Dispersion of regional longitudinal strain and strain rate in nonischemic left ventricular segments: insights from speckle tracking Dobutamine Stress Echocardiography (DSE)

Aims The aim of the study was to evaluate left ventricular (LV) remodeling and systolic function using two-dimensional speckle tracking echocardiographic (2D STE) imaging in children at a long-term (more than 36 months, 107.5±57.8 months) after balloon valvuloplasty for aortic stenosis (BAV). Methods and results 40 patients (mean age 9,68 years, 75% male) after BAV and 62 control subjects matched to the age and heart rate were prospectively evaluated. The 2D STE assessment of LV longitudinal and circumferential strain and strain rate was performed. Left ventricular eccentric hypertrophy (LVEH) was diagnosed in 75% of patients in the study group. Left ventricular ejection fraction (LVEF) was normal in all patients. In study group, global longitudinal strain (GLS), global longitudinal strain rate (GLSr) were significantly lower compared with the controls: GLS (-19.7±2.22% vs. -22.3±1.5%, P< 0.001), GLSr (-0.89±0.15/s vs. -1.04 ±0.12/s, P < 0.001). Regional (basal, middle and apical segments) strain and strain rate were also lower compared with control group. Global circumferential strain (GCS), global circumferential strain rate (GCSr) as well as regional (basal, middle and apical segments) strain and strain rate were normal. Multivariable logistic regression analysis included: instantaneous peak systolic Doppler gradient across aortic valve (PGmax), grade of aortic regurgitation (AR), left ventricular mass index (LVMI), left ventricular relative wall thickness (LVRWT), left ventricular end-diastolic diameter (LVEDd), peak systolic mitral annular velocity of the septal and lateral corner (S’spt, S’lat), LVEF before BAV and time after BAV and showed that the only predictor of reduced GLS was LV eccentric hypertrophy [odds ratio 6.9; (95% CI: 1.37–12.5), P = 0.045]. Conclusion Patients at long-term observation after BAV present the subclinical LV systolic impairment, which is associated with the presence of its remodeling. Longitudinal deformation is the most sensitive marker of LV systolic impairment in this group of patients.

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Abstract 4246: Dobutamine-induced Reserve of the Two-dimensional Longitudinal Strain Rate Predicts Clinical and Neurohumoral Improvement After Levosimendan Treatment in Acutely Decompensated Chronic Heart Failure

Circulation ◽

10.1161/circ.118.suppl_18.s_853 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Vasiliki Bistola ◽

Ioannis Paraskevaidis ◽

Ignatios Ikonomidis ◽

Ioannis Parissis ◽

Gerasimos Filippatos ◽

...

Keyword(s):

Strain Rate ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Nyha Class ◽

Radial Strain ◽

Left Ventricular ◽

Contractile Reserve ◽

Systolic Strain ◽

Strain And Strain Rate ◽

Longitudinal Strain Rate

Objective: Levosimendan improves symptoms and the hemodynamic profile in patients with acutely decompensated chronic heart failure (ADCHF). We aimed to investigate: the association of low dose dobutamine (DSE)-induced changes of two-dimensional strain parameters with the corresponding changes of left ventricular ejection fraction (LVEF) and left ventricular outflow tract velocity time integral (LVOT VTI) in patients with ADCHF, and whether left ventricular contractile reserve assessed by both conventional and speckle tracking echocardiography is associated with clinical and neurohumoral improvement after levosimendan treatment. Methods: Thirty one consecutive patients with ADCHF (mean age 65 ± 10 years, NYHA class 3.6 ± 0.3, LVEF 22 ± 6%) were studied by DSE (peak dose 20 μg/kg/min) prior to 24-hour infusion of levosimendan (0.01 μg/kg/min, without bolus). The LVEF, LVOT VTI, mean longitudinal, circumferential and radial strain and strain rate using speckle tracking imaging were measured. Results: Twenty-three patients (74%) had evidence of contractile reserve (increase of LVEF > 10% and LVOT VTI > 20% after peak dobutamine dose, CR+), and 8 (26%) showed no reserve (CR−). CR+ versus CR- patients demonstrated greater improvement of NYHA class (mean NYHA change: −1.0±0.5 vs −0.5±0.3 NYHA class, p=0.01), and reduction of b-type natriuretic peptide levels (− 34±30 vs + 4±31%, p <0.01) 48 hours after completion of treatment. By multivariate analysis, mean longitudinal systolic strain rate reserve (resting - peak longitudinal strain rate ΔLSR (%)) was the best predictor of improvement of NYHA class (p= 0.039) and BNP (p= 0.042) after levosimendan administration among the reserve of: LV FS, EF, LVOT VTI, longitudinal strain, circumferential and radial strain and strain rate. Conclusion: Dobutamine-induced reserve of 2-dimentional speckle tracking longitudinal systolic strain rate is associated with clinical and neurohumoral improvement after treatment with levosimendan in patients with ADCHF.

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The Feasibility of Ultrasonic Regional Strain and Strain Rate Imaging in Quantifying Dobutamine Stress Echocardiography

European Heart Journal - Cardiovascular Imaging ◽

10.1053/euje.4.2.81 ◽

2003 ◽

Vol 4 (2) ◽

pp. 81-91 ◽

Cited By ~ 16

Author(s):

M. Kowalski ◽

M.-C. Herregods ◽

L. Herbots ◽

F. Weidemann ◽

L. Simmons ◽

...

