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Mørch J, Kolnes EH, Greve G, Omdal TR, Ebbing C, Kessler J, Khan U. Increasing region of interest width reduces neonatal circumferential strain. Echocardiography 2024; 41:e15873. [PMID: 38985125 DOI: 10.1111/echo.15873] [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: 03/01/2024] [Revised: 06/10/2024] [Accepted: 06/10/2024] [Indexed: 07/11/2024] Open
Abstract
OBJECTIVE There is growing interest in speckle tracking echocardiography-derived strain as a measure of left ventricular function in neonates. However, knowledge gaps remain regarding the effect of image acquisition and processing parameters on circumferential strain measurements. The aim of this study was to evaluate the effect of using different region of interest (ROI) widths on speckle tracking derived circumferential strain in healthy neonates. METHODS Thirty healthy-term-born neonates were examined with speckle-tracking echocardiography in the short-axis view. Circumferential strain values were acquired and compared using two different ROI widths. Furthermore, strain values in the different vendor-defined wall layers were also compared. RESULTS Increasing ROI width led to a decrease in global circumferential strain (GCS) in the midwall and epicardial layers, the respective decreases in strain being -23.4 ± .6% to -22.0 ± 1.1%, p < .0001 and 18.5 ± 1.7% to -15.6 ± 2.0%, p < .0001. Segmental analyses were consistent with these results, apart from two segments in the midwall. There was no statistically significant effect on strain for the endocardial layer. A gradient was seen where strain increased from the epicardial to endocardial layers. CONCLUSION Increasing ROI width led to a decrease in GCS in the midwall and epicardium. There is an increase in circumferential strain when moving from the epicardial toward the endocardial layer. Clinicians wishing to implement circumferential strain into their practice should consider ROI width variation as a potential confounder in their measurements.
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Affiliation(s)
- Johannes Mørch
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Gottfried Greve
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Tom Roar Omdal
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Cathrine Ebbing
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Jörg Kessler
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Umael Khan
- Department of Internal Medicine, Haukeland University Hospital, Bergen, Norway
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Petoello E, Flore AI, Nogara S, Bonafiglia E, Lenzi MB, Arnone OC, Benfari G, Ciarcià M, Corsini I, De Waal K, Gottin L, Ficial B. Global longitudinal strain is an informative index of left ventricular performance in neonates receiving intensive care. Sci Rep 2024; 14:8881. [PMID: 38632330 PMCID: PMC11024117 DOI: 10.1038/s41598-024-59441-5] [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: 01/22/2024] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
Echocardiographic assessment of left ventricular function is crucial in NICU. The study aimed to compare the accuracy and agreement of global longitudinal strain (GLS) with conventional measurements. Real-life echocardiograms of neonates receiving intensive care were retrospectively reviewed. Shortening fraction (SF), ejection fraction (EF) and S' measurements were retrieved from health records. GLS was calculated offline from stored images. The association with stroke volume indexed for body weight (iSV) was evaluated by regression analysis. The diagnostic ability to identify uncompensated shock was assessed by ROC curve analysis. Cohen's κ was run to assess agreement. 334 echocardiograms of 155 neonates were evaluated. Mean ± SD gestational age and birth weight were 34.5 ± 4.1 weeks and 2264 ± 914 g, respectively. SF, EF, S' and GLS were associated with iSV with R2 of 0.133, 0.332, 0.252 and 0.633, (all p < .001). Including all variables in a regression model, iSV prediction showed an adjusted R2 of 0.667, (p < .001). GLS explained 73% of the model variance. GLS showed a better ability to diagnose uncompensated shock (AUC 0.956) compared to EF, S' and SF (AUC 0.757, 0.737 and 0.606, respectively). GLS showed a moderate agreement with EF (κ = .500, p < .001) and a limited agreement with S' and SF (κ = .260, p < .001, κ = .242, p < .001). GLS was a more informative index of left ventricular performance, providing the rationale for a more extensive use of GLS at the cotside.
