scholarly journals A Significant Addition of Left Ventricular Fractional Shortening to Ejection Fraction correlated with Global Longitudinal Strain Value in Predicting Major Acute Cardiovascular Event in patients with Acute Coronary Syndrome

2021 ◽  
Author(s):  
Bertha Gabriela Napitupulu ◽  
Harris Hasan ◽  
Nizam Z Akbar ◽  
Andre Pasha Ketaren ◽  
Zainal Zafri ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Ejection Fraction ◽  
Cardiovascular Event ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Coronary Syndrome ◽  
Acute Cardiovascular Event ◽  
Fractional Shortening

Background: Global longitudinal strain (GLS) was a proven predictor of systolic function improvement and myocardial remodeling after acute coronary syndrome (ACS) for a residual left ventricular function defined their prognosis. However, not all echocardiography devices are equipped by speckle tracking (STE) as compare to the availability of M-mode modality which capable on assessing fractional shortening (FS) instead. Methods: This study evaluated clinical and echocardiography parameters on myocardial infarction (MI) and non-MI ACS patients.  Clinical outcome was defined as composite major acute cardiovascular event (MACE) on 6 months of follow up. Results: Over 145 patients, GLS>-9.4% was found to be an independent predictor of MACE despite of troponin, age, ejection fraction (EF), prior reperfusion and infarct location [(HR 5.89 (1.82-16.51)]. There is negative correlation between FS and GLS (Spearman r -0,717; p<0,01). By using logistic regression analyses, it was found that the addition of FS<25% to biplane Simpson EF<50% could be useful to rule in the presence of GLS>-9.4% (AUC 0.831). Conclusion: GLS had a prognostic value in patients with ACS. Left ventricular conventional M-mode FS in addition to Simpson EF were well correlated with GLS as well they can be considered as an alternative in predicting the incident of MACE in patient with ACS.   Keywords: global longitudinal strain, prognostic, fractional shortening, acute coronary syndrome

P4134Impaired left ventricular systolic function in alcohol abusers expressed by both 3D calculated ejection fraction and longitudinal strain by AFI

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Hamala ◽  
J D Kasprzak ◽  
P Lipiec ◽  
K Wierzbowska-Drabik
Keyword(s):  
Alcohol Abuse ◽  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Harmful Effect ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Function ◽  
Alcohol Abusers

Abstract Aim Despite knowledge regarding the existence of alcohol cardiomyopathy the exact impact of alcohol abuse in consecutive subject is poorly examined. We aimed to evaluate the left ventricle (LV) function in chronic abusers group and compared classical and novel echocardiography parameters in alcohol abusers (ALC) and control group (C). Methods We compared 75 adults (mean age 48±12, 60 male) without other overt heart disease, coronary artery disease excluded, but with alcohol abuse history: average alcohol intake 32 alcohol unit per week (AUW) with control group consisted of 40 subjects without history of excessive drinking, abstinents or drinking ≤8 AUW (mean age 50±4, 16 men). One unit was defined as 10 grams of pure etanol. All patients underwent TTE examination including ejection fraction (EF) calculation with 3D and longitudinal strain assessment by AFI method. Results ALC group showed LV systolic dysfunction expressed as EF 48±14 vs 60±9%, global longitudinal strain (AFI GLS) −15.6±6.6 vs −18.7±3.4; p<0.0001 and p 0.0064, respectively. On the other hand the LV and left atrial diameters as well as diastolic function were similar in both groups, indicating on relatively low advancement of heart remodeling. ALC vs Control group comparison ALC N75 C N40 p value Age 48±12 50±4 ns BMI 24±6 28±6 0.0009 LVd 48±13 47±4 ns LVs 34±15 32±4 ns LA 38±9 38±3 ns EF 48±14 60±9 <0.0001 E/A 1.1±0.6 1.1±0.3 ns E' lateral 10.6±3.9 10.6±2.9 ns AFI 2ch −15.9±6.9 −18.8±4.8 0.0143 AFI 3ch −15.9±6.9 −18.9±3.6 0.0116 AFI 4ch −15.2±7.1 −18.6±3.5 0.0053 AFI GLS −15.6±6.6 −18.7±3.4 0.0064 Conclusions Chronic alcohol abuse revealed harmful effect on LV systolic function which can be assessed quantitatively by both decreased EF and absolute values of myocardial longitudinal strain. This systolic function impairment seems to anticipate the overt remodelling of the heart.

