European Journal of Echocardiography最新文献

{"title":"Effects of heat-not-burn compared to combustible cigarettes on coronary flow, myocardial work index and vascular function","authors":"I. Ikonomidis, K. Katogiannis, D. Vlastos, G. Kostelli, Kallirrhoe Kourea, M. Tsoumani, J. Parissis, J. Thymis, I. Andreadou, D. Alexopoulos","doi":"10.1093/EHJCI/JEAA356.098","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.098","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 Aim/Introduction:\u0000 Heat-not-burn cigarette (HNBC) constitutes a non-combustible smoke product.\u0000 \u0000 \u0000 \u0000 We compare the effects of heat-not-burn and conventional cigarettes on coronary flow, myocardial and vascular function, platelet activation and oxidative stress.\u0000 \u0000 \u0000 \u0000 We compared the effects of HNBC to those of tobacco cigarette (TCig), on arterial stiffness, oxidative stress, and platelet activation, acutely and after 1 month of switching to HNBC, as well as on endothelial, myocardial, and coronary function after 1 month of switching to HNBC. In the acute study, 50 smokers were randomized into smoking a single Tcig or an HNBC and after 60 minutes were crossed over to the alternate smoking (HNBC or Tcig). For the chronic phase, 75 smokers were examined. Of those, 50 were switched to HNBC and 25 continued Tcig for 1 month. Pulse wave velocity (PWV) and biomarkers [malondialdehyde (MDA), protein carbonyls (PC), and thromboxane B2 (TXB2)] were assessed in the acute and chronic study. Myocardial deformation [global longitundinal strain (GLS), myocardial work index (GWI) and wasted myocardial work (GWW)], coronary flow reserve (CFR) by Doppler echocardiography, total arterial compliance (TAC), and flow-mediated dilation (FMD) were additionally assessed in the chronic study.\u0000 \u0000 \u0000 \u0000 Compared to baseline, TCig smoking acutely increased exhaled CO, PWV, MDA, and TxB2 (p < 0.05), while no changes were observed after HNBC. Compared to resuming Tcig smoking, switching to HNBC for 1 month improved CO (mean change: -55% vs -2.4%), FMD ( +55% vs +15%), CFR (+46% vs +4%), TAC (+9% vs -0.5%), GLS (+6% vs +1%), GWW (-19% vs +0.5%), MDA (-19% vs 1 %), and TxB2 (-12% vs 4%) (p < 0.05 for all comparisons).\u0000 \u0000 \u0000 \u0000 HNBCs exert a less detrimental effect on vascular, cardiac and platelet function than combustible tobacco.\u0000","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85537113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interplay of systemic atrial and ventricular function in patients with transposition of the great arteries after arterial switch operation","authors":"A. Schoeber, M. Jerosch-Herold, P. Wegner, I. Voges, D. Gabbert, H. Pham, J. Scheewe, H. Kramer, C. Rickers","doi":"10.1093/EHJCI/JEAA356.413","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.413","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 Background/Introduction: The role of systemic atrial (LA) function and its interplay with the systemic ventricle (LV) in patients with transposition of the great arteries (TGA) after arterial switch operation (ASO) is currently not well defined.\u0000 \u0000 \u0000 \u0000 Investigate the role of LA function and its interplay with the LV.\u0000 \u0000 \u0000 \u0000 Between 2007 and 2018 patients with TGA corrected by ASO and control patients of comparable age, sex, height but without known cardiovascular disease were included in this prospective single centre analysis of 3 Tesla cardiac magnetic resonance cine imaging studies of atrial and ventricular function. Additionally, in TGA patients extracellular volume fraction (ECV) was assessed by T1 mapping and global longitudinal strain (GLS) by feature tracking.