scholarly journals The Investigation of Left Atrial Structure and Stroke Etiology: The I‐LASER Study

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Michelle C. Johansen ◽  
Henrique Doria de Vasconcellos ◽  
Saman Nazarian ◽  
Joao A. C. Lima ◽  
Rebecca F. Gottesman
Keyword(s):  
Left Atrial ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Cryptogenic Stroke ◽  
Active Phase ◽  
Left Ventricular ◽  
Structure And Function ◽  
Stroke Subtype ◽  
And Function

Background Left atrial (LA) function is important in stroke, but often poorly characterized. We evaluated the association of 2‐dimensional speckle tracking echocardiography LA variables with stroke subtype (cardioembolic stroke [CS] or cryptogenic stroke versus other). The hypothesis is worse LA active function is associated with CS, but not cryptogenic strokes. Methods and Results In this prospective cohort (2017–2019), left ventricular/LA structure and function were quantified by 2‐dimensional and speckle tracking echocardiography in 151 patients with stroke. Strain/strain rate curves for the 3 components of the LA cycle, ie, (1) Reservoir (global longitudinal strain [Srmax]), (2) Conductive (early LA Sr [Sre]), and (3) Active (late LA strain [Sra]) were evaluated, masked to stroke subtype. Associations of cardiac features with stroke subtype were tested using multivariable logistic regressions. Odds of CS were increased in patients with a larger LA systolic diameter (odds ratio [OR], 2.96, 95% CI, 1.14–7.69) but reduced in patients with a higher Srmax (better reservoir) (OR, 0.80, 95% CI, 0.67–0.97). Lower Sra (worse function) was associated with an increased odds of CS (OR, 1.72, 95% CI, 1.07–2.76) but not independent of atrial fibrillation. Higher active LA emptying fraction (better active phase) was associated with reduced odds of CS (OR, 0.74, 95% CI, 0.57–0.95) or cryptogenic stroke (OR, 0.82, 95% CI, 0.68–0.98) versus other subtypes; other associations between cryptogenic stroke and speckle tracking echocardiography were not found. Conclusions Markers of LA structure and function were associated with CS. Similar associations were not found for cryptogenic stroke, which might suggest different underlying mechanisms, given study limitations. Further understanding could aid stroke diagnosis and secondary stroke prevention research.

scholarly journals Utility of Speckle-Tracking Echocardiography For Predicting Atrial Fibrillation Following Ischemic Stroke: A Systematic Review And Meta-Analysis

2021 ◽  
Author(s):  
Qinggele Gao ◽  
Peng Liu ◽  
Tingting Lv ◽  
Ying Yang ◽  
Ping Zhang
Keyword(s):  
Atrial Fibrillation ◽  
Strain Rate ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Global Longitudinal Strain ◽  
Cryptogenic Stroke ◽  
Atrial Remodeling

Abstract Purpose: Undiagnosed atrial fibrillation (AF) is one of the main sources of cryptogenic stroke. And strain indices measured by speckle-tracking echocardiography are associated with atrial remodeling supposed to be the substrate of AF. Therefore, there is a strong need for evaluating the utility of speckle-tracking echocardiography to predict the likelihood of AF in patients with cryptogenic stroke.Methods: PubMed, Embase and Cochrane Database were searched for studies. The random-effects model was used to calculate the pooled results, and summary receiver operating characteristic curve (SROC) analysis was performed to show the overall predictive value.Results: There were 1483 patients with cryptogenic stroke from 8 studies. Meta-analysis showed that strain indices including global longitudinal strain (GLS) (mean difference [SMD]: -0.22, 95% confidence interval [95% CI]: -0.40 to -0.04) , left atrial reservoir strain (εR), (SMD: -0.87, 95% CI: -1.26 to -0.48, conduit strain (εCD) (SMD: -0.56, 95% CI: -0.81 to -0.30), contractile strain (εCT) (SMD: -1.00, 95% CI: -1.39 to -0.61), and left atrial reservoir strain rate (SRe) (SMD: -0.54, 95% CI: -0.80 to -0.28) measured at the period of cryptogenic stroke was significantly decreased in patients with AF occurrence compared to without. SROC analysis suggested an acceptable predictive efficiency of εR for AF occurrence (AUC = 0.799).Conclusion: For patients after cryptogenic stroke, GLS, εR, εCD, εCT and SRe were significantly decreased in AF occurrence compared with non-occurrence. But there was no value in left atrial reservoir strain rate (SRs) and contractile strain rate (SRa) for predicting AF.

scholarly journals Correlations between left ventricular and left atrial function assessed by speckle tracking echocardiography in patients with treated well-controlled arterial hypertension

