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Yamano M, Yamano T, Matoba S. Right ventricular dilatation: echocardiographic differential diagnosis. J Med Ultrason (2001) 2024; 51:275-282. [PMID: 38228943 DOI: 10.1007/s10396-023-01399-4] [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: 03/30/2023] [Accepted: 11/15/2023] [Indexed: 01/18/2024]
Abstract
The initial means of detecting right ventricular (RV) dilatation is often transthoracic echocardiography (TTE), and once the presence of RV dilatation is suspected, there is the possibility of RV volume overload, RV pressure overload, RV myocardial disease, and even nonpathological RV dilatation. With respect to congenital heart disease with RV volume overload, defects or valvular abnormalities can be easily detected with TTE, with the exception of some diseases. Volumetric assessment using three-dimensional echocardiography may be useful in determining the intervention timing in these diseases. When the disease progresses in patients with pulmonary hypertension as a result of RV pressure overload, RV dilatation becomes more prominent than hypertrophy, and RV functional parameters predict the prognosis at this stage of maladaptive remodeling. The differential diagnosis of cardiomyopathy or comparison with nonpathological RV dilatation may be difficult in the setting of RV myocardial disease. The characteristics of RV functional parameters such as two-dimensional speckle tracking may help differentiate RV cardiomyopathy from other conditions. We review the diseases presenting with RV dilatation, their characteristics, and echocardiographic findings and parameters that are significant in assessing their status or intervention timing.
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Affiliation(s)
- Michiyo Yamano
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Tetsuhiro Yamano
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
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2
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Mahmod M, Raman B, Chan K, Sivalokanathan S, Smillie RW, Samat AHA, Ariga R, Dass S, Ormondroyd E, Watkins H, Neubauer S. Right ventricular function declines prior to left ventricular ejection fraction in hypertrophic cardiomyopathy. J Cardiovasc Magn Reson 2022; 24:36. [PMID: 35692049 PMCID: PMC9190122 DOI: 10.1186/s12968-022-00868-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 05/19/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The right ventricle (RV) in hypertrophic cardiomyopathy (HCM) tends to be neglected, as previous efforts have predominantly focused on examining the prognostic value of left ventricular (LV) abnormalities. The objectives of this study were to assess RV function in HCM, changes over time, and association with clinical outcomes. METHODS Two hundred and ninety HCM patients with preserved LV ejection fraction (LVEF ≥ 55%) and 30 age- and sex-matched controls underwent cardiovascular magnetic resonance (CMR). All patients were followed up for clinical events for a median duration of 4.4 years. Sixty-three patients had a follow-up CMR undertaken at a median interval of 5.4 years. Main study measures and outcomes were RV function (RV ejection fraction (RVEF) and RV strain) at baseline, temporal changes in RV function over time and prognostic value of RV dysfunction for predicting cardiovascular outcomes in HCM. RESULTS When compared to controls, HCM patients exhibited lower RV and LV peak global longitudinal systolic strains on feature-tracking analysis of cine images, while RVEF and LVEF were within the normal range. On follow-up CMR, both RV and LV strain parameters decreased over time. RVEF decreased at follow-up (65 ± 7% to 62 ± 7%, P < 0.001) but the change in LVEF was not significant (68 ± 10% to 66 ± 8%, P = 0.30). On clinical follow up, reduced RVEF was an independent predictor of non-sustained ventricular tachycardia (NSVT) [HR 1.10 (95% CI 1.06-1.15), P < 0.001] and composite cardiovascular events (NSVT, stroke, heart failure hospitalisation and cardiovascular death) [HR 1.07 (95% CI 1.03-1.10), P < 0.001]. RV longitudinal strain was an independent predictor of NSVT [HR 1.05 (95% CI 1.01-1.09), P = 0.029]. Patients with RVEF < 55% showed an increased risk of NSVT and composite cardiovascular events. In contrast, LVEF and LV global longitudinal strain were not predictive of such events on multivariable analysis. CONCLUSIONS In HCM, RV function, including RV strain, and LV strain decrease over time despite preserved LVEF. Reduction in RV but not LV function is associated with adverse cardiovascular outcomes. Assessing RV function in early HCM disease might have a role in risk stratification to prevent future cardiovascular events.
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Affiliation(s)
- Masliza Mahmod
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
| | - Betty Raman
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Kenneth Chan
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Sanjay Sivalokanathan
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Robert W Smillie
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Azlan H Abd Samat
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Rina Ariga
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Sairia Dass
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Elizabeth Ormondroyd
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Hugh Watkins
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
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3
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Anwar AM, tenCate FJ. Echocardiographic evaluation of hypertrophic cardiomyopathy: A review of up-to-date knowledge and practical tips. Echocardiography 2021; 38:1795-1808. [PMID: 34555207 DOI: 10.1111/echo.15200] [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: 05/19/2021] [Revised: 07/24/2021] [Accepted: 08/23/2021] [Indexed: 11/27/2022] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is the most frequent cardiac disease with genetic substrate, affecting about .2%-.5% of the population. The proper diagnosis is important for optimal management and follow-up. Echocardiography plays an essential role in the assessment of patients with HCM including diagnosis, screening, management formulation, prognosis, and follow up. It also helps to differentiate HCM from other diseases. The advancement of software and probe technology added many echo modalities and techniques that helped in refining the diagnostic and assessing the prognosis of patients with HCM. In this review, we briefly summarize how to integrate the different echocardiographic modalities to obtain comprehensive assessment supported by an updated knowledge of the latest guidelines and recently published articles. Many practical tips and tricks are included in this review to improve the diagnostic accuracy of echocardiography and minimize errors during interpretation.
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Affiliation(s)
- Ashraf M Anwar
- Department of Cardiology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.,Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Tadic M, Kersten J, Nita N, Schneider L, Buckert D, Gonska B, Scharnbeck D, Dahme T, Imhof A, Belyavskiy E, Cuspidi C, Rottbauer W. The Prognostic Importance of Right Ventricular Longitudinal Strain in Patients with Cardiomyopathies, Connective Tissue Diseases, Coronary Artery Disease, and Congenital Heart Diseases. Diagnostics (Basel) 2021; 11:diagnostics11060954. [PMID: 34073460 PMCID: PMC8228710 DOI: 10.3390/diagnostics11060954] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/18/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022] Open
Abstract
Right ventricular (RV) systolic function represents an important independent predictor of adverse outcomes in many cardiovascular (CV) diseases. However, conventional parameters of RV systolic function (tricuspid annular plane excursion (TAPSE), RV myocardial performance index (MPI), and fractional area change (FAC)) are not always able to detect subtle changes in RV function. New evidence indicates a significantly higher predictive value of RV longitudinal strain (LS) over conventional parameters. RVLS showed higher sensitivity and specificity in the detection of RV dysfunction in the absence of RV dilatation, apparent wall motion abnormalities, and reduced global RV systolic function. Additionally, RVLS represents a significant and independent predictor of adverse outcomes in patients with dilated cardiomyopathy (CMP), hypertrophic CMP, arrhythmogenic RV CMP, and amyloidosis, but also in patients with connective tissue diseases and patients with coronary artery disease. Due to its availability, echocardiography remains the main imaging tool for RVLS assessment, but cardiac magnetic resonance (CMR) also represents an important additional imaging tool in RVLG assessment. The findings from the large studies support the routine evaluation of RVLS in the majority of CV patients, but this has still not been adopted in daily clinical practice. This clinical review aims to summarize the significance and predictive value of RVLS in patients with different types of cardiomyopathies, tissue connective diseases, and coronary artery disease.
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Affiliation(s)
- Marijana Tadic
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
- Correspondence: ; Tel.: +49-17632360011
| | - Johannes Kersten
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Nicoleta Nita
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Leonhard Schneider
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Dominik Buckert
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Birgid Gonska
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Dominik Scharnbeck
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Tilman Dahme
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Armin Imhof
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
| | - Evgeny Belyavskiy
- Department of Cardiology, Charité—Universitätsmedizin Berlin (Campus Virchow-Klinikum), 13353 Berlin, Germany;
| | - Cesare Cuspidi
- Department of Medicine and Surgery, University of Milan-Bicocca, 20126 Milan, Italy;
| | - Wolfgang Rottbauer
- Klinik für Innere Medizin II, Universitätsklinikum Ulm, Albert-Einstein Allee 23, 89081 Ulm, Germany; (J.K.); (N.N.); (L.S.); (D.B.); (B.G.); (D.S.); (T.D.); (A.I.); (W.R.)
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Seo J, Hong YJ, Kim YJ, Lkhagvasuren P, Cho I, Shim CY, Ha JW, Hong GR. Prevalence, functional characteristics, and clinical significance of right ventricular involvement in patients with hypertrophic cardiomyopathy. Sci Rep 2020; 10:21908. [PMID: 33318610 PMCID: PMC7736330 DOI: 10.1038/s41598-020-78945-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/26/2020] [Indexed: 02/04/2023] Open
Abstract
We sought to investigate the prevalence, functional characteristics, and clinical significance of right ventricular (RV) involvement in patients with hypertrophic cardiomyopathy (HCM). A total of 256 patients with HCM who underwent both cardiac magnetic resonance (CMR) imaging and transthoracic echocardiography within 6 months of each other were retrospectively analysed. RV involvement was defined as an increased RV wall thickness ≥ 7 mm on CMR in the segments of the RV free wall. Primary outcomes were defined as the composite of all-cause death, heart transplantation, and unplanned cardiovascular admission. Thirty-seven (14.4%) patients showed RV involvement. Patients with RV involvement showed a significantly higher left ventricular (LV) maximal wall thickness and left atrial volume index. Multivariate Cox model revealed that RV involvement was independently associated with primary outcomes (HR: 2.30, p = 0.024). In a subgroup analysis of patients with speckle tracking echocardiography (n = 190), those with RV involvement had significantly more impaired RV strain, which was independently associated with primary outcomes. RV involvement in patients with HCM correlated with more advanced LV structure and biventricular dysfunction, suggesting an indicator of severe HCM. RV involvement and impaired RV strain have a prognostic value related to clinical adverse events in patients with HCM.
