scholarly journals Left Ventricular Longitudinal Function Assessed by Speckle Tracking Ultrasound from a Single Apical Imaging Plane

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Thomas Bagger ◽  
Erik Sloth ◽  
Carl-Johan Jakobsen

Background. Transthoracic ultrasonography of the heart is valuable in monitoring and treatment of critically ill patients. Speckle tracking ultrasound (STU) has proven valid in estimating left ventricular systolic deformation. The aims of the study were to compare conventional and automated STU and to determine whether left ventricular systolic deformation could be estimated from one single imaging plane.Methods. 2D-echocardiography cine-loops were obtained from 20 patients for off-line speckle tracking analysis, consisting of manually tracing of the endocardial border (conventional method) or automatically drawn boundaries (automated method).Results. We found a bias of 0,6 (95% CI −2.2−3.3) for global peak systolic strain comparing the automated and the conventional method. Comparing global peak systolic strain of apical 4-chamber cine-loops with averaged Global Peak Strain obtained from apical 4, 2 and long axis cine-loops, showed a bias of 0.1 (95% CI −3.9−4.0). The agreement between subcostal 4-chamber and apical 4-chamber global peak systolic strain was 4.4 (95% CI −3.7−12.5).Conclusion. We found good agreement between the conventional and the automated method. STU applied to single apical 4-chamber cine-loops is in excellent agreement with overall averaged global peak systolic strain, while subcostal 4-chamber cine-loops proved less compliant with speckle tracking ultrasound.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Kaoru Dohi ◽  
Katsuya Onishi ◽  
Shinya Kato ◽  
Takeshi Takamura ◽  
Naoki Fujimoto ◽  
...  

Background: We tested the hypothesis that speckle-tracking strain imaging can quantify longitudinal right ventricular (RV) function and its association with left ventricular (LV) function in patients with myocardial infarction (MI). Methods: To quantify longitudinal RV function, 39 patients with old MI (OMI: LV ejection fraction 17 – 77 %, 45 ±16 %) and 29 age matched normal controls (Control: LV ejection fraction 65 ± 5 %) were studied with echocardiography. Longitudinal RV global peak systolic strain was assessed from apical four-chamber view using speckle-tracking imaging (EchoPAC, GE Electronic). RV fractional area change was also analyzed. Results: Longitudinal RV global peak systolic strain was significantly impaired in OMI compared to Control (−18 ± 5* and −25 ± 4 %, *p < 0.05 vs. Control) whereas RV fractional area change failed to discriminate from normal to impaired RV function (OMI: 48 ± 11 vs. Control: 52 ± 6 %, p = NS). When divided OMI into three groups regarding to plasma BNP level (Group A: BNP < 100 pg/ml; n = 14, Group B: 100 pg/ml ≤ BNP < 500 pg/ml; n = 14, and Group C; BNP ≥ 500 pg/ml; n = 11), Group A had no significant relations between longitudinal RV global peak systolic strain and LV ejection fraction (y = −0.07x − 11, r = 0.30, p = NS) whereas those were significantly correlated in Group B (y = −0.18x − 11, r = 0.59*, *p < 0.05). Furthermore, the strongest correlation between longitudinal RV global peak systolic strain and LV ejection fraction was observed in Group C (y = −0.58x + 5, r = 0.90*, *p < 0.05). Conclusion: Speckle tracking strain imaging quantified longitudinal RV global systolic function and exhibited its BNP-related dependency to LV systolic function in patents with OMI.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11585-e11585
Author(s):  
Atalay Dogru ◽  
Devrim Cabuk ◽  
Tayfun Sahin ◽  
Ilhan Dolasik ◽  
Kazim Uygun

