Evaluation of systolic LV function and LV mechanics

2021 ◽  
pp. 497-506
Author(s):  
Rainer Hoffmann ◽  
Frank A. Flachskampf
Keyword(s):  
Ejection Fraction ◽  
Visual Analysis ◽  
Systolic Function ◽  
Nuclear Imaging ◽  
Visual Assessment ◽  
Lv Function ◽  
Regional Function ◽  
2D Echocardiography ◽  
Lv Volumes ◽  
Lv Systolic Function

Analysis of global and regional left ventricular (LV) function is the most frequent indication to perform echocardiography. While visual assessment based on 2D images is the basis for analysis of LV function, it may be supplemented by quantitative techniques to obtain parameters of global or regional function. 2D echocardiography tends to underestimate LV volumes compared to cardiac magnetic resonance (CMR), 3D echocardiography results in less volume underestimation and high accuracy in the analysis of ejection fraction. Visual analysis of regional function is limited by significant interobserver variability. Another approach to systolic LV function is the assessment of LV mechanics, typically by measuring global longitudinal deformation (strain) by speckle-tracking echocardiography. Alternatively, information on deformation can be obtained from CMR (currently, mostly by feature tracking). Deformation parameters detect early impairment of LV systolic function with higher sensitivity than ejection fraction. While echocardiography continues to be the first-choice modality for ejection fraction, CMR has become the gold standard for quantification of LV volumes and ejection fraction. Nuclear imaging should be applied to assess LV function only if simultaneous assessment of myocardial perfusion is requested.

Evaluation of left ventricular systolic function and mechanics

2015 ◽  
pp. 315-322
Author(s):  
Rainer Hoffmann ◽  
Paolo Colonna
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Quantitative Analysis ◽  
Magnetic Resonance ◽  
Systolic Function ◽  
Left Ventricular ◽  
Tissue Imaging ◽  
Lv Function ◽  
2D Echocardiography ◽  
Other Information ◽  
Lv Volumes

Analysis of left ventricular (LV) systolic function is the most frequent indication to perform echocardiography and an integral part of cardiac magnetic resonance (CMR) or radionuclide studies. Visual estimation of LV function may be supplemented by quantitative analysis of 2D images to obtain parameters of global or regional function. Administration of contrast agents to improve identification of myocardium–blood interface has been demonstrated to improve the reproducibility of 2D-echocardiography-based analysis of LV function and should be applied in cases of insufficient endocardial border definition (more than two LV segments not adequately visualized). 2D-echocardiography-based analysis of LV volumes results in underestimation of end-systolic and end-diastolic LV volumes compared to CMR. 3D-echocardiography results in significantly less volume underestimation and higher accuracy in the analysis of ejection fraction. Analysis of regional wall motion is mainly based on subjective visual assessment, which is limited by significant inter-observer variability. Doppler tissue imaging and speckle tracking echocardiography have become validated methods for quantitative analysis of regional LV function. Similarly, tagging, strain-encoded cardiac magnetic resonance (SENC) and feature tracking are modalities to quantify regional LV function based on CMR. Echocardiography should be used as a primary technique to assess systolic LV function as it is the cheapest, widely available and can be applied without the use of ionizing radiation or nephrotoxic contrast material. CMR has become the clinical gold standard for quantification of LV function and may be applied if other information achievable best by CMR is required. Similarly, nuclear techniques should be applied to assess LV function only if simultaneous assessment of myocardial perfusion is requested.

scholarly journals Myocardial deformation in patients with a single left ventricle using 2D cardiovascular magnetic resonance feature tracking: a case–control study

2021 ◽  
Author(s):  
Fabian Strodka ◽  
Jana Logoteta ◽  
Roman Schuwerk ◽  
Mona Salehi Ravesh ◽  
Dominik Daniel Gabbert ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Feature Tracking ◽  
Systolic Function ◽  
Radial Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Significant Difference ◽  
Lv Volumes

