scholarly journals 761 Echocardiographic evaluation in patients recovered from COVID-19

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Alberto Michielon ◽  
Priscilla Tifi ◽  
Maddalena Piro ◽  
Massimo Volpe ◽  
Roberto Ricci ◽  
...  
Keyword(s):  
Heart Disease ◽  
Healthy Volunteers ◽  
Left Ventricular ◽  
Hospitalized Patients ◽  
Lv Function ◽  
P Value ◽  
Free Wall ◽  
Significant Difference ◽  
Rv Function

Abstract Aims COVID-19 has a wide spectrum of clinical presentation, from severe forms that require hospitalization to less severe forms that can be managed at home. An acute myocardial involvement was demonstrated in a large proportion of patients admitted for COVID-19 and may persist in the long term. We evaluated the possible cardiac involvement using echocardiography, comprehensive of right and left ventricular strain, in patients who recovered from SARS-CoV-2 infection (hospitalized or home-treated) comparing them with a population of healthy volunteers. Methods and results Forty-one patients with COVID-19, of which fifteen hospitalized, with no prior heart disease, were compared with 13 healthy volunteers. COVID-19 diagnosis was made by a positive molecular swab. Patients with history of pre-existing heart disease were excluded. The median time from infection to outpatient follow-up was 5.9 months. Numerous echocardiographic parameters were compared by unpaired t-test including left ventricular EF, left ventricular GLS, RV free wall strain, FAC, TAPSE, PAPS, TAPSE/PAPS ratio, RA area, and RV thickness. There was a significant difference in RV free wall strain between hospitalized patients and control (−14.6 ± 2.8% vs. −22 ± 0.7%; P-value 0.03) and between hospitalized and home-treated patients (−14.6 ± 2.8% vs. −19.8 ± 0.9%; P-value 0.03), the difference was not significant between control and home-treated patients (−22 ± 0.7% vs. −19.8 ± 0.8%; P-value 0.09). Between hospitalized and not hospitalized group there was a significant reduction in FAC (38.5 ± 3.2% vs. 44.7 ± 1.3%; P-value 0.03) with an increase of RV end diastolic area (19.9 ± 1.3 cm2 vs. 16.8 ± 0.7 cm2; P-value 0.037) and also of end systolic right atrium area (18.2 ± 1.3 cm2 vs. 15.4 ± 0.5 cm2; P-value 0.01). No difference was observed between hospitalized and home-treated patients in TAPSE (22.38 ± 1.26 mm vs. 23.02 ± 0.68 mm; P-value 0.6) and PAPS (24.3 ± 1.6 mmHg vs. 20.2 ± 1.4 mmHg; P-value 0.07) but there was a borderline significant decrease in right ventricular coupling evaluated with TAPSE/PAPS ratio (0.97 ± 0.08 mm/mmHg vs. 1.29 ± 0.10 mm/mmHg; P-value 0.056) and a significant increase in RV thickness in hospitalized patients (5.32 ± 0.45 mm vs. 3.69 ± 0.24 mm; P-value 0.0014). No significant differences were found between hospitalized and not hospitalized group in left ventricular EF (57.8 ± 1.9% vs. 59.9 ± 1.0%; P-value 0.3) and left ventricular GLS (−15.2 ± 0.6% vs. −16.4 ± 0.4%; P-value 0.1). Conclusions Patients hospitalized for COVID-19 showed a dysfunction in RV parameters at 6 months follow-up compared to non-hospitalized patients. No difference in RV function was found between home treated patients and healthy volunteers. No significant differences in LV function were found among the three groups. These preliminary data confirm a decrease in RV function in more severe COVID-19 infection requiring hospital admission, possibly related to increased pulmonary afterload.

P1444 Occurrence and predictors of right ventricular dysfunction after pericardiocentesis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
H Matsutani ◽  
M Amano ◽  
C Izumi ◽  
M Baba ◽  
R Abe ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Longitudinal Strain ◽  
Linear Dimension ◽  
Left Ventricular ◽  
Lv Function ◽  
P Value ◽  
Free Wall ◽  
Right Ventricular Free Wall ◽  
Before And After ◽  
Rv Function

