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Xie WH, Chen LJ, Hu LW, Ouyang RZ, Guo C, Sun AM, Wang Q, Qiu HS, Zhang YQ, Zhang H, Fu QH, Zhong YM. Cardiac Computed Tomography-Derived Left Atrial Strain and Volume in Pediatric Patients With Congenital Heart Disease: A Comparative Analysis With Transthoracic Echocardiography. Front Cardiovasc Med 2022; 9:870014. [PMID: 35795359 PMCID: PMC9251122 DOI: 10.3389/fcvm.2022.870014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/18/2022] [Indexed: 11/21/2022] Open
Abstract
Purpose This study aimed at exploring the feasibility and reproducibility of CCT for the measurement of Left Atrial (LA) strain and volume compared with transthoracic echocardiography (TTE) in pediatric patients with congenital heart disease (CHD). Materials and Methods The present study included 43 postoperative patients with CHD (7.39 ± 3.64 years, 56% male) who underwent clinically indicated CCT, and all patients underwent additional TTE on the same day. LA strain and volume parameters were measured by dedicated software. The correlation and agreement of LA strain and volume parameters were assessed using Pearson’s correlation coefficient and Bland-Altman analysis. Intra-class correlation coefficients (ICC) were used to assess CCT intra-observer and inter-observer reproducibility. Results All strain parameters of CCT were lower compared to TTE (reservoir strain: 28.37 ± 6.92 vs. 32.15 ± 8.15, respectively; conduit strain: 21.33 ± 6.46 vs. 24.23 ± 7.75, respectively; booster strain: 7.04 ± 2.74 vs. 7.92 ± 3.56). While the volume parameters of CCT were higher compared to TTE (LAV: 29.60 ± 19.01 vs. 25.66 ± 17.60, respectively; LAVi: 30.36 ± 22.31 vs. 28.63 ± 19.25, respectively). Both LA strain and volume measurements showed good correlation and agreement between the two modalities (r = 0.63–0.87, p < 0.001). CT-derived LA strain and volume measurements showed good intra- and inter-observer reproducibility using prototype software (ICC = 0.78–0.96). Conclusions CCT was feasible for measuring LA strain and volume with good correlation and high reproducibility as compared with TTE. As a complementary modality, CCT can regard as an accepted method in the evaluation of LA function in pediatric patients with CHD
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Affiliation(s)
- Wei-Hui Xie
- Department of Radiology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li-Jun Chen
- Department of Pediatric Cardiology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li-Wei Hu
- Department of Radiology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Rong-Zhen Ouyang
- Department of Radiology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chen Guo
- Department of Radiology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ai-Min Sun
- Department of Radiology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qian Wang
- Department of Radiology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hai-Sheng Qiu
- Department of Radiology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yu-Qi Zhang
- Department of Pediatric Cardiology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hao Zhang
- Department of Cardiovascular Thoracic Surgery, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qi-Hua Fu
- Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Qi-Hua Fu,
| | - Yu-Min Zhong
- Department of Radiology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Yu-Min Zhong,
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Sunbul M, Midi IG, Agackiran SK, Engin E, Ucem S, Alibaz-Oner F, Sayar N, Direskeneli H, Sadıc BO. Myocardial involvement in Behçet's disease may be higher in patients with Neuro-Behçet's disease: a speckle tracking echocardiographic study. Acta Cardiol 2021; 77:515-523. [PMID: 34392811 DOI: 10.1080/00015385.2021.1965354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Behcet's disease (BD) may present with life threating complications including neurological and cardiovascular involvement. Neuro-Behcet's disease (NBD) is one of the most important causes of morbidity and mortality in patients with BD. The aim of the present study is to investigate whether patients with NBD are different than BD patients with other manifestations in terms of subclinical myocardial dysfunction. METHODS Forty patients with NBD (23 female, mean age: 42.4 ± 9.4 years), 40 patients with BD (9 female, mean age: 39.7 ± 9.0 years) and 40 controls (20 male, mean age: 41.8 ± 6.5 years) were consecutively included in the study. All subjects underwent a transthoracic echocardiography for evaluation of left ventricular (LV) and atrial (LA) functions with two-dimensional (2D) speckle tracking echocardiography (STE). RESULTS Baseline characteristics, clinical data, LV dimensions, systolic and diastolic functions were all in normal range among the groups. LV global longitudinal strain (LV-GLS) was significantly lower in patients with NBD and BD patients without neurologic involvement compared to controls. LA conduit strain was significantly lower in patients with NBD compared to controls. Patients with both parenchymal NBD and vascular NBD manifestations had significantly lower LV-GLS and LA conduit strain compared to controls. Linear regression analysis demonstrated that among cardiovascular risk factors only presence of NBD was the independent predictor of LV-GLS. CONCLUSIONS BD is associated with impaired LV and LA functions. LV-GLS and LA conduit strains of the patients with NBD were lower. NBD was an independent predictor of LV-GLS, suggesting a link between neurological manifestations and cardiac dysfunction in BD patients.
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Affiliation(s)
- Murat Sunbul
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Ipek Gursoy Midi
- Department of Neurology, Marmara University School of Medicine, Istanbul, Turkey
| | - Seda Kutlug Agackiran
- Department of Internal Medicine, Division of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Esin Engin
- Department of Neurology, Marmara University School of Medicine, Istanbul, Turkey
| | - Selen Ucem
- Marmara University School of Medicine, Istanbul, Turkey
| | - Fatma Alibaz-Oner
- Department of Internal Medicine, Division of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Nurten Sayar
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Haner Direskeneli
- Department of Internal Medicine, Division of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Beste Ozben Sadıc
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
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3
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Pommier V, Bredy C, Abassi H, Huguet H, Picot MC, Pierard S, Pasquet A, Iriart X, Thambo JB, Amedro P. Reliability of echocardiographic parameters of the systemic right ventricle systolic function: A prospective multicentre study. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2021. [DOI: 10.1016/j.ijcchd.2021.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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4
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Xie WH, Chen LJ, Hu LW, Ouyang RZ, Guo C, Sun AM, Wang Q, Qiu HS, Yan Q, Zhang YQ, Zhong YM. Postoperative evaluation of left ventricular global strain using cardiac computed tomography in pediatric patients with congenital heart disease: A comparison with echocardiography. Eur J Radiol 2021; 142:109868. [PMID: 34311155 DOI: 10.1016/j.ejrad.2021.109868] [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: 11/19/2020] [Revised: 07/09/2021] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE We explored the feasibility and reproducibility of cardiac computed tomography (CCT)-derived left ventricular (LV) global strain in postoperative children
with congenital heart disease (CHD) and compared its correlation and agreement with transthoracic echocardiography (TTE). METHODS Fifty-one patients (28 males, 23 females) were included who underwent clinically indicated retrospective electrocardiography-triggered CCT. and all patients underwent additional TTE on the same day. LV global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were measured. Correlations of global strains between CCT and TTE were assessed using Pearson's correlation coefficient. Intra-class correlation coefficients (ICC) were used to assess CCT intra-observer and inter-observer reproducibility. RESULTS GLS and GCS were not significantly different between CCT and TTE (GLS: -23.54 ± 3.24 vs. -23.85 ± 3.72, respectively, p = 0.415; GCS: -28.21 ± 3.55 vs. -28.79 ± 3.69, respectively, p = 0.155). GRS was significantly different between CCT and TTE (60.79 ± 15.11 vs. 41.73 ± 4.27, respectively, p < 0.001). There was good correlation between CCT- and TTE-derived GLS (r = 0.70, p < 0.001) and GCS (r = 0.68, p < 0.001), but GRS showed no correlation between CCT and TTE (r = 0.09, p = 0.54). CCT-derived global strain showed good intra- and inter-observer reproducibility (ICC = 0.86-0.92), except the inter-observer reproducibility for GRS (ICC = 0.77). CONCLUSIONS CCT was feasible for postoperative evaluation of LV global strain in pediatric patients with CHD with sufficient reproducibility. CCT-derived global strain can provide additional information in selected CHD patients with poor acoustic windows and who are intolerant to or have contraindications for cardiac magnetic resonance.
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Affiliation(s)
- Wei-Hui Xie
- Diagnostic Imaging Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai 200127, PR China.
| | - Li-Jun Chen
- Department of Pediatric Cardiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai 200127, PR China.
| | - Li-Wei Hu
- Diagnostic Imaging Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai 200127, PR China.
| | - Rong-Zhen Ouyang
- Diagnostic Imaging Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai 200127, PR China.
| | - Chen Guo
- Diagnostic Imaging Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai 200127, PR China.
| | - Ai-Min Sun
- Diagnostic Imaging Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai 200127, PR China.
| | - Qian Wang
- Diagnostic Imaging Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai 200127, PR China.
| | - Hai-Sheng Qiu
- Diagnostic Imaging Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai 200127, PR China.
| | - Qin Yan
- Department of Cardiovascular Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai 200127, PR China.
| | - Yu-Qi Zhang
- Department of Pediatric Cardiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai 200127, PR China.
| | - Yu-Min Zhong
- Diagnostic Imaging Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai 200127, PR China.
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Feasibility of CT-derived myocardial strain measurement in patients with advanced cardiac valve disease. Sci Rep 2021; 11:8793. [PMID: 33888835 PMCID: PMC8062484 DOI: 10.1038/s41598-021-88294-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 04/07/2021] [Indexed: 11/13/2022] Open
Abstract
To explore the feasibility of CT-derived myocardial strain measurement in patients with advanced cardiac valve disease and to compare it to strain measurements derived from transthoracic echocardiography (TTE). 43 consecutive patients with advanced cardiac valve disease and clinically indicated retrospectively gated cardiac CTs were retrospectively analyzed. The longitudinal, circumferential as well as radial systolic strain were determined in all patients utilizing a commercially available CT strain software. In 36/43 (84%) patients, CT-derived longitudinal strain was compared to speckle-tracking TTE. Pearson’s correlation coefficients as well as Bland–Altman analysis were used to compare the CT-derived strain measurements to TTE. The intra- and inter-reader-reliability of the CT-derived strain measurements were assessed by intra-class correlation coefficients (ICCs). Strain measurements were feasible in all patients. CT-derived global longitudinal strain (GLS) correlated moderately with TTE-derived GLS (r = 0.6, p < 0.001). A moderate correlation between CT-derived GLS and CT-derived left ventricular ejection fraction was found (LVEF, r = − 0.66, p = 0.036). Bland–Altman analysis showed a systematic underestimation of myocardial strain by cardiac CT compared to TTE (mean difference: − 5.8%, 95% limit of agreement between − 13.3 and 1.8%). Strain measurements showed an excellent intra- and inter-reader-reliability with an intra-reader ICC of 1.0 and an inter-reader ICC of 0.99 for GLS measurements. CT-derived myocardial strain measurements are feasible in patients with advanced cardiac valve disease. They are highly reproducible and correlate with established parameters of strain measurements. Our results encourage the implementation of CT-derived strain measurement into clinical routine.
