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Akay Caglayan H, Kjønås D, Kornev M, Iqbal A, Jazbani M, Rösner A. Resting segmental speckle tracking strain and strain rate in stable coronary artery disease and revascularized myocardial infarction. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024:10.1007/s10554-024-03200-0. [PMID: 39179715 DOI: 10.1007/s10554-024-03200-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 07/16/2024] [Indexed: 08/26/2024]
Abstract
Patients with acute coronary artery disease (CAD) exhibit reduced global and regional strain and strain rate (S/SR). However, knowledge about segmental S/SR in stable CAD patients is still limited. This study aimed to investigate whether resting segmental S/SR measurements differ in patients with chronic chest pain who have normal coronary arteries or stenotic coronary arteries, and to compare these measurements to those in patients with revascularized myocardial infarction (MI). We prospectively enrolled 510 patients with chronic chest pain referred for coronary computed tomography angiography (CCTA) and 102 patients revascularized after MI. All participants underwent transthoracic echocardiography featuring S/SR analysis. In addition to the patients with MI, patients with suspected CAD based on CCTA findings subsequently underwent invasive coronary angiography (CAG). We assessed global longitudinal strain (GLS) and averaged segmental peak longitudinal strain during systole (PLS), peak systolic strain rate (SRs), peak early diastolic strain rate (SRe), and post systolic shortening (PSS). We also determined functionally reduced segment percentages using differing S/SR cut-off values. There were significant disparities in all average segmental S/SR metrics between the No-CAD and MI groups. SRe was the only S/SR metric that differed significantly between the No-CAD and PCI groups. Differences in SRe, PLS and GLS measurements were observed between the No-CAD and CABG groups. The proportion of diminished segmental S/SR mirrored these findings. For the percentage of pathological segments with varying cut-off values, segmental SRe below 1.5 s- 1 displayed the most marked difference among the four groups (p < 0.001). Revascularized MI patients or those referred to CABG present with diminished segmental S/SR values. However, among patients with chronic chest pain, only segmental SRe discerns subtle disparities between the No-CAD and the PCI group. The diagnostic accuracy of SRe warrants further exploration in subsequent studies.
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Affiliation(s)
- Hatice Akay Caglayan
- Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway.
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Didrik Kjønås
- Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Gastrointestinal surgery, University Hospital of North Norway, Tromsø, Norway
| | - Mikhail Kornev
- Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Amjid Iqbal
- Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Mehran Jazbani
- Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
| | - Assami Rösner
- Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Abdelhafez MA, Aly KME, Youssef AAA. Effect of residual myocardial ischemia on recovery of left ventricular function after primary percutaneous coronary intervention. BMC Cardiovasc Disord 2024; 24:164. [PMID: 38504186 PMCID: PMC10949644 DOI: 10.1186/s12872-024-03777-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/08/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND It is unknown whether the existence of severe bystander damage will affect left ventricular (LV) healing following primary percutaneous coronary intervention (PPCI). The aim of the present analysis was to follow LV recovery using 2D speckle tracking echocardiography (2-D STE) in cases with single versus multiple vessel disease with acute myocardial infarction (AMI) who underwent PPCI and to assess major adverse cardiovascular events (MACEs) within 3 months. PATIENTS AND METHODS This work was conducted at Assiut University Heart Hospital. Of 1026 screened subjects with AMI needing PPCI and assessed for eligibility, only 89 cases fulfilled the inclusion criteria. They were classified into Group A: single vessel and Group B: multiple vessel (≥ 2 vessels) disease. Their data were obtained on admittance and after 90 days. RESULTS In group A compared to group B, there was a statistically preferable value at baseline in the global longitudinal strain- Apical 2 chamber (GLS-A2C) (-12.05 ± 3.57 vs. -10.38 ± 3.92, P = 0.039). At follow-up, the improvement was in all 2-D STE variables, including GLS-long axis (GLS-LAX) (-13.09 ± 3.84 vs.-10.75 ± 3.96, P = 0.006), GLS- apical 4 chamber (GLS-A4C) (-13.23 ± 3.51 vs.-10.62 ± 4.08, P = 0.002), GLS-A2C (-13.85 ± 3.41 vs-10.93 ± 3.97, P < 0.001) and GLS- average (GLS-AVG, P = 0.001). There was a considerable negative correlation between the recovery of LV performance and the existence of multi-vessel lesions (P = 0.009). There was no variance between the groups regarding MACEs. CONCLUSIONS Patients with single vessel lesions who underwent PPCI to the culprit lesion had better recovery of LV function than those with multi-vessel (≥ 2 vessels) lesions who underwent PPCI to the culprit lesion only. The presence of multivessel involvement was an independent risk factor for deterioration in GLS. TRIAL REGISTRATION Registered in clinical trial, clinicalTrial.gov ID NCT04103008 (25/09/2019). IRB registration: 17,100,834 (05/11/2019).
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Affiliation(s)
| | - Karim M E Aly
- Demonstrator of Cardiology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt.
| | - Amr A A Youssef
- Professor of Cardiology, Faculty of Medicine, Assiut University, Assiut, 17575, Egypt
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Fouad A, Farag EM, Roshdy HS, Gad MM, Almaashani S, Sayed A. The possible utility of global longitudinal strain in the risk-stratifying process of non-ST elevation-acute coronary syndrome. Echocardiography 2024; 41:e15769. [PMID: 38329882 DOI: 10.1111/echo.15769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/14/2024] [Accepted: 01/16/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND There are various ways that coronary artery disease (CAD) might present itself. Individual risk stratification for non ST-elevation-acute coronary syndrome (NSTE-ACS) patients should determine whether invasive coronary angiography and revascularization should be scheduled. AIM OF WORK To assess the possible utility of left ventricular global longitudinal strain in the risk-stratifying process of NSTE-ACS. SUBJECTS AND METHODS The cardiology department of Zagazig University in Egypt organized and oversaw this cross-sectional study. The practical portion was carried out on 90 patients with NSTE-ACS based on European society of cardiology (ESC) guidelines (and they agreed for invasive strategy) between May 2019 and December 2020 at Salalah Heart Center in Sultanate of Oman. All patients underwent a full clinical examination, 12-lead ECG, and serial high-sensitivity troponin T (hs-TnT) in addition to a thorough history taking process. On patient's admission, the GRACE risk score was assessed. All patients who were suspected of having NSTE-ACS upon admission underwent transthoracic echocardiography, including two-dimensional speckle tracking (2D-ST). Left ventricular global longitudinal strain (LV-GLS %) was measured and analyzed using 2D speckle tracking. SYNTAX Score was determined for all patients. RESULTS By analysis of the performance of LV-GLS% in prediction of high risk by GRACE score, we found that with cutoff (≥-13.8), the AUC was (0.944) with sensitivity, specificity, PPV, NPV, and accuracy (0.944, 93.3%, 84%, 53.8%, 98.4%, 85.6%), respectively. CONCLUSION Global longitudinal strain can predict accurately high-risk NSTE-ACS patients by GRACE score.
