Three-dimensional Speckle Tracking Imaging Research Articles

Assessment of Left Ventricular Functional Impairment in Patients With Chronic Kidney Disease Using Three-Dimensional Speckle Tracking Imaging.

Chronic kidney disease (CKD) is strongly linked to the incidence and mortality of cardiovascular diseases (CVDs), with left ventricular myocardial damage being the most prevalent. This study aimed to assess left ventricle (LV) dysfunction using three-dimensional speckle tracking imaging (3D-STI) in CKD patients. A total of 110 CKD patients and 55 healthy volunteers underwent echocardiography. CKD patients were divided into CKD1 group and CKD2 group based on the estimated glomerular filtration rate (eGFR). Assessing cardiac function via two-dimensional speckle tracking echocardiography (2D-STE) and three-dimensional speckle tracking echocardiography (3D-STE) parameters, with strain presented in absolute terms. Collecting and comparing clinical and echocardiographic parameters from three groups, assessing 3D-STI's value in evaluating LV functional impairment in CKD patients via correlation and receiver operating characteristic (ROC) curve analyses, and identifying risk factors for CKD progression to end-stage renal disease (ESRD) through univariate and multivariate analyses. In CKD2 group, 2D-left ventricular ejection fraction (LVEF), 3D-LVEF, 2D left ventricular global longitudinal strain (2D-LVGLS), 3D-LVGLS, and 3D-left ventricular global circumferential peak strain (LVGCS) significantly worsen compared to the control and CKD1 groups, with statistically significant distinctions between the latter two (all p < 0.05). The absolute value of 3D-LVGLS shows a robust correlation with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and serum creatinine (Scr) (r = -0.598, -0.649, both p < 0.001). ROC curve analysis indicates higher diagnostic efficacy of 3D-LVGLS and 3D-LVGCS for LV systolic function than 2D-LVGLS. Univariate and multivariate analyses reveal an independent association of 3D-LVGLS with the progression to ESRD in CKD. 3D-LVGLS and 3D-LVGCS effectively detect LV dysfunction in CKD patients. Specifically, 3D-LVGLS demonstrates a robust correlation with NT-proBNP and Scr and is independently linked to CKD progressing to ESRD.

Quantitative evaluation of radiation-induced heart disease in patients with lung cancer: a three-dimensional speckle tracking imaging study.

Adverse cardiovascular events due to radiation-induced heart disease (RIHD) have become the leading cause of death in cancer survivors, and early screening for RIHD has become an important clinical issue. Our objective was to determine the utility of three-dimensional speckle tracking echocardiography (3D-STE) for detecting RIHD. According to inclusion and exclusion criteria, patients with lung cancer who received radiotherapy in our hospital for the first time were recruited as subjects. All subjects underwent the conventional echocardiography and 3D-STE examination at six time points (1 day before radiotherapy, 2.5-3 and 5-6 weeks after beginning radiotherapy, and 3-, 6- and 12-month after ending radiotherapy). Routine electrocardiogram, serum cardiac troponin I (cTnI) and clinical data were detected simultaneously. A total of 105 patients with lung cancer were included in the study. Conventional echocardiography found a small amount of pericardial effusion occurred in 8 subjects at 5-6 weeks after beginning radiotherapy. 3D-STE showed that, compared with before radiotherapy, the absolute values of global longitudinal strain (GLS) and global strain (GS) were significantly decreased at 5-6 weeks after beginning radiotherapy (PGLS<0.001, PGS=0.002), and the absolute values of GLS, global radial strain, global circumferential strain, GS were gradually decreased further at 3-, 6- and 12-month after ending radiotherapy (P<0.001). Electrocardiograph showed that 32 subjects had electrocardiograph abnormalities during radiotherapy and 3 had electrocardiograph abnormalities at 3-month after ending radiotherapy, and most returned to normal within 6 months after ending radiotherapy. Patients with lung cancer undergoing radiation therapy have shown a decrease in the function of the left ventricle of the heart while receiving treatment. Combining the assessment of cTnI with GLS can enhance the early detection of radiation-induced heart damage.

