scholarly journals Abnormal myocardial work in children with Kawasaki disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jolanda Sabatino ◽  
Nunzia Borrelli ◽  
Alain Fraisse ◽  
Jethro Herberg ◽  
Elena Karagadova ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Systolic Function ◽  
Myocardial Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
High Morbidity ◽  
Additional Group ◽  
Constructive Work ◽  
Lv Systolic Function ◽  
Normal Lvef

AbstractKawasaki disease (KD) can be associated with high morbidity and mortality due to coronary artery aneurysms formation and myocardial dysfunction. Aim of this study was to evaluate the diagnostic performance of non-invasive myocardial work in predicting subtle myocardial abnormalities in Kawasaki disease (KD) children with coronary dilatation (CADL). A total of 100 patients (age 8.7 ± 5 years) were included: 45 children with KD and CADL (KD/CADL) (Z-score > 2.5), 45 age-matched controls (CTRL) and, finally, an additional group of 10 children with KD in absence of coronary dilatation (KD group). Left ventricular (LV) systolic function and global longitudinal strain (GLS) were assessed. Global myocardial work index (MWI) was calculated as the area of the LV pressure-strain loops. From MWI, global Constructive Work (MCW), Wasted Work (MWW) and Work Efficiency (MWE) were estimated. Despite normal LV systolic function by routine echocardiography, KD/CADL patients had lower MWI (1433.2 ± 375.8 mmHg% vs 1752.2 ± 265.7 mmHg%, p < 0.001), MCW (1885.5 ± 384.2 mmHg% vs 2175.9 ± 292.4 mmHg%, p = 0.001) and MWE (994.0 ± 4.8% vs 95.9 ± 2.0%, p = 0.030) compared to CTRL. Furthermore, MWI was significantly reduced in children belonging to the KD group in comparison with controls (KD: 1498.3 ± 361.7 mmHg%; KD vs CTRL p = 0.028) and was comparable between KD/CADL and KD groups (KD/CADL vs KD p = 0.896). Moreover, KD/CADL patients with normal GLS (n = 38) preserved significant differences in MWI and MCW in comparison with CTRL. MWI, MCW and MWE were significantly reduced in KD children despite normal LVEF and normal GLS. These abnormalities seems independent from CADL. Thus, in KD with normal LVEF and normal GLS, estimation of MWI may be a more sensitive indicator of myocardial dysfunction.

scholarly journals P316 A feasible and accurate method for the assessment of early ventricular dysfunction in children with kawasaki disease: result from the MyoWoRK (myocardial work related to kawasaki disease) study

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
N S Borrelli ◽  
G Di Salvo ◽  
J Sabatino ◽  
M Avesani ◽  
E Filippini ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Systolic Function ◽  
Myocardial Dysfunction ◽  
Left Ventricular ◽  
Unknown Etiology ◽  
Male Age ◽  
Significant Difference ◽  
Global Work ◽  
Lv Systolic Function

