bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two-dimensional echocardiographic scoring system of the left ventricular filling pressure and clinical outcomes in heart failure with preserved ejection fraction
Authors: Murayama M , Iwano H , Obokata M , Harada T , Omote K , Tsujinaga S , Chiba Y , Ishizaka S , Motoi K , Nakabachi M , Nishino H , Yokoyama S , Nishida M , Kurabayashi M , Anzai T 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Japan Society for the Promotion of Science (JSPS)

Introduction
Elevated left ventricular (LV) filling pressure in non-decompensated state is a powerful indicator of worse clinical outcomes in heart failure regardless of LV ejection fraction. However, its detection is often challenging in heart failure with preserved ejection fraction (HFpEF).

Purpose
This study aimed to elucidate the predictive value of recently proposed echocardiographic parameter of LV filling pressure, Visually assessed time difference between the Mitral valve and Tricuspid valve opening (VMT) score in HFpEF.

Methods
We retrospectively analyzed 310 well-differentiated HFpEF patients in stable conditions. Using two-dimensional echocardiographic images, time sequence of opening of mitral valve and tricuspid valve was visually assessed in the apical four-chamber view and scored to 0 to 2 (0: tricuspid valve first, 1: simultaneous, 2: mitral valve first). When the inferior vena cava diameter was dilated, 1 point was added and VMT score was calculated as four grades from 0 to 3. Based on the previous study, VMT≥2 was regarded as a sign of elevated LV filling pressure (Figure 1). LV diastolic function was graded according to the guidelines. The primary endpoint was defined as a composite of cardiac death and heart failure hospitalisation during the two years after echocardiographic examination.

Results
During the follow-up period, 55 events (18%) occurred, including four cardiac deaths and 51 heart failure hospitalisations. Kaplan-Meier curves demonstrated that VMT≥2 (n = 54) was associated with worse outcomes compared to patients showing VMT ≤ 1 (n = 256) (log-rank test P &lt;0.001). Furthermore, VMT≥2 was associated with worse outcomes when tested in 100 HFpEF patients with atrial fibrillation (log-rank test P = 0.026) (Figure 2). In the adjusted model including age, systolic blood pressure, serum albumin level, and the LV diastolic function grading, VMT≥2 was independently associated with the primary outcome (hazard ratio: 2.23; 95% confidence interval: 1.17 to 4.24, P = 0.014). Additionally, the nested regression model showed that VMT scoring provided an incremental prognostic value over clinically relevant variables (age, sex, the plasma brain natriuretic peptide level, atrial fibrillation) and LV diastolic function grading (chi-square 10.8 vs 16.3, P = 0.035).

Conclusions
In patients with HFpEF, the VMT score was independently and incrementally associated with adverse clinical outcomes. Moreover, it discriminated worse clinical outcome even in HFpEF patients with atrial fibrillation. Abstract Figure. VMT scoring Abstract Figure. Kaplan-Meier analysis
Evaluation of cardiac function by two-dimensional speckle tracking echocardiography in uncomplicated COVID-19 survivors
Authors: Akbulut M , Tan TS , Gerede DM , Kozluca V , Dincer I 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
5COVID-19 is a multi-systemic infectious disease. Nearly 20-30% of hospitalized patients have evidence of acute myocardial involvement, portending a poorer prognosis. However, not much is known about the long-term cardiac effects of the disease. Also, there is a growing concern about the cardiac sequelae of COVID-19 among survivors. In this study, we aimed to investigate the long-term cardiac effects in patients with prior mild-moderate COVID-19 infection, using both conventional and speckle tracking echocardiographic imaging modalities. A total number of 58 patients who have been diagnosed with COVID-19 within the previous six months and 20 age-, sex- and risk factor-matched healthy adults were included. All patients underwent a comprehensive echocardiographic examination. Both conventional and two-dimensional speckle tracking echocardiographic measurements were done. Also, serum cardiac biomarkers were obtained on the day of echocardiographic examination. Compared with healthy controls, COVID-19 survivors had similar left and right ventricular systolic function at six months. Also, left and right atrial peak systolic strain values did not differ between the groups. Long-term cardiac sequelae of COVID-19 infection are still widely unknown, resulting in concern among survivors. This study is valuable in putting forth the unaffected systolic and diastolic myocardial function on long-term in uncomplicated COVID-19 cases and may decrease the survivors’ anxiety and the number of unnecessary applications to cardiology clinics. Abstract Figure. Left ventricle strain analysis Abstract Figure. Right ventricle strain analysis
Left atrial function in patients with heart failure with mid-range and preserved ejection fraction
Authors: Stevanovic A , Stankovic I , Ilic Pasquali N 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction Little is known about the left atrial (LA) function in patients with heart failure with mid-range and preserved ejection fraction (EF). We explored LA function in patients with heart failure with mid-range ejection fraction (HFmrEF) and compared to that in patients heart failure with preserved ejection fraction (HFpEF).

