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Pan HY, Lee CK, Liu TY, Lee GW, Chen CW, Wang TD. The role of wearable home blood pressure monitoring in detecting out-of-office control status. Hypertens Res 2024; 47:1033-1041. [PMID: 38242946 PMCID: PMC10994837 DOI: 10.1038/s41440-023-01539-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
Ambulatory blood pressure (ABP) and home blood pressure (HBP) monitoring is currently recommended for management of hypertension. Nonetheless, traditional HBP protocols could overlook diurnal fluctuations, which could also be linked with adverse cardiovascular outcomes. In this observational study, we studied among a group of treated hypertensive patients (N = 62, age: 52.4 ± 10.4 years) by using out-of-office ABP and wearable HBP. They received one session of 24-h ABP measurement with an oscillometric upper-arm monitor, and totally three sessions of 7-day/6-time-daily wearable HBP measurement separated in each month with HeartGuide. Controlled hypertension is defined as an average BP <130/80 mmHg for both daytime ABP and HBP. There was substantial reliability (intraclass correlation coefficient, ICC 0.883-0.911) and good reproducibility (Cohen's kappa = 0.600) for wearable HBP measurement, especially before breakfast and after dinner. Among all patients, 27.4% had both uncontrolled HBP and ABP, 30.6% had uncontrolled HBP only, while 6.5% had uncontrolled ABP only. Female gender and increased numbers of anti-hypertensive agents are correlated with controlled hypertension. Patients with uncontrolled hypertension had a significantly higher maximal daytime blood pressure, which was previously signified as an imperial marker for cardiovascular risk. In conclusion, wearable HBP monitoring in accordance with a dedicated daily-living schedule results in good reliability and reproducibility. Patients with an uncontrolled wearable HBP should benefit from repeated HBP or ABP measurement for risk stratification.
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Affiliation(s)
- Heng-Yu Pan
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu City, Taiwan
| | - Chih-Kuo Lee
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu City, Taiwan
| | - Tzu-Yao Liu
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu City, Taiwan
| | - Guan-Wei Lee
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu City, Taiwan
| | - Chiao-Wei Chen
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu City, Taiwan
| | - Tzung-Dau Wang
- Cardiovascular Center and Divisions of Cardiology and Hospital Medicine, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei City, Taiwan.
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Höck M, Posod A, Odri Komazec I, Griesmaier E, Ralser E, Pupp-Peglow U, Kiechl-Kohlendorfer U. Cardiac biomarkers and left ventricular systolic function in former very preterm infants and term controls at preschool age. Front Pediatr 2024; 12:1376360. [PMID: 38590770 PMCID: PMC10999603 DOI: 10.3389/fped.2024.1376360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/11/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction Due to improvements in perinatal care, survival rates of preterm infants have improved during the last decades. However, these infants remain at risk of developing cardiovascular sequelae later in life. This study aimed to investigate the cardiac biomarkers and left ventricular systolic function in former preterm infants in comparison with term controls at preschool age. Methods The study included children aged 5-7 years old born below 32 weeks of gestational age. The control group consisted of same-age children born at term. Basic data of study participants were collected using questionnaires and follow-up databases. During the study visit, we recorded anthropometric data and blood pressure readings, determined high-sensitive cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) concentrations, and calculated fractional shortening (FS) and left ventricular mass (LVM). Results Term-born (n = 25; median gestational age, 40.1 weeks) compared with preterm-born infants (n = 80; median gestational age 29.6 weeks) showed no significant differences in the median concentration of hs-cTnT [median, 3.5 (IQR 3.5; 3.5) vs. 3.5 (3.5; 3.5) ng/L, p = 0.328] and the median concentration of NT-pro-BNP [median, 91.0 (IQR 40.8; 150.3) vs. 87.5 (50.1; 189.5) ng/L, p = 0.087]. FS and LVM/LVMI were not significantly different between the two groups. Conclusion At preschool age, we observed no significant differences in cardiac biomarkers and left ventricular systolic function in preterm infants. Further studies are warranted to explore the potential of cardiac biomarkers as a prognostic tool for subclinical cardiac alterations after preterm birth.
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Affiliation(s)
- Michaela Höck
- Department of Pediatrics II, Neonatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Posod
- Department of Pediatrics II, Neonatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Irena Odri Komazec
- Department of Pediatrics III, Division of Cardiology, Pulmonology, Allergology and Cystic Fibrosis, Medical University of Innsbruck, Innsbruck, Austria
| | - Elke Griesmaier
- Department of Pediatrics II, Neonatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Elisabeth Ralser
- Department of Pediatrics II, Neonatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ulrike Pupp-Peglow
- Department of Pediatrics II, Neonatology, Medical University of Innsbruck, Innsbruck, Austria
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Ngiam JN, Chew N, Jou E, Ho JS, Pramotedham T, Liong TS, Kuntjoro I, Yeo TC, Sia CH, Kong WKF, Poh KK. Increased left ventricular remodelling index in paradoxical low-flow severe aortic stenosis with preserved left ventricular ejection fraction compared to normal-flow severe aortic stenosis. Singapore Med J 2024:00077293-990000000-00094. [PMID: 38363650 DOI: 10.4103/singaporemedj.smj-2022-107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 08/01/2022] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Patients with paradoxical low-flow (LF) severe aortic stenosis (AS) despite preserved left ventricular ejection fraction (LVEF) appear distinct from normal-flow (NF) patients, showing worse prognosis, more concentric hypertrophy and smaller left ventricular (LV) cavities. The left ventricular remodelling index (LVRI) has been demonstrated to reliably discriminate between physiologically adapted athlete's heart and pathological LV remodelling. METHODS We studied patients with index echocardiographic diagnosis of severe AS (aortic valve area <1 cm2) with preserved LVEF (>50%). The LVRI was determined by the ratio of the LV mass to the end-diastolic volume, as previously reported, and was compared between patients with LF and NF AS. Patients were prospectively followed up for at least 3 years, and clinical outcomes were examined in association with LVRI. RESULTS Of the 450 patients studied, 112 (24.9%) had LF AS. While there were no significant differences in baseline clinical profile between LF and NF patients, LVRI was significantly higher in the LF group. Patients with high LVRI (>1.56 g/mL) had increased all-cause mortality (log-rank 9.18, P = 0.002) and were more likely to be admitted for cardiac failure (log-rank 7.61, P = 0.006) or undergo aortic valve replacement (log-rank 18.4, P < 0.001). After adjusting for the effect of age, hypertension, aortic valve area and mean pressure gradient on multivariate Cox regression, high LVRI remained independently associated with poor clinical outcomes (hazard ratio 1.64, 95% confidence interval 1.19-2.25, P = 0.002). CONCLUSION Pathological LV remodelling (increased LVRI) was more common in patients with LF AS, and increased LVRI independently predicts worse clinical outcomes.
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Affiliation(s)
| | - Nicholas Chew
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Eric Jou
- MRC Laboratory of Molecular Biology, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Jamie Sy Ho
- Academic Foundation Programme, Royal Free London NHS Foundation Trust, London, United Kingdom
| | | | - Tze Sian Liong
- Department of Medicine, National University Health System, Singapore
| | - Ivandito Kuntjoro
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Tiong-Cheng Yeo
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ching-Hui Sia
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - William Kok Fai Kong
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kian-Keong Poh
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Mekki M, Algebaly HF, Sabry HA, Samir M, Rady H. Left ventricle mass index in paediatric intensive care unit acquired hypertension. Cardiol Young 2024; 34:56-61. [PMID: 37170773 DOI: 10.1017/s1047951123000781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Hypertension acquired in paediatric critical patients is a recognised challenge, with variable reported frequency. Pain, agitation, and/or medications such as beta stimulants and corticosteroids are well-known risk factors. Sympathomimetics in septic patients can cause high blood pressure, especially with unobserved haemodynamic monitors. Beyond haemodynamic factors, several endocrinal-metabolic factors - including catecholamines, insulin, renin, angiotensin, the aldosterone system, and sodium consumption - may contribute to the left ventricular growth. It is well known that the sympathetic tone has a trophic effect on the heart muscle. METHOD A prospective cohort study was conducted during the year 2021. The children were divided into two groups: those who were critically ill with paediatric intensive care unit-acquired hypertension (n = 59) and those without paediatric intensive care unit-acquired hypertension (n = 62). We used the American Academy of Pediatrics' 2017 definition of hypertension to diagnose paediatric intensive care unit-acquired hypertension. Measurement of cardiac output and systemic vascular resistance was performed by cardiometry. Left ventricular myocardial performance and left ventricular mass index were measured by bedside echocardiography at the onset of hypertension diagnosis. RESULTS Critically ill children with acquired hypertension had a higher cardiac index (p = 0.0001), systemic vascular resistance index (<0.0001), myocardial performance (0.037), and left ventricular mass index (0.009). The longer duration of stay observed in the hypertension group had no observable effect on mortality (<0.0001). CONCLUSION Both myocardial performance and left ventricle mass index increased in critically ill children with paediatric intensive care unit-acquired hypertension.
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Affiliation(s)
- Mostafa Mekki
- Department of Pediatric and Pediatric Intensive Care Unit, Cairo University, Cairo, Egypt
| | | | - Hend Aly Sabry
- Department of Public Health, Cairo University, Cairo, Egypt
| | - Mohamed Samir
- Department of Pediatric and Pediatric Cardiology Unit, Cairo University, Cairo, Egypt
| | - Hanaa Rady
- Department of Pediatric and Pediatric Intensive Care Unit, Cairo University, Cairo, Egypt
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5
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Božić‐Iven M, Rapacchi S, Tao Q, Pierce I, Thornton G, Nitsche C, Treibel TA, Schad LR, Weingärtner S. Improved reproducibility for myocardial ASL: Impact of physiological and acquisition parameters. Magn Reson Med 2024; 91:118-132. [PMID: 37667643 PMCID: PMC10962577 DOI: 10.1002/mrm.29834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE To investigate and mitigate the influence of physiological and acquisition-related parameters on myocardial blood flow (MBF) measurements obtained with myocardial Arterial Spin Labeling (myoASL). METHODS A Flow-sensitive Alternating Inversion Recovery (FAIR) myoASL sequence with bSSFP and spoiled GRE (spGRE) readout is investigated for MBF quantification. Bloch-equation simulations and phantom experiments were performed to evaluate how variations in acquisition flip angle (FA), acquisition matrix size (AMS), heart rate (HR) and bloodT 1 $$ {\mathrm{T}}_1 $$ relaxation time (T 1 , B $$ {\mathrm{T}}_{1,B} $$ ) affect quantification of myoASL-MBF. In vivo myoASL-images were acquired in nine healthy subjects. A corrected MBF quantification approach was proposed based on subject-specificT 1 , B $$ {\mathrm{T}}_{1,B} $$ values and, for spGRE imaging, subtracting an additional saturation-prepared baseline from the original baseline signal. RESULTS Simulated and phantom experiments showed a strong dependence on AMS and FA (R 2 $$ {R}^2 $$ >0.73), which was eliminated in simulations and alleviated in phantom experiments using the proposed saturation-baseline correction in spGRE. Only a very mild HR dependence (R 2 $$ {R}^2 $$ >0.59) was observed which was reduced when calculating MBF with individualT 1 , B $$ {\mathrm{T}}_{1,B} $$ . For corrected spGRE, in vivo mean global spGRE-MBF ranged from 0.54 to 2.59 mL/g/min and was in agreement with previously reported values. Compared to uncorrected spGRE, the intra-subject variability within a measurement (0.60 mL/g/min), between measurements (0.45 mL/g/min), as well as the inter-subject variability (1.29 mL/g/min) were improved by up to 40% and were comparable with conventional bSSFP. CONCLUSION Our results show that physiological and acquisition-related factors can lead to spurious changes in myoASL-MBF if not accounted for. Using individualT 1 , B $$ {\mathrm{T}}_{1,B} $$ and a saturation-baseline can reduce these variations in spGRE and improve reproducibility of FAIR-myoASL against acquisition parameters.
