scholarly journals Two-dimensional echocardiography compared to cardiac computed tomography for assessment of left ventricular volume and function in patients with anteroapical aneurysm

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
O Nemchyna ◽  
N Solowjowa ◽  
M Dandel ◽  
Y Hrytsyna ◽  
J Knierim ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cox Regression ◽  
Left Ventricular ◽  
Two Dimensional ◽  
Prognostic Role ◽  
2D Echocardiography ◽  
Significant Difference ◽  
Lv Volumes ◽  
And Function ◽  
Lv Aneurysm

Abstract Funding Acknowledgements Type of funding sources: None. Background. Two-dimensional (2D) echocardiography is widely accepted method for the assessment of left ventricular (LV) morphology and function after myocardial infarction and for initial preoperative evaluation of patients planned for surgical ventricular repair (SVR). Magnetic resonance imaging and cardiac computer tomography (CT) provide more accurate measurements, but not always available. Purpose. The aim of this study was to compare 2D-echocardiography and CT for preoperative assessment of patients with LV aneurysm in order to optimize the perioperative management in SVR. Methods. Patients (n = 179, mean age 62.6 ± 11 years, 23.5% women) with LV anteroapical aneurysm due to myocardial infarction were examined by echocardiography and CT before SVR. LV end-diastolic and end-systolic volumes (LVEDV and LVESV) and ejection fraction (EF) obtained by two methods were compared pairwise. Prognostic role for the prediction of all-cause death was assessed for preoperative parameters in multivariate Cox regression model adjusted for patient age, sex, NYHA class, diabetes mellitus, renal failure, atrial fibrillation and arterial hypertension. Results. There was a strong correlation for preoperative LVEDV and LVESV measured by echocardiography and CT (r = 0.85, r = 0.87, p < 0.0001), however volumes obtained by echocardiography were smaller compared to those by CT (Table) with higher difference in patients with more dilated LV, as demonstrated by Bland-Altman analysis (Fig.). No significant difference in mean preoperative EF was observed with moderate correlation between two methods (r = 0.67, p < 0.0001). In total 68 patients died during median follow up of 5.3 years (IQR: 1.7-8.7 years) after SVR. Comparable predictive value was demonstrated for LVEDV measured by CT and echocardiography (for 10 ml increase HR = 1.04, p = 0.004 and HR = 1.06, p = 0.0001), as well as for LVESV (for 10 ml increase HR = 1.04, p = 0.001 and HR = 1.07, p = 0.0001) and for EF (for 5% increase HR = 0.83, p = 0.004 and HR = 0.81, p = 0.004). Conclusion. In patients with LV aneurysm 2D-echocardiography may be used for the assessment of LV volumes and function and have similar prognostic role compared to CT in patients evaluated for SVR. Underestimation of LV volumes by echocardiography must be considered, especially in patients with more dilated LV. Comparison of CT and echocardiography Parameter CT Echo Mean difference p-value LVEDV, ml LVESV, ml EF, % 289 ± 104 198 ± 97 34 ± 12 222 ± 81 149 ± 67 35 ± 9 67 ± 56 49 ± 51 -0.9 ± 9.2 <0.0001 <0.0001 0.215 Abstract Figure. Bland-Altman plots for LVEDV and LVESV

scholarly journals Evaluation by Dipirydamole MRI of the effects of cardiac rehabilitation after myocardial infarction

2007 ◽  
Vol 30 (3) ◽  
pp. 33
Author(s):  
P. Blanc ◽  
H. Douard ◽  
M. Courregelongue ◽  
J. M. Perron ◽  
R. Roudaut ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Perfusion ◽  
Cardiac Mri ◽  
Work Capacity ◽  
Left Ventricular ◽  
Control Group ◽  
Preliminary Study ◽  
Lv Volumes ◽  
And Function ◽  
First Myocardial Infarction

Background: The effects of exercise training (ET) on myocardial perfusion after myocardial infarction have been well studied with scintigraphy whereas cardiac MRI seems a better technique which was not used yet in the literature in this indication. Methods: 11 patients after a first myocardial infarction were left again in 2 groups: a 20 session-ET program (T, n=6) and a control group (C, n=5). All patients underwent a dipirydamole MRI and a cardiopulmonary test at entry and after 3 months. Results At 3 months, improvements in work capacity (P < 0,05), peak VO2 (P < 0,05) were observed in T but not in C. Ejection fraction and left ventricular (LV) volumes were unchanged in T and C. Myocardial perfusion assessed by MRI was comparable at rest and after dipirydamole in each group. The recuperation of the segmentary kinetics was inversely proportional to the delayed enhancement given by MRI and was better for T than for C (P < 0,02). Conclusions: This is a preliminary study. Cardiac MRI makes it possible to apprehend perfusion in a reliable and reproducible way. ET has no detrimental effects on LV volumes and function; rather, it improves recovery of infarcted segments.

