Left ventricular myocardial function in congenital valvar aortic stenosis assessed by ultrasound tissue-velocity and strain-rate techniques

2003 ◽  
Vol 29 (4) ◽  
pp. 615-620 ◽  
Author(s):  
Peter Kiraly ◽  
Livia Kapusta ◽  
Johan M Thijssen ◽  
Otto Daniëls
Keyword(s):  
Aortic Stenosis ◽  
Strain Rate ◽  
Myocardial Function ◽  
Left Ventricular ◽  
Tissue Velocity ◽  
Valvar Aortic Stenosis

Abstract 2073: Use of Diastolic Tissue Velocity and Standard Parameters to Assess Treatment Response in Subclinical Myocardial Disease - A Randomized Trial of Lifestyle Intervention in Type 2 Diabetes

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Matthew D Hordern ◽  
Louise M Smith ◽  
Leanne Short ◽  
Melodie Downey ◽  
Johannes B Prins ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Strain Rate ◽  
Usual Care ◽  
Treatment Response ◽  
Lifestyle Intervention ◽  
Myocardial Function ◽  
Myocardial Dysfunction ◽  
Left Ventricular ◽  
Tissue Velocity

Background. Myocardial dysfunction is common in type 2 diabetes (T2DM), but the best markers of treatment response are undefined. We sought the effects of a 1 year lifestyle intervention (LI) on myocardial function and left ventricular (LV) characteristics, and to determine the predictors of this improvement. Methods. Pts with uncomplicated T2DM (223), no known cardiac disease and a negative stress echo were randomized into usual care (n=112) or LI groups (n=111). The LI involved individualized home-based training (150min/wk of moderate exercise) and caloric restriction. Myocardial function (diastolic (E′) tissue velocity, strain and strain rate), LV characteristics (EF, E/A, LVMI and E/E′), metabolic control (HbA 1c , blood glucose, insulin resistance (HOMA), BMI, fat mass) and VO 2max were assessed at baseline and follow-up in 159 pts (LI n=74) who remained in the study for 1 year. Results. Compared with usual care, LI was associated with significant (p<0.05) increases in E′ but not in strain, strain rate, EF, E/A, LVMI and E/E′ (Table ). Changes in E′ tissue velocity were significantly correlated with baseline E′ (r=−0.59, p<0.01), baseline metabolic status (BMI (r=0.23, p<0.01), insulin (r=0.22, p<0.01), HDL (r=−0.18, p<0.03)) and metabolic improvement (BMI (r=−0.17, p<0.04), insulin (r=−0.22, p<0.01), HbA 1c (r=−0.24, p<0.01) and HOMA (r=−0.24, p<0.01)). Multivariate analysis revealed that age (beta=−0.33, p<0.01), baseline E′ (beta=−0.68, p<0.01) and changes in HbA 1c (beta=−0.21, p<0.01) were independent predictors of changes in E′ and together accounted for 52% of the change in E′ (p<0.01). Conclusions. Diastolic myocardial properties, but not systolic deformation or standard LV characteristics respond to a 1 year individualized lifestyle intervention in T2DM. Improved diastolic myocardial function were associated with poor metabolic and myocardial health at baseline and greater improvements in metabolism over the intervention period. Comparison between Intervention and Control Groups

scholarly journals Left ventricular and left atrial deformation imaging early after pPCI: does diabetes mellitus make any difference?

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
D Trifunovic Zamaklar ◽  
G Krljanac ◽  
M Asanin ◽  
L Savic-Spasic ◽  
J Vratonjic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Strain Rate ◽  
Myocardial Function ◽  
Radial Strain ◽  
Left Ventricular ◽  
Deformation Analysis ◽  
Syntax Score ◽  
Deformation Imaging ◽  
Early Diastole