Values of three-dimensional speckle tracking imaging for the diagnosis of coronary artery disease

Background: Coronary artery disease (CAD) is a top life-threatening disease and early and sensitive detection of CAD remains a challenge. This study aimed to assess the value of three-dimensional speckle tracking imaging (3D-STI) in diagnosing CAD patients and investigate the parameters of 3D-STI associated with disease severity. Methods: A total of 260 suspected CAD patients who met the study criteria underwent coronary angiography within one week after the ultrasound examination. Based on the examination results, 142 patients were confirmed to have CAD (CAD group), while 118 patients were classified as non-CAD (NCAD group). Age, gender, family history, smoking status, diabetes, hypertension, dyslipidemia, electrocardiogram, BMI, heart rate, and left ventricular ejection fraction were compared between the two groups. Additionally, 3D-STI parameters including left ventricular global radial strain (GRS), left ventricular global longitudinal strain (GLS), left ventricular global area strain (GAS), and left ventricular global circumferential strain (GCS) were analyzed. Results: No significant differences were found between the CAD and NCAD groups in terms of demographics, smoking history, physiological measurements, and common comorbidities such as diabetes mellitus and dyslipidemia. However, when comparing the 3D-STI parameters, all four parameters, including GLS, GRS, GCS, and GAS, were significantly different in the CAD group compared to the NCAD group. The results suggest that 3D-STI parameters have diagnostic value for CAD, and their changes are associated with CAD severity. Conclusions: Combined detection of these parameters enhances diagnostic accuracy compared to individual detection.

Retracted: Evaluation of Cardiac Function before and after PAD Regimen in Patients with Multiple Myeloma by Three-Dimensional Speckle Tracking Imaging

Retracted: Evaluation of Cardiac Function before and after PAD Regimen in Patients with Multiple Myeloma by Three-Dimensional Speckle Tracking Imaging

3D-based strain analysis and cardiotoxicity detection in cancer patients received chemotherapy

BackgroundChemotherapy-induced cardiotoxicity has become a prevalent complication. Regular monitoring of patients who received chemotherapy using 3D strain parameters may aid in early detection of myocardial damage and its prevention. The purpose of this study was to evaluate the effectiveness of three-dimensional speckle tracking imaging (3D-STI) in diagnosing and predicting the likelihood of cardiotoxicity. This was achieved by conducting a systematic review of original research articles.ObjectivesTo evaluate the role of 3D speckle tracking echocardiography in early detection of cardiotoxicity.MethodsRelevant case control studies published prior to December 2022 were extracted to assess cardiotoxicity by 3D STE in patients after chemotherapy.ResultsA total of 1991 chemotherapy treated patients and control patients were included in the present review via pooling 22 studies.Conclusions3D speckle tracking echocardiography has the utility of non-invasive and objective evaluation of changes in left ventricular function in cancer patients undergoing chemotherapy.ROSPERO registration NoStudy ID, CRD42023383790 on PROSPERO: International prospective register of systematic reviews.

Analysis of the Application Value of Ultrasound Three-Dimensional Speckle Tracking Technology Combined with Thyroid Autoantibodies and Hormones in the Diagnosis and Treatment of Graves' Disease.

Objective The aim of the study is to evaluate the application value of three-dimensional speckle tracking imaging (3D-STI) and combined detection of thyroid autoantibodies and hormones in the diagnosis and treatment of Graves' disease. Methods A total of 60 patients with Graves' disease enrolled in our hospital from February 2020 to February 2021 were included in the experimental group, and 60 healthy patients after a physical examination during the same period were selected as the control group. No intervention was performed on the control group, and the experimental group received conventional Graves' disease treatment. The levels of thyroid autoantibodies and hormones in the two groups before and after the treatment were measured, and the 3D-STI was performed to compare the 3D-STI strain parameters of the research objects. Results A significantly higher level of thyroid autoantibodies in the experimental group than that in the control group before and after the treatment was found (P < 0.001), with a remarkable decline observed after the treatment (P < 0.001). The positive rate of thyroid autoantibodies in the experimental group before the treatment was significantly higher than that in the control group (P < 0.05). After the treatment, the positive rate of TRAb and TPOAb was higher than that of the control group (P < 0.05), and the positive rate of TPOAb was higher than before the treatment. The two groups showed no significant difference in the positive rate of TGAb (P > 0.05). Significant differences were observed in the thyroid hormone levels between the two groups and also between before and after the treatment (P < 0.001). The experimental group garnered significantly higher 3D-STI strain parameters than the control group before the treatment (P < 0.05); after the treatment, the hyperthyroidism of the patients was relieved with a decreased 3D-STI value, but it was still notably higher than the control group (P < 0.05). Remarkably higher positive rates of combined detection before and after the treatment in the experimental group than those in the control group were obtained (P < 0.05). Conclusion The combined detection of 3D-STI and thyroid autoantibodies and hormones ensures a better detection rate of Graves' disease and monitors the treatment effect of patients in real time, which provides a basis for clinical diagnosis and treatment and merits clinical promotion and application.

