Speckle Tracking Echocardiography In Patients Research Articles

Myocardial iron overload: the use of speckle-tracking echocardiography in patients with transfusion-dependent beta-thalassaemia

Myocardial iron overload: the use of speckle-tracking echocardiography in patients with transfusion-dependent beta-thalassaemia

Association between CHA2DS2-VASc score and left atrial function by speckle tracking echocardiography in patients with sinus rhythm

Abstract Background The CHA2DS2-VASc score is a scoring system that was first used for the risk assessment of cerebrovascular or thromboembolic events in patients with atrial fibrillation (AF). The factors that constitute the CHA2DS2-VASc scoring system can all individually have an impact on LA function. The application of this scoring system can also be applied to patients without AF. The LA structural remodeling and/or functional impairment play a part in the pathogenesis and development of AF and independent of rhythm, may result in atrial hemostasis and confer a prothrombotic diathesis, resulting in thromboembolic stroke. Speckle- tracking echocardiography (STE) makes it possible to measure LA function with relatively high accuracy and at the very early stage even in the absence of LA enlargement. Purpose The aim of our study was to assess the left atrial function in patients with sinus rhythm with different CHA2DS2-VASc scores (low, moderate and high) by speckle tracking echocardiography and to identify the association between them. Methods This study was conducted using prospectively collected data (1st May, 2022 to 30th October 2022) from patients with sinus rhythm and different CHA2DS2-VASc scores (50 Low risk score patients (1 for females and 0 for males), 50 moderate risk score patients (2 for females and 1 for males) and 50 high risk score patients (≥3 for females and ≥2 for males) After obtaining an informed consent, all volunteers underwent thorough history taking, 12 lead ECG and conventional transthoracic echocardiography and speckle-tracking echocardiography. Results LA strain during the reservoir (LASr) and conduit phases (LAScd) were statistically significantly lower in the high-risk score group (33.2 ± 7.1 and 20.3 ± 5.7) than the moderate-risk score group (36.9 ± 6.1 and 23.5 ± 4.8, p = 0.005 and 0.003 respectively) and low -risk score group (40.6 ± 5.6 and 26.9 ± 3.9, p < 0.001). In addition, LASr and LAScd were statistically significantly lower in moderate- risk score group (36.9 ± 6.1 and 23.5 ± 4.8) than the low -risk score group (40.6 ± 5.6 and 26.9 ± 3.9 ,p=0.007 and 0.001 respectively). Conclusion Higher CHA2DS2-VASc scores were associated with decreased LA strain during the reservoir and conduit phases as markers of LA function with relatively high accuracy and at the very early stage even in the absence of LA enlargement.

Feasibility of Intraoperative 3-Dimensional Speckle-Tracking Echocardiography in Patients Undergoing Surgical Aortic Valve Replacement: A Prospective Observational Pilot Study

To assess the feasibility of intraoperative 3-dimensional speckle-tracking-based myocardial deformation analysis for evaluation of twist, torsion, and strain using speckle tracking, and to investigate the immediate changes in these parameters after aortic valve replacement. Prospective observational study SETTING: Single-center study at a tertiary academic cardiac center PARTICIPANTS: Forty-nine patients undergoing minimally invasive surgical aortic valve replacement INTERVENTIONS: Acquisition of full-volume images of the left ventricle after induction of anesthesia and at the end of surgery using transesophageal echocardiography (TEE), and analysis of the datasets using 3D speckle-tracking-based myocardial deformation analysis (Tomtec Arena). Of the 49 complete volume datasets, 30 (61%) had quality sufficient for speckle tracking. No significant differences were observed between the examinations in terms of ejection fraction (EF) (p = 0.177), global longitudinal strain (GLS) (p = 0.276), circumferential strain (CS) (p = 0.238), twist (p = 0.970), or torsion (p = 0.417). 3D speckle-tracking-based myocardial deformation analysis from intraoperative TEE datasets is feasible in >60% of patients with aortic valve stenosis. There were no statistically significant differences in GLS, CS, twist, or torsion between the intraoperative examinations.

Left ventricular diastolic function assessed by speckle tracking echocardiography in patients with left ventricular aneurysm.

