Cardiovascular Ultrasound最新文献

{"title":"The role of left atrial strain in patients with functional tricuspid regurgitation before and after annuloplasty: a long-term follow-up study.","authors":"Qing-Long Meng,&nbsp;Hong Meng,&nbsp;Jia Tao,&nbsp;Shu Yang,&nbsp;Hao Wang","doi":"10.1186/s12947-021-00264-z","DOIUrl":"https://doi.org/10.1186/s12947-021-00264-z","url":null,"abstract":"<p><strong>Background: </strong>Functional tricuspid regurgitation (TR) is common among patients with left heart disease and may recur during the follow-up period after selective tricuspid valve annuloplasty (TVA). This study aims to analyse the relationship between left atrial (LA) strain and the degree of preoperative functional TR and to explore the role of LA strain in predicting TR recurrence.</p><p><strong>Methods: </strong>This study included 63 patients with rheumatic mitral stenosis who underwent mitral valve replacement and concomitant TVA. Additionally, 20 healthy controls were enrolled. Preoperative conventional LA echocardiographic parameters and LA strain were measured. The association between LA strain and preoperative functional TR severity was analysed by Pearson correlation. Predictors of recurrent TR were determined by multivariate logistic regression analyses.</p><p><strong>Results: </strong>Compared with the control group, the mitral stenosis group developed a significant impairment in terms of LA strain. The degree of preoperative functional TR exhibited moderate correlations with LA reservoir strain (r = - 0.57) and LA conduit strain (r = 0.48). During a median follow-up period of 66.4 ± 36.4 months, TR recurred in 18 patients. Preoperative LA reservoir strain and the mean transmitral gradient were predictors of postoperative TR recurrence. When the two indexes were combined to establish a prediction, the sensitivity and specificity of prediction increased. The area under the receiver operating characteristic curve of the combined indicator was higher than those of the single indicators (0.90 vs. 0.70 and 0.72).</p><p><strong>Conclusions: </strong>LA strain correlates with preoperative functional TR severity in patients with rheumatic mitral stenosis. The LA reservoir strain and preoperative mean transmitral gradient are independent predictive factors for recurrent TR after TVA.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"33"},"PeriodicalIF":1.9,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39529100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic assessment of diastolic dysfunction in elderly patients with severe aortic stenosis before and after aortic valve replacement.","authors":"Hatice Akay Caglayan,&nbsp;Didrik Kjønås,&nbsp;Siri Malm,&nbsp;Henrik Schirmer,&nbsp;Assami Rösner","doi":"10.1186/s12947-021-00262-1","DOIUrl":"https://doi.org/10.1186/s12947-021-00262-1","url":null,"abstract":"<p><strong>Background: </strong>The 2016 guidelines of the American Society of Echocardiography (ASE) and European Association of Cardiovascular Imaging (EACVI) for evaluation of left ventricular (LV) diastolic dysfunction by Doppler flow and tissue Doppler- echocardiography do not adjust assessment of high filling pressures for patients with aortic stenosis (AS). However, most of the studies on this patient group indicate age independent specific diastolic features in AS. The aim of this study is to identify disease-specific range and distribution of diastolic functional parameters and their ability to identify high N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels as a marker for high filling pressures.</p><p><strong>Methods: </strong>In this study, 169 patients who underwent surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR) were prospectively enrolled. Resting echocardiography was performed including Doppler of the mitral inflow, pulmonary venous flow, tricuspid regurgitant flow and tissue Doppler in the mitral ring and indexed volume-estimates of the left atrium (LAVI). Echocardiography, and NT-proBNP levels were assessed before TAVR/SAVR and at two postoperative visits at 6 and 12 months.