Evaluation of Cardiac Function before and after PAD Regimen in Patients with Multiple Myeloma by Three-Dimensional Speckle Tracking Imaging.

In this manuscript, we have evaluated numerous changes of cardiac function in patients with multiple myeloma before and after PAD chemotherapy with 3D speck tracking imaging (3D-STI). For this purpose, 39 patients with multiple myeloma, from July 2019 to December 2020, who received the PAD regimen (bortezomib + doxorubicin liposome + dexamethasone, a course of 12 days) were selected as subjects. A comparison of two-dimensional conventional echocardiographic parameters before and after chemotherapy and 3D-STI related parameters was carried out. After 6 cycles of chemotherapy, the levels of TAPSE, RVFAC, and LVEF were significantly lower than those before chemotherapy (P < 0.05). There was no significant difference in the results of left and right ventricle two-dimensional conventional echocardiography before chemotherapy and 2 or 4 cycles after chemotherapy (P > 0.05). There were significant differences in the levels of RVGCS, RVGLS, RVGRS, LVGLS, and LVGRS before and after chemotherapy (P < 0.05). Specifically, RVGCS: after 6 cycles of chemotherapy < after 4 cycles of chemotherapy < before chemotherapy; RVGLS: after 6 cycles of chemotherapy < after 4 cycles of chemotherapy < after 2 cycles of chemotherapy < before chemotherapy; RVGRS: after 6 cycles of chemotherapy < after 4 cycles of chemotherapy < before chemotherapy; LVGLS: after 6 cycles of chemotherapy < after 4 cycles of chemotherapy < before chemotherapy; and LVGRS: after 6 cycles of chemotherapy < before chemotherapy. The results of Pearson correlation analysis showed that the dose of doxorubicin was negatively correlated with RVGCS, RVGLS, RVGRS, and LVGLS, but not with TAPSE, RVFAC, LVEF, and LVGRS. 3D-STI is helpful for early detection of the changes of left and right ventricular myocardial function after PAD chemotherapy in patients with multiple myeloma. And the early screening value of the RVGLS parameter is higher.

Evaluation of Left Ventricular Systolic Function in Patients with Coronary Microvascular Dysfunction by Three-Dimensional Speckle-Tracking Imaging.

IntroductionThe objective of this study is to evaluate the left ventricular systolic function of patients with coronary microvascular dysfunction (CMD) using the three-dimensional speckle-tracking imaging (3D-STI) technique.MethodsFrom June 2018 to June 2019,72 subjects from Huzhou Central Hospital were enrolled, including 42 CMD in-patients with typical chest pain or chest tightness and positive treadmill exercise stress test, but without coronary stenosis on coronary angiography, (the CMD group) and another 30 healthy individuals who were undergoing physical examinations in an outpatient clinic (the control group). Using 3D-STI technique, the global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), global area strain (GAS), and left ventricle were measured.ResultsCompared with the control group, GLS and GAS were significantly reduced in the CMD group (P<0.05), while GRS and GCS were similar in both groups (P>0.05). Univariate logistic regression analysis showed that GLS and GAS were the influencing factors of CMD. For the diagnosis of CMD, the area under the receiver operating characteristic (ROC) curve of GLS was 0.883, and the area under the ROC curve of GAS was 0.875. GAS of -29.3% (log-rank test chi-square=34.245, P<0.001) was a strong predictor of major adverse cardiac events.Conclusion3D-STI technique has obvious advantages in the evaluation of the left ventricular systolic function for CMD patients. Moreover, 3D-STI parameters, especially GLS and GAS, can detect the early abnormal changes in the ischaemic myocardium. Being timelier and more sensitive than echocardiography, 3D-STI should be recommended for clinical application.

