scholarly journals Left ventricle longitudinal strain of the endocardial and epicardial layers and left ventricle remodelling in children born with low and extremely low body weight aged from one to five years old

2021 ◽  
Vol 8 (2) ◽  
pp. 23-36
Author(s):  
E. N. Pavlyukova ◽  
M. V. Kolosova ◽  
G. V. Neklyudova ◽  
R. S. Karpov
Keyword(s):  
Body Weight ◽  
Left Ventricle ◽  
Premature Infants ◽  
Longitudinal Strain ◽  
Left Ventricular ◽  
Termination Of Pregnancy ◽  
Healthy Children ◽  
Weight Changes ◽  
2D Strain ◽  
Transmural Gradient

Background. In last decades, the number of babies born preterm has increased significantly. Premature newborns are more susceptible to cardiovascular disease in the long-term. To identify subclinical myocardial impairment in premature infants, an assessment of of the left ventricle (LV) deformation could be used.Objective. The aim of the study was to study the left ventricle (LV) Longitudinal Strain of the endocardial, middle and epicBardial layers in children born with very low and extremely low body weight, at the age from one to five years.Design and methods. The study included 88 children aged from one to 5 years old, born very premature with very low and extremely low body weight. The comparison group consisted of 43 healthy children of the same age, born full-term. The LV Longitudinal Strain of the endocardial, middle and epicardial layers was studied using the Speckle Tracking Imaging-2D Strain.Results. In children aged 1 to 5 years, born with very low and extremely low body weight, changes in the gradient of transmural wall Strain and a decrease in LV segments longitudinal strain were detected in 15.90 % and 14.77 % of cases, respectively. Mothers of children born prematurely and who subsequently registered disturbance of the transmural gradient of left ventricular strain in 10 cases (71.43 %) had a history of threatened termination of pregnancy. The threat of termination of pregnancy was noted in all women whose children had a decrease in LV segmental strain. In children who have normal of LV segmental strain, the threat of termination of pregnancy in mothers was registered in 16 cases (26.23 %). LV remodeling is observed in children with a change in the gradient of transmural wall strain or and with a decrease in LV longitudinal segment strain. Conclusion. Changes in the transmural gradient of wall deformation or reduction of segmental LV deformation in the longitudinal direction in premature infants require correction of the conventional algorithm of dispensary observation in an outpatient setting.

Reference values for two-dimensional myocardial strain echocardiography of the left ventricle in healthy children

2019 ◽  
Vol 29 (3) ◽  
pp. 325-337
Author(s):  
Laurens P. Koopman ◽  
Bas Rebel ◽  
Devi Gnanam ◽  
Mirthe E. Menting ◽  
Willem A. Helbing ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Strain Rate ◽  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Left Ventricular ◽  
Myocardial Deformation ◽  
Healthy Children ◽  
Deformation Parameters ◽  
Strain And Strain Rate ◽  
Echocardiographic Parameters

AbstractBackgroundMyocardial deformation by speckle tracking echocardiography provides additional information on left ventricular function. Values of myocardial deformation (strain and strain rate) depend on the type of ultrasound machine and software that is used. Normative values for QLAB (Philips) are scarce, especially for children. It is important to evaluate the influence of age and body size on myocardial deformation parameters, since anthropometrics strongly influence many standard echocardiographic parameters. The aim of this study was to provide comprehensive normal values for myocardial deformation of the left ventricle using a Philips platform and to evaluate the association with anthropometric and standard echocardiographic parameters.MethodsHealthy children between 1 and 18 years of age were prospectively examined using a standard echocardiographic protocol. Short-axis and apical four-chamber, two-chamber, and three-chamber views were used to measure peak systolic circumferential and longitudinal strain and systolic and early diastolic strain rate of the left ventricle using dedicated software.ResultsA total of 103 children were included with a mean age of 10.8 and inter-quartile range 7.3–14.3 years. Global circumferential strain values (±SD) were −24.2±3.5% at basal, −25.8±3.5% at papillary muscle, and −31.9±6.2% at apex levels. Global left ventricular longitudinal strain values were −20.6±2.6% in apical four-chamber view, −20.9±2.7% in apical two-chamber, and −21.0 ±2.7% in apical three-chamber. Age was associated with longitudinal strain, longitudinal systolic and early diastolic strain rate, but not with circumferential strain.ConclusionsNormal values for left ventricular deformation parameters in children are obtained using a Philips platform. Age partly explains normal variation of strain and strain rate.