Speckle-tracking echocardiography (STE) parameters are an integral part of the assessment of left ventricular (LV) function. We aimed to evaluate established and novel STE parameters of LV diastolic function and their prognostic role in patients with LV anteroapical aneurysm undergoing surgical ventricular repair (SVR). We retrospectively examined the data of 137 patients with anteroapical LV aneurysm who underwent SVR. In 27 patients, the correlation of STE parameters with invasive hemodynamic parameters was evaluated. Preoperative echocardiographic parameters were assessed for their association with outcome, defined as all-cause mortality, LV assist device implantation, or heart transplantation. The late diastolic strain rate (GLSRa) showed a stronger correlation with mean pulmonary artery pressure (r = - 0.75, p < 0.001) than all other parameters. GLSRa was also significantly correlated with mean pulmonary capillary wedge pressure and LV end-diastolic pressure. In the multivariate model, GLSRa and the ratio of early diastolic filling velocity to GLSRa demonstrated incremental prognostic value in addition to clinical and echocardiographic parameters. Patients with GLSRa < 0.59s-1 had significantly shorter event-free survival than those with GLSRa > 0.59s-1 (6.7 vs. 10.9years, p < 0.001). Peak reservoir left atrial strain showed a weaker association with hemodynamic parameters and outcome compared to GLSRa. In patients with LV aneurysm, late diastolic strain rate and left atrial strain can be used for the assessment of LV diastolic function and have a predictive value for the outcome after surgical ventricular restoration.

Role of Strauss ECG criteria as predictor of response in patients undergoing cardiac resynchronization therapy

Abstract Background Cardiac resynchronization therapy( CRT) is a standard treatment in patients with heart failure, however, approximately 20–40% of recipients of (CRT) do not respond to it based on the current patients’ election criteria. The purpose of this study was to identify the baseline parameters that predict the CRT response and how the ECG morphology can affect the outcome. Objective To evaluate the Strauss ECG criteria as predictor of response in patients undergoing Cardiac resynchronization therapy. Material and Methods From March 2020 to March 2022, 70 patients underwent CRT or CRT-D insertion with LBBB morphology in Ain Shams university hospitals, Cardiology department were enrolled in the study. All patients subjected to history, clinical examination, Electrocardiogram and echocardiography before CRT insertion and after 6 months. We analyzed the QRS morphology of the patients with LBBB-like pattern as we classified patients in two groups, Strauss LBBB criteria (SLBBB) which was (a QRS duration of &amp;lt; 140 ms for men and &amp;lt;130 ms for women, along with mid-QRS notching or slurring in at least 2 of the leads V1, V2, V5, V6, I, or aVL and also rS or QS morphology in lead V1 patients) and the other group that was not meeting the previous criteria as non-strauss LBBB (non-SLBBB), also all patients subjected to echocardiography ( conventional 2D and speckle tracking “global longitudinal strain and global circumferential strain), Ejection fraction was assessed together with LV volumes and speckle tracking to assess response to CRT. Results Out of 70 patients, 3 patients missed the 6 months follow up after CRT implantation, so the study enrolled 67 patients that have been classified according to ECG morphology of LBBB to 37 patients with non-Strauss ECG criteria- one of whom died after 4 months- and 30 patients with Strauss ECG criteria. The number of responders in the study was 50 patients with percentage 75.8%, 52% of CRT responder (26 patients) had non Strauss ECG criteria while 48% of CRT responders (24 patients) had Strauss ECG criteria with P value=0.463. While there was no statistical significance of overall CRT response nor 6 months hospitalization and mortality between patients of Strauss and non-Strauss ECG criteria, there was a significant improvement in NYHA class, EF assessed by biplane Simpson’s, End- systolic volume, Global longitudinal strain and Global circumferential strain by speckle tracking echocardiography in patients with Strauss ECG criteria of LBBB. Conclusion There is no statistical significance in overall CRT response nor the 6 months hospitalization and mortality after 6 months of follow up between patients with Strauss and non-Strauss ECG criteria of LBBB, however, patients with Strauss ECG criteria have better improvement in NYHA class, echocardiographic parameters such as EF and ESV and speckle tracking parameters (GLS and GCS).

