Abstract 5817.5: Assessment of Global Left Ventricular Function and Volumes with 320-Slice MSCT: A Comparison with 2D Echocardiography

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Fleur R de Graaf ◽  
Joanne D Schuijf ◽  
Jacob M van Werkhoven ◽  
J Wouter Jukema ◽  
Gaetano Nucifora ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Function Analysis ◽  
Imaging Modality ◽  
Linear Regression Analysis ◽  
Left Ventricular ◽  
Lv Function ◽  
Intravenous Contrast ◽  
2D Echocardiography ◽  
Artery Disease

Background. Multi-slice computed tomography (MSCT) has been demonstrated as a feasible imaging modality for non-invasive assessment of coronary artery disease and left ventricular (LV) function analysis. Recently, 320-slice systems have become available with 16 cm anatomical coverage allowing prospective image acquisition of the entire heart within a single rotation or heart beat. However, limited data are currently available with these systems. The purpose of the present study therefore was to evaluate the accuracy of 320-slice MSCT in the assessment of global LV function as compared to 2-dimensional (2D) echocardiography. Methods. A head-to-head comparison between 320-slice MSCT and 2D echocardiography was performed in 40 patients (24 male; mean age 61 ± 9 years) with known or suspected coronary artery disease (CAD). During intravenous contrast agent administration, the entire heart was imaged in a single heartbeat, using prospective dose modulation (full dose during 65–85% of R-R interval). The following parameters were used: gantry rotation time 350 ms, tube voltage 120 kV, tube current 300–500mA. LV end-diastolic volumes (LVEDV) and LV end-systolic volumes (LVESV) were determined and the LV ejection fraction (LVEF) was derived. Two-dimensional echocardiography served as the gold standard. Results. Average LVEF was 59% ± 8% (range 31%–77%) as determined on 2D-echocardiography, compared with 61% ± 8% (range 33%–78%) on MSCT. Evaluation of LVEF by linear regression analysis showed a good correlation between MSCT and 2D-echocardiography (r = 0.84; p < 0.001). A close correlation between MSCT and 2D-echocardiography was also demonstrated for the assessment of LVEDV (r = 0.81; p < 0.001) and LVESV (r = 0.89; p < 0.001). At Bland-Altman analysis, mean differences (± SD) of 20.88 ml ± 23.07 ml (p < 0.01) and 6.83 ml ± 13.01 ml (p < 0.01) were observed between MSCT and 2D-echocardiography for LVEDV and LVESV respectively. As a result, LVEF was slightly overestimated with MSCT (1.98% ± 4.54%; p < 0.01). Conclusion. Accurate assessment of LV function and volumes is feasible with 320-slice MSCT in patients with known or suspected CAD.

scholarly journals Three-dimensional speckle tracking echocardiography in evaluating left ventricular function in patients with triple vessel coronary artery disease

2021 ◽  
Author(s):  
Xiuxiu Cui ◽  
Huaying Bo ◽  
Yu Dong ◽  
Ying Wang ◽  
wenxing chang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Lv Function ◽  
Vessel Coronary Artery Disease ◽  
Stenosis Rate ◽  
Artery Disease ◽  
Vessel Coronary Artery

AIM Using three-dimensional ultrasound speckle tracking echocardiography (3D-STE) to evaluate left ventricular (LV) function in patients with triple vessel coronary artery disease(TVD) without myocardial infarction. METHODS Sixty patients with TVD without myocardial infarction were divided into two groups according to the results of coronary angiography. Group B (n=31)：50%≤the stenosis rate of all triple vessel coronary artery＜75%; Group C (n=29)：the stenosis rate of all triple vessel coronary artery≥75%. Thirty healthy subjects were recruited as the group A. We measured LV end-diastolic and end-systolic volume (LVEDV, LVESV) and LV ejection fraction (LVEF) using real-time dynamic three-dimensional echocardiography. The 3D-STE parameters of LV included global longitudinal strain (GLS), global area strain (GAS), global radial strain (GRS) and global circumferential strain (GCS). The correlation between 3D-STE parameters and NT-proBNP were analyzed by Pearson linear correlation analysis. RESULTS In group C, LVEDV and LVESV were significantly increased (all P＜0.05), while LVEF, GLS, GRS, GCS and GAS were significantly decreased compared with groups A and B (all P＜0.05). In groups A and B, there were no statistical differences in LVEDV, LVESV and LVEF. However, GLS, GCS and GAS were lower in group B than in group A (all P＜0.05). The correlation analysis showed a negative correlation between the absolute values of GLS, GRS, GCS, GAS and NT-proBNP in group C (r=-0.866、-0.587、-0.428、-0.600，P＜0.001、P=0.001、P=0.020、P=0.010). CONCLUSIONS Our study shows that 3D-STE can evaluate the LV function in patients with triple vessel coronary artery disease without myocardial infarction through multiple strain parameters.

