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Ficial B, Benfari G, Bonafiglia E, Clemente M, Cappelleri A, Flore AI, Petoello E, Ciarcià M, Nogara S, Milocchi C, Dani C, Ribichini FL, Gottin L, Corsini I. Tissue-Tracking Mitral Annular Displacement in Neonates: A Novel Index of Left Ventricular Systolic Function. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:729-739. [PMID: 38140738 DOI: 10.1002/jum.16399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/23/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES To assess the feasibility, accuracy, and reproducibility of tissue-tracking mitral annular displacement (TMAD) compared with other measures of left ventricular systolic function in healthy preterm and term neonates in the transitional period. METHODS This was a prospective observational study. Two echocardiograms were performed at 24 and 48 hours of life. TMAD, shortening fraction (SF), ejection fraction (EF), s', and global longitudinal strain (GLS) were measured offline. Accuracy to detect impaired GLS was tested by ROC curve analysis. DeLong test was used to compare AUCs. Intra and interobserver reproducibility of the off-line analysis was calculated. RESULTS Mean ± SD gestational age and weight were 34.2 ± 3.8 weeks and 2162 ± 833 g, respectively. TMAD was feasible in 168/180 scans (93%). At 24 hours the AUC (95% CI) of SF, EF, s', and TMAD (%) was 0.51 (0.36-0.67), 0.68 (0.54-0.82), 0.63 (0.49-0.77), and 0.89 (0.79-0.99) respectively. At 48 hours the AUC (95% CI) of SF, EF, s', and TMAD (%) was 0.64 (0.51-0.77), 0.59 (0.37-0.80), 0.70 (0.54-0.86), and 0.96 (0.91-1.00), respectively. The AUC of TMAD was superior to the AUC of SF, EF, s', at both timepoints (P < .02). Intraclass correlation coefficients (95% CI) of intra and interobserver reproducibility of TMAD were 0.97 (0.95-0.99) and 0.94 (0.88-0.97), respectively. CONCLUSION TMAD showed improved accuracy and optimal reproducibility in neonates in the first 48 hours of life.
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Affiliation(s)
- Benjamim Ficial
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Giovanni Benfari
- Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Elena Bonafiglia
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Maria Clemente
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Alessia Cappelleri
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Alice Iride Flore
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Enrico Petoello
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Martina Ciarcià
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Silvia Nogara
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Carlotta Milocchi
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, Verona, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | | | - Leonardo Gottin
- Intensive Care Unit, Department of Surgery, Dentistry, Maternity and Infant, University and Hospital Trust of Verona, Verona, Italy
| | - Iuri Corsini
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
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Ji X, Zhang Y, Xie Y, Zhao R, Li Y, Xie M, Zhang L. Feasibility and prognostic value of tissue motion annular displacement in patients with heart transplantation. Echocardiography 2024; 41:e15809. [PMID: 38581298 DOI: 10.1111/echo.15809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/17/2024] [Accepted: 03/18/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Tissue motion of mitral annular displacement (TMAD) assessment has proved to be an effective method for several cardiovascular diseases including hypertrophic cardiomyopathy, heart failure, non-ST-elevation myocardial infarction, etc. However, there are no studies exploring the feasibility of TMAD in heart transplantation (HT) recipients, and the predictive value of this parameter for adverse outcomes in these patients remains unknown. Consequently, this study aimed to evaluate the feasibility of TMAD in the evaluation of left ventricular (LV) systolic function in clinically well adult HT patients, and further investigate the prognostic value of TMAD. METHODS Echocardiography was performed in 155 adult HT patients and 49 healthy subjects. All the subjects were examined by conventional transthoracic two-dimensional echocardiography and two-dimensional speckle tracking echocardiography (2D-STE) with evaluation of the LV end-diastolic diameter, LV end-diastolic volume index, LV end-systolic volume index, interventricular septal thickness, left atrial diameter, mitral annular plane systolic excursion (MAPSE), LV ejection fraction (LVEF), TMAD and LV global longitudinal strain (LVGLS). The end point was defined as all-causes mortality or posttransplant related hospitalization during follow up. Cox proportional hazards regression was performed to evaluate the prognostic value of the parameters for predicting poor outcomes in HT patients. RESULTS A significant positive correlation was found between the measurements of TMAD and LVGLS (r = .714, p < .001). TMAD obtained by 2D-STE had good reproducibility. The LVGLS and TMAD were significantly lower in HT group than in control group (both p < .001). In HT patients, compared with event free group, adverse outcome group displayed reduced TMAD and LVGLS, and elevated age (p < .001, < .001, = .017, respectively). Patients with higher TMAD (> 9.1 mm) had comparatively better survival when stratified by cutoff value (log-rank p < .001). LVGLS and TMAD were independently associated with adverse outcomes in multivariable analysis (both p < .001). CONCLUSION Assessment of TMAD is effective for evaluating LV longitudinal systolic function and predicting adverse outcomes in clinically well adult HT patients.