Early effect of different bifurcation techniques on left ventricular mechanics in elective percutaneous coronary intervention

BackgroundBifurcation lesions are prevalent amongst patients with symptomatic coronary artery disease subjected to percutaneous coronary intervention (PCI). Recent consensus commends a conservative (provisional) approach when managing the side branch. Here, the aim was to explore the immediate impact of different bifurcation techniques (one stent and two stent strategies) on left ventricular LV) myocardial functions using speckle tracking echocardiography in patients subjected to elective PCI. Sixty two consecutive patients diagnosed with coronary bifurcation lesion (CBL) were enrolled. Patients were categorized into: one-stent strategy (Provisional group, n = 44) and a two-stent strategy (TAP, DK crush, or Culotte technique, n = 18), based on the coronary bifurcation site, angle, side branch diameter and Medina classification. LVEF%, regional and global longitudinal strain (GLS), and E/E' were measured before and within 24 h post PCI.ResultsIn both provisional and 2- stent technique, the mitral inflow velocities and mitral annular velocities showed improvement with significant reduction in E/e' (P < 0.03 and P < 0.001) respectively while LVEF% did not change. There were no significant changes in any other echo parameters post PCI. In provisional group, there were significant improvements in LAD (P < 0.001), RCA (P < 0.01) territories and GLS (P < 0.01). Δ LAD was expressively higher (34.5%) compared with Δ LCX (9.6%) and ΔRCA (25.4%), P < 0.001, P < 0.01 respectively. In the 2-stent technique group, there were significant improvements in peak longitudinal strain of LAD territory (P < 0.01), RCA territory (P < 0.01) and GLS (P < 0.01) respectively. Δ LAD territory was significantly higher in provisional group in comparison with the 2- stent technique group. Δ GLS was correlated inversely to Gensini score in provisional group and to the number of vessel diseased in 2-stent technique group.ConclusionPCI of the bifurcation lesion positively impact myocardial function. Both bifurcation techniques improve LV mechanical properties using 2D strain imaging while LV EF% remains unchanged.

Speckle Tracking Echocardiography in Patients with Non-Ischemic Dilated Cardiomyopathy Who Undergo Cardiac Resynchronization Therapy: A Narrative Review.

Non-ischemic dilated cardiomyopathy (DCM) represents a significant cause of heart failure, defined as the presence of left ventricular (LV) dilatation and systolic dysfunction unexplained solely by abnormal loading conditions or coronary artery disease. Cardiac resynchronization therapy (CRT) has emerged as a cornerstone in the management of heart failure, particularly in patients with DCM. However, identifying patients who will benefit the most from CRT remains challenging. Speckle tracking echocardiography (STE) has garnered attention as a non-invasive imaging modality that allows for the quantitative assessment of myocardial mechanics, offering insights into LV function beyond traditional echocardiographic parameters. This comprehensive review explores the role of STE in guiding patient selection and optimizing outcomes in CRT for DCM. By assessing parameters such as LV strain, strain rate, and dyssynchrony, STE enables a more precise evaluation of myocardial function and mechanical dyssynchrony, aiding in the identification of patients who are most likely to benefit from CRT. Furthermore, STE provides valuable prognostic information and facilitates post-CRT optimization by guiding lead placement and assessing response to therapy. Through an integration of STE with CRT, clinicians can enhance patient selection, improve procedural success rates, and ultimately, optimize clinical outcomes in patients with DCM. This review underscores the pivotal role of STE in advancing personalized management strategies for DCM patients undergoing CRT.

Left Atrial Strain by 2D Speckle Tracking Echocardiography in Patients with Systemic Hypertension in Babylon Province

Abstract Background: Systemic hypertension is an expanding health problem and a major cause of cardiovascular morbidity and mortality. Left atrial (LA) strain by speckle tracking is a new echocardiographic modality that can detect impairment in LA function. Objectives: The aim was to analyze the parameters of LA strain in patients with systemic hypertension and compare them to those of normal persons. Materials and Methods: A case–control study was conducted at the echocardiography department of Marjan Medical City in Hillah from February 2023 to June 2023. The study focused on patients with hypertension and compared their 2D echocardiography, Doppler, tissue Doppler, left ventricle global longitudinal strain, and LA strain to those of a control healthy group. Data collection included a questionnaire, echocardiography using the GE Vivid iq machine, and statistical analysis using Statistical Package for the Social Sciences (SPSS) 27 software. Results: In total, 100 persons were enrolled in the study; 50 of them were patients with systemic hypertension, and the other 50 were persons with negative medical history. The two groups were age, gender, and body surface area matched. Echocardiographic parameters were compared, concentrating on LA strain and diastolic function parameters. A strong correlation was found between hypertension and LA strain parameters. Reservoir, conduit, and contractile strain were lower in the hypertensive group, while the LA volume and LA indexed volume were statistically larger in the hypertensive group than the control group, with a P value of less than 0.001 in both. Conclusion: LA strain by speckle tracking is affected in systemic hypertension more and even before the diastolic function affection. Earlier detection and treatment of dysfunction can delay or even prevent complications.

