scholarly journals P664 Relationship of left atrial function assessed by 2D speckle tracking echocardiography with left ventricular systolic function in patients with degenerative mitral regurgitation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E Melillo ◽  
G Palmiero ◽  
A Ferro ◽  
G Carlomagno ◽  
L Dell"urzo ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Left Ventricular ◽  
Lv Function ◽  
Continuous Variables ◽  
Significant Difference ◽  
2D Speckle Tracking ◽  
Relationship Of

Abstract Funding Acknowledgements none Background In degenerative mitral regurgitation (DMR), left ventricle (LV) and left atrium (LA) undergo progressive volume overload leading to chamber remodelling and dysfunction in advanced stages. Speckle tracking echocardiography (STE) is an estabilished technique able in detecting subclinical LA and LV dysfunction in this setting. However data are lacking on the relationship of LA and LV function in DMR patients. Purpose Our aim was to assess LA function in patients with DMR and to explore its possible correlations with LV dimensions and systolic function. Methods We enrolled 95 patients with mild to severe DMR, dichotomizing them on the basis of mitral regurgitation severity (DMR 1-2: mild and mild-to-moderate MR; DMR 3-4: at least moderate to severe MR). LA function was assesed with 2D speckle tracking echocardiography. Results The two groups were well matched. DMR 3-4 group (n= 48) showed higher LA and LV volumes, lower right ventricle longitudinal systolic function and higher values of systolic pulmonary pressure. There was not significant difference in LV ejection fraction (LVEF) and global longitudinal strain (GLS). Among LA function indexes, only peak systolic reservoir strain was significantly reduced in DMR 3-4 group (21,9± 6,2% vs 24,7± 7,2% ; p= 0,04). Then population study was further divided in two groups according to the presence (LA dys+) or absence (LA dys-) of LA dysfunction, defined as reservoir strain values below the median [median 23.7%; LAdys- group (n. 49), LAdys+ group (n.46) ]. At the comparison of continuous variables (Tab.1), LAdys+ group showed larger LV end systolic diameter and more impaired LVEF (60,9± 9,8% vs 65,4± 4,8%; p: 0,004) and GLS (20,04 ± 3,7% vs 23,53 ± 2,7%; p <0,001). Conclusions Our data showed that LA reservoir strain was impaired in patients with moderate to severe DMR. Furthermore, patients with LA dysfunction showed reduced LVEF and GLS values. Consequently, LA dysfunction assessed with STE may be a novel marker of early LV systolic dysfunction in patients with degenerative mitral regurgitation. Tab.1 LAdysf- (n = 49) LAdysf+ (n = 46) P value LVESD (mm) 31.78 ± 4.1 34.74 ± 7.6 0.020 LAVI (mL/mq) 44.5 ± 15.1 55.6 ± 25.6 0.015 TAPSE (mm) 26.30 ± 3.96 24.02 ± 3.31 0.004 sPAP (mmHg) 31.4 ± 7.0 36.4 ± 10.9 0.009 LVEF (%) 65.4 ± 4.8 60.9 ± 9.8 0.004 GLS (%) 23.5 ± 2.7 20.0 ± 3.7 <0.001 Comparison of continuous variables between patients with and without LA dysfunction.

Left ventricular myocardial work in patients with secondary mitral regurgitation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Yedidya ◽  
R.P Lustosa ◽  
F Fortuni ◽  
P Van Der Bijl ◽  
F Namazi ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Blood Pressure Measurement ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Work Efficiency ◽  
Constructive Work ◽  
Secondary Mitral Regurgitation

Abstract Background Assessment of left ventricular (LV) function in patients with secondary mitral regurgitation (SMR) remains challenging because LV ejection fraction (LVEF) reflects changes in LV volume without taking into account the direction of the blood flow. LV global longitudinal strain better reflects active LV myocardial deformation but does not incorporate afterload. LV myocardial work derived from pressure-strain loops integrates speckle tracking echocardiography with non-invasive blood pressure measurement. Purpose To evaluate LV myocardial work components to better characterize LV function in patients with SMR. Methods 378 patients (72% men, median age 68 [range 60 to 74 years]) with various grades of SMR were retrospectively analysed. LV myocardial constructive work, wasted work and work efficiency were measured with speckle tracking echocardiography. Results 145 patients had mild SMR, 130 moderate SMR and 103 severe SMR. Patients with severe SMR had larger LV volumes, lower LVEF and more impaired LV GLS (Table 1). While LV constructive work was more impaired in patients with severe SMR, wasted work was lower as compared to mild SMR (Table 1). Consequently, patients with severe SMR had better myocardial work efficiency than patients with mild MR. This could reflect, the regurgitant volume which is pumped into a low pressure chamber (the left atrium) resulting in less myocardial wasted work and preservation of myocardial efficiency. Conclusion In patients with severe SMR, LVEF, LV GLS and myocardial constructive work are more impaired when compared to mild SMR. However, myocardial wasted work is lower, resulting in higher better LV myocardial work efficiency. Funding Acknowledgement Type of funding source: None

scholarly journals Comparison of left ventricular systolic function by 2D speckle-tracking echocardiography between normal pregnant women and pregnant women with preeclampsia