Abstract Funding Acknowledgements EACVI Training Grant Introduction Kawasaki disease (KD) is an acute vasculitis of unknown etiology. It is associated with high morbidity and mortality due to the development of coronary artery aneurysms and myocardial dysfunction. Purpose The aim of this study was to evaluate sensitivity and specificity of left ventricular (LV) pressure–strain loop (PSL) area, which reflects regional myocardial work and metabolic demand, in predicting subtle myocardial abnormalities in KD patients with coronaries aneurisms. Methods A total of 88 patients (59 male, age 8.95 ± 4.95 years) were included in our study. Among the children admitted in our institution with a diagnosis of KD during the study time frame, 42 patients (KDg) (29 male) with coronary artery dilatation (Z-score &gt;2.5) were selected. These cases were compared with 46 (30 male) age-matched controls (CTRg). Classical echocardiographic parameters of LV systolic function were normal in both groups, while global longitudinal strain (GLS) was decreased in 6 KD patients. Global work index (GWI) was calculated as the area of the LV PSL. From GWI, it was estimated also Global Constructive Work (GCW), Global Wasted Work (GWW) and Global Work Efficiency (GWE). We also made a subgroup analysis between KD patients with normal GLS (&gt; -19 %) and control patients. Results Despite normal LV systolic function by routine echocardiography, compared to controls, KD patients had lower GWI (1448 ± 382 mmHg% in KDg vs 1751 ± 263] mmHg% in CTRg, p = 0.00003), GCW (1904 ± 390 mmHg% in KDg vs 2174 ± 292 mmHg% in CTRg, p= 0.0004) and GWE (94 ± 5 % in KDg vs 96 ± 2 % in CTRg, p= 0.01). There was not significant difference in GWW between the KDg and CTRg. When KD patients with normal GLS were analysed separately, they preserved a significant difference in GWI, GCW and GWE in comparison with controls (GWI: 1490 ± 347 mmHg% in KDg vs 1751 ± 263 mmHg% in CTRg, p = 0.0002; GCW: 1972 ± 321 mmHg% in KDg vs 2174 ± 292 mmHg% in CTRg, p = 0.004; GWE: 95 ± 3 in KDg vs 96 ± 2 % in CTRg, p= 0.04). No association was found between GWI, GCW, GWW, GWE and number or dimension of the involved aneurysmatic coronaries. Conclusions The estimation of myocardial work by PSL is a novel tool for the evaluation of patients with KD. GWI, GCW and GWE were significantly reduced in KD patients with dilated coronaries. In KD patients with normal GLS, estimation of GWI, GCW and GWE may be a sensitive indicator of myocardial dysfunction and an adjuvant criterion to avoid delayed diagnosis of KD. Abstract P316 Figure. Myocardial work in KD and CTR.

Abstract 14432: Myocardial Work in Stage I and II Hypertensive Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Akshar Jaglan ◽  
Sarah Roemer ◽  
Ana C Perez Moreno ◽  
Bijoy K Khandheria
Keyword(s):  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Deformation Analysis ◽  
Hypertensive Patients ◽  
Reduced Ejection Fraction ◽  
Work Index ◽  
Significant Difference ◽  
Global Work ◽  
Lv Systolic Function

Introduction: Myocardial work is a novel parameter that can be used in a clinic setting to assess left ventricular (LV) pressures and deformation. This study sought to distinguish patterns of global myocardial work index in hypertensive vs. non-hypertensive patients. Methods: Fifty (25 male, mean age 60±14 years) hypertensive patients and 15 (7 male, mean age 38±12 years) control patients underwent transthoracic echocardiography at rest. Hypertensive patients were divided into stage 1 (26 patients) and stage 2 (24 patients) based on the 2017 American College of Cardiology guidelines. We excluded patients with suboptimal image quality for myocardial deformation analysis, reduced ejection fraction (EF), valvular heart disease, and arrhythmia. Global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) were estimated from LV pressure strain loops utilizing proprietary software from speckle-tracking echocardiography. LV systolic and diastolic pressures were estimated using a noninvasive brachial artery cuff. Results: Global longitudinal strain (GLS) and EF were preserved between the two groups with no statistically significant difference whereas there was a statistically significant difference in the GWI (p<0.01), GCW (p=0.03), GWW (p<0.01), and GWE (p=0.03) (Figure and Table). Conclusions: Myocardial work gives us a closer look at the relationship between LV pressure and contractility in settings of increased load dependency whereas LVEF and GLS cannot. We show how myocardial work is an advanced assessment of LV systolic function in hypertensive patients.

scholarly journals Evaluation of left ventricular myocardial work quantitatively by pressure-strain loop in young strength athletes with different heart rates