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Affiliation(s)
- Enrico Petoello
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, P.le A. Stefani 1, 37126, Verona, Italy
| | - Alice Iride Flore
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, P.le A. Stefani 1, 37126, Verona, Italy
| | - Silvia Nogara
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, P.le A. Stefani 1, 37126, Verona, Italy
| | - Elena Bonafiglia
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, P.le A. Stefani 1, 37126, Verona, Italy
| | - Maria Beatrice Lenzi
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, P.le A. Stefani 1, 37126, Verona, Italy
| | - Olivia C Arnone
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, P.le A. Stefani 1, 37126, Verona, Italy
| | - Giovanni Benfari
- Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Martina Ciarcià
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, P.le A. Stefani 1, 37126, Verona, Italy
| | - Iuri Corsini
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Koert De Waal
- Department of Neonatology, John Hunter Children's Hospital, Newcastle, NSW, Australia
- University of Newcastle, Newcastle, NSW, Australia
| | - Leonardo Gottin
- Intensive Care Unit, Department of Surgery, Dentistry, Maternity and Infant, University and Hospital Trust of Verona, Verona, Italy
| | - Benjamim Ficial
- Neonatal Intensive Care Unit, University and Hospital Trust of Verona, P.le A. Stefani 1, 37126, Verona, Italy.
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Dalmer A, Meinel FG, Böttcher B, Manzke M, Lorbeer R, Weber MA, Baeßler B, Klemenz AC. Native myocardial T1 mapping: influence of spatial resolution on quantitative results and reproducibility. Quant Imaging Med Surg 2024; 14:20-30. [PMID: 38223095 PMCID: PMC10784086 DOI: 10.21037/qims-23-943] [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: 06/28/2023] [Accepted: 09/28/2023] [Indexed: 01/16/2024]
Abstract
Background Myocardial mapping techniques can be used to quantitatively assess alterations in myocardial tissue properties. This study aims to evaluate the influence of spatial resolution on quantitative results and reproducibility of native myocardial T1 mapping in cardiac magnetic resonance imaging (MRI). Methods In this cross-sectional study with prospective data collection between October 2019 and February 2020, 50 healthy adults underwent two identical cardiac MRI examinations in the radiology department on the same day. T1 mapping was performed using a MOLLI 5(3)3 sequence with higher (1.4 mm × 1.4 mm) and lower (1.9 mm × 1.9 mm) in-plane spatial resolution. Global quantitative results of T1 mapping were compared between high-resolution and low-resolution acquisitions using paired t-test. Intra-class correlation coefficient (ICC) and Bland-Altman statistics (absolute and percentage differences as means ± SD) were used for assessing test-retest reproducibility. Results There was no significant difference between global quantitative results acquired with high vs. low-resolution T1 mapping. The reproducibility of global T1 values was good for high-resolution (ICC: 0.88) and excellent for low-resolution T1 mapping (ICC: 0.95, P=0.003). In subgroup analyses, inferior test-retest reproducibility was observed for high spatial resolution in women compared to low spatial resolution (ICC: 0.71 vs. 0.91, P=0.001) and heart rates >77 bpm (ICC: 0.53 vs. 0.88, P=0.004). Apical segments had higher T1 values and variability compared to other segments. Regional T1 values for basal (ICC: 0.81 vs. 0.89, P=0.023) and apical slices (ICC: 0.86 vs. 0.92, P=0.024) showed significantly higher reproducibility in low-resolution compared to high-resolution acquisitions but without differences for midventricular slice (ICC: 0.91 vs. 0.92, P=0.402). Conclusions Based on our data, we recommend a spatial resolution on the order of 1.9 mm × 1.9 mm for native myocardial T1 mapping using a MOLLI 5(3)3 sequence at 1.5 T particularly in individuals with higher heart rates and women.
