Papillary Muscle Level Research Articles

The quantitative assessment of left ventricular local myocardial systolic function in patients with coronary heart disease by velocity vector imaging

Objective To explore the preliminarily clinical value of strain rate parameters using velocity vector imaging (VVI) evaluating left ventricular regional endocardial systolic function in patients with coronary artery heart disease (CAD). Methods A total of eight six inner subjects who were suspected as CAD was enrolled in the study. Patients with the vascular stenosis rate ≥50% were defined as the CAD group, patients with the vascular stenosis rate <50% were defined as the coronary atherosclerosis group, and patients with the completely normal angiographic results were included in the control group, according to the results of angiography. The left ventricular endocardial systolic strain rate parameters of VVI were obtained in standard long axis views (apical two, three, and four-chamber view) and short axis views (at the level of the mitral valve, papillary muscles, and apex). The strain rate parameters were global longitudinal endocardial systolic strain rate in the apical two, three, and four-chamber views (A2-GLSRs, A3-GLSRs, and A4-GLSRs), global radial endocardial systolic strain rate in short axis view of the mitral valve level, papillary muscles, and apex (MV-GRSRs, PM-GRSRs, and AP-GRSRs), and global circumferential endocardial systolic strain rate in short axis view of the mitral valve level, papillary muscles, and apex (MV-GCSRs, PM-GCSRs, and AP-GCSRs). The parametric differences were compared among three groups. Results All the subjects included in the present study had normal left ventricular ejection fraction (LVEF) and there was no significant difference in LVEF across three groups. Compared to other groups, the control group had significantly higher E/A ratio. The LV endocardial systolic strain rate parameters were all significantly reduced in the CAD group compared to the control group and the coronary atherosclerosis group (all P<0.05). Compared to the control group[(-1.37 ± 0.25)/s], the coronary atherosclerosis group[(-1.12 ± 0.42)/s] had significantly lower MV-GCSRs (P<0.01). Conclusions VVI is useful for quantitative assessment of the left ventricular systolic function in CAD. MV-GCSRs might have the potential to predict early left ventricle (LV) systolic dysfunction in subjects with coronary artery stenosis<50% . Key words: Echocardiography; Coronary disease/US

Improvement of left ventricular myocardial perfusion after acidic fibroblast growth factor delivered by using ultrasound-targeted microbubble destruction in rats with diabetic cardiomyopathy: an preliminary study

Objective To investigate the protective effects of left ventricular myocardial perfusion after delivery of acidic fibroblast growth factor (aFGF) in rats with diabetic cardiomyopathy (DCM) by using ultrasound-targeted microbubble destruction (UTMD) with real-time myocardial contrast echocardiography(RT-MCE). Methods Among 64 male SD rats, 52 rats were randomly selected and were induced DCM by streptozotocin through intraperitoneal injecting, the other rats as normal control group. DCM rats were randomly divided into the DCM model group, aFGF only group, SonoVue-aFGF group and the SonoVue-aFGF+ UTMD group in this study. The aFGF only group rats were injected with aFGF solution through tail vein, the SonoVue-aFGF group were injected with SonoVue-aFGF solution through tail vein and SonoVue-aFGF+ UTMD group rats were injected with SonoVue-aFGF solution through tail vein and using UTMD simultaneously. All rats underwent conventional echocardiography and RT-MCE exams before and 4 weeks after intervention. Left ventricular ejection fraction (LVEF) and left ventricular fraction shortening(LVFS) were measured by conventional echocardiography. The plateau intensity (A), initial slope of the curve (β) and myocardial blood flow (A×β) of left ventricular anterior wall at the papillary muscle level were measured in left ventricular short-axis view by RT-MCE. Results Before intervention, LVEF and LVFS in the DCM model group, aFGF only group, SonoVue-aFGF group and the SonoVue-aFGF+ UTMD group were significantly lower than in the normal control group (P 0.05), however A and A×β in the SonoVue-aFGF+ UTMD group were significantly increased than those in the DCM model group(P<0.01). Compared with the same group before intervention, A and A×β in the SonoVue-aFGF+ UTMD group were higher (P<0.05) and these in the DCM model group were lower during four weeks after intervention (P<0.05). Conclusions Acidic fibroblast growth factor delivered by using UTMD can improve the left ventricular myocardial perfusion in diabetic cardiomyopathy rats. Key words: Echocardiography; Diabetic cardiomyopathies; Fibroblast growth factor; Microbubbles; Ventricular function, left

Evaluation of left ventricular myocardial deformation parameters in individuals with electrocardiographic early repolarization pattern.

