P1496Use of strain, strain rate, tissue velocity imaging and endothelial function for early detection of cardiovascular involvement in young diabetics

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kaushik ◽  
A Kapoor ◽  
P Dabadghao ◽  
R Khanna ◽  
S Kumar ◽  
...  
Keyword(s):  
Strain Rate ◽  
Young Patients ◽  
Lateral Wall ◽  
Left Ventricular ◽  
Myocardial Velocity ◽  
Tissue Velocity ◽  
Flow Mediated Dilatation ◽  
Basal Septum ◽  
Conventional Echocardiography

Abstract Background Subtle structural and functional changes may precede the onset of overt global left ventricular dysfunction and obvious reduction of ejection fraction (EF), especially in young diabetics. Data pertaining to tissue velocity indices (TVI) and strain imaging to assess regional myocardial function and flow mediated vasodilatation is limited in young patients with diabetes. Purpose To evaluate conventional echocardiography parameters, tissue doppler indices, global and regional strain, carotid intimal medial thickness (CIMT), endothelial dependent (FMD) and independent function (NMD) of brachial artery in young patients (age <18 years) with type 1 diabetes and compare them with matched controls. Methods Conventional echocardiography parameters, tissue velocity indices (TVI) parameters along with strain (S), and strain rate (SR) in basal and mid left ventricular (LV) lateral wall, right ventricular (RV) lateral wall and septum were measured in 50 young diabetics (age 15.16±2.95 years, mean HBA1c 8.15±1.37 gm %) and 25 controls (age 15.60±2.51 years). Flow-mediated dilatation (FMD), nitrate mediated dilatation and carotid intimal media thickness (CIMT) were also estimated. Results Conventional echocardiography parameters were similar in patients and controls however deceleration time of the mitral inflow velocity (EDT) was significantly shorter in patients when compared with controls (149.06±31.66 vs. 184.56±19.27 ms, p<0.05). Lateral early diastolic myocardial velocity (LV-Em) was significantly lower (10.30±0.99 vs. 11.67±3.21, p<0.05) whereas lateral late diastolic myocardial velocity (LV-Am) was significantly higher than controls (11.73±1.44 vs. 8.82±1.69, p<0.05), thus a significantly lower ratio of early/late diastolic velocity at the basal segment of lateral LV (LV-Em/Am). Lower strain values at the basal lateral LV (21.39±4.12 vs. 23.78±2.02; p<0.05), mid lateral LV (21.43±4.27 vs. 23.17±1.92; p<0.05), basal septum (20.59±5.28 vs. 22.91±2.00; p<0.05), and mid septum (22.06±4.75 vs. 24.10±1.99; p<0.05) as compared to controls. SR at the basal and mid segments of the lateral LV wall and at the basal septum were also significantly lower in diabetic subjects. Strain rate (SR) in mid septal, basal and mid RV were lower than controls although not statistically significant. Patients also had significantly lower flow mediated dilatation (FMD) (8.36±4.27 vs. 10.57±4.12, p<0.05) implying endothelial dysfunction. Strain rate in diabetic patient Conclusion Left ventricular strain indices are impaired in asymptomatic children and adolescents with type 1 DM despite absence of overt heart failure and normal ejection fraction. Early detection of subclinical regional myocardial dysfunction by deformation analysis including strain and strain rate may be useful in the asymptomatic diabetic population. In addition, evidence of endothelial dysfunction in the form of impaired flow mediated vasodilatation was observed in the diabetic children. Acknowledgement/Funding None

scholarly journals Left Ventricular Adaptations in Herding Dogs

2019 ◽  
Vol 47 (1) ◽  
Author(s):  
Raimy Costa Martins ◽  
João Paulo Da Exaltação Pascon ◽  
Karen Guzmán Béltran ◽  
Maria Ligia De Arruda Mistieri
Keyword(s):  
Physical Activity ◽  
Physical Exercise ◽  
Strain Rate ◽  
Blood Pressure Measurement ◽  
Left Ventricular ◽  
Tei Index ◽  
Strain And Strain Rate ◽  
Deformation Velocity ◽  
Conventional Echocardiography ◽  
Exercise In Humans