scholarly journals Correlation of B-Type Natriuretic Peptide Level with Severity of Coronary Artery Disease in Non St Elevated Acute Coronary Syndrome with Normal Left Ventricular Function

2017 ◽  
Vol 12 (1) ◽  
pp. 17-22
Author(s):  
Sohel Mahmud ◽  
AKM Fazlur Rahman ◽  
SM Ahsan Habib ◽  
Chaudhury Meshkat Ahmed ◽  
SM Mustafa Zaman ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Ventricular ◽  
Lv Function ◽  
Syntax Score ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Normal Left Ventricular ◽  
Artery Disease ◽  
The Relationship

Background: Coronary artery disease (CAD) is predicted to be the most common cause of death and disability globally by 2020. In Bangladesh, for better management of coronary artery disease and to reduce the burden of acute coronary events patients with non ST elevated acute coronary syndrome (NSTE–ACS) should be focused. B-type natriuretic peptide (BNP) can be suggested as a tool to predict severity of coronary atherosclerotic lesion even with normal left ventricular (LV) function and thus to categorize the patients for appropriate referral and invasive evaluation.Aims: This study is designed to assess the relationship between level of BNP and severity of coronary artery disease assessed with SYNTAX score in NSTE-ACS patients with normal LV function. Methods: This cross sectional observational study was conducted at UCC, BSMMU during the period of May 2014 to April 2015 among the patients with non ST elevated myocardial infarction (NSTEMI) and unstable angina. 116 patients were enrolled by non-random purposive sampling who was admitted for coronary angiogram. All the data were recorded in structured questionnaire including details of medical history, coronary risk factors and physical findings. In NSTE-ACS patients with normal LV function venous blood samples were collected for BNP and later SYNTAX scoring was assessed during coronary angiogram. The relationship between level of BNP and SYNTAX score in patients with both UA and NSTE-MI was assessed statistically to evaluate the validity of BNP as a tool to predict severity of coronary atherosclerotic lesions among the patients with NSTE-ACS.Results: The mean age was 57.84±8.82 years. Among the 116 patients, highest frequency of patients was in the age group 51-60 years 55(47.4%) .In which 88(75.9%) were male. Male:Female ratio is 3.1:1.The percentage of risk factors was higher in NSTEMI group and difference with UA was statistically significant (p <0.05). Serum BNP in UA 64.9±13.07 and in NSTEMI 107.2±11.53. The mean difference of serum BNP between two groups is statistically significant. In UA group the SYNTAX score was found 13.2±11.1 and in NSTEMI 19.9±13.5 which is statistically significant. In UA group maximum patients were found two vessel disease and in NSTEMI maximum patients in three vessel disease. 70.0% of patients of three vessel disease had e” 80pg/ml of BNP. The association is statistically significant (p< 0.05). Higher the level of BNP reflect higher the vessel involvement and SYNTAX score irrespective of UA and NSTEMI.Conclusion: Our study reveals BNP is a candidate for entry into the setting of principal risk scores. Our findings indicate that the level of BNP may reflect the severity of ischemic insult even when irreversible injury and systolic dysfunction have not occurred.University Heart Journal Vol. 12, No. 1, January 2016; 17-22

scholarly journals PET Stress Testing with Coronary Flow Capacity in the Evaluation of Patients with Coronary Artery Disease and Left Ventricular Dysfunction: Rethinking the Current Paradigm

2021 ◽  
Vol 23 (4) ◽  
Author(s):  
Robert M. Bober ◽  
Richard V. Milani ◽  
Selim R. Krim ◽  
Daniel P. Morin
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Flow ◽  
Stress Testing ◽  
Left Ventricular ◽  
Regional Perfusion ◽  
Lv Function ◽  
Flow Capacity ◽  
Lv Dysfunction ◽  
Artery Disease

