bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phasic left atrial strain to predict diastolic dysfunction development in women: results from the prospective Berlin Female Risk Evaluation (BEFRI) follow up trial
Authors: Brand A , Romero Dorta E , Blaschke-Waluga D , Wolf A , Stangl K , Seeland U , Regitz-Zagrosek V , Knebel F , Dreger H , Stangl V 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Supported by the DZHK (German Centre for Cardiovascular Research) and by the BMBF (German Ministry of Education and Research)

OnBehalf
BEFRI
Background/Introduction: During the past few years, left atrial strain (LAS) has been identified to be significantly associated with left ventricular diastolic dysfunction (DD). However, the predictive value of LAS reductions on the course of DD in patients without or mild DD has so far not been investigated.

Purpose
To assess the predictive impact of phasic left atrial strain (LAS) reductions on the development of left ventricular (LV) diastolic function in women with normal (DD0) or mildly impaired diastolic function in a longitudinal study design.

Methods
We reinvited 449 participants of the Berlin Female Risk Evaluation (BEFRI) study for follow-up examinations. A comprehensive clinical and echocardiographic assessment comprising the analysis of phasic LAS was performed in 256 participants. The diagnostic and predictive value of LAS analysis was assessed and compared with standard echocardiographic DD parameters using receiver operating characteristic (ROC) curve analyses and a multivariate logistic regression model.

Results
After a mean time interval of 6.8 years, subjects with DD0 at baseline investigation and a worsening of diastolic function of at least one stage according to recent ASE / EACVI recommendations (DD_progress) showed a significantly reduced baseline LA reservoir strain (LASr) and conduit strain (LAScd) [LASr 28.1% (6.9) in DD_progress vs. 41.9% (8.5) in DD0 at follow up; and LAScd -13.2% (5.0) in DD_progress vs. -25.4% (9.1) in DD0 at follow up; p &lt; 0.001 respectively]. With an area under the curve (AUC) of 0.89 [95% confidence interval (CI) 0.83-0.94], and 0.85 (95% CI 0.80-0.90), LASr and LAScd showed the highest discriminative value to predict DD_progress while the echocardiographic standard DD parameter left atrial volume index (LAVI) featured a limited predictive diagnostic accuracy [AUC of 0.65 (95%CI 0.52-0.72)]. In a multivariate logistic regression model controlling for age, BMI, and other standard echocardiographic DD parameters including LAVI, only LASr and LAScd remained significantly associated with DD_progress over time.

Conclusions
In addition to improving the diagnostic accuracy of the current DD algorithm, the analysis of phasic LAS reductions may be useful to predict the development of DD in previously healthy women.
Effect of Sacubitril/Valsartan or enalapril on left ventricular longitudinal strain in patients with hematologic malignancies after bone marrow transplantation
Authors: Katogiannis K , Ikonomidis I , Stamouli M , Makavos G , Tsilivarakis D , Koliou GA , Vythoulkas D , Thymis J , Tsirigotis P 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Hellenic Association of Lipidiology, Atherosclerosis and Vascular disease

Background and Aims
Chemotherapy is known for its potential adverse effects on myocardium. Optimal medical treatment for heart failure may reverse myocardial dysfunction in the early stages of toxicity development. We hypothesized that early initiation of treatment with enalapril or sacubitril/valsartan could prevent cardiotoxicity.

Patients and methods
60 patients (mean age 44,8± 14,1 years old, 34 male) with preserved ejection fraction, who suffered from hematologic malignancies (lymphoma, leukemia) and underwent bone marrow transplantation, were randomized to receive sacubitril/valsartan 24/26 mg bid daily or enalapril 5 mg bid daily or placebo. We measured at baseline, before transplantation, after three and after six months: i) Global Longitudinal Strain of left ventricle (LV) (GLS), ii) Left Ventricular End Diastolic Volume, Left Ventricular End Systolic Volume and Left Ventricular Ejection Fraction (LVEF Simpson’s Method).

