scholarly journals Early adulthood obesity is associated with impaired left ventricular and right ventricular functions evaluated by speckle tracking and 3D echocardiography

2021 ◽  
Vol 49 (4) ◽  
pp. 312-3
Author(s):  
Serkan Unlu ◽  
◽  
Gulten Tacoy ◽  
Keyword(s):  
Right Ventricular ◽  
Speckle Tracking ◽  
Early Adulthood ◽  
Left Ventricular ◽  
3D Echocardiography ◽  
Ventricular Functions

scholarly journals Speckle tracking echocardiography in primary mitral regurgitation: should we reconsider the time for intervention?

2021 ◽  
Author(s):  
Maria Concetta Pastore ◽  
Giulia Elena Mandoli ◽  
Aleksander Dokollari ◽  
Gianluigi Bisleri ◽  
Flavio D’Ascenzi ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Right Ventricular ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Main Concern ◽  
Cardiac Damage ◽  
Asymptomatic Patients ◽  
Right Ventricular Strain

Abstract Thanks to the improvement in mitral regurgitation (MR) diagnostic and therapeutic management, with the introduction of minimally invasive techniques which have considerably reduced the individual surgical risk, the optimization of the timing for MR “open” or percutaneous surgical treatment has become a main concern which has highly raised scientific interest. In fact, the current indications for intervention in MR, especially in asymptomatic patients, rely on echocardiographic criteria with high severity cut-offs that are fulfilled only when not only mitral valve apparatus but also the cardiac chambers’ structure and function are severely impaired, which results in poor benefits for post-operative clinical outcome. This led to the need of new indices to redefine the optimal surgical timing in these patients. Speckle tracking echocardiography provides early markers of cardiac dysfunction due to subtle myocardial impairment; therefore, it could offer pivotal information in this setting. In fact, left ventricular and left atrial strains have already shown evidence about their usefulness in recognizing MR impact not only on symptoms and quality of life but also on cardiovascular events and new-onset atrial fibrillation in these patients. Moreover, right ventricular strain could be used to identify those patients with advanced cardiac damage and different grades of right ventricular dysfunction, which entails higher risks for cardiac surgery that could overweigh surgical benefits. This review aims to describe the importance of reconsidering the timing of intervention in MR and to analyze the potential additive value of speckle tracking echocardiography in this clinical setting.

scholarly journals P797 Assessment of right ventricular systolic function with 3D echocardiography following cardiac resynchronization therapy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Jenei ◽  
E Papp ◽  
M Clemens ◽  
Z Csanadi
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Right Ventricular ◽  
Systolic Function ◽  
Left Ventricular ◽  
3D Echocardiography ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
S Wave ◽  
Ventricular Systolic Function ◽  
Significant Difference

Abstract Background In approximately 30-40% of cases, the left ventricular systolic function does not improve following cardiac resynchronization therapy (CRT; non-responders). Currently, the role of right ventricular (RV) systolic function is not yet completely clear in the background. Our aim was to assess the RV systolic function with 3D echocardiography in CRT patients. Methods We selected 19 patients who received CRT in our department between May and June 2017, and whose 1-year follow-up data were available. We characterized several 2D parameters of RV systolic function, such as RV free wall strain (RV GLSFW), annular s’ wave velocity (TDI s), tricuspid annulus plane systolic excursion (TAPSE), RV fractional area change (RV FAC). A number of 3D parameters were also assessed, such as RV ejection fraction (EF), end-diastolic (EDV) and end-systolic (ESV) volumes, using a dedicated RV analysis software. Moreover, we measured the LV EF and considered the patients "responder", when the LV EF improved with at least 10% after CRT implantation. Results From 19 patients, 12 was identified as responders (R) and 7 as non-responders (NR). No significant difference was seen in the mean age of patients in the two groups (NR: 68 ± 6 year; R: 67 ± 9 year, p = 0.76), however, the proportion of male individuals was higher in the NR group (8/12 vs. 1/7). The RV EF was higher in the R group (41 ± 8% vs.29 ± 10%; p = 0.012), while the EDV or ESV did not differ between the two groups. The RV GLSFW (–21.2 ± 7% vs.–13.9 ± 7%, p = 0.045) and the TAPSE (16.8 ± 5 mm vs.11.4 ± 3 mm, P = 0.03) values were significantly different between the two groups. Based on logistic regression analysis, the RV EF was an independent predictor of non-respondence. Conclusions The lower RV EF indicates non-respondence to CRT, however, it is not associated with RV dilation, i.e.adverse remodelling. These results suggest mechanical abnormality of RV function in the background of impaired EF.

scholarly journals Evaluation of Right Ventricular Functions in Patients of Left Ventricular Hypertrophy

2017 ◽  
Vol 16 (01) ◽  
pp. 61-65
Author(s):  
Abhishek Bhatia ◽  
Nishant Wadhera ◽  
Shirobhisharma Shirobhisharma ◽  
Abhishek Gupta ◽  
S.K. Virmani.
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Right Ventricular ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Ventricular Functions

scholarly journals Usefulness of Speckle Tracking Echocardiography and Biomarkers for Detecting Acute Cellular Rejection After Heart Transplantation

2020 ◽  
Author(s):  
Cecília Beatriz Bittencourt Viana Cruz ◽  
Ludhmila A. Hajjar ◽  
Fernando Bacal ◽  
Marco S. Lofrano-Alves ◽  
Márcio S.M. Lima ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Right Ventricular ◽  
Speckle Tracking ◽  
Troponin I ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Acute Cellular Rejection ◽  
Control Group ◽  
Transplant Patients ◽  
Cellular Rejection