Global longitudinal strain as a marker for systolic function in patients with pheochromocytomas

2020 ◽  
Vol 27 (10) ◽  
pp. 561-570
Author(s):  
Atanaska Elenkova ◽  
Rabhat Shabani ◽  
Elena Kinova ◽  
Vladimir Vasilev ◽  
Assen Goudev ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Strong Positive Correlation ◽  
Echocardiographic Parameters ◽  
Positive Correlations ◽  
Fractional Shortening

Cardiomyopathy is a frequent complication of pheochromocytoma, and echocardiography is the most accessible method for its evaluation. The objective of this study was to assess the clinical significance of classical and novel echocardiographic parameters of cardiac function in 24 patients with pheochromocytomas (PPGL) compared to 24 subjects with essential hypertension (EH). Fourteen PPGL patients were reassessed after successful surgery. Left ventricular hypertrophy was four times more prevalent in patients with PPGL vs EH (75% vs 17%; P = 0.00005). Left ventricular mass index (LVMi) significantly correlated with urine metanephrine (MN) (rs = 0.452, P = 0.00127) and normetanephrine (NMN) (rs = 0.484, P = 0.00049). Ejection fraction (EF) and endocardial fractional shortening (EFS) were normal in all participants and did not correlate with urine metanephrines. Global longitudinal strain (GLS) was significantly lower in PPGL compared to EH group (−16.54 ± 1.83 vs −19.43 ± 2.19; P < 0.00001) and revealed a moderate significant positive correlations with age (rs = 0.489; P = 0.015), LVMi (rs = 0.576, P < 0.0001), MN (rs = 0.502, P = 0.00028) and NMN (rs = 0.580, P < 0.0001). Relative wall thickness (RWT) showed a strong positive correlation with urine MN (rs = 0.559, P < 0.0001) and NMN (rs = 0.689, P < 0.00001). Markedly decreased LVMi (118.2 ± 26.9 vs 102.9 ± 22.3; P = 0.007) and significant improvement in GLS (−16.64 ± 1.49 vs −19.57 ± 1.28; P < 0.001) was observed after surgery. ΔGLS depended significantly on the follow-up duration. In conclusion, classical echocardiographic parameters usually used for assessment of systolic cardiac function are not reliable tests in pheochromocytoma patients. Instead, GLS seems to be a better predictor for the severity and the reversibility of catecholamine-induced myocardial function damage in these subjects. RWT should be measured routinely as an early indicator of cardiac remodeling.

scholarly journals P1318 Clinical utility of global longitudinal strain in acute myocarditis: a case report

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
D Lai Chin Kon ◽  
O Mcconnell ◽  
I Andrade ◽  
A Simpson ◽  
M Luckie
Keyword(s):  
Ejection Fraction ◽  
Risk Stratification ◽  
Cardiac Mri ◽  
Strong Correlation ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Acute Myocarditis ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Myocardial Oedema

