1
|
Pan CK, Zhao BW, Zhang XX, Pan M, Mao YK, Yang Y. Three-dimensional echocardiographic assessment of left ventricular volume in different heart diseases using a fully automated quantification software. World J Clin Cases 2022; 10:4050-4063. [PMID: 35665130 PMCID: PMC9131239 DOI: 10.12998/wjcc.v10.i13.4050] [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: 09/03/2021] [Revised: 12/10/2021] [Accepted: 03/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND HeartModel (HM) is a fully automated adaptive quantification software that can quickly quantify left heart volume and left ventricular function. This study used HM to quantify the left ventricular end-diastolic (LVEDV) and end-systolic volumes (LVESV) of patients with dilated cardiomyopathy (DCM), coronary artery heart disease with segmental wall motion abnormality, and hypertrophic cardiomyopathy (HCM) to determine whether there were differences in the feasibility, accuracy, and repeatability of measuring the LVEDV, LVESV, LV ejection fraction (LVEF) and left atrial end-systolic volume (LAESV) and to compare these measurements with those obtained with traditional two-dimensional (2D) and three-dimensional (3D) methods.
AIM To evaluate the application value of HM in quantifying left heart chamber volume and LVEF in clinical patients.
METHODS A total of 150 subjects who underwent 2D and 3D echocardiography were divided into 4 groups: (1) 42 patients with normal heart shape and function (control group, Group A); (2) 35 patients with DCM (Group B); (3) 41 patients with LV remodeling after acute myocardial infarction (Group C); and (4) 32 patients with HCM (Group D). The LVEDV, LVESV, LVEF and LAESV obtained by HM with (HM-RE) and without regional endocardial border editing (HM-NE) were compared with those measured by traditional 2D/3D echocardiographic methods to assess the correlation, consistency, and repeatability of all methods.
RESULTS (1) The parameters measured by HM were significantly different among the groups (P < 0.05 for all). Compared with Groups A, C, and D, Group B had higher LVEDV and LVESV (P < 0.05 for all) and lower LVEF (P < 0.05 for all); (2) HM-NE overestimated LVEDV, LVESV, and LAESV with wide biases and underestimated LVEF with a small bias; contour adjustment reduced the biases and limits of agreement (bias: LVEDV, 28.17 mL, LVESV, 14.92 mL, LAESV, 8.18 mL, LVEF, -0.04%). The correlations between HM-RE and advanced cardiac 3D quantification (3DQA) (rs = 0.91-0.95, P < 0.05 for all) were higher than those between HM-NE (rs = 0.85-0.93, P < 0.05 for all) and the traditional 2D methods. The correlations between HM-RE and 3DQA were good for Groups A, B, and C but remained weak for Group D (LVEDV and LVESV, rs = 0.48-0.54, P < 0.05 for all); and (3) The intraobserver and interobserver variability for the HM-RE measurements were low.
CONCLUSION HM can be used to quantify the LV volume and LVEF in patients with common heart diseases and sufficient image quality. HM with contour editing is highly reproducible and accurate and may be recommended for clinical practice.
Collapse
Affiliation(s)
- Chen-Ke Pan
- Department of Diagnostic Ultrasound and Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou 310016, Zhejiang Province, China
- Department of Ultrasound, The Fourth Affiliated Hospital of Zhejiang University College of Medicine, Yiwu 322200, Zhejiang Province, China
| | - Bo-Wen Zhao
- Department of Diagnostic Ultrasound and Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou 310016, Zhejiang Province, China
| | - Xuan-Xuan Zhang
- Department of Ultrasound, The Fourth Affiliated Hospital of Zhejiang University College of Medicine, Yiwu 322200, Zhejiang Province, China
| | - Mei Pan
- Department of Diagnostic Ultrasound and Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou 310016, Zhejiang Province, China
| | - Yan-Kai Mao
- Department of Diagnostic Ultrasound and Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou 310016, Zhejiang Province, China
| | - Yuan Yang
- Department of Diagnostic Ultrasound and Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou 310016, Zhejiang Province, China
| |
Collapse
|
2
|
Accuracy of three-dimensional systolic dyssynchrony and sphericity indexes for identifying early left ventricular remodeling after acute myocardial infarction. Anatol J Cardiol 2019; 22:13-20. [PMID: 31264652 PMCID: PMC6683215 DOI: 10.14744/anatoljcardiol.2019.02844] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: Left ventricle (LV) geometry and dyssynchrony are associated with LV remodeling after acute myocardial infarction (AMI). The aim of this prospective study was to assess the diagnostic value of new three-dimensional echocardiography (3DE) parameters [sphericity (SI) and systolic dyssynchrony indexes (SDI)] for the prediction of LV remodeling after AMI and to compare them with two-dimensional echocardiography (2DE) parameters. Methods: 2DE and 3DE were performed in 75 patients with AMI within 3 days from the onset of MI and 6 months later. LV remodeling was defined as a ≥15% increase in the LV end-diastolic volume (EDV) at follow-up. 3D SI was calculated by dividing EDV by the volume of a sphere whose diameter was derived from the major end-diastolic LV long axis. SDI was considered as a standard deviation of the time from cardiac cycle onset to minimum systolic volume in 16 LV segments. Results: LV remodeling was identified in 34 (45%) patients using the 2DE method and in 22 (29%) patients using the 3DE method. Evaluated 3DE parameters, such as EDV [area under the receiver operating characteristic (ROC) curve (AUC) 0.742, sensitivity 71%, specificity 79%], end-systolic volume (AUC 0.729, sensitivity 69%, specificity 78%), SDI (AUC 0.777, sensitivity 73%, specificity 77%), and SI, had significant prognostic value for LV remodeling. According to the AUC, the highest predictive value had 3D SI (AUC 0.957, sensitivity 90%, specificity 91%). Conclusion: 3DE parameters, especially 3D SI and SDI, play important roles in the prediction of LV remodeling after AMI and can be used in clinical practice.
