The Echocardiographic Parameters of Systolic Function Are Associated with Specific Metabolomic Fingerprints in Obstructive and Non-Obstructive Hypertrophic Cardiomyopathy

The purpose of this study was to assess whether metabolomics, associated with echocardiography, was able to highlight pathophysiological differences between obstructive (OHCM) or non-obstructive (NOHCM) hypertrophic cardiomyopathy. Thirty-one HCM patients underwent standard and advanced echocardiography; a plasma sample was collected for metabolomic analysis. Results. Patients with OHCM compared with subjects with NOHCM had higher values of 2DLVEF (66.5 ± 3.3% vs. 60.6 ± 1.8%, p < 0.01), S wave (7.6 ± 1.1 vs. 6.3 ± 0.7 cm/s, p < 0.01) and 3D global longitudinal strain (17.2 ± 4.2%, vs. 13.4 ± 1.3%, p < 0.05). A 2-group PLS-Discriminant Analysis was performed to verify whether the two HCM groups differed also based on the metabolic fingerprint. A clear clustering was shown (ANOVA p = 0.014). The most discriminating metabolites resulted as follows: in the NOHCM Group, there were higher levels of threitol, aminomalonic acid, and sucrose, while the OHCM Group presented higher levels of amino acids, in particular those branched chains, of intermediates of glycolysis (lactate) and the Krebs cycle (fumarate, succinate, citrate), of fatty acids (arachidonic acid, palmitoleic acid), of ketone bodies (2-OH-butyrate). Our data point out a different systolic function related to a specific metabolic activity in the two HCM phenotypic forms, with specific metabolites associated with better contractility in OHCM.

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P286 Inverse relation between systolic blood pressure variability and global longitudinal strain in patients with Parkinson"s disease and autonomic dysfunction

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.140 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

G Caminiti ◽

V D"antoni ◽

V Morsella ◽

M Torti ◽

P Grassini ◽

...

Keyword(s):

Blood Pressure ◽

Autonomic Dysfunction ◽

Longitudinal Strain ◽

Systolic Function ◽

Blood Pressure Monitoring ◽

Global Longitudinal Strain ◽

Left Ventricular Systolic Function ◽

Left Ventricular ◽

S Wave ◽

Hypertensive Patients

Abstract Background Parkinson"s disease (PD) patients often present cardiac blood pressure (BP) derangement as a result of autonomic dysfunction. However their echocardiography pattern have been poorly investigated yet . Study aim: to evaluate the correlation between indices of left ventricular function ad 24/h blood pressure pattern in patients with PD Methods We evaluated 20 patients with diagnosed PD and autonomic dysfunction and 15 hypertensive age-matched subjects. All patients performed 24/h blood pressure monitoring (ABPM) and echocardiography. Left ventricular systolic function was evaluated through ejection fraction (EF), tissue doppler S wave and global longitudinal strain (GLS). BP variability (BPV) was evaluated through average real variability. Results GLS (17.6 vs 22.8; p = 0.04) was reduced in the PD group compared to hypertensive patients. Conversely EF and S wave was similar between the two groups. Patients with PD had an inverse significant correlation between GLS and 24/h systolic BPV (r= -0.64; p = 0.003) and a trend through significance between S wave and systolic BPV (r= -0.31; p = 0.07). sNocturnal diastolic BP was inversely related to GLS (r= -0.44; p = 0.001) . There were no correlation between GLS and BPV and values in hypertensive patients. Conclusions In PD patients GLS is related to indices of poor BP control. GLS appears to be an early detector of LV dysfunction in patients with PD and autonomic dysfunction.