P14893D strain echocardiography in assessing left ventricular diastolic dysfunction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H T Ozer ◽  
O Ozer ◽  
C Coteli ◽  
A Kivrak ◽  
M L Sahiner ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Longitudinal Strain ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Volume Index ◽  
Heart Catheterization ◽  
Left Heart ◽  
Left Heart Catheterization ◽  
2D Strain

Abstract Background Diastolic dysfunction is an important factor in the development of heart failure with preserved ejection fraction (HFpEF). As the ejection fraction is preserved in HFpEF, the diagnosis of this disease with non-invasive methods is difficult. Purpose In this study, the relationship of BNP, NT-proBNP, Ghrelin, and echocardiographic 3D strain findings with diastolic dysfunction was investigated in patients undergoing left heart catheterization. Methods Our study is a cross-sectional study and included 78 patients in whom echocardiography was performed, and who underwent left heart catheterization based on relevant indications. The patient data recorded for evaluation included the findings from left heart catheterization, follow-up 3D echocardiography; and the levels of blood NT-proBNP, and Ghrelin. Results The rate of diastolic dysfunction was 42.3%. Longitudinal 2D and 3D mean strain as absolute values were observed to decrease more in patients with diastolic dysfunction. The median levels of BNP, NT-proBNP, and Ghrelin levels were higher in patients with diastolic dysfunction. The independent predictors of diastolic dysfunction were determined to be the left atrial volume index (LAVI) (OR=1.17; p=0.018), longitudinal 3D strain values (OR=1.88; p<0.001), NT-proBNP (OR=1.11; p=0.001), and Ghrelin (OR=1.40; p=0.001), respectively. Relationship Between LV EDP and LV Longitudinal Strain LV EDP 2D Strain 3D Strain r p r p r p BNP, pg/ml 0.429 <0.001* 0.115 0.316 0.178 0.118 NT-proBNP, pg/ml 0.484 <0.001* 0.155 0.177 0.186 0.104 Ghrelin, pg/ml 0.478 <0.001* 0.086 0.455 0.157 0.169 SolV DB – – 0.481 <0.001* 0.591 <0.001* dP/dT −0.389 <0.001* −0.283 0.012* −0.307 0.006* Negative dP/dT −0.747 <0.001* −0.337 0.003* −0.458 <0.001* 2D. % 0.481 <0.001* – – 0.852 <0.001* 3D. % 0.591 <0.001* 0.852 <0.001* – – If p value is less than 0.05 shows statistical significance. Measurement of longitudinal strain Conclusion In conclusion, our study found out that the reduced 3D strain absolute values and increased levels of NT-proBNP and Ghrelin biomarkers predicted diastolic dysfunction. If further large-scale studies prove the efficiency of these practical, they may not only allow for making a diagnosis of HFpEF more readily but may also eliminate the confusion in diagnostic algorithms. Acknowledgement/Funding None

scholarly journals Distribution pattern of left-ventricular myocardial strain analyzed by a cine MRI based deformation registration algorithm in healthy Chinese volunteers

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Hong Liu ◽  
Dan Yang ◽  
Ke Wan ◽  
Yong Luo ◽  
Jia-Yu Sun ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Left Ventricle ◽  
Longitudinal Strain ◽  
Myocardial Strain ◽  
Distribution Patterns ◽  
Left Ventricular ◽  
Cine Mri ◽  
Registration Algorithm ◽  
Healthy Chinese ◽  
Chinese Subjects

AbstractThe cine magnetic resonance imaging based technique feature tracking-cardiac magnetic resonance (FT-CMR) is emerging as a novel, simple and robust method to evaluate myocardial strain. We investigated the distribution characteristics of left-ventricular myocardial strain using a novel cine MRI based deformation registration algorithm (DRA) in a cohort of healthy Chinese subjects. A total of 130 healthy Chinese subjects were enrolled. Three components of orthogonal strain (radial, circumferential, longitudinal) of the left ventricle were analyzed using DRA on steady-state free precession cine sequence images. A distinct transmural circumferential strain gradient was observed in the left ventricle that showed universal increment from the epicardial to endocardial myocardial wall (epiwall: −15.4 ± 1.9%; midwall: −18.8 ± 2.0%; endowall: −22.3 ± 2.3%, P < 0.001). Longitudinal strain showed a similar trend from epicardial to endocardial layers (epiwall: −16.0 ± 2.9%; midwall: −15.6 ± 2.7%; endowall: −14.8 ± 2.4%, P < 0.001), but radial strain had a very heterogeneous distribution and variation. In the longitudinal direction from the base to the apex of the left ventricle, there was a trend of decreasing peak systolic longitudinal strain (basal: −23.3 ± 4.6%; mid: −13.7 ± 7.3%; apical: −13.2 ± 5.5%; P < 0.001). In conclusion, there are distinct distribution patterns of circumferential and longitudinal strain within the left ventricle in healthy Chinese subjects. These distribution patterns of strain may provide unique profiles for further study in different types of myocardial disease.

