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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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Doria de Vasconcellos H, Win TT, Chamera E, Hong SY, Venkatesh BA, Young P, Yang X, Ciuffo L, Sharma RK, Imai M, Habibi M, Wud CO, Heckbert SR, Bluemke DA, Lima JAC. References Values for Left Atrial Volumes, Emptying Fractions, Strains, and Strain Rates and Their Determinants by Age, Gender, and Ethnicity: The Multiethnic Study of Atherosclerosis (MESA). Acad Radiol 2021; 28:356-363. [PMID: 32279912 DOI: 10.1016/j.acra.2020.02.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/03/2020] [Accepted: 02/14/2020] [Indexed: 02/07/2023]
Abstract
RATIONALE AND OBJECTIVES Left Atrial (LA) adverse remodeling is an important predictor of morbidity and mortality in several cardiovascular (CV) diseases. Our goals were to quantify and provide reference ranges for LA structure and function using feature tracking cine cardiac magnetic resonance. MATERIALS AND METHODS 2526 participants of the Multiethnic Study of Atherosclerosis study who had feature tracking cine cardiac magnetic resonance derived LA data and were free of atrial fibrillation/flutter and prior CV events at year five follow-up examination (2010-2012) were included in this study. LA phasic indexed volumes: maximum (LAVi max), minimum (LAVi min), and preatrial contraction (LAVi preA); LA empty fractions: total, passive, and active (LAtEF, LApEF, and LAaEF); LA longitudinal strain: maximum and preatrial contraction (S max and S preA); and LA longitudinal strain rate: systolic (SR max) and early/late diastolic (SR e and SR a) were measured. Age, gender, and race/ethnicity-specific reference ranges were identified. Also, reference values in a select subgroup of healthy participants free of traditional CV risk factors at the time of exam date were reported. RESULTS The mean ± SD for LAVi max, LAVi min, LAVi preA, S max, SR e, and SR a were in the 45-65-year-old participants: (33.8 ± 10 mL/m2), (14.5 ± 6.4 mL/m2), (24.8 ± 8.2 mL/m2), (34.6 ± 13.8 %), (-1.4 ± 0.7 s-1), (-2.1 ± 1 s-1) and in the ≥ 65-year-old participants: (35 ± 11.5 mL/m2), (16.6 ± 8.3 mL/m2), (27.6 ± 9.9 mL/m2), (31.2 ± 14.3 %), (-1 ± 0.6 s-1), (-2.1 ± 1 s-1) respectively. Younger individuals had Powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation smaller LA volumes and better LA function compared to their older counterparts. Similar findings were observed in Chinese-Americans as compared to Whites. CONCLUSION This study provides reference values of LA structure and function parameters from a healthy multiethnic community-based population aged 53-94 years evaluated by FTMRI.
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Affiliation(s)
- Henrique Doria de Vasconcellos
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 524, Baltimore, Maryland 21287-8222
| | - Theingi Tiffany Win
- Division of Cardiology, Department of Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Ela Chamera
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 524, Baltimore, Maryland 21287-8222
| | - Seo Young Hong
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 524, Baltimore, Maryland 21287-8222
| | - Bharath Ambale Venkatesh
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 524, Baltimore, Maryland 21287-8222
| | - Patrick Young
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 524, Baltimore, Maryland 21287-8222
| | - Xiaoying Yang
- Department of Statistics, The George Washington University, Washington, District of Columbia
| | - Luisa Ciuffo
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, United States
| | - Ravi K Sharma
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 524, Baltimore, Maryland 21287-8222
| | - Masamichi Imai
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 524, Baltimore, Maryland 21287-8222
| | - Mohammadali Habibi
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 524, Baltimore, Maryland 21287-8222
| | - Colin O Wud
- Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, Washington, District of Columbia
| | - David A Bluemke
- Radiology and Imaging Sciences, NIH Clinical Center, Bethesda, Maryland
| | - Joao A C Lima
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 524, Baltimore, Maryland 21287-8222.