Evaluation of the right ventricular function in patients with pneumoconiosis by three-dimensional speckle-tracking imaging

Objective: To evaluate the changes of right ventricular function in patients with pneumoconiosis in different stages using three-dimensional speckle-tracking imaging (3D-STI) . Methods: In June 2020, 114 pneumoconiosis patients were selected as subjects, including 45 patients in stage Ⅰ pneumoconiosis group, 36 patients in stage Ⅱ pneumoconiosis group and 33 patients in stage Ⅲ pneumoconiosis group. Fifty healthy subjects were enrolled and served as control group. The longitudinal strain (LS) , radial strain (RS) and circumferential strain (CS) of free wall middle and basal segment of right ventricular were collected and compared. The right ventricular global longitudinal strain (GLS) , right ventricular global circumferential strain (GCS) , right ventricular ejection fraction (RVEF) , right ventricular global radial strain (GRS) , the rate of fractional area change (FAC) , the tricuspid valve systolic peak velocity (TVSPV) and the pulmonary artery systolic pressure (PASP) of each subject in the groups were collected and compared by 3D-STI. Results: The LS and RS of the right ventricular basal segment of patients in stage Ⅱ pneumoconiosis group were significantly lower than those of control group (P<0.0125) . The LS, CS, RS of the right ventricular basal segment and RS of right ventricular middle segment of patients in stage Ⅲ pneumoconiosis group were significantly lower than those of control group (P<0.0125) . The LS, CS and RS of the right ventricular basal segment of patients in stage Ⅰ pneumoconiosis group were significantly higher than those of stage Ⅲ pneumoconiosis group (P<0.0125) , and the RS of the right ventricular basal segment of patients in stage Ⅱ pneumoconiosis group was significantly higher than that of stage Ⅲ pneumoconiosis group (P<0.0125) . The levels of RVEF and GLS of patients in stage Ⅱ and stage Ⅲ pneumoconiosis group were significantly lower than those of control group (P<0.0125) , while the levels of PASP were significantly higher than that of control group (P<0.0125) . The levels of FAC and TVSPV of patients in stage Ⅲ pneumoconiosis group were significantly lower than those of control group (P<0.0125) . The levels of RVEF, GLS and FAC of patients in stage Ⅰ pneumoconiosis group were significantly higher those that of stage Ⅲ pneumoconiosis group (P<0.0125) , and the PASP level was significantly lower than that of stage Ⅲ pneumoconiosis group (P<0.0125) . The FAC level of patients in stage Ⅱ pneumoconiosis group was significantly higher than that of stage Ⅲ pneumoconiosis group (P<0.0125) . Conclusion: Patients with pneumoconiosis could experience a decline in right ventricular function at an early stage. The 3D-STI can accurately detect the GLS, GRS, GCS and hemodynamic changes of the right ventricular and evaluate the right ventricular function comprehensively and objectively. 3D-STI is of great significance for the early detection of right ventricular dysfunction in patients with pneumoconiosis.

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

Left ventricular systolic function between left bundle branch pacing and right ventricular septum pacing in patients with pacemaker dependence by three-dimensional speckle tracking imaging.

