Hodnotenie subklinickej systolickej dysfunkcie ľavej komory pomocou parametrov deformácie / The use of deformation parameters in assessment of left ventricle subclinical dysfunction

AbstractBackgroundMyocardial deformation by speckle tracking echocardiography provides additional information on left ventricular function. Values of myocardial deformation (strain and strain rate) depend on the type of ultrasound machine and software that is used. Normative values for QLAB (Philips) are scarce, especially for children. It is important to evaluate the influence of age and body size on myocardial deformation parameters, since anthropometrics strongly influence many standard echocardiographic parameters. The aim of this study was to provide comprehensive normal values for myocardial deformation of the left ventricle using a Philips platform and to evaluate the association with anthropometric and standard echocardiographic parameters.MethodsHealthy children between 1 and 18 years of age were prospectively examined using a standard echocardiographic protocol. Short-axis and apical four-chamber, two-chamber, and three-chamber views were used to measure peak systolic circumferential and longitudinal strain and systolic and early diastolic strain rate of the left ventricle using dedicated software.ResultsA total of 103 children were included with a mean age of 10.8 and inter-quartile range 7.3–14.3 years. Global circumferential strain values (±SD) were −24.2±3.5% at basal, −25.8±3.5% at papillary muscle, and −31.9±6.2% at apex levels. Global left ventricular longitudinal strain values were −20.6±2.6% in apical four-chamber view, −20.9±2.7% in apical two-chamber, and −21.0 ±2.7% in apical three-chamber. Age was associated with longitudinal strain, longitudinal systolic and early diastolic strain rate, but not with circumferential strain.ConclusionsNormal values for left ventricular deformation parameters in children are obtained using a Philips platform. Age partly explains normal variation of strain and strain rate.

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Donation after circulatory death hearts recipients compared to donation after brain death heart recipients have comparable systolic left ventricular function and better myocardial strain at 1 year

European Heart Journal ◽

10.1093/ehjci/ehaa946.1108 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Ciarka ◽

A Page ◽

S Messer ◽

E Pavlushkov ◽

S Tsui ◽

...

Keyword(s):

Left Ventricle ◽

Left Ventricular ◽

Myocardial Deformation ◽

Lv Function ◽

Donation After Circulatory Death ◽

Deformation Parameters ◽

Echocardiographic Parameters ◽

Donation After Brain Death ◽

Circulatory Death

Abstract Purpose Cardiac transplantation from donation after circulatory death (DCD) has been implemented at our hospital since February 2015. Despite encouraging results some concerns may be raised about the impact of the warm ischemia and reperfusion injury on the myocardium status at longer follow-up. Therefore, we aimed to analyse systolic performance of the left ventricle at 1 year follow in DCD and donation after brain death (DBD) cardiac recipients, as assessed by echocardiography with myocardial deformation imaging. Methods We identified 46 consecutive DCD cardiac recipients who were transplanted from February 2015 to August 2018 and we matched them with 46 DBD cardiac recipients. Six and 7 patients from DCD and DBD group, respectively, died in the first-year post transplant. In the remaining patients we have compared the classical echocardiographic measurements as well as global longitudinal strain (GLS) and global circumferential strain (GCS) at 1-year follow-up. Results DCD and DBD patients did not present with differences in terms of classical echocardiographic parameters of left ventricular (LV) structure and systolic function at one-year follow-up. LVEDV was similar in DCD and DBD patients (101±24 vs. 95±32 ml, p=0.4 respectively), as well as LVESV (42±13 vs. 42±16 ml, p=0.9, respectively), LV ejection fraction (58±6 vs. 56±8%, p=0.22) and LV mass (156±39 vs. 163±38 gr, p=0.2, respectively). In contrast, myocardial deformation parameters, such as GLS and GCS, were better in DCD than in DBD (16.1 vs. −14.5%, p<0.01; and −25.2 vs. 22.3%, p<0.05, respectively). The diastolic LV function parameters were similar in DCD and DBD group, as evidenced by E wave velocity, A wave velocity and deceleration time of mitral inflow, however E over E prime was lower in DCD than in DBD recipients (7.7±8.7, p<0.05). Fractional area change of the right ventricle was higher in DCD in comparison with DBD (46±7 vs. 40±7%, p<0.01) while right atrial volume index was lower in DCD than in DBD (25±8 vs. 29±9 ml/m2, p<0.01). Other parameters of RV function (systolic excursion of the tricuspid annulus, TAPSE) were similar in both groups. Conclusion DCD and DBD heart recipients present with similar systolic LV function at 1-year follow, as assessed by classical echocardiographic parameters. DCD cardiac recipients have better myocardial deformation parameters as assessed by the speckle tracking, better systolic right ventricular function and lower filling pressures of the left ventricle. Funding Acknowledgement Type of funding source: None

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Parameters of left atrial during stress in patients with asymptomatic primary mitral regurgitation

European Heart Journal ◽

10.1093/ehjci/ehaa946.0016 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

R Zvirblyte ◽

E Tamulenaite ◽

A Saniukaite ◽

I Merkyte ◽

V Mizariene ◽

...

