scholarly journals P946 Right atrial volumetric and functional analysis by three-dimensional speckle-tracking echocardiography in acromegaly

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Kormanyos ◽  
A Kalapos ◽  
P Domsik ◽  
N Gyenes ◽  
N Ambrus ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Three Dimensional ◽  
Radial Strain ◽  
Human Growth ◽  
Active Phase ◽  
Right Atrial ◽  
Control Group ◽  
Cardiovascular Comorbidities ◽  
Atrial Contraction

Abstract Introduction Acromegaly is a chronic, rare hormonal disease associated with major cardiovascular comorbidities. The disease, in the majority of the cases, is caused by a benign human growth hormone secreting adenoma. Cardiovascular involvement is especially common in acromegaly patients from the most common hypertension to cardiomyopathy. It was set out to quantify right atrial (RA) morphology and function in a group of acromegaly patients using three-dimensional (3D) speckle-tracking echocardiography (3DSTE). Methods The study comprised 30 patients from which 8 patients were excluded due to inadequate image quality. Mean age of the remaining acromegaly patients were 53.7 ± 14.5 years (7 males). Ten patients were in active phase, while 12 subjects had inactive acromegaly. In the control group 40 healthy adults were enrolled (mean age: 52.3 ± 8.2 years, 15 males). In each case, complete two-dimensional Doppler echocardiography was performed followed by 3DSTE. Results Maximum (54.5 ± 14.4 ml vs. 47.2 ± 11.6 ml, p <0.05) and minimum (35.5 ± 10.2 ml vs. 29.2 ± 9.1 ml, p <0.05) RA volumes and RA volume before atrial contraction (45.1 ± 11.1 ml vs. 38.2 ± 10.3 ml, p <0.05) were significantly higher in case of acromegaly compared to the healthy controls. Both global and mean segmental peak 3D strain (-11.94 ± 7.52% vs. -8.07 ± 5.03%, p <0.05 and -17.16 ± 6.13% vs. -13.78 ± 5.35%, p <0.05) were higher in the acromegaly group compared to the controls. At atrial contraction, mean segmental radial strain (-13.22 ± 6.45% vs. -9.74 ± 4.58%, p <0.05) was significantly higher and mean segmental 3D strain (-9.78 ± 5.44% vs. -13.78 ± 5.35%, p <0.05) was significantly lower in the acromegaly group compared to the controls. Between the active and inactive group of acromegaly patients, mean segmental longitudinal strain (28.17 ± 4.89% vs. 35.34 ± 9.75%, p <0.05) was significantly different. Numerous independent strain parameters had significant correlations with different hormonal variables in the active acromegaly group. These correlations were not present in the inactive acromegaly subgroup. Conclusion Acromegaly is associated with significant RA volumetric and functional abnormalities.

scholarly journals P1406 Normal reference values of right atrial strain parameters using three-dimensional speckle-tracking echocardiography in healthy adults

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Nemes ◽  
A Kormanyos ◽  
P Domsik ◽  
A Kalapos ◽  
N Ambrus ◽  
...  
Keyword(s):  
Image Quality ◽  
Reference Values ◽  
Healthy Subjects ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Three Dimensional ◽  
Right Atrial ◽  
Imaging Method ◽  
Normal Reference ◽  
Atrial Contraction

