scholarly journals P697 Left ventricular non compaction highlighted by three-dimensional and speckle tracking echocardiography

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
V T Hotta ◽  
L M B Martinelli ◽  
F Fernandes ◽  
V A Moises ◽  
M L C Vieira ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
New Technologies ◽  
Imaging Modality ◽  
Color Doppler ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
3D Echo

Abstract Introduction Left ventricular non-compaction (LVNC) is a relatively new cardiomyopathy, first reported by Chin et al. in 1990. Since then, much has been learned about this entity, but until now, there are some limitations for the diagnosis of this disease. Cardiac Magnetic Resonance Imaging is considered the gold standard for the diagnosis of LVNC, but echocardiography remains the first line imaging modality due to its availability and cost efficacy. Case report In this case, we report a case of an asymptomatic 21 years old young male with no personal or familiar history of cardiomyopathies. Two dimensional echocardiography (2D Echo) evidenced increased left ventricular trabeculation in the apical segments of lateral and anterior walls and a non compacted myocardium/ (compacted + non compacted myocardium) ratio of 0,33, compatible with LVNC according to Chin´s criteria. 3D Echo provided more detailed LV morphology analysis and 3D Echo Color Doppler evidenced ventricular flow within the intraventricular recesses. Strain analysis by speckle tracking (STE) evidenced global longitudinal strain = - 17% (Normal values < -18%), probably related to an incipient systolic dysfunction not evidenced by the evaluation of left ventricular ejection fraction by 2D Echo. Conclusions This case illustrates new echocardiographic modalities for LVNC diagnosis. 3D Echo and STE are new technologies that may play an incremental role in the evaluation of LVNC but need further investigation and validation. Abstract P697 Figure.

scholarly journals Left Ventricular Myocardial Deformations in Hemodialysis Children by Speckle Tracking Echocardiography

2020 ◽  
Vol 14 ◽  
pp. 117954682093001
Author(s):  
Manal F Elshamaa ◽  
Fatma A Mostafa ◽  
Inas AES Sad ◽  
Ahmed M Badr ◽  
Yomna AEM Abd Elrahim
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Radial Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Myocardial Mechanics

Background: Cardiac systolic dysfunction was potentially found in adult patients with end-stage renal disease (ESRD) who have preserved left ventricular ejection fraction (EF%). In children with ESRD, little data are available on early changes in myocardial function. This study aimed to detect the early changes in myocardial mechanics in pediatric patients with ESRD using speckle tracking echocardiography (STE). Methods: Thirty ESRD children receiving hemodialysis (HD) and30 age-matched controls were prospectively studied. Patients underwent echocardiographic studies before and after HD. Left ventricular longitudinal strain (LS), circumferential strain (CS), and radial strain (RS) myocardial deformation parameters (strain, strain rate) were evaluated by STE. Results: The LS was significantly reduced in pre-HD and post-HD patients compared with controls ( P = .000). Controls showed the highest global longitudinal strain. The RS measurements did not differ significantly among the studied groups except for the inferior segment that is significantly reduced after HD compared with controls ( P < .05). The CS was significantly reduced in pre-HD and post-HD patients compared with controls at the lateral and posterior segments ( P = .035 and P = .013, respectively). Conclusion: Speckle-tracking echocardiography might detect early changes in myocardial mechanics in children with ESRD with preserved EF%.

scholarly journals Disease activity is associated with LV dysfunction in rheumatoid arthritis patients without clinical cardiovascular disease