Methods
A total of 66 HF patients (35 HFpEF and 31 HFmrEF) were included in the study. Left venticular EF, global longitudinal strain (GLS) and the mitral E/e" ratio were measured in all patients. LA function was assesed by measuring phasic changes in LA volume - maximal LA volume, pre-atrial contraction volume and minimal LA volume. All volumes were indexed to body surface area before calculating the indices of LA function: LA total emtying fraction (reservoir function), LA passive emptying fraction (conduit function) and LA active emptying fraction (pump function).
Peak LA strain during ventricular systole (S-LAs) and peak LA strain during atrial systole (S-LAa) were measured also as LA functional parameters (reservoir and pump function). Conduit function of LA was derived as difference of S-LAs and S-LAa.
LA deformation was also assessed by strain rate at different phases of the cardiac cycle. Strain rate analysis was used to measure peak LA strain rate during ventricular systole (SR-LAs), during early LV filling (SR-LAe) and during atrial contraction (SR-LAa).

Results
There were no significant differences in GLS and the mitral E/e’ between patients with HFmrEF and HFpEF (p &gt; 0.05 for all). Significantly lower values of LA total emptyng fraction (47.6 ± 13.0 vs 38.9 ± 11.8, p = 0.006), LA passive emptyng fraction (26.6 ± 13,2 vs 20.9 ± 9.4, p = 0.049) and LA active emptyng fraction (33.0 ± 10.0 vs. 26.0 ± 9.7, p = 0.005) were observed in HFmrEF tham HFpEF patients, respectively.
Significantly lower values of S-LAs (27,3 ± 5,8 vs 22,3 ± 8,0, p = 0,004), S-LAa (12,8 ± 4,0 vs 10,3 ± 3,7, p = 0,01) (Figure 1), SR-LAs (1,40 ± 0,42 vs 1,18 ± 0,43, p = 0,045), SR-Lae (-1,47 ± 0,56 vs -1,13 ± 0,51, p = 0,012) and SR-LAa (-1,90 ± 0,50 vs -1,64 ± 0,55, p = 0,044) were obtained in group of HFmrEF patients.

Conclusions
All components of left atrial function were worse in patients with HFmrEF than in those with HFpEF, despite similar GLS and mitral E/e" ratio. Clinical and prognostic implications of these observations warrant futher research. Abstract Figure.
Left ventricular myocardial work indices and invasive measurement of stroke work: a correlation study
Authors: Landra F , Chiantini B , Mandoli GE , Barilli M , Merello G , De Carli G , Sciaccaluga C , Lisi M , D" Ascenzi F , Fineschi M , Iadanza A , Bernazzali S , Valente S , Cameli M 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

BACKGROUND
A novel echocardiographic method allows to non-invasively assess myocardial work using pressure-strain loops. Even though left ventricular myocardial work has already emerged as a promising prognostic tool for various pathological conditions, its relationship with invasively-derived corresponding indices has not been assessed in humans yet.

PURPOSE
This study aimed to explore the correlation between left ventricular myocardial work (LVMW) indices and invasively-derived left ventricular stroke work index (LVSWI) in a cohort of patients with advanced heart failure (HF) considered for heart transplantation.

