P5977Predicting significant ventricular arrhythmias in STEMI patients: never-ending challenge, still more place for myocardial deformation imaging?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Krljanac ◽  
D Trifunovic ◽  
M Asanin ◽  
L Savic Spasic ◽  
S Aleksandric ◽  
...  
Keyword(s):  
Rotation Rate ◽  
Ventricular Arrhythmias ◽  
Speckle Tracking ◽  
Myocardial Deformation ◽  
Deformation Analysis ◽  
First Year ◽  
Deformation Imaging ◽  
End Point ◽  
Myocardial Deformation Imaging ◽  
Malignant Arrhythmias

Abstract Background Malignant ventricular arrhythmias in STEMI patients carry ominous prognosis including sudden cardiac death (SCD). According to the current guidelines only EF<35%, 40 days after STEMI, is indication for ICD implantation. Recently, index of myocardial dispersion (IMD) estimated by myocardial deformation imaging (speckle tracking echocardiography) was documented to provide better risk stratification. Aim To define whether quantification of myocardial mechanics early after pPCI using modern echocardiography offers information more to predict malignant arrhythmias during the first year after STEMI. Methods In the 226 consecutive STEMI patients (pts) 57.8±10.4yr, 71.7% males, in PREDICT-VT study (NCT03263949) treated with pPCI early echo (5±2 days) was done including conventional parameters and comprehensive speckle tracking LV deformation analysis with longitudinal (L), circumferential (C) strain (S;%) and strain rate (SR, 1/sec) and rotational LV mechanics. ROC analysis was performed to identify the best parameters to predict composite end-point defined as secondary VF, sustained/non-sustained VT and SCD, 48h after pPCI and during the first year of follow up. Results Twenty two patients (9.7%) reached the end-point. Classical parameters of LV systolic function, including LVEF, wall motion score index; global, systolic LS, CS and parameters of diastolic dysfunction were not significant predictors of the malignant arrhythmias. Early L SR, systolic C SR, IMD of global rotation and late rotation rate predicted the primary end-point (table). Parameter ROC area 95% CI p Cutt-off Sens Spec Longirudinal mechanics   SR E (1/sec) 0.687 0.577–0.796 0.019 0.69 64 65   IMD S (ms) 0.752 0.666–0.838 0.002 66.1 71 72 Circumferencial mechanics   SR S (1/sec) 0.732 0.613–0.852 0.002 −1.22 71 67 Rotational mechanics   Global IMD (ms) 0.329 0.177–0.481 0.036 82.9 63 62   Late rotation rate IMD (ms) 0.318 0.196–0.442 0.026 41.1 65 64 Conclusion Myocardial deformation imaging offers deeper insight into complex mechanical abnormalities during LV contraction and relaxation in longitudinal, circumferential and rotational directions (impaired and asynchronous deformations) in STEMI patients and predicts serious arrhythmic events.

P1472Predicting significant ventricular arrhythmias in STEMI patients in middle-range and preserved EF

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Krljanac ◽  
D Trifunovic ◽  
M Asanin ◽  
L Savic Spasic ◽  
S Aleksandric ◽  
...  
Keyword(s):  
Systolic Function ◽  
Deformation Analysis ◽  
First Year ◽  
End Point ◽  
Mechanical Dispersion ◽  
Middle Range ◽  
Roc Area ◽  
Myocardial Deformation Imaging ◽  
Lv Systolic Function ◽  
Contraction And Relaxation