Keyword(s):

Left Ventricle ◽

Mitral Regurgitation ◽

Structural Changes ◽

Peak Stress ◽

Myocardial Deformation ◽

Volume Index ◽

Control Group ◽

Deformation Parameters ◽

Asymptomatic Patients ◽

Primary Mitral Regurgitation

Abstract Introduction Progressive volume overload caused by chronic mitral regurgitation (MR) leads to left atrium (LA) and left ventricle (LV) remodeling. Despite these structural changes, most of MR patients may remain asymptomatic for a long time. LA enlargement and reduced LA deformation parameters in asymptomatic MR patients predict a worse prognosis and may provide additional information to guide for earlier surgery. Purpose The aim of the study was to evaluate changes of LA size and deformation parameters in patients with asymptomatic primary MR during stress. Methods 84 asymptomatic patients (age 59.87±13.47 years) with sinus rhythm and preserved left ventricle (LV) ejection fraction (EF) (>50%) at rest were included in the study. Resting and stress (veloergometry as per protocol 25 + 25 W every 3 minutes) echocardiography and speckle tracking off-line analyses were performed to 52 (61.9%) patients with moderate MR (MR group) and 32 (38.1%) patients without significant heart valves disease (control group). Statistical analyses were performed using the SPSS 20.0 software. The value of p<0.05 was considered as statistically significant. Results Volume index of LA was significantly higher in subjects with MR (picture 1). LA area was similar in MR and control groups at rest. However, during stress LA area became significantly larger in MR group (picture 1). LA myocardial deformation parameters were calculated during 3 phases of LA cycle: reservoir phase strain (LASr), conduit phase strain (LAScd), contraction phase strain (LASct). At rest, during peak stress and at recovery phase all of them were higher in controls but difference was not significant. During initial stress (25 W) LAScd was significantly higher in MR group (−16.86±−8.06% vs. −11.33 ±−6.26% p=0.034), while healthy subjects had a tendency to lower LASr (20.32±10.53% vs. 22.7±10.89%, p=0.535) (picture 1). Better LV EF at rest was related to smaller LA area (p=0.003, r – 0.390) and volume index (p=0.020, r – 0.308) during peak stress. Conclusions Stress provokes significant increase of LA size (volume and area) and LAScd in patients with primary mitral regurgitation. Other myocardial deformation parameters of LA were not significantly related to MR. LV EF at rest correlates with LA parameters during peak stress. Changes of LA parameters during stress Funding Acknowledgement Type of funding source: None

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Dynamics of left ventricle myocardial deformation, soluble ST2 and cardiotrophin-1 in hypertensive women on combined valsartan/hydrochlorothiazide therapy

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.113 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

M Kolesnyk ◽

MV Sokolova ◽

OV Nikityuk ◽

IV Horlova

Keyword(s):

Blood Pressure ◽

Left Ventricle ◽

Arterial Hypertension ◽

Left Ventricular ◽

Interquartile Range ◽

Myocardial Deformation ◽

Soluble St2 ◽

Mechanical Dispersion ◽

Deformation Parameters

Abstract Funding Acknowledgements Type of funding sources: None. Background. The treatment-induced regression of left ventricular hypertrophy (LVH) is associated with improved prognosis in patients with arterial hypertension. However, the assessment of LVH by echo is restricted by substantial measurement variability and low sensitivity to changes during follow-up. The alternative approach could be the dynamic evaluation of myocardial deformation parameters and biochemical markers of cardiac remodeling. The purpose of this study was to assess the dynamics of left ventricle (LV) myocardial deformation, soluble ST2 and cardiotrophin-1 levels in hypertensive women treated with combination of valsartan/hydrochlorothiazide. Methods. The study involved 100 postmenopausal women (mean age – 57.7 ± 4.3 years) with uncomplicated arterial hypertension. All patients were treated with combination of valsartan (80-320 mg; average dose 195 mg) and hydrochlorothiazide (12.5 mg). Ambulatory blood pressure monitoring, conventional and 2-dimensional speckle tracking echocardiography were performed before and 6 months after treatment. The concentrations of cardiotrophin-1 and soluble ST2 were determined by ELISA method. The data are presented as median and interquartile range. Results. Treatment with valsartan/hydrochlorothiazide was effective and well tolerated. Target blood pressure level was achieved in 64 % of the patients. The LV global longitudinal strain (GLS) raised significantly after 6 months of treatment (Table). We found the reduction of mechanical dispersion - parameter, which indirectly reflects myocardial tissue homogenicity. The levels of circulating cardiotrophin-1 and soluble ST2 decreased by 37.93% and 19.74%, respectively (p < 0.0001). Conclusions. The 6-month therapy with valsartan/hydrochlorothiazide was associated with improvement of myocardial deformation parameters with concomitant reduction of soluble ST-2 and cardiotrophin-1 levels. These markers could be more sensitive than standard parameters for hypertensive patients" follow-up. However, this approach should be confirmed in future studies. Parameter Baseline 6-month p Office SBP, mm Hg 148 (140; 157) 135 (124; 143) <0.0001 Office DBP, mm Hg 89 (82; 96) 81 (74; 87) <0.0001 LV GLS, % -19.6 (-18.1; -21.1) -20.4 (-18.9; -21.8) 0.01 Mechanical dispersion, ms 43 (37; 51) 41 (37; 48) 0.04 Cardiotrophin-1, pg/ml 12.2 (9.4; 16.81) 8.5 (6.26; 10.82) <0.0001 Soluble ST2, ng/ml 25.3 (17.93; 29.72) 18.2 (13.93; 25.96) <0.0001 Values are given as median and interquartile range