\u0000 \u0000 \u0000 \u0000 Overall, 81 TGA (16.3 [IQR 10.5-21.2] years, 32% female) and 30 control patients (11.9 [IQR 8.7-22.5] years, 63% female) were included in the current analysis. TGA patients had smaller LA maximum volume index, and reduced total atrial and conduit volume emptying. This resulted in a reduced LA reservoir and conduit function compared to controls. In TGA, a higher LA active/conduit and active/total ratio indicated impaired passive filling of the LV. (Table 1)\u0000 The median ECV was 28.3% (IQR 25.8-33.9) and the median GLS -24.2% (IQR -28.6- -20.4) in TGA patients. LA reservoir (Fig. 1A), conduit and contractile function showed a negative correlation with GLS (r=-0.470, p < 0.001, r=-0.270, p = 0.022 and r=-0.257, p = 0.030, respectively). Interestingly, the LA active/conduit ratio (Fig. 1B) and the active/total ratio showed a positive correlation with ECV (r = 0.418, p = 0.002 and r = 0.339, p = 0.013, respectively).\u0000 \u0000 \u0000 \u0000 Impaired LA function is frequent among patients with TGA following ASO. The impairment of LA function is linked to both LV dysfunction and fibrosis.\u0000 Table 1 Variable TGA (n = 81) Control (n = 30) p-value LAVI max.[ml/m²] 37.8 (29.9-42.9) 42.02 (38.3-51.6) 0.002 LAVI total emptying [ml/m²] 16.8 (13.7-20.8) 24.3 (20.6-29.4) <0.001 LAVI conduit emptying [ml/m²] 10.3 (8.1-13.9) 17.5 (15.2-20.8) <0.001 LAVI active [ml/m²] 6.7 (4.1-8.6) 6.4 (5.0-7.9) 0.984 LA-EF-reservoir [%] 46.6 (42.0-50.5) 57.2 (51.2-60.1) <0.001 LA-EF-conduit [%] 28.1 (23.4-34.3) 42.5 (35.4-45.8) <0.001 LA-EF-active [%] 24.11 (17.9-29.1) 25.7 (21.5-29.7) 0.339 LA active/conduit ratio 0.60 (0.41-0.90) 0.37 (0.28-0.44) <0.001 LA active/total ratio 0.38 (0.29-0.47) 0.27 (0.22-0.30) <0.001 Differences in left atrial function between TGA and control patients Abstract Figure. Fig. 1A and B\u0000","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87238712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular adaptation after liver transplantation. Ventricular changes detect by 2d echocardiography and by speckle tracking","authors":"SM Alharbi, A. Alfehaid, A. Eltayeb, A. Alsomali, D. Galzerano, B. Alamro, M. Pirisi, R. Troisi, O. Vriz","doi":"10.1093/EHJCI/JEAA356.150","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.150","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 Background. Patients who underwent liver transplantation (LT) may suffer from heart disease that can be related to the liver disease itself or to other  associated pathologies.  It has been suggested that there is a specific heart disease associated with cirrhosis, termed cirrhotic cardiomyopathy which  is characterized by the presence of increased baseline cardiac output, systolic and diastolic left ventricular (LV) dysfunction and increased in pulmonary artery systolic pressure (PASP). The aim of the study was to evaluate the cardiac structural and functional changes after LT and eventually to determine the improvement in PASP.\u0000 Method. 51 patients were considered for the analysis who had a good quality pre and post LT echocardiograms.  The echo-study was done preLT and  repeated within 4 months and 3 years after LT. All studies were red of-line, global longitudinal stains (GLS) of the LV and right ventricle (RV) were analyzed using TOMTEC application. A Paired T-test was used to compare the echocardiographic parameters.  The group was also divided according to tertiles of pre LT PASP for the evaluation of pulmonary pressure.\u0000 Results . Patients` mean age was 58.1 ± 7.8 years, 32 (62.6%) men, mean time between the 2 echocardiographic studies was 529.2 ± 471 days. After LT all the patients were on immunosuppressant therapy (calcineurin inhibitors, ciclosporin and/or tacrolimus).  After LT  blood pressure (BP) (83.4 ± 16 vs 91.5 ± 14 mmHg, p = 0.009 for mean BP ), heart rate (72.5 ± 15.2 vs 80.6 ± 15.3 bpm, p = 0.004), increased as LV mass index (78.6 ± 21.1 to 91.4 ± 29,  p= 0.003) and relative wall thickness (0.34 ± 0.06 to 0.39 ± 0.08,  p = 0.001).  