scholarly journals Assessment of Biventricular Myocardial Function with 2-Dimensional Strain and Conventional Echocardiographic Parameters: A Comparative Analysis in Healthy Infants and Patients with Severe and Critical Pulmonary Stenosis

2022 ◽  
Vol 12 (1) ◽  
pp. 57
Author(s):  
Liliana Gozar ◽  
Mihaela Iancu ◽  
Horea Gozar ◽  
Anca Sglimbea ◽  
Andreea Cerghit Paler ◽  
...  
Keyword(s):  
Longitudinal Strain ◽  
Pulmonary Stenosis ◽  
Strain Analysis ◽  
Control Group ◽  
Healthy Infants ◽  
Echocardiographic Evaluation ◽  
Single Center Study ◽  
Significant Difference ◽  
Echocardiographic Parameters ◽  
Critical Pulmonary Stenosis

Our aim was to compare the global longitudinal and regional biventricular strain between infants with severe and critical pulmonary stenosis (PS), and controls; to compare pre- and post-procedural strain values in infants with severe and critical PS; and to assess the correlations between echocardiographic strain and conventional parameters. We conducted a retrospective single-center study. The comparisons of echocardiographic variables were performed using separate linear mixed models. The overall mean right ventricle (RV) regional strains measured before intervention in PS patients was significantly different when compared to the control group (p = 0.0324). We found a significant change in the left ventricle, RV, and inter-ventricular septum strain (IVS) values from basal to apical location (p < 0.05). IVS strain values showed a higher decrease in mean strain values from basal to apical in PS patients. There was no significant difference in means of baseline and post-interventional strain values in PS patients (p > 0.05). Following the strain analysis in patients with PS, we obtained statistically significant changes in the RV global-4-chamber longitudinal strain (RV4C). The RV4C, which quantifies the longitudinal strain to the entire RV, can be used in current clinical practice for the evaluation of RV function in infants with severe and critical PS. The longitudinal and segmental strain capture the pathological changes in the IVS, modifications that cannot be highlighted through a classical echocardiographic evaluation.

scholarly journals 710 Advanced echocardiographic analysis to identify cardiac toxicity after TKI exposure in patients with CML

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Antonio Parlavecchio ◽  
Rodolfo Caminiti ◽  
Giampaolo Vetta ◽  
Giuseppe Pelaggi ◽  
Francesca Lofrumento ◽  
...  
Keyword(s):  
Left Atrial ◽  
Longitudinal Strain ◽  
Cardiac Toxicity ◽  
Strain Analysis ◽  
Control Group ◽  
Additional Tool ◽  
Significant Difference ◽  
Global Work ◽  
Atrial Strain

Abstract Aims Worsening of cardiac function with increased arrhythmic risk is common in cancer patients undergoing chemotherapy. Impaired LV global longitudinal strain (GLS) in these patients despite preserved ejection fraction is a common issue. Recently, myocardial work by speckle-tracking echocardiography has been used to overcome GLS limitations in various conditions, but little is known about its usefulness in the detection of cardiac toxicity. Moreover, left atrial (LA) toxicity may occur early in the course of cancer therapy. The main aim of the study was to assess the cardiotoxic effects of tyrosine kinase inhibitors (TKIs) on patients with Philadelphia chromosome-positive chronic myeloid leukaemia (Ph+ CML) by using novel echocardiographic tools as myocardial work and atrial strain analysis. Methods and results We retrospectively enrolled Ph+ CML patients treated with TKIs followed at the cardio-oncology outpatient clinic of our hospital from December 2018 to March 2019 who underwent clinical evaluation with ECG and echocardiogram (TTE) before and after 1 year of treatment with TKIs. Healthy subjects were enrolled in the control group matched for gender, age and cardiovascular risk factors. Myocardial work was derived from the strain-pressure relation, integrating in its calculation the non-invasive arterial pressure. LA longitudinal strain (reservoir, conduit, and booster) was obtained from an optimized apical 4-chamber view of the LA. The study recruited 32 patients in Ph+ CML group and 32 healthy controls. 39% of patients were treated with Imatinib, 29.3% with Nilotinib, 4.9% with Dasatinib and 4.9% with Ponatinib. Main results are detailed in Table 1. At 1-year follow-up there was a significant reduction compared to baseline in global constructive work (2555.22 ± 564.33 vs. 2119.31 ± 700.19; P = 0.0001), global work efficiency (96.13 ± 1.90 vs. 94.00 ± 2.96; P = 0.002), and global work index (2340.75 ± 579.57 vs. 1938.46 ± 680.23; P = 0.001), and a non-significant reduction in global wasted work (P = 0.393). Regarding left atrial strain analysis at the 1-year follow-up there was a statistically significant reduction in LA contractile strain (booster= 14.63 ± 1.408 vs. 12.38 ± 1.581; P = 0.018). LA contractile strain reduction was also observed in the comparison with controls (12.38 ± 2.99 vs. 14.91 ± 3.09; P = 0.009). Any other significant difference was detected between baseline and FU TTE data in the Ph+ CML group. Conclusions New imaging methods for the study of cardiotoxicity provide an additional tool for early prediction of potential adverse effects of antineoplastic drugs. TKIs therapy leads to an impairment of atrial contractility, which can be detected by atrial strain e myocardial work analysis.

