Cardiovascular Ultrasound最新文献

{"title":"The impact of native Fallot anatomy on future therapeutic requirements and outcomes at follow-up.","authors":"Antonio Ravaglioli,&nbsp;Lamia Ait-Ali,&nbsp;Duccio Federici,&nbsp;Stefano Salvadori,&nbsp;Arketa Pllumi,&nbsp;Vitali Pak,&nbsp;Chiara Marrone,&nbsp;Alessandra Pizzuto,&nbsp;Philipp Bonhoeffer,&nbsp;Pierluigi Festa","doi":"10.1186/s12947-021-00249-y","DOIUrl":"https://doi.org/10.1186/s12947-021-00249-y","url":null,"abstract":"<p><strong>Background: </strong>In patients with repaired Fallot, subsequent surgical or interventional procedures and adverse cardiac events are frequent. We aimed to evaluate the impact of a simple pre-operative anatomic classification based on the size of the pulmonary valve (PV) annulus and branches on future therapeutic requirements and outcomes.</p><p><strong>Method: </strong>This is a single-center retrospective analysis of patients operated for Fallot before the age of 2 years, from January 1990. Pre-operative anatomy, surgical and interventional procedures and adverse events were extrapolated from clinical records.</p><p><strong>Results: </strong>Among the 312 patients, a description of the PV and pulmonary arteries (PAs) native anatomy was known in 239 patients (male:147, 61.5%), which were divided in the following 3 groups: group 1 (65 patients) with normal size of both PV and PAs; group 2 (108 patients) with PV hypoplasia but normal size PAs; group 3 (66 patients) with concomitant hypoplasia of the PV and PAs. During the 12.7 years (IQR 6.7-17) follow-up time, 23% of patients required at least one surgical or interventional procedure. At Kaplan-Meier analysis, there was a significant difference in requirement of future surgical or interventional procedures among the 3 groups (p < 0,001). At multivariate Cox regression analysis, hypoplasia of PV and PAs was an independent predictor of subsequent procedures (HR:3.1,CI:1.06-9.1, p = 0.03).</p><p><strong>Conclusion: </strong>Native anatomy in Tetralogy of Fallot patients affects surgical strategy and follow-up. It would be therefore advisable to tailor patient's counseling and follow-up according to native anatomy, rather than following a standardized protocol.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"23"},"PeriodicalIF":1.9,"publicationDate":"2021-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00249-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39247893","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":"Post Procedural Peak Left Atrial Contraction Strain Predicts Recurrence of Arrhythmia after Catheter Ablation of Atrial Fibrillation.","authors":"Songnan Wen,&nbsp;Manasawee Indrabhinduwat,&nbsp;Peter A Brady,&nbsp;Cristina Pislaru,&nbsp;Fletcher A Miller,&nbsp;Naser M Ammash,&nbsp;Vuyisile T Nkomo,&nbsp;Ratnasari Padang,&nbsp;Sorin V Pislaru,&nbsp;Grace Lin","doi":"10.1186/s12947-021-00250-5","DOIUrl":"https://doi.org/10.1186/s12947-021-00250-5","url":null,"abstract":"<p><strong>Background: </strong>Left atrial (LA) function can be impaired by the atrial fibrillation (AF) ablation and might be associated with the risk of recurrence. We sought to determine whether the post-procedural changes in LA function impact the risk of recurrence following AF ablation.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent AF ablation between 2009 and 2011 and underwent transthoracic echocardiography before ablation, 1-day and 3-month after ablation. Peak left atrial contraction strain (PACS) and left atrial emptying fraction (LAEF) were evaluated during sinus rhythm and compared across the three time points. The primary endpoint was atrial tachyarrhythmia recurrence after ablation.</p><p><strong>Results: </strong>A total of 144 patients were enrolled (mean age 61 ± 11 years, 77% male, 46% persistent AF). PACS and LAEF initially decreased 1-day following ablation but partially recovered within 3 months in PAF patients, with a similar trend in the PerAF patients. After median 24 months follow-up, 68 (47%) patients had recurrence. Patients with recurrence had higher PACS_1-day than that in non-recurrence subjects (-10.9 ± 5.0% vs. -13.4 ± 4.7%, p = 0.003). PACS_1-day -12% distinguished recurrence cases with a sensitivity of 67.7% and specificity of 60.5%. The Kaplan-Meier curves showed significant difference in 5-year cumulative probability of recurrence between those with PACS ≥ -12% and PACS < -12% (log rank p < 0.0001). Multivariate regression showed that PACS_1-day was an independent risk factor of arrhythmia recurrence.