scholarly journals Atrial performance in healthy subjects following high altitude exposure at 4100 m: 2D speckle-tracking strain analysis

2021 ◽  
Author(s):  
Chunyan He ◽  
Chuan Liu ◽  
Shiyong Yu ◽  
Jie Yang ◽  
Xiaohan Ding ◽  
...  
Keyword(s):  
High Altitude ◽  
Speckle Tracking ◽  
Contractile Function ◽  
Strain Analysis ◽  
Atrial Function ◽  
Peak Strain ◽  
Short Term ◽  
Atrial Contraction ◽  
2D Speckle Tracking ◽  
Ventricular Filling

AbstractHigh altitude (HA) exposure has been considered as a cardiac stress and might impair ventricular diastolic function. Atrial contraction is involved in ventricular passive filling, however the atrial performance to HA exposure is poorly understood. This study aimed to evaluate the effect of short-term HA exposure on bi-atrial function. Physiological and 2D-echocardiographic data were collected in 82 healthy men at sea level (SL, 400 m) and 4100 m after an ascent within 7 days. Atrial function was measured using volumetric and speckle-tracking analyses during reservoir, conduit and contractile phases of cardiac cycle. Following HA exposure, significant decreases of reservoir and conduit function indexes were observed in bi-atria, whereas decreases of contractile function indexes were observed in right atrium (RA), estimated via RA active emptying fraction (SL 41.7 ± 13.9% vs. HA 35.4 ± 12.2%, p = 0.001), strain during the contractile phase [SL 13.5 (11.4, 17.8) % vs. HA 12.3 (9.3, 15.9) %, p = 0.003], and peak strain rate during the contractile phase [SL − 1.76 (− 2.24, − 1.48) s−1 vs. HA − 1.57 (− 2.01, − 1.23) s−1, p = 0.002], but not in left atrium (LA). In conclusion, short-term HA exposure of healthy individuals impairs bi-atrial performance, mostly observed in RA. Especially, atrial contractile function decreases in RA rather than LA, which seems not to compensate for decreased ventricular filling after HA exposure. Our findings may provide a novel evidence for right-sided heart dysfunction to HA exposure.

scholarly journals Assessment of right atrial dyssynchrony by 2D speckle-tracking in healthy young men following high altitude exposure at 4100 m

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247107
Author(s):  
Chunyan He ◽  
Hedong Xiang ◽  
Chuan Liu ◽  
Shiyong Yu ◽  
Jie Yang ◽  
...  
Keyword(s):  
Arterial Pressure ◽  
High Altitude ◽  
Speckle Tracking ◽  
Pulmonary Arterial Pressure ◽  
Young Men ◽  
Right Atrial ◽  
Peak Strain ◽  
Altitude Exposure ◽  
2D Speckle Tracking ◽  
Pulmonary Arterial

Background High altitude exposure induces overload of right-sided heart and may further predispose to supraventricular arrhythmia. It has been reported that atrial mechanical dyssynchrony is associated with atrial arrhythmia. Whether high altitude exposure causes higher right atrial (RA) dyssynchrony is still unknown. The aim of study was to investigate the effect of high altitude exposure on right atrial mechanical synchrony. Methods In this study, 98 healthy young men underwent clinical examination and echocardiography at sea level (400 m) and high altitude (4100 m) after an ascent within 7 days. RA dyssynchrony was defined as inhomogeneous timing to peak strain and strain rate using 2D speckle-tracking echocardiography. Results Following high altitude exposure, standard deviation of the time to peak strain (SD-TPS) [36.2 (24.5, 48.6) ms vs. 21.7 (12.9, 32.1) ms, p<0.001] and SD-TPS as percentage of R–R’ interval (4.6 ± 2.1% vs. 2.5 ± 1.8%, p<0.001) significantly increased. Additionally, subjects with higher SD-TPS (%) at high altitude presented decreased right ventricular global longitudinal strain and RA active emptying fraction, but increased RA minimal volume index, which were not observed in lower group. Multivariable analysis showed that mean pulmonary arterial pressure and tricuspid E/A were independently associated with SD-TPS (%) at high altitude. Conclusion Our data for the first time demonstrated that high altitude exposure causes RA dyssynchrony in healthy young men, which may be secondary to increased pulmonary arterial pressure. In addition, subjects with higher RA dyssynchrony presented worse RA contractile function and right ventricular performance.