2019 ◽  
Vol 11 (4) ◽  
pp. 309-313
Author(s):  
Atoosa Mostafavi ◽  
Yaser Tase Zar ◽  
Farahnaz Nikdoust ◽  
Seyed Abdolhossein Tabatabaei
Keyword(s):  
Pregnant Women ◽  
Speckle Tracking ◽  
Circumferential Strain ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Left Ventricular ◽  
Ventricular Systolic Function ◽  
2D Speckle Tracking ◽  
The Mean ◽  
The Right

Introduction: In light of previous studies reporting the significant effects of preeclampsia on cardiac dimensions, we sought to evaluate changes in the left ventricular (LV) systolic and diastolic functions in patients with preeclampsia with a view to investigating changes in cardiac strain. <br /> Methods: This cross-sectional study evaluated healthy pregnant women and pregnant women suffering from preeclampsia who were referred to our hospital for routine healthcare services. LV strain was measured by 2D speckle-tracking echocardiography. <br /> Results: Compared with the healthy group, echocardiography in the group with preeclampsia showed a significant increase in the LV end-diastolic diameter (47.43 ± 4.94 mm vs 44.84 ± 4.30 mm; P = 0.008), the LV end-systolic diameter (31.16 ± 33.3 mm vs 29.20 ± 3.75 mm; P = 0.008), and the right ventricular diameter (27.93 ± 1.71 mm vs 24.53 ± 23.3; P = 0.001). The mean global longitudinal strain was -18.69 ± 2.8 in the group with preeclampsia and -19.39 ± 3.49 in the healthy group, with the difference not constituting statistical significance (P = 0.164). The mean global circumferential strain in the groups with and without preeclampsia was -20.4 ± 12.4 and -22.68 ± 5.50, respectively, which was significantly lower in the preeclampsia group (P = 0.028).<br /> Conclusion: The development of preeclampsia was associated with an increase in the right and left ventricular diameters, as well as a decrease in the ventricular systolic function, demonstrated by a decline in global circumferential strain.

Evaluation of Left Ventricular Dysfunction in Patients with Isolated Mitral Valve Stenosis Using Speckle Tracking Echocardiography

2021 ◽  
Vol 23 (Supplement_D) ◽  
Author(s):  
Mohamed ElGendi ◽  
Mohamed Ayman ◽  
Mohamed Sadaka ◽  
Gehan Magdi
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Mean Value ◽  
Left Ventricular ◽  
2D Speckle Tracking ◽  
Lv Systolic Function

Abstract Aim The aim was to evaluate left ventricular (LV) systolic function in patients with isolated mitral stenosis (MS) using 2D speckle tracking echocardiography. Methods 24 patients (39.50 ± 5.55 years, 17 females) with isolated MS (MVA: 1.35 ± 0.16 cm2) with preserved LV systolic function and sinus rhythm were compared to 12 matched healthy control subjects (36.42 ± 5.99 years, 8 females). Conventional echocardiography was performed to both groups. Longitudinal strain and Circumferential strain echocardiography were obtained. Peak systolic strain was measured from the mean strain profile for a total of 17 segments of the LV for the longitudinal strain and 16 segments for the circumferential strain. Global longitudinal (G.L.) and circumferential strain (G.C.) were calculated separately as the average of the sum of the studied segments. Results The global longitudinal strain of the cases group ranged from -11 – -17% with a mean value of -14.67 ± -1.69% and that of the control group ranged from -15 – -20% with a mean value of -17.83 ± -1.53% with a statistically significant difference between the two groups. In our study, there was a negative but non-significant correlation between LV GLSS and LA diameter (r = -0.054, p = 0.802), Echo score (r = -0.018, p = 0.933) and PASP (r = 0.021, p = 0.922) in patients group. Also, the correlation was negative but non-significant between LV GCSS and LA diameter (r = -0.142, p = 0.507), Echo score (r = -0.200, p = 0.349) and PASP (r = -0.155, p = 0.471) in patients group. Conclusion • 2D speckle tracking echocardiography can detect subclinical LV systolic dysfunction which cannot be recognized by 2D conventional echocardiography. • Isolated rheumatic MS may be associated with subclinical LV systolic dysfunction.