</p><p><strong>Conclusions: </strong>Left atrial function deteriorates immediately following AF ablation and partially recovers in 3 months but remains abnormal in the majority of patients. PACS_1-day post procedure predicts arrhythmia recurrence at long-term follow-up.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"22"},"PeriodicalIF":1.9,"publicationDate":"2021-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00250-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39083867","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":"Characteristics and prognosis of patients with cryptogenic stroke and suggestive of patent foramen ovale.","authors":"Jaehuk Choi,&nbsp;Min-Kyung Kang,&nbsp;Jin-Sun Jun,&nbsp;Dong Geum Shin,&nbsp;Donghoon Han,&nbsp;Seonghoon Choi,&nbsp;Jung Rae Cho,&nbsp;Namho Lee","doi":"10.1186/s12947-021-00255-0","DOIUrl":"https://doi.org/10.1186/s12947-021-00255-0","url":null,"abstract":"<p><strong>Aims: </strong>The purpose of this study were to identify the usefulness of screening for PFO using agitated saline echocardiography (ASE) and characteristics and prognosis of patients with suggestive of patent foramen ovale (PFO).</p><p><strong>Methods: </strong>Three hundred three patients (mean age, 53 ± 9 years; 199 [66%] men) admitted with acute stroke or suspicion of stroke were included. Patients were classified into those with and without right-to-left shunt (RLS) according to the ASE results (positive ASE [n = 92] vs. negative ASE [n = 211]). Fifty-one out of ninety-two patients with positive ASE and twenty-one out of two hundred eleven patients with negative ASE underwent TEE with ASE to confirm PFO.</p><p><strong>Results: </strong>Ninety-two were positive for ASE and thirty-six of the fifty-one patients who underwent TEE were confirmed as having PFO. Of the patients with RLS grade 1, 50% were diagnosed with PFO and all patients with RLS grade ≥ 2 were diagnosed with PFO. All patients with negative ASE had no PFO (sensitivity of 100% and specificity of 58%). Patients with positive ASE were younger, had a lower body mass, and a lower prevalence of hypertension. The positive ASE patients had a higher mean S' velocity and better diastolic function. Four of ninety-one patients with positive ASE and thirteen of one hundred seventy-seven showed recurrence of stroke and suspicion of stroke.</p><p><strong>Conclusion: </strong>Transthoracic ASE is a good method to screen for PFO. Patients with suggestive of PFO had lower risk factors, less atherosclerosis, and better cardiac performance.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"20"},"PeriodicalIF":1.9,"publicationDate":"2021-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00255-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39063121","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":"Left ventricular global longitudinal strain predicts elevated cardiac pressures and poor clinical outcomes in patients with non-ischemic dilated cardiomyopathy.","authors":"Ieva Kažukauskienė,&nbsp;Giedrė Balčiūnaitė,&nbsp;Vaida Baltrūnienė,&nbsp;Jelena Čelutkienė,&nbsp;Vytė Valerija Maneikienė,&nbsp;Sigitas Čibiras,&nbsp;Kęstutis Ručinskas,&nbsp;Virginija Grabauskienė","doi":"10.1186/s12947-021-00254-1","DOIUrl":"https://doi.org/10.1186/s12947-021-00254-1","url":null,"abstract":"<p><strong>Background: </strong>Risk stratification in patients with non-ischemic dilated cardiomyopathy (NI-DCM) is essential to treatment planning. Global longitudinal strain (GLS) predicts poor prognosis in various cardiac diseases, but it has not been evaluated in a cohort of exclusively NI-DCM. Although deformation parameters have been shown to reflect diastolic function, their association with other hemodynamic parameters needs further elucidation. We aimed to evaluate the association between GLS and E/GLS and invasive hemodynamic parameters and assess the prognostic value of GLS and E/GLS in a prospective well-defined pure NI-DCM cohort.