Assessment of Longitudinal Left Ventricular Function in Patients with Coronary Artery Ectasia by 2D Speckle Tracking Echocardiography

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Radwa Gad EL sayed ◽  
Mustafa Abdelmonaem ◽  
Viola William ◽  
Walaa Adel
Keyword(s):  
Coronary Artery ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Control Group ◽  
Coronary Artery Ectasia ◽  
Lv Mass ◽  
Significant Difference ◽  
Peak Longitudinal Strain ◽  
2D Speckle Tracking ◽  
Global Peak

Abstract Background Coronary artery ectasia (CAE) is one of the uncommon cardiovascular disorders. CAE is one of the known risk factors for acute coronary syndrome, its incidence ranges from 1.5%-5% of patients undergoing coronary angiography, with predominance in males. Coronary artery ectasia (CAE) is defined as dilatation of an arterial segment to a diameter at least 1.5 times that of an adjacent normal artery and involves at least one third of the affected artery (1)(1). The exact pathogenesis of CAE is not well established; however, Coronary atherosclerosis is detected in more than 50% of the patients. Objective To evaluate global left ventricle longitudinal strain by 2D speckle tracking echocardiography in patients with coronary artery ectasia and without significant (>50%) coronary artery stenosis. Patients and Methods This study carried on sixty patients referred to cath lab of Ain Shams university hospital for elective coronary angiography during period between January 2018 and Augest 2019. The patients were divided in to two groups (Group A) included thirty patients with ectasia in one or more of the coronary arteries without any significant coronary artery stenosis and (Group B) included thirty patients with normal coronary angiographic findings serving as control group. Results The present study showed a statistically significant decrease in EF comparing CAE group to control group .As regards other echocardiography parameters, there was a highly significant difference of LVEDD, LVEDD index, LVESD,, LVESD index, LV mass, LV mass index, LA volume and LA volume index between the two groups. Global peak longitudinal strain showed highly significant difference between two groups as its mean value was significantly lower in the CAE group. Conclusion In our study, we have concluded that global peak longitudinal strain was significantly impaired in patients with coronary artery ectasia without significant coronary artery lesion denoting subclinical LV systolic dysfunction .LV diastolic dysfunction was more prevalent in coronary artery ectasia patients compared to control subjects.

scholarly journals 1033 Prominent longitudinal strain involvement of left ventricular basal segments in native hypertensive patients without clear-cut hypertrophy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Lembo ◽  
R Esposito ◽  
C Santoro ◽  
R Sorrentino ◽  
F Luciano ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Longitudinal Strain ◽  
Linear Regression Analysis ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Hypertensive Patients ◽  
Clear Cut ◽  
Lv Mass ◽  
Significant Difference

Abstract Background Left ventricular (LV) global longitudinal strain (GLS) is able to detect an early subclinical dysfunction and it has been demonstrated to be a prognosticator in arterial hypertension. Information of regional longitudinal strain (LS) pattern has not been investigated in this clinical setting. Purpose We analyzed regional LV patterns of LS and base-to-apex behaviour of LS in newly diagnosed and never-treated hypertensive patients (HTN) without clear-cut LV hypertrophy (LVH). Methods 166 HTN (M/F = 107/59; age 43.9 ± 14.3 years, blood pressure [BP] = 146.5± 10.7/90.1 ± 7.5 mmHg) and a control group of 94 healthy subjects (M/F = 58/36; age 41.2 ± 15.0 years) underwent standard echo-Doppler exam, including speckle tracking quantification of regional LS and GLS (considered in absolute values). The average LS of six basal (BLS), six middle (MLS), and six apical (ALS) segments and relative regional strain ratio - RRSR = [ALS/(BLS + MLS)] - were also computed. Exclusion criteria were LVH (LV mass index ≥45 g/m^2.7 in females and ≥49 g/m^2.7 in males), diabetes mellitus, coronary artery disease, overt heart failure, hemodynamically significant valve heart disease, primary cardiomyopathies, atrial fibrillation and inadequate echo imaging. Results The two groups were comparable for sex, age, heart rate and LV ejection fraction (EF). Body mass index (BMI), systolic (SBP), diastolic (DBP) and mean BP (MBP) (all p < 0.0001), LV mass index (p = 0.03), relative wall thickness (RWT) (p < 0.02) and E/e’ ratio (p < 0.01) were higher, and GLS lower (21.6 ± 2.0 vs. 22.2 ± 2.1%, p < 0.02) in HTN. By analyzing regional LS, BLS (18.2 ± 2.1% vs. 19.2 ± 2.1%, p < 0.0001) and MLS (20.7 ± 2.0 vs. 21.4 ± 2.1%, p = 0.007) resulted significantly lower in HTN, without significant difference in ALS (26.0 ± 3.6 vs. 25.9 ± 3.8%, p = 0.98). Accordingly, RRSR was higher in HTN (0.67 ± 0.09 vs. 0.64 ± 0.09, p < 0.01). Even after excluding patients with LV concentric remodeling (RWT > 0.42) (n = 34), BLS (p < 0.0001) and MLS (p < 0.002) were again lower and RRSR (p < 0.01) higher in HTN than in controls. In the pooled population, BLS negatively correlated with SBP (r=-0.22), DBP (r=-0.25) and MBP (r=-0.26) (Figure) (all p < 0.0001). By a multiple linear regression analysis, after adjusting for age, sex, BMI and RWT, the association between BLS and MBP remained significant (β coefficient=-0.23, p < 0.0001), with an additional significant impact of male sex (β=-0.33, p < 0.0001) (cumulative R²=0.18, SEE = 1.9%, p < 0.0001). Conclusions Besides normal LV EF, GLS is lower in HTN. LS dysfunction involves basal and, with a lower extent, middle myocardial segments, with a compensation of apical segments. RRSR appears to be significantly higher in HTN. These results are even confirmed in hypertensive patients with normal LV geometry. The association of BLS and BP appears to be independent on several confounders. Regional LS pattern might be useful to detect very early LV systolic abnormalities in arterial hypertension. Abstract 1033 Figure. Relation between MBP and BLS

