Assessment of left ventricular longitudinal regional myocardial systolic function by strain imaging echocardiography in patients with hypertrophic cardiomyopathy

2005 ◽  
Vol 25 (6) ◽  
pp. 703-705 ◽  
Author(s):  
Liu Yani ◽  
Deng Youbin ◽  
Li Xiulan ◽  
Chang Qing ◽  
Lu Yongping ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Systolic Function ◽  
Strain Imaging ◽  
Left Ventricular

scholarly journals Tachycardia-induced myocardial ischemia and diastolic dysfunction potentiate secretion of ANP, not BNP, in hypertrophic cardiomyopathy

2006 ◽  
Vol 290 (3) ◽  
pp. H1064-H1070 ◽  
Author(s):  
Shinsuke Kido ◽  
Naoyuki Hasebe ◽  
Yoshinao Ishii ◽  
Kenjiro Kikuchi
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Myocardial Ischemia ◽  
Diastolic Dysfunction ◽  
Diastolic Pressure ◽  
Systolic Function ◽  
Left Ventricular ◽  
Atrial Pacing ◽  
Catheter Tip ◽  
Lv Systolic Function ◽  
Lv Diastolic Dysfunction

The aim of this study was to investigate what factor determines tachycardia-induced secretion of atrial and brain natriuretic peptides (ANP and BNP, respectively) in patients with hypertrophic cardiomyopathy (HCM). HCM patients with normal left ventricular (LV) systolic function and intact coronary artery ( n = 22) underwent rapid atrial pacing test. The cardiac secretion of ANP and BNP and the lactate extraction ratio (LER) were evaluated by using blood samples from the coronary sinus and aorta. LV end-diastolic pressure (LVEDP) and the time constant of LV relaxation of tau were measured by a catheter-tip transducer. These parameters were compared with normal controls ( n = 8). HCM patients were divided into obstructive (HOCM) and nonobstructive (HNCM) groups. The cardiac secretion of ANP was significantly increased by rapid pacing in HOCM from 384 ± 101 to 1,268 ± 334 pg/ml ( P < 0.05); however, it was not significant in control and HNCM groups. In contrast, the cardiac secretion of BNP was fairly constant and rather significantly decreased in HCM ( P < 0.01). The cardiac ANP secretion was significantly correlated with changes in LER ( r = −0.57, P < 0.01) and tau ( r = 0.73, P < 0.001) in HCM patients. Tachycardia potentiates the cardiac secretion of ANP, not BNP, in patients with HCM, particularly when it induces myocardial ischemia and LV diastolic dysfunction.

Abstract 1962: Quantification of Longitudinal Right Ventricular Systolic Function and Its Coupling to Left Ventricular Global Function Using Speckle-Tracking Strain Imaging in Patients with Old Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Kaoru Dohi ◽  
Katsuya Onishi ◽  
Shinya Kato ◽  
Takeshi Takamura ◽  
Naoki Fujimoto ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Speckle Tracking ◽  
Systolic Function ◽  
Strain Imaging ◽  
Left Ventricular ◽  
Systolic Strain ◽  
Peak Systolic Strain ◽  
Lv Ejection Fraction ◽  
Rv Function ◽  
Global Peak

Background: We tested the hypothesis that speckle-tracking strain imaging can quantify longitudinal right ventricular (RV) function and its association with left ventricular (LV) function in patients with myocardial infarction (MI). Methods: To quantify longitudinal RV function, 39 patients with old MI (OMI: LV ejection fraction 17 – 77 %, 45 ±16 %) and 29 age matched normal controls (Control: LV ejection fraction 65 ± 5 %) were studied with echocardiography. Longitudinal RV global peak systolic strain was assessed from apical four-chamber view using speckle-tracking imaging (EchoPAC, GE Electronic). RV fractional area change was also analyzed. Results: Longitudinal RV global peak systolic strain was significantly impaired in OMI compared to Control (−18 ± 5* and −25 ± 4 %, *p < 0.05 vs. Control) whereas RV fractional area change failed to discriminate from normal to impaired RV function (OMI: 48 ± 11 vs. Control: 52 ± 6 %, p = NS). When divided OMI into three groups regarding to plasma BNP level (Group A: BNP < 100 pg/ml; n = 14, Group B: 100 pg/ml ≤ BNP < 500 pg/ml; n = 14, and Group C; BNP ≥ 500 pg/ml; n = 11), Group A had no significant relations between longitudinal RV global peak systolic strain and LV ejection fraction (y = −0.07x − 11, r = 0.30, p = NS) whereas those were significantly correlated in Group B (y = −0.18x − 11, r = 0.59*, *p < 0.05). Furthermore, the strongest correlation between longitudinal RV global peak systolic strain and LV ejection fraction was observed in Group C (y = −0.58x + 5, r = 0.90*, *p < 0.05). Conclusion: Speckle tracking strain imaging quantified longitudinal RV global systolic function and exhibited its BNP-related dependency to LV systolic function in patents with OMI.

