2139Left atrial dysfunction assessed by strain correlates with symptoms and severity of aortic stenosis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Santoro ◽  
A Pardo ◽  
R Hinojar ◽  
A Garcia ◽  
L Salido ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Speckle Tracking ◽  
Global Longitudinal Strain ◽  
Control Group ◽  
Lv Function ◽  
Functional Changes ◽  
Lv Dysfunction ◽  
Significant Difference ◽  
Atrial Strain ◽  
And Function

Abstract Background Aortic stenosis (AS) results in high pressure afterload causing detrimental effect especially on the left chambers. Structural and functional changes of the left ventricle (LV) usually corresponds to concomitant remodelling of the left atrium (LA). However, how this pressure afterload specifically affects LA function and whether the study of LA function could help in stratifying patients with different degree of AS it is not known. Purpose We aim to evaluate the differences in LA and LV function according different degree of AS by standard and speckle tracking echocardiographic. Methods From January 2016 to May 2018 we recruited 135 patients referring to our echo-lab with diagnosis of AS (mean age 79.5±4.4; 60/55% female). We divided this population according to AS severity in patients with moderate AS, severe asymptomatic and severe symptomatic AS and matched with 35 control group with no aortic stenosis (n=45, mean age: 77.6±4.5). All patients underwent standard and 2-dimensional speckle tracking echocardiography computing global longitudinal strain (GLS) of LV and peak atrial strain of LA (PALS). Results In all patients PALS was a good predictor of E/e' ratio after correction for LV EF and age (p<0.001, β: −0.48). LVEF and GLS progressively decreased together with worsening of AS degree, as well as parameters of geometry and function of LA (Table1). By excluding patients with LV dysfunction the reduction gradient of parameters of LA geometry and function was still present. However, when severe symptomatic with asymptomatic severe AS are compared, no difference in E/e' ratio was found while both GLS and PALS were significantly reduced (both p<0.0001). Variables Overall population (180) Control (45) Moderate AS (45) Severe asympt AS (45) Severe sympt. AS (45) p LVEF 65.0±11.1 67.7±5.6 69.4±8.5 66.1±10.7 59.5±13.5 0.0001 GLS −20.4±4.1 −23.1±2.4 −21.5±2.9 −21.4±3.2 −17.1±4.3 0.0001 LA vol index 41.6±21.5 28.2±10.4 40.1±19.7 39.8±16.7 52.3±24.9 0.0001 LA strain 23.6±10.9 30.8±10.3 27.8±9.2 24.4±9.7 15.2±7.1 0.0001 LA reservoir 46.4±15.9 51.9±11.5 53.0±15.0 48.3±14.1 37.2±16.1 0.0001 Ee' ratio 14.8±7.0 9.6±2.7 13.7±6.3 15.4±6.2 19.3±7.2 0.0001 Conclusions LA function seems to progressively decrease according to the degree of AS, independently from LV function. Significant difference was found between parameters of LA remodelling and dysfunction between symptomatic and asymptomatic AS patients. The assessment of LA function by strain may help stratify the patients with AS, identifying those who need intensive medical/surgical treatment.

scholarly journals Some Morpho-Functional Changes of the Left Heart in Patients with Viral Liver Cirrhosis

2018 ◽  
Vol 14 (4) ◽  
pp. 537-542
Author(s):  
M V. Chistyakova ◽  
A. V. Govorin ◽  
N. N. Kushnarenko
Keyword(s):  
Diastolic Function ◽  
Left Atrial Volume ◽  
Holter Monitoring ◽  
Nonparametric Test ◽  
Control Group ◽  
Lv Function ◽  
Myocardial Mass ◽  
Functional Changes ◽  
Concentric Hypertrophy ◽  
Lv Dysfunction

