Abstract 4239: Speckle Tracking Imaging Detects Sub-Clinical Myocardial Dysfunction in Asymptomatic Patients with Type 2 Diabetes Mellitus

Diabetic cardiomyopathy, a major complication of diabetes mellitus (DM), is preceded by a silent phase of progressive left ventricular (LV) remodeling. Our aim was to evaluate whether speckle tracking imaging (STI) was able to detect early, sub-clinical myocardial dysfunction in a population of asymptomatic type II DM patients with no signs or history of heart disease and a normal conventional echo . 114 patients with type II DM (52 ± 4 years, 45 females, HbA1c 7.7 ± 1.4%) and 88 age-matched healthy volunteers (HV) without any cardiovascular risk factor (52 ± 3 years, 58 females) underwent a conventional and STI echocardiography (Vivid 7, GE). Mean longitudinal strain (S L ) was assessed from the basal, mid and apical segments of the myocardial walls in apical 2- and 4-chamber views. Mean radial strain (S R ) was calculated from the short-axis view at the midventricular level. Univariate and multivariate regression analyses were used to identify the parameters contributing to the difference in S L and S R between the 2 groups. Variables used for analysis were as follows: DM, gender, BMI, systolic (sBP) and diastolic blood pressure (dBP), heart rate, IVSd and PWd thickeness, LV end-diastolic (LVEDD) and end-systolic diameters (LVESD). Clinical, conventional echo and STI parameters in the 2 groups are summurized in the table . On univariate analysis, factors associated with a significant lower strain in type II DM patients were: DM, male gender, BMI, sBP and dBP for S L and DM, sex and LVESD for S R (p<0.05 for all). On multiple regression analysis, the only factors accociated with a significant decrease in strain in the DM group were DM (p = 0.005) and male gender (p = 0.008) for S L and DM (p = 0.01) for S R . STI is able to early detect subclinical myocardial dysfunction in a population with Type II DM. This decrease in S L and S R might be considered as a preclinical marker of diabetic cardiomyopathy.

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Atrial and Ventricular Structural and Functional Alterations in Obese Children

Medicina ◽

10.3390/medicina57060562 ◽

2021 ◽

Vol 57 (6) ◽

pp. 562

Author(s):

Rima Šileikienė ◽

Karolina Adamonytė ◽

Aristida Ziutelienė ◽

Eglė Ramanauskienė ◽

Jolanta Justina Vaškelytė

Keyword(s):

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Myocardial Dysfunction ◽

Global Longitudinal Strain ◽

Radial Strain ◽

Left Ventricular ◽

Z Score ◽

Obese Children ◽

2D Speckle Tracking

Background and objectives: Childhood obesity has reached epidemic levels in the world. Obesity in children is defined as a body mass index (BMI) equal to or above the 95th percentile for age and sex. The aim of this study was to determine early changes in cardiac structure and function in obese children by comparing them with their nonobese peers, using echocardiography methods. Materials and methods: The study enrolled 35 obese and 37 age-matched nonobese children. Standardized 2-dimensional (2D), pulsed wave tissue Doppler, and 2D speckle tracking echocardiography were performed. The z-score BMI and lipid metabolism were assessed in all children. Results: Obese children (aged 13.51 ± 2.15 years; 20 boys; BMI z-score of 0.88 ± 0.63) were characterized by enlarged ventricular and atrial volumes, a thicker left ventricular posterior wall, and increased left ventricular mass. Decreased LV and RV systolic and diastolic function was found in obese children. Atrial peak negative (contraction) strain (−2.05% ± 2.17% vs. −4.87% ± 2.97%, p < 0.001), LV and RV global longitudinal strain (−13.3% ± 2.88% vs. −16.87% ± 3.39%; −12.51% ± 10.09% vs. −21.51% ± 7.42%, p < 0.001), and LV global circumferential strain (−17.0 ± 2.7% vs. −19.5 ± 2.9%, p < 0.001) were reduced in obese children. LV torsion (17.94° ± 2.07° vs. 12.45° ± 3.94°, p < 0.001) and normalized torsion (2.49 ± 0.4°/cm vs. 1.86 ± 0.61°/cm, p = 0.001) were greater in obese than nonobese children. A significant inverse correlation was found between LV and RV global longitudinal strain and BMI (r = −0.526, p < 0.01; r = −0.434, p < 0.01) and total cholesterol (r = −0.417, p < 0.01). Multivariate analysis revealed that the BMI z-score was independently related to LV and RV global longitudinal strain as well as LV circumferential and radial strain. Conclusion: 2D speckle tracking echocardiography is beneficial in the early detection of regional LV systolic and diastolic dysfunctions, with preserved ejection fraction as well as additional RV and atrial involvement, in obese children. Obesity may negatively influence atrial and ventricular function, as measured by 2D speckle tracking echocardiography. Obese children, though they are apparently healthy, may have subclinical myocardial dysfunction.