To compare the left ventricular systolic function between the 1eft bundle branch pacing (LBBP) and right ventricular septum pacing (RVSP) in patients with pacemaker dependence by three-dimensional speckle tracking imaging (3D-STI). A total of 65 patients with atrioventricular block (AVB) (Mobitz type II second-degree AVB, high-degree AVB, or third-degree AVB), who underwent permanent cardiac pacing implantation including 32 patients receiving LBBP (LBBP group) and 33 patients receiving RVSP (RVSP group) from June 2018 to June 2019,were enrolled in this study. These patients met the following inclusion criterion: pre-operative left ventricular ejection fraction (LVEF)>50% and ventricular pacing rate>40% at 6-month programming follow-up; and the patients underwent echocardiography at pre-operation and 6 months after operation. The 3D-STI was used to obtain global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS). All the patients in the LBBP group and the RVSP group had normal LVEF, there was no significant difference between the 2 group (P>0.05). The LVEF was slightly decreased at 6-month follow-up in the RVSP group, but there was no significant change compared with pre-operation (P>0.05). There were no significant difference in LVEF, GLS, GCS, GRS and GAS at pre-operation and 6-month after operation between the LBBP group and the RVSP group (all P>0.05). Compared with pre-operation, the GLS and GCS were significantly decreased in the LBBP group; while the GLS, GCS, GRS and GAS in the RVSP group were also significantly decreased at 6-month follow-up (all P<0.05). For patients with pacemaker dependence and normal LVEF at pre-operation, the cardiac function in the LBBP group is not significantly better than that in the RVSP group in short term follow-up. But in terms of physiologic pacing and long-term cardiac function protection, the 1eft bundle branch pacing is an optimal pacing mode.

三维斑点追踪评价左束支起搏对左心室同步性的影响

三维斑点追踪评价左束支起搏对左心室同步性的影响

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.

3D-STI evaluation of the effect of dexrazoxane on the mechanical properties of right ventricular myocardium in breast cancer patients treated with pirarubicin.

Observation indexes used to evaluate the effect of dexrazoxane-anthracycline combinations in breast cancer often only take into account the clinical symptoms, or left ventricular ejection fraction (LVEF), biomarkers [such as creatine kinase MB (CK-MB), brain natriuretic peptide (BNP) and cardiac troponin T (cTnT)], or tumor recurrence rate, improvement of autonomic nerve function or economic benefits. This study aimed to evaluate the effect of dexrazoxane on the changes of mechanical properties of right ventricular myocardium in patients who underwent pirarubicin chemotherapy with three-dimensional speckle-tracking imaging (3D-STI). A total of 64 breast cancer post-operation patients who received pirarubicin chemotherapy were randomly divided into two groups: the experimental group (with dexrazoxane added) and the control group (without dexrazoxane). The mechanical properties of the right ventricular myocardium were monitored by 3D-STI before and after chemotherapy. The levels of serum hypersensitive troponin I (hs-cTnI) and N-terminal B-type pro-natriuretic peptide (NT-proBNP) as well as conventional echocardiographic parameters were also measured. After chemotherapy, right ventricular global longitudinal strain (RVGLS) and right ventricular global area strain (RVGAS) were significantly reduced in both groups (P<0.05). There was a significant difference between the two groups (P<0.05). Dexrazoxane can alleviate the toxicity of pirarubicin in the right ventricular myocardium. 3D-STI is a potential new method for early and accurate evaluation of the mechanical properties and functional changes of the right ventricular myocardium.

The role of three-dimensional speckle tracking imaging derived parameters on predicting outcome of hypertrophic cardiomyopathy patients with MYH7 mutations

