scholarly journals GLOBAL LONGITUDINAL STRAIN AND GLOBAL CIRCUMFERENTIAL STRAIN IN RELATION TO LATE GADOLINIUM ENHANCEMENT IN CMR

2021 ◽  
Vol 77 (18) ◽  
pp. 1396
Author(s):  
Abra Guo ◽  
Colin McGuire ◽  
Peter Bergquist ◽  
Jose Vargas ◽  
Monvadi Srichai-Parsia
Keyword(s):  
Late Gadolinium Enhancement ◽  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Global Longitudinal Strain ◽  
Gadolinium Enhancement ◽  
Global Circumferential Strain

scholarly journals Late Gadolinium Enhancement Predicts Improvement in Global Longitudinal Strain after Aortic Valve Replacement in Aortic Stenosis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Tsuyoshi Fujimiya ◽  
Masumi Iwai-Takano ◽  
Takashi Igarashi ◽  
Hiroharu Shinjo ◽  
Keiichi Ishida ◽  
...  
Keyword(s):  
Late Gadolinium Enhancement ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Longitudinal Strain ◽  
Severe Aortic Stenosis ◽  
Global Longitudinal Strain ◽  
Lv Function ◽  
Gadolinium Enhancement

Abstract Myocardial fibrosis, as detected by late gadolinium enhancement (LGE) magnetic resonance imaging (MRI), is related to mortality after aortic valve replacement (AVR). This study aimed to determine whether LGEMRI predicts improvement in global longitudinal strain (GLS) after AVR in patients with severe aortic stenosis (AS). Twenty-nine patients with severe AS who were scheduled to undergo AVR were enrolled. Two-dimensional echocardiography and contrast-enhanced MRI were performed before AVR. GLS and LGEcore (g: > 5 SD of normal area), LGEgray (g: 2–5 SD), and LGEcore+gray (g) were measured. One year after AVR, GLS were examined by echocardiography to assess improvement in LV function. Preoperatively, GLS correlated with LGEcore (g) (r2 = 0.14, p < 0.05), LGEgray (g) (r2 = 0.32, p < 0.01) and LGEcore+gray (g) (r2 = 0.36, p < 0.01). LGEcore was significantly lower in patients with improved GLS after AVR (GLS1year ≥ −19.9%) compared to those with no improvement (1.34 g vs. 4.70 g, p < 0.01). LGE predicts improvement in LV systolic function after AVR.

scholarly journals Three‐Dimensional Global Left Ventricular Myocardial Strain Reduced in All Directions in Subclinical Diabetic Cardiomyopathy: A Systematic Review and Meta‐Analysis

2021 ◽  
Author(s):  
Seyed‐Mohammad Ghoreyshi‐Hefzabad ◽  
Prajith Jeyaprakash ◽  
Alpa Gupta ◽  
Ha Q. Vo ◽  
Faraz Pathan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Meta Analysis ◽  
Global Longitudinal Strain ◽  
Three Dimensional ◽  
Significant Heterogeneity ◽  
Global Circumferential Strain ◽  
Patients With Diabetes