scholarly journals P790 Bi-ventricular dysfunction in patients after bone marrow transplant: the value of strain imaging

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
T Deshmukh ◽  
P Geenty ◽  
L Geraghty ◽  
D Emmerig ◽  
S Sivapathan ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Ventricular Function ◽  
Ventricular Dysfunction ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Strain Analysis ◽  
Strain Imaging ◽  
Left Ventricular ◽  
Control Group ◽  
Cardiac Events

Abstract Background Cardiovascular events are a significant cause of morbidity and mortality in cancer survivors, particularly occurring at 5-10 years after their cancer therapy. Purpose To assess the utility of strain imaging by 2-dimensional (2D) speckle tracking echocardiography in detecting bi-ventricular dysfunction, as compared to traditional measures, in patients post bone marrow transplantation (BMT) with previous anthracycline (AC) therapy for haematological conditions. Methods 50 consecutive patients post BMT + AC, reviewed at a long-term survivor clinic, were compared to 50 age and gender matched controls. 48/50 patients received AC doses below the recommended cumulative lifetime thresholds set by the European Society of Medical Oncology. 2D left ventricular global longitudinal strain (LV GLS) and right ventricle free wall strain (RV FWS) were compared to conventional measures of bi-ventricular function. Results The mean LVEF (58 ± 6% vs 63 ± 6%) and RV fractional area change (FAC) (39 ± 5% vs 44 ± 5%), although reduced in the BMT + AC group vs controls, were within normal limits. LV GLS was reduced in BMT + AC patients as compared to controls (-17.8 ± 3.1% vs -20.5 ± 2.2%, p &lt; 0.01) while RV FWS was also reduced (-23.2 ± 4.0% vs -27.9 ± 2.7%, p &lt; 0.001). In BMT + AC patients with a preserved LVEF (LVEF &gt; 53%), 28% (11/40) had reduced GLS (GLS &lt; -17%) while 52% (24/46) of those with preserved FAC (FAC &gt; 35%) had reduced FWS (FWS &lt; -25%). Major adverse cardiac events (MACE) occurred in 9/50 patients in the BMT + AC group and none in the control group. 8/9 patients had normal biventricular function as assessed by traditional parameters (LVEF and RV FAC) but 5/9 patients had reduced LV GLS and/or RV FWS. Conclusions Subclinical bi-ventricular dysfunction is common in patients post BMT + AC therapy, and can be detected using strain analysis, despite preserved LV and RV systolic function using conventional measures. MACE occurred at a significantly higher rate in BMT patients exposed to AC. More than half of MACE events occurred in patients with reduced LV or RV strain, with preserved bi-ventricular function by traditional measures. LV GLS and RV FWS should be utilised for early identification of subclinical dysfunction in BMT patients.

Abstract 16989: Impaired Systolic Function Assessed by Strain Imaging Predicts Cardiovascular Morbidity and Mortality in Heart Failure with Preserved Ejection Fraction

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Amil M Shah ◽  
Brian Claggett ◽  
Nancy K Sweitzer ◽  
Sanjiv J Shah ◽  
Inder S Anand ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Systolic Function ◽  
Strain Imaging ◽  
Left Ventricular ◽  
Morbidity And Mortality ◽  
Preserved Ejection Fraction ◽  
Composite Outcome ◽  
History Of ◽  
Lv Systolic Function