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Affiliation(s)
- Maša Božić‐Iven
- Medical Faculty MannheimHeidelberg UniversityMannheimGermany
- Department of Imaging PhysicsDelft University of TechnologyDelftThe Netherlands
| | | | - Qian Tao
- Department of Imaging PhysicsDelft University of TechnologyDelftThe Netherlands
| | - Iain Pierce
- Barts Heart CentreSt Bartholomew's HospitalLondonUK
| | - George Thornton
- Barts Heart CentreSt Bartholomew's HospitalLondonUK
- Institute of Cardiovascular ScienceUniversity College LondonLondonUK
| | - Christian Nitsche
- Barts Heart CentreSt Bartholomew's HospitalLondonUK
- Institute of Cardiovascular ScienceUniversity College LondonLondonUK
- Division of CardiologyMedical University of ViennaViennaAustria
| | - Thomas A. Treibel
- Barts Heart CentreSt Bartholomew's HospitalLondonUK
- Institute of Cardiovascular ScienceUniversity College LondonLondonUK
| | - Lothar R. Schad
- Medical Faculty MannheimHeidelberg UniversityMannheimGermany
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Sveric KM, Cansız B, Winkler A, Ulbrich S, Ende G, Heidrich F, Kaliske M, Linke A, Jellinghaus S. Accuracy of Devereaux and Teichholz formulas for left ventricular mass calculation in different geometric patterns: comparison with cardiac magnetic resonance imaging. Sci Rep 2023; 13:14089. [PMID: 37640771 PMCID: PMC10462733 DOI: 10.1038/s41598-023-41020-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023] Open
Abstract
Left ventricular (LV) myocardial mass is important in the evaluation of cardiac remodeling and requires accurate assessment when performed on linear measurements in two-dimensional echocardiography (Echo). We aimed to compare the accuracy of the Devereaux formula (DEV) and the Teichholz formula (TEICH) in calculating LV myocardial mass in Echo using cardiac magnetic resonance (CMR) as the reference method. Based on preceding mathematical calculations, we identified primarily LV size rather than wall thickness as the main source of bias between DEV and TEICH in a retrospective derivation cohort (n = 1276). Although LV mass from DEV and TEICH were correlated with CMR, TEICH did not show a proportional bias as did DEV (- 2 g/m2 vs. + 22 g/m2). This could be validated in an independent prospective cohort (n = 226) with symptomatic non-ischemic heart failure. DEV systematically overestimated LV mass in all tiers of LV remodeling as compared to TEICH. In conclusion, the TEICH method accounts for the changes in LV geometry with increasing LV mass and thus better reflects the different pattern of LV remodeling than the DEV method. This has important clinical implications, as TEICH may be more appropriate for use in clinical practice, rather than DEV, currently recommended.
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Affiliation(s)
- Krunoslav Michael Sveric
- Department for Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Fetscherstr. 76, 01307, Dresden, Germany.
| | - Barış Cansız
- Institute for Structural Analysis, Technische Universität Dresden, 01062, Dresden, Germany
| | - Anna Winkler
- Department for Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Fetscherstr. 76, 01307, Dresden, Germany
| | - Stefan Ulbrich
- Department for Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Fetscherstr. 76, 01307, Dresden, Germany
| | - Georg Ende
- Department for Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Fetscherstr. 76, 01307, Dresden, Germany
| | - Felix Heidrich
- Department for Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Fetscherstr. 76, 01307, Dresden, Germany
| | - Michael Kaliske
- Institute for Structural Analysis, Technische Universität Dresden, 01062, Dresden, Germany
| | - Axel Linke
- Department for Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Fetscherstr. 76, 01307, Dresden, Germany
| | - Stefanie Jellinghaus
- Department for Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Fetscherstr. 76, 01307, Dresden, Germany
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Morrison BN, Campbell AJ, Coté AT, Mohammad A, Sambrook L, Robinson G, George K, Oxborough D. Three-Dimensional-Derived Echocardiographic Left Ventricular Structure and Function and Indices from the 12-Lead Electrocardiogram across the Menstrual Cycle in Healthy Physically Active Females: An Exploratory Study. J Cardiovasc Dev Dis 2023; 10:331. [PMID: 37623344 PMCID: PMC10455515 DOI: 10.3390/jcdd10080331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/17/2023] [Accepted: 07/27/2023] [Indexed: 08/26/2023] Open
Abstract
Background: The impact of the menstrual phases on left ventricular (LV) structure and function using 3D echocardiography and resting electrocardiogram (ECG) in healthy, eumenorrheic, and physically active females has not been investigated. Methods: sixteen females (20 y ± 2) underwent 3D echocardiography and an ECG at three time points in the menstrual cycle phases (follicular, ovulation, luteal). LV end-diastolic volume (LVEDVi), LV ejection fraction (LVEF), LV mass allometrically indexed to height2.7 (LVMi), torsion, and global longitudinal, circumferential, and radial strain (GLS, GCS, and GRS) were evaluated. ECG data of the P and QRS waves were presented as well as axis deviation, chamber enlargement, and any rhythm abnormalities. Results: LVMi was significantly higher in the luteal phase (36.4 g/m2.7 ± 3.3) compared to the follicular (35.0 g/m2.7 ± 3.7) and ovulation (34.7 g/m2.7 ± 4.3) phases (p = 0.026). There were no differences in other indices of LV structure and function or ECG variables across all phases of the menstrual cycle or evidence of arrhythmia. Conclusions: In physically active females, there is a small but significantly higher LVMi associated with the luteal phase of the menstrual cycle with no concomitant change in LV function or ECG parameters. These findings are important to consider when conducting clinical or research serial assessments.
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Affiliation(s)
- Barbara N. Morrison
- School of Human Kinetics, Trinity Western University, Langley, BC V2Y 1Y1, Canada; (B.N.M.); (A.J.C.); (A.T.C.)
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (A.M.); (L.S.); (G.R.); (K.G.)
| | - Allison J. Campbell
- School of Human Kinetics, Trinity Western University, Langley, BC V2Y 1Y1, Canada; (B.N.M.); (A.J.C.); (A.T.C.)
| | - Anita T. Coté
- School of Human Kinetics, Trinity Western University, Langley, BC V2Y 1Y1, Canada; (B.N.M.); (A.J.C.); (A.T.C.)
| | - Aleah Mohammad
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (A.M.); (L.S.); (G.R.); (K.G.)
| | - Laura Sambrook
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (A.M.); (L.S.); (G.R.); (K.G.)
| | - Georgia Robinson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (A.M.); (L.S.); (G.R.); (K.G.)
| | - Keith George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (A.M.); (L.S.); (G.R.); (K.G.)
| | - David Oxborough
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (A.M.); (L.S.); (G.R.); (K.G.)
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Gumanova NG, Gorshkov AU, Bogdanova NL, Korolev AI. Effects of COVID-19 Infection in Healthy Subjects on Cardiac Function and Biomarkers of Oxygen Transport, Blood Coagulation and Inflammation. Viruses 2023; 15:1623. [PMID: 37631966 PMCID: PMC10459398 DOI: 10.3390/v15081623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The manifestations, severity, and mortality of COVID-19 are considered to be associated with the changes in various hematological parameters and in immunity. Associations of immunoglobulin G antibodies against severe acute respiratory syndrome-linked coronavirus (IgG-SARS)-positive status with cardiac function and hematological and biochemical parameters in apparently health subjects are poorly understood. METHODS The present cross-sectional study included 307 healthy volunteers (24-69 years of age; 44.8 ± 8.6 years; 80.4% men) and was initiated in 2019 before the COVID-19 pandemic. COVID-19 episodes were confirmed by detection of IgG-SARS against SARS-CoV-2 S1 RBD to reveal 70 IgG-SARS-positive and 237 negative participants. Numerous ultrasound characteristics were assessed by echocardiography, and 15 hematological and biochemical parameters were assayed in the blood. Descriptive and comparative analysis was based on the IgG-SARS status of the participants. RESULTS The left ventricular mass index, mitral ratio of peak early to late diastolic filling velocity or flow velocity across the mitral valve, and deceleration time of early mitral inflow were decreased (p < 0.05) in IgG-SARS-positive participants versus those in IgG-SARS-negative participants according to multivariate logistic regression analysis. Erythrocyte sedimentation rate and platelet count were slightly increased, and blood hemoglobin was decreased in IgG-SARS-positive participants compared with those in IgG-SARS-negative participants. CONCLUSIONS LV filling, inflammation, blood coagulation, and hemoglobin appear to be influenced by COVID-19 infection in healthy participants. Our observations contribute to the definition of vulnerabilities in the apparently healthy subjects with long COVID-19. These vulnerabilities may be more severe in patients with certain chronic diseases.
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Affiliation(s)
| | | | - Natalya L. Bogdanova
- National Research Center for Preventive Medicine (NRCPM), Petroverigsky, 10, Building 3, 101990 Moscow, Russia; (N.G.G.); (A.U.G.); (A.I.K.)
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9
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Altes A, Bernard J, Dumortier H, Dupuis M, Toubal O, Mahjoub H, Tartar J, Côté N, Clavel MA, O'Connor K, Bernier M, Beaudoin J, Vincentelli A, Pibarot P, Maréchaux S. Clinical significance of myocardial contraction fraction in significant primary mitral regurgitation. Arch Cardiovasc Dis 2023; 116:151-158. [PMID: 36805238 DOI: 10.1016/j.acvd.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND The optimal timing for mitral valve (MV) surgery in asymptomatic patients with primary mitral regurgitation (MR) remains a matter of debate. Myocardial contraction fraction (MCF) - the ratio of the left ventricular (LV) stroke volume to that of the myocardial volume - is a volumetric measure of LV myocardial shortening independent of size or geometry. AIM To assess the relationship between MCF and outcome in patients with significant chronic primary MR due to prolapse managed in contemporary practice. METHODS Clinical, Doppler-echocardiographic and outcome data prospectively collected in 174 patients (mean age 62 years, 27% women) with significant primary MR and no or mild symptoms were analysed. The impact of MCF< or ≥30% on cardiac events (cardiovascular death, acute heart failure or MV surgery) was studied. RESULTS During an estimated median follow-up of 49 (22-77) months, cardiac events occurred in 115 (66%) patients. The 4-year estimates of survival free from cardiac events were 21±5% for patients with MCF <30% and 40±6% for those with ≥30% (P<0.001). MCF <30% was associated with a considerable increased risk of cardiac events after adjustment for established clinical risk factors, MR severity and current recommended class I triggers for MV surgery (adjusted hazard ratio: 2.33, 95% confidence interval: 1.51-3.58; P<0.001). Moreover, MCF<30% improved the predictive performance of models, with better global fit, reclassification and discrimination. CONCLUSIONS MCF<30% is strongly associated with occurrence of cardiac events in patients with significant primary MR due to prolapse. Further studies are needed to assess the direct impact of MCF on patient management and outcomes.
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Affiliation(s)
- Alexandre Altes
- GCS-Groupement des Hôpitaux de l'Institut Catholique de Lille/ Lille Catholic hospitals, Heart Valve Center, Cardiology Department, ETHICS EA 7446, Lille Catholic University, Lille, France
| | - Jérémy Bernard
- Institut universitaire de cardiologie et de pneumologie de Québec / Québec Heart & Lung Institute, Laval University, Québec City QC G1V 4G5, Québec, Canada
| | - Hélène Dumortier
- GCS-Groupement des Hôpitaux de l'Institut Catholique de Lille/ Lille Catholic hospitals, Heart Valve Center, Cardiology Department, ETHICS EA 7446, Lille Catholic University, Lille, France
| | - Marlène Dupuis
- Institut universitaire de cardiologie et de pneumologie de Québec / Québec Heart & Lung Institute, Laval University, Québec City QC G1V 4G5, Québec, Canada
| | - Oumhani Toubal
- Institut universitaire de cardiologie et de pneumologie de Québec / Québec Heart & Lung Institute, Laval University, Québec City QC G1V 4G5, Québec, Canada
| | - Haïfa Mahjoub
- Institut universitaire de cardiologie et de pneumologie de Québec / Québec Heart & Lung Institute, Laval University, Québec City QC G1V 4G5, Québec, Canada
| | - Jean Tartar
- GCS-Groupement des Hôpitaux de l'Institut Catholique de Lille/ Lille Catholic hospitals, Heart Valve Center, Cardiology Department, ETHICS EA 7446, Lille Catholic University, Lille, France
| | - Nancy Côté
- Institut universitaire de cardiologie et de pneumologie de Québec / Québec Heart & Lung Institute, Laval University, Québec City QC G1V 4G5, Québec, Canada
| | - Marie-Annick Clavel
- Institut universitaire de cardiologie et de pneumologie de Québec / Québec Heart & Lung Institute, Laval University, Québec City QC G1V 4G5, Québec, Canada
| | - Kim O'Connor
- Institut universitaire de cardiologie et de pneumologie de Québec / Québec Heart & Lung Institute, Laval University, Québec City QC G1V 4G5, Québec, Canada
| | - Mathieu Bernier
- Institut universitaire de cardiologie et de pneumologie de Québec / Québec Heart & Lung Institute, Laval University, Québec City QC G1V 4G5, Québec, Canada
| | - Jonathan Beaudoin
- Institut universitaire de cardiologie et de pneumologie de Québec / Québec Heart & Lung Institute, Laval University, Québec City QC G1V 4G5, Québec, Canada
| | - André Vincentelli
- Cardiac Surgery Department, Centre Hospitalier Régional et Universitaire de Lille, 59000 Lille, France
| | - Philippe Pibarot
- Institut universitaire de cardiologie et de pneumologie de Québec / Québec Heart & Lung Institute, Laval University, Québec City QC G1V 4G5, Québec, Canada
| | - Sylvestre Maréchaux
- GCS-Groupement des Hôpitaux de l'Institut Catholique de Lille/ Lille Catholic hospitals, Heart Valve Center, Cardiology Department, ETHICS EA 7446, Lille Catholic University, Lille, France.
