Diastolic function assessed with speckle tracking over a decade and its prognostic value: The Copenhagen City Heart Study

2021 ◽  
Author(s):  
Kristoffer Grundtvig Skaarup ◽  
Mats Christian Højbjerg Lassen ◽  
Jacob Louis Marott ◽  
Sofie R. Biering‐Sørensen ◽  
Niklas Dyrby Johansen ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Speckle Tracking ◽  
Prognostic Value ◽  
Heart Study ◽  
Copenhagen City Heart Study

DIASTOLIC FUNCTION ASSESSED WITH SPECKLE TRACKING OVER A DECADE AND ITS PROGNOSTIC VALUE: THE COPENHAGEN CITY HEART STUDY

2020 ◽  
Vol 75 (11) ◽  
pp. 1554
Author(s):  
Kristoffer Skaarup ◽  
Mats Højbjerg Lassen ◽  
Niklas Dyrby Johansen ◽  
Sofie Reumert Biering-Sørensen ◽  
Daniel Modin ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Speckle Tracking ◽  
Prognostic Value ◽  
Heart Study ◽  
Copenhagen City Heart Study

P1526Pre-dialysis left atrial function assessed by two-dimensional speckle tracking echocardiography as a predictor of upcoming heart failure in hemodialysis patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Park ◽  
M Kim ◽  
H K Jeong ◽  
K H Kim ◽  
J Y Cho ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diastolic Function ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Prognostic Value ◽  
Speckle Tracking Echocardiography ◽  
Hemodialysis Patients ◽  
Volume Index ◽  
Hemodialysis Session ◽  
Echocardiographic Parameters

Abstract Background Left atrial global longitudinal strain (LA GLS) by 2-dimensional speckle tracking echocardiography is a useful tool to assess LA function and left ventricular (LV) diastolic function. The authors assessed prognostic value of LA GLS, and other diastolic functional parameters in patients undergoing hemodialysis. Methods A total of 78 (49 male) patients undergoing hemodialysis who checked echocardiography due to heart failure (HF) symptoms were included for this analysis. Echocardiography wasperformed at the same day of, and before hemodialysis session. Besides conventional echocardiographic measurements, GLS of the LA and the LV were checked and compared. Incidence of rehospitalization due to HF symptoms during mean follow up duration of 381.4±197.5 days was investigated and echocardiographic parameters were compared between patients who experienced rehospitalization and who did not. Results 16 (20.1%) patients experienced rehospitalization due to HF. HF rehospitalization group had significantly low baseline LV ejection fraction (55.7±7.2 vs. 61.3±7.1%, p=0.006) and LV GLS (14.7±3.4 vs. 18.2±3.9%, p=0.002), while LV geometry (LV end-diastolic volume index and LV wall thickness) did not show significant differences. In HF rehospitalization group, baseline LA function and diastolic function were significantly impaired as reflected by LA GLS (18.8±2.6 vs. 23.8±3.6%, p<0.001), E/E' ratio (20.8±3.3 vs. 15.8±4.6%, p<0.001), and right ventricular systolic pressure (61.4±9.6 vs. 53.4±12.8%, p=0.022). LA end-systolic volume index was not significantly different between the 2 groups. Among various echocardiographic parameters, receiver operation characteristic curve analysis revealed that LA GLS had the strongest power (cutoff value 20.6%, sensitivity 0.813 and specificity 0.790, area under curve 0.849) in prediction of future rehospitalization due to HF. Predictor of future HF: ROC analysis Conclusions The present study demonstrated that functional changes of the LA as measured by LA GLS before hemodialysis session can be used as an echocardiographic parameter to predict future rehospitalization due to HF. Further studies are required to evaluate prognostic value of LA function in predicting other cardiovascular events in hemodialysis patients.

Age- and sex-based normal values of layer-specific longitudinal and circumferential strain by speckle tracking echocardiography: the Copenhagen City Heart Study

2021 ◽  
Author(s):  
Kristoffer Grundtvig Skaarup ◽  
Mats Christian Højbjerg Lassen ◽  
Niklas Dyrby Johansen ◽  
Flemming Javier Olsen ◽  
Jannie Nørgaard Lind ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Circumferential Strain ◽  
Speckle Tracking Echocardiography ◽  
Normal Values ◽  
Reference Ranges ◽  
Mean Values ◽  
Heart Study ◽  
Males And Females ◽  
Copenhagen City Heart Study ◽  
Age And Sex

Abstract Aims Technical advancements in 2D-speckle tracking echocardiography (2DSTE) have allowed for quantification of layer-specific global longitudinal strain (GLS) and circumferential strain (GCS) of the left ventricle (LV). The aim of this study was to establish age- and sex-based reference ranges of peak systolic layer-specific GLS and GCS and to assess normal values of regional strain. Methods and results We performed 2DSTE analysis of 1997 members of the general population from the fifth round of the Copenhagen City Heart Study, who were free of cardiovascular disease and risk factors. The mean age was 46 ± 16 years (range 21–97) and 62% were female. Mean values for peak systolic whole wall GLS (GLSWW.Sys), endomycardial (GLSEndo.Sys), and epimyocardial (GLSEpi.Sys) were 19.9 ± 2.1% (prediction interval [PI]: 15.8–24.0%), 23.5 ± 2.5% (PI: 18.6–28.4%), and 17.3 ± 1.9% (PI: 13.6–21.1%), respectively. Mean peak systolic whole wall GCS (GCSWW.Sys), was 21.6 ± 3.7% (PI: 14.3–28.9%), endomyocardial (GCSEndo.Sys) was 31.9 ± 4.7% (PI: 22.7–41.1%), and epimyocardial (GCSEpi.Sys) was 14.3 ± 3.8% (PI: 6.8–21.8%). A significant discrepancy in normal strain values between males and females was observed. Men had lower mean values and lower reference limits for all strain parameters. Furthermore, GLS and GCS changed differently with age in males and females. Finally, regional LS decreased from the apical to the basal LV region in both sexes, and regional CS varied significantly by LV segment. Conclusion In this study, we reported age- and sex-based reference ranges of layer-specific GLS and GCS. These reference ranges varied significantly with sex and age.

