scholarly journals Speckle-Tracking Echocardiography in Cardio-Oncology and Beyond

2020 ◽  
Vol 47 (2) ◽  
pp. 96-107 ◽  
Author(s):  
Raymundo A. Quintana ◽  
Linh P. Bui ◽  
Rohit Moudgil ◽  
Nicolas Palaskas ◽  
Saamir Hassan ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Myocardial Strain ◽  
Case Series ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Myocardial Segment ◽  
Ventricular Ejection Fraction ◽  
Cardiovascular Side Effects

Speckle-tracking echocardiography has enabled clinicians to detect changes in myocardial function with more sensitivity than that afforded by traditional diastolic and systolic functional measurements, including left ventricular ejection fraction. Speckle-tracking echocardiography enables evaluation of myocardial strain in terms of strain (percent change in length of a myocardial segment relative to its length at baseline) and strain rate (strain per unit of time). Both measurements have potential for use in diagnosing and monitoring the cardiovascular side effects of cancer therapy. Regional and global strain measurements can independently predict outcomes not only in patients who experience cardiovascular complications of cancer and cancer therapy, but also in patients with a variety of other clinical conditions. This review and case series examine the clinical applications and overall usefulness of speckle-tracking echocardiography in cardio-oncology and, more broadly, in clinical cardiology.

scholarly journals Assessment of aortic and mitral annuli dynamics during the cardiac cycle using speckle tracking echocardiography

2014 ◽  
Vol 1 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Wenjuan Bai ◽  
Hui Li ◽  
Hong Tang ◽  
Qing Zhang ◽  
Ye Zhu ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Speckle Tracking ◽  
Cardiac Cycle ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Healthy Adults ◽  
Aortic Annulus ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

The aims of this study were i) to evaluate mitral and aortic annuli excursion, and aortomitral angle (AMA) during the cardiac cycle in healthy adults using two-dimensional speckle tracking echocardiography, ii) to assess two annuli dynamics and coupling behaviors as an integral, and iii) to detect the relation between two annuli and left ventricular ejection fraction (LVEF). A total of 74 healthy adults underwent transthoracic echocardiography. In the parasternal long-axis view, a number of points were extracted, including right coronary aortic annular, aortomitral fibrous junction, and posterior mitral annular points. The annuli excursion and AMA were measured using a speckle tracking-derived software during the cardiac cycle. During the isovolumic contraction and the isovolumic relaxation phase, annuli excursion and AMA remain stable for a short time. During the systole, annuli excursion increased sharply to the maximum, while AMA narrowed quickly to the minimum value. During the diastole, there are three patterns of decrease in annuli excursion and AMA expansion in different phases. The annuli excursion of three points correlates well with the LVEF (right coronary aortic annulus excursion, r=0.71, P<0.05; non-coronary aortic annulus excursion, r=0.70, P<0.05; posterior mitral annulus excursion, r=0.82, P<0.05). Moreover, there are positive correlations between annuli excursion and the variation of AMA (r=0.60, P<0.05). The annuli excursion and AMA have various regular patterns in healthy adults. The interactions of mitral and aortic annuli correlate with the left ventricular function. Our findings may have relevance to the evaluation of left ventricular function and presurgical planning of patients with valvular diseases.

scholarly journals Left Ventricular Myocardial Deformations in Hemodialysis Children by Speckle Tracking Echocardiography

2020 ◽  
Vol 14 ◽  
pp. 117954682093001
Author(s):  
Manal F Elshamaa ◽  
Fatma A Mostafa ◽  
Inas AES Sad ◽  
Ahmed M Badr ◽  
Yomna AEM Abd Elrahim
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Radial Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Myocardial Mechanics