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Affiliation(s)
- Antonia Dalmer
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Felix G. Meinel
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Benjamin Böttcher
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Mathias Manzke
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilian University, Munich, Germany
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Bettina Baeßler
- Institute of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Ann-Christin Klemenz
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
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4
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Støylen A, Mølmen HE, Dalen H. Regional motion of the AV-plane is related to the cardiac anatomy and deformation of the AV-plane. Data from the HUNT study. Clin Physiol Funct Imaging 2023; 43:453-462. [PMID: 37395325 DOI: 10.1111/cpf.12845] [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: 01/27/2023] [Revised: 06/15/2023] [Accepted: 06/26/2023] [Indexed: 07/04/2023]
Abstract
The study examines global and regional systolic shortening of the left (LV) and right ventricle (RV) in 1266 individuals without evidence of heart disease in the third wave of the HUNT study. Regional mitral annular systolic displacement (mitral annular plane systolic excursion [MAPSE]) was 1.5 cm in the septum and anterior walls, 1.6 cm in the lateral wall and 1.7 cm in the inferior wall, global mean 1.6 cm. Peak systolic velocity S' was 8.0, 8.3, 8.8 and 8.6 cm/s in the same walls (global mean 8.7 cm/s). All measures of LV longitudinal shortening correlated, mean MAPSE and S' also correlated with stroke volume (SV) and ejection fraction (EF). Global longitudinal strain by either method correlated with MAPSE, S' and EF, but not with SV, reflecting a systematic difference. S' and MAPSE correlated with early annular diastolic velocity (e'), reflecting that e' is the recoil from systole. Mean displacement was 2.8 (0.5) cm in the tricuspid annulus (tricuspid annular plane systolic excursion [TAPSE]). Normal values by age and sex are provided. Both TAPSE and S' were lower in women, where body size explained the sex difference. Normalisation of MAPSE and S' for wall length reduced intra-individual variation of displacement and velocity by 80%-90%, showing regional MAPSE to be related to LV wall length, and that longitudinal wall strain was relatively uniform. Displacement and S' were lowest in the septum and highest in the left and right free walls, shows systolic bending of the AV-plane into a U-shape, relating to the total cardiac volume changes during the heart cycle.
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Affiliation(s)
- Asbjørn Støylen
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Harald E Mølmen
- Division of Medicine, Department of Endocrinology, Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway
- Department of general practice, Asgardstrand GP, Horten, Norway
| | - Håvard Dalen
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
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5
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Daniels LJ, Macindoe C, Koutsifeli P, Annandale M, James SL, Watson LE, Coffey S, Raaijmakers AJA, Weeks KL, Bell JR, Janssens JV, Curl CL, Delbridge LMD, Mellor KM. Myocardial deformation imaging by 2D speckle tracking echocardiography for assessment of diastolic dysfunction in murine cardiopathology. Sci Rep 2023; 13:12344. [PMID: 37524893 PMCID: PMC10390581 DOI: 10.1038/s41598-023-39499-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 07/26/2023] [Indexed: 08/02/2023] Open
Abstract
Diastolic dysfunction is increasingly identified as a key, early onset subclinical condition characterizing cardiopathologies of rising prevalence, including diabetic heart disease and heart failure with preserved ejection fraction (HFpEF). Diastolic dysfunction characterization has important prognostic value in management of disease outcomes. Validated tools for in vivo monitoring of diastolic function in rodent models of diabetes are required for progress in pre-clinical cardiology studies. 2D speckle tracking echocardiography has emerged as a powerful tool for evaluating cardiac wall deformation throughout the cardiac cycle. The aim of this study was to examine the applicability of 2D speckle tracking echocardiography for comprehensive global and regional assessment of diastolic function in a pre-clinical murine model of cardio-metabolic disease. Type 2 diabetes (T2D) was induced in C57Bl/6 male mice using a high fat high sugar dietary intervention for 20 weeks. Significant impairment in left ventricle peak diastolic strain rate was evident in longitudinal, radial and circumferential planes in T2D mice. Peak diastolic velocity was similarly impaired in the longitudinal and radial planes. Regional analysis of longitudinal peak diastolic strain rate revealed that the anterior free left ventricular wall is particularly susceptible to T2D-induced diastolic dysfunction. These findings provide a significant advance on characterization of diastolic dysfunction in a pre-clinical mouse model of cardiopathology and offer a comprehensive suite of benchmark values for future pre-clinical cardiology studies.
