bluuebunny/crossref_metadata_2025_split huggingface dataset:
1024 Left ventricle myocardial deformation (strain) pattern in severe aortic valve stenosis. AMY-TAVI study
Authors: Bastos Fernandez M , Lopez Otero D , Lopez Pais J , Pubul Nunez V , Gude Sampedro F , Neiro Rey C , Trillo Nouche R , Martinez Monzonis A , Gonzalez Juanatey J R 
Published: January 2020

Abstract

OnBehalf
AMY-TAVI study
PURPOSE.
To study left ventricular (LV) myocardial deformation in patients with severe symptomatic aortic stenosis (AS), through the analysis of the Regional and Global Longitudinal Strain (GLS), as well as the phenotypic pattern of peak systolic longitudinal strain represented in the bull´s eye.

METHODS.
A total of 42 patients with severe symptomatic AS were prospectively and consecutively included. Conventional morphological and functional parameters were analyzed, along with LV strain parameters and the strain pattern phenotype using two-dimensional speckle-tracking echocardiography. Indices derived from strain accepted as suggestive of cardiac amyloidosis were calculated (RELAPS: relative apical sparing: defined using the equation (average apical LS/(average basal LS + mid-LS); ­­Eyection Fraction strain ratio (EFSR= LVEF/GLS). Scintigraphy with technetium pyrophosphate99 and blood protein electrophoresis were performed in all patients for the diagnosis / exclusion of cardiac amyloidosis.

RESULTS
The mean age was 80 ± 7 years, and 52% were women. The mean aortic valvular area was 0.6 ± 0.1 cm2 and the left ventricular ejection fraction (LVEF) was 56 ± 16%. 19 patients (45.2%) presented a pattern of relative apical sparing of LV longitudinal strain (RELAPS&gt; 1); and 16 patients (38%) showed an EFSR&gt; 4.1. Cardiac amyloidosis was excluded in all patients. In the univariate analysis, RELAPS&gt; 1 was significantly associated with higher degree of LV hypertrophy, lower LV end-diastolic volume, and greater myocardial contraction fraction.

CONCLUSIONS.
In our series, patients with severe symptomatic AS have with high frequency a "relative apical sparing" longitudinal strain pattern and Eyection Fraction Strain Ratio similar to those described in cardiac amyloidosis. Our results suggest that the classic patterns of cardiac amyloidosis are common in patients with severe AS in the absence of said pathology, findings that we believe may have important clinical implications.
Abstract 1024 Figure. Peak systolic LS patterns in severe AS
1027 Mechanical dispersion of the left and right ventricle and the correlation with ventricular arrhythmias in hypertrophic cardiomyopathy
Authors: Popa-Fotea N M , Micheu M M , Dorobantu M 
Published: January 2020

Abstract

Funding Acknowledgements
CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF

Introduction
One important cause of sudden cardiac death in hypertrophic cardiomyopathy (HCM) are ventricular arrhythmias. In patients with HCM, non-sustained ventricular arrhythmias were analysed in relation with 2D speckle tracking mechanical dispersion of left ventricle (LVMD), but not in relation with mechanical dispersion of the right ventricle.

Purpose
To investigate the possible associations between mechanical dispersion and other echocardiographic parameters and the development of non-sustained ventricular tachycardias (NSVT) in HCM patients.

Methods
Clinical, 24 hours ECG-Holter, 2D and 3D echocardiography data were registered in HCM patients and in a healthy control group (with normal echocardiography). The 24 hours ECG-Holter was used for detecting NSVT. LVMD was calculated as the standard deviation of time to peak negative strain in the sixteenth segments of the left ventricle. The right ventricle mechanical dispersion (RVMD) was calculated on a three free wall segments model (FWMD), but also in six segments (three RV free wall segments plus three septal segments). Right and left ventricle function was evaluated by conventional echography and 2D speckle tracking imaging.