Material and methods. 55 patients with VLC class А, B, C according to Сhild-Pugh were examined. The average age of patients 42 years, disease duration – 3,8 years. Depending on the presence of ascites, patients were divided into 2 groups: 28 patients had no ascites (group 1), 27 patients had ascites (group 2), and a control group of 22 healthy people. Echocardiography was performed by the "VIVID E 95" device. All patients were evaluated diastolic function of the LV in accordance with the АSЕ/ЕAЕ-2009 and ASE/EACVI-2016 recommendations. Holter monitoring of ECG was performed. Statistical data processing was carried out using Statistica 6.0 statistical software package and Mann-Whitney nonparametric test. The correlation analysis was performed using the Spearman coefficient.Results. In all patients there was an increase in the index of myocardial mass and relative wall thickness of LV in comparison with the control group, more severe disorders were identified in patients with VLC with ascites, p<0.001. In the study of LV remodeling, concentric hypertrophy was most common in patients with VLC – in 11 (43%) patients of the 1st group and in 19 (70%) patients of the 2nd group. Holter monitoring of ECG revealed supraventricular extrasystoles in 9 (32%) patients of the 1st group and 11 (40%) – 2nd group; paroxysmal form of atrial fibrillation – in 2 (7%) patients and in 5 (18%), respectively. It was found that the maximum index of the left atrial volume was higher in patients with VLC compared to control, and in patients with ascites this disorder was more pronounced (p<0.001). In accordance with the ASE/EACVI-2016 algorithm, normal diastolic LV function was registered almost twice as often as when using the ASE/EAE-2009 algorithm. Undefined result was recorded in 8% of cases due to tricuspid regurgitation.Conclusion. Thus, patients with VLC develop an increase in the LV myocardial mass with the formation of concentric hypertrophy, remodeling of the left atrium with the occurrence of cardiac arrhythmias, diastolic LV dysfunction, and these changes are more pronounced in patients with ascites. In accordance with the new algorithm ASE/EACVI-2016 for detection of diastolic LV dysfunction, normal LV diastolic function was almost 2 times more common in patients with VLC than in accordance with the old ASE/EAE-2009 algorithm.

scholarly journals 1187 Evaluation of left and right ventricular functions with 3D speckle tracking in patients with mitral stenosis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
O Seckin ◽  
S Unlu ◽  
G Tacoy
Keyword(s):  
Right Ventricular ◽  
Mitral Stenosis ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Control Group ◽  
Free Wall ◽  
Significant Difference

Abstract Background The function of both ventricles have been suggested to be affected in patients with mitral stenosis. In this study, it was aimed to investigate deformation properties of right (RV) and left ventricles (LV) in mild and moderate rheumatic mitral stenosis (MS) patients with three-dimensional speckle tracking echocardiography (3D-STE). Methods A total of 60 patients were included in the study (20 patients with mild MS diagnosis, 20 patients with moderate MS diagnosis and 20 healthy volunteers). Three-dimensional echocardiography datasets were obtained for both ventricles in all patients. An example for RV assessment is shown in Figure 1. LV global longitudinal strain (GLS), LV torsion, RV free wall (FW) LS and interventricular septal (IVS) LS measurements were analyzed. Results The LV ejection fraction (EF), RV fractional area change and tricuspid annular plane systolic excursion values were statistically similar and in the normal range. The LV GLS measurements were significantly different among the groups by being highest in the control group and least in the moderate stenosis group (ANOVA,p &lt; 0.001) (Table 1). Patients with MS showed higher torsional values, correlated with MS severity (ANOVA,p &lt; 0.001) (Table 1). IVS LS, RVFW LS values obtained by RV analysis also differed significantly among groups. The FW-GLS values only showed significant difference between the control group and moderate MS group (Table 1). Conclusion Patients with mitral stenosis showed lower LV-GLS and higher LV torsion values. Although the LV GLS is affected; the LV EF was detected to be normal due to increase in LV torsion. RV deformation indices showed signıficant decrease in correlation with the severity of the mitral stenosis. In conclusion, our data suggest that subclinical LV and RV systolic dysfunction is present in mild-moderate MS patients and this dysfunction can be detected by 3D-STE. Table 1 Parameters Control group Mild MS Moderate MS P LV GLS (%) 23.3 ± 2.08 18.9 ± 1.3 17.5 ± 1.8 &lt;0.001 LV torsion 1.5 ± 0.6 2.1 ± 0.6 2.6 ± 0.5 &lt;0.001 IVS LS (%) 23 ± 3.0% 20 ± 2.6 17.1 ± 2.9 &lt;0.001 RV FW LS (%) 25.4 ± 5 22.7 ± 3.2 21.1 ± 4.8 &lt;0.001 FW; free-wall, GLS; global longitudinal strain, IVS; interventricular septum, LV; left ventricular, RV; right ventricular Abstract 1187 Figure 1

scholarly journals Early detection with speckle tracking echocardiography of biventricular systolic dysfunction, and its relationship with fatigue, in patients with multiple sclerosis