Results
The three treatment groups had similar age, sex, atherosclerotic risk factors and cardiotoxic medication before, and after bone marrow transplantation. Compared to baseline, patients treated with sacubitril/valsartan did not show a deterioration of LV GLS at three and six months follow up (GLS=-20.2 ± 3.1% vs -19.8 ± 3.1%, p = 0.551 vs -19.6 ± 3.2%, p = 0.452, respectively). Similarly, compared to baseline, patients treated with enalapril did not show a deterioration of LV GLS at three and six months follow up (GLS=-20.7 ± 3.0% vs -20.5 ± 2.8%, p = 0.772 vs -20.3 ± 3.2%, p = 0.730, respectively). Conversely, patients treated with placebo, presented a significant impairment of LV GLS, at three and six months follow up (GLS=-20,5 ± 1.9% vs -18.5 ± 2.4%, p = 0.003 vs -18.6 ± 2.9%, p = 0.018, respectively). No significant changes were found in LVEF after treatment with sacubitril/valsartan (57,9 ± 5,6% vs 57,6 ± 6,1%, p = 0,733) or enalapril (59.2 ± 6.3% vs 60.4 ± 7.7%, p = 0.464) vs placebo (60,1 ± 5,6% vs 57,8 ± 6,6%, p = 0,166) at six months follow up.

Conclusions
Treatment with sacubitril/valsartan or enalapril prevented deterioration of myocardial deformation six months after bone marrow transplantation in patients with hematologic malignancies and preserved ejection fraction.
Early predictors of the development of pathological postinfarction left ventricular remodeling
Authors: Golubeva A , Galimskaya V , Babina A , Korenkova K , Oleinikov V 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Objective
to assess the ability of standard echocardiography parameters and parameters of myocardial deformation on the 7th-9th day of the STEMI to predict the risk of pathological remodeling in the postinfarction period.

Methods
the study included 114 patients with ST-segment elevation myocardial infarction (STEMI) mean age was 52.3 ± 8.4 years, men prevailed 100 (88%). On the 7th-9th day, echocardiography has been performed using the MyLab device (Italy) with the determination of end-diastolic and systolic volume indices (EDVi, ESVi), left ventricular myocardial mass index (LVMI). Global longitudinal (GLS), circumferential (GCS) and radial (GRS) strain (-%) have been determined using X-Strain ™ software. The development of pathological left ventricular remodeling (an increase in EDVi of more than 20% and / or ESVi of more than 15% at any visit within 48 weeks) has been considered as the end point. Multivariate Cox regression analysis was performed by including significant variables from a one-dimensional model (p &lt;0.05), taking into account the absence of correlations between them.

Results
within 48 weeks, 45 (39%) patients developed pathological postinfarction remodeling. The following strong and independent predictors of the pathological postinfarction remodeling were included in the multivariate predictive model: GLS - RR 0.799 (95% CI 0.735-0.868) (p = 0.001), GRS - 1.047 (95% CI 1.013-1.083) (p = 0.001), EDVi - RR 1.041 (95% CI 1.015-1.07) (p = 0.026). Chi-square model 30.02, p ˂ 0.0001. Maximum likelihood ratio 385.

Conclusions
a multivariate model including GLS, GRS, and EDVi parameters on the 7th-9th day of STEMI is able to predict the development of pathological remodeling in patients within 48 weeks of the postinfarction period.
Correlation of new and traditional indicators of myocardial contractility in ST-segment elevation myocardial infarction
Authors: Golubeva A , Galimskaya V , Babina A , Donetskaya N , Korenkova K , Oleinikov V 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Purpose
to assess the relationship of indicators of global myocardial work of the left ventricle (LV) in patients with ST-segment elevation myocardial infarction (STEMI) with hemodynamic and deformation parameters that traditionally characterize the systolic function of the heart.

Methods
45 people with primary STEMI were included: 13 women and 32 men aged 38 to 66 years (52.3 ± 7.4). Myocardial infarction was confirmed by ECG, biomarkers (troponin I, CPK-MB) and by the results of coronary angiography. Echocardiography has been performed on the 7-9th day of STEMI using a Vivid GE 95 Healthcare ultrasound scanner (USA). EchoPAC software version 202 (GE Healthcare) has been used. The end-diastolic volume index (EDVi, ml / m2), end-systolic volume index (ESVi, ml / m2), LV ejection fraction (EF,%) have been assessed using the Simpson biplane method. The global longitudinal strain (GLS,%) has been determined using the speckle-tracking echocardiography method. The indicators of myocardial work have been automatically calculated: the index of global myocardial work (GWI, mm Hg%), global constructive work (GCW, mm Hg%), and global wasted work (GWW, mm Hg%), global work efficiency (GWE,%). Statistical data processing has been performed using the Statistica 13.0 software package (StatSoft Inc., USA).

