scholarly journals Left Ventricular Myocardial Function in a Cat with Nonspecific Cardiomyopathy Phenotype

2020 ◽  
Vol 48 ◽  
Author(s):  
Thaís Gomes Barbosa ◽  
Mariana De Resende Coelho ◽  
Ruthnea Aparecida Lázaro Muzzi ◽  
Ana Flávia Silva Pereira ◽  
Luiz Eduardo Duarte de Oliveira ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Left Atrium ◽  
Structural Changes ◽  
Myocardial Dysfunction ◽  
Clinical Signs ◽  
Left Ventricular ◽  
Myocardial Deformation ◽  
Two Dimensional ◽  
Echocardiographic Examination ◽  
Cardiac Evaluation

Background: Non-specific phenotype feline cardiomyopathy (CFNE) is one that does not fit properly in the other categories, and it is necessary to describe in detail the morphology and cardiac function. The causes of CFNE is not very clear, and it may be due to congenital or acquired disease, or also to primary or secondary myocardial dysfunction associated with other conditions. In symptomatic cases, the clinical signs observed are compatible with left congestive heart failure (ICCE). This study reports a CFNE case in an asymptomatic cat, in order to demonstrate the importance of echocardiographic examination in the early diagnosis of the disease.Case: A 6.5-year-old non-neutered crossbred cat weighing 3.1 kg was seen at the institution's veterinary hospital for routine cardiac evaluation. No clinical signs were reported in the history. On physical examination, the animal presented calm behavior, body score 5/9, heart rate 200 bpm, systolic blood pressure of 102 mmHg, respiratory rate 64 mrp, and other normal parameters. CBC and urinalysis laboratory tests were requested, which were unchanged. The electrocardiogram showed normal patterns. In the conventional echocardiographic examination, a significant increase in the left atrium (LA) was observed, and the LA/Ao ratio was 2.05 and the diastolic function was abnormal. There was no presence of concentric hypertrophy of the left ventricle (LV), the thickness of the ventricular wall measured at different points, in the two-dimensional mode and the M mode, was less than 5 millimeters. Other parameters of conventional echocardiography were within the normal range. Through these echocardiographic findings, the suggestive diagnosis was non-specific phenotype cardiomyopathy, with a significant increase in LA. For the assessment of left ventricular myocardial deformation, the strain (St%) and strain rate (StR 1/s) indexes (which correspond to the percentage and speed at which the myocardial fiber deforms during the cardiac cycle, respectively) were evaluated using two-dimensional feature tracking (2D-FTI), with the aid of Xstrain version 10.1 software, optical flow algorithm (ESAOTE®). This analysis showed a decrease in the overall value of the longitudinal and radial St/StR variables.Discussion: The CFNE echocardiographic examination can demonstrate several structural cardiac changes that are not characterized in any other category of cardiomyopathy. Although the patient is still asymptomatic, the echocardiogram made it possible to identify structural changes compatible with the reported disease (enlargement of the left atrium and left ventricular myocardial deformation). Using the 2D-FTI technique, the vulnerability of the myocardial fibers in the longitudinal and radial directions of the left ventricle was observed, demonstrating that despite the patient still not showing clinical signs, there were already signs of ventricular dysfunction. These changes observed by the 2D-FTI technique, suggest that the patient may develop clinical signs of ICCE, resulting from pleural effusion and/or pulmonary edema, requiring more frequent reassessments. For this reason, animals with CFNE should undergo periodic cardiac evaluation to monitor the evolution of the patient's clinical condition. The use of more specific tools, such as 2D-FTI, allows an earlier assessment of clinical changes, which provides a faster therapeutic intervention when necessary, preventing the patient from abruptly decompressing.

scholarly journals Clinical-laboratory Manifestations of Myocarditis in Dogs

2019 ◽  
Author(s):  
Valeriy Shumakov ◽  
Ludmila Kletikova ◽  
Alexanderx Martynov ◽  
Victoria Khrushcheva
Keyword(s):  
Blood Pressure ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Left Atrium ◽  
Blood Pressure Reduction ◽  
Clinical Signs ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Left Ventricular Myocardium ◽  
Electrocardiographic Study