</p><p><strong>Results: </strong>Pre- and postoperative values were septal e'; 5.1 ± 3.9, 5.2 ± 1.6 cm/s; lateral e' 6.3 ± 2.1; 7.7 ± 2.7 cm/s; E/e'19 ± 8; 16 ± 7 cm/s; E velocity 96 ± 32; 95 ± 32 cm/s; LAVI 39 ± 8; 36 ± 8 ml/m², pulmonary artery pressure (PAP) 39 ± 8; 36 ± 8 mmHg, respectively. The scoring recommended by ASE/EACVI detected elevated NT pro-BNP with a specificity of 25%. Adjusting thresholds towards PAP ≥ 40 mmHg, E velocity ≥ 100 cm/s, E deceleration time < 220 ms, and E/septal e' ≥ 20 or septal e' < 5.0 cm/s increased prediction of NT-proBNP levels ≥500 ng/L with substantially improved specificity (> 85%).</p><p><strong>Conclusion: </strong>Diastolic echocardiographic parameters in AS indicate persistent impaired relaxation and NT-proBNP indicate elevated filling pressures in most of the patients, improving only modestly 6-12 months after TAVR and SAVR. Applying the 2016 ASE/EACVI recommendations for detection of elevated filling pressures to patients with AS, elevated NT pro-BNP levels could not be reliably detected. However, adjusting thresholds of the echocardiographic parameters increased specificities to useful diagnostic levels.</p><p><strong>Trial registration: </strong>The study was prospectively approved by the regional ethical committee, REK North with the registration number: REK 2010/397-10 .</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"32"},"PeriodicalIF":1.9,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8480046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39465672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency cardiac imaging for coronavirus disease 2019 (COVID-19) in practice: a case of takotsubo stress cardiomyopathy.","authors":"Oriana Belli,&nbsp;Maddalena Ardissino,&nbsp;Maurizio Bottiroli,&nbsp;Francesco Soriano,&nbsp;Calogero Blanda,&nbsp;Jacopo Oreglia,&nbsp;Michele Mondino,&nbsp;Antonella Moreo","doi":"10.1186/s12947-021-00251-4","DOIUrl":"https://doi.org/10.1186/s12947-021-00251-4","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular complications of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV2) are known to be associated with poor outcome. A small number of case series and reports have described cases of myocarditis and ischaemic events, however, knowledge on the aetiology of acute cardiac failure in SARS-CoV2 remains limited. We describe the occurrence and risk stratification imaging correlates of 'takotsubo' stress cardiomyopathy presenting in a patient with Coronavirus Disease 2019 (COVID-19) in the intensive care unit. An intubated 53-year old patient with COVID19 suffered acute haemodynamic collapse in the intensive care unit, and was thus investigated with transthoracic echocardiography (TTE), 12-lead electrocardiograms (ECG) and serial troponins and blood tests, and eventually coronary angiography due to clinical suspicion of ischaemic aetiology. Echocardiography revealed a reduced ejection fraction, with evident extensive apical akinesia spanning multiple coronary territories. Troponins and NT-proBNP were elevated, and ECG revealed ST elevation: coronary angiography was thus performed. This revealed no significant coronary stenosis. Repeat echocardiography performed within the following week revealed a substantial recovery of ejection fraction and wall motion abnormalities. Despite requirement of a prolonged ICU stay, the patient now remains clinically stable, and is on spontaneous breathing.</p><p><strong>Conclusion: </strong>This case report presents a case of takotsubo stress cardiomyopathy occurring in a critically unwell patient with COVID19 in the intensive care setting. Stress cardiomyopathy may be an acute cardiovascular complication of COVID-19 infection. In the COVID19 critical care setting, urgent bedside echocardiography is an important tool for initial clinical assessment of patients suffering haemodynamic compromise.