Prognostic role of left ventricular diastolic function assessed by speckle tracking echocardiography in patients after surgical ventricular repair

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
O Nemchyna ◽  
N Solowjowa ◽  
M Dandel ◽  
Y Hrytsyna ◽  
J Stein ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Prognostic Role ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Lv Diastolic Function ◽  
Lv Aneurysm

Abstract Background Assessment of left ventricular (LV) diastolic function brings important prognostic information for patients with heart failure and could be evaluated by speckle tracking echocardiography (STE). Less known about its role in patients planned for surgical ventricular repair due to LV aneurysm. Purpose The aim of this study was to evaluate the prognostic role of STE parameters of LV diastolic function for prediction of all-cause mortality in patients after surgical ventricular repair. Methods We retrospectively evaluated data of 163 consecutive pts (mean age 62.3±11.5 years, 74.8% males) with anteroapical LV aneurysm who underwent surgical ventricular repair combined with coronary artery bypass surgery (71.8%) Prognostic role for prediction of all-cause mortality was assessed for various STE parameters, including left atrial strain (LAS) measured as peak reservoir strain and for the ratio of early to late global longitudinal strain rate (GLSRe/GLSRa). Results During a median follow-up of 4.7 years (IQR: 1.6–8.9 years) there were 65 deaths, 5 year survival rate was 73.8 (95% CI 67–79%). Baseline ejection fraction, end-diastolic and end-systolic volumes of LV did not differ between pts who died and survived at 5 year after the surgery, whereas LAS was significantly higher and GLSRe/GLSRa was significantly lower in survivors. Cox proportional hazard model adjusted to demographic and clinical variables demonstrated that LAS and GLSRe/GLSRa were independent predictors of all-cause death, with HR of 0.79 (95% CI 0.66–0.95, p=0.012) for each 5% increase of LAS and HR of 1.24 (95% CI 1.1–1.4, p=0.001) for each 0.5 increase of GLSRe/GLSRa. Moreover, GLSRe/GLSRa remained an independent predictor after additional adjustment for LV end-systolic volume, sphericity index and presence of mitral insufficiency of grade 2 and higher. A significant difference in median survival time was demonstrated according to the following cut-offs: LAS ≥16.7% (12.1 vs. 6.4 years, p=0.01), GLSRe/GLSRa ratio ≥2.3 (3.3 years vs. 10.2 years, p=0.0005) (Figure). The classification and regression tree analysis with the application of all two-dimensional, Doppler and various speckle-tracking echocardiographic parameters revealed that GLSRe/GLSRa and LAS were the most important echocardiographic variables for risk stratification for 5-year mortality. Conclusion This study demonstrates that STE parameters of LV diastolic function are important predictors of all-cause mortality after surgical ventricular repair due to anteroapical aneurysm of LV and could be used in the preoperative decision-making process. Funding Acknowledgement Type of funding source: None

scholarly journals Reliability of respiratory-triggered two-dimensional cine k-adaptive-t-autocalibrating reconstruction for Cartesian sampling for the assessment of biventricular volume and function in patients with repaired tetralogy of Fallot

2021 ◽  
Vol 94 (1120) ◽  
pp. 20201249
Author(s):  
Makoto Orii ◽  
Tsuyoshi Sugawara ◽  
Hidenobu Takagi ◽  
Satoshi Nakano ◽  
Hironobu Ueda ◽  
...  
Keyword(s):  
Image Quality ◽  
Tetralogy Of Fallot ◽  
Left Ventricular ◽  
Breath Hold ◽  
Two Dimensional ◽  
Reliable Technique ◽  
Repaired Tetralogy Of Fallot ◽  
Scan Time ◽  
Significant Difference ◽  
And Function

