Utility of 2D-speckle tracking echocardiography in early identification of left ventricular dysfunction in antineoplastic therapy-induced cardiotoxicity.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 631-631
Author(s):  
Carmela Coppola ◽  
Carlo G. Tocchetti ◽  
Giovanna Piscopo ◽  
Clemente Cipresso ◽  
Carlo Maurea ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Antineoplastic Therapy ◽  
Speckle Tracking ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Dysfunction ◽  
Increased Risk ◽  
2D Speckle Tracking ◽  
Group D

631 Background: ErbB2 is overexpressed in about 25% of breast cancers; in the heart, it modulates myocardial development and function. Trastuzumab (T), an anti-ErbB2 inhibitor, has improved the prognosis of patients with breast cancer, but is related to an increased risk of asymptomatic left ventricular (LV) dysfunction (3-34%) and heart failure (2-4%). Conventional measures of ventricular function, such as fractional shortening (FS) and ejection fraction (FE) are insensitive in detecting early cardiomyopathy induced by antineoplastic therapy. Aim of this study is to evaluate whether myocardial strain by 2D-speckle tracking (ST) is able to identify early LV dysfunction in mice treated with doxorubicin (D) and T, alone or in combination (D+T) and to relate data of cardiac function with tissue alterations. Methods: Cardiac function was measured with FS, by M-mode echocardiography, and with radial myocardial strain with ST in sedated C57BL/6 mice (8-10 wk old) at time 0, 2 and 6 days of daily administration of D, T, D+T and in a control group. In excised hearts, we evaluated TNFα and CD68 by immunohistochemistry; interstizial fibrosis was analyzed with picrosirius red staining. Results: FS was reduced in group D and D+T at 2 days (52+0.2% and 49+2% respectively), both p<0.001 vs 60+0.4% (sham), while in group T it decreased only at 6 days (49+1.5% vs 60+0.5%, p=.002). In contrast, after 2 days, myocardial strain was already reduced not only in D and D+T, but also in T alone: 43+3%, 49+1%, and 44+7%, respectively, all p<0.05 vs sham (66+0.6%). Cardiotoxicity was associated with significant alterations in extracellular matrix remodeling as confirmed by an increase of interstizial collagen with D (4.56%), T (2.17%) and D+T (3.77%)at 6 days p<0.05 vs sham (1.17%) and by increased cardiac inflammation in fact the myocytes were positive for TNFα and CD68 cells/mm2at 6 days in group D (16.46% and 155 respectively), in group T+D (12.35% and 74.16) and in group T (5.65% and 72.32) p<0.01 vs sham (0.56% and 2.3). Conclusions: Myocardial strain identifies LV systolic dysfunction earlier than conventional echocardiography and can be a useful tool to predict cardiotoxicity in this setting.

Utility of 2D-speckle tracking echocardiography in diagnosis of left ventricular dysfunction in anti-ErbB2 therapy.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 169-169
Author(s):  
Nicola Maurea ◽  
Giovanna Piscopo ◽  
Clemente Cipresso ◽  
Domenica Rea ◽  
Emanuela Esposito ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Speckle Tracking ◽  
Systolic Dysfunction ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Dysfunction ◽  
Increased Risk ◽  
2D Speckle Tracking ◽  
Group D

