Abstract 14937: Evaluation of Biventricular Functions in Patients With Covid-19 Using Speckle Tracking Echocardiography

Introduction: A new infectious outbreak sustained by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is now spreading all around the world. The aim of this study was to evaluate the prognostic value of left ventricular global longitudinal strain (LV-GLS) and right ventricular longitudinal strain (RV-LS) in patients with coronavirus disease 2019 (COVID-19). Hypothesis: As some studies have shown that COVID-19 could affect the cardiovascular system due to the capability of pathogenity of the virus, biventricular functions could be affected in the tissue level even though the routine evaluations of the heart functions seem normal. Methods: In this prospective, single-center study, data were gathered from patients treated for COVID-19, who had biventricular systolic function and no history of coronary artery disease. Two-dimensional echocardiography (2-DE) and speckle tracking echocardiography (STE) images were obtained for all patients. Patients were divided into three groups: those with severe COVID-19 infection, those with non-severe COVID-19 infection, and those without COVID-19 infection (the control group). Data regarding clinical characteristics and laboratory findings were obtained from electronic medical records. The primary endpoint was in-hospital mortality. Results: A total of 100 patients hospitalized for COVID-19 were included in this study. The mean age of the severe group (n = 44) was 59.1 ± 12.9, 40% of whom were male. The mean age of the non-severe group (n = 56) was 53.7 ± 15.1, 58% of whom were male. Of these patients, 22 died in the hospital. In patients in the severe group, LV-GLS and RV-LS were decreased compared to patients in the non-severe and control groups (LV-GLS: -14.5 ± 1.8 vs. -16.7 ± 1.3 vs. -19.4 ± 1.6, respectively [p < 0.001]; RV-LS: -17.2 ± 2.3 vs. -20.5 ± 3.2 vs. -27.3 ± 3.1, respectively [p < 0.001]). The presence of cardiac injury, D-dimer, arterial oxygen saturation (SaO2), LV-GLS (OR:1.63, 95% confidence interval [CI] 1.08-2.47; p = 0.010) and RV-LS (OR:1.55, 95% CI 1.07-2.25; p = 0.019) were identified as independent predictors of mortality via multivariate analysis. Conclusions: LV-GLS and RV-LS are independent predictors of in-hospital mortality in patients with COVID-19.

Download Full-text

Abnormal left ventricular global longitudinal strain by speckle tracking echocardiography in COVID-19 patients

Future Cardiology ◽

10.2217/fca-2020-0121 ◽

2020 ◽

Author(s):

Lori B Croft ◽

Parasuram Krishnamoorthy ◽

Richard Ro ◽

Malcolm Anastasius ◽

Wenli Zhao ◽

...

Keyword(s):

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Healthy Population ◽

Significant Difference ◽

The Mean ◽

Lv Ejection Fraction ◽

Prognostic Implications

COVID-19 infection can affect the cardiovascular system. We sought to determine if left ventricular global longitudinal strain (LVGLS) is affected by COVID-19 and if this has prognostic implications. Materials & methods: Retrospective study, with LVGLS was measured in 58 COVID-19 patients. Patients discharged were compared with those who died. Results: The mean LV ejection fraction (LVEF) and LVGLS for the cohort was 52.1 and -12.9 ± 4.0%, respectively. Among 30 patients with preserved LVEF(>50%), LVGLS was -15.7 ± 2.8%, which is lower than the reference mean LVGLS for a normal, healthy population. There was no significant difference in LVGLS or LVEF when comparing patients who survived to discharge or died. Conclusion: LVGLS was reduced in COVID-19 patients, although not significantly lower in those who died compared with survivors.

Download Full-text

Effect of Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors on Left Ventricular Remodelling and Longitudinal Strain: A Prospective Observational Study

10.21203/rs.3.rs-582026/v1 ◽

2021 ◽

Author(s):

Sergio Gamaza-Chulian ◽

Enrique Díaz-Retamino ◽

Fátima González-Testón ◽

José Carlos Gaitero ◽

María José Castillo ◽

...

