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Zheng JY, Chen BH, Wu R, An DA, Shi RY, Wu CW, Tang LL, Zhao L, Wu LM. Prognostic value of right atrial strains in arrhythmogenic right ventricular cardiomyopathy. Insights Imaging 2024; 15:58. [PMID: 38411736 PMCID: PMC10899550 DOI: 10.1186/s13244-024-01630-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/18/2024] [Indexed: 02/28/2024] Open
Abstract
OBJECTIVES Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy characterized by progressive fibrofatty infiltration of atrial and ventricular myocardium resulting in adverse cardiac events. Atrial function has been increasingly recognized as prognostically important for cardiovascular disease. As the right atrial (RA) strain is a sensitive parameter to describe RA function, we aimed to analyze the prognostic value of the RA strain in ARVC. METHODS RA strain parameters were derived from cardiac magnetic resonance (CMR) images of 105 participants with definite ARVC. The endpoint was defined as a combination of sudden cardiac death, survival cardiac arrest, and appropriate implantable cardioverter-defibrillator intervention. Cox regression and Kaplan-Meier survival analyses were performed to evaluate the association between RA strain parameters and endpoint. Concordance index (C index), net reclassification index (NRI), and integrated discrimination improvement (IDI) were calculated to assess the incremental value of RA strain in predicting the endpoint. RESULTS After a median follow-up of 5 years, 36 (34.3%) reaching the endpoint displayed significantly reduced RA strain parameters. At Kaplan-Meier analysis, impaired RA reservoir (RARS) and booster strains (RABS) were associated with an increased risk of the endpoint. After adjusting for conventional risk factors, RARS (hazard ratio [HR], 0.956; p = 0.005) and RABS (HR, 0.906; p = 0.002) resulted as independent predictors for endpoint at Cox regression analyses. In addition, RARS and RABS improved prognostic value to clinical risk factors and CMR morphological and functional predictors (all p < 0.05). CONCLUSION RARS and RABS were independent predictors for adverse cardiac events, which could provide incremental prognostic value for conventional predictors in ARVC. CRITICAL RELEVANCE STATEMENT We evaluated the prognostic value of right atrial strain in ARVC patients and suggested cardiologists consider RA strain as a predictive parameter when evaluating the long-term outcome of ARVC patients in order to formulate better clinical therapy. KEY POINTS • Patients with ARVC had significantly reduced RA strain and strain rates compared with healthy participants. • Participants with lower RA reservoir and booster stains were associated with a significantly higher risk of adverse cardiac events. • RA booster and reservoir strain provide incremental value to conventional parameters.
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Affiliation(s)
- Jin-Yu Zheng
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People's Republic of China
| | - Bing-Hua Chen
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People's Republic of China
| | - Rui Wu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People's Republic of China
| | - Dong-Aolei An
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People's Republic of China
| | - Ruo-Yang Shi
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People's Republic of China
| | - Chong-Wen Wu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People's Republic of China
| | - Lang-Lang Tang
- Department of Radiology, Longyan First Hospital, Affiliated to Fujian Medical University, Longyan, 364000, People's Republic of China
| | - Lei Zhao
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, People's Republic of China.
| | - Lian-Ming Wu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People's Republic of China.
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Sakai A, Nagao M, Yamamoto A, Nakao R, Sakai S, Yamaguchi J. Prognostic value of right atrial strain in systemic sclerosis based on tissue tracking analysis using cine cardiac magnetic resonance imaging: a retrospective observational study. Heart Vessels 2024; 39:135-143. [PMID: 37777970 DOI: 10.1007/s00380-023-02320-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 09/14/2023] [Indexed: 10/03/2023]
Abstract
Interstitial lung disease and cardiac involvement are common manifestations and prognostic factors of systemic sclerosis. However, it is unclear whether impaired right atrial function associated with interstitial lung disease in systemic sclerosis can be used as a prognostic factor in this patient population. Therefore, this study aimed to investigate the relationship between right atrial function, interstitial lung disease, and prognosis in patients with systemic sclerosis using tissue tracking analysis with cine cardiac magnetic resonance imaging. In this retrospective observational study, a total of 40 patients with systemic sclerosis were enrolled. Tissue tracking analysis was used to obtain time curves of right atrial strain. Reservoir (total strain), conduit (passive strain), and booster (active strain) pump function were calculated, and right atrial strain, interstitial lung disease, and clinical outcomes were examined. An adverse clinical event was defined as all-cause death. Overall, 23 patients had interstitial lung disease (58%). Six patients died during the follow-up (median, 44 months). The total skin score and right ventricular systolic pressure on echocardiography were higher in patients with an event than in those without an event (28 ± 16% vs. 13 ± 13%, P = 0.02; 46.3 ± 10.7 mmHg vs. 36.0 ± 8.5 mmHg, P = 0.01, respectively). Further, right atrial total strain and active strain were significantly lower in patients with an event than in those without an event (14.3 ± 11.3% vs. 25.8 ± 11.4%, P = 0.03; 3.48 ± 2.37 vs. 11.7 ± 6.78, P = 0.007, respectively). Multivariate analysis revealed that active strain was an independent predictor of all-cause death (hazard ratio 0.76, P = 0.029). Kaplan-Meier analysis revealed that the survival rate was significantly higher in patients with right atrial active strain levels above the cutoff 7.4 (P < 0.05). In systemic sclerosis, right atrial booster function was predictive of mortality. Hence, right atrial functional assessment may have incremental prognostic value for patients with systemic sclerosis, leading to better risk stratification.
