scholarly journals The Diagnostic Value of 2D- Speckle Tracking Echocardiography for Identifying Subclinical Ventricular Dysfunction in Subjects with Early Repolarization Pattern

Author(s):  
Tuğçe Çöllüoğlu ◽  
Orhan Onalan ◽  
Fahri Çakan

Introduction: Early repolarization pattern (ERP) has been known a benign electrocardiographic variant for decades. However, it can exist a silent substrate for arrhytmic events in accordance with the previous studies which have shown that there has been evidence of morphological changes in left ventricle (LV) in subjects with ERP. Despite structural changes in ERP subjects, it has not exactly known that whether a change in functional parameters of LV occur in these population. The aim of our study was to investigate LV functional parameters in subjects with ERP by the use of 2D- speckle tracking echocardiography (2D-STE). Method: In this study, subjects with ERP (n= 50) and subjects without ERP (n= 50) were recruited between 01.04.2018 and 01.09.2018. For each case, 2D- STE evaluation was performed by the same cardiologist. Results: Mean LV global longitudinal strain (GLS) and GLS in all apical chamber views, longitudinal peak systolic strain rate (SRS) at A3C, early diastolic strain rate (SRE) at A3C and late diastolic strain rate (SRA) at A3C in the ERP subjects were significantly lower than those in the subjects without ERP. Furthermore, LV basal segment circumferential SRS and SRE were significantly lower in ERP subjects compared to subjects without ERP. Conclusion: Our study suggests that ERP can be more associated with impaired LV longitudinal function than LV circumferential function. In addition, both LV inferolateral region and LV basal segment can be more affected functionally in ERP subjects.

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 562
Author(s):  
Rima Šileikienė ◽  
Karolina Adamonytė ◽  
Aristida Ziutelienė ◽  
Eglė Ramanauskienė ◽  
Jolanta Justina Vaškelytė

Background and objectives: Childhood obesity has reached epidemic levels in the world. Obesity in children is defined as a body mass index (BMI) equal to or above the 95th percentile for age and sex. The aim of this study was to determine early changes in cardiac structure and function in obese children by comparing them with their nonobese peers, using echocardiography methods. Materials and methods: The study enrolled 35 obese and 37 age-matched nonobese children. Standardized 2-dimensional (2D), pulsed wave tissue Doppler, and 2D speckle tracking echocardiography were performed. The z-score BMI and lipid metabolism were assessed in all children. Results: Obese children (aged 13.51 ± 2.15 years; 20 boys; BMI z-score of 0.88 ± 0.63) were characterized by enlarged ventricular and atrial volumes, a thicker left ventricular posterior wall, and increased left ventricular mass. Decreased LV and RV systolic and diastolic function was found in obese children. Atrial peak negative (contraction) strain (−2.05% ± 2.17% vs. −4.87% ± 2.97%, p < 0.001), LV and RV global longitudinal strain (−13.3% ± 2.88% vs. −16.87% ± 3.39%; −12.51% ± 10.09% vs. −21.51% ± 7.42%, p < 0.001), and LV global circumferential strain (−17.0 ± 2.7% vs. −19.5 ± 2.9%, p < 0.001) were reduced in obese children. LV torsion (17.94° ± 2.07° vs. 12.45° ± 3.94°, p < 0.001) and normalized torsion (2.49 ± 0.4°/cm vs. 1.86 ± 0.61°/cm, p = 0.001) were greater in obese than nonobese children. A significant inverse correlation was found between LV and RV global longitudinal strain and BMI (r = −0.526, p < 0.01; r = −0.434, p < 0.01) and total cholesterol (r = −0.417, p < 0.01). Multivariate analysis revealed that the BMI z-score was independently related to LV and RV global longitudinal strain as well as LV circumferential and radial strain. Conclusion: 2D speckle tracking echocardiography is beneficial in the early detection of regional LV systolic and diastolic dysfunctions, with preserved ejection fraction as well as additional RV and atrial involvement, in obese children. Obesity may negatively influence atrial and ventricular function, as measured by 2D speckle tracking echocardiography. Obese children, though they are apparently healthy, may have subclinical myocardial dysfunction.


