scholarly journals Assessment of immediate effects of percutaneous balloon mitral valvuloplasty on right ventricular and pulmonary functions in severe rheumatic mitral stenosis patients using speckle tracking echocardiography and spirometry

2020 ◽  
Vol 12 (4) ◽  
pp. 280-285
Author(s):  
Praveen Kumar Reddy Sakkuru ◽  
Vanajakshamma Velam ◽  
Rajasekhar Durgaprasad ◽  
Narendra Chanda ◽  
Raja Naga Mahesh Maddala ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Pulmonary Function ◽  
Right Ventricular ◽  
Strain Rate ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Pulmonary Functions ◽  
The Mean

Introduction: The current study was sought to assess the immediate effect of percutaneous balloonmitral valvuloplasty (PBMV) on right ventricular (RV) and pulmonary functions using speckle tracking echocardiography (STE) and spirometry respectively. Methods: Two-dimensional speckle tracking and doppler studies for strain and strain rate imaging of RV were performed before PBMV, after 48h and 15 days of PBMV using echocardiography and spirometry. Mitral valve area, peak and mean mitral valve transannular pressure gradients, late filling velocities,Wilkins score, Systolic pulmonary artery pressure, TAPSE, RV end-diastolic and end-systolic areas,RV fractional area change and Tei index were measured. Results: There was a significant rise in peak RV global longitudinal strain (GLS) from baseline to48h post PBMV and at 15 days post PBMV. Segmental RV strain at basal septum, mid septum,apical septum and basal RV free wall showed considerable improvement from baseline to 48h post PBMV and 15 days post PBMV. RV longitudinal strain rate parameters did not show significant improvement after PBMV and remained low at follow-up. Post PBMV all patients showed restrictive features on pulmonary function test. The mean FEV1 (% predicted), mean FVC (% predicted), mean PEFR improved from baseline to 48h PBMV and 15 days post PBMV. Though the mean FEV1/FVC increased post PBMV at 15 days follow-up, but it was statistically insignificant. Conclusion: RV performance in MS was decreased mainly due to increase in RV after load which improves after PBMV. Patients with severe MS have impaired pulmonary function which is of restrictive type and successful PBMV improves pulmonary function.

scholarly journals Assessment of Myocardial Mechanics in Acute Rheumatic Fever Using Speckle Tracking Echocardiography

2021 ◽  
Author(s):  
Utku Pamuk ◽  
Hazım Gursu ◽  
Emine Azak ◽  
İlker Çetin
Keyword(s):  
Right Ventricular ◽  
Strain Rate ◽  
Acute Phase ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Acute Rheumatic Fever ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Strain Rates

Objectives: This study aims to evaluate the role of speckle tracking echocardiography (STE) to identify myocardial deformation abnormalities in acute rheumatic fever. Methods: Twenty-seven patients and twenty-seven healthy children were studied prospectively. The patients were divided into two subgroups as moderate/severe carditis and mild/no carditis according to valve involvement. The left ventricular global longitudinal strain (LVGLS) and strain rate (LVGLSR), left ventricular global circumferential strain (LVGCS) and strain rate (LVGCSR), and right ventricular global longitudinal strain (RVGLS) and strain rate (RVGLSR) were examined by STE. Results: Left ventricular global longitudinal strain, LVGLSR, LVGCS, LVGCSR, RVGLS and RVGLSR were significantly lower in patients in acute phase of disease than controls. There were no differences in strain and strain rates between patient subgroups before treatment. After acute phase, statistically significant improvements were found in LVGLS, LVGLSR, LVGCSR values of the patients with moderate/severe carditis and LVGLS, LVGCS, LVGCSR, RVGLS, RVGLSR values of the patients with mild/no carditis. The strain parameters of the patients and controls did not differ significantly after the treatment. Conclusions: In acute phase of rheumatic heart disease, patients have reduced left and right ventricular strain and strain rates, which shows improvements after treatment.

scholarly journals Myocardial Contraction during the Diastolic Isovolumetric Period: Analysis of Longitudinal Strain by Means of Speckle Tracking Echocardiography

2018 ◽  
Vol 5 (3) ◽  
pp. 41 ◽  
Author(s):  
Vicente Mora ◽  
Ildefonso Roldán ◽  
Elena Romero ◽  
Assumpció Saurí ◽  
Diana Romero ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Interventricular Septum ◽  
Myocardial Contraction ◽  
Band Model ◽  
Anatomical Location ◽  
Period Analysis ◽  
The Mean ◽  
Deformation Peak

