1
|
Normative healthy reference values for global and segmental 3D principal and geometry dependent strain from cine cardiac magnetic resonance imaging. Int J Cardiovasc Imaging 2023; 39:115-134. [PMID: 36598686 DOI: 10.1007/s10554-022-02693-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/03/2022] [Indexed: 01/07/2023]
Abstract
3-Dimensional (3D) myocardial deformation analysis (3D-MDA) enables novel descriptions of geometry-independent principal strain (PS). Applied to routine 2D cine cardiovascular magnetic resonance (CMR), this provides unique measures of myocardial biomechanics for disease diagnosis and prognostication. However, healthy reference values remain undefined. This study describes age- and sex-stratified reference values from CMR-based 3D-MDA, including 3D PS. One hundred healthy volunteers were prospectively recruited following institutional ethics approval and underwent CMR imaging. 3D-MDA was performed using validated software. Age- and sex-stratified global and segmental strain measures were derived for conventional geometry-dependent [circumferential (CS), longitudinal (LS), and radial (RS)] and geometry-independent [minimum (minPS) and maximum principal (maxPS)] directions of deformation. Layer-specific contraction angle interactions were determined using local minPS vectors. The average age was 43 ± 15 years and 55% were women. Strain measures were higher in women versus men. 3D PS-based assessment of maximum tissue shortening (minPS) and maximum tissue thickening (maxPS) were greater than corresponding geometry-dependent markers of LS and RS, consistent with improved representation of local tissue deformations. Global maxPS amplitude best discriminated both age and sex. Segmental analyses showed greater strain amplitudes in apical segments. Transmural PS contraction angles were higher in females and showed a heterogeneous distribution across segments. In this study we provided age and sex-based reference values for 3D strain from CMR imaging, demonstrating improved capacity for 3D PS to document maximal local tissue deformations and to discriminate age and sex phenotypes. Novel markers of layer-specific strain angles from 3D PS were also described.
Collapse
|
2
|
La Gerche A, Pedrizzetti G, Ranieri B, D’Andrea A, Bossone E. On the characterization of athlete’s heart using 3D Echocardiography. Eur J Prev Cardiol 2022; 29:1592-1593. [DOI: 10.1093/eurjpc/zwac117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Andre La Gerche
- Clinical Research Domain, Baker Heart and Diabetes Institute , 99 Commercial Road, Melbourne VIC 3004, Australia
| | - Gianni Pedrizzetti
- Department of Engineering and Architecture, University of Trieste , Via Alfonso Valerio, 6/1 – 34127, Trieste, Italy
| | - Brigida Ranieri
- IRCCS SYNLAB SDN, Via Emanuele Gianturco, 113 – 80143, Naples, Italy
| | - Antonello D’Andrea
- Department of Cardiology, Umberto I Hospital Nocera Inferiore, Via Alfonso de Nicola , 84014, Nocera Inferiore, SA, Italy
| | - Eduardo Bossone
- Cardiology Division, Antonio Cardarelli Hospital, Via Antonio Cardarelli , 9 – 80131, Naples, Italy
| |
Collapse
|
3
|
Myocardial Fitness of Bicuspid Aortic Valve Athletes during COVID 19 Pandemic. J Funct Morphol Kinesiol 2022; 7:jfmk7020037. [PMID: 35645299 PMCID: PMC9149884 DOI: 10.3390/jfmk7020037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/20/2022] [Accepted: 04/27/2022] [Indexed: 11/30/2022] Open
Abstract
COVID 19 pandemic has induced a large sedentarism in several kinds of sports. Some peculiar categories of athletes could particularly suffer from a prolonged inactivity as those affected by minimal cardiopathies as bicuspid aortic valve (BAV) athletes. This study aims to verify the myocardial performance in a restricted group of BAV athletes compared to a control group of agonistic athletes evaluated by traditional echocardiography and deformation parameters. 2D standard and deformations parameters were measured at rest conditions in BAV athletes and controls. Particularly EF, LVDD/LVS diameters, GLS rotation and twisting were considered as myocardial performance data; E/A, E1 and A1 as diastolic ones. All the 2D standard parameters measured were within the normal range in both groups, especially the EF value. Significant differences were found in the diastolic function with reduced values of E and E1 waves in BAV vs. controls. The strain analysis showed a significant reduction in GLS measured in 2C, 3C, 4C in BAV if compared to controls, while no significant differences were found in torsional and rotational parameters. These results are suggestive for a potential long term negative impact of inactivity on cardiac performance more evident in BAV athletes, if compared to athletes with normal aortic valve. GLS of LV and RV can be considered as a predictive parameter of this mild dysfunction and assumed as follow-up parameter to restore a progressive training.