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The strain and strain rate imaging paradox in echocardiography: overabundant literature in the last two decades but still uncertain clinical utility in an individual case. Arch Med Sci Atheroscler Dis 2021; 5:e297-e305. [PMID: 33644489 PMCID: PMC7885811 DOI: 10.5114/amsad.2020.103032] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 11/02/2020] [Indexed: 11/17/2022] Open
Abstract
Almost two decades ago strain and strain rate imaging were proposed as a new, potentially more sensitive modality for quantifying both regional and global myocardial function. Until now, however, strain and strain rate imaging have been slow to be incorporated into everyday clinical practice. More recently, two dimensional strain has been claimed as of greater clinical utility, given that it is angle independent, with improved feasibility and reproducibility as compared to tissue Doppler strain. Nevertheless, speckle tracking strain is reliant on 2D image quality and frame rates. Three dimensional speckle tracking could eliminate the problem of through-plane motion inherent in 2D imaging, but 3D strain is currently limited by low frame rates. Another limitation of strain imaging is that the results are dependent on the ultrasound machine on which analyses are performed, with variability in measurements between different vendors. Despite the diagnostic and prognostic advantages of 2D strain, there is a lack of specific therapeutic interventions based on strain and a paucity of long-term large-scale randomized trial evidence on cardiovascular outcomes. After overabundant literature the same definition of normal cut-off values is controversial and not univocal. Further studies are needed, involving both manufacturers and medical professionals, on the additive contribution, possibly different case by case, of interfering and artifactual factors, aside from myocardial function per se. These artifactual determinants and motion artifacts components could be dominant in individual cases and should always be taken into account in the clinical decision making process in a single case.
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Chelakkat M, Jacob M, Sebastian S, Paul G, NM A, Joy B, Afsal M. Echocardiographic abnormalities in patients with chronic liver disease: Observations from Thrissur, Kerala, India. MGM JOURNAL OF MEDICAL SCIENCES 2021. [DOI: 10.4103/mgmj.mgmj_84_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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8
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Nadar SK, Daar S, Abdelmottaleb WA, Shaikh MM, Al Mahrouqi H, Al-Raiisi M, Hassan M, Al Rawahi B, Al Rahbi S. Abnormal diastolic function and Global longitudinal strain in patients with Thalassemia Major on long term chelation therapy. Int J Cardiovasc Imaging 2020; 37:643-649. [PMID: 32965605 DOI: 10.1007/s10554-020-02036-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/18/2020] [Indexed: 11/30/2022]
Abstract
Cardiac complications are the major cause of mortality in patients with Thalassemia major (TM). Cardiac T2* MRI is currently the gold standard for assessing myocardial iron concentration. The aim of our study was to assess whether any echocardiographic parameter would correlate with these findings in patients well established on chelation therapy. This was a prospective study on patients with TM who are regularly followed in our clinic. Patients had a cardiac MRI and echocardiogram within 2 months of each other. Echo parameters included global longitudinal strain and diastolic function. We also compared these findings with those from a cohort of thalassemia intermedia (TI) and normal controls. A total of 84 patients (mean age 26.3 ± 6.1 years, 42.8% male) with TM were enrolled. All had normal left ventricular ejection fraction and only 8 patients had MRI T2* < 10. As compared to 17 patients with TI and 53 controls, these patients had significantly higher E/E' and lower pulmonary vein s/dd ratio suggesting early diastolic dysfunction. 28 patients fulfilled criteria for diastolic dysfunction even in the presence of normal MRI T2*. Global longitudinal strain (GLS) was significantly lower in the TM group as compared to the TI and controls. We found no correlation between any of the echo findings and the MRI T2*in TM patients. In patients with thalassemia and MRI T2* > 20 ms features of diastolic dysfunction persist even in the presence of normal LV function and normal GLS. This suggests that diastolic function remains abnormal even when myocardial iron concentrations are normal and follow up therefore is essential.
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Affiliation(s)
- Sunil K Nadar
- Department of Medicine, Sultan Qaboos University Hospital, POBox 38, Muscat, 123, Oman.
| | - Shahina Daar
- Department of Hematology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.,Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre At Stellenbosch University, Stellenbosch, 7600, South Africa
| | - Wael A Abdelmottaleb
- Department of Medicine, Sultan Qaboos University Hospital, POBox 38, Muscat, 123, Oman
| | - Muhammad M Shaikh
- Department of Medicine, Sultan Qaboos University Hospital, POBox 38, Muscat, 123, Oman
| | - Hafsa Al Mahrouqi
- Department of Clinical Physiology, Sultan Qaboos University Hospital, POBox 38, Muscat, 123, Oman
| | - Majida Al-Raiisi
- Department of Clinical Physiology, Sultan Qaboos University Hospital, POBox 38, Muscat, 123, Oman
| | - Moez Hassan
- Department of Hematology, Sultan Qaboos University Hospital, POBox 38, Muscat, 123, Oman
| | - Badar Al Rawahi
- Department of Hematology, Sultan Qaboos University Hospital, POBox 38, Muscat, 123, Oman
| | - Sarah Al Rahbi
- Department of Hematology, Sultan Qaboos University Hospital, POBox 38, Muscat, 123, Oman
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9
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Jin Wang N, Perry R. A sonographer's guide to the clinical utility of left ventricular speckle tracking strain. SONOGRAPHY 2020. [DOI: 10.1002/sono.12236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Nikolas Jin Wang
- Department of Cardiology Eastern Health Box Hill Victoria Australia
| | - Rebecca Perry
- Medical Sonography, UniSA Allied Heath and Human Performance University of South Australia Adelaide South Australia Australia
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Tsuda T, Kernizan D, Del Grippo E, Thacker D, Kharouf R, Srivastava S. Echocardiographic assessment of ventricular function: Conventional and advanced technologies and their clinical applications. PROGRESS IN PEDIATRIC CARDIOLOGY 2020. [DOI: 10.1016/j.ppedcard.2020.101269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Emara M, Hafez MA, El-Bendary A, Razaky OE. Speckle tracking echocardiography for the evaluation of left ventricular function in children with systemic lupus erythematosus. Lupus 2020; 29:1449-1455. [PMID: 32723060 DOI: 10.1177/0961203320942296] [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: 11/16/2022]
Abstract
BACKGROUND Many studies in adult patients with systemic lupus erythematosus (SLE) have demonstrated that myocardial dysfunction was significantly associated with enhanced disease activity. However, similar studies in paediatric patients with SLE are limited. The aim of this study was to evaluate the role of speckle tracking echocardiography (STE) to detect left ventricular dysfunction in children with active and inactive SLE. METHODS This prospective case-control study was carried out on 50 children with SLE. Thirty healthy age- and sex-matched children comprised the control group. The patients were further subdivided into two subgroups: active SLE and inactive SLE. Laboratory investigations undertaken included complete blood count, renal function, C3, C4, ANA, anti-dsDNA and serum N-terminal pro-B type natriuretic peptide. Echocardiographic examinations were performed on all children and included conventional echocardiography, tissue Doppler imaging (TDI) and two- and three-dimensional STE. RESULTS There was no statistically significant difference in N-terminal pro B natriuretic peptide between the studied groups. The myocardial performance index by TDI was statistically significantly higher in SLE patients compared to controls. STE parameters were statistically significantly lower in SLE patients compared to controls. There was no correlation between STE parameters and disease activity. CONCLUSIONS STE could be a promising technique in the early detection of subclinical left ventricular dysfunction in children with SLE.
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Affiliation(s)
- Mai Emara
- Paediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Maher Abdel Hafez
- Paediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Aml El-Bendary
- Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Osama El Razaky
- Paediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Szilveszter B, Nagy AI, Vattay B, Apor A, Kolossváry M, Bartykowszki A, Simon J, Drobni ZD, Tóth A, Suhai FI, Merkely B, Maurovich-Horvat P. Left ventricular and atrial strain imaging with cardiac computed tomography: Validation against echocardiography. J Cardiovasc Comput Tomogr 2020; 14:363-369. [DOI: 10.1016/j.jcct.2019.12.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/07/2019] [Accepted: 12/05/2019] [Indexed: 12/12/2022]
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13
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Cinotti R, Le Tourneau T, Grillot N, Rooze P, Millour P, Asehnoune K. Influence of mechanical ventilation and loading modifications on left ventricular global longitudinal strain in patients undergoing general anesthesia: a pilot study. Minerva Anestesiol 2020; 86:712-718. [DOI: 10.23736/s0375-9393.20.14079-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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14
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Krishnamoorthy V, Chaikittisilpa N, Lee J, Mackensen GB, Gibbons EF, Laskowitz D, Hernandez A, Velazquez E, Lele AV, Vavilala MS. Speckle Tracking Analysis of Left Ventricular Systolic Function Following Traumatic Brain Injury: A Pilot Prospective Observational Cohort Study. J Neurosurg Anesthesiol 2020; 32:156-161. [PMID: 30676403 PMCID: PMC6646112 DOI: 10.1097/ana.0000000000000578] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Systolic dysfunction and reduction in left ventricular ejection fraction (LVEF) has been documented after traumatic brain injury (TBI). Speckle tracking is an emerging technology for myocardial strain assessment which has been utilized to identify subclinical myocardial dysfunction, and is most commonly reported as global longitudinal strain (GLS). We examined myocardial strain and regional strain patterns following moderate-severe TBI. MATERIALS AND METHODS We conducted a prospective cohort study of moderate-severe TBI patients (Glasgow Coma Scale≤12) and age/sex-matched controls. Transthoracic echocardiography was performed within the first day and 1 week following TBI. Myocardial function was assessed using both GLS and LVEF, and impaired systolic function was defined as GLS >-16% or LVEF ≤50%. Regional strain patterns and individual strain trajectories were examined. RESULTS Thirty subjects were included, 15 patients with TBI and 15 age/sex-matched controls. Among patients with adequate echocardiographic windows, systolic dysfunction was observed in 2 (17%) patients using LVEF and 5 (38%) patients using GLS within the first day after TBI. Mean GLS was impaired in patients with TBI compared with controls (-16.4±3.8% vs. -20.7±1.8%, P=0.001). Regional myocardial examination revealed impaired strain primarily in the basal and mid-ventricular segments. There was no improvement in GLS from day 1 to day 7 (P=0.81). CONCLUSIONS Myocardial strain abnormalities are common and persist for at least 1 week following moderate-severe TBI. Speckle tracking may be useful for the early diagnosis and monitoring of systolic dysfunction following TBI.
