Changes Of Myocardial Systolic Function Research Articles

Layer-specific strain for assessing the effect of naringin on systolic myocardial dysfunction induced by sepsis and its underlying mechanisms.

ObjectiveThis study aimed to investigate the protective effects of naringin on myocardial deformation and oxidative responses in rats with sepsis-induced myocardial dysfunction (SIMD).MethodsGlobal and segmental layer-specific longitudinal strain (LS) was assessed by speckle tracking echocardiography. Serum levels of creatine kinase, lactate dehydrogenase, superoxide dismutase, and malondialdehyde were measured. The activity of cleaved caspase-3 was determined by immunohistochemistry. Protein expression levels of Kelch-like ECH-related protein 1 (Keap1), nuclear erythroid factor 2-related factor 2 (Nrf2), and heme oxygenase-1 (HO-1) were measured by western blotting.ResultsNaringin inhibited the lipopolysaccharide-induced decrease in global and layer-specific LS of the left ventricle. Naringin also increased superoxide dismutase expression and decreased malondialdehyde, creatine kinase, lactate dehydrogenase, and cleaved caspase-3 expression in rats with SIMD. Furthermore, naringin increased Nrf2 and HO-1 protein expression levels, and decreased Keap1 protein expression levels in rats with SIMD.ConclusionLayer-specific LS analysis of myocardial function by speckle tracking echocardiography can reflect early changes in myocardial systolic function. Naringin may possess a protective effect through moderating lipopolysaccharide-induced myocardial oxidative stress via the Keap1/Nrf2/HO-1 pathway in rats with SIMD.

Clinical significane of two-dimensional speckle tracking technique in the evaluation of diagnosis and prognosis of heart failure with left ventricular ejection fraction preservation

Objective To observe the clinical effect of two-dimensional speckle tracking technique in diagnosis and prognosis evaluation of heart failure with left ventricular ejection fraction preservation. Methods A total of 64 heart failure patients with reduced left ventricular ejection fraction (HFNEF) and 64 healthy volunteers in the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou were selected from July 2016 to July 2018.Conventional echocardiography and two-dimensional speckle tracking were performed in all subjects.The hemodynamic parameters and strain parameters of two-dimensional speckle tracking were recorded.The differences of conventional echocardiographic parameters and two-dimensional speckle tracking strain parameters in different subjects were analyzed. Results The E/A (0.79±0.24) and E/E' value (18.93±3.41) in HFNEF patients had statistically significant differences compared with healthy subjects [(1.28±0.35) and (6.84±1.37)] (t=9.507, 23.294; P=0.000, 0.000). There were no statistically significant differences in HR, LAD, LVD, LVSD, LVPWD, LVEF and LVFS between HFNEF patients [(71.37±5.93)times/min, (35.32±4.37)mm, (47.13±5.01)mm, (9.24±1.76)mm, (9.35±1.82)mm, (63.98±5.37)%, (35.49±4.46)%] and healthy subjects [(70.14±5.28)times/min, (37.64±4.69)mm, (49.26±5.54)mm, (9.39±1.82)mm, (9.48±1.90)mm, (66.35±5.41)%, (34.02±4.17)%] (t=0.384-1.628; P=0.102-0.564). In HFNEF patients, the anterior septum, anterior wall, posterior wall, inferior wall and posterior wall of apical segment of left ventricle, the inferior wall and posterior wall of papillary muscle and the posterior wall, inferior wall and posterior wall of basal segment, SRs and ROT of left ventricle were significantly lower than those of healthy subjects, while GLS (-13.52±4.18) and GCS (-10.43±3.85) of left ventricle in HFNEF patients were significantly higher than those of healthy subjects [(-19.89±4.61) and (-15.67±4.24)] (t=8.947~14.063; P=0.000-0.000<0.05). After treatment, the clinical symptoms of HFNEF patients improved significantly in the whole apical segment of left ventricle, inferior and posterior wall of papillary muscle segment, posterior lateral wall, inferior wall, posterior wall SRs and left ventricular GLS, GCS and ROT (t=7.258-13.193; P=0.000-0.000<0.05). Two-dimensional strain GLS and GC values in HFNEF patients were negatively correlated with E/A values and positively correlated with E/E' value (r=-0.817, -0.763; P=0.004, 0.012<0.05), while two-dimensional strain ROT results were positively correlated with E/A values and negatively correlated with E/E' values (r=-0.805, -0.759; P=0.006, 0.014<0.05). Conclusion Left ventricular systolic function damage has occurred in HFNEF patients.Two-dimensional speckle tracking technique is highly sensitive to the changes of myocardial systolic function for HFNEF patients.It has high clinical value in the diagnosis and prognosis evaluation of HFNEF.Relevant clinical workers should pay attention to it. Key words: Two-dimensional speckle tracking technique; Echocardiography; Heart failure with left ventricular ejection fraction preservation; Relevance; Left ventricle; Myocardial dysfunction; Diagnosis; Prognostic evaluation