Objective: To compare left ventricular (LV) and right ventricular (RV) volume, function, and image quality of a respiratory-triggered two-dimensional (2D)-cine k-adaptive-t-autocalibrating reconstruction for Cartesian sampling (2D kat-ARC) with those of the standard reference, namely, breath-hold 2D balanced steady-state free precession (2D SSFP), in patients with repaired tetralogy of Fallot (TOF). Methods: 30 patients (14 males, mean age 32.2 ± 13.9 years) underwent cardiac magnetic resonance, and 2D kat-ARC and 2D SSFP images were acquired on short-axis view. Biventricular end-diastolic volume (EDV) and end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and LV mass (LVM) were analysed. Results: The 2D kat-ARC had significantly shorter scan time (35.2 ± 9.1 s vs 80.4 ± 16.7 s; p < 0.0001). Despite an analysis of image quality showed significant impairment using 2D kat-ARC compared to 2D SSFP cine (p < 0.0001), the two sequences demonstrated no significant difference in terms of biventricular EDV, LVESV, LVSV, LVEF, and LVM. However, the RVESV was overestimated for 2D kat-ARC compared with that for 2D SSFP (73.8 ± 43.2 ml vs 70.3 ± 44.5 ml, p = 0.0002) and the RVSV and RVEF were underestimated (RVSV = 46.2±20.5 ml vs 49.4 ± 20.4 ml, p = 0.0024; RVEF = 40.2±12.7% vs. 43.5±14.0%, p = 0.0002). Conclusion: Respiratory-triggered 2D kat-ARC cine is a reliable technique that could be used in the evaluation of LV volumes and function. Advances in knowledge: 2D cine kat-ARC is a reliable technique for the assessment LV volume and function in patients with repaired TOF.

scholarly journals Three-dimensional Real-time Triplane versus Biplane Simpson for left ventricular ejection fraction estimation after ST-Segment Elevation Myocardial Infarction

2021 ◽  
Author(s):  
Diogo Rodrigues Brás ◽  
Carla Reis ◽  
Eduarda Horta ◽  
Miguel Mendes ◽  
Maria João Andrade
Keyword(s):  
Myocardial Infarction ◽  
Reference Method ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Significant Difference ◽  
Lv Volumes

Abstract Purpose: The Biplane Simpson (BPS) remains the recommended 2-dimensional method to assess left ventricular ejection fraction (LVEF). However, it has known limitations that may be overcome with 3D real-time triplane (RTTP), for instance, obtaining all apical views simultaneously at the same cardiac cycle. Accurate LVEF measurement is of utmost importance, as it guides the allocation of many treatments that reduce morbidity and mortality in heart failure. We sought to compare LVEF and volumes assessed by BPS and RTTP, using 3D LV full volume as reference, in patients with ST-segment elevation myocardial infarction (STEMI).Methods and results: Prospective study that included consecutive STEMI patients. LV volumes and EF were compared between BPS and RTTP and the reference method. Fifty-two patients were studied and anterior MI was the most frequent location (44%). There was strong correlation between EF measured by BPS (r=0.80, p<0.001) and RTTP (r=0.91, p<0.001) versus the reference method, with significant difference between coefficients (0.11, p=0.034). EF by BPS attained a good inter-operator agreement, with an intraclass correlation (ICC) of 0.82 (95% CI 0.710-0.894,p<0.001), as well as EF by RTTP (ICC 0.88, 95% CI 0.801–0.930,p<0.001), without statistically significant difference between the two methods (p=0.279).Conclusion: Estimation of LV volumes and EF by RTTP method showed higher correlation than BPS with 3D-echocardiography, in a population of STEMI patients. As an accurate LVEF estimation is of high relevance for its potential to alter clinical decision pathways, this data points to the usefulness of the RTTP method, especially in myocardial infarction setting.

scholarly journals ECHOCARDIOGRAPHY IN RIGHT VENTRICULAR MYOCARDIAL INFARCTION

2013 ◽  
Vol 12 (3) ◽  
pp. 58-62
Author(s):  
H. G. Hayrapetyan ◽  
K. G. Adamyan
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Structure And Function ◽  
Two Dimensional ◽  
Tei Index ◽  
Global Function ◽  
Area Change ◽  
2D Echocardiography ◽  
Right Ventricular Myocardial Infarction ◽  
And Function

This paper presents the views on two-dimensional (2D) echocardiography (EchoCG) in the assessment of right ventricular (RV) structure and function. In order to quantitatively assess the RV global function, the following parameters can be used: RV outflow tract shortening fraction, RV fractional area change, tricuspid annular plane systolic excursion, and Tei index. For these parameters, their assessment methods, as well as their strengths and limitations, are discussed.

scholarly journals Myocardial deformation in patients with a single left ventricle using 2D cardiovascular magnetic resonance feature tracking: a case–control study

2021 ◽  
Author(s):  
Fabian Strodka ◽  
Jana Logoteta ◽  
Roman Schuwerk ◽  
Mona Salehi Ravesh ◽  
Dominik Daniel Gabbert ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Feature Tracking ◽  
Systolic Function ◽  
Radial Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Significant Difference ◽  
Lv Volumes