LV ejection fraction did not change while there was a significant decrease in LV GLS (-20.9 ± 4.4% vs -17.4 ± 3.9%, p < 0.0001), impaired diastolic function (E/A 1.12 ± 0.5 vs 0.94 ± 0.4, p = 0.002) and increase in LV diastolic filling pressure (E/E’ 7.7 ± 3.6 vs 8.9 ± 3.6, p = 0.018).  PASP increased (26.6 ± 8 vs 30.8 ± 11 mmHg, p = 0.018)  and  TAPSE (24.1 ± 4.5 vs 21.6 ± 3.9 mm, p = 0.002) decresed.  The pre and post echo data, were divided in preLT PASP to see if there was any tendency to decrease in PASP after LT. A progressive increase in LV remodeling and impaired diastolic function, RV- pulmonary arterial coupling decreased as an index of RV maladaptation to the increase PASP as tertiles of in PASP increased.\u0000 Conclusion. Increased in BP has been found in patients after LT , likely related to immensuppressive therapy. LV remodeling, impaired diastolic function were likely a conseguence of increase in BP and the increased in PASP and worst RV- pulmonary circulation coupling was secondary to impaired diastolic function and increased filling pressure. After LT, patients require particular clinical attention and echocardiographic monitoring included GLS for target organ damage and  prompt adequate therapy at least in terms of BP control to avoid later cardi","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88240190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac resynchronization therapy improves left atrial reservoir function through resynchronization of the left atrium in patients with heart failure","authors":"Kumiko Dokuni, Kensuke Matsumoto, Kazuhiro Tatsumi, Ayu Shono, Makiko Suzuki, Keiko Sumimoto, Yusuke Tanaka, Kentarou Yamashita, Nao Shibata, S. Yokota, M. Sutou, Hiroshi Tanaka, K. Kiuchi, K. Fukuzawa, K. Hirata","doi":"10.1093/EHJCI/JEAA356.123","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.123","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 \u0000 \u0000 \u0000 The structural remodeling of the left atrium (LA) has been proposed as an important determinant of adverse outcomes in patients with heart failure (HF). However, little is known about the potential impact of LA mechanical dyssynchrony on its reservoir function and the prognosis of patients with HF. In addition, it has not been fully investigated whether cardiac resynchronization therapy (CRT) is also beneficial to LA function.\u0000 \u0000 \u0000 \u0000 The purposes of this study were to test whether left ventricular (LV) dyssynchrony may negatively affect LA synchronicity and reservoir function, and to assess whether residual LA dyssynchrony after CRT affects the prognosis in patients with HF with reduced ejection fraction (HFrEF).\u0000 \u0000 \u0000 \u0000 This study included total of 90 subjects: 40 HFrEF with a wide-QRS complex (≧130 ms), 28 HFrEF with a narrow-QRS, and 22 age- and sex-matched normal controls. LA global longitudinal strain (LA-GLS) and LA dyssynchrony were quantified using speckle-tracking strain analysis. LA dyssynchrony was defined as the maximal difference of time-to-peak strain (LA time-diff). All wide-QRS HFrEF received CRT, and event-free survival was tracked for 24 months.\u0000 \u0000 \u0000 \u0000 At baseline, HFrEF patients showed significant LA remodeling coupled with the reduced LA reservoir function, as evidenced by larger LA volume index (LAVi: 46 ± 16 vs. 30 ± 14 mL/m², P < 0.01) and smaller LA-GLS (13.0 ± 4.8 vs. 30.6 ± 10.7%, P < 0.01). Of note was that, not only LV dyssynchrony (381 ± 178 vs. 177 ± 62 ms, P < 0.01) but also LA dyssynchrony (298 ± 136 vs. 186 ± 78 ms, P < 0.01) were significantly larger in patients with HFrEF compared to normal subjects and this applied even more to patients with a wide-QRS complex. All patients with a wide-QRS complex underwent CRT, and only responders exhibited the