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Affiliation(s)
- Ahmed Fouad
- Salalah Heart Center, Salalah, Oman
- Sednawy Health Insurance Hospital, Zagazig, Egypt
| | | | | | | | | | - Amro Sayed
- Salalah Heart Center, Salalah, Oman
- Faculty of Medicine, Assiut University, Assiut, Egypt
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Kaur P, Fatmi S, Tangco E, Zhao EE, Tariq F, Jahan S, Pich KJ, Aliabadi D. Acute global longitudinal strain evaluation in patients with subacute to chronic chest pain: A pilot, observational study. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2024; 37:100342. [PMID: 38510507 PMCID: PMC10945955 DOI: 10.1016/j.ahjo.2023.100342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 03/22/2024]
Abstract
Background Global longitudinal strain (GLS) imaging is a multifaceted modality that has been utilized in various fields of clinical cardiology in the recent past; however, its implementation for the assessment of ischemia has been limited. Objectives This study aimed to document the functional changes in GLS secondary to acute myocardial ischemia in patients with chronic chest pain. Methods In this unblinded, single-center, investigator-initiated, prospective pilot study, the functional changes in GLS at baseline, during, and immediately following coronary percutaneous intervention were monitored in 10 ambulatory patients who underwent elective catheterization. The exclusion criteria included a low ejection fraction, or a history of chemoradiation, myopathy, and congenital heart disease. Results The average GLS at baseline, during the balloon intervention (BI), and 1-2 min after BI was -15.4 % ± 3.3 %, -10.2 % ± 3.6 %, and -16.1 % ± 4.2 %, respectively. The average GLS decreased significantly by 5.1 % (95 % CI, -7.9 % to -2.3; P = 0.0013) from baseline to BI, increased by 6.3 % (95 % CI, 3.7 % to 8.9 %; P < 0.001) from BI to immediately post-BI, and increased by 0.7 % from baseline to post-BI (95 % CI, -0.4 % to 2.7 %; P = 0.161). Conclusion Patients undergoing BI showed a significant decrease in the average GLS within 1-2 min of BI, with GLS returning to baseline subsequently, clearly demonstrating the efficacy of the modality and the clinical significance of data obtained. These functional changes replicate cardiac perfusion to the segments supplied by respective vessels and its effect with reperfusion or ballooning. The slight increase in GLS from baseline to post-intervention was not statistically significant, which could be attributed to the confounding factors. Analyzing our data, we can safely conclude that GLS is potentially a sensitive, temporal, and quantitative tool for identifying patients with acute ischemia with its limitations and need for further perfection of this modality. Therefore, GLS assessments on 2D echo can be used for risk stratification of patients with subacute to chronic chest pain concerning for ischemia in addition to EKG, troponins and other data obtained by non-invasive testing and evaluation.
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Affiliation(s)
- Paramjit Kaur
- Southeast Medical Center, Dothan, AL, Internal Medicine, United States of America
| | - Syed Fatmi
- Southeast Medical Center, Dothan, AL, Internal Medicine, United States of America
| | - Emmanuel Tangco
- Southeast Medical Center, Dothan, AL, Internal Medicine, United States of America
| | - Elise E. Zhao
- Carilion Medical Center, Roanoke, VA, Internal Medicine, United States of America
| | - Fateeha Tariq
- Southeast Medical Center, Dothan, AL, Internal Medicine, United States of America
| | - Sanjida Jahan
- Southeast Medical Center, Dothan, AL, Internal Medicine, United States of America
| | - Kristy Johnson Pich
- Southeast Medical Center, Dothan, AL, Internal Medicine GME, United States of America
| | - Darius Aliabadi
- Southeast Medical Center, Dothan, AL, Department of Cardiology, United States of America
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Gherbesi E, Gianstefani S, Angeli F, Ryabenko K, Bergamaschi L, Armillotta M, Guerra E, Tuttolomondo D, Gaibazzi N, Squeri A, Spaziani C, Pizzi C, Carugo S. Myocardial strain of the left ventricle by speckle tracking echocardiography: From physics to clinical practice. Echocardiography 2024; 41:e15753. [PMID: 38284665 DOI: 10.1111/echo.15753] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/21/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Speckle tracking echocardiography (STE) is a reliable imaging technique of recognized clinical value in several settings. This method uses the motion of ultrasound backscatter speckles within echocardiographic images to derive myocardial velocities and deformation parameters, providing crucial insights on several cardiac pathological and physiological processes. Its feasibility, reproducibility, and accuracy have been widely demonstrated, being myocardial strain of the various chambers inserted in diagnostic algorithms and guidelines for various pathologies. The most important parameters are Global longitudinal strain (GLS), Left atrium (LA) reservoir strain, and Global Work Index (GWI): based on large studies the average of the lower limit of normality are -16%, 23%, and 1442 mmHg%, respectively. For GWI, it should be pointed out that myocardial work relies primarily on non-invasive measurements of blood pressure and segmental strain, both of which exhibit high variability, and thus, this variability constitutes a significant limitation of this parameter. In this review, we describe the principal aspects of the theory behind the use of myocardial strain, from cardiac mechanics to image acquisition techniques, outlining its limitation, and its principal clinical applications: in particular, GLS have a role in determine subclinical myocardial dysfunction (in cardiomyopathies, cardiotoxicity, target organ damage in ambulatory patients with arterial hypertension) and LA strain in determine the risk of AF, specifically in ambulatory patients with arterial hypertension.
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Affiliation(s)
- Elisa Gherbesi
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Silvia Gianstefani
- Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences - DIMEC - Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Francesco Angeli
- Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences - DIMEC - Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Khrystyna Ryabenko
- Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences - DIMEC - Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Luca Bergamaschi
- Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences - DIMEC - Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Matteo Armillotta
- Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences - DIMEC - Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Emiliano Guerra
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico Di Modena, Modena, Italy
| | - Domenico Tuttolomondo
- Cardiology Division, Parma University Hospital, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Nicola Gaibazzi
- Cardiology Division, Parma University Hospital, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Angelo Squeri
- Maria Cecilia Hospital, GVM Care and Research, Cotignola, Ravenna, Italy
| | - Cristina Spaziani
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Carmine Pizzi
- Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences - DIMEC - Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Stefano Carugo
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
- Department of Clinical Sciences and Community Health, University of Milano, Milano, Italy
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Nguyen VA, Nguyen DT, Ong LTT, Tran AV, Tran BLT, Tran CM. Early detection of reduced left ventricular systolic function by 2D speckle tracking echocardiography in patients with primary mitral regurgitation in a Vietnamese cohort. Glob Cardiol Sci Pract 2023; 2023:e202326. [PMID: 38623555 PMCID: PMC11017305 DOI: 10.21542/gcsp.2023.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 08/12/2023] [Indexed: 04/17/2024] Open
Abstract
Background: Mitral regurgitation (MR) is a common heart valve disease, causing many serious complications in several organ systems, especially the cardiovascular system. The 2D speckle tracking echocardiography (STE) is a new technique for detecting potential cardiac dysfunction when only tissue function abnormalities are present. The study aimed to assess left ventricular (LV) systolic function early by STE in patients with primary MR through global LV deformity along the global longitudinal strain (GLS). Methods: An analytical cross-sectional study was performed on 46 patients with moderate to severe primary MR as recommended by the American Society of Echocardiography (ASE) 2017. Results: The prevalence of patients with GLS reduction with ejection fraction (EF) >60%, New York Heart Association (NYHA) I, and left ventricular internal diameter systolic (LVIDs) <40 mm was 38.1%, 35.7%, and 39.5%, respectively. 100% of patients with EF<60% and LVIDs ≥40 mm had reduced GLS (<16%). The GLS index strongly correlates with the NYHA classification, degree of MR, EF, and echocardiographic parameters. Conclusion: GLS index gives a significant sign in the early detection of cardiac function abnormalities before symptoms or other echocardiographic parameters in patients with MR.