Background: Athlete’s heart syndrome comprises a set of functional and anatomic cardiac changes secondary to intense and prolonged physical exercise in humans and animals. The heart adapts to the type of activity performed, and Doppler echocardiography is the best tool for identifying these changes. Speckle tracking echocardiography (STE) has provided new data on cardiovascular adaptations secondary to physical exercise in humans, information that conventional echocardiography cannot provide. Although physical activity and work in dogs are well documented, there are few studies on cardiovascular adaptations secondary to exercise in dogs, and no studies to date evaluated these adaptations using STE.Materials, Methods &Results:A total of 31 dogs of the Border Collie and OvelheiroGaúchoBrasileiro breeds were divided into two groups: a herding group (HG, n = 15), which performed herding activity five to six times a week for at least 4 months, and a sedentary group (SG, n = 16), with no history of physical activity in the past twelve months. All dogs were previously subjected to electrocardiography and blood pressure measurement. After that, the animals underwent echocardiographic examination at rest at a single time point. The data were analyzed by two-way multivariate analysis of variance (ANOVA) at a level of significance of 5% (P < 0.05) and a trend at 90% (P < 0.1). The dogs of the HG had higher values for left-ventricular end-systolic diameter (LVESD) and systolic volume (SV), and lower values for left-ventricular myocardial performance index (Tei index) and systolic septal movement. STE results indicated that the HG presented lower values for strain and strain rate in some myocardial segments in the radial, circumferential, longitudinal, and transverse directions.Discussion:The increase in LVESD is justified by the increase in preload (volume) required to meet the increased oxygen demand, whereas SV is directly related to the Frank-Starling mechanism. The lower Tei index in the HG indicates better systolic-diastolic performance, explained by a shorter isovolumetric relaxation time and isovolumetric contraction time and by an increase in left ventricular (LV) ejection time. Similar results were not observed in LV systolic wall motion. Therefore, we believe that the most likely explanation is a higher systolic efficiency, associated with lower energy demand at rest. According to STE criteria, the lower strain and strain rate in the HG in some myocardial segments in all directions suggest less need for myocardial deformation and lower deformation velocity in order to maintain systolic function. In conclusion, conventional echocardiography and STE were complementary and fundamental to understand cardiovascular adaptations in herding dogs.

INFLAMMATORY MARKERS, HEMOSTATIC PARAMETERS AND STATUS OF TARGET ORGANS IN YOUNG PATIENTS WITH VARIOUS COMPONENTS OF METABOLIC SYNDROME

2017 ◽  
Author(s):  
Вл. Чулков ◽  
В. Сумеркина ◽  
В. Чулков ◽  
Н. Вереина ◽  
С. Синицын
Keyword(s):  
Metabolic Syndrome ◽  
Plasminogen Activator ◽  
Interleukin 6 ◽  
Low Density Lipoprotein ◽  
Young Patients ◽  
Density Lipoprotein ◽  
Plasminogen Activator Inhibitor ◽  
Left Ventricular ◽  
Target Organs