2020 ◽  
Author(s):  
Beata Uziebło-Życzkowska ◽  
Paweł Krzesiński
Keyword(s):  
Arterial Hypertension ◽  
Diastolic Function ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Statistical Significance ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Diastolic Function

Abstract BackgroundEven in patients with well-controlled arterial hypertension (AH) and without significant comorbidities left ventricular (LV) and left atrial (LA) strain abnormalities may sometimes be found in speckle-tracking echocardiography. Therefore, the aim of this study was to investigate the correlation between LA strain and LV diastolic and systolic function in a group of patients with treated, well-controlled AH.Methods LA contractile, conduit, and reservoir function, together with echocardiographic signs of LV diastolic function and LV global longitudinal strain (LV GLS), were assessed in 101 patients with treated, well-controlled AH who met the standard criteria of normal LV ejection fraction (LVEF) and normal LV diastolic function.ResultA relevant percentage of study participants presented lower than reference LV and LA strain values. Moreover, there were statistically significant differences in LA longitudinal strain (LAS) values (LAS during reservoir phase—LASr (p<0.001) and LAS during conduit phase—LAScd (p = 0.008)) between patients with high and lower LV GLS, confirmed by significant correlations between LASr, LAScd, and GLS. In the correlations analysis between LAS values and LV diastolic function parameters, statistical significance was obtained for the following: LASct (contraction) vs. e’avg, LASct vs. E/A, LASct vs. A, LAScd vs. e’avg, LAScd vs. E/A, and LAScd vs. A. Conclusions LV and LA strain abnormalities occurred within a significant percentage of patients with treated, well-controlledAH. Impaired LA strain is associated with lower LV strain and reduced LV diastolic function parameters, reflecting both the passive and active properties of the LA.

scholarly journals P1294Evaluation of right atrium mechanics and relation with loading conditions by speckle tracking echocardiographyP1295Late detection of left ventricular dysfunction using 2D and 3D speckle-tracking in patients with history of non-severe acute myocarditisP1296The impact of abnormal circadian BP profile on left atrial function by 2D speckle tracking echocardiography and its effect on functional capacity in hypertensive patientsP1297Right heart echocardiographic parameters alterations in asymptomatic breast cancer patients during chemotherapyP1299The Impact of myocardial deformation imaging for assessment of long-life prognosis in young patients with Kawasaki diseasesP1300Early detection of lv systolic dysfunction in asymptomatic patients with rheumatoid arthritis using global longitudinal strain assessmentP1301Cardiovascular risk assessment in haemodialysis patients with preserved left ventricular ejection fraction and left ventricular hypertrophyP1302Echocardiographic determinants of the functional capacity in systemic sclerosis: role of the right heartP1303 Speckle tracking echocardiography assessment of left atrial strain in hypertensive patientsP1304Comparison of global longitudinal strain in rheumatic mitral regurgitation and degenerative mitral regurgitation : does etiology affect?P1305Specific correlations between aortic stiffness and three-dimensional speckle-tracking echocardiography-derived segmental left ventricular strainsP1306Three-dimensional right ventricular strain analysis for the dependency of preload changes

2016 ◽  
Vol 17 (suppl 2) ◽  
pp. ii277-ii280
Author(s):  
S. Unlu ◽  
T. Caspar ◽  
T. Ahmed ◽  
M. Abdar Esfahani ◽  
R. Marinov ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Functional Capacity ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

scholarly journals Direct comparison of multilayer left ventricular global longitudinal strain using CMR feature tracking and speckle tracking echocardiography

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saikrishna Ananthapadmanabhan ◽  
Giau Vo ◽  
Tuan Nguyen ◽  
Hany Dimitri ◽  
James Otton
Keyword(s):  
Feature Tracking ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Imaging Modality ◽  
Global Longitudinal Strain ◽  
Intraclass Correlation ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Multilayer Strain

Abstract Background Cardiac magnetic resonance feature tracking (CMR-FT) and speckle tracking echocardiography (STE) are well-established strain imaging modalities. Multilayer strain measurement permits independent assessment of endocardial and epicardial strain. This novel and layer specific approach to evaluating myocardial deformation parameters may provide greater insight into cardiac contractility when compared to whole-layer strain analysis. The aim of this study is to validate CMR-FT as a tool for multilayer strain analysis by providing a direct comparison between multilayer global longitudinal strain (GLS) values between CMR-FT and STE. Methods We studied 100 patients who had an acute myocardial infarction (AMI), who underwent CMR imaging and echocardiogram at baseline and follow-up (48 ± 13 days). Dedicated tissue tracking software was used to analyse single- and multi-layer GLS values for CMR-FT and STE. Results Correlation coefficients for CMR-FT and STE were 0.685, 0.687, and 0.660 for endocardial, epicardial, and whole-layer GLS respectively (all p < 0.001). Bland Altman analysis showed good inter-modality agreement with minimal bias. The absolute limits of agreement in our study were 6.4, 5.9, and 5.5 for endocardial, whole-layer, and epicardial GLS respectively. Absolute biases were 1.79, 0.80, and 0.98 respectively. Intraclass correlation coefficient (ICC) values showed moderate agreement with values of 0.626, 0.632, and 0.671 respectively (all p < 0.001). Conclusion There is good inter-modality agreement between CMR-FT and STE for whole-layer, endocardial, and epicardial GLS, and although values should not be used interchangeably our study demonstrates that CMR-FT is a viable imaging modality for multilayer strain