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
E Michelotto ◽  
MC Oliva ◽  
MT Amoruso ◽  
G Giovannetti ◽  
C Battista ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Function ◽  
Healthy Population ◽  
The Mean

Abstract Funding Acknowledgements Type of funding sources: None. Background Fatigue is a frequent and debilitating symptom of multiple sclerosis (MS), affecting 90% of patients. Symptoms seems multifactorial, but little is known about the contribution of cardiovascular morpho-functional alterations linked to comorbidities, to lifestyle, to MS itself or to drugs (i.e. mitoxantrone). Aim to investigate the presence of cardiac alterations in MS patients, and to evaluate their impact on fatigue. Methods  24 patients with relapsing-remitting MS (RR-MS) underwent an electrocardiogram (ECG), a transthoracic echocardiographic (TTE), a six minutes walking test (6MWT) with Borg scale (BS), and two fatigue self-assessment scales, the Fatigue Severity Scale (FSS) and the Modified Fatigue Impact Scale (MFIS). The patients were divided into 2 groups: group 1, without traditional cardiovascular risk factors (CVRF: smoke, hypertension, diabetes, hypercholesterolemia; n = 12, 11 females), and group 2, with at least one CVRF (n = 12, 5 females). None of the patients had ever been on mitoxantrone therapy. No new control group was studied due to the SARS-CoV-2 pandemic restrictions , so the comparison was performed with general healthy population in internationally validated previous studies. Results No arrhythmias were found. In both MS groups all the TTE left ventricular (LV) systolic function parameters were depressed compared to the healthy population, but only the mean global longitudinal strain (GLS), the mean longitudinal strain rate (LSR) of LV and estimated pulmonary artery systolic pressure (PAPs) were statistically significant depressed compared to the healthy general population (p &lt; 0.005): see table. This reduction was observed in both MS groups, while there were non significant differences among the two groups. TTE LV function depression significantly correlated to variation of parameters of fatigue , especially considering LV GLS in relation to BS values. Conclusions Subclinical biventricular systolic dysfunction is present in MS patients, and it seems to be linked to the disease itself without being influenced by CVRF. This dysfunction, detected by speckle tracking echocardiographic techniques, seems to contribute to the symptom of fatigue in patients with MS. It is important to include TTE in the workup and follow-up of MS patients, in order to promptly treat cardiac dysfunction and relieve fatigue. Echocardiography and LV strain MS total MS no CVRF MS + CVRF Healthy population LV GLS 17.7 ± 2.2* 18.0 ± 2.1* 17.4 ± 2.4* 22.6 ± 1.7 LV LSR 1.0 ± 0.1* 1.0 ± 0.1* 1.0 ± 0.2* 1.2 ± 0.1 PAPs 25.0 ± 2.6* 24.8 ± 2.9* 25.2 ± 2.5* 14.0 ± 6.0 * p &lt; 0.05 vs healthy population

scholarly journals Evaluation of Cardiac Functions By Speckle Tracking Echocardiography in Type 2 Diabetes Mellitus With Hyperlipidemia

2021 ◽  
Author(s):  
Zhizhi Dong ◽  
Jun Zhou ◽  
Yue Chen ◽  
Zulin Liu ◽  
Douzi Shi ◽  
...  
Keyword(s):  
Normal Control ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Normal Control Group ◽  
Control Group ◽  
Cardiac Functions ◽  
Significant Difference

