Assessment of Biventricular Function by Three-Dimensional Speckle Tracking Echocardiography in Adolescents and Young Adults with Human Immunodeficiency Virus Infection: A Pilot Study

Cardiology ◽  
2019 ◽  
Vol 144 (3-4) ◽  
pp. 101-111 ◽  
Author(s):  
Lidia Capotosto ◽  
Gabriella D’Ettorre ◽  
Camilla Ajassa ◽  
Nelson Cavallari ◽  
Maria Rosaria Ciardi ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Speckle Tracking Echocardiography ◽  
Three Dimensional ◽  
Hiv Patients ◽  
Immunodeficiency Virus ◽  
Normal Controls

Background: The purpose of the study was to assess biventricular parameters of wall deformation with three-dimensional speckle tracking echocardiography (3DSTE) in adolescents and young adults with human immunodeficiency virus (HIV) infection on antiretroviral therapy in order to detect a possible subclinical myocardial dysfunction. Methods: Twenty-one patients aged 12–39 years with HIV, 21 normal controls of the same age and sex, and 21 patients with idiopathic nonischemic dilated cardiomyopathy (DCM) were studied with 3DSTE. All HIV patients were stable in terms of HIV infection, with no history of heart disease or other chronic systemic disease except HIV infection, and were on highly active antiretroviral therapy with good immunological control. Standard echocardiographic measures of left ventricular (LV)-right ventricular (RV) function were assessed. 3D LV global longitudinal strain (GLS), circumferential strain, radial strain, and LV twist were calculated. Global area strain (GAS) was calculated by 3DSTE as percentage variation in surface area defined by the longitudinal and circumferential strain vectors. 3D RV global and free-wall longitudinal strain (FWLS) were obtained. Results: LV GLS and GAS were lower in HIV patients compared to normal controls (p = 0.002, and p = 0.01, respectively). There were no significant differences in LV ejection fractions between the groups. There was a weak positive correlation between LV GLS and age (r = 0.215, p = 0.034) and a weak negative correlation between LV GLS and nadir-CD4 T-cells count (r = 0.198, p = 0.043). DCM patients had more marked and widespread reduction in LV GLS and GAS compared to controls (p < 0.001), whereas in HIV patients LV strain impairment (p < 0.05) was more localized in basal and apical regions. RV FWLS was significantly reduced in HIV patients when compared with the control group (p = 0.03). No patient had pulmonary systolic pressure higher than 35 mm Hg. Conclusions: 3DSTE may help to identify HIV patients at high cardiovascular risk allowing early detection of biventricular dysfunction in the presence of normal LV ejection fraction and in the absence of pulmonary hypertension. LV strain impairment in HIV patients is less prominent and widespread compared to DCM patients.

P615Role of three-dimensional (3D) speckle-tracking echocardiography (STE) system, using comparison with cardiac magnetic resonance imaging (CMR) and to assess the contribution of regional RV function to

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Sen ◽  
S Tanwar ◽  
A Jain ◽  
B Kalra ◽  
N Chandra
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Speckle Tracking Echocardiography ◽  
Three Dimensional ◽  
Resonance Imaging ◽  
End Diastolic Volume ◽  
Echocardiographic Parameters ◽  
Rv Function ◽  
Area Strain

Abstract Background Chronic obstructive pulmonary disease may alter right and left ventricular function by changing intrathoracic pressure. Pulmonary hyperinflation may increase right atrial pressure, leading to reduced venous return and subsequent reductions in RV pre-load. In COPD patients, hyperinflation has been directly correlated with reduced atrial chamber size, global RV dysfunction, and reduced LV filling. Accurate assessment of global and regional right ventricular (RV) systolic function is challenging. Purpose The aims of this study were to confirm the reliability and feasibility of a three-dimensional (3D) speckle-tracking echocardiography (STE) system, using comparison with cardiac magnetic resonance imaging (CMR), and to assess the contribution of regional RV function to global function. Methods In a retrospective, cross-sectional study setting, RV volumetric data were studied in 302 patients who were referred for both CMR and 3D echocardiography within 1 month. Three-dimensional STE-derived area strain, longitudinal strain, and circumferential strain were assessed as global, inlet, outflow, apical, and septal segments. Results 208 patients (69%) had adequate 3D echocardiographic data. RV measurements derived from 3D STE and CMR were closely related (RV end-diastolic volume, R2=0.88; RV end-systolic volume, R2=0.81; RV ejection fraction [RVEF], R2=0.69; P<0.004 for all). RVEF and RV end-diastolic volume from 3D STE were slightly but significantly smaller than CMR values (mean differences, −2.8% and −7.8 mL for RVEF and RV end-diastolic volume, respectively). Among conventional echocardiographic parameters for RV function (tricuspid annular plane systolic excursion, fractional area change, S' of the tricuspid annulus, RV free wall two-dimensional longitudinal strain), only fractional area change was significantly related to RVEF (r=0.29, P=0.003). Among segmental 3D strain variables, inlet area strain (r=−0.48, P<0.002) and outflow circumferential strain (r=−0.37, P<0.003) were independent factors associated with CMR-derived RVEF. Conclusions Regional RV wall motion showed that heterogeneous segmental deformations affect global RV function differently; specifically, inlet area strain and outflow circumferential strain.RV volume and RVEF determined by STE were comparable with CMR measurements. Severity of COPD influences RV systolic dysfunction, which is reflected in speckle tracking 3D echocardiographic parameters.

