bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of 24-hour ambulatory central aortic pressure and left atrium-ventriculo-arterial interactions
Authors: Georgieva N , Kinova E , Krustev B , Borizanova A , Ilieva R , Goudev A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

INTRODUCTION
Arterial stiffness is an independent risk factor in arterial hypertension, but little is known about the association between left –heart side remodeling and arterial stiffness in middle – aged hypertensive patients.

AIM
The aim of our study was to assess the independence between the parameters of arterial stiffness and their relation with left atrium – ventriculo – arterial coupling in hypertensive patients, without any target-organ damage (TOD).

METHODS
A total 110 patients (56 ± 14 years) with hypertension, were separated in two groups: 32 patients with normal EA/Ees ratio (Arterial elastance (AE) and ventricular elastance (Ees)) and 78 hypertensive patients with decrease EA/Ees ratio, marker for ventriculo – arterial coupling. All patients underwent standard two - dimentional echocardiography with Speckle tracking analysis for LA – reservoir (LARs), conduit (LAScd) and contractile (LASct) and LV global longitudinal strain ( LV - GLS). End – systolic pressure was determined from the brachial pulse wave. Arterial elastance (AE) and ventricular elastance (Ees) were calculated as and – systolic pressure/stroke volume and end – systolic pressure/end – systolic volume. Parameters for arterial stiffness – 24 - hour central systolic pressure (cSys24h), central pulse pressure (cPP24h) and 24 - hour pulse wave velocity (PWV24h) were measured non – invasively with oscillometric method by Mobil-O-graph PWA.

RESULTS
Statistically significant differences in parameters of vascular stiffness were found in patients with normal ventriculo – arterial coupling in comparison with disturbed EA/Ees: cSys24h (106.78 ± 9.33 vs. 114.59 ± 16.1 mm Hg, p = 0.02), cPP24h (39.89 ± 11.78 vs. 48.56 ± 10.21 mm Hg, p= 0.04). There were statistically significant differences in echocardiography parameters between patients with disturbed VAC in comparison to other group: LAScd (16.66 ± 1.67 vs. 19.57 ± 1.34 %, p&lt; 0.001), LASr (31.76 ± 5.14 vs. 30.56 ± 3.28 %, p= 0.007) and LAVI (30.15 ± 9.20 vs. 36.78 ± 8.80 ml/m², p= 0.007). There was positive correlation between LAScd with EA/Ees (r = -0.285, p&lt; 0.008) and negative E/Em (r = -0.278, p&lt; 0.01). LAVI correlated moderate positively with E/Em ratio (r = 0.416, p&lt; 0.0001) and negatively with LAScd (r = - 0.418, p &lt; 0.0001). cSys24h correlated negatively with LV – GLS (r = - 0.218, p &lt; 0.03) and with EA/Ees (r = - 0.253, p = 0.013).

CONCLUSION
In well-controlled hypertension, 24 - hour ambulatory central aortic pressure played a part in LV remodeling. High LV filling pressures determined LA remodeling and dysfunction in middle–aged patients. These results could be used for a new direction of central aortic pressure-guided therapy.
Speckle tracking analysis of left ventricular function in patients with type 1 diabetes mellitus and kidney failure
Authors: Lehner LJ , Haag K , Zhang K 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Speckle tracking echocardiography (STE) is an excellent tool to detect early myocardial dysfunction when conventional parameters such as left ventricular ejection fraction are still unaltered. Reduced left ventricular strain has been described in patients with chronic kidney disease as well as in patients with diabetes mellitus. However, diabetes mellitus as a systemic microvascular disease can affect renal and cardiac function, potentially leading to kidney failure and diabetic cardiomyopathy.

Purpose
Aim of this study was to assess left ventricular function by speckle tracking analysis to delineate cardiac function in patients with diabetes mellitus type 1 and kidney failure (DM1 + KF) from patients with kidney failure without diabetes mellitus (KF).

Methods
We conducted a retrospective study and included 16 patients with DM1 + KF who were listed for a simultaneous pancreas-kidney-transplantation and received an echocardiogram between 2013 to 2016 in our clinic. They were compared to a sex- and age-matched group of kidney failure patients without diabetes mellitus (n= 20) and a healthy control group (n= 48).