AbstractVentricular dysfunction is a well-known complication in single ventricle patients in Fontan circulation. As studies exclusively examining patients with a single left ventricle (SLV) are sparse, we assessed left ventricular (LV) function in SLV patients by using 2D-cardiovascular magnetic resonance (CMR) feature tracking (2D-CMR-FT) and 2D-speckle tracking echocardiography (2D-STE). 54 SLV patients (11.4, 3.1–38.1 years) and 35 age-matched controls (12.3, 6.3–25.8 years) were included. LV global longitudinal, circumferential and radial strain (GLS, GCS, GRS) and strain rate (GLSR, GCSR, GRSR) were measured using 2D-CMR-FT. LV volumes, ejection fraction (LVEF) and mass were determined from short axis images. 2D-STE was applied in patients to measure peak systolic GLS and GLSR. In a subgroup analysis, we compared double inlet left ventricle (DILV) with tricuspid atresia (TA) patients. The population consisted of 19 DILV patients, 24 TA patients and 11 patients with diverse diagnoses. 52 patients were in NYHA class I and 2 patients were in class II. Most SLV patients had a normal systolic function but median LVEF in patients was lower compared to controls (55.6% vs. 61.2%, p = 0.0001). 2D-CMR-FT demonstrated reduced GLS, GCS and GCSR values in patients compared to controls. LVEF correlated with GS values in patients (p < 0.05). There was no significant difference between GLS values from 2D-CMR-FT and 2D-STE in the patient group. LVEF, LV volumes, GS and GSR (from 2D-CMR-FT) were not significantly different between DILV and TA patients. Although most SLV patients had a preserved EF derived by CMR, our results suggest that, LV deformation and function may behave differently in SLV patients compared to healthy subjects.

Acute coronary syndromes in chronic kidney disease patients: the good, the bad or the ugly?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Saleiro ◽  
D De Campos ◽  
J Lopes ◽  
R Teixeira ◽  
J.P Sousa ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Systolic Function ◽  
Lv Function ◽  
Angiotensin Ii Antagonist ◽  
All Cause Mortality ◽  
Group A ◽  
Lv Ejection Fraction ◽  
Group B ◽  
Lv Systolic Function

Abstract Background Patients with chronic kidney disease (CKD) are at increased risk of composite cardiovascular (CV) events and all-cause mortality. However, current aggressiveness of therapeutic strategies may minimize the course of the disease. Aim To assess the prognostic impact of optimized medical treatment in a CKD population with acute coronary syndrome (ACS). Methods 355 ACS patients admitted to a single coronary care with CKD who were discharged from hospital were included. Those with end-stage renal disease were excluded. Three groups were created based on the KDIGO classification: Group A (Stage 3A, eGFR [estimated glomerular filtration rate] 45–59mL/min/1.73 m2) N=190; Group B (Stage 3B, eGFR 30–44mL/min/1.73 m2) N=113; and Group C (Stage 3B, eGFR 15–29mL/min/1.73 m2) N=52. The primary endpoint was long-term all-cause mortality. Kaplan-Meyer survival curves and Cox regression were done. The median of follow-up was 32 (IQ 15–70) months. Results Groups were similar regarding demographics, CV risk factors, ACS type, heart failure diagnosis, left ventricular (LV) systolic function, peak troponin, multivessel disease, treatment option (PCI, CABG or OMT) and medical therapy at discharge. More advance renal failure patients had a higher prevalence of diabetes mellitus (DM), a lower haemoglobin, a higher NT-proBNP and were less likely to receive ACE inhibitors/angiotensin II antagonist at discharge. 170 patients met the primary outcome. Kaplan-Meyer curves showed decreased survival with worse renal function (Group A 68% vs Group B 57% vs Group C 37%, Log Rank P=0.006 – Figure 1). After adjustment for age, DM, haemoglobin, NT-proBNP, LV systolic function and ACE inhibitors/angiotensin II antagonist at discharge, eGFR was not associated with increased death (HR 1.00, 95% CI 0.98–1.01). In this model, only age (HR 1.04, 95% CI 1.01–1.07), haemoglobin (HR 0.86, 95% CI 0.979–0.94), Nt-proBNP (HR 1.00, 95% CI 1.00–1.00) and impaired LV function (LV ejection fraction 40–49%: HR 2.95, 95% CI 1.89–4.81; LV ejection fraction &lt;40%: HR 2.15, 95% CI 1.44–3.21) remained associated with the outcome. Conclusion The worse outcome attributed to CKD after an ACS seems to be related not the eGFR itself but to associated comorbidities such as age, anaemia, fluid overload and impaired LV function. The fact that some of these comorbidities may be altered by intensive therapy indicates that CKD patients should also be candidates to optimized medical treatment. Funding Acknowledgement Type of funding source: None

scholarly journals Central and obstructive apneas prevalence in heart failure with reduced, mid-range and preserved ejection fraction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Borrelli ◽  
P Sciarrone ◽  
F Gentile ◽  
N Ghionzoli ◽  
G Mirizzi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Cardiopulmonary Exercise Testing ◽  
Left Ventricular ◽  
Apnea Hypopnea Index ◽  
Preserved Ejection Fraction ◽  
2D Echocardiography

