Velocity vector imaging echocardiography and N- terminal pro- brain natriuretic peptide study of people with preclinical hypertrophic cardiomyopathy

Background: To investigate whether familial hypertrophic cardiomyopathy (HCM) gene mutation carriers without overt left ventricular hypertrophy have subclinical changes in left ventricular function.Methods: We studied Eighteen HCM families with pathogenic mutations, 45 patients with overt HCM (gene positive/phenotype positive (G+/P+)), 40 patients without myocardial hypertrophy (gene positive/phenotype negative G+/P-)), and 48 genotype-negative related healthy controls. Conventional echocardiography and velocity vector imaging (VVI) were performed, and blood levels of N- terminal pro- brain natriuretic peptide (NT- pro- BNP) were analyzed.Results: Although the global longitudinal, circumferential and radial strain was similar between the G+/P- group and the control group, the longitudinal strain of basal inferoseptum and basal anteroseptum was lower in G+/P- patients than in controls, while the basal and middle inferolateral longitudinal strains were significantly higher. Compared with the controls, G+/P+ patients had significantly lower global and segmental longitudinal and radial strains. There were no significant differences between the normal control and G+/P+ groups for global and segmental circumferential strains. The middle of the left ventricle (LV) was clockwise in G+/P+ patients (opposite to normal).The rotation angle of the mid LV rotation in the G+/P+ group were significantly higher than those in the G+/P- subjects and controls. The NT-proBNP levels were higher in G+/P+ patients than in G+/P- people and controls.Conclusions: Sarcomere gene mutation carriers without overt left ventricular hypertrophy have subclinical segmental systolic dysfunction. Velocity vector imaging is feasible for differentiating HCM, G+/P- patients from controls.

Abstract 13078: Evaluation of Ventricular Function in Fetus With Transposition of Great Arteries by Velocity Vector Imaging

Background: The aim of this study was to test the hypotheses that (1) fetuses with complete transposition of the great arteries (D-TGA) and Taussig-Bing anomaly (TBA) has decreased the left ventricular (LV) and right ventricular(RV) mechanical function compared with normal fetuses, and (2)the decreased myocardial mechanical function in fetal D-TGA and TBA was associated with the degree of transposition of the great arteries, pulmonary stenosis(PS) and ventricular septal defect(VSD). Methods: We retrospectively identified 49 cases of fetal D-TGA and 29 cases of fetal TBA and compared findings to 49 controls of comparable gestational age. Postprocessing analysis of the left ventricle and right ventricle were done using syngo Velocity Vector Imaging version 2.3. Global and regional longitudinal systolic peak velocity, strain and strain rate were generated. Results: (1) Comparing with control group, the global and regional longitudinal systolic peak velocity (GLV), strain (GLS) and strain rate (GLSR) of the LV and RV were decreased in the group of D-TGA and TBA (P<0.05). (2) In the group of D-TGA and TBA, the multivariate linear regression analysis, the VSD was the independent determinant of LVGLS and RVGLS (β = 0.270, P=0.014 and β = 0.465, P< 0.001). The PS was the independent determinant of RVGLSR (β = 0.090, P=0.009). Conclusion: The ventricular function of fetal D-TGA and TBA were decreased compared with control group. The PS and VSD were the independent determinant factors of the decreased LVGLS, RVGLS and RVGLSR in the fetal D-TGA and TBA.

Mechanical systolic dyssynchrony assessed with 3-D echocardiography and its association with global strain

