scholarly journals The Association of Echocardiographic Peak Systolic Strain Rate with Cardiovascular Outcomes in Haemodialysis Patients

2018 ◽  
Vol 43 (6) ◽  
pp. 1935-1942 ◽  
Author(s):  
John Hughes ◽  
Darren Green ◽  
Diana Y.Y. Chiu ◽  
Nik Abidin ◽  
Philip A. Kalra
2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L F Nhola ◽  
T Daramola ◽  
S Barros-Gomes ◽  
J S Rico-Mesa ◽  
M C Arciniegas ◽  
...  

Abstract Background Anthracyclines are one of the most effective chemotherapeutic agents but can lead to a decline in cardiac function. Two-dimensional (2D) speckle tracking echocardiography derived strain can predict cancer therapeutics-related cardiac dysfunction (CTRCD). However, little is known about the role of three-dimensional (3D) strain imaging in this setting. Purpose To evaluate different methods of Left Ventricular Ejection Fraction (LVEF) and strain, and to identify the best strain parameter for the prediction of CTRCD in this group of patients during treatment with anthracycline based chemotherapy. Methods Patients with Hodgkin's or non-Hodgkin's lymphoma receiving anthracycline based chemotherapy were enrolled. 2D-and 3D echocardiography was performed at 3 time points: baseline, at the completion of chemotherapy and at 1 year. 2D- and 3D LVEF (2D Modified Quinones, M-mode, 2D Biplane, 3D Philips, 3D GE and 3D TomTec), peak systolic left and right ventricular longitudinal, radial and circumferential strain and strain rate were measured. CTRCD was defined as a decrease in LVEF >10% to an absolute value of <53%. Lin's Concordance Correlation Coefficient (CCC) was calculated to compare LVEF methods. ANOVA, uni and multivariate analysis was performed. Results A total of 130 patients (79 males, mean age 57±16 years) were enrolled; 104 non-Hodgkin.3D Philips and GE (CCC 0.88 [0.84, 0.92]), 3D Philips and biplane (CCC 0.84 [0.79, 0.89]), 3D Philips and Modified Quinones (CCC 0.86 [0.82, 091]) as well as 3D Philips and M-mode (CCC 0.77 [0.70, 0.85]) showed strong correlation for LVEF. 15 patients (12%) developed CTRCD. Mean cumulative anthracycline dose was 263±65 mg/m2. 2D and 3D global longitudinal and circumferential peak systolic strain, 2D global longitudinal systolic and early diastolic strain rate, 2D global early diastolic strain rate, 2D right ventricular longitudinal peak systolic strain and systolic strain rate, 2D global radial peak systolic strain and systolic strain rate measured at the completion of chemotherapy were independent predictors of the development of CTRCD at 1 year post-chemotherapy. The strongest predictors of CTRCD were 3D global longitudinal and circumferential strain either individually (area under the curve, 0.90 and 0.95 respectively) or combined (area under the curve, 0.95) at the completion of chemotherapy; a cutoff value of <-18% in 3D global longitudinal strain had a sensitivity of 82% and specificity of 99%, while for 3D global circumferential peak systolic strain of <-24% had a sensitivity of 82% and specificity of 95%. Conclusions To our knowledge this is the first prospective trial that shows that 3D EF correlates well with other EF methods and 3D strain predicts cardiac toxicity in this group of patients with a very good sensitivity and specificity. Acknowledgement/Funding Department of Cardiovascular Medicine-Mayo Clinic Rochester MN


Cardiology ◽  
2009 ◽  
Vol 112 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Huixia Lu ◽  
Guihua Yao ◽  
Huili Lin ◽  
Xinsheng Xu ◽  
Changjiang Li ◽  
...  