Background: Cardiac systolic dysfunction was potentially found in adult patients with end-stage renal disease (ESRD) who have preserved left ventricular ejection fraction (EF%). In children with ESRD, little data are available on early changes in myocardial function. This study aimed to detect the early changes in myocardial mechanics in pediatric patients with ESRD using speckle tracking echocardiography (STE). Methods: Thirty ESRD children receiving hemodialysis (HD) and30 age-matched controls were prospectively studied. Patients underwent echocardiographic studies before and after HD. Left ventricular longitudinal strain (LS), circumferential strain (CS), and radial strain (RS) myocardial deformation parameters (strain, strain rate) were evaluated by STE. Results: The LS was significantly reduced in pre-HD and post-HD patients compared with controls ( P = .000). Controls showed the highest global longitudinal strain. The RS measurements did not differ significantly among the studied groups except for the inferior segment that is significantly reduced after HD compared with controls ( P < .05). The CS was significantly reduced in pre-HD and post-HD patients compared with controls at the lateral and posterior segments ( P = .035 and P = .013, respectively). Conclusion: Speckle-tracking echocardiography might detect early changes in myocardial mechanics in children with ESRD with preserved EF%.

scholarly journals Diagnostic and Predictive Value of Speckle Tracking Echocardiography in Cardiac Sarcoidosis

2019 ◽  
Author(s):  
Cristina Di Stefano ◽  
Giulia Bruno ◽  
Maria Arciniegas Calle ◽  
Gayatri A. Acharya ◽  
Lynn M. Fussner ◽  
...  
Keyword(s):  
Heart Failure ◽  
Speckle Tracking ◽  
Cardiac Sarcoidosis ◽  
Speckle Tracking Echocardiography ◽  
Early Stage ◽  
Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Strain And Strain Rate

Abstract Background: Sarcoidosis is a systemic granulomatous disease that may affect the myocardium. This study evaluated the diagnostic and prognostic value of 2-dimensional speckle tracking echocardiography in cardiac sarcoidosis (CS). Methods: Eighty-three patients with extracardiac, biopsy-proven sarcoidosis and definite/probable diagnosis of cardiac involvement diagnosed from January 2005 through December 2016 were included. Strain parameters in early stages of CS, in a subgroup of 23 CS patients with left ventricular ejection fraction (LVEF) within normal limits (LVEF>52% for men: >54% for women, mean value: 57.3%±3.8%) and no wall motion abnormalities was compared with 97 controls (1:4) without cardiac disease. LV and right ventricular (RV) global longitudinal (GLS), circumferential (GCS), and radial (GRS) strain and strain rate (SR) analyses were performed with TomTec software and correlated with cardiac outcomes (including heart failure and arrhythmias). This study was approved by the Mayo Clinic Institutional Review Board, and all patients gave informed written consent to participate. Results: Mean age of CS patients was 53.6±10.8 years, and 34.9% were women. Mean LVEF was 43.2%±12.4%; LV GLS, -12.4%±3.7%; LV GCS, -17.1%±6.5%; LV GRS, 29.3%±12.8%; and RV wall GLS, 14.6%±6.3%. In the 23 patients with early stage CS with normal LVEF and RV systolic function, strain parameters were significantly reduced when compared with controls (respectively: LV GLS, -15.9%±2.5% vs -18.2%±2.7% [ P =.001]; RV GLS, -16.9%±4.5% vs -24.1%±4.0% [ P <.001]). A LV GLS value of -16.3% provided 82.2% sensitivity and 81.2% specificity for the diagnosis of CS (AUC 0.91), while a RV value of -19.9% provided 88.1% sensitivity and 86.7% specificity (AUC 0.93). Hospital admission and heart failure significantly correlated to impaired LV GLS (> -14%). Conclusion: Reduced strain values in the LV GLS and RV GLS can be used in the diagnostic algorithm in patients with suspicion of cardiac sarcoidosis. These values also correlate with adverse cardiovascular events.

scholarly journals Three Dimensional Speckle Tracking Echocardiography (3D-STE) for Early Detection of Subtle Myocardial Deformation Dysfunction in Thalassemic Patients

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2158-2158
Author(s):  
Hala Mounir Mohamed Moustafa Agha ◽  
Antoine AbdelMassih ◽  
Mohamed Youssef Abd El Rahman ◽  
Ornella Milanesi, ◽  
Biagio Castaldi ◽  
...  
Keyword(s):  
Early Detection ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Myocardial Deformation ◽  
Left Ventricular Ejection ◽  
Myocardial Iron ◽  
Ventricular Ejection Fraction ◽  
Control Subjects

