Myocardial strain pattern progress in patients with Coarctation of the Aorta undergoing aortic stenting

2020 ◽  
Author(s):  
Natalia Freitas de Deus Vale Aragão ◽  
Juliana Nicchio Valentim Borgo ◽  
Carlos Alberto de Jesus ◽  
Tathiane Davoglio ◽  
Anderson da Costa Armstrong ◽  
...  
Keyword(s):  
Myocardial Strain ◽  
Coarctation Of The Aorta ◽  
Strain Pattern ◽  
Aortic Stenting

Be Aware of Aberrant Right Subclavian Artery Origin Before Aortic Coarctation Stenting: A Case Report Study

2019 ◽  
Vol 53 (7) ◽  
pp. 609-612
Author(s):  
Alireza Dehghan ◽  
Sara Haseli ◽  
Pedram Keshavarz ◽  
Marzieh Ahmadi ◽  
Pooyan Dehghani
Keyword(s):  
Subclavian Artery ◽  
Coarctation Of The Aorta ◽  
Vascular Anomaly ◽  
Subclavian Steal Syndrome ◽  
Aberrant Right Subclavian Artery ◽  
Descending Aorta ◽  
Subclavian Steal ◽  
Aortic Stenting ◽  
Artery Flow ◽  
Steal Syndrome

The subclavian steal syndrome (SSS), also called subclavian steal steno-occlusive disease, is defined as reversal of the vertebral artery flow secondary to significant hemodynamically ipsilateral occlusion or stenosis of the proximal subclavian artery. It is usually seen secondary to atherosclerosis and aberrant right subclavian artery (ARSA), resulting in SSS which is even less common. Aberrant right subclavian artery is a kind of vascular anomaly associated with coarctation of the aorta (CoA). It usually originates from the descending aorta distal to the site of CoA. Here, we present a young man who was a case of ARSA and CoA. He developed SSS after transcatheter aortic stenting secondary to unusual origin of ARSA from the site of CoA. Awareness of this rare anomaly helps to overcome this complication in patients undergoing interventional stenting for CoA and ARSA with anomalous origin.

Abstract 18045: Mild Coarctation of the Aorta: To Touch or Not to Touch the Patient? Looking at Left Ventricular Function and Hemodynamics

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Zahra Keshavarz Motamed ◽  
Amanda Randles ◽  
Farhad Rikhtegar Nezami ◽  
Ramon Partida ◽  
Kenta Nakamura ◽  
...  
Keyword(s):  
Myocardial Strain ◽  
Treatment Strategies ◽  
Particle Image Velocimetry Data ◽  
Coarctation Of The Aorta ◽  
Left Ventricular ◽  
Stroke Work ◽  
Modeling Framework ◽  
Optimal Method ◽  
Lumped Parameter ◽  
Lumped Parameter Modeling

Introduction: Coarctation of the aorta (COA) is an obstruction of the aorta distal to the left subclavian artery. A peak-to-peak trans-coarctation pressure gradient (P K dP) of greater than 20 mmHg warns of severe COA and the need for interventional/surgical repair. The optimal method and timing of the intervention remain uncertain especially when the severity of COA is mild (P K dP < 20 mmHg) and it is unclear if mild COA should be treated at all. Rosenthal (2001; J Am Coll Cardiol) suggested that treatment strategies for patients with mild COA may need to be redefined as transcatheter interventions emerge, and yet the risks and benefits of such interventions in patients with mild COA are unclear. The aim of this study is to investigate the effects of transcatheter intervention on hemodynamics of the aorta and left ventricle (LV) in eleven patients with mild COA. Methods. We used specially developed computational fluid dynamics and lumped parameter modeling framework along with highly-resolved particle image velocimetry data and clinical measurements (Doppler-echocardiography, cardiac catheterization, CT and MRI) in this study. Results . COA intervention can improve aortic hemodynamics to some extent (i.e., time-averaged wall shear stress, oscillating shear index, peak jet velocity and kinetic energy [all averaged in the descending aorta] were reduced by 20%, 13.3%, 26.7% and 25%, respectively). However there is no concomitant effect on the LV hemodynamics (i.e., stroke work, normalized stroke work and peak LV pressure were reduced by only 3.8%, 3.7% and 3.2%, respectively; arterial systemic compliance was also reduced by 17%; N=11; p < 0.05). Conclusion . Our computational approach can effectively model and predict clinical conditions. Herein one must question intervention for mild COA, as it has limited utility in reducing myocardial strain. Figure 1. Catheter data and results of lumped parameter modeling in patient No. 1.

scholarly journals Visualization of Myocardial Strain Pattern Uniqueness with Respect to Activation Time and Contractility: A Computational Study

Data ◽  
2019 ◽  
Vol 4 (2) ◽  
pp. 79
Author(s):  
Borut Kirn
Keyword(s):  
Parameter Space ◽  
Measurement Errors ◽  
Computational Study ◽  
Myocardial Strain ◽  
Myocardial Tissue ◽  
Connected Component ◽  
Activation Time ◽  
Mechanical Coupling ◽  
Strain Pattern ◽  
High Uncertainty

