Clinical significance of myocardial strain in the patients with chd (literature review)

10.12737/7363 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Туаева ◽  
Z. Tuaeva ◽  
Кириченко ◽  
T. Kirichenko
Keyword(s):  
Left Ventricle ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Contractile Function ◽  
Imaging Modality ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Left Ventricular Myocardium ◽  
Wide Range

2-D echocardiography is currently the first-line imaging modality for assessing global and regional function of left ventricle (LV). Using 2-D echocardiography, LV function is most often evaluated visually, as a result of the quality of the research depends directly on the experience and qualifications of the expert. The new technology of two-dimensional speckle tracking echocardiography allows to assessing the contractile function of the left ventricle quantitative. Over the years, the numerous studies have demonstrated the value of speckle tracking echocardiography in the diagnosis and risk stratification of a wide range of cardiac diseases, including coronary heart disease [14]. During the cardiac cycle the speckle tracking echocardiography allows in semi-automatic mode to evaluate the deformation of the myocardium in the three spatial directions: longitudinal, radial, and circular. In addition, speckle tracking estimates the direction of rotation and speed of motion of the left ventricular myocardium. This technology may have important clinical value for quick and accurate assessment of global and segmental myocardial function. The use of estimates of the deformation of the myocardium and the speed of deformation of the myocardium by means of speckle tracking method may be able to increase the sensitivity and precision of stenosing lesions of the coronary arteries [16].

scholarly journals Possibilities of preclinical diagnosis of anthracycline cardiotoxicity using the technique of "speckle-tracking echocardiography"

2021 ◽  
Vol 23 (1) ◽  
pp. 81-88
Author(s):  
Evgeny V. Kryukov ◽  
Oleg Y. Golubtsov ◽  
Vadim V. Tyrenko ◽  
Vyacheslav N. Semelev ◽  
Ruslan G. Makiev
Keyword(s):  
Left Ventricle ◽  
Ejection Fraction ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Left Ventricular Myocardium ◽  
Anthracycline Cardiotoxicity ◽  
Myocardial Mechanics ◽  
Apical Area

In case of antitumour anthracyclines therapy of patients with non-Hodgkin lymphomas the possibility of using speckle-tracking echocardiography is being considered. It was found that patients with non-Hodgkin lymphomas have early violations of the left ventricular myocardium during the course of antitumor chemotherapy using anthracyclines. They are characterized by reducing of longitudinal deformation of the myocardium with a gradual spread from the apical to the basal segments of the left ventricle. A statistically significant reduction in global and segmental systolic deformation after the 4th course of chemotherapy (cumulative dose of doxorubicin 333.5 88.5 mg/m2) is the earliest marker of left ventricular mechanical dysfunction, appearing before the development of diastolic dysfunction and ejection fraction reduction of the left ventricular. Early violations of myocardial mechanics in the dynamics of the course of antitumour therapy with anthracyclines are identified in the apical area of the left ventricle, it can be connected with circulatory failure in this area. Violations of myocardial mechanics in the apical area of the left ventricle can be an erly predictor of ischemia of this area with possible progression to global contractile muscle dysfunction of the left ventricular. The global longitudinall deformation of the left ventricular myocardium in contrast to ejection fraction of the left ventricular is more sensitive to myocardial damages against the backdrop of chemotherapy using anthracyclines. So, it can be used as an early preclinical marker of myocardial damage, that takes echocardiography closer to the most advanced methods of myocardial visualization.

scholarly journals Direct comparison of multilayer left ventricular global longitudinal strain using CMR feature tracking and speckle tracking echocardiography

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saikrishna Ananthapadmanabhan ◽  
Giau Vo ◽  
Tuan Nguyen ◽  
Hany Dimitri ◽  
James Otton
Keyword(s):  
Feature Tracking ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Imaging Modality ◽  
Global Longitudinal Strain ◽  
Intraclass Correlation ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Multilayer Strain