277 Temporal trends of advanced 2D-speckle tracking echocardiography in trastuzumab treated patients

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Paolo Springhetti ◽  
Corinna Bergamini ◽  
Lorenzo Niro ◽  
Luisa Ferri ◽  
Giovanni Benfari ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Left Ventricular ◽  
Atrial Function ◽  
Left Atrial Function ◽  
2D Speckle Tracking ◽  
Her 2 ◽  
Positive Breast Cancer

Abstract Aims Trastuzumab (TZ) is widely used for his key role in HER2 positive breast cancer. However, it may have different side effects on the cardiovascular system. One of the most concerning complication is cardiotoxicity. Many studies have highlighted the importance of the screening for subclinical myocardial dysfunction using left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). However, there are few studies investigating the left atrial function in relation to the development of early cardiac damage. Aim of this study is to analyse the modification of GLS and PALS in patients undergoing therapy with TZ in a follow-up period of 12 months. The eventual fluctuation of left atrial function under chemotherapy was evaluated and the correlation between subclinical atrial disfunction and early left ventricular impairment was searched. Methods One hundred and five women affected by non-metastatic HER-2 positive breast cancer treated with TZ were enrolled. Each patient underwent a complete echocardiography every 3 months, for a total of five exams pro patient. Thirty-seven patients (35%) were excluded from the left atrial function analysis while LV function evaluation was performed in 83 patients (21%). Exclusion criteria were poor quality imaging and lack of a complete Follow-up with consequent missing data. 2D-Speckle tracking analysis was performed at baseline and at each examination using Tomtec software in order to analyse both atrial and left ventricular function. Subclinical LV disfunction was defined as a GLS reduction of ≥ 15% compared to the baseline value. Left atrial impairment was arbitrary defined as a PALS reduction of ≥ 25% compared to the initial value. Finally, trends of GLS and PALS during 12 months-Follow-up periods were analysed. Results A total of 48.9% patients developed subclinical LV dysfunction. Similarly, 48.3% patients showed a left atrial impairment. Interestingly a significant (P = 0.0001) reduction in GLS was observed during the follow-up, particularly in the first 6 months of treatment. PALS showed a similar trend with a significant decrease during the whole 12 months-follow-up (P = 0.0001) and mostly in the first 6 months. Only 11% patients showed a significant reduction of LVEF defined as an absolute reduction of LVEF &gt;10% from baseline. Conclusions In HER 2 positive breast cancer patients treated with Trastuzumab development of left atrial impairment in not uncommon and PALS modifications follow a similar pattern to GLS variations during the treatment course, suggesting a possible cardiotoxic effect of such therapy on both atrial and left ventricular myocardium and physiology. However, the potential role of an early atrial impairment detection in predicting subsequent cardiotoxicity in terms of significant LVEF reduction still needs to be tested with further studies.

Evaluation of the local atrial function by regional speckle tracking imaging using intracardiac echocardiography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Inoue ◽  
T Ohnishi ◽  
K Iwakura ◽  
K Tanaka ◽  
T Oka ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Low Voltage ◽  
Intracardiac Echocardiography ◽  
Atrial Function ◽  
Inferior Wall ◽  
Speckle Tracking Imaging ◽  
Contraction Phase ◽  
Af Ablation ◽  
Atrial Contraction ◽  
Atrial Strain

