bluuebunny/crossref_metadata_2025_split huggingface dataset:
Left ventricular global longitudinal strain as an early marker of the need for echocardiographic follow-up in patients with breast cancer: a real-life study
Authors: Gallo Fernandez I , Esteban Martinez F , Delgado Ortega M , Rodriguez Almodovar A , Martin Ruiz M , Pastor Wulf D , Lopez Baizan J , Carnero Montoro L , Gonzalez Manzanares R , Pericet Rodriguez C , Fernandez Ruiz A , Rodriguez Nieto J , Piserra Lopez-Fernandez De Heredia A , Pan Alvarez-Ossorio M , Mesa Rubio D 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
The monitoring of the left ventricular ejection fraction (LVEF) is a common practice in patients with breast cancer undergoing chemotherapeutic treatment. Although indiscriminate follow-up is not very cost-effective, we don’t have enough data to determine which patients would benefit from it.

Purpose
To analyze if any baseline ventricular function echocardiographic parameter can help to identify the subsequent development of ventricular dysfunction secondary to cardiotoxic drugs (DV-CTOX).

Methods
Retrospective study of patients with breast cancer who have received treatment with anthracyclines with / without adjuvant treatment with immunotherapy and / or radiotherapy. We analyzed baseline and follow-up ventricular function parameters (LVEF estimated by 2D-3D automatic quantification and semi-automatic quantification of global longitudinal strain (GLS)).

Results
We included 93 patients (mean age 59 ± 11 years, 98.9% women). 67% received immunotherapy and 84% radiotherapy. Median follow-up was 6 months. 10 patients (11%) developed DV-CTOX. There were differences in baseline clinical characteristics between patients and those with no DV-CTOX. Regarding echocardiographic parameters we didn’t observe differences between both groups in basline 2D LVEF (65 ± 1% vs 62 ± 14%, p = 0.4), and 3D LVEF (60 ± 7% vs 57 ± 8%, p = 0.4), although the GLS was lower in patients who later developed DV CTOX (GLS 19 ± 3% vs 16 ± 3%, p = 0.03); At follow-up, patients who developed DV-CTOX had worse LVEF estimated by 2D-3D and maintained a worse GLS value (52 ± 7% vs 69 ± 8% p &lt;0.001.49 ± 8% vs 61 ± 4%, p = 0.005 and 14 ± 3% vs 20 ± 4%, p = 0.04 respectively). We used the area under the curve for the use of baseline GLS as a diagnostic method for the early detection of DV-CTOX. It was 0.785 (CI 0.585-0.985 for a p value = 0.047). A baseline GLS cut-off point of 17.5% was determined with a sensitivity of 73% and a specificity of 80%.

Conclusion
The quantification of baseline GLS in patients with breast cancer who are going to start treatment with cardiotoxic drugs could help to discriminate which patients require a closer LVEF monitoring, improving efficiency in the Cardio-Onco-Hematology unit. A value greater than 17.5% in absolute terms of baseline GLS could be an optimal cut-off point that discriminates between patients who will develop DV-CTOX. Abstract Figure. Abstract Figure.
Hidden systolic dysfunction of the right ventricle in patients with increased pulmonary vascular resistance 3 months after COVID-19 pneumonia
Authors: Shirokov N , Yaroslavskaya E , Krinochkin D , Osokina N 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Coronavirus disease 2019 (COVID-19) is caused by the novel severe acute respiratory syndrome coronavirus 2. Pulmonary vascular resistance (PVR) is an important hemodynamic variable used in the management of patients with cardiovascular and pulmonary pathology. Doppler echocardiography has significantly impacted clinical medicine by its ability to assess intracardiac hemodynamics noninvasively. It seems actual to reveal the relationship between right heart function and lungs involvement in COVID-19.

Purpose
To assess the relationship right ventricular (RV) echocardiographic structural and functional parameters with indicators of increased pulmonary vascular resistance (PVR) in patients 3 months after COVID-19 pneumonia.

Methods
96 patients (mean age 47.6 ± 15.2 years) were examined during hospitalization and at control visit (3 months follow-up). The equation tricuspid regurgitation velocity / time-velocity integral of the RV outflow tract X 10 + 0.16 has been used to determine PVR. Patients were divided into 2 groups: I group (n = 31) – patients with increase of PVR ≥1.5 Wood unit (WU) and II group (n = 65) – with decrease of PVR &lt;1.5 WU.

