scholarly journals The influence of training status on right ventricular morphology and segmental strain in elite pre-adolescent soccer players

2021 ◽  
Vol 121 (5) ◽  
pp. 1419-1429
Author(s):  
Viswanath B. Unnithan ◽  
Alexander Beaumont ◽  
Thomas W. Rowland ◽  
Nicholas Sculthorpe ◽  
Keith George ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Global Longitudinal Strain ◽  
Soccer Players ◽  
Group Differences ◽  
High Intensity Training ◽  
Strain And Strain Rate ◽  
2D Echocardiography ◽  
Global Strain ◽  
Clinical Consequences ◽  
And Function

AbstractCardiac modifications to training are a product of the genetic pre-disposition for adaptation and the repetitive haemodynamic loads that are placed on the myocardium. Elite pre-adolescent athletes are exposed to high-intensity training at a young age with little understanding of the physiological and clinical consequences. It is unclear how right ventricular (RV) structure and function may respond to this type of stimulus. The aim of this study was to compare RV structure and strain across the cardiac cycle and within individual segments in elite soccer players (SP) and controls (CON). Methods: Twenty-two highly trained, male pre-adolescent SP and 22 age-and sex-matched recreationally active individuals CON were investigated using 2D echocardiography, including myocardial speckle tracking to assess basal, mid-wall, apical and global longitudinal strain and strain rate during systole (SRS) and diastole (SRE and SRA). Results: greater RV cavity size was identified in the SP compared to CON (RVD1 SP: 32.3 ± 3.1 vs. CON: 29.6 ± 2.8 (mm/m2)0.5; p = 0.005). No inter-group differences were noted for peak global RV strain (SP: − 28.6 ± 4.9 vs CON: − 30.3 ± 4.0%, p = 0.11). Lower mid-wall strain was demonstrated in the SP compared to CON (SP: − 27.9 ± 5.8 vs. CON: − 32.2 ± 4.4%, p = 0.007). Conclusion: Soccer training has the potential to increase RV size in pre-adolescent players. The unique segmental analyses used in this study have identified inter-group differences that were masked by global strain evaluations. The clinical and physiological implications of these findings warrant further investigation.

Abstract 15706: Association of Blood Pressure Level With Left Atrial Size and Function in Adolescents (SHIP AHOY)

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Edem Binka ◽  
Cedric Manlhiot ◽  
Elaine M Urbina ◽  
Tarek ALSAIED ◽  
Tammy M Brady
Keyword(s):  
Blood Pressure ◽  
Left Atrial ◽  
Global Longitudinal Strain ◽  
Blood Pressure Level ◽  
Left Ventricular ◽  
Z Score ◽  
Linear Regression Models ◽  
Cvd Risk ◽  
Strain And Strain Rate ◽  
And Function

Introduction: Left atrial (LA) enlargement and dysfunction are risk factors for stroke, atrial fibrillation and death in adults, and are associated with hypertension (HTN). In children, left ventricular hypertrophy is the most common manifestation of cardiac-specific organ damage in those with HTN, but gaps in knowledge remain regarding the association of HTN with LA size and function. Hypothesis: Increasing blood pressure (BP) is associated with increased LA volume and abnormal LA strain in children. Methods: Echocardiographic images of youth, aged 11 to 18 yrs from 5 clinical sites were obtained. LA strain and strain rate were analyzed using 2-D speckle tracking imaging with R-R gating in the apical 4 and 2-chamber views and averages of both views were used. Subjects were grouped by SBP as low-risk (L; <80th %ile), mid-risk (M; 80-<90th %ile), or high-risk, (H;≥90th %ile). Linear regression models were used to determine the association between BP z-score and LA size and function adjusting for age, sex, race and ethnicity. Results: N=347 youth (median age 15.7 yrs) 60% (n=208) male and 40% (n=139) non-white were included. BP groups differed by age (L&H<M) and BMI (L<M&H). BP groups did not differ by LA size and strain but differed by left ventricular mass index (H>L), stroke volume (M&H<L), peak global longitudinal strain (L>H), mitral E/e’ (H>L) and pulse wave velocity (H>L), each indicating worse CVD risk in the H vs. L group (Table). Multivariable analyses revealed DBP z-score to be independently associated with LA conduit strain (beta 0.73, 95% CI 0.01, 1.45, p<0.05). No other LA size or function variables were associated with BP. Conclusions: Greater BP is associated with increased CVD risk among youth as assessed by non-invasive measurements of CV structure and function. DBP is independently associated with LA conduit strain, a finding associated with CV events in adults. Future studies to determine the long-term association of abnormal DBP with LA strain are needed.