Left ventricular myocardial velocities in healthy children: quantitative assessment by tissue Doppler echocardiography and relation to the characteristics of filling of the left ventricle

2004 ◽  
Vol 14 (2) ◽  
pp. 156-163 ◽  
Author(s):  
Canan Ayabakan ◽  
Süheyla Özkutlu
Keyword(s):  
Left Ventricle ◽  
Longitudinal Velocity ◽  
Lateral Wall ◽  
Longitudinal Axis ◽  
Mitral Annulus ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Healthy Children ◽  
Diastolic Velocity ◽  
Mitral Annulus Velocity

Aim:To assess the myocardial velocities of the mitral annulus, left ventricular lateral wall, and midseptum in healthy children, and to compare these parameters with transmitral and pulmonary venous velocities.Methods and results:We examined 72 children, half being male, who had no systemic or cardiac pathologies. Their mean age was 6.73 ± 5.10 years, with a range from 0.1 to 17.75 years, and a median age of 6.71 years. Each parameter was measured twice, at end inspiration and end expiration. The tissue velocities are similar in males and females (p > 0.05). The longitudinal velocity of the heart in early diastole has a positive correlation with age (p < 0.05; midseptum velocity r = 0.57, left ventricular lateral wall velocity r = 0.56, mitral annulus velocity r = 0.56), and the tissue velocities are not influenced by respiration (p > 0.05). The myocardial velocities of different segments of the left ventricle are not correlated with the transmitral or pulmonary venous flows (p < 0.05). When age is controlled for heart rate, age mainly affects the systolic velocity of the mitral annulus and the early diastolic velocity of the midseptum in longitudinal axis, as well as the early diastolic velocity of the midseptum in transverse axis (p > 0.05 for all, r = 0.34, 0.29, 0.30 respectively).Conclusion:This study, which has determined reference values for tissue velocities in a large healthy group of children, will now set the scene for further studies in children with heart disease.

Prognostic value of automated longitudinal strain measurements in asymptomatic aortic stenosis

Heart ◽  
2020 ◽  
pp. heartjnl-2020-318256
Author(s):  
Tetsuji Kitano ◽  
Yosuke Nabeshima ◽  
Kazuaki Negishi ◽  
Masaaki Takeuchi
Keyword(s):  
Aortic Stenosis ◽  
Longitudinal Strain ◽  
Univariate Analysis ◽  
Ventricular Tachyarrhythmia ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Prognostic Information ◽  
End Point ◽  
2D Strain ◽  
Significant Difference

ObjectiveTwo-dimensional (2D) longitudinal strain (LS) predicts cardiac events in aortic stenosis (AS). However, it requires manual editing, which affects its accuracy and reliability. We investigated whether left ventricular (LV), left atrial (LA) and right ventricular (RV) LSs using fully automated 2D strain software provide useful prognostic information in asymptomatic AS.MethodsWe performed LS analyses in 340 asymptomatic patients with AS using novel, fully automated 2D strain analytical software (AutoStrain, Philips) to obtain LV global LS (LVGLS), LALS, RV free wall LS and RVLS. The primary end point was a composite of cardiac events, including cardiac death, heart failure hospitalisation, myocardial infarction or ventricular tachyarrhythmia.ResultsDuring a median of 24 months follow-up, 46 patients reached a primary end point. 62 patients had aortic valve surgery. All four LSs were significantly associated with the primary end point using univariate analysis (HR 0.821 to 0.951, p<0.05). Multivariate analysis revealed that LVGLS (HR 0.873 to 0.888, p<0.05) remained significantly associated with cardiac events, even after adjusting haemodynamic measures of AS severity and LV ejection fraction. Kaplan-Meier survival curve showed median values of both LVGLS (cut-off: 15.1%) and LALS (cut-off: 22.3%) provide a significant difference in cardiac event rate (3-year event-free rate; LVGLS: 89% vs 76%, p=0.002; LALS: 89% vs 76%, p=0.001). Classification and regression-tree analysis, including four LSs, clinical characteristics and traditional echocardiographic parameters, selected LVGLS and E/ε’ for stratifying a high-risk group of patients with cardiac events.ConclusionsFully automated 2D LS analysis, especially LVGLS provides useful prognostic information in asymptomatic AS.

