bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1350 New 3D Doppler flow method for quantitation of aortic regurgitation
Authors: Berg E A R , Avdal J , Espeland T , Torp H , Aakhus S 
Published: January 2020

Abstract

Funding Acknowledgements
Centre for Innovative Ultrasound Solutions, NTNU

OnBehalf
Centre for Innovative Ultrasound Solutions

Introduction
The echocardiographic assessment of valvular regurgitation severity may be challenging. This is reflected in the current EACVI and ASE recommendations, which are quite extensive and include numerous parameters. To date, there are no widely reliable quantitative methods. Moreover, the inter-observer variability in the overall severity assessment is substantial.

Purpose
Development of a new, automated 3D Doppler method for reliable and accurate quantitation of regurgitant volume.

Methods
A 3D high frame rate plane wave imaging sequence is employed to insonate the vena contracta region of the jet using a modified GEVU Vivid E95 system with a 4V probe. In this way we obtain spectral information from all voxels within the sample volume of approximately 2cm x 2cm x 2cm. Vena contracta is localised from the plane containing the maximum velocities and its cross sectional area determined by a power threshold. Velocity-time-integral is then estimated for all voxels within the designated cross sectional area.
For clinical validation, we include patients with aortic regurgitation ranging from mild to severe with a stable sinus rhythm. 3D flow data is recorded immediately after a comprehensive standard echocardiographic exam. The standard exam undergoes expert evaluation in accordance with EACVI recommendations. 3D flow data are currently processed and analysed offline by an independent investigator, blinded to the results from the standard exam.

Results
The results from the first twelve patients are presented in Figure 1. Compared to expert echocardiographic evaluation, the 3D flow method seems to overestimate the regurgitant volume in some patients with mild aortic regurgitation. This may be caused by limitations in lateral resolution. Due to failure of aligning the vena contracta within the sample volume, there is a significant underestimation of regurgitant volume in one patient (Figure 1: red dot). As 3D flow analysis is currently performed offline, this was not obvious at the time of recording. The 3D flow method clearly discriminates the other two patients with severe aortic regurgitation from the patients with mild or moderate regurgitation.

Conclusion
We find these preliminary results encouraging, motivating further work on method refinement and validation.
Abstract P1350 Figure 1
P1353 Left ventricular performance patterns in patients with dilated cardiomyopathy and advanced heart failure
Authors: Kinova E , Somleva D , Spasova N , Borizanova A , Goudev A 
Published: January 2020

Abstract

Background
Left ventricular (LV) global longitudinal strain (GLS) is a more sensitive parameter than ejection fraction in the assessment of LV function. It has been established as a predictor of cardiac death and adverse events. In patients with dilated cardiomyopathy (DCM) LV deformation and twist mechanics are reduced in varying degrees.

Purpose
The aim of the study was to determine different LV performance patterns in patients with DCM and advanced heart failure (HF).

Methods
In 52 patients with DCM with HF NYHA class III-IV (62 ± 13 years, 36 males) LV function had been assessed by conventional, Tissue Doppler and 2D-speckle tracking echocardiography (2D-STE) with measurement of GLS, circumferential strain (CS) and twist mechanics. Patients were divided into two groups: with GLS≥-7 %, and GLS&lt;-7 %.

Results
In a group with more reduced GLS≥-7% systolic parameters were worse, Table. Systolic velocities of medial and lateral mitral annulus (S’lat), and CS at the LV basal and mid levels (CSmid) were significantly more altered. Rotational parameters did not differ between the groups. In a multivariate regression model CSmid (p &lt; 0.0001; B = 0.66, 95%CI [0.37 ÷ 0.95]), S’lat (p = 0.001; B=-0.34, 95%CI [-1.5÷-0.46]) and VCW (p = 0.002; B = 0.31, 95%CI [0.15 ÷ 0.66]) were independent predictors of GLS. ROC curves identified CSmid (AUC 0.91, p &lt; 0.0001) and VCW (AUC 0.69, p = 0.02) as the best discriminators of patients with severely reduced GLS≥-7%.

