bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the global work of the myocardium in myocardial infarction with ST segment elevation of various localization
Authors: Oleinikov V , Golubeva A , Golubeva A , Babina A , Babina A , Galimskaya V , Galimskaya V , Burko N , Burko N , Donetskaya N , Donetskaya N , Korenkova K , Korenkova K 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Purpose
To assess the degree of impairment of the global myocardial function of the left ventricle in different localization of myocardial infarction with ST segment elevation (STEMI) using speckle tracking echocardiography.

Methods
The study included 45 patients with primary STEMI aged 38 to 66 years (52.3 ± 7.4). Myocardial infarction was confirmed by ECG data, biomarkers (troponin T, CPK-MB) and by the results of coronary angiography with the presence of one infarct-related coronary artery in the absence of hemodynamically significant stenosis of other arteries. Echocardiography has been performed 7-9 days after STEMI on a Vivid GE 95 Healthcare ultrasound scanner (USA) using EchoPAC software version 202 (GE Healthcare). In the automatic mode, the indicators of myocardial work have been calculated: the index of global myocardial work (GWI, mm Hg%.), Global constructive work (GCW, mm Hg.%.), 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
Taking into account the localization of STEMI on the 7th-9th day, patients were divided into two groups: group 1, which included 29 patients (64.4%) with lesions of the anterior LV wall (LAD), group 2 - 16 patients (35, 6%) with LV posterior wall infarction (RCA and CA). The comparison of the indices of global myocardial work in the two groups, has found that the GWI in group 1 was 1219 [95% CI 1053.1; 1384.9] mm Hg%, in group 2 - 1550.8 [95% CI 1371.6; 1730] mm Hg%, (p = 0.02). The GWE parameter in group 1 was 88.2 [95% CI 85.5; 90.9]%, in group 2 - 94.3 [95% CI 92; 96.6]%, (p = 0.01). The GСW index had the following values: in group 1 - 1383 [95% CI 1205.1; 1560.9] mm Hg%, in group 2 - 1805.5 [95% CI 1576.2; 2034.8] mm Hg%, (p = 0.01). GWW in group 1 was 152.8 [95% CI 94.3; 211.3] mm Hg%, in group 1b - 73.3 [95% CI 47.6; 99.0] mm Hg%, (p = 0.02).

Conclusion
Thus, the localization of STEMI is reflected in the indicators of myocardial function. LV anterior wall infarction has lower GWI, GWE, and GCW values and higher GWW values than posterior wall infarction.
The prognostic value of left atrial strain in patients with end stage renal disease on dialysis
Authors: Tsartsalis D , Kakiouzi V , Aggeli C , Giannou P , Karabela M , Petras D , Dimitroglou Y , Politarxou K , Raftopoulos L , Angelis A , Kastellanos S , Kalompatsou A , Xristofi A , Tousoulis D , Tsioufis K 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Chronic kidney disease (CKD) is associated with higher incidence of cardiovascular death especially as the disease progresses and the patients undergo long term dialysis treatment (1). Left ventricular (LV) dysfunction evaluated by cardiac deformation measurements with speckle tracking echocardiography seems to have an important prognostic role in several different specific populations (2-4).

Purpose
Τhe prognostic value of strain analysis measurements, including the novel diastolic parameters such as left atrial (LA) strain, in patients with end-stage renal disease on dialysis (stage 5 CKD).

Methods
67 patients (mean age 62.3 ± 11.8, 65.7% men) with stage 5 CKD (45 on hemodialysis and 22 on peritoneal dialysis) were enrolled in the study protocol. The mean duration of dialysis was 102.48 ± 84.98 months. Patients were submitted to a transthoracic echocardiogram at rest and dobutamine stress contrast echo (DSCE) protocol. Mean follow-up lasted five years.