scholarly journals Assessment of Biventricular Function in Clinically Well Pediatric Heart Transplantation Patients by Three-dimensional Speckle Tracking Echocardiography

2020 ◽  
Author(s):  
Qing Lv ◽  
Meng Li ◽  
He Li ◽  
Chun Wu ◽  
Nianguo Dong ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Three Dimensional ◽  
Free Wall ◽  
Ischemic Time ◽  
Biventricular Function ◽  
Pediatric Heart Transplantation

Abstract Background Studies on pediatric heart transplantation (HTx) are uniquely challenging because pediatric HTx center volumes are generally low. And, the biventricular function plays an important role in the prognosis of pediatric HTx. The primary aim of our study was to evaluate biventricular function of pediatric HTx by three-dimensional speckle tracking echocardiography(3D-STE). Methods We enrolled 30 clinically well pediatric HTx patients and 30 sex- and age- matched healthy controls. All subjects underwent comprehensive echocardiographic examinations. Left ventricular (LV) global longitudinal strain (GLS), global circumferential strain (GCS), LV and right ventricular (RV) ejection fraction (EF) and RV longitudinal strain (RVLS) of free wall and septum were acquired by 3D-STE. And the correlations between strains and clinical data were explored. Results Compared with controls, LV GLS was decreased in pediatric HTx patients (P<0.05), while LV GCS and LVEF showed no difference. RVEF, RVLS (free wall) and RVLS (septum) in HTx group were diminished (P<0.05), but RVEF was still in normal range. Cold ischemic time was correlated inversely with LV GLS (β=-0.401, P<0.05). The mean pulmonary artery pressure (β=0.447, P<0.05) and postoperative tricuspid regurgitation pressure (β=0.607, P<0.05) were associated with RVLS (free wall). Conclusion Biventricular longitudinal systolic function rather than global systolic function was impaired after HTx. 3D STE may be able to evaluate the ventricular function better. Prolonged ischemic time leads to impaired LV longitudinal systolic function in pediatric HTx patients. It’s interesting that in HTx patients, it shows compensatory enhancement due to increased pulmonary vascular resistance.

Unrecognised Human Immunodeficiency Virus Patients in an Emergency Department in Hong Kong: A Report of Four Cases

2005 ◽  
Vol 12 (3) ◽  
pp. 168-177
Author(s):  
KL Mok ◽  
PG Kan
Keyword(s):  
Emergency Department ◽  
Human Immunodeficiency Virus ◽  
Hong Kong ◽  
Hiv Infection ◽  
Opportunistic Infections ◽  
Hiv Patients ◽  
Accident And Emergency ◽  
Immunodeficiency Virus ◽  
High Index Of Suspicion ◽  
Immunodeficiency Syndrome

Human immunodeficiency virus (HIV) causes breakdown of the immune system and predisposes patients to various opportunistic infections and neoplasms. However, many patients may not be aware of the HIV infection before the development of their first HIV related complications. We reported four unrecognised HIV patients presenting to our accident and emergency department with common complications of HIV infection and the acquired immunodeficiency syndrome (AIDS). Although not as common as in America, emergency physicians in Hong Kong still have to take care of patients with unknown HIV status. The common presentations of HIV patients will be discussed. A high index of suspicion and knowledge of common HIV/AIDS complications are required for managing these patients.

Evaluation of Left Ventricular Dysfunction in Patients with Isolated Mitral Valve Stenosis Using Speckle Tracking Echocardiography

2021 ◽  
Vol 23 (Supplement_D) ◽  
Author(s):  
Mohamed ElGendi ◽  
Mohamed Ayman ◽  
Mohamed Sadaka ◽  
Gehan Magdi
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Mean Value ◽  
Left Ventricular ◽  
2D Speckle Tracking ◽  
Lv Systolic Function

