scholarly journals Evaluation of left ventricular myocardial work quantitatively by pressure-strain loop in young strength athletes with different heart rates

2021 ◽  
Author(s):  
Pengge Li ◽  
Yonggao Zhang ◽  
Lijin Li ◽  
Mengjiao Sun ◽  
Zhen Li ◽  
...  
Keyword(s):  
Systolic Function ◽  
Linear Regression Analysis ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Peak Strain ◽  
Work Efficiency ◽  
Heart Rates ◽  
Work Index ◽  
Lv Systolic Function

Objective: The present study aimed to investigate the difference in left ventricular (LV) global and regional myocardial (MW) of strength athletes with different heart rates (HR) through non-invasive LV pressure-strain loop (PSL) and further address the effect of athlete’s heart rate variability on the LV systolic function. Methods: Fifty young professional wrestlers were collected randomly and divided into two groups in accordance with their different HR: the low HR (45~60 bpm, n=25) and the high HR (60~80 bpm, n=25). Thirty individuals with gender- and age-matched healthy volunteers served as controls ( n=30). Global and regional MW parameters were evaluated using LV-PSL derived from speckle tracking echocardiography (STE) and brachial artery pressure, and then compared between the above three groups. Results: The indicators of global and regional MW did statistically significantly differ between the athlete and control groups. Peak strain dispersion (PSD) and global myocardial wasted work (GWW) increased while global myocardial work efficiency (GWE) reduced in LHR and HHR groups compared with the control group, and global myocardial work index (GWI), global myocardial constructive work (GCW), global longitudinal strain (GLS) decreased in LHR group ( P＜0.05). In comparison to the LHR group, GWI, GCW, GWW, PSD increased in HHR group and GWE reduced ( P＜0.05). According to the regional MW analysis, the mean regional myocardial work index (RMWI) increasing gradually from basal to apical levels were similar across the three groups and regional myocardial work efficiency (RMWE) did not. Multiple linear regression analysis indicated that the HR, posterior wall thickness (PWT), interventricular septal thickness (IVST), GLS, and PSD were correlated with GWE ( b’= -0.247, -0.390, -0.370, 0.340, and -0.554, respectively, P＜0.05). Conclusions: The LV contractile performance was more impaired in young strength athletes with high heart rates and PSL can be used to assess LV GMW and RMW quantitatively and accurately in reflecting LV systolic function.

scholarly journals Evaluation of Left Ventricular Global and Regional Myocardial Work Quantitatively by Pressure-strain Loop in Young Strength Athletes With Different Heart Rates

2021 ◽  
Author(s):  
Pengge Li ◽  
Yonggao Zhang ◽  
Lijin Li ◽  
Mengjiao Sun ◽  
Zhen Li ◽  
...  
Keyword(s):  
Systolic Function ◽  
Linear Regression Analysis ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Peak Strain ◽  
Work Efficiency ◽  
Heart Rates ◽  
Work Index ◽  
Lv Systolic Function

Abstract Objective: The present study aimed to investigate the difference in left ventricular (LV) global and regional myocardial work (MW) of strength athletes with different heart rates (HR) through non-invasive LV pressure-strain loop (PSL) and further address the effect of athlete’s resting heart rate variability on the LV systolic function.Methods:Fifty young professional wrestlers were collected randomly and divided into two groups in accordance with their different heart rates: the low HR group (45~60 bpm, n1=25) and the high HR group (60~80 bpm, n2=25). Thirty individuals with gender- and age-matched healthy volunteers served as controls (n3=30). Global and regional MW parameters were evaluated using LV-PSL derived from speckle tracking echocardiography (STE) and brachial artery pressure. The differences between three groups of data and the linear relationship among conventional echocardiographic parameters and global myocardial work efficiency (GWE) were analyzed.Results:The indicators of global and regional MW did statistically significantly differ between the athlete and control groups. Compared with the control group, Peak strain dispersion (PSD) and global myocardial wasted work (GWW) increased while GWE reduced all in the low HR and high HR groups, and global myocardial work index (GWI), global myocardial constructive work (GCW), global longitudinal strain (GLS) decreased in the low HR group (all P＜0.05). In comparison to the low HR group, GWI, GCW, GWW, PSD increased in the high HR group and GWE reduced (P＜0.05). According to the regional MW analysis, the mean regional myocardial work index (RMWI) was increased gradually from basal to apical levels, which were similar across the three groups, but regional myocardial work efficiency (RMWE) did not. Multiple linear regression analysis indicated that the HR, posterior wall thickness (PWT), interventricular septal thickness (IVST), GLS, and PSD were well correlated with GWE (b’= -0.247, -0.390, -0.370, 0.340, and -0.554, respectively, P＜0.05).Conclusions:The sub-clinical changes of LV contractile performance were more obvious in young strength athletes with high resting heart rates and PSL could be used to assess LV GMW and RMW quantitatively and accurately in reflecting LV systolic function.