scholarly journals The role of peripheral type 2 innate lymphoid cells in bronchiolitis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yong-Jun Tang ◽  
Li-Li Xie ◽  
Xiang-Rong Zheng ◽  
Chen-Tao Liu ◽  
Xia Wang
Keyword(s):  
Statistical Significance ◽  
Serum Levels ◽  
Innate Lymphoid Cells ◽  
Lymphoid Cells ◽  
Orphan Receptor ◽  
Control Group ◽  
Interleukin 5 ◽  
Healthy Infants ◽  
Significant Difference

AbstractOur aim was to detect type 2 innate lymphoid cells (ILC2s)-related cytokines of infants with bronchiolitis by using Elisa, Liquidchip technology and RT-PCR and investigated its correlation with bronchiolitis. We recruited 26 infants with bronchiolitis and 20 healthy infants as control from Xiangya Hospital. Compared to the control group, the serum levels of interleukin-5 (IL-5) [41.99 (21.11) vs 25.70 (19.64)], IL-9 [27.04 (37.51) vs 8.30 (0.54)], IL-13 [184.05 (132.81) vs 121.75 (176.13)], IL-33 [83.70 (46.69) vs 11.23 (55.31)] and thymic stromal lymphopoietin (TSLP) [31.42 (5.41) vs 28.76 (2.56)] were significantly increased in infants with bronchiolitis (P < 0.05), while the level of IgE had no significant difference between the two groups [19.05 (14.15) vs 14.85 (20.2), P > 0.05]. The mRNA expression of IL-17RB (9.83 ± 0.35 vs 9.19 ± 0.58), TSLP (16.98 ± 2.12 vs 15.07 ± 2.25), retinoid acid receptor related orphan receptor α (7.18 ± 0.71 vs 5.46 ± 1.09) and trans-acting T-cell-specific transcription factor 3 (4.86 ± 0.66 vs 4.19 ± 0.90) were significantly increased in infants with bronchiolitis versus the control group (P < 0.05), while there was no statistical significance for suppression of tumorigenicity 2 (5.59 ± 0.68 vs 5.41 ± 0.87, P > 0.05). Our findings suggested that ILC2s possibly play a specific role in immunopathology of bronchiolitis.

Abstract 17246: Sensitivity and Specificity of Relative Sparing of Apical Longitudinal Strain for Detection of Systemic Light-Chain Amyloidosis versus Transthyretin Amyloidosis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Michael Jiang ◽  
Julia M Simkowski ◽  
Nadia El Hangouche ◽  
Jeesoo Lee ◽  
Milica Marion ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Sensitivity And Specificity ◽  
Light Chain ◽  
Longitudinal Strain ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Control Group ◽  
Transthyretin Amyloidosis ◽  
Light Chain Amyloidosis ◽  
Significant Difference