Abstract The role of conventional 2D echocardiography in the setting of acute myocarditis is limited as often it reveals no significant changes in global systolic function. Published studies have demonstrated the usefulness of myocardial deformation imaging in acute myocarditis with global longitudinal strain (GLS) being more sensitive in the recognition of myocardial dysfunction even in preserved systolic function and its strong correlation to the amount of myocardial oedema found on cardiac MRI. It also has the advantage of being more readily available, requiring a shorter interpretation time and is significantly cheaper as compared to cardiac MRI. GLS has also been shown to play a role in risk stratification with a lower GLS being associated with a higher rate of major adverse cardiac events (MACE) among all myocarditis cases independent of LV ejection fraction. We describe a case where there was strong correlation between GLS and myocardial oedema on CMR T1 weighted imaging. A 26 year old with no relevant past medical history presented to hospital complaining of pleuritic sounding chest pain. ECG showed ST segment changes suggestive of pericarditis. White blood cell count and troponin levels were elevated. Echocardiography performed on the same day showed apical akinesia and reduced longitudinal LV function. Global longitudinal strain was an average of -8% and was notably reduced in the apical, inferior, posterior and lateral regions. The overall left ventricular function was normal (55% by bi-plane Simpson"s method). Cardiac MRI showed normal LV size and function with myocardial oedema in the mid inferolateral, apical inferior and apical anterior segments. These findings were consistent with acute myocarditis affecting the involved segments. Our case demonstrates that the global longitudinal strain reduction correlated very similarly to the pattern of myocardial oedema in the affected segments and is consistent with similar findings from published studies. GLS by 2D speckled imaging may therefore play an important role in the assessment of acute myocarditis especially in patients with preserved ejection fraction and may help in risk stratification. Abstract P1318 Figure. combined GLS CMR

scholarly journals Subclinical LV Dysfunction Detection Using Speckle Tracking Echocardiography in Hypertensive Patients with Preserved LV Ejection Fraction

2016 ◽  
Vol 10 ◽  
pp. CMC.S38407 ◽  
Author(s):  
Amal Mohamed Ayoub ◽  
Viola William Keddeas ◽  
Yasmin Abdelrazek Ali ◽  
Reham Atef El Okl
Keyword(s):  
Ejection Fraction ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Hypertensive Patients

Background Early detection of subclinical left ventricular (LV) systolic dysfunction in hypertensive patients is important for the prevention of progression of hypertensive heart disease. Methods We studied 60 hypertensive patients (age ranged from 21 to 49 years, the duration of hypertension ranged from 1 to 18 years) and 30 healthy controls, all had preserved left ventricular ejection fraction (LVEF), detected by two-dimensional speckle tracking echocardiography (2D-STE). Results There was no significant difference between the two groups regarding ejection fraction (EF) by Simpson's method. Systolic velocity was significantly higher in the control group, and global longitudinal strain was significantly higher in the control group compared with the hypertensive group. In the hypertensive group, 23 of 60 patients had less negative global longitudinal strain than −19.1, defined as reduced systolic function, which is detected by 2D-STE (subclinical systolic dysfunction), when compared with 3 of 30 control subjects. Conclusion 2D-STE detected substantial impairment of LV systolic function in hypertensive patients with preserved LVEF, which identifies higher risk subgroups for earlier medical intervention.

scholarly journals Estimation of myocardial work – a new concept of non-invasive left ventricular systolic function assessment

2021 ◽  
Vol 28 (1) ◽  
pp. 56-65
Author(s):  
M.Yu. Kolesnyk
Keyword(s):  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Non Invasive ◽  
Lv Systolic Function

Assessment of left ventricular (LV) systolic function is a mandatory component of cardiovascular diseases diagnostics. In clinical practice, the main parameters are the ejection fraction and LV global longitudinal strain. Both parameters have a number of limitations, including dependence on afterload. This review describes a new technique for non-invasive assessment of global and segmental myocardial contractility based on the calculation of myocardial work by analyzing pressure-strain curves. The main advantage of the technique is the ability to take into account the afterload conditions by the traditional measurement of blood pressure on the brachial artery. The characteristics of the key parameters of the methodology (global work index, global constructive work, global effective and wasted work) as well as their normative values are presented. The stages of the analysis and the limitations of the method are described separately. The results of the main pilot studies of myocardial work parameters in various cardiovascular diseases are presented. Possibilities of the technique for characterizing LV segmental function in left bundle branch block, selection of patients for cardiac resynchronization therapy with subsequent response assessment are presented. The diagnostic and prognostic value of the parameters of myocardial work in arterial hypertension, acute and chronic forms of ischemic heart disease, hypertrophic and dilated cardiomyopathy, chronic heart failure are analyzed. The possibilities of the technique in assessing the effectiveness of therapy in patients with heart failure are described. Potential advantages of the parameters of myocardial work over other markers of LV systolic function, such as ejection fraction and global longitudinal strain, have been determined. The review is illustrated with clinical examples of the use of the technique for various cardiovascular diseases from our own practice.