Results
Fifty-two patients with HCM and thirty-six age and sex matched subjects were included in the study. In HCM group, 6 patients (11,5%) associated biventricular hypertrophy, while 15 (28.8%) had NSVT on ECG monitoring (group HCM1). HCM1 patients had a much higher LVMD (77.38 ± 11.19 ms) compared with HCM patients without NSVT (group HCM2) (55.8 ± 23.85 ms, p = 0.001, CI:-33.9,-9.3) or compared with controls (43.07 ± 14.19 ms, p &lt;0.001, CI: -44.68, -25.99). The 6 segments RVMD (60.23 ± 10.2 ms) was significantly higher in the CMH1 group compared with CMH2 (45.22 ± 9.8 ms, p = 0.01, CI: -32.1, -28.1) or with the control group (22 ±14 ms, p &lt; 0.001,CI: -36.28, -30.12) independently of the existence of RV hypertrophy. Also, FWMD (55.2 ± 4.8 ms) was significantly higher in CMH1 group in comparation with CMH2 (42.3 ± 5.6 ms, p = 0.02, CI: -27.1, -8.2) or controls (32.1 ± 2.2 ms, p = 0.006, CI: -28.1, -12.1).
The presence of NSVT correlated with global longitudinal strain (GS) 2C (-0.442, p = 0.009), GS LAX (r=-0.373, p = 0.03), GS mean value (r=-0.345, p = 0.046), LVMD (r = 0.462, p = 0.006), FWMD (r = 0.51, p = 0.004), 6 segments RVMD (r = 0.46, p = 0.05), 2D and 3D left atrial volume (r = 0.446, p = 0.008 and respectively, r = 0.512, p = 0.002).
In a logistic regression, the only parameters associated with NSVT were LVMD (OR = 1.046, p = 0.05), FWMD (OR = 1.03, p = 0.05) and 6 segments MD (OR = 1.1, p = 0.04).

Conclusions
Increased mechanical dispersion of the left, but also right ventricle is associated with the risk of non-sustained ventricular tachycardias in HCM patients.
1037 Differences in reverse remodelling between ischemic and non-ischemic left ventricular segments as assessed by myocardial work after sacubitril-valsartan therapy
Authors: Valentim Goncalves A A , Galrinho A , Pereira-Da-Silva T , Moura Branco L , Rio P , Teresa Timoteo A , Abreu J , Soares R , Feliciano J , Ilhao Moreira R , Cruz Ferreira R 
Published: January 2020

Abstract

Introduction
Myocardial work (MW) is a new transthoracic echocardiographic (TTE) parameter that enhances the information provided through left ventricular (LV) global longitudinal strain (GLS), allowing to investigate LV performance even in cases of changes in afterload.
None is known about the effects of Sacubitril-Valsartan (LCZ696) therapy in MW parameters.

Purpose
Compare the changes in MW parameters between ischemic and non-ischemic segments after LCZ696 therapy.

Methods
The study was a prospective evaluation of chronic Heart Failure (HF) patients with optimized standard of care therapy and LV ejection fraction ≤40%, in which LCZ696 therapy was started and no other HF treatment was expected to change.
A TTE study was performed before and 6 months after LCZ696 therapy, using the GE Vivid E95 ultrasound system. A semiautomated analysis of GLS was performed after two-dimensional images were acquired in the standard apical 4-, 3- and 2 chamber views. MW and related indices were estimated using custom software.
Two groups were created according to the 17 segment model TTE study before LCZ696 therapy:
G1 (ischemic group): dyskinesia/akinesia/hypokinesia segments in patients with ischemic HF etiology;
G2 (non-ischemic group): normokinesia segments in patients with ischemic and all segments in patients with non-ischemic HF etiology;

Results
Of the 42 patients, 35 (83.3%) completed the six-months follow-up with LCZ696, since 2 patients (4.8%) died and 5 patients (11.9%) discontinued treatment for adverse events. Mean age was 58.6 ± 11.1 years, with ischemic etiology in 15 (42.9%), resulting in a total of 26.5% segments for G1.
Baseline global MW index (GWI) had no statistical difference between G1 and G2 (566.1 VS 584.8mmHg%, p = 0.257), but baseline MW efficiency (GWE) were significantly lower in G1 (71.9 VS 78.8%, p &lt; 0.001).
The table represents the mean values for MW parameters in G1 and G2 before and 6 months after LCZ696 therapy, with a significantly increase in GWI and GWE values in both groups. Despite no difference in the increase in GWE (p = 0.872), the increase in GWI were higher in G2 than G1 (p &lt; 0.001).

