scholarly journals Echocardiographic Myocardial Strain Analysis Describes Subclinical Cardiac Dysfunction after Craniospinal Irradiation in Pediatric and Young Adult Patients with Central Nervous System Tumors

2020 ◽  
Author(s):  
Thomas D Ryan ◽  
Hugo R. Martinez ◽  
Ralph Salloum ◽  
Erin Wright ◽  
Lauren Bueche ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cardiac Dysfunction ◽  
Myocardial Strain ◽  
Strain Analysis ◽  
Late Time ◽  
Systolic Strain ◽  
Peak Systolic Strain ◽  
Myocardial Strain Analysis ◽  
Late Time Point ◽  
Time Point

Abstract Background: Craniospinal irradiation (CSI) is part of the treatment of central nervous system (CNS) tumors and is associated with cardiovascular disease in adults. Global myocardial strain analysis including longitudinal peak systolic strain (GLS), circumferential peak systolic strain (GCS) and radial peak systolic strain (GRS) can reveal subclinical cardiac dysfunction.Methods: Retrospective, single-center study in patients managed with CSI vs. age-matched controls. Clinical data and echocardiography, including myocardial strain analysis, were collected at early (<12 months) and late ( 12 months) after completion of CSI.Results: Echocardiograms were available in 20 early and 34 late patients. Patients at the late time point were older (21.7±10.4 vs. 13.3 9.6 years), and further out from CSI (13.1±8.8 vs. 0.2±0.3 years). Standard echocardiographic parameters were normal for all subjects. For the early time, CSI vs. control: GLS was -16.8 3.6% vs. -21.3 4.0% (p=0.0002), GCS was -22.5 5.2% vs. -21.3 3.4% (p=0.28), and GRS was 21.8 11.0% vs. 26.9 7.7% (p=0.07). At the late time point, CSI vs. control: GLS was -16.2 5.4% vs. -21.6 3.7% (p<0.0001), GCS was -20.9 6.8% vs. -21.9 3.5% (p=0.42), and GRS was 22.5 10.0% vs. 27.3 8.3% (p=0.03). Radiation type (proton vs. photon), and radiation dose (<30 Gy vs. 30 Gy) did not impact any parameter.Conclusions: Subclinical cardiac systolic dysfunction by GLS is present both early and late after CSI. These results argue for inclusion of baseline cardiovascular assessment and early initiation of longitudinal follow-up post CSI.

scholarly journals Echocardiographic myocardial strain analysis describes subclinical cardiac dysfunction after craniospinal irradiation in pediatric and young adult patients with central nervous system tumors

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hugo R. Martinez ◽  
Ralph Salloum ◽  
Erin Wright ◽  
Lauren Bueche ◽  
Philip R. Khoury ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cardiac Dysfunction ◽  
Myocardial Strain ◽  
Strain Analysis ◽  
Late Time ◽  
Systolic Strain ◽  
Time Points ◽  
Peak Systolic Strain ◽  
Myocardial Strain Analysis

Abstract Background Craniospinal irradiation (CSI) is part of the treatment of central nervous system (CNS) tumors and is associated with cardiovascular disease in adults. Global myocardial strain analysis including longitudinal peak systolic strain (GLS), circumferential peak systolic strain (GCS), and radial peak systolic strain (GRS) can reveal subclinical cardiac dysfunction. Methods Retrospective, single-center study in patients managed with CSI vs. age-matched controls. Clinical data and echocardiography, including myocardial strain analysis, were collected at early (< 12 months) and late (≥ 12 months) time points after completion of CSI. Results Echocardiograms were available at 20 early and 34 late time points. Patients at the late time point were older (21.7 ± 10.4 vs. 13.3 ± 9.6 years) and further out from CSI (13.1 ± 8.8 vs. 0.2 ± 0.3 years). Standard echocardiographic parameters were normal for both groups. For early, CSI vs. control: GLS was − 16.8 ± 3.6% vs. -21.3 ± 4.0% (p = 0.0002), GCS was − 22.5 ± 5.2% vs. -21.3 ± 3.4% (p = 0.28), and GRS was 21.8 ± 11.0% vs. 26.9 ± 7.7% (p = 0.07). For late, CSI vs. control: GLS was − 16.2 ± 5.4% vs. -21.6 ± 3.7% (p < 0.0001), GCS was − 20.9 ± 6.8% vs. -21.9 ± 3.5% (p = 0.42), and GRS was 22.5 ± 10.0% vs. 27.3 ± 8.3% (p = 0.03). Radiation type (proton vs. photon), and radiation dose (< 30 Gy vs. ≥ 30 Gy) did not impact any parameter, although numbers were small. Conclusions Subclinical cardiac systolic dysfunction by GLS is present both early and late after CSI. These results argue for future studies to determine baseline cardiovascular status and the need for early initiation of longitudinal follow-up post CSI.