Abstract Background It has been reported that low voltage areas and conduction abnormalities detected by electrophysiology catheters in the left atrium (LA) represent regional degeneration and fibrosis of the atrium and are related to a poor atrial fibrillation (AF) ablation outcome. Assessment of the local atrial function is clinically useful because atrial degeneration does not occur uniformly throughout the atrium. Though evaluating the global atrial function using speckle tracking imaging (STI) by transthoracic echocardiography (TTE) has been attempted, TTE does not have a sufficient image quality to assess local atrial STI. Purpose To evaluate the local atrial function by STI using intracardiac echocardiography (ICE) and to elucidate the characteristics of the STI in normal and abnormal voltage regions in the LA. Methods We included 9 patients undergoing AF ablation with written informed consent for this prospective observational study. After pulmonary vein isolation, we performed voltage mapping of the LA in sinus rhythm using a CARTO system (Biosense). Abnormal regions and normal regions were defined as those with low voltage areas (&lt;0.5 mV) and those with normal voltages, respectively. Echo images were recorded by an ACUSON SC2000 (Siemens) and SOUNDSTAR catheter (Biosense). We inserted the SOUNDSTAR catheter into the LA to obtain clear images, recorded the STI of the anterior and inferior wall, and performed an offline analysis of the atrial strain with an eSie VVI work station (Siemens) and the LA voltage data with CARTO system at each site simultaneously (left figure). We compared the strain during the atrial contraction phase (Sct) between the normal and abnormal regions. Results Among the study population, 5 patients had low voltage areas in the LA. We evaluated the STI at 26 normal regions and 44 abnormal regions. The typical regional speckle tracking waveform in the normal region was similar to a jugular vein pressure waveform (right figure). There was a difference in the amplitude of the Sct between the groups; it was significantly smaller in the abnormal regions (normal and abnormal regions, 9.8±5.0% and 5.6±3.8%, p=0.0001). The duration of the Sct was significantly more prolonged in the abnormal regions than normal regions (98.8±26.3ms and 118.2±33.9ms, p=0.015). Conclusions This pilot study demonstrated that the local atrial function was evaluable by STI using ICE and that the regional strain tracking waveform during the atrial contraction phase in abnormal voltage regions was smaller and more prolonged than that in normal regions. An evaluation of the regional STI with an ICE may be useful to detect regional abnormalities of the atrium. Representative case Funding Acknowledgement Type of funding source: None

scholarly journals P08.03: 2D speckle‐tracking echocardiography: atrial and biventricular strain analysis in normal fetal hearts

2019 ◽  
Vol 54 (S1) ◽  
pp. 178-178
Author(s):  
C. Enzensberger ◽  
M. Meister ◽  
O. Graupner ◽  
R. Axt‐Fliedner ◽  
A. Wolter ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Strain Analysis ◽  
2D Speckle Tracking

scholarly journals 1030 Usefulness of novel fully automated 2D speckle tracking software for left ventricular, left atrial, and right ventricular longitudinal strain analysis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
Y Nabeshima ◽  
K Otani ◽  
T Kitano ◽  
M Takeuchi
Keyword(s):  
Left Atrial ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Strain Analysis ◽  
Automated Analysis ◽  
Left Ventricular ◽  
Medical Systems ◽  
Endocardial Border ◽  
Software Packages ◽  
2D Speckle Tracking

