The Impact of Aerobic Training Periodisation on Global and Regional Right Ventricular Strain in Coronary Heart Disease

Objective:Linear aerobic training periodisation (LP) is recommended in patients with coronary heart disease (CHD). However, the effects of training periodisation on right heart mechanics in CHD patients have never been examined. This study aimed to explore the effects of LP and non-linear periodisation (NLP) on right heart mechanics. Methods: We prospectively randomised CHD patients to 12 weeks aerobic training with LP or NLP. Whereas there was a weekly increase in energy expenditure with LP, there was a steeper increase during the first 3 weeks followed by a decrease the fourth week with NLP. Echocardiography at baseline and after the training period was performed to assess right ventricular free wall (RVFW) and right atrial strain. Results: Thirty CHD patients were included (NLP, n=16; LP, n=14). Traditional right and left heart parameters showed no significant time effect. There was a decrease of RVFW strain with time in both groups (+1.3±0.9% with NLP, and +1.5±0.8% with LP; p=0.033). Mid-ventricular RVFW strain changed significantly with time (+2.0±1.3% with NLP, and from +2.3±1.2% with LP; p=0.025). There was no time effect on right atrial strain. Conclusions: In stable CHD patients, LP and NLP resulted in right ventricular strain decrements with a segment-specific pattern. This study was registered on ClinicalTrials.gov (identifier number: NCT03414996). Novelty: • In stable coronary heart disease patients, both linear and non-linear aerobic training periodisation programs result in right ventricular strain decrements with time, particularly in the mid-ventricular segment • Traditional right and left heart parameters, and right atrial strain showed no significant time effect in both 12 weeks aerobic training periodisation programs

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RIGHT ATRIAL STRAIN ADDS PROGNOSTIC USEFULNESS TO RIGHT VENTRICULAR STRAIN IN PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(19)32505-7 ◽

2019 ◽

Vol 73 (9) ◽

pp. 1899

Author(s):

Yuko S. Soyama ◽

Nobuyuki Kagiyama ◽

Nina Hasselberg ◽

Masataka Sugahara ◽

Marc Simon ◽

...

Keyword(s):

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Right Ventricular ◽

Right Atrial ◽

Right Ventricular Strain ◽

Pulmonary Arterial ◽

Right Atrial Strain ◽

Atrial Strain

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Usefulness of regional right ventricular and right atrial strain for prediction of early and late right ventricular failure following a left ventricular assist device implant: A machine learning approach

The International Journal of Artificial Organs ◽

10.1177/0391398819884941 ◽

2019 ◽

Vol 43 (5) ◽

pp. 297-314 ◽

Cited By ~ 1

Author(s):

Diego Bellavia ◽

Attilio Iacovoni ◽

Valentina Agnese ◽

Calogero Falletta ◽

Claudia Coronnello ◽

...

Keyword(s):

Right Ventricular ◽

Left Ventricular Assist Device ◽

Left Ventricular ◽

Right Ventricular Failure ◽

Right Atrial ◽

Ventricular Failure ◽

Left Ventricular Assist ◽

Acute Right Ventricular Failure ◽

Right Atrial Strain ◽

Atrial Strain

Background: Identifying candidates for left ventricular assist device surgery at risk of right ventricular failure remains difficult. The aim was to identify the most accurate predictors of right ventricular failure among clinical, biological, and imaging markers, assessed by agreement of different supervised machine learning algorithms. Methods: Seventy-four patients, referred to HeartWare left ventricular assist device since 2010 in two Italian centers, were recruited. Biomarkers, right ventricular standard, and strain echocardiography, as well as cath-lab measures, were compared among patients who did not develop right ventricular failure (N = 56), those with acute–right ventricular failure (N = 8, 11%) or chronic–right ventricular failure (N = 10, 14%). Logistic regression, penalized logistic regression, linear support vector machines, and naïve Bayes algorithms with leave-one-out validation were used to evaluate the efficiency of any combination of three collected variables in an “all-subsets” approach. Results: Michigan risk score combined with central venous pressure assessed invasively and apical longitudinal systolic strain of the right ventricular–free wall were the most significant predictors of acute–right ventricular failure (maximum receiver operating characteristic–area under the curve = 0.95, 95% confidence interval = 0.91–1.00, by the naïve Bayes), while the right ventricular–free wall systolic strain of the middle segment, right atrial strain (QRS-synced), and tricuspid annular plane systolic excursion were the most significant predictors of Chronic-RVF (receiver operating characteristic–area under the curve = 0.97, 95% confidence interval = 0.91–1.00, according to naïve Bayes). Conclusion: Apical right ventricular strain as well as right atrial strain provides complementary information, both critical to predict acute–right ventricular failure and chronic–right ventricular failure, respectively.

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