Systolic Function In Patients Research Articles

Postoperative changes in left ventricular systolic function after combined mitral and aortic valve replacement in patients with rheumatic heart disease.

We sought to identify short- and long-term changes in postoperative left ventricular systolic function in patients with rheumatic heart disease (RHD) who underwent combined aortic and mitral valve replacement. We analyzed 146 patients according to their preoperative left ventricular ejection fraction (LVEF) (113 with preoperative LVEF ≥50% and 33 with preoperative LVEF <50%). A restricted cubic spline model was used to assess the effect of time on the postoperative changes in echocardiographic parameters. There were no significant difference in preoperative and immediately postoperative LVEF before discharge in either group. During median follow-up of 3.2 years (interquartile range: 1.3-4.7 years) after surgery, postoperative LVEF increased slightly and then plateaued in patients with preoperative LVEF ≥50%, whereas it increased over 3-4 years after surgery and then gradually decreased in patients with preoperative LVEF <50% (p < .001). Long-term postoperative LVEF showed a downward trend in RHD patients with reduced preoperative LVEF, whereas it reached a plateau in RHD patients with normal preoperative LVEF.

Continuous positive airway pressure treatment in sleep apnea: patient compliance and impact on the right heart

Obstructive sleep apnea syndrome (OSAS) is considered to be an important predisposing factor for cardiovascular diseases. The main objective of this study was to investigate the impact of CPAP treatment on cardiac structure and function and to assess patient compliance over a long-term course of CPAP treatment. A total of 50 patients diagnosed with moderate-to-severe OSAS based on overnight study, without relevant concomitant diseases were enrolled. Patient compliance, along with echocardiographic and CPAP parameters, was assessed. The average time to follow-up was 38 ± 4.2 months. An increase in tricuspid annular plane systolic excursion (TAPSE) (22.1 ± 4.3–25.5 ± 4.6 mm, p = 0.005) and peak early systolic tricuspid annular velocity (S’) (14 ± 3.2–17.2 ± 5.2 cm/s, p = 0.005) after CPAP treatment was noted. In patients without CPAP, no significant change in right ventricular (RV) contractility was found. There were no significant differences regarding right atrial (RA) and RV diameters, as well as tricuspid regurgitant peak gradient (TRPG) in both groups; however, a predisposition to increased RA size along with RV and tricuspid annulus diameters was revealed. The mean duration of nightly CPAP use was 3 ± 2.3 h/night in all-day analysis and 4.7 ± 2.1 h/night on days with device usage. The non-adherence rate was 57%. The use of effective CPAP therapy may lead to increased RV systolic function in patients with OSAS in long-term observation. However, long-term patient compliance is generally poor. Regardless of CPAP therapy, a gradual increase in heart size is observed.

Acute myocarditis: prognostic role of speckle tracking echocardiography and comparison with cardiac magnetic resonance features.

To evaluate longitudinal systolic function in patients with myocarditis, its correlation with cardiac magnetic resonance (CMR) features, and its predictive value in functional recovery and arrhythmias onset during follow-up (FU) on optimized medical therapy (OMT). Patients with acute myocarditis, confirmed through CMR criteria, and age- and sex-matched healthy controls were enrolled. Two-dimensional (2D) transthoracic echocardiography, including speckle tracking analysis, was performed at admission and after 6months of FU. Patients of myocarditis group also underwent 24h ECG Holter monitoring during FU. 115 patients with myocarditis (mean age 41 ± 17, 70% males) and 70 healthy subjects were enrolled. Global longitudinal strain (GLS) and sub-epicardial strain were markedly lower in the myocarditis group than in controls (mean GLS%: -14.1 ± 5.1 vs -23.1 ± 3.6, p < 0.001). A strong positive correlation between total scar burden (TSB) on CMR and baseline LV GLS was found (r = 0.67, p < 0.0001). GLS improved after 6months of FU in myocarditis on OMT (mean GLS%: -14.1 ± 5.1 vs -16.5 ± 4.8, p < 0.01). By bivariate correlation analysis, baseline LVEF, GLS, and TSB were all associated with LVEF at 6months of FU. Moreover, by multivariable linear regression analysis, these parameters confirmed to be independent predictors of functional recovery at 6months (LVEF β 0.38, p < 0.01; GLS β -0.35, p < 0.01; total scar burden β -0.52, p < 0.0001). Segmental peak systolic strain was significantly different between segments with and without late gadolinium enhancement on CMR (-13.2 ± 3.1% vs -18.1 ± 3.5%, p < 0.001). A segmental strain of - 12% identified scar with a sensitivity of 79% and a specificity of 84% (AUC = 0.91; 95% CI 0.73-0.97; p < 0.001). In addition, baseline LV GLS in myocarditis resulted predictive of non-sustained ventricular tachycardias (cut-off value > -12%; sensitivity84%; specificity74.4%; AUC = 0.75). Parameters of myocardial longitudinal deformation are importantly associated with the presence of a scar on CMR and are predictors of functional outcome and ventricular arrhythmias in patients with acute myocarditis. Their assessment during ultrasound examination should be considered to get more information about the prognosis and risk stratification of this subset of patients.