Abstract Background—The changes in cardiac function that occur after pericardiocentesis are unclear.Purpose—This study was performed to assess right ventricular (RV) and left ventricular (LV) function with echocardiography before and after pericardiocentesis. Method and Results—In total, 19 consecutive patients who underwent pericardiocentesis for more than moderate pericardial effusion were prospectively enrolled from August 2015 to October 2017. Comprehensive transthoracic echocardiography was performed before, immediately after (within 3 hours), and 1 day after pericardiocentesis to investigate the changes in RV and LV function. RV dysfunction is defined as meeting three of the four criteria: a TAPSE of <17 mm, an S’ of <9.5 cm, an FAC of <35%, and an RV free wall longitudinal strain >−20%. The mean age of all patients was 72.6 ± 12.2 years. The changes of echocardiographic parameters related to RV function are shown in Table. After pericardiocentesis, RV inflow and outflow diameters increased and the parameters of RV function significantly decreased. These abnormal values or RV dysfunction remained at 1 day after pericardiocentesis. Conversely, no parameters of LV function parameters changed after pericardiocentesis. Of 19 patients, 13 patients showed RV dysfunction immediately after pericardiocentesis and 6 patients did not. RV free wall longitudinal strain before pericardiocentesis was higher in patients with post-procedural RV dysfunction (−18.9 ± 3.6%) than in those without (−28.4 ± 6.3%). ROC analysis revealed that a RV free wall longitudinal strain cut-off value of −23.0% had a sensitivity of 100% and a specificity of 83.3% for predicting the occurrence of RV dysfunction after pericardiocentesis (AUC = 0.910). Conclusions—The occurrence of RV dysfunction after pericardiocentesis should be given more attention. Pre-existing RV dysfunction maybe related to the occurrence of RV dysfunction after pericardiocentesis. Changes in RV function before and after Before Immediately after One day after P−value Basal right ventricular linear dimension (mm) 32.8 ± 5.0 37.1 ± 4.4† 33.6 ± 5.4 0.028 Mid-cavity right ventricular linear dimension (mm) 34.5 ± 4.6 38.8 ± 5.3† 37.0 ± 5.6 0.0504 Proximal right ventricular outflow diameter (mm) 30.2 ± 4.0 33.9 ± 3.5† 31.4 ± 3.9 0.014 TAPSE (mm) 20.0 ± 4.2 13.6 ± 4.3* 14.7 ± 3.9 <0.001 S" (cm/s) 12.6 ± 3.3 8.7 ± 2.4* 9.1 ± 2.4 <0.001 Fractional area change (%) 48.3 ± 5.9 37.8 ± 8.0* 40.0 ± 9.0 <0.001 Right ventricular free wall strain (%) −21.3 ± 6.3 −15.8 ± 6.7* −16.9 ± 5.2 0.036 Tricuspid regurgitation velocity peak (m/s) 2.41 ± 0.29 2.43 ± 0.25 2.34 ± 0.32 0.37

P2472Two-dimensional speckle tracking echocardiography in heart transplant patients: five year follow-up of right and left ventricular function

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Lozano Jimenez ◽  
V Monivas Palomero ◽  
J Goirigolzarri Artaza ◽  
S Navarro Rico ◽  
A Borrego Hernandez ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Ventricular Function ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Normal Values ◽  
Left Ventricular ◽  
Free Wall ◽  
Normal Ranges ◽  
Rv Function

Abstract Background Evolution of left and right ventricular (LV and RV) function after heart transplantation (HT) has not been well described. Our objective was to evaluate the normal evolution of echocardiographic parameters of both ventricles and to explore if there is a link between the decrease of strain values and acute rejection (AR) or coronary allograft vasculopathy (CAV) Methods We followed 29 HT recipients with serial echocardiograms performed between 2011 and 2018, with a median follow-up of 5 years. LV global longitudinal strain (LV GLS) was analyzed by speckle tracking in 12 LV segments in 4 and 2 chamber views, and RV free wall longitudinal strain (RV free Wall LS) was measured in 4 chamber view. Acute rejection was diagnosed by EMB following our HT protocol. We take into consideration only moderate or severe rejection episodes (grade ≥2R).The presence of CAV was studied by coronariography or IVUS one year post-HT. Results As shown in the table below, LVEF was preserved from the begining of the follow up while LV GLS reached the normality in the 6th month, and both remained in normal ranges untill the 5th year. Regarding RV function, TAPSE was impaired in the early post-HT period and increased progressively and reached normality 1 year after HT. RV lateral wall LS rose during follow-up as well, reaching normal values 6 months after HT. Nevertheless, we noticed an impairment in this parameter at 5 years (−20.1±2.7, p=0.001), although it remained within normal ranges compared to guidelines reference parameters. We did not find any correlation between any parameter evaluated and the presence of AR or CAV at five years of follow-up. LV and RV function parameters LVEF LV GLS TAPSE FAC RV free wall LS Basal (14 days) 63.0±7.9 −17.2±3.6 12.1±2.9* 43.7±9.8 −19.3±4.2 3 months 65.0±8.6 −17.7±2.8 14.8±3.4* 45.3±8.2 −22.0±4.6 6 months 65.8±9.6 −18.7±3.4 16.1±3.6 44.6±9.6 −24.6±4.9* 1 year 63.5±8.1 −18.1±2.2 17.1±4.1 44.0±8.1 −26.7±7.1* 2 years 63.8±6.8 −18.3±9.0 19.4±3.7 45.3±7.9 −27.6±6.3* 5 years 64.4±7.3 −18.1±3.3 17.9±3.9 46.6±12.1 −20.1±2.8 P (Anova) 0.85 0.85 <0.001 0.82 <0.001 Conclusion As we show in this series of HT recipients with uneventful postoperative course, all LV and RV function parameters showed normal values 1 year after HT and manteined them during long-term follow-up. The presence of AR or CAV did not have any influence in ventricular function.