METHODS
All consecutive patients with advanced heart failure considered for heart transplantation from 2016 to 2021 that had already performed right heart catheterization (RHC) as part of the workup and with an available echocardiographic exam were included (n = 91). Myocardial work analysis was performed in 44 patients, according to exclusion criteria. Conventional LV functional parameters and LVMW indices, including LV global work index (LVGWI), LV global constructive work (LVGCW), LV global wasted work (LVGWW), LV global work efficiency (LVGWE) and other were calculated and compared with invasively measured LV stroke work index (LVSWI).

RESULTS
Median time between RHC and echocardiography was 0 months [interquartile range (IQR): 0 – 1]. Median age was 60 years (IQR: 54 – 63). For the most part, etiology of HF was non-ischemic (61.4%) and all patients were either on class NYHA II (61.4%) or III (27.3%). Median left ventricular ejection fraction was 25% (IQR: 22.3 – 32.3), median NT-proBNP 1377 pg/mL (IQR: 646 – 2570). Among conventional parameters of LV function, LV global longitudinal strain (LVGLS) significantly correlated with LVSWI (r = - 0.337; p = 0.031), whereas LVEF did not (r = 0.308; p = 0.050). With regard to LVMW indices, some of them demonstrated correlation with LVSWI, particularly LVGWI (r = 0.425; p = 0.006), LVGCW (r = 0.506; p = 0.001), LV global positive work (LVGPW; r = 0.464; p = 0.003) and LV global systolic constructive work (LVGSCW; r = 0.471; p = 0.002).

CONCLUSIONS
Among left ventricular myocardial work indices, LVGCW correlated better with invasively-derived stroke work, thus representing a powerful and reliable tool for a more comprehensive evaluation of myocardial function. Abstract Figure. Study flow chart Abstract Figure. Correlation results
Pathophysiological alterations of left ventricular myocardial systolic function during normal pregnancy assessed by speckle tracking echocardiography: a prospective cohort echocardiography study
Authors: Tryfou E , Kostakou P , Kostopoulos V , Mahairiotis C , Mihas K , Olympios C , Paraskevaidis I , Kouris N 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Pregnancy induces a variety of haemodynamic and morphological changes, leading to the amplification of cardiac pumping function. These changes do not cause any significant left ventricular (LV) dysfunction by using conventional echocardiographic indices, but it is not fully elucidated whether subclinical or/and reversible myocardial dysfunction is provoked during pregnancy. Two-dimensional speckle tracking echocardiography (2D-STE) can detect subclinical myocardial dysfunction even when conventional echocardiography reveal LV normal ejection fraction (LVEF).Purpose: The aim of this study was to evaluate whether LV systolic performance is impaired during normal low risk pregnancy by using both conventional 2D and 3D echo indices and 2D-STE. Materials and methods: One hundred and twelve consecutive pregnant women without any history of heart disease were prospectively recruited. They underwent serial echocardiographic evaluation in each pregnancy trimester (1st: 8th-12th week, 2nd: 22th-26th week, 3rd: 32-36th week) and 6 months after delivery (time indicated as 4). LV dimensions, relative wall thickness (RWT), 2D-LVEF, 3D-LVEF, systolic S wave from Tissue Doppler Imaging, LV global longitudinal strain (LVGLS), LV global circumferential strain (LVGCS) and LV-twist were measured and compared to 31 nulliparous women of similar age, who served as a control group (c).Results: Progressive eccentric LV hypertrophy was observed during pregnancy, which was subsided postpartum (p1-2 = 0.08, p2-3= 0.002, p3-4 = 0.001, p1-3 &lt; 0.001, p1-4= 0.789), while no significant change in LV dimensions was found. 2D-LVEF, 3D-LVEF and S wave values were not significantly different among the three trimesters, postpartum and controls. LVGLS progressively decreased during pregnancy (1st:-21.71 ± 2.13%, 2nd: -21.20 ± 2.30%, 3rd: -19.82 ± 2.10%,4th: -21.81 ± 2.05%, c: -21.71 ± 2.2[E1]%,overall p &lt; 0,001 ) and returned to normal during puerperium. No significant difference was noted in LVGCS (1st: -18.08 ± 5.54%, 2nd: -18.57 ± 3.41%, 3rd: -18.20 ± 3.33%,4th: -17.95 ± 3.39%,c: -18.8 ± 2.2% , p &gt; 0.3). LV-Twist was significantly higher in the 1st trimester compared to controls (p= 0.04) and remained constantly high during the rest of the pregnancy and puerperium (1st:13.80 ± 5.09°, 2nd :13.46 ± 5.35°, 3rd:13.58 ± 4.32°, 4th:13.37 ± 4.26°, c: 11.5 ± 4.3°, ).Conclusion: Left ventricular subclinical dysfunction seems to occur in the longitudinal axis even in low risk individuals with normal pregnancy. Increased torsional movement of the heart seems to counterbalance the temporal impairment of longitudinal systolic function.
A check of the grading system among the 2009 and 2016 EACVI/ASE left ventricular diastolic function guidelines statistically and invasively
Authors: Barakat A , Alsaadi A,R 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): Al-mouwasat University Hospital and University Heart Surgery Center in Damascus, Syrian Arab Republic.