Assessment of biventricular function in patients with hepatopulmonary syndrome.

Cardiac function impairment in the setting of hepatopulmonary syndrome (HPS) in patients with end stage liver disease remains an issue of debate. The current study evaluated possible correlations between HPS and biventricular systolic function in patients with decompensated cirrhosis. Consecutive liver transplantation candidates with stable decompensated cirrhosis were prospectively evaluated. HPS was defined as the presence of an elevated alveolar-arterial oxygen gradient and intrapulmonary vasodilatation, detected by contrast enhanced echocardiography. HPS severity was determined based on arterial blood oxygen pressure values, while shunt size was assessed with a semi-quantitative method. Demographic, clinical and laboratory parameters were also prospectively collected. In total, 130 patients (mean age 56.5, M/F: 94/36, MELD score 14.6 ± 5.6) were enrolled, of whom 45 (34.6%) fulfilled the criteria for HPS diagnosis (mild: 57.7%, moderate: 33.3%, severe 4.4% and very severe 4.4%). Significantly lower absolute left ventricular (LV) global longitudinal strain (GLS) values (- 21.6 ± 2.3 vs. - 22.6 ± 2.5%, p = 0.041) were measured in patients with HPS compared to cirrhotic patients without HPS, while there was no statistically significant difference regarding right ventricular GLS (- 22.1 ± 3.3 vs. - 23.2 ± 3.5%, p = 0.061) between the two groups. Lower LV ejection fraction values were also recorded in the HPS group (53.9 ± 3.5 vs. 56.3 ± 4.5%, p < 0.01). No other echocardiographic parameter was correlated to HPS. Intrapulmonary shunt grading was correlated to HPS classification (χ2 = 19.8, p < 0.01), with lower arterial oxygen values being recorded in higher stages of intrapulmonary shunt. In patients with cirrhosis, the presence of HPS is associated with worse LV contractile performance.

47-OR: Acute Fluctuations in Plasma Glucose Affect Echocardiographic-Derived Measures of Systolic Function in Patients with Type 1 Diabetes