169 Background: ErbB2 is overexpressed in about 25% of breast cancers; in the heart, it modulates myocardial development and function. Trastuzumab (T), an anti-ErbB2 inhibitor, has improved the prognosis of patients with breast cancer, but is related to an increased risk of asymptomatic left ventricular (LV) dysfunction (3-34%) and heart failure (2-4%). Conventional measures of ventricular function, such as fractional shortening (FS) and ejection fraction (FE) are insensitive in detecting early cardiomyopathy induced by antineoplastic therapy. Here, we aim at assessing whether myocardial strain by 2D-speckle tracking (ST) is able to identify early LV dysfunction in mice treated with doxorubicin (D) and T, alone or in combination (D+T) and to relate data of cardiac function with tissue alterations. Methods: Cardiac function was measured with FS, by M-mode echocardiography, and with radial myocardial strain with ST in sedated C57BL/6 mice (8-10 wk old) at time 0, 2 and 6 days of daily administration of D (2.17 mg/kg/day), T (2.25 mg/kg/day), D+T (2.17 mg/kg/day + 2.25 mg/kg/day) and in a control group. In excised hearts, we evaluated TNFα and CD68 by immunohistochemistry; interstizial fibrosis was analyzed with picrosirius red staining. Results: FS was reduced in group D and D+T at 2 days (52+0.2% and 49+2%), both p<0.001 vs 60+0.4% (sham), while in group T it decreased only at 6 days (49+1.5% vs 60+0.5%, p=.002). In contrast, after 2 days, myocardial strain was already reduced not only in D and D+T, but also in T alone: 43+3%, 49+1%, and 44+7%, respectively, all p<0.05 vs sham (66+0.6%). Cardiotoxicity was associated with significant alterations in extracellular matrix remodeling as confirmed by an increase of interstizial collagen with D (4.56%), T (2.17%) and D+T (3.77%)at 6 days p<0.05 vs sham (1.17%) and by increased cardiac inflammation in fact the myocytes were positive for TNFα and CD68 cells/mm2at 6 days in group D (16.46% and 155), in group T+D (12.35% and 74.16) and in group T (5.65% and 72.32) p<0.01 vs sham (0.56% and 2.3). Conclusions: Myocardial strain identifies LV systolic dysfunction earlier than conventional echocardiography and can be a useful tool to predict cardiotoxicity in this setting.

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

Circulation ◽  
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.

scholarly journals P932 What is new in the assessment of patients with hereditary hemochromatosis - can 2D speckle tracking echocardiography be helpful in the early detection of heart abnormalities?

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
L Danilowicz-Szymanowicz ◽  
K Rozwadowska ◽  
M Swiatczak ◽  
K Sikorska ◽  
M Fijalkowski ◽  
...  
Keyword(s):  
Early Detection ◽  
Iron Overload ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Hereditary Hemochromatosis ◽  
Rotation Velocity ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Dysfunction ◽  
Heart Abnormalities

Abstract Background Hereditary hemochromatosis (HH) is a very common genetic disease. Abnormally increased intestinal iron absorption and accelerated recycling of iron lead to progressive body iron accumulation and the generation of oxidative stress in tissues. In the late stages iron overload of the heart can lead to the left ventricular (LV) dysfunction. It is believed, that two dimensional speckle tracking echocardiography (2D STE) can evaluate LV dysfunction more accurately and earlier than conventional echocardiography. Evaluation of such assessment was the purpose of this paper. Methods We prospectively enrolled 58 patients with genetically confirmed HH; 29 healthy age- and sex-matched volunteers constituted the control group. Classic echocardiographic and 2D STE parameters (GE VIVID E9, EchoPAC v201) were compared between the groups, additionally correlations between echo and iron turnover parameters were performed. Results The HH patients had all standard echo parameters within the normal range. All 2D STE parameters were significantly worse in HH than in control group (Table 1). We did not find any correlation between echo and iron turnover parameters, whilst significant correlation with the time from diagnosis and the numbers of venesections was noticed. Conclusions Novel 2D STE analyzes seem to be helpful in early detection of heart abnormalities in HH patients. The correlations between the echo and iron indices are weak, allowing to suggest the lack of a "direct" relationship between the iron turnover and myocardial function and that myocardial iron overload is not the only mechanism involved in development of HH cardiomyopathy. HH All n = 58 Controls n = 29 p LAVI (ml/BSA) 31 (23-37) 22 (19-27) &lt;0.001 RWT 0.42 (0.38-0.47) 0.38 (0.34-0.43) &lt;0.003 LVMI (g/BSA) 78 (58-96) 66 (53-72) &lt;0.006 E/Em 7.0 (5.6-8.3) 6.7 (5.0-7.5) 0.071 LVEF (%) 60 (54-62) 63 (61-65) &lt;0.006 LV twist (º) 17.2 (13.1-22.2) 24.1 (19.9-32.1) &lt;0.001 LV torsion (º/cm) 2.2 (1.6-2.9) 3.3 (2.7-4.3) &lt;0.001 LV peak rotation velocity (º/s) 118.0 (88.3-146.3) 140.0 (112.7-168.9) &lt;0.015 LV peak untwisting velocity (º/s) -132.0 (-163.5–93.0) -156.0 (-197.0–122.6) &lt;0.039 Peak systolic longitudinal strain (%) -18.3 (-20.0–16.9) -21.0 (-22.0–19.3) &lt;0.001

