scholarly journals Systolic longitudinal global and segmental myocardial mechanics in symptomatic isolated left ventricular non‐compaction cardiomyopathy

2021 ◽  
Author(s):  
Nikola Bogunovic ◽  
Martin Farr ◽  
Lukas Pirl ◽  
Lothar Faber ◽  
Frank Buuren ◽  
...  
Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ayman I Ayache ◽  
Kenya Kusunose ◽  
Hussain A Ismaeel ◽  
Muhammad Tariq ◽  
Deborah H Kwon ◽  
...  

Introduction: Reversible constrictive pericarditis (CP) has been described with resolution of constriction after treatment with anti-inflammatory medications. In our study, we assessed the improvement of biventricular myocardial strain in CP patients treated medically compared to CP patients who underwent pericardiectomy. Methods and Results: We compared myocardial mechanics by 2-dimensional speckle tracking in 16 CP patients (age: 56±13; 75% males) who received anti-inflammatory medications to an age and sex matched CP group (age: 57±12; 75% males) who underwent pericardiectomy. At baseline, both treatment groups had depressed left ventricular (LV) anterolateral wall strain (LWS) and right ventricular (RV) free wall longitudinal systolic strain (FWS) but preserved LV septal wall systolic strain (SWS). In a median follow-up of 150 days the medically treated patients showed improvement of the depressed LVLWS/LVSWS (Pre: 0.61±0.17, Post: 0.89±0.21;P<0.001) and a trend in RVFWS/LVSWS (Pre:0.66±0.45, Post:0.89±0.38;P=0.12), that is similar to the improvement of the depressed LVLWS/LVSWS (Pre: 0.85±0.12, Post: 0.92±0.1;P<0.05) and trend in RVFWS/LVSWS (Pre: 0.77±0.32, Post: 0.86±0.18;P=0.09) of post pericardiectomy patients at a median follow-up of 74 days. Conclusions: Biventricular myocardial strain imaging is a robust technique for assessment of response to anti-inflammatory therapy in CP patients. Medical treatment of CP leads to systolic strain improvement that is more pronounced in the LV and RV free walls, hence having similar impact on the biventricular myocardial mechanics as pericardiectomy.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Veronica Rolim S. Fernandes ◽  
Beatriz Jauregui Garrido ◽  
Maria E Siqueira ◽  
Jonathan Katz ◽  
Adam Jacobi ◽  
...  

Objective: To assess myocardial mechanics by cardiac magnetic resonance (CMR)-derived strain in patients with biopsy-proven systemic sarcoidosis. Methods: We included 50 consecutive patients (age 51 ± 11 years old, 30 males) with biopsy-proven systemic sarcoidosis who underwent gadolinium-enhanced CMR for suspected cardiac sarcoid involvement. Late gadolinium enhancement (LGE) was considered positive if showing an intramyocardial/subepicardial location with a nonischemic pattern. From cine images and using dedicated software (TomTec©), we quantified mean left ventricular (LV) longitudinal, radial, and circumferential peak strains as the average of 16 standard myocardial segments. We also randomly selected from our database 15 control subjects without structural heart disease (age 41 ± 11 years old, 5 males). Results: Both mean longitudinal strain (LS) and LV ejection fraction (LVEF) were lower in sarcoid patients than controls (-11.8 ± 7.3% vs. -18.1 ± 3.9%, p55%, n=32) mean LS was reduced compared to controls (-12.2 ± 7.8% vs. -18.1 ± 3.9% respectively, p=0.01; Fig 1B). There was no correlation between LVEF and mean LS (r=-0.11, p=0.65). We found no significant differences in circumferential or radial strains. LGE was present in 16 patients (32%). Sarcoid patients with LGE showed significantly less mean LS than those without (-8.5 ± 8.4% vs. -13.6 ± 6.4%, p<0.001; Fig 1A) although LVEF did not differ significantly (52% vs. 59%, p=0.35). No significant differences in circumferential or radial strains were found. Conclusions: In patients with systemic sarcoidosis, evaluation of cardiac mechanics with CMR detects myocardial dysfunction even in the presence of preserved LVEF. This is more pronounced in patients with positive LGE. The potential diagnostic and prognostic significance of CMR-derived myocardial strain in sarcoidosis deserves further investigation.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Dimosthenis Pandis ◽  
Marc Miller ◽  
Ahmed El-Eshmawi ◽  
Ioulia A Grapsa ◽  
Percy Boateng ◽  
...  