Conclusion
MW seems to be a new tool providing signs of reverse remodelling and better cardiac performance in ischemic and non-ischemic segments after LCZ696 therapy.
Table 1 Time 0 6 months p GWI in ischemic segments (mmHg%) 566.1 ± 364.0 696.5 ± 445.2 &lt;0.001 GWE in ischemic segments (%) 71.9 ± 25.0 78.9 ± 19.1 0.009 GWI in non-ischemic segments (mmHg%) 584.8 ± 434.3 812.3 ± 442.0 &lt;0.001 GWE in non-ischemic segments (%) 78.8 ± 21.2 85.7 ± 15.8 0.004 MW data before and after six months of LCZ696 therapy
1040 Unexpected prevalence of subtle systolic and diastolic dysfunction in genotype-positive phenotype-negative relatives of dilated cardiomyopathy patients
Authors: Paldino A , De Angelis G , Dal Ferro M , Faganello G , Porcari A , Barbati G , Korcova R , Gentile P , Artico J , Pinamonti B , Merlo M , Sinagra G 
Published: January 2020

Abstract

Funding Acknowledgements
None

Background
Left ventricular global longitudinal strain (LV-GLS) and peak left atrial longitudinal strain (PALS) are promising techniques for the detection of a subtle systolic and diastolic dysfunction for an early diagnosis of genetically determined dilated cardiomyopathy (DCM). Purpose. We sought to evaluate the prevalence of subtle systolic and diastolic dysfunction by LV-GLS and PALS in a cohort of genotype-positive phenotype-negative (GPFN) DCM relatives. Methods. We analysed echocardiograms (including LV-GLS and PALS) of 41 GPFN relatives of DCM patients (GPFN group - 37 ± 14 years, 48.8% male). They were compared with a matched group of 52 healthy individuals (control group). Reduced LV-GLS and PALS were defined as &gt;-18% and &lt;23.1%, respectively, according to literature data. Results. GPFN and control groups were grossly similar according to standard echocardiographic measurements. Conversely, mean LV-GLS was -18.8 ± 2.7% in the GPFN group vs. -24.0 ± 1.8% in the control group (p &lt; 0.001). 20 subjects (48.8%) in the GPFN group and no subjects in the control group had a reduced LV-GLS. The mean PALS was 29.2 ± 6.7% in the GPFN group vs. 40.8 ± 8.5% in the control group (p &lt; 0.001). 7 subjects (18.4%) in the GPFN group and one (2%) in the control group had a reduced PALS. During a median follow-up of 27 months, 6 (14.6%) GPFN relatives developed a LV ejection fraction &lt;50%. Among them, 4 (66%) had a reduced LV-GLS at initial evaluation. Conclusions. LV-GLS and PALS are impaired in GPFN relatives of DCM patients compared to healthy individuals, when standard echocardiographic parameters are normal. Further studies are warranted to add prognostic significance to this result, which may lead in the future to an early therapy initiation.
Abstract 1040 Figure. Mean LV-GLS and PALS in GPFN and control
1042 Assessment of left ventricular systolic function in obstructive sleep apnea with automatic function imaging and its relation relation with hypoxia
Authors: Chenyao M A , Sanderson JOHN , Mi L U , Hu L I U , Lei XIAO , Jie X U , Yongxiang W E I , Fang F 
Published: January 2020

Abstract

Funding Acknowledgements
OSA & Subclinical myocardial impairment

Background
Early detection of left ventricular (LV) systolic dysfunction is crucial for patients with obstructive sleep apnea (OSA) . LV longitudinal strain (GLS), derived from automated function imaging (AFI) based on 2D echocardiography, provides a new tool to detect subclinical impairment of both global and regional myocardium. Its value in OSA remains unclear compared to traditional parameters since obesity is not uncommon in OSA, which may compromise the accuracy of AFI. We aimed to investigate the feasibility of AFI in OSA and further to explore the impact of OSA severity and degree of hypoxia on LV function.

Methods
Comprehensive transthoracic echocardiography was done in those receiving polysomnography (PSG) suspected as OSA consecutively (n = 322). All subjects were divided into 3 groups by apnea-hyponea index (AHI) by PSG (Control: AHI＜5; mild-to-moderate AHI 5-30; severe: AHI≥30) and GLS and mitral annular plane systolic excursion (MAPSE) were compared among the 3 groups.

Results
322 patients with normal LVEF (≥50%) were finally analyzed. Though more segments were measured, inter- and intra- observer variability of GLS were comparable with MAPSE in a Bland-Altman analysis. For group comparison, GLS was reduced compared to the other 2 groups in the severe OSA category (p ≤ 0.001) while MAPSE showed no differences. Further analysis showed the feasibility of AFI was acceptable even in obese patients. In multivariable analysis of GLS, only maximum desaturation was an independent associated factor (p = 0.027).