scholarly journals Evaluation of Left Ventricular Myocardial Work Quantitatively by Pressure-strain Loop in Young Strength Athletes With Different Heart Rates

2021 ◽  
Author(s):  
Pengge Li ◽  
Lijin Li ◽  
Mengjiao Sun ◽  
Zhen Li ◽  
Mengmeng Liu ◽  
...  
Keyword(s):  
Systolic Function ◽  
Linear Regression Analysis ◽  
Global Longitudinal Strain ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Control Group ◽  
Peak Strain ◽  
Work Efficiency ◽  
Heart Rates ◽  
Work Index

Abstract Objective: The present study aimed to investigate the difference in left ventricular (LV) global and regional myocardial (MW) of strength athletes with different heart rates (HR) through non-invasive LV pressure-strain loop (PSL) and further address the effect of athlete’s heart rate variability on the LV systolic function.Methods:Fifty young professional wrestlers were collected randomly and divided into two groups in accordance with their different HR: the low HR (45~60 bpm, n1=25) and the high HR (60~80 bpm, n2=25). Thirty individuals with gender- and age-matched healthy volunteers served as controls (n3=30). Global and regional MW parameters were evaluated using LV-PSL derived from speckle tracking echocardiography (STE) and brachial artery pressure, and then compared between the above three groups.Results:The indicators of global and regional MW did statistically significantly differ between the athlete and control groups. Peak strain dispersion (PSD) and global myocardial wasted work (GWW) increased while global myocardial work efficiency (GWE) reduced in LHR and HHR groups compared with the control group, and global myocardial work index (GWI), global myocardial constructive work (GCW), global longitudinal strain (GLS) decreased in LHR group (P＜0.05). In comparison to the LHR group, GWI, GCW, GWW, PSD increased in HHR group and GWE reduced (P＜0.05). According to the regional MW analysis, the mean regional myocardial work index (RMWI) increasing gradually from basal to apical levels were similar across the three groups and regional myocardial work efficiency (RMWE) did not. Multiple linear regression analysis indicated that the HR, posterior wall thickness (PWT), interventricular septal thickness (IVST), GLS, and PSD were correlated with GWE (b’= -0.247, -0.390, -0.370, 0.340, and -0.554, respectively, P＜0.05).Conclusions:The LV contractile performance was more impaired in young strength athletes with high heart rates and PSL can be used to assess LV GMW and RMW quantitatively and accurately in reflecting LV systolic function.

scholarly journals Assessment of left ventricular systolic function by non-invasive pressure-strain loop area in young male strength athletes

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Pengge Li ◽  
Yonggao Zhang ◽  
Lijin Li ◽  
Yingchun Chen ◽  
Zhen Li ◽  
...  
Keyword(s):  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Young Male ◽  
Left Ventricular ◽  
Control Group ◽  
Peak Strain ◽  
Non Invasive ◽  
Lv Systolic Function ◽  
Contractile Performance ◽  
Athlete Group