Objective:Although an early repolarization (ER) pattern was considered to be a benign electrocardiographic variant, several studies have shown that it is associated with an increased risk of idiopathic ventricular fibrillation and death. The aim of the present study was to determine whether there is any abnormality in myocardial deformation parameters (strain, strain rate, rotation, and twist) of the left ventricle obtained by speckle-tracking echocardiography (STE) in subjects with ER pattern.Methods:There were two groups in this prospective case-control study. The first group consisted of subjects with ER pattern (n=35). The other group was control without ER pattern (n=25). Subjects with poor echocardiographic image quality and history of cardiovascular, pulmonary, systemic, or metabolic disease were excluded from the study. For STE of the left ventricle, two-dimensional images from apical long-axis, two-chamber, and four-chamber views and from parasternal short-axis views were obtained.Results:We did not observe significant differences between the groups for left ventricular (LV) longitudinal deformation parameters, rotation, and twist. When LV circumferential deformation parameters were analyzed, early diastolic strain rate value at the level of apex was higher in subjects with ER pattern (2.3±0.7 s–1 vs. 1.9±0.4 s–1, p=0.01). Among LV radial deformation parameters, only peak strain (42.5±16.1% in the ER group vs. 56.9±21.1% in controls, p=0.004) and early diastolic strain rate (–2.0±0.7 s–1 in the ER group vs. –2.3±0.7 s–1 in controls, p=0.03) values at the level of papillary muscle were different.Conclusion:In subjects with ER pattern, LV myocardial deformation evaluated by STE is normal with a few regional exceptions. STE does not provide much information about risk stratification of these subjects.

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Comment on "Comparison of Electroacupuncture in Restrained and Unrestrained Rat Models".

Abstract 12797: A Global Longitudinal Strain in Endocardial Layer Selectively Correlated With Left Ventricular Ejection in Systemic Autoimmune Disorder Patients: A Multi-layer Transthoracic Echocardiography Study

Introduction: In patients with systemic autoimmune disorders (SAD), hemodynamic abnormalities such as pulmonary hypertension occur. Hypothesis: Some specific myocardial characteristics in SAD patients may precipitate hemodynamic abnormalities. Using myocardial multi-layer transthoracic echocardiography (TTE) analysis, we determine left ventricular (LV) myocardial characteristics in SAD patients, and compared LV ejection fraction (LVEF), estimated pulmonary arterial systolic pressure (ePASP) on TTE and serum brain natriuretic protein (BNP). Methods: Twenty SAD patients (18 female; mean age 49±18 years; systemic lupus erythematosus 35%; vasculitis 20%; scleroderma 5%, rheumatoid arthritis 5%, mixed connective tissue disease 5%) underwent TTE (Vivid E9, GE Healthcare). Apical 2-, 3-, and 4-chamber GLS views and parasternal short axis GCS view at the level of the papillary muscle was acquired. GLS was defined by averaging all 17 LV segments. GCS was defined as averaged LV segments at the level of papillary muscle. Furthermore strain measurements (absolute values) of whole, endocardial, and epicardial layers were performed using Echo PAC version 113 (GE Healthcare). Results: There was no significant correlation between GLS (whole, endocardial, and epicardial layers) and LVEF, ePASP, and BNP, respectively. GCS was significantly negatively correlated with serum BNP (R=-0.606 (whole), -0.452 (endocardial) and -0.447 (epicardial layer)). GCS in whole and epicardial layer was significantly negative correlated with ePASP (-0.528 (whole) and -0.457 (epicardial layer)). Only GCS in endocardial layer was significantly positive correlated with LVEF (R=0.466). Conclusions: In SAD patients, GCS significantly correlated with cardiac function and, especially in the endocardial layer selectively and positively correlated with LVEF. These specific myocardial characteristics in SAD patients may precipitate hemodynamic abnormalities.