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Affiliation(s)
- Vijay Krishnamoorthy
- Department of Anesthesiology, Duke University
- Harborview Injury Prevention & Research Center, University of Washington
| | | | - James Lee
- Department of Internal Medicine, Division of Cardiology, Henry Ford Health System
| | | | - Edward F. Gibbons
- Harborview Injury Prevention & Research Center, University of Washington
- Department of Cardiology, University of Washington
| | | | - Adrian Hernandez
- Department of Internal Medicine, Division of Cardiology, Duke University
| | - Eric Velazquez
- Department of Internal Medicine, Division of Cardiology, Yale University
| | - Abhijit V. Lele
- Department of Anesthesiology & Pain Medicine, University of Washington
| | - Monica S. Vavilala
- Department of Anesthesiology & Pain Medicine, University of Washington
- Harborview Injury Prevention & Research Center, University of Washington
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Huang YC, Tsai HH, Fu TC, Hsu CC, Wang JS. High-Intensity Interval Training Improves Left Ventricular Contractile Function. Med Sci Sports Exerc 2020; 51:1420-1428. [PMID: 30829901 DOI: 10.1249/mss.0000000000001931] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Improved myocardial contractility is a critical circulatory adaptation to exercise training. However, the types of exercise that enhance left ventricular (LV) contractile and diastolic functions have not yet been established. This study investigated how high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) influence LV mechanics during exercise. METHODS Fifty-four healthy sedentary men were randomized to engage in either HIIT (3-min intervals at 40% and 80% of V˙O2max, n = 18) or MICT (sustained 60% of V˙O2max, n = 18) for 30 min·d, 5 d·wk for 6 wk or to a control group (n = 18) that did not engage in exercise intervention. LV mechanics during semiupright bicycle exercise tests were measured by two-dimensional speckle-tracking echocardiography. RESULTS Before the interventions, acute bicycle exercise increased (i) peak basal/apical radial and circumferential and peak longitudinal strains and strain rates, (ii) peak basal/apical rotations and torsion, and (iii) peak systolic twisting and early diastolic untwisting velocities in the LV. After the interventions, the HIIT group exhibited greater LV mass and diastolic internal diameter as well as higher ratio of E wave to A wave and early diastolic propagation velocity than did the MICT group. Despite decreased peak apical rotation and torsion, HIIT enhanced peak apical radial strain and strain rate as well as shortened the time to reach peak untwisting velocity in the LV during exercise. However, the LV mechanics during exercise were unchanged in the control group. CONCLUSION HIIT but not MICT induces eccentric myocardial hypertrophy. Moreover, HIIT effectively improves the LV mechanics during exercise by increasing contractile and diastolic functions.
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Affiliation(s)
- Yu-Chieh Huang
- Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical Collage, Chang Gung University, Tao-Yuan, TAIWAN
| | - Hsing-Hua Tsai
- Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical Collage, Chang Gung University, Tao-Yuan, TAIWAN
| | - Tieh-Cheng Fu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, TAIWAN.,Heart Failure Center, Chang Gung Memorial Hospital, Keelung, TAIWAN
| | - Chih-Chin Hsu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, TAIWAN.,Heart Failure Center, Chang Gung Memorial Hospital, Keelung, TAIWAN
| | - Jong-Shyan Wang
- Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical Collage, Chang Gung University, Tao-Yuan, TAIWAN.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, TAIWAN.,Heart Failure Center, Chang Gung Memorial Hospital, Keelung, TAIWAN
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16
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Trivedi SJ, Altman M, Stanton T, Thomas L. Echocardiographic Strain in Clinical Practice. Heart Lung Circ 2019; 28:1320-1330. [DOI: 10.1016/j.hlc.2019.03.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/17/2019] [Accepted: 03/22/2019] [Indexed: 01/07/2023]
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17
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Review of Echocardiographic Findings in Patients with Obstructive Sleep Apnea. Can Respir J 2018; 2018:1206217. [PMID: 30581512 PMCID: PMC6276396 DOI: 10.1155/2018/1206217] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 11/01/2018] [Indexed: 01/11/2023] Open
Abstract
Obstructive sleep apnea (OSA) causes recurrent apneas due to upper respiratory tract collapse, leading to sympathetic nervous system hyperactivation and increased cardiovascular risk. Moderate and severe forms of obstructive sleep apnea are associated with increased atrial volumes and affect left ventricular diastolic and then systolic function. Right ventricular ejection fraction can be accurately assessed via three-dimensional echocardiography, while bidimensional imaging can only provide a set of surrogate parameters to characterize systolic function (tricuspid annulus plane systolic excursion, right ventricular fractional area change, and lateral S'). Tissue Doppler imaging is a more sensitive tool in detecting functional ventricular impairment, but its use is limited by angle dependence and the unwanted influence of tethering forces. Two-dimensional speckle tracking echocardiography is considered more suitable for the assessment of ventricular function, as it is able to distinguish between active and passive wall motion. Abnormal strain values, a marker of subclinical myocardial dysfunction, can be detected even in patients with normal ejection fraction and chamber volumes. The left ventricular longitudinal strain is more affected by the presence of obstructive sleep apnea than circumferential strain values. Although the observed OSA-induced changes are subtle, the benefit of a detailed echocardiographic screening for subclinical heart failure in OSA patients on therapy adherence and outcome should be addressed by further studies.
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18
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Attachaipanich T, Krittayaphong R. Fragmented QRS as a predictor of in-hospital life-threatening arrhythmic complications in ST-elevation myocardial infarction patients. Ann Noninvasive Electrocardiol 2018; 24:e12593. [PMID: 30117636 DOI: 10.1111/anec.12593] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 07/24/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Fragmented QRS (fQRS) complex is an electrocardiographic pattern that reflects the inhomogeneity of ventricular depolarization. The aims of this study were to determine the prognostic significance of fQRS for predicting in-hospital life-threatening arrhythmic complications in ST-elevation myocardial infarction (STEMI) patients, and to identify the most appropriate duration of cardiac rhythm monitoring in STEMI patients with fQRS. METHODS Patients diagnosed with and treated for STEMI at Siriraj Hospital (Bangkok, Thailand) during 2009-2012 were enrolled. Patients were divided according to fQRS status (having or not having fQRS) at hospital admission. The primary outcome was in-hospital life-threatening arrhythmic events, including sustained ventricular tachycardia and ventricular fibrillation. Time to last life-threatening arrhythmic event from hospital admission was recorded. RESULTS Of the 452 patients that were included, 96 patients (21.2%) had fQRS. There were significantly more life-threatening arrhythmic events in the fQRS group than in the non-fQRS group (22.9% vs. 4.5%, respectively; p < 0.001). Median (IQR) time to last life-threatening arrhythmic event from hospital admission was significantly longer in fQRS than in non-fQRS (6.58 hr [3.08-39.34] vs. 2.59 hr [1.75-5.75], respectively; p = 0.047). Multivariate analysis identified fQRS as an independent predictor of in-hospital life-threatening arrhythmic events (OR: 4.162, 95% CI: 1.669-10.384; p = 0.002). CONCLUSIONS The presence of fQRS complex on admission ECG was found to be an independent predictor of in-hospital life-threatening arrhythmic events in STEMI patients. Since the time to last life-threatening arrhythmic event from admission was longer in fQRS than in non-fQRS, cardiac rhythm monitoring longer than 24-48 hr may be needed in patients with fQRS.
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Affiliation(s)
- Tanawat Attachaipanich
- Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Rungroj Krittayaphong
- Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Krishnamoorthy V, Rowhani-Rahbar A, Gibbons EF, Rivara FP, Temkin NR, Chaikittisilpa N, Luk K, Vavilala MS. The authors reply. Crit Care Med 2017; 45:e1194-e1195. [PMID: 29028720 PMCID: PMC5708866 DOI: 10.1097/ccm.0000000000002663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Vijay Krishnamoorthy
- Department of Anesthesiology and Pain Medicine, University of Washington
- Department of Epidemiology, University of Washington
- Harborview Injury Prevention and Research Center, University of Washington
| | - Ali Rowhani-Rahbar
- Department of Epidemiology, University of Washington
- Harborview Injury Prevention and Research Center, University of Washington
| | - Edward F. Gibbons
- Department of Medicine, Division of Cardiology, University of Washington
- Harborview Injury Prevention and Research Center, University of Washington
| | - Frederick P. Rivara
- Department of Epidemiology, University of Washington
- Department of Pediatrics, University of Washington
- Harborview Injury Prevention and Research Center, University of Washington
| | - Nancy R. Temkin
- Department of Neurosurgery, University of Washington
- Department of Biostatistics, University of Washington
- Harborview Injury Prevention and Research Center, University of Washington
| | | | - Kevin Luk
- Department of Anesthesiology and Pain Medicine, University of Washington
| | - Monica S. Vavilala
- Department of Anesthesiology and Pain Medicine, University of Washington
- Harborview Injury Prevention and Research Center, University of Washington
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20
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Di Odoardo LAF, Giuditta M, Cassinerio E, Roghi A, Pedrotti P, Vicenzi M, Sciumbata VM, Cappellini MD, Pierini A. Myocardial deformation in iron overload cardiomyopathy: speckle tracking imaging in a beta-thalassemia major population. Intern Emerg Med 2017; 12:799-809. [PMID: 28456904 DOI: 10.1007/s11739-017-1670-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/24/2017] [Indexed: 12/13/2022]
Abstract
Traditional echocardiography is unable to detect neither the early stages of iron overload cardiomyopathy nor myocardial iron deposition. The aim of the study is to determine myocardial systolic strain indices in thalassemia major (TM), and assess their relationship with T2*, a cardiac magnetic resonance index of the severity of cardiac iron overload. 55 TM cases with recent cardiac magnetic resonance (CMR-T2*) underwent speckle tracking analysis to assess regional myocardial strains and rotation. The results were compared with a normal control group (n = 20), and were subsequently analyzed on the basis of the CMR-T2* values. Two TM groups were studied: TM with significant cardiac iron overload ("low" T2*, ≤20 ms; n = 21), and TM with normal T2* values ("normal" T2*, >20 ms; n = 34). TM patients show significant, uniform decrease in circumferential and radial strain (P < 0.05), and a remarkable reduction in end-systolic rotation, both global, and for all segments (P < 0.001). No significant differences were found between the low- and the normal T2* group either in regional strains and rotation or in standard echocardiographic and CMR parameters. Spearman's correlation coefficient shows no significant correlation between myocardial strains, rotation and cardiac T2* values. In conclusion, our results are in accordance with recent evidence that myocardial iron overload is not the only mechanism underlying iron cardiomyopathy in TM. Strain imaging can predict subclinical myocardial dysfunction irrespective of CMR-T2* values, although it cannot replace CMR-T2* in assessing cardiac iron overload. Finally, it might be useful to appropriately time cardioactive treatment.