Early change in left atrial and left ventricular strain predicts sinus rhythm maintenance after cardioversion

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Kupczynska ◽  
D Miskowiec ◽  
B Michalski ◽  
L Szyda ◽  
K Wierzbowska-Drabik ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Recurrence Risk ◽  
Left Ventricular ◽  
Mechanical Function ◽  
Af Recurrence

Abstract Background Atrial fibrillation (AF) impairs mechanical function of the heart, especially atria and restoration of sinus rhythm (SR) leads to improvement of mechanics. The predicting role of changes in strain parameters for AF recurrence is not established yet. Purpose To analyse changes in left atrial (LA) and left ventricular (LV) mechanical function after conversion to SR and their prognostic values for AF recurrence during 24 months follow-up. Methods Prospective study involved 59 patients after successful electrical cardioversion (EC) because of nonvalvular AF (mean age 65±4 years, 47% female). Speckle tracking analysis (STE) was applied to calculate longitudinal strain of LV and LA before EC and within 24 hours after restoration of SR and additionally total left heart strain (TS) defined as a sum of absolute peak LV and LA strain. We calculated change in strain between AF and SR analyses expressed as delta (Δ). During follow-up we noticed AF recurrence in 42 (71%) patients, most of them (93%) during 1st year after EC. Median time of AF recurrence was 3 months. Results We noticed significant immediate post-EC improvement in peak LA longitudinal strain (PALS) and LV global longitudinal strain (LVGLS) (table). Unlike CHA2DS2-VASc score, strain parameters were predictors of AF recurrence. Every 1% increment in ΔLVGLS was related with 13% increase in AF recurrence risk (p=0.02) and every 1% increment in ΔPALS and ΔTS were related with 9% decrease in AF recurrence risk (p=0.007 and p=0.0014, respectively). Multivariate analysis revealed ΔTS as a strongest predictor with 9% decrease in AF risk per every 1% increment. The criterion of ΔTS ≤7.5% allows to predict AF recurrence with 81% sensitivity and 63% specificity. Conclusions Speckle tracking measurements are able to detect early mechanical changes in LA even within 24 hours of SR and these absolute changes in LVGLS as well as PALS can predict AF recurrence, with optimal stratification by novel parameter - TS. Funding Acknowledgement Type of funding source: None

Left ventricular myocardial work in patients with secondary mitral regurgitation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Yedidya ◽  
R.P Lustosa ◽  
F Fortuni ◽  
P Van Der Bijl ◽  
F Namazi ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Blood Pressure Measurement ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Work Efficiency ◽  
Constructive Work ◽  
Secondary Mitral Regurgitation

Abstract Background Assessment of left ventricular (LV) function in patients with secondary mitral regurgitation (SMR) remains challenging because LV ejection fraction (LVEF) reflects changes in LV volume without taking into account the direction of the blood flow. LV global longitudinal strain better reflects active LV myocardial deformation but does not incorporate afterload. LV myocardial work derived from pressure-strain loops integrates speckle tracking echocardiography with non-invasive blood pressure measurement. Purpose To evaluate LV myocardial work components to better characterize LV function in patients with SMR. Methods 378 patients (72% men, median age 68 [range 60 to 74 years]) with various grades of SMR were retrospectively analysed. LV myocardial constructive work, wasted work and work efficiency were measured with speckle tracking echocardiography. Results 145 patients had mild SMR, 130 moderate SMR and 103 severe SMR. Patients with severe SMR had larger LV volumes, lower LVEF and more impaired LV GLS (Table 1). While LV constructive work was more impaired in patients with severe SMR, wasted work was lower as compared to mild SMR (Table 1). Consequently, patients with severe SMR had better myocardial work efficiency than patients with mild MR. This could reflect, the regurgitant volume which is pumped into a low pressure chamber (the left atrium) resulting in less myocardial wasted work and preservation of myocardial efficiency. Conclusion In patients with severe SMR, LVEF, LV GLS and myocardial constructive work are more impaired when compared to mild SMR. However, myocardial wasted work is lower, resulting in higher better LV myocardial work efficiency. Funding Acknowledgement Type of funding source: None

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