Assessment of left atrial function by two-dimensional speckle tracking echocardiography in patients with metabolic-associated fatty liver disease

BackgroundMetabolic-associated fatty liver disease (MAFLD) and cardiovascular diseases have mutual risk factors that contribute to pathogenic processes, increasing mortality and morbidity. This study aimed to evaluate variations in left ventricular (LV) structure and diastolic function among different subtypes and severity degrees of MAFLD patients, allowing early identification, intervention, and prevention of severe cardiac outcomes in high-risk populations.ResultsThe cross-sectional study included 142 MAFLD patients and 142 non-MAFLD participants as a control group. All participants underwent abdominal ultrasound, transient elastography, transthoracic echocardiography, tissue Doppler, and strain imaging. The results showed a significant impairment in the diastolic left ventricular function, as assessed with tissue Doppler, and the left atrial (LA) function, as evaluated with strain imaging, in the MAFLD group. Additionally, the left atrial stiffness was significantly higher in the MAFLD group.ConclusionThe use of strain imaging facilitated the detection of subtle impairments of the left atrial reservoir, contraction, conduit function, and left ventricular diastolic function in MAFLD patients.

The Contemporary Role of Speckle Tracking Echocardiography in Cirrhotic Cardiomyopathy.

Cirrhotic cardiomyopathy (CCM) is characterized by elevated cardiac output at rest, an inability to further increase contractility under stress, and diastolic dysfunction. The diagnosis of CCM is crucial as it can lead to complications during liver transplantation. However, its recognition poses challenges with conventional echocardiography techniques. Speckle tracking echocardiography (STE), particularly global longitudinal strain (GLS), is a novel index that enhances the diagnostic efficacy of echocardiography for both ischemic and non-ischemic cardiomyopathies. GLS proves more sensitive in identifying early systolic dysfunction and is also influenced by advanced diastolic dysfunction. Consequently, there is an expanding scope for GLS utilization in cirrhotic cases, with newly updated diagnostic criteria for CCM incorporating GLS. Specifically, systolic dysfunction is now defined as either a left ventricular ejection fraction below 50% or an absolute GLS below 18%. However, conflicting data on GLS alterations in liver cirrhosis patients persist, as many individuals with advanced disease and a poor prognosis exhibit a hyperdynamic state with preserved or increased GLS. Consequently, the presence of CCM, according to the updated criteria, does not exhibit a significant association-in the majority of studies-with the severity of liver disease and prognosis. Furthermore, information on other indices measured with STE, such as left atrial and right ventricular strain, is promising but currently limited. This review aims to offer a critical assessment of the existing evidence concerning the application of STE in patients with liver cirrhosis.

The Role of Speckle-Tracking Echocardiography in Predicting Mortality and Morbidity in Patients With Congenital Heart Disease: A Systematic Review and Meta-analysis

Speckle-tracking echocardiography (STE) is now routinely included in cardiac evaluations, but its role in predicting mortality and morbidity in congenital heart disease (CHD) is not well described. We conducted a systematic review to evaluate the prognostic value of STE in patients with CHD. The EMBASE, Medline, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from inception to January 2023 for terms related to all CHD, STE, and prognosis. Meta-analysis of association of right ventricle and left ventricle strain (RV Sl and LV Sl, respectively) with major adverse cardiovascular events (MACEs) was performed in atrial switch transposition of the great arteries (asTGA)/congenitally corrected TGA (ccTGA), tetralogy of Fallot (ToF), and congenital aortic stenosis (cAS)/bicuspid aortic valve (BAV). P-value combination analysis was additionally performed for all CHD groups. A total of 33 studies (30 cohorts, n=8,619 patients, children, and adults) were included. Meta-analysis showed the following parameters as being associated with MACE: RV Sl in asTGA/ccTGA (hazard ratio [HR]=1.1/%; CI, [1.03; 1.18]), RV Sl and LV Sl in ToF (HR=1.14/%; CI, [1.03; 1.26] and HR=1.14/%; CI, [1.08; 1.2], respectively), and LV Sl in cAS/BAV (HR=1.19/%; CI, [1.15; 1.23]). The RV Sl and strain rate were associated with outcomes also in single ventricle/hypoplastic left heart syndrome (at all palliation stages except before Norwood stage 1) and LV Sl in Ebstein's anomaly. This systematic review and meta-analysis showed that biventricular strain and strain rate were associated with outcomes in a variety of CHD, highlighting the need for updated recommendations on the use of STE in the current guidelines, specific to disease types.