Background
Left ventricular diastolic function assessment undergoes continuous updates. EACVI/ASE 2016 guidelines handles with this case, which is an expert consensus and simplified update of the 2009 recommendations. As stated in the latest guidelines, studies need to check that the simplicity does not affect much the accuracy.

Aim
This study compares the corresponding subgroups between the 2009 and 2016 EACVI/ASE guidelines, for the assessment of left ventricular diastolic function statistically. Furthermore, it invasively validates of the relation between the grading results of each guidelines and the measured LV filling pressure during catheterization lab.

Methods
124 patients underwent transthoracic echocardiography just before angiography. A trained echo cardiographer obtained E/A mitral flow, Av E/e", LAVI, TR, septal and lateral e" and other supportive parameters to assess LV diastolic function and filling pressure according to 2009 and 2016 EACVI/ASE guidelines algorithms and we compared the results with LV pre-a wave during catheterization with a cut-off &gt;12mmhg considered elevated.

Results
EACVI/ASE 2016 resulted in {normal (46.77%), Grade I (29.03%), Grade II (10.48%), Grade III (7.26%) and indeterminate (6.45%)}, while EACVI/ASE 2009 resulted in {normal (39.52%), Grade I (25%), Grade II (13.71%), Grade III (7.26%) and indeterminate (14.52%)} with no statically significant difference between subgroups. EACVI/ASE 2016 vs. 2009 in assessment LV filling pressure (odds ratio =0.51 and p value = 0.034. EACVI/ASE 2016 sensitivity and specificity were (0.36, 0.94 ) respectively and EACVI/ASE 2009 sensitivity and specificity were (0.63, 0.80) respectively. All results are summarized in (tables: 1 + 2+3 + 4+5 + 6).

Conclusion
This study found that the updated and simplified 2016 EACVI/ASE guidelines algorithm did not affect statistically the grading results of 2009 EACVI/ASE. Even more, 2016 had a higher relation between diastolic subgroups and invasively measured LV filling pressure which reflects the higher specificity than 2009. On the other hand 2016 was less able to detect elevated LV filling pressure which reflects a lower sensitivity than 2009. 2016 was more specific but less sensitive than 2009. There were no statistically significant difference between the means of invasively measured LV filling pressures among both guidelines. Abstract Figure. Abstract Figure.
Endogenous Cushings syndrome is associated with impaired myocardial work efficiency
Authors: Sahiti F , Morbach C , Ehrlich K , Detomas M , Kroiss M , Lengenfelder B , Gelbrich G , Frantz S , Fassnacht M , Heuschmann PU , Hahner S , Stoerk S , Deutschbein T 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): German Ministry of Research and Education within the Comprehensive Heart Failure Center, Würzburg