Results
Subjects in all groups were young in age and had normal BMI. In the DM1 + KF group, 62.5% of patients were on dialysis as compared to 95% of patients in the KF group. As to be expected, only patients in the DM1 + KF group had elevated HbA1c plasma levels (Table 1).
Left ventricular ejection fraction was not significantly different between all three groups. Hypertrophy was present in the DM1 + KF group and even more in the KF group, as indicated by left ventricular mass index. Diastolic function was impaired in both patient groups compared to healthy controls. STE analysis revealed reduced global longitudinal strain (GLS) in the DM1 + KF (-13.07 ± 2.67 %) as well as KF group (-14.68 ± 4.87 %) to a similar extent in comparison to healthy control (-19.78 ± 1.89 %, p &lt; 0.001). Interestingly, DM1 + KF patients had significantly worse global radial strain (GRS) and global circumferential strain (GCS) than KF patients, as shown in Table 2.

Conclusions
DM1 + KF and KF patients displayed comparable impairment in left ventricular function when using conventional echocardiography. STE analysis provided more differentiated results, showing significantly worse GRS and GCS in patients with DM1 + KF, even though hypertrophy was more pronounced in KF patients. These parameters seem to capture the detrimental effects of diabetic microvasculopathy on the myocardium, in addition to the interdependency of the reno-cardiac axis. Abstract Figure. Patient characteristics Abstract Figure. Echocardiographic estimates
Quantification of mitral papillary muscle function using speckle tracking echocardiography in apparently healthy population
Authors: Kallala MY , Bouchahda N , Bettaieb SK , Mechri N , Lamine S , Hmidi M , Memmi K , Bnouni A , Hassan H , Boussaada M , B Messaoud M , Hassine M , Mahjoub M , Gamra H 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Cardiac mitral papillary muscle is a structure that has been long ignored. Recently, growing evidence from case reports showed an important role in the pathophysiology of many cardiac pathologies such as hypertrophic cardiomyopathy and dilated cardiomyopathy.
To our knowledge, there isn’t any approved standard technique nor any methodological descriptive study of papillary muscle function in the apparently healthy population.

Purpose
To investigate mitral papillary muscle function in apparently healthy population by speckle tracking echocardiography (STE) using a proposed standard method.

Methods
We prospectively performed standard transthoracic echocardiography(TTE) in an apparently healthy cohort. Posterior mitral papillary muscle(PPM) was visualized on a modified three chamber view. The anterior papillary muscle(APM) was visualized on a modified 4 chamber view. To measure the value of the papillary muscles longitudinal strain, tracing of PPM and APM was done by a drag and click technique using an ECHOPAC software. Good quality tracing was ensured before approving the measurements. Each papillary muscle was divided into three segments by the software.
2D longitudinal strain curves of each papillary muscle consisted in 3 solid lines of the three segments and a dashed line that represented the mean longitudinal strain of the whole papillary muscle. This latter line was used to derive peak values, post systolic shortening (PSS) and systolic stretch (SS). Time of aortic valve closure was determined on the LV outflow pulsed doppler.

Results
Our study included 57 apparently healthy individuals between May 2021 and August 2021. Two patients were excluded due to lack of echogenicity. 71.19% (n = 44) were male. Mean age was 36 ± 14 yrs. 15.7% (n = 9) had history of hypertension and 7% (n = 4) were diabetic. 3.5% (n = 2) had history of stroke. 91.2% (n= 52) had functional status NYHA class I, 12.2% (n = 7) had functional status class II.
All of our cohort had a left ventricular ejection fraction (LVEF) above 55%, did not have diastolic dysfunction and were on sinus rhythm.
PPM peak strain value was -15.49 ±4.69 %. PSS was present in 98.2% (n = 56) and SS in 62.5%(n = 36) of cases.
Anterior papillary muscle (APM) had a peak strain value of -15.61 ± 3.66, PSS was present in 78.5% (n = 45) and SS in 51.7% (n = 29).

