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Lv Q, Li M, Li H, Wu C, Dong N, Li Y, Zhang L, Xie M. Assessment of biventricular function by three-dimensional speckle-tracking echocardiography in clinically well pediatric heart transplantation patients. Echocardiography 2020; 37:2107-2115. [PMID: 33078446 DOI: 10.1111/echo.14893] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/08/2020] [Accepted: 09/25/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The biventricular function plays an important role in the prognosis of pediatric heart transplantation (HTx) patients. Therefore, in this study, we aimed to evaluate the biventricular function of pediatric HTx patients by three-dimensional (3D) speckle-tracking echocardiography (3D-STE). METHODS We enrolled 30 clinically well pediatric HTx patients and 30 healthy controls with a similar distribution of sex and age to the HTx. All participants underwent comprehensive two-dimensional (2D) and 3D echocardiography. Left ventricular (LV) global longitudinal strain (GLS), global circumferential strain (GCS), left and right ventricular ejection fraction (LVEF and RVEF, respectively), and right ventricular free wall longitudinal strain (RV FWLS) were acquired by 3D-STE. Moreover, the correlations between strains and clinical data were explored. RESULTS Compared with controls, LV GLS was decreased in pediatric HTx patients (P < .05), while LV GCS and LVEF showed no difference. LV GLS showed a weak correlation with cold ischemic time in HTx group (r = 0.396, P < .05). Meanwhile, RVEF and RV FWLS were significantly lower in the HTx group (P < .05). In the HTx group, RV FWLS showed a weak correlation with the preoperative mean pulmonary artery pressure (r = 0.420, P < .05) and postoperative pulmonary artery systolic pressure (r = 0.465, P < .05). CONCLUSION The 3D-biventricular mechanical functions were decreased in clinically well pediatric HTx patients. The provided characteristics and appropriate normal values of biventricular mechanical functions can be the basis in subsequent studies in the pediatric HTx patients.
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Affiliation(s)
- Qing Lv
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Meng Li
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - He Li
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Chun Wu
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Nianguo Dong
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuman Li
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Li Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Mingxing Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
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Lv Q, Sun W, Wang J, Wu C, Li H, Shen X, Liang B, Dong N, Li Y, Zhang L, Xie M. Evaluation of Biventricular Functions in Transplanted Hearts Using 3-Dimensional Speckle-Tracking Echocardiography. J Am Heart Assoc 2020; 9:e015742. [PMID: 32370590 PMCID: PMC7660853 DOI: 10.1161/jaha.119.015742] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The current study aims to validate the accuracy of 3-dimensional speckle-tracking echocardiography (3D-STE) in evaluating biventricular functions against the accuracy of cardiac magnetic resonance (CMR) and to explore the comprehensive characteristics and normal values for 3D-biventricular functions in transplanted hearts. Methods and Results A cohort of 35 heart transplant (HT) patients underwent both 3D echocardiography and CMR examination to validate the accuracy of 3D-STE in evaluating biventricular functions (Protocol 1). Then, 3D-STE derived biventricular functions were compared between 46 HT patients and 46 non-HT controls (Protocol 2). Protocol 1, validated that 3D-STE showed excellent accuracy in evaluating biventricular functions of transplanted hearts against CMR. Protocol 2, revealed lower (normal range) 3D-biventricular ejection fractions in HT patients than in controls (P<0.001). 3D-left ventricular global longitudinal strain, left ventricular-global circumferential strain, left ventricular-global radial strain, left ventricular-global performance index and right ventricular free-wall longitudinal strain were all lower in the HT patients than in healthy controls (P<0.001). Further, these strain values were all good for differentiating between groups (areas under the curve: 0.80-0.94, P<0.001). Moreover, left ventricular-lateral-wall radial displacement was higher and septal-wall radial displacement was lower in the HT group than in control group (P<0.001). Conclusions Compared with cardiac magnetic resonance, 3D-STE can evaluate biventricular functions of transplanted hearts accurately; 3D-biventricular mechanical functions are reduced even in clinically well HT patients. The provided characteristics and appropriate normal values of biventricular functions can be the basis for detection of ventricular dysfunction during follow-ups and further studies on transplanted hearts.