scholarly journals Echocardiographic Myocardial Strain Analysis Describes Subclinical Cardiac Dysfunction after Craniospinal Irradiation in Pediatric and Young Adult Patients with Central Nervous System Tumors

2021 ◽  
Author(s):  
Hugo R. Martinez ◽  
Ralph Salloum ◽  
Erin Wright ◽  
Lauren Bueche ◽  
Philip R. Khoury ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cardiac Dysfunction ◽  
Myocardial Strain ◽  
Strain Analysis ◽  
Late Time ◽  
Systolic Strain ◽  
Time Points ◽  
Peak Systolic Strain ◽  
Myocardial Strain Analysis

Abstract Background: Craniospinal irradiation (CSI) is part of the treatment of central nervous system (CNS) tumors and is associated with cardiovascular disease in adults. Global myocardial strain analysis including longitudinal peak systolic strain (GLS), circumferential peak systolic strain (GCS), and radial peak systolic strain (GRS) can reveal subclinical cardiac dysfunction.Methods: Retrospective, single-center study in patients managed with CSI vs. age-matched controls. Clinical data and echocardiography, including myocardial strain analysis, were collected at early (<12 months) and late ( 12 months) time points after completion of CSI.Results: Echocardiograms were available at 20 early and 34 late time points. Patients at the late time point were older (21.7±10.4 vs. 13.3 9.6 years) and further out from CSI (13.1±8.8 vs. 0.2±0.3 years). Standard echocardiographic parameters were normal for all subjects. For early, CSI vs. control: GLS was -16.8 3.6% vs. -21.3 4.0% (p=0.0002), GCS was -22.5 5.2% vs. -21.3 3.4% (p=0.28), and GRS was 21.8 11.0% vs. 26.9 7.7% (p=0.07). For late, CSI vs. control: GLS was -16.2 5.4% vs. -21.6 3.7% (p<0.0001), GCS was -20.9 6.8% vs. -21.9 3.5% (p=0.42), and GRS was 22.5 10.0% vs. 27.3 8.3% (p=0.03). Radiation type (proton vs. photon), and radiation dose (<30 Gy vs. 30 Gy) did not impact any parameter, although numbers were small.Conclusions: Subclinical cardiac systolic dysfunction by GLS is present both early and late after CSI. These results argue for future studies to determine baseline cardiovascular status and the need for early initiation of longitudinal follow-up post CSI.

scholarly journals RONC-31. ADVANCED ECHOCARDIOGRAPHY WITH MYOCARDIAL-STRAIN-ANALYSIS DESCRIBES SUBCLINICAL CARDIAC DYSFUNCTION AFTER CRANIOSPINAL IRRADIATION (CSI) IN PEDIATRIC AND YOUNG ADULT PATIENTS WITH CENTRAL NERVOUS SYSTEM (CNS) TUMORS

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii460-iii461
Author(s):  
Hugo Martinez ◽  
Ralph Salloum ◽  
Erin Wright ◽  
Philip Khoury ◽  
Justin Tretter ◽  
...  
Keyword(s):  
Young Adult ◽  
Myocardial Strain ◽  
Strain Analysis ◽  
Cns Tumors ◽  
Systolic Strain ◽  
Tumor Patients ◽  
Cns Tumor ◽  
Peak Systolic Strain ◽  
Myocardial Strain Analysis ◽  
Subclinical Dysfunction

Abstract CSI is part of the treatment of CNS tumors and is associated with cardiovascular disease; data in pediatric/young-adult patients are limited. Myocardial-strain-analysis can reveal subclinical dysfunction. Retrospective, single-center study in CNS tumor patients managed with CSI from 1986–2018. Clinical details, and echocardiography including myocardial-strain-analysis were collected at T1=first echocardiogram after CSI, and T2=most recent echocardiogram. Data are mean±standard deviation. Echocardiograms were available in 44 patients (36%female, 14±8.0years) at T1 and 39 patients (38%female, 21.0±11.3years) at T2. Standard echocardiography was normal for all subjects. At T1, global longitudinal peak systolic strain (GLS) was -16.3%±3.7% in CSI vs. -21.6%±3.5% in controls (p&lt;0.0001); global radial peak systolic strain (GRS) was 21.5%±10.1% in CSI vs. 26.5%±7.4% in controls, and global circumferential peak systolic strain (GCS) was -19.5%±6.0% in CSI vs. -21.4%±3.4% in controls (p&lt;0.05, both comparisons). At T2, GLS was -15.8%±5.2% in CSI vs. -21.9±3.5% in controls (p&lt;0.0001); GRS was 22.6%±10.4% in CSI vs. 27.1±8.2% in controls (p&lt;0.05); GCS was -20.5%±6.9% in CSI vs. -21.8±3.5% in controls (p=0.10). For 17 patients with myocardial-strain-analysis available for both time points: difference in GLS was 0.06±7.2% (p&gt;0.95); GRS was 5.5±9.5% (p&lt;0.05); GCS was -3.4±4.9% (p&lt;0.05). Subclinical dysfunction is present at first echocardiogram after CSI. Myocardial impairment may recover with time, however further analysis is needed to identify risk factors and trends. These results argue for inclusion of baseline cardiovascular assessment and longitudinal follow-up in CNS tumor patients post CSI.