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Affiliation(s)
- Jiwon Seo
- Cardiology Division, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Yoo Jin Hong
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea
| | - Young Jin Kim
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea
| | - Purevjargal Lkhagvasuren
- Cardiology Division, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Iksung Cho
- Cardiology Division, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Chi Young Shim
- Cardiology Division, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Jong-Won Ha
- Cardiology Division, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Geu-Ru Hong
- Cardiology Division, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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6
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Cavigli L, Focardi M, Cameli M, Mandoli GE, Mondillo S, D'Ascenzi F. The right ventricle in “Left-sided” cardiomyopathies: The dark side of the moon. Trends Cardiovasc Med 2020; 31:476-484. [DOI: 10.1016/j.tcm.2020.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/26/2020] [Accepted: 10/09/2020] [Indexed: 02/07/2023]
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7
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Peverill RE. Understanding preload and preload reserve within the conceptual framework of a limited range of possible left ventricular end-diastolic volumes. ADVANCES IN PHYSIOLOGY EDUCATION 2020; 44:414-422. [PMID: 32697153 DOI: 10.1152/advan.00043.2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Preload has been variously defined, but if there is to be a direct relationship with activity of the Frank-Starling mechanism in its action to increase the force and extent of contraction, preload must directly reflect myocardial stretch. The Frank-Starling mechanism is activated during any stretch of a cardiac chamber beyond its resting size, which is present immediately before contraction. Every left ventricle has an intrinsic and limited range of possible volumes at end diastole. There is a curvilinear relationship between left ventricular (LV) end-diastolic pressure (LVEDP) and LV end-diastolic volume (LVEDV), and, at maximal or near maximal LVEDV, there will be a high LVEDP. Within the possible range, the LVEDV will be determined by the extent of filling, any change in LVEDV will result in changed activity of the Frank-Starling mechanism, and change in LVEDV might, therefore, be considered to represent change in preload. On the other hand, it is the difference between the current and the maximal possible LVEDV (or the preload reserve) that may be of the most clinical relevance. There is a reciprocal relationship between preload and preload reserve, with minor or absent LV preload reserve indicating that there will be either minimal or no increase in stroke volume following intravenous fluid administration. As left atrial pressure can remain within the normal range when the LVEDP is elevated, it is LVEDP, and not left atrial pressure, that provides the most reliable guide to preload reserve in an individual at a specific period in time.
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Affiliation(s)
- Roger E Peverill
- Monash Cardiovascular Research Centre, MonashHeart, Monash Health, Clayton, Victoria, Australia
- Department of Medicine, School of Clinical Sciences at Monash Medical Centre, Monash University, Clayton, Victoria, Australia
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8
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D'Ascenzi F, Solari M, Corrado D, Zorzi A, Mondillo S. Diagnostic Differentiation Between Arrhythmogenic Cardiomyopathy and Athlete's Heart by Using Imaging. JACC Cardiovasc Imaging 2019; 11:1327-1339. [PMID: 30190032 DOI: 10.1016/j.jcmg.2018.04.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 04/17/2018] [Accepted: 04/19/2018] [Indexed: 12/17/2022]
Abstract
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an important cause of sudden cardiac death (SCD) in youth and athletes. In the last decade, several studies focused on right ventricular (RV) remodeling in athletes and revealed that features of the physiological adaptation of the right heart to training, such as RV dilation, may overlap with those of ARVC. Therefore, a careful multiparametric evaluation is required for differential diagnosis in order to avoid false diagnosis of ARVC or, in contrast, fail to identify the risk of causing SCD. This review summarizes physiological adaptation of the RV to exercise and describes features that could help distinguishing between athlete's heart and ARVC.
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Affiliation(s)
- Flavio D'Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.
| | - Marco Solari
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Domenico Corrado
- Department of Cardiac, Thoracic, and Vascular Sciences, Division of Cardiology, University of Padova, Padova, Italy
| | - Alessandro Zorzi
- Department of Cardiac, Thoracic, and Vascular Sciences, Division of Cardiology, University of Padova, Padova, Italy
| | - Sergio Mondillo
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
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9
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Cho JY, Kim KH, Rink L, Hornsby K, Park H, Park JH, Yoon HJ, Ahn Y, Jeong MH, Cho JG, Park JC. University athletes and changes in cardiac geometry: insight from the 2015 Gwangju Summer Universiade. Eur Heart J Cardiovasc Imaging 2019; 20:407-416. [PMID: 30541113 DOI: 10.1093/ehjci/jey196] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 09/12/2018] [Accepted: 11/16/2018] [Indexed: 11/13/2022] Open
Abstract
AIMS There is a paucity of data regarding the changes of cardiac geometry in highly trained international and multiracial university athletes. We aimed to investigate the incidence of structural cardiac abnormalities and changes of cardiac geometry in highly trained university athletes. METHODS AND RESULTS Comprehensive echocardiographic studies were performed in 1185 university athletes through the Check-up Your Heart Program during the 2015 Gwangju Summer Universiade. Participants were divided into two groups: normal vs. abnormal left ventricular (LV) geometry (concentric remodelling, concentric hypertrophy, or eccentric hypertrophy). Structural heart diseases associated with sudden cardiac death were not identified, but minor structural cardiac abnormalities were common in university athletes. One hundred and fifty-six athletes (13.2%) had abnormal LV geometry; concentric remodelling (n = 73, 6.2%), concentric hypertrophy (n = 25, 2.1%), and eccentric hypertrophy (n = 58, 4.9%). Abnormal LV geometry was significantly more common in athletes of African descent and in endurance, mixed, or power disciplines. In multivariate logistic regression analysis, athletes of African descent [odds ratio (OR) 2.16, 95% confidence interval (CI) 1.34-3.46; P = 0.001], endurance disciplines (OR 1.79, 95% CI 1.26-2.54; P = 0.001), and training time (OR 1.01, 95% CI 1.00-1.02; P = 0.045) were independent predictors of abnormal LV geometry. CONCLUSION A large scale cardiovascular screening programme of the 2015 Summer Universiade demonstrated that abnormal LV geometry is not uncommon (13.2%) and concentric remodelling is the most common pattern of LV geometric change in young trained university athletes. Race, type of sport, and training time are significant predictors of abnormal LV geometry. Structural cardiac abnormalities are common in university athletes even though they are minor abnormalities.
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Affiliation(s)
- Jae Yeong Cho
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Korea
| | - Kye Hun Kim
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Korea
| | - Lawrence Rink
- International University Sports Federation (FISU), Quartier UNIL-Centre, Bâtiment Synathlon, Lausanne, Switzerland.,Indiana University School of Medicine, Indiana University Sports Medicine, 550 Landmark Avenue, Bloomington, IN, USA
| | - Kyle Hornsby
- International University Sports Federation (FISU), Quartier UNIL-Centre, Bâtiment Synathlon, Lausanne, Switzerland.,Indiana University School of Medicine, Indiana University Sports Medicine, 550 Landmark Avenue, Bloomington, IN, USA
| | - Hyukjin Park
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Korea
| | - Jae-Hyeong Park
- Department of Cardiology, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, Korea
| | - Hyun Ju Yoon
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Korea
| | - Youngkeun Ahn
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Korea
| | - Jeong Gwan Cho
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Korea
| | - Jong Chun Park
- Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Korea
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10
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Hiemstra YL, Debonnaire P, Bootsma M, Schalij MJ, Bax JJ, Delgado V, Marsan NA. Prevalence and Prognostic Implications of Right Ventricular Dysfunction in Patients With Hypertrophic Cardiomyopathy. Am J Cardiol 2019; 124:604-612. [PMID: 31204037 DOI: 10.1016/j.amjcard.2019.05.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/28/2019] [Accepted: 05/07/2019] [Indexed: 12/28/2022]
Abstract
Right ventricular (RV) dysfunction is a well-known prognostic factor in several cardiac diseases. However, the prevalence of RV dysfunction in hypertrophic cardiomyopathy (HC) is unclear and its prognostic value is unknown. This study aims at addressing these issues assessing RV function with speckle tracking echocardiography. In 267 HC patients (52 ± 15 years, 68% male), standard and advanced echocardiographic measurements of RV function were performed including RV 4-chamber longitudinal strain (RV4CLS) and RV free wall longitudinal strain (RVFWLS). The primary end point was all-cause mortality and heart failure development. RV dysfunction was observed in 9% of patients based on tricuspid annular plane systolic excursion (≤17 mm), 5% based on fractional area change (<35%), 23% based on RVFWLS ≥-19%, 39% based on RVFWLS ≥-23%, and 55% based on RV4CLS ≥-20%. In total 59 (22%) patients reached the primary end point during a median follow-up of 6.7 (interquartile range 4.2 to 9.8) years. Kaplan-Meier survival curve showed a significant worse survival free of the end point for patients with impaired RV4CLS ≥-20% versus patients with preserved RV4CLS <-20% (log-rank 7.0, p = 0.008) and for patients with impaired RVFWLS ≥-19% versus patients with preserved RVFWLS <-19% (log-rank 4.4, p = 0.037). Multivariable Cox regression analysis showed that E/E' (hazards ratio [HR] 2.26 [1.30 to 3.92], p = 0.004), left ventricular global longitudinal strain LV GLS (HR 1.08 (1.01 to 1.17), p = 0.034) and RV4CLS (HR 1.08 (1.02 to 1.15), p = 0.007) were independently associated with the primary end point. In conclusion, RV dysfunction as measured by longitudinal strain is relatively frequent in HC patients. Impaired RV4CLS is - together with LV GLS and E/E' - associated with adverse outcome, which may indicate a more severe form of HC.