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10
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Asheghan MM, Javadikasgari H, Attary T, Rouhollahi A, Straughan R, Willi JN, Awal R, Sabe A, de la Cruz KI, Nezami FR. Predicting one-year left ventricular mass index regression following transcatheter aortic valve replacement in patients with severe aortic stenosis: A new era is coming. Front Cardiovasc Med 2023; 10:1130152. [PMID: 37082454 PMCID: PMC10111021 DOI: 10.3389/fcvm.2023.1130152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/16/2023] [Indexed: 04/22/2023] Open
Abstract
Aortic stenosis (AS) is the most common valvular heart disease in the western world, particularly worrisome with an ever-aging population wherein postoperative outcome for aortic valve replacement is strongly related to the timing of surgery in the natural course of disease. Yet, guidelines for therapy planning overlook insightful, quantified measures from medical imaging to educate clinical decisions. Herein, we leverage statistical shape analysis (SSA) techniques combined with customized machine learning methods to extract latent information from segmented left ventricle (LV) shapes. This enabled us to predict left ventricular mass index (LVMI) regression a year after transcatheter aortic valve replacement (TAVR). LVMI regression is an expected phenomena in patients undergone aortic valve replacement reported to be tightly correlated with survival one and five year after the intervention. In brief, LV geometries were extracted from medical images of a cohort of AS patients using deep learning tools, and then analyzed to create a set of statistical shape models (SSMs). Then, the supervised shape features were extracted to feed a support vector regression (SVR) model to predict the LVMI regression. The average accuracy of the predictions was validated against clinical measurements calculating root mean square error and R 2 score which yielded the satisfactory values of 0.28 and 0.67, respectively, on test data. Our work reveals the promising capability of advanced mathematical and bioinformatics approaches such as SSA and machine learning to improve medical output prediction and treatment planning.
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Affiliation(s)
- Mohammad Mostafa Asheghan
- Division of Thoracic and Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Hoda Javadikasgari
- Division of Thoracic and Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Taraneh Attary
- Bio-Intelligence Unit, Sharif Brain Center, Electrical Engineering Department, Sharif University of Technology, Tehran, Iran
| | - Amir Rouhollahi
- Division of Thoracic and Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Ross Straughan
- Division of Thoracic and Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - James Noel Willi
- Division of Thoracic and Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Rabina Awal
- Mechanical Engineering Department, University of Louisiana at Lafayette, Louisiana, LA, United States
| | - Ashraf Sabe
- Division of Thoracic and Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Kim I. de la Cruz
- Division of Thoracic and Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Farhad R. Nezami
- Division of Thoracic and Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
- Correspondence: Farhad R. Nezami
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11
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Normal Values of Left Ventricular Mass by Two-Dimensional and Three-Dimensional Echocardiography: Results from the World Alliance Societies of Echocardiography Normal Values Study. J Am Soc Echocardiogr 2022; 36:533-542.e1. [PMID: 36584904 DOI: 10.1016/j.echo.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/05/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Although increased left ventricular (LV) mass is associated with adverse outcomes, measured values vary widely depending on the specific technique used. Moreover, the impact of sex, age, and race on LV mass remains controversial, further limiting the clinical use of this parameter. Accordingly, the authors studied LV mass using a variety of two-dimensional and three-dimensional echocardiographic techniques in a large population of normal subjects encompassing a wide range of ages. METHODS Transthoracic echocardiograms obtained from 1,854 healthy adult subjects (52% men) enrolled in the World Alliance Societies of Echocardiography (WASE) Normal Values Study, were divided into three age groups (young, 18-35 years; middle aged, 36-55 years; and old, >55 years). LV mass was obtained using five conventional techniques, including linear and two-dimensional methods, as well as direct three-dimensional measurement. All LV mass values were indexed to body surface area, and differences according to sex, age, and race were analyzed for each technique. RESULTS LV mass values differed significantly among the five techniques. Three-dimensional measurements were considerably smaller than those obtained using the other techniques and were closer to magnetic resonance imaging normal values reported in the literature. For all techniques, LV mass in men was significantly larger than in women, with and without body surface area indexing. These technique- and sex-related differences were larger than measurement variability. In women, age differences in LV mass were more pronounced and depicted significantly larger values in older age groups for all techniques, except three-dimensional echocardiography, which showed essentially no differences. LV mass was overall larger in black subjects than in white or Asian subjects. CONCLUSIONS Significant differences in LV mass values exist across echocardiographic techniques, which are therefore not interchangeable. Sex-, race-, and age-related differences underscore the need for separate population specific normal values.
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12
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Cardiac Morphofunctional Characteristics of Individuals with Early Repolarization Pattern: A Literature Review. J Cardiovasc Dev Dis 2022; 10:jcdd10010004. [PMID: 36661899 PMCID: PMC9861558 DOI: 10.3390/jcdd10010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
The early repolarization pattern (ERP) is an electrocardiographic phenomenon characterized by the appearance of a distinct J-wave or J-point elevation at the terminal part of the QRS complex. ERP is associated with an increased risk of ventricular arrhythmias in susceptible individuals. The cardiac morphofunctional parameters in subjects with ERP have been characterized mainly by imaging techniques, which suggests that certain changes could be identified in the background of the electrical pathomechanism: however, in this regard, current data are often contradictory or insufficiently detailed. For clarification, a more comprehensive cardiac imaging evaluation of a large patient population is necessary. This review summarizes and analyses the data from the literature related to cardiac morphofunctional characteristics in individuals with ERP.
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13
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Siddiqi N, Vasireddi S, Sattayaprasert P, Thamman R, Narang A, Aneja A. Determination of sources of error and improvement in accuracy of left ventricular mass measurement by echocardiography. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2022; 38:2129-2137. [PMID: 37726463 DOI: 10.1007/s10554-022-02627-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/18/2022] [Indexed: 01/19/2023]
Abstract
Abnormal Left ventricular mass (LVM) prognosticates adverse cardiovascular events. Conventionally, LVM measured by echo assumes a prolate ellipsoid (PE) shape; however, it poorly correlates with reference standard of cardiac magnetic resonance imaging (CMR) derived LVM. PE model assumes LVL = 2 × LVID. We developed a new echo LVM formula based on LV length and tested for accuracy against CMR. A retrospective study of consecutive patients with an echocardiogram and CMR within 3 months. Derivation (n = 170) and validation cohorts (n = 54) were used to test the new formula. Following analysis of correlation of interventricular septum (IVS), LV internal dimension (LVID), posterior wall (PW) and LVL between echo and CMR, a novel paraboloid-shape linear regression (PLR) model was derived. LVM by both models were compared to CMR. Poor correlation observed between actual and assumed LVL (0.52 with CMR; 0.44 with echo). Strong correlation was noted between echo and CMR measured LVL, LVID, IVS (r > 0.80) and a moderate correlation with PW (r = 0.62). Strong correlation of LVL was harnessed to develop PLR model, which significantly decreased paired error in derivation cohort (from 64 ± 42 to 22 ± 21 gm) and validation cohort (from 63 ± 46 to 25 ± 18 gm). Furthermore, it demonstrates significant reduction in absolute, relative errors and variability along with superior correlation in both cohorts. Between echo and CMR, LVL demonstrates one of the best correlation among LV dimensions. The assumption, LVL = 2 × LVID appears inaccurate. PLR model incorporates LVL and significantly improves accuracy, reduces variability of LVM.
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Affiliation(s)
- Najmul Siddiqi
- Heart and Vascular Center, MetroHealth Campus of Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.
| | - Sunil Vasireddi
- Heart and Vascular Center, MetroHealth Campus of Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA
| | - Prasongchai Sattayaprasert
- Heart and Vascular Center, MetroHealth Campus of Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA
| | - Ritu Thamman
- School of Medicine, University of Pittsburgh, 490 E North Avenue, Suite G104, Pittsburgh, PA, 15212, USA
| | - Akhil Narang
- Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 600, Chicago, IL, 60611, USA
| | - Ashish Aneja
- Heart and Vascular Center, MetroHealth Campus of Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA
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14
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Akbay E, Akinci S, Coner A, Adar A, Genctoy G, Demir AR. New perspective on fatigue in hemodialysis patients with preserved ejection fraction: diastolic dysfunction : Fatigue and diastolic dysfunction. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2022; 38:2143-2153. [PMID: 37726453 DOI: 10.1007/s10554-022-02609-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/25/2022] [Indexed: 11/05/2022]
Abstract
The relationship between diastolic dysfunction and fatigue in hemodialysis patients with preserved ejection fraction is unknown. In this context, the objective of this study is to assess fatigue using the relevant scales and to demonstrate its relationship with diastolic dysfunction. The patients who underwent hemodialysis were evaluated prospectively. Patients' fatigue was assessed using the Visual Analogue Scale to Evaluate Fatigue Severity (VAS-F). The echocardiographic works were performed as recommended in the American Society of Echocardiography guidelines. A total of 94 patients [mean age 64.7 ± 13.5 years, 54 males (57.4%)] were included in the study. The median VAS-F score of these patients was 68.5 (33.25-91.25), and they were divided into two groups according to this value. Peak myocardial velocities during early diastole (e') and tricuspid annular plane systolic excursion (TAPSE) values were found to be significantly lower in the group with high VAS-F scores, whereas the early diastolic flow velocities (E)/e' ratio and pulmonary artery peak systolic pressures (PAP) were found to be significantly higher (p < 0.05, for all). E/e' ratio (r 0.311, p 0.002) and PAP (r 0.281, p 0.006) values were found to be positively correlated with the VAS-F score, as opposed to the TAPSE (r - 0.257, p 0.012) and e' (r - 0.303, p 0.003) values, which were found to be negatively correlated with the VAS-F score. High fatigue scores in hemodialysis patients may be associated with diastolic dysfunction. In addition, in our study, we determined the correlation of VAS-F score with E/e' ratio, PAP and TAPSE.
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Affiliation(s)
- Ertan Akbay
- Department of Cardiology, Alanya Medical and Research Center, Baskent University Hospital, Saray Mahallesi Yunus Emre Caddesi No: 1, 07400, Alanya, Turkey.
| | - Sinan Akinci
- Department of Cardiology, Alanya Medical and Research Center, Baskent University Hospital, Saray Mahallesi Yunus Emre Caddesi No: 1, 07400, Alanya, Turkey
| | - Ali Coner
- Department of Cardiology, Alanya Medical and Research Center, Baskent University Hospital, Saray Mahallesi Yunus Emre Caddesi No: 1, 07400, Alanya, Turkey
| | - Adem Adar
- Department of Cardiology, Alanya Medical and Research Center, Baskent University Hospital, Saray Mahallesi Yunus Emre Caddesi No: 1, 07400, Alanya, Turkey
| | - Gultekin Genctoy
- Department of Nephrology, Alanya Medical and Research Center, Baskent University Hospital, Alanya, Turkey
| | - Ali Riza Demir
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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15
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Keles N. Editorial commentary for the manuscript entitled determination of sources of error and improvement in accuracy of left ventricular mass measurement by echocardiography. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2022; 38:2139-2140. [PMID: 37726469 DOI: 10.1007/s10554-022-02680-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 06/20/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Nursen Keles
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Research and Training Hospital, Selimiye Mahallesi, Tıbbiye Caddesi, No: 13, 34668, Uskudar, Istanbul, Turkey.