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Affiliation(s)
- Luca Antonio Felice Di Odoardo
- Cardiovascular Disease Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy.
| | - Marianna Giuditta
- Cardiovascular Disease Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy
- Rare Diseases Center, Department of Medicine and Medical Specialties, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122, Milan, Italy
| | - Elena Cassinerio
- Rare Diseases Center, Department of Medicine and Medical Specialties, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122, Milan, Italy
| | - Alberto Roghi
- Cardiovascular Magnetic Resonance Unit, Department of Cardiology, Niguarda Cà Granda Hospital, P.zza Ospedale Maggiore 3, 20162, Milan, Italy
| | - Patrizia Pedrotti
- Cardiovascular Magnetic Resonance Unit, Department of Cardiology, Niguarda Cà Granda Hospital, P.zza Ospedale Maggiore 3, 20162, Milan, Italy
| | - Marco Vicenzi
- Cardiovascular Disease Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy
| | - Veronica Maria Sciumbata
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122, Milan, Italy
| | - Maria Domenica Cappellini
- Rare Diseases Center, Department of Medicine and Medical Specialties, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122, Milan, Italy
- Department of Clinical Science and Community Health, Università Degli Studi di Milano, via F. Sforza 35, 20122, Milan, Italy
| | - Alberto Pierini
- Cardiovascular Disease Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy
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21
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Song Y, Zhang RF, Liu Y. 2D-STI combined with gated 99Tc m-MIBI MPI for the diagnosis of myocardial ischemia in hypercholesterolemia patients. Exp Ther Med 2017; 14:981-994. [PMID: 28810550 PMCID: PMC5526078 DOI: 10.3892/etm.2017.4602] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 03/24/2017] [Indexed: 01/09/2023] Open
Abstract
This study aimed to investigate the reliability of ultrasound two-dimensional speckle tracking imaging (2D-STI) for the evaluation of myocardial ischemia in familial hypercholesterolemia (FH) patients. We recruited 28 patients clinically diagnosed with homozygous familial hypercholesterolemia (HoFH) and subjected them to 2D-STI, gated transthoracic Doppler echocardiography (TTDE), and 99Tcm-methoxyisobutylisonitrile myocardial perfusion imaging (99Tcm-MIBI MPI). The sensitivity, specificity and diagnostic accordance rate of TTDE and 2D-STI for myocardial ischemia in HoFH patients were compared with the 99Tcm-MIBI scores. According to the diagnosis of ischemia in the three main coronary arteries (LAD, LCX, and RCA) by MPI, patients were further divided into different groups for comparing segmental strain by 2D-STI. The total correlation between TTDE and 99Tcm-MIBI MPI for evaluation of myocardial ischemia was r=0.483 and between 2D-STI and 99Tcm-MIBI MPI was 0.786. The total correlation index for ejection fraction (EF) between TTDE and 99Tcm-MIBI MPI was r=0.606 and for 2D-STI and 99Tcm-MIBI MPI was r=0.919. TTDE indicated that differences among LVDd, LVDs, IVS, LVPW, AO Vmax, PG, E/e', and DT were statistically significant. STI indicated that the total strain of the ischemia group was lower than that of the non-ischemia group. The total systolic strain and total early diastolic strain of the ischemia group were lower than that of the non-ischemia group. TTDE can be used for primary observation and evaluation of ventricular wall ischemia for HoFH patients. Ultrasound 2D-STI is better than TTDE in the evaluation of myocardial ischemia in HoFH patients. Ultrasound 2D-STI shows the same effectiveness as 99Tcm-MIBI MPI for the detection of myocardial ischemia, serving as good tool for prognosis and treatment evaluation in HoFH patients.
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Affiliation(s)
- Yi Song
- Department of Medical Ultrasonics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Rui-Fang Zhang
- Department of Medical Ultrasonics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Yu Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
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Zhang L, Chen X. Investigation of the predictive value of speckle tracking imaging for the assessment of cardiac function and clinical prognosis in patients with hypercholesterolemia. Exp Ther Med 2017; 13:2951-2959. [PMID: 28587366 PMCID: PMC5450676 DOI: 10.3892/etm.2017.4325] [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: 09/14/2016] [Accepted: 03/17/2017] [Indexed: 11/10/2022] Open
Abstract
The predictive value of speckle tracking imaging (STI) for the assessment of cardiac function and clinical prognosis in patients with hypercholesterolemia was explored. One hundred forty-seven patients with hypercholesterolemia diagnosed in our hospital and 137 healthy adults from our health examination center over the same period were included in this study. Using STI and color Doppler ultrasound, we carried out follow-up of cardiac function in patients with hypercholesterolemia and statistical analysis based on collected data. Global longitudinal strain, global circumferential strain, and the strains of apical long-axis, four-chamber and two-chamber planes, and short-axis mitral valve, short-axis papillary muscle, and short-axis apical levels in the hypercholesterolemia group were significantly lower than those in the control group. Global systolic and early diastolic strain rates were significantly lower than those in the control group. In the coronaries, the percentage of segments with significant differences was 80% (24/30) in the left anterior descending coronary artery (LAD), 66.7% (9/12) in the left circumflex coronary artery (LCX), and 75% (8/12) in the right coronary artery (RCA). The average strains in the long axis, radial, and circumferential directions (StrainSL, SC, SR - Avg) in the three main coronaries were significantly different between the hypercholesterolemia group and control group (P<0.0001). In the three coronaries and their basal and mid segments, there were significant differences between LCX and LAD, and between LCX and RCA (P<0.0001). In conclusion, the application of STI for monitoring cardiac function in patients with hypercholesterolemia provides physicians with useful information related to hypercholesterolemia to achieve early diagnosis and effective treatment.
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Affiliation(s)
- Ling Zhang
- Department of Physical Diagnosis, Daqing Longnan Hospital, Daqing, Heilongjiang 163453, P.R. China
| | - Xiaoxu Chen
- Department of Physical Diagnosis, Daqing Longnan Hospital, Daqing, Heilongjiang 163453, P.R. China
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23
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Stoodley PW, Richards DAB. Anatomical and physiological complications related to left ventricular apical aneurysm. SONOGRAPHY 2017. [DOI: 10.1002/sono.12095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Paul W. Stoodley
- School of Medicine; Western Sydney University; NSW Australia
- Westmead Private Cardiology; Suite 1 Westmead Private Hospital; NSW Australia
| | - David A. B. Richards
- Westmead Private Cardiology; Suite 1 Westmead Private Hospital; NSW Australia
- Department of Cardiology; Liverpool Hospital; NSW Australia
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24
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Lopez-Candales A, Hernandez-Suarez DF. Strain Imaging Echocardiography: What Imaging Cardiologists Should Know. Curr Cardiol Rev 2017; 13:118-129. [PMID: 27799029 PMCID: PMC5452148 DOI: 10.2174/1573403x12666161028122649] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/06/2016] [Accepted: 10/18/2016] [Indexed: 01/30/2023] Open
Abstract
Despite recent advances in clinical imaging, echocardiography remains as the most accessi-ble and reliable noninvasive. Since knowledge of left ventricular systolic function remains so critically important in determining prognosis; every effort should be made to prevent subjective estimations. The advent of strain imaging echocardiography now offers a readily available and portable imaging tool that not only offers an objective characterization of myocardial dynamics; but also allows for early detection of subclinical left ventricular dysfunction. This review outlines the basic concepts of strain imaging to better understand the mechanism of myocardial function as well their applicability in the least common cardiac diagnosis among current clinical practice.
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Affiliation(s)
- Angel Lopez-Candales
- Cardiovascular Medicine Division, University of Puerto Rico School of Medicine, Medical Sciences Building, PO Box 365067, San Juan, Puerto Rico
| | - Dagmar F Hernandez-Suarez
- Cardiovascular Medicine Division, University of Puerto Rico School of Medicine, Medical Sciences Building, PO Box 365067, San Juan, Puerto Rico
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25
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Cinotti R, Piriou N, Launey Y, Le Tourneau T, Lamer M, Delater A, Trochu JN, Brisard L, Lakhal K, Bourcier R, Desal H, Seguin P, Mallédant Y, Blanloeil Y, Feuillet F, Asehnoune K, Rozec B. Speckle tracking analysis allows sensitive detection of stress cardiomyopathy in severe aneurysmal subarachnoid hemorrhage patients. Intensive Care Med 2016; 42:173-82. [PMID: 26499884 DOI: 10.1007/s00134-015-4106-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 05/04/2015] [Indexed: 01/01/2023]
Abstract
PURPOSE Stress cardiomyopathy is a common life-threatening complication after aneurysmal subarachnoid hemorrhage (SAH). We hypothesized that left ventricular (LV) longitudinal strain alterations assessed with speckle tracking could identify early systolic function impairment. METHODS This was an observational single-center prospective pilot controlled study conducted in a neuro-intensive care unit. Forty-six patients with severe SAH with a World Federation of Neurological Surgeons grade (WFNS) ≥ III were included. Transthoracic echocardiography (TTE) was performed on day 1, day 3, and day 7 after the patient's admission. A cardiologist blinded to the patient's management analyzed the LV global longitudinal strain (GLS). The control group comprised normal subjects matched according to gender and age. RESULTS On day 1 median (25th-75th percentile) GLS was clearly impaired in SAH patients compared to controls [-16.7 (-18.7/-13.7) % versus -20 (-22/-19) %, p < 0.0001], whereas LVEF was preserved [65 (59-70) %]. GLS was severely impaired in patients with a WFNS score of V versus III-IV [-15.6 (-16.9/-12.3) % versus -17.8 (-20.6/-15.8) %, p = 0.008]. Seventeen (37 %) patients had a severe GLS alteration (>- 16 %). In these patients, GLS improved from day 1 [-12.4 (-14.8/-10.9) %] to last evaluation [-16.2 (-19/-14.6) %, p = 0.0007] in agreement with the natural evolution of stress cardiomyopathy. CONCLUSIONS On the basis of LV GLS assessment, we demonstrated for the first time that myocardial alteration compatible with a stress cardiomyopathy is detectable in up to 37 % of patients with severe SAH while LVEF is preserved. GLS could be used for sensitive detection of stress cardiomyopathy. This is critical because cardiac impairment remains a major cause of morbidity and mortality after SAH.
