1
|
Gao L, Lin Y, Ji M, Wu W, Li H, Qian M, Zhang L, Xie M, Li Y. Clinical Utility of Three-Dimensional Speckle-Tracking Echocardiography in Heart Failure. J Clin Med 2022; 11:6307. [DOI: 10.3390/jcm11216307] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
Heart failure (HF) is an extremely major health problem with gradually increasing incidence in developed and developing countries. HF may lead to cardiac remodeling; thus, advanced imaging techniques are required to comprehensively evaluate cardiac mechanics. Recently, three-dimensional speckle-tracking echocardiography (3D-STE) has been developed as a novel imaging technology that is based on the three-dimensional speckle-tracking on the full volume three-dimensional datasets. Three-dimensional speckle-tracking echocardiography allows a more accurate evaluation of global and regional myocardial performance, assessment of cardiac mechanics, detection of subclinical cardiac dysfunction, and prediction of adverse clinical events in a variety of cardiovascular diseases. Therefore, this review summarizes the clinical usefulness of 3D-STE in patients with HF.
Collapse
|
2
|
Tomoaia R, Beyer RȘ, Zdrenghea D, Dădârlat-Pop A, Popescu MI, Cismaru G, Gușetu G, Șerban AM, Simu GR, Minciună IA, Caloian B, Roșu R, Chețan MI, Pop D. Impact of Three-Dimensional Strain on Major Adverse Cardiovascular Events after Acute Myocardial Infarction Managed by Primary Percutaneous Coronary Intervention-A Pilot Study. Life (Basel) 2021; 11:life11090930. [PMID: 34575079 PMCID: PMC8465252 DOI: 10.3390/life11090930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Three-dimensional speckle-tracking echocardiography (3D-STE) allows simultaneous assessment of multidirectional components of strain. However, there are few data on its usefulness to predict prognosis in patients with acute myocardial infarction (AMI). The objective of our pilot study was to evaluate the prognostic value of four different 3D-STE parameters (global longitudinal strain (GLS-3D), global circumferential strain (GCS-3D), global radial strain (GRS-3D), and global area strain (GAS)) in AMI, after successful revascularization by primary PCI. Methods: We enrolled 94 AMI patients (66 ± 13 years, 56% men) who underwent coronary angiography. All patients had been 3D-STE assessed and followed-up for 1 year for the occurrence of MACE. Results: A total of 25 MACE were recorded over follow-up. Cut-off values of −17% for GAS (HR = 3.1, 95% CI: 1.39–6.92, p = 0.005), −12% for GCS-3D (HR = 3.06, 95% CI: 1.36–6.8, p = 0.006), −10% for GLS-3D (HR = 3.04, 95% CI: 1.36–6.78, p = 0.006), and 25% for GRS-3D (HR = 2.89, 95% CI: 1.29–6.46, p = 0.009) showed moderate accuracy in MACE prediction. Multivariate regression showed that GAS (HR = 1.1, 95% CI: 1.03–1.16), GLS-3D (HR = 1.13, 95% CI: 1.03–1.26), and GCS-3D (HR = 1.13, 95% CI: 1.03–1.23) remained independent predictors of MACE (HR = 1.07, 95% CI: 1.01–1.14 for GAS, and HR = 1.1, 95% CI: 1.01–1.2 for GCS-3D). However, post hoc power analysis indicated adequate sample size (power of 80%) only for GAS and GCS-3D for the ROC curve analysis and for GAS, GCS-3D, and GRS-3D for the log-rank test. Conclusion: Patients with AMI might benefit from early risk stratification with the aid of 3D-STE measurements, particularly GAS and GCS-3D, but larger studies are necessary to determine the optimal cut-off values to predict MACE.
Collapse
Affiliation(s)
- Raluca Tomoaia
- Cardiology Department, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania; (R.Ș.B.); (A.D.-P.); (A.M.Ș.); (M.I.C.)
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Correspondence:
| | - Ruxandra Ștefana Beyer
- Cardiology Department, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania; (R.Ș.B.); (A.D.-P.); (A.M.Ș.); (M.I.C.)
| | - Dumitru Zdrenghea
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| | - Alexandra Dădârlat-Pop
- Cardiology Department, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania; (R.Ș.B.); (A.D.-P.); (A.M.Ș.); (M.I.C.)