significant decrease in LA time-diff (from 338 ± 123 to 245 ± 141 ms, P < 0.05) and increase in LA-GLS (from 11.9 ± 4.7 to 19.6 ± 10.1%, P < 0.05) in parallel with the reduction in LAVi (from 48 ± 17 to 37 ± 18 mL/m², P < 0.05) at 6 months after CRT. Receiver operating characteristic curve analysis identified the optimal cut-off value of LA time-diff at 6 months after CRT as 202 ms (P < 0.05) and that of LA-GLS as 14.6% (P < 0.05) for predicting adverse cardiac events. The patients whose LA time-diff reduced <202 ms after CRT showed significantly favorable event-free survival than the others. Similarly, the patients whose LA-GLS improved >14.6% after CRT exhibited significantly favorable event-free survival than the others (P < 0.05, respectively). Of note was that, when the patients were restricted to CRT responders only, those who showed LA time-diff less than 202 ms at 6 months after CRT almost never experienced cardiac events (P < 0.05).\u0000 \u0000 \u0000 \u0000 The improved LV coordination by CRT also resulted in resynchronization of discoordinated LA wall motion and a consecutive improvement of LA reservoir function, which ultimately lead ","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87158260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of atrial strain ratio with invasive pulmonary hemodynamics in rheumatic mitral stenosis","authors":"V. Kaur, A. Manouras, A. Venkateshvaran","doi":"10.1093/EHJCI/JEAA356.062","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.062","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 Background. Symptomatic rheumatic mitral stenosis (MS) results in elevation in left atrial (LA) pressure that is passively transmitted to derange pulmonary hemodynamics and subsequently elevate right ventricular afterload. We studied associations between LA to right atrial reservoir strain ratio (LA-RAs) and invasive pulmonary hemodynamics in addition to the ratio’s ability to identify subjects with elevated pulmonary vascular resistance (PVR).\u0000 Methods.  Consecutive MS subjects undergoing right heart catheterization (RHC) and percutaneous transvenous mitral commissurotomy (PTMC) were enrolled. Subjects with atrial fibrillation, >mild mitral regurgitation, concomitant aortic valve or ischemic heart disease were excluded. LA-RAs was assessed by speckle-tracking echocardiography and stratified into high or low LA-RAs subgroups based on mean value. Correlations with invasive pulmonary hemodynamics was studied. ROC analysis was performed to identify pulmonary hypertension (PH) and PVR > 3 Wood Units.\u0000 Results. 110 subjects were analysed (age: 32 ± 8; 72% female). LA and RA reservoir strain was feasible in 88 (80%) and 83 (75%) subjects respectively. Patients with low LA-RAs demonstrated more severe MS (0.8 ± 0.1 vs. 1.0 ± 0.2cm2), higher mean pulmonary artery (43 ± 13 vs. 33 ± 13mmHg) and capillary wedge pressure (28 ± 6 vs.23 ± 16mmHg) as compared with high LA-RAs (p < 0.001 for all). LA-RAs was associated with invasive PA systolic (r=-0.30;p = 0.05), diastolic (r=-0.28;p = 0.02) and mean (r=-0.33; p = 0.002) pressures, demonstrated modest ability to identify elevated PVR (AUC = 0.65;p = 0.03) and strong ability to identify PH (AUC = 0.75; p < 0.001). LA-RAs significantly increased after PTMC (0.43 ± 0.1 to 0.52 ± 0.1;p < 0.001).\u0000 Conclusions. The novel atrial strain ratio is associated with measures of invasive pulmonary hemodynamics and demonstrates ability to identify PH and elevated PVR in MS.