scholarly journals P1572 The role of 3D echocardiography in the evaluation of left ventricular remodeling

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
O Guseva ◽  
O Guseva ◽  
O Mamaeva ◽  
N Pavlova ◽  
D Pavlov ◽  
...  

Abstract Purpose to assess the left ventricular (LV) remodeling with using transthoracic 3D Echo and MRI in young athletes. Materials for the period from October 2015 to April 2018, 88 athletes (61 men and 27 women) were examined. Mean age was 20.8 ± 3.9 years. Group A (professionals) – 65 athletes (4 or more training days a week, experience in sports for at least 7 years, the presence of at least the 1st sports category). Group B (Amateurs) – 23 athletes (3 or less training days a week). By types of loads were identified 4 groups: 1st - high-static, low-dynamic (climbing); 2nd - medium-static, medium-dynamic (volleyball, Rugby, sports dancing); 3rd - medium-static, high-dynamic (badminton, orienteering, hockey); 4th - high-static, high-dynamic (triathlon, water polo, rowing). Methods 2D-, 3D-Echo was performed on Vivid E9 XDclear 4D (GE, USA). With the help of software package for processing 3D arrays (4D auto LVQ and 4D Strain and LV-mass) in automatic and semi-automatic mode was obtained end diastolic and end systolic volumes (EDV, ESV), ejection fraction (EF) and LV mass. The device was used for MRI - Avanto (Siemens) - 1.5 T, using: sensors for breathing and synchronization with ECG, standard surface coil Body Matrix. Visualization of the mobile myocardium was carried out by SSFP protocols in standard two-and four-chamber view, as well as on the short axis. In addition, the black-blood Protocol was performed in axial projection for visualization of mediastinal organs and chest. Evaluation of the results was performed on a workstation Syngo Via VB10B (Siemens) using a worker thread MR Cardiac analisis. Results There were significant differences in the types of loads (p < 0.001): 22% of men in Group B had 1st type, 2nd type - 78% of men and 93% of women in group B, 3rd type - 45% of men and 36% of women in group A, 4th type - 39% of men and 21% of women in group A. In the evaluation of LV remodeling and its relationship with the type of loads revealed significant differences (p < 0.01): 87.5% had LV remodeling (95.4% - aggregate type load 1, 2, 3), 6.8% - concentric remodeling (21.7% of all type 4), and 4.5% eccentric hypertrophy (8.7% of all type 4), 1.1 per cent of concentric hypertrophy (4.4% of all type 4). Consequently, most athletes with loads of type 4 had different types of LV remodeling. Comparing 3D Echo and MRI, high-grade positive correlations were obtained in indicators: EDV (R 0.82, p < 0.0001), ESV (R 0.80, p < 0.0001), LV mass (R 0.85, p < 0.0001), as well as moderate positive the index of EDV (R 0.54, p < 0.037) and unreliable for the EF. Conclusions three-dimensional visualization allows to carry out a reliable assessment of the volumetric parameters of the heart chambers, comparable with MRI data and to identify the signs and type of LV remodeling. Requires further study of the performance of 3D Echo in athletes, given the lack of normative data on the modern stage.

2010 ◽  
Vol 62 (3) ◽  
pp. 555-563 ◽  
Author(s):  
E.C. Soares ◽  
G.G. Pereira ◽  
L.C. Petrus ◽  
M. Leomil Neto ◽  
F.L. Yamaki ◽  
...  

Sixty dogs with idiopathic dilated cardiomyopathy were randomly treated with traditional therapy - digitalis, diuretics, angiotensin-converting inhibitors - (group A) or treated with these drugs plus carvedilol (group B). Echocardiographic variables were measured before and after 3, 13, 26, and 52 weeks of treatment or until death. Comparisons between groups and time were performed. No significant differences between groups were found in the most of the echocardiographic variables. The left ventricular end-systolic diameter indexed to body surface area (LVESDi) increased significantly in the group A dogs compared to the group B animals. The survival of groups A and B dogs were not different (P-value=0.1137). In conclusion, the stability of the LVESDi observed in the group treated with carvedilol may represent the beneficial effect over the ventricular remodeling.


Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Bryan R Wilner ◽  
Sonia Garg ◽  
Colby R Ayers ◽  
Satyam Sarma ◽  
Anand Rohatgi ◽  
...  