Results
The majority of the study population had normal or mildly impaired systolic function with a mean LV ejection fraction 49.17% (±10.41) while 70% of the patients had impaired LV global longitudinal strain, (mean 14.35%, ±4.49). Regarding LA strain parameters the mean LA reservoir, LA conduit, and LA contractile reserve were 24.11%(±12.61), 10.56% (±5.88) and 13.60% (±9.15) respectively. Thus 50% of the population had impaired LA strain. DSCE was positive for ischemia in 55.7%. The 5-year cumulative event-free survival was 58.2% (±6.7), while 30% of major events happened during the first 2 years after DSCE (see Figure). Logistic regression analysis showed that of the various echocardiographic parameters LV ejection fraction, LV global longitudinal strain, and the conduit phase of LA strain were significantly associated with DSCE result and total prognosis (p = 0.009, p = 0.007, p = 0.05, and p = 0.005, p = 0.049, p = 0.043, respectively). The conduit element of LA strain notably was the strongest predictor among them(OR = 0.76 p = 0.05 and OR = 0.72 p = 0.043, respectively).

Conclusion
Left ventricular diastolic dysfunction is an important prognostic factor among patients with advanced CKD under long-term dialysis. The novel echocardiographic parameters such as LA strain couldadd valuable information to the overall cardiac evaluation of this specific population. Abstract Figure.
Blood flow vortices adapt their behaviour to the presence of kent accessory pathway
Authors: Borrelli N , Di Salvo G , Ciriello GD , Grimaldi N , Barracano R , Fusco F , Merola A , Correra A , Colonna D , Palma M , Scognamiglio G , Russo MG , Sarubbi B 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Blood speckle imaging (BSI) is a new speckle-tracking-based technique for the evaluation of blood flow. Ventricular flow vortices have been studied in sinus rhythm in normal and dysfunctional hearts, however, data are lacking in patients with Kent accessory pathway (KAP) and short atrio-ventricular (AV) conduction.

Purpose
We aimed to evaluate the characteristics of left ventricle blood vortices in children with KAP.

Methods
Nineteen paediatric patients (age 7 ± 2.9 years) were included in the study: 13 patients with manifest KAP (KAP group) and 6 age and sex -matched controls with normal AV conduction (CTR group). A thorough echocardiographic evaluation with 2D, color doppler and BSI was performed in all the included patients. BSI was recorded in apical 3-chamber view with a 6S-D probe. Vortices characteristic were analysed during filling phase of the left ventricle. We focused on the anterior vortex generated by mitral valve, which persisted longer during the cardiac cycle and is assumed to contribute to optimizing cardiac function. A standard 12-lead ECG was also recorded for each child in KAP group to esteem KAP localization.

Results
According to Arruda criteria for KAP localization, all patients in KAP group manifested the accessory pathway in the septal region. All patients in CTR group presented one major anterior vortex during filling phase, while in KAP group 10 patients out of 13 (p= 0.009) lacked of this main anterior vortex, showing instead fragmented different vortices. There were no differences in term of left ventricle function (KAPg 59.8 ± 4.02% vs CTRg 59.0 ± 2.5%, p= 0.6) and global longitudinal strain (KAPg -18.6 ± 1.0% vs CTRg -19.6 ± 3.1%, p= 0.5) between the two groups.

Conclusion
In our preliminary analysis, in patients with septal KAP, blood vortices adapted their diastolic traces to the septal dyssynchrony showing a fragmented pattern. We speculate this fragmentation may contribute to impair the performance of the left ventricle. Abstract Figure. BSI in control vs patient with WPW
Assessment of left atrial strain reservoir in patients with ischaemic stroke: a case-control study
Authors: Vassaki M , Miaris N , Grigoraki E , Destounis A , Karakosta M , Barmpagiannis D , Kalesi A-E , Mitsiadis S , Katsillis N , Zampelis D , Maritsa D , Yiangou K , Theodosis-Georgilas A , Pisimisis E , Kasinos N 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
Left atrial (LA) function is considered a seperate marker of cardiovascular disease and its assessment with echocardiography strain analysis has been gaining interest lately. The association of LA characteristics with ischaemic stroke has not been fully understood.

Purpose
This is a case-control study aiming to identidy differences in LA reservoir strain between ischaemic stroke patients and healthy controls.