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Affiliation(s)
- Vu Anh Nguyen
- Hue University of Medicine and Pharmacy, Hue, Viet Nam
| | - Diem Thi Nguyen
- Can Tho University of Medicine and Pharmacy, Can Tho, Viet Nam
| | | | - An Viet Tran
- Can Tho University of Medicine and Pharmacy, Can Tho, Viet Nam
| | | | - Chau Minh Tran
- Can Tho University of Medicine and Pharmacy, Can Tho, Viet Nam
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Ardelean AM, Olariu IC, Isac R, Jurac R, Stolojanu C, Murariu M, Toma AO, Braescu L, Mavrea A, Doros G. Correlation of Speckle-Tracking Echocardiography with Traditional Biomarkers in Predicting Cardiotoxicity among Pediatric Hemato-Oncology Patients: A Comprehensive Evaluation of Anthracycline Dosages and Treatment Protocols. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1479. [PMID: 37761440 PMCID: PMC10528093 DOI: 10.3390/children10091479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/14/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023]
Abstract
Speckle tracking-echocardiography (STE) is a novel non-invasive imaging tool capable of quantifying myocardial deformation, and thus holds promise in detecting early subclinical myocardial injury. This study aimed to evaluate the correlation of STE with traditional biomarkers in predicting anthracycline-induced cardiotoxicity in the context of varying dosages and treatment protocols in pediatric hemato-oncology patients. We conducted a retrospective study involving pediatric hemato-oncology patients undergoing anthracycline-based chemotherapy. A total of 99 patients were included in the final analysis, with 82 receiving Doxorubicin, of which 58.5% were males, and 17 receiving Epirubicin, of which 70.6% were males, with a median of 10 years old. Traditional biomarkers, such as Troponin I (cTnI) and B-type natriuretic peptide (BNP), were compared with STE parameters, including the global longitudinal strain (GLS), Simpson method of discs (SMOD), and myocardial performance index (MPI). A comprehensive evaluation was conducted based on different dosages of anthracyclines and different treatment protocols, with a follow-up period of one year post-chemotherapy. It was observed that the cTnI levels in the Doxorubicin group were significantly higher (3.2 ng/mL, p = 0.002) than in the Epirubicin group (2.7 ng/mL). However, BNP and NT-proBNP levels were not significantly different between the two groups (p = 0.096 and p = 0.172, respectively). Regarding STE parameters, a significant negative correlation was observed between the anthracycline dose and GLS (Rho = -0.411, p = 0.001), indicating increased cardiotoxicity with dose elevation. The SMOD and MPI gave significantly better values in the Epirubicin group (59.2 and 0.41 vs. 54.4 and 0.36, respectively). However, the ROC analysis did not find GLS, SMOD, or MPI to be significant independent predictors of cardiotoxicity (p > 0.05). There was also considerable variation in cardiotoxicity between the Doxorubicin and Epirubicin study groups, suggesting that the risk of cardiotoxicity is not solely determined by dose. Our study underlines the potential of STE as a sensitive tool for the early detection and prediction of anthracycline-induced cardiotoxicity in pediatric hemato-oncology patients, but only in association with the clinical findings and cardiac biomarkers. While traditional biomarkers still play a role, STE can offer a more accurate prediction of cardiac risk, potentially leading to better management and outcomes for these patients.
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Affiliation(s)
- Andrada Mara Ardelean
- Department of Pediatrics, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (A.M.A.); (I.C.O.); (R.I.); (R.J.); (G.D.)
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.S.); (M.M.); (L.B.)
- Louis Turcanu Emergency Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
| | - Ioana Cristina Olariu
- Department of Pediatrics, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (A.M.A.); (I.C.O.); (R.I.); (R.J.); (G.D.)
- Louis Turcanu Emergency Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
| | - Raluca Isac
- Department of Pediatrics, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (A.M.A.); (I.C.O.); (R.I.); (R.J.); (G.D.)
- Louis Turcanu Emergency Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
| | - Ruxandra Jurac
- Department of Pediatrics, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (A.M.A.); (I.C.O.); (R.I.); (R.J.); (G.D.)
- Louis Turcanu Emergency Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
| | - Cristiana Stolojanu
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.S.); (M.M.); (L.B.)
- Louis Turcanu Emergency Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
| | - Mircea Murariu
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.S.); (M.M.); (L.B.)
- Louis Turcanu Emergency Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
| | - Ana-Olivia Toma
- Department of Dermatology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Laurentiu Braescu
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.S.); (M.M.); (L.B.)
- Department of Cardiovascular Surgery, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Center for Translational Research and Systems Medicine (CERT-MEDS), “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Adelina Mavrea
- Department of Internal Medicine I, Cardiology Clinic, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Gabriela Doros
- Department of Pediatrics, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (A.M.A.); (I.C.O.); (R.I.); (R.J.); (G.D.)
- Louis Turcanu Emergency Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
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Bhore A, Shah P, Hardas S, Asawa M. Myocardial strain analysis by 4D-speckle tracking echocardiography for prediction of coronary artery disease severity in patients with stable angina pectoris. Indian Heart J 2023:S0019-4832(23)00041-X. [PMID: 36894121 DOI: 10.1016/j.ihj.2023.03.002] [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: 09/26/2022] [Revised: 02/17/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023] Open
Abstract
OBJECTIVE We sought to evaluate the myocardial strain by four-dimensional speckle-tracking echocardiography (4D-STE) in patients with stable angina pectoris (SAP) to determine the severity of coronary artery disease (CAD) based on the Gensini score. METHODS The present study comprised of 150 patients with SAP. Patients with history of SAP, normal left ventricular ejection fraction, and without regional wall motion abnormalities (RWMA) were scheduled for elective coronary angiography. Based on Gensini score, there were two groups: non-critical stenosis group [Gensini score (0-19), n=117] and critical stenosis group [Gensini score ≥20, n=33]. Correlation between Gensini score and 4D-STE strain parameters were investigated. RESULTS Out of 150 patients, critical stenosis group had significantly depressed values of all 4D-STE strain parameters than non-critical stenosis group (P <0.001), except global radial strain (GRS) parameter. Significant positive correlation was found between Gensini score and 4D global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS) with Spearman's correlation coefficient (ρ) as 0.626, 0.548, and 0.631, respectively (P <0.001), whereas significant negative correlation was found between Gensini score and GRS (ρ = -0.433, P <0.001). A 4D GLS value of ≥ -17 had 84.9% sensitivity and 97.4% specificity, GAS ≥ -31 (90.9% sensitivity, 78.6% specificity), GCS ≥ -17 (69.7% sensitivity, 92.3% specificity), and GRS < 47 (sensitivity 72.7%, specificity 76.1%) to detect critical CAD described by Gensini score ≥20. CONCLUSION The 4D-STE can aid in the assessment of severe CAD stenosis with good sensitivity and specificity in the patients with SAP without RWMA on traditional echocardiography.