Keyword(s):

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Control Group ◽

Ventricular Remodelling ◽

Left Ventricular Remodelling ◽

Sodium Glucose Cotransporter ◽

Clinical Benefits

Abstract Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) lower cardiovascular events in type 2 diabetes mellitus (T2DM) patients, although the mechanisms underlying these benefits are not clearly understood. Our aim was to study the effects of SGLT2i on left ventricular remodelling and longitudinal strain.Methods: Between November 2019 and April 2020, we included 52 patients with T2DM ≥18 years old, with HbA1c between 6.5% and 10.0%, and estimated glomerular filtration ≥45 ml/min/1.73 m2. Patients were classified into SGLT2i group and control group, according to prescribed treatment by their referring physician. Conventional and speckle tracking echocardiography were performed by blinded sonographers, at baseline and after 6 months of treatment.Results: Among the 52 included patients (44% females, mean age 66.8±8.6 years, mean HbA1c was 7.40±0.7%), 30 patients were prescribed SGLT2i and 22 patients were classified as control group. Mean change in indexed left ventricular mass (LVM) was -10.85±3.31 g/m2 (p=0.003) in the SGLT2i group, and +2.34±4.13 g/m2 (p=0.58) in the control group. Absolute value of Global Longitudinal Strain (GLS) increased by a mean of 1.29±0.47 (p=0.011) in the SGLT2i group, and 0.40±0.62 (p=0.34) in the control group. We did not find correlations between changes in LVM and GLS, and other variables like change in HbA1c.Conclusions: Among patients with T2DM, SGLT2i were associated with a significant reduction in indexed LVM and a significant increment in longitudinal strain measured by speckle tracking echocardiography, which may explain in part the clinical benefits found in clinical trials.

Download Full-text

Subclinical LV Dysfunction Detection Using Speckle Tracking Echocardiography in Hypertensive Patients with Preserved LV Ejection Fraction

Clinical Medicine Insights Cardiology ◽

10.4137/cmc.s38407 ◽

2016 ◽

Vol 10 ◽

pp. CMC.S38407 ◽

Cited By ~ 12

Author(s):

Amal Mohamed Ayoub ◽

Viola William Keddeas ◽

Yasmin Abdelrazek Ali ◽

Reham Atef El Okl

Keyword(s):

Ejection Fraction ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Systolic Function ◽

Systolic Dysfunction ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Control Group ◽

Hypertensive Patients

Background Early detection of subclinical left ventricular (LV) systolic dysfunction in hypertensive patients is important for the prevention of progression of hypertensive heart disease. Methods We studied 60 hypertensive patients (age ranged from 21 to 49 years, the duration of hypertension ranged from 1 to 18 years) and 30 healthy controls, all had preserved left ventricular ejection fraction (LVEF), detected by two-dimensional speckle tracking echocardiography (2D-STE). Results There was no significant difference between the two groups regarding ejection fraction (EF) by Simpson's method. Systolic velocity was significantly higher in the control group, and global longitudinal strain was significantly higher in the control group compared with the hypertensive group. In the hypertensive group, 23 of 60 patients had less negative global longitudinal strain than −19.1, defined as reduced systolic function, which is detected by 2D-STE (subclinical systolic dysfunction), when compared with 3 of 30 control subjects. Conclusion 2D-STE detected substantial impairment of LV systolic function in hypertensive patients with preserved LVEF, which identifies higher risk subgroups for earlier medical intervention.

Download Full-text

Early detection with speckle tracking echocardiography of biventricular systolic dysfunction, and its relationship with fatigue, in patients with multiple sclerosis

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.384 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

E Michelotto ◽

MC Oliva ◽

MT Amoruso ◽

G Giovannetti ◽

C Battista ◽

...

