QUALITY CONTROL IN ECHOCARDIOGRAPHY REPORTING (PART B)

This is the second part of the article under same head (published in the same issue of this journal). ‘Quality control measures in echocardiography reporting’ with regard to ventricular function assessment, cardiac thrombi and valvular assessment are described as a continuum of the previously described measures for study analysis.

Hot Executive Function Assessment Instruments in Preschool Children: A Systematic Review

The study aimed to systematically analyze the empirical evidence that is available concerning batteries, tests or instruments that assess hot executive functions (EFs) in preschoolers, identifying which are the most used instruments, as well as the most evaluated hot EFs. For the review and selection of articles, the systematic review methodology PRISMA was used. The article search considered the EBSCO, Web of Science (WoS), SciELO and PubMed databases, with the keywords “Hot executive function”, “Assessment”, “test”, “evaluation”, using the Boolean operators AND and OR indistinctly, between 2000 and April 2021. Twenty-four articles were selected and analyzed. The most commonly used instruments to assess hot EFs in preschool children were the Delayed Gratification Task, the Child’s Play Task, and the Delayed Reward Task. Amongst those analyzed, 17 instruments were found to assess hot EFs in preschoolers. The accuracy and conceptual clarity between the assessment of cognitive and emotional components in EFs is still debatable. Nevertheless, the consideration of affective temperature and reward stimulus type, could be an important influence when assessing EFs in this age range. Evidence of the possible involvement of cortical and subcortical structures, as well as the limbic system, in preschool executive functioning assessment has also been incorporated.

652 Myocardial work in patients undergoing transcatheter aortic valve implantation: clinical value and implications for outcome

Aims Non-invasive myocardial work (MW) quantification has emerged in the last years as an alternative echocardiographic tool for myocardial function assessment. This new parameter provides a less loading-dependent evaluation of myocardial performance through the combined assessment of global longitudinal strain (GLS) and non-invasive left ventricle (LV) pressures. The role of MW as a marker of cardiac dysfunction and reverse remodelling in patients with severe aortic stenosis (AS) after aortic valve implantation (TAVI) has not been adequately investigated. This study aims to evaluate MW indices as early echocardiographic markers of LV reverse remodelling within a month after TAVI and their prognostic value. Methods and results We conducted a single-centre prospective study, enrolling 70 consecutive patients (mean age 80.1 ± 5.5 years) with severe AS undergoing TAVI between 2018 and 2020, selected from the EffecTAVI registry. Exclusion criteria were prior valve surgery, severe mitral stenosis, permanent atrial fibrillation, left bundle branch block (LBBB) at baseline, and suboptimal quality of speckle-tracking image analysis. Echocardiographic assessment was performed before TAVI and at 30-day follow-up. Clinical, demographic, and resting echocardiographic data were recorded, including quantification of 2D global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE). LV peak systolic pressure was estimated non-invasively from the sum of systolic blood pressure and trans-aortic mean gradient. One month after the procedure, there was a significant improvement of LV GLS (−17.94 ± 4.24% vs. −19.35 ± 4.31%, before and after TAVI respectively, P = 0.002), as well as a significant reduction of GWI (2430 ± 586 mmHg% vs. 1908 ± 472 mmHg%, P < 0.001), GCW (2828 ± 626 mmHg% vs. 2206 ± 482 mmHg%, P < 0.001), and GWW (238 ± 207 mmHg% vs. 171 ± 118 mmHg%, P = 0.006). Conversely, MWE did not significantly change early after intervention (90.53 ± 6.05% vs. 91.45 ± 5.05%, P = 0.204). After TAVI, 30 patients (42.8%) developed LV dyssynchrony due to LBBB or pacemaker implantation. When the population was divided according to the presence or absence of LV dyssynchrony at 30-day follow-up, a significant reduction in GWW was found only in those without dyssynchrony (244 ± 241 vs. 141 ± 110 mmHg% with and without dyssynchrony respectively, P = 0.002). Consistently, in this subgroup, MWE significantly improved post-TAVI (90 ± 7 vs. 93 ± 5%, P = 0.002), while a trend of MWE reduction was observed in patients who developed dyssynchrony post-TAVI (91 ± 4 vs. 89 ± 5%, P = 0.164). In the overall population, a baseline value of MWE< 92% was associated with an increased rate of cardiovascular events (composite of all-cause death and rehospitalization for heart failure) at 1-year follow-up (22.2 vs. 3.1%, long rank, P = 0.016). Conclusions In patients with severe AS undergoing TAVI a significant reduction of GWW and improvement of MWE can be detected only in those who did not develop LV dyssynchrony. In this setting, MWE lower than 92% at baseline is associated with poor outcome. Thus, MWE could represent an alternative tool for myocardial function assessment in patients receiving TAVI.