scholarly journals Right Ventricular Free Wall Strain for Detection of Anthracycline Induced Cardiac Toxicity

2021 ◽  
Author(s):  
Armin Attar ◽  
Fatemeh Azizi ◽  
Firoozeh Abtahi ◽  
Mojtaba Karimi
Keyword(s):  
Cardiac Toxicity ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Lv Function ◽  
Free Wall ◽  
Right Ventricular Free Wall ◽  
Before And After ◽  
The Right ◽  
Rv Function

Abstract Background Anthracycline agents are routinely used for treatment of many types of malignancy, while imposing the risk for cardiotoxicity (AT-CMP). Although the right ventricle (RV) is more susceptible to cardiotoxicity, most of the studies have focused on left ventricle (LV) function for monitoring AT-CMP. In this study, we have focused on RV function before and after chemotherapy using two-dimensional speckle tracking Echocardiography (2D-STE). Material and Methods In this prospective study, newly diagnosed and untreated cancerous patients without previous cardiovascular diseases were enrolled. For all patients, baseline echocardiography was performed before the initiation of the anthracycline regimen and after 6 months of follow up when the chemotherapy was stopped. Several parameters of LV and RV function were measured using 3D echocardiography and STE techniques. Results 60 patients were enrolled in the study. There was a significant decrease (P = 0.001) in RV fractional area change (53.57 %±4.36 vs. 45.66% ±6.19), RV Global longitudinal strain (GLS) (− 22.93%±1.95 vs. −18.53 ± 2.75), and RV free wall strain (FWLS) (− 25.75%±3.01 VS. −20.30 ± 3.78). There was a significant decline in LVEF (59.42 ± 6.36% vs. 51.1 ± 6.31%) and LV-GLS (-21.1 ± 1.8% vs -18.6 ± 2.6%) (both P = 0.001) as well. Among the parameters changed following chemotherapy, RV-FWLS was dropped to a pathological level in 25% of patients showing the highest potential for detection of anthracyclines effect on the myocardium. Conclusion Anthracycline therapy can induce subclinical RV dysfunction. RV-FWLS may be proposed as the most sensitive echocardiographic marker for monitoring AT-CMP. This finding needs to be confirmed in future and larger studies.

scholarly journals Outcomes After PCI in Patients with LV Dysfunction

2017 ◽  
Vol 02 (02) ◽  
pp. 005-010
Author(s):  
M Ravikiran ◽  
G. Indrani
Keyword(s):  
Subgroup Analysis ◽  
Previous History ◽  
Chronic Stable Angina ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Lv Function ◽  
Coronary Syndrome ◽  
Lv Dysfunction ◽  
Significant Difference