Background: According to the ventricular myocardial band model, the diastolic isovolumetric period is a contraction phenomenon. Our objective was to employ speckle-tracking echocardiography (STE) to analyze myocardial deformation of the left ventricle (LV) and to confirm if it supports the myocardial band model. Methods: This was a prospective observational study in which 90 healthy volunteers were recruited. We evaluated different types of postsystolic shortening (PSS) from an LV longitudinal strain study. Duration of latest deformation (LD) was calculated as the time from the start of the QRS complex of the ECG to the latest longitudinal deformation peak in the 18 segments of the LV. Results: The mean age of our subjects was 50.3 ± 11.1 years. PSS was observed in 48.4% of the 1620 LV segments studied (19.8%, 13.5%, and 15.1% in the basal, medial, and apical regions, respectively). PSS was more frequent in the basal, medial septal, and apical anteroseptal segments (>50%). LD peaked in the interventricular septum and in the basal segments of the LV. Conclusions: The pattern of PSS and LD revealed by STE suggests there is contraction in the postsystolic phase of the cardiac cycle. The anatomical location of the segments in which this contraction is most frequently observed corresponds to the main path of the ascending component of the myocardial band. This contraction can be attributed to the protodiastolic untwisting of the LV.

scholarly journals Abnormal left ventricular global longitudinal strain by speckle tracking echocardiography in COVID-19 patients

2020 ◽  
Author(s):  
Lori B Croft ◽  
Parasuram Krishnamoorthy ◽  
Richard Ro ◽  
Malcolm Anastasius ◽  
Wenli Zhao ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Healthy Population ◽  
Significant Difference ◽  
The Mean ◽  
Lv Ejection Fraction ◽  
Prognostic Implications

COVID-19 infection can affect the cardiovascular system. We sought to determine if left ventricular global longitudinal strain (LVGLS) is affected by COVID-19 and if this has prognostic implications. Materials & methods: Retrospective study, with LVGLS was measured in 58 COVID-19 patients. Patients discharged were compared with those who died. Results: The mean LV ejection fraction (LVEF) and LVGLS for the cohort was 52.1 and -12.9 ± 4.0%, respectively. Among 30 patients with preserved LVEF(>50%), LVGLS was -15.7 ± 2.8%, which is lower than the reference mean LVGLS for a normal, healthy population. There was no significant difference in LVGLS or LVEF when comparing patients who survived to discharge or died. Conclusion: LVGLS was reduced in COVID-19 patients, although not significantly lower in those who died compared with survivors.

scholarly journals Early detection of subclinical left ventricular dysfunction after breast cancer radiation therapy using speckle-tracking echocardiography: association between cardiac exposure and longitudinal strain reduction (BACCARAT study)

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Valentin Walker ◽  
Olivier Lairez ◽  
Olivier Fondard ◽  
Atul Pathak ◽  
Baptiste Pinel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Univariate Analysis ◽  
Left Ventricular ◽  
Radiation Doses ◽  
Lv Dysfunction

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

P1476Global longitudinal strain assessed by 2-D speckle tracking echocardiography identifies myocardial viability and predicts LV function and remodeling after acute MI with systolic dysfunction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Ben Driss ◽  
C Ben Driss Lepage ◽  
A Sfaxi ◽  
M Hakim ◽  
J Y Tabet ◽  
...  
Keyword(s):  
Functional Recovery ◽  
Myocardial Viability ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Systolic Dysfunction ◽  
Lv Remodeling ◽  
Acute Mi ◽  
Lge Cmr

Abstract Aims To assess whether two-dimensional speckle-tracking echocardiography (2D-STE) could (1) identify myocardial viability in comparison with late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR); (2) predict global left ventricular (LV) functional recovery and remodeling and (3) assess prognosis after acute myocardial infarction (MI) with LV systolic dysfunction. Methods Seventy one first STEMI patients with LVEF ≤45%, treated with acute percutaneous coronary intervention, underwent 2D-echocardiography for 2D-STE analysis and LGE CMR between 2 and 45 days after STEMI. Segments were defined as viable when transmural LGE extension was <50% and non viable when transmural LGE extension was ≥50%. At 8-month follow-up, transthoracic echocardiography was repeated to determine global LV functional recovery (increase in LVEF ≥5%) and LV remodeling (increase in end-systolic volume >15%) (n=30) and clinical outcomes were obtained (n=46). Results Global longitudinal strain (GLS) was lower in non viable than in viable infarct segments (−6.6±6.1% vs −10.3±5.9%, p<0.0001) and in viable infarct segments than in normal segments (−10.3±5.9% vs −14.5±6.4%, p<0.0001). GLS >−12% had sensitivity of 78% and specificity of 69% to identify non viable segments (area under the curve (AUC), 0.79; 95% confidence interval (CI), 0.77–0.81, p<0.0001). GLS >−11.3% had sensitivity of 53% and specificity of 100% to predict the absence of global functional improvement (AUC=0.73 (CI: 0.55–0.87) p=0.01) at 8-month follow-up. GLS <−12.5% predicted the absence of adverse LV remodeling at 8-month follow-up with a sensitivity of 100% and a specificity of 54% (AUC=0.83 (CI: 0.66–0.94) p<0.0001). GLS >−11.5% was associated with a poor prognosis. Conclusions In patients with recent first acute MI with LV systolic dysfunction, GLS assessed by 2D-STE: (1) is able to identify non viable segments in comparison with LGE CMR, (2) allows prediction of LV global functional recovery and LV remodeling at 8-month follow-up and (3) provides strong prognostic information, independently of LVEF.

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