Collapse
|
4
|
Morning blood pressure surge in the early stage of hypertensive patients impacts three-dimensional left ventricular speckle tracking echocardiography. Clin Hypertens 2021; 27:16. [PMID: 34391469 PMCID: PMC8364689 DOI: 10.1186/s40885-021-00173-3] [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: 03/21/2021] [Accepted: 06/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to examine left ventricular (LV) function in untreated, newly diagnosed hypertensive patients with morning blood pressure surge (MBPS) status using three-dimensional (3D) speckle tracking echocardiography (STE). METHODS In this study, 163 newly diagnosed hypertensive patients were included, and all patients underwent 24-h ambulatory blood pressure monitoring (ABPM). According to ABPM, participants were divided into a MBPS group and a non-MBPS group. The entire study population was examined by complete two-dimensional (2D) transthoracic echocardiography (TTE) and 3D STE. RESULT The results of this study showed that 3D LV longitudinal strain was significantly decreased in the MBPS group compared with the non-MBPS group (- 30.1 ± 2.0 vs. -31.1 ± 2.7, p = 0.045). Similar trends were observed for 3D twist (9.6 ± 6.1 vs. 12.1 ± 4.8, p = 0.011) as well as for 3D torsion (1.23 ± 0.78 vs. 1.49 ± 0.62, p = 0.042). The LV principal strain was decreased in the MBPS group (- 33.9 ± 1.7 vs. -35.5 ± 2.8, p < 0.001). The 3D LV global longitudinal strain (GLS) and principal strain were significantly associated with quartile of MBPS as measured by systolic blood pressure (SBP). CONCLUSION The 3D STE revealed that LV mechanics were more impaired in the MBPS group than in the non-surge newly diagnosed, untreated hypertensive patients; even the 2D TTE parameters showed no difference.
Collapse
|
5
|
D'Ascenzi F, Valentini F, Anselmi F, Cavigli L, Bandera F, Benfari G, D'Andrea A, Di Salvo G, Esposito R, Evola V, Malagoli A, Elena Mandoli G, Santoro C, Galderisi M, Mondillo S, Cameli M. Bicuspid aortic valve and sports: From the echocardiographic evaluation to the eligibility for sports competition. Scand J Med Sci Sports 2020; 31:510-520. [PMID: 33260267 DOI: 10.1111/sms.13895] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 10/23/2020] [Accepted: 11/27/2020] [Indexed: 12/19/2022]
Abstract
Bicuspid aortic valve (BAV) is the most common congenital heart defect in adults. Although a BAV may remain without clinical consequences for a lifetime, it can deteriorate in aortic valve stenosis and regurgitation and aortic dilatation. Unfortunately, the impact of regular training on patients with BAV and its natural course is not fully understood, although preliminary evidence suggests that the progression of valvular disease occurs primarily in an independent manner from sports practice. The current review aims to report how to perform a comprehensive echocardiographic examination in athletes with BAV and analyze the current literature on the influence of sports practice and how it impacts the aortic valve in athletes with BAV. The article also summarizes the current recommendations on sports eligibility and disqualification for competitive athletes with BAV.