Results
the average values of the determined parameters were the following: LVEF - 49.4 ± 6.7%, EDVi - 62.8 ± 12.7 ml / m2, ESVi - 32 ± 8.9 ml / m2, GLS - (-13, 5) ± 4%, GWI - 1192.4 ± 416.2 mm Hg%, GWE - 88.9 ± 6.5%, GCW - 1362.1 ± 442.5 mm Hg%, GWW - 98.5 (69; 130) mm Hg%. The values of the correlation coefficient GWI were: with EF (r = 0.26; p = 0.19), with EDVi (r = -0.3; p = 0.12), with ESVi (r = -0.35; p = 0.07), with GLS (r = 0.85; p = 0.000002). GWE had the following correlation coefficient values: with EF (r = 0.17; p = 0.39), with EDVi (r = -0.42; p = 0.026), with ESVi (r = -0.4; p = 0.025), with GLS (r = 0.74; p = 0.00001). The correlation coefficient of GCW with EF was 0.24 (p = 0.24), with EDVi - (-0.26) (p = 0.19), with ESVi - (- 0.3) (p = 0.1), with GLS - 0.85 (p = 0.000004). The correlation coefficient of GWW with EF was -0.02 (p = 0.9), with EDVi - 0.26 (p = 0.17), with ESVi - 0.2 (p = 0.3), with GLS - 0.37 (p = 0.06).

Conclusion
the analysis of the correlations between the indicators of myocardial work and the determined parameters revealed that GWE had a moderate correlation with EDVi, ESVi. Parameters GWI, GWE, GCW had a strong correlation with GLS.
Evaluation of ventricular strain values in patients after coronavirus 2019 infection
Authors: Chavez Caballero RD , Tuero E , Orlandini A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
During the first months of coronavirus disease 2019 (COVID 19) pandemic there were several reports of myocardial involvement in recovered patients despite of symptoms presented during acute phase of the infection. That information led to a rising number of recomendations of screening for myocardial damage with different methods like electrocardiogram, echocardiography, cardiac magnetic resonance and biomarkers in the pursuit of a cardiac event free return to normal activities. Because of this and knowing the capability of strain imaging to detect subclinical myocardial damage we decided to evaluate values of left ventricular global longitudinal strain (GLS) and right ventricular free wall strain (RVFWS) in patients that were derived for echocardiographic evaluation after COVID 19 infection and their evolution.

Methods
We enrolled prospectively patients derived to our laboratory for evaluation of Doppler echocardiography after confirmed COVID 19 infection if they were in the month after clinical discharge and did not have previous known structural cardiac alterations. We obtained demographic, symptoms and echocardiographic data and calculated GLS and RVFWS. Six months after the index examination we did phone calls to asess symptoms and events. Data is presented with mean and standard deviation and percentages.

Results
Of 68 patients included 38 (55,88%) were male, mean age was 42 years (+- 12,5) and half of them were sedentary. 52 had mild symptoms during infection, 15 moderate and 1 severe that required mechanical ventilation. At the time of examination 58 were asymptomatic (85,29%) and the other complaint of dyspnea (3), weakness (8) and palpitations (6). Regarding echocardiographic data, mean eyection fraction estimated by Simpson´s biplane method was 65,6% (+- 4,33) and left atrial indexed volume 25 ml/m2 (+- 5,98). 44 patients had normal left ventricular diastolic function, 21 grade 1 dysfunction and 2 had grade 2, with mean E/e´ relation 8,52 (+-2,03). Mean pulmonary artery systolic pressure estimated was 27,4 mmHg (+- 4,1) and tricuspid anular plane systolic excursion was 23,81 mm (+-3,12). Mean GLS was – 21,52% (+- 1,91) and RVFWS was – 29,15% (+- 5,4), in 2 patients we could not measure RVFWS due to bad quality of images. Only 2 patients had GLS above – 18%, thta were the patient with severe symptoms and 1 with moderate symptoms; and 10 had RVFWS above – 23%, all of them with moderate symptoms. We could contact 60 patients (88,23%) after 6 months and none of them had cardiac events or persistence of symptoms.

Conclusions
Calculation of GLS and RVFWS in this patients was feasible. We observed abnormalities in patients with severe and moderate symptoms at the time of infection, more frequently in RVFWS, but without relation to cardiac events or symptoms on follow up. Abstract Figure. GLS and RVFWS values
Left atrial functional remodeling assessed by echocardiography in patients undergoing ablation for atrial fibrillation: correlation with the presence of fibrosis and invasive atrial pressure
Authors: Dal Porto M , Dematte" C , Maines M , Giovanelli C , Vinco G , Setti E , Cemin C , Rossi A , Benfari G , Fezzi S , Catanzariti D , Ribichini FL , Del Greco M 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Radiofrequency catheter ablation of pulmonary veins has become a common procedure for treatment of atrial fibrillation (AF). Nevertheless, the procedure is characterized by an extremely variable success rate, which reflects a great heterogeneity of factors implicated in AF recurrence and AF burden.

