Heart function in juvenile idiopathic arthritis patients: A biventricular two-dimensional speckle-tracking echocardiography study

2021 ◽  
Author(s):  
Alessandro C Lianza ◽  
Gabriela N Leal ◽  
Nádia E Aikawa ◽  
Katia T Kozu ◽  
Maria De Fátima R Diniz ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Cardiac Function ◽  
Right Ventricular ◽  
Strain Rate ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Biological Agents ◽  
Systolic Strain ◽  
Conventional Echocardiography

ABSTRACT Objectives We evaluated cardiac function in juvenile idiopathic arthritis (JIA) patients by 2D speckle-tracking echocardiography (2DSTE) and to assess possible associations with clinical, laboratorial, and treatment data. Methods A group of 42 JIA patients and 42 healthy controls were evaluated using both conventional echocardiography and 2DSTE. JIA patients underwent clinical and laboratory assessment. Results Conventional echocardiography data demonstrated normal left ventricular (LV) ejection fraction in both groups (71 vs. 71%; p = .69). 2DSTE analysis demonstrated that JIA patients presented significantly lower LV global systolic longitudinal strain (LVGLS) (−18.76 vs. −22%; p < .0001), LV systolic strain rate (LVSSR) (1.06 vs. 1.32 s−1; p < .0001), LV diastolic strain rate (LVDSR) (1.58 vs. 1.8 s−1; p < .0137), right ventricular global systolic strain (RVGLS) (−24.1% vs. −27.7%; p = .0002), and right ventricular systolic strain rate (RVSSR) (1.4 vs. 1.8 s−1; p = .0035). JIA patients under biological agents presented higher LVGLS (p = .02) and RVLS (p = .01). We also detected an association between LVGLS and C-reactive protein [CRP; −20% in normal CRP (10/42) vs. −18% in elevated CRP patients (32/42), p = .03]. Conclusions JIA patients present different echocardiographic status from healthy patients. Moreover, our data suggest that JIA patients under biological agents present association with better cardiac function as shown by strain analysis.

2D-Speckle tracking echocardiography contributes to early identification of impaired left ventricular myocardial function in children with chronic kidney disease

2018 ◽  
Vol 28 (12) ◽  
pp. 1404-1409 ◽  
Author(s):  
Hasan Demetgul ◽  
Dilek Giray ◽  
Ali Delibas ◽  
Olgu Hallioglu
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Strain Rate ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Control Group ◽  
Healthy Children ◽  
Systolic Strain ◽  
2D Speckle Tracking

AbstractIntroductionThe aim of this study is to determine early changes in cardiac function of children with chronic kidney disease by using 2D-speckle tracking echocardiography.MethodThe study included 38 children – 16 girls and 22 boys – diagnosed as having chronic kidney disease in the nephrology department with a glomerular filtration rate of <90 ml/minute/1.73 m2 for at least 3 months. A total of 37 – 15 girls and 22 boys – age- and sex-matched healthy children were included as the control group. 2D-Speckle tracking echocardiography was performed in all subjects.ResultsThe mean age was 13.45±2.8 years in patients and 12.89±3.07 years in controls. Systolic and diastolic blood pressures and left ventricular mass index were significantly higher in patients (p<0.05). The values of mitral e, mitral a, mitral e/a ratio, and mitral deceleration time were not different between the groups. Tricuspid annular plane systolic excursion values were lower in patients (p<0.01). Global strain values in apical long-axis 3-chamber and 2-chamber views were significantly lower in patients (p<0.05). Longitudinal, radial, and circumferential peak systolic strain values were lower in patients, but the difference was statistically significant in all segments of longitudinal view and basal segment of circumferential view (p<0.05). Radial and circumferential systolic strain rates were significantly lower in patients in all three segments (p<0.05). Moreover, early diastolic strain rate was significantly lower in longitudinal and radial apical segments and in all segments of circumferential measurements in patients. Besides, strain rate e/a ratio was significantly lower in all longitudinal segments of patients (p=0.01).ConclusionThe study concluded that 2D-speckle tracking echocardiography method can determine cardiac involvement earlier than conventional echocardiography in children with chronic kidney disease having preserved ejection fraction.

scholarly journals Assessment of Myocardial Mechanics in Acute Rheumatic Fever Using Speckle Tracking Echocardiography

2021 ◽  
Author(s):  
Utku Pamuk ◽  
Hazım Gursu ◽  
Emine Azak ◽  
İlker Çetin
Keyword(s):  
Right Ventricular ◽  
Strain Rate ◽  
Acute Phase ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Acute Rheumatic Fever ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Strain Rates