Introduction: Left ventricular (LV) systolic function by strain imaging is impaired in heart failure with preserved ejection fraction (HFpEF) but its prognostic relevance is not known. Hypothesis: We hypothesized that worse longitudinal strain (LS) is independently associated with adverse outcomes. Methods: LS was assessed by 2D speckle-tracking echocardiography in a blinded core laboratory at baseline in 447 patients with HFpEF (left ventricular ejection fraction [LVEF] ≥45%) enrolled in the Treatment Of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial and was related to the primary composite outcome of cardiovascular (CV) death, HF hospitalization, or aborted cardiac arrest, and its components. Results: At a median follow-up of 2.6 (IQR 1.5-3.9) years, 115 patients experienced the primary outcome. Impaired LS, defined as an absolute LS < 15.8%, was present in 53% of patients and was associated with the composite outcome (adjusted HR 2.14, 95% CI 1.26-3.66; p=0.005), CV death alone (adjusted HR 3.20, 95% CI 1.44-7.12; p=0.004), and HF hospitalization alone (adjusted HR 2.23, 95% CI 1.16-4.28; p=0.016) after adjusting for age, gender, race, randomization strata (prior HF hospitalization vs elevated B-type natriuretic peptide level), region of enrollment (Americas vs Russia or Georgia), randomized treatment assignment, history of atrial fibrillation, heart rate, New York Heart Association class, history of stroke, creatinine, hematocrit, LVEF, mass, end-systolic volume index, and E/E’ ratio. These findings were similar in the subgroup of 354 patients with LVEF ≥55%. Conclusions: Among HFpEF patients enrolled in TOPCAT, impaired LV systolic function, measured by LS, is predictive of adverse CV outcomes independent of clinical and conventional echocardiographic predictors. Impaired LS represents a novel imaging biomarker to identify HFpEF patients at particularly high risk for CV morbidity and mortality.

Abstract 695: Significant Hypertrophy and Reduced Systolic Function Predict Intramyocardial Fibrosis in Patients with Hypertrophic Cardiomyopathy Undergoing Cardiac Magnetic Resonance Imaging

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Ronen Rubinshtein ◽  
James F Glockner ◽  
Bernard J Gersh ◽  
Philip A Araoz ◽  
Michael J Ackerman ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Systolic Function ◽  
Left Ventricular ◽  
Prognostic Impact ◽  
Resonance Imaging ◽  
Post Contrast ◽  
Septal Thickness ◽  
Lv Mass

Background: Contrast enhanced magnetic resonance imaging (CE-MRI) is a useful tool to define cardiac morphology, systolic function, and the presence of late gadolinium enhancement (LGE). In patients (pts) with hypertrophic cardiomyopathy (HCM), LGE may represent intra-myocardial fibrosis. We explored the association between left ventricular (LV) morphology and function to the presence and amount of LGE in pts with HCM. Methods: 424 HCM pts (age = 55 ± 16 years, 41% females), without prior history of septal ablation/myectomy, underwent CE-MRI (GE 1.5T) during a 6-year period. LV volumes, diameter, ejection fraction (EF), septal shape and thickness, and the presence of obstructive physiology were assessed from standard steady state free precession pulse sequences. The presence and amount of LGE were traced from a dynamic post contrast inversion recovery pulse sequence. Morphologic and functional findings were then compared with presence and amount of LGE. Results: Over half of the pts [239/424 (56%)] had LGE, most commonly localizing to RV insertion points [174/239 pts, (73%)]. The extent of LGE ranged from 0.4–65% of LV mass. Univariate (morphologic) predictors of LGE were: reverse curve septal shape [OR = 7.8, (95% CI, 3.9–15.6)], septal thickness ≥ 16 mm (OR = 4.5, 2.4–8.2), LV mass ≥ 150 grams (OR = 2.6, 1.7–3.8)], LVEF<50% (OR = 4.6, 1.3–16), and presence of obstructive physiology (OR = 1.8, 1.02–3). The percentage of LV mass involved with LGE increased with higher LV mass, increased septal wall thickness, and decreasing LVEF (Spearman rank = 0.2– 0.4, p<0.0001 for all). Multivariate analysis (adjusting for all morphologic and functional parameters) showed that septal thickness ≥ 16mm (p = 0.0001), LV mass ≥ 150 grams (p = 0.01) and LVEF < 50% (p = 0.02) were independent predictors of LGE on CE-MRI. Conclusions: LGE, as determined by CE-MRI, was seen in over half of the patients with HCM. Decreased LVEF, increased septal thickness, and increased LV mass were associated with the presence of LGE. The clinical and prognostic impact of these morphological features warrants further investigation.

Abstract 705: The Difference in Left Ventricular Twisting Behavior Between Patients With Hypertensive Heart Disease and Hypertrophic Cardiomyopathy

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Kazuhisa Nishimura ◽  
Hideki Okayama ◽  
Makoto Saito ◽  
Katsuji Inoue ◽  
Toyofumi Yoshii ◽  
...  
Keyword(s):  
Heart Disease ◽  
Hypertrophic Cardiomyopathy ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Hypertensive Heart Disease ◽  
Left Ventricular ◽  
Control Group ◽  
Control Groups ◽  
The Difference ◽  
And Control