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26
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Detection of left atrial dysfunction with speckle tracking echocardiography. Herz 2016; 42:418-424. [PMID: 27752715 DOI: 10.1007/s00059-016-4485-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 05/17/2016] [Accepted: 09/04/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the relationship between the SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) score and left ventricular end-diastolic pressure (LVEDP) measured with an invasive method and with speckle-tracking echocardiography (STE). METHODS The study included 124 patients who underwent cardiac catheterization. LVEDP values and coronary images were obtained for all patients. SYNTAX scores were calculated and separated into three tertiles (SYNTAX = 0, SYNTAX < 22, and SYNTAX > 22). Standard echocardiography and STE were performed on all the patients. Peak LA strain (LAs strain) in ventricular end-systole and LA strain during LA contraction (LAa strain) values were obtained with STE. RESULTS In univariate analysis, a strong correlation was observed between the SYNTAX score and LAs strain and a moderate correlation with LAa strain. A moderate correlation was also found between both LAs strain and LAa strain and LVEDP. In multiple regression analysis, LAs strain and LVEDP were observed to be independent predictors of SYNTAX score. CONCLUSION LAs strain and LVEDP were observed to be independent predictors of SYNTAX scores. The relationship between LAs strain, LVEDP, and SYNTAX score could be useful in clinical practice.
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27
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Sunbul M, Kivrak T, Durmus E, Akin H, Aydin Y, Ergelen R, Yilmaz Y, Agirbasli M. Nonalcoholic Steatohepatitis Score is an Independent Predictor of Right Ventricular Dysfunction in Patients with Nonalcoholic Fatty Liver Disease. Cardiovasc Ther 2016. [PMID: 26202098 DOI: 10.1111/1755-5922.12145] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Nonalcoholic fatty liver disease (NAFLD) is associated with increased risk of cardiovascular disease and impaired left ventricular (LV) function, yet the impact of NAFLD on right ventricular (RV) function remains unclear. We investigate the RV functional properties in patients with NAFLD. METHODS Ninety consecutive patients with the diagnosis of biopsy-proven NAFLD and 45 age- and sex-matched controls were included. All patients underwent an echocardiographic examination. RV function was evaluated by two-dimensional (2D) speckle-tracking echocardiography (STE). RESULTS Mean fibrosis stage and nonalcoholic steatohepatitis (NASH) scores were 1.3 ± 1.1 and 5.2 ± 1.6, respectively. NAFLD patients displayed decreased RV function compared to controls. NAFLD patients with liver fibrosis (67 patients) had significantly lower RV function assessed by GLS (global longitudinal strain) compared to patients without liver fibrosis (18.9 ± 3.4% vs. 21.6 ± 2.3%, P < 0.001). NASH score ≥5 was associated with lower RV-GLS (18.9 ± 3.1% vs. 21.0 ± 3.4%, P = 0.006). NASH score inversely correlated with RV-GLS (r = -0.370, P < 0.001) such as patients with impaired RV-GLS (<19%) showed significantly higher NASH score compared to normal RV-GLS group (5.8 ± 1.4 vs. 4.8 ± 1.7, P = 0.009). Logistic regression analysis revealed that NASH score was an independent predictor of impaired RV function in patients with NAFLD. CONCLUSIONS Patients with NAFLD have impaired RV function. NASH score inversely correlates with RV-GLS and independently predicts impaired RV function in patients with NAFLD.
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Affiliation(s)
- Murat Sunbul
- Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Tarik Kivrak
- Cardiology Clinic, Sivas Numune Hospital, Sivas, Turkey
| | - Erdal Durmus
- Cardiology Clinic, Silifke State Hospital, Mersin, Turkey
| | - Hakan Akin
- Department of Gastroenterology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Yucel Aydin
- Department of Gastroenterology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Rabia Ergelen
- Department of Radiology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Yusuf Yilmaz
- Department of Gastroenterology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Agirbasli
- Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey
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28
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Affiliation(s)
- Joseph B Selvanayagam
- Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, SA, Australia; Flinders University, Adelaide, SA, Australia; South Australian Health & Medical Research Institute (SAHMRI), Adelaide, SA, Australia.
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29
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Currie KD, West CR, Krassioukov AV. Differences in Left Ventricular Global Function and Mechanics in Paralympic Athletes with Cervical and Thoracic Spinal Cord Injuries. Front Physiol 2016; 7:110. [PMID: 27065879 PMCID: PMC4809896 DOI: 10.3389/fphys.2016.00110] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 03/07/2016] [Indexed: 01/20/2023] Open
Abstract
Following a spinal cord injury, there are changes in resting stroke volume (SV) and its response to exercise. The purpose of the following study was to characterize resting left ventricular structure, function, and mechanics in Paralympic athletes with tetraplegia (TETRA) and paraplegia (PARA) in an attempt to understand whether the alterations in SV are attributable to inherent dysfunction in the left ventricle. This retrospective study compared Paralympic athletes with a traumatic, chronic (>1 year post-injury), motor-complete spinal cord injury (American Spinal Injury Association Impairment Scale A-B). Eight male TETRA wheelchair rugby players (34 ± 5 years, C5-C7) and eight male PARA alpine skiers (35 ± 5 years, T4-L3) were included in the study. Echocardiography was performed in the left lateral decubitus position and indices of left ventricular structure, global diastolic and systolic function, and mechanics were derived from the average across three cardiac cycles. Blood pressure was measured in the supine and seated positions. All results are presented as TETRA vs. PARA. There was no difference in left ventricular dimensions between TETRA and PARA. Additionally, indices of global diastolic function were similar between groups including isovolumetric relaxation time, early (E) and late (A) transmitral filling velocities and their ratio (E/A). While ejection fraction was similar between TETRA and PARA (59 ± 4 % vs. 61 ± 7 %, p = 0.394), there was evidence of reduced global systolic function in TETRA including lower SV (62 ± 9 ml vs. 71 ± 6 ml, p = 0.016) and cardiac output (3.5 ± 0.6 L/min vs. 5.0 ± 0.9 L/min, p = 0.002). Despite this observation, several indices of systolic and diastolic mechanics were maintained in TETRA but attenuted in PARA including circumferential strain at the level of the papillary muscle (−23 ± 4% vs. −15 ± 6%, p = 0.010) and apex (−36 ± 10% vs. −23 ± 5%, p = 0.010) and their corresponding diastolic strain rates (papillary: 1.90 ± 0.63 s−1 vs. 1.20 ± 0.51 s−1, p = 0.028; apex: 3.03 ± 0.71 s−1 vs. 1.99 ± 0.69 s−1, p = 0.009). All blood pressures were lower in TETRA. The absence of an association between reduced global systolic function and mechanical dysfunction in either TETRA or PARA suggests any reductions in SV are likely attributed to impaired loading rather than inherent left ventricular dysfunction.
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Affiliation(s)
- Katharine D Currie
- Autonomic Research Laboratory, International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia Vancouver, BC, Canada
| | - Christopher R West
- Autonomic Research Laboratory, International Collaboration on Repair Discoveries, Faculty of Medicine, University of British ColumbiaVancouver, BC, Canada; Translational Integrative Physiology Laboratory, Faculty of Education, School of Kinesiology, University of British ColumbiaVancouver, BC, Canada
| | - Andrei V Krassioukov
- Autonomic Research Laboratory, International Collaboration on Repair Discoveries, Faculty of Medicine, University of British ColumbiaVancouver, BC, Canada; Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British ColumbiaVancouver, BC, Canada; GF Strong Rehabilitation Centre, Vancouver Coastal HealthVancouver, BC, Canada
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Koza Y. The Impact of Isolated Right Coronary Artery Angioplasty on Right Ventricular Functions in Patients with Unstable Angina Pectoris. Int Cardiovasc Res J 2016. [DOI: 10.17795/icrj-10(1)49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Shepherd DL, Nichols CE, Croston TL, McLaughlin SL, Petrone AB, Lewis SE, Thapa D, Long DM, Dick GM, Hollander JM. Early detection of cardiac dysfunction in the type 1 diabetic heart using speckle-tracking based strain imaging. J Mol Cell Cardiol 2016; 90:74-83. [PMID: 26654913 PMCID: PMC4725063 DOI: 10.1016/j.yjmcc.2015.12.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 11/11/2015] [Accepted: 12/02/2015] [Indexed: 12/14/2022]
Abstract
Enhanced sensitivity in echocardiographic analyses may allow for early detection of changes in cardiac function beyond the detection limits of conventional echocardiographic analyses, particularly in a small animal model. The goal of this study was to compare conventional echocardiographic measurements and speckle-tracking based strain imaging analyses in a small animal model of type 1 diabetes mellitus. Conventional analyses revealed differences in ejection fraction, fractional shortening, cardiac output, and stroke volume in diabetic animals relative to controls at 6-weeks post-diabetic onset. In contrast, when assessing short- and long-axis speckle-tracking based strain analyses, diabetic mice showed changes in average systolic radial strain, radial strain rate, radial displacement, and radial velocity, as well as decreased circumferential and longitudinal strain rate, as early as 1-week post-diabetic onset and persisting throughout the diabetic study. Further, we performed regional analyses for the LV and found that the free wall region was affected in both the short- and long-axis when assessing radial dimension parameters. These changes began 1-week post-diabetic onset and remained throughout the progression of the disease. These findings demonstrate the use of speckle-tracking based strain as an approach to elucidate cardiac dysfunction from a global perspective, identifying left ventricular cardiac regions affected during the progression of type 1 diabetes mellitus earlier than contractile changes detected by conventional echocardiographic measurements.