Abstract Background Central apneas (CA) and obstructive apneas (OA) are highly prevalent in heart failure (HF) both with reduced and preserved systolic function. However, a comprehensive evaluation of apnea prevalence across HF according to ejection fraction (i.e HF with patients with reduced, mid-range and preserved ejection fraction- HFrEf, HFmrEF and HFpEF, respectively) throughout the 24 hours has never been done before. Materials and methods 700 HF patients were prospectively enrolled and then divided according to left ventricular EF (408 HFrEF, 117 HFmrEF, 175 HFpEF). All patients underwent a thorough evaluation including: 2D echocardiography; 24-h Holter-ECG monitoring; cardiopulmonary exercise testing; neuro-hormonal assessment and 24-h cardiorespiratory monitoring. Results In the whole population, prevalence of normal breathing (NB), CA and OA at daytime was 40%, 51%, and 9%, respectively, while at nighttime 15%, 55%, and 30%, respectively. When stratified according to left ventricular EF, CA prevalence decreased from HFrEF to HFmrEF and HFpEF: (daytime CA: 57% vs. 43% vs. 42%, respectively, p=0.001; nighttime CA: 66% vs. 48% vs. 34%, respectively, p&lt;0.0001), while OA prevalence increased (daytime OA: 5% vs. 8% vs. 18%, respectively, p&lt;0.0001; nighttime OA: 20 vs. 29 vs. 53%, respectively, p&lt;0.0001). When assessing moderte-severe apneas, defined with an apnea/hypopnea index &gt;15 events/hour, prevalence of CA was again higher in HFrEF than HFmrEF and HFpEF both at daytime (daytime moderate-severe CA: 28% vs. 19% and 23%, respectively, p&lt;0.05) and at nighttime (nighttime moderate-severe CA: 50% vs. 39% and 28%, respectively, p&lt;0.05). Conversely, moderate-severe OA decreased from HFrEF to HFmrEF to HFpEF both at daytime (daytime moderate-severe OA: 1% vs. 3% and 8%, respectively, p&lt;0.05) and nighttime (noghttime moderate-severe OA: 10% vs. 11% and 30%, respectively, p&lt;0.05). Conclusions Daytime and nighttime apneas, both central and obstructive in nature, are highly prevalent in HF regardless of EF. Across the whole spectrum of HF, CA prevalence increases and OA decreases as left ventricular systolic dysfunction progresses, both during daytime and nighttime. Funding Acknowledgement Type of funding source: None

scholarly journals Acute recoordination rather than functional hemodynamic improvement determines reverse remodelling by cardiac resynchronisation therapy

2021 ◽  
Author(s):  
Philippe C. Wouters ◽  
Geert E. Leenders ◽  
Maarten J. Cramer ◽  
Mathias Meine ◽  
Frits W. Prinzen ◽  
...  
Keyword(s):  
Systolic Function ◽  
Cardiac Resynchronisation Therapy ◽  
Left Ventricular ◽  
Lv Function ◽  
Peak Strain ◽  
Cardiac Resynchronisation ◽  
Reverse Remodelling ◽  
Resynchronisation Therapy ◽  
Lv Systolic Function