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Affiliation(s)
- Yasmine L Hiemstra
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Philippe Debonnaire
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiology, Sint-Jan Hospital, Bruges, Belgium
| | - Marianne Bootsma
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Martin J Schalij
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Nina Ajmone Marsan
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
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11
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Yang F, Wang J, Li Y, Li W, Xu Y, Wan K, Sun J, Han Y, Chen Y. The prognostic value of biventricular long axis strain using standard cardiovascular magnetic resonance imaging in patients with hypertrophic cardiomyopathy. Int J Cardiol 2019; 294:43-49. [PMID: 31405582 DOI: 10.1016/j.ijcard.2019.08.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 07/26/2019] [Accepted: 08/02/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Long axis strain (LAS) is a parameter derived from standard cardiovascular magnetic resonance imaging. However, the prognostic value of biventricular LAS in hypertrophic cardiomyopathy (HCM) is unknown. METHODS Patients with HCM (n = 384) and healthy volunteers (n = 150) were included in the study. Left ventricular (LV)-LAS was defined as the percentage change in the length measured from the epicardial border of the LV apex to the midpoint of a line connecting the mitral annulus at end-systole and end-diastole. Right ventricular (RV)-LAS represented the percentage change of length between epicardial border of the LV apex to the midpoint of a line connecting the tricuspid annulus at end-systole and end-diastole. The primary endpoint was a combination of all-cause death and sudden cardiac death aborted by appropriate implantable cardioverter-defibrillator discharge and cardiopulmonary resuscitation after syncope. The secondary endpoint was a combination of the primary endpoint and hospitalization for congestive heart failure. RESULTS Twenty-nine patients (7.6%) achieved the primary endpoint, and the secondary endpoint occurred in 66 (17.2%) patients. In multivariate Cox regression analysis, RV-LAS was an independent prognostic factor for the primary (hazard ratio (HR), 1.13) and secondary (HR, 1.11) endpoints. In the subgroup of patients with a normal RV ejection fraction (EF) (>45.0%, n = 345), impaired RV-LAS was associated with adverse outcomes and might add incremental prognostic value to RVEF and tricuspid annular plane systolic excursion (TAPSE) (p < 0.01). CONCLUSIONS RV-LAS is an independent predictor of adverse prognosis in HCM in addition to RVEF and TAPSE.
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Affiliation(s)
- Fuyao Yang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jie Wang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yuancheng Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Weihao Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yuanwei Xu
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ke Wan
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Jiayu Sun
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Yuchi Han
- Department of Medicine (Cardiovascular Division), University of Pennsylvania, Philadelphia, PA, USA
| | - Yucheng Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China; Center of Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
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12
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Park JH. Two-dimensional Echocardiographic Assessment of Myocardial Strain: Important Echocardiographic Parameter Readily Useful in Clinical Field. Korean Circ J 2019; 49:908-931. [PMID: 31456367 PMCID: PMC6753023 DOI: 10.4070/kcj.2019.0200] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 07/03/2019] [Indexed: 01/14/2023] Open
Abstract
Echocardiography is the first and is the most-available imaging modality for many cardiovascular diseases, and echocardiographic parameters can give much important information for diagnosis, treatment, and prognostic evaluations. Left ventricular ejection fraction (LVEF) is the most commonly used echocardiographic parameter for left ventricular (LV) systolic function. Although LVEF is used routinely in daily practice, it is calculated from volumetric change without representing true myocardial properties. Recently, strain echocardiography has been used to objectively measure myocardial deformation. Myocardial strain can give accurate information about intrinsic myocardial function, and it can be used to detect early-stage cardiovascular diseases, monitor myocardial changes with specific therapies, differentiate cardiomyopathies, and predict the prognosis of several cardiovascular diseases. Although strain echocardiography has been applied to measure the right ventricle and left atrium, in addition to analyzing the LV, many cardiologists who are not imaging specialists are unaware of its clinical use and importance. Therefore, this review describes the measurement and clinical utility of 2-dimensional strain analysis in various cardiovascular diseases.
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Affiliation(s)
- Jae Hyeong Park
- Department of Cardiology in Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.
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13
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Wu X, Li Y, Wang Y, Zhang M, Zhu W, Cai Q, Jiang W, Sun L, Ding X, Ye X, Qin Y, Lu X. Impaired Right Ventricular Mechanics at Rest and During Exercise Are Associated With Exercise Capacity in Patients With Hypertrophic Cardiomyopathy. J Am Heart Assoc 2019; 8:e011269. [PMID: 30798647 PMCID: PMC6474915 DOI: 10.1161/jaha.118.011269] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 01/24/2019] [Indexed: 12/27/2022]
Abstract
Background Impaired right ventricular ( RV ) function indicates RV involvement in patients with hypertrophic cardiomyopathy ( HCM ). We aimed to assess RV function at rest and during exercise in HCM patients and to examine the association between impaired RV mechanics and exercise capacity. Methods and Results A total of 76 HCM patients (48 without and 28 with RV hypertrophy) and 30 age- and sex-matched controls were prospectively recruited. RV function was evaluated at rest and during semisupine bicycle exercise by conventional echocardiography and 2-dimensional speckle-tracking imaging. Exercise capacity was measured by metabolic equivalents. RV functional reserve was calculated as the difference of functional parameters between peak exercise and rest. Compared with controls, HCM patients had significantly higher RV free wall thickness, lower RV global longitudinal strain and RV free wall longitudinal strain at rest and during exercise, and reduced RV systolic functional reserve. Compared with those with HCM without RV hypertrophy, patients with HCM with RV hypertrophy had lower metabolic equivalents. Among HCM patients, an effective correlation was seen between exercise capacity and peak exercise RV global longitudinal strain and peak exercise RV free wall longitudinal strain. A binary logistic regression model revealed several independent predictors of exercise intolerance in HCM patients, but receiver operating characteristic curve analysis indicated exercise RV global longitudinal strain had the highest area under the curve for the prediction of exercise intolerance in HCM patients. Conclusions HCM patients have RV dysfunction and reduced contractile reserve. Exercise RV global longitudinal strain correlates with exercise capacity and can independently predict exercise intolerance. In addition, patients with HCM with RV hypertrophy exhibit more reduced exercise capacity, suggesting more severe disease and poorer prognosis.
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MESH Headings
- Adult
- Cardiomyopathy, Hypertrophic/diagnostic imaging
- Cardiomyopathy, Hypertrophic/physiopathology
- Case-Control Studies
- Echocardiography, Doppler, Pulsed
- Echocardiography, Stress
- Exercise Test
- Exercise Tolerance
- Female
- Humans
- Hypertrophy, Right Ventricular/diagnostic imaging
- Hypertrophy, Right Ventricular/physiopathology
- Male
- Middle Aged
- Prospective Studies
- Ventricular Dysfunction, Right/diagnostic imaging
- Ventricular Dysfunction, Right/physiopathology
- Ventricular Function, Right
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Affiliation(s)
- Xiao‐Peng Wu
- Department of EchocardiographyHeart CenterBeijing ChaoYang HospitalCapital Medical UniversityBeijingChina
| | - Yi‐Dan Li
- Department of EchocardiographyHeart CenterBeijing ChaoYang HospitalCapital Medical UniversityBeijingChina
| | - Yi‐Dan Wang
- Department of EchocardiographyHeart CenterBeijing ChaoYang HospitalCapital Medical UniversityBeijingChina
| | - Miao Zhang
- Department of EchocardiographyHeart CenterBeijing ChaoYang HospitalCapital Medical UniversityBeijingChina
| | - Wei‐Wei Zhu
- Department of EchocardiographyHeart CenterBeijing ChaoYang HospitalCapital Medical UniversityBeijingChina
| | - Qi‐Zhe Cai
- Department of EchocardiographyHeart CenterBeijing ChaoYang HospitalCapital Medical UniversityBeijingChina
| | - Wei Jiang
- Department of EchocardiographyHeart CenterBeijing ChaoYang HospitalCapital Medical UniversityBeijingChina
| | - Lan‐Lan Sun
- Department of EchocardiographyHeart CenterBeijing ChaoYang HospitalCapital Medical UniversityBeijingChina
| | - Xue‐Yan Ding
- Department of EchocardiographyHeart CenterBeijing ChaoYang HospitalCapital Medical UniversityBeijingChina
| | - Xiao‐Guang Ye
- Department of EchocardiographyHeart CenterBeijing ChaoYang HospitalCapital Medical UniversityBeijingChina
| | - Yun‐Yun Qin
- Department of EchocardiographyHeart CenterBeijing ChaoYang HospitalCapital Medical UniversityBeijingChina
| | - Xiu‐Zhang Lu
- Department of EchocardiographyHeart CenterBeijing ChaoYang HospitalCapital Medical UniversityBeijingChina
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14
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Paterick ZR, Paterick TE. Preparticipation Cardiovascular Screening of Student-Athletes with Echocardiography: Ethical, Clinical, Economic, and Legal Considerations. Curr Cardiol Rep 2019; 21:16. [PMID: 30820677 DOI: 10.1007/s11886-019-1101-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE OF REVIEW To identify whether the use of echocardiography is a viable approach for the screening of athletes for the prevention of sudden cardiac death when considering ethical, clinical, economic, and legal issues. RECENT FINDINGS Ethical musings, echocardiographic findings, economic calculations, and legal analysis suggest that echocardiographic screening may reduce sudden cardiac death on the athletic field. Ethical, clinical, economic, and legal considerations suggest echocardiographic screening is a viable option to meet the societal goal to prevent athletic field sudden death.
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15
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Keramida K, Lazaros G, Nihoyannopoulos P. Right ventricular involvement in hypertrophic cardiomyopathy: Patterns and implications. Hellenic J Cardiol 2018; 61:3-8. [PMID: 30508591 DOI: 10.1016/j.hjc.2018.11.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/17/2018] [Accepted: 11/23/2018] [Indexed: 10/27/2022] Open
Abstract
Although hypertrophic cardiomyopathy (HCM) is the most common inherited cardiomyopathy worldwide, the criteria for its definition and most of the literature concern the left ventricle, thus confirming the theory that the right ventricle is the neglected one. Right ventricular (RV) involvement includes structural and functional changes with significant impact on clinical presentation and prognosis. The pattern of RV hypertrophy can be variable with possible dynamic obstruction. Histological findings suggest similar pathogenetic changes in both ventricles supporting the common myopathic process with sarcomeric mutations. Systolic dysfunction of the RV is subtle, and the classical echocardiographic indices are usually within normal limits, while global longitudinal strain is significantly impaired. Diastolic dysfunction of the RV is also evident in patients with HCM possibly due to fibrosis of the RV free wall and/or the obstruction of the RV filling with significant prognostic implications. RV involvement in HCM is associated with increased incidence of supraventricular and ventricular arrhythmias, severe dyspnea, pulmonary thromboembolism, progressive heart failure, and increased risk of sudden cardiac death. Therefore, the RV should be routinely included in the detailed assessment of patients with HCM.