Abstract Funding Acknowledgements Type of funding sources: None. onbehalf PREDICT-VT More extensive coronary atherosclerosis in diabetes mellitu (DM) induces poorer clinical outcomes after STEMI, but there are data suggesting that impaired myocardial function in DM, even independently from epicardial coronary lesions severity, might have detrimental effect, predominately on heart failure development in DM. Aim the current study is a sub-study of PREDICT-VT study (NCT03263949), aimed to analyse LV and LA function using myocardial deformation imaging based on speckle tracking echocardiography after pPCI in STEMI patients with and without DM. Methods in 307 consecutive pts enrolled in PREDICT-VT study early echocardiography (5 ± 2 days after pPCI) was done including LA and multilayer LV deformation analysis with longitudinal (L), radial (R) and circumferential (C) strain (S; %) and strain rate (SR, 1/sec), LV index of post systolic shortening for longitudinal (PSS LS) and circumferential (PSS CS) strains and analysis of LV rotation mechanic. Results from 242 patients who completed 1 year follow up, 48 (20%) had DM. Pts with DM were older (60 ± 1,01 vs 57 ± 10; p = 0.067) and had insignificantly higher SYNTAX score (18.5 ± 9.2 vs 15.8 ± 9.8, p = 0.118) . However, diabetics had more severely impaired EF (44.2 ± 8.6 vs 49.2 ± 9.8, p = 0.001), E/A ratio (0.78 ± 0.33 vs 0.90 ± 0.34; p = 0.036) and MAPSE (1.18 ± 0.32 vs 1.32 ± 0.33; p = 0.001).  Global LV LS on all layers (endo: -13.6 ± 4.0 vs-16.2 ± 4.7; mid: -11.9 ± 3.5 vs -14.1 ± 4.1; epi: -10.4 ± 3.1 vs -12.3 ± 3.6; p &lt; 0.005 for all) was impaired in DM patients, as well as longitudinal systolic SR (-0.71 ± 0.23 vs -0.84 ± 0.24; p = 0.001) and SR during early diastole (0.65 ± 0.26 vs 0.83 ± 0.33, p &lt; 0.001). Patients with DM had more pronounced longitudinal posts-systolic shortening throughout LV wall (endo: 21.4 ± 16.1 vs 13.7 ± 13.3, p = 0.005; mid: 21.9 ± 16.1 vs 14.3 ± 13.1, p = 0.006; epi: 22.4 ± 16.5 vs 15.3 ± 13.7, p = 0.010) and higher LV mechanical dispersion (MDI: 71.3 ± 38.3 vs 59.0 ± 18.9, p = 0.037). LA strain was significantly impaired in DM patients (18.9 ± 7.7 vs 22.6 ± 10.0, p = 0.011) and even more profoundly LA strain rate during early diastole (-0.73 ± 0.48 vs -1.00 ±0.58, p = 0.002). Patients with DM also had more impaired LV global (15.7 ± 9.1 vs 19.8 ± 10.4, p = 0.013) radial strain, global LV circumferencial strain, especially at the mid-wall level (-13.9 ± 4.2 vs -16.0 ± 4.3, p = 0.005) and impaired circumferential SR E (1.25± 0.44 vs 1.49 ± 0.46, p = 0.003). End-systolic rotation of the LV apex was more impaired in DM (4.7 ± 5.1 vs 6.8 ± 5.5, p= 0.022). During 1 year follow-up heart failure and all-cause mortality tend to be higher among DM pts (46.7% vs 35.2%, p = 0.153). Conclusion STEMI patients with DM have more severely impaired LV systolic and diastolic function estimated both by traditional parameter and advanced echo techniques. These results might, at least partially, explain why outcomes after STEMI in DM might be poorer, even in the absence of more complex angiographic findings, pointing to the significance of impaired myocardial function DM itself.

scholarly journals A study of changes in various echocardiographic parameters in patients with chronic stable angina undergoing percutaneous coronary intervention (PCI)

2015 ◽  
Vol 9 (2) ◽  
pp. 99-106
Author(s):  
Muhammad Mobarock Hossain ◽  
AKM Fazlur Rahman ◽  
Md Abu Siddique ◽  
Sajal Krishna Banerjee ◽  
Chowdhury Meskat Ahmed ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Strain Rate ◽  
Doppler Echocardiography ◽  
Stable Angina ◽  
Myocardial Function ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Percutaneous Coronary

PCI has been used increasingly for revascularization in ischemic heart disease patients. In the cardiology practice, the assessment of left ventricular (LV) function is of paramount importance. Two-dimensional echocardiography and Doppler echocardiography remain the most important diagnostic tests/tool for the evaluation of left ventricular function. The present study was conducted to determine the impact of PCI on myocardial function assessed by 2D, M mode and tissue Doppler echocardiography in patients with chronic stable angina. The interventional study was carried out in the Department of Cardiology, University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University Hospital, Dhaka over a period of 1 year between January 2013 to December 2013. Patients with chronic stable angina undergoing percutaneous coronary intervention (PCI) during the study period were the study population. A total of 40 such patients were consecutively included in the study. The myocardial function parameters were assessed by 2D, M mode and Tissue Doppler echocardiography before PCI and 48 hours and 6 weeks after PCI. Left ventricular end diastolic dimension (LVEDD) did not experience any change 2 days after PCI, but a significant reduction was noted 6 weeks after PCI (P < 0.001). Similarly no change was observed 48 hours after PCI in left ventricular end systolic dimension (LVESD) but a significant decrease was evident 6 weeks after PCI (p < 0.001). LVEF also did not exhibit any change in the first 2 days after PCI, but significantly raised 6 weeks after PCI (p < 0.001). Tissue Doppler Imaging (TDI) showed that there was insignificant improvement in Em, Am, and Em/ Am ratio 48 hours after PCI. But there was significant improvement of the same parameters at the lateral mitral annulus 6 weeks after PCI (p = 0.044, p = 0.036 and p = 0.021 respectively). While DTm did not experience any change in first 2 days after PCI, it exhibited significant change at endpoint of study (p = 0.018), RTm and Sm peak velocity however, did not improve following PCI. Q-wave increased from 7.0 cm/sec before PCI to 7.2 cm/ sec 48 hours after PCI and 7.5 cm 6 weeks after PCI (p < 0.001). Percentage of strain decreased from -15.0 before PCI to -15.4 at the endpoint (p < 0.001) and strain rate from -1.3% before PCI to -1.4% 6 at the endpoint. From the findings of the study it can be concluded that Tissue Doppler echocardiographic indices Strain, strain rate and Q analysis can detect the early changes of improvement in the left ventricular myocardium in patient with chronic stable angina after 48 hours of PCI . Other 2D , M mode and tissue Doppler echocardiographic indices showed improvement after 6 weeks of PCI.University Heart Journal Vol. 9, No. 2, July 2013; 99-106

Effects of Nitroglycerin on Left Ventricular and Myocardial Function in Aortic Stenosis

Nitrates III ◽  
1981 ◽  
pp. 558-564
Author(s):  
U. Tebbe ◽  
G. Sauer ◽  
K.-L. Neuhaus ◽  
H. Kreuzer
Keyword(s):  
Aortic Stenosis ◽  
Myocardial Function ◽  
Left Ventricular
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