Introduction: Asymptomatic patients on active surveillance for degenerative mitral regurgitation are at risk of ventricular arrhythmia and sudden death. Hypothesis: Abnormal myocardial mechanics may precede ventricular remodeling and may help identify at-risk patients. Methods: Multi-directional myocardial mechanics and LV dyssynchrony were assessed in 204 consecutive patients awaiting surgical mitral repair for severe degenerative MR in a quaternary mitral reference center. Results: The mean age was 58 ±12.5 years and 40% were females. The mean EF was 63% ± 6% and 92% had compensated LV function (EF>60% and LVESD<4cm) and only 24% had elevated LV filling pressures (E/e'≥13). Indexed LV wall stress-to-LVEDD, relative wall thickness and indexed LV mass-to-BSA were similar amongst males-females, although males had higher mean blood pressure (94 Vs. 90, P=0.02) . The peak global longitudinal strain (GLS) was -25.2% ± 3.3% and the mid-ventricular circumferential and radial strains were -33.5%±6.7% and 56%±25% respectively. Ventricular ectopy was present in 24.5% of patients and only 17% had atrial fibrillation (Afib) despite the significantly dilated left atria (mean LAVi 70±26.6 ml/m 2 ). The median LV mechanical dispersion was 40msec (IQR 30.7-56.5) but increased significantly with ventricular ectopy (65msec, P<0.01) and further influenced by concomitant Afib (p=0.001 for 2-factor interaction). Diastolic LV function did not correlate with dispersion (r=0.02 and 0.01 for E/A and E/e', P=NS) but was associated with the duration of LV diastolic filling (mean 502±140msec; r=0.2, P=0.004). Interpapillary radial strain delay was noted in the study cohort (mean delay 52.8msec, range 0-335msec) while intepapillary activation delay was manifested with concomitant ventricular ectopy (mean time-to-peak LS delay 57.5±48msec). Conclusions: Left ventricular dyssynchrony manifested by increased mechanical dispersion and imbalanced interpapillary mechanics are observed prior to overt chamber remodeling in significant degenerative MR and is associated with ventricular ectopy. Further studies are needed to assess the related clinical implications and potential impact on risk stratification in this patient group.


2020 ◽  
Vol 14 ◽  
pp. 117954682093001
Author(s):  
Manal F Elshamaa ◽  
Fatma A Mostafa ◽  
Inas AES Sad ◽  
Ahmed M Badr ◽  
Yomna AEM Abd Elrahim

Background: Cardiac systolic dysfunction was potentially found in adult patients with end-stage renal disease (ESRD) who have preserved left ventricular ejection fraction (EF%). In children with ESRD, little data are available on early changes in myocardial function. This study aimed to detect the early changes in myocardial mechanics in pediatric patients with ESRD using speckle tracking echocardiography (STE). Methods: Thirty ESRD children receiving hemodialysis (HD) and30 age-matched controls were prospectively studied. Patients underwent echocardiographic studies before and after HD. Left ventricular longitudinal strain (LS), circumferential strain (CS), and radial strain (RS) myocardial deformation parameters (strain, strain rate) were evaluated by STE. Results: The LS was significantly reduced in pre-HD and post-HD patients compared with controls ( P = .000). Controls showed the highest global longitudinal strain. The RS measurements did not differ significantly among the studied groups except for the inferior segment that is significantly reduced after HD compared with controls ( P < .05). The CS was significantly reduced in pre-HD and post-HD patients compared with controls at the lateral and posterior segments ( P = .035 and P = .013, respectively). Conclusion: Speckle-tracking echocardiography might detect early changes in myocardial mechanics in children with ESRD with preserved EF%.


1991 ◽  
Vol 261 (6) ◽  
pp. H1880-H1888
Author(s):  
J. M. Capasso ◽  
P. Li ◽  
P. Anversa

To determine whether mechanical evaluation of muscle tissue removed from the myocardium can be employed as a direct indicator of cardiac contractile performance in situ, isometric and isotonic parameters of muscle mechanics in vitro were correlated with in vivo global functional characteristics of the same heart. Twelve-month-old animals maintained on standard food and water were employed as representative of normal cardiac function. Animals of identical age with left ventricular (LV) dysfunction induced by oral alcohol (30%) ingestion from 4 to 12 mo were utilized to represent depressed cardiac performance. Accordingly, 24 h after the establishment of the hemodynamic profile for a control or experimental heart, the LV posterior papillary muscle was removed from the same heart and examined isometrically and isotonically. Least squares regression analysis was employed to establish a correlation coefficient and P values between various in vitro and in vivo parameters. Hemodynamic measurements were performed under chloral hydrate anesthesia and LV pump performance was evaluated with respect to aortic and ventricular pressures and the rates of rise and decay of the LV pressure trace. Papillary muscles were evaluated with respect to timing parameters of the isometric and isotonic twitch, the first derivative of isometric tension development, and the speed of muscle shortening at increasing physiologic loads. LV peak rate of pressure rise and decay were then correlated with the various isometric and isotonic properties. Myocardial mechanics and hemodynamics revealed depressed function in the papillary muscles and hearts from alcoholic rats. Moreover, significant correlations were found between the LV rate of pressure change (peak +dP/dt and -dP/dt) and both isometric and isotonic twitch measurements.(ABSTRACT TRUNCATED AT 250 WORDS)


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