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Affiliation(s)
- Xiang Ji
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yiwei Zhang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yuji Xie
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Ruohan Zhao
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yuman Li
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Mingxing Xie
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Li Zhang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
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Wang Z, Hu Y, Ou H, Feng J, Dong S, Ren S, Lu G, Li J. Speckle tracking tissue motion mitral annulus displacement to assess early changes in the left ventricle and its association with lung function in patients with chronic obstructive pulmonary disease. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:1439-1448. [PMID: 37883119 DOI: 10.1002/jcu.23568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/30/2023] [Accepted: 09/12/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE To evaluate the early changes in left ventricular (LV) in patients with chronic obstructive pulmonary disease (COPD) by measuring tissue motion mitral annulus displacement (TMAD) and three-dimensional (3D) parameters using speckle tracking imaging (STI), and to explore its correlation with lung function. METHODS Forty two COPD patients (GOLD I, GOLD II, GOLD III) and 30 healthy individuals (control group) were included. STI was used to assess the changes in LV structure and systolic function. Receiver operating characteristic (ROC) curves were drawn, and correlations among TMAD parameters, LV systolic function, structural, pulmonary artery systolic pressure (PASP), and lung function were analyzed. RESULTS Compared to the control group, COPD patients were able to undergo LV remodeling, with a decrease in the absolute value of global longitudinal strain (GLS) and TMAD, but no significant modification of LVEF. Correlation analysis showed that TMAD was positively related to the absolute value of GLS (r > 0.51, P < 0.01) and predicted forced expiratory volume in the first second (FEV1%) (r > 0.56, P < 0.01), and negatively to PASP (r < -0.52, P < 0.01). The LV posterior wall thickness (LVPWd), relative wall thickness (RWT), end-diastolic volume (LVEDV) and PASP negatively correlated with FEV1%. CONCLUSION The LV geometric changes and systolic function impairment in COPD patients were found to correlate with airflow restriction (FEV1%). TMAD aided in detection of early changes in LV systolic function in COPD patients. It negatively correlated with PASP and positively with FEV1%. Moreover, it was more convenient than GLS.
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Affiliation(s)
- Zijing Wang
- Department of Ultrasound, The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Yunhua Hu
- School of Medicine, Shihezi University, Shihezi, China
| | - Huajing Ou
- Department of Respiratory Medicine, The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Jia Feng
- Department of Ultrasound, The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Shanshan Dong
- Department of Ultrasound, The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Shan Ren
- Department of Critical Care Medicine, The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Guilin Lu
- Department of Ultrasound, The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Jun Li
- Department of Ultrasound, The First Affiliated Hospital, Shihezi University, Shihezi, China
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Wang YH, Sun L, Li SW, Wang CF, Pan XF, Liu Y, Wu J, Guan XP, Zhang SL, Dun GL, Liu YL, Wang LY, Cui L, Liu Y, Lai YQ, Ding MY, Lu GL, Tan J, Yang XJ, Li YH, Zhang XT, Fan M, Yu JH, Zheng QJ, Ma CY, Ren WD. Normal reference values for mitral annular plane systolic excursion by motion-mode and speckle tracking echocardiography: a prospective, multicentre, population-based study. Eur Heart J Cardiovasc Imaging 2023; 24:1384-1393. [PMID: 37530466 PMCID: PMC10531139 DOI: 10.1093/ehjci/jead187] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 08/03/2023] Open
Abstract
AIMS Mitral annular plane systolic excursion (MAPSE) is a simple and reliable index for evaluating left ventricular (LV) systolic function, particularly in patients with poor image quality; however, the lack of reference values limits its widespread use. This study aimed to establish the normal ranges for MAPSE measured using motion-mode (M-mode) and two-dimensional speckle tracking echocardiography (2D-STE) and to explore its principal determinants. METHODS AND RESULTS This multicentre, prospective, cross-sectional study included 1952 healthy participants [840 men (43%); age range, 18-80 years] from 55 centres. MAPSE was measured using M-mode echocardiography and 2D-STE. The results showed that women had a higher MAPSE than men and MAPSE decreased with age. The age- and sex-specific reference values for MAPSE were established for these two methods. Multiple linear regression analyses revealed that MAPSE on M-mode echocardiography correlated with age and MAPSE on 2D-STE with age, blood pressure (BP), heart rate, and LV volume. Moreover, MAPSE measured by 2D-STE correlated more strongly with global longitudinal strain compared with that measured using M-mode echocardiography. CONCLUSION Normal MAPSE reference values were established based on age and sex. BP, heart rate, and LV volume are potential factors that influence MAPSE and should be considered in clinical practice. Normal values are useful for evaluating LV longitudinal systolic function, especially in patients with poor image quality, and may further facilitate the use of MAPSE in routine assessments.