Segmentally impaired left ventricular longitudinal strain: a new predictive diagnostic parameter for asymptomatic patients with severe aortic stenosis and preserved ejection fraction

Perfusion ◽  
2021 ◽  
pp. 026765912199599
Author(s):  
Peggy M Kostakou ◽  
Elsie S Tryfou ◽  
Vassilios S Kostopoulos ◽  
Lambros I Markos ◽  
Dimitrios S Damaskos ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Aortic Stenosis ◽  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Severe Aortic Stenosis ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Average Strain ◽  
Asymptomatic Patients ◽  
Significant Difference

Introduction: This study aims to investigate the correlation between severe aortic stenosis (sAS) and impairment of left ventricular global longitudinal strain (LVGLS) in particular segments, using two-dimensional speckle tracking echocardiography in patients with sAS and normal ejection fraction of left ventricle (LVEF). Methods: The study included 53 consecutive patients with asymptomatic sAS and preserved LVEF. The regional longitudinal systolic LV wall strain was evaluated at the area opposite of the aorta as the median strain value of the basal, middle, and apical segments of the lateral and posterior walls and was compared to the average strain value of the interventricular septum (IVS) at the same views. Results: LVGLS was decreased and was not statistically different between three- and four-chamber views (−12.5 ± 3.6 vs −11.4 ± 5.5%, p = 0.2). The average strain values of the lateral and posterior walls were statistically reduced compared to the average value of the IVS (lateral vs IVS: −7.8 ± 3.7 vs −10 ± 5.3%, p = 0.005, posterior vs IVS: −7.7 ± 4.2 vs −10.3 ± 3.8%, p < 0.0001). There was no significant difference between lateral and posterior walls (−7.8 ± 3.7 vs −7.7 ± 4.2%, p = 0.9). Conclusions: The strain of lateral and posterior walls of left ventricle, which lay just opposite to the aortic valve seem to be more reduced compared to other walls in patients with sAS and preserved LVEF possibly due to their anatomical position. This impairment seems to be the reason of the overall LVGLS reduction. Regional strain could be used as an extra tool for the estimation of the severity of AS as well as for prognostic information in asymptomatic patients.

Effects of hypoxia on cardiac growth in neonatal rat

1976 ◽  
Vol 231 (5) ◽  
pp. 1445-1450 ◽  
Author(s):  
M Hollenberg ◽  
N Honbo ◽  
AJ Samorodin
Keyword(s):  
Body Weight ◽  
Left Ventricle ◽  
Cardiac Muscle ◽  
Neonatal Period ◽  
Vascular Endothelial Cells ◽  
Muscle Cells ◽  
Left Ventricular ◽  
Neonatal Rat ◽  
Low Oxygen ◽  
Cardiac Muscle Cells

To determine whether low oxygen environments enhance cardiac cell division in the neonatal period, newborn rat pups were reared for 21 days in 12-15% oxygen. Left ventricle and right ventricle weights were 30 and 180% greater than controls matched for body weight (P less than 0.001) as were left ventricle/body weight ratios (3.68+/-0.26 vs. 2.99+/-0.05 mg LV/g body wt,P less than 0.001). Left ventricular total DNA and DNA concentration was 95 and 48% greater than controls (P less than 0.001). Autoradiography confirmed that this increase in ventricular DNA resulted from an increased rate of division of cardiac muscle cells, fibroblast, and vascular endothelial cells. When [3H]thymidine was injected on day ), autoradiographs prepared on day 21 reflected an increased dilution of label in hypoxic rats consistent with enhanced proliferation. The labeling index and grains per nucleus of ventricular muscle cells was 25% (P less than 0.01) and 20% (P less than 0.02) less than controls, Thus, hypoxic stress applied early in the neonatal period augments the rate of division and ultimate number of cardiac muscle cells. Whether this enhancement results from a primary effect of oxygen or from secondary hemodynamic factors remains unknown.