2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
MRA Lacanin ◽  
EST Tucay

Abstract Funding Acknowledgements Type of funding sources: None. BACKGROUND  2D speckle strain echocardiography has been recognized in different studies to provide additional important prognostic information in patients with chronic stable coronary artery disease or acute coronary syndrome (ACS)—more often on (ST elevation myocardial infarction (STEMI) patients. PURPOSE  This study aimed to determine the clinical utility of 2D speckle tracking echocardiography in predicting major adverse cardiac events (MACE) in patients with non ST elevation – acute coronary syndrome (NSTE-ACS). METHODOLOGY This is a prospective cohort study which included 91 patients diagnosed to have NSTE-ACS. Baseline characteristics were collected and echocardiographic evaluations of patients were done within 48 hours of admission. In hospital and 6 months MACE were evaluated in relation to their baseline echocardiographic parameters, 2D speckle strain and strain rate analyses. RESULTS Among the conventional echocardiographic parameters, only left ventricular end systolic diameter (LVESD) and wall motion score showed significant difference between those with and without outcomes after 6 months. There were no significant difference among the 2D speckle tracking strain and strain rate parameters between those patients with and without major cardiac events during their in hospital admission. However after 6 months follow-up, there were significantly lower mean left ventricular global longitudinal strain (GLS) (-14.22% ± 4.45 versus -16.44% ± 4.19, p-value 0.0261) and strain rate (-0.69 1/sec ± 0.36 versus -0.94 1/sec ± 0.25, p-value 0.009) were observed among patients with MACE compared to those without. Also, incidence of reduced GLS strain and strain rate, were significantly higher in those with MACE after 6 months. The left ventricular global circumferential strain and strain rate, and right ventricular global longitudinal strain did not have significant difference between those with and without but these had a generally lower value among those who had in-hospital and  6 months MACE. In this study, LV GLS sensitivity and specificity were 64.64% and 61.70% respectively, at cut-off value of &lt;-15.0% for detecting MACE within 6 month follow-up. LV GLS cut-off point &lt;-12.0%, which detects severe LV dysfunction in previous studies, have sensitivity of 40% but high specificity of 82.98% for predicting MACE after 6 months. CONCLUSION Both LV GLS strain and strain rate can be used to predict major adverse cardiovascular events after NSTE-ACS. Abstract Figure. ROC curve LV strain and strain rate


2019 ◽  
Vol 9 (3) ◽  
pp. ???
Author(s):  
Bing-yang Liu ◽  
Wei-chun Wu ◽  
Qi-xian Zeng ◽  
Zhi-hong Liu ◽  
Li-li Niu ◽  
...  

We investigated and compared the correlations between two-dimensional speckle tracking echocardiography detected left ventricular peak early diastolic strain rates (global: left ventricular global peak early diastolic strain rate; septum: left ventricular peak early diastolic strain rate of septum; free wall: left ventricular peak early diastolic strain rate of free wall) and disease severity in pre-capillary pulmonary hypertension. Seventy-four pre-capillary pulmonary hypertension patients (23 males and 51 females, 35 ± 13 years) and thirty healthy controls were consecutively recruited for two-dimensional speckle tracking echocardiography analyses in our study. Medical records of pre-capillary pulmonary hypertension patients were reviewed to capture clinical data; risk assessments were performed based on the 2015 ESC Guidelines. Compared with healthy controls, left ventricular global peak early diastolic strain rate was lower in pre-capillary pulmonary hypertension patients (1.11 ± 0.60 s−1 versus 1.47 ± 0.45 s−1, P = 0.001), especially that of the septum (1.13 ± 0.58 s−1 versus 1.68 ± 0.46 s−1, P<0.001). Linear correlation analyses showed significant but weak correlations between left ventricle diastolic parameters and peak oxygen consumption, N-terminal pro-brain natriuretic peptide, and conventional echocardiographic right ventricle parameters: E/E′, tricuspid annular plane systolic excursion, S′, and fractional area change. No or weak correlations were observed between left ventricle diastolic parameters and hemodynamics. Multivariate logistic regression analyses showed left ventricular global peak early diastolic strain rate (OR: 0.304; 95%CI: 0.101–0.911) and left ventricular peak early diastolic strain rate of septum (OR: 0.252; 95%CI: 0.075–0.848) independently predict intermediate–high risk of pulmonary hypertension patients, even adjusted by age, gender, and body mass index. Receive operating characteristic curves showed that all the three models had the capacity to predict intermediate–high risk of pulmonary hypertension patients, and the model including left ventricular peak early diastolic strain rate of septum showed the strongest predictive capacity (area under the curve = 0.76, 95%CI: 0.59–0.93). Two-dimensional speckle tracking echocardiography detected left ventricle diastolic function parameters are significantly correlated with clinical data and can independently predict intermediate–high risk in pre-capillary pulmonary hypertension patients; the dysfunction of interventricular septum may make major contribution.


2021 ◽  
Author(s):  
Qinggele Gao ◽  
Peng Liu ◽  
Tingting Lv ◽  
Ying Yang ◽  
Ping Zhang