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Affiliation(s)
- Yong-Huai Wang
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, No. 155 Nanjingbei Street, Heping District, Shenyang 110001, China
| | - Lu Sun
- Department of Ultrasound, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, China
| | - Shi-Wen Li
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, No. 155 Nanjingbei Street, Heping District, Shenyang 110001, China
| | - Chun-Feng Wang
- Department of Cardiovascular Ultrasound, Mineral Hospital of Liaoning Provincial Health Industry Group, Fushun, China
| | - Xiao-Fang Pan
- Department of Ultrasonic Medicine, Central Hospital of Dalian University of Technology, Dalian, China
| | - Ying Liu
- Department of Ultrasound, Zibo Municipal Hospital, Zibo, China
| | - Jun Wu
- Department of Cardiovascular Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiang-Ping Guan
- Ultrasound Medical Center, ShanXi Province People’s Hospital, Xi’an, China
| | - Su-Li Zhang
- Department of Cardiovascular Ultrasound, Chaoyang Central Hospital, Chaoyang, China
| | - Guo-Liang Dun
- Department of Ultrasound Medicine, Baoji Central Hospital, Baoji, China
| | - Yi-Lin Liu
- Special Inspection Section, Liaocheng People’s Hospital, Liaocheng, China
| | - Li-Yan Wang
- Department of Ultrasound, Jilin Central General Hospital, Jilin, China
| | - Lei Cui
- Department of Ultrasound Diagnosis, Xianyang Central Hospital, Xianyang, China
| | - Yan Liu
- Department of Ultrasound, Dali Bai Autonomous Prefecture People’s Hospital, Dali, China
| | - Yu-Qiong Lai
- Depatment of Cardiovascular Ultrasound, The First People’s Hospital of Foshan, Foshan, China
| | - Ming-Yan Ding
- Department of Cardiac Function, The People’s Hospital of Liaoning Province, Shenyang, China
| | - Gui-Lin Lu
- Department of Ultrasound Diagnosis, The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Jing Tan
- Department of Ultrasound in Medicine, Chengdu Wenjiang District People’s Hospital, Chengdu, China
| | - Xin-Jian Yang
- Department of Ultrasound, The Second People’s Hospital of Baiyin City, Baiyin, China
| | - Yi-Hong Li
- Department of Ultrasound, Tangshan Fengnan District Hospital, Tangshan, China
| | - Xin-Tong Zhang
- Department of Ultrasound, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, China
| | - Miao Fan
- Department of Ultrasound, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, China
| | - Jia-Hui Yu
- Department of Ultrasound, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, China
| | - Qiao-Jin Zheng
- Department of Ultrasound, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, China
| | - Chun-Yan Ma
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, No. 155 Nanjingbei Street, Heping District, Shenyang 110001, China
| | - Wei-Dong Ren
- Department of Ultrasound, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, China
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A Novel Speckle-Tracking Echocardiography Derived Parameter That Predicts Clinical Worsening in Children with Pulmonary Arterial Hypertension. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pulmonary arterial hypertension is a severe, progressive disease in children, that causes right ventricular dysfunction over time. Tissue motion annular displacement is a novel speckle-tracking derived echocardiographic parameter used in assessing ventricular function. The aim of our study was to determine the prognostic value of this echocardiographic parameter in children with pulmonary arterial hypertension. We conducted a case-control study by assessing twenty children with pulmonary arterial hypertension (idiopathic or secondary) and twenty age- and sex-matched controls, using clinical (WHO functional class, 6-min walking test), laboratory (brain natriuretic peptide level) and echocardiographic parameters (conventional and speckle-tracking derived tissue motion annular displacement) at enrolment and after one year of follow-up. According to their WHO functional class altering after one year, the pulmonary arterial hypertension patients were divided into two groups: non-worsening (eleven) and worsening (nine). The conventional echocardiographic parameters and all measured tricuspid tissue motion annular displacement indices (lateral, septal, midpoint and midpoint fractional displacement—TMADm%) were significantly lower in both pulmonary arterial hypertension groups (non-worsening and worsening) compared to controls. Comparing the worsening and non-worsening groups, only the TMADm% and brain natriuretic peptide level was significantly lower in worsening in comparison with non-worsening pulmonary arterial hypertension children (p = 0.010 and p = 0.018, respectively). In receiver-operating characteristic curve analysis, we found a cut-off value of 16.15% for TMADm% and a cut-off value of 34.35 pg/mL for the brain natriuretic peptide level that can predict worsening in pulmonary arterial hypertension children. In conclusion, tricuspid annulus midpoint fractional displacement, an angle-dependent speckle-tracking derived parameter, could be a good additional parameter in the assessment of the longitudinal right ventricular systolic function and in prediction of clinical worsening in children with pulmonary arterial hypertension.
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Tissue motion annular displacement to assess the left ventricular systolic function in healthy cats. Vet Res Commun 2022; 46:823-836. [PMID: 35258757 DOI: 10.1007/s11259-022-09907-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/16/2022] [Indexed: 10/18/2022]
Abstract
The tissue motion annular displacement (TMAD) measures the longitudinal displacement of the mitral annulus during systole, using speckle-tracking echocardiography (STE). The main objective was to determine the TMAD means in healthy cats, exploring the correlations with systolic surrogates. The influence of age, body surface area (BSA), heart rate, and systemic blood pressure on the indices was also analyzed. One hundred ninety-three healthy, client-owned cats participated in this prospective, cross-sectional observational study undergoing conventional and STE. Apical four-chamber (AP4) and two-chamber (AP2) images were recorded for offline calculations. Mean TMAD values were similar to mitral annulus plane systolic excursion (MAPSE), varying between 4 to 4.8 mm depending on the annulus and image used. No significant differences between age and BSA categories were detected, except for AP4 MP%, reduced in the heavier group. TMAD variables showed moderate correlation with longitudinal strain (LSt) and MAPSE, but not with fraction shortening (FS) and ejection fraction (EF). The median time required for the offline calculation was 12.2 s for AP4 and 11.8 s for AP2. The technique showed moderate inter and intraobserver variation, proving a reliable tool for assessing left ventricular longitudinal systolic function in cats.