2019 ◽  
Vol 59 (1) ◽  
Author(s):  
Punchong Hanvivadhanakul ◽  
Adisai Buakhamsri
Keyword(s):  
Rheumatoid Arthritis ◽  
Cardiovascular Disease ◽  
Disease Activity ◽  
Speckle Tracking ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Abstract Objectives The cross-sectional study aimed to assess left ventricular systolic function using global longitudinal strain (GLS) by speckle-tracking echocardiography (STE) and arterial stiffness using cardio-ankle vascular index (CAVI) in Thai adults with rheumatoid arthritis (RA) and no clinical evidence of cardiovascular disease (CVD). Methods Confirmed RA patients were selected from a list of outpatient attendees if they were 18 years (y) without clinical, ECG and echocardiographic evidence of CVD, diabetes mellitus, chronic kidney disease, and excess alcoholic intake. Controls were matched with age and sex to a list of healthy individuals with normal echocardiograms. All underwent STE and CAVI. Results 60 RA patients (females = 55) were analysed. Mean standard deviation of patient and control ages were 50 ± 10.2 and 51 ± 9.9 y, respectively, and mean duration of RA was 9.0 ± 6.8 y. Mean DAS28-CRP and DAS28-ESR were 2.9 ± 0.9 and 3.4 ± 0.9, respectively. There was no between-group differences in left ventricular ejection fraction (LVEF), LV sizes, LVMI, LV diastolic function and CAVI were within normal limits but all GLSs values was significantly lower in patients vs. controls: 17.6 ± 3.4 vs 20.4 ± 2.2 (p = 0.03). Multivariate regression analysis demonstrated significant correlations between GLSs and RA duration (p = 0.02), and GLSs and DAS28-CRP (p = 0.041). Conclusions Patients with RA and no clinical CV disease have reduced LV systolic function as shown by lower GLSs. It is common and associated with disease activity and RA disease duration. 2D speckle-tracking GLSs is robust in detecting this subclinical LV systolic dysfunction.

scholarly journals The Value of 4D Speckle-Tracking Strain Echocardiography in Evaluating the Relationship Between Asprosin and Growth Differentiation Factor-15 Levels and Subclinical Systolic Dysfunction in Patients With Acromegaly and Prolactinoma

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A650-A651
Author(s):  
Busra Firlatan ◽  
Ugur N Karakulak ◽  
Vedat Hekimsoy ◽  
Burcin G Iremli ◽  
Incilay Lay ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Speckle Tracking ◽  
Systolic Dysfunction ◽  
Linear Regression Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Patient Groups ◽  
The Relationship

Abstract Introduction: In patients with acromegaly and prolactinoma, the long-term presence of elevated GH and PRL levels is associated with an unfavorable cardiovascular risk profile. Early recognition of dysfunctions related to cardiovascular complications, which can be a significant contributor to mortality, is important. The aim of this study was to assess the relationship of four-dimensional speckle-tracking strain echocardiographic (4DSTE) measurements with asprosin, GDF-15 levels, and the Framingham cardiovascular risk score (FRS) in patients with acromegaly and prolactinoma. Methods: The study included 41 acromegaly [20F/21M, age: 49 (41-57)], 29 prolactinoma patients [18F/11M, age: 40 (28-48)] and 33 healthy control subjects [15F/18M, age: 48 (37-54)]. Data are presented as median with interquartile ranges (IQR). Anthropometric, biochemical and echocardiographic measurements were performed. Asprosin and GDF-15 levels were measured by ELISA. Results: Plasma asprosin concentration in the prolactinoma group [2.4 ng/mL (0.0-9.7)] was significantly lower than the concentration in both the acromegaly group [6.8 ng/mL (2.6-9.9)] and the control group [10.2 ng/mL (2.3-18.0)] (p=0.022 and p=0.006, respectively). In the study population, asprosin levels were positively correlated with age, FRS, and GDF-15 levels (r=0.361, p&lt;0.001; r=0.275, p=0.005 and r=0.240, p=0.015; respectively). Plasma GDF-15 concentration was lower in prolactinoma group [262.2 pg/mL (169.3-336.1)] than in the acromegaly [332.5 pg/mL (257.4-438.8)] and control groups [331.3 pg/mL (233.6-428.9)] (p=0.008 and p=0.047, respectively). In multiple linear regression analysis, GDF-15 level was independently positively related to the FRS in both patient groups (p&lt;0.001). FRS was highest in patients with acromegaly (p=0.004). In 2DE; the left ventricular ejection fraction although within normal limits, was lower in acromegaly [63% (63-65)] and prolactinoma [63% (60-65)] patients compared to the healthy controls [66% (63-68)] (p=0.003). In both acromegaly and prolactinoma groups; global longitudinal, circumferential, areal and radial strain measurements identified by 4DSTE were lower than the control group (acromegaly: p=0.007, p=0.008, p=0.015, p=0.008; prolactinoma: p=0.033, p=0.019, p=0.030, p=0.025, respectively). In contrast, diastolic functions were evaluated as normal in 85% of acromegaly patients, 86% of prolactinoma patients, and 93% of the control group (p=0.365). Conclusion: This is the first study to demonstrate the isolated subclinical systolic dysfunction identified by four-dimensional echocardiography in patients with acromegaly and prolactinoma. Asprosin may be associated with cardiovascular diseases in addition to its role in the pathogenesis of type 2 diabetes mellitus, and GDF-15 can be used as a biomarker to predict cardiovascular risk in these patient groups.