scholarly journals Association of Opium Consumption and Coronary Artery Ectasia: A Propensity Score-matched Study

2020 ◽  
Author(s):  
Mahan Shafie ◽  
Arya Aminorroaya ◽  
Ali Vasheghani-Farahani ◽  
Arash Jalali ◽  
Abdolvahab Baradaran
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Propensity Score ◽  
Control Group ◽  
Coronary Artery Ectasia ◽  
Increased Risk ◽  
Significant Difference ◽  
Artery Disease ◽  
Matched Study ◽  
Coronary Angiograms

Abstract Background: Opium consumption is associated with an increased risk of atherosclerosis and a hyper-inflammatory state that are suggested as contributing factors to the development of coronary artery ectasia (CAE). We aimed to determine if opium consumption is an independent risk factor of CAE. Methods: In this propensity score-matched study, we enrolled patients who underwent elective coronary angiography between September 2004 and March 2017 in Tehran Heart Center. We studied patients with CAE and without coronary artery disease as cases. The control group, patients with normal coronary angiograms, were selected after applying the propensity score matching to match for age, sex, diabetes mellitus, hypertension, hyperlipidemia, family history of coronary artery disease, and cigarette smoking.Results: We studied 242 patients with pure CAE and selected 968 control patients. The prevalence of opium consumption was not significantly different across these groups, 17 (7.5%) in the pure CAE group compared to 76 (8.6%) in the control group (Odds ratio: 0.81; p=0.455). Amongst the patients with pure CAE, Markis scores were not significantly different between opium consumers and non-consumers (p=0.136).Conclusions: We found no significant difference regarding opium consumption between patients with pure CAE and patients with normal coronary angiograms. In addition, there is no correlation between opium consumption and Markis scores in patients with pure CAE.

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

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

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

scholarly journals Elevated high sensitivity C-reactive protein and uric acid levels in coronary artery ectasia.

2014 ◽  
Vol 61 (4) ◽  
Author(s):  
Şerafettin Demir ◽  
Gulhan Karakoyun ◽  
Mehmet Kanadasi
Keyword(s):  
Uric Acid ◽  
Coronary Artery ◽  
High Sensitivity ◽  
Control Group ◽  
Coronary Artery Ectasia ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Group I ◽  
Significant Difference ◽  
Hs Crp

The aim of this study is to examine uric asid (UA) and high sensitive C-Reactive protein (Hs-CRP) levels in patients with coronary artery ectasia (CAE). Ninety-eight patients with isolated CAE (mean age 57.5±10.3), (group-I), 110 patients with CAD but without CAE (mean age 56.3±10.7), (group-II), and 105 patients with normal coronary angiographies (mean age 58.1±10.8), (group-III) were included in the study. Blood samples of all individual were taken after coronary angiography from an antecubital vein, the patients uric acid and Hs-CRP levels were assessed. The severity of ectasia was evaluated and categorized according to Markis. A significant difference was not seen in serum uric acid and Hs-CRP levels between CAE and CAD groups. However, relative to the control group, uric acid and Hs-CRP levels in CAE and CAD groups were higher to a significant degree (p=0.001, p

Short term improvement of global left ventricular longitudinal strain by speckle tracking echocardiography after transcatheter aortic valve implantation in patients with severe aortic stenosis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Nosir ◽  
M.Y.F Nosir ◽  
A.K Al-Shaibi ◽  
M Petilla ◽  
M Alasnag ◽  
...  
Keyword(s):  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Severe Aortic Stenosis ◽  
Left Ventricular ◽  
Short Term ◽  
Transcatheter Aortic Valve ◽  
Lv Mass ◽  
Significant Difference ◽  
The Mean ◽  
Valve Implantation