Objective: To evaluate the cardiac functional changes in hypertrophic cardiomyopathy(HCM) patients with β-myosin heavy chain gene (MYH7) mutations by three-dimensional (3D) speckle tracking imaging(3D-STI) and conventional echocardiography modalities, and then to explore the potential predictors of adverse cardiovascular events in these patients. Methods: A consecutive series of 192 HCM patients admitted in our center from October 2014 to October 2016 were genetically screened to identify MYH7 mutations in this retrospective study. A total of 43 HCM patients with MYH7 mutations were enrolled. The patients were divided into events group(n=13) and no event group(n=30) according to the presence or absence of adverse cardiovascular events(primary and secondary endpoints). All patients were followed up to January 2019 after comprehensive evaluation of 3D-STI, two-dimensional and Doppler echocardiography. The adverse cardiovascular events were recorded. Results: The median follow up time was 1 012 (812, 1 330) days. During follow-up, 13 patients (30.2%) reached endpoints: 6 cases of the primary endpoints(2 cases of sudden cardiac death(SCD), 3 cases of survival after defibrillation, and 1 case of appropriate implantable cardioverter-defibrillator(ICD) discharge); 7 cases of the second endpoints(5 cases of heart failure hospitalization, 1 case of syncope and cardioversion due to supraventricular tachycardia, and 1 case of end-stage HCM). Patients with adverse cardiovascular events had higher prevalence of syncope and risk of SCD, enlarged left atrial volume index(LAVI) and reduced 3D left ventricular global longitudinal train (3D-GLS), as compared to those without adverse events(all P<0.05). The multivariate Cox regression analysis showed that reduced 3D-GLS(HR=0.814, 95%CI 0.663-0.999, P=0.049) was an independent predictor for adverse cardiovascular events. The cutoff value of 3D-GLS≤13.67% was linked with significantly increased risk of adverse cardiovascular events in this patient cohort(AUC=0.753, 95%CI 0.558-0.948, sensitivity 86%, specificity 69%, P<0.05). The Kaplan-Meier analysis indicated that the patients with the 3D-GLS≤ 13.67% faced higher risk of death than those with 3D-GLS>13.67%. Conclusion: 3D-GLS is useful on predicting adverse cardiovascular events in HCM patients with MYH7 mutations.

The role of three-dimensional speckle tracking imaging in the diagnosis of immunoglobulin light-chain cardiac amyloidosis with normal left ventricular ejection fraction

Objective To explore the value of three-dimensional speckle tracking imaging (3D-STI) in the diagnosis of immunoglobulin light-chain cardiac amyloidosis(AL-CA) patients with normal left ventricular ejection fraction (LVEF). Methods A total of 92 consecutive patients diagnosed with systemic immunoglobulin light chain amyloidosis(sAL) and with normal LVEF from October 2014 to January 2018 in Xijing Hospital were enrolled.Based on the diagnostic criteria of cardiac involvement, the patients were divided into AL-CA group (52 cases) and immunoglobulin light chain amyloidosis (AL) group (40 cases). The clinical data and serological markers of the patients were collected, the conventional echocardiography and full-volume three dimensional dynamic images were acquired, left ventricular global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), and global area strain (GAS) were analyzed using off-line TomTec software. The differences between the two groups were compared. Results Compared with the AL group, the NT-proBNP of AL-CA group was significantly higher (P 0.05). Compared with the AL group, the maximal left ventricular wall thickness, left ventricular mass index, left atrial volume index, and E/e′ in the AL-CA group were significantly increased (all P 0.05). Compared with the AL group, GLS, GAS, and GRS were significantly lower in AL-CA group (all P 0.05). The ROC curve analysis showed that the cut-off values discriminating cardiac involvement were 16.09% for GLS, 36.54% for GAS and 31.90% for GRS. Conclusions 3D-STI measurements of left ventricular myocardial mechanics could detect cardiac involvement in patients with sAL amyloidosis, and provides a new method for diagnosis of AL-CA. Key words: Echocardiography; Three-dimensional speckle tracking imaging; Immunoglobulin light-chain cardiac amyloidosis; Strain

Assessment of left ventricular dysfunction of sarcomere mutation carriers in hypertrophic cardiomyopathy by three-dimensional speckle tracking imaging combined with conventional echocardiography