2021 ◽  
Author(s):  
Pengge Li ◽  
Yonggao Zhang ◽  
Lijin Li ◽  
Mengjiao Sun ◽  
Zhen Li ◽  
...  
Keyword(s):  
Systolic Function ◽  
Linear Regression Analysis ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Peak Strain ◽  
Work Efficiency ◽  
Heart Rates ◽  
Work Index ◽  
Lv Systolic Function

Objective: The present study aimed to investigate the difference in left ventricular (LV) global and regional myocardial (MW) of strength athletes with different heart rates (HR) through non-invasive LV pressure-strain loop (PSL) and further address the effect of athlete’s heart rate variability on the LV systolic function. Methods: Fifty young professional wrestlers were collected randomly and divided into two groups in accordance with their different HR: the low HR (45~60 bpm, n=25) and the high HR (60~80 bpm, n=25). Thirty individuals with gender- and age-matched healthy volunteers served as controls ( n=30). Global and regional MW parameters were evaluated using LV-PSL derived from speckle tracking echocardiography (STE) and brachial artery pressure, and then compared between the above three groups. Results: The indicators of global and regional MW did statistically significantly differ between the athlete and control groups. Peak strain dispersion (PSD) and global myocardial wasted work (GWW) increased while global myocardial work efficiency (GWE) reduced in LHR and HHR groups compared with the control group, and global myocardial work index (GWI), global myocardial constructive work (GCW), global longitudinal strain (GLS) decreased in LHR group ( P＜0.05). In comparison to the LHR group, GWI, GCW, GWW, PSD increased in HHR group and GWE reduced ( P＜0.05). According to the regional MW analysis, the mean regional myocardial work index (RMWI) increasing gradually from basal to apical levels were similar across the three groups and regional myocardial work efficiency (RMWE) did not. Multiple linear regression analysis indicated that the HR, posterior wall thickness (PWT), interventricular septal thickness (IVST), GLS, and PSD were correlated with GWE ( b’= -0.247, -0.390, -0.370, 0.340, and -0.554, respectively, P＜0.05). Conclusions: The LV contractile performance was more impaired in young strength athletes with high heart rates and PSL can be used to assess LV GMW and RMW quantitatively and accurately in reflecting LV systolic function.

scholarly journals Quantitative assessment of left ventricular longitudinal function and myocardial deformation in Duchenne muscular dystrophy patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Roman Panovský ◽  
Martin Pešl ◽  
Jan Máchal ◽  
Tomáš Holeček ◽  
Věra Feitová ◽  
...  
Keyword(s):  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Cardiac Involvement ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Radial Strain ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Muscle Impairment ◽  
Lv Systolic Function

Abstract Background Duchenne muscular dystrophy (DMD) manifests in males mainly by skeletal muscle impairment, but also by cardiac dysfunction. The assessment of the early phases of cardiac involvement using echocardiography is often very difficult to perform in these patients. The aim of the study was to use cardiac magnetic resonance (CMR) strain analysis and mitral annular plane systolic excursion (MAPSE) in the detection of early left ventricular (LV) dysfunction in DMD patients. Methods and results In total, 51 male DMD patients and 18 matched controls were examined by CMR. MAPSE measurement and functional analysis using feature tracking (FT) were performed. Three groups of patients were evaluated: A/ patients with LGE and LV EF < 50% (n = 8), B/ patients with LGE and LVEF ≥ 50% (n = 13), and C/ patients without LGE and LVEF ≥ 50% (n = 30). MAPSE and global LV strains of the 3 DMD groups were compared to controls (n = 18). Groups A and B had significantly reduced values of MAPSE, global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) in comparison to controls (p < 0.05). The values of MAPSE (11.6 ± 1.9 v 13.7 ± 2.7 mm) and GCS (− 26.2 ± 4.2 v − 30.0 ± 5.1%) were significantly reduced in group C compared to the controls (p < 0.05). Conclusion DMD patients had decreased LV systolic function measured by MAPSE and global LV strain even in the case of normal LV EF and the absence of LGE. FT and MAPSE measurement provide sensitive assessment of early cardiac involvement in DMD patients.