P2608Impact of sub-clinical systolic dysfunction on exercise hemodynamics in HFpEF: time to integrate diastolic and systolic indices

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Nanayakkara ◽  
F Telles ◽  
A M Beale ◽  
S Evans ◽  
D M Vizi ◽  
...  
Keyword(s):  
Cardiac Index ◽  
Ejection Fraction ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Preserved Ejection Fraction ◽  
Ventricular Ejection Fraction ◽  
Exercise Hemodynamics ◽  
Rest And Exercise

Abstract Background A potential role for subclinical systolic impairment as a contributor to the pathophysiology and outcomes of heart failure with preserved ejection fraction (HFpEF) has been proposed recently. However, the precise relationship of indices of systolic dysfunction with exercise hemodynamics in HFpEF is not known. In this study, we characterize the relationship between left ventricular mechanical function assessed by strain imaging with the key hemodynamic features of HFpEF at rest and during exercise. Methods Simultaneous echocardiography and exercise right heart catheterization was performed in 90 subjects (68 HFpEF, 22 control) referred for assessment of dyspnea. HFpEF was defined as left ventricular ejection fraction (LVEF) ≥50% with a pulmonary capillary wedge pressure (PCWP) ≥15mmHg at rest and/or ≥25mmHg at maximal exertion. Measures of left ventricular strain were taken using speckle tracking and analyzed together with natriuretic peptides and rest and exercise hemodynamics. Results At rest, HFpEF patients had impaired GLS compared to NCD subjects (−18.4±2.5 vs −21.2±3.5%, p≤0.001. Ejection fraction was similar (62±6 vs 61±6%, p=0.81). With worsening global longitudinal strain, patients with HFpEF displayed a worse cardiac index at both rest and exercise (p<0.001 for both), but similar filling pressure (p=0.85). The tertile with the worst strain had the highest level of natriuretic peptide. The association of strain with peak cardiac index was independent of LVEF, BNP, age, LAVI, LVMI, and systolic blood pressure. Conclusions Despite a preserved ejection fraction, a proportion of patients with HFpEF display impaired GLS, which correlates with a worse cardiac output. Impaired GLS was not associated with higher filling pressures at rest or exercise. Acknowledgement/Funding National Heart Foundation of Australia

scholarly journals Ventricular Dysfunction in the Case of the Sever Fetal Aortic Stenosis – the Role of Speckle-tracking

2020 ◽  
Vol 6 (1) ◽  
pp. 20-23
Author(s):  
Liliana Gozar ◽  
Daniela Toma ◽  
Amalia Făgărășan ◽  
Dorottya Miklósi ◽  
Rodica Togănel
Keyword(s):  
Aortic Stenosis ◽  
Speckle Tracking ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Clinical Severity ◽  
Left Ventricular Ejection ◽  
Ultra Sound ◽  
Premature Delivery ◽  
Congenital Aortic Stenosis ◽  
Ventricular Ejection Fraction