Collapse
|
3
|
Sobhy R, Samir M, Abdelmohsen G, Ibrahim H, Abd El Rahman MY, Abdelrahman N, Behairy N, Imam O, Hamza H. Subtle Myocardial Dysfunction and Fibrosis in Children with Rheumatic Heart Disease: Insight from 3D Echocardiography, 3D Speckle Tracking and Cardiac Magnetic Resonance Imaging. Pediatr Cardiol 2019; 40:518-525. [PMID: 30315339 DOI: 10.1007/s00246-018-2006-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 10/03/2018] [Indexed: 01/14/2023]
Abstract
Rheumatic heart disease (RHD) is a major cause of morbidity and mortality in developing countries, so early diagnosis and treatment can reduce morbidity and mortality resulting from subsequent valvular damage. The aim of this study was to detect subtle myocardial dysfunction among children with RHD with preserved left ventricular systolic function. This is a cross-sectional case-control study that was conducted on 30 children with RHD (who had valvular affection of any degree and were not in activity) compared to 23 healthy children. After history taking and cardiac examination, 2D echocardiography, tissue Doppler imaging, 3D-echocardiography and 3D speckle tracking echocardiography were done to both groups, whereas cardiac magnetic resonance imaging was done only to the patient group. The 3D-derived left ventricular end-diastolic volume and sphericity index among patients were significantly increased when compared to controls [131.5 (101.5 to 173.7) vs. 69 (58 to 92), P = 0.001, and 0.46 (0.36 to 0.59) vs. 0.33 (0.29 to 0.38), P = 0.001, respectively]. The 3D-derived ejection fraction and longitudinal strain did not differ significantly among both groups. The 3D-derived global circumferential strain was higher in patients when compared to controls [- 14 (- 16 to - 10) vs. - 11(- 13 to - 10), P = 0.04]. None of the examined patients demonstrated late enhancement myocardial fibrosis. In children with RHD and preserved systolic function, subtle systolic dysfunction could not be detected using conventional and novel non-conventional methods. This may indicate that the myocardial affection during the acute stage of rheumatic carditis is minimal with almost complete resolution.
Collapse
Affiliation(s)
- R Sobhy
- Pediatric Cardiology Unit, Department of Pediatrics, Cairo University Children's Hospital, Cairo University, 2 Aly Basha Ibrahim Street, PO Box: 11111, Cairo, Egypt.