Introduction: Obesity is linked to an adverse cardiac structural phenotype in cross-sectional studies. However, the effects of longitudinal changes in generalized and central adiposity on left ventricular (LV) remodeling are unknown. Methods: Participants without baseline cardiovascular disease or LV dysfunction in the Dallas Heart Study underwent assessment of body composition and cardiac structure by MRI at baseline and then 7 years later. Associations between change in weight and waist circumference with alterations in structure and function were assessed using multivariable linear regression. Results: The study cohort (n=1262) had a mean age of 44 years and was 43% (545 of 1262) male, 44% (556 of 1262) African-American, and 36% (460 of 1262) obese at baseline. At 7 years follow-up, 7% (85 of 1262) had >10% weight loss, 8% (108 of 1262) had 5-10% weight loss, 44% (551 of 1262) had <5% weight change, 20% (248 of 1262) had 5-10% weight gain, and 21% (270 of 1262) had >10% weight gain. Those who gained >10% weight were younger, had lower BMI and LV mass at baseline, and had greater increases in blood pressure, glucose, triglycerides, LDL cholesterol, and hs-CRP over follow-up. In multivariable models adjusted for age, sex, race, and baseline and interim development of comorbidities, 1-standard deviation increases in body weight and waist circumference over follow-up were significantly associated with higher LV mass, LV wall thickness, and concentricity; but minimally or not significantly associated with LV end-diastolic volume or ejection fraction (EF) (Table). Conclusion: Increases in generalized and central adiposity are characterized primarily by concentric remodeling, with a more modest impact on LV volume and EF. These results support the notion that the development of specific obesity patterns may impact cardiac remodeling with potential implications for the development of cardiac hypertrophy and heart failure.


2015 ◽  
Vol 17 (2) ◽  
pp. 160 ◽  
Author(s):  
Fujian Duan ◽  
Zhi Qi ◽  
Sheng Liu ◽  
Xiuzhang Lu ◽  
Hao Wang ◽  
...  

Aims: The graft of stem cells to treat ischemic cardiomyopathy is popular in many clinical trials. The aim of this study was to evaluate the effectiveness of isolated coronary artery bypass graft combined with bone marrow mononuclear cells (BMMNC) delivered through graft vessels to improve left ventricular remodeling of patients with previous myocardial infarc- tion and chronic heart failure using echocardiography. Material and methods: Patients with previous myocardial infarction and chronic heart failure were randomly allocated to one of the two groups: CABG only (18 patients), or CABG with BMMNC transplantation (24 patients). Echocardiographic parameters were measured on B-mode imaging, 3D imaging and color flow imaging. Results Post-operative LVEDD (end-diastolic dimension of left ventricle), LVESD (end-systolic dimension of left ventricle), LVEDV (end-diastolic volume of left ventricle), LVESV (end-systolic volume of left ventricle), LVEDVI (LVEDV indexed to body surface area), LVESVI (LVESV indexed to body surface area), LV-mass (mass of left ventricle) and LV- massI (LV-mass indexed to body surface area) were significantly improved compared with those obtained prior to operation in CABG+BMMNC group (al p0.05). Postoperative mitral regurgitation score was not significantly different from those prior to opera- tion in both groups (al p>0.05). In Chi-square tests, LVEDD, LVESD, LVEDV, LVESV, LVEDVI, LVESVI, LV-mass, LV- massI were determinants of the left ventricular remodeling. Conclusion: The improvement of left ventricular remodeling in CABG+BMMNC group was better than in the CABG group and this improvement was verified by echocardiography.


2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Selma Kenar Tiryakioglu ◽  
Hakan Ozkan ◽  
Hasan Ari ◽  
Kıvanc Yalin ◽  
Senol Coskun ◽  
...  

Background. The aim of this study is to show whether the septalE/(E′×S′)ratio assessed by tissue Doppler echocardiography can predict left ventricular remodeling after first ST segment elevation myocardial infarction treated successfully with primary percutaneous intervention.Methods. Consecutive patients (n=111) presenting with acute anterior myocardial infarction for the first time in their life were enrolled. All patients underwent successful primary percutaneous coronary intervention. Standard and tissue Doppler echocardiography were performed in the first 24-36 hours of admission. Echocardiographic examination was repeated after 6 months to reassess left ventricular volumes. SeptalE/(E′×S′)ratio was assessed by pulsed Doppler echocardiography.Results. Group 1 consisted of 33 patients with left ventricular (LV) remodeling, and Group 2 had 78 patients without LV remodeling.E/(E′×S′)was significantly higher in Group 1 (4.1±1.9versus1.65±1.32,p=0.001). The optimal cutoff value forE/(E′×S′)ratio was 2.34 with 87.0% sensitivity and 82.1% specificity.Conclusion. SeptalE/(E′×S′)values measured after the acute anterior myocardial infarction can strongly predict LV remodeling in the 6-month follow-up. In the risk assessment, the septalE/(E′×S′)can be evaluated together with the conventional echocardiographic techniques.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Carlos G Santos-Gallego ◽  
Belén Picatoste ◽  
Ida U Njerve ◽  
Kiyotake Ishikawa ◽  
Jaime Aguero ◽  
...  