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Johansen MC, Doria de Vasconcellos H, Nazarian S, Lima JAC, Gottesman RF. The Investigation of Left Atrial Structure and Stroke Etiology: The I-LASER Study. J Am Heart Assoc 2021; 10:e018766. [PMID: 33442991 PMCID: PMC7955322 DOI: 10.1161/jaha.120.018766] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Left atrial (LA) function is important in stroke, but often poorly characterized. We evaluated the association of 2-dimensional speckle tracking echocardiography LA variables with stroke subtype (cardioembolic stroke [CS] or cryptogenic stroke versus other). The hypothesis is worse LA active function is associated with CS, but not cryptogenic strokes. Methods and Results In this prospective cohort (2017-2019), left ventricular/LA structure and function were quantified by 2-dimensional and speckle tracking echocardiography in 151 patients with stroke. Strain/strain rate curves for the 3 components of the LA cycle, ie, (1) Reservoir (global longitudinal strain [Srmax]), (2) Conductive (early LA Sr [Sre]), and (3) Active (late LA strain [Sra]) were evaluated, masked to stroke subtype. Associations of cardiac features with stroke subtype were tested using multivariable logistic regressions. Odds of CS were increased in patients with a larger LA systolic diameter (odds ratio [OR], 2.96, 95% CI, 1.14-7.69) but reduced in patients with a higher Srmax (better reservoir) (OR, 0.80, 95% CI, 0.67-0.97). Lower Sra (worse function) was associated with an increased odds of CS (OR, 1.72, 95% CI, 1.07-2.76) but not independent of atrial fibrillation. Higher active LA emptying fraction (better active phase) was associated with reduced odds of CS (OR, 0.74, 95% CI, 0.57-0.95) or cryptogenic stroke (OR, 0.82, 95% CI, 0.68-0.98) versus other subtypes; other associations between cryptogenic stroke and speckle tracking echocardiography were not found. Conclusions Markers of LA structure and function were associated with CS. Similar associations were not found for cryptogenic stroke, which might suggest different underlying mechanisms, given study limitations. Further understanding could aid stroke diagnosis and secondary stroke prevention research.
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Affiliation(s)
- Michelle C Johansen
- Department of Neurology The Johns Hopkins University School of Medicine Baltimore MD
| | | | - Saman Nazarian
- Department of Cardiology The University of Pennsylvania Perelman School of Medicine Philadelphia PA
| | - Joao A C Lima
- Department of Cardiology The Johns Hopkins University School of Medicine Baltimore MD
| | - Rebecca F Gottesman
- Department of Neurology The Johns Hopkins University School of Medicine Baltimore MD
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Doria de Vasconcellos H, Betoko A, Ciuffo LA, Moreira HT, Nwabuo CC, Ambale-Venkatesh B, Reis JP, Allen N, Lloyd-Jones DM, Colangelo LA, Schreiner PJ, Lewis CE, Shikany JM, Sidney S, Cox C, Gidding SS, Lima JAC. Sex Differences in the Association of Cumulative Body Mass Index from Early Adulthood to Middle Age and Left Atrial Remodeling Evaluated by Three-Dimensional Echocardiography: The Coronary Artery Risk Development in Young Adults Study. J Am Soc Echocardiogr 2020; 33:878-887.e3. [PMID: 32336609 PMCID: PMC7388576 DOI: 10.1016/j.echo.2020.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/11/2020] [Accepted: 02/14/2020] [Indexed: 11/25/2022]
Abstract
Background: The relationship between long-term obesity and left atrial (LA) structure and function is not entirely understood. We examined the association of cumulative body mass index (cBMI) with LA remodeling using three-dimensional (3D) speckle-tracking echocardiography (STE). Methods: The Coronary Artery Risk Development in Young Adults (CARDIA) study is a community-based cohort of black and white, men and women, ages 18–30 years at baseline in 1985–86 from four U.S. centers. This study included 2,144 participants who had satisfactory image quality and body mass index measurements during the entire follow-up period. The 3D STE-derived LA parameters were maximum, minimum, and pretrial contraction volumes; total, passive, and active emptying fraction; maximum systolic longitudinal strain; and early and late diastolic longitudinal strain rates. Multivariable linear regression analyses stratified by sex assessed the relationship between cBMI and 3D STE-derived LA parameters, adjusting for demographics and traditional cardiovascular. Results: The mean age of the cohort was 55 ± 3.6 years; 54.8% were women, and 46.5% were black. There were statistically significant additive sex interactions for the association between cBMI and LA minimum contraction value, maximum systolic longitudinal strain, and early and late diastolic longitudinal strain rates. In the fully adjusted model, greater cBMI was associated with lower magnitude LA longitudinal deformation (maximum systolic longitudinal strain and early and late diastolic longitudinal strain rates) in men and with higher LA emptying fraction in women. In addition, greater cBMI was associated with higher LA phasic volumes indices in both men and women. Conclusions: This study showed that while greater cBMI from early adulthood throughout middle age was associated with higher LA volumes in both genders, differences were found for LA function, with lower longitudinal deformation in men and higher reservoir and active LA function in women. (J Am Soc Echocardiogr 2020;33:878–87.)