The leading clinical signs of myocarditis in dogs were the sudden development of signs of disease, refusal to eat, dyspnea at rest, rapid fatigue. At the diagnostic stage, the position of animals forced, lying, increased breathing speed up to 60-72 movements per minute, pale visible mucous membranes and conjunctiva, weak filling of pulse, rapid filling of capillaries, high blood pressure, increase in the number of leukocytes up to 25–27×109/l, SRS up to 15,4–17,4 mg/l, troponin up to 3,85–4,2 ng/ml. Electrocardiographic study established sinus or ectopic rhythm, heart rate 133– 198 oz/min, conductivity disturbance and deceleration. ECHOKG showed moderate expansion of the left ventricle, moderate expansion of the left atrium. Sealing of the mitral valve leaves, regurgitation on the mitral valve of the first degree. Left ventricular myocardium is inhomogeneous, wall echogenicity is increased. Fraction of contractility 16–18 %. After establishment of a dietary regime and correction of conditions of the maintenance, to dogs strictly with a twelve-hour interval twice a day are appointed vedmedin (0,25 mg/kg), sotalol (1,5 mg/kg), sinulox (20 mg/kg), mexidol-vet (1 table), verospheron (1 mg/kg). As a result of four-week monitoring of patients’ condition positive results were noted: lack of dyspnea, normalization of pulse rate and blood pressure, reduction of capillary filling rate up to 1 second, leukocyte concentration up to 12,6–15,7 ×109/l, SRS up to 1,3–1,4 mg/l, troponin up to 0,09–0,17 ng/ml. The electrocardiographic study showed a decrease in the height of teeth R and P, increase in the intervals P-Q and Q-T. The sinus rhythm is irregular. Echokg showed expansion of the left ventricle, moderate expansion of the left atrium. Sealing of mitral valve leaves, regurgitation on mitral valve of the first degree. Left ventricular myocardium is less heterogeneous, wall echogenicity is increased. Fraction of contractility 23–24 %. It is difficult to predict the outcome of the disease at this stage, as the age of dogs is 7–12 years, and in many respects the quality of life will be provided by their owners.

Determination of multidirectional myocardial deformations in cats with hypertrophic cardiomyopathy by using two-dimensional speckle-tracking echocardiography

2017 ◽  
Vol 19 (12) ◽  
pp. 1283-1289 ◽  
Author(s):  
Ryohei Suzuki ◽  
Yohei Mochizuki ◽  
Hiroki Yoshimatsu ◽  
Takahiro Teshima ◽  
Hirotaka Matsumoto ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Contractile Function ◽  
Radial Strain ◽  
Clinical Signs ◽  
Myocardial Deformation ◽  
Radial Deformation ◽  
Two Dimensional

Objectives Hypertrophic cardiomyopathy, a primary disorder of the myocardium, is the most common cardiac disease in cats. However, determination of myocardial deformation with two-dimensional speckle-tracking echocardiography in cats with various stages of hypertrophic cardiomyopathy has not yet been reported. This study was designed to measure quantitatively multidirectional myocardial deformations of cats with hypertrophic cardiomyopathy. Methods Thirty-two client-owned cats with hypertrophic cardiomyopathy and 14 healthy cats serving as controls were enrolled and underwent assessment of myocardial deformation (peak systolic strain and strain rate) in the longitudinal, radial and circumferential directions. Results Longitudinal and radial deformations were reduced in cats with hypertrophic cardiomyopathy, despite normal systolic function determined by conventional echocardiography. Cats with severely symptomatic hypertrophic cardiomyopathy also had lower peak systolic circumferential strain, in addition to longitudinal and radial strain. Conclusions and relevance Longitudinal and radial deformation may be helpful in the diagnosis of hypertrophic cardiomyopathy. Additionally, the lower circumferential deformation in cats with severe hypertrophic cardiomyopathy may contribute to clinical findings of decompensation, and seems to be related to severe cardiac clinical signs. Indices of multidirectional myocardial deformations by two-dimensional speckle-tracking echocardiography may be useful markers and help to distinguish between cats with hypertrophic cardiomyopathy and healthy cats. Additionally, they may provide more detailed assessment of contractile function in cats with hypertrophic cardiomyopathy.

Abstract 2294: The Use of Myocardial Deformation Imaging Based on Ultrasonic Pixel Tracking to Identify Reversible Myocardial Dysfunction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Michael Becker ◽  
Mithra Lenzen ◽  
Katharina Stempel ◽  
Andreas Franke ◽  
Malte Kelm ◽  
...  
Keyword(s):  
Left Ventricular Dysfunction ◽  
Myocardial Viability ◽  
Predictive Value ◽  
Ventricular Dysfunction ◽  
Myocardial Dysfunction ◽  
Radial Strain ◽  
Left Ventricular ◽  
Myocardial Deformation ◽  
Deformation Imaging ◽  
Myocardial Deformation Imaging

