Atrial and Ventricular Structural and Functional Alterations in Obese Children

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.

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Left Ventricular Myocardial Deformations in Hemodialysis Children by Speckle Tracking Echocardiography

Clinical Medicine Insights Cardiology ◽

10.1177/1179546820930015 ◽

2020 ◽

Vol 14 ◽

pp. 117954682093001

Author(s):

Manal F Elshamaa ◽

Fatma A Mostafa ◽

Inas AES Sad ◽

Ahmed M Badr ◽

Yomna AEM Abd Elrahim

Keyword(s):

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Systolic Dysfunction ◽

Global Longitudinal Strain ◽

Radial Strain ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Myocardial Mechanics

Background: Cardiac systolic dysfunction was potentially found in adult patients with end-stage renal disease (ESRD) who have preserved left ventricular ejection fraction (EF%). In children with ESRD, little data are available on early changes in myocardial function. This study aimed to detect the early changes in myocardial mechanics in pediatric patients with ESRD using speckle tracking echocardiography (STE). Methods: Thirty ESRD children receiving hemodialysis (HD) and30 age-matched controls were prospectively studied. Patients underwent echocardiographic studies before and after HD. Left ventricular longitudinal strain (LS), circumferential strain (CS), and radial strain (RS) myocardial deformation parameters (strain, strain rate) were evaluated by STE. Results: The LS was significantly reduced in pre-HD and post-HD patients compared with controls ( P = .000). Controls showed the highest global longitudinal strain. The RS measurements did not differ significantly among the studied groups except for the inferior segment that is significantly reduced after HD compared with controls ( P < .05). The CS was significantly reduced in pre-HD and post-HD patients compared with controls at the lateral and posterior segments ( P = .035 and P = .013, respectively). Conclusion: Speckle-tracking echocardiography might detect early changes in myocardial mechanics in children with ESRD with preserved EF%.

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Accuracy and Reliability of Left Ventricular (LV) Global Longitudinal Strain (GLS) Measurement by 2D Speckle Tracking Echocardiography (STE) - An In-house Quality Assurance Exercise Prior to Clinical Roll-out

Heart Lung and Circulation ◽

10.1016/j.hlc.2017.06.461 ◽

2017 ◽

Vol 26 ◽

pp. S243

Author(s):

S. Napier ◽

A. Chong ◽

A. Ng ◽

S. Wahi

Keyword(s):

Quality Assurance ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

2D Speckle Tracking ◽

Roll Out

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Myocardial Function in Offspring Aged 5 to 8 Years of Pregnancy Complicated by Severe Preeclampsia Measured by Two-Dimensional Speckle-Tracking Echocardiography

Frontiers in Physiology ◽

10.3389/fphys.2021.643926 ◽

2022 ◽

Vol 12 ◽

Author(s):

Huiyun Chen ◽

Yu Gong ◽

Fangcan Sun ◽

Bing Han ◽

Bingyuan Zhou ◽

...

Keyword(s):

Right Ventricular ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Circumferential Strain ◽

Speckle Tracking Echocardiography ◽

Radial Strain ◽

Left Ventricular ◽

Two Dimensional ◽

Preterm Children ◽

2D Speckle Tracking

Objective: This study aimed to quantitatively assess myocardial strain in preterm children aged 5 to 8 years of pregnancy complicated by severe preeclampsia (PE) by two-dimensional (2D) speckle tracking echocardiography.Method: A cohort study of 23 preterm children delivered by severe PE pregnant women from 2010 to 2012 in the First Affiliated Hospital of Soochow University was carried out. 23 preterm children from uneventful pregnancies in the same period served as controls. Myocardial functions including left ventricular longitudinal strain, radial strain, circumferential strain, and right ventricular longitudinal strain were evaluated by conventional Doppler, tissue Doppler imaging, and 2D speckle-tracking echocardiography (2D STE). All examinations were performed by an experienced ultrasonographer using the VIVID E9 (GE Healthcare) machine, according to standard techniques.Results: Children aged 5–8 years delivered from severe PE presented less weight (24.41 vs. 20.89 kg, P < 0.05), shorter height (124.1 vs 115.6 cm, P < 0.05) and faster heart rates (84 vs. 93 bpm, P < 0.05) compared to offspring of normotensive women. There were no significant differences in global left ventricular longitudinal strain, radial strain, circumferential strain, and right ventricular longitudinal strain between the children in the experimental group and the control group (P > 0.05).Conclusion: Exposure to the intrauterine environment of severe PE during the fetal period did not have a significant impact on cardiac structure in premature children at 5–8 years old, but they had a higher resting heart rate which may be associated with cardiovascular disease in the long run.

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Layer-specific strain analysis by speckle tracking echocardiography reveals differences in left ventricular function between rats and humans

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00017.2010 ◽

2010 ◽

Vol 299 (3) ◽

pp. H664-H672 ◽

Cited By ~ 26

Author(s):

Noa Bachner-Hinenzon ◽

Offir Ertracht ◽

Marina Leitman ◽

Zvi Vered ◽

Sara Shimoni ◽

...

