Index-Beat Assessment of Left Ventricular Systolic and Diastolic Function during Atrial Fibrillation Using Myocardial Strain and Strain Rate

2012 ◽  
Vol 25 (9) ◽  
pp. 953-959 ◽  
Author(s):  
Kenya Kusunose ◽  
Hirotsugu Yamada ◽  
Susumu Nishio ◽  
Noriko Tomita ◽  
Junko Hotchi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Strain Rate ◽  
Diastolic Function ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Strain And Strain Rate ◽  
Systolic And Diastolic Function

scholarly journals Stiffness- and relaxation-based quantitation of radial left ventricular oscillations: elucidation of regional diastolic function mechanisms

2007 ◽  
Vol 102 (5) ◽  
pp. 1862-1870 ◽  
Author(s):  
Matt M. Riordan ◽  
Sándor J. Kovács
Keyword(s):  
Strain Rate ◽  
Diastolic Function ◽  
Causal Relation ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Tissue Imaging ◽  
Short Axis ◽  
Strain Rate Imaging ◽  
Strain And Strain Rate ◽  
Volume Property

Traditionally, global and longitudinal (i.e., regional) left ventricular (LV) diastolic function (DF) assessment has utilized features of transmitral Doppler E and A waves or Doppler tissue imaging (DTI)-derived mitral annular E′ and A′ waves, respectively. Quantitation of regional DF has included M-mode echocardiography-based approaches and strain and strain rate imaging (in selected imaging planes), while analysis of mitral annular “oscillations” has recently provided a new window into longitudinal (long-axis) function. The remaining major spatial degree of kinematic freedom during diastole, radial (short-axis) motion, has not been fully characterized, nor has it been exploited for its potential to provide radial LV stiffness ( krad) and relaxation/damping ( crad) indexes. Prior characterization of regional (longitudinal) DF used only annular E′- and A′-wave peak velocities or, alternatively, myocardial strain and strain rate. By kinematically modeling short-axis tissue motion as damped radial oscillation, we present a novel method of estimating krad and crad during early filling. As required by the (near) constant-volume property of the heart and tissue/blood incompressibility, in subjects ( n = 10) with normal DF, we show that oscillation duration-determined longitudinal ( klong and clong) and radial ( klong and crad) parameters are highly correlated ( R = 0.69 and 0.92, respectively). Selected examples of diabetic and LV hypertrophic subjects yield radial ( klong and crad) parameters that differ substantially from controls. Results underscore the utility of the incompressibility-based causal relation between DTI-determined mitral annular long-axis (longitudinal mode) and short-axis (radial mode) oscillations in healthy subjects. Selected pathological examples provide mechanistic insight and illustrate the value and potential role of regional (longitudinal and radial) DF indexes in fully characterizing normal vs. impaired DF states.

Abstract MP209: Troponin I Phosphorylation Is Essential For Cardiac Reserve

2021 ◽  
Vol 129 (Suppl_1) ◽  
Author(s):  
Sarah L Sturgill ◽  
Lorien G Salyer ◽  
Vikram Shettigar ◽  
Elizabeth Brundage ◽  
Brandon J Biesiadecki ◽  
...  
Keyword(s):  
Heart Rate ◽  
Strain Rate ◽  
Diastolic Function ◽  
Troponin I ◽  
Contractile Function ◽  
Radial Strain ◽  
Left Ventricular ◽  
Resting Heart Rate ◽  
Cardiac Reserve ◽  
Systolic And Diastolic Function

In response to increase in metabolic demand (e.g., exercise), the heart must increase its pumping performance to meet this demand. To achieve this increase, the heart relies on its cardiac reserve, which is the ability to increase in its contractile and diastolic function. The mechanism responsible for cardiac reserve is poorly understood. The myofilament is the mechanism responsible for contraction and relaxation. Troponin I (the inhibitory subunit of troponin, TnI) is a key regulatory protein. Studies have shown TnI serine 23/24 (S23/S24) phosphorylation, the most abundant and important TnI phosphorylation, is a key mechanism for accelerating relaxation by decreasing Ca 2+ senstivity. The role of TnI in cardiac reserve is unknown. For this study, we thoroughly characterized the systolic and diastolic reserve in TnI S23/S24 phosphorylation-null transgenic mice (S23/S24 mutated to alanine, AA mice). Even with increased Ca 2+ sensitivity, the AA mice exhibited normal function at resting heart rate and no difference in cardiac structure compared to wildtype. To increase in vivo heart performance, the most important system is the Bowditch effect (i.e., an increase in contractile function with increasing heart rate). To examine the role TnI S23/S24 phosphorylation in systolic and diastolic reserve, we assessed hemodynamics via left ventricular catheterization on the Bowditch effect by increasing heart rate from 240 to 420 beats per minute. Our data exhibited a clear loss of diastolic and systolic reserve in the AA mice. Since we observed a clear inability to increase systolic and diastolic function in AA mice, we performed speckle tracking echocardiography to more quantitatively investigate AA mice function. We observed that AA mice demonstrated normal systolic function (radial strain rate) and impaired directional diastolic function (reverse radial strain rate) at resting heart rate. We conclude that TnI S23/S24 phosphorylation is essential for cardiac reserve by enhancing systolic and diastolic function. A blunted cardiac reserve leads to heart disease making TnI S23/S24 phosphorylation a potential therapeutic strategy.