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Wolf M, Lucina SB, Silva VBC, Tuleski GLR, Sarraff AP, Komatsu EY, Sousa MG. Assessment of longitudinal systolic function using tissue motion annular displacement in dogs with degenerative mitral valve disease. J Vet Cardiol 2021; 38:44-58. [PMID: 34800922 DOI: 10.1016/j.jvc.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/10/2021] [Accepted: 10/13/2021] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Although degenerative mitral valve disease (DMVD) is essentially a disorder of the valve, the progression of the disease leads to structural myocardial changes that may compromise left ventricular systolic function. Tissue motion annular displacement (TMAD) is a surrogate for longitudinal fiber function based on speckle tracking assessment of the movement of the mitral annulus toward the apex during systole. The aim of this study was to evaluate longitudinal systolic function with TMAD in dogs with DMVD. ANIMALS Ninety-four dogs with DMVD and 32 healthy dogs. METHODS Prospective cross-sectional observational study. Dogs with DMVD of various American College of Veterinary Internal Medicine classification stages and healthy control dogs underwent physical examination, electrocardiography, systolic blood pressure measurement, as well as a standard and speckle tracking echocardiography. Global longitudinal strain (GLS) and TMAD were used to assess longitudinal systolic function. RESULTS The global TMADmm and global TMAD% were higher in American College of Veterinary Internal Medicine B2 animals than in the stage CD. Global TMAD (mm/kg,mm/bodyweight3, mm/m2) were correlated with GLS and ejection fraction. Global TMAD (mm/kg,mm/m2,%) and GLS were influenced by sex. In addition, systolic blood pressure influenced GLS (P < 0.01; r = -0.23), global TMADmm/kg (P = 0.017; r = -0.21) and global TMADmm/m2 (P = 0.031; r = -0.19). Tissue motion annular displacement was fast to be performed and produced good repeatability in dogs with DMVD. CONCLUSIONS Global TMAD (mm,%), was reduced in DMVD dogs with clinical signs of heart failure compared with stage B2. Tissue motion annular displacement was shown to be a repeatable technique for evaluation of longitudinal systolic function in dogs with DMVD.
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Affiliation(s)
- M Wolf
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil.
| | - S B Lucina
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
| | - V B C Silva
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
| | - G L R Tuleski
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
| | - A P Sarraff
- School of Life Sciences, Pontifical Catholic University of Paraná (PUC-PR), Rua Rockfeller 1311, Curitiba, 80230-130, Brazil
| | - E Y Komatsu
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
| | - M G Sousa
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
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Wang Y, Zhang Y, Li G, Kong F, Guan Z, Yang J, Ma C. Validation of estimating left ventricular ejection fraction by mitral annular displacement derived from speckle-tracking echocardiography: A neglected method for evaluating left ventricular systolic function. JOURNAL OF CLINICAL ULTRASOUND : JCU 2021; 49:563-572. [PMID: 33569776 DOI: 10.1002/jcu.22987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/19/2021] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE The echocardiographic measurement of left ventricular (LV) ejection fraction (EF) is dependent on professional experience and adequate visualization. Tissue motion of mitral annular displacement (TMAD) can be easily assessed using speckle-tracking echocardiography (STE), even in patients with poor acoustic windows. Therefore, this study aimed to assess whether left ventricular ejection fraction (LVEF) can be estimated using STE-derived TMAD when LVEF is not available. METHODS Four-hundred fifty-six outpatients were enrolled after excluding the patients whose LVEF measurements remained challenging or TMAD value could be confounded. An optimized regression model for LVEF-TMAD was developed in the derivation set (n = 287), and its reliability was verified in the validation set (n = 123) and regional wall motion abnormalities (RWMA) set (n = 46). RESULTS In the derivation set, the power models had the highest F-value. Therefore, the power equations were chosen to estimate LVEF by TMAD in the validation set. There was a near-zero bias and a narrow range between the observed and estimated LVEF. The highest intra-class correlation coefficient was found between the observed and the estimated LVEF by normalized TMAD at the midpoint of mitral annular (nTMADmid). Moreover, there were no significant differences between the observed and the estimated LVEF in the RWMA set. CONCLUSION The LVEF can be estimated with STE-derived TMAD, even for patients with RWMA, and nTMADmid may be the optimal parameter.
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Affiliation(s)
- Yonghuai Wang
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Yan Zhang
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Guangyuan Li
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Fanxin Kong
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Zhengyu Guan
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
- Department of Ultrasound, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Jun Yang
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Chunyan Ma
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
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Comparison of Quantitative Versus Qualitative Assessment of Single Right Ventricular Function for the Prediction of Midterm Outcomes. Pediatr Cardiol 2021; 42:768-773. [PMID: 33517466 DOI: 10.1007/s00246-021-02539-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
Multiple studies have shown that quantitative evaluation of right ventricular (RV) systolic function in children with hypoplastic left heart syndrome (HLHS) is associated with outcomes. However, the most widely used method is qualitative, or subjective echocardiographic evaluation. Tricuspid annular displacement (TMAD) is a quantitative method and has been shown to be associated with transplant/death in a cohort of pediatric patients with HLHS. In this study, the same echocardiograms used in the quantitative TMAD study were qualitatively evaluated to see if the assessment correlated with midterm outcomes. We hypothesized that TMAD measures would outperform qualitative measurements. A previously published retrospective study of patients with systemic right ventricle demonstrated that TMAD measurements of function prior to the Glenn procedure were associated with midterm mortality/transplant (mean TMAD 12.4% for survivors and 10.0% for non-survivors/transplant, p = 0.03). Echocardiographic images used in that study were re-evaluated using qualitative assessment of function. A score between severely depressed (0) and supra-normal (7) was assigned independently by three cardiologists. A chart review included short-term clinical outcome measures in addition to midterm mortality/transplant. Spearman correlations and logistic regression were used to estimate the associations between function scores and clinical outcomes. Function scores were measured with acceptable inter- and intra-rater reliabilities in 47 patients who had echocardiograms used in the prior analysis before their bidirectional Glenn. The mean functional score was 5.3 ± 1.32 in survivors and 5.0 ± 1.02 in non-survivors/transplant. Subjective echocardiographic scores of function were not predictive of mortality (p = 0.23). Scores were correlated with length of cardiac intensive care unit stay (Spearman's rho = - 0.31, p = 0.04), but not post-Glenn total length of hospital stay (p = 0.4). A sub-analysis was performed for each individual operator. Only one of three operators produced scores with a significant association with mortality/transplant (p = 0.01, p = 0.25, p = 0.22, respectively). Averaged subjective measurement of function by three pediatric cardiologists in children with single right ventricle prior to the Glenn procedure was not associated with midterm outcomes. Previous work based on the same echocardiograms showed that quantitative analysis was associated with midterm outcomes. This suggests quantitative analysis may be more useful in prognostication. Future studies could confirm these results and identify which quantitative methods are most helpful.