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Affiliation(s)
- Kalliopi Keramida
- Unit of Inherited Cardiovascular Diseases/Heart Center of the Young and Athletes, First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, Greece.
| | - George Lazaros
- Unit of Inherited Cardiovascular Diseases/Heart Center of the Young and Athletes, First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, Greece
| | - Petros Nihoyannopoulos
- Unit of Inherited Cardiovascular Diseases/Heart Center of the Young and Athletes, First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University of Athens, Greece; National Heart and Lung Institute Imperial College London, London, UK
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16
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Vitarelli A, Lai S, Petrucci MT, Gaudio C, Capotosto L, Mangieri E, Ricci S, Germanò G, De Sio S, Truscelli G, Vozella F, Pergolini MS, Giordano M. Biventricular assessment of light-chain amyloidosis using 3D speckle tracking echocardiography: Differentiation from other forms of myocardial hypertrophy. Int J Cardiol 2018; 271:371-377. [DOI: 10.1016/j.ijcard.2018.03.088] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 02/24/2018] [Accepted: 03/19/2018] [Indexed: 01/08/2023]
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17
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Lee JH, Park JH. Strain Analysis of the Right Ventricle Using Two-dimensional Echocardiography. J Cardiovasc Imaging 2018; 26:111-124. [PMID: 30310878 PMCID: PMC6160817 DOI: 10.4250/jcvi.2018.26.e11] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/11/2018] [Accepted: 08/28/2018] [Indexed: 01/12/2023] Open
Abstract
Right ventricular (RV) systolic dysfunction has been identified as an independent prognostic marker of many cardiovascular diseases. However, there are problems in measuring RV systolic function objectively and identification of RV dysfunction using conventional echocardiography. Strain echocardiography is a new imaging modality to measure myocardial deformation. It can measure intrinsic myocardial function and has been used to measure regional and global left ventricular (LV) function. Although the RV has different morphologic characteristics than the LV, strain analysis of the RV is feasible. After strain echocardiography was introduced to measure RV systolic function, it became more popular and was incorporated into recent echocardiographic guidelines. Recent studies showed that RV global longitudinal strain (RVGLS) can be used as an objective index of RV systolic function with prognostic significance. In this review, we discuss RVGLS measurement, normal reference values, and the clinical importance of RVGLS.
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Affiliation(s)
- Ju-Hee Lee
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jae-Hyeong Park
- Department of Cardiology in Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
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18
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Qasem M, George K, Somauroo J, Forsythe L, Brown B, Oxborough D. Right ventricular function in elite male athletes meeting the structural echocardiographic task force criteria for arrhythmogenic right ventricular cardiomyopathy. J Sports Sci 2018; 37:306-312. [PMID: 30022711 DOI: 10.1080/02640414.2018.1499392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Athlete pre-participation screening is focused on detecting pathological conditions like arrhythmogenic right ventricular cardiomyopathy (ARVC). The diagnosis of ARVC is established by applying the revised 2010 ARVC Task Force Criteria (TFC) that assesses RV structure and function. Some athletes may meet structural TFC without having ARVC but we do not know the consequences for RV function. This study compared RV structural and functional indices in male athletes that meet the structural TFC (MTFC) for ARVC and those that do not (NMTFC). We recruited 214 male elite athletes. All participants underwent 2D, Doppler, tissue Doppler and strain (ε) echocardiography with a focused and comprehensive assessment of the right heart. Athletes were grouped on RV structural data: MTFC n = 34; NMTFC n = 180. Functional data were compared between groups. By selection, MTFC had larger absolute and scaled RV outflow tract (RVOT) diameter compared to NMTFC (P ˂0.05) but these athletes did not develop a proportional increase in the RV inflow dimensions. There was no difference in global conventional RV systolic function between both groups however, there was significantly lower global RV ε in athletes that MTFC which can be explained, in part, by the RVOT dimension.
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Affiliation(s)
- Mohammad Qasem
- a Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - Keith George
- a Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - John Somauroo
- a Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - Lynsey Forsythe
- a Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - Benjamin Brown
- a Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - David Oxborough
- a Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
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19
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The Prognostic Implications of Two-Dimensional Speckle Tracking Echocardiography in Hypertrophic Cardiomyopathy. Cardiol Rev 2018; 26:130-136. [DOI: 10.1097/crd.0000000000000172] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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20
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Wang L, Bai F, Zhang Q, Song W, Messer A, Kawai M. Development of apical hypertrophic cardiomyopathy with age in a transgenic mouse model carrying the cardiac actin E99K mutation. J Muscle Res Cell Motil 2018; 38:421-435. [PMID: 29582353 DOI: 10.1007/s10974-018-9492-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/12/2018] [Indexed: 10/17/2022]
Abstract
In both humans and mice, the Glu-99-Lys (E99K) mutation in the cardiac actin gene (ACTC) results in little understood apical hypertrophic cardiomyopathy (AHCM). To determine how cross-bridge kinetics change with AHCM development, we applied sinusoidal length perturbations to skinned papillary muscle fibres from 2- and 5-month old E99K transgenic (Tg) and non-transgenic (NTg) mice, and studied tension and its transients. These age groups were chosen because our preliminary studies indicated that AHCM develops with age. Fibres from 5-month old E99K mice showed significant decreases in tension, stiffness, the rate of the medium-speed exponential process and its magnitude compared to non-transgenic control. The nucleotide association constants increased with age, and they were significantly larger in E99K compared to NTg. However, there were no large differences in the rates of the cross-bridge detachment step, the rates of the force generation step, or the phosphate association constant. Our result on force/cross-bridge demonstrates that the decreased active tension of E99K fibres was caused by a decreased amount of force generated per each cross-bridge. The effects were generally less or insignificant at 2 months. A pCa-tension study showed increased Ca2+-sensitivity (pCa50) with age in both the E99K and NTg sample groups, and pCa50 was significantly larger (but only for 0.05-0.06 pCa units) in E99K than in NTg groups. A significant decrease in cooperativity (nH) was observed only in 5-month old E99K mice. We conclude that the AHCM-causing ACTC E99K mutation is associated with progressive alterations in biomechanical parameters, with changes smaller at 2 months but larger at 5 months, correlating with the development of AHCM.
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Affiliation(s)
- Li Wang
- School of Nursing, Medical College, Soochow University, Suzhou, 215006, Jiangsu, China.,Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA, 52242, USA
| | - Fan Bai
- Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA, 52242, USA
| | - Qing Zhang
- School of Nursing, Medical College, Soochow University, Suzhou, 215006, Jiangsu, China
| | - Weihua Song
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Andrew Messer
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Masataka Kawai
- Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA, 52242, USA.
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21
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Influence of different dynamic sporting disciplines on right ventricular Structure and function in elite male athletes. Int J Cardiovasc Imaging 2018; 34:1067-1074. [DOI: 10.1007/s10554-018-1316-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 02/02/2018] [Indexed: 01/22/2023]
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22
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D'Ascenzi F, Pelliccia A, Solari M, Piu P, Loiacono F, Anselmi F, Caselli S, Focardi M, Bonifazi M, Mondillo S. Normative Reference Values of Right Heart in Competitive Athletes: A Systematic Review and Meta-Analysis. J Am Soc Echocardiogr 2017; 30:845-858.e2. [DOI: 10.1016/j.echo.2017.06.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Indexed: 01/23/2023]
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23
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Haugaa KH, Basso C, Badano LP, Bucciarelli-Ducci C, Cardim N, Gaemperli O, Galderisi M, Habib G, Knuuti J, Lancellotti P, McKenna W, Neglia D, Popescu BA, Edvardsen T. Comprehensive multi-modality imaging approach in arrhythmogenic cardiomyopathy-an expert consensus document of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2017; 18:237-253. [PMID: 28069601 PMCID: PMC5837226 DOI: 10.1093/ehjci/jew229] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 10/03/2016] [Indexed: 12/29/2022] Open
Abstract
Arrhythmogenic cardiomyopathy (AC) is a progressive disease with high risk of life-threatening ventricular arrhythmias. A genetic mutation is found in up to 50-60% of probands, mostly affecting desmosomal genes. Diagnosis of AC is made by a combination of data from different modalities including imaging, electrocardiogram, Holter monitoring, family history, genetic testing, and tissue properties. Being a progressive cardiomyopathy, repeated cardiac imaging is needed in AC patients. Repeated imaging is important also for risk assessment of ventricular arrhythmias. This expert consensus document gives clinical recommendations for how to use multi-modality imaging in the different aspects of AC disease, including diagnosis, family screening, follow-up, risk assessment, and differential diagnosis.
