[Echocardiographic evaluation of the right atrium - from M-mode to 3D speckle-tracking imaging]

Autonomic function and specific right atrial functions - Is there a relationship? Correlations from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study

INTRODUCTION

Similarly to the ventricles, the atria are under sympathetic/parasympathetic neural regulation. Accordingly, correlations were investigated between Ewing's standard cardiovascular reflex tests (SCRTs) and three-dimensional speckle-tracking echocardiography (3DSTE)-derived right atrial (RA) volumes and strains in healthy subjects.

MATERIALS AND METHODS

The study comprised 45 healthy adults, but 5 subjects were excluded due to inferior image quality for 3DSTE-derived RA assessments. The remaining 40 individuals being in sinus rhythm had a mean age of 35.1 ± 3.5 years (20 men). Two-dimensional, Doppler, 3DSTE and SCRTs were performed in all cases.

RESULTS

RA maximum volume and total and passive RA stroke volumes correlated with the Valsalva ratio. Active RA stroke volume and emptying fraction showed correlations with 30/15 ratio. Peak global and mean segmental RA circumferential (CS) and longitudinal strains (LS) showed correlation with the Valsalva ratio. At atrial contraction, global RA-LS and mean segmental RA-CS showed correlations with the Valsalva ratio. Moreover, mean segmental RA-CS correlated with 30/15 ratio and mean segmental RA radial strain showed correlations with systolic blood pressure in response to standing. Autonomic neuropathy score correlated with peak global RA-LS.

CONCLUSIONS

Autonomic function parameters have significant associations with specific RA functions in healthy adults, making the latter possible indicators of autonomic dysregulation.

Right ventricle toxicity in cancer treatment: a focused review on cardiac imaging

Background: The right ventricle (RV) remains the 'forgotten chamber' in the clinical assessment of cancer therapy-related cardiac dysfunction (CTRCD). Aim: We aimed to review the role that various cardiac imaging modalities play in RV assessment as part of the integrative management of patients undergoing cancer therapy. Discussion: RV assessment remains challenging by traditional 2D echocardiography. In this review we discuss other parameters such as right atrial strain, and other echocardiographic modalities such as 3D and stress echocardiography. We also elaborate on the specific role that cardiac magnetic resonance imaging and equilibrium radionuclide angiocardiography can play in assessing the RV. Conclusion: Biventricular function should be monitored following chemotherapy for early detection of subclinical CTRCD and possible solitary RV changes.

Normal reference values of right atrial strain parameters using three-dimensional speckle-tracking echocardiography (results from the MAGYAR-Healthy Study)

Classic echocardiographic methodologies offer limited opportunities in assessing right atrial (RA) morphology and function. Three-dimensional (3D) speckle-tracking echocardiography (3DSTE) is a novel imaging method with objective 3D capability in assessing volumetric and functional properties of heart chambers. Normal reference values of different 3DSTE-derived RA strains are not available, therefore the aim of this prospective study was to establish these parameters in healthy subjects. The present study comprised 295 healthy volunteers, from which 110 were excluded due to inadequate image quality. The final population consisted of 185 healthy subjects in the present study (mean age: 32.1 ± 12.2 years, 89 males). Complete two-dimensional echocardiography and 3DSTE have been performed in all cases. While radial strain (RS) does not change significantly over the years in males, in female subjects it increases with age most significantly between at the age of 40–49, and it starts to decline at the age of 50 in females. While females have higher circumferential (CS) and area (AS) strain values, CS and AS decrease with age in both gender. While LS remains almost unchanged in females until ages 40–49 years with a decline above the age of 50, it decreases over the decades in males. 3D strain (3DS) increases with age in both gender, but almost doubles in females in older ages. Specific pattern of strains at atrial contraction could also be demonstrated. 3DSTE-derived RA normal reference values with age-, gender-dependency and regional values are demonstrated in a healthy population.

Three-dimensional speckle-tracking echocardiography detects different patterns of right atrial dysfunction in selected disorders: a short summary from the MAGYAR-Path Study

The right atrium (RA) is the most under-evaluated heart chamber in the clinical practice. Three-dimensional (3D) speckle-tracking echocardiography (STE) merges the benefits of 3D echocardiography and STE: volumetric and strain assessment of the RA can be performed at the same time from the same digitally acquired 3D echocardiographic dataset with a special equipment using a virtual 3D model of the RA. A diagnostic focused study is under way at the Second Department of Medicine and Cardiology Center, University of Szeged, Hungary to assess 3D-STE-derived RA variables in different patient populations, which serves as a substudy of Motion Analysis of the heart and Great vessels bY three-dimensionAl speckle-tRacking echocardiography in Pathological cases (MAGYAR-Path) Study. The aim of the present review is to summarize these early results.