Purpose
We focused on the role of left atrium (LA) in patients with paroxysmal and persistent AF who underwent catheter pulmonary veins ablation procedure. In particular we paid attention to three factors: echocardiographic evaluation of LA function, LA scar evaluated by electroanatomic mapping and LA pressures (LAP) during ablation procedure. The aim of the study was to investigate the correlation between echocardiographic parameters indicating atrial dysfunction (LA volume indexed, E/E’, LAA contraction velocity, LA stiffness and LA longitudinal strain during reservoir phase (LASr)) and intraprocedural parameters (such as LAPpeak and the amount of fibrosis).

Methods
The study included 25 patients; mean age was 63 ± 8 years; nineteen patients (76%) had paroxysmal AF, eighteen patients (72%) were in sinus rhythm at the time of ablation. The population was divided into two subgroups according to the amount of fibrosis evaluated by electroanatomic mapping: patients with fibrosis ≥ 5% of the total LA volume were considered as having an atrial scar. All patients underwent a comprehensive transthoracic echocardiography and a transesophageal echocardiography before the ablation procedure. Intraprocedural data regarding LAPpeak and electroanatomic mapping were collected. Measurements were acquired during both sinus rhythm (SR) and AF.

Results
Patients with atrial scar had similar LA volume compared to patients without scar (44 ml vs 37.4 ml, p = 0.108) , but presented a trend towards higher LAPpeak (24.3 mmHg vs 15.9 mmHg, p = 0.053) and had higher E/E’ (11 vs 7, p = 0.037) and consequently increased LA stiffness (0.72 vs 0.23, p= 0.006). Still, they had lower LASr (16.6% vs 33.2%, p = 0.013) and tended to have reduced LAA contraction velocity (0.4 m/sec vs 0.7 m/sec, p= 0.005).

