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Lenell J, Lindahl B, Erlinge D, Jernberg T, Spaak J, Baron T. Global longitudinal strain in long-term risk prediction after acute coronary syndrome: an investigation of added prognostic value to ejection fraction. Clin Res Cardiol 2024:10.1007/s00392-024-02439-w. [PMID: 38526603 DOI: 10.1007/s00392-024-02439-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024]
Abstract
AIMS This study aimed to investigate the additional value of global longitudinal strain (GLS) on top of left ventricular ejection fraction (LVEF) in long-term risk prediction of combined death and heart failure (HF) re-hospitalization after acute coronary syndrome (ACS). METHOD AND RESULTS This retrospective study included patients admitted with ACS between 2008 and 2014 from the three participating university hospitals. LVEF and GLS were assessed at a core lab from images acquired during the index hospital stay. Their prognostic value was studied with the Cox proportional hazards model (median follow-up 6.2 years). A nested model comparison was performed with C-statistics. A total of 941 patients qualified for multivariable analysis after multiple imputation of missing baseline covariables. The combined outcome was reached in 17.7% of the cases. Both GLS and LVEF were independent predictors of the combined outcome, hazard ratio (HR) 1.068 (95% CI 1.017-1.121) and HR 0.980 (95% CI 0.962-0.998), respectively. The C-statistic increased from 0.742 (95% CI 0.702-0.783) to 0.749 (95% CI 0.709-0.789) (P = 0.693) when GLS entered the model with clinical data and LVEF. CONCLUSION GLS emerged as an independent long-term risk predictor of all-cause death and HF re-hospitalization. However, there was no significant incremental predictive value of GLS when LVEF was already known.
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Affiliation(s)
- Joel Lenell
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
| | - Bertil Lindahl
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - David Erlinge
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Tomas Jernberg
- Division of Cardiovascular Medicine, Dept. of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Jonas Spaak
- Division of Cardiovascular Medicine, Dept. of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Tomasz Baron
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
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2
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Vancheri F, Longo G, Henein MY. Left ventricular ejection fraction: clinical, pathophysiological, and technical limitations. Front Cardiovasc Med 2024; 11:1340708. [PMID: 38385136 PMCID: PMC10879419 DOI: 10.3389/fcvm.2024.1340708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 01/12/2024] [Indexed: 02/23/2024] Open
Abstract
Risk stratification of cardiovascular death and treatment strategies in patients with heart failure (HF), the optimal timing for valve replacement, and the selection of patients for implantable cardioverter defibrillators are based on an echocardiographic calculation of left ventricular ejection fraction (LVEF) in most guidelines. As a marker of systolic function, LVEF has important limitations being affected by loading conditions and cavity geometry, as well as image quality, thus impacting inter- and intra-observer measurement variability. LVEF is a product of shortening of the three components of myocardial fibres: longitudinal, circumferential, and oblique. It is therefore a marker of global ejection performance based on cavity volume changes, rather than directly reflecting myocardial contractile function, hence may be normal even when myofibril's systolic function is impaired. Sub-endocardial longitudinal fibers are the most sensitive layers to ischemia, so when dysfunctional, the circumferential fibers may compensate for it and maintain the overall LVEF. Likewise, in patients with HF, LVEF is used to stratify subgroups, an approach that has prognostic implications but without a direct relationship. HF is a dynamic disease that may worsen or improve over time according to the underlying pathology. Such dynamicity impacts LVEF and its use to guide treatment. The same applies to changes in LVEF following interventional procedures. In this review, we analyze the clinical, pathophysiological, and technical limitations of LVEF across a wide range of cardiovascular pathologies.