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Affiliation(s)
- Danielle L Shepherd
- Department of Exercise Physiology, Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, 26505, United States
| | - Cody E Nichols
- Department of Exercise Physiology, Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, 26505, United States
| | - Tara L Croston
- Department of Exercise Physiology, Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, 26505, United States
| | - Sarah L McLaughlin
- Department of Cancer Cell Biology, School of Medicine, West Virginia University, Morgantown, WV 26505, United States
| | - Ashley B Petrone
- Department of Neurobiology and Anatomy, School of Medicine, West Virginia University, Morgantown, WV 26505, United States
| | - Sara E Lewis
- Department of Exercise Physiology, Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, 26505, United States
| | - Dharendra Thapa
- Department of Exercise Physiology, Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, 26505, United States
| | - Dustin M Long
- Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV 26505, United States
| | - Gregory M Dick
- Department of Exercise Physiology, Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, 26505, United States
| | - John M Hollander
- Department of Exercise Physiology, Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, 26505, United States.
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Tigen K, Karaahmet T, Dundar C, Cincin A, Ozben B, Guler A, Gurel E, Sunbul M, Basaran Y. Right ventricular and atrial functions in patients with nonischemic dilated cardiomyopathy. Wien Klin Wochenschr 2015; 127:877-883. [DOI: 10.1007/s00508-015-0852-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 08/12/2015] [Indexed: 12/15/2022]
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Stoodley P, Richards D. Cardiac amyloidosis: the value of myocardial strain echocardiography in diagnosis and treatment. SONOGRAPHY 2015. [DOI: 10.1002/sono.12021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Paul Stoodley
- Westmead Private Cardiology, Suite 1; Westmead Private Hospital; Westmead NSW Australia
- School of Medicine, Blacktown Clinical School; University of Western Sydney; Blacktown NSW Australia
| | - David Richards
- Westmead Private Cardiology, Suite 1; Westmead Private Hospital; Westmead NSW Australia
- Department of Cardiology; Liverpool Hospital; Liverpool NSW Australia
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Karavidas A, Xylomenos G, Matzaraki V, Papoutsidakis N, Leventopoulos G, Farmakis D, Lazaros G, Perpinia A, Arapi S, Paisios N, Parissis J, Pyrgakis V, Gargalianos P. Myocardial deformation imaging unmasks subtle left ventricular systolic dysfunction in asymptomatic and treatment-naïve HIV patients. Clin Res Cardiol 2015; 104:975-81. [PMID: 25977163 DOI: 10.1007/s00392-015-0866-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 04/30/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND Patients infected by the human immunodeficiency virus (HIV) and receiving highly active antiretroviral therapy have a higher incidence of cardiovascular disease than healthy subjects, but little is known about cardiac function in asymptomatic and treatment-naïve patients. We sought to study cardiac function in asymptomatic HIV-infected, treatment-naïve patients. METHODS We studied 41 HIV-infected and treatment-naïve patients and 20 age- and sex-matched healthy controls. Patients with cardiac symptoms, history of cardiac disease or NT-proBNP >100 pg/mL were excluded. We addressed cardiac function using standard echocardiography along with tissue Doppler (TDI) measurements, including strain/strain rate assessment. RESULTS Standard echocardiographic parameters did not differ between groups, except for transmitral E wave velocity (64.8 ± 14 cm/s in HIV vs 76.1 ± 10 cm/s in controls, p = 0.002). In contrast, TDI mitral and tricuspid annulus s velocity and all strain/strain rate measurements were significantly lower in HIV patients: s lateral, 10.2 ± 2.4/11.3 ± 0.7, p = 0.011; s septal, 8.1 ± 1.6/8.7 ± 0.8, p = 0.045; s tricuspid, 13.4 ± 2.3/14.9 ± 1.3, p = 0.002; strain/strain rate, septal (strain/strain rate, 15.1 ± 5.7/-0.9 ± 0.3, 25.3 ± 1.7/-1.9 ± 0.2, p < 0.001), anterior (16.7 ± 3/-1.0 ± 0.1, 26.7 ± 1.7/-1.9 ± 0.2, p < 0.001), lateral (16.0 ± 6/-1.0 ± 0.1, 27.5 ± 1.8/-2.2 ± 0.3, p < 0.001) and posterior (15.2 ± 5.8/-1.0 ± 0.2, 26.2 ± 1.8/-2.2 ± 0.3, p < 0.001) left ventricular wall. CONCLUSIONS HIV infection itself is accompanied by subclinical systolic dysfunction, not apparent to standard echocardiography that can be unmasked though using sensitive echocardiographic techniques.
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Affiliation(s)
- Apostolos Karavidas
- Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece
| | - George Xylomenos
- First Department of Internal Medicine, Athens General Hospital "G. Gennimatas", Athens, Greece
| | - Vassiliki Matzaraki
- Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece
| | | | | | - Dimitrios Farmakis
- Heart Failure Unit, Department of Cardiology, Athens University Hospital "Attikon", 1 Rimini St, Haidari, 12461, Athens, Greece.
| | - George Lazaros
- Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece
| | - Anastasia Perpinia
- Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece
| | - Sophia Arapi
- Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece
| | - Nikolaos Paisios
- First Department of Internal Medicine, Athens General Hospital "G. Gennimatas", Athens, Greece
| | - John Parissis
- Heart Failure Unit, Department of Cardiology, Athens University Hospital "Attikon", 1 Rimini St, Haidari, 12461, Athens, Greece
| | - Vlasios Pyrgakis
- Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece
| | - Panagiotis Gargalianos
- First Department of Internal Medicine, Athens General Hospital "G. Gennimatas", Athens, Greece
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Abstract
Transthoracic echocardiography is the most widely used imaging test in cardiology. Although completely noninvasive, transthoracic echocardiography has a well-established role in the diagnosis of numerous cardiovascular diseases, and also provides critical qualitative and quantitative information on their prognosis and pathophysiological processes. The aim of this Review is to outline the broad principles of transthoracic echocardiography, including the traditional techniques of two-dimensional, colour, and spectral Doppler echocardiography, and newly developed advances including tissue Doppler, myocardial deformation imaging, torsion, stress echocardiography, contrast and three-dimensional echocardiography. The advantages and disadvantages, clinical application, prognostic value, and salient research findings of each modality are described. Advances in complex imaging techniques are expected to continue unabated, and this Review highlights technical improvements that will influence the diagnosis and improve our understanding of cardiovascular function and disease.
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Affiliation(s)
- Anita C Boyd
- South Western Sydney Clinical School, University of New South Wales, Liverpool Hospital, Corner Elizabeth/Goulburn Street, NSW 2170, Australia
| | - Nelson B Schiller
- University of California, 505 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Liza Thomas
- South Western Sydney Clinical School, University of New South Wales, Liverpool Hospital, Corner Elizabeth/Goulburn Street, NSW 2170, Australia
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Qi Z, Liu S, Lv X, Duan F, Wang H, Gao Y, Wang J. Effects of Bone Marrow Mononuclear Cells Delivered through a Graft Vessel for Patients with Previous Myocardial Infarction and Chronic Heart Failure: An Echocardiographic Study of Left Atrium Function. Echocardiography 2015; 33:1835-1843. [PMID: 25773139 DOI: 10.1111/echo.12883] [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] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES The graft of stem cells to treat ischemic cardiomyopathy is popular in many clinical trials. The aim of this study was to evaluate the effectiveness of isolated coronary artery bypass graft combined with bone marrow mononuclear cells (BMMNC) delivered through the graft vessels to improve left atrium (LA) function of patients with previous myocardial infarction and chronic heart failure using echocardiography. METHODS Forty-two patients with previous myocardial infarction and chronic heart failure were randomly allocated to one of the two groups: coronary artery bypass graft (CABG) only (18 in CABG group) or CABG with BMMNC transplantation (24 in CABG + BMMNC group). Echocardiographic parameters were measured on two-dimensional (2D) imaging, three-dimensional imaging, 2D strain, and strain rate imaging, eight parameters were measured totally. RESULTS Postoperative LA global strain (LAGS) versus Preoperative LAGS were 24.875 ± 1.588% versus 14.250 ± 1.281% (P < 0.05) in CABG + BMMMNC group and 17.556 ± 1.834% versus 13.111 ± 1.479% (P < 0.05) in CABG group, LVEF was 49.083 ± 1.914% versus 36.042 ± 1.185% (P < 0.05) in CABG + BMMMNC group and 41.389 ± 2.210% versus 34.667 ± 1.369% (P < 0.05) in CABG group, and LA volume (LAV) was 15.651 ± 0.631 mL versus 23.894 ± 0.831 mL (P < 0.05) in CABG + BMMMNC group and 21.429 ± 0.707 mL versus 22.379 ± 0.959 mL (P < 0.05) in CABG group. LAGS, LVEF, and LAV were significantly improved postoperatively in both groups. The degree of the improvement was significantly different between the two groups with the CABG + BMMNC group improved more versus the group of CABG only (P < 0.05). Postoperative LVEDV and LVESV were significantly improved compared with those obtained prior to operation in CABG + BMMNC group (P < 0.05). CONCLUSIONS The improvement of LA function in CABG + BMMNC group is better than CABG group. 2D strain imaging is a more sensitive tool to evaluate LA function.
