scholarly journals Three and Two-Dimensional Cardiac Mechanic Parameters by Speckle Tracking Echocardiography are Predictors of Outcomes In Chagas Heart Disease

Author(s):  
Viviane Tiemi Hotta ◽  
Maria Cristina Donadio Abduch ◽  
Marcelo Luiz Campos Vieira ◽  
Andrea Andrade Vilela ◽  
Edimar Alcides Bocchi

Abstract BACKGROUND: Chagas disease (CD) is a neglected infectious disease associated with early mortality and substantial disability. Three-dimensional speckle tracking (3D STE) may play a role in the evaluation of CD. We aim to characterize new echocardiographic variables in patients with CD and to assess the hypothesis that 3D STE may predict outcomes. METHODS: Seventy-two patients with CD were included. Clinical and conventional 2D and 3D STE analysis were performed. Patients were followed up for sixty months. Clinical events were defined as hospitalization for heart failure, complex ventricular arrhythmias, heart transplant and all-cause death. RESULTS: Seventy-two patients were recruited and enrolled in three groups: left ventricular ejection fraction (LVEF) < 0.40 (N=22); 0.40 < LVEF < 0.50 (N=10) and LVEF > 0.50 (N=30). After a Cox model analysis, the top predictors of composite endpoints were 2D LV global longitudinal strain (GLS) ≤ -11.3% (AUC=0.87), 2D LV global circumferential strain (GCS) ≤ -10.1% (AUC=0.79), 3D LV GLS≤ -13% (AUC=0.82), 3D LV area strain ≤ -16% (AUC=0.81) and right ventricle (RV) GLS ≤ -17.2% (AUC=0.78). CONCLUSIONS: Patients with CD and mrLVEF were morphologically similar to the rLVEF patients despite the benign evolution as the pLVEF group. RV GLS, 2D LV GLS, 2D LV GCS, 3D LV GLS, and 3D LV area strain are strong predictors of sixty months outcomes in patients with CD.

2020 ◽  
Vol 14 ◽  
pp. 117954682093001
Author(s):  
Manal F Elshamaa ◽  
Fatma A Mostafa ◽  
Inas AES Sad ◽  
Ahmed M Badr ◽  
Yomna AEM Abd Elrahim

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%.


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 ◽  
...  

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.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
V T Hotta ◽  
L M B Martinelli ◽  
F Fernandes ◽  
V A Moises ◽  
M L C Vieira ◽  
...  

Abstract Introduction Left ventricular non-compaction (LVNC) is a relatively new cardiomyopathy, first reported by Chin et al. in 1990. Since then, much has been learned about this entity, but until now, there are some limitations for the diagnosis of this disease. Cardiac Magnetic Resonance Imaging is considered the gold standard for the diagnosis of LVNC, but echocardiography remains the first line imaging modality due to its availability and cost efficacy. Case report In this case, we report a case of an asymptomatic 21 years old young male with no personal or familiar history of cardiomyopathies. Two dimensional echocardiography (2D Echo) evidenced increased left ventricular trabeculation in the apical segments of lateral and anterior walls and a non compacted myocardium/ (compacted + non compacted myocardium) ratio of 0,33, compatible with LVNC according to Chin´s criteria. 3D Echo provided more detailed LV morphology analysis and 3D Echo Color Doppler evidenced ventricular flow within the intraventricular recesses. Strain analysis by speckle tracking (STE) evidenced global longitudinal strain = - 17% (Normal values &lt; -18%), probably related to an incipient systolic dysfunction not evidenced by the evaluation of left ventricular ejection fraction by 2D Echo. Conclusions This case illustrates new echocardiographic modalities for LVNC diagnosis. 3D Echo and STE are new technologies that may play an incremental role in the evaluation of LVNC but need further investigation and validation. Abstract P697 Figure.


2020 ◽  
Vol 6 (1) ◽  
pp. 20-23
Author(s):  
Liliana Gozar ◽  
Daniela Toma ◽  
Amalia Făgărășan ◽  
Dorottya Miklósi ◽  
Rodica Togănel

AbstractCongenital aortic stenosis (AS) occurs in around 0.2–0.5% of newborns, and its clinical severity is quite variable. Some of the newborns with AS require urgent medical care: prostaglandin infusion, balloon aortic valvuloplasty, or surgical intervention. Despite having a severe clinical evolution in neonates, the prenatal diagnosis of congenital AS is quite low. We present the case of a fetus with critical AS, who had been prenatally diagnosed at 35 weeks of gestation, via fetal cardiac ultra-sound. The echocardiographic parameters revealed a severely depressed left ventricular systolic function, with dilated chambers, and a severe aortic stenosis. Offline speckle-tracking analysis was performed in order to aid in deciding the optimal methods and timing of delivery. Left ventricular analysis revealed a severely impaired global longitudinal strain of 2.1%, left ventricular ejection fraction 18.4%, increased LV volumes, while the right ventricular function was only mildly depressed. Therefore, the decision was to delay the premature delivery, and the fetus was born at a gestational age of 38 weeks, in a hospital with a neonatal cardiovascular surgery department. The patient had undergone surgical repair of the cardiac anomaly at 3 days after birth.