Abstract 2250: Is Atrial Fibrillation in Hypertrophic Cardiomyopathy Due to Left Atrial Structural Remodeling as Determined by Speckle-Derived Atrial Strain Imaging?

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Ying Shan ◽  
Grace Lin ◽  
Toshinori Yuasa ◽  
Fletcher A Miller ◽  
Steve R Ommen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Hypertrophic Cardiomyopathy ◽  
Strain Rate ◽  
Left Atrial ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Left Atrial Strain ◽  
Structural Remodeling ◽  
Strain And Strain Rate ◽  
Atrial Strain

Background: Atrial fibrillation (AF) is common in HCM yet the mechanisms are poorly understood but are likely secondary to either the consequences of left atrial structural remodeling (LASR) or myopathy, or triggers arising from pulmonary and other thoracic veins. The presence and severity of LASR as characterized by left atrial strain (LA ϵ), and its relationship to AF in HCM, has not been determined. Therefore, we measured LA ϵ and strain rate (SR) in Pts with HCM both with (AF+) and without (AF−) prior AF and compared these measures to those in age and gender matched controls without HCM or AF. Methods: Two-dimensional speckle-derived LA longitudinal peak ϵ, SR during systole (SR S ), early (SR E ) and late diastole (SR A ) were measured at the basal and mid portions of the lateral, septal, and posterior LA walls using Vector Velocity Imaging during sinus rhythm and were averaged. Results: Mean age of Pts in each of the matched groups was 56 ± 2 years (16 males; 59%). Significant left ventricular outflow tract obstruction was present in all Pts with HCM. Diastolic dysfunction was similar in both HCM groups and worse when compared to controls. Peak LA 3 , SR S , SR E , and SR A for each group is shown (table 1 ). HCM was associated with significantly lower LA ϵ and SR compared to controls. Although LA size was increased in Pts with HCM when compared to controls there was no correlation between LA size and ϵ or SR (p>0.05 for all). No differences in LA ϵ and SR were found between AF+ versus AF− Pts. Conclusion: HCM is associated with LASR as determined by decreased LA ϵ and SR. However, LA ϵ and SR were similar in AF+ versus AF− Pts suggesting that the occurrence of AF in HCM is not due to LASR alone. Table 1. Left Atrial Strain and Strain Rate in Hypertrophic Cardiomyopathy

Applications of Strain And Strain Rate in the Evaluation of Left Ventricular Diastolic Function

2019 ◽  
Vol 32 (2) ◽  
Author(s):  
José Maria Del Castillo ◽  
Carlos Mazzarollo ◽  
Waldemiro Carvalho ◽  
Jonny Vitor Diniz ◽  
Katarina Barros Oliveira ◽  
...  
Keyword(s):  
Strain Rate ◽  
Diastolic Function ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Ventricular Diastolic Function ◽  
Strain And Strain Rate

P1032Efficacy and safety of radiofrequency catheter ablation for atrial fibrillation in patients undergoing hemodaialysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Hachisuka ◽  
H Hayashi ◽  
R Mimuro ◽  
Y Maru ◽  
Y Fujimoto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Diastolic Function ◽  
Radiofrequency Catheter Ablation ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Systolic And Diastolic Function ◽  
Free Rate