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Affiliation(s)
- Zhi Qi
- Department of Echocardiography, Fuwai Hospital & Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, Beijing, China
| | - Sheng Liu
- Department of Cardiovascular Surgery, Fuwai Hospital & Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, Beijing, China
| | - Xiuzhang Lv
- Department of Echocardiography, Fuwai Hospital & Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, Beijing, China
| | - Fujian Duan
- Department of Echocardiography, Fuwai Hospital & Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, Beijing, China
| | - Hao Wang
- Department of Echocardiography, Fuwai Hospital & Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, Beijing, China
| | - Yiming Gao
- Department of Echocardiography, Fuwai Hospital & Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, Beijing, China
| | - Jianpeng Wang
- Department of Echocardiography, Fuwai Hospital & Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, Beijing, China
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Echocardiographic Evaluation of Coronary Artery Disease. Coron Artery Dis 2015. [DOI: 10.1007/978-1-4471-2828-1_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Chia EM, Hsieh CHC, Boyd A, Pham P, Vidaic J, Leung D, Thomas L. Effects of Age and Gender on Right Ventricular Systolic and Diastolic Function Using Two-Dimensional Speckle-Tracking Strain. J Am Soc Echocardiogr 2014; 27:1079-1086.e1. [DOI: 10.1016/j.echo.2014.06.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Indexed: 01/12/2023]
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40
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Cincin A, Tigen K, Karaahmet T, Dündar C, Gürel E, Bulut M, Sünbül M, Başaran Y. Right ventricular function in hypertrophic cardiomyopathy: A speckle tracking echocardiography study. Anatol J Cardiol 2014; 15:536-41. [PMID: 25537994 PMCID: PMC5337031 DOI: 10.5152/akd.2014.5538] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective: The aim of this study was to explore right ventricular (RV) mechanical function in patients with hypertrophic cardiomyopathy (HCM) by 2-D speckle tracking echocardiography (2-D-STE). Methods: Forty-three patients with HCM (mean age 48, 17 females) and 40 healthy subjects were consecutively included in this cross-sectional study. The diagnosis of HCM was based on the presence of typical clinical, electrocardiographic (ECG), and echocardiographic features. Patients with LV systolic impairment, significant valvular disease, history of coronary artery disease, hypertension, malignancy, and chronic obstructive pulmonary disease were excluded. Right and left ventricular (LV) function was assessed by tissue Doppler imaging (TDI) and 2-D-STE. Hypertrophic cardiomyopathy patients were divided into two groups according to ACC/ESC guidelines (LVOT gradient below and above 30 mm Hg). Student t-test was used to compare differences between groups. Non-parametric tests (Mann-Whitney U) were used in cases of abnormal distribution. Results: Hypertrophic cardiomyopathy patients had a significantly larger right atrium and RV diameters compared to controls. Mean pulmonary artery pressures (mPAB) were significantly higher in HCM patients (19.01±13.09 mm Hg vs. 8.40±4.50 mm Hg; p<0.001). Although RV Sm measure-ments were similar, RV strain measurements (-28.51±5.36% vs. -32.06±7.65%; p=0.016) were significantly lower in HCM patients. Left ventricular global longitudinal, radial, and circumferential strain values were also significantly different between the two groups (-20.50±3.58% vs. -24.12±3.40%; p<0.001, 38.18±12.67% vs. 44.80±10.15%; p=0.012, -21.94±4.28% vs. -23.91±3.95%; p=0.036 consecutively). Rotational movement of LV in each apical, mid-, and basal left ventricular segment was determined, and only mid-ventricular rotation of the HCM patients was more clockwise (-1.71±2.16 ° vs. 0.04±1.72 p<0.001). Although mPAP measurements were higher in HCM patients with significant LVOT obstruction (21.52±13.26 mm Hg vs. 12.31±10.53 mm Hg; p=0.049), none of the other TDI or 2-D-STE parameters was significantly different between groups. Conclusion: Speckle tracking echocardiography-derived right ventricular systolic function is impaired in HCM patients when compared with healthy subjects. However, RV systolic function is not affected form LVOT obstruction and left ventricular rotation dynamics in HCM patients.
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Affiliation(s)
- Altuğ Cincin
- Department of Cardiology, Faculty of Medicine, Marmara University; İstanbul-Turkey.
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Salehi R, Samadikhah J, Azarfarin R, Goldust M. Effect of left atrium volume on patients' prognosis following acute myocardial infarction. Pak J Biol Sci 2014; 16:1936-42. [PMID: 24517009 DOI: 10.3923/pjbs.2013.1936.1942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Evaluating left atrium volume is a good way to estimate prognosis in acute myocardial infarction patients because it indicates to time and severity of diastolic dysfunction and longer-term results of acute myocardial infarction. The present study aims at evaluating the effect of left atrium volume on patients' prognosis following acute myocardial infarction. This is a cohort study conducted on 100 patients who were admitted with acute myocardial infarction. They were studied for 9 months and their one-month mortality rate was evaluated. The patients were studied considering demographic factors, risk factors, mechanical and arrhythmic complications and echocardiography indexes such as systolic and diastolic functions and left atrium volume. It was seen that mortality (27.3%, 6.22) in patients with atrium index > 32 mL m(-2) is more than cases with lower atrium index (1.3%, 1.78) (p = 0.001). There was not any meaningful difference in mortality rate of the patients considering age and gender (p > 0.05). This study indicated to lack of any meaningful difference in patients' mortality rate in terms of hypertension, diabetes, smoking and dyslipidemia. But, mortality rate was significantly higher in MI as a result of elevated-ST, diastolic dysfunction, restrictive pattern, ejection fraction of left atrium < 40%, left atrium volume index > 32 mL m(-2). High volume left atrium independently refers to bad prognosis in patients with acute myocardial infarction which is confirmed with outcome clinical predictors and common echocardiography indexes even following modification.
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Affiliation(s)
- Rezvanie Salehi
- Dapartment of Cardiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Rasul Azarfarin
- Dapartment of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohamad Goldust
- Student Research Committee, Tabriz University of Medical Sciences, Iran
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Chow V, Yeoh T, Ng ACC, Pasqualon T, Scott E, Plater J, Whitwell B, Hanzek D, Chung T, Thomas L, Celermajer DS, Kritharides L. Asymptomatic left ventricular dysfunction with long-term clozapine treatment for schizophrenia: a multicentre cross-sectional cohort study. Open Heart 2014; 1:e000030. [PMID: 25332789 PMCID: PMC4195917 DOI: 10.1136/openhrt-2013-000030] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 01/15/2014] [Accepted: 01/30/2014] [Indexed: 12/01/2022] Open
Abstract
Objectives Patients with schizophrenia treated with clozapine are at risk of acute myocarditis and dilated cardiomyopathy. However, there are no data on the prevalence of subclinical cardiomyopathy or its associations. Methods 100 consecutive patients with schizophrenia treated with clozapine for >1 year and without a history of cardiac pathology (group 1), 21 controls with a history of schizophrenia treated with non-clozapine antipsychotics for >1 year (group 2) and 20 controls without schizophrenia (group 3) were studied. Comprehensive evaluation by clinical examination, ECG, transthoracic echocardiography including left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) and biochemical profiles were performed. Results Patients with schizophrenia were of similar age, but had higher body mass index (BMI), rates of smoking and hyperlipidaemia than controls. Patients with schizophrenia had received clozapine or non-clozapine antipsychotics for a mean duration of 6.8±5.3 and 9.7±6.1 years, respectively. Patients taking clozapine demonstrated globally impaired LVEF (58.3%: group 1 vs 62.2%: group 2 vs 64.8%: group 3, p<0.001) and GLS (−16.7%: group 1 vs −18.6%: group 2 vs −20.2%: group 3, p<0.001). Moreover, LVEF was <50% in 9/100 (9%) patients receiving clozapine and in non-clozapine schizophrenia patients or healthy controls, but this was not statistically significantly different (analysis of covariance, p=0.19). Univariate analysis in patients taking clozapine found that impaired LV was not predicted by high-sensitivity troponin T, but was associated with features of the metabolic syndrome (including increased triglycerides, low high-density lipoprotein cholesterol (HDL-C), high-sensitivity C reactive protein and BMI), elevated neutrophil count, elevated heart rate, smoking and N-terminal probrain natriuretic peptide. In patients taking clozapine, multivariable analysis identified elevated neutrophil count and low HDL-C as the only independent predictors of impaired GLS. Conclusions Asymptomatic mild LV impairment is common in patients with schizophrenia receiving long-term clozapine treatment and is associated with neutrophilia and low HDL-C.