Left atrial mechanics evaluated by two-dimensional strain analysis: alterations in essential hypertension.

Hypertension is a cardiovascular risk factor that predisposes to cardiac structural alterations namely increased left ventricular (LV) wall thickness, reduced LV compliance and diastolic dysfunction, with consequent left atrial (LA) dilation and functional impairment. In this article, we evaluated differences in left atrial structure and function using two-dimensional speckle tracking echocardiography in patients with hypertension compared with controls. This was a retrospective cross-sectional study of 208 hypertensive patients and 157 controls who underwent a comprehensive transthoracic echocardiogram. Patients with hypertension were stratified by the presence of left ventricular hypertrophy (LVH). Non-LVH hypertension patients had lower left atrial reservoir strain (LAS RES ) (34.78 ± 29.78 vs. 29.78 ± 6.08; P = 0.022) and conduit strain (LAS CD ) (19.66 ± 7.29 vs. 14.23 ± 4.59; P = 0.014) vs. controls despite similar left atrial volumes (LAV) . Left atrial contractile strain (LAS CT ) was not significantly different between non-LVH hypertension patients and controls (15.12 ± 3.77 vs. 15.56 ± 3.79; P = 0.601). Left atrial mechanical dispersion was significantly higher in the LVH group compared with the non-LVH hypertension group (42.26 ± 13.01 vs. 50.06 ± 14.95; P = 0.009). In multivariate regression analysis, LVH correlated with left atrial mechanical dispersion ( P = 0.016). An age-hypertension interaction independently correlated with LAS CT ( P < 0.001). Hypertension results in functional left atrial changes even before development of LV hypertrophy and structural left atrial changes with increased left atrial volume. We demonstrate both a likely hypertension-associated left atrial myopathy that prevents age-related compensatory increase in left atrial contractile function, and impact of LVH in hypertension on left atrial dyssynchrony.

Evaluation of left atrial and left ventricular functions with 3D speckle-tracking echocardiography in patients with coronary artery tortuosity.

Tortuosity in the coronary arteries is a very common entity encountered during angiography. The effect of coronary artery tortuosity (CAT) on the myocardium has not been completely investigated. The aim of the current study was to assess the effects of CAT on left atrial (LA) and left ventricular (LV) myocardial functions by 3D speckle-tracking echocardiography (3D-STE). Seventy-five patients with CAT and 80 age- and gender-matched controls who proved to have normal coronary angiograms (CAG) were enrolled into the study. Following CAG, the 2D images were obtained first, and then 3D images were obtained for strain analysis. The LAS-r, LAS-active, and LV-GLS were significantly depressed in the CAT (+) group (p<.001, p<.001, p=.012, respectively). The multivariate regression models demonstrated that LAS-r (p<.001), LAS-active (p=.009), and LV-GLS (p=.024) were found to be independent factors predicting CAT. The current study is the first to focus on the assessing both LA and LV myocardial dynamics in CAT (+) patients by strain echocardiography. The results of our study support the patients with CAT may have subclinical LA and LV myocardial involvements.

Myocardial Strain Analysis by 2-Dimensional Speckle Tracking Echocardiography in Patients with Suspected Coronary Artery Disease

Myocardial Strain Analysis by 2-Dimensional Speckle Tracking Echocardiography in Patients with Suspected Coronary Artery Disease

Characterization of Subclinical Cardiac Dysfunction by Speckle Tracking Echocardiography in Patients With Non-severe Acute-Phase Myocarditis