Conclusions
Patients with DCM and HF with severely depressed LV function assessed by GLS were characterized with more altered CS and more pronounced MR. Rotational parameters failed to be significant determinants of LV performance.
Echocardiographic parameters GLS≥-7% N = 24 GLS&lt;-7% N = 28 p End diastolic volume index(ml/m&sup2;) 113.55 ± 41.64 87.98 ± 26.98 0.01 End systolic volume index(ml/m&sup2;) 84.50 ± 39.05 55.51 ± 21.93 0.001 Ejection fraction (%) 28 ± 8 35 ± 7 0.001 Systolic velocity of medial mitral annulus (cm/sec) 3.57 ± 0.81 4.88 ± 1.52 0.001 Systolic velocity of lateral mitral annulus (cm/sec) 4.38 ± 1.09 5.38 ± 1.42 0.014 Circumferential strain at basal level (%) -5.92 ± 3.15 55.52 ± 21.93 0.014 Circumferential strain at mid-level (%) -5.11 ± 1.77 -8.71 ± 2.34 &lt;0.0001 Epicardial Torsion (°/cm) 0.31 ± 0.18 0.47 ± 0.35 0.05 Vena contracta width of mitral regurgitation (mm) 7.34 ± 2.23 5.58 ± 2.82 0.017 GLS - global longitudinal strain.
P1375 Echocardiographic estimation of right ventricle wall tension: hemodynamic comparison and long term follow up
Authors: Annone U , Bocchino P , Grosso Marra W , Milan A , D"ascenzo F , Magnino C , Montefusco A , Omede P , Veglio F , Rinaldi M 
Published: January 2020

Abstract

Introduction
Natural history of pulmonary hypertension (PH) is linked to right ventricle (RV) failure; in first phases of PH, coupling is preserved at the price of augmented RV wall tension (RVWT), which may represent an early sign of disease.

Methods
Patients with suspected PH, in absence of RV failure, underwent right heart catheterization and nearly-simultaneous echocardiography. We extrapolated RVWT from Laplace’s law as RV length × tricuspid regurgitation peak gradient (TRPG), and we correlated it with RV haemodynamic profile. Its impact on survival was tested.

Results
190 patients were enrolled; RVWT correlated with invasive measure of RV telediastolic pressure, mean pulmonary artery (PA) pressure, PA compliance, transpulmonary gradient, pulmonary vascular resistance, right atrial pressure and RV stroke work index (all p &lt; 0.001). At a mean follow-up of five years and three months, RVWT predicted all-cause mortality at univariate and multivariate analysis (p 0.036, p 0,023); tricuspid annular plane systolic excursion (TAPSE) (p 0.536), RV fractional area change (p 0.383), RV S’ (p 0.076) and TAPSE/TRPG (p 0.181) did not.

Conclusions
We identified a novel echocardiographic predictor of precocious RV impairment, able to predict all-cause mortality at a long-term follow-up.
Regression: RVWT and invasive parameters Characteristics R - R2 p value mPAP 0.742 - 0.550 &lt;0.001 PA pulsatory pressure 0.740 - 0.547 &lt;0.001 RV differential pressure 0.794 - 0.630 &lt;0.001 Mean RAP 0.326 - 0.106 &lt;0.001 CI/RAP 0.209 - 0.044 0.012 RVSWI 0.326 - 0.106 &lt;0.001 PA compliance 0.449 - .202 &lt;0.001 PVR 0.531 - 0.282 &lt;0.001 RV basal diameter 0.326 - 0.106 &lt;0.001 RV medium diameter 0.403 - 0.162 &lt;0.001 Right atrium area 0.204 - 0.042 0.013 RV FAC 0.382 - 0.146 &lt;0.001 RV telediastolic area 0.347 - 0.120 &lt;0.001 Correlation between RVWT and invasive haemodynamic parameters of RV function. mPAP, mean pulmonary artery pressure. RAP, right atrial pressure. CI, cardiac index. RVSWI, right ventricle stroke work index. PVR, pulmonary vascular resistance. RV, right ventricle. FAC, fractional area change.
Abstract P1375 Figure. RVWT and invasive hemodynamic profile
P1380 tissue Doppler and speckeled tracking of left ventricle post coarctation repair
Authors: Hassan F , Abdelsattar E , Emam S , Ebrahem R , Ebrahem H 
Published: January 2020

Abstract

Introduction
Left ventricular dysfunction was observed after repair of coarctation of the aorta (COA) before development of left ventricular concentric hypertrophy.

Aim
The aim of this study was to assess the the LV functions after COA repair.

Methods
Thirty pediatric patients with COA repair underwent echocardiographic examinations using Conventional echocardiography, tissue doppler image (TDI) and 2D-STE.

Results
The LV systolic functions assessed by TDI and 2-D-STE showed a significant reduction of (S׳׳LW LV, IVA at LW LV, IVA at the septum, longtudinal strain (LS) basal and global radial (GRS) in cases compared to control group . There is significant increase in GCS in cases compared to control group, the conventional Doppler derived MPI of LV in post coarctation repair cases was significantly prolonged compared to control. Analysis of mitral annulus velocities including E", A", E"/A" ratio and E/E′ ratio revealed worsening of the left ventricular diastolic mechanics in the post COA repair cases compared to healthy controls. The E" wave velocity (at the left ventricular lateral wall) was significantly lower in post COA repair in cases compared with controls , E"/A" ratio was significantly lower in post COA repair cases compared with controls . The E/E′ ratio was significantly higher in the post COA repair cases compared to the control group .