Abstract Background The health of athletes has been recognized as a worldwide public concern with more reported sudden cardiac deaths (SCD). Therefore, early detection of abnormal heart function in athletes can help reduce the risk of exercise. A novel valid non-invasive method to evaluate left ventricular (LV) myocardial work (MW) using LV pressure-strain loop (PSL), was used in this paper to explore LV systolic function in young male strength athletes. Methods Thirty-six professional young male strength athletes (the athlete group) and 32 healthy, age-matched young men (the control group) were involved in the study. The LVMW parameters were calculated as the area of PSL by two-dimensional speckle tracking echocardiography (2D-STE) and peak systolic LV pressure. The differences between two groups of data and the predictive efficacy of MW parameters for LV systolic function were analyzed. Results The athlete group had significantly higher values of global wasted myocardial work (GWW) and peak strain dispersion (PSD) than did the control group (P<0.05). Global myocardial work index (GWI), global constructive myocardial work (GCW) and global longitudinal strain (GLS) were lower in the athlete group than that in the control group, although statistical significance was not reached (P>0.05). Due to the proportion of GWW and GCW, statistically significant reduction was found in global myocardial work efficiency (GWE) in the athlete group. Conventional echocardiography parameters were well correlated with GWW and GWE (P<0.05). The best predictor of LV myocardial contractile performance in the athletes using receiver operating characteristic curve (ROC) was GWE, with the area under ROC (AUC) of 0.733, sensitivity of 83.3% and specificity of 59.4%. Conclusions Subclinical changes have appeared in the hearts of young male strength athletes after long-term intensive exercise and LVMW parameters by PSL play an important role in the evaluation of athlete’s LV contractile performance.

scholarly journals Assessment of left ventricular systolic function by non-invasive pressure-strain loop area in young male strength athletes

2020 ◽  
Author(s):  
Shaohua Hua ◽  
Pengge Li ◽  
Lijin Li ◽  
Yingchun Chen ◽  
Zhen Li ◽  
...  
Keyword(s):  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Young Male ◽  
Left Ventricular ◽  
Control Group ◽  
Peak Strain ◽  
Non Invasive ◽  
Lv Systolic Function ◽  
Contractile Performance ◽  
Athlete Group

Abstract Background The health of athletes has been recognized as a worldwide public concern with more reported sudden cardiac deaths (SCD). Therefore, early detection of abnormal heart function in athletes can help reduce the risk of exercise. A novel valid non-invasive method to evaluate left ventricular (LV) myocardial work (MW) using LV pressure-strain loop (PSL), was used in this paper to explore LV systolic function in young male strength athletes. Methods 36 professional young male strength athletes (the athlete group) and 32 healthy, age-matched young men (the control group) were involved in the study. The LVMW parameters were calculated as the area of PSL by two-dimensional speckle tracking echocardiography (2D-STE) and peak systolic LV pressure. The differences between two groups of data and the predictive efficacy of MW parameters for LV systolic function were analyzed. Results The athlete group had significantly higher values of global wasted myocardial work (GWW) and peak strain dispersion (PSD) than did the control group (P༜0.05).Global myocardial work index (GWI), global constructive myocardial work (GCW) and global longitudinal strain (GLS) were lower in the athlete group than that in the control group, although statistical significance was not reached (P༞0.05). Due to the proportion of GWW and GCW, statistically significant reduction was found in global myocardial work efficiency (GWE) in the athlete group. The best predictor of LV myocardial contractile performance in the athletes using receiver operating characteristic curve (ROC) was GWE, with the area under ROC (AUC) of 0.733, sensitivity of 83.3% and specificity of 59.4%. Conclusions Subclinical changes have appeared in the hearts of young male strength athletes after long-term intensive exercise and LVMW parameters by PSL play an important role in the evaluation of athlete’s LV contractile performance.

scholarly journals Assessment of left ventricular systolic function by non-invasive pressure-strain loop area in young male strength athletes

2020 ◽  
Author(s):  
Shaohua Hua ◽  
Pengge Li ◽  
Yonggao Zhang ◽  
Lijin Li ◽  
Yingchun Chen ◽  
...  
Keyword(s):  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Young Male ◽  
Left Ventricular ◽  
Control Group ◽  
Peak Strain ◽  
Non Invasive ◽  
Lv Systolic Function ◽  
Contractile Performance ◽  
Athlete Group