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Affiliation(s)
- Federico Vancheri
- Department of Internal Medicine, S.Elia Hospital, Caltanissetta, Italy
| | - Giovanni Longo
- Cardiovascular and Interventional Department, S.Elia Hospital, Caltanissetta, Italy
| | - Michael Y. Henein
- Institute of Public Health and Clinical Medicine, Umea University, Umea, Sweden
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3
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Sun L, Zhu W, Xu Y, Gao M, Sun S, Li J. Clinical study of two-dimensional speckle tracking to evaluate abnormal myocardial motion due to coronary lesions. Echocardiography 2024; 41:e15744. [PMID: 38284681 DOI: 10.1111/echo.15744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/21/2023] [Accepted: 12/30/2023] [Indexed: 01/30/2024] Open
Abstract
OBJECTIVE To investigate the predictive ability of global longitudinal strain (GLS) and mechanical dispersion for coronary stenosis and provide a more reliable noninvasive method for diagnosis of obstructive coronary artery disease(OCAD). METHODS Sixty-seven patients diagnosed with suspected CAD were included in the study. Patients with coronary stenosis greater than 50% were assigned as OCAD, while the others were assigned as non obstructive coronary artery disease(NOCAD). General information was collected and patients underwent speckle tracking echocardiogram(STE). RESULTS Spearman's correlation analysis showed that GLS and mechanical dispersion were positively correlated with the degree of coronary stenosis (r = 0.383, 0.342, p < 0.05), and there was also a positive correlation between GLS and mechanical dispersion (r = 0.327, p < 0.05). GLS, longitudinal strain (LS) of each chamber, and mechanical dispersion were higher in the OCAD group than in the NOCAD group (p < 0.05). Univariate regression analysis showed that GLS, each lumen LS and mechanical dispersion were statistically significant (p < 0.05). Multifactorial regression analysis showed that elevated GLS (p = 0.007) and elevated mechanical dispersion (p = 0.030) were independent risk factors for OCAD. The ROC curves showed that GLS predicted OCAD (AUC area 0.745, 95% CI 0.624 to 0.865) versus mechanical discrete prediction of OCAD (AUC area 0.702, 95% CI 0.569 to 0.834) were more diagnostic than conventional cardiac ultrasound observations of ventricular wall motion abnormalities (AUC area 0.566, 95% CI 0.463 to 0.669). CONCLUSIONS Combining GLS with mechanical dispersion can rapidly assess OCAD in a very short period, which has strong promotion value and in-depth research value.
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Affiliation(s)
- Lin Sun
- Departments of Cardiology, Hospital of Harbin Medical University, Harbin, China
| | - Weiwei Zhu
- Departments of Cardiology, Hospital of Harbin Medical University, Harbin, China
| | - Yidan Xu
- Departments of Cardiology, Hospital of Harbin Medical University, Harbin, China
| | - Ming Gao
- Departments of Cardiology, Hospital of Harbin Medical University, Harbin, China
| | - Shaoqing Sun
- Department of Cardiology, Hangzhou Lin'an District Hospital of Traditional Chinese Medicine Hangzhou, Zhejiang, China
| | - Jingjie Li
- Departments of Cardiology, Hospital of Harbin Medical University, Harbin, China
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4
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Nabeta T, Meucci MC, Westenberg JJM, Reiber JH, Knuuti J, van der Bijl P, Marsan NA, Bax JJ. Prognostic implications of left ventricular inward displacement assessed by cardiac magnetic resonance imaging in patients with myocardial infarction. Int J Cardiovasc Imaging 2023; 39:1525-1533. [PMID: 37249652 PMCID: PMC10427538 DOI: 10.1007/s10554-023-02861-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/23/2023] [Indexed: 05/31/2023]
Abstract
Risk stratification of patients with ischemic heart disease (IHD) still depends mainly on the left ventricular ejection fraction (LVEF). LV inward displacement (InD) is a novel parameter of LV systolic function, derived from feature tracking cardiac magnetic resonance (CMR) imaging. We aimed to investigate the prognostic impact of InD in patients with IHD and prior myocardial infarction. A total of 111 patients (mean age 57 ± 10, 86% male) with a history of myocardial infarction who underwent CMR were included. LV InD was quantified by measuring the displacement of endocardially tracked points towards the centreline of the LV during systole with feature tracking CMR. The endpoint was a composite of all-cause mortality, heart failure hospitalization and arrhythmic events. During a median follow-up of 142 (IQR 107-159) months, 31 (27.9%) combined events occurred. Kaplan-Meier analysis demonstrated that patients with LV InD below the study population median value (23.0%) had a significantly lower event-free survival (P < 0.001). LV InD remained independently associated with outcomes (HR 0.90, 95% CI 0.84-0.98, P = 0.010) on multivariate Cox regression analysis. InD also provided incremental prognostic value to LVEF, LV global radial strain and CMR scar burden. LV InD, measured with feature tracking CMR, was independently associated with outcomes in patients with IHD and prior myocardial infarction. LV InD also provided incremental prognostic value, in addition to LVEF and LV global radial strain. LV InD holds promise as a pragmatic imaging biomarker for post-infarct risk stratification.