OnBehalf
STAAB Cohort Study and CV-CORT-EX Study

Background
Endogenous Cushing’s syndrome (CS) is associated with increased cardiovascular morbidity and mortality. Long-term remission (LTR) after successful treatment is considered to positively affect the cardiovascular system including the heart. Left ventricular (LV) myocardial work (MyW) based on pressure-strain loops is a novel tool to non-invasively assess LV performance and is considered less load-dependent than LV ejection fraction (LVEF) and global longitudinal strain (GLS). We analyzed LV function in patients with overt CS and CS in LTR in comparison to healthy individuals derived from a local population-based cohort.
Methods/Results: In a cross-sectional analysis, we compared n = 31 comprehensively characterized patients with overt CS (mean age 48 ± 12 years, 71% women) and 49 patients with CS in LTR (53 ± 12 years, 77% women) with a control group who underwent transthoracic echocardiography. As control group, we analyzed a population-based sample of apparently healthy individuals (in sinus rhythm, free from CV risk factors, and no significant valve disease) from a population-based cohort: n = 439, 49 ± 11 years, 56% women. MyW assessment was performed off-line using EchoPAC (GE, version 202).
Systolic and diastolic blood pressure, HbA1c, and body mass index were significantly higher in patients with either overt CS or CS in LTR when compared to healthy participants (without significant differences between both patient groups). LVEF was equal between all three groups, but GLS was significantly lower in healthy participants and tended to be lower in LTR when compared to patients with CS. Global work index was equal between all three groups, but global wasted work was significantly higher in CS patients when compared to healthy participants, resulting in lower global work efficiency (Table).

Conclusion
In contrast to LVEF as established parameter of cardiac function, myocardial work analysis revealed functional alterations in patients with current and previous cortisol excess when compared to healthy individuals derived from a population-based sample. CS patients´ hearts appear to perform larger amounts of wasted work even during long-term remission. Abstract Figure.
Right ventricle function before and after different types of cardiac surgery
Authors: Zagatina A , Kim G , Kappushev R , Pyagay V , Shmatov D 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Right ventricular (RV) dysfunction is an established independent predictor for adverse prognosis in a heterogeneous group of cardiac surgery patients (pts). However, there is lack of information about normal and abnormal dynamics of echocardiographic parameters for different types of cardiac surgery.
The aim of the study was to define changes in RV parameters after cardiac surgery.

Methods
sixty-five pts (39 men, 62 ± 9 years old) were selected into prospective study (NCT03953755). There were the groups of pts with left-sided valves surgery with/ without tricuspid valve (TV) repair, and pts with left-sided coronary artery bypass surgery without lesions of right coronary artery were included control group. A transthoracic echocardiography assessment before and an average of 101 days (88-115) following the operation was performed. Tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), strain of the RV free wall (SRV), and right atrial volume were assessed in groups of patients with and without tricuspid valve repair as in CABG-group. Follow-up during 12 months was available in all pts.

Results
Valve repair for secondary tricuspid regurgitation was performed in nineteen patients undergoing left-sided valve surgery. Thirty-six patients had repair and/or replacement of left-sided valves without a tricuspid valve operation. There was a strong correlation between TAPSE, FAC, and RV strain before the operation (R = 0.61-0.67, p &lt; 0.000001). However, there was no correlation between TAPSE and FAC; TAPSE, and RV strain after the operation. TAPSE and RV strain significantly decreased after the operations and were below the normal range in both the groups with valve surgery, whereas, the CABG group showed only significantly TAPSE decreasing, RV strain was unchanged. TAPSE was 20 ± 5mm vs. 13 ± 2 mm, p &lt; 0.0003 for the group which underwent tricuspid valve repair; 22 ± 4mm vs. 14 ± 4 mm, p &lt; 0.0000001 for the group with tricuspid valves which were not operated on; 25 ± 6mm vs. 16 ± 3 mm, p &lt; 0.009 for CABG group. There was no difference in TAPSE and SRV ranges among patients with and without tricuspid valve repair. Dynamics in SRV didn’t correlate with patients’ clinical status or with normalized right chambers volumes. An increase in FAC correlated with a decrease in right chamber sizes after operations (R=-0.46, p &lt; 0.03). More prominent decreasing in TAPSE was connected in adverse events during follow-up (dTAPSE 6.7 ± 3.5 mm vs. 12.7 ± 5.1 mm, p &lt; 0.02)

Conclusion
TAPSE significantly decreases in all patients after CABG or valve cardiac operations with/without tricuspid valve repair, range of TAPSE were below normal standard in all patients. However more severe decreasing in TAPSE is connected with further adverse outcomes.