Background: Adverse cardiac remodeling after MI is associated with excessive degradation of the extracellular matrix (ECM). IK-5001 is a low viscosity injectable solution that provides the polysaccharide alginate. After intracoronary injection into the MI area it undergoes phase transition forming a hydrogel which can support the ECM. We hypothesized that administration of alginate post-MI would provide a temporary scaffold and attenuate adverse LV remodeling. Methods: Acute MI was induced in 16 pigs by balloon occlusion of the proximal LAD for 2 hours. Animals randomly received intracoronary alginate or saline 4 days post-MI. LV function and remodeling were evaluated with cardiac MRI, 3D-echo and pressure-volume loops at 1 and 2 months post-MI. Histology and Western blot analysis were performed after 2 months. Results: Both groups had similar LVEF and infarct size 4 days post-MI. Coronary angiography immediately after alginate injection showed no impairment in coronary flow. However, 2 months post-MI, alginate-treated pigs exhibited reduced LV remodeling compared with controls demonstrated by reduced LV end-systolic volume, LV mass and sphericity (Table). Alginate-treated pigs had less cardiomyocyte hypertrophy and decreased interstitial fibrosis. Consistent with this, chronic activation of Akt and ERK was reduced. Alginate pigs also showed lower plasma levels of BNP and aldosterone. Interestingly, after 2 months, alginate pigs showed better systolic LV function: higher LVEF, better contractile reserve with dobutamine, and higher dP/dt. Conclusions: Intracoronary administration of alginate ameliorates adverse post-MI LV remodeling at the anatomical, histological and molecular level, and mitigates neurohormonal activation in a porcine model of MI. Alginate also improves systolic LV function. Intracoronary injection of alginate represents an exciting novel treatment option to reduce post-MI remodeling that merits assessment in clinical studies.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A I Scarlatescu ◽  
S Onciul ◽  
D Zamfir ◽  
A Pascal ◽  
M Dorobantu

Abstract Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF. Background Left ventricule (LV) function plays an important role in the pathophysiology of decompensation after acute ST elevation myocardial infarction (STEMI). LV remodeling (LVR) after STEMI is associated with development of heart failure, predicting poor clinical outcome therefore its identification is of clinical importance to set up preventive strategies. Prediction of the left ventricular remodeling (LVR) after STEMI in patients treated by primary PCI is challenging. Purpose Finding an echocardiographic parameter that can predict left ventricular remodeling in time after STEMI. Materials and methods In this prospective study we included 30 consecutive patients, median age 60 (37-79), 76% male, with STEMI treated by primary PCI. We performed conventional 2D transthoracic echocardiography for all included patients. In addition to conventional parameters we measured LV global longitudinal strain (GLS) and LV mechanical dispersion using 2D speckle tracking imaging technique. For morphological and functional analysis of LV we used 3D echocardiography (volumes, LVEF) considering its superiority in assessment of LV. All measurements were performed at baseline (up to 7 days after STEMI) and at 5 year follow up. LVR was defined as an increase of over 15% of the LV end diastolic volume (LVEDV) in time, at 5 years after the STEMI. Results We obtained significant differences in time (up to 7 days after STEMI vs at 5 years) between 3D LVEF (46,48 vs 51,68, p = 0.002), LVEDV (97,12 vs 107,76, p = 0.000), 2D global strain (-11.76 vs - 14,1, p = 0.00), and mechanical dispersion (65,06 vs 57,66, p = 0.00) in all patients. LV remodeling at 5 years (15% increase in LVEDV) was observed in 36,6% of the included patients. At 5 years follow up, LVEDV mean value in the remodeling group was 130 ml and in the no remodeling group 90,21 ml (p = 0.002), 3D LVEF was 48,18 vs 54,42 (p = 0.05), global strain was - 12,33 vs -15,35 (p = 0.02) and LV mechanical dispersion 66,27 vs 55,55 (p = 0.05). Therefore patients with LV remodeling in time had lower LVEF, lower global strain and higher LV mechanical dispersion at baseline. Using ROC analysis we identified two cut off values, one of -11.55 for global LV strain measured at baseline (Sb 81.8%, Sp 77%, AUC 0.776, CI 95%, p = 0.022) and the other one of 63.7 for LV mechanical dispersion at admission (Sb 72,7%, Sp 62%, AUC 0.734, p 0.05) to discriminate between patients with or without LV adverse remodeling at 5 years after STEMI. We also found, using regression analysis, that GLS and LV mechanical dispersion are able to predict LV remodeling in time. Conclusion Global longitudinal strain and left ventricular mechanical dispersion measured in the acute phase can predict which patient is likely to undergo LV remodeling at 5 years after STEMI. GLS and LV dispersion could be used as predictors for future LV adverse remodeling after STEMI. Larger scale studies are needed to validate these findings.