scholarly journals Speckle Tracking Echocardiography and All-Cause and Cardiovascular Mortality Risk in Chronic Kidney Disease Patients

2019 ◽  
Vol 44 (4) ◽  
pp. 690-703 ◽  
Author(s):  
Laura Jahn ◽  
Rafael Kramann ◽  
Nikolaus Marx ◽  
Jürgen Floege ◽  
Michael Becker ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Mortality Risk ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Myocardial Dysfunction ◽  
Left Ventricular ◽  
Control Group ◽  
Increased Risk ◽  
All Cause Mortality

Background and Objectives: Patients with chronic kidney disease (CKD) exhibit a highly increased risk of cardiovascular (CV) morbidity and mortality. Subtle changes in left ventricular function can be detected by two-dimensional (2D) speckle tracking echocardiography (STE). This study investigated whether myocardial dysfunction detected by 2D STE may aid in CV and all-cause mortality risk assessment in patients with CKD stages 3 and 4. Method: A study group of 285 patients (CKD 3: 193 patients; CKD 4: 92 patients) and a healthy control group (34 participants) were included in the retrospective study. 2D STE values as well as early and late diastolic strain rates were measured in ventricular longitudinal, circumferential and radial directions. Patients’ CV and all-cause outcome was determined. Results: In the CKD group all measured longitudinal STE values and radial strain were significantly reduced compared to the control group. Cox proportional hazards regression revealed global longitudinal strain to predict CV and all-cause mortality (hazard ratio [HR] 1.15, 95% CI 1.06–1.25; p = 0.0008 and HR 1.09, 95% CI 1.04–1.14; p = 0.0003). After adjustment for sex, age, diabetes, estimated glomerular filtration rate, and preexisting CV disease, this association was maintained for CV mortality and all-cause mortality (HR 1.16, 95% CI 1.06–1.27; p = 0.0019 and HR 1.08, 95% CI 1.03–1.14; p = 0.0026, respectively). Conclusions: The present study shows that 2D STE detects reduced left ventricular myocardial function and allows the prediction of CV and all-cause mortality in patients at CKD stages 3 and 4.

scholarly journals Elevated vascular resistance and afterload reduce the cardiac output response to dobutamine in early growth-restricted rats in adulthood

2011 ◽  
Vol 106 (9) ◽  
pp. 1374-1382 ◽  
Author(s):  
Vladislava Zohdi ◽  
M. Jane Black ◽  
James T. Pearson
Keyword(s):  
Cardiac Output ◽  
Cardiac Function ◽  
Peripheral Resistance ◽  
Early Growth ◽  
Left Ventricular ◽  
Growth Restriction ◽  
Protein Diet ◽  
Ventricular Pressure ◽  
Control Group ◽  
Increased Risk