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Affiliation(s)
- Akiko Sakai
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjyuku-Ku, Tokyo, 162-8666, Japan.
| | - Michinobu Nagao
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjyuku-Ku, Tokyo, 162-8666, Japan
| | - Atsushi Yamamoto
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjyuku-Ku, Tokyo, 162-8666, Japan
| | - Risako Nakao
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjyuku-Ku, Tokyo, 162-8666, Japan
| | - Shuji Sakai
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjyuku-Ku, Tokyo, 162-8666, Japan
| | - Junichi Yamaguchi
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjyuku-Ku, Tokyo, 162-8666, Japan
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Jouan J, Craiem D, Masari I, Bliah V, Soulat G, Mousseaux E. Morphological and Dynamic Analysis of the Right Atrioventricular Junction in Healthy Subjects with 4D Computed Tomography. Cardiovasc Eng Technol 2022; 13:699-711. [PMID: 35167041 DOI: 10.1007/s13239-021-00604-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 12/13/2021] [Indexed: 01/27/2023]
Abstract
PURPOSE To improve knowledge of the tricuspid valve and right atrioventricular junction (RAVJ) coupling, four-dimensional (4D) imaging is mandatory (3D + time). Based on multiphase cardiac-volume computed tomography (CT) and innovative 4D analysis, we proposed to assess dynamical features of tricuspid annulus (TA) in relation to the right ventricle (RV) and right atrial (RA) functions. METHODS Cardiac-volume CT data sets through time were obtained in 30 healthy patients (Male 57%, mean age 57 ± 11 years). Using an in-house software, 3D semi-automated delineation of 18 points around TA perimeter were defined through 10 cardiac phases within RR interval and used to calculate TA features such as 3D/2D areas, perimeters, 360°-diameters and vertical deformation. RV and RA inner contours were also delineated. Bi-dimensional parameters were compared with multiplanar reconstruction (MPR) measurements. RESULTS TA was elliptical in horizontal projection with a maximal eccentricity index (EcImax) of 0.58 ± 0.12; and saddle-shaped in vertical projection with a horn nearby the antero-septal commissure. This feature remained throughout the cardiac cycle, but TA was more planar and less circular in late diastole (TA-height: 4.53 ± 1.06 mm, EcImax = 0.61 ± 0.14) when TA 3D area and perimeter reached a maximum of 7.05 ± 1.23 and 7.48 ± 0.93cm/m2, respectively. Correlations between minimal and maximal TA 3D areas and TA Projected 2D areas were excellent (r = 0.993 and r = 0.995, p < 0.001). TA 2D area measurements by MPR overestimated the projected values by 22 to 24%. Correlation between RV concentric strain and TA maximal diameter shortening was r = 0.452 (p = 0.01). CONCLUSIONS Cardiac-volume CT improves physiological knowledge of the relationships between the RAVJ components in healthy subjects.