\u0000","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90607913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in diastology and atrial function in multimodality imaging after breast cancer radiotherapy - a six-year follow-up study","authors":"M. Vaarpu, L. Lehmonen, S. Kivistö, T. Skyttä, P. Kellokumpu-Lehtinen, H. Aula, P. Raatikainen, V. Virtanen, K. Nikus, S. Tuohinen","doi":"10.1093/EHJCI/JEAA356.127","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.127","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: Public grant(s) – National budget only. Main funding source(s): State research funding (Finland) Heart Hospital funding (Tampere, Finland)\u0000 \u0000 \u0000 \u0000 Breast cancer radiotherapy (RT) increases the incidence of heart failure with preserved ejection fraction with long latency. The prevalence and the early phases of this process are not well characterized. The aims of our study were to evaluate changes in diastology and left atrial function after breast cancer RT in a prospective manner.\u0000 \u0000 \u0000 \u0000 31 patients with early stage left-sided breast cancer were studied prior to RT, immediately after RT and three and six years after RT. Biomarkers were measured and echocardiography, including left atrial strain, was performed at each visit. Cardiac magnetic resonance imaging (CMR) was performed at the six-year follow-up (FU).\u0000 \u0000 \u0000 \u0000 At baseline, the median diastology gradus was 1 with 5 patients displaying diastology gradus greater than 2. At six-year follow-up the median diastology gradus had increased to 2 (p = 0.012) with 13 patients in diastology gradus 3-4. Additionally, proBNP increased progressively from  baseline level of 63 [37, 124] ng/l to post-RT level of 84 [40, 154] ng/l (p = 0.031), to 90 [46, 132] ng/l at the three-year follow-up (p = 0.021) and to 98 [50, 176] ng/l at the six-year follow-up (p = 0.010). Left atrial strain initially increased from 23.2 ± 4.9% at baseline to 25.5 ± 6.7% post-RT (p = 0.199) and thereafter decreased to 21.2 ± 6.0% (p = 0.002) at six-year follow-up. There was no correlation in left atrial strain between 2D-echocardiography and CMR. Age (mean 62.2 years) had no correlation with changes in diastology or left atrial strain. Furthermore, left atrial strain rate (SR) increased progressively from 2.14 [1.83, 2.50]1/s at baseline to  2.35 [1.95, 2.96]1/s at the three-year follow-up (p = 0.040) and thereafter declined to 1.92 [1.62, 2.59]1/s (p = 0.014). The change in left atrial SR (from RT to the six-year control) was independently correlated with body mass index (BMI) (p = 0.044, β=0.472). The changes in diastology had no independent predictors.\u0000 \u0000 \u0000 \u0000 RT induced a gradual worsening in diastology gradus, which was initially compensated with an increase in left atrial function. However, at the six-year follow-up, 43.7% of the patients had restrictive or pseudonormal diastology and a significant decline in left atrial strain and SR were detected. A lower BMI had a negative influence on the left atrial function.\u0000 Abstract Figure. Changes in diastoly during six-year FU\u0000","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83670637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of anti-inflammatory treatment and surgical intervention on endothelial glycocalyx, peripheral and coronary microcirculation and myocardial deformation in inflammatory bowel disease patients","authors":"C. Triantafyllou, I. Ikonomidis, M. Nikolaou, G. Bamias, J. Thymis, G. Kostelli, A. Kalogeris, I. Papaconstantinou","doi":"10.1093/EHJCI/JEAA356.423","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.423","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: Foundation. Main funding source(s): EOMIFNE (Hellenic Society of IBD study)\u0000 \u0000 \u0000 \u0000 IBD alter gastrointestinal physiology and mucosal immunity through a complex inflammatory process which leads to significant arterial endothelial dysfunction and modification of cardiac structure and function. This study is performed to test the hypothesis that treatment with TNF-a inhibitor or surgical intervention improves cardiovascular function through anti-inflammatory mechanisms.