Abstract 13989: Duration of Interventricular Septal Shift Predicts Clinical Outcome in Patients With Precapillary Pulmonary Hypertension: A CMR Study

Introduction: Right ventricular pressure overload results in interventricular septal (IVS) shift towards the left ventricle in patients with precapillary pulmonary hypertension (pPH). Hypothesis: The duration of IVS shift towards left ventricle during the cardiac cycle, as expressed by a novel marker called curvature duration index (CDi), predicts clinical outcome in pPH patients. Methods: This was a prospective study. All patients underwent cardiac magnetic resonance (CMR, Avanto Siemens 1,5T). CMR parameters of right ventricular function and dimensions were assessed. CDi (duration of IVS shift towards left ventricle x 100/cardiac cycle duration) was defined in the short-axis view at the level of papillary muscles (Figure 1). Time from enrollment to clinical failure (hospitalization due to pPH, initiation of parenteral prostanoid therapy, atrial septostomy or death) was recorded. Results: Our study included 36 consecutive patients (28 women, mean age 50.6±13.8 years) with pPH. Over a median follow-up period of 20.4 months (IQR 16.3-24.6 months) 14 clinical events were observed. In Cox proportional hazard analysis, only baseline CDi was significantly related to the composite event (HR 1.05, 95% CI 1.01-1.08, p=0.016). ROC curve analysis showed that the optimal cut-off value of CDi which predicted events was 66.7%. Kaplan-Meier survival analysis showed that CDi ≥66.7% was associated with a 9-fold increased risk for clinical failure (Figure 2). Conclusions: Ventricular septal shift towards left ventricle lasting for more than the 2/3 of the cardiac cycle is associated with worse prognosis in pPH.

Abstract 12494: Optimal Timing for Echocardiographic Assessment of Left Ventricular Function During Reduced Left Ventricular Assist Device Support

Introduction: In some circumstances left ventricular assist devices (LVAD) can be used to bridge patients with advanced heart failure to myocardial recovery or “remission”. Evaluation of the underlying myocardial function in patients supported with an LVAD is often performed with the pump speed turned down to minimal support for 15 minutes, to simulate unassisted ventricular loading conditions. Longer duration of reduced support and performance of exercise may allow for a more realistic evaluation of myocardial function to assess for recovery. Methods: Nine turn-down exams from 4 patients were analyzed. Subjects were participants in a multi-center prospective non-randomized study of LV recovery with HeartMate II LVAD together with a standardized protocol of pharmacological therapy (REmission from STAGE D Heart Failure (RESTAGE-HF)). LVEF and speckle tracking parameters were measured during full support, at 15 minutes of reduced support (6000 rpm) and again after a 6-min walk test. Averaged radial and circumferential strain, and global circumferential strain were analyzed from papillary muscle level short-axis view using speckle-tracking. Results: LV systolic parameters for each of these patients are shown, (Table). Improvement in LV function was not evident at 15 minutes of reduced support, compared to full support but was evident after the 6-min walk test. Conclusions: After 15 minutes of LVAD turndown, LV systolic parameters did not differ from full support values. Improvement in LV function compared to full support became evident when the protocol was extended to include imaging after a longer period of turndown with the addition of a 6-min walk test.

Experimental Study of Kinematic Activity of Left Ventricular Myocardium.

A method of invasive and non-invasive examination of epicardial motion was tested on domestic pigs (n=15). The invasive study employed a contact kinematic sensor of the epicardial wall motion, which determined the amplitude, velocity, and angular parameters of examined epicardial region. A non-invasive assessment of the epicardial kinematics based on echocardiographic 2D Velocity Vector Imaging and ECG recoding used to determine the heart electrical axis. The 4-chamber views were uses to analyze the longitudinal displacements of lateral wall of the left ventricle at the basal, mid, and apical segments. In addition, the radial displacements were determined in short axis projections at basal and apical segments as well as at the level of papillary muscles. The animals with normal or horizontal heart's electrical axis demonstrated similar displacement of the epicardium along X-axis and in longitudinal direction, while displacement along Y-axis corresponded to that in radial direction. The combined invasive and non-invasive approach in measurement of epicardium motion makes it possible to quantify the kinematic epicardial activity.

Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death

Mitral valve prolapse (MVP) may present with ventricular arrhythmias and sudden cardiac death (SCD) even in the absence of hemodynamic impairment. The structural basis of ventricular electric instability remains elusive. The cardiac pathology registry of 650 young adults (≤40 years of age) with SCD was reviewed, and cases with MVP as the only cause of SCD were re-examined. Forty-three patients with MVP (26 females; age range, 19-40 years; median, 32 years) were identified (7% of all SCD, 13% of women). Among 12 cases with available ECG, 10 (83%) had inverted T waves on inferior leads, and all had right bundle-branch block ventricular arrhythmias. A bileaflet involvement was found in 70%. Left ventricular fibrosis was detected at histology at the level of papillary muscles in all patients, and inferobasal wall in 88%. Living patients with MVP with (n=30) and without (control subjects; n=14) complex ventricular arrhythmias underwent a study protocol including contrast-enhanced cardiac magnetic resonance. Patients with either right bundle-branch block type or polymorphic complex ventricular arrhythmias (22 females; age range, 28-43 years; median, 41 years), showed a bileaflet involvement in 70% of cases. Left ventricular late enhancement was identified by contrast-enhanced cardiac magnetic resonance in 93% of patients versus 14% of control subjects (P<0.001), with a regional distribution overlapping the histopathology findings in SCD cases. MVP is an underestimated cause of arrhythmic SCD, mostly in young adult women. Fibrosis of the papillary muscles and inferobasal left ventricular wall, suggesting a myocardial stretch by the prolapsing leaflet, is the structural hallmark and correlates with ventricular arrhythmias origin. Contrast-enhanced cardiac magnetic resonance may help to identify in vivo this concealed substrate for risk stratification.

Early Impairment of Cardiac Function and Asynchronization of Systemic Amyloidosis with Preserved Ejection Fraction Using Two-Dimensional Speckle Tracking Echocardiography.

To observe the ventricular global and regional function of the patients with systemic amyloidosis using two-dimensional speckle tracking echocardiography. The study enrolled 31 consecutive biopsy-proved patients with systemic amyloidosis who underwent echocardiographic examination and EF ≥ 55% and 37 age- and gender-matched healthy controls. We compared systolic strain and strain rate, diastolic strain rate, time to peak strain, peak delay time in longitudinal, radial, circumferential directions in 16 left ventricular segments. The global peak systolic longitudinal and radial strain of left ventricle, peak systolic longitudinal strain and strain rate, diastolic strain rate of right ventricular free wall were also compared. (1) Global peak systolic longitudinal strain (GPSLS), peak systolic longitudinal strain (PSLS) and strain rate (PSLSR), peak early diastolic longitudinal strain rate (PELSR) in 16 segments were decreased in case (P < 0.05). (2) Peak systolic radial strain and strain rate of inferoseptum and inferolateral at the level of papillary muscle were lower (P < 0.05), and peak early diastolic radial strain rate (PERSR) was reduced (P < 0.05). (3) Peak early diastolic circumferential strain rate was lower (P < 0.05). (4) Time to peak systolic longitudinal, radial, circumferential strain was longer, and peak delay time at the same level retarded (P < 0.05). (5) Into right ventricular wall, PSLS and PSLSR at mid-segment, and PSLSR, PELSR, peak atrial systolic longitudinal strain rate (PALSR) at basal were reduced (P < 0.05). (6) Inverse correlation between interventricular septum (IVS) thickness and GPSLS and GPSRS was found (P < 0.05). Systolic and diastolic dysfunction existed in systemic amyloidosis with preserved EF. Mechanical contraction disorder may be one reason for systolic dysfunction. GPLSR and GPRSR were negatively related to IVS thickness.

Characteristic myocardial strain identified in hypertrophic cardiomyopathy subjects with preserved left ventricular ejection fraction using a novel multi-layer transthoracic echocardiography technique

PurposeIn order to evaluate compensatory mechanisms in hypertrophic-cardiomyopathy (HCM) subjects with preserved left-ventricular (LV) ejection-fraction (EF), we measured myocardial percentage endocardial strain dependency, as represented by 2D LV global longitudinal (GLS) and circumferential-strain (GCS), using a novel, multi-layer, speckle-tracking transthoracic-echocardiography (TTE) technique. MethodsA total of 60 subjects (40 HCM with preserved LV EF (30 male; 62±15years, all LV EF>50%)) and 20 controls (10 male; 59±10years) underwent TTE (Vivid-E9). Quantitative strain-measurements of: endocardial, all and epicardial layers were performed at each-site. We defined percentage endocardial strain dependency as the ratio of endocardial strain to epicardial strain. ResultsAbsolute GLS values at all views in all, endocardial and epicardial myocardial layers were significantly smaller in HCM subjects than in controls (all P<0.001). There were no significant differences between both-groups in absolute GCS values in the endocardial layers, at the mitral valve and papillary muscle levels. Percentage endocardial GCS dependency at all levels were greater in HCM subjects than in controls (all P<0.01). In HCM subjects, percentage endocardial GCS dependency at the mitral valve and papillary muscle levels revealed significant, moderate, negative correlations with LV end-diastolic and systolic dimensions (correlation coefficients −0.505, −0.451 (mitral valve level) and −0.533, −0.591 (papillary muscle level), respectively). ConclusionsIn HCM subjects with preserved LV EF, 2D LV GLS was lower than in controls, but endocardial GCS was maintained in compensation for reduction in endocardial GLS; thus percentage endocardial GCS dependency may increase, and the larger the LV size, the smaller this compensatory effect.