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16
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Kristensen CB, Myhr KA, Grund FF, Vejlstrup N, Hassager C, Mattu R, Mogelvang R. A new method to quantify left ventricular mass by 2D echocardiography. Sci Rep 2022; 12:9980. [PMID: 35705586 PMCID: PMC9200734 DOI: 10.1038/s41598-022-13677-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/18/2022] [Indexed: 11/23/2022] Open
Abstract
Increased left ventricular mass (LVM) is a strong independent predictor for adverse cardiovascular events, but conventional echocardiographic methods are limited by poor reproducibility and accuracy. We developed a novel method based on adding the mean wall thickness from the parasternal short axis view, to the left ventricular end-diastolic volume acquired using the biplane model of discs. The participants (n = 85) had various left ventricular geometries and were assessed using echocardiography followed immediately by cardiac magnetic resonance, as reference. We compared our novel two-dimensional (2D) method to various conventional one-dimensional (1D) and other 2D methods as well as the three-dimensional (3D) method. Our novel method had better reproducibility in intra-examiner [coefficients of variation (CV) 9% vs. 11–14%] and inter-examiner analysis (CV 9% vs. 10–20%). Accuracy was similar to the 3D method (mean difference ± 95% limits of agreement, CV): Novel: 2 ± 50 g, 15% vs. 3D: 2 ± 51 g, 16%; and better than the “linear” 1D method by Devereux (7 ± 76 g, 23%). Our novel method is simple, has considerable better reproducibility and accuracy than conventional “linear” 1D methods, and similar accuracy as the 3D-method. As the biplane model forms part of the standard echocardiographic protocol, it does not require specific training and provides a supplement to the modern echocardiographic report.
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Affiliation(s)
- Charlotte Burup Kristensen
- Department of Cardiology, The Heart Center, Rigshospitalet - University hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Katrine Aagaard Myhr
- Department of Cardiology, The Heart Center, Rigshospitalet - University hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Frederik Fasth Grund
- Department of Cardiology, The Heart Center, Rigshospitalet - University hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Niels Vejlstrup
- Department of Cardiology, The Heart Center, Rigshospitalet - University hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Christian Hassager
- Department of Cardiology, The Heart Center, Rigshospitalet - University hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2100, Copenhagen, Denmark
| | - Raj Mattu
- Kettering General Hospital NHS Foundation Trust, Kettering, NN16 8UZ, Northants, UK.,University College London, Gower St, London, WC1E 6BT, UK
| | - Rasmus Mogelvang
- Department of Cardiology, The Heart Center, Rigshospitalet - University hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2100, Copenhagen, Denmark.,Cardiovascular Research Unit, University of Southern Denmark, Baagoees allé 15, 5700, Svendborg, Denmark
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17
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Okhovatian S, Mohammadi MH, Rafatian N, Radisic M. Engineering Models of the Heart Left Ventricle. ACS Biomater Sci Eng 2022; 8:2144-2160. [PMID: 35523206 DOI: 10.1021/acsbiomaterials.1c00636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Despite capturing the imagination of scientists for decades, the goal of creating an artificial heart for transplantation proved to be significantly more challenging than initially anticipated. Toward this goal, recent ground-breaking studies demonstrate the development of functional left ventricular (LV) models. LV models are artificially constructed 3D chambers that are capable of containing liquid within the engineered cavity and exhibit the functionality of native LV including contraction, ejection of fluid, and electrical impulse propagation. Various hydrogels and polymers have been used in manufacturing of LV models, relying on techniques such as electrospinning, bioprinting, casting, and molding. Most studies scaled down the models based on the dimensions of the human or rat ventricle. Initially, neonatal rat cardiomyocytes were the cell type of choice for construction the LV models. Yet, as the stem cell biology field advanced, recent studies focused on the use of cardiomyocytes derived from human induced pluripotent stem cells. In this review, we first describe the physiological characteristics of the human heart, to establish the parameter space for modeling. We then elaborate on current advances in the field and compare recently developed LV models among themselves and with the native human left ventricle. Fabrication methods, cell types, biomaterials, functional properties, and disease modeling capability are some of the major parameters that have distinguished these models. We also highlight some of the current challenges in this field, such as vascularization, cell composition and fidelity, and discuss potential solutions to overcome them.
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Affiliation(s)
- Sargol Okhovatian
- Institute of Biomaterials Engineering, University of Toronto, Toronto, Ontario M5S 3G9, Canada
| | - Mohammad Hossein Mohammadi
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario M5S 3E5, Canada
| | - Naimeh Rafatian
- Institute of Biomaterials Engineering, University of Toronto, Toronto, Ontario M5S 3G9, Canada
| | - Milica Radisic
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario M5S 3E5, Canada.,Institute of Biomaterials Engineering, University of Toronto, Toronto, Ontario M5S 3G9, Canada.,Toronto General Research Institute, Toronto, Ontario M5G 2C4, Canada
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18
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Menon D, Kadiu G, Sanil Y, Aggarwal S. Anthracycline Treatment and Left Atrial Function in Children: A Real-Time 3-Dimensional Echocardiographic Study. Pediatr Cardiol 2022; 43:645-654. [PMID: 34787697 DOI: 10.1007/s00246-021-02769-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 11/02/2021] [Indexed: 11/25/2022]
Abstract
Anthracycline (AC) therapy is associated with left ventricular (LV) dysfunction. Left atrial (LA) size and function are used to assess LV diastolic function in heart failure in adults. Data on LA size and function following AC therapy in children is limited. We hypothesized that LA size and function will be abnormal in children following AC chemotherapy. This retrospective review included patients who received AC for pediatric cancers. Controls had normal echocardiograms performed for evaluation of chest pain, murmur, or syncope. Real-time three-dimensional echocardiography was performed to evaluate LA reservoir, conduit, and booster pump function parameters. In addition to LA volume data, LV shortening fraction, spectral and tissue Doppler variables assessing diastolic function as well as myocardial performance index was obtained. Groups with and without AC therapy were compared by student t-test and chi-square test. We evaluated 136 patients, 55 (40.4%) had received AC. There was no significant difference between the groups in LV shortening fraction, diastolic as well as global function indices. LA reservoir and conduit function parameters were significantly lower in AC group compared to controls. The booster function parameters showed variable results. It is intriguing that AC-treated children have smaller LA reservoir and abnormal booster function. We speculate that these findings may reflect early changes in LA compliance associated with AC exposure. Assessment of LA volumes and function as prognostic markers of AC-induced cardiotoxicity in children is warranted.
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Affiliation(s)
- Dipika Menon
- Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA.
| | - Gilda Kadiu
- Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
| | - Yamuna Sanil
- Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
| | - Sanjeev Aggarwal
- Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
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19
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Moidu S, Oomen AT, Pillai G, VS S. Microalbuminuria as an Independent Risk Factor for Developing Concentric Left Ventricular Hypertrophy in Primary Hypertension: A Single-Center Observational Study From South India. Cureus 2022; 14:e21119. [PMID: 35165576 PMCID: PMC8830508 DOI: 10.7759/cureus.21119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 11/05/2022] Open
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20
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Rathore K, Boon E, Yussouf R, Newman M, Weightman W. Euvolemic off pump coronary surgery further improves early postoperative outcomes. Ann Card Anaesth 2022; 25:11-18. [PMID: 35075015 PMCID: PMC8865341 DOI: 10.4103/aca.aca_139_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Fluid resuscitation during Off-Pump Coronary Surgery (OPCABG) is still not protocolized and depends on multiple variables. We are exploring in this study whether a restrictive or euvolemic approach has any impact on short term surgical outcomes following OPCABG. Methods: It is a retrospective study of 300 patients analyzed based on the intraoperative fluid requirement with 150 patients in each group (Group I: Fluid <2 Litres, Group II: Fluid >2 Litres). Results: Multivariable analysis showed echocardiography variables such as E/e ratio, LA volume index, and atrial fibrillation (AF). LA volume index is related to the higher fluid requirement. Group II had significantly higher ventilation time (P < 0.05), drain output (P = 0.05), drain removal time (<0.05), inotropic requirement, and diuretic use. Conclusion: The requirement of the intraoperative fluid was associated with various factors including diastolic dysfunction (left atrial volume index, left ventricle mass index, E/e ratio) and preoperative dual antiplatelet use. Group II patients had longer ventilation time, diuretics use, high drain output, and required drains for a longer period of time. Although there was no statistical difference among two groups as far as postoperative AF concerned, a reversal of AF to sinus rhythm was delayed in group II patients.
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21
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Ranjbarvaziri S, Kooiker KB, Ellenberger M, Fajardo G, Zhao M, Vander Roest AS, Woldeyes RA, Koyano TT, Fong R, Ma N, Tian L, Traber GM, Chan F, Perrino J, Reddy S, Chiu W, Wu JC, Woo JY, Ruppel KM, Spudich JA, Snyder MP, Contrepois K, Bernstein D. Altered Cardiac Energetics and Mitochondrial Dysfunction in Hypertrophic Cardiomyopathy. Circulation 2021; 144:1714-1731. [PMID: 34672721 PMCID: PMC8608736 DOI: 10.1161/circulationaha.121.053575] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Hypertrophic cardiomyopathy (HCM) is a complex disease partly explained by the effects of individual gene variants on sarcomeric protein biomechanics. At the cellular level, HCM mutations most commonly enhance force production, leading to higher energy demands. Despite significant advances in elucidating sarcomeric structure-function relationships, there is still much to be learned about the mechanisms that link altered cardiac energetics to HCM phenotypes. In this work, we test the hypothesis that changes in cardiac energetics represent a common pathophysiologic pathway in HCM. METHODS We performed a comprehensive multiomics profile of the molecular (transcripts, metabolites, and complex lipids), ultrastructural, and functional components of HCM energetics using myocardial samples from 27 HCM patients and 13 normal controls (donor hearts). RESULTS Integrated omics analysis revealed alterations in a wide array of biochemical pathways with major dysregulation in fatty acid metabolism, reduction of acylcarnitines, and accumulation of free fatty acids. HCM hearts showed evidence of global energetic decompensation manifested by a decrease in high energy phosphate metabolites (ATP, ADP, and phosphocreatine) and a reduction in mitochondrial genes involved in creatine kinase and ATP synthesis. Accompanying these metabolic derangements, electron microscopy showed an increased fraction of severely damaged mitochondria with reduced cristae density, coinciding with reduced citrate synthase activity and mitochondrial oxidative respiration. These mitochondrial abnormalities were associated with elevated reactive oxygen species and reduced antioxidant defenses. However, despite significant mitochondrial injury, HCM hearts failed to upregulate mitophagic clearance. CONCLUSIONS Overall, our findings suggest that perturbed metabolic signaling and mitochondrial dysfunction are common pathogenic mechanisms in patients with HCM. These results highlight potential new drug targets for attenuation of the clinical disease through improving metabolic function and reducing mitochondrial injury.
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Affiliation(s)
- Sara Ranjbarvaziri
- Department of Pediatrics (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., S.Reddy, K.M.R., D.B.), Stanford University School of Medicine, CA
- Cardiovascular Research Institute (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., N.M., L.T., S.Reddy, J.C.W., D.B.), Stanford University School of Medicine, CA
| | - Kristina B Kooiker
- Department of Medicine, Division of Cardiology, University of Washington, Seattle (K.B.K.)