Abstract Background Global longitudinal strain (GLS) has incremental value in assessing left ventricular (LV) function in patients with severe aortic stenosis (AS). Long-standing AS causes LV hypertrophy which predisposes to increased cardiac morbidity and mortality. The recent development of transcatheter aortic valve implantation (TAVI) device for treatment of severe symptomatic AS, offers an option for high risk patients. Objectives Our aim was to investigate the correlation between the time elapsed after performing a TAVI procedure and the LV GLS by Speckle tracking echocardiography (STE) and its correlation with progressive degree of regression in LV mass (LVM) by transthoracic echocardiography (TTE). Methods TTE was performed on 54 patients with severe AS who underwent TAVI procedure. TTE was performed at baseline (before the procedure) and then at 3 months and 6 months post TAVI. GLS was calculated for every patient from STE of the three apical views (apical 4, apical 2 and apical long axis views). The LV muscle volume was calculated by subtraction of LV pericardial volume from LV endocardial volume using biplane Simpson's formula. LVM was then calculated by multiplying LV mass volume by muscle density (1.05). Results The study included 54 patients with severe AS (average PG =79.5 mmHg and average mean gradient 40.5 mmHg), with a mean age of 79±10 years and 46 were male. All patients underwent TAVI and average mean gradient post TAVI was 7 mmHg. The mean ± SD of GLS were −15.3±2.0, −15.9±1.7 and −17.2±1.8 for STE obtained at baseline, 3- and 6-months post TAVI, respectively. There was significant difference in LV GLS when comparing baseline measurements with measurements obtained at both 3 months {mean difference ± SD (MD±SD) was 0.57±0.7 (p&lt;0.001)} and at 6 months post TAVI was 1.8±0.8 (p&lt;0.0001). There was significant difference when comparing LV GLS measurements at 3- and 6- months post TAVI MD±SD was 1.2±0.65 (p&lt;0.001). The mean±SD of LVM was 118.5±31, 110.5±29.2 and 101.1±26.4 at baseline, 3- and 6-months post TAVI, respectively. There was significant difference between baseline and 3 months measurement of LVM, MD±SD is 7.6±6.0 (p&lt;0.001). There was significant difference between baseline and 6 months measurement of LVM, MD±SD was 17.0±10.5 (p&lt;0.0001). In addition, there was significant difference of LVM calculation at 3 and 6 months with MD±SD of 9.4±7.9 and (P&lt;0.001). Conclusions In patient with severe AS that underwent TAVI, there is short term continues significant improvement of LV GLS by STE. This could be attributed to relieving the pressure overload and regression of LVM over time. Decreasing LV hypertrophy and increasing LV GLS on the short term indicate high efficacy of TAVI procedure and subsequently improving patient prognosis and quality of life. Funding Acknowledgement Type of funding source: None

2D Speckle Tracking echocardiography in the prognostication of left ventricle diastolic dysfunction

2020 ◽  
Vol 24 (3) ◽  
pp. 76-87
Author(s):  
O. M. Zherko ◽  
E. I. Shkrebneva
Keyword(s):  
Left Ventricle ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Type Ii ◽  
Dispersion Index ◽  
Time To Peak ◽  
Mechanical Dispersion ◽  
Peak Longitudinal Strain ◽  
2D Speckle Tracking

The aim of the study: to develop prediction comprehensive criteria for the diastolic dysfunction (DD) of the left ventricle (LV) according to 2D Speckle Tracking echocardiography (STE).Materials and methods. A clinical and instrumental study of 91 patients aged 64.0 was performed [58.0; 70.0] years in the Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology in 2019. Criteria for inclusion: sinus rhythm, essential arterial hypertension, chronic coronary artery disease, previous left myocardial infarction, after which at least six months have passed to stabilize the LV structural and functional parameters, chronic heart failure, patient informed consent. Exclusion criteria: primary mitral regurgitation, mitral stenosis, mitral valve repair or prosthetics, congenital heart defects, acute and chronic diseases of the kidneys, lungs. Transthoracic echocardiography and STE was performed on ultrasound machine Vivid E9 (GE Healthcare, USA).Results. The leading functional anomalies, interconnected in the development of LV DD, are decline of the LV longitudinal diastolic, regional and global systolic strain, LV mechanical dispersion and dyssynergy. Correlations between LV DD type II and the mechanical dispersion index (r = 0.69, p < 0.001), delta of LV time to peak longitudinal deformation (r = 0.66, p < 0.001), LV global post-systolic index (r = 0.58, p < 0.001), GLSAVG (r = 0.63, p < 0.001) were established. LV DD is characterized by early diastolic longitudinal strain E of the LV basal lateral segment > −6.75%, LV basal septal segment > −5.22%, early and late diastolic longitudinal strain ratio E/A of the LV basal lateral segment ≤0.91, basal-septal segment ≤0.69. LV DD type I is characterized by an LV mechanical dispersion index >49.34 ms, LV delta time to peak longitudinal strain >157 ms. Prognostic values for LV DD type II are LV mechanical dispersion index >49.34 ms, delta time to peak longitudinal strain is >136 ms, global post-systolic index >6.24%, mechanical dyssynergy index >4.60%, global LV peak longitudinal displacement ≤9.88 mm, GLSAVG > −18.5% (sensitivity 88.2%, specificity 83.3%).Conclusions. The use of the developed STE prediction value in practical public health will increase the efficiency of diagnosis of LV DD.

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