Insulin treatment in patients with type 1 diabetes (T1D) causes rapid and large fluctuations in plasma glucose (PG) concentrations, and patients with T1D and poor glycemic control have an increased risk of cardiovascular disease including heart failure. We evaluated echocardiographic changes in cardiac function during experimental hypoglycemia and rebound hyperglycemia in patients with T1D. Patients with T1D (age 52.8±11.4 years, HbA1c 7.5±0.8% [57.6±8.9 mmol/mol], BMI 25.7±3.1 kg/m2) underwent two clamp days in random order. Both clamp days included three steady-state phases: 1) a 45-min hyperinsulinemic euglycemic phase (PG=6 mmol/L); 2) a 60-min hyperinsulinemic hypoglycemic phase (PG=2.5 mmol/L), and 3) a 60-min recovery phase in either hyperglycemia or euglycaemia (Clamp A: PG: 20 mmol/L; Clamp B: PG: 6 mmol/L). Cardiac function was evaluated with echocardiography at each phase by a blinded observer. Acute hypoglycemia increased left ventricular ejection fraction (LVEF) (absolute change, Clamp A: 6.5% [5.0;8.1], P=0.0001; Clamp B: 6.2% [4.6;7.9], P&amp;lt;0.0001) and global longitudinal strain (GLS) (absolute change, Clamp A: -3.1% (-4.5;-1.6), P&amp;lt;0.001; Clamp B: -3.5% (-4.6;-2.3), P&amp;lt;0.0001) from baseline. In Clamp A during hyperglycemia, LVEF and GLS were increased compared to baseline euglycemia (5.0% [3.2;6.8] (P&amp;lt;0.0001) and 2.1% [-3.7;-0.6] (P&amp;lt;0.01), respectively). An increase in LVEF was also observed in the recovery phase in Clamp B despite normalization of PG for 60 min (2.1% [0.5;3.8], P&amp;lt;0.05). In the recovery phase, LVEF was greater during hyperglycemia in Clamp A (2.9% [1.0;4.7], P&amp;lt;0.01) compared to euglycaemia in Clamp B. In conclusion, our findings suggest that acute fluctuations in PG affect echocardiographic-derived measures of systolic function in patients with T1D. Disclosure C. R. Andreasen: None. F. K. Knop: Advisory Panel; Self; MSD Corporation, Novo Nordisk A/S, Sanofi, Consultant; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Novo Nordisk A/S, Pharmacosmos, Zealand Pharma A/S, Research Support; Self; Novo Nordisk A/S, Zealand Pharma A/S, Speaker’s Bureau; Self; AstraZeneca, Bayer AG, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, MSD Corporation, Novo Nordisk A/S. T. Vilsbøll: Consultant; Self; Amgen Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Gilead Sciences, Inc., Lilly Diabetes, Merck Sharp &amp; Dohme Corp., Mundipharma International, Novo Nordisk, Sanofi, Sun Pharmaceutical Industries Ltd. A. Andersen: None. P. G. Hagelqvist: None. K. U. Abelin: None. J. V. Lauritsen: None. P. G. Jørgensen: Speaker’s Bureau; Self; AstraZeneca. S. Engberg: None. J. J. Holst: Consultant; Self; Novo Nordisk, Other Relationship; Self; Antag Therapeutics, Bainan Biotech, MSD Corporation, Novo Nordisk, Other Relationship; Spouse/Partner; Antag Therapeutics, Bainan Biotech, Synklino ApS. U. Pedersen-bjergaard: Advisory Panel; Self; Novo Nordisk A/S, Sanofi-Aventis, Consultant; Self; Abbott, Speaker’s Bureau; Self; Novo Nordisk A/S. Funding Novo Nordisk Foundation (NNF17SA0031406)

Evaluation of left ventricular myocardial systolic function in patients with premature ovarian insufficiency using real-time three-dimensional speckle tracking imaging

Evaluation of left ventricular myocardial systolic function in patients with premature ovarian insufficiency using real-time three-dimensional speckle tracking imaging

Beta-Blocker Use Is Associated With Prevention of Left Ventricular Remodeling in Recovered Dilated Cardiomyopathy.

BackgroundWithdrawal of optimal medical therapy has been reported to relapse cardiac dysfunction in patients with dilated cardiomyopathy (DCM) whose cardiac function had improved. However, it is unknown whether beta‐blockers can prevent deterioration of cardiac function in those patients. We examined the effect of beta‐blockers on left ventricular ejection fraction (LVEF) in recovered DCM.Methods and ResultsWe analyzed the clinical personal record of DCM, a national database of the Japanese Ministry of Health, Labor and Welfare, between 2003 and 2014. Recovered DCM was defined as a previously documented LVEF <40% and a current LVEF ≥40%. Patients with recovered DCM were divided into 2 groups according to the use of beta‐blockers. A one‐to‐one propensity case‐matched analysis was used. The primary outcome was defined as a decrease in LVEF >10% at 2 years of follow‐up. Of 5370 eligible patients, 4104 received beta‐blockers. Propensity score matching yielded 1087 pairs. Mean age was 61.9 years, and 1619 (74.5%) were men. Mean LVEF was 49.3±8.2%, and median B‐type natriuretic peptide was 46.6 (interquartile range, 18.0–118.1) pg/mL. The primary outcome was observed less frequently in the beta‐blocker group than in the no‐beta‐blocker group (19.6% versus 24.0%; odds ratio [OR], 0.77; 95% CI, 0.63–0.95; P=0.013). Subgroup analysis demonstrated that female patients (women: OR, 0.54; 95% CI, 0.36–0.81; men: OR, 0.88; 95% CI, 0.69–1.12; P for interaction=0.040) were benefited by beta‐blockers.ConclusionsBeta‐blocker use could prevent deterioration of left ventricular systolic function in patients with recovered DCM.

