scholarly journals Can Serial Examination of Global Longitudinal Strain by Three-Dimensional Speckle-Tracking Become a Well-Established Parameter in the Clinical Setting?

2021 ◽  
Author(s):  
Hidekazu Tanaka
2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
O Seckin ◽  
S Unlu ◽  
G Tacoy

Abstract Background The function of both ventricles have been suggested to be affected in patients with mitral stenosis. In this study, it was aimed to investigate deformation properties of right (RV) and left ventricles (LV) in mild and moderate rheumatic mitral stenosis (MS) patients with three-dimensional speckle tracking echocardiography (3D-STE). Methods A total of 60 patients were included in the study (20 patients with mild MS diagnosis, 20 patients with moderate MS diagnosis and 20 healthy volunteers). Three-dimensional echocardiography datasets were obtained for both ventricles in all patients. An example for RV assessment is shown in Figure 1. LV global longitudinal strain (GLS), LV torsion, RV free wall (FW) LS and interventricular septal (IVS) LS measurements were analyzed. Results The LV ejection fraction (EF), RV fractional area change and tricuspid annular plane systolic excursion values were statistically similar and in the normal range. The LV GLS measurements were significantly different among the groups by being highest in the control group and least in the moderate stenosis group (ANOVA,p < 0.001) (Table 1). Patients with MS showed higher torsional values, correlated with MS severity (ANOVA,p < 0.001) (Table 1). IVS LS, RVFW LS values obtained by RV analysis also differed significantly among groups. The FW-GLS values only showed significant difference between the control group and moderate MS group (Table 1). Conclusion Patients with mitral stenosis showed lower LV-GLS and higher LV torsion values. Although the LV GLS is affected; the LV EF was detected to be normal due to increase in LV torsion. RV deformation indices showed signıficant decrease in correlation with the severity of the mitral stenosis. In conclusion, our data suggest that subclinical LV and RV systolic dysfunction is present in mild-moderate MS patients and this dysfunction can be detected by 3D-STE. Table 1 Parameters Control group Mild MS Moderate MS P LV GLS (%) 23.3 ± 2.08 18.9 ± 1.3 17.5 ± 1.8 <0.001 LV torsion 1.5 ± 0.6 2.1 ± 0.6 2.6 ± 0.5 <0.001 IVS LS (%) 23 ± 3.0% 20 ± 2.6 17.1 ± 2.9 <0.001 RV FW LS (%) 25.4 ± 5 22.7 ± 3.2 21.1 ± 4.8 <0.001 FW; free-wall, GLS; global longitudinal strain, IVS; interventricular septum, LV; left ventricular, RV; right ventricular Abstract 1187 Figure 1


Author(s):  
Noriaki Iwahashi ◽  
Jin Kirigaya ◽  
Takeru Abe ◽  
Mutsuo Horii ◽  
Noriko Toya ◽  
...  

Abstract Aims In patients with ST-segment elevation myocardial infarction (STEMI), predicting left ventricular (LV) remodelling (LVR) and prognosis is important. We explored the clinical usefulness of three-dimensional (3D) speckle-tracking echocardiography to predict LVR and prognosis in STEMI. Methods and results The study group comprised 255 first STEMI patients (65 years; 210 men) treated with primary percutaneous coronary intervention between April 2008 and May 2012 at Yokohama City University Medical Center. Baseline global longitudinal strain (GLS) was measured with two-dimensional (2D) and 3D speckle-tracking echocardiography. Within 48 of admission, standard 2D echocardiography and 3D full-volume imaging were performed, and 2D-GLS and 3D-GLS were calculated. Infarct size was estimated by 99mTc-sestamibi single-photon emission computed tomography. Echocardiography was performed at 1 year repeatedly in 239 patients. The primary endpoint was LVR, defined as an increase of 20% of LV end-diastolic volume index and major adverse cardiac and cerebrovascular events (MACE: cardiac death, non-fatal MI, heart failure, and ischaemic stroke) at 1 year, and the secondary endpoint was cardiac death and heart failure. Patients were followed for 1 year; 64, 25, and 16 patients experienced LVR, MACE, and the secondary endpoint, respectively. Multivariate analysis revealed that 3D-GLS was the strongest predictor of LVR (odds ratio = 1.437, 95% CI: 1.047–2.257, P = 0.02), MACE (odds ratio = 1.443, 95% CI: 1.240–1.743, P = 0.0002), and the secondary end point (odds ratio = 1.596, 95% CI: 1.17–1.56, P < 0.0001). Receiver-operating characteristic curve analysis showed that 3D-GLS was superior to 2D-GLS in predicting LVR and 1-year prognosis. Conclusion 3D-GLS obtained immediately after STEMI is independently associated with LVR and 1-year prognosis.