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Affiliation(s)
- Jérôme Jouan
- Department of Cardiothoracic Surgery, University Hospital Centre Limoges, Dupuytren 2, 16 rue Bernard Descottes, 87042, Limoges Cedex, France. .,University Paris-Descartes, Paris, France. .,INSERM U970, Paris, France.
| | - Damian Craiem
- University Paris-Descartes, Paris, France.,Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | - Ignacio Masari
- University Paris-Descartes, Paris, France.,Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | - Virginie Bliah
- Department of Cardiovascular Imaging, Georges Pompidou European Hospital, APHP, Paris, France
| | - Gilles Soulat
- University Paris-Descartes, Paris, France.,INSERM U970, Paris, France.,Department of Cardiovascular Imaging, Georges Pompidou European Hospital, APHP, Paris, France
| | - Elie Mousseaux
- University Paris-Descartes, Paris, France.,INSERM U970, Paris, France.,Department of Cardiovascular Imaging, Georges Pompidou European Hospital, APHP, Paris, France
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van Mourik MJW, Artola Arita V, Lyon A, Lumens J, De With RR, van Melle JP, Schotten U, Bekkers SCAM, Crijns HJGM, Van Gelder IC, Rienstra M, Linz DK. Association between comorbidities and left and right atrial dysfunction in patients with paroxysmal atrial fibrillation: Analysis of AF-RISK. Int J Cardiol 2022; 360:29-35. [PMID: 35618104 DOI: 10.1016/j.ijcard.2022.05.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/10/2022] [Accepted: 05/16/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND To identify the association between comorbidities and left atrial (LA) and right atrial (RA) function in patients with paroxysmal atrial fibrillation (AF). METHODS This is a cross-sectional study. Speckle-tracking echocardiography was performed in 344 patients with paroxysmal AF at baseline, and available in 298 patients after 1-year follow-up. The number of comorbidities (hypertension, diabetes mellitus, coronary artery disease, body mass index > 25 kg/m2, age > 65 years, moderate to severe mitral valve regurgitation and kidney dysfunction (estimated glomerular filtration rate < 60 ml/min/1.73 m2)) was determined and the association with atrial strain was tested. RESULTS Mean age of the patients was 58 (SD 12) years and 137 patients were women (40%). Patients with a higher number of comorbidities had larger LA volumes (p for trend <0.001), and had a decrease in all strain phases from the LA and RA, except for the RA contraction phase (p for trend 0.47). A higher number of comorbidities was associated with LA reservoir and conduit strain decrease independently of LA volume (p < 0.001, p < 0.001 respectively). Patients with 1-2 comorbidities, but not patients with 3 or more comorbidities, showed a further progression of impaired LA and RA function in almost all atrial strain phases at 14 [13-17] months follow-up. CONCLUSIONS In patients with paroxysmal AF, individual and combined comorbidities are related to lower LA and RA strain. In patients with few comorbidities, impairment in atrial function progresses during one year of follow-up. Whether comorbidity management prevents or reverses decrease in atrial function warrants further study.
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Affiliation(s)
- Manouk J W van Mourik
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Cardiology, Maastricht University, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Vicente Artola Arita
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Aurore Lyon
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Biomedical Engineering, Maastricht University, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Joost Lumens
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Biomedical Engineering, Maastricht University, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Ruben R De With
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Joost P van Melle
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ulrich Schotten
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Sebastiaan C A M Bekkers
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Cardiology, Maastricht University, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Harry J G M Crijns
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Cardiology, Maastricht University, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Isabelle C Van Gelder
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Michiel Rienstra
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Dominik K Linz
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Cardiology, Maastricht University, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands; Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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5
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Artola Arita V, Santema BT, De With RR, Nguyen BO, Linz D, Schotten U, Van Gelder IC, Crijns HJGM, Voors AA, Rienstra M. Atrial function in paroxysmal AF patients with and without heart failure with preserved ejection fraction: Data from the AF-RISK study. Am Heart J 2022; 244:36-41. [PMID: 34688651 DOI: 10.1016/j.ahj.2021.10.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 10/02/2021] [Indexed: 11/01/2022]
Abstract
Atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) are 2 cardiovascular conditions that often coexist. Strain phases of both the left and right atria are more impaired in paroxysmal AF patients with HFpEF than those without HFpEF in spite of comparable global longitudinal strain of the left ventricle. Atrial function may differentiate paroxysmal AF patients with HFpEF from those without HFpEF.