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
| | - Mircea Ioachim Popescu
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
- Cardiology Department, Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania
| | - Gabriel Cismaru
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| | - Gabriel Gușetu
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| | - Adela Mihaela Șerban
- Cardiology Department, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania; (R.Ș.B.); (A.D.-P.); (A.M.Ș.); (M.I.C.)
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
| | - Gelu Radu Simu
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| | - Ioan Alexandru Minciună
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| | - Bogdan Caloian
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| | - Radu Roșu
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| | - Maria Ioana Chețan
- Cardiology Department, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania; (R.Ș.B.); (A.D.-P.); (A.M.Ș.); (M.I.C.)
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
| | - Dana Pop
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (D.Z.); (G.C.); (G.G.); (G.R.S.); (I.A.M.); (B.C.); (R.R.); (D.P.)
- Cardiology Department, Rehabilitation Hospital, 400347 Cluj-Napoca, Romania
| |
Collapse
|
3
|
Pamukcu HE, Felekoğlu MA, Algül E, Şahan HF, Aydinyilmaz F, Guliyev İ, İnci SD, Özbeyaz NB, Nallbani A. Copeptin levels predict left ventricular systolic function in STEMI patients: A 2D speckle tracking echocardiography-based prospective observational study. Medicine (Baltimore) 2020; 99:e23514. [PMID: 33327294 PMCID: PMC7738094 DOI: 10.1097/md.0000000000023514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In the present study, we aimed to investigate whether copeptin values on admission are related to left ventricle (LV) systolic function and its improvement at 6 months in ST-segment elevation myocardial infarction (STEMI) patients.In this single-center, prospective observational study, we included 122 STEMI patients from January 2016 to November 2016. LV systolic functions in the form of global longitudinal strain (GLS) in addition to conventional echocardiography parameters were evaluated on admission and at 6-month. Serum copeptin levels were determined using an ultrasensitive immunofluorescence assay.The study population was divided into 2 groups according to median values of copeptin. GLS was significantly lower in patients with high copeptin levels compared to those with low copeptin levels at early stage and 6-month (-16% (16-16.5) vs -15% (15-15.5), P < .001 and -18% (18-19) vs -16% (16-16.25), P < .001, respectively). Copeptin values were negatively correlated with an early and 6-month GLS (r = -0.459 at early stage and r = -0.662 at 6-month). In addition, we observed that copeptin values were negatively correlated with the improvement of GLS at 6-month follow-up (r = -0.458, P < .001 and r = -0.357, P = .005, respectively).Serum copeptin levels in STEMI patients at the time of admission may predict early and 6-month LV systolic function assessed by two-dimensional GLS. To the best of our knowledge, this study is the first to specifically address the relationship between copeptin values and GLS in STEMI patients.
Collapse
Affiliation(s)
- Hilal Erken Pamukcu
- Department of Cardiology, University of Health Sciences Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara
| | - Mehmet Ali Felekoğlu
- Department of Cardiology, University of Health Sciences Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara
| | - Engin Algül
- Department of Cardiology, Bitlis State Hospital, Bitlis
| | - Haluk Furkan Şahan
- Department of Cardiology, University of Health Sciences Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara
| | | | - İlkin Guliyev
- Department of Cardiology, Tokat Medical Park Hospital, Tokat, Turkey
| | - Saadet Demirtaş İnci
- Department of Cardiology, University of Health Sciences Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara
| | - Nail Burak Özbeyaz
- Department of Cardiology, University of Health Sciences Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara
| | - Ali Nallbani
- Department of Cardiology, University of Health Sciences Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara
| |
Collapse
|
4
|
A Comparison of Three-Dimensional Speckle Tracking Echocardiography Parameters in Predicting Left Ventricular Remodeling. JOURNAL OF HEALTHCARE ENGINEERING 2020; 2020:8847144. [PMID: 32802300 PMCID: PMC7416266 DOI: 10.1155/2020/8847144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/27/2020] [Accepted: 07/14/2020] [Indexed: 01/19/2023]
Abstract
Three-dimensional speckle tracking echocardiography (3D STE) is an emerging noninvasive method for predicting left ventricular remodeling (LVR) after acute myocardial infarction (AMI). Previous studies analyzed the predictive value of 3D STE with traditional models. However, no models that contain comprehensive risk factors were assessed, and there are limited data on the comparison of different 3D STE parameters. In this study, we sought to build a machine learning model for predicting LVR in AMI patients after effective percutaneous coronary intervention (PCI) that contains the majority of the clinical risk factors and compare 3D STE parameters values for LVR prediction. We enrolled 135 first-onset AMI patients (120 males, mean age 54 ± 9 years). All patients went through a 3D STE and a traditional transthoracic echocardiography 24 hours after reperfusion. A second echocardiography was repeated at the three-month follow-up to detect LVR (defined as a 20 percent increase in left ventricular end-diastolic volume). Six models were constructed using 15 risk factors. A receiver operator characteristic curve and four performance measurements were used as evaluation methods. Feature importance was used to compare 3D STE parameters. 26 patients (19.3%) had LVR. Our evaluation showed that RF can best predict LVR with the best AUC of 0.96. 3D GLS was the most valuable 3D STE parameters, followed by GCS, global area strain, and global radial strain (feature importance 0.146, 0.089, 0.087, and 0.069, respectively). To sum up, RF models can accurately predict the LVR after AMI, and 3D GLS was the best 3D STE parameters in predicting the LVR.
