Abstract 15877: Chamber Volumes and Deformation Measures are Abnormal in Chemotherapy-Naïve Cancer Patients: Potential Implications for Surveillance and Definitions of Cardiotoxicity

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Dina Labib ◽  
Alessandro Satriano ◽  
Steven Dykstra ◽  
Yoko Mikami ◽  
Zdenka Slavikova ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Strain Amplitude ◽  
Left Ventricular ◽  
Principal Strain ◽  
Systolic Strain ◽  
Peak Systolic Strain ◽  
Cardiac Phenotype ◽  
Lv Mass ◽  
Contractile Performance ◽  
Active Cancer

Background: Cancer Therapeutics-related Cardiac Dysfunction (CTRCD) is defined by an interval drop in contractile performance to below reference lower limits of normal. This definition assumes healthy reference data appropriately represent referral populations with active cancer. However, the influence of active cancer on cardiac chamber volumes and contractile performance has not been established. Using cardiac magnetic resonance (CMR), we studied chamber volume- and deformation-based markers in ~400 cancer patients with comparison to ~100 healthy controls. Methods: 394 active cancer patients referred for first-time anthracycline-based chemotherapy and 102 healthy volunteers (HV) were recruited. Both underwent identical CMR protocols with quantification of chamber volumes and ejection fraction (EF). Left ventricular (LV) mechanics were also assessed by 3D myocardial deformation analysis (3D-MDA), providing global longitudinal, circumferential, radial and principal peak-systolic strain amplitude and rate. Results: The mean age was 53.8±13 years (78% female), with 64% having breast cancer and 36% lymphoma. Table 1 summarizes CMR findings of cancer patients versus HV, stratified by sex. Chamber volumes were significantly smaller while LV mass was significantly greater versus HV. LV EF and global longitudinal (GLS) were similar. However, cancer patients demonstrated significantly higher radial, circumferential and maximal principal strain amplitude. Peak-systolic strain rates were also consistently elevated. Conclusion: Chemotherapy-naïve cancer patients have smaller chamber volumes, greater LV mass, and higher radial, circumferential, and maximal principal strain versus healthy subjects. LV EF and peak GLS remain similar, and therefore are most appropriate to define CTRCD. However, an altered state of cardiac health is apparent by all other CMR-based markers, reflecting a unique cardiac phenotype of patients with active cancer.

Abstract 19981: Relationship of Cardiorespiratory Fitness and Adiposity With Left Ventricular Peak Systolic Strain in Middle-age Adults: The Dallas Heart Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Ambarish Pandey ◽  
Colby Ayers ◽  
Ian J Neeland ◽  
Susan Matulevicius ◽  
Anand Rohatgi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Fat ◽  
Left Ventricular ◽  
Systolic Strain ◽  
Peak Systolic Strain ◽  
Heart Study ◽  
Lv Mass ◽  
Total Body Fat ◽  
Total Body ◽  
Dallas Heart Study

Introduction: Low cardiorespiratory fitness (CRF) and obesity are associated with an increased risk for heart failure (HF). However, the mechanisms through which CRF and adiposity might increase HF risk are not fully understood. Because impaired left ventricular (LV) peak systolic strain is an early subclinical marker of HF, we evaluated the association of CRF and adiposity with LV peak systolic strain. Methods: We studied Dallas Heart Study-II participants without cardiovascular disease who had CRF estimated as the peak oxygen uptake from a submaximal treadmill test using the Givoni’s equation and Hellerstein’s formula and total body fat measured by dual x-ray absorptiometry. The participants also had ECG-gated tissue-tagged cardiac MRI imaging using 3-T MRI. Peak mid-wall systolic circumferential strain (Ecc) was determined by harmonic phase imaging. Associations of CRF and measures of overall adiposity [percent body fat (%BF)] and visceral adiposity [waist circumference (WC)] with Ecc were determined using multivariable adjusted linear regression analysis. Results: A total of 1,493 participants (57% women, 42% African Americans) were included in the analysis. After adjustment for baseline risk factors, higher LV mass (β = 0.17; P< .0001), lower ejection fraction (β = -0.32; P = < .0001), higher hs-cTnT levels (β = 0.06; P= 0.04), and lower CRF (β = -0.16; P< .0001) were each associated with higher Ecc (indicating worse systolic function). Higher WC was also significantly associated with higher Ecc (β = 0.07; P= .0006) while %BF was not associated with Ecc (P= 0.08). The relationship between CRF and Ecc did not change after additional adjustment for %BF and other significant confounders (Table). Conclusion: Lower CRF, but not total body fat, is associated with reduced peak systolic strain independent of LV mass and ejection fraction.These findings highlight the independent contributions of low fitness in mid-life towards heart failure risk at a later age.

Abstract 1962: Quantification of Longitudinal Right Ventricular Systolic Function and Its Coupling to Left Ventricular Global Function Using Speckle-Tracking Strain Imaging in Patients with Old Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Kaoru Dohi ◽  
Katsuya Onishi ◽  
Shinya Kato ◽  
Takeshi Takamura ◽  
Naoki Fujimoto ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Speckle Tracking ◽  
Systolic Function ◽  
Strain Imaging ◽  
Left Ventricular ◽  
Systolic Strain ◽  
Peak Systolic Strain ◽  
Lv Ejection Fraction ◽  
Rv Function ◽  
Global Peak

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.