</p><p><strong>Methods and results: </strong>Forty-one patients with NI-DCM were enrolled in the study. They underwent a standard diagnostic workup, including transthoracic echocardiography and right heart catheterization. During a five-year follow-up, 20 (49%) patients reached the composite outcome measure: LV assist device implantation, heart transplantation, or cardiovascular death. Pulmonary capillary wedge pressure (PCWP), mean pulmonary artery pressure, pulmonary vascular resistance (PVR) correlated with GLS and E/GLS (p < 0.05). ROC analysis revealed that GLS and E/GLS could identify elevated PCWP (≥ 15 mmHg) and PVR (> 3 Wood units). Survival analysis showed GLS and E/GLS to be associated with short- and long-term adverse cardiac events (p < 0.05). GLS values above thresholds of -5.34% and -5.96% indicated 18- and 12-fold higher risk of poor clinical outcomes at one and five years, respectively. Multivariate Cox regression analysis revealed that GLS is an independent long-term outcome predictor.</p><p><strong>Conclusion: </strong>GLS and E/GLS correlate with invasive hemodynamics parameters and identify patients with elevated PCWP and high PVR. GLS and E/GLS predict short- and long-term adverse cardiac events in patients with NI-DCM. Worsening GLS is associated with incremental risk of long-term adverse cardiac events and might be used to identify high-risk patients.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"21"},"PeriodicalIF":1.9,"publicationDate":"2021-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00254-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38984359","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":"Feasibility of focused cardiac ultrasound during cardiac arrest in the emergency department.","authors":"Jessica R Balderston,&nbsp;Alan X You,&nbsp;David P Evans,&nbsp;Lindsay A Taylor,&nbsp;Zachary M Gertz","doi":"10.1186/s12947-021-00252-3","DOIUrl":"https://doi.org/10.1186/s12947-021-00252-3","url":null,"abstract":"<p><strong>Background: </strong>Focused cardiac ultrasound (FOCUS) can aid in evaluation and management of patients with cardiac arrest, but image quality in this population has been questioned. Our goal was to determine how often adequate imaging can be obtained in cardiac arrest patients.</p><p><strong>Methods: </strong>We conducted a prospective cohort study to examine the utility of FOCUS in cardiac arrest. All patients who presented to the Emergency Department (ED) in cardiac arrest or who had cardiac arrest while in the ED over 6 months were prospectively identified. FOCUS images were obtained as part of routine clinical care. Patients with images obtained were paired with age- and gender-matched controls who underwent FOCUS for another indication during the study period. Image quality was scored by two blinded reviewers using a 0-4 scale, with a score of ≥ 2 considered adequate.</p><p><strong>Results: </strong>There were 137 consecutive cardiac arrests, 121 out-of-hospital and 16 in-hospital, during the study period. FOCUS images were recorded in 126 (92%), who were included in the analysis. The average age was 58 years, and 45% were female. Ninety-seven studies (77%) were obtained during advanced cardiac life support while 29 (23%) were obtained after return of spontaneous circulation. The controls were appropriately matched. Of the cardiac arrest studies, 106 (84%) were rated adequate, compared to 116 (92%) in controls (p = 0.08). When compared to control FOCUS studies, the scores given to studies of cardiac arrest patients were lower (p = 0.001).</p><p><strong>Conclusions: </strong>FOCUS can reliably be used during cardiac arrest to obtain images adequate to answer clinical questions and guide therapies.