hospital Santa Maria della Misericordia, Udine, Italy; and the Interuniversity Cardiology Institute of the Netherlands (E.E.v.d.W.), Utrecht, the Netherlands
| | - Victoria Delgado
- From the Department of Cardiology (G.N., N.A.M., M.B., V.D., H.-M.J.S., J.M.v.W., A.J.S., M.J.S., E.E.v.d.W., E.R.H., J.J.B.), Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiopulmonary Sciences (G.N.), University Hospital Santa Maria della Misericordia, Udine, Italy; and the Interuniversity Cardiology Institute of the Netherlands (E.E.v.d.W.), Utrecht, the Netherlands
| | - Hans-Marc J. Siebelink
- From the Department of Cardiology (G.N., N.A.M., M.B., V.D., H.-M.J.S., J.M.v.W., A.J.S., M.J.S., E.E.v.d.W., E.R.H., J.J.B.), Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiopulmonary Sciences (G.N.), University Hospital Santa Maria della Misericordia, Udine, Italy; and the Interuniversity Cardiology Institute of the Netherlands (E.E.v.d.W.), Utrecht, the Netherlands
| | - Jacob M. van Werkhoven
- From the Department of Cardiology (G.N., N.A.M., M.B., V.D., H.-M.J.S., J.M.v.W., A.J.S., M.J.S., E.E.v.d.W., E.R.H., J.J.B.), Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiopulmonary Sciences (G.N.), University Hospital Santa Maria della Misericordia, Udine, Italy; and the Interuniversity Cardiology Institute of the Netherlands (E.E.v.d.W.), Utrecht, the Netherlands
| | - Arthur J. Scholte
- From the Department of Cardiology (G.N., N.A.M., M.B., V.D., H.-M.J.S., J.M.v.W., A.J.S., M.J.S., E.E.v.d.W., E.R.H., J.J.B.), Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiopulmonary Sciences (G.N.), University Hospital Santa Maria della Misericordia, Udine, Italy; and the Interuniversity Cardiology Institute of the Netherlands (E.E.v.d.W.), Utrecht, the Netherlands
| | - Martin J. Schalij
- From the Department of Cardiology (G.N., N.A.M., M.B., V.D., H.-M.J.S., J.M.v.W., A.J.S., M.J.S., E.E.v.d.W., E.R.H., J.J.B.), Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiopulmonary Sciences (G.N.), University Hospital Santa Maria della Misericordia, Udine, Italy; and the Interuniversity Cardiology Institute of the Netherlands (E.E.v.d.W.), Utrecht, the Netherlands
| | - Ernst E. van der Wall
- From the Department of Cardiology (G.N., N.A.M., M.B., V.D., H.-M.J.S., J.M.v.W., A.J.S., M.J.S., E.E.v.d.W., E.R.H., J.J.B.), Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiopulmonary Sciences (G.N.), University Hospital Santa Maria della Misericordia, Udine, Italy; and the Interuniversity Cardiology Institute of the Netherlands (E.E.v.d.W.), Utrecht, the Netherlands
| | - Eduard R. Holman
- From the Department of Cardiology (G.N., N.A.M., M.B., V.D., H.-M.J.S., J.M.v.W., A.J.S., M.J.S., E.E.v.d.W., E.R.H., J.J.B.), Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiopulmonary Sciences (G.N.), University Hospital Santa Maria della Misericordia, Udine, Italy; and the Interuniversity Cardiology Institute of the Netherlands (E.E.v.d.W.), Utrecht, the Netherlands
| | - Jeroen J. Bax
- From the Department of Cardiology (G.N., N.A.M., M.B., V.D., H.-M.J.S., J.M.v.W., A.J.S., M.J.S., E.E.v.d.W., E.R.H., J.J.B.), Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiopulmonary Sciences (G.N.), University Hospital Santa Maria della Misericordia, Udine, Italy; and the Interuniversity Cardiology Institute of the Netherlands (E.E.v.d.W.), Utrecht, the Netherlands