Right ventricular myocardial work in patients with HFrEF

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S.C Butcher ◽  
F Fortuni ◽  
J.M Montero ◽  
N Ajmone Marsan ◽  
V Delgado ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Right Ventricular ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
The Novel ◽  
Global Work

Abstract Background Right ventricular myocardial work (RVMW) is a novel method of non-invasively quantifying right ventricular (RV) systolic function. Through the use of speckle tracking echocardiography-derived RV pressure-strain loops, RVMW provides a quantitative evaluation of afterload-dependent RV systolic function. Purpose To investigate RVMW in patients with heart failure and reduced ejection fraction (HFrEF) and compare to that of patients without cardiovascular disease (CVD) and a structurally and functionally normal heart. Methods Noninvasive analysis of RVMW was performed in 23 HFrEF patients and 23 patients without cardiovascular or structural heart disease. The novel indices of RV global constructive work (RVGCW), RV global work index (RVGWI), RV wasted work (RVWW) and RV global work efficiency (RVGWE) were analysed utilizing proprietary software originally developed for the assessment of left ventricular myocardial work by speckle tracking echocardiography. Parameters of RVMW were then compared between the two patient groups. Results The HFrEF group had lower left ventricular (LV) ejection fraction (18.7% [±6.7] vs 60.1% [±4.6], p&lt;0.0001), LV global longitudinal strain (−3.6% [±1.6] vs −20.4% [±2.1), p&lt;0.0001) and RV global longitudinal strain (−10.0% [±4.2] vs −22.0% [±3.1], p&lt;0.0001) when compared to those with no CVD. Estimated pulmonary artery systolic pressure (42.5mm Hg [±12] vs 22.5mm Hg [±3.7], p&lt;0.0001) and estimated right atrial pressure (8mm Hg (5 to 15) vs 5mm Hg (5 to 5), p&lt;0.0001) were significantly higher in the HFrEF group. RVGWI (259.7mmHg% [±135.0] vs 385.3mmHg% [±103.1], p=0.001), RVGWW (83.7mmHg% [±58.6] vs 14.5mmHg% [8.5 to 20.5], p&lt;0.0001) and RVGWE (77.2% [11.4] vs 95.5% [93.5 to 97], p&lt;0.0001) were significantly lower in the HFrEF group when compared to those without CVD. There was no statistically significant difference in RVGCW between the two groups (353.5mmHg% [±118.4] vs 417.2 [±102.1], p=0.057). Conclusion The novel parameters of RVGWI, RVGWW and RVGWE were significantly reduced in patients with HFrEF when compared to those without CVD. Further exploration of the clinical role and prognostic value of these afterload dependent parameters of RV systolic function is warranted. Funding Acknowledgement Type of funding source: None

An Atypical Presentation of Acute Coronary Syndrome

2012 ◽  
Vol 8 (1) ◽  
pp. 67
Author(s):  
Syed Khurram Mushtaq Gardezi ◽  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Systolic Function ◽  
Artery Bypass ◽  
Left Ventricular Systolic Function ◽  
Regional Wall Motion ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Ventricular Systolic Function ◽  
Coronary Syndrome

A 61-year-old man was admitted to hospital with severe occipital headache and weakness and numbness of the left arm. His electrocardiograms showed changes hinting at acute coronary syndrome (ACS). However, in view of his clinical presentation, he underwent tests for likely subarachnoid haemorrhage, but this was ruled out. The next day, he was referred to cardiology. A transthoracic echocardiogram showed reduced left ventricular systolic function along with regional wall motion abnormalities involving inferoposterior walls. The patient was treated as per the protocol for ACS. A dobutamine stress echocardiogram confirmed inferior myocardial infarction with evidence of myocardial viability in the affected left ventricular segments. Subsequent investigations confirmed three-vessel coronary artery disease and reduced left ventricular systolic function. The patient underwent successful coronary artery bypass grafting.

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