Epidemiological studies have linked intra-uterine growth restriction (IUGR) with an increased risk of CVD later in life. The aim of the present study was to examine the effect of maternal protein restriction on cardiac function in adulthood during dobutamine (DOB) stimulation. IUGR was induced in Wistar Kyoto dams through administration of a low-protein diet (LPD; 8·7 % casein) during pregnancy and lactation; the control group received a normal-protein diet (NPD; 20 % casein). At 14 weeks of age, cardiac function was assessed in male and female NPD (eight females and eight males) and LPD offspring (ten females and ten males) by pressure volumetry using an anaesthetised closed-chest approach. We determined mean arterial pressure (MAP), heart rate and left ventricular pressure–volume indices under baseline conditions and DOB stimulation (2 and 4 μg/kg per min). During β-adrenergic activation in LPD offspring, increases in cardiac output (CO, P < 0·018) and stroke volume (SV, P < 0·005) were attenuated in comparison with NPD offspring, while increases in ejection fraction and the maximal rate of ventricular pressure development were not affected. LPD females maintained a smaller end-diastolic volume (P < 0·017). MAP did not differ between the groups and did not change significantly during DOB infusion. Arterial elastance and total peripheral resistance decreased in all rats but remained significantly elevated in LPD offspring (P < 0·015 and < 0·01). Early growth restriction did not affect ventricular contractility but led to an increased afterload and impaired the ability to increase SV and CO during β-adrenergic stimulation.

2D-Speckle tracking echocardiography contributes to early identification of impaired left ventricular myocardial function in children with chronic kidney disease

2018 ◽  
Vol 28 (12) ◽  
pp. 1404-1409 ◽  
Author(s):  
Hasan Demetgul ◽  
Dilek Giray ◽  
Ali Delibas ◽  
Olgu Hallioglu
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Strain Rate ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Control Group ◽  
Healthy Children ◽  
Systolic Strain ◽  
2D Speckle Tracking

AbstractIntroductionThe aim of this study is to determine early changes in cardiac function of children with chronic kidney disease by using 2D-speckle tracking echocardiography.MethodThe study included 38 children – 16 girls and 22 boys – diagnosed as having chronic kidney disease in the nephrology department with a glomerular filtration rate of <90 ml/minute/1.73 m2 for at least 3 months. A total of 37 – 15 girls and 22 boys – age- and sex-matched healthy children were included as the control group. 2D-Speckle tracking echocardiography was performed in all subjects.ResultsThe mean age was 13.45±2.8 years in patients and 12.89±3.07 years in controls. Systolic and diastolic blood pressures and left ventricular mass index were significantly higher in patients (p<0.05). The values of mitral e, mitral a, mitral e/a ratio, and mitral deceleration time were not different between the groups. Tricuspid annular plane systolic excursion values were lower in patients (p<0.01). Global strain values in apical long-axis 3-chamber and 2-chamber views were significantly lower in patients (p<0.05). Longitudinal, radial, and circumferential peak systolic strain values were lower in patients, but the difference was statistically significant in all segments of longitudinal view and basal segment of circumferential view (p<0.05). Radial and circumferential systolic strain rates were significantly lower in patients in all three segments (p<0.05). Moreover, early diastolic strain rate was significantly lower in longitudinal and radial apical segments and in all segments of circumferential measurements in patients. Besides, strain rate e/a ratio was significantly lower in all longitudinal segments of patients (p=0.01).ConclusionThe study concluded that 2D-speckle tracking echocardiography method can determine cardiac involvement earlier than conventional echocardiography in children with chronic kidney disease having preserved ejection fraction.

scholarly journals Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Kazutoshi Hirose ◽  
Koki Nakanishi ◽  
Masao Daimon ◽  
Naoko Sawada ◽  
Yuriko Yoshida ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
General Population ◽  
Cardiac Disease ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Normal Weight ◽  
Model Assessment ◽  
Lv Dysfunction ◽  
Increased Risk