Objective To explore the value of three-dimensional speckle tracking imaging (3D-STI) and conventional echocardiography in evaluating left ventricular function characteristics of sarcomere mutation carriers in hypertrophic cardiomyopathy. Methods Totally 91 subjects with sarcomere mutations in family HCM but without left ventricular hypertrophy (G+ /P- group), and 100 normal family members with gender and age matched as the control group (G-/P- group) were enrolled from the center of hypertrophic cardiomyopathy of Xijing Hospital affiliated to the Air Force Military Medical University from February 2013 to April 2017. They all received the comprehensive evaluation of 3D-STI and conventional echocardiography. The ultrasonic paramaters between the two groups were compared. And the diagnostic performance of these paramaters with sarcomere mutations was evaluated. Results Compared with the G-/P- group, the G+ /P-group had larger left atrial diameter (LAD), longer left ventricular isovolumic relaxation time (IVRT), reduced mitral annular systolic velocity (e′), elevated E/e′ ratio, as well as impaired left ventricular global longitudinal and radial strain(GLS and GRS) (P<0.05). Moreover, the GLS≤19.9%(AUC 0.861, sensitivity 61.4%, specificity 98.5%) and IVRT≥75.5 ms(AUC 0.762, sensitivity 61.4%, specificity 72.6%) showed the best diagnostic performance with sarcomere mutations (P<0.05). Conclusions In HCM family members, the sarcomere mutations carriers without left ventricular hypertrophy exhibit impaired left ventricular diastolic function, reduced longitudinal and radial systolic function.Moreover, the GLS and IVRT show the best diagnostic performance for those with sarcomere mutations. Key words: Three-dimensional speckle tracking imaging; Hypertrophic cardiomyopathy; Sarcomere mutation carriers; Ventricular function, left

Correlation between three-dimensional speckle tracking echocardiography combined with cardiac magnetic resonance imaging-late gadolinium enchancemet on left ventricular global systolic function and myocardial fibrosis in adult hypertrophic cardiomyopathy

Objective To evaluate the left ventricular global systolic function and myocardial fibrosis in adult hypertrophic cardiomyopathy (HCM) patients by three-dimensional speckle tracking echocardiography(3D-STE) combined with cardiac magnetic resonance imaging-late gadolinium enchancemet (CMRI-LGE) sequence, and to explore the association between left ventricular global systolic function and myocardial fibrosis. Methods Thirty patients with HCM(HCM group) and 33 healthy controls(control group) were enrolled in the study. All patients underwent conventional two-dimensional echocardiography (2DE), tissue Doppler imaging (TDI), and 3D-STE. The following parameters were acquired and compared between the groups: interventricular septal end-diastolic thickness (IVSD), left ventricular posterior wall end-diastolic thickness (LVPWD), left ventricular mass(LVM), left ventricular mass index (LVMI), left atrial volume (LAV), and left ventricular end-systolic volume(LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular outflow tract pressure gradient (LVOT-PG), left ventricular outflow tract velocity time integral (LVOT-VTI), isovolumic relaxation time (IVRT), global strain (GS), global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS). And 28 patients who met the CMRI indications underwent CMRI-LGE to obtain the LVM, and the correlation and consistency of LVM results obtained from CMRI and 3D-STE were performed.According to LGE results, HCM patients were divided into LGE(+ ) group and LGE (-) group, the differences of GLS, GRS and GCS between the two groups were analyzed. Results ①Compared with the control group, IVSD, LVPWD, LVMI, LAV, LVOT-PG, LVOT-VTI and IVRT were significantly increased in the HCM group (all P 0.05), while GLS and GRS decreased and GCS increased significantly in HCM group (P<0.05); ③The correlation between 3D-STE and CMRI in measuring measured LVM in HCM patients was good, and the results showed good concordance(r=0.807, P<0.01). ④GLS in LGE(+ ) group was lower than in LGE(-) group(P=0.004), but there was no significant difference in GCS and GRS between the two groups(P=0.597, 0.534). Conclusions ①3D-STE can detect the early damage of left ventricular global systolic function in patients with HCM; ②3D-STE combined with CMRI-LGE technology can provide an important imaging reference for the evaluation of the relationship between left ventricular global systolic function and myocardial fibrosis in patients with HCM. Key words: Echocardiography; Three-dimensional speckle tracking imaging; Cardiomyopathy, hypertrophic; Cardiac magnetic resonance imaging; Ventricular function, left; Myocardial fibrosis

Assessment of left atrial function in elderly patients with ischemic mitral regurgitation by real-time three-dimensional speckle tracking imaging