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Affiliation(s)
- Takeru Nabeta
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2300 RC, The Netherlands.
| | - Maria Chiara Meucci
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2300 RC, The Netherlands
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Jos J M Westenberg
- Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2300 RC, The Netherlands
| | - Johan Hc Reiber
- Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2300 RC, The Netherlands
- Medis Medical Imaging Systems, Schuttersveld 9, Leiden, 2316 XG, The Netherlands
| | - Juhani Knuuti
- Heart Centre, University of Turku, Turku University Hospital, Kiinamyllynkatu 4-8, Turku, FI-20520, Finland
| | - Pieter van der Bijl
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2300 RC, The Netherlands
| | - Nina Ajmone Marsan
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2300 RC, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2300 RC, The Netherlands
- Heart Centre, University of Turku, Turku University Hospital, Kiinamyllynkatu 4-8, Turku, FI-20520, Finland
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5
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Aagaard EN, Lyngbakken MN, Kvisvik B, Berge T, Pervez MO, Ariansen I, Tveit A, Steine K, Røsjø H, Omland T. Associations between cardiovascular risk factors, biomarkers, and left ventricular mechanical dispersion: insights from the ACE 1950 Study. EUROPEAN HEART JOURNAL OPEN 2022; 2:oeac006. [PMID: 35919126 PMCID: PMC9242045 DOI: 10.1093/ehjopen/oeac006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/22/2022] [Indexed: 11/14/2022]
Abstract
Aims Mechanical dispersion measures left ventricular contraction heterogeneity and is associated with the risk of sudden cardiac death. However, the associations between mechanical dispersion and cardiovascular risk factors in early mid-life, and established biomarkers of sub-clinical myocardial injury and dysfunction are not known. We aimed to examine this in the general population. Methods and results During 2012–15, we included 2527 Norwegian individuals from the general population born in 1950, with measurements of mechanical dispersion by 2D speckle tracking echocardiography and concentrations of high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) available. Mechanical dispersion was calculated as the standard deviation of the contraction duration of 17 strain segments. We assessed the associations between mechanical dispersion, concentrations of hs-cTnT and NT-proBNP, and cardiovascular risk factors collected at a national health screening survey two decades earlier. At echocardiography baseline, median age was 64 (interquartile range 63.5–64.5) years, 49.8% were women, 59.1% had hypertension, and 5.9% reported established coronary artery disease. Median mechanical dispersion was 38.0 (29.5–47.0) ms, median hs-cTnT concentration 6 (4–8) ng/L, and the median NT-proBNP concentration 54 (34–93) ng/L. Mechanical dispersion was associated with both hs-cTnT and NT-proBNP concentrations in multivariable models adjusted for clinical and echocardiographic variables. High body mass index, serum triglyceride concentrations, and low resting heart rate at Age 40 were independently associated with increased mechanical dispersion two decades later. Conclusion Established risk factors at Age 40 are associated with mechanical dispersion two decades later, and mechanical dispersion is cross-sectionally associated with biomarkers of subclinical myocardial injury and dysfunction.