scholarly journals P667 Protein supplementation improves left ventricular systolic functions in athletes by 2D speckle tracking echocardiography

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
B Yaman ◽  
H Kemal Gunsel ◽  
L Cerit ◽  
E Acikgoz ◽  
S Usalp ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Protein Supplementation ◽  
Protein Supplements ◽  
Strain And Strain Rate ◽  
Significant Difference ◽  
2D Speckle Tracking ◽  
Group 2 ◽  
Group 1

Abstract Funding Acknowledgements none Background Exercise induced left ventricular remodelling is known for many years. Left ventricular enlargement, hypertrophy, left atrial dilatation are adaptive responsive mechanisms of myocardial tissue to increased physiological demand by exercise. In recent years, strain and strain rate have been used for the assessment of myocardial adaptation in athletes’. In literature, left ventricular and right ventricular deformation is decreased in athletes’, compared to normal healthy individuals. Also left atrial reservoir and contractile functions, which can be measured by speckle tracking echocardiography, decrease in endurance athletes with atrial fibrillation. Athletes have been using protein supplementation frequently in recent years however cardiac effects are largely unknown. There is limited data in the literature about cardiac effects of protein supplementation. Purpose In our study, we aim to evaluate the effects of protein supplementation on cardiac functions in athletes with 2D speckle tracking echocardiography. This is the first study in the literature evaluating the effects of protein supplements on echocardiographic parameters. Methods Eighty-three athletes (mean age = 29.7 ± 7.9) without history of cardiac disease or other chronic diseases such as hypertension, diabetes mellitus, kidney failure were prospectively included in our study. 73.5% (n = 61) of them were male. Participants were divided into two groups; participants who use protein supplementation regularly was defined as group 1 (n = 33); did not use protein supplementation was defined as group 2 (n = 50). In addition to Standard 2D echocardiographic measurements, left ventricle global longitidunal strain (LvGLS), right ventricle global longitidunal strain (RvGLS), right ventricle free wall strain (RvFWS), left atrium strain and strain rate were analyzed with Vivid E9, offline using a customized software package (Echo Pac for PC, GE Vingmed) (Figure 1). Results Diameter of interventricular wall was higher in group 1 (10.1 ± 1.0 vs 9.5 ± 1.2, p = 0.022). Systolic peak ejection velocity of the mitral valve medial annulus is higher in group 1 than group 2 (0.09 ± 0.1 vs 0.08 ± 0.1, p &lt; 0.001). Late diastolic velocity of the mitral valve medial annulus is higher in the group 1 (0.09 ± 0.02 vs 0.08 ± 0.02, p = 0.015). LvGLS which was the indicator of left ventricular deformation was significantly higher in the group 1 (-19.49 ± 1.9 vs -18.45 ± 2.2, p = 0.030). Although RvGLS was higher in the group 1, there was no statistically significant difference (-22.93 ± 4.52 vs -21.07 ± 5.02, p = 0.083). Conclusion In recent years protein supplementation usage increases in young adults and athletes. In our study, although there was no statistically significant difference with left ventricular ejection fraction, LvGLS which is the early indicator of LV systolic functions better in the athletes who used protein supplementation. Further studies are needed to evaluate the long term effects of protein supplements on the heart.

scholarly journals Catecholamines Induce Left Ventricular Subclinical Systolic Dysfunction: A Speckle-Tracking Echocardiography Study

Cancers ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 318 ◽  
Author(s):  
Jan Kvasnička ◽  
Tomáš Zelinka ◽  
Ondřej Petrák ◽  
Ján Rosa ◽  
Branislav Štrauch ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Echocardiographic Parameters ◽  
Lv Systolic Function ◽  
Lower Magnitude

Background: Pheochromocytomas (PHEO) are tumors arising from chromaffin cells from the adrenal medulla, having the ability to produce, metabolize and secrete catecholamines. The overproduction of catecholamines leads by many mechanisms to the impairment in the left ventricle (LV) function, however, endocardial measurement of systolic function did not find any differences between patients with PHEO and essential hypertension (EH). The aim of the study was to investigate whether global longitudinal strain (GLS) derived from speckle-tracking echocardiography can detect catecholamine-induced subclinical impairments in systolic function. Methods: We analyzed 17 patients (10 females and seven males) with PHEO and 18 patients (nine females and nine males) with EH. The groups did not differ in age or in 24-h blood pressure values. Results: The patients with PHEO did not differ in echocardiographic parameters including LV ejection fraction compared to the EH patients (0.69 ± 0.04 vs. 0.71 ± 0.05; NS), nevertheless, in spackle-tracking analysis, the patients with PHEO displayed significantly lower GLS than the EH patients (−14.8 ± 1.5 vs. −17.8 ± 1.7; p < 0.001). Conclusions: Patients with PHEO have a lower magnitude of GLS than the patients with EH, suggesting that catecholamines induce a subclinical decline in LV systolic function.