Introduction: Relative apical sparing of longitudinal strain (RALS, the ratio of apical strain vs the rest of the heart) on echocardiography has been found to have high sensitivity and specificity for differentiating cardiac amyloidosis (CA) from other causes of left ventricular hypertrophy. Previous studies have shown no significant difference between amyloid subtypes, systemic light-chain amyloidosis (AL) and transthyretin amyloidosis (ATTR) Hypothesis: There will be a significant difference in sensitivity and specificity of RALS to detect CA across amyloid subtypes. Methods: A cohort of patients with either AL or ATTR amyloid was identified, with a control cohort of patients with left ventricular hypertrophy (LVH) of other etiologies. Speckle tracking echocardiography was performed on EchoPAC (GE Medical Systems) software to obtain values of basal, mid, and apical longitudinal strain for each patient; relative apical strain was then calculated. Results: The TTR group (n=22) was older (66.4±7.9, 76.6±11.6, p=0.001) and more likely to be female (p=0.009) than the AL group (n=30), both groups had similar rates of hypertension, diabetes mellitus, and end stage renal disease. Echocardiographic markers of diastolic function were decreased in both groups; the AL group had decreased left ventricle end diastolic volume (60.9±25.5, 94.9±50.2, p=0.012) and mean wall thickness (1.4±0.3, 1.6±0.4 p=0.017). ROC analysis using a RALS cutoff of 2 to differentiate AL and ATTR from the LVH control group revealed similar specificity (AL 85%, ATTR 85%) and sensitivity (AL 40%, ATTR 50%). Difference in area-under-curve (AUC) was not significant (p=0.2) (figure). Conclusions: ATTR and AL amyloid have similar specificity, but ATTR has a trend towards improved sensitivity over AL for detection of CA using RALS with the previously validated threshold of 2. This might become significant with a larger sample, work that is currently on-going..

scholarly journals 1187 Evaluation of left and right ventricular functions with 3D speckle tracking in patients with mitral stenosis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
O Seckin ◽  
S Unlu ◽  
G Tacoy
Keyword(s):  
Right Ventricular ◽  
Mitral Stenosis ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Control Group ◽  
Free Wall ◽  
Significant Difference

Abstract Background The function of both ventricles have been suggested to be affected in patients with mitral stenosis. In this study, it was aimed to investigate deformation properties of right (RV) and left ventricles (LV) in mild and moderate rheumatic mitral stenosis (MS) patients with three-dimensional speckle tracking echocardiography (3D-STE). Methods A total of 60 patients were included in the study (20 patients with mild MS diagnosis, 20 patients with moderate MS diagnosis and 20 healthy volunteers). Three-dimensional echocardiography datasets were obtained for both ventricles in all patients. An example for RV assessment is shown in Figure 1. LV global longitudinal strain (GLS), LV torsion, RV free wall (FW) LS and interventricular septal (IVS) LS measurements were analyzed. Results The LV ejection fraction (EF), RV fractional area change and tricuspid annular plane systolic excursion values were statistically similar and in the normal range. The LV GLS measurements were significantly different among the groups by being highest in the control group and least in the moderate stenosis group (ANOVA,p &lt; 0.001) (Table 1). Patients with MS showed higher torsional values, correlated with MS severity (ANOVA,p &lt; 0.001) (Table 1). IVS LS, RVFW LS values obtained by RV analysis also differed significantly among groups. The FW-GLS values only showed significant difference between the control group and moderate MS group (Table 1). Conclusion Patients with mitral stenosis showed lower LV-GLS and higher LV torsion values. Although the LV GLS is affected; the LV EF was detected to be normal due to increase in LV torsion. RV deformation indices showed signıficant decrease in correlation with the severity of the mitral stenosis. In conclusion, our data suggest that subclinical LV and RV systolic dysfunction is present in mild-moderate MS patients and this dysfunction can be detected by 3D-STE. Table 1 Parameters Control group Mild MS Moderate MS P LV GLS (%) 23.3 ± 2.08 18.9 ± 1.3 17.5 ± 1.8 &lt;0.001 LV torsion 1.5 ± 0.6 2.1 ± 0.6 2.6 ± 0.5 &lt;0.001 IVS LS (%) 23 ± 3.0% 20 ± 2.6 17.1 ± 2.9 &lt;0.001 RV FW LS (%) 25.4 ± 5 22.7 ± 3.2 21.1 ± 4.8 &lt;0.001 FW; free-wall, GLS; global longitudinal strain, IVS; interventricular septum, LV; left ventricular, RV; right ventricular Abstract 1187 Figure 1

scholarly journals Modern critical approach to the diagnosis of acute viral myocarditis and inflammatory cardiomyopathies in clinical practice: Focus on the roles of echocardiography and antivirus antibodies