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Correlations between B-type natriuretic peptide levels and nongeometric echocardiographic parameters in pediatric cardiomyopathies

Orvosi Hetilap ◽

10.1556/oh.2013.29541 ◽

2013 ◽

Vol 154 (11) ◽

pp. 409-414

Author(s):

Krisztina Kádár ◽

Anna Zsuzsa Bagoly ◽

Zita Sikos

Keyword(s):

Hypertrophic Cardiomyopathy ◽

Dilated Cardiomyopathy ◽

Natriuretic Peptide ◽

Significant Negative Correlation ◽

Tissue Doppler ◽

Left Ventricular ◽

Doppler Imaging ◽

S Wave ◽

Echocardiographic Evaluation ◽

Echocardiographic Parameters

Introduction: B-type natriuretic peptide is a conventional cardiac biomarker in adult cardiology, however, it is not commonly used in pediatric cases. Aims: After introducing B-type natriuretic peptide measurements in pediatric patients for the evaluation of systemic right ventricular function, the authors wanted to evaluate the value of plasma B-type natriuretic peptide and compare the results with systolic and diastolic myocardial parameters obtained with conventional echocardiography and tissue Doppler imaging in children with cardiomyopathy. Methods: Between 2007 and 2010, 58 plasma B-type natriuretic peptide measurements were performed in 32 children (dilated cardiomyopathy in 20, hypertrophic cardiomyopathy in 10 and non-compacted cardiomyopathy in 2 cases). The age of the patients was 7.9±6.6 years (mean±SD). Plasma B-type natriuretic peptide was measured using an electrochemiluminescent assay within one day from echocardiographic evaluation. Results: As compared to normal values, children with the 3 types of cardiomyopathies showed significant differences in plasma B-type natriutretic peptide levels (dilated cardiomyopathy vs normal, p<0.001; hypertrophic cardiomyopathy vs. normal, p<0.01; non-compacted cardiomyopathy vs. normal, p<0.001). There was a significant negative correlation (r = –0,63; p<0,01) between B-type natriuretic peptide levels (range, 12–7002 ng/L; mean±SD, 1531±1750 ng/L) and linEF values (range, 4–50%; mean±SD, 22.5±13%). For B-type natriuteric peptide, a cut-off point of 1000 ng/L proved to differentiate significantly decreased linEF values (<17%). B-type natriuretic peptide levels significantly correlated with left ventricular end-diastolic diameter (r = 0.899; p<0.001), with left ventricular anular S wave parameters (r = 0.689; p<0.001) and with E/e ratio (r = 0.43; p<0.05). Conclusions: B-type natriuretic peptide measurements are recommended in all types of cardiomyopathies. Orv. Hetil., 2013, 154, 409–414.

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CLINICAL AND ECHOCARDIOGRAPHIC PARAMETERS IN PEDIATRIC PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY: RELATIONSHIP TO LV GLOBAL LONGITUDINAL STRAIN

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(20)31248-1 ◽

2020 ◽

Vol 75 (11) ◽

pp. 621

Author(s):

Jared Klein ◽

Alaa Alashi ◽

Laurence Max Svensson ◽

Rukmini Komarlu ◽

Elizabeth Saarel ◽

...

Keyword(s):

Hypertrophic Cardiomyopathy ◽

Longitudinal Strain ◽

Pediatric Patients ◽

Global Longitudinal Strain ◽

Echocardiographic Parameters

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Global longitudinal strain as a marker for systolic function in patients with pheochromocytomas

Endocrine Related Cancer ◽

10.1530/erc-20-0137 ◽

2020 ◽

Vol 27 (10) ◽

pp. 561-570

Author(s):

Atanaska Elenkova ◽

Rabhat Shabani ◽

Elena Kinova ◽

Vladimir Vasilev ◽

Assen Goudev ◽

...

Keyword(s):

Cardiac Function ◽

Longitudinal Strain ◽

Systolic Function ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Strong Positive Correlation ◽