Acute Changes in Myocardial Systolic Function in Preterm Infants Undergoing Patent Ductus Arteriosus Ligation: A Tissue Doppler and Myocardial Deformation Study

Ligation of a patent ductus arteriosus (PDA) in preterm infants causes profound hemodynamic changes that can result in low cardiac output syndrome and hypotension. The effect of PDA ligation on left ventricular myocardial function has not been studied using tissue Doppler and myocardial deformation imaging, mainly because of the limited validation of these methods in preterm infants. The primary objective of the present study was to determine the feasibility and reliability (intraobserver and interobserver variability) of tissue Doppler and myocardial deformation imaging for evaluating myocardial function in preterm infants undergoing surgical PDA ligation. Additionally, we sought to study the immediate effect of surgical ligation on the left ventricular tissue Doppler and strain measurements in the first 24 hours after surgery. Echocardiography was performed in 19 preterm infants before, 1 hour after, and 18 hours after PDA ligation born at 24-29 weeks of gestation. The tissue Doppler velocities of the lateral tricuspid and lateral and septal mitral valve annuli were obtained. The global and regional longitudinal peak systolic strain values were determined using two-dimensional speckle tracking echocardiography. The results of the three measurement points were compared using repeated measures analysis of variance. The intra- and interobserver variability was assessed using the intraclass correlation coefficient and Bland-Altman analysis. The median gestational age was 25.0 weeks (interquartile range 24.9-25.9) and the birth weight was 750 g (interquartile range 600-810). For the global longitudinal strain, the intraobserver intraclass correlation coefficient was 0.92 (95% CI, 0.78-0.97, P < .001), and the interobserver intraclass correlation coefficient was 0.93 (95% CI, 0.66-0.98, P < .001). Bland-Altman analysis showed no significant bias between the two observers, with good agreement. The systolic and diastolic tissue Doppler velocities of the mitral valve decreased significantly immediately after ligation and remained significantly lower than the preoperative levels at 18 hours. Also, the global longitudinal strain values significantly decreased 1 hour after the procedure (global longitudinal strain before -19.7% ± -3.8% vs -11.5% ± -3.5%; P= .001) but had significantly improved 18hours after the procedure (-15.1% ± -2.9%, P= .01). The present study has shown the feasibility and reliability of using tissue Doppler and strain imaging in premature infants with a hemodynamically significant PDA. Significant changes in myocardial function were observed immediately after PDA ligation, suggesting important changes in myocardial performance immediately after ductal ligation.

Comparison of the Detection of Subtle Changes in Myocardial Regional Systolic Function Using Qualitative and Semi-Quantitative Techniques

To evaluate qualitative wall motion assessment vs. quantitative wall thickening for the assessment of subtle changes in myocardial systolic function using cine MRI. Cine MR images were obtained in 5 canines with a significant coronary artery stenosis and in 2 controls on a 1.5T scanner. Qualitative results were obtained using a numerical scoring system; quantitative analysis was performed using a semi-automatic segmentation program. The techniques were matched and compared using Spearman correlations. All correlations in the experimental group revealed significant but weak to moderate relationships between the qualitative and quantitative results (e.g., at-risk tissue rho = 0.363, p < 0.0001; remote tissue rho = 0.275, p = 0.0002), with each identifying changes in regional function that ensued following creation of the stenosis. Intra-observer variability was reasonable in both methods when repeat analysis on a subset of the data was performed, with both techniques showing a significant correlation between the repeated measurements (quantitative - rho = 0.52, p < 0.0001; qualitative - rho = 0.54, p < 0.0001). Both methods were able to detect very limited wall motion abnormalities present in the canines with significant stenosis and either method gives comparable results.