Evaluation of anthracycline incuced cardiotoxicity by speckle tracking echocardiography.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11585-e11585
Author(s):  
Atalay Dogru ◽  
Devrim Cabuk ◽  
Tayfun Sahin ◽  
Ilhan Dolasik ◽  
Kazim Uygun
Keyword(s):  
Left Ventricular Dysfunction ◽  
Speckle Tracking ◽  
Ventricular Dysfunction ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Left Ventricular ◽  
High Dose ◽  
Systolic Strain ◽  
Peak Systolic Strain ◽  
Global Peak

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.

scholarly journals Cardiac characterization of sgca-null mice using high resolution echocardiography

2013 ◽  
Vol 5 (4) ◽  
pp. 22 ◽  
Author(s):  
Abdallah Fayssoil ◽  
Gilles Renault ◽  
Nicolas Guerchet ◽  
Carmen Marchiol-Fournigault ◽  
Françoise Fougerousse ◽  
...  
Keyword(s):  
High Resolution ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Knock Out ◽  
Cardiac Phenotype ◽  
Lv Mass ◽  
Different Ages ◽  
Cardiac Probe ◽  
A Prospective Study

Limb-girdle muscular dystrophy 2D (LGMD2D) is an inherited myogenic disorder belonging to the group of muscular dystrophies. <em>Sgca-null</em> mouse is a knock-out model of LGMD2D. Little is known about cardiac phenotype characterization in this model at different ages. We conducted a prospective study to characterize cardiac <em>sgca-null</em> mice phenotype using high resolution Doppler echocardiography at different ages. Conventional echocardiography was performed on anesthetised mice using a Vevo 770 (Visualsonics) with 30 MHz cardiac probe. Wild Type (WT) and <em>sgca-null</em> mice were scanned at 13, 15 and 17 months. From M-mode, we measured interventricular septal (IVS) wall thickness, posterior wall (PW) thickness, and end-left ventricular diameter in systolic and diastolic. From the above parameters, we calculated left ventricular (LV) shortening fraction (SF), LV ejection fraction (EF) and LV mass. At age 13 months, PW diastolic thickness was increased in <em>sgca-null </em>mice (0.89±0.14 mm <em>vs</em> 0.73±0.2 mm; P=0.020) and LV mass was higher in <em>sgca-nul</em>l mice (LV mass 205.2 mg <em>vs</em> 143 mg; P=0.001). We found also dilation of the LV (LVEDD: 4.84 mm <em>vs</em> 4.29 mm; P=0.019) in <em>sgca-null</em> mice. At age 15 months, dilation of the LV (LVEDD: 4.86 mm <em>vs</em> 4 mm; P=0.05) with an increase of the LV mass (165.7 mg <em>vs</em> 127.12; P=0.03) are found in <em>sgca-null</em> mice. At age 17 months, we found a decrease of the PW thickening (17% <em>vs</em> 30%; P=0.036). This work provides echocardiographic insights for the assessment of pharmaceutical therapies in <em>sgca-null</em> mice.

scholarly journals P1387 Correlations between left atrial strain parameters and left ventricular function in young patients presenting with acute ST elevation myocardial infarction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A I Scarlatescu ◽  
M M Micheu ◽  
M Stoian ◽  
D Zamfir ◽  
I Petre ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Diastolic Dysfunction ◽  
Left Atrial ◽  
Young Patients ◽  
Left Ventricular ◽  
Systolic Strain ◽  
Left Atrial Strain ◽  
Peak Systolic Strain ◽  
Atrial Strain ◽  
Lv Diastolic Dysfunction

Abstract Funding Acknowledgements This work was supported by CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF Background Previous studies demonstrated the role of left atrial (LA) deformation parameters in characterisation of left ventricular (LV) diastolic dysfunction. It is a marker of the severity of diastolic dysfunction; LA remodelling also proved to be a predictor of clinical outcome, therefore a prognostic marker in acute coronary syndromes. Purpose In this study we aimed to investigate the correlations between left atrial strain and conventional systolic and diastolic dysfunction parameters in a cohort of young patients with acute ST elevation myocardial infarction (STEMI) treated by primary PCI. Material and methods We included 56 consecutive patients in this study: 46 patients under 50 years of age with STEMI and 10 healthy age and sex matched controls. We performed conventional transthoracic echocardiography for all included patients. In addition to conventional echocardiographic parameters, LA strain curves were obtained for each patient using two-dimensional speckle tracking imaging with measurement LA deformation parameters. Results LV ejection fraction, LV global strain and peak LA systolic strain (PALS) were significantly reduced in STEMI patients compared to controls. PALS had significant correlation with 2D LVEF (p = 0.00), LV global longitudinal strain (p = 0.03), E wave (p &lt; 0.05), E/e’ (p &lt; 0.05), left atrial volume and the type of diastolic dysfunction (p = 0.06). PALS also had inversre correlation with the presence of an occluded coronary artery at angiography. PALS was higher in control group than in STEMI group ( 34.6 vs 20.4, p &lt; 0.05). PALS values progressively decreased with worsening of LV diastolic dysfunction showing significant differences between all diastolic dysfunction grades. Using ROC (Receiver operating Characteristics) analysis we identified a cut off value of 25.9 (Sensibility 88%, Specificity 74%, AUC 0.94, CI 95%, p &lt; 0.05) to discriminate between diastolic dysfunction and normal diastolic function. Moreover, PALS was significantly different in patients with normal vs high LV filling pressures. Using ROC analysis we determined a cut off value of 14.5 for LA peak systolic strain to discriminate between the two subgroups, with excellent discrimination power, AUC 0.935, CI 95%, p = 0.045, Sensibility 100%, Specificity 91%. Therefore LA peak systolic strain could be considered a surrogate estimate of LV filling pressures. Conclusion LA peak systolic strain correlated significantly with LV systolic and diastolic function in young patients with acute myocardial infarction treated with primary PCI. Peak LA strain may be helpful as a complementary method to evaluate diastolic dysfunction in this patient population and may also improve the detection of elevated LV filling pressures.

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