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Affiliation(s)
- Amol Bhore
- Consultant and interventional cardiologist in Department of Cardiology, Sahyadri group of hospitals, Pune-411038, Maharashtra, India.
| | - Prasad Shah
- Fellow of Interventional Cardiology (Toronto, Canada), Fellow of Electrophysiology (Toronto Canada), Head of department in Department of Cardiology, Poona hospital and research centre, Pune-411030, Maharashtra, India.
| | - Suhas Hardas
- Consultant and interventional cardiologist and Director of Cath lab in Department of Cardiology, Sahyadri group of hospitals, Pune-411038, Maharashtra, India.
| | - Madhusudan Asawa
- Consultant and interventional cardiologist in Department of Cardiology, Poona hospital and research centre, Pune-411030, Maharashtra, India.
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Nabati M, Golshani S, Rahmani M, Yazdani J, Parsaee H. The Association Between Postsystolic Index and SYNTAX Score in Hospitalized Patients With Non-ST-Elevation Acute Coronary Syndrome. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2023. [DOI: 10.1177/87564793231153656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: Non-ST-elevation acute coronary syndrome (NSTE-ACS) is a heterogeneous disorder including subgroups with a low or high risk for myocardial ischemia. The presence of postsystolic index (PSI) is associated with myocardial ischemia. The focus of this study was to find probable association between PSI and severity of coronary artery disease (CAD) in a cohort of patients. Materials and Methods: This was a cross-sectional study that consisted of 83 patients with unstable angina, non-ST-segment myocardial infarction (UA/NSTEMI), and a left ventricular ejection fraction ≥50%, without visible regional wall motion abnormalities. All patients underwent echocardiography, and global longitudinal strain (GLS), PSI, and mitral annular peak systolic (s′) and early diastolic (e′) velocities were measured. Coronary angiography was then performed, and a SYNTAX score was calculated. Results: The patient cohort was divided into two groups based on their high and low SYNTAX scores. PSI and GLS were higher in those patients with a higher SYNTAX score than in individuals with a lower score (85.04% ± 67.02% vs 46.67 ± 39.03, P = .001 and −16.09 ± 3.70 vs −17.99 ± 2.87, P = .012, respectively). Among the different variables assessed, only PSI was an independent predictor of a high SYNTAX score ( B = 1.014, 95% confidence interval [CI]: 1.001–1.027, P = .034). Conclusion: This cohort study demonstrated that a cumulative PSI may be predictive of much more complex and extensive CAD, especially in patients with UA/NSTEMI.
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Affiliation(s)
- Maryam Nabati
- Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Fatemeh Zahra Teaching Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Samad Golshani
- Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Fatemeh Zahra Teaching Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Rahmani
- Student Research Committee, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani
- Department of Biostatics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Homa Parsaee
- Student Research Committee, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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10
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Abdel Mawla TS, Abdel Wanees WS, Abdel Fattah EM, El Khashab KA, Momtaz OM. Diagnostic accuracy of global longitudinal strain in prediction of severity and extent of coronary artery stenosis in patients with acute coronary syndrome. Acta Cardiol 2023; 78:109-117. [PMID: 35900302 DOI: 10.1080/00015385.2022.2066810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND 2 D Speckle tracking echocardiography (STE) is a non-invasive, angle-independent, semiautomatic and objective technique that quantitatively assesses global and regional longitudinal systolic strain and provides a single bull's eye map for segmental wall strain of the left ventricle. OBJECTIVES assessment of the accuracy of global longitudinal strain (GLS) using STE in the detection of resting myocardial ischaemia and its severity compared with visual assessment of wall motion score index by conventional 2 D echo. PATIENTS AND METHODS 100 patients who presented with ACS were included. Wall motion score index (WMSI) was calculated in a 16-segment model and compared with GLS assessed in left ventricle 17 segments and calculated automatically by summation of regional longitudinal peak systolic strain (RLS) using STE. Quantitative coronary angiography was performed on clinical indication and significant stenosis was defined as a 70% reduction of the arterial lumen. RESULTS 56 patients (56%) of patients were males with a mean age of 58.3 years. GLS showed a significant positive correlation between ejection fraction (EF) and GLS (p < 0.05), (r value 0.514) and a good significant negative correlation between WMSI and GLS (p < 0.05), (r value 0.593). And a good significant correlation between GLS and both severity of the lesion and the number of affected vessels was found (p < 0.05). ROC curves showed the cut-off point of GLS was (-15.9) for predicting lesion ≥70% with 88.1% sensitivity, 90.2% specificity respectively. CONCLUSION GLS has higher specificity, sensitivity, and diagnostic accuracy for the detection of the severity of lesion and number of the vessel affected than WMSI.
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Ahmadi ZA, Mokhtari Dizaji M, Sadeghpour A, Khesali H, Firouzi A. Estimation of the segmental left ventricular physical and mechanical parameters using echocardiographic imaging for stent candidate patients. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:20-28. [PMID: 36069427 DOI: 10.1002/jcu.23324] [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: 02/24/2022] [Revised: 06/08/2022] [Accepted: 07/15/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Left ventricular (LV) dysfunction can be assessed by quantifying LV structure. In this study, physical parameters were extracted, including the systolic strain, wall stress, and elastic modulus of LV to diagnose stent candidate patients from the control group. METHODS Based on angiography results, 88 patients with coronary artery disease (CAD) were divided into 64 patients candidates for PCI (percutaneous coronary intervention) and 24 patients in the control group. With the thick-walled ellipsoidal model, the passive wall stresses at end-systole and end-diastole were estimated. Regional circumferential strain and regional longitudinal strain were obtained by speckle tracking technique. RESULTS The inferoseptal circumferential wall stress in end-systole was statistically significant for the PCI group compared to the control group (p = .026). Anterior and inferoseptal circumferential strain for the PCI group (-17.25 ± 4.22 and -18.21 ± 4.04%) compared to the control group (-21.71 ± 4.74 and 20.58 ± 3.04%) were statistically significant, respectively (p = .000 and p = .011). Anterior and inferoseptal circumferential elastic modulus were statistically significant (p = .000 and p = .005). The receiver operator characteristic (ROC) curve analysis revealed that anterior and inferoseptal circumferential elastic modulus had the highest area under the curve with 76.6% sensitivity, 83.3% specificity for anterior circumferential, 68.8% sensitivity, and 70.8% specificity for inferoseptal circumferential, for the diagnosis of stent candidate patients. CONCLUSIONS Regional elastic modulus parameter is suggested as a noninvasive and quantitative method for measuring LV function. Strain and stress parameters using the STE method and geometrical model can be helpful for diagnostic stent candidate patients.