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"31"},"PeriodicalIF":1.9,"publicationDate":"2021-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39340858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac amyloidosis screening using a relative apical sparing pattern in patients with left ventricular hypertrophy.","authors":"Yasuhisa Nakao,&nbsp;Makoto Saito,&nbsp;Katsuji Inoue,&nbsp;Rieko Higaki,&nbsp;Yuki Yokomoto,&nbsp;Akiyoshi Ogimoto,&nbsp;Moeko Suzuki,&nbsp;Hideo Kawakami,&nbsp;Go Hiasa,&nbsp;Hideki Okayama,&nbsp;Shuntaro Ikeda,&nbsp;Osamu Yamaguchi","doi":"10.1186/s12947-021-00258-x","DOIUrl":"https://doi.org/10.1186/s12947-021-00258-x","url":null,"abstract":"<p><strong>Background: </strong>Cardiac amyloidosis (CA) mimics left ventricular hypertrophy (LVH). It is treatable, but its prognosis is poor. A simple screening tool for CA would be valuable. CA is more precisely diagnosed with echocardiographic deformation parameters (e.g., relative apical sparing pattern [RASP]) than with conventional parameters. We aimed to 1) investigate incremental benefits of echocardiographic deformation parameters over established parameters for CA screening; 2) determine the resultant risk score for CA screening; and 3) externally validate the score in LVH patients.</p><p><strong>Methods: </strong>We retrospectively studied 295 consecutive non-ischemic LVH patients who underwent detailed diagnostic tests. CA was diagnosed with biopsy or ^99mTc-PYP scintigraphy. The base model comprised age (≥65 years [men], ≥70 years [women]), low voltage on the electrocardiogram, and posterior wall thickness ≥ 14 mm in reference to the literature. The incremental benefit of each binarized echocardiographic parameter over the base model was assessed using receiver operating characteristic curve analysis and comparisons of the area under the curve (AUC).</p><p><strong>Results: </strong>Fifty-four (18%) patients had CA. RASP showed the most incremental benefit for CA screening over the base model. After conducting multiple logistic regression analysis for CA screening using four variables (RASP and base model components), a score was determined (range, 0-4 points). The score demonstrated adequate discrimination ability for CA (AUC = 0.86). This result was confirmed in another validation cohort (178 patients, AUC = 0.88).</p><p><strong>Conclusions: </strong>We developed a score incorporating RASP for CA screening. This score is potentially useful in the risk stratification and management of LVH patients.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"30"},"PeriodicalIF":1.9,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39337317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in echocardiography: detection, functional evaluation, and disease diagnosis.","authors":"Jia Zhou,&nbsp;Meng Du,&nbsp;Shuai Chang,&nbsp;Zhiyi Chen","doi":"10.1186/s12947-021-00261-2","DOIUrl":"10.1186/s12947-021-00261-2","url":null,"abstract":"<p><p>Ultrasound is one of the most important examinations for clinical diagnosis of cardiovascular diseases. The speed of image movements driven by the frequency of the beating heart is faster than that of other organs. This particularity of echocardiography poses a challenge for sonographers to diagnose accurately. However, artificial intelligence for detection, functional evaluation, and disease diagnosis has gradually become an alternative for accurate diagnosis and treatment using echocardiography. This work discusses the current application of artificial intelligence in echocardiography technology, its limitations, and future development directions.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"29"},"PeriodicalIF":1.9,"publicationDate":"2021-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8379752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39330524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global and regional right ventricular mechanics in repaired tetralogy of Fallot with chronic severe pulmonary regurgitation: a three-dimensional echocardiography study.","authors":"Jurate Bidviene, Denisa Muraru, Attila Kovacs, Bálint Lakatos, Egle Ereminiene, Csilla Liptai, Jolanta-Justina Vaskelyte, Remigijus Zaliunas, Elena Surkova, Luigi P Badano","doi":"10.1186/s12947-021-00260-3","DOIUrl":"10.1186/s12947-021-00260-3","url":null,"abstract":"<p><strong>Background: </strong>Data about the right ventricular (RV) mechanics adaptation to volume overload in patients with repaired tetralogy of Fallot (rToF) are limited. Accordingly, we sought to assess the mechanics of the functional remodeling occurring in the RV of rToF with severe pulmonary regurgitation.</p><p><strong>Methods: </strong>We used three-dimensional transthoracic echocardiography (3DTE) to obtain RV data sets from 33 rToF patients and 30 age- and sex- matched controls. A 3D mesh model of the RV was generated, and RV global and regional longitudinal (LS) and circumferential (CS) strain components, and the relative contribution of longitudinal (LEF), radial (REF) and anteroposterior (AEF) wall motion to global RV ejection fraction (RVEF) were computed using the ReVISION method.