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Affiliation(s)
- L J Daniels
- Cellular and Molecular Cardiology Laboratory, Department of Physiology, University of Auckland, Auckland, New Zealand
- Radcliffe Department of Medicine, OCDEM, University of Oxford, Oxford, UK
| | - C Macindoe
- Cellular and Molecular Cardiology Laboratory, Department of Physiology, University of Auckland, Auckland, New Zealand
| | - P Koutsifeli
- Cellular and Molecular Cardiology Laboratory, Department of Physiology, University of Auckland, Auckland, New Zealand
| | - M Annandale
- Cellular and Molecular Cardiology Laboratory, Department of Physiology, University of Auckland, Auckland, New Zealand
| | - S L James
- Cellular and Molecular Cardiology Laboratory, Department of Physiology, University of Auckland, Auckland, New Zealand
| | - L E Watson
- Cellular and Molecular Cardiology Laboratory, Department of Physiology, University of Auckland, Auckland, New Zealand
| | - S Coffey
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - A J A Raaijmakers
- Department of Anatomy and Physiology, University of Melbourne, Melbourne, Australia
| | - K L Weeks
- Department of Anatomy and Physiology, University of Melbourne, Melbourne, Australia
- Baker Department of Cardiometabolic Health, University of Melbourne, Melbourne, Australia
| | - J R Bell
- Department of Anatomy and Physiology, University of Melbourne, Melbourne, Australia
- Department of Microbiology, Anatomy, Physiology and Pharmacology, La Trobe University, Melbourne, Australia
| | - J V Janssens
- Department of Anatomy and Physiology, University of Melbourne, Melbourne, Australia
| | - C L Curl
- Department of Anatomy and Physiology, University of Melbourne, Melbourne, Australia
| | - L M D Delbridge
- Department of Anatomy and Physiology, University of Melbourne, Melbourne, Australia
| | - Kimberley M Mellor
- Cellular and Molecular Cardiology Laboratory, Department of Physiology, University of Auckland, Auckland, New Zealand.
- Department of Anatomy and Physiology, University of Melbourne, Melbourne, Australia.
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.
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Chawla S, Sato R, Duggal A, Alwakeel M, Hasegawa D, Alayan D, Collier P, Sanfilippo F, Lanspa M, Dugar S. Correlation between tissue Doppler-derived left ventricular systolic velocity (S') and left ventricle ejection fraction in sepsis and septic shock: a retrospective cohort study. J Intensive Care 2023; 11:28. [PMID: 37400918 DOI: 10.1186/s40560-023-00678-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/25/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Tissue Doppler-derived left ventricular systolic velocity (mitral S') has shown excellent correlation to left ventricular ejection fraction (LVEF) in non-critically patients. However, their correlation in septic patients remains poorly understood and its impact on mortality is undetermined. We investigated the relationship between mitral S' and LVEF in a large cohort of critically-ill septic patients. METHODS We conducted a retrospective cohort study between 01/2011 and 12/2020. All adult patients (≥ 18 years) who were admitted to the medical intensive care unit (MICU) with sepsis and septic shock that underwent a transthoracic echocardiogram (TTE) within 72 h were included. Pearson correlation test was used to assess correlation between average mitral S' and LVEF. Pearson correlation was used to assess correlation between average mitral S' and LVEF. We also assessed the association between mitral S', LVEF and 28-day mortality. RESULTS 2519 patients met the inclusion criteria. The study population included 1216 (48.3%) males with a median age of 64 (IQR: 53-73), and a median APACHE III score of 85 (IQR: 67, 108). The median septal, lateral, and average mitral S' were 8 cm/s (IQR): 6.0, 10.0], 9 cm/s (IQR: 6.0, 10.0), and 8.5 cm/s (IQR: 6.5, 10.5), respectively. Mitral S' was noted to have moderate correlation with LVEF (r = 0.46). In multivariable logistic regression analysis, average mitral S' was associated with an increase in both 28-day ICU and in-hospital mortality with odds ratio (OR) 1.04 (95% CI 1.01-1.08, p = 0.02) and OR 1.04 (95% CI 1.01-1.07, p = 0.02), respectively. CONCLUSIONS Even though mitral S' and LVEF may be related, they are not exchangeable and were only found to have moderate correlation in this study. LVEF is U-shaped, while mitral S' has a linear relation with 28-day ICU mortality. An increase in average mitral S' was associated with higher 28-day mortality.
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Affiliation(s)
- Sanchit Chawla
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ryota Sato
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Abhijit Duggal
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine, Case Western University Reserve University, Cleveland, OH, USA
| | - Mahmoud Alwakeel
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Daisuke Hasegawa
- Department of Internal Medicine, Mount Sinai Beth Israel, New York, NY, USA
| | - Dina Alayan
- Department of Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Patrick Collier
- Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Filippo Sanfilippo
- Anaesthesiology and Intensive Care, University of Catania, Catania, Italy
- Policlinico-San Marco University Hospital, Catania, Italy
| | - Michael Lanspa
- Critical Care Echocardiography Service, Intermountain Medical Center, Murray, UT, USA
- Division of Pulmonary and Critical Care Medicine, University of Utah, Salt Lake City, UT, USA
| | - Siddharth Dugar
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.
- Cleveland Clinic Lerner College of Medicine, Case Western University Reserve University, Cleveland, OH, USA.
