scholarly journals Diastolic function assessed my CMR feature tracking is a predictor for outcomes in patients with suspected myocarditis and preserved left ventricular ejection fraction

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
B Bernhard ◽  
K Fischer ◽  
AW Stark ◽  
SA Erne ◽  
SJ Obrist ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Strain Rate ◽  
Diastolic Function ◽  
Feature Tracking ◽  
Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Diastolic Strain Rate ◽  
Lv Systolic Function

Abstract Funding Acknowledgements Type of funding sources: None. Diastolic function assessed my CMR feature tracking is a predictor for outcomes in patients with suspected myocarditis and preserved left ventricular ejection fraction Background Impairment of left ventricular (LV) systolic function was reported to be a valuable predictor for outcomes in patients with myocarditis. However, in patients with myocarditis and preserved LV systolic function, prediction of outcomes remains challenging. So far, minimal data exists about the prognostic role of diastolic function, as assessed by cardiac magnetic resonance imaging (CMR) in the clinical setting of suspected myocarditis. Purpose To determine the predictive value of LV diastolic function in patients with suspected myocarditis and preserved LV ejection fraction (LVEF). Methods In patients referred for CMR with clinically suspected myocarditis and LVEF≥50%, diastolic function was assessed by CMR feature tracking (FT). The primary endpoint was defined as a composite of major adverse cardiovascular events (MACE) including hospitalization for heart failure, recurrent myocarditis, sustained ventricular tachycardia and all-cause death. Results Of 381 patients included with clinically suspected myocarditis (216, 56.7% male, mean age 45.7 ± 16.4 years) late gadolinium enhancement (LGE) was present in 124 (32.4 %) of patients (mean LGE extent 4.9 ± 5.0 g). MACE occurred in 25 (6.6%) individuals at a median follow-up time of 4.5 years. In a univariate cox-regression model, radial, circumferential and longitudinal early diastolic strain rate (EDSR) and circumferential late diastolic strain rate were significantly associated with MACE. After adjustment for age, gender and extent of LGE, radial EDSR remained an independent predictor for MACE (HR = 2.26, 95% CI 1.06 to 4.8; p = 0.034). Conclusion Diastolic strain rate, as assessed by CMR-FT, can be useful in the prediction of outcomes in patients with myocarditis and preserved LVEF.

scholarly journals Accuracy of estimating left ventricular ejection fraction in clinical routine. A SWEDEHEART registry validation study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J Lenell ◽  
B Lindahl ◽  
P Karlsson ◽  
G Batra ◽  
D Erlinge ◽  
...  
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Systolic Function ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Funding Sources ◽  
Lv Systolic Function ◽  
Good Agreement

Abstract Objective Patients admitted to Swedish hospitals with myocardial infarction (MI) are reported to the nationwide Swedish registry for MI (SWEDEHEART). During hospital stay an echocardiography is routinely performed, and left ventricular ejection fraction (LVEF) is assessed according to the clinical praxis. LVEF is categorized as normal (>50%) or mild, moderate or severely impaired (40–49%, 30–39% and <30%, respectively) and reported to the registry by the treating center. The purpose of this study was to validate the reported LVEF assessments against independent echocardiography re-evaluation as this has never previously been done. Methods A random sample of 130 patient from three different hospitals were included. LVEF re-evaluation was performed by two independent reviewers using the modified biplane Simpson method and their mean LVEF was compared to the SWEDEHEART LVEF. Agreement between reported and re-evaluated LVEF was assessed using Gwet's AC2 statistics. Results Analysis showed good agreement between reported and reevaluated LVEF (AC2: 0.76 [95% CI 0.69–0.84]). The LVEF re-evaluations corresponded with registry reported categorized LVEF in 66.0% of cases. In 25.4% of cases the SWEDEHEART LVEF was lower than re-evaluated LVEF. The opposite relation was found in 8.6% of cases (p<0.005). Conclusion Independent validation of SWEDEHEART-reported LVEF shows an overall good agreement with the re-evaluated LVEF. However, a tendency to underestimation of LVEF was observed in patients with impaired LV systolic function, in whom the reported assessment of LVEF should be interpreted more cautiously. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Selanders Stiftelse

scholarly journals Detection of subclinical myocardial dysfunction in cocaine addicts with feature tracking cardiovascular magnetic resonance