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Affiliation(s)
- Qing Lv
- Department of Ultrasound Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China.,Hubei Province Key Laboratory of Molecular Imaging Wuhan China
| | - Wei Sun
- Department of Ultrasound Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China.,Hubei Province Key Laboratory of Molecular Imaging Wuhan China
| | - Jing Wang
- Department of Ultrasound Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China.,Hubei Province Key Laboratory of Molecular Imaging Wuhan China
| | - Chun Wu
- Department of Ultrasound Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China.,Hubei Province Key Laboratory of Molecular Imaging Wuhan China
| | - He Li
- Department of Ultrasound Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China.,Hubei Province Key Laboratory of Molecular Imaging Wuhan China
| | - Xuehua Shen
- Department of Radiology Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Bo Liang
- Department of Radiology Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Nianguo Dong
- Department of Cardiovascular Surgery Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Yuman Li
- Department of Ultrasound Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China.,Hubei Province Key Laboratory of Molecular Imaging Wuhan China
| | - Li Zhang
- Department of Ultrasound Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China.,Hubei Province Key Laboratory of Molecular Imaging Wuhan China
| | - Mingxing Xie
- Department of Ultrasound Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China.,Hubei Province Key Laboratory of Molecular Imaging Wuhan China
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Cameli M, Mandoli GE, Sciaccaluga C, Mondillo S. More than 10 years of speckle tracking echocardiography: Still a novel technique or a definite tool for clinical practice? Echocardiography 2019; 36:958-970. [DOI: 10.1111/echo.14339] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 12/29/2022] Open
Affiliation(s)
- Matteo Cameli
- Department of Cardiovascular DiseasesUniversity of Siena Siena Italy
| | - Giulia E. Mandoli
- Department of Cardiovascular DiseasesUniversity of Siena Siena Italy
| | | | - Sergio Mondillo
- Department of Cardiovascular DiseasesUniversity of Siena Siena Italy
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Lisi M, Cameli M, Di Tommaso C, Curci V, Reccia R, D'ascenzi F, Focardi M, Maccherini M, Chiavarelli M, Lisi G, Lindqvist P, Mondillo S, Henein M. Mitral regurgitation severity correlates with symptoms and extent of left atrial dysfunction: Effect of mitral valve repair. JOURNAL OF CLINICAL ULTRASOUND : JCU 2018; 46:32-40. [PMID: 28949022 DOI: 10.1002/jcu.22521] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 06/12/2017] [Accepted: 06/21/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE We aimed to assess the relationship between mitral regurgitation (MR) severity, symptoms, and left atrial (LA) structure and function, before and after mitral valve repair (MVR). METHODS Global peak atrial longitudinal strain (PALS) was evaluated in 37 patients with severe symptomatic MR and preserved left ventricular (LV) ejection fraction (60.4% ± 4.6%) before and 3 months after MVR and was compared with values from 30 age- and gender-matched controls. RESULTS Before surgery, PALS was worse in patients than in controls and indexed LA volume was greater (P < .0001 for both). After MVR, PALS deteriorated further and LA volume decreased (P = .001 and P = .05, respectively) as did LV ejection fraction, longitudinal strain (P = .05 and P < .001, respectively), and LV mass (P < .0001). Before surgery, LA volume correlated modestly with LV end-diastolic volume (R = 0.51; P = .01); effective regurgitant orifice area (EROA) correlated with PALS (R = -0.69, P < .001) and with LV longitudinal strain (R = 0.54, P = .01), and New York Heart Association class correlated with PALS (R = -0.69, P < .001), EROA (R = 0.69, P < .001), and LA volume (R = 0.51, P = .04). LA volume was the strongest predictor of global PALS reduction (P < .001), whereas global PALS was the main predictor of postoperative atrial fibrillation (AF) (P < .001). CONCLUSIONS In patients with severe MR, EROA correlate with symptoms and LA PALS, which itself predicts the occurrence of postoperative AF. Strain values were superior to 2D data for the prediction of postoperative AF.
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Affiliation(s)
- Matteo Lisi
- Department of Cardiovascular Disease, University of Siena, Siena, Italy
- Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden
| | - Matteo Cameli
- Department of Cardiovascular Disease, University of Siena, Siena, Italy
| | | | - Valeria Curci
- Department of Cardiovascular Disease, University of Siena, Siena, Italy
| | - Rosanna Reccia
- Department of Cardiovascular Disease, University of Siena, Siena, Italy
| | - Flavio D'ascenzi
- Department of Cardiovascular Disease, University of Siena, Siena, Italy
| | - Marta Focardi
- Department of Cardiovascular Disease, University of Siena, Siena, Italy
| | - Massimo Maccherini
- Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden
| | | | - Gianfranco Lisi
- Department of Cardiac Surgery, University of Siena, Siena, Italy
| | - Per Lindqvist
- Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden
| | - Sergio Mondillo
- Department of Cardiovascular Disease, University of Siena, Siena, Italy
| | - Michael Henein
- Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden
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Grotenhuis HB, Nyns ECA, Kantor PF, Dipchand AI, Greenway SC, Yoo SJ, Tomlinson G, Chaturvedi RR, Grosse-Wortmann L. Abnormal Myocardial Contractility After Pediatric Heart Transplantation by Cardiac MRI. Pediatr Cardiol 2017; 38:1198-1205. [PMID: 28555404 PMCID: PMC5514218 DOI: 10.1007/s00246-017-1642-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 05/18/2017] [Indexed: 11/27/2022]
Abstract