Longitudinal strain in patients with severe aortic regurgitation: superiority to ejection fraction for detection of myocardial dysfunction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.C Reil ◽  
G.-H Reil ◽  
N Necker ◽  
J Borer ◽  
H.H Sievers ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Aortic Regurgitation ◽  
Longitudinal Strain ◽  
Myocardial Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Stroke Work ◽  
Indication For Surgery ◽  
Severe Aortic Regurgitation ◽  
Normal Lvef

Abstract Objectives The aim of the study was to analyse LV systolic function and mechanical energetics in asymptomatic patients with severe aortic regurgitation (AR) to seek a new hemodynamic concept for timing for surgery. Background Current guidelines suggest surgery for patients with severe AR including clinical symptoms, subnormal LV ejection fraction (EF), or markedly abnormal left ventricular dimensions. However, the optimal measure to detect intrinsic myocardial systolic dysfunction in the presence of normal LVEF remains elusive. Methods Strain and echo-derived single beat pressure-volume analyses were performed in cohorts with severe AR without indication for surgery (ARNS; LVEDD &lt;70mm, EF &gt;50%, n=41), with indication for surgery (ARS; n=19) and in healthy, age-matched controls (C; n=20). Additionally, end-systolic elastance (Ees=LV contractility), stroke work (SW) and total energy (PVA) were calculated. Results Patients with ARNS demonstrated significant depression of LV contractility vs. C: Ees (1.5mmHg/ml ±0.7 vs. 2.25mmHg/ml ±0.7; p&lt;0.001), despite comparable ejection fractions (EF: 0.56±0.05 vs. 0.60±0.07; p=0.10). Accordingly, global longitudinal strain (GLS) was decreased (−16.0±2.5% vs. −21.5±2%; p&lt;0.001), end-diastolic volume markedly enlarged (236ml ±90 vs. 136ml ±30; p&lt;0.001), as were PVA and SW indicating waste of energy. The correlation of GLS vs. Ees was good (r=−0.68; p&lt;0.001). Results of ARS-patients were consistently worse. Conclusion Patients with severe AR and normal LVEF showed depressed LV contractility and waste of energy when assessed by Ees and GLS, both correlating well with each other. Hence, GLS may outperform LV dimensions for predicting timing for surgery and clinical outcomes in AR patients. Funding Acknowledgement Type of funding source: None

scholarly journals Assessment of global longitudinal strain and plasma natriuretic peptide in patients with asymptomatic left ventricular dysfunction

Kardiologiia ◽  
2021 ◽  
Vol 61 (10) ◽  
pp. 53-60
Author(s):  
Ganchimeg Ulziisaikhan ◽  
Mungun-Ulzii Khurelbaatar ◽  
Chingerel Khorloo ◽  
Naranchimeg Sodovsuren ◽  
Altaisaikhan Khasag ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Roc Curve ◽  
Longitudinal Strain ◽  
Troponin I ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Systolic Function