Effect of preoperative inspiratory muscle training on right ventricular systolic function in patients after heart valve replacement surgery

Background: The reduction of right ventricular function after heart valve surgery was associated with mortality and morbidity after cardiac surgery, prolonged ICU length of stay, and higher hospital cost. Inspiratory muscle training can be considered for improving right ventricular systolic function by optimizing afterload dan cardiac contractility. The study aims to determine the effect of inspiratory muscle training on right ventricular systolic function in patients after heart valve surgery.Methods: Patients undergoing heart valve surgery were randomized into a conventional preoperative rehabilitation group and conventional preoperative rehabilitation added high-intensity inspiratory muscle training at least 14 days before surgery. Echocardiography examination was performed before rehabilitation and after cardiac surgery.Results: There were 24 subjects consist of 12 control group and 12 intervention group. By using independent t-test or Mann Whitney test, we found significant differences on right ventricular function between intervention and control group, by using RV free wall strain (17.7 + 3.0% and 14.4 + 4.0%; p=0.033), RV FAC (43.2 + 4.9% and 35.1 + 8.8%; p=0.006), and TAPSE (12.7 + 3.4 mm and 9.9 + 2.7 mm; p=0.039). ICU length of stay in the intervention group was significantly shorter than the control group (3.2 + 0.8 and 4.2 + 1.3 days; p=0.044).Conclusion: Patients underwent conventional preoperative rehabilitation added inspiratory muscle training had better right ventricular systolic function than patients in control group.

The relationship between systolic function and serum NGAL levels in patients with chronic heart failure of ischemic origin

Neutrophil gelatinase-associated lipocalin (NGAL) is considered one of the most informative biomarkers of chronic kidney disease (CKD). NGAL can also serve as a biomarker of cardiovascular disease and heart failure (HF). However, the relationship between systolic function and serum NGAL concentrations in patients with chronic HF (CHF) of ischemic origin remains insufficiently studied. The aim. To study the influence of tubulo-interstitial injury marker NGAL on systolic function in patients with CHF of ischemic origin. Materials and methods. The study included 51 patients with CHF, stage II AB, NYHA II-IV FC. Doppler echocardiographic examination was performed on the device Esaote MyLab Eight (Italy) according to standard methods. NGAL levels were analyzed using an ELISA kit (E-EL-H0096, Elabscience, USA). Depending to the concentration of serum NGAL, the patients were divided into 2 subgroups. In the first group (n = 37), the NGAL level was higher than 168 ng/ml, in the second (n = 14) – less than 168 ng/ml. Results. The mean serum NGAL concentration in the first subgroup was 192 (183; 200) ng/ml, in the second subgroup – 154 (134; 160) ng/ml. The patients with CHF of ischemic origin with tubulo-interstitial injury (according to the serum concentration of NGAL) did not differ significantly from the patients with CHF of ischemic origin without tubulo-interstitial injury in age (P = 0.950), height (P = 0.983), weight (P = 0.681), body surface area (P = 0.975). Most of left ventricular systolic function indicators showed a downward tendency (S 6.90 ± 2.85 cm/s vs. 7.67 ± 2.83 cm/s (P = 0.536); S lat 7.33 ± 2.08 cm/s vs. 11.00 ± 4.00 cm/s (P = 0.467); TEI LV 0.56 ± 0.26 c.u. vs. 0.49 ± 0.14 c.u. (P = 0.747)) in the patients with CHF of ischemic origin with elevated serum levels of NGAL compared to similar indicators in the patients with CHF of ischemic origin without tubulo-interstitial injury. The index of LVEF was significantly lower in the patients with CHF with elevated serum NGAL compared to that in the patients with CHF with normal serum NGAL (50.43 ± 17.85 % vs. 63.29 ± 13.24 % (P = 0.021)). Conclusions. Serum NGAL was not only the sensitive marker of tubulo-interstitial injury in patients with CHF of ischemic origin, but also appeared to be a predictor of changes in systolic heart function.