Methods
Consecutive ischaemic stroke patients with preserved left ventricular ejection fraction and sinus rhythm were enrolled in the study. Patients were assessed with 2-dimensional transthoracic echocardiography (apical 4-chamber view) using longitudinal speckle-tracking technique. Non-parametric testing with Mann-Whitney U analysis (new procedure) was carried out to identify differences in the distribution of LA reservoir strain values within the patients group and the controls. A p value of &lt;0.05 was considered statistically significant.

Results
Sixty-six patients (44 males, 22 females) of a mean age of 49.97 years [minimum = 20, maximum = 61, standard deviation (SD)=8.90] were enrolled in the stroke group. The control group included 39 healthy volunteers (27 males, 12 females) of a mean age of 42.23 years (minimum = 19, maximum = 71, SD = 12.77). In the stroke group, the mean LA reservoir strain was 34.24% (minimum = 5.62, maximum = 71.88%, SD = 10.21%) and the median was 34.06%, whereas the mean and median values of control subjects were 42.84% (minimum = 24.20, maximum = 90, SD = 13.87%) and 39.59% respectively. Mann-Whitneu U analysis (new procedure) showed lower LA strain values in the stroke group (mean rank = 45.29, Mann-Whitney U = 778, p = 0.001) compared to controls (mean rank = 66.05).

Conclusion
Our study showed that ischaemic stroke patients on sinus rhythm at presentation had impaired LA reservoir strain compared to healthy adults. The role of speckle-tracking echocardiography in assessing LA function and predicting stroke needs to be further evaluated thorougly.
Figure
Mann-Whitney U testing (new procedure) of left atrial reservoir strain in the stroke group and in healthy controls. Abstract Figure.
Stress echocardiography with regadenoson for the assessment of perioperative cardiovascular risk in non-cardiac surgery
Authors: Fernandez Galindo M , Romero-Castro MJ , Garcia Robles JA , Anmad Shihadeh Musa LA , Fernandez Herrero I , Priego Rodenas A , Sanchez Sanchez V , Jimenez Lopez-Guarch MC , Corros Vicente C , Carbonell San Roman A , Arribas Ynsaurriaga F , Solis J 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
The most commonly used drug in pharmacological stress echocardiography (SE) for perioperative cardiovascular (CV) risk assessment is dobutamine. Its arrhythmogenic potential and the unpredictable hypertensive response in patients with vascular pathology, makes us often resort to other less accessible and more expensive techniques such as Cardio-MRI or SPECT. Regadenoson is emerging as a safe drug in the detection of myocardial ischemia, although its use has not yet been validated in SE.

Purpose
The objective is to assess the short-medium term prognosis in patients undergoing high-risk noncardiac surgery who undergo SE with regadenoson.

Methods
A unicentric retrospective observational study. We included a subgroup of 58 patients referred for detection of ischemia prior to high-risk noncardiac surgery who underwent SE with regadenoson during the years 2017-2020. No patient has had cardiological symptoms. The test was considered positive if it presented at least one of the following: wall motion abnormalities, electrocardiographic and/or clinical changes compatible with ischemia. Patients were followed up in the immediate postoperative period (30 days), at 12 months and at 24 months, considering the presence of CV events such as admission for heart failure (HF), chest pain, acute myocardial infarction (AMI) or CV death. It was compared the group with negative (NG) and the group with positive (PG) results.

Results
97% of the patients underwent vascular high-risk noncardiac surgery, 3% underwent other surgeries such as kidney transplantation or lung surgery considered high risk in the preanesthetic assessment. Twelve studies (21%) were positive and of these, only 2 patients underwent coronary artery bypass prior to surgery. The only CV event observed in this period was HF: in the NG 3 episodes were observed compared to 1 in the PG (p = 0.82), only in one of the events for HF was coronary angiography done that did not show coronary artery disease. The time to the NG event was a median of 90 [3-600] days versus 180 days in the PG. The cumulative incidence (CI) of events in the NG in the immediate postoperative period (30 days post-surgery) was 2%, annual 4% and biannual 7%.