Abstract Introduction Although radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) has become a standard therapy, the ablation outcomes in patients undergoing hemodialysis (HD) has not been fully elucidated. The present study aimed to evaluate the clinical outcomes of RFCA for AF in patients undergoing HD. Methods Twenty-three patients undergoing HD (17 men, age 65±8 years, 19 paroxysmal AF) who underwent RFCA for drug-refractory AF in two institutes were enrolled in the study and defined as HD group. The clinical parameters, recurrence free rate and frequency of periprocedural complications were compared to 46 randomly selected age, gender and left atrial diameter matched controls not requiring HD defined as non-HD group (34men, age 67±7 years, 38 paroxysmal AF). Results The patients in HD group had a significantly lower body mass index (21±3 vs. 25±3 P<0.01), higher prevalence of coronary artery disease (30% vs. 10% P=0.04), and higher prevalence of congestive heart failure (52% vs. 10% P<0.01) compared to patients in non-HD group. Echocardiography indicated lower left ventricular ejection fraction (57±17% vs. 65±9% P=0.02), higher E/e' (20±8 vs. 12±4 P<0.01), higher tricuspid regurgitation pressure gradient (30mmHg vs. 24mmHg P<0.01) and more impaired left ventricular diastolic function in HD group. All the subjects underwent bilateral pulmonary vein isolation plus additional linear lesion. The number of ablation procedure was similar between the two groups (1.43±0.5 vs. 1.46±0.6 P=0.88). During the follow-up period of 37±25 months after the last procedure, the arrhythmia free rate was similar between the two groups (86% vs. 84% log-rank P=0.82). Vascular access complication occurred in two patients in HD group, and pericardial effusion occurred in one patient in non-HD group, while no life-threatening complications were observed in either group. Cardiogenic cerebral infarction occurred in one patient in non-HD group. Discontinuation of oral anticoagulation after the ablation was more often seen in the HD group compared to non-HD group (91% vs. 60% P<0.01). Conclusions Although patients undergoing HD had more impaired left ventricular systolic and diastolic function, RFCA for AF in patients with HD was shown to be as effective and safe as in non-HD patients. RFCA may be an efficient approach to manage AF in patients undergoing HD.

scholarly journals Impaired myocardial deformation and ventricular vascular coupling in obese adolescents with dysglycemia

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Preneet Cheema Brar ◽  
Anne Chun ◽  
Xiazhou Fan ◽  
Vivek Jani ◽  
Mary Craft ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Strain Rate ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Myocardial Deformation ◽  
Oral Glucose ◽  
Age And Gender ◽  
Obese Adolescents ◽  
Strain And Strain Rate ◽  
And Gender

Abstract Background It is unknown that dysglycemia in obese adolescents has effects on myocardial deformation that are more pronounced when compared to obesity alone. We hypothesized that obesity associated abnormal glucose tolerance (dysglycemia) would have adverse effects on two-dimensional speckle tracking echocardiography derived longitudinal, radial and circumferential strain (LS, RS, CS) compared to age and gender lean controls. We also examined if changes in deformation would be reflected in abnormal ventricular vascular coupling indices (VVI). Methods In a prospective cross-sectional design 39 obese adolescents (15.9 ± 1.7 years; 101.5 ± 39 kg; female − 58%) were compared to age and gender matched lean controls (15.7 ± 1.8 yrs, 60 ± 12.8 kg). Based on results from an oral glucose tolerance test (OGTT), obese adolescents were categorized as obese normoglycemic (ONG, n = 25) or obese dysglycemic (ODG, n = 14). Left ventricular (LV) global and average LS, CS, RS and strain rate were measured. LV ejection fraction and mass index were measured and VVI approximated as ratio of arterial elasticity (Ea) and end-systolic elastance (Ees). Results Adolescents with ODG had significantly (P = 0.005) impaired global LS (− 20.98% ± 2.8%) compared to controls (− 23.01% ± 2.3%). A similar (P = 0.0027) reduction was observed in average LS for adolescents with ODG (18.87% ± 2.5%) compared to controls (20.49% ± 2%). Global CS was also decreased (P = 0.03) in ODG (− 23.95%) compared to ONG (− 25.80). A similar trend was observed in average CS after multivariate regression for BMI and blood pressure. CS correlated with HbA1c in both groups (P = 0.05). VVI had a negative correlation with both LS (r = − 0.4, P = 0.025) and CS rate (r = − 0.36, P = 0.04). Conclusions Myocardial strain and strain rate were significantly altered in obese adolescents. Unfavorable subclinical reductions in global and average CS were more pronounced in adolescents with dysglycemia compared to obese adolescents with normoglycemia and controls. These data indicate progressive worsening of subendocardial function across the spectrum of glucose tolerance. Strain rate was predictive of VVI in obese adolescents, suggesting strain rate may be a sensitive marker for cardiac remodeling in abnormal glucose homeostasis states.

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