Keyword(s):

Strain Rate ◽

Stress Echocardiography ◽

Dobutamine Stress Echocardiography ◽

Dobutamine Stress ◽

Strain Rate Imaging ◽

Regional Strain ◽

Strain And Strain Rate

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P673Improvement of arterial stiffness and myocardial deformation in patients with poorly controlled diabetes mellitus type 2 after optimization of antidiabetic medicationP674Clinical presentation, echocardiographic findings and complications in patients with typical and atypical form of takotsubo cardiomyopathyP675Left ventricular mass/end-diastolic volume ratio with tridimensional echocardiography in newly-diagnosed hypertensive patients: which relation between left ventricular geometry and stroke volume?P676Endothelial dysfunction: the link between arterial hypertension, diabetes mellitus and heart diseaseP677Dynamic of changes of arterial stiffness evaluated by cardio-ankle vascular index(CAVI) during the growth and development of children and adolescentsP678Peripheral arterial stiffness in pulmonary hypertension and pulmonary embolism: assessment with cardio ankle vascular index, noninvasive markers of vascular diseaseP679Early detection and prediction of CHOP-induced cardiotoxicity in nonHodgkin lymphoma by 4D echocardiography, vascular ultrasound, and cardiac biomarkersP680Right ventricular remodeling in children engaged in endurance sports: a longitudinal study in preadolescent athletesP681Electrocardiographic criteria for atria enlargement are not useful in the evaluation of junior high-dynamic high-static athletesP682Prognostic value of right ventricle, pulmonary arterial pressure and biomarkers in patients with acute heart failure: one year follow upP683One-point carotid stiffness parameters by echo-tracking method in a wide-age range of healthy population. A single center experienceP684Role of bidimensional speckle tracking longitudinal strain in the evaluation of right and left ventricular function in adult patients with transposition of the great arteriesP685Interfaces between FBN1 gene polymorphism and biomechanical parameters estimated by speckle-tracking echocardiography of dilative pathology of ascending aorta P686Layer-specific speckle tracking analysis for the detection of coronary artery disease during dipyridamole stress echoP687Stress echo in Italy: state-of-the art 2015P688The declining frequency of Inducible myocardial ischemia during stress echocardiography over 27 consecutive years (1983-2009)P689Global longitudinal strain can unmask inducible myocardial ischemia at submaximal heart rate during dobutamine stress echocardiography.P690Low risk syntax score predicted by wall motion score index during dobutamine stress echocardiographyP691Outdoor stress echo by lung ultrasound for subclinical detection of high altitude pulmonary edema with B-linesP692Predictors and consequences of infective endocarditis with perivalvular extension - a subgroup with worse short and medium-term prognosisP693Analysis of left atrial auricle morphology and function to detect considerable risk factors regarding the prevention of strokeP694LAA closure - does size really matter?P695Real assessment of mitral regurgitation by three-dimensional transesophageal echocardiographyP696Myocardial contrast dobutamine stress echocardiography for detection of coronary artery disease

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jew250.002 ◽

2016 ◽

Vol 17 (suppl 2) ◽

pp. ii136-ii143

Author(s):

I. Ikonomidis ◽

M. Budnik ◽

M. Lembo ◽

A-M Vintila ◽

T. Jurko ◽

...

Keyword(s):

Diabetes Mellitus ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Arterial Stiffness ◽

Speckle Tracking ◽

Stress Echocardiography ◽

Longitudinal Strain ◽

Dobutamine Stress ◽

Left Ventricular ◽

Artery Disease

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Evaluation of Longitudinal Tissue Velocity and Deformation Imaging in Akinetic Non-viable Apical Segments of Left Ventricular Myocardium

Internal Medicine And Medical Investigation Journal ◽

10.24200/imminv.v2i4.140 ◽

2018 ◽

Vol 3 (4) ◽

Author(s):

Hakimeh Sadeghian ◽

Parastoo Vosoughi ◽

Afsaneh Sadeghian ◽

Masoumeh Lotfi-Tokaldany ◽

Mohammad Moein Ashrafi ◽

...

Keyword(s):

Strain Rate ◽

Patient Group ◽

Dobutamine Stress Echocardiography ◽

Peak Systolic Velocity ◽

Dobutamine Stress ◽

Left Ventricular ◽

Systolic Strain ◽

Tissue Velocity ◽

Strain Rate Imaging ◽

Strain And Strain Rate

Introduction: The use of tissue velocity and strain rate imaging is proposed for the quantification of non-viable myocardium. This study is aimed at investigating the differences in tissue velocity and strain rate imaging indices between non-viable left ventricular apical segments and the normal segments using segment-by-segment comparison.Materials and Method: Thirty-two patients with akinetic left ventricular apical segments and without viability were selected using two-dimensional echocardiography and dobutamine stress echocardiography; 32 individuals with normal echocardiography and coronary angiography formed the normal group. Peak systolic velocity, peak systolic strain, and strain rate were measured in the four left ventricular apical segments and the apex 17th segment.Results: The patient group had a significantly lower ejection fraction (26.88±6.06% vs. 56.56±2.36%; p<0.001). Overall, the patient group had significantly lower resting peak systolic velocity, systolic strain, and strain rate. In the segment-by-segment comparison, only systolic strain showed a remarkable reduction in the patient group, while reduction in Sm and strain rate were not significant in all the segments. After dobutamine stress echocardiography, only systolic strain showed an insignificant increase compared to the resting values. In the apex 17th segment, Sm showed significant reduction in the patient group.Conclusion: The ST in apical segments may be used as a quantitative index for detecting akinesia both at rest and after dobutamine infusion. Reduction in Sm can be used as a marker of akinesia in the apical cap at rest.

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