2021 ◽  
Vol 5 (4) ◽  
pp. 169-175
Author(s):  
E.G. Akramova ◽  
◽  
Е.V. Vlasova ◽  
◽  

Aim: to assess the results of speckle tracking echocardiography (STE) in patients of working age with acute inferior wall myocardial infarction (MI) in the early period after coronary stenting. Patients and Methods: STE was performed using EPIQ-7 Ultrasound Machine (Philips, USA) in 55 patients with acute inferior wall MI one week after percutaneous coronary intervention and 29 healthy individuals of working age. Patients with acute inferior wall MI were divided into two subgroups, i.e., with (n=45) or without (n=10) areas of local contractile impairment (dyskinesia, akinesia, hypokinesia). Results: the most common cause of MI was the occlusion of the right coronary artery (82.4% in subgroup 1 and 60% in subgroup 2) in multivascular involvement (84.4% and 90%. respectively). In patients with local contractile impairment, reduced left ventricular ejection fraction (EF) was reported in 28.9%, global longitudinal strain in 86.7%, and global circular strain in 76.7%. Meanwhile, in patients without local contractile impairment, left ventricular ejection fraction (LV EF) was within normal ranges, global longitudinal strain was reported in 100% and global circumferential strain in 70%. The presence and severity of local dysfunction did not affect the reduction in segmental strain (median varied from -9% to -15%). In inferior wall MI, the abnormal regional longitudinal strain of 6 LV segments (basal and mid inferoseptal, inferior, and inferolateral) was reported in both hypokinesia and normokinesia. Conclusions: ultrasound evaluation of systolic LV function using STE is characterized by greater diagnostic value compared to the measurement of EF only and objectifies the efficacy of surgery. Quantitative assessment of the recovery of both global and local systolic contractility is another advantage of STE allowing for personalized treatment. KEYWORDS: inferior wall myocardial infarction, echocardiography, speckle tracking technology, percutaneous coronary intervention, ejection fraction. FOR CITATION: Akramova E.G., Vlasova Е.V. Assessment of left ventricular contractility in acute inferior wall myocardial infarction by speckle tracking echocardiography. Russian Medical Inquiry. 2021;5(4):169–175 (in Russ.). DOI: 10.32364/2587-6821-2021-5-4-169-175.


scholarly journals P697New indices for a best quantification of left ventricular function in heart valve diseasesP698Intrapatient comparison of three echocardiographic techniques of determination of left ventricular (LV) longitudinal strain, and evaluation of their respective relationship to ejection fractionP699Myocardial strain as an early marker of cardiac dysfunction in a large cohort of anthracycline-treated pediatric cancer survivors?P700Resting 2D speckle tracking echocardiography for the prediction of death 5 years after ST- elevation myocardial infarctionP701Use of fully automated software to quantify left ventricular ejection fraction and left ventricular global longitudinal strainP702Can two-dimensional speckle tracking echocardiography be useful for the left ventricular assessment in the early stages of hereditary hemochromatosis?P703Assessment of left ventricular ejection fraction, global longitudinal strain and mechanical dispersion in acute myocardial infarction after revascularization with percutaneous coronary interventionP704Echocardiographic predictors of worse outcome in patients with ischemic chronic heart failure and renal disfunctionP705Impact of volume overload on right ventricular systolic and diastolic functions evaluated by speckle tracking echocardiographyP706Detection and localisation of obstructive coronary artery disease in chronic stable angina by myocardial deformation parmaters using tissue doppler imagingP707The determinants of deleterious effects of diabetes on the myocardiumP708Echocardiographic evaluation of the left atrium function after catheter ablation of long-standing persistent atrial fibrillationP709Early assessment of chemotherapy-related cardiovascular toxicity: an integrated evaluation through global longitudinal strain and arterial stiffness studyP710Prognostic value of right atrial 3-dimensional speckle tracking in different types of pulmonary arterial hypertensionP711Assessment of biventricular strain by 3-dimensional speckle-tracking echocardiography in chronic aortic regurgitation

2016 ◽  
Vol 17 (suppl 2) ◽  
pp. ii143-ii147
Author(s):  
A. Hubert ◽  
D. De Zuttere ◽  
MG. Slieker ◽  
E. Szymczyk ◽  
V. Sokalskis ◽  
...  

2021 ◽  
Vol 13 (10) ◽  
pp. 32
Author(s):  
Marília Matos Marília Matos Oliveira ◽  
Beatriz Hallal Jorge Lara ◽  
Janaíne Machado Tomé ◽  
Beatriz Pires Ferreira ◽  
Maria Candida Calzada Borges ◽  
...  

BACKGROUND: Acromegaly is most commonly caused by growth hormone secreting pituitary (GH) macroadenoma. Cardiovascular events are the leading cause of death in this population. OBJECTIVE: To analyze the cardiac structural and functional changes in patients with acromegaly and to correlate the findings with the concentrations of GH and IGF-1 post treatment and with the presumed time of disease. METHOD: A quantitative study involving 19 individuals with acromegaly, 10 with inactive disease and 9 with active disease and 16 healthy individuals, matched by sex and age. Age ranged from 19 to 78 years. Two-dimensional echocardiogram and speckle tracking were performed. RESULTS: Mean left ventricular mass index (LVMI) were significantly higher in acromegalic patients (89.1 &plusmn; 27.9) compared to the control group (66.9 &plusmn; 15.7) (p = 0.015). There was a direct correlation between IGF-1 mean concentration and left ventricular systolic volume (LVSV) in acromegalic patients (r = 0.64; p = 0.004) even when the disease was inactive (n=10; r = 0.9; p = 0.002) and between IGF1 mean concentration and left ventricular diastolic volume (LVDV). The left ventricular ejection fraction (EF) and the global longitudinal strain (GLS) did not differ between groups (p&gt; 0.05). CONCLUSION: Although patients with acromegaly had higher LVMI, they did not show difference in GLS indicating a small chance of progression to systolic disfunction. Direct correlation between IGF-1 and LDVD and LVSV demonstrates the relevance of a good hormonal control to reduce cardiac changes.


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