Conclusions
Even in OSA patients with obesity, AFI-derived GLS is feasible. GLS is more sensitive than MAPSE or TDI for detection of reduced LV systolic function in OSA.
Control(n = 27) Mild-Mod OSA(n = 145) Severe OSA(n = 160) P-value Age(years) 43 ± 13 47 ± 12 46 ± 11 0.218 Males, n(%) 17(63.0%) 118(81.4%) 154(96.3%) ＜0.001 BSA(m2) 1.82 ± 0.18 1.88 ± 0.18 1.97 ± 0.17*† ＜0.001 BMI(kg/ m2) 24.7 ± 4.4 26.8 ± 3.7* 28.6 ± 4.2*† ＜0.001 LVEF(%) 66.5 ± 6.4 67.0 ± 5.0 66.7 ± 4.6 0.813 Sep S’(cm/s) 8.3 ± 1.7 8.4 ± 1.5 8.7 ± 1.9 0.256 Sep E’(cm/s) 9.5 ± 3.0 9.0 ± 2.4 8.2 ± 2.0*† 0.003 E/ E’ 9.2 ± 2.9 9.1 ± 2.9 9.8 ± 2.9 0.145 GLS(%) 19.1 ± 2.7 19.0 ± 2.5 17.9 ± 2.4*† ＜0.001 MAPSE(mm) 15.1 ± 2.5 14.7 ± 2.3 14.3 ± 2.2 0.302 *p＜0.05 compared with mild OSA patients, †p＜0.05 compared with moderate OSA patients Echo Comparison between 3 OSA Groups
1043 Association of left ventricular global longitudinal strain with myocardial perfusion evaluated by 13N-ammonia positron emission tomography in hemodialysis patients with preserved ejection fraction
Authors: Yamabe S , Ito R , Sakakibara T , Yamada A , Ohshima S , Ozaki Y 
Published: January 2020

Abstract

Background
Global longitudinal strain (GLS) is an echocardiographic marker to detect subclinical left ventricular systolic dysfunction prior to the appearance of reduced left ventricular ejection fraction (LVEF). Reduced GLS identified in patients with maintenance hemodialysis (HD) has been reported to be a predictor of their higher mortality and cardiovascular events. On the other hand, pharmacological stress 13N-ammonia positron emission tomography (13N-NH3-PET) has been an established and reliable imaging modality to evaluate myocardial perfusion expressed as coronary flow reserve (CFR) or maximal stress myocardial blood flow (MBF). CFR and MBF are powerful parameters to detect coronary artery disease and to predict cardiovascular events and mortality. However, association between GLS and those myocardial perfusion parameters are not fully understood.
Purpose：The aim of this study was to evaluate the relationship between GLS and the myocardial perfusion parameters of 13N-NH3-PET in HD patients with preserved LVEF.

Methods
We studied 24 HD patients (mean age 67 years, 67% male) who underwent ATP stress 13N-NH3-PET as well as transthoracic echocardiography including 2-dimensional speckle tracking imaging for suspected ischemic heart disease. Exclusion criteria were as follows: LVEF &lt;50%, moderate to severe valvular diseases, and atrial fibrillation. Myocardial perfusion abnormality (MPA) was defined as CFR &lt;2.0 and/or stress MBF &lt;2.0.

Results
Mean GLS in all patients was -16.2 ± 3.6%. The patients were divided into 2 groups based on GLS: patients with reduced GLS (&lt;-16%) (Group A, N = 11) and those with preserved GLS (≧-16%) (Group B, N = 14). There were no significant differences between 2 groups in age, gender, body mass index, left ventricular mass index, and average E/e’. Nevertheless, Group A had significantly lower stress MBF than Group B (1.7 ± 0.41 vs 2.0 ± 0.33, p = 0.031). In addition, Group A showed more frequent MPA compared with Group B (81.8% vs 42.9%, p = 0.043). There was a moderate correlation between GLS and stress MBF (r = 0.62, p = 0.0012), whereas no significant correlation was noted between GLS and CFR (r = 0.079, p = 0.71).

Conclusion
Reduced GLS was significantly associated MPA. MPA may be one of the major contributors to the reduction in GLS in HD patients with preserved LVEF.
1044 Simple echocardiographic scoring in screening for aortic stenosis by emergency physicians in the emergency department
Authors: Furukawa A , Abe Y , Miyaji T , Hatakenaka M , Naito M , Ageta K , Takeuchi S , Morizane A , Nishida T , Ito H 
Published: January 2020

