scholarly journals Effect of Sacubitril/Valsartan on left ventricular longitudinal strain in patients with hematologic malignancies after bone marrow transplantation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
K Katogiannis ◽  
I Ikonomidis ◽  
M Stamouli ◽  
G Makavos ◽  
D Tsilivarakis ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Ejection Fraction ◽  
Marrow Transplantation ◽  
Longitudinal Strain ◽  
Hematologic Malignancies ◽  
Left Ventricular ◽  
Preserved Ejection Fraction ◽  
Systolic Volume ◽  
End Systolic Volume

Abstract Background and aims Chemotherapy is known for its potential adverse effects on myocardium. Optimal medical treatment for heart failure may reverse myocardial dysfunction in the early stages of toxicity development. We hypothesized that early initiation of treatment with sacubitril valsartan could prevent cardiotoxicity. Patients and methods 40 patients (mean age 45,3±13,1 years old, 23 male) with preserved ejection fraction, who suffered from hematologic malignancies (lymphoma, leukemia) and underwent bone marrow transplantation and were randomized to receive sacubitril/valsartan 24/26 mg bid daily or placebo. We measured at baseline, before transplantation, and after three months: i) Global Longitudinal Strain of left ventricle (LV) (GLS), ii) Left Ventricular Epicardial Strain (GLSepi), iii) Left Ventricular Endocardial Strain GLSendo), by speckle tracking imagind iv) Left Ventricular End Diastolic Volume, Left Ventricular End Systolic Volume and Left Ventricular Ejection Fraction (LVEF-Simpson's Method). Results The two treatment groups had similar age, sex atherosclerotic risk factors and cardiotoxic medication before and after bone marrow transplantation. Compared to baseline, patients treated with sacubitril/valsartan did not show a deterioration of LV GLS and GLSepi [(GLS = −20,2±3,1% vs −19,8±3,1%, p=0,551), (GLSepi = −17,9±2,8% vs −17,8±3,1%, p=0,855), (GLSendo = −23,02±3,6% vs −22,6±3,5%, p=0,572)], Conversely, patients treated with placebo group, presented a significant impairment of LV GLS and GLSepi [(GLS = −20,5±1,9% vs 18,5±2,3%, p=0,006, GLSepi = −18,1±1,5% vs −16,1±2,1%, p=0,003), (GLSendo = −23,4±2,2% vs −21,4±2,6%, p=0,008)] six months after bone marrow transplantation. No significant changes were found in LVEF after treatment with sacubitril/valsartan (57,9±5,6% vs 57,6±6,1%, p=0,733) or the placebo (60,1±5,6% vs 57,8±6,6%, p=0,166). However, in the sacubitril valsartan group, we noticed a significant reduction of left ventricular end diastolic and end-systolic volume [(103,1±27,01 ml vs 89,2±21,1 ml, p=0,012), (44,65±15,83 ml vs 36.4±8.3 ml, p=0,003), respectively]. Conclusions Treatment with sacubitril/valsartan prevented deterioration of myocardial deformation three months after bone marrow transplantation in patients with hematologic malignancies and preserved ejection fraction. FUNDunding Acknowledgement Type of funding sources: None.

Effect of enalapril on left ventricular longitudinal strain in patients with hematologic malignancies after bone marrow transplantation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Katogiannis ◽  
I Ikonomidis ◽  
M Stamouli ◽  
G Makavos ◽  
A Frogoudaki ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Ejection Fraction ◽  
Marrow Transplantation ◽  
Longitudinal Strain ◽  
Hematologic Malignancies ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Preserved Ejection Fraction ◽  
Ventricular Ejection Fraction