Collapse
Affiliation(s)
- Flavio D'Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Francesca Valentini
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Francesca Anselmi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Luna Cavigli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Francesco Bandera
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giovanni Benfari
- Department of Medicine, Section of Cardiology, University of Verona, Verona, Italy
| | - Antonello D'Andrea
- Department of Cardiology, Umberto I° Hospital Nocera Inferiore, Salerno, Italy
| | | | - Roberta Esposito
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Vincenzo Evola
- Department of Clinical and Experimental Medicine, University of Palermo, Palermo, Italy
| | | | - Giulia Elena Mandoli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Ciro Santoro
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Sergio Mondillo
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | | |
Collapse
|
6
|
Bi X, Yeung DF, Salah HM, Arciniegas Calle MC, Thaden JJ, Nhola LF, Schaff HV, Pislaru SV, Pellikka PA, Pochettino A, Greason KL, Nkomo VT, Villarraga HR. Dissecting myocardial mechanics in patients with severe aortic stenosis: 2-dimensional vs 3-dimensional-speckle tracking echocardiography. BMC Cardiovasc Disord 2020; 20:33. [PMID: 32000672 PMCID: PMC6993452 DOI: 10.1186/s12872-020-01336-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 01/09/2020] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Aortic stenosis (AS) causes left ventricular (LV) pressure overload, leading to adverse LV remodeling and dysfunction. Identifying early subclinical markers of LV dysfunction in patients with significant AS is critical as this could provide support for earlier intervention, which may result in improved long-term outcomes. We therefore examined the impact of severe AS and its consequent increase in LV afterload on myocardial deformation and rotational mechanics by 2-dimensional (2D) and 3-dimensional (3D) speckle-tracking echocardiography.
Methods
We prospectively measured various strain parameters in 168 patients (42% female, mean age 72 ± 12 years) with severe AS and LV ejection fraction (EF) ≥50%, and compared them to normal values found in literature. 2D and 3D images were analyzed for global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), basal rotation, apical rotation, and peak systolic twist. We further assessed the degree of concordance between 2D and 3D strain, and examined their association with measures of LV preload and afterload.
Results
Patients with severe AS exhibited significantly lower GLS and GRS but higher GCS, apical rotation, and twist by 2D and 3D echocardiography compared with published normal values (P = 0.003 for 3D twist, P < 0.001 for all others). Agreement between 2D- and 3D-GLS by concordance correlation coefficient was 0.49 (95% confidence interval: 0.39–0.57). GLS was correlated with valvulo-arterial impedance, a measure of LV afterload (r = 0.34, p < 0.001 and r = 0.23, p = 0.003, respectively).
Conclusion
Patients with severe AS demonstrated lower-than-normal GLS and GRS but appear to compensate with higher-than-normal GCS, apical rotation, and twist in order to maintain a preserved LVEF. GLS showed a modest correlation with valvulo-arterial impedance.
Collapse
|
7
|
Zhu M, Chen H, Fulati Z, Liu Y, Su Y, Shu X. The value of left ventricular strain-volume loops in predicting response to cardiac resynchronization therapy. Cardiovasc Ultrasound 2019; 17:3. [PMID: 30777069 PMCID: PMC6379938 DOI: 10.1186/s12947-019-0153-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 02/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Three-dimensional (3D) speckle tracking imaging (STI) allows the simultaneous assessment of left ventricular (LV) strain and volume. We aim to explore the value of LV strain-volume loops in predicting response to cardiac resynchronization therapy (CRT). METHODS Forty heart failure (HF) patients scheduled for CRT and twenty healthy individuals were enrolled. All subjects received a 3D echocardiography and 3D STI analysis to acquire LV global and segmental principal strain (PS) and volume simultaneously. Values were plotted in a Cartesian system to construct PS-volume loop which was assessed using the two characteristics of the linear fitting curve: the slope and the coefficient of determination (R2-S/D coupling). RESULTS HF patients at baseline showed significantly lower slope and R2-S/D coupling of all PS-volume loops than healthy subjects. As for as comparing Segmental PS-Global volume loop at baseline, Midseptal R2-S/D coupling was lower and Midlateral slope was higher in CRT responders than in non-responders. For each individual, the abnormal segmental heterogeneity of Midseptal slope and R2-S/D coupling were lower than Midlateral was observed only in responders. At follow-up, significant improvements of the Midseptal slope and R2-S/D coupling were observed in responders. Midseptal R2-S/D coupling at baseline was an independent predictor of CRT response and the cut-off value of 0.55 was recommended with sensitivity of 89% and specificity of 77%. CONCLUSIONS Analysis of strain-volume loops could provide unique information for predicting response to CRT. Assessment of septal myocardial wasted work at baseline is helpful to improve patient selection for CRT.