| | - M Samir
- Pediatric Cardiology Unit, Department of Pediatrics, Cairo University Children's Hospital, Cairo University, 2 Aly Basha Ibrahim Street, PO Box: 11111, Cairo, Egypt
| | - G Abdelmohsen
- Pediatric Cardiology Unit, Department of Pediatrics, Cairo University Children's Hospital, Cairo University, 2 Aly Basha Ibrahim Street, PO Box: 11111, Cairo, Egypt
| | - H Ibrahim
- Pediatric Cardiology Unit, Department of Pediatrics, Cairo University Children's Hospital, Cairo University, 2 Aly Basha Ibrahim Street, PO Box: 11111, Cairo, Egypt
| | - M Y Abd El Rahman
- Pediatric Cardiology Unit, Department of Pediatrics, Cairo University Children's Hospital, Cairo University, 2 Aly Basha Ibrahim Street, PO Box: 11111, Cairo, Egypt
| | - N Abdelrahman
- Pediatric Cardiology Unit, Department of Pediatrics, Cairo University Children's Hospital, Cairo University, 2 Aly Basha Ibrahim Street, PO Box: 11111, Cairo, Egypt
| | - N Behairy
- Department of Radiology, Cairo University, Cairo, Egypt
| | - O Imam
- Department of Radiology, Cairo University, Cairo, Egypt
| | - H Hamza
- Pediatric Cardiology Unit, Department of Pediatrics, Cairo University Children's Hospital, Cairo University, 2 Aly Basha Ibrahim Street, PO Box: 11111, Cairo, Egypt
| |
Collapse
|
4
|
Ola RK, Meena CB, Ramakrishnan S, Agarwal A, Bhargava S. Detection of Left Ventricular Remodeling in Acute ST Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention by Two Dimensional and Three Dimensional Echocardiography. J Cardiovasc Echogr 2018; 28:39-44. [PMID: 29629258 PMCID: PMC5875134 DOI: 10.4103/jcecho.jcecho_32_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Left ventricular remodeling (LVR) after ST-elevation myocardial infarction (STEMI) harbingers poor prognosis. Three-dimensional echocardiography (3DE) is more accurate than 2 D echo for the assessment of left ventricle (LV) shape. We assessed LV geometry with 3D ECHO 6 months after STEMI in patients who had primary angioplasty. Materials and Methods In this prospective study, morphological and functional analysis of LV with 3D ECHO (volumes, LVEF, 3D sphericity index [SI]) was assessed up to 7 days and 6 months in 42 STEMI patients. The LVR was considered for increase >15% of the end diastolic volume of the LV (LVEDV) 6 months after the STEMI, compared to the LVEDV up to 7 days of it. Results Sixteen (38%) patients had LVR. 3D Echocardiographic measurements up to 7 days after the acute myocardial infarction (AMI) 1-LVEDV in ventricular remodeling group was 99.8 ± 19.1 ml and in no ventricular remodeling group was 87 ± 18.2 mL (P = 0.037); 2-LVEF was 0.48 ± 0.01 and 51 ± 0.02 (P <.001); 3D-SI was 0.41 ± 0.05 and 31 ± 0.05 (P < 0.001) II-after 6 months: 1-LVEDV in remodeling group was 114.2 ± 19.5 mL and no remodeling group was 94.2 ± 18.6 (P = 0.002); 2-LVEF was 0.58 ± 0.01 and 59 ± .01 (P = 0.003); 3D-sphericity was 0.35 ± 0.05 and 28 ± .05 (P < 0.001). Conclusion LVR was observed in 38% of the patients 6 months after AMI. The 3D SI has been associated with occurrence of LVR and can differentiate patients with and without subsequent development of LVR accurately and early on its basis.
Collapse
Affiliation(s)
- Rakesh Kumar Ola
- Department of Cardiology, SMS Medical College, Jaipur, Rajasthan, India
| | | | | | - Ashish Agarwal
- Department of Cardiology, SMS Medical College, Jaipur, Rajasthan, India
| | - Smriti Bhargava
- Department of Cardiology, SMS Medical College, Jaipur, Rajasthan, India
| |
Collapse
|
5
|
Zeng D, Chen H, Jiang CL, Wu J. Usefulness of three-dimensional spherical index to assess different types of left ventricular remodeling: A meta-analysis. Medicine (Baltimore) 2017; 96:e7968. [PMID: 28885350 PMCID: PMC6392792 DOI: 10.1097/md.0000000000007968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 07/17/2017] [Accepted: 08/09/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Left ventricular (LV) remodeling after myocardial injury, volume or pressure overload is characterized by a change in LV shape from an ellipse to more of a sphere. The usefulness of 3-dimensional (3D) sphericity index (SpI) for accurate evaluation of LV remodeling remains uncertain despite extensive research. METHODS We searched Pubmed, Embase, Web of Science, and Cochrane databases to identify relevant studies from January 1, 1990 to August 1, 2016. The quality of each study was evaluated using the Newcastle-Ottawa Scale. Meta regression and sensitivity and subgroup analyses based on patterns of LV remodeling were performed. RESULTS Thirteen studies with a total of 1064 patients were included in this meta-analysis. There was evidence of obvious heterogeneity (I = 82.4%; P < .001), which was mainly accounted for by the pattern of remodeling according to meta-regression. The result of subgroup meta-analyses suggested that SpI in patients with eccentric remodeling was significantly higher compared with control group (95% confidence interval [CI], 0.78-1.10). No statistic difference was found in LV SpI between healthy controls and patients with concentric hypertrophy (95% CI, -0.89 to 0.16) or myocardial injury (95% CI, -0.13 to 0.41). CONCLUSION 3D SpI can be widely used to assess LV remodeling in patients with eccentric remodeling, but has limitations in predicting concentric hypertrophy and regional or chronic myocardial injury.