Введение. Согласно современным представлениям, инициирующим фактором для запуска каскада метаболических нарушений при артериальной гипертензии (АГ) и абдоминальном ожирении (АО) является инсулинорезистентность. Активация локального и системного воспалительного ответа, а также протромботические изменения при АГ и АО являются основой для органных поражений, прогрессирования атеросклеротического процесса и развития осложнений. Цель исследования. Изучение взаимосвязи между маркерами воспалительного ответа, показателями гемостаза и состоянием органов-мишеней у молодых пациентов с различными компонентами метаболического синдрома. Материалы и методы. Проведена комплексная оценка взаимосвязи уровней адипокинов, цитокинов и показателей гемостаза с состоянием органов-мишеней у 251 пациента в возрасте 18–44 лет: 1 группа — 35 пациентов с изолированной АГ; 2 группа — 76 пациентов с изолированным АО; 3 группа — 60 пациентов с сочетанием АГ и АО; 4 группа — 80 практически здоровых волонтеров. Результаты. У больных с комбинацией АГ и АО выявлено повышение лептина и интерлейкина-6, снижение адипонектина и протромботические изменения гемостаза по сравнению с пациентами с изолированными АГ, АО и практически здоровыми. В группе больных с комбинацией АГ и АО с бóльшей частотой обнаруживались гипертрофия левого желудочка и увеличение комплекса интима-медиа сонных артерий по сравнению с пациентами, имевшими только АГ и только АО. Обнаружены положительные линейные корреляции индекса массы миокарда левого желудочка с концентрацией интерлейкина-6 и толщины комплекса интима-медиа с уровнем интерлейкина-1β, отрицательная связь этих показателей с уровнями адипонектина и ингибитора активатора плазминогена 1 типа. Заключение. При сочетании АГ с АО в молодом возрасте чаще выявляется субклиническое поражение органов-мишеней; установлено более высокое содержание глюкозы, общего холестерина, холестерина липопротеинов низкой плотности, триглицеридов, лептина, интерлейкина-6, фибриногена, ингибитора активатора плазминогена 1 типа и ингибитора пути тканевого фактора по сравнению с пациентами с изолированной АГ и изолированным АО. Introduction. According to modern concepts insulin resistance is the initiating factor for triggering a cascade of metabolic disorders in hypertension (AH) and abdominal obesity (AO). Activation of local and systemic infl ammatory response as well as prothrombotic changes at AH and AO are the basis for organ’s lesions, progression of atherosclerotic process and complications development. The aim: to study the relationship between the markers of infl ammatory response, hemostatic parameters and target organs in young patients with diff erent components of metabolic syndrome. Materials and methods. Complex assessment of relationships between adipokines, cytokines, hemostatic parameters and status of target organs was done in 251 patients (18–44 years old): group 1–35 patients with isolated AH; group 2–76 patients with isolated AO; group 3–60 patients with combination of AH and AO; group 4–80 practically healthy volunteers. Results. In patients with combination of AH and AO we revealed increased values of leptin and interleukin-6, decreased values of adipokine and prothrombotic changes as compared to patients with isolated AH, isolated AO and with healthy people. Left ventricular hypertrophy and thickening of intima-media of carotid arteries were revealed more frequently in patients with combination of AH and AO. We found positive correlations between the left ventricular mass index and interleukin-6 content, thickening of intima-media complex and interleukin-1β concentration, negative correlation of these parameters with adiponectin level and plasminogen activator inhibitor type 1 content. Conclusion. The subclinical lesion of target organs is more often detected in young people with AH in combination with AO; higher levels of glucose, total cholesterol, low-density lipoprotein cholesterol, triglycerides, leptin, interleukin-6, fibrinogen, inhibitor of plasminogen activator type 1 and inhibitor of tissue factor were revealed as compared to patients with isolated AH and with isolated AO.

scholarly journals Subclinical Alterations of Cardiac Mechanics Present Early in the Course of Pediatric Type 1 Diabetes Mellitus: A Prospective Blinded Speckle Tracking Stress Echocardiography Study

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Kai O. Hensel ◽  
Franziska Grimmer ◽  
Markus Roskopf ◽  
Andreas C. Jenke ◽  
Stefan Wirth ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Strain Rate ◽  
Type 1 Diabetes Mellitus ◽  
Speckle Tracking ◽  
Stress Testing ◽  
Disease Duration ◽  
Left Ventricular ◽  
Pathophysiological Mechanism

Diabetic cardiomyopathy substantially accounts for mortality in diabetes mellitus. The pathophysiological mechanism underlying diabetes-associated nonischemic heart failure is poorly understood and clinical data on myocardial mechanics in early stages of diabetes are lacking. In this study we utilize speckle tracking echocardiography combined with physical stress testing in order to evaluate whether left ventricular (LV) myocardial performance is altered early in the course of uncomplicated type 1 diabetes mellitus (T1DM). 40 consecutive asymptomatic normotensive children and adolescents with T1DM (mean age11.5±3.1years and mean disease duration4.3±3.5years) and 44 age- and gender-matched healthy controls were assessed using conventional and quantitative echocardiography (strain and strain rate) during bicycle ergometer stress testing. Strikingly, T1DM patients had increased LV longitudinal (p=0.019) and circumferential (p=0.016) strain rate both at rest and during exercise (p=0.021). This was more pronounced in T1DM patients with a longer disease duration (p=0.038). T1DM patients with serumHbA1c>9%showed impaired longitudinal (p=0.008) and circumferential strain (p=0.005) and a reduced E/A-ratio (p=0.018). In conclusion, asymptomatic T1DM patients have signs of hyperdynamic LV contractility early in the course of the disease. Moreover, poor glycemic control is associated with early subclinical LV systolic and diastolic impairment.

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

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.