(Background) Left ventricular (LV) untwisting behavior is a novel index of LV diastolic function since it is a powerful determinant of LV diastolic suction. The LV of patients with hypertrophic cardiomyopathy (HCM) and hypertensive heart disease (HHD) has diastolic dysfunction despite normal systolic function. However, the role of untwisting behavior in HCM and HHD in the pathophysiology of diastolic dysfunction is unknown. The aim of this study was to investigate the difference of LV twisting behavior between patients with HCM and HHD. (Methods) Forty-four patients with HCM (mean age, 63+/−15 y, 34 males), 30 patients with HHD (mean age, 62+/−12 y, 20 males), and 20 age and sex-matched control subjects were evaluated. After a standard echocardiographic examination, LV twist and twisting velocity profiles from apical and basal short-axis images were analyzed using two-dimensional speckle tracking imaging. All temporal parameters were normalized by R-R intervals. (Results) LV diastolic and systolic dimensions, and ejection fraction were not significantly different among the groups. LV mass index and early diastolic mitral annular velocity were not significantly different between the HCM and HHD groups. The peak torsion in the HCM and HHD groups was significantly greater than that in the control group (Table ). The peak untwisting velocity in the HCM group was comparable to that in the control group. However, when the peak untwisting velocity was corrected by peak torsion, the value in the HCM group was significantly decreased compared with that in the HHD and control groups. The time to peak untwisting velocity from aortic valve closure in the HCM group was significantly longer than that in the HHD and control groups. (Conclusion) These results suggest that enhanced peak torsion in HCM might compensate for untwisting behavior, but this mechanism fails to fully compensate for untwisting behavior compared with HHD. Left ventricular twisting behavior

scholarly journals P681 Surprise imaging findings in an asymptomatic patient with an ECG suggestive of apical hypertrophic cardiomyopathy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
D Cadil ◽  
A Calin ◽  
C Calin ◽  
B A Popescu
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Asymptomatic Patient ◽  
Systolic Function ◽  
Hematologic Malignancy ◽  
Hypereosinophilic Syndrome ◽  
Parasitic Infection ◽  
Specific Treatment ◽  
Left Ventricular ◽  
White Blood Count ◽  
Apical Hypertrophic Cardiomyopathy

Abstract We present the case of a 55-year old woman with an unremarkable past medical history, allergic to eggs and cinnamon and without any clinical complaints, who presented for a routine ECG prior to a dental implant procedure. The ECG revealed signs of left ventricular (LV) hypertrophy with deep negative T waves in V2-V6 (Figure) suggesting apical hypertrophic cardiomyopathy. Her physical exam was unremarkable and a transthoracic echocardiography (TTE) was ordered. The TTE revealed normal LV dimensions, a normal global systolic function of both ventricles, but most remarkably, an isoechoic mass that occupied the whole apex and one third of the LV cavity (Figure), with a maximum thickness of 22 mm and a 2 mm hyperechogenic lining towards the LV, all these findings being suggestive of Loeffler endocarditis. The routine laboratory tests showed (apart from a slightly increased LDL-cholesterol and normal BNP values) hypereosinophilia: more than 10% of the white blood count. Chest X-Ray and the abdominal scan showed no signs of pulmonary or hepatic infiltration. Cardiac magnetic resonance imaging was scheduled, but the patient has claustrophobia and was unable to perform the exam. The aetiological workup included the investigation of allergic, hematologic, as well as parasitic causes of the hypereosinophilic syndrome. Consequently, serological tests for Coxiella, Chlamydia, Echinococcus and Toxocara were all performed. The IgG antibodies for Toxocara canii were found in a very high level, indicating a chronic parasitic infection as a possible cause of the hypereosinophilic syndrome. The hematologic exams were all within normal limits. The endomyocardial biopsy, the gold standard for diagnosis could not be performed for technical reasons. The first step in the management of hypereosinophilia (HE) is stopping exposure to the trigger, as well as specific treatment- albendazole. The patient received oral anticoagulant treatment in order to prevent thromboembolic complications, which are frequently reported in this clinical setting. Loeffler’s endocarditis is usually a late cardiac manifestation of the HE syndrome. This is a rare and surprising case of an incidental imaging diagnosis in a totally asymptomatic patient after a routine ECG that was suggestive of hypertrophic cardiomyopathy. The challenge consisted in finding the cause of HE in order to attempt an aetiological treatment. Although the allergic and parasitic causes were most likely, considering the patient’s history, a hematologic malignancy had to be excluded. HE associated with toxocariasis rarely causes cardiac manifestations, but it should not be excluded when the patient has a history of canine exposure. The most fearsome complication in this case is the embolization of the eosinophilic mass, but the prompt management and routine follow-up allow the prevention of a thromboembolic event. Abstract P681 Figure. ECG and TTE apical views

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