Left ventricular global longitudinal strain alteration in young patient and correlation with post-COVID syndrome (TUN END COV Study)

Abstract Background Left ventricular ejection fraction (LVEF) is the parameter of choice for left ventricular (LV) function assessment and risk stratification of patients with ST-elevation myocardial infarction (STEMI); however, its prognostic value is limited. Other measures of LV function such as global longitudinal strain (GLS) and mitral annular plane systolic excursion (MAPSE) might provide additional prognostic information post-STEMI. However, comprehensive investigations comparing these parameters in terms of prediction of hard clinical events following STEMI are lacking so far. Purpose We aimed to investigate the comparative prognostic value of LVEF, MAPSE and GLS by cardiac magnetic resonance (CMR) imaging in the acute stage post-STEMI for the occurrence of major adverse cardiac events (MACE). Methods This observational study included 407 consecutive acute STEMI patients treated with primary percutaneous coronary intervention (PCI). Comprehensive CMR investigations were performed 3 [interquartile range (IQR): 2–4] days after PCI to determine LVEF, GLS and MAPSE as well as myocardial infarct characteristics. Primary endpoint was the occurrence of MACE defined as composite of death, re-infarction and congestive heart failure. Results During a follow-up of 21 [IQR: 12–50] months, 40 (10%) patients experienced MACE. LVEF (p=0.005), MAPSE (p=0.001) and GLS (p<0.001) were significantly related to MACE. GLS showed the highest prognostic value with an area under the curve (AUC) of 0.71 (95% CI 0.63–0.79; p<0.001) compared to MAPSE (AUC: 0.67, 95% CI 0.58–0.75; p=0.001) and LVEF (AUC: 0.64, 95% CI 0.54–0.73; p=0.005). After multivariable analysis, GLS emerged as sole independent predictor of MACE (HR: 1.22, 95% CI 1.11–1.35; p<0.001). Of note, GLS remained associated with MACE (p<0.001) even after adjustment for infarct size and microvascular obstruction. Conclusion CMR-derived GLS emerged as strong and independent predictor of MACE after acute STEMI with additive prognostic validity to LVEF and parameters of myocardial damage. Funding Acknowledgement Type of funding source: None

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Direct comparison of multilayer left ventricular global longitudinal strain using CMR feature tracking and speckle tracking echocardiography

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-01916-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Saikrishna Ananthapadmanabhan ◽

Giau Vo ◽

Tuan Nguyen ◽

Hany Dimitri ◽

James Otton

Keyword(s):

Feature Tracking ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Imaging Modality ◽

Global Longitudinal Strain ◽

Intraclass Correlation ◽

Strain Analysis ◽

Left Ventricular ◽

Multilayer Strain

Abstract Background Cardiac magnetic resonance feature tracking (CMR-FT) and speckle tracking echocardiography (STE) are well-established strain imaging modalities. Multilayer strain measurement permits independent assessment of endocardial and epicardial strain. This novel and layer specific approach to evaluating myocardial deformation parameters may provide greater insight into cardiac contractility when compared to whole-layer strain analysis. The aim of this study is to validate CMR-FT as a tool for multilayer strain analysis by providing a direct comparison between multilayer global longitudinal strain (GLS) values between CMR-FT and STE. Methods We studied 100 patients who had an acute myocardial infarction (AMI), who underwent CMR imaging and echocardiogram at baseline and follow-up (48 ± 13 days). Dedicated tissue tracking software was used to analyse single- and multi-layer GLS values for CMR-FT and STE. Results Correlation coefficients for CMR-FT and STE were 0.685, 0.687, and 0.660 for endocardial, epicardial, and whole-layer GLS respectively (all p < 0.001). Bland Altman analysis showed good inter-modality agreement with minimal bias. The absolute limits of agreement in our study were 6.4, 5.9, and 5.5 for endocardial, whole-layer, and epicardial GLS respectively. Absolute biases were 1.79, 0.80, and 0.98 respectively. Intraclass correlation coefficient (ICC) values showed moderate agreement with values of 0.626, 0.632, and 0.671 respectively (all p < 0.001). Conclusion There is good inter-modality agreement between CMR-FT and STE for whole-layer, endocardial, and epicardial GLS, and although values should not be used interchangeably our study demonstrates that CMR-FT is a viable imaging modality for multilayer strain

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Left ventricular global longitudinal strain in identifying subclinical myocardial dysfunction among patients hospitalized with COVID-19

IJC Heart & Vasculature ◽

10.1016/j.ijcha.2021.100719 ◽

2021 ◽

Vol 32 ◽

pp. 100719

Author(s):

Hezzy Shmueli ◽

Maulin Shah ◽

Joseph E. Ebinger ◽

Long-Co Nguyen ◽

Fernando Chernomordik ◽

...

Keyword(s):

Longitudinal Strain ◽

Myocardial Dysfunction ◽

Global Longitudinal Strain ◽

Left Ventricular

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Early change in left atrial and left ventricular strain predicts sinus rhythm maintenance after cardioversion

European Heart Journal ◽

10.1093/ehjci/ehaa946.0142 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

K Kupczynska ◽

D Miskowiec ◽

B Michalski ◽

L Szyda ◽

K Wierzbowska-Drabik ◽

...