Results
At baseline groups did not differ in main clinical characteristics, including severity of lung involvement in COVID-19 by computed tomography (32.7 ± 22.1% vs 36.5 ± 20.4%, р=0.418). Linear, planimetric and volumetric parameters did not differ significantly between groups. At the control visit RV free wall (FW) global endocardial longitudinal strain (LS) (-19.3 [-17.9; -25.8] % in group I vs -23.4 [-19.8; -27.8] % in group II, p = 0.048), tricuspid annular plane systolic excursion (21.7 ± 3.8 mm vs 23.3 ± 3.4 mm, p = 0.040) and RV maximum systolic velocity assessed by tissue Doppler imaging (12.3 ± 2.4 cm/s vs 13.4 ± 2.0 cm/s, p = 0.024) were significantly reduced in group I, systolic pulmonary artery pressure (sPAP) according to Otto C. (32.0 [26,0; 35.0] mm Hg vs 23.0 [20.0; 28.0] mm Hg, p &lt;0.001) was significantly increased in group I. According to logistic regression only endocardial RV FW LS (OR 0.859; 95% CI 0.746 - 0.989; p = 0.034) and sPAP (OR 1.248; 95% CI 1.108 - 1405; p &lt;0.001) had an independent relationship with increase of PVR. According to Spearman correlation analysis the moderate relationship was found between PVR and mean pulmonary artery pressure according to Mahan G. (r = 0.516, p = 0.003), PVR and RV–pulmonary artery coupling (r=-0.509, p = 0.007) in group I at the control visit.

Conclusion
Hidden RV systolic dysfunction defined as decreased endocardial RV FW LS to -19.3% is associated with increased PVR ≥1.5 WU in patients 3 months after COVID-19 pneumonia. Abstract Figure. RV FW LS by STE
Multimodal imaging assessment of left atrial strain in cardiac amyloidosis and hypertrophic cardiomyopathies
Authors: Lucas C , Martel H , Ruimy A , Fabre C , Gardenat A , Rique A , Michel N , Dernys A , Jacquier A , Habib G 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Despite the increasing number of studies concerning Left Atrial Strain (LAS), few data are available comparing LAS patients with cardiac amyloidosis (CA) and sarcomeric hypertrophic cardiomyopathies (HCM).

Purposes
We aimed to perform a comparative multimodal imaging analysis of LAS of a prospective cohort of patients with CA and HCM.

Methods
For each enrolled patient, we performed same-day two and three-dimension echocardiography (TTE) and cardiac magnetic resonance imaging (CMR) to blindly measure the peak atrial longitudinal strain (PALS) and the peak atrial contraction strain (PACS). Patients with acute atrial fibrillation were excluded.

Results
Between January 2020 and July 2021, 67 patients were included: 31 patients with CA (age 75.1 ± 10 years, left ventricular ejection fraction 60.6 ± 10.4%, maximum left ventricular thickness 17.8 ± 3.9 mm) and 36 with HCM (age 50.8 ± 15.5 years, left ventricular ejection fraction 66.1 ± 9.8%, maximum left ventricular thickness 20.7 ± 4.5 mm). Left atrial volume was similar in the 2 groups (42.5 ± 15.6 mL/m2 in HCM vs 47.9 ± 15 in CA, P = 0.1557).
Concerning PALS, its values for CA and for CMH were on 2D TTE manual (10.9 ± 5.8% vs 21.4 ± 9.4%, P &lt; 0.001), 2D TTE automatic (11.5 ± 7.3% vs 22.9 ± 10.2%, P &lt; 0.001), 3D TTE (10 ± 6.8% vs 18.1 ± 6.7%, P &lt; 0.001), and CMR (11.3 ± 8 vs 24.4 ± 17.1, P &lt; 0.001) respectively.
Concerning PACS, its values for CA and for CMH were on 2D TTE manual (5.2 ± 3.4% vs 10 ± 4%, P &lt; 0.001), 2D TTE automatic (4.9 ± 3.9% vs 10.2 ± 5.1%, P &lt; 0.001), 3D TTE (3.6 ± 3.8% vs 7.9 ± 4%, P = 0.001) and CMR (6.2 ± 5.8% vs 11.9 ± 9%, P = 0.004) respectively.
Multivariate analysis adjusted on main factors influencing LAS (left ventricular (LV) mass, LV ejection fraction, LV global longitudinal strain, renal function and history of hypertension) found that the differences between the two groups remained significant for PALS and PACS for almost all technics.
Furthermore, although concordance between the 3 echocardiographic technics was excellent (the interclass correlation coefficient (ICC) was higher than 0.80 between each TTE methods), ICC was poor between TTE and CMR technics: 0.40 (0.18-0.59) for manual 2D TTE and CMR, 0.46 (0.24-0.63) for auto 2D TTE and CMR, 0.40 (0.14-0.60) for 3D TTE and CMR.