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Early detection of subclinical dysfunction of left ventricle in dialysis patients.

Cardiologia Croatica ◽

10.15836/ccar.2015.64 ◽

2015 ◽

Vol 10 (3-4) ◽

pp. 64-64

Author(s):

Slavica Mitrovska

Keyword(s):

Early Detection ◽

Left Ventricle ◽

Dialysis Patients ◽

Subclinical Dysfunction

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P5258Three-dimensional speckle tracking echocardiography identifies subclinical dysfunction of left ventricle on long-term lymphoma survivors: a case-control study

European Heart Journal ◽

10.1093/eurheartj/ehx493.p5258 ◽

2017 ◽

Vol 38 (suppl_1) ◽

Author(s):

C.J. Zhang ◽

L.L. Cheng ◽

Y.C. Xu ◽

F.Y. Song ◽

X.H. Shu ◽

...

Keyword(s):

Left Ventricle ◽

Speckle Tracking ◽

Case Control Study ◽

Speckle Tracking Echocardiography ◽

Case Control ◽

Lymphoma Survivors ◽

Subclinical Dysfunction ◽

Control Study

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P310 The role of the left ventricle deformation parameters determining reverse remodeling due to six months of spironolactone therapy

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.163 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

W Sacharczuk ◽

R Dankowski ◽

A Baszko ◽

A Sowinska ◽

S Ozegowski ◽

...

Keyword(s):

Left Ventricle ◽

Exercise Test ◽

Circumferential Strain ◽

Systolic Function ◽

Nyha Class ◽

Left Ventricular ◽

Reverse Remodeling ◽

Deformation Parameters ◽

Lv Systolic Function ◽

Mean Strain

Abstract Introduction Spironolactone is widely used in the pharmacotherapy of patients (pts) with HFrEF. However, there is still little information on the influence of spironolactone therapy on the global and regional left ventricular (LV) function. Aim Evaluation of the influence of regional deformation parameters on global LV systolic function as a result of six months of spironolactone therapy. Methods The study included 39 pts (mean age 64 years, with stable heart failure; NYHA class II-III, mean LVEF 37,4%, mean wall motion index score, WMSI 1,62). All pts received optimal standard treatment before entering the study. Then therapy of spironolactone 25mg daily was introduced. Clinical status, treadmill exercise test (compilation time and effort level), NT-pro-BNP and speckle tracking echocardiography (STE) assessment were analyzed. Two groups were created according to LV reverse remodeling (PRR -responders, 10% increase in LVEF and/or 15% decrease in LVESV; NRR- nonresponders). Differences between NRR I PRR, at the start point and after six months therapy of spironolactone for the above-mentioned parameters, were analyzed. Results Reverse remodeling was observed in 21 pts (PRR). There were no differences between PRR I NRR in: exercise test on the treadmill (compilation parameters: 27,86 vs 29,41), NYHA class, Nt-pro BNP levels (1071 vs 1172 pg/ml). WMSI in both groups was similar (respectively: 1,62 vs 1,61), however akinetic region in apical and septal regions of LV in NRR were more often represented (NRR 91,6% vs PRR 35% pts). PRR showed significantly better improvement of peak systolic longitudinal (LS) and circumferential (CS) strain in the apical (AP) and LV septal region of LV (SEP) depending on the post-infarction condition. (table 1) Conclusions Improvement of left ventricle systolic function depends on the regional contractility status of the myocardium. Longitudinal (LS) and circumferential (CS) peak systolic strain, regardless of ejection fraction and WMSI are the sensitive parameters determining improvements of the LV systolic function. The study showed that cut-off values to predict reverse LV remodeling must be lower than -10.08% for CS and -11.55% for LS. Tab.1. CS nad LS value at the end point Region of LV NRR mean strain % PRR mean strain% p value (NRRvs PRR) CS AP -11,42 -15,47 0.03 CS SEP -12,3 -17,04 0.02 LV 3CH -13,42 -16,30 0.04 CA AP-circumferential strain in apical LV region, CS SEP- circumferential strain in septal LV region, LV 3CH- longitudinal strain in three-chamber view of LV

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