Conclusions
LV systolic and diastolic dysfunction was fount in patient after COA repair.
LV systolic function by 2-D-STE Cases Control P value Mean SD mean SD GLS -21.51 2.79 -22.63 2.99 .094 LS basal -19.94 2.83 -22.63 2.99 &lt;0.01 (S) LS Mid -21.08 2.75 -21.87 2.78 .273 LS apical -23.52 4.22 -21.74 4.23 .109 GRS 22.58 5.24 49.01 10.08 &lt;0.01 (S) RS basal 20.92 8.29 43.56 18.95 &lt;0.01 (S) RS mid 25.03 7.59 56.80 14.27 .223 RS apical 21.78 8.34 46.66 15.11 &lt;0.01 (S) GCS -20.09 2.66 -16.73 2.78 &lt;0.01 (S) CS basal -21.49 2.70 -16.98 4.69 &lt;0.01 (S) CS mid -21.27 4.09 -15.83 3.67 &lt;0.01 (S) CS apical -17.51 4.63 -17.39 4.57 .920
P1389 Less dependent to loading conditions, TAPSE and S peak systolic tricuspid velocity are the 2 most robust indices to investigate right ventricular systolic function
Authors: Fauvel C , Raitiere O , Burdeau J , Si Belkacem N , Bauer F 
Published: January 2020

Abstract

Background
The daily challenge in pulmonary hypertension (PH) is to utilize a non-invasive echocardiographic parameter that is less load-dependent to follow-up right ventricular (RV) systolic function. VMAX, also called the maximum no-load contractile element velocity is known to be a strong load-independent contractility parameter, as good as the end-systolic pressure volume relationship that is simply obtained from pressure tracing.

Purpose
We aimed to investigate which among the 6 most common RV systolic function echocardiographic indices are less load-dependent by comparing them to VMAX.

Population
Sixteen patients scheduled for suspected or established PH had right-heart catheterization and ultrasound study the same day. Tricuspid annular plane systolic excursion (TAPSE), peak S tricuspid annulus velocity, both RV free wall and septal 2D strain, RV TEI index, tricuspid regurgitation - dP/dt and RV fractional area change were acquired from standardized echocardiographic protocol. The PressureWire Certus (Saint Jude Medical, Minnesota, USA) used to monitor invasive RV pressure is a 0.014" wire with high-fidelity sensor technology, operating with a frequency response of 0 to 25 Hz and exhibiting an accuracy of ± 1 mm Hg. A dedicated software was used to display simultaneously RV pressure and dP/dt and tracings where stored for offline analysis. VMAX was the y-axis intercept obtained by fitting a straight line through multiple points on the stress and pressure derivative curves by a least squares technique during isovolumic contraction.

Results
VMAX averaged 2.1 ± 0.9 length/s (range 0.80 to 4.43 length/s). The relationship is acceptable for the 2D strain (y = 0.08 x + 0.89, r = 0.53, p = 0.038) compared with VMAX, is improved between TAPSE and VMAX (y = 1.19x + 0.03, r = 0.76, p &lt; 0.0001) but is best between peak S tricuspid annulus velocity and VMAX (y = 0.26 x – 0.60, r = 0.90, p &lt; 0.0001). The TEI index, non-invasive dP/dt and right ventricular fractional area change did not correlate with VMAX. (FIG 1)

Conclusion
Both TAPSE and S peak systolic velocity are good markers of RV contractility with relatively load-independency in the setting of pulmonary hypertension.
Abstract P1389 Figure.
P1392 Association of iron deficiency with left ventricular longitudinal function abnormalities in patients with acute myocarditis
Authors: Kosmala W , Franczuk P , Jasic-Szpak E , Tkaczyszyn M , Drozd M , Sidorowicz N , Kulej-Lyko K , Walczak T , Zapolska A , Przewlocka-Kosmala M , Ponikowski P , Jankowska E A 
Published: January 2020

Abstract

Background
Recent evidence suggests that iron depletion may be involved in the pathophysiology of acute myocarditis (MCD), however no data on the contribution of this mechanism to the MCD-associated cardiac performance abnormalities are available. The decrease in longitudinal deformation is an early manifestation of left ventricular (LV) dysfunction. Nonetheless, global longitudinal strain (GLS) is afterload-dependent, and the estimation of myocardial work correcting GLS for changes in systolic blood pressure may permit a more adequate assessment of LV contractility.