2021 ◽  
Vol 12 ◽  
Author(s):  
Qiang Li ◽  
Weihua Chen ◽  
Shanshan Shi ◽  
Haozhang Huang ◽  
Wenguang Lai ◽  
...  

Background: Acute kidney injury (AKI) is a common complication after coronary angiography (CAG) and associated with heart failure (HF). Left ventricular (LV) remodeling is a vital process in the progression of HF. However, few studies investigate the relationship between AKI and LV remodeling.Methods: We included consecutive patients undergoing CAG from January 2007 to December 2018 at Guangdong Provincial People’s Hospital (NCT04407936). AKI was defined as an absolute increase in serum creatinine (Scr) of ≥ 0.3mg/dl or a ≥ 50% increase in Scr from baseline within the first 48–72 h after the procedure. LV remodeling was defined as: (1) an absolute decrease in left ventricular ejection fraction (LVEF) of ≥ 10% compared to baseline, or (2) a follow-up LVEF &lt; 40%. Univariate and multivariate logistical regressions were used to assess the association between AKI and LV remodeling.Results: Of the 1,573 patients (62.2 ± 9.7 years, female 36.7%) included in the study, 231 (14.7%) had AKI. The incidence of LV remodeling was higher in patients with AKI than in those without AKI (24.7% vs. 14.5%). After adjusting for confounding, multivariate logistic regression showed that AKI was associated with a significantly higher risk of LV remodeling [adjusted odds ratio (aOR) 1.87; 95% CI, 1.30–2.66; p &lt; 0.001]. In addition, LV remodeling patients had higher all-cause mortality compared to non-LV remodeling patients (9.7% vs. 19.1%).Conclusion: Our data suggested that AKI is present in up to 15% of patients after CAG and that nearly a quarter of AKI patients suffered LV remodeling and AKI patients have a two-fold risk of developing LV remodeling than non-AKI patients. Our findings suggest that more active measures be taken not only to prevent AKI patient developing into LV remodeling, but to prevent patients undergoing CAG from developing AKI.


2013 ◽  
Vol 113 (suppl_1) ◽  
Author(s):  
Sophie Cardin ◽  
Marie-Pier Scott-Boyer ◽  
Sylvie Picard ◽  
Tim L Reudelhuber ◽  
Christian F Deschepper

Background: Although C57Bl/6 mice are widely used in cardiovascular research, little is known about possible substrain differences. We compared the left ventricular (LV) remodeling induced by angiotensin II (angII) in C57Bl/6J and C57Bl/6N mice, these 2 substrains corresponding to two main branches having diverged since 1951. Methods and Results: Male C57Bl/6J and C57Bl/6N mice were treated with angII (350ng/kg/min) or vehicle via mini-osmotic pumps for either 48h (for microarray profiling of gene expression and macrophage cytofluorometry counting) or 15 days (for both gene expression and histology). AngII (15d) induced fibrosis in LV from C57BL/6N (as shown by histology and col1a expression), but not in C57BL/6J. After 48h of treatment, about 100 genes responded in a strain-specific fashion, most responses being specific for C57Bl/6N mice. Among genes showing greater than 2-fold induction by angII (48h) in C57Bl/6N mice, there was enrichment for markers of macrophages activation and M2 polarization (including osteopontin, arginase1 and galectin3). These strain-specific differences were confirmed (both in LV tissues and macrophages isolated from LVs) by Q-RT-PCR, and occurred despite that fact that AngII increased the abundance of Cd11b+ macrophages to the same extent in both strains. Moreover, AngII (48h) increased expression of several markers of fibroblast activation (including Timp1, Lox and tenascin) in C57Bl/6N (both in LV tissue and fibroblasts isolated from LVs), but not in C57Bl/6J. Although one of the best known genetic differences in both substrains is the inactivation of the Nnt gene in C57Bl6/J mice, experiments performed in F2 mice do not indicate that the fibrotic response co-segregates with the Nnt mutation. Conclusions: Although angII-treatment induces macrophage recruitment in the LVs of both C57Bl/6J and C57Bl/6N mice, activation of cardiac macrophages and their M2 pro-reparative polarization (with subsequent activation of fibroblasts and synthesis of collagen) occurs only in the genetic C57Bl/6N background. The absence of macrophage activation and cardiac fibrosis in C57BL/6J may possibly explain some differences in experimental results obtained by various investigators using different C57BL/6 substrains.