</p><p><strong>Results: </strong>Corresponding to decreased global RVEF (45 ± 6% vs 55 ± 5%, p < 0.0001), rToF patients demonstrated lower absolute values of LEF (17 ± 4 vs 28 ± 4), REF (20 ± 5 vs 25 ± 4) and AEF (17 ± 5 vs 21 ± 4) than controls (p < 0.01). However, only the relative contribution of LEF to global RVEF (0.39 ± 0.09 vs 0.52 ± 0.05, p < 0.0001) was significantly decreased in rToF, whereas the contribution of REF (0.45 ± 0.08 vs 0.46 ± 0.04, p > 0.05) and AEF (0.38 ± 0.09 vs 0.39 ± 0.04, p > 0.05) to global RVEF was similar to controls. Accordingly, rToF patients showed lower 3D RV global LS (-16.94 ± 2.9 vs -23.22 ± 2.9, p < 0.0001) and CS (-19.79 ± 3.3 vs -22.81 ± 3.5, p < 0.01) than controls. However, looking at the regional RV deformation, the 3D CS was lower in rToF than in controls only in the basal RV free-wall segment (p < 0.01). 3D RV LS was reduced in all RV free-wall segments in rToF (p < 0.0001), but similar to controls in the septum (p > 0.05).</p><p><strong>Conclusions: </strong>3DTE allows a quantitative evaluation of the mechanics of global RVEF. In rToF with chronic volume overload, the relative contribution of the longitudinal shortening to global RVEF is affected more than either the radial or the anteroposterior components.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"28"},"PeriodicalIF":1.9,"publicationDate":"2021-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8349004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39287420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The feasibility, reliability, and incremental value of two-dimensional speckle-tracking for the detection of significant coronary stenosis after treadmill stress echocardiography.","authors":"Marc-André d'Entremont,&nbsp;Gabriel Fortin,&nbsp;Thao Huynh,&nbsp;Étienne Croteau,&nbsp;Paul Farand,&nbsp;Samuel Lemaire-Paquette,&nbsp;Marie-Claude Brochu,&nbsp;Doan Hoa Do,&nbsp;Serge Lepage,&nbsp;Warner Mbuila Mampuya,&nbsp;Étienne L Couture,&nbsp;Michel Nguyen,&nbsp;Btissama Essadiqi","doi":"10.1186/s12947-021-00259-w","DOIUrl":"https://doi.org/10.1186/s12947-021-00259-w","url":null,"abstract":"<p><strong>Background: </strong>Two-dimensional speckle-tracking echocardiography (STE) may help detect coronary artery disease (CAD) when combined with dobutamine stress echocardiography. However, few studies have explored STE with exercise stress echocardiography (ESE). We aimed to evaluate the feasibility, reliability, and incremental value of STE combined with treadmill ESE compared to treadmill ESE alone to detect CAD.</p><p><strong>Methods: </strong>We conducted a case-control study of all consecutive patients with abnormal ESE in 2018-2020 who subsequently underwent coronary angiography within a six-month interval. We 1:1 propensity score-matched these patients to those with a normal ESE. Two blinded operators generated a 17-segment bull's-eye map of longitudinal strain (LS). We utilized the mean differences between stress and baseline LS values in segments 13-17, segment 17, and segments 15-16 to create receiver operator curves for the overall examination, the left anterior descending artery (LAD), and the non-LAD territories, respectively.</p><p><strong>Results: </strong>We excluded 61 STEs from 201 (30.3%) eligible ESEs; 47 (23.4%) because of suboptimal image quality and 14 (7.0%) because of excessive heart rate variability precluding the calculation of a bull's-eye map. After matching, a total of 102 patients were included (51 patients in each group). In the group with abnormal ESE patients (mean age 66.4 years, 39.2% female), 64.7% had significant CAD (> 70% stenosis) at coronary angiogram. In the group with normal ESE patients (mean age 65.1 years, 35.3% female), 3.9% were diagnosed with a new significant coronary stenosis within one year. The intra-class correlation for global LS was 0.87 at rest and 0.92 at stress, and 0.84 at rest, and 0.89 at stress for the apical segments. The diagnostic accuracy of combining ESE and STE was superior to visual assessment alone for the overall examination (area under the curve (AUC) = 0.89 vs. 0.84, p = 0.025), the non-LAD territory (AUC = 0.83 vs. 0.70, p = 0.006), but not the LAD territory (AUC = 0.79 vs. 0.73, p = 0.11).