Abstract Purpose of Review Cardiomyopathy with underlying left ventricular (LV) dysfunction is a heterogenous group of disorders that may be present with, and/or secondary to, coronary artery disease (CAD). The purpose of this review is to demonstrate, via case illustrations, the benefits offered by cardiac positron-emission tomography (PET) stress testing with coronary flow capacity (CFC) in the evaluation and treatment of patients with left ventricular (LV) dysfunction and CAD. Recent Findings CFC, a metric that is increasing in prominence, represents the integration of several absolute perfusion metrics into clinical strata of CAD severity. Our prior work has demonstrated improvement in regional perfusion metrics as a result of revascularization to territories with severe reduction in CFC. Conversely, when CFC is adequate, there is no change in regional perfusion metrics following revascularization, despite angiographically severe stenosis. Furthermore, Gould et al. demonstrated decreased rates of myocardial infarction and death following revascularization of myocardium with severely reduced CFC, with no clinical benefit observed following revascularization of patients with preserved CFC. In a series of cases, we present pre-revascularization and post-revascularization PET scans with perfusion metrics in patients with LV dysfunction and CAD. In these examples, we demonstrate improvement in LV function and perfusion metrics following revascularization only in cases where baseline CFC is severely reduced. Summary PET with CFC offers unique guidance regarding revascularization in patients with reduced LV function and CAD.

scholarly journals Three-dimensional speckle tracking echocardiography in evaluating left ventricular function in patients with triple vessel coronary artery disease without myocardial infarction

2021 ◽  
Author(s):  
Xiuxiu Cui ◽  
Huaying Bo ◽  
Yu Dong ◽  
Ying Wang ◽  
ying li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Lv Function ◽  
Vessel Coronary Artery Disease ◽  
Artery Disease ◽  
Group B ◽  
Vessel Coronary Artery

Purpose Using three-dimensional speckle tracking echocardiography (3D-STE) to evaluate left ventricular (LV) function in patients with triple vessel coronary artery disease(TVD) without myocardial infarction. Methods Sixty patients with TVD without myocardial infarction were divided into two groups according to the results of coronary angiography. Group B (n=31)：50%≤the stenosis rates of all triple vessel coronary artery＜75%; Group C (n=29)：the stenosis rates of all triple vessel coronary artery≥75%. Thirty healthy subjects were recruited as the group A. We measured LV end-diastolic and end-systolic volume (LVEDV, LVESV) and LV ejection fraction (LVEF) using real-time three-dimensional echocardiography. The 3D-STE parameters of LV included global longitudinal strain (GLS), global area strain (GAS), global radial strain (GRS) and global circumferential strain (GCS). Results In group C, LVEDV and LVESV were significantly increased (all P＜0.05), while LVEF, GLS, GRS, GCS and GAS were significantly decreased compared with groups A and B (all P＜0.05). In groups A and B, there were no statistical differences in LVEDV, LVESV and LVEF. However, GLS, GCS and GAS were lower in group B than in group A (all P＜0.05). Conclusion Our study shows that 3D-STE can evaluate the LV function in patients with triple vessel coronary artery disease without myocardial infarction through multiple strain parameters.

scholarly journals Left ventricular myocardial performance index in prediabetic patients without coronary artery disease

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Hossam Eldin M. Mahmoud ◽  
Mohamed Alsenbesy ◽  
Gehad Osama Fawzy Sayed ◽  
Abdulla Eliaw Mohamed Ali ◽  
Ahlam M. Sabra
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Performance Index ◽  
Left Ventricular ◽  
Myocardial Performance Index ◽  
Control Group ◽  
Lv Function ◽  
Myocardial Performance ◽  
Artery Disease ◽  
Ventricular Ejection Time

Abstract Background Prediabetes is considered a major risk factor for diabetes mellitus (DM), leading to microvascular and cardiovascular disorders. Myocardial performance index (MPI) is a non-invasive Doppler method for the determination of global ventricular activity. We have not enough knowledge about the effect of prediabetes on the left ventricular (LV) function. We aimed to assess the MPI in prediabetic patients without coronary artery disease (CAD) utilizing echocardiography tissue Doppler imaging (TDI). Results We conducted a randomized controlled study that included fifty prediabetic patients and fifty healthy participants as the control group. All the participants were subjected to laboratory tests and echocardiography TDI to evaluate the LV systolic and diastolic functions We found that the isovolumic relaxation time (IVRT) and MPI values were significantly increased in the prediabetic patients compared to the control group (P < 0.001). In contrast, left ventricular ejection time (ET) was significantly longer in the control group than in prediabetic patients. Conclusion Prediabetes may adversely affect the LV function as assessed by MPI. Screening for prediabetes and early intervention is required for the prevention of cardiovascular morbidity and mortality.