Myocardial strain analysis of echocardiographic sequences using non-rigid registration

2005 ◽  
Author(s):  
M.J. Ledesma-Carbayo ◽  
A. Santos ◽  
J. Kybic ◽  
P. Mahia-Casado ◽  
M.A. Garcia-Feernandez ◽  
...  
Keyword(s):  
Myocardial Strain ◽  
Strain Analysis ◽  
Rigid Registration ◽  
Myocardial Strain Analysis

P1470Myocardial dysfunction index: a novel myocardial strain parameter for diagnosing myocardial ischemia

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Tanekda ◽  
T Asanuma ◽  
K Masuda ◽  
A Kozuma ◽  
S Minami ◽  
...  
Keyword(s):  
Myocardial Ischemia ◽  
Myocardial Dysfunction ◽  
Myocardial Strain ◽  
Integrated Analysis ◽  
Acute Ischemia ◽  
Systolic Strain ◽  
Operating Characteristics ◽  
Strain Index ◽  
Peak Systolic Strain ◽  
Normal Ranges

Abstract Background and purpose Peak systolic strain (ε-sys) derived from speckle tracking echocardiography (STE) is a useful parameter for assessing regional contractile dysfunction during acute ischemia. However, low ε-sys does not always indicate myocardial ischemia because of its relatively large variation in segmental normal ranges and intervendor differences. Therefore, comparison of strain before and after an ischemic event and demonstration of a decrease in ε-sys should be necessary to confirm myocardial ischemia, which is not always possible in clinical situations. It is well known that early systolic lengthening (ESL) and post-systolic shortening (PSS) occur during acute ischemia. We hypothesized that ESL and PSS would correlate with the decrease in ε-sys and integrated analysis of ESL and PSS could be useful to diagnose the presence of myocardial ischemia. Methods 2D short-axis or 3D full-volume images were acquired by Artida at baseline, during flow-limiting stenosis (mean 50±20% flow reduction), and during complete occlusion of the left circumflex coronary artery in 22 dogs (2D-STE = 12, 3D-STE = 10).Circumferential strain was analyzed in the center of risk area, and the absolute value of peak systolic strain (ε-sys), post-systolic strain index (PSI) as a parameter of PSS, and early systolic strain index (ESI) as a parameter of ESL were measured. A new parameter, myocardial dysfunction index (MDI), which was calculated as follows: (ESL amplitude + PSS amplitude)/maximal strain amplitude during the cardiac cycle, was also calculated. The difference in ε-sys between at baseline and during ischemia (Δε-sys) was measured and the diagnostic accuracy for estimating Δε-sys < −3% was assessed by the receiver operating characteristics (ROC) curve analysis. Results During ischemia, ε-sys decreased from 19±3 to 12±6% and MDI increased from 2±4 to 27±30%. MDI was significantly correlated with Δε-sys (2D-STE: r=−0.80, 3D-STE: r=−0.83, p<0.01, respectively) (Figure). The area under the curve (AUC) of MDI for estimating Δε-sys < −3% tended to be larger than those of ESI and PSI (MDI: 0.9, ESI: 0.73, PSI: 0.85). Figure 1 Conclusions The novel parameter, MDI was correlated with the decrease in ε-sys during acute ischemia. Integrated analysis of ESL and PSS may be useful for diagnosing the presence of myocardial ischemia.

scholarly journals Equivalent tumor detection for early and late FAPI-46 PET acquisition

2021 ◽  
Author(s):  
J. Ferdinandus ◽  
L. Kessler ◽  
N. Hirmas ◽  
M. Trajkovic-Arsic ◽  
R. Hamacher ◽  
...  
Keyword(s):  
Early Time ◽  
Tumor Detection ◽  
University Hospital ◽  
Late Time ◽  
Early Time Point ◽  
Positron Emission ◽  
Organ Uptake ◽  
Significant Difference ◽  
Late Time Point ◽  
Time Point