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Wang J, Liu X, Jin H, Du J. Markers for predicting the efficacy of beta-blockers in vasovagal syncope management in children: A mini-review. Front Cardiovasc Med 2023; 10:1131967. [PMID: 36970341 PMCID: PMC10030864 DOI: 10.3389/fcvm.2023.1131967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 02/20/2023] [Indexed: 03/11/2023] Open
Abstract
Vasovagal syncope (VVS) is a common subtype of neurally mediated syncope. It is prevalent in children and adolescents, and critically affects the quality of life of patients. In recent years, the management of pediatric patients with VVS has received extensive attention, and β-blocker serves as an important choice of the drug therapy for children with VVS. However, the empirical use of β-blocker treatment has limited therapeutic efficacy in patients with VVS. Therefore, predicting the efficacy of β-blocker therapy based on biomarkers related to the pathophysiological mechanism is essential, and great progress has been made by applying these biomarkers in formulating individualized treatment plans for children with VVS. This review summarizes recent advances in predicting the effect of β-blockers in the management of VVS in children.
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Affiliation(s)
- Jing Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Xueqin Liu
- Department of Pediatrics, Peking University First Hospital, Beijing, China
- Correspondence: Junbao Du Hongfang Jin Xueqin Liu
| | - Hongfang Jin
- Department of Pediatrics, Peking University First Hospital, Beijing, China
- Correspondence: Junbao Du Hongfang Jin Xueqin Liu
| | - Junbao Du
- Department of Pediatrics, Peking University First Hospital, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China
- Correspondence: Junbao Du Hongfang Jin Xueqin Liu
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8
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Bateson M, Kervadec H, Dolz J, Lombaert H, Ben Ayed I. Source-free domain adaptation for image segmentation. Med Image Anal 2022; 82:102617. [DOI: 10.1016/j.media.2022.102617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 07/25/2022] [Accepted: 09/02/2022] [Indexed: 11/25/2022]
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9
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Dela Justina V, Miguez JSG, Priviero F, Sullivan JC, Giachini FR, Webb RC. Sex Differences in Molecular Mechanisms of Cardiovascular Aging. FRONTIERS IN AGING 2022; 2:725884. [PMID: 35822017 PMCID: PMC9261391 DOI: 10.3389/fragi.2021.725884] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/25/2021] [Indexed: 12/12/2022]
Abstract
Cardiovascular disease (CVD) is still the leading cause of illness and death in the Western world. Cardiovascular aging is a progressive modification occurring in cardiac and vascular morphology and physiology where increased endothelial dysfunction and arterial stiffness are observed, generally accompanied by increased systolic blood pressure and augmented pulse pressure. The effects of biological sex on cardiovascular pathophysiology have long been known. The incidence of hypertension is higher in men, and it increases in postmenopausal women. Premenopausal women are protected from CVD compared with age-matched men and this protective effect is lost with menopause, suggesting that sex-hormones influence blood pressure regulation. In parallel, the heart progressively remodels over the course of life and the pattern of cardiac remodeling also differs between the sexes. Lower autonomic tone, reduced baroreceptor response, and greater vascular function are observed in premenopausal women than men of similar age. However, postmenopausal women have stiffer arteries than their male counterparts. The biological mechanisms responsible for sex-related differences observed in cardiovascular aging are being unraveled over the last several decades. This review focuses on molecular mechanisms underlying the sex-differences of CVD in aging.