Abstract BackgroundThe health of athletes has been recognized as a worldwide public concern with more reported sudden cardiac deaths (SCD). Therefore, early detection of abnormal heart function in athletes can help reduce the risk of exercise. A novel valid non-invasive method to evaluate left ventricular (LV) myocardial work (MW) using LV pressure-strain loop (PSL), was used in this paper to explore LV systolic function in young male strength athletes.Methods 36 professional young male strength athletes (the athlete group) and 32 healthy, age-matched young men (the control group) were involved in the study. The LVMW parameters were calculated as the area of PSL by two-dimensional speckle tracking echocardiography (2D-STE) and peak systolic LV pressure. The differences between two groups of data and the predictive efficacy of MW parameters for LV systolic function were analyzed.Results The athlete group had significantly higher values of global wasted myocardial work (GWW) and peak strain dispersion (PSD) than did the control group (P＜0.05).Global myocardial work index (GWI), global constructive myocardial work (GCW) and global longitudinal strain (GLS) were lower in the athlete group than that in the control group, although statistical significance was not reached (P＞0.05). Due to the proportion of GWW and GCW, statistically significant reduction was found in global myocardial work efficiency (GWE) in the athlete group. Conventional echocardiography parameters were well correlated with GWW and GWE (P＜0.05). The best predictor of LV myocardial contractile performance in the athletes using receiver operating characteristic curve (ROC) was GWE, with the area under ROC (AUC) of 0.733, sensitivity of 83.3% and specificity of 59.4%. ConclusionsSubclinical changes have appeared in the hearts of young male strength athletes after long-term intensive exercise and LVMW parameters by PSL play an important role in the evaluation of athlete’s LV contractile performance.

Abstract 14432: Myocardial Work in Stage I and II Hypertensive Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Akshar Jaglan ◽  
Sarah Roemer ◽  
Ana C Perez Moreno ◽  
Bijoy K Khandheria
Keyword(s):  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Deformation Analysis ◽  
Hypertensive Patients ◽  
Reduced Ejection Fraction ◽  
Work Index ◽  
Significant Difference ◽  
Global Work ◽  
Lv Systolic Function

Introduction: Myocardial work is a novel parameter that can be used in a clinic setting to assess left ventricular (LV) pressures and deformation. This study sought to distinguish patterns of global myocardial work index in hypertensive vs. non-hypertensive patients. Methods: Fifty (25 male, mean age 60±14 years) hypertensive patients and 15 (7 male, mean age 38±12 years) control patients underwent transthoracic echocardiography at rest. Hypertensive patients were divided into stage 1 (26 patients) and stage 2 (24 patients) based on the 2017 American College of Cardiology guidelines. We excluded patients with suboptimal image quality for myocardial deformation analysis, reduced ejection fraction (EF), valvular heart disease, and arrhythmia. Global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) were estimated from LV pressure strain loops utilizing proprietary software from speckle-tracking echocardiography. LV systolic and diastolic pressures were estimated using a noninvasive brachial artery cuff. Results: Global longitudinal strain (GLS) and EF were preserved between the two groups with no statistically significant difference whereas there was a statistically significant difference in the GWI (p<0.01), GCW (p=0.03), GWW (p<0.01), and GWE (p=0.03) (Figure and Table). Conclusions: Myocardial work gives us a closer look at the relationship between LV pressure and contractility in settings of increased load dependency whereas LVEF and GLS cannot. We show how myocardial work is an advanced assessment of LV systolic function in hypertensive patients.

scholarly journals Value of peak strain dispersion in discovering left ventricular dysfunction in diabetes mellitus

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Chunmei Li ◽  
Miao Yuan ◽  
Kun Li ◽  
Wenjuan Bai ◽  
Li Rao
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Linear Regression Analysis ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Multivariate Linear Regression Analysis ◽  
Peak Strain ◽  
Lv Dysfunction ◽  
Glucose Group

AbstractCardiovascular disease is one of the main causes of death in diabetes mellitus (DM) patients. The aim of the current study was to explore the value of peak strain dispersion (PSD) for discovering early-stage left ventricular (LV) dysfunction in type 2 diabetes mellitus (T2DM) patients. One hundred and one T2DM patients and sixty healthy subjects were selected for this study. T2DM patients were further divided into controlled blood glucose (HbA1c < 7%, n = 46) and uncontrolled blood glucose (HbA1c ≥ 7%, n = 55) subgroups. All participants underwent conventional echocardiography and two-dimensional speckle-tracking echocardiography. Our results showed that an obvious difference was not observed in global longitudinal strain (GLS) between the controlled blood glucose group and the control group (− 20.34% vs − 21.22%, P = 0.068). Compared with the healthy controls, the uncontrolled blood glucose group showed an impaired GLS (− 18.62% vs − 21.22%, P < 0.001). Nevertheless, PSD was appreciably increased in the controlled blood glucose group (36.02 ms vs 32.48 ms, P = 0.01) and uncontrolled blood glucose group (57.51 ms vs 32.48 ms, P < 0.001). Multivariate linear regression analysis showed that HbA1c was closely related to PSD lesion in the LV in the T2DM group (β = 0.520, P < 0.001). PSD plays an important role in evaluating the coordination and synchronization of myocardial movement and provides a more accurate and sensitive index assessment of early LV systolic function in T2DM patients. In addition, HbA1c levels were related to LV dysfunction.