Collapse
|
5
|
Nabeshima Y, Seo Y, Takeuchi M. A review of current trends in three-dimensional analysis of left ventricular myocardial strain. Cardiovasc Ultrasound 2020; 18:23. [PMID: 32591001 PMCID: PMC7320541 DOI: 10.1186/s12947-020-00204-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/15/2020] [Indexed: 12/19/2022] Open
Abstract
Three-dimensional (3D) left ventricular (LV) myocardial strain measurements using transthoracic 3D echocardiography speckle tracking analysis have several advantages over two-dimensional (2D) LV strain measurements, because 3D strain values are derived from the entire LV myocardium, yielding more accurate estimates of global and regional LV function. In this review article, we summarize the current status of 3D LV myocardial strain. Specifically, we describe how 3D LV strain analysis is performed. Next, we compare characteristics of 2D and 3D strain, and we explain validation of 3D strain measurements, feasibility and measurement differences between 2D and 3D strain, reference values of 3D strain, and its applications in several clinical scenarios. In some parts of this review, we used a meta-analysis to draw reliable conclusions. We also describe the added value of 3D over 2D strain in several specific pathologies and prognoses. Finally, we discuss novel techniques using 3D strain and suggest its future directions.
Collapse
Affiliation(s)
- Yosuke Nabeshima
- Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi, Kitakyushu, 807-8555, Japan.
| | - Yoshihiro Seo
- Department of Cardiology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, School of Medicine, Hospital of University of Occupational and Environmental Health, Kitakyushu, Japan
| |
Collapse
|
6
|
Bendary A, Afifi M, Tawfik W, Mahros M, Ramzy A, Salem M. The predictive value of global longitudinal strain on late infarct size in patients with anterior ST-segment elevation myocardial infarction treated with a primary percutaneous coronary intervention. Int J Cardiovasc Imaging 2018; 35:339-346. [PMID: 30430328 DOI: 10.1007/s10554-018-1498-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/07/2018] [Indexed: 01/30/2023]
Abstract
Late infarct size (IS) after ST segment elevation myocardial infarction (STEMI) is a determinant of subsequent mortality. Late Gadolinium enhancement in cardiac magnetic resonance imaging (LGE-CMRI) is the gold standard for IS measurement, however, it is not readily accessible in many areas. We aimed to evaluate the value of early baseline 2D-echocardiographic global longitudinal strain (GLS) for the prediction of late IS after STEMI. From October 2017 to July 2018, we studied 100 patients with their 1st anterior STEMI treated with primary percutaneous coronary intervention. Baseline GLS calculation was performed within 48 h of admission. In addition, the average value of the nine segments supplied by the LAD was assessed separately (anterior GLS). Infarct size was assessed 3 months later using LGE-CMRI, and large infarcts were defined as ≥ 20% LV myocardium covered by scar. Based on CMRI, we defined two groups; 57 patients with large infarcts (group I) and 43 patients with small infarcts (group II). Both groups were matched in all baseline demographics and risk factors. There was a good and significant correlation between GLS and late IS (r = - 0.840, P < 0.001). This correlation was even higher for anterior GLS (r = - 0.867, P < 0.001). ROC analysis showed a cut-off point of GLS (- 13%) that identified large late IS with a sensitivity and specificity of 66.7% and 88.4% respectively (AUC = 0.85). For anterior GLS, the cut-off point was - 9.6% (Sensitivity 94%, specificity 86%, AUC = 0.9). We concluded that baseline GLS significantly predicts late IS after anterior STEMI.
