Abstract
Abstract Background Three-dimensional (3D) speckle-tracking echocardiography is largely employed to evaluate left ventricle (LV) morphology and function. Purpose To investigate LV function before and after surgical ventricular reconstruction (SVR) through the analysis of global (GLS) and segmental (SLS) longitudinal strain, and the derived mechanical dispersion (MD). Methods Twenty patients eligible for SVR, with previous LV remodelling and ischemic heart failure (HF), received 3D echocardiographic evaluation before SVR and at 6-months follow-up; 15 normal controls, matched by age and BSA, were enrolled. Standard off-line GLS analysis was performed with 4D LV-ANALYSIS©; advanced segmental analysis was accomplished automatically through in-house numerical post-processing. Results Before SVR, GLS deteriorated compared to normal subjects (−6.7% vs. −19.6%, P<0.0001) as confirmed by SLS at each LV segment basal, mid and apical level (P<0.0001); MD was higher than in controls (P<0.001) and markedly increased from basal to apical LV segment. After SVR, GLS significantly improved from −6.7% to −11.3% (P<0.0001). Analysis of variance showed that SLS recovery was higher in the basal region (7.25%) than in both mid (4.06%, P=0.001) and apical (1.92%, P<0.0001) segments, respectively, with adjustment for baseline values. Conclusions After SVR, LV longitudinal strain mostly improves in the basal segments, outlining the role of the remote myocardium in enhancing LV function through an extensive volume reduction; post-surgical MD reduction indicates a more homogeneous myocardial contraction. Heath map of longitudinal strain (%) Funding Acknowledgement Type of funding source: Private hospital(s). Main funding source(s): IRCCS Policlinico San Donato is a clinical research hospital partially funded by the Italian Ministry of Health.
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