Growth of the Heart and Lungs in Hypoxic Rodents: A Model of Human Hypoxic Disease

1974 ◽  
Vol 46 (3) ◽  
pp. 375-391 ◽  
Author(s):  
Carolin Hunter ◽  
Gwenda R. Barer ◽  
J. W. Shaw ◽  
E. J. Clegg
Keyword(s):  
Body Weight ◽  
Left Ventricle ◽  
Right Ventricle ◽  
Left Ventricular ◽  
Muscle Fibre Size ◽  
Littermate Control ◽  
Normal Environment ◽  
The Right ◽  
Rats And Mice ◽  
The Relationship

1. Rats and mice were kept in a decompression chamber at 52 kPa (390 mmHg) for 1–4 weeks and their hearts and lungs were compared with littermate control animals. In both species growth was retarded in the hypoxic environment. 2. In both species small peripheral lung vessels became thickened, developing two elastic laminae with a muscular coat between. A method was developed for assessing these changes in large numbers of animals. The number of thick-walled vessels was still high after 4 weeks' recovery in a normal environment. Pulmonary vascular resistance, measured by a perfusion method, increased in animals kept in the decompression chamber. 3. Mouse lungs became heavier than controls; the increase was not due to a greater fluid content. Rat lungs were heavy in relation to body weight but not heavier than controls; there may have been slight thickening of alveolar walls. Chest areas, measured from radiographs, were large relative to body weight in hypoxic rats. 4. The relationship between right and left ventricular weight and body weight was studied in normal rats and mice. The left ventricle grew about four times more quickly than the right. Changes in ventricular weights during exposure in the decompression chamber and subsequent recovery in a normal environment were related to these normal growth curves. 5. In both species the right ventricle grew abnormally fast in the decompression chamber. It was absolutely heavier than that of controls and relative to body weight was extremely heavy. After 4 weeks' recovery the relationship between right ventricular weight and body weight was nearly normal; this was achieved by retarded growth or actual loss of weight. 6. In mice the left ventricle grew normally in the decompression chamber and was heavy in relation to body weight. In rats its growth was retarded in the chamber and was normal in relation to body weight. 7. Morphometry of the hypertrophied right ventricle showed that muscle fibre size and total muscle mass had increased in hypoxic rats. There had been no increase in nuclear mass, but the perinuclear sarcoplasm had increased. All layers of the myocardium participated in the hypertrophy.

Left ventricular longitudinal strain and strain rate measurements in paediatric patients in long-term treatment for Chagas disease

2021 ◽  
pp. 1-7
Author(s):  
Alejandro Goldsman ◽  
Haydee Vazquez ◽  
Alberto Quilindro ◽  
María Sicurello ◽  
Mariana Cazalas ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Ejection Fraction ◽  
Chagas Disease ◽  
Longitudinal Strain ◽  
Heart Function ◽  
Left Ventricular ◽  
New Techniques ◽  
Paediatric Patients ◽  
Systolic And Diastolic Function

Abstract Introduction: Previous echocardiographic studies failed to show residual alterations of heart function in paediatric patients that have received treatment for Chagas disease. While the echocardiogram is the fundamental front-line tool for evaluating heart function, the appearance of new techniques allows a more detailed analysis. We aimed to evaluate systolic and diastolic function with new techniques in a paediatric population with Chagas disease several years after treatment completion. Material and methods: Echocardiograms were obtained from 84 Chagas disease patients (48 female) and 27 healthy controls. All patients had received treatment concluding on average 10 years prior to the study. The prospective analysis considered cardiac dimensions and cardiac function using two-dimensional, M-mode, Doppler and tissue Doppler imaging with emphasis on measuring longitudinal strain in the left ventricle by speckle tracking. Ejection fraction was measured with three-dimensional echocardiography. Results: Patients had an age of 14.2 ± 5.7 years (6–33) at the time of evaluation. Global and segmental motility of the left ventricle was normal in all patients. Ejection fraction was 59.2 ± 6.5 and 57.4 ± 6.5% (p = 0.31) in patients and controls respectively. Left ventricular global longitudinal systolic strain was −19 ± 2.4% in patients and −19 ± 3.6% (p = 0.91) in controls. No significant differences were found in remaining systolic and diastolic function measurements. Conclusions: Paediatric patients that have received treatment for Chagas disease, evaluated with either conventional techniques or new tools, do not show significant long-term alterations of ventricular function.

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