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Affiliation(s)
- V Chow
- Department of Cardiology , Concord Hospital, The University of Sydney , Sydney, New South Wales , Australia ; ANZAC Medical Research Institute , Sydney, New South Wales , Australia
| | - T Yeoh
- Department of Cardiology , Concord Hospital, The University of Sydney , Sydney, New South Wales , Australia ; Department of Cardiology , Canterbury Hospital, The University of Sydney , Sydney, New South Wales , Australia
| | - A C C Ng
- Department of Cardiology , Concord Hospital, The University of Sydney , Sydney, New South Wales , Australia
| | - T Pasqualon
- Department of Psychiatry , Croydon Health Centre , Sydney, New South Wales , Australia
| | - E Scott
- School of Medicine, Notre Dame University, Sydney, Australia
| | - J Plater
- Department of Psychiatry , Croydon Health Centre , Sydney, New South Wales , Australia
| | - B Whitwell
- National Youth Mental Health Foundation, The University of Sydney , Sydney, New South Wales , Australia
| | - D Hanzek
- Department of Cardiology , Canterbury Hospital, The University of Sydney , Sydney, New South Wales , Australia
| | - T Chung
- Department of Cardiology , Concord Hospital, The University of Sydney , Sydney, New South Wales , Australia
| | - L Thomas
- Department of Cardiology , Liverpool Hospital, University of New South Wales , Sydney, New South Wales , Australia
| | - D S Celermajer
- Department of Cardiology , Royal Prince Alfred Hospital, The University of Sydney , Sydney, New South Wales , Australia
| | - L Kritharides
- Department of Cardiology , Concord Hospital, The University of Sydney , Sydney, New South Wales , Australia ; ANZAC Medical Research Institute , Sydney, New South Wales , Australia
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Martufi G, Gasser TC, Appoo JJ, Di Martino ES. Mechano-biology in the thoracic aortic aneurysm: a review and case study. Biomech Model Mechanobiol 2014; 13:917-28. [DOI: 10.1007/s10237-014-0557-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 01/27/2014] [Indexed: 01/22/2023]
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Chong A, MacLaren G, Chen R, Connelly KA. Perioperative Applications of Deformation (Myocardial Strain) Imaging With Speckle-Tracking Echocardiography. J Cardiothorac Vasc Anesth 2014; 28:128-140. [DOI: 10.1053/j.jvca.2013.04.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Indexed: 12/24/2022]
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Hiemstra JA, Liu S, Ahlman MA, Schuleri KH, Lardo AC, Baines CP, Dellsperger KC, Bluemke DA, Emter CA. A new twist on an old idea: a two-dimensional speckle tracking assessment of cyclosporine as a therapeutic alternative for heart failure with preserved ejection fraction. Physiol Rep 2013; 1:e00174. [PMID: 24744855 PMCID: PMC3970750 DOI: 10.1002/phy2.174] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 11/01/2013] [Accepted: 11/04/2013] [Indexed: 01/12/2023] Open
Abstract
We recently reported that mitochondrial dysfunction, characterized by increased mitochondrial permeability transition (MPT), was present in a translational swine model of heart failure with preserved ejection fraction (HFpEF). Cyclophilin D is a key component of the MPT pore, therefore, the purpose of this study was to test the efficacy of a novel cyclosporine (CsA) dosing scheme as a therapeutic alternative for HFpEF. Computed tomography (CT), two‐dimensional speckle tracking two‐dimensional speckle tracking (2DST), and invasive hemodynamics were used to evaluate cardiac function. CT imaging showed 14 weeks of CsA treatment caused eccentric myocardial remodeling (contrasting concentric remodeling in untreated HF animals) and elevated systemic pressures. 2DST detected left ventricular (LV) mechanics associated with systolic and diastolic dysfunction prior to the onset of significantly increased LV end diastolic pressure including: (1) decreased systolic apical rotation rate, longitudinal displacement, and longitudinal/radial/circumferential strain; (2) decreased early diastolic untwisting and longitudinal strain rate; and (3) increased late diastolic radial/circumferential mitral strain rate. LV mechanics associated with systolic and diastolic impairment was enhanced to a greater extent than seen in untreated HF animals following CsA treatment. In conclusion, CsA treatment accelerated the development of heart failure, including dilatory LV remodeling and impaired systolic and diastolic mechanics. Although our findings do not support CsA as a viable therapy for HFpEF, 2DST was effective in differentiating between progressive gradations of developing HF and detecting diastolic impairment prior to the development of overt diastolic dysfunction. We recently reported that mitochondrial dysfunction, characterized by increased mitochondrial permeability transition (MPT), was present in a translational swine model of heart failure with preserved ejection fraction (HFpEF). Cyclophilin D is a key component of the MPT pore, therefore, the purpose of this study was to test the efficacy of a novel cyclosporine (CsA) dosing scheme as a therapeutic alternative for HFpEF. CsA treatment accelerated the development of heart failure, including dilatory LV remodeling and impaired systolic and diastolic mechanics. Although our findings do not support CsA as a viable therapy for HFpEF, 2DST was effective in differentiating between progressive gradations of developing HF and detecting diastolic impairment prior to the development of overt diastolic dysfunction.
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Affiliation(s)
- Jessica A Hiemstra
- Department of Biomedical Science, University of Missouri- Columbia, Columbia, Missouri
| | - Songtao Liu
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland ; Molecular Biomedical Imaging Laboratory, National Institute of Biomedical Imaging and Bioengineering, Bethesda, Maryland
| | - Mark A Ahlman
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland ; Molecular Biomedical Imaging Laboratory, National Institute of Biomedical Imaging and Bioengineering, Bethesda, Maryland
| | - Karl H Schuleri
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Albert C Lardo
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Christopher P Baines
- Department of Biomedical Science, University of Missouri- Columbia, Columbia, Missouri ; Dalton Cardiovascular Research Center, University of Missouri- Columbia, Columbia, Missouri
| | - Kevin C Dellsperger
- Department of Medical Pharmacology and Physiology, University of Missouri- Columbia, Columbia, Missouri ; Department of Internal Medicine, University of Missouri- Columbia, Columbia, Missouri ; Center for Health Care Quality, University of Missouri- Columbia, 1600 E. RollinsW160 Veterinary Medicine, Columbia, 65211, Missouri
| | - David A Bluemke
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland ; Molecular Biomedical Imaging Laboratory, National Institute of Biomedical Imaging and Bioengineering, Bethesda, Maryland
| | - Craig A Emter
- Department of Biomedical Science, University of Missouri- Columbia, Columbia, Missouri
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N-Terminal proBNP Levels and Tissue Doppler Echocardiography in Acute Rheumatic Carditis. ISRN PEDIATRICS 2013; 2013:970394. [PMID: 24109516 PMCID: PMC3786526 DOI: 10.1155/2013/970394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 07/03/2013] [Indexed: 12/02/2022]
Abstract
Background. Rheumatic heart disease (RHD) is a leading cause of heart failure in children and young adults worldwide. B-type natriuretic peptide (BNP) is a useful marker of critical pediatric heart disease, and its N-terminal peptide, NT-proBNP, is elevated in congenital and acquired heart disease in children. Aim. To measure NT-proBNP levels as a marker of carditis in children with acute rheumatic carditis, as compared to children with quiescent RHD and healthy controls. Methods. 16 children with acute rheumatic carditis, 33 children with quiescent RHD, and a cohort of 30 healthy children were studied. Transthoracic echocardiography was performed to assess valve and cardiac function. Tissue Doppler echocardiography was performed for E/E′ (ratio between mitral inflow E wave and lateral mitral annulus E′ wave) and systolic strain. Results. NT-proBNP levels were significantly higher in children with acute rheumatic carditis and dropped with its resolution. Strain and E/E′ values were comparable among the three groups. Conclusion. NT-proBNP is significantly elevated in children with acute rheumatic carditis in the acute stage compared to children with quiescent RHD and healthy subjects, in the presence of comparable echocardiographic indices of LV systolic and diastolic function.
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Tee M, Noble JA, Bluemke DA. Imaging techniques for cardiac strain and deformation: comparison of echocardiography, cardiac magnetic resonance and cardiac computed tomography. Expert Rev Cardiovasc Ther 2013; 11:221-31. [PMID: 23405842 DOI: 10.1586/erc.12.182] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Myocardial function assessment is essential for determining the health of the myocardium. Global assessment of myocardial function is widely performed (by estimating the ejection fraction), but many common cardiac diseases initially affect the myocardium on a regional, rather than global basis. Regional myocardial wall motion can be quantified using myocardial strain analysis (a normalized measure of deformation). Myocardial strain can be measured in terms of three normal strains (longitudinal strain, radial strain and circumferential) and six shear strains. Cardiac MRI (cMRI) is usually considered the reference standard for measurement of myocardial strain. The most common cMRI method, termed tagged cMRI, allows full, 3D assessment of regional strain. However, due to its complexity and lengthy times for analysis, tagged cMRI is not usually used outside of academic centers. Tagged cMRI is also primarily used only in research studies. Echocardiography combined with tissue Doppler imaging or a speckle tracking technique is now widely available in the clinical setting. Myocardial strain measurement by echocardiography shows reasonable agreement with cMRI. Limited standardization and differences between vendors represent current limitations of the technique. Cardiac computed tomography (CCT) is the newest and most rapidly growing modality for noninvasive imaging of the heart. While CCT studies are most commonly applied to assess the coronary arteries, CCT is easily adapted to provide functional information for both the left and right ventricles. New methods for CCT assessment of regional myocardial function are being developed. This review outlines the current literature on imaging techniques related to cardiac strain analysis and discusses the strengths and weaknesses of various methods for myocardial strain analysis.
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Affiliation(s)
- Michael Tee
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Old Road Campus Research Building, Headington, Oxford, OX3 7DQ, UK
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Zheng XZ, Yang B, Wu J. Sex-specific assessment of reduced coronary sinus flow in non-hypertensive patients with coronary artery disease at rest. Libyan J Med 2013; 8:21553. [PMID: 23863220 PMCID: PMC3714674 DOI: 10.3402/ljm.v8i0.21553] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Accepted: 06/26/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Access to data on the coronary flow in the coronary sinus (CS) can aid in the diagnosis of coronary artery disease (CAD). We tested the hypothesis that assessing the CS flow by transthoracic Doppler echocardiography (TTE) at rest can detect coronary artery stenosis in non-hypertensive patients. METHODS The antegrade phase of coronary flow in the CS was analyzed and compared in 140 male and 135 female non-hypertensive subjects who had all undergone coronary angiography. RESULTS There were statistically significant differences noted between males and females for the CS flow both in normal subjects and patients with CAD. Compared with normal subjects, patients with CAD had significantly lower blood flow in the CS both in males (196.6±174.31 vs. 367.65±168.04 ml/min, P<0.01) and females (183.04±65.46 vs. 244.13±135.43 ml/min P<0.01). For males, the diagnostic sensitivity, specificity, and accuracy of the cutoff value of the CS flow (206 ml/min) for predicting a significant coronary artery stenosis (>70%) were 91.67%, 81.25%, and 85.71%, respectively. For females, those of the cutoff value of the CS flow (195 ml/min) were 85.71%, 75%, and 80%, respectively. CONCLUSION TTE can effectively detect coronary hemodynamically significant stenosis in non-hypertensive male and female patients at different cutoff values.
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Affiliation(s)
- Xiao-Zhi Zheng
- Department of Ultrasound, Jinling Hospital, Nanjing University School of Medicine, Nanjing City, Jiangsu Province, People's Republic of China
- Department of Ultrasound, The Fourth Affiliated Hospital of Nantong University, The First People's Hospital of Yancheng, Jiangsu Province, People's Republic of China
| | - Bin Yang
- Department of Ultrasound, Jinling Hospital, Nanjing University School of Medicine, Nanjing City, Jiangsu Province, People's Republic of China
| | - Jing Wu
- Department of Ultrasound, The Fourth Affiliated Hospital of Nantong University, The First People's Hospital of Yancheng, Jiangsu Province, People's Republic of China
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Helfer S, Schmitz L, Bührer C, Czernik C. Reproducibility and Optimization of Analysis Parameters of Tissue Doppler-Derived Strain and Strain Rate Measurements for Very Low Birth Weight Infants. Echocardiography 2013; 30:1219-26. [DOI: 10.1111/echo.12273] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Sven Helfer
- Department of Pediatric Cardiology; Charité University Medical Center; Berlin Germany
| | - Lothar Schmitz
- Department of Pediatric Cardiology; Charité University Medical Center; Berlin Germany
| | - Christoph Bührer
- Department of Neonatology; Charité University Medical Center; Berlin Germany
| | - Christoph Czernik
- Department of Neonatology; Charité University Medical Center; Berlin Germany
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