Objective To assess left atrial(LA)function by evaluating changes of LA wall movement and volume detected by real-time three-dimensional speckle tracking imaging(RT3D-STI)in elderly patients with ischemic mitral regurgitation(IMR). Methods Eighty-six elderly patients with coronary heart disease(CHD)were enrolled in this study.According to whether or not to have IMR, the patients were divided into the pure CHD group(n=32)and the CHD-induced ischemic mitral regurgitation(IMR)group(n=54, including 20 cases of mild IMR, 18 cases of moderate IMR and 16 cases of severe IMR). Thirty-two healthy elderly volunteers were considered as control group.RT3D-STI was used to evaluate the global atrial longitudinal strain(GLS), global circumferential strain(GCS), global radial strain(GRS)and LA maximal, minimal and pre-systolic volumes(LAVmax, LAVmin, and LAVp). LA ejection fraction(LAEF), LA passive ejection fraction(LApEF)and LA active ejection fraction(LAaEF)were calculated.The relationship of LA volume changes and myocardial strain with LA function was analyzed. Results The left ventricular ejection fraction(LVEF)and LAEF were reduced in CHD group and IMR group as compared with the control group, and were lower in IMR group than in CHD group(P<0.05). Compared with the control group, the LAVmin was increased, and the LAaEF was decreased in the IMR group(P<0.05). Compared with the control group, the GLS, GCS, GRS were declined in the CHD and IMR groups, and were lower in IMR group than in control group(P<0.05). Along with the increased severity of regurgitation, GLS, GCS, and GRS were decreased in varying degrees.The standard deviations of time to peak longitudinal strains(TLS-SD), of time to peak circumferential strains(TCS-SD), and of time to peak radial strain(TRS-SD)rose in the IMR group as compared with the control group(P<0.05). The myocardial motion indicators(GLS, GCS, GRS)had a quite strong correlation with LAEF in the CHD and IMR groups(CHD group: r=-0.745, -0.718 and 0.627, P=0.006, 0.007 and 0.009; IMR group: r=-0.785, -0.781, 0.643, P=0.006, 0.007 and 0.008). The receiver operating characteristic(ROC)curves analysis showed that the sensitivity and specificity of TLS-SD, TCS-SD and TRS-SD were 89.7% and 81.8%, 78.6% and 84.8%, 85.7% and 72.1%, respectively in the evaluation of LA function changes. Conclusions RT3D-STI can precisely and objectively assess the LA function changes by measuring the volume changes and tracing the myocardial motion in elderly IMR patients. Key words: Coronary disease; Mitral valve insufficiency; Echocardiography, three-dimensional; Atrail function, left

Early detection of cardiotoxicity by 3D speckle tracking imaging of area strain in breast cancer patients receiving chemotherapy.

Eighty-three breast cancer patients who underwent six cycles of EC chemotherapy regimen (epirubicin+cyclophosphamide) without symptoms and signs of heart disease were enrolled in the study. Three-dimensional speckle tracking imaging technique (3D-STI) was used to measure left ventricular global area strain (GAS), overall annular strain (GCS), overall longitudinal strain (GLS), and overall radial strain (GRS). Meanwhile, serum troponin T (Hs-cTnT) was measured. The clinical value of each index on cardiotoxicity after chemotherapy was analyzed using the receiver operating characteristic (ROC) curve. Hs-cTnT increased from the early stage to the end during chemotherapy, but it was still in the normal range. During the mid-chemotherapy and the end-chemotherapy, GAS, GLS, GCS, and E/A significantly reduced, while the changes in LVESV, LVEDV, LVEF, and GRS were not significant after chemotherapy. Pearson correlation analysis showed a significant negative correlation between GAS and anthracycline doses (r=-.772, P<.01); GAS and Hs-cTnT were significantly negatively correlated (P<.05). The area under the curve (AUC) of GAS, GLS, GCS, and GRS are 0.815, 0.683, 0.645, and 0.585, respectively. A GAS of -31.5% was used as the cutoff value for diagnosing left ventricular systolic dysfunction after receiving chemotherapy. The sensitivity of the previous parameters was 81.9%, and the specificity was 80.3%. Interobserver consistency analysis showed that 3D-STI strain parameter measurement has good repeatability. GAS has greater value in predicting early myocardial damage after anthracycline chemotherapy.