scholarly journals Comparison of Left Ventricular Global Longitudinal Strain Measured with Real Time Triplane and 2-Dimensional Echocardiography in Patients with Atrial Fibrillation

2015 ◽  
Vol 4 ◽  
pp. 24 ◽  
Author(s):  
Ling Yun Kong ◽  
Chao Yu ◽  
Jihong Guo ◽  
Tiangang Zhu
Keyword(s):  
Atrial Fibrillation ◽  
Real Time ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Simultaneous Presentation ◽  
Left Ventricular ◽  
Control Group ◽  
Reproducibility Study ◽  
Dimensional Echocardiography ◽  
Lv Systolic Function

<p><strong>Background: </strong>Left ventricular (LV) global longitudinal peak systolic strain (GLPS, also known as GLS) based on speckle tracking echocardiography (STE) is validated to evaluate global LV systolic function, particularly the global average GLPS (GLPS<sub>Avg</sub>, which is averaged from three apical longitudinal views). But its application is limited in patients with atrial fibrillation (AF) due to its variability of cycle lengths. A novel imaging technique, real time triplane echocardiography (3PE), allows simultaneous presentation of apical 4-, 2-, and 3- chamber views within one ultrasonic view. We compared GLPS measures using 3PE and conventional 2-dimensional echocardiography (2DE) in patients with AF.</p><p><strong>Methods: </strong>Patients with AF and a control group with sinus rhythm were enrolled prospectively. Three apical sectional GLPSs and GLPS<sub>Avg </sub>were measured with conventional 2D (2D-STE) and 3PE (3P-STE) modes. Comparison, correlation and agreement of measurements with both modes were made. Ten patients were selected randomly for reproducibility study.</p><p><strong>Results:</strong> (1) A total of 39 patients with AF and 38 control subjects were analyzed. Adequate apical 3PE views were acquired in most subjects (95%). Measurement of GLPSs with 3P-STE was more readily available than with 2D-STE in AF group (97.5% vs. 60.0%, <em>P</em>=000). (2) The GLPS<sub>s</sub> measured with 3P-STE was constantly lower than that of 2D-STE, but linearly correlated, with GLPS<sub>Avg</sub> revealing the best correlation (<em>r</em>=0.86, <em>P</em>=0.00 in both groups). (3) The reproducibility of GLPS measured by 3P-STE was valid.</p><p><strong>Conclusions: </strong>Triplane echocardiography may extend the use of LV GLPS<sub>Avg</sub> to patients with AF for assessment of LV systolic function.</p>

scholarly journals Acute recoordination rather than functional hemodynamic improvement determines reverse remodelling by cardiac resynchronisation therapy

2021 ◽  
Author(s):  
Philippe C. Wouters ◽  
Geert E. Leenders ◽  
Maarten J. Cramer ◽  
Mathias Meine ◽  
Frits W. Prinzen ◽  
...  
Keyword(s):  
Systolic Function ◽  
Cardiac Resynchronisation Therapy ◽  
Left Ventricular ◽  
Lv Function ◽  
Peak Strain ◽  
Cardiac Resynchronisation ◽  
Reverse Remodelling ◽  
Resynchronisation Therapy ◽  
Lv Systolic Function