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Alicia M. Maceira ◽  
Sara Guardiola ◽  
Carmen Ripoll ◽  
Juan Cosin-Sales ◽  
Vicente Belloch ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Strain Rate ◽  
Feature Tracking ◽  
Circumferential Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Dyssynchrony Index

Abstract Background Cocaine is an addictive, sympathomimetic drug with potentially lethal effects. We have previously shown with cardiovascular magnetic resonance (CMR) the presence of cardiovascular involvement in a significant percentage of consecutive asymptomatic cocaine addicts. CMR with feature-tracking analysis (CMR-FT) allows for the quantification of myocardial deformation which may detect preclinical involvement. Therefore, we aimed to assess the effects of cocaine on the left ventricular myocardium in a group of asymptomatic cocaine users with CMR-FT. Methods In a cohort of asymptomatic cocaine addicts (CA) who had been submitted to CMR at 3 T, we used CMR-FT to measure strain, strain rate and dyssynchrony index in CA with mildly decreased left ventricular ejection fraction (CA-LVEFd) and in CA with preserved ejection fraction (CA-LVEFp). We also measured these parameters in 30 age-matched healthy subjects. Results There were no differences according to age. Significant differences were seen in global longitudinal, radial and circumferential strain, in global longitudinal and radial strain rate and in radial and circumferential dyssynchrony index among the groups, with the lowest values in CA-LVEFd and intermediate values in CA-LVEFp. Longitudinal, radial and circumferential strain values were significantly lower in CA-LVEFp with respect to controls. Conclusions CA-LVEFp show decreased systolic strain and strain rate values, with intermediate values between healthy controls and CA-LVEFd. Signs suggestive of dyssynchrony were also detected. In CA, CMR-FT based strain analysis can detect early subclinical myocardial involvement.

ACCESSMENT OF RIGHT VENTRICULAR SYSTOLIC FUNCTION USING TAPSE

2011 ◽  
pp. 62-70
Author(s):  
Lien Nhut Nguyen ◽  
Anh Vu Nguyen
Keyword(s):  
Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Systolic Function ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Background: The prognostic importance of right ventricular (RV) dysfunction has been suggested in patients with systolic heart failure (due to primary or secondary dilated cardiomyopathy - DCM). Tricuspid annular plane systolic excursion (TAPSE) is a simple, feasible, reality, non-invasive measurement by transthoracic echocardiography for evaluating RV systolic function. Objectives: To evaluate TAPSE in patients with primary or secondary DCM who have left ventricular ejection fraction ≤ 40% and to find the relation between TAPSE and LVEF, LVDd, RVDd, RVDd/LVDd, RA size, severity of TR and PAPs. Materials and Methods: 61 patients (36 males, 59%) mean age 58.6 ± 14.4 years old with clinical signs and symtomps of chronic heart failure which caused by primary or secondary DCM and LVEF ≤ 40% and 30 healthy subject (15 males, 50%) mean age 57.1 ± 16.8 were included in this study. All patients and controls were underwent echocardiographic examination by M-mode, two dimentional, convensional Dopler and TAPSE. Results: TAPSE is significant low in patients compare with the controls (13.93±2.78 mm vs 23.57± 1.60mm, p<0.001). TAPSE is linearly positive correlate with echocardiographic left ventricular ejection fraction (r= 0,43; p<0,001) and linearly negative correlate with RVDd (r= -0.39; p<0.01), RVDd/LVDd (r=-0.33; p<0.01), RA size (r=-0.35; p<0.01), TR (r=-0.26; p<0.05); however, no correlation was found with LVDd and PAPs. Conclusions: 1. Decreased RV systolic function as estimated by TAPSE in patients with systolic heart failure primary and secondary DCM) compare with controls. 2. TAPSE is linearly positive correlate with LVEF (r= 0.43; p<0.001) and linearly negative correlate with RVDd (r= -0.39; p<0.01), RVDd/LVDd (r=-0.33; p<0.01), RA size (r=-0.35; p<0.01), TR (r=-0.26; p<0.05); however, no correlation is found with LVDd and PAPs. 3. TAPSE should be used routinely as a simple, feasible, reality method of estimating RV function in the patients systolic heart failure DCM (primary and secondary).

