Myocardial strain assessment by 2D Speckle Tracking to evaluate the effect of cardiac rehabilitation in patients with or without heart failure

IF 18 Q4 Medicine
N. Hrynchyshyn , M.T. Bailly , A. Briedj , P. Jourdain , F. Bailly
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引用次数: 1

Abstract

Introduction

Cardiac rehabilitation improves the subjective condition of the patient but little is known about associated structural and functional cardiac adaptations specifically the myocardial strain.

Objective

To evaluate the impact of rehabilitation on structural and functional cardiac parameters using myocardial strain assessment by 2D Speckle Tracking.

Method

The study group consisted of 86 patients: 46 with heart failure with optimal medical treatment and 40 after acute myocardial infarction. A monocentric cohort study has included all patients who performed a 2-months cardiac rehabilitation program during 1 year. Clinical characteristics, a resting ECG, 2-dimensional Doppler echocardiography with tissue Doppler and strain imaging, and an incremental maximal exercise test on a bicycle ergometer were collected before and after the rehabilitation program. Paired student t-test for comparison and Pearson's correlation coefficient were used for the statistical analysis.

Results

Performance capacity was significantly improved after cardiac rehabilitation: performance in watts 112 W (±50) vs. 69.8 W (±34.5); effort test duration 10.7 min (±4.4) vs. 6.9 min (±3.1) and 6 min walking time 565 m (±127) vs. 496 m (±113). TEE parameters were significantly improved: LVFE 52.9% (±13) vs. 46.9% (±12.7), E/E’ 6.7 (±1.54) vs. 7.38 (±2.9). Significant difference of strain before and after cardiac rehabilitation 15.38% (+/4.72) vs. 14.12 (±4,79) has been also recorded. BNP level decreased by 29 ng/dL but not statistically significant from baseline. No significant correlation was found between biological, functional and TTE parameters.

Conclusion

Strain imaging could be an interesting additional parameter to evaluate the positive response and structural improvement in patients with or without chronic heart failure who are undergoing cardiac rehabilitation (Table 1).

用2D斑点追踪法评估心肌应变,评价有或无心力衰竭患者心脏康复的效果
心脏康复改善了患者的主观状况,但对相关的心脏结构和功能适应,特别是心肌应变,知之甚少。目的应用二维散斑追踪心肌应变评估来评估康复对心脏结构和功能参数的影响。方法研究组包括86名患者:46名采用最佳药物治疗的心力衰竭患者和40名急性心肌梗死患者。一项单中心队列研究纳入了所有在一年内进行了两个月心脏康复计划的患者。在康复计划前后收集临床特征、静息心电图、带组织多普勒和应变成像的二维多普勒超声心动图以及自行车测力计上的增量最大运动测试。采用配对学生t检验进行比较,Pearson相关系数进行统计分析。结果心功能康复后,运动能力显著提高:运动功率112W(±50),而运动功率69.8W(±34.5);用力测试持续时间10.7分钟(±4.4)vs.6.9分钟(±3.1)和6分钟步行时间565米(±127)vs.496米(?13)。TEE参数显著改善:LVFE 52.9%(±13)vs.46.9%(±12.7),E/E’6.7(±1.54)vs.7.38(±2.9)。心脏康复前后的应变显著差异15.38%(+/-4.72)vs.14.12(±4.79)。BNP水平下降了29 ng/dL,但与基线相比没有统计学意义。生物学、功能和TTE参数之间没有发现显著相关性。结论应变成像可能是一个有趣的额外参数,用于评估正在接受心脏康复的慢性心力衰竭患者的积极反应和结构改善(表1)。
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来源期刊
Archives of Cardiovascular Diseases Supplements
Archives of Cardiovascular Diseases Supplements CARDIAC & CARDIOVASCULAR SYSTEMS-
自引率
0.00%
发文量
508
期刊介绍: Archives of Cardiovascular Diseases Supplements is the official journal of the French Society of Cardiology. The journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles, editorials, and Images in cardiovascular medicine. The topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Additionally, Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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