AbstractBackground: Coronary artery disease (CAD) is the most common cause of left ventricular dysfunction. Percutaneous coronary intervention (PCI) in patient with LV dysfunction is a high risk procedure and may be associated with adverse outcomes. We observed for outcomes after PCI in the elective and acute coronary syndrome setting in patient with LV dysfunction.Methods: A prospective single center study was performed in 836 patients with and without LV dysfunction who underwent PCI with a follow up period of 1 year for MACCE.Results: A total of 836 patients were studied. 329 (39.4%) patients have LV dysfunction (LVD) and 507 (60.6%) patients have good LV function (GLV). Among the patients with LVD, 160 (48.6%) has mild, 89 (27.1%) has moderate, 80 (24.3%) has severe LVD. Mean age was 56.5±12.5 years in patients with GLV and 58.8±10 years in LVD patients (p=0.003). Number of males were 259 (78.7%) in LVD and 364 (71.7%) in GLV group. Hypertension and diabetes were present in 237(72%) vs 368(72.5%), 168 (51%) vs 286 (56.4%) in LVD and GLV groups respectively (p=0.8, 0.1). There was no difference in the previous history of CABG (5.2% vs 3.4%, p=0.2) and PCI (19.5% vs 16.4%, p=0.3) in both groups. 174 (52.9%) patients with LVD and 409 (80.7%) patients with GLV has chronic stable angina. Multivessel PCI was done in 79 (24%) patients with LVD and 110 (21.7%) patients with GLV (p=0.4). Major adverse cardiovascular and cerebrovascular events (MACCE) occurred in 3 patients with mild, 5 patients with moderate, 6 patients with severe LVD during the follow up of 1 year. There was no difference in outcomes between the LVD and GLV group at one year (p=0.2), but when a subgroup analysis was made among patients with LV dysfunction there was a significant occurrence of MACCE in patients with severe LV dysfunction when compared with mild LVD (p=0.05).Conclusion: There was no significant difference between the occurrence of MACCE in patients with LV dysfunction and without LV dysfunction who underwent PCI. But when a subgroup analysis was done there was a significant occurrence of MACCE in patients with severe LV dysfunction (p=0.05) when compared to mild LVD.

P3367Echocardiographic assessment of right ventricle function in patients with severe tricuspid regurgitation and correlates with outcomes

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Gavazzoni ◽  
E V Vizzardi ◽  
A C Castiello ◽  
R R Raddino ◽  
L P B Badano ◽  
...  
Keyword(s):  
Heart Disease ◽  
Right Ventricle ◽  
Tricuspid Regurgitation ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Cox Regression ◽  
Free Wall ◽  
Severe Tricuspid Regurgitation ◽  
Rv Function

Abstract Background/Introduction Speckle tracking echocardiography has been recently proposed as an accurate and sensitive measure of right ventricle (RV) function that could integrate other more conventional parameters. This tool can be important in the clinical context of severe tricuspid regurgitation (TR), since TAPSE is not fully representative of global RV function and can overestimate this in presence of severe TR. Purpose Evaluate the prognostic relevance of different parameters of RV structure and function derived from 2D and speckle tracking echocardiographic analysis of clinically stable patients with severe TR referred for routine follow up in the context of many etiologies of left side heart disease (secondary TR). Methods The present is a retrospective analysis of prospectively acquired echocardiographic studies including patients with severe secondary TR in the context of left side heart disease. Fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), RV global longitudinal strain (RVLS) and RV free-wall longitudinal strain (RVFWLS) as well as LV function were measured. As suggested in previous studies, we also aimed to explored the use in this population of: i)RVLS/pulmonary systolic arterial pressure (PASP); ii) RVFWLS (average lateral 3 segments strain)/IVSLS (average medial 3 segment strain) as index of RV-LV dependency. The composite end-point of this study included death for any cause and heart failure hospitalization. Results 61 patients (mean age 58±20 years, 65% men), were included. After a mean follow up period of 3,6±2 years 57% of patients reached the combined end-point. At Cox regression univariate analysis a significant correlation with outcomes was found for RVend-diastolic diameter (HR 0,42, p: 0.018), right atrial area (HR: 3, p: 0.02), RVFWLS/IVSLS (HR: 0.5, p: 0.020), RVLS/PASP (HR 0.186, p: 0.039). In multivariable Cox-regression model we found that LVEF, RV dimension and RVFWLS/IVSLS were independently related to outcome; this last one parameter showed the best correlation with outcomes. Conclusions In asymptomatic and clinically stable patients with severe secondary TR longitudinal function of RV free wall is not related to outcomes but RV-arterial coupling and the ratio between deformation of free wall and septal wall of RV are good predictors of clinical deterioration at follow up. The last one conceptually represents the interaction between RV and LV in secondary TR and allows a real “correction” of those effects of severity of TR on the base to apex gradient of lateral wall longitudinal deformation (TR increases movement of basal segments).