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Treguer F, Donal E, Tamareille S, Ghaboura N, Derumeaux G, Furber A, Prunier F. Speckle tracking imaging improves in vivo assessment of EPO-induced myocardial salvage early after ischemia-reperfusion in rats. Am J Physiol Heart Circ Physiol 2010; 298:H1679-86. [DOI: 10.1152/ajpheart.01058.2009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A noninvasive assessment of infarct size and transmural extension of myocardial infarction (TEMI) is fundamental in experimental models of ischemia-reperfusion. Conventional echocardiography parameters are limited in this purpose. This study was designed to examine whether speckle tracking imaging can be used in a rat model of ischemia-reperfusion to accurately detect the reduction of infarct size and TEMI induced by erythropoietin (EPO) as early as 24 h after reperfusion. Rats were randomly assigned to one of three groups: myocardial infarction (MI)-control group, 45 min ischemia followed by 24 h of reperfusion; MI-EPO group, similar surgery with a single bolus of EPO administered at the onset of reperfusion; and sham-operated group. Short-axis two-dimensional echocardiography was performed after reperfusion. Global radial (GSr) and circumferential (GScir) strains were compared with infarct size and TEMI assessed after triphenyltetrazolium chloride staining. As a result, ejection fraction, shortening fraction, GSr, and GScir significantly correlated to infarct size, whereas only GSr and GScir significantly correlated to TEMI. EPO significantly decreased infarct size (30.8 ± 3.5 vs. 56.2 ± 5.7% in MI-control, P < 0.001) and TEMI (0.37 ± 0.05 vs. 0.77 ± 0.05 in MI-control, P < 0.001). None of the conventional echocardiography parameters was significantly different between the MI-EPO and MI-control groups, whereas GSr was significantly higher in the MI-EPO group (29.1 ± 4.7 vs. 16.4 ± 3.3% in MI-control; P < 0.05). Furthermore, GScir and GSr appeared to be the best parameters to identify a TEMI >0.75 24 h after reperfusion. In conclusion, these findings demonstrate the usefulness of speckle tracking imaging in the early evaluation of a cardioprotective strategy in a rat model of ischemia-reperfusion.
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Affiliation(s)
- Frederic Treguer
- Protection et Remodelage du Myocarde, Unité Propre de Recherche de l'Enseignement Supérieur 3860, Université d'Angers, Angers
- Service de Cardiologie, Centre Hospitalier Universitaire d'Angers, Angers
| | - Erwan Donal
- Service de Cardiologie, Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique et d'Innovation Technologique 804, Laboratoire Traitement du Signal et de l'Image, Institut National de la Santé Et de la Recherche Médicale U 642, Rennes; and
| | - Sophie Tamareille
- Protection et Remodelage du Myocarde, Unité Propre de Recherche de l'Enseignement Supérieur 3860, Université d'Angers, Angers
| | - Nehmat Ghaboura
- Protection et Remodelage du Myocarde, Unité Propre de Recherche de l'Enseignement Supérieur 3860, Université d'Angers, Angers
| | - Geneviève Derumeaux
- Cardioprotection, Institut National de la Santé Et de la Recherche Médicale U 886, Université Claude Bernard, Lyon, France
| | - Alain Furber
- Protection et Remodelage du Myocarde, Unité Propre de Recherche de l'Enseignement Supérieur 3860, Université d'Angers, Angers
- Service de Cardiologie, Centre Hospitalier Universitaire d'Angers, Angers
| | - Fabrice Prunier
- Protection et Remodelage du Myocarde, Unité Propre de Recherche de l'Enseignement Supérieur 3860, Université d'Angers, Angers
- Service de Cardiologie, Centre Hospitalier Universitaire d'Angers, Angers
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Deng YB, Liu R, Wu YH, Xiong L, Liu YN. Evaluation of short-axis and long-axis myocardial function with two-dimensional strain echocardiography in patients with different degrees of coronary artery stenosis. ULTRASOUND IN MEDICINE & BIOLOGY 2010; 36:227-233. [PMID: 20045591 DOI: 10.1016/j.ultrasmedbio.2009.09.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Revised: 07/15/2009] [Accepted: 09/27/2009] [Indexed: 05/28/2023]
Abstract