P622Role of right ventricular strain measured by 2D-echocardiography in the diagnosis of cardiac amyloidosis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Durante Lopez ◽  
V M P Monivas Palomero ◽  
M T S Torres Sanabria ◽  
J S C Segovia Cubero ◽  
S M S Mingo Santos
Keyword(s):  
Right Ventricular ◽  
Cardiac Amyloidosis ◽  
Global Longitudinal Strain ◽  
Restrictive Cardiomyopathy ◽  
Common Finding ◽  
Deformation Pattern ◽  
Free Wall ◽  
2D Echocardiography ◽  
Right Ventricular Strain ◽  
Specific Finding

Abstract Introduction Cardiac amyloidosis (CA) causes a restrictive cardiomyopathy usually associated with a poor prognosis. Two subtypes predominate: systemic (ALCA) and transthyretin (ATTR, either wild type -TTRwt- or mutant -TTRm-). Left ventricle (LV) apical sparing has been extensively studied by speckle-tracking echocardiography (STE) for diagnosis, but right ventricular (RV) deformation pattern has not been described. Purpose To characterize RV involvement in CA patients and to identify which parameters may help in the differential diagnosis between ALCA and ATTR subtypes. Methods 78 patients with CA (47 ALCA, 20 TTRwt, 11 TTRm) and 24 healthy controls were included. We analyzed global longitudinal strain (GLS) in 16 LV and 6 RV segments. LV and RV apical ratios (AR) were obtained. Results LVGLS and Free-Wall RVLS were impaired in all patients (LVGLS: 11.9±2.9% in ALCA, 12.5±3.8% in TTRwt, 14.9±2.7% in TTRm, 21.9±2.6 in controls and Free-Wall RVLS: 13.1±6.8% vs 14.9±4.5% vs 17.2±3.4% vs 22.1±3.1, respectively). LV and RV AR were higher in ALCA as compared to both TTRwt, ATRm and controls (LVAR: 1.1±0.2 vs 0.8±0.2 vs 0.9±0.1 vs 0.7±0.1, p<0.001; RVAR: 1.1±0.2 vs 0.6±0.2 vs 0.6±0.1 vs 0.6±0.1, p<0.001). Cut-off values of LVAR>0.96 and RVAR>0.8 showed high accuracy to differentiate between ALCA and ATTR. Conclusion RV disfunction is a common finding in CA. Apical sparing pattern was present in RV strain, similarly to that described in LV and we describe it as an specific finding of ALCA patients. We propose RVAR as an accessible and easy way to differentiate, among different subtypes of amyloidosis based on STE analysis.

scholarly journals ECHOCARDIOGRAPHY IN RIGHT VENTRICULAR MYOCARDIAL INFARCTION

2013 ◽  
Vol 12 (3) ◽  
pp. 58-62
Author(s):  
H. G. Hayrapetyan ◽  
K. G. Adamyan
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Structure And Function ◽  
Two Dimensional ◽  
Tei Index ◽  
Global Function ◽  
Area Change ◽  
2D Echocardiography ◽  
Right Ventricular Myocardial Infarction ◽  
And Function

This paper presents the views on two-dimensional (2D) echocardiography (EchoCG) in the assessment of right ventricular (RV) structure and function. In order to quantitatively assess the RV global function, the following parameters can be used: RV outflow tract shortening fraction, RV fractional area change, tricuspid annular plane systolic excursion, and Tei index. For these parameters, their assessment methods, as well as their strengths and limitations, are discussed.

Abstract 16108: Right Ventricular Strain is a More Sensitive Marker of Right Ventricular Dysfunction Than Right Ventricular Ejection Fraction in a Cohort of Patients With Idiopathic Pulmonary Arterial Hypertension

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Julia Grapsa ◽  
Timothy C Tan ◽  
David Dawson ◽  
Petros Nihoyannopoulos
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Right Ventricular Ejection Fraction ◽  
Idiopathic Pulmonary Arterial Hypertension ◽  
Free Wall ◽  
Ventricular Ejection Fraction ◽  
Global Strain ◽  
Pulmonary Arterial ◽  
And Function

Introduction: Strain has been shown to be more sensitive that ejection fraction in detecting subclinical dysfunction in the left ventricle. A number of echocardiographic parameters associated with right heart size and function have been shown to be impaired in idiopathic pulmonary arterial hypertension (IPAH) but there is minimal data on which may be the most sensitive. Aim: To characterize the changes in functional and echocardiographic indices of right ventricular (RV) size and function, in a cohort of IPAH patients followed serially to determine if strain is a more sensitive measure of RV dysfunction than RVEF. Methods: Thirty patients (24 women, mean age 46.8 ± 5.3 years) with newly diagnosed IPAH were prospectively recruited and followed with serial transthoracic echocardiograms (TTE; Philips Medical Systems, Andover, MA) 6 monthly for up to 18 months. A range of 2D and 3D echocardiographic measures of right ventricular dimensions and function, including right ventricular ejection fraction (RVEF) and systolic longitudinal strain (LS), was assessed at each time point after commencing treatment using vendor independent software (TomTec, Germany). Functional status was assessed at18 months. Statistical analyses were performed using JMP statistical package (SAS Institute In. Cary, NC) Results: 3D RV volumes, ejection fraction, mass, 2D global strain and 2D free wall strain all show significant changes over 18 months (p-value < 0.05; ANOVA of repeated measures) although peak tricuspid regurgitant velocity, RV systolic pressure and stroke volume do not. However, RV global strain and RV free wall strain showed significant changes within 6 months after diagnosis but not RVEF, peak TR velocity or RVSP. The degree of change in the RV free wall strain change at 18 months but not RVSP, RV mass or RVEF, was also associated with an abnormal 6 min walk test (18 months change, p=0.03). Conclusion: RV global and free wall strain demonstrate significant decreases prior to RVEF, peak TR velocity and RVSP hence may be more more sensitive measures of RV dysfunction in patients with IPAH. These results may help guide treatment decisions and highlight the potential value of echocardiography in detecting subacute cardiac pathology.

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