Conclusion
Our study is the first to describe and compare, both on TTE and CMR, LAS on a prospective cohort of patients with CA and HCM. Although they have same mean left atrial volume, we found significant differences on PALS and PACS between these two groups of patients on all the studied technics. These findings may be used in future multi-modality imaging studies dealing with diagnosis or prognosis of these hypertrophic cardiopathies. Abstract Figure. LAS 2D TTE manual Abstract Figure. LAS comparison between CA and HCM
Strain measurement for 2D echo with ultrasound enhancing agents can be performed with software available for non-enhanced recordings
Authors: Church M , Foster B , Choy J , Pituskin E , Paterson DI , Becher H 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): ABACUS Cardiovascular Research Centre, Mazankowski Alberta Heart Institute

Background
Global longitudinal strain (GLS) measurement are less reliable when 2D image quality is reduced. While ultrasound enhancing agents (UEA; also known as "echo contrast") have been shown to enhance the reliability of EF measurements, there has been sparse evidence on performing GLS measurements after UEA injection. The aim of this study was to assess the feasibility of GLS analysis using the same software validated for non-enhanced 2D recordings.

Methods
GLS measurements were performed before and after injection of an approved UEA in 131 patients with acceptable image quality for GLS measurements. These patients were referred prior to chemotherapy initiation or were being monitored for potential cardiotoxic effects. As all these patients undergo echocardiography with UEA in order to achieve the best reproducibility of EF measurements, comparison of GLS measurements with and without UEA was possible. A commercially available ultrasound system was used and the same analysis software was applied. On end-diastolic and end-systolic frames, the inner border of the region of interest was manually adjusted to align with interface between the compact and trabeculated myocardium on non-enhanced images and the LV blood pool on the recordings with UEA.

Results
GLS measurements on recordings with UEA were performed in 131 patients. A strong positive correlation (r 0.67, p &lt; 0.001) was found between measurements on non-enhanced recordings with mean bias 0.58% (see figure). Mean GLS was 19.5 +/- 2.1% from non-enhanced recordings and 20.1 +/- 2.2% from UEA recordings. Differences in GLS &gt; 2% between methods were related to foreshortening or suboptimal delineation of segments on non-contrast recordings.

Conclusion
On a commercially available echocardiography scanner, software developed for GLS measurements on non-enhanced 2D recordings can be also applied to recordings that use UEA. Comparable results are obtained, provided the LV cavity is well delineated and not foreshortened. Abstract Figure 1
Early improvement of cardiac performance after atrial fibrillation direct current cardioversion
Authors: Colombo C , Degiovanni A , Ghiglieno C , Maulini GM , Patti G 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Atrial fibrillation (AF) is the most common arrhythmia and one of the most prevalent cardiac disease. Restoring sinus rhythm improves long-term systolic and diastolic function, quality of life and relieve symptoms in patients with symptomatic AF.

Purpose
The aim of the study was to evaluate the early effects of AF direct current cardioversion on myocardial deformation using speckle-tracking echocardiography.

Methods
51 patients with persistent AF who underwent successful direct current cardioversion were enrolled (age: 70 ± 9 years; men: 72.5%). Patients with ischemic, dilatative, hypertrophic cardiomyopaties, valvular heart disease, previous cardiac interventions were excluded from the study. Left ventricular ejection fraction was 55.2 ± 7.0%. A transthoracic echocardiography was performed one day before the successful cardioversion and 6 hours after, employing 2d standard echocardiography and speckle-tracking technique to evaluate left atrial, left ventricular and free-wall right ventricular longitudinal strain.