Collapse
Affiliation(s)
- Ahmed Bendary
- Cardiology Department, Benha Faculty of Medicine, Benha University, Benha, Egypt.
| | - Mohamed Afifi
- Radiology Department, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Wael Tawfik
- Cardiology Department, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Mohamed Mahros
- Cardiology Department, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Ahmed Ramzy
- Cardiology Department, Benha Faculty of Medicine, Benha University, Benha, Egypt
| | - Mohamed Salem
- Cardiology Department, Benha Faculty of Medicine, Benha University, Benha, Egypt
| |
Collapse
|
7
|
Muraru D, Niero A, Rodriguez-Zanella H, Cherata D, Badano L. Three-dimensional speckle-tracking echocardiography: benefits and limitations of integrating myocardial mechanics with three-dimensional imaging. Cardiovasc Diagn Ther 2018. [PMID: 29541615 DOI: 10.21037/cdt.2017.06.01] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Three-dimensional (3D) speckle-tracking echocardiography (3DSTE) is an advanced imaging technique designed for left ventricular (LV) myocardial deformation analysis based on 3D data sets. 3DSTE has the potential to overcome some of the intrinsic limitations of two-dimensional STE (2DSTE) in the assessment of complex LV myocardial mechanics, offering additional deformation parameters (such as area strain) and a comprehensive quantitation of LV geometry and function from a single 3D acquisition. Albeit being a relatively young technique still undergoing technological developments, several experimental studies and clinical investigations have already demonstrated the reliability and feasibility of 3DSTE, as well as several advantages of 3DSTE over 2DSTE. This technique has provided new insights into LV mechanics in several clinical fields, such as the objective assessment of global and regional LV function in ischemic and non-ischemic heart diseases, the evaluation of LV mechanical dyssynchrony, as well as the detection of subclinical cardiac dysfunction in cardiovascular conditions at risk of progression to overt heart failure. However, 3DSTE generally requires patient's breathhold and regular rhythm for enabling an ECG-gated multi-beat 3D acquisition. In addition, the measurements, normal limits and cut-off values pertaining to 3D strain parameters are currently vendor-specific and highly dependent on the 3D ultrasound equipment used. Technological advances with improvement in spatial and temporal resolution and a standardized methodology for obtaining vendor-independent 3D strain measurements are expected in the future for a widespread application of 3DSTE in both clinical and research arenas. The purpose of this review is to summarize currently available data on 3DSTE methodology (feasibility, accuracy and reproducibility), strengths and weaknesses with respect to 2DSTE, as well as the main clinical applications and future research priorities of this emerging technology.
Collapse
Affiliation(s)
- Denisa Muraru
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Alice Niero
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Hugo Rodriguez-Zanella
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.,Echocardiography Laboratory, National Institute of Cardiology, "Ignacio Chávez", Mexico City, Mexico
| | - Diana Cherata
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.,Department of Cardiology, "Filantropia" Municipal Hospital, Craiova, Romania
| | - Luigi Badano
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| |
Collapse
|
8
|
Luo Y, Liu Y, Guan X, Zhang Y, Li J. Value of three dimensional-speckle tracking imaging for predicting left ventricular function after non-ST-segment elevation myocardial infarction with percutaneous coronary intervention. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2018; 26:331-339. [PMID: 29562571 DOI: 10.3233/xst-17316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) is the recommended treatment for high risk patients with non-ST-segment elevation myocardial infarction (NSTEMI). OBJECTIVE To investigate the application of three dimensional-speckle tracking imaging (3D-STI) on patients diagnosed with NSTEMI undergoing PCI. METHODS Forty-four NSTEMI patients and 20 healthy subjects that received basic clinical and laboratory examinations were included in our study. NSTEMI patients were divided into three groups: heart failure (HF) with normal ejection fraction (HF-NEF group, n = 19), heart failure with preserved ejection fraction (HF-PEF group, n = 14) and heart failure with a reduced ejection fraction (HF-REF group, n = 11). The global longitudinal peak systolic strain (GLS), global circumferential peak systolic strain (GCS), global radial peak systolic strain (GRS) and left ventricular (LV) torsion of all subjects were measured by 3D-STI before PCI and 1 month, 3 months after PCI. The high-sensitivity troponin T (hs-TNT), high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-brain natriuretic peptide (NT-pro BNP) were measured in each group. Correlations between these parameters and LV ejection fraction (LVEF) were tested by Pearson correlation analysis. RESULTS GLS, GCS and torsion were significantly decreased in the 3 NSTEMI groups compared with control group (P < 0.05). GLS, torsion were significantly improved in the three NSTEMI groups at postoperative 1 and 3 months (P < 0.05). HF-REF group showed improved GCS on postoperative 1 and 3 month compared with preoperative data, and improved GLS at 3-month follow-up compared with 1-month follow-up (P < 0.05). The hs-TNT, hs-CRP and NT-pro BNP increased in the three NSTEMI groups before PCI (P < 0.05), and decreased at postoperative 1 and 3 month (P < 0.05). LVEF has the positive correlations with LV endsystolic volume (LVESV) and torsion, as well as the negative correlations with LVGLS, LVGCS, NT-pro BNP (P < 0.05). CONCLUSIONS The combinative detection of 3D-STI and NT-pro BNP is an efficient way to assess the cardiac function in patients diagnosed with NSTEMI undergoing PCI.
