Impact of Right Ventricular Function on Left Ventricular Torsion and Ventricular Deformations in Pulmonary Artery Hypertension Patients

2021 ◽  
Vol 21 ◽  
Author(s):  
Krishnananda Nayak ◽  
Abdul Razak ◽  
Megha A. ◽  
Padmakumar R. ◽  
Jyothi Samanth ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Strain Rate ◽  
Radial Strain ◽  
Left Ventricular ◽  
Controlled Study ◽  
Routine Practice ◽  
Systolic Strain ◽  
Current Case ◽  
Strain And Strain Rate ◽  
Apical Rotation

Introduction: Ventricular interdependence in pulmonary arterial hypertension (PAH) by the use of most recent echocardiographic techniques are still rare. The current case-controlled study aims to assess left ventricular (LV) torsion in patients with PAH. Methods: The study included 42 cases of moderate to severe PAH and 42 age and gender-matched healthy controls between March 2016 and January 2018. All the patients and controls undergo routine practice echocardiography using the Vivid 7-echocardiography (2.5MHz transducer) system. Results: The LV twisting parameters, peak basal rotation, peak apical rotation, and twist were similar among both cases and controls, however, LV torsion was significantly (p=0.04) impacted. Right ventricular (RV) longitudinal deformation was clinically significant in the cases compared to controls: RV systolic strain imaging (p=0.001, 95%CI-9.75 to -2.65), RV systolic strain rate (p=0.01, 95%CI-0.99 to -0.09), and RV late diastolic strain rate (p=0.01, 95%CI-0.64 to -0.85). Although PAH did not impact longitudinal LV deformations significantly. At basal level circumferential strain and strain rate were significantly impacted (p=0.005, 95%CI-4.38 to -0.70; p=0.004, 95%CI-0.35 to -0.07) in the PAH group, while the radial strain was preserved. All RV echocardiographic parameters and LV end-diastolic dimension, LV end-systolic volume in the PAH were affected significantly (p=0.002, 95%CI-19.91 to -4.46; p=0.01, 95%CI-8.44 to -2.77). However, only a weak correlation (p=0.05, r =-0.20) was found between tricuspid annular plane systolic excursion and LV Tei index. Conclusion: RV pressure overload directly affects RV longitudinal systolic deformation further influences the interventricular septal and LV geometry, which impaired LV torsion.

Abstract 4246: Dobutamine-induced Reserve of the Two-dimensional Longitudinal Strain Rate Predicts Clinical and Neurohumoral Improvement After Levosimendan Treatment in Acutely Decompensated Chronic Heart Failure

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Vasiliki Bistola ◽  
Ioannis Paraskevaidis ◽  
Ignatios Ikonomidis ◽  
Ioannis Parissis ◽  
Gerasimos Filippatos ◽  
...  
Keyword(s):  
Strain Rate ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Nyha Class ◽  
Radial Strain ◽  
Left Ventricular ◽  
Contractile Reserve ◽  
Systolic Strain ◽  
Strain And Strain Rate ◽  
Longitudinal Strain Rate

Objective: Levosimendan improves symptoms and the hemodynamic profile in patients with acutely decompensated chronic heart failure (ADCHF). We aimed to investigate: the association of low dose dobutamine (DSE)-induced changes of two-dimensional strain parameters with the corresponding changes of left ventricular ejection fraction (LVEF) and left ventricular outflow tract velocity time integral (LVOT VTI) in patients with ADCHF, and whether left ventricular contractile reserve assessed by both conventional and speckle tracking echocardiography is associated with clinical and neurohumoral improvement after levosimendan treatment. Methods: Thirty one consecutive patients with ADCHF (mean age 65 ± 10 years, NYHA class 3.6 ± 0.3, LVEF 22 ± 6%) were studied by DSE (peak dose 20 μg/kg/min) prior to 24-hour infusion of levosimendan (0.01 μg/kg/min, without bolus). The LVEF, LVOT VTI, mean longitudinal, circumferential and radial strain and strain rate using speckle tracking imaging were measured. Results: Twenty-three patients (74%) had evidence of contractile reserve (increase of LVEF > 10% and LVOT VTI > 20% after peak dobutamine dose, CR+), and 8 (26%) showed no reserve (CR−). CR+ versus CR- patients demonstrated greater improvement of NYHA class (mean NYHA change: −1.0±0.5 vs −0.5±0.3 NYHA class, p=0.01), and reduction of b-type natriuretic peptide levels (− 34±30 vs + 4±31%, p <0.01) 48 hours after completion of treatment. By multivariate analysis, mean longitudinal systolic strain rate reserve (resting - peak longitudinal strain rate ΔLSR (%)) was the best predictor of improvement of NYHA class (p= 0.039) and BNP (p= 0.042) after levosimendan administration among the reserve of: LV FS, EF, LVOT VTI, longitudinal strain, circumferential and radial strain and strain rate. Conclusion: Dobutamine-induced reserve of 2-dimentional speckle tracking longitudinal systolic strain rate is associated with clinical and neurohumoral improvement after treatment with levosimendan in patients with ADCHF.