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Affiliation(s)
- Zeinab Alsadat Ahmadi
- Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Manijhe Mokhtari Dizaji
- Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Anita Sadeghpour
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamideh Khesali
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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12
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Sankaran R, Sadhanandham S, Senguttuvan N, Muralidharan T, Balakrishnan V, Panchanatham M, Boppana D, Balasubramaniyan J. Applying resting global longitudinal strain by two-dimensional speckle tracking as a noninvasive diagnostic tool in predicting coronary artery disease. JOURNAL OF THE PRACTICE OF CARDIOVASCULAR SCIENCES 2022. [DOI: 10.4103/jpcs.jpcs_15_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Yadav K, Prajapati J, Singh G, Patel I, Karre A, Bansal PK, Garhwal V. The correlation between speckle-tracking echocardiography and coronary angiography in suspected coronary artery disease with normal left ventricular function. J Cardiovasc Thorac Res 2022; 14:234-239. [PMID: 36699556 PMCID: PMC9871166 DOI: 10.34172/jcvtr.2022.30520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 10/09/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction: Our study objects to determine the diagnostic accuracy of two-dimensional speckle tracking echocardiography (2DSTE) in predicting presence and severity of coronary artery disease (CAD). Methods: Patients with stable angina pectoris with normal left ventricular function (>50%) undergoing coronary angiography were enrolled and subjected to speckle tracking echocardiography. Global longitudinal peak systolic strain was measured and correlated to the results of coronary angiography for each patient. Results: Number of male (P=0.001), diabetes (P=0.01) and smoking (P=0.01) patients were significantly higher in the CAD group compared to non-CAD patients. Global longitudinal peak systolic strain (GLPSS) was significantly (P=0.0001) lower in CAD patients in comparison to non- CAD patients. GLPSS showed significantly lower in patients with Syntax score (SS)≥22 in comparison to SS<22. Cut-off value -19 for GLPSS could be used to predict the presence of significant CAD with 80.6% sensitivity and 76.5% specificity (area under curve (AUC) -0.83, P=0.0001). The mean GLPSS value decreased as the number of diseased coronary vessels increased (P=0.0001). The optimal cut-off value of -16 GLPSS with a sensitivity of 76.7% and specificity of 83.3% [AUC 0.84, P<0.0001] was found significant to predict CAD severity. Multivariate regression of GLPSS and another risk factor for predicting significant CAD, GLPSS showed OR=1.55 (CI-1.36-1.76) P=0.0001 for predicting the presence of CAD. Conclusion: 2DSTE can be used as a non-invasive screening test in predicting presence, extent and severity of significant CAD patients with suspected stable angina pectoris.
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Affiliation(s)
- Krishan Yadav
- Yatharth Super Speciality Hospital, Noida, UP, India
| | - Jayesh Prajapati
- Department of Cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India,Corresponding Author: Jayesh Prajapati,
| | - Gaurav Singh
- Department of Cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India
| | - Iva Patel
- Department of Research U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India
| | - Ajay Karre
- Department of Cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India
| | - Pradeep Kumar Bansal
- Department of Cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India
| | - Vicky Garhwal
- Department of Cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad-380016, Gujarat, India
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14
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Akiash N, Mohammadi M, Mombeini H, Nikpajouh A. Myocardial strain analysis as a non-invasive screening test in the diagnosis of stable coronary artery disease. Egypt Heart J 2021; 73:49. [PMID: 34032936 PMCID: PMC8149515 DOI: 10.1186/s43044-021-00173-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/13/2021] [Indexed: 11/16/2022] Open
Abstract
Background Coronary artery disease (CAD) is one of the most prevalent diseases around the world; however, finding the best noninvasive, low-cost, and more easily accessible test for its screening has been a challenge for several years. Eighty-nine patients suspected of stable CAD underwent 2D-speckle-tracking echocardiography (2DSTE) at resting position and offline longitudinal myocardial strain analysis, followed by coronary angiography. The correlation of the global longitudinal strain (GLS) and territorial longitudinal strain (TLS) with significant CAD (70% and more stenosis in at least one coronary artery) was then evaluated. Results The statistical analysis showed a significant correlation between low GLS and significant CAD (P=0.0001). The results also showed a significant correlation between low TLS and significant CAD in the left and right coronary artery territories. The optimal cut-off point of GLS for the detection of significant CAD was −19.25, with a sensitivity of 76.5% and specificity of 76.6%. Conclusion This study confirmed the usefulness of 2DSTE myocardial strain analysis in diagnosis of CAD for detecting the affected coronary arteries using GLS and SLS.
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Affiliation(s)
- Nehzat Akiash
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Mohammadi
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Hoda Mombeini
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Akbar Nikpajouh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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15
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Pastore MC, Mandoli GE, Contorni F, Cavigli L, Focardi M, D'Ascenzi F, Patti G, Mondillo S, Cameli M. Speckle Tracking Echocardiography: Early Predictor of Diagnosis and Prognosis in Coronary Artery Disease. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6685378. [PMID: 33623788 PMCID: PMC7875622 DOI: 10.1155/2021/6685378] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/12/2020] [Accepted: 01/23/2021] [Indexed: 01/24/2023]
Abstract
Echocardiography represents a first level technique for the evaluation of coronary artery disease (CAD) which supports clinicians in the diagnostic and prognostic workup of these syndromes. However, visual estimation of wall motion abnormalities sometimes fails in detecting less clear or transient myocardial ischemia and in providing accurate differential diagnosis. Speckle tracking echocardiography (STE) is a widely available noninvasive tool that could easily and quickly provide additive information over basic echocardiography, since it is able to identify subtle myocardial damage and to localize ischemic territories in accordance to the coronary lesions, obtaining a clear visualization with a "polar map" useful for differential diagnosis and management. Therefore, it has increasingly been applied in acute and chronic coronary syndromes using rest and stress echocardiography, showing good results in terms of prediction of CAD, clinical outcome, left ventricular remodeling, presence, and quantification of new/residual ischemia. The aim of this review is to illustrate the current available evidence on STE usefulness for the assessment and follow-up of CAD, discussing the main findings on bidimensional and tridimensional strain parameters and their potential application in clinical practice.