Author(s):  
Philip Goody ◽  
Sebastian Zimmer ◽  
Angela Zimmer ◽  
Jens Kreuz ◽  
Marc Becher ◽  
...  

Abstract Background: The diagnostic importance of three-dimensional (3D) speckle-tracking strain-imaging echocardiography in patients with acute myocarditis has not yet been assessed. The aim of this study was to test the sensitivity and specificity of 3D-speckle-tracking echocardiography as compared to CMR (cardiovascular magnetic resonance imaging) for the diagnosis of acute myocarditis. Methods and Results: 45 patients that were admitted to the Medical Clinic II of the University Hospital Bonn with clinically suspected myocarditis were enrolled in our study (71% male, mean age: 43.9±16.3 years, peak troponin level: 1.38±3.51 ng/ml). 3D full-volume echocardiographic images were obtained and offline speckle-tracking analysis of regional and global LV deformation was performed. All patients received CMR scans and myocarditis was diagnosed in 29 subjects. The 16 patients, in whom myocarditis was excluded by CMR, served as controls. Regional changes in myocardial texture and tissue edema (diagnosed by CMR) were significantly associated with regional impairment of circumferential, longitudinal, and radial strain, as well as regional 3D displacement and total 3D strain. The 3D diastolic strain index was not associated with pathological findings in the CMR. However, the 3D global longitudinal strain (GLS) outperformed well-known 2D parameters associated with myocarditis, such as LVEF and LVEDV. Conclusions: This is the first study examining the use of 3D-speckle-tracking echocardiography in patients with acute myocarditis. Global longitudinal strain was significantly associated with and impaired in patients with myocarditis. Therefore, 3D echocardiography could become a useful diagnostic tool in the primary diagnosis of myocarditis.


2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Mohammad Iqbal Janhangeer ◽  
Ghada Youssef ◽  
Weal El Naggar ◽  
Dalia El Remisy

Abstract Background Chronic heavy cigarette smoking can affect the right ventriclular function. The standard echocardiography may not show early right ventricular functional changes, and a more sensitive measure is needed. The aim of this work was to evaluate the subtle subclinical effects of chronic heavy cigarette smoking on the right ventricular function. The study included 55 healthy asymptomatic chronic heavy cigarette smokers (smoking history of at least 5 pack-years and a daily cigarette consumption of at least 1 pack) and 35 healthy non-smoking control subjects. Patients underwent a full clinical assessment and a conventional as well as a 2D-speckle tracking transthoracic echocardiography of the right ventricle and data was compared between the 2 groups. Results The mean age was 32.9 ± 7.2 years in smokers and 30.9 ± 7.9 years in non-smokers (p = 0.227). The 2 groups showed comparable conventional right ventricular systolic and diastolic functions. Smokers showed a significantly lower (less negative) right ventricular global longitudinal strain (− 19.0 ± 3.2% vs. − 24.5 ± 3.5%, p < 0.001). Patients with a higher daily cigarette consumption showed a poorer right ventricular global longitudinal strain (p = 0.014). Conclusion Chronic heavy cigarette smoking can adversely affect the right ventricular function, a finding that can be easily missed by conventional echocardiography and can be better detected by the right ventricular speckle tracking.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Takahashi ◽  
T Kitai ◽  
T Watanabe ◽  
T Fujita

Abstract Background Low-voltage zone (LVZ) in the left atrium (LA) seems to represent fibrosis. LA longitudinal strain assessed by speckle tracking method is known to correlate with the extent of fibrosis in patients with mitral valve disease. Purpose We sought to identify the relationship between LA longitudinal strain and LA bipolar voltage in patients with atrial fibrillation (AF). We tested the hypothesis that LA strain can predict LA bipolar voltage. Methods A total of 96 consecutive patients undergoing initial AF ablation were analyzed. All patients underwent transthoracic echocardiography including 2D speckle tracking measurement on the day before ablation during sinus rhythm (SR group, N=54) or during AF (AF group, N=42). LA longitudinal strain was measured at basal, mid, and roof level of septal, lateral, anterior, and inferior wall in apical 4- and 2-chamber view. Global longitudinal strain (GLS) was defined as an average value of the 12 segments. LA voltage map was created using EnSite system, and global mean voltage was defined as a mean of bipolar voltage of the whole LA excluding pulmonary veins and left atrial appendage. LVZ was defined as less than 1.0 mV. Results There was a significantly positive correlation between GLS and global mean voltage (r=0.708, p&lt;0.001). Multivariate regression analysis showed that GLS and age were independent predictors of global mean voltage. There was a significant negative correlation between global mean voltage and LVZ areas. Conclusions There was a strong correlation between LA longitudinal strain and LA mean voltage. GLS can independently predict LA mean voltage, subsequently LVZ areas in patients with AF. Funding Acknowledgement Type of funding source: None


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