Abstract Background Predicting malignant ventricular and sudden cardiac death (SCD) in STEMI patients with middle-range and preserved EF is challenge. Aim To identify the best parameters to predict composite end-point defined as secondary VF, sustained/non-sustained VT and sudden death, 48h after and during the first year of follow up after STEMI in patients with middle-range and preserved EF. Methods In the 192 consecutive STEMI patients (pts) 57.8±10.4yr, 69.9% males, in PREDICT-VT study (NCT03263949) treated with pPCI, with EF ≥40%, early echo (5±2 days) was done including conventional parameters and comprehensive speckle tracking left ventricle (LV) deformation analysis with longitudinal (L), circumferential (C) strain (S; %) strain rate (SR, 1/sec), index mechanical dispersion (IMD) and rotational LV mechanics. Results Thirteen patients (8.3%) reached the end-point. Classical parameters of LV systolic function, including LVEF, wall motion score index and parameters of diastolic dysfunction were not significant predictors of the malignant arrhythmias. IMD of late rotation rate (63.7 vs. 40.7ms, p=0.055) and late diastolic untwisting rate (−48.85 vs. −63.18°/s, p=0.059) had trend to become the significant predictors. CS in papillary muscle level in endo and mid layers predicted the primary end-point (endo: −20.5±11.8 vs. −24.9±4.6, mid: −14.6±3.9 vs. −17.0±2.1, epi: −10.1±3.3 vs. −11.8±1.8) (table). Parameter of circumferencial mechanics ROC area 95% CI p Cutt-off Sens Spec PM endo (%) 0.302 0.146–0.458 0.038 −22.75 70 67 PM mid (%) 0268 0.153–0.383 0.015 −15.65 80 62 Conclusion Myocardial deformation imaging offers deeper insight into complex mechanical abnormalities during LV contraction and relaxation in STEMI patients with middle-range and preserved EF that predicts serious arrhythmic events.

scholarly journals Early detection of cardiotoxicity in patients on cancer therapy: the role of myocardial deformation imaging and biomarkers

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. 4574-4574
Author(s):  
S. Valbuena ◽  
D. Iglesias ◽  
T. Lopez ◽  
O. Rodriguez ◽  
D. Gemma ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Early Detection ◽  
Myocardial Deformation ◽  
Deformation Imaging ◽  
Myocardial Deformation Imaging

Abstract 2294: The Use of Myocardial Deformation Imaging Based on Ultrasonic Pixel Tracking to Identify Reversible Myocardial Dysfunction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Michael Becker ◽  
Mithra Lenzen ◽  
Katharina Stempel ◽  
Andreas Franke ◽  
Malte Kelm ◽  
...  
Keyword(s):  
Left Ventricular Dysfunction ◽  
Myocardial Viability ◽  
Predictive Value ◽  
Ventricular Dysfunction ◽  
Myocardial Dysfunction ◽  
Radial Strain ◽  
Left Ventricular ◽  
Myocardial Deformation ◽  
Deformation Imaging ◽  
Myocardial Deformation Imaging

Objective. Myocardial deformation imaging allows analysis of myocardial Objective. Myocardial deformation imaging allows analysis of myocardial viability in ischemic left ventricular dysfunction. This study evaluated the predictive value of myocardial deformation imaging for improvement in cardiac function after revascularization therapy in comparison to contrast-enhanced cardiac magnetic resonance imaging (ceMRI). Methods and Results. In 53 patients with ischemic left ventricular dysfunction, myocardial viability was assessed using pixel-tracking-derived myocardial deformation imaging and ceMRI to predict recovery of function at 9±2 months follow-up. For each left ventricular segment in a 16-segment model peak systolic radial strain was determined from parasternal 2D echocardiographic views using an automatic frame-by-frame tracking system of natural acoustic echocardiographic markers (EchoPAC, GE Ultrasound), and maximal thickness of myocardial tissue without late enhancement (LE) using ceMRI. Of 463 segments with abnormal baseline function, 227 showed regional recovery. Compared with segments showing functional improvement, those that failed to recover had lower radial strain (15.2±7.5 vs 22.6±6.3 %; p<0.001) and lower thickness without LE (5.2±2.9 vs 8.7±2.2 mm; p<0.001). Using a cut-off of 17.2 % for peak systolic radial strain, functional recovery could be predicted with high accuracy (specificity 85%, sensitivity 70%, area under the curve (AUC) 0.859, 95% CI: 0.825– 0.893). The predictive value of thickness without LE by ceMRI was similar at a cut-off of 8.2 mm (specificity 84%, sensitivity 70%, AUC 0.831, 95% CI: 0.793– 0.870). Conclusion. Myocardial deformation imaging based on frame-to-frame tracking of acoustic markers in 2D echocardiographic images is a powerful novel modality to identify reversible myocardial dysfunction.