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Affiliation(s)
- Maria Concetta Pastore
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
- University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Giulia Elena Mandoli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Francesco Contorni
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Luna Cavigli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Marta Focardi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Flavio D'Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Giuseppe Patti
- University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Sergio Mondillo
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
| | - Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
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16
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Meng S, Qiu L, Wu J, Huang R, Wang H. Two-year left ventricular systolic function of percutaneous coronary intervention vs optimal medical therapy for patients with single coronary chronic total occlusion. Echocardiography 2021; 38:368-373. [PMID: 33475185 DOI: 10.1111/echo.14976] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/29/2020] [Indexed: 01/05/2023] Open
Abstract
In this study, two-dimensional speckle tracking echocardiography (2D-STE) and real-time three-dimensional echocardiography (RT-3DE) were applied to compare the changes of left ventricular systolic function associated with percutaneous coronary intervention (PCI) versus optimal medical therapy (OMT) in patients with single chronic total occlusion (CTO). 63 single CTO patients (age 61.88 ± 8.86 years) were examined by echocardiography and were divided into the PCI group (n = 27) and OMT group (n = 36) according to the initial treatment strategy. Two-dimensional left ventricular ejection fraction (2D-LVEF), two-dimensional indexed left ventricular end-systolic volume (2D-LVESVI), and two-dimensional indexed left ventricular end-diastolic volume (2D-LVEDVI) were measured using two-dimensional echocardiography (2DE). Three-dimensional left ventricular ejection fraction (3D-LVEF), three-dimensional indexed left ventricular end-systolic volume (3D-LVESVI), and three-dimensional indexed left ventricular end-diastolic volume (3D-LVEDVI) were measured using RT-3DE. Global circumferential strain (GCS) and global longitudinal strain (GLS) were measured using 2D-STE. After 2 years of follow-up, there were no significant differences in the 2D-LVEF, 2D-LVESVI, 3D-LVEF, 3D-LVESVI, 3D-LVEDVI, and GCS, except for GLS (P = .001) between the CTO-PCI and CTO-OMT groups. GLS decreased significantly in OMT group (P = .016) in contrast with PCI group in which GLS increased significantly (P = .007). Left ventricular systolic function assessment using 2D-STE showed a significant difference in GLS between CTO-PCI and CTO-OMT. And the patients who chose PCI revascularization at the 2-year follow-up had better left ventricular systolic function improvement than those who were conservatively treated with OMT.
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Affiliation(s)
- Shuang Meng
- Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian City, China
| | - Lin Qiu
- Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian City, China
| | - Jian Wu
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian City, China
| | - Rongchong Huang
- Cardiac Center/Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing City, China
| | - Hui Wang
- Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian City, China
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17
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Saidova MA, Avalyan AA, Oshchepkova EV, Shitov VN, Chazova IE. [Comparative capabilities of the speckle-tracking echocardiography technologiesin two-dimensional and three-dimensional modes in the detection of subclinical cardiotoxicity in patients with breast cancer]. TERAPEVT ARKH 2020; 92:142-147. [PMID: 33720586 DOI: 10.26442/00403660.2020.12.200431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 02/07/2021] [Indexed: 11/22/2022]
Abstract
AIM The study was to assess the deformation properties of the left ventricle (LV) myocardium in patients with breast cancer initially and after anthracycline chemotherapy according to 2D and 3D speckle-tracking echocardiography (STE). MATERIAL AND METHODS the study included 99 patients with triple negative breast cancer with hypertensionandnormotension. All patients underwent standard transthoracic echocardiography with assessment of systolic function of the LV. To assess the indicator of global longitudinal strain (GLS), as a marker of cardiotoxicity, STE was used in two-and three-dimensional modes. In the three-dimensional STE mode, a new strain parameter, the global area strain (GAS) was evaluated. RESULTS The study showed that in patients with breast cancer for a more accurate assessment of LV systolic function (ejection fraction) it is advisable to use 3D-echocardiography. A comparative analysis revealed statistically significantly lower values of the GLS according to the three-dimensional mode of STE compared to two-dimensional. The study also evaluated a new strain parameter GAS (%). In patients with breast cancer during ROC analysis with a value of -14.0, the GAS indicator for the development of subclinical cardiotoxicity showed a sensitivity of 81.5% and a specificity of 73.3%. Сonclusion.the advantage of the STE in the three-dimensional mode, in contrast to the two-dimensional mode, is the simultaneous and more accurate assessment of LVEF. The value of the additional parameter of LV deformation the area of deformation requires further study.
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Affiliation(s)
- M A Saidova
- National Medical Research Center of Cardiology
| | - A A Avalyan
- National Medical Research Center of Cardiology
| | | | - V N Shitov
- National Medical Research Center of Cardiology
| | - I E Chazova
- National Medical Research Center of Cardiology
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18
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Alaika O, Jamai S, Doghmi N, Cherti M. Diagnostic Accuracy of Global Longitudinal Strain for Detecting Significant Coronary Artery Disease in Diabetic Patients without Regional Wall Motion Abnormality. J Saudi Heart Assoc 2020; 32:425-433. [PMID: 33299787 PMCID: PMC7721456 DOI: 10.37616/2212-5043.1096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/25/2020] [Accepted: 08/31/2020] [Indexed: 11/20/2022] Open
Abstract
AIMS Speckle-tracking imaging is a novel method for assessing left ventricular (LV) function and ischemic changes. The aim of this prospective study was to assess the diagnostic accuracy of global longitudinal strain (GLS) and regional longitudinal strain (RLS) parameters at rest in comparison to stress echocardiography findings for detecting significant coronary artery disease (CAD) in patients with diabetes mellitus (DM). METHODS We prospectively studied echocardiographic characteristics at rest with Speckle tracking echocardiography (2D STE) measures; then stress echocardiography and coronary angiography data in 34 diabetic patients without regional wall motion abnormality (RWMA) at rest. Patients were grouped according to coronary angiography and stress echocardiography results into two groups CAD (+) vs control group CAD (-). RESULTS GLS at rest was lower in the CAD (+) group ((-14.2 % ± 3.1 vs -17.8 % ± 3.1 in the control group CAD (-), P=0.004). GLS at rest had the highest area under the ROC curve (AUC) (AUC 0.78, sensitivity 61%, specificity 91%,P=0.009) with the cut-off of -14.5% which is equal to predictive power of wall motion scoring index (WMSI) at peak stress to detect significant CAD (AUC=0.76 (95% CI 0.58-0.94, P= 0.016) with the cut-off value of 1.21). CONCLUSIONS Global longitudinal strain at rest by STE showed excellent specificity (>90%) and good sensitivity (60%) for the diagnosis of severe CAD among the diabetic population with unknown CAD. This is the first study showing that GLS at rest with cutoff value at -14.5% had good and equal diagnostic accuracy as WMSI at peak stress to detect significant CAD among the diabetic population.