scholarly journals Lipopolysaccharide acutely suppresses right-ventricular strain in rats with pulmonary artery hypertension

2017 ◽  
Vol 8 (1) ◽  
pp. 204589321774450 ◽  
Author(s):  
Junjie Zhang ◽  
Yanan Cao ◽  
Xiaowei Gao ◽  
Maoen Zhu ◽  
Zhong Zhang ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricular ◽  
Strain Rate ◽  
Acute Inflammation ◽  
Pulmonary Artery Hypertension ◽  
Left Ventricular ◽  
Systolic Strain ◽  
Peak Systolic Strain ◽  
Strain And Strain Rate ◽  
Rv Function

Worsening right ventricular (RV) dysfunction in the presence of pulmonary artery hypertension (PAH) increases morbidity and mortality in this patient population. Transthoracic echocardiography (TTE) is a non-invasive modality to evaluate RV function over time. Using a monocrotaline-induced PAH rat model, we evaluated the effect of acute inflammation on RV function. In this study, both PAH and control rats were injected with Escherichia coli lipopolysaccharide (LPS) to induce an acute inflammatory state. We evaluated survival curves, TTE parameters, and inflammatory markers to better understand the mechanism and impact of acute inflammation on RV function in the presence of PAH. The survival curve of the PAH rats dropped sharply within 9 h after LPS treatment. Several echocardiographic parameters including left ventricular (LV) stroke volume, RV tricuspid annular plane systolic excursion, RV longitudinal peak systolic strain, and strain rate decreased significantly in PAH rats before LPS injection and 2 h after LPS injection. The expression of phospholamban (PLB) and tumor necrosis factor-α (TNF-α) significantly increased and the expression of SERCA2a significantly decreased in PAH rats after LPS administration. LPS suppressed the RV longitudinal peak systolic strain and strain rate and cardiac function deteriorated in PAH rats. These effects may be associated with the signal pathway activity of SERCA2a/PLB.

scholarly journals Right ventricular strain rate during exercise accurately identifies male athletes with right ventricular arrhythmias

2019 ◽  
Author(s):  
Mathias Claeys ◽  
Guido Claessen ◽  
Piet Claus ◽  
Ruben De Bosscher ◽  
Christoph Dausin ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Strain Rate ◽  
Exercise Intensity ◽  
Left Ventricular ◽  
Moderate Intensity ◽  
Moderate Exercise ◽  
Deformation Imaging ◽  
Strain And Strain Rate ◽  
Right Ventricular Strain ◽  
Moderate Exercise Intensity

Abstract Aims Athletes with right ventricular (RV) arrhythmias, even in the absence of desmosomal mutations, may have subtle RV abnormalities which can be unmasked by deformation imaging. As exercise places a disproportionate stress on the right ventricle, evaluation of cardiac function and deformation during exercise might improve diagnostic performance. Methods and results We performed bicycle stress echocardiography in 17 apparently healthy endurance athletes (EAs), 12 non-athletic controls (NAs), and 17 athletes with RV arrhythmias without desmosomal mutations (EI-ARVCs) and compared biventricular function at rest and during low (25% of upright peak power) and moderate intensity (60%). At rest, we observed no differences in left ventricular (LV) or RV function between groups. During exercise, however, the increase in RV fractional area change (RVFAC), RV free wall strain (RVFWSL), and strain rate (RVFWSRL) were significantly attenuated in EI-ARVCs as compared to EAs and NAs. At moderate exercise intensity, EI-ARVCs had a lower RVFAC, RVFWSL, and RVFWSRL (all P < 0.01) compared to the control groups. Exercise-related increases in LV ejection fraction, strain, and strain rate were also attenuated in EI-ARVCs (P < 0.05 for interaction). Exercise but not resting parameters identified EI-ARVCs and RVFWSRL with a cut-off value of >−2.35 at moderate exercise intensity had the greatest accuracy to detect EI-ARVCs (area under the curve 0.95). Conclusion Exercise deformation imaging holds promise as a non-invasive diagnostic tool to identify intrinsic RV dysfunction concealed at rest. Strain rate appears to be the most accurate parameter and should be incorporated in future, prospective studies to identify subclinical disease in an early stage.

scholarly journals Acute right ventricular pressure overload compromises left ventricular function by altering septal strain and rotation