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.

scholarly journals Speckle tracking echocardiography in primary mitral regurgitation: should we reconsider the time for intervention?

2021 ◽  
Author(s):  
Maria Concetta Pastore ◽  
Giulia Elena Mandoli ◽  
Aleksander Dokollari ◽  
Gianluigi Bisleri ◽  
Flavio D’Ascenzi ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Right Ventricular ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Main Concern ◽  
Cardiac Damage ◽  
Asymptomatic Patients ◽  
Right Ventricular Strain

Abstract Thanks to the improvement in mitral regurgitation (MR) diagnostic and therapeutic management, with the introduction of minimally invasive techniques which have considerably reduced the individual surgical risk, the optimization of the timing for MR “open” or percutaneous surgical treatment has become a main concern which has highly raised scientific interest. In fact, the current indications for intervention in MR, especially in asymptomatic patients, rely on echocardiographic criteria with high severity cut-offs that are fulfilled only when not only mitral valve apparatus but also the cardiac chambers’ structure and function are severely impaired, which results in poor benefits for post-operative clinical outcome. This led to the need of new indices to redefine the optimal surgical timing in these patients. Speckle tracking echocardiography provides early markers of cardiac dysfunction due to subtle myocardial impairment; therefore, it could offer pivotal information in this setting. In fact, left ventricular and left atrial strains have already shown evidence about their usefulness in recognizing MR impact not only on symptoms and quality of life but also on cardiovascular events and new-onset atrial fibrillation in these patients. Moreover, right ventricular strain could be used to identify those patients with advanced cardiac damage and different grades of right ventricular dysfunction, which entails higher risks for cardiac surgery that could overweigh surgical benefits. This review aims to describe the importance of reconsidering the timing of intervention in MR and to analyze the potential additive value of speckle tracking echocardiography in this clinical setting.

Speckle tracking echocardiography in patients with stroke

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Trush ◽  
S.V Ivanova ◽  
E.N Yushchuk ◽  
A.A Savin ◽  
I.V Melehina
Keyword(s):  
Ischemic Stroke ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Ct Scanning ◽  
Left Ventricular ◽  
Stroke Severity ◽  
Large Artery ◽  
Stroke Subtypes ◽  
Significant Difference

Abstract Introduction Global longitudinal strain (GLS) via speckle tracking echocardiography (STE) has emerged as a quantitative technique to estimate myocardial function and has been shown to have clinical utility in a variety of settings. The use of this technique in patients with a stroke is limited. Purpose Comparative analysis of myocardial deformation indicators in patients with a stroke, depending on the severity and subtype. Results 230 patients with an acute cerebrovascular accident (132 men and 98 women) were included in our study, with the mean age of 64,9±10,8. Transient ischemic attack (TIA) was diagnosed in 39 (17%), acute ischemic stroke (AIS) in 191 (83%) patients. The type of an ischemic stroke in each patient was classified as one of the following traditional stroke subtypes: large-artery atherosclerosis (LAA) was diagnosed in 85 (44,5%), cardioembolic infarcts were diagnosed in 58 (30,4%), lacunar infarcts were diagnosed in 32 (16,8%) and in 16 (8,4%) the stroke was of another determined or undetermined etiology. There was no significant difference in left ventricular (LV) ejection fraction (EF) between the subgroups of TIA and AIS - 63.0% [60.0; 65.0] and 62.0% [58.0; 65.0], respectively. The LV GLS was within normal limits and amounted to 19.9±2.6 in the TIA group where as in the group of patients with stroke there was a significant (p&lt;0.01) decrease in GLS below standard values - 17.1±3.8. The LV EF showed no significant difference between the groups of stroke subtypes. However, a decrease in GLS was found in the series from cardioembolic infarct &gt; lacunar infarct &gt; LAA - 17.5±3.7 &gt; 16.5±6.5 &gt; 16.2±3.2 (p=0,7). A decrease in GLS was significantly more often observed in male patients. A decrease in the level of GLS in patients with a stroke is associated with duration of type 2 diabetes, stroke severity by the National Institutes of Health Stroke Scale (NIHSS) score, ECG voltage criteria for LVH, increase in heart rate, LV mass/BSA, relative wall thickness (RWT) according to echocardiography. Significant differences in GLS from the size of the stroke focus according to CT scanning/ magnetic resonance imaging were not detected. Conclusion GLS via STE in patients with a stroke correlates with the severity of a stroke, the severity of LV remodeling, risk factors for cardiovascular events and requires a further study to assess the long-term prognosis Funding Acknowledgement Type of funding source: None

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