Abstract Background To investigate the value of two-dimensional speckle tracking echocardiography (2D-STE) in evaluating cardiac functions in type 2 diabetes mellitus (T2DM) with hyperlipidemia. Methods Sixty T2DM patients with normal left ventricular ejection fraction (LVEF) and poorly-controlled blood glucose were selected. Among these, thirty had hyperlipidemia. Thirty age- and gender-matched healthy individuals were recruited as the normal control group. Longitudinal strain of left ventricular segments, left ventricular global longitudinal strain (LV GLS), left atrial global longitudinal strain (LA GLS), right ventricular global longitudinal strain (RV GLS) and right atrial global longitudinal strain (RA GLS) were measured by 2D-STE. Results (1) Compared with the normal control group, LV GLS in T2DM group and T2DM with hyperlipidemia group decreased (P < 0.05), but there was no significant difference of LV GLS between T2DM group and T2DM with hyperlipidemia group (P > 0.05). Compared with the normal control group and T2DM group, longitudinal strain of middle segment of LV in T2DM with hyperlipidemia group decreased (P < 0.05). (2) There was a significant difference in LA GLS among the three groups. LA GLS of T2DM with hyperlipidemia group was lower compared with the normal control and T2DM group (P < 0.05). (3) Compared with the normal control group, RV GLS in T2DM group and T2DM with hyperlipidemia group was lower (P < 0.05), but there was no significant difference of RV GLS between T2DM group and T2DM with hyperlipidemia group (P > 0.05). RA GLS in T2DM with hyperlipidemia group decreased (P < 0.05) compared to the normal control group and T2DM group. Conclusion Speckle tracking echocardiography can effectively evaluate cardiac dysfunction in patients with T2DM. LA GLS and RA GLS can be used as potential markers of cardiac dysfunction in T2DM with hyperlipidemia, and provide the basis for early clinical diagnosis and treatment.

scholarly journals Assessment of global longitudinal strain by speckle tracking echocardiography in patients with severe primary mitral regurgitation

2021 ◽  
Vol 35 ◽  
pp. 19-25
Author(s):  
Nguyen Mai Huong ◽  
Vu Quynh Nga ◽  
Nguyen Quang Tuan
Keyword(s):  
Mitral Regurgitation ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Optimal Timing ◽  
Lv Dysfunction ◽  
Asymptomatic Patients ◽  
Primary Mitral Regurgitation

Background: In asymptomatic patients with severe primary mitral regurgitation (PMR), early detection of left ventricular (LV) dysfunction indicates the optimal timing of mitral valve surgery and predictes impaired postoperative LV function. Objectives: Evaluation long longitudinal strain by Speckle Tracking in Patients with Severe Primary Mitral Regurgitation Methods and results: 35 preoperative patients with severe PMR and 25 age-matched healthy subjects at Hanoi Heart Hospital from June 2018 to September 2019. Patients with PMR had longitudinal dysfunction by comparison with controls, although EF were similar. Mean global myocardial longitudinal strain (GLS avg) has a linear correlation with FS (r² = 0.127, p <0.05) and EF biplane (r² = 0.216, p <0.005). Conclusion: Longitudinal LV deformation assessed by speckle tracking can detect subclinical LV dysfunction and predict impaired postoperative LV function in asymptomatic patients with severe PMR.

scholarly journals Cardiac Structural Alterations of Acromegalic, Without Alteration in Cardiac Function, Evaluated by Doppler Echocardiography with Speckle Tracking

2021 ◽  
Vol 13 (10) ◽  
pp. 32
Author(s):  
Marília Matos Marília Matos Oliveira ◽  
Beatriz Hallal Jorge Lara ◽  
Janaíne Machado Tomé ◽  
Beatriz Pires Ferreira ◽  
Maria Candida Calzada Borges ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Hormonal Control ◽  
Inactive Disease ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Functional Changes ◽  
Mean Concentration

BACKGROUND: Acromegaly is most commonly caused by growth hormone secreting pituitary (GH) macroadenoma. Cardiovascular events are the leading cause of death in this population. OBJECTIVE: To analyze the cardiac structural and functional changes in patients with acromegaly and to correlate the findings with the concentrations of GH and IGF-1 post treatment and with the presumed time of disease. METHOD: A quantitative study involving 19 individuals with acromegaly, 10 with inactive disease and 9 with active disease and 16 healthy individuals, matched by sex and age. Age ranged from 19 to 78 years. Two-dimensional echocardiogram and speckle tracking were performed. RESULTS: Mean left ventricular mass index (LVMI) were significantly higher in acromegalic patients (89.1 &plusmn; 27.9) compared to the control group (66.9 &plusmn; 15.7) (p = 0.015). There was a direct correlation between IGF-1 mean concentration and left ventricular systolic volume (LVSV) in acromegalic patients (r = 0.64; p = 0.004) even when the disease was inactive (n=10; r = 0.9; p = 0.002) and between IGF1 mean concentration and left ventricular diastolic volume (LVDV). The left ventricular ejection fraction (EF) and the global longitudinal strain (GLS) did not differ between groups (p&gt; 0.05). CONCLUSION: Although patients with acromegaly had higher LVMI, they did not show difference in GLS indicating a small chance of progression to systolic disfunction. Direct correlation between IGF-1 and LDVD and LVSV demonstrates the relevance of a good hormonal control to reduce cardiac changes.