Abstract Introduction Classic echocardiographic methodologies offer limited opportunities in assessing right atrial (RA) morphology and function. Three-dimensional (3D) speckle-tracking echocardiography (3DSTE) is a novel imaging method with objective 3D capability in assessing volumetric and functional properties of heart chambers. Normal reference values of different 3DSTE-derived RA strains are not available, therefore the aim of this prospective study was to establish these parameters in healthy subjects. Methods The present study comprised 295 healthy volunteers, from which 110 were excluded due to inadequate image quality. The final population consisted of 185 healthy subjects in the present study (mean age: 32.1 ± 12.2 years, 89 males). Complete two-dimensional echocardiography and 3DSTE have been performed in all cases. Results While radial strain (RS) does not change significantly over the years in males, RS increases with age most significantly between 40-49 years, and it starts to decline at the age of 50 years in females. While females have higher circumferential strain (CS) and area strain (AS) values, RS decreases with age in both gender. While longitudinal strain (LS) remains almost unchanged in females until 40-49 years and declines above the age of 50 years in females, it decreases over decades in males. 3D strain (3DS) increases with ages in both gender, but almost doubles in females in older ages. While RS at atrial contraction does not change over decades in males, an obvious increase could be seen in females with a higher value between 40-49 years and a decline over 50 years. A decrease could be seen in CS at atrial contraction in males over decades, it is almost tripled in value between 40-49 years in females. Although LS at atrial contraction is higher in females, it decreases over decades in both genders. AS decreases over decades in males, while females have almost doubled AS values at the ages 40-49 years. 3DS is almost unchanged in males, while doubled in older ages in females. During evaluations, 110 subjects were excluded due to inferior image quality from the total of 295 enrolled subjects, therefore the overall feasibility of 3DSTE-derived RA quantification was 185 out of 295 (63% overall feasibility). Conclusion 3DSTE-derived RA normal reference values with age- and gender-dependency are demonstrated in a healthy population.

scholarly journals P1795 Active acromegaly is associated with enhanced left ventricular contractility - A three-dimensional speckle-tracking echocardiographic study

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Kormanyos ◽  
P Domsik ◽  
A Kalapos ◽  
N Gyenes ◽  
Z Valkusz ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Interventricular Septum ◽  
Three Dimensional ◽  
Radial Strain ◽  
Human Growth ◽  
Left Ventricular ◽  
Healthy Population ◽  
Valvular Regurgitation ◽  
Ventricular Contractility ◽  
Active Acromegaly

Abstract Introduction Acromegaly is a relatively rare, chronic hormonal disease resulting in disfigurement. In 90% of the cases, acromegaly is caused by a benign pituitary monoclonal human growth hormone-secreting tumor. Hypertension and left ventricular (LV) hypertrophy are the most common cardiovascular comorbidites, but serious valvular regurgitation and heart failure could also develop at the end-stages. The aim of the present study was to determine the presence of LV deformational abnormalities using three-dimensional speckle-tracking echocardiography (3DSTE) in a group of acromegaly patients. Methods Thirty-eight acromegaly patients were involved in the present study. Thirteen patients were excluded due to inadequate image quality. The mean age of the remaining patients were 57.2 ± 13.6 years (7 males). The active acromegaly subgroup consisted of 14 patients (mean age: 58.6 ± 14.6 years, 5 males), while the inactive group contained 11 patients (mean age: 54.0 ± 12.9, 2 males). Their data was compared to an age- and gender matched control population, which comprised of 34 healthy volunteers (mean age: 52.7 ± 4.9 years, 15 males). All subjects have undergone complete two-dimensional Doppler echocardiography extended with 3DSTE. Results Significant differences in left atrial diameter and volume, LV end-diastolic diameter and volume, interventricular septum and LV posterior wall thickness could be demonstrated between the acromegaly group and healthy controls. Global and mean segmental 3DSTE-derived LV radial strain (RS)(33.2 ± 13.4% vs. 25.2 ± 10.8%, p =0.01 and 36.0 ± 12.1% vs. 28.2 ± 10.0%, p =0.009, respectively) proved to be significantly higher in acromegaly patients compared to controls. Active acromegaly patients had a significantly higher global and mean segmental RS (35.5 ± 14.4% vs. 25.2 ± 10.8%, p =0.03 and 37.9 ± 13.3% vs. 28.2 ± 10.0%, p =0.03, respectively) as compared to that of controls. Between active and inactive acromegaly groups only basal LV circumferential strain (-30.2 ± 4.8% vs. -26.7 ± 4.1%, p =0.02) was found to be significantly different. Conclusion With presented clinical, demographic, therapeutic and echocardiographic features, active acromegaly is associated with enhanced LV-RS as compared to the healthy population.

scholarly journals P1562 Normal reference values of three-dimensional speckle-tracking echocardiography-derived right atrial volumes and volume-based functional properties in healthy adult subjects