2013 ◽  
Vol 115 (2) ◽  
pp. 186-193 ◽  
Author(s):  
Jason Chua ◽  
Wei Zhou ◽  
Jonathan K. Ho ◽  
Nikhil A. Patel ◽  
G. Burkhard Mackensen ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Circumferential Strain ◽  
Median Sternotomy ◽  
Radial Strain ◽  
Pressure Overload ◽  
Left Ventricular ◽  
Rotational Dynamics ◽  
Time To Peak ◽  
End Diastolic Volume ◽  
Apical Rotation

While right ventricular (RV) dysfunction has long been known to affect the performance of left ventricle (LV), the mechanisms remain poorly defined. Recently, speckle-tracking echocardiography has demonstrated that preservation of strain and rotational dynamics is crucial to both LV systolic and diastolic function. We hypothesized that alteration in septal strain and rotational dynamics of the LV occurs during acute RV pressure overload (RVPO) and leads to decreased cardiac performance. Seven anesthetized pigs underwent median sternotomy and placement of intraventricular pressure-volume conductance catheters. Two-dimensional echocardiographic images and LV pressure-volume loops were acquired for offline analysis at baseline and after banding of the pulmonary artery to achieve RVPO (>50 mmHg) induced RV dysfunction. RVPO resulted in a significant decrease ( P < 0.05) in LV end-systolic elastance (50%), systolic change in pressure over change in time (19%), end-diastolic volume (22%), and cardiac output (37%) that correlated with decrease in LV global circumferential strain (58%), LV apical rotation (28%), peak untwisting (reverse rotation) rate (27%), and prolonged time to peak rotation (17%), while basal rotation was not significantly altered. RVPO reduced septal radial and circumferential strain, while no other segment of the LV midpapillary wall was affected. RVPO decreased septal radial strain on LV side by 27% and induced a negative radial strain from 28 ± 5 to −16 ± 2% on the RV side of the septum. The septal circumferential strain on both LV and RV side decreased by 46 and 50%, respectively, following RVPO ( P < 0.05). Our results suggest that acute RVPO impairs LV performance by primarily altering septal strain and apical rotation.

scholarly journals High-frequency speckle tracking echocardiography in the assessment of left ventricular function and remodeling after murine myocardial infarction

2014 ◽  
Vol 306 (9) ◽  
pp. H1371-H1383 ◽  
Author(s):  
Amit Bhan ◽  
Alexander Sirker ◽  
Juqian Zhang ◽  
Andrea Protti ◽  
Norman Catibog ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Infarct Size ◽  
Strain Rate ◽  
High Frequency ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Radial Strain ◽  
Left Ventricular ◽  
Intraobserver Variability ◽  
Strain And Strain Rate

The objectives of this study were to assess the feasibility and accuracy of high-frequency speckle tracking echocardiography (STE) in a murine model of myocardial infarction (MI). STE is used clinically to quantify global and regional cardiac function, but its application in mice is challenging because of the small cardiac size and rapid heart rates. A high-frequency microultrasound system with STE (Visualsonics Vevo 2100) was compared against magnetic resonance imaging (MRI) for the assessment of global left ventricular (LV) size and function after murine MI. Animals subjected to coronary ligation ( n = 46) or sham ligation ( n = 27) were studied 4 wk postoperatively. Regional and global deformation were also assessed. STE-derived LV ejection fraction (EF) and mass correlated well with MRI indexes ( r = 0.93, 0.77, respectively; P < 0.001), as did STE-derived mass with postmortem values ( r = 0.80, P < 0.001). Higher STE-derived volumes correlated positively with MRI-derived infarct size ( P < 0.01). Global strain parameters were significantly reduced after MI (all P < 0.001) and strongly correlated with LV mass and MRI-derived infarct size as promising surrogates for the extent of remodeling and infarction, respectively (both P < 0.05). Regional strain analyses showed that radial strain and strain rate were relatively preserved in anterior basal segments after MI compared with more apical segments ( P < 0.001); however, longitudinal strain and strain rate were significantly impaired both basally and distally ( P < 0.001). Strain-derived parameters of dyssynchrony were significantly increased in the MI group ( P < 0.01). Analysis time for STE was 210 ± 45 s with acceptable inter- and intraobserver variability. In conclusion, high-frequency STE enables quantitative assessment of regional and global function in the remodeling murine LV after MI.