Abstract Background and aims Chemotherapy is known for its potential adverse effects on myocardium. Optimal medical treatment for heart failure may reverse myocardial dysfunction in the early stages of toxicity development. We hypothesized that early initiation of treatment with Angiotensin Converter Enzyme inhibitor (ACE-i) enalapril could prevent cardiotoxicity. Patients and methods 60 patients (mean age 46,3±12,9 years old, 19 male) with preserved ejection fraction, who suffered from hematologic malignancies (lymphoma, leukemia) and underwent bone marrow transplantation and were randomized to receive 2,5 mg enalapril bid daily or placebo. We measured at baseline, before transplantation, and after three months: i) Global Longitudinal Strain of left ventricle (LV) (GLS), ii) Left Ventricular Epicardial Strain (GLSepi), iii) Left Ventricular Endocardial Strain GLSendo), by speckle tracking imagind iv) Left Ventricular End Diastolic Volume, Left Ventricular End Systolic Volume and Left Ventricular Ejection Fraction (LVEF-Simpson's Method). Results The two treatment groups had similar age, sex atherosclerotic risk factors and cardiotoxic medication befeor and after bone marroe transplantation. Compared to baseline, patients treated with enalapril did not show a deterioration of LV GLS and GLSepi [(GLS = −20.2±3.6% vs 19.7±3.7%, p=0.540), (GLSepi = −17.9±3.1% vs −17.2±3.2%, p=0.422)], Conversely, patients treated with placebo group, presented a significant impairment of LV GLS and GLSepi [(GLS = −20.2±1.8% vs 18.9±2.1%, p=0.041, GLSepi = −17.8±1.5% vs −16.6±1.7%, p=0.028)] three months after bone marrow transplantation. No significant changes were found in LVEF after treatment with enalapril (58.6±17.6% vs 59.4±9.2%, p=0.692) or the placebo (59.4±6.6% vs 59.7±6.8%, p=0.892). Conclusions Treatment with enalapril prevented deterioration of myocardial deformation three months after bone marrow transplantation in patients with hematologic malignancies and preserved ejection fraction. Funding Acknowledgement Type of funding source: None

scholarly journals Beneficial effect of angiotensin converter enzyme inhibitors on left ventricular deformation in patients with hematologic malignancies after bone marrow transplantation

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
I Ikonomidis ◽  
K Katogiannis ◽  
M Stamouli ◽  
G Makavos ◽  
A Frogoudaki ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Ejection Fraction ◽  
Marrow Transplantation ◽  
Longitudinal Strain ◽  
Myocardial Dysfunction ◽  
Global Longitudinal Strain ◽  
Hematologic Malignancies ◽  
Left Ventricular

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Hellenic society of lipidiology, atherosclerosis and cardiovascular disease Background/Introduction:  Optimal medical treatment for heart failure may reverse myocardial dysfunction in the early stages of cardiotoxic treatment. Patients and methods 60 patients age 46,3 ± 12,9 years old, 19 male) with preserved ejection fraction, who suffered from hematologic malignancies (lymphoma, leukemia) and underwent bone marrow transplantation, were randomized to receive 2,5 mg enalapril bid daily or placebo. We measured at baseline, before transplantation, and after three months: i) Global Longitudinal Strain of left ventricle (LV) (GLS), ii) LV Epicardial Strain (GLSepi), iii) LV Endocardial Strain (GLSendo), by speckle tracking imaging, iv) LV End Diastolic ,End Systolic Volume and Ejection Fraction (LVEF). Results   The two treatment groups had similar age, sex atherosclerotic risk factors and cardiotoxic medication before and after bone marrow transplantation. Compared to baseline, patients treated with enalapril did not show a deterioration of LV GLS and GLSepi [ p = 0,540 and p = 0,422)], Conversely, patients treated with placebo group, presented a significant impairment of LV GLS and GLSepi [p = 0,041 and p = 0,028)] three months after bone marrow  transplantation. No significant changes were found in LVEF after treatment with enalapril ( p = 0,692) or the placebo ( p = 0,892). Table 1 Conclusions   Treatment with enalapril prevented deterioration of myocardial deformation three months after bone marrow transplantation Table 1 group baseline 3 months follow-up p Longitudinal strain apical 4 chambers view placebo -20.56 ± 2.55 -19.46 ± 2.59 0.154 enalapril -20.41 ± 3.31 -19.70 ± 3.70 0.433 Longitudinal strain apical 2 chambers view placebo -20.5 ± 1.97 -16.11 ± 10.38 0.149 enalapril -20.30 ± 3.90 -20.00 ± 3.82 0.763 Longitudinal strain apical 3 chambers view placebo -19.55 ± 2.36 -18.55 ± 2.43 0.197 enalapril -20.01 ± 4.09 -19.26 ± 3.68 0.489 Global Longitudinal Strain placebo -20.19 ± 1.76 -18.96 ± 2.08 0.041 enalapril -20.24 ± 3.58 -19.66 ± 3.65 0.540 Average Global Epicardial Strain placebo -17.82 ± 1.45 -16.60 ± 1.68 0.028 enalapril -17.84 ± 3.09 -17.16 ± 3.20 0.422 Average Global Endocardial Strain placebo -23.03 ± 2.15 -21.96 ± 2.56 0.181 enalapril -23.07 ± 4.19 -23.60 ± 4.17 0.666 EF (Simpon’s method) placebo 59.46 ± 6.59 59.69 ± 6.79 0.892 enalapril 58.65 ± 7.63 59.45 ± 9.28 0.692 Left ventricular parameters during 3 months of follow-up.