Abstract Introduction Positron emission tomography (PET) using small ligands of the fibroblast activation protein (FAP) was recently introduced. However, optimal uptake time has not been defined yet. Here, we systematically compare early (~ 10 min p.i.) and late (~ 60 min p.i.) FAPI-46 imaging in patients with various types of cancer. Methods This is a retrospective single-institutional study. Imaging was performed at the Essen University Hospital, Germany. A total of 69 patients who underwent dual time-point imaging for either restaging (n = 52, 75%) or staging (n = 17, 25%) of cancer were included. Patients underwent PET with two acquisitions: early (mean 11 min, SD 4) and late (mean 66 min, SD 9). Mean injected activity was 148 MBq (SD 33). Results In total, 400 lesions were detected in 69 patients. Two of 400 (0.5%) lesions were only seen in early time-point imaging but not in late time-point imaging. On a per-patient level, there was no significant difference between SUVmax of hottest tumor lesions (Wilcoxon: P = 0.73). Organ uptake demonstrated significant early to late decrease in SUVmean (average ∆SUVmean: − 0.48, − 0.14, − 0.27 for gluteus, liver, and mediastinum, respectively; Wilcoxon: P < 0.001). On a per-lesion basis, a slight increase of SUVmax was observed (average ∆SUVmax: + 0.4, Wilcoxon: P = 0.03). Conclusion In conclusion, early (~ 10 min p.i.) versus late (~ 60 min p.i.) FAPI-46 imaging resulted in equivalent lesion uptake and tumor detection. For improved feasibility and scan volume, we implement early FAPI-46 PET in future clinical and research protocols.

Feature-tracking myocardial strain analysis in acute myocarditis: diagnostic value and association with myocardial oedema

2017 ◽  
Vol 27 (11) ◽  
pp. 4661-4671 ◽  
Author(s):  
Julian A. Luetkens ◽  
Ulrike Schlesinger-Irsch ◽  
Daniel L. Kuetting ◽  
Darius Dabir ◽  
Rami Homsi ◽  
...  
Keyword(s):  
Feature Tracking ◽  
Acute Myocarditis ◽  
Myocardial Strain ◽  
Strain Analysis ◽  
Diagnostic Value ◽  
Myocardial Oedema ◽  
Myocardial Strain Analysis

scholarly journals Heart transplantation and antibody-mediated rejection: role of myocardial strain as an early marker of cardiac dysfunction in patients with anti-HLA antibody

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C Sciaccaluga ◽  
B.M Natali ◽  
G.E Mandoli ◽  
N Sisti ◽  
F.M Righini ◽  
...  
Keyword(s):  
Cardiac Dysfunction ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Myocardial Strain ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Hla Antibodies ◽  
Antibody Mediated Rejection ◽  
Right Ventricular Strain ◽  
Hla Antibody

Abstract Background Antibody-mediated rejection of the transplanted heart is still currently diagnosed by endomyocardial biopsy whereas clinical elements, anti-Human Leukocite Antigens (HLA) antibody and graft dysfunction represents supplementary components. Purpose The aim of the study was to identify though a non-invasive imaging technique, such as advanced transthoracic echocardiography, early signs of altered cardiac function in patients with anti-HLA antibodies and no histological signs of antibody-mediated rejection. Methods The study population included 117 heart transplanted patients, in whom both acute and chronic rejection was excluded. They were divided into two groups “HLA+`' (45 patients) and “HLA−” (72 patients), based on the presence and the absence of circulating anti-HLA antibodies, respectively. The echocardiographic exam was performed within one week from the biopsy, including Speckle Tracking analysis. Results Deceleration Time of E wave was the strongest traditional echocardiographic parameter which correlated with circulating anti-HLA antibodies (165±39,5 vs 196,5±25; p&lt;0.001). Regarding strain analysis, both left ventricular global longitudinal strain (−16,1±3,4 vs −19,8±2,0; p&lt;0.001) and right ventricular strain (−17,2±0,7 vs −20,6±0,5; p=0.0002) differed significantly between the two subgroups (Figure 1). On the other hand, neither peak atrial longitudinal strain nor peak atrial contraction strain showed a significant correlation with anti-HLA antibodies. Conclusion The presence of circulating anti-HLA antibodies seems to be correlated with a mild cardiac dysfunction, even in the absence of antibody-mediated rejection. This subtle dysfunction is not completely detectable by standard echocardiographic parameters, whereas strain analysis has showed promising results since it revealed more clearly an impaired function of both ventricles in heart transplanted HLA+ patients, with potentially important clinical repercussion. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

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