2007 ◽  
Vol 292 (1) ◽  
pp. H530-H538 ◽  
Author(s):  
Yasuyuki Onai ◽  
Jun-ichi Suzuki ◽  
Yasuhiro Maejima ◽  
Go Haraguchi ◽  
Susumu Muto ◽  
...  

Several studies have demonstrated that NF-κB is substantially involved in the progression of cardiac remodeling; however, it remains uncertain whether the continuous inhibition of NF-κB is effective for the prevention of myocardial remodeling. Myocardial infarction (MI) was produced by ligation of the left anterior coronary artery of rats. IMD-0354 (10 mg/kg per day), a novel phosphorylation inhibitor of IκB that acts via inhibition of IKK-β, was injected intraperitoneally starting 24 h after induction of MI for 28 days. After 28 days, the IMD-0354-treated group showed significantly improved survival rate compared with that of the vehicle-treated group ( P < 0.05). Although infarct size was similar in both groups, improved left ventricular (LV) remodeling and diastolic dysfunction, as indicated by smaller LV cavity (LV end-diastolic area: vehicle, 74.13 ± 3.57 mm2; IMD-0354, 55.00 ± 3.73 mm2; P < 0.05), smaller peak velocity of early-to-late filling wave (E/A) ratio (vehicle, 3.87 ± 0.26; IMD-0354, 2.61 ± 0.24; P < 0.05), and lower plasma brain natriuretic peptide level (vehicle, 167.63 ± 14.87 pg/ml; IMD-0354, 110.75 ± 6.41 pg/ml; P < 0.05), were observed in the IMD-0354-treated group. Moreover, fibrosis, accumulation of macrophages, and expression of several factors (transforming growth factor-β1, monocyte chemoattractant protein-1, matrix metalloproteinase-9 and -2) in the noninfarcted myocardium was remarkably inhibited by IMD-0354. In conclusion, inhibition of NF-κB activation may reduce the proinflammatory reactions and modulate the extracellular matrix and provide an effective approach to prevent adverse cardiac remodeling after MI.


2016 ◽  
Vol 120 (8) ◽  
pp. 956-964 ◽  
Author(s):  
Christian M. Westby ◽  
David S. Martin ◽  
Stuart M. C. Lee ◽  
Michael B. Stenger ◽  
Steven H. Platts

Short periods of weightlessness are associated with reduced stroke volume and left ventricular (LV) mass that appear rapidly and are thought to be largely dependent on plasma volume. The magnitude of these cardiac adaptations are even greater after prolonged periods of simulated weightlessness, but the time course during and the recovery from bed rest has not been previously described. We collected serial measures of plasma volume (PV, carbon monoxide rebreathing) and LV structure and function [tissue Doppler imaging, three-dimensional (3-D) and 2-D echocardiography] before, during, and up to 2 wk after 60 days of 6° head down tilt bed rest (HDTBR) in seven healthy subjects (four men, three women). By 60 days of HDTBR, PV was markedly reduced (2.7 ± 0.3 vs. 2.3 ± 0.3 liters, P < 0.001). Resting measures of LV volume and mass were ∼15% ( P < 0.001) and ∼14% lower ( P < 0.001), respectively, compared with pre-HDTBR values. After 3 days of reambulation, both PV and LV volumes were not different than pre-HDTBR values. However, LV mass did not recover with normalization of PV and remained 12 ± 4% lower than pre-bed rest values ( P < 0.001). As previously reported, decreased PV and LV volume precede and likely contribute to cardiac atrophy during prolonged LV unloading. Although PV and LV volume recover rapidly after HDTBR, there is no concomitant normalization of LV mass. These results demonstrate that reduced LV mass in response to prolonged simulated weightlessness is not a simple effect of tissue dehydration, but rather true LV muscle atrophy that persists well into recovery.


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