Abstract Aim The aim was to evaluate left ventricular (LV) systolic function in patients with isolated mitral stenosis (MS) using 2D speckle tracking echocardiography. Methods 24 patients (39.50 ± 5.55 years, 17 females) with isolated MS (MVA: 1.35 ± 0.16 cm2) with preserved LV systolic function and sinus rhythm were compared to 12 matched healthy control subjects (36.42 ± 5.99 years, 8 females). Conventional echocardiography was performed to both groups. Longitudinal strain and Circumferential strain echocardiography were obtained. Peak systolic strain was measured from the mean strain profile for a total of 17 segments of the LV for the longitudinal strain and 16 segments for the circumferential strain. Global longitudinal (G.L.) and circumferential strain (G.C.) were calculated separately as the average of the sum of the studied segments. Results The global longitudinal strain of the cases group ranged from -11 – -17% with a mean value of -14.67 ± -1.69% and that of the control group ranged from -15 – -20% with a mean value of -17.83 ± -1.53% with a statistically significant difference between the two groups. In our study, there was a negative but non-significant correlation between LV GLSS and LA diameter (r = -0.054, p = 0.802), Echo score (r = -0.018, p = 0.933) and PASP (r = 0.021, p = 0.922) in patients group. Also, the correlation was negative but non-significant between LV GCSS and LA diameter (r = -0.142, p = 0.507), Echo score (r = -0.200, p = 0.349) and PASP (r = -0.155, p = 0.471) in patients group. Conclusion • 2D speckle tracking echocardiography can detect subclinical LV systolic dysfunction which cannot be recognized by 2D conventional echocardiography. • Isolated rheumatic MS may be associated with subclinical LV systolic dysfunction.

scholarly journals True “costs” of neurological illness in human immunodeficiency virus patients in a “free” health facility

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Sridhar Amalakanti ◽  
Samdhani Syed
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Financial Burden ◽  
Public Health Services ◽  
Hiv Patients ◽  
Face To Face ◽  
Neurological Illness ◽  
Immunodeficiency Virus ◽  
Neurological Illnesses ◽  
Hiv Seropositive

Objectives: Human immunodeficiency virus (HIV) infection and neurological illness cause heavy financial burden to the patients. The economic costs of each of the disease have been reported in many studies, but the toll of both together on the patients has not been studied clearly. As neurological illnesses are seen in up to one-third of HIV patients, the combined costs need to be understood. Even with free public health services, there are out of pocket expenditures on the patients. Material and Methods: In the tertiary Government General Hospital, Guntur in India, we studied the out-of-pocket costs of time and money borne by 50 HIV-seropositive individuals hospitalized for a neurological illness during April and May 2019. We obtained data from the patients and caregivers by face-to-face oral questionnaires. Results: The median duration of HIV infection was 2.5 (IQR 0.4–7.8) years. A high proportion of our patients (20/50) was diagnosed with tuberculous meningitis. The total median time lost by each HIV-seropositive patient due to neurological illness (private consultation, travel, and hospital stay) was 27.5 (8.7–134.3) days. The total median financial burden due to neurological disease requiring hospitalization (travel, food and medicine, wages lost, private consultation expense, and loans incurred) on each patient was ₹19,150 (855–59881). Conclusion: HIV patients with neurological illness are burdened by heavy costs of time and money. They are forced into debt and lose substantial wages, most of it due to private consultation.

scholarly journals Спекл-трекинг эхокардиография в оценке систоло-диастолической функции левого желудочка при ишемической болезни сердца с учетом особенностей строения миокарда

2021 ◽  
pp. 19-38
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Left Ventricle ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Speckle Tracking Echocardiography ◽  
Radial Strain

В обзоре представлены диагностические возможности спекл-трекинг эхокардиографии (speckle tracking echocardio graphy) для оценки систоло-диастолической функции левого желудочка при ишемической болезни сердца с учетом особенностей строения миокарда. Спиральное строение миокарда и взаимодействие разнонаправленных волокон левого желудочка усложняют задачу оценки регионарной и глобальной сократимости левого желудочка. Спекл-трекинг эхокардиография позволяет измерить деформацию миокарда в продольном, циркулярном и радиальном направлениях. Обсуждается клиническое использование метода при наиболее опасных формах ишемической болезни сердца: остром инфаркте миокарда и нестабильной стенокардии. Спекл-трекинг эхокардиография позволяет выявлять компенсаторное увеличение деформации интактного миокарда, а также ротации левого желудочка при нарушениях локальной сократимости. Измерение глобальных значений деформации, скручивания и раскручивания левого желудочка представляет прогностическую информацию у больных с острым инфарк том миокарда и нестабильной стенокардией. Несмотря на преимущества, существуют препятствия, затрудняющие использование данного метода в клинической практике. Основные из них - качество ультразвукового изображения и отсутствие общепринятых нормативных значений величин деформации. Ключевые слова: спекл-трекинг эхокардиография, продольная деформация, циркулярная деформация, радиальная деформация, левый желудочек, ишемическая болезнь сердца speckle tracking echocardiography, longitudinal strain, circumferential strain, radial strain, left ventricle, coronary heart disease

scholarly journals Speckle-Tracking Echocardiography for Detecting Subclinical Left Ventricular Dysfunction in Patients With Familial Hypercholesterolemia