Conclusions
A SE test with negative regadenoson prior to high-risk noncardiac surgery presents a low CI of events in the immediate postoperative period and in the short-medium term. Abstract Figure.
Assessment of pulmonary circulation unit during exercise in patients with ankylosing spondilitis and sporiatic arthritis
Authors: Morvai-Illes B , Burcsar SZ , Monoki M , Varga A , Kovacs L , Balog A , Agoston G 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background Ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are chronic multisystem inflammatory disorders that present with articular and extra-articular features. Cardiac dysfunction and pulmonary disease are well-known and commonly reported extra-articular manifestations of AS and PsA. The inflammatory process can induce respiratory complications, including chest wall restriction, significantly impacting patients" cardiorespiratory status.
We aimed to assess pulmonary circulation and right ventricle behaviour during exercise in patients with AS and PsA and to detect the possible effect of chest wall restriction on right heart function.
Methods A total of 45 spondylarthritis patients were enrolled in the study (age 51.5 ± 12.3 years, 82.2% men): 27 of them were diagnosed with AS (20 of them had ankylosis at the time of the study), while 18 had PsA (2 of them in ankylosis). According to a standardized protocol, all subjects underwent resting and exercise stress echocardiography on a semi-recumbent cycle ergometer with an incremental workload up to the maximal tolerated workload. Basic echocardiographic measurements were taken, focusing on the right and left ventricular functions and the systolic pulmonary artery pressure (PASP) at rest, at 50 watts workload, and maximal exercise. During the examination, non-invasive blood pressure measurements, transcutaneous capillary oxygen saturation and continuous ECG recording were performed.
Results PASP did not differ between the AS and PsA patients at rest (15.6 ± 6.7 mmHg vs 13.7 ± 8.3 mmHg; p = ns); however, PASP measured at the maximal workload was significantly higher among AS patients (31.4 ± 15.9mmHg vs 21.6 ± 12.7mmHg; p &lt; 0.05; Figure 1). PASP did not correlate with the age or the time that passed since the diagnosis. Parameters describing the left and right ventricular systolic and diastolic function did not differ significantly between AS and PsA patients at rest and peak stress. Comparing the LV diastolic parameters of ankylosing patients with non-ankylosing patients irrespective of the underlying disease showed significantly different values in peak E/e"ratio (8.9 ± 3 vs 7.4 ± 1.6; p &lt; 0,05; Figure 2).
Conclusion Exercise stress echocardiography is a promising diagnostic modality in autoimmune diseases. In AS patients, the chest wall restriction may results in elevation of PASP during the exercise. The noninvasive indice of left ventricular filling pressure increases significantly in patients with ankylosis in both groups, explaining the effect of the rigid chest wall on the left ventricular filling. Abstract Figure. Abstract Figure.
Inconsistency in LVOT measurement between cardiac computed tomography, magnetic resonance imaging and 3D echocardiography
Authors: Kaly A , Aripov MA 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. As a rule, cardiac computed tomography (CT) and magnetic resonance imaging (MRI) are undertaken in the supine position, and in the majority of cases, the ideal position for echocardiography is the left lateral position with the left arm raised above the head. Changing the position of the body from supine to lateral shifts the apex of the left ventricle by 1.5 cm. At the same time, the base of the heart does not alter its position. We evaluated how altering body position can affect visualization of the left ventricular outflow tract (LVOT).
Aim. The purpose of this study is to examine was whether the changing of body position modifies the shape of LVOT.
Methods. The study enrolled 12 patients, 2 of them had aortic valve stenosis. All these patients underwent 3D echocardiography, for 5 patients cardiac computed tomography with intravenous contrast, and for 7 patients cardiac MRI was undertaken. The LVOT shape was assessed by measuring the long and short diameter and calculating its ratios.
Results. On the lateral positioning of the body, there was not observed any changes in the short diameter of the LVOT by cardiac CT and 3D echocardiography. However, the large diameter of the LVOT by cardiac CT and MRI is 1.27± 0.09 mm. In addition, on the supine position, this ratio was 1.24± 0.08 mm, p &lt; 0.005.
Conclusion. An alteration in the shape of the LVOT, in particular, is due to the large diameter of the LVOT. The large diameter modifies the shape of LVOT without changing its area.
A comparison between left ventricular filling pressure two waves: end-diastolic and pre-a for the correlation with echocardiographic parameters
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, University Heart Surgery Center Damascus, Syrian Arab Republic.