Abstract Background Cardiac magnetic resonance feature tracking (CMR-FT) and speckle tracking echocardiography (STE) are well-established strain imaging modalities. Multilayer strain measurement permits independent assessment of endocardial and epicardial strain. This novel and layer specific approach to evaluating myocardial deformation parameters may provide greater insight into cardiac contractility when compared to whole-layer strain analysis. The aim of this study is to validate CMR-FT as a tool for multilayer strain analysis by providing a direct comparison between multilayer global longitudinal strain (GLS) values between CMR-FT and STE. Methods We studied 100 patients who had an acute myocardial infarction (AMI), who underwent CMR imaging and echocardiogram at baseline and follow-up (48 ± 13 days). Dedicated tissue tracking software was used to analyse single- and multi-layer GLS values for CMR-FT and STE. Results Correlation coefficients for CMR-FT and STE were 0.685, 0.687, and 0.660 for endocardial, epicardial, and whole-layer GLS respectively (all p < 0.001). Bland Altman analysis showed good inter-modality agreement with minimal bias. The absolute limits of agreement in our study were 6.4, 5.9, and 5.5 for endocardial, whole-layer, and epicardial GLS respectively. Absolute biases were 1.79, 0.80, and 0.98 respectively. Intraclass correlation coefficient (ICC) values showed moderate agreement with values of 0.626, 0.632, and 0.671 respectively (all p < 0.001). Conclusion There is good inter-modality agreement between CMR-FT and STE for whole-layer, endocardial, and epicardial GLS, and although values should not be used interchangeably our study demonstrates that CMR-FT is a viable imaging modality for multilayer strain

Left ventricular myocardial work in patients with secondary mitral regurgitation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Yedidya ◽  
R.P Lustosa ◽  
F Fortuni ◽  
P Van Der Bijl ◽  
F Namazi ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Blood Pressure Measurement ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Work Efficiency ◽  
Constructive Work ◽  
Secondary Mitral Regurgitation

Abstract Background Assessment of left ventricular (LV) function in patients with secondary mitral regurgitation (SMR) remains challenging because LV ejection fraction (LVEF) reflects changes in LV volume without taking into account the direction of the blood flow. LV global longitudinal strain better reflects active LV myocardial deformation but does not incorporate afterload. LV myocardial work derived from pressure-strain loops integrates speckle tracking echocardiography with non-invasive blood pressure measurement. Purpose To evaluate LV myocardial work components to better characterize LV function in patients with SMR. Methods 378 patients (72% men, median age 68 [range 60 to 74 years]) with various grades of SMR were retrospectively analysed. LV myocardial constructive work, wasted work and work efficiency were measured with speckle tracking echocardiography. Results 145 patients had mild SMR, 130 moderate SMR and 103 severe SMR. Patients with severe SMR had larger LV volumes, lower LVEF and more impaired LV GLS (Table 1). While LV constructive work was more impaired in patients with severe SMR, wasted work was lower as compared to mild SMR (Table 1). Consequently, patients with severe SMR had better myocardial work efficiency than patients with mild MR. This could reflect, the regurgitant volume which is pumped into a low pressure chamber (the left atrium) resulting in less myocardial wasted work and preservation of myocardial efficiency. Conclusion In patients with severe SMR, LVEF, LV GLS and myocardial constructive work are more impaired when compared to mild SMR. However, myocardial wasted work is lower, resulting in higher better LV myocardial work efficiency. Funding Acknowledgement Type of funding source: None

ASSESSMENT OF SEGMENTAL MYOCARDIAL STRAIN OF THE LEFT VENTRICULAR MYOCARDIUM IN CHILDREN WITH HYPERTROPHIC CARDIOMYOPATHY

2021 ◽  
Vol 100 (5) ◽  
pp. 46-52
Author(s):  
N.Yu. Chernykh ◽  
◽  
А.А. Tarasova ◽  
O.S. Groznova ◽  
I.M. Shigabeev ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Longitudinal Strain ◽  
Contractile Function ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Normative Values ◽  
Left Ventricular Myocardium ◽  
Open Label ◽  
Timely Initiation ◽  
Compensatory Increase