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Abstract 14632: Effect of Obesity on Myocardial Strain Determined by Speckle Tracking Imaging

Circulation ◽

10.1161/circ.132.suppl_3.14632 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Meihua Zhu ◽

Cole Streiff ◽

Tao He ◽

Muhammad Ashraf ◽

Jiahui Zhang ◽

...

Keyword(s):

Speckle Tracking ◽

Myocardial Dysfunction ◽

Global Longitudinal Strain ◽

Myocardial Strain ◽

Left Ventricular ◽

Control Group ◽

Speckle Tracking Imaging ◽

Initial Weight ◽

Newborn Mice ◽

2D Speckle Tracking

Introduction: Obesity may affect cardiac function, which is hard to detect by traditional echocardiography in the early stages. Speckle tracking imaging (STI) is sensitive to subtle myocardial dysfunction. The aim of this study was to determine the influence of obesity on left ventricular (LV) myocardial function in diet-induced obesity (DIO) mice using two-dimensional (2D) speckle tracking echocardiography (STE). Hypothesis: 2D STE is useful to detect obesity-caused myocardial dysfunction. Methods: Twenty newborn mice were divided into two groups: a DIO group (high-fat diet) and a control group (regular-fat diet). 2D image loops were acquired at the end of each month for 6 months. Global longitudinal strain (GLS) and global circumferential strain (GCS) were analyzed at feeding periods over 3 months and 6 months, and compared between the two groups. Results: The control group gained 64% of its initial weight, while the DIO group gained 82% of its initial weight at the 3 month feeding period; and the two groups gained 88% (control) and 125% (DIO) respectively at 6 months. STE analysis revealed an insignificant decrease in strain values in the DIO mice after 3 months; however, after 6 months, the DIO group demonstrated a significant decrease in strain values (P<0.05) despite normal ejection fractions in both groups. Conclusions: 2D STE is highly feasible to detect the myocardial dysfunction caused by obesity in earlier stage. These strain values appear to be related to the severity of obesity.

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Ultrasound speckle tracking imaging contributes to early diagnosis of impaired left ventricular systolic function in patients with type 2 diabetes mellitus

Journal of Huazhong University of Science and Technology [Medical Sciences] ◽

10.1007/s11596-008-0624-5 ◽

2008 ◽

Vol 28 (6) ◽

pp. 719-723 ◽

Cited By ~ 12

Author(s):

Hong Ma ◽

Mingxing Xie ◽

Jing Wang ◽

Qing Lü ◽

Xinfang Wang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Speckle Tracking ◽

Systolic Function ◽

Left Ventricular Systolic Function ◽

Left Ventricular ◽

Speckle Tracking Imaging ◽

Ventricular Systolic Function

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Abstract 2816: Assessment Of Left Ventricular Mechanical Dyssynchrony With Radial Strain By Speckle-tracking Best Predicts Response To Cardiac Resynchronization Therapy

Circulation ◽

10.1161/circ.116.suppl_16.ii_626-b ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Victoria Delgado ◽

Claudia Ypenburg ◽

Laurens F Tops ◽

Sjoerd A Mollema ◽

Nina Ajmone Marsan ◽

...

Keyword(s):

Speckle Tracking ◽

Longitudinal Strain ◽

Radial Strain ◽

Mechanical Dyssynchrony ◽

Left Ventricular ◽

Cardiac Resynchronization ◽

Speckle Tracking Imaging ◽

Resynchronization Therapy ◽

Left Ventricular Mechanical Dyssynchrony

Background: Recently, 2-dimensional strain by speckle tracking imaging has emerged as a new technology for assessment of myocardial deformation in three dimensions: radial, circumferential and longitudinal. The current study evaluates which type of deformation study can best identify left ventricular mechanical dyssynchrony (LVMD) and predicts response to cardiac resynchronization therapy (CRT). Methods: One-hundred fifty-two consecutive patients underwent echocardiographic study before implantation of the CRT device and at 6 months follow-up. Radial (RS) and circumferential (CS) strains were applied to midventricular short axis views; difference in time to peak systolic strain value between anteroseptal-to-posterior walls was used to study LVMD. Longitudinal strain (LS) was applied to apical 4-chamber views and LVMD was calculated as the difference between basal septum-to-basal lateral walls. Patients with a decrease of LV end-systolic volume ≥15% at 6 months follow-up were considered responders. Results: After 6 months of CRT, 85 pts (56%) showed response to CRT. Compared to non-responders, responders had significant more LVMD when it was assessed by RS (212±146 ms vs. 127±108 ms; p<0.001), whereas there were no differences with neither CS nor LS (Table ). With RS, the optimal cut-off value to predict response to CRT was identified at a time-difference value of ≥130 ms yielding a sensitivity of 83% and a specificity of 71%. Conclusions: Radial strain by speckle-tracking imaging is a useful tool to assess LVMD and best predicts echocardiographic response to CRT. Left Ventricular Mechanical Dyssynchrony assessed by radial, circumferential and longitudinal strain