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Affiliation(s)
- Oumaima Alaika
- Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | - Souad Jamai
- Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | - Nawal Doghmi
- Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | - Mohamed Cherti
- Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
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Biswas K, Mukherjee A, Nandi S, Khanra D, Sharma RK, Maji S. Utility of global longitudinal strain to detect significant coronary artery disease, its extent and severity in patients with stable ischemic heart disease. Echocardiography 2020; 37:2000-2009. [DOI: 10.1111/echo.14908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/01/2020] [Accepted: 10/09/2020] [Indexed: 02/02/2023] Open
Affiliation(s)
- Kaushik Biswas
- Department of Cardiology NRS Medical College Kolkata India
| | | | - Saumen Nandi
- Department of Cardiology NRS Medical College Kolkata India
| | - Dibbendhu Khanra
- Department of Cardiology Wolverhampton NHS Trust Wolverhampton UK
| | | | - Sujata Maji
- Department of Obstetrics and Gynaecology NRS Medical College Kolkata India
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20
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Comparison of mitral annular displacement and global longitudinal strain imaging for predicting significant coronary atherosclerotic disease in patients of chronic stable angina pectoris. Int J Cardiovasc Imaging 2020; 37:861-870. [PMID: 33078275 DOI: 10.1007/s10554-020-02058-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
Myocardial strain by two-dimensional speckle-tracking echocardiography (2D-STE) is a validated clinical index of myocardial deformation, for predicting CAD in patients with chronic stable angina pectoris (CSAP) with preserved ejection fraction (EF). However, it is complex, imaging dependant with intra and intervendor variability. The mitral annulus displacement (MAD) has been correlated to left ventricular (LV) longitudinal deformation and may be interchanged with strain imaging. This cross-sectional study was conducted on patients with suspected CSAP (n = 146) and preserved LVEF without wall motion abnormalities. We excluded patients with prior heart disease, ACS, arrhythmia, heart failure or poor imaging. GLS, Average MAD and normalized MAD were calculated using 2D-STE by automated function imaging. CAG was gold standard. MAD had significantly lesser dropout due to suboptimal imaging. Receiver operating characteristic (ROC) analysis showed that GLS had significantly better area under curve (AUC) compared to Normalised MAD and Average MAD (P = 0.035) in predicting significant CAD in patients of CSAP. The optimal cut-off of GLS, normalized MAD and Average MAD were ≥ - 20.67% (sensitivity 94.2%, specificity 86.7%), ≤ 15.22% (sensitivity 90.7%, specificity 80%) and ≤ 11.18 mm (sensitivity 83.7%, specificity 71.1%) respectively. GLS showed strong correlation with Normalised MAD (R = 0.669, P < 0.001) and good correlation to Average MAD (R 0.572, P < 0.001). Absolute GLS and Normalised MAD showed significant inverse correlation to SYNTAX score. GLS is a more accurate measure for predicting presence and severity of CAD then MAD however latter is a reliable simpler, robust, and expeditious tool with lesser dropouts. It can be at least of complementary value to other imaging markers for myocardial function when LV curvatures are poorly visualized or in busy outdoors with time constraint.
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21
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Bajracharya P, Acharya KP, Banerjee SK, Ahmed CM, Alam MM, Arzu J, Sheikh N, Osmany D, Ahsan SA. Correlation between Myocardial Strain by 2-D Speckle-Tracking Echocardiography and Angiographic findings by Coronary Angiogram in Stable Angina. MAEDICA 2020; 15:365-372. [PMID: 33312253 PMCID: PMC7726495 DOI: 10.26574/maedica.2020.15.3.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Background and aims: Identification of coronary artery disease by non-invasive means is a subject of interest for all. Myocardial strain has shown some promising results. This study intends to see if change in strain value correlates with the angiographic findings in patients with stable angina. It is also assessing whether myocardial strain can predict the presence of coronary artery disease (CAD) in stable angina patients. Method: This cross-sectional study was carried out on 84 stable angina patients with no previous cardiac history and normal LV function undergoing coronary angiogram for guideline-based indication. After careful history, clinical examination and investigations, including conventional echocardiography, selected participants underwent 2-D speckle tracking echocardiography for measurement of myocardial strain by automated functional imaging. All participants underwent coronary angiogram and stenosis >70% was considered significant. Gensini score was calculated. The myocardial strain value and Gensini score were correlated. Results: Global longitudinal strain (GLS) was significantly lower in patients with significant CAD than those with non-significant CAD (-16.1±2.6% vs -19.4±2.2%; p < 0.001). The optimal cut-off value of GLS, which discriminated between patients with and without significant coronary artery disease, was -18.05% (sensitivity=81.8% and specificity=85%). Also, GLS declined incrementally with the increasing severity of CAD defined by increasing number of stenotic vessels. There was an inverse correlation between GLS and severity of CAD (expressed in Gensini score) in this study (r = 0.669, p< 0.001), meaning that GLS decreased with increasing severity of CAD. GLS remained an independent predictor for the presence of significant CAD after multivariate adjustment for other significant baseline characteristics and echocardiographic parameters. Conclusions: The myocardial strain by 2DSE correlates with the angiographic severity by coronary angiogram in patients with stable angina. It is an independent predictor of significant coronary artery disease, which it can detect with good sensitivity and specificity.
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Affiliation(s)
- Prashant Bajracharya
- Department of Cardiology, Shahid Gangalal National Heart Center, Kathmandu, Nepal
| | - Kiran Prasad Acharya
- Department of Cardiology, Shahid Gangalal National Heart Center, Kathmandu, Nepal
| | - Sajal Krishna Banerjee
- Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | - Md Mashiul Alam
- Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Jahanara Arzu
- Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Naveen Sheikh
- Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Dmmf Osmany
- Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Syed Ali Ahsan
- Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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Li X, Kou H, Dong Y, Zheng C, Wang P, Xu M, Zou C, Wang L. The value of 2D speckle-tracking strain echocardiography in evaluating the relationship between carotid elasticity and left ventricular systolic function in patients with diabetic nephropathy. Insights Imaging 2020; 11:95. [PMID: 32804263 PMCID: PMC7431513 DOI: 10.1186/s13244-020-00897-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/16/2020] [Indexed: 12/02/2022] Open
Abstract
Objective To investigate the relationship between the elasticity of the carotid artery and the LV (left ventricle) systolic function in patients with diabetic nephropathy (DN) by using two-dimensional speckle-tracking strain echocardiography (2D-STE). Methods DN patients (n = 108) and control subjects (n = 112), all of whom underwent echocardiography and carotid ultrasound. Analysis of LV GLS (global longitudinal strain) from the apical two-chamber (2C), three-chamber (3C), and four-chamber (4C) views. Meanwhile, the circumferential strain (CS) of the carotid artery was obtained from the view of the short-axis right common carotid artery. The differences between the two groups were compared, and a correlation analysis between CS and GLS was performed. Results The 4CGLS, 2CGLS, 3CGLS, and CS of the DN group were significantly lower at significant levels in contrast to the control group (p < 0.05). There was a significantly positive correlation of CS with 4CGLS, 2CGLS, and 3CGLS in all subjects (r = 0.809, p = 0.000; r = 0.830, p = 0.000; r = 0.830, p = 0.000, respectively). Conclusion 2D-STE is a relatively new technique for assessing the mechanical characteristics of the carotid artery in patients with DN. Reduced values of CS correlate with reduced LV systolic function as evaluated by strain measurements, which can predict the risk of systolic dysfunction of LV.
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Affiliation(s)
- Xiuyun Li
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children' s Hospital of Wenzhou Medical University, No.109 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Hongju Kou
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children' s Hospital of Wenzhou Medical University, No.109 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Yanyan Dong
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children' s Hospital of Wenzhou Medical University, No.109 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Chao Zheng
- Department of Endocrinology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Pengfei Wang
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children' s Hospital of Wenzhou Medical University, No.109 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Maosheng Xu
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children' s Hospital of Wenzhou Medical University, No.109 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Chunpeng Zou
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children' s Hospital of Wenzhou Medical University, No.109 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China.
| | - Liang Wang
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children' s Hospital of Wenzhou Medical University, No.109 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China.
