K. Badaoui, H. Bendahou, M. Haboub, S. Arous, A. Drighil, R. Habbal
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The aim of this study is to assess a </span>left ventricle (LV) dyssynchrony using 2D-STE analysis in this population.</p></div><div><h3>Method</h3><p>This is a prospective study, conducted from March 2020 to October 2022 which included DM1 with normal LV ejection fraction (LVEF) and control patients with comprehensive resting echocardiography. Three measures were performed to assess LV mechanical dyssynchrony: opposing-wall delays (longitudinal and radial analyses), modified Yu index, and time to-peak delays of each segment.</p></div><div><h3>Results</h3><p>Mean age was 23<!--> <!-->±<!--> <!-->7<!--> <!-->years. All three mechanical dyssynchrony criteria were significantly higher in the DM1 group than in healthy subjects: opposing-wall delays in basal inferoseptal to basal anterolateral segments (61.4<!--> <!-->±<!--> <!-->45.3<!--> <!-->msec vs. 18.3<!--> <!-->±<!--> <!-->50.4<!--> <!-->msec, <em>P</em> <!--><<!--> <!-->0.001, respectively) and in mid inferoseptal to mid anterolateral segments (58.6<!--> <!-->±<!--> <!-->35.3<!--> <!-->msec vs. 42.4<!--> <!-->±<!--> <!-->36.4<!--> <!-->msec, <em>P</em> <!--><<!--> <!-->0.05, respectively) (Fig. 1), modified Yu index (33.3<!--> <!-->±<!--> <!-->10.1<!--> <!-->msec vs. 28.5<!--> <!-->±<!--> <!-->8.1<!--> <!-->msec, <em>P</em> <!--><<!--> <!-->0.05, respectively), and most of time-to-peak values, especially in basal and mid anterolateral segments.</p></div><div><h3>Conclusion</h3><p>The existence of an early LV mechanical dyssynchrony using 2D-STE analysis in DM1 patients before the onset of cardiomyopathy represents a perspective for early prediction of sudden heart death. However, are ICDs really beneficial in terms of improving overall survival, in patients with conduction system disease often presenting more severe forms of myotonic dystrophy itself. Mean corrected time-to-peak delays.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessment of left ventricular dyssynchrony by speckle tracking echocardiography in patients with Steinert's disease\",\"authors\":\"K. Badaoui, H. Bendahou, M. Haboub, S. Arous, A. Drighil, R. Habbal\",\"doi\":\"10.1016/j.acvdsp.2023.04.038\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Conduction system abnormalities and myocardial dysfunction are observed in patients<span> with myotonic dystrophy type 1 (DM1) and may represent the initial manifestations of the disease.</span></p><p><span>Some studies have shown improvements of outcomes with use of early cardiac resynchronization therapy (CRT) in DM1 patients. Two-dimensional speckle tracking echocardiography (2D-STE) has recently emerged as a non-invasive biomarker for early detection of dyssynchrony. The aim of this study is to assess a </span>left ventricle (LV) dyssynchrony using 2D-STE analysis in this population.</p></div><div><h3>Method</h3><p>This is a prospective study, conducted from March 2020 to October 2022 which included DM1 with normal LV ejection fraction (LVEF) and control patients with comprehensive resting echocardiography. Three measures were performed to assess LV mechanical dyssynchrony: opposing-wall delays (longitudinal and radial analyses), modified Yu index, and time to-peak delays of each segment.</p></div><div><h3>Results</h3><p>Mean age was 23<!--> <!-->±<!--> <!-->7<!--> <!-->years. All three mechanical dyssynchrony criteria were significantly higher in the DM1 group than in healthy subjects: opposing-wall delays in basal inferoseptal to basal anterolateral segments (61.4<!--> <!-->±<!--> <!-->45.3<!--> <!-->msec vs. 18.3<!--> <!-->±<!--> <!-->50.4<!--> <!-->msec, <em>P</em> <!--><<!--> <!-->0.001, respectively) and in mid inferoseptal to mid anterolateral segments (58.6<!--> <!-->±<!