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Prieto O, Cianciulli TF, Stewart-Harris A, Rodriguez A, Saccheri MC, Lax JA, Kazelián LR, Argento LV, Marambio GM, Gagliardi JA. Speckle Tracking Imaging in Patients with Pulmonary Hypertension. J Cardiovasc Imaging 2021; 29:236-251. [PMID: 34080333 PMCID: PMC8318815 DOI: 10.4250/jcvi.2020.0192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Right ventricular (RV) systolic dysfunction is a strong predictor of mortality in pulmonary hypertension (PH). The goal of this study was to investigate whether right atrium (RA) and RV myocardial strain related to PH using speckle tracking echocardiography provide a superior estimation of RV systolic function than 2-dimensional (2D)-echo. METHODS This cross-sectional study analyzed 22 patients with a diagnosis of PH stratified by right heart catheterization, and they were compared to a control group of 22 age- and sex-matched healthy subjects. RESULTS Global longitudinal peak systolic strain measured in the RV free wall from the apical 4 chamber view was −15% vs. −14.5% when measured from the subcostal view (p = 0.99). Mean longitudinal strain during reservoir phase, and longitudinal strain rate during atrial reservoir and passive conduit function was significantly impaired measured in the right atrial free wall in patients with PH. CONCLUSIONS This study showed impaired LV contractility in patients with PH assessed by speckle tracking strain. RV free wall longitudinal strain does not correlate with any of the measurements of RV systolic function obtained by 2D echocardiography. A major strength of RV longitudinal strain is its ability to assess the RV function without the limitations of 2D parameters. The subcostal RV strain is a feasible and accurate alternative to conventional RV strain from the apical view in patients with poor acoustic apical 4-chamber windows. The RA strain and strain rates values may be a valuable additive to assess right-sided heart function.
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Affiliation(s)
- Omar Prieto
- Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich", Buenos Aires, Argentina
| | - Tomás Francisco Cianciulli
- Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich", Buenos Aires, Argentina.
| | - Alejandro Stewart-Harris
- Pulmonary Hypertension Reference Center, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich", Buenos Aires, Argentina
| | - Andrea Rodriguez
- Pulmonary Hypertension Reference Center, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich", Buenos Aires, Argentina
| | - María Cristina Saccheri
- Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich", Buenos Aires, Argentina
| | - Jorge Alberto Lax
- Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich", Buenos Aires, Argentina
| | - Lucia Raquel Kazelián
- Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich", Buenos Aires, Argentina
| | - Laura Vanina Argento
- Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich", Buenos Aires, Argentina
| | - Gerardo Manuel Marambio
- Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich", Buenos Aires, Argentina
| | - Juan Alberto Gagliardi
- Division of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich", Buenos Aires, Argentina
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Li J, Lu C, Wang W, Gong K, Zhao L, Wang Z. Assessment of right atrium dysfunction in patients with obstructive sleep apnea syndrome using velocity vector imaging. Cardiovasc Ultrasound 2018; 16:32. [PMID: 30545377 PMCID: PMC6292122 DOI: 10.1186/s12947-018-0150-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 11/30/2018] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives This study aimed to assess the changes of RA function in patients with obstructive sleep apnea syndrome (OSAS) using velocity vector imaging (VVI) and to evaluate the application of VVI technology. Methods According to the apnea–hypopnea index (AHI), 71 patients with OSAS were divided into three groups: mild, moderate, and severe. A total of 30 cases of healthy subjects were enrolled as the control group. Digital images of apex four-chamber views were acquired to measure the right atrium (RA) linear dimensions and volume parameters including RA longitudinal diameter (RAL), transverse diameter (RAT), RA maximum volume (Vmax), RA minimum volume (Vmin), right atrial volume before contraction (Vpre). Right atrial volume parameters were corrected by body surface area (VImax, VImin, VIpre). The total right atrial emptying fraction (RATEF), right atrial passive emptying fraction (RAPEF), right atrial active contraction emptying fraction (RAAEF) were calculated. The VVI data measuring right atrial global strain (RA-GLS), right atrial strain rate in ventricular systolic phase (RA-SRs), right atrial strain rate in ventricular early diastolic phase (RA-SRe), right atrial strain rate in ventricular late diastolic phase (RA-SRa). Results RA linear dimensions and volume parameters in severe OSAS were higher than those of control group. RAPEF in severe group was lower than control group and mild OSAS group (t = 2.681, P = 0.021; t = 2.985, P = 0.011; respectively). RAAEF in OSAS moderate group was higher than that of control group (t = 3.006, P = 0.02), and without statistical difference (P > 0.05) in the severe OSAS group and the control group. RA-GLS in moderate OSAS group was significantly lower than that of control group (t = 2.333, P = 0.040) and reduced more obvious in the severe OSAS group (vs control, t = 3.25, P = 0.008, vs mild; t = 3.011, P = 0.012; respectively). RA-SRe in moderate and severe OSAS groups were lower than control group (t = 2.466, P = 0.031; t = 3.547, P = 0.005; respectively). RA-SRs of OSAS in severe group was lower than that of control and mild groups (t = 3.665, P = 0.004; t = 3.204, P = 0.008; respectively). RA-SRa in severe OSAS group was lower than that of control group (t = 2.425, P = 0.034). Multivariate regression analysis showed that RA-GLS and RA-SRe were independently correlated with AHI (t = − 2.738, P = 0.010; t = − 2.191, P = 0.036; respectively).