Keyword(s):

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Heart Function ◽

Global Longitudinal Strain ◽

Radial Strain ◽

Strain Analysis ◽

Left Ventricular ◽

Lv Function ◽

Disease States

The rat heart is commonly used as an experimental model of the human heart in both health and disease states, assuming that heart function of rats and humans is alike. When studying a rat model, echocardiography is usually performed on sedated rats, whereas standard echocardiography on adult humans does not require any sedation. Since echocardiography results of sedated rats are usually inferred to alert humans, in the present study, we tested the hypothesis that differences in left ventricular (LV) function may be present between rats sedated by a low dose of ketamine-xylazine and alert humans. Echocardiography was applied to 110 healthy sedated rats and 120 healthy alert humans. Strain parameters were calculated from the scans using a layer-specific speckle tracking echocardiography program. The results showed that layer longitudinal strain is equal in rats and humans, whereas segmental strain is heterogeneous ( P < 0.05) in a different way in rats and humans ( P < 0.05). Furthermore, layer circumferential strain is larger in humans ( P < 0.001), and the segmental results showed different segmental heterogeneity in rats and humans ( P < 0.05). Radial strain was found to be homogeneous at the apex and papillary muscle levels in humans and heterogeneous in rats ( P < 0.001). Additionally, whereas LV twist was equal in rats and humans, in rats the rotation was larger at the apex ( P < 0.01) and smaller at the base ( P < 0.001). The torsion-to-shortening ratio parameter, which indicates the transmural distribution of contractile myofibers, was found to be equal in rats and humans. Thus, when evaluating LV function of sedated rats under ketamine-xylazine, it is recommended to measure the global longitudinal strain, LV twist, and torsion-to-shortening ratio, since no scaling is required when converting these parameters and inferring them to humans.

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Direct comparison of multilayer left ventricular global longitudinal strain using CMR feature tracking and speckle tracking echocardiography

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-01916-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Saikrishna Ananthapadmanabhan ◽

Giau Vo ◽

Tuan Nguyen ◽

Hany Dimitri ◽

James Otton

Keyword(s):

Feature Tracking ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Imaging Modality ◽

Global Longitudinal Strain ◽

Intraclass Correlation ◽

Strain Analysis ◽

Left Ventricular ◽

Multilayer Strain

Abstract Background Cardiac magnetic resonance feature tracking (CMR-FT) and speckle tracking echocardiography (STE) are well-established strain imaging modalities. Multilayer strain measurement permits independent assessment of endocardial and epicardial strain. This novel and layer specific approach to evaluating myocardial deformation parameters may provide greater insight into cardiac contractility when compared to whole-layer strain analysis. The aim of this study is to validate CMR-FT as a tool for multilayer strain analysis by providing a direct comparison between multilayer global longitudinal strain (GLS) values between CMR-FT and STE. Methods We studied 100 patients who had an acute myocardial infarction (AMI), who underwent CMR imaging and echocardiogram at baseline and follow-up (48 ± 13 days). Dedicated tissue tracking software was used to analyse single- and multi-layer GLS values for CMR-FT and STE. Results Correlation coefficients for CMR-FT and STE were 0.685, 0.687, and 0.660 for endocardial, epicardial, and whole-layer GLS respectively (all p < 0.001). Bland Altman analysis showed good inter-modality agreement with minimal bias. The absolute limits of agreement in our study were 6.4, 5.9, and 5.5 for endocardial, whole-layer, and epicardial GLS respectively. Absolute biases were 1.79, 0.80, and 0.98 respectively. Intraclass correlation coefficient (ICC) values showed moderate agreement with values of 0.626, 0.632, and 0.671 respectively (all p < 0.001). Conclusion There is good inter-modality agreement between CMR-FT and STE for whole-layer, endocardial, and epicardial GLS, and although values should not be used interchangeably our study demonstrates that CMR-FT is a viable imaging modality for multilayer strain

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Abstract 13101: Assessment of Left Ventricular Myocardial Fibrosis Using Two-dimensional and Three-dimensional Speckle Tracking Echocardiography in Patients With End-stage Heart Failure

Circulation ◽

10.1161/circ.142.suppl_3.13101 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Mingxing XIE ◽

TiAN Fangyan ◽

Li Yuman

Keyword(s):