Collapse
Affiliation(s)
- Mengruo Zhu
- Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, 180 Fenglin Road, Shanghai, 200032, China.,Department of Cardiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Cardiovascular Diseases, 180 Fenglin Road, Shanghai, 200032, China
| | - Haiyan Chen
- Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, 180 Fenglin Road, Shanghai, 200032, China
| | - Zibire Fulati
- Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, 180 Fenglin Road, Shanghai, 200032, China
| | - Yang Liu
- Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, 180 Fenglin Road, Shanghai, 200032, China
| | - Yangang Su
- Department of Cardiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Cardiovascular Diseases, 180 Fenglin Road, Shanghai, 200032, China
| | - Xianhong Shu
- Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, 180 Fenglin Road, Shanghai, 200032, China. .,Department of Cardiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Cardiovascular Diseases, 180 Fenglin Road, Shanghai, 200032, China.
| |
Collapse
|
8
|
Xu Y, Yamashiro T, Moriya H, Tsubakimoto M, Nagatani Y, Matsuoka S, Murayama S. Strain measurement on four-dimensional dynamic-ventilation CT: quantitative analysis of abnormal respiratory deformation of the lung in COPD. Int J Chron Obstruct Pulmon Dis 2018; 14:65-72. [PMID: 30587962 PMCID: PMC6305131 DOI: 10.2147/copd.s183740] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Strain measurement is frequently used to assess myocardial motion in cardiac imaging. This study aimed to apply strain measurement to pulmonary motion observed by four-dimensional dynamic-ventilation computed tomography (CT) and to clarify motion abnormality in COPD. Materials and methods Thirty-two smokers, including ten with COPD, underwent dynamic-ventilation CT during spontaneous breathing. CT data were continuously reconstructed every 0.5 seconds. In the series of images obtained by dynamic-ventilation CT, five expiratory frames were identified starting from the peak inspiratory frame (first expiratory frame) and ending with the fifth expiratory frame. Strain measurement of the scanned lung was performed using research software that was originally developed for cardiac strain measurement and modified for assessing deformation of the lung. The measured strain values were divided by the change in mean lung density to adjust for the degree of expiration. Spearman’s rank correlation analysis was used to evaluate associations between the adjusted strain measurements and various spirometric values. Results The adjusted strain measurement was negatively correlated with FEV1/FVC (ρ=−0.52, P<0.01), maximum mid-expiratory flow (ρ=−0.59, P<0.001), and peak expiratory flow (ρ=−0.48, P<0.01), suggesting that abnormal deformation of lung motion is related to various patterns of expiratory airflow limitation. Conclusion Abnormal deformation of lung motion exists in COPD patients and can be quantitatively assessed by strain measurement using dynamic-ventilation CT. This technique can be expanded to dynamic-ventilation CT in patients with various lung and airway diseases that cause abnormal pulmonary motion.