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Affiliation(s)
- Vanessa Dela Justina
- Graduate Program in Biological Sciences, Federal University of Goiás, Goiânia, Brazil
| | | | - Fernanda Priviero
- Cardiovascular Translational Research Center, University of South Carolina, Columbia, SC, United States
| | - Jennifer C Sullivan
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Fernanda R Giachini
- Graduate Program in Biological Sciences, Federal University of Goiás, Goiânia, Brazil.,Institute of Biological Sciences and Health, Federal University of Mato Grosso, Barra do Garças, Brazil
| | - R Clinton Webb
- Cardiovascular Translational Research Center, University of South Carolina, Columbia, SC, United States
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10
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Støylen A, Daae AS. Physiological significance of pre- and post-ejection left ventricular tissue velocities and relations to mitral and aortic valve closures. Clin Physiol Funct Imaging 2021; 41:443-451. [PMID: 34184410 DOI: 10.1111/cpf.12721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/07/2021] [Accepted: 06/23/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Tissue Doppler shows short duration velocity spikes during pre- and post-ejection (protodiastole). They have been assumed to be isovolumic contraction and relaxation movements, but this is not in accordance with newer studies. METHODS We examined 22 healthy volunteers. Valve closures and openings were determined from spectral Doppler from LVOT and mitral inflow and transferred to colour tissue Doppler recordings for comparison with tissue velocities, colour M-mode and strain rate (SR). RESULTS Pre-ejection positive velocity spikes were simultaneous in both walls, starting ca. 24.8 ± 10.1 ms after start QRS, duration 51.5 ± 10.8 ms, ending 10.2 ± 11.5 ms after mitral valve closure (MVC) (p < 0.001). There were corresponding colour tracings and negative strain rate. Protodiastolic lengthening was predominant in the septum. Negative velocity spikes had a duration of 35.5 ± 10.7 ms, ending 9.5 ± 14.7 ms after aortic valve closure (AVC, p < 0.001) in septum. During isovolumic relaxation, strain rate showed apical lengthening (Peak SR-0.72 ± 0.50 s-1 ) and basal shortening (Peak SR 0.44 ± 0.63 s-1 ). CONCLUSION Electromechanical activation of the LV is simultaneous in septum and lateral wall, occurs before MVC, is terminated by MVC itself and is thus not isovolumic. Protodiastole is a short event of lengthening, predominantly in the septum. It may be the mechanism for valve closure and ends by AVC itself. Isovolumic relaxation occurs after this velocity spike, and is characterized by elongation of the apex, shortening of the base, thus showing a volume shift from base towards apex.
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Affiliation(s)
- Asbjørn Støylen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Cardiology, St. Olav Hospital/Trondheim University Hospital, Trondheim, Norway
| | - Annichen Søyland Daae
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Cardiology, St. Olav Hospital/Trondheim University Hospital, Trondheim, Norway
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11
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Succurro E, Miceli S, Fiorentino TV, Sciacqua A, Perticone M, Andreozzi F, Sesti G. Sex-specific differences in left ventricular mass and myocardial energetic efficiency in non-diabetic, pre-diabetic and newly diagnosed type 2 diabetic subjects. Cardiovasc Diabetol 2021; 20:60. [PMID: 33676510 PMCID: PMC7937311 DOI: 10.1186/s12933-021-01248-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/15/2021] [Indexed: 01/14/2023] Open
Abstract
Background Women with type 2 diabetes (T2DM) have a higher excess risk for cardiovascular disease (CVD) than their male counterparts. However, whether the risk for CVD is higher in prediabetic women than men is still debated. We aimed to determine whether sex-related differences exist in left ventricular mass index (LVMI), and myocardial mechano-energetic efficiency (MEEi) in with normal glucose tolerant (NGT), pre-diabetic and newly diagnosed type 2 diabetic subjects. Methods Sex-related differences in LVMI and myocardial MEEi, assessed by validated echocardiography-derived measures, were examined among 1562 adults with NGT, prediabetes, and newly diagnosed T2DM, defined according to fasting glucose, 2-h post-load glucose, or HbA1c. Results Worsening of glucose tolerance in both men and women was associated with an increase in age-adjusted LVMI and myocardial MEEi. Women with newly diagnosed T2DM exhibited greater relative differences in LVMI and myocardial MEEi than diabetic men when compared with their NGT counterparts. Prediabetic women exhibited greater relative differences in myocardial MEEi, but not in LVMI, than prediabetic men when compared with their NGT counterparts. The statistical test for interaction between sex and glucose tolerance on both LVMI (P < 0.0001), and myocardial MEEi (P < 0.0001) was significant suggesting a sex-specific association. Conclusions Left ventricle is subject to maladaptive changes with worsening of glucose tolerance, especially in women with newly diagnosed T2DM. The sex-specific increase in LVM and decrease in MEEi, both being predictors of CVD, may have a role in explaining the stronger impact of T2DM on the excess risk of CVD in women than in men.
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Affiliation(s)
- Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.
| | - Sofia Miceli
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Maria Perticone
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, University of Rome-Sapienza, 00189, Rome, Italy
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The Interplay between Left Ventricular Deformation, Flow, and Geometry in Aortic Stenosis. J Am Soc Echocardiogr 2021; 34:701-702. [PMID: 33524493 DOI: 10.1016/j.echo.2021.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 01/22/2021] [Indexed: 11/23/2022]
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