e11585 Background: Anthracyclines have been widely used in the treatment of solid and hematologic malignancies. Cardiotoxicity is the most serious adverse effect that limits anthracycline treatment. Cardiotoxicity is classified by time of onset as acute, subacute and chronic. Conventional echocardiography is not sensitive enough for early detection of cardiotoxicity. In this study we aimed to evaluate anthracycline induced cardiac toxicity by speckle tracking echocardiography (STE) before left ventricular dysfunction occurs. Methods: The study included newly diagnosed breast cancer (BC) and lymphoma patients (pts) who were treated with an anthracycline containing chemotherapy (CT) regimen. They had examination with conventional echocardiyography, STE before and after anthracycline treatment. Longitudinal strain values were assessed by automated function image (AFI). Results: Thirty five pts with BC and 15 pts with lymphoma were included in the study. Ejection fraction (EF) and fractional shortening values were decreased in lymphoma pts receiving high dose anthracycline treatment (346 mg/m2) compared to BC pts receiving low dose (168 mg/m2) anthracycline. There was statistically significant increase in myocardial performance index in both groups after anthracycline CT (p=0.001 and p=0.004 for BC and lymphoma group respectively). In STE measurements, apical long axis, apikal 4 chamber and global peak systolic strain showed significant reduction in lymphoma group who had a post-therapy EF <55% (p=0.002, p=0.041, and p=0.004, respectively). Apical long axis and global peak systolic strain were also significantly decreased among the lymphoma pts with normal systolic function after CT (p=0.01 and p=0.05, respectively). Conclusions: STE can display the effect of anthracycline induced cardiotoxicity early before left ventricular dysfunction occurs. Larger prospective studies are needed to verify these data and direct the treatment of pts receiving anthracycline.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Hideaki Kanzaki ◽  
Makoto Amaki ◽  
Takuya Hasegawa ◽  
Takahiro Ohara ◽  
Kazuhiko Hashimura ◽  
...  

Background. Myocardial strain is an index of regional function, whereas global left ventricular (LV) systolic function is generally assessed with ejection fraction (EF). Recent development of speckle tracking analysis software allows angle-independent and less time-consuming measurement of whole LV strain. Our objective was to assess whether the method is useful as another index of global LV systolic function. Methods. In 54 patients (LVEF 36±19%, 7–72%), digital gray-scales cine-loops were acquired from the apical 4-, 2-chamber, and long-axis views (GE Vivid7). After defining a region of interest (ROI) by tracing the LV endocardial border with several points at each view, a bull’s eye map was automatically constructed based on longitudinal strain and an averaged value of systolic peak strain was easily determined (EchoPAC Dimension AFI, GE). The strain value multiplied by −1 was used as global strain. Nineteen of the 54 patients underwent dobutamine stress and global strain value was calculated at baseline and during administration of 10 μg/kg/min. Results. Figure at left shows a bull’s eye strain map in a case of anterior myocardial infarction with regional dyskinetic wall motion. The blue area indicates the dyskinetic region. Despite of low dose, dobutamine increased global strain value (from 15.3 ± 5.3 to 17.1 ± 6.0, P <0.001) as well as LVEF. Figure at right shows global strain value was well correlated with LVEF ( r =0.917, P <0.001). Conclusion. Global strain is a new index which reflects the location, severity and extent of myocardial damage in addition to global LV systolic function.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T F Cianciulli ◽  
M C Saccheri ◽  
A M Risolo ◽  
J A Lax ◽  
R J Mendez ◽  
...  