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"19"},"PeriodicalIF":1.9,"publicationDate":"2021-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00252-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39021124","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 fetal foramen ovale blood flow by pulsed Doppler ultrasonography combined with spatiotemporal image correlation : To define the normal reference range of fetal foramen ovale blood volume for each gestational age: a cross-sectional study.","authors":"Wenjuan Tang,&nbsp;Yuanchen Luo,&nbsp;Shi Zeng,&nbsp;Jiawei Zhou,&nbsp;Ganqiong Xu,&nbsp;Jianwen Yang","doi":"10.1186/s12947-021-00247-0","DOIUrl":"https://doi.org/10.1186/s12947-021-00247-0","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to determine fetal foramen ovale blood flow utilizing pulsed Doppler combined with spatiotemporal image correlation.</p><p><strong>Methods: </strong>A cross-sectional study was performed in 440 normal fetuses between 20 and 40 weeks of gestation. In order to calculate foramen ovale blood flow, the foramen ovale flow velocity-time integral was obtained by pulsed Doppler ultrasonography, and the foramen ovale area was measured by using spatiotemporal image correlation rendering mode. Foramen ovale blood flow was calculated as the product of the foramen ovale area and the velocity-time integral.</p><p><strong>Results: </strong>Gestational age-specific reference ranges are given for the absolute blood flow (ml/min) of foramen ovale, showing an exponential increase from 20 to 30 weeks of gestation, and a flat growth trend during the last trimester, while the weight-indexed flow (ml/min/kg) of foramen ovale decreased significantly. The median weight-indexed foramen ovale blood flow was 320.82 ml/min/kg (mean 319.1 ml/min/kg; SD 106.33 ml/min/kg).</p><p><strong>Conclusions: </strong>The reference range for fetal foramen ovale blood flow was determined from 20 to 40 weeks of gestation. The present data show that the volume of foramen ovale blood flow might have a limited capacity to increase during the last trimester.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"18"},"PeriodicalIF":1.9,"publicationDate":"2021-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00247-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38952983","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":"Mitral early-diastolic inflow peak velocity (E)-to-left atrial strain ratio as a novel index for predicting elevated left ventricular filling pressures in patients with preserved left ventricular ejection fraction.","authors":"You Zhou,&nbsp;Cai-Ming Zhao,&nbsp;Zhen-Ya Shen,&nbsp;Xin Zhao,&nbsp;Bing-Yuan Zhou","doi":"10.1186/s12947-021-00248-z","DOIUrl":"https://doi.org/10.1186/s12947-021-00248-z","url":null,"abstract":"<p><strong>Objectives: </strong>We sought to explore the relationship between an index of left ventricular diastolic function parameters combined with left atrial strain and the diastolic function of patients with preserved ejection fraction.</p><p><strong>Methods: </strong>We prospectively enrolled 388 patients with left ventricular ejection fraction (LVEF) ≥ 50%, 49 of whom underwent left heart catherization. Transthoracic echocardiography was performed within 12 h before or after the procedure. Left atrial (LA) strain was obtained by speckle tracking echocardiography. These patients served as the test group. The remaining patients (n = 339) were used to validate the diagnostic performance of the mitral early-diastolic inflow peak velocity (E)-to-left atrial reservoir strain ratio (E/LASr) in left ventricular diastolic dysfunction.</p><p><strong>Results: </strong>Invasive measurements of LV end-diastolic pressure (LVEDP) demonstrated that the E/LASr ratio was increased in patients with elevated LVEDP [ 2.0 (1.8-2.2) vs 3.0 (2.6-4.0), p < 0.001] in the test group (n = 49). After adjusting for age, mitral A, E/e' ratio and β-blocker use, the E/LASr ratio was an independent predictor of elevated LVEDP and showed good diagnostic performance in determining elevated LVEDP [area under the curve (AUC) 0.903, cutoff value 2.7, sensitivity 74.2%, specificity 94.4%]. In the validation group (n = 339), the E/LASr ratio also performed well in diagnosing elevated left atrial pressure (LAP) (AUC 0.904, cutoff value 3.2, sensitivity 76.5%, specificity 89.0%), while with a cut-off value of 2.7, the E/LASr ratio showed high accuracy in discriminating elevated LAP. In addition, E/LASr was a good index of excellent diagnostic utility (AUC: 0.899 to 0.996) in the categorization of diastolic dysfunction grades. Regarding the clinical relevance of this index, the E/LASr ratio could accurately diagnose HF with preserved ejection fraction (HFpEF) (0.781), especially in patients with \"indeterminate\" status (AUC: 0.829). Furthermore, an elevated E/LASr ratio was significantly associated with the risk of rehospitalization due to major adverse cardiac events (MACEs) within one year (odds ratio: 1.183, 95% confidence interval: 1.067, 1.312).