The integrated role of NT-pro BNP and STE-GLS for the early detection of chemotherapy-induced cardiotoxicity

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G Youssef ◽  
L Sulaiman ◽  
D Hisham ◽  
M Abdel Hamid
Keyword(s):  
Breast Cancer ◽  
Plasma Level ◽  
Early Detection ◽  
Global Longitudinal Strain ◽  
Sandwich Elisa ◽  
Chemotherapeutic Agents ◽  
Left Ventricular ◽  
Lv Function ◽  
P Value

Abstract Background Chemotherapeutic agents, used for the treatment of breast cancer, have many side effects, among them is cardiomyopathy. Ejection fraction (EF) is fails to detect the subtle alterations of left ventricular (LV) function. There comes the need for a more sensitive tool for the detection of preclinical chemotherapy-induced cardiomyopathy. Aim Detection of subclinical LV systolic dysfunction in breast cancer patients after 6 weeks of the initiation of their chemotherapeutic treatment, using N-terminal pro brain natriuretic peptide (NT-proBNP) plasma level as well as Speckle tracking echo-global longitudinal strain (STE-GLS). Methods Seventy-four asymptomatic, non-metastasizing breast cancer female patients were included. They were assessed before taking their first chemotherapeutic session and 6 weeks thereafter. Assessment included baseline clinical characteristics, conventional two-dimensional (2D) as well as three-dimensional (3D) echocardiography. Loops of different apical views were recorded for later offline STE-GLS analysis. Blood samples for NT-BNP plasma level were collected before and 6 weeks after the initiation of chemotherapy. Samples were later analyzed using a Sandwich ELISA technique. Results The median NT-proBNP almost doubled after 6 weeks of chemotherapy (73.50 vs 34.4 pg/L, p value &lt;0.001). One patient died before her scheduled follow up visit, and the cause of death is unknown. Fifty patients showed NT-proBNP elevation at their follow up, compared to the baseline visit, 22 (44%) of them had worse (less negative) LV-GLS in their follow up visit. Five patients had an abnormally elevated NT-proBNP plasma level, all of them had a worse follow up LV-GLS. Only two patients showed significant reduction of LVEF &gt;10% to less &lt;53% (chemotherapy-induced cardiotoxicity) but their NT-proBNP did not exceed the cutoff limit. Conclusion The integration of LV-GLS and NT-proBNP is useful in the diagnosis of subclinical, subtle chemotherapy-induced cardiotoxicity. Early detection will prompt early cardioprotective measures and thus helps improving the clinical outcomes. Funding Acknowledgement Type of funding source: None

3D right ventricular ejection fraction and longitudinal strain are independent predictors of major adverse cardiovascular events in patients with rrhythmogenic right ventricular cardiomyopathy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Hosseini ◽  
A Sadeghpour ◽  
M Maleki ◽  
A Alizadehasl ◽  
N Rezaeian ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Cardiovascular Events ◽  
Longitudinal Strain ◽  
P Value ◽  
Free Wall ◽  
Ventricular Cardiomyopathy ◽  
Rv Function

Abstract Introduction Evaluation of right ventricular (RV) function is essential in the follow up of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). Role of advance echocardiography including 3D transthoracic echocardiography (3DTTE) for evaluation of 3D RV function and RV longitudinal strain in predicting prognosis in ARVC patients, has not been well investigated. Purpose We aimed to evaluate 3DTTE parameters in predicting major advance cardiovascular events (MACE) defined as ventricular arrhythmia, cardiac hospitalization, heart transplantation, and death in ARVC patients. Methods Forty-eight definite ARVC subjects based on the 2010 Task force criteria were evaluated with standard 2D transthoracic echocardiography (2DTTE) and 3DTTE. Patients with poor image quality were excluded. RV function was evaluated by 2D and 3D TTE including: fractional area change (FAC), RV global and free wall longitudinal strain (RV2DGLS and RV2DFWLS) and 3D RV ejection fraction (RV3DEF), RV global and free wall longitudinal strain (RV3DGLS, and RV3DFWLS). The patients were followed up for a median period of 12 months (6–18 months) to record MACE. Results Forty-eight patients with mean age =38.5±14 years; 79.2% male, and mean RV3DEF =30.33%, were included. During the mean follow up 12 months, 12 patients (25%, with mean RV3DEF = 24.8±9%) experienced MACE whereas mean RV3EF in patient without any cardiovascular events during follow up was 34.21±9%. The most common causes of hospitalization were arrhythmia, right-sided heart failure, and RV clot as the following: Ventricular arrhythmia in 7 patients (14.6%, with mean RV3DEF = 29.01±8.82%), RV clot in 2 cases (4.2%, with mean RV3DEF = 20.2%), right-sided heart failure in 3 patients (6.3%, with mean RV3DEF = 16.83±3.6%) that 2 of them (2.1%, with mean RV3DEF = 14.58±0.63) underwent heart transplantation. Logistic regression analysis revealed RV3DTTE (p-value = 0.03, OR=0.90, CI: 0.82–0.99), RV3DGLS (p-value = 0.05, OR=1.27, CI: 0.99–1.61) and RV3DFWLS (p-value = 0.01, OR=1.29, CI: 1.05–1.59), predicted cardiac adverse events, but there were no significant association between RV2DGLS, RV2DEWLS and FAC with MACE. Conclusion RV3DEF, RV3DGLS, and RV3DFWLS were powerful predictors of morbidity and mortality and can be useful as a valuable method in the prediction of major cardiovascular complications in ARVC patients. Funding Acknowledgement Type of funding source: None