\u0000 \u0000 \u0000 \u0000 57 IBD patients (45 CD and 12 UC, 40 ± 8 years, 57% male) were examined at baseline and 4 months after pharmaceutical (antiTNF-a) or surgical intervention. Subjects with a history of established cardiovascular risk factors were excluded.\u0000 We measured a) carotid-femoral pulse wave velocity (PWV - Complior SP ALAM) and augmentation index (AI), b) flow mediated dilatation (FMD) of the brachial artery), c) perfused boundary region (PBR) of the sublingual arterial microvessels, d) LV longitudinal strain (GLS) and (PWV/GLS) as a marker of ventricular-arterial coupling, e) peak LV twisting, peak twisting velocity (pTwVel) and peak untwisting velocity (pUtwVel) using speckle tracking echocardiography, f) mitral annulus velocities by tissue doppler imaging (S’ and E’) and mitral inflow velocity (E), g) coronary flow reserve (CFR) by Doppler echocardiography, h) C-reactive protein (CRP), white blood cells (WBC).\u0000 IBD severity was quantified using Mayo score and Harvey-Bradshaw Index (HBI) for UC and CD respectively.\u0000 \u0000 \u0000 \u0000 At baseline, the disease severity score and the WBC values were significantly correlated with peripheral PWV (r = 0.3, p < 0.05 and r = 0.364, p < 0.05), while central arterial AI was associated with median arterial pressure (r = 0.479, p < 0.05), lateral and septal mitral E’ velocity (r=-0.651, p < 0.05 and r=-0.587, p < 0.05). Four months after treatment, there was a reduction of CRP (13 ± 2.8 mg/L vs 3.9 ± 1.2 mg/L, p < 0.05), CFR (2.5 ± 0.08 vs 3.1 ± 0.11, p < 0.05) and PBR5-25 (2.27 ± 0.06 vs 2.09 ± 0.05 μm, p < 0.05) more significantly in pharmaceutical group (p < 0.05 vs p = 0.23). Moreover, there was an improvement of GLS (-18.6 ± 0.37 vs -20 ± 0.34, p < 0.05), LS-4ch (-18.3 ± 0.47 vs -19.3 ± 0.41, p < 0.05), GcircS (-18.1 ± 0.7 vs -20.1 ± 0.9, p < 0.05) and FMD (7.2%±0.6 vs 11.8%±1.4, p < 0.05). Moreover, there was an overall improvement of PWV/GLS (-0.49 ± 0.02 vs -0.43 ± 0.02, p < 0.05). It was greater after with anti-TNFa therapy compared to surgery (p < 0.05 vs p = 0.1) and particular for the GLS component (p < 0.05 vs p = 0.07). The difference in PBR5-25 was significantly correlated with the difference in GLS (r=-0.403, p < 0.05) and PWV/GLS (r = 0.421, p < 0.05).\u0000 \u0000 \u0000 \u0000 IBD severity is associated with vascular and diastolic dysfunction, with significant improvement after anti-inflammatory treatment. Systemic anti-TNFa inhibition leads to significant improvement in myocardial deformation, endothelial and coronary microcircu","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85246066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular magnetic resonance normal values for pulmonary arteries and ventricular volumes in paediatric patients with transposition of the great arteries after arterial switch operation","authors":"I. Voges, C. Boll, A. Caliebe, A. Uebing, S. Krupickova","doi":"10.1093/EHJCI/JEAA356.400","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.400","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 \u0000 \u0000 \u0000 The anatomy of the pulmonary arteries (PA) in patients with transposition of the great arteries (TGA) after arterial switch operation (ASO) with Lecompte manoeuvre is different compared to healthy subjects and stenoses of the PA are known to occur. Cardiovascular magnetic resonance (CMR) imaging is an excellent imaging modality to assess PA anatomy in TGA patients. However, disease specific normal values for PA size do not exist. Furthermore, the impact of pulmonary artery size, age and gender on ventricular volumes and function is unknown. Therefore, we sought to establish disease specific normative ranges for PA dimensions as well as biventricular volumes and function.