Thiamine mediated reversal of left ventricular dysfunction in patients with alcoholic cardiomyopathy

This study aimed to evaluate the effect of thiamine supplementation on left ventricular (LV) systolic function in patients of alcoholic cardiomyopathy(ACM) presenting with acute heart failure(HF). 11 newly diagnosed patients were included. They were treated with 3 days of intravenous(IV) therapy with thiamine followed by oral supplementation. LVEF was 30% at baseline which improved by 45% and 53% along with reduction in LV dimensions over 3 and 6 months respectively. The study suggests the benefit of thiamine supplementation on LVEF in ACM patients with HF.

Left ventricular longitudinal wall fractional shortening accurately predicts longitudinal strain in critically ill patients with septic shock

BackgroundLeft ventricular longitudinal strain (LVLS) may be a sensitive indicator of left ventricular (LV) systolic function in patients with sepsis, but is dependent on high image quality and analysis software. Mitral annular plane systolic excursion (MAPSE) and the novel left ventricular longitudinal wall fractional shortening (LV-LWFS) are bedside echocardiographic indicators of LV systolic function that are less dependent on image quality. Both are sparsely investigated in the critically ill population, and may potentially be used as surrogates for LVLS. We assessed if LVLS may be predicted by LV-LWFS and MAPSE in patients with septic shock. We also assessed the repeatability and inter-rater agreement of LVLS, LV-LWFS and MAPSE measurements.Results122 TTE studies from 3 echocardiographic data repositories of patients admitted to ICU with septic shock were retrospectively assessed, of which 73 were suitable for LVLS analysis using speckle tracking. The correlations between LVLS vs. LV-LWFS and LVLS vs. MAPSE were 0.89 (p < 0.001) and 0.81 (p < 0.001) with mean squared errors of 5.8% and 9.1%, respectively. Using the generated regression equation, LV-LWFS predicted LVLS with a high degree of accuracy and precision, with bias and limits of agreement of -0.044 ± 4.7% and mean squared prediction error of 5.8%. Interobserver repeatability was good, with high intraclass correlation coefficients (0.96–0.97), small bias and tight limits of agreement (≤ 4.1% for all analyses) between observers for all measurements.ConclusionsLV-LWFS may be used to estimate LVLS in patients with septic shock. MAPSE also performed well, but was slightly inferior compared to LV-LWFS in estimating LVLS. Feasibility of MAPSE and LV-LWFS was excellent, as was interobserver repeatability.

Value of quantitative analysis of left ventricular systolic function in patients on maintenance hemodialysis based on myocardial work technique

BackgroundThis study aimed to determine the left ventricular (LV) systolic function in patients on maintenance hemodialysis (MHD) using the myocardial work (MW) technique and investigate the clinical value of the MW technique for the quantitative analysis of left ventricular (LV) systolic function in MHD patients with left ventricular hypertrophy (LVH).MethodsA total of 68 MHD patients and 35 controls were registered in this study. The MHD patients were divided into the non-left ventricular hypertrophy (NLVH) group (n = 35) and the LVH group (n = 33) according to the LV mass index (LVMI). MW was used to generate the LV global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), and global wasted work (GWW), global work efficiency (GWE). GLS and the MW parameters (GWI, GCW, GWW, GWE) were compared between groups and the correlations between these parameters and the LV ejection fraction (LVEF) in the LVH group were examined. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of MW parameters and GLS for the assessment of LV systolic dysfunction in MHD with LVH patients.ResultsThe LVH group had significantly lower GWE, GWI, GCW, and GLS but higher GWW than the control and NLVH groups. Compared with the control group, the NLVH group had significantly lower GWE and GLS and higher GWW, but no significant differences in GWI, GCW were observed between these two groups. The LVEF was negatively correlated with GWW in MHD patients, but positively correlated with GWI, GWE, and GCW in the LVH group. Receiver operating characteristic curve (ROC) analysis revealed that GWE, GWW, GWI, and GCW had appreciable area under the curve (AUC), sensitivity, and specificity for evaluating LV function in LVH patients on MHD.ConclusionsThe MW parameters can quantitatively represent the LV myocardial work in MHD patients. Thus, the technique provides a new method for the quantitative evaluation of LV systolic function in MHD with LVH patients.