Conclusion RA function was impaired in patients with OSAS. On hemodynamics, the change of RA function performed increased of reserve function, reduced pipeline function and increased of contraction function. However, the strain and strain rate reduced in different degree. RA-GLS and RA-SRe decreased the earliest, which suggested that strain and strain rate were the parameters which can reflect myocardial function damage earliest. VVI can more earlier and accurately detect myocardial dysfunction of right atrium in patients with OSAS, which is expected to be a worthy technique for early clinical therapy in patients with OSAS.
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Affiliation(s)
- Junfang Li
- Department of Echocardiography, Qingdao University Affiliated Hospital, No. 16 Jiangsu Road, Qingdao, 266001, China
| | - Changhong Lu
- Department of Heart Center, Qingdao Fuwai Cardiovascular Hospital, Qingdao, 2660034, China
| | - Wugang Wang
- Department of Echocardiography, Qingdao University Affiliated Hospital, No. 16 Jiangsu Road, Qingdao, 266001, China
| | - Kun Gong
- Department of Echocardiography, Qingdao University Affiliated Hospital, No. 16 Jiangsu Road, Qingdao, 266001, China
| | - Liang Zhao
- Department of Echocardiography, Qingdao University Affiliated Hospital, No. 16 Jiangsu Road, Qingdao, 266001, China
| | - Zhibin Wang
- Department of Echocardiography, Qingdao University Affiliated Hospital, No. 16 Jiangsu Road, Qingdao, 266001, China.
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Meng X, Li Y, Li H, Wang Y, Zhu W, Lu X. Right atrial function in patients with pulmonary hypertension: A study with two-dimensional speckle-tracking echocardiography. Int J Cardiol 2018; 255:200-205. [PMID: 29425560 DOI: 10.1016/j.ijcard.2017.11.093] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 11/13/2017] [Accepted: 11/27/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND The role of right atrial (RA) dysfunction in patients with pulmonary hypertension (PH), as evaluated by two-dimensional speckle-tracking echocardiography (2D-STE) remains to be determined. METHODS Sixty consecutive PH patients and 30 healthy volunteers were included. RA function was evaluated by 2D-STE, and the following parameters were recorded: an average longitudinal strain (LS) curve that included LSpos during RA filling and LSneg representing RA active contraction (their summation is LStot), the phasic RA volumes, total RA emptying fraction, and the ratio of RA passive and active emptying to total emptying. The associations between these indices and the results of invasive pulmonary hemodynamics, cardiac structure and function, and NT-terminal pro brain natriuretic peptide (NT-proBNP) level were evaluated. RESULTS LStot, total RA emptying fraction, LSpos, passive RA emptying fraction were significantly lower, while the contribution of active RA empting fraction/total RA emptying fraction was higher in PH patients than in controls. Among PH patients, LStot was negatively correlated with greater RA size, RA pressure, and pulmonary vascular resistance, but not pulmonary artery pressure, while LStot was also negatively associated with right ventricular enlargement and higher NT-proBNP. In receiver-operator characteristic analysis, RA LStot was of optimal accuracy for prediction of WHO-function class ≥III in PH patients. CONCLUSIONS PH was associated with impaired reservoir and conduit function, but enhanced active contract function of RA, while RA LStot confers an optimal predictive effect of poor WHO-function class in PH patients.
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Affiliation(s)
- Xiangli Meng
- Department of Echocardiography, Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Yidan Li
- Department of Echocardiography, Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Hong Li
- Department of Echocardiography, Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Yidan Wang
- Department of Echocardiography, Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Weiwei Zhu
- Department of Echocardiography, Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Xiuzhang Lu
- Department of Echocardiography, Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing, 100020, China.