Strain and strain rate imaging using speckle tracking in acute allograft rejection in children with heart transplantation.

Acute allograft rejection is a major cause of morbidity and mortality following heart transplantation. There is no reliable noninvasive test to diagnose rejection. We aimed to investigate the accuracy of strain by speckle tracking echocardiography in the detection of acute rejection. We identified acute rejection episodes in patients followed at a single transplant center. Data were collected at baseline, during rejection and two follow-up points. Peak systolic radial and circumferential strain at the level of papillary muscles and peak systolic longitudinal strain from apical four-chamber view were analyzed offline. ANOVA was used for comparison between groups. p value ≤0.05 was considered significant. Fifteen rejection episodes were identified. There were no differences in the fractional shortening, LV posterior wall thickness, E/A, septal E/E', septal S', lateral E/E', lateral S', or MPI during rejection, compared to baseline. There was a significant increase in the LV mass during a rejection episode (47.5 vs. 34.4 g/ht(2.7) [p = 0.03]). The peak systolic radial strain (18.3 vs. 26.5; p = 0.03), longitudinal strain (-11.7 vs. -14.6; p = 0.05), and circumferential strain (-14.4 vs. -21.7; p = 0.05) declined significantly during rejection. In conclusion, peak systolic radial, longitudinal and circumferential strain decline and LV mass increases during an episode of rejection.

Abstract 12721: Compensatory Mechanism in HCM Patients With Preserved LV Ejection Fraction Determined by 2D Speckle Tracking Echocardiographic LV Myocardial Strain Gradient Using a Novel Multi-Layer Technique

Introduction: A novel multi-layer technique on speckle tracking transthoracic echocardiography (TTE) can achieve quantitative strain measurements of all, subendocardial, and subepicardial layer of left ventricle (LV), respectively. Aim: To evaluate compensatory mechanism in hypertrophic cardiomyopathy (HCM) subjects with preserved LV ejection fraction (EF), we measured myocardial strain gradient by 2D LV global longitudinal (GLS) and circumferential strain (GCS) using a multi-layer technique on speckle tracking TTE. Methods: 60 subjects (40 HCM (30 male; age 62 ± 15 years, LV EF &gt;50%, and 20 age matched controls (10 male; age 59 ± 10 years)) underwent TTE (Vivid E9, GE). Apical 4-, 2-, 3-chamber views for GLS and parasternal short-axis views at the level of mitral valve, papillary muscle, and apex for GCS were acquired. We defined myocardial strain gradient as the ratio of subendocardial strain to subepicardial strain. Results: GLS from each view were significantly smaller in HCM than controls in all, subendocardial, and subepicardial layers. GCS at all levels were significantly smaller in HCM than controls in all and subepicardial layer; however there were no significant differences in subendocardial GCS between both groups at mitral valve and papillary muscle levels. GLS gradient was significant greater in HCM than controls in GLS from 4 chamber views. GCS gradients were significantly greater in HCM than in controls at all levels. In HCM, subendocardial GCS at mitral valve and papillary muscle levels significantly positive correlated with LV EF (R=0.446, 0.34, respectively) and subendocardial GLS from 4-, and 2- chamber views, and subendocardial GCS at mitral valve and papillary muscles levels significantly negatively and GCS gradients at mitral valve and papillary muscle levels significantly positively correlated with interventricular septum thickness in end diastole (R=-0.44, -0.347, -0.335, -0.359, 0.363, and 0.373, respectively). Conclusions: In HCM subjects with preserved LV EF, GLS was significantly smaller than in controls, but GLS and GCS gradients tended to be greater than controls. We speculate that in HCM, subendocardial GCS was maintained in compensation for subendocardial GLS decrement; thus GCS gradient may increase.