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Affiliation(s)
- Erika N Aagaard
- Division of Medicine, Department of Cardiology, Akershus University Hospital , Lørenskog, Norway
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo , Oslo, Norway
| | - Magnus N Lyngbakken
- Division of Medicine, Department of Cardiology, Akershus University Hospital , Lørenskog, Norway
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo , Oslo, Norway
| | - Brede Kvisvik
- Division of Medicine, Department of Cardiology, Akershus University Hospital , Lørenskog, Norway
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo , Oslo, Norway
| | - Trygve Berge
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust , Norway
| | - Mohammad O Pervez
- Division of Medicine, Department of Cardiology, Akershus University Hospital , Lørenskog, Norway
| | - Inger Ariansen
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health , Oslo, Norway
| | - Arnljot Tveit
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo , Oslo, Norway
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust , Norway
| | - Kjetil Steine
- Division of Medicine, Department of Cardiology, Akershus University Hospital , Lørenskog, Norway
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo , Oslo, Norway
| | - Helge Røsjø
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo , Oslo, Norway
- Division of Research and Innovation, Akershus University Hospital , Sykehusveien 25, 1478 Lørenskog, Norway
| | - Torbjørn Omland
- Division of Medicine, Department of Cardiology, Akershus University Hospital , Lørenskog, Norway
- Faculty of Medicine, Institute for Clinical Medicine, University of Oslo , Oslo, Norway
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6
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Appadurai V, Scalia GM, Lau K, Chamberlain R, Edwards N, Bushell H, Scalia W, Tomlinson S, Hamilton-Craig C, Chan J. Impact of inter-vendor variability on evaluation of left ventricular mechanical dispersion. Echocardiography 2021; 39:54-64. [PMID: 34873750 DOI: 10.1111/echo.15270] [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: 05/03/2021] [Revised: 10/31/2021] [Accepted: 11/16/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Left ventricular mechanical dispersion (LVMD) is a novel speckle tracking parameter for prognostic assessment of arrhythmic risk prediction. There is growing evidence to support its use in a variety of cardiomyopathic processes. There is paucity of data addressing any presence of inter-vendor discrepancies for LVMD. The aim of this study was to assess inter-vendor variability of LVMD in vendor specific software (VSS) and vendor independent software (VIS) in subjects with preserved and reduced left ventricular function. METHODS Fifty-nine subjects (14 normal subjects and 45 subjects with cardiac disease) were recruited and 2D speckle tracking echocardiographic images were acquired on two different ultrasound machines (GE and Philips). LVMD was measured by two different VSS (EchoPac GE and QLAB Philips) and one VIS (TomTec Arena). RESULTS There was significant bias and wide limits of agreement (LOA) in the overall cohort observed between two different VSS (17.6 ms; LOA: -29.6 to 64.8; r: .47). There was acceptable bias and narrower LOA with good agreement for LVMD between images obtained on different vendors when performed on VIS (-3.1 ms; LOA: -27.6 to 21.4; r: .75). QLAB LVMD was consistently higher than GE LVMD and TomTec LVMD in both preserved and reduced left ventricular function. LVMD measurements have high intra-vendor reproducibility with excellent inter and intra-observer agreement. CONCLUSIONS There was acceptable bias and narrower LOA for LVMD assessment on a VIS. Inter-vendor variability exists for LVMD assessment between VSS. Serial measurements of LVMD should be performed using a single vendor for consistent and reliable results.