Background Three‐dimensional (3D) speckle tracking echocardiography can identify subclinical diabetic cardiomyopathy without geometric assumption and loss of speckle from out‐of‐plane motions. There is, however, significant heterogeneity among the previous reports. We performed a systematic review and meta‐analysis to compare 3D strain values between adults with asymptomatic, subclinical diabetes mellitus (ie, patients with diabetes mellitus without known clinical manifestations of cardiac disease) and healthy controls. Methods and Results After systematic review of 5 databases, 12 valid studies (544 patients with diabetes mellitus and 489 controls) were eligible for meta‐analysis. Pooled means and mean difference (MD) using a random‐effects model for 3D global longitudinal, circumferential, radial, and area strain were calculated. Patients with diabetes mellitus had an overall 2.31 percentage points lower 3D global longitudinal strain than healthy subjects (16.6%, 95% CI, 15.7–17.6 versus 19.0; 95% CI, 18.2–19.7; MD, −2.31, 95% CI, −2.72 to −2.03). Similarly, 3D global circumferential strain (18.9%; 95% CI, 17.5–20.3 versus 20.5; 95% CI, 18.9–22.1; MD, −1.50; 95% CI, −2.09 to −0.91); 3D global radial strain (44.6%; 95% CI, 40.2–49.1 versus 48.2; 95% CI, 44.7–51.8; MD, −3.47; 95% CI, −4.98 to −1.97), and 3D global area strain (30.5%; 95% CI, 29.2–31.8 versus 32.4; 95% CI, 30.5–34.3; MD, −1.76; 95% CI, −2.74 to −0.78) were also lower in patients with diabetes mellitus. Significant heterogeneity was noted between studies for all strain directions (inconsistency factor [I 2 ], 37%–78%). Meta‐regression in subgroup analysis of studies using the most popular vendor found higher prevalence of hypertension as a significant contributor to worse 3D global longitudinal strain. Higher hemoglobulin A 1c was the most significant contributor to worse 3D global circumferential strain in patients with diabetes mellitus. Conclusions Three‐dimensional myocardial strain was reduced in all directions in asymptomatic diabetic patients. Hypertension and hemoglobin A 1c were associated with worse 3D global longitudinal strain and 3D global circumferential strain, respectively. Registration URL: https://www.crd.york.ac.uk/prospero ; unique identifier: CRD42020197825.

Abstract 12145: Cardiac Magnetic Resonance Late Gadolinium Enhancement is Associated With Ventricular Elastance That May Predict Latent Ventricular Dysfunction After Fontan Procedure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Michihiro Okuyama ◽  
Shuta Ishigami ◽  
Daiki Ousaka ◽  
Junko Kobayashi ◽  
Sadahiko Arai ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Late Gadolinium Enhancement ◽  
Magnetic Resonance ◽  
Prognostic Value ◽  
Circumferential Strain ◽  
Fontan Procedure ◽  
Volume Index ◽  
Gadolinium Enhancement ◽  
Global Circumferential Strain ◽  
Ventricular Elastance

Backgrounds: Systemic right ventricular circulation after Fontan procedures is known to have late hemodynamic complications. Although a number of studies have investigated the factors that may impact on survival, postoperative outcomes after palliations remain to be elucidated. Objective: The purpose of this study is to investigate the prognostic value of myocardial fibrosis identified by cardiac magnetic resonance imaging (cMRI) in patients with single ventricular physiology. Methods: Consecutive 23 patients undergoing Fontan procedures were prospectively scheduled to have cMRI study with late gadolinium enhancement (LGE) imaging and ventricle circumferential strain measurement before and 4 months after Fontan operation. Results: Of 23 patients (mean age 3.3±0.9 years), 7 were positive for LGE (LGE+) and median percent LGE was 3.0% (interquartile range 3.0% to 7.5%). Pre-Fontan examinations revealed that patients with LGE+ showed an increase in end-diastolic volume index (139.7±26.8 ml/BSA vs. 113.3±20.9 ml/BSA; P=0.02) and end-systolic volume index (ESVI: 99.9±32.2 ml/BSA vs. 70.8±20.0 ml/BSA; P=0.01) compared with those without LGE (LGE-). In contrast to LGE- group, LGE+ patients showed lower global circumferential strain (4.1±2.3% vs. 7.9±2.7%, P=0.006), decreased ejection fraction (EF: 29±9.1% vs. 38±8.7%; P=0.04), and reduced end-systolic elastance (1.1±0.3 mm Hg/ml/m2 vs. 1.7±0.5 mm Hg/ml/m2). In addition, LGE+ group had higher levels of BNP (91.0±72.4 pg/ml vs. 30.9±44.0 pg/ml, P=0.02) and New York University Pediatric Heart Failure Index (10.9±3.3 vs. 7.8±1.1, P=0.02) than LGE- group. This was validated by positive correlations between the area of LGE versus ESVI (r=0.85, P=0.01) and BNP levels (r=0.82, P=0.02), respectively. At 4 months after Fontan procedure, LGE- group showed higher EF (37.5±8.6% vs. 24.0±8.9%, P=0.02) compared with those in LGE+ patients, and increased global circumferential strain (6.5±2.0% to 7.4±2.7%, P=0.04). Conclusion: LGE identified by cMRI before operation may be associated with lower ventricular elastance that resulted in poorer functional recovery after staged palliation. This novel strategy may provide a prognostic value of latent myocardial dysfunction after Fontan procedure.