| | - Mathew Ellenberger
- Department of Genetics (M.E., G.M.T., M.P.S., K.C.), Stanford University School of Medicine, CA
| | - Giovanni Fajardo
- Department of Pediatrics (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., S.Reddy, K.M.R., D.B.), Stanford University School of Medicine, CA
- Cardiovascular Research Institute (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., N.M., L.T., S.Reddy, J.C.W., D.B.), Stanford University School of Medicine, CA
| | - Mingming Zhao
- Department of Pediatrics (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., S.Reddy, K.M.R., D.B.), Stanford University School of Medicine, CA
- Cardiovascular Research Institute (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., N.M., L.T., S.Reddy, J.C.W., D.B.), Stanford University School of Medicine, CA
| | - Alison Schroer Vander Roest
- Department of Pediatrics (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., S.Reddy, K.M.R., D.B.), Stanford University School of Medicine, CA
- Cardiovascular Research Institute (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., N.M., L.T., S.Reddy, J.C.W., D.B.), Stanford University School of Medicine, CA
| | - Rahel A Woldeyes
- Department of Bioengineering (R.A.W., W.C.), Stanford University, CA
| | - Tiffany T Koyano
- Department of Cardiothoracic Surgery (T.T.K., R.F., J.Y.W.), Stanford University, CA
| | - Robyn Fong
- Department of Cardiothoracic Surgery (T.T.K., R.F., J.Y.W.), Stanford University, CA
| | - Ning Ma
- Cardiovascular Research Institute (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., N.M., L.T., S.Reddy, J.C.W., D.B.), Stanford University School of Medicine, CA
- Department of Medicine, Division of Cardiology (N.M., L.T., J.C.W.), Stanford University, CA
| | - Lei Tian
- Cardiovascular Research Institute (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., N.M., L.T., S.Reddy, J.C.W., D.B.), Stanford University School of Medicine, CA
- Department of Medicine, Division of Cardiology (N.M., L.T., J.C.W.), Stanford University, CA
| | - Gavin M Traber
- Department of Genetics (M.E., G.M.T., M.P.S., K.C.), Stanford University School of Medicine, CA
| | - Frandics Chan
- Department of Radiology (F.C.), Stanford University, CA
| | - John Perrino
- Cell Sciences Imaging Facility (J.P.), Stanford University, CA
| | - Sushma Reddy
- Department of Pediatrics (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., S.Reddy, K.M.R., D.B.), Stanford University School of Medicine, CA
- Cardiovascular Research Institute (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., N.M., L.T., S.Reddy, J.C.W., D.B.), Stanford University School of Medicine, CA
| | - Wah Chiu
- Department of Bioengineering (R.A.W., W.C.), Stanford University, CA
- Division of Cryo-Electron Microscopy and Bioimaging, SLAC National Accelerator Laboratory (W.C.), Stanford University, CA
| | - Joseph C Wu
- Cardiovascular Research Institute (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., N.M., L.T., S.Reddy, J.C.W., D.B.), Stanford University School of Medicine, CA
- Department of Medicine, Division of Cardiology (N.M., L.T., J.C.W.), Stanford University, CA
| | - Joseph Y Woo
- Department of Cardiothoracic Surgery (T.T.K., R.F., J.Y.W.), Stanford University, CA
| | - Kathleen M Ruppel
- Department of Pediatrics (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., S.Reddy, K.M.R., D.B.), Stanford University School of Medicine, CA
- Department of Biochemistry (K.M.R.), Stanford University School of Medicine, CA
| | | | - Michael P Snyder
- Department of Genetics (M.E., G.M.T., M.P.S., K.C.), Stanford University School of Medicine, CA
| | - Kévin Contrepois
- Department of Genetics (M.E., G.M.T., M.P.S., K.C.), Stanford University School of Medicine, CA
| | - Daniel Bernstein
- Department of Pediatrics (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., S.Reddy, K.M.R., D.B.), Stanford University School of Medicine, CA
- Cardiovascular Research Institute (S.Ranjbarvaziri, G.F., M.Z., A.S.V.R., N.M., L.T., S.Reddy, J.C.W., D.B.), Stanford University School of Medicine, CA
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22
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Bae S, Yoon HJ, Kim KH, Kim HY, Park H, Cho JY, Kim MC, Kim Y, Ahn Y, Cho JG, Jeong MH. Usefulness of Diastolic Function Score as a Predictor of Long-Term Prognosis in Patients With Acute Myocardial Infarction. Front Cardiovasc Med 2021; 8:730872. [PMID: 34568464 PMCID: PMC8460859 DOI: 10.3389/fcvm.2021.730872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Left ventricular diastolic function (LVDF) evaluation using a combination of several echocardiographic parameters is an important predictor of adverse events in patients with acute myocardial infarction (AMI). To date, the clinical impact of each individual LVDF marker is well-known, but the clinical significance of the sum of the abnormal diastolic function markers and the long-term clinical outcome are not well-known. This study aimed to investigate the usefulness of LVDF score in predicting clinical outcomes of patients with AMI. Methods: LVDF scores were measured in a 2,030 patients with AMI who underwent successful percutaneous coronary intervention from 2012 to 2015. Four LVDF parameters (septal e' ≥ 7 cm/s, septal E/e' ≤ 15, TR velocity ≤ 2.8 m/s, and LAVI ≤ 34 ml/m2) were used for LVDF scoring. The presence of each abnormal LVDF parameter was scored as 1, and the total LVDF score ranged from 0 to 4. Mortality and hospitalization due to heart failure (HHF) in relation to LVDF score were evaluated. To compare the predictive ability of LVDF scores and left ventricular ejection fraction (LVEF) for mortality and HHF, receiver operating characteristic (ROC) curve and landmark analyses were performed. Results: Over the 3-year clinical follow-up, all-cause mortality occurred in 278 patients (13.7%), while 91 patients (4.5%) developed HHF. All-cause mortality and HHF significantly increased as LVDF scores increased (all-cause mortality-LVDF score 0: 2.3%, score 1: 8.8%, score 2: 16.7%, score 3: 31.8%, and score 4: 44.5%, p < 0.001; HHF-LVDF score 0: 0.6%, score 1: 1.8%, score 2: 6.3%, score 3: 10.3%, and score 4: 18.2%, p < 0.001). In multivariate analysis, a higher LVDF score was associated with significantly higher adjusted hazard ratios for all-cause mortality and HHF. In landmark analysis, LVDF score was a better predictor of long-term mortality than LVEF (area under the ROC curve: 0.739 vs. 0.640, p < 0.001). Conclusion: The present study demonstrated that LVDF score was a significant predictor of mortality and HHF in patients with AMI. LVDF scores are useful for risk stratification of patients with AMI; therefore, careful monitoring and management should be performed for patients with AMI with higher LVDF scores.
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Affiliation(s)
- SungA Bae
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine and Cardiovascular Center, Yongin Severance Hospital, Yongin, South Korea
| | - Hyun Ju Yoon
- Division of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Kye Hun Kim
- Division of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Hyung Yoon Kim
- Division of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Hyukjin Park
- Division of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Jae Yeong Cho
- Division of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Min Chul Kim
- Division of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Yongcheol Kim
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine and Cardiovascular Center, Yongin Severance Hospital, Yongin, South Korea
| | - Youngkeun Ahn
- Division of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Jeong Gwan Cho
- Division of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Myung Ho Jeong
- Division of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
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23
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Anwar AM, tenCate FJ. Echocardiographic evaluation of hypertrophic cardiomyopathy: A review of up-to-date knowledge and practical tips. Echocardiography 2021; 38:1795-1808. [PMID: 34555207 DOI: 10.1111/echo.15200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/24/2021] [Accepted: 08/23/2021] [Indexed: 11/27/2022] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is the most frequent cardiac disease with genetic substrate, affecting about .2%-.5% of the population. The proper diagnosis is important for optimal management and follow-up. Echocardiography plays an essential role in the assessment of patients with HCM including diagnosis, screening, management formulation, prognosis, and follow up. It also helps to differentiate HCM from other diseases. The advancement of software and probe technology added many echo modalities and techniques that helped in refining the diagnostic and assessing the prognosis of patients with HCM. In this review, we briefly summarize how to integrate the different echocardiographic modalities to obtain comprehensive assessment supported by an updated knowledge of the latest guidelines and recently published articles. Many practical tips and tricks are included in this review to improve the diagnostic accuracy of echocardiography and minimize errors during interpretation.
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Affiliation(s)
- Ashraf M Anwar
- Department of Cardiology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.,Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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24
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Joseph N, Craft M, Mill L, Erickson CC, Danford DA, Kutty S, Li L. Assessment of mitral valve function in children and young adults with hypertrophic cardiomyopathy using three-dimensional echocardiography. Int J Cardiol 2021; 332:182-188. [PMID: 33753187 DOI: 10.1016/j.ijcard.2021.03.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of this study was to assess papillary muscle (PM) and mitral valve (MV) structure and function in children and young adults with mild and moderate hypertrophic cardiomyopathy (HCM) using real-time three-dimensional echocardiography (3DE) and to correlate them with HCM related adverse outcomes. METHODS Transthoracic research 3DE was performed in HCM patients and controls matched for age and gender. Anterolateral and posteromedial PM mass, apical displacement of anterolateral PM, and left ventricular (LV) mass were measured and indexed to body surface area. The MV annulus and leaflet structure and function were analyzed. Individual PMs were manually planimetered by tracing the endocardial borders on each mid systole frame, taking care to distinguish PMs as distinct from the LV wall. Apical PM displacement was expressed as ratio of the distance between the apex and the base of the anterolateral PM to the entire length of the LV lateral wall (APL index). All 3DE measurements were correlated to adverse outcomes. RESULTS Forty subjects were studied, including 20 HCM patients (age 18.1 ± 9.6 years, 16 male and 4 female), and 20 controls (18.2 ± 9.6 years, 16 male and 4 female). The indexed LV mass in HCM was 74.8 ± 25.8 g/m2 compared to 50.8 ± 12.4 g/m2 in controls (p = 0.001). The anterolateral, posteromedial and combined PM mass were 3.1 ± 2.2 g/m2, 1.7 ± 1.2 g/m2 and 4.9 ± 2.7 g/m2 in HCM, in contrast to respective measurements of 1.1 ± 0.6 g/m2, 1.2 ± 0.6 g/m2 and 2.3 ± 0.8 g/m2 in controls (p < 0.001, p = 0.062, and p < 0.001, respectively). The mitral valve annular parameters (annulus circumference, height and area) in HCM were not significantly different from controls. The APL index in HCM was less than in controls (0.44 ± 0.07 vs. 0.55 ± 0.04, p < 0.001). The LV lateral wall length and LV mass correlated with adverse HCM outcomes, while the APL index and PM total mass were not associated with adverse events. CONCLUSION It is feasible to evaluate PM muscles and MV annulus geometry in children and young adults with HCM using 3DE. The morphologic and functional changes of anterolateral PM may occur in the absence of MV annulus changes. Prospective validation will be required to determine if LV lateral wall length and LV mass may be used as predictors of adverse events.
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Affiliation(s)
- Navya Joseph
- University of Nebraska Medical Center, Omaha, NE, United States
| | - Mary Craft
- University of Nebraska Medical Center, Omaha, NE, United States; Children's Hospital and Medical Center, Omaha, NE, United States
| | - LuAnn Mill
- University of Nebraska Medical Center, Omaha, NE, United States
| | - Christopher C Erickson
- University of Nebraska Medical Center, Omaha, NE, United States; Children's Hospital and Medical Center, Omaha, NE, United States
| | - David A Danford
- University of Nebraska Medical Center, Omaha, NE, United States; Children's Hospital and Medical Center, Omaha, NE, United States
| | - Shelby Kutty
- Johns Hopkins Hospital and School of Medicine, Baltimore, MD, United States.
| | - Ling Li
- University of Nebraska Medical Center, Omaha, NE, United States; Children's Hospital and Medical Center, Omaha, NE, United States
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25
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Kim KH, Vallabhajosyula S, Rha SW, Choi BG, Byun JK, Choi CU. Initial diastolic dysfunction is a powerful predictor of 5-year mortality in peripheral arterial disease patients undergoing percutaneous transluminal angioplasty. Heart Vessels 2021; 36:1514-1524. [PMID: 33687543 DOI: 10.1007/s00380-021-01823-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/26/2021] [Indexed: 11/28/2022]
Abstract
Peripheral arterial disease (PAD) and heart failure share common risks and are associated with increased morbidity and mortality. However, it is unknown whether cardiac function can be an independent predictor of long-term mortality in patients with PAD. In total, 902 patients who underwent percutaneous transluminal angioplasty for PAD were enrolled. The patients were categorized into three groups according to the left ventricular ejection fraction (LVEF): reduced EF (< 40%, n = 62); mid-range EF (40-49%, n = 76); and preserved EF (≥ 50%, n = 764). Echocardiographic (EF, ratio of mitral inflow velocity to annular velocity E/e' ≥ 15, and others) and clinical parameters were tested using stepwise logistic regression analysis to determine independent predictors of 5-year mortality. A higher proportion of patients with reduced EF had ischemic heart disease than those with preserved EF (77.4% vs. 56.8%, p < 0.001). Up to 5 years, patients with reduced EF and mid-range EF showed a higher incidence of total death than those with normal EF. However, there was no difference in the incidence of myocardial infarction, stroke, and revascularization among the three groups. After multivariable adjustment, the ratio of E/e' ≥ 15 was the only strong predictor of total mortality (hazard ratio 6.14; 95% confidence interval 3.7-10.1; p < 0.01). Patients with PAD and reduced EF undergoing PTA had a higher incidence of total death during the 5-year follow-up. Initial tissue Doppler E/e' ≥ 15, a non-invasive estimate of left atrial filling pressure, was the only independent predictor of long-term mortality. The relationship between PAD and HF.