Index of microcirculatory resistance predicts long term cardiac systolic function in patients with STEMI undergoing primary PCI

BackgroundTo evaluate the predictive value of the index of microcirculatory resistance (IMR) for long-term cardiac systolic function after primary percutaneous coronary intervention (pPCI) in patients with acute anterior wall ST-segment elevation myocardial infarction (STEMI).MethodsA total of 53 acute anterior wall STEMI patients were included and followed up within 1-year. IMR was measured to evaluate the immediate intraoperative reperfusion. IMR > 40 U was defined as the high IMR group and ≤ 40 U was defined as the low IMR group. Left ventricular ejection fraction (LVEF) was measured by echocardiography at 24 h, 1 month, 3 months, and 1 year after PCI to analyze the correlation between IMR and cardiac systolic function. Heart failure was estimated according to classification within one year.ResultsThe ratio of TMPG (TIMI myocardial perfusion grade) 3 (85.7% vs. 52%, p = 0.015) and STR (ST-segment resolution) > 70% (82.1% vs. 48%, p = 0.019) were significantly higher in the low IMR group. The LVEF in the low IMR group was significantly higher than that in the high IMR group at 3 months (43.06 ± 2.63% vs. 40.20 ± 2.67%, p < 0.001) and 1 year (44.16 ± 2.40% vs. 40.13 ± 3.48%, p < 0.001). IMR was negatively correlated with LVEF at 3 months (r = − 0.1014, p = 0.0040) and 1 year (r = − 0.1754, p < 0.0001).ConclusionsThe IMR showed significant negative correlation with the LVEF value after primary PCI. The high IMR is a strong predictor of heart failure within 1 year after anterior myocardial infarction.

Clinical Application of Information Medicine Cardiac Magnetic Resonance Quantitative Imaging in Central Nervous System Cardiology Cardiomyopathy

Objective: To study the left ventricular systolic function in patients with central nervous system endocarditis myocarditis by using information-based cardiac magnetic resonance quantitative imaging technique. LGE and T1 mapping techniques were used to evaluate myocardial localized fibrosis and diffuse fibrosis, respectively. The situation is to explore the limitations and the relationship between diffuse cardiomyopathy and cardiac function. Methods: A total of 44 patients with dilated cardiomyopathy and 23 healthy volunteers were scanned with a magnetic resonance imager to determine the occurrence of focal myocardial and diffuse fibrosis, and to analyze the relationship between left ventricular systolic function and left ventricular systolic function. Relationship. Results: The TML values (1335.23 ± 60.91 ms) and LGE (–) subgroups (1309.05 ± 55.02 ms) in the DCMLGE(+) subgroup were significantly different from those in the control group (P &lt; 0.001); however, DCMLGE ( There was no significant difference in the myocardial T1 values between the + and LGE (–) groups (P &gt; 0.05). Conclusion: Cardiac magnetic resonance quantitative imaging technology can reflect the diffuse fibrosis of patients with cardiomyopathy, and can detect early myocardial fibrosis early. In addition, patients with cardiomyopathy have myocardial limitations and diffuse fibrosis, which affects the contractile function of the left ventricle of the heart.

Usefulness of Right Ventricular Longitudinal Shortening Fraction to Detect Right Ventricular Dysfunction in Acute Cor Pulmonale Related to COVID-19

ObjectiveTo compare two-dimensional–speckle tracking echocardiographic parameters (2D-STE) and classic echocardiographic parameters of right ventricular (RV) systolic function in patients with coronavirus disease 2019 (COVID-19)–related acute respiratory distress syndrome (CARDS) complicated or not by acute cor pulmonale (ACP).DesignProspective, between March 1, 2020 and April 15, 2020.SettingIntensive care unit of Amiens University Hospital (France).ParticipantsAdult patients with moderate-to-severe CARDS under mechanical ventilation for fewer than 24 hours.InterventionsNone.Measurements and Main ResultsTricuspid annular displacement (TAD) parameters (TAD-septal, TAD-lateral, and RV longitudinal shortening fraction [RV-LSF]), RV global longitudinal strain (RV-GLS), and RV free wall longitudinal strain (RVFWLS) were measured using transesophageal echocardiography with a dedicated software and compared with classic RV systolic parameters (RV-FAC, S′ wave, and tricuspid annular plane systolic excursion [TAPSE]). RV systolic dysfunction was defined as RV-FAC <35%. Twenty-nine consecutive patients with moderate-to-severe CARDS were included. ACP was diagnosed in 12 patients (41%). 2D-STE parameters were markedly altered in the ACP group, and no significant difference was found between patients with and without ACP for classic RV parameters (RV-FAC, S′ wave, and TAPSE). In the ACP group, RV-LSF (17% [14%-22%]) had the best correlation with RV-FAC (r = 0.79, p < 0.001 v r = 0.27, p = 0.39 for RVGLS and r = 0.28, p = 0.39 for RVFWLS). A RV-LSF cut-off value of 17% had a sensitivity of 80% and a specificity of 86% to identify RV systolic dysfunction.ConclusionsClassic RV function parameters were not altered by ACP in patients with CARDS, contrary to 2D-STE parameters. RV-LSF seems to be a valuable parameter to detect early RV systolic dysfunction in CARDS patients with ACP.