Assessment of segmental myocardial strain is a promising and relevant direction in the diagnosis of early impairments of left ventricular (LV) contractility in children with hypertrophic cardiomyopathy (HCM). Objective of the study: to assess the indicators of segmental myocardial strain in children with HCM. Materials and methods of research: prospective, open-label, nonrandomized, controlled. 61 patients with asymmetric HCM aged 7 to 17 years (median 9 [7,6; 13,2]) underwent echocardiography according to the standard technique with the determination of segmental longitudinal, radial, circular LV myocardium in 2D speckle tracking mode. 45 (74%) children had a non-obstructive form (NF) of HCM, 16 (26%) children had an obstructive form (OF). Obstruction was detected at the level of the LV outflow tract with a pressure gradient of 30-50 mm Hg. Results: when assessing segmental myocardial strain, a decrease in longitudinal strain was found less than the normative values in the antero-septal, anterior, antero-lateral segments in children with NF HCM with a compensatory increase in strain values in the contralateral segments (inferior septal, inferior lateral and lower ). In similar segments in children with OF, there was a significant decrease in deformity, while in the contralateral segments a less pronounced compensatory increase in deformity was determined, as well as a decrease in the minimum values of strain indicators. Assessment of segmental radial and circular strain, a statistically significant predominance of indicators in all segments, except for anterolateral, in the group with NF compared to the OF HCM was determined. A decrease in strain in the antero-septal, anterior, antero-lateral segments was found, but less pronounced compared to the indicators of longitudinal strain, as well as a compensatory increase in strain in the antero-septal values in the contralateral segments (inferior septal, inferior lateral and inferior). It has been found that the assessment of global strain values widely used in clinical practice might not be optimal enough, since too many segmental strain values are discarded and averaged, which are unevenly distributed, and therefore the assessment of strain in each segment of the myocardium in children with an asymmetric form of HCM acquires important diagnostic value. Conclusion: changes in the indicators of segmental myocardial strain reflect violations of LV contractile function and are most pronounced in OF compared with NF HCM. Their study in children is important for the timely initiation of therapy and improving the prognosis of the disease.

scholarly journals Speckle-Tracking Echocardiography With Novel High Frame-Rate Imaging

2021 ◽  
Author(s):  
Kana Fujikura ◽  
Mohammed Makkiya ◽  
Muhammad Farooq ◽  
Yun Xing ◽  
Wayne Humphrey ◽  
...  
Keyword(s):  
Temporal Resolution ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Frame Rate ◽  
High Frame Rate ◽  
Echocardiographic Images ◽  
The Impact ◽  
Normal Lvef

Background: global longitudinal strain (GLS) measures myocardial deformation and is a sensitive modality for detecting subclinical myocardial dysfunction and predicting cardiac outcomes. The accuracy of speckle-tracking echocardiography (STE) is dependent on temporal resolution. A novel software enables relatively high frame rate (Hi-FR) (~200 fps) echocardiographic images acquisition which empowers us to investigate the impact of Hi-FR imaging on GLS analysis. The goal of this pilot study was to demonstrate the feasibility of Hi-FR for STE. Methods: In this prospective study, we acquired echocardiographic images using clinical scanners on patients with normal left ventricular systolic function using Hi-FR and conventional frame rate (Reg-FR) (~50 FPS). GLS values were evaluated on apical 4-, 2- and 3-chamber images acquired in both Hi-FR and Reg-FR. Inter-observer and intra-observer variabilities were assessed in Hi-FR and Reg-FR. Results: There were 143 resting echocardiograms with normal LVEF included in this study. The frame rate of Hi-FR was 190 &plusmn; 25 and Reg-FR was 50 &plusmn; 3, and the heart rate was 71 &plusmn; 13. Strain values measured in Hi-FR were significantly higher than those measured in Reg-FR (all p &lt; 0.001). Inter-observer and intra-observer correlations were strong in both Hi-FR and Reg-FR. Conclusions: We demonstrated that strain values were significantly higher using Hi-FR when compared with Reg-FR in patients with normal LVEF. It is plausible that higher temporal resolution enabled the measurement of myocardial strain at desired time point. The result of this study may inform clinical adoption of the novel technology. Further investigations are necessary to evaluate the value of Hi-FR to assess myocardial strain in stress echocardiography in the setting of tachycardia.

Association between Serum Ferritin Level and Left Ventricular Function by Speckle Tracking Echocardiography in Patients with Thalassemia

2021 ◽  
Vol 104 (9) ◽  
pp. 1421-1427
Keyword(s):  
Serum Ferritin ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Early Stage ◽  
Ferritin Level ◽  
Left Ventricular ◽  
Lv Function ◽  
Lv Dysfunction ◽  
Spearman's Rho ◽  
Spearman’S Rho