Conversion of the wavelength distribution to the energy spectrum of the wave

When designing a vessel, spectral calculating methods of wave induced oscillation are used, and during vessel operation, available technical means allow us to obtain only the pitch spectrum. For a complete solution of navigational tasks, it is necessary to have a wave disturbance spectrum and pitch amplitude-frequency characteristic as well. The latter function can be received in sailing, if obtaining the actual wave disturbance spectrum is possible. The lack of available and sufficiently accurate methods of actual wave disturbance assessment in modern navigation creates the need to use statistical mathematical models in addition to available information in order to connect various wave elements. Taking into account the possibility of obtaining the wavelength distribution from the wave field radar image, a hypothesis is formulated about the possibility of using a statistical mathematical connection between the wind wave lengths and heights. Within the proposed hypothesis, an algorithm is presented for converting the actual wavelength probability distribution obtained from wave field radar images into the disturbance frequency spectrum. The conclusion is made about possible application of the hypothesis in pitch transfer function assessment.

Using Sensorized Gloves and Dimensional Reduction for Hand Function Assessment of Patients with Osteoarthritis

Sensorized gloves allow the measurement of all hand kinematics that are essential for daily functionality. However, they are scarcely used by clinicians, mainly because of the difficulty of analyzing all joint angles simultaneously. This study aims to render this analysis easier in order to enable the applicability of the early detection of hand osteoarthritis (HOA) and the identification of indicators of dysfunction. Dimensional reduction was used to compare kinematics (16 angles) of HOA patients and healthy subjects while performing the tasks of the Sollerman hand function test (SHFT). Five synergies were identified by using principal component (PC) analyses, patients using less fingers arch, higher palm arching, and a more independent thumb abduction. The healthy PCs, explaining 70% of patients’ data variance, were used to transform the set of angles of both samples into five reduced variables (RVs): fingers arch, hand closure, thumb-index pinch, forced thumb opposition, and palmar arching. Significant differences between samples were identified in the ranges of movement of most of the RVs and in the median values of hand closure and thumb opposition. A discriminant function for the detection of HOA, based in RVs, is provided, with a success rate of detection higher than that of the SHFT. The temporal profiles of the RVs in two tasks were also compared, showing their potentiality as dysfunction indicators. Finally, reducing the number of sensors to only one sensor per synergy was explored through a linear regression, resulting in a mean error of 7.0°.

Characteristics of muscle contraction of the rectus femoris using Tensiomyography by sex in healthy adolescents: a Cross-Sectional Study

Background Tensiomyography (TMG) is a non-invasive instrument for measuring mechanical muscle contraction characteristics, and measures the maximum displacement of the muscle belly in the vertical direction and the time needed to achieve this from electrical stimulation. There have only been few reports of TMG on general healthy adults. A systematic review on TMG reported a low proportion of female participants with a small sample size. Therefore, it is unclear whether there is a difference in TMG parameters by sex and between the dominant and non-dominant feet. Furthermore, the relationship between the TMG parameters and the evaluations commonly used in clinical practice has not been clarified. This study aimed to clarify the characteristics of muscle contraction of the rectus femoris using tensiomyography by sex among healthy adolescents and its relationship with muscle function evaluation, such as lower limb muscle mass and muscle strength. The subjects included 91 healthy university students. The measurement items included TMG, lower limb muscle mass, rectus femoris thickness, isometric knee joint extension torque, and thigh circumference. Results There was a main effect on sex in all parameters (ρ ≤ 0.05). In terms of TMG parameters, maximum displacement (Dm) in the non-dominant foot was significantly lower in women. The correlation between TMG parameters for males and females and lower limb muscle mass, muscle thickness, joint torque, and thigh circumference had a significant correlation with some TMG parameters and lower limb muscle mass (ρ ≤ 0.05). The absolute value of the correlation coefficient was overall low with 0.27 ~0.45. Conclusion In healthy adolescents, there was a difference by sex in TMG parameters and a weak correlation between TMG parameters and the lower limb muscle mass. TMG parameter evaluation may indicate a different function compared with the traditional muscle function assessment used in clinical practice. The TMG parameter is considered as a unique evaluation method for neuromuscular function assessment.