2021 ◽  
Vol 46 (2) ◽  
pp. 57-71
Author(s):  
Dušan Bastać ◽  
Biserka Tirmenštajn-Janković ◽  
Predrag Marušić ◽  
Zoran Joksimović ◽  
Vojkan Čvorović ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Diastolic Function ◽  
Viral Myocarditis ◽  
Left Ventricular ◽  
Control Group ◽  
Acute Viral Myocarditis ◽  
Significant Difference ◽  
Echocardiographic Parameters ◽  
Group A ◽  
Group B

SIGNIFICANCE OF THE PROBLEM: The diagnosis of acute viral myocarditis is one of the diagnoses most difficult to make in cardiology and medicine in general. Echocardiography and cardiomagnetic resonance play a crucial role in the clinical diagnosis and the serum titer of antiviral antibodies to cardiotropic viruses is still unjustifiably used for the diagnosis of myocarditis in everyday practice. RESEARCH OBJECTIVES: To analyze the frequency and significance of echocardiographic parameters in the diagnosis of clinically suspected acute viral myocarditis, to determine the role of antiviral antibody titer (AVA) dynamics for the diagnosis of myocarditis and to compare viral serology and echocardiographic function versus echocardiographic function. METHODOLOGY: A retrograde transverse study was performed in the ten-year period from 2006. to 2015, where 126 consecutive patients from the database of the Office of Internal medicine ''Dr. Bastać'' were analyzed, with a working diagnosis of clinically suspected viral myocarditis. They were clinically, ECG, echocardiographically and serologically monitored for 4 to 8 weeks due to the dynamics of AVA titer. The examined group (A) was divided into subgroups: A1 with elevated AVA class IgM titer in 43 (32%) subjects and subgroup A2 without elevated IgM titer in 83 (68%) patients. The control group of healthy (B) of 103 subjects was comparable.Statistical processing was done in the EXCELL database via descriptive statistics, Student's-T test and Chi2 test. RESULTS: 126 patients had clinically suspected myocarditis (≥2 ESC criteria). Diastolic left ventricular dysfunction in 39/126 (31%) patients was the dominant echocardiographic criterion for clinically suspected myocarditis. Reduced ejection fraction (EF <50%) was measured at 19/126 (15%), followed by left ventricular dilatation. Regional systolic dysfunction was found in 21/126 (17%) and changes in myocardial texture in 17 (13%) subjects. The clinical probability of viral etiology was diagnostically supported by elevated titer of IgM antibodies in 43 (32%) subjects (subgroup A1) where IgM antibodies to Parvo B 19 virus predominate in 36/43 patients (84%). Most were without elevated titer of IgM antibodysubgroup A2 83 (68%). Clear dynamics of IgM antibody titer was observed in 23 persons, a decrease in IgM titer with an increase in IgG titer (seroconversion) in 13 patients. Determination of anti-heart autoantibodies (AHA) was done in 17 severe cases, of which 9 had positive AHA. A comparison of subgroups A1 and A2 did not reveal a statistically significant difference in echocardiographic parameters. The whole group A of clinically suspected myocarditis compared to control group B has statistically highly significantly lower parameters of global systolic (EF=8,7±4,6 vs. 63±7,9; p<0,001), longitudinal systolic (S'=6,9±1,3 vs. 9,9±2,1) and diastolic function (E/e'11,9±4,8 vs. 8,7±4,6; p<0,001), and a highly statistically significant increase in left ventricular telediastolic dimension, myocardial mass index, and left atrial size. CONCLUSION: The diagnosis of acute viral myocarditis in clinical practice is made on the basis of the clinical picture, ECG and echocardiography that indicate myocarditis with the exclusion of cardiac comorbidities, based on the ESC criteria for suspected clinical myocarditis. The whole group A had highly statistically significantly lower parameters of systolic and diastolic function compared to control group B. Normal ECG and echocardiography cannot serve to exclude the diagnosis of myocarditis. Comparison of subgroups A1 and A2 did not reveal a statistically significant difference in echocardiographic parameters.