Background
left ventricular (LV) filling pressure has an important prognostic and therapeutic role. Echocardiography plays an essential noninvasive role in its assessment and diagnosis. Checking of the correlation between echo parameters and different LV filling pressure wave invasively measure may add a step forward in its diagnosis, prognosis and treatment.

Purpose
this study invasively measures left end-diastolic pressure (LVEDP) and left ventricular pre-a wave (LV pre-a wave) and validates the correlation of each wave with echo parameters obtained immediately before angiography.

Methods
124 patients who accepted to participate for this study underwent transthoracic echocardiography just before catheterization. E/A, Av E/e", lateral and septal e", TR. LAVI, S/D, AR-A and other parameters were obtained to validate and compare the correlation with LVEDP and LV pre-a wave.

Results
Correlation of different echo parameters with LVEDP and LV pre-a wave are summarized in table.

Conclusion
Among these echo parameters of this study, there was a significant correlation between LVEDP and E, E/A, TR, S velocity, S/D, AR duration, AR-A duration and LVMI. LV pre-a wave had a significant correlation with LAVI, EF, FS, Av E/e", E velocity, A velocity, E/A, TR, S velocity, S/D, AR duration, AR-A duration, LVDd, RWT, LVDs and LVMI. LVEDP correlated more than LV pre-a wave with S velocity, S/D, AR duration, AR-A duration and LVMI. LV pre-a wave correlated more than LVEDP with TR and E velocity. E/A was equally correlated with LVEDP and LV pre-a wave. Abstract Table of results 1 Abstract Table of results 2
Deep learning based classification of left ventricular function from two-dimensional echocardiographic images
Authors: Thorben Gessert N , Oliveira L , Jin L , Wehle S , Prabhu D , Olivier A , De Craene M , Sun D , Waechter I , Eslami P , Mor-Avi V , Lang RM 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Philips Healthcare
Background. Echocardiographic quantification of left ventricular function (LVF) is mainly based on ejection fraction (EF) measurements, which relies on either manual or automated identification of endocardial boundaries followed by calculation of model-based end-systolic and end-diastolic LV volumes. Recent developments in artificial intelligence resulted in computer algorithms that allow fully automated detection of endocardial boundaries and measurement of LV volumes and EF. However, this methodology is prone to errors and inter-measurement variability. We hypothesized that a fully automated deep learning algorithm could be developed, which would accurately classify LVF while avoiding volume and EF measurements. This study was designed to test the accuracy of this approach.
Methods. Deep learning algorithm was developed (Philips Research) based on convolutional neural network (CNN) that uses as input dynamic sequences of apical 2- and 4-chamber echocardiographic views obtained without ultrasound enhancing agents. We used for CNN development a database of clinical DICOM studies: a training set of 14,427 studies with normal LV function and 6,135 abnormal, and a validation set of 2,898 normal and 1,081 abnormal studies, based on Philips IntelliSpace Cardiovascular (ISCV) codes found (defined by cardiologists) in the patients’ reports. The CNN was trained to automatically classify LVF into 3 categories: (1) normal, (2) mildly-to-moderately or moderately reduced, and (3) moderately-to-severely or severely reduced. In the validation set, the automated classifications were compared to those in the patients’ reports as a reference standard. Accuracy of the automated classification was tested using contingency tables, from which sensitivity, specificity, and negative and positive predictive values (NPV, PPV) and overall accuracy were calculated for each category of LVF. Additionally, the area under ROC curve (AUC) was calculated to assess the diagnostic accuracy of the automated classification for each LVF category.
Results. Automated classification of LVF showed high levels of diagnostic accuracy in identifying cases with LVF in all 3 categories, reflected by high AUC values: (1) 0.94, (2) 0.87 and (3) 0.97 (Figure), and overall accuracy of 0.84 (Table).
Conclusions. Deep learning algorithm based on CNN allowed accurate automated classification of LVF, when tested on ∼4,000 clinical studies and compared to ISCV codes found in the patients’ reports. This novel fully-automated methodology may become a useful aid in the interpretation of echocardiographic images by providing the reader with a preliminary assessment of LVF. Abstract Figure.