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Myocardial Function Assessed by Multi-Layered Two-Dimensional Speckle Tracking Analysis in Asymptomatic Young Subjects with Diabetes Mellitus Type 1

Cardiology ◽

10.1159/000504532 ◽

2019 ◽

Vol 145 (2) ◽

pp. 80-87

Author(s):

Mihaela Berceanu ◽

Oana Mirea ◽

Ionut Donoiu ◽

Constantin Militaru ◽

Adrian Săftoiu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Young Adults ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Myocardial Dysfunction ◽

Diabetes Mellitus Type 1 ◽

Left Ventricular ◽

Diabetes Mellitus Type ◽

Mechanical Dispersion

Background: Diabetes mellitus type 1 (DM1) is associated with a high risk for cardiovascular disease, and early detection of myocardial dysfunction is crucial for the prevention of cardiac complications. Objectives: The aim of this study was to evaluate left ventricular (LV) and right ventricular (RV) function by using both conventional echocardiography as well as multi-layered speckle tracking echocardiography (STE) in young adults with DM1. Methods: We included 50 young asymptomatic adults diagnosed with DM1 (mean interval from diagnosis 9 ± 6 years) and 80 healthy controls. STE was acquired using the GE Vivid S60 equipment. The LV longitudinal strain (LS), layer-specific strains of the endocardium, myocardium, and epicardium (global longitudinal strain [GLS]endo, GLSmyo, GLSepi) as well as RV strain were obtained using the EchoPAC BT13 workstation. Results: No significant intergroup differences in LV ejection fraction were noted. GLSendo and GLSmyo were reduced in the DM1 group (–20.6 ± 2.7 vs. –22.0 ± 2.3 and –18.0 ± 2.4 vs. –19.1 ± 1.9, respectively, p < 0.05) compared to controls. Mechanical dispersion was higher in the diabetes group (34 ± 11 vs. 29 ± 7, p < 0.05). RV strain measurements showed no significant difference between the groups. Conclusions: Young adults with DM1 and without known heart disease have subclinical myocardial dysfunction with lower LV endocardium and myocardium LS and higher mechanical dispersion demonstrated by multi-layered STE.

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Diabetic heart: Metabolic reasons for the development of cardiomyopathy

Problems of Endocrinology ◽

10.14341/probl12056 ◽

1996 ◽

Vol 42 (6) ◽

pp. 20-26

Author(s):

E. I. Sokolov ◽

O. S. Zaichikova

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Coronary Arteries ◽

Diabetic Cardiomyopathy ◽

Myocardial Dysfunction ◽

Stroke Volume Index ◽

Left Ventricular ◽

Volume Index ◽

Dependent Diabetes Mellitus ◽

Patients With Diabetes

Cardiovascular disease is a common cause of death in patients with diabetes mellitus (DM). The likelihood of developing heart failure with this disease increases, even if you take into account the influence of factors such as age, blood pressure, plasma cholesterol, body weight and the condition of the coronary arteries. The term "diabetic cardiomyopathy" was proposed in 1972 by S. Rubier et al. They performed postmortem autopsy of patients with diabetes complicated by diabetic nephropathy and congestive heart failure without arterial hypertension and severe atherosclerosis of the coronary arteries. The hemodynamic parameters of a group of patients with diabetes without hypertension without significant atherosclerotic changes in the coronary arteries according to angiography were studied by T. Regan et al. In these patients, a decrease in stroke volume index and an increase in diastolic pressure in the left ventricle were detected. The observed changes, indicating a decrease in left ventricular myocardial extensibility, were interpreted as signs of subclinical cardiomyopathy. Based on the results of an echocardiographic examination of patients with insulin-dependent diabetes mellitus (IDDM) Ch. Dimitar proposed the following stages of development of diabetic cardiomyopathy: I - increased myocardial contractility; II - systolic and diastolic functions are not impaired; III - the beginning of the development of diastolic dysfunction, a decrease in the "compliance" of the left ventricular myocardium and dilatation of the left atrium; IV - progression of diastolic myocardial dysfunction (DDM) and the addition of systolic dysfunction.

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