AbstractVentricular dysfunction is a well-known complication in single ventricle patients in Fontan circulation. As studies exclusively examining patients with a single left ventricle (SLV) are sparse, we assessed left ventricular (LV) function in SLV patients by using 2D-cardiovascular magnetic resonance (CMR) feature tracking (2D-CMR-FT) and 2D-speckle tracking echocardiography (2D-STE). 54 SLV patients (11.4, 3.1–38.1 years) and 35 age-matched controls (12.3, 6.3–25.8 years) were included. LV global longitudinal, circumferential and radial strain (GLS, GCS, GRS) and strain rate (GLSR, GCSR, GRSR) were measured using 2D-CMR-FT. LV volumes, ejection fraction (LVEF) and mass were determined from short axis images. 2D-STE was applied in patients to measure peak systolic GLS and GLSR. In a subgroup analysis, we compared double inlet left ventricle (DILV) with tricuspid atresia (TA) patients. The population consisted of 19 DILV patients, 24 TA patients and 11 patients with diverse diagnoses. 52 patients were in NYHA class I and 2 patients were in class II. Most SLV patients had a normal systolic function but median LVEF in patients was lower compared to controls (55.6% vs. 61.2%, p = 0.0001). 2D-CMR-FT demonstrated reduced GLS, GCS and GCSR values in patients compared to controls. LVEF correlated with GS values in patients (p < 0.05). There was no significant difference between GLS values from 2D-CMR-FT and 2D-STE in the patient group. LVEF, LV volumes, GS and GSR (from 2D-CMR-FT) were not significantly different between DILV and TA patients. Although most SLV patients had a preserved EF derived by CMR, our results suggest that, LV deformation and function may behave differently in SLV patients compared to healthy subjects.

Right ventricular rather than left ventricular systolic dysfunction predicts outcome in patients undergoing transcatheter aortic valve implantation: insights from cardiac magnetic resonance imaging

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Koschutnik ◽  
C Nitsche ◽  
C Dona ◽  
V Dannenberg ◽  
A.A Kammerlander ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cox Regression ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Prognostic Information ◽  
Transcatheter Aortic Valve ◽  
Kaplan Meier ◽  
Lv Volumes ◽  
Valve Implantation ◽  
Rv Function

Abstract Background Right ventricular (RV) function is strongly associated with outcome in heart failure. Whether it also adds important prognostic information in patients undergoing transcatheter aortic valve implantation (TAVI) is unknown. Methods We consecutively enrolled patients with severe aortic stenosis (AS) scheduled for TAVI and preprocedural cardiac magnetic resonance (CMR) imaging. Kaplan-Meier estimates and multivariate Cox regression analyses were used to identify factors associated with outcome. A composite of heart failure hospitalization and/or cardiovascular death was selected as primary study endpoint. Results 423 consecutive patients (80.7±7.3 years; 48% female) were prospectively included, 201 (48%) underwent CMR imaging. 55 (27%) patients presented with RV systolic dysfunction (RVSD) defined by RV ejection fraction (RVEF) &lt;45%. RVSD was associated with male sex (69 vs. 40%; p&lt;0.001), New York Heart Association (NYHA) functional status (NYHA ≥ III: 89 vs. 57%; p&lt;0.001), NT-proBNP serum levels (9365 vs. 2715 pg/mL; p&lt;0.001), and history of atrial fibrillation (AF: 51 vs. 30%; p=0.005). On CMR, RVSD was associated with left ventricular (LV) volumes (end-diastolic: 187 vs. 137 mL, end-systolic: 119 vs. 53 mL; p&lt;0.001) and EF (39 vs. 64%; p&lt;0.001). A total of 51 events (37 deaths, 14 hospitalizations for heart failure) occurred during follow-up (9.8±9 months). While LVSD (LVEF &lt;50%) was not significantly associated with outcome (HR 0.83, 95% CI: 0.33 – 2.11; p=0.694), RVSD showed a strong and independent association with event-free survival by multivariate Cox regression analysis (HR 2.47, 95% CI: 1.07–5.73; p=0.035), which was adjusted for all relevant CMR parameters (LV volumes and EF), cardiovascular risk factors (sex, NYHA, AF, diabetes mellitus type II, use of diuretics), and routine biomarkers (NT-proBNP, creatinine). Conclusions RVSD rather than LVSD, as determined on CMR, is an important predictor of outcome in patients undergoing TAVI. RV function might thus add useful prognostic information on top of established risk factors. Figure 1. Kaplan-Meier survival curves Funding Acknowledgement Type of funding source: None

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