Keyword(s):

Multiple Sclerosis ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Systolic Dysfunction ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Control Group ◽

Lv Function ◽

Healthy Population ◽

The Mean

Abstract Funding Acknowledgements Type of funding sources: None. Background Fatigue is a frequent and debilitating symptom of multiple sclerosis (MS), affecting 90% of patients. Symptoms seems multifactorial, but little is known about the contribution of cardiovascular morpho-functional alterations linked to comorbidities, to lifestyle, to MS itself or to drugs (i.e. mitoxantrone). Aim to investigate the presence of cardiac alterations in MS patients, and to evaluate their impact on fatigue. Methods 24 patients with relapsing-remitting MS (RR-MS) underwent an electrocardiogram (ECG), a transthoracic echocardiographic (TTE), a six minutes walking test (6MWT) with Borg scale (BS), and two fatigue self-assessment scales, the Fatigue Severity Scale (FSS) and the Modified Fatigue Impact Scale (MFIS). The patients were divided into 2 groups: group 1, without traditional cardiovascular risk factors (CVRF: smoke, hypertension, diabetes, hypercholesterolemia; n = 12, 11 females), and group 2, with at least one CVRF (n = 12, 5 females). None of the patients had ever been on mitoxantrone therapy. No new control group was studied due to the SARS-CoV-2 pandemic restrictions , so the comparison was performed with general healthy population in internationally validated previous studies. Results No arrhythmias were found. In both MS groups all the TTE left ventricular (LV) systolic function parameters were depressed compared to the healthy population, but only the mean global longitudinal strain (GLS), the mean longitudinal strain rate (LSR) of LV and estimated pulmonary artery systolic pressure (PAPs) were statistically significant depressed compared to the healthy general population (p < 0.005): see table. This reduction was observed in both MS groups, while there were non significant differences among the two groups. TTE LV function depression significantly correlated to variation of parameters of fatigue , especially considering LV GLS in relation to BS values. Conclusions Subclinical biventricular systolic dysfunction is present in MS patients, and it seems to be linked to the disease itself without being influenced by CVRF. This dysfunction, detected by speckle tracking echocardiographic techniques, seems to contribute to the symptom of fatigue in patients with MS. It is important to include TTE in the workup and follow-up of MS patients, in order to promptly treat cardiac dysfunction and relieve fatigue. Echocardiography and LV strain MS total MS no CVRF MS + CVRF Healthy population LV GLS 17.7 ± 2.2* 18.0 ± 2.1* 17.4 ± 2.4* 22.6 ± 1.7 LV LSR 1.0 ± 0.1* 1.0 ± 0.1* 1.0 ± 0.2* 1.2 ± 0.1 PAPs 25.0 ± 2.6* 24.8 ± 2.9* 25.2 ± 2.5* 14.0 ± 6.0 * p < 0.05 vs healthy population

Download Full-text

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

10.21203/rs.3.rs-899277/v1 ◽

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.

Download Full-text

Cardiac Involvement in Patients Recovered From COVID-19 Identified Using Left Ventricular Longitudinal Strain

10.21203/rs.3.rs-470171/v1 ◽

2021 ◽

Author(s):

Luiz Darcy Cortez Caiado ◽

Nathalia Caiado de Azevedo ◽

Rafael R. C. Azevedo ◽

Brasil R. Caiado

Keyword(s):

Speckle Tracking ◽

Longitudinal Strain ◽

Cardiac Involvement ◽

Speckle Tracking Echocardiography ◽

Myocardial Dysfunction ◽

Left Ventricular ◽

Acute Stage ◽

Left Ventricular Ejection ◽

Control Group ◽

Myocardial Involvement

Abstract Coronavirus disease-19 (COVID-19) has been associated with subclinical myocardial dysfunction during its acute phase and a recurring pattern of reduced basal left ventricular longitudinal strain on speckle-tracking echocardiography (STE) in hospitalized patients. But a question still remains unanswered: speckle tracking echocardiography might also be suitable to detect residual myocardial involvement after acute stage of COVID-19? Methods and results: We studied 100 patients recovered from COVID-19 with STE to evaluate global (GLS) and segmentar longitudinal strain (LS) and compared with a control group of 100 healthy individuals. STE was performed at a median of 130.35 +/- 76.06 days after COVID-19 diagnostic. Demographic and echocardiographic parameters are similar in both groups. Left ventricular ejection faction (LVEF) and GLS were normal in COVID-19 patients (66.20 +/- 1.98% and -19.51 +/- 2.87%, respectively). A reduction in mean LS for the basal segments was found in COVID-19 (16.48 +/- 5.41%) when compared to control group (19.09 +/- 4.31%) (p<0.001). Conclusion: The present study suggests that COVID-19 induced cardiac involvement could persist after recovery of the disease and may be detected by deformation abnormalities using STE. COVID-19 induced myocardial involvement often shows specific LV deformation patterns due to pronounced edema and/or myocardial damage in basal LV segments.