Assessment of left ventricular systolic function in patients with paroxysmal atrial fibrillation by three-dimensional speckle tracking imaging

Objective To assess the clinical value of three-dimensional speckle tracking imaging (3D-STI) in detecting left ventricular systolic function in patients with paroxysmal atrial fibrillation (PAF).Methods 34 patients with PAF and 34 matched subjects were included.The strains of the left ventricular 17 segments (longitudinal and radial strain) were acquired using 3D-STI.Results Compared with the controls,the strains were decreased in the posterior wall,the inferior wall and the posterior septum below the left ventricular papillary muscle level in the PAF group,the differences were statistically significant (P ＜ 0.05),while there were no significant differences in other segments (P ＞ 0.05).Conclusions Left ventricular systolic function in patients with PAF was decreased,but the decreased degree of the segments was not all the same.3D-STI can evaluate left ventricular systolic function in patients with PAF and provide valuable clinical information. Key words: Echocardiography; Atrial fibrillation; Ventricular function,left ; Speckle tracking imaging

Assessment of the Rotation Motion at the Papillary Muscle Short-Axis Plane with Normal Subjects by Two-Dimensional Speckle Tracking Imaging: A Basic Clinical Study

BackgroundThe aim of this study was to observe the rotation patterns at the papillary muscle plane in the Left Ventricle(LV) with normal subjects using two-dimensional speckle tracking imaging(2D-STI).MethodsWe acquired standard of the basal, the papillary muscle and the apical short-axis images of the LV in 64 subjects to estimate the LV rotation motion by 2D-STI. The rotational degrees at the papillary muscle short-axis plane were measured at 15 different time points in the analysis of two heart cycles.ResultsThere were counterclockwise rotation, clockwise rotation, and counterclockwise to clockwise rotation at the papillary muscle plane in the LV with normal subjects, respectively. The ROC analysis of the rotational degrees was performed at the papillary muscle short-axis plane at the peak LV torsion for predicting whether the turnaround point of twist to untwist motion pattern was located at the papillary muscle level. Sensitivity and specificity were 97% and 67%, respectively, with a cut-off value of 0.34°, and an area under the ROC curve of 0.8. At the peak LV torsion, there was no correlation between the rotational degrees at the papillary muscle short-axis plane and the LVEF in the normal subjects(r = 0.000, p = 0.998).ConclusionsIn the study, we conclude that there were three rotation patterns at the papillary muscle short-axis levels, and the transition from basal clockwise rotation to apical counterclockwise rotation is located at the papillary muscle level.

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Right ventricular wall hypertrophy predicts functional capacity in pulmonary hypertension. A cardiac magnetic resonance study

Purpose: Right ventricular (RV) dilatation and wall hypertrophy is a compensatory mechanism to pressure and volume overload occurring in patients with pulmonary arterial hypertension (PAH). The aim of our study is to investigate the relationship between RV dimensions and wall thickness as accessed with cardiac magnetic resonance (CMR) and distance walked in 6-minute walking test (6MWD) in adult patients with PAH. Methods: All patients underwent 6 minute walking test (6MWT) and CMR on the same day. RV end diastolic (RVEDa) and end systolic area (RVESa) was obtained in short axis at the level of the papillary muscles at end diastole and end systole respectively and RV anterior wall thickness (RVWT) was measured at the same level at end diastole. Results: Our study included 14 patients with PAH (12 women, mean age 46.64±13.4 years), that walked 485.1±108.0 m in 6MWT. After controlling for confounding parameters as age, sex and body surface index, a negative correlation between distance walked in 6 minutes and RVWT (r=-0.671, p<0.001), RVESa (r=-0.660, p<0.01) and RVEDa (r=-0.704, p<0.005) was observed. Multivariate regression analysis showed that only RVWT is an independent predictor of 6MWD (B=-0.267, p<0.05) in the studied population (Table). View this table: Conclusions: The degree of RV hypertrophy may be used as a predictor of functional capacity of patients with PAH.

GW24-e3685 Three-dimensional speckle tracking imaging in assessment of left ventricular regional systolic function after transcatheter aortic valve implantation

ObjectivesTranscatheter aortic valve implantation (TAVI) is a new medical technology developed in recent years. It solves the problem of high operation risk of aortic valve stenosis undergoing thoracotomy replacement, its...

GW24-e0656 Radial displacement by speckle tracking echocardiography on locating the target coronary artery is much better compared to radial strain

ObjectivesThe value of radial displacement (RD) by speckle tracking echocardiography in locating target coronary artery disease has not been able to determine. We hypothesised that the myocardial RD by speckle...

GW24-e0648 Clinical application of left ventricular systolic function in patients with rheumatic disease by three-dimensional ultrasound speckle tracking imaging

ObjectivesThe aim of our study is to assess left ventricular global and regional systolic function in patients with pure mild to moderate rheumatic mitral stenosis (MS) by 3-dimensional ultrasound speckle...