Collapse
Affiliation(s)
- Yongjuan Luo
- Department of Ultrasound, Tianjin Chest Hospital, China
| | - Yujie Liu
- Department of Cardiovascular Medicine, Tianjin Chest Hospital, China
| | - Xin Guan
- Department of Ultrasound, Tianjin Chest Hospital, China
| | - Ying Zhang
- Department of Cardiovascular Medicine, Tianjin Chest Hospital, China
| | - Jing Li
- Department of Cardiovascular Medicine, Tianjin Chest Hospital, China
| |
Collapse
|
9
|
Diao KY, Yang ZG, Ma M, He Y, Zhao Q, Liu X, Gao Y, Xie LJ, Guo YK. The Diagnostic Value of Global Longitudinal Strain (GLS) on Myocardial Infarction Size by Echocardiography: A Systematic Review and Meta-analysis. Sci Rep 2017; 7:10082. [PMID: 28855658 PMCID: PMC5577208 DOI: 10.1038/s41598-017-09096-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 07/20/2017] [Indexed: 02/05/2023] Open
Abstract
A systematic review and meta-analysis of prospective randomized studies were performed to evaluate the diagnostic value of measuring global longitudinal strain (GLS) using speckle tracking echocardiography (STE) in determining myocardial infarction (MI) size, which is usually measured based on late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR). Eleven trials with a total of 765 patients were included. The pooled correlation was 0.70 (95% CI: 0.64, 0.74) between two-dimensional (2D) GLS and the LGE percentage, and it was 0.55 (95% CI: 0.19, 0.78) for three-dimensional (3D) GLS. Pooled diagnostic estimates for 2D GLS to differentiate an MI size >12% were as follows: sensitivity, 0.77 (95% CI: 0.61, 0.90); specificity, 0.86 (95% CI: 0.68, 0.96); positive likelihood ratio (PLR), 8.13 (95% CI: 1.90, 26.61); negative likelihood ratio (NLR), 0.28 (95% CI: 0.10, 0.54); and diagnostic odds ratio (DOR), 39.87 (95% CI: 4.12, 172.83). The estimated area under the curve (AUC) of the summary receiver operating characteristic (SROC) curve was 0.702. The 2D STE results positively correlated with the infarction size quantified by CMR for patients who had experienced their first MI. This approach can serve as a good diagnostic index for assessing infarction area. However, more consolidated STE studies are still needed to determine the value of 3D STE.
Collapse
Affiliation(s)
- Kai-Yue Diao
- Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Zhi-Gang Yang
- Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
| | - Min Ma
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
- Department of Cardiology, The Sixth People's Hospital of Chengdu, Chengdu, China
| | - Yong He
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Qin Zhao
- Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Xi Liu
- Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Yue Gao
- Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Lin-Jun Xie
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Ying-Kun Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
| |
Collapse
|
10
|
Value of three-dimensional strain parameters for predicting left ventricular remodeling after ST-elevation myocardial infarction. Int J Cardiovasc Imaging 2017; 33:663-673. [DOI: 10.1007/s10554-016-1053-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 12/24/2016] [Indexed: 12/22/2022]
|
11
|
Wang Y, Shan G, Shen J, Zhou Q, Tan B, Liu Y, Luo R, Zhao S, Bi W, Yao F, Li G. Assessment of left ventricular function in chronic alcoholics by real-time three-dimensional echocardiography. Medicine (Baltimore) 2017; 96:e6033. [PMID: 28151910 PMCID: PMC5293473 DOI: 10.1097/md.0000000000006033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Chronic alcohol consumption may lead to progressive cardiac dysfunction. The aim of this study was to evaluate the feasibility of using real-time 3-dimensional echocardiography (3DE) on assessing left ventricular (LV) function in chronic alcoholics.We classified 92 male alcoholics into mild, moderate, and severe groups; 30 age-matched controls were also recruited. LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), LV ejection fraction (LVEF), LV mass (LVM), LV mass index (LVMI), and systolic dyssynchrony index (SDI) were measured by 3DE and 2-dimensional echocardiography (2DE).Compared to the control group, LV volume and mass were higher in the moderate and severe alcoholic groups (P < 0.05). The severe alcoholic (symptomatic) group demonstrated decreased LVEF and increased SDI (detected by 3DE) (P < 0.05).Real-time 3DE can detect the increases of LV volumes and mass in asymptomatic alcoholics, and the changes of LVEF and systolic synchrony index in symptomatic alcoholics.