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Affiliation(s)
- Kristina H Haugaa
- Department of Cardiology, Center for Cardiological Innovation and Institute for Surgical Research, Oslo University Hospital, Oslo and University of Oslo, Oslo, Norway
| | - Cristina Basso
- Cardiovascular Pathology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy
| | - Luigi P Badano
- Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy
| | - Chiara Bucciarelli-Ducci
- Department of Cardiology, Bristol Heart Institute, University Hospitals Bristol NHS Trust and University of Bristol and Bristol NIRH Cardiovascular Biomedical Research Unit, Bristol, UK
| | - Nuno Cardim
- Department of Cardiology, Multimodality Cardiac Imaging Center, Sports Cardiology and Cardiomyopathies Center, Hospital da Luz, Lisbon, Portugal
| | - Oliver Gaemperli
- Interventional Cardiology and Cardiac Imaging, University Heart Center Zurich, Zurich, Switzerland
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Gilbert Habib
- Aix-Marseille Université, Marseille and Cardiology Department, APHM, La Timone Hospital, Marseille, France
| | - Juhani Knuuti
- Turku PET Centre, Turku University Hospital and University of Turku, Kiinamyllynkatu, Turku, Finland
| | - Patrizio Lancellotti
- GIGA Cardiovascular Sciences, Department of Cardiology, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, Liège, Belgium and Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - William McKenna
- Heart Hospital, Hamad Medical Corporation, Doha, Qatar and Imperial College, London, UK
| | - Danilo Neglia
- Cardiovascular Department at Fondazione Toscana G. Monasterio, CNR Institute of Clinical Physiology and Scuola Superiore San’Anna, Pisa, Italy
| | - Bogdan A Popescu
- University of Medicine and Pharmacy “Carol Davila”—Euroecolab, Institute of Cardiovascular Diseases “Prof. Dr. C. C. Iliescu,” Bucharest, Romania
| | - Thor Edvardsen
- Department of Cardiology, Center for Cardiological Innovation and Institute for Surgical Research, Oslo University Hospital, Oslo and University of Oslo, Oslo, Norway
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24
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D'Andrea A, Limongelli G, Baldini L, Verrengia M, Carbone A, Di Palma E, Vastarella R, Masarone D, Tagliamonte G, Riegler L, Calabrò R, Russo MG, Bossone E, Pacileo G. Exercise speckle-tracking strain imaging demonstrates impaired right ventricular contractile reserve in hypertrophic cardiomyopathy. Int J Cardiol 2017; 227:209-216. [DOI: 10.1016/j.ijcard.2016.11.150] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/06/2016] [Indexed: 11/15/2022]
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25
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D'Andrea A, Martone F, Liccardo B, Mazza M, Annunziata A, Di Palma E, Conte M, Sirignano C, D'Alto M, Esposito N, Fiorentino G, Russo MG, Bossone E, Calabrò R. Acute and Chronic Effects of Noninvasive Ventilation on Left and Right Myocardial Function in Patients with Obstructive Sleep Apnea Syndrome: A Speckle Tracking Echocardiographic Study. Echocardiography 2016; 33:1144-55. [PMID: 27060461 DOI: 10.1111/echo.13225] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND In patients with obstructive sleep apnea syndrome (OSAS), repetitive hypoxia due to sleep-induced apnea adversely affects the interaction between myocardial oxygen demand and supply, resulting in the development of subclinical cardiac dysfunction. The purpose of the study was to analyze the different involvement of left and right heart myocardial function in patients with OSAS treated with noninvasive ventilation (NIV). METHODS Conventional Doppler echocardiography, Doppler myocardial imaging (DMI), and two-dimensional speckle tracking echocardiography (2DSTE) of left (LV) and right ventricular (RV) longitudinal and right atrial (RA) deformation were performed in 55 patients with OSAS undergoing NIV (M/F 38/17; mean age 67.8 ± 11.2 years). LV and RV global longitudinal strain (GLS) was calculated by averaging local strain along the entire right and left ventricle, before and during NIV, and after 6 months of nocturnal NIV therapy. RESULTS LV morphology was comparable before and during NIV, whereas LV ejection fraction and LV DMI early diastolic peak velocity were significantly improved in patients with OSAS during NIV, as was LV regional peak myocardial strain (P < 0.001). RV diameters were slightly increased in patients with OSAS during ventilation, whereas pulmonary artery systolic pressure (PASP), RV GLS, and regional peak myocardial RV strain were significantly reduced during ventilation (P < 0.0001). RA transverse diameters and RA area were also slightly increased during NIV, whereas RA lateral wall strain was reduced (P < 0.001). Acute RV myocardial impairment completely reversed at follow-up, with a decrease in PASP and subsequent increase in both RV and RA myocardial performance. CONCLUSIONS Conventional 2DSTE is a useful tool for assessing left and right heart morphology and myocardial deformation in patients with OSAS and for monitoring both acute and chronic effects of NIV.
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Affiliation(s)
- Antonello D'Andrea
- Chair of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy
| | - Francesca Martone
- Chair of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy
| | - Biagio Liccardo
- Chair of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy
| | - Mariano Mazza
- Division of Pneumology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy
| | - Anna Annunziata
- Division of Pneumology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy
| | - Enza Di Palma
- Chair of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy
| | - Marianna Conte
- Chair of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy
| | - Cesare Sirignano
- Institute of Biostructure and Bioimaging (IBB) of the Italian National Research Council, Naples, Italy
| | - Michele D'Alto
- Chair of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy
| | - Nicolino Esposito
- Division of Cardiology, Evangelic Hospital Villa Betania, Naples, Italy
| | - Giuseppe Fiorentino
- Division of Pneumology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy
| | - Maria Giovanna Russo
- Chair of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy
| | - Eduardo Bossone
- Department of Cardiology and Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Raffaele Calabrò
- Chair of Cardiology, Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Naples, Italy
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26
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Locatelli C, Spalla I, Zanaboni AM, Brambilla PG, Bussadori C. Assessment of right ventricular function by feature-tracking echocardiography in conscious healthy dogs. Res Vet Sci 2016; 105:103-10. [DOI: 10.1016/j.rvsc.2016.01.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 01/18/2016] [Accepted: 01/24/2016] [Indexed: 01/08/2023]
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27
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Galderisi M, Cardim N, D'Andrea A, Bruder O, Cosyns B, Davin L, Donal E, Edvardsen T, Freitas A, Habib G, Kitsiou A, Plein S, Petersen SE, Popescu BA, Schroeder S, Burgstahler C, Lancellotti P. The multi-modality cardiac imaging approach to the Athlete's heart: an expert consensus of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2016; 16:353. [PMID: 25681828 DOI: 10.1093/ehjci/jeu323] [Citation(s) in RCA: 156] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The term 'athlete's heart' refers to a clinical picture characterized by a slow heart rate and enlargement of the heart. A multi-modality imaging approach to the athlete's heart aims to differentiate physiological changes due to intensive training in the athlete's heart from serious cardiac diseases with similar morphological features. Imaging assessment of the athlete's heart should begin with a thorough echocardiographic examination.Left ventricular (LV) wall thickness by echocardiography can contribute to the distinction between athlete's LV hypertrophy and hypertrophic cardiomyopathy (HCM). LV end-diastolic diameter becomes larger (>55 mm) than the normal limits only in end-stage HCM patients when the LV ejection fraction is <50%. Patients with HCM also show early impairment of LV diastolic function, whereas athletes have normal diastolic function.When echocardiography cannot provide a clear differential diagnosis, cardiac magnetic resonance (CMR) imaging should be performed.With CMR, accurate morphological and functional assessment can be made. Tissue characterization by late gadolinium enhancement may show a distinctive, non-ischaemic pattern in HCM and a variety of other myocardial conditions such as idiopathic dilated cardiomyopathy or myocarditis. The work-up of athletes with suspected coronary artery disease should start with an exercise ECG. In athletes with inconclusive exercise ECG results, exercise stress echocardiography should be considered. Nuclear cardiology techniques, coronary cardiac tomography (CCT) and/or CMR may be performed in selected cases. Owing to radiation exposure and the young age of most athletes, the use of CCT and nuclear cardiology techniques should be restricted to athletes with unclear stress echocardiography or CMR.
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MESH Headings
- Adult
- Arrhythmogenic Right Ventricular Dysplasia/diagnosis
- Cardiac Imaging Techniques/methods
- Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography
- Cardiomegaly/diagnosis
- Cardiomegaly, Exercise-Induced
- Cardiomyopathy, Dilated/diagnosis
- Cardiomyopathy, Hypertrophic/diagnosis
- Consensus
- Contrast Media
- Death, Sudden, Cardiac/prevention & control
- Echocardiography, Stress/methods
- Electrocardiography
- European Union
- Gadolinium
- Humans
- Hypertrophy, Left Ventricular/diagnosis
- Magnetic Resonance Imaging, Cine
- Predictive Value of Tests
- Sensitivity and Specificity
- Societies, Medical
- Technetium Tc 99m Sestamibi
- Tomography, Emission-Computed, Single-Photon
- Tomography, X-Ray Computed/methods
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28
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Roşca M, Călin A, Beladan CC, Enache R, Mateescu AD, Gurzun MM, Varga P, Băicuş C, Coman IM, Jurcuţ R, Ginghină C, Popescu BA. Right Ventricular Remodeling, Its Correlates, and Its Clinical Impact in Hypertrophic Cardiomyopathy. J Am Soc Echocardiogr 2015; 28:1329-38. [DOI: 10.1016/j.echo.2015.07.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Indexed: 10/23/2022]
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29
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Afonso L, Briasoulis A, Mahajan N, Kondur A, Siddiqui F, Siddiqui S, Alesh I, Cardozo S, Kottam A. Comparison of right ventricular contractile abnormalities in hypertrophic cardiomyopathy versus hypertensive heart disease using two dimensional strain imaging: a cross-sectional study. Int J Cardiovasc Imaging 2015; 31:1503-9. [DOI: 10.1007/s10554-015-0722-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 07/25/2015] [Indexed: 11/28/2022]
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30
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D'Andrea A, Bossone E, Radmilovic J, Caso P, Calabrò R, Russo MG, Galderisi M. The role of new echocardiographic techniques in athlete's heart. F1000Res 2015; 4:289. [PMID: 26664708 PMCID: PMC4654447 DOI: 10.12688/f1000research.6745.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/15/2015] [Indexed: 01/15/2023] Open
Abstract
‘Athlete’s heart’ is a common term for the various adaptive changes induced by intensive exercise. Exercise causes alterations of the heart in hemodynamic response to the increased systemic and pulmonary demand during exercise. The understanding of these adaptations is of high importance, since they may overlap with those caused by pathological conditions. Cardiac imaging assessment of the athlete’s heart should begin with a complete echocardiographic examination. In recent years classical echocardiographic surveys have been joined by new developments: tissue Doppler imaging, strain rate echocardiography, and real-time 3-dimensional echocardiography. This review paper focuses on the importance of these new echocardiographic techniques in delineating the morphological characteristics and functional properties of the athlete’s heart.