Conclusion
Mitral papillary muscles echocardiographic study is feasible in routine scans with modified apical views.
Post systolic shortening and systolic stretch are present in the majority of individuals. Abstract Figure. posterior papillary muscle strain curve Abstract Figure. anterior papillary muscle strain curve
Subclinical left and right ventricular dysfunction in COVID-19 recovered patients using speckle tracking echocardiography
Authors: Kunal S , Gupta M , Shah B , Palleda G , Bansal A , Batra V , Yusuf J , Mukhopadhyay S , Tyagi S 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Myocardial injury during acute COVID-19 infection is well characterised however, its persistence during recovery is unclear.

Purpose
We assessed left ventricle (LV) global longitudinal strain (GLS) and right ventricular (RV) free wall longitudinal strain and RV global longitudinal strain (RV-GLS) using speckle tracking echocardiography (STE) in COVID-19 recovered patients (30-45 days post recovery) and studied its correlation with various parameters.

Methods
Of the 245 subjects screened, a total of 53 subjects recovered from COVID-19 infection and normal LV ejection fraction were enrolled. Routine blood investigations, inflammatory markers (on admission) and comprehensive echocardiography including STE were done for all.

Results
All the 53 subjects were symptomatic during COVID-19 illness and were categorized as mild: 27 (50.9%), moderate: 20 (37.7%) and severe: 6 (11.4%) COVID-19 illness. Reduced LV GLS was reported in 22 (41.5%), reduced RV-GLS in 23 (43.4%) and reduced RVFWS in 22 (41.5%) patients respectively. LVGLS was significantly lower in patients recovered from severe illness (mild: -20.3 ± 1.7%; moderate: -15.3 ± 3.4%; severe: -10.7 ± 5.1%; P &lt; 0.0001). Similarly, RVGLS (mild: -21.8 ± 2.8%; moderate: -16.8 ± 4.8%; severe: -9.7 ± 4.6%; P &lt; 0.0001) and RVFWS (mild: -23.0 ± 4.1%; moderate: -18.1 ± 5.5%; severe: -9.3 ± 4.4%; P &lt; 0.0001) were significantly lower in subjects with severe COVID-19. Subjects with reduced LVGLS as well as RVGLS and RVFWS had significantly higher interleukin-6, C-reactive protein, lactate dehydrogenase and serum ferritin levels during index admission.

Conclusions
Subclinical LV and RV dysfunction was seen in majority of COVID-19 recovered patients. Patients with severe disease during index admission had far lower LV and RVGLS as compared to mild and moderate cases. Our study highlights the need for close follow-up of COVID-19 recovered subjects in order to determine the long-term cardiovascular outcomes.
Segmental speckle tracking strain and strain rate in stable coronary artery disease
Authors: Akay Caglayan H , Kjonas D , Jazbani M , Kornev M , Rosner A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Northern Norway Regional Health Authority

Background
It is known that patients with coronary artery disease (CAD) display reduced
global and regional strain and strain rate (SR). However, knowledge about segmental strain
and SR in stable CAD patients is still limited.

Purpose
The purpose of this study was to explore whether segmental strain and SR analyses
are different between patients with normal and stenotic coronary arteries among individuals
with chest-pain.

Methods
A total of 510 patients with chest pain, referred to coronary computed
tomography angiography (CCTA) and additional 102 patients with myocardial infarction (MI)
were prospectively included. All patients underwent transthoracic echocardiography (TTE)
with strain-rate analysis. All patients with CCTA-suspected CAD subsequently underwent
invasive CAG, as well as in all MI patients. Global longitudinal strain (GLS) and average for
segmental peak longitudinal strain during systole (PLS), peak systolic strain rate (PLSR S),
peak early diastolic strain rate (PLSR E), post systolic shortening (PSS) measurements were analysed. Further, different cut-off values for reduced strain and SR
were used to define the percentage of functionally reduced segments between patients
with normal CAD (no CAD), MI, and stable CAD patients who were further treated by
percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG).