The relationship between monocyte HDL-C ratio and reduced left ventricular systolic function in patients among acute myocarditis

The relationship between monocyte HDL-C ratio and reduced left ventricular systolic function in patients among acute myocarditis

Epicardial fat tissue can predict subclinical left ventricular dysfunction in patients with erectile dysfunction

Background Erectile dysfunction (ED) is an early form of atherosclerosis and subclinical myocardial dysfunction. Epicardial fat tissue (EFT) is associated with impaired left ventricular (LV) function, even in the absence of cardiovascular disease. The aim of this study was to investigate the association between EFT and LV systolic function in patients with erectile ED by speckle tracking echocardiography (2D-STE) method. Methods A total of 129 consecutive patients with ED were compared with 145 age- and sex-matched control subjects. ED was evaluated using the International Index of Erectile Function questionnaire. Thickness of EFT was measured by TTE. Global LV longitudinal strain (LV-GLS) and global LV circumferential strain (LV-GCS) were measured by 2D-STE method. Results The EFT thickness was significantly higher in the patients with ED (p <.01). LV-GLS and LV-GCS were revealed to be more deterioration in the ED group compared to controls (−18.2 ± 2.7 vs. (−21.1 ± 3.9, p<.001; −19.5 ± 4.1 vs. −21.9 ± 3.9, p<.001, respectively). It has been shown that EFT thickness is an independent predictor of LV dysfunction. Conclusions These results indicate that EFT thickness is associated with subclinical LV systolic dysfunction in patients with ED.

Changes in left ventricular function induced by carboplatin combined with paclitaxel in patients with ovarian cancer identified using three-dimensional spot tracking imaging technology.

To investigate the clinical value of three-dimensional speckle tracking imaging (3D-STI) in evaluating left ventricular (LV) systolic function in patients with ovarian cancer (OC) treated with paclitaxel and carboplatin. We studied 30 patients with OC treated with paclitaxel combined with carboplatin chemotherapy. Two-dimensional echocardiography and 3D-STI were performed in the patients before they underwent 2- and 6-cycle chemotherapies, and in 30 normal control subjects. Were measured LV end-diastolic volume (EDV), end-systolic volume (ESV), three-dimensional LV ejection fraction (3D-LVEF), stroke volume (SV), spherical index (SPI), LV end-diastolic mass (LV EDmass), LV end-systolic mass (LV ESmass), LV global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), global area strain (GAS) and cardiac troponin T(cTnT). At the end of chemotherapy, magnetic resonance imaging (MRI) was also performed. The 3D conventional strain values (3D-LVEF, SV, LV EDV) after the 2- and 6-cycle chemotherapy were lower than before chemotherapy. LV Edmass, LV ESmass and cTnT were higher while LV GLS, GCS, GRS, GAS were lower after 2- and after 6-cycle chemotherapy than before chemotherapy. There was no significant difference in ESV and EDV between the 3D-STI and MRI parameters. GAS showed a significant negative correlation with cTnT. MRI and 3D-STI variables were significantly correlated, and the receiver operating characteristic curves showed the greater area under the curve for GAS after 2- and after 6-cycle chemotherapy. After 2-cycle chemotherapy, the highest specificity for GAS was 93.3%, and the highest sensitivity for GLS was 70.0%. After 6-cycle chemotherapy, the highest specificity for GAS was 96.7%, and the highest sensitivity for GLS was 96.7%. The LV systolic function decreased in OC patients treated with paclitaxel and carboplatin, showing that 3D-STI may detect early LV systolic dysfunction.