Collapse
|
6
|
Huang CH, Kuo CL, Huang CS, Liu CS, Chang CC. Depleted Leukocyte Mitochondrial DNA Copy Number Correlates With Unfavorable Left Ventricular Volumetric and Spherical Shape Remodeling in Acute Myocardial Infarction After Primary Angioplasty. Circ J 2017. [PMID: 28626147 DOI: 10.1253/circj.cj-17-0088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Left ventricular (LV) shape influences LV systolic function. It is possible to assess LV shape using 3-D echocardiography sphericity index (SI). Maintaining mitochondrial DNA copy number (MCN) is important for preserving mitochondrial function and LV systolic function after acute myocardial infarction (AMI). Information is limited, however, regarding the relationship between leukocyte MCN and the subsequent change in LV shape after AMI.Methods and Results:Fifty-five AMI patients undergoing primary angioplasty were recruited. Plasma MCN was measured before primary angioplasty using quantitative polymerase chain reaction. 3-D echocardiography measurement of SI was performed at baseline, and at 1-, 3-, and 6-month follow-up. AMI subjects with MCN lower than the median had a higher 6-month SI and LV volume compared with those with higher MCN. Baseline echocardiographic parameters were similar between the 2 groups. MCN was negatively correlated with 3- and 6-month SI, and 3- and 6-month LV volume. On multiple linear regression analysis, baseline plasma MCN could predict LV SI and LV volume at 6 months after primary angioplasty for AMI, even after adjusting for traditional prognostic factors. CONCLUSIONS In AMI patients, higher plasma leukocyte MCN at baseline was associated with favorable LV shape and remodeling at 6-month follow-up. Plasma leukocyte MCN may provide a novel prognostic biomarker for LV remodeling after AMI.
Collapse
Affiliation(s)
- Ching-Hui Huang
- Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital.,Institute of Statistics and Information Science, National Changhua University of Education.,School of Medicine, College of Medicine, Kaohsiung Medical University.,Department of Beauty Science and Graduate Institute of Beauty Science Technology, Chienkuo Technology University
| | - Chen-Ling Kuo
- Vascular and Genomic Center, Changhua Christian Hospital
| | | | - Chin-San Liu
- Vascular and Genomic Center, Changhua Christian Hospital.,Department of Neurology, Changhua Christian Hospital
| | - Chia-Chu Chang
- Department of Nephrology, Changhua Christian Hospital.,Medical Research Center, Department of Internal Medicine, Changhua Christian Hospital.,School of Medicine, Chung Shan Medical University
| |
Collapse
|
7
|
Wong C, Chen S, Iyngkaran P. Cardiac Imaging in Heart Failure with Comorbidities. Curr Cardiol Rev 2017; 13:63-75. [PMID: 27492227 PMCID: PMC5324322 DOI: 10.2174/1573403x12666160803100928] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 06/30/2016] [Accepted: 07/05/2016] [Indexed: 01/19/2023] Open
Abstract
Imaging modalities stand at the frontiers for progress in congestive heart failure (CHF) screening, risk stratification and monitoring. Advancements in echocardiography (ECHO) and Magnetic Resonance Imaging (MRI) have allowed for improved tissue characterizations, cardiac motion analysis, and cardiac performance analysis under stress. Common cardiac comorbidities such as hypertension, metabolic syndromes and chronic renal failure contribute to cardiac remodeling, sharing similar pathophysiological mechanisms starting with interstitial changes, structural changes and finally clinical CHF. These imaging techniques can potentially detect changes earlier. Such information could have clinical benefits for screening, planning preventive therapies and risk stratifying patients. Imaging reports have often focused on traditional measures without factoring these novel parameters. This review is aimed at providing a synopsis on how we can use this information to assess and monitor improvements for CHF with comorbidities.
Collapse
Affiliation(s)
- Chiew Wong
- Flinders University, NT Medical School, Darwin Australia
| | - Sylvia Chen
- Flinders University, NT Medical School, Darwin Australia
| | | |
Collapse
|
8
|
Lu W, Zhang Z, Fu C, Ma G. Intermediate Monocytes Lead to Enhanced Myocardial Remodelling in STEMI Patients With Diabetes. Int Heart J 2015; 56:22-8. [PMID: 25503660 DOI: 10.1536/ihj.14-174] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Wenbin Lu
- Division of Endocrinology, The Drum Tower Hospital Affiliated to Nanjing University
- Department of Cardiology, ZhongDa Hospital Affiliated to Southeast University China
| | - Ziwei Zhang
- Division of Endocrinology, The Drum Tower Hospital Affiliated to Nanjing University
| | - Cong Fu
- Department of Cardiology, ZhongDa Hospital Affiliated to Southeast University China
| | - Genshan Ma
- Department of Cardiology, ZhongDa Hospital Affiliated to Southeast University China
| |
Collapse
|