</p><p><strong>Conclusions: </strong>In patients with EF preservation, the E/LASr ratio is a novel index for assessing elevated left ventricular filling pressure with high accuracy.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"17"},"PeriodicalIF":1.9,"publicationDate":"2021-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00248-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38904878","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":"Impact of concomitant tricuspid annuloplasty on right ventricular remodeling in patients with rheumatic mitral valve disease.","authors":"Yue Zhong,&nbsp;Wenjuan Bai,&nbsp;Hui Wang,&nbsp;Hong Qian,&nbsp;Li Rao","doi":"10.1186/s12947-021-00245-2","DOIUrl":"https://doi.org/10.1186/s12947-021-00245-2","url":null,"abstract":"<p><strong>Background: </strong>Studies on the management of functional tricuspid regurgitation (TR) during mitral valve operations have drawn inconsistent conclusions. This study was designed to compare the treatment strategy of concomitant tricuspid annuloplasty (TAP) against isolated mitral valve replacement (MVR) in rheumatic mitral valve disease patients, and to assess the effect of concomitant TAP on postoperative right ventricular (RV) remodeling and function.</p><p><strong>Methods: </strong>One hundred-seventy patients with rheumatic mitral valve disease receiving MVR were categorized into TAP group (n = 124) and non-TAP group (n = 46). Clinical and echocardiographic data were collected preoperatively and at 1-year follow-up. Three-dimensional echocardiographic indices of RV geometry and function were analyzed.</p><p><strong>Results: </strong>At baseline, concomitant TAP group had larger RV end-diastolic volume, more decreased RV ejection fraction and RV longitudinal strain than non-TAP group (all P <  0.001). At 1-year follow-up, TAP group had improved RV geometry and function. While adverse changes were observed in non-TAP group. In analysis of variance, the above indices demonstrated significant interaction with different treatment group (all P <  0.001). In multivariate regression analysis, independent of age and Maze procedure, concomitant TAP was associated with postoperative RV volume reduction (P <  0.001), improvement of RV ejection fraction (P <  0.001), and relieved postoperative functional TR severity (P = 0.025).</p><p><strong>Conclusions: </strong>Our results suggest that concomitant TAP could improve RV remodeling and function for rheumatic mitral valve disease patients, while those with mild preoperative functional TR who had isolated MVR might experience RV dilation and deterioration of RV function at follow-up. Concomitant surgery for functional TR could be considered for patients undergoing MVR with rheumatic mitral valve disease.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"16"},"PeriodicalIF":1.9,"publicationDate":"2021-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00245-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25439250","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":"Layer-specific strain echocardiography may reflect regional myocardial impairment in patients with hypertrophic cardiomyopathy.","authors":"Zhongxiu Chen,&nbsp;Chunmei Li,&nbsp;Yajiao Li,&nbsp;Li Rao,&nbsp;Xiaoling Zhang,&nbsp;Dan Long,&nbsp;Chen Li","doi":"10.1186/s12947-021-00244-3","DOIUrl":"https://doi.org/10.1186/s12947-021-00244-3","url":null,"abstract":"<p><p>Our study aimed to determine whether layer-specific strain (LSS) could reflect regional myocardial impairment in patients with hypertrophic cardiomyopathy (HCM). The study enrolled 50 patients with HCM and 30 age-matched healthy controls. Transmural gradient of longitudinal strain (TGLS), defined as the difference between the longitudinal strain of the endocardium