2021 ◽  
Vol 48 (2) ◽  
Author(s):  
Rongjuan Li ◽  
Jinjie Xie ◽  
Bo Jiang ◽  
Zhonghua Sun ◽  
Lvya Wang ◽  
...  
Keyword(s):  
Familial Hypercholesterolemia ◽  
Patient Group ◽  
Left Ventricular Dysfunction ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Ventricular Dysfunction ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Transthoracic Doppler Echocardiography

Myocardial ischemia and left ventricular dysfunction have been documented in young adults with familial hypercholesterolemia. We investigated whether speckle-tracking echocardiography can be used to detect subclinically impaired global and regional myocardial function in patients with this lipid disorder. This single-center study included 47 patients with familial hypercholesterolemia and 37 healthy control subjects who underwent transthoracic Doppler echocardiography and speckle-tracking echocardiography from January 2003 through December 2016. Conventional echocardiographic and strain parameters in the 2 groups were analyzed and compared. Left ventricular dimensions were significantly larger at end-diastole (P=0.02) and end-systole (P=0.013), left ventricular walls were significantly thicker (P &lt;0.0001), and the early transmitral/early diastolic mitral annular velocity ratio was significantly higher (P=0.006) in the patient group than in the control group. In the patient group, global longitudinal and circumferential strain values were significantly lower (P &lt;0.0001) and global radial strain values significantly higher (P=0.006); all segmental longitudinal strain (P &lt;0.04) and most segmental circumferential strain values (P ≤0.01) were significantly lower; and some segmental radial strains, especially at the apex, were significantly higher (P ≤0.04). However, average longitudinal, circumferential, and radial strains in the different segments of the 3 main coronary artery territories were significantly lower in the patient group (P &lt;0.01). Global longitudinal strain (r=0.561; P=0.001) and global circumferential strain (r=0.565; P &lt;0.0001) were inversely correlated with low-density-lipoprotein cholesterol levels. We conclude that speckle-tracking echocardiography can be used to detect subclinical global and regional systolic abnormalities in patients with familial hypercholesterolemia.

Abstract P143: Assessment Of Biventricular And Aortic Function In Arterial Systemic Hypertension By Speckle Tracking Echocardiography

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Lidia Capotosto ◽  
Giuseppe Germanò ◽  
Marcello Giordano ◽  
Marianna Lorenzano ◽  
Rosanna Germanò ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Stiffness Index ◽  
Systemic Hypertension ◽  
Group I ◽  
Group 2 ◽  
Aortic Strain

Background: The purpose of the present study was to assess whether systemic arterial hypertension is associated with abnormal right ventricular (RV) structure and function as assessed by three-dimensional speckle tracking echocardiography and how those changes are related to left ventricular (LV) strain, left ventricular hypertrophy (LVH) and aortic (Ao) function. Methods: We examined 115 hypertensive (mean age, 65±16 years; 52% male) and 115 healthy adults (mean age, 68±13 years; 54% male). Patients were divided into two groups: patients with LVH (Group I, LVMI>115g/m 2 men, LVMI>95g/m 2 women) and patients without LVH (group II). LV longitudinal (LS), circumferential, radial and area (GAS) strains were calculated by three-dimensional speckle tracking echocardiography (3DSTE). RV free-wall longitudinal strain (LS) was determined by 3DSTE. Aortic (Ao) distensibility and stiffness index (SI) were calculated using accepted formulae. The corrected aortic strain (Ao-S) by two-dimensional speckle tracking echocardiography was calculated as the global aortic strain /pulse pressure. Data analysis was performed offline (GE EchoPAC). Results: Overall, Ao-SI was increased (r=0.74, p=0.003) and Ao-S was decreased (r=0.79, p=0.002) in hypertensive patients compared with controls. Ao-SI had a negative correlation with Ao-S (r=-0.76, p<0.001). Ao-S correlated with LV and RV longitudinal strain (r=0.62,p=0.02, and r=0.58,p<0.05, respectively) and LV and RV area strain (r=0.66,p=<0.01, and r=0.53,p<0.05, respectively). RV-LS and LV-GAS were lower in Group 1 patients compared to Group 2 (r=0.81, p<0.001), and lower in Group 2 patients compared to controls (r=0.59, p=0.02). There was a positive correlation between LV and RV LS (r=0.52, p<0.05). RV-LS was independently associated with Ao-S (β=0.37, p=0.01), LV-GAS (β=0.32, p=0.027) and LV-LS (β=0.26, p=0.034) in the whole hypertensive population. Conclusions: In systemic hypertension there is a complex interaction between LV strain, RV strain and Ao strain. Reduced RV strain can occur even in the absence of LV hypertrophy.

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