Objective    The purpose of this study was to investigate the association between global longitudinal strain (GLS) and plasma NT-proBNP for predicting left ventricular (LV) performance in asymptomatic patients after acute myocardial infarction (AMI).Material and methods    We prospectively included patients with diagnosis of AMI without clinical signs and symptoms of heart failure (HF) and followed these patients for 6 mos. Baseline echocardiography was performed at admission, and follow-up echocardiography was performed after 6 mos. A normal GLS was defined as having an absolute value of ≥16 %. According to the baseline GLS, participants were divided into two groups and compared. In all participants, blood samples of plasma NT-proBNP were obtained at admission, before discharge, and 6 mo after discharge.Results    The study population was consisted of 98 participants, of which 80 (81.6 %) were males, and the mean age was 56.0±9.3 years. Baseline echocardiography showed that most of the participants (60, 61.2 %) had abnormal GLS<16 %, whereas 38 (38.8 %) participants had normal or borderline GLS ≥16 %. Compared with the normal GLS group, participants with abnormal GLS had higher GRACE score, higher troponin I concentration, lower systolic blood pressure, lower mean LV ejection fraction, and decreased LV diastolic function. At 6‑mo follow-up, only LV systolic function remained significantly different between the two groups. Compared to baseline, there was a significant improvement of GLS in the abnormal GLS group at 6‑mo follow-up (p=0.04). Prevalence of complications after AMI was significantly higher in this group. There were significant differences between baseline and discharge NT-proBNP concentrations between the two groups (p<0.05). In the abnormal GLS group, there were significant correlations between baseline and discharge NT-proBNP concentrations with baseline LV systolic function. Discharge NT-proBNP concentration also correlated significantly with 6‑mo follow-up GLS. For determining the effect of baseline GLS abnormality, the areas under the ROC curve for baseline and discharge NT-proBNP concentrations were 0.73 (95 % CI 0.60–0.85, p=0.001) and 0.77 (95 % CI 0.66–0.87, p<0.001), respectively. Regarding early prediction of follow-up GLS abnormality, the area under the ROC curve for discharge NT-proBNP concentration was significantly higher 0.70 (95 % CI 0.55–0.84, p=0.016). The optimum cut-off value of discharge NT-pro-BNP was 688.5 pg / ml, with 72.4 % sensitivity and 65.4 % specificity to predict 6‑mon GLS abnormality following acute myocardial infarction.Conclusion    The main finding of this study is that impaired LV GLS is associated with elevated plasma concentrations of NT-proBNP in post-AMI patients. Pre-discharge NT-proBNP concentration combined with impaired initial GLS could predict worsening LV systolic function over time in asymptomatic post-AMI patients.

scholarly journals Evaluation of Left Ventricular Global and Regional Myocardial Work Quantitatively by Pressure-strain Loop in Young Strength Athletes With Different Heart Rates

2021 ◽  
Author(s):  
Pengge Li ◽  
Yonggao Zhang ◽  
Lijin Li ◽  
Mengjiao Sun ◽  
Zhen Li ◽  
...  
Keyword(s):  
Systolic Function ◽  
Linear Regression Analysis ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Peak Strain ◽  
Work Efficiency ◽  
Heart Rates ◽  
Work Index ◽  
Lv Systolic Function

Abstract Objective: The present study aimed to investigate the difference in left ventricular (LV) global and regional myocardial work (MW) of strength athletes with different heart rates (HR) through non-invasive LV pressure-strain loop (PSL) and further address the effect of athlete’s resting heart rate variability on the LV systolic function.Methods:Fifty young professional wrestlers were collected randomly and divided into two groups in accordance with their different heart rates: the low HR group (45~60 bpm, n1=25) and the high HR group (60~80 bpm, n2=25). Thirty individuals with gender- and age-matched healthy volunteers served as controls (n3=30). Global and regional MW parameters were evaluated using LV-PSL derived from speckle tracking echocardiography (STE) and brachial artery pressure. The differences between three groups of data and the linear relationship among conventional echocardiographic parameters and global myocardial work efficiency (GWE) were analyzed.Results:The indicators of global and regional MW did statistically significantly differ between the athlete and control groups. Compared with the control group, Peak strain dispersion (PSD) and global myocardial wasted work (GWW) increased while GWE reduced all in the low HR and high HR groups, and global myocardial work index (GWI), global myocardial constructive work (GCW), global longitudinal strain (GLS) decreased in the low HR group (all P＜0.05). In comparison to the low HR group, GWI, GCW, GWW, PSD increased in the high HR group and GWE reduced (P＜0.05). According to the regional MW analysis, the mean regional myocardial work index (RMWI) was increased gradually from basal to apical levels, which were similar across the three groups, but regional myocardial work efficiency (RMWE) did not. Multiple linear regression analysis indicated that the HR, posterior wall thickness (PWT), interventricular septal thickness (IVST), GLS, and PSD were well correlated with GWE (b’= -0.247, -0.390, -0.370, 0.340, and -0.554, respectively, P＜0.05).Conclusions:The sub-clinical changes of LV contractile performance were more obvious in young strength athletes with high resting heart rates and PSL could be used to assess LV GMW and RMW quantitatively and accurately in reflecting LV systolic function.