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Affiliation(s)
- Vinesh Appadurai
- Department of Cardiology, The Prince Charles Hospital, Queensland, Australia.,School of Medicine, The University of Queensland, Queensland, Australia
| | - Gregory M Scalia
- Department of Cardiology, The Prince Charles Hospital, Queensland, Australia.,School of Medicine, The University of Queensland, Queensland, Australia
| | - Katherine Lau
- Department of Cardiology, The Prince Charles Hospital, Queensland, Australia.,School of Medicine, The University of Queensland, Queensland, Australia
| | - Robert Chamberlain
- Department of Cardiology, The Prince Charles Hospital, Queensland, Australia.,School of Medicine, Griffith University, Queensland, Australia
| | - Natalie Edwards
- Department of Cardiology, The Prince Charles Hospital, Queensland, Australia.,School of Medicine, Griffith University, Queensland, Australia
| | - Hannah Bushell
- Department of Cardiology, The Prince Charles Hospital, Queensland, Australia
| | - William Scalia
- Department of Cardiology, The Prince Charles Hospital, Queensland, Australia.,School of Medicine, The University of Queensland, Queensland, Australia
| | - Stephen Tomlinson
- Department of Cardiology, The Prince Charles Hospital, Queensland, Australia.,School of Medicine, Griffith University, Queensland, Australia
| | - Christian Hamilton-Craig
- Department of Cardiology, The Prince Charles Hospital, Queensland, Australia.,School of Medicine, The University of Queensland, Queensland, Australia.,School of Medicine, Griffith University, Queensland, Australia
| | - Jonathan Chan
- Department of Cardiology, The Prince Charles Hospital, Queensland, Australia.,School of Medicine, Griffith University, Queensland, Australia
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7
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Cosyns B, Sade LE, Gerber BL, Gimelli A, Muraru D, Maurer G, Edvardsen T. The year 2020 in the European Heart Journal-Cardiovascular Imaging: part II. Eur Heart J Cardiovasc Imaging 2021:jeab225. [PMID: 34718480 DOI: 10.1093/ehjci/jeab225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Indexed: 12/18/2022] Open
Abstract
The European Heart Journal-Cardiovascular Imaging was launched in 2012 and has during these years become one of the leading multimodality cardiovascular imaging journal. The journal is now established as one of the top cardiovascular journals and is the most important cardiovascular imaging journal in Europe. The most important studies published in our Journal from 2020 will be highlighted in two reports. Part II will focus on valvular heart disease, heart failure, cardiomyopathies, and congenital heart disease. While Part I of the review has focused on studies about myocardial function and risk prediction, myocardial ischaemia, and emerging techniques in cardiovascular imaging.
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Affiliation(s)
- Bernard Cosyns
- Department of Cardiology, CHVZ (Centrum voor Hart en Vaatziekten), ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Universitair Ziekenhuis Brussel, 101 Laarbeeklaan, 1090 Brussels, Belgium
| | - Leyla Elif Sade
- University of Pittsburgh Medical Center, Heart and Vascular Institute, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260, USA
- Department of Cardiology, University of Baskent, Bağlıca Kampüsü, Dumlupınar Blv. 20. Km, 06810 Etimesgut/Ankara, Turkey
| | - Bernhard L Gerber
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Av Hippocrate 10/2806, Brussels, Belgium
| | - Alessia Gimelli
- Fondazione Toscana G. Monasterio, Via Giuseppe Moruzzi, 1, 56124 Pisa PI, Italy
| | - Denisa Muraru
- Department of Cardiac, Neurological and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, Piazzale Brescia 20, 20149 Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Gerald Maurer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Spitalgasse 23, 1090 Wien, Austria
| | - Thor Edvardsen
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo Norway and Institute for clinical medicine, University of Oslo, Sognsvannsveien 9, 0372 Oslo, Norway
- KG Jebsen Cardiac Research Centre, Institute for clinical medicine, University of Oslo, Sognsvannsveien 20, NO-0424 Oslo, Norway
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8