Collapse
Affiliation(s)
- Yuanzheng Wang
- Department of Ultrasound, The Xinhua Affiliated Hospital of Dalian University, Shahekou District, Dalian, Liaoning
| | - Guoxin Shan
- Department of Ultrasound, the Weifang Traditional Chinese Hospital, Kuiwen District, Weifang, Shandong, China
| | - Jiaqi Shen
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Qiao Zhou
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Bijun Tan
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Yue Liu
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Runlan Luo
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Shifen Zhao
- Department of Ultrasound, The Xinhua Affiliated Hospital of Dalian University, Shahekou District, Dalian, Liaoning
| | - Wenjun Bi
- Department of Ultrasound, The Xinhua Affiliated Hospital of Dalian University, Shahekou District, Dalian, Liaoning
| | - Fangyi Yao
- Department of Ultrasound, The Xinhua Affiliated Hospital of Dalian University, Shahekou District, Dalian, Liaoning
| | - Guangsen Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| |
Collapse
|
12
|
Dimitriu-Leen AC, Scholte AJHA, Katsanos S, Hoogslag GE, van Rosendael AR, van Zwet EW, Bax JJ, Delgado V. Influence of Myocardial Ischemia Extent on Left Ventricular Global Longitudinal Strain in Patients After ST-Segment Elevation Myocardial Infarction. Am J Cardiol 2017; 119:1-6. [PMID: 27776800 DOI: 10.1016/j.amjcard.2016.08.091] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/25/2016] [Accepted: 08/25/2016] [Indexed: 11/28/2022]
Abstract
Two-dimensional echocardiographic left ventricular (LV) global longitudinal strain (GLS) after ST-segment elevation myocardial infarction (STEMI) is moderately correlated with infarct size and reflects the residual LV systolic function. This correlation may be influenced by the presence of myocardial ischemia. The present study investigated how myocardial ischemia modulates the correlation between LV GLS and infarct size determined with single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in patients with first STEMI treated with primary coronary intervention. A total of 1,128 patients (age 60 ± 11 years) who underwent SPECT MPI for the evaluation of infarct size and residual ischemia were evaluated. LV GLS was measured on transthoracic echocardiography. The time interval between echocardiography and SPECT MPI was 1 ± 1 month. A moderate correlation between echocardiographic LV GLS and infarct size on SPECT MPI was observed (r = 0.58, p <0.001). This correlation was weakened by the presence or extent of ischemia; in the group of patients without ischemia, the correlation between LV GLS and infarct size on SPECT MPI was r = 0.66 (p <0.001), whereas in patients with mild or moderate-to-severe ischemia, the correlations were r = 0.56 and 0.38, respectively (both p <0.001). Moderate-to-severe myocardial ischemia was independently associated with more impaired LV GLS after adjusting for infarct size, age, diabetes mellitus, and hypertension (β 0.60, 95% confidence interval 013 to 1.06). In conclusion, the presence of myocardial ischemia after STEMI impacts on the correlation between echocardiographic LV GLS and infarct size measured on SPECT MPI. Residual ischemia is independently associated with more impaired LV GLS.