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Nemes ◽  
A Kormanyos ◽  
P Domsik ◽  
A Kalapos ◽  
N Ambrus ◽  
...  
Keyword(s):  
Functional Properties ◽  
Reference Values ◽  
Speckle Tracking ◽  
Healthy Adult ◽  
Speckle Tracking Echocardiography ◽  
Three Dimensional ◽  
Right Atrial ◽  
Normal Reference ◽  
Significant Difference ◽  
Significant Impairment

Abstract Introduction The right atrium (RA) has several roles including a systolic reservoir, early diastolic conduit and late-diastolic booster pump functions. The present study aimed to assess normal reference values of three-dimensional speckle-tracking echocardiography (3DSTE)-derived RA volumetric data and volume-based functional properties (stroke volumes, SVs and emptying fractions, EFs) in healthy adult subjects. Methods 260 healthy adult subjects in sinus rhythm with complete clinical and demographic dataset have been included in the present study. However, due to inferior image quality 110 subjects have been excluded. The remaining population comprised 150 cases (31.0 ± 11.6 years, 79 males). Complete two-dimensional Doppler echocardiography and 3DSTE have been performed in all subjects. Results While systolic maximum RA volume did not change over age decades, early and late-diastolic RA pre-atrial contraction volume and minimum RA volume increased over time. Significantly larger values could be detected in more than 50 year-old healthy subjects as compared to younger subjects. Total atrial SV remained almost unchanged over age decades with a significant reduction in subjects aged >50 years. Passive atrial SV showed a continuous reduction over age decades and significant difference could be demonstrated between subjects aged 18-29 years and >50 years. Active atrial SV increased over age decades with a significant reduction in subjects aged >50 years. Total atrial EF did not show any changes over age decades, but a significant reduction could be demonstrated in cases aged >50 years. Passive atrial EF showed significant continuous reduction over age decades. Active atrial EF did not change in younger ages, it was the highest at ages 40-49 years with a significant impairment after 50 years. Females proved to have tendentiously higher RA volumes respecting the cardiac cycle regardless of age. No significant differences could be demonstrated between RA stroke volumes between genders except between 40-49 years when females had tendentiously higher values. RA emptying fractions were non-significantly, but tendentiously higher in females as compared to that of males regardless of age. Conclusions Normal reference values of 3DSTE-derived RA volumes and volume-based functional properties and their age- and gender dependency were defined in healthy adult subjects.

scholarly journals P333 Left ventricular rotational abnormalities in hypereosinophilic syndrome as assessed by three-dimensional speckle-tracking echocardiography

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Nemes ◽  
A Kormanyos ◽  
I Marton ◽  
P Domsik ◽  
A Kalapos ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Hypereosinophilic Syndrome ◽  
Three Dimensional ◽  
Organ Damage ◽  
Left Ventricular ◽  
Diagnostic Methods ◽  
Control Group ◽  
Apical Rotation ◽  
Basal Rotation

Abstract Introduction Hypereosinophilic syndrome (HES) is a very heterogeneous group of disorders with varied etiologies characterized by peripheral eosinophilia and eosinophilic tissue/end-organ damage. In the present study, the ability of a novel non-invasive clinical tool, three-dimensional speckle-tracking echocardiography (3DSTE) was investigated to reveal any change in left ventricular (LV) rotational mechanics in clinically asymptomatic HES patients without manifest organ damage as determined by conventional diagnostic methods. Methods The present study comprised 13 patients established diagnosis of HES. However, one patient with idiopathic HES has been excluded due to insufficient image quality. The remaining patient population contained 11 cases with idiopathic HES and one patient with acute T-lymphoma associated HES (mean age: 59.7 ± 13.7 years, 8 males). The control group consisted of 36 healthy volunteers (mean age: 52.9 ± 8.3 years, 23 males). All HES patients and controls underwent complete two-dimensional Doppler echocardiography and 3DSTE. Results Both LV apical rotation (4.86 ± 1.92 degree vs. 10.07 ± 3.92 degree, p < 0.0001) and LV twist (8.52 ± 2.79 degree vs. 14.41 ± 4.26 degree, p < 0.0001) showed significant deteriotations in most of HES patients. In 2 subjects absence of LV twist called as LV „rigid body rotation’ (RBR) was detected. One patient had 1.77 degree counterclockwise (abnormally directed) LV basal rotation and 14.29 degree counterclockwise (normally directed) LV apical rotation resulting in 12.59 degree LV apico-basal gradient. The other patient had normally directed -2.09 degree LV basal rotation and almost zero (-0.27 degree) LV apical rotation resulting in 1.82 degree LV apico-basal gradient. Conclusions Reduced LV apical rotation and twist could be demonstrated in HES. LV-RBR could be detected in some HES patients.