Echocardiographic Parameters ◽

Positive Correlations ◽

Fractional Shortening

Cardiomyopathy is a frequent complication of pheochromocytoma, and echocardiography is the most accessible method for its evaluation. The objective of this study was to assess the clinical significance of classical and novel echocardiographic parameters of cardiac function in 24 patients with pheochromocytomas (PPGL) compared to 24 subjects with essential hypertension (EH). Fourteen PPGL patients were reassessed after successful surgery. Left ventricular hypertrophy was four times more prevalent in patients with PPGL vs EH (75% vs 17%; P = 0.00005). Left ventricular mass index (LVMi) significantly correlated with urine metanephrine (MN) (rs = 0.452, P = 0.00127) and normetanephrine (NMN) (rs = 0.484, P = 0.00049). Ejection fraction (EF) and endocardial fractional shortening (EFS) were normal in all participants and did not correlate with urine metanephrines. Global longitudinal strain (GLS) was significantly lower in PPGL compared to EH group (−16.54 ± 1.83 vs −19.43 ± 2.19; P < 0.00001) and revealed a moderate significant positive correlations with age (rs = 0.489; P = 0.015), LVMi (rs = 0.576, P < 0.0001), MN (rs = 0.502, P = 0.00028) and NMN (rs = 0.580, P < 0.0001). Relative wall thickness (RWT) showed a strong positive correlation with urine MN (rs = 0.559, P < 0.0001) and NMN (rs = 0.689, P < 0.00001). Markedly decreased LVMi (118.2 ± 26.9 vs 102.9 ± 22.3; P = 0.007) and significant improvement in GLS (−16.64 ± 1.49 vs −19.57 ± 1.28; P < 0.001) was observed after surgery. ΔGLS depended significantly on the follow-up duration. In conclusion, classical echocardiographic parameters usually used for assessment of systolic cardiac function are not reliable tests in pheochromocytoma patients. Instead, GLS seems to be a better predictor for the severity and the reversibility of catecholamine-induced myocardial function damage in these subjects. RWT should be measured routinely as an early indicator of cardiac remodeling.

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Obstructive Hypertrophic Cardiomyopathy with Concomitant Mitral Regurgitation Treated with a Septal Myectomy and MV Repair: A Case Report

Serbian Journal of Experimental and Clinical Research ◽

10.2478/sjecr-2018-0017 ◽

2018 ◽

Vol 19 (2) ◽

pp. 195-200

Author(s):

Irena Mitevska ◽

Elizabeta Srbinovska ◽

Marijan Bosevski ◽

Sasko Jovev ◽

Omer Dzemali

Keyword(s):

Hypertrophic Cardiomyopathy ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Medical Treatment ◽

Beta Blocker ◽

Systolic Function ◽

Left Ventricular ◽

Shortness Of Breath ◽

Septal Myectomy ◽

Obstructive Hypertrophic Cardiomyopathy

Abstract Case presentation Hypertrophic cardiomyopathy (HCM) is the most common and very heterogeneous genetic cardiac disease with a different clinical presentation and prognosis. The overall prevalence of the disease is estimated between 0.05-0.2% of the population. Left ventricular outflow obstruction at rest is present in about 20% of patients. Most of the patients have a normal life expectancy, however high risk patients might develop heart failure, atrial fibrillation, ventricular arrhythmias and sudden cardiac death. We present the case of 47-year-old Caucasian man who was hospitalized at our clinic with a history of chest pain and shortness of breath on physical activity in the last six months, which caused significant limitations of his life quality. Hypertrophic obstructive cardiomyopathy was diagnosed in 2011, when the patient was put on therapy with beta blocker. Transthoracic echocardiography revealed normal systolic function, presence of systolic anterior mitral valve motion (SAM) with moderate mitral regurgitation (MR). There was a significant concentric left ventricular hypertrophy predominantly located in the ventricular septum. The intraventricular gradient at rest was 77.8 mmHg. MRI of the heart confirmed significant LV hypertrophy with regions of fibrosis at the septum. The patient shortness of breath worsened progressively in the last month (NYHA III) despite optimized medical treatment with maximal beta blocker dose. Surgical approach with septal myectomy was performed with mitral valve repair. There were no operative complications, with excellent postoperative recovery and complete symptoms resolution. Control Doppler echocardiograms revealed LVOT rest gradient reduction to 34 mmHg. The good operative results were still present 9 months after the intervention. Our case confirmed that septal myectomy with MV repair is an excellent treatment approach in young patient with obstructive hypertrophic cardiomyopathy and mitral valve involvement refractory to medical treatment.