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Affiliation(s)
- Antonello D'Andrea
- Second University of Naples, Monaldi Hospital, Caserta, CE, 81100, Italy
| | | | - Juri Radmilovic
- Second University of Naples, Monaldi Hospital, Caserta, CE, 81100, Italy
| | - Pio Caso
- Second University of Naples, Monaldi Hospital, Caserta, CE, 81100, Italy
| | - Raffaele Calabrò
- Second University of Naples, Monaldi Hospital, Caserta, CE, 81100, Italy
| | | | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, 80138, Italy
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31
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D'Andrea A, Stanziola A, Di Palma E, Martino M, D'Alto M, Dellegrottaglie S, Cocchia R, Riegler L, Betancourt Cordido MV, Lanza M, Maglione M, Diana V, Calabrò R, Russo MG, Vannan M, Bossone E. Right Ventricular Structure and Function in Idiopathic Pulmonary Fibrosis with or without Pulmonary Hypertension. Echocardiography 2015; 33:57-65. [DOI: 10.1111/echo.12992] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Antonello D'Andrea
- Department of Cardiology; Second University of Naples; Monaldi Hospital; “dei Colli - Monaldi” Hospitals; Naples Italy
| | - Anna Stanziola
- Division of Pneumology; Federico II University; Monaldi Hospital; “dei Colli - Monaldi” Hospitals; Naples Italy
| | - Enza Di Palma
- Department of Cardiology; Second University of Naples; Monaldi Hospital; “dei Colli - Monaldi” Hospitals; Naples Italy
| | - Maria Martino
- Division of Pneumology; Federico II University; Monaldi Hospital; “dei Colli - Monaldi” Hospitals; Naples Italy
| | - Michele D'Alto
- Department of Cardiology; Second University of Naples; Monaldi Hospital; “dei Colli - Monaldi” Hospitals; Naples Italy
| | | | - Rosangela Cocchia
- Department of Cardiology; Second University of Naples; Monaldi Hospital; “dei Colli - Monaldi” Hospitals; Naples Italy
| | - Lucia Riegler
- Department of Cardiology; Second University of Naples; Monaldi Hospital; “dei Colli - Monaldi” Hospitals; Naples Italy
| | | | - Maurizia Lanza
- Division of Pneumology; Federico II University; Monaldi Hospital; “dei Colli - Monaldi” Hospitals; Naples Italy
| | - Marco Maglione
- Global Marketing US Cardio - Esaote Ultrasound Technology; Florence Italy
| | - Veronica Diana
- Department of Cardiology; Second University of Naples; Monaldi Hospital; “dei Colli - Monaldi” Hospitals; Naples Italy
| | - Raffaele Calabrò
- Department of Cardiology; Second University of Naples; Monaldi Hospital; “dei Colli - Monaldi” Hospitals; Naples Italy
| | - Maria Giovanna Russo
- Department of Cardiology; Second University of Naples; Monaldi Hospital; “dei Colli - Monaldi” Hospitals; Naples Italy
| | - Mani Vannan
- Department of Cardiovascular Medicine; Piedmont Heart Institute; Atlanta Georgia
| | - Eduardo Bossone
- Department of Cardiology and Cardiac Surgery; “San Giovanni di Dio e Ruggi d'Aragona” University Hospital; Salern Italy
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32
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Leischik R, Dworrak B, Foshag P, Strauss M, Spelsberg N, Littwitz H, Horlitz M. Pre-participation and follow-up screening of athletes for endurance sport. J Clin Med Res 2015; 7:385-92. [PMID: 25883700 PMCID: PMC4394910 DOI: 10.14740/jocmr2129w] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2015] [Indexed: 12/17/2022] Open
Abstract
Physical activity increases life expectancy and sport is a priori not harmful. Exhausted sporting activity (e.g. endurance running, triathlon, cycling or competitive sport) can lead under individual conditions to negative cardiac remodelling (pathological enlargement/function of cardiac cavities/structures) or in worst case to cardiac arrhythmias and sudden cardiac death (SCD). This individually disposition can be genetically determined or behaviourally/environmentally acquired. Overall competitive young male athletes suffer five-fold higher than non-competitive athletes from sudden death and athletes aged over 30 bear a potential for arrhythmias, atrial fibrillation or a 20-fold higher possibility for SCD as female athletes. Patients with diabetes, coronary disease, obesity or hypertension require different special managements. Screening of cardiorespiratory health for sport activities has a lot of faces. Basically there is a need for indicated examinations or possible preventive measures inside or outside of pre-competition screening. The costs of screening compared to expenditure of whole effort for sporting activities are acceptable or even negligible, but of course dependent on national/regional settings. The various causes and possibilities of screening will be discussed in this article as basic suggestion for an open discussion beyond national borders and settings.
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Affiliation(s)
- Roman Leischik
- Faculty of Health, School of Medicine, University Witten/Herdecke, Germany
| | - Birgit Dworrak
- Faculty of Health, School of Medicine, University Witten/Herdecke, Germany
| | - Peter Foshag
- Faculty of Health, School of Medicine, University Witten/Herdecke, Germany
| | - Markus Strauss
- Faculty of Health, School of Medicine, University Witten/Herdecke, Germany
| | - Norman Spelsberg
- Faculty of Health, School of Medicine, University Witten/Herdecke, Germany
| | - Henning Littwitz
- Faculty of Health, School of Medicine, University Witten/Herdecke, Germany
| | - Marc Horlitz
- Faculty of Health, School of Medicine, University Witten/Herdecke, Germany
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33
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Hayabuchi Y, Sakata M, Kagami S. Right ventricular myocardial deformation patterns in children with congenital heart disease associated with right ventricular pressure overload. Eur Heart J Cardiovasc Imaging 2015; 16:890-9. [DOI: 10.1093/ehjci/jev011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 01/19/2015] [Indexed: 11/12/2022] Open
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34
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New and existing risk factors in patients with hypertrophic cardiomyopathy. Can J Cardiol 2015; 31:699-701. [PMID: 25921865 DOI: 10.1016/j.cjca.2015.01.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 01/23/2015] [Accepted: 01/25/2015] [Indexed: 10/24/2022] Open
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35
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Nagata Y, Konno T, Fujino N, Hodatsu A, Nomura A, Hayashi K, Nakamura H, Kawashiri MA, Yamagishi M. Right ventricular hypertrophy is associated with cardiovascular events in hypertrophic cardiomyopathy: evidence from study with magnetic resonance imaging. Can J Cardiol 2015; 31:702-8. [PMID: 25935883 DOI: 10.1016/j.cjca.2014.12.036] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 12/26/2014] [Accepted: 12/27/2014] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Although left ventricular (LV) morphology and function have been well studied in hypertrophic cardiomyopathy (HCM), few data exist regarding the right ventricle. Accordingly, we studied right ventricular (RV) morphology and function and their effect on cardiovascular events in HCM using cardiac magnetic resonance (CMR) imaging. METHODS This retrospective study included 106 HCM patients (age 61.6 ± 14.5 years) examined using CMR imaging during January 2008 to September 2014. RV hypertrophy (RVH) was defined as RV maximal wall thickness > 5 mm. RESULTS RVH was observed in 30 of the 106 patients (RVH group), with the remaining 76 patients assigned to the non-RVH group. The RVH group had higher brain natriuretic peptide levels (461.6 ± 699.8 pg/mL vs. 225.3 ± 254.5 pg/mL; P = 0.01) and also showed a reduced RV end-diastolic volume index (43.4 ± 16.0 mL/m2 vs. 56.6±15.2 mL/m2; P = 0.0001), in keeping with a greater LV mass index (109.1 ± 24.9 g/m2 vs. 78.6 ± 23.0 g/m2; P < 0.0001). The RVH group was prominently associated with RV late gadolinium enhancement compared with the non-RVH group (33.3% vs. 0%; P < 0.0001). After CMR imaging, 15 patients developed cardiovascular events that included admission for heart failure, ventricular tachyarrhythmia/fibrillation, stroke, and sudden cardiac death. Cox proportional hazard analysis revealed that RVH was an independent predictor of the occurrence of cardiovascular events after adjustments by sex, age, LV mass index, LV ejection fraction, and LV outflow tract obstruction (hazard ratio, 5.42; 95% confidence interval, 1.16-25.3; P = 0.03). CONCLUSIONS These results suggest that HCM patients with RVH on CMR images have a greater incidence of cardiovascular events than non-RVH patients. Further work is needed to confirm this observation and assess its clinical importance.
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Affiliation(s)
- Yoji Nagata
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Tetsuo Konno
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan; Research and Education Center for Innovative and Preventive Medicine, Kanazawa University, Kanazawa, Japan.
| | - Noboru Fujino
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Akihiko Hodatsu
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Akihiro Nomura
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Kenshi Hayashi
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Hiroyuki Nakamura
- Research and Education Center for Innovative and Preventive Medicine, Kanazawa University, Kanazawa, Japan; Department of Public Health, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan
| | - Masa-Aki Kawashiri
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Masakazu Yamagishi
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan; Research and Education Center for Innovative and Preventive Medicine, Kanazawa University, Kanazawa, Japan
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36
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Salvo GD, Pergola V, Fadel B, Bulbul ZA, Caso P. Strain Echocardiography and Myocardial Mechanics: From Basics to Clinical Applications. J Cardiovasc Echogr 2015; 25:1-8. [PMID: 28465921 PMCID: PMC5353453 DOI: 10.4103/2211-4122.158415] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The aim of this review is to summarize the recent developments in strain imaging, an evolving technique – from tissue Doppler to 3D echocardiography – for resolving the complex left ventricular mechanics. Following a brief overview of the different used technique to extract myocardial deformation data, the authors summarize the role of the technique in the assessment of cardiac mechanics and its role in the clinical arena.