Keyword(s):

Sinus Rhythm ◽

Left Atrial ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Recurrence Risk ◽

Left Ventricular ◽

Mechanical Function ◽

Af Recurrence

Abstract Background Atrial fibrillation (AF) impairs mechanical function of the heart, especially atria and restoration of sinus rhythm (SR) leads to improvement of mechanics. The predicting role of changes in strain parameters for AF recurrence is not established yet. Purpose To analyse changes in left atrial (LA) and left ventricular (LV) mechanical function after conversion to SR and their prognostic values for AF recurrence during 24 months follow-up. Methods Prospective study involved 59 patients after successful electrical cardioversion (EC) because of nonvalvular AF (mean age 65±4 years, 47% female). Speckle tracking analysis (STE) was applied to calculate longitudinal strain of LV and LA before EC and within 24 hours after restoration of SR and additionally total left heart strain (TS) defined as a sum of absolute peak LV and LA strain. We calculated change in strain between AF and SR analyses expressed as delta (Δ). During follow-up we noticed AF recurrence in 42 (71%) patients, most of them (93%) during 1st year after EC. Median time of AF recurrence was 3 months. Results We noticed significant immediate post-EC improvement in peak LA longitudinal strain (PALS) and LV global longitudinal strain (LVGLS) (table). Unlike CHA2DS2-VASc score, strain parameters were predictors of AF recurrence. Every 1% increment in ΔLVGLS was related with 13% increase in AF recurrence risk (p=0.02) and every 1% increment in ΔPALS and ΔTS were related with 9% decrease in AF recurrence risk (p=0.007 and p=0.0014, respectively). Multivariate analysis revealed ΔTS as a strongest predictor with 9% decrease in AF risk per every 1% increment. The criterion of ΔTS ≤7.5% allows to predict AF recurrence with 81% sensitivity and 63% specificity. Conclusions Speckle tracking measurements are able to detect early mechanical changes in LA even within 24 hours of SR and these absolute changes in LVGLS as well as PALS can predict AF recurrence, with optimal stratification by novel parameter - TS. Funding Acknowledgement Type of funding source: None

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Predictive Parameters of Decreased Left Ventricular Global Longitudinal Strain at 1 Month After Pediatric Heart Transplantation

Pediatric Cardiology ◽

10.1007/s00246-021-02542-z ◽

2021 ◽

Author(s):

Jihye You ◽

Jeong Jin Yu ◽

Mi Jin Kim ◽

Seulgi Cha ◽

Jae Suk Baek ◽

...

Keyword(s):

Heart Transplantation ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Predictive Parameters ◽

Pediatric Heart Transplantation

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Impact of rhythm in non-valvular atrial fibrillation on four cardiac chamber deformation imaging

European Heart Journal ◽

10.1093/ehjci/ehaa946.0139 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

P Philabout ◽

L Soulat-Dufour ◽

I Benhamou-Tarallo ◽

S Lang ◽

S Ederhy ◽

...

Keyword(s):

Atrial Fibrillation ◽

Sinus Rhythm ◽

Cardiac Rhythm ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Cardiac Chamber ◽

Deformation Imaging ◽

And Function

Abstract Background Few studies have assessed the evolution of cardiac chambers deformation imaging in patients with atrial fibrillation (AF) according to cardiac rhythm outcome. Purpose To evaluate cardiac chamber deformation imaging in patients admitted for AF and the evolution at 6-month follow-up (M6). Methods In forty-one consecutive patients hospitalised for AF two-dimensional transthoracic echocardiography was performed at admission (M0) and after six months (M6) of follow up. In addition to the usual parameters of chamber size and function, chamber deformation imaging was obtained including global left atrium (LA) and right atrium (RA) reservoir strain, global left ventricular (LV) and right ventricular (RV) free wall longitudinal strain. Patients were divided into three groups according to their cardiac rhythm at M0 and M6: AF at M0 and sinus rhythm (SR) at M6 (AF-SR) (n=23), AF at M0 and AF at M6 (AF-AF) (n=11), SR at M0 (spontaneous conversion before the first echocardiography exam) and SR in M6 (SR-SR) (n=7) Results In comparison with SR patients (n=7), at M0, AF patients (n=34)) had lower global LA reservoir strain (+5.2 (+0.4 to 12.8) versus +33.2 (+27.0 to +51.5)%; p<0.001), lower global RA reservoir strain (+8.6 (−5.4 to 11.6) versus +24.3 (+12.3 to +44.9)%; p<0.001), lower global LV longitudinal strain (respectively −12.8 (−15.2 to −10.4) versus −19.1 (−21.8 to −18.3)%; p<0.001) and lower global RV longitudinal strain (respectively −14.2 (−17.3 to −10.7) versus −23.8 (−31.1 to −16.2)%; p=0.001). When compared with the AF-SR group at M0 the AF-AF group had no significant differences with regard to global LA and RA reservoir strain, global LV and RV longitudinal strain (Table). Between M0 and M6 there was a significant improvement in global longitudinal strain of the four chambers in the AF-SR group whereas no improvements were noted in the AF-AF and SR-SR group (Figure). Conclusion Initial atrial and ventricular deformations were not associated with rhythm outcome at six-month follow up in AF. The improvement in strain in all four chambers strain suggests global reverse remodelling all cardiac cavities with the restoration of sinus rhythm. Evolution of strain between M0 and M6 Funding Acknowledgement Type of funding source: None

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