Objective. Myocardial deformation imaging allows analysis of myocardial Objective. Myocardial deformation imaging allows analysis of myocardial viability in ischemic left ventricular dysfunction. This study evaluated the predictive value of myocardial deformation imaging for improvement in cardiac function after revascularization therapy in comparison to contrast-enhanced cardiac magnetic resonance imaging (ceMRI). Methods and Results. In 53 patients with ischemic left ventricular dysfunction, myocardial viability was assessed using pixel-tracking-derived myocardial deformation imaging and ceMRI to predict recovery of function at 9±2 months follow-up. For each left ventricular segment in a 16-segment model peak systolic radial strain was determined from parasternal 2D echocardiographic views using an automatic frame-by-frame tracking system of natural acoustic echocardiographic markers (EchoPAC, GE Ultrasound), and maximal thickness of myocardial tissue without late enhancement (LE) using ceMRI. Of 463 segments with abnormal baseline function, 227 showed regional recovery. Compared with segments showing functional improvement, those that failed to recover had lower radial strain (15.2±7.5 vs 22.6±6.3 %; p<0.001) and lower thickness without LE (5.2±2.9 vs 8.7±2.2 mm; p<0.001). Using a cut-off of 17.2 % for peak systolic radial strain, functional recovery could be predicted with high accuracy (specificity 85%, sensitivity 70%, area under the curve (AUC) 0.859, 95% CI: 0.825– 0.893). The predictive value of thickness without LE by ceMRI was similar at a cut-off of 8.2 mm (specificity 84%, sensitivity 70%, AUC 0.831, 95% CI: 0.793– 0.870). Conclusion. Myocardial deformation imaging based on frame-to-frame tracking of acoustic markers in 2D echocardiographic images is a powerful novel modality to identify reversible myocardial dysfunction.

scholarly journals 1112 Discovering the origin of a mysterious heart cavity

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
V Vidal Urrutia ◽  
P Garcia Gonzalez ◽  
J L Perez Bosca ◽  
D Escribano Alarcon ◽  
J M Simon Machi ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Left Atrium ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Contrast Echocardiography ◽  
Left Ventricular ◽  
Atrial Appendage ◽  
Invasive Approach ◽  
Cardiovascular Morbidity And Mortality ◽  
Doppler Color

Abstract Left atrial appendage aneurysm is an infrequent cardiac malformation, with less than 150 cases reported in the literature. It is a congenital anomaly in the majority of cases, related to a dysplasia of pectinate muscles and atrial muscle bands, which tends to grow with age. At the present time, and despite of being not considered in current guidelines, surgical resection is the standard of treatment in the current literature, even in asymptomatic cases, based on cardiovascular morbidity and mortality by predisposing to atrial tachyarrhythmia, thromboembolism, and other rare conditions as coronary or left ventricular compression and rupture of the aneurysm. We report the case of a 53-year-old male patient presenting an episode of supraventricular paroxysmal tachycardia with the casual finding of a mysterious cavity in the transthoracic echocardiography. We found out the presence of a 50 mm cavity adjacent to the left atrium and left ventricle, with a bidirectional blood flow between the left atrium and the cavity when applying Doppler color and with contrast echocardiography. Given this finding, several differential diagnosis had to be considered, including vascular and structural disorders. In order to clarify the diagnosis, a cardiac magnetic resonance was performed. It revealed the presence of a huge aneurysm of the left atrial appendage (50 x 53 mm) causing a mild compression of the left ventricle, with no thrombus and no other significant findings. Due to its size, the compression of the left ventricle and the history of atrial arrhythmia we decided to manage it with an invasive approach by performing a middle thoracotomy, in order to prevent potentially serious complications. Abstract 1112 Figure. CMR 3D reconstruction; echocardiography

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.

Donation after circulatory death hearts recipients compared to donation after brain death heart recipients have comparable systolic left ventricular function and better myocardial strain at 1 year

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Ciarka ◽  
A Page ◽  
S Messer ◽  
E Pavlushkov ◽  
S Tsui ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Left Ventricular ◽  
Myocardial Deformation ◽  
Lv Function ◽  
Donation After Circulatory Death ◽  
Deformation Parameters ◽  
Echocardiographic Parameters ◽  
Donation After Brain Death ◽  
Circulatory Death