AbstractCongenital aortic stenosis (AS) occurs in around 0.2–0.5% of newborns, and its clinical severity is quite variable. Some of the newborns with AS require urgent medical care: prostaglandin infusion, balloon aortic valvuloplasty, or surgical intervention. Despite having a severe clinical evolution in neonates, the prenatal diagnosis of congenital AS is quite low. We present the case of a fetus with critical AS, who had been prenatally diagnosed at 35 weeks of gestation, via fetal cardiac ultra-sound. The echocardiographic parameters revealed a severely depressed left ventricular systolic function, with dilated chambers, and a severe aortic stenosis. Offline speckle-tracking analysis was performed in order to aid in deciding the optimal methods and timing of delivery. Left ventricular analysis revealed a severely impaired global longitudinal strain of 2.1%, left ventricular ejection fraction 18.4%, increased LV volumes, while the right ventricular function was only mildly depressed. Therefore, the decision was to delay the premature delivery, and the fetus was born at a gestational age of 38 weeks, in a hospital with a neonatal cardiovascular surgery department. The patient had undergone surgical repair of the cardiac anomaly at 3 days after birth.

scholarly journals Echocardiographic evidence of left ventricular untwisting-filling interplay

2019 ◽  
Author(s):  
Amir Hodzic ◽  
Damien Garcia ◽  
Eric Saloux ◽  
Paula A.B. Ribeiro ◽  
Amélie Ethier ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Speckle Tracking ◽  
Color Doppler ◽  
Adult Population ◽  
Intraclass Correlation ◽  
Quantitative Relationship ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Peak Strain ◽  
Ventricular Ejection Fraction

Abstract Background: Left ventricular untwisting generates an early diastolic intraventricular pressure gradient (DIVPG) than can be quantified by echocardiography. We sought to confirm the quantitative relationship between peak untwisting rate and peak DIVPG in a large adult population.Methods: From our echocardiographic database, we retrieved all the echocardiograms with a normal left ventricular ejection fraction, for whom color Doppler M-Mode interrogation of mitral inflow was available, and left ventricular untwisting rate was measurable using speckle tracking. Standard indices of left ventricular early diastolic function were assessed by Doppler (peaks E, e’ and Vp) and speckle tracking (peak strain rate Esr). Load dependency of DIVPG and untwisting rate was evaluated using a passive leg raising maneuver. Results: We included 154 subjects, aged between 18 to 77 years old, 63% were male. Test-retest reliability for color Doppler-derived DIVPG measurements was good, the intraclass correlation coefficients were 0.97 [0.91-0.99] and 0.97 [0.67-0.99] for intra- and inter-observer reproducibility, respectively. Peak DIVPG was positively correlated with peak untwisting rate (r = 0.73, P < 0.001). On multivariate analysis, peak DIVPG was the only diastolic parameter that was independently associated with untwisting rate. Age and gender were the clinical predictive factors for peak untwisting rate, whereas only age was independently associated with peak DIVPG. Untwisting rate and DIVPG were both load-dependent, without affecting their relationship. Conclusions: Color Doppler-derived peak DIVPG was quantitatively and independently associated with peak untwisting rate. It thus provides a reliable flow-based index of early left ventricular diastolic function.

scholarly journals Assessment of left ventricular contractility in acute inferior wall myocardial infarction by speckle tracking echocardiography

2021 ◽  
Vol 5 (4) ◽  
pp. 169-175
Author(s):  
E.G. Akramova ◽  
◽  
Е.V. Vlasova ◽  
◽  
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Inferior Wall ◽  
Ventricular Ejection Fraction