</p><p><strong>Conclusions: </strong>Two-dimensional speckle-tracking combined with treadmill ESE is relatively feasible, reliable, and may provide incremental diagnostic value for the detection and localization of significant CAD.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"27"},"PeriodicalIF":1.9,"publicationDate":"2021-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00259-w","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39215142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonography to detect cardiovascular damage in children with essential hypertension.","authors":"Wei Liu,&nbsp;Cui Hou,&nbsp;Miao Hou,&nbsp;Qiu-Qin Xu,&nbsp;Hui Wang,&nbsp;Pei-Pei Gu,&nbsp;Ling Sun,&nbsp;Hai-Tao Lv,&nbsp;Yue-Yue Ding","doi":"10.1186/s12947-021-00257-y","DOIUrl":"https://doi.org/10.1186/s12947-021-00257-y","url":null,"abstract":"<p><strong>Background: </strong>Essential hypertension in adults may begin in childhood. The damages to the heart and blood vessels in children with essential hypertension are hidden and difficult to detect. We noninvasively examined changes in cardiovascular structure and function in children with hypertension at early stage using ultrasonography.</p><p><strong>Methods: </strong>All patients with essential hypertension admitted from March 2020 to May 2021 were classified into simple hypertension (group 1, n = 34) and hypertension co-existing with obesity (group 2, n = 11) isolation. Meanwhile 32 healthy children were detected as control heathly group (group 3). We used pulse-wave Doppler to measure carotid-femoral pulse wave velocity (cfPWV), intimal-medial thickness (cIMT) and distensibility of carotid artery (CD). Cardiac structure and function (left atrial diameter [LAD], left ventricular mass [LVM], LVM index [LVMI], relative wall thicknes [RWT], end-diastolic left ventricular internal diameter [LVIDd], diastolic interventricular septum thickness [IVSd], diastolic left ventricular posterior wall thickness [LVPWd], root diameter of aorta [AO], E peak, A peak, E' peak, A' peak, E/E' ratio, and E/A ratio) were measured by echocardiography.</p><p><strong>Results: </strong>The cfPWV of children in group 1 and group 2 were significantly higher than healthy children in group 3. Significant differences were observed in LVM, LVMI, RWT, LVIDd, IVSd, LVPWd, LAD, A peak, E' peak, A' peak, and E/E' among three groups.</p><p><strong>Conclusion: </strong>Children and adolescents with essential hypertension demonstrate target organ damages in the heart and blood vessels.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"26"},"PeriodicalIF":1.9,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00257-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39206533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of prenatal changes in fetal cardiac morphology and function in maternal diabetes mellitus using a novel fetal speckle-tracking analysis: a prospective cohort study.","authors":"Dong Wang,&nbsp;Caixia Liu,&nbsp;Xinyu Liu,&nbsp;Ying Zhang,&nbsp;Yu Wang","doi":"10.1186/s12947-021-00256-z","DOIUrl":"https://doi.org/10.1186/s12947-021-00256-z","url":null,"abstract":"<p><strong>Background: </strong>Due to metabolic changes in the second trimester and the increasing number of pregnant women with obesity and advanced maternal age, the incidence of gestational diabetes mellitus (GDM) remains high. This study aimed to evaluate the effects of GDM on fetal cardiac morphology and function, and to determine whether these changes increase with increasing estimated fetal weight (EFW).</p><p><strong>Methods: </strong>Fifty-eight women with GDM (GDM group) and 58 women with a healthy pregnancy (control group) were included in this prospective observational cohort study. Each group included subgroups of 31 pregnant women with a gestational age between 24⁺⁰ weeks and 27⁺⁶ weeks as well as 27 pregnant women with a gestational age between 28⁺⁰ weeks and 40⁺⁰ weeks. For all fetuses, a cine of 2-3 s in the four-chamber view was obtained, and online speckle-tracking analysis was performed using the GE Automatic Fetal Heart Assessment Tool (fetal HQ; General Electric Healthcare Ultrasound, Zipf, Austria) to measure the global sphericity index (GSI), global longitudinal strain (GLS), fractional area change (FAC), 24-segment sphericity index (SI), and 24-segment end-diastolic diameter of the left ventricle (LV) and right ventricle (RV). Data were analyzed using the independent t-test and Wilcoxon rank-sum test, as applicable.