Abstract Background Fabry disease is a rare X-linked storage disorder caused by a deficiency of the lysosomal enzyme α-galactosidase A and generally causes multi-organ dysfunction. Heart disease is the main cause of death, due to severe left ventricular (LV) systolic dysfunction and sudden death. In several heart diseases, the LV systolic dysfunction and ventricular arrhythmias are associated with mechanical dispersion (MD). The presence of MD in patients with FD has not been studied yet. In this cross-sectional study, we investigated the prevalence of MD in patients with FD. Methods Complete echocardiographic and speckle tracking echocardiographic (STE) data were collected. MD is an index of inter-segmental discoordination of contraction which has been used to quantify LV dyssynchrony and was defined as the standard deviation (SD) of time to peak negative strain in 17 left ventricular segments. Patients were divided into two groups according to whether or not they had left ventricular hypertrophy (LVH). MD was defined as an SD >49 msec. Results We studied 108 patients with FD, 24 patients (22%) were excluded due to inadequate imaging quality or presence of comorbidities, so the final study population consisted of 84 patients (mean age 33.3±14.6 years, 60.7% women). LVH in FD appears at older ages than in patients without LVH (48±12.5 y/o vs 27.8±11.1 y/o, p<0.0001). Patients with FD without LVH (Group I) showed normal global longitudinal peak strain (GLPS) (21.2±2.5%) and no MD (32.7±8.8 msec). In Group II (n=23) patients with FD with LVH, 17 (73.9%) had MD >49 msec prolonged mechanical dispersion (73.3±20.7 msec) and reduced GLPS (13.6±4.0%). MD was more pronounced in Fabry patients with LVH than in patients without LVH (63.4±24.7 msec vs. 32.7±8.8 msec, p<0.0001). GLPS was lower in Fabry patients with LVH than in patients without LVH (15.3±4.7% vs 21.2±2.5%, p<0.0001). Figure 1 Conclusions To our knowledge, this is the first study to demonstrate the prevalence of mechanical dispersion in patients with FD. Mechanical dispersion was seen in 73.9% of patients with FD with LVH. This dyssynchrony should be taken into account in patients who develop heart failure or life-threatening ventricular tachyarrhythmias.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
I Rodriguez Sanchez ◽  
A Anton ◽  
J J Onaindia ◽  
S Velasco ◽  
J Florido ◽  
...  

Abstract Objectives to evaluate the relationship between left atrial (LA) peak strain and left ventricular (LV) diastolic function and determine whether LA strain could be used to detect elevated filling pressures in a population of patients with preserved LV ejection fraction (LVpEF). Background the assessment of diastolic function is complex and multiparameter. 2016 ASE and EACVI algorithm has simplified this approach, but there are still patients with discrepant values leading to an indeterminate diagnosis, specially in patients with preserved ejection fraction. Methods we prospectively included 129 patients in our cohort. Inclusion criteria were LVEF &gt; 50% and sinus rhythm. Patients with atrial fibrillation, significant mitral valvulopathy or poor quality imaging were excluded. Two-dimensional speckle tracking was used to measure peak LA strain in all LA segments (using apical 4 chamber, 2 chamber and 3 chamber views). We evaluated the association of LA global peak strain and LA 4 chamber peak strain with the different categories of diastolic function according to the 2016 ASE and EACVI algorithm. Results Both LA global peak strain and 4 chamber LA peak strain showed a progressive decrease with worsening diastolic dysfunction (DD) severity (Table 1). A global LA peak strain cutoff value of 28,35% was very accurate to differentiate normal from elevated filling pressures (normal function or grade 1 DD from grades 2 and 3 DD). Diagnostic accuracy: 80.20%; area under the curve: 0,80 (0,72-0,88); A significant group of patients (21,1%) could not be categorized using 2016 algorithm. Conclusions Both LA global peak strain and 4 chamber LA peak strain demonstrated a progressive decrease with worsening DD severity. Global LA peak strain value of 28,35% was an accurate cutoff to differenciate patients with normal vs elevated filling pressures. LA strain values and diastolic function Total LA global peak STRAIN LA 4C STRAIN N (%) p-value p-value Total 129 30.90 %(11.77) 30.43 (12.36) Diastole &lt;0.0001 &lt;0.0001 Normal function 36 (28.13) 39.72% (9.59) 39.98 (10.59) Indeterminate Diastolic Function 23 (17.97) 31.07% (7.97) 30.19 (7.50) Indeterminate DD 4 (3.13) 30.68 % (6.72) 29.75 (7.31) grade 1 DD 22 (17.19) 32.69 % (12.54) 32.98 (14.46) grade 2 DD 36 (28.13) 23.90 % (9.32) 23.53 (9.49) grade 3 DD 7 (5.47) 15.43 % (5.72) 15.85 (7.32)


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