P2459Do left atrial strain measurements provide information independent from left ventricular function parameters?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G G Malaescu ◽  
A Petrescu ◽  
J Duchenne ◽  
R Capota ◽  
J U Voigt
Keyword(s):  
Cardiac Cycle ◽  
Volume Ratio ◽  
Lateral Wall ◽  
Left Ventricular ◽  
Valvular Regurgitation ◽  
Additional Information ◽  
Tissue Velocity ◽  
Strain Components ◽  
Lv Volume ◽  
Longitudinal Strains

Abstract Introduction LA strain has been proposed to be a reliable and independent prognostic marker, as well as a useful surrogate of LA function. Purpose To assess if LA deformation measurements add independent information to standard echocardiographic measurements. Methods We included 66 normals and patients with a wide range of pathology and diastolic dysfunction grade from the echo data base of our hospital if image quality was sufficient for both LA and LV strain analysis. Patients with a mobile interatrial septum, arrhythmias and more than mild valvular regurgitation were not considered. Standard echocardiographic measurements including LA and LV volumes were performed according to current guidelines. LA and LV longitudinal strains were assessed by 2D speckle tracking in the same cardiac cycle in apical 4 and 2 chambers views using peak R as time reference. Peak LA and LV strain as well as LA and LV strain at onset of LA contraction were measured to calculate the strain components of all three phases of the cardiac cycle (systolic, early diastolic and late diastolic). Results In our cohort, the ratio of LA and LV systolic strain was directly and strongly related to the volume ratio of the two chambers (R2=0,894, slope=-1.001, p<0.0001, see Figure 1). This was confirmed by a multivariate regression analysis, where systolic LA strain proved to be strongly dependent on systolic LV strain, LA volume and LV volume (R2=0.872, p<0.0001 for the final model). For early diastolic strain, confounders were LV early diastolic strain, LA volume, LV volume and lateral wall E' tissue velocity (R2=0.784, p<0.0001); while LA late diastolic strain was dependent on LV late diastolic strain, LA volume, LV volume and lateral wall A' tissue velocity (R2=0.823, p<0.0001). Strain ratio vs volume ratio Conclusions Our data suggest that systolic LA strain (reservoir strain) is strictly dependent on systolic LV strain and the volume ratio of both chambers and, therefore, its measurement cannot provide additional information beyond classical measurements. Diastolic LA strain components show a less strict dependence on LV function and may therefore provide additional information.

scholarly journals Assessment of the Cardiac Functions Using Full Conventional Echocardiography with Tissue Doppler Imaging before and after Xylazine Sedation in Male Shiba Goats

Animals ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 2320
Author(s):  
Ahmed S. Mandour ◽  
Haney Samir ◽  
Tomohiko Yoshida ◽  
Katsuhiro Matsuura ◽  
Hend A. Abdelmageed ◽  
...  
Keyword(s):  
Tissue Doppler Imaging ◽  
Lateral Wall ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Cardiac Functions ◽  
Before And After ◽  
Left Ventricular Dimensions ◽  
Pulsed Wave Doppler ◽  
Conventional Echocardiography

The present study aimed to provide a complete conventional echocardiographic protocol in adult male Shiba goats by using two-dimensional, M-mode, Pulsed Wave Doppler, and tissue Doppler imaging (TDI) echocardiography, and to study concomitantly xylazine-induced alteration of cardiac functions in a highly sensitive species. For this purpose, 12 male Shiba goats were included and complete conventional echocardiography from the standard right and left parasternal views was carried to report the echocardiographic data in male Shiba goats, and also before and after xylazine (Pre-Xyl and Post-Xyl) administration (0.05 mg/IM/kg). Results revealed that the full echocardiographic protocol was feasible in all goats through different cardiac windows and good Doppler alignment was achieved with non-significant variability for assessment of the left ventricular dimensions, trans-pulmonary, trans-aortic, and trans-mitral blood flow. The TDI, which was not reported previously in goats, was successfully assessed from the standard left apical view and showed distinct systolic and diastolic patterns. Xylazine administration was found to significantly reduce heart rate, fractional shortening, and cardiac output as well as the Doppler hemodynamic parameters of the pulmonary artery, aortic and mitral inflows (p < 0.05). For TDI, the Post-Xyl group revealed a significant decrease in the myocardial velocities of the septal and lateral wall of the left ventricle. The present study provides, for the first time, complete data of conventional echocardiography in male goats using the full protocol, which is routinely used in pet’s practice. Further, we illustrate in-depth the adverse effect of short-term sedative, xylazine, as used under field conditions and emphasize a simultaneous reduction in both systolic and diastolic cardiac function in goats based on full echocardiography assessment of the heart.

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