Implication of anti-angiogenic VEGF-A165b in angiogenesis and systolic function after reperfused myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Marcos Garces ◽  
C Rios-Navarro ◽  
L Hueso ◽  
A Diaz ◽  
C Bonanad ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Adjuvant Therapy ◽  
Ejection Fraction ◽  
Infarct Size ◽  
Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Funding Source ◽  
Coronary Reperfusion ◽  
Ventricular Ejection Fraction

Abstract Background Angiogenesis participates in re-establishing microcirculation after myocardial infarction (MI). Purpose In this study, we aim to further understand the role of the anti-angiogenic isoform vascular endothelial growth factor (VEGF)-A165b after MI and explore its potential as a co-adjuvant therapy to coronary reperfusion. Methods Two mice MI models were formed: 1) permanent coronary ligation (non-reperfused MI), 2) transient 45-min coronary occlusion followed by reperfusion (reperfused MI); in both models, animals underwent echocardiography before euthanasia at day 21 after MI induction. Serum and myocardial VEGF-A165b levels were determined. In both experimental MI models, functional and structural implication of VEGF-A165b blockade was assessed. In a cohort of 104 ST-segment elevation MI patients, circulating VEGF-A165b levels were correlated with cardiovascular magnetic resonance-derived left ventricular ejection fraction at 6-months and with the occurrence of adverse events (death, heart failure and/or re-infarction). Results In both models, circulating and myocardial VEGF-A165b presence was increased 21 days after MI induction. Serum VEGF-A165b levels inversely correlated with systolic function evaluated by echocardiography. VEGF-A165b blockage increased capillary density, reduced infarct size, and enhanced left ventricular function in reperfused, but not in non-reperfused MI experiments. In patients, higher VEGF-A165b levels correlated with depressed ejection fraction and worse outcomes. Conclusions In experimental and clinical studies, higher serum VEGF-A165b levels associates with a worse systolic function. Its blockage enhances neoangiogenesis, reduces infarct size, and increases ejection fraction in reperfused, but not in non-reperfused MI experiments. Therefore, VEGF-A165b neutralization represents a potential co-adjuvant therapy to coronary reperfusion. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study was funded by “Instituto de Salud Carlos III” and “Fondos Europeos de Desarrollo Regional FEDER” (Exp. PIE15/00013, PI17/01836, PI18/00209 and CIBERCV16/11/00486).

scholarly journals Changes in Mitral Annular Ascent with Worsening Echocardiographic Parameters of Left Ventricular Diastolic Function

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Paula M. Hernández Burgos ◽  
Angel López-Candales
Keyword(s):  
Ejection Fraction ◽  
Diastolic Function ◽  
Electromechanical Coupling ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Clinical Indication ◽  
Ventricular Ejection Fraction ◽  
Stage 1 ◽  
Lv Diastolic Function

Background. While the mitral annular plane systolic excursion (MAPSE) has been suggested as a surrogate measurement of left ventricular ejection fraction, less is known about the relative value of mitral annular ascent (MAa).Methods. Our database was queried for complete transthoracic echocardiograms performed for any clinical indication. Baseline echocardiographic measurements were compared to determine any correlation between MAa and traditional Echo-Doppler echocardiographic measures to characterize left ventricular diastolic dysfunction (LVDD).Results. Patients with normal LV diastolic function were younger (41±13years) than patients with LVDD (stage 1:61±13years; stage 2:57±14years; and stage 3:66±17years;p=0.156). LV ejection fraction decreased in patients with stage 2 LVDD (63±17%) and was further reduced in patients with stage 3 LVDD (28±21;p=0.003).Discussion. While a vigorous MAa excursion was seen in patients with stage 1 LVDD, MAa significantly decreased in stage 2 and stage 3 LVDD patients. Our results highlight the importance of atrioventricular coupling, as MAa motion seems to reflect changes in left atrial pressure. Additional studies are now required to better examine atrioventricular interactions and electromechanical coupling that might improve our assessment of LV diastolic function.

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