Abstract Background Insulin resistance carries increased risk of heart failure, although the pathophysiological mechanisms remain unclear. LV global longitudinal strain (LVGLS) assessed by speckle-tracking echocardiography has emerged as an important tool to detect early LV systolic abnormalities. This study aimed to investigate the association between insulin resistance and subclinical left ventricular (LV) dysfunction in a sample of the general population without overt cardiac disease. Methods We investigated 539 participants who voluntarily underwent extensive cardiovascular health check including laboratory test and speckle-tracking echocardiography. Glycemic profiles were categorized into 3 groups according to homeostatic model assessment of insulin resistance (HOMA-IR): absence of insulin resistance (HOMA-IR < 1.5), presence of insulin resistance (HOMA-IR ≥ 1.5) and diabetes mellitus (DM). Multivariable logistic regression models were conducted to evaluate the association between abnormal glucose metabolism and impaired LVGLS (> − 16.65%). Results Forty-five (8.3%) participants had DM and 66 (12.2%) had abnormal HOMA-IR. LV mass index and E/e′ ratio did not differ between participants with and without abnormal HOMA-IR, whereas abnormal HOMA-IR group had significantly decreased LVGLS (− 17.6 ± 2.6% vs. − 19.7 ± 3.1%, p < 0.05). The prevalence of impaired LVGLS was higher in abnormal HOMA-IR group compared with normal HOMA-IR group (42.4% vs. 14.0%) and similar to that of DM (48.9%). In multivariable analyses, glycemic abnormalities were significantly associated with impaired LVGLS, independent of traditional cardiovascular risk factors and pertinent laboratory and echocardiographic parameters [adjusted odds ratio (OR) 2.38, p = 0.007 for abnormal HOMA-IR; adjusted OR 3.02, p = 0.003 for DM]. The independent association persisted even after adjustment for waist circumference as a marker of abdominal adiposity. Sub-group analyses stratified by body mass index showed significant association between abnormal HOMA-IR and impaired LVGLS in normal weight individuals (adjusted OR 4.59, p = 0.001), but not in overweight/obese individuals (adjusted OR 1.62, p = 0.300). Conclusions In the general population without overt cardiac disease, insulin resistance carries independent risk for subclinical LV dysfunction, especially in normal weight individuals.

scholarly journals Analysis of left ventricular rotational deformation by 2D speckle tracking echocardiography: a feasibility study in athletes

2021 ◽  
Author(s):  
Phillipp Hofrichter ◽  
Andreas Hagendorff ◽  
Ulrich Laufs ◽  
Sven Fikenzer ◽  
Pierre Hepp ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Image Acquisition ◽  
Left Ventricular ◽  
Control Group ◽  
Radial Deformation ◽  
Short Axis ◽  
Physiological Strain ◽  
2D Speckle Tracking ◽  
Rotational Deformation

Abstract2D speckle tracking echocardiography (2DSTE) is established to analyse left ventricular (LV) longitudinal function. The analysis of LV rotational deformation is challenging and requires standardization of image acquisition as well as postprocessing analysis. The aim of this study was to test the feasibility to analyse LV rotational deformation using 2DSTE by introducing a novel algorithm for the detection of artefacts. The study was performed in 20 healthy subjects serving as a control group and in 53 competitive sportsmen. Circumferential, radial strain (CS, RS) and LV rotation were analysed by 2DSTE in parasternal short axis views. The stepwise algorithm to exclude potential artefacts starts with the visual estimation of the image quality with respect to complete visualization of all myocardial segments during the entire cardiac cycle followed by the exclusion of data sets in participants with conduction abnormalities. The next step is the optimization of tracking areas and a cross-check of implausible strain waveforms in multiple acquired comparable cineloops. The last step is the exclusion of strain curves with persisting implausible waveforms if standardization failures and incorrect LV wall tracking are fixed. Plausible physiological strain curves were observed in 89% (n = 65/73) of all subjects. In controls all implausible waveforms could be verified as artefacts. The algorithm was applied in 53 professional athletes to test and confirm its feasibility. Abnormal CS waveforms were documented in 25 athletes, verified as artefacts due to tracking failures in 22 athletes and due to incorrect image acquisition in 3 athletes. CS artefacts were mostly located in the basal posterior and lateral LV segments. (endocardial: 6%, n = 4/70; p < 0.05) and basal posterior (endocardial: 8%, n = 5/70; p < 0.05) segments were highly susceptible to artefacts. 2DSTE of parasternal short axis views to analyse circumferential and radial deformation as well as LV rotation is feasible in athletes. The proposed algorithm helps to avoid artefacts and might contribute to standardization of this technique. 2DSTE might provide an interesting diagnostic tool for the detection of viral myocarditis, e.g. in athletes.

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