and epicardium in a left ventricular segment, was used to reflect layer-specific myocardial impairment. Negative TGLS was consistently observed in healthy controls. The TGLS was relatively consistent within the basal, middle, and apical levels in healthy controls,but showed a significant gradient from the base towards the apex. In patients with HCM, the hypertrophic segments had significantly higher TGLS than the relatively normal segments or healthy controls at all 3 levels (0.14 % ± 3.48 % vs. -2.65 % ± 4.44 % vs. -2.17 % ± 1.66 % for basal, - 0.72 % ± 3.71 % vs. -4.02 % ± 4.00 % vs. -3.58 % ± 2.29 % for middle, and - 8.69 % ± 7.96 % vs. -11.44 % ± 6.65 % vs. -10.04 % ± 3.20 % for apex). Abnormal TGLS, defined as positive TGLS, in patients with HCM was associated with chest pain. In receiver operating characteristic curve analysis, a large area of abnormal TGLS (> 4 segments) had moderate accuracy for predicting chest pain (sensitivity, 73.3 %; specificity, 70.0 %). TGLS, a novel LSS derived parameter, may reflect regional myocardial impairment in patients with HCM.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"15"},"PeriodicalIF":1.9,"publicationDate":"2021-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00244-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25434212","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":"Pre- and postoperative left atrial and ventricular volumetric and deformation analyses in severe aortic regurgitation.","authors":"Jonas Jenner,&nbsp;Ali Ilami,&nbsp;Johan Petrini,&nbsp;Per Eriksson,&nbsp;Anders Franco-Cereceda,&nbsp;Maria J Eriksson,&nbsp;Kenneth Caidahl","doi":"10.1186/s12947-021-00243-4","DOIUrl":"https://doi.org/10.1186/s12947-021-00243-4","url":null,"abstract":"<p><strong>Background: </strong>The impact of volume overload due to aortic regurgitation (AR) on systolic and diastolic left ventricular (LV) indices and left atrial remodeling is unclear. We assessed the structural and functional effects of severe AR on LV and left atrium before and after aortic valve replacement.</p><p><strong>Methods: </strong>Patients with severe AR scheduled for aortic valve replacement (n = 65) underwent two- and three-dimensional echocardiography, including left atrial strain imaging, before and 1 year after surgery. A control group was selected, and comprised patients undergoing surgery for thoracic aortic aneurysm without aortic valve replacement (n = 20). Logistic regression analysis was used to assess predictors of impaired left ventricular functional and structural recovery, defined as a composite variable of diastolic dysfunction grade ≥ 2, EF < 50%, or left ventricular end-diastolic volume index above the gender-specific normal range.</p><p><strong>Results: </strong>Diastolic dysfunction was present in 32% of patients with AR at baseline. Diastolic LV function indices and left atrial strain improved, and both left atrial and LV volumes decreased in the AR group following aortic valve replacement. Preoperative left atrial strain during the conduit phase added to left ventricular end-systolic volume index for the prediction of impaired LV functional and structural recovery after aortic valve replacement (model p < 0.001, accuracy 70%; addition of left atrial strain during the conduit phase to end-systolic volume index p = 0.006).</p><p><strong>Conclusions: </strong>One-third of patients with severe AR had signs of diastolic dysfunction. Aortic valve surgery reduced LV and left atrial volumes and improved diastolic indices. Left atrial strain during the conduit phase added to the well-established left ventricular end-diastolic dimension for the prediction of impaired left ventricular functional and structural recovery at follow-up. However, long-term follow-up studies with hard endpoints are needed to assess the value of left atrial strain as predictor of myocardial recovery in aortic regurgitation.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"19 1","pages":"14"},"PeriodicalIF":1.9,"publicationDate":"2021-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12947-021-00243-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25367174","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}