Đánh giá tình trạng suy tim ở bệnh nhân nhồi máu cơ tim cấp ST chênh lên trước và sau can thiệp động mạch vành

2021 ◽  
Author(s):  
Anh Binh Ho
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Ejection Fraction ◽  
Left Ventricular Mass ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Systolic Volume ◽  
Ventricular Mass ◽  
Percutaneous Coronary ◽  
End Systolic Volume

Mục tiêu: Khảo sát sự biến đổi hình thái và chức năng thất trái của bệnh nhân nhồi máu cơ tim cấp ST chênh lên trước và sau can thiệp tại thời điểm 48 giờ và 3 tháng bằng siêu âm tim. Đối tượng nghiên cứu: Trong thời gian từ tháng 02/2020 đến 09/2020 chúng tôi đã tiến hành nghiên cứu trên 97 bệnh nhân bệnh nhồi máu cơ tim cấp ST chênh lên được can thiệp động mạch vành qua da. Phương pháp nghiên cứu: nghiên cứu tiến cứu quan sát. Kết quả: khối lượng cơ thất trái giảm từ 195,2 ± 65,8 gr xuống 170,2 ± 51,1 gr, thể tích thất trái cuối tâm trương giảm từ 105,2 ± 37,4 mm xuống 95,5 ± 41,3 mm, thể tích thất trái cuối tâm thu giảm từ 57,3 ± 45,2 mm xuống 49,8 ± 50,3 mm. Chức năng tâm thu thất trái (EF) sau 3 tháng can thiệp động mạch vành qua da của nhóm EF ≤ 45 % tăng lên đáng kể từ 39,3 ± 11,2 % lên 45,85 ± 7,56 %, (p < 0,05), ngược lại nhóm EF > 45 % cũng có sự biến đổi từ 57,7 ± 14,4% lên 60,1 ± 13,3 %, (p > 0,05). Kết luận: Sau can thiệp động mạch vành qua da ở thời điểm 3 tháng, khối lượng cơ thất trái, thể tích thất trái cuối tâm thu và cuối tâm trương có sự thay đổi đáng kể. Chức năng tâm thu thất trái (EF) sau 3 tháng can thiệp động mạch vành qua da nhóm EF ≤ 45 % tăng lên có ý nghĩa thống kê. ABSTRACT EVALUATION OF HEART FAILURE IN ST - ELEVATED MYOCADIAL INFARCTION BEFORE AND AFTER PERCUTANEOUS CORONARY INTERVENTION Objectives: Assess the function of left ventricle in ST elevation myocardial infarction before, 48 - hour and 3 - month after primary percutaneous coronary intervention by cardiac ultrasound. Patients: 97 patients who underwent PCI for ST elevated myocardial infarction from 02/2021 to 09/2020. Methods: Prospective observational study. Results: Left ventricular mass index decreased from 195.2 ± 65.8 gr/m2 to 170.2 ± 51.1 gr/m2, end - diastolic left ventricular volume decreased from 105.2 ± 37.4 mm to 95.5 ± 41.3 mm. End systolic volume decreased from 57.3 ± 45.2 mm to 49.8 ± 50.3 mm. Ejection fraction 3 month after the intervention of the EF ≤ 45 % group significantly increased from 39.3 ± 11.2 % to 45.85 ± 7.56 % (p < 0.05). In contrast, there were a rise of the ejection fraction among the EF > 45% group from 57.7 ± 14.4% to 60.1 ± 13.3 % (p > 0.05). Conclusion: 3 month after PCI, left ventricular mass, end - systolic and diastolic volume changed remarkably. The ejection fraction of EF ≤ 45 % group increased with a statical significance. Keywords: PCI, cardiac ultrasonography, ejection fraction, left ventricular mass, end systolic volume end diastolic volume.

