Quantification of Coupled Stiffness and Fiber Orientation Remodeling in Hypertensive Rat Right-Ventricular Myocardium Using 3D Ultrasound Speckle Tracking with Biaxial Testing

Introduction: In recent years, COPD is observed as not an isolated, but an associated pathology, in particular, concurrent with metabolic syndrome. The aim of the research is to identify the differences in changes of the rheopulmonography parameters (RPG) depending on the presence of hypertrophy or atrophy of the right ventricular myocardium in patients with COPD concurrent with metabolic syndrome.. Materials and methods: We studied changes in rheopulmonography (RPG) in 145 patients with chronic obstructive pulmonary disease (COPD) concurrent with metabolic syndrome. Results: We detected precapillary hypertension of the pulmonary circulation in patients with right ventricular myocardial hypertrophy: anacrotism serration; flattened peak of the systolic wave; decreased Vcp; high placement of incisura; horizontal course of catacrotism; decreased amplitude of the systolic wave (in this case, due to a greater increase in the resistance of the blood flow in the pulmonary vessels than the decreased impact volume of the right ventricle); prolonged Q-a (in this group of patients, it depends more on hypertension of the pulmonary circulation than on the reduction of contractile function of the myocardium). In atrophy of the right ventricular myocardium, the following changes in the RPG were revealed: decreased systolic wave at its dramatic rise; prolonged Q-a (in this case, due to the weakened heart contraction); Vmax reduction (it reflects the reduction of myocardial contractility); in hypertrophy of the myocardium, Vcp., unlike RPG, does not decrease, which is explained by the decrease in the pressure of the pulmonary circulation. Conclusions: We believe that these changes in RPG allow differentiating hypertrophy and right ventricular myocardial atrophy along with established diagnostic criteria, and can be used as markers for the diagnosis and treatment of COPD concurrent with metabolic syndrome.

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Evidence-based management of arrhythmogenic right ventricular cardiomyopathy in pregnancy

Future Cardiology ◽

10.2217/fca-2020-0127 ◽

2020 ◽

Author(s):

Jagjit Khosla ◽

Reshma Golamari ◽

Alice Cai ◽

Jamal Benson ◽

Wilbert S Aronow ◽

...

Keyword(s):

Heart Failure ◽

Right Ventricular ◽

Retrospective Studies ◽

Arrhythmogenic Right Ventricular Cardiomyopathy ◽

Genetic Disorder ◽

Ventricular Myocardium ◽

Evidence Based ◽

Ventricular Cardiomyopathy ◽

Genes Encoding ◽

In Pregnancy

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetic disorder resulting in fibrofatty replacement of the myocardium. Genetic mutations in genes encoding for desmosome proteins result in a ventricular myocardium prone to arrhythmias and heart failure. Although ARVC is known for a few decades, most of the outcomes in pregnancy are reported recently. Pregnancy leads to significant physiological changes with excess mechanical stress on the myocardium. All the retrospective studies suggest that pregnancy is well tolerated in these patients despite the high risk of arrhythmias and heart failure. Our review focuses on the most up-to-date evidence on the management of ARVC patients during the antepartum and postpartum period.

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Subtle right ventricular dysfunction in asymptomatic chronic heavy cigarette smokers: a speckle tracking case-control study

The Egyptian Heart Journal ◽

10.1186/s43044-021-00151-y ◽

2021 ◽

Vol 73 (1) ◽

Author(s):

Mohammad Iqbal Janhangeer ◽

Ghada Youssef ◽

Weal El Naggar ◽

Dalia El Remisy

Keyword(s):

Cigarette Smoking ◽

Right Ventricular ◽

Ventricular Function ◽

Right Ventricular Function ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Cigarette Consumption ◽

Cigarette Smokers ◽

The Right

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.

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Premature ventricular contractions of the right ventricular outflow tract: is there an incipient underlying disease? New insights from a speckle tracking echocardiography study

Indian Pacing and Electrophysiology Journal ◽

10.1016/j.ipej.2021.02.007 ◽

2021 ◽

Author(s):

Marta Fonseca ◽

Leonor Parreira ◽

José Maria Farinha ◽

Rita Marinheiro ◽

Ana Esteves ◽

...

Keyword(s):

Right Ventricular ◽

Speckle Tracking ◽

Speckle Tracking Echocardiography ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Underlying Disease ◽

Outflow Tract ◽

Premature Ventricular Contractions ◽

The Right

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Speckle tracking echocardiography in primary mitral regurgitation: should we reconsider the time for intervention?

Heart Failure Reviews ◽

10.1007/s10741-021-10100-1 ◽

2021 ◽

Author(s):

Maria Concetta Pastore ◽

Giulia Elena Mandoli ◽

Aleksander Dokollari ◽

Gianluigi Bisleri ◽

Flavio D’Ascenzi ◽

...

Keyword(s):

Mitral Regurgitation ◽

Right Ventricular ◽

Speckle Tracking ◽

Speckle Tracking Echocardiography ◽

Right Ventricular Dysfunction ◽

Left Ventricular ◽

Main Concern ◽

Cardiac Damage ◽

Asymptomatic Patients ◽

Right Ventricular Strain

Abstract Thanks to the improvement in mitral regurgitation (MR) diagnostic and therapeutic management, with the introduction of minimally invasive techniques which have considerably reduced the individual surgical risk, the optimization of the timing for MR “open” or percutaneous surgical treatment has become a main concern which has highly raised scientific interest. In fact, the current indications for intervention in MR, especially in asymptomatic patients, rely on echocardiographic criteria with high severity cut-offs that are fulfilled only when not only mitral valve apparatus but also the cardiac chambers’ structure and function are severely impaired, which results in poor benefits for post-operative clinical outcome. This led to the need of new indices to redefine the optimal surgical timing in these patients. Speckle tracking echocardiography provides early markers of cardiac dysfunction due to subtle myocardial impairment; therefore, it could offer pivotal information in this setting. In fact, left ventricular and left atrial strains have already shown evidence about their usefulness in recognizing MR impact not only on symptoms and quality of life but also on cardiovascular events and new-onset atrial fibrillation in these patients. Moreover, right ventricular strain could be used to identify those patients with advanced cardiac damage and different grades of right ventricular dysfunction, which entails higher risks for cardiac surgery that could overweigh surgical benefits. This review aims to describe the importance of reconsidering the timing of intervention in MR and to analyze the potential additive value of speckle tracking echocardiography in this clinical setting.

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