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The non-invasive assessment of myocardial work by pressure-strain analysis: clinical applications

Heart Failure Reviews ◽

10.1007/s10741-021-10119-4 ◽

2021 ◽

Author(s):

Dawud Abawi ◽

Tommaso Rinaldi ◽

Alessandro Faragli ◽

Burkert Pieske ◽

Daniel A. Morris ◽

...

Keyword(s):

Systolic Function ◽

Global Longitudinal Strain ◽

Strain Analysis ◽

Response Prediction ◽

Left Ventricular ◽

Cardiac Resynchronization ◽

Lv Function ◽

Current Application ◽

Non Invasive ◽

Echocardiographic Parameters

AbstractPressure–volume (PV) analysis is the most comprehensive way to describe cardiac function, giving insights into cardiac mechanics and energetics. However, PV analysis still remains a highly invasive and time-consuming method, preventing it from integration into clinical practice. Most of the echocardiographic parameters currently used in the clinical routine to characterize left ventricular (LV) systolic function, such as LV ejection fraction and LV global longitudinal strain, do not take the pressure developed within the LV into account and therefore fall too short in describing LV function as a hydraulic pump. Recently, LV pressure-strain analysis has been introduced as a new technique to assess myocardial work in a non-invasive fashion. This new method showed new insights in comparison to invasive measurements and was validated in different cardiac pathologies, e.g., for the detection of coronary artery disease, cardiac resynchronization therapy (CRT)-response prediction, and different forms of heart failure. Non-invasively assessed myocardial work may play a major role in guiding therapies and estimating prognosis. However, its incremental prognostic validity in comparison to common echocardiographic parameters remains unclear. This review aims to provide an overview of pressure-strain analysis, including its current application in the clinical arena, as well as potential fields of exploitation.

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Catecholamines Induce Left Ventricular Subclinical Systolic Dysfunction: A Speckle-Tracking Echocardiography Study

Cancers ◽

10.3390/cancers11030318 ◽

2019 ◽

Vol 11 (3) ◽

pp. 318 ◽

Cited By ~ 3

Author(s):

Jan Kvasnička ◽

Tomáš Zelinka ◽

Ondřej Petrák ◽

Ján Rosa ◽

Branislav Štrauch ◽

...

Keyword(s):

Speckle Tracking ◽

Speckle Tracking Echocardiography ◽

Systolic Function ◽

Systolic Dysfunction ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Lv Function ◽

Echocardiographic Parameters ◽

Lv Systolic Function ◽

Lower Magnitude

Background: Pheochromocytomas (PHEO) are tumors arising from chromaffin cells from the adrenal medulla, having the ability to produce, metabolize and secrete catecholamines. The overproduction of catecholamines leads by many mechanisms to the impairment in the left ventricle (LV) function, however, endocardial measurement of systolic function did not find any differences between patients with PHEO and essential hypertension (EH). The aim of the study was to investigate whether global longitudinal strain (GLS) derived from speckle-tracking echocardiography can detect catecholamine-induced subclinical impairments in systolic function. Methods: We analyzed 17 patients (10 females and seven males) with PHEO and 18 patients (nine females and nine males) with EH. The groups did not differ in age or in 24-h blood pressure values. Results: The patients with PHEO did not differ in echocardiographic parameters including LV ejection fraction compared to the EH patients (0.69 ± 0.04 vs. 0.71 ± 0.05; NS), nevertheless, in spackle-tracking analysis, the patients with PHEO displayed significantly lower GLS than the EH patients (−14.8 ± 1.5 vs. −17.8 ± 1.7; p < 0.001). Conclusions: Patients with PHEO have a lower magnitude of GLS than the patients with EH, suggesting that catecholamines induce a subclinical decline in LV systolic function.