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Silva VBC, Wolf M, Lucina SB, Sarraff-Lopes AP, Sousa MG. Assessment of right ventricular systolic function by tissue motion annular displacement in healthy dogs. J Vet Cardiol 2020; 32:40-48. [PMID: 33137658 DOI: 10.1016/j.jvc.2020.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 09/19/2020] [Accepted: 09/22/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION/OBJECTIVES There are few parameters for assessment of right ventricular (RV) systolic function on echocardiographic examination. Morphofunctional studies are limited by the irregular shape of the RV. Recently, tissue motion annular displacement (TMAD), a technique that evaluates valve annulus displacement toward the cardiac apex, has shown a good correlation with left ventricular global longitudinal strain (GLS) in healthy dogs. Therefore, the aim of this study was to evaluate the longitudinal systolic function of the RV of healthy dogs using TMAD. ANIMALS A hundred healthy client-owned dogs. MATERIALS AND METHODS Cross-sectional study. Physical examination, electrocardiogram, blood pressure measurement, and echocardiography were recorded. The systolic function of the RV was evaluated by GLS free wall and TMAD. Data were compared with those derived from conventional echocardiography. RESULTS TMAD values varied according to body weight. There was a correlation of TMAD in millimeters with all indices of RV systolic function, including GLS free wall (R:-0.239; p:0.017). TMAD had a correlation with age and heart rate; whereas there was no relationship with sex and blood pressure. The coefficient of variation for the intraobserver evaluation was lower for the TMAD in millimeters (9.9%) compared with the GLS free wall (17.9%). In addition, the mean time to perform TMAD (8.1 s) was lower than that of the GLS free wall (37.7 s). CONCLUSIONS TMAD is a fast, reproducible, and promising method for assessing RV systolic function in healthy dogs. However, further studies are needed to understand the applicability of this technique in patients with heart disease.
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Affiliation(s)
- V B C Silva
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil.
| | - M Wolf
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
| | - S B Lucina
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
| | - A P Sarraff-Lopes
- School of Life Sciences, Pontifical Catholic University of Paraná (PUC-PR), Rua Rockfeller 1311, Curitiba, 80230-130, Brazil
| | - M G Sousa
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
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Teraguchi I, Hozumi T, Emori H, Takemoto K, Fujita S, Wada T, Kashiwagi M, Shiono Y, Shimamura K, Kuroi A, Tanimoto T, Kubo T, Tanaka A, Akasaka T. Prognostic value of tissue-tracking mitral annular displacement by speckle-tracking echocardiography in asymptomatic aortic stenosis patients with preserved left ventricular ejection fraction. J Echocardiogr 2020; 19:95-102. [PMID: 32970310 DOI: 10.1007/s12574-020-00490-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/26/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Tissue-tracking mitral annular displacement (TMAD) by speckle-tracking echocardiography provides rapid and simple assessment of left ventricular (LV) longitudinal deformation. The purpose of this study was to evaluate the value of TMAD for the assessment of LV longitudinal deformation in patients with severe AS and preserved LV ejection fraction (LVEF). METHODS We studied 44 patients with severe AS preserved and LVEF in whom TMAD was assessed. Using TMAD analysis software, the base-to-apex displacement of automatically defined mid-point of mitral annular line in four-chamber view was quickly assessed, and the percentage of its displacement to LV length at end-diastole (%TMAD) was calculated. We investigated the association between %TMAD and the cardiac events including appearance of symptom (dyspnea on exertion and hospitalization due to heart failure), decreased LVEF (< 50%), and cardiac death. RESULTS During follow-up, the cardiac events developed in 16 (36%) of 44 patients. %TMAD was significantly impaired in patients with the cardiac events compared with those without the cardiac events (9.6 ± 1.9 vs 12.1 ± 2.6, p = 0.002). The cardiac events were predicted by %TMAD (HR 0.68, 95% CI 0.54-0.85; p = 0.0012). CONCLUSIONS The present study suggests that TMAD easily and rapidly estimated by speckle-tracking echocardiography may be used as a simple method to predict occurrence of the cardiac events in asymptomatic severe AS patients with preserved LVEF.