Conclusions
The present findings suggest that functional remodeling of the LA, more than morphological changes, are correlated with the presence of atrial fibrosis and elevated atrial pressure detected during ablation procedures. These parameters may represent potential criteria to guide patients’ selection for ablation procedure and deserve dedicated studies to be confirmed. Abstract Figure.
Right heart chambers geometry and function in patients with the atrial and the ventricular phenotypes of functional tricuspid regurgitation
Authors: Florescu D , Muraru D , Florescu C , Gavazzoni M , Volpato V , Caravita S , Tomaselli M , Balseanu TA , Parati G , Badano LP 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction — Atrial functional tricuspid regurgitation (A-FTR) is a recently defined phenotype of FTR associated with persistent/permanent atrial fibrillation. Differently from the classical ventricular form of FTR (V-FTR), patients with A-FTR might present with severely dilated right atrium (RA) and tricuspid annulus (TA), and with preserved right ventricular (RV) size and systolic function. However, the geometry and function of the RV, RA and TA in patients with A-FTR and V-FTR remain to be systematically evaluated.
Purpose — Accordingly, we sought to: i. study the geometry and function of the RV, RA and TA in A-FTR by two- and three-dimensional transthoracic echocardiography; and ii. compare them with those found in V-FTR.
Methods — We prospectively analysed 113 (44 men, age 68 ± 18 years) FTR patients (A-FTR = 55 and V-FTR = 58) that were compared to two groups of age- and sex-matched controls to develop the respective Z-scores.
Results — The severity of FTR, and the degree of TA dilation were similar in A-FTR and V-FTR patients. The Z-scores of RV size were significantly larger, and those of RV function were significantly lower in V-FTR than in A-FTR (p &lt; 0.001 for all). The RA was significantly enlarged in both A-FTR and V-FTR compared to controls (p &lt; 0.001, Z-scores &gt; 2), with similar RA maximal volumes (RAVmax) between A-FTR and V-FTR (p = 0.2). Whereas, the RA minimal volumes (RAVmin) were significantly larger in A-FTR than in V-FTR (p = 0.001).
Conclusion — Despite similar degrees of FTR, RAVmax and TA size, A-FTR patients show larger RAVmin than V-FTR patients. Conversely, V-FTR patients show dilated, more elliptic and dysfunctional RV than A-FTR patients. Abstract Figure. A-FTR versus V-FTR Abstract Figure. Remodelling patterns in A-FTR and V-FTR
Routine use of automated strain analysis and 3D echocardiography provides a more comprehensive assessment of cardiac chambers than conventional 2D echocardiography and is time-saving
Authors: Volpato V , Ciampi P , Johnson R , Hipke K , Tomaselli M , Oliverio G , Muraru D , Lang RM , Badano LP 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. In most laboratories three-dimensional echocardiography (3DE) and longitudinal strain (Lstrain) analysis are not part of the routine studies. Although these modalities have been shown to provide additional clinical information and prognostic value compared to conventional two-dimensional echocardiography (2DE), their acquisition and analysis are perceived as being time-consuming. Recently, new automated tools have been developed to perform accurate, fast and reproducible analyses of heart chambers’ geometry and function. However, their cost-effectiveness when compared to conventional 2DE remains to be demonstrated.
Aim. We designed a prospective, multicenter, observational study aimed to compare the time required for the acquisition and analysis of conventional transthoracic 2DE vs advanced echocardiography (AEcho, i.e. 3DE+ Lstrain) for the assessment of cardiac chambers and myocardial mechanics.
Methods. According to current guidelines, 196 consecutive patients referred for clinically indicated echocardiography underwent complete 2DE and Doppler echocardiography. In addition, 3DE datasets of the left atrium (LA), left and right ventricle (LV, RV) were acquired using automated 3DE software package (Heart Model). Acquisition time for both 2DE and 3DE images were recorded. Conventional 2DE analyses of LA (biplane volume), LV (biplane volumes and mass) and RV (both linear dimensions, areas, and longitudinal function) were performed following current guidelines, and the time required for acquisition and analysis was recorded. The time spent for AEcho analysis (both 3DE volumetric analysis and Lstrain of LA, LV and RV) was also recorded.
Results. Feasibility of AEcho was 86% (169 patients). The additional time for 3D dataset acquisition over conventional 2DE was 38 ± 0.16 sec. Quantitative analysis of the cardiac chambers by 2DE required an average of 5.55 ± 1.51 min vs 4.25 ± 1.23 min using AEcho (p &lt; 0.001). Total time for both 3D dataset acquisition and AEcho assessment was 5.03 ± 1.28 min vs 5.55 ± 1.51 min of 2DE analysis alone (p &lt; 0.001). Globally, AEcho provided a more comprehensive assessment of heart chambers than 2DE (Table). Moreover, the time spent for 3DE dataset acquisition and AEcho analysis on top of standard 2DE acquisition was significantly shorter compared to the 2DE acquisition and analysis (18:50 ± 4.23 vs 19:42 ± 4.24 min, p &lt; 0.001) (Table).
Conclusions. Our data showed that the use of new AEcho automated tools are highly feasible resulting in significant time-savings compared to standard 2DE evaluation, while providing significant additional information. Abstract Table
Impact of post- transplant diabetes on left ventricular function following heart transplantation
Authors: Borgenvik S , Jumatate R , Giesdal G , Werther Evaldsson A , Braun O , Smith JG , Radegran G , Meurling C , Ingvarsson A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Orthotopic heart transplantation (OHT) is a standard treatment option for end-stage heart failure (HF). Although post-transplant diabetes (PTDM) is a main complication due to immunosuppressive corticosteroid treatment, its impact on left ventricular (LV) function following OHT has not been described.

Purpose
The purpose of this study was to analyse the possible effect of PTDM on LV function in OHT patients using conventional and speckle tracking echocardiography. Furthermore, this study aimed to compare echocardiographic LV function parameters to clinical parameters, including heart rate, blood pressure, and Hemoglobin A1C (HbA1c) in OHT recipients with or without PTDM.

Methods
We performed a retrospective study including 77 (59 males) OHT patients (PTDM n = 29) using data from the routine 3-year follow-up. The mean age of the study population was 52 ± 14 years. All patients were examined using 2-dimensional transthoracic echocardiography with an ultrasound system equipped with a S5-1 transducer. Systolic-, diastolic blood pressure, heart rate, and HbA1c levels were recorded in conjunction with the TTE examination for each participant.

Results
Participants with PTDM had impaired LV function measured by global longitudinal strain (LVGLS), increased septum diameter, and a lower diastolic EA-ratio compared to the non- PTDM patients. Additionally, a significant correlation between high HbA1c levels and poor LVGLS was detected.

Conclusion
We found that subtle LV dysfunction, including remodeling of the heart (i.e., increased wall thickness), reduced longitudinal contractile function, and altered diastolic function, was present in OHT patients with PTDM. Our findings suggest that sub-clinical myocardial dysfunction in OHT patients with PTDM is progressive and may evolve to clinical LV dysfunction and HF. Hence, analyzing secondary cardiac effects of PTDM in OHT patients have a therapeutic and prognostic value and may influence long-term patient survival. Abstract Figure.