Abstract Purpose: Undiagnosed atrial fibrillation (AF) is one of the main sources of cryptogenic stroke. And strain indices measured by speckle-tracking echocardiography are associated with atrial remodeling supposed to be the substrate of AF. Therefore, there is a strong need for evaluating the utility of speckle-tracking echocardiography to predict the likelihood of AF in patients with cryptogenic stroke.Methods: PubMed, Embase and Cochrane Database were searched for studies. The random-effects model was used to calculate the pooled results, and summary receiver operating characteristic curve (SROC) analysis was performed to show the overall predictive value.Results: There were 1483 patients with cryptogenic stroke from 8 studies. Meta-analysis showed that strain indices including global longitudinal strain (GLS) (mean difference [SMD]: -0.22, 95% confidence interval [95% CI]: -0.40 to -0.04) , left atrial reservoir strain (εR), (SMD: -0.87, 95% CI: -1.26 to -0.48, conduit strain (εCD) (SMD: -0.56, 95% CI: -0.81 to -0.30), contractile strain (εCT) (SMD: -1.00, 95% CI: -1.39 to -0.61), and left atrial reservoir strain rate (SRe) (SMD: -0.54, 95% CI: -0.80 to -0.28) measured at the period of cryptogenic stroke was significantly decreased in patients with AF occurrence compared to without. SROC analysis suggested an acceptable predictive efficiency of εR for AF occurrence (AUC = 0.799).Conclusion: For patients after cryptogenic stroke, GLS, εR, εCD, εCT and SRe were significantly decreased in AF occurrence compared with non-occurrence. But there was no value in left atrial reservoir strain rate (SRs) and contractile strain rate (SRa) for predicting AF.


2018 ◽  
Vol 28 (12) ◽  
pp. 1404-1409 ◽  
Author(s):  
Hasan Demetgul ◽  
Dilek Giray ◽  
Ali Delibas ◽  
Olgu Hallioglu

AbstractIntroductionThe aim of this study is to determine early changes in cardiac function of children with chronic kidney disease by using 2D-speckle tracking echocardiography.MethodThe study included 38 children – 16 girls and 22 boys – diagnosed as having chronic kidney disease in the nephrology department with a glomerular filtration rate of <90 ml/minute/1.73 m2 for at least 3 months. A total of 37 – 15 girls and 22 boys – age- and sex-matched healthy children were included as the control group. 2D-Speckle tracking echocardiography was performed in all subjects.ResultsThe mean age was 13.45±2.8 years in patients and 12.89±3.07 years in controls. Systolic and diastolic blood pressures and left ventricular mass index were significantly higher in patients (p<0.05). The values of mitral e, mitral a, mitral e/a ratio, and mitral deceleration time were not different between the groups. Tricuspid annular plane systolic excursion values were lower in patients (p<0.01). Global strain values in apical long-axis 3-chamber and 2-chamber views were significantly lower in patients (p<0.05). Longitudinal, radial, and circumferential peak systolic strain values were lower in patients, but the difference was statistically significant in all segments of longitudinal view and basal segment of circumferential view (p<0.05). Radial and circumferential systolic strain rates were significantly lower in patients in all three segments (p<0.05). Moreover, early diastolic strain rate was significantly lower in longitudinal and radial apical segments and in all segments of circumferential measurements in patients. Besides, strain rate e/a ratio was significantly lower in all longitudinal segments of patients (p=0.01).ConclusionThe study concluded that 2D-speckle tracking echocardiography method can determine cardiac involvement earlier than conventional echocardiography in children with chronic kidney disease having preserved ejection fraction.


Author(s):  
Jedrzej Michalik ◽  
Alicja Dabrowska-Kugacka ◽  
Katarzyna Kosmalska ◽  
Roman Moroz ◽  
Adrian Kot ◽  
...  

We compared the effects of right ventricular (RVP; n = 26) and His bundle (HBP; n = 24) pacing in patients with atrioventricular conduction disorders and preserved LVEF. Postoperatively (1D), and after six months (6M), the patients underwent global longitudinal strain (GLS) and peak systolic dispersion (PSD) evaluation with 2D speckle-tracking echocardiography, assessment of left atrial volume index (LAVI) and QRS duration (QRSd), and sensing/pacing parameter testing. The RVP threshold was lower than the HBP threshold at 1D (0.65 ± 0.13 vs. 1.05 ± 0.20 V, p < 0.001), and then it remained stable, while the HBP threshold increased at 6M (1.05 ± 0.20 vs. 1.31 ± 0.30 V, p < 0.001). The RVP R-wave was higher than the HBP R-wave at 1D (11.52 ± 2.99 vs. 4.82 ± 1.41 mV, p < 0.001). The RVP R-wave also remained stable, while the HBP R-wave decreased at 6M (4.82 ± 1.41 vs. 4.50 ± 1.09 mV, p < 0.02). RVP QRSd was longer than HBP QRSd at 6M (145.0 ± 11.1 vs. 112.3 ± 9.3 ms, p < 0.001). The absolute value of RVP GLS decreased at 6M (16.32 ± 2.57 vs. 14.03 ± 3.78%, p < 0.001), and HBP GLS remained stable. Simultaneously, RVP PSD increased (72.53 ± 24.15 vs. 88.33 ± 30.51 ms, p < 0.001) and HBP PSD decreased (96.28 ± 33.99 vs. 84.95 ± 28.98 ms, p < 0.001) after 6 months. RVP LAVI increased (26.73 ± 5.7 vs. 28.40 ± 6.4 mL/m2, p < 0.05), while HBP LAVI decreased at 6M (30.03 ± 7.8 vs. 28.73 ± 8.7 mL/m2, p < 0.01). These results confirm that HBP does not disrupt ventricular synchrony and provides advantages over RVP.


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