Abstract Background: Among patients with beta-thalassemia early detection of transfusion-induced myocardial iron loading and its intervention with aggressive chelation therapy may delay or reverse heart failure. Three dimensional speckle tracking echocardiography (3D-STE) is a novel tool that may early detect myocardial affection in these patients. Methods: Thirty-two thalassemic patients with a mean age of 18.1± 7.03 years and 30 aged matched healthy control subjects have been included in the study. Patients have been recruited from pediatric hematology clinics in both Cairo University, Egypt (n=18) and Padova University, Italy (n=14). 3D-STE was performed to all patients and control subjects in addition to the myocardial relaxometry T2* by cardiac MRI. Results: The left ventricular ejection fraction (LVEF) derived from 3D echocardiography among the studied thalassemia patients was within normal range 62.5± 5.6%. Compared to the normal subjects, thalassemia patients had a statistical significant reduction of the left ventricular global longitudinal strain (-16.81± 0.93% vs -18.76 ± 1.12 %, p=0.001), the left ventricular global circumferential strain (-10.56 ± 0.61% vs -11.83 ± 0.71 %, p=0.001 ) and the left ventricular global area strain (-20.13 ±1.18% vs -22.48 ±,1.29 %, p=0.001). No statistical significant correlation was found between the severity of myocardial iron overload measured by T2* and the measured left ventricular global strain. Conclusion: In asymptomatic thalassemia patients with preserved left ventricular global systolic function 3D-STE derived strain can detect early subtle myocardial dysfunction. The observed subtle myocardial deformation dysfunction is not related to the extent of myocardial iron deposition. Disclosures No relevant conflicts of interest to declare.

scholarly journals Association Between Myocardial Strain and Frailty in CHS

2021 ◽  
Author(s):  
Annabel X. Tan ◽  
Sanjiv J. Shah ◽  
Jason L. Sanders ◽  
Bruce M. Psaty ◽  
Chenkai Wu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Community Dwelling ◽  
Left Ventricular Ejection ◽  
Cross Sectional ◽  
Risk Of Death ◽  
Lower Strain

Background: Myocardial strain, measured by speckle-tracking echocardiography, is a novel measure of subclinical cardiovascular disease and may reflect myocardial aging. We evaluated the association between myocardial strain and frailty—a clinical syndrome of lack of physiological reserve. Methods: Frailty was defined in participants of the CHS (Cardiovascular Health Study) as having ≥3 of the following clinical criteria: weakness, slowness, weight loss, exhaustion, and inactivity. Using speckle-tracking echocardiography data, we examined the cross-sectional (n=3206) and longitudinal (n=1431) associations with frailty among participants who had at least 1 measure of myocardial strain, left ventricular longitudinal strain (LVLS), left ventricular early diastolic strain rate and left atrial reservoir strain, and no history of cardiovascular disease or heart failure at the time of echocardiography. Results: In cross-sectional analyses, lower (worse) LVLS was associated with prevalent frailty; this association was robust to adjustment for left ventricular ejection fraction (adjusted odds ratio, 1.32 [95% CI, 1.07–1.61] per 1-SD lower strain; P =0.007) and left ventricular stroke volume (adjusted OR, 1.32 [95% CI, 1.08–1.61] per 1-SD lower strain; P =0.007). In longitudinal analyses, adjusted associations of LVLS and left ventricular early diastolic strain with incident frailty were 1.35 ([95% CI, 0.96–1.89] P =0.086) and 1.58 ([95% CI, 1.11–2.27] P =0.013, respectively). Participants who were frail and had the worst LVLS had a 2.2-fold increased risk of death (hazard ratio, 2.20 [95% CI, 1.81–2.66]; P <0.0001). Conclusions: In community-dwelling older adults without prevalent cardiovascular disease, worse LVLS by speckle-tracking echocardiography, reflective of subclinical myocardial dysfunction, was associated with frailty. Frailty and LVLS have an additive effect on mortality risk.

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