Results
Restoration of sinus rhythm led to a reduction of the heart rate (83 ± 14 vs 70 ± 13 bpm, p &lt; 0.001). After about six hours from successful AF direct current cardioversion, we highlighted an increase in left ventricular filling pressure estimated with the ratio E/E’ (8.19 ± 0.29 vs 9.34 ± 0.41, p = 0.0016). A significant increase in left atrial longitudinal strain (10.47 ± 0.64% vs 19.76 ± 1.01%, p &lt; 0.001, Figure A) and in left ventricular longitudinal strain (-13.10 ± 0.60% vs -15.86 ± 0.51%, p &lt; 0.001, Figure C) were noticed; also the free wall right ventricular longitudinal strain increased (-12.06 ± 1.16% vs -15.86 ± 1.29%, p = 0.047, Figure B).

Conclusion
Restoring sinus rhythm improves cardiac performance as evidenced by the increase in either left atrial and bi-ventricular longitudinal strain, suggesting an amelioration even if after early time. Abstract Figure
Using parameters of myocardial deformation as markers of pathological postinfarction remodeling
Authors: Oleinikov V , Golubeva A , Galimskaya V , Babina A , Burko N 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Objective
to predict pathological left ventricular (LV) remodeling using global parameters of strain and twisting.

Methods
the study included 114 people with primary ST-segment elevation myocardial infarction (STEMI): 14 women and 100 males aged 32 to 67 years (52.3 ± 8.4). STEMI has been confirmed by ECG data, cardiospecific biomarkers (troponin T, CPK-MB) and coronary angiography - the presence of one infarct-related coronary artery in the absence of hemodynamically significant stenosis of other arteries. Echocardiography has been performed using a MyLab ultrasound scanner (Italy) on the 7th-9th day, 3rd, 6th and 12th months after the disease onset with the evaluation of standard parameters. On the 7th-9th days the parameters of global longitudinal (GLS,%), circumferential (GCS,%) strain, and LV twisting (Twist, °) have been analyzed using the X-Strain ™ software. The criterion for pathological LV remodeling has been considered to be an increase in EDVi ≥ 20% compared with the initial value. Prediction of pathological remodeling has been performed using ROC analysis by 3 criteria. To assess the quality of the model, the area under the curve (AUR –Area under ROC) has been determined with the calculation of 95% confidence intervals and the statistical significance of the point estimate of the area.

Results
Within 48 weeks pathological remodeling was developed in 45 (39.5%) patients. Three months after the index event, LV remodeling was detected in 24 (53.3%) patients of these 45; after 6 months - in another 15 (33.3%); after 12 months - in another 6 (13.4%). GLS - 11.7% with 96% sensitivity and 80% specificity, AUR 0.750 (95% CI 0.659 - 0.841), GCS - 12.4% with test sensitivity and specificity - 90% and 82%, respectively ((AUR 0.641 ( 95% CI 0.534 - 0.749)), Twist - 7.8 ° with a sensitivity of 93% and a specificity of 78%, AUR 0.657 (95% CI 0.558 - 0.757) predict the development of pathological postinfarction LV remodeling on the 7th-9th day. For all models the value of p ≤ 0.001.

Conclusion
Previously, LV remodeling has developed within 3 months after STEMI in 45 (39.5%) patients. The longitudinal strain, measured in the acute period of STEMI, has the greatest predictive ability in relation to the development of pathological postinfarction LV remodeling.
Correlation relationships of myocardial work indices with left ventricular ejection fraction and postsystolic strain index in healthy individuals
Authors: Babina A , Galimskaya V , Golubeva A , Korenkova K , Burko N , Oleinikov V 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Purpose
to identify correlations between the indicators of the global work of the left ventricular (LV) myocardium with the ejection fraction (EF) and the post-systolic contraction index (iPSI) in healthy individuals.

Methods
the study included 70 healthy people: 34 men and 36 women aged 21 to 61 years (mean age 39.3 ± 8.9 years). Inclusion criteria: absence of complaints, anamnestic and physical data indicating the presence of cardiovascular diseases and / or damage to other organs and systems; ECG without significant changes; lack of regular intake of any medications. Exclusion criteria: diseases of the cardiovascular system, respiratory system, kidney, liver; type 1 and 2 diabetes mellitus; chest trauma; BMI&gt; 30 kg / m2; poor visualization of the echogram. Echocardiography was performed on a Vivid GE 95 Healthcare scanner (USA). EchoPAC software version 202 (GE Healthcare) has been used. LVEF has been determined by the Simpson biplane method. The index of global myocardial work (GWI, mmHg%), global constructive work (GCW, mmHg%), global wasted work (GWW, mmHg%), global work efficiency have been assessed in automatic mode. (GWE,%). The iPSS and the number of segments, the PSS index of which was more than 1, have been automatically determined. Spearman"s correlation coefficient (r) has been used to study the relationship between quantitative traits.