Aim: to assess the results of speckle tracking echocardiography (STE) in patients of working age with acute inferior wall myocardial infarction (MI) in the early period after coronary stenting. Patients and Methods: STE was performed using EPIQ-7 Ultrasound Machine (Philips, USA) in 55 patients with acute inferior wall MI one week after percutaneous coronary intervention and 29 healthy individuals of working age. Patients with acute inferior wall MI were divided into two subgroups, i.e., with (n=45) or without (n=10) areas of local contractile impairment (dyskinesia, akinesia, hypokinesia). Results: the most common cause of MI was the occlusion of the right coronary artery (82.4% in subgroup 1 and 60% in subgroup 2) in multivascular involvement (84.4% and 90%. respectively). In patients with local contractile impairment, reduced left ventricular ejection fraction (EF) was reported in 28.9%, global longitudinal strain in 86.7%, and global circular strain in 76.7%. Meanwhile, in patients without local contractile impairment, left ventricular ejection fraction (LV EF) was within normal ranges, global longitudinal strain was reported in 100% and global circumferential strain in 70%. The presence and severity of local dysfunction did not affect the reduction in segmental strain (median varied from -9% to -15%). In inferior wall MI, the abnormal regional longitudinal strain of 6 LV segments (basal and mid inferoseptal, inferior, and inferolateral) was reported in both hypokinesia and normokinesia. Conclusions: ultrasound evaluation of systolic LV function using STE is characterized by greater diagnostic value compared to the measurement of EF only and objectifies the efficacy of surgery. Quantitative assessment of the recovery of both global and local systolic contractility is another advantage of STE allowing for personalized treatment. KEYWORDS: inferior wall myocardial infarction, echocardiography, speckle tracking technology, percutaneous coronary intervention, ejection fraction. FOR CITATION: Akramova E.G., Vlasova Е.V. Assessment of left ventricular contractility in acute inferior wall myocardial infarction by speckle tracking echocardiography. Russian Medical Inquiry. 2021;5(4):169–175 (in Russ.). DOI: 10.32364/2587-6821-2021-5-4-169-175.

Abstract 13928: Subclinical Myocardial Dysfunction With Coronavirus Disease 2019

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jordan B Strom ◽  
Lila M Martin ◽  
Sarah E Fostello ◽  
James D Chang ◽  
Connie W Tsao ◽  
...  
Keyword(s):  
Left Ventricular Systolic Dysfunction ◽  
Myocardial Dysfunction ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Cardiac Injury ◽  
Multivariable Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Multicenter Studies ◽  
Ventricular Ejection Fraction

Background: Coronavirus disease 2019 (COVID-19) is associated with cardiac injury and overt myocardial dysfunction. However, whether COVID-19 is associated with subclinical myocardial dysfunction is unknown. Methods: We evaluated patients hospitalized for COVID-19 referred for transthoracic echocardiography (TTE), between March 17 and May 22, 2020, with a left ventricular ejection fraction (LVEF) ≥ 50%. Controls in a 1:1 ratio were selected from patients receiving TTE during the same month. Global longitudinal strain (GLS) was used to assess the association of COVID-19 and subclinical myocardial disease. Results: Among 99 patients (49 cases, 50 controls), average GLS was significantly reduced in cases vs. controls (mean ± SD, -14.8 ± 4.0% vs. -21.1 ± 4.0%, p < 0.0001). A total of 82.8% of cases vs. 7.1% of controls had an average GLS below normal (> 18%; p < 0.0001), which persisted despite multivariable adjustment ( Table ). Among COVID-19 patients with a prior TTE, absolute average GLS decreased 3.2% (p = 0.008) despite no change in LVEF (p = 0.41). Average GLS was reduced in non-survivors compared with survivors (p = 0.04), though only septal wall thickness (p = 0.03) was associated with in-hospital mortality on multivariable analysis. Conclusions: Among hospitalized patients receiving TTE, COVID-19 is independently associated with subclinical left ventricular systolic dysfunction in the vast majority of patients, and subclinical LV dysfunction is associated with survival. The clinical implications of these findings should be evaluated in future longitudinal multicenter studies.

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