Abstract
Background; Aortic stenosis (AS) is one of the important critical diseases and may influence hemodynamics in cardiovascular or non-cardiovascular emergency, however, there is no established methodology to diagnose AS in a focused cardiac ultrasound (FOCUS). We have previously reported that our developed visual AS score was a simple index for AS screening using rapid echocardiography and it could successfully diagnose clinically significant AS. The purpose of the present study was to evaluate the diagnostic accuracy of visual AS score assessed by emergency physicians in the emergency department. Methods; Visual AS score was calculated as the sum of the scores of each three aortic cusp’s opening in a short-axis view scored as follows: 0 = not restricted, 1 = restricted, or 2 = severely restricted; and classified in 0 – 6 as we previously reported. Emergency physicians who did not specialize in cardiology or ultrasonography underwent basic 30 minutes training to visualize aortic valve in a short-axis view and to assess visual AS score beforehand. They performed echocardiography and evaluated visual AS score in emergency outpatients with suspected cardiovascular diseases such as chest symptom, consciousness disorder, abnormal vital signs, heart murmur or abnormal electrocardiogram in the emergency department. Then, another assessment of visual AS score and complete echocardiography including quantitative assessment of AS was performed by expert sonographers. Aortic valve area index (AVAI) was calculated using continuity equation and body surface area, and an AVAI &gt; 0.85 cm/m2, 0.6 - 0.85 cm/m2, and &lt; 0.6 cm/m2 were defined as none or mild, moderate and severe AS, respectively. Results: Sixty patients underwent evaluations of visual AS score by emergency physicians. Visual AS score could not be assessed in 5 patients and continuity equation could not be evaluated in 2 patients, both due to poor echocardiographic imaging quality. Visual AS scores assessed by emergency physicians and expert sonographers showed strong positive correlation (R = 0.94, P &lt; 0.0001). Fourteen patients (26 %) including 6 with shock or hypotension, 3 with congestive heart failure, 2 with syncope, 1 with acute myocardial infarction, 1 with suspected cardiac tamponade and 1 with abnormal electrocardiogram had moderate or more degree of AS in complete echocardiography performed by expert sonographers. Visual AS score 3 or more assessed by emergency physicians had 86 %, 100 %, 100 % and 95 % of a diagnostic sensitivity, specificity, positive predictive value and negative predictive value, respectively. Conclusion: Visual AS score in FOCUS is useful to screen for AS for emergency physicians who do not specialize in cardiology.
1046 Prognostic value of cardiac magnetic resonance imaging in mitral valve prolapse
Authors: Bouttier A L , Jobbe-Duval A , Cueff C , Piriou N , Jaafar P , Pattier S , Capoulade R , Warin-Fresse K , Senage T , Serfaty J M , Roussel J C , Le Tourneau T 
Published: January 2020

Abstract
Background Mitral valve prolapse (MVP) is a frequent pathology that can be complicated by mitral regurgitation, heart failure, rhythm disorders, arterial embolism and death. The aim of this study was to evaluate the prognostic interest of ventricular volumes, right ventricular ejection fraction (RVEF) and late gadolinium enhancement (LGE) assessed by cardiac magnetic resonance (CMR) imaging on cardiovascular morbi-mortality in a cohort of patients with MVP
Methods We examined the prognostic value of CMR imaging in 237 patients with MVP (no to severe mitral regurgitation) included between 2010 and 2019. All patients underwent a comprehensive echocardiography. The main endpoint was a composite endpoint of cardiovascular death, heart failure, new onset atrial fibrillation, arterial embolism.
Results Among the 237 patients (63% male), 97 (41%) had LGE (75 myocardial wall, 10 papillary muscle tip and 12 both locations). Factors associated with LGE in multivariable analysis were age (OR 1.02, P = 0.037), left ventricular (LV) mass (OR 1.01, P = 0.008) and pulmonary artery systolic pressure (PAPS, OR 1.02, P = 0.069). Follow-up was censored at the time of surgery or percutaneous repair. In univariate analysis NYHA class, LV mass, left atrial volume, PAPS, LV end-diastolic and end-systolic volumes, chordal rupture and MR degree were associated with outcome. RVEF and biventricular dysfunction (LV EF &lt; 60% and RV EF &lt; 40%) were also associated with impaired event-free survival (36.0 ± 17.0% vs 65.4± 5.8%, P = 0.019). Finally, LGE was associated with a decreased event-free survival (55.6 ± 9.9% vs 70.7± 6.9%, P = 0.002). In multivariablee analysis, moderate to severe mitral regurgitation (HR : 2.14 [1.44-3.19], P &lt; 0.0001) and the presence of LGE were predictors of impaired event-free survival (HR : 2.12 [1.08-4.16], P = 0.003).
Conclusion CMR imaging provides additional prognostic information to echocardiography in the study of MVP. Myocardial fibrosis of the left ventricle and right ventricular function as assessed by CMR imaging are predictors of cardiovascular morbidity and mortality in MVP.