scholarly journals P308 Changes in the echocardiographic phenotype during the evolution of cardiac amyloidosis from preserved to reduced left ventricle ejection fraction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
V Faga ◽  
V Mora Llabata ◽  
I Roldan Torres ◽  
A Saad ◽  
A M Cuevas Vilaplana ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Ejection Fraction ◽  
Speckle Tracking ◽  
Cardiac Amyloidosis ◽  
Speckle Tracking Echocardiography ◽  
Radial Strain ◽  
Left Ventricle Ejection Fraction ◽  
Control Group ◽  
P Value ◽  
2D Speckle Tracking

Abstract Introduction Cardiomyopaties like Cardiac Amyloidosis (CA), are an important cause of Heart Failure (HF). They can cause endocardial or transmural involvement. It is possible to characterize the kind of affectation thanks to different phenotypes identified by 2D speckle tracking echocardiography. Purpose: To study the pattern of myocardial involvement in patients (p) affected by CA and HF. Methods: Comparative study of 30 p with CA and HF, in NYHA class ≥II/IV, of which 16 had preseved left ventricle ejection fraction (pLVEF) and 14 had reduced LVEF (rLVEF), considering as cut point a LVEF > 50%. There was a control group (CG) of 16 healthy subjects. Twist, radial strain (RS), circunferential strain (CS) and longitudinal strain (LS) were determined using 2D speckle-tracking echocardiography, along with mitral annulus plane systolic excursion (MAPSE) and basal-apex distance (B-A). The following indexes were calculated: Twist (apical rotation + basal rotation, °); Torsion (twist/B-A, °/cm); Torsion Index (TorI: twist/MAPSE, °/cm), and Deformation Index (DefI:twist/LS,°). The last indexes are dynamic parameters that allow for a more realistic assessment of LV torsion, since they include longitudinal shortening measures such as MAPSE and LS, describing in a more complete and physiological way the global LV systolic movement. Results There were differences of age between the three gropus, being older the p with rLVEF and younger the ones in the CG (63,7 ± 2,8; 68,2 ± 11,5; y 73,9 ± 12,9 years respectively). LS and CS were lower in rLVEF group when compared with pLVEF group, as well as in pLVEF group compared with the CG. The p with pLVEF showed increased values of the dynamic torsion parameters (DefI and TorI), indicating a compensatory increase of LV twist that disappears in p with rLVEF. Twist and Torsion are significantly lower only in the rLVEF group (see table). Conclusions In both CA groups, LS and CS deterioration indicates endocardial and transmural involvement. The loss of compensation given by the increased LV twist, reflected by DefI and TorI, marks the transition to the deterioration of LVEF. Results Table LVEF (%) LS (%) CS (%) TWIST (°) Torsion (°/cm) TorI (°/cm) DefI (°/%) Control Group (n = 15) 68.2 ± 6.3 -20.6 ± 2.5 -22.7 ± 4.9 21.7 ± 6.1 2.7± 0.8 16.4 ± 4.7 -1.0 ± 0.3 CA pLVEF (n = 16) 60,6 ± 5.4* -11.7 ± 4.2* -17.2 ± 4.8* 19.8 ± 8.3 2.5± 1.1 27.7 ±13.5* -1.8 ± 0.9* CA rLVEF (n = 14) 37.2 ± 8.8** -8.7 ± 3.2** -13.0 ± 3.4** 8.3 ± 5.6** 1.0 ± 1.7** 13.4 ± 9.6** -1.0 ± 0.7** *:p value <0,01 between CG and pLVEF group; **:p value <0,01 between pLVEF and rLVEF

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