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Affiliation(s)
- Giovanni Di Salvo
- King Faisal Specialist Hospital and Research Center, Heart Center, Riyadh, Saudi Arabia
| | - Valeria Pergola
- King Faisal Specialist Hospital and Research Center, Heart Center, Riyadh, Saudi Arabia
| | - Bahaa Fadel
- King Faisal Specialist Hospital and Research Center, Heart Center, Riyadh, Saudi Arabia
| | - Ziad Al Bulbul
- King Faisal Specialist Hospital and Research Center, Heart Center, Riyadh, Saudi Arabia
| | - Pio Caso
- Monaldi Hospital Cardiology, Naples, Italy
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37
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Morris DA, Blaschke D, Canaan-Kühl S, Krebs A, Knobloch G, Walter TC, Haverkamp W. Global cardiac alterations detected by speckle-tracking echocardiography in Fabry disease: left ventricular, right ventricular, and left atrial dysfunction are common and linked to worse symptomatic status. Int J Cardiovasc Imaging 2014; 31:301-13. [PMID: 25315709 DOI: 10.1007/s10554-014-0551-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 10/07/2014] [Indexed: 01/29/2023]
Abstract
The aim of this study was to test the hypothesis that in patients with Fabry disease, 2D speckle-tracking echocardiography (2DSTE) could detect functional myocardial alterations such as left ventricular (LV), right ventricular (RV), and left atrial (LA) dysfunction, even when conventional cardiac measurements are normal. In addition, we hypothesized that these global cardiac alterations could be linked to worse symptomatic status in these patients. Fifty patients with Fabry disease and a control group of 118 healthy subjects of similar age and gender were included. The myocardial function and structural changes of the LV, RV, and LA were analyzed by 2DSTE and cardiac magnetic resonance imaging. Patients with Fabry disease had significantly lower functional myocardial values of the LV, RV, and LA than healthy subjects (LV, RV, and LA strain -18.1 ± 4.0, -21.4 ± 4.9, and 29.7 ± 9.9 % vs. -21.6 ± 2.2, -25.2 ± 4.0, and 44.8 ± 11.1 %, respectively, P < 0.001) and elevated rates of LV, RV, and LA myocardial dysfunction (24, 20, and 26 %, respectively), even when conventional cardiac measurements such as LVEF, TAPSE, and LAVI were normal. LV septal wall thickness ≥15 mm, RV free wall thickness ≥7 mm, and LV longitudinal dysfunction were the principal factors linked to reduced LV, RV, and LA strain, respectively. In addition, but to a lesser extent, LV and RV fibrosis were linked to reduced LV and RV strain. Patients with reduced LV, RV, and LA strain had worse functional class (dyspnea-NYHA classification) than those with normal cardiac function. In conclusion, in patients with Fabry disease, 2DSTE analyses detect LV, RV, and LA functional myocardial alterations, even when conventional cardiac measurements are normal. These functional myocardial alterations are common and significantly associated with worse symptomatic status in Fabry patients. Therefore, these findings provide important evidence to introduce global myocardial analyses using 2DSTE in the early detection of functional cardiac alterations in Fabry disease.
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Affiliation(s)
- Daniel A Morris
- Department of Cardiology, Charité University Hospital, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany,
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38
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Speckle-tracking and tissue-Doppler stress echocardiography in arterial hypertension: a sensitive tool for detection of subclinical LV impairment. BIOMED RESEARCH INTERNATIONAL 2014; 2014:472562. [PMID: 25389528 PMCID: PMC4214170 DOI: 10.1155/2014/472562] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 08/06/2014] [Indexed: 01/19/2023]
Abstract
Early diagnosis of cardiac alterations in hypertensive heart disease is still challenging. Since such patients might have depressed global LV systolic strain or strain rate when EF is still normal, speckle-tracking echocardiography (STE) and tissue-Doppler imaging (TDI) combined with stress echocardiography might improve early diagnosis of cardiac alterations. In this prospective study standard 2D Doppler echocardiography, STE, and TDI were performed at rest and during bicycle exercise in 92 consecutive patients—46 hypertensive subjects with normal ejection fraction and 46 healthy controls. STE and TDI were used to measure global peak systolic LV circumferential strain (CS), longitudinal strain (LS), and longitudinal strain rate (SR). Mean arterial blood pressure was significantly higher in hypertensive patients at rest (100.8 mmHg SD 13.5 mmHg; P = 0.002) and during physical exercise testing (124.2 mmHg SD 13.4 mmHg; P = 0.003). Hypertensive patients had significantly reduced values of systolic CS (P = 0.001), LS (P = 0.014), and SR (P < 0.001) at rest as well as during physical exercise—CS (P < 0.001), LS (P < 0.001), and SR (P < 0.001). Using STE and TDI, reduced LV systolic strain and strain rate consistent with early cardiac alterations can be detected in patients with arterial hypertension. These findings were evident at rest and markedly pronounced during exercise echocardiography.
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Peyrou J, Parsaï C, Chauvel C, Simon M, Dehant P, Abergel E. Echocardiographic assessment of right ventricular systolic function in a population of unselected patients before cardiac surgery: A multiparametric approach is necessary. Arch Cardiovasc Dis 2014; 107:529-39. [DOI: 10.1016/j.acvd.2014.06.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 06/16/2014] [Accepted: 06/20/2014] [Indexed: 11/28/2022]
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40
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D'Andrea A, La Gerche A, Golia E, Teske AJ, Bossone E, Russo MG, Calabrò R, Baggish AL. Right Heart Structural and Functional Remodeling in Athletes. Echocardiography 2014; 32 Suppl 1:S11-22. [DOI: 10.1111/echo.12226] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
| | - Andrè La Gerche
- Department of Medicine; St. Vincent's Hospital; University of Melbourne; Melbourne Australia
| | - Enrica Golia
- Chair of Cardiology; Second University of Naples; Naples Italy
| | - Arco J. Teske
- Department of Cardiology; Division of Heart and Lungs; University Medical Center Utrecht; Utrecht The Netherlands
| | - Eduardo Bossone
- Department of Cardiac Surgery; Istituto di Ricovero e Cura a Carattere Scientifico; Policlinico San Donato; San Donato Milanese Milan Italy
| | | | | | - Aaron L. Baggish
- Cardiovascular Performance Program; Massachusetts General Hospital; Boston Massachusetts USA
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41
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Paterick TE, Gordon T, Spiegel D. Echocardiography: Profiling of the Athlete’s Heart. J Am Soc Echocardiogr 2014; 27:940-8. [DOI: 10.1016/j.echo.2014.06.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Indexed: 01/15/2023]
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42
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Ikeda S, Tsuneto A, Kojima S, Koga S, Nakata T, Yoshida T, Eto M, Minami T, Yanagihara K, Maemura K. Longitudinal strain of right ventricular free wall by 2-dimensional speckle-tracking echocardiography is useful for detecting pulmonary hypertension. Life Sci 2014; 111:12-7. [DOI: 10.1016/j.lfs.2014.06.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 06/05/2014] [Accepted: 06/30/2014] [Indexed: 10/25/2022]
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43
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Lord RN, George K, Jones H, Somauroo J, Oxborough D. Reproducibility and feasibility of right ventricular strain and strain rate (SR) as determined by myocardial speckle tracking during high-intensity upright exercise: a comparison with tissue Doppler-derived strain and SR in healthy human hearts. Echo Res Pract 2014; 1:31-41. [PMID: 26693290 PMCID: PMC4676466 DOI: 10.1530/erp-14-0011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/16/2014] [Accepted: 07/28/2014] [Indexed: 11/08/2022] Open
Abstract
This study aimed to establish feasibility for myocardial speckle tracking (MST) and intra-observer reliability of both MST and tissue velocity imaging (TVI)-derived right ventricular (RV) strain (ϵ) and strain rate (SR) at rest and during upright incremental exercise. RV ϵ and SR were derived using both techniques in 19 healthy male participants. MST-derived ϵ and SR were feasible at rest (85% of segments tracked appropriately). Feasibility reduced significantly with progressive exercise intensity (3% of segments tracking appropriately at 90% maximum heart rate (HRmax)). Coefficient of variations (CoVs) of global ϵ values at rest was acceptable for both TVI and MST (7-12%), with low bias and narrow limits of agreement. Global SR data were less reliable for MST compared with TVI as demonstrated with CoV data (systolic SR=15 and 61%, early diastolic SR=16 and 17% and late diastolic SR=26 and 31% respectively). CoVs of global RV ϵ and SR obtained at 50% HRmax were acceptable using both techniques. As exercise intensity increased to 70 and 90% HRmax, reliability of ϵ and SR values reduced with larger variability in MST. We conclude that RV global and regional ϵ and SR data are feasible, comparable and reliable at rest and at 50% HRmax using both MST and TVI. Reliability was reduced during higher exercise intensities with only TVI acceptable for clinical and scientific use.
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Affiliation(s)
- Rachel N Lord
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University , Tom Reilly Building, Byrom Street, Liverpool, L3 3AF , UK
| | - Keith George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University , Tom Reilly Building, Byrom Street, Liverpool, L3 3AF , UK
| | - Helen Jones
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University , Tom Reilly Building, Byrom Street, Liverpool, L3 3AF , UK
| | - John Somauroo
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University , Tom Reilly Building, Byrom Street, Liverpool, L3 3AF , UK ; Countess of Chester Hospital, NHS Trust , Chester , UK
| | - David Oxborough
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University , Tom Reilly Building, Byrom Street, Liverpool, L3 3AF , UK
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Cincin A, Tigen K, Karaahmet T, Dündar C, Gürel E, Bulut M, Sünbül M, Başaran Y. Right ventricular function in hypertrophic cardiomyopathy: A speckle tracking echocardiography study. Anatol J Cardiol 2014; 15:536-41. [PMID: 25537994 PMCID: PMC5337031 DOI: 10.5152/akd.2014.5538] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective: The aim of this study was to explore right ventricular (RV) mechanical function in patients with hypertrophic cardiomyopathy (HCM) by 2-D speckle tracking echocardiography (2-D-STE). Methods: Forty-three patients with HCM (mean age 48, 17 females) and 40 healthy subjects were consecutively included in this cross-sectional study. The diagnosis of HCM was based on the presence of typical clinical, electrocardiographic (ECG), and echocardiographic features. Patients with LV systolic impairment, significant valvular disease, history of coronary artery disease, hypertension, malignancy, and chronic obstructive pulmonary disease were excluded. Right and left ventricular (LV) function was assessed by tissue Doppler imaging (TDI) and 2-D-STE. Hypertrophic cardiomyopathy patients were divided into two groups according to ACC/ESC guidelines (LVOT gradient below and above 30 mm Hg). Student t-test was used to compare differences between groups. Non-parametric tests (Mann-Whitney U) were used in cases of abnormal distribution. Results: Hypertrophic cardiomyopathy patients had a significantly larger right atrium and RV diameters compared to controls. Mean pulmonary artery pressures (mPAB) were significantly higher in HCM patients (19.01±13.09 mm Hg vs. 8.40±4.50 mm Hg; p<0.001). Although RV Sm measure-ments were similar, RV strain measurements (-28.51±5.36% vs. -32.06±7.65%; p=0.016) were significantly lower in HCM patients. Left ventricular global longitudinal, radial, and circumferential strain values were also significantly different between the two groups (-20.50±3.58% vs. -24.12±3.40%; p<0.001, 38.18±12.67% vs. 44.80±10.15%; p=0.012, -21.94±4.28% vs. -23.91±3.95%; p=0.036 consecutively). Rotational movement of LV in each apical, mid-, and basal left ventricular segment was determined, and only mid-ventricular rotation of the HCM patients was more clockwise (-1.71±2.16 ° vs. 0.04±1.72 p<0.001). Although mPAP measurements were higher in HCM patients with significant LVOT obstruction (21.52±13.26 mm Hg vs. 12.31±10.53 mm Hg; p=0.049), none of the other TDI or 2-D-STE parameters was significantly different between groups. Conclusion: Speckle tracking echocardiography-derived right ventricular systolic function is impaired in HCM patients when compared with healthy subjects. However, RV systolic function is not affected form LVOT obstruction and left ventricular rotation dynamics in HCM patients.