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Affiliation(s)
- Kyung-Hee Kim
- Cardiovascular Center, Sejong General Hospital, Incheon, South Korea
| | | | - Seung-Woon Rha
- Cardiovascular Center, Korea University Guro Hospital, 148, Gurodong-ro, Seoul, Guro-gu, 08308, South Korea.
| | - Byoung Geol Choi
- Cardiovascular Center, Korea University Guro Hospital, 148, Gurodong-ro, Seoul, Guro-gu, 08308, South Korea
| | - Jae-Kyung Byun
- Cardiovascular Center, Korea University Guro Hospital, 148, Gurodong-ro, Seoul, Guro-gu, 08308, South Korea
| | - Cheol Ung Choi
- Cardiovascular Center, Korea University Guro Hospital, 148, Gurodong-ro, Seoul, Guro-gu, 08308, South Korea
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26
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A robust bidirectional motion-compensated interpolation algorithm to enhance temporal resolution of 3D echocardiography. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2020.102384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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27
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Huang D, Wessler BS. Echocardiogram Assessment of Left Ventricular Mass for Hemodialysis Patients. Kidney Med 2020; 2:523-525. [PMID: 33090121 PMCID: PMC7568075 DOI: 10.1016/j.xkme.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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28
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Identification of cardiac organ damage in arterial hypertension: insights by echocardiography for a comprehensive assessment. J Hypertens 2020; 38:588-598. [PMID: 31809464 DOI: 10.1097/hjh.0000000000002323] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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29
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Guta AC, Badano LP, Ochoa-Jimenez RC, Genovese D, Previtero M, Civera S, Ruocco A, Bettella N, Parati G, Muraru D. Three-dimensional echocardiography to assess left ventricular geometry and function. Expert Rev Cardiovasc Ther 2020; 17:801-815. [PMID: 31770493 DOI: 10.1080/14779072.2019.1697234] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Introduction: Quantification of left ventricular (LV) size and function represents the most frequent indication for an echocardiographic study. New echocardiographic techniques have been developed over the last decades in an attempt to provide a more comprehensive, accurate, and reproducible assessment of LV function.Areas covered: Although two-dimensional echocardiography (2DE) is the recommended imaging modality to evaluate the LV, three-dimensional echocardiography (3DE) has proven to be more accurate, by avoiding geometric assumptions about LV geometry, and to have incremental value for outcome prediction in comparison to conventional 2DE. LV shape (sphericity) and mass are actually measured with 3DE. Myocardial deformation analysis using 3DE can early detect subclinical LV dysfunction, before any detectable change in LV ejection fraction.Expert opinion: 3DE eliminates the errors associated with foreshortening and geometric assumptions inherent to 2DE and 3DE measurements approach very closely those obtained by CMR (the current reference modality), while maintaining the unique clinical advantage of a safe, highly cost/effective, portable imaging technique, available to the cardiologist at bedside to translate immediately the echocardiography findings into the clinical decision-making process.
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Affiliation(s)
- Andrada C Guta
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua School of Medicine, Padua, Italy.,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Luigi P Badano
- Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Roberto C Ochoa-Jimenez
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua School of Medicine, Padua, Italy.,Internal Medicine Department, Mount Sinai St Luke's and Mount Sinai West, New York, NY, USA
| | - Davide Genovese
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua School of Medicine, Padua, Italy
| | - Marco Previtero
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua School of Medicine, Padua, Italy
| | - Stefania Civera
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua School of Medicine, Padua, Italy
| | - Alessandro Ruocco
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua School of Medicine, Padua, Italy
| | - Natascia Bettella
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua School of Medicine, Padua, Italy
| | - Gianfranco Parati
- Facoltà di Medicina e Chirurgia, Università degli Studi di Milano-Bicocca, Monza, Italy
| | - Denisa Muraru
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua School of Medicine, Padua, Italy.,Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy
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30
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Singam NSV, Fine C, Fleg JL. Cardiac changes associated with vascular aging. Clin Cardiol 2020; 43:92-98. [PMID: 31845364 PMCID: PMC7021646 DOI: 10.1002/clc.23313] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/05/2019] [Accepted: 11/20/2019] [Indexed: 12/20/2022] Open
Abstract
Cardiovascular aging is a complex process of adaptive structural and functional changes over time. With advancing age, the arterial tree thickens and decreases in compliance, resulting in increased pulse wave velocity, systolic blood pressure, and left ventricular afterload. In response to these arterial changes, the myocardium remodels to maintain systolic function and diastolic filling. These adaptive mechanisms are not necessarily pathologic but increase the susceptibility for myocardial ischemia and heart failure in the presence of common age-associated comorbidities. This article reviews the pathophysiology of cardiovascular aging and discusses therapeutic interventions that may ameliorate these processes.
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Affiliation(s)
| | - Christopher Fine
- Division of Cardiovascular MedicineUniversity of LouisvilleLouisvilleKentucky
| | - Jerome L. Fleg
- Division of Cardiovascular SciencesNational Heart, Lung, and Blood InstituteBethesdaMaryland
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31
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Walpot J, Juneau D, Massalha S, Dwivedi G, Rybicki FJ, Chow BJW, Inácio JR. Left Ventricular Mid-Diastolic Wall Thickness: Normal Values for Coronary CT Angiography. Radiol Cardiothorac Imaging 2019; 1:e190034. [PMID: 33778527 DOI: 10.1148/ryct.2019190034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 07/23/2019] [Accepted: 09/04/2019] [Indexed: 11/11/2022]
Abstract
Purpose To generate normal reference values for left ventricular mid-diastolic wall thickness (LV-MDWT) measured by using CT angiography. Materials and Methods LV-MDWT was measured in 2383 consecutive patients, without structural heart disease, undergoing prospective electrocardiographically (ECG) triggered mid-diastolic coronary CT angiography. LV-MDWT was manually measured on automatically segmented short-axis images according to the American Heart Association's 17-segment model. Commercially available automatic software was used to calculate the left ventricular (LV) mass. Results Among the 2383 patients, average LV-MDWT was 7.24 mm ± 1.86 (standard deviation [SD]), with the basal anteroseptal segment being the thickest wall (8.71 mm ± 2.19) and the apical inferior segment being the thinnest wall (5.9 mm ± 1.58; P < .001). Over all LV segments, the maximum upper limit, as defined as 2 SD above the mean, was 13.6 mm for men (LV1) and 11.2 mm for women. For men, only the basal anterior segment was above 13 mm. There was a significant difference in average LV-MDWT between women and men with 6.47 mm ± 1.07 and 7.90 mm ± 1.24, respectively (P < .001). Significant differences in LV-MDWT were found in the subgroups aged less than 65 years and greater than or equal to 65 years (P < .001). There was a strong correlation between LV-MDWT and LV mass (P < .001). Conclusion Normal sex- and age-specific reference ranges for LV-MDWT in prospective ECG-triggered mid-diastolic coronary CT angiography have been provided. These benchmarks may expand the diagnostic and prognostic roles of CT angiography, beyond its role in the identification of coronary artery disease.© RSNA, 2019.
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Affiliation(s)
- Jeroen Walpot
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada (J.W., S.M., B.J.W.C.); Service de Médecine Nucléaire, Centre Hospitalier de l'Université de Montréal, Montréal, Canada (D.J.); Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, Australia (G.D.); and Department of Radiology, University of Ottawa, The Ottawa Hospital, Medical Imaging and The Ottawa Hospital Research Institute, 501 Smyth Rd, Office M1466B, Mailbox 232, Ottawa, ON, Canada K1H 8L6 (F.J.R., J.R.I.)
| | - Daniel Juneau
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada (J.W., S.M., B.J.W.C.); Service de Médecine Nucléaire, Centre Hospitalier de l'Université de Montréal, Montréal, Canada (D.J.); Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, Australia (G.D.); and Department of Radiology, University of Ottawa, The Ottawa Hospital, Medical Imaging and The Ottawa Hospital Research Institute, 501 Smyth Rd, Office M1466B, Mailbox 232, Ottawa, ON, Canada K1H 8L6 (F.J.R., J.R.I.)
| | - Samia Massalha
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada (J.W., S.M., B.J.W.C.); Service de Médecine Nucléaire, Centre Hospitalier de l'Université de Montréal, Montréal, Canada (D.J.); Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, Australia (G.D.); and Department of Radiology, University of Ottawa, The Ottawa Hospital, Medical Imaging and The Ottawa Hospital Research Institute, 501 Smyth Rd, Office M1466B, Mailbox 232, Ottawa, ON, Canada K1H 8L6 (F.J.R., J.R.I.)
| | - Girish Dwivedi
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada (J.W., S.M., B.J.W.C.); Service de Médecine Nucléaire, Centre Hospitalier de l'Université de Montréal, Montréal, Canada (D.J.); Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, Australia (G.D.); and Department of Radiology, University of Ottawa, The Ottawa Hospital, Medical Imaging and The Ottawa Hospital Research Institute, 501 Smyth Rd, Office M1466B, Mailbox 232, Ottawa, ON, Canada K1H 8L6 (F.J.R., J.R.I.)
| | - Frank J Rybicki
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada (J.W., S.M., B.J.W.C.); Service de Médecine Nucléaire, Centre Hospitalier de l'Université de Montréal, Montréal, Canada (D.J.); Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, Australia (G.D.); and Department of Radiology, University of Ottawa, The Ottawa Hospital, Medical Imaging and The Ottawa Hospital Research Institute, 501 Smyth Rd, Office M1466B, Mailbox 232, Ottawa, ON, Canada K1H 8L6 (F.J.R., J.R.I.)
| | - Benjamin J W Chow
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada (J.W., S.M., B.J.W.C.); Service de Médecine Nucléaire, Centre Hospitalier de l'Université de Montréal, Montréal, Canada (D.J.); Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, Australia (G.D.); and Department of Radiology, University of Ottawa, The Ottawa Hospital, Medical Imaging and The Ottawa Hospital Research Institute, 501 Smyth Rd, Office M1466B, Mailbox 232, Ottawa, ON, Canada K1H 8L6 (F.J.R., J.R.I.)
| | - João R Inácio
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada (J.W., S.M., B.J.W.C.); Service de Médecine Nucléaire, Centre Hospitalier de l'Université de Montréal, Montréal, Canada (D.J.); Harry Perkins Institute of Medical Research, University of Western Australia, Nedlands, Australia (G.D.); and Department of Radiology, University of Ottawa, The Ottawa Hospital, Medical Imaging and The Ottawa Hospital Research Institute, 501 Smyth Rd, Office M1466B, Mailbox 232, Ottawa, ON, Canada K1H 8L6 (F.J.R., J.R.I.)
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32
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Takeuchi M, Kitano T, Nabeshima Y, Otsuji Y, Otani K. Left ventricular and left atrial volume ratio assessed by three-dimensional echocardiography: Novel indices for evaluating age-related change in left heart chamber size. Physiol Rep 2019; 7:e14300. [PMID: 31814325 PMCID: PMC6900493 DOI: 10.14814/phy2.14300] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
We hypothesized that left ventricular and left atrial volume ratio (LVLAVR) assessed by three-dimensional echocardiography (3DE) reflects age- and gender-related change in left chamber size. We aimed to (1) determine the reference values of LVLAVR, (2) investigate their age and gender dependency, and (3) clarify which anthropometric and echocardiography parameters are closely associated with these indices. Both left ventricular (LV) and left atrial (LA) volume curves were obtained using 3DE speckle tracking analytical software, and the LVLAVR curve throughout one cardiac cycle was created, from which LVLAVR at ventricular end-diastole and at ventricular end-systole were determined in 313 healthy subjects (age, 20-85 years; 51% men). The mean values of LVLAVR at ventricular end-diastole and ventricular end-systole in male subjects were 5.74 ± 1.54 and 1.37 ± 0.35, respectively. Corresponding values in female subjects were significantly lower (5.20 ± 1.47, p = .003 and 1.13 ± 0.29, p < .001) than the values in male subjects. LVLAVR at ventricular end-diastole step wisely decreased to advanced aging, and had a highest F ratio compared with other left chamber volumetric parameters in both genders. LV mass and LA ejection fraction were significantly associated with LVLAVR at ventricular end-diastole. In contrast, LV mass and LV ejection fraction were significantly coupled with LVLAVR at ventricular end-systole. This study provides the reference values for LVLAVR from a relatively large number of healthy subjects. LVLAVR may be a sensitive parameter to reflect age- and gender-related change in LV and LA volumes. Further studies should be required to determine its clinical usefulness over traditional echocardiography parameters in various cardiovascular diseases.