Acute cellular rejection (ACR) compromises graft function after heart transplantation (HTX). The purpose of this study was to describe systolic myocardial deformation in pediatric HTX and to determine whether it is impaired during ACR. Eighteen combined cardiac magnetic resonance imaging (CMR)/endomyocardial biopsy (EMBx) examinations were performed in 14 HTX patients (11 male, age 13.9 ± 4.7 years; 1.2 ± 1.3 years after HTX). Biventricular function and left ventricular (LV) circumferential strain, rotation, and torsion by myocardial tagging CMR were compared to 11 controls as well as between patients with and without clinically significant ACR. HTX patients showed mildly reduced biventricular systolic function when compared to controls [LV ejection fraction (EF): 55 ± 8% vs. 61 ± 3, p = 0.02; right ventricular (RV) EF: 48 ± 7% vs. 53 ± 6, p = 0.04]. Indexed LV mass was mildly increased in HTX patients (67 ± 14 g/m2 vs. 55 ± 13, p = 0.03). LV myocardial deformation indices were all significantly reduced, expressed by global circumferential strain (-13.5 ± 2.3% vs. -19.1 ± 1.1%, p < 0.01), basal strain (-13.7 ± 3.0% vs. -17.5 ± 2.4%, p < 0.01), mid-ventricular strain (-13.4 ± 2.7% vs. -19.3 ± 2.2%, p < 0.01), apical strain (-13.5 ± 2.8% vs. -19.9 ± 2.0%, p < 0.01), basal rotation (-2.0 ± 2.1° vs. -5.0 ± 2.0°, p < 0.01), and torsion (6.1 ± 1.7° vs. 7.8 ± 1.1°, p < 0.01). EMBx demonstrated ACR grade 0 R in 3 HTX cases, ACR grade 1 R in 11 HTX cases and ACR grade 2 R in 4 HTX cases. When comparing clinically non-significant ACR (grades 0-1 R vs. ACR 2 R), basal rotation, and apical rotation were worse in ACR 2 R patients (-1.4 ± 1.8° vs. -4.2 ± 1.4°, p = 0.01 and 10.2 ± 2.9° vs. 2.8 ± 1.9°, p < 0.01, respectively). Pediatric HTX recipients demonstrate reduced biventricular systolic function and decreased myocardial contractility. Myocardial deformation indices by CMR may serve as non-invasive markers of graft function and, perhaps, rejection in pediatric HTX patients.
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Affiliation(s)
- Heynric B Grotenhuis
- Department of Paediatrics, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
| | - Emile C A Nyns
- Department of Paediatrics, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Paul F Kantor
- Department of Paediatrics, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
- Department of Pediatric Cardiology, Stollery Children's Hospital, Edmonton, AB, Canada
| | - Anne I Dipchand
- Department of Paediatrics, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Steven C Greenway
- Department of Paediatrics, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
- Departments of Paediatrics and Cardiac Sciences, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada
| | - Shi-Joon Yoo
- Department of Paediatrics, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - George Tomlinson
- Department of Medicine, Toronto General Hospital and Mt. Sinai Hospital, University of Toronto, Toronto, ON, Canada
| | - Rajiv R Chaturvedi
- Department of Paediatrics, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Lars Grosse-Wortmann
- Department of Paediatrics, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Sera F, Kato TS, Farr M, Russo C, Jin Z, Marboe CC, Di Tullio MR, Mancini D, Homma S. Left ventricular longitudinal strain by speckle-tracking echocardiography is associated with treatment-requiring cardiac allograft rejection. J Card Fail 2014; 20:359-64. [PMID: 24561182 DOI: 10.1016/j.cardfail.2014.02.006] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 02/13/2014] [Accepted: 02/14/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Noninvasive detection of rejection is a major objective in the management of heart transplant recipients. METHODS AND RESULTS To investigate the utility of 2-dimensional speckle-tracking echocardiography (2D-STE), we retrospectively evaluated 160 sets of endomyocardial biopsies and echocardiograms from 59 asymptomatic heart transplant recipients. Conventional International Society for Heart and Lung Transplantation grade 1B or higher rejection was considered as treatment-requiring rejection (group R), whereas International Society for Heart and Lung Transplantation grade 0 or 1A was classified as group Non-R. Left ventricular global longitudinal strain (GLS), global circumferential strain, and global radial strain were assessed by 2D-STE. Twenty-five specimens were classified into group R. GLS was significantly associated with treatment-requiring rejection, whereas neither global radial strain nor global circumferential strain were. Lower GLS remained significantly associated with an increased risk of treatment-requiring rejection (odds ratio, 1.15 [95% CI, 1.01-1.30]; P=0.03) even in multivariate analysis. GLS with the absolute value of less than 14.8% showed sensitivity and specificity of 64% and 63%, respectively, for detection of treatment-requiring rejection. CONCLUSION The 2D-STE-derived left ventricular GLS was associated with treatment-requiring rejection. Two-dimensional STE might be useful as a noninvasive supplemental tool for monitoring heart transplant recipients for possible treatment-requiring rejection.
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Affiliation(s)
- Fusako Sera
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York
| | - Tomoko S Kato
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York.
| | - Maryjane Farr
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York
| | - Cesare Russo
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York
| | - Zhezhen Jin
- Department of Biostatistics, Columbia University Medical Center, New York, New York
| | - Charles C Marboe
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York
| | - Marco R Di Tullio
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York
| | - Donna Mancini
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York
| | - Shunichi Homma
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, New York
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Cameli M, Righini FM, Lisi M, Mondillo S. Right ventricular strain as a novel approach to analyze right ventricular performance in patients with heart failure. Heart Fail Rev 2013; 19:603-10. [DOI: 10.1007/s10741-013-9414-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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