scholarly journals Long-Term Functional Results of Patients Operated for Isolated Discrete Subaortic Stenosis

2021 ◽  
Vol 24 (3) ◽  
pp. E512-E516
Author(s):  
Veysel ŞAHİN ◽  
Savas Demirpence ◽  
Funda Tetik ◽  
Faik Fevzi Okur ◽  
Emin Alp Alayunt

Background: This study aimed to examine the long-term functional results of patients with isolated discrete subaortic stenosis who underwent subaortic membrane resection and myectomy, using transthoracic M-mode echocardiography and 2D speckle-tracking echocardiography. Methods: Twenty patients operated for isolated discrete subaortic stenosis and 31 controls were included in the study. Patients underwent subaortic membrane resection and myectomy. During the long-term follow up, patients were evaluated with transthoracic M-mode echocardiography and 2D speckle-tracking echocardiography for functional assessment. Results: The mean age at operation and mean duration of follow up was 8.1±5.6 years and 7.2±3.3 years, respectively. Interventricular septal thickness at diastole (0.9±0.1 vs. 0.8±0.1 cm, P = 0.001), ejection time (285.7±26.2 vs. 261.2±24.3 msec, P = 0.001), and aortic strain (15.6±3.7 vs. 10.5±4.0, P < 0.001) were significantly higher in patients. On the other hand, ejection fraction (64.9±6.1 vs. 75.1±5.4 %, P < 0.001), fractional shortening (35.0±5.1 vs. 43.7±5.1, P < 0.001), and corrected velocity circumferential fiber shortening (0.12±0.02 vs. 0.17±0.03, P < 0.001) were significantly lower, when compared with the controls. Longitudinal strain value significantly differed among the groups, with patients having significantly lower strain (18.8±1.8 vs. 20.1±2.1, P = 0.021). Conclusion: In patients operated for isolated discrete subaortic stenosis, aortic gradient seems to continue in the long-term, with the persistence of low longitudinal strain.

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 562
Author(s):  
Rima Šileikienė ◽  
Karolina Adamonytė ◽  
Aristida Ziutelienė ◽  
Eglė Ramanauskienė ◽  
Jolanta Justina Vaškelytė

Background and objectives: Childhood obesity has reached epidemic levels in the world. Obesity in children is defined as a body mass index (BMI) equal to or above the 95th percentile for age and sex. The aim of this study was to determine early changes in cardiac structure and function in obese children by comparing them with their nonobese peers, using echocardiography methods. Materials and methods: The study enrolled 35 obese and 37 age-matched nonobese children. Standardized 2-dimensional (2D), pulsed wave tissue Doppler, and 2D speckle tracking echocardiography were performed. The z-score BMI and lipid metabolism were assessed in all children. Results: Obese children (aged 13.51 ± 2.15 years; 20 boys; BMI z-score of 0.88 ± 0.63) were characterized by enlarged ventricular and atrial volumes, a thicker left ventricular posterior wall, and increased left ventricular mass. Decreased LV and RV systolic and diastolic function was found in obese children. Atrial peak negative (contraction) strain (−2.05% ± 2.17% vs. −4.87% ± 2.97%, p < 0.001), LV and RV global longitudinal strain (−13.3% ± 2.88% vs. −16.87% ± 3.39%; −12.51% ± 10.09% vs. −21.51% ± 7.42%, p < 0.001), and LV global circumferential strain (−17.0 ± 2.7% vs. −19.5 ± 2.9%, p < 0.001) were reduced in obese children. LV torsion (17.94° ± 2.07° vs. 12.45° ± 3.94°, p < 0.001) and normalized torsion (2.49 ± 0.4°/cm vs. 1.86 ± 0.61°/cm, p = 0.001) were greater in obese than nonobese children. A significant inverse correlation was found between LV and RV global longitudinal strain and BMI (r = −0.526, p < 0.01; r = −0.434, p < 0.01) and total cholesterol (r = −0.417, p < 0.01). Multivariate analysis revealed that the BMI z-score was independently related to LV and RV global longitudinal strain as well as LV circumferential and radial strain. Conclusion: 2D speckle tracking echocardiography is beneficial in the early detection of regional LV systolic and diastolic dysfunctions, with preserved ejection fraction as well as additional RV and atrial involvement, in obese children. Obesity may negatively influence atrial and ventricular function, as measured by 2D speckle tracking echocardiography. Obese children, though they are apparently healthy, may have subclinical myocardial dysfunction.


2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Valentin Walker ◽  
Olivier Lairez ◽  
Olivier Fondard ◽  
Atul Pathak ◽  
Baptiste Pinel ◽  
...  

Abstract Background Breast cancer (BC) radiotherapy (RT) can induce cardiotoxicity, with adverse events often observed many years after BC RT. Subclinical left ventricular (LV) dysfunction can be detected early after BC RT with global longitudinal strain (GLS) measurement based on 2D speckle-tracking echocardiography. This 6-month follow-up analysis from the BACCARAT prospective study aimed to investigate the association between cardiac radiation doses and subclinical LV dysfunction based on GLS reduction. Methods The patient study group consisted of 79 BC patients (64 left-sided BC, 15 right-sided BC) treated with RT without chemotherapy. Echocardiographic parameters, including GLS, were measured before RT and 6 months post-RT. The association between subclinical LV dysfunction, defined as GLS reduction > 10%, and radiation doses to whole heart and the LV were performed based on logistic regressions. Non-radiation factors associated with subclinical LV dysfunction including age, BMI, hypertension, hypercholesterolemia and endocrine therapy were considered for multivariate analyses. Results A mean decrease of 6% in GLS was observed (− 15.1% ± 3.2% at 6 months vs. − 16.1% ± 2.7% before RT, p = 0.01). For left-sided patients, mean heart and LV doses were 3.1 ± 1.3 Gy and 6.7 ± 3.4 Gy respectively. For right-sided patients, mean heart dose was 0.7 ± 0.5 Gy and median LV dose was 0.1 Gy. Associations between GLS reduction > 10% (37 patients) and mean doses to the heart and the LV as well as the V20 were observed in univariate analysis (Odds Ratio = 1.37[1.01–1.86], p = 0.04 for Dmean Heart; OR = 1.14 [1.01–1.28], p = 0.03 for Dmean LV; OR = 1.08 [1.01–1.14], p = 0.02 for LV V20). In multivariate analysis, these associations did not remain significant after adjustment for non-radiation factors. Further exploratory analysis allowed identifying a subgroup of patients (LV V20 > 15%) for whom a significant association with subclinical LV dysfunction was found (adjusted OR = 3.97 [1.01–15.70], p = 0.048). Conclusions This analysis indicated that subclinical LV dysfunction defined as a GLS decrease > 10% is associated with cardiac doses, but adjustment for non-radiation factors such as endocrine therapy lead to no longer statistically significant relationships. However, LV dosimetry may be promising to identify high-risk subpopulations. Larger and longer follow-up studies are required to further investigate these associations. Trial registration ClinicalTrials.gov: NCT02605512, Registered 6 November 2015 - Retrospectively registered


2014 ◽  
Vol 12 (1) ◽  
Author(s):  
Sebastian Spethmann ◽  
Karl Rieper ◽  
Gabriela Riemekasten ◽  
Adrian C Borges ◽  
Sebastian Schattke ◽  
...  

2021 ◽  
Vol 23 (Supplement_D) ◽  
Author(s):  
Mohamed ElGendi ◽  
Mohamed Ayman ◽  
Mohamed Sadaka ◽  
Gehan Magdi

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.


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