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Abdelfattah Shoeir ◽  
Ghada Elshahed ◽  
Yasmin Abdelrazek Esmail ◽  
Dina Adel Ezz Eldin

Abstract Background The changes in loading conditions, atrial function, and the different echocardiographic parameters before and after transcatheter atrial septal defect (ASD) closure are still under study. So we felt the need to evaluate the echocardiographic changes that occur and detect the timing after closure at which the right-sided heart hemodynamics, and measurements are back to normal. Objectives To evaluate the changes in cardiac hemodynamics, loading conditions, and atrial function after percutaneous closure of ASD using echocardiography. Patients and Methods The study included 30 patients referred to percutaneous closure of ASD in Ain Shams University hospital we performed echocardiography before, 1 week, and 3 months after closure. Results The study showed that RV dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure (p &lt; 0.001). RA dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure (p &lt; 0.001). RA peak systolic strain, and strain rate increased significantly 1 week, and 3 months after ASD closure (p &lt; 0.001). LA dimensions and volumes increased significantly 1 week, and 3 months after ASD closure (P &lt; 0.001). LA peak systolic strain showed no significant difference before, 1week, and 3 months after ASD closure (P = 0.063), and strain rate showed no significant difference before, 1week, and 3 months after ASD closure (P = 0.207). Conclusion In our study, we have concluded that RV dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure. RA dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure. RA peak systolic strain, and strain rate increased significantly 1 week, and 3 months after ASD closure, as a result of improvement of the RA wall velocity, due to relief of the volume overload after closure of the shunt. LA peak systolic strain, and strain rate showed no significant difference before, 1week, and 3 months after ASD closure. Abbreviations list ASD (atrial septal defect), RV (right ventricle), RA (right atrium), LA (left atrium).


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Aylin Tugcu ◽  
Yelda Tayyareci ◽  
Ozlem Yildirimturk ◽  
Saide Aytekin

The aim of this study was to compare right ventricular (RV) global and regional systolic function in patients with and without patient prosthesis mismatch (PPM) after isolated mitral valve replacement (MVR) using Velocity Vector Imaging (VVI) method. The PPM group consisted of 20 patients that underwent isolated MVR with an indexed effective orifice area (EOA) ≤ 1.2 cm 2 /m 2 determined by continuity equation and indexed for body surface area. The non-PPM group consisted of 20 patients that also underwent isolated MVR with an indexed EOA > 1.2cm 2 /m 2 . Echocardiographic images in apical planes were analyzed for RV volumes, ejection fractions, myocardial velocity, strain and strain rate at the basal, mid and apical segments of RV free wall and ventricular septum using VVI. The demographic and preoperative data were similar between PPM and non-PPM groups. Evidence of PA hypertension defined as systolic PA pressure > 40 mmHg was present in 50% of patients in PPM group, whereas none of the patients in non-PPM group had PA hypertension. RV volumes were significantly increased, and RV ejection fraction, peak systolic myocardial velocities, strain and strain rates were significantly impaired in patients with PPM compared to non-PPM group (p<0.001 for all). Indexed EOA correlated strongly with myocardial velocities, strain and strain rates in all segments of the RV (p<0.05 for all). Multivariate stepwise regression analysis demonstrated that indexed EOA and systolic PA pressure were the independent determinants of basal free wall peak systolic strain (β=0.547, p<0.001 and β=−0.304, p=0.033 respectively) and strain rate (β=0.497, p=0.001 and β=−0.332, p = 0.026 respectively). Using receiver-operating characteristics analysis cut-off values for basal free wall peak systolic strain and strain rate in determining patients with indexed EOA ≤ 1.2 cm 2 /m 2 were −25.62 % (sensitivity 85%, specificity 95%) and −1.87 1/s (sensitivity 95%, specificity 95%) respectively. PPM after MVR is associated with RV global and regional RV dysfunction. Two-dimensional echocardiography has some limitations in evaluating RV function due to its complex geometry. VVI is a feasible modality in assessment of RV global and regional RV function.


2010 ◽  
Vol 21 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Eirik Nestaas ◽  
Asbjørn Støylen ◽  
Leif Brunvand ◽  
Drude Fugelseth