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Affiliation(s)
- Ikuko Teraguchi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takeshi Hozumi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Hiroki Emori
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kazushi Takemoto
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Suwako Fujita
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Teruaki Wada
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Manabu Kashiwagi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kunihiro Shimamura
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Akio Kuroi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Tanimoto
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Kubo
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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Teraguchi I, Hozumi T, Takemoto K, Ota S, Kashiwagi M, Shimamura K, Shiono Y, Kuroi A, Yamano T, Yamaguchi T, Matsuo Y, Ino Y, Kitabata H, Kubo T, Tanaka A, Akasaka T. Assessment of decreased left ventricular longitudinal deformation in asymptomatic patients with organic mitral regurgitation and preserved ejection fraction using tissue‐tracking mitral annular displacement by speckle‐tracking echocardiography. Echocardiography 2019; 36:678-686. [DOI: 10.1111/echo.14290] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/17/2019] [Accepted: 01/28/2019] [Indexed: 12/27/2022] Open
Affiliation(s)
- Ikuko Teraguchi
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Takeshi Hozumi
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Kazushi Takemoto
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Shingo Ota
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Manabu Kashiwagi
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Kunihiro Shimamura
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Yasutsugu Shiono
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Akio Kuroi
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Takashi Yamano
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Tomoyuki Yamaguchi
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Yoshiki Matsuo
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Yasushi Ino
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Hironori Kitabata
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Takashi Kubo
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Atsushi Tanaka
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
| | - Takashi Akasaka
- Department of Cardiovascular MedicineWakayama Medical University Wakayama Japan
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Derpa VF, Koch R, Möllers M, Hammer K, Oelmeier de Murcia K, Köster HA, Falkenberg MK, Braun J, Klockenbusch W, Schmitz R. Comparison of Longitudinal and Apical Foetal Speckle Tracking Echocardiography Using Tissue Motion Annular Displacement and Segmental Longitudinal Strain. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:233-245. [PMID: 30482712 DOI: 10.1016/j.ultrasmedbio.2018.09.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 09/05/2018] [Accepted: 09/14/2018] [Indexed: 06/09/2023]
Abstract
The aim of our prospective pilot study with exploratory analysis was to compare longitudinal and apical foetal speckle tracking echocardiography (STE) using tissue motion annular displacement (TMAD) and segmental longitudinal strain (SLS). We compared two different STE quantification tools in a longitudinal and apical four-chamber view in 57 normal foetuses between 20 and 40 wk of gestation. Myocardial mechanical dyssynchrony and strain were assessed using offline quantification software (QLab Version 10.3, Philips Medical Systems, Andover, MA, USA). We compared the dyssynchrony measurements with TMAD and SLS in longitudinal and apical four-chamber views. Furthermore, we examined the segmental strain values of both ventricles with SLS and compared the differences between longitudinal and apical measurements. Dyssynchrony measurements with TMAD and SLS and strain measurements with SLS were feasible in all cases. In the apical view, the dyssynchrony measurements with TMAD were systematically greater than those achieved with SLS (p < 0.001). For the longitudinal view, no differences were observed between tools (p = 0.153). The application of SLS provided similar results for dyssynchrony in both views (intra-class correlation coefficient [ICC] = 0.281, p = 0.623), but the strain measurements in the left and right ventricles differed significantly between views (ICC = -0.082, p = 0.011, and ICC = -0.061, p = 0.024, respectively). For TMAD, we found large differences in the dyssynchrony values between longitudinal and apical assessment (ICC = -0.060, p = 0.03). Furthermore, TMAD exhibited reduced accuracy in the system's automatic tracking algorithm, limiting the data quality. The dyssynchrony assessment is affected less by the foetal position in SLS than in TMAD. The strain readings in SLS varied depending on the view in which they were assessed. The application of TMAD cannot be recommended for foetal STE.
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Affiliation(s)
- Vivian F Derpa
- Department of Obstetrics and Gynecology, University Hospital Münster, Münster, Germany.
| | - Raphael Koch
- Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - Mareike Möllers
- Department of Obstetrics and Gynecology, University Hospital Münster, Münster, Germany
| | - Kerstin Hammer
- Department of Obstetrics and Gynecology, University Hospital Münster, Münster, Germany
| | | | - Helen A Köster
- Department of Obstetrics and Gynecology, University Hospital Münster, Münster, Germany
| | - Maria K Falkenberg
- Department of Obstetrics and Gynecology, University Hospital Münster, Münster, Germany
| | - Janina Braun
- Department of Obstetrics and Gynecology, University Hospital Münster, Münster, Germany
| | - Walter Klockenbusch
- Department of Obstetrics and Gynecology, University Hospital Münster, Münster, Germany
| | - Ralf Schmitz
- Department of Obstetrics and Gynecology, University Hospital Münster, Münster, Germany
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Asada D, Okumura K, Ikeda K, Itoi T. Tissue Motion Annular Displacement of the Mitral Valve Can Be a Useful Index for the Evaluation of Left Ventricular Systolic Function by Echocardiography in Normal Children. Pediatr Cardiol 2018. [PMID: 29520464 DOI: 10.1007/s00246-018-1847-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
As the important role of longitudinal shortening in ventricular function has been well recognized over the past decade, evaluation of longitudinal systolic function of the left ventricle has become a subject of growing interest. Tissue motion annular displacement of the mitral valve (TMAD) is a new parameter of longitudinal systolic function. Although some studies have reported that this new parameter correlates with left ventricular ejection fraction (LVEF) in adults, little is known about TMAD in normal children. In this work, we investigated 94 children with no history of cardiovascular disease. TMAD was measured in the apical four-chamber view using the two-dimensional speckle tracking technique. Three points for tracking were selected in a diastolic frame: the lateral mitral valve annulus, medial mitral valve annulus, and left ventricular apex. The value was expressed as the percentage of displacement of the midpoint of the mitral valve annulus, using software to correct for left ventricular length at end-diastole. Pearson's coefficient was used to estimate the correlation between TMAD and left ventricular systolic function parameters including the biplane modified Simpson method-derived ejection fraction and global longitudinal strain (GLS). We also analyzed the correlation between TMAD and heart rate (HR), height, age, and body surface area (BSA). TMAD was found to correlate significantly with LVEF (r = 0.71, p < 0.01) and GLS (r = -0.77, p < 0.01). However, no correlation was revealed for HR (r = -0.14, p = 0.19), height (r = -0.17, p = 0.10), age (r = -0.19, p = 0.09), or BSA (r = -0.19, p = 0.08). These results indicate that TMAD is useful for assessing LVEF and longitudinal systolic function in normal children, and is not influenced by changes in HR, height, age, or BSA.