AbstractPurpose: Cardiac resynchronisation therapy (CRT) improves left ventricular (LV) function acutely, with further improvements and reverse remodelling during chronic CRT. The current study investigated the relation between acute improvement of LV systolic function, acute mechanical recoordination, and long-term reverse remodelling after CRT. Methods: In 35 patients, LV speckle tracking longitudinal strain, LV volumes & ejection fraction (LVEF) were assessed by echocardiography before, acutely within three days, and 6 months after CRT. A subgroup of 25 patients underwent invasive assessment of the maximal rate of LV pressure rise (dP/dtmax,) during CRT-implantation. The acute change in dP/dtmax, LVEF, systolic discoordination (internal stretch fraction [ISF] and LV systolic rebound stretch [SRSlv]) and systolic dyssynchrony (standard deviation of peak strain times [2DS-SD18]) was studied, and their association with long-term reverse remodelling were determined. Results: CRT induced acute and ongoing recoordination (ISF from 45 ± 18 to 27 ± 11 and 23 ± 12%, p < 0.001; SRS from 2.27 ± 1.33 to 0.74 ± 0.50 and 0.71 ± 0.43%, p < 0.001) and improved LV function (dP/dtmax 668 ± 185 vs. 817 ± 198 mmHg/s, p < 0.001; stroke volume 46 ± 15 vs. 54 ± 20 and 52 ± 16 ml; LVEF 19 ± 7 vs. 23 ± 8 and 27 ± 10%, p < 0.001). Acute recoordination related to reverse remodelling (r = 0.601 and r = 0.765 for ISF & SRSlv, respectively, p < 0.001). Acute functional improvements of LV systolic function however, neither related to reverse remodelling nor to the extent of acute recoordination. Conclusion: Long-term reverse remodelling after CRT is likely determined by (acute) recoordination rather than by acute hemodynamic improvements. Discoordination may therefore be a more important CRT-substrate that can be assessed and, acutely restored.

Abstract 90: Bendavia (MTP-131), a Novel Mitochondria-Targeting Peptide, Improves ADP-Stimulated Mitochondrial Respiration in Cardiomyocytes Isolated From Dogs with Chronic Heart failure

2014 ◽  
Vol 115 (suppl_1) ◽  
Author(s):  
Hani Sabbah ◽  
Ramesh C Gupta ◽  
Sharad Rastogi ◽  
Paula Mohyi ◽  
Kristina Szekely
Keyword(s):  
Heart Failure ◽  
Mitochondrial Respiration ◽  
Systolic Function ◽  
Atp Synthesis ◽  
Vehicle Control ◽  
Electrode System ◽  
Lv Function ◽  
Targeting Peptide ◽  
Lv Systolic Function ◽  
Mitochondria Targeting

Background: Mitochondria (MITO) of failed human hearts and hearts of dogs with experimental heart failure (HF) manifest structural and functional abnormalities characterized by hyperplasia and reduced organelle size and reduced respiration. These abnormalities lead to reduced ATP synthesis that adversely impacts LV function. We previously showed that chronic therapy (3 months) with Bendavia (MTP-131), a novel mitochondria-targeting peptide, improves LV systolic function in dogs with heart failure (HF), reverses MITO abnormalities and normalizes mitochondria ATP synthesis in myocardium from Bendavia-treated HF dogs. In the present study we examined the direct effects of Bendavia on mitochondria ADP-stimulated state 3 respiration in freshly isolated cardiomyocytes from dogs with advanced chronic HF. Methods: Cardiomyocytes were isolated from LV free wall of 3 untreated dogs with HF produced by intracoronary microembolizations (LV ejection fraction <30%). A standard collagenase-based enzymatic process was used for isolation that yielded ~70% viable rod-shaped cardiomyocytes that excluded trypan blue. Equal aliquotes of cardiomyocytes were incubated in 0, 0.01, 0.10, 1.0 and 10 μM concentration of Bendavia for one hour at 37°C. At the end of incubation, ADP-stimulated state-3 respiration was measured using a Clark electrode system and quatified in nAtom Oxygen/min/mg protein. Results: State-3 respiration in the absence of Bendavia (Vehicle-Control) was 248±9 nAtom Oxygen/min/mg protein. Compared to vehicle-control, incubation of failing cardiomyocytes with Bendavia significantly increased state-3 respiration to 303±33 at 0.01 μM, p<0.05; 405±39 at 0.10 μM, p<0.05; 371±28 at 1.0 μM, p<0.05; and 346±29 at 10.0 μM, p<0.05. Conclusions: Results of this study indicate that the effects of Bendavia on mitochondrial respiration in cardiomyocytes is direct and not a consequence of improved global LV structure or function. Furthermore, the results indicate that the improvement in mitochondrial respiration after treatment with Bendavia can occur early after initiation of therapy (within one hour) and is dose-dependent up to concentrations of 0.10 μM.