Abstract Funding Acknowledgements Philips Medical Systems Background Continuous efforts of EACVI-ASE strain standardization task force make inter-vendor variability of left ventricular (LV) global longitudinal strain (GLS) lower. However, observer variability is still a major source of measurement inconsistency. The adoption of fully automated 2D strain software has a potential to eliminate this problem. Purpose We aimed to validate the usefulness of novel fully automated LV, left atrial (LA), and right ventricular (RV) 2D speckle tracking software packages. Methods We retrospectively selected 91 healthy subjects who had undergone 2D echocardiography using a specific ultrasound machine (EPIQ, Philips Medical Systems). Standard apical 4-chamber, 2-chamber, and long-axis views which encompassed whole part of both left ventricle and left atrium and RV focused view were acquired in all subjects. Novel fully automated speckle tracking software packages (AutoStrain, QLAB 13.0) were used for measuring GLS on the three apical views, LA longitudinal strain (LALS) on the apical-4-chamber view, and RV free wall longitudinal strain (RVfwLS) on the RV-focused view. Image quality was assessed by 3-point scales (good, fair, and poor). Endocardial border detection was also classified into 3 groups (adequate, poor, and no detection). Endocardial border was manually adjusted, when required. Results of fully automated analysis and results with fully automated analysis + manual editing were compared. Results Mean age was 37 ± 13 years, and 61 subjects were men. The image quality was categorized more than "fair" in 80% of subjects. The software did not recognize LA border in 3 cases and RV border in 4 cases. Thus, the feasibility of fully automated LV, LA, and RV analysis were 100%, 97%, and 96%, respectively. LVGLS, LALS, and RVfwLS using fully automated approach were 19.7 ± 2.3%, 45.5 ± 11.6%, and 25.7 ± 5.6%, respectively. Manual correction was required in all cases. LVGLS, LALS, and RVfwLS after the manual editing were 18.9 ± 2.1%, 44.0 ± 10.4%, and 26.6 ± 6.4%. The intraclass correlation coefficient (ICC) between the two methods were 0.86, 0.72, and 0.74. The fully automated analysis took 22 ± 2 sec, 11 ± 1 sec, and 10 ± 1 sec for the measurements of LVGLS, LALS, and RVfwLS. The corresponding values with manual editing were 98 ± 18 sec, 53 ± 12 sec, and 52 ± 12 sec, respectively. Inter-observer ICCs of LVGLS, LALS, and RVfwLS with fully automated approach were all 1.0, but corresponding values after the manual editing were 0.82, 0.74, and 0.79, respectively. Conclusions Novel fully automated 2D speckle tracking software packages provide LVGLS, LALS, and RVfwLS within one minute, and these values were well correlated with the corresponding values after the manual editing, especially for LVGLS. This is a time-saving approach for longitudinal strain analysis in the three cardiac chambers. Further studies should be required to validate their potential utility in clinical setting.

scholarly journals Clinical importance of left atrial infiltration in cardiac transthyretin amyloidosis

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
F Bandera ◽  
R Martone ◽  
L Chacko ◽  
S Ganesananthan ◽  
JA Gilbertson ◽  
...  
Keyword(s):  
Left Atrial ◽  
Speckle Tracking ◽  
Contractile Function ◽  
Clinical Importance ◽  
Transthyretin Amyloidosis ◽  
Funding Sources ◽  
Atrial Contraction ◽  
Congo Red Staining ◽  
Distinctive Phenotype ◽  
Normal Architecture

Abstract Funding Acknowledgements Type of funding sources: None. INTRODUCTION  The clinical significance of left atrial (LA) involvement in ATTR amyloidosis cardiomyopathy (ATTR-CM) has not been characterized. The aims of this study were to characterize: (1)LA pathology in explanted ATTR-CM hearts; (2)LA mechanics using echocardiographic speckle-tracking in a large cohort of ATTR-CM patients; (3)to study the association with mortality. METHODS AND RESULTS Congo red staining and immunohistochemistry was performed to assess the presence, type and extent of amyloid and associated changes in 5 explanted ATTR-CM atria. Echo speckle-tracking was used to assess LA reservoir, conduit, contractile function and stiffness in 906 ATTR-CM patients (551 wt-ATTR-CM;93 T60A-ATTR-CM;241 V122I-ATTR-CM;21 other). There was extensive ATTR amyloid infiltration in the 5 atria with loss of normal architecture, vessels remodelling, capillary disruption and subendocardial fibrosis. Echo speckle-tracking in 906 ATTR-CM patients demonstrated increased atrial stiffness [median(25th-75th quartile) 1.83(1.15-2.92)] that remained independently associated with prognosis, after adjusting for known predictors (lnLA stiff:HR = 1.26,CI 1.07-1.57;p = 0.009). There was substantial impairment of the three phasic functional atrial components [reservoir 8.86(5.94-12.97)%; conduit 6.5(4.53-9.28)%; contraction function 4.0(2.29-6.56)%]. Atrial contraction was absent in 21.6% of patients whose ECG showed sinus rhythm (SR)-"atrial electro-mechanical dissociation"(AEMD). AEMD was associated with poorer prognosis compared to SR patients with effective mechanical contraction (p &lt; 0.0001). AEMD conferred a similar prognosis to patients in AF. CONCLUSION The phenotype of ATTR-CM includes significant infiltration of the atrial walls with progressive loss of atrial function and increased stiffness, which is a strong independent predictor of mortality. AEMD emerged as a distinctive phenotype identifying patients in SR with poor prognosis. Abstract Figure.

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