P815Tako-Tsubo Cardiomyopathy: clinical correlations of typical and atypical left ventricular contraction patterns

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Gaede ◽  
A Herchenbach ◽  
M Troebs ◽  
M Marwan ◽  
S Achenbach
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Clinical Presentation ◽  
Left Ventricular ◽  
Hospital Death ◽  
Lv Function ◽  
Ventricular Contraction ◽  
Coronary Syndrome ◽  
Different Types ◽  
Artery Disease

Abstract Background Takotsubo cardiomyopathy (TCM) is diagnosed in 1–2% of all patients presenting with acute coronary syndrome (ACS). Clinical differences in individuals presenting with either the typical (apical) or atypical (midventricular, basal and focal) localization of left ventricular contraction abnormalities are not well understood. Methods We retrospectively analyzed 102 consecutive patients diagnosed with TCM based on clinical presentation, coronary angiography, and laevocardiography. Patients with different contraction abnormality patterns were compared regarding sex, clinical presentation, trigger for TCM, LV-function and LV enddiastolic pressure (LVEDP) as well as coronary artery disease. Results Of all TCM 102 patients, 69 (68%) presented with the typical pattern of apical contraction abnormality. 33 patients (32%) had an atypical pattern: 22 (22%) with the midventricular type, 2 (2%) with the basal type and 9 (9%) with a focal type. There was no difference in sex distribution among the different types of TCM (female: typical 86% vs atypical 85% p=0.83). Presentation as a ST-elevation ACS was more common in patients with atypical compared to typical TCM (21% vs. 17%; p=0.85), but without statistical significance. Cardiogenic shock (typical 6% vs atypical 3%; p=0.91) as well as intra-hospital death (typical 3% vs atypical 3%; p=0.56) were rare in both types. A trigger was not more common in patients with typical TCM (58% vs atypical 55%; p=0.91). The trigger was more often physical in typical (73%) and atypical TCM (78%) than psychological, but the distribution did not differ between the two types (p=0.92). 83.6% of the patients showed an impaired LV-EF. Median LV-EF in patients with typical TCM (35% (IQR 25–40)) tended to be lower than in patients with atypical TCM (40% (IQR 25–40); p=0.63; LV-EF ≤30% typical TCM 45% vs. atypical TCM 39%; p=0.75). In 72% (73/102) of the patients the LVEDP was determined. In 75% (55/73) the LVEDP was elevated (>15mmHg). LVEDP tended to be more often elevated in patients with typical TCM (83% vs. atypical 52%; p=0.11). Extent of coronary artery disease did not differ in the different types of TCM. Coronary stenosis >50% was rare (typical TCM 20% vs atypical TCM 9%; p=0.26), whereas exclusion of coronary artery disease was common in both types (typical TCM 71%; atypical TCM 76%; p=0.79). Conclusion While an apical contraction anomaly is the most common type of presentation in TCM, atypical contraction patterns are found in 32% of the patients. Overall, psychological triggers are not found as frequently in TCM as previously described. Patients with typical and atypical TCM do not differ in clinical presentation, LV-EF, LVEDP and extent of coronary artery disease.

scholarly journals P1777 Circulating microRNAs are associated with myocardial damage in patients with coronary artery disease: implications for a role of microRNA in myocardial matrix remodeling

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
L Gheorghiu ◽  
A Ciobanu ◽  
R Macarie ◽  
M Vadana ◽  
L Ciortan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Arterial Stiffness ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Lv Function ◽  
Arterial Function ◽  
Diagnosis And Prognosis ◽  
Artery Disease ◽  
Stable Cad

Abstract Background Recent studies have reported that circulating microRNA (miR) can target different metalloproteases involved in matrix remodelling and plaque vulnerability. Consequently, they might have a role in the diagnosis and prognosis of cardiovascular diseases. Aim. To quantify circulating miRs (miR126, miR146) which are suggested to have possible cardiovascular implications, as well as levels of MMP-1 and MMP-9, and to determine their association with left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), and arterial function, in patients with stable and unstable coronary artery disease (CAD). Methods 90 patients with CAD (61% men, 58+/-12 years), including 60 patients with ST elevation acute myocardial infarction (STEMI) and 30 patients with stable CAD were assessed within 24 hours of admission by serum microRNA quantification (TaqMan PCR analysis), and serum MMP-1 and MMP-9 analysis (ELISA kits). 2D and 3D echocardiography were used to assess LVEF; speckle tracking was used to asses GLS; echo tracking, CAVI, and peripheral Doppler were used to assess arterial function (Young"s elastic modulus - EP and β index, arterial stiffness, and ABI). Results Circulating levels of miR146, miR126, MMP1, and MMP9 were significantly increased in patients with STEMI vs. stable CAD (95% CI 1.92-8.43, p = 0.002). miR126 correlated with LVEF (r=-.41, p = 0.03) and arterial stiffness (r=.44, and r=.42, p = 0.02 for L-CAVI and R-CAVI respectively) in patients with STEMI, and with arterial stiffness (r=-.72, p = 0.04, r=-.72, p = 0.01 for L-CAVI and R-CAVI respectively) and ABI (r=-.62, p = 0.04, r=-.62, p = 0.03 for L-ABI and R-ABI respectively) in patients with stable CAD. miR146 did not have any significant correlations. Both MMP-1 and MMP-9 correlated with LV function, LVEF ( r=-.27, p = 0.04, r=-.40, p = 0.01) and GLS (r=-.27, p = 0.03, r=-.26, p = 0.04) in patients with STEMI, and with arterial stiffness (r=.40, p = 0.03, for L-CAVI and r = 0.42, p = 0.02 for R-CAVI) in patients with stable CAD. Conclusion miR126 and both MMP1 and MMP9 are potential biomarkers of LV function in STEMI patients. Meanwhile, they correlate with arterial function in patients with stable CAD. However, further studies are needed to establish whether these new biomarkers have diagnosis and prognosis significance. Abstract P1777 Figure.