Collapse
Affiliation(s)
- Yanyan Xu
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan, .,Department of Radiology, China-Japan Friendship Hospital, Beijing, Republic of China
| | - Tsuneo Yamashiro
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan,
| | - Hiroshi Moriya
- Department of Radiology, Ohara General Hospital, Fukushima-City, Fukushima, Japan
| | - Maho Tsubakimoto
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan,
| | - Yukihiro Nagatani
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Shin Matsuoka
- Department of Radiology, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Sadayuki Murayama
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan,
| | | |
Collapse
|
9
|
Ahn HS, Kim YK, Song HC, Choi EJ, Kim GH, Cho JS, Ihm SH, Kim HY, Park CS, Youn HJ. The impact of preload on 3-dimensional deformation parameters: principal strain, twist and torsion. Cardiovasc Ultrasound 2017; 15:22. [PMID: 28899401 PMCID: PMC5596939 DOI: 10.1186/s12947-017-0111-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 09/01/2017] [Indexed: 12/20/2022] Open
Abstract
Background Strain analysis is feasible using three-dimensional (3D) echocardiography. This approach provides various parameters based on speckle tracking analysis from one full-volume image of the left ventricle; however, evidence for its volume independence is still lacking. Methods Fifty-eight subjects who were examined by transthoracic echocardiography immediately before and after hemodialysis (HD) were enrolled. Real-time full-volume 3D echocardiographic images were acquired and analyzed using dedicated software. Two-dimensional (2D) longitudinal strain (LS) was also measured for comparison with 3D strain values. Results Longitudinal (pre-HD: −24.57 ± 2.51, post-HD: −21.42 ± 2.15, P < 0.001); circumferential (pre-HD: −33.35 ± 3.50, post-HD: −30.90 ± 3.22, P < 0.001); and radial strain (pre-HD: 46.47 ± 4.27, post-HD: 42.90 ± 3.61, P < 0.001) values were significantly decreased after HD. The values of 3D principal strain (PS), a unique parameter of 3D images, were affected by acute preload changes (pre-HD: −38.10 ± 3.71, post-HD: −35.33 ± 3.22, P < 0.001). Twist and torsion values were decreased after HD (pre-HD: 17.69 ± 7.80, post-HD: 13.34 ± 6.92, P < 0.001; and pre-HD: 2.04 ± 0.86, post-HD:1.59 ± 0.80, respectively, P < 0.001). The 2D LS values correlated with the 3D LS and PS values. Conclusion Various parameters representing left ventricular mechanics were easily acquired from 3D echocardiographic images; however, like conventional parameters, they were affected by acute preload changes. Therefore, strain values from 3D echocardiography should be interpreted with caution while considering the preload conditions of the patients.
Collapse
Affiliation(s)
- Hyo-Suk Ahn
- Divisions of Cardiology, College of Medicine, Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Yong-Kyun Kim
- Nephrology, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Ho Chul Song
- Nephrology, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Euy Jin Choi
- Nephrology, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Gee-Hee Kim
- Divisions of Cardiology, College of Medicine, Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Jung Sun Cho
- Divisions of Cardiology, College of Medicine, Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Sang-Hyun Ihm
- Divisions of Cardiology, College of Medicine, Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Hee-Yeol Kim
- Divisions of Cardiology, College of Medicine, Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Chan Seok Park
- Divisions of Cardiology, College of Medicine, Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
| | - Ho-Joong Youn
- Divisions of Cardiology, College of Medicine, Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| |
Collapse
|
10
|
Lopez-Candales A, Hernandez-Suarez DF. Strain Imaging Echocardiography: What Imaging Cardiologists Should Know. Curr Cardiol Rev 2017; 13:118-129. [PMID: 27799029 PMCID: PMC5452148 DOI: 10.2174/1573403x12666161028122649] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/06/2016] [Accepted: 10/18/2016] [Indexed: 01/30/2023] Open
Abstract
Despite recent advances in clinical imaging, echocardiography remains as the most accessi-ble and reliable noninvasive. Since knowledge of left ventricular systolic function remains so critically important in determining prognosis; every effort should be made to prevent subjective estimations. The advent of strain imaging echocardiography now offers a readily available and portable imaging tool that not only offers an objective characterization of myocardial dynamics; but also allows for early detection of subclinical left ventricular dysfunction. This review outlines the basic concepts of strain imaging to better understand the mechanism of myocardial function as well their applicability in the least common cardiac diagnosis among current clinical practice.
