scholarly journals The influence of region of interest width in fetal 2D-speckle tracking echocardiography late in pregnancy

Author(s):  
Tom Roar Omdal ◽  
Umael Khan ◽  
Cathrine Ebbing ◽  
Jörg Kessler ◽  
Henriette Odland Karlsen ◽  
...  

AbstractSpeckle tracking echocardiography is a promising method for assessment of myocardial function in fetal and neonatal hearts, but further studies are necessary to validate and optimize the settings for use in fetal cardiology. Previous studies have shown that the definition of the region of interest (ROI) affects strain values in adults. The aim of this study was to investigate how different widths of ROI influences measurements of four-chamber longitudinal systolic strain in fetuses late in pregnancy. Thirty-one singleton, healthy fetuses born to healthy mothers underwent an echocardiographic examination during gestational week 37. Speckle tracking was performed with two different settings for ROI width; the narrowest and second most narrow, provided both widths were assessed as suitable for the myocardial wall thickness of the fetus. We found an inverse correlation between the ROI width and the strain values. Four-chamber longitudinal strain changed from − 20.7 ± 3.6% to − 18.0 ± 4.4% (p < 0.001) with increasing ROI width. Further, strain decreased from the endocardium to the epicardium with multilayer measurements. Different widths of ROI influenced the strain measurements significantly in the fetal heart, comparable to what has been reported in adults. A standardization of the ROI setting could improve the interpretation, and reduce variability in fetal strain measurements.

2021 ◽  
Author(s):  
Tom Roar Omdal ◽  
Umael Khan ◽  
Cathrine Ebbing ◽  
Jörg Kessler ◽  
Henriette Odland Karlsen ◽  
...  

Abstract Purpose: Speckle tracking echocardiography is a promising method for assessment of myocardial function in fetal and neonatal hearts, but further studies are necessary to validate and optimize the settings for use in fetal cardiology. Previous studies have shown that the definition of the region of interest (ROI) affects strain values in adults. The aim of this study was to investigate how different widths of ROI influences measurements of four-chamber longitudinal systolic strain in fetuses late in pregnancy.Methods: Thirty-one singleton, healthy fetuses born to healthy mothers underwent an echocardiographic examination during gestational week 37. Speckle tracking was performed with two different settings for ROI width; the narrowest and second most narrow, provided both widths were assessed as suitable for the myocardial wall thickness of the fetus. Results: We found an inverse correlation between the ROI width and the strain values. Four-chamber longitudinal strain changed from -20.7 ± 3.6% to -18.0 ± 4.4% (p<0.001) with increasing ROI width. Further, strain decreased from the endocardium to the epicardium with multilayer measurements.Conclusions: Different widths of ROI influenced the strain measurements significantly in the fetal heart, comparable to what has been reported in adults. A standardization of the ROI setting could improve the interpretation, and reduce variability in fetal strain measurements.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
D Zhao ◽  
G M Quill ◽  
K Gilbert ◽  
V Y Wang ◽  
T Sutton ◽  
...  

Abstract Background Global longitudinal strain (GLS) has emerged as a sensitive index of left ventricular (LV) systolic function with greater prognostic value than LV ejection fraction (LVEF) in a variety of cardiac disorders. While GLS is routinely derived from 2D speckle tracking echocardiography (STE) and feature tracking in cardiac magnetic resonance (CMR) imaging, calculation of strain via 3D geometric modelling enables analyses of deformation that are independent of 2D image plane constraints. Purpose We sought to compare longitudinal strain measurements extracted from geometric 3D analysis of CMR against values obtained from conventional 2D-STE. Methods Consecutive 2D-echocardiography (2D-echo) and steady-state free precession multiplanar cine CMR scans were performed in 80 prospectively recruited participants (48 healthy controls with LVEF range 53–74%, 30 patients with non-ischaemic cardiac disease with LVEF range 25–77%, and 2 heart transplant recipients with LVEF 53% and 58%), &lt;1 hour apart. Average endocardial peak GLS from 2D-STE was calculated offline using vendor-independent clinical software from apical triplane (2, 3 and 4-chamber) images for each of the standardised LV walls (anterior, anteroseptal, inferoseptal, inferior, inferolateral, anterolateral). Dynamic 3D geometric models of the LV were reconstructed from 3 long- and 6 short-axis CMR slices over one cardiac cycle. Corresponding longitudinal strain measurements were then evaluated by extracting analogous endocardial arc lengths (apex to base of each LV wall) from the 3D LV model. Finally, an average peak GLS was calculated as the mean of the peak longitudinal strains in each LV wall. Results GLS measured by 2D-STE ranged between −6.5% and −27.9% for the study population. A two-way mixed-effects intraclass correlation coefficient (ICC) for absolute agreement of 0.820 (95% CI: [0.720, 0.885]) demonstrated good correlation between average GLS obtained from 2D-STE and CMR. A Bland-Altman analysis revealed a minimal bias (&lt;1%) and 95% limits of agreement (LOA) between −6.3% and 5.5% (Fig. 1), with no apparent proportional bias. Comparatively lower correlation and wider LOA between longitudinal strains from 2D-STE and CMR were observed for each LV wall (Table I). Conclusions Fully automated calculation of LV GLS can be obtained from geometric 3D CMR analysis. Average peak GLS from cine CMR exhibits good agreement with 2D-STE, despite showing only moderate agreement at each LV wall. The increased discrepancy in regional longitudinal strain may be attributed to subjective plane positioning in 2D-echo, which can be expected to improve with advances in 3D-STE. The calculation of GLS by 3D geometric modelling may enhance the diagnostic value of routine cine CMR examinations for LV systolic function assessment. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Health Research Council (HRC) of New Zealand and National Heart Foundation (NHF) of New Zealand Figure 1. Bland-Altman analysis Table I. Regional correlations


Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 562
Author(s):  
Rima Šileikienė ◽  
Karolina Adamonytė ◽  
Aristida Ziutelienė ◽  
Eglė Ramanauskienė ◽  
Jolanta Justina Vaškelytė

Background and objectives: Childhood obesity has reached epidemic levels in the world. Obesity in children is defined as a body mass index (BMI) equal to or above the 95th percentile for age and sex. The aim of this study was to determine early changes in cardiac structure and function in obese children by comparing them with their nonobese peers, using echocardiography methods. Materials and methods: The study enrolled 35 obese and 37 age-matched nonobese children. Standardized 2-dimensional (2D), pulsed wave tissue Doppler, and 2D speckle tracking echocardiography were performed. The z-score BMI and lipid metabolism were assessed in all children. Results: Obese children (aged 13.51 ± 2.15 years; 20 boys; BMI z-score of 0.88 ± 0.63) were characterized by enlarged ventricular and atrial volumes, a thicker left ventricular posterior wall, and increased left ventricular mass. Decreased LV and RV systolic and diastolic function was found in obese children. Atrial peak negative (contraction) strain (−2.05% ± 2.17% vs. −4.87% ± 2.97%, p < 0.001), LV and RV global longitudinal strain (−13.3% ± 2.88% vs. −16.87% ± 3.39%; −12.51% ± 10.09% vs. −21.51% ± 7.42%, p < 0.001), and LV global circumferential strain (−17.0 ± 2.7% vs. −19.5 ± 2.9%, p < 0.001) were reduced in obese children. LV torsion (17.94° ± 2.07° vs. 12.45° ± 3.94°, p < 0.001) and normalized torsion (2.49 ± 0.4°/cm vs. 1.86 ± 0.61°/cm, p = 0.001) were greater in obese than nonobese children. A significant inverse correlation was found between LV and RV global longitudinal strain and BMI (r = −0.526, p < 0.01; r = −0.434, p < 0.01) and total cholesterol (r = −0.417, p < 0.01). Multivariate analysis revealed that the BMI z-score was independently related to LV and RV global longitudinal strain as well as LV circumferential and radial strain. Conclusion: 2D speckle tracking echocardiography is beneficial in the early detection of regional LV systolic and diastolic dysfunctions, with preserved ejection fraction as well as additional RV and atrial involvement, in obese children. Obesity may negatively influence atrial and ventricular function, as measured by 2D speckle tracking echocardiography. Obese children, though they are apparently healthy, may have subclinical myocardial dysfunction.


2018 ◽  
Vol 20 (6) ◽  
pp. 694-699 ◽  
Author(s):  
Pieter van der Bijl ◽  
Marianne Bootsma ◽  
Yasmine L Hiemstra ◽  
Nina Ajmone Marsan ◽  
Jeroen J Bax ◽  
...  

2019 ◽  
Vol 11 (4) ◽  
pp. 309-313
Author(s):  
Atoosa Mostafavi ◽  
Yaser Tase Zar ◽  
Farahnaz Nikdoust ◽  
Seyed Abdolhossein Tabatabaei

Introduction: In light of previous studies reporting the significant effects of preeclampsia on cardiac dimensions, we sought to evaluate changes in the left ventricular (LV) systolic and diastolic functions in patients with preeclampsia with a view to investigating changes in cardiac strain. <br /> Methods: This cross-sectional study evaluated healthy pregnant women and pregnant women suffering from preeclampsia who were referred to our hospital for routine healthcare services. LV strain was measured by 2D speckle-tracking echocardiography. <br /> Results: Compared with the healthy group, echocardiography in the group with preeclampsia showed a significant increase in the LV end-diastolic diameter (47.43 ± 4.94 mm vs 44.84 ± 4.30 mm; P = 0.008), the LV end-systolic diameter (31.16 ± 33.3 mm vs 29.20 ± 3.75 mm; P = 0.008), and the right ventricular diameter (27.93 ± 1.71 mm vs 24.53 ± 23.3; P = 0.001). The mean global longitudinal strain was -18.69 ± 2.8 in the group with preeclampsia and -19.39 ± 3.49 in the healthy group, with the difference not constituting statistical significance (P = 0.164). The mean global circumferential strain in the groups with and without preeclampsia was -20.4 ± 12.4 and -22.68 ± 5.50, respectively, which was significantly lower in the preeclampsia group (P = 0.028).<br /> Conclusion: The development of preeclampsia was associated with an increase in the right and left ventricular diameters, as well as a decrease in the ventricular systolic function, demonstrated by a decline in global circumferential strain.


2020 ◽  
Vol 35 (12) ◽  
pp. 2307-2317
Author(s):  
Mohamed H. Afify ◽  
Safaa M. Abdelrahman ◽  
Hossam I. Mohamed ◽  
Rasha Helmy ◽  
Gaser Abdelmohsen ◽  
...  

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