P1494Usefulness of longitudinal strain adjusted to regional thickness in hypertrophic cardiomyopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Mansencal ◽  
S Utado ◽  
M Hauguelf-Moreau ◽  
S Mallet ◽  
P Charron ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Strain Analysis ◽  
Region Of Interest ◽  
Left Ventricular ◽  
Control Group ◽  
Myocardial Wall ◽  
Regional Strain ◽  
Standard Software

Abstract Background In hypertrophic cardiomyopathy (HCM), longitudinal strain analysis allows to early detect left ventricular (LV) contraction abnormalities despite preserved LV ejection fraction. In current software, the width of the region of interest (ROI) is the same over the entire myocardial wall, and might analyze partially LV hypertrophic segments. Purpose The aim of this study is to evaluate a novel software for strain analysis with an adjustable ROI according to each segment thickness. Methods We included 110 patients: 55 patients with HCM (HCM group) and 55 healthy subjects (age- and sex-matched control group). All patients underwent echocardiography using a Vivid 9 GE system and measurements were performed using EchoPAC software. Global longitudinal strain (GLS) and regional strain for each of the 17 segments was calculated with standard software (for 2 groups) and with software adjusted to the myocardial wall thickness (for HCM group). Results GLS was significantly decreased in the HCM group as compared to the control group (−15.1±4.8% versus −20.5±4.3%, p<0.0001). In HCM group, GLS (standard method versus adjusted to thickness) were not significantly different (p=0.34). Interestingly, regional strain adjusted to thickness was significantly lower than standard strain in hypertrophic segments, especially in basal inferoseptal segment (p=0.0002), median inferoseptal segment (p<0.001) and median anteroseptal segment (p=0.02). Strain adjusted to thickness was still significantly lower in the most hypertrophic segments (≥20 mm) (−3.7±3%, versus −5.9±4.4%, p=0.049 in the basal inferoseptal segment and −5.7±3.5% versus −8.3±4.5%, p=0.0007 in the median inferoseptal segment). Analysis of strain adjusted to thickness had a better feasibility (97.5% versus 99%, p=0.01). Conclusion Analysis of longitudinal strain adjusted to regional thickness is feasible in HCM and allows a better evaluation of myocardial deformation, especially in the most LV hypertrophic segments.

scholarly journals A Comparative Study on Psychosocial Factors between Mothers of Infants with and without Physical Abnormalities

2021 ◽  
Vol 31 (1) ◽  
pp. 26-34
Author(s):  
Mahtab Ranjbar ◽  
◽  
Ebrahim Masoudnia ◽  
Mohsen Haghshenas Mojaver ◽  
◽  
...  
Keyword(s):  
Social Support ◽  
Coping Strategies ◽  
Psychosocial Factors ◽  
Birth Defects ◽  
Congenital Anomalies ◽  
Short Form ◽  
The Body ◽  
Control Group ◽  
Healthy Infants ◽  
Significant Difference

Introduction: Congenital anomalies are one of the most important causes of disability and mortality in childhood seen in developing and developed countries. Mothers with physically-abnormal newborns have unfavorable lifestyle compared to mothers with healthy infants. Objective: The aim of this study was to determine the difference between mothers of infants with and without physical abnormalities in terms of psychosocial factors. Materials and Methods: This is a case-control study with two study groups; the case group (n=133) consists of mothers who had babies with birth defects referred to health centers in Amol city, Iran for postnatal care in 2018. The control group (n=133) included mothers with healthy infants in this city. They were selected using a convenience sampling method. Measurement tools included a Socio-demographic form, Health-Promoting Lifestyle Profile (HPLP), Multidimensional Perceived Social Support Scale (MPSSS), Coping Strategies Scale - Short Form (CSS-SF), Prenatal Distress Questionnaire (PDQ), and General Health Questionnaire - Short Form (GHQ-SF). Data were analyzed using descriptive statistics, chi-square test, and t-test. Results: A total of 266 mothers with a mean age of 31.9±5.6 years were examined. There was a significant difference between the two groups of mothers in terms of overall HPLP score (P=0.01), and its dimensions of spiritual growth (P<0.05), physical activity, nutrition (P=0.01), and stress management (P<0.05). Moreover, a significant difference was reported between them in terms of MPSSS and its dimensions of social support from friends, family, and significant others (P=0.01). Furthermore, There was a significant difference between them with respect to GHQ dimensions of anxiety/insomnia, and depression (P<0.01); CSS dimensions of escape avoidance and emotion-focused coping strategies (P=0.01); and PDQ and its dimensions of concerns about the delivery and the health of the baby, and about the body weight/image (P=0.01). Conclusion: Mothers of infants with and without birth defects are significantly different from each other in terms of psychosocial factors. It seems that poor psychosocial variables in mothers during pregnancy can act as a risk factor for congenital anomalies.