Ventricular Myocardial Deformation Imaging of Patients with Repaired Tetralogy of Fallot

2020 ◽  
Vol 33 (7) ◽  
pp. 788-801
Author(s):  
Vivian Wing-yi Li ◽  
Clement Kwong-man Yu ◽  
Edwina Kam-fung So ◽  
Wilfred Hing-sang Wong ◽  
Yiu-fai Cheung
Keyword(s):  
Tetralogy Of Fallot ◽  
Myocardial Deformation ◽  
Deformation Imaging ◽  
Repaired Tetralogy Of Fallot ◽  
Myocardial Deformation Imaging

scholarly journals P1381 The utility of left ventricle deformation in patients with myocarditis with midle-range and preserved ejection fraction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
G Krljanac ◽  
I Veljic ◽  
A Ristic ◽  
R Maksimovic ◽  
I Milinkovic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Speckle Tracking ◽  
Systolic Function ◽  
Acute Myocarditis ◽  
Deformation Analysis ◽  
Mechanical Dispersion ◽  
Middle Range ◽  
Myocardial Deformation Imaging ◽  
Lv Systolic Function ◽  
Insight Into

Abstract Background Predicting malignant ventricular arrhythmias and heart failure in patients (pts) with acute myocarditis and middle-range and preserved EF is challenge Aim: to define whether quantification of myocardial mechanics in early, acute phase of myocarditis offers more information to predict six months outcome of patients.Methods: In the 36 consecutive pts with myocarditis, middle age 32.86 ± 12.04yr, 75% males, echocardiography exam was done 1-3 day of diseases, including conventional parameters and comprehensive speckle tracking LV deformation analysis with longitudinal (L), circumferential (C) strain (S;%), strain rate (SR, 1/sec) and rotational LV mechanics. Results: The most patients were present as infarct-like myocarditis (80.56%), the others patients were present as heart failure-like (11.11%) and arrhythmia-like myocarditis (8.33%). At admission 27 (90%) pts had chest pain, 20 (66.7%) pts had ECG changes, 15 (50%) pts had symptoms of heart failure, 5 (16.7%) pts had arrhythmias. Amount of edema and fibrosis assessed by cardiovascular magnetic resonance (CMR) and echo correlate significantly. Classical and conventional parameters of LV systolic function, and deformation were not significantly different between groups. However, mechanical dispersion index (IMD) of global LS and systolic S were significantly different between groups (p &lt; 0.05). Conclusion: Myocardial deformation imaging, like speckle tracking echocardiography, offers deeper insight into complex mechanical abnormalities during not only LV contraction but LV relaxation in longitudinal directions in patients with acute myocarditis. Infarct-like Arrhythmia-like Heart failure-like p EF (%) 57.5 ± 5.42 54.7 ± 12.9 58.3 ± 6.8 NS GLS endo (%) -20.8 ± 2.59 -19.78 ± 2.27 -17.36 ± 5.65 NS GLS (mid (%) -18.31 ± 2.4 -17.31 ± 1.52 -15.3 ± 5.10 NS GLS epi (%) -16.15 ± 2.28 -15.20 ± 0.92 -13.55 ± 4.68 NS IMD LS (ms) 37.04 ± 7.71 33.04 ± 6.58 60.75 ± 38.56 0.008 CS endo (%) -26.39 ± 6.93 -21.59 ± 3.88 -25.17 ± 6.48 NS CS mid (%) -17.32 ± 6.77 -13.03 ± 2.07 -15.95 ± 4.41 NS CS epi (%) -10.99 ± 6.89 -7.13 ± 0.72 -9.53 ± 2.73 NS IMD CS (ms) 47.69 ± 8.86 41.43 ± 23.92 41.01 ± 20.51 NS IMD SL peak S* 12.27 (21) 13.96 (4) 20.28 (84) 0.042 *Median and range values are presented.

scholarly journals Myocardial Deformation Imaging Based on Ultrasonic Pixel Tracking to Identify Reversible Myocardial Dysfunction

2008 ◽  
Vol 51 (15) ◽  
pp. 1473-1481 ◽  
Author(s):  
Michael Becker ◽  
Alexandra Lenzen ◽  
Christina Ocklenburg ◽  
Katharina Stempel ◽  
Harald Kühl ◽  
...  
Keyword(s):  
Myocardial Dysfunction ◽  
Myocardial Deformation ◽  
Deformation Imaging ◽  
Myocardial Deformation Imaging
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