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Affiliation(s)
- Henrique Doria de Vasconcellos
- Johns Hopkins University, Baltimore, Maryland; Universidade Federal do Vale do Sao Francisco/School of Medicine, Petrolina, Pernambuco
| | | | | | - Henrique T Moreira
- Johns Hopkins University, Baltimore, Maryland; University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | | | | | - Jared P Reis
- National Heart, Lung, and Blood Institute, Bethesda, Maryland
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Sharashova E, Wilsgaard T, Ball J, Morseth B, Gerdts E, Hopstock LA, Mathiesen EB, Schirmer H, Løchen ML. Long-term blood pressure trajectories and incident atrial fibrillation in women and men: the Tromsø Study. Eur Heart J 2020; 41:1554-1562. [PMID: 31050731 PMCID: PMC7174044 DOI: 10.1093/eurheartj/ehz234] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/23/2018] [Accepted: 04/08/2019] [Indexed: 12/11/2022] Open
Abstract
AIMS To explore sex-specific associations between long-term individual blood pressure (BP) patterns and risk of incident atrial fibrillation (AF) in the general population. METHODS AND RESULTS Blood pressure was measured in 8376 women and 7670 men who attended at least two of the three population-based Tromsø Study surveys conducted in 1986-87, 1994-95, and 2001. Participants were followed for incident AF throughout 2013. Latent mixed modelling was used to identify long-term trajectories of systolic BP and hypertension. Cox regression was used to estimate associations between the identified trajectories and incident AF. Elevated systolic BP throughout the exposure period (1986-2001) independently and differentially increased risk of AF in women and men. In women, having elevated systolic BP trajectories doubled AF risk compared to having persistently low levels, irrespective of whether systolic BP increased, decreased, or was persistently high over time, with hazard ratios of 1.88 (95% confidence interval 1.37-2.58), 2.32 (1.61-3.35), and 1.94 (1.28-2.94), respectively. In men, those with elevated systolic BP that continued to increase over time had a 50% increased AF risk: 1.51 (1.09-2.10). When compared to those persistently normotensive, women developing hypertension during the exposure period, and women and men with hypertension throughout the exposure period had 1.40 (1.06-1.86), 2.75 (1.99-3.80), and 1.36 (1.10-1.68) times increased risk of AF, respectively. CONCLUSION Long-term BP and hypertension trajectories were associated with increased incidence of AF in both women and men, but the associations were stronger in women.
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Affiliation(s)
- Ekaterina Sharashova
- Department of Community Medicine, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
| | - Jocasta Ball
- Pre-Clinical Disease and Prevention, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Bente Morseth
- Department of Community Medicine, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Eva Gerdts
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
| | - Ellisiv B Mathiesen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Henrik Schirmer
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Akershus University Hospital, Lørenskog, Oslo, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
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