Subclinical changes in left ventricular (LV) function have been demonstrated in patients with acute-phase myocarditis (AM) despite normal LV ejection fraction. The impact of AM on right ventricular (RV) and left atrial (LA) function has not been well described. This study aimed to assess for subclinical chamber dysfunction by speckle tracking echocardiography and its clinical relevance in this population. Patients with a diagnosis of AM (as per the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases) admitted to our institution from 2013 to 2018 were assessed. Patients with elevated serum troponin, normal coronary assessment, and normal LV ejection fraction on transthoracic echocardiogram were included. Clinical and echocardiographic parameters were compared with healthy age-, gender- and risk-factor matched controls. Global longitudinal strain assessed through speckle tracking echocardiography was performed using vendor independent software (v4.6; TomTec Arena, Munich, Germany). The final cohort consisted of 80 patients (40 AM patients and 40 controls). No significant differences in baseline clinical characteristics were observed between groups. Of the echocardiographic parameters, AM patients had lower LV-global longitudinal strain (p <0.01), lower RV free-wall strain (p=0.02) and lower peak LA strain (p <0.01). There were no differences in traditional echocardiographic measures of LV, RV, and LA function appreciated between groups. The presence of multichamber involvement was associated with peak Troponin levels (p <0.01). In conclusion, our study demonstrates the presence of global subclinical myocardial dysfunction in patients with AM. Additionally, the presence of multichamber involvement was significantly associated with degree of myocardial necrosis.

Evaluation of left atrial function by two-dimensional speckle tracking echocardiography in patients with cryptogenic stroke

Abstract Cryptogenic cerebro-vascular stroke is defined as ischemic stroke without definite etiology in spite of complete work up. It differs from embolic stroke of undetermined source (ESUS) which is a subgroup including the cardio-embolic sources.We aimed to evaluate the left atrial function using two-dimensional speckle tracking echocardiography (2D-STE) as a possible cause for cryptogenic stroke or a predictor for subclinical AF.TEE has an important role in the work up of cryptogenic stroke and ESUS searching for a possible cardio-embolic source including PFO, left atrial appendage thrombi and atheromatous plaques in aortic arch. Patients and methods Our retrospective cohort study included 62 patients of both sexes with unexplained cerebro-vascular stroke or TIA in stroke unit of Minia University.After performing TEE, 22 patients were excluded as they were proven to have a possible source for cardio-embolism.So, Participants were divided into two groups, group I which included 40 patients with cryptogenic stroke and group II which included 40 healthy participants with no medical history of significance as a control group.Two-dimensional trans-thoracic echocardiography and speckle tracking echocardiography were performed in both groups. We used LA diameter in PLAX, LA volume index (LAVI), LA ejection fraction (LAEF), LA strain rate during reservoir phase (LASr) and LV diastolic dysfunction as parameters of LA dysfunction.48 hours ECG rhythm monitoring during hospitalization was used in participants of group I for detection of more than 30 s episodes of subclinical or paroxysmal atrial fibrillation.Bilateral carotid duplex ultrasonography was also performed for exclusion of significant carotid artery stenosis as a possible cause for stroke. Results The parameters of LA dysfunction were significantly affected in group I than group II with P-value &amp;lt; 0.0001 for LV diastolic dysfunction, LAVI, LAEF and LASr, and 0.001 for LA diameter in PLAX. Episodes of AF were noticed in 14 patients of group I (group Ia, 35%) and the other 26 patients were called (group Ib, 65%).We compared LA dysfunction parameters in Group Ib and group II (healthy controls). There was significant affection of LV diastolic dysfunction in group Ib than group II with P-value &amp;lt; 0.011. LAVI, LAEF and LASr were significantly affected in group Ib than group II with P-value &amp;lt; 0.0001. While, there is no significant difference in LA diameter between both groups with P-value = 0.053.We found that left atrial strain rate during reservoir phase (LASr) is the most sensitive and specific parameter of left atrial cardiopathy in prediction of AF with cut-off point ≤24.5 % and P-value &amp;lt; 0.0001, then LAEF with cut-off point ≤40.5 % and P-value = 0.011. The LAVI is the least sensitive and specific parameter with cut-off point ≥38.5 ml/m2 and P-value = 0.003. Conclusion 2D-STE has an important role in the evaluation of LA dysfunction as a possible cause for cryptogenic stroke after performing of TEE and exclusion of possible sources for cardio-embolism.LA strain during reservoir phase (LASr) is a strong parameter for LA cardiopathy even before the occurrence of AF.Also, LASr is an independent risk factor for AF. LAEF and LAVI are important as parameters for LA dysfunction and predictors for AF as well but with less sensitivity and specificity than LASr.