Abstract Background: Acute cellular rejection (ACR) is a major complication after heart transplantation. Endomyocardial biopsy (EMB) remains the gold standard for its diagnosis, but it has concerning complications. We evaluated the usefulness of speckle tracking echocardiography (STE) and biomarkers for detecting ACR after heart transplantation.Methods: We prospectively studied 60 transplant patients with normal left and right ventricular systolic function who underwent EMB for surveillance six months after transplantation. Sixty age- and sex-matched healthy individuals constituted the control group. Conventional echocardiographic parameters, left ventricular global longitudinal, radial and circumferential strain (LV-GLS, LV-GRS and LV-GCS, respectively), left ventricular systolic twist (LV-twist) and right ventricular free wall longitudinal strain (RV-FWLS) were analyzed just before the procedure. We also measured biomarkers at the same moment. Results: Among the included 60 patients, 17 (28%) had severe ACR (grade ≥ 2R), and 43 (72%) had no significant ACR (grade 0 – 1R). The absolute values of LV-GLS, LV-twist and RV-FWLS were lower in transplant patients with ACR degree ≥ 2 R than in those without ACR (12.5% ± 2.9% vs 14.8% ± 2.3%, p=0.002; 13.9° ± 4.8° vs 17.1° ± 3.2°, p=0.048; 21.4%± 3.2% vs 16.6% ± 2.9%, p<0.001; respectively), while no differences were observed between the LV-GRS or LV-GCS. All of these parameters were lower in the transplant group without ACR than in the nontransplant control group, except for the LV-twist. Cardiac troponin I levels were significantly higher in patients with significant ACR than in patients without significant ACR [0.19 ng/mL (0.09–1.31) vs. 0.05 ng/mL (0.01–0.18), p=0.007]. The combination of troponin with LV-GLS, RV FWLS and LV-Twist had an AUC (area under curve) for the detection of ACR of 0.80 (0.68 – 0.92), 0.89 (0.81 – 0.93) and 0.79 (0.66 – 0.92), respectively. Conclusion: Heart transplant patients have altered left ventricular dynamics compared with control individuals. The combination of troponin with strain parameters had higher accuracy for the detection of ACR than the isolated variables and this association might select patients with a higher risk for ACR who will benefit from an EMB procedure in the first year after heart transplantation.

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

P552Predictors of pacing induced left ventricular dysfunction and cardiomyopathy assessed by three-dimensional echocardiography and speckle tracking strain

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
M Dawood ◽  
M Nawar ◽  
M Abdelhay ◽  
E Elsharkawy
Keyword(s):  
Ejection Fraction ◽  
Speckle Tracking ◽  
Structural Heart Disease ◽  
Left Ventricular ◽  
3D Echocardiography ◽  
Clinical Approach ◽  
Percentage Points ◽  
Rv Pacing ◽  
And Function ◽  
Longitudinal Strains

Abstract OnBehalf Alexandria EPS Unit Background During recent years there was a focus on the negative effects associated with long term right ventricular (RV) pacing. It was shown in both experimental and clinical studies that RV pacing leads to ventricular dyssynchrony, similar to that of left bundle branch block (LBBB) with subsequent electrical, mechanical and anatomical changes leading to detrimental effects on left ventricular structure and function. During the last two decades, 3D echocardiography developed from a time-consuming method to a routine clinical approach. At present, evidence suggested that 3D echocardiography provided improved accuracy and reproducibility over 2D methods for LV volume and function calculation. There is a growing number of literature signifying that speckle tracking strain is able to identify left ventricular (LV) dysfunction even before any reduction in LV ejection fraction (LVEF). Methods This was an observational study of fifty consecutive patients without structural heart disease and preserved ejection fraction (LVEF &gt; 50%) presented with high grade atrioventricular block for permanent pacing. Complete 2D and a full volume 3D echocardiography was done before implantation, one-week and 6-months after implantation together with global longitudinal strains analysis (GLS). Patients were followed for 6 months to detect the incidence of PIVD (defined as a reduction in LVEF &gt;10 percentage points but still above 50%) and PICMP (defined as a decrease in LVEF by 10 percentage points from baseline in the absence of other known causes of cardiomyopathy resulting in EF &lt; 50%). PIVD and PICMP predictors and risk factors were analyzed over a 6-month period. Results At six months, 25 (50%) patients developed PIVD; of these, 6 (12%) developed PICMP. Pre-implantation, GLS was significantly lower in the 6 patients who subsequently developed PICMP, compared to those who developed PIVD and the preserved EF group (mean GLS -15.50 vs. -21.0, -20.0 respectively; p = 0.005, 0.033 respectively). At one week, GLS was significantly lower in the 25 patients who subsequently developed PIVD, compared to those who did not (GLS -13.0 vs. -18.0 respectively; p = 0.002). A reduction of baseline GLS by 15% or more at one week was associated with the development of PIVD and PICMP (p = &lt;0.001). A wider native QRS complex was associated with the development of PIVD and PICMP (p = 0.008, 0.018 respectively). The other predictors (Age, Sex, HTN, D.M, Post-pacing QRS width and axis, presence of native BBB, Pacemaker type and lead site) were found non-significant. Conclusion PICMP may be more common than previously reported and it may occur shortly after implantation. This rise in its incidence is due to the application of new sensitive tools like 3D echocardiography and speckle tracking strain. Pre-implantation GLS is a sensitive parameter for the development of PICMP. One-week GLS is an early predictor for the development of PICMP and PIVD before any reduction in EF develops.

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