Impact of the Severity of Mitral Stenosis on the LV Systolic function as assessed by 2D Strain using Speckle tracking

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Adel ◽  
Tarek K Mosa ◽  
Ahmed Yehia ◽  
Ahmed Shawqi
Keyword(s):  
Heart Disease ◽  
Ejection Fraction ◽  
Healthy Volunteers ◽  
Rheumatic Heart Disease ◽  
Mitral Stenosis ◽  
Speckle Tracking ◽  
Systolic Function ◽  
University Hospitals ◽  
Lv Systolic Function ◽  
Rheumatic Heart

Abstract Background Rheumatic heart disease remains a considerable cause of cardiovascular morbidity and mortality in developing countries and mitral stenosis is the most common valve affection of rheumatic heart disease worldwide.The left ventricular ejection fraction is the most widely used index of contractile function, but due to the visual component, assessment of endocardial excursion is subjective leading to inter-observer variability.Speckle-tracking echocardiography is an imaging technique developed as a method to objectively quantify myocardial function and analyzes cardiac motion and deformation by tracking naturally occurring speckle patterns in the myocardium. Objective To evaluate the effect of the severity of mitral stenosis on LV systolic function as assessed by speckle tracking. Patients and Methods This study was a case-control study involving 80 individuals which included 60 patients having mitral stenosis who presented to the outpatient clinics of Ain Shams University Hospitals and 20 healthy volunteers, The patients suffering from mitral stenosis were subdivided into 3 sub-groups: GROUP(1) 20 Patients having severe mitral stenosis (MV Area less than 1 cm²) GROUP (2) 20 Patients having moderate mitral stenosis (MV Area more than 1 cm² and less than 1.5 cm²) GROUP(3) 20 Patients having mild mitral stenosis (MV Area more than 1.5 cm²) A Control group involved 20 healthy volunteers recruited from health care workers in Ain Shams University hospitals. Results Study included 60 patients,16 males (26.7%) and 44 females (73.3%), with mean age of 41.30 ± 8.64 years. Patients living in rural Areas were 34 (57.7%) while those in urban areas were 26 (43.3%).Which was significant.There was no significant difference between gender or habitat and the severity of mitral Stenosis.There was a strong significance between the duration of the disease and its severity. The more the duration of mitral Stenosis, the more severe the mitral stenosis.A strong positive relation was noticed between the severity of mitral stenosis and both RVSP and LA diameter, while a strong negative relation between severity of mitral stenosis and GLPS. GLPS was affected in severe mitral stenosis only. Conclusion Subtle LV systolic dysfunction is present in large number of patients with severe mitral stenosis even in patients with normal ejection fraction by conventional 2D echocardiography.There was a significant relationship between the duration of mitral stenosis and its severity. The longer the duration of mitral stenosis, the more severe the mitral stenosis.Speckle tracking echocardiography (STE) can play a great role in identification of higher risk subgroups in whom earlier and more aggressive intervention could have a significant impact on their prognosis.

scholarly journals Non-Invasive Assessment of Left Ventricle Ejection Fraction: Where Do We Stand?

2021 ◽  
Vol 11 (11) ◽  
pp. 1153
Author(s):  
Alessandra Scatteia ◽  
Angelo Silverio ◽  
Roberto Padalino ◽  
Francesco De Stefano ◽  
Raffaella America ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Ejection Fraction ◽  
Systolic Function ◽  
Left Ventricular ◽  
Left Ventricle Ejection Fraction ◽  
Advantages And Disadvantages ◽  
Non Invasive ◽  
Lv Ejection Fraction ◽  
Lv Systolic Function ◽  
Invasive Evaluation

The left ventricular (LV) ejection fraction (EF) is the preferred parameter applied for the non-invasive evaluation of LV systolic function in clinical practice. It has a well-recognized and extensive role in the clinical management of numerous cardiac conditions. Many imaging modalities are currently available for the non-invasive assessment of LVEF. The aim of this review is to describe their relative advantages and disadvantages, proposing a hierarchical application of the different imaging tests available for LVEF evaluation based on the level of accuracy/reproducibility clinically required.

scholarly journals Correlation between hemoglobin level and left ventricular systolic functions and dimensions in children with chronic severe anemia