Background: Thalassemia is a common disease in Thailand. Most patients with thalassemia receive regular blood transfusion, resulting in iron accumulation in the body. Ferritin levels are associated with iron accumulation in vital organs of patients with thalassemia. The relationship between the ferritin levels and left ventricular (LV) function in these patients showed no relationship in most data, but all data were measured by conventional echocardiography. Currently, LV function can be measured by more advanced methods, such as the speckle tracking echocardiography, which demonstrates high accuracy in detecting early-stage LV dysfunction. Objective: To investigate the association between the serum ferritin level and LV function by speckle tracking echocardiography in patients with thalassemia. Materials and Methods: The present study was a cross-sectional analytic study that enrolled patients with thalassemia in the Faculty of Medicine, Vajira Hospital, between January and December 2019. Each participants provided an informed consent. Serum ferritin, conventional echocardiography, and speckle tracking echocardiography using global longitudinal strain [GLS] parameters were collected. Results: Among 45 participants, 33 had transfusion-dependent thalassemia (TDT), and 12 had non-transfusion-dependent thalassemia (NTDT). Female participants accounted for 64.4% with 29 patients. The mean age was 35.51±13.81 years, and participants had no other systemic diseases. The median serum ferritin was 1,159 ng/dL with a range of 638 to 1,983. The mean values for GLS and LVEF by biplane were −22.97±2.20% and 63.90±7.62%, respectively. Serum ferritin was not significantly related to GLS (Spearman’s rho 0.164, 95% CI −0.136 to 0.437, p=0.280). In the TDT group, ferritin was significantly related to GLS (Spearman’s rho 0.405, 95% CI 0.072 to 0.657, p=0.019), whereas in the NTDT group, such relationship was insignificant (Spearman’s rho −0.394, 95% CI 0.790 to 0.232, p=0.205). Conclusion: Serum ferritin and speckle tracking echocardiography in patients with thalassemia are not significantly associated. Therefore, serum ferritin should not be a single candidate for detecting early-stage LV dysfunction. As a result, using various measurements remains the best option. Keywords: Ferritin; Speckle tracking echocardiography; Thalassemia; Echocardiography

scholarly journals P1603 Changes of cardiac function in cirrhotic patients after liver transplantation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
H M Kim ◽  
H K Kim ◽  
J H Lee ◽  
E A Park ◽  
J B Park ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Mr Imaging ◽  
Cardiac Function ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Lv Function ◽  
Qtc Interval ◽  
Cardiac Mr ◽  
Cirrhotic Patients

Abstract Funding Acknowledgements This study was supported by the grant of CJ healthcare 2016 research fund. Background Liver cirrhosis (LC) has been known to affect cardiovascular performance. Limited study have evaluated the alteration of myocardial function in patients with LC after liver transplantation (LT). Purpose The aim of study was to evaluate changes of cardiac function in patients with cirrhosis following LT using conventional and speckle-tracking echocardiography and late gadolinium enhancement (LGE) of cardiac magnetic resonance (MR). Methods Thirty-five patients with cirrhosis (mean age, 57.1 ± 9.0; male, 75%) who were listed for LT were prospectively enrolled. Patients underwent conventional, speckle-tracking echocardiography, and cardiac MR imaging with LGE. Echocardiography and cardiac MR were performed at pre and 1 year after LT. Cirrhotic patients were compared with normal control (n = 20, mean age, 65.0 ± 14.8; men, 11(55%)) and echocardiographic and cardiac MR data were compared pre and post LT. Results Conventional and speckle-tracking echocardiography and Cardiac MR imaging demonstrated hyperdynamic left ventricular (LV) function in patients with cirrhosis (LV ejection fraction (EF) with cardiac MR 67.8 ± 7.0% in LC vs. 63.4 ± 6.4% in control, P = 0.028; global longitudinal strain (GLS) -24.3 ± 2.6% in LC vs. -18.6 ± 2.2% in control, P &lt; 0.001). There were no LGE in patients with cirrhosis and no significant differences in LV size, LV wall thickness, LV mass index, and diastolic function between cirrhotic patients and control group (all P &gt; 0.1). Corrected QT interval (QTc) in electrocardiogram was prolonged in LC patients (P &lt; 0.001). One-year after LT, LV end-diastolic diameter and LV end-diastolic volume significantly decreased (P = 0.016 and 0.022, respectively). Although LVEF showed no significant changes 1 year post-LT (P = 0.362), LV-GLS (from -24.7 ± 1.8% to -20.8 ± 3.4%, P &lt; 0.001) significantly decreased. QTc interval also decreased 1 year after LT (from 470.4 ± 29.6msec to 428.2 ± 31.6msec, P = 0.001). Conclusions The present study demonstrated that cirrhotic patients showed hyperdynamic circulation and prolonged QTc interval compared with normal controls. After 1 year LT, LV size reduced and augmented LV function was normalized. Given that no LGE in cardiac MR and normalized GLS and QTc after LT, cardiac dysfunction in LC patients could be reversed by LT.

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