scholarly journals 1228 New predictors of sudden cardiac death in hypertrophic cardiomyopathy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
D M Adamczak ◽  
A Rogala ◽  
M Antoniak ◽  
Z Oko-Sarnowska
Keyword(s):  
Risk Factors ◽  
Hypertrophic Cardiomyopathy ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Volume Index ◽  
Lv Function ◽  
Icd Implantation ◽  
Significant Difference

Abstract BACKGROUND Hypertrophic cardiomyopathy (HCM) is a heart disease characterized by hypertrophy of the left ventricular myocardium. HCM is the most common cause of sudden cardiac death (SCD) in young people and competitive athletes due to fatal ventricular arrhythmias. However, in most patients, HCM has a benign course. That is why it is of utmost importance to properly evaluate patients and identify those who would benefit from a cardioverter-defibrillator (ICD) implantation. The HCM SCD-Risk Calculator is a useful tool for estimating the risk of SCD. The parameters included in the model at evaluation are: age, maximum left ventricular (LV) wall thickness, left atrial (LA) dimension, maximum gradient in left ventricular outflow tract, family history of SCD, non-sustained ventricular tachycardia (nsVT) and unexplained syncope. Nevertheless, there is potential to improve and optimize the effectiveness of this tool in clinical practice. Therefore, the following new risk factors are proposed: LV global longitudinal strain (GLS), LV average strain (ASI) and LA volume index (LAVI). GLS and ASI are sensitive and noninvasive methods of assessing LV function. LAVI more accurately characterizes the size of the left atrium in comparison to the LA dimension. METHODS 252 HCM patients (aged 20-88 years, of which 49,6% were men) treated in our Department from 2005 to 2018, were examined. The follow-up period was 0-13 years (average: 3.8 years). SCD was defined as sudden cardiac arrest (SCA) or an appropriate ICD intervention. All patients underwent an echocardiographic examination. The medical and family histories were collected and ICD examinations were performed. RESULTS 76 patients underwent an ICD implantation during the follow-up period. 20 patients have reached an SCD end-point. 1 patient died due to SCA and 19 had an appropriate ICD intervention. There were statistically significant differences of GLS and ASI values between SCD and non-SCD groups; p = 0.026389 and p = 0.006208, respectively. The average GLS in the SCD group was -12.4% ± 3.4%, and -15.1% ± 3.5% in the non-SCD group. The average ASI values were -9.9% ± 3.8% and -12.4% ± 3.5%, respectively. There was a statistically significant difference between LAVI values in SCD and non-SCD groups; p = 0.005343. The median LAVI value in the SCD group was 45.7 ml/m2 and 37.6 ml/m2 in the non-SCD group. The ROC curves showed the following cut-off points for GLS, ASI and LAVI: -13.8%, -13.7% and 41 ml/m2, respectively. Cox’s proportional hazards model for the parameters used in the Calculator was at the borderline of significance; p = 0.04385. The model with new variables (GLS and LAVI instead of LA dimension) was significant; p = 0.00094. The important factors were LAVI; p = 0.000075 and nsVT; p = 0.012267. CONCLUSIONS The proposed new SCD risk factors were statistically significant in the study population and should be taken into account when considering ICD implantation.