2011 ◽  
Vol 51 (2) ◽  
pp. 79
Author(s):  
Erlina Masniari Napitupulu ◽  
Fera Wahyuni ◽  
Tina Christina L. Tobing ◽  
Muhammad Ali ◽  
Bidasari Lubis
Keyword(s):  
Systolic Function ◽  
Pearson Correlation ◽  
Systolic Dysfunction ◽  
Univariate Analysis ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Lv Function ◽  
Severe Anemia ◽  
Cross Sectional ◽  
Lv Systolic Function

Background Chronic severe anemia is a connnon disease. Cardiac output may increase when the hemoglobin (Hb) level decreases to < 7 g/dL for 3 months or more. Alteration of left ventricular (LV) function occurs frequently in children 'With chronic severe anemia, in the {onn of concentric LV hypertrophy, LV dilatation with or v.ithout LV hypertrophy, or systolic dysfunction. Objective To examine the correlation between Hb level and alteration of LV systolic function in children with chronic severe anemia. Methods We conducted a cross-sectional study in Adam Malik Hospital from October to December 2009. Subjects were chronic severely anemic children. Left ventricular systolic function (ejection fraction/EF, fractional shortening/FS) and dimensions (left ventricular end diastolic diameter/LVEDD and left ventricular end systolic diameter/LVESD) were measured using Hitachi EUB 5500 echocardiography unit. Univariate analysis  and Pearson correlation were performed.Results Thirty children were enrolled in the study. The mean of age was 113.5 months (SD 53.24). Hb values ranged from 2.1 to 6.9 g/dL with mean value of 4.6 g/dL (SD 1.44). Mean duration of anemia was 3.9 months (SD 0.70). Chronic severe anemia was not associated \\lith decreased LV systolic function [EF 62.2% (SD 9.16), r =0.296, P=0.112; FS 33.8% (SD 7.26), r =0.115, P=0.545], nor LV dimension changes [LVEDD 40.2 mm (SD 6.85), r = -0.192, P=0.308; LVESD 26.2 mm (SD 4.98), r=-0.266, P=0.156]. Conclusion There was no correlation between Hb level in chronically anemic children and changes in LV systolic function or dimension.

Abstract 15362: Epicardial Adipose Tissue Effects on Systolic Function: A Direct or Systemic Metabolic Effect?

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Shiva Reddy ◽  
Aditi Shankar ◽  
Katrin A Dias ◽  
James P Macnamara ◽  
Christopher M Hearon ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Epicardial Adipose Tissue ◽  
Systolic Function ◽  
Left Ventricular ◽  
Lv Function ◽  
Ectopic Fat ◽  
Paracrine Effects ◽  
Regional Strain ◽  
Data Points ◽  
Lv Systolic Function

Introduction: Obesity is associated with increased epicardial adipose tissue (EAT). It is unknown if this ectopic fat deposit has direct cardiotoxic paracrine effects on regional systolic function. We have previously shown that EAT mediates diastolic dysfunction via systemic effects, rather than localized effects. We similarly hypothesized regional EAT deposits would have no effect on the left ventricular (LV) strain of adjoining myocardial segments. Methods: We studied 28 obese healthy adults (mean age 48 ± 5 yrs, BMI 38.2 ± 5.0 kg/m 2 ). EAT was quantified on each individual MRI slice from base to apex and summed to obtain total volume. It was then separated into anterior, lateral, and inferior regions corresponding to the adjacent LV segments. Using MRI feature tracking, global longitudinal LV strain (GLS) and peak regional anterior, inferior, and lateral LV strain were quantified. Associations between total EAT and GLS, and between regional EAT and corresponding regional strain were determined by linear regression. Results: Mean total EAT volume was 69.6 ± 29.8 mL and mean GLS was -19.4 ± 2.0%. Individual data points for EAT and longitudinal strain are shown in the figure. Greater total EAT volume was modestly associated with decreased GLS (r2 = 0.127). However, anterior, lateral, and inferior EAT volume did not correlate with a decrease in corresponding regional strain (r2 = 0.003, r2 = 0.088, r2 = 0.016, respectively). Conclusion: In obese adults, total EAT volume was associated with a decrease in global LV systolic function measured by GLS. There was no association between regional EAT depots and corresponding regional LV function to suggest localized metabolic cardiotoxic effect. These preliminary results support our previous findings that EAT has little paracrine effect on cardiac function. Rather, EAT likely represents an additional depot of ectopic fat reflective of a general metabolic abnormality.

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