scholarly journals Evaluation of Left Ventricular Function in Polymyositis and Dermatomyositis Patients with Global Longitudinal Strain Using Two Dimensional Speckle Tracking Method

2021 ◽  
Keyword(s):  
Diastolic Dysfunction ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Two Dimensional ◽  
Ventricular Ejection Fraction ◽  
Significant Difference

Background: Heart problems are one of the main causes of death in patients with idiopathic inflammatory myopathies, such as polymyositis (PM) and dermatomyositis (DM). Speckle tracking echocardiography (STE) and global longitudinal strain (GLS) are non-invasive, accurate, repeatable, and angle-independent imaging techniques that facilitate a full global and regional evaluation of the left ventricular (LV) function. Objectives: This study aimed to evaluate myocardial dysfunction in DM and PM patients using STE and GLS methods. Methods: The present control-case study was conducted on 30 polymyositis and dermatomyositis patients and 40 healthy people as the control group. Both groups showed no symptoms of cardiovascular diseases. Both groups underwent two-dimensional STE and GLS evaluation. The GLS value was taken as a marker of LV systolic dysfunction. Results: The 2D GLS value of LV was significantly lower in the DM and PM patients, compared to the control group. A mild diastolic dysfunction was observed in seven (23.3%) patients, and 23 (76.7%) patients had a normal state. The patients’ age and duration of the disease were found to be significantly correlated with the left ventricular diastolic dysfunction. No significant difference was observed between the DM and PM patients with the control group in terms of pulmonary artery pressure level. Conclusion: Although the DM and PM patients had normal left ventricular ejection fraction values, there was a significant difference between the patients in these two groups and the control group in terms of LV dysfunction using GLS. Therefore, GLS is a useful variable that can be used to diagnose sustained and subclinical disorders in LV systolic function of DM and PM patients.

scholarly journals Evaluation of Subclinical Left Ventricular Systolic Dysfunction in Chronic Asymptomatic Alcoholics by Speckle Tracking Echocardiography

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Murathan Kucuk ◽  
Can Ramazan Oncel ◽  
Aytul Belgi Yıldırım ◽  
Fatih Canan ◽  
Mehmet Murat Kuloglu
Keyword(s):  
Speckle Tracking ◽  
Circumferential Strain ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Radial Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Two Dimensional ◽  
Functional Changes

By using two-dimensional speckle tracking echocardiography, we aimed to investigate the structural and functional changes on myocardium in chronic asymptomatic alcoholics without any cardiovascular disease. Forty-one consecutive asymptomatic male alcoholics who were admitted to the outpatient alcoholism unit and 30 age matched healthy male volunteers selected as the control group were enrolled in the study. The study group were investigated by using standard two-dimensional echocardiography and speckle tracking echocardiography. The left ventricular (LV) global longitudinal strain and LV global circumferential strain were significantly lower in alcoholics when compared with control subjects. There was no difference in global radial strain between the two groups. To demonstrate the effect of total life time dose of ethanol (TLDE) on echocardiographic abnormalities, we assessed the correlation analysis. There was a nonsignificant weak correlation between global LV circumferential strain and TLDE (r=0.27,p=0.083). Speckle tracking echocardiography derived left ventricular systolic function was impaired in chronic alcoholic patients when compared with healthy controls.

scholarly journals Evaluation of prenatal changes in fetal cardiac morphology and function in maternal diabetes mellitus using a novel fetal speckle-tracking analysis: a prospective cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Dong Wang ◽  
Caixia Liu ◽  
Xinyu Liu ◽  
Ying Zhang ◽  
Yu Wang
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Pregnant Women ◽  
Gestational Age ◽  
Speckle Tracking ◽  
Control Group ◽  
Second Trimester ◽  
Cardiac Morphology ◽  
Sphericity Index ◽  
And Function