Download Full-text

Effect of sodium-glucose cotransporter 2 (SGLT2) inhibitors on left ventricular remodelling and longitudinal strain: a prospective observational study

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02250-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sergio Gamaza-Chulián ◽

Enrique Díaz-Retamino ◽

Fátima González-Testón ◽

José Carlos Gaitero ◽

María José Castillo ◽

...

Keyword(s):

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Control Group ◽

Ventricular Remodelling ◽

Left Ventricular Remodelling ◽

Sodium Glucose Cotransporter ◽

Clinical Benefits

Abstract Background Sodium-glucose cotransporter 2 inhibitors (SGLT2i) lower cardiovascular events in type 2 diabetes mellitus (T2DM) patients, although the mechanisms underlying these benefits are not clearly understood. Our aim was to study the effects of SGLT2i on left ventricular remodelling and longitudinal strain. Methods Between November 2019 and April 2020, we included 52 patients with T2DM ≥ 18 years old, with HbA1c between 6.5 and 10.0%, and estimated glomerular filtration ≥ 45 ml/min/1.73 m2. Patients were classified into SGLT2i group and control group, according to prescribed treatment by their referring physician. Conventional and speckle tracking echocardiography were performed by blinded sonographers, at baseline and after 6 months of treatment. Results Among the 52 included patients (44% females, mean age 66.8 ± 8.6 years, mean HbA1c was 7.40 ± 0.7%), 30 patients were prescribed SGLT2i and 22 patients were classified as control group. Mean change in indexed left ventricular mass (LVM) was − 0.85 ± 3.31 g/m2 (p = 0.003) in the SGLT2i group, and + 2.34 ± 4.13 g/m2 (p = 0.58) in the control group. Absolute value of Global Longitudinal Strain (GLS) increased by a mean of 1.29 ± 0.47 (p = 0.011) in the SGLT2i group, and 0.40 ± 0.62 (p = 0.34) in the control group. We did not find correlations between changes in LVM and GLS, and other variables like change in HbA1c. Conclusions Among patients with T2DM, SGLT2i were associated with a significant reduction in indexed LVM and a significant increment in longitudinal strain measured by speckle tracking echocardiography, which may explain in part the clinical benefits found in clinical trials.

Download Full-text

P4546Acute heart failure: speckle tracking echocardiography, a new ally in intensive care unit

European Heart Journal ◽

10.1093/eurheartj/ehz745.0937 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M Cameli ◽

F Falciani ◽

G E Mandoli ◽

M L Parisella ◽

E Incampo ◽

...

Keyword(s):

Heart Failure ◽

Intensive Care Unit ◽

Intensive Care ◽

Hospital Mortality ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Left Ventricular ◽