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Gao Y, Xu HY, Guo YK, Wen XL, Shi R, Li Y, Yang ZG. Impact of myocardial scars on left ventricular deformation in type 2 diabetes mellitus after myocardial infarction by contrast-enhanced cardiac magnetic resonance. Cardiovasc Diabetol 2021; 20:215. [PMID: 34696783 PMCID: PMC8547068 DOI: 10.1186/s12933-021-01407-2] [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: 09/11/2021] [Accepted: 10/17/2021] [Indexed: 02/08/2023] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) is a major risk factor for coronary artery disease and myocardial infarction (MI). The interaction of diabetic cardiomyopathy and MI scars on myocardial deformation in T2DM patients is unclear. Therefore, we aimed to evaluate myocardial deformation using cardiac magnetic resonance (CMR) in T2DM patients with previous MI and investigated the influence of myocardial scar on left ventricular (LV) deformation. Methods Overall, 202 T2DM patients, including 46 with MI (T2DM(MI+)) and 156 without MI (T2DM(MI−)), and 59 normal controls who underwent CMR scans were included. Myocardial scars were assessed by late gadolinium enhancement. LV function and deformation, including LV global function index, LV global peak strain (PS), peak systolic strain rate (PSSR), and peak diastolic strain rate (PDSR), were compared among these groups. Correlation and multivariate linear regression analyses were used to investigate the relationship between myocardial scars and LV deformation. Results Decreases were observed in LV function and LV global PS, PSSR, and PDSR in the T2DM(MI+) group compared with those of the other groups. Reduced LV deformation (p < 0.017) was observed in the T2DM(MI+) group with anterior wall infarction. The increased total LV infarct extent and infarct mass of LV were related to decreased LV global PS (radial, circumferential, and longitudinal directions; p < 0.01) and LV global PSSR (radial and circumferential directions, p < 0.02). Multivariate analysis demonstrated that NYHA functional class and total LV infarct extent were independently associated with LV global radial PS (β = − 0.400 and β = − 0.446, respectively, all p < 0.01; model R2 = 0.37) and circumferential PS (β = 0.339 and β = 0.530, respectively, all p < 0.01; model R2 = 0.41), LV anterior wall infarction was independently associated with LV global longitudinal PS (β = 0.398, p = 0.006). Conclusions The myocardial scarring size in T2DM patients after MI is negatively correlated with LV global PS and PSSR, particularly in the circumferential direction. Additionally, different MI regions have different effects on the reduction of LV deformation, and relevant clinical evaluations should be strengthened.
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Affiliation(s)
- Yue Gao
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Hua-Yan Xu
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Ying-Kun Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Xiao-Ling Wen
- Department of Radiology, West China Fourth Hospital, Sichuan University, 18# Section 3, Renmin South Road, Chengdu, Sichuan Province, China
| | - Rui Shi
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yuan Li
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
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9
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Edvardsen T, Donal E, Marsan NA, Maurovich-Horvat P, Dweck MR, Maurer G, Petersen SE, Cosyns B. The year 2020 in the European Heart Journal - Cardiovascular Imaging: part I. Eur Heart J Cardiovasc Imaging 2021; 22:1219-1227. [PMID: 34463734 DOI: 10.1093/ehjci/jeab148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 07/24/2021] [Indexed: 12/22/2022] Open
Abstract
The European Heart Journal - Cardiovascular Imaging was launched in 2012 and has during these 9 years become one of the leading multimodality cardiovascular imaging journals. The journal is currently ranked as number 20 among all cardiovascular journals. Our journal is well established as one of the top cardiovascular journals and is the most important cardiovascular imaging journal in Europe. The most important studies published in our Journal in 2020 will be highlighted in two reports. Part I of the review will focus on studies about myocardial function and risk prediction, myocardial ischaemia, and emerging techniques in cardiovascular imaging, while Part II will focus on valvular heart disease, heart failure, cardiomyopathies, and congenital heart disease.