Abstract Background Due to metabolic changes in the second trimester and the increasing number of pregnant women with obesity and advanced maternal age, the incidence of gestational diabetes mellitus (GDM) remains high. This study aimed to evaluate the effects of GDM on fetal cardiac morphology and function, and to determine whether these changes increase with increasing estimated fetal weight (EFW). Methods Fifty-eight women with GDM (GDM group) and 58 women with a healthy pregnancy (control group) were included in this prospective observational cohort study. Each group included subgroups of 31 pregnant women with a gestational age between 24+0 weeks and 27+6 weeks as well as 27 pregnant women with a gestational age between 28+0 weeks and 40+0 weeks. For all fetuses, a cine of 2–3 s in the four-chamber view was obtained, and online speckle-tracking analysis was performed using the GE Automatic Fetal Heart Assessment Tool (fetal HQ; General Electric Healthcare Ultrasound, Zipf, Austria) to measure the global sphericity index (GSI), global longitudinal strain (GLS), fractional area change (FAC), 24-segment sphericity index (SI), and 24-segment end-diastolic diameter of the left ventricle (LV) and right ventricle (RV). Data were analyzed using the independent t-test and Wilcoxon rank-sum test, as applicable. Results The GDM group (mean HbA1c value was 5.3 ± 0.57 mmol/L) showed a lower GSI value than the control group (1.21 vs. 1.27, P = 0.000), which indicated a rounder shape of the heart. In addition, fetuses in the GDM group demonstrated significant impairment in cardiac function compared to those in the control group (LV-GLS: -18.26% vs. -22.70%, RV-GLS: -18.52% vs. -22.74%, LV-FAC: 35.30% vs. 42.36%, RV-FAC: 30.89% vs. 36.80%; P = 0.000 for all). Subgroup analyses according to gestational age (24+0–27+6 weeks and 28+0–40+0 weeks) showed that the statistical differences were retained between the GDM and control groups in each subgroup. Conclusions Fetuses of women with GDM present with signs of biventricular systolic dysfunction according to deformation analysis using fetal HQ. Additionally, the heart had a rounder shape in the GDM group than in the control group. This study showed that fetal HQ can be used to assess fetal cardiac morphology and function easily and quickly, and the effects of GDM on fetal cardiac morphology and function appeared from the second trimester. Thus, whether earlier and stricter clinical intervention was necessary remained to be further studied. Furthermore, future studies will need to supplement the effects of blood glucose levels on GLS, FAC, GSI, and 24-segment SI. Additionally, the long-term follow-up after birth should also be improved to observe the influence of changes in the indicators on the prognosis.

Left ventricular myocardial work in patients with secondary mitral regurgitation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Yedidya ◽  
R.P Lustosa ◽  
F Fortuni ◽  
P Van Der Bijl ◽  
F Namazi ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Blood Pressure Measurement ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Work Efficiency ◽  
Constructive Work ◽  
Secondary Mitral Regurgitation

Abstract Background Assessment of left ventricular (LV) function in patients with secondary mitral regurgitation (SMR) remains challenging because LV ejection fraction (LVEF) reflects changes in LV volume without taking into account the direction of the blood flow. LV global longitudinal strain better reflects active LV myocardial deformation but does not incorporate afterload. LV myocardial work derived from pressure-strain loops integrates speckle tracking echocardiography with non-invasive blood pressure measurement. Purpose To evaluate LV myocardial work components to better characterize LV function in patients with SMR. Methods 378 patients (72% men, median age 68 [range 60 to 74 years]) with various grades of SMR were retrospectively analysed. LV myocardial constructive work, wasted work and work efficiency were measured with speckle tracking echocardiography. Results 145 patients had mild SMR, 130 moderate SMR and 103 severe SMR. Patients with severe SMR had larger LV volumes, lower LVEF and more impaired LV GLS (Table 1). While LV constructive work was more impaired in patients with severe SMR, wasted work was lower as compared to mild SMR (Table 1). Consequently, patients with severe SMR had better myocardial work efficiency than patients with mild MR. This could reflect, the regurgitant volume which is pumped into a low pressure chamber (the left atrium) resulting in less myocardial wasted work and preservation of myocardial efficiency. Conclusion In patients with severe SMR, LVEF, LV GLS and myocardial constructive work are more impaired when compared to mild SMR. However, myocardial wasted work is lower, resulting in higher better LV myocardial work efficiency. Funding Acknowledgement Type of funding source: None

Sign in / Sign up

Export Citation Format

Share Document