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Farag SI, El-Rabbat KEED, Ahmed Mostafa S, Abd Alnaby MS, Sabry ASM. The predictive value of speckle tracking during dobutamine stress echocardiography in patients with chronic stable angina. Indian Heart J 2020; 72:40-45. [PMID: 32423559 PMCID: PMC7231862 DOI: 10.1016/j.ihj.2020.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/24/2020] [Accepted: 03/12/2020] [Indexed: 11/18/2022] Open
Abstract
Objective Methods Results Conclusion
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Obaid N, Hadidy SE, Badry ME, Khaled H. The Outcome of Diabetic Patients with Cardiomyopathy in Critical Care Unit: Hospital and Short-Term Outcome in a Period of Six Months to One Year. Open Access Maced J Med Sci 2019; 7:2796-2801. [PMID: 31844439 PMCID: PMC6901858 DOI: 10.3889/oamjms.2019.655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 06/04/2019] [Accepted: 06/12/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is a major risk factor for heart failure (HF) and coronary artery disease (CAD). DM may cause structural changes involving the left ventricle (LV) systolic and diastolic function. AIM To compare patients who have diabetes and ischemic cardiomyopathy (ICM) to those with diabetic cardiomyopathy (DMCMP) regarding LV systolic function, diastolic function, in hospital long term and short-term mortality. METHODS Ninety diabetic patients with heart failure and left ventricular ejection fraction (LVEF) ≤ 35%, admitted to Critical Care Medicine department Cairo University were divided into two groups based on coronary angiography results; group I (ICM) n = 48 patients and group II (DMCMP) n = 42 patients. RESULTS Group I patients had higher mean age (63 ± 7 years), (p = 0.004), Hypertension (p < 0.001) and dyslipidemia (p = 0.008) were significantly more present in group I compared to group II. No significant differences were found regarding LVEF, global longitudinal strain (GLS), E/A and E/É ratio in both groups. A significant difference in the wall motion score index (WMSI) in group I; (1.4 ± 0.4) versus group II; (1.1 ± 0.2), (p = 0.005) was found. In the study, 6 patients had a cardiogenic shock with no documented in-hospital mortality. At 6 months, statistically, significantly higher mortality rates were found in group I, (p = 0.006), while at one year there was no significant difference in the mortality between the two groups, (p = 0.077). In comparison of the survived and non-survived patients at 6 months and one year in group I (ICM) there was a significant difference in LVEF (40 ± 6% vs 23 ± 6%, p < 0.001), GLS (- 8.1 ± 2.4 vs - 4.6 ± 2.6, p = 0.007), E/A (1.25 ± 0.91 vs 1.8 ± 0.5, p = 0.038), E/É (11.68 ± 7.5 vs 21.3 ± 3.6, p = 0.001) respectively. In group ll (DMCMP) there was no documented mortality at 6 months follow up, however, at one year there was statistically significant difference in the mortality between survived and non-survived patients; the LVEF (35 ± 8% vs 25 ± 2%, p = 0.014), GLS (-7.9 ± 2.9% vs -5 ± 0.1%, p = 0.032), E/A (1.45 ± 0.8 vs 3.3 ± 0, p = 0.006) respectively. The E/É ratio in group ll was not significantly different between the groups (15.73 ± 5.3 vs 15 ± 1, p = 0.873). CONCLUSION The combination of cardiomyopathy and diabetes affects LV systolic and diastolic function; however; ischemic cardiomyopathy and diabetic cardiomyopathy had a similar systolic and diastolic function. Ischemic cardiomyopathy is associated with worse prognosis compared to diabetic cardiomyopathy.
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Affiliation(s)
- Najjat Obaid
- Critical Care Medicine Department, Cairo University, Cairo, Egypt
| | - Samir El Hadidy
- Critical Care Medicine Department, Cairo University, Cairo, Egypt
| | - Mahmoud El Badry
- Critical Care Medicine Department, Cairo University, Cairo, Egypt
| | - Hassan Khaled
- Critical Care Medicine Department, Cairo University, Cairo, Egypt
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Utilidad del “speckle tracking” en pacientes no oncológicos. REVISTA COLOMBIANA DE CARDIOLOGÍA 2019. [DOI: 10.1016/j.rccar.2018.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Singh A, Voss WB, Lentz RW, Thomas JD, Akhter N. The Diagnostic and Prognostic Value of Echocardiographic Strain. JAMA Cardiol 2019; 4:580-588. [DOI: 10.1001/jamacardio.2019.1152] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Arushi Singh
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Robert W. Lentz
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - James D. Thomas
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Nausheen Akhter
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Left ventricular global longitudinal strain rate is influenced by stable coronary artery disease. Anatol J Cardiol 2019; 21:350. [PMID: 31142719 PMCID: PMC6683231 DOI: 10.14744/anatoljcardiol.2019.36525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Moustafa S, Elrabat K, Swailem F, Galal A. The correlation between speckle tracking echocardiography and coronary artery disease in patients with suspected stable angina pectoris. Indian Heart J 2017; 70:379-386. [PMID: 29961454 PMCID: PMC6034017 DOI: 10.1016/j.ihj.2017.09.220] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 08/30/2017] [Accepted: 09/26/2017] [Indexed: 11/18/2022] Open
Abstract
Background To examine the value of speckle tracking echocardiography to detect the presence, extent and severity of coronary artery affection in patients with suspected stable angina pectoris. Methods Two hundred candidates with suspected stable angina pectoris and normal resting conventional echocardiography were subjected to speckle tracking echocardiography and coronary angiography. Global and segmental longitudinal peak systolic strain were assessed and were correlated to the results of coronary angiography for each patient. Results There was a statistically significant difference in the mean of global longitudinal peak systolic strain between normal coronaries and different degrees of coronary artery disease (CAD) (−20.11 ± 0.8 for normal, −18.34 ± 2.52 for single vessel, −16.14 ± 2.85 for two vessels, −14.81 ± 2.12 for three vessels, −13.01 ± 2.92 for left main disease). GLPSS showed high sensitivity for the diagnosis of single vessel CAD (90%, specificity 95.1%, cutoff value: −18.44, AUC: 0.954); two vessels disease (90%, sensitivity 88.9%, cutoff value −17.35, AUC: 0.906) and for three vessels CAD (cutoff value −15.33, sensitivity 63% and specificity 72.2% AUC 0.681) segmental LPSS also showed statistical significance for localization of the affected vessel for left anterior descending, left circumflex and right coronary artery (ρ = 0.001) and inverse correlation with syntax score that was significant with high and intermediate score (ρ = 0.001) and insignificant for low syntax score (ρ value 0.05). Conclusion Two-dimensional speckle tracking echocardiography has good sensitivity and specificity to predict the presence, extent and severity of CAD.
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Affiliation(s)
- Shaimaa Moustafa
- Department of Cardiology, Benha Faculty of Medicine, Benha University, and National Heart Institute, Egypt.
| | - Khalid Elrabat
- Department of Cardiology, Benha Faculty of Medicine, Benha University, and National Heart Institute, Egypt
| | - Fathy Swailem
- Department of Cardiology, Benha Faculty of Medicine, Benha University, and National Heart Institute, Egypt
| | - Alaa Galal
- Department of Cardiology, Benha Faculty of Medicine, Benha University, and National Heart Institute, Egypt
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