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Affiliation(s)
- Dai Asada
- Department of Pediatric Cardiology and Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Kenichi Okumura
- Department of Pediatric Cardiology and Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Kazuyuki Ikeda
- Department of Pediatric Cardiology and Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Toshiyuki Itoi
- Department of Pediatric Cardiology and Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
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Penk JS, Zaidi SJH, Lefaiver CA, Muangmingsuk S, Cui VW, Roberson DA. Tissue Motion Annular Displacement Predicts Mortality/Transplant After the Bidirectional Glenn. World J Pediatr Congenit Heart Surg 2018; 9:171-176. [DOI: 10.1177/2150135117742650] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Quantifying right ventricular function in patients with a systemic right ventricle (RV) is difficult but important for prognosis. Tissue motion annular displacement tracks displacement of the tricuspid annulus toward the apex. We evaluated this measure alongside fractional area change (FAC) on patients with single, RV prior to the bidirectional Glenn procedure. We tested both measures for correlation with outcomes. Methods: Retrospective measurement of tissue motion annular displacement and FAC was performed on echocardiographic clips obtained prior to the bidirectional Glenn. A chart review included postoperative outcomes and midterm mortality/transplant. Bivariate correlations and Cox proportional hazards models were used for analyses. Results: Fifty-one patients with dominant RV underwent the bidirectional Glenn procedure and all had image quality that allowed analysis. The age ranged from 3 to 11 months (median 4 months). Neither tissue motion annular displacement nor FAC correlated with short-term postoperative outcomes. Tissue motion annular displacement was independently predictive of mortality/transplant ( P = .03) in the Cox hazard model. The mean for survivors was 12.4% and for nonsurvivors/transplants was 10.0%. Tissue motion annular displacement intra-observer variability was 2.8% (1.2%-3.5%). Interobserver mean variability was 6.1% (3.3%-8.1%). Fractional area change was not predictive of mortality/transplant. Conclusion: Tissue motion annular displacement is an independent predictor of midterm mortality/transplant after the bidirectional Glenn procedure in patients with single, RV, in this study. It may outperform FAC in this regard and has good reproducibility. Tissue motion annular displacement may be a useful measure in identifying high-risk children in this population.
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Affiliation(s)
- Jamie S. Penk
- Department of Pediatrics, Advocate Children’s Hospital, Oak Lawn, IL, USA
| | - S. Javed H. Zaidi
- Department of Pediatrics, Advocate Children’s Hospital, Oak Lawn, IL, USA
| | - Cheryl A. Lefaiver
- Department of Pediatrics, Advocate Children’s Hospital, Oak Lawn, IL, USA
| | | | - Vivian W. Cui
- Department of Pediatrics, Advocate Children’s Hospital, Oak Lawn, IL, USA
| | - David A. Roberson
- Department of Pediatrics, Advocate Children’s Hospital, Oak Lawn, IL, USA
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Subclinical reduction in left ventricular function using triplane and 2D speckle tracking echocardiography after anthracycline exposure in children. Anatol J Cardiol 2018; 19:58-66. [PMID: 29339701 PMCID: PMC5864791 DOI: 10.14744/anatoljcardiol.2017.7944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objective: Speckle tracking echocardiography (STE) enables global and regional evaluation of the left ventricle (LV); therefore, it is the most useful method for detecting subclinical dysfunction in patients exposed to cardiotoxic agents. A novel technique triplane (3P) echocardiography also allows single beat assessment of LV global longitudinal strain values. We firstly aimed to demonstrate both two-dimensional (2D)- and 3P-STE-derived LV global longitudinal strain measurements in children after anthracycline exposure. Methods: This study included 23 cross-sectionally enrolled asymptomatic pediatric cancer patients who received anthracycline chemotherapy and 17 healthy controls matched by age, gender, and body surface area. All subjects underwent detailed 2D, Doppler, 2D-STE, and 3P-STE for assessment of LV function. The patients had received a median cumulative dose of 150 mg/m2. Results: 1. From “Pulsed” Doppler-based measurements, only pulmonary vein flow ratio showed a significant difference between the groups. 2. When measurements were taken from the interventricular septum, the patients’ ejection time values decreased significantly and their myocardial performance index values increased significantly; when the measurements were taken from the LV free wall, the peak systolic velocities showed a statistically significant difference. 3. Both 2D- and 3P-STE-derived longitudinal myocardial deformation values of LV were lower in the patient group. 4. 2D-STE-derived LV circumferential strain values were decreased in the patient group, whereas radial strain values were not significantly different compared with matched controls. Conclusion: Using Doppler and 2D- and 3P-STE methods, this study confirmed the subclinical LV dysfunction in patients after anthracycline exposure.