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Hemodynamic determinants of left atrial strain in patients with hypertrophic cardiomyopathy: A combined echocardiography and CMR study

PLoS ONE ◽

10.1371/journal.pone.0245934 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0245934

Author(s):

Bhupendar Tayal ◽

Maan Malahfji ◽

John M. Buergler ◽

Dipan J. Shah ◽

Sherif F. Nagueh

Keyword(s):

Atrial Fibrillation ◽

Hypertrophic Cardiomyopathy ◽

Exercise Tolerance ◽

Left Atrial ◽

Systolic Function ◽

Global Longitudinal Strain ◽

Mitral Annulus ◽

Left Ventricular ◽

Clinical Events ◽

Hemodynamic Determinants

Background Left atrial (LA) strain is associated with symptomatic status and atrial fibrillation in patients with hypertrophic cardiomyopathy (HCM). However, hemodynamic determinants of LA reservoir (LARS), conduit, and pump strains have not been examined and data are needed on the relation of LA strain with exercise tolerance in HCM. Methods Fifty HCM patients with echocardiographic and CMR imaging within 30 days were included. Left ventricular (LV) volumes, mass, EF, scar extent, extracellular volume fraction (ECV), and LA maximum volume were measured by CMR. Echo studies were analyzed for mitral inflow, pulmonary vein flow, mitral annulus tissue Doppler velocities, LV global longitudinal strain, and LA strain. Twenty six patients able and willing to exercise underwent cardiopulmonary stress testing for peak oxygen consumption (MVO2), and VE/VCO2 slope. Patients were followed for clinical events. Findings LARS was significantly associated with indices of LA systolic function, LV GLS, and LV filling pressures (P<0.05). Conduit strain was significantly associated with mitral annulus early diastolic velocity and ECV, whereas LA pump strain was determined by LA systolic function and indices of LV end diastolic pressure (all P<0.05). LARS and conduit strain were significantly higher in patients who achieved ≥80% of MVO2. LARS, conduit, and pump strains were significantly associated with atrial fibrillation (P<0.05). Conclusions LV structure, systolic and diastolic function, and LA systolic function determine the 3 components of LA strain. LA strain is associated with exercise tolerance and clinical events in patients with HCM.

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Prognostic value of right ventricular systolic function by speckle tracking echocardiography beyond conventional echocardiography in significant tricuspid regurgitation

European Heart Journal ◽

10.1093/ehjci/ehaa946.1912 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

R Hinojar Baydes ◽

V De Angelis ◽

A Garcia-Martin ◽

A Gonzalez-Gomez ◽

M Sanroman ◽

...

Keyword(s):

Right Ventricular ◽

Tricuspid Regurgitation ◽

Prognostic Value ◽

Systolic Function ◽

Clinical Status ◽

S Wave ◽

Mean Values ◽

2D Echocardiography ◽

Echocardiographic Parameters ◽

Rv Function

Abstract Background Right ventricular (RV) systolic function is determinant in the evaluation of patients with significant tricuspid regurgitation (TR). Timely detection of RV dysfunction with conventional 2D echocardiography is limited by the geometry and position of the RV. RV strain has emerged as an accurate and sensitive tool for evaluation of RV function with the capability of detect subclinical RV dysfunction Purpose This study was aimed to evaluate the prognostic value of RV strain in consecutive patients with significant TR, in comparison with conventional parameters of RV systolic function. Methods Consecutive patients in stable clinical status with significant TR (severe, massive or torrential TR) evaluated in the Heart Valve Clinic were included. RV systolic function was measured with conventional echocardiographic parameters (RV fractional area change [FAC], tricuspid annular plane systolic excursion [TAPSE]), DTI S wave ('S) and with STE derived automatic peak global and free wall longitudinal strain (GLS, FW-LS respectively) using the EPIQ system. A combined endpoint of hospital admission due to heart failure or cardiovascular mortality was defined. Results A total of 100 patients were included (mean age was 76±10 years, 65% females, 84% in NYHA I/II, 86% functional TR). Mean values of RV function parameters are shown in the table. During a mean follow up of 24±10 months, 24% of the patients reached the combined endpoint. Patients with events showed impaired RV GLS and FW-LS (p<0.01). Both parameters were predictive of the combined endpoint (table 1). Conventional parameters of RV systolic function were not associated with outcomes (p>0.05 for all). Conclusion In patients with severe TR, RV strain values are superior to conventional parameters to detect RV dysfunction. Among different measurements of RV function, RV GLS and FW-LS were the only predictors of poor prognosis. These parameters should be included in the serial evaluation of these patients. Funding Acknowledgement Type of funding source: None

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