Collapse
Affiliation(s)
| | - Arthur J H A Scholte
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Spyridon Katsanos
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Georgette E Hoogslag
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Alexander R van Rosendael
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Erik W van Zwet
- Department of Medical Statistics and Bio-informatics, 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.
| |
Collapse
|
13
|
Xu L, Cai Z, Xiong M, Li Y, Li G, Deng Y, Hau WK, Li S, Huang W, Qiu J. Efficacy of an early home-based cardiac rehabilitation program for patients after acute myocardial infarction: A three-dimensional speckle tracking echocardiography randomized trial. Medicine (Baltimore) 2016; 95:e5638. [PMID: 28033254 PMCID: PMC5207550 DOI: 10.1097/md.0000000000005638] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 08/14/2016] [Accepted: 11/21/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The effect of an early short-term home-based cardiac rehabilitation (CR) program on ventricular function in acute myocardial infarction (AMI) patients is not yet clear. The purpose of this study was to evaluate the efficacy of our CR program on the improvement of myocardial function using three-dimensional speckle tracking echocardiography (3D-STE) in AMI patients. METHODS Fifty-two AMI patients were randomly assigned to 2 groups after discharge: the rehabilitation group, which participated in an early, home-based CR program, and the control group, which received only usual care. All subjects in both groups underwent 3D-STE examinations of the left ventricle within 48 hours of percutaneous coronary intervention and again 4 weeks after discharge. Global longitudinal strain (GLS), global radial strain (GRS), global area strain (GAS), global circumferential strain (GCS), left ventricular ejection fraction (LVEF), and segmental strains were computed. The CR program was initially conducted with supervised inpatient training, followed by an unsupervised home-based training program during a 4-week follow-up. RESULTS We obtained segmental strains from 832 segments, of which 319 were defined as interventional segments, 179 as ischemic segments, and the remaining segments as normal segments. At the 4-week follow-up, when controlling for baseline values, the rehabilitation group showed significant improvements in GLS, GRS, GCS, GAS, LVEF, and in all of the segmental strains of the 3 subgroups compared with the control group (P <0.05). CONCLUSION Our study suggests that an early, home-based CR program can greatly improve the ventricular function of AMI patients in a short period of time.
Collapse
Affiliation(s)
- Lin Xu
- Department of Cardiology, Guangzhou General Hospital of Guangzhou Military Region, PLA
| | - Zekun Cai
- Department of Cardiology, Guangzhou General Hospital of Guangzhou Military Region, PLA
- The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Meihua Xiong
- Department of Cardiology, Guangzhou General Hospital of Guangzhou Military Region, PLA
| | - Yekuo Li
- Department of Ultrasound, Guangzhou General Hospital of Guangzhou Military Region, PLA, Guangzhou
| | - Guoying Li
- Department of Ultrasound, Guangzhou General Hospital of Guangzhou Military Region, PLA, Guangzhou
| | - Yu Deng
- Department of Cardiology, Guangzhou General Hospital of Guangzhou Military Region, PLA
| | - William Kongto Hau
- LiKaShing Faculty of Medicine, Institute of Cardiovascular Medicine and Research, University of Hong Kong, Hong Kong, China
| | - Shuo Li
- Department of Medical Imaging, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Wenhua Huang
- School of Basic Medical Science, Southern Medical University, Guangzhou, China
| | - Jian Qiu
- Department of Cardiology, Guangzhou General Hospital of Guangzhou Military Region, PLA
| |
Collapse
|
14
|
Abstract
Non-Doppler, 2-dimensional strain imaging is a new echocardiographic technique for obtaining strain and strain rate measurements, which serves as a major advancement in understanding myocardial deformation. It analyzes motion in ultrasound imaging by tracking speckles in 2 dimensions. There are a lot of data emerging with multiple applications of strain imaging in the clinical practice of echocardiography. As incorporation of strain imaging in daily practice has been challenging, we intend to systematically highlight the top 10 applications of speckle-tracking echocardiography, which every cardiologist should be aware of: chemotherapy cardiotoxicity, left ventricular assessment, cardiac amyloidosis, hypertrophic obstructive cardiomyopathy, right ventricular dysfunction, valvular heart diseases (aortic stenosis and mitral regurgitation), cardiac sarcoidosis, athlete heart, left atrial assessment, and cardiac dyssynchrony.