Review and status report of pediatric left ventricular systolic strain and strain rate nomograms

2015 ◽  
Vol 20 (5) ◽  
pp. 601-612 ◽  
Author(s):  
Massimiliano Cantinotti ◽  
Shelby Kutty ◽  
Raffaele Giordano ◽  
Nadia Assanta ◽  
Bruno Murzi ◽  
...  
Keyword(s):  
Strain Rate ◽  
Left Ventricular ◽  
Status Report ◽  
Systolic Strain ◽  
Strain And Strain Rate

scholarly journals Evaluation of Longitudinal Tissue Velocity and Deformation Imaging in Akinetic Non-viable Apical Segments of Left Ventricular Myocardium

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Hakimeh Sadeghian ◽  
Parastoo Vosoughi ◽  
Afsaneh Sadeghian ◽  
Masoumeh Lotfi-Tokaldany ◽  
Mohammad Moein Ashrafi ◽  
...  
Keyword(s):  
Strain Rate ◽  
Patient Group ◽  
Dobutamine Stress Echocardiography ◽  
Peak Systolic Velocity ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Systolic Strain ◽  
Tissue Velocity ◽  
Strain Rate Imaging ◽  
Strain And Strain Rate

Introduction: The use of tissue velocity and strain rate imaging is proposed for the quantification of non-viable myocardium. This study is aimed at investigating the differences in tissue velocity and strain rate imaging indices between non-viable left ventricular apical segments and the normal segments using segment-by-segment comparison.Materials and Method: Thirty-two patients with akinetic left ventricular apical segments and without viability were selected using two-dimensional echocardiography and dobutamine stress echocardiography; 32 individuals with normal echocardiography and coronary angiography formed the normal group. Peak systolic velocity, peak systolic strain, and strain rate were measured in the four left ventricular apical segments and the apex 17th segment.Results: The patient group had a significantly lower ejection fraction (26.88±6.06% vs. 56.56±2.36%; p<0.001). Overall, the patient group had significantly lower resting peak systolic velocity, systolic strain, and strain rate. In the segment-by-segment comparison, only systolic strain showed a remarkable reduction in the patient group, while reduction in Sm and strain rate were not significant in all the segments. After dobutamine stress echocardiography, only systolic strain showed an insignificant increase compared to the resting values. In the apex 17th segment, Sm showed significant reduction in the patient group.Conclusion: The ST in apical segments may be used as a quantitative index for detecting akinesia both at rest and after dobutamine infusion. Reduction in Sm can be used as a marker of akinesia in the apical cap at rest.

scholarly journals Echocardiographic evaluation of left ventricle mechanical parameters in infants of the first year of life

2017 ◽  
Vol 21 (3) ◽  
pp. 23
Author(s):  
Yu. S. Sinelnikov ◽  
E. N. Orekhova ◽  
T. V. Matanovskaya ◽  
M. A. Polevshikova
Keyword(s):  
Left Ventricle ◽  
Strain Rate ◽  
Conflict Of Interest ◽  
Longitudinal Strain ◽  
Radial Strain ◽  
Left Ventricular ◽  
First Year ◽  
Strain And Strain Rate ◽  
Healthy Infants ◽  
First Year Of Life

<p><strong>Aim.</strong> The study focused on the analysis of the measurement range of left ventricle mechanics (strain, strain rate, rotation, rotation rate, twisting, untwisting, torsion) in healthy infants of the first year of life to obtain their baseline values.<br /><strong>Methods.</strong> The study included 125 healthy infants aged 5 days to 12 months (average 5.9±3.9 months. The Аcuson S 2000 machine (Siemens Medical Systems, Mountain View, CA, USA) was used to perform echocardiography. The indicators of left ventricle longitudinal strain (%) and strain rate (s–1), radial strain and strain rate (% and s–1), circumferential strain and strain rate (% and s–1), basal and apical rotation in systole and diastole (°) and rotation rate (°/s), twisting (°), untwisting (°), twisting and unwinding rate (°/s) and torsion (°/cm) were measured and analyzed. <br /><strong>Results</strong>. It was found out that the values of the longitudinal strain and strain rate inversely correlate with the pumping function (stroke volume index) and diastolic function (filling pressures and the untwisting rate). The parameters of the circular and radial strain tended to depend on the left ventricle mass index, interventricular septum/left ventricle posterior wall thicknesses. Left ventricle twisting and untwisting would increase in healthy infants from the newborn period to the first year of life. Left ventricle torsion range was determined by the twist values and not by left ventricular geometry.<br /><strong>Conclusion.</strong> The obtained data on the values of longitudinal, circumferential and radial left ventricle strain and strain rate can be used as reference ranges to evaluate the mechanical left ventricular function in infants of the first year of life.</p><p>Received 27 January 2017. Accepted 15 June 2017.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and study design: Yu.S. Sinelnikov, E.N. Orekhova<br />Data collection and analysis: M.A. Polevshikova, T.V. Matanovskaya <br />Drafting the article: E.N. Orekhova, M.A. Polevshikova<br />Critical revision of the article: Yu.S. Sinelnikov, E.N. Orekhova<br />Final approval of the version to be published: Yu.S. Sinelnikov, E.N. Orekhova, T.V. Matanovskaya, M.A. Polevshikova</p>

Sign in / Sign up

Export Citation Format

Share Document