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Ylänen K, Eerola A, Vettenranta K, Poutanen T. Speckle tracking echocardiography detects decreased cardiac longitudinal function in anthracycline-exposed survivors of childhood cancer. Eur J Pediatr 2016; 175:1379-86. [PMID: 27620626 DOI: 10.1007/s00431-016-2776-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 08/22/2016] [Accepted: 09/05/2016] [Indexed: 10/21/2022]
Abstract
UNLABELLED Longitudinal motion significantly contributes to the contraction of the ventricles. We studied the left (LV) and right ventricular (RV) longitudinal functions in 75 anthracycline-exposed, long-term childhood cancer survivors and 75 healthy controls with conventional echocardiography, tissue Doppler imaging (TDI), speckle tracking echocardiography (STE) of the mitral and tricuspid annular motion, and real-time three-dimensional echocardiography (RT-3DE). Cardiac magnetic resonance (CMR) imaging was performed on 61 of the survivors. The survivors had lower systolic myocardial velocities in the LV and lower diastolic velocities in both ventricles by TDI than did their healthy peers. The STE-based tissue motion annular displacement (TMAD) values describing the LV and RV systolic longitudinal function (MAD and TAD mid%, respectively) were also lower among the survivors (15.4 ± 2.4 vs. 16.1 ± 2.2 %, p = 0.049 and 22.5 ± 3.0 vs. 23.5 ± 3.0 %, p = 0.035). MAD and TAD mid in millimeters correlated with the respective ventricular volumes measured with RT-3DE or CMR. CONCLUSION Childhood cancer survivors exposed to low to moderate anthracycline doses had decreased longitudinal systolic and diastolic functions (TDI or STE) compared with healthy controls. The STE-based TMAD is a fast and reproducible method to assess cardiac longitudinal function. What is Known? • High anthracycline doses cause LV dysfunction as evidenced by a decreased ejection fraction. What is new? • Low to moderate anthracycline doses also have a negative impact on the LV and RV longitudinal systolic and diastolic function. • TMAD is a new and fast method to assess the cardiac longitudinal function after anthracycline exposure.
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Affiliation(s)
- Kaisa Ylänen
- Department of Pediatrics, Tampere University Hospital, PO BOX 2000, FIN-33521, Tampere, Finland. .,University of Tampere, Tampere, Finland.
| | - Anneli Eerola
- Department of Pediatrics, Tampere University Hospital, PO BOX 2000, FIN-33521, Tampere, Finland
| | - Kim Vettenranta
- Hospital for Children and Adolescents, PO BOX 281, FIN-00029 HUS, Helsinki, Finland.,University of Helsinki, Helsinki, Finland
| | - Tuija Poutanen
- Department of Pediatrics, Tampere University Hospital, PO BOX 2000, FIN-33521, Tampere, Finland.,University of Tampere, Tampere, Finland
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Speckle tracking determination of mitral tissue annular displacement: comparison with strain and ejection fraction, and association with outcomes in haemodialysis patients. Int J Cardiovasc Imaging 2016; 32:1511-8. [DOI: 10.1007/s10554-016-0946-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 07/19/2016] [Indexed: 10/21/2022]
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Strachinaru M, Annis C, Catez E, Jousten I, Lutea ML, Pavel O, Morissens M. The mitral annular displacement by two-dimensional speckle tracking: a new tool in evaluating the left atrial function. J Cardiovasc Med (Hagerstown) 2016; 17:344-53. [PMID: 27031582 DOI: 10.2459/jcm.0000000000000346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The methods used to characterize the volume change and the deformation of the left atrium are highly dependent on technical factors and difficult to use in a clinical environment. The aim of this study was to demonstrate that mitral annular displacement by speckle tracking can be an alternative method to studying the longitudinal left atrial function. METHODS Ninety study participants (54% men), with a mean age of 53(±15) years, underwent a complete echocardiographic examination, comprising two-dimensional, three-dimensional and tissue Doppler imaging (TDI). They were divided into normal individuals (35) and patients having an abnormal echocardiography (55). RESULTS There was a very strong correlation between three-dimensional volumetric function and mitral annular displacement, both for the reservoir (r = 0.78; P < 0.0001) and contractile (r = 0.76; P < 0.0001) functions. The correlation with the longitudinal strain displayed an r = 0.87, P > 0.0001 for the reservoir and r = 0.81, P < 0.0001 for the contractile function. The systolic speed in pulsed TDI and the systolic displacement had an r = 0.83, P < 0.0001. Mitral annular displacement was a very good discriminator for normal versus abnormal participants [area under the curve (AUC) for reservoir = 0.872 and for contractile = 0.843; P < 0.0001], performing less well than three-dimensional (AUC reservoir = 0.892 and contractile = 0.915; P < 0.0001) or deformation (AUC = 0.921 and 0.903 respectively; P < 0.0001), but better than pulsed TDI (AUC = 0.807; P < 0.0001). The percentage error was ±15% for interobserver and ±12% for intraobserver variability. The time taken for displacement analysis was 9 ± 3 s for an experienced cardiologist and 12 ± 4 s for a beginner. CONCLUSION Mitral annular displacement by speckle tracking is a reliable and fast method to evaluate left atrial function. Given the strength of the correlations with strain parameters, it could be used as a surrogate measure of the deformation of left atrium.
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Affiliation(s)
- Mihai Strachinaru
- Cardiology Department, Brugmann University Hospital, Brussels, Belgium
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Hashimoto I, Watanabe K. Z-Value of Mitral Annular Plane Systolic Excursion Is a Useful Indicator to Predict Left Ventricular Stroke Volume in Children: Comparing Longitudinal and Radial Contractions. Echocardiography 2015; 33:290-8. [DOI: 10.1111/echo.13016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Ikuo Hashimoto
- Department of Pediatrics; Toyama City Hospital; Toyama Japan
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