Collapse
|
15
|
Evaluation of myocardial infarction size with three-dimensional speckle tracking echocardiography: a comparison with single photon emission computed tomography. Int J Cardiovasc Imaging 2015; 31:1571-81. [DOI: 10.1007/s10554-015-0745-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 08/13/2015] [Indexed: 12/17/2022]
|
16
|
Wang Q, Huang D, Zhang L, Shen D, Ouyang Q, Duan Z, An X, Zhang M, Zhang C, Yang F, Zhi G. Assessment of Myocardial Infarct Size by Three-Dimensional and Two-Dimensional Speckle Tracking Echocardiography: A Comparative Study to Single Photon Emission Computed Tomography. Echocardiography 2015; 32:1539-46. [PMID: 25684359 DOI: 10.1111/echo.12901] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Qiushuang Wang
- Department of Cardiology; First Affiliated Hospital of Chinese PLA General Hospital; Beijing China
| | - Dangsheng Huang
- Department of Cardiology; First Affiliated Hospital of Chinese PLA General Hospital; Beijing China
| | - Liwei Zhang
- Department of Cardiology; First Affiliated Hospital of Chinese PLA General Hospital; Beijing China
| | - Dong Shen
- Department of Cardiology; First Affiliated Hospital of Chinese PLA General Hospital; Beijing China
| | - Qiaohong Ouyang
- Department of Nuclear Medicine; First Affiliated Hospital of Chinese PLA General Hospital; Beijing China
| | - Zhongxiang Duan
- Department of Nuclear Medicine; First Affiliated Hospital of Chinese PLA General Hospital; Beijing China
| | - Xiuzhi An
- Department of Cardiology; First Affiliated Hospital of Chinese PLA General Hospital; Beijing China
| | - Meiqing Zhang
- Department of Cardiology; First Affiliated Hospital of Chinese PLA General Hospital; Beijing China
| | - Chunhong Zhang
- Department of Cardiology; First Affiliated Hospital of Chinese PLA General Hospital; Beijing China
| | - Feifei Yang
- Department of Cardiology; First Affiliated Hospital of Chinese PLA General Hospital; Beijing China
| | - Guang Zhi
- Department of Cardiology; Chinese PLA General Hospital; Beijing China
| |
Collapse
|
17
|
Nguyen BL, Capotosto L, Persi A, Placanica A, Rafique A, Piccirillo G, Gaudio C, Gang ES, Siegel RJ, Vitarelli A. Global and regional left ventricular strain indices in post-myocardial infarction patients with ventricular arrhythmias and moderately abnormal ejection fraction. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:407-417. [PMID: 25542492 DOI: 10.1016/j.ultrasmedbio.2014.09.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 09/15/2014] [Accepted: 09/19/2014] [Indexed: 06/04/2023]
Abstract
The aim of the study described here was to compare myocardial strains in ischemic heart patients with and without sustained ventricular tachycardia (VT) and moderately abnormal left ventricular ejection fraction (LVEF) to investigate which index could better predict VT on the basis of the analysis of global and regional left ventricular (LV) dysfunction. We studied 467 patients with previous myocardial infarction and LVEF >35%. Fifty-one patients had documented VT, and 416 patients presented with no VT. LV volumes and score index were obtained by 2-D echocardiography. Longitudinal, radial and circumferential strains were determined. Strains of the infarct, border and remote zones were also obtained. There were no differences in standard LV 2-D parameters between patients with and those without VT. Receiver operating characteristic values were -12.7% for global longitudinal strain (area under the curve [AUC] = 0.72), -4.8% for posterior-inferior wall circumferential strain (AUC = 0.80), 61 ms for LV mechanical dispersion (AUC = 0.84), -10.1% for longitudinal strain of the border zone (AUC = 0.86) and -9.2% for circumferential strain of the border zone (AUC = 0.89). In patients with previous myocardial infarction and moderately abnormal LVEF, peri-infarct circumferential strain was the strongest predictor of documented ventricular arrhythmias among all strain quantitative indices. Additionally, strain values from posterior-inferior wall infarctions had a higher association with arrhythmic events compared with global strain.
Collapse
Affiliation(s)
| | | | | | | | - Asim Rafique
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | | | | | - Eli S Gang
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | | | | |
Collapse
|
18
|
Haberka M, Liszka J, Kozyra A, Finik M, Gąsior Z. Two-Dimensional Speckle Tracking Echocardiography Prognostic Parameters in Patients after Acute Myocardial Infarction. Echocardiography 2014; 32:454-60. [DOI: 10.1111/echo.12666] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Maciej Haberka
- 2nd Department of Cardiology; Medical University of Silesia; Katowice Poland
| | - Jerzy Liszka
- Department of Cardiology; Multidisciplinary Hospital; Jaworzno Poland
| | - Andrzej Kozyra
- 2nd Department of Cardiology; Medical University of Silesia; Katowice Poland
| | - Maciej Finik
- Department of Cardiology; Multidisciplinary Hospital; Jaworzno Poland
| | - Zbigniew Gąsior
- 2nd Department of Cardiology; Medical University of Silesia; Katowice Poland
| |
Collapse
|