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Affiliation(s)
- Masaaki Takeuchi
- Department of Laboratory and Transfusion MedicineSchool of MedicineHospital of University of Occupational and Environmental HealthKitakyushuJapan
| | - Tetsuji Kitano
- Second Department of Internal MedicineSchool of MedicineUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Yosuke Nabeshima
- Second Department of Internal MedicineSchool of MedicineUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Yutaka Otsuji
- Second Department of Internal MedicineSchool of MedicineUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Kyoko Otani
- Department of Laboratory and Transfusion MedicineSchool of MedicineHospital of University of Occupational and Environmental HealthKitakyushuJapan
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Amigues I, Russo C, Giles JT, Tugcu A, Weinberg R, Bokhari S, Bathon JM. Myocardial Microvascular Dysfunction in Rheumatoid Arthritis Quantitation by 13N-Ammonia Positron Emission Tomography/Computed Tomography. Circ Cardiovasc Imaging 2019; 12:e007495. [PMID: 30636512 PMCID: PMC6361523 DOI: 10.1161/circimaging.117.007495] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND The goal of this study was to assess the prevalence of myocardial microvascular dysfunction in rheumatoid arthritis (RA) patients without clinical cardiovascular disease and its association with RA characteristics and measures of cardiac structure and function. METHODS Participants with RA underwent rest and vasodilator stress N-13 ammonia positron emission tomography and echocardiography. Global myocardial blood flow was quantified at rest and during peak hyperemia. Myocardial flow reserve (MFR) was calculated as peak stress myocardial blood flow/rest myocardial blood flow. A small number of asymptomatic and symptomatic non-RA controls were also evaluated. RESULTS In RA patients, mean±SD MFR was 2.9±0.8, with 29% having reduced MFR (<2.5). Male sex and higher interleukin-6 were significantly associated with lower MFR, while the use of tumor necrosis factor inhibitors was associated with higher MFR. Lower MFR was associated with higher left ventricle mass index and higher left ventricle volumes but not with ejection fraction or diastolic dysfunction. RA and symptomatic controls had comparable MFR (mean±SD: 2.9±0.8 versus 2.55±0.6; P=0.48). In contrast, MFR was higher in the asymptomatic controls (mean±SD: 3.25±0.7) although not statistically different. CONCLUSIONS Reduced MFR was observed in a third of RA patients without clinical cardiovascular disease and was associated with a measure of inflammation and with higher left ventricle mass and volumes. MFR in RA patients was similar to controls referred for clinical scans (symptomatic controls). Whether reduced MFR contributes to the increased risk for heart failure in RA remains unknown.
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Affiliation(s)
- Isabelle Amigues
- Division of Rheumatology (I.A., J.T.G., J.M.B.), Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital
| | - Cesare Russo
- Division of Cardiology (C.R., A.T., R.W., S.B.), Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital
- Current address for Cesare Russo: Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Jon T Giles
- Division of Rheumatology (I.A., J.T.G., J.M.B.), Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital
| | - Aylin Tugcu
- Division of Cardiology (C.R., A.T., R.W., S.B.), Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital
- Current address for Aylin Tugcu: Bristol Myers Squibb, Lawrenceville, NJ
| | - Richard Weinberg
- Division of Cardiology (C.R., A.T., R.W., S.B.), Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital
- Nuclear Cardiology Laboratory (R.W., S.B.), Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital
| | - Sabahat Bokhari
- Division of Cardiology (C.R., A.T., R.W., S.B.), Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital
- Nuclear Cardiology Laboratory (R.W., S.B.), Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital
| | - Joan M Bathon
- Division of Rheumatology (I.A., J.T.G., J.M.B.), Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital
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Abstract
Hypertension (HTN) is a major modifiable risk factor for cardiovascular disease (CVD) morbidity and mortality. The left ventricle (LV) is a primary target for HTN end-organ damage. In addition to being a marker of HTN, LV geometrical changes: concentric remodeling, concentric or eccentric LV hypertrophy (LVH) are major independent risk factors for not only CVD morbidity and mortality but also for all-cause mortality and neurological pathologies. Blood pressure control with lifestyle changes and antihypertensive agents has been demonstrated to prevent and regress LVH. Herein, we provide a comprehensive review of literature on the relationship between HTN and LV geometry abnormalities with a focus on diagnosis, prognosis, pathophysiological mechanisms, and treatment approaches.
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Lang RM, Addetia K, Narang A, Mor-Avi V. 3-Dimensional Echocardiography: Latest Developments and Future Directions. JACC Cardiovasc Imaging 2019; 11:1854-1878. [PMID: 30522687 DOI: 10.1016/j.jcmg.2018.06.024] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/31/2018] [Accepted: 06/22/2018] [Indexed: 01/03/2023]
Abstract
The ongoing refinements in 3-dimensional (3D) echocardiography technology continue to expand the scope of this imaging modality in clinical cardiology by offering new features that stem from the ability to image the heart in its complete dimensionality. Over the years, countless publications have described these benefits and tested new frontiers where 3D echocardiographic imaging seemed to offer promising ways to improve patients' care. These include improved techniques for chamber quantification and novel ways to visualize cardiac valves, including 3D printing, virtual reality, and holography. The aims of this review article are to focus on the most important developments in the field in the recent years, discuss the current utility of 3D echocardiography, and highlight several interesting future directions.
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Affiliation(s)
- Roberto M Lang
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.
| | - Karima Addetia
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Akhil Narang
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Victor Mor-Avi
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
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Levy F, Iacuzio L, Schouver ED, Essayagh B, Civaia F, Dommerc C, Maréchaux S. Performance of a new fully automated transthoracic three-dimensional echocardiographic software for quantification of left cardiac chamber size and function: Comparison with 3 Tesla cardiac magnetic resonance. JOURNAL OF CLINICAL ULTRASOUND : JCU 2019; 47:546-554. [PMID: 31355477 DOI: 10.1002/jcu.22764] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 06/06/2019] [Accepted: 07/09/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE To evaluate the accuracy and reproducibility of a new fully automated fast three-dimensional (3D) transthoracic echocardiography (TTE) software for the simultaneous assessment of left atrial (LA) volumes and LA ejection fraction (EF), left ventricular (LV) volumes, LV mass, and LVEF, and to compare the results obtained with a cardiac magnetic resonance (CMR) reference. METHODS We included retrospectively 56 patients (46 men; mean age 63 ± 13 years) in sinus rhythm who had had comprehensive 3D TTE and CMR examinations within 24 hours. RESULTS Despite a slight underestimation of LV and LA volumes, LVEF and LAEF were similar using CMR or 3DTTE (58% ± 16% vs 58% ± 12%; P = .65 and 45% ± 14% vs 46% ± 15%; P = .38, respectively) in the total population. Despite significant correlation between TTE and CMR measurements (r = 0.78; P < .001), 3D TTE underestimated LV mass (bias = -27 ± 35 g). CONCLUSION 3D TTE using a new-generation fully automated software is a fast and reproducible imaging modality for simultaneous extensive quantification of left heart chambers size and function in routine practice. Potential underestimation of LA volume and LV mass, and of LVEF in patients with LVEF <50%, should be taken into consideration.
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Affiliation(s)
- Franck Levy
- Imaging department, Centre Cardio-Thoracique de Monaco, Monte-Carlo, Monaco
| | - Laura Iacuzio
- Imaging department, Centre Cardio-Thoracique de Monaco, Monte-Carlo, Monaco
| | - Elie D Schouver
- Imaging department, Centre Cardio-Thoracique de Monaco, Monte-Carlo, Monaco
| | - Benjamin Essayagh
- Imaging department, Centre Cardio-Thoracique de Monaco, Monte-Carlo, Monaco
| | - Filippo Civaia
- Imaging department, Centre Cardio-Thoracique de Monaco, Monte-Carlo, Monaco
| | - Carinne Dommerc
- Imaging department, Centre Cardio-Thoracique de Monaco, Monte-Carlo, Monaco
| | - Sylvestre Maréchaux
- Groupement des Hôpitaux de l'Institut Catholique de Lille/Faculté Libre de Médecine, Université Lille Nord de France, Lille, France
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Kitano T, Nabeshima Y, Otsuji Y, Negishi K, Takeuchi M. Accuracy of Left Ventricular Volumes and Ejection Fraction Measurements by Contemporary Three-Dimensional Echocardiography with Semi- and Fully Automated Software: Systematic Review and Meta-Analysis of 1,881 Subjects. J Am Soc Echocardiogr 2019; 32:1105-1115.e5. [DOI: 10.1016/j.echo.2019.04.417] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/18/2019] [Accepted: 04/19/2019] [Indexed: 12/17/2022]
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Sawyer AA, Pollock NK, Gutin B, Weintraub NL, Stansfield BK. Proportionality at birth and left ventricular hypertrophy in healthy adolescents. Early Hum Dev 2019; 132:24-29. [PMID: 30953878 PMCID: PMC7101490 DOI: 10.1016/j.earlhumdev.2019.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/22/2019] [Accepted: 03/26/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Perinatal growth has important implications for cardiac development. Low birth weight is associated with cardiovascular (CV) events and mortality, and animal studies have shown that fetal growth restriction is associated with cardiac remodeling in the perinatal period leading to a permanent loss of cardiomyocyte endowment and compensatory hypertrophy. AIMS To determine associations of birthweight (BW) and multiple proportionality indexes (body mass index (BMI); weight/length2 and Ponderal index (PI); weight/length3) at birth on one hand, with left ventricular (LV) structure and function during adolescence. SUBJECTS 379 healthy adolescents aged 14-18 years in Augusta, Georgia. OUTCOME MEASURES LV structure and function parameters, including intraventricular septal thickness in diastole (IVSd), LV internal dimension in diastole (LVIDd), LV internal diameter in systole (LVIDs), LV posterior wall thickness in diastole (LVPWd), relative wall thickness (RWT), midwall fractional shortening (MFS), and ejection fraction, were assessed by echocardiography. RESULTS When associations of birthweight, birth BMI, and birth PI with LV structure and function parameters were separately evaluated with linear regression adjusting for age, sex, race, Tanner stage, socioeconomic status, and physical activity, significant positive associations of BW with LVIDd (P = 0.004), birth BMI with LV mass index (P = 0.01), and birth PI with IVSd (P = 0.02), LVPWd (P = 0.03), and LV mass index (P = 0.002) were identified. When LV structure and function parameters were compared across PI tertiles, a significant U-shaped trend for LV mass index (Pquadratic = 0.04) was identified. CONCLUSIONS Our adolescent data suggest that proportionality at birth may identify associations between perinatal growth and cardiac remodeling independent of birthweight alone.
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Affiliation(s)
- Alexandra A. Sawyer
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Norman K. Pollock
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA,Georgia Prevention Institute, Augusta University, Augusta, GA, USA
| | - Bernard Gutin
- Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA
| | - Neal L. Weintraub
- Division of Cardiology, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA,Vascular Biology Center, Augusta University, Augusta, GA, USA
| | - Brian K. Stansfield
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA,Vascular Biology Center, Augusta University, Augusta, GA, USA,Corresponding author at: Division of Neonatology, Department of Pediatrics, Medical College of Georgia at Augusta University, 1120 15th Street, BIW-6033, Augusta, GA 30912, USA. (B.K. Stansfield)
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Nabeshima Y, Nagata Y, Negishi K, Seo Y, Ishizu T, Sato K, Aonuma K, Koto D, Izumo M, Akashi YJ, Yamashita E, Oshima S, Otsuji Y, Takeuchi M. Direct Comparison of Severity Grading Assessed by Two-Dimensional, Three-Dimensional, and Doppler Echocardiography for Predicting Prognosis in Asymptomatic Aortic Stenosis. J Am Soc Echocardiogr 2018; 31:1080-1090.e3. [DOI: 10.1016/j.echo.2018.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Indexed: 10/28/2022]
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40
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Three-dimensional echocardiography: a further step in the evaluation of hypertensive heart disease. J Hypertens 2018; 36:1648-1650. [PMID: 29952849 DOI: 10.1097/hjh.0000000000001734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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41
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Di Nora C, Cervesato E, Cosei I, Ravasel A, Popescu BA, Zito C, Carerj S, Antonini-Canterin F, Popescu AC. New classification of geometric ventricular patterns in severe aortic stenosis: Could it be clinically useful? Echocardiography 2018; 35:1077-1084. [PMID: 29663506 DOI: 10.1111/echo.13892] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND In severe aortic stenosis, different left ventricle (LV) remodeling patterns as a response to pressure overload have distinct hemodynamic profiles, cardiac function, and outcomes. The most common classification considers LV relative wall thickness and LV mass index to create 4 different groups. A new classification including also end-diastolic volume index has been recently proposed. AIM To describe the prevalence of the newly identified remodeling patterns in patients with severe aortic stenosis and to evaluate their clinical relevance according to symptoms. METHODS We analyzed 286 consecutive patients with isolated severe aortic stenosis. Current guidelines were used for echocardiographic evaluation. Symptoms were defined as the presence of angina, syncope, or NYHA class III-IV. RESULTS The mean age was 75 ± 9 years, 156 patients (54%) were men, while 158 (55%) were symptomatic. According to the new classification, the most frequent remodeling pattern was concentric hypertrophy (57.3%), followed by mixed (18.9%) and dilated hypertrophy (8.4%). There were no patients with eccentric remodeling; only 4 patients had a normalLV geometry. Symptomatic patients showed significantly more mixed hypertrophy (P < .05), while the difference regarding the prevalence of the other patterns was not statistically significant. When we analyzed the distribution of the classic 4 patterns stratified by the presence of symptoms, however, we did not find a significant difference (P = .157). CONCLUSIONS The new classification had refined the description of different cardiac geometric phenotypes that develop as a response to pressure overload. It might be superior to the classic 4 patterns in terms of association with symptoms.