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Affiliation(s)
- Altuğ Cincin
- Department of Cardiology, Faculty of Medicine, Marmara University; İstanbul-Turkey.
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Esposito R, Galderisi M, Schiano-Lomoriello V, Santoro A, De Palma D, Ippolito R, Muscariello R, Santoro C, Guerra G, Cameli M, Mondillo S, De Simone G. Nonsymmetric Myocardial Contribution to Supranormal Right Ventricular Function in the Athlete's Heart: Combined Assessment by Speckle Tracking and Real Time Three-Dimensional Echocardiography. Echocardiography 2013; 31:996-1004. [DOI: 10.1111/echo.12499] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Roberta Esposito
- Echocardiography Laboratory; Department of Translational; Medical Sciences Federico II University; Naples Italy
| | - Maurizio Galderisi
- Echocardiography Laboratory; Department of Translational; Medical Sciences Federico II University; Naples Italy
| | - Vincenzo Schiano-Lomoriello
- Echocardiography Laboratory; Department of Translational; Medical Sciences Federico II University; Naples Italy
| | - Alessandro Santoro
- Echocardiography Laboratory; Department of Translational; Medical Sciences Federico II University; Naples Italy
| | - Daniela De Palma
- Echocardiography Laboratory; Department of Translational; Medical Sciences Federico II University; Naples Italy
| | - Renato Ippolito
- Echocardiography Laboratory; Department of Translational; Medical Sciences Federico II University; Naples Italy
| | - Riccardo Muscariello
- Echocardiography Laboratory; Department of Translational; Medical Sciences Federico II University; Naples Italy
| | - Ciro Santoro
- Echocardiography Laboratory; Department of Translational; Medical Sciences Federico II University; Naples Italy
| | - Germano Guerra
- Department of Medicine and Health Sciences; University of Molise Campobasso; Campobasso Italy
| | - Matteo Cameli
- University Cardiology; University of Siena; Siena Italy
| | | | - Giovanni De Simone
- Echocardiography Laboratory; Department of Translational; Medical Sciences Federico II University; Naples Italy
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Pagourelias ED, Kouidi E, Efthimiadis GK, Deligiannis A, Geleris P, Vassilikos V. Right Atrial and Ventricular Adaptations to Training in Male Caucasian Athletes: An Echocardiographic Study. J Am Soc Echocardiogr 2013; 26:1344-52. [DOI: 10.1016/j.echo.2013.07.019] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Indexed: 11/30/2022]
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47
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BERNHEIM ALAINMARCEL, ATTENHOFER JOST CHRISTINEHELENA, ZUBER MICHEL, PFYFFER MONICA, SEIFERT BURKHARDT, DE PASQUALE GABRIELLA, LINKA ANDRE, FAEH-GUNZ ANJA, MEDEIROS-DOMINGO ARGELIA, KNECHTLE BEAT. Right Ventricle Best Predicts the Race Performance in Amateur Ironman Athletes. Med Sci Sports Exerc 2013; 45:1593-9. [DOI: 10.1249/mss.0b013e31828ba558] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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48
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Carneiro-Júnior MA, Prímola-Gomes TN, Quintão-Júnior JF, Drummond LR, Lavorato VN, Drummond FR, Felix LB, Oliveira EM, Cruz JS, Natali AJ, Mill JG. Regional effects of low-intensity endurance training on structural and mechanical properties of rat ventricular myocytes. J Appl Physiol (1985) 2013; 115:107-15. [DOI: 10.1152/japplphysiol.00041.2013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
We tested the effects of low-intensity endurance training (LIET) on the structural and mechanical properties of right (RV) and left ventricular (LV) myocytes. Male Wistar rats (4 mo old) were randomly divided into control (C, n = 7) and trained (T, n = 7, treadmill running at 50–60% of maximal running speed for 8 wk) groups. Isolated ventricular myocyte dimensions, contractility, Ca2+ transients {intracellular Ca2+ concentration ([Ca2+]i)}, and ventricular [Ca2+]i regulatory proteins were measured. LIET augmented cell length (C, 152.5 ± 2.0 μm vs. T, 162.2 ± 2.1 μm; P < 0.05) and volume (C, 5,162 ± 131 μm3 vs. T, 5,506 ± 132 μm3; P < 0.05) in the LV but not in the RV. LIET increased cell shortening (C, 7.5 ± 0.3% vs. T, 8.6 ± 0.3%; P < 0.05), the [Ca2+]i transient amplitude (C, 2.49 ± 0.06 F/F0 vs. T, 2.82 ± 0.06 F/F0; P < 0.05), the expression of sarcoplasmic reticulum Ca2+-ATPase 2a (C, 1.07 ± 0.13 vs. T, 1.59 ± 0.12; P < 0.05), and the levels of phosphorylated phospholamban at serine 16 (C, 0.99 ± 0.11 vs. T, 1.34 ± 0.10; P < 0.05), and reduced the total phospholamban-to-sarcoplasmic reticulum Ca2+-ATPase 2a ratio (C, 1.19 ± 0.15 vs. T, 0.40 ± 0.16; P < 0.05) in the LV without changing such parameters in the RV. In conclusion, LIET affected the structure and improved the mechanical properties of LV but not of RV myocytes in rats, helping to characterize the functional and morphological changes that accompany the endurance training-induced cardiac remodeling.
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Affiliation(s)
| | - Thales Nicolau Prímola-Gomes
- Department of Physical Education, Laboratory of Exercise Biology, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - Judson Fonseca Quintão-Júnior
- Department of Physical Education, Laboratory of Exercise Biology, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - Lucas Rios Drummond
- Department of Physical Education, Laboratory of Exercise Biology, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - Victor Neiva Lavorato
- Department of Physical Education, Laboratory of Exercise Biology, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - Filipe Rios Drummond
- Department of Physical Education, Laboratory of Exercise Biology, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - Leonardo Bonato Felix
- Department of Electrical Engineering, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - Edilamar Menezes Oliveira
- School of Physical Education and Sport, Laboratory of Biochemistry and Molecular Biology of the Exercise, University of São Paulo, São Paulo, Brazil; and
| | - Jader Santos Cruz
- Department of Biochemistry and Immunology, Laboratory of Excitable Membranes and Cardiovascular Biology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Antonio José Natali
- Department of Physical Education, Laboratory of Exercise Biology, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - José Geraldo Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
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Speckle-tracking echocardiographic imaging of the right ventricular systolic and diastolic parameters in chronic exercise. Int J Cardiovasc Imaging 2013; 29:1265-71. [DOI: 10.1007/s10554-013-0204-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 03/01/2013] [Indexed: 10/27/2022]
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50
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Moro AS, Okoshi MP, Padovani CR, Okoshi K. Doppler echocardiography in athletes from different sports. Med Sci Monit 2013; 19:187-93. [PMID: 23478754 PMCID: PMC3628709 DOI: 10.12659/msm.883829] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 12/12/2012] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Studies have shown cardiac changes induced by intense and regular physical activity. The purpose of this study was to evaluate cardiac structures and function in soccer players, cyclists and long-distance runners, and compare them with non-athlete controls. MATERIAL AND METHODS Cardiac structural, systolic, and diastolic function parameters in 53 athletes and 36 non-athlete controls were evaluated by Doppler echocardiography. RESULTS Athletes presented higher left atrial volume, left ventricular (LV) thickness, and LV and right ventricular (RV) diastolic diameters (LVDD and RVDD, respectively) compared to non-athletes. Left atrium and LVDD were higher in cyclists than runners, and RVDD was higher in cyclists than soccer players. LV mass index was higher in athletes, and cyclists had higher values than runners and soccer players. LV systolic function did not differ significantly between groups. The only altered index of LV diastolic function was a higher E/A ratio in cyclists compared to controls. There was no difference in LV E/E' ratio. RV systolic function evaluated by tissue Doppler imaging was higher in cyclists and soccer players than runners. There were no conclusive differences in RV diastolic function. CONCLUSIONS Soccer players, runners and cyclists had remodeling of left and right ventricular structures compared to controls. Cardiac remodeling was more intense in cyclists than runners and soccer players.
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Affiliation(s)
- Andre Santos Moro
- University of Marilia – Unimar, Faculty of Medicine, Marilia, Sao Paulo State, Brazil
| | - Marina Politi Okoshi
- Department of Internal Medicine, Botucatu Medical School, University of Sao Paulo State, UNESP, Botucatu, Sao Paulo, Brazil
| | - Carlos Roberto Padovani
- Department of Internal Medicine, Botucatu Medical School, University of Sao Paulo State, UNESP, Botucatu, Sao Paulo, Brazil
| | - Katashi Okoshi
- Department of Internal Medicine, Botucatu Medical School, University of Sao Paulo State, UNESP, Botucatu, Sao Paulo, Brazil
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