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Vitarelli A, Gaudio C, Mangieri E, Capotosto L, Tanzilli G, Ricci S, Viceconte N, Placanica A, Placanica G, Ashurov R. Bi-Atrial Function before and after Percutaneous Closure of Atrial Septum in Patients with and without Paroxysmal Atrial Fibrillation: A 2-D and 3-D Speckle Tracking Echocardiographic Study. Ultrasound Med Biol 2018; 44:1198-1211. [PMID: 29609808 DOI: 10.1016/j.ultrasmedbio.2018.02.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/12/2018] [Accepted: 02/26/2018] [Indexed: 06/08/2023]
Abstract
Our aim was to analyze atrial function with 2-D (2-D-STE) and 3-D (3-D-STE) speckle tracking echocardiography in patients with atrial septal devices and paroxysmal atrial fibrillation (PAF). One hundred sixteen patients and a subgroup of 22 patients who developed PAF after device insertion were studied. Left atrial and right atrial peak longitudinal strain and standard deviations of time to peak strain (TPS) were calculated using 2-D-STE. The left atrial/right atrial emptying fraction and expansion index were determined using 3-D-STE. By multivariate analysis, pre-closure 3-D right atrial expansion index, left atrial time to peak strain, and 3-D left atrial expansion index were independently associated with PAF. Compared with the other indices, receiver operating characteristic analysis revealed better diagnostic accuracy for the combination of pre-closure time to peak strain and 3-D expansion index in detecting PAF. Patients with atrial septal devices have pre-existing left and right atrial dilation and dysfunction as assessed by 2-D-STE and 3-D-STE that appear sensitive for the stratification of PAF risk in this population.
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Affiliation(s)
- Antonio Vitarelli
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy.
| | - Carlo Gaudio
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Enrico Mangieri
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Lidia Capotosto
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Gaetano Tanzilli
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Serafino Ricci
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Nicola Viceconte
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Attilio Placanica
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Giuseppe Placanica
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
| | - Rasul Ashurov
- Deptartments of Cardiology and Medicine, Sapienza University, Rome, Italy
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10
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Sakata K, Uesugi Y, Isaka A, Minamishima T, Matsushita K, Satoh T, Yoshino H. Evaluation of right atrial function using right atrial speckle tracking analysis in patients with pulmonary artery hypertension. J Echocardiogr 2015; 14:30-8. [PMID: 26613742 PMCID: PMC4779791 DOI: 10.1007/s12574-015-0270-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 11/05/2015] [Accepted: 11/06/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND In patients with pulmonary artery hypertension (PAH), right ventricular pressure overload eventually causes right heart failure (RHF), leading to a poor prognosis. Right atrial (RA) overload and RA dysfunction occur in patients with PAH-complicated RHF. OBJECTIVES We evaluated RA function using right atrial longitudinal strain (RALS) by two-dimensional speckle tracking echocardiography (2D-STE) and investigated the association between RALS and the severity of RHF in patients with pulmonary artery hypertension (PAH) noninvasively. METHODS We performed 2D-STE in 56 PAH patients and 20 normal control subjects. The peak global RALS and peak global RA longitudinal strain rate (RALSR) were analyzed by 2D-STE. Simultaneous right heart catheterization was performed to determine the right atrial pressure (RAP) and cardiac index (CI). RESULTS Peak global RALS (34.6 ± 14.1 vs. 58.3 ± 9.9%, p < 0.0001) and peak global RALSR (2.5 ± 1.3 vs. 3.1 ± 1.2 s(-1), p < 0.0001) were significantly lower in PAH patients compared with normal controls. There was a significant negative correlation between peak global RALS and RAP (r = -0.8037, p < 0.0001). There was a significant positive correlation between peak global RALS and CI (r = 0.8179, p < 0.0001). Peak global RALSR was also correlated with RAP (r = -0.7308, p < 0.0001) and CI (r = 0.7596, p < 0.0001). CONCLUSIONS RALS and RALSR by 2D-STE were useful for noninvasive evaluation of RA dysfunction and the severity of RHF in patients with PAH.
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Affiliation(s)
- Konomi Sakata
- Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Yoichiro Uesugi
- Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Aoi Isaka
- Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Toshinori Minamishima
- Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Kenichi Matsushita
- Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Toru Satoh
- Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Hideaki Yoshino
- Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
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