\u0000 \u0000 \u0000 \u0000 70 CMR scans of paediatric patients with TGA after ASO with Lecompte manoeuvre (mean age 12.3 ± 3.6 years; range 5-18 years; 57 males) were included. Cine CMR sequences as well as contrast-enhanced magnetic resonance angiography (CE-MRA) data were used to measure pulmonary artery dimensions. Right and left PA were each measured at three locations during its course around the aorta. Ventricular volumes, mass and ejection fraction were measured from a stack of short axis cine images.\u0000 \u0000 \u0000 \u0000 Mean systolic and diastolic diameters of the MPA were 15.0 ± 2.3 mm (10.5 ± 2.7 mm/m²) / 13.2 ± 2.9 mm (9.2 ± 2.9 mm/m²) and mean cross-sectional MPA area was 286.7 ± 81.7 mm². Mean systolic and diastolic diameters for the RPA and LPA at the narrowest point were: RPA 10.5 ± 2.8 mm (7.8 ± 2.4 mm/m²)  / 8.1 ± 2.2 mm (6.0 ± 1.9 mm/m²); LPA 8.4 ± 2.8 mm (6.2 ± 2.1 mm/m²) / 7.4 ± 2.3 mm (5.4 ± 1.6 mm/m²). Mean values for biventricular volumes, ejection fraction and mass were as follows: 1) left  ventricular (LV) end-diastolic volume (EDV) 89.0 ± 20.3 ml/m² and end-systolic volume (ESV) 35.1 ± 11.7 ml/m², 2) right ventricular (RV) EDV 76.4 ± 15.4 ml/m² and ESV 32.4 ± 9.1 ml/m², 3) LV and RV ejection fraction 61.1 ± 6.5 % / 58.9 ± 6.1 % and 4) LV and RV mass 59.6 ± 15.2 g/m² / 23.3 ± 7.4 g/m². Separate centile charts for boys and girls for PA dimensions as well as biventricular volumes, mass and ejection fraction were created.\u0000 \u0000 \u0000 \u0000 We established disease specific CMR normal values for the PA dimensions as well as for ventricular volumes, mass and ejection fraction in paediatric patients with TGA after ASO. Our data will improve CMR image interpretation and may serve as a reference in future studies.\u0000","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85360417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of mechanical dyssynchrony for predicting response to cardiac resynchronization therapy in patients with non-ischemic cardiomyopathy","authors":"V. Saushkin, Y. Varlamova, A. I. Mishkina, D. Lebedev, S. Popov, K. Zavadovskiy","doi":"10.1093/EHJCI/JEAA356.351","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.351","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 Aim/Introduction: Assessment of mechanical dyssynchrony by myocardial perfusion gated-SPECT in patients with non-ischemic cardiomyopathy for predict response to cardiac resynchronization therapy (CRT).\u0000 \u0000 \u0000 \u0000  We examined 32 patients with non-ischemic cardiomyopathy before and six months after CRT.  Left ventricular mechanical dyssynchrony and contractility were assessed for all patients by myocardial perfusion gated-SPECT. The phase standard deviation (PSD), histogram bandwidth (HBW), phase histogram skewness (S) and phase histogram kurtosis (K) were used as an indicator of mechanical dyssynchrony for the both ventricles. \u0000 \u0000 \u0000 \u0000  Mechanical dyssynchrony of both ventricles before CRT was increased in all patients. Median value PSD 53°(41-61°), HBW 176°(136-202°), S 1,62(1,21-1,89), K 2,81(1,21-3,49). Six months after CRT 22(68%) respondents were identified. We divided the patients into two groups (responders and non-responders) and compared phase parameters. It was found that the PSD (44°(35-54°)) and HBW (158°(118-179°) in the responders were significantly lower than in the non-responders (PSD (68°(58-72°); HBW (205°(199-249°)). The value of phase histogram skewness and kurtosis in responders were significantly higher (Responders: S 1,77(1,62-2,02); K 3,03(2,60-3,58). Non-responders: S 1,21(0,93-1,31); K 1,21(0,19-1,46)).  We found that all four indicators of mechanical dyssynchrony can predict CRT response according to the results of univariate logistic regression analysis. Moreover, It was found that only phase histogram kurtosis (OR = 1.196, 95% CI 1.04-1.37) is an independent predictor of CRT response according to multivariate logistic regression.