Aim
We sought to investigate the association between iron status and LV function in patients with MCD.

Methods
We prospectively included 30 patients (age 32 ± 8 years; 97% male) hospitalized for acute MCD in a tertiary cardiology center. MCD was diagnosed based on the following criteria: 1) new onset symptoms suggestive of myocarditis (exercise intolerance, dyspnea, palpitations or chest pain), 2) elevated high sensitivity cardiac troponin I (hscTnI), 3) exclusion of obstructive coronary artery disease, 4) confirmation of myocardial oedema based on T2 mapping in cardiac magnetic resonance. On admission, each participant underwent echocardiography with LV strain and myocardial work (global work index [GWI], global constructive work [GCW], global wasted work [GWW], global work efficiency [GWE]) analysis, and laboratory assessment including the iron status markers: ferritin and transferrin saturation (TSAT). Iron deficiency (ID) was defined as transferrin saturation (TSAT) &lt;20%; we did not use serum transferrin to categorize iron status because of the strong association of this marker with acute inflammation, which might affect the interpretation of its values.

Results
ID was found in 16 (53%) enrollees. Patients with reduced TSAT demonstrated lower GCW and GWI than their peers with normal TSAT (Table). No significant between-group differences were found for GLS, LV ejection fraction, early diastolic tissue velocity (e’) and E/e’ ratio. Both subsets did not significantly differ with respect to hemoglobin, creatinine, NT-proBNP, hscTnI and CRP. Both GWI and GCW significantly correlated with TSAT (r = 0.39, p = 0.03, and r = 0.37, p = 0.04, respectively). In multivariable analysis, after adjustment for patient age, body mass index, creatinine, hscTnI and CRP, TSAT was an independent predictor of GWI (beta = 0.40; p = 0.02) and GCW (beta = 0.38; p = 0.02).

Conclusion
In patients with MCD, ID defined as low TSAT is associated with a worse LV longitudinal performance as assessed by GCW and GWI, which might suggest a role of this pathophysiological pathway in the development of cardiac dysfunction. Myocardial work parameters seem to outperform GLS in diagnosing LV functional impairment in this clinical setting.
Abstract P1392 Figure.
P1394 Left atrial strain as a tool to explore disturbed system biology involving cerebral cognition in diabetes: A sub study of the European multicenter MOPEAD project
Authors: Saha S K , Kiotsekoglou A , Borysenko A , Gopal A , Govind S C 
Published: January 2020

Abstract

Funding Acknowledgements
EU GRANT

OnBehalf
MOPEAD STUDY GROUP

Background
Although the 2D speckle tracking software (2DSTE-SW) has been irrevocably proved to be useful for quantification of left ventricular (LV) function, the same SW has also been used successfully in a plethora of cardiac illnesses using left atrial (LA) strain and strain rate, even in the absence of a dedicated LA SW. LA peak longitudinal strain during ventricular systole (LA-Reservoir strain%; LA-Res S), and strain rate during early (LA-SRE) and late (LA-SRA) phases constitute respectively the reservoir (LA-RS%), conduit, and booster pump functions of this chamber. The role of this dynamic function has not been investigated to assess cerebral cognition in type 2 diabetes (DM).

Methods
We enrolled thirty-nine subjects with DM and mild LV dysfunction (76 ± 5 years, 25 F) in the EU- funded MOPEAD (Models of Patient Engagement for Alzheimer’s Disease) project. Fifteen of them underwent standard echocardiography and 2DSTE. We assessed cerebral cognition using the standard MMSE (Mini-Mental Stage Examination) score: we considered a score of less than 28 as a surrogate of mild cognitive impairment (MCI+). Besides LA-Res strain, LA-SRE, LA-SRA, LV-GLS and right ventricular free wall strain (RV-FWS) were also computed (RV-FWS). Routine biochemistry included, among other, HbA1c and NT-proBNP.

Results
Mean values of the 2D STE measures were LVGLS: 14± 3%, LAVI: 36± 21 ml/m2, LA -RS: 18 ±8 %, LA-SRE: 0.6± 0.3, and LA-SRA: 1.6± 0.4. RV FWS was 20± 5 %. HbA1c was 58 ± 16 mmol/mol. LVEF was 53± 7%. There was no difference in theses variable between MCI+ and those with normal cognition (MCI-). However, in the regression model, LA-Res S had the strongest association with MCI (P &lt; 0.01) (Fig), with excellent strength of association ( R2 = 0.8). LA-SRE, indexed LA volume, and NT-proBNP were not retained by the model (p &gt; 0.05).