Clinical Usefulness of Speckle-Tracking Echocardiography in Patients with Heart Failure with Preserved Ejection Fraction.

Heart failure with preserved ejection fraction (HFpEF) is defined as HF with left ventricular ejection fraction (LVEF) not less than 50%. HFpEF accounts for more than 50% of all HF patients, and its prevalence is increasing year to year with the aging population, with its prognosis worsening. The clinical assessment of cardiac function and prognosis in patients with HFpEF remains challenging due to the normal range of LVEF and the nonspecific symptoms and signs. In recent years, new echocardiographic techniques have been continuously developed, particularly speckle-tracking echocardiography (STE), which provides a sensitive and accurate method for the comprehensive assessment of cardiac function and prognosis in patients with HFpEF. Therefore, this article reviewed the clinical utility of STE in patients with HFpEF.

Early detection of reduced left ventricular systolic function by 2D speckle tracking echocardiography in patients with primary mitral regurgitation in a Vietnamese cohort.

Background: Mitral regurgitation (MR) is a common heart valve disease, causing many serious complications in several organ systems, especially the cardiovascular system. The 2D speckle tracking echocardiography (STE) is a new technique for detecting potential cardiac dysfunction when only tissue function abnormalities are present. The study aimed to assess left ventricular (LV) systolic function early by STE in patients with primary MR through global LV deformity along the global longitudinal strain (GLS). Methods: An analytical cross-sectional study was performed on 46 patients with moderate to severe primary MR as recommended by the American Society of Echocardiography (ASE) 2017. Results: The prevalence of patients with GLS reduction with ejection fraction (EF) >60%, New York Heart Association (NYHA) I, and left ventricular internal diameter systolic (LVIDs) <40mm was 38.1%, 35.7%, and 39.5%, respectively. 100% of patients with EF<60% and LVIDs ≥40mm had reduced GLS (<16%). The GLS index strongly correlates with the NYHA classification, degree of MR, EF, and echocardiographic parameters. Conclusion: GLS index gives a significant sign in the early detection of cardiac function abnormalities before symptoms or other echocardiographic parameters in patients with MR.

Speckle Tracking Echocardiography in Patients with Ankylosing Spondylitis and Evaluation of Subclinical Involvement

Speckle Tracking Echocardiography in Patients with Ankylosing Spondylitis and Evaluation of Subclinical Involvement

Assessment of Myocardial Function by Speckle Tracking Echocardiography in Patients with Acute Ischemic Stroke.

Acute stroke is an important cause of morbidity and mortality. Myocardial injury is an important complication of acute cerebrovascular events. Neurogenic stress cardiomyopathy (NSC) is a condition of acute myocardial systolic dysfunction that can be observed after acute cerebrovascular events. In this study, we aimed to investigate the relationship between myocardial function assessed by two-dimensional speckle-tracking echocardiography and National Institutes of Health Stroke Scale (NIHSS) score in patients with acute ischemic stroke. This cross-sectional study screened 97 patients (males, 42; females, 55; 65 ± 16 years) with acute ischemic stroke. Around 17 patients were excluded and 80 patients were studied. Patients were divided into two groups based on the calculated NIHSS score (Group 1, NIHSS score <16; Group 2, NIHSS score ≥16). Demographic, clinical, and laboratory data for all patients were collected. Cardiac function was evaluated by two-dimensional speckle tracking echocardiography within 48 h of admission to the neurology care unit. There were no significant differences in the demographic parameters of patients. The absolute value of global longitudinal systolic strain (GLS) was significantly higher in Group 1 patients than in Group 2 patients (21.4 ± 2.2 vs 15.9 ± 2.7, P = 0.0281). We found that thirteen patients (22%) had normal LVEF and abnormal LV GLS in Group 1 (P = 0.036). Eight patients (36%) had normal LVEF and abnormal LV GLS in Group 2 (P = 0.042). E/e', QT on ECG, and serum troponin levels were significantly higher in Group 2 patients than in Group 1 patients (P < 0.05). Our results suggest that GLS is associated with stroke severity on admission in patients with acute ischemic stroke. GLS is an indicator of myocardial deformation with a different from LVEF. GLS can detect early myocardial dysfunction despite preserved LVEF.