This study was designed to characterize the changes in the peak systolic longitudinal, circumferential and radial strains by using 2-D strain echocardiography in patients with coronary artery stenosis without segmental wall motion abnormalities on conventional 2-D echocardiography. 2D strain echocardiography was performed in 44 patients with different degrees of coronary artery stenosis. Myocardial longitudinal, circumferential and radial strain profiles were obtained and peak systolic strain values were measured. The peak systolic longitudinal strain was significantly reduced in myocardial segments subtended by coronary arteries with greater than 75% stenosis when compared with those subtended by coronary artery with less than 75% stenosis and those in control. Sensitivity and specificity were 74% and 72%, respectively, for peak systolic longitudinal strain to predict segments subtended by coronary arteries with greater than 75% stenosis (cutoff value--17.7%; area under the receiver operating characteristic curve, 0.825). There were no significant differences in circumferential and radial strains among myocardial segments subtended by coronary arteries with greater than 75% stenosis and those with less than 75% stenosis and in control. In conclusion, our study suggests that analysis of long-axis cardiac function by using the 2-D strain echocardiography may help to identify the myocardial segments subtended by coronary arteries with severe stenosis.
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Affiliation(s)
- You-Bin Deng
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China.
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25
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Govind SC, Gadiyaram VK, Quintana M, Ramesh SS, Saha S. Study of Left Ventricular Rotation and Torsion in the Acute Phase of ST-Elevation Myocardial Infarction by Speckle Tracking Echocardiography. Echocardiography 2010; 27:45-9. [DOI: 10.1111/j.1540-8175.2009.00971.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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26
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Liel-Cohen N, Tsadok Y, Beeri R, Lysyansky P, Agmon Y, Feinberg MS, Fehske W, Gilon D, Hay I, Kuperstein R, Leitman M, Deutsch L, Rosenmann D, Sagie A, Shimoni S, Vaturi M, Friedman Z, Blondheim DS. A New Tool for Automatic Assessment of Segmental Wall Motion Based on Longitudinal 2D Strain. Circ Cardiovasc Imaging 2010; 3:47-53. [DOI: 10.1161/circimaging.108.841874] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Identification and quantification of segmental left ventricular wall motion abnormalities on echocardiograms is of paramount clinical importance but is still performed by a subjective visual method. We constructed an automatic tool for assessment of wall motion based on longitudinal strain.
Methods and Results—
Echocardiograms of 105 patients (3 apical views) were blindly analyzed by 12 experienced readers. Visual segmental scores (VSS) and peak systolic longitudinal strain were assigned to each of 18 segments per patient. Ranges of peak systolic longitudinal strain that best fit VSS (by receiver operating characteristic analysis) were used to generate automatic segmental scores (ASS). Comparisons of ASS and VSS were performed on 1952 analyzable segments. There was agreement of wall motion scores between both methods in 89.6% of normal, 39.5% of hypokinetic, and 69.4% of akinetic segments. Correlation between methods was
r
=0.63 (
P
<0.0001). Interobserver and intraobserver reliability using interclass correlation for scoring segmental wall motion into 3 scores by ASS was 0.82 and 0.83 and by VSS 0.70 and 0.69, respectively. Compared with VSS (majority rule), ASS had a sensitivity, specificity, and accuracy of 87%, 85%, and 86%, respectively. ASS and VSS had similar success rates for correct identification of wall motion abnormalities in territories supplied by culprit arteries. VSS had greater specificity and positive predictive values, whereas ASS had higher sensitivity and negative predictive values for identifying the culprit artery.
Conclusions—
Automatic quantification of wall motion on echocardiograms by this tool performs as well as visual analysis by experienced echocardiographers, with a greater reliability and similar agreement to angiographic findings.