\u0000 \u0000 \u0000 \u0000  Radionuclide assessment of mechanical dyssynchrony may be the optimal diagnostic method for selecting patients with non-ischemic cardiomyopathy on CRT.\u0000","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88414414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of clinical and echocardiographic scores to predict pre-capillary pulmonary hypertension","authors":"M. F. Oliveira, Marta Oliveira, S. Cabral, S. Torres, Amanda Maria Sena Reis, Myrna Serapião dos Santos","doi":"10.1093/EHJCI/JEAA356.005","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.005","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 \u0000 \u0000 \u0000 Right heart catheterization (RHC) is the gold-standard method to confirm the diagnosis of Pulmonary Hypertension (PH) and to differentiate between pre- and post-capillary PH. However, RHC is an invasive and sometimes low-available procedure, which cannot be performed in all the patients with suspected PH. Clinical and echocardiographic scores have been developed to predict pre-capillary PH. We aimed to compare the performance of four of these scores in a population with suspected PH.\u0000 \u0000 \u0000 \u0000 We retrospectively included consecutive patients who underwent RHC for suspected PH. If the non-invasive evaluation was clearly suggestive of left heart disease, RHC was dispensed being considered not clinically relevant. We also excluded patients with congenital heart disease. We compared the performance of four scores to predict pre-capillary PH: Score 1 (Opotowsky et al.), score 2 (Richter et al.), score 3 (Berthelot et al.) and score 4 (D’Alto et al..\u0000 \u0000 \u0000 \u0000 Of the 142 included patients, 76 patients had pre-capillary PH, 42 had post-capillary PH and 24 patients did not meet invasive criteria for PH. We were able to perform the aforementioned scores in the majority of our patients (82% for score 1, 100% for score 2, 98% for score 3 and 83% for score 4). The AUC to predict pre-capillary PH using these scores were 0.74 for score 1, 0.77 for score 2, 0.82 for score 3 and 0.70 for score 4 (p = 0.37). Using the best cut-off points for each score, the score 3 correctly classified the highest percentage of patients (75.5%), with a sensitivity of 92% and a specificity of 60% to predict pre-capillary PH.\u0000 \u0000 \u0000 \u0000 Combined clinical and echocardiographic characteristics can be used to predict pre-capillary PH with a fairly good performance. Score 3 (Berthelot et al.) was the score with the highest discrimination power. Validation of these scores in larger cohorts of patients with suspected PH are needed.\u0000 Clinical and echocardiographic characteristics Interpretation Opotowsky et al. LA diameter (<32 mm: +1, >24 mm: -1), mid-systolic notch or acceleration time <80 msec (+1), E/e’>10 (-1) Score ≥ 0 has a sens. 100% and a spec. 62% for pre-capillary PH Richter et al. Age > 68 years (+1), BMI > 30 kg/m2 (+1), absence of RV enlargement (+1), LA enlargement (+1) Score >4 predicted post-capillary PH (AUC 0.78) Berthelot et al. Atrial fibrillation (+2), diabetes mellitus (+1), LA enlargement (15 ≤ LAA < 19: +1, 19 ≤ LAA < 24: +2, ≥ 19 cm2: +3), RV end-diastolic area (<27 cm2: +2), LV mass index (46 < LVMI ≤ 62: +1, 62 < LBMI ≤ 81: +2,< 81 cm2: +3) Score <5 ruled out post-capillary PH D’Alto et al E/e\" ≤ 10 (+2), dilated non-collapsible IVC (+2), EI ≥ 1.2 (+1), right-to-left heart chamber dimension ratio > 1 (+1), RV forming the heart apex (+1) Score ≥ 2 has a sens. 99% and a spec. 54% for pre-capillary PH (AUC 0.85) Table 1. The clinical and echocardiographic scores evaluated in this study. AUC: area under the curve, EI: eccentricity ","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89406921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}