AbstractThe function of the heart was studied in 20 asphyxiated term neonates by measuring the longitudinal peak systolic strain and peak systolic strain rate by tissue Doppler in 18 segments of the heart on days 1, 2, and 3 of life. The fractional shortening was assessed at each examination as well. Measurements were compared against measurements in 48 healthy term neonates examined by the same protocol. The function of the heart was lower in the asphyxiated neonates – peak systolic strain (mean (95% confidence interval) −19.4% (−20.4, −18.5), peak systolic strain rate −1.65 (−1.74, −1.56) per second) than in the healthy term neonates (peak systolic strain −21.7% (−22.3, −21.0), peak systolic strain rate −1.78 (−1.84, −1.74) per second; p < 0.001). Fractional shortening was similar in the asphyxiated (29.2% (26.8, 31.5)) and healthy term neonates (29.0% (27.9, 30.1); p = 0.874). The peak systolic strain differed significantly between the asphyxiated and healthy term neonates for the left basal and right basal groups of segments (p < 0.05) but not for the left apical, right apical, septum apical, or septum basal groups of segments. The peak systolic strain rate differed significantly only for the septum apical group of segments. The differences were largest on the second day of life. Measurements were similar in asphyxiated neonates with elevated and normal cardiac troponin T levels. The peak systolic strain and strain rate were in this study more sensitive indices than fractional shortening for assessing the reduced myocardial function in asphyxiated term neonates.


2017 ◽  
Vol 8 (1) ◽  
pp. 204589321774450 ◽  
Author(s):  
Junjie Zhang ◽  
Yanan Cao ◽  
Xiaowei Gao ◽  
Maoen Zhu ◽  
Zhong Zhang ◽  
...  

Worsening right ventricular (RV) dysfunction in the presence of pulmonary artery hypertension (PAH) increases morbidity and mortality in this patient population. Transthoracic echocardiography (TTE) is a non-invasive modality to evaluate RV function over time. Using a monocrotaline-induced PAH rat model, we evaluated the effect of acute inflammation on RV function. In this study, both PAH and control rats were injected with Escherichia coli lipopolysaccharide (LPS) to induce an acute inflammatory state. We evaluated survival curves, TTE parameters, and inflammatory markers to better understand the mechanism and impact of acute inflammation on RV function in the presence of PAH. The survival curve of the PAH rats dropped sharply within 9 h after LPS treatment. Several echocardiographic parameters including left ventricular (LV) stroke volume, RV tricuspid annular plane systolic excursion, RV longitudinal peak systolic strain, and strain rate decreased significantly in PAH rats before LPS injection and 2 h after LPS injection. The expression of phospholamban (PLB) and tumor necrosis factor-α (TNF-α) significantly increased and the expression of SERCA2a significantly decreased in PAH rats after LPS administration. LPS suppressed the RV longitudinal peak systolic strain and strain rate and cardiac function deteriorated in PAH rats. These effects may be associated with the signal pathway activity of SERCA2a/PLB.


2019 ◽  
Vol 8 (8) ◽  
pp. 1243 ◽  
Author(s):  
Jolanda Sabatino ◽  
Giovanni Di Salvo ◽  
Costantina Prota ◽  
Valentina Bucciarelli ◽  
Manjit Josen ◽  
...  

Background: Left ventricular (LV) diastolic dysfunction (DD) carries worse prognosis in childhood. 2-dimensional (2-D) left atrial (LA) strain accurately categorizes DD in adults but its role in children is unknown. Thus, the aim of this study is to investigate whether LA strain and strain rate could diagnose and classify DD in children with dilated (CMD), hypertrophic (HCM) and restrictive (RCM) cardiomyopathies (CM). Methods and Results: The study includes 136 children (aged 8.8 ± 6 years): 44 with DCM, 40 with HCM, 7 with RCM and 45 healthy controls (CTRL). They underwent standard echocardiographic examination and 2-D speckle-tracking analyses (LV longitudinal peak systolic strain (LS), LA peak systolic strain and strain rate). No significant differences in mitral E/A and pulmonary S/D ratios were observed among the four groups. Although E/E’ and indexed left atrial volumes were found to be significantly higher in HCM, DCM and RCM compared to CTRL (p < 0.001), they showed no significant difference among the three CM groups. LV LS values were significantly reduced in CM vs CTRL (p < 0.001) and in DCM vs HCM (p < 0.01), with no other differences between the remaining groups. LA peak systolic strain and strain rate values showed a steady and significant decrease with worsening of DD. Receiver Operating Characteristics (ROC) curves showed area under the curve of 0.976 (p < 0.001) for LA strain and 0.946 (p < 0.001) for LA strain rate, to distinguish CTRL from CMs. Conclusions: LA strain and strain rate could be a promising tool to better understand and classify DD in children with cardiomyopathies, opening the way to its clinical use.


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