</p><p><strong>Results: </strong>The GDM group (mean HbA1c value was 5.3 ± 0.57 mmol/L) showed a lower GSI value than the control group (1.21 vs. 1.27, P = 0.000), which indicated a rounder shape of the heart. In addition, fetuses in the GDM group demonstrated significant impairment in cardiac function compared to those in the control group (LV-GLS: -18.26% vs. -22.70%, RV-GLS: -18.52% vs. -22.74%, LV-FAC: 35.30% vs. 42.36%, RV-FAC: 30.89% vs. 36.80%; P = 0.000 for all). Subgroup analyses according to gestational age (24⁺⁰-27⁺⁶ weeks and 28⁺⁰-40⁺⁰ weeks) showed that the statistical differences were retained between the GDM and control groups in each subgroup.</p><p><strong>Conclusions: </strong>Fetuses of women with GDM present with signs of biventricular systolic dysfunction according to deformation analysis using fetal HQ. Additionally, the heart had a rounder shape in the GDM group than in the control group. This study showed that fetal HQ can be used to assess fetal cardiac morphology and function easily and quickly, and the effects of GDM on fetal cardiac morphology and function appeared from the second trimester. Thus, whether earlier and stricter clinical intervention was necessary remained to be further studied. Furthermore, future studies will need to supplement the effects of blood glucose levels on GLS, FAC, GSI, and 24-segment SI. Additionally, the long-term follow-up after birth should also be improved to observe the influence of changes in the indicators on the prognosis.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"25"},"PeriodicalIF":1.9,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00256-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39125208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Afterload-related reference values for myocardial work indices.","authors":"Qiancheng Li,&nbsp;Hui Wang,&nbsp;Haiyan Feng,&nbsp;Tingfan Wu,&nbsp;Ying Yang,&nbsp;Dongmei Gao,&nbsp;Lina Sun","doi":"10.1186/s12947-021-00253-2","DOIUrl":"https://doi.org/10.1186/s12947-021-00253-2","url":null,"abstract":"<p><strong>Background: </strong>The novel noninvasive pressure-strain loop (PSL) is a reliable tool that reflects myocardial work (MW). Systolic blood pressure (SBP) is the only independent factor for MW indices. However, afterload-related reference values have not been previously reported. The aim of the present study was to establish reference values for MW parameters by wide range SBP grading.</p><p><strong>Methods: </strong>We prospectively selected healthy individuals and subjects with SBP ≥ 140 mmHg at the time of study without myocardial remodeling. MW parameters were collected and the reference values achieved were grouped by SBP in 10-mmHg.</p><p><strong>Results: </strong>Significant differences were noted among the SBP-groups for global work index (GWI) and global constructive work (GCW). The majority of statistical comparisons of the differences in GWI and GCW were significant at each SBP-group. With SBP ranging from 90 to 189 mmHg, the parameters GWI and GCW tended to increase linearly with afterload. Overall, the global wasted work (GWW) tended to rise as SBP was increased, but not all of the differences noted in GWW were significant for each SBP-group. Global work efficiency (GWE) remained stable across all SBP-groups, with the exception of a slight drop noted when it exceeded 160 mmHg.</p><p><strong>Conclusions: </strong>The amount of MW but not the work efficiency varied greatly according to the different afterload. This finding cannot be ignored during clinical research or diagnosis and afterload-related reference values are required to make a reasonable judgment on the myocardial function.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"24"},"PeriodicalIF":1.9,"publicationDate":"2021-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00253-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39024068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}