Homocysteine, left ventricular dysfunction and coronary artery disease: is there a link?

2007 ◽  
Vol 45 (12) ◽  
Author(s):  
Gian Paolo Rossi ◽  
Teresa Maria Seccia ◽  
Achille Cesare Pessina
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Systolic Function ◽  
Left Ventricular ◽  
Lv Function ◽  
Atherosclerotic Burden ◽  
Mechanistic Investigation ◽  
Artery Disease ◽  
Genetic And Environmental Factors ◽  
Lv Systolic Function

AbstractExperimental and observational studies support a role of plasma homocysteine levels (tHcy) in coronary artery disease (CAD). In the GENICA (Genetic and Environmental factors In Coronary Atherosclerosis) study, we found that high tHcy predicted cardiovascular mortality in hypertensive, but not in normotensive, patients independently of CAD and history of myocardial infarction. Moreover, despite not being associated with the coronary atherosclerotic burden, tHcy was inversely associated with left ventricular (LV) ejection fraction. This inverse relationship between LV systolic function and tHcy, which has been independently confirmed, might explain the association of tHcy with the risk of incident heart failure documented in the Framingham Heart Study. Thus, additional mechanistic investigation taking into consideration the effects of tHcy on LV function is necessary to further explore the potential therapeutic usefulness of tHcy lowering treatment in CAD.Clin Chem Lab Med 2007;45:1645–51.

scholarly journals Myocardial Work by Speckle Tracking Echocardiography Accurately Assesses Left Ventricular Function of Coronary Artery Disease Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Huolan Zhu ◽  
Ying Guo ◽  
Xiang Wang ◽  
Chenguang Yang ◽  
Yi Li ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Additional Information ◽  
Artery Disease ◽  
Normal Lvef

Objective: Myocardial work (MW) is a novel non-invasive method that uses speckle tracking echocardiography (STE) to assess left ventricular (LV) function. MW incorporates the global longitudinal strain and afterload conditions. Here we aimed to use MW to assess the LV function of patients with coronary artery disease (CAD) with or without heart failure (HF).Methods: We enrolled a total of 150 individuals (50 each) with CAD and a normal LV ejection fraction (LVEF), CAD with HF, and healthy controls. Patients were divided into the hypertension (HTN) and normal blood pressure (no HTN) subgroups. MW was determined from the pressure-strain loop using STE. The relationships between MW indices and conventional echocardiographic parameters were evaluated, and the MW indices were compared among groups.Results: Univariate and multivariate analyses showed that MW indices were strongly correlated with LVEF. The global work index (GWI) was increased in the CAD with normal LVEF subgroup with HTN vs. controls (1,922.3 ± 393.1 vs. 1,639.7 ± 204.6 mmHg%, p &lt; 0.05) and decreased in CAD patients with HF (no HTN: 940.9 ± 380.6 vs. 1,639.7 ± 204.6 mmHg%, p &lt; 0.05; HTN: 857.3 ± 369.3 vs. 1,639.7 ± 204.6 mmHg%, p &lt; 0.05). Global waste work was increased in all CAD subgroups vs. controls. Global constructive work had the same tendency as GWI in patients with CAD. Global MW efficiency was decreased in all patients with CAD.Conclusion: MW using STE accurately quantifies LV function in patients with CAD. It offers additional information about LV function with respect to disease progression, particularly in CAD patients with a normal LVEF.

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