Abstract Purpose Cardiac transplantation from donation after circulatory death (DCD) has been implemented at our hospital since February 2015. Despite encouraging results some concerns may be raised about the impact of the warm ischemia and reperfusion injury on the myocardium status at longer follow-up. Therefore, we aimed to analyse systolic performance of the left ventricle at 1 year follow in DCD and donation after brain death (DBD) cardiac recipients, as assessed by echocardiography with myocardial deformation imaging. Methods We identified 46 consecutive DCD cardiac recipients who were transplanted from February 2015 to August 2018 and we matched them with 46 DBD cardiac recipients. Six and 7 patients from DCD and DBD group, respectively, died in the first-year post transplant. In the remaining patients we have compared the classical echocardiographic measurements as well as global longitudinal strain (GLS) and global circumferential strain (GCS) at 1-year follow-up. Results DCD and DBD patients did not present with differences in terms of classical echocardiographic parameters of left ventricular (LV) structure and systolic function at one-year follow-up. LVEDV was similar in DCD and DBD patients (101±24 vs. 95±32 ml, p=0.4 respectively), as well as LVESV (42±13 vs. 42±16 ml, p=0.9, respectively), LV ejection fraction (58±6 vs. 56±8%, p=0.22) and LV mass (156±39 vs. 163±38 gr, p=0.2, respectively). In contrast, myocardial deformation parameters, such as GLS and GCS, were better in DCD than in DBD (16.1 vs. −14.5%, p&lt;0.01; and −25.2 vs. 22.3%, p&lt;0.05, respectively). The diastolic LV function parameters were similar in DCD and DBD group, as evidenced by E wave velocity, A wave velocity and deceleration time of mitral inflow, however E over E prime was lower in DCD than in DBD recipients (7.7±8.7, p&lt;0.05). Fractional area change of the right ventricle was higher in DCD in comparison with DBD (46±7 vs. 40±7%, p&lt;0.01) while right atrial volume index was lower in DCD than in DBD (25±8 vs. 29±9 ml/m2, p&lt;0.01). Other parameters of RV function (systolic excursion of the tricuspid annulus, TAPSE) were similar in both groups. Conclusion DCD and DBD heart recipients present with similar systolic LV function at 1-year follow, as assessed by classical echocardiographic parameters. DCD cardiac recipients have better myocardial deformation parameters as assessed by the speckle tracking, better systolic right ventricular function and lower filling pressures of the left ventricle. Funding Acknowledgement Type of funding source: None

scholarly journals Chronic Heart Failure in Rheumatoid Arthritis Patients (Part II): Difficulties of Diagnosis

2019 ◽  
Vol 14 (6) ◽  
pp. 870-878 ◽  
Author(s):  
D. S. Novikova ◽  
H. V. Udachkina ◽  
I. G. Kirillova ◽  
T. V. Popkova
Keyword(s):  
Rheumatoid Arthritis ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Natriuretic Peptides ◽  
Myocardial Dysfunction ◽  
Left Ventricular ◽  
Myocardial Deformation ◽  
Left Ventricular Ejection

Rheumatoid arthritis (RA) is characterized by a twofold increase in morbidity and mortality due to chronic heart failure (CHF). At the same time, the prevalence of CHF among RA patients is significantly underestimated. The aim of the review was to analyze the results of the main studies on the features of the clinical presentation of heart failure (HF) in RA patients, the role of visualization techniques and biomarkers in the diagnosis of HF and preclinical dysfunction of the myocardium. HF in patients with RA is characterized by a predominance of HF with a preserved left ventricular ejection fraction (LVEF). The use of clinical diagnostic criteria in RA patients can lead to both over- or underdiagnosis of CHF. Systolic dysfunction estimated by LVEF is rare in RA and does not reflect the real frequency of myocardial dysfunction. Echocardiography (ECHO-CG) with tissue Doppler echocardiography (TDE) and visualization of myocardial deformation, magnetic resonance imaging (MRI) of the heart in RA patients revealed a high frequency of HF with preserved ejection fraction, left ventricular remodeling and hypertrophy, pre-clinical systolic and diastolic dysfunction. Determination of natriuretic peptides is useful for verifying the diagnosis of HF and estimating the prognosis in this cohort, despite the possible decrease in the sensitivity and specificity of these indicators in RA patients. The review discusses the advantages of MRI of the heart, including quantitative T1 and T2 regimens, in the diagnosis of myocarditis, myocardial fibrosis, and myocardial perfusion disorders in RA patients. In order to verify the diagnosis of heart failure and detect pre-clinical myocardial dysfunction in RA patients, the determination of natriuretic peptides concentration should become part of the routine examination, beginning with the debut of the disease, along with the collection of a cardiological history, physical examination, ECHO-CT with TDE, and visualization of myocardial deformation. Evaluation of the quantitative characteristics of tissue according to MRI of the heart could improve the diagnosis of myocardial damage.

Biatrial Approach for Bicameral Myxoma with Mitral Regurgitation

2000 ◽  
Vol 8 (2) ◽  
pp. 167-168 ◽  
Author(s):  
Pankaj Goel ◽  
Nainar Madhu Sankar ◽  
Sethurathinam Rajan ◽  
Kotturathu Mammen Cherian
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Left Atrium ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Severe Mitral Regurgitation ◽  
Two Dimensional ◽  
Dimensional Echocardiography ◽  
Two Dimensional Echocardiography

A 16-year-old girl presented with an episode of syncope. Two-dimensional echocardiography revealed masses in the left atrium and left ventricle with severe mitral regurgitation. She underwent removal of myxomas and mitral valve replacement using an extended biatrial approach.

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