Background The evaluation of global longitudinal strain using 2-D velocity vector imaging, is an accurate automatized tool for assessment of ventricular function, nevertheless its correlation with systolic synchrony by 3D echocardiography, remains unclear. Aims To evaluate the correlation between global longitudinal strain and systolic synchrony index (SSI). In addition, identify which ventricle has the global longitudinal strain with the best odds ratio for detecting systolic dyssynchrony (SSI ≥6.0 ms). Methods We evaluate left (LV-GS, LA-GS) and right (RV-GS; RA-GS) global longitudinal strain using automatized 2-D velocity vector imaging. SSI was measured using 17 segments according to guidelines. Results We included 420 subjects. Characteristics of study population are presented in table 1. We found a positive and significant correlation with LV-GS (r=0.152, 95% CI: 0.052–0.247), RV-GS (r=0.119, 95% CI: 0.02–0.215), LA-GS (r=0.160, 95% CI: 0.290,0.212) and RA-GS (r=0.249, 95% CI: 0.355,-0.136) (Figure 1). Decreased values of RV-GS (OR: 1.06, 95% CI: 1.01–1.10) had the better association with mechanical systolic dyssynchrony after adjusted for covariates. Conclusion Automated measurement of the global longitudinal deformation of the left and right chambers correlates with the systolic synchrony index. The quantification of RV-GS could be an ideal tool to detect systolic dyssynchrony using an automated approach Funding Acknowledgement Type of funding source: None

Evaluation of the Effects of Schisandra chinensis on the Myocardium of Rats with Hyperthyroid Heart Disease by Using Velocity Vector Imaging Combined with the Estimation of p53 Expression and Calmodulin Activity

Schisandra chinensis (SC) is reported to improve myocardial ischemia. Velocity vector imaging (VVI) is a noninvasive technique for evaluating myocardial function in humans, while few reported on the application in animals. In this study, we aimed to evaluate the improved effects of SC on the myocardium of Sprague Dawley rats having hyperthyroid heart disease (HHD) using VVI technique. HHD models were established by injecting daily with subcutaneous levothyroxine (0.5 mg/kg). Then, the SC group was administered the aqueous extract of SC (2 g/kg) once daily, while the HHD and control (CON) groups were administered the same amount of distilled water daily. All the rats were provided the same amount of food and water daily, and the intervention was stopped after 28 days. The efficacy of SC in HHD rats was evaluated by ultrasound VVI. The serum total triiodothyronine level, total thyroxine level, N-terminal pro-brain natriuretic peptide expression, p53 expression, and calmodulin (CaM) activity were assessed by western blotting, Hematoxylin-Eosin and Masson staining, and electron microscopy. The results indicated that SC significantly improved the systolic velocity, diastolic velocity, strain, systolic strain rate, and diastolic strain rate of the heart by significantly reducing p53 expression and CaM activity (P<0.05), improving myocardial fibrosis in HHD rats. Also, VVI can be a valuable tool for the evaluation of myocardial function in HHD rats.

Velocity Vector Imaging technology and standard echocardiography in evaluation of left ventricular function in patients with coronary artery disease before and after coronary bypass surgery

Aim. To study strain and strain rate dynamics the left ventricle (LV) myocardium fibers in patients with ischemic heart disease after coronary artery bypass grafting (CABG) in the early and late periods.Material and methods. The dynamics of strain (S) and strain rate (SR) of longitudinal, circular and radial fibers in 148 patients (in 2646 LV segments) before and on the 12th day after CABG was studied using Velocity Vector Imaging technology. In the long-term (6, 12 and 24 months) 40 patients (720 LV segments) were examined.Results. A positive dynamics of SR longitudinal fibers (p = 0.0002) was on the 12th day after CABG. Weak and medium correlation was between S and SR radial (R = –0.56; R = –0.52) and circular fibers with LDG-1 and duration of aortic clamping. In the long term, patients with complaints showed a decrease in global deformation properties in the coronary artery areas. The stable result of improvement S and SR longitudinal and circular fibers and SR radial fibers was obtained in segments with initially low deformation properties.Conclusions. The use of Velocity Vector Imaging technology allows to estimate the dynamics of LV fibers deformation parameters in early and long-term periods. In the early period after CABG was a positive dynamic only from the global SR longitudinal fibers. In the long-term global deformation parameters of longitudinal and circular fibers was decrease in in the area of the coronary arteries. In the long-term was a significant improvement of the deformation parameters of segments with initially low deformation properties.