The potential role of 2D-speckle tracking echocardiography for detecting left ventricular systolic dysfunction in patients with Parkinson’s disease: a case control study

Background The prevalence of heart failure among patients with Parkinson’s disease (PD) was found to be twice that of the general population. The aim of this work is to evaluate the global left ventricular systolic function in patients with PD in comparison with healthy controls using speckle tracking echocardiography and to correlate the global left ventricular systolic function with both motor and cognitive functions in PD patients. Methods A case-control study was conducted on 40 patients diagnosed with PD and 40 healthy controls. Evaluation and staging of PD were performed using the Modified Hoehn and Yahr staging scale (H&Y staging) and Unified Parkinson’s Disease Rating Scale (UPDRS). Cognitive assessment for PD patients was done using Parkinson’s Disease - Cognitive Rating Scale (PD-CRS). Conventional and two-dimensional (2D) speckle-tracking strain echocardiography was done for both groups to assess the global left ventricular systolic function. Results There was a statistically significant difference between PD patients and controls regarding global longitudinal strain (p = 0.025), left ventricular end-diastolic dimension (p = 0.032), left ventricular end-systolic dimension (p = 0.003) and ejection fraction (p = 0.015). There were statistically significant negative correlations between both H&Y staging and UPDRS and both GLS (p ˂ 0.001, p ˂ 0.001) and EF (p = 0.017, p = 0.05). There were statistically significant positive correlations between PD-CRS and both GLS (p = 0.025) and EF (p = 0.012) Conclusion PD patients were found to have significant subclinical left ventricular systolic dysfunction in comparison with healthy controls. Such dysfunction was correlated with the severity of the motor disability and cognitive impairment.

Abstract 14385: The Exist of Enlarged Left Ventricular Diastolic Volume is Not a Predictor of Irreversible Left Ventricular Systolic Function in Patients With Atrial Arrhythmia

Introduction: Atrial arrhythmia (AA) and left ventricular systolic dysfunction (LVSD) frequently co-exist, which loom as burgeoning public health problems. It is difficult to determine whether a tachycardia is the indicator or consequence of LVSD in patients with tachycardia and LVSD. Tachycardia mediated cardiomyopathy (TCM) raises a “chicken or egg” question. Regardless of the etiology, the patients with severe LVSD are considered as the candidate for the implantation of cardioverter defibrillator as primary prevention. It is well known that the LVSD improves after the successful treatment of AA in TCM population. However, enlarged left ventricular end-diastolic dimension (LVDd) is considered as a parameter of irreversible LVSD. Hypothesis: Enlarged LVDd could not be a predictor for irreversible LVSD in patients with AA. Methods: We assessed patients with persistent AA and heart failure (Ejection Fraction (EF) &lt;45%) who were received aggressive rhythm control therapy and maintained sinus rhythm with catheter ablation, electrical cardioversion and anti arhythmic drugs. Echocardiographic parameters and brain natriuretic peptide (BNP) were evaluated before and after the treatment. Results: Twenty-five patients with persistent AA and LVSD (23 men; mean age 63.8±9.3 years) were enrolled in this study. After restored and maintained SR, EF and left ventricular end-systolic volume (ESV) and BNP were improved in all patients respectively (EF 30.7±10.7 to 54.0±7.3%, ESV; 82.1±32.4 to 50.6±24.1ml, BNP; 379.2±237.9 to 48.0±29.7pg/ml P&lt;0.001). In the other hand, there were no significant improvement of LVDd and left ventricular end-diastolic volume (EDV) (LVDd; 54.7±7.6 to 54.3±5.5mm P=0.68, EDV; 120.1±37.9 to 108.2±38.0ml P=0.16). Enlarged LVDd &gt;60mm were observed in 5 patients (25%) before the treatment. EF was normalized in patients with severe LVSD (EF&lt;35%, n=13; 52%). Conclusions: The unnecessary device implantation could be avoided in patients with AA and severe LVSD with aggressive rhythm control therapy. Even in the patients with severe LVSD and enlarged LVDd, LVSD is reversible when AA exists.