Idiopathic Dilated Cardiomyopathy ◽

Free Wall

Abstract Background Acute Heart Failure (AHF) is a life-threatening condition with high mortality rate. Purpose The aim of our study was to identify the best predictors of in-hospital mortality and stay, among laboratory blood tests, clinic and echocardiographic (standard and by Speckle Tracking Echocardiography, STE) parameters in patients admitted to our Intensive Care Unit (ICU) for AHF. Methods We enrolled 57 patients (age 70±13 y, 70% man) admitted to our ICU with de novo AHF or acute decompensation of Chronic Heart Failure (CHF). Exclusion criteria were: active malignancies, chronic liver disease, absent acoustic echocardiographic window and patient refusal. At ICU admission, all patients were assessed with vital signs (heart rate, HR; systolic blood pressure, SBP), blood laboratory tests, standard echo and STE of left ventricle (LV), right ventricle (RV) and left atrium (LA). These indexes were then related to the length of stay and mortality. Results The population was finally composed of 52 patients, due to 5 in-hospital deaths. 56% had an ischemic aetiology, 26% idiopathic dilated cardiomyopathy, 11% valvular diseases, 7% other causes of HF. At admission, average HR was 78±16 bpm, SBP 119±24 mmHg and EF 33±13%. Among all the parameters, the ones that showed significant statistical correlation with the length of hospitalization (15,34±7.03 days) were plasmatic creatinine, SBP, Systolic Pulmonary Artery Pressure, high LV filling pressure (E/E' >12) and Peak Atrial Longitudinal Strain (PALS). The maximal dose of intravenous loop diuretics and inotropic drugs also showed a good correlation. Analysing the two sub-populations with mortality data, we observed that patients who died, had a significantly lower EF (19±9.62% vs 35±12.55%; p=0,01), but not a higher left atrial volume indexed (31.04±14.87 vs 26.36±12.03 ml/m2; p= ns) compared to the survivors; instead PALS was significant worse (10.08±4.62 vs 20.64±13,35%; p<001). Free wall RV Longitudinal Strain (fw-RVLS) values for the patients who died (−9.41±4.66%) were significantly lower than in survivors (−13.67±6.02%; p<0.01). LVGLS (Left Ventricular Global Longitudinal Strain) did not show statistical significant differences between the two populations. Based on the results of ROC analysis (Figure 1), we created a score to predict in-hospital mortality, composed of: EF, PALS and RVLS-free wall. The ideal cut point to predict mortality was >1.5. Figure 1 Conclusions AHF represents one of the major challenges in ICU. The use of a combined echocardiographic score, assessed at admission, could help to better predict mortality risk, in addition to commonly used indexes.

Download Full-text

Effect of Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors on Left Ventricular Remodelling and Longitudinal Strain: A Prospective Observational Study

10.21203/rs.3.rs-582026/v2 ◽

2021 ◽

Author(s):

Sergio Gamaza-Chulian ◽

Enrique Díaz-Retamino ◽

Fátima González-Testón ◽

José Carlos Gaitero ◽

María José Castillo ◽

...

Keyword(s):

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Control Group ◽

Ventricular Remodelling ◽

Left Ventricular Remodelling ◽

Sodium Glucose Cotransporter ◽

Clinical Benefits

Download Full-text

Subclinical Myocardial Dysfunction Revealed by Two-dimensional Speckle Tracking Echocardiography in Chronic Alcoholic Patients

10.21203/rs.3.rs-783432/v1 ◽

2021 ◽

Author(s):

Magdalena Kaznica-Wiatr ◽

Klaudia Pacia ◽

Marta Hat ◽

Monika Noga ◽

Piotr Podolec ◽

...

Keyword(s):

Alcohol Consumption ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Myocardial Injury ◽

Speckle Tracking Echocardiography ◽

Global Longitudinal Strain ◽

Control Group ◽

Dependent Manner ◽

Two Dimensional ◽

The Mean

Abstract Background and aim:Alcohol is a potent risk factor for heart diseases. Alcohol consumption can damage myocytes earlier than overt LV dysfunction occurs. We aimed that two-dimensional speckle tracking echocardiography (2DSTE) can be used for early detection of heart failure caused by alcohol intake.Methods:A 100 chronic alcoholics were enrolled into the study. All patients underwent physical examination, biochemical analysis and echocardiography. Following parameters were assessed: LV diameters, LV systolic and diastolic function. Also RV diameters, LA and RA volumes were measured. LV and RV global longitudinal strain (GLS), LA and RA strain were calculated. The results were compared with control group, composed of 20 healthy subjects.Results:The mean LVEF was 57.55±6.99%, the mean E/A ratio 1.09±0.32 and E/E` 7.36±2.4 in the study group. Mean LA volume was 35.4±10.78 mL, RA volume 34.7±10.25 mL. The 2DSTE of LA was 29.1±10.0, LVGLS was -15.03±2.07. The RA strain was 30.46±10.25 and RVGLS -16.22±6.27. All strain parameters were lower than in the control group. Graded reduction of global longitudinal strain of the both ventricles and both atria in dose-dependent manner was found, lower strain was observed in heavy alcoholics than light/moderate drinkers. Conclusions:The study proved that chronic alcohol consumption leads to myocardial injury in dose-depended manner, the deterioration of global strain of the ventricles and atria can be the sensitive marker of myocardial injury.

Download Full-text