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Affiliation(s)
- Concetta Di Nora
- Cardiovascular Department, ASUITS, University of Trieste, Trieste, Italy
| | | | - Iulian Cosei
- Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania
| | - Andreea Ravasel
- Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania
| | - Bogdan A Popescu
- Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania.,University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | - Concetta Zito
- Cardiology Department, University of Messina, Messina, Italy
| | - Scipione Carerj
- Cardiology Department, University of Messina, Messina, Italy
| | | | - Andreea C Popescu
- University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania.,Cardiology Department, Elias Emergency Hospital, Bucharest, Romania
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Abstract
PURPOSE OF REVIEW Three-dimensional (3D) echocardiography (3DE) and 4-dimensional echocardiography (4DE), also known as real-time (RT) 3DE (RT3DE), are rapidly emerging technologies which have made significant impact in the clinical arena over the years. This review will discuss the recent applications of 3DE in diagnosing and treating different types of cardiovascular disease. RECENT FINDINGS Recent studies using 3DE expanded on prior findings and introduced additional applications to different cardiac conditions. Some studies have used 3D parameters to prognosticate long-term outcomes. Numerous innovative software designs including fully automated algorithms have been introduced to better evaluate valvular heart disease and cardiac function. SUMMARY With further evolution of 3DE technologies, this imaging modality will emerge as a powerful tool and likely become the imaging modality of choice in the diagnosis and management of various cardiac disorders.
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Affiliation(s)
- Susan H. Kwon
- Research Department, 100 Port Washington Blvd, Roslyn, NY 11576 USA
| | - Aasha S. Gopal
- Research Department, 100 Port Washington Blvd, Roslyn, NY 11576 USA
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Noninvasive cardiovascular imaging for evaluating subclinical target organ damage in hypertensive patients. J Hypertens 2017; 35:1727-1741. [DOI: 10.1097/hjh.0000000000001396] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Perrone-Filardi P, Coca A, Galderisi M, Paolillo S, Alpendurada F, de Simone G, Donal E, Kahan T, Mancia G, Redon J, Schmieder R, Williams B, Agabiti-Rosei E, Delgado V, Cosyns B, Lombardi M, Lancellotti P, Muraru D, Kauffmann P, Cardim N, Haugaa K, Hagendorff A. Non-invasive cardiovascular imaging for evaluating subclinical target organ damage in hypertensive patients. Eur Heart J Cardiovasc Imaging 2017; 18:945-960. [DOI: 10.1093/ehjci/jex094] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 04/26/2017] [Indexed: 01/09/2023] Open
Affiliation(s)
- Pasquale Perrone-Filardi
- Section of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Antonio Coca
- Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clínic (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Maurizio Galderisi
- Section of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | | | - Francisco Alpendurada
- NIHR Cardiovascular BRU, Royal Brompton & Harefield NHS Trust, Imperial College London, London, UK
| | - Giovanni de Simone
- Hypertension Research Center (CIRIAPA), Federico II University of Naples, Naples, Italy
| | - Erwan Donal
- Cardiology & Cic-it 1414, CHU Rennes LTSI, Insert 1099, Université Rennes-1, Rennes, France
| | - Thomas Kahan
- Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, SE-182 88 Stockholm, Sweden
| | - Giuseppe Mancia
- IRCCS Istituto Auxologico Italiano e Istituto Clinico Universitario di Verano Brianza, Policlinico di Monza, Italy
| | - Josep Redon
- INCLIVA Research Institute, University of Valencia and CIBERObn Carlos III Institute, Madrid, Spain
| | - Roland Schmieder
- University Hospital, Nephrology and Hypertension, Erlangen, Germany
| | - Bryan Williams
- National Institute for Health Research, University College London Hospitals, Biomedical Research Centre, University College London, London, UK
| | - Enrico Agabiti-Rosei
- Department of Clinical and Experimental Sciences, Clinica Medica, Hypertension and Cardiovascular Risk Research Centre, University of Brescia, Spedali Civili, Brescia
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Left atrium passive ejection fraction is the most sensitive index of type 2 diabetes mellitus-related cardiac changes. Int J Cardiovasc Imaging 2017; 34:141-151. [PMID: 28721548 DOI: 10.1007/s10554-017-1213-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/13/2017] [Indexed: 12/30/2022]
Abstract
The aims of this study were to use cardiovascular magnetic resonance (CMR) cine to assess left atrium (LA) and left ventricle (LV) function and structure in normotensive type 2 diabetes mellitus (T2DM) patients and to identify the most sensitive index of those T2DM-related cardiac changes. Fifty T2DM patients with normotension (25 males, age 54.7 ± 8.7 years, duration of diabetes: 7.5 ± 5.1 years) and 35 controls (16 males, age: 52.2 ± 13.2 years) were prospectively enrolled. All patients were scanned using CMR four- and two-chamber long-axis cine to assess LA and LV structure and function. Normotensive T2DM patients were associated with decreased LA total ejection fraction (EF), passive EF and LV end diastolic volume, normal LA active EF and LV myocardial mass and increased LV mass/volume (M/V). LA total EF and passive EF correlated with body mass index, duration of diabetes and M/V. To differentiate between diabetic patients and healthy controls, area under the receiver operating characteristic (ROC) curve (AUC) values were calculated to be 0.763, 0.706, 0.647 and 0.649 for LA passive EF, total EF, LVEDV and M/V, respectively. The addition of LA total EF, LVEDV, M/V and the combination thereof did not significantly improve AUC values in a model containing LA passive EF. Normotensive T2DM patients were associated with LA decreased total ejection fraction, decreased passive EF and LV concentric remodeling. Among these indices, LA passive EF was the most sensitive to T2DM-related LA function changes.
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Liu CY, Lai S, Kawel-Boehm N, Chahal H, Ambale-Venkatesh B, Lima JAC, Bluemke DA. Healthy aging of the left ventricle in relationship to cardiovascular risk factors: The Multi-Ethnic Study of Atherosclerosis (MESA). PLoS One 2017. [PMID: 28640873 PMCID: PMC5481019 DOI: 10.1371/journal.pone.0179947] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Understanding the relationship of cardiovascular structure and function to age is confounded by the high prevalence of traditional risk factors in the United States. The purpose of the study is to compare left ventricular (LV) and aortic structural, and functional parameters in individuals with and without traditional risk factors in a population-based cohort. Methods and results 3015 study participants (48% men, age 55–94, mean 69.01±9.17 years) in the Multi-Ethnic Study of Atherosclerosis (MESA) underwent cardiovascular magnetic resonance (CMR) imaging from 2010–2012. Absence of cardiovascular (CV) risk factors (no hypertension, diabetes or impaired fasting glucose, obesity, smoking or hypercholesterolemia) was infrequent, occurring in just 314 (10.4%, 38% men) of 3015 participants. In multivariable analyses adjusting for age, sex and race, individuals with CV risk factors had significantly larger LV mass index (by 17%) and lower LV contractibility (circumference strain, lower by 14%). Indexed LV volumes and stroke volume were inversely associated with age, but such relationships were not statistically significant in risk-free male subjects (p>0.05). Men with CV risk factors showed positive association of CMR T1 indices of myocardial fibrosis with age. Aortic function was similar in individuals with and without risk factors; age was associated with decline of aortic function in both CV and no CV risk factor groups. Conclusion Our results support that LV structure and function are better preserved in senescent hearts in the absence of traditional cardiovascular risk factors, and such protection is more prominent in men than in women.
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Affiliation(s)
- Chia-Ying Liu
- Radiology and Imaging Sciences, National Institutes of Health (NIH), Bethesda, Maryland, United States of America
| | - Shenghan Lai
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Nadine Kawel-Boehm
- Radiology and Imaging Sciences, National Institutes of Health (NIH), Bethesda, Maryland, United States of America
- Kantonsspital Graubuenden, Clinic of Radiology, Chur, Switzerland
| | - Harjit Chahal
- Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland, United States of America
| | | | - Joao A. C. Lima
- Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland, United States of America
| | - David A. Bluemke
- Radiology and Imaging Sciences, National Institutes of Health (NIH), Bethesda, Maryland, United States of America
- * E-mail:
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Alkema M, Spitzer E, Soliman OII, Loewe C. Multimodality Imaging for Left Ventricular Hypertrophy Severity Grading: A Methodological Review. J Cardiovasc Ultrasound 2016; 24:257-267. [PMID: 28090249 PMCID: PMC5234336 DOI: 10.4250/jcu.2016.24.4.257] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 10/28/2016] [Accepted: 11/30/2016] [Indexed: 01/04/2023] Open
Abstract
Left ventricular hypertrophy (LVH), defined by an increase in left ventricular mass (LVM), is a common cardiac finding generally caused by an increase in pressure or volume load. Assessing severity of LVH is of great clinical value in terms of prognosis and treatment choices, as LVH severity grades correlate with the risk for presenting cardiovascular events. The three main cardiac parameters for the assessment of LVH are wall thickness, LVM, and LV geometry. Echocardiography, with large availability and low cost, is the technique of choice for their assessment. Consequently, reference values for LVH severity in clinical guidelines are based on this technique. However, cardiac magnetic resonance (CMR) and computed tomography (CT) are increasingly used in clinical practice, providing excellent image quality. Nevertheless, there is no extensive data to support reference values based on these techniques, while comparative studies between the three techniques show different results in wall thickness and LVM measurements. In this paper, we provide an overview of the different methodologies used to assess LVH severity with echocardiography, CMR and CT. We argue that establishing reference values per imaging modality, and possibly indexed to body surface area and classified per gender, ethnicity and age-group, might be essential for the correct classification of LVH severity.
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Affiliation(s)
- Maaike Alkema
- Department of Biomedical Sciences, Leiden University Medical Center, Leiden, the Netherlands.; Cardialysis, Clinical Trial Management & Core Laboratories, Rotterdam, the Netherlands
| | - Ernest Spitzer
- Cardialysis, Clinical Trial Management & Core Laboratories, Rotterdam, the Netherlands.; Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Osama I I Soliman
- Cardialysis, Clinical Trial Management & Core Laboratories, Rotterdam, the Netherlands.; Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Christian Loewe
- Section of Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
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Feasibility of One-Beat Real-Time Full-Volume Three-Dimensional Echocardiography for Assessing Left Ventricular Volumes and Deformation Parameters. J Am Soc Echocardiogr 2016; 29:853-860.e2. [DOI: 10.1016/j.echo.2016.05.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Indexed: 11/20/2022]
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49
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Shang Y, Zhang X, Chen L, Leng W, Lei X, Yang Q, Liang Z, Wang J. Assessment of Left Ventricular Structural Remodelling in Patients with Diabetic Cardiomyopathy by Cardiovascular Magnetic Resonance. J Diabetes Res 2016; 2016:4786925. [PMID: 27419144 PMCID: PMC4933864 DOI: 10.1155/2016/4786925] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 04/26/2016] [Indexed: 12/12/2022] Open
Abstract
Background. Diabetic cardiomyopathy (DCM) is always accompanied with alteration of left ventricular structure and function. The aims of this study were to assess the structural remodelling in patients with DCM by cardiovascular magnetic resonance (CMR) and correlation of structural remodelling with severity of DCM. Methods. Twenty-five patients (53.8 ± 8.8 years, 52.0% males) with DCM and thirty-one normal healthy controls (51.9 ± 13.6 years, 45.2% males) were scanned by CMR cine to assess function and structure of left ventricular. Length of diabetic history and results of cardiac echocardiography (E', A', and E'/A') were also measured. Results. Compared with normal controls group, DCM group was associated with significantly increased ratio of left ventricular mass at end diastole to end-diastolic volume (MVR) (P < 0.05) and no significant difference was in mass at end diastole (P > 0.05). The ratio correlated with both length of diabetic history and echocardiographic Doppler tissue imaging E' (all P < 0.05). Conclusions. CMR can be a powerful technique to assess LV remodelling, and MVR may be considered as an imaging marker to evaluate the severity of LV remodelling in patients with DCM.
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Affiliation(s)
- Yongning Shang
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Xiaochun Zhang
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Liu Chen
- Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Weiling Leng
- Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Xiaotian Lei
- Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Qi Yang
- Department of Radiology, Xuanwu Hospital, Beijing 100053, China
| | - Ziwen Liang
- Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
- *Ziwen Liang: and
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
- *Jian Wang:
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