Abstract 2819: Identification and Characterization of Super-Responders to Cardiac Resynchronization Therapy: An Echocardiographic Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Amira Zaroui ◽  
Patricia Reant ◽  
Erwan Donal ◽  
Aude Mignot ◽  
Pierre Bordachar ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Lv Function ◽  
Resynchronization Therapy ◽  
Systolic Volume ◽  
End Systolic Volume

In some patients, cardiac resynchronization therapy (CRT) has been recently shown to induce a spectacular effect on left ventricular (LV) function and inverted remodeling with nearby normalization of LV contraction. Objectives: To analyze and characterize super-responders (CRTSR) by echocardiography before CRT. 186 patients have been investigated before and 6 months after implantation of a CRT device with conventional indication according to ESC guidelines. Echocardiographies including measurements of LV dimensions, and contraction by 2-dimensional strain, and pressure assessment, mitral valve analysis were performed at baseline and at 6 months in an independent core-center lab. CRTSR were defined as a reduction of end-systolic volume of at least 15% and an ejection fraction (EF)>50% and were compared to normal responder patients (CRTNo, patients with a reduction of end-systolic volume of at least 15% but an EF <50%). 17/186 patients (9.1%) were identified as CRTSR, only 2 with ischemic cardiomyopathy (p<0.01). No difference was observed regarding NYHA status, EKG duration or EF between CRTSR and CRTNo at baseline. CRTSR presented with significant lower end-diastolic and end-systolic diameters (64±9mm vs 73±9mm (p<0.01) and 53±7.4mm vs 63±8.4mm (p<0.01), respectively), and end-diastolic and end-systolic volumes 161±44ml vs 210±76ml (p<0.02) and 123±43ml vs 163±69ml (p<0.01)) as well as a higher LV dP/dt max (714±251mmHg.s −1 vs 527±188 mmHg.s −1 (p<0.05)). Regarding strain analysis, CRTSR had significantly higher longitudinal values than CRTNo (−12.8±3% vs −9±2.6%, p<0.001) whereas no difference was observed for other components (p ns). Global longitudinal strain obtained by ROC curves was identified as the best parameter for predicting CRTSR with a cut-off value of −11% (Se=80%, Spe=87%, AUC=0.89, p<0.002) and was confirmed as an independent predictor by the logistic regression (RR: 21.3, p<0.0001). In a large multicenter study, CRT super-responders (EF>50%) were observed in 9% of the population and were associated with less-depressed LV function as determined by strain analysis. Global longitudinal strain appears to be the best predictor of CRTSR.

scholarly journals The effect of left ventricle ischemia severity on cardiac performance appeared on ejection fraction using radioactive TC 99m MIBI in comparison with echocardiography

2021 ◽  
Vol 2114 (1) ◽  
pp. 012006
Author(s):  
M K Mohammed ◽  
S I Essa
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Mean Value ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
Significant Difference ◽  
End Systolic Volume ◽  
The Mean

Abstract Ischemic heart disease is a major causes of heart failure. Heart failure patients have predominantly left ventricular dysfunction (systolic or diastolic dysfunction, or both). Acute heart failure is most commonly caused by reduced myocardial contractility, and increased LV stiffness. We performed echocardiography and gated SPECT with Tc99m MIBI within 263 patients and 166 normal individuals. Left ventricular end systolic volume (LVESV), left ventricular end diastolic volume (LVEDV), and left ventricular ejection fraction (LVEF) were measured. For all degrees of ischemia, there was a significant difference between ejection fraction values measured by SPECT and echocardiography, and there were no significant differences among end systolic volume and end diastolic volume value calculated by two methods for all cases. The mean value for EDV (ECHO)/EDV (SPECT) was 1.07 ± 0.31 for degree (1, 2); in the degree 3 the mean value was 1.02 ± 0.08, and 1.005 ± 0.07 for degree 4. The mean value for ESV (ECHO)/ESV (SPECT) was 1.08 ± 0.34 for degree (1, 2); while 1.03 ± 0.12, 1.021 ± 0.128 for degree 3 and 4 respectively. This study was showed a good relation between left ventricular size and ejection fraction measured by SPECT with Tc99m, and echocardiography.

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