scholarly journals Patients with acute myocarditis and preserved systolic left ventricular function: comparison of global and regional longitudinal strain imaging by echocardiography with quantification of late gadolinium enhancement by CMR

2021 ◽  
Author(s):  
Christine Meindl ◽  
Michael Paulus ◽  
Florian Poschenrieder ◽  
Florian Zeman ◽  
Lars S. Maier ◽  
...  
Keyword(s):  
Late Gadolinium Enhancement ◽  
Longitudinal Strain ◽  
Acute Myocarditis ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Gadolinium Enhancement ◽  
Ventricular Ejection Fraction ◽  
Group 2 ◽  
Group 1

Abstract Background Conventional transthoracic echocardiography (TTE) does often not accurately reveal pathologies in patients with acute myocarditis and preserved left ventricular ejection fraction (LVEEF). Therefore, we investigated the diagnostic value of two-dimensional (2D) speckle tracking echocardiography compared to late gadolinium enhancement (LGE) by cardiac magnetic resonance (CMR) imaging in patients with acute myocarditis and normal global LVEF. Methods and results 31 patients (group 1) with the diagnosis of acute myocarditis confirmed by CMR according to the Lake Louise criteria and 20 healthy controls (group 2) were analyzed including global longitudinal strain (GLS) and regional longitudinal strain (RLS) derived by the bull’s eye plot. Although preserved LVEF was present in both groups, GLS was significantly lower in patients with acute myocarditis (group 1: GLS − 19.1 ± 1.8% vs. group 2: GLS − 22.1 ± 1.7%, p < 0.001). Compared to controls, lower RLS values were detected predominantly in the lateral, inferolateral, and inferior segments in patients with acute myocarditis. Additionally RLS values were significantly lower in segments without LGE. Conclusion In patients with acute myocarditis and preserved LVEF, a significant reduction of GLS compared to healthy subjects was detected. Further RLS adds important information to the localization and extent of myocardial injury. Graphic abstract

Circumferential deformation in diagnosis and risk assessment of patients with left ventricular non-compaction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Anwer ◽  
P.S Heiniger ◽  
S Rogler ◽  
D Cassani ◽  
L Rebellius ◽  
...  
Keyword(s):  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Strong Association ◽  
Global Longitudinal Strain ◽  
Diagnostic Algorithm ◽  
Left Ventricular ◽  
Deformation Analysis ◽  
Funding Source ◽  
Apical Rotation ◽  
Increased Risk