Results
As shown in the table 1, all average segmental strain and SR parameters differed
significantly between no CAD and MI groups. However, only PLSR E showed significant differences
between no CAD and PCI groups . PLSR E, PLS and GLS showed significant differences between no CAD and CABG groups. The percentage of reduced segmental strain and SR
showed similar results. Regarding the percentage of pathological segments at different cut-off values, PLSR E showed the most significant difference between these four groups at a cut-off value 1.5 (p &lt; 0.001) (Figure 1).

Conclusion
Patients with MI or CABG display clearly reduced segmental strain and SR
values. However, in patients with chest-pain, segmental PLSR E seemed to be the only
indicator revealing subtle differences between patients with no CAD or those assigned to
PCI. The diagnostic value of PLSR E needs to be investigated in further studies. Abstract Table 1 Abstract Figure 1
Three-dimensional myocardial deformation parameters are associated with functional capacity assessed by cardiopulmonary exercise testing in patients with hypertrophic cardiomyopathy
Authors: Cardoso I , Garcia Bras P , Aguiar Rosa S , Moura Branco L , Galrinho A , Rio P , Fiarresga A , Lopes L , Mota Carmo M , Cruz Ferreira R 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction
Myocardial deformation parameters, derived from three-dimensional (3D) speckle-tracking echocardiography (3DSTE) are useful tools to determine left ventricular (LV) systolic function, and are often abnormal before a decline in ejection fraction (EF).
Aims
To study the correlation between systolic function evaluated by myocardial deformation parameters obtained by 3DSTE and functional capacity in patients with HCM.
Methods
HCM patients seen prospectively at outpatient cardiomyopathy clinic at a tertiary centre were included. Systolic function was assessed by strain measures – global longitudinal, circumferential and radial strain - obtain by 3DSTE, LVEF by 2D and 3D echocardiography were also assessed. Functional capacity was evaluated by CPET.
Results
Of 67 P with HCM (mean age 57 ± 14 years, 41 males), 38 P (56.7%) were in New York Heart Association (NYHA) functional class I, 24 (35.8%) in class II and 5 (7.5%) in class III. 46P (68.7%) had obstructive (HCM), with a maximum LV wall thickness (MWT) of 20 (7) mm. 3DSTE and CPET parameters are reported in Table 1.
Absolute values of 3D global radial strain showed correlation with pVO2 (r=-0.336, p = 0.006), as well as longitudinal strain (r=-0.280, p= 0.024). No association was found between LVEF and pVO2. MWT did not correlate with 3DSTE strain measures.
Conclusion
Impaired myocardial deformation was associated with worse functional capacity assessed by peak oxygen consumption.
Impaired left atrial reservoir strain in patients with ischaemic stroke is associated with atrial fibrillation development
Authors: Miaris N , Vassaki M , Grigoraki E , Linardakis S , Karakosta M , Mpoukis D , Ntiloudi D , Kastis I , Michelongona A , Zachos P , Yiangou K , Destounis A , Theodosis-Georgilas A , Pisimisis E , Kasinos N 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
The investigation of patients with ischaemic stroke includes undoubtedly their evaluation for atrial fibrillation (AF). On the other hand, the role of left atrial (LA) function in cardiovascular disease is increasingly researched, while echocardiography strain analysis is a novel attractive technique.

Purpose
In this retrospective study, we investigated the association between LA function assessed with reservoir strain and the follow-up development of AF.

Methods
The study population consisted of consecutive ischaemic stroke patients with preserved left ventricular ejection fraction who were on sinus rhythm at the moment of enrollment and had no history of AF. Baseline LA reservoir strain was assessed with 2-dimensional transthoracic echocardiography (apical 4-chamber view) using longitudinal speckle-tracking technique. Afterwards, patients were investigated for AF with ambulatory electrocardiography during one-year follow-up. Differences in the distribution of LA reservoir strain values within the groups of patients with and without AF development were examined with Mann-Whitney U test (new procedure). The level of statistical significance was set to a p value of &lt;0.05.