Collapse
Affiliation(s)
- Angel Lopez-Candales
- Cardiovascular Medicine Division, University of Puerto Rico School of Medicine, Medical Sciences Building, PO Box 365067, San Juan, Puerto Rico
| | - Dagmar F Hernandez-Suarez
- Cardiovascular Medicine Division, University of Puerto Rico School of Medicine, Medical Sciences Building, PO Box 365067, San Juan, Puerto Rico
| |
Collapse
|
11
|
Lo Iudice F, Petitto M, Ferrone M, Esposito R, Vaccaro A, Buonauro A, D'Andrea A, Trimarco B, Galderisi M. Determinants of myocardial mechanics in top-level endurance athletes: three-dimensional speckle tracking evaluation. Eur Heart J Cardiovasc Imaging 2016:jew122. [DOI: 10.1093/ehjci/jew122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
|
12
|
Szauder I, Kovács A, Pavlik G. Comparison of left ventricular mechanics in runners versus bodybuilders using speckle tracking echocardiography. Cardiovasc Ultrasound 2015; 13:7. [PMID: 25890373 PMCID: PMC4340118 DOI: 10.1186/s12947-015-0002-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 02/10/2015] [Indexed: 01/20/2023] Open
Abstract
Background Athlete’s heart is a common definition for a broad spectrum of adaptations induced by intense exercise. We intended to compare left ventricular (LV) mechanics in two sports disciplines with different exercise nature: marathon runners (endurance) and bodybuilders (power). Methods 24 marathon or ultramarathon runners (R), 14 bodybuilders (B) and 15 healthy, sedentary male volunteers (N) were investigated. Beyond standard echocardiographic protocol, parasternal short-axis and apical recordings optimized for speckle tracking analysis were acquired (Esaote MyLab 25). Using dedicated software (TomTec 2D Performance Analysis), global longitudinal (GLS), circumferential (GCS) and radial strain (GRS) were calculated by averaging the corresponding 16 LV segments. Data are presented as mean ± SD. Results Calculated LV mass was higher in bodybuilders compared to normal controls (R vs. B vs. N: 198 ± 52 vs. 224 ± 69 vs. 186 ± 30 g, p < 0.05). We found no difference regarding conventional systolic function parameters among the groups (ejection fraction: 55 ± 9 vs. 60 ± 6 vs. 59 ± 5%; mitral lateral S’ velocity: 10.7 ± 0.6 vs. 10.6 ± 0.4 vs. 11.0 ± 0.8 cm/s). However, speckle tracking analysis showed a different pattern of myocardial deformation in our groups: while GRS was similar, GLS was decreased in runners, GCS was decreased in bodybuilders compared to the other two groups (GLS: -19.4 ± 3.4 vs. -23.3 ± 2.1 vs. -24.1 ± 3.0; GCS: -26.6 ± 3.8 vs. -22.4 ± 4.3 vs. -26.4 ± 2.7%, p < 0.05). Significant correlations were found in runners between GLS and end-diastolic volume (r = 0.46; p < 0.05), and body surface area (r = 0.49; p < 0.05). In bodybuilders, GCS was closely related to LV mass (r = 0.61; p < 0.01) and systolic blood pressure (r = 0.42; p < 0.05). Conclusions While conventional morphological and functional echocardiographic parameters failed to distinguish between the athlete’s heart of the two different sport disciplines, deformation parameters showed a different pattern of LV mechanics in runners versus bodybuilders. Electronic supplementary material The online version of this article (doi:10.1186/s12947-015-0002-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Ipoly Szauder
- Cardiologic Diagnostic Centre, Szabó Ilonka Str. 31, H-1015, Budapest, Hungary.
| | - Attila Kovács
- Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
| | - Gábor Pavlik
- University of Physical Education, Budapest, Hungary.
| |
Collapse
|