Results
indicators of global myocardial work had the following values: GWE - 97.5 (97; 98)%; GWI - 2062.6 ± 345.5 mm Hg%; GCW - 2353.3 ± 344.6 mm Hg%; GWW - 45 (32; 68) mm Hg%. LVEF on average 60.8 ± 4.6%, iPSS - 1.35 (0.73; 2.35). The average number of segments with iPSS&gt; 1 - 4 (3; 6) (26.5%). The correlation coefficient of LVEF with GCW was 0.49 (p = 0.00001), with GWI - 0.45 (p = 0.00007), with GWE - 0.25 (p = 0.032), with GWW - (-0 , 19) (p = 0.1). Correlation coefficient of iPSS with indicators of myocardial work: with GWE - (-0.85) (p = 0.0007), with GWW - 0.85 (p = 0.00004), with GCW - (-0.05) (p = 0.68), with GWI - 0.07 (p = 0.5). When determining the relationship between the number of segments with iPSS&gt; 1 and GWE, the correlation coefficient was 0.46 (p = 0.0002), with GWW - 0.57 (p = 0.0003), with GWI - 0.26 (p = 0 , 03), with GCW - 0.12 (p = 0.3).

Conclusions
GCW and GWI had moderate positive correlations with LVEF. GWE and GWW had a strong relationship with iPSS and moderate correlations with the number of segments with iPSS&gt; 1.
Total atrial conduction time and its relationship with morphological & functional characteristics in hypertrophic cardiomyopathy
Authors: Pagourelias E , Boulmpou A , Alexandridis G , Tsarouchas A , Mouselimis D , Bakogiannis K , Karamanolis A , Vergopoulos S , Tsavousoglou C , Antoniadis A , Fragakis N , Papadopoulos CE , Vassilikos V 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Total atrial conduction time (TACT), estimated by tissue Doppler imaging (TDI), is an index reflecting left atrial (LA) structural and electrical remodeling, connected to atrial fibrillation (AF) development and heart failure progression in various substrates. In hypertrophic cardiomyopathy (HCM), the significance of TACT beyond AF and its determinants are not fully investigated.

Purpose
Aim of this study was to estimate TACT in a cohort of HCM patients without AF history and to examine its relationship with other parameters of atrial myopathy, such as LA volume index (LAVI) or LA reservoir strain (LARS). Additionally, to investigate TACT correlation with other phenotypic and functional characteristics of HCM.

Methods
We included 50 HCM patients (60 ± 16 years, 80% male, maximum wall thickness 18.6 ± 4.1mm) without history of AF who have consecutively undergone 2D-speckle tracking echocardiography and cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE). TACT was measured from the onset P wave on electrocardiogram to the peak A’ wave of the lateral LA wall using TDI (left panel). Burden of fibrosis (percentage of LV mass) was defined by LGE extent (&gt;5 standard deviations compared to nulled myocardium) in CMR slices. Cut-off points for TACT, LAVI and LARS were adopted by literature (≥115 msec, ≥34 mL/m2 and &lt;21.3 % respectively).

Results
All HCM patients had preserved EF (61.8 ± 8%), while 13 (26%) presented outflow tract obstruction and 4 (8%) diastolic dysfunction stage≥2. LGE was observed in 32 patients (64%) occupying 7.2 ± 5% of left ventricular (LV) mass. Mean TACT was 139.9 ± 22 msec, with LAVI being 30.8 ± 16.1 mL/m2 and LARS 27.6 ± 13.9%. After assessing prevalence of atrial myopathy parameters, 41 patients (82%) presented a prolonged (≥115 msec) TACT with only 13 of them having also a significantly dilated LA (≥34 mL/m2) and 16 an impaired LARS. Among HCM demographic, phenotypic and functional characteristics tested, age and LV mass index were found to be the only independent regressors of TACT (r = 0.54, p &lt; 0.0005 and r = 0.44, p = 0.002 respectively, right panels). On the contrary, no significant correlation was established between TACT and traditional diastolic dysfunction indices such as E/E’ or fibrosis extent.

Conclusions
Atrial electro-mechanical delay assessed through TDI based TACT, is very frequent among HCM patients irrespective of AF and even before LA dilatation and LA strain impairment. Age and hypertrophy magnitude are the main determinants of TACT, the prognostic significance of which remains to be further elucidated. Abstract Figure.