Results
Sixty-three patients (41 males, 22 females) of a mean age of 50.94 years [minimum = 20, maximum = 65, standard deviation (SD)=10,02] were enrolled in the study. Eight (12.7%) patients developed atrial fibrillation on follow-up. Overall, the mean LA reservoir strain was 32.75% (minimum = 5.62%, maximum = 71.88%, SD=%) and the median value was 32.91%. The values were shown to be lower in the group with later AF development (mean rank = 13.94, Mann-Whitney U = 75.5, p = 0.003) than in those without this finding (mean rank = 13.94). Neither the gender nor the age was associated with AF diagnosis.

Conclusion
Lower LA reservoir strain values were found to be associated with AF development in ischaemic stroke patients of our study. Pending more research data from large studies, this novel technique appears to be promising in identifying AF risk in stroke patients.
Figure
Non parametric assessment with Mann-Whitney U test (new procedure) of left atrial reservoir strain analysis with 2-dimensional transthoracic echocardiography in the groups of ischaemic stroke patients with and without atrial fibrillation development. Abstract Figure.
Impairment of LA strain and LV myocardial work in Ph+ Chronic myeloid leukaemia patients treated with TKis
Authors: Parlavecchio A , Caminiti R , Vetta G , Pelaggi G , Lofrumento F , Vinciguerra P , Parisi F , Demurtas E , Licordari R , Cusma M , Manganaro R , Micari A , Di Bella G , Carerj S , Zito C 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Worsening of cardiac function with increased arrhythmic risk is common in cancer patients undergoing chemotherapy. Impaired LV Global Longitudinal Strain (GLS) in these patients despite preserved ejection fraction is a common issue. Recently, myocardial work by speckle-tracking echocardiography has been used to overcome GLS limitations in various conditions, but little is known about its usefulness in the detection of cardiac toxicity. Moreover, left atrial (LA) toxicity may occur early in the course of cancer therapy. The main aim of the study was to assess the cardiotoxic effects of tyrosine kinase inhibitors (TKIs) on patients with Philadelphia chromosome-positive chronic myeloid leukaemia (Ph+ CML) by using novel echocardiographic tools as myocardial work and atrial strain analysis.

Methods
We retrospectively enrolled Ph+ CML patients treated with TKIs followed at the cardio-oncology outpatient clinic of our hospital from December 2018 to March 2019 who underwent clinical evaluation with ECG and echocardiogram (TTE) before and after one year of treatment with TKIs. Healthy subjects were enrolled in the control group matched for gender, age and cardiovascular risk factors. Myocardial work was derived from the strain-pressure relation, integrating in its calculation the non-invasive arterial pressure. LA longitudinal strain (reservoir, conduit and booster) was obtained from an optimized apical 4-chamber view of the LA.

Results
The study recruited 32 patients in Ph+ CML group and 32 healthy controls. 39% of patients were treated with Imatinib, 29.3% with Nilotinib, 4.9% with Dasatinib and 4.9% with Ponatinib. Main results are detailed in the Table 1. At one-year follow-up there was a significant reduction compared to baseline in Global Constructive Work (2555.22 ± 564.33 vs 2119.31 ± 700.19; p = 0.0001), Global Work Efficiency (96.13 ± 1.90 vs 94.00 ± 2.96; p = 0.002) and Global Work Index (2340.75 ± 579.57 vs 1938.46 ± 680.23; p = 0.001), and a non-significant reduction in Global Wasted Work (p = 0.393). Regarding left atrial strain analysis at the one-year follow-up there was a statistically significant reduction in LA contractile strain (booster= 14.63 ± 1.408 vs 12.38 ± 1.581; p= 0.018). LA contractile strain reduction was also observed in the comparison with controls (12.38 ± 2.99 vs 14.91 ± 3.09; p = 0.009). Any other significant difference was detected between baseline and FU TTE data in the Ph+ CML group.

Conclusions
New imaging methods for the study of cardiotoxicity provide an additional tool for early prediction of potential adverse effects of antineoplastic drugs. TKIs therapy leads to an impairment of atrial contractility, which can be detected by atrial strain e myocardial work analysis. Abstract table 1 Abstract figure 1