scholarly journals Echocardiographic evaluation of total anomalous pulmonary venous connection: comparison of obstructed and unobstructed type

2019 ◽  
Author(s):  
Yonghua Xiang ◽  
Xuehua Zhang ◽  
Jun Qiu ◽  
Qing Gan ◽  
Ke Jin
Keyword(s):  
Retrospective Study ◽  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Echocardiographic Evaluation ◽  
Significant Difference ◽  
Echocardiographic Parameters ◽  
Anomalous Pulmonary Venous Connection ◽  
First Admission

Abstract Purpose The purpose of this study was to compare the differences between obstructed and unobstructed TAPVC using echocardiography, then to predict PVO by assessing clinical and echocardiographic parameters. Methods We conducted a retrospective study included 70 patients with TAPVC between 2014 and 2018. The morphological and hemodynamic echocardiographic parameters were observed and measured. The clinical and echocardiographic parameters that existed difference between obstructed and unobstructed TAPVC were selected to predict PVO by running ROC curve analysis. Results Between obstructed and unobstructed TAPVC, there were significant differences in ASD size, PA Vmax, MV VE, LVFS, LVEF, SV and the incidence of PDA, but there was no significant difference in birth weight. The first admission age of obstructed TAPVC was earlier than unobstructed type. The ROC curve analysis for the first admission age in predicting PVO showed the sensitivity and specificity were 76.7%, 80% respectively. The ROC curve analysis for multiple echocardiographic parameters showed the sensitivity and specificity were 82.6%, 100% respectively. Conclusions The presence of PVO led to anatomical and functional abnormity of patients with TAPVC, and then led to hospitalize earlier. The first admission age was a simple and feasible parameter in predicting PVO. The integrated use of multiple echocardiographic parameters had an excellent value in predicting PVO.

scholarly journals Phasic Left Atrial Function in Cancer Patients Before Initiation of Anti-Cancer Therapy

2019 ◽  
Vol 8 (4) ◽  
pp. 421 ◽  
Author(s):  
Marijana Tadic ◽  
Martin Genger ◽  
Cesare Cuspidi ◽  
Evgeny Belyavskiy ◽  
Athanasios Frydas ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Left Atrial ◽  
Longitudinal Strain ◽  
Strain Analysis ◽  
Control Group ◽  
Solid Cancer ◽  
Rate Analysis ◽  
Cancer Group ◽  
Echocardiographic Examination ◽  
And Gender

: We aimed to explore left atrial (LA) remodeling in the patients with solid cancer before initiation of chemo- or radiotherapy. This retrospective investigation included 92 chemo- and radiotherapy-naive cancer patients and 40 age- and gender-matched controls with a similar cardiovascular risk profile as the cancer group. All participants underwent comprehensive echocardiographic examination before the start of chemo- or radiotherapy. LA phasic function was evaluated in volumetric and strain method. Indexed minimal and pre-A LA volumes were significantly higher in the cancer patients. Total and passive LA emptying fraction (EF) were significantly lower, whereas active LAEF was significantly higher in the cancer patients. LA total longitudinal strain was significantly lower in the cancer patients. Strain rate analysis of LA phasic function showed that LA function during systole and early diastole was reduced in the cancer group, while it was increased during late diastole. These findings indicated that LA reservoir and conduit functions, assessed with LA volumetric and strain analysis, were deteriorated in the cancer group. On the other hand, LA booster pump function was elevated in the cancer group in comparison with the controls. In the whole population, cancer was associated with reduced LA total longitudinal strain independently of age, gender, BMI, LV hypertrophy, E/e’ ratio, diabetes, and hypertension. LA phasic function was impaired in the chemo- and radiotherapy-naive cancer patients in comparison with the control group. Cancer, LV hypertrophy, and hypertension were associated with reduced LA longitudinal strain independently of other important clinical parameters.