scholarly journals Right ventricular 2D speckle-tracking echocardiography in children with osteosarcoma under chemotherapy

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Ibtsam Khairat ◽  
Mohamed Khalfallah ◽  
Aliaa Shaban ◽  
Ibrahim Abu Farag ◽  
Asmaa Elkady
Keyword(s):  
Right Ventricular ◽  
Animal Studies ◽  
Left Ventricular ◽  
Lv Function ◽  
Patients With Cancer ◽  
Number Of Patients ◽  
2D Speckle Tracking ◽  
Rv Function

Abstract Background Cardiotoxicity from anthracyclin chemotherapy is a leading cause of death in patients with cancer. Therefore, left ventricular (LV) function is routinely assessed during protocol to detect cardiotoxicity; however, animal studies suggest that right ventricular (RV) function may be also impaired. So, our objective was to investigate the incidence of RV dysfunction in children with osteosarcoma receiving anthracyclines and to highlight the role of 2D STE in early detection of RV dysfunction. Results RV function was affected by anthacyclines through direct cardiotoxic effect on RV myocardium without simultaneous derangement of LV function. Furthermore, there is a direct proportion between the incidence of RV dysfunction and the cumulative dose of anthracyclines. At the first echo follow-up at 10th week, 7 patients had impaired RV GLS in comparison to baseline study. At 20th week, the number of patients with impaired RV strain increased to 10. At 29th week, it reaches 12 patients. This effect was early detected by RV 2DSTE before adversely affecting TAPSE and FAC. The incidence of RV dysfunction from anthracyclines was around 12%, and the recovery rate was around 8% in 3 months after completion of chemotherapy. Conclusion RV 2DSTE is the best modality to detect early affection of RV function in comparison with other modalities. RV function decreases early even before derangement of LV function. Accordingly, it should be assessed separately in all patients who received anthracyclines even without evident LV affection.

scholarly journals Cardiac function is normal in most patients recovered from COVID-19

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J Tangen ◽  
P Aukrust ◽  
A Barrat-Due ◽  
M Troseid ◽  
I Christoffer Olsen ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Global Longitudinal Strain ◽  
Normal Function ◽  
Left Ventricular ◽  
Lv Function ◽  
Myocardial Inflammation ◽  
Slight Reduction ◽  
Free Wall ◽  
Very High Frequency ◽  
Rv Function

Abstract Background There are conflicting results regarding impaired cardiac function in patients that have recovered from COVID-19. Cardiovascular magnetic resonance (CMR) studies have revealed a very high frequency of cardiac involvement (78%) and ongoing myocardial inflammation (60%) in patients recently recovered from COVID-19. Findings are advocating further investigation of the long-term myocardial consequences of COVID-19 disease. Purpose We aimed to investigate left ventricular (LV) and right ventricular (RV) function by a comprehensive echocardiographic study in patients recovered from COVID-19 infection 3 months after admission to hospital. Methods All patients (n=92) had been hospitalized for COVID-19 and were examined with echocardiography three months after hospitalization. They were 59±13 years, and 43% were women. LV function was assessed by ejection fraction (EF) and global longitudinal strain (GLS) and RV function was measured by fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE) and RV GLS free wall. Tricuspid regurgitation pressure gradient was measured to estimate pulmonary artery pressure. Results LV EF was 63±6% and LV GLS was −18.6±2.2%. All patients had normal EF &gt;53%, but 10 showed signs of subtle impaired LV function by LV GLS (≥ −16%). Only two of these did not have hypertension, LV hypertrophy, diabetes or other preexisting diagnosis of heart disease explaining subtle LV dysfunction. All had normal RV FAC (48±7%) and TAPSE (2.3±0.3 cm). We found modestly impaired RV longitudinal function (RV GLS free wall &gt;−25%) in 30% patients, but none had RV GLS worse than −20%. One-third of all patients with reduced RV GLS had signs of elevated pulmonary arterial pressures, which might impact the assessment of RV function. Conclusions Traditional echocardiographic parameters showed normal function in all hospitalized COVID-19 patients three months after hospital admittance. Approximately one-third had subtle ventricular dysfunction detected by sensitive echocardiographic methods, but these findings could mostly be explained by systemic or pulmonary hypertension. We cannot, however, exclude that a slight reduction in cardiac function in a minority of our patients was caused by the COVID-19 infection. FUNDunding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): National Clinical Therapy Research in the Specialist Health Services, Norway

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