scholarly journals P1390 Myocardial work indices in the assessment of the systolic function of the left ventricle in amateur half marathon runners

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R Dankowski ◽  
A Szalek ◽  
J Tschurl ◽  
W Sacharczuk ◽  
A Baszko ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Volume Index ◽  
Training Period ◽  
Loading Conditions ◽  
Myocardial Mechanics ◽  
Constructive Work ◽  
The Impact

Abstract Background Myocardial work (MW) has been recently introduced as a tool for non-invasive assessment of left ventricular (LV) systolic function. It is based on myocardial strain analysis but incorporates also data regarding loading conditions, which is potential advantage of this technique. Purpose We south to evaluate the impact of a three-month training before the half-marathon on cardiac function using indices of MW. Methods The study included 28 young amateur runners (11 women, mean age 32 years). None of the participants had a prior history of cardiovascular disease. The group was assessed at the beginning of training period, after three month (within 48 hours before half-marathon), and within 72 hours after the run. We collected clinical, laboratory and echocardiographic data. All participants underwent echocardiography to assess myocardial mechanics and MW indices using speckle-tracking technique. Results 23 participants completed the training and all of them finished the race. After the training period we observed significant increase in LV end-diastolic diameter only (49,9 ± 0,94 mm vs 51,6 ± 0,9 mm, p= 0,007) with no significant change after the run. There were no changes in global longitudinal strain (GLS), global work index (GWI) global wasted work (GWW) neither after the training period nor after the run. We observed significant changes suggesting myocardial injury after the race, including slight increase of NT-proBNP and troponin levels, increase in left atrial volume index, and reduction of tissue Doppler lateral e` wave. Global constructive work (GCW) decreased significantly after the training period, with no change after the run (2122,0 ± 299,4 vs 1929,0 ± 227 vs 1986,5 ± 295,7 mmHg%; start of the training vs before the run assessment vs after the run assessment, respectively; p = 0,005). GCW was correlated significantly with systolic blood pressure, which decreased also significantly after the training period. Conclusion Three-months training before the participation in half-marathon run was not associated with significant changes in myocardial work indices except the global constructive work, which could be related to decrease of loading conditions. Despite the signs of myocardial injury there was no deterioration in myocardial mechanics parameters, which may indicate the beneficial effects of training before the half-marathon run.

P3377MDCT-derived left ventricular global longitudinal strain and left ventricular ejection fraction in patients with aortic stenosis: a comparative analysis with echocardiographic measurements

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Gegenava ◽  
P Bijl ◽  
M Vollema ◽  
F Kley ◽  
A Weger ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Mean Value ◽  
Left Ventricular ◽  
Altman Analysis ◽  
Limits Of Agreement ◽  
Bland Altman Analysis ◽  
Lv Systolic Function