scholarly journals 1033 Prominent longitudinal strain involvement of left ventricular basal segments in native hypertensive patients without clear-cut hypertrophy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Lembo ◽  
R Esposito ◽  
C Santoro ◽  
R Sorrentino ◽  
F Luciano ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Longitudinal Strain ◽  
Linear Regression Analysis ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Hypertensive Patients ◽  
Clear Cut ◽  
Lv Mass ◽  
Significant Difference

Abstract Background Left ventricular (LV) global longitudinal strain (GLS) is able to detect an early subclinical dysfunction and it has been demonstrated to be a prognosticator in arterial hypertension. Information of regional longitudinal strain (LS) pattern has not been investigated in this clinical setting. Purpose We analyzed regional LV patterns of LS and base-to-apex behaviour of LS in newly diagnosed and never-treated hypertensive patients (HTN) without clear-cut LV hypertrophy (LVH). Methods 166 HTN (M/F = 107/59; age 43.9 ± 14.3 years, blood pressure [BP] = 146.5± 10.7/90.1 ± 7.5 mmHg) and a control group of 94 healthy subjects (M/F = 58/36; age 41.2 ± 15.0 years) underwent standard echo-Doppler exam, including speckle tracking quantification of regional LS and GLS (considered in absolute values). The average LS of six basal (BLS), six middle (MLS), and six apical (ALS) segments and relative regional strain ratio - RRSR = [ALS/(BLS + MLS)] - were also computed. Exclusion criteria were LVH (LV mass index ≥45 g/m^2.7 in females and ≥49 g/m^2.7 in males), diabetes mellitus, coronary artery disease, overt heart failure, hemodynamically significant valve heart disease, primary cardiomyopathies, atrial fibrillation and inadequate echo imaging. Results The two groups were comparable for sex, age, heart rate and LV ejection fraction (EF). Body mass index (BMI), systolic (SBP), diastolic (DBP) and mean BP (MBP) (all p &lt; 0.0001), LV mass index (p = 0.03), relative wall thickness (RWT) (p &lt; 0.02) and E/e’ ratio (p &lt; 0.01) were higher, and GLS lower (21.6 ± 2.0 vs. 22.2 ± 2.1%, p &lt; 0.02) in HTN. By analyzing regional LS, BLS (18.2 ± 2.1% vs. 19.2 ± 2.1%, p &lt; 0.0001) and MLS (20.7 ± 2.0 vs. 21.4 ± 2.1%, p = 0.007) resulted significantly lower in HTN, without significant difference in ALS (26.0 ± 3.6 vs. 25.9 ± 3.8%, p = 0.98). Accordingly, RRSR was higher in HTN (0.67 ± 0.09 vs. 0.64 ± 0.09, p &lt; 0.01). Even after excluding patients with LV concentric remodeling (RWT &gt; 0.42) (n = 34), BLS (p &lt; 0.0001) and MLS (p &lt; 0.002) were again lower and RRSR (p &lt; 0.01) higher in HTN than in controls. In the pooled population, BLS negatively correlated with SBP (r=-0.22), DBP (r=-0.25) and MBP (r=-0.26) (Figure) (all p &lt; 0.0001). By a multiple linear regression analysis, after adjusting for age, sex, BMI and RWT, the association between BLS and MBP remained significant (β coefficient=-0.23, p &lt; 0.0001), with an additional significant impact of male sex (β=-0.33, p &lt; 0.0001) (cumulative R²=0.18, SEE = 1.9%, p &lt; 0.0001). Conclusions Besides normal LV EF, GLS is lower in HTN. LS dysfunction involves basal and, with a lower extent, middle myocardial segments, with a compensation of apical segments. RRSR appears to be significantly higher in HTN. These results are even confirmed in hypertensive patients with normal LV geometry. The association of BLS and BP appears to be independent on several confounders. Regional LS pattern might be useful to detect very early LV systolic abnormalities in arterial hypertension. Abstract 1033 Figure. Relation between MBP and BLS

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