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Affiliation(s)
- Noah Liel-Cohen
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Yossi Tsadok
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Ronen Beeri
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Peter Lysyansky
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Yoram Agmon
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Micha S. Feinberg
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Wolfgang Fehske
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Dan Gilon
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Ilan Hay
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Rafael Kuperstein
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Marina Leitman
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Lisa Deutsch
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - David Rosenmann
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Alik Sagie
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Sarah Shimoni
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Mordehay Vaturi
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - Zvi Friedman
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
| | - David S. Blondheim
- From the Soroka University Medical Center (N.L.-C.), Beer Sheva, Israel; Ben-Gurion University (Y.T.), Beer Sheva, Israel; Hadassah University Hospital (R.B., D.G.), Jerusalem, Israel; General Electric Healthcare (P.L., L.D., Z.F.), Haifa, Israel; Rambam Medical Center (Y.A.), Haifa, Israel; Sheba Medical Center (M.S.F., I.H., R.K.), Tel Aviv, Israel; St Vinzenz Hospital (W.F.), Cologne, Germany; Asaff Harofeh Medical Center (M.L.), Zerifin, Israel; Shaare Zedek Medical Center (D.R.), Jerusalem,
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27
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Ruan W, Lu L, Zhang Q, Cao M, Zhu ZB, Wang LJ, Shen WF. Serial assessment of left ventricular remodeling and function by echo-tissue Doppler imaging after myocardial infarction in streptozotocin-induced diabetic swine. J Am Soc Echocardiogr 2009; 22:530-6. [PMID: 19450744 DOI: 10.1016/j.echo.2009.02.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2008] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of this study was to determine the value of Doppler tissue imaging (DTI) in detecting serial changes in left ventricular (LV) geometry and function after myocardial infarction (MI) in diabetic swine. METHODS Thirteen minipigs with streptozotocin-induced diabetes for 1 month and 13 controls were subjected to occlusion of the left anterior descending coronary artery. Echocardiography and DTI were performed before, 30 minutes, 90 minutes, and 4 weeks after left anterior descending coronary artery occlusion. RESULTS At baseline, LV end-diastolic volume and mass were greater in pigs with diabetes. After MI, LV ejection fractions and systolic mitral annular velocities were decreased and LV chambers dilated in both groups, which were exacerbated in animals with diabetes. At 30 minutes, 90 minutes, and 4 weeks after MI, strain rates were significantly lower in both infarct and noninfarct areas in the diabetic group than in controls. CONCLUSIONS DTI proved to be a useful tool in the serial assessment of subclinical LV dysfunction after MI in pigs with diabetes.
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Affiliation(s)
- Wen Ruan
- Department of Cardiology, Rui Jin Hospital, Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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28
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Bertini M, Nucifora G, Marsan NA, Delgado V, van Bommel RJ, Boriani G, Biffi M, Holman ER, Van der Wall EE, Schalij MJ, Bax JJ. Left ventricular rotational mechanics in acute myocardial infarction and in chronic (ischemic and nonischemic) heart failure patients. Am J Cardiol 2009; 103:1506-12. [PMID: 19463507 DOI: 10.1016/j.amjcard.2009.02.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2008] [Revised: 02/05/2009] [Accepted: 02/05/2009] [Indexed: 01/19/2023]
Abstract
Left ventricular (LV) twist and untwisting rate are emerging as global and thorough parameters for assessment of LV function. This study explored differences of LV twist and untwisting rate in patients with acute myocardial infarction (AMI) and patients with ischemic and nonischemic chronic heart failure (HF). Fifty patients with AMI, 49 with ischemic HF, and 38 with nonischemic HF were studied. As a control group, 28 subjects without evidence of structural heart disease were included. Speckle-tracking analysis was applied to LV short-axis images at basal and apical levels. LV twist was defined as the net difference of apical and basal rotations at isochronal time points. The first time derivative of LV untwist was defined as the LV untwisting rate. Compared with control subjects, peak LV twist was decreased in patients with AMI and extremely decreased in those with HF (p <0.001, analysis of variance). A strong correlation (r = 0.87, p <0.001) was found between peak LV twist and LV ejection fraction in the overall study population. LV untwisting rate was progressively decreased in patients with AMI and HF compared with control subjects (p <0.001, analysis of variance). A moderate correlation (r = 0.56, p <0.001) was noted between peak LV untwisting rate and grade of diastolic dysfunction in the overall study population. In conclusion, LV twist and untwisting rate are strongly related to LV systolic and diastolic functions, respectively. Impairment of LV function observed in patients with AMI and HF is associated with a decrease of LV twist and untwisting rate.