The prognostic value of left atrial dyssynchrony measured by speckle tracking echocardiography in the general population

2021 ◽  
Author(s):  
Emil Høegholm Karsum ◽  
Ditte Madsen Andersen ◽  
Daniel Modin ◽  
Sofie R. Biering-Sørensen ◽  
Rasmus Mogelvang ◽  
...  
Keyword(s):  
General Population ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Prognostic Value ◽  
Speckle Tracking Echocardiography

scholarly journals Prognostic utility of early systolic lengthening by speckle tracking in patients undergoing coronary artery bypass graft

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
P Brainin ◽  
S Lindberg ◽  
F Olsen ◽  
S Pedersen ◽  
A Iversen ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Speckle Tracking ◽  
Prognostic Value ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Positive Strain ◽  
All Cause Mortality ◽  
Cabg Patients

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Independent Research Fund Denmark Background Early systolic lengthening (ESL), a paradoxical stretch of myocardial fibers, has been linked to myocardial viability and contractile dysfunction. We assessed the long-term prognostic potential of ESL in coronary artery bypass graft (CABG) patients. Methods We retrospectively included patients (n = 709; mean age 68 years; 85% men) who underwent speckle tracking echocardiography (median 15 days) prior to CABG. Endpoints were cardiovascular death (CVD) and all-cause mortality. We assessed amplitude of ESL (%), defined as peak positive strain, and duration of ESL (ms), determined as time from Q-wave on the ECG to peak positive strain. We applied Cox proportional hazards models adjusted for the clinical risk tool, EuroSCORE II. Results During median follow-up of 3.8 years [IQR 2.7 to 4.9 years], 45 (6%) experienced CVD and 80 (11%) died. In survival analyses adjusted for EuroSCORE II, amplitude of ESL was associated with CVD (HR 1.37 [95%CI 1.13 to 1.66], P = 0.001) and all-cause mortality (HR 1.31 [95%CI 1.13 to 1.54], P = 0.001). Similar findings applied to duration of ESL and CVD (HR 1.17 [95%CI 1.08 to 1.26], P &lt; 0.001) and all-cause mortality (HR 1.14 [95%CI 1.07 to 1.21], P &lt; 0.001). The prognostic value of ESL amplitude was modified by sex (P interaction &lt; 0.05), such that it was greater in women for both endpoints (Figure 1A-B). When adding ESL duration to EuroSCORE II, the net reclassification index improved significantly for both CVD and all-cause mortality. Conclusions Assessment of ESL provides independent and incremental prognostic information in addition to the EuroSCORE II for CVD and all-cause mortality in CABG patients. The prognostic value was greater in women. Abstract Figure. Prognostic value of ESL amplitude by sex

Prognostic value of diastolic function assessment in patients undergoing cardiac resynchronization therapy

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E Galli ◽  
OA Smiseth ◽  
JM Aalen ◽  
CK Larsen ◽  
E Sade ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Primary Endpoint ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Systolic Volume ◽  
Funding Sources ◽  
American Society ◽  
Sensitivity Specificity ◽  
Crt Response

Abstract Funding Acknowledgements Type of funding sources: None. Objective The best modality to assess diastolic function in CRT-candidates is an object of debate and the relationship between diastolic function, CRT-response and survival are not clearly understood. Purpose of the study: to assess diastolic patterns in patients undergoing CRT according to the 2016 recommendations of the American Society of Echocardiography/European Association of Cardiovascular Imaging and to evaluate the prognostic value of diastolic dysfunction (DD) in CRT candidates. Methods 193 patients (age: 67 ± 11 years, QRS width: 167 ± 21 ms) were included in this multicentre prospective study. Patients were stratified according to DD grades (grade I to III). CRT-response was defined as a reduction of left ventricular (LV) end-systolic volume &gt;15% at 6-month follow-up (FU). The primary endpoint was defined as a composite of heart transplantation, LV assisted device implantation or all-cause death during FU. Results During FU, 132 (68%) patients were CRT-responders. CRT delivery was associated with diastolic function degradation in non-responders. Grade I DD was able to predict CRT-response with a sensitivity, specificity and accuracy of 70%, 65%, and 63%, respectively. After a median period of 35 months, the primary endpoint occurred in 29 (15%) patients. Grade I DD was associated with a better outcome [HR 0.26 95% CI: (0.10-0.66)], independently from ischemic cardiomyopathy, LV dyssynchrony and CRT-response (Table 1). Non-responders with grade II or grade III DD had the worse prognosis (HR 4.36, 95%CI: 2.10-9.06) Figure 1. Conclusions Grade I DD is associated with LV remodelling after CRT and is an independent predictor of prognosis in CRT candidates. Abstract Figure.

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