Conclusion
LA reservoir strain may emerge as a useful tool to explore disturbed system biology involving extracardiac organ such as the brain in older adults with type 2 diabetes, in the background of mild LV dysfunction.
Abstract P1394 Figure. Fig.Regression analysis
P1399 Global longitudinal systolic deformation of the left ventricle during stress echocardiography with physical exercise may identify patients with severe coronary artery disease
Authors: Stepanova A , Alekhin M N 
Published: January 2020

Abstract

Background
Assessment of longitudinal systolic deformation of the left ventricular myocardium during speckle tracking stress echocardiography can potentially be significant in the diagnosis of transient myocardial ischemia. In this regard, determination of the global longitudinal systolic deformation (GLSD) of the left ventricle during stress echocardiography is challenging and its diagnostic capabilities can be assessed by comparing them with the data obtained with invasive methods for diagnosing coronary artery disease (CAD).

Aim of the study
The aim of this study was to determine the diagnostic capabilities of the left ventricular GLSD obtained during stress echocardiography with exercise on the treadmill in defining the presence and significance of CAD.

Methods
The study included 80 patients (mean age 68.3 ± 7.8 years; 29 females). All patients underwent stress echocardiography with exercise on the treadmill. At rest and after treadmill-test, all patients were measured for the values of the left ventricular GLSD using the AFI (Automated functional imaging) algorithm. The delta of the left ventricular GLSD values was counted. The delta of the left ventricular GLSD values was counted as the difference of the left ventricular GLSD values at rest and after the exercise. All patients underwent coronary angiography, assessment of the severity of CAD was counted according to the Gensini score. According to the results of coronary angiography, the patients were divided into 3 groups: 21 patients without CAD, 45 patients with moderate CAD (&lt;34 points on the Gensini score) and 14 patients with severe CAD (&gt; 34 points on the Gensini score).

Results
In the group of patients with severe CAD, the value of the left ventricular GLSD delta at rest and after treadmill-test significantly differed from the groups of patients with moderate CAD and without CAD (-0.56 compared with 2.17; p = 0,009). In the group of patients without CAD, the value of the left ventricular GLSD delta at rest and after treadmill-test did not significantly differ from the group of patients with CAD (0.23 compared to -0.95; p = 0.199).

Conclusions
The delta of the left ventricular GLSD obtained during stress echocardiography with exercise on the treadmill showed a reliable significance in determining severe CAD, but did not demonstrate a reliable significance in identifying the absence of CAD.
P1400 Improving ischemia diagnosis: 3D speckle-tracking stress echocardiography
Authors: Pascual Izco M , Casas Rojo E , Kardos A , Alonso Salinas G L , Garcia Martin A , Hinojar Baydes R , Monteagudo Ruiz J M , Sanchez Vega J D , Ramos Jimenez J , Jimenez Nacher J J , Ruiz S , Moya J L , Zamorano Gomez J L , Fernandez-Golfin Loban C 
Published: January 2020

Abstract

Background
2D stress echocardiography (SE) is based in the visual analysis of wall motion abnormalities and it requires a trained operator. This operator-dependence has promoted the search for a semiautomatic method to reduce SE limitations and improve test accuracy. The aim of this study was to evaluate the value of 3D speckle tracking (3DSTE) in SE in patients with chest pain.

Methods
44 consecutive patients with chest pain and pathological findings on CCTA (&gt;50% stenosis or high calcium score (&gt;400 HU) with undetermined severity) were included. These patients underwent SE with acquisition of 3DSTE at rest and at peak stress.

Results
Mean age was 63.9 ± 9.9 years. 90% were men. The images of the 44 patients were processed with automatic tracking and manual corrections. 11 patients developed inducible ischaemia during SE. Patients with ischaemic response showed significant reductions in 3D area strain (AS) compared to resting values. The 33 patients without inducible ischaemia showed, however, a significant increase in this parameter. Results are shown in table 1.

Conclusion
3D area strain SE could help to identify patients with inducible ischemia. However, further studies are need to confirm these data.
Ischemia + (n = 11) Ischemia - (n = 33) P 2D LVEF rest 57.2; 5.5 61.4; 6.0 0.04 2D LVEF peak stress 56.9; 11.7 70.0; 9.0 &lt;0.01 3D LVEF at rest 54.3; 6.9 64.3; 9.7 0.17 3D LVEF peak stress 51.9; 22.5 66.0; 8.6 0.17 AS rest 38.3; 5.1 40.4; 5.7 0.29 AS peak stress 37.2; 11.3 43.6; 7.2 0.03 LVEF: left ventricle ejection fracion; AS: area strain.