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Affiliation(s)
- Matteo Bertini
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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29
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Dandel M, Lehmkuhl H, Knosalla C, Suramelashvili N, Hetzer R. Strain and strain rate imaging by echocardiography - basic concepts and clinical applicability. Curr Cardiol Rev 2009; 5:133-48. [PMID: 20436854 PMCID: PMC2805816 DOI: 10.2174/157340309788166642] [Citation(s) in RCA: 262] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Revised: 09/23/2008] [Accepted: 09/23/2008] [Indexed: 12/13/2022] Open
Abstract
Echocardiographic strain and strain-rate imaging (deformation imaging) is a new non-invasive method for assessment of myocardial function. Due to its ability to differentiate between active and passive movement of myocardial segments, to quantify intraventricular dyssynchrony and to evaluate components of myocardial function, such as longitudinal myocardial shortening, that are not visually assessable, it allows comprehensive assessment of myocardial function and the spectrum of potential clinical applications is very wide. The high sensitivity of both tissue Doppler imaging (TDI) derived and two dimensional (2D) speckle tracking derived myocardial deformation (strain and strain rate) data for the early detection of myocardial dysfunction recommend these new non-invasive diagnostic methods for extensive clinical use. In addition to early detection and quantification of myocardial dysfunction of different etiologies, assessment of myocardial viability, detection of acute allograft rejection and early detection of allograft vasculopathy after heart transplantation, strain and strain rate data are helpful for therapeutic decisions and also useful for follow-up evaluations of therapeutic results in cardiology and cardiac surgery. Strain and strain rate data also provide valuable prognostic information, especially prediction of future reverse remodelling after left ventricular restoration surgery or after cardiac resynchronization therapy and prediction of short and median-term outcome without transplantation or ventricular assist device implantation of patients referred for heart transplantation.The Review explains the fundamental concepts of deformation imaging, describes in a comparative manner the two major deformation imaging methods (TDI-derived and speckle tracking 2D-strain derived) and discusses the clinical applicability of these new echocardiographic tools, which recently have become a subject of great interest for clinicians.
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Affiliation(s)
- Michael Dandel
- Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Germany
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30
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Left Ventricular Mechanics in Idiopathic Dilated Cardiomyopathy: Systolic-Diastolic Coupling and Torsion. J Am Soc Echocardiogr 2009; 22:486-93. [DOI: 10.1016/j.echo.2009.02.022] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Indexed: 11/24/2022]
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31
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Quantification of low-dose dobutamine stress using speckle tracking echocardiography in coronary artery disease. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2009; 10:607-12. [DOI: 10.1093/ejechocard/jep011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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32
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Dandel M, Hetzer R. Echocardiographic strain and strain rate imaging — Clinical applications. Int J Cardiol 2009; 132:11-24. [PMID: 18760848 DOI: 10.1016/j.ijcard.2008.06.091] [Citation(s) in RCA: 192] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2008] [Revised: 06/09/2008] [Accepted: 06/28/2008] [Indexed: 11/24/2022]
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33
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Alharthi MS, Jiamsripong P, Calleja A, Sengupta PP, McMahon EM, Khandheria B, Tajik AJ, Belohlavek M. Selective echocardiographic analysis of epicardial and endocardial left ventricular rotational mechanics in an animal model of pericardial adhesions. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2009; 10:357-62. [DOI: 10.1093/ejechocard/jen338] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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34
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Assessment of left ventricular torsion in patients with anterior wall myocardial infarction before and after revascularization using speckle tracking imaging. Chin Med J (Engl) 2008. [DOI: 10.1097/00029330-200808020-00008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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35
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Speckle tracking echocardiography - a new tool for quantification of myocardial function. COR ET VASA 2008. [DOI: 10.33678/cor.2008.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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