Abstract Introduction Known predictors of poor outcome in aortic valve stenosis patients include older age, significant valvular calcification, rapid hemodynamic progression and impaired left ventricular (LV) systolic function. LV global longitudinal strain (GLS) quantifies myocardial deformation and LV function and is associated with prognosis in patients with severe aortic stenosis (AS). Multi-detector row computed tomography (MDCT) data are key in the evaluation of patients undergoing transcatheter aortic valve implantation (TAVI) and when acquired throughout the entire cardiac cycle, LV systolic function can be assessed. Novel software can assess LV GLS from MDCT-data. Purpose The present study aimed at assessing the feasibility of determining novel MDCT-derived LV GLS as well as MDCT-derived LV ejection fraction (EF) and their agreement with echocardiographic LV GLS and LVEF in patients treated with TAVI. Methods LVEF and LV GLS were measured on echocardiography and dynamic MDCT using novel CT-software. Agreement between the measurements of two different modalities was assessed using Bland-Altman analysis. Results A total 214 patients (51% male, mean age: 80±7 years) were analysed retrospectively. Mean value of LV GLS on echocardiography was −14±4% whereas mean MDCT-derived GLS was −12.5±4%. Mean value of LVEF on echocardiography was 47±10% and mean MDCT-derived LVEF was 39±11%. On Bland-Altman analysis, MDCT-derived strain analysis underestimated LV GLS compared to echocardiography with a mean difference of 1.44% (95% limits of agreement −3.8 to 6.7%). LVEF was also underestimated on CT with a mean difference of 7.68% (95% limits of agreement −11.5% to −26%). Correlation of measurements between MDCT-derived LV GLS and echocardiographic LV GLS was significant (r=0.791, p<0.001), as well as the correlation between MDCT-derived LVEF and echocardiographic LVEF (r=0.590, p<0.001) (Figure). Conclusions Assessment of LV GLS and LVEF on dynamic MDCT data provides similar values to those obtained with echocardiography and could be used in the risk-stratification of severe AS patients undergoing TAVI.

scholarly journals Prognostic Value of Left Ventricular Function and Mechanics in Pulmonary Hypertension: A Pilot Cardiovascular Magnetic Resonance Feature Tracking Study

Medicina ◽  
2019 ◽  
Vol 55 (3) ◽  
pp. 73 ◽  
Author(s):  
Lina Padervinskienė ◽  
Aušra Krivickienė ◽  
Deimantė Hoppenot ◽  
Skaidrius Miliauskas ◽  
Algidas Basevičius ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Cardiovascular Magnetic Resonance ◽  
Feature Tracking ◽  
Prognostic Value ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Lv Systolic Function

Background and objective: Cardiovascular magnetic resonance (CMR) - based feature tracking (FT) can detect left ventricular (LV) strain abnormalities in pulmonary hypertension (PH) patients, but little is known about the prognostic value of LV function and mechanics in PH patients. The aim of this study was to evaluate LV systolic function by conventional CMR and LV global strains by CMR-based FT analysis in precapillary PH patients, thereby defining the prognostic value of LV function and mechanics. Methods: We prospectively enrolled 43 patients with precapillary PH (mean pulmonary artery pressure (mPAP) 55.91 ± 15.87 mmHg, pulmonary arterial wedge pressure (PAWP) ≤15 mmHg) referred to CMR for PH evaluation. Using FT software, the LV global longitudinal strain (GLS) and global circumferential strain (GCS), also right ventricular (RV) GLS were analyzed. Results: Patients were classified into two groups according to survival (survival/non-survival). LV GLS was significantly reduced in the non-survival group (−12.4% [−19.0–(−7.8)] vs. −18.4% [−22.5–(−15.5)], p = 0.009). By ROC curve analysis, LV GLS > −14.2% (CI: 3.229 to 37.301, p < 0.001) was found to be robust predictor of mortality in PH patients. Univariable analysis using the Cox model showed that severely reduced LV GLS > −14.2%, with good sensitivity (77.8%) and high specificity (93.5%) indicated an increase of the risk of death by 11-fold. LV GLS significantly correlated in PH patients with RV ESVI (r = 0.322, p = 0.035), RV EF (r = 0.444, p < 0.003). Conclusions: LV systolic function and LV global longitudinal strain measurements using CMR-FT correlates with RV dysfunction and is associated with poor clinical outcomes in precapillary PH patients.

Sign in / Sign up

Export Citation Format

Share Document