AbstractPurpose: Cardiac resynchronisation therapy (CRT) improves left ventricular (LV) function acutely, with further improvements and reverse remodelling during chronic CRT. The current study investigated the relation between acute improvement of LV systolic function, acute mechanical recoordination, and long-term reverse remodelling after CRT. Methods: In 35 patients, LV speckle tracking longitudinal strain, LV volumes & ejection fraction (LVEF) were assessed by echocardiography before, acutely within three days, and 6 months after CRT. A subgroup of 25 patients underwent invasive assessment of the maximal rate of LV pressure rise (dP/dtmax,) during CRT-implantation. The acute change in dP/dtmax, LVEF, systolic discoordination (internal stretch fraction [ISF] and LV systolic rebound stretch [SRSlv]) and systolic dyssynchrony (standard deviation of peak strain times [2DS-SD18]) was studied, and their association with long-term reverse remodelling were determined. Results: CRT induced acute and ongoing recoordination (ISF from 45 ± 18 to 27 ± 11 and 23 ± 12%, p < 0.001; SRS from 2.27 ± 1.33 to 0.74 ± 0.50 and 0.71 ± 0.43%, p < 0.001) and improved LV function (dP/dtmax 668 ± 185 vs. 817 ± 198 mmHg/s, p < 0.001; stroke volume 46 ± 15 vs. 54 ± 20 and 52 ± 16 ml; LVEF 19 ± 7 vs. 23 ± 8 and 27 ± 10%, p < 0.001). Acute recoordination related to reverse remodelling (r = 0.601 and r = 0.765 for ISF & SRSlv, respectively, p < 0.001). Acute functional improvements of LV systolic function however, neither related to reverse remodelling nor to the extent of acute recoordination. Conclusion: Long-term reverse remodelling after CRT is likely determined by (acute) recoordination rather than by acute hemodynamic improvements. Discoordination may therefore be a more important CRT-substrate that can be assessed and, acutely restored.

scholarly journals P790 Bi-ventricular dysfunction in patients after bone marrow transplant: the value of strain imaging

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
T Deshmukh ◽  
P Geenty ◽  
L Geraghty ◽  
D Emmerig ◽  
S Sivapathan ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Ventricular Function ◽  
Ventricular Dysfunction ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Strain Analysis ◽  
Strain Imaging ◽  
Left Ventricular ◽  
Control Group ◽  
Cardiac Events

Abstract Background Cardiovascular events are a significant cause of morbidity and mortality in cancer survivors, particularly occurring at 5-10 years after their cancer therapy. Purpose To assess the utility of strain imaging by 2-dimensional (2D) speckle tracking echocardiography in detecting bi-ventricular dysfunction, as compared to traditional measures, in patients post bone marrow transplantation (BMT) with previous anthracycline (AC) therapy for haematological conditions. Methods 50 consecutive patients post BMT + AC, reviewed at a long-term survivor clinic, were compared to 50 age and gender matched controls. 48/50 patients received AC doses below the recommended cumulative lifetime thresholds set by the European Society of Medical Oncology. 2D left ventricular global longitudinal strain (LV GLS) and right ventricle free wall strain (RV FWS) were compared to conventional measures of bi-ventricular function. Results The mean LVEF (58 ± 6% vs 63 ± 6%) and RV fractional area change (FAC) (39 ± 5% vs 44 ± 5%), although reduced in the BMT + AC group vs controls, were within normal limits. LV GLS was reduced in BMT + AC patients as compared to controls (-17.8 ± 3.1% vs -20.5 ± 2.2%, p &lt; 0.01) while RV FWS was also reduced (-23.2 ± 4.0% vs -27.9 ± 2.7%, p &lt; 0.001). In BMT + AC patients with a preserved LVEF (LVEF &gt; 53%), 28% (11/40) had reduced GLS (GLS &lt; -17%) while 52% (24/46) of those with preserved FAC (FAC &gt; 35%) had reduced FWS (FWS &lt; -25%). Major adverse cardiac events (MACE) occurred in 9/50 patients in the BMT + AC group and none in the control group. 8/9 patients had normal biventricular function as assessed by traditional parameters (LVEF and RV FAC) but 5/9 patients had reduced LV GLS and/or RV FWS. Conclusions Subclinical bi-ventricular dysfunction is common in patients post BMT + AC therapy, and can be detected using strain analysis, despite preserved LV and RV systolic function using conventional measures. MACE occurred at a significantly higher rate in BMT patients exposed to AC. More than half of MACE events occurred in patients with reduced LV or RV strain, with preserved bi-ventricular function by traditional measures. LV GLS and RV FWS should be utilised for early identification of subclinical dysfunction in BMT patients.

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