--> <!-->35.3<!--> <!-->msec vs. 42.4<!--> <!-->±<!--> <!-->36.4<!--> <!-->msec, <em>P</em> <!--><<!--> <!-->0.05, respectively) (Fig. 1), modified Yu index (33.3<!--> <!-->±<!--> <!-->10.1<!--> <!-->msec vs. 28.5<!--> <!-->±<!--> <!-->8.1<!--> <!-->msec, <em>P</em> <!--><<!--> <!-->0.05, respectively), and most of time-to-peak values, especially in basal and mid anterolateral segments.</p></div><div><h3>Conclusion</h3><p>The existence of an early LV mechanical dyssynchrony using 2D-STE analysis in DM1 patients before the onset of cardiomyopathy represents a perspective for early prediction of sudden heart death. 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引用次数: 0
摘要
1型肌强直性营养不良(DM1)患者可观察到传导系统异常和心肌功能障碍，这可能是该疾病的初始表现。一些研究表明，在DM1患者中使用早期心脏再同步化治疗(CRT)可以改善预后。二维斑点跟踪超声心动图(2D-STE)最近成为一种非侵入性生物标志物，可用于早期检测非同步化运动。本研究的目的是利用2D-STE分析来评估这一人群的左心室(LV)非同步化。方法本研究是一项前瞻性研究，于2020年3月至2022年10月进行，纳入左室射血分数(LVEF)正常的DM1患者和对照组的综合静息超声心动图患者。采用三种方法评估左心室机械不同步:对壁延迟(纵向和径向分析)、修正Yu指数和各节段到达峰值的时间延迟。结果患者平均年龄23±7岁。DM1组的所有三项机械非同步化标准均显著高于健康受试者:基底隔间段至基底前外侧段对壁延迟(61.4±45.3 msec vs. 18.3±50.4 msec);间隔内段和前外侧段中部(58.6±35.3 msec vs. 42.4±36.4 msec, P <0.05)(图1)，修正Yu指数(33.3±10.1 msec vs. 28.5±8.1 msec, P <(分别为0.05)，且大部分峰值时间，特别是在基底和中前外侧节段。结论利用2D-STE分析DM1患者在心肌病发病前存在早期左室机械非同步化，为心脏性猝死的早期预测提供了一个视角。然而，对于传导系统疾病患者来说，icd在提高总体生存率方面真的有益吗?传导系统疾病患者通常表现为更严重的肌强直性营养不良。校正后的平均峰值时间延迟。
Assessment of left ventricular dyssynchrony by speckle tracking echocardiography in patients with Steinert's disease
Introduction
Conduction system abnormalities and myocardial dysfunction are observed in patients with myotonic dystrophy type 1 (DM1) and may represent the initial manifestations of the disease.
Some studies have shown improvements of outcomes with use of early cardiac resynchronization therapy (CRT) in DM1 patients. Two-dimensional speckle tracking echocardiography (2D-STE) has recently emerged as a non-invasive biomarker for early detection of dyssynchrony. The aim of this study is to assess a left ventricle (LV) dyssynchrony using 2D-STE analysis in this population.
Method
This is a prospective study, conducted from March 2020 to October 2022 which included DM1 with normal LV ejection fraction (LVEF) and control patients with comprehensive resting echocardiography. Three measures were performed to assess LV mechanical dyssynchrony: opposing-wall delays (longitudinal and radial analyses), modified Yu index, and time to-peak delays of each segment.
Results
Mean age was 23 ± 7 years. All three mechanical dyssynchrony criteria were significantly higher in the DM1 group than in healthy subjects: opposing-wall delays in basal inferoseptal to basal anterolateral segments (61.4 ± 45.3 msec vs. 18.3 ± 50.4 msec, P < 0.001, respectively) and in mid inferoseptal to mid anterolateral segments (58.6 ± 35.3 msec vs. 42.4 ± 36.4 msec, P < 0.05, respectively) (Fig. 1), modified Yu index (33.3 ± 10.1 msec vs. 28.5 ± 8.1 msec, P < 0.05, respectively), and most of time-to-peak values, especially in basal and mid anterolateral segments.
Conclusion
The existence of an early LV mechanical dyssynchrony using 2D-STE analysis in DM1 patients before the onset of cardiomyopathy represents a perspective for early prediction of sudden heart death. However, are ICDs really beneficial in terms of improving overall survival, in patients with conduction system disease often presenting more severe forms of myotonic dystrophy itself. Mean corrected time-to-peak delays.
期刊介绍：
Archives of Cardiovascular Diseases Supplements is the official journal of the French Society of Cardiology. The journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles, editorials, and Images in cardiovascular medicine. The topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Additionally, Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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