Abstract Introduction Echocardiography-based deformation analysis is used for studying left ventricular (LV) mechanics and have an emerging role in the diagnosis of cardiomyopathies. Left ventricular non-compaction (LVNC) is a rare cardiomyopathy characterised by a two-layered LV myocardium with prominent trabeculae separated by deep recesses perfused from the LV cavity. Left ventricular hypertrabeculation (LVHT) may be difficult to differentiate from LVNC. In this study, we aim to develop a diagnostic algorithm based on the circumferential deformation (CD) of LVNC, LVHT and controls; and find their associations with LVNC outcomes. Methods We compared 45 LVNC patients, 45 LVHT individuals, and 45 matched healthy controls. LVNC was diagnosed according to current echocardiographic criteria. LVHT was defined as presence of three or more trabeculae in the LV apex visualised in both parasternal short axis and apical views. Controls had a normal echocardiographic examination and no evidence of cardiovascular disease. Strain analysis was performed using TomTec Image-Arena (version 4.6). Results Receiver observer characteristics curve (ROC) analyses revealed that GCS &lt;22.3% differentiated LVNC from control or LVHT. In individuals with global circumferential strain (GCS) below 22.3%, an apical peak circumferential strain (PCS) cut-off value of 18.4% differentiated LVNC [&lt;18.4%] and LVHT [≥18.4%] (fig. 1). An independent echocardiographer (Table 1) performed blind validation of diagnosis on 32 subjects from each group. Combined endpoint of cardiovascular events in LVNC (CVE) is described in figure 2. Multi-variate regression analyses have shown that GCS was associated with 11-fold increased risk of CVE independent of LVEF and NC:C ratio, while global longitudinal strain (GLS) displayed only 2-fold increased risk. Regional basal and apical peak circumferential or longitudinal strain, left ventricular twist, basal-apical rotation ratio have shown significant associations (Fig. 3). Conclusions A diagnostic algorithm with GCS and aPCS (threshold value 18.4%) differentiates LVNC from LVHT and control with very high sensitivity and specificity independent of additional echocardiographic or clinical information. Circumferential strain derived parameters exhibit a very strong association with outcomes independent of LVEF and NC:C ratio. Absence of CVE in LVHT provides further evidence on the distinct nature of LVNC and LVHT. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): 2018 research grant from the Swiss Heart Foundation

Abstract 18181: Left Ventricular Myocardial Mechanics at Rest and During Exercise in Children After Arterial Switch Operation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Barbara Cifra ◽  
Andreea Dragulescu ◽  
Heynric Grotenhuis ◽  
Cedric Manlhiot ◽  
Mark K Friedberg ◽  
...  
Keyword(s):  
Stress Echocardiography ◽  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Arterial Switch Operation ◽  
Global Longitudinal Strain ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Peak Exercise ◽  
Arterial Switch ◽  
Switch Operation

Introduction: Arterial switch operation (ASO) is the standard surgical procedure for transposition of the great arteries allowing a complete anatomical and physiological repair. In these patients the functional impact of myocardial perfusion on global and regional myocardial function has not been investigated. Stress echocardiography with visual myocardial assessment has been used to detect regional myocardial dysfunction. Studying LV mechanics using speckle-tracking echocardiography during exercise could provide more quantitative information. The aim of the study was to study the myocardial response to exercise in children after ASO using semi-supine cycle ergometry stress echocardiography (SSCE). Materials and Methods: Forty children after ASO and 29 age and gender matched controls were included. Median age was 14 years. A stepwise SSCE protocol was used. LV global longitudinal strain and circumferential strain was measured in all subjects at rest and at incremental heart rate. Results: Resting HR was similar between groups, peak HR was lower in the ASO group compared with controls (142 ±11 vs 157±14 bpm, p=0.0007). LV global longitudinal strain was lower at rest (19±2.3% vs. 21±2.5%, p=0.004) but not at peak exercise (22.7±5.6 % vs. 24±4.5 % p=0.2) in the ASO group compared to controls. No significant difference was found in LV global circumferential strain at rest (23.7±2.3% vs. 24±3.2 %, p=0.6) and peak exercise (28±2.6% vs. 27.9±4.1 %, p=0.9). Also when plotted versus heart rates the increase in longitudinal and circumferential strain values were not significantly different. Conclusions: These data show that circumferential and longitudinal myocardial deformation during exercise is preserved in children after ASO compared to controls. Earlier data obtained using Tissue Doppler in the same study cohort, showed a normal increase in systolic tissue Doppler velocities. These data suggest a preserved LV reserve during exercise in this patient cohort.

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