Speckle tracking echography is used to measure myocardial strain patterns in order to assess the state of myocardial tissue. Because electro-mechanical coupling in myocardial tissue is complex and nonlinear, and because of the measurement errors the uniqueness of strain patterns is questionable. In this study, the uniqueness of strain patterns was visualized in order to revel characteristics that may improve their interpretation. A computational model of sarcomere mechanics was used to generate a database of 1681 strain patterns, each simulated with a different set of sarcomere parameters: time of activation (TA) and contractility (Con). TA and Con ranged from −100 ms to 100 ms and 2% to 202% in 41 steps respectively, thus forming a two-dimensional 41 × 41 parameter space. Uniqueness of the strain pattern was assessed by using a cohort of similar strain patterns defined by a measurement error. The cohort members were then visualized in the parameter space. Each cohort formed one connected component (or blob) in the parameter space; however, large differences in the shape, size, and eccentricity of the blobs were found for different regions in the parameter space. The blobs were elongated along the TA direction (±50 ms) when contractility was low, and along the Con direction (±50%) when contractility was high. The uniqueness of the strain patterns can be assessed and visualized in the parameter space. The strain patterns in the studied database are not degenerated because a cohort of similar strain patterns forms only one connected blob in the parameter space. However, the elongation of the blobs means that estimations of TA when contractility is low and of Con when contractility is high have high uncertainty.

Myocardial strain pattern in patients with cardiac amyloidosis secondary to multiple myeloma: a cardiac MRI feature tracking study

2016 ◽  
Vol 34 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Sabha Bhatti ◽  
Srikanth Vallurupalli ◽  
Stephanie Ambach ◽  
Adam Magier ◽  
Evan Watts ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Cardiac Mri ◽  
Feature Tracking ◽  
Cardiac Amyloidosis ◽  
Myocardial Strain ◽  
Strain Pattern

Apical sparing strain pattern observed in danon disease: insights from a global registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Q Bui ◽  
G Ma ◽  
M Kraushaar ◽  
V Escobedo ◽  
B Le ◽  
...  
Keyword(s):  
Cardiac Amyloidosis ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Myocardial Strain ◽  
Posterior Wall ◽  
Volume Index ◽  
Danon Disease ◽  
Strain Pattern ◽  
Echocardiographic Parameters ◽  
Echocardiographic Images

Abstract Background Danon Disease (DD) is a rare X-linked autophagic disorder due to mutations in the Lysosomal Associated Membrane Protein 2 (LAMP-2) gene and causes severe cardiac manifestations. Measurement of longitudinal strain (LS) has been shown to provide diagnostic insights into different etiologies of hypertrophic cardiomyopathies compared to conventional echocardiographic parameters. Purpose The aim of this study was to describe the pattern of global and regional LS in DD. Methods A retrospective, international registry, using medical records provided by patients, was formed to describe the natural history of DD. Complete echocardiogram images were available for review and LS was analyzed globally and regionally (basal, mid, apex). Results A total of eighteen DD patients (male 72%, mean age 17.2±10 years) had sufficient quality echocardiographic images for both traditional and myocardial strain evaluation. Notable traditional echocardiographic parameters included a mean EF of 60±11%, LV mass index 200±159 g/m2, intraventricular septal diameter 17.7±10.3 mm, LV posterior wall diameter 16.1±7.7 mm, LA volume index 21.9±13 mL/m2. Global longitudinal strain was reduced with a mean of −12.1±4.9% with an observed regional strain gradient: apex (−16.6±6.6%), mid (−10.9±4.7%) and basal (−9.2±4.5%). Bull's eye plot patterns reflected an apical sparing pattern that was similar to that described in cardiac amyloidosis. Conclusion In this DD cohort, we describe for the first time a strain pattern characterized by reduction in global longitudinal strain with apical sparing, which was originally pathognomonic for cardiac amyloidosis. This strain pattern in conjunction with a paradoxically normal LA volume may discriminate patients with DD from other hypertrophic conditions. Funding Acknowledgement Type of funding source: None

Restenosis after aortic stenting

2004 ◽  
Vol 14 (2) ◽  
pp. 210-211 ◽  
Author(s):  
Joydeep Mookerjee ◽  
Derek Roebuck ◽  
Graham Derrick
Keyword(s):  
Williams Syndrome ◽  
Aortic Coarctation ◽  
Proliferative Response ◽  
Aortic Wall ◽  
Coarctation Of The Aorta ◽  
Aortic Stenting ◽  
Primary Stenting

Aortic coarctation is a recognized arteriopathy in patients with Williams’ syndrome. We present an adolescent with Williams’ syndrome who developed rapid restenosis after primary stenting of coarctation of the aorta. We believe such restenosis within the stent is due to a proliferative response of the abnormal aortic wall. Attention should be paid to the potential for restenosis during follow-up after stenting of aortic coarctation in patients with Williams’ syndrome.

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