Objectives: This study aims to evaluate the role of speckle tracking echocardiography (STE) to identify myocardial deformation abnormalities in acute rheumatic fever. Methods: Twenty-seven patients and twenty-seven healthy children were studied prospectively. The patients were divided into two subgroups as moderate/severe carditis and mild/no carditis according to valve involvement. The left ventricular global longitudinal strain (LVGLS) and strain rate (LVGLSR), left ventricular global circumferential strain (LVGCS) and strain rate (LVGCSR), and right ventricular global longitudinal strain (RVGLS) and strain rate (RVGLSR) were examined by STE. Results: Left ventricular global longitudinal strain, LVGLSR, LVGCS, LVGCSR, RVGLS and RVGLSR were significantly lower in patients in acute phase of disease than controls. There were no differences in strain and strain rates between patient subgroups before treatment. After acute phase, statistically significant improvements were found in LVGLS, LVGLSR, LVGCSR values of the patients with moderate/severe carditis and LVGLS, LVGCS, LVGCSR, RVGLS, RVGLSR values of the patients with mild/no carditis. The strain parameters of the patients and controls did not differ significantly after the treatment. Conclusions: In acute phase of rheumatic heart disease, patients have reduced left and right ventricular strain and strain rates, which shows improvements after treatment.

scholarly journals Speckle tracking echocardiography in primary mitral regurgitation: should we reconsider the time for intervention?

2021 ◽  
Author(s):  
Maria Concetta Pastore ◽  
Giulia Elena Mandoli ◽  
Aleksander Dokollari ◽  
Gianluigi Bisleri ◽  
Flavio D’Ascenzi ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Right Ventricular ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Main Concern ◽  
Cardiac Damage ◽  
Asymptomatic Patients ◽  
Right Ventricular Strain

Abstract Thanks to the improvement in mitral regurgitation (MR) diagnostic and therapeutic management, with the introduction of minimally invasive techniques which have considerably reduced the individual surgical risk, the optimization of the timing for MR “open” or percutaneous surgical treatment has become a main concern which has highly raised scientific interest. In fact, the current indications for intervention in MR, especially in asymptomatic patients, rely on echocardiographic criteria with high severity cut-offs that are fulfilled only when not only mitral valve apparatus but also the cardiac chambers’ structure and function are severely impaired, which results in poor benefits for post-operative clinical outcome. This led to the need of new indices to redefine the optimal surgical timing in these patients. Speckle tracking echocardiography provides early markers of cardiac dysfunction due to subtle myocardial impairment; therefore, it could offer pivotal information in this setting. In fact, left ventricular and left atrial strains have already shown evidence about their usefulness in recognizing MR impact not only on symptoms and quality of life but also on cardiovascular events and new-onset atrial fibrillation in these patients. Moreover, right ventricular strain could be used to identify those patients with advanced cardiac damage and different grades of right ventricular dysfunction, which entails higher risks for cardiac surgery that could overweigh surgical benefits. This review aims to describe the importance of reconsidering the timing of intervention in MR and to analyze the potential additive value of speckle tracking echocardiography in this clinical setting.

scholarly journals Usefulness of Speckle Tracking Echocardiography and Biomarkers for Detecting Acute Cellular Rejection After Heart Transplantation

2020 ◽  
Author(s):  
Cecília Beatriz Bittencourt Viana Cruz ◽  
Ludhmila A. Hajjar ◽  
Fernando Bacal ◽  
Marco S. Lofrano-Alves ◽  
Márcio S.M. Lima ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Right Ventricular ◽  
Speckle Tracking ◽  
Troponin I ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Acute Cellular Rejection ◽  
Control Group ◽  
Transplant Patients ◽  
Cellular Rejection