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Affiliation(s)
- Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Postbox 4950 Nydalen, Sognsvannsveien 20, NO-0424 Oslo, Norway.,Institute for clinical medicine, University of Oslo, Sognsvannsveien 20, NO-0424 Oslo, Norway
| | - Erwan Donal
- Department of Cardiology and CIC-IT1414, CHU Rennes, Inserm, LTSI-UMR 1099, University Rennes-1, Rennes F-35000, France
| | - Nina A Marsan
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Semmelweis University, 2 Korányi u., 1083 Budapest, Hungary
| | - Marc R Dweck
- Centre for Cardiovascular Sciences, University of Edinburgh, Chancellors Building, Little France Crescent, Edinburgh EH16 4SB, UK
| | - Gerald Maurer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Wahringer Gurtel 18-20, 1090 Vienna, Austria
| | - Steffen E Petersen
- Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK.,William Harvey Research Institute, Queen Mary University of London, CharterhouseSquare, London EC1M 6BQ, UK
| | - Bernard Cosyns
- Cardiology, CHVZ (Centrum voor Hart en Vaatziekten), ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Universitair ziekenhuis Brussel, 109 Laarbeeklaan, Brussels 1090, Belgium
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10
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Voigt JU. Shapes or numbers? Eur Heart J Cardiovasc Imaging 2021; 22:866-867. [PMID: 34051080 DOI: 10.1093/ehjci/jeab093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jens-Uwe Voigt
- Department of Cardiovascular Diseases, University Hospitals Leuven, Belgium.,Department of Cardiovascular Sciences, Catholic University Leuven, Belgium
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11
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Trivedi SJ, Campbell T, Stefani LD, Thomas L, Kumar S. Strain by speckle tracking echocardiography correlates with electroanatomic scar location and burden in ischaemic cardiomyopathy. Eur Heart J Cardiovasc Imaging 2021; 22:855-865. [PMID: 33585879 DOI: 10.1093/ehjci/jeab021] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
AIMS Ventricular tachycardia (VT) in ischaemic cardiomyopathy (ICM) originates from scar, identified as low-voltage areas with invasive high-density electroanatomic mapping (EAM). Abnormal myocardial deformation on speckle tracking strain echocardiography can non-invasively identify scar. We examined if regional and global longitudinal strain (GLS) can localize and quantify low-voltage scar identified with high-density EAM. METHODS AND RESULTS We recruited 60 patients, 40 ICM patients undergoing VT ablation and 20 patients undergoing ablation for other arrhythmias as controls. All patients underwent an echocardiogram prior to high-density left ventricular (LV) EAM. Endocardial bipolar and unipolar scar location and percentage were correlated with regional and multilayer GLS. Controls had normal GLS and normal bipolar and unipolar voltages. There was a strong correlation between endocardial and mid-myocardial longitudinal strain and endocardial bipolar scar percentage for all 17 LV segments (r = 0.76-0.87, P < 0.001) in ICM patients. Additionally, indices of myocardial contraction heterogeneity, myocardial dispersion (MD), and delta contraction duration (DCD) correlated with bipolar scar percentage. Endocardial and mid-myocardial GLS correlated with total LV bipolar scar percentage (r = 0.83; 0.82, P < 0.001 respectively), whereas epicardial GLS correlated with epicardial bipolar scar percentage (r = 0.78, P < 0.001). Endocardial GLS -9.3% or worse had 93% sensitivity and 82% specificity for predicting endocardial bipolar scar >46% of LV surface area. CONCLUSIONS Multilayer strain analysis demonstrated good linear correlations with low-voltage scar by invasive EAM. Validation studies are needed to establish the utility of strain as a non-invasive tool for quantifying scar location and burden, thereby facilitating mapping and ablation of VT.
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Affiliation(s)
- Siddharth J Trivedi
- Department of Cardiology, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145, Australia.,Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145, Australia
| | - Timothy Campbell
- Department of Cardiology, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145, Australia.,Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Luke D Stefani
- Department of Cardiology, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145, Australia
| | - Liza Thomas
- Department of Cardiology, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145, Australia.,Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145, Australia.,South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Liverpool Hospital, Elizabeth Street, Liverpool, NSW 2170, Australia
| | - Saurabh Kumar
- Department of Cardiology, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145, Australia.,Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145, Australia.,Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead Hospital, Westmead, NSW 2145, Australia
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12
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Edvardsen T, Klæboe LG, Haugaa KH. The infarcted myocardium and mechanical dispersion: another brick in the wall. Eur Heart J Cardiovasc Imaging 2021; 21:1235-1236. [PMID: 32856038 DOI: 10.1093/ehjci/jeaa209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0372 Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lars Gunnar Klæboe
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0372 Oslo, Norway
| | - Kristina H Haugaa
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0372 Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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