Myocardial Fibrosis ◽

Speckle Tracking ◽

Speckle Tracking Echocardiography ◽

Global Longitudinal Strain ◽

Radial Strain ◽

Surrogate Marker ◽

Area Under The Curve ◽

Left Ventricular ◽

End Stage ◽

2D And 3D

Background: Previous studies showed that 2-dimensional speckle-tracking echocardiography (2D-STE) correlates with the extent of left ventricular(LV)myocardial fibrosis (MF). However, the utility of 3D-STE in predicting LV MF remains unknown. We aimed to identify which LV strain assessed by 2D- and 3D-STE is the most reliable parameter to predict LV MF in patients with end-stage HF. Methods: 105 patients with end-stage HF undergoing heart transplantation were enrolled in our study. LV global longitudinal strain (GLS), global circumferential strain (GCS) and global radial strain (GRS) were measured by 2D- and 3D-STE. LV ejection fraction (EF) was determined by 3D-STE.The degree of MF was quantified by using Masson trichrome stain in LV myocardial samples. The study population was divided into 3 groups according to the degree of MF on histology (mild, moderate, and severe MF). Results: Patients with severe MF had lower 2D-STE, 3D-STE, and LVEF compared with those with mild and moderate MF. LV MF strongly correlated with 3D-LVGLS (r =0.73; P < 0.001), modestly with 3D-LVGRS (r =0.53; P< 0.001), weakly with 2D-LVGLS (r =0.49, P<0.001), 3D-LVGCS(r = 0.37, P <0.01), and LVEF (r =-0.46, P<0.001), but did not correlated with 2D-LVGCS and 2D-LVGRS. 3D-LVGLS correlated best with the degree of MF (r = 0.73 vs 0.37~0.53; P<0.05) compared with other 2D- and 3D-STE, and LVEF. 3D-LVGLS had the highest accuracy for detecting severe MF (area under the curve 0.90 VS 0.62~0.80; P< 0.05) compared with the 2D- and 3D-STE, and LVEF. Stepwise multivariate analysis showed that 3D-LVGLS (β=0.79, p < 0.001) was the only independent predictor of the degree of MF. Conclusion: 3D-LVGLS may be an ideal surrogate marker for LV MF in patients with end-stage HF.

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Abstract 14632: Effect of Obesity on Myocardial Strain Determined by Speckle Tracking Imaging

Circulation ◽

10.1161/circ.132.suppl_3.14632 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Meihua Zhu ◽

Cole Streiff ◽

Tao He ◽

Muhammad Ashraf ◽

Jiahui Zhang ◽

...

Keyword(s):

Speckle Tracking ◽

Myocardial Dysfunction ◽

Global Longitudinal Strain ◽

Myocardial Strain ◽

Left Ventricular ◽

Control Group ◽

Speckle Tracking Imaging ◽

Initial Weight ◽

Newborn Mice ◽

2D Speckle Tracking

Introduction: Obesity may affect cardiac function, which is hard to detect by traditional echocardiography in the early stages. Speckle tracking imaging (STI) is sensitive to subtle myocardial dysfunction. The aim of this study was to determine the influence of obesity on left ventricular (LV) myocardial function in diet-induced obesity (DIO) mice using two-dimensional (2D) speckle tracking echocardiography (STE). Hypothesis: 2D STE is useful to detect obesity-caused myocardial dysfunction. Methods: Twenty newborn mice were divided into two groups: a DIO group (high-fat diet) and a control group (regular-fat diet). 2D image loops were acquired at the end of each month for 6 months. Global longitudinal strain (GLS) and global circumferential strain (GCS) were analyzed at feeding periods over 3 months and 6 months, and compared between the two groups. Results: The control group gained 64% of its initial weight, while the DIO group gained 82% of its initial weight at the 3 month feeding period; and the two groups gained 88% (control) and 125% (DIO) respectively at 6 months. STE analysis revealed an insignificant decrease in strain values in the DIO mice after 3 months; however, after 6 months, the DIO group demonstrated a significant decrease in strain values (P<0.05) despite normal ejection fractions in both groups. Conclusions: 2D STE is highly feasible to detect the myocardial dysfunction caused by obesity in earlier stage. These strain values appear to be related to the severity of obesity.

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Abnormal left ventricular global longitudinal strain by speckle tracking echocardiography in COVID-19 patients

Future Cardiology ◽

10.2217/fca-2020-0121 ◽

2020 ◽

Author(s):

Lori B Croft ◽

Parasuram Krishnamoorthy ◽

Richard Ro ◽

Malcolm Anastasius ◽

Wenli Zhao ◽

...

Keyword(s):

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Healthy Population ◽

Significant Difference ◽

The Mean ◽

Lv Ejection Fraction ◽

Prognostic Implications

COVID-19 infection can affect the cardiovascular system. We sought to determine if left ventricular global longitudinal strain (LVGLS) is affected by COVID-19 and if this has prognostic implications. Materials & methods: Retrospective study, with LVGLS was measured in 58 COVID-19 patients. Patients discharged were compared with those who died. Results: The mean LV ejection fraction (LVEF) and LVGLS for the cohort was 52.1 and -12.9 ± 4.0%, respectively. Among 30 patients with preserved LVEF(>50%), LVGLS was -15.7 ± 2.8%, which is lower than the reference mean LVGLS for a normal, healthy population. There was no significant difference in LVGLS or LVEF when comparing patients who survived to discharge or died. Conclusion: LVGLS was reduced in COVID-19 patients, although not significantly lower in those who died compared with survivors.

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