Abstract Background: Acute cellular rejection (ACR) is a major complication after heart transplantation. Endomyocardial biopsy (EMB) remains the gold standard for its diagnosis, but it has concerning complications. We evaluated the usefulness of speckle tracking echocardiography (STE) and biomarkers for detecting ACR after heart transplantation.Methods: We prospectively studied 60 transplant patients with normal left and right ventricular systolic function who underwent EMB for surveillance six months after transplantation. Sixty age- and sex-matched healthy individuals constituted the control group. Conventional echocardiographic parameters, left ventricular global longitudinal, radial and circumferential strain (LV-GLS, LV-GRS and LV-GCS, respectively), left ventricular systolic twist (LV-twist) and right ventricular free wall longitudinal strain (RV-FWLS) were analyzed just before the procedure. We also measured biomarkers at the same moment. Results: Among the included 60 patients, 17 (28%) had severe ACR (grade ≥ 2R), and 43 (72%) had no significant ACR (grade 0 – 1R). The absolute values of LV-GLS, LV-twist and RV-FWLS were lower in transplant patients with ACR degree ≥ 2 R than in those without ACR (12.5% ± 2.9% vs 14.8% ± 2.3%, p=0.002; 13.9° ± 4.8° vs 17.1° ± 3.2°, p=0.048; 21.4%± 3.2% vs 16.6% ± 2.9%, p<0.001; respectively), while no differences were observed between the LV-GRS or LV-GCS. All of these parameters were lower in the transplant group without ACR than in the nontransplant control group, except for the LV-twist. Cardiac troponin I levels were significantly higher in patients with significant ACR than in patients without significant ACR [0.19 ng/mL (0.09–1.31) vs. 0.05 ng/mL (0.01–0.18), p=0.007]. The combination of troponin with LV-GLS, RV FWLS and LV-Twist had an AUC (area under curve) for the detection of ACR of 0.80 (0.68 – 0.92), 0.89 (0.81 – 0.93) and 0.79 (0.66 – 0.92), respectively. Conclusion: Heart transplant patients have altered left ventricular dynamics compared with control individuals. The combination of troponin with strain parameters had higher accuracy for the detection of ACR than the isolated variables and this association might select patients with a higher risk for ACR who will benefit from an EMB procedure in the first year after heart transplantation.

scholarly journals P1603 Changes of cardiac function in cirrhotic patients after liver transplantation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
H M Kim ◽  
H K Kim ◽  
J H Lee ◽  
E A Park ◽  
J B Park ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Mr Imaging ◽  
Cardiac Function ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Lv Function ◽  
Qtc Interval ◽  
Cardiac Mr ◽  
Cirrhotic Patients

Abstract Funding Acknowledgements This study was supported by the grant of CJ healthcare 2016 research fund. Background Liver cirrhosis (LC) has been known to affect cardiovascular performance. Limited study have evaluated the alteration of myocardial function in patients with LC after liver transplantation (LT). Purpose The aim of study was to evaluate changes of cardiac function in patients with cirrhosis following LT using conventional and speckle-tracking echocardiography and late gadolinium enhancement (LGE) of cardiac magnetic resonance (MR). Methods Thirty-five patients with cirrhosis (mean age, 57.1 ± 9.0; male, 75%) who were listed for LT were prospectively enrolled. Patients underwent conventional, speckle-tracking echocardiography, and cardiac MR imaging with LGE. Echocardiography and cardiac MR were performed at pre and 1 year after LT. Cirrhotic patients were compared with normal control (n = 20, mean age, 65.0 ± 14.8; men, 11(55%)) and echocardiographic and cardiac MR data were compared pre and post LT. Results Conventional and speckle-tracking echocardiography and Cardiac MR imaging demonstrated hyperdynamic left ventricular (LV) function in patients with cirrhosis (LV ejection fraction (EF) with cardiac MR 67.8 ± 7.0% in LC vs. 63.4 ± 6.4% in control, P = 0.028; global longitudinal strain (GLS) -24.3 ± 2.6% in LC vs. -18.6 ± 2.2% in control, P &lt; 0.001). There were no LGE in patients with cirrhosis and no significant differences in LV size, LV wall thickness, LV mass index, and diastolic function between cirrhotic patients and control group (all P &gt; 0.1). Corrected QT interval (QTc) in electrocardiogram was prolonged in LC patients (P &lt; 0.001). One-year after LT, LV end-diastolic diameter and LV end-diastolic volume significantly decreased (P = 0.016 and 0.022, respectively). Although LVEF showed no significant changes 1 year post-LT (P = 0.362), LV-GLS (from -24.7 ± 1.8% to -20.8 ± 3.4%, P &lt; 0.001) significantly decreased. QTc interval also decreased 1 year after LT (from 470.4 ± 29.6msec to 428.2 ± 31.6msec, P = 0.001). Conclusions The present study demonstrated that cirrhotic patients showed hyperdynamic circulation and prolonged QTc interval compared with normal controls. After 1 year LT, LV size reduced and augmented LV function was normalized. Given that no LGE in cardiac MR and normalized GLS and QTc after LT, cardiac dysfunction in LC patients could be reversed by LT.

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